Traditional Chinese medicine combined with conventional treatment for the patients after percutaneous coronary intervention: A systematic review and meta-analysis

Purpose: To evaluate the efficacy, quality of care and safety of Traditional Chinese Medicine (TCM) after Percutaneous Coronary Intervention (PCI). using systematic review and meta-analysis of randomized controlled trials.Methods: Relevant studies published between January 1st 2010 and August 20th, 2021, on traditional Chinese medicine (TCM) and conventional treatment (CT) after PCI were sourced from different databases including CNKI, CBM, Web of Science, PubMed, Embase and Cochrane library. The TCM was composed of preparations of chinese eaglewood, peppermint, radix notoginseng, scabrous elephant foot herb, Tongxinluo, Danhong, Naoxintong capsule, Huxin Formula and liquorice root while the CT included aspirin (100 mg/day), clopidogrel (75 mg/day), and statins. PRISMA guidelines were used. Primary outcome was to evaluate the efficacy, quality of care and safety of TCM versus conventional treatment post percutaneous coronary intervention (PCI).Results: 110 randomized controlled trials (RCTs) were retrieved and analyzed. The results from metaanalysis showed an enhanced left ventricular ejection fraction (LVEF) % among patients that received TCM compared to those on CT [mean difference ± sd (MD)=5.17, 95% CI (3.29-7.06), Z = 5.38, (P < 0.001)]. Further, hypersensitive C-reactive protein (HS-CRP) level in TCM group was found to be relatively lower than that of the CT group (CG) [MD=-1.44, 95% CI (-2.87-0.00), Z=1.96, (P=0.05)]. In terms of safety, TCM group relative risk score in fixed-effect model was lower than that of the CG [RR=0.66, 95% CI (0.40, 1.10), Z=1.66,].Conclusion: It can be inferred from the results that TCM has more advantages in terms of clinical efficacy, quality of care and safety compared to conventional therapy. However, the lack of substantial research in deploying TCM for the treatment of CHD demands further exploration and strong evidence prior to clinical application of TCM

Localization and interaction of interlayer excitons in MoSe2_2/WSe2_2 heterobilayers

Transition metal dichalcogenide (TMD) heterobilayers provide a versatile platform to explore unique excitonic physics via properties of the constituent TMDs and external stimuli. Interlayer excitons (IXs) can form in TMD heterobilayers as delocalized or localized states. However, the localization of IX in different types of potential traps, the emergence of biexcitons in the high-excitation regime, and the impact of potential traps on biexciton formation have remained elusive. In our work, we observe two types of potential traps in a MoSe$_2$/WSe$_2$ heterobilayer, which result in significantly different emission behavior of IXs at different temperatures. We identify the origin of these traps as localized defect states and the moir{\'e} potential of the TMD heterobilayer. Furthermore, with strong excitation intensity, a superlinear emission behavior indicates the emergence of interlayer biexcitons, whose formation peaks at a specific temperature. Our work elucidates the different excitation and temperature regimes required for the formation of both localized and delocalized IX and biexcitons, and, thus, contributes to a better understanding and application of the rich exciton physics in TMD heterostructures.Comment: 18 pages, 15 figures incl supplemental materia

Laser-Like Emission from a Sandwiched MoTe2 Heterostructure on a Silicon Single-Mode Resonator

Molybdenum ditelluride (MoTe2) has recently shown promise as a gain material for silicon photonics. Reliable single-mode operation and material stability remain two of the major issues that need to be addressed to advance this exciting technology, however. Here, laser-like emission from a sandwiched MoTe2 heterostructure on a silicon single-mode resonator is reported. The heterostructure consists of a layer of MoTe2 sandwiched between thin films of hexagonal boron nitride. It is known that tellurium compounds are sensitive to oxygen exposure, which leads to rapid degradation of the exposed layers in air. By encapsulating the MoTe2 gain material, much improved environmental stability is observed. Using a recently introduced single-mode resonator design, better control over the mode spectrum of the cavity is exercised and single-mode operation with a wide free spectral range is demonstrated. At room temperature, a Q-factor of 4500 and a threshold of 4.2 kW cm−2 at 1319 nm wavelength are achieved. These results lend further support to the paradigm of 2D material-based integrated light sources on the silicon platform

Altered dynamic functional network connectivity in drug-naïve Parkinson’s disease patients with excessive daytime sleepiness

