Microwave-field sensing via electromagnetically induced absorption of Rb irradiated by three-color infrared lasers.

A microwave electric field sensing has been set up based on a three-color electromagnetically induced absorption in rubidium vapor cell via cascading transitions. All transitions are irradiated by infrared lasers: a 780 nm laser servers as probe to monitor the optical transmittancy via transition 5S1/2→P3/2;, a 776 nm laser and a 1260 nm laser are used to couple the states 5P3/2 and 5D5/2 and states 5D5/2 and 44F7/2, respectively. We find that a frequency detuning ∼2π × ( - 40) MHz of the 776 nm dressing beam prefers to a better signal-to-noise ratio for the probe beam. The off-resonance greatly depresses the double resonance pumping effect. A demonstration measurement for the electric field of microwave 1.18988 GHz, corresponding to the coupling resonance between two adjacent Rydberg states 44F7/2 and 44F9/2, gives a sensitivity of 55.79(23)nVcm-1/Hz and a smallest discernible electric field of 78.9(33) nVcm-1 in time scale of 500 ms.

[ABC prognostic classification and MELD 3.0 and COSSH-ACLF â ¡ prognostic evaluation in acute-on-chronic liver failure].

Objective: To investigate the ABC prognostic classification and the updated version of Model for End-stage Liver Disease (MELD) score 3.0 and Chinese Group on the Study of Severe Hepatitis B ACLF Ⅱ score (COSSH-ACLF Ⅱ score) to evaluate the prognostic value in acute-on-chronic liver failure (ACLF). Methods: ABC classification was performed on a 1 409 follow-up cohorts. The area under the receiver operating characteristic curve (AUROC) was used to analyze MELD, MELD 3.0, COSSH-Ⅱ and COSSH-Ⅱ score after 3 days of hospitalization (COSSH-Ⅱ-3d). The prognostic predictive ability of patients were evaluated for 360 days, and the prediction differences of different classifications and different etiologies on the prognosis of ACLF were compared. Results: The survival curve of 1 409 cases with ACLF showed that the difference between class A, B, and C was statistically significant, Log Rank (Mantel-Cox) χ2=80.133, P<0.01. Compared with class A and C, χ2=76.198, P<0.01, the difference between class B and C, was not statistically significant χ2=3.717, P>0.05. AUROC [95% confidence interval (CI)] analyzed MELD, MELD 3.0, COSSH-Ⅱ and COSSH-Ⅱ-3d were 0.644, 0.655, 0.817 and 0.839, respectively (P<0.01). COSSH-Ⅱ had better prognostic predictive ability with class A ACLF and HBV-related ACLF (HBV-ACLF) for 360-days, and AUROC (95% CI) were 0.877 and 0.881, respectively (P<0.01), while MELD 3.0 prognostic predictive value was not better than MELD. Conclusion: ACLF prognosis is closely related to ABC classification. COSSH-Ⅱ score has a high predictive value for the prognostic evaluation of class A ACLF and HBV-ACLF. COSSH-Ⅱ score has a better prognostic evaluation value after 3 days of hospitalization, suggesting that attention should be paid to the treatment of ACLF in the early stage of admission.

[Ultrasound biomicroscopic differences between fellow eyes of acute angle-closure glaucoma and chronic angle-closure glaucoma].

