超声引导下PTCD应用于BismuthⅢ型胆道梗阻患者临床对照研究

目的探讨超声引导下的经皮肝穿刺胆道引流术(PTCD)应用于BismuthⅢ、Ⅳ型胆道梗阻患者的临床疗效。方法将95例恶性胆道梗阻患者中的BismuthⅢ型患者65例设为Ⅲ型组,BismuthⅣ型患者30例设为Ⅳ型组。比较两组患者手术时间、临床疗效及术后并发症发生情况,比较治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、总胆红素(TBIL)和直接胆红素(DBIL)]水平及癌症患者生命质量测定量表(QLQ-C30)评分。结果Ⅲ型组患者手术时间短于Ⅳ型组,治疗总有效率高于Ⅳ型组(P<0.05或0.01)。治疗后两组患者血清ALT、AST、GGT、ALP、TBIL和DBIL水平均较治疗前降低,且Ⅲ型组低于Ⅳ型组(P<0.05或0.01)。治疗后两组患者QLQ-C30的总体健康状况、躯体功能、角色功能、情绪功能、认知功能、社会功能、疲乏、恶心呕吐、疼痛、呼吸困难、睡眠障碍、食欲丧失、便秘维度评分均较治疗前改善,Ⅲ型组患者QLQ-C30的总体健康状况、躯体功能、情绪功能、社会功能维度评分高于Ⅳ型组,而疲乏、恶心呕吐、疼痛、呼吸困难、睡眠障碍、食欲丧失、便秘维度评分低于Ⅳ型组(P<0.05或0.01)。Ⅲ型组患者术后并发症发生率低于Ⅳ型组,但差异无统计学意义(P>0.05)。结论相较于BismuthⅣ型胆道梗阻,超声引导下的PTCD应用于BismuthⅢ型胆道梗阻患者有较好的疗效,可以改善患者肝功能和生存质量。

Solid Bi_(2)O_(3)-derived nanostructured metallic bismuth with high formate selectivity for the electrocatalytic reduction of CO_(2)

CO_(2) electrochemical reduction(CO_(2)ER)is an important research area for carbon neutralization.However,available catalysts for CO_(2) reduction are still characterized by limited stability and activity.Recently,metallic bismuth(Bi)has emerged as a promising catalyst for CO_(2) ER.Herein,we report the solid cathode electroreduction of commercial micronized Bi2O3as a straightforward approach for the preparation of nanostructured Bi.At-1.1 V versus reversible hydrogen electrode in a KHCO3aqueous electrolyte,the resulting nanostructure Bi delivers a formate current density of~40 mA·cm^(-2) with a current efficiency of~86%,and the formate selectivity reaches97.6% at-0.78 V.Using nanosized Bi2O3as the precursor can further reduce the primary particle sizes of the resulting Bi,leading to a significantly increased formate selectivity at relatively low overpotentials.The high catalytic activity of nanostructured Bi is attributable to the ultrafine and interconnected Bi nanoparticles in the nanoporous structure,which exposes abundant active sites for CO_(2) electrocatalytic reduction.

Plasma-assisted synthesis of porous bismuth nanosheets for electrocatalytic CO_(2)-to-formate reduction

The electrochemical carbon dioxide reduction(eCO_(2)RR)to formate,driven by clean energy,is a promising approach for producing renewable chemicals and high-value fuels.Despite its potential,further development faces challenges due to limitations in electrocatalytic activity and durability,especially for nonnoble metal-based catalysts.Here,naturally abundant bismuth-based nanosheets that can effectively drive CO_(2)-to-formate electrocatalytic reduction are prepared using the plasma-activated Bi_(2)Se_(3) followed by a reduction process.Thus-obtained plasma-activated Bi nanosheets(P-BiNS)feature ultrathin structures and high surface areas.Such nanostructures ensure the P-BiNS with outstanding eCO_(2)RR catalytic performance,highlighted by the current density of over 80 mA cm^(-2) and a formate Faradic efficiency of>90%.Furthermore,P-BiNS catalysts demonstrate excellent durability and stability without deactivation following over 50h of operation.The selectivity for formate production is also studied by density functional theory(DFT)calculations,validating the importance and efficacy of the stabilization of intermediates(^(*)OCHO)on the P-BiNS surfaces.This study provides a facile plasma-assisted approach for developing high-performance and low-cost electrocatalysts.

