Ultra-compact, broadband adiabatic passage optical couplers in thin-film lithium niobate on insulator waveguides.

We report the first demonstration of broadband adiabatic directional couplers in thin-film lithium niobate on insulator (LNOI) waveguides. A three LN-waveguide configuration with each waveguide having a ridge cross section of less than 1 square micron, built atop a layer of SiO2 based on a 500-µm-thick Si substrate, has been designed and constructed to optically emulate a three-state stimulated Raman adiabatic passage system, with which a unique counterintuitive adiabatic light transfer phenomenon in a high coupling efficiency of >97% (corresponding to a >15 dB splitting ratio) spanning telecom S, C, and L bands for both TE and TM polarization modes has been observed for a 2-mm long coupler length. An even broader operating bandwidth of >800 nm of the device can be found from the simulation fitting of the experimental data. The footprint of the realized LNOI adiabatic coupler has been reduced by >99% compared to its bulk counterparts. Such an ultra-compact, broadband LNOI adiabatic coupler can be further used to implement or integrate with various photonic elements, a potential building block for realizing large-scale integrated photonic (quantum) circuits in LN.

[Review of Research Progress in Biliary Substitutes].

Research and development of artificial biliary substitutes is an indispensable part of modern biliary surgery, bearing great clinical significance on the recovery of the normal functions of the biliary system. The implantation of artificial biliary substitutes may cause the blockage or stenosis of the biliary duct at the transplantation site, which is the most urgent problem in the research of artificial biliary substitutes. The fundamental cause of the problem is tissue hyperplasia caused by chronic inflammatory stimulation of artificial biliary substitutes. The regeneration of new bile duct tissue at the transplantation site can provide a solution to this problem. By looking at the literature from China and abroad, this paper reviewed the research and development of non-degradable artificial bile duct, degradable artificial bile duct and tissue-engineered artificial bile duct in order to provide reference for the further development of biliary replacements. Future studies should focus on the rapid formation of biliary epithelial layer on the tissue-engineered artificial biliary wall, the promotion of new biliary tissue formation, and the regulation of the degradation performance and mechanical properties of artificial biliary duct in order to fundamentally solve the problems encountered in the research of artificial biliary substitutes and accelerate the development of artificial biliary duct.

Optical control of an Airy beam via four-wave mixing and six-wave mixing.

We use a conventional linear Airy beam to prepare a nonlinear Airy beam via four-wave mixing (FWM) and six-wave mixing (SWM) processes in an atomic vapor. We find that its ballistic trajectory is a result of the competition between the transverse self-acceleration and nonlinear phase shift, and the intensity of Airy beam's sub lobes or main lobe is suppressed due to destructive interference of the FWM and SWM processes. By controlling the nonlinear overlap area of the linear Airy beam and two Gaussian beams, we find that the Airy beam's profile varies from one-dimensional (1D) to two-dimensional (2D). The profile evolution process can be applied to create a new (to our knowledge) type of nonlinear filter. In addition, we also observe the Airy beam's pattern in momentum space with electromagnetically induced transparency (EIT) in an atomic vapor. Our research results open up new possibilities for manipulating Airy beams that cannot be achieved with a conventional Airy beam.

A Novel Nomogram Predicting Distant Metastasis in T1 and T2 Gallbladder Cancer: A SEER-based Study.

