Single-stage Treatment Research Articles

Surgical intervention on the wound channels of gunshot non-penetrating craniocerebral injuries

Objective – to optimize of surgical approaches to damaged tissues of the head and methods of primary surgical treatment for gunshot non-penetrating gunshot craniocerebral injuries in accordance with the principles of comprehensive and single-stage surgical treatment accepted in military field surgery. Materials and methods. An analysis of the surgical treatment of 155 wounded people with non-penetrating gunshot wounds of the skull vault and brain for the period from 2014 to 2020 was carried out. Anatomical and morphological features of wound canals were studied depending on the traumatic agent. Variants of surgical approaches for the primary surgical treatment of non-penetrable gunshot wounds of the skull and brainwere developed based on the clinical X-ray and computed tomography characteristics of the affected head tissues. Results. The choice of surgical approaches depends on the nature of the wound canals (single fragment blind, multiple fragment blind, ball and fragment tangent) and the presence of concomitant epidural and subdural hematomas. Primary plasty of the skull defect with a titanium plate during primary surgical treatment is indicated for gunshot impenetrable craniocerebral injuries with a single fragmental blind wound channel. Such plastic surgery was performed in 33.5% of cases with a favorable postoperative course. Peculiarities of surgical approaches to damaged tissues of the head in case of single fragmentary, blind wound canal; with multiple blind fragmental wound canals, the adjacent wound canal and the sequence of their surgical treatment were established. Conclusions. Planning of surgical approaches to damaged tissues of the head in case of gunshot impenetrable craniocerebral wounds in modern local wars should be carried out taking into account clinical and computed tomography data. The high proportion of comprehensive and one-time early primary surgical treatments (92.9%) performed on the first day after the injury testifies to the high efficiency of the system of providing specialized medical care during the local war.

Achieving high strength and high electrical conductivity in Cu-Cr-Zr alloy by modifying shear banding during rolling

An economical and practical thermomechanical process that is able to achieve a good combination of strength and conductivity is highly desired for the copper alloys. Here, a new multi-stage thermomechanical treatment, characterized by a pre-rolling with small strain followed by a short-time aging before the secondary rolling and aging, is implemented in the Cu-Cr-Zr alloys. Its effect on the mechanical and electrical properties of the alloy is investigated, as well as the mechanism for improving the properties. Strength and ductility are improved at the expense of only a little electrical conductivity compared to those alloys that have undergone conventional single-stage thermomechanical treatment. The pre-rolling and pre-aging result in dense, dispersive and stable shear bands, which contain lots of dislocations and fine grains. Dislocation strengthening is the main reason for the increased yield strength, while heterostructure consisting of microstructures inside and outside the shear bands gives the processed alloys good tensile plasticity. Our studies shed some lights on development of a short and cost saving thermomechanical process for the Cu-Cr-Zr alloys.

Mixed-Phase Fe2O3 Derived from Natural Hematite Ores/C3N4 Z-Scheme Photocatalyst for Ofloxacin Removal

Abatement of pharmaceutical pollutants from aquatic systems is crucial but remains a challenge. Semiconductor photocatalysis has emerged as an eco-friendly technique that utilizes renewable solar energy to address environmental issues. Naturally occurring and earth abundant hematite (Fe2O3) ores can be incorporated as a suitable component of a photocatalyst. Herein, Brazilian hematite was partially phase transformed into heterophase (consisting of α/γ-Fe2O3) by a simple single-stage heat treatment procedure. The method of synthesis was simple and economical, requiring neither solvents nor concentrated acids. The existence of α/γ-phases in the produced Fe2O3 (FO) was confirmed by X-ray diffraction analysis. After the phase transformation process, the local structure surrounding the Fe atoms was varied as evidenced from X-ray absorption spectroscopy. Given its low toxicity, narrow bandgap, and chemical stability, FO was further combined with g-C3N4 (CN) to form composites. The optical properties of the synthesized CNFO composites confirmed that the visible light harvesting ability of CN was enhanced after combining with FO. The CN sheets were grown uniformly over the surface of FO as evidenced from scanning electron microscopy. The prepared composites could degrade an aqueous solution of ofloxacin (OFX, 10 ppm) under visible light with remarkable efficacy. The performance of CNFO-5% was 4.8 times higher when compared to pure CN. The initial rate constant value for the photocatalytic degradation of OFX by CNFO-5% was 0.1271 min−1. The catalyst was stable even after five repeated cycles of photodegradation. The photoluminescence spectra and electrochemical measurements confirmed the efficient separation and transfer of the photogenerated charges across their interface. The investigations on different scavengers demonstrated that superoxide anion radicals and holes played a significant role in the degradation of OFX. The mechanism for the charge transfer was proposed to be a Z-scheme heterojunction. These results point to the potential of using inexpensive, abundant, and recyclable natural hematite ores as state-of-the-art photocatalysts for the elimination of pharmaceuticals in wastewater.

