MRI radiomics for predicting intracranial progression in non-small-cell lung cancer patients with brain metastases treated with epidermal growth factor receptor tyrosine kinase inhibitors

AIM

To identify clinical and magnetic resonance imaging (MRI) radiomics predictors specialised for intracranial progression (IP) after first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment in non-small-cell lung cancer (NSCLC) patients with brain metastases (BMs).

MATERIALS AND METHODS

Seventy EGFR-mutated NSCLC patients with a total of 212 BMs who received first-line EGFR-TKI therapy were enrolled. Radiomics features were extracted from the BM regions on the pretreatment contrast-enhanced T1-weighted images, and the radiomics score (rad-score) of each BM was established based on the selected features. Furthermore, the mean rad-score derived from the average rad-score of all included BMs in each patient was calculated. Univariate and multivariate logistic regression analyses were performed to identify potential predictors of IP. Prediction models based on different predictors and their combinations were constructed, and nomogram based on the optimal prediction model was evaluated.

RESULTS

Thirty-three (47.1 %) patients developed IP, and the remaining 37 (52.9 %) patients were IP-free. EGFR-19del mutation (OR 0.19, 95 % CI 0.05-0.69), third-generation TKI treatment (OR 0.33, 95 % CI 0.16-0.67) and mean rad-score (OR 5.71, 95 % CI 1.65-19.68) were found to be independent predictive factors. Models based on these three predictors alone and in combination (combined model) achieved AUCs of 0.64, 0.64, 0.74, and 0.86 and 0.64, 0.64, 0.75, and 0.84 in the training and validation sets, respectively, and the combined model demonstrated optimal performance for predicting IP.

CONCLUSIONS

The model integrating EGFR-19del mutation, third-generation TKI treatment and mean rad-score had good predictive value for IP after EGFR-TKI treatment in NSCLC patients with BM.

TEMPORARY REMOVAL: The first investigation of a nosocomial outbreak caused by ST80 vancomycin-resistant Enterococci faecium in China

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Self-reported sleep disorders and the risk of all cancer types: evidence from the Kailuan Cohort study

OBJECTIVES

Previous studies that focussed on sleep disturbance have primarily examined specific aspects of sleep disorders rather than considering overall sleep quality. We aimed to investigate different sleep disorders and their combination as risk factors for different types of cancer.

STUDY DESIGN

Prospective cohort study.

METHODS

In this prospective cohort study, we included 78,232 participants. A self-reported questionnaire was used to address insomnia, daytime sleepiness, snoring, and sleep duration. Overall sleep quality was evaluated by summarising these four sleep parameters. Cox proportional hazards analysis was used to estimate the hazard ratios and their 95% confidence intervals for determining the effect of the overall sleep-quality score and its components on the risk of incident cancer.

RESULTS

During a median follow-up of 5.67 years, 1266 participants were diagnosed with incident cancer. Compared to participants in the best sleep-quality score group, participants in the worst sleep-quality score group had a higher subsequent risk of overall cancer, and colorectal, breast, uterine or uterine cervical, prostatic, kidney, and bladder cancer. Participants with insomnia and snoring status had an elevated risk of head and neck, breast, uterine or uterine cervical, prostatic, kidney, bladder cancer, and lymphoma.

CONCLUSIONS

Poor overall sleep-quality scores as well as poor scores for the scale's components, including insomnia and snoring status, elevated the risk of overall and several specific-site cancers.

TRIAL REGISTRATION

Kailuan Study, ChiCTR2000029767. Registered 12 February, 2020-Retrospectively registered, https://www.chictr.org.cn/showprojEN.html?proj=48316.

Finger touching combined X-ray-guided percutaneous nephrolithotomy in 640 cases: an 8-years' experience

OBJECTIVE

We aimed to evaluate the safety and efficacy of finger touching combined X-ray-guided percutaneous nephrolithotomy, and the feasibility of avoiding damage in medical staff caused by X-ray.

PATIENTS AND METHODS

From January 2013 to December 2020, 640 cases of percutaneous nephrolithotomy were performed through the 18-24-F channel. Among those cases, 22 (3.4%) cases were double-sided kidney stones surgeries, 294 (45.8%) cases were on the right side and 324 (50.5%) cases were on the left side. The targeted renal calyceal puncture was carried out under the combined guidance of the doctor's finger and X-ray. We assessed the X-ray exposure time of patients and doctors, average number of punctures, postoperative hospitalization, calculus removal rates, and complications.

