Spatiotemporal Single-Photon Airy Bullets

Uninhibited control of the complex spatiotemporal quantum wave function of a single photon has so far remained elusive even though it can dramatically increase the encoding flexibility and thus the information capacity of a photonic quantum link. By fusing temporal waveform generation in an atomic ensemble and spatial single-photon shaping, we hereby demonstrate for the first time complete spatiotemporal control of a propagation invariant (2+1)D Airy single-photon optical bullet. These correlated photons are not only self-accelerating and impervious to spreading as their classical counterparts, but can be concealed and revealed in the presence of strong classical stray light.

Fate of the unoperated ascending thoracic aortic aneurysm: three-decade experience from the Aortic Institute at Yale University

AIMS

This study aims to outline the 'true' natural history of ascending thoracic aortic aneurysm (ATAA) based on a cohort of patients not undergoing surgical intervention.

METHODS AND RESULTS

The outcomes, risk factors, and growth rates of 964 unoperated ATAA patients were investigated, over a median follow-up of 7.9 (maximum of 34) years. The primary endpoint was adverse aortic events (AAE), including dissection, rupture, and aortic death. At aortic sizes of 3.5-3.9, 4.0-4.4, 4.5-4.9, 5.0-5.4, 5.5-5.9, and ≥6.0 cm, the average yearly risk of AAE was 0.2%, 0.2%, 0.3%, 1.4%, 2.0%, and 3.5%, respectively (P < 0.001), and the 10-year survival free from AAE was 97.8%, 98.2%, 97.3%, 84.6%, 80.4%, and 70.9%, respectively (P < 0.001). The risk of AAE was relatively flat until 5 cm of aortic size, at which it began to increase rapidly (P for non-linearity <0.001). The mean annual growth rate was estimated to be 0.10 ± 0.01 cm/year. Ascending thoracic aortic aneurysms grew in a very slow manner, and aortic growth over 0.2 cm/year was rarely seen. Multivariable Cox regression identified aortic size [hazard ratio (HR): 1.78, 95% confidence interval (CI): 1.50-2.11, P < 0.001] and age (HR: 1.02, 95% CI: 1.00-1.05, P = 0.015) as significant independent risk factors for AAE. Interestingly, hyperlipidemia (HR: 0.46, 95% CI: 0.23-0.91, P = 0.025) was found to be a significant protective factor for AAE in univariable Cox regression.

CONCLUSION

An aortic size of 5 cm, rather than 5.5 cm, may be a more appropriate intervention criterion for prophylactic ATAA repair. Aortic growth may not be an applicable indicator for intervention.

The role of surgeon's intuition for acute type A aortic dissection in an era of evidence-based medicine: a prospective cohort study

Background

Intuition may play a role in clinical practice. This prospective cohort study aimed to explore whether surgeons' intuition is valid in predicting the operative mortality of acute type A aortic dissection (ATAAD).

Methods

After admission (before surgery), attending surgeons were asked to rate the mortality on a scale of 1 to 10, with 1 to 3 representing unlikely, 4-6 possible, and 7-10 very likely. The area under the curve (AUC) of receiver operating characteristic (ROC) analysis was performed to assess the accuracy of prediction models.

Results

A significantly higher Surgeon's Score [5.0 (2.0, 8.0) vs. 8.0 (7.0, 10.0)] was observed in the mortality group, compared to the survival group. The odds ratio (OR) for Surgeon's Score was 1.32 [95% confidence interval (CI): 1.09-1.66, P=0.009]. Least absolute shrinkage and selection operator (LASSO) regression picked the following variables as significant predictors for early mortality of ATAAD: Surgeon's Score, Penn classification, age, aortic regurgitation, coronary artery disease, chronic obstructive pulmonary disease, platelet count, and ejection fraction. The AUC for the German Registry for Acute Aortic Dissection Type A (GERAADA) score and Surgeon's Score were 0.740 (95% CI: 0.625-0.854), and 0.710 (95% CI: 0.586-0.833), respectively. The combined model of GERAADA score and Surgeon's Score yielded an AUC of up to 0.761 (95% CI: 0.638-0.884).

Conclusions

Intuition certainly has a place alongside evidence-based medicine. The duet of intuition and statistics-based scoring systems allows us to make more accurate predictions, potentially resulting in more rational clinical decisions.

Technical Feasibility and Safety of a Snare-Less, EVAR-First Technique for Iliac Branch Endoprosthesis

OBJECTIVE

The purpose of this study was to evaluate the technical feasibility, safety, and early outcomes of a snare-less, endovascular abdominal aortic aneurysm repair (EVAR)-first technique (SET) for iliac branch endoprosthesis (IBE) placement.

METHODS

We retrospectively reviewed all patients who received IBEs between July 2018 and March 2022. Patients were divided into 2 categories based on method of IBE deployment: SET or Standard. Primary endpoints were technical success, major adverse events, mortality, reintervention, internal iliac artery (IIA) patency, and freedom from IIA branch instability. Technical success was defined by successful deployment of both the EVAR and the IBE with maintained patency of the IIA and no stent graft migration.

RESULTS

There were 20 patients (90% male, median age 72 [65.4-74.5] years) who underwent IBE placement. Among these, 5 (33.3%) underwent SET to treat 5 common iliac artery (CIA)/IIA aneurysms, while the remaining 15 (66.7%) underwent standard IBE deployment with through-and-through femoral access (n=13) or trans-brachial access (n=2) to treat 19 CIA/IIA aneurysms. Overall median renal to iliac bifurcation length was 169 (152-177) mm, with 9 patients falling short of the minimum of 165 mm for on-label IBE placement. Median contrast used was 148 (120-201) mL, fluoroscopy time 42.8 (35.0-49.8) minutes, estimated blood loss 200 (100-275) mL, and procedure time 192 (167-246) minutes, with no significant differences between the 2 groups. Technical success was achieved in 100% of cases. At 30 days, there were no mortalities or major adverse events in either group; there were 100% IIA patency, no IIA instability, and no reinterventions in both groups. Median follow-up in the SET group was 5.7 (5.5-6.2) months, with 1 death at 6 months and 1 type 1B endoleak at 6 months requiring reintervention. Median follow-up for the Standard group was 1.6 (0.8-2.1) years with 2 non-aneurysm-related deaths and no reinterventions at 1 year.

CONCLUSIONS

SET for IBE is a safe and effective approach that decreases technical complexity and mitigates anatomic barriers to IBE placement.

CLINICAL IMPACT

SET for IBE is a safe and effective approach to IBE placement that decreases technical complexity. A critical component to this technique is a large bore sheath with a stiff steerable tip. Importantly, this approach also mitigates anatomic barriers to IBE placement, expanding applicability of IBE technology to patients who may be otherwise ineligible.

Does the weekend effect exist for acute type A aortic dissection?-a retrospective case-control study

Background

The weekend effect refers to the mortality difference for patients admitted/operated on weekends compared to those on weekdays. The study aimed to provide new evidence on the impact of the weekend effect on acute type A aortic dissection (ATAAD).

Methods

Primary endpoints were operative mortality, stroke, paraplegia, and continuous renal replacement therapy (CRRT). A meta-analysis of current evidence on the weekend effect was first conducted. Analyses based on single-center data (retrospective, case-control study) were further performed.

Results

A total of 18,462 individuals were included in the meta-analysis. The pooled results showed that mortality was not significantly higher for ATAAD on weekends compared to that on weekdays [odds ratio (OR): 1.16, 95% CI: 0.94-1.43]. The single-center cohort included 479 patients, which also showed no significant differences in primary and secondary outcomes between the two groups. The unadjusted OR for weekend group over weekday group was 0.90 (95% CI: 0.40-1.86, P=0.777). The adjusted OR for weekend group was 0.94 (95% CI: 0.41-2.02, P=0.880) controlling for significant preoperative factors, and 0.75 (95% CI: 0.30-1.74, P=0.24) controlling for significant preoperative and operative factors altogether. In PSM matched cohort, the operative mortality was still comparable between the weekend group [10 (7.2%)] and weekday group [9 (6.5%)] (P=1.000). No significant survival difference was observed between the two groups (P=0.970).

