Utilization of cannulated screw fixation of Jail and TiRobot-assisted percutaneous indirect reduction technique for AO/OTA type 41B2 tibial plateau fracture treatment.

PURPOSE: The present study was designed to investigate the precise procedure and effectiveness of percutaneous minimally invasive fixation assisted by TiRobot in managing AO/OTA type 41B2 tibial plateau fracture to provide an alternative solution for clinical application. METHODS: In total, 10 participants with AO/OTA type 41B2 tibial plateau fractures diagnosed by preoperative imaging examinations were enrolled in this study between May 2019 and May 2022. They were 5 males and 5 females, with an average age of 45.6 ± 11.3 years old (range 27-62 years old). All of them had closed fractures, including 6 cases with anterior cruciate ligament (ACL) tibial insertion avulsion fractures, 1 case with medial collateral ligament (MCL) tear, and 4 cases with a lateral meniscus tear. From injury through surgery, the entire time frame was 4.0 ± 1.5 days (range, 2-7 days). Following indirect percutaneous reduction assisted by TiRobot, the Jail method was used to treat all patients with minimally invasive internal fixation. Patients with ligament or meniscus injurieswere treated with arthroscopic surgery in one stage. The standardized functional exercise was performed postoperatively. The knee function was measured using the Hospital for Special Surgery (HSS) score, and the fracture reduction was assessed through the Rasmussen radiology score. RESULTS: All patients were followed up for 12.7 ± 6.8 months (6-24 months).The fracture healing time was 11.8 ± 0.8 weeks (10-13 weeks), and the X-rays revealed satisfactory fracture reduction.The knee joint's Rasmussen score was 17.8 ± 0.4 (in the range of 17-18) a year after the procedure, with 8 patients receiving outstanding ratings and 2 cases receiving satisfactory scores. The HSS score was 93.8 ± 2.3 (range, 89 to 96), of which 10 cases were excellent. The motion range of the kneewas 138.7°±2.7° (range, -5° to 0° to 135°). No adverse effects or serious complications, such as internal fixation failure, postoperative infection, popliteal vascular injury, and common peroneal nerve injury, were observed during the last follow-up visit. CONCLUSIONS: The intelligent assistance and accurate guidance of TiRobot can simplify and standardize procedures of percutaneous minimally invasive fixation in theSchatzker type Ⅲ tibial plateau fracture treatment. This technique increases the precision of indirect percutaneous reduction and screw fixation while minimizing bone grafting.

Induced-Fit-Identification in a Rigid Metal-Organic Framework for ppm-Level CO2 Removal and Ultra-Pure CO Enrichment.

Removing CO2 from crude syngas via physical adsorption is an effective method to yield eligible syngas. However, the bottleneck in trapping ppm-level CO2 and improving CO purity at higher working temperatures are major challenges. Here we report a thermoresponsive metal-organic framework (1 a-apz), assembled by rigid Mg2 (dobdc) (1 a) and aminopyrazine (apz), which not only affords an ultra-high CO2 capacity (145.0/197.6 cm3 g-1 (0.01/0.1 bar) at 298 K) but also produces ultra-pure CO (purity ≥99.99 %) at a practical ambient temperature (TA ). Several characterization results, including variable-temperature tests, in situ high-resolution synchrotron X-ray diffraction (HR-SXRD), and simulations, explicitly unravel that the excellent property is attributed to the induced-fit-identification in 1 a-apz that comprises self-adaption of apz, multiple binding sites, and complementary electrostatic potential (ESP). Breakthrough tests suggest that 1 a-apz can remove CO2 from 1/99 CO2 /CO mixtures at practical 348 K, yielding 70.5 L kg-1 of CO with ultra-high purity of ≥99.99 %. The excellent separation performance is also revealed by separating crude syngas that contains quinary mixtures of H2 /N2 /CH4 /CO/CO2 (46/18.3/2.4/32.3/1, v/v/v/v/v).

Quasi-Orthogonal Configuration of Propylene within a Scalable Metal-Organic Framework Enables Its Purification from Quinary Propane Dehydrogenation Byproducts.

Propylene production via nonoxidative propane dehydrogenation (PDH) holds great promise in meeting growing global demand for propylene. Effective adsorptive purification of a low concentration of propylene from quinary PDH byproducts comprising methane (CH4), ethylene (C2H4), ethane (C2H6), propylene (C3H6), and propane (C3H8) has been an unsolved academic bottleneck. Herein, we now report an ultramicroporous zinc metal-organic framework (Zn-MOF, termed as 1) underlying a rigid one-dimensional channel, enabling trace C3H6 capture and effective separation from quinary PDH byproducts. Adsorption isotherms of 1 suggest a record-high C3H6 uptake of 34.0/92.4 cm3 cm-3 (0.01/0.1 bar) at 298 K. In situ spectroscopies, crystallographic experiments, and modeling have jointly elucidated that the outstanding propylene uptakes at lower pressure are dominated by multiple binding interactions and swift diffusion behavior, yielding quasi-orthogonal configuration of propylene in adaptive channels. Breakthrough tests demonstrate that 30.8 L of propylene with a serviceable purity of 95.0-99.4% can be accomplished from equimolar C3H6/C3H8 mixtures for 1 kg of activated 1. Such an excellent property is also validated by the breakthrough tests of quinary mixtures containing CH4/C2H4/C2H6/C3H6/C3H8 (3/5/6/42/44, v/v/v/v/v). Particularly, structurally stable 1 can be easily synthesized on the kilogram scale using cheap materials (only $167 for per kilogram of 1), which is important in industrial applications.

One-Step Ethylene Purification by an Ethane-Screening Metal-Organic Framework.

