Efficacy and safety of prophylactic balloon occlusion in the management of placenta accreta spectrum disorder: a retrospective cohort study.

OBJECTIVE: Placenta accreta spectrum disorder (PAS) is a serious obstetric complication associated with significant maternal morbidity and mortality. Prophylactic balloon occlusion (PBO), as an intravascular interventional therapies, has emerged as a potential management strategy for controlling massive hemorrhage in patients with PAS. However, current evidence about the clinical application of PBO in PAS patients are still controversial. This study aimed to evaluate the effectiveness and safety of PBO in the management of PAS. METHODS: A retrospective cohort study including PAS patients underwent cesarean delivery was conducted in a tertiary hospital from January 2015 to March 2022. Included PAS patients were further divided into balloon and control groups by whether PBO was performed. Groups were compared for demographic characteristics, intraoperative and postoperative parameters, maternal and neonatal outcomes, PBO-related complication and follow up outcomes. Additionally, multivariate-logistic regression analysis was performed to determine the definitive associations between PBO and risk of massive hemorrhage and hysterectomy. RESULTS: A total of 285 PAS patients met the inclusion criteria were included, of which 57 PAS patients underwent PBO (PBO group) and 228 women performed cesarean section (CS) without PBO (control group). Irrespective of the differences of baseline characteristics between the two groups, PBO intervention did not reduce the blood loss, hysterectomy rate and postoperative hospital stay, but it prolonged the operation time and increased the cost of hospitalization (All P < 0.05) Additionally, there were no significant differences in postoperative complications, neonatal outcomes, and follow-up outcomes(All P > 0.05). In particular, patients undergoing PBO were more likely to develop the venous thrombosis postoperatively (P = 0.001). However, multivariate logistic regression analysis showed that PBO significantly decreased the risk of massive hemorrhage (OR 0.289, 95%CI:0.109-0.766, P = 0.013). The grade of PAS and MRI with S2 invasion were the significant risk factors affecting massive hemorrhage(OR:6.232 and OR:5.380, P<0.001). CONCLUSION: PBO has the potential to reduce massive hemorrhage in PAS patients undergoing CS. Obstetricians should, however, be aware of potential complications arising from the PBO. Additionally, MRI with S2 invasion and PAS grade will be useful to identify PAS patients who at high risk and may benefit from PBO. In brief, PBO seem to be a promising alternative for management of PAS, yet well-designed randomized controlled trials are needed to convincingly demonstrate its benefits and triage the necessity of PBO.

Suitability of 3.5-mm screw for the atlas in children: a retrospective computed tomography analysis.

BACKGROUND: The growth and development of the atlas in children has not been studied to date using a large sample size. OBJECTIVE: To study whether a 3.5-mm screw is suitable for the atlas in children, to explore the anatomical size and development of the atlas in 0-14-year-old children, and to provide morphological basis for lateral mass screw internal fixation. METHODS: A Computed Tomography (CT) morphometric analysis was performed on 420 pediatric atlases. In the atlas, D1, D2, D3, D4, and α of the atlas lateral mass were measured. Statistical analysis was performed using one-way ANOVA and Students' t test. The least square method was used for the regression analysis of the change trend in anatomical structure. The curve with the greatest goodness of fit was used as the anatomic trend regression curve. RESULTS: D1, D2, D3, and D4 generally showed an increasing trend with age. The ranges of averages of D1, D2, D3, D4, and α in 0-14 year-old children were as follows: 4.576-9.202 mm, 9.560-25.100 mm, 3.414-10.554 mm, 11.150-27.895, and 12.41°-20.97°, respectively. The trends of the fitting curves of L1 and L3 were power functions, and those of L2 and L4 were logarithmic curves. CONCLUSIONS: CT examination could help in preoperative decision-making, and 3.5-mm screw was found to be suitable for lateral mass screw internal fixation in children aging 2 years and older. D1-D4 increased with age. This provided a certain reference to perform posterior atlantoaxial fusion in children and is of great significance to design posterior atlantoaxial screw in children.

