BACKGROUND Choledocholithiasis is a severe disorder that affects a significant portion of the world’s population.Treatment using endoscopic sphincterotomy(EST)has become widespread;however,recurrence post-EST is rela...BACKGROUND Choledocholithiasis is a severe disorder that affects a significant portion of the world’s population.Treatment using endoscopic sphincterotomy(EST)has become widespread;however,recurrence post-EST is relatively common.The bile microbiome has a profound influence on the recurrence of choledocholithiasis in patients after EST;however,the key pathogens and their functions in the biliary tract remain unclear.AIM To investigate the biliary microbial characteristics of patients with recurrent choledocholithiasis post-EST,using next-generation sequencing.METHODS This cohort study included 43 patients,who presented with choledocholithiasis at the Guangdong Second Provincial General Hospital between May and June 2020.The patients had undergone EST or endoscopic papillary balloon dilation and were followed up for over a year.They were divided into either the stable or recurrent groups.We collected bile samples and extracted microbial DNA for analysis through next-generation sequencing.Resulting sequences were analyzed for core microbiome and statistical differences between the diagnosis groups;they were examined using the Kyoto Encyclopedia of Genes and Genomes pathway hierarchy level using analysis of variance.Correlation between the key genera and metabolic pathways in bile,were analyzed using Pearson’s correlation test.RESULTS The results revealed distinct clustering of biliary microbiota in recurrent choledocholithiasis.Higher relative abundances(RAs)of Fusobacterium and Neisseria(56.61%±14.81%vs 3.47%±1.10%,8.95%±3.42%vs 0.69%±0.32%,respectively)and the absence of Lactobacillus were observed in the bile of patients with recurrent disease,compared to that in stable patients.Construction of a microbiological co-occurrence network revealed a mutual relationship among Fusobacterium,Neisseria,and Leptotrichia,and an antagonistic relationship among Lactobacillales,Fusobacteriales,and Clostridiales.Functional prediction of biliary microbiome revealed that the loss of transcription and metabolic abilities may lead to recurrent choledocholithiasis.Furthermore,the prediction model based on the RA of Lactobacillales in the bile was effective in identifying the risk of recurrent choledocholithiasis(P=0.03).CONCLUSION We demonstrated differences in the bile microbiome of patients with recurrent choledocholithiasis compared to that in patients with stable disease,thereby adding to the current knowledge on its microbiologic etiology.展开更多
Purpose:To evaluate the effect of interesting games on reducing preoperative anxiety and improving compliance with anaesthesia in children.Methods:Ninety preschool-aged children undergoing elective surgery were random...Purpose:To evaluate the effect of interesting games on reducing preoperative anxiety and improving compliance with anaesthesia in children.Methods:Ninety preschool-aged children undergoing elective surgery were randomly assigned to two groups.The children in the control group were admitted to a general preoperative room with one parent for 15e20 min,and were then taken into the anaesthesia room.During anaesthetic induction,the nurse attracted the children’s attention using an interesting game with encouragement and attention diversion.The children’s anxiety was assessed using the Modified Yale Preoperative Anxiety Scale(mYPAS)when they entered the operating room,while they were waiting to undergo s0urgery,and during anaesthetic induction.Moreover,the children’s compliance with anaesthetic induction was assessed using the Induction Compliance Checklist(ICC).Results:No statistically significant differences in the mYPAS scores were observed between the two groups upon entering the operating room(p>0.05).The mYPAS scores were significantly lower in the experimental group than in the control group while waiting for surgery and during anaesthetic induction(p<0.05),while there were no significant differences in the mYPAS scores upon entering the operating room.The children’s compliance with anaesthetic induction was significantly higher in the experimental group than in the control group(p<0.05).Conclusion:Engagement in an interesting game can reduce preschool-aged children’s preoperative anxiety and improve their compliance with anaesthetic induction.展开更多
The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic,which has lasted for nearly a year,has made people deeply aware of the strong transmissibility and pathogenicity of SARS-CoV-2 since its outbreak...The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic,which has lasted for nearly a year,has made people deeply aware of the strong transmissibility and pathogenicity of SARS-CoV-2 since its outbreak in December 2019.By December 2020,SARS-CoV-2 had infected over 65 million people globally,resulting in more than 1 million deaths.At present,the exact animal origin of SARS-CoV-2 remains unclear and antiviral vaccines are now undergoing clinical trials.Although the social order of human life is gradually returning to normal,new confirmed cases continue to appear worldwide,and the majority of cases are sporadic due to environmental factors and lax self-protective consciousness.This article provides the latest understanding of the epidemiology and risk factors of nosocomial and community transmission of SARS-CoV-2,as well as strategies to diminish the risk of transmission.We believe that our review will help the public correctly understand and cope with SARS-CoV-2.展开更多
