Cancer immunometabolism: advent, challenges, and perspective.

For decades, great strides have been made in the field of immunometabolism. A plethora of evidence ranging from basic mechanisms to clinical transformation has gradually embarked on immunometabolism to the center stage of innate and adaptive immunomodulation. Given this, we focus on changes in immunometabolism, a converging series of biochemical events that alters immune cell function, propose the immune roles played by diversified metabolic derivatives and enzymes, emphasize the key metabolism-related checkpoints in distinct immune cell types, and discuss the ongoing and upcoming realities of clinical treatment. It is expected that future research will reduce the current limitations of immunotherapy and provide a positive hand in immune responses to exert a broader therapeutic role.

Advanced Polymers in Cathodes and Electrolytes for Lithium-Sulfur Batteries: Progress and Prospects.

Lithium-sulfur (Li-S) batteries, which store energy through reversible redox reactions with multiple electron transfers, are seen as one of the promising energy storage systems of the future due to their outstanding advantages. However, the shuttle effect, volume expansion, low conductivity of sulfur cathodes, and uncontrollable dendrite phenomenon of the lithium anodes have hindered the further application of Li-S batteries. In order to solve the problems and clarify the electrochemical reaction mechanism, various types of materials, such as metal compounds and carbon materials, are used in Li-S batteries. Polymers, as a class of inexpensive, lightweight, and electrochemically stable materials, enable the construction of low-cost, high-specific capacity Li-S batteries. Moreover, polymers can be multifunctionalized by obtaining rich structures through molecular design, allowing them to be applied not only in cathodes, but also in binders and solid-state electrolytes to optimize electrochemical performance from multiple perspectives. The most widely used areas related to polymer applications in Li-S batteries, including cathodes and electrolytes, are selected for a comprehensive overview, and the relevant mechanisms of polymer action in different components are discussed. Finally, the prospects for the practical application of polymers in Li-S batteries are presented in terms of advanced characterization and mechanistic analysis.

NMI promotes tumor progression and gemcitabine resistance in pancreatic cancer via STAT3-IFIT3 axis.

N-myc and STAT interactor (NMI) has been reported to interact with several transcription factors, including STATs family, c-Myc, N-Myc, and BRCA1, to indirectly affect transcription events and participate in multiple cellular processes. However, its function in pancreatic ductal adenocarcinoma (PDAC) has seldom been studied. In this study, we investigated the regulation of NMI on PDAC progression and uncovered the underlying molecular mechanisms. We found that NMI expression was significantly upregulated in PDAC and high NMI expression was related to a worse patient survival. Cell proliferation and migration assay, including cell viability, transwell assay, wound healing, and subcutaneous mouse model were utilized to confirm the function of NMI in PDAC progression. Downregulation of NMI abrogates tumor progression of PDAC both in vitro and in vivo. RNA sequencing was utilized to identify the downstream molecules of NMI and interferon-induced protein with tetratricopeptide repeats 3 (IFIT3) was confirmed to be regulated by NMI in both mRNA and protein level. The binding function of NMI to STAT3 was essential in regulating the IFIT3 expression. Moreover, the NMI/STAT3-IFIT3 axis was identified to markedly facilitate the gemcitabine resistance in PDAC cells.

Outcomes of Patients Transferred to Tertiary Care Centers for Treatment of Cardiogenic Shock: A Cardiogenic Shock Working Group Analysis.

