Clinical application of reserved gastric tube in neuroendoscopic endonasal surgery for pituitary tumor

BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for sphenoidal pituitary tumor is widely used.But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.AIM To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.METHODS A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each group.Experimental group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from anesthesia.Control group:Given the routine intraoperative care,no gastric tube was left.The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h postoperation.The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared.The hospitalization days of the two groups were statistically compared.RESULTS The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group,but there was no statistically significant difference from the control group(P>0.05).The hospitalization days of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).CONCLUSION Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors,combined with intraoperative and postoperative gastrointestinal decompression,can effectively reduce the incidence of nausea,reduce the number of vomiting and aspiration in patients,and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.

“In situ bone flap” combined with vascular pedicled mucous flap to reconstruction of skull base defect

BACKGROUND At present,neuroendoscopy technology has made rapid development,and great progress has been made in the operation of lesions in the saddle area of the skull base.However,the complications of cerebrospinal fluid and intracranial infection after the operation are still important and life-threatening complications,which may lead to poor prognosis.AIM To investigate the method of in situ bone flap combined with nasal septum mucosal flap for reconstruction of enlarged skull base defect by endonasal sphenoidal approach and to discuss its application effect.METHODS Clinical data of 24 patients undergoing transnasal sphenoidal endoscopic approach in the Department of Neurosurgery,Affiliated 2 Hospital of Nantong University from January 2019 to December 2022 were retrospectively analyzed.All patients underwent multi-layer reconstruction of skull base using in situ bone flap combined with nasal septum mucosa flap.The incidence of intraoperative and postoperative cerebrospinal fluid leakage and intracranial infection were analyzed,and the application effect and technical key points of in situ bone flap combined with nasal septum mucosa flap for skull base bone reconstruction were analyzed.RESULTS There were 5 cases of high flow cerebrospinal fluid(CSF)leakage and 7 cases of low flow CSF leakage.Postoperative cerebrospinal fluid leakage occurred in 2 patients(8.3%)and intracranial infection in 2 patients(8.3%),which were cured after strict bed rest,continuous drainage of lumbar cistern combined with antibiotic treatment,and no secondary surgical repair was required.The patients were followed up for 8 to 36 months after the operation,and no delayed cerebrospinal fluid leakage or intracranial infection occurred during the follow-up.Computed tomography reconstruction of skull base showed satisfactory reconstruction after surgery.CONCLUSION The use of in situ bone flap combined with vascular pedicled mucous flap to reconstruction of skull base defect after endonasal sphenoidal approach under neuroendoscopy has a lower incidence of cerebrospinal fluid leakage and lower complications,which has certain advantages and is worthy of clinical promotion.

Positioning and design by computed tomography imaging in neuroendoscopic surgery of patients with chronic subdural hematoma

BACKGROUND Neuroendoscopy is a very useful technique to Chronic Subdural Hematoma(CSH).But how to achieve the goal of treatment more minimally invasive?AIM To develop a simple,fast and accurate preoperative planning method in our way for endoscopic surgery of patients with CSH.METHODS From June 2018 to May 2020,forty-two patients with CSH,admitted to our hospital,were performed endoscopic minimally invasive surgery;computed tomography(CT)imaging was employed to locate the intracerebral hematoma and select the appropriate endoscopic approach before the endoscopic surgery.The clinical data and treatment efficacy were analyzed.RESULTS According to the learning of CT scanning images,the surgeon can accurately design the best minimally invasive neuroendoscopic surgical approach and realize the precise positioning and design of the drilling site of the skull and the size of the bone window,so as to provide the most effective operation space with the smallest bone window.In this group,the average operation time was only about 1 h,and the clearance rate of hematoma was about 95%.CONCLUSION Patients with CSH can achieve good therapeutic effect by using our way to positioning and design to assist the operation of CSH according to CT scan and image,and our way is very useful and necessary.

