Clinical and radiological outcome of Gustilo type III open distal tibial and tibial shaft fractures after staged treatment with posterolateral minimally invasive plate osteosynthesis (MIPO) technique.

OBJECTIVES: To evaluate the methods and the outcomes of Gustilo type III open distal tibial and tibial shaft fractures with severe anterior and medial soft-tissue injuries, treated with posterolateral minimally invasive plate osteosynthesis (MIPO) technique. METHODS: From May 2015 to May 2016, 10 patients with Gustilo type III open distal tibial and tibial shaft fractures with severe anterior and medial soft-tissue injuries (Gustilo-Anderson classification IIIA, 6; IIIB, 4) were treated with staged protocol using posterolateral minimally invasive plate osteosynthesis (MIPO) technique. The initial wound lavage, debridement, and application of a spanning external fixator were performed within 24 h and the mean interval from injury to definitive surgical treatment was 12.8 (range 4-21) days. An additional bone graft was performed in two patients when definitive internal fixation was performed. All patients were followed to union. Postoperative radiographs, postoperative complications, bone union, ankle joint motion, and limb functional outcome information of AOFAS ankle-hindfoot score were recorded. RESULTS: The mean follow-up period was 17.8 (range 12-26) months. The mean interval to bony union was 25.8 (range 20-40) weeks. Bone union was achieved in all cases. There were no complications, such as incision breakdown, deep infection, or impingement of the flexor hallucis longus tendon. The average AOFAS score was 90 (range 83-96). In ten patients, two patients had a superficial wound infection and another one patient showed a 6° varus deformity. CONCLUSIONS: Staged treatment using MIPO technique through a posterolateral approach is a reasonable and safe treatment option for open distal tibial and tibial shaft fractures, especially Gustilo type III with severe anterior and medial soft-tissue injuries. However, it should have a higher level of research evidence in more patients to confirm the safety of the clinical application of this technique.

Analysis of red blood cells' dynamic status in a simulated blood circulation system using an ultrahigh-speed simultaneous framing optical electronic camera.

Alterations in the morphologic and mechanical properties of red blood cells (RBCs) are considered direct indicators of blood quality. Current measures of characterizing these properties in vivo are limited by the complicated hemodynamic environment. To better evaluate the quality of fresh and stored blood, a new research platform was constructed to evaluate the hemodynamic characteristics of RBCs. The research platform consists mostly of a microfluidic chip, microscope, and ultrahigh-speed simultaneous framing optical electronic camera (USFOEC). The microfluidic chip was designed to simplify the complicated hemodynamic environment. The RBCs were diluted in erythrocyte preservative fluid and infused into the microfluidic channels. After approximately 600× magnification of using the microscope and camera, the RBCs' dynamic images were captured by the USFOEC. Eight sequential and blur-free images were simultaneously captured by the USFOEC system. Results showed that RBC deformation changed with flow velocity and stored RBCs were less sensitive to deformation (Kfresh < Kstored ). The frozen-stored RBCs were better able to sustain hydrodynamic stress (DI49day = 0.128 vs. DIfrozen = 0.118) than cold-stored RBCs but more sensitive to variations in flow speed (K49day = 1626.2 vs. Kfrozen = 1318.2). Results showed that the stored RBCs had worse deformability than fresh RBCs, but frozen-stored RBCs may incur less damage during storage than those stored at merely cold temperatures. This USFOEC imaging system can serve as a platform for direct observation of cell morphological and mechanical properties in a medium similar to a physiologic environment. © 2016 International Society for Advancement of Cytometry.

Simple and low-cost microscopy setup for 3D particle field measurement using incoherent illumination and open-source hardware.

The quantification of 3D particle field is of interest for a vast range of fields. While in-line particle holography (PH) can provide high-resolution measurements of particles, it suffers from speckle noise. Plenoptic imaging (PI) is less susceptible to speckle noises, but it involves a trade-off between spatial and angular resolution, rendering images with low resolution. Here, we report a simple microscopy setup with the goals of getting the strengths of both techniques. It is built with off-the-shelf and cost-effective components including a photographic lens, a diaphragm, and a CCD camera. The cost of the microscopy setup is affordable to small labs and individual researchers. The pupil plane of the proposed setup can be mechanically accessible, allowing us to implement pupil plane modulation and increase the depth of field (DOF) without requiring any additional relay lenses. It also allows us to understand the working principle of pupil plane modulation clearly, benefiting microscopy education. It illuminates the sample (particles) using diffuse white light, and thus avoids the problem of speckle noise. It captures multiple perspective images via pupil plane modulation, without requiring trading off angular and spatial resolution. We validate the setup with 2D and 3D particle samples. RESEARCH HIGHLIGHTS: We report a simple and cost-effective microscopy setup with the goals of getting the strengths of plenoptic imaging and in-line particle holography. It is built with off-the-shelf and cost-effective components. The cost of the microscopy setup is affordable to small labs and individual researchers. The pupil plane of the proposed setup can be mechanically accessible, allowing us to implement pupil plane modulation and increase the DOF without requiring any additional relay lenses. It also allows us to understand the working principle of pupil plane modulation clearly, benefiting microscopy education. It illuminates the sample (particles) using diffuse white light, and thus avoids the problem of speckle noise. It captures multiple perspective images via pupil plane modulation, without requiring trading off angular and spatial resolution. We validate the setup with 2D and 3D particle samples.

Percutaneous cryoablation for stage IV lung cancer: a retrospective analysis.