Kinetic-boosted CO_(2) electroreduction to formate via synergistic electric-thermal field on hierarchical bismuth with amorphous layer

Electrocatalytic converting CO_(2) into chemical products has emerged as a promising approach to achieving carbon neutrality.Herein,we report a bismuth-based catalyst with high curvature terminal and amorphous layer which fabricated via two-step electrodeposition achieves stable formate output in a wide voltage window of 600 mV.The Faraday efficiency(FE) of formate reached up to 99.4% at-0.8 V vs.RHE and it remained constant for more than 92 h at-15 mA cm^(-2).More intriguingly,FE formate of95.4% can be realized at a current density of industrial grade(-667.7 mA cm^(-2)) in flow cell.The special structure promoted CO_(2) adsorption and reduced its activation energy and enhanced the electric-thermal field and K^(+) enrichment which accelerated the reaction kinetics.In situ spectroscopy and theoretical calculation further confirmed that the introduction of amorphous structure is beneficial to adsorpting CO_(2)and stabling*OCHO intermediate.This work provides special insights to fabricate efficient electrocatalysts by means of structural and crystal engineering and makes efforts to realize the industrialization of bismuth-based catalysts.

In situ observation of the phase transformation kinetics of bismuth during shock release

A time-resolved x-ray diffraction technique is employed to monitor the structural transformation of laser-shocked bismuth.Results reveal a retarded transformation from the shock-induced Bi-Ⅴphase to a metastable Bi-Ⅳphase during the shock release,instead of the thermodynamically stable Bi-Ⅲphase.The emergence of the metastable Bi-Ⅳphase is understood by the competitive interplay between two transformation pathways towards the Bi-Ⅳand Bi-Ⅲ,respectively.The former is more rapid than the latter because the Bi-Ⅴto B-Ⅳtransformation is driven by interaction between the closest atoms while the Bi-Ⅴto B-Ⅲtransformation requires interaction between the second-closest atoms.The nucleation time for the Bi-Ⅴto Bi-Ⅳtransformation is determined to be 5.1±0.9 ns according to a classical nucleation model.This observation demonstrates the importance of the formation of the transient metastable phases,which can change the phase transformation pathway in a dynamic process.

Probing the Nucleation and Growth Kinetics of Bismuth Nanoparticles via In-situ Transmission Electron Microscopy

The nucleation and growth mechanism of nanoparticles is an important theory,which can guide the preparation of nanomaterials.However,it is still lacking in direct observation on the details of the evolution of intermediate state structure during nucleation and growth.In this work,the evolution process of bismuth nanoparticles induced by electron beam was revealed by in-situ transmission electron microscopy(TEM)at atomic scale.The experimental results demonstrate that the size,stable surface and crystallographic defect have important influences on the growth of Bi nanoparticles.Two non-classical growth paths including single crystal growth and polycrystalline combined growth,as well as,corresponding layer-by-layer growth mechanism along{012}stable crystal plane of Bi nanoparticles with dodecahedron structure were revealed by in-situ TEM directly.These results provide important guidance and a new approach for in-depth understanding of the nucleation and growth kinetics of nanoparticles.

Soil Profile Concentration Distributions of Antimony and Bismuth across Southeastern Missouri (USA)

Recent research has suggested that increased industrial and technological utilization of antimony and bismuth necessitates greater research to determine the soil and water chemistry and the environmental risks associated with these elements. The near-total soil profile concentrations of antimony and bismuth were determined for key soil series across southeastern Missouri. The antimony concentrations ranged from 0.65 to 0.08 mg kg−1, whereas the bismuth soil profile concentrations ranged from 0.92 to 0.03 mg kg−1. Most pedons showed antimony concentrations ranging from 20 to 30 mg kg−1, whereas bismuth concentrations were commonly 10 to 20 mg kg−1. For soils having argillic horizons, antimony and bismuth concentrations were greater for the illuvial horizons than the eluvial horizons, whereas Entisols, Inceptisols, and one Vertisol showed rather uniform antimony and bismuth concentrations, features paralleling the soil texture distribution. Both antimony and bismuth showed significant correlations with iron.