Single-stage endovitreal surgery of retinal detachment complicated by macular hole involving the short-term perfluorocarbon tamponade

Rhegmatogenous retinal detachment complicated by macular hole is a rare disorder that is the most challenging in terms of vitreoretinal surgery, and good anatomical outcome is not always associated with high visual functions. Today, vitrectomy, involving macular hole closure with autologous platеlet-rich plasma, sealing peripheral retinal tears, and subsequent vitreal cavity tamponade with vitreous substitutes, is considered to be the most effective method for surgical treatment of this disorder. Despite variability of surgical approaches to treatment of rhegmatogenous retinal detachment complicated by macular holes, the search for safe and effective surgical technique, allowing one to achieve benificial morphological and functional outcome with minimal damage to the retinal structures and to minimize the patient's rehabilitation period, is still relevant. The clinical case reported demonstrates the possibility of performing single-stage endovitreal treatment of retinal detachment complicated by macular hole using the autologous conditioned plasma in combination with the short-term perfluorocarbon tamponade. The results of using this technique show its reliability and superior efficiency and ensure good morphological and functional outcome in the postoperative period: restored macular architectonics, macular hole closure, anatomic retinal adhesion, and improved visual functions.

Distal stent graft-induced new entry (dSINE) after frozen elephant trunk: a scoping review.

The introduction of hybrid total arch replacement with the frozen elephant trunk (FET) technique has improved the field of aortic surgery by allowing single-stage treatment of complex aortic pathologies. Although FET has been associated with favorable aortic remodeling, it is also associated with the potential development of distal stent graft-induced new entries (dSINEs). The aim of our review is to collect data about the incidence and the supposed conditions for the occurrence of dSINE after total hybrid arch replacement with FET technique. The literature review was performed using PubMed databases from inception to January 2022. A descriptive approach to detect and display supposed risk factors and predictors for dSINE occurrence has been adopted. Eight studies summarized the state-of-the-art of dSINE in a total number of 544 FET procedures performed to treat acute and chronic aortic dissections. The scoping review showed dSINEs occurrence in 69 patients (12.7%). The mean time between surgery and the diagnosis ranged from 12.6 to 30.6 months. Most patients that developed dSINE received endovascular treatment, whereas a couple of them needed open surgery. According to our experience, from January 2007 to December 2021, in 225 FET procedures a total of 54 cases of dSINE, both with Thoraflex and E-vita grafts have been detected. The mean time between the surgical procedure and the diagnosis was 27.2±33.6 months. dSINEs are frequent complications after FET. Although not emergent, they require proper treatment. Due to dSINE's asymptomatic nature and potential harm, a rigorous follow-up including angio-computed tomography (CT) should be planned.

Evolution of microstructure and properties of an ultrahigh strength Cu–Ni–Sn alloy with low Sn content during the multi-stage thermomechanical treatment

An ultrahigh strength Cu–9Ni-1.5Sn-0.8Si-0.1Al alloy was designed. The effect of multi-stage thermomechanical treatment on the evolution of the microstructure and the properties of designed alloy is explored. The alloy treated by cold rolled (60%)-pre-aging (400 °C/30 min)-cold rolled (50%)-450 °C/120 min-cold rolled (50%)-330 °C/120 min had a tensile strength of 1150 MPa and remained electrical conductivity of 18.1 %IACS. Nanoscale β′-Ni3Sn, β-Ni3Si, γ′-Ni3Al precipitates formed during the thermomechanical treatment. The Cu matrix and precipitates maintain an orientation relationship (OR) were [111]Cu//[111]p and [200]Cu//[200]p. More than half of the ultra-high strength of the design alloy is contributed by precipitation strengthening. The multi-stage thermomechanical treatment further improves mechanical and electrically conductivity properties of Cu–Ni–Sn alloy compared to the single-stage aging treatment. The synergistic impact of nanoparticles formed on heat treatment and dislocations formed on deformation further promoted the precipitation of Ni3X (X = Sn, Si, Al) in the matrix.

