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Abstract Background Aims of this study were to compare the functional and radiographic results, perioperative complication after lateral unicompartmental knee arthroplasty (LUKA) with total knee arthroplasty (TKA) and the legacy constrained condylar knee (LCCK) arthroplasty for the treatment of lateral compartmental knee osteoarthritis (LCKOA), and to provide a basis for the treatment of LCKOA. Methods From January 2021 to January 2024, analyzed retrospectively clinical data of 74 patients with LCKOA treated with LUKA, TKA and LCCK arthroplasty. According to the operation plan, the patients were divided into three groups: LUKA group (23 cases), TKA group (23 cases) and LCCK group (28 cases). The changes of hip-knee-ankle (HKA) angle of the affected knee before and after operation were measured. All patients were assessed using the operation time, blood loss during operation, incision length, visual analogue scale (VAS) score before operation and after operation, Hospital for Special Surgery score (HSS), Oxford Knee Score (OKS), range of motion (ROM). Results All 74 patients were followed up for (2.38 ± 0.33) years. The operation time, blood loss during operation, incision length and VAS score after operation in the LUKA group were significantly less than those in the TKA group and LCCK group (P 0.05). Conclusion LUKA, TKA and LCCK arthroplasty have good clinical effect in the treatment of LCKOA; Compared with TKA and LCCK arthroplasty, LUKA has the advantages of less trauma, less bleeding, less pain and quick recovery. The short-term effect is satisfactory, and the long-term effect remains to be observed.

Abstract This study aims to evaluate the biomechanical performance of the Gamma 3 nail with an anti-rotation screw (GNS) and compare it to two established gold-standard methods for treating unstable femoral neck fractures (UFNFs). Synthetic bone models were prepared with Pauwels’ type III osteotomy and an additional posterior wedge. Three different implant configurations were tested: three cannulated crews (3CS) in an inverted triangle configuration, a dynamic hip screw with an anti-rotation screw (DHSS), and GNS. Non-destructive cyclic axial loading was applied at 7° adduction, with 1000 cycles ranging from 100 to 1000 N. Subsequently, a construct failure test was conducted using progressive axial compression, and fracture reduction loss was recorded. The average axial stiffness was 321 ± 52 N/mm for 3CS, 430 ± 71 N/mm for DHSS, and 519 ± 104 N/mm for GNS. The average ultimate failure loads were 2699.3 N for 3CS, 3427.1 N for DHSS, and 3758.9 N for GNS. GNS demonstrated significantly greater axial stiffness compared to the other two groups (P

Abstract Capturing fine spatial, spectral, and temporal information of the scene is highly desirable in many applications. However, recording data of such high dimensionality requires significant transmission bandwidth. Current computational imaging methods can partially address this challenge but are still limited in reducing input data throughput. In this paper, we report a video-rate hyperspectral imager based on a single-pixel photodetector which can achieve high-throughput hyperspectral video recording at a low bandwidth. We leverage the insight that 4-dimensional (4D) hyperspectral videos are considerably more compressible than 2D grayscale images. We propose a joint spatial-spectral capturing scheme encoding the scene into highly compressed measurements and obtaining temporal correlation at the same time. Furthermore, we propose a reconstruction method relying on a signal sparsity model in 4D space and a deep learning reconstruction approach greatly accelerating reconstruction. We demonstrate reconstruction of 128 × 128 hyperspectral images with 64 spectral bands at more than 4 frames per second offering a 900× data throughput compared to conventional imaging, which we believe is a first-of-its kind of a single-pixel-based hyperspectral imager.

Driving safety is significant to building a people-oriented and harmonious society, Tires are one of the key components of a vehicle and the character information on the tire sidewall is critical to their storage and usage. However, due to the diverse and differentiated features of typographic fonts, simultaneously extracting comprehensive characteristics is an extremely challenging task. To effectively break through these performance degradation issues, a multi-scale tire sidewall text region detection algorithm based on YOLOv5 is introduced, called YOLOT, which fuses comprehensive feature information in both width and depth directions. In this study, we firstly propose the Width and Depth Awareness (WDA) module in the text region detection field and successfully integrated it with the FPN structure to form the WDA-FPN. The purpose of WDA-FPN is to empower the network to capture multi-scale and multi-shape features in images, thereby augmenting the algorithm’s abstraction and representation of image features and concurrently boosting its robustness and generalization performance. Experimental findings indicate that, compared to the primary algorithm, YOLOT achieves significant improvement in accuracy, providing a higher detection reliability. The dataset and code for the paper are available at: https://github.com/Cloude-dehua/YOLOT.

Objective Hip fractures are the most common fractures among older adults, with most patients undergoing surgery. The debate regarding the type of anesthetic technique for hip fracture surgery is still ongoing. This meta‐analysis aimed to compare the intraoperative and postoperative outcomes of spinal and general anesthesia in older patients undergoing hip fracture surgery. Methods Eligible studies that compared the effects of spinal and general anesthesia were systematically searched from PubMed, Embase, and the Cochrane Library until May 27, 2022. The intraoperative and postoperative outcomes of the two anesthesia techniques were compared. Quality assessment, heterogeneity analysis, and publication bias of the studies were also assessed. Results Nine articles of methodological quality were included in the meta‐analysis. The pooled results revealed that there were significant differences in hypotension (risk ratio [RR] (95% confidence interval [CI]) = 0.81 (0.68, 0.97), p = 0.02) and ephedrine dose (weighted mean difference [WMD] [95%CI] = −20.94 [−37.50, −4.37] mg, p = 0.01) between the spinal and general anesthesia groups. However, no significant differences were observed in the use of ephedrine (RR [95% CI] = 0.77 [0.19, 3.05]), blood loss (WMD [95%CI] = −34.38 [−89.56, 20.80) mL], myocardial infarction (RR [95% CI] = 0.78 [0.31, 1.94] mL), heart failure (RR [95% CI] = 0.87 [0.17, 4.36] mL), stroke (RR [95%CI) = 0.65 [0.22, 1.95] mL), postoperative nausea and vomiting (RR [95% CI] = 0.88 [0.17, 4.35] mL), delirium (RR [95% CI] = 1.08 [0.89, 1.31] mL), and mortality (RR [95% CI] = 1.10 [0.72, 1.68] mL) (all p

Abstract Posterolateral (PL)-depression fractures of the tibial plateau are difficult to manage. The aim of this study was: (1) to present our experience with a novel technique of robot-assisted percutaneous reduction and fixation and (2) to compare it with the traditional percutaneous screw osteosynthesis (PSO) technique for the treatment of PL-depression tibial plateau fractures. The clinical data of patients with PL-depression tibial plateau fractures treated by robot-assisted percutaneous reduction and fixation technique and traditional PSO technique from January 2017 to January 2021 were retrospectively analyzed. Among them, there were 18 cases in the robot-assisted group (RA group) and 23 cases in the PSO group. All fractures were unilateral, closed and fresh PL-depression fractures of the tibial plateau. Patients in the RA group were treated by robot assisted reduction and minimally invasive absorbable screw fixation. The PSO group was treated by closed reduction and percutaneous absorbable screw osteosynthesis. The incision length, operation time, intraoperative blood loss, fluoroscopic times, inpatient time, weight training time and postoperative complications of the two groups were statistically analyzed. The Rasmussen radiological score was used to assess the reduction quality after operation while the Rasmussen functional score was used to evaluate knee joint functions at one year postoperatively. All patients were followed for at least one year. There was no significant difference in demographic information between the two groups (p > 0.05). Compared with the PSO group, the RA group showed less fluoroscopic times and better Rasmussen radiological and functional scores (p 0.05). The novel robot-assisted percutaneous reduction and fixation technique had the characteristics of less radiation, accurate reduction and fixation. It could accelerate the rehabilitation of patients with PL-depression fractures of the tibial plateau and enable patients to obtain good joint functions.

