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BACKGROUND: Pneumoperitoneum and Trendelenburg position in laparoscopic surgeries could contribute to postoperative pulmonary dysfunction. In recent years, intraoperative lung-protective mechanical ventilation (LPV) has been reportedly able to attenuate ventilator-induced lung injuries (VILI). Our objectives were to test the hypothesis that LPV could improve intraoperative oxygenation function, pulmonary mechanics and early postoperative atelectasis in laparoscopic surgeries. METHODS: In this randomized controlled clinical trial, 62 patients indicated for elective abdominal laparoscopic surgeries with an expected duration of greater than 2 h were randomly assigned to receive either lung-protective ventilation (LPV) with a tidal volume (Vt) of 7 ml kg- 1 ideal body weight (IBW), 10 cmH2O positive end-expiratory pressure (PEEP) combined with regular recruitment maneuvers (RMs) or conventional ventilation (CV) with a Vt of 10 ml kg- 1 IBW, 0 cmH2O in PEEP and no RMs. The primary endpoints were the changes in the ratio of PaO2 to FiO2 (P/F). The secondary endpoints were the differences between the two groups in PaO2, alveolar-arterial oxygen gradient (A-aO2), intraoperative pulmonary mechanics and the incidence of atelectasis detected on chest x-ray on the first postoperative day. RESULTS: In comparison to CV group, the intraoperative P/F and PaO2 in LPV group were significantly higher while the intraoperative A-aO2 was clearly lower. Cdyn and Cstat at all the intraoperative time points in LPV group were significantly higher compared to CV group (p < 0.05). There were no differences in the incidence of atelectasis on day one after surgery between the two groups. CONCLUSIONS: Lung protective mechanical ventilation significantly improved intraoperative pulmonary oxygenation function and pulmonary compliance in patients experiencing various abdominal laparoscopic surgeries, but it could not ameliorate early postoperative atelectasis and oxygenation function on the first day after surgery. TRIAL REGISTRATION: https://www.clinicaltrials.gov/identifier: NCT04546932 (09/05/2020).
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Abdome/cirurgia , Respiração com Pressão Positiva/métodos , Lesão Pulmonar Induzida por Ventilação Mecânica/prevenção & controle , Adulto , Idoso , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Complicações Pós-Operatórias/epidemiologia , Atelectasia Pulmonar/epidemiologia , Volume de Ventilação PulmonarRESUMO
Stokes polarimeters are most commonly used to measure the state of polarization of optical wave. Dependence of Stokes parameters, degree of polarization on external magnetic field are presented for garnet and groove films on garnet in the transmission and reflection modes. The Stokes parameters S1, S2, S3 of different modes show different tendency and asymmetrically change when the external magnetic field change, while the degree of polarization basically unchange.
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Backgrounds/Aims: Parenchymal-sparing anatomical hepatectomy (Ps-AH) based on portal ramification of the right anterior section (RAS) is a new technique to avoid unnecessarily transecting too much liver parenchyma, especially in cases of major anatomical hepatectomy. Methods: We prospectively assessed 26 patients with primary hepatic malignancies having undergone major Ps-AH based on portal ramification of the RAS from August 2018 to August 2022 (48 months). The perioperative indications, clinical data, intra-operative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: Among the 26 patients analyzed, there was just one case that had intrahepatic cholangiocarcinoma The preoperative level of α-Fetoprotein was 25.2 ng/mL. All cases (100%) had Child-Pugh A liver function preoperatively. The ventral/dorsal RAS was preserved in 19 and 7 patients, respectively. The mean surgical margin was 6.2 mm. The mean surgical time was 228.5 minutes, while the mean blood loss was 255 mL. In pathology, 5 cases (19.2%) had microvascular invasion, and in the group of HCC patients, 92% of all cases had moderate or poor tumor differentiation. Six cases (23.1%) of postoperative complications were graded over III according to the Clavien-Dindo system, including in three patients resistant ascites or intra-abdominal abscess that required intervention. Conclusions: Parenchymal-sparing anatomical hepatectomy based on portal ramification of the RAS to achieve R0-resection was safe and effective, with favorable short-term outcomes. This technique can be used widely in clinical practice.
