No pulsed radio emission during a bursting phase of a Galactic magnetar.

Fast radio bursts (FRBs) are millisecond-duration radio transients of unknown physical origin observed at extragalactic distances1-3. It has long been speculated that magnetars are the engine powering repeating bursts from FRB sources4-13, but no convincing evidence has been collected so far14. Recently, the Galactic magnetar SRG 1935+2154 entered an active phase by emitting intense soft γ-ray bursts15. One FRB-like event with two peaks (FRB 200428) and a luminosity slightly lower than the faintest extragalactic FRBs was detected from the source, in association with a soft γ-ray/hard-X-ray flare18-21. Here we report an eight-hour targeted radio observational campaign comprising four sessions and assisted by multi-wavelength (optical and hard-X-ray) data. During the third session, 29 soft-γ-ray repeater (SGR) bursts were detected in γ-ray energies. Throughout the observing period, we detected no single dispersed pulsed emission coincident with the arrivals of SGR bursts, but unfortunately we were not observing when the FRB was detected. The non-detection places a fluence upper limit that is eight orders of magnitude lower than the fluence of FRB 200428. Our results suggest that FRB-SGR burst associations are rare. FRBs may be highly relativistic and geometrically beamed, or FRB-like events associated with SGR bursts may have narrow spectra and characteristic frequencies outside the observed band. It is also possible that the physical conditions required to achieve coherent radiation in SGR bursts are difficult to satisfy, and that only under extreme conditions could an FRB be associated with an SGR burst.

Three-dimensional pseudo-continuous arterial spin-labelled perfusion imaging for diagnosing upper cervical lymph node metastasis in patients with nasopharyngeal carcinoma: a whole-node histogram analysis.

AIM: To evaluate whole-node histogram parameters of blood flow (BF) maps derived from three-dimensional pseudo-continuous arterial spin-labelled (3D pCASL) imaging in discriminating metastatic from benign upper cervical lymph nodes (UCLNs) for nasopharyngeal carcinoma (NPC) patients. MATERIALS AND METHODS: Eighty NPC patients with a total of 170 histologically confirmed UCLNs (67 benign and 103 metastatic) were included retrospectively. Pre-treatment 3D pCASL imaging was performed and whole-node histogram analysis was then applied. Histogram parameters and morphological features, such as minimum axis diameter (MinAD), maximum axis diameter (MaxAD), and location of UCLNs, were assessed and compared between benign and metastatic lesions. Predictors were identified and further applied to establish a combined model by multivariate logistic regression in predicting the probability of metastatic UCLNs. Receiver operating characteristic (ROC) curves were used to analyse the diagnostic performance. RESULTS: Metastatic UCLNs had larger MinAD and MinAD/MaxAD ratio, greater energy and entropy values, and higher incidence of level II (upper jugular group), but lower BF10th value than benign nodes (all p<0.05). MinAD, BF10th, energy, and entropy were validated as independent predictors in diagnosing metastatic UCLNs. The combined model yielded an area under the curve (AUC) of 0.932, accuracy of 84.42 %, sensitivity of 80.6 %, and specificity of 90.29 %. CONCLUSIONS: Whole-node histogram analysis on BF maps is a feasible tool to differentiate metastatic from benign UCLNs in NPC patients, and the combined model can further improve the diagnostic efficacy.

[Emphasizing the timing and procedure selection for vitrectomy in pathological myopic traction maculopathy].

Myopic maculopathy is the primary cause of irreversible visual impairment in patients with pathologic myopia, and myopic traction maculopathy often requires vitrectomy for treatment. Myopic traction maculopathy encompasses epiretinal membrane, foveoschisis, macular hole, and macular hole-related retinal detachment. It is recommended to perform vitrectomy combined with inner limiting membrane peeling for Type II epiretinal membrane, foveal-sparing inner limiting membrane peeling for foveoschisis, inverted inner limiting membrane flap technique for macular hole, and vitrectomy combined with macular buckle for refractory macular hole-related retinal detachment. Myopic traction maculopathy is a chronically progressive condition, and surgeons need to accurately determine the timing of surgery and choose appropriate procedures to maximize the benefits for patients.

[Preliminary study on automatic quantification and grading of leopard spots fundus based on deep learning technology].

