[Correlation of MYB/NFIB gene fusion with the grade and prognosis of head and neck adenoid cystic carcinoma and the concordance of two detection methods]

Objective: To explore the correlation between MYB/NFIB gene fusion and clinicopathological features such as tumor grade and prognosis of head and neck adenoid cystic carcinoma (ACC), and to assess the concordant rate of fluorescent in situ hybridization (FISH) with MYB and NFIB immunohistochemistry. Methods: FISH detection of MYB/NFIB gene fusion was performed on 48 head and neck ACC cases and 15 non-ACC salivary gland tumors at National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China during April 2014 and January 2020. ACC cases were divided into grade Ⅰ-Ⅱ, grade Ⅲ and high-grade transformation, according to pathological grading criteria. Prognosis, FISH results and other clinicopathological characteristics were analyzed. MYB and NFIB immunohistochemistry was performed on the 48 ACC and 15 non-ACC cases. The diagnostic accuracy of FISH and immunohistochemistry was compared. Results: FISH detected MYB/NFIB gene fusion in 41.7% (20/48) of the ACC. Its positive rate was inversely correlated with higher pathological grades (P=0.036). The higher histological grade was linked to worse progression-free survival (P=0.024), whereas there was no correlation between the status of gene fusion detected by FISH and progression-free survival (P=0.536). FISH didnot detect MYB/NFIB gene fusion in 15 non-ACC salivary gland tumors The specificity of diagnosing ACC is 100% for both FISH detection of gene fusion and immunohistochemical detection of MYB expression. However, the sensitivity for both methods was only about 41.7%, respectively. By combining FISH and MYB immunohistochemistry, the sensitivity for diagnosing ACC was increased to 66.7%. Conclusions: MYB/NFIB gene fusion has a lower detection rate in grade Ⅲ ACC and high-grade transformation ACC. Meanwhile gene fusion status is not correlated with prognosis. The sensitivity for diagnosing ACC can be improved by combining FISH and MYB immunohistochemistry.

[Advances of pathological diagnosis and molecular pathology of lung neuroendocrine neoplasms]

The pathological classification and diagnostic criteria for lung neuroendocrine neoplasms (NENs) in the 2021 World Health Organization (WHO) lung tumor classification are similar to the prior classifications. However, the advances on the molecular studies of lung NENs have shown that both small cell lung carcinoma and large cell neuroendocrine carcinoma are highly heterogeneous tumors with neuroendocrine characteristics and can be subclassified based on the features of genomics or transcriptomics, which are valuable in the diagnosis of lung NENs subtypes and patient treatment. In addition, it is necessary to interpret emerging concepts such as "lung neuroendocrine tumor G3" and "histological transformation" from pathological perspectives, as well as to know the novel neuroendocrine biomarkers such as INSM1 and POU2F3. This article summarized the diagnostic changes and the advances of molecular pathology of lung NENs based on the latest WHO classification and molecular research.

Clerodane diterpenoids with in-vitro anti-neuroinflammatory activity from the tuberous root of Tinospora sagittata (Menispermaceae)

Twenty-six clerodane diterpenoids have been isolated from T. sagittata, a plant species of traditional Chinese medicine Radix Tinosporae, also named as "Jin Guo Lan". Among them, there are eight previously undescribed clerodane diterpenoids (tinotanoids A-H: 1-8), and 18 known diterpenoids (9-26). The absolute configurations of compounds 1, 2, 5, 8, 13, 17 and 20 were determined by single-crystal X-ray diffraction. Compound 1 is the first example of rotameric clerodane diterpenoid with a γ-lactone ring which is constructed between C-11 and C-17; meanwhile, compounds 3 and 4 are two pairs of inseparable epimers. Compounds 2, 12 and 17 demonstrated excellent inhibitory activity on NO production against LPS-stimulated BV-2 cells with IC50 values of 9.56 ± 0.69, 9.11 ± 0.53 and 11.12 ± 0.70 μM, respectively. These activities were significantly higher than that of the positive control minocycline (IC50 = 23.57 ± 0.92 μM). Moreover, compounds 2, 12 and 17 dramatically reduced the LPS-induced upregulation of iNOS and COX-2 expression. Compounds 2 and 12 significantly inhibited the levels of pro-inflammatory cytokines TNF-α, IL-1β and IL-6 that were increased by LPS stimulation.

[Analysis on epidemiological characteristics of central obesity/pre-central obesity and influencing factors in Jilin Province]

Objective: To understand the epidemiological characteristics of central obesity and pre-central obesity and influencing factors in residents in Jilin Province, and provide reference for the prevention and control of central obesity and pre-central obesity. Methods: Based on the results of early screening and comprehensive intervention program in high-risk groups of cardiovascular disease in Jilin dyring 2017-2018, a total of 11 903 participants aged 35-75 years in 6 project areas in Jilin were included as the survey subjects for physical examination, laboratory test and questionnaire survey. The prevalence of central obesity and pre-central obesity in populations with different characteristic and health status were analyzed by χ2 test, trend χ2 test, F-test. Multivariate logistic regression model was used for influencing factor analysis. Results: The central obesity rate was 33.35% (3 970/11 903), the standardized rate was 31.73%, the pre-central obesity rate was 28.79% (3 427/11 903), the standardized rate was 28.86%. Multifactor analysis results showed that being rural resident (OR=1.99, 95%CI: 1.78-2.23), being woman (OR=1.76, 95%CI: 1.57-1.97), 65-75 years old (OR=1.21, 95%CI: 1.03-1.45), senior high school and technical secondary school education level (OR=1.38, 95%CI: 1.17-1.63), annual family income >100 000 yuan (OR=1.65, 95%CI: 1.20-2.26), overweight (OR=9.27, 95%CI: 8.26-10.41), obesity (OR=82.82, 95%CI: 62.63-109.52), normal high blood pressure (OR=1.49, 95%CI: 1.27-1.74), hypertension (OR=1.70, 95%CI: 1.42-2.04), diabetes (OR=2.30, 95%CI: 1.94-2.73), dyslipidemia (OR=1.33, 95%CI: 1.18-1.50) were positively related to the risk for central obesity and pre central obesity. Conclusions: The prevalence rates of central obesity and pre central obesity in residents in Jilin were at high levels, being rural resident, being woman, older age, senior high school and technical secondary school education level, high income, overweight and obesity, normal high blood pressure and hypertension, diabetes, dyslipidemia were risk factors for central obesity and pre-central obesity in Jilin.

Tinopanoids K-T, clerodane diterpenoids with anti-inflammatory activity from Tinospora crispa

A total of 17 structurally diverse clerodane diterpenoids, including ten undescribed clerodane diterpenoids (tinopanoids K-T, 1-10) and seven known compounds (11-17), were isolated from the vines and leaves of Tinospora crispa. Compound 3 has not only bear the dominant substituents of γ-hydroxy-α, β-unsaturated-γ-lactone with anti-inflammatory activity, but also a ternary epoxy structure at C-3/C-4. The planar structures and relative configurations of the clerodane diterpenoids were elucidated by spectroscopic data interpretation. The absolute configurations of compounds 1, 4, 8 and 13 were determined by single-crystal X-ray crystallographic, while that of compound 3 was determined using computed ECD data and single crystal X-ray diffraction of related p-bromobenzoate ester (3a). Subsequently, all compounds were evaluated for their inhibitory effect on nitric oxide (NO) production of LPS-activated BV-2 cells, and compounds 3 and 8 exhibited better NO inhibitory potency, with IC50 values of 5.6 and 13.8 μM than the positive control minocycline (Mino, IC50 = 22.9 μM). The corresponding results of western blot analysis and qRT-PCR revealed that compound 3 can significantly inhibit the inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) protein expressions, mRNA levels of pro-inflammatory cytokins of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) and interleukin 1β (IL-1β). The underlying mechanism by which compound 3 exerted anti-neuroinflammatory effects was investigated by western blot and immunofluorescence assay, which suggested compound 3 inhibited LPS induced neuroinflammation via the suppression of toll-like receptor 4 (TLR4) dependent Signal Transducer and Activator of Transcription 3 (Stat3) and mitogen-activated protein kinase (MAPK) signaling pathways, and the activation of Heme Oxygenase-1 (HO-1) mediated signals.

