Objective:To understand the prevalence, blood pressure control, and influencing factors of hypertension in residents aged 35-75 years in Jiangsu Province, and provide data support and basis for hypertension prevention and treatment.Methods:A stratified cluster sampling method was adopted to conduct community population surveys in 22 districts and counties in 12 prefectures in Jiangsu from 2021 to 2022. A total of 123 531 permanent residents aged 35-75 years were included in the study. The questionnaire survey collected the information about the demographic characteristics, disease history, lifestyle, and control of hypertension of study subjects. Statistical software SPSS 23.0 was used for χ2 test and multivariate logistic regression analysis, and Joinpoint 4.9.1.0 software was used to evaluate the trend of age change. Results:The standardized prevalence of hypertension in study subjects was 46.60%, the prevalence was higher in men than in women, and in rural residents than in urban residents, and the standardized blood pressure control rate was 11.24%, and it was lower in men than in women and in rural residents than in urban residents. The hypertension prevalence and control rates showed increasing trends with age (both P<0.001). The multivariate analysis results showed that being man, older age, being rural resident, higher frequency of alcohol consumption, marital status of being separated and widowed, overweight and obese, abdominal obesity and stroke, diabetes mellitus and dyslipidaemic diseases histories, and family history of hypertension were risk factors for hypertension, and being man, being rural resident, living north area, higher frequency of alcohol consumption, and obesity were risk factors for blood pressure control. Conclusions:The prevalence of hypertension in residents aged 35-75 years in Jiangsu was high, and the rate of blood pressure control was low. It is suggested to take integrated intervention measures, especially in in rural residents and people with low levels of education to reduce the disease burden of the patients.

Atrial fibrillation is one of the most common arrhythmias and is associated with multiple adverse cardiovascular events.Imaging techniques such as echocardiography,MRI and CT can evaluate the structure and function of the left ventricle,which is of great significance for the selection of clinical treatment and the prediction of postoperative recurrence risk.This article reviews the progress of the above cardiac imaging techniques in left ventricular structure and function in atrial fibrillation.

Objective:To design and evaluate a novel arcuate multi-channel rectal endoluminal applicator to enhance dose coverage of tumors in the upper and middle rectum and reduce pressure on the rectal wall.Methods:Pelvic MRI images of 200 Chinese cases without rectal lesions in the Peking University Third Hospital from July 2022 to August 2022 were retrospectively analyzed. Based on the image data, a rectal model with general characteristics of the population and two novel hard and soft rectal endoluminal applicators were designed and fabricated. The following properties of the conventional applicators and two new applicators were compared: deformation to the model rectal wall, maximum pressure, stable pressure, D 90%, D 100%, V 100%, V 150% and V 200% of the GTV, and D 2 cm3, D 1 cm3, and D 0.1 cm3 of the organs at risk (OAR). ANOVA or Kruskal-Wallis H-test was used to compare the differences among three applicators, and Dunnett's multiple comparison test was used for pairwise comparisons. Results:The novel hard and soft rectal endoluminal applicators caused less deformation of the model rectal wall. The maximum pressure on the rectal wall was (0.606 ± 0.182) kPa and (0.481 ± 0.229) kPa for the hard arcuate applicator and soft arcuate applicator, respectively, and the stable pressure was (0.207 ± 0.137) kPa and (0.055 ± 0.097) kPa, respectively, which were significantly smaller than those of the conventional applicator ( P <0.001, <0.001; P =0.024, <0.001), and the degree of reduction was at or near 50%. Under the premise of ensuring target dose, the D 2 cm3, D 1 cm3, and D 0.1 cm3 of OAR in the treatment plan designed with the novel applicator were significantly reduced compared to the cylindrical applicator (all P<0.001). Conclusion:The novel arcuate multi-channel rectal endoluminal applicator can significantly reduce rectal wall pressure and deformation, while also reducing the dose to OAR without compromising target dose coverage, offering certain therapeutic advantages.

The adenosine 5'-triphosphate (ATP)-binding cassette (ABC) transporter, IrtAB, plays a vital role in the replication and viability of Mycobacterium tuberculosis (Mtb), where its function is to import iron-loaded siderophores. Unusually, it adopts the canonical type IV exporter fold. Herein, we report the structure of unliganded Mtb IrtAB and its structure in complex with ATP, ADP, or ATP analogue (AMP-PNP) at resolutions ranging from 2.8 to 3.5 Å. The structure of IrtAB bound ATP-Mg2+ shows a "head-to-tail" dimer of nucleotide-binding domains (NBDs), a closed amphipathic cavity within the transmembrane domains (TMDs), and a metal ion liganded to three histidine residues of IrtA in the cavity. Cryo-electron microscopy (Cryo-EM) structures and ATP hydrolysis assays show that the NBD of IrtA has a higher affinity for nucleotides and increased ATPase activity compared with IrtB. Moreover, the metal ion located in the TM region of IrtA is critical for the stabilization of the conformation of IrtAB during the transport cycle. This study provides a structural basis to explain the ATP-driven conformational changes that occur in IrtAB.
Siderophores/metabolism* ; Iron/metabolism* ; Mycobacterium tuberculosis/metabolism* ; Cryoelectron Microscopy ; Adenosine Triphosphate/metabolism* ; ATP-Binding Cassette Transporters

