Effect of Intraoperative Infusion of Esketamine on Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Bariatric Surgery: A Randomized Controlled Trial.

INTRODUCTION: This study aims to evaluate the efficacy of esketamine on postoperative recovery quality after laparoscopic bariatric surgery. METHODS: Patients (n = 74) scheduled for laparoscopic bariatric surgery were randomly divided into two groups: the esketamine group (group E: 0.5 mg/kg/h infusion, i.e., 0.2 mL/kg/h) or the control group (group C: 0.2 mL/kg/h normal saline infusion). The infusions were stopped 20 min before the end of the procedure. The primary outcome was the Quality of Recovery-40 (QoR-40) score on postoperative day 1 (POD 1). The secondary outcomes included QoR-40 scores on PODs 2 and 7, Numeric Rating Scale (NRS) on PODs 1, 2, and 7, time to extubation, additional postoperative analgesic use, length of hospital stay, and time to first exhaust. Additonally, the safety indices were also recorded, including hemodynamic profile, perioperative anesthesia index (Ai), utilization of vasoactive drugs or urapidil, and side effects. RESULTS: All in all, 70 of the 74 patients completed the study, 35 in each group. The difference of QoR-40 scores on POD 1 was both statistically and clinically significant [difference 7.21, 95% confidence interval (CI) 5.17, 9.25, p < 0.001]. The difference of QoR-40 on POD 2 was statistically significant but clinically insignificant (difference 4.81, 95% CI 2.69, 6.92, p < 0.001). The difference of NRS scores on POD 1 was statistically significant (difference -1.23, 95% CI -2.36, -0.10, p = 0.033). Compared with group C, group E had a lower utilization rate of phenylephrine and higher Ai values (p < 0.05). There was no statistical difference between the two groups on other measures. CONCLUSION: Continuous ketamine infusion seems to be safe and well tolerated in laparoscopic bariatric surgery. It improved the quality of postoperative recovery and reduced pain on POD 1. In spite of the increased Ai value during the surgery, it also provided better hemodynamics with less usage of phenylephrine.

Investigating the association between maternal childbirth intention, labor epidural analgesia, and postpartum depression: A prospective cohort study.

BACKGROUND: Postpartum depression (PPD) is a general depressive episode after childbirth. Studies have shown that unmatched analgesic intention increases the risk of PPD, but the use of labor epidural analgesia (LEA) during childbirth can reduce this risk. We aimed to investigate the association between maternal childbirth intention, LEA, and PPD and risk factors that may be related to PPD. METHODS: A total of 590 mothers were included in this prospective cohort study. Demographic, prenatal, intrapartum and postpartum data were recorded. We investigated the association between childbirth intention, LEA and PPD and assessed the interactions between two factors. Logistic regression analysis was used to screen variables that might be associated with the occurrence of PPD. RESULTS: Overall, 130 of 451 women completing the study at 3 months had PPD (28.8 %). We did not find an association between unmatched childbirth intention, use of LEA and PPD (adjustOR = 0.684 CI 0.335-1.396, p = 0.296; adjustOR = 0.892, CI 0.508-1.565, p = 0.690). Chronic pain affecting daily life, prenatal EPDS, SAS, SSRS score, family accompaniment during labor, and 1-day numerical rating scale (NRS) score were significantly associated with PPD (p < 0.05). LIMITATIONS: In the 3-month follow-up, we only recorded the EPDS score, not the pain score, and did not evaluate the association between postpartum chronic pain and PPD. CONCLUSIONS: The association between maternal childbirth intention, LEA and PPD was not significant. Chronic pain affecting daily life, prenatal EPDS, SAS, SSRS score, family accompaniment during labor, and 1-day NRS score were significantly related to the occurrence of PPD (p < 0.05).

Exploring associations between postpartum depression and oxytocin levels in cerebrospinal fluid, plasma and saliva.

