Efficacy of intraoperative thoracoscopic intercostal nerve blocks in nonintubated and intubated video-assisted thoracic surgery: A randomized study.

BACKGROUND: The efficacy of thoracoscopic intercostal nerve blocks (TINBs) for noxious stimulation from video-assisted thoracic surgery (VATS) remains unclear. The efficacy of TINBs may also be different between nonintubated VATS (NIVATS) and intubated VATS (IVATS). We aim to compare the efficacy of TINBs on analgesia and sedation for NIVATS and IVATs intraoperatively. METHODS: Sixty patients randomized to the NIVATS or IVATS group (30 each) received target-controlled propofol and remifentanil infusions, with bispectral index (BIS) maintained at 40-60, and multilevel (T3-T8) TINBs before surgical manipulations. Intraoperative monitoring data, including pulse oximetry, mean arterial pressure (MAP), heart rate, BIS, density spectral arrays (DSAs), and propofol and remifentanil effect-site concentration (Ce) at different time points. A two way ANOVA with post hoc analysis was applied to analyze the differences and interactions of groups and time points. RESULTS: In both groups, DSA monitoring revealed burst suppression and α dropout immediately after the TINBs. The Ce of the propofol infusion had to be reduced within 5 min post-TINBs in both NIVATS (p < 0.001) and IVATS (p = 0.252) groups. The Ce of remifentanil infusion was significantly reduced after TINBs in both groups (p < 0.001), and was significantly lower in NIVATS (p < 0.001) without group interactions. CONCLUSION: The surgeon-performed intraoperative multilevel TINBs allow reduced anesthetic and analgesic requirement for VATS. With lower requirement of remifentanil infusion, NIVATS presents a significantly higher risk of hypotension after TINBs. DSA is beneficial for providing real-time data that facilitate the preemptive management, especially for NIVATS.

Spray-Printed Flexible Li2S Cathode with Inorganic Ion-Conductive Binder Nano-Li3PS4.

Flexible solid-state batteries fabricated by printing techniques are promising integrated power supplies for miniaturized and customized electronic devices. While typically these batteries use polymer solid electrolytes, a flexible Li2S cathode with sulfide solid electrolyte is spray-printed in this work, by using solvated Li3PS4 nanoparticles as inorganic ion-conductive binder. This benefits from a novel low-temperature-sintering property of these nanoparticles, which can be pressure-free densified, along with the desolvation process, and thus bind the cathode at 250 °C. The battery can be stably charged and discharged for 300 cycles with no stacking pressure, and the capacity maintains at 840 mA h gLi2 S-1. We believe this low-temperature-sintering phenomenon of solid electrolyte nanoparticles will open a new path toward the application of sulfide solid electrolytes in printed solid-state batteries.

Small interfering RNA targeted to secretory clusterin blocks tumor growth, motility, and invasion in breast cancer.

Clusterin/apolipoprotein J (Clu) is a ubiquitously expressed secreted heterodimeric glycoprotein that is implicated in several physiological processes. It has been reported that the elevated level of secreted clusterin (sClu) protein is associated with poor survival in breast cancer patients and can induce metastasis in rodent models. In this study, we investigated the effects of sClu inhibition with small interfering RNAs (siRNAs) on cell motility, invasion, and growth in vitro and in vivo. MDA-MB-231 cells were transfected with pSuper-siRNA/sClu. Cell survival and proliferation were examined by 3-(4,5-dimethyl-thiazol-2yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium and clonogenic survival assay. The results showed that sClu silencing significantly inhibited the proliferation of MDA-MB-231 cells. The invasion and migration ability were also dramatically decreased, which was detected by matrigel assays. TUNEL staining and caspase-3 activity assay demonstrated that sClu silencing also could increase the apoptosis rate of cells, resulting in the inhibition of cell growth. We also determined the effects of sClu silencing on tumor growth and metastatic progression in an orthotopic breast cancer model. The results showed that orthotopic primary tumors derived from MDA-MB-231/pSuper sClu siRNA cells grew significantly slower than tumors derived from parental MDA-MB-231 or MDA-MB-231/pSuper scramble siRNA cells, and metastasize less to the lungs. These data suggest that secretory clusterin plays a significant role in tumor growth and metastatic progression. Knocking-down sClu gene expression may provide a valuable method for breast cancer therapy.

Improving Cycling Stability of the Lithium Anode by a Spin-Coated High-Purity Li3PS4 Artificial SEI Layer.

Controlling the composition and microstructure of the solid electrolyte interphase (SEI) layer is critical to improving the cycling stability of the high-energy-density lithium-metal electrode. It is a quite tricky task to control the properties of the SEI layer which is conventionally formed by the chemical reactions between a Li metal and the additives. Herein, we develop a new route to synthesize a lithium-compatible sol of the sulfide electrolyte Li3PS4, so that a Li3PS4 artificial SEI layer with a controllable nanoscale thickness and high phase purity can be prepared by spin-coating. The layer stabilizes the lithium/electrolyte interface by homogenizing the Li-ion flux, preventing the parasitic reactions, and alleviating concentration polarization. Consequently, a symmetrical cell with the Li3PS4-modified lithium electrodes can achieve stable lithium plating/stripping for 800 h at a current density of 1 mA cm-2. The Li-S batteries assembled with the Li3PS4-protected Li anodes show better capacity retention than their bare Li counterparts, whose average decay rate from the 240th cycle to the 800th cycle is only 0.004%/cycle. In addition, the Li3PS4 layer improves the rate capacity of the batteries, significantly enhancing the capacity from 175 to 682 mA h g-1 at a 2 C rate. The spin-coated Li3PS4 artificial SEI layer provides a new strategy to develop high-performance Li metal batteries.

Changes of Myocardial Muscarinic Receptor during Septic Shock of the Rat.

The present study reports the structural and functional changes of myocardial muscarinic receptor during early and late septic shock, Septic shock was induced by caecum ligation and puncture (CLP). The results showed that the number of M receptor on sarcolemma (SL) increased and that on the light vesicle (LV) decreased during early septic shock. The (3)H-QNB binding of M receptor on SL increased by 33.37%. By contrast during late septic shock, the number of M receptor on LV increased and that on SL decreased. The (3)H-QNB binding of LV M receptor was increased by 29.26%. At the same time phosphorylation of the M receptor was decreased during early septic shock and increased during late septic shock. These results suggest that the changes of M receptors may be related to the myocardial dysfunction during septic shock.