Chemical composition, oxidative potential and identifying the sources of outdoor PM2.5 after the improvement of air quality in Beijing.

Air pollution poses a serious threat to human health. The implementation of air pollution prevention and control policies has gradually reduced the level of atmospheric fine particles in Beijing. Exploring the latest characteristics of PM2.5 has become the key to further improving pollution reduction measures. In the current study, outdoor PM2.5 samples were collected in the spring and summer of Beijing, and the chemical species, oxidative potential (OP), and sources of PM2.5 were characterized. The mean PM2.5 concentration during the entire study period was 41.6 ± 30.9 µg m-3. Although the PM2.5 level in summer was lower, its OP level was significantly higher than that in spring. SO42-, NH4+, EC, NO3-, and OC correlated well with volume-normalized OP (OPv). Strong positive correlations were found between OPv and the following elements: Cu, Pb, Zn, Ni, As, Cr, Sn, Cd, Al, and Mn. Seven sources of PM2.5 were identified, including traffic, soil dust, secondary sulfate, coal and biomass burning, oil combustion, secondary nitrate, and industry. Multiple regression analysis indicated that coal and biomass combustion, industry, and traffic were the main contributors to the OPv in spring, while secondary sulfate, oil combustion, and industry played a leading role in summer. The source region analysis revealed that different pollution sources were related to specific geographic distributions. In addition to local emission reduction policies, multi-provincial cooperation is necessary to further improve Beijing's air quality and reduce the adverse health effects of PM2.5.

Delayed Discharge after Thoracic Surgery under the Guidance of ERAS Protocols.

BACKGROUND: Enhanced recovery after surgery (ERAS) protocols have been applied in thoracic surgery and are beneficial to patients. However, some issues about ERAS are still pending. METHODS: A total of 1,654 patients who underwent thoracic surgery under the guidance of ERAS protocols were enrolled in this study. We set the length of postoperative stay (LOPS) as our key research indicator. Patients were divided into routine discharge group and delayed discharge group based on LOPS. Causes of delayed discharge were analyzed to improve management of postoperative recovery. RESULTS: Male, old age, underlying disease (coronary artery disease, chronic kidney disease, old cerebral infarction, chronic obstructive pulmonary disease, and arrhythmia), intensive care unit (ICU) stay, type of insurance, and lower forced expiratory volume in one second (FEV1) are the independent impact factors causing delayed discharge. Increased nonchylous drainage (INCD) and prolonged air leakage were the two leading causes for delayed discharge. CONCLUSION: Patients should have personalized recovery goal under the same ERAS protocols. We should accept that patients in poor general condition have a prolonged LOPS. More stringent ICU stay indications should be developed to increase postoperative patients' ERAS protocols compliance. Further research on chest tube management will make a contribution to ERAS protocols.

The analgesic effect and safety of preoperative versus postoperative administration of celecoxib in patients who underwent arthroscopic rotator cuff repair: a randomized, controlled study.

AIMS: Celecoxib presents a good analgesic effect in patients who undergo arthroscopic rotator cuff repair (ARCR) surgery, while few studies investigate the optimal timing of celecoxib administration. This study aimed to explore the analgesic effect of preoperative versus postoperative administration of celecoxib in ARCR-treated patients. METHODS: A total of 106 ARCR-treated patients were enrolled and randomized at a 1:1 ratio into preoperative analgesia group (N = 53) and postoperative analgesia group (N = 53). The pain visual analog scale (VAS) score at rest or flexion, salvage consumption of pethidine, patient's satisfaction score, modified University of California at Los Angeles (UCLA) score and adverse events were evaluated. RESULTS: Pain VAS scores at rest at 12 h and D1 (but not D2, D3 or D7) and pain VAS scores at flexion at 12 h, D1 and D2 (but not D3 or D7) were decreased in preoperative analgesia group compared to postoperative analgesia group. Meanwhile, rescue analgesia rate and 7-day pethidine consumption in preoperative analgesia group were lower than that in postoperative analgesia group. Besides, the overall satisfaction scores at D1 and D3 (but not at D7 or M3) were elevated in preoperative analgesia group compared to postoperative analgesia group. However, no difference of modified UCLA scores at D7 or M3, or the occurrences of adverse events were found between the two groups. CONCLUSIONS: Celecoxib preoperative administration remits acute pain and facilitates satisfaction but does not improve long-term shoulder joint function recovery compared to its postoperative administration in patients who undergo ARCR surgery.

