[Comparison of effectiveness between unilateral biportal endoscopic and uniportal interlaminar endoscopic decompression in the treatment of lumbar spinal stenosis].

Objective: To compare the effectiveness between unilateral laminotomy and bilateral decompression (ULBD) with unilateral biportal endoscopy (UBE) and uniportal interlaminar endoscopy (UIE) in the treatment of lumbar spinal stenosis. Methods: A clinical data of 52 patients with lumbar spinal stenosis, who met the selection criteria and treated with ULBD between March 2021 and November 2022, was retrospectively analyzed. The patients were allocated into UBE group (23 cases) and UIE group (29 cases) according to the surgical methods. There was no significant difference ( P>0.05) in age, gender, body mass index, surgical segment, type of lumbar stenosis, and preoperative visual analogue scale (VAS) score of low back pain, VAS score of leg pain, Oswestry disability index (ODI), disc height, and dural sac area between the two groups. Perioperative indexes (incision length, operation time, hospital stay, and surgical complications), clinical indicators (VAS score of low back pain, VAS score of leg pain, and ODI before operation and at 3 days, 1 month, 6 months, and 12 months after operation), and imaging indicators (disc height and dural sac area before operation and at 1, 12 months after operation, and dural sac expansion area) were recorded and compared between the two group. Results: All operations in both groups were successfully completed. Compared with the UIE group, the UBE group had shorter operation time and longer incision length, with significant differences ( P<0.05). But there was no significant difference in hospital stay and incidence of complications between the two groups ( P>0.05). All patients were followed up 12-20 months (mean, 14 months). The VAS scores of low back pain and leg pain and ODI after operation significantly improved when compared with preoperative values ( P<0.05), and there was no significant difference in the above indicators between different time points after operation ( P>0.05). There was no significant difference between the two groups at different time points ( P>0.05). Imaging examination showed that there was no significant difference in disc height between the two groups at different time points after operation ( P>0.05). However, the dural sac area and dural sac expansion area were significantly larger in the UBE group than in the UIE group ( P<0.05). Conclusion: ULBD with UBE and UIE can achieve satisfactory effectiveness in the treatment of lumbar spinal stenosis. But the former has more thorough decompression and better dural sac expansion than the latter.

Single injection technique with ultrasound-guided superficial cervical fascia block combined with brachial plexus block in clavicular surgery: a prospective randomized comparative trial.

BACKGROUND: To investigate the effects of a single injection technique with ultrasound-guided superficial cervical fascia block combined with brachial plexus block in clavicular surgery. METHODS: Forty patients, 25 males and 15 females, aged 18-85 years with ASA class I or II underwent unilateral clavicular fracture internal fixation. The patients were randomly divided into a superficial cervical plexus block group (group S, n = 20) and a superficial cervical fascia block group (group F, n = 20). First, the brachial plexus of the intermuscular sulcus of all patients was blocked with an ultrasound-guided injection of one injection with 15ml 0.33% ropivacaine 15ml in both groups. Second, the superficial cervical plexus was blocked by another injection of 5-8ml 0.33% ropivacaine in group S, and the superficial cervical fascia was blocked by an injection with 5-8ml 0.33% ropivacaine in Group F. We evaluated operation time, onset time of anaesthesia, effective time and the grades of nerve block effect in the two groups. Additionally, we evaluated the incidences of local anaesthetic poisoning, hoarseness, dyspnoea, and postoperative nausea and vomiting, and the number of patients requiring remedial analgesia within 24 h. Repeated measurements were analysed by repeated data analysis of variance, and count data were compared by the χ2 test. A P value < 0.05 was considered statistically significant. RESULTS: The operation time and onset time in Group F were significantly shorter than those in group S (P < 0.05); the effect of intraoperative block was better than that in group S (P < 0.05), and the effective time was significantly longer in group F than in group S (P < 0.05). However, no severe case of dyspnoea, local anaesthetic poisoning or hoarseness after anaesthesia occurred in either of two groups. There was no significant difference in the rate of postoperative salvage analgesia or that of postoperative nausea and vomiting between the two groups. CONCLUSIONS: The application of the single injection technique with ultrasound-guided superficial cervical fascia block combined with brachial plexus block in clavicular surgery is beneficial because it shortens the operation time, has a faster onset, produces a more effective block and prolongs the longer analgesia time. TRIAL REGISTRATION: Chinese Clinical Trial Registry- ChiCTR2200064642(13/10/2022).

Improving the High-Temperature Energy Storage Performance of Epoxy Films: Moderately Reducing Unsaturation for Extremely High Efficiency.

