Efficient Carrier Transport in 2D Bi2O2Se/CsBi3I10 Perovskite Heterojunction Enables Highly-Sensitive Broadband Photodetection.

2D Bi2O2Se has recently garnered significant attention in the electronics and optoelectronics fields due to its remarkable photosensitivity, broad spectral absorption, and excellent long-term environmental stability. However, the development of integrated Bi2O2Se photodetector with high performance and low-power consumption is limited by material synthesis method and the inherent high carrier concentration of Bi2O2Se. Here, a type-I heterojunction is presented, comprising 2D Bi2O2Se and lead-free bismuth perovskite CsBi3I10, for fast response and broadband detection. Through effective charge transfer and strong coupling effect at the interfaces of Bi2O2Se and CsBi3I10, the response time is accelerated to 4.1 µs, and the detection range is expanded from ultraviolet to near-infrared spectral regions (365-1500 nm). The as-fabricated photodetector exhibits a responsivity of 48.63 AW-1 and a detectivity of 1.22×1012 Jones at 808 nm. Moreover, efficient modulation of the dominant photocurrent generation mechanism from photoconductive to photogating effect leads to sensitive response exceeding 103 AW-1 for heterojunction-based photo field effect transistor (photo-FETs). Utilizing the large-scale growth of both Bi2O2Se and CsBi3I10, the as-fabricated integrated photodetector array demonstrates outstanding homogeneity and stability of photo-response performance. The proposed 2D Bi2O2Se/CsBi3I10 perovskite heterojunction holds promising prospects for the future-generation photodetector arrays and integrated optoelectronic systems.

Controlled Growth of Large-Sized and Phase-Selectivity 2D GaTe Crystals.

GaTe has recently attracted significant interest due to its direct bandgap and unique phase structure, which makes it a good candidate for optoelectronics. However, the controllable growth of large-sized monolayer and few-layer GaTe with tunable phase structures remains a great challenge. Here the controlled growth of large-sized GaTe with high quality, chemical uniformity, and good reproducibility is achieved through liquid-metal-assisted chemical vapor deposition method. By using liquid Ga, the rapid growth of 2D GaTe flakes with high phase-selectivity can be obtained due to its reduced reaction temperature. In addition, the method is used to synthesize many Ga-based 2D materials and their alloys, showing good universality. Raman spectra suggest that the as-grown GaTe own a relatively weak van der Waals interaction, where monoclinic GaTe displays highly-anisotropic optical properties. Furthermore, a p-n junction photodetector is fabricated using GaTe as a p-type semiconductor and 2D MoSe2 as a typical n-type semiconductor. The GaTe/MoSe2 heterostructure photodetector exhibits large photoresponsivity of 671.52 A W-1 and high photo-detectivity of 1.48 × 1010 Jones under illumination, owing to the enhanced light absorption and good quality of as-grown GaTe. These results indicate that 2D GaTe is a promising candidate for electronic and photoelectronic devices.

High-performance mesoporous γ-Fe2O3 sphere/graphene aerogel composites towards enhanced lithium storage.

Transition metal oxides have recently been demonstrated as highly attractive anodes for high-capacity lithium ion batteries, whose electrochemical properties could be further improved through rational architecture design and incorporating reliable conductive network. Herein, mesoporous γ-Fe2O3 spheres/graphene aerogel composites were synthesized via a solvothermal pathway followed by suitable annealing. Experimental results reveal the uniform mesoporous structure and well-dispersed γ-Fe2O3 spheres with the size of 300-400 nm embedded in the mesopores of the graphene aerogel network. Compared with α-Fe2O3/graphene aerogel and pure γ-Fe2O3, the as-synthesized composite delivers, at the first cycle, a high discharging capacity of 1080 mAh g-1 at current density of 200 mA g-1. Even at much higher current density of 8000 mA g-1, satisfactory discharging capacities of 421.5 mAh g-1 can still be achieved. Upon 100 charging-discharging cycles, the specific capacity of as high as 890.5 mAh g-1 at 200 mA g-1 is maintained. The enhanced electrochemical properties could be attributed to their favorable three-dimensional graphene aerogel network, which accounts for the improved structural stability and electronic conductivity of γ-Fe2O3 during the lithiation/delithiation process.

