Experimental Realization of Stable Exceptional Chains Protected by Non-Hermitian Latent Symmetries Unique to Mechanical Systems

Lines of exceptional points are robust in the three-dimensional non-Hermitian parameter space without requiring any symmetry. However, when more elaborate exceptional structures are considered, the role of symmetry becomes critical. One such case is the exceptional chain (EC), which is formed by the intersection or osculation of multiple exceptional lines (ELs). In this Letter, we investigate a non-Hermitian classical mechanical system and reveal that a symmetry intrinsic to second-order dynamical equations, in combination with the source-free principle of ELs, guarantees the emergence of ECs. This symmetry can be understood as a non-Hermitian generalized latent symmetry, which is absent in prevailing formalisms rooted in first-order Schrödinger-like equations and has largely been overlooked so far. We experimentally confirm and characterize the ECs using an active mechanical oscillator system. Moreover, by measuring eigenvalue braiding around the ELs meeting at a chain point, we demonstrate the source-free principle of directed ELs that underlies the mechanism for EC formation. Our Letter not only enriches the diversity of non-Hermitian exceptional point configurations, but also highlights the new potential for non-Hermitian physics in second-order dynamical systems.

Electroacupuncture Stimulation Alleviates Inflammatory Pain in Male Rats by Suppressing Oxidative Stress

In the present study, we focused on whether the analgesic effect of Electroacupuncture (EA) is related to the regulation of oxidative stress. We established a chronic inflammatory pain model in male rats by a single injection of complete Freund's adjuvant (CFA) and then treated the animals with daily EA stimulation at the site of "zusanli". The analgesic effect of EA was evaluated by measuring the paw withdrawal threshold (PWT) when rats received mechanical and thermal pain stimulation. The levels of inflammation-related molecules and oxidative stress-related markers in the spinal cord were measured by western blotting or ELISA kits. EA stimulation and antioxidants effectively increased the PWT in CFA rats. Co-treatment of CFA rats with the ROS donor t-butyl hydroperoxide (t-BOOH) further decreased the PWT and weakened the analgesic effect of EA. EA treatment inhibited inflammation and oxidative stress, as shown by decreased levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), IL-6, and MDA and increased activity of SOD and catalase. Moreover, EA reduced the expression of p-p38, p-ERK, and p-p65 and simultaneously downregulated the expression of TRPV1 and TRPV4 in CFA rats. In an in vitro study, direct stimulation with t-BOOH to the C6 cells increased the production of TNF-alpha, IL-1beta, IL-6, activated p38, ERK, and p65 and up-regulated the expression of TRPV1 and TRPV4, and these effects could be prevented by the ROS scavenger PBN. Taken together, our data indicate that the inhibition of oxidative stress and the generation of ROS contribute to the analgesic effect of EA in male CFA rats.

[Advances in the role of autoimmune mechanisms in chronic obstructive pulmonary disease]

Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease whose pathogenesis mainly involves airway remodelling and alveolar destruction caused by inflammation, protease-antiprotease imbalance, oxidative stress, and imbalance between apoptosis and compensatory repair of lung tissue structure cells. In recent years, the role of the autoimmune response in COPD has attracted widespread attention, but there is still some controversy. This article reviewed the role of autoimmunity in COPD from different perspectives, starting with the relationship between autoimmunity and the pathogenesis of COPD.

Scalar topological photonic nested meta-crystals and skyrmion surface states in the light cone continuum

Topological photonics is rapidly expanding. However, discovering three-dimensional topological electromagnetic systems can be more challenging than electronic systems for two reasons. First, the vectorial nature of electromagnetic waves results in complicated band dispersions, and simple tight-binding-type predictions usually fail. Second, topological electromagnetic surface modes inside the light cone have very low quality factors (Q factors). Here, we propose the concept of scalar topological photonics to address these challenges. Our approach is experimentally validated by employing a nested meta-crystal configuration using connected coaxial waveguides. They exhibit scalar-wave-like band dispersions, making the search for photonic topological phases an easier task. Their surface states have skyrmion-like electric field distributions, resulting in a whole, bright surface state band inside the light cone continuum. As such, the topological surface states in our three-dimensional nested crystals can be exposed to air, making such systems well-suited for practical applications.

Experimental realization of chiral Landau levels in two-dimensional Dirac cone systems with inhomogeneous effective mass

Chiral zeroth Landau levels are topologically protected bulk states. In particle physics and condensed matter physics, the chiral zeroth Landau level plays a significant role in breaking chiral symmetry and gives rise to the chiral anomaly. Previous experimental works on such chiral Landau levels are mainly based on three-dimensional Weyl degeneracies coupled with axial magnetic fields. Their realizations using two-dimensional Dirac point systems, being more promising for future applications, were never experimentally realized before. Here we propose an experimental scheme for realizing chiral Landau levels in a two-dimensional photonic system. By introducing an inhomogeneous effective mass through breaking local parity-inversion symmetries, a synthetic in-plane magnetic field is generated and coupled with the Dirac quasi-particles. Consequently, the zeroth-order chiral Landau levels can be induced, and the one-way propagation characteristics are experimentally observed. In addition, the robust transport of the chiral zeroth mode against defects in the system is also experimentally tested. Our system provides a new pathway for the realization of chiral Landau levels in two-dimensional Dirac cone systems, and may potentially be applied in device designs utilizing the chiral response and transport robustness.

Observation of Non-Abelian Charged Nodes Linking Nonadjacent Gaps

Nodal links are special configurations of band degeneracies in the momentum space, where nodal line branches encircle each other. In PT symmetric systems, nodal lines can be topologically characterized using the eigenvector frame rotations along an encircling loop and the linking structure can be described with non-Abelian frame charges involving adjacent bands. While the commutation rules between the frame charges are well established, the underlying relationship between distant band gap closing nodes remains to be explored. In this Letter, we present a photonic multiple nodal links system, where the nodal lines of nonadjacent bands are investigated with symmetry constraints on frame charges. Through an orthogonal nodal chain, the nodal line from the lower two bands predicts the existence of nodal lines formed between the higher bands. We designed and fabricated a metamaterial, with which the multiple nodal links and the topological connection between nonadjacent nodal lines are experimentally demonstrated.

