First-stage Treatment Research Articles

Synergy of γ′ phase, MC carbide and grain boundary phase on creep behavior for nickel-based superalloy K439B

The synergy of γ′ phase, MC carbide and grain boundary phase on 815 °C/379 MPa creep behavior for nickel-based superalloy K439B was investigated by adjusting the time and temperature of the first-stage aging treatment. Increasing aging time from 4 h to 6 h, the total creep life is reduced by 35.8% due to the increased bimodal γ′ phase size. The bimodal γ′ phase transforms into small unimodal γ′ phase when increasing aging temperature from 1000 °C to 1080 °C. In addition, the content of M23C6 carbide increases, and the total creep life is increased by about 1.3 times. Small-size γ′ phase with bimodal distribution redissolves into γ matrix during creep deformation. Dislocations pile up at the γ/γ′ interface, and partial dislocations enter into large-size γ′ phase, mainly forming isolated parallel stacking faults. By comparison, the crossed stacking faults within small unimodal γʹ phase form Lomer-Cottrell locks, APB coupled dislocation pairs shear into γʹ phase, and more granular M23C6 carbide precipitates at the grain boundary, which further decreases the minimum steady creep rate and improves the creep life. At the beginning of creep deformation, MC carbide prevents the movement of dislocations. MC carbide formed at grain boundaries can delay crack propagation to a certain extent. MC carbide debonds from γ matrix subsequently due to the dislocation accumulation and higher interface energy, which provides a pathway for crack initiation and propagation. Moreover, the fragmentation and degeneration inside MC carbide promote crack initiation.

Experience of successful diagnosis and first-stage treatment of a patient with Moschcowitz syndrome

Experience of successful diagnosis and first-stage treatment of a patient with Moschcowitz syndrome

Valorization of lignite to arene-rich compounds via two-stage selective cleavage of C-O bridged bonds over Co-MoS2

Directly converting lignite into arenes as commodity chemicals and drop-in fuels is a highly desirable target for researchers. However, this is severely limited by the presence of stable inter unit C-O linkages in lignite. Herein, a highly active catalyst, Co-MoS2, has been designed and prepared to be used for the selective catalytic cleavage of inter unit C-O bridged bonds (BBs) in the conversion of Naomaohu (NMH), a lignite, to yield arenes. Both catalytic hydrogenation conversion (CHC) and thermal dissolution (a non-catalytic process, named NCHC) of NMH were conducted using n-hexane as the solvent. The soluble fractions from the first stage of NCHC (SFNCHC-1) and CHC (SFCHC-1), as well as the second stage of NCHC (SFNCHC-2) and CHC (SFCHC-2) were obtained using the same solvent. After the first-stage catalytic treatment, the relative contents of arenes and alkanes in SFCHC-1 increased by 16.7 % and 9.3 %, respectively, compared to those in SFNCHC-1, and the relative content of oxygen-containing compounds (OCCs), such as alcohols, phenols, esters, ketones, acids, and furans, decreased by 13.2 %. For the second-stage conversion, the relative contents of arenes and alkanes in SFCHC-2 were 53.5 % and 15.5 % higher than those in SFNCHC-2, and the relative contents of OCCs was only 6.6 % in SFCHC-2. The catalytic mechanisms of cleavage of C-O BBs and deoxygenation were proposed based on the CHC of model compounds and density functional theory (DFT) calculation. The adsorption of OCCs and the activation of released hydrogen radical (H·) by Co-MoS2, followed by H· addition to the carbon atom connected to oxygen in C-O BBs and oxygen-containing functional groups, are crucial for the cleavage of C-O BBs and formation of deoxygenated compounds, particularly arenes.

