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The recent development of tough tissue adhesives has stimulated intense interests among material scientists and medical doctors. However, these adhesives have seldom been tested in clinically demanding surgeries. Here we demonstrate adhesive anastomosis in organ transplantation. Anastomosis is commonly conducted by dense sutures and takes a long time, during which all the vessels are occluded. Prolonged occlusion may damage organs and even cause death. We formulate a tough, biocompatible, bioabsorbable adhesive that can sustain tissue tension and pressurized flow. We expose the endothelial surface of vessels onto a gasket, press two endothelial surfaces to the adhesive using a pair of magnetic rings, and reopen the bloodstream immediately. The time for adhesive anastomosis is shortened compared to the time for sutured anastomosis. We have achieved adhesive anastomosis of a great vein in transplanting the liver of a pig. After the surgery, the adhesive is absorbed, the vein heals, and the pig lives for over one month.

Two-dimensional (2D) transition metal chalcogenides (TMCs) become more attractive upon addition of a third element owing to their unique structure and remarkable physical and chemical properties, which endow these materials with considerable potential for applications in nanoscale devices. In this work, a RexNb(1-x)S2-based saturable absorber (SA) device for ultrafast photonics applications is studied. The device is assembled by placing RexNb(1-x)S2 nanosheets with a thickness of 1-3 nm onto a microfiber to increase their compatibility with an all-fiber laser cavity. The prepared RexNb(1-x)S2-based device exhibits a modulation depth of 24.3%, a saturation intensity of 10.1 MW/cm2, and a nonsaturable loss of 28.5%. Furthermore, the RexNb(1-x)S2-based device is used to generate ultrashort pulses in an erbium-doped fiber (EDF) laser cavity. At a pump power of 260 mW, the EDF laser operates in a conventional soliton mode-locked region. The pulse width is 285 fs, and the repetition frequency is 61.993 MHz. In particular, the bound-state soliton mode-locking operation is successfully obtained in a pump power range of 300-900 mW. The bound-state pulses are formed by doubling identical solitons with a temporal interval of 0.8 ps. The output power is as high as 47.9 mW, and the repetition frequency is 123.61 MHz. These results indicate that the proposed RexNb(1-x)S2-based SAs have comparable properties to currently used 2D SAs and provide a basis for their application in the field of ultrafast photonics.

Magnetic anchor technique (MAT) is an important part of the magnetic surgery that utilizes the characteristics of the “field” interaction of magnets. By operating the anchoring magnets outsides the body, it draws the target magnets in the body and the instruments carried by them to the target position to assist expose the surgical field. At present, MAT has been applied in many fields, such as general surgery, thoracic surgery, gynecology and obstetrics, urinary surgery and endoscopic operation. In the reduction trocar or single incision laparoscopic surgery, it is difficult to establish triangulation. Besides, the main operating instrument, laparoscopic grasping forceps, laparoscopic camera system, etc. need to be accommodated in a narrow surgical entrance, they are easy to collide and interfere with each other, which increases the difficulty of operation and makes it difficult for operators to master. With the chest and abdominal wall coupling, MAT successfully reduces the trocar and pulling instruments, establishes effective triangulation, obtains a good surgical insight, and makes the surgery more minimally invasive and precision. MAT has been successfully used in laparoscopic cholecystectomy, appendectomy, total hysterectomy, hysteromyomectomy, adnexectomy, ovarian cyst resection, nephrectomy and radical prostatectomy, thoracoscopic pulmonary wedge resection and esophagectomy, endoscopic submucosal dissection. Besides, it also works well in radical mastectomy and preparation of donor liver in liver transplantation. In magnet-assisted single trocar (MAST) surgery, magnetic instruments provide sufficient retraction, good triangulation and surgical field exposure, improving the human mechanics of the surgeon during appendectomy and cholecystectomy. With the help of MAT, single incision laparoscopic surgery has been successfully completed appendectomies, cholecystectomies, Nissen fundoplications, gastrojejunostomies, splenectomies, ovarian tumor/cyst resections, retroperitoneal lymphangioma resection, adrenalectomy, total abdominal colectomy and pulmonary wedge resection. The traction generated by the combination of external magnets and internal magnets makes it possible to carry out NOTES surgery in patients with thick abdominal walls, and obtain a powerful traction/reverse traction without abdominal puncturing. With the deep cross and integration of magnetic materials, biomechanics and clinical diagnosis and treatment technique, MAT will expand the application in the future and promote the progress of surgical diagnosis and treatment technique and medical device industry.