Background: Gallbladder cancer (GBC) is the most common malignancy of the biliary system. Early T stage GBC patients with distant metastasis are proven to have a worse prognosis. In this study, our aim was to construct and validate a novel nomogram for predicting distant metastasis in T1 and T2 GBC. Methods: Between 2004 and 2014, patients with T1 and T2 GBC were identified in the Surveillance, Epidemiology, and End Results (SEER) database. All of the eligible patients were randomly divided into training and validation cohorts. Univariate and multivariate analyses were used to assess significant predictive factors associated with distant metastasis. A nomogram was developed and validated by a calibration curve and receptor operating characteristic curve (ROC) analysis. Results: According to the inclusion and exclusion criteria, 3013 patients with historically confirmed AJCC stage T1 and T2 GBC were enrolled. Younger age, high pathological grade, nonadenocarcinoma, T1, N1 and larger tumor size correlated positively with the risk of distant metastasis. A novel nomogram was established to predict distant metastasis in early T stage GBC patients. Internal validation with a calibration plot in the training cohort showed that this nomogram was well calibrated. Through ROC curve analysis, the areas under the ROC curves in the training and validation cohorts were 0.723 and 0.679, respectively. Conclusions: Although some limitations exist in this predictive model, the nomogram revealed the relationship between the clinicopathological characteristics of T1 and T2 GBC patients and the risk of distant metastasis. The novel nomogram will assist in patient counseling and guide treatment decision making for T1 and T2 GBC patients.

Membrane phospholipids remodeling upon imbibition in Brassica napus L. seeds.

Successful seed germination depends on the rapid repair of cell membrane damaged by dry storage. However, little is known about the reorganization of lipids during this process. In this study, the changes of intracellular redox environment, cell membrane integrity, lipid composition, and expression of genes related to phospholipid metabolism were assessed during imbibition of Brassica napus seeds. A total number of 443 lipids belonging to 7 categories were detected by ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS/MS). In the 24 h-imbibed seeds, the relative content of triacylglycerol was lower than in dry seeds, while the relative content of phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylinositol (PI), and phosphatidylserine (PS), especially PC (36:2, number of carbons in the acyl chains: number of double bonds), PC (36:3), and PE (36:3) were higher than those in dry seeds. Meanwhile, the content and unsaturation levels of phospholipids increased, indicating membrane lipids remodeling during seed imbibition. The plasma membrane integrity, which was measured by the relative electrolyte leakage (REL) of the membrane and FM4-64 fluorescent dye, was improved upon imbibition, confirming that cell membrane was repaired after 24 h-imbibition. The reduction of H2O2 content, redox potential, and malondialdehyde (MDA) content indicated that the degree of membrane lipid peroxidation was significantly decreased upon imbibition. Gene expression analysis showed that the differential expression of genes for key enzymes occurred in the plateau phase of the imbibition curve, i.e. after 8 h-to 24 h-imbibition. Moreover, the differential expression of genes such as those encoding phospholipase C (PLC), phospholipase D (PLD), triacylglycerol lipase (TAG lipase), choline/ethanolamine phosphotransferase (CEPT), and phosphatidylserine synthase (PTDSS2) during imbibition indicated that membrane lipid remodeling was related to complex metabolic pathways, among which the degradation of triacylglycerol and the synthesis of phospholipids using diacylglycerol might play an important role during membrane remodeling.

MiR-205 suppresses tumor growth, invasion, and epithelial-mesenchymal transition by targeting SEMA4C in hepatocellular carcinoma.

Growing evidence indicates that microRNAs are involved in tumorigenesis and progression of hepatocellular carcinoma (HCC). However, the functional mechanisms of miR-205 in HCC remain largely unknown. Here, we demonstrate that miR-205 expression was significantly down-regulated in HCC tissues and cell lines and was correlated with metastatic pathologic features and shorter disease-free and overall survival. Overexpression of miR-205 dramatically inhibited HCC cell proliferation, apoptosis, migration, invasion, epithelial-mesenchymal transition (EMT) in vitro, and tumor growth in vivo. We subsequently identified semaphorin 4C (SEMA4C) as a novel target of miR-205. Furthermore, high expression levels of SEMA4C were frequently found in HCC tissues and were associated with poor prognosis. Ectopic expression of SEMA4C restored the suppressive effect of overexpressed miR-205 on migration, invasion, and EMT. Taken together, our findings provide new insight into the critical role of miR-205 in regulating tumor growth, invasion, and EMT of HCC, suggesting miR-205 may serve as a promising therapeutic target and novel prognostic indicator for patients with HCC.-Lu, J., Lin, Y., Li, F., Ye, H., Zhou, R., Jin, Y., Li, B., Xiong, X., Cheng, N. MiR-205 suppresses tumor growth, invasion and epithelial-mesenchymal transition by targeting SEMA4C in hepatocellular carcinoma.