BACKGROUND: Consensus recommendations for cardiogenic shock (CS) advise transfer of patients in need of advanced options beyond the capability of "spoke" centers to tertiary/"hub" centers with higher capabilities. However, outcomes associated with such transfers are largely unknown beyond those reported in individual health networks. OBJECTIVES: To analyze a contemporary, multicenter CS cohort with the aim of comparing characteristics and outcomes of patients between transfer (between spoke and hub centers) and nontransfer cohorts (those primarily admitted to a hub center) for both acute myocardial infarction (AMI-CS) and heart failure-related HF-CS. We also aim to identify clinical characteristics of the transfer cohort that are associated with in-hospital mortality. METHODS: The Cardiogenic Shock Working Group (CSWG) registry is a national, multicenter, prospective registry including high-volume (mostly hub) CS centers. Fifteen U.S. sites contributed data for this analysis from 2016-2020. RESULTS: Of 1890 consecutive CS patients enrolled into the CSWG registry, 1028 (54.4%) patients were transferred. Of these patients, 528 (58.1%) had heart failure-related CS (HF-CS), and 381 (41.9%) had CS related to acute myocardial infarction (AMI-CS). Upon arrival to the CSWG site, transfer patients were more likely to be in SCAI stages C and D, when compared to nontransfer patients. Transfer patients had higher mortality rates (37% vs 29%, < 0.001) than nontransfer patients; the differences were driven primarily by the HF-CS cohort. Logistic regression identified increasing age, mechanical ventilation, renal replacement therapy, and higher number of vasoactive drugs prior to or within 24 hours after CSWG site transfer as independent predictors of mortality among HF-CS patients. Conversely, pulmonary artery catheter use prior to transfer or within 24 hours of arrival was associated with decreased mortality rates. Among transfer AMI-CS patients, BMI > 28 kg/m2, worsening renal failure, lactate > 3 mg/dL, and increasing numbers of vasoactive drugs were associated with increased mortality rates. CONCLUSION: More than half of patients with CS managed at high-volume CS centers were transferred from another hospital. Although transfer patients had higher mortality rates than those who were admitted primarily to hub centers, the outcomes and their predictors varied significantly when classified by HF-CS vs AMI-CS.

Association of the Advanced Lung Cancer Inflammation Index (ALI) and Gustave Roussy Immune (GRIm) score with immune checkpoint inhibitor efficacy in patients with gastrointestinal and lung cancer.

OBJECTIVE: This study aimed to conduct a comprehensive analysis, evaluating the prognostic significance of the baseline Advanced Lung Cancer Inflammation Index (ALI) and Gustave Roussy Immune (GRIm) Score in patients undergoing immune checkpoint inhibitor (ICI) therapy. METHODS: A comprehensive search was performed across various databases, including PubMed, the Cochrane Library, EMBASE, and Google Scholar, until October 21, 2023, to compile relevant articles for analysis. The investigation encompassed diverse clinical outcomes, including overall survival (OS) and progression-free survival (PFS). RESULTS: This analysis included a total of 15 articles, comprising 19 studies involving 3335 patients. Among the 19 studies, nine studies focused on NSCLC, and six studies were conducted on HCC. Pooled results revealed that patients with elevated ALI levels experienced prolonged OS (HR: 0.51, 95% CI: 0.37-0.70, p < 0.001) and extended PFS (HR: 0.61, 95% CI: 0.52-0.72, p < 0.001). Furthermore, a GRIm score > 1 was associated with reduced OS (HR: 2.07, 95% CI: 1.47-2.92, p < 0.001) and diminished PFS (HR: 1.78, 95% CI: 1.35-2.34, p < 0.001) in cancer patients receiving ICIs. Subgroup analysis indicated that ALI cutoff values of 18 exhibited enhanced predictive potential. Additionally, for HCC patients, those with HCC-GRIm score > 2 showed a substantially decreased risk of mortality compared to individuals with HCC-GRIm score ≤ 2 (HR: 2.63, 95% CI: 1.89-3.65, p < 0.001). CONCLUSION: The ALI and GRIm score served as dependable prognostic indicators for patients undergoing ICI therapy in the context of cancer treatment.

SMAD4 endows TGF-ß1-induced highly invasive tumor cells with ferroptosis vulnerability in pancreatic cancer.

Pancreatic ductal adenocarcinoma (PDAC) is an extremely aggressive malignancy prone to recurrence and metastasis. Studies show that tumor cells with increased invasive and metastatic potential are more likely to undergo ferroptosis. SMAD4 is a critical molecule in the transforming growth factor ß (TGF-ß) pathway, which affects the TGF-ß-induced epithelial-mesenchymal transition (EMT) status. SMAD4 loss is observed in more than half of patients with PDAC. In this study, we investigated whether SMAD4-positive PDAC cells were prone to ferroptosis because of their high invasiveness. We showed that SMAD4 status almost determined the orientation of transforming growth factor ß1 (TGF-ß1)-induced EMT via the SMAD4-dependent canonical pathway in PDAC, which altered ferroptosis vulnerability. We identified glutathione peroxidase 4 (GPX4), which inhibited ferroptosis, as a SMAD4 down-regulated gene by RNA sequencing. We found that SMAD4 bound to the promoter of GPX4 and decreased GPX4 transcription in PDAC. Furthermore, TGF-ß1-induced high invasiveness enhanced sensitivity of SMAD4-positive organoids and pancreas xenograft models to the ferroptosis inducer RAS-selective lethal 3 (RSL3). Moreover, SMAD4 enhanced the cytotoxic effect of gemcitabine combined with RSL3 in highly invasive PDAC cells. This study provides new ideas for the treatment of PDAC, especially SMAD4-positive PDAC.

