Single-port versus traditional three-port laparoscopic total extraperitoneal inguinal hernia repair: A single-centre, prospective, randomised study.

OBJECTIVE: To explore the efficacy and safety of single-incision laparoscopic (SIL) technique compared with the traditional three-port total extraperitoneal (TEP) technique for inguinal hernia repair. METHODS: This prospective, randomised study involved patients who underwent surgery for inguinal hernia at our hospital from December 2021 to July 2023. Patients were randomly assigned to SIL-TEP or TEP groups based on a computer-generated random number table. Perioperative clinical indicators for the surgical approaches were evaluated. RESULTS: Of the 127 patients eligible for study, 66 were randomised to the SIL-TEP group and 61 to the TEP group. The operation time for SIL-TEP was significantly longer than for TEP but the time to return to normal activities was significantly shorter and short-term pain score was significantly lower. There were no differences between groups in intraoperative blood loss, postoperative hospital stays, pain relief time, hospitalization costs or cosmetic satisfaction scores. CONCLUSION: While SIL-TEP is more challenging than TEP for hernia repair, we found that at our centre it is comparable with regard to overall safety and feasibility. Further studies are needed to validate our findings.

Predominant P3-Type Solid-Solution Phase Transition Enables High-Stability O3-Type Na-Ion Cathodes.

Layered O3-type oxides are one of the most promising cathode materials for Na-ion batteries owing to their high capacity and straightforward synthesis. However, these materials often experience irreversible structure transitions at elevated cutoff voltages, resulting in compromised cycling stability and rate performance. To address such issues, understanding the interplay of the composition, structure, and properties is crucial. Here, we successfully introduced a P-type characteristic into the O3-type layered structure, achieving a P3-dominated solid-solution phase transition upon cycling. This modification facilitated a reversible transformation of the O3-P3-P3' structure with minimal and gradual volume changes. Consequently, the Na0.75Ni0.25Cu0.10Fe0.05Mn0.15Ti0.45O2 cathode exhibited a specific capacity of approximately 113 mAh/g, coupled with exceptional cycling performance (maintaining over 70% capacity retention after 900 cycles). These findings shed light on the composition-structure-property relationships of Na-ion layered oxides, offering valuable insights for the advancement of Na-ion batteries.

Slight Multielement Doping-Induced Structural Order-Disorder Transition for High-Performance Layered Na-Ion Oxide Cathodes.

To realize concurrently the high-energy density and excellent cycling stability, maximum utilization of redox couple, minimization of detrimental phase transition, and structural degradation of O3-type layered oxide cathodes are critical for developing Na-ion batteries. Ni2+/Ni4+ redox couple showing multielectron reaction and higher redox potential is favorable to increase the energy density. However, the Jahn-Teller distortion of Ni3+ generated upon (dis)charging results in a strong anisotropy in the local crystal structure that causes irreversible interlayer bending and chemo-mechanical cracks of the cathode particles, compromising the electrochemical properties eventually. In this work, we show a slight multielement doping strategy that enlarges the amount of active redox components while minimizing the inactive contents. The results show that the uniform distribution of multiple components can help increase the disorder degree of atom arrangement and alleviate the structural changes and detrimental anisotropy cracks. As a proof of concept, a multielement-doped O3-type Na0.9Ni0.25Cu0.05Mg0.05Zn0.05Fe0.05Al0.05Mn0.40Ti0.05Sn0.05O2 oxide is rationally prepared that presents better chemo-mechanical stability and delayed O3-P3 phase transition behavior. Compared to the high Ni-content Na0.9Ni0.35Fe0.2Mn0.45O2 cathode, this as-prepared multielement material delivers a reversible capacity of about 120 mAh/g in the voltage range of 2-4.0 V, superior cycling stability with 90% of capacity retention after 500 cycles, and excellent rate capability (more than 70% of initial capacity at 5.0 C). This work indicates that the multielement doping method is highly suitable for the development of advanced Na-ion layered oxide cathodes.

Manipulating of P2/O3 Composite Sodium Layered Oxide Cathode through Ti Substitution and Synthesis Temperature.

