Promising Mass-Productive 4-Inch Commercial SERS Sensor with Particle in Micro-Nano Porous Ag/Si/Ag Structure Using in Auxiliary Diagnosis of Early Lung Cancer.

The construction of commercial surface enhanced Raman scattering (SERS) sensors suitable for clinical applications is a pending problem, which is heavily limited by the low production of high-performance SERS bases, because they usually require fine or complicated micro/nano structures. To solve this issue, herein, a promising mass-productive 4-inch ultrasensitive SERS substrate available for early lung cancer diagnosis is proposed, which is designed with a special architecture of particle in micro-nano porous structure. Benefitting from the effective cascaded electric field coupling inside the particle-in-cavity structure and efficient Knudsen diffusion of molecules within the nanohole, the substrate exhibits remarkable SERS performance for gaseous malignancy biomarker, with the limit of detection is 0.1 ppb and the average relative standard deviation value at different scales (from cm2 to µm2 ) is ≈16.5%. In practical application, this large-sized sensor can be further divided into small ones (1 × 1 cm2 ), and more than 65 chips will be obtained from just one 4-inch wafer, greatly increasing the output of commercial SERS sensor. Further, a medical breath bag composed of this small chip is designed and studied in detail here, which suggested high-specificity recognition for lung cancer biomarker in mixed mimetic exhalation tests.

Multiple venous thromboembolisms in a pregnant patient carrying a novel mutation in SERPINC1 (p.M313T) that causes a transient antithrombin deficiency: a case report.

BACKGROUND: Congenital antithrombin deficiency is an autosomal dominant disease that results in deep venous thrombosis and pulmonary embolism, which is mainly caused by mutations in the antithrombin gene (SERPINC1). Since SERPINC1 is highly susceptible to alterations, severe structural and functional changes that promote thrombosis may occur. Clinical presentations vary from different alterations. We report a pregnant case with novel mutation in SERPINC1 presenting transient antithrombin deficiency and multiple venous thromboembolisms. CASE PRESENTATION: We report a case of a 36-year-old pregnant patient who was diagnosed with congenital antithrombin deficiency for carrying a novel heterozygous mutation, NM_000488:exon5:c.T9 38 C:p. M313T in SERPINC1 presenting transient antithrombin deficiency and multiple venous thromboembolisms. Thrombolytic with alteplase and anticoagulant therapies with low-molecular-weight heparin and warfarin were administrated. After confirming the genetic analysis and the termination of pregnancy, rivaroxaban was administrated, and the thrombosis reduced. CONCLUSIONS: Our study enriched the mutation database of SERPINC1 gene, provided some new theoretical basis for gene diagnosis and genetic counseling of patients with transient antithrombin deficiency. While it still needs for subsequent exploration of molecular pathogenesis.

Pregnancy outcomes in women with pulmonary hypertension: a retrospective study in China.

BACKGROUND: In recent years, with the development of monitoring conditions and the application of pulmonary vascular-targeted drugs, pregnancy outcomes in women with pulmonary hypertension (PH) have improved, but the maternal mortality rate is still high. The purpose of this study was to describe the maternal-foetal outcomes in pregnant women with PH. METHODS: The clinical data of 154 pregnant women with PH who were admitted to the Third Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2020 were collected and descriptively analysed. RESULTS: Among the 154 pregnant women with PH, 6 (3.9%) had idiopathic pulmonary arterial hypertension (iPAH), 41 (26.6%) had pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH), 45 (29.2%) had PAH related to other diseases (oPAH), and 62 (40.3%) had PH related to left heart disease (LHD-PH). The systolic pulmonary artery pressure (sPAP) was 36-49 mmHg in 53.2% of the patients, 50-69 mmHg in 22.1% of the patients and ≥ 70 mmHg in 24.7% of the patients. Five (3.2%) pregnant women died within 1 week after delivery; iPAH patients had the highest mortality rate (3/6, 50%). Fifty-four patients (35.1%) were admitted to the intensive care unit (ICU), and the incidence of heart failure during pregnancy was 14.9%. A total of 70.1% of the patients underwent caesarean section; 42.9% had premature infants; 28.6% had low-birth-weight (LBW) infants; 13.0% had very-low-birth-weight (VLBW) infants; 3.2% had extremely-low-birth-weight (ELBW) infants; 61% had small for gestational age (SGA) infants; and 1.9% experienced neonatal mortality. CONCLUSION: There were significant differences in the maternal-foetal outcomes in the iPAH, CHD-PAH, oPAH and LHD-PH groups. Maternal mortality was highest in the iPAH group; therefore, iPAH patients should be advised to prevent pregnancy. Standardized and multidiscipline-assisted maternal management is the key to improving maternal-foetal outcomes.

