Global longitudinal diastolic strain rate as a novel marker for predicting adverse outcomes in hypertrophic cardiomyopathy by cardiac magnetic resonance tissue tracking

AIM

To examine the prognostic value of global peak diastolic strain rate (PDSR) derived from cardiac magnetic resonance (CMR) tissue tracking (CMR-TT) in predicting adverse outcomes in hypertrophic cardiomyopathy (HCM) patients.

MATERIALS AND METHODS

A total of 98 patients diagnosed with HCM (44 patients had left ventricle [LV] outflow tract obstruction [LVOTO] and 54 patients did not) were enrolled and followed for the specified endpoint. LV global myocardial mechanics was assessed in all participants using CMR-TT at study entry.

RESULTS

Compared with the non-obstructive subgroup, the obstructive subgroup demonstrated deteriorated magnitude of LV global radial, circumferential, and longitudinal PDSR (all p<0.05). After a mean follow-up period of 4.5 years, 24 patients reached an endpoint before the end of the study. Furthermore, when using the specified cut-off value (0.33 1/s) of longitudinal PDSR, the Kaplan-Meier curve demonstrated that patients with lower longitudinal PDSR had a significantly lower freedom from major adverse cardiovascular events (MACE) compared with their counterparts in the non-obstructive, obstructive, and overall cohorts (all log-rank p<0.05). Multivariable analysis showed that longitudinal PDSR remained the strongest predictor of outcome after adjusting for baseline and CMR variables (hazard ratio, 2.65; 95% confidence interval, 2.21-11.44; p<0.05).

CONCLUSION

CMR-TT-derived longitudinal PDSR is probably considered a novel and easy-to-perform marker for predicting adverse outcomes in HCM patients, which is beneficial to risk stratification. Further confirmatory studies are needed.

Kinetics of Enzymatic Synthesis of Cyanidin-3-Glucoside Lauryl Ester and Its Physicochemical Property and Proliferative Effect on Intestinal Probiotics

The interest in anthocyanins used in food, cosmetic, and pharmaceutical industries has increased the research in order to improve their stability while maintaining bioactivity. In this work, cyanidin-3-glucoside lauryl ester (Cy3glc-C12) was enzymatically synthesized, using Novozym 435 as a catalyst, as well as to obtain a kinetic model for the bioprocess. Its liposolubility, UV–VIS absorbance property, thermostability, and potential proliferative effect on intestinal probiotics were also studied. The maximum conversion yield (68.7 ± 2.1%) was obtained with a molar ratio (substrate:donor) of 1:56, 435 16.5 g/L Novozym, temperature of 56 °C, and a time of 28 h via the acylation occurred at 6′′-OH position of the glucoside. The kinetics of the reaction is consistent with a ping-pong bi-bi mechanism and the parameters of the respective kinetic equations are reported. Compared with native Cy3glc, the liposolubility, pH resistivity and thermostability of Cy3glc-C12 were significantly improved. The growth kinetics of Bifidobacteria and Lactobacillus was established based on the Logistic equation, and Cy3glc-C12 could promote their proliferation especially during the logarithmic growth, in which lower pH and more bacteria population were found compared with those of media without anthocyanins. This research provided a reference for the industrial production of Cy3glc-C12 and extended its application to natural products in lipophilic systems.

Influence of Pasteurization and Storage on Dynamic In Vitro Gastric Digestion of Milk Proteins: Quantitative Insights Based on Peptidomics

It is important to evaluate the nutritional quality of milk during the shelf-life, especially during home storage, from a consumer viewpoint. In this study, we investigated the impact of pasteurization (85 °C/15 s) and subsequent storage (at 4 °C for 7 days) on the coagulation behavior of milk and protein digestibility in a dynamic in vitro gastric digestion test. A high level of hydration in curd formed in pasteurized milk upon 7-day cold storage compared to raw and pasteurized milk, indicating fast pepsin diffusion in the interior of curds, increasing the hydrolysis rate. The digesta collected at various time points throughout the gastric digestion were studied using o-phthaldialdehyde (OPA), sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), liquid chromatography tandem mass spectrometry (LC-MS/MS), and amino acid analysis. These results showed that milk proteins were hydrolyzed quickly upon a long period of cold storage. Additionally, qualitative and quantitative results obtained using LC-MS/MS exhibited significant differences between samples, especially in pasteurized milk upon cold storage. Processing and storage played a decisive role in bioactive peptide generation. Such knowledge could provide insights into and directions for the storage of pasteurized milk for further clinical studies on protein bioavailability and the generation of bioactive peptides for desired health outcomes.

