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1.
Nat Commun ; 15(1): 5128, 2024 Jun 15.
Article in English | MEDLINE | ID: mdl-38879628

ABSTRACT

Accurately controlling the product selectivity in syngas conversion, especially increasing the olefin selectivity while minimizing C1 byproducts, remains a significant challenge. Epsilon Fe2C is deemed a promising candidate catalyst due to its inherently low CO2 selectivity, but its use is hindered by its poor high-temperature stability. Herein, we report the successful synthesis of highly stable ε-Fe2C through a N-induced strategy utilizing pyrolysis of Prussian blue analogs (PBAs). This catalyst, with precisely controlled Mn promoter, not only achieved an olefin selectivity of up to 70.2% but also minimized the selectivity of C1 byproducts to 19.0%, including 11.9% CO2 and 7.1% CH4. The superior performance of our ε-Fe2C-xMn catalysts, particularly in minimizing CO2 formation, is largely attributed to the interface of dispersed MnO cluster and ε-Fe2C, which crucially limits CO to CO2 conversion. Here, we enhance the carbon efficiency and economic viability of the olefin production process while maintaining high catalytic activity.

2.
J Phys Chem Lett ; 15(16): 4384-4390, 2024 Apr 25.
Article in English | MEDLINE | ID: mdl-38659407

ABSTRACT

Rational design of catalysts relies on a deep understanding of the active centers. The structure and activity distribution of active centers on a surface are two of the central issues in catalysis and important targets of theoretical and experimental investigations. Herein, we report a machine learning-driven adequate sampling (MLAS) framework for obtaining a statistical understanding of the chemical environment near catalyst sites. Combined strategies were implemented to achieve highly efficient sampling, including the decomposition of degrees of freedom, stratified sampling, Gaussian process regression, and well-designed constraint optimization. The MLAS framework was applied to the rate-determining step in NH3 synthesis, namely the N2 activation process. We calculated the produced population function, PA, which provides a comprehensive and intuitive understanding of active centers. The MLAS framework can be broadly applied to other more complicated catalyst materials and reaction networks.

3.
ACS Nano ; 18(17): 11449-11461, 2024 Apr 30.
Article in English | MEDLINE | ID: mdl-38644575

ABSTRACT

Bimetallic alloy nanoparticles have garnered substantial attention for diverse catalytic applications owing to their abundant active sites and tunable electronic structures, whereas the synthesis of ultrafine alloy nanoparticles with atomic-level homogeneity for bulk-state immiscible couples remains a formidable challenge. Herein, we present the synthesis of RuxCo1-x solid-solution alloy nanoparticles (ca. 2 nm) across the entire composition range, for highly efficient, durable, and selective CO2 hydrogenation to CH4 under mild conditions. Notably, Ru0.88Co0.12/TiO2 and Ru0.74Co0.26/TiO2 catalysts, with 12 and 26 atom % of Ru being substituted by Co, exhibit enhanced catalytic activity compared with the monometallic Ru/TiO2 counterparts both in dark and under light irradiation. The comprehensive experimental investigations and density functional theory calculations unveil that the electronic state of Ru is subtly modulated owing to the intimate interaction between Ru and Co in the alloy nanoparticles, and this effect results in the decline in the CO2 conversion energy barrier, thus ultimately culminating in an elevated catalytic performance relative to monometallic Ru and Co catalysts. In the photopromoted thermocatalytic process, the photoinduced charge carriers and localized photothermal effect play a pivotal role in facilitating the chemical reaction process, which accounts for the further boosted CO2 methanation performance.

