[Comparison of talonavicular-cuneiform joint fusion with bone grafting and without bone grafting in treatment of Müller-Weiss disease].

Objective: To compare the effectiveness of talonavicular-cuneiform joint fusion with iliac bone grafting and without bone grafting in the treatment of Müller-Weiss diseases (MWD). Methods: The clinical data of 44 patients (44 feet) with MWD who received talonavicular-cuneiform joint fusion between January 2017 and November 2022 and met the selection criteria was retrospectively analyzed. Among them, 25 patients were treated with structural iliac bone grafting (bone grafting group) and 19 patients without bone grafting (non-bone grafting group). There was no significant difference ( P>0.05) in age, gender composition, body mass index, disease duration, affected side, Maceira stage, and preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score, anteroposterior/lateral Meary angle, and Pitch angle between the two groups. Operation time, operation cost, and postoperative complications were recorded in the two groups. AOFAS and VAS scores were used to evaluate the function and pain degree of the affected foot. Meary angle and Pitch angle were measured on the X-ray film, and the joint fusion was observed after operation. The difference (change value) of the above indexes before and after operation was calculated for comparison between groups to evaluate the difference in effectiveness. Results: The operation was successfully completed in both groups, and the incisions in the two groups healed by first intention. The operation time and cost in the bone grafting group were significantly more than those in the non-bone grafting group ( P<0.05). All patients were followed up. The median follow-up time was 41.0 months (range, 16-77 months) in the non-bone grafting group and 40.0 months (range, 16-80 months) in the bone grafting group. There was skin numbness of the medial dorsalis of the foot in 1 case, internal fixation stimulation in 2 cases, and pain at the iliac bone harvesting area in 1 case of the bone grafting group. There was skin numbness of the medial dorsalis of the foot in 1 case and muscle atrophy of the lower limb in 1 case of the non-bone grafting group. There was no significant difference in the incidence of complications between the two groups ( P>0.05). At last follow-up, the AOFAS scores of the two groups significantly improved when compared with those before operation, while the VAS scores significantly decreased, the anteroposterior/lateral Meary angle and Pitch angle significantly improved, and the differences were significant ( P<0.05). There was no significant difference in the change values of outcome indicators between the two groups ( P>0.05). There was no delayed bone union or bone nonunion in both groups, and joint fusion was achieved at last follow-up. Conclusion: In the treatment of MWD, there is no significant difference in effectiveness and imaging improvement of talonavicular-cuneiform joint fusion combined with or without bone grafting. However, non-bone grafting can shorten the operation time, reduce the cost, and may avoid the complications of bone donor site.

Müller-Weiss Disease: Midfoot Arthrodesis in Reduction vs Malreduction.

BACKGROUND: Midfoot arthrodesis is regarded as the main surgical approach for treating Müller-Weiss disease (MWD). This study aimed to investigate the incidence of postoperative pain during MWD treatment through midfoot reduction or malreduction during arthrodesis and to explore the factors influencing postoperative pain in patients with MWD. METHODS: A total of 67 patients with MWD were recruited and divided into two groups according to whether midfoot alignment was reduced: reduction group (n = 38) and malreduction group (n = 29). Demographic characteristics before the operation and at the last follow-up, as well as clinical and radiographic parameters, were compared between the two groups. Clinical parameters included the American Orthopaedic Foot & Ankle Society score and visual analog scale score, whereas radiographic parameters included the calcaneal pitch angle, lateral Meary's angle, talometatarsal-1 angle dorsoplantar (TMT1dp), talocalcaneal angle dorsoplantar (Kite angle), talonavicular coverage angle, and medial navicular pole extrusion. Postoperative complications and incidence of midfoot pain were evaluated at the last follow-up visit. RESULTS: The reduction group exhibited better clinical and radiological parameters, including the TMT1dp and medial navicular pole extrusion, than the malreduction group at the last follow-up (all P < .05). However, the calcaneal pitch angle, lateral Meary's angle, Kite angle, and talonavicular coverage angle did not significantly differ between the two groups (all P > .05). The overall incidence of midfoot pain was 26.4%. The reduction group showed a lower incidence of medial pain than the malreduction group (15.7% vs. 40.0%, P < .05). Regression analysis revealed that midfoot abduction, represented by the TMT1dp, was a critical factor for midfoot arthrodesis failure and that medial navicular pole extrusion was not correlated with postoperative midfoot pain. CONCLUSION: Midfoot reduction arthrodesis yields better clinical outcomes than malreduction arthrodesis. The TMT1dp, representing midfoot abduction, is a key factor for midfoot arthrodesis failure. The extruded medial navicular bone may not affect postoperative medial midfoot pain. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Visible light-induced metal-free chemoselective oxidative cleavage of benzyl C-heteroatom (N, S, Se) bonds utilizing organoboron photocatalysts.

