Establishment and validation of a nomogram to predict postoperative anemia after total hip arthroplasty.

BACKGROUND: Anemia is a common complication of total hip arthroplasty (THA). In this study, we evaluated the preoperative risk factors for postoperative anemia after THA and developed a nomogram model based on related preoperative and intraoperative factors. METHODS: From January 2020 to May 2023, 927 THA patients at the same medical center were randomly assigned to either the training or validation cohort. The correlation between preoperative and intraoperative risk factors and postoperative anemia after THA was evaluated using univariate and multivariate logistic regression analysis. A nomogram was developed using these predictive variables. The effectiveness and validation for the clinical application of this nomogram were evaluated using the concordance index (C-index), receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). RESULTS: Through univariate and multivariate logistic regression analysis, 7 independent predictive factors were identified in the training cohort: Lower body mass index (BMI), extended operation time, greater intraoperative bleeding, lower preoperative hemoglobin level, abnormally high preoperative serum amyloid A (SAA) level, history of cerebrovascular disease, and history of osteoporosis. The C-index of the model was 0.871, while the AUC indices for the training and validation cohorts were 84.4% and 87.1%, respectively. In addition, the calibration curves of both cohorts showed excellent consistency between the observed and predicted probabilities. The DCA curves of the training and validation cohorts were high, indicating the high clinical applicability of the model. CONCLUSIONS: Lower BMI, extended operation time, increased intraoperative bleeding, reduced preoperative hemoglobin level, elevated preoperative SAA level, history of cerebrovascular disease, and history of osteoporosis were seven independent preoperative risk factors associated with postoperative anemia after THA. The nomogram developed could aid in predicting postoperative anemia, facilitating advanced preparation, and enhancing blood management. Furthermore, the nomogram could assist clinicians in identifying patients most at risk for postoperative anemia.

Variability of BMP-2 content in DBM products derived from different long bone.

Demineralized bone matrix (DBM) has been regarded as an ideal bone substitute as a native carrier of bone morphogenetic proteins (BMPs) and other growth factors. However, the osteoinductive properties diverse in different DBM products. We speculate that the harvest origin further contributing to variability of BMPs contents in DBM products besides the process technology. In the study, the cortical bone of femur, tibia, humerus, and ulna from a signal donor were prepared and followed demineralizd into DBM products. Proteins in bone martix were extracted using guanidine-HCl and collagenase, respectively, and BMP-2 content was detected by sandwich enzyme-linked immunosorbent assay (ELISA). Variability of BMP-2 content was found in 4 different DBM products. By guanidine-HCl extraction, the average concentration in DBMs harvested from ulna, humerus, tibia, and femur were 0.613 ± 0.053, 0.848 ± 0.051, 3.293 ± 0.268, and 21.763 ± 0.344, respectively (p < 0.05), while using collagenase, the levels were 0.089 ± 0.004, 0.097 ± 0.004, 0.330 ± 0.012, and 1.562 ± 0.008, respectively (p < 0.05). In general, the content of BMP-2 in long bones of Lower limb was higher than that in long bones of upper limb, and GuHCl had remarkably superior extracted efficiency for BMP-2 compared to collagenase. The results suggest that the origin of cortical bones harvested to fabricate DBM products contribute to the variability of native BMP-2 content, while the protein extracted method only changes the measured values of BMP-2.

Screening of Sintering Aids for Oxide Ceramics: A Case of NASICON Electrolyte.