[Study on the recurrence pattern of rectal cancer patients undergoing radical surgery after neoadjuvant chemoradiotherapy]

Objective: To analyze the recurrence pattern of rectal cancer patients with radical surgery after neoadjuvant chemoradiotherapy. Methods: The clinicopathological characteristics and follow-up information of rectal cancer patients with radical surgery after neoadjuvant chemoradiotherapy in the Cancer Hospital of the Chinese Academy of Medical Sciences from June 2004 to December 2017 were retrospectively collected. The recurrence pattern including the time and site was investigated. Results: The age of 537 patients was (55.5±11.7) years, of whom 361 were male (67.2%). The median follow-up time [M(Q₁,Q₃)] was 77.9 (64.5, 95.6) months. Moreover, 30.7% (165/537) of patients had distant metastasis or local recurrence; 26.8% (144/537) of patients had distant metastasis; 5.6% (30/537) of patients had local recurrence; 1.7% (9/537) of patients had both distant metastasis and local recurrence. In all the recurrent patients, 23.6% (39/165) were in the first year after surgery, followed by 27.3% (45/165) in the second year, 17.0% (28/165) in the third year, and 15.8% (26/165) after five years. According to the risk curve drawn by the life table, the highest metastasis risk of patients occurred in the second year after surgery, and the metastasis risk peak occurred again after more than five years. The lung was the most common metastatic organ, accounting for 47.9% (69/144), followed by the liver (18.8%, 27/144). The ratios of the recurrent patients in each ypTNM stage were 9.5% (8/84), 12.0% (12/100), 26.5% (41/155), 52.5% (104/198), respectively. The proportion of recurrent patients in tumor regression grade (TRG) 1-2 and TRG 3-5 patients were 19.2% (38/198) and 37.5% (127/339), respectively. Conclusions: The recurrence pattern of patients undergoing radical surgery after neoadjuvant chemoradiotherapy is mainly distant metastasis. The lung is the primary metastatic organ. The risk of distant metastasis and local recurrence is high in the first three years after surgery, and there is still high risk of recurrence after five years. For patients with ypTNM stage 2, 3 and TRG3-5, the postoperative adjuvant chemotherapy and long-term follow-up should be strengthened.

[Diagnostic value of contrast-enhanced ultrasound in hepatic epithelioid hemangioendothelioma]

Objective: To investigate the features of contrast-enhanced ultrasound (CEUS) in hepatic epithelioid hemangioendothelioma (HEHE) in order to improve the preoperative diagnosis rate. Methods: CEUS images of 32 pathologically-proven cases of hepatic epithelioid hemangioendothelioma from January 2004 to August 2021 were collected. Lesions were analyzed to observe the features of enhancement mode, enhancement intensity, and distinct enhancement phases. Results: Among the 32 cases, one had a solitary lesion, 29 had multiple lesions, and two had diffuse-type lesions. Contrast-enhanced ultrasound revealed a total of 42 lesions in 32 cases. In terms of arterial phase enhancement, 18 lesions had overall enhancement, six lesions had uneven dendritic enhancement, 16 lesions had rim-like enhancement, and two lesions had just slight peripheral spot enhancement around the lesions. Among the three cases, there were multiple lesions that had overall enhancement and ring enhancement. In terms of the enhancement phase, 20 lesions showed "fast progression", 20 lesions showed "same progression", and two lesions showed "slow progression". During the late arterial or early portal venous phases with rapid washout, all lesions manifested as hypoechoic. With peaked enhanced intensity, 11 lesions had a lower enhancement intensity than the surrounding normal liver parenchyma; 11 lesions had the same enhancement degree as the surrounding normal liver parenchyma; and 20 lesions had a higher enhancement degree than the surrounding normal liver parenchyma. All 16 ring-enhancing lesions had marked hyperenhancement. In the typical enhancing lesions, four showed hyperenhancement, five showed low enhancement, and nine showed isoenhancement. In the dendrite-enhancing lesions, there were two isoenhancing and four hypoenhancing. Contrast-enhanced ultrasound delineated the boundaries of all lesions more clearly than two-dimensional ultrasound. Conclusion: Contrast-enhanced ultrasound has certain value in the diagnosis of hepatic epithelioid hemangioendothelioma.

[A long-term follow-up study on recurrence and benefit of standardized postoperative chemotherapy of rectal cancer patients with complete pathological response after neoadjuvant chemoradiotherapy]

Objective: To analyze the clinicopathological factors affecting long-term disease-free survival and the characteristics of local recurrence or distance metastasis of rectal cancer patients with complete pathological response after neoadjuvant chemoradiotherapy. Methods: The clinicopathological data and follow-up information of patients with a complete pathological response of rectal cancer after neoadjuvant chemoradiotherapy in the Cancer Hospital of Chinese Academy of Medical Sciences from June 2004 to December 2019 were retrospectively collected. The clinicopathological factors affecting the long-term disease-free survival of patients were analyzed to build a prediction model of local recurrence and distant metastasis and to evaluate the benefits of postoperative chemotherapy. Results: The age of 108 patients was(56.3±11.6) years, of which 68 were males (63.0%); The median follow-up time was 79.9 (61.8, 112.6) months. There were 12 patients (11.1%) who had a local recurrence or distant metastasis. The 5-year disease-free survival rate was 91.1% with 9 patients who experienced recurrence. Multivariate Cox proportional hazards regression analysis showed that the maximum diameter of the residual tumor or scar (HR=8.41, 95%CI: 1.08-65.22, P=0.042) and the distance from the lower edge of the tumor to the anal margin before treatment (HR=4.54, 95%CI: 1.23-16.81, P=0.023) were independent risk factors affecting the prognosis. The prognosis of patients was stratified based on relevant factors. The 5-year cumulative disease-free survival rate of those patients receiving postoperative standardized chemotherapy was 92.0%, while for patients who did not receive or complete standardized chemotherapy, the 5-year cumulative disease-free survival rate was 82.3%. Conclusions: The maximum diameter of the residual tumor or scar and the distance from the lower edge of the tumor to the anal margin before treatment were independent risk factors affecting the prognosis of patients with a complete pathological response. Patients with independent risk factors could benefit from the standardized postoperative chemotherapy.

[Analysis of recurrent factors and therapeutic effect after laparoscopic inguinal hernia repair]

Objective: To analyze the recurrence factors and reoperation effect of laparoscopic inguinal hernia repair. Methods: A total of 41 patients with recurrence after laparoscopic repair of the inguinal hernia admitted to the Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2017 to December 2021 were retrospectively analyzed. All patients were males, aging (62±7) years (range: 51 to 75 years). The recurrence intervals were 3 days to 7 years postoperatively. The surgical methods, causes of recurrence, and treatment outcomes of the patients were analyzed. Fisher exact probability method is used to compare the rates. Results: Among all cases, the primary surgical procedures included transabdominal preperitoneal herniorrhaphy (TAPP) in 31 cases and total extraperitoneal herniorrhaphy in 10 cases. The reoperative procedures included the TAPP of 11 cases and the Lichtenstein procedure of 30 cases. The factors of recurrent cases in all patients could be divided into 4 categories, including insufficient mesh coverage in 23 cases, mesh curling in 9 cases, mesh contractuture in 7 cases, and improper mesh fixation in 2 cases. Recurrence, infection, chronic pain, foreign body sensation didn't occur in the followed period of(M(IQR)) 18(24) months(range: 12 to 50 months). There was no statistical difference in the incidence of postoperative seroma between the TAPP and Lichtenstein procedure (3/11 vs. 20.0% (6/30), P=0.68). Conclusions: Postoperative recurrence of laparoscopic inguinal hernia is mostly caused by the lack of mesh coverage. Due to the emphasis on standardized surgical operation, a good outcome could be achieved through reoperation by the TAPP or Lichtenstein procedure.

New polychlorinated bibenzyls from Rhododendron minutiflorum

Five new polychlorinated bibenzyls (1-5) along with 3 known compounds (6-8) were isolated from the stems and leaves of Rhododendron minutiflorum. The chemical structures of all the isolates were determined by spectroscopic methods, and compounds 1 and 2 were further verified by single-crystal X-ray diffraction analyses. Compounds 1-5 were halogenated compounds which bear three to five chlorine atoms in their chemical structures. Biologically, compounds 2, 5 and 6 showed varying degrees of toxicity toward the Asian citrus psyllid (Diaphorina citri) with LD₅₀ values 27.15, 17.02 and 16.20 mg/L, respectively. These values were comparable to the positive control matrine (LD₅₀ = 11.86 mg/L), which were calculated using observations on day 6. Meanwhile, compound 4 had α-glucosidase inhibitory activity with IC₅₀ value of 17.87 ± 0.74 μM.