Regulation of the placental BCRP transporter by PPAR gamma.

Identifying regulators of placental breast cancer resistance protein (BCRP) expression is critical as downregulation of this transporter may increase exposure of the fetus to xenobiotics. Here, we sought to test whether the nuclear receptor peroxisome proliferator-activated receptor γ (PPARγ) regulates BCRP expression in the placenta. To test this, human BeWo placental choriocarcinoma cells were cultured with the PPARγ agonist rosiglitazone or the PPARγ antagonist T0070907 for 24 h. Messenger RNA (mRNA) expression of syncytialization markers, GCM1 and hCGß, as well as BCRP increased with PPARγ agonist treatment. Conversely, BCRP mRNA and protein expression decreased 30%-50% with PPARγ antagonist treatment. Rosiglitazone enhanced BCRP protein expression and transport activity, resulting in a 20% greater efflux of the substrate Hoechst 33342 compared with control cells. These results suggest that PPARγ can upregulate BCRP expression in the placenta, which may be important in understanding mechanisms that protect the fetus from xenobiotic exposure during development.

Patient-Specific Neutralizing Antibody Responses to Herpes Simplex Virus Are Attributed to Epitopes on gD, gB, or Both and Can Be Type Specific.

UNLABELLED: Herpes simplex virus 1 (HSV-1) and HSV-2 infect many humans and establish a latent infection in sensory ganglia. Although some infected people suffer periodic recurrences, others do not. Infected people mount both cell-mediated and humoral responses, including the production of virus-neutralizing antibodies (Abs) directed at viral entry glycoproteins. Previously, we examined IgGs from 10 HSV-seropositive individuals; all neutralized virus and were directed primarily against gD or gD+gB. Here, we expand our studies and examine 32 additional sera from HSV-infected individuals, 23 of whom had no recurrent disease. Using an Octet RED96 system, we screened all 32 serum samples directly for both glycoprotein binding and competition with known neutralizing anti-gD and -gB monoclonal Abs (MAbs). On average, the recurrent cohort exhibited higher binding to gD and gB and had higher neutralization titers. There were similar trends in the blocking of MAbs to critical gD and gB epitopes. When we depleted six sera of Abs to specific glycoproteins, we found different types of responses, but always directed primarily at gD and/or gB. Interestingly, in one dual-infected person, the neutralizing response to HSV-2 was due to gD2 and gB2, whereas HSV-1 neutralization was due to gD1 and gB1. In another case, virus neutralization was HSV-1 specific, with the Ab response directed entirely at gB1, despite this serum blocking type-common anti-gD and -gB neutralizing MAbs. These data are pertinent in the design of future HSV vaccines since they demonstrate the importance of both serotypes of gD and gB as immunogens. IMPORTANCE: We previously showed that people infected with HSV produce neutralizing Abs directed against gD or a combination of gD+gB (and in one case, gD+gB+gC, which was HSV-1 specific). In this more extensive study, we again found that gD or gD+gB can account for the virus neutralizing response and critical epitopes of one or both of these proteins are represented in sera of naturally infected humans. However, we also found that some individuals produced a strong response against gB alone. In addition, we identified type-specific contributions to HSV neutralization from both gD and gB. Contributions from the other entry glycoproteins, gC and gH/gL, were minimal and limited to HSV-1 neutralization. Knowing the variations in how humans see and mount a response to HSV will be important to vaccine development.

Lymphocyte to monocyte ratio and prognostic nutritional index predict survival outcomes of hepatitis B virus-associated hepatocellular carcinoma patients after curative hepatectomy.