Enhanced Transmission and Self-Cleaning of Patterned Sapphire Substrates Prepared by Wet Chemical Etching Using Silica Masks.

Highly transparent and superhydrophilic sapphire with surface antireflective subwavelength structures were prepared by wet etching using colloidal monolayer silica masks. The film thicknesses of the silica masks were adjusted by the volume concentrations of polystyrene spheres. The evolution of etching morphologies of sapphire was studied, and antireflective concave pyramid nanoarrays on sapphire substrates were designed by calculation and were then prepared. The transmission and wettability of as-obtained patterned sapphire substrates were also investigated. As for sapphire with optimum surface concave micropyramid arrays, average visible transmittance can reach 91.7%, which is apparently higher than that of flat sapphire (85.5%). Moreover, the concave pyramid arrays can significantly increase the surface hydrophilicity of sapphire, exhibiting a water contact angle of 12.6° compared with 62.7° of flat sapphire. The proposed method can be an excellent strategy for preparing antireflective and self-cleaning concave micropyramid subwavelength structures on sapphire without complicated equipment and expensive raw materials.

Broad-band anti-reflective pore-like sub-wavelength surface nanostructures on sapphire for optical windows.

Compared with conventional anti-reflective film, an anti-reflective sub-wavelength surface structure provides an ideal choice for a sapphire optical window especially in harsh environments. However, it is still a challenge to obtain a sapphire anti-reflective surface microstructure because of its high hardness and chemical inertness. In this paper, combined with optical simulation, we proposed a facile method based on the anodic oxidation of aluminum film and following epitaxial annealing. Al thin film was deposited on a sapphire substrate by magnetron sputtering, and anodic oxidation was then performed to prepare surface pore-like structures on the Al film. Followed by two-step annealing, both the anodic oxidized coating and underlying unoxidized Al film were transformed totally into alumina. The parameters of anodic oxidation were analyzed to obtain the optimal pore-like structures for the antireflection in the mid-infrared and visible spectrum regions, respectively. Finally, the optimized surface sub-wavelength nanostructure on sapphire can increase the transmittance by 7% in the wavelength range of 3000-5000 nm and can increase 13.2% significantly for visible spectrum region, respectively. Meanwhile, the surface wettability can be also manipulated effectively. The preparation of surface pore-like sub-wavelength structure by the annealing of anodic oxidized aluminum film on sapphire is a feasible, economical and convenient approach and can find the applications for various optoelectronic fields.

A retrospective study of the efficacy and safety of levofloxacin in children with severe infection.

Objectives: Levofloxacin is widely used because of its broad-spectrum antimicrobial activity and convenient dosing schedule. However, the relevance of its use in children remains to be investigated. The purpose of this study is to investigate the efficacy and safety of levofloxacin use in children with severe infections. Methods: We conducted a retrospective observational study of patients <18 years of age who received levofloxacin intravenously in the Pediatric Intensive Care Unit (PICU) of our hospital during the period between 2021 and 2022. Patient demographics, course characteristics, clinical effectiveness, and adverse event correlations were extracted through a retrospective tabular review. Results: We included 25 patients treated with 28 courses of levofloxacin. The mean age of these children treated with levofloxacin was 4.41 years. Conversion of pathogenic microbiological test results to negative after levofloxacin treatment was detected in 11 courses (39.29%). A decrease in inflammatory markers, white blood cell or C-reactive protein counts, was detected in 18 courses (64.29%). A total of 57 adverse events occurred during the treatment period, of which 21 were possibly related to levofloxacin and no adverse events were probably related to levofloxacin. Conclusion: The effectiveness of levofloxacin use in children with serious infections is promising, especially for the treatment of multidrug-resistant bacteria. Adverse events occurring during the initiation of levofloxacin therapy in children are reported to be relatively common, but in this study, only a small percentage of them were possibly related to levofloxacin, and none of them were highly possibly related to levofloxacin.

