Individualized anti-thrombotic therapy for acute myocardial infarction complicated with left ventricular thrombus: A case report

BACKGROUND Presently,there is no established standard anti-blood clot therapy for patients facing acute myocardial infarction(AMI)complicated by left ventricular thrombus(LVT).While vitamin K antagonists are the preferred choice for oral blood thinning,determining the best course of blood-thinning medication remains challenging.It is unclear if non-vitamin K antagonist oral blood thinners have different effectiveness in treating LVT.This study significantly contributes to the medical community.CASE SUMMARY The blood-thinning treatment of a patient with AMI and LVT was analyzed.Triple blood-thinning therapy included daily enteric-coated aspirin tablets at 0.1 g,daily clopidogrel hydrogen sulfate at 75 mg,and dabigatran etexilate at 110 mg twice daily.After 15 d,the patient’s LVT did not decrease but instead increased.Clinical pharmacists comprehensively analyzed the cases from the perspective of the patient’s disease status and drug interaction.The drug regimen was reformulated for the patient,replacing dabigatran etexilate with warfarin,and was administered for six months.The clinical pharmacist provided the patient with professional and standardized pharmaceutical services.The patient’s condition was discharged after meeting the international normalized ratio value(2-3)criteria.The patient fully complied with the follow-up,and the time in the therapeutic range was 78.57%,with no serious adverse effects during pharmaceutical monitoring.CONCLUSION Warfarin proves to be an effective drug for patients with AMI complicated by LVT,and its blood-thinning course lasts for six months.

Generation of elliptical airy vortex beams based on all-dielectric metasurface

Elliptical airy vortex beams(EAVBs) can spontaneously form easily identifiable topological charge focal spots. They are used for topological charge detection of vortex beams because they have the abruptly autofocusing properties of circular airy vortex beams and exhibit unique propagation characteristics. We study the use of the dynamic phase and Pancharatnam–Berry phase principles for generation and modulation of EAVBs by designing complex-amplitude metasurface and phase-only metasurface, at an operating wavelength of 1500 nm. It is found that the focusing pattern of EAVBs in the autofocusing plane splits into |m| + 1 tilted bright spots from the original ring, and the tilted direction is related to the sign of the topological charge number m. Due to the advantages of ultra-thin, ultra-light, and small size of the metasurface, our designed metasurface device has potential applications in improving the channel capacity based on orbital angular momentum communication, information coding, and particle capture compared to spatial light modulation systems that generate EAVBs.

Trim21 depletion alleviates bone loss in osteoporosis via activation of YAP1/β-catenin signaling

Despite the diverse roles of tripartite motif(Trim)-containing proteins in the regulation of autophagy,the innate immune response,and cell differentiation,their roles in skeletal diseases are largely unknown.We recently demonstrated that Trim21 plays a crucial role in regulating osteoblast(OB)differentiation in osteosarcoma.However,how Trim21 contributes to skeletal degenerative disorders,including osteoporosis,remains unknown.First,human and mouse bone specimens were evaluated,and the results showed that Trim21 expression was significantly elevated in bone tissues obtained from osteoporosis patients.Next,we found that global knockout of the Trim21 gene(KO,Trim2^(1-/-))resulted in higher bone mass compared to that of the control littermates.We further demonstrated that loss of Trim21 promoted bone formation by enhancing the osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs)and elevating the activity of OBs;moreover,Trim21 depletion suppressed osteoclast(OC)formation of RAW264.7 cells.In addition,the differentiation of OCs from bone marrow-derived macrophages(BMMs)isolated from Trim21^(-/-)and Ctsk-cre;Trim21^(f/f)mice was largely compromised compared to that of the littermate control mice.Mechanistically,YAP1/β-catenin signaling was identified and demonstrated to be required for the Trim21-mediated osteogenic differentiation of BMSCs.More importantly,the loss of Trim21 prevented ovariectomy(OVX)-and lipopolysaccharide(LPS)-induced bone loss in vivo by orchestrating the coupling of OBs and OCs through YAP1 signaling.Our current study demonstrated that Trim21 is crucial for regulating OB-mediated bone formation and OC-mediated bone resorption,thereby providing a basis for exploring Trim21 as a novel dual-targeting approach for treating osteoporosis and pathological bone loss.

