Technological innovation and clinical application of direct percutaneous computed tomography-guided enterostomy vs other enterostomy techniques.

BACKGROUND: To investigate the technological innovation, safety, operational advantages, and clinical application value of direct percutaneous computed tomography (CT)-guided enterostomy. METHODS: This retrospective study included patients who underwent direct percutaneous CT-guided enterostomy (n = 52), percutaneous endoscopic gastrojejunostomy (PEG-J, n = 39), or laparoscopic jejunostomy (n = 68) at Fujian Provincial Hospital between October 2019 and July 2021. The study indices included stoma surgery success rate, operation time, complication rate, and postoperative pain score. We concurrently analyzed the technological innovation of direct percutaneous CT-guided enterostomy and the changes in body mass index (BMI), serum albumin, prealbumin, and C-reactive protein (CRP) levels and patient-generated subjective global assessment (PG-SGA) scores after patients received 2 months of nutritional support. RESULTS: Direct percutaneous CT-guided enterostomy had a high success rate (100%) and low postoperative complication rate (5.77%). Compared to laparoscopic jejunostomy, direct percutaneous CT-guided enterostomy had a shorter operation time (36.92 ± 10.60) minutes, lower postoperative pain score (4.06 ± 2.02), lower anesthesia risk, and lower operative cost. The anesthetic risk for direct percutaneous CT-guided enterostomy is lower than that for PEG-J and has wider applications. After 2 months of postoperative nutritional support, patients had increased BMI, serum albumin level, and serum prealbumin level and decreased PG-SGA scores and CRP level with statistically significant differences compared to the preoperative state ( p < 0.05). CONCLUSION: Direct percutaneous CT-guided enterostomy is an important method of establishing an enteral nutrition therapy pathway, especially when endoscopic jejunostomy is not possible. It has a high safety profile and few complications, has unique advantages, and deserves further promotion of its application in clinical practice.

Wettability of a quartz surface in the presence of four cationic surfactants.

Advancing contact angle (θ) measurements were carried out for aqueous solutions of four cationic surfactants, hexadecanol glycidyl ether ammonium chloride (C(16)PC), guerbet alcohol hexadecyl glycidyl ether ammonium chloride (C(16)GPC), hexadecanol polyoxyethylene(3) glycidyl ether ammonium chloride (C(16)(EO)(3)PC), and guerbet alcohol hexadecyl polyoxyethylene(3) glycidyl ether ammonium chloride (C(16)G(EO)(3)PC), on the quartz surface using the sessile drop analysis. The influences of surfactant type and bulk concentration on contact angle were expounded, and the changes in adhesional tension and adhesion work were discussed. The contact angle increases up to a maximum with the increasing concentration for all cationic surfactants. Surfactants with branched chain have more hydrophobic group density on the quartz surface, which results in higher values of maxima in contact angle curves. When ethylene oxide groups CH(2)CH(2)O were incorporated in the hydrophobic group, the decrease in contact angle maximum was observed for C(16)(EO)(3)PC and C(16)G(EO)(3)PC. Moreover, an increase in quartz-water interfacial free energy (γ(SL)) has been observed due to the adsorption of four cationic surfactants. The four cationic surfactants can form a monolayer with alignment structure on the quartz surface through electrostatic interaction and then form the bilayer with increasing bulk concentration. In contrast with literature, the maximal contact angles may not necessarily correspond to the beginning of the formation of bilayer for cationic surfactants at the quartz-water interface. Moreover, the concentrations corresponding to maximal contact angles for C(16)PC and C(16)(EO)(3)PC were much lower than their CMC. The contact angle passes through a maximum at a concentration obviously higher than CMC for C(16)G(EO)(3)PC.