Constructing Dynamic Anode/Electrolyte Interfaces Coupled with Regulated Solvation Structures for Long-Term and Highly Reversible Zinc Metal Anodes.

Aqueous zinc ion batteries (AZIBs) show a great potential for next-generation energy storage due to their high safety and high energy density. However, the severe side reactions of zinc negative electrode largely hinder the further application of AZIBs. Herein, trace tris(hydroxymethyl)aminomethane (Tris) additive with rich lone-pair-electrons and zincophilic sites is firstly introduced to achieve long-term and highly reversible Zn plating/stripping. Specifically, Tris not only regulates the solvation structure of Zn2+, but is also adsorbed vertically on the Zn anode surface with a changed coordination intensity during the plating/stripping process of Zn to generate an in situ dynamic adsorption layer for the first time. The dynamic adsorption layer could successively attract the solvated Zn2+ and then promote the de-solvation of the solvated Zn2+ owing to the orientation polarization with regularly-changed applied electric field, the volume rejection effect, and strong intermolecular force towards H2O of the vertically-adsorbed Tris. Therefore, an improved Zn2+-transport kinetics as well as the inhibition of side reactions of Zn anode are successfully realized. Accordingly, the Zn||Zn symmetric cell provides an ultra-long cycle life of 2600 h. Furthermore, the Zn||MnO2 full cell with Tris could demonstrate a high capacity and structural stability for practical applications.

Constructing Atomic Fe and N Co-doped Hollow Carbon Nanospheres with a Polymer Encapsulation Strategy for High-Performance Lithium-Sulfur Batteries with Accelerated Polysulfide Conversion.

As competitive next-generation rechargeable batteries, lithium-sulfur batteries (LSBs) suffer from the shuttle effect and the sluggish kinetics of intermediate polysulfides during charge and discharge processes, adversely affecting their electrochemical performances and actual applications. Herein, we demonstrate a polymer encapsulation strategy to synthesize atomic Fe and N co-doped hollow carbon nanospheres (Fe-NHC) with Fe-Nx sites for modifying commercial PP separator of LSBs to suppress the shuttle effect and promote the kinetics of intermediate polysulfides. Benefiting from the excellent structural design, the doped-N with positive charges could effectively adsorb negatively charged soluble polysulfides, help attract the soluble polysulfides to the Fe atoms and boost the catalytic transformation of the soluble polysulfides. Additionally, such a thin carbon shell could provide a short mass diffusion pathway and hence promote the adsorption and the catalytic conversion. Therefore, the battery with the Fe-NHC/PP separator delivers outstanding cycling and rate performances. At the large current density of 1 C, the specific capacity is 1079 mA h g-1 and maintains a low loss of 0.076 % per cycle within 500 cycles. Even at a harsh current density of 4 C, a high capacity of 824 mA h g-1 is still achieved, indicating the advantage of the Fe-NHC/PP separator in LSBs.

Baseline neutrophil-lymphocyte ratio is associated with outcomes in patients with castration-resistant prostate cancer treated with Docetaxel in South China.

ABSTRACT: The aim of this study is to investigate the association between baseline neutrophil-to-lymphocyte ratio (NLR) and progression-free survival (PFS), overall survival (OS) and radiological response in castration-resistant prostate cancer patients treated with docetaxel.Forty-one prostate cancer patients who were treated with docetaxel were selected. Univariable and multivariable Cox regression models were used to predict the association of baseline NLR as a dichotomous variable with PFS and OS after chemotherapy initiation.In Kaplan-Meier analysis, the median PFS (9.8 vs 7.5 months, P = .039, Fig. 1) and OS (17.6 vs 14.2 months, P = .021, Fig. 2) was higher in patients who did not have an elevated NLR than in those with an elevated NLR. In univariate analysis, the pretreatment NLR was significantly associated with PFS (P = .049) and OS (P = .023). In multivariable analysis, patients with a NLR of >3 were at significantly higher risk of tumor progress (hazard ratio 2.458; 95% confidence interval 1.186-5.093; P = .016) and death (hazard ratio 3.435; 95% CI 1.522-7.750; P = .003)than patients with a NLR of ⩽3.NLR may be an independent predictor of PFS and OS in castration-resistant prostate cancer patients treated with docetaxel. The findings require validation in further prospective, big sample-sized studies.