Conclusions

The weekend effect was not found to be applicable to ATAAD. However, clinicians should be cautious of the weekend effect as it is disease-specific and may vary across healthcare systems.

Inferior Mesenteric Artery Snorkel for Endovascular Treatment of a Large Degenerating Saccular Aneurysm

Objective

Preservation of the inferior mesenteric artery (IMA) during endovascular aortic aneurysm repair (EVAR) is necessary for prevention of mesenteric ischaemia in the case of chronically occluded coeliac and superior mesenteric arteries (SMA). This case report presents an approach in a complex patient.

Methods

A 74 year old man with hepatitis C cirrhosis and recent non-ST elevation myocardial infarction presented with an infrarenal degenerating saccular aneurysm (58 mm), chronically occluded SMA and coeliac artery, and 9 mm IMA with high grade ostial stenosis. He also had concomitant atherosclerosis of the aorta with a narrow distal aortic lumen of 14 mm, which tapered to 11 mm at the aortic bifurcation. Endovascular attempts to cross long segment occlusions of the SMA and coeliac artery were unsuccessful. Thus, EVAR was performed using the unibody AFX2 endograft and chimney revascularisation of the IMA using a VBX stent graft. One year follow up demonstrated regression of the aneurysm sac to 53 mm with patent IMA graft and no endoleak.

Conclusion

Few reports have described techniques for endovascular preservation of the IMA, which is a necessary consideration in the context of coeliac and SMA occlusion. Because open surgery was not a good option for this patient, available endovascular options had to be weighed up. An added challenge was the exceptionally narrow aortic lumen in the context of aortic and iliac atherosclerotic disease. It was decided that the anatomy was prohibitive for a fenestrated design and extensive calcification was too limiting for gate cannulation of a modular graft. Thus a bifurcated unibody aortic endograft with chimney stent grafting of the IMA was successfully used as a definitive solution.

Elucidating the role of the AFX2 endograft in endovascular treatment of aortic pathology

OBJECTIVE

The purpose of this study is to elucidate the role of the AFX2 platform in the endovascular treatment of aortic pathology.

METHODS

All procedures by a single surgeon resulting in implantation of a bifurcated unibody stent graft were retrospectively reviewed. Indications for selection of the AFX2 endograft in each case were evaluated. Aortic anatomy was determined via review of pre-operative computed tomography (CT) scans. Cumulative event probabilities for endoleak, reintervention, and mortality were estimated. Patient and procedural details were described using mean, standard deviation, medians, and interquartile range (IQR). Kaplan-Meier survival analysis estimated freedom from mortality and reintervention. Cumulative incidence probabilities were calculated as one minus the Kaplan-Meier estimator.

RESULTS

Between March 2018 and December 2020, the author (NN) used 142 aortic endografts in 142 patients. Of these, 46 (32.4%) were AFX2 endografts and the remaining were modular bifurcated devices, predominantly Medtronic Endurant II and Terumo Treo. No AFX-Strata or AFX-Duraply devices were placed. Amongst the patients who received an AFX2, mean age was 71.3 +/- 9.8 years with 84.8% male. Median operative time was 116 (86-166) minutes, with contrast dose of 79 (41-120) milliliters and fluoroscopy time of 12 (8.6-18) minutes. Overall, 78.3% (n=36) of AFX2 devices were placed in aortas with maximum true lumen diameter <5.0cm. Median postoperative follow-up was 1.7 years (IQR 1.0-2.4 years), with a maximum follow-up of 3.6 years. There was 1 patient lost to follow-up at 5 months. The 2-year incidence of type II endoleak, reintervention, and all-cause mortality was 12.7% (95% CI, 0-29.6%), 2.2% (95% CI, 0-6.3%), and 11.3% (95% CI, 0.1-2.1.2%), respectively. There were no type I or III endoleaks.

CONCLUSION

The AFX2 endograft plays a safe and effective role in treatment of infrarenal aortic pathologies that may be otherwise more technically challenging for traditional modular, bifurcated devices.

Quantum Interference between Photons and Single Quanta of Stored Atomic Coherence

Essential for building quantum networks over remote independent nodes, the indistinguishability of photons has been extensively studied by observing the coincidence dip in the Hong-Ou-Mandel interferometer. However, indistinguishability is not limited to the same type of bosons. For the first time, we hereby observe quantum interference between flying photons and a single quantum of stored atomic coherence (magnon) in an atom-light beam splitter interface. We demonstrate that the Hermiticity of this interface determines the type of quantum interference between photons and magnons. Consequently, not only the bunching behavior that characterizes bosons is observed, but counterintuitively, fermionlike antibunching as well. The hybrid nature of the demonstrated magnon-photon quantum interface can be applied to versatile quantum memory platforms, and can lead to fundamentally different photon distributions from those occurring in boson sampling.

[A cohort study on the correlation between alanine aminotransferase trajectories and new-onset metabolic fatty liver disease]

Objective: To explore the correlation between alanine aminotransferase (ALT) trajectories and new-onset metabolic fatty liver disease (MAFLD) to provide a scientific basis for the prevention and treatment of MAFLD. Methods: The study cohort was composed of 3 553 subjects who met the inclusion criteria in the cohort study of the Henan physical examination population. According to the ALT levels of the subjects' physical examination from 2017-2019, three different ALT trajectory groups were determined by R LCTMtools, namely low-stable group, medium-stable group, and high-stable group. The incidence of MAFLD during physical examination in 2020 was followed up, the cumulative incidence rate in each group was calculated by product-limit method, and Cox proportional hazards regression model analyzed the correlation between different ALT trajectories and new-onset MAFLD. Results: The incidence rate of MAFLD parallelly increased with the increase of ALT locus, which was 6.93%, 15.42%, and 19.05%, respectively, and the difference was statistically significant (P<0.001). After adjusting for multiple confounding factors, such as gender, waist circumference, blood pressure, BMI, fasting blood sugar, and blood lipid by Cox proportional hazards regression model, the risks of MAFLD in ALT medium-stable and the high-stable group were still 1.422 times (95%CI:1.115-1.813) and 1.483 times (95%CI:1.040-2.114) of low-stable ALT group (P<0.05). Conclusions: The risk of MAFLD parallelly increases with the increase of ALT level in the normal long-term range. it is necessary to carry out the intervention for MAFLD with long-term average high value to avoid the progress of MAFLD disease to achieve the early prevention on MAFLD.

SU(2)-in-SU(1,1) Nested Interferometer for High Sensitivity, Loss-Tolerant Quantum Metrology

We present experimental and theoretical results on a new interferometer topology that nests a SU(2) interferometer, e.g., a Mach-Zehnder or Michelson interferometer, inside a SU(1,1) interferometer, i.e., a Mach-Zehnder interferometer with parametric amplifiers in place of beam splitters. This SU(2)-in-SU(1,1) nested interferometer (SISNI) simultaneously achieves a high signal-to-noise ratio (SNR), sensitivity beyond the standard quantum limit (SQL) and tolerance to photon losses external to the interferometer, e.g., in detectors. We implement a SISNI using parametric amplification by four-wave mixing (FWM) in Rb vapor and a laser-fed Mach-Zehnder SU(2) interferometer. We observe path-length sensitivity with SNR 2.2 dB beyond the SQL at power levels (and thus SNR) 2 orders of magnitude beyond those of previous loss-tolerant interferometers. We find experimentally the optimal FWM gains and find agreement with a minimal quantum noise model for the FWM process. The results suggest ways to boost the in-practice sensitivity of high-power interferometers, e.g., gravitational wave interferometers, and may enable high-sensitivity, quantum-enhanced interferometry at wavelengths for which efficient detectors are not available.

[Investigation on awareness of schistosomiasis control knowledge among residents going to Africa in Taizhou City]

OBJECTIVE

To understand the awareness of schistosomiasis control knowledge among people going to Africa in Taizhou City, to provide insights into the development of control measures for imported schistosomiasis.

METHODS

During the period from July to October, 2019, a face-to-face questionnaire survey was conducted among people that had gone to African countries between 2015 and 2018 and return to China now, including awareness of schistosomiasis control knowledge, type of living and drinking water and contact with river and lake water.

