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In this study, standard test specimens with flame-retarded short glass fiber-reinforced PC/ABS materials were fabricated under rapid thermal cycle injection molding condition by selecting a potassium perfluorobutane sulfonate flame retardant specially used for PC, FR2025, and two kinds of aryl phosphorus halogen-free flame retardants, UN707 and PX-220. The flame-retardancy effect of the above different flame retardants on the studied systems was compared through combustion tests of the specimens. Meanwhile, the thermal and mechanical properties of flame-retarded composites were studied by using the thermogravimetry analysis, dynamic mechanical thermal analysis (DMTA), and universal testing machine. The results show that the 'candlewick effect' of fibers exacerbates the fire behavior of composites. With the increase of the aryl phosphorus halogen-free flame retardants, the flame-retardancy effect of composites is obviously improved, and the maximum thermal degradation rate of composites is significantly decreased. The UL94 combustion rating is improved, and the time of residual flame is substantially reduced with the increase of PC content under the same content of flame retardant. The DMTA results show that the flame retardants have a reinforcement action on PC/ABS matrix. However, the macroscopic mechanical properties are slightly decreased in the glass fiber-reinforced composites because of the destructive effect of the flame retardants on the interface compatibility between matrix and fibers; the scanning electron microscopic micrographs of tensile fracture fully prove this action mechanism of flame retardants. In addition, the addition of toughener and antidripping additive significantly affects the flame retardancy and mechanical properties of composites. POLYM. COMPOS., 36:1653-1663, 2015. © 2014 Society of Plastics Engineers [ABSTRACT FROM AUTHOR]

Highlights: [•] Effect of OP treatment on air exposed MoO x , a crucial material for OPV and OLED. [•] OP treatment can partially recovered the work function (WF) of MoO x reduced by air exposure. [•] The WF recovery of over 60% is adequate to provide a hole extraction layer to many organic materials. [•] OP treatment shifted the core levels of O and Mo toward the lower binding energy. [•] The favorable energy level alignment was observed at the interface of CuPc and MoO x treated by OP. [ABSTRACT FROM AUTHOR]

The electronic structure evolution of interfaces of fullerene (C 60) with copper phthalocyanine (CuPc) on highly oriented pyrolytic graphite (HOPG) and on native silicon oxide has been investigated with ultraviolet photoemission spectroscopy and inverse photoemission spectroscopy. The LUMO edge of C 60 was found to be pinned at the interface with CuPc on SiO 2. A substantial difference in the electron affinity of CuPc on the two substrates was observed as the orientation of CuPc is lying flat on HOPG and standing up on SiO 2. The ionization potential and electron affinity of C 60 were not affected by the orientation of CuPc due to the spherical symmetry of C 60 molecules. We observed band bending in C 60 on the standing-up orientation of CuPc molecules, while the energy levels of C 60 on the flat-lying orientation of CuPc molecules were observed to be flat. The observation points to a dependence of photoexcited charge transfer on the relative molecular orientation at the interface. [ABSTRACT FROM AUTHOR]

Projections of future tropical cyclone frequency are uncertain, ranging from a slight increase to a considerable decrease according to climate models. Estimation of how much the Earth's surface temperature warms in response to greenhouse gas increase, quantified by effective climate sensitivity, is also uncertain. These two uncertainties have historically been studied independently as they concern different scales: One quantifies the extreme weather and the other the mean climate. Here, we show that these two uncertainties are not independent and are both influenced by the response of tropical clouds to warming. Across climate models, we show an anticorrelation between shortwave cloud radiative feedback and changes in the frequency of seed vortices, a prevalent type of tropical cyclone precursors. We further show an anticorrelation between effective climate sensitivity and tropical cyclone frequency changes, suggesting that global tropical cyclone frequency tends to decrease more substantially in models with larger temperature increase.

