BACKGROUND:Accurate detection of fetal cardiac time intervals is essential for diagnosing arrhythmias, yet conventional echocardiography cannot record fetal cardiac electrical activity. Fetal magnetocardiography (fMCG) offers precise, noninvasive detection, but clinical evidence remains limited. OBJECTIVE:This study aimed to evaluate the efficacy and safety of fMCG for detecting fetal cardiac magnetic signals, by comparison with fetal electrocardiography (fECG). METHODS:We conducted a 2-center, single-arm, prospective trial involving 342 pregnant women aged ≥18 years with gestational ages of >18 weeks. Each participant underwent both fECG and fMCG on the same day, with cardiac time intervals recorded. The primary end point was the detection rate of fetal cardiac waveforms reflecting atrial and ventricular rhythm relationships. RESULTS:In the full analysis set (n = 342), fMCG demonstrated a significantly higher detection rate for QRS complexes and RR intervals than fECG (87.98% vs 78.95%; P < .01), with a rate difference of 9.03% (95% confidence interval 3.50-14.56). Similar results were observed in the per-protocol set (n = 340; fMCG 87.94% vs fECG 79.41%; P < .01). Notably, only fMCG could reliably detect PR intervals (86.22%), P waves (86.22%), T waves (78.89%), and QT/corrected QT intervals (78.89%). Adverse events were rare (n = 1; 0.29%) and unrelated to the device. CONCLUSION:fMCG was superior to fECG in detecting RR and QRS signals. Moreover, fMCG uniquely enabled visualization of other intervals critical to arrhythmia diagnosis. It also exhibited a favorable safety profile, supporting its potential in fetal cardiac monitoring.

Background Noninvasive detection of TP53 mutations is useful for the molecular stratification of breast cancer. Purpose To explore MRI radiomics features reflecting TP53 mutations in breast cancer and propose a classifier for detecting such mutations. Study Type Retrospective. Population/Subjects A total of 139 breast cancer patients with TP53 expression profiling (98 with TP53 mutations and 41 without TP53 mutations). Field Strength/Sequence 1.5 T, T1-weighted (T1W) DCE-MRI. Assessment Lesions were manually segmented using subtracted T1WI. A total of 944 radiomics features (including 744 wavelet-related features) and 7 clinicopathological features were extracted from each lesion. Principal component analysis and Pearson's correlation analysis were used to preprocess the features. Linear discriminant analysis, logistic regression (LR), support vector machine (SVM), and random forest (RF) were used as the classifiers. Statistical Tests Analysis of variance, Kruskal-Wallis and recursive features elimination were used to select features. Receiver operating characteristic (ROC) analysis was performed to compare the diagnostic accuracy. Results For the radiomics model, the validation cohorts AUCs of the four classifiers ranged from 0.69 (RF) to 0.74 (LR), and LR (0.74) attained the highest AUCs. For the clinicopathological-radiomics combined model, the validation AUCs of the four classifiers ranged from 0.68 (RF) to 0.86 (SVM), and SVM (0.86) attained highest AUCs. In the subgroup analysis of triple-negative (TN) and luminal type breast cancer, RF achieved the highest AUCs (0.83 and 0.94). Data Conclusion Clinicopathological-radiomics combined model with SVM could be used as noninvasive biomarkers for predicting TP53 mutations. RF was recommended for the detection of TP53 mutations in TN and luminal type breast cancer. Level of Evidence 3 Technical Efficacy Stage 2.

