Room temperature tunable multicolor phosphorescent polymers for humidity detection and information encryption.

Amorphous polymer-based room temperature phosphorescence (RTP) materials exhibiting tunable emission colors have received tremendous attention and are extremely challenging to prepare. Herein, polyacrylamide-based RTP materials with tunable multicolor emission were prepared via copolymerizing phosphor with concentration dependent luminescence colors and acrylamide with different molar ratios. The hydrogen bonding interactions and chemically crosslinked structures in these polymers effectively restrict the mobility of phosphors and activate efficient RTP emission. The molar ratio of phosphor and acrylamide has a significant influence on the photophysical properties of these polymers, which can be used to fabricate multicolor materials. In addition, the RTP intensity decreases with increasing humidity due to the disassociation of hydrogen bonding by adsorption of water, manifesting as a humidity sensor. Benefiting from the distinguishable RTP lifetimes and the responsiveness to humidity, triple encoding for information encryption is successfully realized.

A bio-inspired, ultra-tough, high-sensitivity, and anti-swelling conductive hydrogel strain sensor for motion detection and information transmission.

Conductive hydrogels are excellent candidates for the next-generation wearable materials and are being extensively investigated for their potential use in health monitoring devices, human-machine interfaces, and other fields. However, their relatively low mechanical strength and performance degradation due to swelling have presented challenges in their practical application. Inspired by the multiscale heterogeneous architecture of biological tissue, a dynamic cross-linked, ultra-tough, and high-sensitivity hydrogel with a swelling resistance characteristic was fabricated by the principle of multiple non-covalent interaction matching and a step-by-step construction strategy. A heterogeneous structure was constructed by the combination of a 'soft' hydrophobic-conjugated micro-region structural domain with inter/intra-molecular hydrogen bonding and π-π stacking along with 'rigid' cross-linking via strong ionic coordination interactions. Reversible cross-linking synergies and variations in the content of rigid and flexible components guaranteed the hydrogel to undergo flexible and efficient modulation of the structures and gain excellent mechanics, including elongation at break (>2000%), toughness (∼60 MJ m-3), and recovery (>88%). Notably, hydrogels displayed good anti-swelling properties even in solutions with different pH (pH 2-11) and solvents. Moreover, the hydrogel further exhibited fast response (47.4 ms) and high sensitivity due to the presence of dynamic ions (Fe3+, Na+, and Cl-); therefore, it was assembled into a sensor to detect various human motions and used as a signal transmitter for the encryption and decryption of information according to Morse code. This study provides basis for the development of a variety of robust and flexible conductive hydrogels with multifunctional sensing applications in next-generation wearable devices.

A Hematological-Related Prognostic Scoring System for Patients With Newly Diagnosed Glioblastoma.

BACKGROUND: Glioblastoma is the most common primary malignant brain tumor. Recent studies have shown that hematological biomarkers have become a powerful tool for predicting the prognosis of patients with cancer. However, most studies have only investigated the prognostic value of unilateral hematological markers. Therefore, we aimed to establish a comprehensive prognostic scoring system containing hematological markers to improve the prognostic prediction in patients with glioblastoma. PATIENTS AND METHODS: A total of 326 patients with glioblastoma were randomly divided into a training set and external validation set to develop and validate a hematological-related prognostic scoring system (HRPSS). The least absolute shrinkage and selection operator Cox proportional hazards regression analysis was used to determine the optimal covariates that constructed the scoring system. Furthermore, a quantitative survival-predicting nomogram was constructed based on the hematological risk score (HRS) derived from the HRPSS. The results of the nomogram were validated using bootstrap resampling and the external validation set. Finally, we further explored the relationship between the HRS and clinical prognostic factors. RESULTS: The optimal cutoff value for the HRS was 0.839. The patients were successfully classified into different prognostic groups based on their HRSs (P < 0.001). The areas under the curve (AUCs) of the HRS were 0.67, 0.73, and 0.78 at 0.5, 1, and 2 years, respectively. Additionally, the 0.5-, 1-y, and 2-y AUCs of the HRS were 0.51, 0.70, and 0.79, respectively, which validated the robust prognostic performance of the HRS in the external validation set. Based on both univariate and multivariate analyses, the HRS possessed a strong ability to predict overall survival in both the training set and validation set. The nomogram based on the HRS displayed good discrimination with a C-index of 0.81 and good calibration. In the validation cohort, a high C-index value of 0.82 could still be achieved. In all the data, the HRS showed specific correlations with age, first presenting symptoms, isocitrate dehydrogenase mutation status and tumor location, and successfully stratified them into different risk subgroups. CONCLUSIONS: The HRPSS is a powerful tool for accurate prognostic prediction in patients with newly diagnosed glioblastoma.