[New progress of excimer laser corneal refractive surgery for presbyopia]

Presbyopia refers to the decline in the accommodation of eye that occurs with age, symptoms begin to appear after the age of 40 and the clarity of vision at near is insufficient to satisfy an individual's requirements. The correction of presbyopia include restoring natural accommodation and improving symptom. The former is still difficult to achieve at present, while the latter mainly involves wearing convex lens, and with more and more patients wanting to get rid of frame glasses, refractive surgery is gradually promoted and applied. Corneal refractive surgery, especially laser-assisted in situ keratomileusis, is one of the most common methods for surgical correction of presbyopia. We reviewed the recent literature to introduce the mechanism of corneal refractive surgery treating presbyopia and the efficacy of different surgical algorithms.

[Progress in application of deep learning in orthodontic diagnosis and treatment]

In recent years, the application of artificial intelligence technology in the field of orthodontics has gradually increased, and deep learning, as a hot direction, has also been rapidly applied in the detection, evaluation, diagnosis, prediction and effect evaluation. At present, deep learning research has the advantages of high efficiency and accuracy, but it also has limitations such as weak interpretability and insufficient data volume. This paper reviewed the proposal and development of deep learning, the application in orthodontic diagnosis and treatment, as well as the limitations and countermeasures of the popularization, and prospect of the future research.

Topological phononics arising from fluid-solid interactions

Nontrivial band topologies have been discovered in classical systems and hold great potential for device applications. Unlike photons, sound has fundamentally different dynamics and symmetries in fluids and solids, represented as scalar and vector fields, respectively. So far, searches for topological phononic materials have only concerned sound in either fluids or solids alone, overlooking their intricate interactions in “mixtures”. Here, we report an approach for topological phononics employing such unique interplay, and demonstrate the realization of type-II nodal rings, elusive in phononics, in a simple three-dimensional phononic crystal. Type-II nodal rings, as line degeneracies in momentum space with exotic properties from strong tilting, are directly observed through ultrasonic near-field scanning. Strongly tilted drumhead surface states, the hallmark phenomena, are also experimentally demonstrated. This phononic approach opens a door to explore topological physics in classical systems, which is easy to implement that can be used for designing high-performance acoustic devices.

Fluid-solid interaction, long investigated, is mostly neglected in topological acoustics. Here the authors find that it can give rise to intriguing topological phenomena in simple phononic crystals due to intrinsic differences between sound in fluid and solid.

Topological near fields generated by topological structures

The central idea of metamaterials and metaoptics is that, besides their base materials, the geometry of structures offers a broad extra dimension to explore for exotic functionalities. Here, we discover that the topology of structures fundamentally dictates the topological properties of optical fields and offers a new dimension to exploit for optical functionalities that are irrelevant to specific material constituents or structural geometries. We find that the nontrivial topology of metal structures ensures the birth of polarization singularities (PSs) in the near field with rich morphologies and intriguing spatial evolutions including merging, bifurcation, and topological transition. By mapping the PSs to non-Hermitian exceptional points and using homotopy theory, we extract the core invariant that governs the topological classification of the PSs and the conservation law that regulates their spatial evolutions. The results bridge singular optics, topological photonics, and non-Hermitian physics, with potential applications in chiral sensing, chiral quantum optics, and beyond photonics in other wave systems.

Observation of boundary induced chiral anomaly bulk states and their transport properties

The most useful property of topological materials is perhaps the robust transport of topological edge modes, whose existence depends on bulk topological invariants. This means that we need to make volumetric changes to many atoms in the bulk to control the transport properties of the edges in a sample. We suggest here that we can do the reverse in some cases: the properties of the edge can be used to induce chiral transport phenomena in some bulk modes. Specifically, we show that a topologically trivial 2D hexagonal phononic crystal slab (waveguide) bounded by hard-wall boundaries guarantees the existence of bulk modes with chiral anomaly inside a pseudogap due to finite size effect. We experimentally observed robust valley-selected transport, complete valley state conversion, and valley focusing of the chiral anomaly bulk states (CABSs) in such phononic crystal waveguides. The same concept also applies to electromagnetics.

Evaluation of cardiac function and 30-day clinical outcome with synchronized analysis of phonocardiogram and electrocardiogram in patients with acute myocardial infarction

Background

Acute myocardial infarction (AMI) is associated with short-term and long-term mortality. Survivors of AMI suffer from cardiovascular events, among which heart failure (HF) is the most important factor affecting the prognosis. Echocardiography is a traditional method of measuring cardiac function, but it is inconvenient. Previous studies have identified the effectiveness of a new wearable coin-sized phonocardiogram (PCG) and electrocardiogram (ECG) device in HF patients. In our study, we apply this device in the hospitalization monitoring of post-AMI patients.

Purpose

The purpose of this study was to evaluate the role of the synchronized analysis of PCG and ECG in identifying cardiac functions in hospitalized AMI patients and to forecast adverse events for 30-days post-AMI in general clinical practice.

Methods

One hundred and sixty-three ST-elevated myocardial infarction (STEMI) patients and sixty-nine non-ST-elevated myocardial infarction (NSTEMI) patients were enrolled. All were admitted to the hospital and diagnosed with AMI. The left ventricular ejection function (LVEF) was determined by echocardiography and synchronized PCG and ECG signals were recorded using the wearable coin-sized PCG and ECG device on the first day of admission. PCG and ECG signals were analyzed to determine electromechanical activation time (EMAT), EMAT/RR (EMAT%), pre-ejection period/RR (PEP%), left ventricular systolic time/RR (LVST%), left ventricular ejection time/RR (LVET%). Primary endpoint was defined as the occurrence of major adverse cardiovascular events (MACE) following AMI in thirty days.

Results

ROC analysis demonstrated that the sensitivity and specificity of EMAT% >12.1% for the diagnosis of LVEF <50% were 81% and 82%, respectively. Overall, 232 patients were enrolled who were divided into four groups according to the classification of AMI and EMAT%. Patients in STEMI group with EMAT% >12.1% had a lower LVEF% (p<0.001), greater EMAT (p<0.001), PEP% (p<0.001), LVET% (p<0.001), LVST% (p=0.001), LVEDV (p<0.001) and LVESV (p<0.001). The same pattern was observed in NSTEMI patients between EMAT% >12.1% and EMAT≤12.1% group. Twenty-eight STEMI patients (17.28%) and seventeen NSTEMI patients (24.6%) developed a MACE event. Compared with EMAT≤12.1% group, EMAT% >12.1% group showed a higher occurrence of MACE, especially in post-STEMI patients (36.54% vs 8.11%, p<0.001).