Objective: To achieve automatic segmentation, quantification, and grading of different regions of leopard spots fundus (FT) using deep learning technology. The analysis includes exploring the correlation between novel quantitative indicators, leopard spot fundus grades, and various systemic and ocular parameters. Methods: This was a cross-sectional study. The data were sourced from the Beijing Eye Study, a population-based longitudinal study. In 2001, a group of individuals aged 40 and above were surveyed in five urban communities in Haidian District and three rural communities in Daxing District of Beijing. A follow-up was conducted in 2011. This study included individuals aged 50 and above who participated in the second 5-year follow-up in 2011, considering only the data from the right eye. Color fundus images centered on the macula of the right eye were input into the leopard spot segmentation model and macular detection network. Using the macular center as the origin, with inner circle diameters of 1 mm, 3 mm, and outer circle diameter of 6 mm, fine segmentation of the fundus was achieved. This allowed the calculation of the leopard spot density (FTD) and leopard spot grade for each region. Further analyses of the differences in ocular and systemic parameters among different regions' FTD and leopard spot grades were conducted. The participants were categorized into three refractive types based on equivalent spherical power (SE): myopia (SE<-0.25 D), emmetropia (-0.25 D≤SE≤0.25 D), and hyperopia (SE>0.25 D). Based on axial length, the participants were divided into groups with axial length<24 mm, 24-26 mm, and>26 mm for the analysis of different types of FTD. Statistical analyses were performed using one-way analysis of variance, Kruskal-Wallis test, Bonferroni test, and Spearman correlation analysis. Results: The study included 3 369 participants (3 369 eyes) with an average age of (63.9±10.6) years; among them, 1 886 were female (56.0%) and 1, 483 were male (64.0%). The overall FTD for all eyes was 0.060 (0.016, 0.163); inner circle FTD was 0.000 (0.000, 0.025); middle circle FTD was 0.030 (0.000, 0.130); outer circle FTD was 0.055 (0.009, 0.171). The results of the univariate analysis indicated that FTD in various regions was correlated with axial length (overall: r=0.38, P<0.001; inner circle: r=0.31, P<0.001; middle circle: r=0.36, P<0.001; outer circle: r=0.39, P<0.001), subfoveal choroidal thickness (SFCT) (overall: r=-0.69, P<0.001; inner circle: r=-0.57, P<0.001; middle circle: r=-0.68, P<0.001; outer circle: r=-0.72, P<0.001), age (overall: r=0.34, P<0.001; inner circle: r=0.30, P<0.001; middle circle: r=0.31, P<0.001; outer circle: r=0.35, P<0.001), gender (overall: r=-0.11, P<0.001; inner circle: r=-0.04, P<0.001; middle circle: r=-0.07, P<0.001; outer circle: r=-0.11, P<0.001), SE (overall: r=-0.20; P<0.001; inner circle: r=-0.19, P<0.001; middle circle: r=-0.20, P<0.001; outer circle: r=-0.20, P<0.001), uncorrected visual acuity (overall: r=-0.18, P<0.001; inner circle: r=-0.26, P<0.001; middle circle: r=-0.24, P<0.001; outer circle: r=-0.22, P<0.001), and body mass index (BMI) (overall: r=-0.11, P<0.001; inner circle: r=-0.13, P<0.001; middle circle: r=-0.14, P<0.001; outer circle: r=-0.13, P<0.001). Further multivariate analysis results indicated that different region FTD was correlated with axial length (overall: ß=0.020, P<0.001; inner circle: ß=-0.022, P<0.001; middle circle: ß=0.027, P<0.001; outer circle: ß=0.022, P<0.001), SFCT (overall: ß=-0.001, P<0.001; inner circle: ß=-0.001, P<0.001; middle circle: ß=-0.001, P<0.001; outer circle: ß=-0.001, P<0.001), and age (overall: ß=0.002, P<0.001; inner circle: ß=0.001, P<0.001; middle circle: ß=0.002, P<0.001; outer circle: ß=0.002, P<0.001). The distribution of overall (H=56.76, P<0.001), inner circle (H=72.22, P<0.001), middle circle (H=75.83, P<0.001), and outer circle (H=70.34, P<0.001) FTD differed significantly among different refractive types. The distribution of overall (H=373.15, P<0.001), inner circle (H=367.67, P<0.001), middle circle (H=389.14, P<0.001), and outer circle (H=386.89, P<0.001) FTD differed significantly among different axial length groups. Furthermore, comparing various levels of FTD with systemic and ocular parameters, significant differences were found in axial length (F=142.85, P<0.001) and SFCT (F=530.46, P<0.001). Conclusions: The use of deep learning technology enables automatic segmentation and quantification of different regions of theFT, as well as preliminary grading. Different region FTD is significantly correlated with axial length, SFCT, and age. Individuals with older age, myopia, and longer axial length tend to have higher FTD and more advanced FT grades.

