[A successfully treated case of respiratory failure caused by eating Nassariidaes]

Food poisoning caused by Nassariidaes has occurred frequently in coastal areas of China, especially in summer and autumn. Nassariidaes poisoning can be manifested as lip and tongue paralysis, dizziness, headache, nausea and vomiting, arrhythmia and even respiratory failure. We admitted a case of respiratory failure caused by eating Nassariidaes. After timely respiratory support, hemoperfusion and other active treatment, the patient was recovered and was discharged. This paper summarized clinical characteristics and treatment of Nassariidaes poisoning, in order to provide reference for clinical diagnosis and treatment of similar cases.

New radiofrequency ablation procedure for selective reduction in complicated monochorionic twin or triplet pregnancy using multistep, incremental expansion technique

OBJECTIVE

Radiofrequency ablation (RFA) is the preferred approach for selective reduction in complex monochorionic (MC) multiple pregnancies owing to the ease of operation and minimal invasiveness. To optimize the RFA technique and reduce the risk of adverse pregnancy outcome resulting from the heat-sink effect of RFA therapy, we used an innovative RFA method, in which an electrode needle was expanded incrementally and stepwise. This study aimed to assess the efficacy and safety profile of this novel multistep incremental expansion RFA method for selective fetal reduction in MC twin and triplet pregnancies.

METHODS

This was a single-center retrospective cohort study of all MC multiple pregnancies undergoing RFA between March 2016 and October 2022 at our center. The multistep RFA technique involved the use of an expandable needle, which was gradually expanded during the RFA procedure until cessation of umbilical cord blood flow was achieved. The needle used for the single-step RFA method was fully extended from the start of treatment.

RESULTS

In total, 132 MC multiple pregnancies underwent selective reduction using RFA, including 50 cases undergoing multistep RFA and 82 cases undergoing single-step RFA. The overall survival rates were not significantly different between the multistep and single-step RFA groups (81.1% vs 72.3%; P = 0.234). Similarly, the rates of preterm prelabor rupture of the membranes within 2 weeks after RFA, procedure-related complications, spontaneous preterm delivery and pathological findings on cranial ultrasound, as well as gestational age at delivery and birth weight, did not differ between the two groups. However, there was a trend towards a prolonged procedure-to-delivery interval following multistep RFA compared with single-step RFA (median, 109 vs 99 days; P = 0.377). Moreover, the fetal loss rate within 2 weeks after RFA in the multistep RFA group was significantly lower than that in the single-step RFA group (10.0% vs 24.4%; P = 0.041). The median ablation time was shorter (5.3 vs 7.8 min; P < 0.001) and the median ablation energy was lower (10.2 vs 18.0 kJ; P < 0.001) in multistep compared with single-step RFA. There were no significant differences in neonatal outcomes following multistep vs single-step RFA.

CONCLUSIONS

Overall survival rates were similar between the two RFA methods. However, the multistep RFA technique was associated with a lower risk of fetal loss within 2 weeks after RFA. The multistep RFA technique required significantly less ablation energy and a shorter ablation time compared with single-step RFA in selective fetal reduction of MC twin and triplet pregnancies. Additionally, there was a trend towards a prolonged procedure-to-delivery interval with the multistep RFA technique. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Coherent feedback enhanced quantum-dense metrology in a lossy environment

Quantum dense metrology (QDM) performs high-precision measurements by a two-mode entangled state created by an optical parametric amplifier (PA), where one mode is a meter beam and the other is a reference beam. In practical applications, the photon losses of meter beam are unavoidable, resulting in a degradation of the sensitivity. Here, we employ coherent feedback that feeds the reference beam back into the PA by a beam splitter to enhance the sensitivity in a lossy environment. The results show that the sensitivity is enhanced significantly by adjusting the splitting ratio of the beam splitter. This method may find its potential applications in QDM. Furthermore, such a strategy that two non-commuting observables are simultaneous measurements could provide a new way to individually control the noise-induced random drift in phase or amplitude of the light field, which would be significant for stabilizing the system and long-term precision measurement.

[Interpretation of Chinese expert consensus on the surgical treatment for adenocarcinoma of esophagogastric junction(2024 edition)]

Due to the unique nature of its anatomical location, the adenocarcinoma of esophagogastric junction (AEG) has been a subject of controversy and disagreement including its definition, staging, and treatment strategies. Chinse expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2018 Edition) had been released in September 2018 and had played a pioneering role in unifying thoracic and general surgeons in China on surgical treatment strategies for AEG. Over the past five years, the emergence of several clinical research results on AEG has provided new clinical evidence for the selection of key surgical treatment strategies. Therefore, to further standardize the surgical treatment of AEG in China, Chinese Expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2024 Edition) was released in 2024 by Chinese expert panel including 25 gastrointestinal surgeons and 24 thoracic surgeons. Based on the highest-level clinical research evidence in recent 5 years, this consensus ultimately formulates 29 recommendations on hotspots and key points on surgical treatment of AEG and summary 5 issues that are still awaiting further exploration. This review will provide a summary and detailed interpretation of the recommendations outlined in this consensus.

Interferometry-Integrated Noise-Immune Quantum Memory

A quantum memory with the performances of low noise, high efficiency, and high bandwidth is of crucial importance for developing practical quantum information technologies. However, the excess noises generated during the highly efficient processing of quantum information inevitably destroy quantum state. Here, we present a quantum memory with built-in excess-noise eraser by integrating a photon-correlated quantum interferometry in quantum memory, where the memory efficiency can be enhanced and the excess noises can be suppressed to the vacuum level via destructive interference. This quantum memory is demonstrated in a rubidium vapor cell with a 10-ns-long photonics signal. We observe ∼80% noise suppression, the write-in efficiency enhancement from 87% to 96.2% without and with interferometry, and the corresponding memory efficiency excluding the noises from 70% to 77%. The fidelity is 93.7% at the single-photon level, significantly exceeding the no-cloning limit. Such interferometry-integrated quantum memory, the first expansion of quantum interference techniques to quantum information processing, simultaneously enables low noise, high bandwidth, high efficiency, and easy operation.

SERF-like magnetometry in room-temperature environment

We demonstrate an atomic magnetometry using amplitude-modulated pumping and hyperfine repumping techniques in a paraffin-coated cell. By exploiting the constructive interference between spins polarized by the pump beam and an additional repump beam, we observe a three-fold increase in the amplitude of magnetic resonance, along with a reduction in linewidth by approximately two times. The implementation of the repump beam effectively narrows the linewidth, demonstrating successful suppression of spin-exchange relaxation. This reduction in relaxation rate, combined with the enhanced signal, significantly improves the sensitivity of the magnetometer. Consequently, our technique offers a promising approach for achieving SERF-like magnetometry with sub-fT-level sensitivity in Earth-field range and room-temperature environment.

