Efficient and stable N-heterocyclic ketone-Cu complex catalysts for acetylene hydrochlorination: the promotion effect of ligands revealed from DFT calculations.

Cu-based catalysts are a promising alternative to toxic mercury catalysts for acetylene hydrochlorination, but their effectiveness is limited due to the poor dispersion and deactivation caused by reduction, agglomeration, and carbon deposition. In this study, the activity and stability of carbon-supported CuCl2 catalysts were largely improved by introducing N-heterocyclic ketones. Remarkably, N-methyl-2-pyridone (NM2P) coordinated Cu-based catalysts exhibited over 95% acetylene conversion with better stability under the reaction conditions of T = 180 °C, GHSV (C2H2) of 80 h-1, and VHCl/VC2H2 = 1.2. The combined results of characterization and exhaustive density functional theory (DFT) calculations revealed that the O-Cu coordination between the NM2P ligand and Cu cation strengthened the combination of reactants and Cu active sites, lowering the key reaction energy barrier, thereby leading to high activity. Meanwhile, the addition of the NM2P ligand significantly inhibited the reduction of Cu2+ to Cu+/Cu0, avoiding the formation of CuCl aggregates and the coking caused by Cu0, enhancing the catalytic stability. Overall, our study provides important insights into the design and optimization of Cu-based catalysts for acetylene hydrochlorination.

The effectiveness of an internet-based support program on maternal self-efficacy, postpartum depression and social support for primiparous women during the COVID-19 pandemic: Randomized controlled trial.

Background: Many primiparous women usually encounter various parenting and mental health issues after childbirth. The effects of intervention based on internet platform on parenting and mental health outcomes for Chinese first-time mothers remain unknown during the COVID-19 pandemic. Therefore, our research aimed to evaluate the effectiveness of an internet-based support program (ISP) on maternal self-efficacy (MSE), postpartum depression (PPD) and social support for primiparous women amid the pandemic. Methods: A multicenter randomized controlled trial (RCT) was conducted. From May 2020 to March 2021, 242 primiparous women were recruited in the maternity wards of two hospitals in Shenzhen City, China and randomly assigned to the intervention group and the control group. Women in control group (n = 118) received the routine postpartum care, and women in intervention group (n = 118) accessed to the ISP intervention (expert education and peer support) and routine postpartum care. Intervention outcomes were measured at baseline before randomization (T0), post-intervention (T1), and three-month follow up (T2) through questionnaires. The chi-square (χ2), the independent sample t-test and the repeated measures multivariate analysis of covariance were performed, and the two-tailed p-value <0.05 was regarded as statistically significant. Results: In comparison with women in the control group, women in the intervention group had a significantly higher score of MSE at T1 (mean: 73.53, standard deviation [SD]: 6.21) and at T2 (mean: 72.90, SD: 6.73); and a lower score of PPD at T1(mean: 6.03, SD: 2.50) and T2 (mean: 5.70, SD: 2.23); and a higher score of social support at T1 (mean: 45.70, SD: 3.73), but no significant difference at T2 (mean: 42.90, SD: 3.29). Conclusions: The effect of ISP was evaluated to significantly increase the levels of MSE, social support, and to alleviate PPD symptoms for Chinese first-time mothers. As an effective and easily accessible intervention, ISP could become a significant source for health professionals to support primiparous women on parenting and mental health during the COVID-19 pandemic. Trial registration: The trial is registered at the Chinese Clinical Trials Registry (ChiCTR2000033154).

Effect of Negative Pressure Wound Therapy on Surgical Site Infections following Stoma Reversal in Colorectal Surgery: A Meta-Analysis.

