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The accumulation of metabolic waste is a leading cause of numerous neurological disorders, yet we still have only limited knowledge of how the brain performs self-cleansing. Here we demonstrate that neural networks synchronize individual action potentials to create large-amplitude, rhythmic and self-perpetuating ionic waves in the interstitial fluid of the brain. These waves are a plausible mechanism to explain the correlated potentiation of the glymphatic flow 1 , 2 through the brain parenchyma. Chemogenetic flattening of these high-energy ionic waves largely impeded cerebrospinal fluid infiltration into and clearance of molecules from the brain parenchyma. Notably, synthesized waves generated through transcranial optogenetic stimulation substantially potentiated cerebrospinal fluid-to-interstitial fluid perfusion. Our study demonstrates that neurons serve as master organizers for brain clearance. This fundamental principle introduces a new theoretical framework for the functioning of macroscopic brain waves. Rhythmic neural activity drives cerebrospinal fluid perfusion through brain parenchyma to enhance brain cleansing.

Ever since the initial discovery of general anesthetics almost 170 years ago, how general anesthesia (GA) induces loss of consciousness remains a century-long mystery. In addition, whether diverse anesthetic drugs and sleep share a common neural pathway is hotly debated and largely unknown. Previous studies have established that many GA drugs inhibit neural activity through targeting GABA receptors. Here, by using Fos staining, ex vivo brain slice recording, and eventually in vivo multichannel extracellular electrophysiology, we discovered a core ensemble of hypothalamic neurons in and near the supraoptic nucleus, consisting primarily of peptidergic neuroendocrine cells, which are surprisingly and persistently activated by multiple classes of GA drugs. Strikingly, chemogenetic or optogenetic stimulation of these anesthesia-activated neurons (AANs) strongly potentiated slow-wave sleep and prolonged GA, whereas conditional ablation through diphtheria toxin receptor strategy or inhibition of AANs with optogenetics led to reduced slow-wave oscillation in the brain, significant loss of slow-wave and rapid-eye movement sleep, and shortened durations under GA. Together, these findings identify a previously unknown common neural substrate underlying diverse GA drugs and natural sleep, and further illustrate a crucial role of the neuroendocrine system in regulating global brain states.

Background：Obstructive sleep apnea hypopnea syndrome （OSAHS） constitutes an independent factor for high warfarin dose for patients with pulmonary embolism （PE）.The aim of this study was to investigate whether the 6-month anticoagulation treatment by warfarin is enough for patients with PE complicated by OSAHS.Methods：We investigated 97 PE patients,32 of them had OSAHS and 65 non-OSAHS.Warfarin was administered for 6-month if no abnormal circumstances occurred.All patients were followed up for 18 months.Adverse events （AE） included death,major bleeding,hospitalization due to heart failure or pulmonary hypertension,and recurrence or aggravation of PE （including deep vein thrombosis）.Recurrence rate of PE after warfarin cessation was compared between the two groups.Results：OSAHS patients required a significantly higher dose of warfarin than their non-OSAHS counterparts （4.73 mg vs.3.61 mg,P 〈 0.001）.During warfarin treatment,no major bleeding and aggravation of PE occurred among OSAHS patients,and the rates of various AE were not significantly different between the OSAHS and non-OSAHS groups.PE recurrence was higher in OSAHS than non-OSAHS groups after withdrawal of warfarin （21.43% vs.6.78%,P =0.047）.Compared with non-OSAHS patients,OSAHS group had lower international normalized ratio （INR） value but higher plasminogen on baseline and INR resumed to a relatively low level after warfarin discontinuation.Conclusions：OSAHS patients may present with hypercoagulation and relatively high-risk of recurrence of PE after cessation of 6-month warfarin treatment.

Previous studies have reported a discrepancy in baseline characteristics and outcomes after percutaneous coronary intervention between men and women. However, this finding has never been verified in the Chinese population. The present study analyzed two-year clinical outcomes after placement of coronary drug-eluting stents in Chinese men and women. From January 2005 to December 2010, a total of 3804 Chinese patients (2776 men, 1028 women) who underwent drug-eluting stent implantation were studied prospectively. The primary endpoint was the composite major adverse cardiac event (MACE) rate, including myocardial infarction, cardiac death, and target vessel revascularization at two years. Stent thrombosis served as the safety endpoint. Propensity score matching was used to compare the adjusted MACE rate between the two groups. At two-year follow-up, unadjusted rates of myocardial infarction, non-ST segment elevation myocardial infarction, target vessel revascularization, and MACE were significantly different between men (6.84%, 4.6%, 13.1%, and 21.7%, respectively) and women (3.8% [P = 0.001], 2.0% [P < 0.001] 10.3% [P = 0.025], and 16.3% [P < 0.001], respectively). After propensity score matching, there were no significant differences in composite MACE and individual endpoints at two years between the genders. Despite all the unfavorable risk factor clustering in women and complex coronary disease in men, the two-year clinical outcomes after coronary stent placement were comparable between Chinese women and men.

