Room-Temperature Self-Healing and Recyclable Self-Crosslinked Isosorbide-Based Adhesive Bioelastomer.

Recently, renewable bio-based materials have received more and more attention due to environmental issues such as global warming and ecosystem destruction. In the present work, a series of isosorbide-based bioelastomers poly(isosorbide carbonate-co-butanediol aliphatic esters)s (PICBAs) are synthesized by a facile and economical two-step melt polycondensation. Due to the slightly self-crosslinking reaction of isosorbide, PICBAs exhibit excellent tensile strength and self-healing ability, the mechanical properties of PICBAs can recover over 95% after 48 h under room temperature. In addition, PICBAs can stick different substances, such as glass, rubber, plastic, and stones, and show better adhesive performance than 3M commercially available double-sided tape. Consequently, isosorbide-based bioelastomers PICBAs are of great potential to be used as environmentally friendly pressure-sensitive adhesives (PSA) in the future.

Detoxification mechanisms of a combination of Semen Strychni and Radix Glycyrrhizae: A comparative analyses of differences in toxicokinetics and tissue distribution after oral administration of Semen Strychni-Radix Glycyrrhizae decoction.

To evaluate the detoxification effect of a combination of Radix Glycyrrhizae (GU) and Semen Strychni (SN) from toxicokinetics and drug tissue distribution perspectives, decoctions of processed SN and codecoction of SN and GU (SGN) were prepared, and an HPLC-ESI-MS/MS method was developed to monitor the severe exposure level in 1-month toxicokinetics and tissue distribution experiments to detect brucine and strychnine in rats. The toxicokinetic characteristics and tissue distribution before and after the addition of GU were analyzed. The method was successfully applied to evaluate the toxicokinetics and tissue distribution before and after the combination of SN and GU. The results show that GU decreased the blood concentration of toxic components in SN, and a double peak was observed in the drug time curve. The results of tissue distribution show that a combination of GU and SN significantly decreased the accumulation of toxic substances in metabolic organs and accelerated the clearance of toxic substances in the brain. These results provide a reference for the toxicity reduction mechanism of GU combined with SN.

Content Determination and Release Characteristics of Six Components in the Different Phases of "Glycyrrhizaglabra-Nux vomica" Decoction by UPLC-MS/MS.

The decoction turns into a complex multiphase system following exposure to high temperature and a complex chemical environment. However, the differences in the concentration of key active ingredients in different phase states and the release of drugs in sedimentary phase have yet to be elucidated. A simple ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed and validated for the simultaneous quantitative determination of brucine, strychnine, liquiritin, isoliquiritin, isoliquiritigenin and glycyrrhizic acid concentrations and it was applied to compare the content of different phases and measure the release characteristics of the sedimentary phase in "Glycyrrhiza glabra-Nux vomica" decoction (NGD). The results show that the method's selectivity, precision (intraday and interday ≤ 2%), matrix effect (101-108%), recovery and stability results were acceptable according to the guidelines. The method is sensitive and reliable. The content determination results show that the most toxic strychnine in the sedimentary phase accounted for 75.70% of the total components. The different components exhibited differential release in different media, and its components were released in the artificial intestinal fluid up to 81.02% in 12 h. Several components conformed to the primary kinetic model and the Ritger-Peppas model, and the most toxic compound exhibited slow release, thus conforming to the Ritger-Peppas model. This study provides a standard of reference for studies investigating reduction in toxicity of the combination of Glycyrrhiza glabra (Glycyrrhiza glabra L.) and Nux vomica (Strychnos nux-vomica L.).

Long-Term Survival Impact of High-Grade Complications after Liver Resection for Hepatocellular Carcinoma: A Retrospective Single-Centre Cohort Study.

