Lymphovenous anastomosis and complex decongestive therapy for severe deformed lymphedema with recurrent infection: A case report.

BACKGROUND: Lower extremity lymphedema is a common complication following treatment for gynecological malignancies. Its incidence rate can reach up to 70%, affecting ~20 million people worldwide. However, specialized treatment centers are scarce, and there is a lack of consensus on treatment approaches. Furthermore, there are even fewer reports on the systematic and effective treatment of severe lymphedema with malformations. Effective management of this condition remains a significant challenge for clinicians. CASE SUMMARY: A 40-year-old woman developed bilateral leg swelling 6 years after receiving treatment for endometrial cancer. Since August 2018, she experienced > 30 episodes of lymphangitis. Upon presentation, she exhibited bilateral leg swelling and deformation, with four large swellings in the posterior thigh that impeded movement, and pain in the limbs. Skin manifestations included lichenoid lesions and features of deep sclerosis. Radionuclide lymphoscintigraphy confirmed the diagnosis of lower limb lymphedema. After 6 mo of complex decongestive therapy (CDT) and three lymphaticovenous anastomosis (LVA) treatments, the patient lost 49 kg in weight. She also experienced a maximum circumference reduction of 35.2 cm in the left lower limb and 37.5 cm in the right lower limb. The leg pain disappeared, her swelling significantly decreased, and she regained the ability to walk, cycle, and run normally. CONCLUSION: The combined application of CDT and LVA therapy demonstrates significant positive effects in the treatment of severe, deformed stage III lymphedema.

Chiral photon blockade in the spinning Kerr resonator.

We propose how to achieve chiral photon blockade by spinning a nonlinear optical resonator. We show that by driving such a device at a fixed direction, completely different quantum effects can emerge for the counter-propagating optical modes, due to the spinning-induced breaking of time-reversal symmetry, which otherwise is unattainable for the same device in the static regime. Also, we find that in comparison with the static case, robust non-classical correlations against random backscattering losses can be achieved for such a quantum chiral system. Our work, extending previous works on the spontaneous breaking of optical chiral symmetry from the classical to purely quantum regimes, can stimulate more efforts towards making and utilizing various chiral quantum effects, including applications for chiral quantum networks or noise-tolerant quantum sensors.

Anisotropic optical property of ferroelectric Bi2O2X(X = S,Se,Te) monolayer and strain engineering.

Based on the first-principles calculations, ferroelectricBi2O2X(X=S,Se,Te)monolayers with unequivalent in-plane lattice constants are confirmed to be the ground state, which is consistent with the experiment result (Ghoshet al2019Nano Lett.195703-09), and the anisotropic optical property is firstly investigated. We find that the polarizations ofBi2O2Xmonolayers points along the direction ofa-axis, andBi2O2Temonolayer process the largest polarization. Furthermore, both the biaxial and uniaxial strains are favor for the enhancement of polarization ofBi2O2Xmonolayers. It should be mentioned that the type of band gap will convert from indirect to direct forBi2O2Temonolayer when thea-axial tensile strain is larger than 2%. At last, the optical absorption coefficient forBi2O2Xmonolayers are calculated, and we obtain thatBi2O2Temonolayer has the strongest optical absorption within the range of visible light, the anisotropy and possible strain engineering to improve the optical absorption are discussed in detail. Our findings are significant in fields of optoelectronics and photovoltaics.

Clinical Efficacy of Percutaneous Osteoplasty Under Fluoroscopy and Cone-Beam CT Guidance for Painful Sternal Metastases: A Case Series.

Background: Although percutaneous osteoplasty (POP) has been widely accepted and is now being performed for the treatment of painful bone metastases outside the spine. It is emerging as one of the most promising procedures for patients with painful bone metastasis who are unsuitable for surgery or who show resistance to radiotherapy and/or analgesic therapies. However, there are only scarce reports regarding osteoplasty in painful sternal metastases. Subjects and Method: We report four patients with sternal metastases suffered with severe pain of anterior chest wall. The original tumors included lung cancer and thyroid cancer. For the initially pain medication failing, all the four patients received POP procedure under fluoroscopic and cone-beam CT (CBCT) guidance, and obtained satisfying resolution of painful symptoms at 6-month postop follow-up. Conclusion: POP is a safe and effective treatment for pain caused by metastatic bone tumors in the sternum. In practice, however, percutaneous puncture of pathologic sternal fractures can be a challenge because of the long flat contour and the defacement by lytic tumor of bony landmarks. We find that the use of fluoroscopic and CBCT can facilitate POP for flat bone fractures with displacing the trajectory planning, needle advancement, and cement delivery in time.

