Tunable random laser based on hybrid plasmonic enhancement.

This research investigates the hybridized plasmonic response of silver film combined with dispersed silver (Ag) nanowires (NWs) to random laser emission. The mixture of Rhodamine B (RhB) dye and polyvinyl alcohol (PVA) matrix is taken as the gain medium for random lasing, and the silver combination provides feedback mechanisms for light trapping. Importantly, film roughness and the coupling between localized and extended (delocalized) surface plasmons play a vital role in RL performance evaluation. The laser threshold is strongly influenced by film thickness attributed to surface roughness. Furthermore, the variation in film thickness also supports the wavelength modulation of 9 nm (597 nm to 606 nm), which results from the reabsorption of RhB. Additionally, the intriguing capability of emission wavelength tuning under the variation of temperature facilitates exciting prospects for precise wavelength control in plasmonic devices.

Switchable whispering gallery mode lasing via phase transition.

Combining phase-transition materials with optical microcavities may advance the applications of whispering-gallery mode (WGM) lasing in performance customization, sensing, and optical switching. In this study, switchable WGM lasing based on phase transition is reported. The device is designed by introducing the phase-transition hydrogel into the capillary microcavity. After approaching the phase-transition point in hydrogel, the number of WGM lasing modes decreases sharply with a significant blueshift in the wavelength. The phenomenon is caused by the increase in light scattering and decrease in effective refractive index of the device. Furthermore, single-mode lasing is obtained by manipulating the phase transition, which exhibits superior reversibility. This study may pave the way for designing and multifunctioning of novel WGM lasing in photonic devices.

The Prognostic Significance of Nomogram-Based Pretreatment Inflammatory Indicators in Patients With Esophageal Squamous Cell Carcinoma Receiving Intensity-Modulated Radiotherapy.

BACKGROUND: At present, there is no objective prognostic index available for patients with esophageal squamous cell carcinoma (ESCC) who underwent intensity-modulated radiotherapy (IMRT). This study is to develop a nomogram based on hematologic inflammatory indices for ESCC patients treated with IMRT. METHODS: 581 patients with ESCC receiving definitive IMRT were enrolled in our retrospective study. Of which, 434 patients with treatment-naïve ESCC in Fujian Cancer Hospital were defined as the training cohort. Additional 147 newly diagnosed ESCC patients were used as the validation cohort. Independent predictors of overall survival (OS) were employed to establish a nomogram model. The predictive ability was evaluated by time-dependent receiver operating characteristic curves, the concordance index (C-index), net reclassification index (NRI), and integrated discrimination improvement (IDI). Decision curve analysis (DCA) was performed to assess the clinical benefits of the nomogram model. The entire series was divided into 3 risk subgroups stratified by the total nomogram scores. RESULTS: Clinical TNM staging, primary gross tumor volume, chemotherapy, neutrophil-to-lymphocyte ratio and platelet lymphocyte ratio were independent predictors of OS. Nomogram was developed incorporating these factors. Compared with the 8th American Joint Committee on Cancer (AJCC) staging, the C-index for 5-year OS (.627 and .629) and the AUC value of 5-year OS (.706 and .719) in the training and validation cohorts (respectively) were superior. Furthermore, the nomogram model presented higher NRI and IDI. DCA also demonstrated that the nomogram model provided greater clinical benefit. Finally, patients with <84.8, 84.8-151.4, and >151.4 points were categorized into low-risk, intermediate-risk, and high-risk groups. Their 5-year OS rates were 44.0%, 23.6%, and 8.9%, respectively. The C-index was .625, which was higher than the 8th AJCC staging. CONCLUSIONS: We have developed a nomogram model that enables risk-stratification of patients with ESCC receiving definitive IMRT. Our findings may serve as a reference for personalized treatment.

The long-term outcomes of vaginoplasty using acellular porcine small intestinal submucosa grafts in patients with Mayer-Rokitansky-Küster-Hauser syndrome: A case series.

