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Comparative observation of the effectiveness and safety of remimazolam besylate versus dexmedetomidine in gastrointestinal surgery in obese patients

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1320-1327页

作者： Yu-fu Deng Xue-Run Jiang Zeng-guang Feng Department of Anesthesiology Xiangtan Central HospitalXiangtan 411100Hunan ProvinceChina

BACKGROUND Surgery for obese patients carries a higher risk of anesthesia complications compared with surgery for nonobese patients.Thus,a safe and effective anesthesia strategy is necessary to improve the medical experience of such patients and ensure their safety.AIM To compared the effectiveness and safety of remimazolam besylate versus dexmedetomidine(DEX)in gastrointestinal surgery in obese patients.METHODS The study cohort included 60 obese patients undergoing gastrointestinal surgery between July 2021 and April 2023,comprising 30 patients who received DEX intervention(control group)and 30 patients who received remimazolam besylate intervention(research group).Heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),blood oxygen saturation(SpO_(2)),safety(nausea and vomiting,bradycardia,hypotension,and apnea),anesthesia and examination indices[induction time,anesthesia recovery time,and postanesthesia care unit(PACU)discharge time],sedation effect(Ramsay Sedation Scale),and postoperative pain visual analog scale were comparatively analyzed before anesthesia(T0),during anesthesia(T1),and after anesthesia(T2).RESULTS At T1,the research group showed significantly smaller changes in HR,RR,MAP,and SpO_(2) than the control group,with a significantly lower adverse reaction rate and shorter induction,anesthesia recovery,and PACU discharge times.Additionally,the intra-and postoperative Ramsay Sedation Scale scores were statistically higher in the research group than in the control group.CONCLUSION Remimazolam besylate was significantly more effective than DEX in gastrointestinal surgery in obese patients and had a higher safety profile and value in clinical promotion.

关键词： Remimazolam besylate Dexmedetomidine Obesity Gastrointestinal surgery Effectiveness Safety

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Irreducible anteromedial radial head dislocation without fracture caused by transposed biceps tendon in an adult:A case report and literature review

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Chinese Journal of Traumatology 2024年第3期27卷 180-186页

作者： Ming-fu fu Hai-Ning Zuo Tao Sun Ming-Zhang Mu zhi-Yong Zhou Department of Orthopedic Surgery Yantaishan HospitalYantaiShandong Province264003China

Irreducible anteromedial radial head dislocation(IARHD)caused by transposed biceps tendon is rare.Delayed diagnosis and surgical failure often occur.A 46-year-old fisherman presented with 10 days history of painful swelling and restricted movement of his right elbow due to strangulation injury by a fishing boat cable.On examination,the images of the right elbow reveals in a"semi-extended and pronated"elastic fixation position.Radiography and 3-dimensional reconstruction CT reveals an isolated anteromedial radial head dislocation with extreme protonation of the radius and the bicipital tuberosity towards the posterior aspect of the elbow joint,and MRI shows biceps tendon wrapping around the radial neck,similar to umbilical cord wrapping seen in newborns.The Henry approach was applied for the first time to reduce the biceps tendon.The patient achieved a good functional recovery at 26 months,which represents the first reported case of IARHD without fracture caused by biceps tendon in an adult.In treatment of IARHD,attention should be paid to the phenomenon of biceps tendon transposition.Careful clinical examination,comprehensive imaging modalities,and appropriate surgical approach are the keys to successful management.

关键词： Biceps tendon Henry approach Irreducible Anteromedial dislocation Radial head Elbow Adult

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Polydatin ameliorates hepatic ischemia-reperfusion injury by modulating macrophage polarization

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 25-34页

作者： Hai-Li Bao Chuan-zhi Chen Chang-Zhen Ren Ke-Yan Sun Hao Liu Shao-Hua Song zhi-Ren fu Department of Organ Transplantation Shanghai Changzheng HospitalNavy Military Medical UniversityShanghai 200003China Department of Surgical Oncology the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Cardiology Shanghai Changzheng HospitalNaval Military Medical UniversityShanghai 200003China Department of General Surgery Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