Vascular endothelial growth factor induces the migration of human airway smooth muscle cells by activating the RhoA/ROCK pathway.

BACKGROUND: Airway remodeling due to increased airway smooth muscle cell (ASMC) mass, likely due to enhanced proliferation, hypertrophy, and migration, has been proven to be highly correlated with decreased lung function in asthma patients. Vascular endothelial growth factor (VEGF) mediates vascular and extravascular remodeling and inflammation and has been proven to be involved in the progression of asthma. Previous studies have focused on the effects of VEGF on ASMC proliferation, but few researchers have focused on the effects of VEGF on human ASMC migration. The purpose of this study was to explore the effect of VEGF on the migration of ASMCs and its related signaling pathway mechanism to provide evidence for the treatment of airway remodeling. METHODS: We examined the effects of VEGF induction on ASMC migration and explored the mechanisms involved in ASMC migration. RESULTS: We found by wound healing and Transwell assays that VEGF promoted ASMC migration. Through the Cell Counting Kit-8 (CCK-8) experiment, we found that VEGF had no significant effect on the proliferation of ASMCs, which excluded the involvement of cell proliferation in the process of wound healing. Moreover, a cellular immunofluorescence assay showed that VEGF promoted F-actin reorganization, and Western blotting showed that VEGF improved RhoA activation and myosin phosphatase targeting subunit-1 (MYPT1) and myosin light chain (MLC) phosphorylation in ASMCs. Treatment with the ROCK inhibitor Y27632 significantly attenuated the effects of VEGF on MYPT1/MLC activation and cell migration. CONCLUSION: In conclusion, the results suggest that the promigratory function of VEGF activates the RhoA/ROCK pathway, induces F-actin reorganization, improves the migration of ASMCs, and provides a better rationale for targeting the RhoA/ROCK pathway for therapeutic approaches in airway remodeling.

Non-Hermitian mode-locking synthesized by parity-time and anti-parity-time symmetric modulations.

We study the pulse characteristics in a laser mode-locked by active modulators with non-Hermitian driven signals. The signal assembles a parity-time (P T) symmetric and an anti-parity-time (A P T) symmetric function with fundamental and harmonic frequencies, respectively, inducing the complex coupling between modes in the frequency domain. A one-dimensional synthetic lattice is used to analyze the spectral mode coupling. By enlarging the weight and harmonic order of the A P T part of the signal, the optical spectrum can be adjusted from redshift to blueshift. Simultaneously, the pulse duration and spectral width are shortened and broadened, respectively. The work explores the role of non-Hermitian modulation in the mode-locked laser area.

Precise real-time quantification for photocatalytic reaction: integration of the sensitivein-situSERS sensor and high-efficiency photocatalyst.