BACKGROUND: Surgical site infections (SSI) are common complications after surgery, which cause other complications and increase medical costs. However, the effect of negative-pressure wound therapy (NPWT) for the prevention of SSI at stoma reversal remains inconclusive, with controversial results. This meta-analysis aimed to evaluate the safety and efficacy of NPWT following stoma reversal in colorectal surgery to prevent SSI and other wound complications. METHODS: We conducted a systematic search of the PubMed, EMBASE, and Cochrane Library databases for articles published up to July 2022 and identified relevant studies reporting the NPWT administration following stoma reversal in colorectal surgery compared with non-pressure dressing. The primary outcome was the incidence of SSI, and the secondary outcomes were hematoma, seroma, and length of hospital stay (LOS). RESULTS: Nine studies were included in the meta-analysis, with 825 patients with (n = 310) or without (n = 515) NPWT. Pooled SSI rate was lower in the NPWT group than in the non-pressure dressing group (OR = 0.50; 95% CI: 0.29, 0.84; P = 0.01). There was no significant effect on hematoma (OR = 0.21; 95% CI: 0.03, 1.27; P = 0.09), seroma (OR = 0.26; 95% CI: 0.05, 1.28; P = 0.1) and LOS (MD = -0.16, 95% CI: -0.83, 0.51; P = 0.64). CONCLUSION: The use of NPWT following stoma reversal in colorectal surgery reduced the incidence of SSI. However, this conclusion needs to be interpreted with caution, and further studies should be conducted to confirm in higher-quality RCTs.

Risk of incident cardiovascular disease among patients with gastrointestinal disorder: a prospective cohort study of 330,751 individuals.

BACKGROUND AND AIMS: The associations between gastrointestinal diseases (GIs) and cardiovascular disease (CVD) were unclear. We conducted a prospective cohort study to explore their associations. METHODS: This study included 330 751 individuals without baseline CVD from the UK Biobank cohort. Individuals with and without GIs were followed up until the ascertainment of incident CVDs, including coronary heart disease (CHD), cerebrovascular disease (CeVD), heart failure (HF) and peripheral artery disease (PAD). The diagnosis of diseases was confirmed with combination of the nationwide inpatient data, primary care data, and cancer registries. A multivariable Cox proportional hazard regression model was used to estimate the associations between GIs and the risk of incident CVD. RESULTS: During a median follow-up of 11.8 years, 31 605 incident CVD cases were diagnosed. Individuals with GIs had an elevated risk of CVD (hazard ratio 1.37; 95% confidence interval 1.34-1.41, P < 0.001). Eleven out of fifteen GIs were associated with an increased risk of CVD after Bonferroni-correction, including cirrhosis, non-alcoholic fatty liver disease, gastritis and duodenitis, irritable bowel syndrome, Barrett's esophagus, gastroesophageal reflux disease, peptic ulcer, celiac disease, diverticulum, appendicitis, and biliary disease. The associations were stronger among women, individuals aged ≤ 60 years, and those with body mass index ≥ 25 kg/m2. CONCLUSIONS: This large-scale prospective cohort study revealed the associations of GIs with an increased risk of incident CVD, in particular CHD and PAD. These findings support the reinforced secondary CVD prevention among patients with gastrointestinal disorders.

Temperature-triggered fluorocopolymer aggregate coating switching from antibacterial to antifouling and superhydrophobic hemostasis.

The multifunction antibacterial hemostatic materials can reduce blood loss, infection and wound complications, which probably decrease morbidity and health care costs. However, the contradictory relationship between antibacterial ability and biocompatibility, and the unnecessary blood loss restricts the practical application of hydrophilic cationic antibacterial hemostatic materials. Herein, a multifunctional temperature-triggered antibacterial hemostatic fluorocopolymer aggregate coating was developed. After self-assembly and quaternization process, the quaternized poly(N,N-dimethylaminoethylmethacrylate)-b-poly(1H,1H,2H,2H-heptadecafluorodecyl acrylate) block copolymers (PDMA-b-PFOEMA) aggregate coating consisting of fluoropolymer and quaternary ammonium salt were built. The synergistic effect on fluorinated block with low surface energy and quaternary ammonium salt block with bactericide activity severs the way of initial bacterial attachment and proliferation, while the migration of fluorinated block greatly promotes the biocompatibility and anti-adhesion performance in response to the switch from room temperature to physiological temperature. Furthermore, the fluorocopolymer aggregate coating with hydrophobic properties possessed the property of rapid coagulation, low blood loss, minor secondary bleeding and least bacteria infiltration. The multifunctional temperature-triggered fluorocopolymer aggregate coating with antifouling, antibacterial and hemostatic properties may have a great potential in the biomedical application.

Chlorogenic Acids in Cardiovascular Disease: A Review of Dietary Consumption, Pharmacology, and Pharmacokinetics.