Background:Polydatin,a glucoside of resveratrol,has shown protective effects against various diseases.However,little is known about its effect on hepatic ischemia-reperfusion(I/R)injury.This study aimed to elucidate whether polydatin protects liver against I/R-induced injury and to explore the underlying mechanism.Methods:After gavage feeding polydatin once daily for a week,mice underwent a partial hepatic I/R procedure.Serum alanine aminotransferase(ALT)/aspartate aminotransferase(AST),hematoxylin-eosin(H&E)and TdT-mediated dUTP nick-end labeling(TUNEL)staining were used to evaluate liver injury.The severity related to the inflammatory response and reactive oxygen species(ROS)production was also investigated.furthermore,immunofluorescence and Western blotting were used to detect macrophage polarization and the NF-κB signaling pathway in macrophages.Results:Compared with the I/R group,polydatin pretreatment significantly attenuated I/R-induced liver damage and apoptosis.The oxidative stress marker(dihydroethidium fluorescence,malondialdehyde,superoxide dismutase and glutathione peroxidase)and I/R related inflammatory cytokines(interleukin1β,interleukin-10 and tumor necrosis factor-α)were significantly suppressed after polydatin treatment.In addition,the result of immunofluorescence indicated that polydatin reduced the polarization of macrophages toward M1 macrophages both in vivo and in vitro.Western blotting showed that polydatin inhibited the pro-inflammatory function of RAW264.7 via down-regulating the NF-κB signaling pathway.Conclusions:Polydatin protects the liver from I/R injury by remodeling macrophage polarization via NFκB signaling.

关键词： Hepatic ischemia-reperfusion injury Polydatin Macrophage Polarization Inflammation

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Community structure and species diversity dynamics of a subtropical evergreen broad-leaved forest in China:2005 to 2020

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Plant Diversity 2024年第1期46卷 70-77页

作者： Shi-guang Wei Lin Li Kun-Dong Bai zhi-Feng Wen Jing-Gang Zhou Qin Lin Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection(guangxi Normal University) Ministry of EducationGuilin 541004GuangxiChina School of Life&Environmental Sciences Guilin University of Electronic TechnologyGuilin 541004GuangxiChina guangxi Key Laboratory of Landscape Resources Conservation and Sustainable Utilization in Lijiang River Basin Guilin 541004GuangxiChina Key Laboratory of Vegetation Restoration and Management of South China Botanical Garden of Degraded Ecosystems Chinese Academy of SciencesGuangzhou 510650GuangdongChina Center of Plant Ecology Core Botanical GardensChinese Academy of SciencesGuangzhou 510650GuangdongChina

Here,we characterize the temporal and spatial dynamics of forest community structure and species diversity in a subtropical evergreen broad-leaved forest in China.We found that community structure in this forest changed over a 15-year period.Specifically,renewal and death of common species was large,with the renewal of individuals mainly concentrated within a few populations,especially those of Aidia canthioides and Cryptocarya concinna.The numbers of individual deaths for common species were concentrated in the small and mid-diameter level.The spatial distribution of community species diversity fluctuated in each monitoring period,showing a more dispersed diversity after the 15-year study period,and the coefficient of variation on quadrats increased.In 2010,the death and renewal of the community and the spatial variation of species diversity were different compared to other survey years.Extreme weather may have affected species regeneration and community stability in our subtropical monsoon evergreen broad-leaved forests.Our findings suggest that strengthening the monitoring and management of the forest community will help better understand the long-and short-term causes of dynamic fluctuations of community structure and species diversity,and reveal the factors that drive changes in community structure.

关键词： Community structure Death and renewal dynamics Species diversity dynamics South subtropical forest

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Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China

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World Journal of Gastroenterology 2024年第5期30卷 462-470页

作者： Yu-Peng Li Jie Zhang zhi-De Li Chao Ma guang-Lei Tian Yuan Meng Xiong Chen zhi-Gang Ma Department of Hepatobiliary Surgery People's Hospital of Xinjiang Uygur Autonomous RegionUrumqi 830000Xinjiang Uygur Autonomous RegionChina

BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries.METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region(China)from January 2018 to September 2023 were retrospectively analyzed.Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis,routine abdominal ultrasound,high-frequency ultrasound,abdominal computed tomography(CT)scan,and laparoscopy.Subsequent to the treatments,these patients underwent reexaminations at the outpatient clinic until October 2023.The evaluations included the diagnostic precision of diverse examinations,the efficacy of surgical approaches,and the incidence of CE recurrence.RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan.Among them,16 patients were preoperatively diagnosed with atypical CE1,and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound.All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy,of whom 14 patients were intraoperatively confirmed to have CE1,which was consistent with the postoperative pathological diagnosis,one patient was diagnosed with a mesothelial cyst of the liver,and the other was diagnosed with a hepatic cyst combined with local infection.Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts,4 received aspiration sclerotherapy of hepatic cysts,and 19 received laparoscopic fenestration.These patients were intraoperatively diagnosed with simple hepatic cysts.During the followup period,none of the 14 patients with CE1 experienced recurrence or implantation of hydatid sc