The rapid development of renewable energy systems, electric vehicles, and pulsed equipment requires energy storage media to have a high energy storage density and efficiency in a wide temperature range. The state-of-the-art biaxially oriented polypropylene (BOPP) film is insufficient to meet the growing demand for energy storage devices due to its low energy storage density and working temperature, which make it a research hotspot for developing dielectric energy storage materials. In this manuscript, based on the epoxy materials that have been shown as a potential energy storage medium, we aim to reduce the influence of the benzene ring delocalization structure on the energy storage losses and enhance the efficiency by gradually replacing them with cyclohexane structures to adjust the segment unsaturation of epoxy materials. The results show that by partially reducing the unsaturation of the curing agent, the epoxy material achieves an excellent high-temperature energy storage density of 2.21 J/cm3 at 150 °C and 300 MV/m while maintaining an extremely high energy storage efficiency of 99.2%. Leakage current density and high-voltage dielectric spectroscopy tests confirm that a moderate reduction of the segment unsaturation of epoxy materials can greatly inhibit polarization loss at high temperatures, which may explain their high energy storage efficiency.

A Study on the Clinical Significance of Blood Exosomal PD-L1 in Non-Small Cell Lung Cancer Patients and its Correlation with PD-L1 in Tumor Tissues.

Exosomal programmed cell-death ligand 1 (ePD-L1) can influence immune inhibition and dysfunction. We were dedicated to unearthing the relation between ePD-L1 in blood and pathological characteristics as well as PD-L1 in tumor tissues. We recruited 65 non-small cell lung cancer (NSCLC) patients for exosome extraction and detected the blood ePD-L1 expression in these patients by enzyme-linked immunosorbent assay (ELISA) method. Besides, the correlation between blood ePD-L1 and patients' pathological characteristics was also analyzed. The expression of PD-L1 in tumor tissues was tested by immunohistochemistry (IHC) and its correlation with blood ePD-L1 expression level was analyzed by Spearman correlation coefficient. No significant correlation was observed in PD-L1 expression levels between blood-derived exosome and tumor tissue. Altogether, high blood ePD-L1 expression was relevant to NSCLC progression, while no such relevance to PD-L1 expression in tumor tissue.

Preparation of Montmorillonite Nanosheets with a High Aspect Ratio through Heating/Rehydrating and Gas-Pushing Exfoliation.

Montmorillonite (MMT) is an abundant silicate mineral with ultrahigh stability. The exfoliation of stacked MMT into high-aspect-ratio nanosheets is of crucial importance for various applications such as toxic gas suppression, barrier property enhancement, flame retardancy, and ion conduction. In this work, we develop a new heating/rehydrating and gas-pushing method that can successfully exfoliate MMT into nanosheets with aspect ratios (600-5000) far higher than the currently reported values (1-120). The MMT first goes through a "starvation pretreatment" under different heating temperatures to improve its hydrophilicity and is then rehydrated in a hydrogen peroxide solution. The hydrogen peroxide in the MMT interlayer space can decompose into water and oxygen bubbles, thus finally leading to the exfoliation via gas-pushing while preserving the large lateral size (mainly in the range of 1-6 µm) of the nanosheets. By changing the pretreatment temperature and pH value of the hydrogen peroxide solution, the exfoliation performance can be tuned. This simple and low-cost exfoliation method is promising to achieve the mass production of MMT nanosheets with a high aspect ratio and may promote its application in various fields such as energy conversion, drug delivery, and photocatalysis.

Sandwich-Structured h-BN/PVDF/h-BN Film With High Dielectric Strength and Energy Storage Density.

Energy storage film is one of the most important energy storage materials, while the performance of commercial energy storage films currently cannot meet the growing industrial requirements. Hence, this work presents a h-BN/PVDF/h-BN sandwich composite structure film prepared by laminating a large area of ultrathin hexagonal boron nitride (h-BN) and polyvinylidene fluoride (PVDF), the existence of which was confirmed by using an optical microscope and elemental composition analysis based on scanning electron microscopy and X-ray diffraction. This film has an ultrahigh dielectric strength of 464.7 kV/mm and a discharged energy density of up to 19.256 J/cm3, which is much larger than the commercial energy storage film biaxially oriented polypropylene (BOPP) (<2.5 J/cm3). Although the thickness of the h-BN film is only 70 nm compared with that of PVDF (about 12 µm), the dielectric strength of the sandwich-structured film presents a great increase. It is because of the excellent insulation performance of the h-BN film that helps to resist the electron injection and migration under high electric field, and then suppress the formation and growth of the breakdown path, leading to an improvement of the charge-discharge efficiency.