Analysis of synthetic electron cyclotron emission from the high field side of HL-2M tokamak plasmas

A synthetic electron cyclotron emission (ECE) diagnostic is used to interpret ECE signals from preset plasma equilibrium profiles, including magnetic field, electron density, and electron temperature. According to the simulation results, the electron temperature (T_e) profile covering the harmonic overlap region can be obtained by receiving ECE signals at the high field side (HFS) of the HL-2M plasma. The third harmonic ECE at the low field side (LFS) cannot pass through the second harmonic resonance layer at the HFS unless the optical thickness (τ) of the second harmonic becomes gray (τ ≤ 2). In addition, the impact of the relativistic frequency down-shift has been evaluated and corrected. The measurable range of the HFS ECE has been calculated by scanning different parameters (electron density, temperature, and magnetic field). Higher plasma parameters allow a wider radial range of electron temperature measurements. The minimum inner measurable position can reach R = 120 cm (r/a = -0.89) when the product of core temperature (T_e0) and density (n_e0) is greater than 35 × 10¹⁹ keV m^-3, which is extended by more than 30 cm inward compared with that of the LFS measurement. The HFS ECE will greatly improve the diagnostic ability of ECE systems on the HL-2M tokamak.

[The analgesic efficacy and safety of non-steroidal anti-inflammatory drugs combined with medial canthus peribulbar block for postoperative pain in patients with thyroid-associated ophthalmopathy after orbital decompression]

Objective: To explore the analgesic efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) combined with medial canthus peribulbar block for postoperative pain in patients with thyroid-associated ophthalmopathy (TAO) after orbital decompression. Methods: This study was a single-center, single-blind, randomized controlled study. From June 2020 to December 2020, sixty TAO patients in Zhongshan Ophthalmic center, Sun Yat-sen University who were allocated to receive orbital decompression under general anesthesia, were randomly and equally divided into two groups (n=30): the control group (group C) and the medial canthus peribulbar block group (group PB). All patients received intravenous infusion of flurbiprofen axetil 50 mg at 15 min before the end of surgery. In PB group, patients received peribulbar block via caruncular approach for postoperative pain management upon completion of wound closure, while patients in group C did not receive the peribulbar block. If patient sufferred significant postoperative pain (NRS score≥4), Ketorolac 10 mg would be prescribed as analgesic rescue. Postoperative NRS pain scores were recorded at 2, 4, 8, 24, 48 h after the surgery. The usage of Ketorolac during 0-24 h and 24-48 h postoperatively were also recorded. Postoperative complications during the hospital stay were recorded. Severity of orbital swelling would also be evaluated at 24 h after surgery. Results: The NRS pain scores [M(Q₁, Q₃)] in group PB were 2.50(2.00, 3.00)and 2.00(1.75, 3.00), which were both significantly lower than those in group C of 4.50(3.00,5.00), 3.00(2.00,4.25)at 2 h, 4 h after surgery respectively(P=0.001,0.045). During the first 24 h, the usage rate of Ketorolac in group C was 40%(12/30), which was higher than that in the group PB (13.3%, 4/30) with statistical significance (P=0.041). There was no significant difference in the incidences of postoperative nausea, vomiting, dizziness during the first 48 h, as well as the moderate to severe intensity of orbital swelling at 24 h after surgery (all P>0.05). There were no obvious complications of medial canthus peribulbar block in group PB. Conclusions: NSAIDs combined with medial canthus peribulbar block can provide satisfactory analgesia for TAO patients after orbital decompression, which is safe with little complications, and is beneficial to enhanced recovery after surgery.

Terpenoids with α-glucosidase inhibitory activity from Rhododendron minutiflorum Hu

Five undescribed triterpenoids, two unusual omphalane-type sesquiterpenoids together with twenty-five known compounds were isolated from the leaves and stems of Rhododendron minutiflorum Hu. The absolute configurations of 1-3 and 6 were established by single-crystal X-ray diffraction analysis and electronic circular dichroism (ECD). Compounds 6-7 feature the rare omphalane-type sesquiterpene skeleton and are verified by single-crystal X-ray diffraction analysis for the first time. In the biological activity assay, most of the triterpenoids have different degrees of inhibitory effects on α-glucosidase, with IC₅₀ values ranging from 6.97 to 229.3 μM (the positive control drug acarbose has an IC₅₀ value of 3.07 × 10^-3 μM). Structure and activity relationship (SAR) study reveals that the oxidation degrees of C-3, C-8, or C-11 to C-13 of the ursane-type triterpenoid influence the inhibitory activity dramatically.

[Analysis of clinical features and etiological diagnostic indices of reproductive age women with hyperandrogenism]

Objective: To investigate the clinical features and the value of different diagnostic indices for etiology in reproductive age women with hyperandrogenism. Methods: The medical records of 96 reproductive age women with hyperandrogenism in the multi-disciplinary team of Peking University First Hospital from January 2020 to April 2021 were collected. The patients were divided into four groups based on final diagnosis: congenital adrenal hyperplasia (CAH) (n=8), polycystic ovary syndrome (PCOS) (n=67), idiopathic hyperandrogenism (n=13) and other specific diseases (n=8), respectively. The indices related to androgens in different groups were compared, and then their efficiency for diagnosis of CAH and PCOS were analyzed with receiver operator characteristic curve (ROC curve). Results: A total of 96 patients with hyperandrogenism were recruited, with the age of 19-45 (29±6) years old. Overall, 4.2% (4/96) of the patients were with single clinical hyperandrogenism, 56.3% (54/96) were with single laboratory hyperandrogenaemia and 39.6% (38/96) were with both. The breakdown into laboratory hyperandrogenaemia subtypes was as follows: only T elevation 22.8% (21/92), only A2 elevation 7.6% (7/92), none DHEAS elevation, only FAI elevation 5.4% (5/92) and elevation of more than one of the androgen indices mentioned above accounted for 64.1% (59/92). In the reasons of consultation, simple irregular menstruation (36.0%, 32/89) or accompanied by clinical hyperandrogenism with or without infertility (36.0%, 32/89) were the most common. As for primary visiting departments, Obstetrics and Gynecology accounted for 53.2% (51/96), and then Endocrinology as 39.5% (38/96). The 17-OHP level of CAH, PCOS and idiopathic hyperandrogenism group was 20.0 (8.2, 33.1), 1.1 (0.8, 1.4), 0.9 (0.8, 1.3) ng/ml, respectively. The androstenedione level in these groups was 6.3 (4.6, 8.7), 3.8 (2.9, 4.8) and 3.2 (2.7, 3.7) ng/ml, respectively. The 17-OHP and androstenedione levels of CAH group were significantly higher than that in PCOS or idiopathic hyperandrogenism group (all P<0.05). The ratio of LH and FSH in these three groups was 0.8(0.5, 1.0), 1.3(0.6, 1.9) and 0.6(0.3, 0.7), respectively. The ratio of LH and FSH was significantly higher in PCOS than that in idiopathic hyperandrogenism group (P=0.024), but yet there was no significant difference compared with CAH group (P>0.05). The AUC of ROC curve of 17-OHP for CAH diagnosis was 0.94, followed by androstenedione 0.83, whereas LH/FSH for PCOS diagnosis was only 0.63. Conclusions: Among the reasons of consultation in reproductive age women who visited our multi-disciplinary team for female hyperandrogenism, simple irregular menstruation or accompanied by clinical hyperandrogenism with or without infertility are the most common. PCOS accounts for the majority of different androgen excess disorders. 17-OHP is the most valuable parameter for the diagnosis of CAH and secondly androstenedione.

[Quantitative analysis of non-alcoholic fatty liver disease based on MRI proton density fat fraction in the coastal region of Qingdao]

Objective: To explore the clinical application value of MRI-PDFF on different liver segments for the evaluation of non-alcoholic fatty liver disease (NAFLD). Methods: 178 volunteers from March 2019 to February 2020 were included. PDFF values ​​of all nine segments of the liver were measured using CSE3.0T MRI scan. The obtained average value was used to represent the average liver fat content. PDFF values of each or combined liver segment were equally compared with the average value to observe the representativeness of fat content. Receiver operating characteristic curve was used to analyze the diagnostic performance of each liver segment, and the Youden index was used to calculate the cutoff value. Paired-sample t-test or non-parametric Kruskal-Wallis test were used to compare measurement data among groups. Results: 178 volunteers average liver fat content ranged from 0.89% to 42.61% with MRI-PDFF, and 71.35% (127/178) of the volunteers had PDFF > 5%. There was no significant difference between SIII, SIVb, SV, and SVIII liver segments when compared with the average value (P > 0.05). PDFF values ​​of SI, SII, and SIV a liver segments were all lower than the average value, while the PDFF values ​​of SVI and SVII liver segments were all higher than the average value (P ​​< 0.05). MRI-PDFF sensitivity value for diagnosing liver steatosis of nine liver segments was 85.8% ~ 94.5%, and the specificity was higher than 96.0%. Among them, the SV liver segment had the highest sensitivity (94.5%), and the corresponding optimal diagnostic threshold value was 5.13%. Compared with single and combined liver segment, the PDFF value of SII, SV, SVI combined liver segment had the highest diagnostic performance for fatty liver, with the sensitivity and specificity of 96.9%, and 100%, respectively, and the corresponding optimal diagnostic threshold value was 5.17%. Conclusion: Compared with single and other combined liver segments, MRI-PDFF values of SII, SV, and SVI combined liver segments have higher sensitivity and specificity for the diagnosis of NAFLD, and it can be used as the first choice for the determination of liver fat content with MRI.

