[Debulking strategy of endovascular treatment for lower extremity artery lesions]

Objective: To explore the debulking strategy of lower extremity artery lesions. Methods: Retrospectively analyzed the clinical data of 101 patients underwent debulking therapy at Department of Vascular Surgery,Zhongshan Hospital,Fudan University from June 2019 to June 2020.There were 74 males and 27 females,aged (73.2±11.7)years (range:35 to 93 years).There were 31 cases in Rutherford class 3,39 cases in class 4 and 31 cases in class 5. Hypertension occurred in 72 patients. One hundred and forty lesions were treated in 101 patients. Among them, there were 13 lesions(9.3%) in iliac artery,72 lesions(51.4%) in superficial femoral artery,41 (29.3%) lesions in popliteal artery,10 lesions(7.1%) in tibiofibular trunk,and 4 lesions(2.9%) in below the knee artery.Percutaneous mechanical thrombectomy (PMT) was mainly used in acute thrombosis,excimer laser ablation (ELA) was mainly used for chronic in-stent restenosis and chronic stenosis or totally occlusive lesions,while directional atherectomy (DA) was mainly used for short calcified lesions. Results: All of the patients underwent debulking therapy. Eighty-two lesions(58.6%,82/140) were treated by PMT, 56 (40.0%,56/140) were treated by ELA,and 2 (1.4%,2/140) were treated by DA.The ankle-brachial index of the patient was 0.44±0.19 before surgery, 0.87±0.17 immediately after surgery (t=-16.26, P<0.01), and 0.81±0.20 at 6 months after surgery(t=-14.67,P<0.01),and 0.79±0.15 (t=-14.12,P<0.01) at 12 months after surgery. At 12 months,the primary patency was 86.1% (87/101),mortality was 5.0% (5/101), freedom from major-amputation survival rate was 93.1% (94/101),and target lesion reintervention rate was 9.9% (10/101). Conclusions: Debulking is feasible and effective to eliminate the arterial contents and maximize the acquisition of lumen.Selection of suitable debulking methods for different segments and lesions would be helpful to improve the technical success and obtain satisfactory results.

Effects of 4-epianhydrotetracycline on oxidative stress in zebrafish (Danio rerio) embryos

4-Epianhydrotetracycline (4-EATC) is a major intermediate product of tetracycline during its degradation progress in the natural environment, which is frequently detected in aquatic environments and poses a potential threat to aquatic organisms. In the present study, the ecotoxicity of 4-EATC have been studied from the perspective of oxidative stress by using zebrafish embryos. After 96 h exposure, the reactive oxygen species (ROS) levels, malondialdehyde (MDA) concentrations and protein carbonyl (PC) contents in zebrafish embryos in the lower-concentration 4-EATC treatment groups (1.25 mg/L and 2.50 mg/L) showed no significant differences compared with the negative control group. However, the total superoxide dismutase (SOD) activity was increased significantly. After exposed to the higher-concentration of 4-EATC (5.00, 10.0 and 20.0 mg/L) resulted in a significant increase in ROS levels, MDA concentrations and PC contents, in contrast, a significant decrease in SOD activities. The results indicate that exposure to high concentrations of 4-EATC (5.00, 10.0 and 20.0 mg/L) could disrupt the redox equilibrium in zebrafish embryos, leading to the occurrence of oxidative damage. Apoptosis of the embryonic cells could be induced by 4-EATC exposure at different concentration and the rate of apoptosis enhanced with the increase of 4-EATC concentration. The pericardium was the most frequent site of apoptosis. The present study points out that more attention should be paid to the potential ecological risks of antibiotic degradation products.

A radiomics method based on MR FS-T2WI sequence for diagnosing of autosomal dominant polycystic kidney disease progression

OBJECTIVE

We aimed to construct/validate a radiomics method based on MR FS-T2WI sequence for the evaluation of kidney function in patients with autosomal dominant polycystic kidney disease (ADPKD).

PATIENTS AND METHODS

The clinical data and MRI images of 114 patients with ADPKD were retrospectively analyzed. With a glomerular filtration rate of 60 mL/min per 1.73 m2 as the cutoff value, patients were divided into two groups, where there were 59 patients with GFR ≥60 mL/min per 1.73 m2 (including CKD1 and CKD2 phase) and 55 patients with GFR <60 mL/min per 1.73 m2 (including CKD3 phase and higher). All patients underwent the 3.0T MR scan of the kidney. Then, the kidney were delineated layer by layer based on the FS-T2WI sequence to obtain the volume of interest (VOI) for radiomics features extraction. The optimal radiomics features were selected by least absolute shrinkage and selection operator (LASSO). Three kinds of data modality including the pure clinical data, the pure image data and the clinical-image fused data were utilized to establish three types of models (clinical, image and with their combination) separately by five machine learning classifiers: k-nearest-neighbors (KNN), support vector machine (SVM), logistic regression (LR), random forests (RF) and multi-layer perception (MLP). Receiver operating characteristic (ROC) curve, areas under the curve (AUC), sensitivity, specificity and precision were employed to evaluate the model's effectiveness to diagnosis the glomerular filtration rate of patients with ADPKD based on different models. Besides, Delong test was applied to compare ROCs between models.

