[This corrects the article DOI: 10.1016/j.apsb.2018.08.009.].

Objective To observe the performance and safety of self-developed real-time three-dimensional intracardiac echocardiography(ICE)system(system).Methods The self-developed system was constructed using disposable sterile real-time three-dimensional ICE catheter(catheter)and multifunctional cart-mounted digital ultrasound imaging host(ultrasound host).The diameter of catheter was 10F,with effective length of 90 cm and two-dimensional array transducer array(840 elements)integrated at tip.The ultrasound host was connected to the catheter through matching connector.The performance of this system was evaluated with self-made experimental equipment and standard phantom,and live animal experiment was performed to observe its safety and imaging quality.Results The maximum imaging depth of this system was ≥60 mm.Its axial resolution was ≤1 mm and lateral resolution was ≤1 mm within the depth of 40 mm,the horizontal and vertical geometric position accuracy errors were ≤10％and ≤5％,respectively,while the image geometric distortion was ≤10％,and the measurement volume error was ≤30％.The catheter was successfully inserted into right atrium of pig through femoral vein under ultrasound guidance,smoothly passing through the vascular pathway without any bending or jamming with good controllability.The cardiac images of this system were clear,which completely displayed cardiac chamber structures,and the image resolution met diagnostic requirement.No injury related to interventional procedures was found in laboratory tests nor anatomical results.Conclusion The self-developed ICE system was stable and safe,and initial results showed it could meet clinical application expectations.

Objective To observe the performance and safety of self-developed real-time three-dimensional intracardiac echocardiography(ICE)system(system).Methods The self-developed system was constructed using disposable sterile real-time three-dimensional ICE catheter(catheter)and multifunctional cart-mounted digital ultrasound imaging host(ultrasound host).The diameter of catheter was 10F,with effective length of 90 cm and two-dimensional array transducer array(840 elements)integrated at tip.The ultrasound host was connected to the catheter through matching connector.The performance of this system was evaluated with self-made experimental equipment and standard phantom,and live animal experiment was performed to observe its safety and imaging quality.Results The maximum imaging depth of this system was ≥60 mm.Its axial resolution was ≤1 mm and lateral resolution was ≤1 mm within the depth of 40 mm,the horizontal and vertical geometric position accuracy errors were ≤10％and ≤5％,respectively,while the image geometric distortion was ≤10％,and the measurement volume error was ≤30％.The catheter was successfully inserted into right atrium of pig through femoral vein under ultrasound guidance,smoothly passing through the vascular pathway without any bending or jamming with good controllability.The cardiac images of this system were clear,which completely displayed cardiac chamber structures,and the image resolution met diagnostic requirement.No injury related to interventional procedures was found in laboratory tests nor anatomical results.Conclusion The self-developed ICE system was stable and safe,and initial results showed it could meet clinical application expectations.

Objective To establish the quantitative evaluation system on the internal control of drug management, which could reflect the improvement and optimization of the internal control of drug management and be reference for the drug management in the hospital. Methods Brainstorm method was used to design a quantitative evaluation table. The methods of walking test, field inspection and comparative analysis were used to carry out the internal control design and execution effectiveness evaluation. Results Evaluation score increased from 36.50 points in 2015 to 43.75 points in 2021 when the full score was 50 points. The proportion of drug intotal income decreased from 37.97% in 2015 to 21.62% in 2021.The drug markup rate decreased from 14.38% to 0.96%, and the intensity of antibiotic DDDs decreased from 55.48 in 2018 to 39.30 in 2021. The proportion of essential drug prescriptions was higher than the national examination data. Conclusion The optimizing quantitative evaluation system on the internal control of drug management could improve the management specialization, the structure of income and payout and the level of rational drug use, promote the high-quality development of hospitals and safeguard the implementation of the Healthy China strategy.