Coupled electronic and magnetic relaxation in Fe1+yTe: direct evidence for the interaction between itinerant carriers and local moments

Iron chalcogenides are of particular interests among iron-based superconductors due to their distinct properties such as high-T_con FeSe monolayer and competing magnetic correlations in Fe_1+yTe. Here we report unusual transport properties observed near the critical composition of Fe_1+yTe (y∼ 0.09) where competing magnetic correlations exist. The resistivity exhibits surprising temperature-dependent relaxation behavior belowT_N, resulting in the increase of resistivity with time for 35 K <T<T_N, but the decrease of resistivity with time for 10 K <T< 35 K. Such resistivity relaxation is intimately coupled to the magnetization relaxation and can be attributed to the glassy magnetic states induced by the competing magnetic orders. These findings demonstrate strong coupling between itinerant carriers and local ordered moments in Fe_1+yTe.

[The risk factors for regional lymph node metastasis of mismatch repair deficient colorectal cancer]

Objective: To explore the risk factors for regional lymph node (RLN) metastasis in colorectal cancer patients with mismatch repair deficiency (dMMR). Methods: The data of 357 dMMR colorectal cancer patients who underwent surgery in National Cancer Center from January 2012 to December 2016 was retrospectively analyzed. Univariate and multivariate analysis were used to identify the risk factors for RLN metastasis. Results: Among the 357 patients, 204 were male and 153 were female, 61.6% (220/357) lesion located in right half colon, while the other 16.2% (58/357) located in rectum. Univariate analysis showed that tumor size, differentiation, lymphovascular invasion, tumor deposit, postoperative pathologic T stage (pT), the number of negative lymph nodes and the expression of the MSH6 protein were significantly associated with RLN metastasis (P<0.05). All of the patients with well differentiation tumors (15 patients) or staged pT1 (13 patients) had no RLN metastasis. Multivariate analysis showed that tumor differentiation (OR=2.582, 95%CI=1.567-4.274, P<0.001), pT (OR=3.778, 95%CI=1.448-12.960, P=0.015) and the expression of MSH6 protein (OR=2.188, 95%CI=1.159-4.401, P=0.021) were independent risk factors for RLN metastasis. Conclusions: The postoperative pT stage, tumor differentiation and the expression of MSH6 protein are independent risk factors for RLN metastasis of dMMR colorectal cancer. Preoperative assessment of these factors may further improve the accuracy of predicting the risk of RLN metastasis.

Spin-valley locking and bulk quantum Hall effect in a noncentrosymmetric Dirac semimetal BaMnSb2

Spin-valley locking in monolayer transition metal dichalcogenides has attracted enormous interest, since it offers potential for valleytronic and optoelectronic applications. Such an exotic electronic state has sparsely been seen in bulk materials. Here, we report spin-valley locking in a Dirac semimetal BaMnSb2. This is revealed by comprehensive studies using first principles calculations, tight-binding and effective model analyses, angle-resolved photoemission spectroscopy measurements. Moreover, this material also exhibits a stacked quantum Hall effect (QHE). The spin-valley degeneracy extracted from the QHE is close to 2. This result, together with the Landau level spin splitting, further confirms the spin-valley locking picture. In the extreme quantum limit, we also observed a plateau in the z-axis resistance, suggestive of a two-dimensional chiral surface state present in the quantum Hall state. These findings establish BaMnSb2 as a rare platform for exploring coupled spin and valley physics in bulk single crystals and accessing 3D interacting topological states.

[Clinical and imaging characteristics of patients with primary cardiac angiosarcoma]

Objective: To investigate the clinical, cardiac imaging characteristics and prognosis of patients with primary cardiac angiosarcoma. Methods: The clinical data of 14 patients hospitalized with primary cardiac angiosarcoma from January 2001 to December 2017 in Peking Union Medical College Hospital were collected and analyzed. Metastatic cardiac angiosarcoma was not included in this study. Patients were followed up post discharge per telephone call or clinical visit. Results: Of the 14 patients, 8 were males and 6 were females, average age was 48 years. The main clinical symptoms were shortness of breath (8/14), hemoptysis (6/14), fever (5/14), chest pain (4/14) and cough (3/14). Imaging examinations showed that the tumors of 8 patients were located in the right heart and 6 in the pericardial cavity. Tumors in the right heart often infiltrate the atrial wall and cause pericardial effusion (7/8). Tumors in the pericardium were characterized by recurrent bloody pericardial effusion (6/6), prone to progressive constrictive pericarditis (3/6), pericardial fluid cytology was often negative (6/6). MRI showed heterogeneous high signal intensity (cauliflower aspect) on T2-weighted image and heterogeneous enhancement with a"sunray" aspect at the perfusion study. At the time of diagnosis, 8 patients developed lung or adrenal metastasis (8/14). The median survival was only 305 days. Conclusions: Primary cardiac angiosarcoma is a rare disease with non-specific clinical manifestation and poor prognosis. Imaging examinations may help diagnosis. The high invasiveness and the easy-to-metastasis feature of the tumor contribute to the poor prognosis of cardiac angiosarcoma.

[Clinicopathological and prognostic features of young onset patients with middle-low rectal cancer received neoadjuvant chemoradiotherapy]

Objective: To explore the clinicopathological and prognostic features of young onset patients with middle-low rectal cancer who received neoadjuvant chemoradiotherapy (NCRT). Methods: After NCRT, a total of 441 patients with primary middle-low rectal cancer treated with radical surgery at the Cancer Hospital, Chinese Academy of Medical Sciences (CHCAMS) from January 2004 to December 2016 were included. According to the age of disease onset, the patients were divided into the young group (51cases) and the middle-old group (390 cases), and the clinicopathological characteristics and survival of these patients were analyzed. Results: In the young group, 68.6% of patients received radical surgery within 7 weeks after NCRT, which was higher than 52.8% in the middle-old group (P=0.047). The stage ypTNM Ⅲ in the young group was 51.0%, higher than 34.1% in the middle-old group (P=0.027). The stage ypN+ in the young group was 51.0%, higher than 34.1% in the middle-old group (P=0.047), The incidence of disease progression in the young group was 39.2%, higher than 25.1% in the middle-old group (P=0.049). The incidence of distant metastasis in the young group was 35.3%, higher than 21.5% in the middle-old group(P=0.044). Most cases of disease progression occurred in the first 3 years after surgery for the young group, especially in the second year after surgery, the incidence of disease progression in the young group was 55.0%, higher than 26.5% in middle-old group (P=0.025). The 3-year and 5-year disease-free survival (DFS) rates for the young group were 63.7% and 58.2%, lower than 81.0% and 74.3% in the middle-old group (P=0.016), respectively. The 3-year and 5-year overall survival in the middle-old group (OS) rates for the young group were 85.4% and 69.2%, lower than 93.6% and 84.1% in the middle-old group (P=0.033), respectively. The multivariate analysis showed that, response of primary tumor (HR=4.804, 95% CI: 1.360-16.973) and total number of dissected lymph nodes (HR=4.336, 95% CI: 1.739-10.809) in the young group were independent prognostic factors related to DFS. The total dissected number of lymph nodes(HR=3.295, 95% CI: 1.076-10.091)was an independent prognostic factor related to OS. In the middle-old group, response of primary tumor (HR=2.626, 95% CI: 1.354-5.091), ypTNM stage (ypTNM Ⅲ: HR=5.837, 95% CI: 2.968-11.479) and tumor location distance from the anal verge (HR=0.500, 95% CI: 0.308-0.812) were independent prognostic factors related to DFS. Lymphovascular invasion (HR=0.500, 95% CI: 0.308-0.812) and ypTNM stage (ypTNM Ⅲ: HR=16.322, 95% CI: 5.049-52.771) were independent prognostic factors related to OS. Conclusions: Young onset rectal cancer patients are associated with shorter operation time interval, advanced pathological stage and poorer prognosis. More intensive adjuvant treatment and post-treatment surveillance should be conducted to young onset rectal cancer with NCRT.