OBJECTIVE: To investigate the long-term outcomes for Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) patients undergoing vaginoplasty using acellular porcine small intestinal submucosa grafts (SIS). DESIGN: A case series. POPULATION: Seventy-eight MRKH syndrome patients and a post-SIS patient who delivered a baby following the world's first robot-assisted uterus transplantation. METHODS: Mayer-Rokitansky-Küster-Hauser syndrome patients were grouped based on the postoperative time and the diagnosis-surgery interval. Outcomes of sexual function and psychological status were assessed using the female sexual function index (FSFI), self-rating scale of body image (SSBI) and self-acceptance questionnaire (SAQ). Anatomical outcomes were measured by clinicians. MAIN OUTCOME MEASURES: The primary outcome was restoration of sexual function, defined by an FSFI score in the 'good' range. Anatomical and psychological outcomes were also analysed. RESULTS: Sexual function was restored in 42.3% (33/78) of patients and the total FSFI score was 23.44 ± 4.43. Three factors (body defect, recognition of physical appearance and willingness to change physical appearance scores) in the SSBI and two in the SAQ decreased as the postoperative time increased. Based on the interval between diagnosis and surgery, the total SSBI score was lower in the short-interval group than in the long-interval group (7.25 ± 5.55 versus 12.04 ± 10.21, p = 0.038). CONCLUSIONS: Nearly half of MRKH patients in our study had good long-term sexual function after SIS vaginoplasty. Sexual function and psychological status improved as postoperative time increased. In addition, reducing the diagnosis to surgery interval was associated with improved psychological function.

Random Lasing from Label-Free Living Cells for Rapid Cytometry of Apoptosis.

A random laser carrying the scattering information on a biological host is a promising tool for the characterization of biophysical properties. In this work, random lasing from label-free living cells is proposed to achieve rapid cytometry of apoptosis. Random lasing is achieved by adding biocompatible gain medium to a confocal dish containing cells under optically pumped conditions. The random lasing characteristics are distinct at different stages of cell apoptosis after drug treatment. By analyzing the power Fourier transform results of the random lasing spectra, the percentage of apoptotic cells could be distinguished within two seconds, which is more than an order of magnitude faster than traditional flow cytometry. These results provide a label-free approach for rapid cytometry of apoptosis, which is advantageous for further research of random lasers in the biological field.

Crosslinkable and Chelatable Organic Ligand Enables Interfaces and Grains Collaborative Passivation for Efficient and Stable Perovskite Solar Cells.

The organic-inorganic halide perovskite solar cell (PerSC) is the state-of-the-art emerging photovoltaic technology. However, the environmental water/moisture and temperature-induced intrinsic degradation and phase transition of perovskite greatly retard the commercialization process. Herein, a dual-functional organic ligand, 4,7-bis((4-vinylbenzyl)oxy)-1,10-phenanthroline (namely, C1), with crosslinkable styrene side-chains and chelatable phenanthroline backbone, synthesized via a cost-effective Williamson reaction, is introduced for collaborative electrode interface and perovskite grain boundaries (GBs) engineering. C1 can chemically chelate with Sn4+ in the SnO2 electron transport layer and Pb2+ in the perovskite layer via coordination bonds, suppressing nonradiative recombination caused by traps/defects existing at the interface and GBs. Meanwhile, C1 enables in situ crosslinking via thermal-initiated polymerization to form a hydrophobic and stable polymer network, freezing perovskite morphology, and resisting moisture degradation. Consequently, through collaborative interface-grain engineering, the resulting PerSCs demonstrate high power conversion efficiency of 24.31% with excellent water/moisture and thermal stability. The findings provide new insights of collaborative interface-grain engineering via a crosslinkable and chelatable organic ligand for achieving efficient and stable PerSCs.

The Phytophthora effector Avh94 manipulates host jasmonic acid signaling to promote infection.

