Ultrasound is a common used technique for clinical imaging. In recent years, with the advances in preparation technology of microbubbles and the innovations in ultrasound imaging, ultrasound is no longer confined to detection of tissue perfusion, but extends to specific ultrasound molecular imaging and target therapy gradually. With the development of research, ultrasound molecular imaging and target therapy have made great progresses. Targeted microbubbles for molecular imaging are achieved by binding target molecules, specific antibody or ligand to the surface of microbubbles to obtain specific imaging by attaching to target tissues. Meanwhile, it can also achieve targeting gene therapy or drug delivery by ultrasound targeted microbubble destruction (UTMD) mediating genes or drugs to specific target sites. UTMD has a number of advantages, such as target-specific, highly effective, non-invasivity, relatively low-cost and no radiation, and has broad application prospects, which is regarded as one hot spot in medical studies. We reviewed the new development and application of UTMD in gene therapy and drug delivery in this paper. With further development of technology and research, the gene or drug delivery system and related methods will be widely used in application and researches.

Background. As a traditional Chinese medicine, rhubarb (also named Dahuang) is used to treat various diseases. Objective. To explore the possible antitumor mechanism of rhubarb by using network pharmacology and molecular docking in this study. Methods. Bioactive ingredients and related targets of rhubarb were obtained from the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database. And the gene names corresponding to the proteins were found in the UniProt database. Then, the tumor-related targets were screened out from GeneCards and OMIM databases. Key antitumor targets of rhubarb were acquired by overlapping the above targets via the Venn diagram. The antitumor targets network of rhubarb active components was constructed by using Cytoscape 3.6.0 software. The protein interactions network was constructed using the STRING database. The GO and KEGG pathways involved in the targets were analyzed by using the DAVID database. Autodock Vina software was used to verify the molecular docking of rhubarb components and key targets. Results. Through screening and analysis, 10 active ingredients and 58 antitumor prediction targets were obtained and constructed a compound-target network. The targets such as CASP3, JUN, MYC, TNF, and PTGS2 may play a crucial role. These targets are involved in cancer pathway, calcium signaling pathway, cell apoptosis, small-cell lung cancer pathway, p53 signaling pathway, and TNF signaling pathway. The docking results indicated that the rhein binding with the CASP3 showed the highest binding energy. Conclusion. Based on the network pharmacology, the characteristics of multicomponent, multitarget, and multipathway of rhubarb were discussed, which provided a scientific basis for explaining the mechanism in treating cancer and new ideas for further research.

PurposeThe purpose of this study is to describe rotator cuff muscle stiffness in patients with different degrees of rotator cuff tear (RCT) severity and to assess its predictive ability for RCT reparability. MethodsOne hundred and thirty‐three consecutive patients who were scheduled to undergo arthroscopic shoulder surgery were prospectively enrolled. Tendon retraction, fatty infiltration, and muscle atrophy were evaluated using magnetic resonance imaging. Shear modulus of supraspinatus (SSP) and infraspinatus (ISP) muscles were measured by ultrasound shear wave elastography (SWE). The tear size and reparability were determined intraoperatively. ResultsThere were 97 patients in RCT group and 36 patients in control group. Bilateral shear modulus discrepancy (Δshear modulus) was used to represent rotator cuff stiffness. Severely fatty‐infiltrated rotator cuff muscles possessed a significantly higher stiffness compared with their counterparts (SSP: CI 27.8–31.8 vs. 13.5–15.6 kPa, ISP: CI 33.2–38.1 vs. 8.8–11.2 kPa, p < 0.001). The same trend applied to muscles with distinct tendon retraction (SSP: CI 27.7–32.3 vs. 10.9–14.9 kPa, ISP: CI 33.2–38.6 vs. 6.5–11.0 kPa, p < 0.001) and obvious muscle atrophy (SSP: CI 27.9–32.1 vs. 13.6–15.8 kPa, ISP: CI 32.9–38.2 vs. 9.0–11.7 kPa, p < 0.001). Irreparable massive RCT (MRCT) patients had significantly stiffer SSP (CI 27.7–31.9 vs. 13.5–16.5 kPa, p < 0.001) and ISP (CI 33.5–37.8 vs. 10.3–14.8 kPa, p < 0.001) than reparable MRCT. The Δshear modulus of the ISP was a highly accurate predictor of RCT reparability. A cutoff value of 18.0 kPa had a sensitivity of 100% and specificity of 98.8% for irreparable MRCT. ConclusionUltrasound SWE‐derived rotator cuff muscle stiffness is closely correlated with RCT size and severity. Level of evidenceI.

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