RESULTS

A total of 573 peoples going to Africa were investigated, and 572 eligible questionnaires were recovered. Among the 572 people interviewed, senior high school and above was the predominant education level (509 people, 89.0%), labor was the predominant aim (543 people, 94.9%), and Angola (52.3%) and Algeria (15.9%) were predominant destiny countries. There were 7.2% of the interviewees hearing about African schistosomiasis, 19.8% knowing infections by contact with infested water, and 36 people with a history of contact with river and lake water. In addition, 270 interviewees used running water as drinking water and 276 used running water as living water.

CONCLUSIONS

The awareness rate of schistosomiasis control knowledge is low among people going to Africa in Taizhou City. Health education pertaining to schistosomiasis control is required to be improved among those going to Africa in Taizhou City to increase the awareness of schistosomiasis prevention and avoid parasitic infections.

Effects of essential oil/palygorskite composite on performance, egg quality, plasma biochemistry, oxidation status, immune response and intestinal morphology of laying hens

The current study aimed to assess the effects of different levels of essential oil/palygorskite composite (EO-PGS) supplementation on performance, egg quality, oxidative status, immunity and intestinal morphology of laying hens. A total of 480 laying hens aged 65 wk were randomly assigned into 4 groups (6 replicates of 20 hens each). Hens were fed the basal diet supplemented with 0 (control diet), 0.5, 0.75 or 1.0 g/kg EO-PGS for 56 d. Data were analyzed by One-way ANOVA. Results showed that birds fed with diet supplemented with EO-PGS had increased the egg production (P < 0.05) more than birds fed with control diet. The yolk index and shell thickness were increased in 0.75 and 1.0 g/kg EO-PGS groups at d56 (P < 0.05). There was no significant difference in plasma biochemical parameters among all groups. Compared with the control group, supplementation of EO-PGS increased the immunoglobulin-G and interleukin-2 levels in plasma (P < 0.05). The total antioxidant capacity in plasma and liver, the plasma catalase concentration, the activity of total superoxide dismutase in the liver and the activity of glutathione peroxidase in the spleen were increased in the EO-PGS groups (P < 0.05). The concentration of malondialdehyde in the liver was decreased with the increasing level of EO-PGS (P < 0.05). The crypt depth of ileum and duodenum of birds fed with EO-PGS supplemented diet had a tendency to decrease (0.05<P < 0.1) and the villus height to crypt depth ratio of ileum increased (P < 0.05), compared with birds fed with control diet. In summary, EO-PGS supplementation improved the egg production, enhanced antioxidation and immune functions, and ameliorated egg quality and intestinal morphology of laying hens, and a level of 0.75 g/kg EO-PGS was recommended in laying hens diets.

Alternative Endograft Aortoiliac Reconstruction for Iliac Branch Endoprostheses

BACKGROUND

Endovascular treatment of complex common iliac artery (CIA) and internal iliac artery (IIA) aneurysms using iliac branch endoprostheses (IBE) has proven safe and effective. Instructions for use (IFU) require deployment of current IBE technology with the corresponding manufacturer's modular bifurcated aortic endograft. Concomitant aortoiliac occlusive disease, inadequate renal artery-iliac bifurcation length, and unfavorable aortic anatomy preclude on-label IBE deployment. This study aimed to evaluate the technical feasibility and safety of Alternative Endograft Aortoiliac Reconstruction (AEGAR) for branched endovascular treatment of complex iliac artery aneurysms.

METHODS

In 7 consecutive patients with CIA or IIA aneurysms, computed tomography angiography (CTA) and center-line reconstruction revealed aortoiliac anatomy incompatible with the current IBE IFU due to inadequate proximal CIA landing zone (n = 7), inadequate renal artery to iliac bifurcation length (n = 2), compromised aortic anatomy (n = 3), or short infrarenal neck <15 mm (n = 1), either alone or in combination. To overcome these restrictions and facilitate IBE deployment, aortoiliac reconstruction was performed using the Endologix AFX, Endologix Ovation limbs or the Medtronic Endurant II platforms (AEGAR technique). All internal iliac artery reconstructions and external iliac artery extensions were performed using the Gore VBX or Viabahn stent grafts. Technical success was defined as successful delivery of all endograft components without migration or endoleak.

RESULTS

The mean patient age was 69 years (range 52-82 years; 6 male). Four patients had bilateral CIA aneurysms and 3 patients had unilateral CIA aneurysms (mean diameter 4.3cm; range 2.2-7 cm). There were 13 IIA VBX stent grafts used for a total of 9 IIAs treated with IBE (bilateral IBE = 2 patients). The mean fluoroscopy time was 38.8 min (range 21.3-64.3 min) and the mean contrast volume was 168.5 mL (range 122-226 mL). Technical success was achieved in all patients and there were no perioperative complications. Mean hospital-stay was 2.2 days (range 1-3 days). Follow-up ranged from 82-957 days (mean = 487 days). At last follow-up, all patients were alive without cardiovascular morbidity; and CTA revealed stable or decreased aneurysm size, patent endografts, and no evidence of endoleak or migration.

CONCLUSIONS

The AEGAR technique can be used to safely and effectively overcome certain aortoiliac anatomic constraints that preclude use of current IBE technology. We encourage broader use of these alternative endografts in pertinent anatomic configurations.

[Effect of early-life antibiotic exposure on allergic symptoms in children aged 6-11 months and 18-23 months based a birth cohort study]

Objective: To analyze the associations between prenatal and 1-year-old exposure to antibiotics and allergic symptoms in children aged 6-11 months and 18-23 months. Methods: In this study, a prospective birth cohort study was adopted. A total of 2 122 pregnant women were enrolled in Maternal and Child Health Care Center of Ma'anshan from June 2015 to June 2016, and they were followed up from the beginning of pregnancy to children's 24 months of age. Excluding 564 pairs of mothers and children who were lost to follow-up or with incomplete information on the use of antibiotics and children's allergic symptoms, a total of 1 558 pairs of mothers and children were included in the analysis of this study. The parents and children's general demographic information, early-life antibiotic exposure and other data were collected, the information about allergic symptoms in children aged 6-11 months and 18-23 months were investigated by reference to the "International Study of Asthma and Allergies in Childhood (ISAAC)". The univariate and multivariate binary unconditional logistic regression model was used to was used to estimate associations between the effects of early-life antibiotic exposure on allergic symptoms in 2-year-old children. Results: The antibiotic usage rate of pregnant women during pregnancy was 3.4% (53), and the antibiotic usage rates of children between 0 to 2 months, 3 to 5 months, and 6 to 11 months were separately 15.2%(237), 15.5%(242) and 17.3%(269). The total prevalence of allergic diseases in children aged 6 to 11 months was 24.1% (375 children), and the total prevalence of allergic diseases in children aged 18 to 23 months was 22.0% (342 children). After adjust parental (maternal) education level, family monthly income per capita, parental (maternal) allergy history, parental (maternal) age at pregnancy, mother's Body Mass Index (BMI) before pregnancy, exposure to second-hand smoke during pregnancy, delivery method, child gender, birth weight, preterm birth, the use of antibiotics when children were 3-5 months old (RR=1.61,95%CI:1.19-2.17) and 6-11 months old (RR=1.43,95%CI:1.06-1.93) were the risk factors for allergic symptoms at 6-11 months of age; and the use of antibiotics when children were 0-2 months old (RR=1.41, 95%CI: 1.03-1.95), 3-5 months old (RR=1.54, 95%CI: 1.12-2.11) and 6-11 months old (RR=1.58, 95%CI: 1.17-2.14) were the risk factors for allergic symptoms at 18-23 months of age. Conclusion: Children's exposure to antibiotics within 1 year of age was a risk factor for allergic symptoms in children aged 6-11 months and 18-23 months, children should avoid unnecessary antibiotic use in infancy.

