Biological nitrogen fixation(BNF)and photosynthetic carbon fixation underpin food production and climate mitigation,yet natural systems are constrained by oxygen sensitivity,high energy demand,and inefficient catalyst...Biological nitrogen fixation(BNF)and photosynthetic carbon fixation underpin food production and climate mitigation,yet natural systems are constrained by oxygen sensitivity,high energy demand,and inefficient catalysts.This review synthesizes advances that recast these processes as engineering targets and proposes a conceptual roadmap that bridges synthetic symbioses with the synthetic biology of enzymes and pathways.For BNF,progress spans cross-kingdom strategies—from refactoring nif gene sets and targeting nitrogenase assembly to eukaryotic organelles,to engineering plant-associated diazotrophs,rhizosphere control circuits,and emerging nodule-like microenvironments.For carbon assimilation,new-to-nature CO_(2)-fixation modules and photorespiratory bypasses illustrate how pathway redesign and alternative carboxylases can circumvent key Calvin–Benson–Bassham limitations,and expanding photosynthetic light capture offers additional leverage.Across these domains,we extract common design principles:(i)nitrogenase output is increasingly governed by carbon/energy supply and electron delivery as much as by oxygen protection;(ii)robust function requires compartment-aware enzyme–chassis coordination,substrate channeling,and dynamic regulation using sensors and control circuits;and(iii)scalable implementation may benefit from distributing metabolic labor across engineered consortia rather than forcing all functions into a single host.We discuss enabling technologies—including AI-guided protein design and directed evolution,cell-free prototyping,chassis toolkits,and materials/bioelectrochemical interfaces—that can accelerate design–build–test–learn cycles and reduce barriers to deployment.Together,these insights define a path toward integrated nitrogen and carbon fixation systems for low-emission agriculture and biomanufacturing.展开更多
Soybean is an important source of oil,protein,and feed.However,its yield is far below that of major cereal crops.The green revolution increased the yield of cereal crops partially through high-density planting of lodg...Soybean is an important source of oil,protein,and feed.However,its yield is far below that of major cereal crops.The green revolution increased the yield of cereal crops partially through high-density planting of lodging-resistant semi-dwarf varieties,but required more nitrogen fertilizers,posing an environmental threat.Genes that can improve nitrogen use efficiency need to be integrated into semi-dwarf varieties to avoid the overuse of fertilizers without the loss of dwarfism.Unlike cereal crops,soybean can assimilate atmospheric nitrogen through symbiotic bacteria.Here,we created new alleles of Gm GID1-2(Glycine max GIBBERELLIN INSENSITIVE DWARF 1-2)using clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated nuclease 9(Cas9)editing,which improved soybean architecture,yield,seed oil content,and nitrogen fixation,by regulation of important pathways and known genes related to branching,lipid metabolism,and nodule symbiosis.Gm GID1-2 knockout reduced plant height,and increased stem diameter and strength,number of branches,nodes on the primary stem,pods,and seeds per plant,leading to an increase in seed weight per plant and yield in soybean.The nodule number,nodule weight,nitrogenase activity,and nitrogen content were also improved in Gm GID1-2knockout soybean lines,which is novel compared with the semi-dwarf genes in cereal crops.No loss-of-function allele for Gm GID1-2 was identified in soybean germplasm and the edited Gm GID1-2s are superior to the natural alleles,suggesting the Gm GID1-2 knockout mutants generated in this study are valuable genetic resources to further improve soybean yield and seed oil content in future breeding programs.This study illustrates the pleiotropic functions of the GID1 knockout alleles with positive effects on plant architecture,yield,and nitrogen fixation in soybean,which provides a promising strategy toward sustainable agriculture.展开更多
The rate-limited activation of N≡N triple bonds with high bond energies has been a bottleneck in photoctalytic nitrogen fixation.Here,polymeric carbon nitride with frustrated Lewis pairs(FLPs) was constructed by inse...The rate-limited activation of N≡N triple bonds with high bond energies has been a bottleneck in photoctalytic nitrogen fixation.Here,polymeric carbon nitride with frustrated Lewis pairs(FLPs) was constructed by inserting electron-deficient magnesium into g-C_(3)N_(4)(CN).The synergistic interactions between Mg and amino groups in CN led to a 7.2 fold increase in the photoreactivity of nitrogen(N_(2)) fixation by carbon nitride.展开更多
AIM:To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated fourhaptic intraocular lenses(IOLs).METHODS:Thi...AIM:To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated fourhaptic intraocular lenses(IOLs).METHODS:This retrospective consecutive case series included eyes with dislocated Akreos AO60 IOLs underwent scleral refixation using a horizontal mattress doubleneedle suture technique with intralamellar knot burial via Hoffman pockets.Clinical outcomes assessed included pre-and postoperative best-corrected visual acuity(BCVA),intraocular pressure(IOP),spherical equivalent(SE),suture duration,IOL centration,and perioperative complications.RESULTS:A total of 10 eyes from 10 patients(6 males)were included.The mean age at the time of IOL refixation was 53.10±13.07y(range:28-68y).The mean interval between initial IOL implantation and dislocation was 8.44±3.54y.The mean postoperative follow-up duration was 11.45±10.30mo.Surgical time averaged 15.3±1.77min,with no intraoperative complications.The mean axial length was 27.16±4.35 mm,with high myopia(HM)as the leading comorbidity(4/10 eyes).Postoperative BCVA significantly improved compared to preoperative values(P=0.025).Postoperative SE was significantly improved compared with preoperative(P=0.01).All IOLs remained centered throughout follow-up.CONCLUSION:This minimally invasive four-point scleral fixation technique offers a safe and effective refixation strategy for dislocated four-haptic IOLs.The horizontal mattress suture configuration combined with Hoffman pockets facilitates durable centration,avoids conjunctival dissection,and could be adopted into routine surgical practice.展开更多