Chlorogenic acids (CGAs) have gained considerable attention as pervasive human dietary constituents with potential cardiovascular-preserving effects. The main sources include coffee, yerba mate, Eucommia ulmodies leaves, and Lonicerae Japonicae Flos. CGA consumption can reduce the risks of hypertension, atherosclerosis, heart failure, myocardial infarction, and other factors associated with cardiovascular risk, such as obesity and type 2 diabetes. This review recapitulates recent advances of CGAs in the cardiovascular-preserving effects, pharmacokinetics, sources, and safety. Emerging evidence indicates that CGAs exhibit circulatory guarding properties through the suppression of oxidative stress, leukocyte infiltration, platelet aggregation, platelet-leukocyte interactions, vascular remodeling, and apoptosis as well as the regulation of glucose and lipid metabolism and vasodilatory action in the cardiovascular system. CGAs exert these effects by acting on complex signaling networks, but the global mechanisms are still not clear. The oral bioavailability of CGA is poor, and there is a potential sensitization concern about CGA. The bioactive metabolites, systematic toxicity, and optimized structure are needed for further identification.

Designing an Antibody-Based Chaperoning System through Programming the Binding and Release of the Folding Intermediate.

The protein folding pathway consists of sequential intramolecular interactions, while chaperones exert their functions either by stabilizing folding intermediates or by preventing nonspecific intermolecular interactions, which are often associated with aggregation involving exposed hydrophobic residues in folding intermediates. As chaperones do not possess specificity for individual client proteins, we designed an antibody-based chaperoning system to mimic the sequential binding and release of client proteins undergoing folding. The single-chain variable fragment of antibody (scFv) A4 binds to human muscle creatine kinase (HCK) and prevents it from aggregating. The slow dissociation of HCK from A4 resulted in delayed but eventually high-quality refolding, as reflected by the higher recovery of enzymatic activity as well as abolished aggregation. Peptide P6, a sequence in HCK involved in A4 binding, competes with HCK, promotes its dissociation from A4, and accelerates the rate of high-quality refolding. The sequential addition of A4 and P6 is essential for the chaperoning effect. The programmed binding/release method can also be applied to refold HCK from inclusion bodies. Because the association/dissociation of the folding intermediate with the antibody is highly specific, the method can be used to design tailored refolding systems and to investigate chaperoning effects on protein folding/aggregation in a sequence-specific manner.

[Application of pedicle screw internal fixation for atlantoaxial instability of children].

OBJECTIVE: To investigate the effectiveness of pedicle screw internal fixation for the atlantoaxial instability of children. METHODS: Between July 2005 and January 2012, 19 cases of atlantoaxial instability were treated, included 10 boys and 9 girls with an average age of 7.5 years (range, 4-15 years). The X-ray films, CT, and MRI examinations of the cervical spine showed craniocervical malformation in 9 cases, congenital os odontoideum in 3 cases, odontoid fracture (type II) in 1 case, disruption of transverse ligament in 2 cases, atlantoaxial fracture and dislocation in 4 cases; and spinal cord injury in 8 cases, according to the American Spinal Cord Injury Association (ASIA) impairment scale, 1 case was rated as grade B, 2 as grade C, and 5 as grade D. Preoperative skull traction was performed routinely on all cases, and complete reduction was achieved in 17 cases, no reduction in 2 cases. In 17 patients who achieved complete reduction, pedicle screw internal fixation was used through posterior approach, including occipitocervical fusion and fixation in 5 cases, and atlantoaxial fusion and fixation in 12 cases; in 2 patients with no reduction, pedicle screw internal fixation was used through posterior approach (atlantoaxial fusion and fixation) after release by transoral approach. RESULTS: The operation was successfully performed in all patients. The mean operation time was 89 minutes; the mean intraoperative blood loss was 95 mL; the mean postoperative drainage volume was 73 mL; and the mean hospitalization days were 14 days. The patients were followed up 6-27 months (mean, 18.3 months). Satisfactory atlantoaxial fusion was obtained, and bone fusion was obtained at 3-7 months after operation (mean, 4.5 months). No breakage of screw or rods and re-dislocation occurred during follow-up. At last follow-up, the cervical range of motion (CROM) of the left and right rotation were (62.0 +/- 5.9) degrees and (63.9 +/- 3.8) degrees respectively in 5 patients receiving occipitocervical fusion and fixation, showing significant difference when compared with the values of normal children [(72.3 +/- 7.0) degrees and (74.1 +/- 7.6) degrees, respectively] at the same age (t = -3.915, P = 0.018; t = -5.954, P = 0.004). The CROM of the left and right rotation were (70.5 +/- 5.8) degrees and (72.7 +/- 4.9) degrees respectively in 14 patients receiving atlantoaxial fusion and fixation, showing no significant difference when compared with normal children at the same age (t = -1.417, P = 0.180; t = -1.021, P = 0.323). The visual analogue scale (VAS) score was significantly decreased from 7.8 +/- 1.1 at pre-operation to 3.5 +/- 0.8 at last follow-up (t = 17.267, P = 0.000). In 8 cases having spinal cord injury, 2 cases were rated as grade C, 1 case as grade D, and 5 cases as grade E according to ASIA impairment scale. CONCLUSION: Technique of pedicle screw internal fixation has been proven to be an effective treatment for the atlantoaxial instability of children. It plays an important part in relieving pain and limitation of the cervical region.