Background and Objectives: Although complications after liver resection for hepatic cancer are common, the long-term impact of these complications on oncological outcomes remains unclear. This study aimed to investigate the potential effect of high-grade postoperative complications on long-term mortality and cancer recurrence after surgical resection of hepatocellular carcinoma. Materials and Methods: In a retrospective cohort study, patients undergoing curative liver resection for primary hepatocellular carcinoma between 2005 and 2016 were evaluated. The Clavien-Dindo (CD) grading system was used to classify patients into two groups of either high-grade complications (grade III or IV) or none or low-grade complications (grade 0 to II) within 30 days after surgery. The primary endpoint was all-cause mortality. Secondary endpoints were cancer-specific mortality and cancer recurrence. Weighted Cox proportional hazards regression models were used to calculate the adjusted hazard ratio (aHR) with a 95% confidence interval (CI) for the outcomes of interest. Results: A total of 1419 patients with a median follow-up time of 46.6 months were analysed. Among them, 93 (6.6%) developed high-grade complications after surgery. The most common complications were bile leakage (n = 30) in CD grade III and respiratory failure (n = 13) in CD grade IV. High-grade complications were significantly associated with all-cause mortality (aHR: 1.78, 95% CI: 1.55-2.06) and cancer-specific mortality (aHR: 1.34, 95% CI: 1.13-1.60), but not cancer recurrence (aHR: 0.92, 95% CI: 0.84-1.02). Independent influential factors for complications were sex, diabetes mellitus, clinically significant portal hypertension, oesophageal varices, multifocal cancer, intraoperative blood loss, and anaesthesia duration. Conclusions: Patients who had high-grade postoperative complications had a greater risk of long-term mortality after liver resection for hepatocellular carcinoma. Prevention of postoperative complications may serve as an effective strategy for improving long-term survival.

New Mechanism of Gemcitabine and Its Phosphates: DNA Polymerization Disruption via 3'-5' Exonuclease Inhibition.

Gemcitabine (dFdC), a modified deoxycytidine (dC) widely used in tumor treatment, is a prodrug that is phosphorylated to generate mono-, di-, and triphosphates. The triphosphate (dFdCTP) is incorporated into DNA to terminate DNA synthesis in cancer. Some incorporated dFdC nucleotides can be partially removed by the 3'-5' exonuclease activity, namely its editing function, and the others escape the editing. However, whether there is an active mechanism for dFdC to escape the editing remains unclear. We have first discovered that unlike dFdC, its mono-, di-, and triphosphates can inhibit the 3'-5' exonuclease of DNA polymerase I, suppress editing, and allow the active escaping mechanism, whereas its polymerase activity is not remarkably affected. As such, these phosphates can prevent the removal of the incorporated dFdC residue, thereby actively blocking DNA extension and synthesis. The inhibition efficiency of these phosphates follows the increased order of the mono-, di-, and triphosphates of gemcitabine (dFdC < dFdCMP < dFdCDP < dFdCTP). In addition, after the deletion of the 3'-5' exonuclease of cellular DNA polymerase I, the Escherichia coli mutant is more sensitive to dFdCTP than is wild-type E. coli. Our new discovery of the ability of these dFdC phosphates to inhibit exonuclease activity suggests a novel anticancer mechanism of gemcitabine and its phosphate derivatives.

High-accuracy vibration sensor based on a Fabry-Perot interferometer with active phase-tracking technology.

A novel position-sensitive Fabry-Perot interferometer was constructed with direct phase modulation by a built-in electro-optic modulator. Pure sinusoidal phase modulation of the light was produced, and the first harmonic of the interference signal was extracted to dynamically maintain the interferometer phase to the most sensitive point of the interferogram. Therefore, the minute vibration of the object was coded on the variation of the interference signal and could be directly retrieved by the output voltage of a photodetector. The operating principle and the signal processing method for active feedback control of the interference phase have been demonstrated in detail. The developed vibration sensor was calibrated through a high-precision piezo-electric transducer and tested by a nano-positioning stage under a vibration magnitude of 60 nm and a frequency of 300 Hz. The active phase-tracking method of the system provides high immunity against environmental disturbances. Experimental results show that the proposed interferometer can effectively reconstruct tiny vibration waveforms with subnanometer resolution, paving the way for high-accuracy vibration sensing, especially for micro-electro-mechanical systems/nano-electro-mechanical systems and ultrasonic devices.

Functionally responsive hydrogels with salt-alkali sensitivity effectively target soil amelioration.