Eco-friendly extraction and physicochemical properties of pectin from jackfruit peel waste with subcritical water.

BACKGROUND: Water is generally considered to be a safe and green solvent suitable for use in natural product extraction. In this study, an eco-friendly subcritical water method was used to extract pectin from waste jackfruit peel (JFP-S), which was compared with pectin obtained by the traditional citric acid method (JFP-C). RESULTS: The extraction process was optimized using response surface methodology (RSM), and the optimum process parameters were as follows: extraction temperature 138 °C, extraction time 9.15 min, liquid / solid (L/S) ratio 17.03 mL g-1 . Under these conditions, the pectin yield was 149.6 g kg-1 (dry basis). Pectin obtained from the two extraction methods displayed a high degree of esterification and the monosaccharide composition was consistent. The galacturonic acid content of JFP-S and JFP-C was 52.27% and 56.99%, respectively. JFP-S had more hairy regions and side chains than JFP-C. The molecular weight of JFP-S was 113.3 kDa, which was significantly lower than that of JFP-C (174.3 kDa). Fourier-transform infrared spectroscopy (FTIR) indicated that two samples had similar pectin typical absorption peaks. According to differential scanning calorimetry (DSC), both JFP-S and JFP-C had relatively good thermal stability. JFP-S demonstrated lower apparent viscosity and elasticity than JFP-C. Meanwhile, the G' and G'' moduli of JFP-S were lower, which found expression in the gel textural characterization of the samples. CONCLUSION: This work showed that the subcritical water method is an efficient, time-saving, and eco-friendly technology for the extraction of pectin from jackfruit peel compared with the traditional citric acid method. The physicochemical properties of pectin could be changed during subcritical water extraction. © 2019 Society of Chemical Industry.

The role of thymus preservation in parathyroid gland function and surgical completeness after bilateral central lymph node dissection for papillary thyroid cancer: A randomized controlled study.

BACKGROUND: The clinical value of thymus preservation during thyroid carcinoma surgery remains unclear. The aim of this study is to explore the role of bilateral thymus preservation in parathyroid glands (PGs) function and surgical completeness in total thyroidectomy (TT) with bilateral central lymph node dissection (CLND). MATERIALS AND METHODS: Fifty-four consecutive patients who underwent TT and bilateral CLND were assigned to the thymus preservation (TP) group (n = 27) and the bilateral thymectomy (BT) group (n = 27). Surgical completeness was evaluated by the number of lymph nodes dissected, serum Tg level and ultrasound findings postoperatively. RESULTS: Incidental parathyroidectomy was more common in the BT group (29.6% vs 7.4%, p = 0.038). Patients in the BT group had higher risks of neuromuscular symptoms (63.0% vs 29.6%, P = 0.014) and transient hypoparathyroidism (70.4% vs 25.9%, P = 0.001). The incidence of persistent hypoparathyroidism failed to show a significant difference between the TP and BT groups (0 vs 14.8%, P = 0.111). However, those with transient hypoparathyroidism in the BT group had a lower level of serum PTH at 3 weeks postoperatively (p = 0.001). There was no significant difference in the number of lymph nodes dissected (5.89 ±â€¯3.12 vs 8.56 ±â€¯6.93, P = 0.077) and preablation sTg level (1.82 ±â€¯2.18 vs 1.42 ±â€¯1.56 ng/ml, P = 0.775) between the TP and BT groups. No metastatic lymph nodes were found on sonography at 3 months postoperatively in both groups. CONCLUSION: Thymus preservation had benefits on protecting PGs and promoting rapid clinical resolution of hypoparathyroidism. It had no effects on oncologic completeness of TT with bilateral CLND.