Recently,in-situsurface-enhanced Raman spectroscopy (SERS) is gradually becoming an important method for monitoring photocatalytic reaction processes, in which the quantification potential is a vital factor in determining whether this technology can be truly applied in the future. In order to improve the quantification performance ofin-situSERS and explore a precise operando Raman detection for photocatalytic reactions, an architecture of heterostructural Cu2O/ZnO/Ag nano round brush has been designed and discussed in this work. This structure is an integration of sensitivein-situSERS sensor and high-efficiency photocatalyst, realizing real-time monitoring of photocatalytic reaction in a wide concentration range from 20 to 3 mg l-1. The coefficient of determination between different detection methods is beyond 0.86 in this range, implying the high-precise quantification of this platform. Comprehensive analysis on structure effect, SERS performance, photocatalytic property, electric filed characteristic, etc were all systematically made and discussed in detail for this platform. This work presents a precise preliminar real-time photocatalytic monitoring usingin-situSERS detection, which is a new attempt and also meaningful reference for otherin-situanalytical technology.

Light localization in defective periodic photonic moiré-like lattices.

Photonic moiré-like lattices, a readily accessible platform for realizing the spatial localization of light, attract intensive attention due to their unique flatband characteristics. In this paper, a periodic moiré-like lattice with embedded defects is proposed theoretically, and the linear propagation of the probe beam in such a system is investigated intensively. The results show that the positions of defects in periodic moiré-like lattices depend on the sublattice rotation angle. Further studies show that the localization of light could be improved by adjusting the apodization function of defects. In addition, the experimental observation of the moiré-like lattice with apodized defects also confirms the theoretical analysis. Our study enriches the physical connotation of photonic moiré lattices and guides the design of novel photonic crystal fibers.

Generation of gradient photonic moiré lattice fields.

We designed and generated gradient photonic moiré lattice fields comprising three varying periodic moiré wavefields. Because of the common twisted angles between periodic triangular and hexagonal moiré wavefields, gradient patterns can be easily obtained through coherent superposition of hexagonal-triangular-hexagonal photonic moiré lattice fields. In addition, two specific twisted angles of Δα|C=3 and Δα|C=5 are proposed, which not only guarantee the periodicity of moiré fields but also provide an additional degree of freedom to control the structural arrangement of the gradient photonic moiré lattice fields. Further study reveals the non-diffracting character of the gradient photonic moiré lattice field generated using the holographic method. This study proposes an easy way to generate and control the structures of gradient moiré lattice fields that can be used to fabricate photonic lattices in optical storage media for light modulation.

Ultimate conversion efficiency of second harmonic generation in all-dielectric resonators of quasi-BICs in consideration of nonlinear refraction of dielectrics.

We investigate second harmonic generation (SHG) in all-dielectric resonance nanostructures of high-Q factors assisted by quasi-bound states in the continuum (quasi-BICs). The typical resonators, e.g., guided-mode resonance gratings and asymmetric metasurfaces, fabricated by AlGaAs were numerically studied with the consideration of nonlinear refraction of AlGaAs. The resonance peak and line-shape of linear transmission and SHG spectra in the resonators can be dramatically changed under intense pump intensities. The SHG conversion efficiency in the nanostructures working at quasi-BICs is much lower than the traditionally expected values without considering the nonlinear refraction of dielectrics. The ultimate SHG conversion efficiency is finally obtained. The investigation has the significance for the design and understanding of efficient nonlinear metasurfaces of high-Q factors.

Heterostructured Cu2O-Au nanowire as a dual-functional nanocomposite for environmental pollutant degradation and hydrogen peroxide sensing.

Materials engineering is generally regarded as one of the most effective methods in the construction of photocatalysts, but it still faces many challenges. In this context, we designed and prepared a three-dimensional (3D) heterostructure of nanowires (NWs) formed by Cu2O core and an Au shell. The Cu2O-Au NWs not only show fine photocatalytic ability but also proved to have Fenton-like chemical properties and can be used as a hydrogen peroxide sensor. Moreover, this heterostructure realizes an integration of catalytic efficiency, retrievability, and versatility. In further consideration of the facile preparation process and low-cost material source of the structure, the Cu2O-Au NWs show a promising application prospect in the field of multifunctional photocatalysts.