RESULTS

The average number of punctures was 2.8 ± 1.4. Average X-ray exposure time during procedure: 2.8 s (range: 2-8 s). Average surgical time: 106.5 ± 49.4 min. Postoperative hospitalization: 6.8 ± 4.2 d. Average reduced hemoglobin level: 5.9 g/day. Stone-free rate 4 weeks after surgeries: 95.6%. Patients with upper ureteral calculi: 395 cases (61.72%). The calculus residual rate of patients with staghorn renal calculi or multiple renal calculi complementary treatments was 82.9%, including 0 patients who received shock wave lithotripsy, 2 cases of repeated percutaneous nephrolithotomy (PCNL), and 18 cases of ureteroscopy. Postoperative placement of renal drainage tube occurred in 52 cases. As for complications, no perirenal infection occurred, two severe bleeding complication cases occurred, and one case of colon perforation occurred.

CONCLUSIONS

Finger touching combined X-ray-guided percutaneous nephrolithotomy in patients with renal calculus is safe and can accurately guide the puncture without radiation hazards. The placement of a renal drainage tube was beneficial to reduce renal effusion, hematocele, and infections.

Integrated Microfluidic-Based Platforms for On-Site Detection and Quantification of Infectious Pathogens: Towards On-Site Medical Translation of SARS-CoV-2 Diagnostic Platforms

The rapid detection and quantification of infectious pathogens is an essential component to the control of potentially lethal outbreaks among human populations worldwide. Several of these highly infectious pathogens, such as Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been cemented in human history as causing epidemics or pandemics due to their lethality and contagiousness. SARS-CoV-2 is an example of these highly infectious pathogens that have recently become one of the leading causes of globally reported deaths, creating one of the worst economic downturns and health crises in the last century. As a result, the necessity for highly accurate and increasingly rapid on-site diagnostic platforms for highly infectious pathogens, such as SARS-CoV-2, has grown dramatically over the last two years. Current conventional non-microfluidic diagnostic techniques have limitations in their effectiveness as on-site devices due to their large turnaround times, operational costs and the need for laboratory equipment. In this review, we first present criteria, both novel and previously determined, as a foundation for the development of effective and viable on-site microfluidic diagnostic platforms for several notable pathogens, including SARS-CoV-2. This list of criteria includes standards that were set out by the WHO, as well as our own "seven pillars" for effective microfluidic integration. We then evaluate the use of microfluidic integration to improve upon currently, and previously, existing platforms for the detection of infectious pathogens. Finally, we discuss a stage-wise means to translate our findings into a fundamental framework towards the development of more effective on-site SARS-CoV-2 microfluidic-integrated platforms that may facilitate future pandemic diagnostic and research endeavors. Through microfluidic integration, many limitations in currently existing infectious pathogen diagnostic platforms can be eliminated or improved upon.

POS0754 DEVELOPMENT OF A RISK PREDICTION MODEL FOR VENOUS THROMBOEMBOLISM IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: THE SLE-VTE SCORE

Background:

Patients with systemic lupus erythematosus (SLE) have a substantially increased risk of venous thromboembolism (VTE). An individual VTE risk assessment is important to ensure that all patients are assessed and given adequate thromboprophylaxis.

Objectives:

We conducted this study to develop a risk score for VTE in patients with SLE.

Methods:

Patients with SLE who participated in the Chinese SLE Treatment and Research group were enrolled in this study. Patient baseline information and clinical laboratory indicators were obtained, and VTE events were recorded every 3-6 months during follow-up visits. The risk prediction model was created and internally validated using the bootstrap methods, and a scoring system was established (Figure 1).

Figure 1.

Flow chart of study design.

Results:

Out of 4,502 patients included in this study, 135 had a VTE event. After univariate analysis and Lasso regression, the following 11 variables were identified and included in the risk prediction model: male sex, age, BMI ≥25 kg/m2, hyperlipidemia, hypoalbuminemia, hsCRP>3 mg/L, renal involvement, nervous system involvement, anti-β2-glycoprotein I antibody positivity, lupus anticoagulant positivity, and no use of hydroxychloroquine. The AUC for the SLE-VTE score (Table 1) was 0.947 (95% CI, 0.9249-0.9694). The SLE-VTE score’s sensitivity and specificity with the optimal cutoff value of 13 were 0.919 and 0.881, respectively. The SLE-VTE score was superior to the GAPSS system in predicting the risk of VTE in patients with SLE (AUC= 0.947 vs. 0.680, P< 0.001; integrated discrimination improvement (IDI)= 0.6652, P< 0.001; net reclassification improvement (NRI)= 0.6652, P< 0.001).

Table 1.

Final multivariable analysis for venous thromboembolism risk in patients with SLE

β coefficientsOdds ratio* (95% CI)P-valuePoints in scoring systemMale0.6211.86(0.953-3.503)0.0612Age at study entry(≥50)0.8372.308(1.339-3.915)0.0023BMI02(kg/m20.7922.209(1.333-3.627)0.0023Hyperlipemia0.8382.313(1.246-4.166)0.0063Hypoalbuminemia2.1638.697(5.185-14.794)< 0.0017hsCRP>3 mg/L1.4524.272(2.618-6.968)< 0.0015Anti β2GPI1.0132.754(1.543-4.853)0.0013LA1.5594.752(2.799-8.072)< 0.0015Nervous system2.38210.832(6.163-18.998)< 0.0018Lupus nephritis0.8352.305(1.414-3.756)0.0013No use of hydroxychloroquine1.7715.876(3.722-9.401)< 0.0016

BMI: body mass index; hsCRP: Hypersensitive c-reactive protein; ACL: anticardiolipin, antiβ2GPI: anti-β2-glycoprotein I, LA: lupus anticoagulantm;

Values in bold are statistically significant at p <0.05.