Objective To observe the changes of heart function and tumor necrosis factor receptor-associated factor-6（TRAF6）and nuclear factor-κB（NF-κB）P65 proteins in acute myocardial infarction（AMI）mice after being treated with N-acetylcysteine（NAC）,and to investigate the influence of NAC on the heart function in AMI mice and its potential mechanism.Methods Thirty male C57BL/J6 mice were randomly divided into AMI group,AMI+NAC group and sham-operation group,with 10 mice in each group.The mice models were prepared by ligating the anterior descending branch of left coronary artery in AMI and AMI+NAC groups,while sham-operation group was only performed thoracotomy without ligating coronary artery.After modeling,AMI+NAC group was intraperitoneally injected with 100mg/（kg·d）NAC for 7days,and AMI and AMI+NAC groups were injected equivalent volume of normal saline.Echocardiography was done to measure left ventricular ejection fraction,left ventricular end-diastolic dimension and left ventricular end-systolic dimension in three groups 7days later.The blood was collected from the posterior abdominal aorta.The levels of tumor necrosis factor-α（TNF-α）,interleukin（IL）-6 and IL-1β were detected by ELISA.All mice were sacrificed to obtain the heart.The histopathological changes were observed by HE staining.The relative expressions of TRAF6 and NF-κB P65 mRNAs were detected by real-time fluorescence quantitative PCR,and the expressions of TRAF6 and NF-κB P65 proteins were detected by immunohistochemisty in three groups.Results By day 7 after modeling,left ventricular ejection fraction was smaller in AMI group[（43.33±2.31）%]than that in AMI+NAC group[（68.33±4.16）%]and sham-operation group[（81.67±3.06）%]（P＜0.05）,and in AMI+NAC group than that in sham-operation group （P＜0.05）.Left ventricular end-diastolic dimension and left ventricular end-systolic dimension were longer in AMI group[（4.35±0.11）,（4.70±0.14）mm]than those in AMI+NAC group[（4.00±0.05）,（3.98±0.16）mm]and sham-operation group[（3.85±0.09）,（2.04±0.09）mm]（P＜0.05）,and longer in AMI+NAC group than those in sham-operation group （P＜0.05）.The myocardial structure was normal in sham-operation group,and was disordered in AMI group,which was slighter in AMI+NAC group compared with AMI group.The relative expressions of TRAF6 and NF-κB P65mRNA,and the average optical intensity scores of TRAF6 and NF-κB P65 proteins were higher in AMI group（3.22±0.23,3.82±0.16;0.075±0.006,0.071±0.002）than those in AMI+NAC group（2.11±0.25,2.14±0.14;0.056±0.007,0.047±0.004）and sham-operation group（1.00±0.06,1.00±0.05;0.053±0.005,0.039±0.005）（P＜0.05）,and higher in AMI+NAC group than those in sham-operation group（P＜0.05）.The levels of IL-6,IL-1β and TNF-αwere higher in AMI group[（277.30±31.42）,（105.57±2.16）,（105.67±7.09）ng/L]than those in AMI+NAC group[（151.16±9.86）,（81.63±6.85）,（75.33±6.03）ng/L]and sham-operation group[（135.29±10.27）,（50.95±7.22）,（48.33±3.51）ng/L]（P＜0.05）,and higher in AMI+NAC group than those in sham-operation group （P＜0.05）.Conclusion NAC can reduce the release of inflammatory factors and improve the heart function in AMI mice,probably by inhibiting TRAF6and NF-κB signaling pathway.