Ephedra sinica (E. sinica) holds significant economic and medicinal importance and is predominantly found in arid areas. Due to the limitations of environmental variables, growth habits, and human activities, the production and suitability areas of E. sinica have significantly decreased, especially in the five northwestern provinces of China. In this study, 212 distribution points of E. sinica and 40 environmental variables were obtained to project the habitat suitability of E. sinica under different emission scenarios in the future. It identified precipitation in the wettest month, monthly mean of the diurnal temperature difference, and solar radiation intensity in April and July as the primary environmental factors affecting the suitability of E. sinica in the region. The areas of high, medium, and low suitability in the region cover 103,000 km2, 376,500 km2, and 486,800 km2. Under future scenarios, the suitability areas from 2021 to 2100 will decrease by 20%, with high suitability areas decreasing by 65% to 85% particularly. With comprehensive environmental variables, the suitability areas of E. sinica from 2021 to 2100 are projected, filling the gap in the projection of E. sinica suitability areas in the five northwestern provinces of China over long time period. The suitability areas show a significant decreasing trend. This research provides valuable insights into the suitability areas and crucial environmental factors, offering theoretical support for future protection and management efforts for E. sinica.

ObjectiveWe aimed to evaluate the efficacy of antibiotic-loaded calcium sulfate combined with autologous iliac bone transplantation in the treatment of limb-localized osteomyelitis (Cierny–Mader type III) and analyze the causes and risk factors associated with infection recurrence.MethodsClinical data of 163 patients with localized osteomyelitis of the extremities treated with antibiotic-loaded calcium sulfate combined with autologous iliac bone transplantation in Xi’an Honghui Hospital from January 2017 to December 2022 were retrospectively analyzed. All patients were diagnosed with localized osteomyelitis through clinical examination and treated with antibiotic-loaded calcium sulfate combined with autologous iliac bone. Based on the infection recurrence status, the patients were divided into the recurrence group and the non-recurrence group. The clinical data of the two groups were compared using univariate analysis. Subsequently, the distinct datasets were included in the binary logistic regression analysis to determine the risk and protective factors.ResultsThis study included 163 eligible patients, with an average age of 51.0 years (standard deviation: 14.9). After 12 months of follow-up, 25 patients (15.3%) experienced infection recurrence and were included in the recurrence group; the remaining 138 patients were included in the non-recurrence group. Among the 25 patients with recurrent infection, 20 required reoperation, four received antibiotic treatment alone, and one refused further treatment. Univariate analysis showed that education level, smoking, hypoproteinemia, open injury-related infection, and combined flap surgery were associated with infection recurrence (p < 0.05). Logistic regression analysis showed that open injury-related infection (odds ratio [OR] = 35.698; 95% confidence interval [CI]: 5.997–212.495; p < 0.001) and combined flap surgery (OR = 41.408; 95% CI: 5.806–295.343; p < 0.001) were independent risk factors for infection recurrence. Meanwhile, high education level (OR = 0.009; 95% CI: 0.001–0.061; p < 0.001) was a protective factor for infection recurrence.ConclusionAntibiotic-loaded calcium sulfate combined with autologous iliac bone transplantation is an effective method for treating limb-localized osteomyelitis. Patients without previous combined flap surgery and non-open injury-related infections have a relatively low probability of recurrence of infection after treatment with this surgical method. Additionally, patients with a history of smoking and hypoproteinemia should pay attention to preventing the recurrence of infection after operation. Providing additional guidance and support, particularly in patients with lower education levels and compliance, could contribute to the reduction of infection recurrence.

ObjectiveTo compare the effects of allogeneic tendon coracoclavicular ligament reconstruction combined with Kirschner wire fixation and clavicular hook plate fixation on early postoperative pain, postoperative shoulder joint function score and shoulder joint mobility in patients with acromioclavicular joint dislocation.MethodsFrom January 2020 to January 2023, 43 patients with acromioclavicular joint dislocation admitted to Xi ‘an Honghui Hospital were included. Among them, 24 patients were treated with the clavicular hook plate technique (Hook Plate,HP) group, and 19 patients were treated with allogeneic tendon coracoclavicular ligament reconstruction combined with the Kirschner wire technique (Allogeneic Tendon, AT) group. The Constant-Murley score of shoulder joint function 6 months after operation, postoperative shoulder joint activity, preoperative and postoperative pain, operation time, intraoperative blood loss and complications were compared between the two groups.ResultsAll 43 patients were followed up for an average of 9.7 (9–12) months. The intraoperative blood loss in the allogeneic tendon group was less than in the hook plate group. The Constant-Murley shoulder function score was higher than that in the hook plate group 6 months after the operation. The abduction and lifting activity was greater than that in the hook plate group. The visual analogue scale scores at 3 days and 14 days after operation were lower than those in the hook plate group. The difference was statistically significant (p < 0.001). There was 1 case (5.3%) of exudation around the Kirschner needle track in the allogeneic tendon reconstruction group, and 5 cases (20.8%) of complications in the hook plate group, including 1 case of internal fixation stimulation, 2 cases of acromion impingement syndrome, 1 case of acromioclavicular joint osteoarthritis, and 1 case of shoulder joint stiffness. The complication rate of the allogeneic tendon group was lower than that of the hook plate group.ConclusionThe clinical efficacy of allogeneic tendon coracoclavicular ligament reconstruction combined with Kirschner wire fixation in treating acromioclavicular joint dislocation (Rockwood type III-V) is better than hook plate internal fixation. The patients have less early postoperative pain and better recovery of shoulder joint function and shoulder joint mobility.

Background: Bruck syndrome (BS) is an extremely rare autosomal-recessive connective tissue disorder mainly characterized by bone fragility, congenital joint contracture, and spinal deformity. It is also considered as a rare form of osteogenesis imperfecta (OI) due to features of osteopenia and fragility fractures. Its two forms, BS1 and BS2, are caused by pathogenic variations in FKBP10 and PLOD2, respectively. Objective: We aimed to improve the clinical understanding of BS by presenting a case from China and to identify the genetic variants that led to this case. Methods: OI was suspected in a Chinese boy with a history of recurrent long bone fractures, lumbar kyphosis, and dentinogenesis imperfecta (DI). Whole-exome sequencing (WES) was performed to identify pathogenic variations. Sanger sequencing was used to confirm the results of the WES. In silico analysis was used to predict the pathogenicity of genetic variants. Results: WES and Sanger sequencing revealed a compound heterozygous variation in the FKBP10 gene (NM_021939, c.23dupG in exon 1, and c.825dupC in exon 5). Both variants resulted in a frameshift and premature stop codon. Of these two variants, c.23dupG has not been previously reported. The patient's parents were heterozygous carriers of one variant. In addition, zoledronic acid treatment improved the vertebral deformity and bone mineral density (BMD) significantly in this patient. Conclusions: A novel compound heterozygous variation of FKBP10, c.23dupG/c.825dupC, was identified in a patient with moderately severe OI. Based on these findings, the patient was diagnosed with BS1 without congenital joint contractures or OI type XI. This study expands the spectrum of FKBP10 genetic variants that cause BS and OI.

