Superb Research Articles

The preparation and use of γ-graphdiyne, a superb new photoelectrocatalyst

The preparation and use of γ-graphdiyne, a superb new photoelectrocatalyst

Torgny Svensson, a superb mind and an inspiring colleague

Torgny Svensson, a superb mind and an inspiring colleague

Study on the diagnostic value of superb microvascular imaging, advanced dynamic flow and color Doppler flow imaging in breast microcarcinoma and their correlation with pathological microvessel density

Objective To investigate the diagnostic value of superb microvascular imaging(SMI), advanced dynamic flow(ADF) and color Doppler flow imaging(CDFI) in breast microcarcinoma, and to compare the correlation coefficients between these three indicators and postoperative pathological tumor microvascular density(MVD). Methods A total of 85 patients(87 lesions) with BI-RADS 4 and the maximum diameter≤1 cm were selected, of which, 46 lesions were benign(benign group) and 41 lesions were malignant(malignant group). All the patients and the corresponding lesions were examined by SMI, ADF and CDFI. Blood flow grading was performed on the images using Adler grade of blood flow, and the difference of blood flow among the 3 methods was compared. The expression level of MVD in pathological tumor tissues was detected and analyzed for its correlation with Adler classification by three detection techniques. Results The areas under the ROC curve(AUR) of CDFI, ADF and SMI were 0.694, 0.705 and 0.776 respectively based on the gold standard with pathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CDFI were 78.0%, 54.3%, 60.4%, 73.5%, and 65.5%, respectively; those of ADF were 75.6%, 60.9%, 63.3%, 73.7% and 67.8%, respectively; and those of SMI were 78.0%, 69.6%, 69.6%, 78.0% and 73.6%, respectively. The Adler grades of CDFI, ADF and SMI were positively correlated with MVD(P<0.05), which the highest correlation coefficient between SMI and MVD (r=0.430, P<0.001). Conclusions SMI is superior to ADF and CDFI in detecting the abundance of breast microcarcinoma, and has the highest correlation coefficient among those 3 detection techniques with tumor pathological MVD, which indicates that SMI may be used for differential diagnosis of breast microcarcinoma and indirectly evaluate the prognosis of patients. Key words: Superb microvascular imaging; Advanced dynamic flow; Color Doppler flow imaging; Breast microcarcinoma; Adler grade of blood flow; Microvessel density

Evaluation of carotid plaque vulnerability by contrast-enhanced ultrasound and superb microvascular imaging

Objective To observe the plaque surface morphology and neo-vascularization within the plaque using superb microvascular imaging(SMI)and contrast-enhanced ultrasound(CEUS), and to compare the correlation and consistency of the two technologies based on making clinical diagnosis of symptomatic carotid artery plaque as the standard. Methods A total of 92 patients undergoing carotid ultrasonography in Beijing Tiantan Hospital from August 2016 to October 2017 were recruited, including 61 males and 31 females, aged(63.5 ± 7.7)years(range, 42-80 years.A total of 105 plaques were found.According to whether or not to have plaque-induced ipsilateral ischemic symptoms, patients were divided double-blindly into the symptom group and the non-symptom group.The features of plaque(including surface morphology and neo-vascularization)were recorded.The ultrasonographic findings were chi-squarely tested. Results There were statistically significant differences in the surface morphology and enhancement degree of CEUS between carotid artery plaque-induced ischemic symptom group and the non-symptom group(χ2=6.865, P=0.032; χ2=22.494, P<0.001). The SMI-detected surface morphology and neo-vascularization had statistically significant differences between the two groups(χ2=10.367, P=0.006; χ2=8.186, P=0.041). The correlations of plaque surface morphology(r=0.856, P<0.001)and diagnostic consistency(r=0.802, P<0.001)between SMI and CEUS were higher.In the symptom group, SMI-showed plaque fissures and small surface pitting were in 33.9%(20/59)of patients, and CEUS-showed plaque fissures and small surface pitting were in 25.4%(15/59)of patients.And SMI had a better detection rate of slight and irregular appearances on plaque surface.Taking the first grade of the plaque surface as the standard, CEUS showed a sensitivity of 42.4% and specificity of 80.4% for detecting symptomatic plaques, and SMI showed a sensitivity of 54.2% and specificity of 76.1%.The two methods had similar specificity, and SMI had a slightly higher sensitivity than did CEUS.CEUS and SMI had a good correlation of plaque neo-vascularization(r=0.802, P<0.001)and a moderate diagnostic consistency(r=0.539, P<0.001). Taking the enhancement level of 2 as the standard, CEUS showed a sensitivity of 75.8% and specificity of 67.4% for detecting the symptomatic plaque, and SMI showed a sensitivity of 58.6% and specificity of 69.5%.The two methods had similar specificity, and CEUS had a higher sensitivity than did SMI. Conclusions SMI and CEUS have a good consistency for detecting plaque surface morphology.SMI and CEUS are more correlated with plaque-induced symptoms than is two-dimensional ultrasound.The SMI has a higher display rate and repeatability than does CEUS for detecting the small fissures and the surface features of plaques.Compared with SMI-detected neo-vascularization, the degree of CEUS enhancement is more correlated with the symptoms.The specificity of CEUS and SMI is similar, and the sensitivity of CEUS is higher than that of SMI. Key words: Carotid artery thrombosis; Ultrasonography