The long-standing crisis of soil salinization and alkalization poses a significant challenge to global agricultural development. High soil salinity-alkalinity, water dispersion, and nutrient loss present major hurdles to soil improvement. Novel environmentally friendly gels have demonstrated excellent water retention and slow-release capabilities in agricultural enhancement. However, their application for improving saline-alkali soil is both scarce and competitive. This study proposes a new strategy for regulating saline-alkali soil using gel-coated controlled-release soil modifiers (CWR-SRMs), where radical-polymerized gels are embedded on the surface of composite gel beads through spray coating. Characterization and performance analysis reveal that the three-dimensional spatial network structure rich in hydrophilic groups exhibits good thermal stability (first-stage weight loss temperature of 257.7 °C in thermogravimetric analysis) and encapsulation efficiency for fulvic acid­potassium (FA-K), which can enhance soil quality in saline-alkali environments. The molecular chain relaxation under saline-alkali conditions promotes a synergistic effect of swelling and slow release, endowing it with qualifications as a water reservoir, Ca2+ source unit, and slow-release body. The results of a 6 weeks incubation experiment on 0-20 cm saline-alkaline soil with different application gradients showed that the gradient content had a significant effect on the soil improvement effect. Specifically, the T2 (the dosage accounted for 1 % of soil mass) treatment significantly increases water retention (30 % ~ 90 %), and nutrient levels (30 % ~ 50 %), while significantly decreasing soil sodium colloid content (30 % ~ 60 %) and soil pH (10 % ~ 15 %). Furthermore, PCA analysis indicates that the addition of 1 % CWR-SRMs as amendments can significantly adjust the negative aspects of soil salinity and alkalinity. This highlights the excellent applicability of CWR-SRMs in improving saline-alkali agricultural ecosystems, demonstrating the potential value of novel environmentally friendly gels as an alternative solution for soil challenges persistently affected by adverse salinity and alkalinity.

Enhancing the Mn-Removal Efficiency of Acid-Mine Bacterial Consortium: Performance Optimization and Mechanism Study.

In this study, an acclimated manganese-oxidizing bacteria (MnOB) consortium, QBS-1, was enriched in an acid mine area; then, it was used to eliminate Mn(Ⅱ) in different types of wastewater. QBS-1 presented excellent Mn removal performance between pH 4.0 and 8.0, and the best Mn-removal efficiency was up to 99.86% after response surface methodology optimization. Unlike other MnOB consortia, the core bacteria of QBS-1 were Stenotrophomonas and Achromobacter, which might play vital roles in Mn removal. Besides that, adsorption, co-precipitation and electrostatic binding by biological manganese oxides could further promote Mn elimination. Finally, the performance of the Mn biofilter demonstrated that QBS-1 was an excellent inoculant, which indicates good potential for removing Mn contamination steadily and efficiently.

Scaling Solute-Solvent Distances to Improve Solubility and Ion Paring Predictions in Rigid Ion Models.

Force fields based on the rigid ion model (RIM) have been developed to accurately predict the various physical and chemical properties of salts and water. However, the combined use of these models often fails to accurately predict the solubility of salts in water. To address this issue, several approaches, such as charge scaling or reparameterization, have been proposed. Nevertheless, these methods require laborious reparameterization of nonbonded force field parameters. In this article, we propose a scaling solute-solvent distance (SSSD) method to improve force fields in predicting salt solubility without changing the solute-solute and solvent-solvent interactions in the original force fields. This method can also tune the ion pairing of salt in water. One main advantage of the SSSD method is that reparameterization of the crystal and water models is not needed. We use two RIMs for the NaCl-water system (JC-SPC/E and SD-SPC/E) and the CHARMM force field for the KCl-water system to demonstrate the improved accuracy in predicting solubility by the SSSD method. Furthermore, we use the RDG-SPC/Fw force field to show that the SSSD method can also be used to tune the ion pairing of CaCO3 in water. Limitations of this method are also discussed.

Anisotropy in Near-Spherical Colloidal Nanoparticles.