Plasma metagenomics reveals regional variations of emerging and re-emerging pathogens in Chinese blood donors with an emphasis on human parvovirus B19.

At present, many infectious pathogens, especially emerging/re-emerging pathogens, exist in the blood of voluntary blood donors and may be transmitted through blood transfusions. However, most of Chinese blood centers only routinely screen for HBV, HCV, HIV, and syphilis. We employed metagenomic next-generation sequencing (mNGS) to investigate the microbiome in healthy voluntary blood donors to help assess blood safety in China by identifying infectious pathogens presented in donations that could lead to transfusion-acquired infections. We collected 10,720 plasma samples from voluntary blood donors from seven blood centers in different cities during 2012-2018 in China. A total of 562 GB of clean data was obtained. By analyzing the sequencing data, it was found that the most commonly identified bacteria found in the healthy blood were Serratia spp. (5.0176%), Pseudomonas spp. (0.6637%), and Burkholderia spp. (0.5544%). The principal eukaryote were Leishmania spp (1.3723%), Toxoplasma gondii (0.6352%), and Candida dubliniensis (0.1848%). Among viruses, Human Parvovirus B19 (B19V) accounts for the highest proportion (0.1490%), followed by Torque teno midi virus (0.0032%) and Torque teno virus (0.0015%). Since that B19V is a non-negligible threat to blood safety, we evaluated the positive samples for B19V tested by mNGS using quantitative polymerase chain reaction, Sanger sequencing, and phylogenetic analysis to achieve a better understanding of B19V in Chinese blood donors. Subsequently, 9 (0.07%) donations were positive for B19V DNA. The quantitative DNA levels ranged from 5.58 × 102 to 7.24 × 104 IU/ml. The phylogenic analyses showed that prevalent genotypes belonged to the B19-1A subtype, which disclosed previously unknown regional variability in the B19V positivity rate. The investigation revealed that many microbes dwell in the blood of healthy donors, including some pathogens that may be dormant in the blood and only cause disease under specific conditions. Thus, investigating the range and nature of potential pathogens in the qualified donations provided a framework for targeted interventions to help prevent emerging and re-emerging infectious diseases.

Hepatitis B surface antigen variants in voluntary blood donors in Nanjing, China.

BACKGROUND: Hepatitis B virus (HBV) is still one of the serious infectious risks for the blood transfusion safety in China. One plausible reason is the emergence of the variants in the major antigenic alpha determinant within the major hydrophilic region (MHR) of hepatitis B surface antigen (HBsAg), which have been assumed to evade the immune surveillance and pose a challenge to the disease diagnosis. It is well documented that some commercial ELISA kits could detect the wild-type but not the mutant viruses. The high prevalence of HBV in China also impaired the application of nucleic acid testing (NAT) in the improvement of blood security. Molecular epidemiological study of HBsAg variations in China is still limited. This study was designed to identify the prevalence of mutations in the HBsAg in voluntary blood donors in Nanjing, China. METHODS: A total of 20,326 blood units were enrolled in this study, 39 donors were positive for HBV S gene in the nested-PCR. Mutations in the major hydrophilic region (MHR; aa 99-169) were identified by direct sequencing of S region. RESULTS: Among of 20,326 blood units in the Red Cross Transfusion Center of Nanjing from October 2008 to April 2009, 296 samples (1.46%, 296/20,326) were HBsAg positive in the 2 successive rounds of the ELISA test. In these HBsAg positive units, HBV S gene could be successfully amplified from 39 donors (13.18%, 39/296) in the nested-PCR. Sequence analysis revealed that 32 strains (82.1%, 32/39) belong to genotype B, 7 strains (17.9%, 7/39) to genotype C. Besides well known G145R, widely dispersed variations in the MHR of S region, were observed in 20 samples of all the strains sequenced. CONCLUSIONS: HBV/B and HBV/C are dominant in Nanjing, China. The mutations in the MHR of HBsAg associated with disease diagnosis are common.

