Study designSystematic review with meta-analysis.ObjectivesTo evaluate the effects of enhanced recovery after surgery (ERAS) on the postoperative recovery of patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA).MethodsThe PubMed, Embase, Cochrane and ISI Web of Science databases were searched to identify literature including randomised controlled trials (RCTs), cohort studies and case–control studies through 2 May 2018. The analysed outcomes were mortality rate, transfusion rate, range of motion (ROM), 30-day readmission rate, postoperative complication rate and in-hospital length of stay (LOS).ResultsA total of 25 studies involving 16 699 patients met the inclusion criteria and were included in the meta-analysis. Compared with conventional care, ERAS was associated with a significant decrease in mortality rate (relative risk (RR) 0.48, 95% CI 0.27 to 0.85), transfusion rate (RR 0.43, 95% CI 0.37 to 0.51), complication rate (RR 0.74, 95% CI 0.62 to 0.87) and LOS (mean difference (MD) −2.03, 95% CI −2.64 to −1.42) among all included trials. However, no significant difference was found in ROM (MD 7.53, 95% CI −2.16 to 17.23) and 30-day readmission rate (RR 0.86, 95% CI 0.56 to 1.30). There was no significant difference in complications of TKA (RR 0.84, 95% CI 0.34 to 2.06) and transfusion rate in RCTs (RR 0.66, 95% CI 0.15 to 2.88) between the ERAS group and the control group.ConclusionsThis meta-analysis showed that ERAS significantly reduced the mortality rate, transfusion rate, incidence of complications and LOS of patients undergoing TKA or THA. However, ERAS did not show a significant impact on ROM and 30-day readmission rate. Complications after hip replacement are less than those of knee replacement, and the young patients recover better.Level of evidenceLevel 1.
It is of vital importance to engineer the surface structures of carbon dots (CDs) to satisfy their practical biomedical applications, including imaging and treatment.
Solid-state fluorescence sensing is one of the most appealing detection techniques because of its simplicity and convenience in practical operation. Herein, we report the development of a red-emitting carbon dots (RCDs)-based material as a solid-state fluorescence sensor for the selective probing of gaseous ammonia. The RCDs were prepared by a low-cost, one-step carbonization method using sugar cane bagasse as the carbon precursor. The pristine RCDs were then directly coated on polyvinylidene fluoride membrane to produce a new fluorescence sensor capable of selectively distinguishing toxic gaseous ammonia from other analyte vapors through sensitive fluorescence quenching with a low detection limit. More importantly, the interfacial response mechanism occurring on the surface of the RCDs has been studied by X-ray photoelectron spectroscopy, Fourier-transform infrared spectroscopy, and Raman measurements. The results indicate that fluorescence quenching in the RCDs might result from ammonia-induced Michael addition through insertion of N into the C=C group and deprotonation of the carboxyl group. To the best of our knowledge, this is the first report that provides clear insight into the mechanism of surface chemistry on CDs in the solid state.
Photodynamic
therapy (PDT) of hypericin (Hyp) is hampered by poor
water solubility and photostability. Incorporation of photosensitizers
into nanocarriers has been designed to solve these issues. Herein,
SWNH-Hyps nanohybrids were first fabricated by loading hypericin on
the surface of single-walled carbon nanohorns (SWNHs) through π–π
interaction and exhibited high solubility and stability in aqueous
water. SWNH-Hyps could be utilized for a single platform for cancer
therapy because it could simultaneously generate enough reactive oxygen
species and hyperthermia using light irradiation. Moreover, the SWNHs
not only improved water solubility, photostability, and therapy effects
of Hyp but also protected it from light degradation. SWNH-Hyps could
effectively ablate 4T1 cells by photodynamic/photothermal synergistic
therapy upon 590 and 808 nm light irradiations compared with PDT.
Furthermore, remarkable tumor cell death as well as tumor growth inhibition
was proved via photothermal therapy and PDT of SWNH-Hyps under 590
and 808 nm light irradiations, which demonstrated that synergistic
anticancer ability of SWNH-Hyps was better than that of free Hyp in
vivo. Such a simple and facile adsorption method improved water solubility
of Hyp and then enhanced its therapy effect, which displays that SWNHs
can be hopefully used in medicines in the future.
The mechanism of the surface chemistry of carbon dots (CDs) is revealed in the solid state by X.‐C. Shen and co‐workers in the Full Paper on Red‐emitting CDs (RCDs) are prepared, and further used to serve as solid‐state fluorescence sensory material for gaseous ammonia. More importantly, they confirm that the fluorescence response of the RCDs results from ammonia‐induced Michael addition via insertion of N into the CC group and deprotonation of the carboxyl group.
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