Modification of myofibrillar protein structural characteristics: Effect of ultrasound-assisted first-stage thermal treatment on unwashed Silver Carp surimi gel

The hardness properties of unwashed surimi gel are considered as the qualities of gelation defect. This research investigated the effect of ultrasound-assisted first-stage thermal treatment (UATT) on the physicochemical properties of unwashed Silver Carp surimi gel, and the enhancement mechanism. UATT could reduce protein particle size, which significantly reduced from 142.22 μm to 106.70 μm after 30 min of UATT compared with the nature protein. This phenomenon can promote the protein crosslinking, resulting in the hardness of surimi gel increased by 15.08 %. Partially unfolded structure of myofibrillar protein and exposures of tryptophan to water, lead to the increase in the zeta potential absolute value, driven by UATT. The reduced SH group level and the conformational conversion of proteins from random coiling to α-helix and β-sheet, which was in support of intermolecular interaction and gel network construction. The results are valuable for processing protein gels and other food products.

Amoxicillin, gemifloxacin and rabeprazole, as first-line Helicobacter pylori therapy in clinical practice: A pilot study.

Success in eradication of H. pylori is decreasing due to increasing resistant strains. In particular, side-effects due to 4-agent treatment multiple drug use are observed and treatment compliance decreases. The aim of this study was to evaluate the efficacy, reliability, and side-effect profile of the combination of amoxicillin and rabeprazole with gemifloxacin, which is a new generation quinolone, in the treatment of H. pylori infection. This study was conducted on 71 naive patients who received H. pylori eradication. All the patients were administered treatment of Amoxicillin (1000 mg twice a day) + Gemifloxacin (320 mg once a day) + rabeprazole (20 mg twice a day) for 7 days. Drug compliance and treatment tolerance were evaluated after finishing the treatment. At 1 month after the end of the treatment, H. pylori eradication was evaluated in all the patients by examining H. pylori antigen in the feces. In the evaluation after treatment, H. pylori eradication was obtained in 63 (88.7%) patients and eradication was not obtained in 8 (11.3%) patients. The treatment was not completed by 2 patients because of side-effects and noncompliance, so after exclusion of these 2 patients, successful H. pylori eradication was obtained in 63 (91.3%) of 69 patients who completed the treatment. Side-effects were seen in a total of 9 (12.7%) patients. Diarrhea, bloating, abdominal pain, and nausea-vomiting were seen in some patients, but no reflux, constipation, skin rash, listlessness-fatigue, headache, dizziness, palpitations, dry mouth, or weight loss was seen in any patient. In regions with high resistance to clarithromycin and metronidazole in particular, the combination of gemifloxacin with amoxicillin and rabeprazole can be considered for use in first-stage treatment as both the efficacy and tolerability are high.

The Essence of Lipoproteins in Cardiovascular Health and Diseases Treated by Photodynamic Therapy.

Lipids, together with lipoprotein particles, are the cause of atherosclerosis, which is a pathology of the cardiovascular system. In addition, it affects inflammatory processes and affects the vessels and heart. In pharmaceutical answer to this, statins are considered a first-stage treatment method to block cholesterol synthesis. Many times, additional drugs are also used with this method to lower lipid concentrations in order to achieve certain values of low-density lipoprotein (LDL) cholesterol. Recent advances in photodynamic therapy (PDT) as a new cancer treatment have gained the therapy much attention as a minimally invasive and highly selective method. Photodynamic therapy has been proven more effective than chemotherapy, radiotherapy, and immunotherapy alone in numerous studies. Consequently, photodynamic therapy research has expanded in many fields of medicine due to its increased therapeutic effects and reduced side effects. Currently, PDT is the most commonly used therapy for treating age-related macular degeneration, as well as inflammatory diseases, and skin infections. The effectiveness of photodynamic therapy against a number of pathogens has also been demonstrated in various studies. Also, PDT has been used in the treatment of cardiovascular diseases, such as atherosclerosis and hyperplasia of the arterial intima. This review evaluates the effectiveness and usefulness of photodynamic therapy in cardiovascular diseases. According to the analysis, photodynamic therapy is a promising approach for treating cardiovascular diseases and may lead to new clinical trials and management standards. Our review addresses the used therapeutic strategies and also describes new therapeutic strategies to reduce the cardiovascular burden that is induced by lipids.