[Clinicopathological characteristics and prognostic analysis of patients with pathological complete response and near complete response after neoadjuvant treatment of rectal cancer]

Objective: To investigate the clinicopathological characteristics and prognosis of rectal cancer patients with pathological complete response and near complete response after neoadjuvant therapy. Methods: The clinicopathological data of patients who underwent neoadjuvant chemoradiotherapy plus radical surgery of rectal cancer in the Cancer Hospital of Chinese Academy of Medical Sciences from January 2004 to December 2016 were retrospectively collected. The clinicopathological characteristics and prognostic factor of patients with pathological complete response and near complete response were analyzed. Results: The clinical data of 142 patients were collected. There were 93 males and 49 females, aged from 24 to 81 years. The median disease-free survival was 53.9 months and the median overall survival was 55.0 months. Univariate analysis showed that the maximum diameter of scar or lesion, the status of lymph node metastasis and the distance between the lower edge of tumor and anal edge were associated with disease-free survival time; the maximum diameter of scar or lesion and the status of lymph node metastasis were associated with overall survival time. Multivariate Cox proportional hazards regression analysis showed that patients with scar or lesion diameter>3 cm (HR=4.406,95%CI:1.619-12.006), positive lymph node metastasis status (HR=4.102,95%CI:1.461-11.513) and tumor lower margin to anal margin distance ≤4 cm (HR=18.171,95%CI:2.357-140.073) had shorter disease-free survival time.The patients with scar or lesion diameter>3 cm (HR=8.573,95%CI:1.630-45.099) and lymph node metastasis status (HR=4.721, 95%CI:1.068-20.860) had shorter overall survival time. Conclusions: The overall prognosis of patients with pathological complete response or near complete response after neoadjuvant therapy for rectal cancer is better. The distance between the lower margin of the tumor and the anal edge, the status of lymph node metastasis and the maximum diameter of scars or lesion were the related factors affecting the prognosis of patients with rectal cancer.

[COVID-19 epidemic and its characteristics in Heilongjiang province]

Objective: To describe the COVID-19 epidemic and its characteristics in Heilongjiang province, and provide evidence for the further prevention and control of COVID-19 in the province. Methods: The information of COVID-19 cases and clusters were collected from national notifiable disease report system and management information system for reporting public health emergencies of China CDC. The Software's of Excel 2010 and SPSS 23.0 were applied for data cleaning and statistical analysis on the population, time and area distributions of COVID-19 cases. Results: On January 22, 2020, the first confirmed case of COVID-19 was reported in Heilongjiang. By March 11, 2020, a total of 482 cases domestic case of COVID-19, The incidence rate was 1.28/100 000, the mortality rate was 2.70% (13/482) in 13 municipalities in Heilongjiang. There were 81 clusters of COVID-19, The number of confirmed cases accounted for 79.25% (382/482) of the total confirmed cases and 12 cases of deaths. The family clusters accounted for 86.42% (70/81). Compared with the sporadic cases, the mortality rate, proportion of elderly cases aged 60 or above and severe or critical cases of clinical classification were all higher in the clusters especially the family clusters, but the differences were not significant (P>0.05). There were 34 clusters involving more than 5 confirmed cases accounted for 41.98% (34/81) of the total clusters, the involved cases accounted for 68.31% (261/382) of the total cases of clusters. There were significant differences in age distribution of the cases among the case clusters with different case numbers. In the clusters involving 6-9 cases, the proportion of cases aged 65 years or above was more (26.53%, 39/147). Conclusions: The incidence rate of COVID-19 was relatively high and the early epidemic was serious in Heilongjiang, The number of cases was large in clusters especially family clusters.

[Predictive value of two-dimentional shear wave elastography in posthepatoectomy liver failure]

Objective: To investigate the value of two-dimensional shear wave elastography (2D SWE) combined with clinical biochemical data in predicting posthepatoectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC). Methods: A total of 274 HCC patients who underwent hepatectomy in Zhongshan Hospital Fudan University from January 2015 to January 2016 were retrospectively collected, including 235 males and 39 females, age 19-80 (56±11) years. All patients were confirmed to be HCC by postoperative pathology. The preoperative 2D SWE examination, laboratory examination results and intraoperative indicators were analyzed. According to the occurrence of PHLF after surgery, single factor analysis and multiple logistic regression analysis were performed on the above indicators to obtain a binary logistic regression model, and evaluate the diagnostic effect of the model on PHLF. In addition, 103 HCC patients from October 2019 to January 2020 were retrospectively collected as an external validation set, including 89 males and 14 females, age 23-80 (55±11) years old. Results: The liver stiffness measurement (LSM) obtained from 2D SWE, INR and Laminin (LN) were independent predictors of PHLF. The formula of prediction model PM=-15.451+0.095×LSM+11.7×INR+0.012×LN was obtained by combining above three factors. The area under the curve (AUC) of PHLF was 0.82, which was higher than that of end-stage liver disease model (MELD) score and Child-Pugh grading diagnosis of PHLF. The AUC of PHLF predicted by PM in the external validation group was 0.81. Conclusion: 2D SWE is helpful for clinicians to evaluate liver reserve function preoperatively and to predict the occurrence of PHLF in patients with HCC.

[Diagnostic accuracy of liver and spleen stiffness by two dimensional shear wave elastography for portal hypertension in hepatitis B-related cirrhosis]

Objective: To assess the diagnostic accuracy of liver and spleen stiffness measured by two dimensional shear wave elastography (2D-SWE) in hepatitis B-related cirrhosis. Methods: The clinical data of fifty-eight hepatitis B-related cirrhosis patients were collected in Zhongshan Hospital, Fudan University from September 2017 to April 2018. Pearson's correlation analyses were used to assess the relationship between liver/spleen stiffness (L-SWE and S-SWE) and hepatic venous pressure gradient (HVPG), as well as the comparison with serological model. The SWE diagnostic performances of Liver (L-SWE), Spleen (S-SWE) were also evaluated. Results: Of all 58 patients, 47 were found HVPG ≥10 mmHg, diagnosed as clinically significant portal hypertension (CSPH) and severe portal hypertension (SPH), which patients are at increased risk of developing complications. Thirty-four patients were found HVPG≥12 mmHg, diagnosed as SPH, which patients were at increased risk of variceal bleeding. Moderate positive correlation was found between L-SWE and HVPG (r=0.42, P<0.01), and S-SWE were significantly correlated with HVPG (r=0.68, P<0.01), while serological models and HVPG were slightly correlated (r=0.36 and 0.28, all P<0.01). The area under the receiver operating characteristic curves of L-SWE, S-SWE and the combination for CSPH were 0.78, 0.88 and 0.89. When L-SWE was>12.86 kPa or S-SWE was>35.73 kPa, patients were at increased risk of developing complications. The area under the receiver operating characteristic curves for SPH were 0.68, 0.81 and 0.77 and the S-SWE had the highest specificity, so when S-SWE was>41.5 kPa, patients were at increased risk of variceal bleeding. Conclusion: L-SWE and S-SWE are reliable and promising non-invasive parameters to assess CSPH and SPH.

Polar meron lattice in strained oxide ferroelectrics

A topological meron features a non-coplanar structure, whose order parameters in the core region are perpendicular to those near the perimeter. A meron is half of a skyrmion, and both have potential applications for information carrying and storage. Although merons and skyrmions in ferromagnetic materials can be readily obtained via inter-spin interactions, their behaviour and even existence in ferroelectric materials are still elusive. Here we observe using electron microscopy not only the atomic morphology of merons with a topological charge of 1/2, but also a periodic meron lattice in ultrathin PbTiO₃ films under tensile epitaxial strain on a SmScO₃ substrate. Phase-field simulations rationalize the formation of merons for which an epitaxial strain, as a single alterable parameter, plays a critical role in the coupling of lattice and charge. This study suggests that by engineering strain at the nanoscale it should be possible to fabricate topological polar textures, which in turn could facilitate the development of nanoscale ferroelectric devices.

[Association between edentulism and cognition among people aged 50 and over]

Objective: To investigate the association between edentulism and cognition in people aged 50 and over in China. Methods: Cross-sectional data was collected from the first wave of World Health Organization Study on global AGEing and adult health in China, among people aged 50 and over in China. A comprehensive cognitive test was used to assess cognitive functions, including verbal recall (VR), verbal fluency (VF), forward digit span (FDS) and backward digit span (BDS) among the subjects. Association between edentulism and cognition was examined by a two-level (individual level and community level) linear model. Results: A total of 12 843 individuals aged 50 years and over were included for analysis, with an average age of (63.0±9.3) years. The overall prevalence of edentulism was 11.0%. The edentulous adults had lower mean scores of VR (4.55), VF (10.88), FDS (6.25), BDS (2.96) and overall cognition (49.15) (P<0.001). Edentulism was negatively associated with VR (β=-0.216, 95%CI: -0.370 - -0.062), FDS (β=-0.186, 95%CI: -0.293 - -0.078) and overall cognition (β=-1.703, 95%CI: -3.025 - -0.381) after adjusted for age, sex, residence, education level, marital status, household income, co-morbidity of chronic conditions, BMI, smoking and drinking alcohol. Conclusion: Edentulism was related with lower cognition level in people aged 50 and over in China.