Efficient purification of ethylene (C2H4) from ethane (C2H6) is a crucial but daunting task for the chemical industry given their similar physical natures and molecular dimensions. Reversed capture of C2H6 from C2H6/C2H4 dual-mixtures can be expected to directly yield high-purity C2H4 through a one-step separation unit, but it remains a daunting challenge. Here, we skillfully target an unusual "electrostatic-driven linker microrotation" (EDLM) in a Zr-MOF through coupling dual-ligands having electron-withdrawing/donating groups (e.g., F and CH3 motifs). EDLM triggered microrotation of linker geometry and screening sites not only enhanced structural rigidity and hydrophobic nature, etc., but also effectively purified C2H4 through reversely trapping C2H6. Under ambient conditions, 1 kg of activated 2 adsorbents directly produces 7.2 L of C2H4 with over 99.9%+ purity in a single breakthrough operation starting from the equimolar C2H6/C2H4 cracked mixtures. Geometrical models and simulations have revealed that EDLM-derived H-bonding interaction and microrotation of linker geometry, synergistically customized C2H6-selective screening sites and pore inert for reversed C2H6 capture and improved surface hydrophobicity. Adsorption isotherms, modeling simulations, and breakthrough tests based on pressure swing adsorption (PSA) conditions have jointly elucidated the underlying separation properties for C2H4 purification. The enhanced hydrophobic nature, cycling durability, and separation property awarded 2 a new benchmark adsorbent to purify the olefin/paraffin mixtures.

An improvement on the technique of transosseous tunnels for the fixation of lower pole patella fracture: Cerclage around the patella.

ABSTRACT: The technique of transosseous tunnels is widely used in lower pole patella fracture (LPP). Though the extensor mechanism can be restored, distal avulsion fragments are usually unstable. The subsequent fracture gap and nonunion impair the extensor mechanism in turn. Cerclage is a promising method for treating the condition. The aim of this prospective cohort study is to determine if cerclage around the patella combined with the technique of transosseous tunnels stabilizes the avulsion fragments and brings out improved outcomes on LPP.Twenty two patients with LPP were treated with the hybrid technique. The patients were followed up and evaluated clinically and radiographically. The functional outcome was assessed by the average range of knee movement and Lysholm knee rating system at 6 months after surgery, as well as the final follow-up. Radiologically, Insall-Salvati ratio and the time from surgery to bone union were assessed.Postoperatively, with a mean followed-up of 12 months. All of the patients regained stability of the knee with an average range of movements of 131.8 degrees at 6 months after operation and 138.2 degrees at the final follow-up. On the Lysholm knee rating system, all cases were classified as excellent. The average score was 93.2 at 6 months after operation and 95.9 at the final follow-up. In radiological assessment, no fracture gap or nonunion occurred. The average Insall-Salvati ratio (I-S ratio) was 1.03.The hybrid technique offers further stabilization for the avulsion fragments and strengthens attachment of the patellar tendon, which brings forward time of rehabilitation and achieves good clinical outcomes.

Artificial Intelligence to Diagnose Tibial Plateau Fractures: An Intelligent Assistant for Orthopedic Physicians.

OBJECTIVE: To explore a new artificial intelligence (AI)-aided method to assist the clinical diagnosis of tibial plateau fractures (TPFs) and further measure its validity and feasibility. METHODS: A total of 542 X-rays of TPFs were collected as a reference database. An AI algorithm (RetinaNet) was trained to analyze and detect TPF on the X-rays. The ability of the AI algorithm was determined by indexes such as detection accuracy and time taken for analysis. The algorithm performance was also compared with orthopedic physicians. RESULTS: The AI algorithm showed a detection accuracy of 0.91 for the identification of TPF, which was similar to the performance of orthopedic physicians (0.92±0.03). The average time spent for analysis of the AI was 0.56 s, which was 16 times faster than human performance (8.44±3.26 s). CONCLUSION: The AI algorithm is a valid and efficient method for the clinical diagnosis of TPF. It can be a useful assistant for orthopedic physicians, which largely promotes clinical workflow and further guarantees the health and security of patients.

Berberine prevents human nucleus pulposus cells from IL­1ß­induced extracellular matrix degradation and apoptosis by inhibiting the NF­κB pathway.

Intervertebral disc degeneration (IDD) is widely considered to be one of the main causes of lower back pain, which is a chronic progressive disease closely related to inflammation, nucleus pulposus (NP) cell apoptosis and extracellular matrix (ECM) degradation. Berberine (BBR) is an alkaloid compound with an anti­inflammatory effect and has been reported to exert therapeutic action in several inflammatory diseases, including osteoarthritis. Therefore, it was hypothesized that BBR may have a therapeutic effect on IDD through inhibition of the inflammatory response. The aim of the present study was to evaluate the influence of BBR on IDD in interleukin (IL)­1ß­treated human NP cells in vitro. The results showed that BBR attenuated the upregulation of ECM­catabolic factors [matrix metalloproteinase (MMP)­3, MMP­13, a disintegrin and metalloproteinase with thrombospondin motif (ADAMTS)­4 and ADAMTS­5], and the downregulation of ECM­anabolic factors (type II collagen and aggrecan) following stimulation of the human NP cells with IL­1ß. Treatment with BBR also protected human NP cells from IL­1ß­induced apoptosis, as determined by western blotting and flow cytometry. Mechanistically, the IL­1ß­stimulated degradation of IκBα, and the phosphorylation and translocation of nuclear factor (NF)­κB p65 were found to be attenuated by BBR, indicating that NF­κB pathway activation was suppressed by BBR in the IL­1ß­treated human NP cells. The results of the experiments revealed a therapeutic potential of BBR for the prevention or treatment of IDD.