Ternary transition metal chalcogenides (TTMCs) are emerging as a promising branch of two-dimensional (2D) materials due to their special layered structure as well as wide-range tunable bandgap properties, which permit the implementation of novel optoelectronic characteristics. The manifestation of nonlinear optical properties of MoxTa(1-x)Se2 nanosheets and their application in ultrafast erbium-doped fiber (EDF) laser is reported in this work. The MoxTa(1-x)Se2 nanosheets were fabricated by employing the liquid phase exfoliation technology. In addition, the saturable absorption property of MoxTa(1-x)Se2-based saturable absorber (SA) is illustrated by obtaining a large optical modulation depth of 32.01 (0.76)%. Furthermore, an operational ultrashort pulse fiber laser was demonstrated. The laser has the ability to emit ultrashort pulses of 377 (0.3) fs at 1532 nm while a maximum output power of 10.52 mW was delivered by the employed within the EDF cavity MoxTa(1-x)Se2-based SA. Our experimental results provide concrete pieces of evidence that the MoxTa(1-x)Se2 nanosheets exhibit third-order optical nonlinearity and the significant potential in nonlinear optoelectronic devices.

Rationale: Bartter syndrome is an autosomal-recessive inherited disease in which patients present with hypokalemia and metabolic alkalosis. We present 1 case with Bartter syndrome, due to a novel compound heterozygous mutation in the KCNJ1 gene encoding the ATP-sensitive inward rectifier potassium channel in the thick ascending limb of the loop of Henle. Patient concerns: A patient was admitted to our hospital because of weakness, polyuria, and polydipsia. At presentation to our hospital, the female Chinese patient was 34 years old and her physical examination was normal. Laboratory studies revealed hypokalemia, metabolic alkalosis, hypercalciuria, hyperparathyroidemia, and hyper-reninemia. In addition, urinary potassium was obviously higher. Computer tomography scan confirmed the patient had the bilateral medullary nephrocalcinosis. Diagnosis: Blood samples were received from the patient and her parents, and deoxyribonucleic acid was extracted. The genetic analysis of SLC12A1, SLC12A3, KCNJ1, CLCNKB, BSND, and CASR was performed. The compound heterozygous KCNJ1 gene mutation was validated using conventional Sanger sequencing methods. Interventions: The patient was treated with potassium supplementation. Her blood and urine chemistries improved over the next week. Serum potassium normalized with improvement in polyuria and polydipsia over the next month. Outcomes: Our patient was compound heterozygous for Thr234Ile and Thr71Met in the KCNJ1 gene. The c.701C>T variant predicted a change from a threonine codon to an isoleucine codon (p.Thr234Ile). The c.212C>T variant predicted a change from a threonine codon to a methionine codon (p.Thr71Met). The unaffected mother was heterozygous for the Thr234Ile mutation, whereas unaffected father was heterozygous for the Thr71Met mutation. Lessons: The phenotypes of the patient were similar to other patients with Bartter syndrome. The phenotypes of the patient could eventually be explained by the presence of the novel compound heterozygous p.Thr234Ile/p.Thr71Met variants in the KCNJ1 gene.

Rationale Fungal endocarditis (FE) is a rare disease, in which antifungal treatment is necessary. When FE is complicated with prosthetic heart valve and/or atrial fibrillation, the coadministration of antifungal agents and warfarin is inevitable. We report a case of rheumatic heart disease with atrial fibrillation who developed FE following prosthetic heart valve replacement. The international normalized ratio (INR) increased significantly during the antifungal treatment with fluconazole. A discussion of the antifungal strategy in FE patients with prosthetic heart valves and/or atrial fibrillation and the interaction between antifungal agents and warfarin was performed. Patient concerns A 54-year-old Chinese woman experienced intermittent fevers, aphemia, and weakness in her right extremities. Her temperature was 38.7°C, and there was atrial fibrillation with heart rate 110 times/min. Neurological examination revealed that she had drowsiness, Broca aphasia, right central facial paralysis, and hemiplegia (Medical Research Council scale, upper limb grade 0, lower limb grade II). Diagnoses Multiple infarction on magnetic resonance imaging and the occlusion of left middle cerebral artery suggested the occurrence of cerebral embolism. The presence of Candida parapsilosis in the results of 4 blood cultures and the existence of valve vegetation in the reexamination of echocardiogram supported the diagnosis of FE. Interventions The patient was given antifungal therapy with fluconazol. The INR increased dramatically on the 9th day of antifungal treatment, and subcutaneous bruising occurred at the intravenous infusion site. The antagonist of vitamin K1 was used and warfarin was reduced to a smaller dosage. The antifungal agent was replaced with caspofungin. Outcomes Her speech improved significantly, and the muscle strength of her paralyzed side reached the Medical Research Council scale of grade IV. She continued to receive caspofungin for antifungal treatment with relatively stable INR and waited for heart valve surgery. Lessons The choice of antifungal agents is often a big challenge for FE patients, especially when they need warfarin for anticoagulation. It is better to administer a low dose of warfarin while carefully monitoring the INR or choose the antifungal drugs with little or no effect on warfarin.

As a typical zero-dimensional (0D) material, Fe3O4 nanoparticles have been extensively used in various fields because of their unique properties. In this work, Fe3O4 nanoparticles are prepared by the chemical co-precipitation technology, which show nonlinear optical response. By employing Fe3O4 nanoparticles as a slow saturable absorber (SSA) and nonlinear polarization evolution (NPE) as a fast saturable absrober (FSA), a self-started hybrid mode-locked Er-doped fiber (EDF) laser can be easily acquired, which generates the stable pulse train with pulse duration of 361 fs. Pulse duration decreased 35 fs when compared to use NPE SA. This research work suggests that Fe3O4 nanoparticles could be developed as potential SAs for ultrafast nano-photonics applications.

