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ObjectivesTo show the practice of robot-assisted laparoscopic inferior vena cava (IVC) treatment strategies in patients with retroperitoneal tumors.Patients and MethodsFrom October 2020 to July 2021, 17 patients with retroperitoneal tumors successfully underwent robot-assisted laparoscopic tumor resection with IVC management. The patient details, tumor characteristics, intraoperative data, pathological features and severe complications were assessed. The IVC treatment strategies were divided into 4 ways: ①local resection and primary repair of the IVC; ②IVC ligation; ③ IVC reconstruction by bovine pericardial grafts; and ④ IVC transection and anastomosis.ResultsIn terms of IVC management, 5 cases had conventional total occlusion of the IVC and its branches, 3 cases had delayed occlusion of the proximal IVC technique, 2 cases had IVC resection by Satinsky clamp, 5 cases had IVC ligation, 1 case had IVC reconstruction by bovine pericardial grafts and 1 case had IVC transection and anastomosis. The median operation time was 151 min, and blood loss was 500 ml. There was no severe complication perioperatively. The follow-up time of 17 patients was 8 to 17 months (median: 12 months). No local recurrence or overall death was found during follow-up.ConclusionsThese robot-assisted laparoscopic IVC treatment strategies were considered to be safe and feasible in experienced centers, as well as helpful to completely remove the tumor for better oncological prognosis and restore the blood reflux of IVC as much as possible to ensure fewer postoperative complications.

The fermentation process is dynamically changing, and the metabolic status can be grasped through real-time monitoring of environmental parameters. In this study, a real-time and on-line monitoring experiment platform for substrates and products detection was developed based on non-contact type near-infrared (NIR) spectroscopy technology. The prediction models for monitoring the fermentation process of lactic acid, sophorolipids (SLs) and sodium gluconate (SG) were established based on partial least-squares regression and internal cross-validation methods. Through fermentation verification, the accuracy and precision of the NIR model for the complex fermentation environments, different rheological properties (uniform system and multi-phase inhomogeneous system) and different parameter types (substrate, product and nutrients) have good applicability, and R2 was greater than 0.98, exhibiting a good linear relationship. The root mean square error of prediction shows that the model has high credibility. Through the control of appropriate glucose concentration in SG fermentation as well as glucose and oil concentrations SLs fermentation by NIR model, the titers of SG and SLs were increased to 11.8% and 26.8%, respectively. Although high cost of NIR spectrometer is a key issue for its wide application in an industrial scale. This work provides a basis for the application of NIR spectroscopy in complex fermentation systems.

Nanopapers derived from nanofibrillated cellulose (NFC) are urgently required as attractive substrates for thermal management applications of electronic devices because of their lightweight, easy cutting, cost efficiency, and sustainability. In this paper, we provided a facile fabrication strategy to construct hybrid nanopapers composed of dialdehyde nanofibrillated cellulose (DANFC) and silver nanoparticles (AgNPs), which exhibited a favorable thermal conductivity property. AgNPs were in situ proceeded on the surface of DANFC by the silver mirror reaction inspired by the aldehyde groups. Owing to the intermolecular hydrogen bonds inside the hybrid nanopapers, the DANFC enables the uniform dispersion of AgNPs as well as promotes the formation of the hierarchical structure. It was found that the AgNPs-coated DANFC (DANFC/Ag) hybrid nanopapers could easily form an effective thermally conductive pathway for phonon transfer. As a result, the thermal conductivity (TC) of the obtained DANFC/Ag hybrid nanopapers containing only 1.9 vol % of Ag was 5.35 times higher than that of the pure NFC nanopapers along with a significantly TC enhancement per vol % Ag of 230.0%, which was supposed to benefit from the continuous heat transfer pathway constructed by the connection of AgNPs decorated on the cellulose nanofibers. The DANFC/Ag hybrid nanopapers possess potential applications as thermal management materials in the next-generation portable electronic devices.

Nanofibrillated cellulose (NFC) is becoming popular in antibacterial material due to its favorable biocompatibility, stability, and modifiable properties, which give it a great potential as a templ...

