Novel sternoclavicular hook plate for the treatment of posterior sternoclavicular dislocation: a retrospective study.

BACKGROUND: Controversies regarding the optimal internal fixation method for posterior sternoclavicular dislocation (SCD) exist. Therefore, this study aimed to investigate the clinical efficacy of a new type of sternoclavicular hook plate for treating posterior SCD. METHODS: Eleven patients (eight men and three women) with posterior SCD who underwent treatment with the new sternoclavicular hook plate from June 2011 to January 2022 were retrospectively analyzed. The patients' ages ranged from 33 to 71 years (54.91 ± 13.58 years). Operation time, blood loss, length of hospital stay, and postoperative complications were recorded. Postoperative joint reduction and healing were evaluated using radiography and computed tomography. The Constant-Murley and Rockwood sternoclavicular joint scores were used to evaluate the functional recovery of the affected limb 12 months after surgery. RESULTS: All 11 patients were followed up for 12-24 months (18.00 ± 3.74 months). All incisions healed by first intention. The healing time ranged from 9 to 13 days (10.82 ± 1.54 days), and the joint healing time was 3-4 months (3.55 ± 0.52 months). The operation time was 45-75 min (59.55 ± 11.06 min), intraoperative blood loss was 22-58 mL (39.91 ± 11.07 mL), and the length of hospitalization was 6-14 days (9.91 ± 3.27 days). There were no complications such as infections, internal fixation failure, or nerve injury. The Constant-Murley score was 93.64 ± 9.01 at 12 months postoperatively. The Rockwood score was 13.36 ± 1.86, of which nine cases were excellent, one case was good, and one case was fair. CONCLUSION: The novel sternoclavicular hook plate is effective for the treatment of posterior SCD. This novel device can facilitate early joint functional exercises and good functional recovery.

Creation and Generation Mechanism of Macromolecular Representation for Dongsheng Coal Vitrinite.

Insights into macromolecules of coal were critical for improving the understanding of the coal upgrading and coalification process. Here, the creation and generation of macromolecular representation for Dongsheng coal vitrinite was clarified using industry analysis, elemental analysis, and the peak fitting technology of 13C nuclear magnetic resonance (13C NMR), Fourier transform infrared spectrum, and X-ray diffraction. The structural parameters and macromolecular representation (C167H148N2O27) were innovatively calculated and created based on these characterization results and chemical shift correction, finally obtaining the plane macromolecular models whose 13C NMR spectrum was close to the experimental spectrum. The property parameters of basic structural units were L a (average lateral sizes) = 19.917 Å, L c (stacking heights) = 24.776 Å, d 002 (interlayer spacing) = 3.488 Å, N (number of stacking layers) = 5.6213, and L a/L c < 1. Suffering from the dynamic metamorphism effects, the length of intermolecular aromatic lamellae for Dongsheng coal vitrinite was 7-8 aromatic rings in size. The aromatic clusters were dominated by benzene, naphthalene, and anthracene, and their numbers were 2, 4, and 2 per vitrinite model, respectively. Hydrogenated aromatic rings, ether bonds, and oxygen-methylene serve as the main bridge bonds to connect the aromatic clusters, where the short aliphatic chains were distributed around the edge of aromatic rings. Oxygen atoms exist in the form of hydroxyl, ether bond, carbonyl, and carboxyl groups, and their numbers were 2, 7, 4, and 8 per vitrinite model, respectively. The nitrogen atoms exist in the form of pyridine and pyrrole. The entropy weighting method was used to estimate the rationality of the macromolecular representation of long frame coal vitrinite, providing a new mathematical evaluation method for molecular simulation. Comparison of various macromolecular models from different geological conditions indicates that tectonic stress can promote the degree of aromatization and ring condensation. The thermal history and tectonic stress have a compensation effect for promoting the aromatization process. Aliphatic carbons were the most unstable units under thermal history and tectonic stress, and they are more easily removed from the aliphatic structure, followed by methyl. This finding of this paper can provide significance for coal liquefaction engineering in Dongsheng coalfield.

Obturator Oblique and Pubic Ramus Inlet Views Can Better Guide the Insertion of an Anterior Column Acetabular Screw.