Efficacy evaluation of neuroendoscopy vs burr hole drainage in the treatment of chronic subdural hematoma:An observational study

BACKGROUND Chronic subdural hematoma(CSDH)is a common disease in neurosurgery.The traditional treatment methods include burr hole drainage,bone flap craniectomy and other surgical methods,and there are certain complications such as recurrence,pneumocephalus,infection and so on.With the promotion of neuroendoscopic technology,its treatment effect and advantages need to be further evaluated.AIM To study the clinical effect of endoscopic small-bone approach in CSDH.METHODS A total of 122 patients with CSDH admitted to our hospital from August 2018 to August 2021 were randomly divided into two groups using the digital table method:the neuroendoscopy group(n=61 cases)and the burr hole drainage group(n=61 cases).The clinical treatment effect of the two groups of patients with CSDH was compared.RESULTS At the early postoperative stage(1 d and 3 d),the proportion of 1/2 re-expansion of brain tissue in the hematoma cavity and the proportion of complete reexpansion was higher in the neuroendoscopy group than in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).The recurrence rate of hematoma in the neuroendoscopy group was lower than that in the burr hole drainage group,and the difference between the two groups was statistically significant(P<0.05).No intracranial hematoma,low cranial pressure,tension pneumocephalus or other complications occurred in the neuroendoscopy group.CONCLUSION The neuroendoscopic approach for the treatment of CSDH can clear the hematoma under direct vision and separate the mucosal lace-up.The surgical effect is apparent with few complications and definite curative effect,which is worthy of clinical promotion and application.

Anorectal dysfunction in patients with mid-low rectal cancer after surgery: A pilot study with three-dimensional high-resolution manometry

BACKGROUND The quality of life in patients who develop low anterior resection syndrome(LARS)after surgery for mid-low rectal cancer is seriously impaired.The underlying pathophysiological mechanism of LARS has not been fully investigated.AIM To assess anorectal function of mid-low rectal cancer patients developing LARS perioperatively.METHODS Patients diagnosed with mid-low rectal cancer were included.The LARS score was used to evaluate defecation symptoms 3 and 6 mo after anterior resection or a stoma reversal procedure.Anorectal functions were assessed by threedimensional high resolution anorectal manometry preoperatively and 3-6 mo after surgery.RESULTS The study population consisted of 24 patients.The total LARS score was decreased at 6 mo compared with 3 mo after surgery(P<0.05),but 58.3%(14/24)lasted as major LARS at 6 mo after surgery.The length of the high-pressure zone of the anal sphincter was significantly shorter,the mean resting pressure and maximal squeeze pressure of the anus were significantly lower than those before surgery in allpatients (P < 0.05), especially in the neoadjuvant therapy group after surgery (n = 18). The focalpressure defects of the anal canal were detected in 70.8% of patients, and those patients had higherLARS scores at 3 mo postoperatively than those without focal pressure defects (P < 0.05). Spasticperistaltic contractions from the new rectum to anus were detected in 45.8% of patients, whichwere associated with a higher LARS score at 3 mo postoperatively (P < 0.05).CONCLUSIONThe LARS score decreases over time after surgery in the majority of patients with mid-low rectalcancer. Anorectal dysfunctions, especially focal pressure defects of the anal canal and spasticperistaltic contractions from the new rectum to anus postoperatively, might be the majorpathophysiological mechanisms of LARS.

Manufacturing and characterizing of CCTO/SEBS dielectric elastomer as capacitive strain sensors

Calcium copper titanate(CCTO)/polystyrenepolyethylene-polybutylene-poly styrene(SEBS)dielectric elastomers were prepared via blending method.A capacitive strain sensor using CCTO/SEBS as dielectric layer and polyaniline-dodecylbenzensulfonic acid(PANI-DB S A)/SEBS as electrodes was designed and manufactured by thermoforming process.X-ray diffractometer(XRD),scanning electron microscopy(SEM)and Raman spectra analyses were carried out;no impurities were found in the composite and CCTO particles were well dispersed.The dielectric tests showed that the samples filled with 20 wt%CCTO have their permittivity improved by 70%.The capacitive strain sensors have a stabilized capacitance variety range at different strain ranges or stretch speeds,and could remain synchronized after 500-time-stretching,showing high reproducibility.

Single Zn atoms anchored on hollow carbon nanofiber network for dendrite-free lithium metal anode of flexible Li–S full cell

The attractive energy density of lithium-sulfur(Li-S)batteries makes them desirable energy storage systems;however,the slow reaction kinetics and formation of lithium dendrites prevent them from reaching full potential.To address this issue,hierarchical porous carbon nanofibers network containing Zn single atoms(ZnSA@HPCNF)is synthesized by electrospinning and carbonization.This structure serves as the main anode body,providing excellent chemical anchoring and lipophilicity.The uniform distribution of Zn single atoms and N4coordination supports uniform deposition and continuous plating/stripping of lithium.The results show that the Li|Li/ZnSA@HPCNF symmetrical battery presents stable and low overpotential during 700-and 900-h iterative plating/stripping process at1 and 5 mA·cm^(-2),respectively.Furthermore,the S/CNT||Li/ZnSA@HPCNF full cell shows good flexibility,reversible capacity and cycling stability.This work provides a lithium host strategy based on single-atom dispersed hierarchical porous carbon network,enabling the design of rational lithium metal anodes for use in flexible Li-S full cells.

