[Clinical characteristics of patients with odontogenic sinusitis underwent endoscopic sinus surgery]

Objective: To analyze the clinical features of patients with odontogenic sinusitis (OS) treated by endoscopic sinus surgery (ESS). Methods: A retrospective investigation was carried out in our 27 (16 males and 11 females) cases with OS aged (49.74±14.42) years old. Subjects were hospitalized between January 2018 and November 2020 from Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital. The medical history, symptoms, result of nasal endoscopy and paranasal sinus computed tomography (CT) were analyzed statistically by SPSS 19.0. Results: OS mainly occured on unilateral sinuses, with a duration of (8.56±11.79) months. Seventy point four percent (19/27) of the patients had a course within six-month, only 11% was over 12 months (3/27). Symptoms mostly showed as nasal obstruction (88.9%; 24/27), runny nose (81.5%; 22/27), nasal stinks (16/19) and postnasal drip (10/10). Sixty-three percent (17/27) of the OS patients had a dental history. Nasal endoscopic examination revealed a swelling of the ostiomeatal complex (77.8%; 21/27), medial wall interhal displacement of maxillary sinus (55.6%; 15/27), white emulsion-like purulent secretion in the middle meatus (70.4%; 19/27) and nasal polyps (59.3%; 16/27). Etiology of OS included implant-related problems (14.8%; 4/27) and periodontal disease (85.2%; 23/27). Conclusions: OS is usually unilateral sinusitis with a short history. Its clinical features show nasal stinks, white emulsion-like purulent secretion in the middle meatus and imaging findings of unilateral maxillary sinusitis with tooth-related lesions.

[Expression of GATA3 and bcl-11b in peripheral T-cell lymphoma and their clinical significance]

Objective: To study the expression of GATA3 and bcl-11b in peripheral T-cell lymphoma (PTCL) and their correlation with clinicopathological features. Methods: The Oncomine and GEO databases were used for analyzing the expression levels of GATA3 and bcl-11b mRNA in PTCL. Immunohistochemistry was used to detect the expression of GATA3 and bcl-11b proteins in 127 cases of PTCL diagnosed at Shanxi Provincial Cancer Hospital from January 2010 to June 2020, as well as 40 cases of lymph node with reactive hyperplasia. Results: The data in Oncomine and GEO databases showed that the expression of GATA3 and bcl-11b mRNA in PTCL was lower than that in normal tissues (P<0.05). Immunohistochemistry showed that the positive rates of GATA3 in PTCL and lymph nodes with reactive hyperplasia were 60.6% (77/127) and 85.0% (34/40, P<0.05), respectively. The expression rates of bcl-11b in PTCL and lymph nodes with reactive hyperplasia were 55.1% (70/127) and 75.0% (30/40, P<0.05), respectively. The expression of GATA3 was related to the pathological classification of the patients with PTCL, and was inversely related to the Ann Arbor stage of the patient, while the expression of bcl-11b was inversely correlated with the IPI score of the patient (P<0.05). The expression of GATA3 and bcl-11b was related to the patients' age, gender, LDH level, and B symptoms. Other clinicopathological characteristics were irrelevant. Spearman correlation analysis shows that the expression of GATA3 protein was associated with that of bcl-11b protein in PTCL. Conclusion: GATA3 and bcl-11b are closely related to the prognosis of PTCL, and may be important factors involved in the occurrence and development of PTCL.

Peta-electron volt gamma-ray emission from the Crab Nebula

The Crab Nebula is a bright source of gamma rays powered by the Crab Pulsar's rotational energy through the formation and termination of a relativistic electron-positron wind. We report the detection of gamma rays from this source with energies from 5 × 10^-4 to 1.1 peta-electron volts with a spectrum showing gradual steepening over three energy decades. The ultrahigh-energy photons imply the presence of a peta-electron volt electron accelerator (a pevatron) in the nebula, with an acceleration rate exceeding 15% of the theoretical limit. We constrain the pevatron's size between 0.025 and 0.1 parsecs and the magnetic field to ≈110 microgauss. The production rate of peta-electron volt electrons, 2.5 × 10³⁶ ergs per second, constitutes 0.5% of the pulsar spin-down luminosity, although we cannot exclude a contribution of peta-electron volt protons to the production of the highest-energy gamma rays.

