Comparison of the Profile and Management of Chronic Pancreatitis between China and Western Countries: A Single-Center Experience and Literature Review.

OBJECTIVE: The etiology, clinical presentation, diagnosis, and treatment strategies of chronic pancreatitis (CP) vary significantly between countries. Specifically, the etiology and surgical approaches to treating CP differ between China and Western countries. Therefore, this study aims to compare the disparities in CP profiles and management based on our single-center experience and recent data from the West. METHODS: From January 2007 to December 2017, a total of 130 consecutive patients with histologically confirmed chronic pancreatitis (CP) underwent surgical treatment at the First Affiliated Hospital of Nanjing Medical University. The clinical features, etiology, risk factors, and operative procedures of these CP patients were analyzed and compared with recent data from Western countries. RESULTS: Our patient cohort was predominantly male (3.19:1), with a median age of 50.2 ± 9.8 years. Upper abdominal pain was the most common symptom, present in 102 patients (78.5%). The most common etiology was obstructive factors (47.7%), followed by alcohol (34.6%). The incidence of genic mutation was 2%, significantly lower than rates reported in Western research. Steatorrhea, weight loss, and jaundice were present in 6.9%, 18.5%, and 17.7% of patients, respectively. Pancreatic cysts or pseudocysts were diagnosed in 7 patients (5.4%). The following procedures were performed: Partington procedure in 33 patients (25.4%), Frey procedure in 17 patients (13.2%), Berne procedure in 5 patients (3.9%), Beger procedure in 1 patient (0.8%), pancreaticoduodenectomy in 17 patients (13.1%), pylorus-preserving pancreaticoduodenectomy in 18 patients (13.9%), middle pancreatectomy in 1 patient (0.8%), and distal pancreatectomy in 9 patients (6.9%). Choledochojejunostomy was performed in 14 patients (10.8%), gastroenterostomy in 2 (1.5%), and 15 patients (11.5%) underwent aspiration biopsy. CONCLUSION: Our study confirms that, etiologically, obstructive chronic pancreatitis (CP) is more frequent in the Chinese population than in Western populations. Although diagnostic instruments and operative procedures in China and Western countries are roughly comparable, slight differences exist in relation to diagnostic flowcharts/criteria and the indications and optimal timing of surgery.

Near-infrared fluorescent probe with large Stokes shift for specific detection of lysine.

A new near-infrared (NIR) fluorescent probe CL based on coumarin- dicyanoisophorone was synthesized. Addition of Lys to probe CL solution in DMF/H2O (9:1, v/v) medium resulted in noticeable enhancement in the intensity of the fluorescence emission at 702 nm, accompanying distinct color change from yellow to pink. While addition of other amino acids and biothiols (Gly, Hcy, GSH, Glu, Val, Tyr, Arg, Trp, Lys, His, Leu, Phe, Asp and Met) did not bring about substantial changes in both fluorescence emission and color. The detection limit was calculated to be 0.51 µM. Job's plot test revealed that probe CL and Lys formed a complex of 1:1 stoichiometry. Probe CL showed high stability and could be used to recognize Lys in a wide pH range of 4.0-10.0. The sensing mechanism was proposed and verified by 1H NMR spectral measurement. The dual-modal fluorescence turn-on and colorimetric NIR probe with an extremely large Stokes shift of 280 nm may be utilized for highly specific and practical sensing of Lys.

Photochemical synthesis of group 10 metal nanoclusters for electrocatalysis.

Four group 10 metal nanoclusters, Ni10(4-MePhS)20, Ni11(PhS)22, Pd9(PhS)18 and Pd10(PhS)20 were synthesized from disulfides based on a photochemical reduction-oxidation cascade process, which proceeds via a different mechanism to that of the conventional two-step reduction process. The as-obtained nanoclusters possess oxidative resistance and structural robustness under different conditions. Their atomically precise structures are determined to be nickel or palladium rings in which the metal atoms are bridged by Ar-S groups. Their catalytic performance in oxygen reduction reaction was compared, and the ring size-dependent catalytic activity of the group 10 metal nanoclusters was revealed. This work provides an efficient route to atomically precise and structurally stable group 10 metal nanoclusters, and sheds light on their further applications in electrocatalysis.

Customizable High-Contrast Optical Responses: Dual Photosensitive Colors for Smart Textiles.