[Masseter nerve-innervated free gracilis muscle transfer for smile reanimation in adults]

Objective: To investigate the outcomes of masseter nerve-innervated free gracilis muscle transfer for smile reanimation in adults and to explore surgical indications. Methods: A retrospective chart review of 37 patients (11 males, 26 females, with (40.3±12.7) years old)who underwent masseter nerve-innervated free gracilis muscle transfer for smile reanimation between 2016 and 2017 was performed. Patient-reported quality of life (facial clinimetric evaluation, FaCE), physician-reported facial function (eFACE facial grading scale), and oral commissure excursion were compared preoperatively and postoperatively. SPSS 11.0 software was used to analyze the data. Results: Thirty-seven patients were followed up in one year after surgery. Significant postoperative improvements were demonstrated for commissure excursion with smile (preoperatively: (-1.2±3.1) mm, postoperatively: (6.1±3.5) mm, t=-31.1, P<0.01), ipsilateral FaCE (preoperatively: (29.4±14.1), postoperatively: (57.6±23.4), t=-38.1, P<0.01), eFACE score (Composite score t=-35.8, Static score t=-29.1, Dynamic score t=-41.3,Midface score t=-43.9, all P<0.01), respectively. Conclusion: Masseter nerve-innervated free gracilis muscle transfer is an good option for dynamic smile reanimation in adult patients who have undergone treatment for long-standing facial paralysis.

Emergent percutaneous chimney endovascular aortic repair of a secondary aortoenteric fistula in the setting of a solitary kidney

Secondary aortoenteric fistula is a potentially lethal complication after aortic surgery. Traditional treatment consists of open graft excision with extra-anatomic bypass or in situ reconstruction. Patients who present in extremis, however, are generally poor candidates for re-do open aortic surgery. Endovascular repair has emerged as an alternative treatment modality for patients who would otherwise be unable to tolerate an extended operation. We report here a case of urgent endovascular repair of a juxtarenal secondary aortoenteric fistula via endovascular aneurysm repair with a renal artery chimney in a patient with a solitary kidney who presented in hemorrhagic and septic shock.

Snare-assisted thoracic endovascular aortic repair for redirection of a false lumen elephant trunk

In recent years, a hybrid approach to the classic two-stage elephant trunk technique has come into favor for treatment of thoracic aortic dissection. During the first stage, inadvertent intraoperative placement of the elephant trunk into the false lumen can occur on rare occasions, resulting in untoward difficulties during the second stage of the procedure. We describe here a snare-assisted technique for endovascular salvage of an elephant trunk that had inadvertently been placed in the false lumen of a chronic aortic dissection.

Superselective carotid body tumor embolization with platinum-based coils

Resection of Shamblin II and III carotid body tumors can be challenging owing to the potential for significant blood loss. Prophylactic use of liquid embolic agents poses a risk of inflammatory reactions and nontarget embolization. On the other hand, coil embolization has traditionally been limited to cases involving external carotid artery sacrifice. Herein we demonstrate that superselective targeting of tumor-feeding vessels using platinum based, fully detachable packing coils is effective at sustained devascularization of Shamblin II and III carotid body tumors without subsequent inflammation, allowing for a longer interval between embolization and tumor resection, and potentially reducing blood loss without need for ligation or reconstruction of the internal or external carotid artery.

Increased Virulence of Descending Thoracic and Thoracoabdominal Aortic Aneurysms in Women

BACKGROUND

This study evaluates sex differences in the natural history of descending thoracic and thoracoabdominal aortic aneurysms (DTTAAs).

METHODS

In all, 907 patients with descending thoracic and thoracoabdominal aortic sizes greater than 3 cm were retrospectively reviewed. Growth rate estimates were performed utilizing an instrumental variables approach. Yearly complication rates as a function of aortic size were computed.

RESULTS

There were 615 men (67.8%) and 292 women (32.2%) treated between 1990 and 2018, with mean aortic diameters of 4.1 ± 1.4 cm and 4.8 ± 1.6 cm, respectively (P < .001). The mean growth rate of DTTAAs was 0.17 cm per year in men and 0.25 cm per year in women (P < .001), increasing with increasing aneurysm size. Dissection, rupture, or aortic death or the combination of the three occurred at double the rate for women compared with men (5.8% vs 2.3% per year for the combined endpoint). Diameter of DTTAA greater than 5 cm was associated with 26.3% (male) and 33.1% (female) average yearly rates of the composite endpoint of rupture, dissection, and death (P < .05). The probability of fatal complications (rupture and death) increased sharply at 5.75 cm in both sexes. Between 4.5 and 5.75 cm, there was another hinge-point of higher probability of fatal complications among women.

CONCLUSIONS

Women diagnosed with DTTAA fare worse. Faster aneurysm growth and higher rates of dissection, rupture, and aortic death are apparent among women. Current guidelines recommend surgical intervention at 5.5 to 6 cm for DTTAAs without sex considerations. Our findings suggest that increased virulence of DTTAA in women may indicate surgery at a somewhat smaller diameter.

[Clinicopathological characteristics of NTRK-rearranged mesenchymal tumors in childhood]

Objective: To investigate the clinical and pathological features of pediatric NTRK-rearranged tumors. Methods: Four NTRK-rearranged soft tissue tumors and one renal tumor at Shanghai Children's Medical Center, Shanghai Jiaotong University and Singapore KK Women's and Children's Hospital from January 2017 to September 2019 were identified. Pan-TRK immunohistochemistry, and the ALK and ETV6 gene break-apart fluorescence in situ hybridizations (FISH) were performed. NTRK gene rearrangement was detected using sequencing-based methods. Results: There were 3 males and 2 females in this study. The patients were between 3 months and 13 years of age. Histologically, the tumors were infiltrative spindle cell tumors with variable accompanying inflammatory cells. Immunohistochemistry showed positive reactivity for pan-TRK in all tumors, with nuclear staining for NTRK3 fusion, and cytoplasmic staining for NTRK1 fusion. The molecular testing revealed NTRK gene fusions (one each of TPM3-NTRK1, ETV6-NTRK3 and DCTN1-NTRK1, and two cases of LMNA-NTRK1). Two patients were receiving larotrectinib. The others were are well without disease, with follow-up durations of 9 to 29 months. Conclusions: NTRK-rearranged mesenchymal tumors from soft tissue sites and kidney are identified. A novel DCTN1-NTRK1 fusion is described. Pan-TRK immunohistochemistry is useful for diagnosis. NTRK-targeted therapy may be an option for unresectable, recurrent or metastatic cases.

Suppression of p38/HBP1 pathway alleviates hyperosmotic stress-induced senescent progression of chondrocyte senescence

This study aims to explore the effect of p38 mitogen-activated protein kinase and its downstream target HMG-box transcription factor 1 (HBP1) in the chondrocyte (CH) senescence caused by hyperosmotic stress. Human cartilage tissue with or without osteoarthritis (OA) were collected to detect the differential expression of p38 and HBP1 by Western blot. CHs were isolated from cartilage without OA and used the hyperosmotic medium to accelerate CH senescence in vitro. A p38 inhibitor and siRNA were used to mediate the expression of p38 and HBP1. The viability of CHs was determined by cell counting kit 8 (CCK8) assay. CH-related mRNA expression was analyzed by quantitative real-time polymerase chain reaction (RT-PCR). Immunofluorescence was also used to detect collagen II and beta-galactosidase expression. Senescent cells were increased in both OA cartilage and hyperosmotic stress treatment with a marked upregulation of p38 and HBP1. Suppression of p38 activation reversed the hyperosmotic stress-induced CH senescence and led to an inhibition of HBP1, p16, Runx-2, MMP-13, collagen X expression, and an upregulation of collagen II and SOX-9 expression. Moreover, the silencing of HBP1 also played a protective effect on CH senescence. The suppression of the p38/HBP1 pathway alleviates the hyperosmotic stress-induced senescent progression of CHs.

[Genomic analysis of a 2019-novel coronavirus (2019-nCoV) strain in the first COVID-19 patient found in Hangzhou]

Objective: To understand the viral genomic characteristics of a 2019-novel coronavirus (2019-nCoV) strain in the first COVID-19 patient found in Hangzhou, China. Methods: Viral RNA was extracted in throat swab and sputum sample of the patient and was performed real-time reverse transcription PCR detection and obtained viral genome by high-throughput sequencing method. Phylogenetic analysis was conducted using 29 2019-nCoV genomes and 30 β-coronavirus genomes deposited in NCBI GenBank. Fifteen genomes from Wuhan were grouped by mutation sites and others were identified by Wuhan's or specific mutation sites. Results: A 29 833 bp length genome of the first 2019-nCoV strain in Hangzhou was obtained, covering full length of the coding regions of coronavirus. Phylogenetic analysis showed that the genome was closest to the genome of a bat SARS-like coronavirus strain RaTG13 with an identity of 96.11% (28 666/29 826). Among the genes between two genomes, E genes were highly conserved (99.56%), while S genes had lowest identity (92.87%). The genome sequence similarities among 29 strains from China (Hangzhou, Wuhan, and Shenzhen), Japan, USA, and Finland, were all more than 99.9%; however, some single nucleotide polymorphisms were identified in some strains. Conclusion: The genome of Hangzhou 2019-nCoV strain was very close to the genomes of strains from other cities in China and overseas collected at early epidemic phase. The 2019-nCoV genome sequencing method used in this paper provides an useful tool for monitoring variation of viral genes.

