Liberal surgical laparoscopy reduction for acute intussusception: experience from a tertiary pediatric institute.

The optimal treatment for acute intussusception has not yet been defined. In this study, we explored whether employing a liberal laparoscopic intervention for intussusception could lead to favorable outcomes. We performed a historical control analysis to evaluate the outcomes associated with this liberal surgical management protocol. This liberal surgical management protocol were revised to incorporate a new protocol centered around the laparoscopic approach. In some cases of acute intussusception, liberal laparoscopic exploration and intervention were undertaken without initial hydrostatic or pneumatic reduction. During the study interval, a retrospective review was conducted on a total of 3086 patients. These were categorized into two groups: 1338 cases before May 2019 (pre-protocol group) and 1748 cases after May 2019 (post-protocol group). Surgical intervention rates in the pre-protoco and post-protocol period were 10.2% and 27.4% respectively (odds ratio [OR] = 0.30 [95% CI 0.25-0.37]; p < 0.001). No significant differences were observed in baseline clinical characteristics or demographic features between the two groups. The duration from admission to operation was longer for the pre-protocol group (p = 0.008) than for the post-protocol group. The post-protocol group demonstrated decreases in both intestinal resection (OR = 1.50 [95% CI 0.96-2.35]; p = 0.048) and total recurrent events (OR = 1.27 [95% CI 1.04-1.55]; p = 0.012) compared to the pre-protocol group. Liberal laparoscopic intervention for intussusception may effectively reduce the risk of intestinal resection and total recurrent events, thereby exhibiting promising outcomes for patients with intussusception.

Regular use of low-dose of opioids after gastrointestinal surgery may lead to postoperative gastrointestinal tract dysfunction in children: a Chinese national regional health center experience sharing.

BACKGROUND: The need for pain management is increasing in pediatrics, but the side effects of overuse or abuse of analgesics can be harmful to children's health and even life-threatening in severe cases. METHODS: Patients who underwent resection of Meckel's diverticulum at the Children's Hospital of Chongqing Medical University from July 1, 2019, to July 1, 2022, were included in this study. Opioids were administered through patient-controlled analgesia (PCA). Based on the preoperative choices made by the legal guardians, patients were stratified into two groups: PCA Group (PCAG) and Non-PCA Group (NPCAG). Data pertaining to the clinical characteristics and prognoses of these patients were subsequently collected and analyzed to assess the impact of opioid administration. RESULTS: In the study, a total of 126 patients were enrolled, with 72 allocated to the Patient-Controlled Analgesia Group (PCAG) and 54 to the Non-Patient-Controlled Analgesia Group (NPCAG). When compared to the NPCAG, the PCAG exhibited a longer duration of postoperative fasting (median 72 vs. 62 h, p = 0.044) and increased utilization of laxatives (12[16.7%] vs. 2[3.7%], p = 0.022). However, the PCAG also experienced higher incidences of intestinal stasis and abnormal intestinal dilation (13[18.1%] vs. 3[5.6%], p = 0.037). No statistically significant differences were observed in pain assessments at the conclusion of the surgical procedure (0 vs. 1[1.9%], p = 0.429) or within the first 24 h postoperatively (16[22.2%] vs. 18[33.3%], p = 0.164). Additionally, NPCAG patients did not necessitate increased administration of rescue analgesics (2[2.8%] vs. 4[7.4%], p = 0.432). CONCLUSIONS: The administration of opioids did not demonstrably ameliorate postoperative pain but was associated with a heightened incidence of postoperative gastrointestinal tract dysfunction. The retrospective nature of the current research should be considered and should be clarified further.

Underwater Oleophobic Electrospun Membrane with Spindle-Knotted Structured Fibers for Oil-in-Water Emulsion Separation.

