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Background Hypoxemia represents the most prevalent adverse event during flexible bronchoscopy procedures aimed at foreign body retrieval in pediatric patients; if not expeditiously managed, it carries the potential for cardiac or respiratory arrest. The specific risk factors contributing to the occurrence of hypoxemia during foreign body FB removal via bronchoscopy have yet to be definitively established. Methods This retrospective study included a cohort of 266 pediatric subjects from January 1, 2015, to December 31, 2022, who underwent flexible bronchoscopy for the purpose of FB extraction. In this cohort, the supraglottic airway was used to connect the anesthesia apparatus during the removal procedure. Results In total, 45 of the pediatric patients (16.9%) experienced episodes of hypoxemia during the FB removal procedure. Multivariate analysis revealed that the following factors were significantly associated with the occurrence of hypoxemia: an operation time exceeding 60 min (odds ratio [OR] 8.55; 95% confidence interval [CI] 3.82–19.13), a maximum diameter exceeding 7 mm (OR 5.03; 95% CI, 2.24–11.29), and the presence of radiological evidence indicating pneumonia (OR 2.69; 95% CI, 1.27–5.69). Conclusion During flexible bronchoscopy procedures aimed at FB removal in pediatric patients, there is an increased susceptibility to hypoxemia. Factors including extended operation duration, larger FB dimensions, and radiographic evidence suggestive of pneumonia significantly contribute to a heightened risk of hypoxemia. Key message Factors significantly linked to hypoxemia included an operation time surpassing 60 min, a foreign body with a diameter exceeding 7 mm, and the presence of radiological evidence indicating pneumonia. New knowledge In pediatric bronchoscopy for foreign body removal, prolonged procedures, larger objects, and radiographic signs of pneumonia increase the risk of hypoxemia. Impact Hypoxemic risks in rigid bronchoscopy for foreign body removal have been recognized. Supraglottic airway under a controlled ventilation is a new method to support FB removal with a flexible bronchoscopy. However, the associated risks remain unclear. In this study, we delve into the risks of flexible bronchoscopy in pediatric patients, noting prolonged procedures, larger foreign bodies, and pneumonia signs. No cardiac arrest occurred in patients undergoing a controlled ventilation with supraglottic airway. The findings indicate hypoxemia should be reduced, shortening procedures, treating pneumonia, and prioritizing vigilance with large foreign bodies in pediatric patients.

Background Epidural labor analgesia (ELA) is widely and safely used for labor pain relief. However, it remains unclear whether ELA affects maternal and neonatal outcomes in women suffering from preeclampsia. Methods This study reviewed the medical records of women with preeclampsia at ≥ 28 weeks of gestation between January 2015 and December 2020. The medical records of women were divided into ELA and no analgesia (NA) groups. The primary endpoint was the cesarean section (CS) rate. Secondary endpoints included hypotension, operative vaginal delivery, fetal distress, neonatal intensive care unit admission, and complications. Using multivariate logistic regression analysis and propensity score matching (PSM), the association between ELA and maternal and neonatal outcomes was examined. Results A total of medical records of 686 women were enrolled, with 242 (35.3%) receiving ELA. Of these, 126 (18.4%) had a higher incidence of CS in the ELA group than in the NA group (22.7% vs. 16.0%, P = 0.020). Multivariable analysis indicated greater risks of CS [adjusted Odds Ratio (aOR) = 1.71; 95% CI, 1.07–2.74; P = 0.025] and operative vaginal delivery (aOR = 2.810; 95% CI, 1.379–5.725; P = 0.004) in the ELA group than that of NA group. In the PSM, ELA did not increase the risk of CS (aOR = 1.56; 95% CI, 0.97–2.52; P = 0.067) and OVD (aOR = 2.048; 95% CI, 0.936–4.484; P = 0.073). The secondary endpoints showed no significant differences between the two groups. Conclusion The study indicates an association between ELA and maternal and neonatal outcomes, supporting the safety of ELA in this population.