Photocatalytic nitrogen fixation has emerged as a sustainable alternative for ammonia synthesis,playing a crucial role in alleviating energy shortages and environmental pollution.In this study,PbBiO_(2)Br was applied ...Photocatalytic nitrogen fixation has emerged as a sustainable alternative for ammonia synthesis,playing a crucial role in alleviating energy shortages and environmental pollution.In this study,PbBiO_(2)Br was applied to photocatalytic nitrogen fixation for the first time,and its photocatalytic performance was effectively enhanced through Cu doping.The catalyst was synthesized via a simple reduction method,and its morphology,structure,and physicochemical properties were systematically investigated using various characterization techniques and density functional theory calculations.The results revealed that the incorporation of Cu2+partially replaced Pb2+,inducing lattice distortion in PbBiO_(2)Br,promoting the formation of oxygen vacancies,and modifying its electronic band structure.Specifically,Cu doping led to a slight bandgap narrowing,a reduction in work function,and a significant upward shift in the conduction band position.These changes enhanced light absorption,facilitated charge carrier migration and separation,and improved the reduction ability of photogenerated electrons.Moreover,Cu doping promoted N_(2)adsorption and activation.Consequently,the photocatalytic nitrogen fixation performance of Cu-doped PbBiO_(2)Br was significantly enhanced,achieving an optimal nitrogen fixation rate of 293μmol L^(−1)g^(−1)h^(−1),which is 3.6 times higher than that of pristine PbBiO_(2)Br.Additionally,Cu–PbBiO_(2)Br also showed good activity in the photocatalytic degradation of RhB,with a degradation rate 4.6 times higher than that of PbBiO_(2)Br.This work offers new insights into the application of PbBiO_(2)Br in photocatalytic nitrogen fixation and offers valuable guidance for the development of highly efficient nitrogen fixation materials in the future.展开更多
Carbon dioxide(CO_(2))is the main greenhouse gas(GHG)released by human activities.The substitution of fossil resources by biomass as a bio-renewable resource,has significant potential to reduce GHG emissions.The appro...Carbon dioxide(CO_(2))is the main greenhouse gas(GHG)released by human activities.The substitution of fossil resources by biomass as a bio-renewable resource,has significant potential to reduce GHG emissions.The approach to biomass,as the only true full-scale alternative to fossil resources,is progressing rapidly.Converting biomass into furanic compounds,as versatile platform chemicals for synthesizing a wide range of bio-based products is the cornerstone of sustainable technologies.The extensive body of this review combines the biomass valorization to furanic compounds by CO_(2)utilization and furanic compounds conversion by CO_(2)fixation.These processes can be strategically applied through both‘thermochemical’and‘electrochemical’pathways,by utilizing CO_(2)from the atmosphere or industrial emission point and returning it to the natural carbon cycle.In the thermochemical pathway CO_(2)acts as a carbon source(carboxylation and polymerization)or active reaction assistant in the biomass conversion(CO_(2)-assisted conversion),without altering its oxidation state,facilitating the synthesis of valuable products and polymers.Conversely,in the electrochemical pathway,CO_(2)can be used as a carbon source(electrocarboxylation)to give the corresponding carboxylic acid,or it can undergo reduction,yielding methanol,carbon monoxide(CO),formic acid,and analogous compounds,while on the other side,furanic compounds undergo oxidation yielding high-value-added chemicals.Finally,potential future research directions are suggested to promote CO_(2)utilization and fixation in the valorization of biomass-derived furanic compounds,and challenges facing further research are highlighted.展开更多
Photocatalysis uses solar energy to convert nitrogen and water directly into ammonia,helping reduce dependence on fossil fuels and offering a way to integrate the nitrogen cycle into a clean energy network.Ohmic junct...Photocatalysis uses solar energy to convert nitrogen and water directly into ammonia,helping reduce dependence on fossil fuels and offering a way to integrate the nitrogen cycle into a clean energy network.Ohmic junctions between metals and semiconductors have demonstrated significant advantages in enhancing stability and reducing carrier recombination,but their application in photocatalytic nitrogen fixation is limited due to the difficulty of work function matching and the complexity of fabrication processes.In this study,density functional theory(DFT) calculations were used to confirm the work function matching between Bi and Bi_(2)Ti_(2)O_(7)(BTO),ensuring the formation of an Ohmic junction.A Bi-Bi_(2)Ti_(2)O_(7)(B-BTO) composite was successfully synthesized via a one-step hydrothermal method,using bismuth nitrate and titanium sulfate as precursors.Compared to pure BTO,the B-BTO heterojunction,driven by dual electron injection from both metal Bi and BTO,significantly increased the ammonia synthesis rate to 686.95 μmol g^(-1)h^(-1),making it the most active nitrogen fixation material among similar pyrochlorebased catalysts to date.The differential charge density calculations,photocurrent(i-t) measurements,and photoluminescence(PL) tests further validate the role of Ohmic contacts in enhancing charge transfer and prolonging carrier lifetimes.This research provides valuable insight into the application of Ohmic junctions in photocatalytic nitrogen fixation and contributes to advancements in this field.展开更多
Development of robust electrocatalyst for oxygen reduction reaction(ORR)in a seawater electrolyte is the key to realize seawater electrolyte-based zinc-air batteries(SZABs).Herein,constructing a local electric field c...Development of robust electrocatalyst for oxygen reduction reaction(ORR)in a seawater electrolyte is the key to realize seawater electrolyte-based zinc-air batteries(SZABs).Herein,constructing a local electric field coupled with chloride ions(Cl-)fixation strategy in dual single-atom catalysts(DSACs)was proposed,and the resultant catalyst delivered considerable ORR performance in a seawater electrolyte,with a high half-wave potential(E_(1/2))of 0.868 V and a good maximum power density(Pmax)of 182 mW·cm^(−2)in the assembled SZABs,much higher than those of the Pt/C catalyst(E_(1/2):0.846 V;Pmax:150 mW·cm^(−2)).The in-situ characterization and theoretical calculations revealed that the Fe sites have a higher Cl^(−)adsorption affinity than the Co sites,and preferentially adsorbs Cl^(−)in a seawater electrolyte during the ORR process,and thus constructs a low-concentration Cl^(−)local microenvironment through the common-ion exclusion effect,which prevents Cl^(−)adsorption and corrosion in the Co active centers,achieving impressive catalytic stability.In addition,the directional charge movement between Fe and Co atomic pairs establishes a local electric field,optimizing the adsorption energy of Co sites for oxygen-containing intermediates,and further improving the ORR activity.展开更多