Effect of surgery-first approach on quality of life and mental health of orthognathic patients: A systematic review and meta-analysis

ObjectivesThis study intends to explore the effects of the surgery-first approach (SFA) on quality of life and mental health of patients who undergo orthognathic surgery compared to the conventional three-stage approach (CTA). DataThe analysis included eight studies with a total of 307 patients, of which one was randomized controlled trial (RCT), one was clinical controlled trial (CCT), and six were non-randomized studies of interventions (NRSIs). SourcesElectronic databases such as Medline, Embase, Scopus, and Web of Science were searched for eligible trials up to April 2023. Study selectionRCTs, CCTs, and NRSIs, which compared the quality of life or mental health of orthognathic patients treated with SFA and CTA, were included in this study. The meta-analysis showed that the standardized mean differences (SMD) of Oral Health Impact Profiles-14 (OHIP-14) scores and the Orthognathic Quality of Life Questionnaire (OQLQ) between SFA and CTA were −1.58 (P = 0.05) and −2.99 (P < 0.00001) at the termination of the first-stage treatment, which altered to −0.94 (P = 0.54) and 0.09 (P = 0.65) after total treatment. Two studies applied the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the Beck Depression Inventory (BDI-II) to examine mental health, resulting in a trend similar to the former scales. ConclusionIn contrast to the conventional procedure, orthognathic treatment with SFA can instantly enhance the quality of life at the end of the first-stage treatment but has similar effects after the overall treatment. Moreover, SFA has a positive impact on psychological conditions. Clinical significanceThis study first systematically reviewed the effect of SFA on patients' mental well-being. According to our findings, it is better to select SFA if possible. Otherwise, the patient's psychological condition should be monitored appropriately throughout decompensation for better well-being both physically and mentally.

Retracted: The Percutaneous Endoscopic Lumbar Debridement and Irrigation Drainage Technique for the First-Stage Treatment of Spontaneous Lumbar Spondylodiscitis: A Clinical Retrospective Study.

[This retracts the article DOI: 10.1155/2022/6241818.].

The treatment of a malunited posterior pilon fracture with talar dislocation: A staged surgical treatment protocol

BackgroundMalunited posterior pilon fractures with talus dislocation (mPPFtd) are rare and there are no appropriate treatment strategies. The purpose of this study was to introduce a stepped strategy featuring preliminary soft tissue management according to the Ilizarov principle and delayed open reduction and internal fixation (ORIF) through a modified posteromedial approach to overcome rigid soft tissue contracture. MethodFrom February 2015 to August 2021, 12 selected patients with mPPFtd who were treated with the staged protocol (Group A) were retrospectively analysed. The clinical and radiographic outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the visual analogue scale (VAS) score, and the Burwell-Charnley score. Moreover, this case series was compared with some cases of fresh fracture (Group B) in patients that had the same baseline data from our previous study. ResultsIn Group A, the average length of time between the date of injury and the date of surgery was 4.8 ± 3.3 months. The average time to external fixator distraction, as the first-stage treatment, was 13.4 ± 1.0 days. In the second stage of ORIF, the posterosuperior dislocation of the talus was corrected with osteotomy and leverage manoeuvres. According to the Burwell-Charnley score system, the reduction quality was excellent in 9 cases and good in 3 cases. After a mean follow-up of 3.8 ± 2.1 years, there were no infections, wound healing problems, or nerve injuries in our cohort, and union was observed in all fractures without a loss of reduction. The baseline data of the two groups were not significantly different (p>0.05). The mean AOFAS score in Group A was 85.0 ± 10.5 and that in Group B was 95.4 ± 6.1 (p<0.05). The mean VAS score in Group A was 1.7 ± 1.4 and that in Group B was 0.7 ± 0.9 (p<0.05). ConclusionA staged surgical treatment strategy characterized by soft tissue management will improve the treatment of mPPFtd and produce satisfactory clinical outcomes. Level of evidenceLevel IV, retrospective case series

Efficacy comparison of antibiotic bone cement–coated implants and external fixations for treating infected bone defects