[The value of multi-gene testing in benign or malign diagnosis of thyroid nodules with indeterminate cytology]

Objective: To study the diagnostic value of a multi-gene molecular testing in cytologically indeterminate thyroid nodules. Methods: From February 2018 to September 2018, patients with thyroid nodules who underwent fine needle aspiration(FNA) at Peking University Cancer Hospital were enrolled. Three hundred and sixty patients were included, consisting of 86 men and 274 women, with a mean age of 45.8 years (between 13 and 89 years old). Among 391 nodules, 141 were cytologically inderminate and 75 were resected. FNA samples underwent prospective testing using a next-generation sequencing (NGS) assay, which included 16 genes for point mutations and 26 types of gene fusions. The testing results of indeterminate nodules were compared with surgical outcomes, to determine the diagnostic performance. The results were compared with the BRAF V600E single gene mutation analysis by χ(2) test. Results: The multi-gene testing showed a sensitivity of 73.2%, specificity of 96.8%, positive predictive value of 96.8%, and negative predictive value of 73.2%. The diagnostic accuracy of multi-gene testing was significantly higher than the BRAF V600E mutation test (83.3% vs 73.6%, χ(2)=31.588, P<0.01). Conclusion: Multi-gene testing in FNA samples is an effective method to diagnose cytologically indeterminate thyroid nodules, which has a higher accuracy than BRAF V600E mutation detection.

A short follow-up of prosthesis-based breast reconstruction using TiLOOP® Bra surgical mesh

Background

A new approach for prosthesis-based breast reconstruction is the use of a titanium-coated polypropylene mesh TiLOOP^® Bra. However, the safety and outcomes are currently unclear in Chinese breast cancer patients.

Methods

A retrospective study of patients undergoing prosthesis-based breast reconstruction using TiLOOP^® Bra was carried out. Complications were divided into minor complications (require conservative treatment) and major complications (require surgical intervention). The influence of patient- and surgery-related characteristics on complications was analyzed.

Results

Postoperative hematoma and seroma were respectively found in one and two breasts and could be treated conservatively. In three breasts skin infection occurred immediately after surgery resulting in skin necrosis of two breasts and wound dehiscence of one breast. These three breasts were treated with mesh removal, and revisionary surgery. Increased risk of mesh removal and implant explantation were observed in case of skin infection (P = 0.011) and skin necrosis (P = 0.033). Neither patient-related characteristics including age >50 years, BMI >25 kg/m², and postoperative radiotherapy/chemotherapy, nor surgery-related characteristics including sentinel lymph node biopsy or axillary dissection alone, and curative/prophylactic surgery were significantly correlated with minor and major complications. Ultrasound evaluation showed a well-incorporated mesh into surrounding tissue.

Conclusion

This titanium-coated polypropylene mesh showed acceptable complications and could be used safely in prosthesis-based breast reconstruction by stabilizing the implant pocket. Longer follow-up data and more randomized trials are necessary to determine the clinical use of this mesh.

[Clinicopathological characteristics and differential diagnosis of interdigitating dendritic cell sarcoma]

Objective: To analyze the clinicopathological features and differential diagnosis of interdigitating dendritic cell sarcoma (IDCS). Methods: The clinical pathological features of 7 IDCS were analyzed. Among them, the follow-up results of 6 cases were available. Results: Among the 7 IDCS patients, 4 cases were male and 3 were female. The age of the patients ranged from 26 to 69 years.Three cases were originated from lymph nodes and 4 cases were originated from skin, stomach, adrenal gland and mesentery, respectively. Microscopically, the tumor cells presented as fascicular and storiform proliferation and infiltrated by lymphocytes. The tumor cells were short-spindle or ovoid, with indistinct border of cytoplasm. The immunohistochemistry results showed that tumor cells were S-100, Vim, CD68 and CD163 positive, and AE1/AE3, EMA, CD117, CD34, Desmin, SMA, CD1α, CD21, CD23, CD35, HMB45, Melan-A, MelanPan and ALK negative.The BRAF mutation and clonal rearrangement of T and B cells were not detected. Among the follow-up period of 7 IDCS patients, 3 occurred disease progressions. Conclusions: IDCS is extremely rare with unique pathological features, and its lesion is not limited to the lymph node. The IDCS patients with extensive lesions may have worse prognose. The differential diagnosis of IDCS includes other histiocytic and dendritic cell neoplasms, malignant melanoma and soft tissue neoplasms.

Emergence of intrinsic superconductivity below 1.178 K in the topologically non-trivial semimetal state of CaSn3

Topological materials which are also superconducting are of great current interest, since they may exhibit a non-trivial topologically-mediated superconducting phase. Although there have been many reports of pressure-tuned or chemical-doping-induced superconductivity in a variety of topological materials, there have been few examples of intrinsic, ambient pressure superconductivity in a topological system having a stoichiometric composition. Here, we report that the pure intermetallic CaSn₃ not only exhibits topological fermion properties, but also has a superconducting phase at ~1.178 K under ambient pressure. The topological fermion properties, including the nearly zero quasi-particle mass and the non-trivial Berry phase accumulated in cyclotron motions, were revealed from the de Haas-van Alphen (dHvA) quantum oscillation studies of this material. Although CaSn₃ was previously reported to be superconducting with T _c  =  4.2 K, our studies show that the T _c  =  4.2 K superconductivity is extrinsic and caused by Sn on the degraded surface, whereas its intrinsic bulk superconducting transition occurs at 1.178 K. These findings make CaSn₃ a promising candidate for exploring new exotic states arising from the interplay between non-trivial band topology and superconductivity, e.g. topological superconductivity (TSC).

Hyperbolic lens design of local oscillator optics system for electron cyclotron emission imaging on J-TEXT

An electron cyclotron emission imaging diagnostic system that contains two 16-antenna arrays is being developed on J-TEXT tokamak. In this heterodyne system, the mixers in the front microwave antenna are used to down-convert the electron cyclotron emission to a 2-12 GHz radio frequency. All of the 24 antenna mixers in the individual enclosure box are driven by shining local oscillator (LO) power via launching optics. The previous approach for LO optics was designed with spherical and cylinder lenses, which has limitations such as the inhomogeneity of the energy deposition on different channels and the difficulty of optics alignment. A new generation of LO optics has been designed and applied on J-TEXT with a hyperbolic lens for uniform power deposition across the entire antenna array. The robustness of the optical alignment will be significantly increased with three hyperbolic lenses. Furthermore, the simulation results and robustness analysis of these LO optics are discussed in this paper.

A new method of out-of-focus millimeter wave imaging in fusion plasma diagnostics using Bessel beams

Electron cyclotron emission imaging (ECEI) and microwave imaging reflectometry diagnostics have been employed on a number of magnetic fusion plasma confinement devices. The common approach is based on a Gaussian beam assumption, which generates good spatial resolution (centimeter level). However, the radial focal depth is limited by the poloidal resolution, which is comparable with the Rayleigh length (∼150 mm). By contrast, a new Bessel beam approach has been developed and demonstrated to generate much longer focal depth with the property of propagation stability. To test the new approach, the DIII-D tokamak LCP ECEI optics have been re-designed to support a Bessel beam approach based on an axicon lens. The achievable radial coverage can exceed that of the current Gaussian approach by 3×. The imaging result is discussed in this paper based on the simulation analysis and laboratory testing result.

[DS2, a newly synthetic ent-kaurane diterpenoid analog, inhibits proliferation and migration of human gastric cancer cell]

Objective: To investigate the effects and the underlying mechanism of DS2, a newly synthetic analog of natural ent-kaurane diterpenoid, on the proliferation and migration capabilities of human gastric cancer cells. Methods: MTT assay, colony formation assay and flow cytometry were used to measure the effects of DS2 on growth, apoptosis and cell cycle of several human gastric cancer cell lines. The function of DS2 in the migration was further detected by wound healing and transwell assays. The expression of migration related proteins were determined by western blot. Results: DS2 inhibited the growth of MGC-803, SGC-7901 and HGC-27 cells in a dose dependent manner. After treatment of DS2 at a concentration of 6.25 μmol/L for 24 h, the survival rates of MGC-803, SGC-7901 and HGC-27 cells were 53.87±3.05%, 55.91±6.97% and 32.41±2.64%, respectively. However, for the normal gastric epithelial cell GES-1, no obvious growth inhibition was observed. In addition, DS2 caused significant G(2)/M arrest and induced apoptosis in MGC-803 cells. Furthermore, compared with the negative control, the colony formation, wound healing rate as well as the number of migrating cells of MGC-803 were significantly decreased in a dose dependent manner after DS2 treatment. DS2 induced the expression of E-cadherin, whereas β-catenin and N-cadherin levels were downregulated in MGC-803. Conclusion: The new compound DS2 has a strong anti-cancer activity, and this study will help us to design and synthesize better diterpenoids derivatives.