P2/O3 composite sodium layered oxide has emerged as a promising cathode for high-performance Na-ion batteries. However, it has been challenging to regulate accurately the phase ratio of P2/O3 composite due to their high compositional diversity, which brings about some difficulty in manipulating the electrochemical performance of P2/O3 composite. Here, we explore the effect of Ti substitution and the synthesis temperature on the crystal structure and Na storage performance of Na0.8Ni0.4Mn0.6O2. The investigation indicates Ti-substitution and altering synthesis temperature can rationally manipulate the phase ratio of P2/O3 composite, thereby purposefully regulating the cycling and rate performance of P2/O3 composite. Typically, O3-rich Na0.8Ni0.4Mn0.4Ti0.2O2-950 shows excellent cycling stability with a capacity retention of 84% (3C, 700 cycles). By elevating the proportion of P2 phase, Na0.8Ni0.4Mn0.4Ti0.2O2-850 displays concurrently improved rate capability (65% capacity retention at 5 C) and comparable cycling stability. These findings will help guide the rational design of high-performance P2/O3 composite cathodes for sodium-ion batteries.

[Prediction of internal fixation failure of femoral trochanteric fracture by external wall morphology].

OBJECTIVE: To investigate the relationship between the shape of the lateral wall and the early failure of internal fixation in the fracture of the femoral trochanteric region(FFT). METHODS: Total 295 patients with femoral trochanteric fracture underwent internal fixation from January 2015 to January 2020 were selected. The patients were divided into two groups according to whether there was early internal fixation failure after surgery, 19 patients in the failure group and 276 patients in the normal group. Gender, affected side, age, AO classification, body mass index(BMI), preoperative hemoglobin, X-ray measurement of lower lateral wall thickness, preoperative internal diseases, intraoperative blood loss, postoperative tip apex distance(TAD), postoperative neck shaft angle, operation time and other data were compared between two groups. The shape of the lateral wall was compared between two groups, and the correlation between the shape of the lateral wall and the early internal fixation failure of femoral trochanteric fracture was analyzed. RESULTS: All patients were followed up for more than 1 year. There was no significant difference between two groups in terms of intraoperative blood loss, operation time, postoperative TAD, and postoperative neck shaft angle(P>0.05). At the latest follow-up, the visual anaglue scale (VAS) of the failure group was higher than that of the normal group(P<0.01), and the Harris score of the failure group was lower than that of normal group(P<0.05). The receiver operator characteristic (ROC) curve between shape of lateral wall and failure of early internal fixation of femoral trochanteric fracture was drawn. The critical value of the midpoint lateral wall thickness was 16.5 mm, and the area under the ROC curve was 0.845;The critical value of average sidewall thickness was 16.5 mm, and the area under ROC curve was 0.838;The critical value of the axial area of the sidewall was 7.5 mm, and the area under the ROC curve was 0.826. CONCLUSION: The shape of the lateral femoral wall measured by CT could be used as a predictive factor for the early failure of internal fixation of femoral trochanteric fractures. For patients at risk, more reasonable surgical plans and postoperative preventive measures should be developed.

Enhanced Electrorheological Polishing Efficiency of Alumina-Doped Titanium Dioxide Particles.

Electrorheological (ER) polishing is a novel polishing technology having flexible and tunable characteristics. At present, ER polishing uses ER particles to drive abrasive particles to polish the material surface. Under the action of high-speed centrifugation, the abrasive particles are easily separated from ER particles due to their significantly different ER effect, and this can easily cause the degradation of polishing ability. In this work, alumina-doped titanium dioxide ER polishing particles were developed via a sol-gel method. As a classical abrasive, alumina has higher hardness and can improve the ER effect of titanium dioxide by doping. Thus, alumina-doped titanium dioxide particles simultaneously possess high ER effect and high hardness. No phase separation appears in the polishing process and the result shows that alumina-doped titanium dioxide has a good polishing efficiency for materials with Mohs hardness of 3 and below.

Electrorheological Effect of Suspensions of Polyaniline Nanoparticles with Different Morphologies.