Objective: To compare the structural differences of the anterior segment between fellow eyes of acute angle-closure glaucoma (AACG) and the eyes of chronic angle-closure glaucoma (CACG) with milder glaucomatous damage. Methods: In this case-control study, patients with AACG (41 eyes) and CACG (46 eyes) without prior treatment in the glaucoma clinic of Peking University People's Hospital from September 2016 to October 2018 were enrolled. Ultrasound biomicroscopy was performed under dark condition. Parameters were measured on images including lens vault (LV), anterior chamber depth (ACD), iris thickness (IT750 and IT2000), angle-opening distance (AOD500 and AOD750), and trabecular iris angle (TIA500 and TIA750). The independent t-test was used to compare the continuous variables of the fellow eyes of AACG patients and the eyes of CACG patients with milder glaucomatous damage. After adjusting for age and gender, univariate and multivariate logistic regression analyses were performed to explore the most important parameters that may distinguish AACG from CACG. Results: The mean age of AACG patients was (65±10) years old and the age of CACG patients was (67±12) years old (P>0.05). The ACD [(1.79±0.25) mm vs. (1.99±0.34) mm], IT750 [(0.39±0.07) mm vs. (0.43±0.05) mm], AOD500 [(0.12±0.06) mm vs. (0.15±0.07) mm], TIA500 (10.91°±5.23° vs. 13.93°±6.33°), and TIA750 (9.33°±5.02° vs. 13.93°±6.82°) were less and the LV [(0.99±0.44) mm vs. (0.72±0.30) mm] was greater in the fellow eyes of AACG as compared to the eyes of CACG with milder glaucomatous damage (all P<0.05). In the forward multivariate logistic regression analysis, every 1-degree decrease in TIA750 (odds ratio=0.872, 95%CI: 0.794 to 0.958, P<0.01) and every 1-mm increase in LV (odds ratio=14.138, 95%CI: 2.348 to 85.130, P<0.01) were significantly associated with AACG. Conclusions: Compared with the eyes of CACG with milder glaucomatous damage, fellow eyes of AACG have thinner peripheral iris thickness, narrower angle width, shallower ACD, and greater LV. LV and TIA750 may play important roles in distinguishing eyes predisposed to AACG or CACG. (Chin J Ophthalmol, 2021, 57: 672-678).

Feasibility of modulated electro-hyperthermia in preoperative treatment for locally advanced rectal cancer: Early phase 2 clinical results.

Despite advances in the multimodal approach for rectal cancer, treatment-related side effects remain an important issue. From this perspective, a prospective trial was performed to investigate the feasibility of modulated electro-hyperthermia (mEHT) as a concomitant boost to preoperative chemoradiation in locally advanced rectal cancer. Seventy-six patients with cT3-4 or cT2N+ rectal cancer were enrolled consecutively. Whole pelvic radiotherapy of 40 Gy was delivered with a 2-Gy daily fraction. mEHT with 13.56 MHz frequency was boosted on a twice-weekly schedule concurrently with intravenous 5-fluorouracil or oral capecitabine. Surgical resection was planned 6-8 weeks after radiotherapy. The primary endpoint was the non-inferior treatment response rate assessed by pathologic downstaging and tumor regression. The secondary endpoint was acceptable toxicity during the preoperative treatment period. Sixty patients completed the planned treatment schedule. T- and N-downstaging was demonstrated in 40 patients (66.7%) and 53 patients (88.3%), respectively. Pathologic complete response was noted in 15.0% (9 patients) and 76.7% (46 patients) for T-stage and N-stage, respectively. Total or near total tumor regression was observed in 20 patients (33.3%). Grade ≥3 toxicity occurred only in hematologic assessment; one case (1.7%) of leukopenia and one case (1.7%) of anemia. Sixteen patients (26.7%) developed thermal toxicity, which was mostly Grade 1 (15 patients, 93.8%). The relatively low dose of 40 Gy radiation showed comparable pathologic treatment outcomes and tolerable toxicity profiles with the addition of mEHT, which may potentially replace part of the radiation dose in neoadjuvant treatment for rectal cancer.

[Advances in early warning and treatment of pre-hepatic failure].

Liver function of patients with pre-hepatic failure deteriorates rapidly, and with this there exists a risk of liver failure and high rates of mortality. This paper summarizes the concept of pre-hepatic failure, particularly the advances in early warning and treatment of pre-hepatic failure developing into hepatic failure, with a view to enhance clinicians' concerns to pre-hepatic failure for promoting the advancement of liver failure prevention and treatment, and improving the success rate of liver failure treatment.

[Clinical analysis of 2 820 cases of drug-induced liver injury].

