Factor structure and reliability of the symptom measurement of post-stroke depression in the rehabilitation stage.

BACKGROUND: The incidence of Post Stroke Depression (PSD) in the Rehabilitation Stage is high, which can bring serious physical and psychological disorders to patients. However, there is still a lack of targeted tools for screening PSD in the rehabilitation stage. Therefore, the aim of this study was to evaluate the factor structure and reliability of a measurement instrument to screen for PSD in the rehabilitation stage. METHODS: A cross-sectional study was conducted on 780 hospitalized stroke patients who were within the rehabilitation stage from May to August 2020. Exploratory factor analysis (EFA) as well as first- and second-order confirmatory factor analysis (CFA) were performed to evaluate the factor structure of the newly developed Symptom Measurement of Post-Stroke Depression in the Rehabilitation Stage (SMPSD-RS). The reliability and validity of the SMPSD-RS were also verified using several statistical methods. RESULTS: EFA extracted a 24-item, five-factor (cognition, sleep, behavior, emotion, and obsession) model that can clinically explain the symptoms of PSD during the rehabilitation stage. A first-order CFA confirmed the EFA model with good model fit indices, and the second-order CFA further confirmed the five-factor structure model and showed acceptable model fit indices. Acceptable reliability and validity were also achieved by the corresponding indicators. CONCLUSION: The SMPSD-RS was proven to have a stable factor structure and was confirmed to be reliable and valid for assessing PSD symptoms in stroke patients during the rehabilitation stage.

Pyridone-Doped Acenes with Improved Stability.

Besides the peripheral modification, the introduction of heteroatoms to modulate the property of longer acenes with improved chemical stability has been extensively studied for their potential applications in organic electronics. However, the utilization of 4-pyridone, a common unit in the air- and photo-stable acridone and quinacridone, to decorate higher acenes with increased stability has not been realized yet. Here we present the synthesis of a series of monopyridone-doped acenes up to heptacene via the palladium-catalyzed Buchwald-Hartwig amination of aniline and dibromo-ketone. The effect of pyridone on the property of doped acenes were investigated experimentally and computationally. With the π-extension of doped acenes, the pyridone ring shows the weakened conjugation and gradual loss of aromaticity. The doped acenes demonstrate enhanced stability in solution and maintain the electronic communication between the acene planes.

Asymmetric Cascade Carbonylation/Annulation of Benzyl Bromides, CO, and Vinyl Benzoxazinanones Enabled by Pd/Chiral Lewis-Base Relay Catalysis.

A highly enantioselective cascade carbonylation/annulation of benzyl bromides, CO, and vinyl benzoxazinanones under mild conditions has been established by Pd/chiral Lewis base relay catalysis, providing an efficient method to assemble chiral quinolinones from readily available starting materials in good yields with excellent diastereo- and enantioselectivities. The palladium catalyst plays two roles in this reaction, enabling both the carbonylation process and the generation of the zwitterionic π-allyl palladium intermediate.

Multiple portions enteral nutrition and chyme reinfusion of a blunt bowel injury patient with hyperbilirubinemia undergoing open abdomen: A case report.

Blunt bowel injury (BBI) is relatively rare but life-threatening when delayed in surgical repair or anastomosis. Providing enteral nutrition (EN) in BBI patients with open abdomen after damage control surgery is challenging, especially for those with discontinuity of the bowel. Here, we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3. Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed. Postoperatively, the patient was transferred to our trauma center for septic shock and hyperbilirubinemia. Following salvage resuscitation, damage control laparotomy with open abdomen was performed for abdominal sepsis, and a temporary double enterostomy (TDE) was created where the anastomosis was ruptured. Given the TDE and high risk of malnutrition, multiple portions EN were performed, including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube. Besides, chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube. Hyperbilirubinemia was alleviated with the increase in chyme reinfusion. After 6 months of home EN and chyme reinfusion, the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet. For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen, the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.

Development and validation of the Health Education Adherence Scale for Stroke Patients: a cross-sectional study.

