The Value of Applying a Continuous Nursing Model Based on Virtual Platforms for Patients with Colostomy or Ileostomy.

OBJECTIVE: To explore the application potential of continuous nursing training based on a comprehensive virtual platform in patients with colostomy or ileostomy. METHODS: A total of 100 patients with colostomy or ileostomy were equally divided into two groups. Patients in the control group received standardized routine care, whereas patients in the experimental group received continuous nursing care through the virtual platform. Both the control group and the experimental group were followed up by regular telephone calls once per week and completed the following questionnaires both 1 week after discharge and 3 months after discharge: Stoma Care Self-efficacy Scale, Exercise of Self-care Agency Scale, State-Trait Anxiety Inventory, Short Form-36 Health Survey Questionnaire, and a questionnaire on postoperative complications. RESULTS: Patients in the experimental group, who received continuous care, exhibited significantly higher scores in self-efficacy (P = .029), self-care responsibility (P = 0.030), state anxiety and trait anxiety (both Ps < .001), and mental health (P < .001) 1 week after discharge in comparison with patients in the control group. At 3 months postdischarge, compared with the control group, the experimental group showed significant advantages in all dimensions of self-efficacy, self-care ability, mental health, and quality-of-life questionnaires (P < .001). In addition, the incidence of complications in the experimental group was significantly lower (P < .0001). CONCLUSIONS: The virtual platform-based continuous nursing model effectively improves the self-care ability and self-efficacy of patients with a colostomy or ileostomy after colorectal cancer, thereby promoting an improved quality of life and psychological state while simultaneously reducing the incidence of complications after discharge.

Application of an interspinous process device after minimally invasive lumbar decompression could lead to stress redistribution at the pars interarticularis: a finite element analysis.

BACKGROUND: An interspinous process device, the Device for Intervertebral Assisted Motion (DIAM™) designed to treat lumbar neurogenic disease secondary to the lumbar spinal stenosis, it provides dynamic stabilization after minimally invasive (MI) lumbar decompression. The current study was conducted using an experimentally validated L1-L5 spinal finite element model (FEM) to evaluate the limited decompression on range of motion (ROM) and stress distribution on a neural arch implanted with the DIAM. METHODS: The study simulated bilateral laminotomies with partial discectomy at L3-L4, as well as unilateral and bilateral laminotomies with partial discectomy combined with implementation of the DIAM at L3-L4. The ROM and maximum von Mises stresses in flexion, extension, lateral bending, and axial torsion were analyzed in response to the hybrid protocol in comparison with the intact model. RESULTS: The investigation revealed that decreased ROM, intradiscal stress, and facet joint force at the implant level, but considerably increased stress at the pars interarticularis were found during flexion and torsion at the L4, as well as during extension, lateral bending, and torsion at the L3, when the DIAM was implanted compared with the defect model. CONCLUSION: The results demonstrate that the DIAM may be beneficial in reducing the symptoms of stress-induced low back pain. Nevertheless, the results also suggest that a surgeon should be cognizant of the stress redistribution at the pars interarticularis results from MI decompression plus the application of the interspinous process device.

Transjugular closure of secundum atrial septal defects.

OBJECTIVE: This study reports the results of a steerable delivery system under the guidance of transesophageal echocardiography (TEE) for the treatment of transjugular closure of secundum atrial septal defects (ASD). METHODS: From July 2015 to May 2016, 33 patients underwent transjugular closure of a secundum ASD under general anesthesia with TEE guidance. The right internal jugular vein was punctured and a FuStar™ steerable sheath was implanted into the right atrium and aligned vertically with the septum, and a closure device was deployed to close the defect. RESULTS: Thirty-two patients with an ASD were successfully occluded; one patient required ASD closure on cardiopulmonary bypass. Procedure time ranged from 5 to 15 (8.2 ± 3.8) min. The length of stay was three to five days after the operation. The follow-up time ranged from 1.1 to 11.0 (5.5 ± 1.5) months. There was no valve regurgitation, no malignant arrhythmias, no device dislocation, or other serious complications. CONCLUSIONS: A steerable delivery system under the guidance of TEE is a safe, effective, and cosmetic method for the transjugular closure of secundum ASDs.