Polyaniline (PANI) nanospheres, nanofibers, and nanoplates were prepared using the oxidative polymerization method. Scanning electron microscopy (SEM) was used to observe the three morphologies of PANI, and their structure was tested using infrared spectroscopy, X-ray diffraction, Raman spectroscopy, and X-ray photoelectron spectroscopy. The influence of particle morphology on the electrorheological (ER) effect was studied through rheological experiments and molecular dynamics (MD) simulation. The experimental and simulation results indicate that without applying an electric field, the nanofibers easily form a three-dimensional network structure in the suspension, resulting in yield stress. The three-dimensional network structure of the nanoplate suspension becomes weaker and the PANI nanosphere suspension lacks the ability to form a three-dimensional network structure. After applying an electric field, under the same condition, the yield stress and electric field-induced shear stress increment of PANI nanofibers are the highest, followed by nanoplates, and those of PANI nanospheres are the lowest. This indicates that the ER effect increases with the increase in particle morphology anisotropy. Through three-dimensional visual simulation analysis, it can be concluded that the enhanced ER effect associated with increased particle anisotropy can be attributed to improved stability in the ER chain structure.

[Fixation of anterior pelvic ring fracture with long reconstruction plate combined with MIPPO technique].

OBJECTIVE: To evaluate the efficacy of long reconstruction plate combined with minimally invasive percutaneous plate osteosynthesis(MIPPO) technique in the treatment of unstable pelvic anterior ring fractures. METHODS: From January 2013 to February 2019, 16 patients with unstable pelvic fracture were treated, including 12 males and 4 females, aged from 20 to 60 years(mean 46.5 years). According to Tile classification, there were 4 cases of type B1, 6 cases of type B2, 4 cases of type C1 and 2 cases of type C2. The fracture of all patients was closed, and the time from injury to operation was 7 to 10 days with an average of 6.2 days. The operation time, intraoperative blood loss, fracture reduction quality, fracture healing time, complications and limb function during the final follow-up were evaluated in 16 patients. RESULTS: All 16 patients were followed up for 12 to 23 months (mean 19.1 months). The operation time was 60 to 180 min (mean 107.8 min). The intraoperative blood loss was 120 to 600 ml (mean 368.1 ml). The fracture healing time was 12 to 20 weeks (mean 16.3 weeks). According to Matta criteria, the fracture reduction was excellent in 6 cases, good in 8 cases and fair in 2 cases. One patient suffered from lateral femoral cutaneous nerve injury during the operation, and the lateral thigh sensation decreased after operation, which recovered after 6 months. One patient had pain stimulated by internal fixation at the iliac fossa. The symptoms were improved after the internal fixation was removed. The fractures of 16 patients were healed satisfactorily and there was no internal fixation loosening. Majeed score at the final follow-up was 67 to 95, excellent in 10 cases, good in 4 cases and fair in 2 cases. CONCLUSION: Closed reduction and fixation of pelvic anterior ring fracture with long reconstruction plate combined with MIPPO technique through anterior approach has the advantages of less injury, less bleeding time during operation, saving operation time, high intraoperative safety, high fracture healing rate, early functional exercise after operation, and effective treatment of pelvic anterior ring fracture.

Application of a three-dimensional virtual model to study the effect of fluoroscopic angle on infra-acetabular corridor parameters and screw insertion rates.

PURPOSE: To use three-dimensional (3D) virtual models to study how the parameters and insertion rates of the infra-acetabular corridor (IAC) change under different fluoroscopic angles. METHODS: The pelvis computed tomography data of 187 patients are imported into Mimics software in DICOM format to generate a 3D model. The anterior pelvis plane is used as the reference plane to measure the diameter of the optimum IAC when the pelvis model is tilted forward by 5°, 15°, 25°, 35° and 45°. The diameter of at least 3.5 mm is defined as the cutoff for placing a 3.5 mm screw, the rate of infra-acetabular screw (IAS) insertion is calculated, and the mean length of the IAC and the mean tilt of the corridor axis in relation to the sagittal midline plane (SMP) are measured. RESULTS: The similar diameters of the IAC can be found under fluoroscopy at 5°-35°, with the largest diameter of 4.08 ± 1.84 mm and the highest screw insertion rate of 60.42% at 15° and 25°, whereas the diameter and insertion rate are lowest at 45°. The corridor length increases with increasing fluoroscopic angle, and the angle of the corridor axis to the SMP decreases gradually. CONCLUSION: The conventional fluoroscopic angle of the pelvic inlet is not suitable for the IAS insertion. The parameters of the IAC vary according to a certain rule under different fluoroscopic angles, so a surgeon can select the appropriate fluoroscopic angle in accordance with the type of fracture and the fracture line angle.

