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Regional anesthesia such as interscalene brachial plexus block (ISBPB) with intermediate cervical plexus block (ICPB) is generally a preferred choice for clavicular surgery. However, various studies have shown that these blocks, especially ISBPB, could cause phrenic nerve paralysis and decrease diaphragmatic motion. The study aimed to evaluate the efficacy of clavipectoral fascial plane block (CPB), an alternative technique to ISBPB, with ICPB, in reducing hemidiaphragmatic paralysis during midshaft clavicular surgery.Forty patients scheduled for right midshaft clavicular surgery were randomized (1:1) into an ultrasound-guided ISBPB with ICPB (BC) group or ultrasound-guided CPB with ICPB (CC) group. Five milliliter of 0.375% ropivacaine was used for ICPB, another 20 mL for ISBPB or CPB, and no administration of additional sedative or general anesthetic was planned. Primary outcome was measured by the incidence of hemidiaphragmatic paralysis using M-mode ultrasonography, while secondary outcomes were measured by bedside pulmonary function test, the success rate of block, the time required for the block procedure and onset of block, and motor block score in right upper extremity.In comparison with BC group, the incidence of hemidiaphragmatic paralysis postblock was decreased in CC group (50% vs 0%; P.001), and measurement of bedside pulmonary function was significantly improved. There was a 100% success rate for anesthetic block in both BC and CC groups, and CC group showed lower motor block score in upper extremity and less block procedure time than BC group (7.1 ± 1.2 vs 3.2 ± 0.6 minutes; P.001). Moreover, no significant differences were found between time of onset of block and other anesthetic complications in the 2 groups.Ultrasound-guided CPB with ICPB could significantly reduce hemidiaphragmatic paralysis and provide an adequate surgical anesthesia with fewer complications such as motor block in upper extremity during right midshaft clavicular surgery.

To analyze the effect of traditional Chinese medicine Paishi decoction combined with laparoscopic ureterectomy and lithotripsy in the treatment of complex kidney stones. Totally 100 patients with complicated kidney stones admitted to our hospital from January 2019 to January 2021 were selected and randomly divided into a control group and an experimental group, with 50 cases in each group. The control group was treated with laparoscopic ureterectomy for stone removal, the experimental group was treated with traditional Chinese medicine Paishi decoction combined with laparoscopic ureterectomy for stone removal. The therapeutic effects of the two groups were compared. The total effective rate of treatment in the control group was 76% and that of the experimental group was 96%. The stone clearing time, time to pain resolution and time to hematuria disappearance time in the experimental group were significantly shorter as compared with the control group. After treatment, the levels of serum creatinine and blood urea nitrogen in the experimental group were significantly lower than those in the control group. Traditional Chinese medicine Paishi decoction combined with laparoscopic ureterectomy and lithotripsy for treatment of complex kidney stones ameliorates the treatment efficacy, shortens the time of stone removal, mitigates the clinical symptoms of patients, and helps restore renal function, which is worthy of clinical promotion and application.

Two new transition coordination polymers (CPs) with the chemical formula of {[Zn4(dip)4(H2O)2(4-ppbp)2]·12H2O} n (1, H2dpa = diphenic acid, 4-ppbp = (propane-1,3-diylbis(piperazine-4,1-diyl))bis(py...

The composition characteristics and health risks of volatile organic compounds (VOCs) and their effects on secondary organic aerosol (SOA) during polluted and clean periods in winter 2018 for Yuncheng, a typical city in North China, were studied. The average concentration of VOCs was 2.3 times higher during the polluted period (105.29 µg m–3) than the clean period (45.78 µg m–3), whereas the average concentrations of the alkanes, alkenes, and aromatics were 3.4, 2.1, and 3.9 times higher, respectively, during the polluted period than the clean period. In addition, the VOC concentration was significantly influenced by meteorological conditions. Using positive matrix factorization (PMF), seven sources of atmospheric VOCs were identified, with the largest factors being vehicle emission (27.89%), coal combustion (23.37%), liquefied petroleum gas/natural gas evaporation (18.30%), and industrial emission (15.51%). Vehicle emission (30.04%) was the primary contributor during the polluted period, whereas coal combustion (33.53%) was the primary contributor during the clean period. The SOA formation potential (which almost exceeded 80%) was influenced by industrial emission (28.80%), solvent usage (26.30%), and vehicle emission (24.85%). Additionally, an assessment of the health risks of six aromatics based on the health risk exposure model of the United States Environmental Protection Agency revealed that the non-cancer risk was higher during the polluted period (6.61 × 10–2) than the clean period (2.20 × 10–2) but still below the Environmental Protection Agency (EPA) limit (1.00) and therefore negligible for the exposed population. However, the carcinogenic index of benzene (2.85 × 10–5 to 5 × 10–5) exceeded 10–6, suggesting a higher carcinogenic risk. Large-scale energy restructuring during recent years has sharply reduced coal combustion, but the VOC concentration has dramatically increased due to vehicle emission. Hence, regulating vehicle emissions is an effective strategy for controlling VOCs in Yuncheng.

