[Effect of sirolimus combined with anti-CD20 monoclonal antibody desensitization on the prognosis of patients underwent haploidentical stem cell transplantation].

Objective: To investigate the effects of sirolimus combined with anti-CD20 monoclonal antibody desensitization on the prognosis of patients with haploidentical stem cell transplantation (haplo-SCT). Methods: Fifteen consecutive patients who received haplo-SCT and pre-transplant donor specific anti-human leukocyte antigen (HLA) antibody (DSA) positive [mean fluorescence intensity (MFI)≥2 000] in the Institute of Hematological Diseases from November 2021 to March 2023 were retrospectively recruited into the desensitized group. There were 4 males and 11 females, with a median age [M(Q1, Q3)] of 48 (37, 59) years. All patients were desensitized with sirolimus combined with anti-CD20 monoclonal antibody. The non-desensitized group included 29 patients with haplo-SCT who had not received desensitization treatment from August 2012 to June 2016. There were 12 males and 17 females with a median age of 42 (26, 50) years. Up to October 1, 2023, the median follow-up time was 13 (9, 18) months in the study group and 23 (14, 29) months in the control group. The changes of MFI before and after desensitization treatment and the prognosis of patients in the desensitized group were compared, including the incidence of primary implantation failure (pGF), neutrophil implantation time, platelet implantation time, grade Ⅱ-Ⅳ acute graft-versus-host disease (GVHD) and chronic GVHD incidence, non-recurrence related mortality, event-free survival rate, disease-free survival rate and overall survival rate. The survival curve was drawn by Kaplan-Meier method, and the survival rate between groups was compared with Log-rank test. Results: After desensitization treatment, the level of DSA MFI in the desensitized group decreased from 8 879 (7 544, 11 495) to 3 781 (1 638, 4 165) after desensitization treatment (P<0.01). All of the patients achieved hematopoietic recovery, and the median time for neutrophil and platelet engraftment were 14 (11, 15) and 20 (18, 25) days, respectively. The incidence of pGF in the desensitized group was 0, which was lower than that in the non-desensitized group (34.5%, 10/29) (P=0.011). The expected 1-year disease-free survival rate and overall survival rate in the desensitized group were 100% (15/15) and 100% (15/15) respectively, while those in the non-desensitized group were 75.9% (22/29) and 75.9% (22/29) respectively, the difference was not statistically significant (both P>0.05). The one-year event-free survival rate in the desensitized group was expected to be 100% (15/15), which was higher than that in the non-desensitized group (51.3%, 15/29) (P=0.002). Conclusion: Sirolimus combined with anti-CD20 monoclonal antibody desensitization therapy can reduce the DSA level of haplo-SCT recipients, promote hematopoietic engraftment after transplantation, and avoid the occurrence of pGF after transplantation.

[Analysis of risk factors of short-term prognosis in patients with severe Budd-Chiari syndrome].

Objective: To explore the risk factors of short-term prognosis of severe Budd-Chiari syndrome (BCS) patients,established and verified the nomogram prediction model for these BCS patients and evaluated its clinical application value. Methods: This study is a retrospective cohort study. The clinical data of 171 patients with severe BCS diagnosed were retrospectively analyzed in the Department of Hepatopancreatobiliary Surgery First Affiliated Hospital of Zhengzhou University from January 2018 to December 2023. There were 105 males and 66 females, aged (52.1±12.8) years (range: 18 to 79 years). The patients were divided into two groups based on whether they died within 28 days: the death group (n=38) and the survival group (n=133). The risk factors for short-term death of patients were analyzed,and independent risk factors were screened by univariate and multivariate analysis. Furthermore,these factors were used to establish the nomogram prediction model. The area under the curve(AUC),the Bootstrap Resampling,the Hosmer-Lemeshow test and the Decision Curve Analysis(DCA) were used to verify the model's differentiation,internal verification,calibration degree and clinical effectiveness,respectively. Results: Univariate and multivariate Logistics regression analysis showed that the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time were independent risk factors (P<0.05). The above factors were used to successfully establish the prediction model with 0.908 of AUC and 0.895 of the internal verification of AUC,indicating that the predictive model was valuable. The 0.663 P-values in the Hosmer-Lemeshow test indicated the high calibration degree of the model. The clinical effectiveness of the model was proved by the 18% clinical benefit population using the DCA curve with the 17% probability threshold. Conclusions: The independent risk factors are the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time. An adequate basis was acquired by establishing a nomogram prediction model of the short-term prognosis of severe BCS,which was helpful for early clinical screening and identification of high-risk patients with severe BCS who could die in the short term and timely providing timely intervention measures for improving the prognosis.