BACKGROUND: Due to the lack of health education adherence assessment tools for stroke patients, the assessment of health education adherence in this population is insufficient, which hinders the prevention and rehabilitation of stroke. This study aims to develop and validate a Health Education Adherence Scale for Stroke Patients (HEAS-SP). METHODS: A cross-sectional design with a purposive sampling method was used for this study. Six hundred and fifty-four eligible participants completed the demographic questionnaire and the HEAS-SP. The data collection lasted for 7 months, from March 1stto September 30th in 2019. Item analysis and exploratory and confirmatory factor analysis were employed to develop and validate the HEAS-SP. RESULTS: The item analysis, exploratory and confirmatory factor analysis resulted in a 20-item HEAS-SP with 4 domains: medication adherence, diet adherence, rehabilitation exercise adherence, and healthy lifestyle adherence. The four-domain model demonstrated acceptable model fit indexes and the 20-item HEAS-SP demonstrated acceptable reliability and validity. CONCLUSION: The 20-item HEAS-SP was shown to have acceptable reliability and validity for assessing health education adherence with respect to diet, medication, rehabilitation exercise and healthy lifestyle in stroke patients, making it a potential basis for developing targeted interventions for stroke patients.

ß-Lactams modulate neutrophil extracellular traps formation mediated by mTOR signaling pathway.

BACKGROUND: Some biotics, like ß-Lactams, have shown immunomodulation effects during sepsis, but the detailed mechanism was still unclear. Here we postulated that neutrophils play an essential role and ß-Lactams exert immunomodulation effects through modulating neutrophil extracellular traps (NETs) formation. METHODS: NETs formation induced by two ß-Lactams, Meropenem (MEM) and ceftazidime/tazobactam (CAZ/TB) in neutrophils from healthy donors and HL-60 cells was performed. Reactive oxygen species (ROS) generation and the activity of nicotinamide adenine dinucleotide phosphate (NAPDH) oxidase were examined. Additionally, the upstream signal pathway of NETs formation, including protein kinase C (PKC), protein kinase B (Akt) and mammalian target of rapamycin (mTOR), were detected. RESULTS: MEM and CAZ/TB modulate NETs formation in activated PMNs, not resting PMNs. Both reduced ROS generation in resting PMNs and increased in activated PMNs. To test the activity of NADPH oxidase, we detected NADPH in MEM and CAZ/TB pre-cultivated activated PMNs, which showed that MEM and CAZ/TB modulates NETs formation through activation of NADHP oxidase by affecting the subunits of key enzymes. However, MEM reduced levels of phosho-PKC-Akt-mTOR, with no changes in CAZ/TB. CONCLUSIONS: We firstly demonstrate that ß-Lactams showed the definitive immunomodulation effects through modulating NETs formation, which is depended on PKC-Akt-mTOR signal pathway.

Access to fused π-extended acridone derivatives through a regioselective oxidative demethylation.

The oxidative demethylation of ortho-dimethoxyacridone with ceric ammonium nitrate (CAN) regioselectively furnished an ortho-quinone leaving a methoxyl group unreacted, which further condensed with aromatic ortho-diamines to afford angularly fused π-extended acridone derivatives. Crystallographic analysis reveals the distinct manner of molecular packing in the crystals according to the dimension of π-extension. The benzene at the turning point possesses a shorter outer bond and a longer inner bond, which affects molecular conjugation and results in weakened aromaticity.

Sarcopenia associated with 90-day readmission and overall survival after abdominal trauma.

BACKGROUND AND OBJECTIVES: It is widely recognized that sarcopenia increases postoperative complications in trauma patients. However, the effects on prognosis remain unclear. This study aimed to evaluate the impact of sarcopenia on 90-day readmission and overall survival (OS) in abdominal trauma patients. METHODS AND STUDY DESIGN: 485 consecutive patients who underwent abdominal surgery after trauma in our institution were enrolled. Sarcopenia was diagnosed with low muscle mass and low muscle strength-handgrip. Multivariate logistic regression analysis was performed to identify factors that contributed to 90-day readmission and OS. Cox logistic regression analysis was used to assess the relationship between sarcopenia and OS. RESULTS: Sarcopenia was present in 120 of 485 patients (24.7%) with abdominal trauma within one week after admission based on the diagnostic cut-off values (40.9 cm2/m2 for men and 36.8 cm2/m2 for women). 90-day readmission was significantly higher in the sarcopenia group (p=0.019), and OS lower in the sarcopenia group (p=0.025). Sarcopenia was an independent predictor of 90-day readmission [odds ratio (OR): 5.34, 95% confidence interval (CI): 2.52-11.3]. CONCLUSIONS: Sarcopenia was associated with high 90-day readmission and low OS in abdominal trauma patients, and it was an independent risk factor for 90-day readmission.