The oxidation process is widely explored and used to synthesize diverse organic chemicals. Herein, a unified metal-free photooxidative platform for the cleavage of C-heteroatom bonds has been developed. In these reactions, the aminoquinolate diarylboron (AQDAB) complex is utilized as the photocatalyst, instigating the oxidation process induced by visible light. The cleavage of C-heteroatom bonds can be achieved chemoselectively, affording the formal carbonylation product of C-N, C-S, and C-Se bonds. This method provides a channel for connecting amines, thiols, or selenides with the carbonyl compounds directly, broadening the potential applications of oxidation as a synthetic tool.

Mixed oligosaccharides-induced changes in bacterial assembly during cucumber (Cucumis sativus L.) growth.

The application of oligosaccharides can promote plant growth by increasing photosynthesis or inducing plant innate immunity. However, the mechanisms by which oligosaccharides affect bacterial community diversity and abundance remain unclear. In this study, a mixed oligosaccharide was applied to the growth of cucumbers. The findings of the present study suggest that the application of MixOS has significant effects on the bacterial communities in the phyllosphere, rhizosphere, and bulk soil of cucumber plants. The treatment with MixOS resulted in delayed senescence of leaves, well-developed roots, and higher fruit production. The bacterial diversity and composition varied among the different ecological niches, and MixOS application caused significant shifts in the bacterial microbiome composition, particularly in the phyllosphere. Moreover, mixed oligosaccharides increased the abundance of potential growth-promoting bacteria such as Methylorubrum spp. and Lechevalieria spp., and more zOTUs were shared between the WM and MixOS treatments. Furthermore, the bacterial co-occurrence network analysis suggested that the modularity of the phyllosphere networks was the highest among all samples. The bacterial co-occurrence networks were altered because of the application of MixOS, indicating a greater complexity of the bacterial interactions in the rhizosphere and bulk soil. These findings suggest that mixed oligosaccharides has the potential to improve plant growth and yield by modulating the bacterial communities within and outside the plants and could provide a theoretical basis for future agricultural production.

[Comparison of efficacy of platelet-rich plasma and extracorporeal shock wave for the treatment of chronic insertional Achilles tendinopathy].

OBJECTIVE: To compare clinical efficacy of platelet-rich plasma (PRP) and extracorporeal shock wave in treating chronic insertional Achilles tendinopathy. METHODS: From February 2019 to August 2021, 42 patients with chronic insertional Achilles tendinopathy were selected and divided into PRP group(20 patients, 28 feet) and shock wave group (22 patients, 29 feet). In PRP group, there were 12 males and 8 females, aged 47.00(28.00, 50.75) years old, and the courses of disease ranged 7.00(6.00, 7.00) months;PRP injection was performed in the Achilles tendon stop area of the affected side. In shock wave group, there were 16 males and 6 females, aged 42.00(35.75, 47.25) years old;and the courses of disease was 7.00(6.00, 8.00) months;shock wave was performed in Achilles tendon stop area of the affected side and triceps surae area. Visual analogue scale (VAS) and Victorian Institute of Sport Assessment-Achilles (VISA-A) were applied to evaluate clnical effect before treatment, 1, 3 and 6 months after treatment, and satisfaction of patients was investigated. RESULTS: VAS and VISA-A score in both groups were significantly improved at 1, 3 and 6 months after treatment than before treatment (P<0.05), VAS and VISA-A score in PRP group at 6 months after treatment were significantly higher than those at 1 and 3 months after treatment, and VAS and VISA-A score in shock wave group were lower than those at 1 and 3 months after treatment (P<0.05). There was no significant difference in VAS and VISA-A score between two groups before treatment, 1 and 3 months after treatment(P>0.05), while VAS and VISA-A score in PRP group were better than those in shock wave group at 6 months after treatment(P<0.05), and the satisfaction survey in PRP group was better than that in shock wave group(P<0.05). CONCLUSION: PRP injection has a good clinical effect on chronic insertional Achilles tendinopathy with high patient satisfaction, and medium-and long-term effect of PRP injection for the treatment of chronic insertional Achilles tendinopathy is better than that of extracorporeal divergent shock wave.

Preparation and Characterization of a Novel Cassava Starch-Based Phosphorus Releasing Super-Absorbent Polymer, and Optimization of the Performance of Water Absorption and Phosphorus Release.