We study the Goos-Hanchen-like shift of single silicene barrier under the external perpendicular electric field,off- resonant circularly polarized light and the exchange field modulation using the stationary-phase met...We study the Goos-Hanchen-like shift of single silicene barrier under the external perpendicular electric field,off- resonant circularly polarized light and the exchange field modulation using the stationary-phase method.The results show that the Goos-Hanchen-like shift of silicene resulting from the external perpendicular electric field does not have the characteristics of spin or valley polarization,while that from off-resonant circularly polarized light or the exchange field is spin-polarized.More importantly,the combined effect of the external perpendicular electric field and the exchange field or off-resonant circularly polarized light can cause the Goos-Hanchen-like shift of the system to be spin and valley polarized.It is particularly worth noting that when the three modulations are considered at the same time,as the exchange field changes,the system will have a positive or negative Goos-Hanchen-like shift.展开更多
Background:Unpredictable difficult laryngoscopy(DL)remains a challenge for anesthesiologists,especially when difficult ventilation occurs during standard laryngoscopy.Accurate airway assessment should always be perfor...Background:Unpredictable difficult laryngoscopy(DL)remains a challenge for anesthesiologists,especially when difficult ventilation occurs during standard laryngoscopy.Accurate airway assessment should always be performed,but the common airway assessment methods only perform superficial screening.Thus,the deep laryngopharyngeal anatomy may not be evaluated.Ultrasound-based airway assessment has been recently proposed as a useful,simple,and non-invasive bedside tool as an adjunct to clinical methods,which may facilitate identification of DL.The present study aimed to determine the correlation between ultrasound-measured indicators and DL.Methods:Patients undergoing elective surgery under general anesthesia with tracheal intubation were enrolled.Ultrasonic airway assessments were performed before anesthesia induction.Ultrasound diagnostic indicators included the thickness and width of the base of the tongue,the angle between the epiglottis and glottis,the length of the thyrohyoid membrane,and the thickness of the lateral pharyngeal wall.A score of≥3 in the Modified Cormack-Lehane Scoring System was used as a standard of DL and was also applied to divide patients into DL and non-DL groups.The area under the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic ability of various diagnostic indicators.Results:A total of 499 patients were enrolled into non-DL and DL groups comprising 452(452/499,90.6%)and 47(47/499,9.4%)patients,respectively.One ultrasonic diagnoses indicator correlated with DL,namely,the angle between the epiglottis and glottis.When the angle between the epiglottis and glottis was 50°,the area under the ROC curve was maximum(0.902),and the best sensitivity(81%)and specificity(89%)were achieved.Conclusions:Airway ultrasounds should be considered to identify DL.The ultrasonic angle measured between the epiglottis and glottis is highly associated with DL,which may occur when the angle is less than 50°.Clinical trial registration:ChiCTR-DDT-13004102,http://www.chictr.org.cn/showproj.aspxPproj=5465.展开更多
Background： Patients with potential difficult mask ventilation （DV） and difficult intubation （Dl） are often managed with awake intubation, which can be stressful for patients and anesthesiologists. This prospecti...Background： Patients with potential difficult mask ventilation （DV） and difficult intubation （Dl） are often managed with awake intubation, which can be stressful for patients and anesthesiologists. This prospective randomized study evaluated a new approach, fast difficult airway evaluation （FDAE）. We hypothesized that the FDAE approach would reduce the need for awake intubation. Methods： After obtaining informed consent, 302 patients with potential DV/DI undergoing elective surgeries were randomly assigned to the FDAE group （Group E） and the control group （Group C）. In Group E, patients were gradually sedated, and adequacy of manual mask ventilation during spontaneous breathing was assessed at various sedation levels. Awake intubation was applied in those with inadequate mask ventilation. In Group C, DI was evaluated under local anesthesia. However, the care team could intubate under general anesthesia if the vocal