Protection of Noise Squeezing in a Quantum Interferometer with Optimal Resource Allocation

Interferometers are crucial for precision measurements, including gravitational waves, laser ranging, radar, and imaging. The phase sensitivity, the core parameter, can be quantum-enhanced to break the standard quantum limit (SQL) using quantum states. However, quantum states are highly fragile and quickly degrade with losses. We design and demonstrate a quantum interferometer utilizing a beam splitter with a variable splitting ratio to protect the quantum resource against environmental impacts. The optimal phase sensitivity can reach the quantum Cramér-Rao bound of the system. This quantum interferometer can greatly reduce the quantum source requirements in quantum measurements. In theory, with a 66.6% loss rate, the sensitivity can break the SQL using only a 6.0 dB squeezed quantum resource with the current interferometer rather than a 24 dB squeezed quantum resource with a conventional squeezing-vacuum-injected Mach-Zehnder interferometer. In experiments, when using a 2.0 dB squeezed vacuum state, the sensitivity enhancement remains at ∼1.6  dB via optimizing the first splitting ratio when the loss rate changes from 0% to 90%, indicating that the quantum resource is excellently protected with the existence of losses in practical applications. This strategy could open a way to retain quantum advantages for quantum information processing and quantum precision measurement in lossy environments.

[Analysis of reliability and validity of the Chinese version of reflux symptom score 12]

Objective: To standardize the 12-item reflux symptom scale in Chinese and evaluate its reliability, validity, and effect on diagnoses. Methods: A systematic translation version of the RSS-12 scale was performed using the Brislin model. The scale with 12 items included three dimensions of symptoms in ear, nose and throat, gastrointestinal tract and respiratory tract. The effect was assessed by three aspects containing symptom frequency, severity, and the quality of life. The Chinese version of RSS-12 was used to test 432 patients who attended the outpatient ENT department of Fujian Provincial Hospital between March 2021 and December 2021, and 413 patient questionnaires were classified as valid, aged 17-78(40.8±13.3) years, 203 were female and 210 were male. SPSS 26.0 and AMOS 24.0 statistical software were used to evaluate the performance of the scale. Results: The scale was highly discriminatory among items and correlated well among dimensions. The I-CVI ranged from 0.67 to 1.00, and the S-CVI was 0.81. The exploratory factor analysis showed that the cumulative variance contribution was 63.583%. The validation factor analysis showed that the model adaptation was good, and the correlation coefficient with the RSI was 0.796. Cronbach's α coefficient was 0.814, the retest reliability was 0.939, and the Spearman-Brown half reliability was 0.892, all of which showed a high level of reliability. Using 24h MII-pH as the diagnostic criterion for LPRD, the RSS-12 scale had a diagnostic compliance rate of 79.4%, with a sensitivity of 0.768 and specificity of 0.857. Conclusion: The Chinese version of the RSS-12 scale has good reliability, validity, and diagnostic ability, which can be used as a screening tool to diagnose pharyngeal reflux diseases.

Minocycline relieves myocardial ischemia-reperfusion injury in rats by inhibiting inflammation, oxidative stress and apoptosis

OBJECTIVE

Myocardial ischemia-reperfusion (I/R) injury (MIRI) is an important cause of irreversible injury to the myocardium in patients with acute myocardial infarction. The purpose of this study was to investigate the effects of minocycline (MC) on inflammation, oxidative stress and apoptosis of myocardial tissues.

MATERIALS AND METHODS

We used rats to establish MIRI model by ligating coronary arteries. The structure and function of rat myocardium were determined by 2, 3, 5-triphenyl tetrazolium chloride (TTC) staining, hematoxylin-eosin (HE) staining and echocardiography. In addition, we detected the expression of inflammatory factors, antioxidant enzymes and apoptosis-related molecules in rats by enzyme-linked immunosorbent assay (ELISA), immunohistochemical (IHC) staining and reverse transcription-polymerase chain reaction (RT-PCR) to determine the effect of MC on inflammation, oxidative stress and apoptosis in I/R rats. Finally, we studied the effect of MC stimulation on the viability of rat cardiomyocytes (H9c2 cells) in vitro.

RESULTS

After I/R, the heart function of rats decreased, and the structure of myocardium was destroyed. The levels of inflammation and oxidative stress in I/R rats also increased significantly, manifested by increased inflammatory factors and decreased antioxidant enzymes in serum and myocardial tissue. After treatment of I/R rats with MC, the structure and function of rat myocardium improved significantly, and MC reduced inflammation and oxidative stress levels in rats, thus inhibiting the apoptosis of cardiomyocytes. MC also improved the viability of H9c2 cells in vitro.

CONCLUSIONS

MC reduced inflammation and oxidative stress levels in MIRI rat model or H9c2 cells, thus inhibiting cardiomyocyte apoptosis. Therefore, MC has potential application prospects for the treatment of MIRI.

[Treatment of Siewert type II adenocarcinoma of the esophagogastric junction: the perspectives from thoracic surgery]

A greater controversy remains in clinical diagnosis and treatment of Siewert type II adenocarcinoma of esophagogastric junction (AEG), compared with Siewert type I and III AEG. In 2018, the first edition of Chinese Expert Consensus on the Surgical Treatment for Adenocarcinoma of Esophagogastric Junction was published in the Chinese Journal of Gastrointestinal Surgery. In the past few years, the advance in minimally invasive thoracoscopic surgery has been proven to reduce thoracic trauma in Siewert type II AEG. Meanwhile, distal thoracic esophagectomy can achieve more complete resection, and upper abdomen-right thoracic approach can ensure the mediastinal lymph node dissection and improve long-term survival. The concept and practice of endoscopic surgery and the comprehensive treatment also give new supplements to the treatment regimen of Siewert type II AEG. More clinical researches should be conducted to address the surgical residual safety and lymph node dissection issues.

Quantum enhanced electro-optic sensor for E-field measurement

The measurement of intense E-field is a fundamental need in various research areas. An electro-optic (EO) sensor based on common path interferometer (CPI) is widely used due to its better temperature stability and controllability of optical bias. However, the small EO coefficient leads to poor sensitivity. In this paper, a quantum enhanced EO sensor is proposed by replacing the vacuum state in classical one with a squeezed-vacuum state. Theoretical analysis shows that the performance of the quantum enhanced EO sensor, including signal to noise ratio (SNR) and sensitivity, can always beat the classical one due to the noise suppression caused by the squeezed-vacuum state. Experimental results demonstrate that, there is still a 1.12dB quantum enhancement compared with the classical one when the degree of the squeezed-vacuum is 1.60dB. More importantly, except the increase of the EO coefficient or the optical power, the performance of the EO sensor can also be enhanced via quantum light source. Such a quantum enhanced EO sensor could be practically applied for the measurement of intense E-field.