PURPOSE:To investigate the utility of whole-tumor histogram analysis based on multiparametric MRI in distinguishing pure mucinous breast carcinomas (PMBCs) from fibroadenomas (FAs) with strong high-signal intensity on T2-weighted imaging (T2-SHi). MATERIAL AND METHODS:The study included 20 patients (mean age, 55.80 ± 15.54 years) with single PBMCs and 29 patients (mean age, 42.31 ± 13.91 years) with single FAs exhibiting T2-SHi. A radiologist performed whole-tumor histogram analysis between PBMC and FA groups with T2-SHi using multiparametric MRI, including T2-weighted imaging (T2WI), diffusion weighted imaging (DWI) with apparent diffusion coefficient (ADC) maps, and the first (DCE_T1) and last (DCE_T4) phases of T1-weighted dynamic contrast-enhanced imaging (DCE) images, to extract 11 whole-tumor histogram parameters. Histogram parameters were compared between the two groups to identify significant variables using univariate analyses, and their diagnostic performance was assessed by receiver operating characteristic (ROC) curve analysis and logistic regression analyses. In addition, 15 breast lesions were randomly selected and histogram analysis was repeated by another radiologist to assess the intraclass correlation coefficient for each histogram feature. Pearson's correlation coefficients were used to analyze the correlations between histogram parameters and Ki-67 expression of PMBCs. RESULTS:For T2WI images, mean, median, maximum, 90th percentile, variance, uniformity, and entropy significantly differed in PBMCs and FAs with T2-SHi (all P < 0.05), yielding a combined area under the curve (AUC) of 0.927. For ADC maps, entropy was significantly lower in FAs with T2-SHi than in PMBCs (P = 0.03). In both DCE_T1 and DCE_T4 sequences, FAs with T2-SHi showed significantly higher minimum values than PBMCs (P = 0.007 and 0.02, respectively). The highest AUC value of 0.956 (sensitivity, 0.862; specificity, 0.944; positive predictive value, 0.962; negative predictive value, 0.810) was obtained when all significant histogram parameters were combined. CONCLUSIONS:Whole-tumor histogram analysis using multiparametric MRI is valuable for differentiating PBMCs from FAs with T2-SHi.

Background::Intrauterine valvuloplasty is an innovative therapy, which promotes ventricular growth and function in some congenital heart diseases (CHDs). The technique remains challenging and can only be performed in a few centers. This study aimed to assess the feasibility and mid-term outcomes of fetal cardiac intervention (FCI) in fetuses with critical CHD in an experienced tertiary center.Methods::Five fetal aortic valvuloplasty (FAV) or fetal pulmonary valvuloplasty (FPV) procedures were performed in our fetal heart center between August 2018 and May 2022. Technical success was defined as crossing the aortic or pulmonary valve and balloon inflation, followed by evidence of increased blood flow across the valve and/or new regurgitation. Follow-up clinical records and echocardiography were obtained during the prenatal and postnatal periods.Results::Five fetuses received FAV or FPV, including critical aortic stenosis ( n = 2) and pulmonary atresia with intact ventricular septum ( n = 3). The mean maternal age was 33.0 ± 2.6 years. The median gestational age (GA) at diagnosis was 24 weeks (range, 22-26 weeks). The median GA at intervention was 29 weeks (range, 28-32 weeks). All five cases underwent successful or partially successful procedures. One patient had pulmonary valve perforation without balloon dilation. No procedure-related deaths or significant complications occurred. However, one neonatal death occurred due to heart and renal failure. The median follow-up period was 29.5 months (range, 8.0-48.0 months). The four surviving patients had achieved biventricular circulation, exhibited improved valve, and ventricular development at the last follow-up visit. Conclusion::Intrauterine FCI could be performed safely with good prognosis in critical CHD.

Objective: We aimed to evaluate the effectiveness of simultaneous multi-slice readout-segmented echo-planar diffusion-weighted imaging (SMS rs-EPI DWI), compared with readout-segmented echo-planar diffusion -weighted imaging (NOSMS rs-EPI DWI), in discriminating between benign and malignant breast lesions. Materials and methods: This retrospective study evaluated breast lesions from 185 consecutive patients who had undergone preoperative breast MRI. The NOSMS rs-EPI DWI and the prototype SMS rs-EPI DWI sequences were performed on a 1.5-T MR scanner. Two independent radiologists evaluated the image quality of the two se-quences using a 5-point scale (1 = poor, 5 = excellent) and then assessed the scores through visual grading characteristics analysis (VGC). The values of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and whole-tumor-based histogram parameter (ADCmedian) were compared between the two sequences using the Wilcoxon test. Then ROC curves were used for statistical analysis. Results: The visual assessment showed that the SMS rs-EPI yielded superior overall image quality and lesion delineation than the NOSMS rs-EPI (AUCVGC = 0.980 and 0.984, respectively; all P < 0.001). There were no significant differences in relevant artifacts between the two sequences (AUCVGC = 0.531, P = 0.462). The SNR values for SMS rs-EPI DWI were significantly lower than for NOSMS rs-EPI DWI (P = 0.019) while there was no significant difference in CNR values between the two sequences (P = 0.955). In addition, evaluation of the diagnostic performance demonstrated that the difference in ADCmedian values for both DWI sequences between the malignant and benign lesions was statistically significant (P < 0.001). In contrast, the AUC for ADCmedian was higher with SMS rs-EPI than NOSMS rs-EPI (0.879 for SMS vs. 0.839 for NOSMS, P = 0.025). Conclusion: The SMS technique could further improve the image quality and the diagnostic performance of rs-EPI DWI in a comparable time.