Background To explore the safety and effectiveness of a modified surgical technique which could shorten the time of renal ischemia in left renal cancer and Mayo level II to IV inferior vena cava (IVC) tumor thrombus. Method We retrospectively analyzed the clinical data of 14 cases with left renal cell carcinoma (RCC) and Mayo level II to IV IVC tumor thrombus from February 2015 to July 2019. Preoperative imaging showed that there was no obvious sign of tumor thrombus invading the blood vessel wall. During the surgery, after the right renal artery, the right renal vein and the distal end of IVC were blocked, the balloon catheter was used and the tumor thrombus was removed completely from the IVC. The incision of IVC was closed by Satinsky clamp to make IVC partially blocked. Then the right renal artery and right renal vein were released. The incision of IVC was sutured continuously. At last, the Satinsky clamp and the blocking band at the distal end of the IVC were released. Result There were 8 cases (57.1%) of Mayo level II, 3 cases (21.4%) of Mayo level III and 3 cases (21.4%) of Mayo level IV. The operation was successfully completed in all 14 patients. There were 2 cases (14.3%) operated by complete laparoscopic approach, 8 cases (57.1%) by open approach, and 4 patients (28.6%) by laparoscopic conversion to open approach. The occlusion time of right renal artery and vein (renal ischemia time) was 3 to 15 min, with an average of (6.8 ± 3.2) minutes. The mean time of IVC occlusion was (19.4 ± 4.9) min. Preoperative creatinine was 66 to 130 μmol/L, with an average of (96.6 ± 21.2) μmol/L. One week after operation, serum creatinine was 64 to 632 μmol/L, with an average of (132.4 ± 144.9) μmol/L. Among the 14 cases, 5 (42.9%) had early postoperative complications. Besides one of the 14 patients died in perioperative period, the median follow-up of other 13 cases was 10 months (range: 4–29 months). The 5 (35.7%) of the 14 cases were died of disease. Conclusion This modified procedure was relatively safe and effective in shortening the time of renal ischemia in left RCC patients with Mayo II to IV IVC tumor thrombus.

Background To assess therapeutic value of lymph node dissection (LND) in non-metastatic renal cell carcinoma (RCC) with tumor thrombosis (TT) and identify the prognostic factor in these population. Methods We retrospectively reviewed 128 patients with RCC and TT in our institution from February 2015 to January 2019. The baseline characteristics of LND and no LND group were compared. Kaplan–Meier analysis, univariable and multivariable Cox regression models were used to analyze these population. Results Of 128 patients, 58(45%) underwent LND and 70(55%) without LND. Patients who received LND had significantly higher cN1 rate (64% vs 37%; P = 0.004), longer operation time (357 min vs 307 min; p = 0.002) and longer hospital stay (12.6d vs 9.5d; p = 0.094) than that in no LND group. There were 102 patients (79.7%) received followed up with the median 12 months (IQR:8 ~ 19). Estimated three-year overall survival was worse in LND group (75% vs 90%; p = 0.048) but were not significantly different in subgroup of cN0 and cN1. The overall survival were not significantly different between two groups after adjustment for age, tumor size, surgical approach, tumor thrombosis level and histologic type. Non-CCRCC (HR:4.97; 95%CL:1.56 ~ 15.78; P = 0.006) and occurrence of major complication (HR:3.33; 95%CL:1.05 ~ 10.58; P = 0.041) were the predictors of worse OS while positive lymph node is the only independent predictor of worse OS (HR:5.26; 95%CL:1.28 ~ 21.66; P = 0.021) in these populations after receiving LND. Conclusion In this study, we confirm that LND in non-metastatic RCC with TT was not associated with a survival benefit, even we adjusted for clinic node status. Category like age, tumor size, surgical approach, tumor thrombosis level and histologic type were not a indication for LND. Lymph node positive was identified as an independent poor prognostic factor. Therefore, LND in RCC with TT should be considered as a staging procedure rather than therapeutic one.

INTRODUCTION AND OBJECTIVE:To develop and validate Peking University Third Hospital Score (PKUTH Score) for the prediction of intraoperative blood loss volume in radical nephrectomy and thrombectom...

