经尿道980 nm DiLEP与TUPKP治疗良性前列腺增生的疗效及术后储尿期症状改善的影响因素

目的探讨经尿道980 nm红激光前列腺剜除术(DiLEP)与等离子双极前列腺切除术(TUPKP)对良性前列腺增生(BPH)患者的疗效,以及术后储尿期症状改善的影响因素。方法回顾性分析青海省人民医院2018年6月—2019年9月收治的行经尿道980 nm DiLEP 274例患者和行TUPKP 152例患者的临床资料,分别作为研究组和对照组。比较两组疗效,术后血红蛋白(Hb)、残余尿量、手术相关指标、并发症发生情况,以及国际前列腺症状评分(IPSS)、生活质量评分(QOL)、膀胱过度活动症评分(OABSS)。并采用单因素分析及非条件一般多因素Logistic回归分析影响患者术后储尿期症状改善的独立影响因素。结果研究组手术时间、术中冲洗液总量、导尿管留置时间及住院时间均短于对照组,术中冲洗液总量少于对照组(P<0.05)。研究组术后发生膀胱痉挛、急迫性尿失禁等并发症的风险低于对照组(P<0.05)。术后随访6个月,研究组IPSS评分及残余尿量低或少于对照组(P<0.05),QOL、OABSS评分高于对照组(P<0.05)。单因素分析结果表明,年龄、残余尿量、夜尿次数、逼尿肌收缩力及手术方法是患者术后储尿期症状改善的影响因素(P<0.05);一般多因素Logistic回归分析结果显示,年龄[O^R=0.131(95%CI:0.065,0.261)]、逼尿肌收缩力[O^R=10.612(95%CI:6.565,17.153)]、夜尿次数[O^R=0.520(95%CI:0.405,0.668)]、残余尿量[O^R=0.255(95%CI:0.167,0.387)]、手术方法[O^R=0.086(95%CI:0.056,0.130)]是患者术后储尿期症状改善的独立影响因素(P<0.05)。结论经尿道980 nm DiLEP相比传统的TUPKP临床效果更佳,术中出血量少且手术和住院时间短,并发症发生风险低,是治疗BPH的有效手段。年龄、残余尿量、夜尿次数、逼尿肌收缩力均是BPH患者术后储尿期症状改善的独立影响因素,术前应高度重视。

Relationship between celiac artery variation and number of lymph nodes dissection in gastric cancer surgery

BACKGROUND Radical D2 lymphadenectomy for advanced gastric cancer as a standard procedure has gained global consensus. Mounting studies have shown that the number of lymph nodes dissection directly affects the prognosis and recurrence of gastric cancer. Our previous study showed that there was no obvious lymph node around the abnormal hepatic artery derived from the superior mesenteric artery. AIM To investigate the relationship between celiac artery variation and the number of lymph nodes dissection in gastric cancer surgery. METHODS The clinicopathological data of 421 patients treated with radical D2 lymphadenectomy were analyzed retrospectively. The difference of the number of lymph nodes dissection between the celiac artery variation group and the normal vessels group and the relationship with prognosis were analyzed. RESULTS Celiac artery variation was found in 110 patients, with a variation rate of 26.13%. Celiac artery variation, tumor staging, and Borrmann typing were factors that affected lymph node clearance in gastric cancer, and the number of lymph nodes dissection in patients with celiac artery variation was significantly less than that of non-variant groups (P < 0.05). Univariate analysis showed that there was no significant difference in survival time between the two groups (P > 0.05). Univariate and multiple Cox regression analysis showed that celiac artery variation was not a prognostic factor for gastric cancer (P > 0.05). Tumor staging, intraoperative bleeding, and positive lymph node ratio were prognostic factors for gastric cancer patients (all P < 0.05). CONCLUSION The number of lymph nodes dissection in patients with celiac artery variation was reduced, but there was no obvious effect on prognosis. Therefore, lymph nodes around the abnormal hepatic artery may not need to be dissected in radical D2 lymphadenectomy.

