[Application of Erector Spinae Plane Block in Spine Surgery:A Review].

Spine surgery may lead to moderate to severe pain.Poorly controlled postoperative pain seriously affects the prognosis and recovery of patients.The erector spinae plane block (ESPB),firstly proposed in 2016 as a novel interfascial plane block,has been widely used in the management of intraoperative and postoperative pain in spine surgery.It has been confirmed as a safe,simple,and effective block.This review describes the anatomic basis,mechanism,and methods of ESPB,summarizes the clinical application of ESPB in spine surgery,and makes an outlook on the potential role of ESPB as a part in the multimodal management of postoperative pain in spine surgery.

An Octacarboxylate-Linked Sodium Metal-Organic Framework with High Porosity.

Alkali metal-based metal-organic frameworks (MOFs) with permanent porosity are scarce because of their high tendency to coordinate with solvents such as water. However, these MOFs are lightweight and bear gravimetric benefits for gas adsorption related applications. In this study, we present the successful construction of a microporous MOF, designated as HIAM-111, built solely on sodium ions by using an octacarboxylate linker. The structure of HIAM-111 is based on 8-connected Na4 clusters and exhibits a novel topology with an underlying 32,42,8-c net. Remarkably, HAM-111 possesses a robust and highly porous framework with a BET surface area of 1561 m2/g, significantly surpassing that of the previously reported Na-MOFs. Further investigations demonstrate that HIAM-111 is capable of separating C2H2/CO2 and purifying C2H4 directly from C2H4/C2H2/C2H6 with high adsorption capacities. The current work may shed light on the rational design of robust and porous MOFs based on alkali metals.

Carpets with visual cues can improve gait in Parkinson's disease patients: may be independent of executive function.

BACKGROUND: Gait impairment is common in Parkinson's disease (PD) patients, which greatly reduces their quality of life. Executive dysfunction is associated with gait impairment. Compensatory strategies, including visual cues, have been shown to be effective in improving PD gait. In this study, we aimed to understand whether carpets with visual cues could improve PD gait, and how the improvement varies across patients with different executive function state. METHODS: We designed carpets with chessboard and stripe cues. A total of 65 Chinese PD patients were recruited. Movement Disorder Society Unified Parkinson's Disease Rating Scale, L-dopa equivalent daily dosage, Hoehn & Yahr stage, Frontal Assessment Battery, Mini Mental State Examination Scale, Hamilton Anxiety Scale, and Hamilton Depression Scale were evaluated. Gait parameters including stride length, gait speed and fall risk were recorded by a wearable electronic device. RESULTS: The stride length and gait speed were significantly improved and the fall risk was significantly mitigated when PD patients walked on carpets with chessboard and stripe patterns. Further analysis showed the amelioration of gait parameters was independent of executive dysfunction. CONCLUSIONS: Our study demonstrates that carpets with visual cues can improve the gait of PD patients even in those with mild executive dysfunction.

Isolated unilateral oculomotor palsy caused by pure midbrain infarction: a case report.

Purpose: Multiple etiologies may cause oculomotor nerve palsies. Identification of different etiologies is very important for subsequent treatment. Midbrain infarction is a rare cause of oculomotor nerve palsy. Materials and methods: We herein present a case of isolated unilateral oculomotor paresis caused by pure midbrain infarction. Results: Her pupillary sphincter and inferior rectus muscles were selectively spared. The symptoms were completely relieved after two months of antiplatelet therapy. We proposed that fibers from Edinger-Westphal nucleus and inferior rectus nucleus do not course through the paramedian area of the midbrain. Conclusions: Our report adds to the understanding of fascicles arrangement in the midbrain.

Separation of C2H2/C2H4/C2H6 and C2H2/CO2 in a Nitrogen-Rich Copper-Based Microporous Metal-Organic Framework.