Ankle arthrodesis for end-stage haemophilic ankle arthropathy using a Ilizarov method.

PURPOSE: Only a few studies in the literature have reported on the outcome of ankle arthrodesis in haemophilia patients, and the optimal surgery technique for end-stage haemophilic ankle arthropathy remains controversial. The purpose of this study was to evaluate the results of ankle arthrodesis using the Ilizarov method in treating end-stage haemophilic ankle arthropathy. METHODS: Fourteen haemophilia patients with end-stage ankle arthropathy who underwent ankle arthrodesis using the Ilizarov method from December 2013 to May 2018 were enrolled in this study. The hospital day, fusion rate, complications, and functional outcomes were recorded and analyzed. Functional outcomes were evaluated according to the pre-operative and final follow-up of the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score, visual analog scale (VAS), and Medical Outcomes Short Form 12-item questionnaire score (SF-12) . RESULTS: All patients achieved bony fusion as confirmed by post-operative radiographs. The average time to fusion was 12.9 weeks (range, 10-17 weeks). Superficial pin track infection was observed in two patients, and subtalar arthritis was found in one patient. The mean AOFAS ankle-hind foot score, VAS score, physical component summary (PCS), and mental component summary (MCS) at final follow-up were significantly improved compared with the pre-operative data. All patients were satisfied with the surgery. CONCLUSIONS: Ankle arthrodesis using the Ilizarov method is a minimally invasive, effective, and safe surgical method and can be a viable option for hemophilia patients with end-stage ankle arthropathy.

Bilateral rectal sheath hematomas after low-molecular weight heparin treatment in uremia.

Rectus sheath hematomas (RSHs) are uncommon. They are usually unilateral and rarely bilateral. In this paper, we report the first case of spontaneous bilateral RSHs in a uremic patient after the administration of the first dose of low-molecular weight heparin during hemodialysis. The most interesting aspect of this case is that the main symptom of RSH in our patient was urinary bladder irritation. We highlight the importance of the prompt diagnosis and management of this medical emergency.

Efficacy of leflunomide combined with prednisone in the treatment of refractory nephrotic syndrome.

OBJECTIVE: To assess the safety and clinical efficacy of leflunomide (LEF) and prednisone on refractory nephrotic syndrome (RNS). METHODS: A total of 52 patients with RNS were treated for 24 weeks between 2010 and 2014 in our hospital. In the treated group, 26 patients were treated with LEF and prednisone, and, in the control group, 26 patients were treated with cyclophosphamide (CTX) and prednisone. During the treatment, 24 h urinary protein excretion and the serum levels of albumin and cholesterol, and kidney function were assayed before and after the therapy. Adverse reactions during treatment were recorded. RESULTS: In the LEF group, the medication was markedly effective in eight cases and effective in nine cases; the total efficacy rate was 65.30%. In the CTX group, the treatment was markedly effective in six cases and effective in nine cases; the total efficacy rate was 57%. There were no significant differences between the results of the total efficacy rate (p > .05). The 24 h urinary protein excretion and serum cholesterol levels in both groups decreased after therapy and the serum levels of albumin in both groups increased after therapy. There were significant differences between the results for the 24 h urinary protein excretion, serum levels of albumin and cholesterol in the two groups (p < .05). The treatments were well tolerated in both groups. CONCLUSION: LEF combined with prednisone has a certain efficacy on the RNS and displays few adverse reactions. A large-sample, randomized double-blind controlled study and long-term follow-up are needed to verify the efficacy of LEF combined with prednisone.

Utilizing gemstone spectral CT imaging to evaluate the therapeutic efficacy of radiofrequency ablation in lung cancer.