Objective: To investigate the accuracy of split three-dimensional (3D) printing patient-specific instrumentation (PSI) in medial open-wedge high tibial osteotomy (MOWHTO) and its effectiveness in treating medial knee osteoarthritis., Methods: Clinical data of 14 patients with medial knee osteoarthritis and treated with split 3D printing PSI-assisted MOWHTO between August 2019 and August 2020 were retrospectively analyzed. There were 5 males and 9 females with an average age of 61 years (range, 43-68 years). The disease duration ranged from 1 to 16 years, with an average of 4.7 years. Preoperative Kellgren-Lawrence grading of knee osteoarthritis included grade Ⅰ in 2 cases, grade Ⅱ in 6 cases, and grade Ⅲ in 6 cases. The Hospital for Special Surgery (HSS) score was 59.1±4.9. The weight bearing line ratio (WBL), hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), posterior tibial slope angle (PTSA), and actual correction angle of the lower limbs were measured on postoperative imaging data, and compared with the preoperative measurements and the designed target values to evaluate the accuracy of the PSI-assisted surgery. The patients' knee function were evaluated with the HSS score at 3 and 6 months postoperatively, and at last follow-up., Results: One patient suffered from an incision exudation at 2 weeks postoperatively, and the incision healed after symptomatic treatment. The incisions of other patients healed by first intention. All patients were followed up 7-19 months (mean, 14.8 months). There was no neural injuries, hinge fracture, plate or screw fractures, loosening, or other complications. The WBL was maintained at the postoperative level according to the X-ray examination during the follow-up period. The WBL, HKA, MPTA, and PTSA were all within a satisfactory range after operation. The WBL, HKA, and MPTA were significantly improved when compared with the preoperative measurements ( P <0.05). There was no significant difference between preoperative and postoperative PTSA ( P >0.05). The differences in postoperative WBL, HKA, MPTA, and correction angle compared with the preoperative designed target values were not significant ( P >0.05). The HSS scores were 69.2±4.7, 77.7±4.3, and 88.1±5.4 at 3 and 6 months postoperatively, and last follow-up, respectively. The differences between time points were significant ( P <0.05)., Conclusion: For patients with medial knee osteoarthritis, the split 3D printing PSI can assist the surgeon in MOWHTO with accurate osteotomy orthopedics and achieve favorable effectiveness.

Objective: Over the past seven years, our team has designed a simulated operation combined with patient-specific instrumentation (SO-PSI) assisted supramalleolar osteotomy (SMOT) method and applied it in the clinic. This study aimed to evaluate the differences between SO-PSI technology and conventional operation (CO) technology for SMOT in preoperative planning, intraoperative application, and postoperative curative effect., Methods: We retrospectively analyzed SMOT data collected from our hospital between October 2014 and December 2018. Patients (n = 28) were enrolled and divided into CO (n = 17) and SO-PSI (n = 11) groups; mean follow-up time was 33.4 (range, 13 to 59) months. We statistically analyzed and compared perioperative data, accuracy of preoperative planning, intraoperative application, difference between pre- and post-operative radiologic ankle angles, changes in American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analogue scale (VAS) score, range of ankle motion, and Takakura stage after surgery., Results: All ankle alignments and positions were recovered for both groups. Compared with the CO group, the SO-PSI group had a shorter mean operating time and postoperative hospital stay, a decreased number of fluoroscopy examinations, lower albumin reduction, longer preoperative planning time and preoperative hospital stay, and increased hospitalization expenses. In the SO-PSI group, comparison of ankle angles at preoperative planning and postoperatively revealed good correlation, while this was not the case in the CO group. Mean tibial ankle center discrepancy for the SO-PSI group was 1.86 ± 1.06 mm. On follow-up, all radiologic parameters for the two groups improved significantly; however, the improvement of the tibial anterior surface angle and tibiotalar tilt angle for the SO-PSI group were more obvious than those for the CO group. AOFAS score, VAS score, ankle range of motion, and Takakura stage improved after surgery in both groups; however, the improvements in the SO-PSI group were greater than those in the CO group overall., Conclusions: SO-PSI technology can facilitate accurate and rapid preoperative planning for SMOT. In general, compared with conventional technology, SO-PSI has advantages for preoperative planning, intraoperative application, and postoperative curative effect., Competing Interests: None., (AJTR Copyright © 2021.)

