Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The ...Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.展开更多
BACKGROUND Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures.AIM To focus on how to avoid displacement of the lesser trochanter in unsta...BACKGROUND Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures.AIM To focus on how to avoid displacement of the lesser trochanter in unstable intertrochanteric fractures.METHODS We developed a lesser trochanteric reduction fixator for treating intertrochanteric fractures through fixing the lesser trochanter by combining the loop plate through the fixator after reduction by the reducer.Five patients with intertrochanteric fractures treated with the newly developed lesser trochanteric reduction fixator and loop plate combined with intramedullary nails,and 20 patients with intertrochanteric fractures treated with simple intramedullary nails were selected from December 2020 to March 2021.RESULTS The postoperative Harris hip score was significantly higher in patients treated with the lesser trochanteric reduction fixator than in patients treated without the lesser trochanteric reduction fixator,which indicated that this lesser trochanteric reduction fixator had a positive impact on rehabilitation of the hip joint after surgery and could significantly improve the quality of life of patients.CONCLUSION We fully realize the significance of trochanteric reduction and fixation,namely,reconstruction of structures under pressure,in the treatment of intertrochanteric fractures.As long as the general condition of patients is favorable and they are willing to undergo surgery,fixation of the main fracture end should be performed and the lesser trochanter should be reduced and fixed at the same time.展开更多
Objective: To evaluate the effect of open reduction and internal fixation on radial head fracture and assess the post-operative function. Methods: This prospective observational study was conducted from June 2016 to J...Objective: To evaluate the effect of open reduction and internal fixation on radial head fracture and assess the post-operative function. Methods: This prospective observational study was conducted from June 2016 to July 2017 at Liaquat National Hospital and Medical College, Karachi. Altogether, 28 patients with radial head and neck fractures were enrolled in our study. These patients were admitted to the hospital and their fractures were fixed with open reduction and internal fixation. Baseline information of the patients was collected, and patient-rated elbow evaluation scores were calculated. Results: Out of the 28 patients, 21 were male and 7 were female. Besides, 16 fractures were on the right side and 12 were on the left side and 17 involving the dominant hands. In addition, 8 patients had Mason type Ⅱ fracture and 20 had Mason type Ⅲ fracture. The mean age of patients was (31.0 ± 8.0) years, and the mean follow-up is (1.2 ± 0.5) years. The mean average patient-rated elbow evaluation scores were (27.64 ± 1.60) at 1-year follow-up. Conclusions:The majority of the patients who had radial head fractures and treated by open reduction and internal fixation have attained an excellent range of motion postoperatively.展开更多
Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We ana...Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We analyzed a case series of patients with open reduction and internal fixation (ORIF) for complex acetabular fractures. Two hundred patients (132 men, 68 women) in four age groups including with a mean age of 43.39 ± 6.18 years (range 20 - 59 years) and a mean follow-up of 82.34 ± 12.48 months (range 18 - 109 months) met the inclusion criteria. Functional outcome at final follow-up was graded assessed according to Harris score. Factors affecting were defined. Results: Anatomic reduction was achieved in 192 hips, imperfect in 8 and poor in none. Radiological outcome revealed excellent results in 128 (64%) hips, good in eight, fair in five and none in poor. Harris score were excellent in 139 (69.5%) hips, good in 43 (21.5%) and fair in 18 (9%) and poor in none. The anatomical reduction results had a favorable final functional outcome. (0.003) However, BMI (P Conclusion: Optimal functional and radiological outcomes have been achieved with anatomic postoperative reduction. Also experience of specialist, on time surgery and good recovery lead to receiving excellent functional outcome with at least complications.展开更多
Solar‐driven conversion of carbon dioxide,water and nitrogen into high value‐added fuels(e.g.H_(2),CO,CH_(4),CH_(3)OH,NH_(3) and so on)is regarded as an environmental‐friendly and ideal route for relieving the gree...Solar‐driven conversion of carbon dioxide,water and nitrogen into high value‐added fuels(e.g.H_(2),CO,CH_(4),CH_(3)OH,NH_(3) and so on)is regarded as an environmental‐friendly and ideal route for relieving the greenhouse gas effect and countering energy crisis,which is an attractive and challenging topic.Hence,various types of photocatalysts have been developed successively to meet the requirements of these photocatalysis.Among them,cobalt‐based heterogeneous catalysts emerge as one of the most promising photocatalysts that open up alluring vistas in the field of solar‐to‐fuels conversion,which can effectively enhance photocatalytic efficiency by extending light absorption range,promoting charge separation,providing active sites,and lowering reaction barrier.In this review,we first present the working principles of cobalt‐based heterogeneous catalysts for photocatalytic water splitting,CO_(2) reduction,and N_(2) fixation.Second,five efficient strategies including surface modification,morphology modulation,crystallinity controlling,crystal engineering and doping,are discussed for improving the photocatalytic performance with different types cobalt‐based catalysts(cobalt nanoparticles and single atom,oxides,sulfides,phosphides,MOFs,COFs,LDHs,carbide,and nitrides).Third,we outline the applications for the state‐of‐the‐art photocatalytic CO_(2) reduction and water splitting,and nitrogen fixation over cobalt‐based heterogeneous catalysts.Finally,the central challenges and possible improvements of cobalt‐based photocatalysis in the future are presented.The purpose of this review is to summarize the past experience and lessons,and provide reference for the further development of cobalt‐based photocatalysis technology.展开更多