Origin of Bismuth-Rich Strategy in Bismuth Oxyhalide Photocatalysts

Recently,the bismuth-rich strategy via increasing the bismuth content has been becoming one of the most appealing approaches to improve the photocatalytic performance of bismuth oxyhalides.However,insights into the mechanism behind the encouraging experiments are missing.Herein,we report the results of the theory-led comprehensive picture of bismuth-rich strategy in bismuth oxyhalide photocatalysts,selecting Bi_(5)O_(7)X(X=F,Cl,Br,I)as a prototype.First-principle calculations revealed that the strategy enables good n-type conductivity,large intrinsic internal electric field,high photoreduction ability and outstanding harvest of visible light,and particularly ranked the intrinsic activity of this family:Bi_(5)O_(7)F>Bi_(5)O_(7)I>Bi_(5)O_(7)Br>Bi_(5)O_(7)Cl.Designed experiments confirmed the theoretical predictions,and together,these results are expected to aid future development of advanced photocatalysts.

Recent advances in bismuth-based photocatalysts:Environment and energy applications

Photocatalysis is an effective way to solve the problems of environmental pollution and energy shortage.Numerous photocatalysts have been developed and various strategies have been proposed to improve the photocatalytic performance.Among them,Bi-based photocatalysts have become one of the most popular research topics due to their suitable band gaps,unique layered structures,and physicochemical properties.In this review,Bi-based photocatalysts(BiOX,BiVO_(4),Bi_(2)S_(3),Bi_(2)MoO_(6),and other Bi-based photocatalysts)have been summarized in the field of photocatalysis,including their applications of the removal of organic pollutants,hydrogen production,oxygen production etc.The preparation strategies on how to improve the photocatalytic performance and the possible photocatalytic mechanism are also summarized,which could supply new insights for fabricating high-efficient Bi-based photocatalysts.Finally,we summarize the current challenges and make a reasonable outlook on the future development direction of Bi-based photocatalysts.

Effect of Bismuth Subgallate/Borneol Combined with Autologous Platelet-Rich Gel in the Treatment of Patients with Diabetic Foot Ulcers

Objective: To explore the effect of Bismuth Subgallate/Borneol (SuileTM BSB) healing dressing combined with autologous platelet-rich gel (APG) in the treatment of diabetic foot ulcer (DFU). Methods: A total of 120 patients with DFU hospitalized in the Changsha Central Hospital from August 2020 to September 2021 were selected and randomly divided into an experimental group (BSB + APG, n = 60) and a control group (BSB, n = 60) according to random number table method. The total therapeutic effect, healing time, hospital stay, level indexes of various inflammatory factors before and after treatment and ulcer area were observed in the two groups. Results: The total effect of the control group was worse than that of the experimental group, and the data between the two groups were significant (P 0.05);after treatment, the levels of inflammatory factors including WBC, CRP, IL-6 and TNF-α in the control group were higher than those in the experimental group, and there was significant difference between the two groups (P 0.05);after 14 days of treatment, the ulcer area in the control group was larger than that in the experimental group, and the data between the two groups were significant (P Conclusion: BSB combined with APG can achieve better therapeutic effect, reduce the inflammatory reaction of patients, and promote wound healing in the treatment of patients with diabetic foot ulcer.

Effective ethanol-to-CO_(2) electrocatalysis at iridium-bismuth oxide featuring the impressive negative shifting of the working potential

Since low overpotential for the anodic ethanol oxidation reaction(EOR)can favor the higher output voltage and power of direct ethanol fuel cells(DEFCs),it is critical to design new EOR catalysts with efficient ethanol-to-CO_(2)activity at low applied potentials.Thereby,carbon-supported Ir-Bi_(2)O_(3)(Ir-Bi_(2)O_(3)/C)catalysts with highly dispersive bismuth oxide on the iridium surface are designed and prepared,which can merit splitting the ethanol C–C bond and promoting the oxidation of C1 intermediates at the bifunctional interfaces.The as-obtained Ir-Bi2O3/C catalysts show superior EOR mass activity of up to ca.2250 m A mgIr-1.Moreover,they exhibit the record lowest onset oxidation potentials(0.17–0.22 V vs.RHE)and the peak potential(ca.0.58 V vs.RHE),being 130–300 m V lower than the previous landmark noble metallic catalysts.Furthermore,an apparent C1 pathway faraday efficiency(FEC1)of 28%±5.9%at 0.5 V vs.RHE can be obtained at Ir-Bi_(2)O_(3)/C.This work might provide new insights into the new anodic EOR catalysts for increasing the power of DEFCs.