Evaluating the efficacy of laparoscopic radical antegrade modular pancreatosplenectomy in selected early-stage left-sided pancreatic cancer: a propensity score matching study.

BACKGROUND: Laparoscopic radical pancreatectomy is safe and beneficial for recectable pancreatic cancer, but the extent of resection for early-stage tumors remains controversial. METHODS: Consecutive patients with left-sided pancreatic cancer who underwent either laparoscopic radical antegrade modular pancreatosplenectomy (LRAMPS, n = 54) or laparoscopic distal pancreatosplecnectomy (LDP, n = 131) between October 2020 and December 2022 were reviewed. The preoperative radiological selection criteria were as follows: (1) tumor diameter ≤ 4 cm; (2) located ≥ 1 cm from the celiac trunk; (3) didn't invade the fascial layer behind the pancreas. RESULTS: After 1:1 propensity score matching (LRAMPS, n = 54; LDP, n = 54), baseline data were well-balanced with no differences. LRAMPS resulted in longer operation time (240.5 vs. 219.0 min, P = 0.020) and higher intraoperative bleeding volume (200 vs. 150 mL, P = 0.001) compared to LDP. Although LRAMPS harvested more lymph nodes (16 vs. 13, P = 0.008), there were no statistically significant differences in lymph node positivity rate (35.2% vs. 33.3%), R0 pancreatic transection margin (94.4% vs. 96.3%), and retroperitoneal margin (83.3% vs. 87.0%) rate. Postoperative complications did not significantly differ between the two groups. However, LRAMPS was associated with increased drainage volume (85.0 vs. 40.0 mL, P = 0.001), longer time to recover semi-liquid diet compared to LDP (5 vs. 4 days, P < 0.001) and increased daily bowel movement frequency. Tumor recurrence pattern and recurrence-free survival were comparable between the two groups, but the adjuvant chemotherapy regimens varied, and the completion rate of the 6-month intravenous chemotherapy was lower in the LRAMPS group compared to the LDP group (51.9% vs. 75.9%, P = 0.016). CONCLUSIONS: LRAMPS did not provide oncological benefits over LDP for left-sided pancreatic cancer within the selection criteria, but it increased operation time, intraoperative bleeding, and postoperative bowel movement frequency. These factors impacted the regimen selection and completion of adjuvant chemotherapy, consequently compromising the potential benefits of LRAMPS in achieving better local control.

Feasibility of laparoscopic versus open pancreatoduodenectomy following neoadjuvant chemotherapy for borderline resectable pancreatic cancer: a retrospective cohort study.

BACKGROUND: There is no evidence supporting the feasibility of laparoscopic pancreaticoduodenectomy (LPD) compared to open pancreatoduodenectomy (OPD) following neoadjuvant chemotherapy (NACT) for pancreatic ductal adenocarcinoma (PDAC). METHODS: The clinical data of consecutive patients with borderline resectable PDAC who received NACT and underwent either LPD or OPD between January 2020 and December 2022 at Fudan University Shanghai Cancer Center was prospectively collected and retrospectively analyzed. RESULTS: The analysis included 57 patients in the OPD group and 20 in the LPD group. Following NACT, the LPD group exhibited a higher median CA19-9 decrease rate compared to the OPD group (85.3% vs. 66.9%, P = 0.042). Furthermore, 3 anatomically borderline PDACs in the LPD group and 5 in the OPD group were downstaged into resectable status (30.0% vs. 12.3%, P = 0.069). According to RECIST criteria, 51 (66.2%) patients in the entire cohort were evaluated as having stable disease. The median operation time for the LPD group was longer than the OPD group (419 vs. 325 min, P < 0.001), while the venous resection rate was 35.0% vs. 43.9%, respectively (P = 0.489). There was no difference in the number of retrieved lymph nodes, with a median number of 18.5 in the LPD group and 22 in the OPD group, and the R1 margin rate (15.0% vs. 12.3%) was also comparable. The incidence of Clavien-Dindo complications (35.0% vs. 66.7%, P = 0.018) was lower in the LPD group compared to the OPD group. Multivariable regression analysis revealed that a tumor diameter > 3 cm before NACT (HR 2.185) and poor tumor differentiation (HR 1.805) were independent risk factors for recurrence-free survival, and a decrease rate of CA19-9 > 70% (OR 0.309) was a protective factor for early tumor recurrence and overall survival. CONCLUSIONS: LPD for PDAC following NACT is feasible and oncologically equivalent to OPD. Effective control of CA19-9 levels is beneficial in reducing early tumor recurrence and improving overall survival.

Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock.

BACKGROUND: Pulmonary artery catheters (PACs) are increasingly used to guide management decisions in cardiogenic shock (CS). The goal of this study was to determine if PAC use was associated with a lower risk of in-hospital mortality in CS owing to acute heart failure (HF-CS). METHODS AND RESULTS: This multicenter, retrospective, observational study included patients with CS hospitalized between 2019 and 2021 at 15 US hospitals participating in the Cardiogenic Shock Working Group registry. The primary end point was in-hospital mortality. Inverse probability of treatment-weighted logistic regression models were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CI), accounting for multiple variables at admission. The association between the timing of PAC placement and in-hospital death was also analyzed. A total of 1055 patients with HF-CS were included, of whom 834 (79%) received a PAC during their hospitalization. In-hospital mortality risk for the cohort was 24.7% (n = 261). PAC use was associated with lower adjusted in-hospital mortality risk (22.2% vs 29.8%, OR 0.68, 95% CI 0.50-0.94). Similar associations were found across SCAI stages of shock, both at admission and at maximum SCAI stage during hospitalization. Early PAC use (≤6 hours of admission) was observed in 220 PAC recipients (26%) and associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, OR 0.54, 95% CI 0.37-0.81). CONCLUSIONS: This observational study supports PAC use, because it was associated with decreased in-hospital mortality in HF-CS, especially if performed within 6 hours of hospital admission. CONDENSED ABSTRACT: An observational study from the Cardiogenic Shock Working Group registry of 1055 patients with HF-CS showed that pulmonary artery catheter (PAC) use was associated with a lower adjusted in-hospital mortality risk (22.2% vs 29.8%, odds ratio 0.68, 95% confidence interval 0.50-0.94) compared with outcomes in patients managed without PAC. Early PAC use (≤6 hours of admission) was associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, odds ratio 0.54, 95% confidence interval 0.37-0.81).

Advanced active polymer probe for near-field optics.

We report on a novel, to the best of our knowledge, active probe for scanning near-field optical microscopy (SNOM). A fluorescent nanosphere, acting as the secondary source, is grafted in an electrostatic manner at the apex of a polymer tip integrated into the extremity of an optical fiber. Thanks to the high photostability and sensitivity of the secondary source, the near-field interaction with a gold nanocube is investigated. It is shown that the spatial resolution is well defined by the size of the fluorescent nanosphere. The polarization-dependent near-field images, which are consistent with the simulation, are ascribed to the local excitation rate enhancement. Meanwhile, measurement of the distance-dependent fluorescence lifetime of the nanosphere provides strong evidence that the local density of states is modified so that extra information on nano-emitters can be extracted during near-field scanning. This advanced active probe can thus potentially broaden the range of applications to include nanoscale thermal imaging, biochemical sensors, and the manipulation of nanoparticles.

Comparison of clinical and pathological features between early-stage gastric-type and intestinal-type differentiated adenocarcinoma: a retrospective study.

BACKGROUND: The clinicopathological features and endoscopic characteristics under magnifying endoscopy with narrow band imaging (ME-NBI) between early-stage gastric-type differentiated adenocarcinoma (GDA) and intestinal-type differentiated adenocarcinoma (IDA) remain controversial. METHODS: Early gastric adenocarcinomas that underwent endoscopic submucosal dissection (ESD) in Nanjing Drum Tower Hospital between August 2017 and August 2021 were included in the present study. GDA cases and IDA cases were selected based on morphology and immunohistochemistry staining of CD10, MUC2, MUC5AC, and MUC6. Clinicopathological data and endoscopic findings in ME-NBI were compared between GDAs and IDAs. RESULTS: The mucin phenotypes of 657 gastric cancers were gastric (n = 307), intestinal (n = 109), mixed (n = 181) and unclassified (n = 60). No significant difference was observed in terms of gender, age, tumor size, gross type, tumor location, background mucosa, lymphatic invasion, and vascular invasion between patients with GDA and IDA. GDA cases were associated with deeper invasion than IDA cases (p = 0.007). In ME-NBI, GDAs were more likely to exhibit an intralobular loop patten, whereas IDAs were more likely to exhibit a fine network pattern. In addition, the proportion of none-curative resection in GDAs was significantly higher than that in IDAs (p = 0.007). CONCLUSION: The mucin phenotype of differentiated early gastric adenocarcinoma has clinical significance. GDA was associated with less endoscopically resectability than IDA.

