高频超声对先天性肌性斜颈的诊断价值

目的探讨高频超声对先天性肌性斜颈的诊断价值,为临床干预提供影像学依据。方法选取2016年9月~2019年3月在我院就诊的先天性肌性斜颈患儿34例(观察组),另选取颈部正常患儿34例(对照组),两组患儿均进行高频超声检查,观察两超声影像特点。结果观察组胸锁乳突肌的平均厚度(1.87±0.58cm),回声特点(高回声或稍低回声),血供情况(血流稀疏)与对照组间的差异有统计学意义(P<0.05);临床分型:肿块型19例(55.88%),均匀增厚型15例(44.11%);病变部位:右侧胸锁乳突肌病变13例,左侧21例。结论高频超声影像学特点可对病进行准确分型,对临床干预措施的选择有重要的指导作用。

Facet-Controlled LiMn_(2)O_(4)/C as Deionization Electrode with Enhanced Stability and High Desalination Performance

Battery materials as emerging capacitive deionization electrodes for desalination have better salt removal capacities than traditional carbon-based materials.LiMn_(2)O_(4),a widely used cathode mate-rial,is difficult to utilize as a deionization electrode due to its structural instability upon cycling and Mn dissolution in aqueous-based electrolytes.Herein,a facile and low-cost ball-milling routine was proposed to prepare a LiMn_(2)O_(4)material with highly exposed(111)facets.The prepared electrode exhibited relatively low dissolution of Mn during cycling,which shows its long cycle stability.In the hybrid capacitive deionization system,the LiMn_(2)O_(4)/C electrode delivered a high desalination capacity of 117.3 mg g^(−1) without obvious capacity decay at a voltage of 1.0 V with a 20 mM initial salt concentration.In addition,the exposed(111)facets significantly alleviated Mn ion dissolution,which also enhanced the structural steadiness.

Optical fluence compensation for handheld photoacoustic probe:An in vivo human study case

Integrating photoacoustic(PA)and ultrasound(US)into a handheld probe to perform P A/US dual-modal imaging has been widely studied over the past few years.However,optical fuence decreases quickly in deeper tissue due to light scattering and absorption,which would signifi-cantly affect the quantitative PA imaging.In this paper,we performed a fluence compensation for a PA imaging study of human breast.The comparison of P A/US image with and without optical fuence compensation demonstrated that the fuence compensation could effectively improve imaging quality for handheld probe.

Breeding ecology of the Yellow-bellied Warbler (Abroscopus superciliaris)

The life history of birds dictates their activities and is crucial to population success.However,the life history traits of only one-third of the world’s bird species have been described;the rest are poorly understood.We studied the breeding ecology of the Yellow-bellied Warbler(Abroscopus superciliaris)and documented reproductive information throughout the egg and nestling periods.The data included natural nest sites,nest components,nest size,egg laying dates and time,egg morph,egg size,clutch size,egg incubation,nestling brooding and feeding,nestling morph and growth,and reproductive outcome.This study provided particular information of breeding ecology that has not been reported before in the Yellow-bellied Warbler.

Lipid carriers for mRNA delivery

Messenger RNA(mRNA)is the template for protein biosynthesis and is emerging as an essential active molecule to combat various diseases,including viral infection and cancer.Especially,mRNA-based vaccines,as a new type of vaccine,have played a leading role in fighting against the current global pandemic of COVID-19.However,the inherent drawbacks,including large size,negative charge,and instability,hinder its use as a therapeutic agent.Lipid carriers are distinguishable and promising vehicles for mRNA delivery,owning the capacity to encapsulate and deliver negatively charged drugs to the targeted tissues and release cargoes at the desired time.Here,we first summarized the structure and properties of different lipid carriers,such as liposomes,liposome-like nanoparticles,solid lipid nanoparticles,lipid-polymer hybrid nanoparticles,nanoemulsions,exosomes and lipoprotein particles,and their applications in delivering mRNA.Then,the development of lipid-based formulations as vaccine delivery systems was discussed and highlighted.Recent advancements in the mRNA vaccine of COVID-19 were emphasized.Finally,we described our future vision and perspectives in this field.

Improving cancer immunotherapy via co-delivering checkpoint blockade and thrombospondin-1 downregulator

The use of checkpoint-blockade antibodies is still restricted in several malignancies due to the modest efficacy,despite considerable success in anti-tumor immunotherapy.The poor response of cancer cells to immune destruction is an essential contributor to the failure of checkpoint therapy.We hypothesized that combining checkpoint therapy with natural-product chemosensitizer could enhance immune response.Herein,a targeted diterpenoid derivative was integrated with the checkpoint blockade(anti-CTLA-4)to improve immunotherapy using thermo sensitive liposomes as carriers.In vivo,the liposomes enabled the co-delivery of the two drug payloads into the tumor.Consequently,the regulatory T cell proliferation was restrained,the cytotoxic T cell infiltration was enhanced,and the profound immunotherapeutic effect was achieved.In addition,the immunotherapeutic effect of another clinically used checkpoint antibody,anti-PD-1,also benefited from the diterpenoid derivative.Of note,our mechanism study revealed that the targeted diterpenoid derivative increased the sensitivity of cancer cells to immune attack via THBS1 downregulation and the resultant destruction of THBS1-CD47 interaction.Collectively,co-delivering THBS1 inhibitor and checkpoint blockade is promising to boost cancer immunotherapy.We first time discovered that THBS1 suppression could strengthen checkpoint therapy.

