Effects of Talaromyces marneffei on Complete Blood Count by a Sysmex XN-9000 Analyzer.

BACKGROUND: Talaromyces marneffei (T. marneffei) infection detected in the peripheral blood smears has been described by several reports. We studied the effects of T. marneffei in peripheral blood samples on complete blood count (CBC) using a Sysmex XN-9000 analyzer. METHODS: In a simulated T. marneffei infection model, blood samples with and without infectious diseases were selected, with high, medium, and low levels of white blood cell (WBC) and platelet (PLT) count, respectively. All samples were detected immediately and after a warm bath of 37℃ for 2 hours. RESULTS: WBC count of all samples was significantly increased by T. marneffei from a certain concentration and higher. For all samples, the effect of T. marneffei on WBC count after warm bath was significantly reduced compared to that on immediate WBC count from 4 - 6 x 109/L T. Marneffei and higher (p < 0.05). The presence of T. marneffei in all blood samples did not affect the results of PLT count. For all samples, the obvious effects of T. marneffei on WBC differential (WDF) and white cell nucleated red blood cell (WNR) scatter plots were from 4 - 6 x 109 T Marneffei and higher. CONCLUSIONS: As a kind of intracellular yeast, T. marneffei may affect WBC count, NRBC count, and WBC differential count of peripheral blood samples when the yeast concentration is (4 - 6) x 109 T Marneffei and higher. Moreover, the unique scatter plot cloud on WDF and WNR scatter plots caused by T. marneffei, may become an important clue pointing toward T. marneffei in peripheral blood.

Electron-Induced Chirality-Selective Routing of Valley Photons via Metallic Nanostructure.

Valleytronics in 2D transition metal dichalcogenides has raised a great impact in nanophotonic information processing and transport as it provides the pseudospin degree of freedom for carrier control. The imbalance of carrier occupation in inequivalent valleys can be achieved by external stimulations such as helical light and electric field. With metasurfaces, it is feasible to separate the valley exciton in real space and momentum space, which is significant for logical nanophotonic circuits. However, the control of valley-separated far-field emission by a single nanostructure is rarely reported, despite the fact that it is crucial for subwavelength research of valley-dependent directional emission. Here, it is demonstrated that the electron beam permits the chirality-selective routing of valley photons in a monolayer WS2 with Au nanostructures. The electron beam can locally excite valley excitons and regulate the coupling between excitons and nanostructures, hence controlling the interference effect of multipolar electric modes in nanostructures. Therefore, the separation degree can be modified by steering the electron beam, exhibiting the capability of subwavelength control of valley separation. This work provides a novel method to create and resolve the variation of valley emission distribution in momentum space, paving the way for the design of future nanophotonic integrated devices.

Phonon-assisted upconversion in twisted two-dimensional semiconductors.

Phonon-assisted photon upconversion (UPC) is an anti-Stokes process in which incident photons achieve higher energy emission by absorbing phonons. This letter studies phonon-assisted UPC in twisted 2D semiconductors, in which an inverted contrast between UPC and conventional photoluminescence (PL) of WSe2 twisted bilayer is emergent. A 4-fold UPC enhancement is achieved in 5.5° twisted bilayer while PL weakens by half. Reduced interlayer exciton conversion efficiency driven by lattice relaxation, along with enhanced pump efficiency resulting from spectral redshift, lead to the rotation-angle-dependent UPC enhancement. The counterintuitive phenomenon provides a novel insight into a unique way that twisted angle affects UPC and light-matter interactions in 2D semiconductors. Furthermore, the UPC enhancement platform with various superimposable means offers an effective method for lighting bilayers and expanding the application prospect of 2D stacked van der Waals devices.

Two chronically misdiagnosed patients infected with Nocardia cyriacigeorgica accurately diagnosed by whole genome resequencing.