Conclusion

PCG and ECG offer the possibility to assess the systolic parameters associated with left ventricular (LV) function and clinical status that differ between normal and heart failure states in acute AMI patients, with EMAT% >12.1% as a cut-off for deceased LV systolic function. Moreover, EMAT% >12.1% showed strong association with clinical outcome, suggesting EMAT% may be helpful to further improve the risk stratification of post-AMI patients, especially STEMI patients.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Shanghai Clinical Research Center for Interventional Medicine,Clinical Research Plan of SHDC

Photonic Z_{2} Topological Anderson Insulators

That disorder can induce nontrivial topology is a surprising discovery in topological physics. As a typical example, Chern topological Anderson insulators (TAIs) have been realized in photonic systems, where the topological phases exist without symmetry protection. In this Letter, by taking transverse magnetic and transverse electric polarizations as pseudospin degrees of freedom, we theoretically propose a scheme to realize disorder-induced symmetry-protected topological phase transitions in two-dimensional photonic crystals with a combined time-reversal, mirror, and duality symmetry T_{f}=TM_{z}D. In particular, we demonstrate that the disorder-induced symmetry-protected topological phase persists even without pseudospin conservation, thereby realizing a photonic Z_{2} TAI, in contrast to a Z-classified quantum spin Hall (QSH) TAI with decoupled spins. By formulating a new scattering approach, we show that the topology of both the QSH and Z_{2} TAIs can be manifested by the accumulated spin rotations of the reflected waves from the photonic crystals. Using a transmission structure, we also illustrate the trivialization of a disordered QSH phase with an even integer topological index caused by spin coupling.

Straight Photonic Nodal Lines with Quadrupole Berry Curvature Distribution and Superimaging "Fermi Arcs"

In periodic systems, nodal lines are loops in the three-dimensional momentum space with each point on them representing a band degeneracy. Nodal lines exhibit rich topological features, as they can take various configurations such as rings, links, chains, and knots. These line nodes are generally protected by mirror or PT symmetry and frequently accompanied by drumhead surface states. Here, we propose and demonstrate a novel type of photonic straight nodal lines in a D_{2D} metacrystal, which are protected by an unusual rotoinversion time (roto-PT) symmetry. These nodal lines are located at the central axis and hinges of the Brillouin zone. They appear as quadrupole sources of Berry curvature flux in contrast to the Weyl points, which are monopoles. Interestingly, topological surface states exist at all three cutting surfaces, as guaranteed by π-quantized Zak phases along all three directions. As frequency changes, the surface state equifrequency contours evolve from closed to open and become straight lines at a critical transition frequency, at which diffractionless surface wave propagations are experimentally demonstrated, paving the way toward development of superimaging topological devices.

Experimental Observation of Non-Abelian Earring Nodal Links in Phononic Crystals

Nodal lines are symmetry-protected one-dimensional band degeneracies in momentum space, which can appear in numerous topological configurations such as nodal rings, chains, links, and knots. Very recently, non-Abelian topological physics have been proposed in space-time inversion (PT) symmetric systems. One of the most special configurations in such systems is the earring nodal link, composing of a nodal chain linking with an isolated nodal line. Such earring nodal links have not been observed in real systems. We designed phononic crystals with earring nodal links, and experimentally observed two different kinds of earring nodal links by measuring the band structures. We found that the order of the nodal chain and line can be switched after band inversion but their link cannot be severed. Our Letter provides experimental evidence for phenomena unique to non-Abelian band topology and our acoustic system provides a convenient platform for studying the new materials carrying non-Abelian charges.

[Identification of Weak D Type 1 in Rh Blood Group System and Discussion of Transfusion Strategy]

OBJECTIVE

To investigate the molecular mechanism of one patient with abnormal serological phenotype in RhD and discuss the transfusion strategy.

METHODS

The RhD variant sample was screened from a patient with IgM type anti-D antibody and further determined by three different sources of anti-D antibodies. Ten exons and the adjacent introns of the RHD gene were amplified, purified and sequenced. RhCE phenotypes and RHCE genotypes were detected.

RESULTS

The patient with Rh variant showed abnormal results of serological tests. The RHD gene sequence analysis showed that the RHD*01W.01 with a variation (c.809T>G, p.Val270Gly) in exon 6 of the RHD gene was found in the patient. The RhCE phenotype was CcEe. The genotyping results of RHCE were consistent with the serological typing results.

CONCLUSION

The Rh variant of the patient is RHD*01W.01, these findings indicate that RhD variants should be analyzed by molecular assays for the sake of safe transfusion.

[Metabolic reprogramming in pulmonary hypertension]

Pulmonary hypertension is a pathophysiological disorder with elevated pulmonary artery pressures that may involve multiple clinical conditions, yet the mechanism of pulmonary hypertension remains unclear. Metabolic reprogramming of structural cells (smooth muscle cells, endothelial cells, fibroblasts etc.) and immune cells (macrophages etc.) is a hallmark of pulmonary hypertension and leads to pulmonary vascular remodeling. Many studies have investigated the metabolic reprogramming in pulmonary hypertension and some potential therapeutic targets have been developed. In this review, recent work on metabolic programming in pulmonary hypertension is summarized.

[Different Subtypes Caused by c.721C>T Substitution in the Exon 7 of ABO Gene]

OBJECTIVE

To analyze the different subtypes caused by c.721C>T substitution in the exon 7 of the ABO gene, and to investigate the related molecular mechanism of different antigens expression.

METHODS

ABO subtypes in 7 samples were identified by standard serological methods. The exons 6, 7, and adjacent intron of ABO gene were amplified by Polymerase Chain Reaction (PCR), and the PCR products were analyzed by direct DNA sequencing and cloning sequencing.