INTRODUCTION: Lymphocytes are an integral part of lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI). Both LMR and PNI which reflect body's inflammatory and nutritional status can be obtained from routine blood and biochemical test conveniently. Little evidence concerning the prognostic value of LMR and PNI in hepatocellular carcinoma (HCC) patients has been published. This study aimed to investigate the prognostic value of LMR and PNI in hepatitis B virals (HBV)-associated HCC patients who underwent curative hepatectomy. METHODS: Between January 2008 and June 2013, 450 surgically treated HCC patients were retrospectively analyzed. Clinicopathological parameters, LMR and PNI were collected and compared. The multivariate analysis was performed to indentify independent prognostic factors. Overall survival (OS) and recurrence-free survival (RFS) rates were also compared. RESULTS: Tumor size, vascular invasion, alpha fetoprotein level, LMR and PNI were independent prognostic factors for OS. Tumor number, tumor size, vascular invasion, LMR and PNI were independent prognostic factors for RFS. Either a high LMR or PNI could predict favorable OS and RFS in surgically treated HCC patients and vice versa. CONCLUSIONS: Both LMR and PNI were significant independent predictors that can predict survival outcomes in HBV-associated HCC patients who received curative hepatectomy. J. Surg. Oncol. 2016;114:202-210. © 2016 Wiley Periodicals, Inc.

Characterization of the interaction of staphylococcal enterotoxin B with CD1d expressed in human renal proximal tubule epithelial cells.

BACKGROUND: Participation of renal cells in the pathogenesis of staphylococcal enterotoxin B (SEB) is critical for late cleansing and sequestration of the antigens facilitated by CD1d mediated antigen sensing and recognition. This is a noted deviation from the typical antigen recognition process that recruits the major histocompatibility complex class II (MHC II) molecules. The immunological importance of CD1d is underscored by its influences on the performances of natural killer T-cells and thereby mediates the innate and adaptive immune systems. RESULTS: Using diffraction-based dotReady™ immunoassays, the present study showed that SEB directly and specifically conjugated to CD1d. The specificity of the conjugation between SEB and CD1d expressed on human renal proximal tubule epithelial cells (RPTEC) was further established by selective inhibition of CD1d prior to its exposure to SEB. We found that SEB induced the expression of CD1d on the cell surface prompting a rapid conjugation between them. The mRNA transcripts encoding CD1d remained elevated potentially after completing the antigen cleansing process. CONCLUSION: Molecular targets associated with the delayed pathogenic response have essential therapeutic values. Particularly in the event of bioterrorism, the caregivers are typically able to intervene much later than the toxic exposures. Given circumstances mandate a paradigm shift from the conventional therapeutic strategy that counts on targeting the host markers responding to the early assault of pathogens. We demonstrated the role of CD1d in the late stage of pathogen recognition and cleansing, and thereby underscored its clinical potential in treating bioweaponizable antigens, such as Staphylococcal enterotoxin B (SEB).

Prognostic Significance of Sarcomatous Change in Patients with Hepatocellular Carcinoma After Surgical Resection.

BACKGROUND: Hepatocellular carcinoma (HCC) with sarcomatous change (SC) is a rare malignancy associated with high aggressiveness and poor prognosis; however, its prognostic significance remains unclear. METHODS: From January 1994 to April 2012, surgically resected HCCs with SC (n = 52) at West China Hospital were retrospectively reviewed. HCC with SC was defined as the concomitant presence of the sarcomatous component occupying at least 10 % (but not predominantly) of the HCC-bearing tissue. To validate its prognostic significance, we compared the clinicopathological features and survival rates of these patients with a cohort of 214 randomly selected ordinary HCC patients during the same period. RESULTS: The clinicopathological characteristics of HCC with SC were similar to those of ordinary HCC, with the exception of capsule formation, adjacent organ invasion, lymph node metastasis, and TNM staging. A total of 45 (86.5 %) HCC patients with SC experienced a recurrence, with a median time to recurrence of 6.0 months. Overall survival (OS) rates in the sarcomatous HCC group at 1, 2, and 3 years were 55.8, 25, and 17.3 %, respectively, which were significantly lower than those in the ordinary HCC group (p < 0.001). On multivariable analysis, macrovascular invasion, satellite nodules, and R1/R2 resection were identified as independent risk factors for shorter disease-free survival and OS. CONCLUSIONS: The presence of SC in HCC was uncommon, and was associated with much poorer prognosis than ordinary HCC. Radical resection with negative margin is essential for improving the prognosis. Future prospective studies are warranted to determine if recurrent patients can benefit from postoperative adjuvant therapies.

Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis.

BACKGROUND: Appendectomy, the surgical removal of the appendix, is performed primarily for acute appendicitis. Patients who undergo appendectomy for complicated appendicitis, defined as gangrenous or perforated appendicitis, are more likely to suffer from postoperative complications. The routine use of abdominal drainage to reduce postoperative complications after appendectomy for complicated appendicitis is controversial. OBJECTIVES: To assess the safety and efficacy of abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. SEARCH METHODS: We searched The Cochrane Library (Issue 1, 2014), MEDLINE (1950 to February 2014), EMBASE (1974 to February 2014), Science Citation Index Expanded (1900 to February 2014), and Chinese Biomedical Literature Database (CBM) (1978 to February 2014). SELECTION CRITERIA: We included all randomised controlled trials (RCTs) that compared abdominal drainage and no drainage in patients undergoing emergency open appendectomy for complicated appendicitis. DATA COLLECTION AND ANALYSIS: Two review authors identified the trials for inclusion, collected the data, and assessed the risk of bias independently. We performed the meta-analyses using Review Manager 5. We calculated the risk ratio (RR) for dichotomous outcomes (or a Peto odds ratio for very rare outcomes), and the mean difference (MD) for continuous outcomes with 95% confidence intervals (CI). MAIN RESULTS: We included five trials involving 453 patients with complicated appendicitis who were randomised to the drainage group (n = 228) and the no drainage group (n = 225) after emergency open appendectomies. All of the trials were at a high risk of bias. There were no significant differences between the two groups in the rates of intra-peritoneal abscess or wound infection. The hospital stay was longer in the drainage group than in the no drainage group (MD 2.04 days; 95% CI 1.46 to 2.62) (34.4% increase of an 'average' hospital stay). AUTHORS' CONCLUSIONS: The quality of the current evidence is very low. It is not clear whether routine abdominal drainage has any effect on the prevention of intra-peritoneal abscess after open appendectomy for complicated appendicitis. Abdominal drainage after an emergency open appendectomy may be associated with delayed hospital discharge for patients with complicated appendicitis.

Percutaneous needle aspiration versus catheter drainage in the management of liver abscess: a systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to compare the effectiveness of percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the management of liver abscess. METHODS: Electronic searches (Cochrane Library, MEDLINE, EMBASE, SCIE) were conducted to identify randomized controlled trials (RCTs) comparing PNA and PCD. A meta-analysis was subsequently performed. RESULTS: A total of five RCTs covering 306 patients were included. The meta-analysis showed that outcomes in patients treated with PCD were superior to those in patients treated with PNA in terms of success rate [relative risk (RR): 0.81, 95% confidence interval (CI) 0.66-0.99; P = 0.04], clinical improvement [standardized mean difference (SMD): -0.73, 95% CI 0.36-1.11; P = 0.0001] and days to achieve a 50% reduction in abscess cavity size (SMD: -1.08, 95% CI 0.64-1.53; P < 0.00001). No significant differences were found in duration of hospitalization (mean difference: -0.17, 95% CI -2.10 to 1.75; P = 0.86) or procedure-related complications (RR: 0.50, 95% CI 0.10-2.63; P = 0.41). Days to achieve the total or near total resolution of the abscess cavity and mortality were not calculated because data in the RCTs in the meta-analysis were insufficient. CONCLUSIONS: Both PNA and PCD are safe methods of draining liver abscesses. However, PCD is more effective than PNA because it facilitates a higher success rate, reduces the time required to achieve clinical relief and supports a 50% reduction in abscess cavity size. However, among successfully treated patients, the outcomes of PNA are comparable with those of PCD.