The aim of this study was to investigate the therapeutic effect of cryoablation treatment and palliative treatment in stage IV lung cancer. Fifty-four patients were enrolled into the study. Thirty-one patients received cryoablation treatment (including intra- and extrapulmonary tumors), and 23 patients had palliative treatment (no cryoablation). Both the safety of the procedure and overall survival (OS) for stage IV lung cancer were assessed during a 6.5 year follow-up period. The OS of patients in both groups and the effects of treatment timing and frequency were compared. The OS in the cryoablation group was significantly longer than in the palliative group (median OS: 14 months vs. 7 months, P = 0.0009). The OS of those who received delayed cryoablation treatment was longer than that observed for those who received timely treatment (median OS: 18.5 months vs. 10 months, P = 0.0485), but this was not observed in those who received palliative treatment (median OS: 7 months vs. 7.5 months, P = 0.9814). Multiple treatments played an important role in improving the OS of patients who received cryoablation treatment (median OS: 18 months vs. 14 months, P = 0.0376). There was a significant difference between cryoablation and palliative treatment, in terms of OS. In addition, multiple cryoablation treatments may have an advantage over single treatments.

Effect of opposing needling on motor cortex excitability in healthy participants and in patients with post-stroke hemiplegia: study protocol for a single-blind, randomised controlled trial.

BACKGROUND: Opposing needling has an obvious curative effect in the treatment of post-stroke hemiplegia; however, the mechanism of the opposing needling in the treatment of post-stroke hemiplegia is still not clear. The purpose of this study is to investigate the effect of opposing needling on the excitability of primary motor cortex (M1) of healthy participants and patients with post-stroke hemiplegia, which may provide insight into the mechanisms of opposing needling in treating post-stroke hemiplegia. METHODS: This will be a single-blind, randomised, sham-controlled trial in which 80 healthy participants and 40 patients with post-stroke hemiplegia will be recruited. Healthy participants will be randomised 1:1:1:1 to the 2-Hz, 50-Hz, 100-Hz, and sham electroacupuncture groups. Patients with post-stroke hemiplegia will be randomised 1:1 to the opposing needling or conventional treatment groups. The M1 will be located in all groups by using neuroimaging-based navigation. The stimulator coil of transcranial magnetic stimulation (TMS) will be moved over the left and right M1 in order to identify the TMS hotspot, followed by a recording of resting motor thresholds (RMTs) and motor-evoked potentials (MEPs) of the thenar muscles induced by TMS before and after the intervention. The primary outcome measure will be the percent change in the RMTs of the thenar muscles at baseline and after the intervention. The secondary outcome measures will be the amplitude (µV) and latency (ms) of the MEPs of the thenar muscles at baseline and after the intervention. DISCUSSION: The aim of this trial is to explore the effect of opposing needling on the excitability of M1 of healthy participants and patients with post-stroke hemiplegia. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900028138 . Registered on 13 December 2019.

GHz sampling hardware implementation with sub-Nyquist coprime sampling rates.

A sub-Nyquist coprime sampling system for sparse signals is implemented in this article. The proposed system is composed of coprime sampling hardware and a multicoset signal reconstruction algorithm. A pair of uniform samplers is utilized in the hardware to sample a wideband spare analog signal with an uncertain difference in start times. A time difference acquisition module embedded into a field-programmable gate array and a pulse-expanding circuit are then used to measure the difference in start times. Owing to the different frequencies of the two samplers, the coprime sample sets obtained are nonuniform. Before they are used as input to the multicoset signal reconstruction algorithm, these coprime sample sets need to be regrouped into multicoset sample sets according to the sample pattern. The results of experiments indicate that the signals can be reconstructed at an equivalent rate of the order of gigahertz from sub-Nyquist samples acquired by the designed coprime acquisition system.

Compressed sensing based sub-Nyquist sampling of multiple sinusoids with dual rate channels.

In this paper, we propose a reconstruction approach for a multiple-sinusoidal signal. The signal reconstruction requires a small number of samples and is based on a sub-Nyquist sampling scheme with dual rate channels. In the proposed sampling scheme, the samples are grouped into multiple cosets. To obtain enough different cosets to reconstruct a signal, the sampling rates of channels are required to be relative coprime. For each coset, the Whittaker-Shannon interpolation formula is employed to construct the relation between the sub-Nyquist samples and the original signal, which is used to construct the measurement matrix. Since the multiple-sinusoidal signal is sparse in the frequency domain, compressed sensing theory can be adopted to reconstruct the signal. Simulation results are reported to demonstrate the feasibility and effectiveness of the proposed approach.

Application of pre-contoured anatomic locking plate for treatment of humerus split type greater tuberosity fractures: A prospective review of 68 cases with an average follow-up of 2.5 years.

OBJECTIVES: Although various implants exist for 3- and 4-part proximal humerus fractures, few implants are appropriate for humerus split type greater tuberosity fractures. The goal of this study was to assess the efficacy of pre-contoured anatomic locking plate for humerus split type greater tuberosity fractures. METHODS: A retrospective review of 68 patients with humerus split type greater tuberosity fractures treated with open reduction and internal fixation using anatomic locking plates between January 2014 and October 2016. Postoperatively, patient radiographs, functional results, and complications were reviewed. RESULTS: All patients got a mean follow-up of 30.5 months (range 14-46 months). Average fracture healing time was 9.4 weeks (range, 8-14 weeks). Overall mean Constant score was 86.8% (range, 70%-96%). The result was rated as excellent in 25 patients (Constant score: 92.1%), good in 38 patients (Constant score: 85.3%) moderate in 5 patients (Constant score: 71.8%) and poor in 0 cases. The excellent-good rate was 92.6%. No recurrence of dislocation occurred in the 30 cases with shoulder dislocation. All fractures healed without the complications of wound infection, subacromial impingement syndrome, nonunion, secondary displacement, and implant loosening. CONCLUSION: Pre-contoured anatomic locking plate is a reliable option in treating humerus split type greater tuberosity fractures as it provides stable fixation with an early return to function. The surgical technique is easy and efficient.