PURPOSE: To evaluate the therapeutic efficacy of radiofrequency ablation (RFA), quantitative water-based, and iodine-based images of gemstone spectral computed tomography (CT) were analyzed. PATIENTS AND METHODS: 30 patients underwent lung RFAs from March 2012 to March 2013. Through enhanced chest scans, we obtained the tumor size values by conventional CT images, and quantitatively analyzed the densities of iodine and water in lung tumors from water-based and iodine-based material decomposition images. RESULTS: Tumors in 22 cases increased in size after RFA while there was no detectable change in the remaining 8 cases. Through water-based material decomposition images, the water content in the tumors increased from (1014.76 ± 6.83 mg/mL) to (1022.71 ± 10.16 mg/mL) after RFA, and this difference was significant (t = -2.329, p < 0.05). Through iodine-based material decomposition images, the iodine content in the tumors was 2.49 ± 0.74 mg/mL before RFA. The tumors were mostly or completely necrotized after RFA and the iodine content in the area of necrosis reduced to 0.45 ± 0.29 mg/m (t = 11.072, p = 0.000). CONCLUSION: By comparing the tumor size, water content and iodine content before and after RFA, we can visualize the morphology and metabolic states of the tumors and evaluate the therapeutic efficiency.

The management of naso-orbital-ethmoid (NOE) fractures.

The bony naso-orbital-ethmoid (NOE) complex is a 3-dimensional delicate anatomic structure. Damages to this region may result in severe facial dysfunction and malformation. The management and optimal surgical treatment strategies of NOE fractures remain controversial. For a patient with NOE trauma, doctors should perform comprehensive clinical examination and radiographic analysis to assess the type and extent of fracture. The results of assessment will assist doctors to make a patientspecific program for the sake of reducing post-operation complications and restoring normal appearance and function as much as possible. This review focuses on the advancement of management of NOE fractures including symptoms, classifications, diagnosis, approaches, treatment and new techniques in this field.

[Comparing different treatments for femoral neck fracture of displacement type in the elderly:a meta analysis].

OBJECTIVE: To compare the effects and security between internal fixation and total hip arthroplasty for the patients in elderly with femoral neck fracture of displacement type through a meta analysis. METHODS: Studies on comparison between internal fixation and total hip arthroplasty for the patients in the elderly with femoral neck fracture of displacement type were identified from PubMed database,EMBase database, COCHRANE library, CMB database, CNKI database and MEDLINE database. Data analysis were performed using Revman 5.2.6(the Cochrane Collaboration). RESULTS: Six published randomized controlled trials including 627 patients were suitable for the review, 286 cases in internal fixation group and 341 cases in total hip arthroplasty group. The results of meta analysis indicated that statistically significant difference were observed between the two groups in the quality of life which was reflected by the Harris scale (RR = 0.82, 95%CI:0.72-0.93, P < 0.05) , the reoperation rate (RR = 5.81, 95%CI:3.09-10.95, P < 0.05) and the major complications rate (RR = 3.60, 95%CI:2.29-5.67, P < 0.05) postoperatively. There were no difference in the mortality at 1 year and 5 years postoperatively(P > 0.05). CONCLUSIONS: For the patients with femoral neck fracture of displacement type in the elderly, there is no statistical difference between two groups in the mortality postoperatively. The quality of life and the security of operation in internal fixation group is worse than the total hip arthroplasty group.

Self-management in patients with adult spinal deformity: a best practice implementation project.

INTRODUCTION: The prevalence of adult spinal deformity (ASD) has increased in recent years. Patients often have to live for a prolonged period from the onset of the condition, up until the need for surgical treatment. Self-management plays a crucial role in disease progression and prognosis. OBJECTIVES: This project aimed to promote evidence-based practices for the self-management of patients with ASD. METHODS: This project was guided by the JBI Evidence Implementation Framework project and was conducted in the orthopedic department of a tertiary care hospital in China. A baseline audit was conducted to evaluate current practice against best practice recommendations. Barriers were identified and, after the implementation of improvement strategies, a follow-up audit was conducted to assess project effectiveness. RESULTS: A comparison between the baseline and follow-up audits revealed a significant increase in nurses' compliance with best practices (rising from 0%-64% to 97.7%-100%) in the following areas: improved health promotion behaviors by nurses in self-management of ASD patients; acquisition and application of communication skills with patients; increased availability of educational materials in the ward; and establishment of conservative treatment follow-up instructions for patients. For patients, the Visual Analog Scale of pain decreased from (2.72 ± 1.67) to (1.90 ± 1.14), the Oswestry Disability Index decreased from (49.96 ± 16.49) to (39.83 ± 18.97), self-management behaviors improved from (10.84 ± 4.31) to (19.52 ± 6.31), and maximum isometric muscle strength in the standing position increased from (179.48 ± 91.18)N to (250.03 ± 91.50)N, all with statistically significant improvements ( p <0.05). For nurses, the knowledge questionnaire score improved from (34.83 ± 24.16) to (82.00 ± 11.11) ( p <0.05). CONCLUSIONS: This project helped ASD patients improve self-management, alleviated their clinical symptoms, and improved nurses' knowledge of best practices. Future audits will be conducted to review long-term project outcomes. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A193.