Conclusion:

Various factors are related to the occurrence of VTE in patients with SLE. The proposed SLE-VTE risk score can accurately predict the risk of VTE and help identify SLE patients with a high risk of VTE who may benefit from thromboprophylaxis.

References:

[1]Ramirez GA, Efthymiou M, Isenberg DA, Cohen H. Under crossfire: thromboembolic risk in systemic lupus erythematosus. Rheumatology. 2018;58:940-952.

[2]Chung WS, Lin CL, Chang SN, Lu CC, Kao CH. Systemic lupus erythematosus increases the risks of deep vein thrombosis and pulmonary embolism: a nationwide cohort study. J Thromb Haemost. 2014;12:452-458.

[3]Liew NC, Alemany GV, Angchaisuksiri P, et al. Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism. Int Angiol. 2017;36:1.

[4]Savino S, Giovanni S, Veronica M, Dario R, Khamashta MA, Laura BM. GAPSS: the Global Anti-Phospholipid Syndrome Score. Rheumatology. 2013:8.

[5]Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41:543-603.

[6]Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Nguyen NT, Stamos MJ. A Nationwide Analysis of Postoperative Deep Vein Thrombosis and Pulmonary Embolism in Colon and Rectal Surgery. J Gastrointest Surg. 2014;18:2169-2177.

Disclosure of Interests:

None declared

A Microflow Cytometry-Based Agglutination Immunoassay for Point-of-Care Quantitative Detection of SARS-CoV-2 IgM and IgG

A rapid, sensitive and simple microflow cytometry-based agglutination immunoassay (MCIA) was developed for point-of-care (POC) quantitative detection of SARS-CoV-2 IgM and IgG antibodies. The antibody concentration was determined by using the transit time of beads aggregates. A linear relationship was established between the average transit time and the concentration of SARS-CoV-2 IgM and IgG, respectively. The limit of detection (LOD) of SARS-CoV-2 IgM and IgG by the MCIA measurement are 0.06 mg/L and 0.10 mg/L, respectively. The 10 µL sample consumption, 30 min assay time and the compact setup make this technique suitable for POC quantitative detection of SARS-CoV-2 antibodies.

[Quality of life of patients with primary open-angle glaucoma based on EQ-5D in Wenzhou]

Objective: To evaluate the quality of life of patients with primary open-angle glaucoma (POAG) and its related factors in Wenzhou. Methods: Cross-sectional analysis. A total of 339 POAG patients diagnosed in the Wenzhou glaucoma progression study conducted in the Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University from March 2014 to October 2019 were included. Quality of life of POAG patients was assessed by EQ-5D including the visual analogue scale (VAS). The effects of gender, age, visual field loss (VFL), family history of glaucoma, hypertension, diabetes, migraine, sleep quality, and amateur exercise on the quality of life were analyzed. The utility value (UV) and VAS score were expressed as the median (P₂₅, P₇₅), and Mann-Whitney U was used for the comparison between two groups. Kruskal-Wallis H was performed to compare the differences among multiple groups. Results: A total of 339 POAG patients were included in the study; 164 were males (48.4%), and 175 were females (51.6%). The mean age was (63±10) years. Thirty-four patients (10.0%) had received medication (including one with combined surgical treatment), while the remaining 305 patients (90.0%) had received no anti-glaucoma treatment. Among the patients, 10.5% (32/305) had no VFL, 68.9% (210/305) had mild VFL, 17.0% (52/305) had moderate VFL, and 3.6% (11/305) had severe VFL. In all patients, the median of UV was 1.000 (1.000, 1.000), the mean of UV was 0.964, and the median of VAS score was 80 (75, 90), the mean of VAS score was 81.58. Anxiety or depression and pain or discomfort occurred in 45.7% (43/94) and 34.1% (32/94), respectively, of POAG patients with decreased UVs, as well as mobility constraints in 13.8 % (13/94) and usual activity constraints in 6.4% (6/94). The median of UV of the eye with a better visual field in the group without VFL or with mild or moderate VFL was 1.000 (1.000, 1.000), and in the group with severe VFL was 1.000 (0.862, 1.000), but there was no significant difference in the UV and the VAS score of the eye with a better visual field among groups with different degrees of VFL (both P>0.05). There was statistically significant difference in the UV among groups with different sleep qualities (H=17.465; P<0.01). Using pairwise comparison, the median of UV of the very good sleep group was 1.000 (1.000, 1.000), significantly different to the slightly poor sleep group 1.000 (0.866, 1.000) (z=3.613; P<0.05). The median of UV in patients with migraine was 1.000 (0.875, 1.000), without migraine 1.000 (1.000, 1.000), and in patients with hypertension was 1.000 (0.875, 1.000), without hypertension 1.000 (1.000, 1.000), and in patients with diabetes was 1.000 (0.875, 1.000), without diabetes was 1.000 (1.000, 1.000), the difference was statistically significant (Z=-2.189, -3.864, -2.417; all P<0.05). The UV was not related to age, gender, family history of glaucoma, amateur exercise, alcohol and tobacco, and history of anti-glaucoma medication (all P>0.05). Conclusions: VFL is related to the UV of POAG patients in Wenzhou. Quality of life in mild POAG patients is good but decrease in advanced POAG patients. Sleep quality, systemic complications and physical or psychological discomfort impact on quality of life in POAG patients. (Chin J Ophthalmol, 2021, 57: 207-214).