RESULTS

ABO subtypes phenotypes were A_W (1 case), B_W (3 cases), AB_W (2 cases), A₂ or A_int (1 case). The result showed that the 7th exon of ABO gene was c.721C>T variety based on A1.02, B1.01, and O.01.02; the alleles were AW.43（1 case）, BW.03（5 cases） and O.01.07（1 case）, ABO genotypes were ABO*AW.43/O.01.02 (1 case) , ABO*BW.03/O.01.02 (3 cases), ABO*A1.02/BW.03 (2 cases), and ABO*A2.05/O.01.07 (1 case).

CONCLUSION

c.721C>T substitution in the ABO gene causes p.Arg241Trp exchange resulting in the decreasing of GTA or GTB activities and weaker antigen expression. O.01.07 is a null allele which cannot form a functional catalytic enzyme has no effect on A₂ subtype antigen expression.

Four-band non-Abelian topological insulator and its experimental realization

Very recently, increasing attention has been focused on non-Abelian topological charges, e.g., the quaternion group Q8. Different from Abelian topological band insulators, these systems involve multiple entangled bulk bandgaps and support nontrivial edge states that manifest the non-Abelian topological features. Furthermore, a system with an even or odd number of bands will exhibit a significant difference in non-Abelian topological classification. To date, there has been scant research investigating even-band non-Abelian topological insulators. Here, we both theoretically explore and experimentally realize a four-band PT (inversion and time-reversal) symmetric system, where two new classes of topological charges as well as edge states are comprehensively studied. We illustrate their difference in the four-dimensional (4D) rotation sense on the stereographically projected Clifford tori. We show the evolution of the bulk topology by extending the 1D Hamiltonian onto a 2D plane and provide the accompanying edge state distributions following an analytical method. Our work presents an exhaustive study of four-band non-Abelian topological insulators and paves the way towards other even-band systems.

Serum cholesterol efflux capacity is associated with coronary plaque progression in patients with coronary heart disease

Background

Coronary plaque progression is a major risk factor of adverse cardiac events in patients with coronary heart disease (CHD). Emerging evidence showed that attenuated high-density lipoprotein (HDL) function measured by cholesterol efflux capacity (CEC) was associated with development of atherosclerosis independent of HDL cholesterol level. In this study, we sought to investigate whether CEC is a predictor for coronary plaque progression in CHD patients.

Methods

We consecutively enrolled CHD patients from January 2017 to August 2019 in our Hospital who underwent elective percutaneous coronary intervention and had at least one non-target coronary lesion. Follow-up coronary angiography were performed at around 12 months. Fluorescence-labeled cholesterol and J774 macrophages were used to measure the CEC of ApoB-depleted serum sample from all patients. Quantitative coronary angiography (QCA) was performed both at baseline and follow-up to analyze the plaque progression.

Results

A total of 430 CHD patients with 586 non-target coronary lesions were included in the final analysis. During a mean follow-up time of 381.04±59.52 days, patients with decreased CEC presented more severe plaque progression (net luminal loss in highest to lowest CEC quartile: 0.22±0.42mm vs 0.20±0.41mm vs 0.13±0.36mm vs 0.11±0.34mm, p=0.035). In multivariate analysis, baseline CEC was independently associated with coronary plaque progression after adjustment for traditional risk factors including HDL cholesterol and ApoA-I, no matter treated as categorical variable (OR: 0.382 [95% CI 0.180–0.781] for highest to lowest quartile) or continuous variable (OR: 0.522 [95% CI 0.373–0.714] for per SD increase]. Furthermore, CEC demonstrated a better power in predicting coronary plaque progression compared with HDL cholesterol concentration (AUC=0.644 vs 0.514).

Conclusions

This study suggests that HDL function reflected by serum CEC is an independent predictor for coronary plaque progression in CHD patients.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China, Shanghai Municipal Commission of Health and Family Planning

Optically Reconfigurable Spin-Valley Hall Effect of Light in Coupled Nonlinear Ring Resonator Lattice

Scattering immune propagation of light in topological photonic systems may revolutionize the design of integrated photonic circuits for information processing and communications. In optics, various photonic topological circuits have been developed, which were based on classical emulation of either quantum spin Hall effect or quantum valley Hall effect. On the other hand, the combination of both the valley and spin degrees of freedom can lead to a new kind of topological transport phenomenon, dubbed spin-valley Hall effect (SVHE), which can further expand the number of topologically protected edge channels and would be useful for information multiplexing. However, it is challenging to realize SVHE in most known material platforms, due to the requirement of breaking both the (pseudo)fermionic time-reversal (T) and parity symmetries (P) individually, but leaving the combined symmetry S≡TP intact. Here, we propose an experimentally feasible platform to realize SVHE for light, based on coupled ring resonators mediated by optical Kerr nonlinearity. Thanks to the inherent flexibility of cross-mode modulation, the coupling between the probe light can be engineered in a controllable way such that spin-dependent staggered sublattice potential emerges in the effective Hamiltonian. With delicate yet experimentally feasible pump conditions, we show the existence of spin-valley Hall-induced topological edge states. We further demonstrate that both degrees of freedom, i.e., spin and valley, can be manipulated simultaneously in a reconfigurable manner to realize spin-valley photonics, doubling the degrees of freedom for enhancing the information capacity in optical communication systems.

Optical forces on a cylinder induced by surface waves and the conservation of the canonical momentum of light

Based on rigorous derivations using the electromagnetic energy-momentum tensor, we established a generic relationship between the longitudinal optical force (along the surface wave propagating direction) on a cylinder induced by surface waves and the energy flux of each surface mode supported on the interface between air and a lossless substrate possessing continuous translational symmetry along the longitudinal direction. The longitudinal optical force is completely attributed to the canonical momentum of light. Our theory is valid for generic types of surface waves and lays the theoretical foundation for the research and applications of optical manipulations by surface waves.

Topological Corner Modes Induced by Dirac Vortices in Arbitrary Geometry

Recently, higher-order topologies have been experimentally realized, featuring topological corner modes (TCMs) between adjacent topologically distinct domains. However, they have to comply with specific spatial symmetries of underlying lattices, hence their TCMs only emerge in very limited geometries, which significantly impedes generic applications. Here, we report a general scheme of inducing TCMs in arbitrary geometry based on Dirac vortices from aperiodic Kekulé modulations. The TCMs can now be constructed and experimentally observed in square and pentagonal domains incompatible with underlying triangular lattices. Such bound modes at arbitrary corners do not require their boundaries to run along particular lattice directions. Our scheme allows an arbitrary specification of numbers and positions of TCMs, which will be important for future on-chip topological circuits. Moreover, the general scheme developed here can be extended to other classical wave systems. Our findings reveal rich physics of aperiodic modulations, and advance applications of TCMs in realistic scenarios.