关键词： Hepatic echinococcosis Hepatic cystic echinococcosis type 1 Hepatic cyst Color Doppler ultrasound Laparoscopy

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Research on shell-side heat and mass transfer with multi-component in LNG spiral-wound heat exchanger under sloshing conditions

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Petroleum Science 2024年第2期21卷 1333-1345页

作者： Xue-Ping Du guang-Lei Yu Ya-Cheng Xu zhi-Jie Chen Nai-Liang Li Huan-guang Wang School of Low-carbon Energy and Power Engineering China University of Mining and TechnologyXuzhou221116JiangsuChina Key Laboratory of Thermo-Fluid Science and Engineering MOEXi©an Jiaotong UniversityXi'an710049ShaanxiChina Xi©an Aerospace Propulsion Test Technology Institute Xi©an710100ShaanxiChina

The spiral-wound heat exchanger(SWHE) is the primary low-temperature heat exchanger for large-scale LNG plants due to its high-pressure resistance, compact structure, and high heat exchange efficiency. This paper studied the shell-side heat and mass transfer characteristics of vapor-liquid two-phase mixed refrigerants in an SWHE by combining a multi-component model in FLUENT software with a customized multicomponent mass transfer model. Besides, the mathematical model under the sloshing condition was obtained through mathematical derivation, and the corresponding UDF code was loaded into FLUENT as the momentum source term. The results under the sloshing conditions were compared with the relevant parameters under the steady-state condition. The shell-side heat and mass transfer characteristics of the SWHE were investigated by adjusting the component ratio and other working conditions. It was found that the sloshing conditions enhance the heat transfer performance and sometimes have insignificant effects. The sloshing condition is beneficial to reduce the flow resistance. The comprehensive performance of multi-component refrigerants has been improved and the improvement is more significant under sloshing conditions, considering both the heat transfer and pressure drop.These results will provide theoretical support for the research and design of multi-component heat and mass transfer enhancement of LNG SWHE under ocean sloshing conditions.

关键词： Spiral-wound heat exchanger Sloshing conditions Two-phase flow Multi-component Heat and mass transfer

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Static recrystallization behaviors and mechanisms of 7Mo super-austenitic stainless steel with undissolved sigma precipitates during double-stage hot deformation

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Journal of Iron and Steel Research(International) 2024年第2期31卷 475-487页

作者： Shi-guang Xu Jin-shan He Run-ze Zhang fu-cheng Zhang Xi-tao Wang Collaborative Innovation Center of Steel Technology University of Science and Technology BeijingBeijing100083China State Key Laboratory of Metastable Materials Science and Technology Yanshan UniversityQinhuangdao066004HebeiChina Shandong Provincial Key Laboratory for High Strength Lightweight Metallic Materials Advanced Materials InstituteQilu University of Technology(Shandong Academy of Science)Jinan250353ShandongChina

Static recrystallization(SRX)behaviors and corresponding recrystallization mechanisms of 7Mo super-austenitic stainless steel were studied under different deformation conditions.The order of influence of deformation parameters on static recrystallization behaviors,from high to low,is followed by temperature,first-stage strain and strain rate.Meanwhile,the effect of holding time on static recrystallization behaviors is significantly controlled by temperature.In addition,with the increase in temperature from 1000 to 1200°C,the static recrystallization mechanism evolves from discontinuous static recrystallization and continuous static recrystallization(cSRX)to metadynamic recrystallization and cSRX,and finally to cSRX.The cSRX exists at all temperatures.This is because high stacking fault energy(56 mJ m−2)promotes the movement of dislocations,making the deformation mechanism of this steel is dominated by planar slip of dislocation.Large undissolved sigma precipitates promote static recrystallization through particle-stimulated nucleation.However,small strain-induced precipitates at grain boundaries hinder the nucleation of conventional SRX and the growth of recrystallized grains,while the hindering effect decreases with the increase in temperature.