Robotic pancreatic necrosectomy and internal drainage for walled-off pancreatic necrosis

BackgroundPancreatic necrosectomy with concomitant internal drainage is a single-stage treatment option for walled-off pancreatic necrosis (WOPN). However, an optimal minimally invasive technique has not been established. We evaluated the safety and single-intervention success rate of robotic pancreatic necrosectomy and internal drainage. MethodsPatients with WOPN undergoing robotic pancreatic necrosectomy and internal drainage at a single institution from 2011-2022 were identified. The primary outcome was the rate of clinical symptom resolution following the index surgical intervention. Results57 patients underwent robotic pancreatic necrosectomy and internal drainage, consisting of robotic cystgastrostomy (RCG, n = 37), robotic cystjejunostomy (RCJ, n = 13) and robotic fistulojejunostomy (RFJ, n = 7). Surgery was performed a median of 102 (range 28–1153) days following the onset of necrotizing pancreatitis. The median operative time was 187 (91–344) minutes and there were 2 (3.5%) conversions. The median length of hospital stay was 4 (2–38) days. Postoperative morbidity was 11%, and there was one (1.8%) 90-day mortality. At a median follow-up of 5.5 months, 53 (93%) patients had clinical symptom resolution after their index procedure and did not require any reintervention. ConclusionIn select patients, robotic pancreatic necrosectomy and internal drainage is safe and achieves a high single-intervention success rate.

Исследование процесса фазового разделения и разработка прозрачных ситаллов на основе фторсодержащих бороалюмосиликатных систем

The processes of crystallization of glasses to obtain transparent glass-ceramics based on fluorine-containing boron-aluminosilicate systems have been studied. The range of compositions along the section of the 2MgO 2Al2O3 5SiO2 — 2(MgO Al2O3)5B2O3 system (MgO Al2O3 content is 28.6 mol. %) is determined in which it is possible to obtain transparent glass-ceramics with the required physicochemical characteristics with single-stage heat treatment of glasses.

Single-Step Full-Face Surgical Treatment of the Facial Profile.

The present study was performed to describe how much affordable, feasible, and straightforward is the approach the authors called "single-stage full-face surgical profileplasty," tailored to greatly improve the surgery of the facial profiling setting and achieve complete profile correction at the same time. From January 2010 to May 2019, 113 patients (95 females and 18 males; aged 19 - 63 years) were surgically treated for full-face profile amelioration. Profile correction was performed by using a combination of five procedures out of other various previously experienced: forehead fat grafting, rhinoplasty, lip fat grafting, genioplasty, and submental liposuction. All patients were assessed at 1, 3, 6, and 12 months following surgery for assessing the surgical profile treatment (SPT) outcome and any possible side effects of the combined treatment. Facial profile stability at 1 year was taken as the completion point of this treatment. Arnett et al's "Soft Tissue Cephalometric Analysis" (1999) was used to clinically evaluate the soft tissues before and after the SPT. Patients' satisfaction was measured with the Client Satisfaction Questionnaire-8" at 3 and 12 months after surgery. Statistics were used for Arnett et al's evaluation. Almost all the values were consistent and reached the normal ranges indicated by Arnett et al (p < 0.001), confirming that the desired results of the surgical profileplasty have been achieved. Single-stage full-face surgical profile treatment helps in correcting faults of the global facial deformity, in every single treated area, providing an overall improvement in facial aesthetics and harmony. Obtaining the simultaneous correction in the whole face has also the advantage of avoiding multiple surgical procedures, reducing postoperative discomfort, and the overall risks for the patient due to multiple surgical and anesthetic procedures.