Experience with aortic arch inclusion technique using artificial blood vessel for type A aortic dissection: an application study.

BACKGROUND: This study aimed to elucidate the methodology and assess the efficacy of the aortic arch inclusion technique using an artificial blood vessel in managing acute type A aortic dissection (ATAAD). METHODS: We conducted a retrospective review of 18 patients (11 males and 7 females, average age: 56.2 ± 8.6 years) diagnosed with ATAAD who underwent total aortic arch replacement (TAAR) using an artificial vascular "inclusion" between June 2020 and October 2022. During the operation, deep hypothermic circulatory arrest (DHCA) and selective antegrade cerebral perfusion (ACP) of the right axillary artery were employed for brain protection. The 'inclusion' total aortic arch replacement and stented elephant trunk (SET) surgery were performed. RESULTS: Four patients underwent the Bentall procedure during the study, with one additional patient requiring coronary artery bypass grafting (CABG) due to significant involvement of the right coronary orifice. Three patients died during postoperative hospitalization. Other notable complications included two cases of postoperative renal failure necessitating continuous renal replacement therapy (CRRT), one case of postoperative double lower limb paraplegia, and one case of cerebral infarction resulting in unilateral impairment of the left upper limb. Eleven patients underwent computed tomography angiography (CTA) examinations of the aorta three months to one-year post-operation. The CTA results revealed thrombosis in the false lumen surrounding the aortic arch stent in seven patients and complete thrombosis of the false lumen around the descending aortic stent in eight patients. One patient had partial thrombosis of the false lumen around the descending aortic stent, and another patient's false lumen in the thoracic and abdominal aorta completely resolved after one year of follow-up. CONCLUSIONS: Incorporating vascular graft in aortic arch replacement simplifies the procedure and yields promising short-term outcomes. It achieves the aim of total arch replacement using a four-branch prosthetic graft. However, extensive sampling and thorough, prolonged follow-up observations are essential to fully evaluate the long-term results.

Efficacy and safety of short-term edaravone or nerve growth factor add-on therapy for alcohol-related brain damage: A multi-centre randomised control trial.

AIMS: To measure the therapeutic effect of an anti-oxidant, edaravone (EDV), or neurotrophic treatment with nerve growth factor (NGF) as an add-on treatment for alcohol-related brain damage (ARBD). DESIGN: Multi-centre, randomised, single-blinded, comparative clinical trial. SETTING AND PARTICIPANTS: One hundred and twenty-two inpatients recruited from seven hospitals in different regions of China, all diagnosed with ARBD and aged 18 to 65 years old; among them, only two were female. INTERVENTION AND COMPARATOR: Patients were randomly assigned to receive one of three treatments for 2 weeks: 40 patients, treatment as usual (TAU: a combination of intramuscular injections of thiamine, intravenous infusions of other B vitamins with vitamin C and oral medication with vitamin E per day); 40, EDV add-on treatment to TAU (intravenous infusion with 30 mg of EDV twice per day); and 42, NGF add-on treatment to TAU (intramuscular injection of 20 µg of NGF per day). The patients underwent follow-up for 24 weeks. MEASUREMENTS: The primary outcome was the composite score of executive cognitive function in the 2nd week after treatment, which was measured as the mean of the Z scores of the assessments, including the digit symbol substitute test (DSST), digit span memory test-forward (DST-F), digit span memory test-reverse (DST-R) and space span memory test (SSMT). The secondary outcomes were the composite scores at later follow-ups, the score for each component of cognitive function, global cognitive function measured by the Montreal Cognitive Assessment (MoCA), craving for alcohol and the safety of the therapies. FINDINGS: EDV add-on treatment improved the composite score of executive cognitive function better than TAU in the 2nd week (adjusted mean difference: 0.24, 95% confidence interval 0.06 to 0.41; P = 0.008), but NGF add-on treatment did not (adjusted mean difference: 0.07, 95% confidence interval -0.09 to 0.24; P = 0.502). During the follow-up to 24 weeks, EDV add-on treatment improved the composite score of executive cognitive function and DST-R score better than TAU (both P < 0.01). Craving for alcohol was relieved in all three groups. No severe adverse events were observed. CONCLUSION: The short-term addition of edaravone to supplementary therapy treatment for alcohol-related brain damage (ARBD) improved executive cognitive function in patients with ARBD.