A Renaissance mathematician’s art

Piero della Francesca is best known as a painter but he was also a mathematician. His treatise&#x0D; De prospectiva pingendi is a superb example of a union between the fne arts and mathemati‑&#x0D; cal sciences of arithmetic and geometry. In this paper, I explain some reasons why his paint‑&#x0D; ing is considered as a part of perspective and, therefore, can be identifed with a branch of&#x0D; geometry.

Clinical value of ultrasonographic superb micro-vascular imaging assessment for abdominal branch arteries in Stanford B aortic dissection

Objective To investigate the clinical diagnostic value of ultrasonographic superb micro-vascular imaging (SMI) for abdominal branch arteries′ involvement in Stanford B aortic dissection (AD). Methods A total of 34 AD patients underwent conventional ultrasound, SMI and CTA. The characteristics of the ultrasonographic images of branch artery involvement including coeliac artery, superior mesenteric artery, left and right renal artery were analyzed. The diagnostic performance of conventional ultrasound and SMI were compared and CTA was used as the reference standard. Results Among the 34 patients with AD, according to the ultrasonographic images′ characteristics, 136 branch arteries were categorized into four classes: Class Ⅰ(81/136), branch artery perfusion supplied from the aortic true lumen; Class Ⅱ(27/136), dissection extending into the branch; Class Ⅲ (16/136), branch artery perfusion supplied from the aortic false lumen; Class Ⅳ (12/136), branch artery perfusion supplied from the aortic true and false lumens. The diagnostic accordance rate of the conventional ultrasound and SMI were 76.5% (104/136) and 92.6% (126/136) and had significant differences (P<0.001). Conclusions SMI can be used to evaluate branch artery involvement in AD patients which will guide the practice of pre-operation and post-operation. Key words: Ultrasonography; Superb micro-vascular imaging; Aortic dissection; Branch artery; Coeliac artery; Superior mesenteric artery; Renal artery

Clinical Use of Measurable Residual Disease in Acute Myeloid Leukemia.

Treatment of acute myeloid leukemia (AML) remains a high-risk venture for the patient suffering from the disease. There is a real risk of succumbing to the treatment rather than the disease, and even so, cure is much less than certain. Since the establishment of complete remission as a prerequisite for cure in the 1960s, a number of years passed before advanced techniques for detecting minute amounts of disease matured sufficiently for clinical implementation. The two main techniques for detection of measurable residual disease (MRD) remain qPCR and multicolor flow cytometry. When performed in expert laboratories, both these modalities offer treating physicians excellent opportunity to follow the amount of residual disease upon treatment and offer unparalleled prognostication. In some AML and age group subsets, evidence now exist to support the choice of both proceeding to allogeneic transplant and not doing so. In other AML subgroups, MRD has sufficient discriminative power to identify patients likely to benefit from allogeneic transplant and patients likely not to. After treatment or transplantation, follow-up by molecular techniques can, with high certainty, predict relapse months before bone marrow function deterioration. On the other hand, options upon so-called molecular relapse are less well tested but recent evidence supports the use of azacitidine both in transplanted patients and patients consolidated with chemotherapy. In conclusion, MRD testing during treatment is a superb prognosticator and a major tool when choosing whether a patient should be transplanted or not. The exact use of MRD testing after treatment is less well defined but evidence is mounting for the instigation of treatment upon rising MRD levels (pre-emptive treatment) before morphologically detectable relapse.