Two major aspects of functional colloidal nanoparticles are their colloidal stability (dispersion) and controlled assembly of nanoparticles into ordered structures. Simplifying colloidal nanoparticles as isotropically interacting spheres is unsuitable for small nanoparticles capped with hydrocarbon chain ligands in which the ligand-ligand interaction plays a prominent role in the assembly processes. However, experimentally characterizing the ligand shell structure in solution presents significant challenges, and computer simulations yield divergent results without effective validation. Moreover, the connection between detailed information regarding ligand shell structures and interparticle interactions, in relation to the diverse dynamical behaviors of colloidal nanoparticles, remains poorly understood. In this study, we reveal the relationship between the ligand shell structures, interparticle interactions, and dynamical behaviors of few-nm-sized near-spherical nanoparticles capped with hydrocarbon chain ligands immersed in nonpolar solvents. Our study shows a transformation of the interparticle interactions from anisotropic attractions to isotropic repulsions as a result of the change in the ligand shell structures from order to disorder caused by varying temperature and other factors. The interplay between anisotropic attractions from ligand bundles and isotropic repulsions from disordered ligands dictates the nanoparticle dynamical behaviors of dispersion, uncontrolled aggregation, and controlled assembly.

Suppression of Cancer Cell Stemness and Drug Resistance via MYC Destabilization by Deubiquitinase USP45 Inhibition with a Natural Small Molecule.

Cancer stem cells (CSCs) play significant roles in cancer development, drug resistance and cancer recurrence. In cancer treatments based on the CSC characteristics and inducing factors, MYC is a promising target for therapeutic molecules. Although it has been regarded as an undrugable target, its stability tightly regulated by the ubiquitin-proteasome system offers a new direction for molecule targeting and cancer treatment. Herein we report our discoveries in this research area, and we have found that deubiquitinase USP45 can directly bind with MYC, resulting in its deubiquitination and stabilization. Further, USP45 overexpressing can upregulate MYC, and this overexpressing can significantly enhance cancer development, cancer cell stemness and drug resistance. Interestingly, without enhancing cancer development, MYC silencing with shRNA can only suppress USP45-induced stemness and drug resistance. Moreover, we have identified that USP45 can be specifically bound and inhibited by a natural small molecule (α-mangostin), in turn significantly suppressing USP45-induced stemness and drug resistance. Since USP45 is significantly expressed in cervical tumors, we have discovered that the combination of α-mangostin and doxorubicin can significantly inhibit USP45-induced cervical tumorigenesis in an animal model. In general, on the basis of our USP45 discoveries on its MYC deubiquitination and α-mangostin inhibition, suppressing USP45 has opened a new window for suppressing cancer development, stemness and drug resistance.

Precipitation Law of Vanadium in Microalloyed Steel and Its Performance Influencing Factors.

Based on theoretical calculations, laboratory simulation research and industrial production data analysis combined with characterisations such as metallographic microscope, scanning electron microscope (SEM), transmission electron microscope (TEM) and microhardness testing, this study investigated the state of occurrence and the precipitation law of vanadium (V) in microalloyed steel to determine a reasonable production process for V microalloyed steel. The results showed that the V(C,N) precipitation phase was the main form of V in microalloyed steel that precipitated after the transformation of austenite to ferrite. The amount of V precipitation was positively correlated with the amount of V that was added. However, the precipitation temperature was not significantly correlated with the amount added. When the V content increased from 0.03% to 0.06%, the initial precipitation temperature only increased by 23 °C. The coiling temperature was identified as the core factor affecting the strength of V microalloyed steel. When the effects of precipitation strengthening and microstructure strengthening were considered, as the coiling temperature decreased, the strength first increased, then decreased and finally increased again. Under different processing conditions, the strengthening of vanadium in the material increased first and then decreased as the temperature decreased (700-200 °C). The corresponding temperatures for the best strengthening effect of aging treatment, industrial statistical data and simulating coiling were 550, 470 and 400 °C, respectively. The difference between laboratory research results and industrial production was found. When V precipitation strengthening was used to improve material properties, it was necessary to determine a reasonable quantity of V to add and the production process, according to different alloy systems, to make more effective use of V microalloyed resources.

Ca and Cu doped LaFeO3 to promote coupling of photon carriers and redox cycling for facile photo-Fenton degradation of bisphenol A.

