Carbon Nanotube Interlayer Enhances Water Permeance and Antifouling Performance of Nanofiltration Membranes: Mechanisms and Experimental Evidence.

Interlayered thin-film nanocomposite (TFNi) membranes have been shown to achieve enhanced water permeance as a result of the gutter effect. Nevertheless, some studies report impaired separation performance after the inclusion of an interlayer. In this study, we resolve the competing mechanisms of water transport in the transverse direction vs that in the normal direction. To enable easy comparison, carbon nanotube (CNT)-incorporated TFNi membranes with an identical polyamide rejection layer but different interlayer thicknesses were investigated. While increasing the thickness of the CNT interlayer facilitates water transport in the transverse direction (therefore improving the gutter effect), it simultaneously increases its hydraulic resistance in the normal direction. An optimal water permeance of 13.0 ± 0.7 L m-2 h-1 bar-1, which was more than doubled over the control membrane of 6.1 ± 0.7 L m-2 h-1 bar-1, was realized at a moderate interlayer thickness, resulting from the trade-off between these two competing mechanisms. In this study, we demonstrate reduced membrane fouling and improved fouling reversibility for a TFNi membrane over its control without an interlayer, which can be attributed to its more uniform water flux distribution. The fundamental mechanisms revealed in this study lay a solid foundation for the future development of TFNi membranes toward enhanced separation properties and antifouling ability.

A randomized, split-face controlled trial on the safety and effects of microneedle fractional radiofrequency and fractional erbium-doped glass 1,565-nm laser therapies for baggy lower eyelids.

The non-ablative fractional erbium-doped glass 1,565-nm laser (NAFL) and the microneedle fractional radiofrequency (MFR) procedures are effective treatments that enable periorbital skin rejuvenation. To compare the clinical effectiveness and side effects of MFR and the NAFL for baggy lower eyelids (BLEs) in the Chinese population. Fifteen Chinese subjects with BLEs received three split-face treatments on a monthly basis randomly. Objective and subjective assessments were performed at baseline, as well as 1 month and 3 months after the third treatment. The results were evaluated using Antera-3D and CineScan systems. Blinded investigator assessments were performed by two plastic surgeons using a 0 to 4 score in six anatomic categories of BLEs. The patients also reported their level of satisfaction based on a four-point score. Most of the patients reported a greater than 47% satisfaction rate with both treatments. The cumulative contribution scores of prolapse of orbital fat, hollow tear trough, and skin laxity for each category variable declined with time. Using Antera 3D, the volume of elevation (mm3) decreased from 0.6 ± 0.4 to 0.4 ± 0.3 and from 0.6 ± 0.3 to 0.3 ± 0.3, the elevation area (mm2) decreased from 17.0 ± 8.4 to 13.0 ± 7.1 and from 17.0 ± 7.8 to 10.0 ± 5.6, and the maximum peak height (mm) also decreased from 0.10 ± 0.04 to 0.06 ± 0.04 and from 0.10 ± 0.03 to 0.06 ± 0.02 in the MFR and NAFL groups, respectively. Using CineScan, the depth of middle orbital fat (mm) decreased significantly from 10.2 ± 2.2 to 8.0 ± 0.7 and from 9.8 ± 1.1 to 8.0 ± 0.9 and the length of orbital fat significantly decreased from 9.2 ± 1.2 to 7.7 ± 0.7 and from 9.7 ± 1.4 to 7.8 ± 0.6 in the MFR and NAFL groups, respectively. MFR and NAFL therapies were effective for the treatment of BLEs, especially in BLE patients with skin elasticity in addition to tear trough deformity and orbital fat prolapse. TRIAL REGISTRATION NUMBER: NCT04237324. TRIAL REGISTER: ClinicalTrials.gov. LEVEL OF EVIDENCE: Level I, therapeutic study.

The Impact of Pollution Fee Reform on the Emission of Water Pollutants: Evidence from Manufacturing Enterprises in China.

With the development of China's industrial economy and urbanization, water pollution has become serious and gradually exposed to the public. The pollution fee policy is an important tool to force enterprises to reduce pollution. This study used the panel data of manufacturing enterprises during 2006-2013 and the multiperiod difference in differences (DID) method to systematically analyze the impact of water pollution fee reform on emissions of manufacturing enterprises in China. In general, enterprises facing improved pollution fee collection standards reduce COD emissions by approximately 4.1%. However, significant location heterogeneities are captured in China. The rising water pollution fees have promoted the emission reduction of enterprises in northern China and resource-based cities, but the effect is not significant in southern China and nonresource-based cities. Furthermore, the mechanism analysis shows that enterprises mainly reduced emissions through terminal treatment and reducing production. This study provided micro evidence for research on the effect of pollution fee reform and supplied a reference for the improvement of the environmental protection tax system in China.

[Correlation of collateral circulation and prognosis in patients with acute cerebral infarction].

OBJECTIVE: To evaluate the correlation of collateral circulation with prognosis in patients with acute cerebral infarction. METHODS: A total of 260 patients with acute ischemic stroke within 1 week of symptom onset underwent digital subtraction angiogram (DSA). The National Institutes of Health Stroke Scale (NIHSS) scores were obtained at admission. And the Modified Rankin scores (mRS) were assessed at a 3-month follow-up. The follow-up data were acquired through clinic visits or telephone interviews. RESULTS: Among them, 86 were found to have intra- or extra-cranial culprit artery severe stenosis or occlusion. And 36 (75.00%) in 48 patients had collateral arterial circulation while 11 (28.64%) in 38 patients posterior circulation. There were statistical differences in the NIHSS scores at admission and favorite clinical outcome (mRS ≤ 2) at 3-month follow-up for patients with and without collateral circulation. CONCLUSION: DSA is the golden standard for the assessment of collateral circulation in patients with severe cerebral artery stenosis or occlusion. The prognosis is better in stroke patients with collateral circulation.