In this work, an efficient screening method to select appropriate sintering aids for a wide range of oxide material systems is developed. Consequently, Na2 B4 O7 , NaF, and CuO are selected as sintering aids for sodium super ionic conductor (NASICON)-type Na3 Zr2 Si2 PO12 ceramic to verify the feasibility of the as-proposed method. As evidenced by the results, the sinterability and densification of ceramic matrix are apparently improved. Specifically, Na3 Zr2 Si2 PO12 -7%Na2 B4 O7 , Na3 Zr2 Si2 PO12 -3%NaF, and Na3 Zr2 Si2 PO12 -3%CuO endow much higher room temperature ionic conductivity of 1.03 × 10-3 , 1.61 × 10-3 , and 1.63 × 10-3  S cm-1 , respectively, in comparison with the pristine (7.23 × 10-4  S cm-1 ). The underlying mechanism for the enhanced performance is also discussed. The symmetric sodium cells assembled with sintering aids modified Na3 Zr2 Si2 PO12 ceramic electrolyte exhibit ultra-stable metallic Na plating/stripping at room temperature. Moreover, solid-state sodium batteries paired with Na3 V1.5 Cr0.5 (PO4 )3 cathode active material and modified Na3 Zr2 Si2 PO12 ceramic electrolyte demonstrate superior cycling stability and excellent rate capability. Furthermore, an as-developed strategy can be universally extended to synthesize high-performance oxide ceramics.

Active Control of Interface Dynamics in NASICON-Based Rechargeable Solid-State Sodium Batteries.

Severe challenges are restraining the practical application of solid-state batteries, such as the dendrite growth and unsatisfactory compatibility between solid electrolyte and electrode. Here, we propose an interface dynamic control (IDC) strategy to ensure the stable operation of NASICON-based solid-state sodium batteries. First, we introduce intergranular phase (CuO) to effectively promote the densification of Na3Zr2Si2PO12 with an optimized ionic conductivity of 1.74 × 10-3 S cm-1 at 25 °C. Moreover, the kinetically formed Na-Cu-O interlayer reveals outstanding conductive capability. The dramatically reduced interfacial area-specific resistance (70 ohm cm-2) boosts the resistance to Na dendrite growth, ensuring the excellent cycling stability of symmetric Na cells at a current density of 0.4 mA cm-2 and room temperature. All-solid-state sodium metal batteries with Na3V1.5Cr0.5(PO4)3 cathode and modified Na3Zr2Si2PO12 ceramic electrolyte reveal a high retention of 87.4% at 100 mA g-1 over 300 cycles. This work opens up a new route for the rational interface design of NASICON-structure solid electrolyte toward the application in the high energy-density and high safety electrochemical energy storage devices.

Effects of demineralization mode and particle size of allogeneic bone powder on its physical and chemical properties.

At present, the commonly used allogeneic bone powder in the clinic can be divided into nondemineralized bone matrix and demineralized bone matrix (DBM). Commonly used demineralizers include acids and ethylene diamine tetraacetic acid (EDTA). There may be some diversities between them. Also, the size of the bone particle can affects its cell compatibility and osteogenic ability. We produced different particle sizes i.e., < 75, 75-100, 100-315, 315-450, 450-650, and 650-1000 µm, and treated in three ways (nondemineralized, demineralized by EDTA, and demineralized by HCl). Scanning electron microscopy showed that the surface of the samples in each group was relatively smooth without obvious differences. The results of specific surface area and porosity analysis showed that they were significantly higher in demineralized bone powder than in nondemineralized bone powder, however, there was no significant difference between the two decalcification methods. The content of hydroxyproline in nondemineralized bone powder and EDTA-demineralized bone powder had no statistical difference, while HCl-demineralization had statistical significance compared with the former two, and the content increased with the decrease of particle size. The protein and BMP-2 extracted from HCl demineralized bone powder were significantly higher than that from nondemineralized bone powder and EDTA demineralized bone powder, and there were differences among different particle sizes. These results suggested the importance of demineralization mode and particle size of the allogenic bone powder and provided guidance for the choice of the most appropriate particle size and demineralization mode to be used in tissue bioengineering.

Crystalline Unipolymer Monolayer with High Modulus and Conductivity.