[The efficacy of hemostatic powder for chronic rhinosinusitis in endoscopic sinus surgery: a prospective, randomised, controlled and single blinded clinical trial]

Objective: To study the efficacy and patient comfort of absorbable hemostatic powder after endoscopic sinus surgery (ESS). Methods: A total of 21 (17 males, 4 females) patients with an average age of 42(ranging from 18 to 65) underwent bilateral ESS for chronic rhinosinusitis(CRS) in Beijing Tongren Hospital, Capital Medical University between October 2015 and July 2019 were enrolled to compare the effect of absorbable hemostasis powder with Nasopore using an intrapatient control design. A randomized controlled trial was conducted in the left and right nasal cavities of the same patient. If hemostatic powder was applied in the experiment nasal cavity, the Nasopore was applied in the control nasal cavity. The mean preoperative sinus computed tomography (CT) score was 6.25. All patients competed for symptom diaries using a visual analog scale (VAS, score out of 10) at baseline, through 1, 7, 14 and 30 days. Outcomes including bleeding, facial pain, nasal obstruction, nasal discharges using VAS were recorded separately for both sides. Postoperative endoscopic scores were also investigated. SPSS 22 and Graphpad prism 8.0 statistical softwares were used for the analysis. Paired t-test or nonparametric test was used between the test side and the control side. The difference was statistically significant (P<0.05). Results: The bleeding score and total nasal symptom VAS scores at postoperative days (POD) 1, 7, 14 and 30 were not significantly different(t=1.341, 0.552, 0.631, 0.158, all P>0.05;t=0.944, 1.471, 1.612, 2.251, all P>0.05). There was no significant difference between absorbable hemostasis powder and Nasopore side on POD 1, 7, 14 and 30 in terms of each nasal symptom VAS scores(all P>0.05). On POD 1, 7 and 14, the packing material degeneration scores of the absorbable hemostasis powder side were significantly lower than those of the Nasopore side [(1.33±0.21)vs(2.00±0.00),(0.38±0.18) vs (1.95±0.22), 0 vs (1.80±0.13), all P<0.01]. There were significant differences between absorbable hemostasis powder and Nasopore side on POD 1, 7, 14 and 30 in terms of endoscopic scores (edema, crusting, discharges, scar, polyps and material degeneration, t=3.07, 7.00, 6.41, 2.69, all P<0.05). Conclusions: The absorbable hemostasis powder and Nasopore has similar postoperative hemostasis effect. The absorbable hemostasis powder is rapidly cleared and without negative effects on mucosal wound healing 14 days postoperatively.

A Transit Time-Resolved Microflow Cytometry-Based Agglutination Immunoassay for On-Site C-Reactive Protein Detection

An accurate and rapid microflow cytometry-based agglutination immunoassay (MCIA) suitable for on-site antibody or antigen detection was proposed. In this study, quantitative C-reactive protein (CRP) detection was chosen as a model assay in order to demonstrate the detection principle. The average transit time was employed to estimate the extent of the agglutination reaction and improve the detection accuracy as compared to the intensity-dependent methods. The detection time was less than 8 min. and only a 20 µL serum sample was needed for each test. The results showed a linear relationship between the average transit time of aggregates and CRP concentrations ranging from 0 to 1 µg/mL. The R² of this relationship was 0.99. The detection limit of this technology was 0.12 µg/mL CRP. The system used for CRP detection can be extended to also monitor other clinically relevant molecules.

AB0147 GENE EXPRESSION PROFILES OF PRIMARY SJÖGREN’S SYNDROME ASSOCIATED THROMBOCYTOPENIA IN B-LYMPHOCYTE USING HIGH-THROUGHPUT SEQUENCING

Background:

Primary Sjögren’s syndrome(pSS) is a classical systemic autoimmune disease. Thrombocytopenia is one of the hematological manifestations of pSS with great challenges in clinic.