BackgroundExcessive daytime sleepiness (EDS) is a frequent nonmotor symptoms of Parkinson’s disease (PD), which seriously affects the quality of life of PD patients and exacerbates other nonmotor symptoms. Previous studies have used static analyses of these resting-state functional magnetic resonance imaging (rs-fMRI) data were measured under the assumption that the intrinsic fluctuations during MRI scans are stationary. However, dynamic functional network connectivity (dFNC) analysis captures time-varying connectivity over short time scales and may reveal complex functional tissues in the brain.PurposeTo identify dynamic functional connectivity characteristics in PD-EDS patients in order to explain the underlying neuropathological mechanisms.MethodsBased on rs-fMRI data from 16 PD patients with EDS and 41 PD patients without EDS, we applied the sliding window approach, k-means clustering and independent component analysis to estimate the inherent dynamic connectivity states associated with EDS in PD patients and investigated the differences between groups. Furthermore, to assess the correlations between the altered temporal properties and the Epworth sleepiness scale (ESS) scores.ResultsWe found four distinct functional connectivity states in PD patients. The patients in the PD-EDS group showed increased fractional time and mean dwell time in state IV, which was characterized by strong connectivity in the sensorimotor (SMN) and visual (VIS) networks, and reduced fractional time in state I, which was characterized by strong positive connectivity intranetwork of the default mode network (DMN) and VIS, while negative connectivity internetwork between the DMN and VIS. Moreover, the ESS scores were positively correlated with fraction time in state IV.ConclusionOur results indicated that the strong connectivity within and between the SMN and VIS was characteristic of EDS in PD patients, which may be a potential marker of pathophysiological features related to EDS in PD patients

Ultrahigh Numerical Aperture Metalens at Visible Wavelengths

Subwavelength imaging requires the use of high numerical aperture (NA) lenses together with immersion liquids in order to achieve the highest possible resolution. Following exciting recent developments in metasurfaces that have achieved efficient focusing and novel beam-shaping, the race is on to demonstrate ultrahigh-NA metalenses. The highest NA that has been demonstrated so far is NA = 1.1, achieved with a TiO2 metalens and back-immersion. Here, we introduce and demonstrate a metalens with a high NA and high transmission in the visible range, based on crystalline silicon (c-Si). The higher refractive index of silicon compared to TiO2 allows us to push the NA further. The design uses the geometric phase approach also known as the Pancharatnam-Berry (P-B) phase, and we determine the arrangement of nanobricks using a hybrid optimization algorithm (HOA). We demonstrate a metalens with NA = 0.98 in air, a bandwidth (full width at half-maximum, fwhm) of 274 nm, and a focusing efficiency of 67% at 532 nm wavelength, which is close to the transmission performance of a TiO2 metalens. Moreover, and uniquely so, our metalens can be front-immersed into immersion oil and achieve an ultrahigh NA of 1.48 experimentally and 1.73 theoretically, thereby demonstrating the highest NA of any metalens in the visible regime reported to the best of our knowledge. The fabricating process is fully compatible with microelectronic technology and therefore scalable. We envision the front-immersion design to be beneficial for achieving ultrahigh-NA metalenses as well as immersion metalens doublets, thereby pushing metasurfaces into practical applications such as high resolution, low-cost confocal microscopy and achromatic lenses

Identification of floR Variants Associated With a Novel Tn4371-Like Integrative and Conjugative Element in Clinical Pseudomonas aeruginosa Isolates

Florfenicol is widely used to control respiratory diseases and intestinal infections in food animals. However, there are increasing reports about florfenicol resistance of various clinical pathogens. floR is a key resistance gene that mediates resistance to florfenicol and could spread among different bacteria. Here, we investigated the prevalence of floR in 430 Pseudomonas aeruginosa isolates from human clinical samples and identified three types of floR genes (designated floR, floR-T1 and floR-T2) in these isolates, with floR-T1 the most prevalent (5.3%, 23/430). FloR-T2 was a novel floR variant identified in this study, and exhibited less identity with other FloR proteins than FloRv. Moreover, floR-T1 and floR-T2 identified in P. aeruginosa strain TL1285 were functionally active and located on multi-drug resistance region of a novel incomplete Tn4371-like integrative and conjugative elements (ICE) in the chromosome. The expression of the two floR variants could be induced by florfenicol or chloramphenicol. These results indicated that the two floR variants played an essential role in the host’s resistance to amphenicol and the spreading of these floR variants might be related with the Tn4371 family ICE