关键词： 7Mo super-austenitic stainless steel Double-stage hot deformation Conventional static recrystallization Metadynamic recrystallization Strain-induced precipitation

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Risk Assessment of Deep-Water Horizontal X-Tree Installation

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China Ocean Engineering 2024年第2期38卷 210-220页

作者： MENG Wen-bo fu guang-ming HUANG Yi LIU Shu-jie HUANG Liang GAOYong-hai CNOOC China Limited Zhanjiang BranchZhanjiang 524057China Key Laboratory of Unconventional Oil and Gas Development Ministry of Education(China University of Petroleum(East China))Qingdao 266580China

Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a modular risk evaluation model based on a fuzzy fault tree.First,through the analysis of the main process oftree down and combining the Offshore&Onshore Reliability Data(OREDA)failure statistics and the operation procedure and the data provided by the job,the fault tree model of risk analysis of the tree down installation was established.Then,by introducing the natural language of expert comprehensive evaluation and combining fuzzy principles,quantitative analysis was carried out,and the fuzzy number was used to calculate the failure probability of a basic event and the occurrence probability of a top event.Finally,through a sensitivity analysis of basic events,the basic events of top events significantly affected were determined,and risk control and prevention measures for the corresponding high-risk factors were proposed for subsea horizontal X-tree down installation.

关键词： subsea horizontal X-tree risk assessment fuzzy fault tree modular risk evaluation model

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Rational design of robust and transparent superrepellent surfaces for long-term marine antifouling

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Science China Technological Sciences 2024年第7期67卷 2031-2039页

作者： CHEN Hui WANG zhi WANG DaHeng XIAO Feng fu guang-En BU XueLing ZHAO Lei ZHANG Tao WU DaHeng PU JiBin The State Key Laboratory of Refractories and Metallurgy Wuhan University of Science & Technology Key Laboratory of Advanced Marine Materials Ningbo Institute of Materials Technology and Engineering Chinese Academy of Sciences

Superhydrophobic surfaces have demonstrated exceptional efficacy in combatting biofouling contaminations of optical devices and equipment in marine applications. However, the fabrication of highly transparent superhydrophobic materials remains a formidable challenge due to the inherent trade-off between surface roughness for superhydrophobicity and optical transparency.Herein, we design a robust and transparent superhydrophobic coating(Si-POSS) embedded silica nanoparticles(200 nm) with fluorinated polyhedral oligomeric silsesquioxanes(F-POSS) and zinc pyrithione(ZPT). The Si-POSS coating exhibits excellent water repellence toward diverse liquids and optical transmittance exceeding 90% in the visible spectrum. Moreover, the Si-POSS coating sustains long-term anti-bacterial(> 99.11%) and anti-algal effects for over 30 days, accompanied by mechanical,chemical, and thermal stability. This research asserts that the Si-POSS coating with outstanding combined characteristics holds significant potential for marine applications, particularly in self-cleaning and antifouling endeavors.

关键词： superhydrophobic surface transparent marine antifouling nanoparticles

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Present situation and prospect of immunotherapy for unresectable locally advanced esophageal cancer during peri-radiotherapy

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 1-7页

作者： Feng-Mei Wang Peng Mo Xue Yan Xin-Yue Lin zhi-Chao fu Department of Obstetrics and Gynecology Fuzong Clinical Medical College(900th Hospital)Fujian Medical UniversityFuzhou 350025Fujian ProvinceChina Department of Obstetrics and Gynecology Dongfang HospitalXiamen UniversityFuzhou 350025Fujian ProvinceChina Department of Radiotherapy Fuzong Clinical Medical College(900th Hospital)Fujian Medical UniversityFuzhou 350025Fujian ProvinceChina Department of Radiotherapy Dongfang HospitalXiamen UniversityFuzhou 350025Fujian ProvinceChina

Four major studies(Checkmate577,Keynote-590,Checkmate649 and Attraction-4)of locally advanced esophageal cancer published in 2020 have established the importance of immunotherapy,represented by anti-programmed death protein(PD)-1 in postoperative adjuvant treatment and advanced first-line treatment of locally advanced or advanced esophageal cancer and esophagogastric junction cancer,from the aspects of proof of concept,long-term survival,overall survival rate and progression-free survival.For unresectable or inoperable nonmetastatic esophageal cancer,concurrent radiotherapy and chemotherapy is the standard treatment recommended by various guidelines.Because its curative effect is still not ideal,it is necessary to explore radical radiotherapy and chemotherapy in the future,and it is considered to be promising to combine them with immunotherapeutic drugs such as anti-PD-1.This paper mainly discusses how to combine radical concurrent radiotherapy and chemotherapy with immunotherapy for unresectable local advanced esophageal cancer.

关键词： Esophageal carcinoma Locally advanced Radiotherapy Immunotherapy

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