Comparison between Comprehensive Complication Index (CCI®) and Clavien-Dindo Classification for laparoscopic single-stage treatment of choledocholithiasis with concomitant cholelithiasis

The Clavien-Dindo Classification (CDC) and the Comprehensive Complication Index (CCI®) are both widely used methods for reporting postoperative complications. Several studies have compared the CCI® with the CDC in evaluating postoperative complications of major abdominal surgery. However, there are no published reports comparing both indexes in single-stage laparoscopic common bile duct exploration with cholecystectomy (LCBDE) for the treatment of common bile duct stones. This study aimed to compare the accuracy of the CCI® and the CDC in evaluating the complications of LCBDE. In total, 249 patients were included. Spearman's rank test was used to calculate the correlation coefficient between CCI® and CDC with length of postoperative stay (LOS), reoperation, readmission, and mortality rates. Student t-test and Fisher's exact test were used to study, if higher ASA, age, larger surgical time, history of previous abdominal surgery, preoperative ERCP, and intraoperative cholangitis finding were associated with higher CDC grade or higher CCI® score. Mean CCI® was 5.17 ± 12.8. CCI® ranges overlap among three CDC grades: II (20.90-36.20), IIIa (26.20-34.60), and IIIb (33.70-52.10). Age > 60years, ASA ≥ III, and intraoperative cholangitis finding were associated with higher CCI® (p = 0.010, p = 0.044, and p = 0.031) but not with CDC ≥ IIIa (p = 0.158, p = 0.209, and p = 0.062). In patients with complications, LOS presented a significantly higher correlation with CCI® than with CDC (p = 0.044). In LCBDE, the CCI® assesses better the magnitude of postoperative complications in patients older than 60years, with a high ASA as well as in those who present intraoperative cholangitis. In addition, the CCI® correlates better with LOS in patients with complications.

DÖRT YAŞINDAN BÜYÜK GELİŞİMSEL KALÇA DİSPLAZİSİ OLAN HASTALARDA, TEK AŞAMALI AÇIK REDÜKSİYON, FEMORAL KISALMA VE SALTER OSTEOTOMİSİ’NİN RADYOLOJİK SONUÇLARINI, İLK AMELİYAT YAŞI NASIL ETKİLER ?

OBJECTIVE: One of the most controversial issues in pediatric orthopedics is Developmental dysplasia of the hip (DDH). The timing of diagnosis and treatment are is the main goal to treat this condition successfully. Neglected cases that may remain undiagnosed until advancing age are still seen especially in developing countries. Delayed diagnosis and treatment with advancing age leads to more extensive surgery and cause low satisfactory rates. The aim of this study is to evaluate the effect of patients’ age on the results of single-stage treatment of Developmental Dysplasia of the Hip.MATERIAL AND METHODS: 23 patients (34 hips) treated in our hospital between 2004 and 2010 were included in the study. Single-stage treatment including open reduction, femoral shortening, and Salter’s innominate osteotomy was applied to patients whose mean age of surgery was 7.5 years. Radiological results were evaluated in terms of improvement in the acetabular index, in the acetabular angle and according to Severin’s classification, and Bucholz and Ogden’s avascular necrosis (AVN) classification at the final follow-up.RESULTS: The average follow-up period was 60 (range: 24 - 84) months. While the acetabular index was 39.7°±1.4° (range: 25°- 52°) preoperatively, it was measured as 21.8°±1.8° postoperatively. The mean amount of improvement in the acetabular angle was 17.9°±0.8°. According to Bucholz and Ogden’s classification, one patient (2.9%) had Type 1 AVN and one patient (2.9%) had Type 3 AVN. Radiologically, the success rate (85.7%) was significantly higher in children aged 8 years and younger (p = 0.008).CONCLUSIONS: According to the improvement in the acetabular index and Severin's radiological classification, successful results are obtained after a single-step treatment of DDH, which is treated in the 4-8 age range. However, the radiological results of children older than 8 years are worse than those under 8 years old.