Comparison axial length measurements from three biometric instruments in high myopia

AIM： To compare the axial lengths （ALs） measured with Lenstar, IOLMaster and A-scan contact ultrasound （Ultrasound） in normal and high myopia （HM）. METHODS： Eighty-four normal eyes and 49 HM eyes were included. Three consecutive measurements were performed on each eye in the following order： Lenstar, IOLMaster, and Ultrasound. The repeatabilities of the AL measurements for each instrument were assessed by calculating the pooled coefficients of variation （CVs） of 18 eyes in each group. Comparisons between the HM and normal groups were made with independent sample t-tests. The inter-device agreements were evaluated with Bland-Altman analyses and paired two-tailed t-tests. RESULTS： For normal group, the CVs of the AL measurements taken with the Lenstar, IOLMaster and Ultrasound were 0.001%, 0.01% and 0.14%, respectively. The corresponding CVs for the HM group were 0.005%, 0.02% and 0.15%, respectively. There was significant difference between the Lenstar and the IOLMaster in normal group （P=0.031） but not in HM group （n=0.100）. In the two groups, the Lenstar and the IOLMaster produced higher values than did the Ultrasound （all P〈 0.001）. All three instruments exhibited good agreement in terms of AL values. For the intraocular lens （IOL） power calculation using SRK II formula, the Lenstar and the IOLMaster showed 0.5 D higher than Ultrasound in both groups （all P〈0.001）. No significant difference existed between the Lenstar and the IOLMaster for the IOL power calculation in both normal （n=0.474） and HM group （P= 0.103）. CONCLUSION： The three devices exhibited excellent intra-visit repeatabilities in the AL measurements. The AL and IOL power difference between partial coherence interferometry and ultrasound instruments should be noticed.

Crack propagation behavior of inhomogeneous laminated Ti-Nb metal-metal composite

In order to investigate the real-time cracking behavior of each component of a composite with strong interfacial bonding among lamellae, Ti-18 Nb(at.%) composite was prepared by spark plasma sintering(SPS), followed by hot-rolling, annealing, and quenching. The microstructure and mechanical properties were characterized by scanning electron microscopy(SEM), energy dispersive spectroscopy(EDS), micro-region X-ray diffractometry(MRXRD), nanoindentation, and in-situ scanning electron microscopy tensile testing. The results show that the Ti-18 Nb consists of Ti-enriched, diffusion and Nb-enriched zones, and the sharp Nb gradient across different zones leads to inhomogeneous distribution of phase and mechanical properties. A remarkable finding is that the diffusion zones not only enable the cooperative deformation between the brittle Ti-enriched zones and the ductile Nb-enriched zones but also act as the crack-arresters to prevent the local cracks in the Ti-enriched zones from further propagating across the composite.

Experimental and numerical investigation of a Hall thruster with a chamfered channel wall

A discharge channel with a chamfered wall not only has application in the design of modern Hall thrusters, but also exists where the channel wall is eroded, and so is a common status for these units. In this paper, the laws and mechanisms that govern the effect of the chamfered wall on the performance of a Hall thruster are investigated. By applying both experimental measurement and particle-in-cell simulation, it is determined that there is a moderate chamfer angle that can further improve the optimal performance obtained with a straight channel. This is because the chamfering of the wall near the channel exit can enhance ion acceleration and effectively reduce ion recombination on the wall, which is favorable to the promotion of the thrust and efficiency. However, the chamfer angle should not be too large; otherwise, both the density of the propellant gas and the distribution of the plasma potential in the channel are influenced, which is undesirable for efficient propellant utilization and beam concentration. Therefore, it is suggested that the chamfer shape of the channel wall is an important factor that must be carefully considered in the design of Hall thrusters.

Application of artificial intelligence for the diagnosis,treatment,and prognosis of pancreatic cancer

Pancreatic cancer is a complex cancer of the digestive tract.Diagnosis and treatment can be very difficult because of unclear early symptoms,the deep anatomical location of cancer tissues,and the high degree of cancer cell invasion.The prognosis is extremely poor;the 5-year survival rate of patients with pancreatic cancer is less than 1%.Artificial intelligence(AI)has great potential for application in the medical field.In addition to AI-based applications,such as disease data processing,imaging,and pathological image recognition,robotic surgery has revolutionized surgical procedures.To better understand the current role of AI in pancreatic cancer and predict future development trends,this article comprehensively reports the application of AI to the diagnosis,treatment,and prognosis of pancreatic cancer.