To investigate the feasibility of quantifying the chemical composition of coronary artery plaque in terms of water, lipid, protein, and calcium contents using dual-energy computed tomography (CT) in a simulation study. A CT simulation package was developed based on physical parameters of a clinical CT scanner. A digital thorax phantom was designed to simulate coronary arterial plaques in the range of 2-5 mm in diameter. Both non-calcified and calcified plaques were studied. The non-calcified plaques were simulated as a mixture of water, lipid, and protein, while the calcified plaques also contained calcium. The water, lipid, protein, and calcium compositions of the plaques were selected to be within the expected clinical range. A total of 95 plaques for each lesion size were simulated using the CT simulation package at 80 and 135 kVp. Half-value layer measurements were made to make sure the simulated dose was within the range of clinical dual energy scanning protocols. Dual-energy material decomposition using a previously developed technique was performed to determine the volumetric fraction of water, lipid, protein, and calcium contents in each plaque. For non-calcified plaque, the total volume conservation provides the third constrain for three-material decomposition with dual energy CT. For calcified plaque, a fourth criterion was introduced from a previous report suggesting a linear correlation between water and protein contents in soft tissue. For non-calcified plaque, the root mean-squared error (RMSE) of the image-based decomposition was estimated to be 0.7%, 1.5%, and 0.3% for water, lipid, and protein contents, respectively. As for the calcified plaques, the RMSE of the 5 mm plaques were estimated to be 5.6%, 5.7%, 0.2%, and 3.1%, for water, lipid, calcium, and protein contents, respectively. The RMSE increases as the plaque size reduces. The simulation results indicate that chemical composition of coronary arterial plaques can be quantified using dual-energy CT. By accurately quantifying the content of a coronary plaque lesion, our decomposition method may provide valuable insight for the assessment and stratification of coronary artery disease.

Background: To protect and maintain the positivity of self-concept, normal people usually show a self-serving bias (internal attribution of positive events and external attribution of negative events) by the motives of self-enhancement and self-protection. Additionally, self-serving assessments predominantly activate the subcortical-cortical midline structures (CMS) in healthy individuals. However, little is known about self-serving bias and its underlying neural correlates among individuals with Internet gaming disorder (IGD)., Methods: Twenty-four participants with IGD and 25 recreational Internet gaming users (RGUs) were scanned while attributing the causes of positive/negative self- and other-related events that could occur in both the game-world and real-world contexts. Region-of-interest (within CMS regions) and parametric analysis were performed to investigate the neural correlates of self-serving bias in IGD., Results: Behaviorally, the IGD participants attributed more negative and fewer positive events to themselves than RGU participants in both contexts. Neurally, during the attributions of negative events, the IGD participants exhibited increased ventromedial prefrontal cortex (vmPFC) activation in both contexts compared with RGU participants. Higher vmPFC activation was associated with weaker self-protective motivation in the IGD group. Meanwhile, during the attributions of positive events, the IGD participants exhibited decreased precuneus/posterior cingulate cortex activation in the real world compared with RGU participants. Parametric analysis showed a reduced positive correlation between precuneus activation and self-attribution ratings of positive events in the real world in the IGD group relative to the RGU group., Conclusion: These results suggest that individuals with IGD show an attenuated self-serving bias and altered brain activity within CMS regions involved in self-attribution, providing evidence for the negative self-concept and weakened abilities in both self-enhancement and self-protection in IGD.