Nocardiosis is a rare but life-threatening infection particularly affecting immuno-compromised hosts, causing localized or systemic suppurative disease usually in human beings. Nocardia species, as the pathogen of nocardiosis, are difficult to differentiate because of their complex colony morphological features. In this study, we describe two patients who had been misdiagnosed for a long time infected with Nocardia cyriacigeorgica with completely different morphology were accurately diagnosed. Single colonies were analyzed by Gram staining, acid-fast stain, mass spectrometry and whole genome resequencing (WGRS). These two bacterial, strains L5.53 and L5.54, were found to be Gram-negative and acid-fast-weak positive. Blood sample culturing of strain L5.53 yielded white colonies, which were like a layer of hoarfrost, while colonies of L5.54 were yellow, rough, slightly convex. The two strains were identified as Nocardia sp. by mass spectrometry, and WGRS accurately determined them as N. cyriacigeorgica. After medical treatment, one patient was cured and the other was still receiving treatment in the hospital. It can be seen that Nocardia sp. cannot be accurately classified and identified only by phenotypic tests such as bacterial morphological differences, so it is necessary to identify Nocardia spp. with phenotypic tests in combination with other molecular biology technologies, such as WGRS.

miR-211-5p Alleviates the Myocardial Ischemia Injury Induced by Ischemic Reperfusion Treatment via Targeting FBXW7.

Cardiovascular diseases, a class of the most common diseases, seriously threaten human health, which is a direct inducement of death in most countries. The restoration of blood supply is an impactful intervention way for cardiovascular disease treatments while the injury induced by oxygen-glucose deprivation and ischemic reperfusion (I/R) may further impact the tissues of the patients. Myocardial reperfusion is a precondition for saving ischemic myocardial tissues in acute myocardial infarction while the injury induced by immediate reperfusion takes a great challenge for cardiovascular disease treatment. Howbeit, the reperfusion of coronary blood could aggravate the injury triggered by ischemia. At present, several studies have focused on the etiopathogenesis and therapeutic strategies of ischemia-reperfusion injury of the myocardium. The report has verified that miR-211-5p was elevated in the pathological specimens, while the influence of miR-211-5p in I/R-mediated injury of myocardial cells remains unclear. This research is aimed at illustrating the role of miR-211-5p in the progression of I/R injury of myocardial cells, and qRT-PCR, western blot, CCK-8, and TUNEL assay were used to investigate the functions of miR-211-5p on I/R-mediated injury of myocardial cells. The result mirrored that miR-211-5p was distinctly reduced in the I/R-induced AC16, and reduced miR-211-5p could evidently improve the viability of I/R-induced AC16. miR-211-5p could directly target FBXW7, and FBXW7 upregulation could reverse the improvement of AC16 in viability and apoptosis level after suffering I/R. Moreover, it was also proved that miR-211-5p can mediate the activation of Wnt/ß-catenin via attenuating FBXW7. Consequently, this investigation identified miR-211-5p as a positive role to attenuate the injury of myocardial cells when suffering I/R treatment.

Giant excitonic upconverted emission from two-dimensional semiconductor in doubly resonant plasmonic nanocavity.

Phonon-assisted upconverted emission is the heart of energy harvesting, bioimaging, optical cryptography, and optical refrigeration. It has been demonstrated that emerging two-dimensional (2D) semiconductors can provide an excellent platform for efficient phonon-assisted upconversion due to the enhanced optical transition strength and phonon-exciton interaction of 2D excitons. However, there is little research on the further enhancement of excitonic upconverted emission in 2D semiconductors. Here, we report the enhanced multiphoton upconverted emission of 2D excitons in doubly resonant plasmonic nanocavities. Owing to the enhanced light collection, enhanced excitation rate, and quantum efficiency enhancement arising from the Purcell effect, an upconverted emission amplification of >1000-fold and a decrease of 2~3 orders of magnitude in the saturated excitation power are achieved. These findings pave the way for the development of excitonic upconversion lasing, nanoscopic thermometry, and sensing, revealing the possibility of optical refrigeration in future 2D electronic or excitonic devices.

A Rare Human Case of External Ophthalmomyiasis due to Oestrus ovis in West China.

BACKGROUND: Myiasis is an infection of the tissues and organs occurring in animals or humans by fly larvae, and human ophthalmic myiasis has been described worldwide. METHODS: We report here a rare case of unilateral severe conjunctival ophthalmomyiasis due to the larvae of Oestrus ovis in Jixi city, Shaanxi province of west China, in which the climate is relatively dry and cold. RESULTS: The larvae were verified as the first instar larvae of Oestrus ovis according to the previously described morphological criteria. CONCLUSIONS: For the first time, we present an optimal method to identify larvae under a microscope to make images sharper for accurate laboratory diagnosis and preserve the specimen for a long time so that laboratory staff can learn about the rare case, especially in the regions with dry and cold climate like ours, where laboratory staff are not familiar with the disease. Accurate laboratory identification and prompt treatment will provide remarkable benefit to the patients.