Książki na biurko… nie na półkę…

Reminiscences of Professor Stanisław Jaworski, who often joked that books could be divided into those that are to be read immediately, ‘books for the desk’, and those that can wait, ‘books for the shelf’. Following the death of this eminent scholar and superb editor, the author places all Professor’s Jaworski’s books back on her desk...

Superb book about Alzheimer’s disease

Superb book about Alzheimer’s disease

Application of color Superb microvascular imaging and high-frequency ultrasonography in juvenile idiopathic arthritis

Objective To explore the application of color Super Microvascular Imaging (cSMI) and high-frequency ultrasonography (US) in evaluating the knee joint diseases of juvenile idiopathic arthritis (JIA) in the active period. Methods 90 patients diagnosed JIA clinically with knees pain and swelling were collected, the ultrasound diagnostic apparatus was used to examine knee joints. the main US signs were observed, the numbers of thickening of suprapatellar bursa synovial joints were recorded. The thickness of synovial membrane and the thickness of suprapatellar bursa effusion were also recorded, the blood flow signals of the thickening of synovial joints was checked by the cSMI and power doppler ultrasound (PDUS) separately. Color flow signals were graded by the semi-quantitative scoring systems. At the same period, the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. The differences of cSMI and PDUS in thickened synovial blood flow were compared. The correlations between the parameters were analyzed. Results 110 suprapatellar bursa synovial joints showed synovial thickening, synovial thickened joints are associated with varying degrees of suprapatellar bursa effusion. The thickness of synovial membrane and the thickness of suprapatellar bursa effusion were (6.01±3.08) mm, (7.45±3.91) mm, respectively. The proportion of blood flow signals detected by cSMI in thickened synovial membranes of Wri was 86.36%, while that of PDUS was 59.09%. The differences of blood flow signals rate were statistically significant (P=0.000). The differences of grading of PDUS and cSMI were statistically significant (P=0.000), Compared with PDUS, cSMI can raise the blood flow classification level. PDUS and cSMI blood flow signals grading were positively correlated with CRP, ESR, synovial membrane and suprapatellar bursa effusion (P=0.000). CRP was positively correlated with ESR, synovial membrane and suprapatellar bursa effusion (P=0.000). Synovial membrane was positively correlated with suprapatellar bursa effusion (P=0.000). Conclusion The application of cSMI and High-frequency US is helpful in the early diagnosis of knee joint lesions in active JIA children. Key words: Juvenile idiopathic arthritis; Knee joint; Color super microvascular imaging; High-frequency ultrasonography

In Appreciation of a Superb Run

In Appreciation of a Superb Run

Preliminary analysis of diagnostic efficiency of vascular morphology distribution in breast tumor by superb microvascular imaging