Extended Very-High-Energy Gamma-Ray Emission Surrounding PSR J0622+3749 Observed by LHAASO-KM2A

We report the discovery of an extended very-high-energy (VHE) gamma-ray source around the location of the middle-aged (207.8 kyr) pulsar PSR J0622+3749 with the Large High-Altitude Air Shower Observatory (LHAASO). The source is detected with a significance of 8.2σ for E>25  TeV assuming a Gaussian template. The best-fit location is (right ascension, declination) =(95.47°±0.11°,37.92°±0.09°), and the extension is 0.40°±0.07°. The energy spectrum can be described by a power-law spectrum with an index of -2.92±0.17_{stat}±0.02_{sys}. No clear extended multiwavelength counterpart of the LHAASO source has been found from the radio to sub-TeV bands. The LHAASO observations are consistent with the scenario that VHE electrons escaped from the pulsar, diffused in the interstellar medium, and scattered the interstellar radiation field. If interpreted as the pulsar halo scenario, the diffusion coefficient, inferred for electrons with median energies of ∼160  TeV, is consistent with those obtained from the extended halos around Geminga and Monogem and much smaller than that derived from cosmic ray secondaries. The LHAASO discovery of this source thus likely enriches the class of so-called pulsar halos and confirms that high-energy particles generally diffuse very slowly in the disturbed medium around pulsars.

[Cross sectional study of familial hypercholesterolemia in dyslipidemia patients receiving lipid-lowering therapy: DYSIS-China subgroup analysis]

Objectives: To analyze the incidence, blood lipid levels and cardiovascular disease of familial hypercholesterolemia (FH) in dyslipidemia patients receiving lipid-lowing therapy from the DYSIS-China. Methods: Dyslipidemia International Study-China (DYSIS-China) database was re-analyzed according to the criteria of "Chinese guidelines for prevention and treatment of dyslipidemia in adults-2016 version". DYSIS-China database included 25 317 dyslipidemia out-patients who received at least one lipid-lowering drug for at least three months. All the patients were divided into three groups: unlikely HF, possible FH and definite FH according to the Dutch Lipid Clinic Network diagnostic criteria. Age, gender, lipids levels, drug use and complications were compared among the three groups. Factors were compared between Possible FH group and definite FH group in terms of age stratification. Results: A total of 23 973 patients with dyslipidemia were included. The average age was (64.8±9.9) years, 11 757 patients were females (49.0%). The proportion of unlikely FH in the total population was 20 561 (85.7%), possible FH was 3294 (13.7%), and the definite FH was 118(0.5%). Patients in the definite FH group (58.3±8.5 years) was younger than in unlikely HF(65.3±9.8 years) and possible FH(61.8±9.9 years) group. LDL-C ((5.6±1.9) mmol/L) levels were significantly higher in definite FH group than in unlikely HF ((2.5±0.9) mmol/L) and possible FH ((4.3±1.0) mmol/L) group. TC ((7.4±1.8) mmol/L) levels were also significantly higher in definite FH group than in unlikely HF ((4.3±1.0) mmol/L) and possible FH ((6.0±1.0) mmol/L) group. Percent of female sex, sedentary lifestyle and systolic blood pressure value were significantly higher in definite FH group than in other two groups (all P<0.05). Statin use was similar among the 3 groups. Prevalence of ischemic cardiomyopathy (70(59.3%)) was significantly higher in the definite FH group than in unlikely FH group7519 (36.6%) and possible FH group1149 (34.9%). The rate of hypertension (82 (69.5%)) was also significantly higher in the definite FH group than in unlikely FH group (2 063 (62.6%) and in possible FH group (13 928 (67.7%)). The possible FH group had the highest proportion of patients aged 55-64 years (1 146 (34.8%)), and the prevalence of hypertension 358 (76.8%), diabetes 189 (40.6%), ischemic heart disease 186 (39.9%), cerebrovascular disease 149 (32.0%) and heart failure 28 (6.0%) was the highest in patients over 75 years old. The definite FH group had the highest proportion of patients aged 55-64 years (49 (41.52%)), and the prevalence of ischemic heart disease (70 (59.3%)) was the highest in patients aged 45-54 years old group, there was no significant difference in the prevalence of diabetes,hypertension,heart failure,peripheral artery disease and cerebrovascular disease among different age groups. Conclusion: The detection rate of FH in Chinese patients with dyslipidemia is not low, the blood lipid level is poorly controlled, and the risk of cardiovascular disease is high in Chinses FH patients.

Ultrahigh-energy photons up to 1.4 petaelectronvolts from 12 γ-ray Galactic sources

The extension of the cosmic-ray spectrum beyond 1 petaelectronvolt (PeV; 10¹⁵ electronvolts) indicates the existence of the so-called PeVatrons-cosmic-ray factories that accelerate particles to PeV energies. We need to locate and identify such objects to find the origin of Galactic cosmic rays¹. The principal signature of both electron and proton PeVatrons is ultrahigh-energy (exceeding 100 TeV) γ radiation. Evidence of the presence of a proton PeVatron has been found in the Galactic Centre, according to the detection of a hard-spectrum radiation extending to 0.04 PeV (ref. ²). Although γ-rays with energies slightly higher than 0.1 PeV have been reported from a few objects in the Galactic plane^3-6, unbiased identification and in-depth exploration of PeVatrons requires detection of γ-rays with energies well above 0.1 PeV. Here we report the detection of more than 530 photons at energies above 100 teraelectronvolts and up to 1.4 PeV from 12 ultrahigh-energy γ-ray sources with a statistical significance greater than seven standard deviations. Despite having several potential counterparts in their proximity, including pulsar wind nebulae, supernova remnants and star-forming regions, the PeVatrons responsible for the ultrahigh-energy γ-rays have not yet been firmly localized and identified (except for the Crab Nebula), leaving open the origin of these extreme accelerators.