[Functional evaluation of a "two in one" urethroplasty for hypospadias].

OBJECTIVE: To assess the functional result of a "Two in One" urethroplasty which combined oral mucosa graft and local flap. METHODS: 17 patients with hypospadias underwent a "Two in One" urethroplasty, which combined buccal mucosa and local flap for urethral reconstruction. Uroflowmetry was performed 1 day before and 1 year after operation. The urine flow rate, voided volume and urine flow curves were detected using a rotating sensor. The results of maximum urine flow rate (Qmax) were expressed as percentiles and compared to the Toguri value from normal children. RESULTS: Before corrective operation, 12 of 17 patients (70.6%) produced a plateau urine flow curve. 5 patients (29.4%) produced a very low flow curve. The average maximum flow rate was (7.89 +/- 2.29) ml/s per second compared to Toguri values, 12 of 17 patients (70.6%) had a Qmax below the normal 5th percentile. After a "Two in One" urethroplasty, a hell-shaped curve was obtained in 10 patients (58.8%). The maximum flow rate was (11.30 +/- 3.01) mL/s per second. 7 of 17 patients (41.2%) had a Qmax above the normal 25th percentile, 8 patients (47.1%) had a Qmax between the normal 25th percentile and 5th percentile, only 2 patients (11.8%) had a Qmax below the 5th percentile. CONCLUSIONS: The functional result of the "Two in One" urethroplasty is ideal. The maximum urine flow rate of the patients increases after the operation.

[Management of rigid post-traumatic thoracolumbar kyphosis by simultaneous posterior-anterior circumferential releasing and correction with preserved posterior vertebral wall].

OBJECTIVE: To evaluate the surgical management of rigid post-traumatic thoracolumbar kyphosis (RPTK) by simultaneous posterior-anterior circumferential releasing, correction and anterior corpectomy with preserved posterior vertebral wall. METHODS: Twenty patients with RPTK were treated between October 2004 and October 2010 by posterior releasing, anterior subtotal corpectomy with preserved posterior vertebral wall, correction, strut graft, and short segmental fixation. There were 14 males and 6 females with an average age of 43.2 years (range, 23-63 years). The time between injury and operation was 4 months to 23 years (mean, 1.4 years). The affected locations were T11 in 1 case, T12 in 8 cases, L1 in 10 cases, and L2 in 1 case. The Cobb angle and the intervertebral height of the fractured vertebra body were measured before and after operations. The degrees of low back pain were assessed by Japanese Orthopaedic Association (JOA) scores. RESULTS: No incision infection, nerve injury, or cerebral spinal fluid leakage occurred. Seventeen patients were followed up 1-5 years with an average of 2.8 years. The JOA score at last follow-up (26.2 +/- 3.9) was significantly improved when compared with the pre-operative score (14.0 +/- 5.7) (t = 4.536, P = 0.001). One patient had aggravation of kyphosis at 3 months postoperatively, who was in stabilized condition after prolonging immobilized time. The Cobb angle was corrected from (43.2 +/- 11.5) degrees preoperatively to (9.8 +/- 5.7) degrees at last follow-up, showing significant difference (P < 0.01). There was significant difference in the intervertebral height of the fractured vertebra body between preoperation and last follow-up (P < 0.05). The intervertebral height of fractured vertebra was restored to 87.0% +/- 11.2% of adjacent disc height. CONCLUSION: Posterior-anterior circumferential releasing and anterior corpectomy with preserved posterior vertebral wall can achieve satisfactory clinical results, not only in pain relieving, kyphosis correction, vertebral height restoration, and spinal stability restoration, but also in the risk reduce of bleeding and spinal cord disturbance.