Cadmium (Cd) is a toxic metal ion in pig manure impacting on the ecosystem, and hence the immobilization of Cd by green synthesis of iron nanoparticles (G-nFe) is a potential approach. In this study, transformation of Cd (II) during the pig manure thermophilic aerobic composting process in the presence of G-nFe was investigated. The results show that the addition of G-nFe promoted the composting process and release of available phosphorus (AP). In all six experiments, obvious passivation of Cd occurred during 15 days' composting. Particularly when 500 mL kg−1 of G-nFe was added and Cd (II) was added at 0.6%(w/w%), residual Cd increased from 0.0016% to 55.70% and exchangeable Cd decreased from 98.54% to 7.21%. Batch experiments revealed that the G-nFe promoted the transformation of Cd into a larger passivation fraction. X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD), SEM-Mapping and Fourier transform infrared (FTIR) analysis was used to characterize residual samples, where indicated that the passivation of Cd in compost was highly correlated with the increase of P, it can be concluded that fixing with compost resulted in the formation of Cd phosphate precipitation or co-precipitation with other phosphates.

Background and purpose: To evade immune defense, cancer cells can employ extracellular vesicles (EVs) to inhibit the anti-tumor activity of lymphocytes in the tumor microenvironment. However, the mechanisms and key molecules that mediate the effects of EVs on lymphocytes are unclear. Patients and methods: We used Quantibody® Human Cytokine Antibody Array 440 to determine the tumor immunity-related cytokine profile of peripheral blood lymphocytes (PBLs) stimulated with EVs derived from peritoneal washes or malignant ascites. We detected 21 upregulated and 27 downregulated proteins, including the immunosuppressive receptors Siglec-10, SLAM, PD-1, and TIM-3. Results: Flow cytometry analysis of PBLs or ovarian cancer ascites suggested that Siglec-10 expression on CD3+ T cells was higher in ovarian cancer patients than in healthy controls and in the malignant ascites of ovarian cancer patients than in their blood. Moreover, the expression of CD24, the Siglec-10 ligand, was associated with tumor stage and cancer cell metastasis. Finally, compared to the benign peritoneal wash-derived EVs, the malignant EVs significantly upregulated Siglec-10 expression on Jurkat T cells, inhibited the protein kinase C activity induced by phorbol 12-myristate 13-acetate and ionomycin, and impaired the phosphorylation of the tyrosine kinase ZAP-70 activated by crosslinking with an anti-CD3 antibody. Conclusion: The EVs secreted by malignant ovarian cells upregulated Siglec-10 expression on T cells and impaired T cell activation in the tumor microenvironment. We believe that a comprehensive understanding of the regulation of Siglec-10 and CD24 by malignant EVs has clinical importance, as it will aid in the development of better immunotherapeutic strategies for ovarian cancer.

Background Postoperative cognitive dysfunction (POCD) is a common complication after cardiac surgery that influences the clinical outcomes and quality of life of patients. This study aimed to evaluate the effects of Shenmai injection (SMI) on POCD of patients who underwent cardiac valve replacement under cardiopulmonary bypass (CPB). Methods This prospective, randomized, controlled trial was conducted from September 2014 to January 2017. Eighty-eight patients receiving cardiac valve replacement under CPB were randomized into the control (C) or the SMI (S) group. SMI (0.6 mL/kg) was administered intravenously from the time of anesthesia induction to the beginning of CPB. Cognitive function was assessed at 3 days before surgery and 3 days, 7 days, and 1 month after surgery using the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ) score. The serum levels of neuroglobin (Ngb), hypoxia-inducible factor-1α (HIF-1α), and neuron-specific enolase (NSE) were measured at 30 min after induction (T0), immediately after the endonasal temperature rewarmed to 36 °C (T1), and 1 h (T2), 6 h (T3), 24 h (T4), 48 h (T5), and 72 h (T6) after CPB. Results Compared with the baseline values at T0, the serum Ngb levels in group C were significantly decreased at T1–2 and then increased at T3–6, while the levels in group S were decreased at T1–2 and increased at T4–6, compared to group C (p

