Central venous catheter (CVC) insertion is difficult to perform and is a high-risk operation; ultrasound (US)-guided cannulation helps increase the odds of success while reducing the associated ...complications. The internal jugular vein (IJV) and subclavian vein (SCV) are the most commonly sites in US-guided CVC insertion. In the present study, we evaluated the safety and efficacy of US-guided supraclavicular right brachiocephalic vein (BCV) cannulations in adult patients.Between January 2016 and December 2017, 428 adult patients requiring 536 CVC insertions underwent ultrasound-guided right BCV cannulation. The success rate and complications related to indwelling catheters were analyzed.The technical success rate was 98.32% (527/536). The procedure was successful at the first try in 511 cases (95.34%). The mean operation time was 13.26 ± 3.34 minutes. The mean length of catheter introduction was 13.57 ± 3.53 cm. Incidence of intraoperative complications was 2.61%. For 3 patients, the procedure was terminated due to pneumothorax (PNX), and in 11 arterial punctures there were self-limiting hematomas. The incidence of postprocedure complications was 5.97% (32/536). These complications included catheter-related infections (n = 18) and thromboses (n = 14). Insertion lasted an average of 10.68 ± 8.77 days.Supraclavicular, in-plane, US-guided cannulation of the right BCV is an effective and safe method for inserting central venous catheters in adult patients. It provides another option for catheter access to boost clinical performance in central venous catheterization.
Traumatic lymphatic leakage is a rare but potentially life-threatening complication. The purpose of this study was to introduce ultrasound-guided intranodal lymphangiography and embolisation ...techniques for postoperative lymphatic leakage in patients with cancer.
From January 2018 through June 2020, seven cancer patients (three males, four females, aged 59-75 years mean 67.57 ± 6.11 years) developed lymphatic leakage after abdominal or pelvic surgery, with drainage volumes ranging from 550 to 1200 mL per day. The procedure and follow-up of ultrasound-guided intranodal lymphangiography and embolisation were recorded. This study retrospectively analysed the technical success rate, operative time, length of hospital stay, clinical efficacy, and complications.
The operation was technically successful in all patients. Angiography revealed leakage, and embolisation was performed in all seven patients (7/7, 100%). The operative time of angiography and embolisation was 41 to 68 min, with an average time of 53.29 ± 10.27 min. The mean length of stay was 3.51 ± 1.13 days. Lymph node embolisation was clinically successful in five patients (5/7, 71.43%), who had a significant reduction in or disappearance of chylous ascites. The other two patients received surgical treatment 2 weeks later due to poor results after embolisation. All patients were followed for 2 weeks. No serious complications or only minor complications were found in all the patients.
Ultrasound-guided intranodal lymphangiography and embolisation were well tolerated by the patients, who experienced a low incidence of complications. Early intervention is recommended for cancer patients with postoperative lymphatic leakage.
To compare the efficacy and safety of right internal jugular vein (IJV) approach and right innominate vein (INV) approach for US-guided totally implantable venous access devices (TIVADs), and to ...explore the advantages and disadvantages of the two approaches.
Six hundred and nineteen adult patients had long-term infusion and chemotherapy needs and inconvenience of peripheral venous infusion. Right INV approach was used to implant 339 cases of TIVADs, and right IJV approach was used to implant 280 cases of TIVADs. The success rate of one-time catheterization and the incidence of complications in the two groups were retrospectively analyzed.
All patients were successfully implanted in TIVAD. The success rates of one-time puncture in INV group and IJV approach group were 98.53% (334/339) and 95.36% (267/280), respectively. There was significant difference between the two groups (P = 0.020). The incidence of perioperative complications and long-term complications in the right INV group were 1.18% (4/339) and 3.54% (12/339), respectively, while those in the right IJV group were 1.43% (4280) and 3.93% (11280). There was no significant difference in the incidence of perioperative or long-term complications between the two groups (P = 0.785, P = 0.799, respectively).
US-guided TIVADs via the right INV approach and the right IJV approach are both safe and reliable. The right INV approach improves the one-time puncture success rate, as long as the technique is properly operated, serious complications rarely occur.