ObjectivesTo investigate the image quality and diagnostic capability a of whole-lesion histogram and texture analysis of advanced ZOOMit (A-ZOOMit) and simultaneous multislice readout-segmented echo-planar imaging (SMS-RS-EPI) to differentiate benign from malignant breast lesions.Study designFrom February 2020 to October 2020, diffusion-weighted imaging (DWI) using SMS-RS-EPI and A-ZOOMit were performed on 167 patients. Three breast radiologists independently ranked the image datasets. The inter-/intracorrelation coefficients (ICCs) of mean image quality scores and lesion conspicuity scores were calculated between these three readers. Histogram and texture features were extracted from the apparent diffusion coefficient (ADC) maps, respectively, based on a WL analysis. Student’s t-tests, one-way ANOVAs, Mann–Whitney U tests, and receiver operating characteristic curves were used for statistical analysis.ResultsThe overall image quality scores and lesion conspicuity scores for A-ZOOMit and SMS-RS-EPI showed statistically significant differences (4.92 ± 0.27 vs. 3.92 ± 0.42 and 4.93 ± 0.29 vs. 3.87 ± 0.47, p < 0.0001). The ICCs for the image quality and lesion conspicuity scores had good agreements among the three readers (all ICCs >0.75). To differentiate benign and malignant breast lesions, the entropy of ADCA-Zoomit had the highest area (0.78) under the ROC curve.ConclusionsA-ZOOMit achieved higher image quality and lesion conspicuity than SMS-RS-EPI. Entropy based on A-ZOOMit is recommended for differentiating benign from malignant breast lesions.