Poly(N-isopropylacrylamide)/polydopamine/clay nanocomposite hydrogels with stretchability, conductivity, and dual light- and thermo- responsive bending and adhesive properties.

Conducting hydrogels have attracted attention as a special functional class of smart soft materials and have found applications in various advanced fields. However, acquiring all the characteristics such as conductivity, adequate adhesiveness, self-healing ability, stretchability, biocompatibility, and stimulating deformation responsiveness still remains a challenge. Inspired by the mechanism of bioadhesion in marine mussels, a multifunctional nanocomposite hydrogel with excellent adhesiveness to a broad range of substrates including human skin was developed with the help of synergistic multiple coordination bonds between clay, poly(N-isopropylacrylamide) (PNIPAM), and polydopamine nanoparticles (PDA-NPs). The prepared hydrogel showed controllable near-infrared (NIR) responsive deformation after incorporation of PDA-NPs as highly effective photothermal agents in the thermo-sensitive PNIPAM network. Meanwhile, the fabricated nanocomposite hydrogels showed excellent stretchability and conductivity, which make them attractive material candidates for application in various fields, such as electronic skin, wearable devices, and so on.

Removal of pediatric stage IV neuroblastoma by robot-assisted laparoscopy: A case report and literature review.

BACKGROUND: Neuroblastoma (NB) is the most common extracranial solid tumor in children, with an incidence of approximately 1/10000. Surgical resection is an effective treatment for children with NB. Robot-assisted laparoscopic surgery is a new method and is superior to conventional laparoscopic surgery, since it has been preliminarily applied in clinical practice with a significant curative effect. This paper discusses significance and feasibility of complete resection of stage IV NB using robot-assisted laparoscopic surgery, while comparing its safety and effectiveness with conventional laparoscopic surgery. CASE SUMMARY: In June 2018, a girl with stage IV retroperitoneal NB, aged 3 years and 5 mo, was admitted. Her weight was 15 kg, and her height was 100 cm. Robot-assisted, five-port laparoscopic resection of NB was performed. Starting from the middle point between the navel and the anterior superior iliac spine to the left lower abdomen, the pneumoperitoneum and observation hole (10 mm) were established using the Hasson technique. Operation arm #1 was located between the left anterior axillary line, the navel, and the costal margin (8 mm); operation arm #2 was located at the intersection of the right anterior axillary line and Pfannenstiel line (8 mm); one auxiliary hole was located between arm #2 (on the Pfannenstiel line) and the observation hole (12 mm); and another auxiliary hole (5 mm) was located slightly below the left side of the xiphoid. Along the right line of Toldt and the hepatic flexure of the transverse colon, the colon was turned to the left and below with a hook electrode. Through Kocher's incision, the duodenum and the pancreatic head were turned to the left to expose the inferior vena cava and the abdominal aorta. The vein was separated along the right external iliac, and the inferior vena cava was then lifted to expose the right renal vein from the bottom to the top. The tumor was transected horizontally below the renal vein, and it was first cut into pieces and then resected. The right renal artery and the left renal vein were also exposed, and the retrohepatic inferior vena cava was isolated. The tumor was resected along the surface of the psoas muscle, the back of the inferior vena cava, and the right side of the abdominal aorta. Finally, the lymph node metas-tases in front of the abdominal aorta and left renal vein were completely removed. The specimens were loaded into a disposable specimen retrieval bag and removed from the enlarged auxiliary hole. T-tube drainage was placed and brought out through a hole in the right lower quadrant of the abdomen. The operative time was 389 min, the time of pneumoperitoneum was 360 min, the intraoperative blood loss was approximately 200 mL, and the postoperative recovery was smooth. There were no complications, such as lymphatic fistula, diarrhea, bleeding, and paralytic ileus. Two months after discharge, there were no other complications. The literature on the application of robot-assisted laparoscopic surgery in the treatment of NB in children was reviewed. CONCLUSION: The robot has the advantages of a three-dimensional view and flexible operation, and it can operate finely along blood vessels. The successful experience of this case confirmed that robot-assisted laparoscopic surgery can skeletonize the abdominal blood vessels in the tumor and cut the tumor into pieces, indicating that robot-assisted laparoscopic surgery is feasible.

Retroperitoneoscopic approach for partial nephrectomy in children with duplex kidney: A case report.

