In this study, one hundred and three HIV-positive Chinese Han patients treated with a nevirapine (NVP)-based regimens were investigated for the association between nevirapine hypersensitivity reaction (NVP HSR) and human leukocyte antigen (HLA) allele. HLA-Cw, -DRB1 alleles were determined in 32 NVP HSR cases and 71 NVP-tolerant patients. We found that considerable overlap was observed for the clinical and demographic characteristics of the 32 hypersensitive patients and 71 tolerant patients. Twelve out of 32 NVP HSR cases developed allergic hepatotoxicity. More HLA-Cw*04 alleles were observed in NVP HSR cases than in NVP-tolerant cases (p=0.029). The frequency of HLA-DRB1*15 in NVP-tolerant cases was significant higher than that in NVP HSR cases ( p=0.018). Multivariate logistic regression identified that HLA-Cw*04 presence was a risk factor related to NVP HSR (p=0.030, OR=3.611, 95% CI of OR: 1.135-11.489). To clearly understanding its value in clinical practice, further studies involving larger cohorts of patients from different races with different levels of immune suppression are needed.

Objective To compare the surgical outcomes between the transoral-vestibular robotic thyroidectomy (TOVRT) and bilateral axillo-breast approach robotic thyroidectomy (BABART). Methods A total of 99 patients with papillary thyroid carcinoma but no distant metastasis were enrolled in this study from May 2020 to April 2021. Lobectomy or total thyroidectomy with central lymph node dissection were performed in all cases. All 99 patients were received an ultrasound guided fine needle aspiration biopsy prior to surgical intervention, out of which 49 patients underwent TOVRT, while rest 50 patients underwent BABART. During the procedure, intraoperative neuromonitoring system was used and all recurrent laryngeal nerves (RLNs) were preserved, additionally for TOVRT procedure, three intraoral ports or right axillary fold incision was used to allow for fine countertraction of tissue for radical oncological dissection. The clinical data including age, gender, height, weight, BMI, primary tumor size, number of central lymph node removed, central lymph node metastasis, operating time, total hospital stays, postoperative hospital stays, total postoperative drainage volume, postoperative pain score, cosmetic effect and complications were recorded and analyzed. Results There were no significant differences in gender, height, weight, BMI and removed central lymph nodes between the two groups (P > 0.05). Patients accepted TOVRT were younger and had smaller primary tumor size than those who accepted BABART. The TOVRT group had a longer surgical time than the BABART group, but with smaller postoperative drainage volume and superior cosmetic effect (under visual analogue scale, VAS) (P < 0.05). There was no significant difference in lymph node metastasis, hospital stay and postoperative pain score (under numerical rating scale, NRS) between the two groups (P > 0.05). Last but not least, certain peculiar complications were observed in TOVRT group: paresthesia of the lower lip and the chin (one case), surgical site infection (one case) and skin burn (one case). Conclusion Transoral-vestibular robotic thyroidectomy is safe and feasible for certain patients, which could be considered an alternative approach for patients who require no scarring on their neck.

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Novel two-dimensional (2D) materials have received extensive attention in the field of photocatalysis due to their unique properties. Traditional ZnO material with wurtzite structure transforms into a stable graphite-like structure that has the characteristics of 2D material when its thickness is less than a few atomic layers. In this work, using first-principles calculations, we investigated the potential of multilayer graphite-like ZnO as a photocatalyst for water splitting. The results showed that multilayer ZnO is a series of direct bandgap semiconductors, and their band edge positions all straddle the redox potential of water. Increasing with the number of layers, the bandgap of multilayer ZnO decreased from 3.20 eV for one layer to 2.21 eV for six layers, and visible light absorption capacity was significantly enhanced. Hence, multilayer ZnO was indeed promising for photocatalytic water splitting. Furthermore, suitable biaxial tensile strain could decrease the bandgap and maintain the stable graphite-like structure at a broader thickness range. In contrast, excessive biaxial tensile strain could change the redox capacity of multilayer ZnO and prevent it from catalyzing water splitting. Our theoretical results show that six-layer ZnO under 1% biaxial strain had direct bandgap of 2.07 eV and represents the most excellent photocatalytic performance among these multilayer ZnO materials.

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Highlights The kinase Dapk2 is quickly induced in activated T cells. Dapk2 deficient T cells promote GC responses by increasing cognate T-B interactions. mTORC1 pathway mediates Dapk2 function in T cell.

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