[Clinical features and perinatal outcomes of 48 cases of pregnancy complicated with placental cystic lesions]

Objective: To investigate the clinical characteristics and perinatal outcomes of pregnancy with placental cystic lesions. Methods: A retrospective study was carried out on 48 pregnant women diagnosed as pregnancy complicated with placental cystic lesions from January 2000 to January 2020 at the Women's Hospital, Zhejiang University School of Medicine. The clinical features, pathological diagnosis and perinatal outcome were analyzed. Results: The age of 48 cases was (30±5) years, and the diagnostic gestational week of ultrasound was (24±8) weeks. Twenty-five cases in which showed a cystic mass at the fetal surface were diagnosed as placental cyst. The live birth rate was 100% (25/25) and the premature birth rate was 20% (5/25). Twenty-three cases showed "honeycomb like" cystic echo. Cystic lesions of 10 cases were located in the uterine cavity connected with the margin of the normal placenta, and finally diagnosed as hydatidiform mole and coexisting fetus (HMCF). Six cases of HMCF terminated pregnancy, and the live birth rate was 4/10, the premature delivery rate was 2/4. Cystic lesions of 13 cases were located in the placenta substance, and finally diagnosed as 4 cases of placental mesenchymal dysplasia (PMD) and 9 cases of focal chorionic edema; the live birth rate was 6/13 and the premature delivery rate was 4/6. The median hCG was lower in focal chorionic edema group [80 kU/L (60-110 kU/L)] than in the groups of HMCF [240 kU/L (180-430 kU/L)] and PMD [360 kU/L (210-700 kU/L)], and the differences were statistically significant (all P<0.01). Conclusions: For pregnancy complicated with placental cystic lesions, prenatal ultrasound should be performed to evaluate the shape, location and blood flow of the lesions. Maternal serological examination and invasive prenatal diagnosis are helpful for prenatal diagnosis and treatment. Due to the difference of perinatal outcomes, maternal and fetal complications, individualized pregnancy management should be carried out.

Hsa_circ_0041103 induces proliferation, migration and invasion in bladder cancer via the miR-107/FOXK1 axis

OBJECTIVE

CircRNAs have been proven to be vital during the process of malignant tumors. Their functions in bladder cancer (BCa) process remain largely unclear. This study aims to elucidate the role of circ0041103 in affecting the malignant phenotypes of BCa, and the possible molecular mechanism.

PATIENTS AND METHODS

Circ0041103 expression levels in BCa tissues and cell lines were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The clinical significance of circ0041103 in influencing tumor size, tumor staging and lymphatic metastasis of BCa was analyzed. Regulatory effects of circ0041103 on proliferative and metastatic capacities of T24 and UM-UC-3 cells were examined through functional experiments. The binding target of circ0041103 and its downstream protein were predicted by online bioinformatic tools, which were further confirmed by Dual-Luciferase reporter assay and Pearson correlation test. The role of circ0041103/miR-107/ FOXK1 axis in regulating BCa process was explored by rescue experiments.

RESULTS

Circ0041103 was abnormally upregulated in BCa tissues and cell lines. Its level was higher in BCa tissues with a larger tumor size, or worse tumor staging, or BCa cases with lymphatic metastasis. Knockdown of circ0041103 inhibited proliferative and metastatic capacities of T24 and UM-UC-3 cells. MiR-107 was the binding target of circ0041103, and FOXK1 was the downstream gene of miR-107. Overexpression of circ0041103 could reverse the inhibited proliferative and metastatic capacities of T24 and UM-UC-3 cells overexpressing miR-107.

CONCLUSIONS

Circ0041103 is upregulated in BCa and predicts a poor prognosis in BCa. It stimulates BCa cells to proliferate and migrate via the miR-107/FOXK1 axis.

[Patterns of recurrence after neoadjuvant chemoradiotherapy compared with surgery alone in esophageal cancer]

Associated with improvement in survival, the neoadjuvant therapy had become the mainstay of therapy for patients with locally advanced esophageal cancer. Despite a significantly better survival, the recurrence risk after neoadjuvant therapy remains considerably high, with recurrence rate of>40%. Thus, it's important to gain a thorough understanding of the recurrence patterns for developing effective tertiary prevention and follow-up strategies. The aim of this review was to compare the patterns of recurrence in patients with esophageal cancer who received preoperative therapy followed by surgery or surgery alone. It is found that the most frequent recurrence pattern was distant metastasis in esophageal cancer regardless receipt of neoadjuvant therapy or not, and the major effect of neoadjuvant therapy appears to be an improvement in local regional disease control without a reduction in systemic. This frustrating fact may explain the poor survival of esophageal cancer patients receiving neoadjuvant therapy.

[Correlation between preoperative inflammatory biomarkers and postoperative pneumonia or long-term prognosis in patients with esophageal cancer after neoadjuvant therapy]

Objective: To examine the correlation between neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and neutrophil-monocyte ratio (NMR) for postoperative pneumonia or long-term overall survival in patients with esophageal cancer after neoadjuvant therapy. Methods: The clinical data of 137 patients, including 111 males and 26 females, with the age of (M(QR))61(10) years (range: 45 to 75 years), undergoing radical resection of esophageal cancer after neoadjuvant therapy admitted at Department of Thoracic Surgery, West China Hospital from January 2016 to May 2019 were analyzed retrospectively. The blood routine one or two days before surgery and the occurrence of pneumonia after surgery were collected via hospital information system. The absolute count of neutrophils, lymphocytes and monocytes was recorded, to calculate NLR, LMR and NMR. The survival of patients was recorded systematically via follow-up. In the first part, the influencing factors of postoperative inflammation were analyzed, to group the patients into two groups according to the occurrence of postoperative pneumonia. χ2 test, t-test or rank-sum test were conducted for inter-group comparison. In the second part, cutoff values of inflammatory biomarkers were obtained with the receiver operating characteristic (ROC) curve and grouped, with postoperative pneumonia as endpoint criteria. Independent factors correlated with postoperative pneumonia were determined through univariate and multivariate Logistic regression analysis. In the third part, the analysis on prognosis factors was carried on, with the survival as endpoint criteria. Cutoff values of inflammatory biomarkers were obtained with X-Tile software and grouped. The survival analysis was carried on with univariate and multivariate Cox proportional hazards regression model, and the Kaplan-Meier curve was drawn finally. The results of survival analysis were verified by Log-rank test. Results: Median follow-up time was 614 (299) days (range: 382 to 1 612 days). Cutoff values of NLR, LMR, and NMR obtained via the ROC curve were 3.0, 3.9, and 6.2, respectively. According to the multivariate Logistic regression analysis, NLR>3.0 (OR=2.740, 95% CI: 1.221 to 6.152, P=0.015) and LMR>3.9 (OR=0.140, 95% CI: 0.022 to 0.890, P=0.037) were independent prognosis factors for postoperative pneumonia in patients with esophageal cancer after neoadjuvant therapy. Cutoff values of NLR, LMR, and NMR obtained with X-Tile software were 3.3, 4.2, and 7.2, respectively. Through multivariate Cox proportional risk regression analysis, late tumor ypTNM staging (8th AJCC) (HR=2.087, 95% CI:1.079 to 4.038, P=0.029), poor pathologic response (HR=2.251, 95% CI: 1.117 to 4.538, P=0.023), and LMR>4.2 (HR=0.347, 95% CI: 0.127 to 0.946, P=0.039) could be independent prognosis factors for overall survival. Kaplan-Meier survival analysis indicated that the overall survival of patients with LMR ≤4.2 was worse (P=0.002), with the 1-year overall survival rate of 82.9%, and the 1-year overall survival rate of patients with LMR>4.2 was 94.6%. Conclusion: Preoperative LMR ≤3.9 and NLR>3.0 can be considered as independent prognosis factors for postoperative pneumonia, while LMR≤4.2 as one of independent prognosis factors for overall survival.