Good neurologic recovery after cardiac arrest using hypothermia through continuous renal replacement therapy.

Therapeutic hypothermia (TH) is becoming a standard of care to mitigate neurologic injury in cardiac arrest survivors. Several cooling methods are available for use in TH. For maintaining a target temperature, intravascular cooling is superior to, more efficacious than, and safer than surface cooling methods. The use of an intravenous cooling catheter is independently associated with a higher odds ratio for survival. However, many techniques use commercially developed equipment that is expensive to purchase and use. The application and popularization of the intravascular cooling method have been difficult. In patients with pulmonary edema or cardiac insufficiency, liquid is restricted, so intravascular cooling systems cannot be used. Studies have shown abnormalities mimicking the immunologic and coagulation disorders observed in severe sepsis. Continuous renal replacement therapy has been widely used in the intensive care unit to improve clinical parameters and survival in patients with multiple-organ dysfunction of septic origin. Continuous renal replacement therapy can also be used as another type of core cooling method. We used continuous renal replacement therapy as a cooling method to induce TH in a patient who had a cardiac arrest, and the patient regained consciousness 52 hours later.

Multi-UAV autonomous collision avoidance based on PPO-GIC algorithm with CNN-LSTM fusion network.

This paper is concerned with the autonomous effective collision avoidance strategy for multiple unmanned aerial vehicles (multi-UAV) in limited airspace under the framework of proximal policy optimization (PPO) algorithm. An end-to-end deep reinforcement learning (DRL) control strategy and a potential-based reward function are designed. Next, the CNN-LSTM (CL) fusion network is constructed by fusing the convolutional neural network (CNN) and the long short-term memory network (LSTM), which realizes the feature interaction among the information of multi-UAV. Then, a generalized integral compensator (GIC) is introduced into the actor-critic structure, and the CLPPO-GIC algorithm is proposed by combining CL and GIC. Finally, we validate the learned policy in various simulation environments by performance evaluation. The simulation results show that the introduction of the LSTM network and GIC can further improve the efficiency of collision avoidance, and the robustness and accuracy of the algorithm are verified in different environments.

Identifying novel disease categories through divergence optimization: An approach to prevent misdiagnosis in medical imaging.

Given the significant changes in human lifestyle, the incidence of colon cancer has rapidly increased. The diagnostic process can often be complicated due to symptom similarities between colon cancer and other colon-related diseases. In an effort to minimize misdiagnosis, deep learning-based approaches for colon cancer diagnosis have notably progressed within the field of clinical medicine, offering more precise detection and improved patient outcomes. Despite these advancements, practical application of these techniques continues to encounter two major challenges: 1) due to the need for expert annotation, only a limited number of labels are utilized for diagnosis; and 2) the existence of diverse disease types can lead to misdiagnosis when the model encounters unfamiliar disease categories. To overcome these hurdles, we present a method incorporating Universal Domain Adaptation (UniDA). By optimizing the divergence of samples in the source domain, our method detects noise. Furthermore, to identify categories that are not present in the source domain, we optimize the divergence of unlabeled samples in the target domain. Experimental validation on two gastrointestinal datasets demonstrates that our method surpasses current state-of-the-art domain adaptation techniques in identifying unknown disease classes. It is worth noting that our proposed method is the first work of medical image diagnosis aimed at the identification of unknown categories of diseases.

A bio-inspired versatile free-standing membrane for oral cavity microenvironmental monitoring and remineralization to prevent dental caries.