The effects and combinational effects of Bacillus subtilis and montmorillonite on the intestinal health status in laying hens

This study was conducted to evaluate the effects and combinational effects of Bacillus subtilis (BS) and montmorillonite (MMT) on laying performance, gut mucosal oxidation status, and intestinal immunological and physical barrier functions of laying hens. Three hundred sixty laying hens (29-week-old) were randomly assigned to a 2 × 2 factorial arrangement of treatments (n = 6) for 10 wk as follows: (1) basal diet; (2) the basal diet plus 5 × 10⁸ cfu BS/kg; (3) the basal diet plus 0.5 g MMT/kg; and (4) the basal diet plus 5 × 10⁸ cfu BS/kg and 0.5 g MMT/kg. Dietary supplementation with BS increased egg production and egg mass, the activities of catalase (CAT) and total superoxide dismutase in the intestinal mucosa, and villus height and villus height-to-crypt depth ratio of the jejunum (P < 0.05) but downregulated the mRNA expression levels of toll-like receptor 4 and myeloid differentiation factor 88 (MyD88) in the duodenum and jejunum, interleukin 1 beta in the duodenum, and nuclear factor kappa B P65 (NF-κB P65) and tumor necrosis factor alpha in the jejunum (P < 0.05). Dietary supplementation with MMT increased egg production and egg mass, the concentration of secretory immunoglobulin A in the duodenum, and the occludin mRNA expression level in the jejunum (P < 0.05) but reduced feed conversion ratio, malondialdehyde concentration in the duodenum and jejunum, and the mRNA expression level of MyD88 in the jejunum (P < 0.05). In addition, there was an interaction effect between BS and MMT supplementation on the CAT activity and the MyD88 mRNA expression level in the duodenum and the mRNA expression level of occludin in the jejunum (P < 0.05). In conclusion, dietary BS and MMT and their combination may improve the intestinal health status of laying hens, which may contribute to the increase in hens' laying performance.

Natural history of descending thoracic and thoracoabdominal aortic aneurysms

OBJECTIVES

Elucidating critical aortic diameters at which natural complications (rupture, dissection, and death) occur is of paramount importance to guide timely surgical intervention. Natural history knowledge for descending thoracic and thoracoabdominal aortic aneurysms is sparse. Our small early studies recommended repairing descending thoracic and thoracoabdominal aortic aneurysms before a critical diameter of 7.0 cm. We focus exclusively on a large number of descending thoracic and thoracoabdominal aortic aneurysms followed over time, enabling a more detailed analysis with greater granularity across aortic sizes.

METHODS

Aortic diameters and long-term complications of 907 patients with descending thoracic and thoracoabdominal aortic aneurysms were reviewed. Growth rates (instrumental variables approach), yearly complication rates, 5-year event-free survival (Kaplan-Meier), and risk of complications as a function of aortic height index (aortic diameter [centimeters]/height [meters]) (competing-risks regression) were calculated.

RESULTS

Estimated mean growth rate of descending thoracic and thoracoabdominal aortic aneurysms was 0.19 cm/year, increasing with increasing aortic size. Median size at acute type B dissection was 4.1 cm. Some 80% of dissections occurred below 5 cm, whereas 93% of ruptures occurred above 5 cm. Descending thoracic and thoracoabdominal aortic aneurysm diameter 6 cm or greater was associated with a 19% yearly rate of rupture, dissection, or death. Five-year complication-free survival progressively decreased with increasing aortic height index. Hazard of complications showed a 6-fold increase at an aortic height index of 4.2 or greater compared with an aortic height index of 3.0 to 3.5 (P < .05). The probability of fatal complications (aortic rupture or death) increased sharply at 2 hinge points: 6.0 and 6.5 cm.

CONCLUSIONS

Acute type B dissections occur frequently at small aortic sizes; thus, prophylactic size-based surgery may not afford a means for dissection protection. However, fatal complications increase dramatically at 6.0 cm, suggesting that preemptive intervention before that criterion can save lives.

Coil embolization of bilateral internal mammary artery aneurysms in the setting of a heterozygous missense variant of unknown significance in COL5A1 and fibromuscular dysplasia

Internal mammary artery aneurysms are rare but serious clinical entities. Rupture results in hemothorax and can be life threatening. Most reported cases are pseudoaneurysms secondary to iatrogenic or traumatic causes. Noniatrogenic, nontraumatic, true internal mammary artery aneurysms have most commonly been associated with vasculitides or connective tissue disorders; rare cases have been deemed idiopathic. We describe a rare case of bilateral internal mammary artery aneurysms—successfully treated with coil embolization—in the setting of heterozygosity for a missense variant of unknown significance in the COL5A1 gene and multifocal fibrodysplastic changes on angiography.

Non-Hermitian Magnon-Photon Interference in an Atomic Ensemble

The interference of photons in a lossy beam splitter (BS) exhibits anticoalescence, which is surprising for bosons. Such a non-Hermitian system involving open quantum dynamics is of particular interest for quantum information processing and metrology. The Hermiticity of photonic devices is generally fixed according to the material, but is controllable at the interface of photons and atomic systems. Here, we demonstrate a tunable non-Hermitian BS for the interference between traveling photonic and localized magnonic modes. The crossover from a Hermitian to a non-Hermitian magnon-photon BS is achieved by controlling the coherent and incoherent interaction mediated by the excited levels of atoms, which is reconfigurable via the detuning of a control laser. A correlated interference pattern between the photons and magnons is demonstrated by such a non-Hermitian BS. Our system has the potential to operate with photons and magnons at the single-quanta level, and it provides a versatile quantum interface for studying the non-Hermitian quantum physics and parity-time symmetry.

[Characteristics of newly reported HIV/AIDS cases with non-marital but non-commercial heterosexual transmission in Hangzhou, 2015-2017]

Objective: To describe the characteristics of newly reported HIV/AIDS cases via non-marital or non-commercial heterosexual transmission and to find out the relative factors in Hangzhou, from 2015 to 2017. Methods: Data were collected through the national HIV/AIDS comprehensive control and prevention data system. Study subjects would include those reported HIV/AIDS cases who were residents of Hangzhou and were infected via non-marital heterosexual transmission, between January 1, 2015 and December 31, 2017. Demographic characteristics and behavioral information were collected. χ(2) test was used to compare different characteristics of the non-married heterosexual transmission subjects. Logistic regression was used to assess factors that associated with non-marital but non-commercial HIV heterosexual transmission with SPSS. 20 software used to analyze statistically. Results: Non-marital HIV heterosexual transmission accounted for 38.03% (1 393/3 663) of the total new reported HIV/AIDS cases in 2015-2017. Out of the 1 393 HIV/AIDS cases, those infected through non-marital but non-commercial heterosexual transmission accounted for 50.83% (708/1 393), and those through non-martial commercial transmission was accounted for 49.17% (685/1 393). Male to female ratio was 3.51 ∶ 1 (1 084/309). Male HIV cases reported that their major way of infection was via non-marital commercial transmission (670/1 084, 61.81%), while female patients reported the way was via non-marital non-commercial (294/309, 95.1%). Results from multivariate logistic analysis showed that the related risk factors and ORs for non-marital but non-commercial transmission appeared as: female (aOR=48.25, 95%CI: 26.94- 88.44),<30 year olds (aOR=2.43, 95%CI: 1.31-4.51), 30-39 year olds (aOR=1.92, 95%CI: 1.11- 3.33), 40-49 year olds (aOR=1.80, 95%CI: 1.08-3.00), married or unmarried (vs. divorced or widowed, aOR=1.57, 95%CI: 1.10-2.24; aOR=1.78, 95%CI: 1.15-2.78), high school and above of education level (vs. primary school and under of education level, aOR=1.82, 95%CI: 1.18-2.80), administrative officers or employee (vs. farmers, aOR=2.03, 95%CI: 1.04-1.91). Number of non- marital partners less than 5 (vs. number of non-marital partners more than 5, aOR=10.65, 95%CI: 6.41-17.42). Conclusions: HIV/AIDS cases with non-marital heterosexual transmission accounted for considerable proportion regarding the HIV transmission in Hangzhou from 2015 to 2017. Differences were found in the following factors as non-marital and non-commercial heterosexual transmission with diverse gender, age, marital status, educational level and occupation among of the HIV/AIDS patients.