BACKGROUND: Renal duplication is a common deformity of the urinary system, with an incidence of approximately 1/125 in children. Symptomatic patients with hydronephrosis, vesicoureteral reflux, or incontinence may require surgical interventions. Laparoscopy and retroperitoneoscopy are the two main accesses for partial nephrectomy. CASE SUMMARY: A 9-year-old child was admitted to the hospital for hydronephrosis of the left kidney. Ultrasonography showed that the left kidney was larger, approximately 12.6 cm × 6.3 cm × 5.5 cm in size, with visible separation of the pelvis and an obviously separated lower portion. The upper segment of the left ureter was dilated (approximately 2.6 cm in width), and no significant dilation was observed in the middle and upper segments. The right kidney and ureter were normal. Primary diagnosis was left renal duplication malformation and hydronephrosis. Retroperitoneal laparoscopic nephrectomy and ureterectomy were performed. Intraoperative exploration revealed a dilated pelvis and thin renal parenchyma at the lower pole of the left kidney. The upper left kidney was smaller than normal, and the pelvis and ureter were larger than normal. The renal artery was blocked for 40 min. A hemolock was used to clamp down the kidney ureter, and a drainage tube was retained in the retroperitoneal cavity. The operation was uneventful, and the estimated amount of blood loss was 100 mL. Total abdominal drainage amount was 116 mL. The drainage tube was removed on postoperative day (POD) 3 and the patient was discharged on POD6. The pathological diagnosis confirmed the atrophy of the renal parenchyma, the dilation of the renal pelvis, hydronephrosis, and ureteral cystic dilation. CONCLUSION: The retroperitoneoscopic approach for partial nephrectomy is feasible and effective in selective pediatric patients with a duplex kidney.

Robot-assisted gallbladder-preserving hepatectomy for treating S5 hepatoblastoma in a child: A case report and review of the literature.

BACKGROUND: Hepatoblastoma (HB) is the most common hepatic malignant tumour in children, accounting for approximately 50%-60% of primary hepatic malignant tumours in children, mostly in children under 3 years old. In Western countries, the incidence of hepatoblastoma is approximately 1-2/100000. Da Vinci surgical system is fast becoming a key instrument in microinvasive surgery. The past decade has seen the rapid development of robot-assisted laparoscopy, which expends many fields including the liver surgery. This paper discusses the significance and feasibility of robot-assisted gallbladder-preserving hepatectomy for treating S5 hepatoblastoma in children. The aim of this essay is to compare the safety and effectiveness of robotic surgery with conventional laparoscopic surgery, and explore the meaning of preservation of the gallbladder by sharing this case. CASE SUMMARY: A 3-year-old child with a liver mass in the 5th segment was treated using the Da Vinci surgical system, and the gallbladder was retained. The child was admitted to the hospital for 20 d for the discovery of the right hepatic lobe mass. Ultrasonography revealed a low echo mass, 46 mm × 26 mm × 58 mm in size, indicating hepatoblastoma in the right lobe, and enhanced computed tomography showed continuous enhancement of iso-low-density lesions with different sizes and nodules and unclear boundaries, without the dilation of the intrahepatic bile duct, no enlargement of the gallbladder, and uniform thickness of the wall. The diagnosis was "liver mass, hepatoblastoma". It was decided to perform S5 liver tumour resection. During surgery, the tumour and gallbladder were isolated first, and the gallbladder could be completely separated from the tumour surface without obvious infiltration; therefore, the gallbladder was preserved. The cutting line was marked with an electric hook. The hepatic duodenal ligament was blocked with a urethral catheter using the Pringle method, and the tumour and part of the normal liver tissue were completely resected with an ultrasound knife along the incision. The hepatic portal interdiction time was approximately 25 min. An abdominal drainage tube was inserted. The auxiliary hole was connected to the lens, and the specimen was removed. The patient's status was uneventful, and the operation time was 166 min. The robotic time was 115 min, and the bleeding amount was approximately 200 mL. In total, 300 mL of red blood cell suspension and 200 mL of plasma were injected. No serious complications occurred. Pathological findings confirmed fetal hepatoblastoma and R0 resection. A gallbladder contraction test was performed two weeks after surgery. CONCLUSION: Robot-assisted S5 hepatectomy with gallbladder preservation is safe and feasible for specific patients.

Robotic-assisted surgery for pediatric choledochal cyst: Case report and literature review.