Purpose: To investigate the feasibility of simultaneous multi-slice readout-segmented diffusion-weighted echo-planar imaging (SMS rs-EPI DWI) in predicting invasive breast cancer molecular subtypes using whole-tumor histogram and texture analyses. Methods: In our retrospective study, 125 patients (mean age, 52.81 +/- 12.01 years; range, 24-84 years) with single invasive breast cancer who underwent preoperative MRI with SMS rs-EPI DWI and surgery at our insti-tution were included. Two radiologists independently performed whole-tumor histogram and texture analyses on the apparent diffusion coefficient (ADC) map of SMS rs-EPI DWI (TR, 3800.0 ms; TE 90.0 ms; field of view, 340 mm x 206 mm; in-plane matrix, 244 x 148; section thickness, 5 mm; readout segments, 5, b = 0, 800 s/mm2; scan time, 3 mins; slice acceleration factor, 2). The Mann-Whitney U test or Kruskal-Wallis test were used to compare histogram and texture parameters to assess their potential in differentiating molecular subtypes of breast cancer and predicting axillary lymph node status. Receiver operating characteristic (ROC) curves were generated for parameters with significant differences, and the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results: Compared to luminal A breast cancer, the HER2-positive breast cancer subtype showed higher ADC(_95th) percentile values (p = 0.016). In addition, HER2-positive breast cancer yielded significantly higher ADC(_mean) (p = 0.025), ADC(_median) (p = 0.025), and ADC(_5th percentile) (p = 0.041) values than luminal B breast cancer. The ADC(_skewness) value was higher for triple-negative breast cancer (TNBC) than Luminal A breast cancer (p = 0.021). The difference in ADC(_mean), ADC(_median), ADC(_5th) (percentile) and ADC(_95th percentile) values between the HER2-positive breast cancer and luminal types was statistically significant, with a combined AUC for these parameters of 0.762 (sensitivity 72.41%, specificity 75.00%, PPV 27.27 %, and NPV 95.45 %). The ADC(_skewness) value for TNBC was higher than for luminal types (p = 0.012) and yielded an AUC value of 0.688 (sensitivity 96.15%, specificity 36.78%, PPV 31.25%, and NPV 96.97 %). Additionally, significantly higher ADC(_skewness) and ADC(_95th percentile) values (p = 0.003, 0.002, respectively) were reported for non-luminal types than luminal types yielding a combined AUC value of 0.712 (sensitivity 92.11%, and specificity 50.23%, PPV 41.18%, and NPV 92.50%). The AUC value for ADC(_5th) (percentile) for axillary lymph node status prediction was 0.659 (sensitivity 65.38%, speci-ficity of 64.86%). Conclusions: The whole-tumor histogram and texture analyses parameters based on SMS rs-EPI DWI may provide biological information on aggressive molecular subtypes of breast cancer. In addition, ADC_(5th) (percentile) values were significantly different between lymph node-positive and lymph node-negative breast cancer.

目的:探讨Mini-CEX在肾病学科实习带教中的实践与效果评价.方法:以进入肾脏内科实习的2015级临床及口腔医学生为研究对象.利用Mini-CEX评估系统,以实习前后作自身对照,比较出科考成绩以及师生对教学满意度等情况.结果:与入科时比,实习医生出科前的Mini-CEX得分在自我介绍、询问病史等8个方面均有提高(P<0.001),带教老师对使用Mini-CEX的满意度显著升高(P<0.001),而对于应用Min-CEX来指导临床带教内容具有针对性方面,临床带教老师和实习医学生的满意度均高于90％.结论:在肾脏病学实习带教中,利用Mini-CEX来指导带教可以提高教学质量,并有助于改善教学满意度.

目的:探讨情景模拟法教学在日喀则市医疗单位开展的支气管镜教学中的应用效果.方法:选取2019年7月至2020年12月间,40名来自日喀则市人民医院及日喀则市内市级、县级医院接受支气管镜操作培训的住院医师,将其将分为2组,每组20人.采用情景模拟教学法对实验组学员进行支气管镜教学,对照组则采用传统教学法进行教学.课程结束后,比较2组学员的理论考核和支气管镜操作技能考核成绩,并使用问卷调查实验组学员对情景模拟法教学的满意度.结果:实验组学员的支气管镜操作理论考核成绩为(37.65±5.09)分,技能考核成绩为(40.75±5.91)分,均优于对照组[理论考核(32.80±6.82)分,技能考核(34.75±7.52)分],差异有统计学意义(P<0.05).问卷调查结果显示,超过85％的实验组学员对情景模拟法教学满意.结论:在日喀则市医疗单位中运用情景模拟法教学开展支气管镜操作培训的效果优于传统教学法教学,能够培养学员的临床综合能力,获得学员的普遍认可,值得高原地区在支气管镜教学中推广.