Insights into contrast-enhanced ultrasound features of non-tumorous hepatic vascular malformations

Introduction Contrast-enhanced ultrasound(CEUS)is widely used to evaluate focal hepatic lesions and can be used in patients with renal dysfunction or allergies to iodinated contrast medium.However,the number of studies on CEUS for evaluating hepatic vascular malformations(VMs)is limited,especially regarding its application in routine practice.Some patients who present with suspected focal hepatic lesions have hepatic VMs.The timely and non-invasive diagnosis of hepatic VMs can help guide appropriate treatment,such as interventional therapy or follow-up,to prevent the unnecessary waste of medical resources.This study aimed to discuss the CEUS features of non-tumorous hepatic VMs that can be used in clinical practice.Various hepatic VM diagnoses can be made depending on the different manifestations of hepatic VMs and enhancement of the liver parenchyma during CEUS.

基于疾病-知识能力系统的全国超声住院医师规范化培训结业考核设计分析

目的调研分析超声专业住院医师规范化培训(住培)所需的疾病系统及知识能力系统,为住培结业考核设计提供依据。方法选择国家卫生健康委员会“住院医师规范化培训结业考核效度研究(超声医学专业)”专家组进行调研,组建超声住培疾病系统,共计5部位分类及34类具体疾病,评估者独立评估各疾病建议例数及重要性,得到各疾病总权重;制订知识能力系统,包含19项超声住培所需掌握的知识、技能与能力,评估各项指标权重。上述两系统各指标权重相乘,构成疾病系统-知识能力系统联表。结果超声住培疾病系统共计34类疾病,总权重得分最高的前10位疾病为肝局灶性病变、甲状腺疾病、乳腺疾病、肝弥漫性病变、胆囊疾病、卵巢疾病、心脏瓣膜病及冠心病、颈部血管、房/室间隔缺损、心肌疾病。重要性得分最高的前5位疾病为卵巢疾病、心脏瓣膜病及冠心病、房/室间隔缺损、乳腺疾病、甲状腺疾病。知识能力系统权重得分最高的前四项为诊断及鉴别诊断技能,扫查与图像识别技能,解剖、病理及病理生理知识,报告书写技能。疾病系统-知识能力系统联表总权重得分最高的前3位疾病-知识能力项目为肝局灶性病变、甲状腺疾病、乳腺疾病的诊断及鉴别诊断技能。结论本项目评估超声住培疾病系统及知识能力系统各指标权重,通过疾病系统-知识能力系统框架建立考题的结构模型,可为全国超声住培结业考核设计提供依据。

PBL教学在皮肤科研究生教学改革中的作用探讨

以问题为基础的学习(problem-based learning,PBL)已被应用于很多教学领域且效果较佳。皮肤性病学是一门特殊的二级学科,包含皮肤外科、皮肤病理、皮肤激光美容等不同亚专业方向,其涵盖的疾病种类繁多,且皮损鉴别困难。但研究生教学时间有限,传统教学模式不能满足研究生学习需要。本研究通过分析国内外文献,阐述PBL法在医学研究生教学中的应用,以及PBL联合其他教学方法的应用,探讨其在皮肤科研究生教学中的作用。

Direct phase control method for binary phase-shift keying space coherent laser communication

An optical phase locking method based on direct phase control is proposed.The core of this method is to synchronize the carrier by directly changing the phase of the local beam.The corresponding experimental device and the supporting algorithm were configured to verify the feasibility of this method.Phase locking can be completed without cycle skipping,and the acquisition time is 530 ns.Without an optical preamplifier,a sensitivity of-34.4 d Bm is obtained,and the bit error rate is 10^(-9) for 2.5 Gbit/s binary phase-shift keying modulation.The measured standard deviation of the phase error is 5.2805°.

Value of contrast-enhanced ultrasound combined with percutaneous ultrasound-guided fine-needle aspiration in the diagnosis of solid pancreatic lesions

Background:Contrast-enhanced ultrasound(CEUS)can detect lesions hidden in inflammatory regions and find necrosis or areas of severe fibrosis within the lesion.This retrospective study aimed to compare the diagnostic accuracy of solid pancreatic lesions using percutaneous ultrasound(US)-guided fine-needle aspiration(FNA)with or without CEUS assessment.Methods:Clinical,imaging,and pathologic data of 181 patients from January 2014 to December 2018 in Pecking Union Medical College Hospital,with solid pancreatic masses who underwent percutaneous US-FNA and ThinPrep cytologic test were retrospectively evaluated.Patients were divided into CEUS and US groups according to whether CEUS was performed before the biopsy.According to FNA cytology diagnoses,we combined non-diagnostic,neoplastic,and negative cases into a negative category.The positive category included malignant,suspicious,and atypical cases.The final diagnosis was confirmed by pathology or clinical and radiological follow-up for at least 12 months.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy of US-FNA were evaluated between the two groups.Results:This study enrolled 107 male and 74 female patients(average age:60 years).There were 58 cases in the US group and 123 cases in the CEUS group.No statistically significant differences in age,gender,or lesion size were found between the two groups.The diagnostic accuracy of the CEUS group was 95.1%(117/123),which was higher than the 86.2%(50/58)observed in the US group(P=0.036).The sensitivity,specificity,PPV,and NPV of the CEUS group were increased by 7.5%,16.7%,3.4%,and 18.8%,respectively,compared with the US group.However,the differences of the two groups were not statistically significant.Conclusions:Compared with the conventional US,the use of CEUS could improve the biopsy accuracy and avoid the need for a repeat biopsy,especially for some complicated FNA cases.