The potential of spider silk as an intriguing biological prototype for collecting water from a humid environment has attracted wide attention, and various materials with suitable structures have been engineered. Here, inspired by this phenomenon, a kind of superwetting poly(vinylidene fluoride) (PVDF) membrane with spindle-knotted structured fibers was prepared by the electrospinning method followed by oxygen plasma etching treatment. The prepared membrane presented a satisfactory separation efficiency for various oil-in-water emulsions. The cooperative effect of the special wettability property and the spindle-knot structure stimulated the emulsified oil droplets to accumulate quickly on the membrane surface. A model that explains the accumulation of emulsified oil droplets has also been developed. Furthermore, an artificial fiber comprising a micron-sized spindle-knot structure was prepared by the dip-coating method to clearly illustrate the aggregation process of the emulsified oil droplets and to verify the theoretical explanation. We hope that this study will provide new inspiration for oil/water emulsion separation techniques.

Quantitative HPLC-MS/MS determination of Nuc, the active metabolite of remdesivir, and its pharmacokinetics in rat.

Remdesivir is a nucleotide analog prodrug that has received much attention since the outbreak of the COVID-19 pandemic in December 2019. GS-441524 (Nuc) is the active metabolite of remdesivir and plays a pivotal role in the clinical treatment of COVID-19. Here, a robust HPLC-MS/MS method was developed to determine Nuc concentrations in rat plasma samples after a one-step protein precipitation process. Chromatographic separation was accomplished on Waters XBrige C18 column (50 × 2.1 mm, 3.5 µm) under gradient elution conditions. Multiple reaction monitoring transitions in electrospray positive ion mode were m/z 292.2 → 163.2 for Nuc and 237.1 → 194.1 for the internal standard (carbamazepine). The quantitative analysis method was fully validated in line with the United States Food and Drug Administration guidelines. The linearity, accuracy and precision, matrix effect, recovery, and stability results met the requirements of the guidelines. Uncertainty of measurement and incurred sample reanalysis were analyzed to further ensure the robustness and reproducibility of the method. This optimized method was successfully applied in a rat pharmacokinetics study of remdesivir (intravenously administration, 5 mg kg-1). The method can act as a basis for further pharmacokinetic and clinical efficacy investigations in patients with COVID-19. Graphical abstract.

Integration Analysis of Pharmacokinetics and Metabolomics to Predict Metabolic Phenotype and Drug Exposure of Remdesivir.

Remdesivir has displayed pharmacological activity against SARS-CoV-2. However, no pharmacometabolomics (PM) or correlation analysis with pharmacokinetics (PK) was revealed. Rats were intravenously administered remdesivir, and a series of blood samples were collected before and after treatment. Comprehensive metabolomics profile and PK were investigated and quantitated simultaneously using our previous reliable HPLC-MS/MS method. Both longitudinal and transversal metabolic analyses were conducted, and the correlation between PM and PK parameters was evaluated using Pearson's correlation analysis and the PLS model. Multivariate statistical analysis was employed for discovering candidate biomarkers which predicted drug exposure or toxicity of remdesivir. The prominent metabolic profile variation was observed between pre- and posttreatment, and significant changes were found in 65 metabolites. A total of 15 metabolites-12 carnitines, one N-acetyl-D-glucosamine, one allantoin, and one corticosterone-were significantly correlated with the concentration of Nuc (active metabolite of remdesivir). Adenosine, spermine, guanosine, sn-glycero-3-phosphocholine, and l-homoserine may be considered potential biomarkers for predicting drug exposure or toxicity. This study is the first attempt to apply PM and PK to study remdesivir response/toxicity, and the identified candidate biomarkers might be used to predict the AUC and Cmax, indicating capability of discriminating good or poor responders. Currently, this study originally offers considerable evidence to metabolite reprogramming of remdesivir and sheds light on precision therapy development in fighting COVID-19.

Functionalized BaTiO3 enhances piezoelectric effect towards cell response of bone scaffold.

