Management of Nontraumatic Spontaneous Renal Hemorrhage (Wünderlich Syndrome) through Robotic-Assisted Laparoscopic Nephrectomy: A Case Series.

BACKGROUND Wünderlich syndrome (WS) is a rare diagnosis of nontraumatic spontaneous renal hemorrhage into the subcapsular, perirenal, or pararenal spaces. Prompt and effective intervention is necessary for an accurate pathological diagnosis and preservation of life. In the current literature, open surgery is the primary option when conservative treatment fails, but there can be serious trauma and corresponding consequences. Herein, we present 3 cases of Wünderlich syndrome managed by robot-assisted laparoscopic nephrectomy via a retroperitoneal approach. CASE REPORT Patient 1 was a 44-year-old woman with right flank pain for 6 h. Patient 2 was a 53-year-old woman with a history of diabetes who had pain in her right flank pain and nausea for 1 day. Patient 3 was a 45-year-old man with left flank pain for 1 day. All cases of WS were confirmed by CT. All 3 patients were treated with retroperitoneal robot-assisted nephrectomy after conservative treatment failed. Pathological examination confirmed that patient 1 had angiomyolipoma, and patients 2 and 3 had renal clear cell carcinoma. At the 9-month follow-up, renal function was good and no evidence of recurrence or metastasis has been detected. CONCLUSIONS These cases have highlighted the importance of the clinical history and imaging findings in the diagnosis of Wünderlich syndrome, and show that rapid management can be achieved using robot-assisted laparoscopic nephrectomy. However, it is crucial to have a skilled surgical team and adequate preoperative preparation.

Removal of Fermentation Inhibitors from Sugarcane Bagasse Hydrolysate via Post-cross-linked Hydrophilic-Hydrophobic Interpenetrating Polymer Networks.

The efficient and economical removal of fermentation inhibitors from the complex system of biomass hydrolysate was one of the basics and keys in bio-chemical transformation. In this work, post-cross-linked hydrophilic-hydrophobic interpenetrating polymer networks (PMA/PS_pc IPNs and PAM/PS_pc IPNs) were proposed to remove fermentation inhibitors from sugarcane bagasse hydrolysate for the first time. PMA/PS_pc and PAM/PS_pc IPNs can obviously enhance the adsorption performance towards fermentation inhibitors due to their higher surface area and hydrophilic-hydrophobic synergetic surface properties, especially PMA/PS_pc IPNs has higher selectivity coefficients of 4.57, 4.63, 4.85, 16.0, 49.43, and 22.69, and higher adsorption capacity of 24.7 mg/g, 39.2 mg/g, 52.4 mg/g, 9.1 mg/g, 13.2 mg/g, and 144.9 mg/g towards formic acid, acetic acid, levulinic acid (LA), 5-hydroxymethylfurfural (HMF), furfural, and acid-soluble lignin (ASL), respectively, in a lower total sugar loss of 2.03%. The adsorption kinetics and isotherm of PMA/PS_pc IPNs were studied to elucidate its adsorption behavior towards fermentation inhibitors. In addition, the cyclic utilization property of PMA/PS_pc IPNs was stable. Synthesizing PMA/PS_pc IPNs is a new strategy to provide an efficient adsorbent for the removal of fermentation inhibitors from lignocellulosic hydrolysate.

Synthesis of Hyper-cross-linked Nonpolar Polystyrene Divinylbenzene Resins by Pendent Vinyl Groups and Application to the Decolorization of Cane Molasses.

Cane molasses is a by-product of sugar industry. It is widely used in fermentation field, but pigment compounds affect its further application. In this study, nonpolar hyper-cross-linked adsorption resins (HCARs) were synthesized by pendent vinyl groups cross-linking reaction, and were applied to decolorization of molasses. The correlation between the structure and the decolorization performance of HCARs was studied, and the results showed that the Brunauer-Emmett-Teller (BET) surface area and the pore volume of the resin significantly increased to 574.4 m2·g-1 and 1.40 cm3·g-1 after the Friedel-Crafts alkylation reaction with a catalyst dosage of 2.25% at 343 K for 7 h. Furthermore, the decolorization rate of molasses by the HCAR was 74%, and recycle decolorization performance of the resin was stable. The adsorption kinetics results showed that the pseudo-second-order dynamic model could more realistically reflect the decolorization mechanism of molasses on HCARs, and liquid film diffusion is the main rate-limiting step. The results of fixed-bed experiments show that D-ST-DVB resin has a good decolorization effect and recycling ability. Therefore, it is a feasible strategy for the decolorization of molasses with nonpolar HCAR.

Isotactic Polybutene-1/Bamboo Powder Composites with Excellent Properties at Initial Stage of Molding.

