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Background Limited activation and infiltration of CD8+ T cells are major challenges facing T cell-based immunotherapy for most solid tumors, of which the mechanism is multilayered and not yet fully understood.Methods Levels of CD93 expression on monocytes from paired non-tumor, peritumor and tumor tissues of human hepatocellular carcinoma (HCC) were evaluated. The underlying mechanisms mediating effects of CD93+ monocytes on the inhibition and tumor exclusion of CD8+ T cells were studied through both in vitro and in vivo experiments.Results In this study, we found that monocytes in the peritumoral tissues of HCC significantly increased levels of CD93 expression, and these CD93+ monocytes collocated with CD8+ T cells, whose density was much higher in peritumor than intratumor areas. In vitro experiments showed that glycolytic switch mediated tumor-induced CD93 upregulation in monocytes via the Erk signaling pathway. CD93 on the one hand could enhance PD-L1 expression through the AKT-GSK3β axis, while on the other hand inducing monocytes to produce versican, a type of matrix component which interacted with hyaluronan and collagens to inhibit CD8+ T cell migration. Consistently, levels of CD93+ monocytes positively correlated with the density of peritumoral CD8+ T cells while negatively correlated with that of intratumoral CD8+ T cells. Targeting CD93 on monocytes not only increased the infiltration and activation of CD8+ T cells but also enhanced tumor sensitivity to anti-PD-1 treatment in mice in vivo.Conclusion This study identified an important mechanism contributing to the activation and limited infiltration of CD8+ T cells in solid tumors, and CD93+ monocytes might represent a plausible immunotherapeutic target for the treatment of HCC.

Objective: To estimate risk of being unvaccinated against COVID-19 by experience of intimate partner violence (IPV). Methods: Among 3,343 partnered individuals in a community-based U.S. cohort, we quantified emotional and physical IPV experienced between March and December 2020 and estimated risk of being unvaccinated against COVID-19 through June 2021 by experience of IPV. Experience of recent IPV was defined as endorsement of more frequent or severe IPV since the start of the pandemic or report of any past-month IPV in at least one of four follow-up surveys conducted by the end of December 2020. We created a three-level composite variable – no experience of IPV, experience of emotional but not physical IPV, and experience of physical IPV. Results: Cisgender women, non-binary, or transgender individuals who reported experiencing emotional, but not physical, IPV and those who reported experiencing physical IPV were both at significantly higher risk of being unvaccinated for COVID-19 compared to those who reported experiencing no IPV (ARRemotional violence: 1.28 [95 % CI: 1.09 – 1.51]; ARRphysical violence: 1.70 [95 % CI: 1.41 – 2.05]). Cisgender men who reported experiencing physical IPV were also at significantly higher risk of being unvaccinated for COVID-19 (ARRphysical violence: 1.52 [95 % CI: 1.15 – 2.02]). Conclusions: IPV may increase the risk of low vaccine uptake. Results highlight the need to incorporate IPV prevention and support into public health responses, with targeted resources and consideration for reducing barriers to public health interventions among those impacted.