Smart textiles demonstrating optical responses to external light stimuli hold great promise as functional materials with a wide range of applications in personalized decoration and information visualization. The incorporation of high-contrast, vivid, and real-time optical signals, such as color change or fluorescence emission, to indicate light on/off states is both crucial and challenging. In this study, we have developed a dual output photosensitive dye system possessing photochromic and photofluorescent properties, which was successfully applied to the dyeing and finishing processes of cotton fabrics. The design and fabrication of this dye system were based on the unique photoinduced proton transfer (PPT) principle exhibited by the water-soluble spiropyran (trans-MCH) molecule. The dual output response relies on the open-/closed-loop mechanism, wherein light regulates the trans-MCH molecule. Upon excitation by UV or visible light, the dye system and dyed fabrics display significant color changes and fluorescence switching in a real-time and highly reversible manner. Moreover, diverse photosensitive color systems can be tailored by direct blending with commercially available water-soluble dyes. By integrating high-contrast dual optical outputs into this scalable, versatile, and reversible dye system, we envisage the development and design of smart textiles capable of producing high-end products.

Diagnostic accuracy of the FRAIL scale for frailty screening in community-dwelling older adults with diabetes: A cross-sectional study.

There is limited evidence on the diagnostic accuracy of the FRAIL scale in community-dwelling older adults with diabetes. This study aimed to validate the diagnostic accuracy and determine the optimal cutoff point of the FRAIL scale in community-dwelling older adults with diabetes using the Fried Frailty Phenotype as the reference standard. A total of 489 community-dwelling older adults with diabetes aged 60 or above were recruited in this cross-sectional study. The FRAIL scale showed good diagnostic accuracy for frailty screening. The optimal cutoff point for frailty screening in older adults with diabetes was 2. The agreement between the FRAIL scale and the Fried Frailty Phenotype was substantial. The FRAIL scale classified more participants as frail (29.24%) than the Fried Frailty Phenotype (22.09%). These findings provide evidence that the FRAIL scale is a valid tool that can be applied to community-dwelling older adults with diabetes.

Cadmium-Doped and Pincer Ligand-Modified Gold Nanocluster for Catalytic KA2 Reaction.

A gold nanocluster Au17 Cd2 (PNP)2 (SR)12 (PNP=2,6-bis(diphenylphosphinomethyl)pyridine, SR=4-MeOPhS) consisting of an icosahedral Au13 kernel, two Au2 CdS6 staple motifs, and two PNP pincer ligands has been designed, synthesized and well characterized. This cadmium and PNP pincer ligand co-modified gold nanocluster showed high catalytic efficiency in the KA2 reaction, featuring high TON, mild reaction conditions, broad substrate scope as well as catalyst recyclability. Comparison of the catalytic performance between Au17 Cd2 (PNP)2 (SR)12 and the structurally similar single cadmium (or PNP) modified gold nanoclusters demonstrates that the co-existence of the cadmium and PNP on the surface is crucial for the high catalytic activity of the gold nanocluster. This work would be enlightening for developing efficient catalysts for cascade reactions and discovering the catalytic potential of metal nanoclusters in organic transformations.

The exploration of shared genes and molecular mechanisms of systemic lupus erythematosus and atherosclerosis.

OBJECTIVE: Despite widespread recognition, the mechanisms underlying the relationship between systemic lupus erythematosus (SLE) and atherosclerosis (AS) are still unclear. Our study aimed to explore the shared genetic signature and molecular mechanisms of SLE and AS using a bioinformatics approach. METHODS: Gene expression profiles of GSE50772 (contains peripheral blood mononuclear cells from 61 SLE patients and 20 normal samples) and GSE100927 (contains 69 AS plaque tissue samples and 35 control samples) were downloaded from the Gene Expression Database (GEO) before the differentially expressed genes were obtained using the "limma" package in R. The differential genes were then subjected to gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis using the DAVID online platform to annotate their functions. The intersection targets of PPI and WGCNA were used as key shared genes for SLE and AS with their diagnostic value as shared genes being verified through ROC curves. Finally, Cytoscape 3.7.2 software was used to construct a miRNA-mRNA network map associated with the shared genes. RESULTS: A total of 246 DEGs were identified, including 189 upregulated genes and 57 downregulated genes, which were mainly enriched in signaling pathways such as TNF signaling pathway, IL-17 signaling pathway, and NF-kB signaling pathway. The molecular basis for the relationship between SLE and AS may be the aforementioned signaling pathways. Following ROC curve validation, the intersection of PPI and WGCNA, as well as AQP9, CCR1, CD83, CXCL1, and FCGR2A, resulted in the identification of 15 shared genes. CONCLUSION: The study provided a new perspective on the common molecular mechanisms between SLE and AS, and the key genes and pathways that were identified as being part of these pathways may offer fresh perspectives and suggestions for further experimental research.