Visible light communication using dual camera on one smartphone

Dual camera is becoming increasingly prevalent among smartphone camera schemes these days. This paper demonstrates a system prototype by using the color and monochrome cameras on one smartphone simultaneously for visible light communication. To achieve this, we propose a novel dual-modulation scheme. The baseband signal is firstly modulated by color ratio modulation-color shift keying (CRM-CSK) to broadcast color ratio information that can be distinguished by the color camera. Next to it, gray level modulation (GLM) is utilized to generate CRM symbols with gray levels that can be distinguished by the monochrome camera. Our experiment shows a significant improvement in the downlink data rate of the optical camera communication (OCC) using a single light source.

[Efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism]

Objective: To evaluate the efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism(PE). Methods: PE was diagnosed by CT pulmonary angiography(CTPA). After risk stratification, a total of 79 PE patients (age (58.9±14.9) years old)were treated with catheter-directed interventional therapy via pulmonary vessels. The changes of pulmonary hemodynamics were compared before and after treatment. The risk of complications and side effects were observed. Results: The pulmonary artery pressure was changed followed by interventional therapy. The interventional therapy significantly decreased mean pulmonary arterial pressure (mPAP) from (35.3±11.2)mmHg (1 mmHg=0.133 kPa) to (30.0±10.6)mmHg (t=8.803,P<0.05) and the echocardiographic derived right ventricular dimension to left ventricular dimension (RV/LV) ratio from 0.93±0.16 to 0.83±0.15 (t=6.868,P<0.05). The arterial partial pressure of oxygen was increased from (69.0±8.6)mmHg to (75.1±9.9)mmHg (t=8.561,P<0.05) . The oxygen saturation was also increased from (93.9±2.9)% to (95.1±1.9)% at 24 h after the treatment (t=2.621,P<0.05) . Patients were further grouped as high-risk group (n=28) and intermediate risk group (n=51). mPAP and RV/LV ratio were significantly reduced in the two subgroups (all P<0.05) and the range of reduction was more significant in the high-risk group. Five patients experienced minor bleeding complication, 3 patients suffered worsened dispone post procedure and were treated with mechanical ventilation, 1 patient died, and 1 patient developed recurrent PE. Conclusion: The catheter-directed interventional therapy improves pulmonary hemodynamics and reduces load of right ventricle both in high-risk or intermediate risk PE patients, this therapy strategy is safe and effective for patients with PE.

Absolute sensitivity of phase measurement in an SU(1,1) type interferometer

Absolute sensitivity is measured for the phase measurement in an SU(1,1) type interferometer, and the results are compared to that of a Mach-Zehnder interferometer operated under the condition of the same intra-interferometer intensity. The interferometer is phase locked to a point with the largest quantum noise cancellation, and a simulated phase modulation is added in one arm of the SU(1,1) interferometer. Both the signal and noise level are estimated at the same frequency range, and we obtained 3 dB improvement in sensitivity for the SU(1,1) interferometer over the Mach-Zehnder interferometer. Our results demonstrate a direct phase estimation and may pave the way for practical applications of a nonlinear interferometer.

Generation of frequency degenerate twin beams in Rb85 vapor

We demonstrate a new phase-matching geometry for four-wave mixing processes in hot Rb85 vapor, in which all four fields propagate in different directions but two of them are degenerate in frequency. When used as a parametric amplifier with an injected seed, two types of quantum mechanically correlated twin-beam states, either frequency degenerate or nondegenerate, can be generated. The quantum noise reduction in the intensity difference is almost 7 dB for the nondegenerate type and nearly 5 dB for the degenerate type. The spatial nondegeneracy of the four waves allows a variety of configurations of parametric processes, leading to flexible control for both phase insensitive and sensitive parametric amplification. The spatially nondegenerate but frequency degenerate four-wave mixing process will find wide applications in quantum metrology, quantum communication, and quantum information of continuous variables.

Circulating tumour cells as a biomarker for diagnosis and staging in pancreatic cancer

BACKGROUND

Current diagnosis and staging of pancreatic ductal adenocarcinoma (PDAC) has important limitations and better biomarkers are needed to guide initial therapy. We investigated the performance of circulating tumour cells (CTCs) as an adjunctive biomarker at the time of disease presentation.

METHODS

Venous blood (VB) was collected prospectively from 100 consecutive, pre-treatment patients with PDAC. Utilising the microfluidic NanoVelcro CTC chip, samples were evaluated for the presence and number of CTCs. KRAS mutation analysis was used to compare the CTCs with primary tumour tissue. CTC enumeration data was then evaluated as a diagnostic and staging biomarker in the setting of PDAC.

RESULTS

We found 100% concordance for KRAS mutation subtype between primary tumour and CTCs in all five patients tested. Evaluation of CTCs as a diagnostic revealed the presence of CTCs in 54/72 patients with confirmed PDAC (sensitivity=75.0%, specificity=96.4%, area under the curve (AUROC)=0.867, 95% CI=0.798-0.935, and P<0.001). Furthermore, a cut-off of ⩾3 CTCs in 4 ml VB was able to discriminate between local/regional and metastatic disease (AUROC=0.885; 95% CI=0.800-0.969; and P<0.001).

CONCLUSION

CTCs appear to function well as a biomarker for diagnosis and staging in PDAC.

[Construction of the pIRES2-ZsGreen1 eukaryotic expression vector of Factor Ⅸ gene and expression in HEK-293 cells]

目的

以含有凝血因子Ⅸ（FⅨ）cDNA的pcDNA/FⅨ质粒为模板构建真核表达载体pIRES2-ZsGreen1/FⅨ并检测其在HEK-293细胞中的表达。

方法

以pcDNA/FⅨ质粒为模板，扩增出目的基因FⅨ的开放阅读框（ORF）区，使用Infusion酶对线性pIRES2-ZsGreen1双酶切产物及FⅨORF扩增产物进行连接，连接产物进行转化后筛选阳性克隆，对阳性克隆进行DNA测序及凝胶电泳鉴定。野生型pIRES2-ZsGreen1/FⅨ转染HEK-293细胞后，分别采用实时定量PCR、细胞免疫荧光法、一期法检测野生型FⅨ基因mRNA表达水平、蛋白的表达量及细胞裂解液、细胞培养液的FⅨ活性。

结果

成功构建pIRES2-ZsGreen1/FⅨ并转染HEK-293细胞，实时定量PCR证实HEK-293细胞表达FⅨ mRNA，激光共聚焦显微镜下观察到FⅨ蛋白在细胞质中合成，野生型质粒pIRES2-ZsGreen1/FⅨ转染HEK-293细胞裂解液和细胞培养液的FⅨ活性分别为（92.03±0.29）%、（86.89±8.78）%，无转染的HEK-293细胞裂解液和培养液中FⅨ活性均为0。

结论

成功构建FⅨ野生型pIRES2-ZsGreen1真核表达载体。

Increased risk of breast cancer in individuals carrying the TNRC9 rs3803662 C>T polymorphism: a meta-analysis of case-control studies

Currently, the relationship between the trinucleotide repeat containing 9 (TNRC9) rs3803662 C>T polymorphism and risk of breast cancer (BC) is uncertain. Here, we attempted to obtain a more accurate assessment of this association by conducting a meta-analysis of all eligible case-control investigations, comprising 44,820 cases and 58,316 controls. A comprehensive search was performed to identify all suitable studies involving the TNRC9 rs3803662 polymorphism and BC risk. Pooled odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated using fixed- or random-effect models. Heterogeneity, publication bias, and sensitivity analyses were also carried out. We found that the variant T allele of rs3803662 C>T greatly increases BC risk (CT vs CC: OR = 1.14, 95%CI = 1.07-1.22, P < 0.001; TT vs CC: OR = 1.38, 95%CI = 1.25-1.53, P < 0.001; CT/TT vs CC: OR = 1.19, 95%CI = 1.11-1.28, P < 0.001; TT vs

CT/CC

OR = 1.28, 95%CI = 1.19-1.38, P < 0.001). Stratified analysis based on ethnicity also revealed a markedly increased risk in Asian and Caucasian populations. Moreover, studies with hospital-based control groups showed elevated risk under the four genetic models employed, as did those using population-based controls, except under heterozygote comparison. The TNRC9 rs3803662 C>T polymorphism is greatly related to increased risk of BC, in both Asian and Caucasian populations.

