Refracture-related bone transport of tibia: technical notes and preliminary clinical results in nineteen cases.

PURPOSE: Refracture is one of the main complications of bone transport, which brings additional physical and mental burden to surgeries and patients. We aimed to raise a new classification system of refracture-related bone transport based on the Simpson classification and to present our experience on treatment. METHODS: This retrospective analysis included 19 patients with refracture-related bone transport (average age of 37.7 years; 18 men). We developed a modified Simpson classification system to assist decision-making (conservative versus surgical). The ASAMI criteria were used to assess the outcomes at last follow-up. RESULTS: The mean follow-up was 12.3 ± 3.2 months. Complete union was achieved in all patients, with no reinfection. Based on the modified Simpson classification, refracture was Ia type (within regeneration area) in three cases, Ib (collapsed fracture at the regeneration area) in one case, Ic (stress fracture) in three cases, II (at the junction between the regenerate and original bone) in one case, III (at the docking site) in nine cases, and V (at distant site) in two cases. Refracture was managed conservatively in six cases and surgically in 13 cases. Average time to bone union was 2.8 ± 1.2 months in the conservative group versus 4.4 ± 1.4 months in the surgery group. Assessment at the final follow-up using the ASAMI criteria revealed excellent bone result in all patients, excellent functional results in six patients (31.6%), and good functional results in 13 patients. CONCLUSIONS: The modified Simpson classification could include refracture at the docking site and stress fracture in the regeneration zone and provide some guidance in determining the appropriate treatment strategy.

Covalently Bonded Ni Sites in Black Phosphorene with Electron Redistribution for Efficient Metal-Lightweighted Water Electrolysis.

The metal-lightweighted electrocatalysts for water splitting are highly desired for sustainable and economic hydrogen energy deployments, but challengeable. In this work, a low-content Ni-functionalized approach triggers the high capability of black phosphorene (BP) with hydrogen and oxygen evolution reaction (HER/OER) bifunctionality. Through a facile in situ electro-exfoliation route, the ionized Ni sites are covalently functionalized in BP nanosheets with electron redistribution and controllable metal contents. It is found that the as-fabricated Ni-BP electrocatalysts can drive the water splitting with much enhanced HER and OER activities. In 1.0 M KOH electrolyte, the optimized 1.5 wt% Ni-functionalized BP nanosheets have readily achieved low overpotentials of 136 mV for HER and 230 mV for OER at 10 mA cm-2. Moreover, the covalently bonding between Ni and P has also strengthened the catalytic stability of the Ni-functionalized BP electrocatalyst, stably delivering the overall water splitting for 50 h at 20 mA cm-2. Theoretical calculations have revealed that Ni-P covalent binding can regulate the electronic structure and optimize the reaction energy barrier to improve the catalytic activity effectively. This work confirms that Ni-functionalized BP is a suitable candidate for electrocatalytic overall water splitting, and provides effective strategies for constructing metal-lightweighted economic electrocatalysts.

Enlarging the Ni-O Bond Polarizability in a Phosphorene-Hosted Metal-Organic Framework for Boosted Water Oxidation Electrocatalysis.

The emerging lattice-oxygen oxidation mechanism (LOM) presents attractive opportunities for breaking the scaling relationship to boost oxygen evolution reaction (OER) with the direct OLattice-*O interaction. However, currently the LOM-triggering rationales are still debated, and a streamlined physicochemical paradigm is extremely desirable for the design of LOM-defined OER catalysts. Herein, a Ni metal-organic framework/black phosphorene (NiMOF/BP) heterostructure is theoretically profiled and constructed as a catalytic platform for the LOM-derived OER studies. It is found that the p-type BP host can enlarge the Ni-O bond polarizability of NiMOF through the Ni-O bond stretching and Ni valence declining synergically. Such an enlarged bond polarizability will in principle alleviate the lattice oxygen confinement to benefit the LOM pathway and OER performance. As a result, the optimized NiMOF/BP catalyst exhibits promising OER performance with a low overpotential of 260 mV at 10 mA cm-2 and long-term stability in 1 M KOH electrolyte. Both experiment and calculation results suggest the activated LOM pathway with a more balanced step barrier in the NiMOF/BP OER catalyst. This research puts forward Ni-O bond polarizability as the criterion to design LOM-scaled electrocatalysts for water oxidation.