[Effect of technological parameters of sputtering on the microstructure of silicon film investigated by Raman analysis].

In order to facilitate optical polishing of silicon carbide space telescope, in the present paper, silicon film, which has similar coefficient of thermal expansion with silicon carbide, was fabricated on SiC substrate by radio frequency magnetron sputtering. The effect of substrate temperature, radio frequency power, and substrate bias voltage was investigated by Raman scattering. The results indicate that at lower substrate temperature, the crystalline volume fraction of Si films increases with the increase in deposition temperature. Exceeding a certain temperature, the crystalline volume fraction decreases with further increasing deposition temperature; the increase in substrate bias voltage is bad for forming crystalline structure; the effect of radio power on microstructure of silicon film is comparatively complicated. As the rf power increases, the cluster size and crystallite volume fraction decrease, and both of them increase with further increasing the rf power. But when the rf power is too high, the crystallite volume fraction of the silicon film will decrease slightly.

Self-templated formation of (NiCo)9S8 yolk-shelled spheres for high-performance hybrid supercapacitors.

Rational materials design for the synthesis of desirable hollow micro- and nanostructures has recently revealed the remarkable potential for high-performance energy storage and conversion devices. Owing to their unique "core-void-shell" structural configurations, yolk-shell-structured electrode materials can achieve intimate contact with the electrolyte and alleviate the volume expansion issue during electrochemical cycling, which is therefore poised to further boost the electrochemical properties of hybrid supercapacitors. Herein, a facile self-templated strategy, consisting of a hydrothermal step and a high-temperature sulfurization process, has been developed for the construction of yolk-shell (NiCo)9S8 spheres in situ coated by graphite carbon ((NiCo)9S8/GC) due to the non-equilibrium thermal treatment of alkali metal alkoxides. The as-synthesized yolk-shelled sphere exhibits a high specific capacitance of 1434.4 F g-1 (179.3 mA h g-1) at a current density of 1 A g-1, and good rate capability and cycling stability with 83.1% capacitance retention at 8 A g-1 over 5000 cycles. To further demonstrate its practical application, a hybrid supercapacitor device was assembled using (NiCo)9S8/GC as the battery-type positive electrode and activated carbon (AC) as the capacitive-type electrode. The as-fabricated device can reach a wide voltage window of up to 1.6 V, deliver a high energy density of 55.6 W h kg-1 at a power density of 800.3 W kg-1 and maintain 90.2% of specific capacitance after 3000 cycles.

Selenium-rich nickel cobalt bimetallic selenides with core-shell architecture enable superior hybrid energy storage devices.

The continuous exploration of advanced electrode materials is of remarkable significance to revolutionize next-generation high-performance energy storage devices towards a green future. Benefiting from their electrochemically active sites and abundant redox centers, bimetallic selenides with desirable nanostructures recently have emerged as promising electrode alternatives for battery-supercapacitor hybrid (BSH) devices which demonstrate enormous potential in bridging the gap between electrochemical properties with high power densities (supercapacitors) and energy densities (batteries). Herein, employing the hydrothermal approach with solid Ni-Co spheres as precursors followed by the selenization process, selenide-rich bimetallic selenide spheres with a core-shell nanostructure were rationally designed and synthesized for use as the cathode electrode in superior BSH devices. The as-obtained (NiCo)9Se8/(NiCo)0.85Se (Ni-Co-Se) exhibits a high specific capacity of 164.44 mA h g-1 at a current density of 1 A g-1 with 85.72% capacity retention even after 5000 cycles at a current density of as high as 8 A g-1, suggesting its great promise in practical applications for BSH devices. By integrating activated carbon as the anode with the as-obtained bimetallic selenides as the cathode, an alkaline aqueous BSH device is fabricated and delivers a high energy density of 37.54 W h kg-1 at a high power density of 842.7 W kg-1. It is found that the excellent electrochemical performances can be ascribed to facile ion and electron transport pathways, high electrical conductivity and reliable structural robustness of the prepared selenides. Moreover, the synthetic strategy presented in this paper opens up an avenue to guide the synthesis of various anion doped bimetallic compounds towards high-performance energy conversion and storage devices.