The synthesis of crystalline polymer with a well-defined orientated state and a two-dimensional crystalline size beyond a micrometer will be essential to achieve the highest physical feature of polymer material but remain challenging. Herein, we show the synthesis of the crystalline unipolymer monolayer with an unusual ultrahigh modulus that is higher than the ITO substrate and high conductance by simultaneous electrosynthesis and manipulation. We find that the polymer monolayer has fully extended in the vertical and unidirectional orientation, which is proposed to approach their theoretically highest density, modulus, and conductivity among all aggregation formations of the current polymer. The modulus and current density can reach 40 and 1000 times higher than their amorphous counterpart. It is also found that these monolayers exhibit the bias- and length-dependent multiple charge states and asymmetrically negative differential resistance (NDR) effect, indicating that this unique molecular tailoring and ordering design is promising for multilevel resistive memory devices. Our work demonstrates the creation of a crystalline polymer monolayer for approaching the physical limit of polymer electronic materials and also provides an opportunity to challenge the synthetically iterative limit of an isolated ultra-long polymer.

Dual-Function of Cation-Doping to Activate Cationic and Anionic Redox in a Mn-Based Sodium-Layered Oxide Cathode.

Recently, sodium-ion batteries have shown great potential for energy storage owing to their favorable electrochemical properties and intrinsic cost performance, which fuels the research and development of Mn-based layered oxides as promising sodium-ion cathodes. However, the undesirable structural evolution and oxygen redox impose great challenge on the cycling stability and rate capability of such cathodes. In this work, it is reported that Fe and Al can effectively tailor the Na2/3 Mn2/3 Fe1/6 Al1/6 O2 to trigger a stable cationic and anionic redox behavior. In situ X-ray diffraction analysis confirms the retention of a stable P2 phase upon cycling, and density functional theory results demonstrate that Al3+ doping can strengthen the covalency of MnO bond. The Na2/3 Mn2/3 Fe1/6 Al1/6 O2 cathode can retain 90% of its initial capacity within the voltage range of 2.0-4.2 V versus Na+ /Na at 200 mA g-1 after 100 cycles. Moreover, ex situ X-ray photoelectron spectroscopy reveals that the specific capacity can be replenished by the synergistic reactions between Fe3+ /Fe4+ /Fe3+ and O2- /(O2 )n - pairs within the voltage range of 4.0-4.4 V versus Na+ /Na, which is also elucidated by theoretical calculation.

Solid-State Na Metal Batteries with Superior Cycling Stability Enabled by Ferroelectric Enhanced Na/Na3 Zr2 Si2 PO12 Interface.

Solid-state metal batteries are attracting unprecedented concern because of their high energy density and safety. However, their service life, especially at high specific density, is hindered by the undesirable reversibility of metal anodes, owing to the inhomogeneous ion distribution and awkward charge transfer dynamics at the electrode/electrolyte interface. In this work, it is well demonstrated that ferroelectric phase BaTiO3 reinforced Na3 Zr2 Si2 PO12 ceramic electrolyte can deconcentrate the distribution of charge transfer and self-accelerate Na+ migration at the Na/Na3 Zr2 Si2 PO12 interface upon cycling, realizing a compact Na deposition morphology together with a high critical current density (1.05 mA cm-2 at ambient conditions). Assembled symmetric cells based on the proposed composite electrolyte render stable cycling up to 1000 h at 0.3 mA cm-2 . Specifically, the all solid-state sodium metal batteries paired with Na3 V1.5 Cr0.5 (PO4 )3 cathode material can deliver a capacity of 95 mAh g-1 at 100 mA g-1 and maintain 84.4% of the initial capacity after 400 cycles. This excellent electrochemical performance clearly confirm the feasibility of the introduction of ferroelectric BaTiO3 to suppress the dendrite nucleation and Na propagation within ceramic electrolyte. This research offers new insight into the rational design of inorganic electrolyte, revealing dendrite-free and long-term all-solid-state sodium batteries.

Class â histone deacetylase inhibitor regulate of Mycobacteria-Driven guanylate-binding protein 1 gene expression.

