Degradable, antibacterial and ultrathin filtrating electrospinning membranes of Ag-MOFs/poly(l-lactide) for air pollution control and medical protection.

The widely used melt-blown polypropylene (PP) non-woven fabrics had no antibacterial functions and its large-scale use also increased the burden on the environment owing to its non-degradable property. Herein, silver (I) metal organic frameworks (Ag-2MI) were prepared with AgNO3 and 2-methylimidazole and embedded into degradable poly(l-lactide) (PLLA) to make an ultrathin filtration and antibacterial membrane by electrospinning technology with low loading of Ag-2MI. The morphology, mechanical properties, adsorption performance and antibacterial activities of the prepared films were tested and the results indicated that the addition of Ag-2MI could reduce the diameter of PLLA fibers from 910 nm to 520 nm (1.8 wt% of Ag-2MI), while the tensile strength, elongation at break of the membrane and the contact angle of the films were enhanced. Although the thickness of the prepared membranes was only about one-third of that of commercially available melt-blown cloth, they exhibited better filtering performances than the melt-blown cloth. The fiber membrane with low loading of 1.8 wt% Ag-2MI showed 99.99% inhibition rate against Escherichia coli and Staphylococcus aureus.

Vagus nerve preservation during minimally invasive esophagectomy with 2-field lymphadenectomy for esophageal carcinoma: A more physiological alternative.

Vagal-sparing esophagectomy allows for curative tumor resection with better functional outcome and reduced postoperative morbidity, and minimally invasive esophagectomy has the advantage of avoiding the morbidities associated with big thoracoabdominal incisions. The video tutorial demonstrates our technique of preserving both vagus nerves and their celiac and hepatic branches in the abdomen during the thoracoscopic and laparoscopic phases of minimally invasive esophagectomy, with 2-field lymphadenectomy, for esophageal carcinoma. Four ports are used for thoracoscopic mobilization of the esophagus. Both vagus nerves are identified, encircled and suspended with a vascular loop and carefully separated from the esophageal wall along its whole length from above downwards beginning with the left vagus nerve then the right one.  Five ports are used for laparoscopic gastric mobilization and preservation of the hepatic and celiac vagal branches. Care should be taken during ligation and division of the left gastric artery to avoid injury of the celiac branch of the vagus nerve. Resection of the common hepatic artery and left gastric artery group of lymph nodes is performed.