Objective To compare the differences of superb microvascular imaging (SMI) and color Doppler flow imaging (CDFI) in the diagnosis of breast tumor microvessels and explore the value of microvascular morphological features in the detection of benign and malignant tumors. Methods SMI and CDFI were performed in 105 patients (105 breast tumors) in the breast surgery in our hospital. The morphological characteristics of the microvessels of the breast tumor were observed. Their values in the diagnosis of the benign and malignant of the tumor were compared with the pathological results. Results There were statistically differences in differentiation of microvascular morphologic types of benign and malignant breast tumors between SMI and CDFI (P=0.021, 0.042). The type of diagnosing benign tumors was no blood vessel, linear and treelike. The type of diagnosing malignant tumors was root hair-like and crab claw-like. The susceptibility, specificity and accuracy of SMI and CDFI in diagnosing breast tumors were 85.36%, 93.75%, 90.47% and 63.41%, 90.47%, 81.90%. The area of the two ROC curves were 0.896 and 0.786. The results of the Z test show that the diagnostic efficacies of the two methods were statistically significant(Z=2.265, P=0.037). Conclusions SMI is more effective than CDFI in detecting low velocity microvessels in breast tumors. Its morphological typing is of clinical significance in the diagnosis of benign and malignant tumors. Key words: Superb microvascular imaging; Color Doppler flow imaging; Breast neoplasms; Microvessels

Eco-Zero Weeding - A Wow Incredible Scientific Innovation for Altering Things around Us and India Inaction

Weeds grow everywhere and create crop loss, involve huge expenditure in weeding, produ allergic pollens and unpalatable fodder, forages and cause green house gas emission in environment around us. Several high tech weeding machines including robotics were developed and focused as wonderful development and marketing strategy created to make huge profit in the global business by many developed countries forming company consortium to harness the benefits from such unaffordable technologies. Further, these weeding machine based practices are not suitable where sowing is done by hand broadcasting, as is prevalent in eastern India and many countries of the world, as well as under aberrant weather condition making field condition not walk able or too dry condition for any field operation., Hence, problem of weed management and global warming are not likely to get solved by such technical developments. It requires some miracle like discovery to stand as panacea scientific solution. The present study reports an innovative research on science of ecology that becomes a non monetary panacea total solution in agriculture and stands as method of weed management superb over any known mechanical-robotic weeder getting claimed as breakthrough on weeding works. This innovation was submitted to Indian Council of Agricultural Research, New Delhi over a year ago i.e. on August 17, 2017, as fulfillment of a challenge on weed management, but it is pending due to inaction. The new science based discovery not only overcomes weed control under all conditions, including the broad casting situations, as well as aberrant weather condition, but eco zero weeding fixes atmospheric natural nitrogen that enhances unimaginable high yield of crops. This discovery equips world with intellectual property of immense value that enable world acquire huge economic gain and overcome climate change and foster environment protection.

Comparative study of superb micro-vascular imaging and power Doppler imaging in the diagnosis of different size solid breast tumors

Objective To compare the diagnostic efficiency of superb micro-vascular imaging(SMI) and power Doppler imaging (PDI) in differentiating different size breast tumors. Methods Retrospective analysis were performent in a total of 170 cases of breast tumors of 144 patients screened with SMI and PDI in our hospital from August 2016 to July 2017, and pathological results were finally obtained. These tumors were divided into two groups according to the maximum diameter 2.0 cm. SMI and PDI diagnostic efficiency were compared by showing blood flow distribution, vascular morphology and Alder grade. Results There were 68 benign tumors and 102 malignant tumors.When the maximum diameter was no more than 2.0 cm, there were no significant difference in the blood flow distribution, vascular morphology and Alder grade between PDI and SMI of benign tumors(all P>0.05); However, there were significant differences in the vascular morphology and Alder grade of malignant tumors(all P 0.05) in benign tumors, but there was statistical difference in vascular morphology (P=0.001) in malignant tumors, and there was no significant difference in blood flow distribution, Alder grade in malignant tumors between PDI and SMI (all P>0.05). The area under the curve of ROC by PDI and SMI were 0.768 and 0.802, the difference was not statistically significant (P=0.447). Conclusions SMI can show the blood flow characteristics more clearly in breast tumors. When the maximum diameter is no more than 2.0 cm, SMI diagnostic efficiency is better than PDI. Key words: Ultrasonography; Breast neoplasms; Superb micro-vascular imaging; Power Doppler imaging

The application of superb micro-vascular imaging in evaluating the therapeutic efficacy of uterine fibroids treated with high intensity focused ultrasound