Unintrusive multi-cancer detection by circulating cell-free DNA methylation sequencing (THUNDER): development and independent validation studies.

BACKGROUND: Early detection of cancer offers the opportunity to identify candidates when curative treatments are achievable. The THUNDER study (THe UNintrusive Detection of EaRly-stage cancers, NCT04820868) aimed to evaluate the performance of enhanced linear-splinter amplification sequencing, a previously described cell-free DNA (cfDNA) methylation-based technology, in the early detection and localization of six types of cancers in the colorectum, esophagus, liver, lung, ovary, and pancreas. PATIENTS AND METHODS: A customized panel of 161 984 CpG sites was constructed and validated by public and in-house (cancer: n = 249; non-cancer: n = 288) methylome data, respectively. The cfDNA samples from 1693 participants (cancer: n = 735; non-cancer: n = 958) were retrospectively collected to train and validate two multi-cancer detection blood test (MCDBT-1/2) models for different clinical scenarios. The models were validated on a prospective and independent cohort of age-matched 1010 participants (cancer: n = 505; non-cancer: n = 505). Simulation using the cancer incidence in China was applied to infer stage shift and survival benefits to demonstrate the potential utility of the models in the real world. RESULTS: MCDBT-1 yielded a sensitivity of 69.1% (64.8%-73.3%), a specificity of 98.9% (97.6%-99.7%), and tissue origin accuracy of 83.2% (78.7%-87.1%) in the independent validation set. For early-stage (I-III) patients, the sensitivity of MCDBT-1 was 59.8% (54.4%-65.0%). In the real-world simulation, MCDBT-1 achieved a sensitivity of 70.6% in detecting the six cancers, thus decreasing late-stage incidence by 38.7%-46.4%, and increasing 5-year survival rate by 33.1%-40.4%, respectively. In parallel, MCDBT-2 was generated at a slightly low specificity of 95.1% (92.8%-96.9%) but a higher sensitivity of 75.1% (71.9%-79.8%) than MCDBT-1 for populations at relatively high risk of cancers, and also had ideal performance. CONCLUSION: In this large-scale clinical validation study, MCDBT-1/2 models showed high sensitivity, specificity, and accuracy of predicted origin in detecting six types of cancers.

Making Topologically Trivial Non-Hermitian Systems Nontrivial via Gauge Fields.

Non-Hermiticity significantly enriches the concepts of symmetry and topology in physics. Particularly, non-Hermiticity gives rise to the ramified symmetries, where the non-Hermitian Hamiltonian H is transformed to H^{†}. For time-reversal (T) and sublattice symmetries, there are six ramified symmetry classes leading to novel topological classifications with various non-Hermitian skin effects. As artificial crystals are the main experimental platforms for non-Hermitian physics, there exists the symmetry barrier for realizing topological physics in the six ramified symmetry classes: while artificial crystals are in spinless classes with T^{2}=1, nontrivial classifications dominantly appear in spinful classes with T^{2}=-1. Here, we present a general mechanism to cross the symmetry barrier. With an internal parity symmetry P, the square of the combination T[over ˜]=PT can be modified by appropriate gauge fluxes. Using the general mechanism, we systematically construct spinless models for all non-Hermitian spinful topological phases in one and two dimensions, which are experimentally realizable. Our Letter suggests that gauge structures may significantly enrich non-Hermitian physics at the fundamental level.

