笑气联合咪达唑仑在智障儿童口腔治疗中的应用研究

目的在笑气镇静联合咪达唑仑口服镇静条件下对智障患儿实施口腔治疗,评估镇静的有效性及安全性。方法纳入91例在口腔诊疗中不配合的智障患儿,随机分为笑气镇静组、咪达唑仑口服镇静组、联合组。笑气镇静组:给予35%~50%浓度的笑气镇静;咪达唑仑口服镇静组:给予0.50~0.75 mg/kg咪达唑仑口服镇静;联合组:笑气镇静联合咪达唑仑口服镇静。记录治疗中患儿的心率、呼吸、血氧饱和度,以及治疗内容和持续时间,患儿的治疗完成状况采用Houpt量表评估,跟踪记录患儿24 h内的反应。结果联合组的成功率(83.9%)高于笑气镇静组(53.3%)和咪达唑仑口服镇静组(56.7%)(P<0.05)。笑气镇静组不良反应发生率为6.7%,联合组的不良反应发生率为6.5%,均低于咪达唑仑口服镇静组(33.3%)。结论智障儿童行口腔治疗时,笑气镇静联合咪达唑仑口服镇静是一种安全有效的镇静方法,其成功率高于单独使用笑气镇静或咪达唑仑口服镇静,其不良反应发生率低于单独口服咪达唑仑镇静。

PET/CT联合CT三维重建在鉴别早期肺腺癌不同病理亚型中的价值

背景与目的早期肺腺癌中病理亚型以贴壁为主型的浸润性腺癌(lepidic predominant invasive adenocarcinoma,LPA)与原位腺癌(adenocarcinomainsitu,AIS)、微浸润性腺癌(microinvasiveadenocarcinoma,MIA)的良好预后相似,临床上也迫切需要能够区分LPA与非LPA型浸润性腺癌(non-lepidicpredominantinvasive adenocarcinoma,non-LPA)的手段,本研究拟通过正电子发射型计算机断层显像(positronemissioncomputed tomography, PET)/计算机断层扫描(computed tomography, CT)的最大标准化摄取值(maximal standard uptake value,SUVmax)和CT三维重建后参数探讨术前影像学表现为部分实性结节(part-solidnodules,PSNs)的早期肺腺癌不同病理亚型间的关系。方法回顾性分析2016年1月-2019年1月于江苏省苏北人民医院胸外科行解剖性肺切除术且影像学表现为PSNs的早期肺腺癌患者资料,所有患者胸部增强CT和PET/CT资料完整可获取,利用Mimics软件行三维重建,获取肿瘤体积、肿瘤三维平均CT值(3-dimensional mean-CT value, 3Dm-CT)、SUVmax等数据,采用SPSS 25.0进行统计分析,Graph Pad Prism 8.3.0绘制受试者工作曲线(receiver operating curve, ROC),P<0.05为差异有统计学意义。结果最终共计67例患者纳入本研究,按病理亚型不同将所有患者分为两组,AIS、MIA及浸润性腺癌(invasive adenocarcinoma, IAC)中的LPA归为低危组28例(41.8%),其余non-LPA如腺泡型(acinar pattern-predominantadeno-carcinoma,APA)、乳头型(papillarypattern-predominantadenocarcinoma,PPA)、微乳头型(micropapillary pattern-predominant adeno-carcinoma, MPA)归为高危组39例(58.2%),两组间SUVmax(t=3.153,P=0.002)、肿瘤体积(t=3.331, P=0.001)、实性/磨玻璃成分体积(t=2.74, P=0.006)/(t=3.127, P=0.002)、实性/磨玻璃成分3Dm-CT(t=3.655, P<0.001)/(t=7.082, P<0.001)均具有显著统计学意义。ROC曲线提示:SUVmax[曲线下面积(area under curve, AUC)=0.727]、肿瘤体积(AUC=0.740)、磨玻璃成分体积(AUC=0.725)、实性成分3Dm-CT(AUC=0.763)、磨玻璃成分3Dm-CT(AUC=0.756)预测效能最佳。将上述AUC>0.7的协变量纳入多因素ROC曲线分析,获得联合预测因子(AUC=0.835)具有中等以上预测价值。结论 PET/CT中SUVmax和CT三维重建参数与影像学表现为PSNs的早期肺腺癌的不同病理亚型具有显著相关性,联合SUVmax、肿瘤体积、磨玻璃成分体积和实性/磨玻璃成分3Dm-CT对鉴别表现为PSNs的早期肺腺癌的病理亚型具有一定价值。