The potential role of a self-management intervention for benign prostate hyperplasia.

OBJECTIVE: To tentatively evaluate the usefulness of self-management interventions in improving the lower urinary tract symptoms (LUTS) and quality of life (QoL) in patients with benign prostatic hyperplasia (BPH). METHODS: Two-hundred twent-two men were recruited from a teaching hospital at Peking University from March 2008 to September 2009. They were referred by general practitioners to urologic outpatient departments because of BPH after 3-month administration of α-blockers. Participants were randomized to attend either a self-management program or undergo standard care. Difference of scores of International Prostate Symptom Score (IPSS) and BPH-specific QoL scale between 2 groups was analyzed at the enrollment period, and at the first week, third month, and sixth month. RESULTS: All participants had been followed for 6 months. There was no significant difference in IPSS score and QoL score between the 2 groups at the enrollment period and first week, whereas at the third month and sixth month, the IPSS scores and QoL self-management interventional group scores were statistically significant lower than those of the standard care group. CONCLUSION: Self-management intervention may be associated with decreased LUTS symptoms and may improve QoL in BPH patients with α-blocker administration.

[Application of tunica vaginalis flap for multi-fistulas after urethroplasty in hypospadias].

OBJECTIVE: To discussed a new technique for multi-fistulas after urethroplasty in hypospadias. METHODS: 8 cases with postoperative multi-fistulas, which were not successfully repaired by previous treatment, were reoperated with tunica vaginalis flap combined with urethral stent and elastic dressing. The multi-fistulas were located between glan and scrotum. The number of fistulas was 3-7 (median, 5). RESULTS: Primary healing was achieved in all the 8 cases. The micturition and esthetic result were satisfied. 5 cases were followed up for 8-10 months with no recurrence of fistula. There was also no dysuria and penile curvature. CONCLUSIONS: Tunica vaginalis flap combined with urethral stent and elastic dressing is an effective technique for multi-fistulas after urethroplasty. It is easily performed with reliable result.

[The inherent liability to infection of various tissue for urethra reconstruction].

OBJECTIVE: Observing the long-term results of reconstructed urethra to reduce the postop infection rate of hypospadias. To explore the standard of selecting tissue for urethra reconstruction by comparing the different inherent liability to infection in use of different kinds of tissue for urethra reconstruction. METHODS: Neo-urethra inner wall and normal urethra were observed through urography and urethroscope. The tissue section of neo-urethra, normal urethra and tissue for urethra reconstruction were observed through light microscope, scanning electron microscope and transmission electron microscope. RESULTS: The structure and liability to infection of neo-urethra made of bladder mucosa, buccal mucosa or skin never changed after long time. Metaplasia never took place in neo-urethra. CONCLUSIONS: The structure and liability to infection of neo-urethra were the same as those of the congeneric tissue. Bladder or buccal mucosa is the best tissue for urethra reconstruction considering urethra microenvironment. Neo-urethra made of skin is more liable to infection by nature. The best opportunity of hypospadias operation should be before puberty.

[Correction of nasolabial fold].

OBJECTIVE: To introduce a new method for correction of deep nasolabial fold. METHODS: From May 1998 to May 2002, 20 patients (aging 32-48 years, female) with deep nasolabial fold were treated with the buried guiding suture appliance and method through oral incision. RESULTS: All patients recovered without complications, the scar is minimal. Six patients were followed up 6 to 12 months, stable and permanent result was achieved. CONCLUSION: This method is simple and reliable for correction of nasolabial fold.