The development of high‐performance nonprecious metal catalysts(NPMCs)to supersede Pt‐based catalysts for the oxygen reduction reaction(ORR)in polymer electrolyte membrane fuel cells is highly desirable but remains ...The development of high‐performance nonprecious metal catalysts(NPMCs)to supersede Pt‐based catalysts for the oxygen reduction reaction(ORR)in polymer electrolyte membrane fuel cells is highly desirable but remains challenging.In this paper,we present a pyrolysis strategy for spatial confinement and active‐site fixation using iron phthalocyanine(FePc),phthalocyanine(Pc)and Zn salts as precursors.In the obtained carbon‐based NPMC with a hierarchically porous nanostructure of thin‐layered carbon nanosheets,nearly 100%of the total Fe species are Fe^(Ⅱ)‐N_(4) active sites.In contrast,pyrolyzing FePc alone forms Fe‐based nanoparticles embedded in amorphous carbon with only 5.9%Fe^(Ⅱ)‐N_(4) active sites.Both experimental characterization and density functional theory calculations reveal that spatial confinement through the staggeredπ–πstacking of Pc macrocycles effectively prevents the demetallation of Fe atoms and the formation of Fe‐based nanoparticles via aggregation.Furthermore,Zn‐induced microporous defects allow the fixation of Fe^(Ⅱ)‐N_(4) active sites.The synergistic effect of staggered stacking confinement and microporous defect fixation results in a high density of atomic Fe^(Ⅱ)‐N_(4) active sites that can enhance the ORR.The optimal Fe^(Ⅱ)‐N_(4)‐C electro‐catalyst outperforms a commercial Pt/C catalyst in terms of half‐wave potential,methanol toler‐ance,and long‐term stability in alkaline media.This modulation strategy can greatly advance efforts to develop high‐performance NPMCs.展开更多
Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children...Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.展开更多
The incidence of metatarsal fractures is not precisely known. Malposition might cause future metatarsalgia, mid-foot pain and discomfort, which may dictate an on-going need for in-shoe orthosis, shoe modification and,...The incidence of metatarsal fractures is not precisely known. Malposition might cause future metatarsalgia, mid-foot pain and discomfort, which may dictate an on-going need for in-shoe orthosis, shoe modification and, occasionally, operative correction. To minimize and prevent these problems, we describe a simple technique for reduction and fixation of metatarsal fractures by Kirschner wires. We have found this technique to be a simple and efficient way of reducing and fixing metatarsal fractures. It is applied easily by the closed and open technique.展开更多
Objective． An internal fixation apparatus—— distraction reduction fixation system(DRFS) was designed to satisfy the clinical needs for spondylolisthesis. Methods. Since 1996, 53 patients were treated with DRFS. Amo...Objective． An internal fixation apparatus—— distraction reduction fixation system(DRFS) was designed to satisfy the clinical needs for spondylolisthesis. Methods. Since 1996, 53 patients were treated with DRFS. Among them, 35 had spondylolisthesis, 12 had lumbar canal stenosis accompanied with instability, 2 had vertebral tumors and 4 suffered from spinal fracture. The average age was 53.6 years old (ranged 24～ 72yrs). The mean time for follow- up was 30.6 months (16～ 44 months). Results． The slip rate was 0.15± 0.10 before operation, and decreased to 0.09± 0.07 after operation. Entire slip reposition was achieved in 19 cases (54.3％ ). The change in height of the intervertebral space within the fixation segments was 0.7± 0.17. Conclusion． DRFS achieved better results for spondylolisthesis less II degree and no other adverse effects were found. Compared with other foreign and domestic techniques, it had advantages in less implants, less operation gears required and ease to utilize in operation. It was proved to be an ideal internal fixation apparatus.展开更多
Objective:To study the clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures.Methods:From June 2013 to June 2014,100 patients with thoracolumbar ...Objective:To study the clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures.Methods:From June 2013 to June 2014,100 patients with thoracolumbar fractures were selected as the subjects and they were randomly divided into observation group(50 cases)and control group(50 cases).The patients in the observation group were treated with minimally invasive singlesegment reduction and internal fixation.The patients in the control group were treated with short segmental fixation.The clinical effects of the two groups were compared.Results:There was no significant difference in the compression rate and Cobb angle between the two groups before and after operation(P>0.05).For all patients who were followed up for the last time,the Cobb angle was significantly lower in the observation group than in the control group(P<0.05).The social function,affective function and physical pain score of the observation group were significantly better than the control group(P<0.05).The amount of bleeding in the observation group was(250.4±41.0)ml,which was significantly lower than that in the control group(267.5±32.8)ml.The time required for the operation was(90.2±35.4)min,which was significantly lower than that of the control group(104.5±22.6)min(P<0.05).After treatment,the prognosis was 70.00%and the excellent and good rate was 98.00%,which was significantly higher than that of the control group(46.00%)and 78.00%(P<0.05).Conclusion:Thoracolumbar fractures in patients with dilated channel minimally invasive single-segment reduction and internal fixation treatment can effectively repair the patient's vertebral height and Cobb angle and the degree of correction after surgery was significantly better,safer and worthy of clinical recommended use.展开更多
The failure mechanism of two-dimensional（2D） and three-dimensional（3D） slopes were investigated by using the strength reduction method.An extensive study of 3D effect was conducted with respect to boundary conditi...The failure mechanism of two-dimensional（2D） and three-dimensional（3D） slopes were investigated by using the strength reduction method.An extensive study of 3D effect was conducted with respect to boundary conditions,shear strength and concentrated surcharge load.The results obtained by 2D and 3D analyses were compared and the applicable scope of 2D and 3D method was analyzed.The results of the numerical simulation show that 3D effect is sensitive to the width of slip surface.As for slopes with specific geometry,3D effect is influenced by dimensionless parameter c/（γHtanφ）.For those infinite slopes with local loading,external load has the major impact on failure mode.For those slopes with local loading and geometric constraints,the failure mode is influenced by both factors.With the increase of loading length,boundary condition exerts a more significant impact on the failure mode,and then 2D and 3D stability charts are developed,which provides a rapid and reliable way to calculate 2D and 3D factor of safety without iteration.Finally,a simple and practical calculation procedure based on the study of 3D effect and stability charts is proposed to recognize the right time to apply 2D or 3D method.展开更多
Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We...Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library,PubMed,Embase,VIP database,CNKI,and Wanfang data-base with keywords"acetabular fracture","3D printing","three-dimensional printing","open reduction and internal fixation","Acetabulum","Acetabula"from January 2000 to March 2020.Two reviewers independently selected articles,extracted data,assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’s tools and/or Newcastle-Ottawa scale.When the two analysts had different opinions,they would ask the third analyst for opinion.Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF(3D printing group)versus traditional ORIF(conventional group)in the treatment of acetabular fractures were selected.The data of operation time,intraoperative blood loss,intraoperative fluoroscopy times,incidence of complications,excellent and good rate of Matta score for reduction,and excellent and good rate of hip function score were extracted.Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected,including 5 randomized controlled trials and 4 retrospective studies.A total of 467 patients were analyzed,250 in the conventional group,and 217 in the 3D printing group.The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant(standardized mean difference(SMD)=-1.19,95%CI:-1.55 to-0.82,p<0.05).The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group(SMD=-1.08,95%CI:-1.65 to-0.51,p<0.05).The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant(SMD=-1.64,95%CI:-2.35 to-0.93,p<0.05).The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group(OR=0.43,95%CI:0.24-0.79,p<0.05).There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups(OR=0.60,95%CI:0.34-1.06,p>0.05).There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups(OR=0.84,95%CI:0.46-1.56,p>0.05),but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF,3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively,but also effectively reduces operation time,intraoperative blood loss,intraoperative fluoroscopy times,and postoperative complications.However,there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.展开更多
Electrochemical nitrogen reduction(NRR)is deemed as a consummate answer for the traditional Haber–Bosch technology.Breaking the linear correlations between adsorption and transition-state energies of intermediates is...Electrochemical nitrogen reduction(NRR)is deemed as a consummate answer for the traditional Haber–Bosch technology.Breaking the linear correlations between adsorption and transition-state energies of intermediates is vital to improve the kinetics of ammonia synthesis and obtain a less energy-intensive process.Herein,carbon-encapsulated mixed-valence Fe_(7)(PO_(4))_(6) was prepared and applied as an electrocatalyst for high-efficiency NRR.A dramatic faradaic efficiency(FE)of 36.93%and an NH_(3) production rate of 13.1μg h^(-1) mg_(cat)^(-1) were obtained at-0.3 V versus RHE,superior to nearly all Fe-based catalysts.Experiments and DFT calculations revealed that the superior performance was ascribed to the synergistic effect of mixed-valence iron pair,which braked the linear correlations to improve the kinetics of ammonia from collaborative hydrogenation and*NH_(3) separation.This work proves the feasibility of mixedvalence catalysts for nitrogen reduction and thus opening a new avenue towards artificial nitrogenfixation catalysts.展开更多
Objective： To introduce the experience and key points of percutaneous reduction combined with bone graft to treat calcaneal fractures. Methods： Percutaneous reduction and internal fixation combined with bone graft w...Objective： To introduce the experience and key points of percutaneous reduction combined with bone graft to treat calcaneal fractures. Methods： Percutaneous reduction and internal fixation combined with bone graft was performed from April 2004 to April 2006 on 15 cases （16 sides） with intra-articular calcaneal fractures including 13 males （14 feet） and 2 females （2 feet） ,with average age of 36. 6 years （24-61 years）. All patients underwent radiography including lateral and axial views for calcaneus, oblique view for foot and three-dimensional CT imaging reconstruction. According to Sanders classification, there were 12 feet of type Ⅱ （3 type Ⅱa, 3 type Ⅱb and 8 type Ⅱc） and 2 feet of type Illac. The length of calcaneus was recovered through traction by Steinmann pin which passed through calcaneal tubercle perpendicularly and the posterior facet was elevated until reduction by a curve scissors through an 0.5 cm incision along the primary fracture line of lateral calcaneus. The calcaneus was fixed with different cannulated cancellous screws according to the type of fractures. Then bone graft was injected to fill the defect of calcaneus through lateral incision. Results： All patients were followed up for an average of 18.4 months （ranged, 12 to 34 months）. No complication such as wound infection, screw breakage and calcaneum varus was found postoperatively. The average time for bone healing was 10 weeks. The results were excellent in 12 cases, good in 4 cases according to the American Orthopaedic Foot and Ankle Society （AOFAS） hindfoot score. The rate of excellent and good clinical results was 100%. The mean AOFAS hindfoot score in tongue type group （86.5±4.4） was better than in joint depression type group （81.2±1.7, P〈0.05）. Radiography showed basic restoration of Bohler＇s angle, Gissane＇s angle and calcaneal shape. Conclusion： The combination of percutaneous reduction and injectable bone graft is suitable for surgical treatment of Sanders Ⅱ and Ⅲ type calcaneal fractures, with advantages of simple operation, fewer complications and good clinical results.展开更多
N2 fixation rates(NFR,in terms of N)in the northern South China Sea(nSCS)and the East China Sea(ECS)were measured using the acetylene reduction assay in summer and winter,2009.NFR of the surface water ranged from 1.14...N2 fixation rates(NFR,in terms of N)in the northern South China Sea(nSCS)and the East China Sea(ECS)were measured using the acetylene reduction assay in summer and winter,2009.NFR of the surface water ranged from 1.14 nmol/(L·d)to 10.40 nmol/(L·d)(average at(4.89±3.46)nmol/(L·d),n=11)in summer and 0.74 nmol/(L·d)to 29.45 nmol/(L·d)(average at(7.81±8.50)nmol/(L·d),n=15)in winter.Significant spatio-temporal heterogeneity emerged in our study:the anticyclonic eddies(AE)(P<0.01)and the Kuroshio Current(KC)(P<0.05)performed significantly higher NFR than that in the cyclonic eddies or no-eddy area(CEONE),indicating NFR was profoundly influenced by the physical process of the Kuroshio and mesoscale eddies.The depth-integrated N2 fixation rates(INF,in terms of N)ranged from 52.4μmol/(m2·d)to 905.2μmol/(m2·d)(average at(428.9±305.5)μmol/(m2·d),n=15)in the winter.The contribution of surface NFR to primary production(PP)ranged from 1.7%to 18.5%in the summer,and the mean contribution of INF to new primary production(NPP)in the nSCS and ECS were estimated to be 11.0%and 36.7%in the winter.The contribution of INF to NPP(3.0%–93.9%)also decreased from oligotrophic sea toward the eutrophic waters affected by runoffs or the CEONE.Furthermore,we observed higher contributions compared to previous studies,revealing the vital roles of nitrogen fixation in sustaining the carbon pump of the nSCS and ECS.展开更多