Occurrence and exposure risk assessment of pesticide residues in green tea samples cultivated in Hangzhou area, China.

The concentration of pesticide residues in 105 green tea samples grown in Hangzhou area were investigated. Of the 14 pesticides analysed using gas chromatography-tandem mass spectrometry and the 27 pesticides analysed using liquid chromatography-tandem mass spectrometry, only 18 were detected in the tea samples. The most frequently detected pesticide residues were imidacloprid (35.2%), acetamiprid (26.7%), carbendazim (21.0%), bifenthrin (21.0%), and cyhalothrin (19.1%). Carbofuran was the only pesticide which exceeded in one sample the maximum residue limit. The concentrations of the analytes in tea samples ranged from below the limit of detection (LOD) to 2.64 mg/kg. Their mean concentrations were all below the LOD, except for imidacloprid, acetamiprid, carbendazim, bifenthrin and cyhalothrin. Based on a preliminary long-term exposure assessment, the hazard quotient values of the detected pesticides varied in the range 0.47 × 10-3 - 1.1 × 10-3%, which indicates that these levels did not pose a risk to human health in Hangzhou area.

Bibliometric analysis of cerebral organoids and diseases in the last 10 years.

Cerebral organoids have emerged as a powerful tool for mirroring the brain developmental processes and replicating its unique physiology. This bibliometric analysis aims to delineate the burgeoning trends in the application of cerebral organoids in disease research and offer insights for future investigations. We screened all relevant literature from the Web of Science on cerebral organoids in disease research during the period 2013-2022 and analyzed the research trends in the field using VOSviewer, CiteSpace, and Scimago Graphica software. According to the search strategy, 592 articles were screened out. The United States of America (USA) was the most productive, followed by China and Germany. The top nine institutions in terms of the number of publications include Canada and the United States, with the University of California, San Diego (USA), having the highest number of publications. The International Journal of Molecular Sciences was the most productive journal. Knoblich, Juergen A., and Lancaster, Madeline A. published the highest number of articles. Keyword cluster analysis showed that current research trends focused more on induced pluripotent stem cells to construct organoid models of cerebral diseases and the exploration of their mechanisms and therapeutic modalities. This study provides a comprehensive summary and analysis of global research trends in the field of cerebral organoids in diseases. In the past decade, the number of high-quality papers in this field has increased significantly, and cerebral organoids provide hope for simulating nervous system diseases (such as Alzheimer's disease).

Structure and assembly of a hexanuclear AuNi bimetallic nanocluster.

An Au4Ni2 nanocluster containing a square-planar [-PPh2-Au-S-Au-]2 ring and two nickel-pincer arms is reported here. Abundant intra- and inter-cluster noncovalent interactions promote the assembly of the nanocluster into a porous framework material. The assembly-dependent unique solubility and photoluminescence were also investigated.

Modified rigorous coupled-wave analysis for multi-layer deformable gratings with arbitrary profiles and materials.

In this paper, the rigorous coupled-wave analysis (RCWA) is extended for general multi-layer deformable gratings with arbitrary numbers of layers, surface profiles, layer offsets, and materials. The contribution from the offset between grating layers and/or due to the movement of the deformable grating layer is included in the expansion of the relative permittivity by the Fourier series, enabling the calculations of deformable gratings commonly used in many optical-based displacement sensing devices. The accuracy and efficiency of the extended RCWA are verified by a number of grating models. It is found that the numerical results are in excellent agreement with those from the finite element method, while the RCWA method costs only ∼1/10 in computation time when compared to its counterpart. Our approach can be used for fast calculation and optimization of multi-layer deformable gratings for optical displacement sensing applications.

The Ratio of CD226 and TIGIT Expression in Tfh and PD-1+ICOS+Tfh Cells Are Potential Biomarkers for Chronic Antibody-Mediated Rejection in Kidney Transplantation.