Previous research has demonstrated that some false recognitions are accompanied by retrieval of contexts in which the corresponding semantic associates were presented during the study phase. What kind of neural processes support context retrieval in false recognition? Using functional MRI (fMRI), we tested the hypothesis that context retrieval in false recognition might be supported by brain areas in the core recollection network which also support context retrieval in true recognition. During the study, lists of semantically associated words were presented together with scene pictures that served as contexts. During test, participants judged whether the presented word was old or new. If old, they judged which scene picture was its context and rated memory strength for the context. The results revealed that several regions in the core recollection network, including the bilateral hippocampus, left angular gyrus, and left anterior cingulate cortex, showed greater activations for true recognitions with strong context memory than those with weak context memory. More importantly, these same regions also showed greater activations for false recognitions with strong context memory than those with weak context memory. These findings helped account for why some false recognitions are vivid and accompanied by retrieval of context.

Background: A simulation and model (SM) teaching aid using 3D printing was developed to improve a training course for total hip arthroplasty of adult developmental dysplasia of the hip (adult DDH-THA). We named this new method Surgery Simulation Teaching based on a Real Reconstruction Aid (RRA-SST). A prospective randomized comparison was performed with the traditional surgical live teaching method to evaluate the training effectiveness of RRA-SST for adult DDH-THA., Methods: Twenty-six trainees, who were already practicing but were not experienced, participated in the study. We randomly divided the trainees into two groups: Group A (n = 13) received RRA-SST and group B (n = 13) received traditional surgical live teaching. A surgery simulation test and a questionnaire were used for evaluation. Next, each group received training with the other teaching method, and then the test and questionnaire were used again for evaluation., Results: After the first test, the RRA-SST method was shown to produce better results than the traditional surgical live teaching method. After the second test, the results showed the training effect in both groups reached the same level, which was level as Group A RRA-SST results. Analysis of the questionnaire results showed that the training effect of RRA-SST was higher than that of traditional surgical live teaching, from multiple perspectives., Conclusions: The use of RRA-SST improved participant performance according to simulation assessment. RRA-SST can be helpful for trainees who are already practicing but not experienced when developing proficiency in adult DDH-THA surgical techniques.

Purpose: To create a patient-specific instrument (PSI) in lowering the surgical experience requirement for junior physicians to perform total hip arthroplasty (THA) on developmental dysplasia of the hip (DDH) patients., Methods: Combined with rapid prototyping technology, we created a PSI and established DDH hip model in vitro. We enrolled 48 junior physicians and randomly assigned them into two groups. After creation of the PSI, they performed simulated THA surgery on a full-scale hip model with or without PSI on DDH models. The planned prothesis orientation, post-operative prothesis orientation, and surgery time were recorded., Results: The final cup inclination was 42.0 ± 0.8° in PSI group and 37.8 ± 2.0° in control group, while final cup anteversion was 16.0 ± 0.7° in PSI group and 24.7 ± 3.5° in control group. The △inclination in PSI group was smaller than that in control group (4.2 ± 0.5° vs 9.5 ± 1.4°, P < 0.01), so does △inclination (2.9 ± 0.4° in PSI group vs 15.2 ± 2.5° in control group, P < 0.01). The outlier percent was 8.3% in PSI group and 70.8% in control group (P < 0.01). At the same time, the PSI group did not prolong the operation time (P = 0.551)., Conclusion: The PSI can greatly increase the accuracy of placing the cup orientation and lower the threshold for junior physicians to perform THA on DDH patients. It could be a training tool for them to increase their THA surgical skills.

