纤维支气管镜直视下有创机械通气中置入金属支架治疗恶性肿瘤致中心气道狭窄的临床应用

目的探讨在机械通气情况下置入气道支架解除恶性肿瘤引起中心气道狭窄的可行性和安全性。方法在机械通气下,将纤维支气管镜和气管插管并行进入气道,在纤维支气管镜直视下经气管插管置入金属气道支架。结果11例恶性肿瘤引起的中心气道狭窄在机械通气下置入金属气道支架11枚,狭窄解除、呼吸机撤离、操作顺利,缺氧症状缓解。改良英国医学研究学会呼吸困难指数(mMRC)评分、气道压和气道狭窄均改善明显,与支架置入前比较,差异均有统计学意义(P<0.05);动脉血气分析中,动脉血氧分压(PaO2)和动脉血氧饱和度(SaO2)升高,动脉血二氧化碳分压(PaCO2)降低,与支架置入前比较,差异均有统计学意义(P<0.05)。结论在纤维支气管镜直视下,将支架推送器经气管插管置入气道支架治疗中心气道狭窄是可行的、安全的,且近期疗效显著。

在胃的癌症的帮助 laparoscopy 对开的激进的 gastrectomy 的短期的功效

AIM:To investigate the short-term benefits of laparoscopic radical gastrectomy(LARG)and open radical gastrectomy(ORG)in patients with gastric cancer.METHODS:A total of 400 patients with gastric cancer aged≤65 years who were treated at General Hospital of Lanzhou Military Region were enrolled.Among these,200 patients underwent LARG between October2008 and August 2012(LARG group);and 200 patients underwent ORG between March 2000 and September2008(ORG group).The short-term therapeutic benefits between the two groups were analyzed.RESULTS:The LARG procedure offered significantly better benefits to the patients compared to the ORG procedure,including less intraoperative blood loss(103.1±19.5 mL vs 163.0±32.9 mL,P【0.0001),shorter postoperative hospital stay(6.8±1.2 d vs 9.5±1.6 d,P【0.0001),less frequent occurrence of postoperative complications(6.5%vs 13.5%,P=0.02),shorter time to mobilization(1.0±0.3 vs 3.3±0.4 d,P【0.0001),shorter time to bowel opening(3.3±0.7 d vs 4.5±0.7 d,P【0.0001),and shorter time to normal diet(3.0±0.4 vs d 3.8±0.5 d,P【0.0001).However,LARG required a longer time to complete than the ORG procedure(192.3±20.9 min vs 180.0±26.9 min,P【0.0001).CONCLUSION:Compared to ORG,LARG is safer,more effective,and less invasive for treating gastric cancer,with better short-term efficacy.

A review of non-noble metal-based electrocatalysts for CO_(2)electroreduction

The excessive emission of CO_(2) has caused many environmental issues and is severely threatening the eco-system.CO_(2) electroreduction reaction(CO_(2) RR) that driven by sustainable power is an ideal route for realizing the net reduction of CO_(2) and carbon recycle.Developing efficient electrocatalysts with low cost and high performance is critical for the wide applications of CO_(2) RR electrolysis.Among the various explored CO_(2) RR catalysts,non-noble metal(NNM)-based nanomaterials have drawn increasing attentions due to the remarkable performance and low cost.In this mini-review,the recent advances of NNM-based CO_(2) RR catalysts are summarized,and the catalysts are classified based on their corresponding reduction products.The preparation strategies for engineering the electrocatalysts are introduced,and the relevant CO_(2) RR mechanisms are discussed in detail.Finally,the current challenges in CO_(2) RR research are presented,and some perspectives are proposed for the future development of CO_(2) RR technology.This mini-review introduces the recent advances and frontiers of NNM-based CO_(2) RR catalysts,which should shed light on the further exploration of efficient CO_(2) RR electrocatalysts.

Size-controllable synthesis and high-performance formic acid oxidation of polycrystalline Pd nanoparticles

A facile approach was developed for the synthesis of polycrystalline palladium nanoparticles(Pd NPs)by using tannic acid(TA) as green reagent and stabilizer in a 30 ℃ water bath. The size of Pd NPs can be tuned in a range of 10–60 nm simply by adjusting the concentration of Pd precursor. The catalytic activity and stability of the as-obtained Pd NPs toward formic acid oxidation were analyzed. It is found that these Pd NPs with different sizes exhibit size-dependent and enhanced formic acid oxidation performance compared to the commercial Pd black catalyst. It should be noted that the Pd catalysts with an average size of 24 nm demonstrate the best catalytic activity and stability among the other prepared Pd NPs, which can be ascribed to its larger electrochemical surface area(ECSA)and polycrystalline structure with defects.

Improving Li reversibility in Li metal batteries through uniform dispersion of Ag nanoparticles on graphene

Li metal is the most attractive and promising anode material for next-generation high-energy batteries.However,uncontrolled Li dendrite growth during cycling remains a highly challenging drawback.To solve this problem,silver-coated graphene(Ag/GH)was prepared via a simple liquid-phase reduction method.The effect of Ag/GH on Li deposition behavior was investigated by adjusting the dispersion of Ag nanoparticles(Ag NPs).Subsequently,a composite electrode was fabricated via uniform deposition of metallic Li on Ag/GH.Ag was used as a lithiophilic nucleating agent to ensure uniform deposition of Li and inhibit the growth of Li dendrites on the anode.The prepared composite anode showed a significantly improved performance compared to the unmodified electrode.The symmetric cell comprising this composite electrode exhibited a stable cycling performance with a low hysteresis of~40 mV and a lifetime of>2000 h at a current density of 0.5 mA·cm^(-2).Meanwhile,the discharge capacity reached 0.5 mAh·cm^(-2).In addition,Ag/GH was found to be amenable to large-scale synthesis.Thus,the composite Ag/GH anode exhibited improved performance and the preparation method showed significant potential for application in the manufacture of Li metal batteries.