Symbiotic nitrogen fixation in members of the Fabaceae family is highly efficient and beneficial for global agriculture,but not all species in this family form root nodules with rhizobial bacteria.Nodulation mainly oc...Symbiotic nitrogen fixation in members of the Fabaceae family is highly efficient and beneficial for global agriculture,but not all species in this family form root nodules with rhizobial bacteria.Nodulation mainly occurs in plants belonging to the Papilionoideae and Caesalpinioideae subfamilies(Tederso0 et al.,2018;van Velzen et al.,2019).Nodulation mechanisms in Fabaceae are well studied(Yang et al.,2022),and genomic comparisons of nodulating and non-nodulating host species can provide valuable insights into the evolutionary and genetic basis of this key process.展开更多
Ammonia is nowadays one of the most important commodities chemicals intensively produced at about 175 million tons per year,contributing to 1.8%of the global energy demand.The constantly increasing NH3 demand also par...Ammonia is nowadays one of the most important commodities chemicals intensively produced at about 175 million tons per year,contributing to 1.8%of the global energy demand.The constantly increasing NH3 demand also paralleleds by the high CO_(2) emissions associated with its production.Therefore,decarbonizing NH3 synthesis is one of the most urgent contemporary challenges.Taking inspiration from Nature,solar-driven nitrogen fixation under mild conditions is one of the most promising yet challenging alternatives to classic methods.In this review,we focused our attention on the photocatalytic methods for the synthesis of ammonia;in particular,we concentrated on stable and recyclable heterogeneous Fe-based photocatalysts for producing NH3.Indeed,recoverable and widely abundant and low-cost iron catalysts may represent a very promising tool for future sustainable access to this largely desired chemical target.After an overview of the pioneering works on Fe-driven nitrogen photofixation,the recent strategies on the use of Fe are herein reported.Compared with pristine photocatalysts,adding Fe as dopant or composite and heterojunction highly enhances the photocatalytic performances,opening the way to sustainable and low-cost nitrogen production.展开更多
Surface modification is found to be an effective way to control the initial degradation of Mg based biomedical alloys.The present study focuses on the modulation of in vitro and in vivo degradation behavior of Mg-Ce a...Surface modification is found to be an effective way to control the initial degradation of Mg based biomedical alloys.The present study focuses on the modulation of in vitro and in vivo degradation behavior of Mg-Ce alloy through a stearic acid-treated polypyrrole coating,which developed superhydrophobic surface(contact angle∼153°)that drastically enhanced the corrosion resistance(more than 85%efficacy).Cerium addition to Mg alloy results basal texture strengthening and grain refinement,resulting in improved mechanical properties.All the specimens exhibited excellent antibacterial performance against gram-negative E.Coli(DH5α)and gram positive S.aureus bacteria.The oligodynamic effect of polypyrrole coating leads to complete bacterial mitigation.Non-toxic nature of the specimens was studied by MC3T3-E1 cell proliferation and differentiation in indirect cell culture method.Improved corrosion resistance of the coated specimen leads to enhanced cell proliferation and osteogenic differentiation.Hard tissue histology and micro-CT analysis exhibited higher fraction of newly formed callus tissues and highest bone-implant integration across the coated specimen,when implanted in rabbit femur.Efficacy of the material in fracture healing was evaluated by implanting bone plate and screw in a clinically fractured goat tibia.At 3 months,complete fracture healed with no vital organ toxicity was observed for the coated specimen.The present results suggest that Ce addition and polypyrrole coating are effective ways to modulate the corrosion and biocompatibility behavior making it a potential candidate for fracture fixation applications.展开更多
In order to protect the environment and economize energy,a nitrogen-fixing photocatalyst,VMCeact,is investigated in this work.This catalyst is prepared from a natural mineral,vermiculite,and modified by Ce-based metal...In order to protect the environment and economize energy,a nitrogen-fixing photocatalyst,VMCeact,is investigated in this work.This catalyst is prepared from a natural mineral,vermiculite,and modified by Ce-based metal-organic framework,Ce-UiO-66.Vermiculite was treated with formic acid;thus,Ce-UiO-66 particles grew in-situ on vermiculite;then,Ce-UiO-66 particles were activated by ultraviolet irradiation.The vermiculite absorbed visible light with a narrow band gap,and transferred photogenerated electrons to the active sites on Ce-UiO-66.Moreover,the lamella structure of vermiculite protected Ce-UiO-66 during photocatalytic process.Therefore,with only 45.92 wt%of Ce-UiO-66,the nitrogen fixation performance of VMCeact was 2.29 times that of pure activated Ce-UiO-66 particles under 455nm light irradiation(apparent quantum efficiency of 4.49%),and retained at least 96.05%performance after 7×24 h of photocatalytic reaction.This cost-reduced,efficient and stable photocatalyst has the opportunity to facilitate environmentally friendly ammonia production.展开更多
To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center...To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables and χ^(2) or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.展开更多
The replacement of energy-intensive Haber-Bosch technique for ammonia production to mitigate global warming is increasingly emphasized.In this paper,we report the preparation of Z-scheme heterojunction nanocomposites ...The replacement of energy-intensive Haber-Bosch technique for ammonia production to mitigate global warming is increasingly emphasized.In this paper,we report the preparation of Z-scheme heterojunction nanocomposites for photocatalytic nitrogen fixation by coupling ultrathin two-dimensional g-C_(3)N_(4) nanosheets with MIL-101(Fe)using a solvothermal method.Methanol was used as a hole sacrificing reagent to strengthen the catalytic performance.The highest NH3 yield of the composites under full spectrum irradiation was 472.8μmol·g^(−1)·h^(−1),which is about 3.5 times that of MIL-101(Fe).From BET results,photocatalyst with high specific surface area has superior nitrogen fixation performance.The results of PL,EIS,UPS,and ESR show that the presence of Z-scheme heterojunction is largely able to facilitate the separation of electrons and holes.It is one reason for improving performance of nitrogen fixation.The study has provided a viable approach to construct heterojunction photocatalysts with outstanding nitrogen fixation performance.展开更多