[Minimally invasive percutaneous plate internal fixation through anterolateral single incision for the treatment of open distal tibiofibula fractures].

OBJECTIVE: To investigate therapeutic effect of minimally invasive percutaneous plate internal fixation (MIPPO) through a single incision in treating open distal tibiofibula fractures. METHODS: From March 2015 to February 2019, 10 patients with open distal tibiofibula fractures were treated with MIPPO technique through single anterolateral incision, including 8 males and 2 females, aged from 31 to 68 years old. According to Gustilo classification, 6 patients were typeⅠ, 3 patients were typeⅡand 1 patient was type ⅢA. Operative time, intraoperative blood loss and fracture healing were observed, Mazur ankle joint scoring was used to evaluate clinical effect. RESULTS: All patients were followed up from 9 to 24 months. Operative time ranged from 85 to 120 min, intraoperative blood loss ranged from 80 to 200 ml, fracture healing time ranged from 18 to 30 weeks. Nine patients with Gustilo typeⅠandⅡachieved satisfactory healing wound, original wound of 1 patient with Gustilo type ⅢA was poor, and healed by skin flap transplantation at stageⅡ. No steel exposed and infection occurred. According to Mazur ankle scoring at the final following-up, total score was from 61 to 97, and 8 patients got excellent result, 1 good and 1 poor. CONCLUSION: MIPPO technique through anterolateral single incision for the treatment of open distal tibiofibula fractures could protect original medial wound in opertaion, avoid plate exposed through anterolateral extensor tendon to cover internal fixation, and MIPPO technique could protect fracture end blood flow to improve fracture healing rate, and it is a kind of choice.

A new possible megalosauroid theropod from the Middle Jurassic Xintiangou Formation of Chongqing, People's Republic of China and its implication for early tetanuran evolution.

Tetanurae is a special group of theropod dinosaurs that originated by the late Early Jurassic. It includes several early-diverging groups of generally large-bodied predators (megalosauroids, allosauroids, tyrannosauroid coelurosaurs) as well as morphologically disparate small-bodied coelurosaurs, including birds. Aspects of the evolutionary history of tetanurans remain contested, including the topology of their deep phylogenetic divergences (among Megalosauroidea, Allosauroidea and Coelurosauria). We report a new theropod, Yunyangosaurus puanensis gen. et sp. nov., based on a fragmentary specimen recovered from the Middle Jurassic Xintiangou Formation of Chongqing, southwestern China. It shares several features uniquely with some megalosauroids (the clade of megalosaurids + spinosaurids + piatnitzkysaurids), such as prominent rims around the anterior articular surfaces of cervical centra and bifurcated anterior dorsal neural spines (present in piatnitzkysaurids). Nevertheless, it also shows several features that are rare or absent among megalosauroids and more crownward tetanurans, including prominent spinopostyzgopophyseal laminae (also present in non-tetanurans and metriacanthosaurid allosauroids), flat anterior articular surfaces of the cervical centra (also present in piatnitzkysaurids and some earlier-diverging tetanurans), and the presence of a posterior pneumatic foramen or fossa (absent in most tetanurans, but sporadically present in some cervical vertebrae of piatnitzkysaurids). Yunyangosaurus therefore presents a combination of derived and apparently primitive character states that are not seen in other theropods. This suggests that patterns of morphological evolution associated with deep tetanuran divergences were more complex than currently recognized, with implications for understanding the character evolution in theropods.