Non-Hermitian Spatial Symmetries and Their Stabilized Normal and Exceptional Topological Semimetals.

We study non-Hermitian spatial symmetries-a class of symmetries that have no counterparts in Hermitian systems-and study how normal and exceptional semimetals can be stabilized by these symmetries. Different from internal ones, spatial symmetries act nonlocally in momentum space and enforce global constraints on both band degeneracies and topological quantities at different locations. In deriving general constraints on band degeneracies and topological invariants, we demonstrate that non-Hermitian spatial symmetries are on an equal footing with, but are essentially different from Hermitian ones. First, we discover the nonlocal Hermitian conjugate pair of exceptional or normal band degeneracies that are enforced by non-Hermitian spatial symmetries. Remarkably, we find that these pairs lead to the symmetry-enforced violation of the Fermion doubling theorem in the long-time limit. Second, with the topological constraints, we unravel that a certain exceptional manifold is only compatible with and stabilized by non-Hermitian spatial symmetries but is intrinsically incompatible with Hermitian spatial symmetries. We illustrate these findings using two three-dimensional models of a non-Hermitian Weyl semimetal and an exceptional unconventional Weyl semimetal. Experimental cold-atom realizations of both models are also proposed.

Topological Electromagnetic Effects and Higher Second Chern Numbers in Four-Dimensional Gapped Phases.

Higher-dimensional topological phases play a key role in understanding the lower-dimensional topological phases and the related topological responses through a dimensional reduction procedure. In this work, we present a Dirac-type model of four-dimensional Z_{2} topological insulator (TI) protected by CP symmetry, whose 3D boundary supports an odd number of Dirac cones. A specific perturbation splits each bulk massive Dirac cone into two valleys separated in energy-momentum space with opposite second Chern numbers, in which the 3D boundary modes become a nodal sphere or a Weyl semimetallic phase. By introducing the electromagnetic (EM) and pseudo-EM fields, exotic topological responses of our 4D system are revealed, which are found to be described by the (4+1)D mixed Chern-Simons theories in the low-energy regime. Notably, several topological phase transitions occur from a CP-broken Z_{2} TI to a Z TI when the bulk gap closes by giving rise to exotic double-nodal-line or nodal-hyper-torus gapless phases. Finally, we propose to probe experimentally these topological effects in cold atoms.

Continuous-Variable Assisted Thermal Quantum Simulation.

Simulation of a quantum many-body system at finite temperatures is crucially important but quite challenging. Here we present an experimentally feasible quantum algorithm assisted with continuous variable for simulating quantum systems at finite temperatures. Our algorithm has a time complexity scaling polynomially with the inverse temperature and the desired accuracy. We demonstrate the quantum algorithm by simulating a finite temperature phase diagram of the quantum Ising and Kitaev models. It is found that the important crossover phase diagram of the Kitaev ring can be accurately simulated by a quantum computer with only a few qubits and thus the algorithm may be implementable on current quantum processors. We further propose a protocol with superconducting or trapped ion quantum computers.

[Negative effects of donor specific anti-HLA antibody on poor hematopoietic recovery in patients with hematological diseases receiving haploidentical stem cell transplantation and rituximab for desensitization].