Outcomes of single-stage reconstruction with ipsilateral peroneus longus and hamstring graft in multiligament knee injuries: A case series

Abstract Background: The diagnosis and management of patients presenting with more than one ligament injury in the knee have been a controversial topic for several decades and it is difficult to draw any firm conclusions. No single approach has proven optimal for the treatment of multiligament knee injuries (MLKI) and there is no consensus between most specialists. This case series seeks to describe and clarify management's current state and future. Objective: The purpose of this study was to determine the outcome of single staged MLKI reconstruction. Materials and Methods: It is a hospital-based case series conducted on 10 patients. Patients who were surgically treated for MLKI between 2017 and 2020 were included in this study. In our study, we included patients with grade 3 or grade 4 cruciate ligament injury with grade 3 or 4 collaterals injury for arthroscopic reconstruction. Data were collected pre- and postoperatively and their Lysholm and International knee documentation committee (IKDC) scores were used to evaluate the outcomes. Results: A male predominance was noted in the present study. Road traffic accidents were the most common mode of injury (70%). Anterior cruciate ligament and medial collateral ligament combination constituted the most common injury pattern (70%). Overall, there was a statistically significant difference in outcomes postsurgery with regards to pre-operative and postoperative Lysholm and IKDC scores in our patients with a P-value of less than 0.0001, substantiating the need for surgical management of MLKI. With a mean postoperative Lysholm score of 89 and a mean postoperative IKDC score of 85, this study showed functionally good results in the patients treated in a single sitting. At the end of 1 year, none of the patients showed positive results for anterior drawer and valgus or varus stress tests. None of the patients showed extensor lag at the last follow-up. Conclusion: A wide variety of management approaches have been described for MLKI. Proper evaluation and full diagnosis are key in multiligament injury of the knee. Failure to treat all injured structures can lead to changes in knee kinematics, poorer outcomes, and increased risk for graft failure. Single-stage early surgical treatment with proper rehabilitation yields good functional and clinical outcomes with early return to work and sports activity.

Robotic pancreatic necrosectomy and internal drainage for walled-off pancreatic necrosis

Background: Pancreatic necrosectomy with concomitant internal drainage is a single-stage treatment option for walled-off pancreatic necrosis (WOPN). However, an optimal minimally invasive technique has not been established. We evaluated the outcomes of robotic pancreatic necrosectomy and internal drainage for WOPN.

ВЛИЯНИЕ ТЕРМИЧЕСКОЙ ОБРАБОТКИ НА СПЛАВЫ СИСТЕМЫ Al‒Mg‒SiС ИЗБЫТКОМ КРЕМНИЯ И МАЛЫМИ ЦИРКОНИЕВЫМИ ДОБАВКАМИ

The study is aimed at studying heat treatment for the formation of physical and mechanical properties in the Al-Mg-Si system with an excess of silicon and small zirconium additives. The study was carried out on the example of three alloys with different Mg/Si ratios with a zirconium content of 0.15%. The alloys were subjected to both one and two-stage heat treatment. In the course of a single-stage heat treatment, the alloys were annealed at a temperature of 375–550 °C and holding, which ranged from 10 seconds to 100 hours, followed by fixation of the microstructure in water. In addition, a multi-stage heat treatment was carried out, the annealing temperature of the first stage was varied in the range of 425–550 °C with an 8-hour exposure and subsequent fixation in water, after which the metal was subjected to a 3-hour artificial aging. After completion of the heat treatment, the microhardness and electrical conductivity were investigated. Based on the data on the change in the latter depending on the mode of heat treatment, C-curves of the decomposition of the supersaturated solid solution were constructed. For some modes of heat treatment, studies of intermetallic particles were carried out using scanning microscopy. Using scanning electron microscopy, particles were found in the alloys, similar in their chemical composition to Mg2Si, Al3(FeSi) and Zr2Si. The obtained C-curves show that the decomposition of a supersaturated solid solution begins already at a temperature of 375 °C. Using the constructed C-curves, the influence of the content of silicon, magnesium elements on the rate of decomposition of a supersaturated solid solution is shown. It has been established that the annealing temperature of 375 and 425°C adversely affects the microhardness in the alloys under consideration. After an increase in the annealing temperature to 550°C, there is practically no decrease in microhardness. The performed studies made it possible to choose the optimal mode of multi-stage heat treatment, namely heating to 550 °C for 8 hours with cooling in water, and subsequent 3-hour exposure at a temperature of 180 °C. In general, zirconium additives give an increase in microhardness by 11-25 HV compared to base alloys.