Intrinsic in-plane nodal chain and generalized quaternion charge protected nodal link in photonics

Nodal lines are degeneracies formed by crossing bands in three-dimensional momentum space. Interestingly, these degenerate lines can chain together via touching points and manifest as nodal chains. These nodal chains are usually embedded in two orthogonal planes and protected by the corresponding mirror symmetries. Here, we propose and demonstrate an in-plane nodal chain in photonics, where all chained nodal lines coexist in a single mirror plane instead of two orthogonal ones. The chain point is stabilized by the intrinsic symmetry that is specific to electromagnetic waves at the Г point of zero frequency. By adding another mirror plane, we find a nodal ring that is constructed by two higher bands and links with the in-plane nodal chain. The nodal link in momentum space exhibits non-Abelian characteristics on a C₂T - invariant plane, where admissible transitions of the nodal link structure are determined by generalized quaternion charges. Through near-field scanning measurements of bi-anisotropic metamaterials, we experimentally mapped out the in-plane nodal chain and nodal link in such systems.

Topological One-Way Large-Area Waveguide States in Magnetic Photonic Crystals

We have theoretically and experimentally achieved large-area one-way transport by using heterostructures consisting of a domain of an ordinary photonic crystal sandwiched between two domains of magnetic photonic crystals. The nonmagnetized domain carries two orthogonal one-way waveguide states which have amplitude uniformly distributed over a large area. We show that such one-way waveguide states can be used to abruptly narrow the beam width of an extended state to concentrate energy, and the transport is robust against different kinds of defects and imperfections. They are also immune to the Anderson-type localization when large randomness is introduced.

Landau-Zener Transition in the Dynamic Transfer of Acoustic Topological States

Topological notions in physics often emerge from adiabatic evolution of states. It not only leads to fundamental insight of topological protection but also provides an important approach for the study of higher-dimensional topological phases. In this work, we first demonstrate the transfer of topological boundary states (TBSs) across the bulk to the opposite boundary in an acoustic waveguide system. By exploring the finite-size induced minigap between two TBS bands, we unveil the quantitative condition for the breakdown of adiabaticity in the system by demonstrating the Landau-Zener transition with both theory and experiments. Our results not only serve as a foundation of future studies of dynamic state transfer but also inspire applications leveraging nonadiabatic transitions as a new degree of freedom.

[The value of adenosine triphosphate in CD4(+)T lymphocytes in predicting repeated respiratory tract infections in silicosis patients]

Objective: To explore the value of the concentration of adenosine triphosphate (ATP) in CD4(+)T lymphocytes in predicting repeated respiratory tract infections (RRTI) in silicosis patients. Methods: In April 2020, 614 silicosis patients admitted from March 2016 to March 2018 were included in the study, and they were divided into the RRTI group (n=105) and the non RRTI group (n=509) according to whether the occurrence of RRTI, another 30 healthy cases taken from body check were served as control group, and the concentrations of ATP produced by CD4(+)T lymphocytes was measured by ImmuKnow assay, and were compared between the three groups. And drawed the receiver operating characteristic (ROC) curve, and the Logistic regression analysis was used to explore the risk factors of RRTI. Results: The incidence of RRTI in silicosis patients was 17.10% (105/614) . The concentration of ATP produced by CD4(+)T lymphocytes in the RRTI group [ (260.42±90.36) mg/L] was significantly lower than that in the non RRTI group [ (413.66±138.74) mg/L] (t=-10.849, P<0.01) . The area under the ROC curve was 0.834, the cutoff value was 284 mg/L, the sensitivity was 0.88, and the specificity was 0.83. Logistic regression analysis showed that the concentration of ATP produced by CD4(+)T lymphocytes≤284 mg/L, impaired pulmonary ventilation function, serum albumin<40 g/L and diabetes were the risk factors of RRTI in silicosis patients (OR=2.126, 1.217, 1.164, 1.125, P<0.05) . Conclusion: Low CD4(+)T lymphocyte ATP value was a risk factor of RRTI in silicosis patients, and can predict the risk of RRTI in patients with silicosis.

Hidden-symmetry-enforced nexus points of nodal lines in layer-stacked dielectric photonic crystals

It was recently demonstrated that the connectivities of bands emerging from zero frequency in dielectric photonic crystals are distinct from their electronic counterparts with the same space groups. We discover that in an AB-layer-stacked photonic crystal composed of anisotropic dielectrics, the unique photonic band connectivity leads to a new kind of symmetry-enforced triply degenerate points at the nexuses of two nodal rings and a Kramers-like nodal line. The emergence and intersection of the line nodes are guaranteed by a generalized 1/4-period screw rotation symmetry of Maxwell's equations. The bands with a constant k _z and iso-frequency surfaces near a nexus point both disperse as a spin-1 Dirac-like cone, giving rise to exotic transport features of light at the nexus point. We show that spin-1 conical diffraction occurs at the nexus point, which can be used to manipulate the charges of optical vortices. Our work reveals that Maxwell's equations can have hidden symmetries induced by the fractional periodicity of the material tensor components and hence paves the way to finding novel topological nodal structures unique to photonic systems.

P1381Improved outcome in ablation of ventricular tachycardia in patients with structural heart disease under general anaesthetic

Background

Catheter ablation is an important adjunct to device implantation for secondary prevention of ventricular tachycardia (VT). However, several factors may influence the success of ablations in terms of long-term freedom from VT recurrence. A thus far little examined factor is the use of general anaesthetic (GA) versus conscious sedation during the procedure, which has been shown to improve outcomes in persistent atrial fibrillation (AF) ablation.