Comparison of cyanobacterial communities in temperate deserts: A cue for artificial inoculation of biological soil crusts.

The topsoil cyanobacteria in biological soil crusts (BSCs) play a vital role in stabilizing soil surface of disturbed habitats in water and nutrient-poor ecosystems. Currently, artificial inoculation of BSCs is considered as an effective approach to restore habitats and accelerate ecosystem regeneration. Understanding the character of cyanobacterial communities is the necessary prerequisite to explore the artificial inoculation of BSCs. For this reason, cyanobacterial communities in BSCs were compared between two mid-latitute temperate deserts with distinct precipitation patterns. The results showed that Oscillatoriales and Nostocales dominated crusts in the Tengger desert with majority of rainfall in summer and early autumn while Oscillatoriales dominated crusts in the Kyzyl kum desert with more rainfall in winter and early spring. Moreover, filamentous Microcoleus vaginatus overwhelmingly dominated all the crusts in both deserts with Mastigocladopsis sp. and Chroococcidiopsis spp. as the dominant heterocystous cyanobacteria. Of note, genus Wilmottia kept a relative stable and high abundance in both deserts. The top two abundantly shared cyanobacteria (> 1% of total sequences) were M. vaginatus and Mastigocladopsis sp. in both deserts, while 16 genera with significant variances were found between the two deserts (P <0.05). Total variations of cyanobacterial communities across the deserts were largely explained by a combination of biotic factors (microbial biomass C and N) and abiotic factors (soil pH, soil water content, soil water holding capacity, and soil available potassium). Compared to better-developed crusts, cyanobacterial abundance was higher in cyanobacterial crusts. BSC type and/or geographic location significantly affected cyanobacterial Shannon diversity without significantly influencing species richness. Our data suggest that the basic and major groups (e.g. M. vaginatus, Wilmottia spp., Mastigocladopsis sp., and Chroococcidiopsis spp.), and the abundantly shared phylotypes which showed significant difference in cyanobacterial communities between deserts, should be focused on to further explore the artificial inoculation of BSCs in temperate drylands.

[XPS and Raman spectral analysis of nitrogenated tetrahedral amorphous carbon (ta-C : N) films with different nitrogen content].

Nitrogenated tetrahedral amorphous carbon (ta-C : N) films were prepared on the polished C--Si substrates by introducing highly pure nitrogen gas into the cathode region and the depositing chamber synchronously using filtered cathodic vacuum arc (FCVA) technology. The nitrogen content in the films was controlled by changing the flow rate of nitrogen gas. The configuration of ta-C : N films was investigated by means of X-ray photoelectron spectroscopy (XPS) and visible Raman spectroscopy. It was shown that the nitrogen content in the films increased from 0.84 at% to 5.37 at% monotonously when the nitrogen flow rate was varied from 2 seem to 20 sccm. The peak position of C (1s) core level moved towards higher binding energy with the increase in nitrogen content. The shift of C (1s) peak position could be ascribed to the chemical bonding between carbon and nitrogen atoms even though more three-fold coordinated sp2 configuration as in graphite was formed when the films were doped with more nitrogen atoms. Additionally, the half width of C(1s) peak gradually was also broadened with increasing nitrogen content. In order to discover clearly the changing regularities of the microstructure of the films, the XPS C(1s) spectra and Raman spectra were deconvoluted using a Gaussian-Lorentzian mixed lineshape. It was shown that the tetrahedral hybridization component was still dominant even though the ratio of sp2/sp3 obtained from C(1s) spectra rose with the increase in nitrogen content. The Raman measurements demonstrated that the G peak position shifted towards higher frequency from 1,561 to 1,578 cm(-1) and the ratio of ID/IG also rose with the increase in nitrogen content. Both results indicated that the graphitizing tendency could occur with the increase in nitrogen content in the films.