BACKGROUND Neonatal distal humeral physeal fractures are rare and difficult to diagnose.Thus,missed diagnoses and delayed healing are possible.Few studies have reported surgical treatment,because a callus may develop ...BACKGROUND Neonatal distal humeral physeal fractures are rare and difficult to diagnose.Thus,missed diagnoses and delayed healing are possible.Few studies have reported surgical treatment,because a callus may develop at the fracture site 5 d after the fracture,resulting in difficult reduction,and reduction of the limb may cause further physeal injury.Other surgical challenges include the provision of adequate anesthesia and complexity of the operation.However,without appropriate reduction and fixation,a varus elbow deformity may develop.Manual reduction and percutaneous pin fixation are ideal treatment options.CASE SUMMARY A 4-day-old neonate with left elbow pain accompanied by limited movement for 4 d was admitted,and diagnosed with delayed physeal fracture of the distal humerus based on physical examination,ultrasonography,and magnetic resonance imaging.The patient was treated by manual reduction combined with percutaneous pin fixation under arthrography.Postoperatively,the reduction was successful.The upper limbs could have been lifted and the fingers could have been moved freely on the second day after the operation.CONCLUSION The techniques of manual reduction and percutaneous pin fixation,to treat neonatal distal humeral physeal fractures,are safe and reliable.展开更多
BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patient...BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.展开更多
Objective:To explore the effectiveness of percutaneous pedicle screw fixation in injury vertebrate and curving rob indirect decompression for type A3 thoracolumbar burst fracture with neurological deficits.Method:A re...Objective:To explore the effectiveness of percutaneous pedicle screw fixation in injury vertebrate and curving rob indirect decompression for type A3 thoracolumbar burst fracture with neurological deficits.Method:A retrospective study was made in 26 patients with type A3 thoracolumbar burst fracture with neurological deficits from August 2014 to July 2018 treated within 3 days after injury,which were treated with percutaneous pedicle screw fixation in injury vertebrate and curving rob indirect decompression.The radiological indexs、clinical effectiveness indexs、perioperative index and complication incidence were recorded and compared to observe the clinical result.Result:All patients were followed up from 6 to 23 months.There were no nerve injury and other severe complications,which 1.1 grade of neurological recovery was observed at the final follow-up.The average operation time was(102.31±16.87)minutes,with a mean intraoperative blood loss of(87.88±13.05)ml and hospital stays were(15.53±13.00)d.Local anesthesia was 5 patients and general anesthesia were 21 patients.Before the operation,the anterior height of fracture vertebral body(98.31±13.07)%、kyphotic angle(2.76±3.70)°、the Sagittal Cobb angle(1.35±6.78)were improved to(50.19±12.32)%、(21.98±5.58)°、(16.30±8.69)°respectively after the operation(P<0.05).The anterior height of fractured vertebral body and kyphotic angle in final follow-up were worse than the post-operative,but no significant difference was found between two stages(P>0.05).The Sagittal Cobb angle in final follow-up was better than those in post-operative(P<0.05).The VAS scores had statistical improvement(P<0.05).Conclusion Posterior percutaneous pedicle screw fixation in injury vertebrate and curving rob indirect decompression in treating the type A3 thoracolumbar burst fracture with neurological deficits was a minimally invasive,safe and effective surgical procedure to intraspinal interference and direct decompression.展开更多
Optimizing the sensor energy is one of the most important concern in Three-Dimensional(3D)Wireless Sensor Networks(WSNs).An improved dynamic hierarchical clustering has been used in previous works that computes optimu...Optimizing the sensor energy is one of the most important concern in Three-Dimensional(3D)Wireless Sensor Networks(WSNs).An improved dynamic hierarchical clustering has been used in previous works that computes optimum clusters count and thus,the total consumption of energy is optimal.However,the computational complexity will be increased due to data dimension,and this leads to increase in delay in network data transmission and reception.For solving the above-mentioned issues,an efficient dimensionality reduction model based on Incremental Linear Discriminant Analysis(ILDA)is proposed for 3D hierarchical clustering WSNs.The major objective of the proposed work is to design an efficient dimensionality reduction and energy efficient clustering algorithm in 3D hierarchical clustering WSNs.This ILDA approach consists of four major steps such as data dimension reduction,distance similarity index introduction,double cluster head technique and node dormancy approach.This protocol differs from normal hierarchical routing protocols in formulating the Cluster Head(CH)selection technique.According to node’s position and residual energy,optimal cluster-head function is generated,and every CH is elected by this formulation.For a 3D spherical structure,under the same network condition,the performance of the proposed ILDA with Improved Dynamic Hierarchical Clustering(IDHC)is compared with Distributed Energy-Efficient Clustering(DEEC),Hybrid Energy Efficient Distributed(HEED)and Stable Election Protocol(SEP)techniques.It is observed that the proposed ILDA based IDHC approach provides better results with respect to Throughput,network residual energy,network lifetime and first node death round.展开更多
Highly competent and economical photocatalysts are one of the most charming targets in environmental restoration and clean production.Herein,a novel sulfur-vacancy-rich Bi/Bi_(2)S_(3)/SnS_(2)Z-scheme heterostruc-ture ...Highly competent and economical photocatalysts are one of the most charming targets in environmental restoration and clean production.Herein,a novel sulfur-vacancy-rich Bi/Bi_(2)S_(3)/SnS_(2)Z-scheme heterostruc-ture was constructed in situ and applied for the photoreduction Cr(VI)and nitrogen fixation.The fab-ricated Bi/Bi_(2)S_(3)/SnS_(2)-2 exhibits the optimum photoreduction Cr(VI)performance with the efficiency of 94.5%within 15 min visible light irradiation.The remarkably enhanced catalytic efficiency derived from the synergistic effect of the construction of intimate contacted interface,abundant sulfur vacancy and surface plasmon resonance(SPR)effect of metal Bi.Meanwhile,the excellent photocatalytic nitrogen fix-ation property(96.4μmol g^(-1)h^(-1))was achieved by Bi/Bi_(2)S_(3)/SnS_(2)-2 under full solar illumination because sulfur vacancy could provide sufficient catalytic sites to accelerate the adsorption and nitrogen activation.The Z-scheme heterostructure was proposed to expound the photocatalytic mechanism.This work offers a new perspective on hierarchical heterostructure with plentiful vacancies for environmental remediation and energy development.展开更多
基金2022 Key Specialty Construction Project of Traditional Chinese Medicine:Traditional Chinese Orthopedics and Traumatology Department (No.962042)2020 Regional Traditional Chinese Medicine (Orthopedics and Traumatology)Diagnosis and Treatment Center (Jin Wei Zhong[2020]No.5)。
文摘Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.