Abstract Segmental femoral bone defects are a severe challenge for orthopedic trauma surgeons. The objective of this study was to compare the efficacy of the shortening/re-lengthening and nailing (SRN) technique with the traditional bone transport (BT) technique in treating patients with such defects. A retrospective study was conducted involving 46 patients with segmental femoral bone defects, with 21 cases treated using the SRN technique (SRN group) and 25 cases managed with the traditional BT technique (BT group). The mean length of the bone defect was 5.8 ± 1.1 cm in the SRN group and 6.1 ± 1.6 cm in the BT group. Various parameters including time in frame, external fixation index, self-rating anxiety scale (SAS) scores, bone healing scores, limb function scores, and complications were recorded. The mean time in frame for the SRN group was 3.7 ± 1.4 months, significantly shorter than the 9.4 ± 3.7 months observed in the BT group (p

Background: Osteoporosis (OP) is a chronic bone metabolic disease and a serious global public health problem. Several studies have shown that mitophagy plays an important role in bone metabolism disorders; however, its role in osteoporosis remains unclear.Methods: The Gene Expression Omnibus (GEO) database was used to download GSE56815, a dataset containing low and high BMD, and differentially expressed genes (DEGs) were analyzed. Mitochondrial autophagy-related genes (MRG) were downloaded from the existing literature, and highly correlated MRG were screened by bioinformatics methods. The results from both were taken as differentially expressed (DE)-MRG, and Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed. Protein-protein interaction network (PPI) analysis, support vector machine recursive feature elimination (SVM-RFE), and Boruta method were used to identify DE-MRG. A receiver operating characteristic curve (ROC) was drawn, a nomogram model was constructed to determine its diagnostic value, and a variety of bioinformatics methods were used to verify the relationship between these related genes and OP, including GO and KEGG analysis, IP pathway analysis, and single-sample Gene Set Enrichment Analysis (ssGSEA). In addition, a hub gene-related network was constructed and potential drugs for the treatment of OP were predicted. Finally, the specific genes were verified by real-time quantitative polymerase chain reaction (RT-qPCR).Results: In total, 548 DEGs were identified in the GSE56815 dataset. The weighted gene co-expression network analysis(WGCNA) identified 2291 key module genes, and 91 DE-MRG were obtained by combining the two. The PPI network revealed that the target gene for AKT1 interacted with most proteins. Three MRG (NELFB, SFSWAP, and MAP3K3) were identified as hub genes, with areas under the curve (AUC) 0.75, 0.71, and 0.70, respectively. The nomogram model has high diagnostic value. GO and KEGG analysis showed that ribosome pathway and cellular ribosome pathway may be the pathways regulating the progression of OP. IPA showed that MAP3K3 was associated with six pathways, including GNRH Signaling. The ssGSEA indicated that NELFB was highly correlated with iDCs (cor = −0.390, p < 0.001). The regulatory network showed a complex relationship between miRNA, transcription factor(TF) and hub genes. In addition, 4 drugs such as vinclozolin were predicted to be potential therapeutic drugs for OP. In RT-qPCR verification, the hub gene NELFB was consistent with the results of bioinformatics analysis.Conclusion: Mitophagy plays an important role in the development of osteoporosis. The identification of three mitophagy-related genes may contribute to the early diagnosis, mechanism research and treatment of OP.

Abstract Objective Spiral fracture of tibia combined with posterior malleolar fracture (PMF) is a special and regular injury. There is no uniform fixation method for PMF in this kind of injury. Intramedullary nail is the first choice for the treatment of tibial spiral fracture. We proposed a minimally invasive percutaneous screw combined with intramedullary nail technology to fix the PMF in the tibial spiral fracture. This study aims to explore the effectiveness and advantages of this technology. Materials and methods From January 2017 to February 2020, 116 cases of spiral fracture of tibia combined with PMF who were operated in our hospital were divided into Fixation Group (FG) and No Fixation Group (NG) according to whether PMF was fixed. After minimally invasive percutaneous screw fixation of ankle fracture in FG patients, the tibial intramedullary nail was inserted to fix the fracture. Collected the operation and postoperative recovery of the two groups of patients, including the operation time, intraoperative blood loss, AOFAS score, VAS score and dorsiflexion restriction of ankle joint at the last follow-up, and compared whether there is any difference between the two groups of patients. Results The fracture of both groups healed.2 patients in NG had secondary displacement of PMF during operation, and the fracture finally healed after fixation. There were statistical differences between the two groups in terms of operation time, AOFAS score and weight bearing time. The operation time of FG was 67.9±11.2 min, and that of NG was 60.8±9.4 min; The weight bearing time of FG was 57.35±34.72 days, and that of NG was 69.17±21.43 days; The AOFAS score of FG was 92.50±3.46, and that of NG was 91.00±4.16. There were no significant difference in blood loss, VAS and dorsiflexion restriction of ankle joint between the two groups. The blood loss of FG was 66.8±12.3 ml, the blood loss of NG was 65.6±11.7 ml, the VAS score of FG was 1.37±0.47, the VAS score of NG was 1.43±0.51, the dorsiflexion restriction of FG was 5.8±4.1; the NG was 6.1±5.7. Conclusion For the injury of tibial spiral fracture combined with PMF, our fixation technology can achieve minimally invasive fixation of PMF with percutaneous screws on the basis of intramedullary nail fixation of tibial fracture, promoting early functional exercise of ankle joint and early weight bearing of patients. This fixation technology is also characterized by simple and fast operation.

Objective No consensus has been reached regarding optimal implantation for a syndesmotic screw. Thus, we aimed to explore the feasibility of a reliable and static fibular incisura plane reference for ideal syndesmotic screw placement. Methods A retrospective review of computed tomography (CT) scans of 42 uninjured adult ankles with foot fractures were analyzed to measure the tibiofibular vertical distance (TFVD) at 2.5 cm proximal to the plafond from August 2016 to June 2017 in our hospital. The patients (20 females, 22 males) were divided into four groups according to their TFVD: 0–1, 1–2, 2–3, and 3–4 mm, and patients in each group were counted. We retrospectively assessed 41 patients (15 females, 26 males) who underwent syndesmotic screw fixation for ankle fractures from December 2015 to June 2020. We performed t‐testing of two independent samples to determine the differences in the angle between the anatomic axis of the syndesmosis and screw axis (AAS) and ankle function using the American Orthopaedic Foot and Ankle Society (AOFAS) score at 3 and 6 months postoperatively between the conventional (20 patients) and K‐wire marker (21 patients) groups. The correlation between the AAS and AOFAS score was analyzed. Results The TFVD measured 2.23 ± 1.01 mm at 2.5 cm proximal to the plafond, and occurred at 25% of the distance from 2 to 3 mm in 47.6% of the patients. This new technique decreased AAS deformation by 62%, from 13.01° ± 2.84° to 4.89° ± 2.43°, in the conventional group (p

Abstract In the present study, we presented our experience with a new modified technique of shortening and re-lengthening using a monolateral external frame combined with a calcaneal intramedullary nail and compared it with the bone transport technique for the treatment of distal tibial periarticular post-traumatic defects. Forty-one patients were retrospectively analyzed. Among them 19 were treated using our modified shortening and re-lengthening technique (MSR group) and 22 by bone transport (BT group). The difference in external fixation time (EFT), external fixation index (EFI), self-rating anxiety scale (SAS), and complications were compared between the two groups. The mean EFT was 3.4 ± 0.6 months in the MSR group and 7.5 ± 1.4 months in the BT group; the EFI was 0.57 ± 0.06 month/cm and 1.32 ± 0.23 month/cm, respectively. The EFT, EFI, and SAS scores were significantly lower in the MSR group than in the BT Group (p