Achieving Ultrahigh Capacity with Self-Assembled Ni(OH)2 Nanosheet-Decorated Hierarchical Flower-like MnCo2O4.5 Nanoneedles as Advanced Electrodes of Battery-Supercapacitor Hybrid Devices.

Self-assembled Ni(OH)2 nanosheet-decorated hierarchical flower-like MnCo2O4.5 nanoneedles were synthesized via a cost-effective and facile hydrothermal strategy, aiming to realize a high-capacity advanced electrode of a battery-supercapacitor hybrid (BSH) device. It is demonstrated that the as-synthesized hierarchical flower-like MnCo2O4.5@Ni(OH)2-nanosheet electrode exhibits a high specific capacity of 318 mAh g-1 at a current density of 3 A g-1 and still maintains a capacity of 263.5 mAh g-1 at a higher current density of 20 A g-1, with an extremely long cycle lifespan of 87.7% capacity retention after 5000 cycles. Moreover, using the unique core-shell structure as the cathode and hollow Fe2O3 nanoparticles/reduced graphene oxide as the anode, the BSH device delivers a high energy density of 56.53 Wh kg-1 when the power density reaches 1.9 kW kg-1, and there is an extraordinarily good cycling stability with the capacity retention rate of 90.4% after 3000 cycles. It is believed that the superior properties originate from desirable core-shell structures alleviating the impact of volume changes as well as the existence of two-dimensional Ni(OH)2 nanosheets with more active sites, thereby improving the cycle stability and achieving ultrahigh capacity. These results will provide more access to the rational material design of diverse nanostructures toward high-performance energy storage devices.

Improvement effect of diterpene ginkgolides on acute tMCAO rats and chronic tMCAO rats / 药学学报

To study the cognitive effects of diterpene ginkgolides (DG), transient middle cerebral artery occlusion (tMCAO)-induced rats were established. tMCAO-rats induced by suture method were divided into sham operation group, solvent control group, NBP group, DG group. The animal experiments in the present study were performed in accordance with the Ethical Guidelines of the Laboratory Animal Welfare Ethical Committee of Peking Union Medical College (00000646, 00000635). The effects of DG on tMCAO rats were evaluated by neurological severity score, cerebral infarction volume measurement, step-down and Morris water maze test. In the acute tMCAO rat model, 100 mg·kg-1 DG improved the neural score and infarction volume. In the chronic tMCAO rat model, DG 100 mg·kg-1 significantly improved the survival rate of tMCAO-induced rats. The Morris water maze results showed 100 mg·kg-1 DG decreased the latency of tMCAO-induced rats to find the platform, while the effect was weaker than the NBP. However, DG 30 mg·kg-1 did not show a significant effect. In conclusion, DG exerted a therapeutic effect on transient middle cerebral artery occlusion.

Concordance between three integrated scores based on prostate biopsy and grade-grouping of radical prostatectomy specimen / 中华病理学杂志

Objective: To analyze three different integrated scoring schemes of prostate biopsy and to compare their concordance with the scoring of radical prostatectomy specimens. Methods: A retrospective analysis of 556 patients with radical prostatectomy performed in Nanjing Drum Tower Hospital, Nanjing, China from 2017 to 2020. In these cases, whole organ sections were performed, the pathological data based on biopsy and radical prostatectomy specimens were summarized, and 3 integrated scores of prostate biopsy were calculated, namely the global score, the highest score and score of the largest volume. Results: Among the 556 patients, 104 cases (18.7%) were classified as WHO/ISUP grade group 1, 227 cases (40.8%) as grade group 2 (3+4=7); 143 cases (25.7%) as grade group 3 (4+3=7); 44 cases (7.9%) as grade group 4 (4+4=8) and 38 cases (6.8%) as grade group 5. Among the three comprehensive scoring methods for prostate cancer biopsy, the consistency of global score was the highest (62.4%). In the correlation analysis, the correlation between the scores of radical specimens and the global scores was highest (R=0.730, P<0.01), while the correlations of the scores based on radical specimens with highest scores and scores of the largest volume based on biopsy were insignificant (R=0.719, P<0.01; R=0.631, P<0.01, respectively). Univariate and multivariate analyses showed tPSA group and the three integrated scores of prostate biopsy were statistically correlated with extraglandular invasion, lymph node metastasis, perineural invasion and biochemical recurrence. Elevated global score was an independent prognostic risk factor for extraglandular invasion and biochemical recurrence in patients; increased serum tPSA was an independent prognostic risk factor for extraglandular invasion; increased hjighest score was an independent risk factor for perineural invasion. Conclusions: In this study, among the three different integrated scores, the overall score is most likely corresponded to the radical specimen grade group, but there is difference in various subgroup analyses. Integrated score of prostate biopsy can reflect grade group of radical prostatectomy specimens, thereby providing more clinical information for assisting in optimal patient management and consultation.

