Use of a smartphone for imaging,modelling, and evaluation of keloids

ObjectiveWe used a smartphone to construct three-dimensional (3D) models of keloids, then quantitatively simulate and evaluate these tissues.MethodsWe uploaded smartphone photographs of 33 keloids on the chest, shoulder, neck, limbs, or abdomen of 28 patients. We used the parallel computing power of a graphics processing unit to calculate the spatial co-ordinates of each pixel in the cloud, then generated 3D models. We obtained the longest diameter, thickness, and volume of each keloid, then compared these data to findings obtained by traditional methods.ResultsMeasurement repeatability was excellent: intraclass correlation coefficients were 0.998 for longest diameter, 0.978 for thickness, and 0.993 for volume. When measuring the longest diameter and volume, the results agreed with Vernier caliper measurements and with measurements obtained after the injection of water into the cavity. When measuring thickness, the findings were similar to those obtained by ultrasound. Bland–Altman analyses showed that the ratios of 95% confidence interval extremes were 3.03% for longest diameter, 3.03% for volume, and 6.06% for thickness.ConclusionSmartphones were used to acquire data that was then employed to construct 3D models of keloids; these models yielded quantitative data with excellent reliability and validity. The smartphone can serve as an additional tool for keloid diagnosis and research, and will facilitate medical treatment over the internet.     

肝内胆管癌转化治疗

肝内胆管癌（ICC）可切除率低，进展期ICC的治疗有效率不高，预后很差。转化治疗在多种晚期肿瘤中有一定的疗效，是目前晚期肿瘤治疗的研究热点。随着对ICC基因组的深入了解和新的治疗药物的开发及组合，基于系统化疗的联合治疗策略，精准靶向治疗，免疫检查点抑制剂等显示出较好的疗效，使得部分进展期ICC病人能降期转化手术，获得长期生存。     

Heteroepitaxy of Cerium Oxide Thin Films on Cu(111)

An important part of fundamental research in catalysis is based on theoretical and modeling foundations which are closely connected with studies of single-crystalline catalyst surfaces. These so-called model catalysts are often prepared in the form of epitaxial thin films, and characterized using advanced material characterization techniques. This concept provides the fundamental understanding and the knowledge base needed to tailor the design of new heterogeneous catalysts with improved catalytic properties. The present contribution is devoted to development of a model catalyst system of CeO₂ (ceria) on the Cu(111) substrate. We propose ways to experimentally characterize and control important parameters of the model catalyst—the coverage of the ceria layer, the influence of the Cu substrate, and the density of surface defects on ceria, particularly the density of step edges and the density and the ordering of the oxygen vacancies. The large spectrum of controlled parameters makes ceria on Cu(111) an interesting alternative to a more common model system ceria on Ru(0001) that has served numerous catalysis studies, mainly as a support for metal clusters.     

不可切除胃癌转化治疗的研究进展

胃癌在全国范围内是发病率最高的恶性肿瘤之一，在癌症相关死亡原因中排名第三。目前外科手术仍然是胃癌获得根治性治疗的主要手段，但是其中有30%~40%的进展期胃癌患者在初诊时就失去了根治手术的机会，因此不可切除胃癌转化为可切除胃癌是患者获得"治愈"的最佳选择。随着近些年来新型药物的出现、治疗手段的多样化及多学科诊治模式的发展，"转化治疗"的理念应运而生，从而延长患者生存时间并提高其生活质量。本文就不可切除胃癌的治疗现状与进展、"转化治疗"的应用等进行综述。     

四象体质类型与糖调节受损糖尿病转化率的临床研究＊

目的 探讨糖调节受损（IGR）四象体质类型与客观指标相关性。方法 临床收集的122名成年人分为太阳人、太阴人、少阳人和少阴人（因太阳人人数较少，忽略不计）等四种体质，测量空腹血糖（FBG）、餐后2小时血糖（2hBG）、血脂四项等指标，半年后未经治疗，再次测量这些指标，计算糖尿病转化率。结果 IGR者中太阴人所占比例为55.8%，少阳人为21.7%，少阴人为22.5%。其中，朝鲜族的IGR占比明显高于满族和汉族。太阴人与少阳人、少阴人比较，FBG及2hBG、血脂四项、收缩压、舒张压、体重方面有显著性差异（P < 0.05），超重及肥胖人数太阴人中占61.2%、少阳人中占53.8%、少阴人中占29.6%。半年后复查，太阴人与少阳人、少阴人比较，FBG及2hBG、血脂四项、收缩压、舒张压方面有显著性差异（P < 0.05），糖尿病的转化率为太阴人32.8%，少阳人23.1%，少阴人3.7%。结论 IGR者中太阴人所占比例最高。IGR太阴人的FBG及2hBG、血脂四项、收缩压、舒张压、体重偏高，半年后复查，太阴人的DM转化率最高。     

Rupture du Moi-corps à l’adolescence

From the essential notion, clinical and theoretical “breakdown”, the authors present in this text the observation of a teenager aged fourteen. This young girl “triggers” at the beginning of her pubertal metamorphosis, at the age of twelve, paralysis of the lower limbs. The psychotherapeutic technical work undertaken reveals a massive, intrapsychic and intersubjective tension in the maternal and more largely family environment.     