Objective: To explore the related risk factors of serous exudation after antibiotic-loaded calcium sulfate treatment of fracture-related infections and to provide a theoretical basis for clinical treatment and prevention of serous exudation complications.Methods: The clinical data of 145 patients with limb fracture-related infection treated with antibiotic-loaded calcium sulfate in Xi’an Honghui Hospital from January 2019 to December 2022 were retrospectively analyzed. All patients were diagnosed with fracture-related infection by preoperative magnetic resonance examination, bacterial culture and gene detection and received antibiotic-loaded calcium sulfate implantation. The postoperative serous exudation was recorded through hospitalization observation, outpatient review or follow-up. The collected clinical data were sorted out, and the patient data were divided into serous exudation groups and non-exudation groups. Firstly, the clinical data of the two groups were compared by single-factor analysis to screen out the risk factors. Then multivariate binary Logistic regression analysis determined the independent risk factors and protective factors.Results: 1) According to the inclusion and exclusion criteria, there were 145 cases with complete clinical data, including 27 cases in the non-infectious exudation group and 118 cases in the non-exudative group; 2) Univariate analysis showed that the history of diabetes, smoking history, calcium sulfate implantation, drainage time, combined flap surgery, geometric shape of implanted calcium sulfate, and thickness of soft tissue covered by the surgical area were all associated with the occurrence of non-infectious exudation after antibiotic-loaded calcium sulfate implantation (p < 0.05); 3) The amount of implanted calcium sulfate was more [OR = 5.310, (1.302–21.657), p = 0.020], combined with flap surgery [OR = 3.565, (1.195–10.641), p = 0.023], and the thickness of soft tissue coverage in the operation area was thinner [OR = 5.305, (1.336–21.057), p = 0.018]. Longer drainage time [OR = 0.210, (0.045–0.967), p = 0.045] was a protective factor for non-infectious exudation after antibiotic-loaded calcium sulfate implantation.Conclusion: 1) The probability of serous exudation in patients with fracture-associated infection after antibiotic-loaded calcium sulfate surgery was 18.62%. This complication may cause a heavier economic and psychological burden on patients; 2) With the increase of bone infection area and the application of more calcium sulfate, the incidence of serous exudation after antibiotic-loaded calcium sulfate surgery in patients with the fracture-related infection will increase, so we should use the amount of calcium sulfate reasonably on the premise of sufficient control of infection in clinical work, and the incidence of serous exudation will also increase due to the recent skin flap surgery and the thinner soft tissue coverage of calcium sulfate implantation area; 3) Under the premise of being able to drain the drainage from the surgical area, the longer drainage time of the drainage tube has a positive effect on preventing the occurrence of serous exudation.

We reported 2 cases of patellar tendon rupture at the lower pole of the patella. For patellar tendon rupture, simple suture fixation has been proved to be inadequate in strength. Our center uses custom-made anchor-like plate and suture to treat proximal patellar fracture. The fixation strength is reliable, no additional bone tunnel is required, and the fixation of the lower patellar fracture can be achieved at the same time. After the operation, the patient starts functional exercise of the knee joint at an early stage, The function of the knee joint of the patient recovered well after 1 year, without other complications.

Abstract Background The reduction in irreducible extracapsular hip fractures has always been controversial. Here, we present a new minimally invasive reduction technique and compare it with limited open reduction (LOR) to treat irreducible extracapsular hip fractures. Methods From January 2016 to January 2018, our institution treated 653 patients with extracapsular hip fractures by intramedullary fixation. Among them, 525 cases got a successful closed reduction. The other 128 were irreducible and reduced by percutaneous reduction with double screwdrivers (PRDS) or LOR. There were 66 cases in the PRDS group while 62 in the LOR group. All fractures were classified using the Evans-Jensen classification. In addition, the differences in incision length, blood loss, fluoroscopic number, operation time, inpatient time, weight training time, Harris score, and complications were analyzed. Results The incision length was 8.4 ± 1.4 cm in the PRDS group and 15.3 ± 3.0 cm in the LOR group, respectively (p 0.05). There was no significant difference in complication incidence between the two groups (p > 0.05). Conclusions The PRDS group presented better clinical effects for managing irreducible extracapsular hip fractures than the LOR. Therefore, the PRDS technique could be the first reduction choice for patients with irreducible fractures.

Abstract Introduction Intertrochanteric fractures are associated with high mortality rates; however, long-term data on survival and predictors remain scarce. Therefore, this study investigated risk factors associated with 3-year mortality in elderly patients with intertrochanteric fractures. Methods In a retrospective study, 156 elderly patients with intertrochanteric fractures who underwent surgery between January 2017 to January 2018 at our center were included. Association-affecting variables, such as gender, age, time from injury to surgery, hemoglobin (Hb), total lymphocyte count (TLC), albumin, malnutrition, and co-morbidities, were recorded and analyzed. Afterward, logistic regression was used to analyze the significant variables and find independent predictors for 3-year mortality. Results A total of 156 patients were followed up for 3 years. The 1-year, 2-year, and 3-year postoperative cumulative mortality rates were 9.6% (15/156), 16.7% (26/156), and 24.4% (38/156), respectively. Simple analyses found that age, Hb, albumin, and malnutrition were associated with 3-year mortality (p

Abstract Background The purpose of this paper was to compare the clinical effects of acute shortening and re-lengthening (ASR) technique with antibiotic calcium sulfate-loaded bone transport (ACSBT) technique for the management of large segmental tibial defects after trauma. Methods In this retrospective study, 68 patients with large segmental tibial defects were included and completely followed. The bone loss was 3–10 cm. ASR group included 32 patients, while ACSBT group contained 36. There was no significant difference in demographic information between the two groups. The external fixation time (EFT) and external fixation index (EFI) were compared. Bone defect healing and limb functions were evaluated according to the Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria. Complications were compared by Paley classification. Results The mean EFT was 9.2 ± 1.8 months in ASR group and 10.1 ± 2.0 months in ACSBT group, respectively. The mean EFI was 1.5 ± 0.2 month/cm and 1.4 ± 0.3 month/cm. According to the ASAMI criteria, in ASR group bone defect healing was excellent in 22 cases, good in 7 cases and fair in 3 cases. In ACSBT group, it was excellent in 23 cases, good in 11 cases and fair in 2 cases. In ASR group, the limb function was excellent in 15 cases, good in 7 cases and fair in 10 cases, while it was excellent in 14 cases, good in 9 cases and fair in 13 cases with ACSBT group. There was no significant difference in EFI, bone defect healing and limb functions between the two groups (p > 0.05). The mean number of complications per patient in ACSBT group was significantly lower than that in ASR group (p

Reducing the interfacial defects between the perovskite/electron transport layer (ETL) is the key point to improving the efficient and stable performance of perovskite solar cells (PSCs). In this study, two self-assembled molecules ((aminomethyl)phosphonic acid and glycine) with different functional groups (phosphonic acid (-H2PO3) and carboxylic acid (-COOH)) were mixed to form the buried bottom interface of PSCs. The synergistic effect of -H2PO3 with its higher anchoring ability and -COOH with its fast carrier transport improved the performance of PSCs. Additionally, the SnO2 modified by mixed self-assembly molecules (M-SAM) showed a more appropriate energy level alignment, favoring charge transport and minimizing energy loss. In addition, the amine group (-NH2) on the two small molecules effectively interacted with uncoordinated Pb2+ in perovskite and improved the quality of the perovskite films. Consequently, the (FAPbI3)0.992(MAPbBr3)0.008 PSCs with M-SAM reached a PCE of 24.69% (0.08 cm2) and the perovskite modules achieved a champion efficiency of 18.57% (12.25 cm2 aperture area). Meanwhile, it still maintained more than 91% of its initial PCE after being placed in nitrogen atmosphere at 25 °C for 1500 h, which is better than that of the single-SAM and control devices. Further reference is provided for the future commercialization of perovskite with efficient and stable characteristics.

In this study, we investigated two waveform design problems for a dual-functional radar communication (DFRC) system, taking into consideration different constrained communication quality-of-service (QoS) requirements. Our objective was to minimize the mean-square error (MSE) of radar beampattern matching as the cost function. To this end, the multi-user interference (MUI) energy constraint and constructive interference (CI) constraint were, respectively, formulated to ensure the communication QoS. It is important to note that we designed a strict per-user MUI energy constraint at each sampling moment to achieve more accurate control over communication performance. Additionally, we introduced a constant-modulus constraint to optimize the efficiency of the radio frequency (RF) amplifier. To tackle the nonconvex waveform design problems encountered, we employed the alternative direction methods of multipliers (ADMM) technique. This allowed us to decompose the original problem into two solvable subproblems, which were then solved using the majorization–minimization (MM) method and geometrical structure. Finally, we obtained extensive simulation results which demonstrate the effectiveness and superiority of the proposed algorithm.