Binder-free and flexible delta-MnO2@multiwalled carbon nanotubes as high-performance cathode material for aqueous magnesium ion battery.

In order to develop a high-performance electrode material for aqueous magnesium ion battery (AMIB), we report a binder-free and flexibleδ-MnO2@multiwalled carbon nanotubes on carbon cloth (δ-MnO2@MWCNTs/CC) composite by a simple hydrothermal method. The MnO2nanoflakes are deposited on the surface of CC coated with high conductivity MWCNTs to form three-dimensional hierarchy architecture, which improves the electrochemical performances. Theδ-MnO2@MWCNTs/CC electrode displays a discharge capacity of 246.7 mAh g-1at a current density of 50 mA g-1and its capacitance retention at a current density of 1000 mA g-1can reach 80% after 2000 cycles. Furthermore, the AMIB system is assembled byδ-MnO2@MWCNTs/CC as cathode and activated carbon as anode, which dispays a discharge capacity of 72.4 mAh g-1at 100 mA g-1. Theδ-MnO2with interlayer structure can provide sufficient space for the insertion/deinsertion of Mg2+ions into/from the lattice of host materials without the change of phase. This work prepares a high-performance and flexible electrode material for low-cost AMIB system.

Hierarchically porous graphene-like biochar for efficient removal of aromatic pollutants and their structure-performance relationship: A combined experimental, MD and DFT study.

Development of high-efficiency adsorbents and exploration of the structure-performance relationship holds exciting implications for removal of aromatic pollutants (APs) from water. Herein, hierarchically porous graphene-like biochars (HGBs) were successfully prepared by K2CO3 simultaneous graphitization and activation of Physalis pubescens husk. The HGBs possess high specific surface area (1406-2369.7 m2/g), hierarchically meso-/microporous structure and high graphitization degree. The optimized HGB-2-9 sample exhibits rapid adsorption equilibrium time (te) and high adsorption capacities (Qe) for seven widely-used persistent APs with different molecular structures (e.g., phenol: te = 7 min, Qe = 191.06 mg/g; methylparaben: te = 12 min Qe = 482.15 mg/g). HGB-2-9 also shows a wide pH (3-10) suitability and good ionic strength (0.01-0.5 M NaCl) resistance properties. The effects of the physicochemical properties of HGBs and APs on the adsorption performance were deeply investigated by the adsorption experiments, molecular dynamics (MD) and density functional theory (DFT) simulation. The results demonstrate that the large specific surface area, high graphitization degree and hierarchically porous structure of HGB-2-9 can supply more active sites on accessible surface and facilitate the transport of APs. And the aromaticity and hydrophobicity of APs play the more crucial roles during the adsorption process. Besides, the HGB-2-9 presents good recyclability and high removal efficiency for APs in various real water, which further confirms its potential for practical applications.

Concerted catalytic and photocatalytic degradation of organic pollutants over CuS/g-C3N4 catalysts under light and dark conditions.

Organic pollutants in industrial and agricultural sewage are a serious threat to the environment and human health. Achieving continuous photocatalytic degradation of organic pollutants under light and dark conditions would have exciting implications for practical sewage treatment. In this paper, CuS/g-C3N4 composite catalysts with CuS nanoparticles anchored on g-C3N4 sheets were successfully fabricated via a simple solvothermal reaction. The morphology, structure, optical absorption characteristics, electron-hole recombination rate, and degradation performance of the as-prepared CuS/g-C3N4 catalysts were investigated in detail. The results confirmed that the as-fabricated CuS/g-C3N4 catalysts exhibited high Fenton-like catalytic degradation efficiencies in the dark, and rapid concerted Fenton-like catalytic, direct H2O2 photocatalytic and CuS/g-C3N4 photocatalytic degradation activities under visible light. Thus, the as-fabricated CuS/g-C3N4 catalysts can degrade organic pollutants continuously during both day and night. These degradation properties, along with the simple catalyst fabrication process, will facilitate the practical application of this system in the continuous removal of organic pollutants.