[Prevalence of albuminuria and its association with cardiovascular diseases in Chinese residents aged over 35 years].

Objective: To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD). Methods: A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as x¯±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results: The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU (OR=1.23, 95%CI 1.12-1.35) and macroalbuminuria (OR=1.86, 95%CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions: The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.

[Long-term mortality risk of valvular heart disease adults over 35 years old in Chinese communities].

Objective: To investigate the risk and influencing factors of long-term mortality of valvular heart disease (VHD) adults aged 35 years and over in Chinese communities. Methods: A cohort study was carried out. The data of the subjects who underwent echocardiography were collected from the Chinese Hypertension Survey between 2012 and 2015 and survival outcomes were followed up between 2018 and 2019. Kaplan-Meier survival curves were plotted and compared using log-rank test. Cox proportional hazards models were used to analyze the influence of VHD on mortality. Results: During an average follow-up time of (4.6±0.9) years, a total of 23 237 participants (10 881 males and 12 356 females) were pooled into the final analysis from 5 eastern, 5 central, and 4 western provinces, cities and autonomous regions in China, with a mean age of (56.9±13.2) years. Among the included participants, 1 004 had VHD (467 males and 537 females), with a mean age was of (68.1±12.6) years. In the Kaplan-Meier analysis, participants with VHD had a significantly increased risk of all-cause mortality (log-rank χ2=351.82, P<0.001) and cardiovascular mortality (log-rank χ2=284.14, P<0.001) compared with those without VHD. Multivariate Cox regression analysis showed that compared with those without VHD, the participants with rheumatic VHD had a 45% increased risk of all-cause mortality (HR=1.45, 95%CI: 1.12-1.89) and degenerative VHD increased the risk of cardiovascular mortality by 69% (HR=1.69, 95%CI: 1.19-2.38). The risk factors of cardiovascular mortality for VHD were age 55 years and over (55-<75 years: HR=4.93, 95%CI: 1.17-20.85;≥75 years: HR=11.92, 95%CI: 2.85-49.80) and diabetes mellitus (HR=1.71, 95%CI: 1.00-2.93). Conclusions: VHD is a risk factor of all-cause mortality and cardiovascular mortality among adults aged 35 years and over. Age 55 years and over and diabetes mellitus are adverse prognostic factors for patients with VHD.

[A clinical study of high dependency units to reduce ICU readmission rates in patients with severe liver disease].

Objective: To investigate the real-world difference in the ICU readmission rate between the high-dependency unit (HDU) and the general ward so as to reflect the role of HDU in the diagnosis and management of patients with SLD. Methods: Patients with severe liver disease who were consecutively enrolled were step-downed to HDU and general wards in the ICU of the Fifth Medical Center of the People's Liberation Army General Hospital between July 2017 and December 2021. The main liver function indicators, MELD scores, and other were compared between the two groups. SLD severity, ICU readmission rates, and others differences were analyzed among the patients transferred to different wards. The HDU role was clarified for SLD patients' grade management. The area under the curve of the receiver operating characteristic curve (AUROC) was used to calculate and explore the feasibility of a baseline Model for End-Stage Liver Disease (MELD) score to define the treatment scope of HDU. Results: The SLD group of patients who were transferred to HDU had significantly higher levels of the international normalized ratio, bilirubin, alanine aminotransferase, MELD score, and other factors compared to those in the general ward (P < 0.05). 70.7% of SLD patients in the HDU group had a MELD score > 17, while 61.9% of SLD patients in the general ward group had a MELD score ≤ 17. The overall ICU readmission rate in this cohort was 11.4%. The ICU readmission rate was significantly higher with a MELD score of > 23 (20.0%) than that with a MELD score of ≤ 23 (8.6%) in patients with SLD, according to the MELD score quartile P75 (P = 0.020). The ICU readmission rate was 8.2% when MELD score ≤ 23, and 9.1% when MELD score>23 in the HDU group, with no statistically significant difference (P = 1.000). However, in the general ward group, the ICU readmission rate in patients with a MELD score ≤ 23 was 8.8%, and when the MELD score was >23, the ICU readmission rate significantly increased to 36.4% (P = 0.001). The optimal cut-off value of the MELD score for predicting ICU readmission in patients with SLD in the general ward group was 23.5. Conclusion: The high-dependency unit can better undertake ICU step-down patients with SLD and significantly reduce the ICU readmission rate with MELD scores > 23 in practice. Additionally, ICU step-down SLD patients with a MELD score > 23 are suitable for transfer to HDU treatment.