Objective: To investigate the incidences and risk factors of poor hematopoietic reconstitution (PHR) in patients with hematological diseases who underwent haploidentical allograft and were treated with rituximab for desensitization. Methods: Eight-three donor specific anti-HLA antibody (DSA, 2000 ≤MFI<10 000) positive patients who underwent haploidentical allograft were prospectively enrolled. Rituximab (375 mg/m2) was used for desensitization day-3 of conditioning regimen. Incidence and factors associated with PHR, including primary poor graft function and prolonged thrombocytopenia, were investigated. Results: There were 22 males and 61 females with a median age of 39(range: 1-65) years. Kaplan-Meier analysis showed that the 100 day cumulative incidences of neutrophil and platelet engraftment were 93.0% and 90.7%, respectively. The incidences of PHR were 14.7%. The 3-year relapse rate, non-relapse mortality (NRM) rate, event-free survival (EFS), leukemia-free survival (DFS) and overall survival (OS) were 6.5%, 15.1%, 70.8%, 79.4% and 79.4%, respectively. Patients with DSA MFI<5 000 (group A, n=46) experienced lower PHR (4.4% vs. 27.5%, P=0.003), and higher 3-year EFS (79.5% vs. 59.8%, P=0.020) compared to those with DSA MFI≥5 000 (group B, n=37). Multivariate analysis showed that DSA MFI≥5 000 was correlated with PHR (HR=6.101, P=0.021). PHR was associated with higher NRM (HR=4.110, P=0.026), lower DFS (HR=3.656, P=0.019) and OS (HR=3.656, P=0.019). Conclusion: Our data suggest that high pre-transplant DSA level is a risk factor for PHR in patients with hematological diseases receiving haploidentical allograft and rituximab for desensitization.

[The effect of donor cytomegalovirus serological status on the outcome of allogeneic stem cell transplantation].

Objective: Donor cytomegalovirus (CMV) serological negative status may have an adverse effect on the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT), while there is inadequate data for Chinese people. This study is to explore the impact of donor CMV serological status on the outcome of CMV seropositive patients receiving allo-HSCT. Methods: Our study retrospectively analyzed 16 CMV seropositive patients with hematological malignancies receiving allogeneic grafts from CMV seronegative donors (antibody IgG negative) at Peking University People's Hospital from March 2013 to March 2020, which was defined as D-/R+ group. The other 64 CMV seropositive patients receiving grafts from CMV seropositive donors at the same period of time were selected as matched controls through a propensity score with 1∶4 depending on age, disease state and donor-recipient relationship (D+/R+ group). Results: Patients in D-/R+ group developed CMV DNAemia later than patients in the D+/R+ group (+37 days vs. +31 days after allo-HSCT, P=0.011), but the duration of CMV DNAemia in D-/R+ group was longer than that of D+/R+ group (99 days vs. 34 days, P=0.012). The rate of CMV reactivation 4 times or more in D-/R+ group was 4/16, significantly higher than that of D+/R+ group (4.7%, 3/64, P=0.01). The incidences of refractory CMV DNAemia (14/16 vs. 56.3%, P=0.021) and CMV disease (4/16 vs. 4.7%, P=0.01) in D-/R+ group were both higher than those in D+/R+ group. In addition, the application of CMV-CTL as the second-line antiviral treatment in D-/R+ group was more than that in D+/R+ group. Univariate analysis and multivariate analysis suggested that CMV serological negativity is an independent risk factor for refractory CMV DNAemia and the duration of CMV infection. The cumulative incidence of aGVHDⅡ-Ⅳ, cGVHD, 3-year probability of NRM, overall survival, and the cumulative incidence of relapse were all comparable in two groups. Conclusions: Although there is no significant effect on OS and NRM, the incidence of refractory CMV DNAemia, the frequency of virus reactivation, and the development of CMV disease in D-/R+ group are higher than those in controls. Therefore, CMV seropositive donors are preferred for CMV seropositive patients.

[A comparative study of breast cancer mass screening and opportunistic screening in Chinese women].