The fast monitoring of oral bacterial infection, bacterial clearance and repairing of enamel damage caused by dental caries relies on an effective way of monitoring, killing and repairing in situ, but presents a major challenge in oral healthcare. Herein, we developed a bio-inspired versatile free-standing membrane by filling TiO2 nanotube arrays with ß-sheet-rich silk fibroin and cleaving them from Ti foil, as inspired by nacre or enamel-like structures. The robust transparent membrane exhibited good mechanical properties, and could indicate acid-base microenvironment variation and the infection of S. mutans in a 5 min test by loading cyanidin cations in the membrane. Meanwhile, it can be used for photocatalysis and nanoreservoirs ascribed to TiO2 nanotubes, to kill and remove 99% of S. mutans bacteria under interval UV irradiation with low-power density, and load functional peptide to induce the remineralization on the etched-enamel for long-term treatment, tested in vitro and in vivo. The mechanical property of repaired enamel is improved in comparison. This bio-inspired constructed membrane would be applied in the prevention and treatment of oral cavity related diseases, such as enamel demineralization and dental caries, etc.

Riboflavin Supplementation Promotes Butyrate Production in the Absence of Gross Compositional Changes in the Gut Microbiota.

Aims: We performed a randomized, placebo-controlled trial, RIBOGUT, to study the effect of 2 weeks supplementation with either 50 or 100 mg/d of riboflavin on (i) Faecalibacterium prausnitzii abundance, (ii) gut microbiota composition, (iii) short-chain fatty acid (SCFA) profiles, and (iv) the satiety and gut hormones. Results: Neither dose of riboflavin, analyzed separately, impacted the abundance of F. prausnitzii, and only minor differences in SCFA concentrations were observed. However, combining the results of the 50 and 100 mg/d groups showed a significant increase in butyrate production. While the gut bacterial diversity was not affected by riboflavin supplementation, the complexity and stability of the bacterial network were enhanced. Oral glucose tolerance tests showed a trend of increased plasma insulin concentration and GLP-1 after 100 mg/d supplementation. Innovation: Dietary supplements, such as vitamins, promote health by either directly targeting host physiology or indirectly via gut microbiota modulation. Here, we show for the first time that riboflavin intervention changes the activity of the microbiota. The butyrate production increased after intervention and although the composition did not change significantly, the network of microbial interactions was enforced. Conclusion: This RIBOGUT study suggests that oral riboflavin supplementation promotes butyrate production in the absence of major shifts in gut microbiota composition. ClinicalTrials.gov Identifier: NCT02929459.

The use of external fixation combined with vacuum sealing drainage to treat open comminuted fractures of tibia in the Wenchuan earthquake.

PURPOSE: The purpose of this study was to review the results of external fixation combined with vacuum sealing drainage (VSD) to treat patients who sustained tibial and fibular fractures in the Wenchuan earthquake. METHODS: We retrospectively analysed 179 cases (of which 85 were classified as Gustilo grade III) of open comminuted fracture of the tibia and fibula caused by the Wenchuan earthquake. The patients were followed up for an average of 15 months; detailed records were kept on their function and recovery. RESULTS: After caring for the life-threatening injuries; fractures were treated by external fixation, with VSD used on the surface or in the cavity of the wound after debridement. Antibiotics were administered on the basis of drug sensitivity test results. After the infection had been controlled and healthy granulation tissue had developed, the patients underwent secondary suture, free skin grafting, or skin flap transfer. CONCLUSION: Good results can be achieved when external fixation combined with vacuum sealing drainage were used to treat open comminuted fractures of tibia and fibula in the Wenchuan earthquake.

Evolution and Development of Ilizarov Technique in the Treatment of Infected Long Bone Nonunion with or without Bone Defects.

The treatment of infected bone nonunion and bone defects is a considerable challenge in the orthopedics field. The standard clinical therapy methods include local free bone transplantation, vascularized bone graft, and the Ilizarov technique; the first two are controversial due to the iatrogenic self-injury. The Ilizarov bone transport technique has been widely used to treat infected bone nonunion and bone defects, and good clinical effect has been demonstrated. Yet, it brings many related complications, which exerts additional suffering to the patient. The best treatment is to combine bone defect rehabilitation with infection control, intramedullary nail fixation, appropriate time for bone grafts, beaded type scaffold slippage and new Taylor fixation, reducing the external fixation time and the incidence of complications, thereby reducing the occurrence of patients' physical and psychological problems. This review focuses on the induction, summary and analysis of the Ilizarov bone transport technique in the treatment of infected long bone nonunion with or without bone defects, providing new ideas and methods for orthopedic disease prevention and treatment by the Ilizarov technique, which is following the development direction of digital orthopedics.