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To explore clinical efficacy of staged surgery in treating complex closed Pilon fracture.From June 2019 to January 2021, 29 patients with complex closed Pilon fracture were treated by staging surgery, including 18 males and 11 females, aged ranged from 31 to 68 years old with an average of (43.50±6.62) years old;7 cases were typeⅡand 22 cases were type Ⅲ according to Ruedi-Allgower classification. All patients had fresh closed fractures without talus and calcaneal fractures. The time from injury to closed reduction and external fixation, the interval between two stages of surgery, fracture healing time and complications were recorded. American Orthopedic Foot and Ankle Society(AOFAS) was used to assess clinical effects. Burwell-Charnley system was used to evaluate radiological reduction.All 29 patients were followed up from 13 to 30 months with an aver age of (15.43±5.31) months. All fractures healed well from 2 to 6 months with an average of (3.77±1.22) months. No internal fixation fracture, screw loosening, infection, internal fixation irritation, ankle stiffness occurred. The time from injury to closed reduction and cross-ankle fixation ranged from 1.22 to 7.34 h with an average of(2.31±3.52) h, the interval between two stages ranged from 5 to 9 days with an average of (5.98±2.11) days. AOFAS score was improved from 34.11±6.89 before operation to 90.10±10.11 after oepration at 12 months(Staged surgery for complex closed Pilon fracture has advantages of less complications, statisfied reduction, stable fixation, which could obtain good recovery of ankle joint.

Traffic flow system’s stability analysis can be seen as a typical control system problem, which has three kinds of damping ratio properties from the viewpoint of control theory. To discover the damping ratio characteristics of traffic flow system under sudden outer impulse, firstly, we proposed a new method to build the traffic flow model based on state space theory. Secondly, we deduced one form of state transfer matrix from system closed-loop transfer function reversely. Lastly, we fully investigated the proportional–differential effects in the traffic car-following model system analytically and numerically. For unsteady traffic flow system with the proportional–differential (PD) term, in order to suppress the traffic jam, we derived a kind of decoupled delay-feedback control algorithm, which used H ∞ -norm and the numerical simulation method to find the feedback gain k and delay time τ . The traffic flow system’s transient performance formula was presented with and without PD term, and we found out the important impact of PD term on traffic flow system’ stability. The numerical simulation results substantiate our theoretical and analytical results.

In order to further improve the performance of the existing anisotropic Gaussian filters and more fully take advantage of structural information of a boundary, we heuristically develop a new multi-pixel anisotropic Gaussian filter to detect edges or edge-line segments directly from low signal-to-noise ratio images. To significantly increase computational efficiency, the classical isotropic Gaussian filters are first used for quickly estimating an approximate direction along an edge; then our filter is applied to more accurately search edge-line segment direction by a few directional filter masks only near such approximate direction. By comparing the proposed filter with the isotropic Gaussian filters, we analyze two improvement factors associated with the localization and SNR of the proposed filter. Experimental results show that the proposed detector can achieve better performance than several existing edge-detection methods in the sense of noise reduction, good localization, and high edge continuity.

Composite photocatalysts, prepared by mechanical grinding TiO2 with bentonite/ organobentonite, were applied in the dynamic photodegradation of gaseous toluene. A substrate enriched environment surround the loaded TiO2 was formed by the adsorption of the added sorbents, leading to an increase in the degradation rate. The performance of composite catalysts was quite different in the initial and the long-term period of photocatalysis. The differences could be attributed to the adsorption properties of added sorbents related to adsorbility, hydrophilicity and diffusion feasibility, etc. The longer alkyl-chain of organobentonite formed a better partition phase resulting in an ideal adsorption capacity. However, as the alkyl-chain length increased, the diffusion path was segmentally clogged which seriously hindered the photocatalysis in the initial period. Although the adsorption capacity of original bentonite was quite small, the facility of diffusion changed it into the best performer in the initial period. Organobentonite with relatively short alkyl-chain conceived a little smaller adsorption capacity than the longer one. Moreover, the former one showed much more trending to diffuse the adsorbed toluene to catalyst. The long-term period of photocatalysis was also affected by the hydrophilicity of catalyst. Hence, the performance of organobentonites added composite catalyst mended a lot in the final degradation rate. Thus, organobentonite as 20DTAB with the advantage of large adsorption capacity and good diffusion feasibility is believed to be a promising carrier of photocatalys.