PurposeThis study aimed to investigate the clinical efficacy of antibiotic bone cement–coated implants compared with external fixations for treating infected bone defects.MethodsWe retrospectively enrolled 119 patients with infected bone defects in our hospital from January 2010 to June 2021, of which 56 were treated with antibiotic bone cement–coated implants and 63 were with external fixation.ResultsThe pre-operative and post-operative haematological indexes were tested to assess the infection control; the post-operative CRP level in the internal fixation group was lower than that in the external fixation group. No statistical significance was found in the rate of infection recurrence, loosening and rupture of the fixation, and amputation between the two groups. Twelve patients in the external fixation group had pin tract infection. In the evaluation of the Paley score scale, bone healing aspect revealed no significant difference between the two groups, while in the limb function aspect, antibiotic cement–coated implant group showed a much better score than the external fixation group (P = 0.002). The anxiety evaluation scale result also showed lower score in the antibiotic cement implant group (P < 0.001).ConclusionsCompared with external fixation, antibiotic bone cement–coated implant had the same effect on controlling infection and was more effective in recovering limb function and mental health in the first-stage treatment of infected bone defects after debridement.

Outcomes of different types of pulmonary atresia in neonates treated by ductus arteriosus stenting

Objective: To summarize the outcomes of different types of pulmonary atresia in neonates treated by ductus arteriosus stenting. Methods: This study was a retrospective cohort study. A total of 19 neonates who had pulmonary atresia treated by ductus arteriosus stenting in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from April 2014 to June 2021 were included. They were divided into the intact ventricular septum (PA-IVS) group and the ventricular septal defect (PA-VSD) group. Ductus arteriosus stents were implanted by different approaches. These children were followed up regularly at the 1, 3, 6, and 12 months after the surgery and annually since then to evaluate the outcome. Independent sample t-test was used for the statistical analysis. Results: There were 12 children in PA-IVS group and 7 in PA-VSD group. All of them were full term in fants. The gestational age of the PA-IVS group and the PA-VSD group was (38.8±1.1) and (37.7±1.8) weeks, the birth weights were (3.2±0.4) and (3.4±1.1) kg, and the age at operation was (10±9) and (12±7) days, respectively, without significant difference (all P>0.05). Among the 12 children with PA-IVS, 9 had stents successfully implanted through the femoral artery and 3 through the femoral vein. Of the 7 children with PA-VSD, 2 had the stents successfully implanted via the femoral artery and 2 failed, and the remaining 3 had stents successfully implanted via the left carotid artery. There was no postoperative thromboembolism, arteriovenous fistula, pseudoaneurysm or other vascular complications. Five children with PA-VSD who had successful operations were followed up at 6 months of age. They all had the operation for pulmonary atresia, repair of the ventricular septal defect, removal of arterial duct stents, and ligation of the arterial duct. All children survived without any stent displacement or stenosis and biventricular circulation was achieved during the follow-up. Conclusions: Ductus arteriosous stenting can be the first-stage treatment for children with PA-IVS and PA-VSD. In addition to the traditional femoral vein and femoral artery approach, the carotid artery can be used as a route for stent placement.

사관학교 생도의 근골격계 부상 유형 및 특성 연구

The purpose of this study was to describe the 6-month prevalence of musculoskeletal injuries in military cadets. Medical charts of medical patients from January to June 2022 were reviewed. Out of 262 patients, 188 patients were musculoskeletal injuries. The measured data were performed for frequency analysis and Fisher’s exact test through the SPSS 25.0 program, and the significant level was set to 0.05. As a results, the anatomical location of injuries were found in the order of knee 24.5%, waist 18.6%, ankle 18.6%, and shoulder 10.6%. Types of injuries were myalgia 71.3%, ligament/tendon sprains 12.8%, fractures 5.3%, and ligament ruptures 4.3% in that order. The primary cause of injuries was 53.8% of physical education classes, sports activities, and physical training (aerobic exercise, resistance exercise). As for the measures to be taken after the injury, 93.6% of the first-stage treatment (rest, pain relief, physical therapy, anti-inflammatory analgesic, etc.). Preventable injuries were 35.1%, and most of the physical training (aerobic exercise and resistance exercise) was preventable. Therefore, in order to prevent musculoskeletal injuries, cadets should be aware of the risk factors for injuries. To this end, it is considered that the data of this study can be used for the prevention of injuries in advance.

The Percutaneous Endoscopic Lumbar Debridement and Irrigation Drainage Technique for the First-Stage Treatment of Spontaneous Lumbar Spondylodiscitis: A Clinical Retrospective Study.