Measurement of central corneal thickness and precorneal tear film thickness of rabbits using the Scheimpflug system

AIMTo measure central corneal thickness (CCT) and pre-corneal tear film thickness using the Galilei dual-Scheimpflug analyzer (GSA) in New Zealand white rabbits.

Deep-learning-based cryptanalysis of two types of nonlinear optical cryptosystems

The two types of nonlinear optical cryptosystems(NOCs)that are respectively based on amplitude-phase retrieval algorithm(APRA)and phase retrieval algorithm(PRA)have attracted a lot of attention due to their unique mechanism of encryption process and remarkable ability to resist common attacks.In this paper,the securities of the two types of NOCs are evaluated by using a deep-learning(DL)method,where an end-to-end densely connected convolutional network(DenseNet)model for cryptanalysis is developed.The proposed DL-based method is able to retrieve unknown plaintexts from the given ciphertexts by using the trained DenseNet model without prior knowledge of any public or private key.The results of numerical experiments with the DenseNet model clearly demonstrate the validity and good performance of the proposed the DL-based attack on NOCs.

Manipulating the Flipping of Water Dipoles in Carbon Nanotubes

Flipping of water dipoles in carbon nanotubes is of great importance in many physical and biological applications,such as signal amplification,molecular switches and nano-gates.Ahead of these applications,understanding and inhibiting the non-negligible thermal noise is essential.Here,we use molecular dynamics simulations to show that the flipping frequency of water dipoles increases with the rising temperature,and the thermal noise can be suppressed by imposed charges and external uniform electric fields.Furthermore,the water dipoles flip periodically between two equiprobable and stable states under alternating electric fields.These two stable states may be adopted to store 0 and 1 bits for memory storage or molecular computing.

The binocular intraocular lens power difference in eyes with different axial lengths

AIM:To investigate the binocular intraocular lens(IOL)power difference in eyes with short,normal,and long axial lengths(AL)using Lenstar LS 900 optical biometry.METHODS:A total of 716(1432 eyes)participants were included.The groups were categorized into short(group A:AL<22 mm),normal(group B:22 mm≤AL≤25 mm),and long AL groups(group C:AL>25 mm).The central corneal thickness(CCT),anterior chamber depth(ACD),lens thickness(LT),AL,anterior corneal keratometry,whiteto-white(WTW),pupil diameter(PD),as well as IOL power calculated using embedded Barrett formula were assessed.Bland-Altman plots were used to test the agreement of the binocular parameters.RESULTS:In group A,the CCT of the right eye was significantly thinner than that of the left eye(P=0.044)with a difference of-2±8μm[95%limits of agreement(LoA),-17.8 to 13.2μm].For group B,the PD and IOL power in the right eye were significantly lower than those of the left eye(P=0.001,<0.001)with a difference of-0.05±0.32 mm(95%LoA,-0.68 to 0.58 mm)and-0.18±1.01 D(95%LoA,-2.2 to 1.8 D).The AL of right eye was longer than that of the left eye(P=0.002)with a difference of 0.04±0.25 mm(95%Lo A,-0.45 to 0.52 mm).No significant difference was observed for all the binocular parameters in group C.The percentage of participants with binocular IOL power difference within±0.5 D were 62%(31/50),68.3%(339/496),and 38.8%(66/170)in groups A,B,and C,respectively.CONCLUSION:The binocular parameters related to IOL power are in good agreement,but the binocular IOL power difference of more than half of participants with long AL is more than 0.50 D.

Mechanism of Th17/Treg immune axis regulating the intestinal microflora of ulcerative colitis

Ulcerative colitis(UC)is a type of chronic inflammatory recurrent disease.At present,the etiology and pathogenesis are still unclear,and immune factors are usually considered to be the final link in the pathogenesis of UC.Due to the increasing incidence of this disease,longer course of disease,and difficult to heal,related research has gradually deepened,and related researches on intestinal flora,immunity,genetics,etc.have become hotspots.A large amount of evidence indicates that regulatory T cells(Treg),helper T cell 17(Th17),Th17/Treg immune axis and intestinal microbiota in UC patients play an important role in regulating the occurrence and development of diseases.In recent years,the intestine has been gradually discovered There is also a certain correlation between the tract microbiota and the Th17/Treg immune axis.Therefore,this article examines a large number of relevant Chinese and English materials at home and abroad in recent years to analyze the Th17/Treg cells,intestinal microbiota and the relationship between the two in UC patients.The existing relevance and other issues are briefly discussed and summarized in order to provide more practical basis for clinical targeted therapy.