Engineering new limits to magnetostriction through metastability in iron-gallium alloys

Magnetostrictive materials transduce magnetic and mechanical energies and when combined with piezoelectric elements, evoke magnetoelectric transduction for high-sensitivity magnetic field sensors and energy-efficient beyond-CMOS technologies. The dearth of ductile, rare-earth-free materials with high magnetostrictive coefficients motivates the discovery of superior materials. Fe_1-xGa_x alloys are amongst the highest performing rare-earth-free magnetostrictive materials; however, magnetostriction becomes sharply suppressed beyond x = 19% due to the formation of a parasitic ordered intermetallic phase. Here, we harness epitaxy to extend the stability of the BCC Fe_1-xGa_x alloy to gallium compositions as high as x = 30% and in so doing dramatically boost the magnetostriction by as much as 10x relative to the bulk and 2x larger than canonical rare-earth based magnetostrictors. A Fe_1-xGa_x - [Pb(Mg_1/3Nb_2/3)O₃]_0.7-[PbTiO₃]_0.3 (PMN-PT) composite magnetoelectric shows robust 90° electrical switching of magnetic anisotropy and a converse magnetoelectric coefficient of 2.0 × 10^-5 s m^-1. When optimally scaled, this high coefficient implies stable switching at ~80 aJ per bit.

Design of coaxial coils using hybrid machine learning

A coil system to generate a uniform field is urgently needed in quantum experiments. However, general coil configurations based on the analytical method have not considered practical restrictions, such as the region for coil placement due to holes in the center of the magnetic shield, which could not be directly applied in most of the quantum experiments. In this paper, we develop a coil design method for quantum experiments using hybrid machine learning. The algorithm part consists of a machine learner based on an artificial neural network and a differential evolution (DE) learner. The cooperation of both learners demonstrates its higher efficiency than a single DE learner and robustness in the coil optimization problem compared with analytical proposals. With the help of a DE learner, in numerical simulation, a machine learner can successfully design coaxial coil systems that generate fields whose relative inhomogeneity in a 25 mm-long central region is ∼10^-6 under constraints. In addition, for experiments, a coil system with 0.069% inhomogeneity of the field, designed by a machine learner, is constructed, which is mainly limited by machining the precision of the circuit board. Benefitting from machine learning's high-dimension optimization capabilities, our coil design method is convenient and has potential for various quantum experiments.

Forensic Application of Next Generation Sequencing Technology in the Typing of Y Chromosome Genetic Markers

Abstract

The paternal inheritance characteristics of Y chromosome have been widely used in the forensic genetics field to detect the genetic markers in the non-recombining block, and used in the studies such as, genetic relationship identification, mixed stain detection, pedigree screen and ethnicity determination. At present, capillary electrophoresis is still the most common detection technology. The commercial detection kits and data analysis and processing system based on this technology are very mature. However, the disadvantages of traditional detection technology have gradually appeared with the rapid growth of bio-information amount, which promotes the renewal of forensic DNA typing technology. In recent years, next generation sequencing （NGS） technology has developed rapidly. This technology has been applied to various fields including forensic genetics and has provided new techniques for the detection of Y chromosome genetic markers. This article describes the current situation and application prospects of the NGS technology in forensic Y chromosome genetic markers detection in order to provide new ideas for future judicial practice.

Local negative permittivity and topological phase transition in polar skyrmions

Topological solitons such as magnetic skyrmions have drawn attention as stable quasi-particle-like objects. The recent discovery of polar vortices and skyrmions in ferroelectric oxide superlattices has opened up new vistas to explore topology, emergent phenomena and approaches for manipulating such features with electric fields. Using macroscopic dielectric measurements, coupled with direct scanning convergent beam electron diffraction imaging on the atomic scale, theoretical phase-field simulations and second-principles calculations, we demonstrate that polar skyrmions in (PbTiO₃)_n/(SrTiO₃)_n superlattices are distinguished by a sheath of negative permittivity at the periphery of each skyrmion. This enhances the effective dielectric permittivity compared with the individual SrTiO₃ and PbTiO₃ layers. Moreover, the response of these topologically protected structures to electric field and temperature shows a reversible phase transition from the skyrmion state to a trivial uniform ferroelectric state, accompanied by large tunability of the dielectric permittivity. Pulsed switching measurements show a time-dependent evolution and recovery of the skyrmion state (and macroscopic dielectric response). The interrelationship between topological and dielectric properties presents an opportunity to simultaneously manipulate both by a single, and easily controlled, stimulus, the applied electric field.

Supramolecular Solvent Extraction-Gas Chromatography-Tandem Mass Spectrometry for Detection of Benzodiazepines in Urines

Objective To establish a method using supramolecular solvent and gas chromatography-tandem mass spectrometry （GC-MS/MS） to analyze 9 benzodiazepines in urines. Methods Urine samples containing 9 benzodiazepines reference substance were subjected to liquid-liquid extractions with supramolecular solvent, which consisted of tetrahydrofuran and 1-hexanol. The solvent layer was evaporated to dryness by stream of nitrogen. The residue was reconstituted with methanol, and GC-MS/MS analysis was performed on it. The way of data collection was multiple reaction monitoring （MRM） mode; internal standard method was employed for quantification. Results In urine samples, when the range of mass concentration was 1-100 ng/mL for diazepam, midazolam, flunitrazepam and clozapine, 5-100 ng/mL for lorazepam and alprazolam, 2-100 ng/mL for nitrazepam and clonazepam, and 0.2-100 ng/mL for estazolam, respectively, good linearities were obtained, correlation coefficients were 0.999 1-0.999 9, the lower limits of the quantifications ranged from 0.2 to 5 ng/mL, the extraction recovery rates were 81.12%-99.52%. The intra-day precision ［relative standard deviation （RSD）］ and accuracy （bias） were lower than 9.86% and 9.51%, respectively; the inter-day precision （RSD） and accuracy （bias） were lower than 8.74% and 9.98%, respectively. Nine drugs in urine samples showed good stability at ambient temperature and -20 ℃ within 15 days. The mass concentrations of alprazolam in urine samples obtained from 8 volunteers who took alprazolam tablets orally within 8-72 h after ingestions ranged from 6.54 to 88.28 ng/mL. Conclusion The supramolecular solvent extraction GC-MS/MS method for analysis of 9 benzodiazepines in urines provided by this study is simple, fast, accurate and sensitive, which can provide technical support for monitoring of poisoning by benzodiazepines for clinical treatment and judicial identification.