Objective: To compare the population characteristics, the positive rate of screening, the detection rate of breast cancer, early diagnosis rate and the cost between the mass screening group and opportunistic screening group of breast cancer. Methods: This study is a prospective multicenter cohort study conducted from January 1, 2014 to December 31, 2016. The participants were enrolled for mass screening or opportunistic screening of breast cancer. After completing the questionnaire, all the participants received breast physical examination and breast ultrasound examination every year for 3 rounds by year. The participants' characteristics and screening results of the two groups were compared by χ2 test, Fisher exact test or Wilcoxon rank-sum test. Results: A total of 20 080 subjects were enrolled. In the mass screening group, 9 434 (100%), 8 111 (85.98%) and 3 940 (41.76%) cases completed the 3 rounds of screening, and 10 646 (100%), 6 209 (58.32%) and 2 988 (28.07%) cases in the opportunistic screening group, respectively. In the opportunistic screening group, the proportions of less than 3 months lactation (1 275/9 796 vs. 1 061/8 860, χ²=4.597, P=0.032), non-fertility (850/10 646 vs. 574/9 434, χ²=27.400, P<0.01), abortion history (6 384/10 646 vs. 5 062/9 434, χ²=81.232, P<0.01), postmenopausal (2 776/10 646 vs. 2 217/9 434, χ²=17.757, P<0.01), long-term oral contraceptives(>6 months) (171/10 646 vs. 77/9 434, χ²=25.593, P<0.01) and family history of breast cancer in first-degree relatives (464/10 646 vs. 236/9 434, χ²=51.257, P<0.01) were significantly higher than those in mass screening group. The positive rate of screening (514/10 646 vs. 128/9 434, χ²=194.736, P<0.01), the detection rate of breast cancer (158/10 646 vs. 13/9 434, χ²=107.374, P<0.01), and positive rate of biopsy (158/452 vs. 13/87, χ²=13.491, P<0.01) in the opportunistic screening group were significantly higher than those of the mass screening group. The early diagnosis rate of the mass screening group was significantly higher than the opportunistic screening group (10/12 vs. 66/141, χ²=5.902, P=0.015). The average cost for detecting each breast cancer case of the mass screening group was 215 038 CNY, which was 13.6 times of the opportunistic screening group (15 799 CNY/case). In the opportunistic screening group, the positive rate of biopsy in primary hospitals was significantly lower than that in large-volume hospitals (79/267 vs. 79/185, χ²=8.267, P=0.004), but there was no significant difference in the mass screening group (6/37 vs. 7/50, χ²=0.082, P=0.774). Conclusions: Breast cancer screening can improve early detection rate. Compared with the mass screening mode, the opportunistic screening mode has the advantages of higher proportion of high-risk factors, higher positive rate of screening, higher detection rate of breast cancer, higher positive rate of biopsy, and lower cost of screening. However, the early diagnosis rate of breast cancer of opportunistic screening is lower than that of mass screening. The positive rate of opportunistic screening in primary hospitals is lower than that of large-volume hospitals. The two screening modes have their own advantages and should be chosen according to local conditions of different regions in China.

Protocol for Implementing Quantum Nonparametric Learning with Trapped Ions.

Nonparametric learning is able to make reliable predictions by extracting information from similarities between a new set of input data and all samples. Here we point out a quantum paradigm of nonparametric learning that offers an exponential speedup over the sample size. By encoding data into quantum feature space, the similarity between the data is defined as an inner product of quantum states. A quantum training state is introduced to superpose all data of samples, encoding relevant information for learning in its bipartite entanglement spectrum. We demonstrate that a trained state for prediction can be obtained by entanglement spectrum transformation, using the quantum matrix toolbox. We further work out a feasible protocol to implement the quantum nonparametric learning with trapped ions, and demonstrate the power of quantum superposition for machine learning.

[Retrospective analysis of mechanical thrombectomy for distal branch occlusion of middle cerebral artery].