[Investigate developmental coordination disorder of kindergarten children in Zhejiang Province].

In order to investigate developmental coordination disorder (DCD) of kindergarten children in Zhejiang province, 200 ordinary kindergartens were randomly selected by stratified random sampling in 11 prefecture-level cities of Zhejiang Province, and 38 900 children from 1 000 classes in each grade were then randomly selected into the study from June 2019 to December 2019. The Little DCD Questionnaire and a self-designed questionnaire were used to screen the DCD of those children. There were 36 807 valid questionnaires, and 6.50% (2 391/36 807) of them were positive results. The results showed that boy, age ≤5 years, overweight or obesity, left handedness, comorbidity with motor or developmental disorders and premature infants were risk factors of DCD in children. As for parents and families, maternal gestational age<20 years, maternal overweight or obesity before pregnancy, low-middle level education of parents, direct family and low income of family were also associated with DCD in children. Therefore, it is necessary to conduct early prevention and intervention strategies targeting on identified risk factors among relevant population.

[Current status of hypertension prevalence, treatment and control rate among young and middle-aged population in China].

Objective: To estimate the prevalence, awareness, treatment and control rate of hypertension among young and middle-aged population in China. Methods: The analysis was based on the results of 2012-2015 China Hypertension Survey, which was a cross-sectional stratified multistage random sampling survey. A total of 229 593 subjects were included in the final analysis. The data including sex, age, living in urban and rural areas, prevalence of hypertension, history of stroke, family history of coronary heart disease and drinking, physical examination, heart rate were collected. Hypertension was defined as mean systolic blood pressure (SBP) ≥140 mmHg (1 mmHg=0.133 kPa), and (or) diastolic blood pressure (DBP) ≥90 mmHg, and (or) self-report a history of hypertension, and (or) use of antihypertensive medicine within 2 weeks before survey. Prehypertension was defined as SBP between 120-139 mmHg, and (or) DBP between 80-89 mmHg. Control of hypertension was considered for hypertensive individuals with SBP<140 mmHg and DBP<90 mmHg. The prevalence of prehypertension, hypertension, awareness, treatment, control rate were calculated, and the control rate among those with antihypertensive medication was also calculated. Results: The prevalence of prehypertension and hypertension was 43.8% (95%CI: 42.3%-45.4%), and 22.1% (95%CI: 20.8%-23.3%), respectively. The prevalence of prehypertension and hypertension was significantly higher among male than female across different age groups. The awareness, treatment, control rate of hypertension and control rate among treated hypertensive participants were 43.8%, 33.2%, 16.7%, and 40.2%, respectively. The prevalence was higher, and the control rate was lower among individuals with higher heart rate. Conclusion: The prevalence of prehypertension and hypertension among young and middle-aged population is high, the awareness, treatment and control rate need to be further improved in this population. The prevention and treatment of hypertension should be strengthened in the future to improve the control rate of hypertension in China.

Gauge-Field Extended k·p Method and Novel Topological Phases.