BACKGROUND: Postpartum depression (PPD) is a serious mental health concern affecting approximately 17.22 % of new mothers worldwide. In addition to its obstetric effects, oxytocin (OXT) has also been considered to play a role in PPD. However, most previous studies exploring associations between PPD and OXT levels focus on easier accessible compartments such as blood or saliva. STUDY AIM: To explore the possible association between PPD and OXT levels, and to assess the interaction between peripheral secretion and central release of OXT. METHODS: In this study, we prospectively measured OXT concentrations in cerebrospinal fluid (CSF), plasma and saliva of 94 women with elective cesarean section by enzyme-linked immunosorbent assay (ELISA) kits. The participants were divided into the PPD group if the score of Edinburgh Postpartum Depression Scale (EPDS) ≥ 10 at 3 months postpartum, otherwise into the non-PPD (nPPD) group. RESULTS: The incidence of PPD was 30.85 %. OXT concentrations in CSF (r = -0.518, p < 0.001), plasma (r = -0.240, p = 0.020) and saliva (r = -0.263, p = 0.010) were negatively correlated with EPDS score, and were valuable for the prediction of PPD, with AUC and 95%CI of 0.890 (0.809-0.945), 0.683 (0.579-0.775) and 0.699 (0.596-0.790), respectively. Moreover, OXT concentrations in plasma (r = 0.407, p < 0.001) and saliva (r = 0.624, p < 0.001) were positively correlated with CSF OXT concentrations. LIMITATIONS: Only full-term pregnant women undergoing elective cesarean section were included in this study, which may affect study generalizability. CONCLUSIONS: The central and peripheral release of OXT is coordinated, and OXT level measured prenatally in CSF, plasma, or saliva is valuable for the prediction of PPD.

Graphene-carbon 2D heterostructures with hierarchically-porous P,N-doped layered architecture for capacitive deionization.

Exploring a new-family of carbon-based desalinators to optimize their performances beyond the current commercial benchmark is of significance for the development of practically useful capacitive deionization (CDI) materials. Here, we have fabricated a hierarchically porous N,P-doped carbon-graphene 2D heterostructure (denoted NPC/rGO) by using metal-organic framework (MOF)-nanoparticle-driven assembly on graphene oxide (GO) nanosheets followed by stepwise pyrolysis and phosphorization procedures. The resulting NPC/rGO-based CDI desalinator exhibits ultrahigh deionization performance with a salt adsorption capacity of 39.34 mg g-1 in a 1000 mg L-1 NaCl solution at 1.2 V over 30 min with good cycling stability over 50 cycles. The excellent performance is attributed to the high specific surface area, high conductivity, favorable meso-/microporous structure together with nitrogen and phosphorus heteroatom co-doping, all of which are beneficial for the accommodation of ions and charge transport during the CDI process. More importantly, NPC/rGO exhibits a state-of-the-art CDI performance compared to the commercial benchmark and most of the previously reported carbon materials, highlighting the significance of the MOF nanoparticle-driven assembly strategy and graphene-carbon 2D heterostructures for CDI applications.

Comparison of the photocatalytic performance of TiO2/AC and TiO2/CNT nanocomposites for methyl orange photodegradation.

To enhance the photocatalytic degradation efficiency of TiO2 on methyl orange (MO) removal, TiO2/AC (activated carbon) and TiO2/CNT (carbon nanotube) composites were synthesized. The prepared catalysts were characterized by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared spectroscopy (FTIR). The photocatalytic performance of the obtained composites were investigated by the degradation of MO under UV irradiation (254 nm, 365 nm). The results revealed that the prepared nanocomposite showed higher MO degradation efficiency than pure nano-TiO2. Additionally, batch experiments of influencing factors, including H2O2 dosage, metal dopants, inorganic anions, chloride ion concentration and ultraviolet wavelength on the MO removal efficiency were also conducted. The results demonstrated that metal dopant and the presence of H2O2 significantly enhanced MO removal efficiency.

Synthesis of ZnWO4/Ag3PO4 p-n heterojunction photocatalyst and enhanced visible-light photocatalytic applications.

The ZnWO4/Ag3PO4 nanocomposites synthesized by simple precipitation processes were characterized by powder X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), high-resolution transmission electron microscopy (HRTEM) and UV-vis diffuse reflectance spectra. The results indicated that the ZnWO4 nanorods dispersed well on the surface of Ag3PO4 particles and ball-and-rod structure p-n heterojunctions were successfully fabricated. In subsequent degradation experiments of methyl orange (MO), ZnWO4/Ag3PO4 composites showed the highest photocatalytic activity compared to pure Ag3PO4 and ZnWO4, due to the presence of ZnWO4/Ag3PO4 heterojunctions, which could separate and transfer the electron-hole pairs generated by visible light and enhance the photocatalytic performance of the catalysts. The band gap structure and degradation mechanism of the enhanced photocatalytic materials are also discussed in this article. In conclusion, the ZnWO4/Ag3PO4 composite is a promising and excellent photocatalyst for the degradation of dye wastewater under visible light irradiation.