2D–3D dual carbon layer confined ultrasmall VN nanoparticles for improving lithium-ion storage in hybrid capacitors

Lithium-ion capacitors(LICs) of achieving high power and energy density have garnered significant attention. However, the kinetics unbalance between anode and cathode can impede the application of LICs. Vanadium nitride(VN) with a high theoretical specific capacity(~ 1200 m Ah·g^(-1)) is a better pseudocapacitive anode to match the response of cathode in LICs. However, the insertion/extraction of Li-ions in VN's operation results in significant volume expansion. Herein, the VN/N-r GO-5composite that three-dimentional(3D) dicyandiamidederived-carbon(DDC) tightly wrapped VN quantum dots(VN QDTs) on two-dimentional(2D) reduced graphene oxid(r GO) was prepared by a facile strategy. The VN QDTs can reduce ion diffusion length and improve charge transfer kinetics. The 2D r GO as a template provides support for nanoparticle dispersion and improves electrical conductivity. The 3D DDC tightly encapsulated with VN QDTs mitigates agglomeration of VN particles as well as volume expansion. Correspondingly, the LICs with VN/Nr GO-5 composite as anode and activated carbon(AC) as cathode were fabricated, which exhibits a high energy density and power density. Such strategy provides a perspective for improving the electrochemical properties of LIC anode materials by suppressing volume expansion and enhancing conductivity.

Weakly-solvating electrolytes enable ultralow-temperature (-80°C) and high-power CF_(x)/Li primary batteries

Fluorinated carbons(CF_(x))/Li primary batteries with high theoretical energy density have been applied as indispensable energy storage devices with no need for rechargeability,yet plagued by poor rate capability and narrow temperature adaptability in actual scenarios.Herein,benefiting from precise solvation engineering for synergistic coordination of anions and low-affinity solvents,the optimized cyclic ether-based electrolyte is elaborated to significantly facilitate overall reaction dynamics closely correlated to lower desolvation barrier.As a result,the excellent rate(15 C,650 mAh g^(-1))at room-temperature and ultra-lowtemperature performance dropping to-80°C(495 mAh g^(-1)at average output voltage of 2.11 V)is delivered by the end of 1.5 V cut-off voltage,far superior to other organic liquid electrolytes.Furthermore,the CF_(x)/Li cell employing the high-loading electrode(18-22 mg cm^(-2))still yields 1,683 and 1,395 Wh kg^(-1)in the case of-40°C and-60°C,respectively.In short,the novel design strategy for cyclic ethers as basic solvents is proposed to enable the CF_(x)/Li battery with superb subzero performances,which shows great potential in practical application for extreme environments.

钾离子电池先进阻燃电解质:石墨负极的高稳定储钾

在钾离子电池石墨负极中,钾离子在石墨层间嵌入/脱出的模式能够实现储能,且具有较低工作电位和廉价等优势,表现出巨大的吸引力.然而,在缺乏足够界面保护等条件下,石墨负极在传统碳酸酯类电解液中容易发生连续的副反应,充放电容量会面临严重的持续衰减.本文从电解液设计的角度出发,针对石墨负极的钾离子存储问题,配制了阻燃的局部高浓度电解液,其特有的溶剂化结构可调控石墨表面固体电解质界面相,改善界面的结构稳定性和离子传导特性,从而实现石墨负极储钾的高稳定循环.同时,电解液的高阻燃特性也为钾离子电池的高安全性提供了保障.

Epidemiological characteristics of central nervous system tumors in children: a 5-year review of 3180 cases from Beijing Tiantan Hospital

Background:To describe the epidemiological characteristics of central nervous system(CNS)tumors in children,based on the neurosurgery department of Beijing Tiantan Hospital.Methods:From January 2015 to December 2019,3180 children were histopathologically diagnosed with CNS tumors based on the 2016 World Health Organization(WHO)classification of tumors.Patients were 0 to 15 years old.We analyzed age-related gender preferences,tumor locations,and the histological grades of the tumors.In addition,the epidemiological characteristics of the five most common intracranial tumors were compared to the previous studies.Results:In this study,intracranial and spinal tumors account for 96.4%(3066)and 3.6%(114)of all tumors,with a preponderance of supratentorial tumors(57.9%).Among all pediatric patients,low-grade tumors comprise 67.1%(2135).The integral gender ratio of males to females is 1.47:1 and the average age of patients is 7.59 years old.The five most common intracranial tumors are craniopharyngioma(15.4%),medulloblastoma(14.3%),pilocytic astrocytoma(11.8%),diffuse astrocytoma(9.8%),and anaplastic ependymoma(4.8%).Conclusions:Due to the lack of national data on childhood brain tumors,we used a large nationally representative population sample based on the largest pediatric neurosurgery center in China.We analyzed the data of the past 5 years,reflecting the incidence of CNS tumors in Chinese children to a certain extent,and laying a data foundation for subsequent clinical studies.