Background Minimally invasive or open surgery is contentious in the treatment of spondylodiscitis, therefore finding a balance between the two is urgently needed. In this study, we propose a new treatment paradigm for treating spontaneous lumbar spondylodiscitis by percutaneous endoscopic lumbar debridement and irrigation drainage (PELDID). Then, the Pola classification was used to guide subsequent treatment. Methods From November 2017 to April 2019, this study collected data on 16 patients with lumbar spondylodiscitis who were surgically treated utilizing this treatment paradigm in our department. Clinical effectiveness was determined using the visual analogue scale (VAS), the Oswestry Disability Index (ODI), the MOS 36-item short-form health survey (SF-36), and Kirkaldy-Willis criteria. Results All 16 patients completed the treatment using the above paradigm and were followed up for 28.13 ± 10.15 months. The preoperative Pola classification is as follows: 7 cases of type A, 3 cases of type B, and 6 cases of type C. After the first-stage surgery, the evaluation results of Pola classification were as follows: 8 cases of type A, 8 cases of type B, and 0 cases of type C. Four patients received second-stage surgery with internal fixation through the paravertebral multifidus space approach and intervertebral bone graft fusion through the transforaminal approach, and the reoperation rate was 25% (4/16 cases). The Visual analogue scale (VAS), Oswestry Disability Index (ODI), and SF-36 score all improved significantly from 2.43 ± 0.89 to 0.18 ± 0.40, from 77.31% ± 11.15%to 16.93% ± 5.45%, and from 18.34 ± 7.47 to 80.3 ± 15.36. The CRP and ESR decreased dramatically from 49.61 ± 48.84 to12.50 ± 12.18 and from 65.56 ± 26.89 to 29.68 ± 20.68. There were no recurrences of infection in our study. Conclusions The paradigm of the first-stage PELDID technique combined with the Pola classification system to guide the second-stage treatment for spontaneous spondylodiscitis is a novel and effective strategy for treating spontaneous spondylodiscitis.

Treatment of Hydrothermal-Liquefaction Wastewater with Crossflow UF for Oil and Particle Removal.

This study aims to evaluate the application of ceramic ultrafiltration membranes in the crossflow mode for the separation of particles and oil in water emulsions (free oil droplets and micelles) from hydrothermal-liquefaction wastewater (HTL-WW) from the hydrothermal liquefaction of municipal sewage sludge. The experiments were carried out using one-channel TiO2 membranes with pore sizes of 30, 10 and 5 nm. The results showed that the highest stable permeability could be achieved with a membrane-pore size of 10 nm, which experienced less fouling, especially through pore blockage, in comparison to the two other pore sizes. Instead of observing an increase in the permeability, the application of a higher feed temperature as well as backwash cycles led to a clear increase in irreversible fouling due to the presence of surfactants in the HTL-WW. Among several physical and chemical cleaning methods, alkaline cleaning at pH 12 proved to be the most efficient in removing fouling and maintaining stable performance on a long-term basis. Ceramic-membrane ultrafiltration can be considered as an adequate first-stage treatment of real HTL wastewater.

Tibial Cortex Transverse Distraction Followed by Open Correction with Internal Fixation for Management of Foot and Ankle Deformity with Ulcers.