The purification of industrially valuable C2H2 and C2H4 from multicomponent mixtures represents a crucial process in the chemical industry. In this study, we present a copper-based metal-organic framework (L-py-Cu) built on a nitrogen-rich organic linker that is capable of separating C2H2/C2H4/C2H6 and C2H2/CO2 mixtures, therefore producing highly pure C2H4 and C2H2, respectively. L-py-Cu exhibits favorable adsorption of C2H2 and C2H6 over C2H4 and thus achieves one-step C2H4 purification from C2H2/C2H4/C2H6 ternary mixtures, as verified by multicomponent breakthrough measurements. In addition, it can also extract C2H2 from C2H2/CO2 binary mixtures.

Possible Risk Factors for Severe Complications Occurring after Primary Total Knee Arthroplasty.

Objective Total knee arthroplasty is one of the most common orthopedic surgeries. Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons. In this study, we evaluated the risk factors for severe complications after primary total knee arthroplasty. Methods We retrospectively collected clinical data of 2,974 patients who underwent primary total knee arthroplasty from July 2013 to June 2019 in our hospital. Postoperative complication ≥ grade Ⅲ was defined as severe complication according to Clavien-Dindo classification system. Binary logistic regression was used to identify the predictive risk factors for severe complications. Results The complication rate after primary total knee arthroplasty was 6.8% and severe complication rate was 2.5%. Male (OR = 2.178, 95%CI: 1.324-3.585, P= 0.002), individuals above 75 years old (OR = 1.936, 95%CI: 1.155-3.244, P= 0.012), arrhythmia (OR = 2.913, 95%CI: 1.350-6.285, P= 0.006) and cerebrovascular disease (OR = 2.804, 95%CI: 1.432-5.489, P= 0.003) were predictive risk factors for severe complications after primary total knee arthroplasty. Conclusion Advanced age, male, arrhythmia, and cerebrovascular disease might be patients-related risk factors for postoperative severe complications after primary total knee arthroplasty. Special attention should be paid to patients with risk factors.

Lanthanide-Organic Frameworks with Uncoordinated Lewis Base Sites: Tunable Luminescence, Antibiotic Detection, and Anticounterfeiting.

Several new isostructural lanthanide metal-organic frameworks (Ln-MOFs), {[Ln2(L)3DMA4]·2DMA}n (1-Ln, where Ln = Eu, Tb, or EuxTb1-x), were first constructed via the solvothermal reactions of 4,6-di(4-carboxyphenyl)pyrimidine and Ln3+ ions. 1-Ln exhibits a 4-connected two-dimensional framework endowed with uncoordinated Lewis base sites. An exploration of luminescence sensing demonstrated 1-Eu can be used for the selectivity detection of dimetridazole and metronidazole antibiotics in other antibiotics, blood plasma, and urine, acting as an exceptional recyclable luminescent probe. More importantly, the luminescent inks of 1-Ln are invisible, color adjustable, and stabilized, which may greatly improve their anticounterfeiting applications.

Possible Risk Factors for Severe Complications Occurring after Primary Total Knee Arthroplasty / 中国医学科学杂志(英文版)

Objective Total knee arthroplasty is one of the most common orthopedic surgeries. Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons. In this study, we evaluated the risk factors for severe complications after primary total knee arthroplasty. Methods We retrospectively collected clinical data of 2,974 patients who underwent primary total knee arthroplasty from July 2013 to June 2019 in our hospital. Postoperative complication ≥ grade Ⅲ was defined as severe complication according to Clavien-Dindo classification system. Binary logistic regression was used to identify the predictive risk factors for severe complications. Results The complication rate after primary total knee arthroplasty was 6.8% and severe complication rate was 2.5%. Male (OR = 2.178, 95%CI: 1.324-3.585, P= 0.002), individuals above 75 years old (OR = 1.936, 95%CI: 1.155-3.244, P= 0.012), arrhythmia (OR = 2.913, 95%CI: 1.350-6.285, P= 0.006) and cerebrovascular disease (OR = 2.804, 95%CI: 1.432-5.489, P= 0.003) were predictive risk factors for severe complications after primary total knee arthroplasty. Conclusion Advanced age, male, arrhythmia, and cerebrovascular disease might be patients-related risk factors for postoperative severe complications after primary total knee arthroplasty. Special attention should be paid to patients with risk factors.