cords were visible. The primary outcome was the rate of awake intubations in both groups and the induction efficiency assessed by the induction time. The secondary outcome was the incidence of serious complications. Results： The rate of awake intubation was significantly lower in Group E than that in Group C （5.81% vs. 36.05%,χ2 = 42.3, P 〈 0.001 ）. The induction time was much shorter in Group E than in Group C （11.85 ± 4.82 min vs. 18.71± 7.85 min, t = 5.39, P 〈 0.001）. There was no significant difl＇erence in the incidence of intubation related complications between the two groups. Patients in Group E had a much lower incidence of recall （9.68% vs. 44.90%, χ2 = 47.68, P 〈 0.001） of the induction process and higher satisfaction levels than patients in Group C （t=15.36, P〈 0.001）. Conclusions： The FDAE significantly reduces the need for awake intubation and improves the efficiency of the intubation process without comprising safety in patients with potential difficult mask ventilation and DI.展开更多
Electrocatalytic nitrate reduction reaction(ENRR)for ammonia synthesis is a promising strategy to relieve nitration contamination,as well as an alternative to the Haber-Bosch process.Prussian blue analogs(PBAs)are exp...Electrocatalytic nitrate reduction reaction(ENRR)for ammonia synthesis is a promising strategy to relieve nitration contamination,as well as an alternative to the Haber-Bosch process.Prussian blue analogs(PBAs)are expected to be an electrocatalytic material with superior performance owing to their abundant active sites and open channel structure.However,most reported PBA materials possess low nitrate conversion and ammonia yield rates,which has led to a hindrance in their research of ENRR.Herein,CuMn-PBA-shelled nanoboxes(CuMn-PBA SNBs)synthesized through tannic acid etching and cation exchange approaches are demonstrated for efficient ammonia production.The optimal CuMn-PBA SNBs electrode achieves a high nitrate conversion of 91.33%and ammonia selectivity of 98.87%in a 0.2 mol·L^(-1)Na_(2)SO_(4) solution with100×10^(-6) NO_(3)^(-)-N at-1.4 V vs.SCE.Furthermore,the CuMn-PBA SNB s electrode exhibits exceptional stability throughout a 30 h electrocatalytic process.The outstanding electrochemical performance is attributed to the unique hollow nanobox structure with abundant active sites and high-throughput transport pathways for ions'aspects.展开更多
基金Supported by the research grants from Guangdong Provincial Key Laboratory,No.2020B121201009the Science Foundation of Guangdong Second Provincial General Hospital,No.YQ2019-014GDAS’Project of Science and Technology Development,No.2020GDASYL-20200301002。
文摘BACKGROUND Choledocholithiasis is a severe disorder that affects a significant portion of the world’s population.Treatment using endoscopic sphincterotomy(EST)has become widespread;however,recurrence post-EST is relatively common.The bile microbiome has a profound influence on the recurrence of choledocholithiasis in patients after EST;however,the key pathogens and their functions in the biliary tract remain unclear.AIM To investigate the biliary microbial characteristics of patients with recurrent choledocholithiasis post-EST,using next-generation sequencing.METHODS This cohort study included 43 patients,who presented with choledocholithiasis at the Guangdong Second Provincial General Hospital between May and June 2020.The patients had undergone EST or endoscopic papillary balloon dilation and were followed up for over a year.They were divided into either the stable or recurrent groups.We collected bile samples and extracted microbial DNA for analysis through next-generation sequencing.Resulting sequences were analyzed for core microbiome and statistical differences between the diagnosis groups;they were examined using the Kyoto Encyclopedia of Genes and Genomes pathway hierarchy level using analysis of variance.Correlation between the key genera and metabolic pathways in bile,were analyzed using Pearson’s correlation test.RESULTS The results revealed distinct clustering of biliary microbiota in recurrent choledocholithiasis.Higher relative abundances(RAs)of Fusobacterium and Neisseria(56.61%±14.81%vs 3.47%±1.10%,8.95%±3.42%vs 0.69%±0.32%,respectively)and the absence of Lactobacillus were observed in the bile of patients with recurrent disease,compared to that in stable patients.Construction of a microbiological co-occurrence network revealed a mutual relationship among Fusobacterium,Neisseria,and Leptotrichia,and an antagonistic relationship among Lactobacillales,Fusobacteriales,and Clostridiales.Functional prediction of biliary microbiome revealed that the loss of transcription and metabolic abilities may lead to recurrent choledocholithiasis.Furthermore,the prediction model based on the RA of Lactobacillales in the bile was effective in identifying the risk of recurrent choledocholithiasis(P=0.03).CONCLUSION We demonstrated differences in the bile microbiome of patients with recurrent choledocholithiasis compared to that in patients with stable disease,thereby adding to the current knowledge on its microbiologic etiology.