Biomechanical effect of asymmetric mandibular prognathism treated with BSSRO and USSRO on temporomandibular joints: a three-dimensional finite element analysis

Asymmetric mandibular prognathism is a clinically common skeletal dentomaxillofacial deformity. Unilateral sagittal split ramus osteotomy (USSRO) is an effective alternative procedure to bilateral sagittal split ramus osteotomy (BSSRO) for some patients. However, the biomechanical effect of temporomandibular joint (TMJ) of USSRO has not been fully studied. This study aims to evaluate the stress distribution changes in the TMJ of asymmetric mandibular prognathism treated with BSSRO/USSRO, to validate the clinical feasibility of USSRO. Nineteen patients with mandibular prognathism patients who were treated with BSSRO (n=12) and USSRO (n=7) had preoperative and postoperative computed tomographic scanning. Preoperative and postoperative 3-dimensional finite element analysis (FEA) of functional TMJ movements were made on one BSSRO patient and one USSRO patient. In all patients, the ANB angle and mandibular deviation were significantly improved postoperatively. There was no significant difference in the postoperative ANB angle and mandibular deviation between the BSSRO group and the USSRO group. In two preoperative FEA models, the maximum stresses of non-deviation side TMJ structures were greater than the deviation side during functional movements. The unbalanced stress distribution was corrected postoperatively in both BSSRO/USSRO FE models. Both BSSRO/USSRO can improve the ANB angle and mandibular deviation. The bilateral TMJ structure in patients with asymmetric mandibular prognathism had unbalanced stress, which could be significantly improved with the USSRO as effectively as BSSRO.

Obstetric haemorrhage and risk of cardiovascular disease after three decades: a population-based cohort study

OBJECTIVE

To investigate the association between obstetric haemorrhage and cardiovascular disease up to three decades after pregnancy.

DESIGN

Population-based cohort study.

SETTING AND POPULATION

All women who delivered between 1989 and 2016 in Quebec, Canada.

METHODS

Using hospital admissions data, 1 224 975 women were followed from their first delivery until March 2018. The main exposure measures were antenatal (placenta praevia, placental abruption, peripartum haemorrhage) or postpartum haemorrhage, with or without transfusion. Adjusted Cox regression models were used to assess the association between obstetric haemorrhage and future cardiovascular disease.

MAIN OUTCOME MEASURE

Cardiovascular hospitalisation.

RESULTS

Among 104 291 (8.5%) women with haemorrhage, 4612 (4.4%) required transfusion. Women with haemorrhage had a higher incidence of cardiovascular hospitalisation than women without haemorrhage (15.5 versus 14.1 per 10 000 person-years; 2437 versus 28 432 events). Risk of cardiovascular hospitalisation was higher for obstetric haemorrhage, with or without transfusion, compared with no haemorrhage (adjusted hazard ratio [aHR] 1.06, 95% CI 1.02-1.10). Women with haemorrhage and transfusion had a substantially greater risk of cardiovascular hospitalisation (aHR 1.47, 95% CI 1.23-1.76). Among transfused women, placental abruption (aHR 1.79, 95% CI 1.06-3.00) and postpartum haemorrhage (aHR 1.38, 95% CI 1.13-1.68) were both associated with risk of cardiovascular hospitalisation. Antenatal haemorrhage with transfusion was associated with 2.46 times the risk of cardiovascular hospitalisation at 5 years (95% CI 1.59-3.80) and 2.14 times the risk at 10 years (95% CI 1.47-3.12).

CONCLUSIONS

Obstetric haemorrhage requiring transfusion is associated with maternal cardiovascular disease. The benefit of cardiovascular risk prevention in pregnant women with obstetric haemorrhage requires further investigation.

TWEETABLE ABSTRACT

Risk of future cardiovascular disease is increased for women with obstetric haemorrhage who require transfusion.

