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Metal sulfides have been universally studied as anode materials for lithium ion batteries (LIBs). Herein, we studied the lithiation storage behavior of a novel metal sulfide PbTiS3 (PTS), which is one of misfit layer compounds (MLCs) including intercalation-type TiS2 layer and conversion-alloying-type PbS layer. In-situ powder X-ray diffraction measurement reveals that the final lithiated product Li22Pb5 can be restored, indicating a reversible conversion-alloying mechanism in PTS. Theoretical calculation indicates the soft PbS interlayers of rock salt structure can hinder the distortion of TiS2 layers upon lithiation, resulting in a high structural integration of PTS anodes as well as a high concentration of intercalated Li ions. Moreover, with the assistance of the strong interfacial C–O–Pb/Ti interaction between PTS and graphene oxide (GO), PTS can be embedded in the conductive GO network which could stabilize PTS structure during long term cycling. Consequently, the fabricated LIBs anode delivers a relatively high reversible capacity (569 mA h g−1 at 2.0 A g−1 after 1000 cycles) and an outstanding high-rate capability. Besides, the assembled lithium ion full battery maintains a capacity retention of 70% after 100 cycles at 0.1 A g−1. This work provides insights into the design of MLCs as next-generation secondary batteries.

Oxytocin is commonly used to reduce blood loss during suction curettage for missed abortion. However, the potential of oxytocin to mitigate blood loss in early pregnancy remains controversial. Based on the hypothesis that the "timing" of oxytocin administration may be a critical factor, we investigated whether the timing of intravenous (IV) administration is associated with reduced perioperative blood loss during first-trimester suction curettage for missed abortion.The medical charts of 146 patients with ultrasound-confirmed first-trimester missed abortion who underwent suction curettage with IV oxytocin administration were retrospectively reviewed.Among the patients, 67 received 10 IU of IV oxytocin before suction curettage (early-oxytocin administration group), while 79 patients received 10 IU of IV oxytocin after suction curettage (late-oxytocin administration group). The demographic features between the two groups did not significantly differ. However, there was a lower proportion of nulliparous patients in the early-oxytocin administration group than in the late-oxytocin administration group (38.8% vs 60.8%, p = 0.006). The perioperative blood loss amount was significantly lower in the early-oxytocin administration group than in the late-oxytocin administration group (60 [range: 50-100] vs 100 [range: 30-250] mL, p = 0.001). Moreover, the multivariate logistic regression analysis showed that the early-oxytocin administration group had a lower risk for a perioperative blood loss amount of ≥100 mL than the late-oxytocin administration group (0.23 [range: 0.10-0.55], p = 0.001); a gestational age of 9-12 weeks ( p = 0.009) was found to be associated with an increased risk for a perioperative blood loss amount of ≥100 mL.Compared with late-oxytocin administration, early-oxytocin administration could reduce perioperative blood loss during first-trimester suction curettage for missed abortion. However, the results require further investigation.

A strategy of doping chalcogen-heteroatom in red phosphorus (RP) nanoparticles is adopted to improve the electrochemical performance of RP based composites as lithium storage materials. RP nanoparticles embedded in porous carbon with chalcogen-doping (S-, Se- and Te–P@PC) composites are synthesized via a facile evaporation-condensation approach. The large volume expansion of RP upon cycling is well mitigated by nanoscale feature and buffered by pore-closed carbon matrix. The extra fillings of chalcogen dopants lessen the specific surface areas of the doped composites, minimizing parasitic surface reactions of anode materials with electrolyte that can lead to high initial coulombic efficiencies. The high conductivity of Se dopant and the formed conductive Li–Se/Li–Se–P confer the Se–P@PC anode with improved electron/ion transport properties to deliver a superior fast-charging capability over 900 cycles. Moreover, a high-rate capacity of 908.5 mA h g−1 at 5.0 A g−1 and an impressive reversible capacity of 848.2 mA h g−1 even after 1800 cycles at 1.0 A g−1 of Se–P@PC surpass most of reported RP-based anode materials.

