[Anatomical and histological investigation of the area anterior to the anorectum passing through the levator hiatus]

Objective: To document the anatomical structure of the area anterior to the anorectum passing through the levator hiatus between the levator ani slings bilaterally. Methods: Three male hemipelvises were examined at the Laboratory of Clinical Applied Anatomy, Fujian Medical University. (1) The anatomical assessment was performed in three ways; namely, by abdominal followed by perineal dissection, by examining serial cross-sections, and by examining median sagittal sections. (2) The series was stained with hematoxylin and eosin to enable identification of nerves, vessels, and smooth and striated muscles. Results: (1) It was found that the rectourethralis muscle is closest to the deep transverse perineal muscle where the longitudinal muscle of the rectum extends into the posteroinferior area of the membranous urethra. The communicating branches of the neurovascular bundle (NVB) were identified at the posterior edge of the rectourethralis muscle on both sides. The rectum was found to be fixed to the membranous urethra through the rectourethral muscle, contributing to the anorectal angle of the anterior rectal wall. (2) Serial cross-sections from the anal to the oral side were examined. At the level of the external anal sphincter, the longitudinal muscle of the rectum was found to extend caudally and divide into two muscle bundles on the oral side of the external anal sphincter. One of these muscle bundles angled dorsally and caudally, forming the conjoined longitudinal muscle, which was found to insert into the intersphincteric space (between the internal and external anal sphincters). The other muscle bundle angled ventrally and caudally, filling the gap between the external anal sphincter and the bulbocavernosus muscle, forming the perineal body. At the level of the superficial transverse perineal muscle, this small muscle bundle headed laterally and intertwined with the longitudinal muscle in the region of the perineal body. At the level of the rectourethralis and deep transverse perineal muscle, the external urethral sphincter was found to occupy an almost completely circular space along the membranous part of the urethra. The dorsal part of the external urethral sphincter was found to be thin at the point of attachment of the rectourethralis muscle, the ventral part of the longitudinal muscle of the rectum. We identified a venous plexus from the NVB located close to the oral and ventral side of the deep transverse perineal muscle. Many vascular branches from the NVB were found to be penetrating the longitudinal muscle and the ventral part of rectourethralis muscle at the level of the apex of the prostate. The rectourethral muscle was wrapped ventrally around the membranous urethra and apex of the prostate. The boundary between the longitudinal muscle and prostate gradually became more distinct, being located at the anterior end of the transabdominal dissection plane. (3) Histological examination showed that the dorsal part of the external urethral sphincter (striated muscle) is thin adjacent to the striated muscle fibers from the deep transverse perineal muscle and the NVB dorsally and close by. The rectourethral muscle was found to fill the space created by the internal anal sphincter, deep transverse perineal muscle, and both levator ani muscles. Many tortuous vessels and tiny nerve fibers from the NVB were identified penetrating the muscle fibers of the deep transverse perineal and rectourethral muscles. The structure of the superficial transverse perineal muscle was typical of striated muscle. These findings were reconstructed three-dimensionally. Conclusions: In intersphincteric resection or abdominoperineal resection for very low rectal cancer, the anterior dissection plane behind Denonvilliers' fascia disappears at the level of the apex of the prostate. The prostate and both NVBs should be used as landmarks during transanal dissection of the non-surgical plane. The rectourethralis muscle should be divided near the rectum side unless tumor involvement is suspected. The superficial and deep transverse perineal muscles, as well as their supplied vessels and nerve fibers from the NVB. In addition, the cutting direction should be adjusted according to the anorectal angle to minimize urethral injury.

[Prokaryotic expression and polyclonal antibody preparation of human adenovirus type 7 DNA binding protein]

Objective: To express DNA-binding protein (DBP) of human adenovirus (HAdV) type 7 using the prokaryotic expression system, and product anti-HAdV-7 DBP rabbit polyclonal antibody. Methods: The HAdV-7 DBP gene was synthesized and cloned into prokaryotic expressing vector pET30a, and the recombinant plasmid was transformed into E. coli BL21 (DE3) competent cell. The recombinant protein DBP was expressed by induced Isopropyl-beta-D-thiogalactopyranoside (IPTG) and purified with Ni-NTA affinity column. The titer of anti-DBP polyclonal antibody produced in immunized rabbit was measured by indirect ELISA, and the specificity of the antibody was identified by Western blotting and indirect immunofluorescence assay (IFA). In addition, purified rDBP was used as coating antigen for indirect ELISA assay to detect specific IgM and IgG antibodies against DBP in the serum of children infected with HAdV. Results: The HAdV-7 DBP plasmid was constructed successfully. The purified recombinant DBP was more than 95% after purification. The titer of polyclonal antibody was 1∶1 024 000. The polyclonal antibody showed high specificity in vitro using Western blotting and IFA. The positive rate of specific anti-DBP IgM and IgG antibody in acute-phase serum samples collected from children infected with HAdV were 50.0% (19/38) and 63.2% (24/38), respectively, using indirect ELISA. Conclusion: In summary, the HAdV-7 rDBP is expressed using prokaryotic expression system, and the recombinant HAdV-7 DBP protein and the anti-DBP rabbit polyclonal antibody with high titer are prepared.