Recurrent Myocardial Infarction and Catecholamine-Induced Cardiomyopathy: A Case Report.

Pheochromocytomas or paragangliomas are rare and the diagnosis remains a challenge for clinicians. We present a woman suffering from recurrent myocardial infarction and cardiomyopathy, who was finally diagnosed with paraganglioma. Pheochromocytomas or paraganglioma should be considered in the differential diagnosis of a patient with symptoms possibly referring to acute coronary syndrome and cardiomyopathy.

Phrenic Nerve Injury Is a Differential Diagnosis of Hypoxemia after Video-Assisted Thoracoscopic Thymectomy: 2 Cases Report and Literature Review.

Hypoxemia after general anesthesia is not uncommon. For patients after thoracotomy, the differential diagnosis is usually difficult. Surgical, anesthetic, and patient-associated factors may contribute to postoperative hypoxemia. We described two patients who underwent video-assisted thoracoscopic thymectomy and developed hypoxemia immediately after extubation. Phrenic nerve injury was suspected in both patients. One case recovered spontaneously without intervention. The second case who had been demonstrated as bilateral phrenic nerve injury after the operation was continuously on ventilator after physical therapy and respiratory training for 2 months.

A Survey of Surgical Patient's Perception about Anesthesiologist in a Large Scale Comprehensive Hospital in China.

Objectives This study aim to evaluate patient's perception about anesthesiologists' job roles and investigate their expectations for anesthesia care.Methods We designed a self-administered questionnaire for this cross-sectional survey study and delivered questionnaire forms to adult in-patients who were scheduled for elective surgery before pre-operative anesthetic visit the day before surgery. We collected information of respondents' demographic data, education background, health literacy and previous experience of anesthesia, perception of anesthesiologist's job, the expectation on anesthesia care. Descriptive analyses, χ [2] test and multiple linear regression analysis were used for data analysis. Results Of 550 participants, 521（94.7%）completed the questionnaire. In these respondents, 335 (64.3%) considered anesthesiology as an independent medical discipline, 225 (43.2%) believed that anesthesiology department was an independent clinical department, and 243 (46.6%) recognized anesthesiologists as qualified doctors. Only 21.5% of them knew that anesthesiologists also work in the intensive care unit and 26.9% of them knew that anesthesiologists also work in pain clinic as well. Younger patients (ß=-0.044, P<0.001), those with higher education (ß=1.200, P<0.001), or with better health literacy (ß=0.781, P=0.005) had significant more knowledge about the job roles of anesthesiologists. Most patients demanded pre-anesthetic visit (80.5%), expected availability of preoperative anesthetic clinic (74.1%), wished to receive more information about anesthesia (91.3%) and anesthesiologist (77.4%).Conclusions Patients' perception about anesthesiologists might be limited. Efforts should be made on education about anesthesia, especially for elderly patients and those under-educated patients. Preoperative anesthetic clinic is expected by most in-patients.

Five new 3D transition MOFs based on 1-(3,5-dicarboxylatobenzyl)-3,5-pyrazole dicarboxylic acid displaying unique luminescence sensing towards Fe3+ and magnetic properties.

Five new 3D MOFs: {[Zn3(HL)2H2O]·4H2O}n (1), {[Ba2L5H2O]·2H2O}n (2), {[Ba4(L)2·5H2O]·2H2O}n (3), {[Cd3(HL)2·Cl2·2H2O]·2H2O}n (4) and {[Cu2(L)2·2H2O]·4H2O}n (5), were constructed based on 1-(3,5-dicarboxylatobenzyl)-3,5-pyrazole dicarboxylic acid. Structural analysis shows that 1-5 have 3D frameworks, among which 1(Zn) exhibits high luminescence sensing for Fe3+ ions, excellent framework stability and reusability. The sensing mechanism of 1(Zn) is briefly discussed. In addition, 5(Cu) displays antiferromagnetic exchange phenomena.

Perioperative Safety of Patients Undergoing Unilateral or Simultaneous Bilateral Total Knee Arthroplasty.