The exploration of advanced anode materials through rational structure/phase design is the key to developing high-performance rechargeable batteries. Herein, tetraphosphorus tetraselenide (Se

Background Open living donor hepatectomy (OLDH) is a highly painful procedure. Advanced strategies for enhancing perioperative analgesia and accelerating recovery are needed for patients undergoing OLDH. This study evaluated the effects of intravenous infusion of dexmedetomidine (DEX) during OLDH on postoperative analgesia and recovery. Methods This prospective, randomised, double-blinded, and placebo-controlled study included 34 patients randomised to a control group (group C) and a DEX group (group D). Utilisation of intravenous patient-controlled analgesia (IV-PCA) pump, pain intensity, and postoperative recovery variables were recorded. Moreover, intraoperative anaesthetic consumption, hemodynamic parameters, and fluid status were also recorded. Results During the first 24 hours after surgery, patients in group D had a lower pain intensity. The cumulative numbers of IV-PCA pump presses and fentanyl consumption within 24 and 48 hours postoperatively in group C were significantly higher than in group D. The time to first IV-PCA attempt was prolonged in group D. In addition, faster flatus passage was observed in group D. Intraoperatively, fewer anaesthetic agents were required in group D. Less fluctuation in hemodynamics and reduced bleeding were also found in group D. Conclusions The present study revealed that the addition of intravenous infusion of DEX during OLDH provided several benefits in relieving postoperative pain and promoting recovery. Therefore, we concluded that intraoperative DEX infusion may play an important role in enhancing the recovery of patients undergoing OLDH.

OBJECTIVES The objective of the study is to evaluate the therapeutic effect of hyoscine N-butylbromide (HBB) in active phase of labor and its safety to mother and fetus. METHODS A systematic literature search was conducted on Cochrane Library, Pubmed, EMBASE, CINAHL, ClinicalTrials.gov and three databases in Chinese up to March 31, 2020. Randomized controlled trials (RCTs) of HBB administration during the active phase for shortening of spontaneous labor at term compared with placebo were included. Two reviewers assessed the methodological quality and data extraction independently. We calculated pooled risk ratios (RRs), mean differences (MDs) and 95% confidence intervals (CIs) using Review Manager 5.3 software. Intention-to-treat principles and random-effects model were adopted for analysis and pool results. RESULTS In total, 1448 women from 9 RCTs were included in the meta-analysis. The HBB group exhibited significantly decreased durations of active phase (MD -61.1 min; 95% CI: -87.7 to -34.4, I2 : 96%), the second stage (MD -2.0 min; 95% CI: -3.4 to -0.5, I2 : 62%), and third stage (MD -0.7 min; 95% CI: -1.1 to -0.3, I2 : 51%). Intravenous (IV) HBB group and intramuscularly (IM) HBB group were compared to the control group (MD -60.9 min; 95% CI -87.7 to -34.1, I2 : 96%). No significant differences were observed in Cesarean section, post-partum hemorrhage, instrumental labor, Apgar scores or any adverse effects. CONCLUSION Hyoscine N-butylbromide had a significant effect of shortening the duration of the active phase of labor without adverse effects. We recommend a single dose of intravenous administrated HBB when a woman undergoes labor augmentation.

The exploration of advanced anode materials through rational structure/phase design is the key to developing high-performance rechargeable batteries. Herein, tetraphosphorus tetraselenide (Se4P4) nanoparticles confined within porous carbon (named SeP@C) are developed for lithium-ion batteries. The designed SeP@C shows a set of structural/compositional advantages as lithium-ion battery anodes including high electrical conductivity, low ion diffusion barrier, and relieved lithiation stress. Consequently, the SeP@C electrode displays superior comprehensive lithium storage performance, e.g., high reversible capacity (640.8 mA h g-1at 0.1 A g-1), excellent cycling stability (500 cycles with respective capacity retention of over or nearly 100%), and good rate capability, representing a comparable lithium storage performance in reported phosphide-based anodes. More significantly, it shows excellent energy storage properties in lithium-ion full cells which can light up 85 red LEDs for over 3.2 h. This work offers an advanced electrode construction guidance of phosphorous-based anodes for the development of high-performance energy storage devices.