Coexisting Magnetism, Ferroelectric, and Ferrovalley Multiferroic in Stacking-Dependent Two-Dimensional Materials.

Two-dimensional (2D) multiferroic materials have widespread application prospects in facilitating the integration and miniaturization of nanodevices. However, the magnetic, ferroelectric, and ferrovalley properties in one 2D material are rarely coupled. Here, we propose a mechanism for manipulating magnetism, ferroelectric, and valley polarization by interlayer sliding in a 2D bilayer material. Monolayer GdI2 is a ferromagnetic semiconductor with a valley polarization of up to 155.5 meV. More interestingly, the magnetism and valley polarization of bilayer GdI2 can be strongly coupled by sliding ferroelectricity, making these tunable and reversible. In addition, we uncover the microscopic mechanism of the magnetic phase transition by a spin Hamiltonian and electron hopping between layers. Our findings offer a new direction for investigating 2D multiferroic devices with implications for next-generation electronic, valleytronic, and spintronic devices.

Tailoring angle dependent ferroelectricity in nanoribbons of group-IV monochalcogenides.

Ferroelectricity is significant in low dimensional structures due to the potential applications in multifunctional nanodevices. In this work, the tailoring angle dependent ferroelectricity is systematically investigated for the nanoribbons and nanowires of puckered group-IV monochalcogenides MX (M =Ge,Sn; X =S,Se). Based on first-principles calculations, it is found that the ferroelectricity of nanoribbon and nanowire strongly depends on the tailoring angle. Firstly, the critical width for the bare nanoribbon of group-IV monochalcogenide is obtained and discussed. As the nanowires are concerned, the ferroelectricity will disappear when the tailoring angle becomes small. At last, H-passivation on the edge and the strain engineering are employed to improve the ferroelectricity of nanoribbon, and it is obtained that H-passivation is beneficial to the enhancement of polarization for nanoribbons tailored near the armchair direction, while the polarization of nanoribbons tailored along the diagonal direction will decrease when the edges are passivated with H atoms, and the tensile strain along the length direction always favors the improvement of ferroelectricity of the considered nanoribbons. Therefore, tailoring angle has great influence on the ferroelectricity of nanoribbons and nanowires, which may be used as an effective way to tune the ferroelectricity and further the electronic structures of nanostructures in the field of nanoelectronics.

Multiple-photon bundle emission in the n-photon Jaynes-Cummings model.

We study the multiple-photon bundle emission in the n-photon Jaynes-Cummings model composed of a two-level system coupled to a single-mode optical field via the n-photon exciting process. Here, the two-level system is strongly driven by a near-resonant monochromatic field, and hence the system can work in the Mollow regime, in which a super-Rabi oscillation between the zero-photon state and the n-photon state can take place under proper resonant conditions. We calculate the photon number populations and the standard equal-time high-order correlation functions, and find that the multiple-photon bundle emission can occur in this system. The multiple-photon bundle emission is also confirmed by investigating the quantum trajectories of the state populations and both the standard and generalized time-delay second-order correlation functions for multiple-photon bundle. Our work paves the way towards the study of multiple-photon quantum coherent devices, with potential application in quantum information sciences and technologies.

Recovery of neurosurgical high-frequency electroporation injury in the canine brain can be accelerated by 7,8-dihydroxyflavone.

BACKGROUND: Although traumatic brain injury (TBI) occurs in a very short time, the biological consequence of a TBI, such as Alzheimer's disease, may last a lifetime. To date, effective interventions are not available to improve recovery from a TBI. Herein we aimed to ascertain whether recovery of neurosurgical high-frequency irreversible electroporation (HFIRE) injury in brain tissues can be accelerated by 7,8-dihydroxyflavone (7,8-DHF). METHODS: The HFIRE injury was induced in the right parietal cortex of 8 adult healthy and neurologically intact male dogs. Two weeks before HFIRE injury, each dog was administered orally with or without 7,8-DHF (30 mg/kg) once daily for consecutive 2 weeks (n = 4 for each group). The values of blood-brain barrier (BBB) disruption, brain edema, and cerebral infarction volumes were measured. The concentrations of beta-amyloid, interleukin-1ß, interleukin-6 and tumor necrosis factor-α in the cerebrospinal fluid were measured biochemically. RESULTS: The BBB disruption, brain edema, infarction volumes, and maximal cross-section area caused by HFIRE injury in canine brain were significantly attenuated by 7,8-DHF therapy (P < 0.0001). Additionally, 7,8-DHF significantly reduced the HFIRE-induced cerebral overproduction of beta-amyloid and proinflammatory cytokines in the cerebrospinal fluid (P < 0.0001) in dogs with HFIRE. CONCLUSIONS: Recovery of neurosurgical HFIRE injury in canine brain tissues can be accelerated by 7,8-DHT via ameliorating BBB disruption as well as cerebral overproduction of both beta-amyloid and proinflammatory cytokines.