Objective:To evaluate the right ventricular(RV) function by two-dimensional speckle tracking echocardiography(2D-STE) in heart failure patients with different left ventricle diastolic dysfunction grade.Methods:Twenty-nine healthy volunteers(control group), sixteen heart failure patients with reduced ejection fraction(HFrEF group) and eighty-six heart failure patients with preserved ejection fraction(HFpEF group) were enrolled in the Second Affiliated Hospital of Chongqing Medical University from October 2018 to September 2019. HFpEF patients were further divided into four subgroups according to recommendations of the American Society of Echocardiography in 2016: normal left ventricular diastolic function group and left ventricular diastolic dysfunction groups with grade 1, 2, 3 (LVDD1, LVDD2, LVDD3). Conventional ultrasonic parameters were obtained in apical four-chamber images, including RV basal diameter(RVD1), RV middle diameter(RVD2) and RV longitudinal diameter(RVD3), RV end diastolic area(EDA), end systolic area(ESA) and fractional area change(FAC), peak systolic velocity(S′), myocardial performance index(MPI), tricuspid annular plane systolic excursion(TAPSE). 2D-STE was performed to observe strain parameters, including basal, middle, apical and the whole longitudinal peak systolic strain of RV free wall respectively (RVLSbas, RVLSmid, RVLSapi and RVLSfw). Then 2D strain parameters were compared among these groups, and the correlation between 2D strain parameters and conventional ultrasonic parameters were analyzed.Results:①TAPSE and S′ gradually decreased in normal group, HFpEF group and HFrEF group(all P<0.05). For the four subgroups of HFpEF, compared to LVDD3, TAPSE、S′ increased significantly in normal group, LVDD1 and LVDD2(all P<0.05). ②RVLSbas, RVLSmid, RVLSfw gradually increased in control group, HFpEF group and HFrEF group(all P<0.05). The same trend appeared in group LVDD1, LVDD2 and LVDD3(all P<0.05). ③In control group, HFpEF group and HFrEF group, RVLSfw showed strong correlation with LVEF( r=0.77, P<0.01) and middle correlation with age, TAPSE, and S′( r=0.41, -0.48, -0.40, P<0.01). In the subgroups of HFpEF, RVLSfw had middle correlation with LV diastolic function( r=0.59, P<0.01), and weak correlation with age( r=0.21, P<0.01), and the same correlations with B-type natriuretic peptide(BNP), FAC, TAPSE( r=0.28, -0.29, -0.29; all P<0.01). Conclusions:2D-STE can detect the early subtle impairment of RV systolic function in HFpEF patients.

Objective: To compare the preoperative and postoperative dosimetric parameters in the treatment of spinal metastasis, and to verify the accuracy of 3D-printing non-coplanar template (3D-PNCT) combined with CT-guided ¹²⁵I seed implantation for the treatment of spinal metastasis. Methods: The treatment plans of 7 patients with spinal metastasis (9 lesions) from 2016 to 2018 receiving 3D-PNCT in combination with CT-guided ¹²⁵I seed implantation were retrospectively analyzed. The dosimetric parameters including homogeneity index (HI), conformal index (CI), external index (EI), dose of 90% target volume(D₉₀), mPD, volume percent of 100%, 150%, and 200% prescribed dose V₁₀₀、V₁₅₀、V₂₀₀ and D_2cm³ of spinal cord were compared before and after operation. The british columbia cancer ageny particle implantation quality evaluation standard was applied to evaluate the quality of implantation. Results: The HI, EI and CI, D₉₀, mPD, V₁₀₀, V₁₅₀, V₂₀₀ and D_2cm³ of spinal cord did not significantly differ before and after the plan (all P>0.05). Five were evaluated as excellent and 4 were assessed as good. Conclusion The postoperative dosimetric parameters of 3D-PNCT combined with CT guided ¹²⁵I seed implantation of spinal metastasis are basically consistent with preoperative dosimetric parameters. The postoperative plans are evaluated as excellent or good, suggesting that the technology has a good therapeutic accuracy in the treatment of spinal metastasis.