[Active components of Ligustrum lucidum inhibiting hepatitis C virus replicase activity].

Based on previous report that the Chinese herb Ligustrum lucidum (LL) extract directly inhibited hepatitis C virus (HCV) replicase (NS5B) activity, the active components of LL extract to inhibit HCV NS5B activity and their inhibition mode were investigated in this study. LL extract was separated using ethyl acetate and thin layer chromatography (TLC). The inhibitory activity of separated fractions on HCV NS5B was analyzed by the inhibitory assay of NS5B activity. The results showed that only fractions 1 and 2 inhibited NS5B activity, and fraction 2 possessed higher inhibitory activity than fraction 1. HPLC analysis combined with inhibitory assays indicated that ursolic acid and oleanolic acid are the active components within fractions 1 and 2 to inhibit NS5B activity, separately. Moreover, oleanolic acid possessed higher inhibitory activity than ursolic acid. Further inhibition mode analysis found that both oleanolic acid and ursolic acid suppressed NS5B activity as noncompetitive inhibitors. The Ki values of ursolic acid and oleanolic acid were about 4.7 microg x mL(-1) (10 micromol x kg(-1)) and 2.5 microg x mL(-1) (5.5 micromol x kg(-1)), respectively. Taken together, these results demonstrated that oleanolic acid and ursolic acid suppressed NS5B activity as noncompetitive inhibitors, implying that the two natural products have potential value for HCV therapy.

Constructing abundant interfaces by decorating MoP quantum dots on CoP nanowires to induce electronic structure modulation for enhanced hydrogen evolution reaction.

Interface engineering is a method of enhancing catalytic activity while maintaining a material's surface properties. Thus, we explored the interface effect mechanism via a hierarchical structure of MoP/CoP/Cu3P/CF. Remarkably, the heterostructure MoP/CoP/Cu3P/CF demonstrates an outstanding overpotential of 64.6 mV at 10 mA cm-2 with a Tafel slope of 68.2 mV dec-1 in 1 M KOH. DFT calculations indicate that the MoP/CoP interface in the catalyst exhibited the most favorable H* adsorption characteristics (-0.08 eV) compared to the pure phases of CoP (0.55 eV) and MoP (0.22 eV). This result can be attributed to the apparent modulation of electronic structures within the interface domains. Additionally, the CoCH/Cu(OH)2/CF‖MoP/CoP/Cu3P/CF electrolyzer demonstrates excellent overall water splitting performance, achieving 10 mA cm-2 in 1 M KOH solution with a modest voltage of only 1.53 V. This electronic structure adjustment via interface effects provides a new and efficient approach to prepare high-performance hydrogen production catalysts.

Recent advances in interface engineering of Fe/Co/Ni-based heterostructure electrocatalysts for water splitting.

Among various methods of developing hydrogen energy, electrocatalytic water splitting for hydrogen production is one of the approaches to achieve the goal of zero carbon emissions. It is of great significance to develop highly active and stable catalysts to improve the efficiency of hydrogen production. In recent years, the construction of nanoscale heterostructure electrocatalysts through interface engineering can not only overcome the shortcomings of single-component materials to effectively improve their electrocatalytic efficiency and stability but also adjust the intrinsic activity or design synergistic interfaces to improve catalytic performance. Among them, some researchers proposed to replace the slow oxygen evolution reaction at the anode with the oxidation reaction of renewable resources such as biomass to improve the catalytic efficiency of the overall water splitting. The existing reviews in the field of electrocatalysis mainly focus on the relationship between the interface structure, principle, and principle of catalytic reaction, and some articles summarize the performance and improvement schemes of transition metal electrocatalysts. Among them, few studies are focusing on Fe/Co/Ni-based heterogeneous compounds, and there are fewer summaries on the oxidation reactions of organic compounds at the anode. To this end, this paper comprehensively describes the interface design and synthesis, interface classification, and application in the field of electrocatalysis of Fe/Co/Ni-based electrocatalysts. Based on the development and application of current interface engineering strategies, the experimental results of biomass electrooxidation reaction (BEOR) replacing anode oxygen evolution reaction (OER) are discussed, and it is feasible to improve the overall electrocatalytic reaction efficiency by coupling with hydrogen evolution reaction (HER). In the end, the challenges and prospects for the application of Fe/Co/Ni-based heterogeneous compounds in water splitting are briefly discussed.