Acute kidney injury in acute-on-chronic liver failure is different from in decompensated cirrhosis

AIM To evaluate the differences in acute kidney injury(AKI) between acute-on-chronic liver failure(ACLF) and decompensated cirrhosis(DC) patients. METHODS During the period from December 2015 to July 2017, 280 patients with hepatitis B virus(HBV)-related ACLF(HBV-ACLF) and 132 patients with HBV-related DC(HBV-DC) who were admitted to our center were recruited consecutively into an observational study. Urine specimens were collected from all subjects and the levels of five urinary tubular injury biomarkers were detected,including neutrophil gelatinase-associated lipocalin(NGAL), interleukin-18(IL-18), liver-type fatty acid binding protein(L-FABP), cystatin C(CysC), and kidney injury molecule-1(KIM-1). Simultaneously, the patient demographics, occurrence and progression of AKI, and response to terlipressin therapy were recorded. All patients were followed up for 3 mo or until death after enrollment. RESULTS AKI occurred in 71 and 28 of HBV-ACLF and HBV-DC patients, respectively(25.4% vs 21.2%, P = 0.358). Among all patients, the levels of four urinary biomarkers(NGAL, CysC, L-FABP, IL-18) were significantly elevated in patients with HBV-ACLF and AKI(ACLF-AKI), compared with that in patients with HBV-DC and AKI(DC-AKI) or those without AKI. There was a higher proportion of patients with AKI progression in ACLF-AKI patients than in DC-AKI patients(49.3% vs 17.9%, P = 0.013). Fortythree patients with ACLF-AKI and 19 patients with DC-AKI were treated with terlipressin. The response rate of ACLFAKI patients was significantly lower than that of patients with DC-AKI(32.6% vs 57.9%, P = 0.018). Furthermore, patients with ACLF-AKI had the lowest 90 d survival rates among all groups(P < 0.001).CONCLUSION AKI in ACLF patients is more likely associated with structural kidney injury, and is more progressive, with a poorer response to terlipressin treatment and a worse prognosis than that in DC patients.

Simulating tactile and visual multisensory behaviour in humans based on an MoS_(2) field effect transistor

A visual and tactile multisensory integrated system is essential for human walking due to the demand for real-time interactions between perception and action.Here,a piezoresistor and MoS_(2)field effect transistor are combined to construct an artificial integration nervous system to simulate perception and synaptic plasticity.The key characteristics of synaptic plasticity are successfully demonstrated by individual pressure signals,individual optical signals,the synergy of optical and pressure signals,which are based on the electron trapping–detrapping mechanism at the MoS_(2)/SiO_(2)interface.We demonstrate that perception under synergy is stronger than perception under optical or pressure signal alone,which is similar to a biological system.Moreover,various distinguishable motion scenarios(combination of the following conditions:external lighting environment of day or night,flat or rough road,movement state of walking or running)are simulated and verified by adjusting the amplitude and frequency of the optical and pressure signals.

Simulating the obstacle avoidance behavior day and night based on the visible-infrared MoS_(2)/Ge heterojunction field-effect phototransistor

The contradiction between the high number of visually handicapped people and the scarcity of guide dogs has stimulated the demand for electronic guide dogs(EGDs).Here,we demonstrate an EGD by leveraging piezoresistors on a MoS_(2)/Ge heterostructure for simultaneous pressure-sensing and optical-sensing functions.The device has excellent gating capability and exhibits large positive and negative photoresponses under visible(532 nm,182 A/W)and infrared(1550 nm,37 A/W)illumination.These characteristics allow the device to efficiently classify different obstacles at all times of day using pressure and light signals.The device reaches nearly 100%accuracy after 48 training sessions when used to classify frequent scenes.The device adopts passive and active detection modes during the day and night,respectively,which improves the battery life of the EGD.This work provides a significant reference for the future design of EGDs,which may help a greater number of visually impaired people by reducing the cost of such devices.