Objective: To investigate the clinical characteristics, incidence trend, underlying diseases, causative drug and prognosis of drug-induced liver injury (DILI), so as to provide basis for its prevention and treatment. Methods: A retrospective study was conducted on 2 820 DILI cases who were admitted to our hospital from January 2002 to December 2015, and their clinical characteristics, incidence trends, underlying related diseases, causative drug, treatment and outcome were analyzed. Results: Among 2 820 DILI cases, the ratio of male to female was 1:1.44, and the age was (44.00±16.32) years old. According to the clinical classification of DILI, there were 2 353 cases (83.43%) of hepatocyte injury, 353 cases (12.51%) of cholestatic type and 114 cases (4.04%) of mixed type. In the three clinical classification of DILI, there was no statistically significant difference in the ratio of male to female (χ(2) = 3.032, P > 0.05). However, the difference in the ratio of male to female between different age groups was statistically significant (χ(2) = 48.367, P < 0.001). Among the patients with liver disease and acute liver disease admitted to our hospital from January 2002 to December 2015, the proportion of DILI and acute DILI showed an overall upward trend. The main underlying related diseases of 2 820 DILI cases were fever (15.14%), skin diseases (11.84%), cardiovascular and cerebrovascular diseases (11.17%). Chinese herbal patent medicines (37.49%), antibiotics (15.85%), antipyretic-analgesics (14.37%), and so on were the main causative drugs involved, and the prognostic differences among the three clinical classifications of DILI in terms of cure, improvement, ineffectiveness, and death were statistically significant (H = 61.300, P < 0.001). Conclusion: In recent years, among the patients with liver disease in our hospital, the proportion of DILI has shown an obvious upward trend, involving a variety of underlying diseases and causative drugs, and thus it needs clinical attention.

Artificial modulation-free Pound-Drever-Hall method for laser frequency stabilization.

We have proposed an artificial modulation-free Pound-Drever-Hall (PDH) method for laser frequency stabilization and demonstrated it via two-color polarization spectroscopy of Rydberg electromagnetically induced transparency (EIT) resonance in a room-temperature rubidium vapor. Due to the unique error signal profile, the conventional PDH method owns a large capture range in laser frequency locking. Here we manually construct a PDH error signal via a linear combination of polarization spectroscopies of the Rydberg EIT resonances without and with a magnetic field applied. The artificial modulation-free PDH error signal owns a subnatural linewidth dispersion curve as well as a large capture range with which we successfully stabilize the laser to an absolute atomic frequency reference in a long running time, immune to environmental fluctuation and even manmade impulse perturbation. This method can provide an absolute frequency reference based on atomic transition while keeping similar locking ability to provide corrections for frequency fluctuations over a broad bandwidth as the conventional PDH.

Plasma C-type lectin-like receptor 2 as a predictor of death and vascular events in patients with acute ischemic stroke.

BACKGROUND AND PURPOSE: C-type lectin-like receptor 2 (CLEC-2) has prominent involvement in platelet activation, which is increased in coronary heart disease and acute ischaemic stroke (AIS) and is associated with stroke progression and stroke prognosis. Here, the aim was to examine the prognostic value of CLEC-2 in death and vascular event recurrence in AIS patients. METHODS: In all, 352 patients with AIS were studied prospectively. All patients were followed up for 1 year. Death for all vascular events and a combination of death and vascular diseases (recurrent stroke, myocardial infarction, hospitalized and treated angina, hospitalized and treated peripheral arterial disease) were recorded. RESULTS: During 1 year of follow-up, 46 patients (14.2%) experienced death or combined end-points (23 death and 46 combined end-points). Plasma CLEC-2 (pCLEC-2) was significantly associated with an increased risk of death and combined events of death and vascular diseases after adjusting for age, sex, history of hypertension, diabetes mellitus and coronary artery disease, and National Institutes of Health Stroke Scale scores. Each 1 SD higher log-transformed pCLEC-2 was associated with a 4.27-fold (hazard ratio 4.27, 95% confidence interval 1.71-10.65) increased risk for death and a 2.42-fold increased risk for combined end-points (hazard ratio 2.42, 95% confidence interval 1.52-3.86). The optimal cut-off point of pCLEC-2 for predicting death was 184.38 pg/ml. CONCLUSIONS: Higher pCLEC-2 levels at admission were associated with increased risk of death and combined events of death and vascular diseases in patients with AIS, which indicated that pCLEC-2 is an important prognostic factor for AIS.

[Clinical analysis of carotid artery stenting with severe stenosis and extracranial distortion under proximal protection technique].