Postoperative acute kidney injury (AKI) is a common complication that is associated with chronic kidney disease, early postsurgical mortality, and prolonged hospital stays. Preterm neonates who undergo surgery are at risk factors for AKI due to underdeveloped kidneys. To date, little is known about the incidence and perioperative risk factors for AKI in preterm neonates undergoing noncardiac surgery. Preterm neonates who underwent noncardiac surgery between January May 1, 2020, and February 28, 2023, were enrolled in the trial according to the inclusion criteria. Both multivariable and logistic regression analyses were used to analyze the associations between characteristic data and AKI. In total, 106 preterm neonates met the inclusion criteria, and 25 preterm neonates (23.6%) developed postoperative AKI. Multivariate analysis revealed that the factors associated with AKI were gestational age < 32 weeks [OR: 4.88; 95% CI (1.23–19.42)], preoperative sepsis [OR: 3.98; 95% CI (1.29–12.28)], and intraoperative hypotension [OR: 3.75; 95% CI (1.26–11.15)]. Preterm neonates who developed AKI were more likely to have longer hospital length of stays (38 [18,69] days vs. 21[12,46]) and higher medical costs (93,181.6 [620450.0,173,219.0] ￥ vs. 58,134.6 [31015.1,97,224,1) ￥ than neonates who did not develop AKI. Preterm neonates who underwent noncardiac surgery had a high incidence of AKI. Independent risk factors for AKI in preterm neonates who underwent noncardiac surgery were low gestational age, preoperative sepsis, and intraoperative hypotension. Preterm neonates who developed AKI were more likely to have longer hospital stays and higher medical costs.

Background The transversus abdominis plane (TAP) block in conjunction with intrathecal morphine has been demonstrated to provide more superior postcesarean analgesia to intrathecal morphine alone. However, the analgesia efficacy of their conjunction has not been demonstrated in patients with severe pre-eclampsia. The study aimed to compare the postcesarean analgesia of TAP block in conjunction with intrathecal morphine versus intrathecal morphine alone in women with severe pre-eclampsia. Methods Pregnant women with severe pre-eclampsia undergoing planned cesarean section were randomly allocated into 2 groups to receive TAP block with 20 ml of 0.35% Ropivacaine (TAP group) or with the same volume of 0.9% saline (Sham group) after undergoing elective cesarean section under spinal anaesthesia with 15 mg of 0.5% Ropivacaine plus 0.1 mg of morphine. The outcomes for this analysis include the visual analog scale (VAS) pain score at rest and with movement at 4,8,12,24 h after TAP block was performed, times of use of intravenous patient-controlled analgesia (PCA) within 12 h after anesthesia, the occurrence of maternal side effects, maternal satisfaction, and Apgar score at 1 and 5 min of newborns. Results 119 subjects receive TAP block with 0.35% Ropivacaine (n = 59)or 0.9% saline (n = 60). At 4,8, 12 h after TAP block, the TAP group reported lower VAS score at rest [at 4 h: 1(0,1) vs. 1(1,2), P < 0.001 ; at 8 h:1(1,1) vs. 1(1.5,2), P < 0.001 ; at 12 h:1(1,2) vs. 2(1,2), P = 0.001 ] and higher satisfaction [53(89.9%) vs.45(75.0%), P < 0.05 ]. There were no differences between groups in VAS score at 24 h at rest and at all time points above with movement, times of use of PCA within 12 h after anesthesia, maternal side-effect, and Apgar score at 1 and 5 min of newborns. Conclusions In conclusion, The TAP block performed in conjunction with intrathecal morphine may not reduce opioid consumption, but it could reduce VAS scores at rest in the first 12 h after cesarean section in women with severe pre-eclampsia, and improve maternal satisfaction, which is worthy of clinical promotion. Trial registration Registered at Chinese Clinical Trial Registry( http://www.chictr.org.cn ) on 13/12/2021: ChiCTR2100054293.