Alterations in intestinal microbiota of colorectal cancer patients receiving radical surgery combined with adjuvant CapeOx therapy

An intricate relationship exists and interactions occur between gut microbiota and colorectal cancer(CRC).Radical surgery combined with adjuvant chemotherapy(AC) serves as the mainstream therapeutic scheme for most CRC patients.The current research was conducted to assess the effect of surgery or chemotherapy on gut microbiota.Forty-three CRC patients who received radical surgery and AC were enrolled.Fecal samples were collected preoperatively,postoperatively,and after the first to fifth cycles of postoperative chemotherapy.The microbial community of each sample was analyzed using high throughput 16S rRNA amplicon sequencing.Compared with preoperative samples,fecal samples collected postoperatively exhibited a significant decrease of obligate anaerobes,tumor-related bacteria,and butyric acid-producing bacteria.However,a significant increase of some conditional pathogens was observed.In addition,the AC regimen(CapeOx) was found to alter intestinal microbiota dramatically.In particular,several changes were observed after chemotherapy including an increase of pathogenic bacteria,the "rebound effect" of chemotherapy-adapted bacteria,the shift of lactate-utilizing microbiota from Veillonella to Butyricimonas and Butyricicoccus,as well as the decrease of probiotics.Both radical surgery and CapeOx chemotherapy exert a non-negligible effect on the gut microbiota of CRC patients.Microbiota-based intervention may be beneficial for patients during postoperative clinical management.

Ultrasensitive polarization-dependent terahertz modulation in hybrid perovskites plasmoninduced transparency devices

Active control of metamaterial properties with high tunability of both resonant intensity and frequency is essential for advanced terahertz(THz) applications, ranging from spectroscopy and sensing to communications.Among varied metamaterials, plasmon-induced transparency(PIT) has enabled active control with giant sensitivity by embedding semiconducting materials. However, there is still a stringent challenge to achieve dynamic responses in both intensity and frequency modulation. Here, an anisotropic THz active metamaterial device with an ultrasensitive modulation feature is proposed and experimentally studied. A radiative-radiative-coupled PIT system is established, with a frequency shift of 0.26 THz in its sharp transparent windows by polarization rotation. Enabled by high charge-carrier mobility and longer diffusion lengths, we utilize a straightforwardly spincoated MAPbI3 film acting as a photoactive medium to endow the device with high sensitivity and ultrafast speed.When the device is pumped by an ultralow laser fluence, the PIT transmission windows at 0.86 and 1.12 THz demonstrate a significant reduction for two polarizations, respectively, with a full recovery time of 561 ps. In addition, we numerically prove the validity that the investigated resonator structure is sensitive to the optically induced conductivity. The hybrid system not only achieves resonant intensity and frequency modulations simultaneously, but also preserves the all-optical-induced switching merits with high sensitivity and speed, which enriches multifunctional subwavelength metamaterial devices at THz frequencies.

Ultrafast fiber lasers mode-locked by two-dimensional materials:review and prospect

The year 2019 marks the 10th anniversary of the first report of ultrafast fiber laser mode-locked by graphene.This result has had an important impact on ultrafast laser optics and continues to offer new horizons.Herein,we mainly review the linear and nonlinear photonic properties of two-dimensional(2D)materials,as well as their nonlinear applications in efficient passive mode-locking devices and ultrafast fiber lasers.Initial works and significant progress in this field,as well as new insights and challenges of 2D materials for ultrafast fiber lasers,are reviewed and analyzed.

