Intravascular photoacoustic tomography is an emerging technology for mapping lipid deposition within an arterial wall for the investigation of the vulnerability of atherosclerotic plaques to rupture. By converting localized laser absorption in lipid-rich biological tissue into ultrasonic waves through thermoelastic expansion, intravascular photoacoustic tomography is uniquely capable of imaging the entire arterial wall with chemical selectivity and depth resolution. However, technical challenges, including an imaging catheter with sufficient sensitivity and depth and a functional sheath material without significant signal attenuation and artifact generation for both photoacoustics and ultrasound, have prevented in vivo application of intravascular photoacoustic imaging for clinical translation. Here, we present a highly sensitive quasi-collinear dual-mode photoacoustic/ultrasound catheter with elaborately selected sheath material, and demonstrated the performance of our intravascular photoacoustic tomography system by in vivo imaging of lipid distribution in rabbit aortas under clinically relevant conditions at imaging speeds up to 16 frames per second. Ex vivo evaluation of fresh human coronary arteries further confirmed the performance of our imaging system for accurate lipid localization and quantification of the entire arterial wall, indicating its clinical significance and translational capability.

Lumpectomy, also called breast-conserving surgery, has become the standard surgical treatment for early-stage breast cancer. However, accurately locating the tumor during a lumpectomy, especially when the lesion is small and nonpalpable, is a challenge. Such difficulty can lead to either incomplete tumor removal or prolonged surgical time, which result in high re-operation rates (~25%) and increased surgical costs. Here, we report a fiber optoacoustic guide (FOG) with augmented reality (AR) for sub-millimeter tumor localization and intuitive surgical guidance with minimal interference. The FOG is preoperatively implanted in the tumor. Under external pulsed light excitation, the FOG omnidirectionally broadcasts acoustic waves through the optoacoustic effect by a specially designed nano-composite layer at its tip. By capturing the acoustic wave, three ultrasound sensors on the breast skin triangulate the FOG tip’s position with 0.25-mm accuracy. An AR system with a tablet measures the coordinates of the ultrasound sensors and transforms the FOG tip’s position into visual feedback with <1-mm accuracy, thus aiding surgeons in directly visualizing the tumor location and performing fast and accurate tumor removal. We further show the use of a head-mounted display to visualize the same information in the surgeons’ first-person view and achieve hands-free guidance. Towards clinical application, a surgeon successfully deployed the FOG to excise a “pseudo tumor” in a female human cadaver. With the high-accuracy tumor localization by FOG and the intuitive surgical guidance by AR, the surgeon performed accurate and fast tumor removal, which will significantly reduce re-operation rates and shorten the surgery time.

Background: Cancer-associated fibroblasts (CAFs) are vital components of gastric cancer (GC) microenvironments, which impact the aggressive characteristics of GC cells. The objective of this study is to evaluate the influence of High Mobility Group Box (HMGB) on CAF-related GC. Methods: The tissues of 10 GC patients who underwent surgery the Sanya Central Hospital of Hainan Province from July 2018 to July 2019 were collected for the clinical study. Moreover, the GC cell lines, including MGC-803, AGS, and SGC-7901, were used in vitro experiment. We investigated the molecular mechanism of the miR-200b/HMGB3 axis in affecting the chemoresistance and epithelial-mesenchymal transition (EMT) of GC cells induced by CAFs. Cell transfection, Cell Counting Kit-8 (CCK-8), Transwell assay, western blot, enzyme-linked immunosorbent assay (ELISA), and other experiments were employed.Results: We found that miR-200b was down-regulated, yet HMGB3 was up-regulated in CAF-related GC.The CAFs markedly promoted cisplatin (CDDP) resistance, proliferation, invasion, migration, and EMT of GC cells. Gain-assay of miR-200b demonstrated that miR-200b inhibited the HMGB3 release from CAFs.In-vivo experiments confirmed that the growth and EMT of GC cells co-cultured with CAF-miR-200b were significantly reduced. Furthermore, CAFs enhanced the activation of ERK, JNK, and the Wnt/β-catenin pathways, and those pathways, as well as the malignant behaviors of GC cells, were obviously attenuated by miR-200b or HMGB3 silencing.Conclusions: Collectively, HMGB3 derived from CAFs is negatively regulated by miR-200b and promotes the malignant behaviors of GC cells.