Piezoelectric effect of polyvinylidene fluoride (PVDF) plays a crucial role in restoring the endogenous electrical microenvironment of bone tissue, whereas more ß phase in PVDF leads to higher piezoelectric performance. Nanoparticles can induce the nucleation of the ß phase. However, they are prone to aggregate in PVDF matrix, resulting in weakened nucleation ability of ß phase. In this work, the hydroxylated BaTiO3 nanoparticles were functionalized with polydopamine to promote their dispersion in PVDF scaffolds fabricated via selective laser sintering. On one hand, the catechol groups of polydopamine could form hydrogen bonding with the hydroxyl groups of the BaTiO3. On the other hand, the amino groups of polydopamine were able to bond with CF group of PVDF. As a result, the functionalized BaTiO3 nanoparticles homogeneously distributed in PVDF matrix, which significantly increased the ß phase fraction from 46% to 59% with an enhanced output voltage by 356%. Cell testing confirmed the enhanced surface electric cues significantly promoted cell adhesion, proliferation and differentiation. Furthermore, the scaffolds exhibited enhanced tensile strength and modulus, which was ascribed to the rigid particle strengthening effect and the improved interfacial adhesion. This study suggested that the piezoelectric scaffolds shown a potential application in bone repair.

Strong corrosion induced by carbon nanotubes to accelerate Fe biodegradation.

The slow degradation of Fe severely restricts its application in bone repair although it possesses good biocompatibility and high mechanical properties. In this study, carbon nanotubes (CNTs) were introduced to accelerate Fe biodegradation: (I) CNTs acted as cathodes to induce galvanic corrosion owing to their differences in corrosion potential; (II) The large specific surface area of CNTs increased area ratios of cathode to anode; (III) The excellent electrical conductivity of CNTs allowed significant levels of electron transfer through the cathode in galvanic corrosion. Consequently, the degradation rate of Fe/CNTs composites greatly increased by 74% with the increase of CNTs (0.3-0.9 wt%). Further addition of CNTs would lead to corrosion holes and cracks due to localized corrosion. Besides, cell culture experiments showed that MG-63 cells could normally proliferate to maintain their population, indicating good cytocompatibility of Fe/CNTs composites. The results proved that the incorporation of CNTs into Fe was an effective approach to develop Fe-based bone implants with enhanced degradation rates.

Switchable Wettability Surface with Chemical Stability and Antifouling Properties for Controllable Oil-Water Separation.

Membrane materials with special wettability for separating oil-water mixtures have gradually become one of the research hotspots. However, oily wastewater usually has very strong corrosiveness, which puts forward high requirements for the chemical stability of the separation membrane. In addition, oil droplets may block the pores, resulting in the decrease of separation efficiency or even separation failure. Herein, biomimetic TiO2-titanium meshes (BTTMs) with switchable wettability were successfully fabricated by one-step dip coating of poly(vinylidene difluoride) and modified TiO2 suspension on the titanium meshes. The simple and efficient preparation method will facilitate the promotion of this smart material. Due to the controlled wettability, the BTTM can separate water or oil from an oil-water mixture as required. When the BTTM was immersed in strong corrosive solution or liquid nitrogen, the wettability did not change much, showing the good stability of the BTTM. Furthermore, the BTTM also has self-healing ability, self-recovery anti-oil-fouling properties, and self-cleaning behavior, which help it resist oil pollution and improve its recyclability. This study provides a simple and efficient strategy for fabricating a stable smart surface for on-demand controllable treatment of corrosive oily wastewater.

Surface modification of nanodiamond: Toward the dispersion of reinforced phase in poly-l-lactic acid scaffolds.

The agglomeration of nanodiamond severely reduces the reinforcement in matrix of composites although it is often used as a reinforcing phase. In this study, nanodiamond was modified by phospholipid to promote its dispersion in Poly-l-lactic acid (PLLA) scaffolds fabricated via selective laser sintering. Concretely, phospholipid was an amphiphilic substance with hydrophilic head and hydrophobic tails. The hydrophilic head could adsorb on nanodiamond surface through hydrogen bonding between the OH of head and the COOH of nanodiamond. The hydrophobic tails were forced arrange toward the PLLA matrix. As a result, nanodiamond particles were covered with a layer of phospholipid. They are compelled far away from each other due to the exclusion between the hydrophobic tails. This promoted the dispersion of nanodiamond in PLLA scaffolds. Consequently, the compressive strength, compressive modulus and Vickers hardness of the scaffolds modified by phospholipid increased by 162.8%, 163.2% and 88.2% compared with those of unmodified scaffolds, respectively. Meanwhile, the scaffolds could provide a suitable environment that enabled cells to adhere, grow and migrate, indicating good cytocompatibility. This study suggested the PLLA/nanodiamond scaffolds modified by phospholipid could be a potential candidate for bone tissue engineering applications.