Microstructure and properties of honeycomb composite films containing Eu and Sn

Honeycomb composite films were prepared by breath figure method via a straightforward,one-step process by doping complex containing Eu or Sn into polystyrene-b-poly(acrylic acid) solution.Several key influencing factors,such as the concentration of the block polymer solution,the relative humidity of the environment and the amount of complexes,were investigated to control micropore size and tune film surface properties.The characteristics of the composite films were studied by scanning electron microscopy(SEM),atomic force microscopy(AFM),X-ray diffraction(XRD),ultraviolet and emission spectra.Results indicate that composite films containing Eu have excellent optical performance,and micro-patterned bowl-like SnO_(2) microparticles could be fabricated from composite films containing Sn after being calcined at 600℃ for 5 h.This general approach for the fabrication of honeycomb composite films opens a convenient and effective route to the functional modification of honeycomb films and offers new prospects for the application in miniaturized sensors,micro-reactor and catalysis.

Synthesis of anatase TiO_(2) with exposed {001} and {101} facets and photocatalytic activity

Anatase titanium(IV)oxide(TiO_(2))particles with exposed{001}and{101}facets were prepared by hydrothermal treatment of amorphous TiO_(2) with H_(2)O_(2)-NH_(3) solution.Crystal phase,shape,and size of TiO_(2) particles are found to be greatly dependent on the ratio of H_(2)O_(2)-NH_(3) solution.The prepared TiO_(2) particles with specific exposed crystal faces show higher photocatalytic activity for acetaldehyde decomposition than commercial spherical TiO_(2) particles.This result implies that recombination is prevented by spatial separation of redox sites in the particles because of selective migration of electrons and positive holes to specific exposed crystal faces and/or different reactivity of electrons and positive holes on the specific exposed crystal face.

Improvement of photocatalytic activity of high specific surface area graphitic carbon nitride by loading a co-catalyst

Graphitic carbon nitride(g-C3N4)was synthesized by heating melamine and was then treated with sodium hydroxide solution under a hydrothermal condition to obtain g-C3N4 with a large specific surface area(HSSA).HSSA shows higher photocatalytic activity for decomposition of acetaldehyde than that of original g-C3N4.HSSA was modified with RuO2 as a co-catalyst by the impregnation method.HSSA loaded with 0.05 wt%RuO2 shows the highest photocatalytic activity for acetaldehyde decomposition under visible light(k=455 nm).

Tailoring the microstructure and improving the discharge properties of dilute Mg-Sn-Mn-Ca alloy as anode for Mg-air battery through homogenization prior to extrusion

Mg-0.5Sn-0.5Mn-0.5Ca(wt.%) alloys with different microstructures are designed through casting and extrusion with and without homogenization treatment prior to extrusion(HPE).The influence of HPE treatment on the microstructural characteristics and resultant discharge properties of Mg-Sn-Mn-Ca alloy in extruded condition as anode for Mg-air battery was investigated.HPE treatment exerts a prominent effect on the grain structure and orientation,distribution of the second phase particles as well as the dislocation density of the extruded alloy.The HPE alloy exhibits a distinctly high cell voltage together with specific energy compared with that of Non-HPE one.Intermittent discharge tests confirm that the HPE alloy possesses a more excellent discharge activity and more stable discharge process than the NonHPE one.All results demonstrate that the HPE alloy is an attractive anode material for Mg-air battery with long-term storage and under intermittent discharge.