BACKGROUND Spinal tuberculosis,a destructive extrapulmonary form,often causes severe deformity and neurological deficits.Surgical intervention aims to debride lesions,reconstruct stability,and correct deformities.This...BACKGROUND Spinal tuberculosis,a destructive extrapulmonary form,often causes severe deformity and neurological deficits.Surgical intervention aims to debride lesions,reconstruct stability,and correct deformities.This study evaluates a combined posterior fixation and minimally invasive anterior approach for lumbar tuberculosis.AIM To evaluate the clinical outcomes and radiological parameters of posterior internal fixation combined with minimally invasive anterior lesion clearance and bone graft fusion for the treatment of lumbar tuberculosis.METHODS Clinical data from 24 patients with lumbar tuberculosis who underwent posterior pedicle screw fixation combined with minimally invasive anterior lesion clearance were analyzed.The Cobb angle,visual analog scale(VAS)score,and Frankel classification were statistically assessed preoperatively and postoperatively.Complications and bone graft fusion were also recorded.RESULTS Wounds healed in the first stage in 22 patients;one patient developed a posterior incisional sinus tract,and one experienced postoperative tuberculosis recurrence.At the final follow-up,according to the Frankel classification,there were 1,2,and 21 cases classified as grade C,grade D,and grade E,respectively.By the last follow-up,the Cobb angle,VAS score,and erythrocyte sedimentation rate had all decreased.Both X-ray and computed tomography images confirmed bone healing.The fusion time ranged from 3 to 9 months,with an average of 5.2 months.CONCLUSION Posterior pedicle screw fixation combined with minimally invasive anterior lesion clearance is an effective and safe treatment for lumbar tuberculosis.展开更多
The utilization of visible light for photocatalytic nitrogen fixation offers a sustainable and eco-friendly strategy for the production of ammonia.The present study focuses on the synthesis of a series of rare earth-d...The utilization of visible light for photocatalytic nitrogen fixation offers a sustainable and eco-friendly strategy for the production of ammonia.The present study focuses on the synthesis of a series of rare earth-doped carbon nitride composite ultraviolet-activated Ce-UiO-66 catalysts,denoted as RECNactMOF,for efficient nitrogen fixation.Rare earth doping modulates the band structure of carbon nitride,facilitating the formation of a type-I heterojunction with Ce-UiO-66 and promoting photocarrier generation at nitrogen fixation sites.Among these,Sm-doped SmCN-actMOF exhibits high visible-light absorption and efficient utilization of photocarriers,resulting in an apparent quantum efficiency(AQE)of 1.58%under 495 nm light irradiation.This study provides a pathway for enhancing the nitrogen fixation efficiency of photocatalysts through the incorporation of rare earth elements,and expanding the potential applications of rare earth materials in the field of photocatalysis.展开更多
To evaluate the therapeutic effect of a modified Devine procedure with a subcutaneous sliding fixation method for the treatment of congenital concealed penis,we retrospectively selected 45 patients with congenital con...To evaluate the therapeutic effect of a modified Devine procedure with a subcutaneous sliding fixation method for the treatment of congenital concealed penis,we retrospectively selected 45 patients with congenital concealed penises who were admitted to General Hospital of Ningxia Medical University(Yinchuan,China)between September 2020 and November 2023.In all cases,the penis was observed to be short,and retracting the skin at the base revealed a normal penile body,which immediately returned to its original position upon release.All patients underwent the modified Devine procedure with subcutaneous sliding fixation and completed a 12-week postoperative follow-up.A statistically significant increase in penile length was observed postoperatively,with the median length increasing from 4.0(interquartile range[IQR]:3.5–4.8;95%confidence interval[CI]:3.9–4.4)cm to 8.0(IQR:7.8–8.0;95%CI:7.7–7.9)cm,with P<0.001.The parents were satisfied with the outcomes,including increased penile length,improved hygiene,and enhanced esthetics.Except for mild foreskin edema in all cases,no complications(such as infections,skin necrosis,or penile retraction)were observed.The edema was resolved within 4 weeks after the operation.This study demonstrates that the modified Devine procedure utilizing the subcutaneous sliding fixation method yields excellent outcomes with minimal postoperative complications,reduced penile retraction,and high satisfaction rates among patients and their families.展开更多
The Ilizarov apparatus was designed by its author 75 years ago and addresses a wide range of orthopedic conditions.Its classical assemblies are still self-sufficient and versatile.However,certain clinical scenarios re...The Ilizarov apparatus was designed by its author 75 years ago and addresses a wide range of orthopedic conditions.Its classical assemblies are still self-sufficient and versatile.However,certain clinical scenarios require a more specialized approach,and some groups of patients may benefit from customized Ilizarov constructs.Engineering science has designed various external fixators for orthopedic purposes,and some of those have become the gold standard for specific clinical tasks.We aimed to determine the current state and novel modifications of specialized external fixators for specific clinical situations which are based on the principles of the Ilizarov method.They are half-pin-based fixators for temporal fracture fixation,ring or hybrid devices for gradual deformity correction,and compression-distraction devices tailored for definite limb segments.Gradual correction of deformities can be achieved with external hexapods incorporating universal reduction units.Alternatively,external fixators with special connection mechanisms are able to provide independent movement of the rings in six degrees of freedom.Deformity correction can be performed with combined or sequential use of external and internal fixators.Special devices were developed for moving the split fragment for revascularization of the tibia.The units of external frames on the foot were modified to consider its complex anatomy and the clinical needs ranging from correction of multi-plane deformities,joint arthrodesis to distraction arthroplasty.Mini-fixators are compact external fixators for small bones of the hand and foot.The varieties of external fixators based on the Ilizarov principles have been designed to fulfill an ultimate goal of improving treatment outcomes.展开更多
基金supported by the funds of the Ministry of Science and Technology of China(2019YFA0904700)the National Natural Science Foundation of China(32471477)to Cheng Qi.