Lignin was extracted from wheat straw and used for its crosslinking function in the synthesis of polyurethane foam (PUF). The effects of lignin’s addition on the cross-linking structure and macroscopic properties of the PUFs were investigated. A morphological examination, Fourier transform infrared (FT-IR) spectroscopy, and thermogravimetric analysis (TGA) were conducted to measure the performance of the polyurethanes. Kinetic models were simulated to analyze the oily solvent adsorption mechanism of the polyurethane. The results showed that an increase in the cross-linking density was conducive to an improvement of the physical properties of the polyurethane. Moreover, the process of oily solvent adsorption was in accordance with the quasi-second-order kinetic model. Both physical and chemical adsorption occurred during the adsorption process. This work demonstrated a highly effective method for imparting PUFs with an excellent performance and proper lignin content.

To date, various electronic devices have been strategically fabricated, and simultaneous realization of high electrical conductivity, sensing property, and heat-conducting property by a simple, efficient, and accurate approach is significant but still challenging. Here, cellulosic fiber supported 3D interconnected silver nanowire (AgNW) networks with hierarchical structures are rationally designed to achieve excellent electrical conductivity and superior thermal dispersion capability. In particular, thermal annealing at the junctions enables both phonon and electron transfer as well as impedes interfacial slippage. In the current study, the AgNW/cellulosic paper with the low Ag content (1.55 wt %) exhibits a low sheet resistance of 0.51 Ω sq-1. More importantly, the AgNW/cellulosic paper-based flexible strain sensor has been reasonably developed, which can be applied to monitor various microstructural changes and human motions with high sensitivity and robust stability (fast response/relaxation time of ∼100 ms and high stability >2000 bending-stretching cycles). The AgNW/cellulosic paper-based device also displays efficient thermal dispersion property, which offers exciting opportunities for thermal management application. Furthermore, the obtained hybrid paper exhibits superior heat dispersion capacity for thermal management devices. Overall, uniform dispersion and 3D interconnected junctions of AgNW among the fibers inside the cellulosic papers lead to the combination of high mechanical strength, highly efficient electrical conductivity, and ultrahigh heat dispersion property. The AgNW/cellulosic paper has promising potentials in the flexible and wearable sensing elements, thermal management materials, and artificial intelligence devices.

The aim of this work was to demonstrate the production potential of a combination of the two materials cellulose nanofibrils (CNF) and chitin nanowhisker (CNW) using wheat straw and chitin. CNF and CNW were prepared from TEMPO-oxidation and acid hydrolysis prior to high-pressure homogenization. The zeta potential results indicated the differences in the suspended mechanism for the CNF and CNW dispersions. Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) revealed that the chemical composition and crystal unit changes during the chemical separation process. Hybrid CNF/CNW films were prepared via casting and evaporation. The films had better mechanical properties, which were ascribed to multivalent physical interactions between CNF and CNW. However, increasing the CNW content up to 50% negatively affected the mechanical properties of the hybrid films. In addition, all films showed high transparency and excellent flexibility. These results indicated that the interaction between CNF and CNW effectively enhanced the mechanical performance of films.

To investigate the behavior of lignin during the alkali cooking process with different alkali doses, this work demonstrated the structural characteristics illustrated by spectroscopic analyses. Gel permutation chromatography (GPC) and nuclear magnetic resonance (NMR) indicated that the lignin was composed of typical structures for a grass, generally with S and G units and small amounts of H units. The main substructures present were β-O-4 aryl ether linkages, and there were lower amounts of β-β and β-5 linkages. Alkali treatment conditions had evident effects on the chemical structures and properties of lignin. Moreover, NMR indicated that alkali cooking caused lignin to depolymerize more easily with increasing severity and to condense.

It was demonstrated that a photochromic paper could be made through the atom transfer radical polymerization (ATRP) method by grafting spiropyran ether methacrylate (SPMA) onto the fiber surface. The surface composition and topography of the grafted paper were analyzed by Fourier Transform Infrared Spectroscopy (FTIR), X-ray photoelectron spectra (XPS), and scanning electron microscopy-energy dispersive spectrometer (SEM-EDS). Crystal structures of the cellulosic fibers were also examined after the grafting reaction. The characteristic absorption bands detected in the FTIR spectrum after grafting suggested that a new functional group was formed by the reaction. The XPS and SEM results confirmed that SPMA was grafted onto the surface of the fibers successfully. The grafted spiropyran groups exhibited reversible photochromic properties when exposed to UV light irradiation and visible light. The modified paper showed a purple color under UV light irradiation and changed back to its original color when exposed to visible light. This surface modification using ATRP was demonstrated to be a feasible way to prepare photochromic paper.