Radiation Dose during Transarterial Radioembolization: A Dosimetric Comparison of Cone-Beam CT and Angio-CT Technologies

PurposeTo evaluate the radiation dose differences for intraprocedural computed tomography (CT) imaging between cone-beam CT and angio-CT acquired during transarterial radioembolization (TARE) therapies for hepatocellular carcinoma.Materials and MethodsA retrospective cohort of 22 patients who underwent 23 TARE procedures were selected. Patients were imaged in both cone-beam CT and angio-CT rooms as a part of their conventional treatment plan. Effective dose contributions from individual CT acquisitions as well as the cumulative dose contributions from procedural 3D imaging were evaluated. Angiography dose contributions were omitted. Cone-beam CT images were acquired on a C-arm Philips Allura system. Effective doses were evaluated by coupling previously published conversion factors (effective dose per dose-area product) to patient’s dose-area product meter readings after the procedure. Angio-CT images were acquired on a hybrid Canon Infinix-i Aquilion PRIME system. Effective doses from angio-CT scans were estimated using Radimetrics. Comparisons of a single patient’s dose differential between the 2 technologies were made.ResultsThe mean effective dose from a single CT scan was 6.42 mSv and 5.99 mSv in the cone-beam CT room and the angio-CT room, respectively (P = .3224), despite the greater field of view and average craniocaudal scan coverage in angio-CT. The mean effective dose summed across all CTs in a procedure was 12.89 mSv and 34.35 mSv in the cone-beam CT room and the angio-CT room, respectively (P = .0018).ConclusionsThe mean effective dose per CT scan is comparable between cone-beam CT and angio-CT when considered in direct comparison for a single patient.     

Light-driven generation of hydrogen: New chromophore dyads for increased activity based on Bodipy dye and Pt(diimine)(dithiolate) complexes