Background Reintubation is a severe complication during foreign body (FB) removal that uses flexible bronchoscopy. Objective To investigate the incidence and risk factors for reintubations in children undergoing FB extraction by flexible bronchoscopy in a single center. Design A retrospective cross-sectional study. Setting All children with foreign body aspiration at Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University from January 2015 to December 2020. Patients Children with FB removal using a flexible bronchoscopy were enrolled in the trial according to the inclusion criteria. Measurements Both multivariable and logistic regression analyses were used to analyze the association between characteristic data and reintubations. The results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Results In total, 244 patients met with the inclusion criteria and were included in the analysis. Among those participants, 28 children (11.5%) underwent reintubations after FB removal by flexible bronchoscopy. Independent factors associated with reintubations were identified as operative time ≥ 60 min [OR: 3.68, 95% CI (1.64–8.82)] and ASA ≥ III [OR: 5.7, 95% CI (1.23–26.4)]. Conclusions Children undergoing FB removal by a flexible bronchoscopy may encounter with a high incidence of postoperative reintubations. Both long operative duration and a severe physical status cause a growing risk of reintubations.

Effective and safe sedation with rapid recovery remains a critical unmet need for pediatric patients undergoing contrast-enhanced computed tomography (contrast-enhanced CT). We compared the efficacy of intranasal dexmedetomidine (DEX) combined with intravenous propofol (D-P) versus DEX with buccal midazolam (D-M) for sedation during pediatric contrast-enhanced CT. In this single-center, prospective, randomized controlled trial, 110 children (6 months-6 years, ASA I/II) were allocated to D-M (2 μg/kg intranasal DEX + 0.2 mg/kg buccal midazolam) or D-P (2 μg/kg intranasal DEX + 1 mg/kg intravenous propofol). Primary outcome was one-time success rate (completed contrast-enhanced CT without additional sedation). Secondary outcomes included onset time, recovery metrics (Ramsay Sedation Scale [RSS] at 30 minutes, time to oral intake), and adverse events. Analyses followed full-analysis-set (FAS) and per-protocol-set (PPS) principles (ChiCTR2300067469). The D-P group demonstrated superior one-time success rates in both FAS (96.4% vs 74.5%; OR 9.05, 95% CI 1.95-42.05, =0.001) and PPS analyses (96.4% vs 77.1%; OR 7.88, 95% CI 1.65-37.6, =0.003). Sedation onset was faster with D-P (median 17 vs 20 minutes, < 0.001), with 98.2% achieving sleep within 20 minutes versus 54.5% for D-M. Recovery was accelerated in D-P: 61.8% attained RSS ≤3 by 30 minutes (vs 30.9%, < 0.001), and 77.3% resumed oral intake within 1 hour (vs 25.4%, < 0.001). Bradycardia occurred more frequently with D-P (29.1% vs 5.4%, =0.001), but no interventions were required. Intranasal dexmedetomidine combined with propofol significantly improves sedation success, accelerates recovery, and reduces procedural delays in pediatric contrast-enhanced CT compared to midazolam, offering a clinically advantageous regimen for short-duration imaging.

Atomic energy is an important part of current energy resources. Production of nuclear weapons and applications of nuclear fuels in nuclear power plants have accumulated numerous spent fuels containing 238U compounds, which are critical nuclear materials. How to reduce the nuclear wastes and to make use of the spent uranium are key scientific issues of environmental and nuclear science. We have reviewed here the physiochemical properties and photocatalytic mechanisms of homogeneous and heterogeneous uranium-containing materials. The current research efforts demonstrate that spent fuels can become prom- ising new photocatalytic materials.