Heat treatments of peptides from oyster (Crassostrea gigas) and the impact on their digestibility and angiotensin I converting enzyme inhibitory activity

The changes of protein digestibility, the peptides in the digestive juice and angiotensin I converting enzyme (ACE) inhibitory activity after heating of oysters were investigated. The digestibility of raw oysters was 71.1%, and that of oysters heated at 100 °C was 67.9%. A total of 169 and 370 peptides were identified from the digestion of raw oysters and heated oysters, respectively. According to UPLC-Q-TOF-MS spectra, the peptides with a molecular weight below 2000 Da accounted for 87.6% of the total peptides of raw oysters and 94% of heated oysters. Testing the ACE inhibitory activity in vitro, the IC₅₀ values of raw oyster and cooked oyster were 6.77 μg/mL and 3.34 μg/mL, respectively. Taken together, the results showed that heated oysters could produce more active peptides and provide ACE inhibitory activity.

Colorimetric biosensing of nopaline synthase terminator using Fe3O4@Au and hemin-functionalized reduced graphene oxide

In this paper, we present a simple and label-free colorimetric biosensor for detection of the nopaline synthase (NOS) terminator in genetically modified (GM) plants. The "signal on" colorimetric biosensor was developed using a nanocomposite consisted of gold nanoparticles doped magnetic Fe₃O₄ nanoparticles (Fe₃O₄@Au NP), capture probe DNA (cDNA), and hemin-functionalized reduced graphene oxide nanosheets (H-GN). The nanocomposite was successfully prepared by means of Au-S bonds and the strong π interactions between cDNA and H-GN. The sensing approach is based on the excellent peroxidase-mimicking activity of H-GN and its different electrostatic interactions with single-stranded DNA (ssDNA) and double-stranded DNA (dsDNA). In presence of the target NOS, the cDNA in the nanocomposite will hybridize with its complementary sequence, and form dsDNA structure. Due to the weak π interactions between dsDNA and H-GN, a portion of H-GN will be released from the surface of Fe₃O₄@Au NPs and transferred into solution. After magnetic separation was performed, the supernatant was incubated with 3,3',5,5'-tetramethylbenzidine (TMB) in the presence of H₂O₂. The released H-GN can catalyze the oxidation reaction of TMB and turn the colorless solution blue. This "signal-on" colorimetric biosensor shows a broad linear range of 0.5-100 nM for the target NOS, with a 0.19 nM detection limit. The application of the biosensor for determination of NOS segments in samples of GM and non-GM tomatoes shows that it can discriminate between GM and non-GM plants. The reliability of the method for samples of NOS-spiked GM tomato suggests satisfactory recoveries in the range of 93.6%-94.2%.

Effect of pH regulation on the components and functional properties of proteins isolated from cold-pressed rapeseed meal through alkaline extraction and acid precipitation

Cold-pressed rapeseed meal with high protein content (38.76% protein dry weight basis) was used to prepare rapeseed protein isolates (RPIs) by alkaline extraction (pH 8.0, 9.0, 10.0, 11.0, 12.0 and 13.0) and acid precipitation (pH 3.0, 3.5, 4.0, 4.5, 5.0 and 5.5). The protein with an intact structure and the highest yield (65.08%) was obtained at extraction pH 9.0 and precipitation pH 4.5, accompanied by the lowest D-amino acid content, the lightest colour and the lowest contents of glucosinolates (2.85 mmol/kg), phytic acid (1.05 mg/g) and sinapine (0.68 mg/g). Additionally, water/oil absorption, foaming and emulsifying capacities decreased with decreasing precipitation pH, while the solubility showed the reverse trend. During gastric simulation digestion, the α-polypeptide of cruciferin and napin in the RPIs showed digestive resistance. Overall, pH regulation might be an effective method to isolate high quality RPIs for use in the food processing industry.

The role of macrophages during breast cancer development and response to chemotherapy

Macrophages play an important role in the immune system as a key host defense against pathogens. Non-polarized macrophages can differentiate into pro-inflammatory classical pathway-activated macrophages or anti-inflammatory alternative pathway-activated macrophages, both of which play central roles in breast cancer growth and progression in a process called polarization of macrophages. Classical pathway-activated and alternative pathway-activated macrophages can transform into each other and their transformational properties and orientation are determined by cytokines in the tumor microenvironment. Tumor-associated macrophages display many functions, such as tissue reforming, participating in inflammation and tumor growth in breast cancer progression. Some cytokines, such as interleukins and transcriptional activators, reside in the tumor microenvironment and influence tumor-associated macrophages. Chemotherapy is a common treatment for breast cancer and macrophages play an important role in mammary tumor cell migration, cancer invasion, and angiogenesis. This review summarizes the activities of tumor-associated macrophages in the mammary tumor, chemotherapeutic processes and some potential strategies for breast cancer therapy.