ObjectiveTo assess the feasibility and results of tibial cortex transverse distraction (TCTD) followed by open correction with internal fixation (OCIF) for foot and ankle deformity with concurrent ulcers.MethodsA retrospective analysis was conducted. Between 2010 and 2019, a two‐stage management of TCTD followed by OCIF was performed in 13 patients (13 feet). There were five males and eight females with a mean age of 33.8 ± 14.6 years. Ten patients had a right‐side lesion, and three patients had a left‐side lesion. The etiology of deformity included seven cases of congenital neurological disease, one case of Charcot–Marie–Tooth disease, one case of trauma sequelae, and three cases of myelomeningocele. Duration of disease, size of ulcers, surgical procedures, healing time, external fixation time, and complications of these patients were recorded. The Texas wound classification and National Pressure Ulcer Advisory Panel (NPUAP) classification were used for assessing the ulcers. The modified Dimeglio score of deformity and American Orthopeadic Foot and Ankle Society (AOFAS) ankle‐hindfoot score were applied to evaluate the status before treatment and the results at final follow‐up.ResultsThe TCTD and wound debridement were performed in all patients, and an additional Ilizarov correction technique was added in two patients. All ulcers were healed in 3 months after first‐stage treatment. The median patient self‐report time of ulcer healing was 2.0 weeks (IQR, 1.8–3.3). The median external fixation time was 138.0 days (IQR, 134.5–141.5) days. After second‐stage operative correction, the patients were followed‐up for an average of 28.0 ± 2.9 months. At the final follow‐up, the modified Dimeglio score of deformity was decreased from 6.7 ± 2.1 to 1 (IQR, 0.0–1.0), and the mean AOFAS score was improved from 42.9 ± 19.1 to 82.6 ± 7.7. Before the treatment, there were eight patients with severe deformity, four patients with moderate deformity, and one patient with mild deformity. Postoperatively, seven patients were classified as mild deformity and six patients had a postural foot. The results of AOFAS ankle‐hindfoot score were defined as excellent in three patients, as good in five, and as fair in five. Complications include one case of mild displacement of the osteotomized cortex and one case of pin‐tract infection. No delayed union, nonunion, relapse of ulcers, or deformity were observed.ConclusionsThe two‐stage management of TCTD followed by OCIF could be considered as an alternative treatment for foot and ankle deformities combined with chronic ulcers.

Longitudinal Follow-Up of Facial Growth of Patients With Unilateral Cleft Lip and Palate Following Modified Veau-Wardill-Kilner Palatoplasty.

To evaluate facial growth after modified Veau-Wardill-Kilner/pushback (PB) palatoplasty from childhood to adulthood in patients with unilateral cleft lip and palate (UCLP). Retrospective longitudinal study. Single center. Sixty-two (29 males and 33 females) consecutive patients with nonsyndromic UCLP. Pushback palatoplasty and subsequent cleft palate treatment. Lateral and posterior-anterior cephalograms were taken at 3 different phases: phase 1 (before first-stage orthodontic treatment; N = 58; average age, 4.9 ± 1.1 years), phase 2 (before second-stage orthodontic treatment; N = 58; 15.9 ± 1.1 years), and phase 3 (after orthodontic retention; N = 51; 22.1 ± 3.2 years). The majority of patients had skeletal class III morphology in all 3 phases due to retrognathic maxilla. Maxillary growth did not improve in phase 2 despite first-stage orthodontic treatment in phase 1. Maxillary morphology improved in phase 3 but retardation occurred, although 77.42% of patients received orthognathic surgery during second-stage orthodontic treatment. Mandibular growth was slightly reduced in phases 1 and 2 and the mandible remained retrognathic in phase 3, following mandibular setback orthognathic surgery. The horizontal occlusal cant was slightly upward and toward the cleft side with respect to the reference plane, and the upper midline was deviated to the cleft side in phases 1 and 3. Patients with UCLP who undergo phased PB palatoplasty, orthodontic treatment, and orthognathic surgeries do not maintain skeletal class I facial morphology.

Therapeutic Plasma Exchange Application in Children Requires Individual Decision.

Therapeutic plasma exchange (TPE) is a treatment administered with the aim of removing a pathogenic material or compound causing morbidity in a variety of neurologic, hematologic, renal, and autoimmune diseases. In this study, we aimed to assess the indications, efficacy, reliability, complications, and treatment response of pediatric patients for TPE. This retrospective study analyzed data from 39 patients aged from 0 to 18 years who underwent a total of 172 TPE sessions from January 2015 to April 2018 in a tertiary pediatric intensive care unit. Indications for TPE were, in order of frequency, macrophage activation syndrome (28.2%, n = 11), renal transplantation rejection (15.4%, n = 6), liver failure (15.4%, n = 6), Guillain-Barre's syndrome (15%, n = 6), hemolytic uremic syndrome (7.7%, n = 3), acute demyelinating disease (7.7%, n = 3), septic shock (5.1%, n = 2), and intoxication (5.1%, n = 2). No patient had any adverse event related to the TPE during the procedure. The TPE session was ended prematurely in one patient due to insufficient vascular access and lack of blood flow (2.6%). In the long term, thrombosis due to the indwelling central catheter occurred (5.1%, n = 2). TPE appears to be an effective first-stage or supplementary treatment in a variety of diseases, may be safely used in pediatric patients, and there are significant findings that its area of use will increase. In experienced hands and when assessed carefully, it appears that the rate of adverse reactions and vascular access problems may be low enough to be negligible.