Guanylate-binding proteins (GBPs) are a class of interferon (IFN)-stimulated genes with well-established activity against viruses, intracellular bacteria, and parasites. The effect of epigenetic modification on GBP activity upon Mycobacterium tuberculosis (Mtb) infection is poorly understood. In this study, we found that Mtb infection can significantly increase the expression of GBPs. Class Ⅰ histone deacetylase inhibitor (HDACi) MS-275 can selectively inhibit GBP1 expression, ultimately affecting the release of inflammatory cytokines IL-1ß and suppressing Mtb intracellular survival. Moreover, interfering with GBP1 expression could reduce the production of IL-1ß and the level of cleaved-caspase-3 in response to Mtb infection. GBP1 silencing did not affect Mtb survival. Besides, using the bisulfite sequencing PCR, we showed that the CpG site of the GBP1 promoter was hypermethylated, and the methylation status of the GBP1 promoter did not change significantly upon Mtb infection. Overall, this study sheds light on the role of GBP in Mtb infection and provides a link between epigenetics and GBP1 activity.

Elevating Energy Density for Sodium-Ion Batteries through Multielectron Reactions.

It remains a great challenge to explore desirable cathodes for sodium-ion batteries to satisfy the ever-increasing demand for large-scale energy storage systems. In this Letter, we report a NASICON-structured Na4MnCr(PO4)3 cathode with high specific capacity and operation potential. The reversible access of the Mn2+/Mn3+ (3.75/3.4 V), Mn3+/Mn4+ (4.25/4.1 V), and Cr3+/Cr4+ (4.4/4.3 V vs Na/Na+) redox couples in a Na4MnCr(PO4)3 cathode endows a distinct three-electron redox reaction during the insertion/extraction process. The highly stable NASICON structure with a small volume variation upon cycling ensures long-time cycling stability (73.3% capacity retention after 500 cycles within the potential region of 2.5-4.6 V). The impedance analysis and interface characterization indicate that the evolution of a cathode electrolyte interphase at high potential is correlated with the capacity fading, while the robustness of the NASICON framework is redemonstrated.

Surface Potential Regulation Realizing Stable Sodium/Na3 Zr2 Si2 PO12 Interface for Room-Temperature Sodium Metal Batteries.

Inorganic Na3 Zr2 Si2 PO12 is prospective with a high ionic conductivity but suffers large interfacial resistance and stability issues against sodium metal, hindering its practical application in all-solid-state sodium batteries. A surface potential regulation strategy is adopted to address these issues. Na3 Zr2 Si2 PO12 (NZSP) ceramic with homogeneously-sintered surface is synthesized by a simple two-step sintering method to promote its uniform surface potential, which is favorable for mitigating the potential fluctuations at the interface against Na metal and enhancing interfacial compatibility. The Na/NZSP interface can be stabilized for over 4 months with a low interfacial resistance of 129 Ω cm2 at 25 °C. The symmetrical Na/NZSP/Na cell exhibits ultra-stable sodium platting/stripping cycling for over 1000 cycles under 0.1 mA cm-2 . Superior interfacial performance is well retained even under 0.2 mA cm-2 at room temperature. The robust interface is further signified by its excellence under higher current densities of up to 0.85 mA cm-2 at 60 °C. A 4 V all-solid-state Na3 V1.5 Cr0.5 (PO4 )3 /NZSP/Na metal battery is demonstrated at ambient conditions, which exhibits superior rate capability and delivers a high reversible capacity of 103 mA h g-1 under 100 mA g-1 for over 400 cycles with a Coulombic efficiency of over 99%.

Grain Boundary Design of Solid Electrolyte Actualizing Stable All-Solid-State Sodium Batteries.