Kidney transplantation is the ideal treatment for end-stage renal disease (ESRD). Chronic antibody-mediated rejection (CAMR) is the main cause of graft failure. Tfh and B cells are key immune cells that play important roles in CAMR. In this study, the populations of different Tfh cell phenotypes and B cell subsets in CAMR were investigated in a total of 36 patients. Based on Banff-2019, 15 patients were diagnosed with CAMR (CAMR group), 11 recipients were diagnosed with recurrent or de novo IgA nephropathy (IgAN group), and 10 patients displayed stable renal function (stable group). The Tfh and B cell subsets were analyzed by flow cytometry. The percentage and absolute number of PD-1+ICOS+Tfh cells were significantly higher in CAMR (p < 0.05), as was the ratio of CD226+Tfh cells to TIGIT+Tfh cells (p < 0.05). Compared with stable recipients, CAMR patients had lower naïve B cells and higher unswitched memory B cells, which were also significantly related to renal function (p < 0.05). Using the logistic regression model, we concluded that the estimated glomerular filtration rate (eGFR), absolute number of PD-1+ICOS+Tfh cells, and ratio of CD226+Tfh cells to TIGIT+Tfh cells were independent risk factors for CAMR. The combination of eGFR, PD-1+ICOS+Tfh cells, and the ratio of CD226+Tfh cells to TIGIT+Tfh cells showed better diagnostic efficacy for CAMR than each single parameter. The collective findings show that monitoring different Tfh phenotypes and B cell subsets is beneficial to kidney transplant recipients and implicate the combination of eGFR, number of PD-1+ICOS+Tfh cells, and ratio of CD226+Tfh cells to TIGIT+Tfh cells as a biomarker for diagnosing CAMR. The findings may also inform new strategies to identify and treat CAMR.

The diagnostic role of PD-1+ CXCR5+ follicular helper CD8+ T cell in renal allograft dysfunction.

BACKGROUND: The roles of PD-1+ CXCR5+ follicular helper CD8+ T cell were reported in different disease conditions, but their roles in transplantation are unclear. In this study, the association between PD-1+ CXCR5+ follicular helper CD8+ T cell and renal allograft dysfunction in kidney transplant recipients (KTRs) was investigated. METHODS: 82 KTRs were enrolled in this study. 45 KTRs were included in the chronic allograft dysfunction (CAD) group, and 37 KTRs were included in the stable recipients group. Among the CAD group, 12 cases of antibody-mediated rejection (ABMR) and 4 cases of T cell-mediated rejection (TCMR) were diagnosed by biopsy. The percentage of CXCR5+ CD8+ T cells and the co-expression of signal transducers and activators of transcription 4 (STAT4), STAT5, and PD-1 in peripheral blood were determined by flow cytometry. RESULTS: The expression of CXCR5 on CD3+ CD8+ T cells and the percentage of STAT5+ CXCR5+ cells in the CD3+ CD8+ T-cell population were significantly lower in the CAD group (p < 0.05), while the expression of PD-1+ CXCR5+ CD8+ T cells was significantly higher (p < 0.05). Through logistic regression analysis, we concluded that the percentage of PD-1+ CXCR5+ CD8+ T cells was an independent risk factor for renal dysfunction. Grouping by pathological type, PD-1+ CXCR5+ CD8+ T cells showed relatively good diagnostic efficacy for ABMR by ROC analysis. CONCLUSIONS: Our results suggested that PD-1+ CXCR5+ CD8+ T cells were a promising biomarker for distinguishing renal allograft dysfunction and different allograft pathological types. Also, our findings may provide new ways of identifying and treating allograft rejection.

Soluble Tim-3/Gal-9 as predictors of adverse outcomes after kidney transplantation: A cohort study.