文摘BACKGROUND Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures.AIM To focus on how to avoid displacement of the lesser trochanter in unstable intertrochanteric fractures.METHODS We developed a lesser trochanteric reduction fixator for treating intertrochanteric fractures through fixing the lesser trochanter by combining the loop plate through the fixator after reduction by the reducer.Five patients with intertrochanteric fractures treated with the newly developed lesser trochanteric reduction fixator and loop plate combined with intramedullary nails,and 20 patients with intertrochanteric fractures treated with simple intramedullary nails were selected from December 2020 to March 2021.RESULTS The postoperative Harris hip score was significantly higher in patients treated with the lesser trochanteric reduction fixator than in patients treated without the lesser trochanteric reduction fixator,which indicated that this lesser trochanteric reduction fixator had a positive impact on rehabilitation of the hip joint after surgery and could significantly improve the quality of life of patients.CONCLUSION We fully realize the significance of trochanteric reduction and fixation,namely,reconstruction of structures under pressure,in the treatment of intertrochanteric fractures.As long as the general condition of patients is favorable and they are willing to undergo surgery,fixation of the main fracture end should be performed and the lesser trochanter should be reduced and fixed at the same time.
文摘Objective: To evaluate the effect of open reduction and internal fixation on radial head fracture and assess the post-operative function. Methods: This prospective observational study was conducted from June 2016 to July 2017 at Liaquat National Hospital and Medical College, Karachi. Altogether, 28 patients with radial head and neck fractures were enrolled in our study. These patients were admitted to the hospital and their fractures were fixed with open reduction and internal fixation. Baseline information of the patients was collected, and patient-rated elbow evaluation scores were calculated. Results: Out of the 28 patients, 21 were male and 7 were female. Besides, 16 fractures were on the right side and 12 were on the left side and 17 involving the dominant hands. In addition, 8 patients had Mason type Ⅱ fracture and 20 had Mason type Ⅲ fracture. The mean age of patients was (31.0 ± 8.0) years, and the mean follow-up is (1.2 ± 0.5) years. The mean average patient-rated elbow evaluation scores were (27.64 ± 1.60) at 1-year follow-up. Conclusions:The majority of the patients who had radial head fractures and treated by open reduction and internal fixation have attained an excellent range of motion postoperatively.
文摘Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We analyzed a case series of patients with open reduction and internal fixation (ORIF) for complex acetabular fractures. Two hundred patients (132 men, 68 women) in four age groups including with a mean age of 43.39 ± 6.18 years (range 20 - 59 years) and a mean follow-up of 82.34 ± 12.48 months (range 18 - 109 months) met the inclusion criteria. Functional outcome at final follow-up was graded assessed according to Harris score. Factors affecting were defined. Results: Anatomic reduction was achieved in 192 hips, imperfect in 8 and poor in none. Radiological outcome revealed excellent results in 128 (64%) hips, good in eight, fair in five and none in poor. Harris score were excellent in 139 (69.5%) hips, good in 43 (21.5%) and fair in 18 (9%) and poor in none. The anatomical reduction results had a favorable final functional outcome. (0.003) However, BMI (P Conclusion: Optimal functional and radiological outcomes have been achieved with anatomic postoperative reduction. Also experience of specialist, on time surgery and good recovery lead to receiving excellent functional outcome with at least complications.
文摘Solar‐driven conversion of carbon dioxide,water and nitrogen into high value‐added fuels(e.g.H_(2),CO,CH_(4),CH_(3)OH,NH_(3) and so on)is regarded as an environmental‐friendly and ideal route for relieving the greenhouse gas effect and countering energy crisis,which is an attractive and challenging topic.Hence,various types of photocatalysts have been developed successively to meet the requirements of these photocatalysis.Among them,cobalt‐based heterogeneous catalysts emerge as one of the most promising photocatalysts that open up alluring vistas in the field of solar‐to‐fuels conversion,which can effectively enhance photocatalytic efficiency by extending light absorption range,promoting charge separation,providing active sites,and lowering reaction barrier.In this review,we first present the working principles of cobalt‐based heterogeneous catalysts for photocatalytic water splitting,CO_(2) reduction,and N_(2) fixation.Second,five efficient strategies including surface modification,morphology modulation,crystallinity controlling,crystal engineering and doping,are discussed for improving the photocatalytic performance with different types cobalt‐based catalysts(cobalt nanoparticles and single atom,oxides,sulfides,phosphides,MOFs,COFs,LDHs,carbide,and nitrides).Third,we outline the applications for the state‐of‐the‐art photocatalytic CO_(2) reduction and water splitting,and nitrogen fixation over cobalt‐based heterogeneous catalysts.Finally,the central challenges and possible improvements of cobalt‐based photocatalysis in the future are presented.The purpose of this review is to summarize the past experience and lessons,and provide reference for the further development of cobalt‐based photocatalysis technology.