文摘Biological nitrogen fixation(BNF)and photosynthetic carbon fixation underpin food production and climate mitigation,yet natural systems are constrained by oxygen sensitivity,high energy demand,and inefficient catalysts.This review synthesizes advances that recast these processes as engineering targets and proposes a conceptual roadmap that bridges synthetic symbioses with the synthetic biology of enzymes and pathways.For BNF,progress spans cross-kingdom strategies—from refactoring nif gene sets and targeting nitrogenase assembly to eukaryotic organelles,to engineering plant-associated diazotrophs,rhizosphere control circuits,and emerging nodule-like microenvironments.For carbon assimilation,new-to-nature CO_(2)-fixation modules and photorespiratory bypasses illustrate how pathway redesign and alternative carboxylases can circumvent key Calvin–Benson–Bassham limitations,and expanding photosynthetic light capture offers additional leverage.Across these domains,we extract common design principles:(i)nitrogenase output is increasingly governed by carbon/energy supply and electron delivery as much as by oxygen protection;(ii)robust function requires compartment-aware enzyme–chassis coordination,substrate channeling,and dynamic regulation using sensors and control circuits;and(iii)scalable implementation may benefit from distributing metabolic labor across engineered consortia rather than forcing all functions into a single host.We discuss enabling technologies—including AI-guided protein design and directed evolution,cell-free prototyping,chassis toolkits,and materials/bioelectrochemical interfaces—that can accelerate design–build–test–learn cycles and reduce barriers to deployment.Together,these insights define a path toward integrated nitrogen and carbon fixation systems for low-emission agriculture and biomanufacturing.
基金supported by the National Natural Science Foundation of China(32372192)the Core Technology Development for Breeding Program of Jiangsu Province(JBGS-2021-014)Jiangsu Key Laboratory of Soybean Biotechnology and Intelligent Breeding(BM2024005)。
文摘Soybean is an important source of oil,protein,and feed.However,its yield is far below that of major cereal crops.The green revolution increased the yield of cereal crops partially through high-density planting of lodging-resistant semi-dwarf varieties,but required more nitrogen fertilizers,posing an environmental threat.Genes that can improve nitrogen use efficiency need to be integrated into semi-dwarf varieties to avoid the overuse of fertilizers without the loss of dwarfism.Unlike cereal crops,soybean can assimilate atmospheric nitrogen through symbiotic bacteria.Here,we created new alleles of Gm GID1-2(Glycine max GIBBERELLIN INSENSITIVE DWARF 1-2)using clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated nuclease 9(Cas9)editing,which improved soybean architecture,yield,seed oil content,and nitrogen fixation,by regulation of important pathways and known genes related to branching,lipid metabolism,and nodule symbiosis.Gm GID1-2 knockout reduced plant height,and increased stem diameter and strength,number of branches,nodes on the primary stem,pods,and seeds per plant,leading to an increase in seed weight per plant and yield in soybean.The nodule number,nodule weight,nitrogenase activity,and nitrogen content were also improved in Gm GID1-2knockout soybean lines,which is novel compared with the semi-dwarf genes in cereal crops.No loss-of-function allele for Gm GID1-2 was identified in soybean germplasm and the edited Gm GID1-2s are superior to the natural alleles,suggesting the Gm GID1-2 knockout mutants generated in this study are valuable genetic resources to further improve soybean yield and seed oil content in future breeding programs.This study illustrates the pleiotropic functions of the GID1 knockout alleles with positive effects on plant architecture,yield,and nitrogen fixation in soybean,which provides a promising strategy toward sustainable agriculture.
基金supported by the National Natural Science Foundation of China (No.42377227)Beijing Natural Science Foundation (No.2232061)。
文摘The rate-limited activation of N≡N triple bonds with high bond energies has been a bottleneck in photoctalytic nitrogen fixation.Here,polymeric carbon nitride with frustrated Lewis pairs(FLPs) was constructed by inserting electron-deficient magnesium into g-C_(3)N_(4)(CN).The synergistic interactions between Mg and amino groups in CN led to a 7.2 fold increase in the photoreactivity of nitrogen(N_(2)) fixation by carbon nitride.
文摘AIM:To evaluate the clinical outcomes of a new minimally invasive technique using horizontal mattress sutures and Hoffman pockets for four-point refixation of dislocated fourhaptic intraocular lenses(IOLs).METHODS:This retrospective consecutive case series included eyes with dislocated Akreos AO60 IOLs underwent scleral refixation using a horizontal mattress doubleneedle suture technique with intralamellar knot burial via Hoffman pockets.Clinical outcomes assessed included pre-and postoperative best-corrected visual acuity(BCVA),intraocular pressure(IOP),spherical equivalent(SE),suture duration,IOL centration,and perioperative complications.RESULTS:A total of 10 eyes from 10 patients(6 males)were included.The mean age at the time of IOL refixation was 53.10±13.07y(range:28-68y).The mean interval between initial IOL implantation and dislocation was 8.44±3.54y.The mean postoperative follow-up duration was 11.45±10.30mo.Surgical time averaged 15.3±1.77min,with no intraoperative complications.The mean axial length was 27.16±4.35 mm,with high myopia(HM)as the leading comorbidity(4/10 eyes).Postoperative BCVA significantly improved compared to preoperative values(P=0.025).Postoperative SE was significantly improved compared with preoperative(P=0.01).All IOLs remained centered throughout follow-up.CONCLUSION:This minimally invasive four-point scleral fixation technique offers a safe and effective refixation strategy for dislocated four-haptic IOLs.The horizontal mattress suture configuration combined with Hoffman pockets facilitates durable centration,avoids conjunctival dissection,and could be adopted into routine surgical practice.
基金financially supported by the National Natural Science Foundation of China(No.22172144 and 22272151)Key Research and Development Program of Zhejiang Province(2023C03148).