Objectives:

To identify the candidate genes and functionally enriched pathways in the immune genesis and progression of primary Sjögren’s syndrome (pSS) associated thrombocytopenia.

Methods:

High-throughput sequencing was performed on 3 patients with pSS, 3 patients with pSS associated thrombocytopenia and 3 healthy individuals. The differentially expressed genes (DEGs) were identified, and function enrichment analyses were processed. The protein-protein interaction network (PPI) was constructed, followed by calculation of topological characteristics and sub-module analysis in order to obtain hub DEGs. The expression of some hub genes was verified by Real-Time PCR in 24 pSS patients.

Results:

A total of 19 DEGs were identified. The enriched functions and pathway of the DEGs include Toll-like receptor signaling pathway, Salmonella infection, Viral protein interaction with cytokine and cytokine receptor, NF-kappa B signaling pathway and Human cytomegalovirus infection. Seven hub genes (TNF, IL1B, CXCL8, CCL3, CCL4, CCL3L1, CCL4L1) were identified and pathway enrichment analysis revealed that these genes were mainly enriched in toll-like receptor pathway. The relative expression of the CXCL8 mRNA in B-lymphocytes in patients with pSS associated thrombocytopenia was higher than that in the pSS without thrombocytopenia group. No differences were observed in the IL-1β or TNFα expression between these two groups.

Conclusion:

PSS associated thrombocytopenia might be a subset characterized by a systemic inflammatory state. The identification of upregulated genes involved in thrombocytopenia of pSS provides insight in disease pathogenesis and opens avenues for the design of novel therapeutic strategies.

References:

[1] Fox RI: Sjögren’s syndrome. Lancet, 2005; 366: 321–31.

[2]Baldini C, Ferro F, Elefante E, Bombardieri S. Biomarkers for Sjögren’s syndrome. Biomark Med. 2018;12(3):275-286.

[3]Hua F, Li Y, Zhao X, et al. The expression profile of toll-like receptor signaling molecules in CD19(+) B cells from patients with primary immune thrombocytopenia. Immunol Lett. 2016, 176:28-35.

Table 1.

Differentially expressed genes among patients with pSS associated thrombocytopenia, pSS without thrombocytopenia, and healthy controls

GeneLogFCin group2FDRin group 2LogFCin group1FDRin group 1TNF4.961.29E-034.554.98E-05CXCL88.881.29E-039.743.23E-05CCL35.654.54E-035.611.70E-05G0S27.384.54E-0312.331.09E-05LILRA38.427.23E-0310.264.31E-05IER35.449.53E-037.712.98E-06DUSP23.509.53E-033.918.12E-05TNFAIP32.639.53E-032.241.36E-03CCL44.531.19E-025.423.35E-06CCL4L26.721.40E-028.925.19E-05CCL4L14.721.40E-025.943.94E-06IL1B5.541.66E-0210.233.27E-06METRNL3.551.80E-024.022.08E-04ID22.932.43E-023.786.57E-03PER12.332.99E-022.427.68E-04EGR12.983.09E-022.931.80E-04CCL3L15.863.20E-026.665.94E-03FFAR24.944.09E-028.401.34E-05FOSB3.234.86E-023.491.39E-03Figure 1.

DEGs in pSS associated thrombocytopenia. 183 DEGs (31 up- and 151 down- regulated) between pSS patients with and without thrombocytopenia(a, c). 459 DEGs between pSS associated thrombocytopenia patients and healthy individuals were identified (2up- and 457 down- regulated) (b, d). The overlap among the 2 groups contained 19 genes represents the DEGs specified in pSS associated thrombocytopenia (e).

Figure 2.

KEGG pathway analysis.

Acknowledgments:

The authors apologize to all colleagues whose work has not been separately cited or discussed here due to limitations in space or knowledge.

Disclosure of Interests:

SHUO ZHANG: None declared, Jingge Qu: None declared, Li Wang: None declared, Mengtao Li: None declared, Xiaofeng Zeng Consultant of: MSD Pharmaceuticals

Core-shell polymeric nanoparticles co-loaded with photosensitizer and organic dye for photodynamic therapy guided by fluorescence imaging in near and short-wave infrared spectral regions

BACKGROUND

Biodistribution of photosensitizer (PS) in photodynamic therapy (PDT) can be assessed by fluorescence imaging that visualizes the accumulation of PS in malignant tissue prior to PDT. At the same time, excitation of the PS during an assessment of its biodistribution results in premature photobleaching and can cause toxicity to healthy tissues. Combination of PS with a separate fluorescent moiety, which can be excited apart from PS activation, provides a possibility for fluorescence imaging (FI) guided delivery of PS to cancer site, followed by PDT.