Methods

Patients with structural heart disease VT undergoing ablations from January 2015 to March 2019 were retrospectively followed up at a single centre. End points were recurrent VT or device therapy (shock or anti-tachycardia pacing) at one year. Hazard ratios (HR) were generated using a multivariate Cox-regression proportional hazards model including variables of age at ablation, sex, amiodarone use at time of ablation, scar age, left ventricular ejection fraction, use of GA, and diagnosis of: diabetes mellitus (DM), hypertension (HTN), renal impairment or AF.

Results

79 patients (74 male, mean age 68.2+/- 10.3 years) were included. A substrate-based strategy of late potential ablation was employed. 69 had ischaemic and 10 had non-ischaemic cardiomyopathy. Mean scar age was 13.8 +/- 9.8 years; EF was 40-50% in 27 patients, 30-40% in 26 and &lt; 30% in 26. 37 patients had implantable cardioverter defibrillators and 30 had cardiac resynchronisation therapy (CRT) defibrillator devices, 1 had a CRT- pacemaker device and 4 had dual chamber pacemakers. Comorbidities were: DM (16), HTN (31), renal impairment (13), AF (31). 62 patients (79.5%) were on amiodarone at the time of ablation. Mean procedure duration was 234.8 +/- 44.5 min and mean radiofrequency energy application time was 2247 +/- 862 s. 61 were first procedures and 18 were repeat procedures. One patient suffered a complication of groin haematoma. 62 patients (78.5%) underwent VT ablation under GA and 17 (21.5%) under sedation of midazolam and fentanyl. Patient characteristics did not differ between groups. Significant factors which increased freedom from VT recurrence or device therapy were HTN (88.9% vs 59.4%, HR 0.72, 95% confidence interval (CI): 0.007-0.75, p= 0.028), amiodarone treatment (50.0% vs 76.3%, HR 0.036, 95% CI: 0.003-0.404, p = 0.036) and ablation under GA rather than sedation (50.0% vs 75.0%, HR 0.055, 95% CI: 0.006-0.495, p = 0.01) (Fig 1).

Conclusions

In patients with structural heart disease undergoing VT ablation, outcomes are improved with the use of GA over conscious sedation.

Abstract Figure 1

Deterministic Scheme for Two-Dimensional Type-II Dirac Points and Experimental Realization in Acoustics

Low-energy electrons near Dirac/Weyl nodal points mimic massless relativistic fermions. However, as they are not constrained by Lorentz invariance, they can exhibit tipped-over type-II Dirac/Weyl cones that provide highly anisotropic physical properties and responses, creating unique possibilities. Recently, they have been observed in several quantum and classical systems. Yet, there is still no simple and deterministic strategy to realize them since their nodal points are accidental degeneracies, unlike symmetry-guaranteed type-I counterparts. Here, we propose a band-folding scheme for constructing type-II Dirac points, and we use a tight-binding analysis to unveil its generality and deterministic nature. Through realizations in acoustics, type-II Dirac points are experimentally visualized and investigated using near-field mappings. As a direct effect of tipped-over Dirac cones, strongly tilted kink states originating from their valley-Hall properties are also observed. This deterministic scheme could serve as a platform for further investigations of intriguing physics associated with various strongly Lorentz-violating nodal points.

[Application of mendelian randomization methods in causal inference of observational study]

Mendelian randomization (MR) approach follows the Mendel's law of inheritance, which is called "Parental alleles randomly assigned to the offspring", and refers to use genetic variants as an instrumental variable to develop causal inference between the exposure factor and the outcome from observational study. In recent years, with the rapid development of genome-wide association study (GWAS) and various omics data,the disclosure of a large number of aggregated data provides an opportunity for the wide application of MR approach in causal inference. We introduce three methods widely used in MR and then apply them to explore causal relationship between blood metabolites and depressive. The advantages and disadvantages of three methods in causal inference are compared in order to provide reference for the application of MR in observational studies.

[Estimation on the individual treatment effect among heterogeneous population, using the Causal Forests method]

Objective: This project aimed to explore the effectiveness of estimating individual treatment effect on real data, among the heterogeneous population, with Causal Forests (CF) method, to find out the characteristics of heterogeneous population. Methods: We designed and conducted four computer simulation schemes to verify the effect of estimating on individual treatment, using the CF under four different environments of the treatment effects. Real data was then analyzed for the catheterization on right heart. Results: Results from the simulation process showed that the values on individual treatment effect that were estimated by causal forests were consistent with the population effect as well as in line with the expected distribution under the setting of four different effect values. Results of real data analysis showed that values of individual treatment effect among most patients appeared positive, so the use of RHC could cause an increase of the '180-day mortality rate' in the sampled population. Patients with lower predicted probability of 2-mo survival and albumin were more likely to have a lower risk of death after using the RHC. Conclusion: CF method could be effectively used to estimate the individual treatment effect and helping the individuals to make decision on the receipt of treatment.

Metric-Torsion Duality of Optically Chiral Structures

We develop a metric-torsion theory for chiral structures by using a generalized framework of transformation optics. We show that the chirality is uniquely determined by a metric with the local rotational degree of freedom. In analogy to the dislocation continuum, the chirality can be alternatively interpreted as the torsion tensor of a Riemann-Cartan space, which is mimicked by the anholonomy of the orthonormal basis. As a demonstration, we reveal the equivalence of typical three-dimensional chiral metamaterials in the continuum limit. Our theory provides an analytical recipe to design optical chirality.

Subwavelength topological edge states based on localized spoof surface plasmonic metaparticle arrays

Plasmonic cluster arrays have demonstrated rich physics in topological photonics, but they are seriously affected by the material loss and limited by the requirement of high-precision machining. Here, we propose a kind of ultra-thin metaparticle arrays which can mimic the coupled localized plasmonic resonances at lower frequency ranges and so that can overcome the loss and fabrication problems in real metal plasmonic systems. The metaparticle is a metallic disk with circuitous grooves that can support both spoof electric and magnetic localized resonances, and these resonances can be pushed to a subwavelength region through tuning the geometric parameters. In virtue of the highly field confinement of these localized resonances, it is thought to be an ideal experimental platform to be an analogy with various near-field interactions in topological materials. As a first proof-of-concept study to show this feasibility, the subwavelength topological edge states at the zigzag metaparticle chain boundaries are numerically and experimentally demonstrated at microwave ranges. Moreover, the subwavelength topological edge states in this zigzag chain can be excited simply by the plane wave incidence, and the edge modes at two ends can be selectively excited by controlling the polarization direction. Therefore, this kind of metaparticle array not only provides an ideal platform to experimentally study various near-filed interaction dominated topological systems but may also find massive potential applications.