Analysis of T-cell receptor repertoire in peripheral blood of patients with pancreatic cancer and other pancreatic diseases.

Pancreatic cancer (PC) has been the fourth cancer-related death worldwide, diagnosed at an unresectable stage due to its rapid progression and few symptoms of this disease at early stages. The aim of this study was to determine the association between the diversity of T-cell receptor (TCR) repertoire and clinicopathological characteristics of patients with PC and other benign pancreatic diseases. In order to make a comprehensive analysis the TCR repertoire, high-throughput sequencing was used to differentiate complementarity determining region 3 (CDR3) of the TCR ß chain in peripheral blood samples from 3 PC, 3 chronic pancreatitis, 3 pancreatic cystic lesions and 3 pancreatic neuroendocrine tumour patients. We found that there were significant differences related to TCR repertoire between PC and other pancreatic diseases, and PC is a relatively immunosuppressive tumour. Changes of peripheral TCR repertoire may be used to predict the progression of PC and the response to immunotherapy. And there may exist novel-specific antigens in PC patients which could be used to design targeting immunotherapy in the nearly future.

Clinical Application of the Musculoperiosteal Iliac Flap for Osteonecrosis of the Femoral Head.

BACKGROUND: Osteonecrosis of the femoral head (ONFH) often affects young, active patients, and the femoral head's preservation is the primary goal of treatment for this disease. Vascularized iliac crest bone grafting is one of the many vascularized procedures used in treating ONHF. In some cases, we selectively performed this procedure using the musculoperiosteal iliac flap with the ascending branch of the lateral femoral circumflex artery for ONFH treatment. METHODS: Twelve patients (12 hips) with nontraumatic femoral head necrosis underwent musculoperiosteal iliac flap transfer with the ascending branch of the lateral femoral circumflex artery. The Harris Hip Score (HHS), visual analog scale score, and double-hip X-ray findings were used to analyze hip function changes within 10 days preoperatively and 6 and 12 months postoperatively. RESULTS: The mean HHS increased from 52.33 ± 3.34 preoperatively to 65.92 ± 5.04 6 months postoperatively and 79.75 ± 3.84 12 months postoperatively, and the data showed a statistical significance difference between preoperative and postoperative (F = 131.90, P < 0.01). The HHS at 6 and 12 months after surgery were significantly different (P < 0.01). The visual analog scale score showed the same trend. The x-ray of hip joints at 6 and 12 months after surgery showed that the femoral heads' shape and contour were good, femoral heads did not collapse, and the transferred bone flaps healed well. CONCLUSIONS: Musculoperiosteal iliac flap transfer with the ascending branch of the lateral femoral circumflex artery may be an effective method with a high clinical success rate for treating young patients with early to midstage ONFH.

Salivary gland ultrasound integrated with 2016 ACR/EULAR classification criteria improves the diagnosis of primary Sjögren's syndrome.