Abstract Objective To compare the clinical results of homemade hook plates and hollow lag screws combined with spacers in the treatment of posterior cruciate tibial ligament avulsion fractures. Materials and methods This was a retrospective clinical cohort study that included 64 patients with PCL tibial avulsion fractures. Thirty-two of them were fixed with a homemade hook plate (hook plate group), and 32 were fixed with a hollow lag screen combined with a gasket (hollow lag screen group). By reviewing the medical record data and follow-up results, the operation time, postoperative drainage, fracture healing time, surgical complications, knee mobility, recovery of joint function, and whether postoperative gastrocnemius muscle strength changed in the two groups were compared. Results All patients had successful wound and fracture healing. No adverse events, such as bone nonunion, infection, wound haematoma, or joint stiffness, occurred in either group. There were no patients with decreased gastrocnemius muscle strength in either group. Internal fixation failure occurred in 2 cases in the hollow lag screen group but not in the hook plate group. There were no significant differences between the two groups in terms of operative time, postoperative drainage, fracture healing time, knee mobility at the last follow-up, or Lysholm score. Conclusion It is safe and effective to use a homemade hook plate to fix PCL tibial avulsion fractures through an inverted L-shaped posterior medial approach. A homemade hook plate may have potential advantages over a hollow lag screen combined with gasket fixation.

Objective To develop a new approach to intraoperatively identify the presence of coronal plane deformities (both valgus and varus) when treating tibial fractures with closed reduction and intramedullary nail fixation. Methods A retrospective analysis was conducted by enrolling 33 consecutive patients with tibial fractures who received closed reduction and intramedullary nail fixation from January 2018 to January 2019 at our trauma center. Out of the 33 patients, 23 were males and 10 were females and the average age was 41 years (ranging 22 to 69 years of age). Standard anteroposterior and lateral preoperative radiographs were routinely performed. After intraoperatively inserting the tibial intramedullary nail through the standard entry point, the parallel relationship between the distal horizontal interlocking screw and the tibiotalar joint surface on the anteroposterior fluoroscopy was used to determine the occurrence of valgus or varus deformities of the distal tibial fragment. Radiographic and clinical outcomes were analyzed using the average interval from injury to surgery, the lateral distal tibial angle (LDTA) of the unaffected and affected sides, complications and the Olerud–Molander ankle score. Results All 33 patients were postoperatively followed for 13 to 25 months (mean 18.7 months). The fractures achieved bone union at an average of 4.3 months (ranging from 3 to 6 months). The total complication rate was 60.6% (20 cases), including four cases that showed deep vein thrombosis, one case showing an infection and delayed union and 15 cases showing slight to moderate anterior knee pain. The postoperative LDTA of the unaffected side measured 87.3° to 89.6 ° (average 88.7° ± 0.8°), and the LDTA of the affected side was 87.5° to 90.4° (average 88.9° ± 1.1°). There was no significant difference between the unaffected and affected sides (t = −1.865, P = 0.068). The intraoperative measurement indicated six cases of valgus angulation and three cases of varus angulation deformities, and all deformities were corrected during surgery. According to the Olerud–Molander ankle score, clinical outcomes demonstrated 22 excellent cases, eight good cases, two fair cases, and one poor case 12 months after surgery. Conclusion The parallel relationship between the distal horizontal interlocking screw and tibiotalar joint surface on intraoperative anteroposterior films were able to determine the onset of valgus or varus angulations of the distal tibial fragment in the fracture zone after the tibial intramedullary nail was inserted through the standard entry point.

ObjectiveTension band wiring and proximal ulnar plate fixation are commonly used fixation methods for olecranon fractures. However, they may not be suitable for repairing proximal olecranon avulsion fractures. In this study, we present a novel fixation technique for the treatment of proximal avulsion fractures, which is a T-shaped plate combined with a wire.Materials and methodsBetween March 2016 and May 2020, surgery was performed on 16 patients with proximal olecranon avulsion fractures by using a T-shaped plate combined with a wire fixation at our hospital. The parameters followed were fracture healing time, elbow range of motion (ROM), related functional scores (the Mayo score and the DASH score), and complications related to internal fixation.ResultsThe average follow-up period was 17 (14–21) months and fractures had healed in all patients included in the study, with an average fracture union of 9.25 (8–12) weeks. No patient reported fixation failure, serious infection, or revision surgery. The average ROM of the elbow joint was 123° (120–135°). The Mayo score was excellent in 11 patients and good in 5. The average DASH score was 17.75 (12–24).ConclusionOlecranon avulsion fractures were fixed with a T-shaped steel plate combined with a steel wire, which can be used for early functional exercise and for achieving good final functional results. This method can provide stable fixation, especially in elderly patients with osteoporosis.

Abstract Background To compare the clinical efficacy of a femoral neck system (FNS) and cannulated screws (CS) in the treatment of femoral neck fracture in young adults. Methods Data from 69 young adults, who were admitted for femoral neck fracture between March 2018 and June 2020, were retrospectively analyzed. Patients were divided into two groups according to surgical method: FNS and CS. The number of intraoperative fluoroscopies, operative duration, length of hospital stay, fracture healing time, Harris score of hip function, excellent and good rate of hip function, and postoperative complications (infection, cut out the internal fixation, nail withdrawal, and femoral neck shortening) were compared between the two groups. Hip joint function was evaluated using the Harris Hip Scoring system. Results All 69 patients had satisfactory reduction and were followed up for 12–24 months, with a mean follow-up of 16.91 ± 3.01 months. Mean time to fracture healing was13.82 ± 1.59 and 14.03 ± 1.78 weeks in the FNS and CS groups, respectively. There was a statistical difference in the number of intraoperative fluoroscopies between the 2 groups (P = 0.000). There were no significant differences, in operation duration, hospital length of stay, fracture healing time, complications, Harris Hip Score for hip function and excellent and good rate between the two groups (P > 0.05). The incidence of complications was 6.1%(2/33) in the FNS group lower than 25%(9/36) in the CS group, a difference that was statistically significant (P = 0.032). At the last follow-up, the Harris Hip Score of the hip joint in the FNS group was 90.42 ± 4.82and 88.44 ± 5.91 in the CS group. Conclusions Both treatment methods resulted in higher rates of fracture healing and excellent hip function. Compared with CS, the FNS reduced the number of intraoperative fluoroscopies, radiation exposure to medical staff and patients, and short-term complications including femoral neck shortening and bone nonunion.

Abstract Background The purpose of this study was to compare the clinical effects of antibiotic calcium sulfate-loaded hybrid transport (ACSLHT) and traditional Ilizarov bone transport (TIBT) in the treatment of large tibial defects after trauma. Methods Eighty-five patients with large tibial defects after trauma were selected for retrospective study. The range of tibial defects was 6–22 cm. After thorough debridement and infection controlled, bone transport technique was used to reconstruct tibial defects. Forty-four patients were treated with ACSLHT technique (the ACSLHT group), while the other 41 were treated with TIBT technique (the TIBT group). Time in external fixator was evaluated by EFI score. Enneking score was used to evaluate limb functions. SAS score was used to evaluate postoperative anxiety status. In addition, complication incidence was compared, including axis deviation, docking site nonunion, infection recurrence and so on. Results There was no significant difference in preoperative general data between ACSLHT and TIBT group. EFI score in ACSLHT and TIBT group was 0.6 ± 0.1 cm/month and 1.7 ± 0.3 cm/month, respectively (P

Objective Femoral shaft nonunion after intramedullary nailing fixation remains a challenge for orthopedic surgeons. This study evaluated osteoperiosteal decortication and iliac bone grafting combined with wave plating as a treatment for aseptic atrophic nonunion of the femoral shaft after intramedullary nailing. Methods The study included 22 patients (two female, 20 male; mean age 40.8 years [range, 19–61]) with aseptic atrophic nonunion of the femoral shaft who underwent osteoperiosteal decortication and iliac bone grafting combined with wave plating between January 2016 and January 2020. Cases with infected nonunion, hypertrophic nonunion, and nonunion after plate osteosynthesis were excluded. Clinical outcomes were assessed retrospectively using the Samantha X-ray and Paley scale scores. Results The mean follow-up period was 18.8 months (range, 12–35). Bone union was achieved in all patients. The average clinical healing time was 5.7 months (range, 3–14). The mean Samantha X-ray score was 5.7 ± 0.45 and the Paley scores indicated excellent or good clinical results in all cases. One patient developed sterile wound leakage that resolved after a dressing change. Conclusions Osteoperiosteal decortication and bone grafting combined with wave plating is an excellent treatment for aseptic atrophic nonunion of the femoral shaft after intramedullary nailing.