Low let-7d exosomes from pulmonary vascular endothelial cells drive lung pericyte fibrosis through the TGFßRI/FoxM1/Smad/ß-catenin pathway.

The pathogenesis of pulmonary fibrosis (PF) was mediated by the progressive deposition of excessive extracellular matrix, but little is known about the regulatory mechanisms of fibrogenesis by lung pericytes. The mouse PF model was established by treatment with bleomycin, followed by isolation of exosomes from mouse broncho-alveolar lavage fluids by the centrifuge method. Relative mRNA/microRNA levels and protein expression were assessed by qRT-PCR and Western blotting, respectively. The binding of let-7d with gene promoter was validated by dual-luciferase reporter assay. Protein interactions were verified via GST pull-down and co-immunoprecipitation. Nuclear retention of Smad3 was analysed by extraction of cytoplasmic and nuclear fraction of pericytes followed by Western blotting. Association of FoxM1 with gene promoter was detected by EMSA and ChIP-PCR methods. FoxM1 expression is significantly elevated in human lung fibroblasts of PF patients and mouse PF model. The expression of let-7d is repressed in exosomes derived from broncho-alveolar lavage fluids of PF mice. Let-7d or FoxM1 knockdown suppressed the expression of FoxM1, Smad3, ß-catenin, Col1A and α-SMA expression in mouse lung pericytes under TGF-ß1 treatment. FoxM1 overexpression elevated above gene expression in mouse lung pericytes under TGF-ß1 treatment. Let-7d directly targets TGFßRI to regulate FoxM1 and downstream gene expression in mouse lung pericytes. FoxM1 directly interacts with Smad3 proteins to promote Smad3 nuclear retention and binds with ß-catenin promoter sequence to promote fibrogenesis. Exosomes with low let-7d from pulmonary vascular endothelial cells drive lung pericyte fibrosis through activating the TGFßRI/FoxM1/Smad/ß-catenin signalling pathway.

Asymmetric localization and symmetric diffraction-free transmission in synthetic photonic lattice with anti-parity-time symmetry.

We study, to the best of our knowledge, the first observations of light propagation in synthetic photonic lattice with anti-parity-time symmetry by tuning the gain or loss of two coupled fiber rings alternatively and corresponding phase distribution periodically. By tuning the phase φ and the wave number Q in the lattice, asymmetric transmission of the light field can be achieved for both long and short loops when φ≠nπ/2 (n is an integer). Further investigations demonstrate that asymmetric localization of the light field in the long loop and symmetric diffraction-free transmission in two loops can both be realized by changing these two parameters. Our work provides a new method to obtain anti-parity-time symmetry in synthetic photonic lattice and paves a broad way to achieve novel optical manipulation in photonic devices.

Construction of photorefractive photonic quasicrystal microstructures by twisted square lattices.

A convenient method to fabricate two-dimensional photonic quasicrystal microstructures was experimentally demonstrated by using a rotatable four-wedge prism. Two-dimensional eightfold symmetric quasicrystal microstructures are formed by two groups of twisted square lattices in a photorefractive crystal. The experimental devices of this method are simple and stable without complicated optical adjustment equipment. Optical-induced quasicrystal microstructures are analyzed and verified by magnified imaging and far-field diffraction pattern imaging. The method can be extended to fabricate more complex quasicrystal and moiré lattice microstructures. We numerically demonstrate that this method can be used to fabricate other complex photonic microstructures by using different multi-wedge prisms and adjusting the rotation angle properly.

ZrSe2 nanosheet as saturable absorber for soliton operations within an Er-doped passive mode-locked fiber laser.