Bacillus velezensis WLYS23 strain possesses antagonistic activity against hybrid snakehead bacterial pathogens

AIM

The aims of this study were to screen an antagonistic probiotic for the prevention and control of bacterial diseases in snakehead fish and to evaluate the antimicrobial activities, biosafety and biocontrol effect of the antagonistic strain.

METHODS AND RESULTS

In this study, the WLYS23 strain exhibiting the most effective antagonistic properties against several fish pathogens was selected from the intestine of healthy snakehead fish. The strain was identified as Bacillus velezensis based on morphological, physiological and biochemical characteristics, and phylogenetic analysis. This strain showed amylase, cellulase, protease and lipase activities according to extracellular enzyme activity assays. Moreover, the cell-free extract of the WLYS23 strain exhibited strong antibacterial activity, with MICs of ≤64 μg ml^-1 for most fish pathogens. Additionally, the cell-free extract was heat and pH stable, and resistant to protease, whereas their antimicrobial activities were significantly influenced by metal ions at high concentration. The WLYS23 strain and its cell-free extract were safe for snakehead and zebrafish. The disease resistance of snakehead fish was significantly increased following administration of the WLYS23 strain and its cell-free extract respectively. The complete genome of the WLYS23 strain was sequenced and found to harbour seven gene clusters encoding secondary metabolites with antimicrobial activity.

CONCLUSION

The WLYS23 strain possesses great potential as a biocontrol agent, which can be commercially developed to improve disease control in freshwater aquaculture.

SIGNIFICANCE AND IMPACT OF THE STUDY

Snakehead fish are important commercially farmed fish worldwide. However, the bacterial diseases caused by Aeromonas sp. and Nocardia seriolae in farmed snakehead fish lead to huge economic losses. Safe, economical and efficient probiotics are limited to prevent and control these diseases. Here, we provide a promising biocontrol agent with antagonistic activity against bacterial diseases of snakehead.

[Coronavirus and the risk of ocular transmission]

Coronaviruses are a common class of respiratory viruses that can cause human infections. 2019 novel coronavirus(2019-nCoV), a new coronavirus that has recently caused a pandemic, has affected millions of people and put tremendous pressure on the health systems of almost every country in the world. Coronaviruses are known to spread from person to person through droplets or contact. The 2019-nCoV has also been found in the conjunctival secretions and tears of some clinically diagnosed patients. To assess whether the eye is one of the transmission routes of the virus, we review literature, and summarize the anatomy of the eye-nose pathway, the expression of the virus receptor in the eye, the preclinical animal studies, and the clinical data. We analyze the possibility of eyes as a means of transmission and propose some suggestions of ocular protection. (Chin J Ophthalmol, 2021, 57: 305-310).

[Clinical study on preserving right gastroepiploic vein during laparoscopic right hemicolectomy]

Objective: The operative approach and steps of laparoscopic right hemicolon cancer radical resection have been standardlized and professional consensus has been reached. However, some detailed issues such as the handling of Henle's trunk and whether to preserve the right gastroepiploic vein (RGEV) still remain controversial. This study investigates the safety, feasibility, short- and long-term outcomes of preserving RGEV during laparoscopic right hemicolectomy. Methods: A retrospective cohort study was carried out. Clinical data of 92 patients undergoing laparoscopic right hemicolectomy in Taizhou People's Hospital from March 2016 to May 2018 were retrospectively analyzed. All the patients were treated with complete mesocolon resection (CME) and had complete postoperative pathological data and follow-up data. Based on the tumor location, 49 patients preserved RGEV (preservation group) and 43 did not (non-preservation group). Pathological data, postoperative complications, short- and long-term outcomes were compared between the two groups. Results: There were no significant differences in baseline data between the two groups (all P>0.05). No significant differences were found in operation time, intraoperative blood loss, unplanned reoperation, anastomotic leak, number of harvested lymph nodes, number of metastatic lymph node, and time to food intake after surgery between two groups (all P>0.05). Compared with non-preservation group, the preservation group had faster recovery of anal gas passage after operation [(3.1±1.0) days vs. (4.0±1.7) days, t=-2.787, P=0.007], shorter length of hospitalization [(11.5±1.5) days vs. (15.0±7.9) days, t=-2.823, P=0.007], and reduced the hospitalization expenses [(46 000±5000) yuan to (57 000±33 000) yuan, t=-2.076, P=0.044]. No postoperative gastroparesis (PGS) occurred in the preservation group, while 6 cases in the non-preservation group developed gastroparesis during perioperative period (P<0.05). The median time of follow-up time was 31.8 (5.2-43.7) months. The overall survival time of the preservation group and non-preservation group was (35.4±1.8) months and (37.6±1.7) months, respectively without significant difference (P=0.336); the disease-free survival was (32.0±2.2) months and (35.5±2.0) months, respectively without significant difference as well (P=0.201). Conclusions: Dissection of the Henle's truck and preservation of RGEV is safe and feasible during laparoscopic right hemicolectomy, which can significantly reduce the incidence of postoperative gastroparesis, shorten the recovery time of postoperative intestinal function and hospitalization, and decrease the cost of hospitalization. The efficacy of RGEV preservation is similar to non-preservation of RGEV.

