Outbreak of Mycoplasma pneumoniae at a military academy

In 2019, an outbreak of Mycoplasma pneumoniae(M. pneumoniae) occurred at a military academy in China. The attack rate(10.08%, 60/595) was significantly different among the units. High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M. pneumoniae. In-time prevention and control measures effectively controlled the spread of the epidemic.

Anesthetic management of a patient with preoperative R-on-T phenomenon undergoing laparoscopic-assisted sigmoid colon resection:A case report

BACKGROUND The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences.It may initiate ventricular tachycardia or ventricular fibrillation,which can result in syncope or sudden cardiac death.This manifestation poses a great challenge for anesthesiologists.However,it is rarely encountered in the perioperative setting.CASE SUMMARY We herein present a case in which the R-on-T phenomenon was incidentally revealed by 24-h Holter monitoring in a patient diagnosed with sigmoid colon cancer.Careful evaluation and treatment with mexiletine were carried out preoperatively under consultation with a cardiovascular specialist,and surgery was uneventfully performed under general anesthesia after thorough preparation.CONCLUSION Physicians should be vigilant about this infrequent but potentially fatal arrhythmia.Our experience suggests that the anesthetic process can be greatly optimized with careful preparation.

Ipsilateral and contralateral patent processus vaginalis in pediatric patients with a unilateral nonpalpable testis

This study aimed to investigate the incidence of patent processus vaginalis(PPV)in pediatric patients with a unilateral nonpalpable testis and explore the associated factors.From May 2014 to April 2017,152 boys who were diagnosed with a unilateral nonpalpable testis and underwent laparoscopy in Shanghai Children’s Hospital(Shanghai,China)were included in this study.The data were collected and reviewed,and the results were analyzed regarding the age at operation,side,development,and position of the nonpalpable testis.The mean age of the patients was 2.6(standard deviation:2.3)years.The testis was absent in 14 cases,nonviable in 81 cases,and viable in 57 cases.The incidence of PPV was 37.5%(57 of 152)on the ipsilateral side and 16.4%(25 of 152)on the contralateral side.The ipsilateral PPV was more prevalent when the nonpalpable testis occurred on the right side(P<0.01).Besides,patients with a viable testis had a greater incidence of ipsilateral PPV than those with a nonviable or absent testis(P<0.01).Moreover,this rate was the highest when the testis was in the abdominal cavity and the lowest when the testis was in the scrotum(both P<0.01).However,the incidence of contralateral PPV was independent of all the factors.In conclusion,in children with a nonpalpable testis,the incidence of an ipsilateral PPV was significantly related to the side,development,and position of the testis,while it was independent of these factors on the contralateral side.

Association between diacylglycerol kinase kappa variants and hypospadias susceptibility in a Han Chinese population

Previous genome-wide association studies have identified variants in the diacylglycerol kinase kappa （DGKtO gene associated with hypospadias in populations of European descent. However, no variants of DGKKwere confirmed to be associated with hypospadias in a recent Han Chinese study population, likely due to the limited number of single-nucleotide polymorphisms （SNPs） included in the analysis. In this study, we aimed to address the inconsistent results and evaluate the association between DGKK and hypospadias in the Han Chinese population through a more comprehensive analysis of DGKK variants. We conducted association analyses for 17 SNPs in or downstream of DGKKwith hypospadias among 322 cases （58 mild, 113 moderate, 128 severe, and 23 unknown） and 1008 controls. Five SNPs （rs2211122, rs4554617, rs7058226, rs7063116, and rs5915254） in DGKK were significantly associated with hypospadias （P 〈 0.05）, with odds ratios （ORs） of 1.64-1.76. When only mild and moderate cases were compared to controls, 10 SNPs in DGKKwere significant （P〈 0.05）, with ORs of 1.56-2.13. No significant SNP was observed when only severe cases were compared to controls. This study successfully implicated DGKK variants in hypospadias risk among a Han Chinese population, especially for mild/moderate cases. Severe forms of hyposDadias are likely due to other genetic factors.