With the widespread adoption of ultrasound guidance, Seldinger puncture techniques, and intracardiac electrical positioning technology for the placement of peripherally inserted central catheters in ...recent years, an increasing number of medical staff and patients now accept peripheral placement of totally implantable venous access devices (TIVADs) in the upper arm. This approach has the advantage of completely avoiding the risks of hemothorax, pneumothorax, and neck and chest scarring. Medical specialties presently engaged in this study in China include internal medicine, surgery, anesthesiology, and interventional departments. However, command over implantation techniques, treatment of complications, and proper use and maintenance of TIVAD remain uneven among different medical units. Moreover, currently, there are no established quality control standards for implantation techniques or specifications for handling complications. Thus, this expert consensus is proposed to improve the success rate of TIVAD implantation via the upper-arm approach, reduce complication rates, and ensure patient safety. This consensus elaborates on the technical indications and contraindications, procedures and technical points, treatment of complications, and the use and maintenance of upper-arm TIVAD, thus providing a practical reference for medical staff.
Agaricus sinodeliciosus is an edible species described from China and has been successfully cultivated. However, no studies have yet reported the influence factors implicated in the process of ...fructification. To better know abiotic and biotic factors, physiochemical characteristics and microbial communities were investigated in five different soil samples collected in the native habitats of specimens from northern Xinjiang, southern Xinjiang, and Zhejiang Province, respectively. There are major differences in texture and morphology among different specimens of A. sinodeliciosus from Xinjiang Province. A. sinodeliciosus from southern Xinjiang was the largest. Concentrations of DOC and TN and C/N ratio are not the main reason for the differences. Microbial communities were analyzed to find out mushroom growth promoting microbes (MGPM), which may lead to the differences. Functional microbes were picked out and can be divided into two categories. Microbes in the first category may belong to MGPM. There may be symbiotic relationships between microbes in the second category and A. sinodeliciosus. Certain analyses of microbial communities support the hypothesis that interactions between microbes and mushrooms would be implicated in morphological variation of the collected mushrooms. Redundancy analysis results indicate that high DOC/NH
-N ratio and NH
-N concentration can improve the yield of A. sinodeliciosus.
ABSTRACT Introduction: The study aims to compare the accuracy and safety of robotic-assisted navigation puncture to freehand puncture during computed tomography (CT)-guided percutaneous needle ...insertion in the chest and abdomen. Methods: A total of 60 patients required percutaneous puncture procedures, with 40 involving the chest and 20 involving the abdomen. Eligible patients were randomly assigned to two groups. The test group punctured using a robotic-assisted navigation system, whereas the control group punctured manually. The primary outcome assessment standards are single puncture success rates, with the number of needle modifications and CT scan timings during the procedure serving as supplementary outcome evaluation standards. The Wilcoxon rank sum test is used for the comparison. Results: The puncture procedure’s success rates after just one puncture: The test group punctures accurately without adjusting the puncture needle, while the control group uses an average number of 1.73 ± 1.20 pins. The once-puncture success rate of robot navigation puncture is considerably higher than that of bare-handed puncture ( P < 0.001). The times of CT scan are necessitated when the puncture is in place: the average times in the test group is 3.03 ± 0.18 times, while the control group is 4.70 ± 1.24 times. Conclusion: In conclusion, the robotic-assisted navigation system improves puncture accuracy while reducing the need for needle corrections during percutaneous puncture procedures. It also shortens CT scans and reduces radiation exposure from X-rays.
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•A highly effective and non-invasive magnetic thermal ablation (MTA) scheme for hepatocellular carcinoma HCC was proposed in the research.•Polyacrylamide (PAM) and ferric oxide ...(Fe3O4) were utilized to prepare uniformly sized PAM@Fe3O4 microspheres with good biosecurity and excellent eddy current heating effects.•We studied the Impact of MTA on the immune system and investigated the synergistic antitumor mechanisms of MTA and PD-1 mAb combined therapy.•Efficient MTA therapy in a rabbit VX2 in situ liver tumor model by precisely embolizing PAM@Fe3O4 microspheres into tumor-feeding arteries under DSA were conducted.•The aim of research is to provide new strategies for clinical HCC treatment, promoting the transition from image-guided percutaneous minimally invasive ablation to noninvasive ablation.
Hepatocellular carcinoma (HCC) are some of the most difficult malignant tumors to treat, due to their high rates of metastasis and recurrence. Image-guided percutaneous ablation, which serves as an important means in HCC treatment. However, drawbacks such as puncture injury, metastasis, and a limited ablation range still exist. Therefore, A highly effective and non-invasive magnetic thermal ablation (MTA) scheme for HCC was proposed by precisely embolizing magnetic microspheres into tumor-feeding arteries. In this study, polyacrylamide (PAM) and ferric oxide (Fe3O4) were utilized to prepare uniformly sized PAM@Fe3O4 microspheres with excellent eddy current heating effects. Additionally, a combined approach of MTA and immunotherapy was suggested. MTA combined with immune checkpoint blockade therapy efficiently ablated primary tumors and inhibited simulated metastatic tumors in mice. Further arterial embolization experiments in rabbit ears and renal arteries demonstrated the effective retention of PAM@Fe3O4 microspheres in blood vessels for MTA. Finally, we successfully applied PAM@Fe3O4 microspheres for efficient MTA therapy in a rabbit VX2 in situ liver tumor model. The aim of research is to provide new strategies for clinical HCC treatment, promoting the transition from image-guided percutaneous minimally invasive ablation to noninvasive ablation. This significant transition holds the potential for clinical applicability.
