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Background: To investigate the role of antimicrobial prophylaxis in laparoscopic nephrectomy for renal cell carcinoma. Methods: We retrospectively enrolled 1000 patients who underwent laparoscopic nephrectomy from August 2019 to November 2021 in the Peking Union Medical College Hospital. Patients were divided into group without antimicrobial prophylaxis (n = 444) and group with antimicrobial prophylaxis (n = 556). Outcomes including 30-day postoperative infection rate, the increase rate of pre- and post-operative white blood cell counts and hospital stay were analyzed. Results: The overall infection rate was 5.0% (28/556) in the group with antimicrobial prophylaxis, which was similar to 4.1% (18/444) in the group without antimicrobial prophylaxis (P = 0.461). The increase rate of pre- and post-operative white blood cell counts was significantly lower (85.5% versus 97.0%) in the group with antimicrobial prophylaxis (P = 0.004). The postoperative hospital stay was 5 (4, 6) days in both groups (P = 0.483). Logistic regression analyses identified the use of antimicrobial prophylaxis had no influence on the occurrence of infection events (odds ratio = 0.797; 95% confidence interval, 0.435–1.460; P = 0.462). Hemoglobin (odds ratio = 0.430; 95% confidence interval, 0.257–0.719; P = 0.001) and partial nephrectomy (odds ratio = 2.292; 95% confidence interval, 1.724–3.046; P < 0.001) influenced the use of antimicrobial prophylaxis independently. Conclusions: The use of antimicrobial prophylaxis had no impact on postoperative infection in patients receiving laparoscopic nephrectomy for renal cell carcinoma. [ABSTRACT FROM AUTHOR]

Transmuscular quadratus lumborum block (TQLB) may provide postoperative analgesia in patients undergoing intraperitoneal surgeries. The purpose of this study was to examine the potential efficacy of TQLB among patients undergoing retroperitoneal procedures, such as the laparoscopic partial nephrectomy (LPN). This prospective, randomized, controlled study was conducted from August 2017 to November 2018 at Peking Union Medical College Hospital (Beijing, China). Patients who were scheduled for a LPN, aged 18-70 years old with an ASA physical status score of I - II were randomly assigned to receive either TQLB with 0.6 ml/kg of 0.5% ropivacaine plus general anesthesia (TQLB group) or general anesthesia alone (control group). Patient-controlled intravenous analgesia with morphine was initiated immediately upon surgery completion. The primary outcome was the cumulative consumption of morphine within 8 h after surgery. The secondary outcome included postoperative consumptions of morphine at other time points, pain score at rest and during activity, postoperative nausea and vomitting (PONV), and recovery related parameters. Totally 30 patients per group were recruited in the study. The 8 h consumption of morphine was lower in the TQLB group than in the control group (median, 0.023 mg/kg vs. 0.068 mg/kg, U=207.5, P < 0.001). No significant differences were observed in postoperative pain scores between the two groups. Patients in the TQLB group had fewer episodes of PONV (20% vs. 47%, χ2= 4.8, P = 0.028) in the first 24 h after surgery and higher scores for quality of recovery (mean, 138.6 vs. 131.9, t = –2.164, P = 0.035) 120 h after surgery than the controls. TQLB resulted in an opioid-sparing effect during the early postoperative period following LPN, as well as a lower incidence of PONV and improved quality of recovery. [ABSTRACT FROM AUTHOR]

• Design of an optimization framework for battery economic-conscious charging. • Costs of both electrical energy waste and battery ageing are directly considered. • Contradictory objectives along with immeasurable states and constraints are optimized. • Charging strategies towards time, energy and economic managements are obtained. • Effects of three sensitive elements are comparatively studied via Pareto frontier. Technical challenges facing the development of battery economic charging for energy management arise from various contradictory objectives, immeasurable internal states, and hard constraints. Available solutions often resort to optimizing economic charging from the perspective of power grid, while few focus on the benefits of electric vehicle (EV) owners. This paper proposes a constrained multi-objective optimization framework to achieve economy-conscious battery charging management. Specifically, a coupled electrothermal-aging model is first applied to capture the nonlinear electrical, thermal, and aging dynamics of a lithium-ion battery with different timescales. Then an economic indicator considering the total charging cost caused by both the battery aging and electrical energy loss is formulated, based on a battery resale cost model and the Beijing peak-valley time-of-use (TOU) price. In addition, two crucial but contradictory objectives including the charging time and battery average temperature are also taken into account, along with hard constraints on the battery State of Charge (SOC), charging current, terminal voltage, and temperature. The complicated multi-objective charging problem is solved by using NSGA-II to optimize the multistage constant-current (MCC) profile. Sensitivities of the cut-off voltage, convection resistance, and ambient temperature are comparatively analysed via Pareto frontier. Numerical results of two extreme cases and several balanced charging cases demonstrate that feasible, economy-conscious battery charging management for various user demands can be achieved through suitable equilibrations among charging speed and thermal variations during charging. [ABSTRACT FROM AUTHOR]