Electrospun and in situ self-polymerization of polyacrylonitrile containing gadolinium nanofibers for thermal neutron protection

In this work, the polyacrylonitrile containing gadolinium nanofibers for thermal neutron protection were successfully fabricated by electrospunning and followed by in situ self-polymerization. Scanning electron microscopy(SEM) and energy-dispersive spectroscopy(EDS) results show that there are no beads on the smooth surface of the nanofibers and gadolinium elements are uniformly dispersed in the matrix. The thermal analysis and FTIR results prove that gadolinium methacrylate is induced in situ selfpolymerization during the heat treatment. The leaching rate of Gd^(3+) decreases from 79.97% to 10.74% tested by lowfield nuclear magnetic resonance(LF-NMR) method after the self-polymerization of gadolinium methacrylate in the matrix when the nanofibers were immersed in water for7 days. The thermal neutron shielding analysis calculated by MCNP program shows that above 99% thermal neutrons are absorbed when traveling through the 2-mm-thick polyacrylonitrile containing gadolinium nanofibers.

Supercritical fluid extraction and gas chromatography analysis of arsenic species from solid matrices

A method in combination with derivatization-supercritical fluid extraction（SFE） and gas chromatography（GC） for the speciation and quantitative determination of dimethylarsinate（DMA）, monomethylarsonate（MMA） and inorganic arsenic in solid matrices was investigated. Thioglycolic acid methyl ester（TGM） and thioglycolic acid ethyl ester（TGE） were evaluated as derivatization reagents. The effects of pressure, temperature, flow rate of supercritical CO_2, extraction time, modifier and microemulsion on the efficiency of extraction were systematically investigated. The procedure was applied to the analysis of real soil and sediment samples. Results showed that TGE was more effective for arsenic speciation as a derivatization reagent. Modifying supercritical CO_2 with methanol can greatly improve the extraction efficiency. Further, the addition of microemulsion containing surfactant Triton X-100 can further enhance recoveries of arsenic species. The optimum extraction conditions were 100 ℃, 30 MPa, 10 min static and 25 min dynamic extraction with 5%（v/v） methanol, and surfactant modified supercritical CO_2. Detection limits in solid matrices were 0.15, 0.3 and 1.2 mg/kg for DMA, MMA and inorganic arsenic,respectively. The method was validated by the recovery data. The resulting method was fast, easy to perform and selective in the extraction and detection of various arsenic species in solid matrices.

Thermal and Mechanical Properties of Graphene-Titanium Composites Synthesized by Microwave Sintering

The x wt%graphene-Ti composites（x = 0,0.2,0.3 and 0.4） were obtained using the powder metallurgy method.The X-ray diffraction results demonstrated that the peak intensity of graphene increased monotonically with increasing graphene content.Furthermore,the number of grain boundary and interface between graphene and matrix increased as graphene increased,which led to a sharp rise of thermal resistances.The thermal conductivity and specific heat capacity of composites initially decreased drastically with addition of graphene,but then increased with increasing graphene content from 0.2 to 0.4 wt%.This phenomenon was connected with the graphene content and the characteristics of Ti matrix（pores,grain boundary and interface between graphene and matrix）.The variation of the compressive strength of composites was attributed to the interaction effects of the average grain size of the Ti matrix（d_m） and the volume fraction（V_f） and aspect ratio（A） of graphene.

Predicting jet-grout column diameter to mitigate the environmental impact using an artificial intelligence algorithm

This paper describes an approach for predicting the diameter of a jet-grout column using the support vector regression(SVR)technique,which is regarded as a novel learning machine based upon recent advances in statistical theory,in which the combined effects of the construction(construction methods and jetting parameters)and soil properties(soil type and shearing resistance)are considered.Four different kernel functions,namely,a linear kernel function,polynomial kernel function,radial basis kernel function,and sigmoid kernel function,are integrated into the SVR technique.A large amount of field measured data on the diameter of jet-grout column are retrieved from the published literature for training and testing purposes.The results indicate that the SVR technique with a radial basis kernel function provides predictions closest to the measured results,whereas the prepared design charts enable the ability to significantly widen the application of the proposed approach to the areas of ground improvement and environmental protection.

Design and properties of calcium copper titanate/poly(dimethyl siloxane) dielectric elastomer composites

The high phase content of inorganic dielectric fillings will give a strong electric driving force and hard matrix. That is a contradiction in enhancing the electrodeformation of dielectric elastomers(DEs). Therefore, in this paper, by focusing on how to approach a balance between these and finding an effective way to tune the electric response of the DEs, the theoretical calculation and experimental investigation based on calcium copper titanate(CCTO)/poly(dimethyl siloxane)(PDMS) were carried out. It is found that CCTO with a smaller particle size shows a larger dielectric parameter. With smaller CCTO particle as the fillings, the fabricated elastomer composite would approach to a low modulus by a proper CCTO phase morphology in the matrix.