Dual-Carbon-Confined Fe7 S8 Anodes with Enhanced Electrochemical Catalytic Conversion Process for Ultralong Lithium Storage.

Although the electrochemical catalytic conversion process is effective in increasing the reversible capacity of lithium-ion batteries, the low contact efficiency between metal catalyst and substrate and pulverization of the solid electrolyte interface (SEI) film without protection are not beneficial for the electrochemical reactions. Herein, Fe7 S8 nanoparticles are confined by both reduced graphene oxide (RGO) and in-situ-formed amorphous carbon (C) to form dual-carbon-confined Fe7 S8 as a lithium-ion anode. The dual-carbon-confined structure provides a confined space to prevent pulverization of the SEI film and increases the local concentration of intermediate phases, which could be electrocatalytically decomposed by Fe nanoparticles formed in situ to increase the reversibility of the electrochemical reactions and gain high reversible capacity. In addition, the dual-carbon-confined structure ensures fast transfer of electrons and boosts transport of lithium ions due to the highly conductive dual-carbon shell. Thus, the Fe7 S8 /C/RGO anode delivers an excellent rate performance and long cycling stability. At current densities of 2000 and 5000 mA g-1 , the reversible capacities are 520 mA h g-1 over 1500 cycles and 294 mA h g-1 over 2000 cycles, respectively.

Vertically Aligned High-Quality Graphene Foams for Anisotropically Conductive Polymer Composites with Ultrahigh Through-Plane Thermal Conductivities.

Although graphene-based thermal interface materials (TIMs) have great potentials in removing excess heat generated during highly efficient running of electronic devices, their practical applications are usually limited by their unsatisfactory thermal conductions, which are mainly caused by unsatisfactory dispersion and distribution, low loading, and low quality of graphene sheets, as well as the thermal interfacial resistance between graphene sheets and polymer matrix. Herein, we develop vertically aligned graphene hybrid foams (GHFs) with high densities by hydrothermal reduction of graphene oxide in the presence of high-quality graphene nanoplatelets (GNPs) followed by air-drying. The reduced graphene oxide sheets play an important role in constructing a vertically aligned interconnection network for accommodating GNPs during the hydrothermal reduction process, while the incorporated GNPs not only make the thermal conductance network denser but also prevent excessive shrinkage of the foams during air-drying. More critically, graphitization of GHF at 2800 °C removes the residual oxygen-containing groups and heals the defects of their reduced graphene oxide component, leading to high-quality graphene foams. The resultant vertically aligned high-quality graphene porous architecture with high density as an ideal thermal conductance network of TIMs is highly efficient in improving the thermal conductivity of its epoxy composite, which exhibits an ultrahigh through-plane thermal conductivity of 35.5 W m-1 K-1 at a graphene loading of 19.0 vol %. The excellent thermally conductive performance makes the annealed GHF/epoxy composites suitable for the thermal management.

Subcutaneous dissection area contributes less to endoscopic thyroidectomy-related invasiveness.

OBJECTIVE: To clarify the contribution of the subcutaneous area during breast approach endoscopic thyroidectomy (BAET), with regard to invasiveness-related outcomes. METHODS: Seventy-two patients were randomly assigned to two groups: standard dissection and limited dissection. Postoperative pain and inflammatory response were compared between groups. RESULTS: The groups were well matched except for subcutaneous dissection area (137.11 ± 21.10 vs. 83.69 ± 12.10 cm(2), p < 0.0001). No significant difference was found with regard to VAS score and postoperative inflammatory response. CONCLUSION: Our RCT indicated that the subcutaneous area plays a less important role with regard to BAET-related postoperative pain.

Long-term outcomes of cruroplasty reinforcement with composite versus biologic mesh for gastroesophageal reflux disease.