Objective: This study aimed to compare the biomechanical stability and clinical efficacy of the Kirschner-wire (K-wire) tension band combined with patellar cerclage and an anchor-loop plate (ALP) in treating inferior-pole patellar fracture.Methods: The finite element model was established to analyze the mechanical properties of a K-wire tension band combined with patellar cerclage and ALP fixation in the treatment of inferior patellar pole fracture. The clinical data of 49 patients with patellar inferior-pole fracture (AO/OTA 34 A1) admitted to our hospital from January 2017 to July 2021 were retrospectively analyzed. Among these, 28 cases were fixed with ALPs (ALP group) and 21 cases were fixed with K-wire tension bands combined with patellar cerclage (K-wire group). By reviewing the medical records and follow-up results, we compared the operation time, final knee joint activity, incidence of secondary surgery, postoperative complications, and joint function recovery between the two groups.Results: The biomechanical analysis of the finite element model showed that the maximum displacement of the K-wire group was 1.87 times that of the ALP group. The maximum stress of the K-wire group was 1.34 times that of the ALP group. The maximum stress of the pole bone in the K-wire group was 13.89 times that of the ALP group. The average follow-up times of the K-wire group and ALP group were similar (p > 0.05), and the average ages of the two groups were similar (p > 0.05). The operation time of the ALP group was significantly shorter than that of the K-wire group (p < 0.05).The final knee joint activity of the ALP group was significantly greater than that of the K-wire group (p < 0.05). The Bostman patellar fracture function score of the ALP group was significantly better than that of the K-wire group at 3 and 9 months after operation (p < 0.05). Postoperative complications of the two groups included 1 case (3.6%) in the ALP group with internal fixation-stimulation complications and, in the K-wire group, 3 cases (14.3%) with internal fixation stimulation complications and 1 case (4.8%) with infection.Conclusion: The ALP and K-wire tension band combined with patella cerclage models were tested at 500 N, and no damage occurred, indicating that the newly designed ALP is safe in mechanical structure. The ALP has better therapeutic effect in biomechanical stability, postoperative complications, secondary surgery, and knee function. This technique is an effective method for the treatment of inferior-pole patellar fracture.

Abstract Background Awn of rice is an important domestication trait closely associated with yield traits. Therefore, the identification of genes for awn development is of great significance for the elucidation of molecular mechanism of awn development and the genetic improvement of yield traits in rice. Results In this study, using chromosome segment substitution lines (CSSLs) derived from a long-awned Guangxi common wild rice (GXCWR, Oryza rufipogon Griff.) and a short-awned indica cultivar 9311, we identified An-4, a potential quantitative trait locus (QTL) for awn development. Then, An-4 was fine mapped into a 56-kb region of chromosome 2, which contained four annotated genes. Among these four annotated genes, Os02g0594800 was concluded to be the potential candidate gene for An-4. An-4 exhibited pleiotropic effects on awn development and several yield traits. Scanning electron microscopy (SEM) analysis showed that An-4 significantly promoted awn development at Sp7 and Sp8 stage of spikelet development. Transcriptome analysis suggested that An-4 might influence the development of awn by regulating the expression of genes related to growth, developmental process, channel regulation and extracellular region. By contrast to those of 9311, the expression level of OsRR5 in CSSL128 was significantly down-regulated, whereas the expression levels of OsCKX2 and OsGA2ox5 in CSSL128 were significantly up-regulated. In addition, our study showed that An-4 had additive effects with other genes for awn development, such as An-1, An-2/LABA1 and An-3/GAD1/RAE2. Conclusions The identification of An-4 lays a foundation for cloning of An-4 and further elucidation of the molecular mechanism of awn development. Moreover, the identification of favorable allelic variation of An-4 from 9311 will be useful to improve rice yield traits.

Background: Although open reduction internal fixation (ORIF) with periarticular locking plates, retrograde intramedullary nail (IMN) fixation, and distal femoral replacement (DFR) have been widely used for the treatment of periprosthetic distal femur fractures (PPDFF), it remains unclear which one may be an optimal surgical strategy.Objective: This network meta-analysis aimed to determine the optimal surgical strategy for PPDFF from ORIF, IMN, and DFR by evaluating major complication rates and revision rates.Patients and Methods: We identified eligible studies by performing an updated literature search in PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) and checking published meta-analyses. The methodological index for non-randomized studies (MINORS) was used to assess the methodological quality of eligible studies. Major complications and revision rates were defined as outcomes of interest. All statistical analyses were performed by ADDIS 1.4 software.Results: We included 17 eligible studies in the final analysis. Statistical analyses did not reveal significant differences when ORIF was compared with IMN and ORIF compared with DFR, and IMN compared with DFR in terms of two clinical outcomes. However, DFR achieved a beneficial trend in major complications [odds ratio (OR) = 1.34; 95% CrI = 0.48–3.80] and revision (OR = 1.64; 95% CrI = 0.68–4.38) rates compared with IMN. Ranking probabilities indicate that DFR has the highest probability of being the optimal option, followed by ORIF and IMN.Conclusion: There was no difference in major complications or reoperations between the three treatments. However, ORIF with periarticular locking plates may be a preferred alternative option because DFR is limited by the high cost. Moreover, our study highlights the need for future prospective trials evaluating the outcomes of these three surgical strategies.

Purpose: The extra-articular proximal tibial fractures continue to have high malunion rates despite development in intramedullary nailing (IMN) technology. Combined plate and IMN fixation can increase mechanical stability. The purpose of this study was to investigate combined plate and IMN for the treatment of extra-articular proximal tibial fracture using a biomechanical model.Methods: A 10-mm defective osteotomy was created in the fourth-generation composite tibia to simulate extra-articular proximal tibial fractures (AO/OTA 41A2). The fractures were stabilized with IMN alone (IMN group), IMN with supplementary medial plate (M-IMN group), and IMN with supplementary lateral plate (L-IMN group). The biomechanical properties of each specimen were tested under axial compression loading, bending stress, and cyclic loading. The maximum displacement of the fragments and implant-bone construct failure was recorded.Results: The maximum displacement of the M-IMN group was significantly less than either the L-IMN or IMN group in both axial compression loading and bending stress (p < 0.05 for both comparisons). All specimens in the three groups survived in 10,000 cyclic loading without hardware deformation. The maximum stiffness of failure was similar between the M-IMN and L-IMN groups, but the IMN group was statistically lower than either the L-IMN or the IMN group (p < 0.05).Conclusion: The results indicated that combined medial plate and IMN fixation could effectively increase the mechanical stability of proximal tibial fractures.