Two-dimensional materials have extensively promoted the development of ultrafast photonics in the past decade. In our work, the saturable absorption properties of ZrSe2 were presented. The saturation intensity, modulation depth, and nonlinear absorption coefficient of the ZrSe2 saturable absorber (SA) are about 13.14MW/cm2, 6.09%, and 1.85∗10-1cm/GW. In the experiment, based on the ZrSe2 SA, two types of solitons were recorded. A conventional soliton with a pulse width of 985 fs and a three-pulse bound state soliton have been obtained. Our experiment reveals that ZrSe2 can be employed for generating multiple ultrafast soliton generations and possess promising application in ultrafast photonics.

Analysis of volume management by comparing between critical care ultrasound examination and pulse indicator cardiac output in patients with septic shock.

OBJECTIVE: To investigate volume management by comparing between critical care ultrasound examination and pulse indicator cardiac output (PICCO) in patient with septic shock. METHODS: Patients with septic shock during July 2017 and June 2018 were included. Inferior Vena Cava (IVC), total end-diastolic volume index (GEDI), central venous pressure (CVP), lactic acid and oxygenation index were measured by ultrasound. First, the accuracy difference of IVC, GEDI and CVP estimation capacity was compared. According to the changes of IVCmin, IVCmax, and GEDI, they were divided into 5 groups to compare the differences of lactic acid and oxygenation index between the groups and the correlation of lactate and Oxygenation index (PaO2/FiO2) between IVC and GEDI was analyzed. The correlation of lactate and PaO2/FiO2 between B lines and extravascular pulmonary water index (ELWI) was noted. RESULTS: The accuracy of IVC and GEDI in volume estimation was greater than 75%, significantly higher than that of CVP (53.3%) (P<0.05). The correlation results showed that GEDI was significantly correlated with IVCmax and IVCmin (P<0.05), while there was a significant correlation between b-line area and oxygenation index, ELWI and lactic acid, ELWI and oxygenation index (P<0.05). IVCmin, IVCmax and GEDI were respectively divided into 5 groups for comparing the difference between lactic acid and oxygenation. It was found that there were significant differences between the two indicators of IVCmin in different groups (P>0.05). The oxygenation index of the group ≤IVCmax was significantly lower than that of the group 0.5 ≤IVCmax < 1.0cm (P<0.05). The oxgenation indexes of groups 500≤GEDI < 600mL/m2; 600≤GEDI < 700mL/m2. 700≤GEDI < 800mL/m2 were significantly higher than that of group 0 < GEDI < 500mL/m2 (P<0.05). CONCLUSIONS: Critical care ultrasound examination and PICCO are better methods than in volume management, but PICCO is more individualized, and PICCO in patients with valvular heart disease is not recommended.

Vortex degeneracy lifting and Aharonov-Bohm-like interference in deformed photonic graphene.

Photonic graphene, a honeycomb lattice of evanescently coupled waveguides, has provided a superior platform for investigating a host of fundamental phenomena such as unconventional edge states, synthetic magnetic fields, photonic Landau levels, Floquet topological insulators, and pseudospin effects. Here, we demonstrate both experimentally and numerically, topological vortex degeneracy lifting and Aharonov-Bohm-like interference from local deformation in a photonic honeycomb lattice. When a single valley is excited, lattice deformation leads to the generation of a vortex pair due to the lifting of degeneracy associated with pseudospin states. In the case of double-valley excitation, we observe the Aharonov-Bohm-like interference merely due to the deformation of the graphene lattice, which gives rise to an artificial gauge field. Our results may provide insight into the understanding of similar phenomena in other graphene-like materials and structures.

Yoga for asthma.

