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BACKGROUND: The aim was to analyse the impact of cirrhosis on short-term outcomes after laparoscopic liver resection (LLR) in a multicentre national cohort study. METHODS: This retrospective study included all patients undergoing LLR in 27 centres between 2000 and 2017. Cirrhosis was defined as F4 fibrosis on pathological examination. Short-term outcomes of patients with and without liver cirrhosis were compared after propensity score matching by centre volume, demographic and tumour characteristics, and extent of resection. RESULTS: Among 3150 patients included, LLR was performed in 774 patients with (24·6 per cent) and 2376 (75·4 per cent) without cirrhosis. Severe complication and mortality rates in patients with cirrhosis were 10·6 and 2·6 per cent respectively. Posthepatectomy liver failure (PHLF) developed in 3·6 per cent of patients with cirrhosis and was the major cause of death (11 of 20 patients). After matching, patients with cirrhosis tended to have higher rates of severe complications (odds ratio (OR) 1·74, 95 per cent c.i. 0·92 to 3·41; P = 0·096) and PHLF (OR 7·13, 0·91 to 323·10; P = 0·068) than those without cirrhosis. They also had a higher risk of death (OR 5·13, 1·08 to 48·61; P = 0·039). Rates of cardiorespiratory complications (P = 0·338), bile leakage (P = 0·286) and reoperation (P = 0·352) were similar in the two groups. Patients with cirrhosis had a longer hospital stay than those without (11 versus 8 days; P = 0·018). Centre expertise was an independent protective factor against PHLF in patients with cirrhosis (OR 0·33, 0·14 to 0·76; P = 0·010). CONCLUSION: Underlying cirrhosis remains an independent risk factor for impaired outcomes in patients undergoing LLR, even in expert centres.
ANTECEDENTES: El objetivo de este estudio fue analizar el impacto de la cirrosis en los resultados a corto plazo después de la resección hepática laparoscópica (laparoscopic liver resection, LLR) en un estudio de cohortes multicéntrico nacional. MÉTODOS: Este estudio retrospectivo incluyó todos los pacientes sometidos a LLR en 27 centros entre 2000 y 2017. La cirrosis se definió como fibrosis F4 en el examen histopatológico. Los resultados a corto plazo de los pacientes con hígado cirrótico (cirrhotic liver CL) (pacientes CL) y los pacientes con hígado no cirrótico (non-cirrhotic liver, NCL) (pacientes NCL) se compararon después de realizar un emparejamiento por puntaje de propension del volumen del centro, las características demográficas y del tumor, y la extensión de la resección. RESULTADOS: Del total de 3.150 pacientes incluidos, se realizó LLR en 774 (24,6%) pacientes CL y en 2.376 (75,4%) pacientes NCL. Las tasas de complicaciones graves y mortalidad en el grupo de pacientes CL fueron del 10,6% y 2,6%, respectivamente. La insuficiencia hepática posterior a la hepatectomía (post-hepatectomy liver failure, PHLF) fue la principal causa de mortalidad (55% de los casos) y se produjo en el 3,6% de los casos en pacientes CL. Después del emparejamiento, los pacientes CL tendieron a tener tasas más altas de complicaciones graves (razón de oportunidades, odds ratio, OR 1,74; i.c. del 95% 0,92-0,41; P = 0,096) y de PHLF (OR 7,13; i.c. del 95% 0,91-323,10; P = 0,068) en comparación con los pacientes NCL. Los pacientes CL estuvieron expuestos a un mayor riesgo de mortalidad (OR 5,13; i.c. del 95% 1,08-48,6; P = 0,039) en comparación con los pacientes NCL. Los pacientes CL presentaron tasas similares de complicaciones cardiorrespiratorias graves (P = 0,338), de fuga biliar (P = 0,286) y de reintervenciones (P = 0,352) que los pacientes NCL. Los pacientes CL tuvieron una estancia hospitalaria más larga (11 versus 8 días; P = 0,018) que los pacientes NCL. La experiencia del centro fue un factor protector independiente de PHLF (OR 0,33; i.c. del 95% 0,14-0,76; P = 0,010) pacientes CL. CONCLUSIÓN: La presencia de cirrosis subyacente sigue siendo un factor de riesgo independiente de peores resultados en pacientes sometidos a resección hepática laparoscópica, incluso en centros con experiencia.