The emerging possibility of the use of geniposide in the treatment of cerebral diseases: a review.

With the advanced discoveries in the field of pathogenesis, a series of cerebral diseases, such as cerebral ischaemia, Alzheimer's disease, and depression, have been found to have multiple signalling targets in the microenvironment. Only a few existing agents have been shown to have curative effects due to this specific circumstance. In recent decades, active ingredients isolated from natural plants have been shown to be crucial for original drug development. Geniposide, mainly extracted from Gardenia jasminoides Ellis, is representative of these natural products. Geniposide demonstrates various biological activities in the treatment of cerebral, cardiovascular, hepatic, tumorous, and other diseases. The multiple protective effects of geniposide on the brain have especially drawn increasing attention. Thus, this article specifically reviews the characteristics of current models of cerebral ischaemia and illustrates the possible effects of geniposide and its pathogenetic mechanisms on these models. Geniposide has been shown to significantly reduce the area of cerebral infarction and alleviate neuronal damage and necrosis mainly by inhibiting inflammatory signals, including NLRP3, TNF-α, IL-6, and IL-1ß. Neuronal protection was also involved in activating the PI3K/Akt and Wnt/catenin pathways. Geniposide was able to increase autophagy and inhibit apoptosis by regulating the function of mTOR in treating Alzheimer's disease. Geniposide has also been shown to act as a glucagon-like peptide-1 receptor (GLP-1R) agonist to reduce amyloid plaques and inhibit oxidative stress to alleviate memory impairment as well as synaptic loss. Moreover, geniposide has been shown to exert antidepressant effects primarily by regulating the hypothalamic-pituitary-adrenal (HPA) axis. Detailed explorations have shown that the biological activities of inhibiting inflammatory cytokine secretion, alleviating oxidative stress, and suppressing mitochondrial damage are also involved in the mechanism of action of geniposide. Therefore, geniposide is a promising agent awaiting further exploration for the treatment of cerebral diseases via various phenotypes or signalling pathways.

Percutaneous curved vertebroplasty in the treatment of thoracolumbar osteoporotic vertebral compression fractures.

OBJECTIVE: To evaluate the clinical efficacy of percutaneous curved vertebroplasty (PCVP) in treating thoracic and lumbar osteoporotic vertebral compression fractures (OVCFs). METHODS: Patients with thoracolumbar OVCFs were recruited and randomly divided into three treatment groups: PCVP, unilateral percutaneous vertebroplasty (PVP) or bilateral PVP. Bone cement dispersion in the fractured vertebrae was observed. Surgery duration, X-ray frequency, bone cement injection volume, bone cement leakage rate and visual analogue scale (VAS) scores were recorded. RESULTS: Among 78 patients included, surgery duration and X-ray frequency were significantly lower in the PCVP and unilateral PVP groups versus bilateral PVP group. Bone cement injection volume was significantly higher in the bilateral PVP group (6.3 ± 1.4 ml) versus unilateral PVP (3.5 ± 1.1 ml) and PCVP groups (4.6 ± 1.2 ml). VAS scores at 24 h and 3 months post-surgery were significantly decreased versus baseline in all groups. The bone cement leakage rate was lowest in the PCVP group (8.8% [3/34 patients]). CONCLUSION: PCVP is associated with reduced trauma, less complicated surgery with shorter duration, fewer X-rays, lower complication rate, and quicker postoperative recovery versus unilateral and bilateral PVP.

The Transition to Paschen's Law for Microscale Gas Breakdown at Subatmospheric Pressure.

The decrease in electronic device size necessitates greater understanding of gas breakdown and electron emission at microscale to optimize performance. While traditional breakdown theory using Paschen's law (PL), driven by Townsend avalanche, fails for gap distance d [Formula: see text] 15 µm, recent studies have derived analytic equations for breakdown voltage when field emission and Townsend avalanche drive breakdown. This study derives a new analytic equation that predicts breakdown voltage VB within 4% of the exact numerical results of a previously derived theory and new experimental results at subatmospheric pressure for gap distances from 1-25 µm. At atmospheric pressure, VB transitions to PL near the product of pressure and gap distance, pd, corresponding to the Paschen minimum; at lower pressures, the transition to PL occurs to the left of the minimum. We further show that the work function plays a major role in determining which side of the Paschen minimum VB transitions to PL as pressure approaches atmospheric pressure while field enhancement and the secondary emission coefficient play smaller roles. These results indicate that appropriate combinations of these parameters cause VB to transition to PL to the left of the Paschen minimum, which would yield an extended plateau similar to some microscale gas breakdown experimental observations.