Bullying, social skills, peer acceptance, and friendship among students in school transition / Bullying, habilidades sociais, aceitação pelos pares e amizade de estudantes em transição escolar

This study's objective was to assess the social skills, peer acceptance, and friendship among students involved in bullying situations transitioning from elementary to middle school. A total of 408 6th grade students from six public schools in the interior of São Paulo, Brazil composed the sample; 54.9% of whom were aged 11.3 years on average (Standard Deviation = 0.6). Data were analyzed using Analysis of Variance and Spearman's correlation. In regard to social skills, bully-victims present a greater amount of passive and active responses when compared to victims, bullies, and not involved students. Only male bully-victims, however, experienced significantly more frequent rejection by peers, while female bully-victims had significantly fewer friends. The results indicate the need to develop interventions intended to prevent and decrease bullying in the period of school transition. Such interventions should, however, be gender-sensitive because of differences existing between boys and girls.

O objetivo deste estudo foi avaliar as habilidades sociais, aceitação pelos pares e amizade de estudantes em transição escolar envolvidos em situações de bullying. Participaram 408 estudantes do sexto ano do Ensino Fundamental, de seis escolas públicas do interior do estado de São Paulo, Brasil, 54,9% do sexo feminino, idade média de 11,3 anos (Desvio Padrão = 0,6). Os dados foram analisados mediante Análises de Variância e correlação de Spearman. Em relação às habilidades sociais, as vítimas agressoras apresentaram maior quantidade de respostas passivas e de respostas ativas em comparação com as vítimas, agressores e não envolvidos no bullying. Entretanto, somente os meninos vítimas agressoras foram significativamente mais rejeitados pelos pares e as meninas vítimas agressoras tiveram significativamente menos amigos. Os resultados indicam a necessidade do desenvolvimento de intervenções objetivando prevenir e reduzir o bullying no período de transição escolar, intervenções que sejam sensíveis ao gênero, em função das diferenças identificadas.

Pharmacokinetics of doxycycline after oral administration of single and multiple dose in broiler chickens.

As a semisynthetic tetracycline derivative, doxycycline (α-6-deoxy-5-hydroxytetracycline) is a time-dependent bacteriostatic agent. It is being widely used in the broiler husbandry in China. In this study, doxycycline was orally administered by gavage to 10 healthy broiler chickens at the dose of 20 mg/kg body weight every 24 hr for five total treatments. Plasma samples were collected from each animal at 5, 10, 20, and 30 min and 1, 2, 4, 6, 8, and 12 hr after the first dose, at 0.25, 0.5, 0.45, 1, 2, 3, 4, 6, 7, 13.5, 24, 36, 48, 60, and 72 hr after the last dose. Additional plasma samples were collected at a 24-hr interval during the dosing period (immediately prior to each oral administration). The doxycycline concentrations were determined by high-performance liquid chromatography with an ultraviolet detector and subjected to noncompartmental analysis. Then, the pharmacokinetics profiles were compared after the first and last oral doses. After the first dosing, the elimination half-life, area under the concentration-time curve from 0 hr to ∞, peak concentration, time to reach peak concentration, and volume of distribution per fraction absorbed were determined as 7.78 hr, 94.19 µg·hr/ml, 5.65 µg/ml, 3.50 hr, and 2,502.65 ml/kg, respectively, while the corresponding values of these parameters after the last dose were 19.90 hr, 121.08 µg·hr/ml, 5.71 µg/ml, 7.25 hr, and 5,285.28 ml/kg, respectively. After multiple oral doses, the absorption and elimination both became slower, while the distribution was more extensive than that following a single dose. However, after multiple oral doses, accumulation of doxycycline in plasma was not observed with an average accumulation factor of 1.11.

Dual Superlyophobic Copper Foam with Good Durability and Recyclability for High Flux, High Efficiency, and Continuous Oil-Water Separation.