Objective:To systematically evaluate the correlation between chronic periodontitis and postmenopausal osteoporosis (PMOP).Methods:Electronic searches were conducted on Cochrane Library, Pubmed, Embase, Ovid, CNKI, CBM, VIP, and WF databases to collect research literature on the correlation between chronic periodontitis and PMOP. The Newcastle Ottawa Scale (NOS) criteria were used to evaluate the quality of the included literature, and RevMan 5.3 software was used for meta-analysis. The outcome measures were clinical attachment loss (CAL), probing depth (PD), plaque index (PI), calculus index (CI), bleeding on probing (BOP), and simplified oral hygiene index (OHI-S).Results:A total of 16 articles were included, with a total of 1587 patients. Compared with the postmenopausal non osteoporosis group, the osteoporosis group showed significant abnormalities in CAL [standardized mean difference (SMD)=1.09, 95% CI: 0.62-1.57, P<0.001], PD(SMD=0.71, 95% CI: 0.28-1.14, P<0.001), PI(SMD=0.43, 95% CI: 0.29-0.56, P<0.001), and OHI-S(SMD=0.28, 95% CI: 0.22-0.35, P<0.001) indicators, as well as in BOP(SMD=0.01, 95% CI: -0.48-0.49, P=0.97) and GI(SMD=0.01, 95% CI: -0.48-0.49, P=0.97). At the level of 0.24 and 95% CI: -0.34 to 0.81, P=0.42, there was no statistically significant difference. Conclusions:Women with PMOP exhibit more significant changes in indicators such as CAL, PD, PI, and OHI-S, suggesting that postmenopausal women with osteoporosis are more likely to suffer from periodontitis.

Objective:To investigate the tumor perfusion enhancement induced by low intensity ultrasound stimulated microbubble cavitation (USMC) combined with programmed cell death-Ligand 1(PD-L1) antibody on improving the immune microenvironment of solid tumors.Methods:Tumor-bearing mice were divided into 4 groups: Control ( n=26) group, USMC ( n=27) group, anti-PD-L1 ( n=27) group and USMC+ anti-PD-L1 ( n=27) group. USMC treatment was performed with a VINNO 70 ultrasound theranostics system. Tumor perfusion was evaluated by contrast-enhanced ultrasound (CEUS). The anti-tumor efficacy was assessed by the tumor growth curve and the survival time of mice. The number and function of CD8 + T cells, the differentiation of CD4 + T cells, the proportion of MDSC and the phenotype distribution of TAM in tumors were analyzed by flow cytometry. The content of CXCL9, CXCL10 and HIF-1α in tumor were detected by ELISA. The expression of VEGF in tumor tissues was analyzed by immunofluorescence. Results:CEUS showed that the values of PI and AUC of tumors were significantly increased after USMC compared with before USMC (all P<0.05). USMC combined with anti-PD-L1 therapy did suppress the tumor progression. FCM showed the number, the expression of proliferation antigen Ki67, the secretion of IFN-γ and Granzyme B of CD8 + T cells in tumors were higher in combined group than those in other three groups after therapy (all P<0.05). Meantime, the proportion of Th1 was rose while Tregs and MDSC were declined and the polarization of TAM was toward M1 type by combined therapy. ELISA analysis showed that the combined therapy also increased the concentration of CXCL9, CXCL10 and decreased the content of HIF-1α in tumors (all P<0.05). Meanwhile, the immunofluorescence expression of VEGF was significantly lower in combined group than that in the control group after treatment ( P<0.05). Conclusions:Tumor perfusion enhancement by USMC combined with PD-L1 antibody therapy could improve tumor immune microenvironment and USMC might be a novel effective method for potentiating PD-L1 antibody immunotherapy.

Objective:Patients are breathing freely during adjuvant proton pencil beam radiotherapy after breast conserving surgery. Fluctuation of the thorax may affect the position of the end of the proton beam flow, which needs to be precisely evaluated on a millimeter scale.Methods:For 20 patients with breast cancer treated with proton radiotherapy after breast conserving surgery, PET-CT scan was performed approximately 10 min after the end of proton radiotherapy. The images of PET-CT were processed for ROI determination and sampling line (profile) extraction on a Raystation RV workstation to calculate the actual difference between the predicted and real radioactivity from the same spatial location as obtained by PET acquisition R50. Then, the differences in the spatial location between the actual process of proton irradiation and the planned process were obtained. Depth difference values for each pair of sampling lines were presented. Results:For 20 patients with breast cancer with a median follow-up of 22 months (range 12 - 46 months), all patients survived at the last follow-up, and no radiation pneumonitis was observed during the follow-up period. Among the verification results of 21 cases, the depth difference of evenly distributed was (-0.75±1.89) mm in the primary field and (-0.82±2.06) mm in the secondary field; The depth difference of sequential treatment was (1.81±1.87) mm in the primary field and (1.32±1.74) mm in the secondary field; The depth difference of synchronous addition in the primary field was (-1.47±1.44) mm, and the depth difference in the secondary field was (-1.48±2.11) mm.Conclusion:The results of off-line PET-CT in vivo biological verification show that the accuracy of the dose boundary cut-off was within 3 mm in breast cancer patients, which meets the clinical and physician requirement for the precision in breast cancer treatment.