文摘The development of high‐performance nonprecious metal catalysts(NPMCs)to supersede Pt‐based catalysts for the oxygen reduction reaction(ORR)in polymer electrolyte membrane fuel cells is highly desirable but remains challenging.In this paper,we present a pyrolysis strategy for spatial confinement and active‐site fixation using iron phthalocyanine(FePc),phthalocyanine(Pc)and Zn salts as precursors.In the obtained carbon‐based NPMC with a hierarchically porous nanostructure of thin‐layered carbon nanosheets,nearly 100%of the total Fe species are Fe^(Ⅱ)‐N_(4) active sites.In contrast,pyrolyzing FePc alone forms Fe‐based nanoparticles embedded in amorphous carbon with only 5.9%Fe^(Ⅱ)‐N_(4) active sites.Both experimental characterization and density functional theory calculations reveal that spatial confinement through the staggeredπ–πstacking of Pc macrocycles effectively prevents the demetallation of Fe atoms and the formation of Fe‐based nanoparticles via aggregation.Furthermore,Zn‐induced microporous defects allow the fixation of Fe^(Ⅱ)‐N_(4) active sites.The synergistic effect of staggered stacking confinement and microporous defect fixation results in a high density of atomic Fe^(Ⅱ)‐N_(4) active sites that can enhance the ORR.The optimal Fe^(Ⅱ)‐N_(4)‐C electro‐catalyst outperforms a commercial Pt/C catalyst in terms of half‐wave potential,methanol toler‐ance,and long‐term stability in alkaline media.This modulation strategy can greatly advance efforts to develop high‐performance NPMCs.
基金supported by Program of the National Natural Science Foundation of China(No.82074233)Scientific Research Foundation for Advanced Talents,Xiang’an Hospital of Xiamen University(No.PM201809170009).
文摘Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.
文摘The incidence of metatarsal fractures is not precisely known. Malposition might cause future metatarsalgia, mid-foot pain and discomfort, which may dictate an on-going need for in-shoe orthosis, shoe modification and, occasionally, operative correction. To minimize and prevent these problems, we describe a simple technique for reduction and fixation of metatarsal fractures by Kirschner wires. We have found this technique to be a simple and efficient way of reducing and fixing metatarsal fractures. It is applied easily by the closed and open technique.
文摘Objective． An internal fixation apparatus—— distraction reduction fixation system(DRFS) was designed to satisfy the clinical needs for spondylolisthesis. Methods. Since 1996, 53 patients were treated with DRFS. Among them, 35 had spondylolisthesis, 12 had lumbar canal stenosis accompanied with instability, 2 had vertebral tumors and 4 suffered from spinal fracture. The average age was 53.6 years old (ranged 24～ 72yrs). The mean time for follow- up was 30.6 months (16～ 44 months). Results． The slip rate was 0.15± 0.10 before operation, and decreased to 0.09± 0.07 after operation. Entire slip reposition was achieved in 19 cases (54.3％ ). The change in height of the intervertebral space within the fixation segments was 0.7± 0.17. Conclusion． DRFS achieved better results for spondylolisthesis less II degree and no other adverse effects were found. Compared with other foreign and domestic techniques, it had advantages in less implants, less operation gears required and ease to utilize in operation. It was proved to be an ideal internal fixation apparatus.
文摘Objective:To study the clinical effect of minimally invasive single-segment reduction and internal fixation in patients with thoracolumbar fractures.Methods:From June 2013 to June 2014,100 patients with thoracolumbar fractures were selected as the subjects and they were randomly divided into observation group(50 cases)and control group(50 cases).The patients in the observation group were treated with minimally invasive singlesegment reduction and internal fixation.The patients in the control group were treated with short segmental fixation.The clinical effects of the two groups were compared.Results:There was no significant difference in the compression rate and Cobb angle between the two groups before and after operation(P>0.05).For all patients who were followed up for the last time,the Cobb angle was significantly lower in the observation group than in the control group(P<0.05).The social function,affective function and physical pain score of the observation group were significantly better than the control group(P<0.05).The amount of bleeding in the observation group was(250.4±41.0)ml,which was significantly lower than that in the control group(267.5±32.8)ml.The time required for the operation was(90.2±35.4)min,which was significantly lower than that of the control group(104.5±22.6)min(P<0.05).After treatment,the prognosis was 70.00%and the excellent and good rate was 98.00%,which was significantly higher than that of the control group(46.00%)and 78.00%(P<0.05).Conclusion:Thoracolumbar fractures in patients with dilated channel minimally invasive single-segment reduction and internal fixation treatment can effectively repair the patient's vertebral height and Cobb angle and the degree of correction after surgery was significantly better,safer and worthy of clinical recommended use.
基金Project (10972238) supported by the National Natural Science Foundation of ChinaProject (2010ssxt237) supported by the Excellent Doctoral Thesis Program of Central South University,China
文摘The failure mechanism of two-dimensional（2D） and three-dimensional（3D） slopes were investigated by using the strength reduction method.An extensive study of 3D effect was conducted with respect to boundary conditions,shear strength and concentrated surcharge load.The results obtained by 2D and 3D analyses were compared and the applicable scope of 2D and 3D method was analyzed.The results of the numerical simulation show that 3D effect is sensitive to the width of slip surface.As for slopes with specific geometry,3D effect is influenced by dimensionless parameter c/（γHtanφ）.For those infinite slopes with local loading,external load has the major impact on failure mode.For those slopes with local loading and geometric constraints,the failure mode is influenced by both factors.With the increase of loading length,boundary condition exerts a more significant impact on the failure mode,and then 2D and 3D stability charts are developed,which provides a rapid and reliable way to calculate 2D and 3D factor of safety without iteration.Finally,a simple and practical calculation procedure based on the study of 3D effect and stability charts is proposed to recognize the right time to apply 2D or 3D method.
