蔡震宇
深圳孙逸仙心血管医院 放射科
INTRODUCTION:Tricuspid regurgitation (TR) is one of the most prevalent types of valvular heart disease linked to poor prognosis in patients with heart failure and is usually ignored. TR has received considerable attention due to the progressive advancements in transcatheter therapies in recent years.AREAS COVERED:With relatively solid data and rapid technological advancements, tricuspid transcatheter edge-to-edge repair (T-TEER) is the most frequently employed in a series of tricuspid transcatheter interventional treatments for TR. However, the efficacy and technical benefits of T-TEER are limited because of the unique anatomical characteristics and pathological mechanisms of the tricuspid valve. The aim of this review is to summarize reported data on current status of T-TEER and to provide an expert opinion regarding the challenges it is now experiencing and future development direction and approach.EXPERT OPINION:T-TEER is a significant treatment for TR, but its effectiveness and technical promotion are limited due to the tricuspid valve unique anatomical characteristics and pathological mechanisms. The selection criteria for suitable patients, the choice of when to intervene, device innovation, the advancement of ultrasound technology, and the volume of evidence in evidence-based medicine all indicate that the disorder of TR will eventually be better treated and understood.
Expert review of cardiovascular therapy 2023
Objective.Hematoma expansion is closely associated with adverse functional outcomes in patients with intracerebral hemorrhage (ICH). Prediction of hematoma expansion would therefore be of great clinical significance. We therefore attempted to predict hematoma expansion using a dual-modal machine learning (ML) strategy which combines information from non-contrast computed tomography (NCCT) images and multiple clinical variables.Approach.We retrospectively identified 140 ICH patients (57 with hematoma expansion) with 5616 NCCT images of hematoma (2635 with hematoma expansion) and 10 clinical variables. The dual-modal ML strategy consists of two steps. The first step is to derive a mono-modal predictor from a deep convolutional neural network using solely NCCT images. The second step is to achieve a dual-modal predictor by combining the mono-modal predictor with 10 clinical variables to predict hematoma growth using a multi-layer perception network.Main results. For the mono-modal predictor, the best performance was merely 69.5% in accuracy with solely the NCCT images, whereas the dual-modal predictor could boost the accuracy greatly to be 86.5% by combining clinical variables.Significance.To our knowledge, this is the best performance from using ML to predict hematoma expansion. It could be potentially useful as a screening tool for high-risk patients with ICH, though further clinical tests would be necessary to show its performance on a larger cohort of patients.
Physiological measurement 2021
Acute coronary syndrome caused by the rupture of atherosclerotic plaques is one of the primary causes of cerebrovascular and cardiovascular events. Neovascularization within the plaque is closely associated with its stability. Long non-coding RNA (lncRNA) serves a crucial role in regulating vascular endothelial cells (VECs) proliferation and angiogenesis. In this study, we identified lncRNA HCG11, which is highly expressed in patients with vulnerable plaque compared with stable plaque. Then, functional experiments showed that HCG11 reversed high glucose-induced vascular endothelial injury through increased cell proliferation and tube formation. Meanwhile, vascular-related RNA-binding protein QKI5 was greatly activated. Luciferase reporter assays and RNA-binding protein immunoprecipitation (RIP) assays verified interaction between them. Interestingly, HCG11 can also positively regulated by QKI5. Bioinformatics analysis and luciferase reporter assays showed HCG11 can worked as a competing endogenous RNA by sponging miR-26b-5p, and QKI5 was speculated as the target of miR-26b-5p. Taken together, our findings revered that the feedback loop of lncRNA HCG11/miR-26b-5p/QKI-5 played a vital role in the physiological function of HUVECs, and this also provide a potential target for therapeutic strategies of As.
Journal of cellular and molecular medicine 2020
The osteochondral junction (OCJ) of the knee joint is comprised of multiple tissue components, including a portion of the deep layer cartilage, calcified cartilage, and subchondral bone. The OCJ is of increasing radiological interest as it may be relevant in the early pathogenesis of osteoarthritis (OA). Due to its short transverse relaxation, the OCJ is invisible to clinical MR sequences. The purpose of this study was to develop a fast 3D T1-weighted ultrashort echo time cones sequence with fat saturation (FS-UTE-Cones) for high resolution and high contrast imaging of the OCJ on a clinical 3T scanner. First, numerical simulations were performed to investigate how the flip angle affected the signal intensities and contrasts of both short and long T1 tissues. The results from these simulations demonstrated that higher short T1 contrast could be achieved with higher flip angle. Next, T1 relaxation was measured for the different layers of a human patellar cartilage sample, and the results showed that the deepest layer had a significantly shorter T1 value than other layers. Finally, a healthy knee joint was scanned with different flip angles and the OCJ was highlighted in the T1-weighted FS-UTE-Cones sequence using a flip angle greater than 20°. The clinical T2-weighted and proton density-weighted FSE sequences were also included for comparison, revealing a dark OCJ region. Representative T1-weighted FS-UTE-Cones images of the whole knee of a healthy volunteer showed high signal intensity bands in the OCJ regions of the patella, femur, and tibia. On the other hand, T1-weighted FS-UTE-Cones imaging of the knee joints of OA patients revealed regions with reduction or loss of these high signal intensity bands in the OCJ regions, indicating abnormal OCJ tissue composition. The proposed 3D T1-weighted FS-UTE-Cones sequence with a 3-min scan time may be very useful for demonstrating the involvement of the OCJ regions in early OA.
Magnetic resonance imaging 2020