各向异性硫化锗薄片从饱和吸收到反饱和吸收的偏振可调非线性吸收模式及其在全光开关中的应用

近年来,一些二维层状材料,尤其是具有褶皱蜂窝结构的IV-VI族单硫化物,由于其特殊的各向异性化学和物理性质,而备受关注.在IV-VI族层状化合物MX(M=Ge,Sn;X=Se,S)中,硫化锗(GeS)以其最强的各向异性热导率和热电品质因子而引人注目.此外,GeS薄片与层数无关的直接能带(Eg^1.6 eV,E1~2.1 eV)为可见光光探测器的应用提供了良好的应用前景.本文研究了GeS薄片的偏振可调非线性吸收模式,利用偏振相关拉曼光谱和线性吸收光谱表征了厚度为251 nm GeS的晶格取向和吸收能带.考虑到GeS薄片的较低的热损伤阈值,在不改变GeS非线性特性的前提下,制备了硫化锗/石墨烯异质结.非线性吸收结果表明,在硫化锗/石墨烯异质结中,利用偏振可调的600 nm线偏振飞秒激光沿扶手椅方向激发产生饱和吸收(SA)效应,沿锯齿方向激发反饱和吸收(RSA)效应.实验验证了基于偏振的硫化锗/石墨烯异质结全光开关的功能.值得注意的是,正因为GeS的偏振相关非线性吸收模式(SA/RSA),全光开关的"开"、"关"状态可通过控制飞秒开关激光(600 nm,35 fs500 Hz,12 GW cm-2)的偏振,进而改变连续光(CW)激光(532 nm,80 nW)透射率的方式来实现.通过改变开关光的偏振,开关比可以达到17%,与之相比,通过提高开关光入射功率获得的开关比仅为3.0%.本文介绍的偏振可调吸收模式,为基于硫化锗/石墨烯异质结的下一代光电子器件开辟了新的前景.

Ultrafast polarization-dependent all-optical switching of germanium-based metaphotonic devices

Metamaterials play an important role in the modulation of amplitude and group delay in the terahertz(THz)regime on account of their optical properties,which are rare in natural materials.Here an ultrafast anisotropic switch of the plasmon-induced transparency(PIT)effect is experimentally and numerically demonstrated by metamaterial devices composed of two pairs of planar split-ring resonators and a pair of closed-ring resonators.By integration with a germanium(Ge)film,a recovery time of 3 ps and a decay constant of 785 fs are realized in the metadevice.Stimulated by the exterior optical pump,the PIT windows at different frequencies are switched off with an excellent property of slow light for vertical and horizontal THz polarizations,realizing an astonishing modulation depth as high as 99.06%.This work provides a new platform for ultrafast anisotropic metadevices tunable for amplitude and group delay.

Ultrafast Nonlinear Optical Excitation Behaviors of Mono-and Few-Layer Two Dimensional MoS2

The layered MoS2 has recently attracted significant attention for its excellent nonlinear optical properties.Here,the ultrafast nonlinear optical (NLO)absorption and excited carrier dynamics of layered MoS2(monolayer,3-4 layers,and 6-8 layers)are investigated via Z-scan and transient absorption spectra.Our experimental results reveal that NLO absorption coefficients of these MoS2 increase from-27×10^3cm/GW to -11×10^3cm/GW with more layers at 400-nm laser excitation,while the values decrease from 2.0×10^3cm/GW to 0.8×10^3cm/GW at 800nm.In addition, at high pump fluence,when the NLO response occurs,the results show that not only the reformation of the excitonic bands,but also the recovery time of NLO response decreases from 150ps to lOOps with an increasing number of layers,while the reductive energy of A excitonic band decreases from 191.TmeV to 51.1meV.The intriguing NLO response of MoS2 provides excellent potentials for the next-generation optoelectronic and photonic devices.

Electron–phonon coupling in topological insulator Bi_2Se_3 thin films with different substrates

Broadband transient reflectivity traces were measured for Bi_2 Se_3 thin films with various substrates via a 400 nm pump–white-light-probe setup. We have verified the existence of a second Dirac surface state in Bi_2 Se_3 and qualitatively located it by properly analyzing the traces acquired at different probe wavelengths. Referring to the band structure of Bi_2 Se_3, the relaxation mechanisms for photo-excited electrons with different energies are also revealed and studied. Our results show a second rise of the transient reflection signal at the time scale of several picoseconds. The types of substrate can also significantly affect the dynamics of the rising signal. This phenomenon is attributed to the effect of lattice heating and coherent phonon processes. The mechanism study in this work will benefit the fabrication of high-performance photonic devices based on topological insulators.