Identification and characterization of a novel β-lactamase gene, blaAMZ–1, from Achromobacter mucicolens

BackgroundAchromobacter is a genus of gram-negative bacteria that can act as opportunistic pathogens. Recent studies have revealed that some species of Achromobacter show inherent resistance to β-lactams, but the resistance mechanisms of Achromobacter mucicolens have rarely been reported.MethodThe bacterium was isolated using standard laboratory procedures. The agar dilution method was used to determine the minimum inhibitory concentrations (MICs). Genome sequencing was performed using the PacBio RS II and Illumina HiSeq 2500 platforms, and the Comprehensive Antibiotic Resistance Database (CARD) was used to annotate the drug resistance genes. The localization of the novel β-lactamase AMZ-1 was determined, and its characteristics were determined via molecular cloning and enzyme kinetic analysis. The phylogenetic relationship and comparative genomic analysis of the resistance gene-related sequences were also analyzed.ResultAchromobacter mucicolens Y3, isolated from a goose on a farm in Wenzhou, showed resistance to multiple antibiotics, including penicillins and cephalosporins. BlaAMZ–1 showed resistance to amoxicillin, penicillin G, ampicillin, cephalothin and cefoxitin, and the resistance activity could be inhibited by β-lactamase inhibitors. Enzyme kinetic analysis results showed that AMZ-1 has hydrolytic activity against a wide range of substrates, including cephalothin, amoxicillin, penicillin G, and cefoxitin but not ampicillin. The hydrolytic activity of AMZ-1 was greatly inhibited by avibactam but much more weakly inhibited by tazobactam. Mobile genetic elements could not be found around the blaAMZ–1-like genes, which are conserved on the chromosomes of bacteria of the genus Achromobacter.ConclusionIn this study, a novel AmpC gene, blaAMZ–1, from the animal-origin bacterium A. mucicolens Y3 was identified and characterized. It conferred resistance to some penicillins and first- and second-generation cephalosporins. The identification of this novel resistance gene will be beneficial for the selection of effective antimicrobials to treat associated infections

BlaPSZ-1, a novel AmpC gene identified from a Pantoea isolate

BackgroundPantoea species of the family Erwiniaceae are well-known plant pathogens and animal and human conditional pathogens. Due to the widespread and continuous use of antimicrobials, multidrug-resistant strains continue to emerge, making clinical treatment difficult; therefore, there is an increasing need to clarify the mechanisms of drug resistance.MethodsA rabbit anal fecal sample was collected by a swab and the streak plate method was used to isolate single colonies. The standard agar dilution method was used to determine the minimum inhibitory concentrations (MICs) against antimicrobials. The complete genome sequence of the bacterium was obtained using Next-Generation Sequencing platforms. The potential resistance gene was annotated based on the Comprehensive Antibiotic Resistance Database (CARD) and verified by molecular cloning. The β-lactamase PSZ-1 was expressed via the pCold I expression vector and its enzyme kinetic parameters were analyzed. The genetic environment and evolutionary process of the novel resistance gene-related sequences were analyzed by bioinformatic methods.ResultsThe isolate Pantoea endophytica X85 showed some degree of resistance to penicillins as well as cephalosporins. A novel AmpC resistance gene, designated blaPSZ-1 in this research, was identified to be encoded in the plasmid (pPEX85) of P. endophytica X85. BlaPSZ-1 showed resistance to penicillins and several first-, second-and third-generation cephalosporins as well as aztreonam, but it did not show resistance to the fourth-generation cephalosporins or carbapenems tested. Enzyme kinetic assays revealed that it could hydrolyze amoxicillin, penicillin G, cephalothin, and cefazolin, and its hydrolytic activity could be strongly inhibited by the inhibitor avibactam, which was generally consistent with antimicrobial susceptibility testing results. No hydrolytic activity was observed for third-generation cephalosporins or aztreonam.ConclusionIn this study, a novel AmpC β-lactamase gene, designated blaPSZ-1, was characterized and it was encoded in the plasmid of the bacterium P. endophytica X85. It shows resistance to penicillins and several cephalosporins. The discovery of novel drug resistance mechanisms can help guide the scientific use of drugs in animal husbandry and clinical practice, effectively avoiding the abuse of antimicrobials and thus preventing the further development and spread of bacterial resistance