Comparative diagnostic utility of metagenomic next-generation sequencing, GeneXpert, modified Ziehl-Neelsen staining, and culture using cerebrospinal fluid for tuberculous meningitis: A multi-center, retrospective study in China.

BACKGROUND: Early diagnosis of tuberculosis meningitis (TBM) remains a great challenge during clinical practice. The diagnostic efficacies of cerebrospinal fluid (CSF)-based mycobacterial growth indicator tube (MGIT) culture, modified Ziehl-Neelsen (ZN) staining, Xpert MTB/RIF, and metagenomic next-generation sequencing (mNGS) for TBM remained elusive. METHODS: A total of 216 adult patients with suspicious TBM were retrospectively enrolled in this multi-cohort study. The diagnostic performances for MGIT, modified ZN staining, Xpert MTB/RIF, and mNGS using CSF samples were evaluated. RESULTS: Uniform clinical case definition classified 88 (40.7%) out of 216 patients as the definite TBM, 5 (2.3%) patients as probable TBM cases, and 24 (11.1%) patients as possible TBM cases. The sensitivities of MGIT, modified ZN staining, Xpert MTB/RIF, and mNGS for TBM diagnosis against consensus uniform case definition for definite TBM were 25.0%, 76.1%, 73.9%, and 84.1%, respectively. Negative predictive values (NPVs) were 66.0%, 85.9%, 84.8%, and 90.1%, respectively. The sensitivities of MGIT, modified ZN staining, Xpert MTB/RIF, and mNGS for TBM diagnosis against consensus uniform case definition for definite, probable, and possible TBM were 18.8%, 57.3%, 55.5%, and 63.2%, respectively. Negative predictive values (NPVs) were 51.0%, 66.4%, 65.6%, and 69.7%, respectively. mNGS combined with modified ZN stain and Xpert could cover TBM cases against a composite microbiological reference standard, yielding 100% specificity and 100% NPV. CONCLUSION: Metagenomic next-generation sequencing detected TBM with higher sensitivity than Xpert, ZN staining and MGIT culture, but mNGS cannot be used as a rule-out test. mNGS combined with Xpert or modified ZN staining could enhance the sensitivity of diagnostic tests for TBM.

A functional polymorphism at the miR­491­5p binding site in the 3'­untranslated region of the MMP­9 gene increases the risk of developing ventilator­associated pneumonia.

Matrix metalloproteinase (MMP)­9 is associated with the severity of ventilator­associated pneumonia (VAP), while an rs1056629 SNP located in the 3'­untranslated region (UTR) of MMP­9 affects the microRNA (miRNA/miR)­491­mediated regulation of MMP­9 expression. In the present study, the effect of rs1056629 on the development of VAP in patients with chronic obstructive pulmonary disease (COPD) was investigated. Patients with COPD were enrolled in the study and their genotypes of rs1056629 (CC, CA or AA) were determined. ELISA was used to analyze the levels of TNF­α and IL­6 in the monocytes of patients with COPD carrying differential genotypes of rs1056629. Reverse transcription­quantitative PCR was carried out to evaluate the expression of miR­491 and MMP­9 mRNA in the different groups of patients with COPD. Luciferase assay was used to confirm the inhibitory role of miR­491 in MMP­9 expression. Western blot analysis was carried out to assess the expression of MMP­9 protein in A549 and H1299 cells transfected with miR­491 mimics. The risk and severity of VAP were significantly elevated in patients with COPD carrying the CC and AC genotypes of rs1056629. Although there was no difference in the expression of miR­491 in patients carrying different genotypes of rs1056629, the expression levels of TNF­α, IL­6 and MMP­9 were increased in patients with COPD carrying the CC and AC genotypes of rs1056629. The results of luciferase assay revealed that miR­491 inhibited the expression of MMP­9 through direct binding to the 3'UTR of MMP­9. Transfection of miR­491 mimics into A549 and H1299 cells markedly suppressed the expression of MMP­9 in a concentration­dependent manner. On the whole, the findings of the present study confirm that the CC and AC genotypes of rs1056629 increase the risk of developing VAP in patients with COPD by increasing the expression of MMP­9.

Programmable Self-Assembly of Gold Nanoarrows via Regioselective Adsorption.