Enhancements in the light response and hydrogen peroxide utilization are critical to the catalytic performance of heterogeneous Fenton-like perovskites. Here, in this research, oxygen vacancy-enriched La0.9Ca0.1Cu0.5Fe0.5O3-δ was prepared by a co-precipitation method with Cu substitution and Ca doping and demonstrated excellent performance for the degradation of bisphenol A. Both total organic carbon (TOC) removal and hydrogen peroxide utilization were close to 90% within 120 min at pH 3-7, where the TOC removal and hydrogen peroxide utilization were 2.5 times and 5.5 times of LaFeO3 in the absence of Ca and Cu doping. It demonstrated excellent stability to light irradiation and oxidation with respect to cycling and metal ion leaching. This revealed that oxygen vacancies were enriched in the catalyst with the substitution of Ca and Cu and contributed to the recombination of photogenerated electrons, thereby increasing the reduction efficiency of copper ions and accelerating the redox cycling of iron ions.

A comparison of high-flow nasal cannula and standard facemask as pre-oxygenation technique for general anesthesia: A PRISMA-compliant systemic review and meta-analysis.

BACKGROUND: Current practice guidelines recommend the use of nasal cannula as an alternative pre-oxygenation method for tracheal intubation. However, the efficacy of high-flow nasal oxygenation versus standard facemask oxygenation has not been fully evaluated. METHODS: We searched PubMed, Cochrane Library, and ClinicalTrials.gov for English-language studies published from January 1, 2000 to November 30, 2021. We included randomized controlled trials which compared high-flow nasal oxygenation and facemask oxygenation as the pre-oxygenation maneuver. Primary outcome was arterial partial pressure of oxygen (PaO2) after pre-oxygenation. Secondary outcomes were safe apnea time, arterial desaturation during intubation, lowest peripheral capillary oxygen saturation during intubation, and patient comfort score. Random-effects models and Mantel-Haenszel method were used for data synthesis. RESULTS: A total of 16 randomized controlled trials and 1148 patients were included. High-flow nasal oxygenation achieved a higher PaO2 compared with facemask, mean difference: 64.86 mm Hg (95% confidence interval [CI]: 32.33-97.40, P < .0001). Safe apnea time was longer in high-flow nasal oxygenation, mean difference: 131.03 seconds (95% CI: 59.39-202.66, P < .0001). There was no difference in the risk of peri-intubation desaturation or lowest peripheral capillary oxygen saturation between groups. Patient comfort score was higher in high-flow nasal oxygenation, mean difference: 1.00 (95% CI: 0.46-1.54, P = .0003). CONCLUSION: High-flow nasal oxygenation better enhanced PaO2 and extended safe apnea time and is not inferior to facemask oxygenation in preventing desaturation during tracheal intubation. High-flow nasal oxygenation may be considered as an alternative method, especially for patients with a potential difficult airway.

Dose-response relationship between epidural bupivacaine dose and mortality risk after surgical resection of nonsmall-cell lung cancer.

BACKGROUND: Preclinical studies have shown that local anesthetics may modify the growth and invasion of cancer cells. However, few clinical studies have evaluated their impact on cancer outcomes after tumor resection. METHODS: In this single-center cohort study, patients who underwent surgical resection of stage IA through IIIB nonsmall-cell lung cancer and used patient-controlled epidural analgesia from 2005 to 2015 were recruited and followed until May 2017. Data of the epidural bupivacaine dose for each patient were obtained from infusion pump machines. Proportional hazards regression models were used to analyze the associations between bupivacaine dose with postoperative cancer recurrence and all-cause mortality. RESULTS: A total of 464 patients were analyzed. Among these patients, the mean bupivacaine dose was 352 mg (± standard deviation 74 mg). After adjusting for important clinical and pathological covariates, a significant dose-response relationship was observed between epidural bupivacaine dose and all-cause mortality (adjusted hazard ratio: 1.008, 95% confidence interval: 1.001-1.016, p = 0.029). The association between bupivacaine dose and cancer recurrence were not significant (adjusted hazard ratio: 1.000, 95% confidence interval: 0.997-1.002, p = 0.771). Age, sex, body mass index, mean daily maximum pain score, and pathological perineural infiltration were independently associated with bupivacaine dose. CONCLUSION: A dose-dependent association was found between epidural bupivacaine dose and long-term mortality among patients following surgical resection of nonsmall-cell lung cancer. Our findings do not support the hypothetical anticancer benefits of local anesthetics. More studies are needed to elucidate the role of local anesthetics in cancer treatment.