[Risk factors of hepatolithasis-associated intrahepatic cholangiocarcinoma and the value of serum tumor-related makers in its diagnosis].

OBJECTIVE: To explore the risk factors of hepatolithasis-associated intrahepatic cholangiocarcinoma (HICC) and the clinical value of serum tumor-related markers for the detection of HICC. METHODS: Clinical data were collected from 58 patients pathologically diagnosed as HICC between 2005 and 2011 in West China Hospital of Sichuan University and 189 patients diagnosed as hepatolithiasis alone in the same period as matched control group. Logistic regression analysis was used to detect the independent risk factors of HICC and ROCs curve were constructed to assess the diagnostic value of CA199, CEA, GGT and ALP. RESULTS: The patients in both HICC group and control group presented similar clinical symptoms except weight loss. The results of univariate analysis suggested cholangioenterostomy (P < 0.001), early stone removal (OR = 0.001), family history of cancer (P = 0.001) were associated with the incidence of HICC. The results of Multivariate analysis suggested diabetes mellitus (OR = 3.621, 95% CI: 1.333-9.834, P = 0.012), family history of cancer (OR = 16.830, 95% CI: 1.937-146.21, P = 0.010), cholangioenterostomy (OR = 5.115, 95% CI: 1.733-15.098, P = 0.003), early removal of stone (OR = 0.315, 95% CI: 0.128-0.771, P = 0.011) and CA199 > 100 IU/mL (OR = 5.478, 95% CI: 2.539-11.820, P < 0.001) were independent risk factors for hICC. Serum CA199 and CEA level presented low diagnostic accuracy, a combined test (CA199 > 100 IU/mL or CEA > 5 ng/mL) showed better diagnostic performance with a 71.05% of sensitivity and 82.05% of specificity. CONCLUSION: Cholangioenterostomy, diabetes, early and complete stone removal were independent risk factors for hepatolithiasis-associated ICC. A combined test of CA199 and CEA could be an effective detecting tool for HICC.

Development and validation of nomogram to predict overall survival and disease-free survival after surgical resection in elderly patients with hepatocellular carcinoma.

Background: Hepatocellular carcinoma (HCC) is one of the common causes of tumor death in elderly patients. However, there is a lack of individualized prognostic predictors for elderly patients with HCC after surgery. Method: We retrospectively analyzed HCC patients over 65 years old who underwent hepatectomy from 2015 to 2018, and randomly divided them into training cohort and validation cohort in a ratio of 3:1. Univariate Cox regression was used to screen the risk factors related to prognosis. Prognostic variables were further selected by least absolute shrinkage and selection operator regression model (LASSO) and multivariate Cox regression to identify the predictors of overall survival (OS) and disease-free survival (DFS). These indicators were then used to construct a predictive nomogram. The receiver operating characteristic curve (ROC curve), calibration curve, consistency index (C-index) and decision analysis curve (DCA) were used to test the predictive value of these independent prognostic indicators. Result: A total of 188 elderly HCC patients who underwent hepatectomy were enrolled in this study. The independent prognostic indicators of OS included albumin (ALB), cancer embolus, blood loss, viral hepatitis B, total bilirubin (TB), microvascular invasion, overweight, and major resection. The independent prognostic indicators of DFS included major resection, ALB, microvascular invasion, laparoscopic surgery, blood loss, TB, and pleural effusion. In the training cohort, the ROC curve showed that the predictive values of these indicators for OS and DFS were 0.827 and 0.739, respectively, while in the validation cohort, they were 0.798 and 0.694. The calibration curve nomogram exhibited good prediction for 1-year, 2-year, and 3-year OS and DFS. Moreover, the nomogram models exhibited superior performance compared to the T-staging suggested by C-index and DCA. Conclusion: The nomogram established in this study demonstrate commendable predictive efficacy for OS and DFS in elderly patients with HCC after hepatectomy.Core Tip: The purpose of this retrospective study is to screen the risk factors of survival and recurrence in elderly patients with HCC after hepatectomy. The nomogram included cancer embolus, viral hepatitis B, overweight, major resection, ALB, microvascular invasion, laparoscopic surgery, blood loss, TB, and pleural effusion as predictors. The calibration curve of this nomogram was good, indicating credible predictive value and clinical feasibility.

Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery.

BACKGROUND: Laparoscopic surgery is now widely performed to treat various abdominal diseases. Currently, carbon dioxide is the most frequently used gas for insufflation of the abdominal cavity (pneumoperitoneum). Many other gases have been introduced as alternatives to carbon dioxide for establishing pneumoperitoneum. OBJECTIVES: To assess the safety, benefits, and harms of different gases for establishing pneumoperitoneum in patients undergoing laparoscopic abdominal surgery. SEARCH METHODS: We searched The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and Chinese Biomedical Literature Database (CBM) until September 2012. SELECTION CRITERIA: We only included randomized controlled trials comparing different gases for establishing pneumoperitoneum in patients undergoing laparoscopic abdominal surgery under general anaesthesia. DATA COLLECTION AND ANALYSIS: Two review authors identified the trials for inclusion, collected the data, and assessed the risk of bias independently. We performed the meta-analyses using Review Manager 5. We calculated the risk ratio (RR) for dichotomous outcomes and the mean difference (MD) or standardized mean difference (SMD) for continuous outcomes with 95% confidence intervals (CI). MAIN RESULTS: Carbon dioxide pneumoperitoneum versus nitrous oxide pneumoperitoneum Three trials randomized 196 participants (the majority with low anaesthetic risk) to carbon dioxide pneumoperitoneum (n =96) or nitrous oxide pneumoperitoneum (n =100). All of the trials were of high risk of bias. Two trials (n=143) showed lower pain scores in nitrous oxide pneumoperitoneum at various time points on the first post-operative day. One trial (n=53) showed no difference in the pain scores between the groups. There were no significant differences in cardiopulmonary complications, surgical morbidity, or cardiopulmonary changes between the groups. There were no serious adverse events related to either carbon dioxide or nitrous oxide pneumoperitoneum. Carbon dioxide pneumoperitoneum versus helium pneumoperitoneum Four trials randomized 144 participants (the majority with low anaesthetic risk) to carbon dioxide pneumoperitoneum (n =75) or helium pneumoperitoneum (n =69). All of the trials were of high risk of bias. Fewer cardiopulmonary changes were observed with helium pneumoperitoneum than carbon dioxide pneumoperitoneum. There were no significant differences in cardiopulmonary complications, surgical morbidity, or pain scores. There were three serious adverse events (subcutaneous emphysema) related to helium pneumoperitoneum. Carbon dioxide pneumoperitoneum versus any other gas pneumoperitoneum There were no randomized controlled trials comparing carbon dioxide pneumoperitoneum to any other gas pneumoperitoneum. AUTHORS' CONCLUSIONS: 1. Nitrous oxide pneumoperitoneum during laparoscopic abdominal surgery appears to decrease post-operative pain in patients with low anaesthetic risk.2. Helium pneumoperitoneum decreases the cardiopulmonary changes associated with laparoscopic abdominal surgery. However, this did not translate into any clinical benefit over carbon dioxide pneumoperitoneum in patients with low anaesthetic risk.3. The safety of nitrous oxide and helium pneumoperitoneum has yet to be established. More randomized controlled trials on this topic are needed. Future trials should include more patients with high anaesthetic risk. Furthermore, such trials need to use adequate methods to reduce the risk of bias.

Case Report: Primary lymphoepithelioma-like intrahepatic cholangiocarcinoma.