亚油酸属ω-6型多不饱和脂肪酸，具有独特的生理功能，与人体健康密切相关。由于亚油酸大多来源于天然动植物油脂，其含量尚不能满足食品和制药业的需求，有效分离纯化亚油酸已成为近年来的研究热点。为给亚油酸的分离纯化研究提供参考，综述了近年来国内外亚油酸分离纯化技术的研究进展，系统介绍了尿素包合法、硝酸银硅胶柱色谱法、分子蒸馏法、脂肪酶酶解法、溶剂冷冻结晶法、高速逆流色谱法及耦合法的分离原理及研究成果，并分析了各分离纯化方法的优缺点。两种或多种分离纯化技术耦合可优势互补，提高分离效率，淀粉、三聚氰胺包合法和pH区带精制逆流色谱法则值得进一步深入研究。 Linoleic acid，which belongs to an omega-6 type polyunsaturated fatty acid, possesses unique physiological functions and is closely associated with human health. Linoleic acid mostly originates from natural animal fats and vegetable oils, and its content cannot meet the needs of the food and pharmaceutical industries. Therefore, developing effective technologies for the separation and purification of linoleic acid has become a research hotspot in recent years. In order to provide a reference for the separation and purification of linoleic acid, the separation and purification technologies of linoleic acid at home and abroad in recent years were reviewed, the separation principle and research results of the methods of urea adduction fractionation, silver nitrate impregnated-silica gel column chromatography, molecular distillation, lipase hydrolysis, solvent freezing crystallization, high-speed countercurrent chromatography and integration were systematically introduced, and both the pros and cons of each separation and purification method were analyzed. The integration of two or more separation and purification technologies can complement mutual advantage and improve separation efficiency. Moreover, starch, melamine complexation method and pH zone refined countercurrent chromatography are worthy of further research.

Objective To verify the accuracy and cost of the value of serum sodium fluctuation in predicting adverse clinical outcomes, and to propose a warning value of serum sodium fluctuations for early warning of in-hospital death and summarize the methodology for setting warning values. Methods This investigation covered all patients admitted to Peking Union Medical College Hospital from January 1, 2014 to December 31, 2014. Patients with normal serum sodium at the time of admission and older than 18 years old were included. Patients without serum sodium retested during the hospitalization were excluded. Clinical characteristics including gender, age, primary diagnosis, and causes of death were documented and laboratory examinations were collected including all serum sodium values during hospitalization. The highest and lowest values among all measurements of serum sodium during hospitalization were identified. The difference between the highest and lowest serum sodium value was defined as the fluctuation value of serum sodium level.The area under the curve (AUC) of sodium fluctuations predicting in-hospital death was calculated. The specificities and sensitivities were calculated with the cut-off points of 10, 12, 14, 16, 18, 20, 22, and 24 mmol/L. A warning related to death in the hospital was defined as a true warning, and a warning unrelated to death in the hospital was defined as a false warning. The number of false warnings was defined as the cost of warning.The ratio of the true warnings to the total warnings was defined as the efficiency of warning. An appropriate cut-off point was selected for combined accuracy, cost, and efficiency of warning. Results In total, 33 323 hospitalization records met the inclusion criteria, of which 191 patients (0.57%) died. 148 records of death were analyzed. Among these patients, 53 died from tumor (35.6%), 52 died from infection (34.9%), 46 died from respiratory failure (30.9%), and 26 died from heart failure (17.4%), 6 died from sudden death (4.0%), 5 died from cerebral hemorrhage (3.4%), 6 died from bleeding from other parts (4.0%), and 1 died from cerebral herniation (0.7%).There were 75 patients (50.7%) experienced serum sodium fluctuations within 10 days before death. The average serum sodium fluctuation was (13.36±8.62)mmol/L, and the highest was 35 mmol/L. Serum sodium fluctuation predicted in-hospital death with an AUC of 85.2% (95% CI:81.8%-88.5%). Predicting in-hospital death with a serum sodium fluctuation greater than 20 mmol/L had a specificity of 99.0% and a sensitivity of 28.8%. If serum sodium fluctuation greater than 20 mmol/L was set as a warning value, 28.8% of hospital deaths would be identified, the number of warnings would be 397, the number of true warnings would be 55, the cost of warning would be 342, and the efficiency of warning would be 13.9%. Conclusions Serum sodium fluctuation greater than 20 mmol/L could be used as a biomarker value for early warning of in-hospital death with high accuracy and low management cost. Serum sodium fluctuations greater than 20 mmol/L is a warning value point and can be potentially used as a predicting warning to suppot the identification of critically ill patients and thus to improve the management of inpatients at high risk of death.