The Association between General Anesthesia and New Postoperative Uses of Sedative-Hypnotics: A Nationwide Matched Cohort Study.

Sedative−hypnotic misuse is associated with psychiatric diseases and overdose deaths. It remains uncertain whether types of anesthesia affect the occurrence of new postoperative uses of sedative−hypnotics (NPUSH). We used reimbursement claims data of Taiwan's National Health Insurance and conducted propensity score matching to compare the risk of NPUSH between general and neuraxial anesthesia among surgical patients who had no prescription of oral sedative−hypnotics or diagnosis of sleep disorders within the 12 months before surgery. The primary outcome was NPUSH within 180 days after surgery. Multivariable logistic regression models were used to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI). A total of 92,222 patients were evaluated after matching. Among them, 15,016 (16.3%) had NPUSH, and 2183 (4.7%) were made a concomitant diagnosis of sleep disorders. General anesthesia was significantly associated both with NPUSH (aOR: 1.17, 95% CI: 1.13−1.22, p < 0.0001) and NPUSH with sleep disorders (aOR: 1.11, 95% CI: 1.02−1.21, p = 0.0212) compared with neuraxial anesthesia. General anesthesia was also linked to NPUSH that occurred 90−180 days after surgery (aOR: 1.12, 95% CI: 1.06−1.19, p = 0.0002). Other risk factors for NPUSH were older age, female, lower insurance premium, orthopedic surgery, specific coexisting diseases (e.g., anxiety disorder), concurrent medications (e.g., systemic steroids), postoperative complications, perioperative blood transfusions, and admission to an intensive care unit. Patients undergoing general anesthesia had an increased risk of NPUSH compared with neuraxial anesthesia. This finding may provide an implication in risk stratification and prevention for sedative−hypnotic dependence after surgery.

A Non-Isocyanate Route to Poly(Ether Urethane): Synthesis and Effect of Chemical Structures of Hard Segment.

A series of non-isocyanate poly(ether urethane) (PEU) were prepared by an environmentally friendly route based on dimethyl carbonate, diols and a polyether. The effect of the chemical structure of polyurethane hard segments on the properties of this kind of PEU was systematically investigated in this work. Polyurethane hard segments with different structures were first prepared from hexamethylene di-carbamate (BHC) and different diols (butanediol, hexanediol, octanediol and decanediol). Subsequently, a series of non-isocyanate PEU were obtained by polycondensation of the polyurethane hard segments with the polyether soft segments (PTMG2000). The PEU were characterized by GPC, FT-IR, 1H NMR, DSC, WAXD, SAXS, AFM and tensile testing. The results show that the urea groups generated by the side reaction affect the degree of crystallization of hard segments by influencing the hydrogen bonding of the hard segments molecular chains. The degree of hard segment crystallization, in turn, affects the thermal and mechanical properties of the polymer. The urea group content is related to the carbon chain length of the diol used for the synthesis of hard segments. When butanediol is applied to synthesize hard segment, the hard segment of the resulting PEU is unable to crystallize. Therefore, the tensile strength and modulus of elasticity of butanediol-based PEU is lowest among three, though it possesses the highest urea group content. When longer octanediol or decanediol is applied to synthesize the hard segment, the hard segments in the resulting polyether-based polyurethane are crystallizable and the resulting PEU possesses higher tensile strength.

Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial.