Isotactic polybutylene-1 (iPB) has lots of advantages and is best used as hot water pipe. However, to transform into stable crystal form I, the iPB needs as long as 7 days. In this process, the irreversible damage brings great difficulties to the use of the iPB. The method which convert it directly into crystal I has shortcomings such as being requiring complex operation and being expensive. In this study, an innovative idea was put forward, not paying attention to the crystal transformation of iPB but only focusing on reducing the time it can be applied. In this study, bamboo powder was modified by the silane coupling agent KH570 (KBP) to prepare iPB/KBP composite. The infiltration test and Fourier transform infrared (FTIR) analysis showed that the hydrophilicity of KBP is greatly reduced, which can greatly improve the compatibility of the iPB and KBP. The tensile strength, tensile modulus, flexural strength, and flexural modulus of the composites storage for 3 days is equal to the pure iPB with storage 7 days with the KBP additions of 3%, 3%, 7%, and 5%, respectively. The heat deformation temperature (HDT) of the composite with 3% KBP after 1-day storage reached the value of pure iPB storage for 7 days. This provides more space and possibilities for the industrialization of the iPB. The crystallization behavior of iPB/KBP composites proves that the addition of KBP accelerates the crystallization rate of iPB, but the crystallinity of the iPB/KBP composites is not changed. The SEM photograph of iPB/KBP composites showed that when the KBP addition was low the compatibility between KBP and iPB was good. When the KBP addition was increased the agglomeration of KBP in the iPB was very obvious, which leads to the poor mechanical properties of the composite.

Transcrystallization of Isotactic Polypropylene/Bacterial Cellulose Hamburger Composite.

Isotactic polypropylene (iPP) is a commonly used thermoplastic polymer with many excellent properties. But high brittleness, especially at low temperatures, limits the use of iPP. The presence of transcrystallization of iPP makes it possible for fiber-reinforced iPP composites with higher strength. Bacterial cellulose (BC) is a kind of cellulose with great potential to be used as a new filler to reinforce iPP due to its high crystallinity, biodegradability and efficient mechanical properties. In this study, the iPP/BC hamburger composite was prepared by a simple hot press and maleic anhydride grafted polypropylene (MAPP) was used to improve the interface compatibility of iPP and BC. The polarizing microscope (POM) photograph shows that BC successfully induces the transcrystallization of iPP. The differential Scanning Calorimeter (DSC) date proves that the addition of BC could improve the thermal properties and crystallization rate of the composite. Especially, this change is more obvious of the iPP/MAPP/BC. The mechanical properties of the iPP/BC composites were greatly increased. This DSC date is higher than BC; we used BC particles to enhance the iPP in our previous research. The scanning Electron Microscope (SEM) analysis intuitively shows that the interface of the iPP/MAPP/BC is more smooth and flat than the iPP/BC. The fourier Transform infrared spectroscopy (FT-IR) analysis of the iPP/BC hamburger composites was shown that a new C=O group vibration appeared at 1743 cm-1, which indicated that the hydrogen bond structure of BC molecules was weakened and some hydroxyl groups were substituted after modification which can increase the lipophilicity of BC. These results indicated that the BC fiber can easily induce the transcrystallization of iPP, which has excellent mechanical properties. Moreover, the addition of MAPP contributes greatly to the interface compatibility of iPP and BC.

Isothermal Crystallization and Rheology Properties of Isotactic Polypropylene/Bacterial Cellulose Composite.

Bacterial cellulose (BC) is a new kind of cellulose with great potential in enhancing preparation of isotactic Polypropylene (iPP) composites, which have been found with excellent performance. However, the interface compatibility between BC and iPP is poor. In this study, iPP/BC composites were prepared by solution mixing. Esterification modified BC (CO) and Maleic anhydride grafted polypropylene (MAPP) added as a compatibilizer was both used to improve the interfacial compatibility of the iPP/BC composites. The rheology and isothermal crystallization behavior of the composites was tested and discussed. The result shows that the complex viscosity and storage modulus of the composite significantly increase in the rule iPP, iPP/BC2, iPP/CO2, and M-iPP/BC3, which indicates that the compatibility of the composite increases as this rule. According to the isothermal crystallization kinetics result, the crystal growth mode of iPP was not affected by the addition of BC and the interfacial compatibility. The spherulite growth rate of the iPP/BC composite increases with increasing crystallization temperature. Especially, the value decreases as the same rule with the complex viscosity and storage modulus of the composite at the same isothermal crystallization temperature. These results suggest that the interface compatibility of iPP/BC composites is greatly improved and the interface compatibility of the M-iPP/BC3 is better than the iPP/CO2.