Associations between electrocardiogram and carotid ultrasound parameters: a healthy chinese group study.

Background: Electrocardiogram (ECG) and carotid ultrasound (CUS) are important tools for the diagnosis and prediction of cardiovascular disease (CVD). This study aimed to investigate the associations between ECG and CUS parameters and explore the feasibility of assessing carotid health with ECG. Methods: This cross-sectional cohort study enrolled 319 healthy Chinese subjects. Standard 12-lead ECG parameters (including the ST-segment amplitude [STA]), CUS parameters (intima-media thickness [IMT] and blood flow resistance index [RI]), and CVD risk factors (including sex, age, and systolic blood pressure [SBP]) were collected for analysis. Participants were divided into the high-level RI group (average RI ≥ 0.76, n = 171) and the normal RI group (average RI < 0.76, n = 148). Linear and stepwise multivariable regression models were performed to explore the associations between ECG and CUS parameters. Results: Statistically significant differences in sex, age, SBP, STA and other ECG parameters were observed in the normal and the high-level RI group. The STA in lead V3 yielded stronger significant correlations (r = 0.27-0.42, p < 0.001) with RI than STA in other leads, while ECG parameters yielded weak correlations with IMT (|r| ≤ 0.20, p < 0.05). STA in lead V2 or V3, sex, age, and SBP had independent contributions (p < 0.01) to predicting RI in the stepwise multivariable models, although the models for IMT had only CVD risk factors (age, body mass index, and triglyceride) as independent variables. The prediction model for RI in the left proximal common carotid artery (CCA) had higher adjusted R2 (adjusted R2 = 0.31) than the model for RI in the left middle CCA (adjusted R2 = 0.29) and the model for RI in the right proximal CCA (adjusted R2 = 0.20). Conclusion: In a cohort of healthy Chinese individuals, the STA was associated with the RI of CCA, which indicated that ECG could be utilized to assess carotid health. The utilization of ECG might contribute to a rapid screening of carotid health with convenient operations.

Effect of different designs of interspinous process devices on the instrumented and adjacent levels after double-level lumbar decompression surgery: A finite element analysis.

Recently, various designs and material manufactured interspinous process devices (IPDs) are on the market in managing symptomatic lumbar spinal stenosis (LSS). However, atraumatic fracture of the intervening spinous process has been reported in patients, particularly, double or multiple level lumbar decompression surgery with IPDs. This study aimed to biomechanically investigate the effects of few commercial IPDs, namely DIAMTM, CoflexTM, and M-PEEK, which were implanted into the L2-3, L3-4 double-level lumbar spinal processes. A validated finite element model of musculoskeletal intact lumbar spinal column was modified to accommodate the numerical analysis of different implants. The range of motion (ROM) between each vertebra, stiffness of the implanted level, intra stress on the intervertebral discs and facet joints, and the contact forces on spinous processes were compared. Among the three implants, the Coflex system showed the largest ROM restriction in extension and caused the highest stress over the disc annulus at the adjacent levels, as well as the sandwich phenomenon on the spinous process at the instrumented levels. Further, the DIAM device provided a superior loading-sharing between the two bridge supports, and the M-PEEK system offered a superior load-sharing from the superior spinous process to the lower pedicle screw. The limited motion at the instrumented segments were compensated by the upper and lower adjacent functional units, however, this increasing ROM and stress would accelerate the degeneration of un-instrumented segments.

Preliminary Investigation of the Diagnosis of Neonatal Congenital Small Bowel Atresia by Ultrasound.

PURPOSE: To assess the diagnostic value of ultrasonography (US) for congenital small bowel atresia (SBA) in neonates and their sonographic characteristics. METHODS: A retrospective analysis was performed of 20 neonates who were confirmed with SBA by operation from March 2014 to January 2019. All the neonates have been scanned by US before surgery, and no one underwent barium enema or upper gastrointestinal imaging prior to US. Preoperation ultrasound characteristics about intestinal morphology and intestinal contents were collected, further to summarize the typical ultrasonic features of SBA. RESULTS: Five cases were duodenal atresia, and 15 cases were jejuno-ileal atresia. Distended proximal intestines, liquid with tiny points in it, can be found in 20 neonates. The small intestine without any gas can be found in 20 neonates. Microcolon, no gas and other contents in it, can be found in 16 cases. CONCLUSIONS: The typical ultrasonic features of SBA include dilation in proximal intestines, small intestines, and microcolon. US is a promising modality in the clinical diagnosis of SBA.