[Antibiotic analysis and whole genome sequencing of two nocardia farcinica strains causing joint infection]

Objective: To analyze the molecular characteristics and antibiotic susceptibility of two strains of Nocardia farcinica isolated from patients with joint infection using whole genome sequencing. Methods: Two strains of Nocardia farcinica causing knee-joint infections in two elderly patients were collected in January 2020. Whole genome sequencing was used to determine the nocardia species. Drug sensitivity test was performed using the micro-broth dilution and E-test method according to CLSI M24 guideline. ABRicate was used to analyze drug resistance and virulence genes. Snippy and other bioinformatic tools were used for genomic comparison, and to construct SNP homologous tree. Results: The clinical isolates in this study were both Nocardia farcinica. Antimicrobial susceptibility test showed the isolates were resistant to ceftriaxone, cefepime, cefotaxime and trimethoprim/sulfamethoxazole (TMP/SMX). Imipenem, linezolid and amoxicillin-clavulanic acid showed good activity. Four antibiotic resistance genes including class A β-lactamase gene far-1, RNA polymerase binding protein gene RbpA, multi-drug resistance efflux pump transcription activator gene MtrA and regulatory transcription factor gene vanR-O were identified in the Nocardia farcinica genomes, which conferred resistance to beta-lactams, rifampicin, macrolides and vancomycin respectively. No acquired TMP/SMX resistance genes were identified. There are multiple missense mutations in the dihydrofolate reductase family genes. Four virulence genes of icl, mbtH, phoP, and relA that are homologous to Mycobacterium tuberculosis were found. SNP homologous tree analysis showed the two Nocardia strains were closely related, and there were only ten SNP sites, six compound substitutions and one deletion mutation between them. Conclusions: Whole genome sequencing technology is helpful to explore the molecular characteristics and resistance mechanisms of Nocardia species. Nocardia farcinica has a trend of spreading in China. Resistance to TMP/SMX is worthy of attention. The mutation of genes involved in the metabolic pathway of dihydrofolate might be one of multiple TMP/SMX resistance mechanisms.

[Expression and pathological role of galectin-10 in different types of nasal polyps]

Objective: To investigate the different expression of galectin-10 in nasal polyps with different degrees of eosinophil infiltration, and to explore whether galectin-10 can be used as a new biomarker of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) and its possible role in the pathogenesis of ECRSwNP. Methods: A total of 36 patients (20 males, 16 females, aged from 14 to 74 years old) who underwent functional endoscopic sinus surgery at the Second Affiliated Hospital of Nanchang University from November 2018 to April 2019 were enrolled into the retrospective study, including 11 cases of ECRSwNP, 15 cases of non-ECRSwNP and 10 cases in control group (deviation of nasal septum). The patients were divided into allergic rhinitis and non-allergic rhinitis groups, atopy and non-atopy groups according to whether patients in the experimental group and control group had allergic rhinitis and atopy. HE staining was performed for histological assessment of CRSwNP which was classfied as ECRSwNP and non-ECRSwNP. Immunohistochemistry (IHC) was used to determine the positive localization and semi-quantitative expression level of galectin-10 protein in ERSwNP, non-ECRSwNP and control groups. The expression levels of galectin-10 protein in three groups were determined by Western Blot. The expression levels of galectin-10 mRNA in three groups were determined using real-time quantitative polymerase chain reaction (qRT-PCR). Analyzing the correlation between the expression of galectin-10 and clinical factors including the allergic rhinitis and atopy, SPSS 19.0 software and Graphpad prism 7.0 were used for statistical analysis and mapping. Results: By using IHC method, it was found that galectin-10 was mainly localized in eosinophils in the polyp tissues. The semi-quantitative expression of the galectin-10 in the ECRSwNP group (0.051±0.003) was significantly higher than that of non-ECRSwNP (0.028±0.004) and control groups (0.025±0.004, t value was 3.862 and 5.137, both P<0.01). There was no significant difference between the control and non-ECRSwNP groups (t=0.560, P>0.05). The expression of galectin-10 in the ECRSwNP group was significantly higher than that of non-ECRSwNP and control groups (t value was 25.351 and 27.376, both P<0.01). However, there was no significant difference between the non-ECRSwNP and control groups (t=1.071, P>0.05). Compared with the non-ECRSwNP (1.188±0.054) and control groups (1.020±0.142), the expression of galectin-10 mRNA was higher in the ECRSwNP group (2.413±0.303), the differences were significant (t value was 3.973 and 4.156, both P<0.05). There was no significant difference between the non-ECRSwNP and control groups (t=1.110, P>0.05). There was no significant difference in the expression of galectin-10 between the allergic rhinitis group and the non-allergic rhinitis group (all P>0.05), so as to the atopy group and non-atopy group(all P>0.05). Conclusion: The expression level of galectin-10 is elevated in ECRSwNP, and not influenced by allergic status, suggesting that galectin-10 may be a new biomarker for ECRSwNP and play an important role in the pathogenesis of ECRSwNP.