Objective: To explore the necessity, feasibility, technical points, operative complications and prognosis of mechanical thrombectomy for distal branch occlusion of middle cerebral artery. Methods: Mechanical thrombectomy was performed on 42patients (28 males,14 females; age ranged from 43 to 88 years, mean 65.48years)with distal branch occlusion of middle cerebral artery (M2, M3), between May 2017 to July 2019. Theclinical feature was retrospectively analyzed. The NIHSS score before operation, 24 hours after operation and 1 week after operation, the recanalization of occluded vessels during operation, the complications and the recovery after 3 months (3 months mRS score) were analyzed. Results: Of the 42 patients, 38 patients were successfully recanalized, and the recanalization rate was 90.48%. Postoperative hemorrhage in 6 cases and vasospasm in 17 cases. At 90 days after operation, the mRS score was 0 in 13 cases, 1 in 11 cases, 2 in 6 cases, and 0 cases died. Conclusions: Mechanical thrombotomy is safe and feasible for patients with distal branch occlusion of middle cerebral artery (M2, M3). However, the risks and benefits of patients should be fully considered.

[On-pump total arterial revascularization in coronary artery disease patients with left ventricular dysfunction: a multi-center retrospective study].

Objective: To evaluate the clinical outcomes of on-pump total arterial revascularization with bilateral radial artery (BRA) and left internal mammary artery (LIMA) as conduits in coronary artery bypass grafting (CABG) patients with left ventricular dysfunction (LVD). Methods: All the perioperative medical records and follow-up results of coronary artery disease patients with left ventricular ejection fraction (LVEF) ≤ 40% undergoing CABG from 24 heart centers of 15 provinces and autonomous regions in China between July 2015 and December 2019 were retrospectively analyzed. Results: A total of 87 consecutive patients (55 males and 32 females) underwent on-pump CABG with BRA and LIMA, with a mean age of (57.5±9.1) years old. There were 22 patients complicated with primary hypertension, 12 with diabetes mellitus, 8 with peripheral vascular disease, 7 with chronic obstructive lung disease, 12 with mild renal injury and 3 with partial aortic calcification. There were 43 cases with in-stent stenosis, and 21 had left main disease. The mean LVEF and left ventricular end-diastolic diameter (LVEDD) was (35.5±7.3)% and (65.5±2.6) mm, respectively. The mean graft number, aortic cross-clamp time and cardiopulmonary bypass duration was 3.2±0.9, (90.5±22.7) min and (113.4±19.2) min, respectively. There were 32 mitral and 9 aortic valve replacements, and 5 tricuspid annuloplasties. Prophylactic intra-aortic balloon pumps were implanted in 27 patients. There were 2 operative deaths from acute heart failure. After surgery, there were 15 cases of atrial fibrillation, 1 case of acute kidney injury, 1 case of acute myocardial infarction, and 1 cases of stroke. All the patients fulfilled the follow-up, with a mean time of (39.5±7.7) months. At 3 months after surgery, LVEDD was decreased and LVEF was improved significantly compared with pre-operative indicators [(53.0±1.5) mm vs (65.5±2.6) mm, t=9.51 P=0.02; (45.2±3.3)% vs (35.5±7.3)%, t=13.79, P=0.001]. No major cardiac events were reported during the follow-up. At (30.5±7.4) months after surgery, 62.4% of patients (53/85) underwent coronary CT angiography examination, and the results indicated that the graft patency was 98.8%, with only one case of RA occlusion occurred. Conclusion: In selected patients of LVD, on-pump total arterial revascularization with BRA and LIMA conduits was proved to be safe and effective.

Simulation and Manipulation of Tunable Weyl-Semimetal Bands Using Superconducting Quantum Circuits.

We simulated highly tunable Weyl-semimetal bands using superconducting quantum circuits. Driving the superconducting quantum circuits with microwave fields, we mapped the momentum space of a lattice to the parameter space, realizing the Hamiltonian of a Weyl semimetal. By measuring the energy spectrum, we directly imaged the Weyl points, whose topological winding numbers were further determined from the Berry curvature measurement. In addition, we manipulated the band structure with an additional pump microwave field, producing a momentum-dependent Weyl-point energy together with an artificial magnetic field, which are indispensable for generating chiral magnetic topological currents in some special Weyl semimetals and may have significant impact on topological physics.