文摘Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library,PubMed,Embase,VIP database,CNKI,and Wanfang data-base with keywords"acetabular fracture","3D printing","three-dimensional printing","open reduction and internal fixation","Acetabulum","Acetabula"from January 2000 to March 2020.Two reviewers independently selected articles,extracted data,assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’s tools and/or Newcastle-Ottawa scale.When the two analysts had different opinions,they would ask the third analyst for opinion.Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF(3D printing group)versus traditional ORIF(conventional group)in the treatment of acetabular fractures were selected.The data of operation time,intraoperative blood loss,intraoperative fluoroscopy times,incidence of complications,excellent and good rate of Matta score for reduction,and excellent and good rate of hip function score were extracted.Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected,including 5 randomized controlled trials and 4 retrospective studies.A total of 467 patients were analyzed,250 in the conventional group,and 217 in the 3D printing group.The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant(standardized mean difference(SMD)=-1.19,95%CI:-1.55 to-0.82,p<0.05).The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group(SMD=-1.08,95%CI:-1.65 to-0.51,p<0.05).The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant(SMD=-1.64,95%CI:-2.35 to-0.93,p<0.05).The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group(OR=0.43,95%CI:0.24-0.79,p<0.05).There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups(OR=0.60,95%CI:0.34-1.06,p>0.05).There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups(OR=0.84,95%CI:0.46-1.56,p>0.05),but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF,3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively,but also effectively reduces operation time,intraoperative blood loss,intraoperative fluoroscopy times,and postoperative complications.However,there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.
基金supported by the National Natural Science Foundation of China(21908120 and 22109078)the Youth Innovation Team Project of Shandong Provincial Education Department(2019KJC023)。
文摘Electrochemical nitrogen reduction(NRR)is deemed as a consummate answer for the traditional Haber–Bosch technology.Breaking the linear correlations between adsorption and transition-state energies of intermediates is vital to improve the kinetics of ammonia synthesis and obtain a less energy-intensive process.Herein,carbon-encapsulated mixed-valence Fe_(7)(PO_(4))_(6) was prepared and applied as an electrocatalyst for high-efficiency NRR.A dramatic faradaic efficiency(FE)of 36.93%and an NH_(3) production rate of 13.1μg h^(-1) mg_(cat)^(-1) were obtained at-0.3 V versus RHE,superior to nearly all Fe-based catalysts.Experiments and DFT calculations revealed that the superior performance was ascribed to the synergistic effect of mixed-valence iron pair,which braked the linear correlations to improve the kinetics of ammonia from collaborative hydrogenation and*NH_(3) separation.This work proves the feasibility of mixedvalence catalysts for nitrogen reduction and thus opening a new avenue towards artificial nitrogenfixation catalysts.
文摘Objective： To introduce the experience and key points of percutaneous reduction combined with bone graft to treat calcaneal fractures. Methods： Percutaneous reduction and internal fixation combined with bone graft was performed from April 2004 to April 2006 on 15 cases （16 sides） with intra-articular calcaneal fractures including 13 males （14 feet） and 2 females （2 feet） ,with average age of 36. 6 years （24-61 years）. All patients underwent radiography including lateral and axial views for calcaneus, oblique view for foot and three-dimensional CT imaging reconstruction. According to Sanders classification, there were 12 feet of type Ⅱ （3 type Ⅱa, 3 type Ⅱb and 8 type Ⅱc） and 2 feet of type Illac. The length of calcaneus was recovered through traction by Steinmann pin which passed through calcaneal tubercle perpendicularly and the posterior facet was elevated until reduction by a curve scissors through an 0.5 cm incision along the primary fracture line of lateral calcaneus. The calcaneus was fixed with different cannulated cancellous screws according to the type of fractures. Then bone graft was injected to fill the defect of calcaneus through lateral incision. Results： All patients were followed up for an average of 18.4 months （ranged, 12 to 34 months）. No complication such as wound infection, screw breakage and calcaneum varus was found postoperatively. The average time for bone healing was 10 weeks. The results were excellent in 12 cases, good in 4 cases according to the American Orthopaedic Foot and Ankle Society （AOFAS） hindfoot score. The rate of excellent and good clinical results was 100%. The mean AOFAS hindfoot score in tongue type group （86.5±4.4） was better than in joint depression type group （81.2±1.7, P〈0.05）. Radiography showed basic restoration of Bohler＇s angle, Gissane＇s angle and calcaneal shape. Conclusion： The combination of percutaneous reduction and injectable bone graft is suitable for surgical treatment of Sanders Ⅱ and Ⅲ type calcaneal fractures, with advantages of simple operation, fewer complications and good clinical results.
基金The National Natural Science Foundation of China under contract Nos 41876134 and 41406155the University Innovation Team Training Program for Tianjin under contract No.TD12-5003+3 种基金the Tianjin 131 Innovation Team Program under contract No.20180314the Changjiang Scholar Program of Chinese Ministry of Education to Jun Sun under contract No.T2014253the Tianjin Municipal Education Commission Research Program under contract No.2017KJ012the Open Fund of Tianjin Key Laboratory of Marine Resources and Chemistry under contract Nos 201506 and 201801
文摘N2 fixation rates(NFR,in terms of N)in the northern South China Sea(nSCS)and the East China Sea(ECS)were measured using the acetylene reduction assay in summer and winter,2009.NFR of the surface water ranged from 1.14 nmol/(L·d)to 10.40 nmol/(L·d)(average at(4.89±3.46)nmol/(L·d),n=11)in summer and 0.74 nmol/(L·d)to 29.45 nmol/(L·d)(average at(7.81±8.50)nmol/(L·d),n=15)in winter.Significant spatio-temporal heterogeneity emerged in our study:the anticyclonic eddies(AE)(P<0.01)and the Kuroshio Current(KC)(P<0.05)performed significantly higher NFR than that in the cyclonic eddies or no-eddy area(CEONE),indicating NFR was profoundly influenced by the physical process of the Kuroshio and mesoscale eddies.The depth-integrated N2 fixation rates(INF,in terms of N)ranged from 52.4μmol/(m2·d)to 905.2μmol/(m2·d)(average at(428.9±305.5)μmol/(m2·d),n=15)in the winter.The contribution of surface NFR to primary production(PP)ranged from 1.7%to 18.5%in the summer,and the mean contribution of INF to new primary production(NPP)in the nSCS and ECS were estimated to be 11.0%and 36.7%in the winter.The contribution of INF to NPP(3.0%–93.9%)also decreased from oligotrophic sea toward the eutrophic waters affected by runoffs or the CEONE.Furthermore,we observed higher contributions compared to previous studies,revealing the vital roles of nitrogen fixation in sustaining the carbon pump of the nSCS and ECS.