Objective: To investigate the feasibility, efficacy and safety of endovascular reconstruction of the carotid artery with severe stenosis and extracranial distortion under proximal protection. Methods: A retrospective analysis of 21 patients with severe carotid stenosis and extracranial distortion who were admitted to the Second Affiliated Hospital of Soochow University between January 2011 and August 2017, of which 16 patients were symptomatic stenosis with acute ischemic stroke. All the patients were treated with carotid artery stenting under (CAS) proximal protection technique, and assessed with the National Institutes of Health Stroke Scale (NIHSS) before the treatment and hospital discharge. The clinical outcome and vascular morphology were followed-up regularly after the treatment. Results: Twenty-one patients were successfully completed the CAS procedure under the proximal protection technique, the average blocking time was 241.0 (232.5-261.0) seconds. Nine patients received 1block attempt, 6 patients received 2 block attempts, and the other 6 patients received 3 block attempts. Three patients experienced transient ischemic attack (TIA) during the procedure, the maximum duration of TIA was 10 minutes. In 16 patients with symptomatic stenosis, there were no significant differences in NIHSS score before CAS procedure and hospital discharge (P>0.05). The residual stenosis rate of the carotid artery after stenting was(13±6)%, compared with preoperative (87±16)%, which appeared a significant difference (t=19.948, P<0.05). All the patients had no adverse events such as myocardial infarction, recurrent ischemic stroke and death in the follow-up period. Restenosis was assessed in 6 patients by DSA or CTA and no restenosis was found. Conclusion: Endovascular reconstruction of the carotid artery with severe stenosis and extracranial distortion under proximal protection technique has been proven as a safe and effective therapy.

[Clinical characteristics and diagnosis of early hydatidiform mole].

Objective: To evaluate the clinical characteristics and diagnostic strategies of early hydatidiform mole. Methods: A retrospective cohort study was conducted of 526 women with hydatidiform mole who underwent suction curettage and were confirmed by histopathology in Dalian Maternal and ChildHealth Care Hospital from Feb. 2013 to Feb. 2018, including 484 women with gestational age less than or equal to 12 weeks (the early group) and 42 women with gestational age greater than 12 weeks (the late group). The clinical characteristics between the two groups were compared, and the pathological diagnosis and pre-evacuation ultrasound examination of the early group were further discussed. Results: Compared with the late group, the clinical characteristics of the early group tended to be atypical, and the incidence of vaginal bleeding, excessive uterine size, theca lutein cysts (>6 cm) and pregnancy complications decreased significantly (all P<0.05). The serum level of ß-hCG in the early group was significantly lower than that in the late group (Z=-2.382, P=0.017). While there was no significant difference in the pre-evacuation ultrasound detection rate between the two groups (53.5% vs 66.7%; χ(2)=2.697, P=0.101). Five hundred and fifteen patients completed the follow-up, and 38 patients with post-mole neoplasia were all cured. There was no significant difference in the malignant transformation rate of hydatidiform mole between the two groups (7.0% vs 11.9%; χ(2)=0.745, P=0.388). In the early group, 302 cases of complete hydatidiform mole (CHM), 179 cases of partial hydatidiform mole (PHM) and 3 cases of unclassified hydatidiform mole (UHM) were histologically diagnosed, according to pathological morphology combined with p57(KIP2) immunohistochemical staining. Compared with pathological diagnosis, the overall pre-evacuation ultrasound detection rate in the early hydatidiform mole was 53.5% (259/484), which was significantly better for complete (78.1%, 236/302) versus partial (11.7%, 21/179) hydatidiform moles (χ(2)=199.224, P<0.01). There was significantly weak negative correlation between the overall ultrasound detection rate and gestational age of hydatidiform mole (r=-0.211, P<0.01). The gestational age of early PHM was significantly longer than that of CHM (68.0 vs 58.5 days; Z=-8.048, P<0.01). Conclusions: The clinical presentations of early hydatidiform mole are not typical. Although ultrasound examination identifies only about half of hydatidiform moles, ultrasonography is still an important auxiliary examination method. Morphological examination combined with p57(K)IP2 immunohistochemical staining could effectively diagnose early hydatidiform mole, so as to reduce the missed diagnosis of hydatidiform mole.