[Multicenter study of human adenovirus infection in pediatric community-acquired pneumonia in China]

Objective: To investigate the predominant genotypes and epidemiological characteristics of human adenovirus (HAdV) in pediatric community-acquired pneumonia (CAP) in China. Methods: This was a repeated cross sectional study. Between November 2014 and November 2016, nasopharyngeal aspirates (NPAs) or throat swabs from each hospitalized pediatric patients diagnosed as CAP in 12 hospitals in Northern and Southern China were collected. Respiratory specimens were screened for 18 respiratory viruses including HAdV by using Luminex xTAG RVP Fast V2 multiplex Assay. Typing of HAdV and analysis for the epidemiological characteristic of HAdV were performed. Results: (1) A total of 2 723 hospitalized pediatric patients with CAP were enrolled in this study and 156 (5.7%, 156/2 723) respiratory specimens were positive for HAdV, and 74 (6.6%, 74/1 128) and 82 (5.1%, 82/1 595) were in Northern and Southern China, respectively. There was no significant difference in the positive detection rate between the Northern and Southern China. (2) In Northern China, the HAdV positive rate of children at the age of <6 months, 6 months-<1 years, 1-<3 years, 3-<5 years and ≥5 years was 5.9%(6/101), 6.7%(7/104), 10.3%(34/331), 4.1%(11/266) and 4.9%(16/326), respectively, and the incidence of HAdV infection peaked in children aged 1-3 years (χ(2)=11.511, P=0.021). While in Southern China the HAdV positive rate of children at the age of <6 months, 6 months-<1 years, 1-<3 years, 3-<5 years and ≥5 years was 2.2% (7/312), 4.6% (12/259), 6.3% (31/494), 7.3% (18/245) and 4.9%(14/285), respectively. There was no significant difference in the positive detection rate among age groups. (3) In 2015, the highest detection rate of HAdV in northern China was 12.5% (25/200) in winter, and in Southern China was 6.7% (35/525) in spring and 5.3% (19/357) in summer. (4) In 108 cases of HAdV positive specimens typing was done and 80 in cases classification was successfully performed.Totally 7 genotypes of HAdV, including HAdV-3 (n=32), HAdV-7 (n=9), HAdV-1 (n=12), HAdV-2 (n=15), HAdV-5 (n=10), HAdV-6 (n=1) and HAdV-4 (n=1), were detected. The predominant HAdV genotypes were HAdV-3 (30.8%, 8/26) and HAdV-7 (26.9%, 7/26) in Northern China, while HAdV-3 (44.4%, 24/54) and HAdV-2 (22.2%, 12/54) were the most prevalent genotypes in Southern China. Conclusions: HAdV is an important viral pathogen in pediatric CAP. The predominant HAdV genotypes and peak seasons of HAdV infections were different between Northern and Southern China. The predominant HAdV genotypes were HAdV-3 and HAdV-7 in Northern China, while HAdV-3 and HAdV-2 in Southern China. The peak season of HAdV infections was winter in Northern China. However, HAdV infections are more common in spring and summer in Southern China.

Efficiency-enhanced optical parametric down conversion for mid-infrared generation on a tandem periodically poled MgO-doped stoichiometric lithium tantalate chip

We report an efficiency-enhanced mid-infrared generation via optical parametric down conversion. A tandem periodically-poled MgO-doped stoichiometric lithium tantalate crystal is used to realize on-chip generation and amplification of mid-infrared radiation inside an optical parametric oscillator cavity. We achieved 21.2% conversion efficiency (24% slope efficiency), which is among the highest efficiencies for the pump-to-mid-infrared conversion, with 1064 nm Nd class laser pump. The maximum average output power at 3.87 μm reached 635 mW with a 3.0 W pump.