Background: A great deal of research suggests that arthroscopic ankle fusion (AAF) has advantages over open ankle fusion (OAF), but these outcomes would be imprecise because of a selection bias. The purpose of this study is to verify which is better for ankle fusion, AAF or OAF. We regrouped the OAF group into two subgroups according to whether the osseous operation type is the same as AAF group. The goal is to minimize the impact of disease severity, thereby reducing selection bias to some extent., Methods: We retrospectively analyzed the data of ankle fusion in our hospital between July 2015 and October 2018. Forty-three patients were enrolled and divided into AAF group (n = 17) and OAF group (n = 26). In order to eliminate selection bias, we divided OAF group into complex osseous operation subgroup (COO subgroup) (n = 15) and simple osseous operation subgroup (SOO subgroup) (n = 11). The osseous operation type of SOO subgroup is the same as AAF group. Then, we compared the differences between these groups. All patients were followed up at least 1 year after operation. We analyzed data, including etiology composition, surgical time, intra-op blood loss, reduction of albumin, total hospital stays, union time, fusion situation, complications, radiological examination, functional score, and questionnaire survey. Then we performed statistical analyses., Results: We found that the etiological components of AAF group and OAF group were different; the etiological components of AAF group and SOO subgroup were similar. We found that AAF group has advantages over OAF group and COO subgroup in general. However, except in terms of surgical trauma, hospital stays, and short-term complications occurred, the AAF group has not obvious advantages over SOO subgroup, including intra-op blood loss, fusion condition, postoperative function score, and postoperative patient satisfaction; and AAF group need more surgical time than the SOO subgroup., Conclusions: The arthroscopic ankle fusion can bring a good curative effect; however, if the osseous operation type is the same, the arthroscopic ankle fusion only has a limited advantage over the traditional open operation in perioperative soft tissue protection and enhanced recovery after surgery.

Background: Several approaches to spring ligament reconstruction have been reported. However, a comparative study of nonanatomic and anatomic techniques with respect to biomechanical responses, such as kinematics and contact characteristics, has not been previously performed via a finite element analysis. The purpose of this study was to evaluate the biomechanical results of such spring ligament reconstructions via a finite element analysis., Methods: A three-dimensional finite element model of the foot was developed and validated, and four reconstruction methods were simulated. The talonavicular dorsiflexion and abduction, hindfoot valgus, and contact characteristics in the Chopart joints were quantified in each model., Results: Nonanatomic reconstructions corrected the talonavicular and hindfoot deformities to a greater extent than the anatomic reconstructions. The anatomic techniques also corrected the abduction and dorsiflexion deformities, although they presented insufficient power to correct for hindfoot valgus. None of the procedures restored the contact characteristics of the talonavicular and calcaneocuboid joints to those of a normal condition., Conclusion: Nonanatomic reconstruction of the spring ligament complex provided the greatest correction for midfoot and hindfoot misalignments in flatfoot. Severe deformities with large amounts of midfoot pronation and hindfoot valgus may be better treated with nonanatomic reconstruction methods. The spring ligament reconstruction method may mitigate the need for nonanatomic bony procedures associated with complications and allows for the preservation of the triple joint complex.

Background: It is challenging to create an ideal artificial acetabulum during total hip arthroplasty (THA) in adult DDH. Our team developed a new patient-specific instrument (PSI) that uses the superolateral rim of the acetabulum as a positioning mark to assist in the production of an artificial acetabulum in adult Crowe II/III DDH patients. The purpose of this retrospective study is to verify whether this new PSI can be used to implement the preoperative plan accurately and quickly to create an ideal artificial acetabulum during THA in adult Crowe II/III DDH patients., Methods: We selected suitable adult Crowe II/III DDH patients from the registration system for artificial joint surgery at our hospital during April 2016 to March 2018 who underwent THA assisted by a PSI using the superolateral rim of the acetabulum as a positioning mark. We retrospectively analyzed data, including preoperative and postoperative anteversion, inclination, postoperative bilateral rotator center discrepancy (BRCD), surgery time, and the incidence of neurovascular injury. All patients underwent follow-up, and their Harris hip score (HHS) and X-ray data were recorded. Then, we performed statistical analyses on the data described above., Results: A total of 20 hip surgeries from 17 patients were included in our study. All patients underwent a successful operation assisted by the PSI. The mean anteversion of the cup in our preoperative plan was 15.1° (range, 10.0° to 20.0°), while the mean postoperative anteversion of the cup was 15.3° (range, 7.0° to 28.6°). The mean inclination of the cup in our preoperative plan was 44.7° (range, 40.0° to 50.0°), while the mean postoperative inclination of the cup was 45.6° (range, 35.0° to 57.6°). Paired-samples t test revealed no significant differences in anteversion and inclination between pre- and postoperation times (P > 0.05). The mean BRCD was 3.38 ± 3.0 mm (range, 0.5 to 11.0 mm). The average operation time was 105.1 ± 15.4 min, and no patients had neurovascular injury complications. All patients' acetabular components appeared clinically and radiologically stable after surgery. The mean HHS values were significantly improved at 12 weeks (P < 0.05) and 24 weeks (P < 0.05) postoperatively compared to the preoperative mean scores., Conclusions: The new PSI is accurate and practical to create an ideal artificial acetabulum during THA in adult Crowe II/III DDH patients.