OBJECTIVES: To evaluate the utility of salivary gland ultrasound (SGUS) in the diagnosis of primary Sjögren's syndrome (pSS) singly or integrated with 2016 ACR/EULAR classification criteria. METHODS: Patients with suspected pSS were enrolled in the study. SGUS semi-quantitative scoring was used to assess salivary gland. Clinical characteristics were recorded, including autoantibodies, ophthalmic tests, salivary glands scintigraphy (SGS) and labial biopsy. The diagnostic accuracy of SGUS score and complementary value of SGUS to 2016 ACR/EULAR criteria were analysed. RESULTS: 282 patients were included for analysis. 161 were diagnosed as pSS and 121 as non-SS. SGUS score≥5 showed 64.7% sensitivity and 81.4% specificity for the diagnosis of pSS. Positive anti-SSA, abnormal SGS and SGUS score were significantly higher in pSS than non-SS group (80.1% vs. 14.0%, p<0.01; 91.3% vs. 57.0%, p<0.01; 8.4±6.6 vs. 2.6±3.2, p<0.01 respectively). A weighted score [(anti-SSA×16.5) + (SGS×14.5) + (SGUS×4.5)] was constructed. The score ≥17.5 could improve the sensitivity, and almost keep the specificity comparing to 2016 ACR/EULAR criteria (89.9% vs. 85.6% and 79.5% vs. 82.2%). When replacing labial biopsy by SGUS in 2016 ACR/EULAR criteria, both sensitivity and specificity were a bit decreased (85.0% vs. 85.6% and 79.8% vs. 82.2%). When adding SGUS to 2016 ACR/EULAR criteria, it showed better performance by improving the sensitivity (90.8% vs. 85.6%), while not losing the specificity (83.7% vs. 82.2%). CONCLUSIONS: Adding SGUS score to the 2016 ACR/EULAR criteria can improve the diagnosis utility of pSS. SGUS may be a feasible and prospective tool in the diagnosis of pSS.

Space-Confined Growth of Individual Wide Bandgap Single Crystal CsPbCl3 Microplatelet for Near-Ultraviolet Photodetection.

Perovskite photodetectors (PDs) with tunable detection wavelength have attracted extensive attention due to the potential application in the field of imaging, machine vision, and artificial intelligence. Most of the perovskite PDs focus on I- or Br-based materials due to their easy preparation techniques. However, their main photodetection capacity is situated in the visible region because of their narrower bandgap. Cl-based wide bandgap perovskites, such as CsPbCl3 , are scarcely reported because of the bad film quality of the spin-coated Cl-based perovskite, due to the poor solubility of the precursor. Therefore, ultraviolet detection using high-quality full inorganic perovskite films, especially with high thermal stability of materials and devices, is still a big challenge. In this work, high-quality single crystal CsPbCl3 microplatelets (MPs) synthesized by a simple space-confined growth method at low temperature for near-ultraviolet (NUV) PDs are reported. The single CsPbCl3 MP PDs demonstrate a decent response to NUV light with a high on/off ratio of 5.6 × 103 and a responsivity of 0.45 A W-1 at 5 V. In addition, the dark current is as low as pA level, leading to detectivity up to 1011 Jones. Moreover, PDs possess good stability and repeatability.

Investigation of channel model for weakly coupled multicore fiber.

We investigate the evolution of the decorrelation bandwidth of intercore crosstalk (IC-XT) based on the modified mode-coupled equations (MCEs) in homogeneous weakly coupled multicore fibers (WC-MCFs). The modified MCEs are numerically solved by combining the fourth order Runge-Kutta method with the compound Simpson integral method. It can be theoretically and numerically observed that the decorrelation bandwidth of IC-XT decreases with transmission distance by fractional linear function. The evolution rule of IC-XT's decorrelation bandwidth is further confirmed by experiments, which can be used as an evaluation criterion for the channel model. Finally, we propose a new channel model with the coupling matrix of IC-XT generated directly from the phase transfer function (PTF), which is in good agreement with the above evaluation criterion. We believe the proposed channel model can provide a good simulation platform for homogeneous WC-MCF based communication systems.

A comparative study on top-gated and bottom-gated multilayer MoS2 transistors with gate stacked dielectric of Al2O3/HfO2.

Top-gated and bottom-gated transistors with multilayer MoS2 channel fully encapsulated by stacked Al2O3/HfO2 (9 nm/6 nm) were fabricated and comparatively studied. Excellent electrical properties are demonstrated for the TG transistors with high on-off current ratio of 108, high field-effect mobility of 102 cm2 V-1 s-1, and low subthreshold swing of 93 mV dec-1. Also, enhanced reliability has been achieved for the TG transistors with threshold voltage shift of 10-3-10-2 V MV-1 cm-1 after 6 MV cm-1 gate-biased stressing. All improvement for the TG device can be ascribed to the formed device structure and dielectric environment. Degradation of the performance for the BG transistors should be attributed to reduced gate capacitance density and deteriorated interface properties related to vdW gap with a thickness about 0.4 nm. So, the TG transistor with MoS2 channel fully encapsulated by stacked Al2O3/HfO2 is a promising way to fabricate high-performance ML MoS2 field-effect transistors for practical electron device applications.