Assuntos
Carcinoma Hepatocelular/cirurgia , Hepatectomia/efeitos adversos , Laparoscopia/efeitos adversos , Cirrose Hepática/diagnóstico , Neoplasias Hepáticas/cirurgia , Complicações Pós-Operatórias/diagnóstico , Pontuação de Propensão , Idoso , Intervalo Livre de Doença , Feminino , Humanos , Cirrose Hepática/etiologia , Masculino , Pessoa de Meia-Idade , Vigilância da População , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de RiscoRESUMO
A series of triangular metallaprisms with a kinetically inert Pt-N bond have been synthesized from the stepwise assembly of a Pt-corner, linear linker 4,4'-bipy (4,4'-bipy = 4,4'-bipyridine) and triangular ligand [tpb or tpt, tpb = tris(4-pyridyl)benzene, tpt = tris(4-pyridyl)triazine]. The use of an unsymmetrical [Pt(HL)]-corner (H2L = 2,6-diphenylpyridine) leads to novel isostructural products. Phenyl rotation at the metal-corners endows these complexes with good aggregation-induced emission (AIE) function, with varied activities across the isostructural complexes. The coordination sequence of electron-deficient ligand tpt also imparts significant influence on the complex emission. These organoplatinum triangular metallaprisms thus provide a good model to study the influence of building blocks and coordination sequence on the luminescence of supramolecules.
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Advanced batteries with long cycle life and capable of harnessing more energies from multiple electrochemical reactions are both fundamentally interesting and practically attractive. Herein, we report a robust hybrid zinc-battery that makes use of transition-metal-based redox reaction (M-O-OH â M-O, M = Ni and Co) and oxygen reduction reaction (ORR) to deliver more electrochemical energies of comparably higher voltage with much longer cycle life. The hybrid battery was constructed using an integrated electrode of NiCo2O4 nanowire arrays grown on carbon-coated nickel foam, coupled with a zinc plate anode in alkaline electrolyte. Benefitted from the M-O/M-O-OH redox reactions and rich ORR active sites in NiCo2O4, the battery has concurrently exhibited high working voltage (by M-O-OH â M-O) and high energy density (by ORR). The good oxygen evolution reaction (OER) activity of the electrode and the reversible M-O â M-O-OH reactions also enabled smooth recharging of the batteries, leading to excellent cycling stabilities. Impressively, the hybrid batteries maintained highly stable charge-discharge voltage profile under various testing conditions, for example, almost no change was observed over 5000 cycles at a current density of 5 mA cm-2 after some initial stabilization. With merits of higher working voltage, high energy density, and ultralong cycle life, such hybrid batteries promise high potential for practical applications.
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Quinoline-triazoles 2-((4-(diethoxymethyl)-1H-1,2,3-triazol-1-yl)methyl)quinoline (1), 2-((4-(m-tolyl)-1H-1,2,3-triazol-1-yl)methyl)quinoline (2) and 2-((4-(p-tolyl)-1H-1,2,3-triazol-1-yl)methyl)quinoline (3) have been prepared with CuAAC click reactions and used as a model series to probe the relationship between lattice H-bonding interaction and crystal direction of growth. Crystals of 1-3 are 1D tape and prism shapes that correlate with their intermolecular and solvent 1D lattice H-bonding interactions. All compounds were thermally stable up to about 200 C and blue-green emissive in solution.
Assuntos
Cristalografia por Raios X/métodos , Quinolinas/química , Triazóis/química , Ligação de Hidrogênio , Espectroscopia de Ressonância Magnética , Estrutura MolecularRESUMO
Durable electrocatalysts with high catalytic activity toward oxygen reduction reaction (ORR) are crucial to high-performance primary zinc-air batteries (ZnABs) and direct methanol fuel cells (DMFCs). An efficient composite electrocatalyst, Co@Co3 O4 core@shell nanoparticles (NPs) embedded in pyrolyzed polydopamine (PPD) is reported, i.e., in Co@Co3 O4 @PPD core@bishell structure, obtained via a three-step sequential process involving hydrothermal synthesis, high temperature calcination under nitrogen atmosphere, and gentle heating in air. With Co@Co3 O4 NPs encapsulated by ultrathin highly graphitized N-doped carbon, the catalyst exhibits excellent stability in aqueous alkaline solution over extended period and good tolerance to methanol crossover effect. The integration of N-doped graphitic carbon outer shell and ultrathin nanocrystalline Co3 O4 inner shell enable high ORR activity of the core@bishell NPs, as evidenced by ZnABs using catalyst of Co@Co3 O4 @PPD in air-cathode which delivers a stable voltage profile over 40 h at a discharge current density of as high as 20 mA cm(-2) .