Omnidirectional polarization beam splitter for white light

As a key element in optical systems, a broadband and omnidirectional polarization beam splitter has been long desired. Here, based on anisotropic metamaterials, a perfect polarizing beam splitter is theoretically designed for the extremely broad frequency and angle bands without energy loss. When an electromagnetic wave is incident on the beam splitter, the transverse magnetic-polarized component suffers total reflection, while the transverse electric-polarized component is completely transmitted within the incident angle range [-90°, 90°] for the white light. This study provides a new approach to design an efficient polarizing beam splitter and may promote the development and applications of anisotropic metamaterials.

[Analysis on the gender-specific risk factors of new-onset cerebral hemorrhage]

Objective: To explore the gender-specific risk factors of new-onset cerebral hemorrhage. Methods: In this prospective cohort study,a total of 98 961 participants((51.1±12.6)years old), who underwent the 2006 to 2007 physical examination and met the inclusion criteria, were enrolled from the Kailuanstudy cohort. There were 78 908 (79.7%) male,and 20 053 (20.3%) female.The incidence of cerebral hemorrhage was observed once per year until December 31, 2016.The difference on the incidence of cerebral hemorrhage between male and female was compared. Multivariate Cox regression analysis was applied to analyze therisk factors of cerebral hemorrhage events among different genders. Results: The participants were followed up for(10.00±0.73) years,and 860 cerebral hemorrhage events were recorded during follow up. The incidence of cerebral hemorrhage in the population was 86.90/10 million person years (standardized incidence rate of 47.85/10 million person years). The incidence of cerebral hemorrhage was significantly higher in male (49.61/10 million person years) than in female (34.07/10 million person years, P<0.05). Multivariate Cox regression analysis showed that 45-59 years old, ≥ 60 years old, diabetes,and waist-hip ratio were more strongly related to new-onset of cerebral hemorrhage events in female than in male, and the hazard ratios(95%CI) were 2.33 (1.23-4.43) ,2.71 (1.30-5.66) ,2.16 (1.24-3.74) and 8.79 (1.42-54.32) in female versus 1.55 (1.21-1.97) ,2.16 (1.68-2.78) ,1.19 (0.93-1.53) and 3.21 (1.09-9.41) in male, respectively. The risk of male cerebral hemorrhage increased by 29% (HR=1.29, 95%CI 1.19-1.40) in male and 24% (HR=1.24, 95%CI 1.20-1.28) in female,when the systolic blood pressure increased 10 mmHg (1 mmHg=0.133 kPa). Conclusions: The incidence of cerebral hemorrhage is higher in male than in female in this cohort.The association between systolic blood pressure and cerebral hemorrhage is stronger in male than that in female.The associations between age, waist-hip ratio, diabetes and cerebral hemorrhage are stronger in female than in male. Trial Registration: Chinese Clinical Trail Registry, ChiCTR-TNC-11001489.

[Clinicopathologic and molecular features of cribriform morular variant of papillary thyroid carcinoma]

Objective: To investigate the clinicopathologic and molecular features of the rare cribriform morular variant of papillary thyroid carcinoma (CMV-PTC). Methods: The clinicopathologic data of 10 patients with CMV-PTC were retrospectively reviewed. Immunohistochemical (IHC) staining was done using LSAB method. DNA sequencing for APC were applied using Sanger method. BRAF V600E mutation was examined using ARMS method. The cytological, morphological, IHC and molecular features were analyzed. Results: All patients were female at an average age of 27 years old. The tumors were mostly located in the right lobe of thyroid. Fine needle aspiration cytology was performed in three patients; two were diagnosed as suspicious for PTC and one as PTC. Nine tumors presented as solitary nodule and two as multiple nodules in both lobes. Infiltration was demonstrated in three cases. The average size was 2.6 cm. The neoplastic cells were arranged in papillary, cribriform, solid and glandular patterns, with rare or without colloid inside the lumen. The number of morula varied, ranging from zero to many. The neoplastic cells were variably enlarged, showing round, oval or spindle shape. Nuclear irregularity was identified as irregular membrane, nuclear grooves or pseudoinclusion, but no typical ground glass feature. Peculiar nuclear clearing could be observed in the morular cells. IHC staining showed the neoplastic cells were negative for thyroglobulin and p63, but positive for TTF1, cytokeratin 19 and estrogen receptor. Diffuse staining with cytokeratin was seen in the neoplastic cells and the morula. Specific cytoplasmic and nuclear staining of β-catenin was seen in the neoplastic cells but not the morula. Ki-67 proliferation index was 1%-30%. No recurrence or metastasis was observed. One patient was demonstrated to harbor both somatic and germline mutations of the APC gene, who was found to have adenomatous polyposis and her mother died of colonic carcinoma. No BRAF V600E mutation was detected. Conclusions: CMV-PTC is rare and shows atypical cytological and clinicopathological features, and it is easily misdiagnosed.TG, TTF1, ER and β-catenin are specific IHC markers for CMV-PTC. The morula is negative for cytokeratin 19, in contrast to squamous metaplasia. Although CMV-PTC has indolent clinical behavior, a definite diagnosis is necessary to rule out the possibility of APC gene mutation and related extra-thyroidal neoplasm, such as FAP and Gardner syndrome.