The oomycete pathogen Phytophthora sojae is a causal agent of soybean root rot. Upon colonization of soybeans, P. sojae secretes various RXLR effectors to suppress host immune responses, supporting successful infection. Previous research has demonstrated that the RXLR effector Avh94 functions as a virulence effector, but the molecular mechanism underlying its role in virulence remains unknown. Here, we demonstrate that Avh94 overexpression in plants and pathogens promotes Phytophthora infection. Avh94 interacts with soybean JAZ1/2, which is a repressor of jasmonic acid (JA) signaling. Avh94 stabilizes JAZ1/2 to inhibit JA signaling and silencing of JAZ1/2 enhances soybean resistance against P. sojae. Moreover, P. sojae lines overexpressing Avh94 inhibit JA signaling. Furthermore, exogenous application of methyl jasmonate improves plant resistance to Phytophthora. Taken together, these findings suggest that P. sojae employs an RXLR effector to hijack JA signaling and thereby promote infection.

Red-green-blue plasmonic random laser.

A red-green-blue plasmonic random laser is achieved in a multilayer structure, which is fabricated by spin-coating three polymer solutions successively on a silica substrate. Under optical pumping, strong amplification of the polymer radiation can be observed due to the localized surface plasmon resonance of silver nanoparticles embedded in the multilayer structure. Red-green-blue random lasing is simultaneously obtained from the sample based on the enhanced scattering strength of silver nanoparticles. These results are useful for designing compact integrated random laser sources.

Ultra-thin plasmonic random lasers.

An ultrathin plasmonic random laser is fabricated by a simple lift off process, which consists of a free-standing polymer membrane embedded with silver nanoparticles. Low threshold random lasing is observed when the 200-nm-thick membrane device is optically pumped, due to the strong plasmonic feedback and high-quality waveguide confinement provided by the silver nanoparticles and the polymer membrane, respectively. The free-standing polymer membrane is very flexible and transplantable, which can be attached to an optical fiber end face to achieve random lasing. This fabrication technique provides a promising way to realize plasmonic random lasing on surfaces with arbitrary shapes.

Plasmonic random laser on the fiber facet.

A random laser on the optical fiber facet is constructed by dipping an optical fiber end face into the solution of polydimethylsiloxane doped with rhodamine 6G organic dye and silver nanowires. The PDMS film doped with rhodamine 6G acts as the active waveguide layer, and the silver nanowires provide a three-dimensional plasmonic feedback. The plasmon resonance of silver nanowires significantly improves the pump efficiency of the random laser. The most output energy of random laser concentrates in a small angle range along the axis of the optical fiber. This fabrication technique provides a simple and efficient way for the fabrication of random lasers on the optical fiber facet with low cost.

Redisplacement after reduction with intramedullary nails in surgery of intertrochanteric fracture: cause analysis and preventive measures.

OBJECTIVE: During the implantation of intramedullary nail in surgery of intertrochanteric fracture, the fact that the originally satisfactory reduction may incur redisplacement remains a major concern. In this article, we will analyze the reasons of redisplacement and describe some methods that can improve the quality of reduction. METHODS: From January 2012 to October 2014, 67 patients with intertrochanteric fracture were treated using Gamma3 or PFNA system. All the surgical procedures were monitored by fluoroscopy on the AP and lateral views, and the X-ray films were used to evaluate all cases. RESULTS: Redisplacement occurred in ten cases intraoperatively. According to the fracture type, re-occurring deformities appeared in 31-A2 and 31-A3 commonly, 6 and 3 cases. We found the redisplacement emerged usually in operative procedure and some manipulations should be taken to obtain an anatomic reduction. CONCLUSIONS: When reduction is achieved in the surgery of intertrochanteric fracture, surgeons tend to overlook the occurrence of redisplacement, or not to treat it that has emerged timely. Internal fixation in nonanatomic reduction may increase the likelihood of fixation failure postoperatively. For the importance of accurate reduction of the fracture, once redisplacement occurs during the surgery, some methods or tricks are applicable to it to restore the anatomic reduction.

Maternal caffeine exposure impairs insulin secretion by pancreatic ß-cells and increases the risk of type II diabetes mellitus in offspring.