Research on the Node Importance of a Weighted Network Based on the K-Order Propagation Number Algorithm.

To describe both the global and local characteristics of a network more comprehensively, we propose the weighted K-order propagation number (WKPN) algorithm to extract the disease propagation based on the network topology to evaluate the node importance. Each node is set as the source of infection, and the total number of infected nodes is defined as the K-order propagation number after experiencing the propagation time K. The simulation of the symmetric network with bridge nodes indicated that the WKPN algorithm was more effective for evaluation of the algorithm features. A deliberate attack strategy, which indicated an attack on the network according to the node importance from high to low, was employed to evaluate the WKPN algorithm in real networks. Compared with the other methods tested, the results demonstrate the applicability and advancement that a lower number of nodes, with a higher importance calculated by the K-order propagation number algorithm, has to achieve full damage to the network structure.

Outcomes and clinical characteristics of transmural intestinal necrosis in acute mesenteric ischemia.

Background: Acute mesenteric ischemia (AMI) is a rare life-threatening condition, especially for the patients with transmural intestinal necrosis (TIN). However, the optimal time for surgical intervention is controversial. As a series study, this study aimed to identify the outcomes and clinical characteristic of patients with TIN. Methods: Clinical data of 158 patients with AMI from January 2010 to December 2017 were retrospectively analyzed in a national gastrointestinal referral center in China to confirm the outcomes and identify predictors for TIN. Results: According to the results of pathological assessment and follow-up, 62 patients were TIN and 96 were non-TIN. Patients with TIN have a higher mortality and incidence of severe complications. The significant independent predictors for TIN were arterial lactate level (OR: 4.76 [2.29 ∼ 9.89]), free intraperitoneal fluid (OR: 9.49 [2.56 ∼ 35.24]) and pneumatosis intestinalis (OR: 7.08 [1.68 ∼ 29.82]) in computed tomography (CT) scan imaging. The overall area under the receiver operating characteristics (ROC) curve of the model was 0.934 (95% confidence interval: 0.893 ∼ 0.974). Using ROC curve, the cutoff value of arterial lactate level predicting the onset of TIN was 2.65 mmol/L. Conclusions: Patients concomitant with TIN manifest a higher risk of poor prognosis. The three predictors for TIN were arterial lactate level >2.65 mmol/L, free intraperitoneal fluid and pneumatosis intestinalis. Close monitoring these predictors would help identify AMI patients developed TIN and in urgent need for bowel resection.

Endovascular stent placement for isolated superior mesenteric artery dissection with intestinal ischaemia.

BACKGROUND: Isolated superior mesenteric artery dissection (ISMAD) is rare, especially when associated with intestinal ischaemia. We report our clinical experience managing this condition. PATIENTS AND METHODS: Medical records from 22 patients with ISMAD and intestinal ischaemia were retrospectively analysed. Conservative treatment was given to all patients as first line therapy. Subsequently, 15 patients received endovascular stent placement and three patients received endovascular stent placement plus intestinal resection and anastomosis. RESULTS: After conservative treatment, the symptoms of three patients were remarkably relieved; however, a repeat contrast CT showed that stenosis was aggravated. Hence, endovascular stent placement was performed in all 15 patients. Enteral nutrition was successfully restored in 12 patients. Three patients showed signs of chronic intestinal ischaemia, including peritonitis and ileus. These patients underwent intestinal resection and anastomosis. Enteral nutrition was restored at postoperative week two. No signs of intestinal ischaemia recurred during two-years of follow-up. CONCLUSIONS: We recommend endovascular stent placement as a feasible, effective, and minimally invasive procedure in patients with ISMAD and symptoms of intestinal ischaemia.