Super-sensitive rotation measurement with an orbital angular momentum atom-light hybrid interferometer

Lights carrying orbital angular momentum (OAM) have potential applications in precise rotation measurement, especially in remote sensing. Interferometers, especially nonlinear quantum interferometers, have also been proven to greatly improve the measurement accuracy in quantum metrology. By combining these two techniques, we theoretically propose a new atom-light hybrid Sagnac interferometer with OAM lights to advance the precision of the rotation measurement. A rotation sensitivity below standard quantum limit is achieved due to the enhancement of the quantum correlation of the interferometer even with 96% photon losses. This makes our protocol robustness to the photon loss. Furthermore, combining the slow light effect brings us at least four orders of magnitude of sensitivity better than the earth rotation rate. This new type interferometer has potential applications in high precision rotation sensing.

Analysis of a registry database for esophageal cancer from high-volume centers in China

Esophageal cancer has a high incidence among malignancies in China, but a comprehensive picture of the status of its surgical management in China has hitherto not been available. A nationwide database has recently been established to address this issue.

METHOD

A National Database was setup through a network platform, and data was collected from 70 high-volume centers (>100 esophagectomies/per year) across China. Data was entered between January 2009 and December 2014, and was analyzed in June 2015 after a minimal follow-up of 6 months for all patients. 8181 patients with complete data who received surgery for primary esophageal cancer on the Database were included in the analysis.

RESULT

In this series, there were 6052 males and 2129 females, with a mean age of 60.5 years (range: 22-90 years). The pathology in 95.5% of patients was squamous cell carcinoma. The pathological stage distribution was 1.2% in stage 0, 2.5% in Ia, 11.5% in Ib, 14.8% in IIa, 36.1% in IIb, 19.3% in IIIa, 8.3% in IIIb, 6.2% in IIIc. 1800 patients (22.0%) with locally advanced disease received preoperative neoadjuvant therapy and 3592 patients (43.9%) underwent postoperative adjuvant chemotherapy and/or radiotherapy. The esophagectomies were performed through left thoracotomy approach in 5870 cases (72.6%), through right chest approach in 2215 cases (27.4%) including right thoracotomy (21.3%) and VATS (6.1%). The 30-day postoperative mortality rate was 0.6% (43 patients), and the overall postoperative complication rate was 11.6% (951 patients). The 1-, 3-, and 5-year overall survival rates were 82.6%, 61.6%, and 52.9%, respectively.

CONCLUSION

This National Registry Database from high-volume centers provides a comprehensive picture of surgical management for esophageal cancer in China for the first time. Squamous cell carcinoma predominates, but there is heterogeneity with respect to the surgical approach and perioperative oncologic management. Overall, surgical mortality and morbidity rates are low, and good survival rates have been achieved due to improvement of surgical treatment technology in recent years.

Application of Artificial Intelligence Automatic Diatom Identification System in Practical Cases

Abstract

Objective To discuss the application of artificial intelligence automatic diatom identification system in practical cases, to provide reference for quantitative diatom analysis using the system and to validate the deep learning model incorporated into the system. Methods Organs from 10 corpses in water were collected and digested with diatom nitric acid; then the smears were digitally scanned using a digital slide scanner and the diatoms were tested qualitatively and quantitatively by artificial intelligence automatic diatom identification system. Results The area under the curve （AUC） of the receiver operator characteristic （ROC） curve of the deep learning model incorporated into the artificial intelligence automatic diatom identification system, reached 98.22% and the precision of diatom identification reached 92.45%. Conclusion The artificial intelligence automatic diatom identification system is able to automatically identify diatoms, and can be used as an auxiliary tool in diatom testing in practical cases, to provide reference to drowning diagnosis.

[Epidemiological characteristic and current status of surgical treatment for esophageal cancer by analysis of national registry database]

Objective: To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China. Methods: A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014. Results: Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively. Conclusions: The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.

Quality estimation of non-demolition measurement with lossy atom-light hybrid interferometers

The atom-light hybrid interferometer recently attracted much attention in the research of precision metrology for its combination of light and atomic spin wave. With the AC Stark effect and proper design, it can be applied in the scheme of quantum non-demolition (QND) measurement of photon numbers. In this work, we apply the QND criteria to the scheme and theoretically derive its explicit formulas with various losses of the atomic-light hybrid interferometer. With the formulas and actual experiment parameters, we estimate and compare the performance of the vapor-atom-based and cold-atom-based hybrid interferometer in the QND measurement, analyze the influences of different kinds of losses, and provide optimized working parameter ranges of the interferometer.

[Retrospect of 2019: focus on the surgical treatment for adenocarcinoma of esophagogastric junction]

Adenocarcinoma of esophagogastric junction (AEG) has a special anatomical position. In clinical practice, there are many overplays among thoracic surgeons, gastrointestinal surgeons, gastroenterologists and oncologists. In recent years, AEG has attracted more and more clinical attention with its increasing incidence. It has a tendency to be gradually separated from esophageal cancer and gastric cancer and be defined as a new special type of tumor. At present, there are still many controversies in the definition, classification, TNM staging, surgical approach, extent of resection, lymph node dissection, digestive tract reconstruction and neoadjuvant therapy of AEG. Meanwhile many problems still need to be solved, which is in a stage of gradual improvement and standardization. This article mainly reviews the important research progress in the field of AEG in 2019, summarizes the current clinical hotspots of AEG, especially the surgical treatment hotspots and the current application status of related new technologies, and aims the future development. We suggest that communication and cooperation among multiple disciplines should be strengthened. Through more clinical researches, basic experimental researches, and innovation and application of new technologies, personalized and accurate diagnosis and treatment will be carried out for patients with different conditions to ultimately achieve the common goal of maximizing the benefits of patients.

Magnetoelectric Coupling by Piezoelectric Tensor Design

Strain-coupled magnetoelectric (ME) phenomena in piezoelectric/ferromagnetic thin-film bilayers are a promising paradigm for sensors and information storage devices, where strain manipulates the magnetization of the ferromagnetic film. In-plane magnetization rotation with an electric field across the film thickness has been challenging due to the large reduction of in-plane piezoelectric strain by substrate clamping, and in two-terminal devices, the requirement of anisotropic in-plane strain. Here we show that these limitations can be overcome by designing the piezoelectric strain tensor using the boundary interaction between biased and unbiased piezoelectric. We fabricated 500 nm thick, (001) oriented [Pb(Mg_1/3Nb_2/3)O₃]_0.7-[PbTiO₃]_0.3 (PMN-PT) unclamped piezoelectric membranes with ferromagnetic Ni overlayers. Guided by analytical and numerical continuum elastic calculations, we designed and fabricated two-terminal devices exhibiting electric field-driven Ni magnetization rotation. We develop a method that can apply designed strain patterns to many other materials systems to control properties such as superconductivity, band topology, conductivity, and optical response.

Manipulating topological transformations of polar structures through real-time observation of the dynamic polarization evolution

Topological structures based on controllable ferroelectric or ferromagnetic domain configurations offer the opportunity to develop microelectronic devices such as high-density memories. Despite the increasing experimental and theoretical insights into various domain structures (such as polar spirals, polar wave, polar vortex) over the past decade, manipulating the topological transformations of polar structures and comprehensively understanding its underlying mechanism remains lacking. By conducting an in-situ non-contact bias technique, here we systematically investigate the real-time topological transformations of polar structures in PbTiO₃/SrTiO₃ multilayers at an atomic level. The procedure of vortex pair splitting and the transformation from polar vortex to polar wave and out-of-plane polarization are observed step by step. Furthermore, the redistribution of charge in various topological structures has been demonstrated under an external bias. This provides new insights for the symbiosis of polar and charge and offers an opportunity for a new generation of microelectronic devices.