Maternal caffeine exposure may be one of the causes for intrauterine growth retardation and low birth weight (LBW), and increased risk of type 2 diabetes mellitus (T2DM) in the adulthood has been associated with LBW. However, whether maternal caffeine exposure contributes to T2DM development of her offspring has not been fully investigated. We have investigated the influence of maternal caffeine exposure on glucose homeostasis in vivo and effects of long-term caffeine load on insulin secretion of ß-cells. The intake of caffeine during gestation markedly decreases birth weight and postnatal body weight of the offspring. Serum insulin levels of adult offspring after oral glucose tolerance test (OGTT) were significantly lower in the caffeine group compared to the control, although plasma glucose levels were not significantly altered. Proteome analysis of pancreas of adult offspring identified 24 proteins that were differentially expressed between the caffeine and control groups, including proteins involved in energy metabolism. In a rat pancreatic ß-cell line Rin-5f cells, caffeine downregulated expression of one of the proteins involved in insulin synthesis, P4hb, and there was reduced transcriptional expression of insulin. While basal insulin secretion of caffeine-treated cells was elevated, insulin secretion after glucose challenge in long-term caffeine-treated cells was significantly reduced, with increased apoptosis of ß-cells. These results indicate that maternal caffeine exposure may result in potentially abnormal glucose homeostasis and increase the risk of T2DM in the offspring adulthood.

Retrospective analysis of 15 cases of Penicilliosis marneffei in a southern China hospital.

We retrospectively analyzed the medical records and clinical characteristics of 15 patients diagnosed with Penicilliosis marneffei (PSM) between January 1, 1993, and December 31, 2012, at the Third Affiliated Hospital of Sun Yat-sen University. The most common symptoms of PSM were fever (14/15, 93 %), cough (13/15, 87 %), and sputum production (6/15, 40 %), weight loss (14/15, 60 %), lymph node enlargement (9/15, 60 %), hepatosplenomegaly (7/15, 47 %), anemia (7/15, 47 %), and hemoptysis (4/15, 26 %). The most common underlying diseases in patients diagnosed with PSM were AIDS (9/15, 60 %), post-organ transplantation (3/15, 20 %), rheumatic autoimmune disease (2/15, 13 %), and hematological malignancy (1/15, 7 %). All patients, except those with AIDS, were treated with immunosuppressant drugs. White blood cell counts were increased in 10/15 (67 %) patients, while hemoglobin concentrations were decreased in 8/15 (53 %) patients. The ratios of CD4(+)/total T lymphocytes and CD4(+)/CD8(+) T lymphocytes declined in all the 11 test cases. Nodular lesions or masses were the most common anomalies detected during computed tomography scans, but disseminated inflammation and interstitial changes were also seen. Clinical samples with positive culture results were obtained from sputum or secretions obtained by bronchoscopy, venous blood, percutaneous pulmonary puncture, bone marrow, or skin lesions. Between 1993 and 2003, only four cases of PSM, all connected with AIDS, were diagnosed, while 11 cases of PSM, with or without concurrent AIDS, were diagnosed between 2003 and 2012. Amphotericin B was used to control the disease in some cases. In conclusion, the occurrence of PSM, especially in patients without concurrent AIDS, has increased. The early culture of Penicillium marneffei from clinical samples is critical for correct diagnosis of PSM, and amphotericin B is recommended as the first choice for treatment.

Oral Isavuconazole Combined with Nebulized Inhalation and Bronchoscopic Administration of Amphotericin B for the Treatment of Pulmonary Mucormycosis: A Case Report and Literature Review.

Pulmonary mucormycosis (PM) is an invasive and potentially fatal fungal infection, with Rhizopus microsporus (R. microsporus) being the most common pathogen. The routine therapy for this infection includes surgery and antifungal agents. However, the therapeutic effects of single agents are unsatisfactory due to the rapid progression of mucormycosis, while not all patients can tolerate surgery. Innovative treatment methods like combination therapy await validations of their clinical efficacy. We report a case of PM that was diagnosed via metagenomics next-generation sequencing (mNGS) of black drainage fluid from the patient's lung. The patient eventually recovered and was discharged after a combination therapy of oral isavuconazole, inhaled amphotericin B, and local perfusion of amphotericin B through bronchoscopy, which may be a promising strategy for the treatment of PM, especially for cases where surgery is not possible. A retrospective study of 297 cases in a literature review highlights the different treatment methods used in clinical practice.