Successful treatment of an open tibial fracture in a 102-year-old woman: a case report.

Introduction: As the average life expectancy is increasing, the number of patients aged >100 years who have fragility fractures will increase in the future. In female patients, the incidence of open fractures increases with age.Case Presentation: We present the case of a 102-year-old woman with open tibial and fibular diaphyseal fractures (Gustilo-Anderson classification type IIIb) treated with temporary external fixation, advancement flap, and negative pressure wound therapy in the first-stage surgery and treatment, and open reduction and internal fixation with skin grafting in the second-stage surgery. Open wound and bone healing were attained.Conclusion: Surgery should not be denied on the basis of age alone. Medical evaluation should focus on identifying risk factors, assessing risk in detail, optimizing status, predicting complications, and making the appropriate surgical plan for the patient status. Moreover, in the present case, meticulous postoperative management was the main reason for the successful surgical treatment.

Investigation on the development and orientation of mesophase microstructure during the two-stage pyrolysis of FCC decant oil

The two-stage pyrolysis was proposed to effectively form uniaxially fibrous mesophase during pyrolysis of FCC decant oil. Detailed investigation focuses on main factors of regulating mesophase orientation and corresponding changes of mesogen stacks. The first-stage treatment under low temperature of 440 °C and high pressure of 2 MPa for 8 h ensures formation of bulk mesophase with well-coalesced texture and good molten fluidity; subsequently, fracture of residual alkyl side-chains together with devolatilization of trapped light molecules under high temperature (450–480 °C) and low pressure (0.2–1.0 MPa), mainly contributes to volatile evolution at solidification of two-stage pyrolysis. Thereby, the overlap between sufficient volatile evolution that provides enough shear force on mesophase and appropriate viscosity of bulk mesophase, high enough for maintenance of mesophase deformation but not too high to prevent penetration of gas bubbles, is readily achieved and then significantly promotes the transition from mesophase domain into acicular flow texture. Moreover, mesophase orientation at solidification is followed by transformation of mesogen stacks from columnar short-range order into nematic order, leading to decrease of stacked height and number of layer per stack. And further cracking and dehydroaromatization reactions at solidification of two-stage pyrolysis facilitate elimination of steric hindrance, relaxation of structural strains and heal of defects within the planar aromatic sheets, thus resulting into a more homogenous distribution of stacked mesogens and a smaller degree of disorder within the 2D mesogen lattice.

Fabricating mono-dispersed Fe3O4-SiO2 core-shell particles with help of triboelectrification

For years, it has been widely held that triboelectrification is not the sought-after technique to develop innovative materials with enhanced functionalities. In this study, we tried to break such a traditional concept and find its ever-expanding roles in material science. In our strategy, triboelectrification brought adequate charge to particles, so as to achieve their mono-dispersity in solutions. Following this strategy, the synthesis of mono-dispersed Fe3O4-SiO2 core-shell particles involved two-stage triboelectrification treatment. In the first-stage treatment, positive triboelectric charges on Fe3O4 cores ensured their uniform SiO2 coating and well-defined core-shell structure. In the second-stage treatment, positive triboelectric charges on Fe3O4-SiO2 core-shell particles guaranteed their mono-dispersity for further biological use. The Zeta potential of these triboelectrically-treated Fe3O4-SiO2 core-shell particles still maintained at ca. +55 mV after standing for two months, and their conglomeration was negligible owing to their limited increase in hydrodynamic size. Besides, their excellent linearity between relaxivities and iron concentration, and their virtually unchanged r2/r1 ratio within two months manifested that triboelectrification can be a promising technique in fabricating advanced materials.