In a rhizobox experiment with phosphorus(P) fertilizer application and P-deficiency, planting wild-type rice(Nipp), P-efficient mutant rice(PHO2), P-efficient transgenic rice(OsPT4) were chosen to evaluate effects of phosphorus efficient transgenic rice on inorganic phosphorus in the rhizosphere and non-rhizosphere soil. The obtained results were summarized as follows:(1)Significant higer dry weight and P accumulation were observed in OsPT4 and PHO2 than in Nipp, but lower total P and inorganic phosphorus observed in OsPT4 and PHO2 than in Nipp;(2)The concentrations of inorganic phosphorus fractions in the rhizosphere and non-rhizosphere soil were sorted as follows:O-P > Fe-P > Al-P > Ca-P, and the order of inorganic phosphorus fractions adapted to three rice materials;(3)When added phosphorus fertilizer, the concents of rhizospheric Al-P, Fe-P and non-rhizospheric Ca-P in three rice materials had no significant difference. The concents of rhizospheric soil O-P and Ca-P in OsPT4 and PHO2 were significantly inferior to Nipp, and their concents of non-rhizospheric soil Al-P, Fe-P and O-P were significantly lower than Nipp. When added no phosphorus fertilizer, the concents of rhizospheric Al-P, O-P, Ca-P and non-rhizosphere Al-P, Ca-P in three rice materials had no significant difference, and the concents of rhizosphere Fe-P and non-rhizosphere soil Fe-P, O-P in OsPT4 and PHO2 were significantly lower than Nipp, but rhizosphere Ca-P was significantly higher than Nipp.

Background: We investigated the effects of propofol vs desflurane on ischemia and reperfusion injury (IRI)-induced inflammatory responses, especially in matrix metalloproteinase-9 (MMP-9) downregulation and heme oxygenase-1 (HO-1) upregulation, which may result in different clinical outcomes in liver transplant recipients. Methods: Fifty liver transplant recipients were randomized to receive propofol-based total intravenous anesthesia (TIVA group, n = 25) or desflurane anesthesia (DES group, n = 25). We then measured the following: perioperative serum cytokine concentrations (interleukin 1 receptor antagonist [IL-1RA], IL-6, IL-8, and IL-10); MMP-9 and HO-1 mRNA expression levels at predefined intervals. Further, postoperative outcomes were compared between the 2 groups. Results: The TIVA group showed a significant HO-1 level increase following the anhepatic phase and a significant MMP-9 reduction after reperfusion, in addition to a significant increase in IL-10 levels after the anhepatic phase and IL-1RA levels after reperfusion. Compared to DES patients, TIVA patients showed a faster return of the international normalized ratio to normal values, lower plasma alanine aminotransferase concentrations 24 hours after transplantation, and fewer patients developing acute lung injury. Moreover, compared with DES patients, TIVA patients showed a significant reduction in serum blood lactate levels. However, there were no differences in postoperative outcomes between the two groups. Conclusion: Propofol-based TIVA attenuated inflammatory response (elevated IL-1RA and IL-10 levels), downregulated MMP-9 response, and increased HO-1 expression with improved recovery of graft function and better microcirculation compared with desflurane anesthesia in liver transplant recipients.

The nasopharyngeal airway is an important equipment in airway management, a correct placement is crucial for its effectiveness. We measured the nares-to-epiglottis distance (NED) and examined the correlations of the optimal insertion length (NED-1) with patient characteristics and various external facial measurements. We aimed to develop a simple method for estimating the optimal insertion length and to help select an appropriate nasopharyngeal airway. Two hundred patients of ASA grade I & II aged >20 years undergoing elective surgery under general anesthesia were enrolled. We measured nares-to-ear tragus distance (NTD), nares-to-mandibular angle distance (NMD), philtrum-to-ear tragus distance (PTD), and philtrum-to-mandibular angle distance (PMD). The NED was measured by fiber-optic bronchoscope. All measurements were obtained in centimeters. NED-1 (cm) was defined as the optimal insertion length. The patient's sex, age, body weight, body height, and body mass index were recorded. The NED-1 significantly correlated with body weight, body height, NTD, NMD, PTD, and PMD. Backward stepwise multiple linear regression analysis yielded the formula for predicting NED-1: 0.331 − 0.018 × BW + 0.061 × BH + 1.080 × NMD – 1.256 × PMD + 0.697 × PTD (r = 0.640, P