Spongiosum-combined glanuloplasty reduces glans complications after proximal hypospadias repair

We aim to design a new glanuloplasty procedure combined with spongiosum to reduce the incidence of glans dehiscence and coronal fistula after proximal hypospadias repair.Patients who underwent urethroplasty by dorsal preputial island flap for proximal hypospadias between January 2014 and December 2016 were reviewed in this retrospective cohort study.Those who underwent spongiosum-combined glanuloplasty comprised the new-maneuver group,whereas those who underwent conventional glanuloplasty comprised the control group.The incidence of complications was then compared.In the new-maneuver group,dysplastic corpus spongiosum alongside lateral Buck's fascia(0.3-0.4 cm wide)on both sides of the urethral plate was separated from the proximal normal spongy tissue,joining into the glans wings to increase tissue volume and covering the neourethra in the glans penis.In the control group,the neourethra was covered with superficial fascia under the coronal sulcus.As a result,the new-maneuver and control groups comprised 47 and 28 patients,respectively.In the new-maneuver group,no glans dehiscence was detected;however,two(4.3%)patients had coronal fistula,two(4.3%)had urethral stricture,and four(8.5%)had diverticulum.In the control group,two(7.1%)patients had glans dehiscence,eight(28.6%)had coronal fistula,four(14.3%)had urethral stricture,one(3.6%)had diverticulum,and one(3.6%)had penile curvature recurrence.The new-maneuver group had less incidences of coronal fistula(P<0.001),glans dehiscence(P=0.033),and urethral stricture(P=0.008)but had a higher incidence of diverticulum than the control group(P=0.040).It clearly demonstrates that spongiosum-combined glanuloplasty can significantly reduce the incidences of coronal fistula and glans dehisce.

Highly sensitive and stable β-Ga_(2)O_(3) DUV phototransistor with local back-gate structure and its neuromorphic application

Deep ultraviolet(DUV)phototransistors are key integral of optoelectronics bearing a wide spectrum of applications in flame sensor,military detector,oil spill detection,biological sensor,and artificial intelligence fields.In order to further improve the responsivity of UV photodetectors based onβ-Ga_(2)O_(3),in present work,high-performanceβ-Ga_(2)O_(3) phototransistors with local back-gate structure were experimentally demonstrated.The phototransistor shows excellent DUV photoelectrical performance with a high responsivity of 1.01×107 A/W,a high external quantum efficiency of 5.02×109%,a sensitive detectivity of 2.98×1015 Jones,and a fast rise time of 0.2 s under 250 nm illumination.Besides,first-principles calculations reveal the decent stability ofβGa_(2)O_(3) nanosheet against oxidation and humidity without significant performance degradations.Additionally,the hexagonal boron nitride(h-BN)/β-Ga_(2)O_(3) phototransistor can behave as a photonic synapse with ultralow power consumption of~9.6 fJ per spike,which shows its potential for neuromorphic computing tasks such as facial recognition.Thisβ-Ga_(2)O_(3) phototransistor will provide a perspective for the next generation optoelectrical systems.

Polarization-induced photocurrent switching effect in heterojunction photodiodes

The unipolar photocurrent in conventional photodiodes(PDs)based on photovoltaic effect limits the output modes and potential versatility of these devices in photodetection.Bipolar photodiodes with photocurrent switching are emerging as a promising solution for obtaining photoelectric devices with unique and attractive functions,such as optical logic operation.Here,we design an all-solid-state chip-scale ultraviolet(UV)PD based on a hybrid GaN heterojunction with engineered bipolar polarized electric field.By introducing the polarization-induced photocurrent switching effect,the photocurrent direction can be switched in response to the wavelength of incident light at 0 V bias.In particular,the photocurrent direction exhibits negative when the irradiation wavelength is less than 315 nm,but positive when the wavelength is longer than 315 nm.The device shows a responsivity of up to−6.7 mA/W at 300 nm and 5.3 mA/W at 340 nm,respectively.In particular,three special logic gates in response to different dual UV light inputs are demonstrated via a single bipolar PD,which may be beneficial for future multifunctional UV photonic integrated devices and systems.

Shikani Optical Stylet versus Macintosh Laryngoscope for Intubation in Patients Undergoing Surgery for Cervical Spondylosis： A Randomized Controlled Trial

