Analysis of Grip Strength and Its Explanatory Factors in Older Patients with Gastrointestinal Tumours.

Aim: To investigate the grip strength of older patients with gastrointestinal tumours and analyse its explanatory factors. Methods: A total of 170 older patients with gastrointestinal tumours admitted to the Gastrointestinal Surgery Department of a Grade-III hospital in the Zhejiang province from January 2022 to December 2022 were selected as the investigation participants. Among them, there were 102 cases of gastric cancer (60.0%) and 68 cases of colon cancer (40.0%). There were 110 male patients (64.7%) and 60 female patients (35.3%), with patient ages ranging between 64 and 82 years old. A cross-sectional survey was conducted using a general data questionnaire, grip apparatus and the Nutritional Risk Screening 2002 (NRS-2002) score. Multiple linear regression was used to analyse the explanatory factors on the grip strength of older patients with gastrointestinal tumours. Results: The grip strength of older patients with gastrointestinal tumours was 25.3±5.3 kg. Multiple linear regression analysis showed that gender, age, disease, body mass index (BMI), albumin concentration and the NRS-2002 score were the main explanatory factors on grip strength (P<0.05). Conclusion: Grip strength was lower in older patients with gastrointestinal tumours and was lower in females, those aged ≥70 years, patients with colorectal cancer, individuals with a BMI of <18.5, those with an albumin concentration of <35g/l and those with an NRS2002 score of ≥3. Clinical staff should dynamically evaluate the level of grip strength in patients with gastrointestinal tumors and develop individualized interventions based on the related explanatory factors.

Rapid identification and prognosis evaluation by dual-phase computed tomography angiography for stroke patients with a large ischemic region in the anterior circulation treated with endovascular thrombectomy.

Purpose: To investigate the value of dual-phase head-and-neck computed tomography angiography (CTA) in assessing advantages and risks associated with mechanical thrombectomy for stroke with a large ischemic region in the anterior circulation within 6 h of onset. Methods: We retrospectively analyzed the data of patients with acute occlusion of the internal carotid artery or middle cerebral artery-M1 segment. Baseline dual-phase CTA was performed for collateral grading using the 4-point visual collateral score (0, 0% filling; 1, >0% and ≤50% filling; 2, >50 and <100% filling; 3, 100% filling). The rates of modified Rankin score (MRS) ≤ 3 at 90 days, any intracranial hemorrhage (ICH) within 48 h, malignant cerebral edema within 24 h, and all-cause 90-day mortality were analyzed. Results: Among the 69 study patients, 15, 26, 17, and 11 patients had collateral grades of 0, 1, 2, and 3, respectively. At 90 days, the MRS was ≤3 in 0, 8.33, 29.41, and 36.36% of patients with grades 0, 1, 2, and 3, respectively. ICH incidence was 73.33, 57.69, 29.41, and 18.18% for grades 0, 1, 2, and 3, respectively, while the incidence of malignant brain edema was 100, 76.92, 35.29, and 0%, respectively. All-cause 90-day mortality was 53.33% for grade 0 and 30.77% for grade 1; no deaths occurred at grades 2 and 3. Conclusion: Collateral grading based on dual-phase CTA enables simple and rapid preoperative evaluation prior to mechanical thrombectomy for acute anterior-circulation stroke with a large ischemic focus, particularly for patients presenting within the 6-h time window.

Super impact stable TATB explosives recrystallized by bicarbonate ionic liquids with a record solubility.

Ensuring the security for long-term storage of weapons is always of the great cMehilaloncerns in the field of energetic materials. 1,3,5-Triamino-2,4,6-trinitrobenzene (TATB) is a remarkable explosive applied in nuclear weapons where extreme safety is required primarily. Owing to the strong inter or intra molecular hydrogen bonding, TATB shows poor solubility in most solvents. As the result, the particle shape and size of TATB products is hard to regulate, which closely related to the weapons stability. Herein, a new recrystallization method is provided to refine TATB using bicarbonate ionic liquids. Bicarbonate ionic liquids exhibited the record solubility (26.7 wt%) for dissolving TATB explosive. The recrystallized TATB were spherical particles with uniform size and showed extremely insensitivity to impact (>100 J) and friction (>360 N). Moreover, the experimental 1H and 13C NMR spectra of TATB in solution are reported for the first time.

Comparison of preoperative hair removal methods for the reduction of surgical site infections: a meta-analysis.