Objective To evaluate the value of superb micro-vascular imaging(SMI) in evaluating the efficacy of uterine fibroids treated with high intensity focused ultrasound(HIFU). Methods Forty patients with single fibroid were selected before and after HIFU treatment, color Doppler flow imaging(CDFI), SMI and contrast-enhanced ultrasound(CEUS) pattern were used to detect the lesions. CEUS was used as standard. The correlation of different blood flow levels in the fibroids with SMI and the efficacy of HIFU were evaluated. Results Before HIFU treatment, the blood flow signals of different degrees were found in the uterine fibroids. SMI showed that 4 fibroids(10.0%) were in the first degree, 21 fibroids(52.5%) were in the second degree and 15 fibroids(37.5%) were in the third degree. CEUS showed that 8 fibroids(20.0%) were hypo-enhanced, 19 fibroids(47.5%) were iso-enhanced and 13 fobroids(32.5%) were hyper-enhanced. The correlation analysis showed that there was close relationship between the results of SMI and CEUS(Kappa=0.754, P=0.00). After HIFU treatment, SMI and CEUS had no statistical difference in evaluating the efficacy of HIFU(P>0.05). The ratio of non-perfused volume and the ratio of the volume reduction at 6 months after HIFU in the third degree of SMI were lower than those in the first and second degrees(P<0.05). Conclusions There are some relationships between SMI and CEUS in evaluating the blood flow signal of uterine fibroids. SMI can prompt therapeutic efficacy of uterine fibroids ablated by HIFU and provide some clinical reference values. Key words: Ultrasonography; Uterine fibroids; Superb micro-vascular imaging; High intensity focused ultrasound

Application of shear wave elastography combined with superb micro-vascular imaging in diagnosing benign and malignant thyroid masses

Objective To investigate the application value of shear wave elastography (SWE) combined with superb micro-vascular imaging (SMI) in differentiating malignant and benign thyroid masses. Methods Seventy-eight patients diagnosed by ultrasound and verified with postoperative pathological analysis were enrolled. Conventional two-dimensional ultrasound was applied to observe the masses. SWE was performed to evaluate the elasticity and the Young′s modulus (AveT1) value acquired. ROC curve was drawn to calculate the sensibility and specificity using the cut-off value of AveT1. SMI was applied to define Adler′s grading standard according to the degree of blood supply. The sensitivity, specificity and accuracy of SWE and SWE combined with SMI in differentiating malignant and benign thyroid masses were analyzed. Results ①According to pathological analysis, there were 42 benign and 44 malignant masses; ②The AveT1 value between malignant and benign groups were all significantly different (P<0.01). 41.4 kPa was used as the best cut-off value of AveT1. The area under the ROC curve were 0.83 with sensitivity 86.9% and specificity 88.1%; ③There were more masses with the Alder class Ⅱ-Ⅲ in malignant group than those in benign group, and the difference was statistically significant (P<0.01); ④Quantified with SWE or SWE combined with SMI, the sensitivity were 86.9% and 91.3%, specificity were 88.1% and 92.8%, and accuracy were 87.5% and 94.1%, respectively, and the difference was statistically significant (P<0.01). Conclusions SWE combined with SMI represents an excellent application value in differentiating malignant and benign thyroid masses, which could improve the sensitivity, specificity and accuracy of the diagnosis for thyroid masses using ultrasound. Key words: Real-time shear wave elastography; Superb micro-vascular imaging; Thyroid neoplasms

Origin and Clinical Applications of Neural Crest-Derived Dental Stem Cells.

Over the past few decades, scientific research into neural crest-derived stem cells has progressed rapidly. The migration and differentiation of neural crest-derived stem cells has been an interesting area of research. Stem cells within teeth originating from the embryonic neural crest have attracted increasing attention in clinical and scientific research because they are easy to obtain and have superb stemness. The stem cells within the teeth include dental pulp stem cells (DPSCs), dental follicle stem cells (DFSCs), stem cells from apical papilla (SCAPs), stem cells from human exfoliated deciduous teeth (SHEDs), and periodontal ligament stem cells (PDLSCs). To date, there have been several interesting studies focusing on dental pulp regeneration, neural regeneration and the revascularization for therapeutic applications.