Resistive random-access memories (RRAM) has garnered much interest in recent decades as a strong candidate to replace conventional memories like NAND flash, SRAM and DRAM. In contrast to the electrical charge changes in flash memories to define memory states, RRAM devices rely on non-volatile, reversible resistance changes within the device, hence its name. Apart from its superior performance: low power, high speed, high endurance, its simple two-terminal metal-insulator-metal (MIM) structure allows for a more scalable design and simpler fabrication processes. However, the RRAM is not without its problems and challenges. The resistive switching property of RRAM is inherently stochastic, resulting in variations between memory states, which could result in bit errors if unaccounted for. Also, the two-terminal RRAM requires a select device to prevent wrong selection of devices in an array. This chapter focuses on the redox-RRAM, where resistance changes take place through redox reactions within the insulator layer of the MIM, and will describe the basic operating principles of RRAM as well as various RRAM architectures.

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Implementation of analog RRAM technology for neuromorphic computing has faced unique challenges in terms of endurance and variability as compared to the conventional digital memories. In this work, we demonstrate the dual oxide layer RRAM devices with analog performance of low working current, and study the trade-off switching speed, and the on/off ratio. We evaluate the endurance characteristics and define the correlation of endurance degradation with variability behavior. Compromised specifications of switching speed, switching voltage, and working resistance range are suggested to achieve integrative performance for the hardware implementation of neuromorphic network.

In this paper, we investigated retention failure behavior in analog RRAM devices. The retention failure time was found to be longer in TiW/ Al 2 O 3 /Ta 2 O 5 /Ta device than that of TiW/HfO 2 /Ta 2 O 5 /Ta device. Higher diffusion barrier for oxygen ions/vacancies causes retention time to be longer in a TiW/Al 2 O 3 /Ta 2 O 5 /Ta device. Multiple memory states were observed and found to be stable for at least 104 s at room temperature and this failure time is defined as the time for the resistance variation to remain within 10%.

Volatile organic compounds (VOCs) were collected at three environmental sampling sites in Yangquan and quantified by gas chromatography-mass selective detector/flame ionization detector(GC-MSD/FID). The VOC sources were identified by diagnostic ratios and positive matrix factorization (PMF), and environmental impact of VOCs on O

Previous reports have suggested that many gut microbiomes were associated with the development of colorectal cancer (CRC), and could modulate response to numerous forms of cancer therapy, including checkpoint blockade immunotherapy. Here we evaluated the protective efficacy of Lactobacillus acidophilus (L. acidophilus) cell lysates combined with an anti-CTL antigen-4 blocking antibody (CTLA-4 mAb) in syngeneic BALB/c mice CRC models induce by a single intraperitoneal injection of 10 mg/kg azoxymethane (AOM), followed by three cycles of 2% dextran sulfate sodium (DSS) in drinking water. In contrast to CTLA-4 mAb monotherapy, L. acidophilus lysates could attenuate the loss of body weight and the combined administration significantly protected mice against CRC development, which suggested that the lysates enhanced antitumor activity of CTLA-4 mAb in model mice. The enhanced efficacy was associated with the increased CD8 + T cell, increased effector memory T cells (CD44 + CD8 + CD62L+), decreased Treg (CD4 + CD25 + Foxp3+) and M2 macrophages (F4/80 + CD206+) in the tumor microenvironment. In addition, our results revealed that L. acidophilus lysates had an immunomodulatory effect through inhibition the M2 polarization and the IL-10 expressed levels of LPS-activated Raw264.7 macrophages. Finally, the 16S rRNA gene sequencing of fecal microbiota demonstrated that the combined administration significantly inhibited the abnormal increase in the relative abundance of proteobacteria and partly counterbalance CRC-induced dysbiosis in model mice. Overall, these data support promising clinical possibilities of L. acidophilus lysates with CTLA-4 mAb in cancer patients and the hypothesis that probiotics help shape the anticancer immune response.