Comparison of antibiotic-impregnated bone cement coverage versus vacuum sealing drainage in semi-open bone grafting using for tibial fracture with infected bone and soft tissue defect: a retrospective analysis.

OBJECTIVE: To compare antibiotic-impregnated bone cement coverage (bone cement surface technique; BCS-T) versus vacuum sealing drainage (VSD) for tibial fracture with infected bone and soft tissue defect. METHOD: This retrospective analysis compared the clinical outcomes in patients undergoing BCS-T (n = 16) versus VSD (n = 15) for tibial fracture with infected bone and soft tissue defect at the Third Hospital of Hebei Medical University from March 2014 to August 2019. For BCS-T group, osseous cavity was filled with autograft bone graft after debridement, and then the wound was covered with a 3-mm layer of bone cement impregnated with vancomycin and gentamycin. The dressing was changed every day in the first week, and every 2 ~ 3 days in the second week. For VSD group, a negative pressure of -150 ~ -350 mmHg was maintained, and the dressing was changed every 5-7 days. All patients received antibiotics treatment based on bacterial culture results for 2 weeks. RESULTS: The 2 groups did not differ in age, sex and key baseline characteristics, including type of Gustilo-Anderson classification, size of the bone and soft tissue defect, the percentage of primary debridement, bone transport, and the time from injury to bone grafting. The median follow-up was 18.9 months (range:12-40). The time to complete coverage of bone graft by granulation tissue was 21.2 (15.0-44.0) and 20.3 (15.0-24.0) days in the BCS-T and VSD groups, respectively (p = 0.412). The 2 groups also did not differ in wound healing time (3.3 (1.5-5.5) versus 3.2(1.5-6.5) months; p = 0.229) and bone defect healing time (5.4(3.0-9.6) versus 5.9(3.2-11.5) months; p = 0.402). However, the cost of covering material was significantly reduced in the BCS-T group (2071 ± 134 versus 5542 ± 905 yuan; p = 0.026). Paley functional classification at 12 months did not differ between the 2 groups (excellent in 87.5% versus 93.3% in the 2 groups; p = 0.306). CONCLUSION: BCS-T could achieve clinical outcomes similar to VSD in patients receiving bone graft for tibial fracture with infected bone and soft tissue defect, but material cost was significantly reduced. Randomized controlled trials are needed to verify our finding.

Insights on catalytic mechanism of CeO2 as multiple nanozymes.

CeO2 with the reversible Ce3+/Ce4+ redox pair exhibits multiple enzyme-like catalytic performance, which has been recognized as a promising nanozyme with potentials for disease diagnosis and treatments. Tailorable surface physicochemical properties of various CeO2 catalysts with controllable sizes, morphologies, and surface states enable a rich surface chemistry for their interactions with various molecules and species, thus delivering a wide variety of catalytic behaviors under different conditions. Despite the significant progress made in developing CeO2-based nanozymes and their explorations for practical applications, their catalytic activity and specificity are still uncompetitive to their counterparts of natural enzymes under physiological environments. With the attempt to provide the insights on the rational design of highly performed CeO2 nanozymes, this review focuses on the recent explorations on the catalytic mechanisms of CeO2 with multiple enzyme-like performance. Given the detailed discussion and proposed perspectives, we hope this review can raise more interest and stimulate more efforts on this multi-disciplinary field.

Amorphous materials for elementary-gas-involved electrocatalysis: an overview.

Given the critical demands on energy conversion, storage, and transportation, tremendous interest has been devoted to the field of material development related to energy harvesting, recently. As the only route towards energy utilization, the carriers with the characteristics of low carbon are regarded as the future choice, e.g., hydrogen and ammonia. To this end, electrocatalysis provides a green way to access these substances. However, the unfulfilled conversion efficiency is the bottleneck for practical application. In this review, the promising characteristics of amorphous materials and the amorphous-induced electrocatalytic enhancement (AIEE) were emphasized. In the beginning, the characteristics of amorphous materials are briefly summarized. The basic mechanism of heterogeneous electrocatalytic reactions is illustrated, including the hydrogen/oxygen evolution and oxygen/nitrogen reduction. In the third part, the electrocatalytic performance of amorphous materials is discussed in detail, and the mechanism of AIEE is highlighted. In the last section of this review, the challenges and outlook for the development of amorphous enhanced electrocatalysis are presented.