MicroRNAs （miRNAs） have been clemonstrated to play an important role in regulation of the immunoinflammatory response; however, the function of miRNAs in periodontal inflammation has not been investigated. The objective of this study was to explore the properties of miRNAs in periodontal inflammation by comparing miRNA profiles of inflamed and healthy gingival tissues. Gingival tissues were obtained from 10 periodontitis patients and 10 healthy subjects. After RNA extraction, miRNA profiles were analyzed by microarray, and expression levels of selected miRNAs were confirmed by real-time quantitative reverse transcription polymerase chain reaction （RT-PCR）. Analyses using two computational methods, Targetscan and MicroRNA.org, were combined to identify common targets of these miRNAs. Finally, the individual miRNA expression levels of three toll-like receptor （TLR）-related miRNAs from inflamed and healthy gingival tissues were evaluated by RT-PCR. Ninety-one miRNAs were found to be upregulated and thirty-four downregulated over two-fold in inflamed gingival tissue compared with those in healthy gingival tissue. Twelve selected inflammatory-related miRNAs, hsa-miR-126＊, hsa-miR-20a, hsa-miR-142-3p, hsa-miR-19a, hsa-let-7f, hsa-miR-203, hsa-miR-17, hsa-miR-223, hsa-miR-146b, hsa-miR-146a, hsa-miR-155, and hsa-miR-205 showed comparable expression levels by microarray and real-time quantitative RT-PCR analyses. In addition, the putative inflammation targets of these miRNAs were predicted, and three that were tested （hsa-miRNA-146a, hsa-miRNA-146b, and hsa-miRNA-155）, showed significant differences between inflamed and healthy gingiva. This remarkable difference in miRNA profiles between periodontal diseased and healthy gingiva implicates a probable close relationship between miRNAs and periodontal inflammation. The data also suggest that the regulation of TLRs in periodontal inflammation may involve miRNA pathways.

Background： Sepsis is the leading cause of death among critically ill patients. Herein, we conducted a national survey to provide data on epidemiology and treatment of sepsis in the clinical practice in China, which has no detailed epidemiological data available on sepsis. Methods： This was a prospective cross-sectional survey from December 1, 2015 to January 31, 2016 in all provinces/municipalities of the mainland of China. The primary outcome of this study was the incidence of sepsis, and the secondary outcome was its etiology in China. Patients with sepsis admitted to the Intensive Care Units were included in this study. The demographic, physiological, bacteriological, and therapeutic data of these patients were recorded. The incidence of sepsis was estimated using the data from the sixth census in China, reported by the Chinese National Health and Family Planning Commission and the National Bureau of Statistics as the standard population. The independent risk factors for increased mortality from sepsis were calculated. Conclusions： This study indicated the incidence and outcome of sepsis in China. It also showed the most common etiology of different sites and types of infection, which could guide empiric antibiotic therapy. Moreover, it provided information on the independent risk factors for increased mortality due to sepsis. The findings provide evidence to guide clinical management and may help improve the outcome in septic patients.

Background: Previous studies have reported a discrepancy in baseline characteristics and outcomes after percutaneous coronary intervention between men and women. However, this finding has never been verified in the Chinese population. The present study analyzed two-year clinical outcomes after placement of coronary drug-eluting stents in Chinese men and women. Methods: From January 2005 to December 2010, a total of 3804 Chinese patients (2776 men, 1028 women) who underwent drug-eluting stent implantation were studied prospectively. The primary endpoint was the composite major adverse cardiac event (MACE) rate, including myocardial infarction, cardiac death, and target vessel revascularization at two years. Stent thrombosis served as the safety endpoint. Propensity score matching was used to compare the adjusted MACE rate between the two groups. Results: At two-year follow-up, unadjusted rates of myocardial infarction, non-ST segment elevation myocardial infarction, target vessel revascularization, and MACE were significantly different between men (6.84%, 4.6%, 13.1%, and 21.7%, respectively) and women (3.8% [P = 0.001], 2.0% [P < 0.001] 10.3% [P = 0.025], and 16.3% [P < 0.001], respectively). After propensity score matching, there were no significant differences in composite MACE and individual endpoints at two years between the genders. Conclusion: Despite all the unfavorable risk factor clustering in women and complex coronary disease in men, the two-year clinical outcomes after coronary stent placement were comparable between Chinese women and men. Keywords: drug-eluting stent, major adverse cardiac event, gender difference, clinical follow-up

