Significance of ultrasound evaluation of carotid atherosclerotic plaque for diagnosing ischemic cerebrovascular disease

BACKGROUND： Carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular disease.Therefore, the close relationship of carotid atherosclerotic plaque and ischemic cerebrovascular disease, and ultrasound evaluation of carotid atherosclerotic plaque have become the hot spot in studying ischemic cerebrovascular disease.OBJECTIVE： This study was to detect the degree of carotid atherosclerosis of ischemic cerebrovascular disease patients by ultrasonography, and to analyze the situation of carotid atherosclerosis and its relationship with clinic.DESIGN： Clinical randomized concurrent control experiment.SETTING： Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS： Totally 60 outpatients and inpatients with ischemic cerebrovascular disease, 42 males and 18 females, admitted to Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA between January 2006 and December 2006 were involved in the patient group. They met the diagnosis criteria of ischemic cerebrovascular disease constituted by the 4th Cerebrovascular Disease Conference in 1996, and were confirmed to suffer from ischemic cerebrovascular disease by skull CT and MRI. Another 20 subjects who received healthy examination concurrently in the same hospital, 12 males and 8 females, were involved in the control group. Informed consents of detected items were obtained from involved subjects.METHODS： The plaque thickness of mid portion, distal end and crotch of common carotid artery （CCA）,internal carotid artery （ICA）, external carotid artery （ECA） and vertebral artery （VA） of involved subjects,who received health examination was separately detected with color Doppler ultrasonograph （HDI-5000）.Then, total integral of plaque was calculated. The intima-media thickness （IMT） was measured with two-dimensional ultrasonography. The inner diameter stenosis degree of subjects who had plaque was measured. Blood flow parameters were recorded, and stenosis degree and plaque area were calculated. Blood flow volume of bilateral carotid artery and VA was separately measured with ultrasound equipment software,and brain blood flow volume was calculated.MAIN OUTCOME MEASURES： Atherosclerotic degree and blood flow volume of patients of two groups.RESULTS： Sixty patients with ischemic cerebrovascular disease and twenty subjects who received health examination participated in the final analysis. ①The IMT thickness, total plaque score, and total plaque area of patient group was significantly superior to that of control group, respectively（ t=5.216 - 10.158, P 〈 0.05 ）.② There were significant differences in the stenosis degree of CCA, ICA and VA between patient group and control group （t=6.720 - 12.816, P 〈 0.05 ） . ③ The blood flow volume of CCA, ICA, VA and brain of patient group was significantly lower than that of control group, respectively （t=2.872 - 10.860, P 〈 0.05）.CONCLUSION： Ischemic cerebrovascular disease patients have different degrees of changes in atherosclerosis and arterial blood flow.

Hypertrophic cardiomyopathy: Can the noninvasive diagnostic testing identify high risk patients?

Hypertrophic cardiomyopathy(HCM) is the most common cause of sudden cardiac death(SCD) in the young, particularly among athletes. Identifying high risk individuals is very important for SCD prevention. The purpose of this review is to stress that noninvasive diagnostic testing is important for risk assessment. Extreme left ventricular hypertrophy and documented ventricular tachycardia and fibrillation increase the risk of SCD. Fragmented QRS and T wave inversion in multiple leads are more common in high risk patients. Cardiac magnetic resonance imaging provides complete visualization of the left ventricular chamber, allowing precise localization of the distribution of hypertrophy and measurement of wall thickness and cardiac mass. Moreover, with late gadolinium enhancement, patchy myocardial fibrosis within the area of hypertrophy can be detected, which is also helpful in risk stratification. Genetic testing is encouraged in all cases, especially in those with a family history of HCM and SCD.

Online Teaching Practice under the Epidemic Situation of Novel Coronavirus Pneumonia

In the context of preventing and controlling novel coronavirus pneumonia,how to ensure the quality of higher education has become a hot issue of social concern in China.In this article,the problems and challenges are analyzed from teacher,student and technology levels,the teaching pattern of"re-flipped classroom"and the teaching model of"SPOC+MOOC+live broadcast"are proposed,the three teaching methods of PBL,OBE and mind mapping are integrated,the teaching evaluation is introduced to teaching design,and finally,the implementation suggestions are put forward to ensure the quality of teaching.

Practice of Mind Mapping Technology in"Re-flipped Classroom"Teaching Mode:A Case Study of the Course Principles of Residential District Planning

The present study proposed the"re-flipped classroom"teaching mode taking the course Principles of Residential District Planning as an example.Using the Small Private Online Courses(SPOCs)and Massive Open Online Courses(MOOCs)of the iCourse platform,with the aid of the mind mapping technology,the complex content is visualized to the information that can be easily accepted by the brain,to improve the efficiency of thinking problems and apply theories to practical teaching.The results indicate that the teaching mode combined with mind mapping technology has strong appeal,can improve teacher-student interaction,and effectively improve the teaching effects.Finally,it came up with recommendations including attaching importance to the"re-flipped classroom"teaching mode,integrating teaching methods,and using online platform resources.It is concluded that the research of teaching mode has important theoretical and practical significance for ensuring the teaching quality.