RESULTS

960 radiomics features were extracted from each VOIs, and clinical information included the gender and age of each patient. After feature selection, 23 and 21 features based on pure image data and clinical-image fused data were independently used to construct models for the kidney function evaluation. The clinical-image fused model (AUC=0.89) has better performance than the pure image model (p=0.046) and pure clinical model (p<0.001). Clinical-image fused model based on LR classifier showed the best diagnostic efficiency, with AUC=0.89, sensitivity=0.8867 and specificity=0.7959.

CONCLUSIONS

The MR FS-T2WI radiomics analysis based on clinical-image fused model is instrumental in evaluating and predicting the kidney function of patients with polycystic kidney disease.

Evaluating the potential of KOH-modified composite biochar amendment to alleviate the ecotoxicity of perfluorooctanoic acid-contaminated sediment on Bellamya aeruginosa

Modified composite biochar offers a cost-effective solution for the remediation of contaminated sediments; however, few studies have evaluated the effects of modified composite biochar amendment on the ecotoxicity of contaminated sediment based on benthic macroinvertebrates. A 21-day sediment toxicity test was conducted using the freshwater snail Bellamya aeruginosa to examine the intrinsic ecotoxicity of a novel KOH-modified composite biochar (KOH-CBC) and its efficacy for reducing the bioavailability, uptake, and ecotoxicity of perfluorooctanoic acid (PFOA). It was found that KOH-CBC is toxic to B. aeruginosa, which may be attributed to its high polycyclic aromatic hydrocarbons (PAHs) content and alkalinity. The addition of KOH-CBC to PFOA-contaminated sediments can markedly reduce the bioavailability and uptake of PFOA by more than 90% and 50%, respectively, and subsequently alleviate the toxicity of PFOA to B. aeruginosa by at least 30%. Increasing the KOH-CBC dosage is not beneficial for further mitigating the toxicity of PFOA-contaminated sediments. Our findings imply that KOH-CBC is a promising sorbent for the in-situ remediation of PFOA-contaminated sediments. Application of acidified KOH-CBC at a dosage of approximately 1-3% will be sufficient to control the ecotoxicity of PFOA; however, its long-term environmental effects should be further validated.

Development of a deep learning based automated data analysis for step-filter x-ray spectrometers in support of high-repetition rate short-pulse laser-driven acceleration experiments

We present a deep learning based framework for real-time analysis of a differential filter based x-ray spectrometer that is common on short-pulse laser experiments. The analysis framework was trained with a large repository of synthetic data to retrieve key experimental metrics, such as slope temperature. With traditional analysis methods, these quantities would have to be extracted from data using a time-intensive and manual analysis. This framework was developed for a specific diagnostic, but may be applicable to a wide variety of diagnostics common to laser experiments and thus will be especially crucial to the development of high-repetition rate (HRR) diagnostics for HRR laser systems that are coming online.

Relationship between viral load, infection-to-delivery interval and mother-to-child transfer of anti-SARS-CoV-2 antibodies

OBJECTIVE

To investigate the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and infection-to-delivery interval with maternal and cord serum concentrations of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies and transplacental transfer ratio in pregnant women with active or recovered SARS-CoV-2 infection.

METHODS

This was a prospective case series of consecutive pregnant women with laboratory-confirmed SARS-CoV-2 infection between 27 March 2020 and 24 January 2021. We collected information regarding deep throat saliva or nasopharyngeal swab (NPS) reverse transcription polymerase chain reaction (RT-PCR) test results, serial cycle threshold (Ct) values at and after diagnosis, demographic, clinical and outcome data, and neonatal NPS RT-PCR results. Qualitative and quantitative analysis of IgG and immunoglobulin M (IgM) antibodies against SARS-CoV-2 was performed in maternal and cord blood serum samples obtained at delivery. Correlation of maternal Ct values, infection-to-delivery interval, infection duration and viral load area under the curve (AUC) with gestational age (GA) at diagnosis, maternal and cord serum IgG concentrations and transplacental transfer ratio of IgG were evaluated using Pearson's correlation.

RESULTS

Twenty pregnant women who consented to participate and who had delivered their babies by 31 January 2021 were included in the study, comprising 14 who had recovered from coronavirus disease 2019 (COVID-19) and six with active infection at delivery. The median GA at clinical manifestation was 32.7 (range, 11.9-39.4) weeks. The median infection-to-delivery interval and infection duration were 41.5 (range, 2-187) days and 10.0 (range, 1-48) days, respectively. The median GA at delivery was 39.1 (range, 32.4-40.7) weeks and the median seroconversion interval was 14 (range, 1-19) days. Of 13 neonates born to seropositive mothers with recovered infection at delivery, 12 tested positive for anti-SARS-CoV-2 IgG. All neonatal NPS samples were negative for SARS-CoV-2 and all cord sera tested negative for IgM. The median transplacental transfer ratio of IgG was 1.3 (interquartile range, 0.9-1.6). There was a negative correlation between infection-to-delivery interval and anti-SARS-CoV-2 IgG concentrations in maternal (r = -0.6693, P = 0.0087) and cord (r = -0.6554, P = 0.0068) serum and a positive correlation between IgG concentration in maternal serum and viral load AUC (r = 0.5109, P = 0.0310). A negative correlation was observed between transfer ratio and viral load AUC (r = -0.4757, P = 0.0409).