Real-world applications of PARPi maintenance therapy for recurrent ovarian cancer: A single-center study in China.

OBJECTIVE: To assess the actual clinical application of poly (adenosine diphosphate-ribose) polymerase inhibitor (PARPi) maintenance therapy in Chinese patients with recurrent ovarian cancer, and to explore prognostic factors associated with progression-free survival (PFS). METHODS: We retrospectively assessed real-world clinical data from our hospital using the inclusion and exclusion criteria of representative randomized controlled trials, analyzed the prognosis, and performed univariate and multivariate analyses of prognostic factors. RESULTS: Between 2019 and 2022, the proportion of platinum-sensitive recurrence ovarian cancer patients who received PARPi maintenance therapy increased to 29.6%, 53.3%, 43.8% and 62.2%, respectively, each year. A total of 48 patients were included in the prognostic analysis, of which 32 and 16 received olaparib and niraparib, respectively. Using the criteria of the Study19 and SOLO2 studies, the olaparib group in our patients had coincidence rates of 56.3% and 18.8%, respectively. Using the criteria of the NOVA and NORA studies, the niraparib group had coincidence rates of 31.3% and 37.5%, respectively. Median PFS was 26.1 months (95% CI 20.2-32.1). Response to primary therapy was an independent prognostic factor for PFS (relative risk, 3.248; 95% CI 1.081-9.757, P = 0.036). CONCLUSIONS: PARPi maintenance therapy was also effective in real world applications. Complete response (CR) to primary therapy was an independent factor favorably affecting PFS. Therefore, primary treatment choices aimed at optimal cytoreduction during primary surgery and improving the CR rate should still be considered, which positively affects the long-term prognosis of patients in the new treatment mode.

Percutaneous Vertebroplasty Using a Rotary Cutter for Treating Kümmell's Disease with Intravertebral Vacuum Cleft.

BACKGROUND: Reported data indicate that the curative effect of percutaneous vertebroplasty (PVP) on the patients with intravertebral vacuum cleft (IVC) is worse than on those without IVC. OBJECTIVES: This study was to prospectively investigate the advantage of rotary cutter-PVP (RC-PVP) in patients with Kümmell's disease with IVC. STUDY DESIGN: A prospective outcome study. SETTING: A tertiary care hospital. METHODS: Patients who underwent conventional PVP served as the control group. For the RC-PVP group, the rotary cutters were applied before the cement injection to destroy the IVC structure and the surrounding necrotic bone. The following data were compared between the two groups: the cement filling patterns, effective therapeutic rate, the pre- to post-procedural changes of spinal geometry, and the subsequent fractures. RESULTS: This study included a total of 64 patients (30 and 34 patients in RC-PVP group and control group, respectively). In the RC-PVP group, the cement in 26 cases was filled as a mixed pattern, while the filling pattern in the control group was mainly the cystic type (n = 31). There were no significant differences in the height restoration rate between the RC-PVP and control groups (32.7 ± 13.6 and 32.4 ± 13.9, respectively, P = 0.93). The RC-PVP group had a higher effective rate during the first week and the first month (93.3% vs. 70.6%, P = 0.02) and at 3 months (90.4% vs. 73.9%, P = 0.03). Long-term follow-up indicated that vertebral recollapse of the same treated vertebral body occurred in 5 patients after conventional PVP, which was not observed in the RC-PVP group. LIMITATIONS: The small number of included patients and no long-term follow-up. CONCLUSIONS: RC-PVP, with the destruction of IVC, may lead to better clinical outcomes with fewer complications.