Effects of Solutionizing and Aging Alteration on Tensile Behavior of Stir Cast LM4-Si3N4 Composites

The main concern of this research is to identify the effect of multistage solutionizing and artificial aging behaviour on tensile behavior of LM4 + Si3N4 (1, 2, and 3 wt.%) composites. A two-stage stir casting method was employed to produce composites, which minimized the necessity for a lengthy and high-temperature preheating treatment of reinforcement and resulted in homogeneous reinforcement distribution. Cast composites were subjected to single-stage and multistage solutionizing heat treatment (SSHT and MSHT) followed by aging at 100 and 200°C. Peak hardness of the LM4 and cast composites was noted during artificial aging. With the increase in wt.% of reinforcement, the hardness of the composites increased. Cast composites subjected to MSHT and aging at 100°C displayed maximum hardness when matched to other combinations. Compared to as-cast LM4 hardness (70 VHN), L3SN (with MSHT + aged at 100°C) composite attained 124% higher hardness (157 VHN). UTS values followed a similar trend, compared to as-cast LM4 UTS (149 MPa), L3SN (with MSHT + aged at 100°C) composite attained 54% higher UTS (230 MPa). Major reasons for the improvement in mechanical properties of heat-treated composites are due to the existence of hard Si3N4 particles and the formation of θ'-Al2Cu and θ"-Al3Cu (metastable) phases. From the fracture surface analysis of LM4 and L3SN composite, it was concluded that the type of fracture experienced by LM4 is of ductile nature and that of the composite is of mixed nature.

Early and Direct Endoscopic Stone Removal in the Moderate Grade of Acute Cholangitis with Choledocholithiasis Was Safe and Effective: A Prospective Study.

Evidence supporting the feasibility of single-stage stone removal in patients with a moderate grade of acute cholangitis remains insufficient. The maximal size of a common bile-duct stone suitable for removal during a single-stage ERCP in a moderate grade of acute cholangitis is unknown. We prospectively enrolled 196 endoscopic retrograde cholangiopancreatography (ERCP)-naïve patients diagnosed with acute cholangitis and choledocholithiasis. For eligible patients, single-stage treatment involved stone removal at initial ERCP. A total of 123 patients were included in the final analysis. The success rate of complete stone extraction was similar between patients with mild and moderate grades of acute cholangitis (89.2% vs. 95.9%; p = 0. 181). Complication rates were comparable between the two groups. In the moderate grade of the cholangitis group, among patients who underwent early single-stage ERCP, the length of hospitalization declined as short as the patients in the mild grade of cholangitis (10.6 ± 6.2 vs. 10.1 ± 5.1 days; p = 0.408). In the multivariate analysis, early ERCP indicated shorter hospitalization times (≤10 days) (odds ratio (OR), 3.981; p = 0.001). A stone size less than 1.5 cm presented a high success rate (98.0%) for complete stone removal. Single-stage retrograde endoscopic stone removal in mild and moderate grades of acute cholangitis may be safe and effective, which can obviate the requirement for a second session, thus reducing medical expenses. gov: NCT03754491.

Deciding on the optimal treatment protocol for patients with severe unstable pelvic trauma

Pelvic trauma caused by high-energy forces are accounting for 3 % to 8 % of all traumatic fractures. These are often accompanied by other life-threatening injuries that is a serious tactic problem. There are many publications on the advantages and disadvantages of multi-stage treatment with the Damage Control Orthopedics protocol and Early Total Surgical Care. However, the most difficult category was those who are in a borderline or hemodynamically unstable state.Their treatment is often complicated by acute respiratory distress syndrome (ARDS) and multiple organ failure syndrome (MOFS). The reliable risk assessment, associated with the implementation of a single-stage or multi-stage treatment protocol in patients with unstable pelvic injury, is not sufficient, and surgeon has to choose the treatment protocol based only on own experience.The objective was to analyze the results of using single-stage and multi-stage treatment protocols for patients with unstable pelvic trauma and identify insufficiently researched aspects of each of them.