Increase in neutrophils after recombinant tissue plasminogen activator thrombolysis predicts poor functional outcome of ischaemic stroke: a longitudinal study.

BACKGROUND AND PURPOSE: Neutrophils, a pivotal immune responder to ischaemic brain insult, have been involved in neuroplasticity and increase after stroke. Recombinant tissue plasminogen activator (r-tPA), a promising treatment improving neuroplasticity, promotes neutrophil degranulation. However, the dynamic profile of neutrophils after r-tPA treatment and their effect on neurological recovery after stroke are not well studied. METHODS: Cell counts of neutrophils, lymphocytes and their ratio (NLR) were measured on admission and 24 h after r-tPA infusion in 372 consecutively recruited acute ischaemic stroke patients (mean age 64 years). Death or major disability at 3 months after stroke was diagnosed based on the modified Rankin Scale (mRS ≥ 3) obtained by neurologists who were blinded to any hospital records. The longitudinal associations of percentage increase in neutrophils, lymphocytes and the NLR with death or major disability were examined by logistic regression adjusting for covariates including neurological deficits at baseline. RESULTS: Neutrophils exhibited a steeper increase after r-tPA infusion in patients with death or major disability than in those without (P < 0.001). A 10% increase in neutrophils after r-tPA infusion was associated with an 83% increased risk for death or major disability within 3 months after stroke onset [odds ratio (OR) 1.99, P = 0.009]. Increased neutrophils at 24 h after r-tPA (OR 6.30, P < 0.001 after log transformation) but not on admission significantly predicted increased risks for death or major disability within 3 months after stroke onset. A similar phenomenon was also observed for the NLR. CONCLUSIONS: A dynamic increase in neutrophils after stroke significantly predicts 3-month death or major disability in acute ischaemic stroke patients receiving r-tPA treatment.

[Discussion and evaluation of diagnostic criteria for hepatitis B virus-related acute-on-chronic pre-liver failure].

Objective: To investigate the concept of hepatitis B virus (HBV)-related acute-on-chronic pre-liver failure (pre-ACLF), and to develop and evaluate the diagnostic criteria for this disease. Methods: A retrospective analysis was performed for the clinical data of 754 patients with severe acute exacerbation (SAE) of HBV-related chronic liver disease, and their clinical features were identified. A multivariate logistic regression analysis was used to determine the risk factors for acute-on-chronic liver failure (ACLF). The inclusion rate of patients with SAE-HBV-related chronic liver disease and the detection rate of ACLF patients were analyzed to evaluate the value of four different versions of diagnostic criteria for pre-liver failure. The t-test, an analysis of variance, the Mann-Whitney U test, and the chi-square test were used for statistical analysis based on data type. Results: The incidence rate of ACLF in the patients with SAE-HBV-related chronic liver disease was 9.9% and the time to progression to ACLF was 12.0 ± 6.7 days. The multivariate logistic regression analysis showed that HBV reactivation (odds ratio [OR] = 5.118), direct bilirubin ratio (D/T) (OR = 1.041), age (OR = 1.033), total bilirubin (TBil) (OR = 1.005), prothrombin activity (PTA) (OR = 0.880), and serum sodium (Na) (OR = 0.918) were independent risk factors for ACLF. Group B (51.3 µmol/L < TBil < 171.1 µmol/L and 40%≤PTA < 60%, 4.2%) had a significantly lower incidence rate of ACLF than group A (51.3 µmol/L < TBil < 171.1 µmol/L and PTA < 40%, 13.7%) and group C (TBil > 171.1 µmol/L and 40% < PTA < 60%, 20.3%) (P < 0.001). Group C had a significantly shorter time to progression to ACLF than group A (10.5 ± 6.1 days vs 15.6 ± 7.4 days, P = 0.008). A total of 45 patients met the diagnostic criteria developed by Chongqing and the incidence rate of ACLF was 2.2%; 154 patients met the diagnostic criteria developed by Zhejiang and the incidence rate of ACLF was 7.1%; 188 patients met the diagnostic criteria in the Chinese guidelines and the incidence rate of ACLF was 6.4%; 117 patients met the diagnostic criteria for SAE-CHB and the incidence rate of ACLF was 9.4%. Conclusion: At present, these four versions of diagnostic criteria for pre-liver failure are not fully applicable to the clinical practice in China. The diagnostic criteria for HBV-related pre-ACLF should include important assessment indices which affect its progression to ACLF.