Multiple strains and polar states in PbZr0.52Ti0.48O3/PbTiO3 superlattices revealed by aberration-corrected HAADF-STEM imaging

Tuning multiple strain and polar states of ferroelectrics by using strain engineering is an essential approach for designing multifunctional electric devices such as multiple state memories. However, integrating multiple strain states is still a challenge, and in addition, revealing such strains and the resultant polar behaviors on the atomic level remains difficult. In this work we prepare PbZr_0.52Ti_0.48O₃/PbTiO₃ (PZT/PTO) superlattices on SrRuO₃-buffered SrTiO₃(001) substrates. Aberration-corrected high angle annular dark field scanning transmission electron microscopy (HAADF-STEM) reveals that the superlattice is coherent in both c (out-of-plane polar direction) and a (in-plane polar direction) domains. We find that the strain states of both PZT and PTO in c and a domains are variant, leading to four special strain states. For example, the tetragonality for PTO in c and a domains is 1.061 and 1.045, respectively. In contrast, PZT in c domains displays a tetragonality as giant as 1.107, which corresponds to 110 µC cm^-2 spontaneous polarization, much larger than the bulk PZT; while PZT in a domains exhibits 1.010 tetragonality with about 70 µC cm^-2 polarization. This study reveals a practical way to integrate multiple strain states and enhanced polarizations in ferroelectric films, which could be used as multifunctional electric elements.

[Incidence of fall related injury in people aged 50 and above and risk factors in 8 provinces in China: a cross-sectional study]

Objective: To estimate the incidence and distribution characteristics of fall related injury in people aged ≥50 years in 8 provinces in China and related physiological, psychological and social risk factors. Methods: Cross-sectional data were collected from adults aged ≥50 years participating in the World Health Organization (WHO) study on global ageing and adult health (SAGE) round 1 in China. Two-level hierarchical logistic model was used to identify the related factors for fall-related injury. All the models were stratified by living area (urban/rural). Results: Estimated incidence of fall related injury (road traffic injury was not included) was 3.2%. Ageing and multiple chronic conditions (OR=2.55, 95%CI: 1.41-4.64) was significantly associated with the incidence of fall related injury in urban area. In rural area, depression (OR=4.33, 95% CI: 2.52-7.42) and multiple chronic conditions (OR=2.46, 95%CI: 1.37-4.41) were associated with the incidence of fall related injury. Conclusions: This study estimated the incidence of fall related injury in adults aged ≥50 years in 8 provinces in China. A significant association between multiple chronic conditions and fall related injury were found in both urban and rural residents. Targeted measures should be taken for the prevention and control of chronic diseases in elderly population.

[Expanded clinical verification of effectiveness of two-dimensional-shear wave elastography in the noninvasive evaluation of hepatic fibrosis]

Objective: To evaluate the diagnostic value of two-dimensional shear wave elastography(2D-SWE)in the assessment of hepatic fibrosis in a large-scale clinical setting. Methods: A total of 1 079 subjects who underwent partial hepatectomy were examined with 2D-SWE to measure liver stiffness before operation and the liver stiffness measurements were compared with histologic findings.The published cutoff values of liver stiffness examined with 2D-SWE were used as a reference, as 7.2, 9.2, and 10.4 kPa for diagnosing substantial fibrosis(S2), severe fibrosis(S3), and cirrhosis(S4), respectively.The area under curve(AUC)was calculated to verify the value of 2D-SWE in the evaluation of hepatic fibrosis. Results: Compared with the pathological diagnosis, the AUC of 2D-SWE in diagnosing substantial fibrosis(S2), severe fibrosis(S3), and cirrhosis(S4)were 0.976, 0.981, and 0.968, the sensitivity were 95.3%, 92.6%, and 93.5%, the specificity were 87.8%, 87.5% and 89.3%, and the accuracy were 88.8%, 90.0% and 91.0%, respectively(P<0.05). Conclusion: 2D-SWE is an effective imaging tool for noninvasive diagnosis of hepatic fibrosis.

[Relationship between Helicobacter pylori infection and miR-24-3p expression during the development of gastric mucosa lesions]

Objectives: To explore the expression of micro RNA-24-3p (miR-24-3p) in different gastric mucosa lesions, and analyze the potential correlation between Helicobacter pylori (H.pylori) infection and miR-24-3p expression in different gastric lesions. Methods: 158 gastric biopsy specimens were divided into four groups, including 35 chronic superficial gastritis (CSG) samples, 43 chronic atrophic gastritis (CAG) samples, 41 intestinal metaplasia (IM) samples and 39 dysplasia (Dys) samples. Those samples were collected from patients undergoing gastroscopy at the Department of Gastroenterology, Aerospace Center Hospital, from September 2005 to June 2012. The expression of miR-24-3p was detected using in situ hybridization. H. pylori infection status was determined by rapid urease test and Warthin-Starry stain. Results: Higher expression rate of miR-24-3p was observed in CSG compared with those in CAG, IM and Dys, respectively. The miR-24-3p expression rate in CSG with H. pylori infection was significantly lower than that without H. pylori infection (P=0.001), but it was not observed in CAG, IM and Dys groups (all P>0.05). Conclusions: MiR-24-3p was highly expressed at the early stage of gastric mucosal lesion. Attenuation of miR-24-3p expression is associated with the development of severe gastric mucosa lesions. H. pylori may play a role in miR-24-3p regulation in the early stage of gastric mucosa lesions.

A magnetic topological semimetal Sr1-yMn1-zSb2 (y, z < 0.1)

Weyl (WSMs) evolve from Dirac semimetals in the presence of broken time-reversal symmetry (TRS) or space-inversion symmetry. The WSM phases in TaAs-class materials and photonic crystals are due to the loss of space-inversion symmetry. For TRS-breaking WSMs, despite numerous theoretical and experimental efforts, few examples have been reported. In this Article, we report a new type of magnetic semimetal Sr_1-yMn_1-zSb₂ (y, z < 0.1) with nearly massless relativistic fermion behaviour (m^∗ =  0.04 - 0.05m₀, where m₀ is the free-electron mass). This material exhibits a ferromagnetic order for 304 K  <  T  <  565 K, but a canted antiferromagnetic order with a ferromagnetic component for T  <  304 K. The combination of relativistic fermion behaviour and ferromagnetism in Sr_1-yMn_1-zSb₂ offers a rare opportunity to investigate the interplay between relativistic fermions and spontaneous TRS breaking.

Designing of metallic nanocrystals embedded in non-stoichiometric perovskite nanomaterial and its surface-electronic characteristics

Engineering of novel functional nanocomposite as like as the metallic nanocrystals supported non-stoichiometric perovskite nanomaterial in controlled parameters (size, shape and ratio of chemical characteristics) is a challengeable task. In this context, we present a facile route to fabricate and study its physicochemical property at real time mode in this report. Nanoscale pure Pb crystals surfaced on non-stoichiometric A-site deficient Pb_1-xTiO_3-y nanoparticle were fabricated when a precursor lead titanate (PbTiO₃) nanoparticle was exposed to an electron beam irradiation (EBI) in a transmission electron microscope (TEM) at ambient temperature. In the state of the art, the chemical states and electronic structure of non-irradiated and irradiated PbTiO₃ were studied by X-ray photoelectron spectroscopy (XPS). Electron bombardment resulted in a new visible feature at low binding energy in the Pb 4f core level, while Ti 2p and O 1s line shape showed slight changes. The Fermi level of the corresponding materials was determined to be 1.65 ± 0.1 eV and 2.05 ± 0.1 eV above the valence band maximum, respectively. The normal, weakly p-type PTO exhibits peculiar n-type feature after EBI process (The Fermi level moves near to the conduction band). A feasible mechanism is proposed involving the electron-stimulated local bond-breaking phenomenon in PbTiO₃.