Direct observation of the dynamic evolution of polar domain structures at atomic level remains challenging. Here, the authors report the observation of real-time topological transformations of polar structures in PbTiO₃/SrTiO₃ multilayers.

Optical creation of a supercrystal with three-dimensional nanoscale periodicity

Stimulation with ultrafast light pulses can realize and manipulate states of matter with emergent structural, electronic and magnetic phenomena. However, these non-equilibrium phases are often transient and the challenge is to stabilize them as persistent states. Here, we show that atomic-scale PbTiO₃/SrTiO₃ superlattices, counterpoising strain and polarization states in alternate layers, are converted by sub-picosecond optical pulses to a supercrystal phase. This phase persists indefinitely under ambient conditions, has not been created via equilibrium routes, and can be erased by heating. X-ray scattering and microscopy show this unusual phase consists of a coherent three-dimensional structure with polar, strain and charge-ordering periodicities of up to 30 nm. By adjusting only dielectric properties, the phase-field model describes this emergent phase as a photo-induced charge-stabilized supercrystal formed from a two-phase equilibrium state. Our results demonstrate opportunities for light-activated pathways to thermally inaccessible and emergent metastable states.

Kinetic control of tunable multi-state switching in ferroelectric thin films

Deterministic creation of multiple ferroelectric states with intermediate values of polarization remains challenging due to the inherent bi-stability of ferroelectric switching. Here we show the ability to select any desired intermediate polarization value via control of the switching pathway in (111)-oriented PbZr_0.2Ti_0.8O₃ films. Such switching phenomena are driven by kinetic control of the volume fraction of two geometrically different domain structures which are generated by two distinct switching pathways: one direct, bipolar-like switching and another multi-step switching process with the formation of a thermodynamically-stable intermediate twinning structure. Such control of switching pathways is enabled by the competition between elastic and electrostatic energies which favors different types of ferroelastic switching that can occur. Overall, our work demonstrates an alternative approach that transcends the inherent bi-stability of ferroelectrics to create non-volatile, deterministic, and repeatedly obtainable multi-state polarization without compromising other important properties, and holds promise for non-volatile multi-state functional applications.

The use of ferroeletric materials for multi-state device applications is still challenging. Here, the authors present a mechanism to stabilize non-volatile polarization states by populating volume fractions of two domain structures in PbZr_0.2Ti_0.8O₃ via kinetic control of switching pathways.

High-performance Raman quantum memory with optimal control in room temperature atoms

Quantum memories are essential for quantum information processing. Techniques have been developed for quantum memory based on atomic ensembles. The atomic memories through optical resonance usually suffer from the narrow-band limitation. The far off-resonant Raman process is a promising candidate for atomic memories due to broad bandwidths and high speeds. However, to date, the low memory efficiency remains an unsolved bottleneck. Here, we demonstrate a high-performance atomic Raman memory in ⁸⁷Rb vapour with the development of an optimal control technique. A memory efficiency of above 82.0% for 6 ns~20 ns optical pulses is achieved. In particular, an unconditional fidelity of up to 98.0%, significantly exceeding the no-cloning limit, is obtained with the tomography reconstruction for a single-photon level coherent input. Our work marks an important advance of atomic memory towards practical applications in quantum information processing.

Storage and retrieval of memory is important for applications in quantum information processing. Here the authors demonstrate an efficient quantum Raman memory protocol by preparing hot rubidium atoms in specific states using control pulse scheme.

Biosorption of malachite green onto Haematococcus pluvialis observed through synchrotron Fourier-transform infrared microspectroscopy

Microalgae have emerged as promising biosorbents for the treatment of malachite green (MG) in wastewater. However, the underlying mechanism for the biosorption of MG onto microalgae is still unclear and needs further intensive study. In this work, synchrotron Fourier-transform infrared (s-FTIR) microspectroscopy in combination with biochemical assay is employed to evaluate MG removal efficiency (95·2%, 75·6% and 66·5%) by three stages of Haematococcus pluvialis. Meanwhile, the various vital changes of algal cells including lipids, proteins, polysaccharides and carotenoids is distinguished and quantified in situ. This study illustrates that s-FTIR microspectroscopy is an effective and powerful tool to scrutinize the mechanism for the interactions between the MG dye and microalgal cells, and it even provides an effective and noninvasive new approach to screen potentially proper biosorbents for the removal of dyes from wastewater.

SIGNIFICANCE AND IMPACT OF THE STUDY

Microalgae have potential application for their ability to absorb dyes from industrial wastewater. In this study, we initiated the application of synchrotron Fourier-transform infrared (s-FTIR) microspectroscopy to investigate malachite green dye removal efficiency by three stages of Haematococcus pluvialis, demonstrating that s-FTIR is a very powerful tool in exploring the mechanism of the biosorption of dyes onto microalgae.

[Forensic Application of SiFaSTR™ 23plex DNA ID System in Han Population of Eastern China]

OBJECTIVES

To investigate the genetic polymorphism of 21 autosomal STR loci and DYS391 locus of SiFaSTR™ 23plex DNA ID system in Han population of eastern China and to evaluate its application value in forensic science.

METHODS

Typing test of 2 000 unrelated individuals was performed using SiFaSTR™ 23plex DNA ID system. The population genetic parameters of STR loci were statistically analysed. A total of 3 198 parentage confirmed cases were detected with that system and the mutation conditions were observed in 21 autosomal STR loci.

RESULTS

All the 21 autosomal STR loci showed no significant departure from Hardy-Weinberg equilibrium （P>0.05）. The Ho ranged from 0.617 5 to 0.927 0. The DP ranged from 0.796 4 to 0.986 9, as well as the PIC distributed from 0.561 1 to 0.912 3. The CDP was 0.999 999 999 999 999. The CPE_duo was 0.999 997 431 701 961, while CPE_trio was 0.999 999 999 654 865. Five alleles were detected in DYS391 locus, with the allele frequency from 0.004 0 to 0.729 0, and GD was 0.418 9. Except D13S317 and D10S1248, seventy-six mutation events were observed at the rest nineteen autosomal STR loci. Among them, seventy-five （98.68%） were one step mutation, and only one （1.32%） was three steps mutation. The mutation rate ranged from 0.246 5×10⁻³ to 2.711 4×10⁻³, and the averaged mutation rate was 0.892 1×10⁻³ （95% CI： 0.70×10⁻³-1.10×10⁻³）. In 33 trio mutation cases, the proportion of the paternal mutation and the maternal mutation was 2.09:1.

CONCLUSIONS

The involved STRs are highly polymorphic in Eastern Han population with acceptable mutation rates by the SiFaSTR™ 23plex DNA ID system, which is suitable for paternity testing and individual identification.

