Analysis of the Learning Curve in Mitral Valve Replacement Through the Right Anterolateral Minithoracotomy Approach: A Surgeon's Experience with the First 100 Patients.

BACKGROUND: To apply the cumulative sum (CUSUM) failure analysis to assess the performance of a single surgeon during mitral valve replacement via the right anterolateral minithoracotomy (RAMT) approach and to analyse the learning curve for the procedure. METHODS: A total of 100 mitral valve replacements were performed using the RAMT approach from June 2011 to April 2013 by a single surgeon with no prior experience of this technique. Patients were divided into five blocks according to the operation date. The perioperative data were collected prospectively and analysed using descriptive statistics and CUSUM failure analysis. RESULTS: No significant differences in the background factors among the five periods were observed, except for a small increase in patient age from periods 1 to 5 (p=0.004). The surgeon's performance improved with time; a decrease in the cross-clamp time, operative time, and blood loss was observed (p<0.001). However, no significant difference in the number of failed cases was observed among the periods. All failure cases were evaluated by the CUSUM failure analysis and the CUSUM curve reflected a learning curve associated with this new procedure. The surgeon crossed the lower 80% boundary after about 33 operations, which indicates that better results can be obtained after this point. CONCLUSIONS: Minimally invasive mitral valve surgery using the RAMT approach can be performed by a new surgeon. Furthermore, CUSUM curve analysis is a simple statistical method to implement continuous individual performance monitoring.

Application of Da Vinci Robot and Thoracoscopy in Radical Lung Cancer Surgery.

In this article, we have explored the feasibility and safety of Da Vinci's robotic surgery system in the radical resection of lung cancer. For this purpose, 73 cases of patients with lung cancer who underwent radical resection in the thoracic surgery of our hospital, particularly from July to September 2020, were collected, of which 22 cases operated with the Da Vinci robot were the Da Vinci robot group, including 11 men and 11 women. The 51 patients who underwent thoracoscopic surgery were in the thoracoscopic group, including 24 males and 27 females. All 22 patients in the Da Vinci robot group completed the operation under the Da Vinci robot operation system without conversion to thoracotomy. In the thoracoscopic group, 49 patients successfully completed the operation under thoracoscopy, and 2 patients were converted to thoracotomy. There was a significant difference between the two groups in the average operation time and the number of lymph nodes, but there was no significant difference in the amount of intraoperative bleeding and postoperative hospital stay. Compared with thoracoscopic radical lung cancer surgery, Da Vinci's robotic surgery system is equally safe and effective, and more lymph nodes are cleaned during surgery.

Suppressing vanadium dissolution of V2O5via in situ polyethylene glycol intercalation towards ultralong lifetime room/low-temperature zinc-ion batteries.

Zinc-ion batteries (ZIBs) are a main focus worldwide for their potential use in large-scale energy storage due to their abundant resources, environmental friendliness, and high safety. However, the cathode materials of ZIBs are limited, requiring a stable host structure and fast Zn2+ channel diffusion. Here, we develop a strategy for the intercalation of polyethylene glycol (PEG) to facilitate Zn2+ intercalation and to suppress the dissolution of vanadium in V2O5. In particular, PEG-V2O5 shows a high capacity of 430 mA h g-1 at a current density of 0.1 A g-1 as well as excellent 100 mA h g-1 specific capacity after 5000 cycles, with a high current density of 10.0 A g-1. A reversible capacity of 81 mA h g-1 can even be achieved with a low temperature of -20 °C at a current density of 2.0 A g-1 after 3500 cycles. The superior electrochemical performance comes from the intercalation of PEG molecules, which can improve kinetic transport and structural stability during the cycling process. The Zn2+ storage mechanism, which provides essential guidelines for the development of high-performance ZIBs, can be found through various ex situ characterization technologies and density functional density calculations.

Non-intubated, intravenous anesthesia with spontaneous ventilation versus routine intravenous anesthesia in video-assisted thoracoscopic surgery: A randomized controlled trial / 中国胸心血管外科临床杂志

@#Objective    To compare the feasibility and safety of video-assisted thoracoscopic surgery (VATS) under non-intubated, intravenous anesthesia with spontaneous ventilation. Methods    A total of 80 patients undergoing VATS (48 wedge resections, 8 sympathectomies, 24 pleural biopsies) between January 2015 and June 2017 were included. Those patients were randomized into two groups. The 40 patients were enrolled as a treatment group (19 males and 21 females at age of 23.3±10.2 years) and received surgery under non-intubated intravenous anesthesia with spontaneous ventilation. And the other 40 patients were enrolled as a control group (21 males and 19 females at age of 22.2±9.9 years) and received surgery under routine intravenous anesthesia with intubated ventilation. Results    Comparing with the control group, the patients of the treatment group had lower white blood cell count (5.8×109±2.4×109 vs. 7.3×109±3.6×109, P<0.001), lower gastrointestinal adverse reaction rate (7.5% vs. 27.5%, P=0.002), lower sore throat rate (5.0% vs. 30.0%, P<0.001), lower cough grade (0.9±0.3 vs 2.1±0.5, P<0.050), shorter drainage time (1.8±1.6 d vs. 3.7±1.8 d, P<0.050) and shorter hospital stay (2.3±1.8 d vs. 5.8±2.3 d, P<0.050). Conclusion    Video-assisted thoracoscopic surgery under non-intubated, intravenous anesthesia with spontaneous ventilation is safe and feasible, which also has certain advantages in reducing the postoperative complications and promoting patients' quick recovery from surgery.

Selective synthesis of secondary amines by Pt nanowire catalyzed reductive amination of aldehydes and ketones with ammonia.

The process of the reductive amination of aldehydes or ketones in the presence of ammonia using unsupported ultra-thin Pt nanowires has been developed. This catalytic system shows high activity and selectivity under mild reaction conditions.

A highly active nano-palladium catalyst for the preparation of aromatic azos under mild conditions.

A worm-like Pd nanocatalyst has been prepared and used in the preparation of azo compounds from nitroaromatics under mild reaction conditions. This highly dispersible nano-Pd catalyst shows high activity toward the synthesis of both symmetric aromatic azo compounds and a range of asymmetric aromatic azo compounds.