The application of superb micro-vascular imaging in predicting pregnancy outcome in patients with in vitro fertilization-embryo transfer

Objective To investigate the role of endometrial thickness, uterine artery and spiral artery blood flow parameters, endometrial and subendometrial blood flow on pregnancy outcome in vitro fertilization-embryo transfer (IVF-ET) cycle, compare the difference of the endometrial and subendometrial blood flow typing between the superb micro-vascular imaging (SMI) and power doppler ultrasound (PDUS). Methods Forty-one patients undergoing IVF-ET cycles in our hospital were recruited in this study. Transvaginal color Doppler ultrasound was performed to determine and record endometrial thickness, peak systolic velocity(PSV), end diastolic velocity(EDV), pulse index(PI), resistance index(RI), systolic diastolic ratio(S/D) of uterine artery and spiral artery, and degree endometrial and subendometrial blood flow signals were showed under the two blood flow modes of PDUS and SMI respectively on the day of human chorionic gonadotropin(HCG) injection. The degree of the endometrial and subendometrial blood flow was scored using Applehau classification method. According to the pregnancy outcome, patients were divided into pregnancy group and nonpregnancy group, the difference of the above indicators between the two groups were compared, and the degree of endometrial and subendometrial blood flow under two kinds of blood flow mode were observed. Results ①On the day of HCG injection, patients in pregnancy group had lower RI, PI, S/D of spiral artery than those in the nonpregnancy group (P 0.05). ②On the day of HCG injection, there was significant difference between the pregnant group and nonpregnant group in endometrial and subendometrial blood flow degree with SMI mode (P=0.005). The patients with type Ⅲ in pregnancy group were most (50%). ③The endometrial and subendometrial blood flow typing (β=1.085, OR=1.085, 95% CI=1.040-8.421, P=0.042) of pregnancy group under SMI mode have an independent predictive value. With increased blood flow typing under endometrial and subendometrial blood flow, the higher the possibility of pregnancy in patients. The ROC curve analysis showed that the area under ROC endometrial and subendometrial blood flow typing SMI mode on the HCG day was 0.746(P=0.008). Conclusions SMI is a new and effective type of Doppler ultrasound technique to evaluate the endometrial and subendometrial blood flow in IVF-ET cycle. On the day of HCG injection, the endometrial and subendometrial blood flow typing in SMI mode may predict pregnancy outcomes in IVF-ET cycles, and guide to choose the best embryo transfer time. Key words: Superb micro-vascular imaging; Endometrial receptive; Embryo transfer; Pregnancy outcome

The value of superb microvascular imaging in evaluating the renal function of transplanted kidney

Objective To investigate the value of vascular index(VI) in renal functionevaluation after renal transplantation by superb microvascular imaging(SMI). Methods Ultrasound and clinical data of 115 renal transplant recipients were collected: 32 cases had good recovery of renal function after surgery(group A); 35 cases of abnormal renal function caused by diseases or unexplained fluctuations in Scr, but the renal function was normal during the follow-up(group B); 48 cases with abnormal renal function, Scr increased continuously(group C). The correlation between VI of renal cortex and Scr was analysed. Results The VI of renal cortex in group A, B and C were (33.51±3.26)%, (31.64±4.83)%, (25.58±6.07)%, respectively. There were significant differences between VI in group A and C, and between group B and C (P 0.05). There was significant negative correlation between VI of renal cortex and Scr in group C (rs=-0.90, P 0.05). Conclusions When renal function is normal, VI is maintained at a high level. When renal function declines, VI decreases. VI can reflect the renal cortex blood flow, indirectly reflect the glomerular filtration function, and provide a reliable indicator for clinical evaluation of renal allograft function. Key words: Ultrasonography; Kidney transplantition; Superb microvascular imaging; Vascular index

Harold Ross Roberts, MD: inspirational mentor, consummate physician, superb scientist (1930‐2017)

Harold Ross Roberts, MD: inspirational mentor, consummate physician, superb scientist (1930‐2017)