AIM: The aim of this study was to evaluate the issue of improvement of disadvantages of different type meshes. METHODS: A retrospective analysis was performed on 101 gastroesophageal reflux disease patients who underwent reinforcement of crura with or without prosthetic mesh. Three types of mesh, 4-ply biologic small intestine submucosa (SIS, Surgisis(®), since November 2010), 6-ply SIS (Biodesign™ Surgisis(®), since March 2011), and composite synthetic mesh (Crurasoft(®), since May 2010), were used. All patients were assigned to simple suture group (n = 35), 4-ply SIS group (n = 13), 6-ply Biodesign™ group (n = 26) or Crurasoft(®) group (n = 27). Postoperative follow-up was performed via clinical visit or phone call contact. Subjective assessment included dysphagia, patients' symptomatic outcome judgment according to Visick and patients' satisfaction. Objective evaluation included hiatal hernia recurrence according to upper endoscopy and barium contrast swallow. Follow-up was completed in 83 patients with a mean duration of 45 months (range 16-149 months). RESULTS: For the objective outcomes, although anatomic recurrence of hiatal hernia did not significantly differ between groups at 6 months postoperatively, long-term results showed a protective effect of mesh implantation on hernia recurrence (p = 0.047). For the subjective outcomes, the mesh group had a more significant improvement in Visick score (p = 0.020) compared to the simple suture group. Patient satisfaction was significantly higher in the mesh group (p = 0.014), and subgroup analysis showed a clear trend as follows: Crurasoft(®) ≈ Biodesign(®) > SIS(®). A higher frequency of postoperative dysphagia was presented in the Crurasoft group compared with other two groups at 6 months postoperatively, but the difference was not significant over time (p = 0.227). CONCLUSION: Mesh cruroplasty results in satisfactory symptom control with a low recurrence rate. 6-ply biologic mesh is promising with respect to the reduction in anatomic recurrences. Postoperative dysphagia does not occur commonly following mesh cruroplasty with PTFE/ePTFE mesh.

The role of carbon nanoparticles in identifying lymph nodes and preserving parathyroid in total endoscopic surgery of thyroid carcinoma.

AIM: To evaluate the efficacy of carbon nanoparticles (CNs) in identifying lymph nodes and preserving parathyroids in endoscopic total thyroidectomy (ETT) with central neck dissection (CND), and to further explore the role of CNs in recovering postoperative parathyroid function. METHOD: Fifty-five patients with papillary thyroid carcinoma were randomized to either CN group (n = 28) or control group (n = 27). The primary outcome measures were pathological results (e.g., amount of incidental removed parathyroids and lymph nodes dissected) and follow-up results [e.g., recovery of serum calcium and parathyroid hormone (PTH) levels]. The secondary end-points were the rates of neuromuscular symptoms, in-hospital postoperative hormonal assay, and lymph node metastases. RESULTS: A total of 193 lymph nodes in the CN group and 123 lymph nodes in the control group were detected. The mean number of detected lymph nodes was significantly higher in the CN group than in the control group (P = 0.009). Parathyroids were present in the thyroid or central nodal specimens of five patients, which were all in the control group. The control group had a relatively higher incidence of incidental parathyroidectomy compared to the CN group (P = 0.023). Compared to the CN group, the incidence of paresthesia was higher in the control group even if not statistically significant. During follow-up, the serum calcium levels were higher in the CN group than in the control group; however, there was no statistically significant difference. For the serum PTH levels, the CN group recovered rapidly to the preoperative levels, whereas the control group climbed steadily to the normal range. The serum PTH levels in the CN group were apparently higher than in the control group at 1 week and 1 month postoperatively. CONCLUSION: CNs play an important role in protecting parathyroid glands, dissecting lymph nodes thoroughly, and promoting rapid recovery of parathyroid in ETT with CND (ChiCTR-TRC-14005042).

Purification of papain by metal affinity partitioning in aqueous two-phase polyethylene glycol/sodium sulfate systems.

