Brain relaxation using desflurane anesthesia and total intravenous anesthesia in patients undergoing craniotomy for supratentorial tumors: a randomized controlled study

Abstract Background Satisfactory brain relaxation is essential in neurosurgery. Desflurane anesthesia and propofol-based total intravenous anesthesia (TIVA) have different effects on cerebral hemodynamics, potentially contributing to discrepant brain relaxation. The purpose of this study was to compare the effects of desflurane and TIVA on brain relaxation in patients undergoing craniotomy for supratentorial tumors. Methods In this randomized, controlled study, we enrolled patients aged 18–60 years, with ASA I–III, who were scheduled to undergo elective craniotomy for supratentorial tumors. Patients were randomly assigned in a 1:1 ratio to receive desflurane anesthesia or TIVA. The primary outcome was the proportion of satisfactory brain relaxation. Secondary outcomes included emergence and extubation times, recovery of cognitive function and postoperative complications. Results Of 369 patients who were assessed for eligibility, 111 were randomized and 110 were included in the modified intention-to-treat analysis (55 in the desflurane group and 55 in the TIVA group). The proportion of satisfactory brain relaxation was similar between the two groups: 69% in the desflurane group and 73% in the TIVA group (RR: 0.950, 95% CI: 0.748–1.207; P = 0.675). Patients assigned to the desflurane group had shorter emergence (10 [8–13] min vs. 13 [10–20] min, P < 0.001) and extubation times (13 [10–18] min vs. 17 [13–23] min, P < 0.001), and better recovery of cognitive function at 15 min after extubation (16 [0–24] vs. 0 [0–20], P = 0.003), but experienced increased postoperative nausea and vomiting (PONV) (16 [29%] vs. 6 [11%] P = 0.017) and tachycardia (22 [40%] vs. 9 [16%], P = 0.006) during recovery. Conclusions Desflurane anesthesia and TIVA provide similar brain relaxation in patients without intracranial hypertension undergoing elective craniotomy. Desflurane accelerates the recovery from anesthesia but is associated with increased PONV and tachycardia during the recovery period. Trial registration Clinicaltrial.gov (NCT04691128). Date of registration: December 31, 2020

New Potential Biomarker for Methasterone Misuse in Human Urine by Liquid Chromatography Quadrupole Time of Flight Mass Spectrometry

In this study, methasterone urinary metabolic profiles were investigated by liquid chromatography quadrupole time of flight mass spectrometry (LC-QTOF-MS) in full scan and targeted MS/MS modes with accurate mass measurement. A healthy male volunteer was asked to take the drug and liquid–liquid extraction was employed to process urine samples. Chromatographic peaks for potential metabolites were hunted out with the theoretical [M − H]− as a target ion in a full scan experiment and actual deprotonated ions were studied in targeted MS/MS experiment. Fifteen metabolites including two new sulfates (S1 and S2), three glucuronide conjugates (G2, G6 and G7), and three free metabolites (M2, M4 and M6) were detected for methasterone. Three metabolites involving G4, G5 and M5 were obtained for the first time in human urine samples. Owing to the absence of helpful fragments to elucidate the steroid ring structure of methasterone phase II metabolites, gas chromatography mass spectrometry (GC-MS) was employed to obtain structural information of the trimethylsilylated phase I metabolite released after enzymatic hydrolysis and the potential structure was inferred using a combined MS method. Metabolite detection times were also analyzed and G2 (18-nor-17β-hydroxymethyl-2α, 17α-dimethyl-androst-13-en-3α-ol-ξ-O-glucuronide) was thought to be new potential biomarker for methasterone misuse which can be detected up to 10 days

Reversible metal and ligand redox chemistry in two-dimensional iron-organic framework for sustainable lithium-ion batteries

Metal-organic frameworks (MOFs) are emerging as attractive electrode materials for lithium-ion batteries, owing to their fascinating features of sustainable resources, tunable chemical components, flexible molecular skeletons, and renewability. However, they are faced with a limited number of redox-active sites and unstable molecular frameworks during electrochemical processes. Herein, we design a novel two-dimensional (2D) iron(III)-tetraamino-benzoquinone (Fe-TABQ) with dual redox centers of Fe cations and TABQ ligands for high-capacity and stable lithium storage. It is constructed of square-planar Fe-N2O2 linkages and phenylenediamine building blocks, between which the Fe-TABQ chains are connected by multiple hydrogen bonds, and then featured as an extended π-d-conjugated 2D structure. The redox chemistry of both Fe3+ cations and TABQ anions is revealed to render its remarkable specific capacity of 251.1 mAh g-1. Benefiting from the intrinsic robust Fe-N(O) bonds and reinforced Li-N(O) bonds during cycling, Fe-TABQ delivers high capacity retentions over 95% after 200 cycles at various current densities. This work will enlighten more investigations for the molecular designs of advanced MOF-based electrode materials.This work was supported by the National Key R&D Program of China (2022YFB2402200), National Natural Science Foundation of China (52171215), Tianjin Natural Science Foundation (19JCJQJC62400), and Haihe Laboratory of Sustainable Chemical Transformations