RESULTS

In this work, we report nanoformulations (NFs) of core-shell polymeric nanoparticles (NPs) co-loaded with PS [2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a, HPPH] and near infrared fluorescent organic dyes (NIRFDs) that can be excited in the first or second near-infrared windows of tissue optical transparency (NIR-I, ~ 700-950 nm and NIR-II, ~ 1000-1350 nm), where HPPH does not absorb and emit. After addition to nanoparticle suspensions, PS and NIRFDs are entrapped by the nanoparticle shell of co-polymer of N-isopropylacrylamide and acrylamide [poly(NIPAM-co-AA)], while do not bind with the polystyrene (polySt) core alone. Loading of the NIRFD and PS to the NPs shell precludes aggregation of these hydrophobic molecules in water, preventing fluorescence quenching and reduction of singlet oxygen generation. Moreover, shift of the absorption of NIRFD to longer wavelengths was found to strongly reduce an efficiency of the electronic excitation energy transfer between PS and NIRFD, increasing the efficacy of PDT with PS-NIRFD combination. As a result, use of the NFs of PS and NIR-II NIRFD enables fluorescence imaging guided PDT, as it was shown by confocal microscopy and PDT of the cancer cells in vitro. In vivo studies with subcutaneously tumored mice demonstrated a possibility to image biodistribution of tumor targeted NFs both using HPPH fluorescence with conventional imaging camera sensitive in visible and NIR-I ranges (~ 400-750 nm) and imaging camera for short-wave infrared (SWIR) region (~ 1000-1700 nm), which was recently shown to be beneficial for in vivo optical imaging.

CONCLUSIONS

A combination of PS with fluorescence in visible and NIR-I spectral ranges and, NIR-II fluorescent dye allowed us to obtain PS nanoformulation promising for see-and-treat PDT guided with visible-NIR-SWIR fluorescence imaging.

[Effect of anatomical changes of frontal recess and frontal sinus on airflow after nasalisation by image reconstruction and numerical simulation]

Objective: To describe the influence of post-operative anatomical structure changes on nasal airflow characteristics by 3D reconstruction and numerical simulation in real cases after nasalisation with Draf Ⅲ so as to explore the correlation between the changes of anatomical structure and subjective symptoms as well as airflow characteristics. Methods: Ten patients underwent nasalization with Draf Ⅲ in Department of Rhinology in Beijing Tongren Hospital from 2006 to 2018 were selected retrospectively. Postoperative follow-up of all patients was more than 1 year. All patients had no abnormalities in their paranasal sinus CT scans and Lund-Kennedy scores were 0 except scar. VAS scores including nasal obstruction, stimulation in frontal sinus, and headache were collected at the same period. The control model was a normal person. Numerical simulation was used for calculating airflow characteristics in deep inspiratory period of both models. Independent sample Mann-Whitney U test and Spearman correlation test were used by software SPSS 22.0. Results: The airflow pressure in frontal sinus ostium was (7.21±1.39)×10(4) Pa (Mean±SD), which was lower than that in normal subjects (8.99×10(4) Pa) under deep inspiratory simulation. But, the velocities in frontal sinus ostium and frontal sinus were (40.10±2.46) m/s and (28.19±1.73) m/s respectively, which were higher than those in normal one (2.70 m/s, 0.73 m/s). The airflow patterns of the two models were basically similar. There was no significant difference in the opening size and volume of frontal sinus between different groups after grouped by three symptoms respectively. No correlation could be found between the opening size and volume of the frontal sinus with the appearance and severity of three subjective symptoms. Conclusions: The airflow pattern and distribution after nasalisation with Draf Ⅲ are like those of normal person. There is no correlation between the changes of anatomy in frontal recess and frontal sinus and nasal airflow characteristics as well as subjective symptoms.

A goal programming approach for balancing diet costs and feed water use under different environmental conditions

Water is essential in livestock production systems. In typical dairy production systems, 90% of the total water used by a dairy farm is attributed to feed production. Theoretically, ration manipulation is a method to potentially reduce the irrigation water needed for feed crops without dramatically increasing diet costs. However, published quantitative studies on the relationship between feed production and water use that are integrated with linear programming models are scarce. The overall objective of this study was to develop an optimization framework that could achieve a balance between minimization of dietary costs and dietary irrigation water usage, and that could be used as a framework for future research and models for various livestock production systems. Weighted goal programming models were developed to minimize the dietary costs and irrigation water usage for a hypothetical cow under 8 different environmental scenarios. The environmental conditions used a 2 × 2 × 2 factorial design, including 2 atmospheric CO₂ concentrations (400 and 550 ppm), 2 water years (dry and wet), and 2 irrigation methods (furrow and drip). A systematic weighting scheme was used to model the trade-off between minimizing diet cost and minimizing irrigation water use for feedstuffs. Each environmental condition generated a set of distinct diets, which each met the same nutrient requirements of the hypothetical cow but had a different water usage when the weighting scheme was changed from weighting minimum diet costs to minimum irrigation water usage. For water resource planning in areas of dairy production, this set of unique solutions provides the decision maker with different feeding options according to diet cost, water usage, and available feeds. As water was more constrained, dietary dry matter intake increased, concentrations of neutral detergent fiber, ether extract, and energy decreased, and the concentration of lignin increased because less nutritive but more water-saving feedstuffs were included in the diet. Mitigation costs of water usage were calculated from goal programming results and indicated that the potential value of water under water-limited conditions (e.g., in a drought region) was higher than that under water-sufficient conditions. However, a smaller increase in feed costs can initially significantly reduce water usage compared with that of a least-cost diet, which implies that the reduction of water usage through ration manipulation might be possible. This model serves as a framework for the study of irrigation water usage in dairy production and other livestock production systems and for decision-making processes involved in water resources planning in the broader area of animal production.