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Herein, we report a novel approach for the design of a colorimetric aptasensor, relying on a Dye Salt Aggregation-based Colorimetric Oligonucleotide assay (DYSACO assay). This method is based on the use of an intercalating agent, Nile Blue (NB), whose aggregation capacities (and thus modification of its absorption spectrum) are drastically amplified by adding salts to the working solution. The presence of an aptamer could protect NB from such aggregation process due to its intercalation into double-stranded DNA and/or interaction with nucleobases. In response to the addition of the specific ligand, the competition between NB and the target for binding to the aptamer occurs, resulting in an increase in the dye salt aggregation and then in the blue-to-blank color change of the solution. The proof-of-principle was demonstrated by employing the anti-l-tyrosinamide aptamer and the assay was successfully applied to the trace enantiomer detection, allowing the detection of an enantiomeric impurity down to approximately 2% in a non-racemic sample. Through a reversed mechanism based on the increased capture of NB by DNA upon analyte binding, the sensing platform was further demonstrated for the Hg(II) detection. Water samples of different origin were spiked with Hg(II) analyte at final range concentrations comprised between (0.5-15 µM). An excellent overall recovery of 122 ± 14%; 105 ± 14%; 99 ± 9%; was respectively obtained from river, tap and mineral water, suggesting that the sensor can be used under real sample conditions. The assay was also shown to work for sensing the ochratoxin A and d-arginine vasopressin compounds, revealing its simplicity and generalizability potentialities.
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Aptâmeros de Nucleotídeos , Técnicas Biossensoriais , Mercúrio , Nanopartículas Metálicas , Colorimetria/métodos , Nanopartículas Metálicas/química , Técnicas Biossensoriais/métodos , Ouro/química , Cloreto de Sódio , DNA/química , Peptídeos , Cloreto de Sódio na Dieta , Aptâmeros de Nucleotídeos/químicaRESUMO
A Faraday Effect sensor with Nd(2)Fe(14)B biasing magnetic film was described. Ta/Nd(2)Fe(14)B/Ta films were grown by magnetron sputtering method. The magnetic domain in the sensor with the Nd(2)Fe(14)B biasing magnetic film can persist its distribution. The average linearity error of Faraday Effect sensor with biasing magnetic film decreased from 1.42% to 0.125% compared with non-biasing magnetic film, and the measurement range increased from 820 Oe to 900 Oe.
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Boro/química , Ferro/química , Magnetismo/instrumentação , Neodímio/química , Dispositivos Ópticos , Centrais Elétricas/instrumentação , Desenho de Equipamento , Campos Magnéticos , Modelos TeóricosRESUMO
OBJECTIVES: To investigate clinical and histopathological characteristics of Vietnamese patients with thymoma and myasthenia gravis (MG), and the outcomes of surgical management using video-assisted thoracoscopic surgery (VATS) thymectomy. METHODS: A prospective study was carried out on 61 patients undergoing VATS thymectomy for MG class I, IIA with thymoma in the period from 10/2013 to 5/2019. The WHO histopathological classification, Masaoka's stages and MG grading using the guidelines of the Medical Scientific Advisory Board of the Myasthenia gravis foundation of America (MGFA) were used. All patients were followed up at 1 month, 6 months and over 1 year postoperatively. RESULTS: The average patient age was 47.3 ± 10.8 years (21-70). The female/male ratio was 0.91.80.3% of patients had MG class IIA. Most of the patients were at Masaoka's stage I and stage II (75.4%). Only 1 patient (1.7%) had highly malignant type B3 thymoma. Conversion to open surgery was required in 8 patients. The surgical time was 91.8 ± 49.9 min and blood loss was 37.3 ± 31.5 ml. Most patients (68.9%) were extubated in the operating room. The postoperative hospital stay was 9.8 ± 5.9 days (5-37 days). 22.6% of patients relapsed after one-year. Refractory MG declined to 5.7% after surgical treatment. CONCLUSION: VATS thymectomy for MG with thymoma was safe and effective, with a lower rate of intraoperative complications, shorter hospitalization, and better long-term outcomes. This approach could be applicable for patients of all age groups with thymomas at early Masaoka's stages.
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Miastenia Gravis/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Timectomia/métodos , Timoma/cirurgia , Neoplasias do Timo/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/prevenção & controle , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Miastenia Gravis/complicações , Estadiamento de Neoplasias , Estudos Prospectivos , Segurança , Timoma/complicações , Timoma/patologia , Neoplasias do Timo/complicações , Neoplasias do Timo/patologia , Fatores de Tempo , Resultado do Tratamento , Vietnã , Adulto JovemRESUMO
The study on the coatings containing antimony-dope tin oxide mostly has been done on titanium and its alloys for preparation of electrode materials. In this study, we try to prepare the similar coatings on 316L stainless steel, which is more common than titanium, and investigate some characteristics of the formed coatings. The preparation of the coating is by the impregnation of the substrate in solution containing SnCl4 and SbCl3 with the ratio of 93/7, and the concentration of SbCl3, 10 g/L in isopropanol, pH of 1-1.2, and the annealed temperature of 450°C give suitable coating for electrode materials. Some coating features, such as the crystal structure (XRD), morphology (SEM), hardness, electrical resistant, and electrochemical behaviors of the coating on the substrate have been also investigated. The results of the study show that the coatings can be used as electrode materials for the effective treatment of organic colorants in water such as methylene blue in water treatment.