Background Combined methylmalonic acidemia and homocystinuria, cobalamin C type (cblC defect) is the most common inborn error of cobalamin metabolism, and different approaches have been applied to its prenatal diagnosis. To evaluate the reliability of biochemical method for the prenatal diagnosis of cblC defect, we conducted a retrospective study of our 10-year experience at a single center. Methods 248 pregnancies whose probands were diagnosed as cblC defect were referred to our center for prenatal diagnosis from January 2010 to December 2019. Prenatal data of Hcy levels determined by enzymatic cycling assay, acylcarnitine analysis using liquid chromatography tandem mass spectrometry, organic acid analysis using gas chromatography mass spectrometry, and genetic analysis by direct sequencing of 248 at-risk fetuses were retrospectively reviewed. Results For 2.0 and 16.0 μmol/L levels of Hcy AF samples, the relative errors were − 2.5% and 2.8%, respectively. The respective measurement uncertainties were 13.07% and 14.20%. For the 248 at-risk fetuses, 63 fetuses were affected and 185 fetuses were unaffected. Hcy level of 13.20 (6.62–43.30) μmol/L in 63 affected fetuses was significantly higher than that in 185 unaffected fetuses of 2.70 (0.00–5.80) μmol/L, and there was no overlap between the affected and unaffected groups. The diagnostic sensitivity and specificity of Hcy were 100% and 92.05%, respectively. The positive and negative predictive values of the combination of Hcy, propionylcarnitine (C3), ratio of C3 to acetylcarnitine (C2; C3/C2), methylmalonic acid (MMA), and methylcitric acid (MCA) were both 100%. Sixteen fetuses displayed inconclusive genetic results of MMACHC variants, in which seven fetuses were determined to be affected with elevated levels of Hcy, C3, C3/C2 and MMA, and their levels were 18.50 (6.70–43.30) μmol/L, 8.53(5.02–11.91) μmol/L, 0.77 (0.52–0.97), 8.96 (6.55–40.32) mmol/mol Cr, respectively. The remaining nine fetuses were considered unaffected based on a normal amniotic fluid metabolite profile. Conclusions Hcy appears to be another characteristic biomarker for the prenatal diagnosis of cblC defect. The combination of Hcy assay with acylcarnitine and organic acid analysis is a fast, sensitive, and reliable prenatal diagnostic biochemical approach. This approach could overcome the challenge of the lack of genetic analysis for families with at-risk cblC defect fetuses.

Objective: The present study aimed to determine the diagnostic value of prenatal chromosomal micro array analysis (CMA) for fetuses with several indications of being at high risk for various conditions. Materials and methods: This retrospective analysis included 1256 pregnancies that were prenatally evaluated due to high-risk indications using invasive CMA. The indications for invasive prenatal diagnosis mainly included ultrasound anomalies, high-risk for maternal serum screening (MSS), high-risk for noninvasive prenatal tests (NIPT), family history of genetic disorders or birth defects, and advanced maternal age (AMA). The rate of clinically significant genomic imbalances between the different groups was compared. Results: The overall prenatal diagnostic yield was 98 (7.8%) of 1256 pregnancies. Clinically significant genomic aberrations were identified in 2 (1.5%) of 132 patients with non-structural ultrasound anomalies, 36 (12.7%) of 283 with structural ultrasound anomalies, 2 (4.5%) of 44 at high-risk for MSS, 38 (26.6%) of 143 at high-risk for NIPT, 11 (3.8%) of 288 with a family history, and 7 (2.1%) of 328 with AMA. Submicroscopic findings were identified in 29 fetuses, 19 of whom showed structural ultrasound anomalies. Conclusion: The diagnostic yields of CMA for pregnancies with different indications greatly varied. CMA could serve as a first-tier test for structural anomalies, especially multiple anomalies, craniofacial dysplasia, urinary defects, and cardiac dysplasia. Our results have important implications for genetic counseling. (c) 2021 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

上海交通大学医学院已全面推广面向医学专业的整合课程.本学期首次采用内外科整合带教模式进行消化系统见习带教,打破了传统见习以科室为单位的带教模式,使见习课程的内容更丰富,结构更合理,更好地培养学生对疾病全貌的认识,有助于临床思维能力的提高.