Advanced inorganic solid electrolytes (SEs) are critical for all-solid-state alkaline metal batteries with high safety and high energy densities. A new interphase design to address the urgent interfacial stability issues against all-solid-state sodium metal batteries (ASSMBs) is proposed. The grain boundary phase of a Mg2+ -doped Na3 Zr2 Si2 PO12 conductor (denoted as NZSP-xMg) is manipulated to introduce a favorable Na3-2 δ Mgδ PO4 -dominant interphase which facilitates its intimate contact with Na metal and works as an electron barrier to suppress Na metal dendrite penetration into the electrolyte bulk. The optimal NZSP-0.2Mg electrolyte endows a low interfacial resistance of 93 Ω cm2 at room temperature, over 16 times smaller than that of Na3 Zr2 Si2 PO12 . The Na plating/stripping with small polarization is retained under 0.3 mA cm-2 for more than 290 days (7000 h), representing a record high cycling stability of SEs for ASSMBs. An all-solid-state NaCrO2 //Na battery is accordingly assembled manifesting a high capacity of 110 mA h g-1 at 1 C for 1755 cycles with almost no capacity decay. Excellent rate capability at 5 C is realized with a high Coulombic efficiency of 99.8%, signifying promising application in solid-state electrochemical energy storage systems.

Using an artificial neural network to predict the residual stress induced by laser shock processing.

With the purpose of using the artificial neural network (ANN) method to predict the residual stresses induced by laser shock processing (LSP), the Ni-Cr-Fe-based precipitation-hardening superalloy GH4169 was selected as the experimental material in this work, and the experimental samples were treated by LSP with laser power densities of 4.24GW/cm2, 7.07GW/cm2, and 9.90GW/cm2 and overlap rates of 10%, 30%, and 50%. The depth-wise residual stresses of experimental samples prior to and after LSP were taken according to the x-ray diffraction sin2ψ method and electrolytic-polished layer by layer. The ANN model for residual stress prediction was established, and the laser power density, overlap rate, and depth were set as input parameters, while residual stress was set as the output parameter. The residual stresses of untreated samples and those treated with laser power densities of 4.24GW/cm2 and 9.90GW/cm2 were selected as the training sets, and the data of experimental samples treated with a laser power density of 7.07GW/cm2 were reserved as testing sets for validating the trained network. After LSP, beneficial stable compressive residual stresses were introduced in the material's near surface, and the overall maximum compressive residual stresses were formed on the top surface (surface residual stress). Depending on the LSP process parameters, the surface residual stresses ranged from -236MPa to -799MPa, and the compressive residual stress depths of all treated samples were over 0.50 mm. According to the results obtained by ANN, the coefficient of determination R2 of the training sets is 0.9948, which shows a good fitness for the training network. The R2 of the testing sets is 0.9931, which is less than that of the training sets but still shows high accuracy. This work proves that the ANN method can be applied to predict the residual stress of metallic materials by LSP treatment with high accuracy and provides a guiding value for the optimization of the LSP process.

[Design of Detection Module in Coagulometers Based on Dual-magnetic Circuit Beads Method].

Coagulometer, known as blood coagulation analyzer, is a product that can provide accurate test results for medical diagnosis and treatment analysis by detecting a series of items closely related to thrombosis and hemostasis in coagulation reaction. On the basis of previous traditional methods, and with our deep understanding about the principles of hemagglutination detection, we propose a hemagglutination detection method by using the dual-magnetic circuit beads method. Then, the corresponding hemagglutination detection module is designed. The coagulation time of plasma can be measured by detecting the movement of the magnetic beads when the magnetic field intensity is appropriate. The activated partial thromboplastin time(APTT) of plasma is tested when the most suitable magnetic field intensity is found. The results preliminarily show that this blood coagulation test method is valid and the corresponding test module has a potential value in business.

Long noncoding RNA ZEB1-AS1 acts as a Sponge of miR-141-3p to Inhibit Cell Proliferation in Colorectal Cancer.