To prepare a novel cassava starch-based phosphorus releasing super-absorbent polymer (CST-PRP-SAP), the single factor and orthogonal experiment were applied to analyze the effects of different reaction conditions on the absorption and phosphorus release capacities of CST-PRP-SAP samples. The structural and morphological characteristics of the cassava starch (CST), powdered rock phosphate (PRP), cassava starch-based super-absorbent polymer (CST-SAP) and CST-PRP-SAP samples were all compared with various technologies, such as the Fourier transform infrared spectroscopy and X-ray diffraction pattern, etc. The results showed that the CST-PRP-SAP samples had good performances of water retention and phosphorus release which were synthesized, such as the reaction temperature, starch content, P2O5 content, crosslinking agent, initiator, neutralization degree, and acrylamide content, which were 60 °C, 20% w/w, 10% w/w, 0.02% w/w, 0.6% w/w, 70% w/w, and 15% w/w, respectively. The water absorbency of CST-PRP-SAP was almost larger than that of the CST-SAP sample with a P2O5 content of 5.0% and 7.5%, and they all gradually decreased after three consecutive water absorption cycles. The CST-PRP-SAP sample could maintain about 50% of the initial water content after 24 h, even at the temperature of 40 °C. The swelling process of CST-PRP-SAP conformed to the non-Fickian diffusion, which was determined by the diffusion of water molecules and the relaxation process of polymer chain segments. The cumulative phosphorus release amount and release rate of the CST-PRP-SAP samples were increased with the increasing PRP content and the decreasing neutralization degree. After a 216 h immersion, the cumulative phosphorus release amount and release rate of the CST-PRP-SAP samples with different PRP contents were increased by 17.4 and 3.7 times, respectively. The rough surface of the CST-PRP-SAP sample after swelling was beneficial to the performance of water absorption and phosphorus release. The crystallization degree of PRP in the CST-PRP-SAP system was decreased and most of the PRP existed in the form of physical filling, and the available phosphorus content was increased to a certain extent. It was concluded that the CST-PRP-SAP synthesized in this study has excellent properties of continuous water absorption and retention with functions of promotion and the slow-release phosphorus.

Talonavicular-cuneiform arthrodesis for the treatment of Müller-Weiss: mid-term results of 15 cases after 5 years.

BACKGROUND: There is no gold standard for the operative treatment of patients with Müller-Weiss disease (MWD). This study reports the mid-term follow-up results for at least 5 years following talonavicular-cuneiform (TNC) arthrodesis for Müller-Weiss disease. METHODS: A total of 15 patients undergoing TNC arthrodesis for MWD were retrospectively reviewed between January 2015 and August 2017. Two senior doctors assessed the radiographic results twice at each visit (preoperative, three months after the operation, and final follow-up). The clinical results and complications from preoperative and final follow-up were recorded. RESULTS: The mean follow up period was 74.0 (range 64 to 90) months. The calcaneal pitch angle, lateral Meary's angle, anteroposterior (AP) Meary's angle, AP talocalcaneal angle, and talonavicular coverage were significantly different before and three months after the operation (p < 0.05). There was no significant difference between the radiographic results of three months after the operation and the final follow-up (p > 0.05). The radiological measurements of the two senior doctors were calculated and found to be moderate to strong (ICC:0.899-0.995). The AOFAS, VAS, and SF-12 scores significantly improved at the last follow-up compared to those before the operation (p < 0.05). Two patients experienced early complications, four had late complications, and one underwent a second operation of midfoot fusion with calcaneal osteotomy. CONCLUSION: This research confirms that using TNC arthrodesis for the treatment of MWD can substantially improve the clinical and radiographic results. These results were maintained until mid-term follow-up.

Y-shape osteotomy combined with subtalar arthrodesis for calcaneus malunion: a retrospective study.