Is studying medicine good for your health? Long-term health outcomes of a cohort of clinical medicine graduates in England and Wales in the ONS Longitudinal Study.

OBJECTIVE: To quantify the potential protective effect on health associated with study of a clinical medicine degree. DESIGN: Prospective population-based cohort data collected at census and linked over time: cohort born before 1976 and survived to 2011. Subgroup analysis on those who reported having a degree at 1991 census. SETTING: England and Wales population-based, including institutions. PARTICIPANTS: 159 116 men and 174 062 women; 13 390 men with degrees and 8143 women with degrees. MAIN OUTCOME MEASURE: Self-reported general health in 2011 based on logistic regression analysis. RESULTS: Male graduates had 92% higher odds of having good or very good health than male non-graduates after adjustment for age and socioeconomic position (CI 1.82 to 2.03). Female graduates had 85% higher odds of having good or very good health than female non-graduates after adjustment for age and socioeconomic position (CI 1.73 to 1.98). Male clinical medicine graduates had 45% higher odds of having good or very good health than male humanities graduates after adjustment for age and socioeconomic position (CI 1.09 to 1.92). Male physical sciences graduates also had higher odds of having good or very good health than male humanities graduates after adjustment for age and socioeconomic position, but life sciences and social science graduates did not. There were no significant differences by degree subject for women. CONCLUSIONS: Male graduates in clinical medicine have higher odds of good self-reported health. Knowledge of medicine may confer a health advantage for men above that of other degrees.

Percutaneous vertebral augmentation using drill rotation for osteoporotic vertebral compression fractures with intravertebral vacuum cleft.

OBJECTIVE: To evaluate the efficacy of a new technique of percutaneous vertebral augmentation (PVA): drill rotation-cement injected under vacuum aspiration (DR-CIVAS) for vertebral compression fractures (OVCFs) with intravertebral vacuum cleft (IVC) sign. MATERIALS AND METHODS: A retrospective study was conducted in 46 consecutive patients with OVCFs and IVC signs, who underwent PVA using DR-CIVAS (n = 22, DR-CIVAS group) or traditional technique without DR-CIVAS (n = 24, control group). The pre- and postoperative vertebral height and wedge angle change and visual analog scale (VAS), the volume of cement injected, incidences of cement leakage, and subsequent new vertebral compression fractures were evaluated between the two groups. RESULTS: No significant difference was found in cement leakage incidences, pre- and postoperative VAS scores, vertebral height, and wedge angle change between the two groups. The mean cement volume was significantly higher (P < 0.001) in DR-CIVAS group (4.87 mL) than in the control group (3.58 mL). Of the 22 patients in DR-CIVAS group, the subsequent fractures occurred in 2 cases (9.1%) located in the nonadjacent levels. In the control group, the subsequent fractures occurred in 6 cases (25.0%) located in the adjacent level (n = 1) and the augmented levels (n = 5). Although DR-CIVAS group did not demonstrate a statistical reduction of the incidence of subsequent fractures (P = 0.25), the subgroup analysis revealed that subsequent fractures frequently involved the augmented level in the control group (P = 0.04). CONCLUSIONS: PVA with DR-CIVAS technique is effective for OVCFs with IVC sign, with lower incidences of subsequent new vertebral compression fractures in the augmented vertebra.

First-principle study of sulfur vacancy and O2 adsorption on the electronic and optical properties of ferroelectric CuInP2S6 monolayer.

Sulfur vacancy in MoS2 has been found to have an important influence on the performance of optoelectronic devices. Here, we study the effect of sulfur vacancy and O2 adsorption on the electronic and optical properties in the two-dimensional ferroelectric CuInP2S6. It is revealed that a defect state appears at the top of valence band with the presence of sulfur vacancy. However, when O2 is chemisorbed at sulfur vacancy, the defect state disappears. The variation of charge state and charge transfer are calculated and discussed. Although the ferroelectricity is greatly suppressed with the presence of sulfur vacancy, the ferroelectric state can be recovered when the O2 is adsorbed. Within the framework of GW + BSE method, the optical absorption edge of CuInP2S6 monolayer exhibits a red-shift for the presence of sulfur vacancy and further O2 adsorption gives rise to a blue-shift of the spectrum. Our findings have shown an effective way to improve the functionality of two-dimensional ferroelectrics via defect engineering.

Phonon blockade in a nanomechanical resonator quadratically coupled to a two-level system.