AIMS AND OBJECTIVES: To evaluate the efficacy of different methods of preoperative hair removal in reducing surgical site infections. BACKGROUND: Surgical site infections are a major source of morbidity and prolonged hospitalisation following surgery. However, there is a lack of data regarding the impact of different preoperative hair removal techniques on the incidence of surgical site infections. DESIGN: A systematic literature review and meta-analysis. METHODS: Randomised controlled trials and controlled clinical trials reporting the impact of different methods of preoperative hair removal on reducing surgical site infections were collected through databases, including the Cochrane Library, Joanna Briggs Institute Library, PubMed, Elsevier, EMBASE, Nursing Consult, China Biology Medicine disc, China National Knowledge Infrastructure and Wanfang data. The articles were published from 1 January 1990-15 March 2016. Meta-analyses were conducted with review manager version 5.0. RESULTS: Fourteen trials were included (16 comparisons) in the review, including 11 randomised controlled trials and three controlled clinical trials. Interventions in the studies were shaving, clipping, no hair removal and the use of depilatory cream. The meta-analyses included 7278 patients, from 10 countries. Nine studies compared shaving with no hair removal, four studies compared shaving with clipping, two studies compared shaving with depilatory cream, and one study compared clipping with no hair removal. No significant differences in the frequency of surgical site infections were observed between any of the methods assessed. CONCLUSIONS: No significant differences between shaving, clipping, no hair removal and depilatory cream were observed in the frequency of surgical site infections. RELEVANCE TO CLINICAL PRACTICE: Preoperative hair removal should be avoided unless necessary. When it is necessary to remove hair, the existing evidence suggests that clipping is more effective in reducing surgical site infections than shaving or depilatory cream.

Nanoscale effect on thermal decomposition kinetics of organic particles: dynamic vacuum stability test of 1,3,5-triamino-2,4,6-trinitrobenzene.

Despite the extensive research that has been carried out on organic nanoparticles, little explanation has been provided for the reasons behind their exceptional properties. In this work, the effect of the particles being on the nanoscale on the thermal decomposition kinetics of organic particles was examined by means of a dynamic vacuum stability test. Nano- and microscale particles of 1,3,5-triamino-2,4,6-trinitrobenzene were measured for comparison. Analysis of the evolved gas revealed that the nanoparticles (NPs) show much higher reaction activity than the microparticles (MPs). Both the non-isothermal and isothermal reaction mechanisms and kinetics were computed. The NPs and MPs exhibit different reaction mechanisms, while similarly sized particles follow different mechanisms for different stages of the reaction. The mechanisms for the NPs are affected by the temperature in the range considered. NPs have larger values for the apparent activation energy (E(a)) and pre-exponential factor (A) than MPs and the relationship of E(a) to A demonstrates that a kinetic compensation effect is evident. The nanoscale effect shows there to be a significant influence on the apparent performances and kinetics as well as on the intrinsic reaction mechanisms of organic particles. This effect can be attributed to the surface properties of NPs, where the high surface area contributes to efficient mass transfer and heat transfer, thus leading to numerous activated molecules being involved in the reaction.

Effect of microwave irradiation on TATB explosive (II): temperature response and other risk.

TATB (1,3,5-triamino-2,4,6-trinitrobenzene) explosives were safely irradiated with microwave and showed no visible change according to XPS and XRD spectra. Temperature of TATB sample increased quickly at the beginning and gently during sequent continuous irradiation with temperature less than 140 degrees C after 60 min, 480 W irradiation, and increased more quickly in 300 g at 480 W than in 150 g at 480 W, both implied that heat dissipation was in the majority of microwave energy. Two major risk factors in microwave irradiation were concerned including overheating which should be avoidable with temperature monitor and microwave discharge which should be controllable experimentally though dielectric breakdown mechanism was not elucidated theoretically yet.

Effect of microwave irradiation on TATB explosive.

Finished TATB (1,3,5-triamino-2,4,6-trinitrobenzene) explosive safety under 800W microwave irradiation was experimented. No burning, deflagration and detonation were observed during 30-min continuous irradiation and no remarkable change were observed after irradiation according to HPLC, particles size analysis, and differential thermal analysis. Wet TATB sampled from synthesis line was irradiated with microwave vacuum method and irradiated TATB was measured to accord with military standard specifications including appearance, moisture and volatile, chloride content, HPLC, mean particle size, DTA exothermic peak, ash, acetone soluble content, PH value, etc. Microwave vacuum desiccation was deemed laborsaving, energy-efficient, and practicable compared to conventional processing method.