4.
Endoscopy ; 56(5): 334-342, 2024 May.
Article in English | MEDLINE | ID: mdl-38412993

ABSTRACT

BACKGROUND: Inaccurate Forrest classification may significantly affect clinical outcomes, especially in high risk patients. Therefore, this study aimed to develop a real-time deep convolutional neural network (DCNN) system to assess the Forrest classification of peptic ulcer bleeding (PUB). METHODS: A training dataset (3868 endoscopic images) and an internal validation dataset (834 images) were retrospectively collected from the 900th Hospital, Fuzhou, China. In addition, 521 images collected from four other hospitals were used for external validation. Finally, 46 endoscopic videos were prospectively collected to assess the real-time diagnostic performance of the DCNN system, whose diagnostic performance was also prospectively compared with that of three senior and three junior endoscopists. RESULTS: The DCNN system had a satisfactory diagnostic performance in the assessment of Forrest classification, with an accuracy of 91.2% (95%CI 89.5%-92.6%) and a macro-average area under the receiver operating characteristic curve of 0.80 in the validation dataset. Moreover, the DCNN system could judge suspicious regions automatically using Forrest classification in real-time videos, with an accuracy of 92.0% (95%CI 80.8%-97.8%). The DCNN system showed more accurate and stable diagnostic performance than endoscopists in the prospective clinical comparison test. This system helped to slightly improve the diagnostic performance of senior endoscopists and considerably enhance that of junior endoscopists. CONCLUSION: The DCNN system for the assessment of the Forrest classification of PUB showed satisfactory diagnostic performance, which was slightly superior to that of senior endoscopists. It could therefore effectively assist junior endoscopists in making such diagnoses during gastroscopy.


Subject(s)
Peptic Ulcer Hemorrhage , Humans , Peptic Ulcer Hemorrhage/diagnosis , Peptic Ulcer Hemorrhage/classification , Retrospective Studies , Male , Middle Aged , Female , Artificial Intelligence , Neural Networks, Computer , ROC Curve , Prospective Studies , Aged , Video Recording , Gastroscopy/methods , Reproducibility of Results , Adult
5.
J Chromatogr A ; 1710: 464417, 2023 Nov 08.
Article in English | MEDLINE | ID: mdl-37778098

ABSTRACT

Liquid chromatography-tandem with high-resolution mass spectrometry (LCHRMS) has proven challenging for annotating multiple small molecules within complex matrices due to the complexities of chemical structure and raw LCHRMS data, as well as limitations in previous literatures and reference spectra related to those molecules. In this study, we developed a molecular networking assisted automatic database screening (MN/auto-DBS) strategy to examine the combined effect of MS1 exact mass screening and MS2 similarity analysis. We compiled all previously reported compounds from the relevant literatures. With the development of a Python software, the in-house database (DB) was created by automatically calculating the m/z and data from experimental MS1 hits were rapid screened with DB. We then performed a feature-based molecular network analysis on the auto-MS2 data for supplementary identification of unreported compounds, including clustered FBMN and annotated GNPS compounds. Finally, the results from both strategies were merged and manually curated for correct structural assignment. To demonstrate the applicability of MN/auto-DBS, we selected the Huangqi-Danshen herb pair (HD), commonly used in prescriptions or patent medicines to treat diabetic nephropathy and cerebrovascular disease. A total of 223 compounds were annotated, including 65 molecules not previously reported in HD, such as aromatic polyketides, coumarins, and diarylheptanoids. Using MN/auto-DBS, we can profile and mine a wide range of complex matrices for potentially new compounds.


Subject(s)
Software , Tandem Mass Spectrometry , Tandem Mass Spectrometry/methods , Chromatography, Liquid , Databases, Chemical , Databases, Factual , Chromatography, High Pressure Liquid/methods
6.
J Am Chem Soc ; 145(38): 20936-20942, 2023 Sep 27.
Article in English | MEDLINE | ID: mdl-37703050

ABSTRACT

The exploration of non-noble metal catalysts for alkane dehydrogenation and their catalytic mechanisms is the priority in catalysis research. Here, we report a high-density coordinatively unsaturated Zn cation (Zncus) catalyst for the direct dehydrogenation (DDH) of ethylbenzene (EB) to styrene (ST). The catalyst demonstrated good catalytic performance (∼40% initial EB conversion rate and >98% ST selectivity) and excellent regeneration ability in the reaction, which is attributed to the high-density (HD) distribution and high-stability structure of Zncus active sites on the surface of zinc silicate (HD-Zncus@ZS). Density functional theory (DFT) calculations further illustrated the reaction pathway and intermediates, supporting that the Zncus sites can efficiently activate the C-H bond of ethyl on ethylbenzene. Developing the high-density Zncus catalyst and exploring the catalytic mechanism laid a good foundation for designing practical non-noble metal catalysts.