[Exploration on endovascular treatment for symptomatic occlusion of the intracranial vertebral arteries in early non-acute stage]

Objective: To examine the clinical efficacy of endovascular treatment on symptomatic occlusion of intracranial vertebral artery (ICVA) in early non-acute stage. Methods: Nine consecutive patients who presented with aggressive ischemic events in the early non-acute stage of ICVA occlusion from January 2014 to December 2019 and received endovascular treatment at Department of Neurosurgery, Peking University First Hospital were retrospectively reviewed.There were 7 males and 2 females, aged 63.4 years old(range: 52 to 72 years).The average preoperative modified Rankin scale(mRS) was 4.3(range: 4 to 5), the National Institute of Health stroke scale(NIHSS) was 12.3(range: 8 to 18). Among them, 2 patients received a single stage endovascular treatment, and the other 7 patients received staged endovascular treatment.The strategy of staged treatment was as follows: firstly, the occlusion part was passed through by a micro-guidewire and dilated with balloons to maintain the blood flow above Thrombolysis In Cerebral Infarction grade 2b. Then, the intravascular large load thrombus was eliminated by the fibrinolytic system and strengthened antiplatelet drugs. After that, a second stage of angioplasty with stenting was performed on the severe residual stenosis part.The complications and the recanalization rate were collected, and the National NIHSS and mRS after endovascular treatment and in follow-up period were recorded. Results: In the 2 cases received single stage endovascular treatment, although revascularization was achieved lastly, one patient suffered embolus translocation and the other suffered re-occlusion after mechanical thrombectomy during the operation, respectively.Technical success was achieved in 6 of the 7 patients received staged endovascular treatment.On discharge, the average NIHSS scores was 5.7(range: 3 to 4) of the patients. Three months after operation,the average mRS was 1.6(range:0 to 3) and it was 0.9(range: 0 to 2) at the latest follow-up, which were better than preoperative status. Conclusions: Staged endovascular treatment might be a safe, efficient, viable option in carefully selected patients with symptomatic ICVA occlusion in early non-acute stage. It needs to be confirmed by further investigation, preferably in a large controlled setting.

Topologically protected beam splitters and logic gates based on two-dimensional silicon photonic crystal slabs

The beam splitters are essential optical components that are widely used in various optical instruments. The robustness of beam splitters is very necessary to all-optical networks. Here we report the design of the topologically protected beam splitter, whose splitting ratio can change flexibly to an arbitrary ratio, such as 50:50, 33:67, 25:75, based on the two-dimensional silicon photonic crystal slab. By using the 50:50 beam splitter, all major logic gates (OR, AND, NOT, XOR, NAND, XNOR, and NOR) are suitably designed with the linear interference approach. Additionally, these devices exhibit robustness even though some disorders exist. It is expected that these robust and compact devices are potentially applicable in optical computing and signal processing.