High-performance piezoresistive sensors based on transfer-free large-area PdSe_(2) films for human motion and health care monitoring

Two-dimensional transition metal dichalcogenides(TMDs)are needed in highperformance piezoresistive sensors due to their strong strain-induced bandgap modification and thereby large gauge factors.However,integrating a conventional high-temperature chemical vapor deposition(CVD)-grown TMD with a flexible substrate necessitates a transfer process that inevitably degrades the sensing properties of the TMDs and increases the overall fabrication complexity.We present a high-performance piezoresistive strain sensor that employs largearea PdSe_(2) films grown directly on polyimide(PI)substrates via plasma-assisted selenization of a sputtered Pd film.The reliable strain transfer from the substrate to the PdSe_(2) film ensures an outstanding strain-sensing capability of the sensor.Specifically,the sensors have a gauge factor of up to315±2.1,a response time under 25 ms,a detection limit of 8×10^(-6),and an exceptional stability of over 104 loadingunloading cycles.By attaching the sensors to the skin surface,we demonstrate their application for measuring physiological parameters in health care monitoring,including motion,voice,and arterial pulse vibration.Furthermore,using the PdSe_(2) film sensor combined with deep learning technology,we achieved intelligent recognition of artery temperature from arterial pulse signals with only a 2%difference between predicted and actual temperatures.The excellent sensing performance,together with the advantages of low-temperature fabrication and simple device structure,make the PdSe_(2) film sensor promising for wearable electronics and health care sensing systems.

Boosting K-ion kinetics by interfacial polarization induced by amorphous MoO_(3-x)for MoSe_(2)/MoO_(3-x)@rGO composites

Promoting interfacial reaction kinetics is highly desirable for achieving high-performances of anode material in alkali-ion batteries.Herein,flower-like MoSe_(2)/MoO_(3-x)@r GO composites are fabricated by a facile solvothermal method involving a thermal-treatment at 800°C.When evaluated as an anode material for potassium ion batteries,MoSe_(2)/MoO_(3-x)@r GO delivers 248.2 m A h g^(-1)after 50 cycles at 0.2 A g^(-1) with a capacity retention of 84.6%and 182.9 m A h g^(-1)after 150 cycles at 1.0 A g^(-1) with a capacity retention of almost 61.2%,superior to those of bare MoSe_(2)or MoSe_(2)@r GO composites.Analysis from electrochemical measurements,the amorphous MoO_(3-x)containing oxygen vacancies could not only effectively buffer the self-aggregation of MoSe_(2)nanosheets but also provides lots of accessible active sites for potassium ion storage.Additionally,the open channels in the amorphous MoO_(3-x) phase lead to easier ion hopping and smaller diffusion barriers.Furthermore,the built-in electric field at the interface would be beneficial for electron transfer and K-ion migration across the hetero-junction interface.Moreover,larger dielectric polarization induced by the high relative permittivity of amorphous MoO_(3-x) would reduce charge transfer resistance and enhance K-ion migration across electric double-layer.Our work provides new insight into the enhanced performance of anode material coated by an amorphous layer with large relative permittivity.

Novel biomarkers identifying hypertrophic cardiomyopathy and its obstructive variant based on targeted amino acid metabolomics

Background:Hypertrophic cardiomyopathy(HCM)is an underdiagnosed genetic heart disease worldwide.The management and prognosis of obstructive HCM(HOCM)and non-obstructive HCM(HNCM)are quite different,but it also remains challenging to discriminate these two subtypes.HCM is characterized by dysmetabolism,and myocardial amino acid(AA)metabolism is robustly changed.The present study aimed to delineate plasma AA and derivatives profiles,and identify potential biomarkers for HCM.Methods:Plasma samples from 166 participants,including 57 cases of HOCM,52 cases of HNCM,and 57 normal controls(NCs),who first visited the International Cooperation Center for HCM,Xijing Hospital between December 2019 and September 2020,were collected and analyzed by high-performance liquid chromatography-mass spectrometry based on targeted AA metabolomics.Three separate classification algorithms,including random forest,support vector machine,and logistic regression,were applied for the identification of specific AA and derivatives compositions for HCM and the development of screening models to discriminate HCM from NC as well as HOCM from HNCM.Results:The univariate analysis showed that the serine,glycine,proline,citrulline,glutamine,cystine,creatinine,cysteine,choline,and aminoadipic acid levels in the HCM group were significantly different from those in the NC group.Four AAs and derivatives(Panel A;proline,glycine,cysteine,and choline)were screened out by multiple feature selection algorithms for discriminating HCM patients from NCs.The receiver operating characteristic(ROC)analysis in Panel A yielded an area under the ROC curve(AUC)of 0.83(0.75-0.91)in the training set and 0.79(0.65-0.94)in the validation set.Moreover,among 10 AAs and derivatives(arginine,phenylalanine,tyrosine,proline,alanine,asparagine,creatine,tryptophan,ornithine,and choline)with statistical significance between HOCM and HNCM,3 AAs(Panel B;arginine,proline,and ornithine)were selected to differentiate the two subgroups.The AUC values in the training and validation sets for Panel B were 0.83(0.74-0.93)and 0.82(0.66-0.98),respectively.Conclusions:The plasma AA and derivatives profiles were distinct between the HCM and NC groups.Based on the differential profiles,the two established screening models have potential value in assisting HCM screening and identifying whether it is obstructive.