Bismuth (III) Triflate Catalyzed Multicomponent Synthesis of 2,4,5-Trisubstituted Imidazoles

Substituted imidazoles are of interest because of their useful biological activities. While several methods have been developed for the synthesis of such compounds, some of the reported methods utilize corrosive or toxic catalysts. We report a bismuth (III) triflate catalyzed multicomponent synthesis of 2,4,5-trisubstituted imidazoles. Bismuth (III) compounds are attractive from a green chemistry perspective because they are remarkably non-toxic and non-corrosive. Multicomponent syntheses save time and generate less waste.

Bismuth (III) Triflate Catalyzed Multicomponent Synthesis of 2,4,5-Trisubstituted Imidazoles

Substituted imidazoles are of interest because of their useful biological activities. While several methods have been developed for the synthesis of such compounds, some of the reported methods utilize corrosive or toxic catalysts. We report a bismuth (III) triflate catalyzed multicomponent synthesis of 2,4,5-trisubstituted imidazoles. Bismuth (III) compounds are attractive from a green chemistry perspective because they are remarkably non-toxic and non-corrosive. Multicomponent syntheses save time and generate less waste.

Bismuth-Complex-Incorporated Nanocellulose Sheet for Biomedical Application:A Review on New Nanocellulose Composites

Antibiotic resistance is one of the major issues in the medical field and a potential threat to human health.However,newly emerging antimicrobial compounds failed to combat antimicrobial resistance developed by bacterial pathogens.Recently,a bismuth-based complex has been developed to eradicate antimicrobial-resistant microorganism infections.The complex is known as organobismuth(III)phosphinate,which is said to be a potential broad-spectrum antimicrobial agent.This complex has been incorporated into the nanocellulose suspension to fabricate a biomedical composite for various applications.The composite can be fabricated by two methods namely vacuum filtration and spray coating.In this paper,the surface and topography of the composite are investigated and discussed in terms of SEM micrographs and their antimicrobial potential.This review focuses on the organo-bismuth nanocellulose composite and its biomedical application in the future.

腹腔镜胆管癌根治性切除术治疗Bismuth-CorletteⅠ、Ⅱ型肝门胆管癌的临床观察

目的探讨腹腔镜胆管癌根治性切除术治疗Bismuth-CorletteⅠ、Ⅱ型肝门胆管癌(HC)的价值。方法根据患者的意愿和病情等将56例Bismuth-CorletteⅠ、Ⅱ型HC患者分观察组(22例)和对照组(34例)。观察组采用腹腔镜胆管癌根治性切除术。对照组采用开腹胆管癌根治性切除术。对比两组患者的临床评价指标、肝功能指标、细胞免疫指标、应激指标和术后并发症。结果与对照组相比,观察组的术中出血量明显少,术后首次下床活动和肛门排气明显早,术后住院时间和镇痛时间明显短,但手术时间明显长(P<0.05)。与对照组相比,观察组术后7 d的总胆红素浓度、丙氨酸氨基转移酶浓度和天门冬氨酸氨基转移酶浓度均明显低,但白蛋白的浓度明显高(P<0.05)。观察组术后3 d的血浆皮质醇、空腹血糖和C反应蛋白浓度均明显低于对照组(P<0.05)。观察组术后3 d的CD3^+百分比、CD4^+百分比和CD4^+/CD8^+值均明显高于对照组(P<0.05)。结论腹腔镜胆道癌根治性切除术可明显减轻Bismuth-CorletteⅠ、Ⅱ型HC患者的手术创伤、应激反应和细胞免疫损伤,同时可加快术后康复和肝功能恢复。