Open Abdomen Improves Survival in Patients With Peritonitis Secondary to Acute Superior Mesenteric Artery Occlusion.

BACKGROUND: Damage control surgery and open abdomen (OA) have been extensively used in the severe traumatic patients. However, there was little information when extended to a nontrauma setting. The purpose of this study was to evaluate whether the liberal use of OA as a damage control surgery adjunct improved the clinical outcome in acute superior mesenteric artery occlusion patients. STUDY DESIGN: A single-center, retrospective cohort review was performed in a national tertiary surgical referral center. RESULTS: Forty-four patients received OA (OA group) and 65 patients had a primary fascial closure (non-OA group) after diagnosed as peritonitis secondary to acute superior mesenteric artery occlusion from January, 2005 to June, 2016. Revascularization was achieved through endovascular aspiration embolectomy, open embolectomy, or percutaneous stent. No difference of bowel resection length was found between groups in the first emergency surgery. However, more non-OA patients (35.4%) required a second-look enterectomy to remove the residual bowel ischemia than OA patients (13.6%, P<0.05). OA was closed within a median of 7 days (4 to 15 d). There was a mean of 134 cm residual alive bowel in OA, whereas 96 cm in non-OA. More non-OA patients suffered from intra-abdominal sepsis (23.1% vs. 6.8%, P<0.01), intra-abdominal hypertension (31% vs. 0, P<0.01), and acute renal failure (53.8% vs. 31.8%, P<0.05) than OA group after surgery. Short-bowel syndrome occurred infrequently in OA than non-OA patients (9.1% vs. 36.9%, P<0.01). OA significantly decreased the 30-day (27.3% vs. 52.3%, P<0.01) and 1-year mortality rate (31.8 % vs. 61.5%, P<0.01) compared with non-OA group. CONCLUSIONS: Liberal use of OA, as a damage control adjunct avoided the development of intra-abdominal hypertension, reduced sepsis-related complication, and improved the clinical outcomes in peritonitis secondary to acute SMA occlusion.

Biliary Obstruction following Transjugular Intrahepatic Portosystemic Shunt Creation in Patients with Variceal Bleeding.

This report describes an unusual complication after creation of a transjugular intrahepatic portosystemic shunt (TIPS). Biliary obstruction developed in two patients with portal hypertension accompanied by portal vein thrombosis, one patient with and the other without portal cavernous transformation. The biliary obstruction was thought to be secondary to compression of the bile duct by the stent graft placed in the TIPS. Awareness of this possible complication is important for its early diagnosis.

TaZAT8, a C2H2-ZFP type transcription factor gene in wheat, plays critical roles in mediating tolerance to Pi deprivation through regulating P acquisition, ROS homeostasis and root system establishment.

Transcription factors (TFs) play critical roles in mediating defense of plants to abiotic stresses through regulating downstream defensive genes. In this study, a wheat C2H2-ZFP (zinc finger protein) type TF gene designated as TaZAT8 was functionally characterized in mediating tolerance to the inorganic phosphate (Pi)-starvation stress. TaZAT8 bears conserved motifs harboring in the C2H2-ZFP type counterparts across vascular plant species. The expression of TaZAT8 was shown to be induced in roots upon Pi deprivation, with a Pi concentration- and temporal-dependent manner. Overexpression of TaZAT8 in tobacco conferred plants improved tolerance to Pi deprivation; the transgenic lines exhibited enlarged phenotype and elevated biomass and phosphorus (P) accumulation relative to wild-type (WT) after Pi-starvation treatment. NtPT1 and NtPT2, the tobacco phosphate transporter (PT) genes, showed increased transcripts in the Pi-deprived transgenic lines, indicative of their transcriptional regulation by TaZAT8. Overexpression analysis of these PT genes validated their function in mediating Pi acquisition under the Pi deprivation conditions. Additionally, the TaZAT8-overexpressing lines also behaved enhanced antioxidant enzyme (AE) activities and enlarged root system architecture (RSA) with respect to WT. Evaluation of the transcript abundance of tobacco genes encoding AE and PIN proteins, including NtMnSOD1, NtSOD1, NtPOD1;2, NtPOD1;5, NtPOD1;6, and NtPOD1;9, and NtPIN1 and NtPIN4 are upregulated in the TaZAT8-overexpressing lines. Overexpression of NtPIN1 and NtPIN4 conferred plants to enlarged RSA and elevated biomass under the Pi-starvation stress conditions. Our investigation provides insights into plant adaptation to the Pi-starvation stress mediated by distinct ZFP TFs through modulation of Pi acquisition and cellular ROS detoxicity.