Temporal Purity and Quantum Interference of Single Photons from Two Independent Cold Atomic Ensembles

The temporal purity of single photons is crucial to the indistinguishability of independent photon sources for the fundamental study of the quantum nature of light and the development of photonic technologies. Currently, the technique for single photons heralded from time-frequency entangled biphotons created in nonlinear crystals does not guarantee the temporal-quantum purity, except using spectral filtering. Nevertheless, an entirely different situation is anticipated for narrow-band biphotons with a coherence time far longer than the time resolution of a single-photon detector. Here we demonstrate temporally pure single photons with a coherence time of 100 ns, directly heralded from the time-frequency entangled biphotons generated by spontaneous four-wave mixing in cold atomic ensembles, without any supplemented filters or cavities. A near-perfect purity and indistinguishability are both verified through Hong-Ou-Mandel quantum interference using single photons from two independent cold atomic ensembles. The time-frequency entanglement provides a route to manipulate the pure temporal state of the single-photon source.

Glutathione S-transferase P1 rs1695 A>G polymorphism and breast cancer risk: evidence from a meta-analysis

Breast cancer (BC) is the most widespread cause of cancer-related deaths in women. Many published studies have assessed the association between the glutathione S-transferase P1 (GSTP1) rs1695 polymorphism and BC risk. However, the effect of the GSTP1 rs1695 polymorphism on BC risk has remained controversial. Therefore, this meta-analysis was conducted to obtain a comprehensive estimation of this association. A total of 20,615 cases and 20,481 controls from thirty-six case-control trials were extracted from an online literature survey. The meta-analysis indicated that the GSTP1 rs1695 A>G polymorphism did not contribute to the susceptibility of BC when the overall population was considered. However, intriguingly, this polymorphism was significantly associated with increased risk of BC in Asian women [GG vs AA: odds ratio (OR) = 1.4, 95% confidence interval (CI): 1.06-1.88, P = 0.02; AG vs AA: OR = 1.08, 95%CI = 1.00-1.16, P = 0.05; GG/AG vs AA: OR = 1.11, 95%CI = 1.04-1.19, P = 0.00]. Moreover, a subgroup analysis based on the source of control groups showed a marked increase in BC susceptibility in hospital-based control subjects (GG vs AA: OR = 1.28, 95%CI = 1.10-1.48, P= 0.00; GG vs

AG/AA

OR = 1.22, 95%CI = 1.06-1.41, P = 0.00; GG/AG vs AA: OR = 1.10, 95%CI = 1.02-1.18, P = 0.00). In conclusion, our study indicated that the GSTP1 rs1695 A>G polymorphism was correlated with elevated BC risk in Asian women. Our results must be validated with further research.

Regulatory T-cell depletion in the gut caused by integrin β7 deficiency exacerbates DSS colitis by evoking aberrant innate immunity

Integrin α4β7 controls lymphocyte trafficking into the gut and has essential roles in inflammatory bowel disease (IBD). The α4β7-blocking antibody vedolizumab is approved for IBD treatment; however, high dose of vedolizumab aggravates colitis in a small percentage of patients. Herein, we show that integrin β7 deficiency results in colonic regulatory T (Treg) cell depletion and exacerbates dextran sulfate sodium (DSS) colitis by evoking aberrant innate immunity. In DSS-treated β7-deficient mice, the loss of colonic Treg cells induces excessive macrophage infiltration in the colon via upregulation of colonic epithelial intercellular adhesion molecule 1 and increases proinflammatory cytokine expression, thereby exacerbating DSS-induced colitis. Moreover, reconstitution of the colonic Treg cell population in β7-deficient mice suppresses aberrant innate immune response in the colon and attenuates DSS colitis. Thus, integrin α4β7 is essential for suppression of DSS colitis as it regulates the colonic Treg cell population and innate immunity.

Artesunate protects pancreatic beta cells against cytokine-induced damage via SIRT1 inhibiting NF-κB activation

AIM

Artesunate (ART) has been known as the most effective and safe reagents to treat malaria for many years. In this study, we explored whether ART could protect pancreatic beta-cell against cytokine-induced damage.

MATERIALS AND METHODS

The production of nitrite (NO) was detected with the Griess Assay Kit. SIRT1 and inducible nitric oxide synthase (iNOS) expression were determined with Western blot. The transcriptional activity of NF-κB was evaluated by luciferase reporter assay. The expression of Sirt1 was silenced by RNA interference. Glucose-stimulated insulin secretion (GSIS) and potassium-stimulated insulin secretion (KSIS) assays were performed to measure the effect of ART on pancreatic beta-cells' function. The effect of ART on beta-cells apoptosis was evaluated by using Hochest/PI staining and TUNEL assay.

RESULTS

ART enhanced GSIS (KSIS) and reduced apoptosis of pancreatic beta-cells induced by IL-1β. Further study showed that ART inhibited IL-1β-induced increase of NF-κB activity, iNOS expression, and NO production. Moreover, ART up-regulated SIRT1 expression in INS-1 cells and islets exposed to IL-1β. Inhibition of SIRT1 expression could partially abolished the inhibitory effect of ART on NF-κB activity in IL-1β-treated beta-cells. More importantly, the protective effect of ART on cytokine-induced damage was reversed by silencing SIRT1 expression.

CONCLUSIONS

ART can elicit a protective effect on beta-cells exposed to IL-1β by stimulating SIRT1 expression, which resulted in the decrease of NF-κB activity, iNOS expression, and NO production. Hence, ART might be an effective drug for diabetes.

Implicating the H63D polymorphism in the HFE gene in increased incidence of solid cancers: a meta-analysis

A number of previous studies have demonstrated that the HFE H63D polymorphism is associated with increased risk of incidence multiple types of cancer, including colorectal cancer, breast cancer, liver cancer, pancreatic cancer, and gynecological malignant tumors. However, the clinical outcomes were inconsistent. Therefore, this meta-analysis was conducted to summarize the effect of the H63D variant on the incidence of solid tumor. PubMed and EMBASE databases were searched for articles associating the HFE H63D polymorphism with cancer risk. The relationships were evaluated by calculating the pooled odds ratios (ORs) with 95% confidence intervals (CIs). A total of 28 studies, including 7728 cancer cases and 11,895 controls, were identified. Statistically significant associations were identified between the HFE H63D polymorphism and solid cancer risk (CG vs CC, OR = 1.14, 95%CI = 1.07-1.23, P < 0.001; GG vs CC, OR = 1.28, 95%CI = 1.06-1.55, P = 0.010; CG/GG vs CC, OR = 1.16, 95%CI = 1.08-1.24, P < 0.001; GG vs CC/CG, OR = 1.24, 95%CI = 1.02-1.49, P = 0.027). In the subgroup analysis, we illustrated the effect of the H63D polymorphism on hepatocellular carcinoma and pancreatic cancer risk, particularly in the Asian and African subgroups; however, this was not observed in gynecological malignant tumors. In summary, this analysis provided strong evidence that the HFE H63D polymorphism may play a critical role in the increased aggressiveness of hepatocellular carcinoma and pancreatic cancer.