文摘Purpose:To evaluate the effect of interesting games on reducing preoperative anxiety and improving compliance with anaesthesia in children.Methods:Ninety preschool-aged children undergoing elective surgery were randomly assigned to two groups.The children in the control group were admitted to a general preoperative room with one parent for 15e20 min,and were then taken into the anaesthesia room.During anaesthetic induction,the nurse attracted the children’s attention using an interesting game with encouragement and attention diversion.The children’s anxiety was assessed using the Modified Yale Preoperative Anxiety Scale(mYPAS)when they entered the operating room,while they were waiting to undergo s0urgery,and during anaesthetic induction.Moreover,the children’s compliance with anaesthetic induction was assessed using the Induction Compliance Checklist(ICC).Results:No statistically significant differences in the mYPAS scores were observed between the two groups upon entering the operating room(p>0.05).The mYPAS scores were significantly lower in the experimental group than in the control group while waiting for surgery and during anaesthetic induction(p<0.05),while there were no significant differences in the mYPAS scores upon entering the operating room.The children’s compliance with anaesthetic induction was significantly higher in the experimental group than in the control group(p<0.05).Conclusion:Engagement in an interesting game can reduce preschool-aged children’s preoperative anxiety and improve their compliance with anaesthetic induction.
基金National Key Research and Development Program of China,No.2018YFC2001900National Natural Science Foundation of China,No.81873952 and No.81670770.
文摘The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic,which has lasted for nearly a year,has made people deeply aware of the strong transmissibility and pathogenicity of SARS-CoV-2 since its outbreak in December 2019.By December 2020,SARS-CoV-2 had infected over 65 million people globally,resulting in more than 1 million deaths.At present,the exact animal origin of SARS-CoV-2 remains unclear and antiviral vaccines are now undergoing clinical trials.Although the social order of human life is gradually returning to normal,new confirmed cases continue to appear worldwide,and the majority of cases are sporadic due to environmental factors and lax self-protective consciousness.This article provides the latest understanding of the epidemiology and risk factors of nosocomial and community transmission of SARS-CoV-2,as well as strategies to diminish the risk of transmission.We believe that our review will help the public correctly understand and cope with SARS-CoV-2.
基金supported by the National Natural Science Foundation of China(Grant Nos.11864012 and 11764013)the Natural Science Foundation of Jiangxi Province,China(Grant No.20202BABL201018)Jiangxi University of Traditional Chinese Medicine 1050 Youth Talent Project(Grant No.5142001010)。
文摘We study the Goos-Hanchen-like shift of single silicene barrier under the external perpendicular electric field,off- resonant circularly polarized light and the exchange field modulation using the stationary-phase method.The results show that the Goos-Hanchen-like shift of silicene resulting from the external perpendicular electric field does not have the characteristics of spin or valley polarization,while that from off-resonant circularly polarized light or the exchange field is spin-polarized.More importantly,the combined effect of the external perpendicular electric field and the exchange field or off-resonant circularly polarized light can cause the Goos-Hanchen-like shift of the system to be spin and valley polarized.It is particularly worth noting that when the three modulations are considered at the same time,as the exchange field changes,the system will have a positive or negative Goos-Hanchen-like shift.
基金This study was supported by a grant from the National Natural Science Foundation of China(No.81370112).