Traditional oil-water separation materials have to own ultrahigh or ultralow surface energy. Thus, they can only be wetted by one of the two, oil or water. Our experiment here demonstrates that the wettability in oil-water mixtures can be tuned by oil and water initially. Hierarchical voids are built on commercial copper foams with the help of hydrothermally synthesized titanium dioxide nanorods. The foams can be easily wetted by both oil and water. The water prewetted foams are superhydrophilic and superoleophobic under oil-water mixtures, meanwhile the oil prewetted foams are superoleophilic and superhydrophobic. In this paper, many kinds of water-oil mixtures were separated by two foams, prewetted by corresponding oil or water, respectively, combining a straight tee in a high flux, high efficiency, and continuous mode. This research indicates that oil-water mixtures can be separated more eco-friendly and at lower cost.

Introducing rapid oral-fluid HIV testing among high risk populations in Shandong, China: feasibility and challenges.

BACKGROUND: This study was conducted to ascertain the feasibility of using rapid oral fluid testing as an alternative HIV testing method in China. METHOD: This is a mixed-method study among men who have sex with men (MSM), female sex workers (FSW) and VCT clients, conducted in 4 cities in Shandong Province. A pre-tested questionnaire was administered to 1137 participants through face-to-face interview to assess demographic characteristics, HIV testing histories and willingness to accept rapid oral fluid testing. VCT clients were provided with the saliva test kits for a screening test and errors in operation were recorded. Testing results were compared between oral and blood testing. Short feedback questionnaire was administered to 200 FSW who had undergone oral testing. RESULTS: The rate of willingness to take oral-fluid HIV testing among MSM, FSW and VCT clients was 72.8%, 72.1% and 67.4% respectively. Common errors recorded during test kit operation by the 229 VCT clients included: unpreparedness, wrong swab sampling, wrong dilution, wrong testing and inability to read test results. Advantages of oral testing listed by participants included: less intrusive, painlessness, easy self- testing and privacy. Disadvantages included perceived unreliable results (55.5%) and not nationally recognised (9%). Comparison of saliva and the blood testing results recorded a consistency rate of 0.970 (χ2 = 153.348, P < 0.001), implying an excellent consistency. CONCLUSION: Introduction of oral rapid fluid testing as an alternative HIV testing method in China is highly feasible but with some challenges including low recognition and operation errors.

Factors associated with willingness to accept oral fluid HIV rapid testing among most-at-risk populations in China.

BACKGROUND: The availability of oral fluid HIV rapid testing provides an approach that may have the potential to expand HIV testing in China, especially among most-a-risk populations. There are few investigations about the acceptability of oral fluid HIV testing among most-at-risk populations in China. METHOD: A cross-sectional study with men who have sex with men (MSM), female sex workers (FSW) and voluntary counseling and testing (VCT) clients was conducted in three cities of Shandong province, China from 2011 to 2012. Data were collected by face-to-face questionnaire. RESULTS: About 71% of participants were willing to accept the oral fluid HIV rapid testing, and home HIV testing was independently associated with acceptability of the new testing method among MSM, FSW and VCT clients (AOR of 4.46, 3.19 and 5.74, respectively). Independent predictors of oral fluid HIV rapid testing acceptability among MSM were having ever taken an oral fluid HIV rapid test (AOR= 15.25), having ever taken an HIV test (AOR= 2.07), and education level (AOR= 1.74). Engagement in HIV-related risk behaviors (AOR= 1.68) was an independent predictor of acceptability for FSW. Having taken an HIV test (AOR= 2.85) was an independent predictor of acceptability for VCT clients. The primary concern about the oral fluid HIV testing was accuracy. The median price they would pay for the testing ranged from 4.8 to 8.1 U.S. dollars. CONCLUSION: High acceptability of oral fluid HIV rapid testing was shown among most-at-risk populations. Findings provide support for oral rapid HIV testing as another HIV prevention tool, and provide a backdrop for the implementation of HIV home testing in the near future. Appropriate pricing and increased public education through awareness campaigns that address concerns about the accuracy and safety of the oral fluid HIV rapid testing may help increase acceptability and use among most-at-risk populations in China.

Adsorption and aggregation behavior of tetrasiloxane-tailed surfactants containing oligo(ethylene oxide) methyl ether and a sugar moiety.