8.
BMC Musculoskelet Disord ; 24(1): 683, 2023 Aug 29.
Article in English | MEDLINE | ID: mdl-37644473

ABSTRACT

BACKGROUND: Alignment is indispensable for the foot and ankle function, especially in the hindfoot alignment. In the preoperative planning of patients with varus or valgus deformity, the precise measurement of the hindfoot alignment is important. A new method of photographing and measuring hindfoot alignment based on X-ray was proposed in this study, and it was applied in the assessment of flatfoot. METHODS: This study included 28 patients (40 feet) with flatfeet and 20 volunteers (40 feet) from January to December 2018. The hindfoot alignment shooting stand independently designed by our department was used to take hindfoot alignment X-rays at 10 degree, 15 degree, 20 degree, 25 degree, and 30 degree. We measured the modified tibio-hindfoot angle (THA) at the standard hindfoot aligment position (shooting at 20 degree) and evaluated consistency with the van Dijk method and the modified van Dijk method. In addition, we observed the visibility of the tibiotalar joint space from all imaging data at five projection angles and evaluated the consistency of the modified THA method at different projection angles. The angle of hindfoot valgus of flatfoot patients was measured using the modified THA method. RESULTS: The mean THA in the standard hindfoot aligment view in normal people was significantly different among the three evaluation methods (P < .001). The results from the modified THA method were significantly larger than those from the Van Dijk method (P < .001) and modified Van Dijk method (P < .001). There was no significant difference between the results of the modified THA method and the weightbearing CT (P = .605), and the intra- and intergroup consistency were the highest in the modified THA group. The tibiotalar space in the normal group was visible in all cases at 10 degree, 15 degree, and 20 degree; visible in some cases at 25 degree; and not visible in all cases at 30 degree. In the flatfoot group, the tibiotalar space was visible in all cases at 10 degree, visible in some cases at 15 degree and 20 degree, and not visible in all cases at 25 degree and 30 degree. In the normal group, the modified THA was 4.84 ± 1.81 degree at 10 degree, 4.96 ± 1.77 degree at 15 degree, and 4.94 ± 2.04 degree at 20 degree. No significant differences were found among the three groups (P = .616). In the flatfoot group, the modified THA of 18 feet, which was visible at 10 degree, 15 degree and 20 degree, was 13.58 ± 3.57 degree at 10 degree, 13.62 ± 3.83 degree at 15 degree and 13.38 ± 4.06 degree at 20 degree. There were no significant differences among the three groups (P = .425). CONCLUSIONS: The modified THA evaluation method is simple to use and has high inter- and intragroup consistency. It can be used to evaluate hindfoot alignment. For patients with flatfeet, the 10 degree position view and modified THA measurement can be used to evaluate hindfoot valgus.


Subject(s)
Flatfoot , Humans , Flatfoot/diagnostic imaging , Foot , Radiography , Lower Extremity , Ankle Joint
9.
Dalton Trans ; 52(42): 15484-15488, 2023 Oct 31.
Article in English | MEDLINE | ID: mdl-37526930

ABSTRACT

Wide application of novel materials often requires low-cost preparation methods. In this study, we present a simplified and facile preparation method for the [Ca24Al28O64]4+(e-)4 electride material (C12A7:e-). Successful preparation of the C12A7:e- electride was confirmed by XRD patterns and magnetic behavior analysis. The concentration of electrons in the prepared C12A7:e- powder was calculated to be approximately 2.23 × 1021 cm-3, as evaluated by iodometry and TPD. DFT calculations provided insight into the unique electronic structure of C12A7:e-. Additionally, the substitution of the Ca reductant with CaH2 led to a reduction in the solid-state reaction temperature from 1100 to 950 °C, which can be attributed to thermodynamic effects such as a reduction in ΔG°.

10.
J Am Chem Soc ; 145(34): 18748-18752, 2023 Aug 30.
Article in English | MEDLINE | ID: mdl-37606281

ABSTRACT

In this study, single Ni2 clusters (two Ni atoms bridged by a lattice oxygen) are successfully synthesized on monolayered CuO. They exhibit a remarkable activity toward low-temperature CO2 thermal dissociation, in contrast to cationic Ni atoms that nondissociatively adsorb CO2 and metallic Ni ones that are chemically inert for CO2 adsorption. Density functional theory calculations reveal that the Ni2 clusters can significantly alter the spatial symmetry of their unoccupied frontier orbitals to match the occupied counterpart of the CO2 molecule and enable its low-temperature dissociation. This study may help advance single-cluster catalysis and exploit the unexcavated mechanism for low-temperature CO2 activation.