[Factors influencing poor prognosis of mechanical thrombectomy in time window of acute ischemic stroke].

Objective: Investigate the causes of poor prognosis of mechanical thrombectomy in the time window of acute ischemic stroke (AIS) with anterior circulation. Methods: A retrospective analysis was made on the data of 78 patients with anterior circulation AIS who underwent mechanical thrombectomy in the time window from January 2017 to December 2017 in the Department of Vascular Neurosurgery of Liaocheng Brain Hospital. The modified Rankin scale (mRS) was used to evaluate the prognosis of the patients 3 months after operation. According to the prognosis,the patients were divided into the group with good prognosis (42 cases, mRS<2 points) and the group with poor prognosis (36 cases, mRS<3 points). Univariate and multivariate Logistic regression analysis was used to analyze the related factors of poor prognosis. Results: (1) Univariate analysis showed that the prognosis of patients with good combination and primary stenosis of diabetes mellitus and atherosclerosis was lower than that of patients with poor prognosis (P<0.05). The collateral circulation compensation rate and vascular recanalization rate of patients with good prognosis were higher than those of patients with poor prognosis (P<0.05). Learning significance (P<0.05). (2) Multivariate analysis showed that diabetes mellitus (P=0.035), collateral circulation compensation (P=0.011) and primary atherosclerotic stenosis (P=0.042) were independent risk factors for poor prognosis. Conclusion: Perfect preoperative evaluation and strict screening of patients, good collateral circulation compensation,individualized treatment for patients with primary atherosclerotic stenosis,and strict control of postoperative hyperglycemia can improve the clinical prognosis of endovascular therapy.

Photonics meets topology.

The topological phases in materials have been studied in recent decades for their unique boundary states and transport properties. Photonic systems with band structures embrace the topological phases closely, where they not only provide platforms to testify the topological band theory, but also shed light on designing novel optical devices. In this review, we present exciting developments, supported by brief descriptions of prominent milestones of topological phases in photonic systems in recent years. These studies may sustain further developments of optical devices and offer novel methods for light manipulations.

[Expression of FoxM1 and BCRP in invasive breast carcinoma of no special type and its prognosis significance].

Objective: To investigate the relationship between expression of FoxM1 and BCRP in invasive breast carcinoma of no special type (IBC-NST) tissues and the clinical pathological characteristics and prognosis of the patients. Methods: Seventy-eight cases of IBC-NST with excision were included. The expression of FoxM1 and BCRP was assessed by immunohistochemistry and its relationship with the clinical pathological characteristics and prognosis was evaluated. Results: FoxM1 was expressed in 71.8%(56/78) of IBC-NST, and the expression was related to tumor diameter, TNM staging, ER, PR and HER2. BCRP was expressed in 53.8% (42/78) of IBC-NST, and the expression was related to age, tumor diameter, lymph node metastasis, ER and HER2. Kaplan-Meier survival analysis showed the survival time was related to tumor diameter, TNM staging, lymph node metastasis and the expression of FoxM1, BCRP, ER, PR and HER2. Cox multivariate analysis showed that TNM staging, FoxM1, BCRP, HER2 were determinants of patient survival time. Conclusions: The expression of FoxM1 is associated with tumor diameter, TNM staging, ER, PR and HER2 while BCRP is associated with age, tumor diameter, lymph node metastasis, ER and HER2. Both FoxM1 and BCRP have prognostic significance in IBC-NST patients.

Novel Z(2) Topological Metals and Semimetals.

