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Background: Malignant esophageal stent esophagorespiratory fistula (ERF) is an abnormal communication between esophagus and airway among advanced tumor patients with indwelling esophageal stent, which is devastating and life-threatening. This study aims to provide a new feasible treatment scheme for malignant esophageal stent ERF and report its potential advantage compared with double stenting, which was recommended by European Society of Gastrointestinal Endoscopy Guideline. Methods: We retrospectively analyzed the medical data of malignant esophageal stent ERF patients between January 2018 to May 2023 at the First Affiliated Hospital of Guangzhou Medical University and divided them into two groups. Group 1 consisted of patients treated with rigid bronchoscopy to remove the esophageal stent and implant Y silicone trachea stent, while group 2 consisted of patients treated with additional airway stenting without removing the esophageal stent. Demographic parameters, disease diagnoses and treatment, radiological findings before and after the intervention, and complications caused by the stents were obtained and analyzed with chi-squared, Mann-Whitney U, independent-samples t-tests, Kaplan-Meier methods, and log-rank test. Results: Ten patients (seven patients in group 1 and three in group 2) were included. No procedure complications occurred in both groups. The mean Karnofsky Performance Score after the procedure significantly improved compared to the pre-procedure (57.14 vs. 77.14, P=0.001) in group 1, while decreased in group 2 (50 vs. 40, P=0.026). The control of pneumonia in group 1 patients is better than that in group 2. There was significant improvement in the degree of dysphagia after the procedure (3.86 vs. 2.43, P=0.002) in group 1, while no improvement was found in group 2 (4.00 vs. 3.33, P=0.423). The mean survival of group 1 was significantly longer group 2 (381.00 vs. 80.33 days, P<0.001, log-rank test). No patient needed stent repositioning due to migration in both groups. Cause of death in the group 1 included disease progression, novel coronavirus pneumonia, massive hemoptysis, and respiratory insufficiency, while group 2 included severe pneumonia and disease progression. No death was directly attributed to the procedure in both groups. Conclusions: Removing the esophageal stent and implanting Y silicone trachea stent through a rigid bronchoscopy is a safe and feasible treatment for malignant esophageal stent ERF. This procedure can effectively seal the fistula, prevent from recurrent aspiration pneumonia, improve the quality of life, and prolong the survival time.
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4,4'-Dichlorodiphenyl sulfoxide is the main raw material for the manufacture of polysulfone, polyether sulfone and other engineering plastics. It is also an intermediate for medicines, dyes and pesticides, which has been widely utilized in engineering plastics, fine chemicals and other fields. The alkylation of chlorobenzene with thionyl chloride can give 4,4'-dichlorodiphenyl sulfoxide as a product using Lewis acidic ionic liquids. In this work, metal-based methylimidazolium ionic liquids were synthesized, which were found to be efficient catalysts for alkylation reactions. The molar ratio of different metal chlorides to 1-butyl-3-methyl imidazole chloride and the influence of different metal chlorine additives on the catalytic Lewis acid center were investigated. The fissionable species of AlCl3 in ionic liquids will enhance the acidity of ionic liquids and, thus, promote the catalytic performance of ionic liquids. Under the optimized reaction conditions, the conversion rate of excess chlorobenzene was 45.3% and the selectivity of 4,4'-dichlorodiphenyl sulfoxide was 31.9%.
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Through the catalysis system design of in situ Ru SACs (single atoms) anchored on a rGO/NC two-dimensional interface, we successfully realized the SA-Ru@rGO/NC electrocatalyst with high metal loading density at a relatively low temperature. The largest NH3 yield of 110.1 µg h-1 mgcat-1 and FE of 17.9% were achieved at -0.3 V under ambient conditions. The electronic environment of the catalyst was regulated by the electronic metal-support interaction, and the use of SACs had the advantages of inhibiting the hydrogen evolution reaction (HER) and enhancing N2 adsorption, which effectively improved the performance of electrocatalytic nitrogen fixation.
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Plastein reaction is a modification reaction that can improve the functional properties of protein hydrolysate. The product of the reaction is a thixotropic aggregation of peptides. This study investigated the formation condition of soybean-whey plastein and bile acid binding capacity of plastein. Soy protein and whey protein were hydrolyzed by pepsin. The mixture (1:1, w/w) of two hydrolysates was modified by pepsin again. After the reaction, the decrease in free amino groups and the turbidity of the modified hydrolysate were measured to obtain appropriate reaction condition. Results showed that the concentration of hydrolysates 40% (w/v), enzyme ratio of 2.0 KU/g protein, pH 5.0, 37 °C, reaction time of 3.0 h respectively, were showed maximum changes in protein hydrolysates. Tricine SDS-PAGE analysis under denaturing conditions revealed that whey protein was more sensitive to pepsin and yielded different polypeptides (PPs) of molecular weight ranged from 3.5-17 kDa. However, a high molecular weight PP was completely hydrolyzed while PPs of 14.2-26 kDa were partially digested after pepsin treatment. Native page analysis further revealed the presence of a high-molecular weight PP in crude and purified plastein product. The bile acid binding capacity was improved by the plastein reaction. The amount of binding sodium deoxycholate, sodium taurocholate, and sodium cholate were 0.75, 2.0 and 1.87 µmol/100 mg respectively.