Application of bilateral facial perforator artery flap in repairing large area defect in middle and lower part of nose / 中国修复重建外科杂志

OBJECTIVE@#To investigate the feasibility and effectiveness of bilateral facial perforator artery flap in repairing large area defect in middle and lower part of nose.@*METHODS@#The clinical data of 18 patients with large area defect in middle and lower part of nose repaired by bilateral facial perforator artery flap between January 2019 and December 2022 were retrospectively analyzed. Among them, there were 13 males and 5 females, the age ranged from 43 to 81 years, with an average of 63 years. There were 3 cases of nasal trauma, 4 cases of basal cell carcinoma, 8 cases of squamous cell carcinoma, 1 case of lymphoma, and 2 cases of large area solar keratosis. The size of the defect ranged from 3.0 cm×3.0 cm to 4.5 cm×4.0 cm; the size of unilateral flap ranged from 3.0 cm×1.3 cm to 3.5 cm×2.0 cm, and the size of bilateral flaps ranged from 3.3 cm×2.6 cm to 4.5 cm×4.0 cm.@*RESULTS@#One patient developed skin flap necrosis after operation, and a frontal skin flap was used to repair the wound; 1 case gradually improved after removing some sutures due to venous congestion in the skin flap, and the wound healing was delayed after dressing change; the remaining 16 cases of bilateral facial perforator artery flaps survived well and all wounds healed by first intention, without any "cat ear" malformation. All 18 patients had first intention healing in the donor area, leaving linear scars without obvious scar hyperplasia, and no facial organ displacement. All patients were followed up 3-12 months, with an average of 6 months. Due to the appropriate thickness of the flap, none of the 18 patients underwent secondary flap thinning surgery. All flaps had good blood circulation, similar texture and color to surrounding tissues, symmetrical bilateral nasolabial sulcus, and high patient satisfaction.@*CONCLUSION@#The bilateral facial perforator artery flaps for repairing large area defect in middle and lower part of nose can achieve good appearance and function, and the operation is relatively simple, with high patient satisfaction.

Relationship Between Maternal Negative Emotions and Feeding Patterns of Infants Aged 0-6 Months in Remote Rural Areas of Sichuan Province / 中国医学科学院学报

Objective To investigate the status of exclusive breastfeeding and bottle feeding in remote rural areas of Sichuan province and explore the relationship between negative emotions of mothers and feeding patterns of infants.Methods Multistage cluster sampling was employed to select the infants aged 0-6 months and their mothers in remote rural areas of Sichuan province.A self-designed questionnaire was used to collect the demographic characteristics of mothers and infants and the basic family information.The Chinese version of Depression Anxiety Stress scale was used to evaluate mothers' negative emotions,and the Breastfeeding Self-efficacy scale to assess the confidence level of mothers' behavior of adhering to exclusive breastfeeding.Results Totally 723 pairs of infants and their mothers were included.The exclusive breastfeeding and bottle feeding rates were 34.16% (247/723) and 57.54% (416/723),respectively.Mothers with depression tendency were less likely to adopt exclusive breastfeeding (OR=0.532,95%CI=0.291-0.974,P=0.041) and more likely to adopt bottle feeding (OR=1.877,95%CI=1.054-3.344,P=0.033).Further subgroup analysis of breastfeeding self-efficacy showed that in the group of low self-efficacy,the mothers with depression tendency were less likely to adopt exclusive breastfeeding (OR=0.461,95%CI=0.236-0.902,P=0.024) and more likely to adopt bottle feeding (OR=1.968,95%CI=1.047-3.701,P=0.036) than the mothers without depression tendency.In the group of high self-efficacy,mothers' depression,anxiety,and stress tendency had no significant correlation with infant feeding patterns (all P>0.05).Conclusions The mothers in the remote rural areas of Sichuan province are more likely to employ bottle feeding than exclusive breastfeeding.The mothers with stronger depression tendency demonstrate lower possibility of exclusive breastfeeding and higher possibility of bottle feeding.Breastfeeding self-efficacy may affect the association between maternal depression and infant feeding patterns.