[Pathological analysis and treatments of neck infection induced by congenital pyriform sinus fistula]

Objective:To identify the pathogenic bacteria of CPSF and their resistance to antibiotics,and guide the rational use of antibiotics therapy.Method:One hundred and thirty cases of deep neck infection whose imaging finding depicted patients with suspected as CPSF were enrolled in the study from January 2010 to June 2017.Specimens were collected from abscesses or other inflammatory lesions from all patients through a small incision or the external orifice on the skin of the neck.Result:A total of 108 strains of pathogens have been isolated from 88 patients (positive rate: 67.7%), among which the gram-positive bacteria accounted for 56.5%, gram-negative bacteria accounted for 43.5%. Streptococcus and Staphylococcus aureus (22.2%) were the most common pathogens among young patients (≤14 years old) (17.7%);Klebsiellapneumoniae (15.7%) were the most common pathogens among the patients over 14 years old. Separation of pathogenic bacteria have maintained a low resistance to most antibiotics. G+ bacteria is totally sensitive to quinupristin/dalfopristin and vancomycin; G-bacteria is totally sensitive to cefoperazone/Batan, piperacillin/tazobactam,imipenem.Conclusion:Most of pathogens come from upper respiratory tract in CPSF cases, and are mostly sensitive to βlactamase.

[Establishment of 43-plex SNP Typing System and Its Forensic Application]

OBJECTIVES

To evaluate the application of 43-plex SNP typing system in forensic science.

METHODS

The typing of 43 SNP loci in 123 unrelated Han individuals from East China was detected by MALDI-TOF-MS. The application value of 43-plex SNP typing system was assessed according to the forensic parameters of population genetics.

RESULTS

All the 43 SNP loci of 123 individuals showed no significant departure from Hardy-Weinberg equilibrium （P>0.05）. Excepted rs1355366, rs2270529, rs10776839 and rs938283, there were 39 SNP loci had minor allele frequencies （MAF）, which were greater than 0.25. Among the 25 loci MAFs, 24 ranged from 0.4 to 0.5, while 3 were close to 0.4. The DP, CDP, PIC, Ho, PE_trio and PE_duo of the 43 SNP loci were 0.290 1-0.654 4, 1-9.8×10⁻¹¹, 0.170 8-0.500 0, 0.155 7-0.593 5, 0.085 4-0.250 0 and 0.014 6-0.125 0, respectively. The CPE_trio and CPE_duo were 0.999 986 and 0.992 436 1, respectively.

CONCLUSIONS

The 43-plex SNP typing system in present study shows a high polymorphism, which can be an effective supplement and verification for traditional STR genetic markers. It also can be used with other commercial kits for the forensic paternity testing and individual identification.

[Clinical characteristics of thyroid hormone resistance syndrome in two cases with different subtypes]

Objective: To analyze the clinical characteristics of children with two types of thyroid hormone resistance (RTH) syndrome, and to detect the variants of thyroid hormone receptor alpha(TRα) and TRβ gene in children. Method: Two children with RTH were reported in regard to clinical manifestation, laboratory examination and genetic variants. Some related reports in literature were reviewed. Result: Case 1 was a girl, 10 years old, with thyroid enlargement for several days and without thyrotoxicosis. Laboratory work-up revealed that free thyroxine (FT(4)) was 65.77 pmol/L (reference 12-22) , free triiodothyronine (FT(3)) was 15.36 pmol/L (reference 3.1-6.8) and thyroid stimulating hormone (TSH) level was normal. There was a likely pathogenic missense variant detected in TRβ gene and this patient was diagnosed with RTHβ. Case 2 was a boy, 3 years old, with classic features of hypothyroidism(growth retardation, developmental retardation, skeletal dysplasia) but had only borderline-abnormal thyroid hormone levels. Targeted sequencing showed a de novo heterozygous nonsense variant in TRα gene which is a pathogenic variant and this patient been diagnosed with RTHα. Conclusion: Thyroid enlargement is a common clinical manifestation of RTHβ, with laboratory work-up reveals elevated FT(4) and FT(3) levels but TSH level is normal. The clinical manifestations of RTHα are similar to those of hypothyroidism, but the thyroid hormone levels are almost normal. The gene sequence and the pathogenicity analysis for TRα and TRβ will help to make a definitive diagnosis.

Quantum non-demolition measurement of photon number with atom-light interferometers

When atoms are illuminated by an off-resonant field, the AC Stark effect will lead to phase shifts in atomic states. The phase shifts are proportional to the photon number of the off-resonant illuminating field. By measuring the atomic phase with newly developed atom-light hybrid interferometers, we can achieve quantum non-demolition measurement of the photon number of the optical field. In this paper, we analyze theoretically the performance of this QND measurement scheme by using the QND measurement criteria established by Holland et al [Phys. Rev. A 42, 2995 (1990)]. We find the quality of the QND measurement depends on the phase resolution of the atom-light hybrid interferometers. We apply this QND measurement scheme to a twin-photon state from parametric amplifier to verify the photon correlation in the twin beams. Furthermore, a sequential QND measurement procedure is analyzed for verifying the projection property of quantum measurement and for the quantum information tapping. Finally, we discuss the possibility for single-photon-number-resolving detection via QND measurement.

Phase coexistence and electric-field control of toroidal order in oxide superlattices

Systems that exhibit phase competition, order parameter coexistence, and emergent order parameter topologies constitute a major part of modern condensed-matter physics. Here, by applying a range of characterization techniques, and simulations, we observe that in PbTiO₃/SrTiO₃ superlattices all of these effects can be found. By exploring superlattice period-, temperature- and field-dependent evolution of these structures, we observe several new features. First, it is possible to engineer phase coexistence mediated by a first-order phase transition between an emergent, low-temperature vortex phase with electric toroidal order and a high-temperature ferroelectric a₁/a₂ phase. At room temperature, the coexisting vortex and ferroelectric phases form a mesoscale, fibre-textured hierarchical superstructure. The vortex phase possesses an axial polarization, set by the net polarization of the surrounding ferroelectric domains, such that it possesses a multi-order-parameter state and belongs to a class of gyrotropic electrotoroidal compounds. Finally, application of electric fields to this mixed-phase system permits interconversion between the vortex and the ferroelectric phases concomitant with order-of-magnitude changes in piezoelectric and nonlinear optical responses. Our findings suggest new cross-coupled functionalities.

Enhancement of the dielectric response in polymer nanocomposites with low dielectric constant fillers

In order to increase the dielectric constants of polymer-based dielectrics, composite approaches, in which inorganic fillers with much higher dielectric constants are added to the polar polymer matrix, have been investigated. However, high dielectric constant fillers cause high local electric fields in the polymer, resulting in a large reduction of the electric breakdown strength. We show that a significant increase in the dielectric constant can be achieved in polyetherimide nanocomposites with nanofillers whose dielectric constant can be similar to that of the matrix. The presence of nanofillers reduces the constraints on the dipole response to the applied electric field, thus enhancing the dielectric constant. Our results demonstrate that through nanostructure engineering, the dielectric constant of nanocomposites can be enhanced markedly without using high dielectric constant nanofillers.