We report two theoretical discoveries for Z(2) topological metals and semimetals. It is shown first that any dimensional Z(2) Fermi surface is topologically equivalent to a Fermi point. Then the famous conventional no-go theorem, which was merely proven before for Z Fermi points in a periodic system without any discrete symmetry, is generalized so that the total topological charge is zero for all cases. Most remarkably, we find and prove an unconventional strong no-go theorem: all Z(2) Fermi points have the same topological charge ν(Z(2))=1 or 0 for periodic systems. Moreover, we also establish all six topological types of Z(2) models for realistic physical dimensions.

Unified Theory of PT and CP Invariant Topological Metals and Nodal Superconductors.

As PT and CP symmetries are fundamental in physics, we establish a unified topological theory of PT and CP invariant metals and nodal superconductors, based on the mathematically rigorous KO theory. Representative models are constructed for all nontrivial topological cases in dimensions d=1, 2, and 3, with their exotic physical meanings being elucidated in detail. Intriguingly, it is found that the topological charges of Fermi surfaces in the bulk determine an exotic direction-dependent distribution of topological subgap modes on the boundaries. Furthermore, by constructing an exact bulk-boundary correspondence, we show that the topological Fermi points of the PT and CP invariant classes can appear as gapless modes on the boundary of topological insulators with a certain type of anisotropic crystalline symmetry.

[Comparisons of clinical effects among three kinds of treatments of 1/3 displaced midshaft clavicular fractures in adults].

OBJECTIVES: To compare the clinical effects among three kinds of treatments (external fixation, plate fixation, and non-operation) of 1/3 displaced midshaft clavicular fractures in adults. METHODS: Retrospective analysis was conducted on 306 patients with clavicular fractures in Trauma Orthopedic Department in Jishuitan Hospital from March 2010 to May 2013, and 89 of these patients met the inclusive criteria.Among them, there were 29 cases of external fixation (Group A), 30 cases of plate fixation (Group B), and 30 cases of non-operation with the clavicle sling in Outpatient and Emergency Department (Group C). The average follow-up period was 32 months.The results were evaluated from four perspectives, respectively, follow-up period, Constant Shoulder Score (CSS), Disability of the Arm Shoulder and Hand Score (DASH), and imaging.There was no significant difference in demography, severity of injuries, mechanism of injury, and fracture type among the patients in the three groups. RESULTS: Among 29 cases of external fixation, 25 cases were successfully followed up, 4 were lost.60 cases of plate fixationand non-operation were all successfully followed up.Based on the pairwise comparison of CSS and DASH among the three groups, there was no significant difference between external fixation [(94.0±6.4), (15.2±3.4)Score] and plate fixation[(92.9±8.4), (15.7±3.5)Score] (both P>0.05). Mean values of CSS and DASH of non-operation group [(86.0±3.6), (18.0±3.6)Score] were lower than those of the former two groups (P<0.001). The healing time of 3 kinds of treatments were as follows: external fixation 10.4±2.32 weeks; plate fixation 12.1±2.5 weeks; and non-operation 15.7±2.2 weeks.In terms of their complications, for the external fixation group, there was 1 case of nonunion (4%); and 3 cases of angulation deformity in the 12(th) week, whose external fixations were maintained till their unions in the 16(th) week.Shortening and displacement did not appear in any cases.In the plate fixation group, there was 1 case of nonunion (3%) and no malunion in this group.The biggest complications of plate fixation were implants stimulus and to remove the plate in the second operation, accounting for 60%.In the non-operation group, there were 3 cases of nonunion (10%), and 12 cases of malunion (40%) including 10 cases without symptoms and 2 cases with symptoms.The satisfaction rates for the appearance of shoulder after these 3 kinds of treatments among the patients were 96%, 93% and 77%, respectively. CONCLUSIONS: (1) In treating 1/3 displaced midshaft clavicular fractures in adults, external fixation and plate fixation are overall better than non-operation.And there is no significant difference in curative effects between the two. (2) Both external fixation and plate fixation have its advantages and disadvantages.The choice of treatment must be based on the clinical type of the fracture and the communication with patients.