BACKGROUND: In our previous study, serum soluble T-cell immunoglobulin and mucin structure-3 (sTim-3) and galactosin-9 (sGal-9) were found to be associated with renal function after kidney transplantation. However, it is unclear whether these two indicators can predict adverse outcomes after transplantation. METHODS: Ninety-one recipients of kidney transplantation were enrolled and divided into a stable group and an adverse outcome group (consisting of biopsy-proven rejection, graft loss, death and clinically diagnosed rejection). The expression levels of sTim-3 and sGal-9 before (pre-Tim-3 and pre-Gal-9) and one month after transplantation (post-Tim-3 and post-Gal-9) were measured by ELISA. RESULTS: The level of pre-Tim-3 was significantly higher in the stable group than in the adverse outcome group [median (range), 2275 (840-4236) pg/mL vs. 1589 (353-3094) pg/mL, P = 0.002]. The level of post-Gal-9 was significantly lower in the stable group than in the adverse outcome group [median (range), 4869 (1418-13080) pg/mL vs. 6852: (4128-10760) pg/mL, P = 0.003]. The areas under the curve (AUCs) for pre-Tim-3 and post-Gal-9 were 0.737 (P = 0.002) and 0.751 (P = 0.003), respectively, better than AUC of post-eGFR (0.633) (P = 0.071), according to the receiver operating characteristic (ROC) curve. Through Cox regression analysis, including pre-Tim-3, post-Gal-9, post-eGFR, sex, age, BMI of recipients and donors, pre-Tim-3 and post-Gal-9 were independent risk factors for adverse outcomes after kidney transplantation (P = 0.016, P = 0.033, respectively). CONCLUSION: Serum sTim-3 and sGal-9 can predict adverse outcomes within two years after kidney transplantation.

Low Temperature Hydrophilic SiC Wafer Level Direct Bonding for Ultrahigh-Voltage Device Applications.

SiC direct bonding using O2 plasma activation is investigated in this work. SiC substrate and n- SiC epitaxy growth layer are activated with an optimized duration of 60s and power of the oxygen ion beam source at 20 W. After O2 plasma activation, both the SiC substrate and n- SiC epitaxy growth layer present a sufficient hydrophilic surface for bonding. The two 4-inch wafers are prebonded at room temperature followed by an annealing process in an atmospheric N2 ambient for 3 h at 300 °C. The scanning results obtained by C-mode scanning acoustic microscopy (C-SAM) shows a high bonding uniformity. The bonding strength of 1473 mJ/m2 is achieved. The bonding mechanisms are investigated through interface analysis by transmission electron microscopy (TEM) and energy dispersive X-ray spectroscopy (EDX). Oxygen is found between the two interfaces, which indicates Si-O and C-O are formed at the bonding interface. However, a C-rich area is also detected at the bonding interface, which reveals the formation of C-C bonds in the activated SiC surface layer. These results show the potential of low cost and efficient surface activation method for SiC direct bonding for ultrahigh-voltage devices applications.

Maintenance Treatment With Low-Dose Decitabine After Allogeneic Hematopoietic Cell Transplantation in Patients With Adult Acute Lymphoblastic Leukemia.

BACKGROUND: Post-transplant relapse remains a principal leading cause of failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with adult acute lymphoblastic leukemia (ALL). The aim of this study was to investigate the efficacy and safety of low-dose decitabine on the prevention of adult ALL relapse after allo-HSCT. METHODS: In this prospective study, we enrolled 34 patients with ALL who underwent allo-HSCT from August 2016 to April 2020 and received low-dose decitabine maintenance treatment after transplantation. The primary objectives were cumulative incidence of relapse rate (CIR), overall survival (OS), and disease-free survival (DFS). The secondary objectives were graft-versus-host disease (GVHD) and safety. RESULTS: Among the enrolled 34 patients, 6 patients relapsed and 6 patients died. The 2-year CIR, OS, and DFS were 20.2, 77.5, and 73.6%, respectively. Subgroup analysis revealed the 2-year CIR, OS, and DFS rates of 12 patients with T-ALL/lymphoblastic lymphoma (LBL) were 8.3, 90, and 81.5%, respectively. None of the seven patients with T-ALL relapsed. During maintenance treatment, only one patient (2.9%) developed grade IV acute GVHD and four (11.8%) patients had severe chronic GVHD. Thirty-two patients (94.1%) developed only grade I to II myelosuppression, and two patients (5.8%) developed grade III to IV granulocytopenia. CONCLUSIONS: Maintenance treatment with low-dose decitabine after allo-HSCT may be used as a therapeutic option to reduce relapse in patients with adult ALL, especially in patients with T-ALL. Our findings require confirmation in larger-scale controlled trials. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trials Registry, identifier ChiCTR1800014888.

Highly precise in-plane displacement sensor based on an asymmetric fiber Fabry-Perot interferometer.