文摘Photocatalytic nitrogen fixation has emerged as a sustainable alternative for ammonia synthesis,playing a crucial role in alleviating energy shortages and environmental pollution.In this study,PbBiO_(2)Br was applied to photocatalytic nitrogen fixation for the first time,and its photocatalytic performance was effectively enhanced through Cu doping.The catalyst was synthesized via a simple reduction method,and its morphology,structure,and physicochemical properties were systematically investigated using various characterization techniques and density functional theory calculations.The results revealed that the incorporation of Cu2+partially replaced Pb2+,inducing lattice distortion in PbBiO_(2)Br,promoting the formation of oxygen vacancies,and modifying its electronic band structure.Specifically,Cu doping led to a slight bandgap narrowing,a reduction in work function,and a significant upward shift in the conduction band position.These changes enhanced light absorption,facilitated charge carrier migration and separation,and improved the reduction ability of photogenerated electrons.Moreover,Cu doping promoted N_(2)adsorption and activation.Consequently,the photocatalytic nitrogen fixation performance of Cu-doped PbBiO_(2)Br was significantly enhanced,achieving an optimal nitrogen fixation rate of 293μmol L^(−1)g^(−1)h^(−1),which is 3.6 times higher than that of pristine PbBiO_(2)Br.Additionally,Cu–PbBiO_(2)Br also showed good activity in the photocatalytic degradation of RhB,with a degradation rate 4.6 times higher than that of PbBiO_(2)Br.This work offers new insights into the application of PbBiO_(2)Br in photocatalytic nitrogen fixation and offers valuable guidance for the development of highly efficient nitrogen fixation materials in the future.
基金the National Key R&D Program of China(No.2021YFC2101604)National Natural Science Foundation of China(Nos.U23A20123,22278339)+1 种基金Fujian Provincial Key Science and Technology Program of China(No.2022YZ037013)Xiamen University for the financial support.
文摘Carbon dioxide(CO_(2))is the main greenhouse gas(GHG)released by human activities.The substitution of fossil resources by biomass as a bio-renewable resource,has significant potential to reduce GHG emissions.The approach to biomass,as the only true full-scale alternative to fossil resources,is progressing rapidly.Converting biomass into furanic compounds,as versatile platform chemicals for synthesizing a wide range of bio-based products is the cornerstone of sustainable technologies.The extensive body of this review combines the biomass valorization to furanic compounds by CO_(2)utilization and furanic compounds conversion by CO_(2)fixation.These processes can be strategically applied through both‘thermochemical’and‘electrochemical’pathways,by utilizing CO_(2)from the atmosphere or industrial emission point and returning it to the natural carbon cycle.In the thermochemical pathway CO_(2)acts as a carbon source(carboxylation and polymerization)or active reaction assistant in the biomass conversion(CO_(2)-assisted conversion),without altering its oxidation state,facilitating the synthesis of valuable products and polymers.Conversely,in the electrochemical pathway,CO_(2)can be used as a carbon source(electrocarboxylation)to give the corresponding carboxylic acid,or it can undergo reduction,yielding methanol,carbon monoxide(CO),formic acid,and analogous compounds,while on the other side,furanic compounds undergo oxidation yielding high-value-added chemicals.Finally,potential future research directions are suggested to promote CO_(2)utilization and fixation in the valorization of biomass-derived furanic compounds,and challenges facing further research are highlighted.
基金supported by the Natural Science Foundation of China (NSFC,No.52372212)。
文摘Photocatalysis uses solar energy to convert nitrogen and water directly into ammonia,helping reduce dependence on fossil fuels and offering a way to integrate the nitrogen cycle into a clean energy network.Ohmic junctions between metals and semiconductors have demonstrated significant advantages in enhancing stability and reducing carrier recombination,but their application in photocatalytic nitrogen fixation is limited due to the difficulty of work function matching and the complexity of fabrication processes.In this study,density functional theory(DFT) calculations were used to confirm the work function matching between Bi and Bi_(2)Ti_(2)O_(7)(BTO),ensuring the formation of an Ohmic junction.A Bi-Bi_(2)Ti_(2)O_(7)(B-BTO) composite was successfully synthesized via a one-step hydrothermal method,using bismuth nitrate and titanium sulfate as precursors.Compared to pure BTO,the B-BTO heterojunction,driven by dual electron injection from both metal Bi and BTO,significantly increased the ammonia synthesis rate to 686.95 μmol g^(-1)h^(-1),making it the most active nitrogen fixation material among similar pyrochlorebased catalysts to date.The differential charge density calculations,photocurrent(i-t) measurements,and photoluminescence(PL) tests further validate the role of Ohmic contacts in enhancing charge transfer and prolonging carrier lifetimes.This research provides valuable insight into the application of Ohmic junctions in photocatalytic nitrogen fixation and contributes to advancements in this field.
基金supported by the National Natural Science Foundation of China(52164028,52274297)the Start-up Research Foundation of Hainan University(KYQD(ZR)20008,KYQD(ZR)21125,KYQD(ZR)23169))+1 种基金Collaborative Innovation Center of Marine Science and Technology of Hainan University(XTCX2022HYC14)Innovative Research Project for Postgraduate Students in Hainan Province(Qhyb2024-95).
文摘Development of robust electrocatalyst for oxygen reduction reaction(ORR)in a seawater electrolyte is the key to realize seawater electrolyte-based zinc-air batteries(SZABs).Herein,constructing a local electric field coupled with chloride ions(Cl-)fixation strategy in dual single-atom catalysts(DSACs)was proposed,and the resultant catalyst delivered considerable ORR performance in a seawater electrolyte,with a high half-wave potential(E_(1/2))of 0.868 V and a good maximum power density(Pmax)of 182 mW·cm^(−2)in the assembled SZABs,much higher than those of the Pt/C catalyst(E_(1/2):0.846 V;Pmax:150 mW·cm^(−2)).The in-situ characterization and theoretical calculations revealed that the Fe sites have a higher Cl^(−)adsorption affinity than the Co sites,and preferentially adsorbs Cl^(−)in a seawater electrolyte during the ORR process,and thus constructs a low-concentration Cl^(−)local microenvironment through the common-ion exclusion effect,which prevents Cl^(−)adsorption and corrosion in the Co active centers,achieving impressive catalytic stability.In addition,the directional charge movement between Fe and Co atomic pairs establishes a local electric field,optimizing the adsorption energy of Co sites for oxygen-containing intermediates,and further improving the ORR activity.