Genetic analysis of a hybrid sterility gene that causes both pollen and embryo sac sterility in hybrids between Oryza sativa L. and Oryza longistaminata.

Oryza longistaminata originates from African wild rice and contains valuable traits conferring tolerance to biotic and abiotic stress. However, interspecific crosses between O. longistaminata and Oryza sativa cultivars are hindered by reproductive barriers. To dissect the mechanism of interspecific hybrid sterility, we developed a near-isogenic line (NIL) using indica variety RD23 as the recipient parent and O. longistaminata as the donor parent. Both pollen and embryo sac semi-sterility were observed in F1 hybrids between RD23 and NIL. Cytological analysis demonstrated that pollen abortion in F1 hybrids occurred at the early bi-nucleate stage due to a failure of the first mitosis in microspores. Partial embryo sacs in the F1 hybrids were defective during the functional megaspore formation stage. Most notably, nearly half of the male or female gametes were aborted in heterozygotes S40iS40l, regardless of their genotypes. Thus, S40 was indicated as a one-locus sporophytic sterility gene controlling both male and female fertility in hybrids between RD23 and O. longistaminata. A population of 16 802 plants derived from the hybrid RD23/NIL-S40 was developed to fine-map S40. Finally, the S40 locus was delimited to an 80-kb region on the short arm of chromosome 1 in terms with reference sequences of cv. 93-11. Eight open reading frames (ORFs) were localized in this region. On the basis of gene expression and genomic sequence analysis, ORF5 and ORF8 were identified as candidate genes for the S40 locus. These results are helpful in cloning the S40 gene and marker-assisted transferring of the corresponding neutral allele in rice breeding programs.

Prognostic role of hypochloremia in acute ischemic stroke patients.

OBJECTIVES: The impact of electrolyte imbalance on clinical outcomes after acute ischemic stroke (AIS) is still not understood. We investigated the association between hypochloremia and hyponatremia upon hospital admission and in-hospital mortality in AIS patients. MATERIALS AND METHODS: A total of 3314 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included in this study. Hypochloremia was defined as having a serum chloride concentration <98 mmol/L and hyponatremia as having a serum sodium concentration <135 mmol/L. The Cox proportional hazard model was used to examine the effect of hypochloremia and hyponatremia on all-cause in-hospital mortality in AIS patients. RESULTS: During hospitalization, 118 patients (3.6%) died from all causes. Multivariable model adjusted for age, sex, baseline National Institutes of Health Stroke Scale score, serum sodium, and other potential covariates showed that hypochloremia was associated with a 2.43-fold increase in the risk of in-hospital mortality (hazard ratio [HR] 2.43; 95% confidence interval [CI], 1.41-4.19; P=.001). However, no significant association between hyponatremia (P=.905) and in-hospital mortality was observed. Moreover, the multivariable analysis found that serum chloride (HR=0.92, 95% CI 0.88-0.98; P=.004) but not serum sodium (P=.102) was significantly associated with in-hospital mortality. CONCLUSIONS: Hypochloremia at admission was independently associated with in-hospital mortality in AIS patients.

Assessment of grammar optimizes language tasks for the intracarotid amobarbital procedure.

PURPOSE: A previous study showed that assessment of language laterality could be improved by adding grammar tests to the recovery phase of the intracarotid amobarbital procedure (IAP) (Polczynska et al. 2014). The aim of this study was to further investigate the extent to which grammar tests lateralize language function during the recovery phase of the IAP in a larger patient sample. METHODS: Forty patients with drug-resistant epilepsy (14 females, thirty-two right-handed, mean age 38.5years, SD=10.6) participated in this study. On EEG, 24 patients had seizures originating in the left hemisphere (LH), 13 in the right hemisphere (RH), and 4 demonstrated mixed seizure origin. Thirty participants (75%) had bilateral injections, and ten (25%) had unilateral injections (five RH and five LH). Based on results from the encoding phase, we segregated our study participants to a LH language dominant and a mixed dominance group. In the recovery phase of the IAP, the participants were administered a new grammar test (the CYCLE-N) and a standard language test. We analyzed the laterality index measure and effect sizes in the two tests. KEY FINDINGS: In the LH-dominant group, the CYCLE-N generated more profound language deficits in the recovery phase than the standard after injection to either hemisphere (p<0.001). At the same time, the laterality index for the grammar tasks was still higher than for the standard tests. Critically, the CYCLE-N administered in the recovery phase was nearly as effective as the standard tests given during the encoding phase. SIGNIFICANCE: The results may be significant for individuals with epilepsy undergoing IAP. The grammar tests may be a highly efficient measure for lateralizing language function in the recovery phase.