Calcium ion assisted fluorescence determination of microRNA-167 using carbon dots-labeled probe DNA and polydopamine-coated Fe3O4 nanoparticles

A selective and sensitive fluorescence biosensor is described for determination of microRNA-167 using fluorescent resonant energy transfer (FRET) strategy. The FRET system comprises carbon dots (CDs, donor) labeled with probe DNA (pDNA) and polydopamine (PDA)-coated Fe₃O₄ nanoparticles (Fe₃O₄@PDA NPs, acceptor). The CDs-pDNA can be absorbed onto the surface of Fe₃O₄@PDA NPs because of the strong π interaction between pDNA and PDA. With the enhanced adsorption ability of Fe₃O₄@PDA NPs by Ca²⁺, the fluorescence intensity of CDs at 445 nm (excitation at 360 nm) is quenched. In presence of microRNA-167, the hybridized complex of CDs-pDNA-microRNA-167 will be released from the surface of Fe₃O₄@PDA NPs due to the weak π interaction of the complex and PDA. This results in the fluorescence recovery of CDs. By application of twice-magnetic separation, the biosensor shows a wide linear range of 0.5-100 nM to microRNA-167 with a 76 pM detection limit. The method was applied to the determination of microRNA-167 in samples of total microRNA extractions from A. thaliana seedlings, and the recoveries ranged from 96.4 to 98.3%.

Chinese expert group consensus on diagnosis and clinical management of osteoradionecrosis of the mandible

Osteoradionecrosis of the mandible (MORN) is one of the most devastating complications caused by radiation therapy in the head and neck region. It is characterized by infection and chronic necrosis of the mandible as the main manifestation. Clinically, MORN-related symptoms include swelling, pain, dysphagia, trismus, masticatory or speech disorders, refractory orocutaneous fistula, bone exposure, and even pathological fracture. MORN has become a challenging clinical problem for oral and maxillofacial surgeons to deal with, but thus far, this problem has not been solved due to the lack of widely accepted treatment algorithms or guidelines. Because of the nonexistence of standardized treatment criteria, most clinical treatment against MORN nowadays is largely based on controversial empirical understandings, while recommendations on post-therapeutic evaluations are scarce. Therefore, to further unify and standardize the diagnosis and treatment of MORN, to decrease the huge waste of medical resources, and ultimately, to improve the wellbeing of the patients, the Chinese Society of Oral and Maxillofacial Surgery (CSOMS) convened an expert panel specialized in MORN from 16 domestic medical colleges and affiliated hospitals to discuss the spectrum of diagnosis and and formulate treatment. In addition, consensus recommendations were also revised with a comprehensive literature review of the previous treatment experiences and research pearls. This 'expert consensus statement on diagnosis and clinical management of MORN' is for clinical reference.

[Study on the characteristics of major birth defects in 1.69 million cases of fetus in Guangxi Zhuang Autonomous Region]

