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1.
Artigo em Inglês | MEDLINE | ID: mdl-34444526

RESUMO

Patient-controlled epidural analgesia is widely used to control postoperative pain following major intra-abdominal surgeries. However, determining the optimal infusion dose that can produce effective analgesia while reducing side effects remains a task to be solved. Postoperative pain and adverse effects between variable-rate feedback infusion (VFIM group, n = 36) and conventional fixed-rate basal infusion (CFIM group, n = 36) of fentanyl/ropivacaine-based patient-controlled epidural analgesia were evaluated. In the CFIM group, the basal infusion rate was fixed (5 mL/h), whereas, in the VFIM group, the basal infusion rate was increased by 0.5 mL/h each time a bolus dose was administered and decreased by 0.3 mL/h when a bolus dose was not administered for 2 h. Patients in the VFIM group experienced significantly less pain at one to six hours after surgery than those in the CFIM group. Further, the number of patients who suffered from postoperative nausea was significantly lower in the VFIM group than in the CFIM group until six hours after surgery. The variable-rate feedback infusion mode of patient-controlled epidural analgesia may provide better analgesia accompanied with significantly less nausea in the early postoperative period than the conventional fixed-rate basal infusion mode following open gastrectomy.


Assuntos
Analgesia Epidural , Amidas , Analgésicos Opioides/uso terapêutico , Anestésicos Locais , Retroalimentação , Fentanila , Gastrectomia/efeitos adversos , Humanos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Ropivacaina
2.
Sci Rep ; 9(1): 19539, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31862953

RESUMO

Both high activity and mass production potential are important for bifunctional electrocatalysts for overall water splitting. Catalytic activity enhancement was demonstrated through the formation of CoS2 nanoparticles with mono-phase and extremely porous structures. To fabricate porous structures at the nanometer scale, Co-based metal-organic frameworks (MOFs), namely a cobalt Prussian blue analogue (Co-PBA, Co3[Co(CN)6]2), was used as a porous template for the CoS2. Then, controlled sulfurization annealing converted the Co-PBA to mono-phase CoS2 nanoparticles with ~ 4 nm pores, resulting in a large surface area of 915.6 m2 g-1. The electrocatalysts had high activity for overall water splitting, and the overpotentials of the oxygen evolution reaction and hydrogen evolution reaction under the operating conditions were 298 mV and -196 mV, respectively, at 10 mA cm-2.

3.
Nano Lett ; 19(12): 8644-8652, 2019 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-31671269

RESUMO

Controlled phase conversion in polymorphic transition metal dichalcogenides (TMDs) provides a new synthetic route for realizing tunable nanomaterials. Most conversion methods from the stable 2H to metastable 1T phase are limited to kinetically slow cation insertion into atomically thin layered TMDs for charge transfer from intercalated ions. Here, we report that anion extraction by the selective reaction between carbon monoxide (CO) and chalcogen atoms enables predictive and scalable TMD polymorph control. Sulfur vacancy, induced by anion extraction, is a key factor in molybdenum disulfide (MoS2) polymorph conversion without cation insertion. Thermodynamic MoS2-CO-CO2 ternary phase diagram offers a processing window for efficient sulfur vacancy formation with precisely controlled MoS2 structures from single layer to multilayer. To utilize our efficient phase conversion, we synthesize vertically stacked 1T-MoS2 layers in carbon nanofibers, which exhibit highly efficient hydrogen evolution reaction catalytic activity. Anion extraction induces the polymorph conversion of tungsten disulfide (WS2) from 2H to 1T. This reveals that our method can be utilized as a general polymorph control platform. The versatility of the gas-solid reaction-based polymorphic control will enable the engineering of metastable phases in 2D TMDs for further applications.

4.
PLoS One ; 12(9): e0183311, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28877238

RESUMO

Robotic-assisted laparoscopic radical prostatectomy (RARP) needs a steep Trendelenburg position and a relatively high CO2 insufflation pressure, and patients undergoing RARP are usually elderly. These factors make intraoperative ventilatory care difficult and increase the risk of perioperative pulmonary complications. The aim was to determine the efficacy of recruitment manoeuvre (RM) on perioperative pulmonary complications in elderly patients undergoing RARP. A total of 60 elderly patients scheduled for elective RARP were randomly allocated to two groups after induction of anaesthesia; positive end expiratory pressure (PEEP) was applied during the operation without RM in the control group (group C) and after RM in the recruitment group (group R). The total number of patients who developed intraoperative desaturation or postoperative atelectasis was significantly higher in group C compared to group R (43.3% vs. 17.8%, P = 0.034). Intraoperative respiratory mechanics, perioperative blood gas analysis, and pulmonary function testing did not show differences between the groups. Adding RM to PEEP compared to PEEP alone significantly reduced perioperative pulmonary complications in elderly patients undergoing RARP.


Assuntos
Pneumopatias/etiologia , Assistência Perioperatória , Prostatectomia/efeitos adversos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Idoso , Anestesia , Humanos , Respiração com Pressão Positiva , Complicações Pós-Operatórias/etiologia , Troca Gasosa Pulmonar , Testes de Função Respiratória , Mecânica Respiratória
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