Background: Cervical cancer (CC) is one of the most prevailing cancers among females. Accumulated studies concentrated on the regulatory role of micro RNA in cancers. This research is to explore the potential role of mir-195 3p in cervical cancer progression. Methods: Bioinformatics tools were used to investigate differential expression of mir-195-3p and BCDIN3D in cervical cancer. RNA expression patterns of both mir-195-3p and BCDIN3D were detected by RT-PCR in CC cell lines. The protein expression of BCDIN3D was measured by Western Blot. Hela and Siha cell lines were transfected with mir-195-3p inhibitors, mir-195-3p mimics and BCDIN3D si-RNA, si-NC. Luciferase reporter assays were adopted to confirm the binding. The interplays between mir-195-3p and BCDIN3D were explored in CC cell lines. CCK-8 assays checked how mir-195-3p regulated cell proliferation and Ki67 was examined by Western blot for its protein expressions as a biomarker for CC cell proliferation. Results: MiR-195- 3p was downregulated while BCDIN3D was upregulated in cervical cancer cell lines. The binding was confirmed via Luciferase Assay. RT-PCR suggested that upregulation of mir-195-3p inhibited BCDIN3D and downregulation of BCDIN3D in return induced mir-195-3p. CCK-8 pointed out that overexpression of mir-195-3p inhibited the cell viability. Ki67 protein expression was inhibited by miR-195-3p mimics or silence of BCDIN3D. Conclusion: The present research led us to a conclusion that mir-195-3p might inhibit cervical cancer cell proliferation and was reversely regulated by BCDIN3D. This suggests that miR-195-3p mimics/ BCDIN3D si RNA might be used in the treatments of cervical cancer in the future after various animal assays and clinical trials.

BACKGROUND:Propionic acidemia (PA) is a serious metabolic disorder, and different approaches have been applied to its prenatal diagnosis. To evaluate the reliability and validity of a biochemical strategy in the prenatal diagnosis of PA, we conducted a retrospective study of our 11-year experiences at a single center. METHODS:We accumulated data from 78 pregnancies from 58 families referred to our center and provided prenatal diagnosis by directed genetic analysis and/or metabolite measurement using tandem mass spectrometry (MS/MS) and gas chromatography/mass spectrometry (GC/MS) of amniotic fluid (AF) samples. RESULTS:Sixty-five unaffected fetuses (83.33%) and 13 affected fetuses (16.67%) were confirmed in our study. The characteristic metabolites including propionylcarnitine (C3) level, C3/acetylcarnitine (C2) ratio and 2-methylcitric acid (2MCA) level in unaffected and affected groups showed significant differences (P < 0.0001), while the level of 3-hydroxypropionic acid (3HPA) showed no significant difference between the two groups (P > 0.05).Of the 78 pregnancies, 24 fetuses were found to have either one causative pathogenic variant or were without genetic information in the proband. Three of these fetuses had elevated AF levels of C3, C3/C2 ratio, and 2MCA and, thus, were determined to be affected, while the remaining fetuses were determined to be unaffected based on a normal AF metabolite profile. Our genetic and biochemical results were highly consistent with postnatal follow-up results on all unaffected fetuses. CONCLUSIONS:We conclude that a biochemical approach can serve as a fast and convenient prenatal diagnostic method for pregnancies at an increased risk for PA, which could be used in conjunction with genetic testing for precise prenatal diagnosis of this disorder. In our analysis, the characteristic metabolites C3 level, C3/C2 ratio, and 2MCA level in AF supernatant were dependable biochemical markers for diagnosis, of which the C3/C2 ratio appears to be the most reliable biochemical marker for the prenatal diagnosis of PA.

To investigate the diagnostic capability of whole-lesion (WL) histogram and texture analysis of dynamic contrast-enhanced (DCE) MRI inline-generated quantitative parametric maps using CAIPIRINHA-Dixon-TWIST-VIBE (CDTV) to differentiate malignant from benign breast lesions and breast cancer subtypes.