Compared with leaner breeds, local Chinese pig breeds have distinct intestinal microbial, as determined by metagenomic techniques, and the interactions between oral microorganisms and their hosts are also gradually being clarified. However, the high host genome content means that few metagenome-based oral microbiomes have been reported. Here, we combined dilution-based metagenomic sequencing and binning approaches to extract the microbial genomes from the oral microbiomes of Tibetan and Duroc pigs. The host contamination rates were reduced to 13.64%, a quarter of the normal metagenomic level (65.25% on average). Medium–high-quality metagenome-assembled genomes (MAGs; n = 3,448) spanning nine phyla were retrieved and 70.79% were novel species. Of the nonredundant MAGs, only 13.37% were shared, revealing the strong disparities between Tibetan and Duroc pigs. The oral microbial diversity of the Duroc pig was greater than that of the Tibetan pig. We present the first large-scale dilute-based metagenomic data on the pig oral microbiome, which should facilitate further investigation of the functions of oral microorganisms in pigs. [ABSTRACT FROM AUTHOR]

In a Doppler-broadened ladder-type Rubidium atomic system 5 S 1 / 2 – 5 P 3 / 2 – 5 D 5 / 2 , three-photon electromagnetically induced absorption (EIA) and transparency (EIT) in two schemes of two coupling lasers with different propagation directions are comprehensively studied. Two coupling fields are entangled tightly with each other and induce constructive interference such that we observe EIA as two coupling fields are counter-propagating. Two coupling fields are independent and cause destructive interference such that only enhanced EIT occurs when two coupling fields are co-propagating, although all of the Doppler-broadened atoms satisfy the condition for three-photon resonance. The experimental results are coincided with the numerically calculated spectra using the dressed perturbation method. The mechanisms of EIT and EIA could also be understood by the dressed-state pictures. [ABSTRACT FROM AUTHOR]

BackgroundThe sodium-cooled fast reactor adopts the three loops design with sodium-sodium-water. When a double-ended guillotine (DEG) break occurs in the steam generator (SG) tube, a large leakage sodium-water reaction (SWR) accident occurs, which threatens the safety and integrity of the secondary loop. A protection system is therefore designed to ensure secondary loop integrity.PurposeThis study aims to analyze the influence of protection system critical parameters on the large leakage SWR with paralleling SGs.MethodsFirst of all, a large leakage SWR model, including the water/steam leakage rate, hydrogen bubble growth, pressure wave propagation, and protection system models were established. Then, the large leakage SWR model was verified using the experimental data, and the 3-DEG large leakage SWR was simulated on the basis of the secondary loop structure. The integrity of the secondary loop and the protection system response were analyzed. Finally, a sensitivity analysis was performed for the critical parameters of the protection system, including the bursting pressure of liquid rupture disks, bursting delay time of rupture disks, location of liquid rupture disks, length of the release pipe, and volume of the primary accident discharged tank. Parameters with key influence on the integrity of the secondary loop and the protection system response were determined.ResultsThe 3-DEG large leakage sodium water reaction accident results in a peak pressure of 2.003 MPa in the reaction zone and 1.329 MPa in the critical equipment of the secondary circuit except for the reaction zone. The smaller bursting pressure and delay time, and the location of liquid bursting disks at the bottom chamber and the release pipe shorter length are more conducive to the integrity of the secondary loop and the protection system response.ConclusionsThis study provides a reference value for the design requirements of large leakage SWR protection systems with paralleling SGs.

Clinical teaching round is an important way to train students' clinical capacity. Standardized patient (SP) can simulate real clinical situations accurately and reproducibly. Compared with the traditional teaching round, the teaching round with introduction of standardized patients has its unique advantages and can improve the standardization, homogeneity and generalization of clinical teaching rounds more effectively. This article introduces the current status of the application of standardized patients, its application in clinical teaching rounds and challenges, emphasizing its potential in clinical training.