Although topological artificial systems, like acoustic and photonic crystals and cold atoms in optical lattices were initially motivated by simulating topological phases of electronic systems, they have their own unique features such as the spinless time-reversal symmetry and tunable Z_{2} gauge fields. Hence, it is fundamentally important to explore new topological phases based on these features. Here, we point out that the Z_{2} gauge field leads to two fundamental modifications of the conventional k·p method: (i) The little co-group must include the translations with nontrivial algebraic relations. (ii) The algebraic relations of the little co-group are projectively represented. These give rise to higher-dimensional irreducible representations and therefore highly degenerate Fermi points. Breaking the primitive translations can transform the Fermi points to interesting topological phases. We demonstrate our theory by two models: a rectangular π-flux model exhibiting graphenelike semimetal phases, and a graphite model with interlayer π flux that realizes the real second-order nodal-line semimetal phase with hinge helical modes. Their physical realizations with a general bright-dark mechanism are discussed. Our finding opens a new direction to explore novel topological phases unique to crystalline systems with gauge fields and establishes the approach to analyze these phases.

Increasing coenzyme Q10 yield from Rhodopseudomonas palustris by expressing rate-limiting enzymes and blocking carotenoid and hopanoid pathways.

Coenzyme Q10 (CoQ10 ), a strong antioxidant, is used extensively in food, cosmetic and medicine industries. A natural producer, Rhodopseudomonas palustris, was engineered to overproduce CoQ10 . For increasing the CoQ10 content, crtB gene was deleted to block the carotenoid pathway. crtB gene deletion led to 33% improvement of CoQ10 content over the wild type strain. However, it was found that the yield of hopanoids was also increased by competing for the precursors from carotenoid pathway with CoQ10 pathway. To further increase the CoQ10 content, hopanoid pathway was blocked by deleting shc gene, resulting in R. palustris [Δshc, ΔcrtB] to produce 4·7 mg g-1 DCW CoQ10 , which was 1·2 times higher than the CoQ10 content in the wild type strain. The common strategy of co-expression of rate-limiting enzymes (DXS, DPS and UbiA) was combined with the pathway blocking method resulted in 8·2 mg g-1 DCW of CoQ10 , which was 2·9 times higher than that of wild type strain. The results suggested a synergistic effect among different metabolic engineering strategies. This study demonstrates the potential of R. palustris for CoQ10 production and provides viable strategies to increase CoQ10 titer.

[Chordoid glioma: a clinicopathological study].

Objective: To analyze the clinicopathological features of chordoid glioma. Methods: A total of 12 cases of chordoid gliomas from 2009 to 2020 in Xuanwu Hospital of Capital Medical University and General Hospital of Chinese People's Liberation Army were retrospectively analyzed. The clinical and imaging characteristics, pathologic and molecular characteristics were analyzed, and the relevant literature was reviewed. Results: All 12 patients (4 males and 8 females) aged from 25 to 67 years (mean 39 years) and mainly had a history of headache or/and vision loss. MRI showed that the lesions located in the third ventricle, and they showed abnormal enhancement. Pathologically, these 12 cases displayed the morphologic characteristics of chordoid gliomas, including papillary structures in two cases. Immunohistochemically, GFAP and vimentin were expressed in all 12 cases (12/12). TTF1 was also expressed in all cases (10/10). CD34 and CKpan were seen in 11 cases (11/12). EMA with dot-and/or-ring like positivity was seen in 9 cases (9/10). Tissues were available in nine chordoid gliomas for Sanger sequencing to detect PRKCA and IDH gene mutation, and eight cases (8/9) showed PRKCA gene D463H mutation. None of these cases showed IDH1 R132 and IDH2 R172 mutation. All 12 patients underwent surgery, and four were lost to follow up. The remaining eight patients were progression or recurrence free at last follow-up in January 2021. Conclusions: Chordoid gliomas have relatively distinguishing clinical and histopathological features. PRKCA gene mutation in chordoid gliomas can be considered as a biomarker for the diagnosis and differential diagnosis of chordoid gliomas, and may provide a direction for future targeted therapy.

[Role of gut-liver-immune axis in the pathogenesis of nonalcoholic steatohepatitis].

Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in the world. Liver cirrhosis, liver cancer and a variety of extrahepatic chronic diseases are important risk factors for NAFLD. Currently, there is still a lack of effective therapeutic drugs. Liver inflammation is a key driving factor for the progression of NAFLD, so regulating liver inflammation may provide a potential means to delay and reverse the progression of nonalcoholic steatohepatitis (NASH). Studies have found that the gut-liver-immune axis plays an important role in the progression of NASH. Gut microbiota can use its metabolites to induce glycolipid toxicity, oxidative stress and intestinal barrier damage, while bacterial components such as lipopolysaccharides, peptidoglycans, bacterial DNA and extracellular vesicles can translocate into the liver through the damaged intestinal barrier, causing excessive activation of immune cells, thus aggravating liver inflammation and promoting the progress of NASH. This paper focuses on the gut-liver-immune axis to analyze the gut microbiota mediated liver immunity and its mechanism in the occurrence and development of NASH, so as to lay a theoretical foundation for the research and development of new therapeutic strategies for NASH.

Three-field versus two-field lymphadenectomy in transthoracic oesophagectomy for oesophageal squamous cell carcinoma: short-term outcomes of a randomized clinical trial.

BACKGROUND: The benefit and harm of three-field lymphadenectomy for oesophageal cancer are still unknown. The aim of this study was to compare overall survival and morbidity and mortality between three- and two-field lymphadenectomy in patients with oesophageal squamous cell carcinoma. METHODS: Between March 2013 and November 2016, patients with squamous cell carcinoma of the middle or distal oesophagus were assigned randomly to open oesophagectomy with three-field (cervical-thoracic-abdominal) or two-field (thoracic-abdominal) lymphadenectomy. No chemo(radio) therapy was given before surgery. This paper reports on the secondary outcomes of the study: pathology and surgical complications. RESULTS: Some 400 patients were randomized, 200 in each group. A median of 37 (i.q.r. 30-49) lymph nodes were dissected in the three-field group, compared with 24 (18-30) in the two-field group (P < 0·001). Some 43 of 200 patients (21·5 per cent) in the three-field group had cervical lymph node metastasis. More patients in the three-field group had pN3 disease: 21 of 200 (10·5 per cent) versus 10 of 200 (5·0 per cent) (P = 0·040). The rate and severity of postoperative complications were comparable between the two groups, except that six patients in the three-field arm needed reintubation compared with none in the two-field group (3·0 versus 0 per cent; P = 0·030). The 90-day mortality rate was 0 per cent in the three-field group and 0·5 per cent (1 patient) in the two-field group (P = 1·000). CONCLUSION: Oesophagectomy with three-field lymphadenectomy increased the number of lymph nodes dissected and led to stage migration owing to a 21·5 per cent rate of cervical lymph node metastasis. Postoperative complications were largely comparable between two- and three-field lymphadenectomy. Registration number: NCT01807936 ( https://www.clinicaltrials.gov).

ANTECEDENTES: El beneficio y los daños potenciales de la linfadenectomía en tres campos (three-field, 3-FLD) en el cáncer de esófago aún se desconoce. El objetivo de este estudio fue comparar la supervivencia global y la morbilidad y mortalidad entre la linfadenectomía en tres campos (3-FLD) y la linfadenectomía en dos campos (two-field lymphadenectomy, 2-FLD) en pacientes con carcinoma escamoso de esófago. MÉTODOS: Entre marzo de 2013 y noviembre de 2016, pacientes con carcinoma escamoso del tercio medio y distal del esófago fueron asignados de forma aleatoria a esofaguectomía abierta con linfadenectomía 3-FLD (cervical-torácica-abdominal) o 2-FLD (torácica-abdominal). No se administró quimioterapia o quimiorradioterapia antes de la cirugía. Este estudio describe los resultados secundarios: datos de la anatomía patología y complicaciones quirúrgicas. RESULTADOS: Se aleatorizaron un total de 400 pacientes a linfadenectomía 3-FLD y 2-FLD (200 pacientes en cada grupo). En el grupo de 3-FLD se disecaron una mediana (rango) de 37 (30-49) ganglios linfáticos en comparación con 24 (18-30) en el grupo de 2-FLD (P < 0,001). Un total de 43 de 200 (21,5%) pacientes en el grupo 3-FLD presentaron metástasis en los ganglios linfáticos (lymph node metastasis, LNM) cervicales. Más pacientes en el grupo 3-FLD presentaron un estadio de la enfermedad pN3 en comparación con el grupo 2-FLD: 21 de 200 (10,5%) versus 10 de 200 (5,0%), P = 0,040). La tasa y gravedad de las complicaciones postoperatorias fue comparable en ambos grupos, aparte de 6 pacientes en la rama 3-FLD que necesitaron reintubación (3,0%) en comparación con ninguno en el grupo 2-FLD (P = 0,030). La mortalidad a los 90 días fue del 0% en 3-FLD y del 0,5% (1 paciente en el grupo 2-FLD (P = 1,000). CONCLUSIÓN: La esofaguectomía con 3-FLD aumenta el número de ganglios linfáticos y conduce a una migración del estadio debido a la tasa de LNM cervicales del 21,5%. Las complicaciones postoperatorias fueron similares entre las linfadenectomías 3-FLD y 2-FLD.