Purpose: To compare the clinical outcomes of the Masquelet technique and Ilizarov bone transport method for the treatment of patients with infected bone defects in the lower extremities. Methods: Eligible studies were searched from six databases until 12 April 2021. Data extraction was independently conducted by two investigators, which was followed by a quality assessment. Weighted mean difference (WMD) and 95% confidence interval (CI) were used to analyze continuous variables, while odds ratio (OR) and 95% CI were used to analyze categorical variables. All statistical analyses were conducted using RevMan 5.3 and Stata 12.0. Results: Thirteen articles were included in this meta-analysis. There was a significant difference observed in hospitalization costs (WMD [95% CI] = −1.75 [−2.50, −0.99] thousand US dollar, p < 0.00,001), final union time (WMD [95% CI] = −4.54 [−6.91, −2.17] months, p = 0.0002), time to full weight bearing (WMD [95% CI] = −1.73 [−3.36, −0.10] months, p = 0.04), quality of life (WMD [95% CI] = 7.70 [4.74, 10.67], p < 0.00,001), and the risk of complications (OR [95%CI] = 0.39 [0.19, 0.79], p = 0.009) between the Masquelet and Ilizarov groups. No significant differences in other outcomes were observed between the two groups. Conclusion: Masquelet technique exhibited the advantages in the lower hospitalization cost, shorter final union time, shorter time to full weight bearing, lower rate of complications, and better post-operative quality of life, compared with Ilizarov bone transport method. However, this finding should be confirmed in large-scale clinical samples.

Abstract Background To investigate the clinical efficacy of locking compression plate fixation for the treatment of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity. Methods A retrospective analysis was conducted on 37 patients with femoral intertrochanteric fractures combined with preexisting proximal femoral deformity between January 2013 and July 2019. The patients included 24 males and 13 females aged from 23 to 69 years old, with an average age of 47.5 years. The preexisting proximal femoral deformities resulted from poliomyelitis sequela, proximal femoral fibrous dysplasia, malunion and implant failure combined with coxa vara after intramedullary nailing fixation. There were 6 cases of 31-A2.1, 6 cases of 31-A2.2, 20 cases of 31-A3.1, and 5 cases of 31-A3.2, determined based on the AO classification of intertrochanteric fractures. All fractures were managed through open reduction and locking plate fixation. The hip disability and osteoarthritis outcome score (HOOS) was used to assess hip function before injury and at the last postoperative follow-up. The short form 36 (SF-36) Health Survey Questionnaire was used to assess quality of life. Results Thirty-seven patients were followed up for 12 to 27 months (average, 20.7 months). All patients achieved bone healing within 5.1 months on average (range, 3 to 6 months). Postoperative complications included deep vein thrombosis in three patients, bedsores in one and delayed union in one patient. No other complications, such as surgical site infection, fat embolism, nonunion and re-fracture, were presented. There was no significant difference in the HOOS scores and the SF-36 Health Questionnaire outcomes at pre-injury and at the last postoperative follow-up (p > 0.05). Conclusions It is difficult to perform intramedullary fixation of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity, while locking compression plate fixation is a simple and effective method of treatment.

ObjectiveThis study aimed to evaluate the short-term effects of partial fibular head osteotomy for treating posterolateral tibial plateau fractures.MethodsA retrospective analysis was performed on 25 patients with posterolateral tibial plateau fractures who were treated using a partial fibular head osteotomy approach. Computed tomography was performed for fracture typing and evaluation. The mode of injury, time from injury to surgery, time for fracture union, range of motion of the knee, and complications were recorded. Knee joint function was evaluated using the Hospital for Special Surgery Mayo Score (HSS).ResultsThe mean follow-up period was 21.5 (range, 12–36) months. Fracture united in all patients and the average clinical healing time for fractures was 11.2 ± 1.9 (range, 8–16) weeks. The mean time from injury to surgery was 3.1 ± 1.8 (range, 1–10) days. The mean range of flexion was 131.6° ± 12.5° (range, 110°–145°). The mean range of extension was 1.4°–4.2° (range, −5°–10°). The mean HSS at the final follow-up was 93.5 ± 5.4 (range, 79–100). None of the patients exhibited symptoms of common peroneal nerve injury, knee instability, or upper tibiofibular joint injury. One patient had a superficial infection and was treated with surgical dressing.ConclusionThe partial fibular head osteotomy approach is a feasible alternative for treating posterolateral tibial plateau fractures.

Compressed domain image classification performs classification directly on compressive measurements acquired from the single-pixel camera, bypassing the image reconstruction step. It is of great importance for extending high-speed object detection and classification beyond the visible spectrum in a cost-effective manner especially for resource-limited platforms. Previous neural network methods require training a dedicated neural network for each different measurement rate (MR), which is costly in computation and storage. In this work, we develop an efficient training scheme that provides a neural network with dynamic-rate property, where a single neural network is capable of classifying over any MR within the range of interest with a given sensing matrix. This training scheme uses only a few selected MRs for training and the trained neural network is valid over the full range of MRs of interest. We demonstrate the performance of the dynamic-rate neural network on datasets of MNIST, CIFAR-10, Fashion-MNIST, COIL-100, and show that it generates approximately equal performance at each MR as that of a single-rate neural network valid only for one MR. Robustness to noise of the dynamic-rate model is also demonstrated. The dynamic-rate training scheme can be regarded as a general approach compatible with different types of sensing matrices, various neural network architectures, and is a valuable step towards wider adoption of compressive inference techniques and other compressive sensing related tasks via neural networks.

Effectively encapsulating perovskite solar cells (PSCs) to enhance the external reliability is the key towards commercialization. We herein propose a facile encapsulation method by introducing conductive ribbons and a polyethylene terephthalate (PET) backsheet on both sides of PSC. Via applying thermoplastic polyolefin (TPO) encapsulant, we implemented PSCs with fine encapsulation, enabling considerable durability in the ambient atmosphere and even with water immersion, demonstrating almost no degradation in the device output, which is ascribed to the low water vapor transmission rate as well as the high chemical stability of TPO. The operation reliability of the encapsulated cell is also significantly increased, maintaining 80% of the initial efficiency after 770 hours’ light illumination in an ambient atmosphere. This novel encapsulation route provides a feasible idea for the commercial application of PSCs in the future.

Recent years have witnessed the expansion of tissue failures and diseases. The uprising of regenerative medicine converges the sight onto stem cell-biomaterial based therapy. Tissue engineering and regenerative medicine proposes the strategy of constructing spatially, mechanically, chemically and biologically designed biomaterials for stem cells to grow and differentiate. Therefore, this paper summarized the basic properties of embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs) and adult stem cells. The properties of frequently used biomaterials were also described in terms of natural and synthetic origins. Particularly, the combination of stem cells and biomaterials for tissue repair applications was reviewed in terms of nervous, cardiovascular, pancreatic, hematopoietic and musculoskeletal system. Finally, stem-cell-related biomanufacturing was envisioned and the novel biofabrication technologies were discussed, enlightening a promising route for the future advancement of large-scale stem cell-biomaterial based therapeutic manufacturing. Keywords: Stem cells, Biomaterial, Regenerative medicine, Biofabrication, Biomanufacturing

Patrol missiles are a common type of unmanned aerial vehicle, which can be efficiently used for reconnaissance and sensing. In this work, target detection and the damage assessment of typical mobile ground targets by patrol missiles are studied, and a new method, combining the YOLO v3 with the VGG networks, is proposed for the problem. Specifically, with YOLO v3 as the precursor, the proposed method can detect, classify, and localize ground targets accurately and quickly. Then, the image blocks of detected targets are fed into the lightweight VGG networks, which can evaluate their damage level coarsely. Meanwhile, based on class activation mapping (CAM) and deconvolution, we further analyse the activation intensity of clustered convolution kernels, which helps determine whether the targets’ key components are destroyed. Unlike traditional image change detection methods, which require images before and after a strike for comparison, the proposed method learns the target model through extensive training and can assess the target’s damage status in a timely and online manner. Compared to previous learning-based methods, our detailed analysis with convolutional feature visualization of the damaged targets and their components gives a more interpretable perspective. Finally, Unity simulation experiments prove the proposed method’s effectiveness, which improves the accuracy of damage level assessment by 16.0% and 8.8% compared with traditional image-change-detection-based methods and the two-CNN learning-based method. The convolutional feature clustering method evaluates the status of the targets’ key components with an accuracy of 72%.