Objective To investigate the current situation of medical students' cognition and cultivation of medical students on medical leadership, providing the basis for the leadership cultivation and curriculum construction in medical colleges. Methods Taking medical students of Peking Union Medical College and one Chinese Medical College as the research objects, 256 valid data were collected through the network questionnaire, and the survey contents was conducted analysis statistically with descriptive study. Results The analysis result of survey data suggest that there is little difference between clinical and non-clinical students in the cognition of the importance of medical leadership. Peking Union Medical College achieved significant results in cultivation of medical leadership on the exploration and practice. In terms of medical leadership training and curriculum construction, it is suggested to adopt the form of practice-based or case study. Meanwhile, communication ability and the ability of organization and coordination are the abilities that need to be improved mostly. Conclusions The independent opinion and communication skill training for leadership in Peking Union Medical College should be extensively adopted by other medical schools. It is necessary to continuesly strengthen the training of medical leadership and construction of education courses focusing on the capacity building for communication, organization and team spirit and other core skills of medical leadership.

Computer clinical thinking training is a teaching method that uses the computer technology to simulate real clinical scenarios. Compared with the traditional clinical thinking training mode, it has its unique advantages. This article introduces the current status of computer clinical thinking training as well as its application values in rare diseases teaching, existing problems and solutions. And we emphasize its potential in clinical thinking teaching. This new method guaranteeing the homogeneity of physician training will advance the progress of medical teaching reformation.

The isoelectronic molecules UN and UO+ are known to have Ω = 3.5 and Ω = 4.5 ground states, respectively (where Ω is the unsigned projection of the electronic angular momentum along the internuclear axis). A ligand field theory model has been proposed to account for the difference [Matthew and Morse, J. Chem. Phys. 138, 184303 (2013)]. The ground state of UO+ arises from the U3+(5f3(4I4.5))O2− configuration. Owing to the higher nominal charge of the N3− ligand, the U3+ ion in UN is stabilized by promoting one of the 5f electrons to the more polarizable 7s orbital, reducing the repulsive interaction with the ligand and rendering U3+(5f27s(4H3.5))N3− the lowest energy configuration. In the present work, we have advanced the characterization of the UN ground state through studies of two electronic transitions, [18.35]4.5-X(1)3.5 and [18.63]4.5-X(1)3.5, using sub-Doppler laser excitation techniques with fluorescence detection. Spectra were recorded under field-free conditions and in the presence of static electric or magnetic fields. The ground state electric dipole moment [μ = 4.30(2) D] and magnetic ge-factor [2.160(9)] were determined from these data. These values were both consistent with the 5f27s configurational assignment. Dispersed fluorescence measurements were used to determine vibrational constants for the ground and first electronically excited states. Electric dipole moments and magnetic ge-factors are also reported for the higher-energy electronically excited states. [ABSTRACT FROM AUTHOR]

Sulfur is a critical element for plant growth and development, serving as a component of amino acids (cysteine and methionine), iron–sulfur clusters, proteins, glutathione, coenzymes, and auxin precursors. Deficiency or low concentrations of sulfur in the soil can lead to significant growth retardation in plants. The objective of our study was to examine the effects of sulfur (S) deficiency and excess on morphological symptoms, sulfur and nitrogen (N) metabolism, as well as antioxidant activity in soybean. We found that S starvation decreased the fine root length, biomass, and activity, and the chlorophyll content was reduced, while excess sulfur promotes lateral root growth. In contrast to sulfur excess, sulfur deficiency inhibits N and S metabolism levels in both subsurface and above-ground parts, and induced the expression of some sulfur transporters (SULTRs). In this study, we created soybean hairy root lines overexpressing the SULTR gene (GmSULTR2;1a) to observe metabolic changes following sulfur deficiency treatment. The results showed that GmSULTR2;1a saved the sulfur-deficient phenotype, and the antioxidant enzyme activity was much higher than that of the wildtype in the absence of sulfur. Our study revealed the important role of sulfur element in soybean growth and development and the regulation of sulfur deficiency by GmSULTR2;1a. [ABSTRACT FROM AUTHOR]