[Serum metabolomics in latent pneumoconiosis tuberculosis patients based on ultra performance liquid chromatography tandem quadrupole time of flight mass spectrometry]

Objective: To explore the non-target metabonomics of serum in worker's pneumoconiosis (CWP) patients with latent tuberculosis and the biomarkers of latent tuberculosis infection of pneumoconiosis. Methods: In December 2018, 39 CWP inpatients from a hospital in Beijing were taken as subjects. The subjects were screened for latent tuberculosis using the in vitro release test of mycobacterium tuberculosis-interferon (IGRAs) test. According to the screening results, 21 positive patients with latent tuberculosis infection were selected as the latent tuberculosis group of pneumoconiosis. While 18 negative patients with CWP alone were selected as the pneumoconiosis group. Polarity components of metabolites were analyzed by UPLC-QTOF/MS. The data was processed with Progenesis QI software for multidimensional statistical analysis. Identification of structure of differential metabolites were matched through accurate mass and secondary mass spectrum. Searching the Human Metabolome Database (HMDB) , differential metabolites were imported into MetaboAnalyst 4.0 to analyze the metabolic pathways. Results: All 42 differential metabolites were screened out. Excepted for exogenous metabolites, 14 endogenous differential metabolites were identified. Compared with the pneumoconiosis group, 6 metabolites including PC [18∶4 (6Z, 9Z, 12Z, 15Z) /P-18∶1 (11Z) ], 3-Oxododecanoyl-CoA in the latent tuberculosis group were up-regulated, while 8 metabolites including the Stearoyl-CoA, (2S) -Pristanoyl-CoA were down-regulated. These results might be related to lipid, fatty acid and arachidonic acid metabolism pathways. Conclusion: There are significant differences in serum metabonomics between the patients with latent tuberculosis of pneumoconiosis and the patients with ordinary pneumoconiosis, which provide a reference for the study of biomarkers for the diagnosis of latent tuberculosis infection of pneumoconiosis.

Complexity of plastic instability in amorphous solids: Insights from spatiotemporal evolution of vibrational modes

It has been accepted that low-frequency vibrational modes are causally correlated to fundamental plastic rearrangement events in amorphous solids, irrespective of the structural details. But the mode-event relationship is far from clear. In this work, we carry out case studies using atomistic simulations of a three-dimensional Cu₅₀Zr₅₀ model glass under athermal, quasistatic shear. We focus on the first four plastic events, and carefully trace the spatiotemporal evolution of the associated low-frequency normal modes with applied shear strain. We reveal that these low-frequency modes get highly entangled with each other, from which the critical mode emerges spontaneously to predict a shear transformation event. But the detailed emergence picture is event by event and shear-protocol dependent, even for the first plastic event. This demonstrates that the instability of a plastic event is a result of extremely complex multiple-path choice or competition, and there is a strong, elastic interaction among neighboring instability events. At last, the generality of the present findings is shown to be applicable to covalent-bonded glasses.

Polar meron lattice in strained oxide ferroelectrics

A topological meron features a non-coplanar structure, whose order parameters in the core region are perpendicular to those near the perimeter. A meron is half of a skyrmion, and both have potential applications for information carrying and storage. Although merons and skyrmions in ferromagnetic materials can be readily obtained via inter-spin interactions, their behaviour and even existence in ferroelectric materials are still elusive. Here we observe using electron microscopy not only the atomic morphology of merons with a topological charge of 1/2, but also a periodic meron lattice in ultrathin PbTiO₃ films under tensile epitaxial strain on a SmScO₃ substrate. Phase-field simulations rationalize the formation of merons for which an epitaxial strain, as a single alterable parameter, plays a critical role in the coupling of lattice and charge. This study suggests that by engineering strain at the nanoscale it should be possible to fabricate topological polar textures, which in turn could facilitate the development of nanoscale ferroelectric devices.

[Analysis of prognostic factors of low-frequency type of sudden sensorineural hearing loss]

Objective: To investigate the prognostic factors of patients with low-frequency type of sudden sensorineural hearing loss. Methods: From February 2017 to February 2019, adult patients with unilateral low-frequency type of sudden sensorineural hearing loss in Department of Otological Medicine, Shandong Provincial ENT Hospital, Shandong University were selected. All patients were examined by audiology, vestibular function evaluation, imaging examination and serum thyroid function test; the same treatment program was given, the curative effect was recorded and followed up for more than 3 months. SPSS 20.0 software was used to analyze concomitant symptoms (tinnitus, ear tightness, echo, rotatory vertigo), degree of deafness, inducement of deafness, basic disease, vestibular function (caloric test), electrocochleogram, inner ear gadolinium enhanced MRI radiography and thyroid function on prognosis of patients. Results: Among the 155 patients, 76 cases were cured (49.0%), 1 case was markedly effective (0.6%), 19 cases were effective (12.3%), and 59 cases were ineffective (38.1%). The total effective rate was 61.9%. Among them, 24 cases (15.5%) had hearing fluctuations during follow-up, and 1 case (0.6%) developed Meniere's disease. Univariate analysis showed that vestibular function, electrocochleogram and inner ear MRI were correlated with prognosis. Multivariate logistic analysis showed that ear tightness, vestibular function, electrocochleogram and inner ear MRI were correlated with the prognosis of the patients. The two analyses showed that tinnitus, echo, rotational vertigo, degree of deafness, predisposing factors and underlying diseases were not significantly correlated with the prognosis of the patients (all P>0.05). Rotational vertigo was closely related to gender, and women had a high incidence. There was a significant correlation between the degree of deafness and prognosis in patients with course of less than 1 week (P<0.05). The abnormal rate of vestibular function in patients with course of disease ≤ 1 week was significantly different from that>1-≤2 and>2-≤4 weeks (P<0.05). The rate of abnormal thyroid function was significantly higher than that of normal people (P<0.05), but there was no significant correlation between thyroid dysfunction and hearing prognosis (χ(2)=0.009, P=0.923) . Conclusions: The prognosis of low-frequency sudden sensorineural hearing loss is not related to clinical symptoms, inducements, underlying diseases and serological abnormalities of thyroid function, but the degree of deafness is positively related to the prognosis within 1 week from onset. Abnormal thyroid function is one of the risk factors of happening with low-frequency descending sudden deafness. Abnormal vestibular caloric test, electrocochleogram and endolymph hydrops are the factors of poor prognosis.