Medicine+information: Exploring patent applications in precision therapy in cardiac surgery / 中国胸心血管外科临床杂志

@#Currently, in precision cardiac surgery, there are still some pressing issues that need to be addressed. For example, cardiopulmonary bypass remains a critical factor in precise surgical treatment, and many core aspects still rely on the experience and subjective judgment of cardiopulmonary bypass specialists and surgeons, lacking precise data feedback. With the increasing elderly population and rising surgical complexity, precise feedback during cardiopulmonary bypass becomes crucial for improving surgical success rates and facilitating high-complexity procedures. Overcoming these key challenges requires not only a solid medical background but also close collaboration among multiple interdisciplinary fields. Establishing a multidisciplinary team encompassing professionals from the medical, information, software, and related industries can provide high-quality solutions to these challenges. This article shows several patents from a collaborative medical and electronic information team, illustrating how to identify unresolved technical issues and find corresponding solutions in the field of precision cardiac surgery while sharing experiences in applying for invention patents.

Effect of transcatheter aortic valve replacement on postoperative left ventricular reverse remodeling in patients with aortic regurgitation / 中国胸心血管外科临床杂志

@#Objective     To investigate the left ventricular reverse remodeling (LVRR) in patients with aortic valve insufficiency with reduced ejection fraction (AIrEF) and aortic valve insufficiency with preserved ejection fraction (AIpEF) after transcatheter aortic valve replacement (TAVR). Methods    The clinical and follow-up data of patients who underwent TAVR in the Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from 2018 to 2021 were retrospectively analyzed. According to the guideline, the patients with left ventricular ejection fraction<55% were allocated to an AIrEF group, and the patients with left ventricular ejection fraction≥55% were allocated to an AIpEF group. Results    A total of 50 patients were enrolled. There were 19 patients in the AIrEF group, including 15 males and 4 females with a mean age of 74.5±7.1 years. There were 31 patients in the AIpEF group, including 19 males and 12 females with a mean age of 72.0±4.8 years. All patients underwent TAVR successfully. Echocardiographic results showed that TAVR significantly promoted LVRR in the patients. Significant LVRR occurred in the early postoperative period (the first day after the surgery) in both groups. It remained relatively stable after the LVRR in the early postoperative period (the first day after surgery) in the AIpEF patients, while it continued to occur in the early postoperative period (the first day after surgery) to three months after the surgery in the AIrEF patients, and then remained relatively stable. Compared to preoperative values, AIrEF patients had a reduction in the average left ventricular end-diastolic volume index and left ventricular end-systolic volume index by 16.8 mL/m2 (P=0.003) and 8.6 mL/m2 (P=0.005), respectively, and the average left ventricular end-diastolic diameter index and end-systolic diameter index decreased by 2.5 mm/m2 (P=0.003) and 1.9 mm/m2 (P=0.003), respectively on the first day after the surgery. In comparison to the first day after the surgery, AIrEF patients experienced an average increase of 12.1% in the left ventricular ejection fraction three months after the surgery (P<0.001). Conclusion    TAVR has achieved good therapeutic effects in patients with aortic valve insufficiency, significantly promoting the LVRR in patients, and has better curative effects in AIrEF patients.