Programing the self-assembly of colloidal nanoparticles into predetermined superstructures represents an attractive strategy to realize functional assemblies and novel nanodevices, but it remains a challenge. Herein, gold nanoarrows (GNAs) showing a distinct convex-concave structure were employed as unique building blocks for programmable self-assembly involving multiple assembly modes. Regioselective adsorption of 1,10-decanedithiol on the vertexes, edges, and facets of GNAs allowed for programmable self-assembly of GNAs with five distinct assembly modes, and regioselective blocking with 1-dodecanethiol followed by adsorption of 1,10-decanedithiol gave rise to programmable self-assembly with six assembly modes including three novel wing-engaged modes. The assembly mode was essentially determined by regioselective adsorption of the dithiol linker dictated by the local curvature together with the shape complementarity of GNAs. This approach reveals how the geometric morphology of nanoparticles affects their regioselective functionalization and drives their self-assembly.

Selectively steering photon spin angular momentum via electron-induced optical spin Hall effect.

The development of the optical spin Hall effect (OSHE) realizes the splitting of different spin components, contributing to the manipulation of photon spin angular momentum that acts as the information carrier for quantum technology. However, OSHE with optical excitation lacks active control of photon angular momentum at deep subwavelength scale because of the optical diffraction limit. Here, we experimentally demonstrate a selective manipulation of photon spin angular momentum at a deep subwavelength scale via electron-induced OSHE in Au nanoantennas. The inversion of the OSHE radiation pattern is observed by angle-resolved cathodoluminescence polarimetry with the electron impact position shifting within 80 nm in a single antenna unit. By this selective steering of photon spin, we propose an information encoding with robustness, privacy, and high level of integration at a deep subwavelength scale for the future quantum applications.

Hemophagocytic lymphohistiocytosis secondary to Candida albicans and reactivated EBV infections: A case report and review of the literature.

Hemophagocytic lymphohistiocytosis (HLH) has been recognized as a potentially life-threatening syndrome. This is the first case of acquired HLH caused by dual infections with Candida albicans and reactivated EBV infections, which focuses on the importance of morphological awareness of peripheral blood and bone marrow because sometimes they are the only locations that HLH and fungal microorganisms can be diagnosed. A 29-year-old woman with a history of abdominal distension and 9 months of intermittent fevers ($38.8°C) was admitted to the hematology department with treatment for leukopenia and thrombocytopenia. Severe infection of bilateral pulmonary and marked hepatosplenomegaly were detected by computed tomography. EB virus-CA IgG, EB virus-NA IgG and EB virus-CA IgM were positive. Scattered yeast-like fungi were found on peripheral blood and bone marrow (BM) smears. BM smears indicated prominent hemophagocytosis. Cultures of bronchoalveolar lavage and BM confirmed the growth of C. albicans. A diagnosis of HLH caused by dual infections with Candida albicans and reactivated EBV infections was established based on the clinical features of the patient because 7 of the 8 diagnostic criteria were met. She was treated with etoposide, dexamethasone for HLH, as well as highly active antifungal and antiviral therapies for the underlying etiology of dual infections. The patient eventually recovered following the effective treatment. A timely and accurate diagnosis is crucial to the prognosis of the dangerous disease.

Deep subwavelength control of valley polarized cathodoluminescence in h-BN/WSe2/h-BN heterostructure.

Valley pseudospin in transition metal dichalcogenides monolayers intrinsically provides additional possibility to control valley carriers, raising a great impact on valleytronics in following years. The spin-valley locking directly contributes to optical selection rules which allow for valley-dependent addressability of excitons by helical optical pumping. As a binary photonic addressable route, manipulation of valley polarization states is indispensable while effective control methods at deep-subwavelength scale are still limited. Here, we report the excitation and control of valley polarization in h-BN/WSe2/h-BN and Au nanoantenna hybrid structure by electron beam. Near-field circularly polarized dipole modes can be excited via precise stimulation and generate the valley polarized cathodoluminescence via near-field interaction. Effective manipulation of valley polarization degree can be realized by variation of excitation position. This report provides a near-field excitation methodology of valley polarization, which offers exciting opportunities for deep-subwavelength valleytronics investigation, optoelectronic circuits integration and future quantum information technologies.

Light-Controlled Near-Field Energy Transfer in Plasmonic Metasurface Coupled MoS2 Monolayer.