Organic Photosensitizers Incorporating Rigidified Dithieno[3,2-f:2',3'-h]quinoxaline Segment Tethered with Thiophene Substitutes for Dye-Sensitized Solar Cells.

Metal-free D-π-RS-π-A type sensitizers, consisting of triphenylamine as the electron donor, 2,3-bis(3-(2-ethylhexyl)-5-methylthiophen-2-yl)dithieno[3,2-f:2',3'-h]quinoxaline (DTQT) as the rigidified conjugation spacer (RS), thiophene as the π-spacer, and 2-cyanoacrylic acid as the acceptor/anchor, have broad absorption spectra ranging from 350 to 550 nm and a high molar extinction coefficient up to >46 200 M(-1) cm(-1). Under simulated AM 1.5 G illumination, the dye-sensitized solar cells (DSSCs) fabricated from the dyes exhibited light-to-electricity conversions in the range of 6.78% to 8.27%. The best efficiency is slightly higher than that of N719-based standard DSSC (7.92%). The efficiency can be further boosted to 8.51% by optimizing the concentration of LiI electrolyte.

Organic Dyes Incorporating the Dithieno[3,2-f:2',3'-h]quinoxaline Moiety for Dye-Sensitized Solar Cells.

New donor-acceptor'-acceptor-type sensitizers (QBT dyes), comprising arylamine as the electron donor, dithieno[3,2-f:2',3'-h]quinoxaline as the internal acceptor, and 2-cyanoacrylic acid as both the acceptor and anchor, have been synthesized. The QBT dyes have broad absorption spectra covering the range of λ=368-487 nm with a highest molar extinction coefficient of up to approximately 40 000 M(-1) cm(-1) . The light-to-electricity conversion efficiencies of the dye-sensitized solar cells (DSSCs) fabricated from the dyes range from 6.11 to 7.59 % under simulated AM 1.5 G illumination. Upon addition of a threefold concentration of chenodeoxycholic acid as the co-adsorbent, the best performance cell has a power-conversion efficiency of 8.41 %, which is higher than that of the N719-based standard DSSC (8.27 %).

Molluscicidal activity of Aglaia duperreana and the constituents of its twigs and leaves.

The methanol (MeOH) extract of the twigs and leaves of Aglaia duperreana was investigated for its molluscicidal activity against Pomacea canaliculata. The extract was found to exhibit significant molluscicidal activity. The ethyl acetate soluble fraction of the extract showed the most potent molluscicidal activity among different solvent fractions. The bioactivity-guided chemical investigation of the ethyl acetate soluble fraction led to a new triterpenoid along with 15 known compounds. Their structures were elucidated by spectroscopic methods, including one- and two-dimensional nuclear magnetic resonance techniques as well as mass spectroscopic analysis. The molluscicidal activities of compounds 2-16 against P. canaliculata were also investigated. Naringenin trimethyl ether showed significant molluscicidal activity with a median lethal concentration (LC(50)) of 3.9 µg/mL, which was indicated higher potency than the positive control, tea saponin (LC(50)=4.5 µg/mL).

Absolute configuration of monodentate phosphine ligand enantiomers on Cu(111).

Scanning tunneling microscopy (STM) has been employed to investigate the chirality of monophosphine compounds that are highly efficient chiral ligands in transition-metal-catalyzed organic transformations. The absolute configuration of 1-(2-diphenyphosphino-1-naphthyl)isoquinoline enantiomers with axial chirality was discriminated directly by the "marker" group, PPh(2) substitutes. Although the two enantiomer molecules adsorb on a Cu(111) surface and form well-defined (4 x 4) structures, the positions of PPh(2) substitutes in the molecular adlayers are different. The mirror symmetry between two adlayers is demonstrated. On the basis of STM results, structural models are proposed to interpret the chiral adsorption. The results presented here supply a straightforward method for axial chirality analysis in adsorbed adlayers by STM.