Objective: This meta-analysis aimed to systematically compare the clinical outcomes of intramedullary nailing (IMN) fixation and percutaneous locked plating (PLP) fixation in the treatment of proximal tibial fractures. Methods: We searched PubMed, Embase, Cochrane library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wan Fang to select relevant articles up to March 29, 2020 without language limit. Continuous variables were estimated by weighted mean difference (WMD) with a 95% confidence interval (CI) and dichotomous outcomes were calculated by relative risk (RR) with 95% CI. Moreover, heterogeneity analysis was evaluated. Furthermore, publication bias assessment and sensitivity analysis were conducted. Stata 11.0 software was used to perform the statistical analysis. Results: Ten studies involving 667 cases (321 from IMN fixation group and 346 from PLP fixation group) were included. The type of fractures involved in the included articles was extra-articular proximal tibia fractures. IMN fixation method achieved significantly shorter union time ( WMD = −2.88, 95% CI : −3.23 to −2.53, p < 0.001) and full weight-bearing time ( WMD = −2.81, 95% CI : −3.64 to −1.97, p < 0.001) than PLP fixation method. Meanwhile, IMN fixation resulted in lower risks of infection ( RR = 0.50, 95% CI : 0.27 to 0.91, p = 0.02) and total complications ( RR = 0.36, 95% CI : 0.22 to 0.60, p < 0.001) than PLP fixation. No significant differences were found in the incidence of nonunion ( p = 0.33), malunion ( p = 0.38), and osteofascial compartment syndrome (OCS, p = 0.62) between the two groups. Conclusions: Compared to PLP fixation, IMN fixation had several advantages in treating proximal tibial fractures, including the short time of union and full weight-bearing, as well as a low risk of infection and total complications.

Microplastics are widespread in the environment and might transport readily by ocean currents, wind and atmospheric deposition. Simultaneously, antibiotics and heavy metals could often be detected in the environment. They are both positively charged, it is necessary to clarify the interactions of these pollutants with microplastics when they were coexist. In this study, the most commonly used polystyrene (PS) was selected as a representative microplastic. This study investigated the effect of Cd(II) on the sorption of TYL by PS in different coexistence systems. The results showed that: in the composite system, when TYL and Cd(II) coexist, the presence of Cd(II) could inhibit the sorption of TYL by PS, and the inhibitory effect increases with the increase of the concentration of Cd(II), indicating that competitive sorption dominates the sorption. When PS adsorbed Cd(II) first and then adsorbed TYL, the presence of Cd(II) was conducive to the sorption of TYL, and the sorption strengthened with the increase of Cd(II) concentration, indicating that the complexation between TYL and Cd(II) enhanced the sorption of TYL. In addition, initial pH values and ionic strength were essential in the sorption process. Therefore, this study could provide an important basis for evaluating the environmental behavior and ecological risk of microplastics in the process of compound pollution.

Abstract As the power conversion efficiency (PCE) of perovskite solar cells (PSCs) is increased to as high over 25%, it becomes pre‐eminent to study a scalable process with wide processing window to fabricate large‐area uniform perovskite films with good light‐trapping performance. A stable and uniform intermediate‐state complex film is obtained by using tetramethylene sulfoxide (TMSO), which extends the annealing window to as long as 20 min, promotes the formation of a high‐quality perovskite film with larger grains (over 400 nm) and spontaneously forms the surface texture to result in an improved fill factor and open‐circuit voltage (Voc). Moreover, the superior surface texture significantly increases the long‐wavelength response, leading to an improved short‐circuit current density (Jsc). As a result, the maximum PCE of 21.14% is achieved based on a simple planar cell structure without any interface passivation. Moreover, a large area module with active area of 6.75 cm2 is assembled using the optimized TMSO process, showing efficiency as high as 16.57%. The study paves the way to the rational design of highly efficient PSCs for potential scaled‐up production.

This review covers the literature published by chemists from China during the 2015–2016 on natural products (NPs), with 1,985 citations referring to 6,944 new compounds isolated from marine or terrestrial microorganisms, plants, and animals. The emphasis is on 730 new compounds with a novel skeleton or/and significant bioactivity, together with their source organism and country of origin.

Anti-runaway prevention of rolling stocks at a railway station is essential in railway safety management. The traditional track skates for anti-runaway prevention of rolling stocks have some disadvantages since they are operated and monitored completely manually. This paper describes an anti-runaway prevention system (ARPS) based on intelligent track skates equipped with sensors and real-time monitoring and management system. This system, which has been updated from the traditional track skates, comprises four parts: intelligent track skates, a signal reader, a database station, and a monitoring system. This system can monitor the real-time situation of track skates without changing their workflow for anti-runaway prevention, and thus realize the integration of anti-runaway prevention information management. This system was successfully tested and practiced at Sunjia station in Harbin Railway Bureau in 2014, and the results confirmed that the system showed 100% accuracy in reflecting the usage status of the track skates. The system could meet practical demands, as it is highly reliable and supports long-distance communication.

BACKGROUND: Evidence suggested that abiotic airborne exposures may be associated with changes in body composition. However, more evidence is needed to identify key pollutants linked to adverse health effects and their underlying biomolecular mechanisms, particularly in sensitive older adults. OBJECTIVES: Our research aimed to systematically assess the relationship between abiotic airborne exposures and changes in body composition among healthy older adults, as well as the potential mediating mechanisms through the serum lipidome. METHODS: From September 2018 to January 2019, we conducted a monthly survey among 76 healthy adults (60–69 years old) in the China Biomarkers of Air Pollutant Exposure (BAPE) study, measuring their personal exposures to 632 abiotic airborne pollutions using MicroPEM and the Fresh Air wristband, 18 body composition indicators from the InBody 770 device, and lipidomics from venous blood samples. We used an exposome-wide association study (ExWAS) and deletion/substitution/addition (DSA) model to unravel complex associations between exposure to contaminant mixtures and body composition, a Bayesian kernel machine regression (BKMR) model to assess the overall effect of key exposures on body composition, and mediation analysis to identify lipid intermediators. RESULTS: The ExWAS and DSA model identified that 2,4,5-T methyl ester (2,4,5-TME), 9,10-Anthracenedione (ATQ), 4b,8-dimethyl-2-isopropylphenanthrene, and 4b,5,6,7,8,8a,9,10-octahydro-(DMIP) were associated with increased body fat mass (BFM), fat mass indicators (FMI), percent body fat (PBF), and visceral fat area (VFA) in healthy older adults [Bonferroni-Hochberg false discovery rate (FDRBH)<0.05]. The BKMR model demonstrated a positive correlation between contaminants (anthracene, ATQ, copaene, di-epi-a-cedrene, and DMIP) with VFA. Mediation analysis revealed that phosphatidylcholine [PC, PC(16:1e/18:1), PC(16:2e/18:0)] and sphingolipid [SM, SM(d18:2/24:1)] mediated a significant portion, ranging from 12.27% to 26.03% (푝-value <0.05), of the observed increase in VFA. DISCUSSION: Based on the evidence from multiple model results, ATQ and DMIP were statistically significantly associated with the increased VFA levels of healthy older adults, potentially regulated through lipid intermediators. These findings may have important implications for identifying potentially harmful environmental chemicals and developing targeted strategies for the control and prevention of chronic diseases in the future, particularly as the global population is rapidly aging. [ABSTRACT FROM AUTHOR]