Evidence shows that long noncoding RNAs (lncRNAs) play key roles in various cancers, including colorectal cancer. In this current study, we found that the expression of ZEB1-AS1 in colorectal cancer tissues and cell lines was significantly upregulated, and positively correlated with advanced stage of colorectal cancer. Kaplan-Meier assays also indicated that the expression of ZEB1-AS1 was correlated with poor prognosis in patients with colorectal cancer. Knocking down of ZEB1-AS1 inhibited the proliferation of colorectal cancer cells. Subcellular fractionation analyses suggested that ZEB1-AS1 was majorly distributed in cytoplasm of SW480 and LOVO cells. Thus, ZEB1-AS1 might act as a competing endogenous RNA. MicroRNA array analysis suggested that miR-141-3p was significantly downregulated in CRC tissues, which was further verified by RT-qPCR. The results of luciferase reporter assay proved that miR-141-3p was a target of ZEB1-AS1. Functionally, miR-141-3p inhibitor reversed the anti-proliferation effect of sh-ZEB1-AS1 on colorectal cancer cells. Collectively, ZEB1-AS1 may contribute to colorectal cancer cell proliferation by sponging miR-141-3p.

Metastasis suppressor protein 1 regulated by PTEN suppresses invasion, migration, and EMT of gastric carcinoma by inactivating PI3K/AKT signaling.

Epithelial-mesenchymal transition (EMT) is a crucial event for cancer progression and metastasis. Metastasis suppressor protein 1 (MTSS1) is a metastasis suppressor in several cancers. In this study, we elucidated the potential physiological function of MTSS1 in the invasion and migration of gastric cancer (GC), and its distinct role in EMT and subsequently determined the potential molecular mechanism. We observed that MTSS1 expression was downregulated in GC tissues and several GC cell lines (SGC-7901, MGC-803, MKN-28, MKN-45, and BGC-823). Importantly, forced expression of MTSS1 drastically diminished the cell viability in both SGC-7901 and MKN-45 cells. Moreover, overexpression of MTSS1 attenuated the invasion ability of these two cell lines. In addition to the invasive capability, introduction of MTSS1 led to a loss of migratory potential. Furthermore, augmentation of MTSS1 exhibited the typical EMT phenotype switch, accompanied by enhanced the expression of vimentin and N-cadherin and reduced E-cadherin expression. Interestingly, MTSS1 also repressed transforming growth factor beta 1 (TGF-ß1)-induced EMT. Our mechanistic investigations revealed that MTSS1 was positively regulated by the phosphatase and tensin homolog (PTEN), and it functioned as a tumor suppressor, possibly by inactivating the phosphoinositide 3-kinase (PI3K)/v-akt murine thymoma viral oncogene (AKT) pathway in GC cells. Collectively, our data provide insight into an important role for MTSS1 in suppressing tumor cell invasion, migration and EMT, which indicates that MTSS1 may act as a prospective prognostic biological marker and a promising therapeutic target for GC.

Stromal immunoglobulin κC expression is associated with initiation of breast cancer in TA2 mice and human breast cancer.

The initiation of spontaneous breast cancer (SBC) in Tientsin Albino 2 (TA2) mice is related to mouse mammary tumor virus (MMTV) infection, and MMTV amplification is hormonally regulated. To explore the insertion site of MMTVLTR in TA2 mouse genome, reverse PCR and nested PCR were used to amplify the unknown sequence on both sides of the MMTV-LTRSAG gene in SBC and normal breast tissue of TA2 mice. Furthermore, the clinicopathological significance of the insertion site was evaluated in 43 samples of normal breast tissue, 46 samples of breast cystic hyperplasia, 54 samples of ductal carcinoma in situ, 142 samples of primary breast cancer and 47 samples of lymph node metastatic breast cancer by RNA in situ hybridization. We confirmed that the insertion site of the MMTV-LTRSAG gene was located between Igκv2-112 and Igκv14-111 in chromosome 6 of TA2 mouse. IGκC was localized in the stromal cells of TA2 mouse with SBC and in human breast cancer tissues. Tumor cells were negative for IGκC in RNA in situ hybridization. The positive staining index of IGκC in stromal cells was the highest in lymph node metastatic breast cancer, followed by primary breast cancer, ductal carcinoma in situ, and breast cystic hyperplasia. Furthermore, the positive staining index of IGκC was related to the expression of ER, PR, HER2 and Ki-67. Our findings showed that stromal IGκC expression was associated with the initiation of SBC in TA2 mice. IGκC may be a high-risk factor for the initiation and progression of human breast cancer.