Beneficial influence of single-stage posterior surgery for the treatment of lumbar brucella spondylitis combined with spondylolisthesis

We aimed to evaluate the clinical efficacy of the single-stage posterior surgical treatment for patients of lumbar brucella spondylitis combined with spondylolisthesis. In this study, we performed a retrospective analysis of 16 patients with lumbar brucellosis spondylitis combined with spondylolisthesis from January 2015 to January 2019. All patients underwent single-stage posterior lumbar debridement, reduction, interbody fusion, and instrumentation. Preoperative and postoperative of the visual analog scale (VAS), the Oswestry disability index (ODI), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were compared. In addition, the spondylolisthesis reduction rate, reduction loss rate, interbody fusion rate, and complication rate were recorded. VAS, ODI, ESR, and CRP were conducted with repeated analysis of variance data at different follow-ups. The postoperative follow-up was 12–36 months, with an average of (25.0 ± 8.1) months. VAS, ODI, ESR, and CRP were significantly better at 2-week and 1-year follow-up than preoperative results (P = 0.000, respectively). In addition, 1 year after the operation, VAS, ODI, ESR, and CRP showed a significant improvement (P = 0.000, respectively). The average spondylolisthesis reduction in 2 weeks after operation was (91.2 ± 6.7)%, and the median reduction loss rate in 1 year after operation was 8.0 (5.0, 9.8)%. At the last follow-up, all patients achieved interbody fusion, no loosening and fracture of instrumentation were found, and no recurrence happened. Single-stage posterior operation for lumbar debridement, reduction, interbody fusion, and instrumentation is beneficial for treating lumbar brucellosis spondylitis combined with spondylolisthesis. Furthermore, the reconstruction of spinal stability may relieve pain, heal lesions, and improve patients’ living.

Is single-stage minimally invasive plate fixation safe in open distal radius fractures with metadiaphyseal involvement?: Retrospective evaluation of 54 patients.

The aim of this study was to evaluate the safety and results of one-stage surgery in Gustilo grade 1 and 2 open distal radius fractures with metadiaphyseal involvement. This retrospective study included 54 patients with AO-2R3 and metadiaphyseal involvement according to the AO fracture classification. All fractures were treated with a long volar plate using the minimally invasive plate osteosynthesis (MIPO) technique. The patients were divided into two groups as open fracture group (25 patients) and closed fracture group (29 patients), and the groups were compared for their union time and complications and functional and radiological results. There was no statistically significant difference between the groups in terms of clinical and radiographic results (P > .05 for both). The mean union time was 12.77 (range, 8-20) weeks in the open fracture group and 12.75 (range, 8-18) weeks in the closed fracture group. There was no statistically significant difference between the groups in terms of union time (P > .05). Moreover, there was no statistically significant difference between the two groups in terms of major and minor complications. All fractures healed without the need for bone and/or soft tissue grafts. As a result of this study, using with long volar plate immediately minimally invasive plate osteosynthesis might be safely used as a single-stage definitive treatment for Gustilo grade 1 and 2 open distal radius fractures with metadiaphyseal involvement. Level IV, Therapeutic Study.

Simultaneous removal of COD and NH4+-N from domestic sewage by a single-stage up-flow anaerobic biological filter based on Feammox

In recent years, Feammox has made it possible to remove NH4+-N under anaerobic conditions; however, its application in practical wastewater treatment processes has not been extensively reported. In this study, an up-flow anaerobic biological filter based on limonite (Lim-UAF) was developed to facilitate long-term and stable treatment of domestic sewage. Lim-UAF achieved the highest removal efficiency of chemical oxygen demand (COD) and NH4+-N at a hydraulic retention time (HRT) of 24 h (Stage II). Specifically, the COD and NH4+-N content decreased from 240.8 and 30.0 mg/L to about 7.5 and 0.35 mg/L, respectively. To analyze the potential nitrogen removal mechanism, the Lim-UAF was divided into three layers according to the height of the reactor. The results showed that COD and NH4+-N removal had remarkable characteristics in Lim-UAF. More than 55.0% of influent COD was removed in the lower layer (0–30 cm) of Lim-UAF, while 60.2% of NH4+-N was removed in the middle layer (30–60 cm). Microbial community analysis showed that the community structure in the middle and upper layers (60–90 cm) was relatively similar, but quite different from that of the lower layer. Heterotrophic bacteria were dominant in the lower layer, whereas iron-reducing and iron-oxidizing bacteria were enriched in the upper and middle layers. The formation of secondary minerals (siderite and Fe(OH)3) indicated that the Fe(III)/Fe(II) redox cycle occurred in Lim-UAF, which was triggered by the Feammox and NDFO processes. In summary, limonite was used to develop a single-stage wastewater treatment process for simultaneously removing organic matter and NH4+-N, which has excellent application prospects in domestic sewage treatment.