Coherence time limit of the biphotons generated in a dense cold atom cloud

Biphotons with narrow bandwidth and long coherence time can enhance light-atom interaction, which leads to strong coupling between photonic and atomic qubits. Such strong coupling is desirable in quantum information processing, quantum storage and communication. In particular, paired photons with a long coherence time over submicroseconds facilitate the direct manipulation of biphoton wavefunction. In this paper, we report the narrow-band biphotons with a coherence time of 2.34 μs generated from spontaneous four-wave mixing (SFWM) in a dense cold atom cloud, in which the anti-Stokes photons go through a narrow electromagnetically-induced transparency (EIT) window. In our knowledge, this is the best record of coherence time for paired photons achieved so far. A number of factors limiting the coherence time are analyzed in detail. We find the EIT coherence plays an essential role in determining the coherence time for paired photons. The EIT dephasing rate is the ultimate limit to the coherence time, and an ultra-long coherence time above ten microseconds is possible by further improvement of the dephasing rate below 100 kHz.

A systematic review on the use of daily subcutaneous administration of teriparatide for treatment of patients with osteoporosis at high risk for fracture in Asia

This systematic review aimed to examine the evidence for teriparatide in Asia for osteoporosis with a high fracture risk and for exploratory (unapproved) bone-related indications. MEDLINE (1946+), EMBASE (1966+), and ClinicalTrials.gov (2008+) were searched (16 August 2013); all studies of daily subcutaneous teriparatide 20 μg for bone-related conditions from China, Hong Kong, Japan, Republic of Korea, Philippines, Singapore, and Taiwan were included. Evidence on efficacy/safety was retrieved primarily from randomized controlled trials (10 publications) of postmenopausal women from Japan and China. In these studies, teriparatide was well tolerated; subjects had significantly greater increases in lumbar spine bone mineral density (BMD) from baseline compared with placebo, antiresorptive agents, or elcatonin/calcitonin; bone turnover markers increased from baseline and were sustained at elevated levels during teriparatide treatment. Few studies reported fracture risk, pain, or quality of life; one study showed a lower incidence of new-onset vertebral fracture with teriparatide versus antiresorptive agents. Nonrandomized studies (nine publications, one unpublished trial) conducted mainly in Taiwan, Japan, and the Republic of Korea provided supporting data for efficacy. The exploratory (unapproved) use of teriparatide (17 publications) for fracture healing and osteonecrosis of the jaw was described primarily in case reports. The clinical effectiveness of teriparatide for treatment of postmenopausal women with osteoporosis who are at high risk of fracture in Asia is focused primarily on improvements in BMD and tolerability. Recommended additional studies may include assessment of fracture risk and the effect of teriparatide on pain, quality of life, and mortality in Asia.

Study of the sludge reduction in an oxic-settling-anaerobic activated sludge process based on UNITANK

An oxic-settling-anaerobic process (OSA) can effectively reduce sludge production, but most of the research studies on the OSA process have been either under laboratory test conditions or based on synthetic wastewater, which cannot fully reflect the performance and sludge reduction efficiency in existing OSA process. Thus, aiming at examining the sludge reduction efficiency and the stability of the OSA process, UNITANK and UNITANK-OSA processes were performed in a 120 m(3)/d pilot-scale system using actual sewage. The results indicate that UNITANK-OSA achieved a 48% reduction of the sludge compared to the reduction due to UNITANK, not considering the accumulation of the effluent-suspended solids. The effluent quality was not found to change significantly, except that the total phosphorus concentration increased slightly. The extracellular polymeric substances metal floc theory may, to some extent, explain this reduction in this study. The OSA process could be used to reform the classic wastewater treatment process to get lower sludge mass.

Expression analysis of differentially expressed miRNAs in male and female chicken embryos

MicroRNAs (miRNAs) are small non-coding RNA molecules that play key roles in the regulation of development processes of many tissues and organs at the post-transcriptional level. However, little is known about how they affect chicken gonadal development. We examined the expression of four miRNAs (miR-218, -200b, -196, and -206) in chicken embryonic gonads at embryonic days 3.5-6.5. Their target genes were predicted by miRDB, TargetScan and PicTar algorithms. The expression levels of these four miRNAs differed with sex to varying degrees; miR-200b was expressed at a significantly higher level in female gonads during the entire interval. The whole mount in situ hybridization result showed considerably higher expression of miR-200b in females than in males in E5.5 embryos. The miRNA target scanning results indicated several genes with functions in gonad development and gonad function. We conclude that miR-200b is involved in the regulation of gonad development and sexual differentiation of chicken embryos.

Exploration of water jet generated by Q-switched laser induced water breakdown with different depths beneath a flat free surface

The dynamics of a water jet on a flat free surface are investigated using a nanosecond pulsed laser for creating an oscillating bubble with different depths beneath the free surface. A thin jet is shown to deform a crater surface resulted from surface depression and cause a circular ring-shaped crater on the connection surface between the crater of surface depression and the thin jet. The collapse of this circular ring-shaped crater is proposed to the crown-like formation around a thick jet. The evolution of the bubble depth suggests a classification of four distinctive ranges of the bubble depths: non-crown formation when the parameter of bubble depth over the maximum bubble radius γ ≤ 0.5, unstable crown formation when 0.5 ≤ γ ≤ 0.6, crown-like structure with a complete crown wall when 0.6 ≤ γ ≤ 1.1, and non-crown formation when 1.1 ≤ γ. Furthermore, the orientation of the crown wall gradually turns counterclockwise to vertical direction with increasing γ from 0.5 to 1.1, implying a high correlation between the orientation of the crown wall and the depth of the bubble. This correlation is explained and discussed by the directional change of the jet eruption from the collapse of circular ring-shaped crater.

First Report of Didymella bryoniae Causing Gummy Stem Blight of Chayote in Taiwan

Chayote (Sechium edule (Jacq.) Swartz, Cucurbitaceae), originally native to Mexico, is an important vegetable known as "dragon-whisker vegetable" and is cultivated for its shoots in Ji-an, Hualien County in eastern Taiwan. In June 2010, 70 to 80% of the chayote plants grown in Ji-an developed necrotic spots on stems, leaves, and fruits. The disease was severe during the warm and rainy season from June to August. The symptoms on stems, leaves, and fruits were water-soaked lesions that eventually dried up, cracked, and produced perithecia on necrotic tissues. A single ascospore was isolated from perithecia harvested from diseased stems and cultured on potato dextrose agar (PDA) at 25°C for 1 month. Colonies of three isolates (SE5, SE6, and SE7) were white to olivaceous green bearing unicellular conidia measuring 2 to 5 × 3 to 10 μm, which is consistent with the morphological characteristics of Didymella bryoniae (Auersw.) Rehm (anamorph Phoma cucurbitacearum (Fr.:Fr.) Sacc.) (1,2,3). DNA of SE5, SE6, and SE7 isolates were obtained using microwave-based method (4). The internal transcribed spacer (ITS) rDNA (GenBank accessions AB714984, AB714985, and AB714986), PCR-amplified using primers ITS1 and ITS4, had 98 to 99% nucleotide sequence identity with D. bryoniae (GenBank Accession Nos. GU045304 and GU592001). A pathogenicity test was conducted in a greenhouse with temperature ranging from 20 to 30°C. Three-day-old mycelial plugs (5 × 5 mm) of the three isolates were placed on the needle-pricked wounds of stems and leaves of 36 4-month-old potted chayote plants wrapped in plastic bags to maintain 100% relative humidity for 2 days. Six days after inoculation, water-soaked lesions formed on the stems and leaves. Controls inoculated with sterile water had no symptoms. The fungus reisolated from the lesions of diseased stems and leaves had morphological characteristics of D. bryoniae. Based on the results of morphology, molecular data, and pathogenicity tests, we reported for the first time to our knowledge that gummy stem blight of chayote is caused by D. bryoniae in Taiwan. References: (1) J. W. Huang and W. R. Hsieh. Plant Prot. Bull. 27:325, 1985. (2) A. P. Keinath et al. Phytopathology 85:364, 1995. (3) E. Punithalingam and P. Holliday. P. 332 in: Descriptions of Pathogenic Fungi and Bacteria. CMI, Kew, Surrey, UK, 1972. (4) S. R. Tendulkar et al. Biotechnol. Lett. 22:1941, 2003.