Iminium Ion and N-Hydroxyimide as the Surrogate Components in DEAD-Promoted Oxidative Ugi Variant.

A practical metal-free oxidative Ugi-type three-component assembly has been achieved efficiently, employing a tertiary-amine-derived iminium ion as an imine surrogate, N-hydroxyimide as an acid surrogate, and DEAD as an oxidant. This dual-surrogate Ugi variant proceeded with a broad substrate scope and desired functional group tolerance, leading to a wide range of N-alkyl- N-acyl aminophthalimide and N-alkyl- N-acylaminosuccinimide derivatives in good isolated yields.

A bubble-template approach for assembling Ni-Co oxide hollow microspheres with an enhanced electrochemical performance as an anode for lithium ion batteries.

Although significant advancements in the preparation of metal oxide hollow structures have been achieved, most synthesis routes have some complicated aspects such as requiring a hard-template, multistep procedures or other special reagents. This paper proposes a green and facile bubble-template approach to synthesize and organize Ni-Co hollow microspheres. The entire formation mechanism for the hollow spherical structures, including integration for nucleation, morphological tailoring and an Ostwald ripening process, has been elucidated based on time-dependent observations. The Ni-Co hollow microspheres revealed an excellent cycling stability (730 mA h g(-1) even after 140 cycles at 300 mA g(-1)) and good rate capability when evaluated as an anode material for lithium ion batteries (LIBs). The excellent electrochemical performance can be attributed to the rational design and organization of the hollow structures, which offer a large void space for accommodating volume changes, shorten the diffusion path for Li ions and electron transfer, as well as increase the contact area between the electrodes and electrolyte. Moreover, the synergistic effects of the nickel and cobalt ions with different lithiation potentials allowed the volume change to occur in a stepwise manner. The bubble-template strategy was convenient and very effective for constructing the hollow structures, and if well engineered, it could be extended to the synthesis of other advanced metal oxide anode materials for high energy storage devices and many other applications.

Ertapenem prophylaxis of surgical site infections in elective colorectal surgery in China: a multicentre, randomized, double-blind, active-controlled study.

OBJECTIVES: Our purpose was to evaluate ertapenem versus ceftriaxone/metronidazole for prophylaxis of surgical site infections (SSIs) following elective colorectal surgery in Chinese adult patients. METHODS: Eligible Chinese adults aged 18-80 years scheduled to undergo elective colorectal surgery by laparotomy were randomized to receive a 30 min infusion of 1 g of ertapenem/metronidazole placebo or 2 g of ceftriaxone/500 mg of metronidazole within 2 h before initial incision. The study endpoint was the proportion of patients with successful prophylaxis at 4 weeks after treatment. The primary analysis was based on the evaluable population (PP population) and the pre-specified non-inferiority margin was set at -15%. ClinicalTrials.gov: NCT01254344. RESULTS: Of 599 patients randomized, 499 (251 ertapenem and 248 ceftriaxone) were eligible for inclusion in the PP population. The proportions of patients with successful prophylaxis in the ertapenem and ceftriaxone groups were 90.4% (227/251) and 90.3% (224/248), respectively. The difference in the proportion of successful outcomes was 0.1% (95% CI -5.2%, 5.5%). Unexplained antibiotic use was the most frequent reason for prophylaxis failure in both groups [ertapenem 4.8% (12/251), ceftriaxone 4.4% (11/248); difference 0.3%; 95% CI -3.6, 4.3]. Pathogen species isolated from SSI sources were consistent with previously conducted studies and the product package insert. The incidence of adverse events (AEs) was similar between the groups, with the most common AE being pyrexia [ertapenem 7.6% (22/290), ceftriaxone 5.7% (17/297)]. CONCLUSIONS: Ertapenem is as effective as ceftriaxone/metronidazole for SSI prophylaxis in patients undergoing elective colorectal surgery, and is well tolerated.