•By measuring the dielectric properties of 2D confined water and analyzing the relaxation process, the permeation rate of water and the performance of alcohol-water separation can be ...predicted.•Cationic intercalation can modulate the viscosity of 2D confined water, further impacting water permeation.•Compared with other characterization, dielectric spectroscopy shows the potential for accurate prediction on water permeation without the need of subtracting the adsorbed water.•The prediction on separation performance by dielectric analysis shows universality for other 2D membranes.
Attributed to the growing demands for biomass fuels, the alcohol-water separation membranes, particularly the two-dimensional (2D) lamellar structures with high permeability and selectivity have attracted increasing attention. However, owing to the limited tools available for investigating the mass transport in the 2D nanocapillaries, the development of separation membranes mainly relied on theoretical prediction and a summary of experimental performance. In this work, we present an in-operando dielectric study on the pristine and varied ion-crosslinked 2D membranes for alcohol-water separation to establish the relationship between the relaxation process and the separation performance of the membranes. We found that the dielectric relaxation process in the range of 10−2 to 102 Hz, which is related to the viscosity of water in 2D nanocapillaries, can act as an indicator of the separation performance of the membranes. Furthermore, the slowing down of the relaxation process due to the electric field around the cations indicates lower water permeance and separation factor. Compared to the previous characterizations on the surface hydrophilicity or the water absorption, monitoring the dielectric process directly offers insights into the interlayered molecular states and transport, and therefore opens a new avenue towards rational design of 2D selective membranes for alcohol-water separation.
We prepared peapod-like titanium dioxide@graphene@carbon (TiO2@GO@C) nanofiber membranes through electrospinning. Due to the porous structure, large surface area, abundant surface functional groups ...and excellent thermal conductivity, GO can capsulize TiO2 nanoparticles to form a pea-like TiO2@GO structure. Subsequently, TiO2@GO can be wrapped by the carbon nanofiber during an electrospinning process, forming peapod-like TiO2@GO@C nanofiber membranes. The existence of a peapod-like structure is beneficial for enhancing the crystallinity of TiO2, and preventing the phase transformation of TiO2 from anatase to rutile phase at the same time. Furthermore, on the basis of the excellent carrier transport property of GO, the peapod-like TiO2@GO@C structure could also improve the light absorption, reduce recombination of hole–electron pairs, and improve the carrier transport and finally photocatalytic degradation property of methylene blue. Besides, the pea-like TiO2@GO structure shows a dispersion strengthening effect in the carbon nanofibers, preventing the carbon nanofibers from fracture. In particular, by optimizing the heat treatment temperature and additional amount of GO, the peapod-like TiO2@GO@C nanofiber membranes with 0.3 wt% GO show an excellent photocatalytic degradation efficiency of 98.5% in 3 h, and a high strength of 356.07 cN per dtex.
Totally implantable venous access ports (TIVAPs) are widely used and are an essential tool in the efficient delivery of chemotherapy. This study aimed to evaluate the feasibility and safety of ...implantation of ultrasound (US)-guided TIVAPs via the right innominate vein (INV) for adult patients with cancer.
This study retrospectively reviewed the medical records of 283 adult patients with cancer who underwent US-guided INV puncture for TIVAPs between September 2015 and September 2017. It also analysed the technical success rate, operation time, and short-term and long-term surgical complications.
Technical success was achieved in all patients (100%). The mean operation time was 28.31 ± 7.31 min (range: 23–39 min), and the puncture success rate for the first attempt was 99.30% (281/283). Minor complications included artery puncture during the operation in one patient, but no pneumothorax was encountered. The mean TIVAP time was 304.16 ± 42.54 days (range: 38–502 days). The rate of postoperative complications was 2.83% (8/283), including poor healing of the incision in one patient, catheter-related infections in three patients, port thrombosis in one patient, and fibrin sheath formation in three patients; no catheter malposition, pinch-off syndrome, catheter fracture, or other serious complications were observed.
TIVAPs are widely employed for chemotherapy. The present study found that the novel approach of using US-guided INV puncture to implant TIVAPs in adult patients with cancer is both short-termly feasible and safe for long-term central venous access.
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