Postoperative Catheter-Directed Thrombolysis Versus Systemic Anticoagulation for Acute Superior Mesenteric Venous Thrombosis.

BACKGROUND: Little data evaluate catheter-directed thrombolysis (CDT) therapy as a sequential treatment of emergent surgery for patients with acute superior mesenteric venous thrombosis (ASMVT). We compared the outcomes of ASMVT patients receiving CDT via superior mesenteric artery (SMA) with those who had systemic anticoagulation after emergent laparotomy. METHODS: A single-center retrospective study of ASMVT patients receiving emergent laparotomy from May 2012 to April 2014 was performed. Patients in group I had postoperative systemic anticoagulation and patients in group II underwent postoperative CDT. The demography, etiology, imaging features, clinical outcomes, and complications were compared. Moreover, univariate analysis was performed to identify confounding variables of 30-day mortality. RESULTS: Thirty-two patients (20 males, mean age of 44.9 ± 10.6 years) were included, 17 in group I and 15 in group II. No significant differences of demographic data, etiology, baseline value, and perioperative comorbidity were found. The rate of complete thrombus removal was significantly higher in group II than group I (29.4% vs. 80.0%, P = 0.001). The second-look laparotomy and repeat bowel resection (58.8% vs. 13.3%, P = 0.002) were required in fewer patients in group II (20.0% vs. 70.6%, P = 0.001). The incidence of short-bowel syndrome (SBS; 41.2% vs. 6.7%, P = 0.001) and 30-day mortality (41.2% vs. 6.7%, P = 0.001) were lower in group II. The 1-year survival was also better in group II (52.9% vs. 93.3%, P = 0.014). The incidence of massive abdominal hemorrhage requiring blood transfusion and surgical intervention was 11.8% in group I and 20.0% in group II (P = 0.645). The age, serum D-dimer level, SBS, and postoperative CDT were significant risk factors of 30-day mortality in this study. CONCLUSIONS: For ASMVT patients receiving emergent surgery and intraoperative thrombectomy, the algorithm with postoperative CDT via SMA is associated with more favorable clinical outcome compared with systemic anticoagulation.

Clinical and pelvic morphologic correlation after subtotal colectomy with colorectal anastomosis for combined slow-transit constipation and obstructive defecation.

BACKGROUND: The treatment of slow-transit constipation combined with outlet obstruction is controversial. Subtotal colectomy with colorectal anastomosis is regarded as a safe and effective surgical option for refractory constipation. PURPOSE: The clinical and morphologic outcomes of patients who underwent subtotal colectomy with colorectal anastomosis for refractory mixed constipation were prospectively evaluated. DESIGN: This study is a nonrandomized, prospective review of gathered data. SETTING: This investigation was conducted at a tertiary-care GI surgical center in China. PATIENTS: The study prospectively included 42 consecutive patients with refractory constipation who were diagnosed with obstructed defecation syndrome combined with slow colon transit. MAIN OUTCOME MEASURES: The primary outcomes measured were the Longo obstructive defecation syndrome score and the Wexner constipation scale. The pelvic morphologic changes were determined with defecography before surgery and at 6 and 24 months after surgery. RESULTS: A significant reduction in the Wexner constipation score was observed between baseline (median 24) and 6 months (median 10), which was maintained until 24 months (median 8, compared with baseline, p < 0.01). Improvement in the constipation score was matched by an overall improvement in the Longo obstructive defecation syndrome score at the 6- and 24-month follow-up times (compared with baseline, p < 0.01). In 17 of 21 patients, preexisting intussusception was no longer visible during defecography. Rectoceles were significantly reduced in depth, from 36 mm to 8 mm (p < 0.01), whereas the number of detectable rectoceles was also significantly decreased, from 29 to 7 (p < 0.01). Incomplete evacuation disappeared in 28 of 38 patients. No stenosis was observed at the colorectal posterior side-to-side anastomosis. Most complications were managed conservatively without significant events. LIMITATIONS: This study was performed in selected patients with constipation and did not include a comparison group. CONCLUSIONS: Subtotal colectomy with colorectal anastomosis can correct pelvic anatomical disorders in patients with mixed refractory constipation. The clinical improvement of obstructed defecation syndrome after subtotal colectomy with colorectal anastomosis is highly correlated with the morphologic correction of the rectal redundancy.