Validation of Zero TE-MRA in the Characterization of Cerebrovascular Diseases: A Feasibility Study

BACKGROUND AND PURPOSE

Zero TE-MRA is less sensitive to field heterogeneity, complex flow, and acquisition noise. This study aimed to prospectively validate the feasibility of zero TE-MRA for cerebrovascular diseases assessment, compared with TOF-MRA.

MATERIALS AND METHODS

Seventy patients suspected of having cerebrovascular disorders were recruited. Sound levels were estimated for each MRA subjectively and objectively in different modes. MRA image quality was estimated by 2 neuroradiologists. The degree of stenosis (grades 0-4) and the z-diameter of aneurysms (tiny group ≤3 mm and large group >3 mm) were measured for further quantitative analysis. CTA was used as the criterion standard.

RESULTS

Zero TE-MRA achieved significantly lower subjective perception and objective noise reduction (37.53%). Zero TE-MRA images showed higher signal homogeneity (3.29 ± 0.59 versus 3.04 ± 0.43) and quality of venous signal suppression (3.67 ± 0.47 versus 2.75 ± 0.46). The intermodality agreement was higher for zero TE-MRA than for TOF-MRA (zero TE, 0.90; TOF, 0.81) in the grading of stenosis. Zero TE-MRA had a higher correlation than TOF-MRA (zero TE, 0.84; TOF, 0.74) in the tiny group and a higher consistency with CTA (intraclass correlation coefficient, 0.83; intercept, -0.5084-1.1794; slope -0.4952 to -0.2093) than TOF-MRA (intraclass correlation coefficient, 0.64; intercept, 0.7000-2.6133; slope -1.0344 to -0.1923). Zero TE-MRA and TOF-MRA were comparable in the large group. Zero TE-MRA had more accurate details than TOF-MRA of AVM and Moyamoya lesions.

CONCLUSIONS

Compared with TOF-MRA, zero TE-MRA achieved more robust performance in depicting cerebrovascular diseases. Therefore, zero TE-MRA was shown to be a promising MRA technique for further routine application in the clinic in patients with cerebrovascular diseases.

[Effective prevention and control of myopia in children and adolescents]

Myopia prevention and control is an important health issue related to children and adolescents, general public physical fitness and national defense security. In 2018, General Secretary Xi Jinping gave instructions on students' myopia. Ministry of Education and other seven ministries and commissions issued the Implementation Plan of the Myopia Prevention and Control for Children and Adolescents. As the myopia prevalence continues to develop into an urgent situation, myopia prevention and control has become a national strategy. In the battle fighting against prevalent myopia, medical and scientific researchers, as professionals, play a key role in guiding the effective implementation of the project and coordinating among five parties including government, schools, medical institutions, families and individual students. It is of great significance to effectively prevent and control myopia for children and adolescents and to achieve the overall goal of prevention and control. This article summarizes the potential effective methods in myopia prevention and control, hoping to provide useful reference and help for the national prevention and control work. (Chin J Ophthalmol, 2019, 55: 81-85).

Hyperspectral Multiplexed Biological Imaging of Nanoprobes Emitting in the Short-Wave Infrared Region

Optical bioimaging with exogenous luminophores emitting in short-wave infrared spectral region (SWIR, ~ 1000-1700 nm) is a rapidly developing field, and the development of multiple SWIR-photoluminescent nanoprobes has recently been reported. In this regard, hyperspectral imaging (HSI), combined with unmixing algorithms, is a promising tool that can allow for efficient multiplexing of the SWIR-emitting nanoagents by their photoluminescence (PL) spectral profiles. The SWIR HSI technique reported here is developed to multiplex two types of nanoprobes: polymeric nanoparticles doped with organic dye (PNPs) and rare-earth doped fluoride nanoparticles (RENPs). Both types of nanoprobes exhibit PL in the same spectral range (~ 900-1200 nm), which hinders spectral separation of PL with optical filters and limits possibilities for their multiplexed imaging in biological tissues. By applying SWIR HSI, we exploited differences in the PL spectral profiles and achieved the spectrally selective and sensitive imaging of the PL signal from every type of nanoparticles. Unmixing of acquired data allowed for multiplexing of the spectrally overlapping nanoprobes by their PL profile. Both quantitative and spatial distribution for every type of nanoparticles were obtained from their mixed suspensions. Finally, the SWIR HSI technique with unmixing protocol was applied to in vivo imaging of mice subcutaneously injected with PNPs and RENPs. The applicability of hyperspectral techniques to multiplex nanoprobes in the in vivo imaging was successfully demonstrated.