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Cocatalysts, when loaded onto a water splitting photocatalyst, accelerate the gas evolution reaction and improve the efficiency of the photocatalyst. In this paper, we report that the efficiency of the photocatalyst is enhanced using an amorphous cobalt oxide cocatalyst. The WO3 film, when loaded with amorphous or nanocrystalline Co3O4, shows an improvement of up to 40% in photocurrent generation and 34% in hydrogen gas evolution. The effect of cocatalyst crystallinity on performance was systematically studied, and we found that the photocurrent deteriorates with the conversion of the cocatalyst to a highly crystalline phase at an annealing temperature of 500 °C. The mechanism of this effect was studied in detail using electrochemical impedance spectroscopy, and the enhancement effect produced by the amorphous cocatalyst is attributed to the large density of unsaturated catalytically active sites in the amorphous material.
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The development of mild and general methods for C-S bond formation has received significant attention because the C-S bond is indispensable in many important biological and pharmaceutical compounds. Early examples for the synthesis of C-S bonds are generally limited to the condensation reaction between a metal thiolate and an organic halide. Recent chemical approaches for C-S bond formation, based upon direct C-H bond functionalization and decarboxylative reactions, not only provide new insights into the mechanistic understanding of C-S coupling reactions but also allow the synthesis of sulfur-containing compounds from more effective synthetic routes with high atom economy. This review intends to explore recent advances in C-S bond formation via C-H functionalization and decarboxylation, and the growing opportunities they present to the construction of complex chemical scaffolds for applications encompassing natural product synthesis, synthetic methodology development, and functional materials as well as nanotechnology.
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Carbono/química , Hidrogênio/química , Enxofre/química , Catálise , Nanopartículas Metálicas/química , Metais/química , Nanotecnologia , Pirróis/síntese química , Pirróis/química , Tiofenos/síntese química , Tiofenos/químicaRESUMO
Three-component reaction of aryl Grignard reagents, alkynes, and aryl halides in the presence of 1 mol % of NiCl2 proceeded sequentially through carbomagnesiation of the alkyne followed by cross-coupling of the resulting alkenyl Grignard reagent with aryl halide to give tetrasubstituted alkenes in high yields.
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Alcenos/química , Alcinos/química , Níquel/química , Catálise , Técnicas de Química Sintética , EstereoisomerismoRESUMO
The use of simple self-assembly methods to direct or engineer porosity or channels of desirable functionality is a major challenge in the field of metal-organic frameworks. We herein report a series of frameworks by modifying square ring structure of [{Cu2(5-dmpy)2(L1)2(H2O)(MeOH)}2{ClO4}4]·4MeOH (1·4MeOH, 5-dmpy = 5,5'-dimethyl-2,2'-bipyridine, HL1 = 4-pyridinecarboxylic acid). Use of pyridyl carboxylates as directional spacers in bipyridyl chelated Cu(II) system led to the growth of square unit into other configurations, namely, square ring, square chain, and square tunnel. Another remarkable characteristic is that the novel use of two isomers of pyridinyl-acrylic acid directs selectively to two different extreme tubular forms-aligned stacking of discrete hexagonal rings and crack-free one-dimensional continuum polymers. This provides a unique example of two extreme forms of copper nanotubes from two isomeric spacers. All of the reactions are performed in a one-pot self-assembly process at room temperature, while the topological selectivity is exclusively determined by the skeletal characteristics of the spacers.
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This paper demonstrates an optimized fabrication of amorphous Ru nanoparticles through annealing at various temperatures ranging from 150 to 700 °C, which are used as water oxidation catalyst for effective electrochemical water splitting under a low overpotential of less than 300 mV. The amorphous Ru nanoparticles with short-range ordered structure exhibit an optimal and stable electrocatalytic activity after annealing at 250 °C. Interestingly, a small quantity of such Ru nanoparticles in a thin film on fluorine-doped tin oxide glass is also effectively driven by a conventional crystalline silicon solar cell that has excellent capability for harvesting visible light. Remarkably, it achieves an overall solar-to-hydrogen efficiency of 11.3% in acidic electrolyte.