A better understanding of displaced intra-articular calcaneal fractures, their effect on joint mechanics, and the relationship between altered mechanics and osteoarthritis could aid in the development or refinement of treatment methods. Finite element modeling is accepted as the reference standard for evaluating joint contact stresses. The objective of the present study was to analyze the in vivo joint mechanical data from finite element modeling for normal and injured subtalar joints. A 3-dimensional model of the ankle-hindfoot was developed and validated. Both height loss and width increases in the calcaneus were simulated. Next, they were used to investigate the relationship between calcaneal height or width and the contact mechanics of the posterior facet of the subtalar joint. The contact area/joint area ratio increased in the subtalar joint with injury when the calcaneal width increased. Moreover, the peak contact pressure and the proportion of the area under high contact pressure (>6 MPa) increased. The contact area/joint area ratio decreased with reduced calcaneal height, but the peak contact pressure remained almost constant. The width increases of the calcaneus somewhat limited the subtalar joint motion, especially for eversion; however, the height loss mostly resulted in subtalar rotatory instability. The height loss diminished the subtalar joint's stability in eversion, internal rotation, and external rotation. The results of the present study support the advisability of surgery for these complex injuries. Reestablishing the calcaneal height and width could restore the normal kinematics and contact stress distribution in the subtalar joint, improve the tibiotalar position, and diminish long-term degeneration in the ankle., (Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

We engineered Escherichia coli cells to bind to cyanobacteria by heterologously producing and displaying lectins of the target cyanobacteria on their surface. To prove the efficacy of our approach, we tested this design on Microcystis aeruginosa with microvirin (Mvn), the lectin endogenously produced by this cyanobacterium. The coding sequence of Mvn was C-terminally fused to the ice nucleation protein NC (INPNC) gene and expressed in E. coli. Results showed that E. coli cells expressing the INPNC::Mvn fusion protein were able to bind to M. aeruginosa and the average number of E. coli cells bound to each cyanobacterial cell was enhanced 8-fold. Finally, a computational model was developed to simulate the binding reaction and help reconstruct the binding parameters. To our best knowledge, this is the first report on the binding of two organisms in liquid culture mediated by the surface display of lectins and it may serve as a novel approach to mediate microbial adhesion., (Copyright © 2016 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.)

Ankylosing spondylitis is a chronic inflammatory rheumatic disease, which is characterized by inflammation of the spine and the sacroiliac joints. To date, the disease etiology remains unclear. In the present study, the correlation of T lymphocyte subset changes with the progression of ankylosing spondylitis was investigated. A total of 55 patients with ankylosing spondylitis (22 severe and 23 mild cases) and 20 healthy individuals were selected. Firstly, the punctured cells in the lesions and the serum were collected, and the lymphocytes and the peripheral blood mononuclear cells were prepared. Secondly, quantitative PCR, ELISA and flow cytometry analyses were carried out to detect the levels of a series of immunoglobulins, complements, helper T cells, cytotoxic T cells, regulatory cells and cytokines. The expression levels of α-globulin, γ-globulin, immunoglobulin (Ig)G, IgA, IgM, serum complement C3, and complement C4 were found to be significantly increased in ankylosing spondylitis patients. In addition, the percentage of Th1 and Th17 cells was found to be significantly higher in the ankylosing spondylitis groups (mild and severe) compared with the healthy individuals. As a result, the Th1/Th2 and Th17/Treg ratios were significantly higher in patients with ankylosing spondylitis. In addition, T lymphocyte subset ratio imbalances contributed to an increased expression of immune mediators, including interferon (IFN)-γ and interleukin (IL)-17A. The mRNA and protein expression levels of IFN-γ and IL-17A were found to be higher in the ankylosing spondylitis groups compared with the control group. The present study provided further evidence on the function and underlying mechanism of T lymphocyte subsets, which may be useful in the diagnosis and treatment of ankylosing spondylitis.