Control of Immune Response to Allogeneic Embryonic Stem Cells by CD3 Antibody-Mediated Operational Tolerance Induction.

Implantation of embryonic stem cells (ESCs) and their differentiated derivatives into allogeneic hosts triggers an immune response that represents a hurdle to clinical application. We established in autoimmunity and in transplantation that CD3 antibody therapy induces a state of immune tolerance. Promising results have been obtained with CD3 antibodies in the clinic. In this study, we tested whether this strategy can prolong the survival of undifferentiated ESCs and their differentiated derivatives in histoincompatible hosts. Recipients of either mouse ESC-derived embryoid bodies (EBs) or cardiac progenitors received a single short tolerogenic regimen of CD3 antibody. In immunocompetent mice, allogeneic EBs and cardiac progenitors were rejected within 20-25 days. Recipients treated with CD3 antibody showed long-term survival of implanted cardiac progenitors or EBs. In due course, EBs became teratomas, the growth of which was self-limited. Regulatory CD4(+)FoxP3(+) T cells and signaling through the PD1/PDL1 pathway played key roles in the CD3 antibody therapeutic effect. Gene profiling emphasized the importance of TGF-ß and the inhibitory T cell coreceptor Tim3 to the observed effect. These results demonstrate that CD3 antibody administered alone promotes prolonged survival of allogeneic ESC derivatives and thus could prove useful for enhancing cell engraftment in the absence of chronic immunosuppression.

Assessing coughing-induced influenza droplet transmission and implications for infection risk control.

Indoor transmission of respiratory droplets bearing influenza within humans poses high risks to respiratory function deterioration and death. Therefore, we aimed to develop a framework for quantifying the influenza infection risk based on the relationships between inhaled/exhaled respiratory droplets and airborne transmission dynamics in a ventilated airspace. An experiment was conducted to measure the size distribution of influenza-containing droplets produced by coughing for a better understanding of potential influenza spread. Here we integrated influenza population transmission dynamics, a human respiratory tract model, and a control measure approach to examine the indoor environment-virus-host interactions. A probabilistic risk model was implemented to assess size-specific infection risk for potentially transmissible influenza droplets indoors. Our results found that there was a 50% probability of the basic reproduction number (R0) exceeding 1 for small-size influenza droplets of 0·3-0·4 µm, implicating a potentially high indoor infection risk to humans. However, a combination of public health interventions with enhanced ventilation could substantially contain indoor influenza infection. Moreover, the present dynamic simulation and control measure assessment provide insights into why indoor transmissible influenza droplet-induced infection is occurring not only in upper lung regions but also in the lower respiratory tract, not normally considered at infection risk.

Pure non-gestational choriocarcinoma arising in the ovary.

Non-gestational choriocarcinoma (NGCO) is a rare primary ovarian cancer with poor prognosis. It is important to distinguish it from gestational ovarian choriocarcinoma (GCO), because there are different treatment options. However, it is difficult to distinguish the two types by routine histologic, ultrastructural, or immunohistochemical examination. The authors present NGCO in a 41-year-old woman, which was confirmed by DNA polymorphism analysis. All tested microsatellite markers had identical DNA profiles with the same allelic sizes between tumor and normal myometrium of the patient, indicating that both tissues originated from the same person. The results confirmed that the tumor was non-gestational in origin. Although the tumor was large, the authors performed hand- assisted laparoscopic surgical (HALS) staging. After three cycles of combination chemotherapy and surgery, the patient has not had any evidence of disease 48 months after treatment. This case demonstrates the usefulness of HALS staging and DNA polymorphism analysis in NGCO.