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AIMS: We aimed to determine whether the presence of hepatic steatosis and/or non-alcoholic fatty liver disease was associated with decline in renal function or onset of microalbuminuria in a cohort of people with Type 2 diabetes, including those managed in both primary and secondary care. METHODS: Nine hundred and thirty-three patients from the Edinburgh Type 2 Diabetes Study, a cohort of Scottish men and women aged 60-74 years with Type 2 diabetes, underwent assessment for hepatic steatosis by liver ultrasonography 1 year after recruitment. Non-alcoholic fatty liver disease was defined as the presence of steatosis following exclusion of secondary causes of liver disease. Patients were followed for 4 years and decline in renal function was assessed by the change in estimated glomerular filtration rate over time. RESULTS: Of the 933 subjects, 530 had hepatic steatosis and, of those with hepatic steatosis, 388 had non-alcoholic fatty liver disease. Neither hepatic steatosis nor non-alcoholic fatty liver disease were significantly associated with rate of decline in renal function, with the mean rate of decline in estimated glomerular filtration rate being -1.55 ml min(-1) 1.73 m(-2) per year for participants with hepatic steatosis compared with -1.84 ml min(-1) 1.73 m(-2) for those without steatosis (P = 0.19). Similar results were obtained when the analysis was restricted to participants with and without non-alcoholic fatty liver disease (-1.44 vs. -1.64 ml min(-1) 1.73 m(-2) per year, respectively; P = 0.44). Additionally, neither hepatic steatosis nor non-alcoholic fatty liver disease were associated with the onset or regression of albuminuria during follow-up (all P ≥ 0.05). CONCLUSIONS: The presence of hepatic steatosis/non-alcoholic fatty liver disease was not associated with decline in renal function during a 4-year follow-up in our cohort of older people with Type 2 diabetes.
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Diabetes Mellitus Tipo 2/fisiopatologia , Nefropatias Diabéticas/fisiopatologia , Taxa de Filtração Glomerular , Falência Renal Crônica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Idoso , Albuminúria/epidemiologia , Progressão da Doença , Fígado Gorduroso/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Escócia/epidemiologia , População Branca/estatística & dados numéricosRESUMO
A variety of network structures have been prepared by transmetalation of a polymer {Na3[Na9(Cbdcp)6(H2O)18]}n (1) (Cbdcp = N-(4-carboxybenzyl)-(3,5-dicarboxyl)pyridinium) containing dodecahedral Na9 aggregate secondary building units with Cu(II) by modulating the temperature, solvent, and pH. These complexes include a large, zwitterionic hexa-cuprometallocycle [Cu6(Cbdcp)6(H2O)18] (2) formed in H2O at room temperature, two three-dimensional polymers [Cu3(Cbdcp)2(OH)2(H2O)2]n (3) and {[Cu3(Cbdcp)2(OH)2]·2H2O}n (4) isolated from H2O and DMF/H2O at 135 °C, and a mononuclear complex [Cu(HCbdcp)2(H2O)3]·H2O (5) from H2O at 100 °C and pH = 6. All the complexes are robust and water stable. The crystal framework of macrocycle 2 is stable up to 100 °C under vacuum and selectively adsorbs CO2.
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Cobre/química , Polímeros/química , Sódio/química , Cristalografia por Raios X , Modelos Moleculares , Água/químicaRESUMO
A 2D coordination polymer prepared with bulky diethylformamide solvates exhibits channels which allow dipyridyl bridging ligands to diffuse into the crystal lattice. The absorbed dipyridyls thread through the pores of one layer and substitute the surface diethylformamide molecules on the neighboring layers to stitch alternate layers to form flexible interpenetrated metal-orgaic frameworks. The threading process also results in exchange of the bulky diethylformamide solvates for aqua to minimize congestion and, more strikingly, forces the slippage of two-dimensional layers, while still maintaining crystallinity.
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Cádmio/química , Compostos Organometálicos/química , Polímeros/química , 2,2'-Dipiridil/química , Dióxido de Carbono/química , Cristalografia por Raios X , Dimetilformamida/análogos & derivados , Dimetilformamida/química , Modelos Moleculares , Nitrogênio/químicaRESUMO
A series of Cp*Rh-based functional metallarectangles have been synthesized from metallaligands. Enlargement of one linker leads to the isolation of two novel Borromean link architectures. All these complexes are intact in solution, as evident from ESI-MS spectroscopic analysis. Arising from the combination of open Cu centers and favorable cavity space, {(Cp*Rh)4(bpe)2[Cu(opba)·2MeOH]2}4(OTf)·6MeOH shows extraordinary catalytic abilities with high efficiency and wide substrate selectivity in the acyl-transfer reaction.