Three novel amphiphilic dicephalic (double-headed) surfactants containing oligo(ethylene-oxide)methyl-ether and a sugar moiety TGA-m (m = 1, 2, and 3) that incorporate a tetrasiloxane at the terminus of a hydrocarbon chain were designed and synthesized. Their surface activity and aggregation behavior in aqueous solution were systematically investigated by surface tension, dynamic light scattering (DLS), and transmission electron microscopy (TEM) techniques at 298 K. The surface tension measurements provided the critical aggregation concentration (CAC) and the surface tension at the CAC (γ(cac)). In addition, with application of the Gibbs adsorption isotherm, the maximum surface excess concentration (Γ(max)) and the minimum surface area/molecule (A(min)) at the air-water interface were estimated. The effect of EO chain length on the surface activity and aggregation behavior was also investigated. It was found that both the γ(cac) and the CAC were lower than those for reported traditional hydrocarbon surfactants. Aggregates of three surfactants, TGA-m (m = 1, 2, and 3), formed in aqueous solutions could be assigned as spherical vesicles as suggested by analysis using DLS and TEM. Moreover the formation of vesicles can be confirmed by the encapsulation of bromophenol blue. These results indicate that these three surfactants have excellent efficiencies of vesicle formation and surface tension reduction in the aqueous phase.

[ANSYS simulation of subcutaneous pustule electrical characteristics].

With the growing number of clinical surgery, post-operative surgical wound infection has become a very difficult clinical problem. In the treatments of it, non-invasive test of wound infection and healing status has a significance in clinical medicine practice. In this paper, beginning with the electrical properties of skin tissue structure and on the basis of the electromagnetism and the human anatomy, using the finite element analysis software, we applied safe voltage on the 3D skin model, performed the subcutaneous pustule simulation study and gained the relational curve between depth and radius of the pustule model. The simulation results suggested that the method we put forward could be feasible, and it could provide basis for non-invasive detection of wound healing and wound infection status.

Preparation and properties of comb-like surfactants containing poly(ethylene oxide) methyl ether grafts.

The comb-like surfactants, poly(styrene-co-maleic anhydride)-g-(poly(ethylene glycol) monomethyl ether), poly(St-co-MA)-g-(MPEG), have been prepared using a macromonomer approach to get controlled molecular structures. The macromonomer (MAMPEG) was obtained by esterification of poly(ethylene glycol) monomethyl ether with maleic anhydride. Poly(St-co-MA)-g-(MPEG) with various molar ratios of St to MAMPEG (R) were then constructed by radical copolymerization. The comb-like structures of the surfactants were confirmed by infrared and (1)H nuclear magnetic resonance spectroscopy. It is found from gel permeation chromatography characterization that the molecular weight of the surfactants increases as R increases. The polydispersity index was in the range between 1.4 and 2.0 in all the cases. The surfactants with a higher St percentage are less soluble in water due to aggregation. The value of critical aggregation concentration (CAC) and the surface tension at the CAC (gamma(CAC)) decrease as R increases. The steady-shear measurements show that the surfactant solutions at 50 g/L are dilatant fluids. In addition, it appears that there are two break points in the viscosity-shear rate curve. Both break points increase with increasing R. It can therefore be concluded that the properties of comb-like surfactants poly(St-co-MA)-g-(MPEG) are related to molecular structure. The results demonstrate that the properties of these comb-like surfactants can be tailored through appropriate molecular design.

[Detecting multi-drug resistance of bladder cancer for the intravesical chemotherapy].

OBJECTIVE: To explore multi-drug resistance (MDR) of bladder cancer for the intravesical instillation. METHODS: Using immunohistochemical staining, in 44-case human bladder cancer cells, the expressions of P-glycoprotein (P-gp), glutathione S-transferase (GST-pi) and topoisomerase (TOPO-II), were detected to find out the resistance to drugs. RESULTS: P-gp had a higher expression in 54.5% cases. GST-pi had no or a lower expression in 65.9% cases. TOPO-II had a higher expression in 29.5% but a lower expression in 65.9% cases. CONCLUSION: Detecting the factors of MDR in bladder cancer cells could help to choose drugs for intravesical chemotherapy.