We investigate phonon statistics in a nanomechanical resonator (NAMR), which is quadratically coupled to a two-level system, by driving the NAMR and two-level system simultaneously. We find that unconventional phonon blockade (UCPNB), i.e., strong phonon antibunching effect based on quantum interference, can be observed when driven fields are weak. By increasing the strengths of the driving fields, we show the crossover from the UCPNB to the conventional phonon blockade (CPNB), which is induced by the strong nonlinear interaction of the system. Moreover, under the strong coupling condition for CPNB, quantum interference effect can also be used to enhanced the phonon blockade by optimizing the phase difference of the two external driving fields.

[Development of resources, technologies and services at the China Zebrafish Resource Center].

With the rapid growth of the Chinese zebrafish community, there is an increasing demand for various types of zebrafish-related resources and technologies. The China Zebrafish Resource Center (CZRC, web: http://zfish.cn) was established at the Institute of Hydrobiology (IHB), Chinese Academy of Sciences (CAS) in 2012. Till now, CZRC has built the largest zebrafish aquaculture unit in China, organized a resource bank containing more than 1200 zebrafish lines and more than 10 000 frozen sperm samples, among which over 200 mutant and transgenic lines were generated by CZRC. CZRC has established several technical supporting platforms, such as the zebrafish husbandry and health control program of international standard, a high-efficient gene manipulation technology platform, and a stable and efficient sperm cryopreservation technology platform. The main task of CZRC is to provide different types of services to zebrafish investigators in China and worldwide, such as resource services (e.g. zebrafish lines), technical services (e.g. gene knockout) and transgenic services, consultancy services (e.g. zebrafish husbandry and health consultation), and conference services [e.g. holding regular technical training courses and biennale Chinese Zebrafish Principal Investigator Meeting (CZPM)]. After five years' development, CZRC is now recognized as one of the three major resource centers in the global zebrafish community.

Tunable phonon blockade in quadratically coupled optomechanical systems.

We theoretically investigate the phonon statistics of a quadratically coupled optomechanical system, in which an effective second-order nonlinear interaction between an optical mode and a mechanical mode is induced by a strong optical driving field on two-phonon red-sideband resonance. We show that strong phonon antibunching can be observed even if the strength of the effective second-order nonlinear interaction is much weaker than the decay rates of the system, by driving the optical and mechanical modes with weak driving fields respectively. Moreover, the phonon statistics can be dynamically controlled by tuning the strengths and the phase difference of the weak driving fields. The scheme proposed here can be used to realize tunable single-phonon sources with quadratically optomechanical coupling.

[Delayed decompression for cauda equina syndrome secondary to lumbar disc herniation: long-term follow-up results].

OBJECTIVE: To assess the impact of delayed decompression on long-term neurological and bladder function recovery in patients with cauda equina syndrome (CES) secondary to lumbar disc herniation (LDH). METHODS: The clinical data of 35 patients receiving delayed decompression surgery for CES secondary to LDH were reviewed. The bladder empty function, bowel control, sexual ability and neurological functions of the lower limbs were evaluated after the operation, and the urodynamic changes were assessed in 6 patients with urodynamic data before and after the operation. RESULTS: Surgical decompression was performed at 4.1∓3.9 weeks in 12 patients with complete CES and at 5.5∓7.6 weeks in 23 patients with incomplete CES after the onset of symptoms. The patients were followed up for a mean of 43.0∓28.9 months (3-110 months). In the 23 patients with incomplete CES, 19 obtained full recovery, 4 had slight sensory alterations in the saddle area or the lower limbs. In the 12 patients with complete CES, 2 had full recovery, 4 reported slight sensory alterations in the saddle area or the lower limbs (including 2 with occasional constipation); 6 still had sense deficit in the saddle area and difficulties in bladder or bowl emptying, but they all reported significant improvements compared to the condition before operation. Urodynamic analysis in the 6 patients with pre- and postoperative urodynamic data showed increased abdominal pressure when voiding with significantly reduced residual urine in all the 6 patients; 4 patients with abnormal first desire volume before operation reported recovery after the operation. CONCLUSION: Patients with LDH-induced CES who missed the chance of early decompression can still expect favorable functional recovery in the long term. The improvement of bladder function following decompression is probably a result of recovery of bladder sensation and the compensation by increased intra-abdominal pressure. The key strategy to promote bladder function recovery in these patients is to promote the detrusor recovery.