The energy transfer from plasmonic nanostructures to semiconductors has been extensively studied to enhance light-harvesting and tailor light-matter interactions. In this study, the efficient energy transfer from an Au metasurface to monolayered MoS2 within a near-field coupling regime is reported. The metasurface is designed and fabricated to demonstrate strong photoluminescence (PL) and cathodoluminescence (CL) emission spectra. In the coupled heterostructure of MoS2 with a metasurface, both the Raman shift and absorption spectral intensities of monolayered MoS2 are affected. The spectral profile and PL peak position can be tailored owing to the energy transfer between plasmonic nanostructures and semiconductors. This is confirmed by ultrafast lifetime measurement. A theoretical model of two coupled oscillators is proposed, where the expanded general solutions (EGS) of such a model result in a series of eigenvalues that correspond to the renormalization of energy levels in modulated MoS2. The model can predict the peak shift up to tens of nanometers in hybrid structures and hence provides an alternative method to describe energy transfer between metallic structures and two-dimensional (2D) semiconductors. A viable approach for studying light-matter interactions in 2D semiconductors via near-field energy transfer is presented, which may stimulate the applications of functional nanophotonic devices.

Comparison of diagnostic accuracy of the GeneXpert Ultra and cell-free nucleic acid assay for tuberculous meningitis: A multicentre prospective study.

DESIGN: A prospective multicentre study was conducted to compare the diagnostic accuracy of the GeneXpert MTB/RIF Ultra (Xpert Ultra) and cell-free DNA (cfDNA) assay for tuberculous meningitis (TBM) in China. METHODS: A prospective cohort study was conducted among individuals with symptoms suggestive of TBM registered in three TB specialised hospitals in China between June 2018 and January 2019. RESULTS: Overall, 84 patients suggestive of TBM were included in this analysis between June 2018 and January 2019. Using microbiological evidence as reference, the sensitivity/specificity for the diagnostic tests were Xpert Ultra 93.3%/100%, cfDNA 93.3%/92.6% and mycobacteria growth indicator tube (MGIT) culture 13.3%/100%. In addition, the sensitivity of culture was 6.7% when using clinical diagnosis criteria as the gold standard. Xpert Ultra correctly identified 28 cases as TBM, indicating a sensitivity of 46.7%. Notably, four additional TBM cases were detected by cfDNA compared with Xpert Ultra, yielding an overall sensitivity of 53.3%. Statistical analysis revealed that the sensitivity of Xpert Ultra and cfDNA was significantly higher than that of culture. CONCLUSIONS: The data demonstrate that Xpert Ultra and cfDNA assay showed optimal sensitivity compared with MGIT culture. In addition, there was no significant correlation between bacterial load and TBM severity in the participants.

Longitudinal cerebrospinal fluid assessment in a patient with tuberculous meningitis-A case report.

BACKGROUND: Dynamic assessment of cerebrospinal fluid (CSF) is essential for diagnosis, treatment, and prognosis of tuberculous meningitis, one of the most severe forms of central nervous system (CNS) infection. CASE PRESENTATION: A 45-year-old man sought care as he developed confusion, clonic convulsion, and coma. Longitudinal, comprehensive analyses of cytological, biochemical, and microbial changes in CSF specimen were assessed for this patient. On day 1 of hospitalization, modified Ziehl-Neelsen staining of CSF identified positive acid-fast bacilli, cytological analysis revealed neutrophilic-predominant pleocytosis (neutrophils 77%), and adenosine deaminase (ADA) was substantially elevated. Therefore, tuberculous meningitis was diagnosed and first-line standard anti-tuberculosis treatment was initiated. Interestingly, after 7-day treatment, the patient was greatly improved, and CSF disclosed a dominant percentage of lymphocytes (82%) as well as macrophages engulfing Mycobacterium tuberculosis. Later, the dose of dexamethasone was reduced, large number of neutrophils (57%) was present and protein level was immediately elevated in CSF specimen, indicating a possible relapse of tuberculous meningitis. Since the clinical condition of the patient was not worsening, the patient was stick to reduced dose of dexamethasone and standard anti-tuberculosis agents. He was discharged from the hospital on day 34, with 1-year continuation standard anti-tuberculosis therapy, and was clinically resolved from tuberculous meningitis. CONCLUSION: Detailed analyses of cellular composition, biochemical results, and microbial tests of CSF specimen provide the physician direct evidence of the immune surveillance status during tuberculous meningitis, which facilitates early diagnosis, optimal treatment, and improved prognosis.