Thoracic Paravertebral Nerve Block with Ropivacaine and Adjuvant Dexmedetomidine Produced Longer Analgesia in Patients Undergoing Video-Assisted Thoracoscopic Lobectomy: A Randomized Trial.

Purpose: This study evaluated the postoperative analgesic effect of ultrasound-guided single-point thoracic paravertebral nerve block (TPVB) combined with dexmedetomidine (DEX) in patients undergoing video-assisted thoracoscopic lobectomy. Methods: Sixty adult patients of the American Society of Anesthesiologists (ASA) I-III were randomly assigned into three groups (n = 20 each). G group: patients received routine general anesthesia; PR group: patients received 0.5% ropivacaine; and PRD group: patients received 0.5% ropivacaine with 1 µg/kg DEX. TPVB was performed in the T5 space before surgery, and then, general anesthesia induction and video-assisted thoracoscopic lobectomy were performed. Analgesics were administered through the patient-controlled analgesia (PCA) device intravenously. The background infusion of each PCA device was set to administer 0.02 µg/kg/h sufentanil, with a lockout time of 15 min, and a total allowable volume is 100 ml. Results: Compared to PR and G groups, the total sufentanil consumption after operation, the times of analgesic pump pressing, the pain score, and the incidence of postoperative nausea or vomiting in the PRD group were significantly reduced (p < 0.05). Also, the duration of first time of usage of the patient-controlled analgesia (PCA) was longer. The heart rate (HR) and mean arterial pressure (MAP) during operation were lower in the PRD group as compared with the other two groups in most of the time. However, hypotension and arrhythmia occurred in three groups with no statistically significant difference. Conclusions: A small volume of TPVB with ropivacaine and DEX by single injection produced longer analgesia in patients undergoing video-assisted thoracoscopic lobectomy, reduced postoperative opioids consumption, and the incidence of side effects.

Gut microbial balance and liver transplantation: alteration, management, and prediction.

Liver transplantation is a conventional treatment for terminal stage liver diseases. However, several complications still hinder the survival rate. Intestinal barrier destruction is widely observed among patients receiving liver transplant and suffering from ischemia-reperfusion or rejection injuries because of the relationship between the intestine and the liver, both in anatomy and function. Importantly, the resulting alteration of gut microbiota aggravates graft dysfunctions during the process. This article reviews the research progress for gut microbial alterations and liver transplantation. Especially, this work also evaluates research on the management of gut microbial alteration and the prediction of possible injuries utilizing microbial alteration during liver transplantation. In addition, we propose possible directions for research on gut microbial alteration during liver transplantation and offer a hypothesis on the utilization of microbial alteration in liver transplantation. The aim is not only to predict perioperative injuries but also to function as a method of treatment or even inhibit the rejection of liver transplantation.

[Repair of middle and lower face scars using alar thin expanded cervical flap with pedicle in anterior neck].

OBJECTIVE: To explore the application of alar thin expanded cervical flap with pedicle in anterior neck for large scars on middle and lower face. METHODS: From February 2000 to July 2013, 26 patients with scars on the middle and lower face were treated with the alar thin expanded cervical flaps with pedicle in anterior neck. After the skin of anterior neck was expanded by implanting skin expanders, alar thin expanded cervical flap with pedicle in anterior neck was obtained with size of 163-275 cm(2). Then the scars on the middle and lower face with the size of 135-196 cm(2) were excised, with the area of excision allowing full coverage of the expanded flap. The flap was rotated and advanced to the middle and lower face, and the incision was closed in layers. RESULTS: The 26 patients were followed up for 2 to 24 months. Twenty-one flaps survived, with good appearance and function. Four flaps showed venous retardation at distal part, and only one flap showed necrosis of the right edge. They were healed by free skin grafting. CONCLUSIONS: The alar thin expanded cervical flap not only makes maximum use of expanded flap on the premise of ensuring blood supply, but also guarantees good color, texture, and contour of face and neck.

Infraorbital and zygomatic reconstruction using pre-expanded rotation flap based on the orbicularis oculi muscle.

Infraorbital and zygomatic reconstruction procedures pose challenges to plastic surgeons because of the close location of the operation to the eyes and nose. Failed flap design can lead to distortion of the adjacent organs and tissue, particularly for larger defects. Flaps based on the orbicularis oculi muscle (OOM) can be easily rotated from the lateral or temporal region to cover the infraorbital and zygomatic area. We use a soft-tissue expander to enlarge the size of this flap for larger defect repair. Out of a total of 12 patients whose infraorbital or zygomatic defects ranged from 2.0 × 3.0 cm to 4.0 × 5.0 cm, 11 experienced a successful repair without complications. The size of the pre-expanded rotation flap ranged from 3.0 × 4.0 cm to 5.0 × 7.0 cm. The pre-expanded rotation flap based on the OOM has the advantages of an excellent colour and thickness match to the infraorbital and zygomatic areas, a reliable blood supply, abundant tissue and negligible donor-site morbidity. It has thus become our favourite technique for infraorbital and zygomatic reconstruction.

[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.