BACKGROUND: This retrospective study aimed to introduce a novel method for simultaneous Y-shape osteotomy combined with subtalar arthrodesis for calcaneus malunion and to evaluate the feasibility of this method. METHODS: We retrospectively analysed the clinical and imaging data of 11 patients with calcaneus malunion treated using Y-shape osteotomy and subtalar arthrodesis who were admitted to our hospital from June 2018 to October 2020. The patients included 9 males and 2 females aged from 24 to 69 years old, with an average age of 42.18 years. The clinical and radiological results were assessed with the Visual Analogue Scale (VAS) pain score and American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. In addition, functional recovery and general quality of life were evaluated using the 12-Item Short-Form Survey (SF-12). RESULTS: All radiological parameters were significantly improved at the last follow-up, with increases of 14.37°, 9.18°, and 4.51 mm in the Böhler's angle, calcaneal pitch angle, and talocalcaneal height, respectively, and decreases of 6.39 mm and 6.18° in the calcaneal width and Hindfoot alignment angle (p < 0.05). The mean AOFAS and VAS scores at the last follow-up improved compared with those preoperatively, from 34.18 ± 9.53 to 84.18 ± 11.59 and from 6.90 ± 1.22 to 1.90 ± 1.13, respectively (p < 0.05). The SF-12 physical and mental health scores were 49.65 ± 6.84 and 52.68 ± 7.88, respectively. Furthermore, the early postoperative complications included skin necrosis in one and sural neuralgia in one patient, and the late postoperative complication included ankle pain in one patient. No other complications, such as implant discomforts, malunion, nonunion and re-fracture, were presented. CONCLUSION: These results indicate that Y-shape osteotomy combined with subtalar arthrodesis is an effective new method for the treatment of calcaneal malunion. Advantages include improvement of the anatomic shape of the calcaneus and union rates for subtalar arthrodesis.

Highly water-stable Cd-MOF/Tb3+ ultrathin fluorescence nanosheets for ultrasensitive and selective detection of Cefixime.

Two-dimensional Cd-MOF/Tb3+ (Cd-MOF = [Cd (µ-2,3-pdc) (H2O)3]n (2,3-pdc = 2,3-pyridine dicarboxylic acid)) fluorescent nanosheets with the thickness of 1.4 nm were successfully synthesized by a simple solution route with subsequent ultrasonic exfoliation at room temperature. It was found that as-obtained Cd-MOF/Tb3+ ultrathin nanosheets could be homogeneously dispersed in aqueous system to form a sol with excellent stability. Also, the fluorescence intensity of nanosheets remarkably increased to almost 12 times higher than that of Cd-MOF/Tb3+ microsheets before exfoliation. Further investigations uncovered that the above strong fluorescence of Cd-MOF/Tb3+ nanosheets could be highly sensitively quenched by Cefixime antibiotic in aqueous solution without interference from other antibiotics, amino acids and pesticides. Hence, the as-obtained ultrathin Cd-MOF/Tb3+ nanosheets could be prepared as a highly selective and sensitive fluorescence probe for the detection of Cefixime in aqueous system. Compared with the bulk Cd-MOF/Tb3+ sensor, the Cd-MOF/Tb3+ ultrathin nanosheets sensor exhibited a far lower detection limit down to 26.7 nM for CFX. Also, the as-obtained nanosheets sensor presented satisfactory recovery ranging from 98.07% to 103.01% and acceptable repeatability (RSD < 6.29%, n = 6) for the detection of CFX in domestic water. Furthermore, the sensing mechanism studies revealed that the high selection of the present fluorescent probe for detection of CFX should be attributed to the cooperation of the photoinduced electron transfer and the inner filter effect.

Microwave-assisted alkali hydrolysis for cellulose isolation from wheat straw: Influence of reaction conditions and non-thermal effects of microwave.

Microwave-assisted hydrolysis has been widely studied for cellulose fiber isolation, but the influence of reaction conditions and the microwave non-thermal effect are not well clarified. In this study, a series of well-designed experiments were carried out to measure the effects of reaction conditions including temperature, duration and alkali concentration. Compared to the other parameters, temperature was more relevant to the cellulose content in fiber. It could reach the maximum purity of 90.66 % when the temperature was up to 140 °C. Moreover, the existence of non-thermal effect of microwave has been confirmed through extensive determination and characterization of the fibers obtained from parallel controlled experiments conducted with or without microwave assistance. Approximately 50 %-75 % reduction in reaction time or 67 % of that in chemical costs would be realized under microwave with respect to traditional heating hydrolysis. Therefore, this work provides both deep insight and efficiency strategy into the microwave-assisted cellulose isolation.

[VSD technique combined with Bing Shi Yu Shang Ointment for the treatment of foot skin defects].

