Two-photon endomicroscopy is an optical biopsy tool that satisfies clinical requirements for real-time subcellular-resolution imaging to assist pathological biopsy in diagnosis. Herein, we present a two-photon endomicroscopy system based on a piezoelectric ceramic tube scanner. A dual-channel amplitude-modulated sine wave drives the fiber to realize spiral scanning, a double-cladding antiresonant fiber is used for 920-nm femtosecond light-pulse low dispersion transmission, and fluorescence collection occurs with no fiber-tip engineering. The field of view is ∼200 µm, the resolution is 3.1 µm, and the frame rate is 0.7 fps. Pollen grain, GFP-labeled mouse brain section, and human stomach tissue imaging verify the capability of the two-photon endomicroscopy system.

We demonstrate a miniature fiber-optic two two-photon endomicroscopy with microsphere-spliced double-cladding antiresonant fiber for resolution enhancement. An easy-to-operate process for fixing microsphere permanently in an antiresonant fiber core, by arc discharge, is proposed. The flexible fiber-optic probe is integrated with a parameter of 5.8 mm × 49.1 mm (outer diameter × rigid length); the field of view is 210 µm, the resolution is 1.3 µm, and the frame rate is 0.7 fps. The imaging ability is verified using ex-vivo mouse kidney, heart, stomach, tail tendon, and in-vivo brain neural imaging.

Miniature two-photon microscopy combines the two-photon excitation principle and is more lightweight and flexible, allowing it to be applied to freely behaving animals. The piezoelectric tube (PZT) fiber scanner is the key actuated component in miniature fiber-scanning two-photon endomicroscopy (TPEM). In this paper, we use multi-physics field finite element simulation to model and analyze a reverse-fixed PZT fiber scanner for TPEM. The simulation results show that the first two resonant frequencies of the PZT fiber scanner are 163.6 Hz and 757.9 Hz, respectively. At the first two resonant points, the PZT fiber scanner scan range are 0.078 mm and 0.68 mm, respectively. Theoretical guidance for frequency selection of the reverse-fixed PZT fiber scanner is provided by these simulation results.

A flexible and fully integrated two-photon endomicroscope probe with double-cladding antiresonant fiber is reported. In-vivo mouse neural imaging demonstrates the capacity of the fiber-optic nonlinear endomicroscope platform.

Two-photon endomicroscopy is a promising technique with the ability to achieve in situ imaging and diagnosis at subcellular resolution. The large field-of-view capability is essential and useful to locate and image suspicious areas of biological tissue. In this work, we report objective-lens-free, lensed fiber-optic two-photon endomicroscopy for field-of-view enhancement. The field of view of this two-photon endomicroscopic probe is 750 μm with a resolution of 3.03 μm. This 1.6 g miniature probe has an integrated outer diameter of 5.8 mm and a rigid length of 33.5 mm. The imaging performance of the lensed-fiber-optic two-photon endomicroscopy was validated by examining an ex vivo mouse heart, kidney, brain, stomach wall tissues, and in vivo brain tissue.

We built a PZT drived forward-detection fiber scanning endomicroscopy for two-photon fluorescence. The overall structure and the formation of the driving signal were presented. Samples of pollen, large intestine and stomach were imaged.

BackgroundLate severe tricuspid regurgitation (TR) after left-side valve surgery (LSVS) is not uncommon. However, the tricuspid valve has been deemed the forgotten valve because the isolated TR is well tolerated with medication, and reoperation has a higher rate of adverse events. With the advancement of minimally invasive techniques, isolated tricuspid valve reoperation (ITVR) via totally endoscopy or transcatheter approach brings the tricuspid valve into spotlight. Our aim is to report the safety and efficacy of minimally invasive ITVR using endoscopic and transcatheter approaches.MethodsFrom October 2020 to October 2021, 21 patients with LSVS history and secondary massive TR underwent minimally invasive ITVR in our institution. Baseline characteristics, surgical outcomes and follow-up results were analyzed, and data between the totally endoscopy approach and the transcatheter approach were compared.ResultsOf the 21 cases, totally endoscopic isolated tricuspid valve surgery (EITVS) accounts for 16 (76.2%) cases, with 14 tricuspid valvuloplasty cases, and 2 tricuspid valve replacement cases; the remaining 5 (23.8%) cases underwent transcatheter tricuspid valve replacement (TTVR). The mean age was (60.0 ± 8.4) years, with 15 (71.4%) being female. Minimally invasive ITVR procedures were 100% successfully performed in all patients without any perioperative mortality, sternotomy conversion, or reoperation. During the median follow-up of 16.8 months (IQR, 13.0–20.6 months), New York Heart Association Class improved significantly from baseline (P = 0.004). TR severity was significantly improved during postoperative and follow-up period (both P < 0.001). Compared with the EITVS group, the TTVR group had a higher clinical risk score [8.00 (8.00, 9.00) vs. 5.00 (3.25, 5.00), P = 0.001], but a higher success rate in reducing TR to less than grade 1+ (100 vs. 43.8%, P = 0.045) at follow-up.ConclusionIn our series, minimally invasive ITVR, including EITVS and TTVR, is a safe and feasible option for severe TR after LSVS, and presents excellent early outcomes in selected patients. TTVR is a reliable alternative for patients with high surgical risk. To improve the results of ITVR, it is necessary to improve patient’s preoperative status or perform reoperation before the onset of significant right heart failure. Further studies with a larger sample size and a longer follow-up period are awaited.

Background The major public health crisis caused by the rapid spread of the coronavirus disease 2019 (COVID-19) and the large-scale public health measures such as social isolation and school closures enforced by some countries have severely affected on the physical and mental wellbeing of children and adolescents globally. This study aimed to estimate the prevalence of the psychological impact and investigate the similarities and differences in the influential factors for generalized anxiety disorder among rural adolescents as a relatively lesser noticed population the outbreak of COVID-19. Methods From May 11 to 22, 2020, a total of 1,179 adolescents, including Grade 5–6 in primary school and Grade 7–8 in middle school, were selected by multistage sampling in three Southern Chinese cities (Shantou, Guangdong Province; Hezhou, Guangxi Province; Nanchong, Sichuan Province), and completed the questionnaires including sociodemographic, generalized anxiety disorder, academic stress, coronaphobia, knowledge of COVID-19, and precautionary measures. ANOVA, Chi-square test, Kruskalwallis H test and multivariate linear regression were performed in the statistical analysis. Results The average scores of generalized anxiety disorder during the past two weeks were 3.43 (SD 4.46), 4.47 (SD 5.15), and 4.10 (SD 4.94) in Shantou, Hezhou and Nanchong, respectively. For the pooled data, academic stress (P < 0.001), coronaphobia (P < 0.001), and precautionary measures (P = 0.002) contributed to the prediction of anxiety scores. Academic stress was significantly associated to anxiety symptoms in all cities (P all < 0.001). Coronaphobia was also significantly associated to anxiety symptoms in all cities (P all < 0.001). Conclusion This study highlights the urgent need for researchers and policymakers to focus on the mental health of rural children and adolescents during the COVID-19 epidemic. The adolescents with academic stress and coronaphobia, the greater the risk that adolescents will suffer from anxiety, suggesting mental health counseling and professional family support are needed.