ObjectiveTo evaluate the accuracy and reproducibility of three‐dimensional echocardiographic( 3DE) automated quantification technique for assessment of left heart chamber volumes and function in consecutive patients . Methods One hundred and fifty consecutive patients underwent 3DE were enrolled in the cross‐sectional study . According to image quality , the patients were divided into satisfactory group ( n ＝ 102 ) and unsatisfactory group ( n ＝ 33 ) . T he accuracy and reproducibility of automated 3DE for measuring left ventricular end‐diastolic volume ( LVEDV ) , left ventricular end‐systolicvolume ( LVESV ) ,left atrial volume ( LAV ) and left ventricular ejection fraction ( LVEF ) were evaluated by the traditional manual 3DE as the relative standard . Among those with satisfactory image quality ,the effects of cardiac cycle selection on automatic 3DE were analyzed . In addition ,according to LVEDV index and LAV index ,the patients were grouped as enlargement group and normal group ,and the significance of editing the endocardial boundaries for both groups were analyzed . Results ① One hundred and thirty‐five patients were successfully analyzed by the automated 3DE . T he inter‐technique comparisons showed good correlations ( r‐values :LVEDV 0 .90 ,LVESV 0 .87 ,LAV 0 .86 ,LVEF 0 .67 ;all P ＜ 0 .01 ) and small biases( LVEDV 11 .9 ml ,LVESV 6 .4 ml ,LAV 9 .0 ml ,LVEF －0 .4% ) for all measurements in all patients . ② T he various parameters in satisfactory group had better correlations and consistency than those in the unsatisfactory group( all P ＜0 .05) . ③Between the two different cardiac cycles ,the automated 3DE measurements showed good correlations( r‐values :EDV 0 .96 ,ESV 0 .96 ,LAV 0 .95 ,LVEF 0 .80 ;all P＜ 0 .01 ) . ④ After optimized boundary of the automated 3DE ,LVEDV ,LVESV increased and LVEF decreased in the left chamber enlargement group( all P ＜0 .05) . ⑤All automated measurements were more reproducible than conventional manual measurements in both intra‐/inter‐observer studies . Conclusions Since automated 3DE is accurate and reproducible for the assessment of left heart chamber volumes and function ,it can be widely used in clinical practice as a feasible and objective ultrasound technique .

Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.

Purpose To develop the folate-targeted theranostic nanoprobe, investigate the active targeting behavior of nanoprobes to hepatocellular carcinoma(HCC)in vitro,and discuss the effect of enhanced US/MRI dual-mode imaging in vitro and the synergistic effect of high intensity focused ultrasound on HCC killing. Materials and Methods The folate-targeted nanoprobe loaded with iron oxide nanoparticles (Fe3O4) and phase-shift material perfluorohexane (PFH) was prepared by double emulsion method and carbodiimide method. The average particle size, morphological structure and the ability of liquid-gas phase transition were detected. The active targeting ability of the nanoprobe to HCC BEL-7402 was observed in vitro.The ultrasonic imaging effect of nanoprobe was observed by HIFU irradiation in vitro.MRI was performed on the Fe3O4nanoprobe with different content of magnetic particles.The synergistic killing ability of the nanoprobe combined with HIFU on liver cancer cells was detected with in vitro apoptosis experiment. Results The folate-targeted nanoprobe loading iron oxide nanoparticles (Fe3O4) and phase-shift material PFH was prepared, with the average size of (402.50±66.43) nm. It was in the shape of regular sphere with the magnetic particle Fe3O4scattered inside. The HIFU irradiation caused liquid and gas phase transition.In vitro targeting experiments showed that BEL-7402 cells were surrounded by a large number of nanoscale probes.In vitro dual mode imaging showed that the ultrasonic echo intensity was obviously enhanced after HIFU irradiates nanoscale probes. The MR negative imaging ability of the nanoprobe was also enhanced with the enhancement of Fe3O4concentration in nanoparticles. In vitro apoptosis experiments showed that the nanoscale probe had the ability to significantly enhance the effect of HIFU on the killing of HCC. Conclusion The prepared folate-targeted theranostic nanoprobes exhibit the excellent capability for in vitro targeting.They can be used for ultrasound and MRI as multimodal imaging agents and coordinates with HIFU to enhance the effect on killing HCC, which realizes the early diagnosis of tumor and targeted precision therapy.

Objective To compare the dose distribution of postoperative plans with preoperative plans of 3D-printing template (coplanar and non-coplanar) assisted and CT-guided 125I seed implantation for the treatment of soft tissue sarcoma,and to explore the accuracy of treatment at dosimetry level.Methods From December 2015 to July 2017,19 patients with soft tissue sarcoma (a total of 25 lesions)were treated with 3D printing template assisted and CT-guided 125I seed implantation in Peking University Third Hospital.All patients underwent preoperative assessment,CT simulation orientation,preoperative planning,3D-template printing,3D-template reduction,needle and seed implantation,postoperative dosimetry assessment,postoperative care and follow-up.The preoperative and postoperative dosimetric parameters were conpared.Ten cases of soft tissue sarcoma in superficial trunk or limbs were screened.Preoperative planning of coplanar template and non-coplanar template were designed respectively.The dosimetric parameters of preoperative planning guided of two templates were compared.Results Twentyfive 3D-printing templates were designed and constructed,and 25 lesions were totalled.There was no statistical difference between preoperative and postoperative dosimetric parameters.There was no statistical difference of the preoperative plan's dosimetric parameters between coplanar and non-coplanar in soft tissue sarcoma of superficial trunk/limbs.Conclusions The validation of actual dose distribution in postoperative plans assisted by 3D-printing template in 125I seed implantation showed that most of parameters could meet the expectation of preoperative plans,which indicated the improvement in accuracy for this new modality.For soft tissue sarcoma located in the superficial trunk/limbs,it was recommended to select the 3D-printing coplanar template firstly.