New dyads consisting of a strongly absorbing Bodipy (dipyrromethene-BF₂) dye and a platinum diimine dithiolate (PtN₂S₂) charge transfer (CT) chromophore have been synthesized and studied in the context of the light-driven generation of H₂ from aqueous protons. In these dyads, the Bodipy dye is bonded directly to the benzenedithiolate ligand of the PtN₂S₂ CT chromophore. Each of the new dyads contains either a bipyridine (bpy) or phenanthroline (phen) diimine with an attached functional group that is used for binding directly to TiO₂ nanoparticles, allowing rapid electron photoinjection into the semiconductor. The absorption spectra and cyclic voltammograms of the dyads show that the spectroscopic and electrochemical properties of the dyads are the sum of the individual chromophores (Bodipy and the PtN₂S₂ moieties), indicating little electronic coupling between them. Connection to TiO₂ nanoparticles is carried out by sonication leading to in situ attachment to TiO₂ without prior hydrolysis of the ester linking groups to acids. For H₂ generation studies, the TiO₂ particles are platinized (Pt-TiO₂) so that the light absorber (the dyad), the electron conduit (TiO₂), and the catalyst (attached colloidal Pt) are fully integrated. It is found that upon 530 nm irradiation in a H₂O solution (pH 4) with ascorbic acid as an electron donor, the dyad linked to Pt-TiO₂ via a phosphonate or carboxylate attachment shows excellent light-driven H₂ production with substantial longevity, in which one particular dyad [4(bpyP)] exhibits the highest activity, generating ∼40,000 turnover numbers of H₂ over 12 d (with respect to dye).Water splitting into hydrogen and oxygen is the key energy-storing reaction of artificial photosynthesis (AP) and one of the most promising long-term strategies for carbon-free energy on a potentially global scale (1). As a redox reaction, water splitting has been studied primarily in terms of its two half-reactions, the reduction of aqueous protons to H₂ and the oxidation of water to O₂ (2–13). Whereas some of these studies date back more than 30 y (14–22), recent progress on each half-reaction has been notable, particularly with regard to catalyst development and mechanistic understanding of each transformation (6, 23–29). In this paper, we focus on efforts dealing with the light-driven generation of H₂, which in its simplest form requires a light absorber or photosensitizer (PS) for electron-hole creation, a means or pathway for charge separation and electron transfer, an aqueous proton source, a catalyst for collecting electrons and protons and promoting their conversion to H₂, and an ultimate source of electrons in the form of an electron donor.Dating from the earliest work on the light-driven generation of H₂, the photosensitizer has most often been a Ru(II) complex with 2,2′-bipyridine (bpy) and/or related heterocyclic ligands having a long-lived triplet metal-to-ligand charge transfer state (³MLCT) (5, 7, 30–33). Recent studies have included analogous Ir(III) d⁶ systems based on phenylpyridine (ppy) ligands in place of bpy (34). With charge transfer excited states, the sensitizers are poised for photoinduced electron transfer following photon absorption and intersystem crossing (ISC). Another set of charge-transfer chromophores that have been used in related systems is [Pt(terpyridyl)(arylacetylide)]⁺ complexes that also have ³MLCT states (35–37). Despite their success with photoinduced electron transfer, all of these charge transfer (CT) complexes have absorptions that are too weak for efficient photon capture with molar extinction coefficients (ε) of 7–15 × 10³ M⁻¹⋅cm⁻¹, and the energies of their singlet absorbing states (¹MLCT) are too high (typically >2.6 eV with λ < 490 nm) for effective use of the solar spectrum. More strongly absorbing organic dyes with ε of ∼10⁵ M⁻¹⋅cm⁻¹ were also examined during early studies of the light-driven generation of H₂. Whereas those with heavier halogen substituents such as Rose Bengal and Eosin Y were found to promote H₂ formation because of facile ISC to long-lived ³ππ* states, they also exhibited poor photostability, decomposing within 3–5 h (38–41).Platinum diimine dithiolate complexes (PtN₂S₂) such as 1 constitute another class of charge transfer chromophores that are solution luminescent and undergo electron transfer quenching of both oxidative and reductive types (42–48). The excited state energies of these complexes are significantly lower than those of the Ru(bpy), Ir(ppy), and Pt(terpyridyl) complexes mentioned above and have an excited state that has been described as having both MLCT and ligand-to-ligand charge transfer (LLCT) character. In complexes such as 1, the highest occupied molecular orbital (HOMO) is of mixed character, being composed of substantial percentages of both Pt-based and dithiolate-based wavefunctions. As a consequence of the mixed character of the HOMO in PtN₂S₂, the excited states derived from HOMO to LUMO (lowest unoccupied molecular orbital) excitation have been labeled mixed-metal ligand-to-ligand′ charge transfers (MMLL′CT). Based on these charge transfer states, two of the PtN₂S₂ complexes, including 1 with R = COOH, were examined as photosensitizers for H₂ generation with TiO₂ as the electron conduit and Pt islands on the TiO₂ surface as the catalyst (49). The deprotonated carboxlyate groups of di(carboxy)bipyridine (dcbpy) served to link the PS to the platinized TiO₂ (Pt-TiO₂). The system produced hydrogen and proved to be stable for more than 70 h, using light of λ > 450 nm. However, activity of the system was low, based in part on the low absorptivity of the PtN₂S₂ chromophore and the small amount of the complex bound to TiO₂.To improve absorptivity of the PS in such H₂ generating systems, an approach was initiated in which a strongly absorbing organic dye was linked directly to the PtN₂S₂ moiety for more efficient photon absorption and subsequent energy transfer to the CT chromophore. Such a strategy had been adopted by Ziessel through the synthesis of a bipyridine linked to a dipyrromethene-BF₂ (Bodipy) dye similar to 2 and was examined for Ru complexes containing this ligand, resulting in sensitization of the lower-energy ³ππ* of the Bodipy part of the molecule (50). In a study by Lazarides et al. (51), the dye-CT dyad 3 that contained 2 and the dithiolate-linked Bodipy dyad 4 were synthesized and examined by absorption spectroscopy and transient absorption measurements to determine the potential success of photoinduced charge separation. In that study, it was determined that the absorption spectra of the two dyads are essentially the sum of each constituent chromophore and that the redox potentials of each component are virtually unaffected by bringing the two units together in a dyad. The measurements also showed that energy transfer from the ¹ππ* state of the Bodipy moiety to the ¹MMLL′CT state was energetically favorable and that for both 3 and 4, the dynamics progressed as shown in Scheme 1. Although the rates of both singlet energy transfer (SenT) and ISC for the two dyads were similar and proceeded in less than 1 ps, a significant difference was seen for the triplet energy transfer (TEnT) step with the time constant for 3 being 8 ps whereas that for 4 was 160 ps, indicating that for productive electron transfer to TiO₂, the arrangement in 4 with Bodipy attached to the dithiolate was preferred.Open in a separate windowScheme 1.Jablonski diagram of the Bodipy-PtN₂S₂ dyads showing the transitions between the different states (SEnT, singlet energy transfer; ISC, intersystem crossing; TEnT, triplet energy transfer).In this paper, the synthesis and characterization of dyads 4 with R = COOMe, P(O)(OEt)₂, CH₂(P(O)(OEt)₂) and an analogous phenanthroline (phenP) derivative 5 are described, along with studies of their ability to promote light-driven production of H₂ from aqueous protons in conjunction with Pt-TiO₂ as both electron conduit and catalyst. The benefit of attaching the strongly absorbing bodipy chromophore to the charge transfer PtN₂S₂ complex is discussed.