Objective: Tracking the information on 1.69 million fetal cases across Guangxi Zhuang Autonomous Region (Guangxi) so as to study the occurrences of total and major birth defects in order to evaluate the ability on related prevention and control programs in Guangxi. Methods: Using the self-developed "Gui Women's System" to establish a database of 1.69 million fetal cases in Guangxi and to analyze the distribution of time, space and population, as well as the outcomes of pregnancy, using the big data. Results: During the 29 months of observation, the overall live birth rate was 99.25%, with stillbirth rate during pregnancy as 0.44%, stillbirth rate during birth as 0.02%, and the 0-6 days mortality rate as 0.14%. The total detection rate on birth defects was 197.63/10 000; the incidence rate was 103.04/10 000, the birth rate was 102.55/10 000. The overall discovery rate of major birth defects was 48.33/10 000, with the incidence rate as 783 000, the birth rate as 0.58/10 000. The discovery rates of major birth defects in 14 cities were between 35 and 68/10 000, and the birth rate dropped significantly to less than 1.00 in 10 000. Nationalities showed that the number of pregnant women with birth defects more than 50 000 would include Hui (9.68/10 000), Yao (9.57/10 000), and Jing (9.37/10 000). With the increasing age of gestation, number of birth defects, incidence of major birth defects also increased. Ninety-five percent of the major birth defects were found within <28 weeks and with the top 5 kinds of major birth defects as complicated congenital heart disease (9.11/10 000), alpha thalassemia (8.36/10 000), and 21-trisomy syndrome (7.85/10 000), beta thalassemia (5.32/10 000) and fetal edema syndrome (4.92/10 000). The top 5 major birth defects appeared as complicated congenital heart disease (9.11/10 000), alpha thalassemia (8.36/10 000), and 21-trisomy syndrome (7.85/10 000), beta thalassemia (5.32/10 000) and fetal edema syndrome (4.92/10 000). Conclusion: Programs leading to increase the rate on discovery of major birth defects were fundamental in effectively reducing the major birth defects.

Integrated analysis of different mRNA and miRNA profiles in human hypopharyngeal squamous cell carcinoma sensitive and resistant to chemotherapy

The purpose of this study was to identify potential miRNAs and mRNAs involved in chemotherapy insensitivity in hypopharyngeal squamous cell carcinoma (HSCC) and to explore the underlying mechanisms involved to provide diagnostic markers and therapeutic targets for HSCC. We used microarrays to identify differences in both the mRNA and miRNA expression profiles between a group (twelve patients) sensitive to chemotherapy and a resistant group (nine patients). We then employed bioinformatics tools to examine the functions and pathways involved. The genes and miRNAs most related to chemotherapy sensitivity in HSCC were screened. Finally, a miRNA-mRNA-phenotype network was constructed with an integrated analysis based on the identified miRNAs and mRNAs. Nine differentially expressed miRNAs and one hundred differentially expressed mRNAs were identified, and the functions of these genes and miRNAs were predicted. Bioinformatics analysis revealed a regulatory network consisting of eight genes and two miRNAs that influenced HSCC chemosensitivity. According to our analysis, CCL4L1 may be a potential molecular marker for HSCC chemotherapy, and excess CCL4L1 leads to the upregulation of PRAME and the downregulation of miR-375, thus decreasing HSPB8 expression and promoting chemotherapy sensitivity. Our work provides reliable data for further studies investigating the mechanism of HSCC chemotherapy sensitivity.

Expression of Raptor and Rictor and their relationships with angiogenesis in colorectal cancer

Mammalian target of rapamycin (mTOR) has two subtypes, i.e., mTORC1 and mTORC2, which contain the Raptor and Rictor core molecules, respectively. The effect of Raptor and Rictor on hypoxia inducible factor (HIF)-1α, HIF-2α, and vascular endothelial growth factor (VEGF) in colorectal cancer (CRC) is unclear. In this work, we investigated the correlations among Raptor, Rictor, HIF-1α, HIF-2α, and VEGF expression in CRC. We subsequently analyzed the clinicopathological features of patients. Immunohistochemistry, western blot, and RT-PCR analyses were performed to detect the expression of Raptor, Rictor, HIF-1α, HIF-2α, and VEGF in 120 cases of CRC and 60 cases of normal colorectal mucosa. CD34 was used to label microvascular density (MVD), which was found to be higher in patients with positive Raptor or Rictor than in those with negative Raptor or Rictor. The positive rates of Raptor, Rictor, HIF-1α, HIF-2α, and VEGF in CRC were significantly higher than in normal colorectal mucosa. Raptor expression was positively correlated with HIF-1α and VEGF but not with HIF-2α expression. By contrast, Rictor expression was positively correlated with HIF-2α and VEGF but not with HIF-1α expression. Survival analysis further indicated that Raptor, Rictor, HIF-1α, HIF-2α, VEGF and lymph node metastasis were independent prognostic factors in CRC. To conclude, Raptor and Rictor expression was related to the initiation and development of CRC and angiogenesis in different ways. The combined detection of Raptor and Rictor is important for patients with colorectal carcinoma in prognosis and optimal therapy.