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Compostos Organometálicos/química , Ródio/química , Catálise , Cobre/química , Cristalografia por Raios X , Modelos Moleculares , Estrutura Molecular , Compostos Organometálicos/síntese químicaRESUMO
Fabrication of microstructures for imparting omniphobicity to a surface generally requires the use of lithographic techniques and specialized equipment. We report instead a simple strategy for the synthesis of microstructured surfaces via metalorganic framework (MOF) self-assembly. Our method allows us to localize epitaxial growth of MOF at the tips of needle crystals to create mushroom-shaped structures, thus conferring re-entrant textures to the MOF-functionalized surfaces. These structures synthesized via wet chemistry were found to have omniphobic properties due to the resulting re-entrant texture.
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Compostos Organometálicos/química , Interações Hidrofóbicas e Hidrofílicas , Compostos Organometálicos/síntese química , Tamanho da Partícula , Propriedades de SuperfícieRESUMO
A new family of Co/rare-earth intermetallic cubane aggregates [Co3Ln(hmp)4(OAc)5H2O] (Ln = Dy, Ho, Er, Tm, Yb, Y) have been synthesized by self-assembly. Single-crystal X-ray diffraction analysis revealed that they are remarkably isostructural in showing a common [Co3Ln] core. Magnetic studies showed that the Dy, Er, Tm, Yb, and Y complexes are ferromagnetic. The Dy complex exhibits the largest magnetocaloric effect (-ΔSm = 12.58 J kg(-1) K(-1)), which can be attributed to the large magnetic density of Dy(III).
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A series of bis-acryl functionalized porphyrins and their corresponding metalloporphyrins (M=Co, Mn) were synthesized and investigated for their antimicrobial properties through MIC screening and bacteria time-kill kinetic studies. The Mn(III) 4-(bis)methylphenyl-substituted-porphyrins showed superior batericidal activities even in the dark with low hemotoxicity and good cytotoxicity profile.
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Antibacterianos/farmacologia , Escherichia coli/efeitos dos fármacos , Metaloporfirinas/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/síntese química , Antibacterianos/química , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Relação Dose-Resposta a Droga , Hemólise/efeitos dos fármacos , Humanos , Cinética , Metaloporfirinas/síntese química , Metaloporfirinas/química , Estrutura MolecularRESUMO
Fe(3)O(4):PVP/Au nanocomposite synthesized via a two-step procedure was tested as a quasi-homogenous alcohol oxidation catalyst. It was found that the nanocomposite was able to carry out aerobic oxidation of alcohols in water at room temperature. Studies show rapid magnetic recoverability and reusability characteristics.
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Álcoois/química , Óxido Ferroso-Férrico/química , Ouro/química , Magnetismo , Povidona/química , Aerobiose , Catálise , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Oxirredução , Espectrofotometria Ultravioleta , Ressonância de Plasmônio de SuperfícieRESUMO
Five new tetradentate ligands [NNNN] with benzimidazolyl-imine or amine nitrogen donors have been synthesized in good yields under mild conditions from easily available substrates. trans-N,N'-bis(1-Ethyl-2-benzimidazolylmethylene)cyclohexane-1,2-diimine is the best accelerating ligand in this series that supports the Cu(I)-catalyzed Ullmann N-arylation and the direct three-component azide-alkyne cycloaddition reaction to give the corresponding substituted imidazole, pyrazole, and triazole in high yields. Single-crystal X-ray diffraction analysis of its complex with CuI reveals a novel one-dimensional coordination polymer of the metal chain bridged alternately by the [NNNN] ligand and diiodides.
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Alcinos/química , Azidas/química , Cobre/química , Nitrogênio/química , Catálise , Ligantes , Estrutura Molecular , Polímeros/química , Difração de Raios XRESUMO
One-pot oxidation and protonation of the sulfide bridging complex [Pt(2)(micro-S)(2)(PPh(3))(4)] can be promoted by lanthanide or scandium compounds, leading to the isolation of [Pt(2)(micro-S(2)O(2)H)(PPh(3))(4)](+); crystallographic elucidation confirmed sulfide mono-oxygenation without S-S bonding to give formally [SO](2-) in the form of an [SOHOS](3-) overhead bridge.