The Chinese guidelines for the diagnosis and treatment of pancreatic neuroendocrine neoplasms(2020)

Pancreatic neuroendocrine neoplasms(pNENs)are highly heterogeneous,and the management of pNENs patients can be intractable.To address this challenge,an expert committee was established on behalf of the Chinese Pancreatic Surgery Association,which consisted of surgical oncologists,gastroenterologists,medical oncologists,endocrinologists,radiologists,pathologists,and nuclear medicine specialists.By reviewing the important issues regarding the diagnosis and treatment of pNENs,the committee concluded evidence-based statements and recommendations in this article,in order to further improve the management of pNENs patients in China.

Parent-offspring and inter-offspring responses to conspecific versus heterospecific distress calls in 2 sympatric birds

Distress calls,as a type of alarm call,play important roles in expressing bodily condition and conveying information concerning predation threats.In this study,we examined the communication via distress calls in parent–offspring and inter-offspring interactions.First,we used playback of chick distress calls of 2 sympatric breeders,the vinous-throated parrotbill Sinosuthora webbiana and the oriental reed warbler Acrocephalus orientalis,to the adults/chicks of these 2 species,respectively,and measured the responses of conspecifics or heterospecifics.The playback-to-chicks experiment showed that both species of chicks reduced the number of begging calls and begging duration time as a response to conspecific/heterospecific distress calls compared with natural begging and background noise controls.However,reed warbler chicks also reduced beak opening frequency in the response to conspecific distress calls compared with other playback stimuli.Second,the results of the playback-to-adults experiment showed that reed warbler adults could eavesdrop on distress calls of conspecific neighbors and sympatric heterospecifics.Furthermore,the nest-leaving behavior of reed warblers did not differ significantly when they heard the distress calls of conspecifics or parrotbills.Finally,reed warbler adults responded to heterospecific distress calls more quickly than to conspecific distress calls,and parrotbill adults presented the same response.Our results supported the warnkin hypothesis and show that chick distress calls play an important role in conveying risk and the condition of chicks to enhance individual fitness.In addition,we also found that eavesdropping on distress calls is a congenital behavior that begins in the chick stage.

NIR-Ⅱ fluorescence/photoacoustic imaging of ovarian cancer and peritoneal metastasis

Ovarian cancer is a global problem,and is typically diagnosed in the middle or late stages,with a mysterious abdominal mass or atypical abdominal metastases due to the lack of specific initial diagnostic methods.Dual-modal near-infrared Ⅱ(NIR-Ⅱ,1,000–1,700 nm)fluorescence/photoacoustic imaging has great potential in early ovarian cancer diagnosis and image-guided surgery due to its high sensitivity and deep penetration.Herein,we report a novel organic NIR-Ⅱ dye(H10)with excellent aggregation-induced-emission(AIE)characteristics(I/I0>1.6)utilizing a selenadiazolo-[3,4-f]benzo[c][1,2,5]thiadiazole(ST)-based building block.Then,water-soluble and biocompatible H10@follicle-stimulating hormone(H10@FSH)dots with superior optical/photoacoustic properties and a tenfold increase in ovarian-specific targeting ability were synthesized.Finally,for the first time,in vivo dual-mode NIR-Ⅱ fluorescent/photoacoustic(PA)imaging and image-guided surgery of patient-derived tumor xenograft(PDTX)and micro-metastatic abdominal ovarian cancer lesions were investigated.This novel strategy will establish a new method for early detection of ovarian cancer and significantly improve the prognosis of ovarian cancer patients.

聚焦质控指标体系 推进超声质量提升

医疗质量是保障人民健康和卫生事业发展的基石。随着我国医疗改革的深入推进,提升医疗服务质量已成为推进健康中国建设的核心工作。近年来,超声医学快速发展,在临床诊疗中的作用日益显著。中国幅员辽阔,人口众多,医疗资源分布不均衡,我国的超声诊疗面临着数量和质量的双重压力。科学、高效的质量控制方法对于提升超声医疗质量、保障患者安全具有重要意义。为加强超声医学专业医疗质量管理,完善我国超声医疗质量控制体系,2017年国家卫生健康委医政医管局委托北京协和医院成立了国家超声医学质量控制中心,迈出了全国超声质控体系建设的第一步,具有里程碑意义。