[Expression of CDK6 and FOXM1 in peripheral T-cell lymphoma and their significance]

Objective: To investigate the expression of CDK6 and FOXM1 in peripheral T-cell lymphoma (PTCL), and its correlation with clinicopathologic features and patient prognosis. Methods: The Oncomine was used for data mining and analyzing the expression levels of CDK6 and FOXM1 in PTCL. Immunohistochemistry (IHC) of EnVision method was used to detect the expression of CDK6 and FOXM1 proteins in 166 cases of PTCL diagnosed at Shanxi Provincial Cancer Hospital from January 2016 to December 2018, and 30 cases of lymph node with reactive hyperplasia as control. Results: Among the PTCL patients, 104 were male and 62 were female, aged from 3 to 85 years, with an average age of 53 years. Analyses of the Oncomine 4.5 database showed that mRNA expression of CDK6 and FOXM1 in PTCL tissues was significantly higher than that in normal tissue (P<0.05). IHC staining showed the positive rates of CDK6 and FOXM1 proteins in PTCL tissues were 27.7% (46/166) and 80.7% (134/166), respectively. The expression was mainly present in the nuclei of tumor cells, showing a diffuse, strongly positive pattern. The positive rates of CDK6 and FOXM1 proteins among the 30 cases of lymph-node reactive hyperplasia were 0 (0/30) and 30% (9/30), respectively. The expression of FOXM1 was mainly found in the lymphoid follicle germinal center, and not present in the T-zone cells. CDK6 protein, FOXM1 protein and the co-expression of CDK6 and FOXM1 proteins in PTCL were associated with higher Ann Arbor staging and international prognostication index score (P<0.05), and inversely associated with overall survival (P<0.05). Meanwhile, CDK6 protein expression was positively correlated with FOXM1 protein expression (P<0.05). Conclusions: CDK6 and FOXM1 may be new targets for the diagnosis and treatment of PTCL. The overexpression of CDK6 may lead to enhanced function of the transcription factor FOXM1, while the overexpression of CDK6 and FOXM1 also promotes the development and progression of PTCL.

[Estimating the basic reproduction number of COVID-19 in Wuhan, China]

Objective: The number of confirmed and suspected cases of the COVID-19 in Hubei province is still increasing. However, the estimations of the basic reproduction number of COVID-19 varied greatly across studies. The objectives of this study are 1) to estimate the basic reproduction number (R(0)) of COVID-19 reflecting the infectiousness of the virus and 2) to assess the effectiveness of a range of controlling intervention. Methods: The reported number of daily confirmed cases from January 17 to February 8, 2020 in Hubei province were collected and used for model fit. Four methods, the exponential growth (EG), maximum likelihood estimation (ML), sequential Bayesian method (SB) and time dependent reproduction numbers (TD), were applied to estimate the R(0). Results: Among the four methods, the EG method fitted the data best. The estimated R(0) was 3.49 (95%CI: 3.42-3.58) by using EG method. The R(0) was estimated to be 2.95 (95%CI: 2.86-3.03) after taking control measures. Conclusions: In the early stage of the epidemic, it is appropriate to estimate R(0) using the EG method. Meanwhile, timely and effective control measures were warranted to further reduce the spread of COVID-19.

Ethnicity and health inequalities: an empirical study based on the 2010 China survey of social change (CSSC) in Western China

BACKGROUND

In China, ethnic minorities often live in frontier areas and have a relatively small population size, and tremendous social transitions have enlarged the gap between eastern and western China, with western China being home to 44 ethnic minority groups. These three disadvantages have health impacts. Examining ethnicity and health inequality in the context of western China is therefore essential.