Active formatting modulation of electromagnetically induced transparency in metamaterials

We experimentally demonstrate for the first time an active all-optical ultrafast modulation of electromagnetically induced transparency-like effect in a hybrid device of sapphire/Si/metamaterial. From numerical simulations, it can be deducted that the tuning process is attributed to the coupling between the dark mode existing in split-ring resonators and the bright mode existing in cut wire resonators. The transmission amplitude modulation is accompanied by the slow-light effect. In addition, the ultrafast formation process is measured to be as fast as 2 ps. This work should make an important contribution to novel chip-scale photonic devices and terahertz communications.

Gelation capability of cysteine-modified cyclo(L-Lys-L-Lys)s dominated by Fmoc and Trt protecting groups

A series of symmetrical peptidomimetics(3–8) based on cysteine-modified cyclo(L-Lys-L-Lys)s were synthesized, and their gelation capability in organic solvents was dominated by fluorenylmethyloxycarbonyl(Fmoc) and triphenylmethyl(Trt) protecting groups and the exchange of thiol-to-disulfide as well. The peptidomimetics holding Trt(3 and 4) showed no gel performance, while the Fmoc groups promoted 5 and 6 to give rise to thermo-reversible organogels in a number of organic solvents. The self-assembled fibrillar networks were distinctly evidenced in the organogels by transmission electron microscopy(TEM) and scanning electron microscopy(SEM) observations. Fourier transform infrared spectroscopy(FT-IR) and fluorescence analyses revealed that the hydrogen bonding and ?-? stacking play as major driving forces for the self-assembly of these organogelators. A ?-turn secondary structure was deduced for the organogel of 6 by virtue of X-ray diffraction, FT-IR and circular dichroism(CD) measurements, and an interdigitated bilayer structure was also presented.

Optically Controlled Extraordinary Terahertz Transmission of Bi2Se3 Film Modulator

Standing on the potential for high-speed modulation and switching in the terahertz (THz) regime, all-optical approaches whose response speeds mainly depend on the lifetime of nonequilibrium free carriers have attracted a tremendous attention. Here, we establish a novel bi-direction THz modulation experiment controlled by femtosecond laser for new functional devices. Specifically, time-resolved transmission measurements are conducted on a series of thin layers Bi2Se3 films fabricated straightforwardly on AI2O3 substrates, with the pump fluence range from 25(iJ/cm2 to 200 |iJ/cm2 per pulse. After photoexcitation, an ultrafast switching of THz wave with a full recovery time of ?1 Ops is observed. For a longer timescale, a photoinduced increase in the transmitted THz amplitude is found in the 8 and 10 quintuple layers (QL) BizSR, which shows a thickness-dependent topological phase transition. Additionally, the broadband modulation effect of the 8 QL Bi2Se3 film is presented at the time delays of 2.2ps and 12.5ps which have a maximum modulation depth of 6.4% and 1.3% under the pump fluence of 200(iJ/cm2, respectively. Furthermore, the absorption of a optical phonon at 1.9 THz shows a time-dependent evolution which is consistent with the cooling of lattice temperature.

Temperature insensitive multi-channel light amplification systems on SOI platform

We present a theoretical analysis of a novel multi-channel light amplification photonic system on chip,where the nonlinear Raman amplification phenomenon in the silicon(Si)wire waveguide is considered.Particularly,a compact and temperature insensitive Mach–Zehnder interferometer filter working as demultiplexer is also exploited,allowing for the whole Si photonic system to be free from thermal interference.The propagation of the multi-channel pump and Stokes lights is described by a rigorous theoretical model that incorporates all relevant linear and nonlinear optical effects,including the intrinsic waveguide optical losses,first-and second-order frequency dispersion,self-phase and cross-phase modulation,phase shift and two-photon absorption,free-carriers dynamics,as well as the inter-pulse Raman interaction.Notably,to prevent excessive drift of the transmission window of the demultiplexer caused by ambient temperature variations and high thermo-optical coefficient of Si,an asymmetric waveguide width is adopted in the upper and lower arms of each Mach–Zehnder interferometer lattice cell.A Chebyshev half-band filter is utilized to achieve a flat pass-band transmission,achieving a temperature sensitivity of<1.4 pm=K and over 100 K temperature span.This all-Si amplifier shows a thermally robust behavior,which is desired by future Si-on-insulator(SOI)applications.