基金supported by the National Natural Science Foundation of China(No.32160142)Guangxi Natural Science Foundation(No.2023GXNSFDA026034)+3 种基金State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources(SKLCUSAb202302)to H.W.,the National Natural Science Foundation of China(No.32460062)to Y.L.,and 1+9 Leading the Charge with Open Competition'project of Sichuan Academy of Agricultural Sciences(1+9KJGG010)Fruit tree breeding project in Sichuan Province(2021YFYZ0023)to H.X.
文摘Symbiotic nitrogen fixation in members of the Fabaceae family is highly efficient and beneficial for global agriculture,but not all species in this family form root nodules with rhizobial bacteria.Nodulation mainly occurs in plants belonging to the Papilionoideae and Caesalpinioideae subfamilies(Tederso0 et al.,2018;van Velzen et al.,2019).Nodulation mechanisms in Fabaceae are well studied(Yang et al.,2022),and genomic comparisons of nodulating and non-nodulating host species can provide valuable insights into the evolutionary and genetic basis of this key process.
基金funded by the European Union-NextGenerationEU under the Italian Ministry of University and Research(MUR)National Innovation Ecosystem grant ECS00000041-VITALITYThe University of Perugia is acknowledged for financial support to the university project“Fondo Ricerca di Ateneo,edizione 2021”and“Fondo Ricerca di Ateneo,edizione 2022”CSGI(Consorzio Interuniversitario per lo Sviluppo dei Sistemi a Grande Interfase)for the support.
文摘Ammonia is nowadays one of the most important commodities chemicals intensively produced at about 175 million tons per year,contributing to 1.8%of the global energy demand.The constantly increasing NH3 demand also paralleleds by the high CO_(2) emissions associated with its production.Therefore,decarbonizing NH3 synthesis is one of the most urgent contemporary challenges.Taking inspiration from Nature,solar-driven nitrogen fixation under mild conditions is one of the most promising yet challenging alternatives to classic methods.In this review,we focused our attention on the photocatalytic methods for the synthesis of ammonia;in particular,we concentrated on stable and recyclable heterogeneous Fe-based photocatalysts for producing NH3.Indeed,recoverable and widely abundant and low-cost iron catalysts may represent a very promising tool for future sustainable access to this largely desired chemical target.After an overview of the pioneering works on Fe-driven nitrogen photofixation,the recent strategies on the use of Fe are herein reported.Compared with pristine photocatalysts,adding Fe as dopant or composite and heterojunction highly enhances the photocatalytic performances,opening the way to sustainable and low-cost nitrogen production.
基金the financial assistance from Science and Engineering Research Board(SERBCRG/2020/002818/MMM).
文摘Surface modification is found to be an effective way to control the initial degradation of Mg based biomedical alloys.The present study focuses on the modulation of in vitro and in vivo degradation behavior of Mg-Ce alloy through a stearic acid-treated polypyrrole coating,which developed superhydrophobic surface(contact angle∼153°)that drastically enhanced the corrosion resistance(more than 85%efficacy).Cerium addition to Mg alloy results basal texture strengthening and grain refinement,resulting in improved mechanical properties.All the specimens exhibited excellent antibacterial performance against gram-negative E.Coli(DH5α)and gram positive S.aureus bacteria.The oligodynamic effect of polypyrrole coating leads to complete bacterial mitigation.Non-toxic nature of the specimens was studied by MC3T3-E1 cell proliferation and differentiation in indirect cell culture method.Improved corrosion resistance of the coated specimen leads to enhanced cell proliferation and osteogenic differentiation.Hard tissue histology and micro-CT analysis exhibited higher fraction of newly formed callus tissues and highest bone-implant integration across the coated specimen,when implanted in rabbit femur.Efficacy of the material in fracture healing was evaluated by implanting bone plate and screw in a clinically fractured goat tibia.At 3 months,complete fracture healed with no vital organ toxicity was observed for the coated specimen.The present results suggest that Ce addition and polypyrrole coating are effective ways to modulate the corrosion and biocompatibility behavior making it a potential candidate for fracture fixation applications.
基金supported by the National Natural Science Foundation of China(Nos.21978251,22102141 and U1904215)Natural Science Foundation of Jiangsu Province(No.BK20200044).
文摘In order to protect the environment and economize energy,a nitrogen-fixing photocatalyst,VMCeact,is investigated in this work.This catalyst is prepared from a natural mineral,vermiculite,and modified by Ce-based metal-organic framework,Ce-UiO-66.Vermiculite was treated with formic acid;thus,Ce-UiO-66 particles grew in-situ on vermiculite;then,Ce-UiO-66 particles were activated by ultraviolet irradiation.The vermiculite absorbed visible light with a narrow band gap,and transferred photogenerated electrons to the active sites on Ce-UiO-66.Moreover,the lamella structure of vermiculite protected Ce-UiO-66 during photocatalytic process.Therefore,with only 45.92 wt%of Ce-UiO-66,the nitrogen fixation performance of VMCeact was 2.29 times that of pure activated Ce-UiO-66 particles under 455nm light irradiation(apparent quantum efficiency of 4.49%),and retained at least 96.05%performance after 7×24 h of photocatalytic reaction.This cost-reduced,efficient and stable photocatalyst has the opportunity to facilitate environmentally friendly ammonia production.
文摘To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables and χ^(2) or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.
基金financially supported by the Natural Science Foundation of China(22071018)the Natural Science Foundation of Jilin Province(20220101069JC)
文摘The replacement of energy-intensive Haber-Bosch technique for ammonia production to mitigate global warming is increasingly emphasized.In this paper,we report the preparation of Z-scheme heterojunction nanocomposites for photocatalytic nitrogen fixation by coupling ultrathin two-dimensional g-C_(3)N_(4) nanosheets with MIL-101(Fe)using a solvothermal method.Methanol was used as a hole sacrificing reagent to strengthen the catalytic performance.The highest NH3 yield of the composites under full spectrum irradiation was 472.8μmol·g^(−1)·h^(−1),which is about 3.5 times that of MIL-101(Fe).From BET results,photocatalyst with high specific surface area has superior nitrogen fixation performance.The results of PL,EIS,UPS,and ESR show that the presence of Z-scheme heterojunction is largely able to facilitate the separation of electrons and holes.It is one reason for improving performance of nitrogen fixation.The study has provided a viable approach to construct heterojunction photocatalysts with outstanding nitrogen fixation performance.