Diabetes mellitus and risk of anastomotic leakage after esophagectomy: a systematic review and meta-analysis

Diabetes mellitus has the probability to impair the anastomotic healing and cause postesophagectomy anastomotic leakages but previous studies showed controversial results. This review aims to summary the impact of diabetes mellitus on the risk of anastomotic leakage after esophagectomy. We searched the PubMed and EMBASE databases to recognize English articles that met our eligibility criteria. Odds ratio with 95% confidence interval serves as the appropriate summarized statistic. Sensitivity analysis, meta-regression analysis, and publication bias tests were also performed to perceive potential bias risks. Finally, 16 observational studies with 12359 surgical patients were included. An overall analysis identified that diabetes mellitus was significantly associated with the risk of anastomotic leakage after esophagectomy (odds ratio = 1.63; 95% confidence interval = 1.25-2.12; P < 0.001). Further subgroup analysis showed a significant impact of diabetes mellitus in surgical populations from the Europe and America (odds ratio = 1.42; 95% confidence interval = 1.22-1.65; P < 0.001) but not in the Asian populations (odds ratio = 2.27; 95% confidence interval = 0.86-6.05; P = 0.1). The robustness of these estimates was confirmed by meta-regression analysis and sensitivity analysis. No significant publication bias exists between studies. In conclusion, this systematic review demonstrates that diabetes mellitus can be a significant risk factor of anastomotic leakage for patients undergoing esophagectomy. Our findings need to be further confirmed and modified by more well-designed worldwide multivariable analyses in the future.

88% conversion efficiency with an atomic spin wave mediated mode selection

In studying quantum correlation and quantum memory of continuous variables of light fields and atoms, a crucial step is the retrieval of the quantum fields by converting an atomic spin wave to light, and retrieval efficiency is a crucial parameter. In this Letter, we implement a double-pass Raman scheme in Rb87 by incorporating coherent feedback. We find that the transfer efficiency from an atomic spin wave, which is generated from a Raman process in a high gain regime, to light fields is enhanced by the double-pass scheme as compared to the commonly used single-pass scheme. An atomic spin wave as high as 88% is read out, limited only by decoherence of the atomic spin waves. Our analysis shows that the enhancement effect is because a double-pass scheme introduced the coherent feedback mechanism which selects the spatial mode of an atomic spin wave via the correlated optical field and enhances the coupling efficiency between the atom and light. The correlations between the write-in and readout signals generated in such a two-pass Raman process are also better than the single-pass case. We believe such a two-pass scheme with feedback mechanism should be useful for studying continuous variables in quantum systems.

[Forensic Application of HuaxiaTM Platinum Kit]

OBJECTIVES

To investigate the genetic polymorphism of 23 autosomal STR loci of Huaxia™ Platinum kit in Chinese Han population, and to evaluate the forensic efficiency of Huaxia™ Platinum kit.

METHODS

A total of 500 unrelated healthy individuals from Han population were genotyped with Huaxia™ Platinum kit. The frequency distribution and the parameter of population genetics of STR loci were analysed statistically. Huaxia™ Platinum kit was compared with other 7 commercial STR kits commonly seen at home and abroad in the number of STR loci, interior label, fluorescent mark, total number of alleles in Ladder and system effectiveness.

RESULTS

All the 23 autosomal STR loci were consistent with Hardy-Weinberg equilibrium （P>0.05）. The discrimination power was 0.791 5-0.986 2. The polymorphism information content （PIC） was 0.559 0-0.914 0. The combined discrimination power （CDP） was 1-4.1×10⁻²⁸, while combined probability of paternity exclusion in trio （CPET） and in duo （CPED） were 1-4.1×10⁻¹⁰ and 1-8.4×10⁻⁷, respectively. Compared with other 7 kits, Huaxia™ Platinum kit contained the most number of alleles within the Ladder.

CONCLUSIONS

All the 23 autosomal STR loci of Huaxia™ Platinum kit with highly polymorphic in Han population can be used for paternity testing and individual identification. Compared with other 7 kits, it appears that Huaxia™ Platinum kit can provide more genetic information.

[Interpretation of update on The AJCC Esophageal Cancer Staging System, Eighth Edition]

The recently published AJCC Esophageal Cancer Staging System, 8(th) Edition will be implemented on Januray 1, 2018, which was developed by Worldwide Esophageal Cancer Collaboration based on 22 654 esophageal cancer patients from 33 worldwide centers. The definition of T, N, M, G stage and regional lymph nodes were optimized in the 8(th) edition. And the new "2 cm" principle has simplified the definition for the cancer of esophagogastric junction. In addition to pathologic staging, the 8(th) edition also provided clinical staging and pathologic staging after neoadjuvant therapy, making the new esophageal cancer staging system more practicable and reasonable.

Worldwide Esophageal Cancer Collaboration: pathologic staging data

We report data-simple descriptions of patient characteristics, cancer categories, and non-risk-adjusted survival-for patients with pathologically staged cancer of the esophagus and esophagogastric junction after resection or ablation with no preoperative therapy from the Worldwide Esophageal Cancer Collaboration (WECC). Thirty-three institutions from six continents submitted de-identified data using standard definitions: demographics, comorbidities, clinical cancer categories, and all-cause mortality from first management decision. Of 13,300 patients, 5,631 had squamous cell carcinoma, 7,558 adenocarcinoma, 85 adenosquamous carcinoma, and 26 undifferentiated carcinoma. Patients were older (62 years) men (80%) with normal body mass index (51%), little weight loss (1.8 kg), 0-2 ECOG performance status (83%), and a history of smoking (70%). Cancers were pT1 (24%), pT2 (15%), pT3 (50%), pN0 (52%), pM0 (93%), and pG2-G3 (78%); most involved distal esophagus (71%). Non-risk-adjusted survival for both squamous cell carcinoma and adenocarcinoma was monotonic and distinctive across pTNM. Survival was more distinctive for adenocarcinoma than squamous cell carcinoma when pT was ordered by pN. Survival for pTis-1 adenocarcinoma was better than for squamous cell carcinoma, although monotonic and distinctive for both. WECC pathologic staging data is improved over that of the 7th edition, with more patients studied and patient and cancer variables collected. These data will be the basis for the 8th edition cancer staging manuals following risk adjustment for patient, cancer, and treatment characteristics, and should direct 9th edition data collection. However, the role of pure pathologic staging as the principal point of reference for esophageal cancer staging is waning.

Effects of losses in the atom-light hybrid SU(1,1) interferometer

Collective atomic excitation can be realized by the Raman scattering. Such a photon-atom interface can form an SU(1,1)-typed atom-light hybrid interferometer, where the atomic Raman amplification processes take the place of the beam splitting elements in a traditional Mach-Zehnder interferometer. We numerically calculate the phase sensitivities and the signal-to-noise ratios (SNRs) of this interferometer with the method of homodyne detection and intensity detection, and give their differences of the optimal phase points to realize the best phase sensitivities and the maximal SNRs from these two detection methods. The difference of the effects of loss of light field and atomic decoherence on measure precision is analyzed.