[Screening for effective antibiotics in chronic suppurative otitis media]

Objective:To explore the method of screening effective antibiotics in active stage of otitis media, in order to lay ground for rational clinical application of antibiotics in this scenario.Method:The clinical data of 198 patients diagnosed as otitis media were analyzed. Based on the results of bacterial culture and drug sensitivity test of middle ear secretion, the clinical availability and the ototoxicity of corresponding drugs, first and second line drugs were screened to control infection. The therapeutic effect of drugs was summarized.Result:In 21 out of 198 cases, there was no growth of common bacteria, while in the remaining 177 cases, there were 36 cases(20.34%) of coagulase negative staphylococcus, which was sensitive to linezolid, vancomycin, cefuroxime, levofloxacin, SMZ-TMP, and rifampin; 30 cases(16.95%) of pseudomonas aeruginosa, which was sensitive to meropenem, imipenem, ceftazidime, amikacin, and piperacillin; and 26 cases(14.69%) of staphylococcus aureus, which was sensitive to linezolid, vancomycin, oxacilin, gentamycin, levofloxacin, ciprofloxacin, moxifloxacin. Drugs that were administrated based on experience including: local use of levofloxacin eardrops, cefuroxime and moxifloxacin as first line oral antibiotics, and ceftazidime as second line oral antibiotics. There were 3 cases of post-operational infection, which recovered after systemic and local use of sensitive drugs and dressing.Conclusion:In otitis media, sensitive antibiotics chosen from results of bacterial culture and drug sensitivity test, are useful in reducing the complication of infection after surgery.

Giant linear strain gradient with extremely low elastic energy in a perovskite nanostructure array

Although elastic strains, particularly inhomogeneous strains, are able to tune, enhance or create novel properties of some nanoscale functional materials, potential devices dominated by inhomogeneous strains have not been achieved so far. Here we report a fabrication of inhomogeneous strains with a linear gradient as giant as 10⁶ per metre, featuring an extremely lower elastic energy cost compared with a uniformly strained state. The present strain gradient, resulting from the disclinations in the BiFeO₃ nanostructures array grown on LaAlO₃ substrates via a high deposition flux, induces a polarization of several microcoulomb per square centimetre. It leads to a large built-in electric field of several megavoltage per metre, and gives rise to a large enhancement of solar absorption. Our results indicate that it is possible to build up large-scale strain-dominated nanostructures with exotic properties, which in turn could be useful in the development of novel devices for electromechanical and photoelectric applications.

Microbial diversity in raw milk and traditional fermented dairy products (Hurood cheese and Jueke) from Inner Mongolia, China

Hurood cheese (HC) and Jueke (Jk) are 2 traditional fermented dairy products produced from raw milk (RM) in the Inner Mongolia region of China. They have a long history of production and consumption. The microbial compositions of RM, HC, and Jk vary greatly, and are influenced by their geographical origins and unique processing methods. In this study, 2 batches of RM, HC, and Jk samples were collected (April and August 2015) from the Zhenglan Banner, a region located in the southern part of Inner Mongolian belonging to the Xilingol league prefecture. The bacterial and fungal diversities of the samples were determined by 16S rRNA and 18S rRNA gene sequence analysis, respectively. A total of 112 bacterial and 30 fungal sequences were identified, with Firmicutes and Ascomycota being the predominant phyla for bacteria and fungi, respectively. Lactococcus and Lactobacillus were identified as the main bacterial genera, whereas Kluyveromyces was the predominant fungus identified in the 3 dairy products. Different bacterial and fungal compositions were observed in RM, HC, and Jk samples collected at different times. These results suggested that time of production may be an important factor influencing the microbial diversity present in RM, HC, and Jk.

[Analysis of tumor necrosis factor-α and zinc finger protein 36 gene polymorphism for patients with obstructive sleep apnea syndrome]

Objective:To investigate the association between obstructive sleep apnea hypopnea syndrome (OSAHS) and tumor necrosis factor(TNF) -α and zinc finger protein 36 (ZFP36) gene polymorphisms.Method:Two hundred and four patients with OSAHS were enrolled as study group. Meanwhile, 97 healthy subjects were selected as control group. Three sites of ZFP36 gene (rs17879933, rs3746083 and rs251864) were detected by TaqMan-PCR method. The levels of TNF-α and other biochemical markers were detected by radioimmunoassay, and relevant indicators of breathing during sleep at night of all the subjects were recorded by Monet32 system. Result:The levels of TNF-α, total cholesterol, uric acid, diastolic blood pressure, systolic blood pressure, body mass index, abdominal circumference and neck circumference were significantly higher in the study group than those in the control group (all P< 0.05). The genotype and allele frequencies of rs251864 and rs17879933 were significantly different between the study group and the control group (all P< 0.05). The levels of abdominal circumference, BMI, TNF-α and TG in patients with rs251864 GG and rs17879933 Ⅱ genotypes were significantly higher than those with the other two genotypes (all P< 0.05). There was no significant difference in all the sleep respiration indexes between the three genotypes of ZFP36 (all P< 0.05). Logistic regression analysis showed that there was no correlation between three polymorphisms of ZFP36 and OSAHS after controlling a series of factors such as gender and age.Conclusion:ZFP36 may be involved in the pathogenesis of OSAHS by modulating inflammatory factors such as TNF-α and interfering with metabolism. ZFP36 mutation at three sites is not an independent risk factor for OSAHS.

Millimeter-wave imaging diagnostics systems on the EAST tokamak (invited)

Millimeter-wave imaging diagnostics, with large poloidal span and wide radial range, have been developed on the EAST tokamak for visualization of 2D electron temperature and density fluctuations. A 384 channel (24 poloidal × 16 radial) Electron Cyclotron Emission Imaging (ECEI) system in F-band (90-140 GHz) was installed on the EAST tokamak in 2012 to provide 2D electron temperature fluctuation images with high spatial and temporal resolution. A co-located Microwave Imaging Reflectometry (MIR) will be installed for imaging of density fluctuations by December 2016. This "4th generation" MIR system has eight independent frequency illumination beams in W-band (75-110 GHz) driven by fast tuning synthesizers and active multipliers. Both of these advanced millimeter-wave imaging diagnostic systems have applied the latest techniques. A novel design philosophy "general optics structure" has been employed for the design of the ECEI and MIR receiver optics with large aperture. The extended radial and poloidal coverage of ECEI on EAST is made possible by innovations in the design of front-end optics. The front-end optical structures of the two imaging diagnostics, ECEI and MIR, have been integrated into a compact system, including the ECEI receiver and MIR transmitter and receiver. Two imaging systems share the same mid-plane port for simultaneous, co-located 2D fluctuation measurements of electron density and temperature. An intelligent remote-control is utilized in the MIR electronics systems to maintain focusing at the desired radial region even with density variations by remotely tuning the probe frequencies in about 200 μs. A similar intelligent technique has also been applied on the ECEI IF system, with remote configuration of the attenuations for each channel.

Design of the 2D electron cyclotron emission imaging instrument for the J-TEXT tokamak

A new 2D Electron Cyclotron Emission Imaging (ECEI) diagnostic is being developed for the J-TEXT tokamak. It will provide the 2D electron temperature information with high spatial, temporal, and temperature resolution. The new ECEI instrument is being designed to support fundamental physics investigations on J-TEXT including MHD, disruption prediction, and energy transport. The diagnostic contains two dual dipole antenna arrays corresponding to F band (90-140 GHz) and W band (75-110 GHz), respectively, and comprises a total of 256 channels. The system can observe the same magnetic surface at both the high field side and low field side simultaneously. An advanced optical system has been designed which permits the two arrays to focus on a wide continuous region or two radially separate regions with high imaging spatial resolution. It also incorporates excellent field curvature correction with field curvature adjustment lenses. An overview of the diagnostic and the technical progress including the new remote control technique are presented.

Misfit Strain Relaxation of Ferroelectric PbTiO3/LaAlO3 (111) Thin Film System

Ferroelectric thin films grown on high index substrates show unusual structural and switching dynamics due to their special strain states. Understanding the misfit relaxation behavior is crucial to facilitate the high index thin film growth with improved quality. In this paper, ferroelectric PbTiO₃ thin films were grown on LaAlO₃ (111) substrates by pulsed laser deposition technique. The microstructures were investigated by combinations of conventional and aberration-corrected transmission electron microscopy. Diffraction contrast analysis and high resolution imaging reveal that high density interfacial dislocations were distributed at the interfaces. These dislocations have mixed character with Burgers vectors of a <110> and line directions of <112>. The edge components of the dislocations, with the Burgers vectors parallel to the interface, accommodate the lattice mismatch and are the main contributor to the misfit relaxation of this system. The formation mechanism of these dislocations is proposed and discussed to elucidate the novel mismatch relaxation behavior of <111> oriented perovskite films.