Determination of Pneumatic Tourniquet Pressure of Lower Limb by Ultrasonic Doppler.

OBJECTIVE: The aim of this study was to investigate the clinical effect of tourniquet inflation pressure setting by ultrasonic Doppler on lower limb operation. METHODS: Ninety-six patients with total knee arthroplasty were selected in this study from January 2015 to December 2015. The patients were randomly divided into the study group and the control group with 48 cases in each group. In the control group, the tourniquet pressure is determined by the doctor's request for the patient's condition, but all the tourniquet pressure values should be 80 KPa or less. In the study group, ultrasonic Doppler was used to monitor the popliteal artery blood flow of surgery limb with the maximum systolic velocity in artery as a reference value. The pressure of pneumatic tourniquet gradually increased until the maximum systolic velocity was reduced to 0. At this time, the popliteal artery blood flow was not present. The 2 groups of patients with lower extremity tourniquet pressure, hemostatic effect of intraoperative tourniquet, and the incidence of adverse reaction using tourniquets were observed and recorded. RESULTS: In the study group, the lower extremity tourniquet pressure and the incidence of adverse reaction using tourniquets were all better than that in control group; the difference between 2 groups was significant (P < 0.05). There was no significant difference between the 2 groups in the effect of hemostasis and the time of tourniquet operation (P > 0.05). CONCLUSIONS: The method of ultrasonic Doppler setting lower extremity tourniquet pressure during the operation could not only ensure the hemostatic effect, but it could also provide the optimum individual pneumatic tourniquet pressure value for patients. In the meanwhile, it could reduce the incidence of adverse reaction using tourniquets effectively as well as improve the safety of the tourniquet. This method played an important role in the recovery of patients.

Spatial-division multiplexed Brillouin distributed sensing based on a heterogeneous multicore fiber.

We have experimentally investigated spatial-division multiplexed (SDM) Brillouin optical time-domain analysis in a heterogeneous multicore fiber whose central core and six outer cores are made from different preforms, showing a ∼70 MHz Brillouin frequency shift (BFS) difference between them. It reveals that the heterogeneous central core and the outer cores have different temperature sensitivities, but their strain sensitivities are almost the same. By making use of the distinct temperature coefficients of these two kinds of cores, simultaneous and discriminative temperature and strain measurements are achieved. The bending-induced Brillouin gain spectrum (BGS) broadening issue in off-center cores has been clarified, and a solution has been proposed to eliminate the uncertainty caused by a bending-induced BFS shift, by averaging the BFS variations of two symmetrical outer cores. We show a new perspective for discriminative measurement in Brillouin distributed sensors based on SDM solutions.

Carvedilol suppresses cartilage matrix destruction.

Collagen type Ⅱ (col Ⅱ) and aggrecan, the main components of the extracellular matrix (ECM) in human joint cartilage, have been reported to be reduced by chronic production of inflammatory cytokine interleukin (IL)-1ß in arthritic joints. Carvedilol, a licensed medicine, has been used for treatment of hypertension, congestive heart failure and coronary disease in clinics. In this study, we investigated the effects of Carvedilol on the expression of col Ⅱ and aggrecan. Our results demonstrate that treatment with Carvedilol didn't change the expression of aggrecan or col Ⅱ at mRNA levels in SW1353 chondrocytes. However, the expression of aggrecan and Col II at protein levels were significantly reduced by IL-1ß treatment, which were reversed by Carvedilol in a dose dependent manner, suggesting the inhibitory effects of Carvedilol on the expression of aggrecan and Col II are at post-translational modification levels. In addition, it was shown that IL-1ß treatment highly induced MMP-1 and MMP-13 expression in SW1353 chondrocytes at both gene and protein expression levels, which were restored by Carvedilol in a dose dependent manner. Mechanistically, exposure to IL-1ß increased phosphorylation of IKK-α/ß and degradation of IκB-α in SW1353 chondrocytes, which were suppressed by pretreatment with Carvedilol. Administration of Carvedilol inhibited IL-1ß-induced translocation of NF-κB p65 from cytosol to nucleus manner. Notably, a luciferase reporter assay showed that IL-1ß severely increased NF-κB luciferase activity, which was markedly suppressed by Carvedilol treatment. Our results suggest that Carvedilol might be a potential therapeutic agent for chondro-protective therapy.