The clinical efficacy of spectral entropy monitoring in improving postoperative recovery remains unclear. This trial aimed to investigate the impact of M-Entropy (GE Healthcare, Helsinki, Finland) guidance on emergence from anesthesia and postoperative delirium in thoracic surgery. Adult patients undergoing video-assisted thoracoscopic surgery for lung resection at a medical center were randomly allocated into the M-Entropy guidance group (n = 39) and the control group (n = 37). In the M-Entropy guidance group, sevoflurane anesthesia was titrated to maintain response and state entropy values between 40 and 60 intraoperatively. In the control group, the dosing of sevoflurane was adjusted based on clinical judgment and vital signs. The primary outcome was time to spontaneous eye opening. M-Entropy guidance significantly reduced the time proportion of deep anesthesia (entropy value <40) during surgery, mean difference: −21.5% (95% confidence interval (CI): −32.7 to −10.3) for response entropy and −24.2% (−36.3 to −12.2) for state entropy. M-Entropy guidance significantly shortened time to spontaneous eye opening compared to clinical signs, mean difference: −154 s (95% CI: −259 to −49). In addition, patients of the M-Entropy group had a lower rate of emergence agitation (absolute risk reduction: 0.166, 95% CI: 0.005−0.328) and delirium (0.245, 0.093−0.396) at the postanesthesia care unit. M-Entropy-guided anesthesia hastened awakening and potentially prevented emergence agitation and delirium after thoracic surgery. These results may provide an implication for facilitating postoperative recovery and reducing the complications associated with delayed emergence and delirium.

A Comparison of Oxygenation Efficacy between High-Flow Nasal Cannulas and Standard Facemasks during Elective Tracheal Intubation for Patients with Obesity: A Randomized Controlled Trial.

Obese patients are predisposed to rapid oxygen desaturation during tracheal intubation. We aimed to compare the risk of desaturation between high-flow nasal oxygenation (HFNO) and classical facemask oxygenation (FMO) during rapid sequence intubation for elective surgery in obese patients. Adults with a body mass index ≥30 kg·m−2 undergoing laparoscopic sleeve gastrectomy at a medical center were randomized into the HFNO group (n = 40) and FMO group (n = 40). In the HFNO group, patients used a high-flow nasal cannula to receive 30 to 50 L·min−1 flow of heated and humidified 100% oxygen. In the FMO group, patients received a fitting facemask with 15 L·min−1 flow of 100% oxygen. After 5-min preoxygenation, rapid sequence intubation was performed. The primary outcome was arterial desaturation during intubation, defined as a peripheral capillary oxygen saturation (SpO2) <92%. The risk of peri-intubation desaturation was significantly lower in the HFNO group compared to the FMO group; absolute risk reduction: 0.20 (95% confidence interval: 0.05−0.35, p = 0.0122); number needed to treat: 5. The lowest SpO2 during intubation was significantly increased by HFNO (median 99%, interquartile range: 97−100) compared to FMO (96, 92−100, p = 0.0150). HFNO achieved a higher partial pressure of arterial oxygen (PaO2) compared to FMO, with medians of 476 mmHg (interquartile range: 390−541) and 397 (351−456, p = 0.0010), respectively. There was no difference in patients' comfort level between groups. Compared with standard FMO, HFNO with apneic oxygenation reduced arterial desaturation during tracheal intubation and enhanced PaO2 among patients with obesity.

Mannose modified zwitterionic polyester-conjugated second near-infrared organic fluorophore for targeted photothermal therapy.

Cancer resistance has been the huge challenge to clinical treatment. A photothermal therapy of second near-infrared (NIR-II) organic dye small molecule has been used to conquer the cancer resistance. However, the available NIR-II dye lacks selectivity and spreads throughout the body. It has toxicity and indiscriminate burn injuries normal cells and tissues during therapy. Hence, to improve the therapeutic outcomes, herein, for the first time, we report the mannose-modified zwitterionic nanoparticles loading IR1048 dye, aiming to overcome cancer cellular resistance. The targeting molecule mannose has been applied to modify zwitterionic polyester, and the obtained polyester is employed to load IR1048 to prolong the circulation time in the blood and improve the stability of loaded dye, due to the good cytocompatibility of polyester and the antifouling properties of zwitterions. In vitro experimental results show that the pH-responsive targeted nanoparticles display satisfactory photophysical properties, prominent photothermal conversion efficiency (44.07%), excellent photothermal stability, negligible cytotoxicity for normal cells and strong photothermal toxicity to drug-resistant cancer cells. Moreover, due to the mannose targeting effect, cancer cells can endocytose the nanoparticles effectively. All these results demonstrate potential application of this alternative hyperthermal delivery system with remote-controllable photothermal therapy of tumor for accurate diagnosis by NIR-II fluorescence imaging.