GLGFormer: Global Local Guidance Network for Mucosal Lesion Segmentation in Gastrointestinal Endoscopy Images.

Automatic mucosal lesion segmentation is a critical component in computer-aided clinical support systems for endoscopic image analysis. Image segmentation networks currently rely mainly on convolutional neural networks (CNNs) and Transformers, which have demonstrated strong performance in various applications. However, they cannot cope with blurred lesion boundaries and lesions of different scales in gastrointestinal endoscopy images. To address these challenges, we propose a new Transformer-based network, named GLGFormer, for the task of mucosal lesion segmentation. Specifically, we design the global guidance module to guide single-scale features patch-wise, enabling them to incorporate global information from the global map without information loss. Furthermore, a partial decoder is employed to fuse these enhanced single-scale features, achieving single-scale to multi-scale enhancement. Additionally, the local guidance module is designed to refocus attention on the neighboring patch, thus enhancing local features and refining lesion boundary segmentation. We conduct experiments on a private atrophic gastritis segmentation dataset and four public gastrointestinal polyp segmentation datasets. Compared to the current lesion segmentation networks, our proposed GLGFormer demonstrates outstanding learning and generalization capabilities. On the public dataset ClinicDB, GLGFormer achieved a mean intersection over union (mIoU) of 91.0% and a mean dice coefficient (mDice) of 95.0%. On the private dataset Gastritis-Seg, GLGFormer achieved an mIoU of 90.6% and an mDice of 94.6%.

Determination of Enantiomeric Excess by Optofluidic Microlaser near Exceptional Point.

Enantiomeric excess (ee) is an essential indicator of chiral drug purification in the pharmaceutical industry. However, to date the ee determination of unknown concentration enantiomers generally involves two separate techniques for chirality and concentration measurement. Here, a whispering-gallery mode (WGM) based optofluidic microlaser near exceptional point to achieve the ee determination under unknown concentration with a single technique is proposed. Exceptional point induces the unidirectional WGM lasing, providing the optofluidic microlaser with the novel capability to measure chirality by polarization, in addition to wavelength-based concentration detection. The dual-parameters detection of optofluidic microlaser empowers it to achieve ee determination of various unknown enantiomers without additional concentration measurements, a feat that is challenging to accomplish with other methods. Featuring the sensitivity enhancement and miniature structure of the WGM sensors, the obtained chiroptical response of the present approach is ≈30-fold higher than that of the conventional optical rotation-based polarimeter, and the reagent consumption is reduced by three orders of magnitude.

Predictive model for totally implanted venous access ports­related long­term complications in patients with lung cancer.

Totally implanted venous access ports (TIVAPs), which are typically used in oncological chemotherapy and parenteral nutritional support, are convenient and safe, and thus offer patients a higher quality of life. However, insertion or removal of the device requires a minor surgical operation. Long-term complications (>30 days post insertion), such as catheter migration, catheter-related thrombosis and infection, are major reasons for TIVAP removal and are associated with a number of factors such as body mass index and hemoglobin count. Since management of complications is typically time-consuming and costly, a predictive model of such events may be of great value. Therefore, in the present study, a predictive model for long-term complications following TIVAP implantation in patients with lung cancer was developed. After excluding patients with a large amount of missing data, 902 patients admitted to The First Affiliated Hospital with Nanjing Medical University (Nanjing, China) were ultimately included in the present study. Of the included patients, 28 had complications, indicating an incidence rate of 3.1%. Patients were randomly divided into training and test cohorts (7:3), and three machine learning-based anomaly detection algorithms, namely, the Isolation Forest, one-class Support Vector Machines (one-class SVM) and Local Outlier Factor, were used to construct a model. The performance of the model was initially evaluated by the Matthew's correlation coefficient (MCC), area under curve (AUC) and accuracy. The one-class SVM model demonstrated the highest performance in classifying the risk of complications associated with the use of the intracavitary electrocardiogram method for TIVAP implantation in patients with lung cancer (MCC, 0.078; AUC, 0.62; accuracy, 66.0%). In conclusion, the predictive model developed in the present study may be used to improve the early detection of TIVAP-related complications in patients with lung cancer, which could lead to the conservation of medical resources and the promotion of medical advances.