Objective To analyze the perioperative safety of patients undergoing unilateral or simultaneous bilateral total knee arthroplasty(TKA). Methods Totally 500 patients who had undergone unilateral or simultaneous bilateral TKA between December 2014 to December 2015 were retrospectively reviewed. They were divided into two groups:unilateral group(n=310)and bilateral group(n=190).The general data,perioperative transfusion,and complications were compared between these two groups. Results Patients in unilateral group had significantly higher ASA scores(χ2=8.344,P=0.015) and NYHA grade(χ2=7.537,P=0.023)than in bilateral group.Patients in bilateral group had significantly higher posterior drainage volume(t=44.984,P=0.000). Transfusion rate(χ2=42.896,P=0.000) was significantly higher and the lowest postoperative hemoglobin was significantly lower(t=0.006,P=0.000)in the bilateral group. The episodes of transfusion(χ2=1.025,P=0.599) and the amount of transfused packed red blood cells(χ2=3.836,P=0.429) were similar between two groups. There was no significant difference in the length of postoperative hospital stay(t=0.310,P=0.756),admission to intensive care unit(χ2=0.317,P=0.895),and incidences of complications(χ2=0.047,P=0.475). Conclusions For patients with low ASA scores and NYHA grade,simultaneous bilateral TKA is recommended. For older patients with high ASA score,poor cardiac function,and high incidences of complications,unilateral TKA is recommended.

Anesthetic management of a patient with Freeman-Sheldon syndrome: case report and literature review.

The Freeman-Sheldon syndrome (FSS) is a rare congenital syndrome, characterized with myopathy and dysplasia. The musculoskeletal and soft-tissue manifestations often require orthopedic and plastic surgery. We reported a case of 8-year-old girl with FSS operated on for scoliosis.

C-H⋠⋠⋠π interaction-modulated solid-state packing and carrier mobility in thienyl and thieno[3,2-b]thienyl end-capped distyrylarylene derivatives.

Research on structure-property relationships in distyrylarylene derivatives is far behind their wide applications in optoelectronic devices due to the absence of crystal structure information. Herein, the single crystals of 4,4'-bis(2-thienylvinyl)biphenyl (1) and 4,4'-bis(2-thieno[3,2-b]thienylvinyl)biphenyl (2) were successfully grown by the vapor transport method. Both molecules adopt the typical herringbone packing motif. However, the intermolecular C-H⋅⋅⋅π interaction in compound 2 is much stronger than that in compound 1. The correlations of interchain interaction with film morphology, optical and electronic properties were studied. Compound 2 formed higher crystalline films with (001) and (111) orientations. The organic field-effect transistor properties of both materials were investigated. Compound 2 showed better performance with a hole mobility higher than 0.01 cm(2) V(-1) s(-1) and an on/off current ratio over 10(6) . These results reveal that the intensity of C-H⋅⋅⋅π interactions can exert dramatic influences on the optical and electronic properties of distyrylarylene-based materials.

Analgesic effect of gabapentin in a rat model for chronic constrictive injury.

BACKGROUND: Gabapentin has been widely and successfully used in the clinic for many neuropathic pain syndromes since last decade, however its analgesic mechanisms are still elusive. Our study was to investigate whether Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) contributes to the analgesic effect of gabapentin on a chronic constriction injury (CCI) model. METHODS: Gabapentin (2%, 100 mg/kg) or saline (0.5 ml/100 g) was injected intraperitoneally 15 minutes prior to surgery and then every 12 hours from postoperative day 0 - 4 to all rats in control, sham and CCI groups. The analgesic effect of gabapentin was assessed by measuring mechanical allodynia and thermal hyperalgesia of rats. Expression and activation of CaMKII were quantified by reverse-transcriptional polymerase chain reaction and Western blotting. RESULTS: The analgesic effect of gabapentin on mechanical allodynia and thermal hyperalgesia was significant in the CCI model, with maximal reduction reached on postoperative day 8. Gabapentin decreased the expression of the total CaMKII and phosphorylated CaMKII in CCI rats. CONCLUSION: The analgesic effect of gabapentin on CCI rats may be related to the decreased expression and phosphorylation of CaMKII in the spinal cord.