OBJECTIVE: The objective of the present paper was to investigate the value of obturator oblique and pubic ramus inlet views in guiding anterior column acetabular screw insertion. METHODS: We collected pelvic CT scans at the diagnostic imaging center of our hospital between 2017 and 2019. Virtual three-dimensional (3D) models of the pelvis were created based on the CT scans. Then the transparency was adjusted to 30%. Two identical copies of the 3D model data were made. 3D model replications were divided into a control group and an experimental group. In the control group, the screw was inserted into the anterior acetabular column using obturator-outlet and iliac-inlet views. In the experimental group, the screw was guided under obturator oblique and pubic ramus inlet views. Based on whether the screw penetrated the hip joint and/or exited the pubic ramus, models were divided into three grades. Grade I: the screw travels completely within the anterior column bone corridor; Grade II: the screw exits the superior pubic ramus, but the length of the screw outside the channel does not exceed 1/2 of the anterior column; Grade III: the screw exits the superior pubic ramus and the length of the screw outside the corridor exceeds 1/2 of the anterior column. We compared the screw placement quality of the two groups and analyzed differences between genders. In addition, the distance between the screws and the acetabulum was recorded and compared among the two groups. RESULTS: A total of 110 hemipelves were selected, including those of 80 men and 30 women, with an average age of 46.76 ± 14.26 years. In the control group, the screw quality of 64 models (58.2%) was Grade I. In the experimental group, 94 models (85.5%) had Grade I screw placement quality. Grade II screw placement quality accounted for 18.2% of the control group and 7.3% of the experimental group. In the control and the experimental groups, there were 26 and 8 cases with Grade III screw placement quality, respectively. The quality of screw placement in the experimental group was significantly better than that in control group, and the difference between the two groups was statistically significant (P < 0.01). The distance between the screw and the acetabulum in the control group and experimental group was 0.92 ± 0.49 mm and 2.78 ± 1.15 mm, respectively. The difference between the two groups was statistically significant. CONCLUSION: Anterior column acetabular screws can be inserted successfully and more accurately using the obturator oblique and pubic ramus inlet views.

The influence of timing of surgery in the outcome of spinal cord injury without radiographic abnormality (SCIWORA).

BACKGROUND: Spinal cord injury without radiographic abnormality (SCIWORA) is a rare traumatic myelopathy. Although surgery is one of the most important treatments, the surgery for SCIWORA is controversial, especially the time of surgery is a topic of controversy. Here, we investigate the effects of difference in duration from injury to surgery on the outcome of SCIWORA. METHODS: This retrospective study was performed in all patients with spinal cord injury admitted to the Third Affiliated Hospital of Hebei Medical University from January 2013 to April 2017. Fifty-seven patients who met the study requirements were divided into 3 groups according to the duration from injury to surgery. Group A (surgery within 3 days of injury) had 18 patients, group B (surgery within 3-7 days) had 18 patients, and group C (surgery later than 7 days) had 21 patients. All the groups were compared with Mann-Whitney U test; the functional improvement of spinal cord was compared and analyzed using the ASIA sports score and ASIA Impairment Scale (AIS). RESULTS: There was a significant improvement in the long-term AIS (final follow-up) in all the 3 groups compared to before surgery. The final follow-up recovery rate of group C was worse than group A and group B. The curative effect of operation within 7 days was significantly better than the surgery done 7 days later. The recovery rate of group C was worse than group A and B. The ASIA sports score showed that recovery was quicker in the early stage and slow in the later stage. CONCLUSIONS: The optimal schedule of surgical treatment was 3-7 days after injury, which can significantly improve the short-term and long-term follow-up effects. Longer the time to surgery from the time of injury, the worse was the prognosis.

[Research on optimization system on tissue culture and rapid propagation of Pueraria mirifica].

OBJECTIVE: To study the tissue culture and rapid-proliferation techniques of Pueraria mirifica. METHOD: The tender branch were used as explants and cultivated in different media. The optimum media for inducing buds, proliferation and rooting were selected by adjusting the kinds and doses of plant hormones and special compounds. RESULT: The medium of MS + IBA 0.05 mg L(-1) + BA 0.5 mg L(-1) was suitable for buds inducing and could be used in the first generation cultivation; MS + IBA 0. 02 mg L(-1) + BA 0.2 mg L(-1) and MS +BA 0.1 mg L(-1) were employed by turns in subculture, 25 days propagation coefficient was 3.0; and the medium of 1/2MS + IBA 0.1 mg L(-1) + IAA 0.2 mg L(-1) + C (special compound) 10 mg L(-1) was used for roots inducing, the rooting rate was 76.9%. Rooting plantlets were transplanted in spring and summer; the surviving rate was 81.0%. CONCLUSION: This technique system could be employed for rapid propagation of P. mirifica.