Tuning the threshold voltage of a transistor is crucial for realizing robust digital circuits. For silicon transistors, the threshold voltage can be accurately controlled by doping. However, it remains challenging to tune the threshold voltage of single-wall nanotube (SWNT) thin-film transistors. Here, we report a facile method to controllably n-dope SWNTs using 1H-benzoimidazole derivatives processed via either solution coating or vacuum deposition. The threshold voltages of our polythiophene-sorted SWNT thin-film transistors can be tuned accurately and continuously over a wide range. Photoelectron spectroscopy measurements confirmed that the SWNT Fermi level shifted to the conduction band edge with increasing doping concentration. Using this doping approach, we proceeded to fabricate SWNT complementary inverters by inkjet printing of the dopants. We observed an unprecedented noise margin of 28 V at V(DD) = 80 V (70% of 1/2V(DD)) and a gain of 85. Additionally, robust SWNT complementary metal-oxide-semiconductor inverter (noise margin 72% of 1/2VDD) and logic gates with rail-to-rail output voltage swing and subnanowatt power consumption were fabricated onto a highly flexible substrate.

Objective: To observe the effectiveness of vacuum sealing drainage (VSD) combined with anti-taken skin graft on open amputation wound by comparing with direct anti-taken skin graft., Methods: Between March 2005 and June 2010, 60 cases of amputation wounds for limbs open fractures were selected by using the random single-blind method. The amputation wounds were treated with VSD combined with anti-taken skin graft (test group, n = 30) and direct anti-taken skin graft (control group, n = 30). No significant difference was found in age, gender, injury cause, amputation level, defect size, preoperative albumin index, or injury time between 2 groups (P > 0.05). In test group, the redundant stump skin was used to prepare reattached staggered-meshed middle-thickness skin flap by using a drum dermatome dealing after amputation, which was transplanted amputation wounds, and then the skin surface was covered with VSD for continuous negative pressure drainage for 7-10 days. In control group, wounds were covered by anti-taken thickness skin flap directly after amputation, and conventional dress changing was given., Results: To observe the survival condition of the skin graft in test group, the VSD device was removed at 8 days after operation. The skin graft survival rate, wound infection rate, reamputation rate, times of dressing change, and the hospitalization days in test group were significantly better than those in control group [ 90.0% vs. 63.3%, 3.3% vs. 20.0%, 0 vs. 13.3%, (2.0 +/- 0.5) times vs. (8.0 +/- 1.5) times, and (12.0 +/- 2.6) days vs. (18.0 +/- 3.2) days, respectively] (P < 0.05). The patients were followed up 1-3 years with an average of 2 years. At last follow-up, the scar area and grading, and two-point discrimination of wound in test group were better than those in control group, showing significant differences (P < 0.05). No obvious swelling occurred at the residual limbs in 2 groups. The limb pain incidence and the residual limb length were better in test group than those in control group (P < 0.05). Whereas, no significant difference was found in the shape of the residual limbs between 2 groups (P > 0.05). In comparison with the contralateral limbs, the muscle had disuse atrophy and decreased strength in residual limbs of 2 groups. There was significant difference in the muscle strength between normal and affected limbs (P < 0.05), but no significant difference was found in affected limbs between 2 groups (P > 0.05)., Conclusion: Compared with direct anti-taken skin graft on amputation wound, the wound could be closed primarily by using the VSD combined with anti-taken skin graft. At the same time it could achieve better wound drainage, reduce infection rate, promote good adhesion of wound, improve skin survival rate, and are beneficial to lower the amputation level, so it is an ideal way to deal with amputation wound in the phase I.