Boundary Criticality of PT-Invariant Topology and Second-Order Nodal-Line Semimetals.

For conventional topological phases, the boundary gapless modes are determined by bulk topological invariants. Based on developing an analytic method to solve higher-order boundary modes, we present PT-invariant 2D topological insulators and 3D topological semimetals that go beyond this bulk-boundary correspondence framework. With unchanged bulk topological invariants, their first-order boundaries undergo transitions separating different phases with second-order boundary zero modes. For the 2D topological insulator, the helical edge modes appear at the transition point for two second-order topological insulator phases with diagonal and off-diagonal corner zero modes, respectively. Accordingly, for the 3D topological semimetal, the criticality corresponds to surface helical Fermi arcs of a Dirac semimetal phase. Interestingly, we find that the 3D system generically belongs to a novel second-order nodal-line semimetal phase, possessing gapped surfaces but a pair of diagonal or off-diagonal hinge Fermi arcs.

[Effect of ultrasound contrast agent targeting gelatin on uptake of mouse ascites hepatocellular carcinoma cell lines with high lymphatic metastasis].

Objective: To analyze the effect of ultrasound contrast agent targeting gelatin on uptake of high lymphatic metastasis cell lines of mouse hepatocellular carcinoma with peritoneal effusion. Methods: The modified double emulsifying solvent evaporation method was used to construct the macromolecule contrast agent PLGA-Cooh. The carbodiimide was used to connect the monoclonal antibody of gelatin with the contrast agent PLGA-Cooh, and the targeted ultrasound contrast agent Gsn-PLGA was established. The particle size and Zeta potential of the targeted ultrasound contrast agent were measured by laser particle size analyzer. The surface binding of the contrast agent to the gelatin monoclonal antibody was evaluated by immunofluorescence. Hca-F cells with high lymphatic metastasis were cultured in mice with peritoneal effusion hepatocellular carcinoma. Target-seeking ability in vitro was evaluated by in vitro uptake test, and the imaging effect of the contrast agent in vitro was evaluated by in vitro developing test. Results: The contrast agent is white powder with good water solubility. The average particle size and surface potential were (569.68±6.96) nm and (-10.95±2.43) mV, respectively. The fluorescent antibody binding rate of non-targeted and targeted ultrasound contrast agent labeled with DiI were 0.84% and 95.89%, respectively. The results showed that the targeted ultrasound contrast agent Gsn-PLGA had a better of developing effect in vitro. Hca-F cells with high expression of gelsolin protein had stronger uptake ability of targeted ultrasound contrast agent and stronger green fluorescence in vitro than those with low expression of gelsolin protein (P<0.05). Moreover, targeted ultrasound contrast agent Gsn-PLGA had stronger targeting to the gelsolin protein. The echo of the targeted ultrasound contrast agent Gsn-PLGA was uniform and fine, without attenuating echo of the back. Simultaneously, the development effect was more obvious with the increase of contrast agent concentration (P<0.05). Conclusion: Ultrasound contrast agent Gsn-PLGA targeting gelatin can bind Hca-F cells with high expression of gelatin and display a good imaging effect in vitro.

[The incidence of hypertension, overweight, and obesity and relationship with cardiovascular events among middle-aged Chinese: 6 years follow-up results].