Misfit layer SnTiS3 (STS) crystal as a bulk van der Waals (vdW) heterostructure SnS/TiS2 is developed as a superior anode material for lithium-ion batteries (LIBs). STS can combine the advantages of metallic character of TiS2 layers and high lithium-storage of SnS layers. Moreover, graphene oxide (GO) is adopted to support STS via a hand-grinding route. A strong binding between STS and GO is conducive to decreasing the crystalline domain size of STS. Besides, the in-situ electrochemical reduction of GO nanosheets during the first cycling could offer a conductive network for both ions and electrons. Consequently, the electrochemical performance of STS/GO is superior than that of pristine STS and STS/rGO (rGO = reduced GO), and outstanding among the latest reports of SnS- or TiS2-based on LIBs anodes. Specifically, STS/GO anode delivers a capacity of 614 mA h g−1 at 2.0 A g−1 after 1000 cycles, as well as a high rate capability due to the dominated surface-capacitive contribution. Furthermore, the combination of in-situ and ex-situ powder X-ray diffraction patterns unequivocally reveals a conversion-alloy mechanism in STS anode upon lithiation/delithiation.

Background: Nonintubated video-assisted thoracic surgery (VATS) has been widely developed during the recent years. Cough reflex is an inevitably encountered problem while approaching lung lesions, and it may induce major bleeding. Sevoflurane anesthesia may attenuate cough reflex by inhibiting the pulmonary irritant receptors. However, the incidence of postoperative nausea and vomiting (PONV) in inhalational anesthesia is higher than in the propofol-based total intravenous anesthesia (TIVA). We investigated the effect of sevoflurane combination with propofol-based TIVA on cough reflex and PONV in nonintubated VATS. Methods: Ninety patients undergoing nonintubated VATS with laryngeal mask airway (LMA) and spontaneous breathing were randomly assigned for TIVA or propofol/sevoflurane anesthesia. In the TIVA group (n = 45), anesthesia was induced and maintained with propofol and fentanyl; in the propofol/sevoflurane (P/S) group (n = 45), 1% sevoflurane anesthesia was added to propofol and fentanyl anesthesia. The primary outcome measurements were cough reflex. In addition, the incidence of PONV and extubation time were investigated. Results: Patients with cough reflex were significantly fewer in the P/S group than in the TIVA group (10/45 vs 34/45; P

A cermet composite consisting of palladium and BaCe 0.4 Zr0. 4 Gd 0.1 Dy 0.1 O 3− x (BCZGD) is fabricated by mixing palladium and BCZGD powders in a ball mill, followed by pressing and sintering at 1450 °C for 24 h in air. The Pd–BCZGD cermet demonstrates impressive hydrogen permeation flux in a mixture of hydrogen and carbon dioxide at elevated temperature, in which the palladium plays the predominant role of facile transport in the hydrogen atoms whereas the BCZGD provides channels for proton conduction. Material characterization including scanning electron microscopy (SEM), X-ray diffraction (XRD), and thermo-gravimetric analysis (TGA) are performed. XRD patterns indicate pure phases of fcc palladium and perovskite BCZGD. SEM images and element mapping suggest a homogeneous mixture of cermet without noticeable defect and phase segregation. TGA results confirm stability of the cermet against carbon dioxide without chemical decomposition. The hydrogen permeation flux is determined via a gas chromatography from 400 to 700 °C at various hydrogen concentration gradients. We record a hydrogen flux of 1.25 cm 3 min −1 cm −2 in 50% hydrogen and 50% carbon dioxide at 700 °C, with a selectivity of H 2 /CO 2 approaching infinity.

The intraoperative lung protective ventilation with low tidal volume, positive end expiratory pressure (PEEP) and intermittent lungs recruitment was found to decrease postoperative pulmonary complications. In this retrospective medical records study, we investigated the effects of lung protective ventilation on postoperative pulmonary outcomes among the patients received prolonged oral cancer combined with free flap surgery. We collected the medical records of the patients received oral cancer surgery with the operation time more than 12 hours from January 2011 to December 2015. We recorded 1. the patients’ characteristics, past medical history, and laboratory data; 2. intraoperative peak airway pressure, fluid intake, urine output, blood loss, and operation duration; 3. postoperative PaO2/FiO2 (P/F) ratio when arrived at intensive care unit (ICU), infiltration on Chest X-ray (CXR), duration of ventilator use, ICU stay and hospital stay. Fifty nine cases were included. Thirty cases received the lung protective ventilation and 29 cases received conventional ventilation. Compared to the patients received conventional ventilation, the patients received intraoperative lung protective ventilation showed 1. higher postoperative P/F ratio (556.6 ± 115.2) vs 341.9 ± 72.7, P