Choice of ANesthesia for EndoVAScular Treatment of Acute Ischemic Stroke (CANVAS): Results of the CANVAS Pilot Randomized Controlled Trial.

BackgroundThe effect of choice of anesthesia on clinical outcome for endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) remains unclear.MethodsWe conducted a pilot trial of 43 patients with acute anterior circulation ischemic stroke having EVT. Patients were randomly allocated to receive general anesthesia or conscious sedation. We documented the rate of recruitment and rate of conversion from conscious sedation to general anesthesia. In addition, we recorded the change in National Institute of Health stroke scale (NIHSS) on day 7, the rate of successful reperfusion and measured neurological function by certified researchers using modified Rankin Score (mRS 0 to 2) at 90 days.ResultsThe recruitment rate was 31.4% and majority of patients were excluded because of delay in hospital presentation and posterior circulation stroke. The rate of conversion from conscious sedation to general anesthesia was 18.2%. This was primarily related to excessive sedation and uncontrolled movement. Change in NIHSS score, rate of successful reperfusion and functional recovery were similar between groups.ConclusionsIt was feasible to randomize AIS patients receiving either general anesthesia or conscious sedation for EVT

Controlled Growth of Layered Acentric CdTeMoO₆ Single Crystals with Linear and Nonlinear Optical Properties

Acentric compounds with a layered structure are of current interest owing to their advanced functional properties for technical applications. However, the growth of bulk single crystals of acentric materials with a quasi-two-dimensional structure is challenging, which severely hinders the intrinsic properties investigation and optoelectronic applications of these materials. Herein, we report the controlled growth of bulk CdTeMoO₆ single crystals with a layered structure and the investigation of their linear and nonlinear optical properties. High quality CdTeMoO₆ single crystals with dimensions of ∼26 × 10 × 9 mm³ were successfully grown through the modified top-seeded solution growth method using TeO₂-MoO₃ as a flux. The transparent range of CdTeMoO₆ single crystals is in the range of 0.345–5.40 μm, and with large birefringence (Δ<i>n</i> = <i>n</i>_o – <i>n</i>_e = 0.2868–0.2219 from 514 nm to 1.5467 μm). In addition, the nonlinear optical (NLO) coefficient <i>d</i>₃₆ of CdTeMoO₆ single crystals was measured to be 8.5 pm/V using Maker Fringe techniques. We also found CdTeMoO₆ is type-I phase-matchable based on the calculated phase-matching curves. Our results indicated that CdTeMoO₆ single crystal is an excellent birefringent material combined with a promising NLO material for optoelectronic applications

Polymorphic Smooth Interfaces Formation Based on the Biphasic BaTeMo₂O₉ Using Top Multi-Seeded Growth

An interesting phenomenon of two polymorphic heterojunctions is reported in this paper. The selective growth of the individual phases of high-quality α- and β-BaTeMo₂O₉ (BTM) crystals was successfully achieved using an optimized flux system and growth parameters. A biphasic BTM crystal based on a multiseeding technique used to control the nucleation and subsequent growth was realized in a one-flux system. The formation of a grain boundary, similar to a heterojunction, between the α- and β-BTM crystals emerged as an unavoidable consequence of this process, and the factors that led to the formation of the grain boundaries in the multiseeds were examined. Lattice mismatch and interfacial binding energy calculation verified that the BTM crystals were grown together rather than being physically adhered, and the chains at the grain boundary were linked by O₅Mo–O–MoO₅ dioctahedrons corner-sharing O atoms at the eutectic boundary. The screw dislocation growth mechanism was confirmed for β-BTM with the growth unit of a single cell, as well as the similarities in structures for both phases. Additionally, a “pseudo-liquid-phase epitaxial” growth model was used to describe the formation mechanism of biphasic BTM based on a “virtual supercell” of β-BTM. The successful implementation of polymorphic BTM growth may provide information regarding polymorph control, and the heterojunction between the two polymorphic phases may demonstrate interesting future applications