Our paper describes the key surgical points of pediatric choledochocystectomy performed completely by Da Vinci robotic system. A choledochocystectomy was safely carried out for a girl at our hospital, and without any complication. Then systematic literature review was done to discuss the methods of intestine surgery and intestinal anastomosis, the use of 3rd robotic arm, the surgical safety and advantages comparing open and laparoscopic surgery. We systematically reviewed choledochocystectomy for children performed by robotic surgery. We included a total of eight domestic and foreign reports and included a total of 86 patients, whose average age was 6.3 (0.3-15.9) years; the male-to-female ratio was 1:3.5 (19:67). Seven patients experienced conversion to open surgery, and the surgery success rate was 91.9% (79/86). The average total operation time was 426 (180-520) min, the operation time on the machine was 302 (120-418) min, 11 cases used the number 3 arm, and the remaining mainly used the hitch-stitch technique to suspend the stomach wall and liver. Forty-seven patients underwent pull-through intestine and intestinal anastomosis, and 39 patients underwent complete robotic intestine surgery and intestinal anastomosis. The hospitalization time of robotic-assisted choledochocystectomy was 8.8 d. Eight patients had biliary fistula and were all cured by conservative treatment and continuous observation. One patient had anastomotic stenosis, and one patient had wound dehiscence, both cured by surgery. Choledochocystectomy for children performed by completely robotic surgery and Roux-en-Y hepaticojejunostomy is safe and feasible. The initial experience shows that this surgical approach has a clearer field than the traditional endoscopy, and its operation is more flexible, the surgery is more accurate, and the injury is smaller. With the advancement of technology and the accumulation of surgeons' experience, robotic surgery may become a new trend in this surgical procedure.

Intervention effects of ganoderma lucidum spores on epileptiform discharge hippocampal neurons and expression of neurotrophin-4 and N-cadherin.

Epilepsy can cause cerebral transient dysfunctions. Ganoderma lucidum spores (GLS), a traditional Chinese medicinal herb, has shown some antiepileptic effects in our previous studies. This was the first study of the effects of GLS on cultured primary hippocampal neurons, treated with Mg(2+) free medium. This in vitro model of epileptiform discharge hippocampal neurons allowed us to investigate the anti-epileptic effects and mechanism of GLS activity. Primary hippocampal neurons from <1 day old rats were cultured and their morphologies observed under fluorescence microscope. Neurons were confirmed by immunofluorescent staining of neuron specific enolase (NSE). Sterile method for GLS generation was investigated and serial dilutions of GLS were used to test the maximum non-toxic concentration of GLS on hippocampal neurons. The optimized concentration of GLS of 0.122 mg/ml was identified and used for subsequent analysis. Using the in vitro model, hippocampal neurons were divided into 4 groups for subsequent treatment i) control, ii) model (incubated with Mg(2+) free medium for 3 hours), iii) GLS group I (incubated with Mg(2+) free medium containing GLS for 3 hours and replaced with normal medium and incubated for 6 hours) and iv) GLS group II (neurons incubated with Mg(2+) free medium for 3 hours then replaced with a normal medium containing GLS for 6 hours). Neurotrophin-4 and N-Cadherin protein expression were detected using Western blot. The results showed that the number of normal hippocampal neurons increased and the morphologies of hippocampal neurons were well preserved after GLS treatment. Furthermore, the expression of neurotrophin-4 was significantly increased while the expression of N-Cadherin was decreased in the GLS treated group compared with the model group. This data indicates that GLS may protect hippocampal neurons by promoting neurotrophin-4 expression and inhibiting N-Cadherin expression.

Preliminary experimental research on the mechanism of liver bile secretion stimulated by peppermint oil.

OBJECTIVE: To investigate the choleretic effect and molecular mechanisms of action of peppermint oil (PO), the main component of Danshu capsules (Sichuan Jishengtang Pharmaceutical Co., Ltd., Pengzhou, Sichuan Province, China). METHODS: Bile secretion was measured by biliary drainage in rats. Total bile acids, total cholesterol and bilirubin in bile were determined. Cholesterol 7α-hydroxylase (CYP7A1), and farnesoid X receptor (FXR) messenger ribonucleic acid (mRNA) levels were assessed in HepG2 cells (a human hepatocellular carcinoma cell line) by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: PO significantly promoted bile and bile acid secretion in rats. It also increased bile acid efflux and decreased cholesterol levels (P < 0.01) in bile. In HepG2 cells the mRNA levels of CYP7A1 and FXR were significantly upregulated after treatment with PO. CONCLUSIONS: PO stimulates bile fluid secretion and thus has a choleretic effect. PO might play a role in upregulating CYP7A1 and FXR mRNA levels, suggesting that the molecular mechanisms are related to gene expression involved in bile acid synthesis.