Bismuth Ⅲ型肝门胆管癌的外科治疗

目的：研究肝Ｂｉｓｍｕｔｈ Ⅲ型肝门胆管癌根治性切除时，需要伴同切除肝脏的范围。方法：对两家医院近两年半来收治的ＢｉｓｍｕｔｈⅢ型肝门胆管癌３１例进行分析。其中２１例行根治性切除者，伴同左半肝切除１１例，伴同右半肝切除５例，伴同右三叶切除２例，伴同Ⅳ肝段切除３例。与上述各种肝切除合并作尾叶切除者９例。结果：全组无手术死亡，并发膈下脓肿２例，经穿刺置管引流治愈；并发肝衰腹水８例，其中右半肝切除后３例，左半肝切除后３例，右三叶切除后２例，均经强化护肝治疗、反复多次输注血浆和白蛋白治愈；并发胆漏３例，经保守引流而愈。施行Ⅳ肝段＋尾叶切除的３例顺利恢复，无并发症。结论： ＢｉｓｍｕｔｈⅢ型肝门胆管癌根治性切除伴同肝切除的范围应根据肿瘤所在的确切部位以及同侧门静脉有无受侵犯而定，尽量避免大范围的肝切除。

肝门部胆管癌Bismuth分型与经内镜胆道塑料支架引流术后并发症及退黄效果之间的关系

目的:评估肝门部胆管癌Bismuth分型与经内镜胆道塑料支架引流术(ERBD)术后并发症及退黄效果之间的关系.方法:收集已确诊为肝门部胆管癌、且不能或不愿接受外科治疗的,在南昌大学第二附属医院消化科行ERBD的患者.分析各型肝门部胆管癌之间在行ERBD术后胆管炎、胰腺炎、出血发生率以及退黄效果的差异.结果:Bismuth Ⅲ型和Ⅳ型肝门部胆管癌ERBD术后胆管炎发生率显著高于Bismuth Ⅰ型和Ⅱ型(59.52%vs3.33%;59.52%vs4.00%,均P<0.01),而退黄有效率相对较低(71.43%vs96.67%;71.43%vs100.00%,均P<0.01);术后胰腺炎和出血的发生率在各型中无显著性差异(均P>0.05).结论:肝门部胆管癌Bismuth Ⅲ型和Ⅳ型在ERBD术后更易并发胆管炎,且术后退黄效果不够理想.

中肝切除在Bismuth Ⅳ型肝门部胆管癌外科手术中的应用

目的探讨中肝切除在Bismuth Ⅳ型肝门部胆管癌治疗中的应用价值。方法回顾性分析2015年1月至2019年4月间7例Bismuth Ⅳ型肝门部胆管癌行中肝切除病人的临床资料。结果全组病人无围手术期死亡。R0切除6例,R1切除1例。术后主要并发症:A级胆瘘4例,切口感染1例,右侧胸腔积液2例。随访时间2~37个月,平均22个月。截至2019年6月28日,3例病人术后分别随访2、11、37个月,未出现复发和远处转移。结论中肝切除是一种兼顾根治性和保留功能肝体积的手术方法,有利于减少术后肝衰竭发生率,对于不伴有血管侵犯的部分Bismuth Ⅳ型肝门部胆管癌病人是一种较好的选择。

Bismuth Ⅳ型肝门胆管癌的治疗

肝门胆管癌由于手术切除率低、并发症多、预后差,5年生存率不足30%[1],一直是胆道外科的难治疾病。IV型肝门胆管癌由于肿瘤累及左右肝内二级胆管,除做肝移植外,曾经是手术切除的禁区。近年来随着术前影像学评估技术的发展、精准肝切除技术的应用及围手术期各种肝功能保护措施的实施,部分IV型肝门胆管癌得以根治性切除。如何术前正确评估可切除性、提高手术的安全性与彻底性,

Bismuth分型和T分期指导高位胆管癌手术方式选择的价值和评价

根治性手术切除是高位胆管癌唯一可能获得治愈的方法。然而，高位胆管癌由于位置特殊，肿瘤呈多极化浸润性生长，容易累及肝脏、血管、淋巴结和神经，手术切除率低是长期以来困扰外科界的一大难题。近几十年来的临床经验总结可以看出，只有达到R。切除才能给患者带来长期生存的希望，所以肝门部胆管癌的根治性手术呈不断扩大的趋势，为达到R0切除，