Rationale: Cochlear implantation (CI) in CHARGE syndrome is technically challenging because of the anatomical anomalies. This case aims to report a successful case of CI in CHARGE syndrome by using the modified transcanal approach with external auditory canal (EAC) obliteration. Patient concerns: The 3-year-old girl presented at the outpatient department with bilateral hearing loss and nasal obstruction since birth. Diagnosis: The patient had bilateral profound sensorineural hearing loss, patent ductus arteriosus, atresia of the choanae, middle and inner ear anomalies, and growth retardation, fulfilling the criteria for typical CHARGE syndrome. High resolution temporal bone computed tomography scan revealed a poorly developed mastoid cavity, cochlear dysplasia, hypoplastic semicircular canals, ossicular chain malformation, and sigmoid sinus engorgement. Magnetic resonance imaging revealed a narrow internal auditory canal and a hypoplastic cochlear nerve. Interventions: Modified transcanal approach with external auditory canal obliteration Outcomes: CI was successfully done and there are no intraoperative or postoperative complications occurred after 1 year of follow up. Lessons: The modified transcanal approach is a reasonable and safer option for CI in CHARGE syndrome

Supplemental Digital Content is available in the text, Background: Thoracic epidural analgesia is the preferred method for postoperative analgesia following thoracic surgery. However, intravenous patient-controlled analgesia (IVPCA) may be an effective alternative. This study was conducted because few scientific reports exist comparing fentanyl-based IVPCA including a low dose of ketamine (fk-IVPCA) with thoracic patient-controlled epidural analgesia (t-PCEA) for the treatment of postoperative pain after video-assisted thoracic surgery (VATS). Methods: This prospective, and randomized study included 70 patients randomized into fk-IVPCA and t-PCEA groups. Pain at rest and during movement, successful and unsuccessful triggers after pressing the PCA device button, the need for rescue analgesia, drug-related adverse events, and patient satisfaction were recorded for 48 hours postoperatively. Results: No significant differences in the intensity of pain at rest or during movement were observed between the 2 groups within 48 hours postoperatively. The number of unsuccessful PCA triggers in the t-PCEA group 0 to 4 hours after surgery was significantly higher than that in the fk-IVPCA group. However, the numbers of successful PCA triggers in the fk-IVPCA group at 4 to 12 and 0 to 24 hours after surgery were significantly higher than those in the t-PCEA group. The incidence of analgesic-related side effects and patient satisfaction were similar in both groups. Conclusions: Compared with t-PCEA, the addition of a subanesthetic dose of ketamine to fentanyl-based IVPCA resulted in similar pain control after VATS with no increase in the incidence of drug-related adverse effects. The results confirm that both multimodal intravenous analgesia and epidural analgesia can provide sufficient pain control and are safe strategies for treating acute post-thoracotomy pain.

Background As reported, patients experience less postoperative pain after propofol-based total intravenous anesthesia (TIVA). In the present study, we investigated the postoperative analgesic effects between propofol-based TIVA and desflurane anesthesia after spine surgery. Methods Sixty patients were included who received (surgical time >180 minutes) lumbar spine surgery. Patients were randomly assigned to receive either TIVA (with target-controlled infusion) with propofol/fentanyl-based anesthesia (TIVA group) or desflurane/fentanyl-based anesthesia (DES group), titrated to maintain Bispectral Index values between 45 and 55. All patients received patient-controlled analgesia (PCA) with fentanyl for postoperative pain relief. Numeric pain rating scale (NRS) pain scores, postoperative fentanyl consumption, postoperative rescue tramadol use, and fentanyl-related side effects were recorded. Results The TIVA group patients reported lower NRS pain scores during coughing on postoperative day 1 but not day 2 and 3 (P = .002, P = .133, P = .161, respectively). Less fentanyl consumption was observed on postoperative days 1 and 2, but not on day 3 (375 μg vs 485 μg, P = .032, 414 μg vs 572 μg, P = .033, and 421 μg vs 479 μg, P = .209, respectively), less cumulative fentanyl consumption at postoperative 48 hours (790 μg vs 1057 μg, P = .004) and 72 hours (1210 μg vs 1536 μg, P = .004), and total fentanyl consumption (1393 μg vs 1704 μg, P = .007) when compared with the DES group. No difference was found in rescue tramadol use and fentanyl-related side effects. Conclusion Patients anesthetized with propofol-based TIVA reported less pain during coughing and consumed less daily and total PCA fentanyl after lumbar spine surgery.