基金Supported by Medical Research Project of Wuhan Municipal Health Commission,No.WX21M02.
文摘BACKGROUND Spinal tuberculosis,a destructive extrapulmonary form,often causes severe deformity and neurological deficits.Surgical intervention aims to debride lesions,reconstruct stability,and correct deformities.This study evaluates a combined posterior fixation and minimally invasive anterior approach for lumbar tuberculosis.AIM To evaluate the clinical outcomes and radiological parameters of posterior internal fixation combined with minimally invasive anterior lesion clearance and bone graft fusion for the treatment of lumbar tuberculosis.METHODS Clinical data from 24 patients with lumbar tuberculosis who underwent posterior pedicle screw fixation combined with minimally invasive anterior lesion clearance were analyzed.The Cobb angle,visual analog scale(VAS)score,and Frankel classification were statistically assessed preoperatively and postoperatively.Complications and bone graft fusion were also recorded.RESULTS Wounds healed in the first stage in 22 patients;one patient developed a posterior incisional sinus tract,and one experienced postoperative tuberculosis recurrence.At the final follow-up,according to the Frankel classification,there were 1,2,and 21 cases classified as grade C,grade D,and grade E,respectively.By the last follow-up,the Cobb angle,VAS score,and erythrocyte sedimentation rate had all decreased.Both X-ray and computed tomography images confirmed bone healing.The fusion time ranged from 3 to 9 months,with an average of 5.2 months.CONCLUSION Posterior pedicle screw fixation combined with minimally invasive anterior lesion clearance is an effective and safe treatment for lumbar tuberculosis.
基金Project supported by the National Natural Science Foundation of China(22102141)。
文摘The utilization of visible light for photocatalytic nitrogen fixation offers a sustainable and eco-friendly strategy for the production of ammonia.The present study focuses on the synthesis of a series of rare earth-doped carbon nitride composite ultraviolet-activated Ce-UiO-66 catalysts,denoted as RECNactMOF,for efficient nitrogen fixation.Rare earth doping modulates the band structure of carbon nitride,facilitating the formation of a type-I heterojunction with Ce-UiO-66 and promoting photocarrier generation at nitrogen fixation sites.Among these,Sm-doped SmCN-actMOF exhibits high visible-light absorption and efficient utilization of photocarriers,resulting in an apparent quantum efficiency(AQE)of 1.58%under 495 nm light irradiation.This study provides a pathway for enhancing the nitrogen fixation efficiency of photocatalysts through the incorporation of rare earth elements,and expanding the potential applications of rare earth materials in the field of photocatalysis.
基金supported by the National Natural Science Foundation of China(No.81860268,and No.82201000)Ningxia Natural Science Foundation(No.2021AAC02025)+2 种基金Ningxia science and technology innovation leading talent training project(No.2020GKLRLX06 and No.2020GKLRLX11)Ningxia Medical University research project(No.XTJKF240315)Ningxia Key Research and Development Project(No.2023BEG03021 and No.2021BEB04034).
文摘To evaluate the therapeutic effect of a modified Devine procedure with a subcutaneous sliding fixation method for the treatment of congenital concealed penis,we retrospectively selected 45 patients with congenital concealed penises who were admitted to General Hospital of Ningxia Medical University(Yinchuan,China)between September 2020 and November 2023.In all cases,the penis was observed to be short,and retracting the skin at the base revealed a normal penile body,which immediately returned to its original position upon release.All patients underwent the modified Devine procedure with subcutaneous sliding fixation and completed a 12-week postoperative follow-up.A statistically significant increase in penile length was observed postoperatively,with the median length increasing from 4.0(interquartile range[IQR]:3.5–4.8;95%confidence interval[CI]:3.9–4.4)cm to 8.0(IQR:7.8–8.0;95%CI:7.7–7.9)cm,with P<0.001.The parents were satisfied with the outcomes,including increased penile length,improved hygiene,and enhanced esthetics.Except for mild foreskin edema in all cases,no complications(such as infections,skin necrosis,or penile retraction)were observed.The edema was resolved within 4 weeks after the operation.This study demonstrates that the modified Devine procedure utilizing the subcutaneous sliding fixation method yields excellent outcomes with minimal postoperative complications,reduced penile retraction,and high satisfaction rates among patients and their families.
文摘The Ilizarov apparatus was designed by its author 75 years ago and addresses a wide range of orthopedic conditions.Its classical assemblies are still self-sufficient and versatile.However,certain clinical scenarios require a more specialized approach,and some groups of patients may benefit from customized Ilizarov constructs.Engineering science has designed various external fixators for orthopedic purposes,and some of those have become the gold standard for specific clinical tasks.We aimed to determine the current state and novel modifications of specialized external fixators for specific clinical situations which are based on the principles of the Ilizarov method.They are half-pin-based fixators for temporal fracture fixation,ring or hybrid devices for gradual deformity correction,and compression-distraction devices tailored for definite limb segments.Gradual correction of deformities can be achieved with external hexapods incorporating universal reduction units.Alternatively,external fixators with special connection mechanisms are able to provide independent movement of the rings in six degrees of freedom.Deformity correction can be performed with combined or sequential use of external and internal fixators.Special devices were developed for moving the split fragment for revascularization of the tibia.The units of external frames on the foot were modified to consider its complex anatomy and the clinical needs ranging from correction of multi-plane deformities,joint arthrodesis to distraction arthroplasty.Mini-fixators are compact external fixators for small bones of the hand and foot.The varieties of external fixators based on the Ilizarov principles have been designed to fulfill an ultimate goal of improving treatment outcomes.