To discuss a new surgical strategy: Jinling procedure (subtotal colectomy combined with modified Duhamel procedure), of which the indications, technical notes and outcomes were analyzed.The 590 patients with refractory slow-transit constipation associated with outlet obstruction was strictly included between February 2000 and December 2011. The patients included 103 males and 487 females. Their age were 14-75 years (average 42 ± 13). The 412 patients received laparoscopic-assistant Jinling procedure, and 178 patients with open Jinling procedure. The pre- and post-operation data were collected. The follow up rate were 100%, 98.1%, 95.8% and 92.7% at 3, 6, 12 and 24 months.There was no surgery-related death. Mean hospital day was (12 ± 9) days. Most complications were managed conservatively without significant events. The common complications after surgery were adhesive intestinal obstruction (9.2%), anastomosis bleeding (8.1%) and anastomosis leakage (2.9%). The gastrointestinal quality of life index score was 72 ± 9 preoperatively and increased to 68 ± 11, 99 ± 6, 105 ± 9, 106 ± 9 at 3, 6, 12 and 24 month follow-up, respectively (t = 62.1, -25.1, -126.5, -143.2, P0.01). The Wexner constipation scale was 21.9 ± 4.5 preoperatively and decreased to 9.6 ± 2.4, 5.9 ± 2.1, 4.6 ± 1.9, 4.5 ± 1.8 at 3, 6, 12 and 24 month follow-up, respectively (t = 48.6, 61.8, 58.2, 45.9, P0.01). The satisfactory rate was 77.5%, 92.1%, 93.0% and 94.1% at 3, 6, 12, and 24 month follow-up.Jinling procedure provides a good surgical option for refractory slow-transit constipation associated with outlet obstruction.

To propose a novel surgical procedure for refractory constipation, namely Jinling procedure, and to explore its safety and efficacy through long-term follow-up.A total of 614 patients with refractory constipation were admitted to the Department of General Surgery between February 2000 and June 2011. Five hundred and fifty-four patients received Jinling procedure and were included in this study. The general clinical data, complications after Jinling procedure, gastrointestinal quality of life index (GIQLI), Wexner constipation scale and satisfaction rate during follow-up were collected.No operation-associated death occurred. Increased bowel movement frequency was observed during the perioperative period. Temporary difficulty in urination occurred in 24.5% of the patients. Other complications included small bowel obstruction (9.6%), anastomotic bleeding (8.1%), anastomotic leakage (3.1%), sexual dysfunction (3.1%), and wound infection (3.1%). Most postoperative complications were managed conservatively. The most recent follow-up was on August 2011, and the follow-up rate was 100%, 88.8%, 75.1%, 56.3% at 3, 6, 12, and 24 months after surgery. GIQLI temporarily increased from 78.1±9.4 preoperatively to 92.0±9.5 at 3 months follow-up, but continued to decrease during the follow-up at the 6 months (48.4±14.1), 12 months (21.0±4.3), and 24 months (20.0±3.4). Wexner constipation scale decreased from 19.9±4.3 preoperatively to 8.4±2.1 at 3 months follow-up (P0.01). The low Wexner scale sustained until 24 months after operation. The satisfaction rate at the 3, 6,12 and 24 months follow-up was 78.1%, 91.1%, 94.2% and 94.6%, respectively.Jinling procedure provides refractory constipation patients with a novel, safe and effective surgical option.