Background： Airway management is critical in patients with cervical spondylosis, a population with a high incidence of difficult airway. Intubation with Shikani Optical Styler （SOS） has become increasingly popular in difficult airway. We compared the effects ofintubation with SOS versus Macintosh laryngoscope （MLS） in patients undergoing surgery for cervical spondylosis. Methods： A total of 270 patients scheduled for elective surgery for cervical spondylosis of spinal cord and nerve root type from August 2012 to January 2016 were enrolled and randomly allocated to the MLS or SOS group by random numbers. Patients were evaluated for difficult airway preoperatively, and Cormack-Lehane laryngoscopy classification was determined during anesthesia induction. Difficult airway was defined as Cormack-Lehane Grades IlI IV. Patients were intubated with the randomly assigned intubation device. The success rate, intubation time, required assistance, immediate complications, and postoperative complaints were recorded. Categorical variables were analyzed by Chi-square test, and continuous variables were analyzed by independent samples t-test or rank sum test. Results： The success rate of intubation among normal airways was 100% in both groups. In patients with difficult airway, the success rates in the MLS and SOS groups were 84.2% and 94.1%, respectively （P = 0.605）. lntubation with SOS took longer compared with MLS （normal airway： 25.1 ± 5.8 s vs. 24.5 ± 5.7 s, P = 0.426; difficult airway： 38.5± 8.5 s vs. 36.1 ±8,2 s, P = 0.389）. Intubation with SOS required less assistance in patients with difficult airway （5.9% vs. 100%, P 〈 0.001 ）. The frequency of postoperative sore throat was lower in SOS group versus MLS group in patients with normal airway （22.0% vs. 34.5%, P =0.034）. Conclusions： SOS is a sale and effective airway management device in patients undergoing surgery for cervical spondylosis. Compared with MLS, SOS appears clinically beneficial for intubation, especially in patients with difficult airway. Trial Registration： Chinese Clinical Trial Registry, ChiCTR-IOR- 16007821 ; http：//www.chictr.org.cn/showproj.aspx？proj-13203.

Genetic mutations associated with chemical resistance in the cytochrome P450 genes of invasive and native Bemisia tabaci （Hemiptera： Aleyrodidae） populations in China

Bemisia tabaci （Gennadius） is a species complex, and its two most damaging biotypes B and Q are globally distributed pests. Despite increasing biological and economic impacts, little is known about the evolutionary mechanisms that favor their competition with native populations. Here, we investigated the genetic mutations in the P450 gene of the invasive B, Q biotypes and the native Cv population. Four mutations associated with chemical resistance, Pro-Leu, Ala-Ser, Ser-Phe and Trp-Leu, were found in the cytochrome P450 CYP6C and CYP9F genes of the B and Q biotypes. Bioassay results also revealed that both the B and Q biotypes have about 12-47 times more resistance to acephate, beta- cypermethrin, methomyl, and 5-7 times more resistance to imidacloprid insecticide than Cv population. Our results provide a molecular approach for better understanding and monitoring the pesticide resistances of invasive and native B. tabaei populations in China.

Reply to ＂Comparing Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation＂

To the Editor： We thank Dr. Wang, et al. for the comments in our article. With regard to the flint comment point, we agreed with them that Connack-Lehane grades 34 with Macintosh laryngoscope should be defined as difficult laryngoscopy. The definition of difficult airway in our paper should be difficult laryngoscopy, not difficult airway.

High responsivity and flexible deep-UV phototransistor based on Ta-doped β-Ga_(2)O_(3)

Deep-ultraviolet(DUV)phototransistors have shown great potential applications in UV imaging,artificial intelligence,and wearable optoelectronics.Among a large number of wide bandgap semiconductors,the quasi-two-dimensionalβ-Ga_(2)O_(3) is considered as an ideal candidate for DUV photodetector applications.Herein,we report a high responsivity(R)and fully flexible Ta-dopedβ-Ga_(2)O_(3) DUV phototransistor which exhibits outstanding optoelectrical properties with a high R of 1.32×10^(6) A/W,a large detectivity of 5.68×10^(14) Jones,a great photo-to-dark current ratio of 1.10×10^(10)%,a high external quantum efficiency of 6.60×10^(8)%,and an ultra-fast response time of~3.50 ms.Besides,the flexible Ta-dopedβ-Ga_(2)O_(3) device also displays high reliability and mechanical flexibility that can sustain well after over 1×10^(4) bending cycles.Moreover,high-contrast imaging of UV light was obtained on the flexible DUV detector arrays,which can be efficiently trained and recognized by an artificial neural network.Our findings offer a perspective to develop wearable optoelectronics and UV imaging based on high-performance flexibleβ-Ga_(2)O_(3) DUV phototransistors,providing an inspiration for the future work in artificial intelligence and bionic robot fields.

Sequential testis sparing surgery of simultaneous bilateral testicular tumors with different cell types in a Chinese infant:an uncommon presentation

Dear Editor, Patients of bilateral pediatric testicular tumors and bilateral testicular teratoma or yolk sac tumor (YST) were rarely reported, and there was still no standard therapy. However, synchronous bilateral testicular tumors with different histology were a quite rare situation. We reported the first case of successful radical orchiectomy in the left scrotum and testicular sparing surgery in the right testis sequentially. No atrophy or residual tumor in the right testis and no recurrence in the left scrotum were found after 7 years of follow-up. Ethical approval was obtained from the Institutional Review Board of Childrens Hospital of Shanghai, which was affiliated to the Shanghai Jiao Tong University, School of Medicine, Shanghai, China. Informed consent was obtained from his parents.