[The effects and related mechanism of salvianolate on rats with myocardial ischemia-reperfusion injury]

Objective: To investigate the effect and related mechanism of salvianolate on myocardial ischemia-reperfusion (I/R) injury in rats. Methods: Thirty-six adult Sprague-Dawley rats were divided into three groups (n=12 each) using random number table method: control group (coronary artery was not ligated) , I/R group (myocardial I/R model was established by ligation and opening of left anterior descending coronary artery) , and salvianolate+I/R group (5 mg/kg of salvianolate was injected through the tail vein at the time of reperfusion) .Triphenyltetrazolium chloride (TTC) stain was utilized to measure the myocardial infarct size. The ELISA method was used to detect myocardial necrotic markers, including cardiac troponin T (TnT) , creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH) . Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was used to analyses the levels of apoptosis. The levels of cleaved Caspase-3 protein were analyzed with Western blot.Cold luminescence method was used to detect the ATP level of myocardial tissue. The levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) in myocardial tissue were detected by immunofluorescence. Results: (1) The infarct size in control group, I/R group and salvianolate+I/R group were 0, (23.90±5.66) %, and (12.06±5.97) %, respectively (P<0.01 or 0.05) . (2) The TnT level was (0.04±0.03) , (16.96±2.80) , and (6.95±2.31) ng/ml, the CK-MB level was (43.6±23.5) , (1 135.8±180.6) ,and (390.3±121.5) U/L, the LDH level was (119.0±58.6) , (1 838.6±543.8) , and (631.6±228.3) U/L in control group, I/R group and salvianolate+I/R group, all significantly lower in salvianolate+I/R group than in I/R group (all P<0.01) . (3) The rate of TUNEL positive myocardial cells were (1.07±1.16) %, (21.36±4.11) %,and (13.30±3.67) % in control group, I/R group,and salvianolate+I/R group (all P<0.01) . (4) The cleaved Caspase-3 expression was 0.11±0.05, 0.84±0.20,and 0.43±0.09 in control group, I/R group, and salvianolate+I/R group (all P<0.01) . (5) The ATP level of myocardial tissue was (100.0±0.0) %, (34.2±9.2) %,and (62.1±18.0) % respectively in control group, I/R group, and salvianolate+I/R group (all P<0.01) . (6) There was almost no 8-OHdG expression in the myocardial tissue of control group. The expression of 8-OHdG in the myocardial tissue of I/R group was greater than that of the control group. The expression of 8-OHdG in the myocardial tissue of salvianolate+I/R group was less than that of the I/R group. Conclusion: Salvianolate may alleviate myocardial I/R injury of rat through reducing the mitochondrial DNA oxidative damage, protecting mitochondrial function and inhibiting the apoptosis of myocardial cells.

Loss of cane and sugar yield resulting from Ceratovacuna lanigera Zehntner damage in cane-growing regions in China

Ceratovacuna lanigera Zehntner is a major leaf pest of sugarcane. Widely distributed, it affects both the yield and quality of sugarcane in China. This study aimed to assess real yield and sugar yield losses, and the effect of C. lanigera damage on emergence of newly planted and ratoon cane under current production levels. Field experiments were carried out from 2014 to 2016 in Yunnan Province China. At maturity, plants were harvested and weighed to determine yield, and the effect on sugarcane quality and sucrose content analyzed. Real yield decreased by average of 46,185 kg hm-2 (range: 37,545-61,845 kg hm-2) in damaged versus undamaged areas, with an average yield loss rate of 35.9% (28.5-45.7%). Juice yield decreased by an average of 3.01% (2.4-4.13%) and sucrose content by 6.38% (5.48-8.16%). Juice brix decreased by an average of 7.66°BX (6.95-9.05°BX) and juice gravity purity by 12.35% (8.43-19.97%). In contrast, the reducing sugar content increased by an average of 1.21% (1.01-1.3%). Emergence rates of newly planted cane decreased by an average of 26.0% (24.7-27.3%). The emergence number of ratoon cane decreased by 66,834 hm2 (57,429-76,238 hm-2) and relative emergence loss rates of ratoon cane decreased by an average of 57.8% (57.6-58.0%). These findings confirm that C. lanigera damage severely affects sugarcane yield and quality in Yunnan Province. The results will help the implementation of effective control measures, thereby supporting sustainable development of the Chinese sugar industry.

[Comparison of arterial stiffness in non-hypertensive and hypertensive population of various age groups]

Objective: To investigate the impact of blood pressure and age on arterial stiffness in general population. Methods: Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (n=11 608), 45-59 years group (n=12 757), above 60 years group (n=5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension). Multiple linear regression analysis was used to analyze the association between systolic blood pressure (SBP) with baPWV in the total participants and then stratified by age groups. Multivariate logistic regression model was used to analyze the influence of blood pressure on arterial stiffness (baPWV≥1 400 cm/s) of various groups. Results: (1)The baseline characteristics of all participants: 35 350 participants completed 2010, 2012 and 2014 Kailuan examinations and took part in baPWV examination. 2 237 participants without blood pressure measurement values were excluded, 1 569 participants with history of peripheral artery disease were excluded, we also excluded 1 016 participants with history of cardiac-cerebral vascular disease. Data from 29 367 participants were analyzed. The age was (48.0±12.4) years old, 21 305 were males (72.5%). (2) Distribution of baPWV in various age groups: baPWV increased with aging. In non-hypertension population, baPWV in 18-44 years group, 45-59 years group, above 60 years group were as follows: 1 299.3, 1 428.7 and 1 704.6 cm/s, respectively. For hypertension participants, the respective values of baPWV were: 1 498.4, 1 640.7 and 1 921.4 cm/s. BaPWV was significantly higher in hypertension group than non-hypertension group of respective age groups (P<0.05). (3) Multiple linear regression analysis defined risk factors of baPWV: Multivariate linear regression analysis showed that baPWV was positively correlated with SBP(t=39.30, P<0.001), and same results were found in the sub-age groups (t-value was 37.72, 27.30, 9.15, all P<0.001, respectively) after adjustment for other confounding factors, including age, sex, pulse pressure(PP), body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), smoking, drinking, physical exercise, antihypertensive medications, lipid-lowering medication. (4) Multivariate logistic regression analysis of baPWV-related factors: After adjustment for other confounding factors, including age, sex, PP, BMI, FBG, TC, smoking, drinking, physical exercise, antihypertensive medication, lipid-lowering medication, multivariate logistic regression analysis showed that risks for increased arterial stiffness in hypertension group were higher than those in non-hypertension group, the OR in participants with hypertension was 2.54 (2.35-2.74) in the total participants, and same results were also found in sub-age groups, the ORs were 3.22(2.86-3.63), 2.48(2.23-2.76), and 1.91(1.42-2.56), respectively, in each sub-age group. Conclusion: SBP is positively related to arterial stiffness in different age groups, and hypertension is a risk factor for increased arterial stiffness in different age groups. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.