文摘BACKGROUND Neonatal distal humeral physeal fractures are rare and difficult to diagnose.Thus,missed diagnoses and delayed healing are possible.Few studies have reported surgical treatment,because a callus may develop at the fracture site 5 d after the fracture,resulting in difficult reduction,and reduction of the limb may cause further physeal injury.Other surgical challenges include the provision of adequate anesthesia and complexity of the operation.However,without appropriate reduction and fixation,a varus elbow deformity may develop.Manual reduction and percutaneous pin fixation are ideal treatment options.CASE SUMMARY A 4-day-old neonate with left elbow pain accompanied by limited movement for 4 d was admitted,and diagnosed with delayed physeal fracture of the distal humerus based on physical examination,ultrasonography,and magnetic resonance imaging.The patient was treated by manual reduction combined with percutaneous pin fixation under arthrography.Postoperatively,the reduction was successful.The upper limbs could have been lifted and the fingers could have been moved freely on the second day after the operation.CONCLUSION The techniques of manual reduction and percutaneous pin fixation,to treat neonatal distal humeral physeal fractures,are safe and reliable.
文摘BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.
基金National Natural Science Foundation of China(No.81641136,81703659)Chengde city science and technology research and development projects(No.20151048).
文摘Objective:To explore the effectiveness of percutaneous pedicle screw fixation in injury vertebrate and curving rob indirect decompression for type A3 thoracolumbar burst fracture with neurological deficits.Method:A retrospective study was made in 26 patients with type A3 thoracolumbar burst fracture with neurological deficits from August 2014 to July 2018 treated within 3 days after injury,which were treated with percutaneous pedicle screw fixation in injury vertebrate and curving rob indirect decompression.The radiological indexs、clinical effectiveness indexs、perioperative index and complication incidence were recorded and compared to observe the clinical result.Result:All patients were followed up from 6 to 23 months.There were no nerve injury and other severe complications,which 1.1 grade of neurological recovery was observed at the final follow-up.The average operation time was(102.31±16.87)minutes,with a mean intraoperative blood loss of(87.88±13.05)ml and hospital stays were(15.53±13.00)d.Local anesthesia was 5 patients and general anesthesia were 21 patients.Before the operation,the anterior height of fracture vertebral body(98.31±13.07)%、kyphotic angle(2.76±3.70)°、the Sagittal Cobb angle(1.35±6.78)were improved to(50.19±12.32)%、(21.98±5.58)°、(16.30±8.69)°respectively after the operation(P<0.05).The anterior height of fractured vertebral body and kyphotic angle in final follow-up were worse than the post-operative,but no significant difference was found between two stages(P>0.05).The Sagittal Cobb angle in final follow-up was better than those in post-operative(P<0.05).The VAS scores had statistical improvement(P<0.05).Conclusion Posterior percutaneous pedicle screw fixation in injury vertebrate and curving rob indirect decompression in treating the type A3 thoracolumbar burst fracture with neurological deficits was a minimally invasive,safe and effective surgical procedure to intraspinal interference and direct decompression.
文摘Optimizing the sensor energy is one of the most important concern in Three-Dimensional(3D)Wireless Sensor Networks(WSNs).An improved dynamic hierarchical clustering has been used in previous works that computes optimum clusters count and thus,the total consumption of energy is optimal.However,the computational complexity will be increased due to data dimension,and this leads to increase in delay in network data transmission and reception.For solving the above-mentioned issues,an efficient dimensionality reduction model based on Incremental Linear Discriminant Analysis(ILDA)is proposed for 3D hierarchical clustering WSNs.The major objective of the proposed work is to design an efficient dimensionality reduction and energy efficient clustering algorithm in 3D hierarchical clustering WSNs.This ILDA approach consists of four major steps such as data dimension reduction,distance similarity index introduction,double cluster head technique and node dormancy approach.This protocol differs from normal hierarchical routing protocols in formulating the Cluster Head(CH)selection technique.According to node’s position and residual energy,optimal cluster-head function is generated,and every CH is elected by this formulation.For a 3D spherical structure,under the same network condition,the performance of the proposed ILDA with Improved Dynamic Hierarchical Clustering(IDHC)is compared with Distributed Energy-Efficient Clustering(DEEC),Hybrid Energy Efficient Distributed(HEED)and Stable Election Protocol(SEP)techniques.It is observed that the proposed ILDA based IDHC approach provides better results with respect to Throughput,network residual energy,network lifetime and first node death round.
基金supported by the National Natural Science Foun-dation of China(Nos.22178038 and 21878031)Innovation Supporting Plan for High-level Talents of Dalian(No.2021RQ116).
文摘Highly competent and economical photocatalysts are one of the most charming targets in environmental restoration and clean production.Herein,a novel sulfur-vacancy-rich Bi/Bi_(2)S_(3)/SnS_(2)Z-scheme heterostruc-ture was constructed in situ and applied for the photoreduction Cr(VI)and nitrogen fixation.The fab-ricated Bi/Bi_(2)S_(3)/SnS_(2)-2 exhibits the optimum photoreduction Cr(VI)performance with the efficiency of 94.5%within 15 min visible light irradiation.The remarkably enhanced catalytic efficiency derived from the synergistic effect of the construction of intimate contacted interface,abundant sulfur vacancy and surface plasmon resonance(SPR)effect of metal Bi.Meanwhile,the excellent photocatalytic nitrogen fix-ation property(96.4μmol g^(-1)h^(-1))was achieved by Bi/Bi_(2)S_(3)/SnS_(2)-2 under full solar illumination because sulfur vacancy could provide sufficient catalytic sites to accelerate the adsorption and nitrogen activation.The Z-scheme heterostructure was proposed to expound the photocatalytic mechanism.This work offers a new perspective on hierarchical heterostructure with plentiful vacancies for environmental remediation and energy development.