BACKGROUND: Asthma is a common chronic inflammatory disorder affecting about 300 million people worldwide. As a holistic therapy, yoga has the potential to relieve both the physical and psychological suffering of people with asthma, and its popularity has expanded globally. A number of clinical trials have been carried out to evaluate the effects of yoga practice, with inconsistent results. OBJECTIVES: To assess the effects of yoga in people with asthma. SEARCH METHODS: We systematically searched the Cochrane Airways Group Register of Trials, which is derived from systematic searches of bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO, and handsearching of respiratory journals and meeting abstracts. We also searched PEDro. We searched ClinicalTrials.gov and the WHO ICTRP search portal. We searched all databases from their inception to 22 July 2015, and used no restriction on language of publication. We checked the reference lists of eligible studies and relevant review articles for additional studies. We attempted to contact investigators of eligible studies and experts in the field to learn of other published and unpublished studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared yoga with usual care (or no intervention) or sham intervention in people with asthma and reported at least one of the following outcomes: quality of life, asthma symptom score, asthma control, lung function measures, asthma medication usage, and adverse events. DATA COLLECTION AND ANALYSIS: We extracted bibliographic information, characteristics of participants, characteristics of interventions and controls, characteristics of methodology, and results for the outcomes of our interest from eligible studies. For continuous outcomes, we used mean difference (MD) with 95% confidence interval (CI) to denote the treatment effects, if the outcomes were measured by the same scale across studies. Alternatively, if the outcomes were measured by different scales across studies, we used standardised mean difference (SMD) with 95% CI. For dichotomous outcomes, we used risk ratio (RR) with 95% CI to measure the treatment effects. We performed meta-analysis with Review Manager 5.3. We used the fixed-effect model to pool the data, unless there was substantial heterogeneity among studies, in which case we used the random-effects model instead. For outcomes inappropriate or impossible to pool quantitatively, we conducted a descriptive analysis and summarised the findings narratively. MAIN RESULTS: We included 15 RCTs with a total of 1048 participants. Most of the trials were conducted in India, followed by Europe and the United States. The majority of participants were adults of both sexes with mild to moderate asthma for six months to more than 23 years. Five studies included yoga breathing alone, while the other studies assessed yoga interventions that included breathing, posture, and meditation. Interventions lasted from two weeks to 54 months, for no more than six months in the majority of studies. The risk of bias was low across all domains in one study and unclear or high in at least one domain for the remainder.There was some evidence that yoga may improve quality of life (MD in Asthma Quality of Life Questionnaire (AQLQ) score per item 0.57 units on a 7-point scale, 95% CI 0.37 to 0.77; 5 studies; 375 participants), improve symptoms (SMD 0.37, 95% CI 0.09 to 0.65; 3 studies; 243 participants), and reduce medication usage (RR 5.35, 95% CI 1.29 to 22.11; 2 studies) in people with asthma. The MD for AQLQ score exceeded the minimal clinically important difference (MCID) of 0.5, but whether the mean changes exceeded the MCID for asthma symptoms is uncertain due to the lack of an established MCID in the severity scores used in the included studies. The effects of yoga on change from baseline forced expiratory volume in one second (MD 0.04 litres, 95% CI -0.10 to 0.19; 7 studies; 340 participants; I(2) = 68%) were not statistically significant. Two studies indicated improved asthma control, but due to very significant heterogeneity (I(2) = 98%) we did not pool data. No serious adverse events associated with yoga were reported, but the data on this outcome was limited. AUTHORS' CONCLUSIONS: We found moderate-quality evidence that yoga probably leads to small improvements in quality of life and symptoms in people with asthma. There is more uncertainty about potential adverse effects of yoga and its impact on lung function and medication usage. RCTs with a large sample size and high methodological and reporting quality are needed to confirm the effects of yoga for asthma.

NLS-RARα promotes proliferation and inhibits differentiation in HL-60 cells.