Generation of a twin beam at the cesium line and telecom wavelength by cavity phase matching

Cavity phase matching has been recently demonstrated as a phase-matching method for efficient nonlinear frequency conversion in a microcavity. Here we extend it to the Type I configuration using a sub-coherent-length optical parametric oscillator consisting of an MgO-doped lithium niobate crystal sheet. It generates a tunable single-longitudinal-mode twin beam, which covers the cesium D2 line of 852.1 nm and the extended band of optical communication. This microcavity is capable of peak output power of 58 kW with a maximum conversion efficiency of 18.5%. Broad applications in the areas of light-atom interaction, spectroscopy, optical telecommunication, and quantum optics can be expected.

Diode-pumped passively mode-locked Nd:YVO4 laser at 1342 nm with periodically poled LiNbO3

In this Letter, we demonstrate a nonlinear-mirror (NLM) mode-locked diode-pumped solid-state Nd:YVO4 laser operating at 1342 nm, in which the NLM comprises a periodically poled LiNbO3 crystal and a dichroic mirror. The self-starting threshold for cw mode locking is 1.5 W, which is significantly lower than that of saturable absorber mode locking. An average power of 1.52 W at 1342 nm is obtained under diode pump power of 10 W at 808 nm, with the slope efficiency being up to 16.8%. The pulse width and the repetition rate of the mode-locked laser output are about 9.5 ps and 101 MHz, respectively.

Cavity phase matching via an optical parametric oscillator consisting of a dielectric nonlinear crystal sheet

We experimentally demonstrate cavity phase matching for the first time using a sheet optical parametric oscillator which is made of an x-cut KTiOPO(4) crystal sheet. This microcavity presents 220 kW peak power capability for near-frequency-degenerate parametric outputs with up to 23.8% slope efficiency. It also features unique spectral characteristics such as single-longitudinal-mode and narrow linewidth. These attractive properties predict broad applications of such a mini-device, such as terahertz generation, photonic integration, spectroscopy, and quantum information, etc.

Surface plasmon polariton enhanced by optical parametric amplification in nonlinear hybrid waveguide

We theoretically studied nonlinear interactions between surface plasmon polariton (SPP) and conventional waveguide mode in nonlinear hybrid waveguide and proposed a possible method to enhance SPP wave via optical parametric amplification (OPA). The phase matching condition of this OPA process is fulfilled by carefully tailoring the dispersions of SPP and guided mode. The influences of incident intensity and phase of guided wave on the OPA process are comprehensively analyzed. It is found that not only a strong enhancement of SPP but also modulations on this enhancement can be achieved. This result indicates potential applications in nonlinear optical integration and modulations.

Polarization-free second-order nonlinear frequency conversion using the optical superlattice

We propose a universal and practical scheme to realize polarization-free second-order nonlinear frequency-conversion processes, including sum-frequency generation, difference-frequency generation, and optical parametric amplification. This scheme is based on the optical superlattice with a noncritical phase-matching condition, which is suitable for optical integration. A chirped dual-period structure is proposed to ensure the efficiency and stability of the conversions.

Single-pass sum-frequency-generation of 589-nm yellow light based on dual-wavelength Nd:YAG laser with periodically-poled LiTaO(3) crystal

We demonstrate a compact all-solid-state yellow laser source based on Q-switched dual-wavelength Nd:YAG laser and periodically-poled LiTaO(3) crystal. 589-nm yellow light was generated by single-pass sum-frequency generation of the fundamental IR waves at 1064 and 1319 nm. The maximum output power of yellow light was 506 mW and the corresponding conversion efficiency was approximately 5.5% [W(-1)cm(-1)].

Simultaneous optical parametric oscillation and intracavity second-harmonic generation based on a hexagonally poled lithium tantalate

Simultaneous optical parametric oscillation and intracavity second-harmonic generation based on a hexagonally poled lithium tantalate is reported. Both the optical parametric oscillation and the cascaded noncollinear second-order harmonic generation processes reach a high efficiency. A variety of possible self-doubling optical parametric oscillation processes indicate this hexagonally poled lithium tantalate has potential applications as a compact multi-wavelength light source.

Transforming spatial entanglement using a domain-engineering technique

We study the spatial correlation of a two-photon entangled state produced in a multistripe periodically poled LiTaO3 crystal by spontaneous parametric down-conversion. The far-field diffraction-interference experiments reveal that the transverse modulation of domain patterns transforms the spatial mode function of the two-photon state. This result offers an approach to prepare a novel type of two-photon state with a unique spatial entanglement by using a domain-engineering technique.