Background: Lymphoepithelioma-like intrahepatic cholangiocarcinoma (LEL-ICC) is a rare variant of intrahepatic cholangiocarcinoma. Epstein-Barr virus (EBV) infection was considered to play a pivotal role in the tumorigenesis of LEL-ICC. It is difficult to diagnosis of LEL-ICC due to the lack of specific features regarding the laboratory test results and imaging findings. At present, the diagnosis of LEL-ICC mainly depends on the histopathologic and immunohistochemical examinations. In addition, the prognosis of LEL-ICC was better than classical cholangiocarcinomas. To our knowledge, only few cases of LEL-ICC have been reported in the literature. Case presentation: We presented a case of a 32-year-old Chinese female with LEL-ICC. She had a 6-month history of upper abdominal pain. The magnetic resonance imaging (MRI) showed a 1.1× 1.3 cm lesion in the left lobe of liver, appearing low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. The patient underwent laparoscopic left lateral sectionectomy. The postoperative histopathologic and immunohistochemical examinations results allowed for the definitive diagnosis of LEL-ICC. The patient was free from tumor recurrence after a 28 months follow-up. Conclusion: In this study, we reported a rare case of LEL-ICC associated with both HBV and EBV infection. EBV infection might play a pivotal role in the carcinogenesis of LEL-ICC, and surgical resection is still the most effective treatment at present. Further research on the etiology and treatment strategies of LEL-ICC is required.

Recognition Mechanism of Dangerous Goods Marks: Evidence from an Event-Related Potential Study.

Dangerous goods marks are the most effective means of alerting individuals to the potential dangers associated with the transport of dangerous goods. In order to gain a better understanding of how dangerous goods marks convey risk information, the cognitive processing of dangerous goods marks was examined by measuring event-related potentials (ERPs). We recruited 23 participants, and their ERP data were recorded. We discovered that the dangerous goods marks elicited a larger P200 amplitude and a smaller N300 amplitude, indicating that, compared to other marks, the dangerous goods marks exhibited stronger warning information and drew more attention from the subjects. Simultaneously, dangerous goods marks elicited insufficient emotional arousal in individuals. Therefore, these findings suggest that the designs of dangerous goods marks need to be improved, such as improving the graphic consistency. Changes in ERP patterns can be used to measure the risk perception level of dangerous goods marks, which can be used as an accurate indicator of the effectiveness of warning sign design. In addition, this study provides a theoretical foundation for the cognitive understanding mechanism of dangerous goods marks.

Self-Raman 1176 nm Laser Generation from Nd:YVO4 Crystal by Resonator Cavity Coating.

Crystal coating is an important process in laser crystal applications. According to the crystal characteristics of neodymium-doped yttrium vanadate (Nd:YVO4), its intrinsic parameters, and optical film design theory, Ta2O5 and SiO2 were selected separately as high and low refractive index materials. The optical properties and surface roughness of the films were characterized by OptiLayer and Zygo interferometers, and the effects of ion source bias on refractive index and surface roughness were investigated so that the optimal ion source parameters were determined. Optical monitoring and quartz crystal control were combined to accurately control the thickness of each film layer and to reduce the monitoring error of film thickness. The prepared crystal device was successfully applied to the 1176 nm laser output system.

Development of Wide-Angle Depolarizing Reflector at 1064 nm.

Optical coherence tomography is a new promising chromatographic imaging technique with the advantages of noncontact and high resolution without damage, which is widely used in the field of biological tissue detection and imaging. As an important optical element in the system, the wide-angle depolarizing reflector plays a key role in the accurate acquisition of optical signals. Ta2O5 and SiO2 are selected as the coating materials for the technical parameter requirements of the reflector in the system. Based on the basic theory of optical thin film and combined with MATLAB and OptiLayer software, the design of 0~60° incident 1064 ± 40 nm depolarizing reflective film is realized by establishing the evaluation function of the film system. To optimize the oxygen-charging distribution scheme during film deposition, the weak absorption properties of the film materials are characterized by optical thermal co-circuit interferometry. According to the sensitivity distribution of the film layer, the optical control monitoring scheme with a thickness error of less than 1% is designed rationally. "Crystal control + optical control" is used to precisely control the thickness of each film layer and complete the preparation of resonant cavity film. The measurement results show that the average reflectance is more than 99.5%, and the deviation of P-light and S-light is less than 1% in the 1064 ± 40 nm wavelength band range from 0° to 60°, which meets the requirements of optical coherence tomography system.