Acute gastrointestinal dysfunction is a common and important complication of sepsis. As no exiting formal definition and classification of gastrointestinal dysfunction, most of the treatment strategies for gastrointestinal dysfunction are not based on clinical evidence, but on their own clinical experience. Experts of traditional Chinese medicine, integrated traditional Chinese and Western medicine and Western medicine from various disciplines in Shanghai are organized by the Shanghai Society of Integrated Traditional Chinese and Western Medicine and the Emergency Department Branch of Shanghai Physicians Association. After repeated discussion, literature search and formulation of the outline, we developed consensus on gastrointestinal dysfunction secondary to sepsis with integrating Traditional Chinese Medicine and Western medicine by consulting extensively on clinical experts in the fields of emergency medicine, gastroenterology, general surgery, infectious medicine and traditional Chinese medicine, and holding several expert forums and consultation meetings. This clinical expert consensus focused on acute gastrointestinal injury (AGI) classification and inducer of sepsis. In this consensus, the common symptoms, diagnosis, classifications, treatment strategies and suggestions of acute gastrointestinal injury or dysfunction secondary to sepsis were explored from the aspect of both Traditional Chinese Medicine and Western medicine.

As a carbon-storage compound and osmoprotectant in brown algae, mannitol is synthe-sized and then accumulated at high levels in Saccharina japonica (Sja);however, the underlying con-trol mechanisms have not been studied. Our analysis of genomic and transcriptomic data from Sja shows that mannitol metabolism is a cyclic pathway composed of four distinct steps. A mannitol-1-phosphate dehydrogenase (M1PDH2) and two mannitol-1-phosphatases (M1Pase1 and MIPase2) work together or in combination to exhibit full enzymatic properties. Based on comprehensive tran-scriptomic data from different tissues, generations, and sexes as well as under different stress con-ditions, coupled with droplet digital PCR (ddPCR) and proteomic confirmation, we suggest that SjaM1Pase1 plays a major role in mannitol biosynthesis and that the basic mannitol anabolism and the carbohydrate pool dynamics are responsible for carbon storage and anti-stress mechanism. Our proteomic data indicate that mannitol metabolism remains constant during diurnal cycle in Sja. In addition, we discover that mannitol-metabolism-associated (MMA) genes show differential expression between the multicellular filamentous (gametophyte) and large parenchymal thallus (sporophyte) generations and respond differentially to environmental stresses, such as hyposalineand hyperthermia conditions. Our results indicate that the ecophysiological significance of such dif-ferentially expressed genes may be attributable to the evolution of heteromorphic generations (fil-amentous and thallus) and environmental adaptation of Laminariales.

Tyrosine phosphatase SHP2 is a promising drug target in cancer immunotherapy due to its bidirectional role in both tumor growth promotion and T-cell inactivation. Its allosteric inhibitor SHP099 is known to inhibit cancer cell growth both and . However, whether SHP099-mediated SHP2 inhibition retards tumor growth anti-tumor immunity remains elusive. To address this, a CT-26 colon cancer xenograft model was established in mice since this cell line is insensitive to SHP099. Consequently, SHP099 minimally affected CT-26 tumor growth in immuno-deficient nude mice, but significantly decreased the tumor burden in CT-26 tumor-bearing mice with intact immune system. SHP099 augmented anti-tumor immunity, as shown by the elevated proportion of CD8IFN- T cells and the upregulation of cytotoxic T-cell related genes including , which decreased the tumor load. In addition, tumor growth in mice with SHP2-deficient T-cells was markedly slowed down because of enhanced anti-tumor responses. Finally, the combination of SHP099 and anti-PD-1 antibody showed a higher therapeutic efficacy than either monotherapy in controlling tumor growth in two colon cancer xenograft models, indicating that these agents complement each other. Our study suggests that SHP2 inhibitor SHP099 is a promising candidate drug for cancer immunotherapy.