Frequency self-doubling optical parametric amplification: noncollinear red-green-blue light-source generation based on a hexagonally poled lithium tantalate

Simultaneous generation of noncollinear red, green, and blue light from a single hexagonally poled lithium tantalate is reported. It results from the frequency self-doubling optical parametric amplification process, a process of second-order harmonic generation cascaded optical parametric amplification in a single-pass setup. The temperature and spectrum detuning characters of each cascaded quasi-phase-matching process are studied. This unique red-green-blue light source has potential applications in laser display and other laser industries.

[Analysis of early feeding and gastrointestinal dysfunction in neonates with asphyxia]

OBJECTIVE

This article was to investigate the effect of early initiation of enteral feeding in neonates with perinatal asphyxia on gastrointestinal function.

METHODS

Eighty-four cases of enteral feeding of neonates with asphyxia were analysed.

RESULTS

The common dysfunctions were vomiting and abdominal distension, gastric bleeding as well; the percentages of gastrointestinal dysfunction in the early four days were 65.2%, 24.1%, 8.9%, 1.12% respectively and presented a decreasing tendency following the increasing days after birth; The percentage of gastrointestinal dysfunction on the first day was the highest in the early three days (P < 0.05) and not only dextrose but also dilute milk resulted in the dysfunctions. Fasting caused the lower percentage of the dysfunction(2.15%, P < 0.05), but dextrose and dilute milk had no significant difference(P > 0.05).

CONCLUSION

It's not optimal for neonates with asphyxia to initial early enteral feeding, especially in the early three days; it's optimal for the neonates with asphyxia not to be fed on the first day.

Sigma factor-anti-sigma factor interaction in alginate synthesis: inhibition of AlgT by MucA

Conversion from the nonmucoid to the mucoid phenotype is a typical feature of Pseudomonas aeruginosa strains causing chronic pulmonary infections in cystic fibrosis patients. One of the key genetic controls in this conversion to mucoidy is from the algT(U)-mucA-mucB(algN) locus, located at 67.5 min on the standard P. aeruginosa chromosomal map. The algT gene promotes conversion to mucoidy and encodes an alternative sigma factor (sigma E) which belongs to the ECF (for extracytoplasmic function) family. On the other hand, the mucA and mucB (algN) genes suppress conversion to mucoidy. Loss-of-function mutations in mucA have been postulated to be the cause of mucoidy in some P. aeruginosa strains isolated from cystic fibrosis patients. We expressed and purified the protein products from the mucA and mucB open reading frames. The purified MucA protein abolishes the in vitro transcription specified by AlgT and the ability of AlgT to compete with an Escherichia coli sigma factor, FliA, suggesting that inhibiting AlgT-dependent transcription could be the mechanism by which mucA suppresses mucoidy in vivo. Enzyme-linked immunosorbent assay and glycerol density gradient sedimentation experiments suggest that MucA physically interacts with AlgT.

The algT (algU) gene of Pseudomonas aeruginosa, a key regulator involved in alginate biosynthesis, encodes an alternative sigma factor (sigma E)

Chronic infection by alginate-producing (mucoid) Pseudomonas aeruginosa is the leading cause of mortality among cystic fibrosis (CF) patients. During the course of sustained infection, the production of an alginate capsule protects the bacteria and allows them to persist in the CF lung. One of the key regulators of alginate synthesis is the algT (algU) gene encoding a putative alternative sigma factor (sigma E). AlgT was hyperproduced and purified from Escherichia coli. The N-terminal sequence of the purified protein matched perfectly with that predicted from the DNA sequence. The purified protein, in the presence of E. coli RNA polymerase core enzyme, was able to initiate transcription of an algT promoter. Deletion of the -35 region of this promoter abolished this activity in vitro as well as in vivo. These data indicate that the algT gene encodes a sigma factor that is autoregulatory.

Subacute sclerosing panencephalitis in an infant: diagnostic role of viral genome analysis

Subacute sclerosing panencephalitis (SSPE) is related to "defective" measles virus or vaccination, though an association with parainfluenza viruses has been reported. SSPE is characterized by a slow, erratic course and elevated cerebrospinal fluid measles titers. An immunocompetent, vaccinated infant, with onset of symptoms in parainfluenza virus season and a catastrophic course is described. Cerebrospinal fluid titers were negative, but postmortem brain had typical SSPE lesions. Patient brain-derived RNA, subjected to reverse transcription followed by polymerase chain reaction yielded polymerase chain reaction products with measles virus but not parainfluenza virus genes. The sequenced fragment revealed multiple mutations, typical for SSPE. SSPE can thus present in infants, with short latency and no cerebrospinal fluid antibodies. Viral genomic analysis may be diagnostic, permitting early therapy.