Neutrophil extracellular traps contribute to the intestine damage in endotoxemic rats.

BACKGROUND: Sepsis is one of the most troublesome problems in critically ill patients and often accompanied with multiple organ dysfunction and high mortality. Gut injury or dysfunction may contribute to the pathogenesis of sepsis. Neutrophil extracellular traps (NETs) do not only kill microorganisms but also damage host cells during inflammatory response to infection. The aim of this study was to investigate whether NETs are capable of promoting the impairment of the gut in a rat model of lipopolysaccharide (LPS)-induced sepsis. METHODS: The sepsis model was induced in rats by intraperitoneal injection of LPS (10 mg/kg). All rats were divided into three groups as follows: 1) control group; 2) LPS group; and 3) LPS + DNase I group. The DNase I solution (10 mg/kg) was injected intravenously to disrupt NETs 30 min after the LPS treatment. The animals were sacrificed at 3 h and 24 h after LPS or saline challenge. The intestinal cell apoptosis was examined by detecting the level of cleaved caspase-3 and terminal deoxynucleotidyl transferase dUTP nick-end labeling assays. The length and morphology of Villi were assessed histologically through hematoxylin and eosin stain. The levels of tumor necrosis factor-alpha and interleukin-10 in serum and intestine were detected by enzyme-linked immunosorbent assay. Intestinal injury was evaluated with Chiu scoring system. RESULTS: A large number of neutrophils infiltrated were activated to release NETs in the intestine of LPS-induced septic rats. The disruption of NETs reduced the acute systemic inflammatory response and apoptosis of intestinal epithelial cells and alleviated histologic pathogenesis. Removal of NETs provided a beneficial effect on intestinal injury. CONCLUSIONS: This study demonstrates that the release of NETs may contribute to the intestinal damage during sepsis.

Early prophylactic anticoagulation via transjugular intrahepatic route for portal vein thrombosis after splenectomy in cirrhotic portal hypertension.

PURPOSE: To evaluate early transcatheter anticoagulation via the transjugular intrahepatic route to prevent portal vein thrombosis (PVT) after splenectomy in cirrhotic patients with portal hypertension. MATERIALS AND METHODS: This retrospective study included 98 cirrhotic patients with portal hypertension who underwent open splenectomy (48 men and 50 women; age, 45.4 y ± 13.6). Systemic anticoagulation was given to 52 patients in group I, and transcatheter anticoagulation was performed in 46 patients in group II. RESULTS: The technical success rate of catheterization by the transjugular intrahepatic route was 93.5% in group II. The 30-day (6.52% vs 23.1%, P < .05) and 6-month (8.70% vs 26.9%, P < .05) incidences of PVT were significantly lower in group II than in group I. The postoperative bleeding rate was 6.52% in group II and 25% in group I (P < .05). There was no significant difference between groups in 30-day (5.77% vs 2.17%) and 6-month (1.92% vs 6.52%) mortality. After splenectomy, the portal trunk vessel diameter was 16.0 mm ± 3.5 in group I and 14.5 mm ± 2.5 in group II (P < .05). The portal flow velocity was 25.9 cm/s ± 7.1 in group I and 28.2 cm/s ± 5.3 in group II (P > .05). During the first week after splenectomy, notable hypercoagulability was detected within the portal vein compared with peripheral blood. Decreased portal flow velocity was considered an independent risk factor for PVT by univariate and multivariate analysis. CONCLUSIONS: Transcatheter anticoagulation via the transjugular intrahepatic route can decrease the incidence of PVT and postoperative bleeding after open splenectomy in cirrhotic patients with portal hypertension.

