Single-incision laparoscopic approach for linea alba hernia in children.

OBJECTIVE: The aim of this study is to describe the technique and to evaluate the outcome of single-incision laparoscopic (SILC) approach for linea alba hernia in children. MATERIALS AND METHODS: A 2 cm vertical umbilical incision was made and stretched horizontally. A 5-mm trocar was inserted through middle port for the telescope. Another extra-long 5-mm 30° trocar was inserted through the lateral port, 5 mm beside the middle port. The extraperitoneal fat was removed, and the defect of linea alba was repaired after hernial sac was excised. The peritoneum was reconstructed with interrupted suture. RESULTS: From May 2014 to May 2015, eight children with linea alba hernia underwent SILC. Pre-operative abdominal ultrasound showed the average diameter of hernia ring was 3.2 ± 0.7 cm. Mean operation time was 32.5 min (range = 30-45 min). Oral intake was resumed during anaesthesia recovery period. All could endure pain and discharge on the post-operative 12 h. There was no post-operative wound infection. The follow-up period was 1-12 months, no recurrence and other complications occurred. CONCLUSIONS: SILC approach for linea alba hernia is a safe and effective, minimally invasive new technology. The linea alba hernia could be repaired with a cosmetic outcome.

Catalytic Performance of Pt/Reduced Graphene Oxide Composites to Methanol Electrochemical Oxidation: Optimization of Mass-Specific Activity.

Series of catalysts made of Pt nanoparticles supported on reduced graphene oxides (Pt/RGO) were synthesized and tested in methanol oxidation reaction, aiming for optimizing the mass-specific activity of prepared Pt/RGO composites. The loading amount of Pt is controlled through setting different reaction time and determined precisely by atomic absorption spectrophotometer. The structure of Pt/RGO composites is characterized by X-ray diffraction, transmission electron microscopy and Raman spectroscopy. The electrochemical testing data reveal that the Pt/RGO-mass-specific activity, judged by current density and long-term stability, is maximized in the sample in which cooperation of the Pt loading amount and electrochemical active surface area (ECSA) per amount of Pt is best optimized. The performance of the catalyst with smallest Pt particles or highest Pt loading amount is dragged down by either too less Pt loading or poor ECSA per amount of Pt. The results in this research demonstrate that the mass-normalized activity of whole catalyst, which is associated with the anticipated power output per amount of catalyst, could be enhanced significantly by deliberate tuning of fabrication process.

Is extra-pleura Nuss procedure more secure and effective?

PURPOSE: To compare total extra-pleura Nuss procedure with classical Nuss, and evaluate the efficacies and safety of thoracoscopic total extra-pleural approach of Nuss procedure for correction of pectus excavatum in children. METHODS: We managed 69 patients with pectus excavatum from July 2006 to October 2012. Of the 69 patients, 40 underwent thoracoscopic total extra-pleural approach of Nuss (group A), and 29 underwent classical Nuss procedure (group B). In group A, there were 29 boys and 11 girls, and the mean age was 6.4 (ranged from 3.5 to 14.5). Under thoracoscopic guidance, an extra-pleural tunnel was created using a blunt dissector via a right thoracic incision. A steel bar was inserted in the entirely extra-pleural tunnel. The bar was turned and fixed as in standard Nuss procedure. In group B, there were 20 boys and 9 girls, and the mean age was 5.9 (ranged from 4 to 11) years. Under thoracoscopic guidance, a blunt dissector was inserted into pleura cavity directly via a right thoracic incision. It was a standard Nuss procedure. RESULTS: The operations were completed successfully in all patients. None of the children developed pneumothorax or injuries to the pericardium, heart or lungs. The operating time was 42.0 ± 5.3 and 43.4 ± 6.0 min in group A and B, respectively, and the difference was not significant (p = 0.306). Compared to group B, the postoperative hospital stay of group A was shorter (4.0 ± 1.1 vs 5.2 ± 1.2 days, p = 0.001). The outcomes of both groups were similar (97.5% in group A vs 93.8% in group B, p = 0.377) but pain time was shorter, and time of taking painkiller was less than those of group B (2.6 ± 0.8 vs 4.1 ± 1.0 days, p = 0.001; 1.1 ± 0.6 vs 1.8 ± 0.9 time, p = 0.008). No patients in group A developed subcutaneous emphysema or pleural irritation, while 5 patients in group B showed the symptoms (p = 0.004). All patients were followed-up for 4-30 months (mean 20.2). During the follow-up, none of the children had pulmonary infection or dislocation of the steel board or fixation instruments before the bar was removed. 69 patients removed their bar after a 24-month period on average. According to Nuss' postoperative assessment criteria, one patient in group B was fair. The other patients were all excellent or good. CONCLUSIONS: Extra-pleura Nuss procedure under thoracoscopic guidance is a safe and less traumatic procedure for the correction of pectus excavatum. It is not only superior in postoperative recovery and pleural cavity protection, but also results in fewer complications than the intrapleural procedures.

The controllable syntheses and electrochemical study of 1-dimensional nanowires, 2-dimensional nanoplatelets, and 3-dimensional nanotowers of MnO2.

We report a facile hydrothermal synthetic approach to selectively produce 1-dimensional, 2-dimensional, or 3-dimensional MnO2 nanomaterials reliably and conveniently. The influences of reaction conditions on the morphology and crystallographic forms and the formation mechanism of the as-obtained MnO2 nanostructures have been studied in this work. And the materials produced by this method have excellent crystalline nature. Preliminary electrochemical study indicates that the as-prepared 2-dimensional MnO2 nanomaterials are excellent cathode materials using in lithium batteries.