RACGAP1 promotes lung cancer cell proliferation through the PI3K/AKT signaling pathway.

We aimed to investigate the expression and clinic significance of Rac GTPase Activating Protein 1 (RACGAP1) in human lung adenocarcinoma (LUAD). Online database analysis revealed a significant increase in RACGAP1 mRNA expression among 26 types of tumor tissues, including LUAD tissues. Online database and tissue microarray analyses indicated that RACGAP1 expression was significantly upregulated in LUAD tissues. Genetic variation analysis identified four different genetic variations of RACGAPs in LUAD. Moreover, online database analysis showed that RACGAP1 upregulation was correlated with shorter survival in patients with LUAD. After silencing RACGAP1 expression in A549 cells using siRNA and assessing its protein levels via Western blotting, we found that RACGAP1 knockdown inhibited cell growth and induced apoptosis determined using the Cell Counting Kit-8 assay, colony formation assay, and flow cytometry. Mechanistically, western blot analysis indicated that Bax expression increased, whereas Bcl-2 expression decreased. Moreover, RACGAP1 knockdown attenuated PI3K/AKT pathway activation in lung cancer cells. Taken together, our findings showed that RACGAP1 was overexpressed in LUAD tissues and played an important role in lung cancer by increasing cell growth through the PI3K/AKT signaling pathway. This study suggests recommends evaluating RACGAP1 in clinical settings as a novel biomarker and potential therapeutic target for lung cancer.

Long term outcomes and risk factors of compensatory hyperhidrosis after thoracoscopic sympathectomy in primary palmar hyperhidrosis patients: a retrospective single-center study.

OBJECTIVE: This study aims to evaluate the long-term outcomes of compensatory hyperhidrosis (CH) after thoracoscopic sympathectomy and explore the risk factors affecting postoperative CH in primary palmar hyperhidrosis(PPH) patients. METHOD: A retrospective analysis was conducted on patients who underwent thoracoscopic sympathectomy in the thoracic surgery department of our hospital from January 2015 to May 2022. Long-term follow-up surveys was conducted to collect data on post-operative satisfaction, PPH recurrence, and CH occurrence. Postoperative CH outcomes were assessed using the HDSS and satisfaction scores scale. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for postoperative CH. RESULT: A total of 152 patients was included in the final study, with 113 cases in the CH group and 39 cases in the nCH group. The incidence of postoperative CH was 74.3% (113/152), within which 33.6% (38/113) were severe CH. The median follow-up time was 3.1 years(2.5-5.5y) and the median interval of CH onset after surgery was 30 days (14-90d). Univariate analysis showed that body mass index(BMI), surgical time, and transected nerve level are correlated with CH, with statistically significant differences. Multivariate logistic regression analysis indicated a higher BMI (OR = 0.864, 95% CI 0.755-0.989, P < 0.05) is the independent risk factor for the occurrence of CH. There was no statistically significant difference in HDSS scores among CH patients at 1 month, 1 year, and 3 years after surgery. CONCLUSION: A higher BMI is the independent risk factor for postoperative CH after thoracoscopic sympathectomy. The incidence and severity of postoperative CH kept stable during a long term follow up.

Primary hepatic lymphoma presenting as pyogenic liver abscess: A case report.

BACKGROUND: Primary hepatic lymphoma (PHL) is a lymphoproliferative disorder confined to the liver without peripheral lymph node involvement and bone marrow invasion. PHL is extremely rare in clinical practice. The etiology and pathogenesis of PHL are largely unknown. There are no common standard protocols or guidelines for the treatment of PHL. CASE SUMMARY: We report the case of a 66-year-old man who presented with fever and abdominal pain for three weeks. Computed tomography and magnetic resonance imaging scans showed a pyogenic liver abscess. The patient underwent a right posterior hepatectomy. The surgical pathology revealed aggressive B-cell lymphoma, with a primary consideration of diffuse large B-cell lymphoma of non-germinal center origin. CONCLUSION: This article reviews the characteristics, mechanism and treatment of PHL and provides insight into the diagnosis of PHL.