We report the in situ transmission electron microscope （TEM） observation of the catalytic gasification and growth of carbon nanotubes （CNTs）. It was found that iron catalysts can consume the CNTs when pumping out the precursor gas, acetylene, at the growth temperature, and reinitiate the growth when acetylene is re-introduced. The switching between gasification and growth of CNTs can be repeated many times with the same catalyst. To understand the phenomenon, thermogravimetric analysis （TGA） coupled with mass spectroscopy was used to study the mechanism involved. It was shown that the residual water molecules in the growth chamber of the TEM react with and remove carbon atoms of CNTs as carbon monoxide vapor under the action of the catalyst, when the precursor gas is pumped out. This result contributes to a better understanding of the water-assisted and oxygen-assisted synthesis of CNT arrays, and provides useful clues on how to extend the lifetime and improve the activity of the catalysts.

A quantum network provides an infrastructure connecting quantum devices with revolutionary computing, sensing, and communication capabilities. As the best-known application of a quantum network, quantum key distribution (QKD) shares secure keys guaranteed by the laws of quantum mechanics. A quantum satellite constellation offers a solution to facilitate the quantum network on a global scale. The Micius satellite has verified the feasibility of satellite quantum communications, however, scaling up quantum satellite constellations is challenging, requiring small lightweight satellites, portable ground stations and real-time secure key exchange. Here we tackle these challenges and report the development of a quantum microsatellite capable of performing space-to-ground QKD using portable ground stations. The quantum microsatellite features a payload weighing approximately 23 kg, while the portable ground station weighs about 100 kg. These weights represent reductions by more than an order and two orders of magnitude, respectively, compared to the Micius satellite. Additionally, we multiplex bidirectional satellite-ground optical communication with quantum communication, enabling key distillation and secure communication in real-time. Using the microsatellite and the portable ground stations, we demonstrate satellite-based QKD with multiple ground stations and achieve the sharing of up to 0.59 million bits of secure keys during a single satellite pass. The compact quantum payload can be readily assembled on existing space stations or small satellites, paving the way for a satellite-constellation-based quantum and classical network for widespread real-life applications.

Aim： To investigate the effects of the major component of high-density lipoprotein apolipoprotein A-I （apoA-I） on the development of atherosclerosis in LPS-challenged ApoE / mice and the underlying mechanisms. Methods Male ApoE-KO mice were daily injected with LPS （25 μg, sc） or PBS for 4 weeks. The LPS-challenged mice were intravenously injected with rAAV-apoA-I-GFP or rAAV-GFP. After the animals were killed, blood, livers and aortas were collected for biochemical and histological analyses. For ex vivo experiments, the abdominal cavity macrophages were harvested from each treatment group of mice, and cultured with autologous serum, then treated with LPS. Results： Chronic administration of LPS in ApoE-/- mice significantly increased the expression of inflammatory cytokines （TNF-a, IL-1β, IL-6, and MCP-1）, increased infiltration of inflammatory cells, and enhanced the development of atherosclerosis. In LPS-challenged mice injected with rAAV-apoA-I-GFP, viral particles and human apoA-I were detected in the livers, total plasma human apoA-I levels were grammatically increased; HDL-cholesterol level was significantly increased, TG and TC were slightly increased. Furthermore, overexpression of apoA-I significantly suppressed the expression of proinflammatory cytokines, reduced the infiltration of inflammatory cells, and decreased the extent of atherosclerotic lesions. Moreover, overexpression of apoA-I significantly increased the expression of the cytokine mRNA-destabilizing protein tristetraprolin （TFP）, and phosphorylation of JAK2 and STAT3 in aortas. In ex vivo mouse macrophages, the serum from mice overexpressing apoA-I significantly increased the expression of TTP, accompanied by accelerated decay of mRNAs of the inflammatory cytokines. Conclusion： ApoA-I potently suppresses LPS-induced atherosclerosis by inhibiting the inflammatory response possibly via activation of STAT3 and upre~ulation of TTP.