METHODS

This paper is based on data from the 2010 China Survey of Social Change (CSSC2010), which was conducted in 12 provinces, autonomous regions and province-level municipalities in western China and had a sample size of 10,819. We examined self-rated health and disparities in self-rated health between ethnic minorities and Han Chinese in the context of western China. Self-rated health was coded as poor or good, and ethnicity was coded as ethnic minority or Han Chinese. Ethnic differences in self-rated health was examined by using binary logistic regression. Associations among sociodemographic variables, SES variable, health behaviour variable, health problem variables and self-rated health were also explored.

RESULTS

Fourteen percent of respondents reported their health to be poor. A total of 15.75% of ethnic minorities and 13.43% of Han Chinese respondents reported their health to be poor, indicating a difference in self-rated health between ethnic minorities and Han Chinese. Age, gender, marital status, education, alcohol, and health problems were the main factors that affected differences in self-rated health.

CONCLUSION

In western China, there were obvious ethnic disparities in self-rated health. Elderly ethnic minorities, non-partnered ethnic minorities, ethnic minorities with an educational level lower than middle school, and ethnic minorities with chronic disease had higher odds of poor self-rated health.

[Impact of water body environments on the microbial community of Oncomelania hupensis snails in marshlands around the eastern Dongting Lake]

OBJECTIVE

To evaluate the effects of water body environments on the microbial community of Oncomelania hupensis snails in marshlands of the eastern Dongting Lake where natural extinction of O. hupensis snails are found, so as to explore the correlation between the natural extinction of O. hupensis snails and the microbial community in snails.

METHODS

Snails were caged water bodies in the Qianliang Lake marshland (Qianliang Lake regions) where natural extinction of snails was found and in the Junshan Park marshland (Junshan Park regions) in the eastern Dongting Lake for 30 days, and then all snails were collected and identified for survival or death. DNA sequencing of the fungi and bacteria was performed in snails before and after immersion in waters, and the biodiversity and abundance were analyzed.

RESULTS

The survival rates of O. hupensis snails were 28.0% (70/250) and 64.8% (162/250) in Qianliang Lake regions and Junshan Park regions 30 days after immersion in waters, respectively (χ² = 81.365, P < 0.01). The number of the fungal community and the biodiversity of the bacterial community were both greater in snails caged in Qianliang Lake regions post-immersion than pre-immersion, and there was a significant difference in the structure of the fungal and bacterial communities. The microbial community with a significant difference included Flavobacteriaceae,which was harmful to O. hupensis snails.

CONCLUSIONS

The water body environment affects the composition of the microbial community in O. hupensis snails in marshlands with natural snail distinction around the eastern Dongting Lake; however, further studies are required to investigate whether the natural distinction of snails is caused by water body environments-induced changes of the microbial spectrum in O. hupensis snails.

[Evaluation on the effect of clinic standardized blood pressure measurement model applying to first blood pressure measurement among community population aged 35 years old and above]

Objective: To evaluate the effect of clinic standardized blood pressure measurement model (SBPM) applying to first blood pressure measurement among community population aged 35 years old and above. Methods: SBPM was implemented in the community health service center of Dapuqiao street, Huangpu district of Shanghai from June 1, 2018, and the data between June 1 and December 31, 2018 was used as the SBPM data. The first-diagnosis blood pressure measurement data in this center between June 1 and December 31, 2017 was used as the conventional measurement (CM) model data. The detection rate of elevated blood pressure under SBPM was standardized according to the gender and age distribution of subjects in CM. The equilibrium of the value distribution of the end digit of blood pressure value in different pressure-measuring models and difference of elevated blood pressure rate of subjects with different characteristics and seasons were analyzed by using the χ(2) test, and the difference of standardized elevated blood pressure rate in different pressure-measuring models was analyzed by using the U test. Results: The SBPM included 1 548 subjects and 639 (41.28%) of them were males. The CM included 2 952 inpatients and 1 196 (40.51%) of them were males. The frequency of the end digit of blood pressure in SBPM ranged from 9.04% to 10.72%, and both systolic and diastolic blood pressure showed a balanced distribution of end digit (P values were 0.996 and 0.981 respectively). The frequency of blood pressure end digital in the CM ranged from 0.37% to 67.92%, and both systolic and diastolic blood pressure showed an unbalanced distribution (both P values <0.001). The crude rate and standardized elevated blood pressure rate in SBPM were 23.19% (359/1 548) and 23.05%, which were higher than that in CM, about 7.22% (213/2 952) (both P values <0.001). The elevated blood pressure rate in SBPM in summer, autumn and winter was 18.85% (141/748), 26.72% (152/591) and 31.58% (66/209), respectively, which was higher than that in CM, about 6.28% (91/1 450), 7.20% (82/1 139) and 11.02% (40/363), respectively (all P values <0.001). Conclusion: The quality of blood pressure data and the efficiency of hypertension screening of SBPM are better than those of CM when applying to first blood pressure measurement among community population aged 35 years old and above.