Background： Apoptosis of endothelial cells （ECs） plays a key role in the development of atherosclerosis and there are also evidence indicated that phosphatase and tensin homolog deleted on chromosome 10 （PTEN） is a viable target in therapeutic approaches to prevent vascular ECs apoptosis. Aberrant miR-106b-5p expression has been reported in the plasma of patients with unstable atherosclerotic plaques. However, the role and underlying mechanism of miR-106-5p in the genesis of atherosclerosis have not been addressed. In this study, we explored the anti-apoptotic role of miR-106-5p by regulating PTEN expression in vascular ECs. Methods： Real-time reverse transcription polymerase chain reaction （RT-PCR） was performed to detect the expression levels of miR-106b-5p in human atherosclerotic plaques and normal vascular tissues. Human umbilical vein endothelial cells （HUVEC） were transfected with miR-106b-5p mimic or negative control mimic, and apoptosis was induced by serum starvation and tumor necrosis factor-α （TN F-α） treat. Western blotting and real-time RT-PCR experiments were used to detect PTEN expression levels and TN F-α-induced apoptosis was evaluated by the activation of caspase-3 and cell DNA fragmentation levels in HUVEC. Results： The expression ofmiR-106b-5p was significantly downregulated in plaques than in normal vascular tissues. TNF-α significantly downregulated miR-106b-5p expression levels and upregulated activation of caspase-3 and cell DNA fragmentation levels in HUVEC. Overexpression ofmiR-106b-5p with miR-106b-5p mimic inhibited PTEN expression and TNF-α-induced apoptosis in HUVEC. Luciferase reporter assays confirmed that miR-106b-5p binds to PTEN mRNA 3＇ untranslated region site, Conclusion： MiR-106b-5p could inhibit the expression of PTEN in vascular ECs, which could block TNF-α-induced activation of caspase-3, thus prevent ECs apoptosis in atherosclerosis diseases.

Near-infrared （NIR） persistent-luminescence nanoparticles have emerged as a new class of background-free contrast agents that are promising for in vivo imaging. The next key roadblock is to establish a robust and controllable method for synthesizing monodisperse nanoparticles with high luminescence brightness and long persistent duration. Herein, we report a synthesis strategy involving the coating/etching of the SiO2 shell to obtain a new class of small NIR highly persistent luminescent ZnGa2O4：Cr^3＋,Sn^4＋（ZGOCS） nanoparticles. The optimized ZGOCS nanoparticles have an excellent size distribution of -15 nm without any agglomeration and an NIR persistent luminescence that is enhanced by a factor of 13.5, owing to the key role of the SiO2 shell in preventing nanoparticle agglomeration after annealing. The ZGOCS nanoparticles have a signal-to-noise ratio -3 times higher than that of previously reported ZnGa204：Cr^3＋ （ZGC-1） nanoparticles as an NIR persistent-luminescence probe for in vivo bioimaging. Moreover, the persistent-luminescence signal from the ZGOCS nanoparticles can be repeatedly re-charged in situ with external excitation by a white light- emitting diode; thus, the nanopartides are suitable for long-term in vivo imaging applications. Our study suggests an improved strategy for fabricating novel high-performance optical nanoparticles with good biocompatibility.

Aim： To improve the therapeutic efficacy of cancer treatments, combinational therapies based on nanosized drug delivery system （NDDS） has been developed recently. In this study we designed a new NDDS loaded with an anti-metastatic drug silibinin and a photothermal agent indocyanine green （ICG）, and investigated its effects on the growth and metastasis of breast cancer cells in vitro. Methods： Silibinin and ICG were self-assembled into PCL lipid nanoparticles （SIPNs）. Their physical characteristics including the particle size, zeta potential, morphology and in vitro drug release were examined. 4T1 mammalian breast cancer cells were used to evaluate their cellular internalization, cytotoxicity, and their influences on wound healing, in vitro cell migration and invasion. Results： SIPNs showed a well-defined spherical shape with averaged size of 126.3＋0.4 nm and zeta potential of -10.3＋0.2 mV. NIR laser irradiation substantially increased the in vitro release of silibinin from the SIPNs （58.3% at the first 8 h, and 97.8% for the total release）. Furthermore, NIR laser irradiation markedly increased the uptake of SIPNs into 4T1 cells. Under the NIR laser irradiation, both SIPNs and IPNs （PCL lipid nanoparticles loaded with ICG alone） caused dose-dependent ablation of 4T1 cells. The wound healing, migration and invasion experiments showed that SIPNs exposed to NiR laser irradiation exhibited dramatic in vitro anti-metastasis effects. Conclusion： SIPNs show temperature-sensitive drug release following NIR laser irradiation, which can inhibit the growth and metastasis of breast cancer cells in vitro.