Multilayer interparticle linking hybrid MOF-199 for noninvasive enrichment and analysis of plant hormone ethylene.

Ethylene, an important plant hormone, is of utmost importance during many developmental processes of plants. However, the efficient enrichment and analysis of trace ethylene still remains a challenge. A simple and mild multilayer interparticle linking strategy was proposed to fabricate a novel hybrid MOF-199 enrichment coating. Strong chemical interparticle linkages throughout the coating improved the durability and reproducibility of hybrid MOF-199 coating dramatically. This coating performed a significant extraction superiority of ethylene over commonly used commercial coatings, attributed to the multiple interactions including "molecular sieving effect", hydrogen bonding, open metal site interaction, and π-π affinity. The hybridization of multiwalled carbon nanotubes (MWCNTs) with MOF-199 further improved the enrichment capability and also acted as a hydrophobic "shield" to prevent the open metal sites of MOF-199 from being occupied by water molecules, which effectively improved the moisture-resistant property of MOF-199/CNTs coating. Finally, this novel enrichment method was successfully applied for the noninvasive analysis of trace ethylene, methanol, and ethanol from fruit samples with relatively high humidity. The low detection limit was 0.016 µg/L for ethylene. It was satisfactory that trace ethylene could be actually detected from fruit samples by this noninvasive method. Good recoveries of spiked grape, wampee, blueberry, and durian husk samples were obtained in the range of 90.0-114%, 79.4-88.6%, 78.5-86.8%, and 85.2-105% with the corresponding relative standard deviations of 4.8-9.8%, 6.9-8.9%, 3.8-8.1%, and 9.3-10.5% (n = 3), respectively.

Intraintestinal drainage as a damage control surgery adjunct in a hypothermic traumatic shock swine model with multiple bowel perforations.

BACKGROUND: Temporary bowel ligation (TL) has been proposed to prevent contamination as a damage control procedure in multiple bowel perforations. However, bacteria translocation and intestinal ischemia may develop in a prolonged duration. We here hypothesized that intraintestinal drainage combined with temporary ligation (D-TL) would decrease intestinal injury and improve survivals in a gunshot multiple bowel perforation swine model in the setting of a damage control surgery. MATERIALS AND METHODS: The abdomen was shot one time with an experimental modified gun whereas pigs were hemorrhaged to a mean arterial pressure of 40 mm Hg and maintained in shock for 40 min. Cold lactated Ringer solution was gradually infused to induce hypothermia. Animals were randomized to primary anastomosis, TL and intraintestinal D-TL groups (n = 8). Animals were resuscitated for 12 h with the shed blood and lactated Ringer solution. Delayed anastomosis was performed in TL and D-TL animals after resuscitation. Surviving animals were humanely killed 24 h after operation. Systemic hemodynamic parameters were recorded and blood samples were obtained for biochemical assays. Intra-abdominal pressure, portal vein and peripheral vein bacterial cultures, small intestine hematoxylin-eosin staining, and transmission electron microscopy examination were performed at 0, 2, 6, 12, and 24 h after the surgery. RESULTS: All animals suffered extreme physiologic conditions as follows: hypothermia, severe acidosis, hypotension, and depressed cardiac output. Compared with the primary anastomosis and TL group, D-TL animals required less resuscitation fluid, suffered a lower intra-abdominal hypertension and bacterial translocation, normalized lactate levels faster, had lower serum creatine kinase, aspartate aminotransferase levels and tissue TNF-α level, and nuclear factor-kB activations and thus had greater early survival. CONCLUSIONS: Compared with primary intestinal anastomosis and TL, rapid bowel ligation combined with intraintestinal drainage as a damage control adjunct improved survivals in a multiple bowel perforation swine model in the setting of damage control surgery.