Objective: The possibility of subject discriminability based on whole-brain functional connectivity (FC) has been demonstrated. To extract more accurate “fingerprint” encoded in FC, we speculated that the indirect effects in FC might be unfavorable information for subject discriminability, then the remaining component of FC (referred as direct FC (dFC)) may constitute a better “fingerprint.” Methods: We adopted the silencing method to infer dFC from experimentally accessible FC and explained the superiority of dFC in subject discriminability from the perspective of test-retest reliability. Results: We showed that the subject discriminability of dFC (even with much shorter fMRI data) is significantly greater than that of FC (calculated from the whole available fMRI data) in three public datasets. Furthermore, we elucidated that the silencing method improved subject discriminability by increasing the test-retest reliability of reliable edges (i.e., edges with high intra-class correlation coefficient) and the reliable edges dominated the subject discriminability of functional brain networks. After silencing, the reliable edges were distributed throughout the brain, especially in the Fronto-parietal Task Control, Salience, Ventral Attention, and Dorsal Attention subnetworks. Finally, the subject discriminability of functional brain networks calculated from task-fMRI data outperformed that calculated from resting-state fMRI data, and the silencing method could significantly improve the subject discriminability of each task-fMRI data, respectively. Conclusion: These results demonstrated that the dFC estimated by the silencing method from FC might constitute an accurate “fingerprint” for subject discriminability. Significance: This study made a step forward to the personalized neuroscience with fMRI-based brain “fingerprint.”

Parkinson’s disease (PD) is a neurodegenerative disease characterized by dysfunction in distributed functional brain networks. Previous studies have reported abnormal changes in static functional connectivity using resting-state functional magnetic resonance imaging (fMRI). However, the dynamic characteristics of brain networks in PD is still poorly understood. This study aimed to quantify the characteristics of dynamic functional connectivity in PD patients at nodal, intra- and inter-subnetwork levels. Resting-state fMRI data of a total of 42 PD patients and 40 normal controls (NCs) were investigated from the perspective of the temporal variability on the connectivity profiles across sliding windows. The results revealed that PD patients had greater nodal variability in precentral and postcentral area (in sensorimotor network, SMN), middle occipital gyrus (in visual network), putamen (in subcortical network) and cerebellum, compared with NCs. Furthermore, at the subnetwork level, PD patients had greater intra-network variability for the subcortical network, salience network and visual network, and distributed changes of inter-network variability across several subnetwork pairs. Specifically, the temporal variability within and between subcortical network and other cortical subnetworks involving SMN, visual, ventral and dorsal attention networks as well as cerebellum was positively associated with the severity of clinical symptoms in PD patients. Additionally, the increased inter-network variability of cerebellum-auditory pair was also correlated with clinical severity of symptoms in PD patients. These observations indicate that temporal variability can detect the distributed abnormalities of dynamic functional network of PD patients at nodal, intra- and inter-subnetwork scales, and may provide new insights into understanding PD.

Objective To study the clinical application effect of marked type correction device for correcting nipple depression. Methods From Jan 1,2016 to Jun 30,2017,200 primiparas were enrolled in this study and randomly divided into 2 groups,100 primiparas in each. One group was treated with label type correction device while the others treated with unlabeled device. The clinical efficacy of the two groups,breastfeeding rate on 3 and 42 days after delivery and the probability of complications in the 2 groups were statistically analyzed. Results The total treatment efficiency of observation group was 90%(90/100 cases),which significantly higher than that of control group(71%,71/100 cases)(P<0.05).Breastfeeding rate on 3 and 42 days after delivery were 48%(48/100 cases)and 98%(98/100 cases)in observation group,which also significantly higher than that of control group,22% on 3 days(22/100 cases)and 72% on 42 days(72/100 cases)(P<0.05).Further,the rate of complications(4%,4/100 cases)in observation group was significantly lower than the control group(12%,12/100 cases)(P<0.05). Conclusion The clinical effect of marked type correction device in correcting nipple depression is better than the unlabeled device,it is worth to be popularized in clinical application.