An in-plane displacement sensor based on an asymmetric extrinsic fiber Fabry-Perot interferometer (EFPI) is proposed and demonstrated. The asymmetric EFPI composed of a step-shaped external reflector and a cleaved fiber end face can be equivalent to two parallel FPIs with slightly different cavity lengths. By calculating the peak intensity difference of the two FPIs, the in-plane displacement can be demodulated with enhanced sensitivity and suppressed common mode noise. Both theoretical analyses and experimental results show that the sensitivity and the linear range of the in-plane displacement sensor are dependent on the cavity length. A displacement resolution of 5 nm and a linear range of ±7µm under the cavity length of 250 µm are achieved in the experiment. The proposed in-plane displacement sensor with a nanometric resolution and compact size can be widely used in the fields of metrology, accelerometers, and semiconductor manufacture.

Monochloropropanediol in edible vegetable oils from Hangzhou market in China: occurrence and exposure risk assessment.

In this study, 241 vegetable-oil food samples were collected from the Hangzhou market in China and analysed for fatty acid esters of 3- and 2-monochloropropanediol (3-MCPD and 2-MCPD) using non-derivative gas chromatography tandem mass spectrometry (GC-MS/MS). Food consumption data were taken from a food consumption survey of urban and rural residents in Hangzhou city performed in 2010-2011. Levels of 3-MCPD esters in edible oil ranged from not detected to 7.98 mg/kg, and the highest mean levels were found in tea seed oil, with concentrations of 2.94 mg/kg. Esters of 2-MCPD levels ranged from not detected to 4.03 mg/kg, and the highest mean levels were also found in tea seed oil, containing 1.49 mg/kg. The range of mean dietary intake of 3-MCPD esters in different groups of edible oil was from 0.096 to 1.54 µg/kg body weight (bw) per day, which is lower than the tolerable daily intake (TDI) established by the European Food Safety Authority (EFSA) (2 µg/kg bw/day). For people aged above 6 years old, the dietary intake of 3-MCPD from edible oil was 0.42 µg/kg bw per day (mean) and 1.22 µg/kg bw per day (P97.5). The range of mean dietary intake of 2-MCPD esters in different groups of edible oil was from 0.025 to 0.79 µg/kg bw/day, and 2-MCPD esters intake was 0.20 µg/kg bw per day (mean) and 0.60 µg/kg bw per day (P97.5). In addition, the dietary intake exposure to 3-MCPD and 2-MCPD esters for urban residents was lower than that for rural residents. The findings indicate that the potential health risks caused by dietary 3-MCPD esters from edible oils were of low concern for most of the Hangzhou residents. However, the exposure risk for consumers with excessive consumption of certain kind of edible oil calls for attention.

Duration of immobilisation after Achilles tendon rupture repair by open surgery: a retrospective cohort study.

BACKGROUND: The best treatment for acute Achilles tendon ruptures remains controversial. No cohort studies have compared different immobilisation durations after open surgery. This retrospective cohort study aimed to determine the optimal duration of immobilisation after this surgery. METHODS: A total of 266 patients with acute Achilles tendon rupture were divided into 4 groups (A, B, C, and D) according to immobilisation duration of 0, 2, 4, and 6 weeks, respectively. All patients underwent the same suture technique with a similar rehabilitation protocol and were examined clinically at 2, 4, 6, 8, 10, 12, 14, 16, 24, and 48 weeks, with a final follow-up at a mean of 22.3 months postoperatively. The primary outcome was the time of return to light sports activity (LSA). Secondary outcomes included range of motion (ROM) and single-legged heel rise height (SHRH). Data on operation time, complications, visual analogue pain scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and Achilles tendon Total Rupture score (ATRS) were also collected. Demographic baseline data were analysed using one-way analysis of variance; outcome parameters were analysed using Kruskal-Wallis H test, and complications were analysed using Fisher's exact test. Statistical significance was considered at P ≤ 0.05. RESULTS: VAS scores decreased significantly, reaching 0 in all groups after 12 weeks. The AOFAS and ATRS scores were significantly different between the groups from weeks 2 to 12 (P<0.001) and weeks 2 to 16 (P<0.001), respectively. All the mean scores showed better results in group B than in the other groups. In terms of recovery time of ROM, SHRH, and LSA, groups A and B were significantly faster than groups C and D (P<0.001). There were 13 (13/266, 4.9%) complications: 5 superficial infections, 3 deep venous thrombosis, and 5 trauma-related re-ruptures. On the last follow-up, all complications had recovered. There were no significant differences in complications between the groups. CONCLUSIONS: Immobilisation for 2 weeks after this open surgery is the best choice for early rehabilitation and weight-bearing while minimising pain and other complications.