A unique mRNA produced in leukemic cells from a t(15;17) acute promyelocytic leukemia (APL) patient encodes a fusion protein between the retinoic acid receptor α (RARα) and a myeloid gene product called PML. Studies have reported that neutrophil elastase (NE) cleaves bcr-1-derived PML-RARα in early myeloid cells, leaving only the nuclear localization signal (NLS) of PML attached to RARα. The resultant NLS-RARα fusion protein mainly localizes to, and functions within, the cell nucleus. It is speculated that NLS-RARα may act in different ways from the wild-type RARα, but its biological characteristics have not been reported. This study takes two approaches. Firstly, the NLS-RARα was silenced with pNLS-RARα-shRNA. The mRNA and protein expression of NLS-RARα were detected by RT-PCR and Western blot respectively. Cell proliferation in vitro was assessed by MTT assay. Flow cytometry (FCM) was used to detect the differentiation of cells. Secondly, the NLS-RARα was over-expressed by preparation of recombinant adenovirus HL-60/pAd-NLS-RARα. The assays of mRNA and protein expression of NLS-RARα, and cell proliferation, were as above. By contrast, cell differentiation was stimulated by all trans retinoic acid (ATRA) (2.5µmol/L) at 24h after virus infection of pAd-NLS-RARα, and then detected by CD11b labeling two days later. The transcription and translation of C-MYC was detected in HL-60/pAd-NLS-RARα cells which treated by ATRA. Our results showed that compared to the control groups, the expression of NLS-RARα was significantly reduced in the HL-60/pNLS-RARα-shRNA cells, and increased dramatically in the HL-60/pAd-NLS-RARα cells. The proliferation was remarkably inhibited in the HL-60/pNLS-RARα-shRNA cells in a time-dependent manner, but markedly promoted in the HL-60/pAd-NLS-RARα cells. FCM outcome revealed the differentiation increased in HL-60/pNLS-RARα-shRNA cells, and decreased in the HL-60/pAd-NLS-RARα cells treated with 2.5µmol/L ATRA. The expression of C-MYC increased strikingly in HL-60/pAd-NLS-RARα cells treated with 2.5µmol/L ATRA. Down-regulation of NLS-RARα expression inhibited the proliferation and induced the differentiation of HL-60 cells. On the contrary, over-expression of NLS-RARα promoted proliferation and reduced the ATRA-induced differentiation of HL-60 cells.

Association between platelet counts and clinical outcomes in acute fatty liver of pregnancy: A retrospective cohort study.

OBJECTIVES: To investigate whether platelet counts are associated with clinical outcomes in patients with acute fatty liver of pregnancy (AFLP). METHODS: We retrospectively analyzed 140 patients with AFLP admitted to the Third Affiliated Hospital of Guangzhou Medical University between January 2010 and August 2022. In this cohort study, we used smooth curve fitting, Kaplan-Meier analysis, and multivariable logistic regression analysis to examine the independent relationship between platelet counts and 42-day postpartum mortality in AFLP. RESULTS: There were 140 patients with AFLP, of which 15 died and 53 (37.86%) had thrombocytopenia. The overall 42-day postpartum maternal mortality was 10.7%. We observed a U-shaped relationship between the platelet counts and 42-day postpartum mortality. Two different slopes were observed below and above the inflection point at approximately 220 × 109 /L. After adjusting for some confounders, patients with thrombocytopenia (<100 × 109 /L) were found to have increased 42-day postpartum mortality compared with middle-tertile and highest-tertile patients. Patients with thrombocytopenia had a higher 42-day postpartum mortality, and higher proportions of intensive care unit admissions, postpartum hemorrhage, and multiple organ failure (P < 0.05). CONCLUSIONS: A U-shaped association between platelet counts and 42-day postpartum mortality was observed in patients with AFLP. Thrombocytopenia is associated with poorer adverse clinical outcomes in women with AFLP.

Three-dimensional nonparaxial beams in parabolic rotational coordinates.

We introduce a class of three-dimensional nonparaxial optical beams found in a parabolic rotational coordinate system. These beams, representing exact solutions of the nonparaxial Helmholtz equation, have inherent parabolic symmetries. Assisted with a computer-generated holography, we experimentally demonstrate the generation of different modes of these beams. The observed transverse beam patterns along the propagation direction agree well with those from our theoretical predication.