Objective: To identify the incidence of hypertension, overweight/obesity in middle-aged population in China, and explore their impact on cardiovascular events. Methods: From 2009 to 2010, 12 areas were sampled in China, and about 1 000 subjects aged 35 - 64 from each area were enrolled to collect the basic information, physical examination and blood tests were also performed. From 2016 to 2017, data from 8 835 subjects, who completed the 6 years follow-up, were analyzed.Blood pressure and body mass index(BMI) at both baseline and the follow-up, as well as incidence of hypertension, overweight and obesity, were calculated. Cox proportional hazard model was used to investigate the impacts of hypertension, overweight and obesity on cardiovascular events after adjusting confounders. Results: At the end of follow-up, both BMI and systolic and diastolic blood pressure increased significantly compared with the baseline levels (all P<0.001). The cumulative incidence of hypertension, overweight and obesity within 6 years was 39.3%(1 146/2 918), 11.5%(406/3 544) and 4.3%(302/7 025), respectively. Compared with subjects with both normal BMI and blood pressure, people with overweight, obesity, hypertension, overweight with hypertension, and obesity with hypertension faced significantly increased risk of cardiovascular disease (HRs (95%CIs) were 2.394(1.130-5.073), 3.341(1.454-7.674), 6.047(2.978-12.279), 5.808(2.924-11.539) and 8.716(4.391-17.302), respectively, all P<0.05), after adjusting for other confounders. Conclusions: The incidence of overweight, obesity, and hypertension is high in middle-aged people in China. Overweight, obesity and hypertension are associated with significantly increased risk of cardiovascular events during the 6 years follow up.

Evaluation of structural changes and intracellular substance leakage of Escherichia coli O157:H7 induced by ohmic heating.

AIMS: To investigate the effects of ohmic heating (OH) and water bath heating (WB) on the membrane permeability, membrane structure, intracellular organization and leakage of intracellular substances of Escherichia coli O157:H7 at the same inactivation level and at a heating temperature of 72°C. METHODS AND RESULTS: Flow cytometry analysis indicated that membrane permeability of E. coli O157:H7 by OH was comparable to WB at 72°C. Scanning electron microscopy analysis showed that the OH-treated E. coli O157:H7 had greater morphological changes than those of WB-treated ones both at the same inactivation level and the same heating temperature. Transmission electron microscopy analysis showed that both OH and WB caused severe damage on the intracellular organization of E. coli O157:H7 at 72°C. Moreover, OH-treated E. coli O157:H7 had more leakage of intracellular substances than those treated with WB due to the electroporation caused by OH. CONCLUSION: OH presents considerable potential in inactivation of E. coli O157:H7, especially OH at 10 V cm-1 with a much shorter heating time. SIGNIFICANCE AND IMPACT OF THE STUDY: The nonthermal effect of OH had a greater effect on the cell membrane of E. coli O157:H7, resulting in more pores and more leakage of intracellular substances out of the E. coli O157:H7 cells. These results could promote the application of OH in food processing.

A novel Bruton tyrosine kinase gene variation was found in an adult with X-linked agammaglobulinemia during blood cross-matching prior to surgical operation.

AIMS/OBJECTIVES: To investigate the underlying molecular mechanism of the patient's ABO typing discrepancy. BACKGROUND: ABO typing discrepancy was frequently seen in patients due to different causes. In this study, ABO typing discrepancy was found in a 24-year-old man with arthralgia, whose forward ABO grouping was O and reverse ABO grouping was AB. Primary immunodeficiency disease was speculated in this patient, especially X-linked agammaglobulinemia (XLA). METHODS: Immunoglobulins of all isotypes were detected using a specific protein analyser. Lymphocyte subgroups were analysed by flow cytometry. All 19 exons and boundaries of BTK gene were amplified by polymerase chain reaction (PCR), and all PCR products were sequenced by a DNA analyser. BTK protein in the leukocytes and platelets was detected by Western blot. RESULTS: No B lymphocytes could be detected in the peripheral blood of the patient. A novel BTK gene variation, c.817G>T, in the exon 9 of BTK gene was discovered. No BTK protein expression could be detected in the leukocytes and platelets of the patient. CONCLUSIONS: XLA could be occasionally discovered by ABO typing discrepancy in some cases because of the deficiency of reciprocal IgM anti-A and/or anti-B antibodies in the serum of the patient. Humoral immunodeficiency is one of the causes of ABO typing discrepancy.