On the glacial-interglacial variability of the Asian monsoon in speleothem δ18O records

While Asian monsoon (AM) changes have been clearly captured in Chinese speleothem oxygen isotope (δ¹⁸O) records, the lack of glacial-interglacial variability in the records remains puzzling. Here, we report speleothem δ¹⁸O records from three locations along the trajectory of the Indian summer monsoon (ISM), a major branch of the AM, and characterize AM rainfall over the past 180,000 years. We have found that the records close to the monsoon moisture source show large glacial-interglacial variability, which then decreases landward. These changes likely reflect a stronger oxygen isotope fractionation associated with progressive rainout of AM moisture during glacial periods, possibly due to a larger temperature gradient and suppressed plant transpiration. We term this effect, which counteracts the forcing of glacial boundary conditions, the moisture transport pathway effect.

Potential effects of rapeseed peptide Maillard reaction products on aging-related disorder attenuation and gut microbiota modulation in d-galactose induced aging mice

As a good flavor enhancer, rapeseed peptide Maillard reaction products (MRPs) were developed, and the effects of MRPs on d-galactose induced aging Kunming mice were investigated for 6 weeks with low (200 mg kg-1 day-1), medium (400 mg kg-1 day-1) and high (800 mg kg-1 day-1) doses. Compared with the natural aging group and d-galactose induced aging mice, the mice with MRP administration showed increases in body weight gain, food intake, organ indexes, feces color and urine fluorescence intensity. MRP intake significantly decreased the MDA content and elevated the activities of CAT, SOD and GSH-Px, and T-AOC in the serum and tissues of the liver, kidney and brain. Additionally, AChE activity was decreased in the brain, while Na+-K+ ATPase and Ca2+-Mg2+ ATPase activity increased in a dose-dependent manner, and decreasing levels of IL-1β, IL-6 and TNF-α were observed in the liver and kidney. Histopathological analysis suggested an attenuation of inflammatory cell infiltration in the liver and kidney without cell necrosis. High-throughput sequencing results revealed that the ratio of Firmicutes to Bacteroidetes increased in MRP groups, and the pathogenic bacteria were significantly inhibited, while some beneficial bacteria were significantly increased in the intestine. Overall, our results indicated that MRP consumption might have potential beneficial effects on postponing the aging process via reducing the oxidative stress and gut microflora modulation.

Hypoglycemic effects of phenolic compound-rich aqueous extract from water dropwort (Oenanthe javanica DC.) on streptozotocin-induced diabetic mice

Phenolic compounds in water dropwort aqueous extract were identified, and the IRS-2/PI3K-AKT pathway and GLUT4 translocation were regulated for hypoglycemic action.

[The diagnostic utility of thin-slice CT navigation combined with radial endobronchial ultrasound for peripheral pulmonary lesions]

Objective: To evaluate the diagnostic value of thin-slice CT navigation combined with radial endobronchial ultrasound in peripheral lung lesions. Methods: The clinical data of patients with peripheral lung lesions diagnosed by thin-slice CT navigation combined with radial endobronchial ultrasound in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from November 2015 to August 2018 were retrospectively analyzed. The success rate of thin-slice CT for guiding radial endobronchial ultrasound was statistically analyzed, and the diagnostic rate, sensitivity and specificity of thin-slice CT combined with radial endobronchial ultrasound were analyzed. Results: 140 consecutive patients with 145 lesions were included, 139 lesions in 136 patients were found by thin-layer CT guidance, the success rate was 95.9%; 137 lesions in 135 patients were examined by histology and/or cytology, and 106 lesions were finally diagnosed, the diagnostic rate was 77.37%; and the diagnosis sensitivity and specificity was 88.45% and 99.96%. Histological and cytological diagnostic rate, sensitivity and specificity was 72.18% versus 63.50%, 70.58% versus 66.85%, 100% versus 88.23%, respectively. Factors influencing the diagnostic rate of thin-slice CT navigation combined with radial endobronchial ultrasound include the relationship between the lesion and the target bronchus, the location of the probe and the lesion, and the size of the lesion, and the difference between the farthest generation of bronchoscopy insertion and the bronchial generation of lesions. Five patients had mild bleeding and one ultrasonic probe was damaged. Conclusion: Thin-slice CT has a higher positive rate in guiding peripheral lung lesions with radial ultrasound, and this method has a higher diagnostic value for peripheral lung lesions.