A simple and inexpensive aqueous two-phase affinity partitioning system using metal ligands was introduced to improve the selectivity of commercial papain extraction. Polyethylene glycol 4000 was first activated using epichlorohydrin, then it was covalently linked to iminodiacetic acid. Finally, the specific metal ligand Cu(2+) was attached to the polyethylene glycol-iminodiacetic acid. The chelated Cu(2+) content was measured by atomic absorption spectrometry as 0.88 mol/mol (polyethylene glycol). The effects on the purification at different conditions, including polyethylene glycol molecular weight (2000, 4000, and 6000), concentration of phase-forming components (polyethylene glycol 12-20% w/w and sodium sulfate 12-20%, w/w), metal ligand type, and concentration, system pH and the commercial papain loading on papain extraction, were systematically studied. Under optimum conditions of the system, i.e. 18% w/w sodium sulfate, 18% w/w polyethylene glycol 4000, 1% w/w polyethylene glycol-iminodiacetic acid-Cu(2+) and pH 7, a maximum yield of 90.3% and a degree of purification of 3.6-fold were obtained. Compared to aqueous two phase extraction without ligands, affinity partitioning was found to be an effective technique for the purification of commercial papain with higher extraction efficiency and degree of purification.

Dual-sided composite mesh repair of hiatal hernia: our experience and a review of the Chinese literature.

AIM: To summarize our experience in the application of Crurasoft® for antireflux surgery and hiatal hernia (HH) repair and to introduce the work of Chinese doctors on this topic. METHODS: Twenty-one patients underwent HH repair with Crurasoft® reinforcement. Gastroesophageal reflux disease (GERD) and HH-related symptoms including heartburn, regurgitation, chest pain, dysphagia, and abdominal pain were evaluated preoperatively and 6 mo postoperatively. A patient survey was conducted by phone by one of the authors. Patients were asked about "recurrent reflux or heartburn" and "dysphagia". An internet-based Chinese literature search in this field was also performed. Data extracted from each study included: number of patients treated, hernia size, hiatorrhaphy, antireflux surgery, follow-up period, recurrence rate, and complications (especially dysphagia). RESULTS: There were 8 type I, 10 type II and 3 type III HHs in this group. Mean operative time was 119.29 min (range 80-175 min). Intraoperatively, length and width of the hiatal orifice were measured, (4.33 ± 0.84 and 2.85 ± 0.85 cm, respectively). Thirteen and eight Nissen and Toupet fundoplications were performed, respectively. The intraoperative complication rate was 9.52%. Despite dysphagia, GERD-related symptoms improved significantly compared with those before surgery. The recurrence rate was 0% during the 6-mo follow-up period, and long-term follow-up disclosed a recurrence rate of 4.76% with a mean period of 16.28 mo. Eight patients developed new-onset dysphagia. The Chinese literature review identified 12 papers with 213 patients. The overall recurrence rate was 1.88%. There was no esophageal erosion and the rate of dysphagia ranged from 0% to 24%. CONCLUSION: The use of Crurasoft® mesh for HH repair results in satisfactory symptom control with a low recurrence rate. Postoperative dysphagia continues to be an issue, and requires more research to reduce its incidence.

Functionalization and reduction of graphene oxide with p-phenylene diamine for electrically conductive and thermally stable polystyrene composites.

A facile and efficient approach was developed to simultaneously functionalize and reduce graphene oxide (GO) with p-phenylene diamine (PPD) by simple refluxing. This was possible by the nucleophilic substitution reaction of epoxide groups of GO with amine groups of PPD aided by NH(3) solution. As a consequence, electrical conductivity of GO-PPD increased to 2.1 × 10(2) S/m, which was nearly 9 orders of magnitude higher than that of GO. Additionally, after the incorporation of GO-PPD in polystyrene (PS), the composites exhibited a sharp transition from electrically insulating to conducting behavior with a low percolation threshold of ~0.34 vol %, which was attributed to the improved dispersion and the reduction of GO-PPD. Thermal stability of the PS/GO-PPD composite was also ~8 °C higher than that of PS.

Clinical benefits of scarless endoscopic thyroidectomy: an expert's experience.