Application of artificial intelligence in the diagnosis and prediction of gastric cancer

Gastric cancer is the second leading cause of cancer deaths worldwide.Despite the great progress in the diagnosis and treatment of gastric cancer,the incidence and mortality rate of the disease in China are still relatively high.The high mortality rate of gastric cancer may be related to its low early diagnosis rate and poor prognosis.Much research has been focused on improving the sensitivity and specificity of diagnostic tools for gastric cancer,in order to more accurately predict the survival times of gastric cancer patients.Taking appropriate treatment measures is the key to reducing the mortality rate of gastric cancer.In the past decade,artificial intelligence technology has been applied to various fields of medicine as a branch of computer science.This article discusses the application and research status of artificial intelligence in gastric cancer diagnosis and survival prediction.

Programmable activation of Bombyx gene expression using CRISPR/dCas9 fusion systems

The recently developed clustered regularly interspaced short palindromic repeats (CRISPR)-based techniques have made it possible to reprogram target gene expression without cloning complementary DNA or disturbing genomic sequence in mammalian cells and several multicellular organisms. We previously showed that CRISPR-associated protein 9 (Cas9) and CRISPR from Prevotella and Francisella 1 (Cpfl) could induce target mutations, deletions, inversions, and duplications both singly and multiplex in silkworm, Bombyx mori. However, it remains unknown whether the CRISPR activation (CRISPRa) system can be used in B. mori. In this study, we investigated the CRISPRa system, in which a nuclease dead Streptococcus pyogenes Cas9 (SpCas9) is fused to two transcription activation domains, including VP64 (a tetramer of the herpes simplex VP 16 transcriptional activator domain), and VPR (a tripartite activator, composed of VP64, p65, and Rta). The results showed that both dCas9-VP64 and dCas9-VPR systems could be used in B. mori cells, of which the latter showed significantly higher activity. The dCas9-VPR system showed considerable activity on all five tested target genes, and further analysis revealed that the up-regulation of genes was negatively correlated to their basal expression level. We also observed that this system could be used to upregulate a range of target genes. Taken together, our findings demonstrate that CRISPRa can be a powerful tool to study gene functions in B. mori and perhaps other non-drosophila insects.

A concise formal stereoselective total synthesis of(-)-swainsonine

A short formal stereoselective synthesis of （-）-swainsonine （1） is described. Our synthesis started with the versatile building block （R）-3-benzyloxyglutarimide 5. Through controlled regioselective reduction, Ley＇s-sulfone chemistry （N-α-sulfonylation and ZnCl2-catalyzed N-α-amidovinylation）, an RCM reaction, and an amide reduction, the synthesis of unsaturated indolizidine （8R,8aS）-3 has been achieved in five steps. The indolizidine （8R,8aS）-3 is an advanced intermediate toward the synthesis of （-）-swainsonine （1）.

Temperature dependence of Lüders strain and its correlation with martensitic transformation in a medium Mn transformation-induced plasticity steel

The Luders deformation behavior in a medium Mn transformation induced plasticity （TRIP） steel is investigated at different temperatures ranging from 25 to 300 ℃. It demonstrates that the Ltiders band appears at all testing temperatures but with varied Luders strains which do not change monoton ically with temperature. The martensitic transformation is simultaneously observed within the Ltiders band in varying degrees depending on the testing temperature. It is well verified that the martensitic transformation is not responsible for the formation of Luders band, and a reasonable explanation is given for the non-monotonic variation of Luders strain with increasing temperature.

Targeted activation of BmCyclinE in Bombyx mori using designer TAL effectors

Dear Editor, Artificial expression systems are crucial to functional genomics studies, constructing synthetic genetic circuits, and bioengineering (Werner & Gossen, 2014). They are usually achieved by cloning the coding sequence (CDS) of a target gene into a vector containing natural or engineered regulatory elements. However, this strategy is limited when target genes are hard to clone, for example when the CDS is too long, or expression level is too low.