OBJECTIVE: To explore the clinical effect of vacuum sealing drainage (VSD) technique and Bing Shi Yu Shang Ointment in the treatment of foot skin defect. METHODS: From November 2017 to April 2019, 21 patients (21 feet) with foot skin defect were treated with VSD technique and Bing Shi Yu Shang Ointment. There were 17 males and 4 females, aged from 24 to 60 years old with an average of (37.8±11.2) years, 9 cases caused by traffic accident injury, 6 cases by heavy injury, 6 cases by falling injury. The time from injury to operation was for 3 to 36 (8.6±7.2) h, and the area of foot skin defect was for 20.35 to 83.43(47.2±19.5) cm2. All patients underwent debridement or phaseⅠtemporary fixation in emergency, and three-dimensional imagingof the foot was performed by using Mimics software, and the defect area was rendered. The quality of wound healing and complications were observed, and the clinical effect was evaluated by Maryland foot function score. RESULTS: All the 21 patients were followed up for 7 to 17 (10.8±2.7) months. There was no infection or nonunion in all patients. At the final follow-up, the skin margin of the healing site grew tightly, the skin was elastic, the texture was tough, the appearance was no obvious carbuncle. The time of wound healing was for 18 to 63 (41.2±13.3) days. Eight patients underwent stageⅡfixation or/and fusion, and all incisions healed by stageⅠ. According to Maryland's foot scoring, 9 cases got excellent results, 11 good, and 1 middle. CONCLUSION: VSD can effectively remove the necrotic tissue of the wound, provide a smooth drainage of the wound, combine with Bing Shi Yu Shang Ointment to prevent infection and promote the rapid growth of granulation tissue, whose whole treatment cycle was short, the wound healing site was highquality, the limb function was good, and the clinical effect was satisfactory.

Chelating capture and magnetic removal of non-magnetic heavy metal substances from soil.

A soil remediation method based on magnetic beneficiation is reported. A new magnetic solid chelator powder, FS@IDA (core-shell Fe3O4@SiO2 nanoparticles coated with iminodiacetic acid chelators), was used as a reactive magnetic carrier to selectively capture non-magnetic heavy metals in soil by chelation and removal by magnetic separation. FS@IDA was prepared via inorganic-organic and organic synthesis reactions that generated chelating groups on the surface of magnetic, multi-core, core-shell Fe3O4@SiO2 (FS) nanoparticles. These reactions used a silane coupling agent and sodium chloroacetate. The results show that FS@IDA could chelate the heavy metal component of Cd, Zn, Pb, Cu and Ni carbonates, lead sulfate and lead chloride in water-insoluble salt systems. The resulting FS@IDA-Cd and FS@IDA-Pb chelates could be magnetically separated, resulting in removal rates of approximately 84.9% and 72.2% for Cd and Pb, respectively. FS@IDA could not remove the residual heavy metals and those bound to organic matter in the soil. FS@IDA did not significantly alter the chemical composition of the soil, and it allowed for fast chelating capture, simple magnetic separation and facilitated heavy metal elution. FS@IDA could also be easily prepared and reprocessed.

Socioeconomic Factors Associated With Posthospitalization Hospice Care Settings: A 5-Year Perspective.

Investigating whether socioeconomic characteristics determine if hospice is received at home or in a medical facility is important to examine, considering most patients prefer to die at home. This study relied upon The State Inpatient Data of Nevada. A total of 19 206 discharges were analyzed from the data set between 2009 and 2013. The results indicate that increasingly patients are being discharged to home and overall socioeconomic characteristics appear to have less of an influence over whether hospice is received at home or in a medical facility. Further research on the perspectives of patients would provide insight into whether patients' preferences or socioeconomic characteristics are more influential on where hospice services are received.

[Effects of plant polysaccharide compound agents on the photosynthetic characteristics and dry matter of soybean].

A field experiment was conducted to study the effects of foliar spraying three compound agents [plant polysaccharides (P1), plant polysaccharides and 5-aminolevulinic acid (P2), and plant polysaccharides and 5-aminolevulinic acid and dimethylpiperidinium chloride (P3)] at the initial flowering stage of soybean on its leaf chlorophyll content, photosynthesis and transpiration, dry matter accumulation and allocation, and grain yield. Within 35 days after spraying the three compound agents, the leaf chlorophyll content had obvious increase, and its decreasing trend with plant growth had somewhat delay. Compared with the control, spraying P1 and P3 increased the leaf photosynthetic rate and water use efficiency by more than 13.2% and 10.3%, respectively. With the spraying of the three compound agents, the dry matter accumulation in aerial part increased, and the allocation of dry matter from leaf to pod was also enhanced, with the contribution of post-anthesis assimilates to grain yield increased by more than 17.1%. The 100-grain mass and the pods and seeds per plant increased significantly after spraying P1 and P3, but had no significant increase after spraying P2. The grain yield of soybean treated with the three compound agents increased by more than 5.9%, compared with the control. This study showed that the three plant polysaccharide compound agents could increase the leaf chlorophyll content, delay the leaf-senescence, improve the leaf photosynthetic capacity and water status, effectively control the dry matter accumulation and post-anthesis assimilates allocation, and increase the grain yield of soybean.