BACKGROUND: By comparison with the conventional surgical approach to thyroidectomy, scarless (in the neck) endoscopic thyroidectomy (SET) has a superior cosmetic result but a very long learning curve. The objective of the present study was to compare surgical outcomes of SET performed by an experienced surgeon with the outcomes of conventional thyroidectomy. METHOD: Enrolled in this study were 25 patients who underwent SET and 18 who underwent conventional surgery. Differences in size of tumor, length of incision, duration of operation, volume of blood loss, pathological findings, postoperative pain, complications, and cosmetic result were investigated. RESULTS: The two groups were well matched. The total length of incisions and volume of blood loss of SET were significantly lower than those of conventional surgery. In addition to the superior cosmetic result, postoperative pain was significantly less severe and rates of hypesthesia or paresthesia and discomfort while swallowing were significantly lower in the endoscopy group. CONCLUSIONS: In experienced hands, SET offers more benefits than the conventional approach, including less postoperative pain and discomfort and a better cosmetic outcome.

The minimally invasive effect of breast approach endoscopic thyroidectomy: an expert's experience.

We evaluated the invasiveness of breast approach endoscopic thyroidectomy (BAET) carried out by surgeon very experienced in this procedure. Twenty-four patients who underwent BAET and 19 patients who underwent conventional thyroidectomy were the study population. Postoperative pain was assessed by a visual analog scale (VAS). The values 2, 12, and 24 h after surgery were significantly lower in the BAET group than those in the conventional group. Serum IL-6 and CRP levels were measured by an ELISA preoperatively and at 2, 12, 24 and 48 h after operation. Their values increased significantly after both procedures when compared to preoperative levels with significant differences between the two groups detected at the 24-hour and 48-hour time points. Subjective and objective evidence supported the notion that BAET could become a minimally invasive procedure if the surgeon gained sufficient experience.

PDE-based unsupervised repair of hair-occluded information in dermoscopy images of melanoma.

The repair of hair-occluded information is one of the key problems for the precise segmentation and analysis of the skin malignant melanoma image with hairs. Aimed at dermoscopy images of pigmented skin lesions, an unsupervised repair algorithm for the hair-occluded information is proposed in this paper. This algorithm includes three steps: first, the melanoma image with hairs are enhanced by morphologic closing-based top-hat operator and then segmented through statistic threshold; second, the hairs are extracted based on the elongate of connected region; third, the hair-occluded information is repaired by the PDE-based image inpainting. As a matter of fact, with the morphologic closing-based top-hat operator both strong and weak hairs can be enhanced simultaneously, and the elongate state of band-like connected region can be correctly described by the elongate function proposed in this paper so as to measure the hair effectively. Therefore, the unsupervised repair problem of the hair-occluded information can be resolved very well through combining the hair extracting with the image inpainting technology. The experiment results show that the repaired images can satisfy the requirement of medical diagnosis by the proposed algorithm and the segmentation veracity is effectively improved after repairing the hair-occluded information.

Spatial memory performance and hippocampal neuron number in osteoporotic SAMP6 mice.

The senescence-accelerated mouse strain P6 (SAMP6) is an inbred mouse that represents a clinically relevant model of senile osteoporosis. However, whether osteoporotic SAMP6 mice have cognitive deficits remains largely unexplored. Here, we used Morris water maze to assess reference memory and working memory performance in SAMP6 mice and SAMR1 controls, at 4 and 8 months of age. In addition, unbiased stereological techniques were used to estimate total neuron number in hippocampal CA1 subfield of the mice used in the behavioral study. Morris water maze test revealed impairments in working memory but not in reference memory of the 4- and 8-month-old SAMP6 mice compared with the SAMR1 mice at the same age. However, there were no significant differences in the total numbers of neurons in hippocampal CA1 subfield when comparing 4-month-old SAMR1 and 4-month-old SAMP6 and 8-month-old SAMR1 and 8-month-old SAMP6, which indicate that, in SAMP6 mice, the structural correlates of working memory deficits are to be found in parameters other than the number of neurons in hippocampal CA1 subfield. These findings suggest that SAMP6 mice exhibit selective cognitive deficits and highlight the importance of this mouse model for studying the brain alterations associated with osteoporosis.