The investigation of two-dimensional (2D) nonlinear optical materials offers a promising way to construct the high-performance optical devices in fundamental and industrial applications because of their rich distinct optoelectronic properties. Herein, by utilizing the liquid exfoliation method, vanadium disulfide (VS2) nanosheets are prepared and the thickness is measured to be 3.16 nm. In addition, we have fabricated the VS2-based optical device and the nonlinear optical property is characterized with modulation depth of 23.97%. By using VS2 as saturable absorber, a high stable passively mode-locking Er-doped fiber laser is obtained with pulse duration of 169 fs and the largest average output power of 70.5 mW. The slope efficiency is up to 7.9%. In comparison to recent results of mode-locking fiber lasers with 2D materials, the VS2-based fiber laser demonstrates better performance. To the best of our knowledge, this is the first example of using VS2 for generating femtosecond mode-locked laser pulse. Our experimental results not only reveal VS2 ultrafast photonics application, but also advance the high-performance applications for information science and nonlinear optics.

Two-dimensional (2D) transition metal dichalcogenides (TMDs) have been extensively researched as nonlinear optical absorption materials for pulse fiber lasers applications. Herein, the liquid phase exfoliation method is employed to obtain HfSe2 nanosheets, and HfSe2/polyvinyl alcohol (PVA) film is prepared, whose modulation depth (ΔT) is measured to be 12.37 %. When inserting HfSe2-based saturable absorber (SA) into the compact fiber cavity, stable Q-switching pulse train is established at 1558.8 nm. Setting pump power at 559 mW, the narrowest pulse width/largest single pulse energy is determined to be 1.883 μs/292.67 nJ. In comparison to the reported results recently, our laser performance is superior to other works. Our experimental results prove that HfSe2 can be developed as a valid saturable absorption material for pulse laser generation.

Rationale "Nine" syndrome, that is "eight-and-a-half" syndrome associated with hemiplegia and hemidysesthesia, is a rare disorder. This study aimed to report a Chinese patient with acute bilateral pontine infarction manifesting as eight-and-a-half syndrome plus hemiplegia (atypical nine syndrome), and also the clinical and neuroimaging findings were explained and discussed with review of the literature. Patient concerns A 79-year-old woman experienced sudden vertigo, nausea, vomiting, and weakness at her left arm and leg. The neurological examination disclosed her right horizontal gaze palsy, internuclear ophtalmoplegia (INO), and right-sided peripheral facial paralysis combined with slight left-sided hemiplegia, which were consistent with atypical nine syndrome. Diagnoses Cranial magnetic resonance imaging (MRI) displayed acute multiple ischemic infarction, involving bilateral pontine tegmentum, basilar part of right paramedian pontine, and left cerebellar hemisphere. Intracranial MR angiography (MRA) revealed right middle cerebral artery occlusion, no clear visualization of bilateral vertebral arteries, and basilar artery hypoplasia with stenotic segments. Interventions Thrombolysis could not be performed due to the time window. The patient was given low molecular weight heparin for anticoagulation because of posterior circulation and progressive stroke. Outcomes The vertigo disappeared, and a notable improvement with minimal restriction in the right horizontal gaze and partial relief of her facial paralysis were found at discharge, while her left hemiparesis was fully resolved. No recurrence of cerebral infarction was observed during follow-up as well. Lessons This case report with atypical nine syndrome is fairly rare. Nine syndrome may refer to the lesion located in unilateral tegmentum of the caudal pontine plus paramedian pontine, with an important localization value.

Although terbium gallium garnet (TGG) single crystals suitable for practical applications have been grown by the Czochralski technique due to its congruent melting nature, the interface shape readily deteriorates to spiral growth when grown with a flat interface or facet formation when grown with a convex interface. The Edge-defined Film-fed Growth (EFG) method was used to grow TGG crystals for the first time. The influence of the raw material sintering temperature, growth atmosphere, growth rate and other growth conditions on the crystal quality were investigated. The Verdet constant of as-grown crystal was measured as 39 rad/T.m at 1064 nm by the extinction method, which was close to the literature value. The source of color centers in the crystals is also discussed.

Sinacroneuria dabieshana sp. nov. is proposed from Henan and Hubei provinces, China and the new species is compared with related congeners. The discovery of this species represents the northernmost distribution of the genus in China. A provisional key to the males of known species of Sinacroneuria is also presented.

We present a two-dimensional carpet cloak for static magnetic field, a design that renders the magnetic response of a given volume invisible from its exterior, without altering the external magnetic fields. The device is designed using transformation optics method and can be implemented with alternating superconducting and magnetic material layers. Through the proper design of the constitutive tensors and relative thicknesses of each slab, we achieve the perfect performance of invisibility. Full wave numerical simulations confirm our design.