[Changing trends of topical anti-glaucoma medications in the Eye Hospital of Wenzhou Medical University during the past ten years]

Objective: To investigate the changing trends of topical anti-glaucoma medications in the outpatient of the Eye Hospital of Wenzhou Medical University over the decade 2005-2014. Methods: Retrospective case series study. The medications data of glaucoma outpatients in the Eye Hospital of Wenzhou Medical University were collected for the period of January 1(st) 2005 to December 31(st) 2014. SPSS 20.0 statistical software was used, mainly for statistical description of the data. The main outcome measures were the proportions of the prescriptions of different medications, and the proportions of the monotherapy and combination therapies. Results: During the 10 years, the number of glaucoma outpatients increased year by year, from 994 in 2005 to 3 266 in 2014, the gender ration was close to 1∶1, and the age were (57±18) years. The proportion of β-blockers decreased from 56.7% (750/1 323) in 2005 to 33.1% (2 120/6 407) in 2014. The proportion of cholinergic agents decreased from 17.2% (227/1 323) in 2005 to 10.3% (663/6 407) in 2014. While the proportion of prostaglandins increased from 13.3% (176/1 323) in 2005 to 36.8% (1 916/5 209) in 2011, which was close to the 37.9% (1 972/5 209) of β-blockers in 2011. In 2012, the prostaglandins proportion increased to 41.9% (2 435/5 810) exceeding the 37.2% (2 161/5 810) of β-blockers, and became the most prescribed medication. The proportion of prostaglandins continued to increase to 46.9% (3 008/6 407) in 2014. The proportion of α(2)-agonists increased from 17.0% (225/1 323) in 2005 to 22.8% (1 460/6 407) in 2014. The proportion of carbonic anhydrase inhibitors increased from 9.6% (127/1 323) in 2005 to 24.1% (1 546/6 407) in 2014.The proportion of monotherapy decreased from 78.0% (1 032/1 323) in 2005 to 58.6% (3 757/6 407) in 2014. The proportion of two drugs combination increased from 20.0% (264/1 323) in 2005 to 26.7% (1 709/6 407) in 2014. The proportion of three drugs combination increased from 2.0% (26/1 323) in 2005 to 12.3% (788/6 407) in 2014. The proportion of four drugs combination increased from 0.1% (1/1 323) in 2005 to 2.3% (150/6 407) in 2014. Conclusions: The changes of the proportions of topical anti-glaucoma medications were remarkable from 2005 to 2014 in the outpatient of the Eye Hospital of Wenzhou Medical University. The β-blockers and cholinergic agents were declining, while the prostaglandins, α(2)-agonists and carbonic anhydrase inhibitors were increasing, and the prostaglandins became the most prescribed medication since 2012. The proportion of combination therapy was increasing. (Chin J Ophthalmol, 2018, 54: 520-525).

[Quantitative evaluation of the relationship between femoral trochlear dysplasia and the degeneration of the patellofemoral cartilage by using T2mapping]

Objective: To evaluate the relationship between the femoral trochlear dysplasia(FTD) and the degeneration of the patellofemoral cartilage by using MR T2mapping technique. Methods: Sixty two subjects with FTD(aged 18-45 years) were enrolled in Tianjin First Center Hospital from January 2016 to December 2017,the controls which both age and gender were matched.T2mapping scan were aquired for each subject and control. Compare the differences of the T2mapping values for each area between subjects and controls, and compare Dejour types of femoral trochlear in different age groups, respectively. Results: The T2mapping value of subjects was significant lower than controls: the superficial-femoral-lateral layer (sFL) (P=0.000) and the superficial-patella-lateral layer (sPL) (P=0.009). In the group of age less than 30 years, the T2mapping value of subjects was significant lower than controls:sFL (P=0.001) and sPL (P=0.015). In group of age greater than 30 years, the T2mapping value of subjects was significant lower than controls: sFL (P=0.035). In difference Dejour types of FTD, the T2mapping value of type B-D was lowest in sFL(P=0.014),sPL(P=0.000), the superficial-patella-medial layer (sPM) (P=0.020) and the the T2mapping value of type B-D was highest in the deep-femoral-medial layer (dFM) (P=0.006). The difference was statistically significant, P<0.05. Conclusion: The FTD might cause the early degeneration of patellofemoral cartilage, which significantly appear in the young age; The type B-D of FTD is more likely to cause the wider range of superficial cartilage injure and involved some part of deep layer; the injure shows dehydration change in superficial cartilage and edema in deep layer.