文摘Background:Unpredictable difficult laryngoscopy(DL)remains a challenge for anesthesiologists,especially when difficult ventilation occurs during standard laryngoscopy.Accurate airway assessment should always be performed,but the common airway assessment methods only perform superficial screening.Thus,the deep laryngopharyngeal anatomy may not be evaluated.Ultrasound-based airway assessment has been recently proposed as a useful,simple,and non-invasive bedside tool as an adjunct to clinical methods,which may facilitate identification of DL.The present study aimed to determine the correlation between ultrasound-measured indicators and DL.Methods:Patients undergoing elective surgery under general anesthesia with tracheal intubation were enrolled.Ultrasonic airway assessments were performed before anesthesia induction.Ultrasound diagnostic indicators included the thickness and width of the base of the tongue,the angle between the epiglottis and glottis,the length of the thyrohyoid membrane,and the thickness of the lateral pharyngeal wall.A score of≥3 in the Modified Cormack-Lehane Scoring System was used as a standard of DL and was also applied to divide patients into DL and non-DL groups.The area under the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic ability of various diagnostic indicators.Results:A total of 499 patients were enrolled into non-DL and DL groups comprising 452(452/499,90.6%)and 47(47/499,9.4%)patients,respectively.One ultrasonic diagnoses indicator correlated with DL,namely,the angle between the epiglottis and glottis.When the angle between the epiglottis and glottis was 50°,the area under the ROC curve was maximum(0.902),and the best sensitivity(81%)and specificity(89%)were achieved.Conclusions:Airway ultrasounds should be considered to identify DL.The ultrasonic angle measured between the epiglottis and glottis is highly associated with DL,which may occur when the angle is less than 50°.Clinical trial registration:ChiCTR-DDT-13004102,http://www.chictr.org.cn/showproj.aspxPproj=5465.
文摘Background： Patients with potential difficult mask ventilation （DV） and difficult intubation （Dl） are often managed with awake intubation, which can be stressful for patients and anesthesiologists. This prospective randomized study evaluated a new approach, fast difficult airway evaluation （FDAE）. We hypothesized that the FDAE approach would reduce the need for awake intubation. Methods： After obtaining informed consent, 302 patients with potential DV/DI undergoing elective surgeries were randomly assigned to the FDAE group （Group E） and the control group （Group C）. In Group E, patients were gradually sedated, and adequacy of manual mask ventilation during spontaneous breathing was assessed at various sedation levels. Awake intubation was applied in those with inadequate mask ventilation. In Group C, DI was evaluated under local anesthesia. However, the care team could intubate under general anesthesia if the vocal cords were visible. The primary outcome was the rate of awake intubations in both groups and the induction efficiency assessed by the induction time. The secondary outcome was the incidence of serious complications. Results： The rate of awake intubation was significantly lower in Group E than that in Group C （5.81% vs. 36.05%,χ2 = 42.3, P 〈 0.001 ）. The induction time was much shorter in Group E than in Group C （11.85 ± 4.82 min vs. 18.71± 7.85 min, t = 5.39, P 〈 0.001）. There was no significant difl＇erence in the incidence of intubation related complications between the two groups. Patients in Group E had a much lower incidence of recall （9.68% vs. 44.90%, χ2 = 47.68, P 〈 0.001） of the induction process and higher satisfaction levels than patients in Group C （t=15.36, P〈 0.001）. Conclusions： The FDAE significantly reduces the need for awake intubation and improves the efficiency of the intubation process without comprising safety in patients with potential difficult mask ventilation and DI.
基金supported by the National Natural Science Foundation of China(Nos.52102235,52203352,52100065)Natural Science Foundation of Hebei Province(E2022202095,E2023202141)+3 种基金Natural Science Foundation of Heilongjiang Province(YQ2020C015)Heilongjiang Province Key Research and Development Plan guidance project(GZ20210149)China Postdoctoral Science Foundation(CPSF,Grant No.2021M703136)Natural Science Foundation of Chongqing(Grant No.cstc2021jcyj-bshX0230)。
文摘Electrocatalytic nitrate reduction reaction(ENRR)for ammonia synthesis is a promising strategy to relieve nitration contamination,as well as an alternative to the Haber-Bosch process.Prussian blue analogs(PBAs)are expected to be an electrocatalytic material with superior performance owing to their abundant active sites and open channel structure.However,most reported PBA materials possess low nitrate conversion and ammonia yield rates,which has led to a hindrance in their research of ENRR.Herein,CuMn-PBA-shelled nanoboxes(CuMn-PBA SNBs)synthesized through tannic acid etching and cation exchange approaches are demonstrated for efficient ammonia production.The optimal CuMn-PBA SNBs electrode achieves a high nitrate conversion of 91.33%and ammonia selectivity of 98.87%in a 0.2 mol·L^(-1)Na_(2)SO_(4) solution with100×10^(-6) NO_(3)^(-)-N at-1.4 V vs.SCE.Furthermore,the CuMn-PBA SNB s electrode exhibits exceptional stability throughout a 30 h electrocatalytic process.The outstanding electrochemical performance is attributed to the unique hollow nanobox structure with abundant active sites and high-throughput transport pathways for ions'aspects.