CONCLUSIONS

In pregnant women who have recovered from COVID-19, anti-SARS-CoV-2 IgG concentrations at delivery increased with increasing viral load during infection and decreased with increasing infection-to-delivery interval. The median transplacental transfer ratio of IgG was 1.3 and it decreased with increasing viral load during infection. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Measurement of the Cosmic Ray Helium Energy Spectrum from 70 GeV to 80 TeV with the DAMPE Space Mission

The measurement of the energy spectrum of cosmic ray helium nuclei from 70 GeV to 80 TeV using 4.5 years of data recorded by the Dark Matter Particle Explorer (DAMPE) is reported in this work. A hardening of the spectrum is observed at an energy of about 1.3 TeV, similar to previous observations. In addition, a spectral softening at about 34 TeV is revealed for the first time with large statistics and well controlled systematic uncertainties, with an overall significance of 4.3σ. The DAMPE spectral measurements of both cosmic protons and helium nuclei suggest a particle charge dependent softening energy, although with current uncertainties a dependence on the number of nucleons cannot be ruled out.

Simulations of wavelength-multiplexed holography for single-shot spatiotemporal characterization of NIF's advanced radiographic capability (ARC) laser

We simulate the use of a newly developed single-shot wavelength-multiplexed holography-based diagnostic, STRIPED FISH, to fully characterize the as-delivered laser pulses of the National Ignition Facility's Advanced Radiographic Capability (NIF-ARC) laser. To that end, we have performed simulations of the NIF-ARC pulse incorporating (a) a time-integrated spatial-profile measurement and a complete temporal-intensity-and-phase measurement using a frequency resolved optical gating, but without any spatiotemporal pulse characterizations, and (b) simulated first-order spatiotemporal distortions, which could be measured on a single shot if a STRIPED FISH device were deployed.

The efficacy of dendritic cell vaccine for newly diagnosed glioblastoma: A meta-analysis of randomized controlled studies

INTRODUCTION

The efficacy of dendritic cell vaccine to treat glioblastoma remained elusive and therefore we conducted a meta-analysis to explore the influence of dendritic cell vaccine on treatment efficacy of glioblastoma.

METHODS

PubMed, EMbase, Web of science, EBSCO and Cochrane library databases have been searched through October 2020, and we included randomized controlled trials (RCTs) assessing the efficacy of dendritic cell vaccine for glioblastoma.

RESULTS

Four RCTs and 267 patients were included in the meta-analysis. Compared to control group for glioblastoma, dendritic cell vaccine demonstrated no obvious impact on overall survival (HR=0.59; 95% CI=0.34 to 1.04; P=0.07), progression-free survival (PFS, HR=0.72; 95% CI=0.52 to 1.00; P=0.05), nervous system disorders (OR=0.61; 95% CI=0.29 to 1.29; P=0.20), or adverse events (OR=1.44; 95% CI=0.82 to 2.50; P=0.20).

CONCLUSIONS

Dendritic cell vaccine may be not effective to treat glioblastoma.

[Application and value of excimer laser ablation in the treatment of lower limb atherosclerotic obliterans]

Objective: To evaluate the results of excimer laser ablation (ELA) in the treatment of lower limb atherosclerotic obliterans (ASO). Methods: From June 2019 to March 2020, patients who underwent ELA combined with drug-coated balloon (DCB) for lower limb atherosclerotic obliterans (ASO) were enrolled. Demographics, lesion characteristics, procedure-related outcomes and complications were collected and analyzed. Results: Thirty patients were enrolled, including 21 males and 9 females. The mean age was (76.5±10.5) years. The mean lesion length was (11.7±6.4) cm. A total of 41 lesions, including in-stent restenosis (ISR) in 12 (29.3%), chronic totally occlusion (CTO) at initial treatment in 24 (58.5%), and severe stenosis in 5 (12.2%) patients. Sixteen (51.6%) patients were classified as Peripheral Arterial Calcium Scoring System (PACSS) category 4. The technical success rate was 93.5%. Incidence of distal embolization and bailout stenting was 12.9% and 6.5%, respectively. The mean follow-up time was (6.6±3.0) months. Ankle-brachial index (ABI) was significantly increased from 0.43(0.32,0.55) preoperatively to 0.91(0.87,1.01) postoperatively (Z=-5.43, P<0.01) and 0.82(0.73,1.02) (Z=-3.99, P<0.01) three months after surgery. The 3-month major-amputation free survival rate was 96.7%, primary patency rate was 100%, the target lesion reintervention (TLR) rate was 0 and ulcer healing rate was 76.9%. Conclusion: Debulking of ELA is feasible and effective for both ISR and CTO at initial treatment, providing a new option for DCB preparation and reducing stent implantation.