11.
Sci Rep ; 13(1): 11422, 2023 Jul 14.
Article in English | MEDLINE | ID: mdl-37452105

ABSTRACT

Orthorhombic Ca2CO4 is a recently discovered orthocarbonate whose high-pressure physical properties are critical for understanding the deep carbon cycle. Here, we study the structure, elastic and seismic properties of Ca2CO4-Pnma at 20-140 GPa using first-principles calculations, and compare them with the results of CaCO3 polymorphs. The results show that the structural parameters of Ca2CO4-Pnma are in good agreement with the experimental results. It could be the potential host of carbon in the Earth's mantle subduction slab, and its low wave velocity and small anisotropy may be the reason why it cannot be detected in seismic observation. The thermodynamic properties of Ca2CO4-Pnma at high temperature and high pressure are obtained using the quasi-harmonic approximation method. This study is helpful in understanding the behavior of Ca-carbonate in the Earth's lower mantle conditions.


Subject(s)
Carbon Cycle , Carbon , Physical Phenomena , Thermodynamics , Anisotropy
12.
Phytochem Anal ; 34(5): 560-570, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37202874

ABSTRACT

INTRODUCTION: Lanqin Oral Liquid (LQL) is a traditional Chinese medicine preparation (TCMP) containing five herbal medicines and has been commonly used for the treatment of pharyngitis and hand-foot-and-mouth disease in clinic. The material basis of LQL has been reported in our previous study, but the contents of the major components and the features of saccharide in LQL are still unclear. OBJECTIVES: This study aimed to establish accurate and rapid methods for the quantification of the major components and profiling of saccharide in LQL. The quantitative results combined with similarity evaluation were applied to improve the quality control of LQL. METHODOLOGY: An ultra-high performance liquid chromatography coupled with triple-quadrupole tandem mass spectrometry (UPLC-QQQ-MS) method was utilised to determine 44 major components. Cosine similarity was used to evaluate the similarities among 20 batches of LQL based on the quantitative results of 44 major components. The physicochemical properties, structure, composition, and contents of saccharide in LQL were detected by a combination of chemical and instrumental analysis. RESULTS: A total of 44 compounds, including flavonoids, iridoid glycosides, alkaloids, and nucleosides, were accurately determined. The 20 batches of LQL were remarkably similar (> 0.95). In addition, d-glucose, galactose, d-glucuronic acid, arabinose, and d-mannose were detected in saccharide of LQL. The contents of saccharide in LQL were 13.52-21.09 mg/ml. CONCLUSIONS: The established methods can be applied for the comprehensive quality control of LQL, including characterisation of saccharide and quantification of representative components. Our study will provide a robust chemical foundation for disclosing the quality markers of its therapeutic effect.


Subject(s)
Drugs, Chinese Herbal , Drugs, Chinese Herbal/chemistry , Medicine, Chinese Traditional , Tandem Mass Spectrometry/methods , Flavonoids/analysis , Quality Control , Chromatography, High Pressure Liquid/methods
13.
Sci Rep ; 13(1): 7057, 2023 Apr 29.
Article in English | MEDLINE | ID: mdl-37120441

ABSTRACT

A two-dimensional phononic crystal sensor model with high-quality factor and excellent sensitivity for sensing acetone solutions and operating at 25-45 kHz is proposed. The model for filling solution cavities is based on reference designs of quasi-crystal and gradient cavity structures. The transmission spectrum of sensor is simulated by the finite element method. High-quality factor of 45,793.06 and sensitivity of 80,166.67 Hz are obtained for the acetone concentration with 1-9.1%, and quality factor of 61,438.09 and sensitivity of 24,400.00 Hz are obtained for the acetone concentration range of 10-100%, which indicated the sensor could still achieve high sensitivity and quality factor at operating frequencies from 25 to 45 kHz. To verify the application of the sensor to sensing other solutions, the sensitivity for sound velocity and density is calculated as 24.61 m-1 and 0.7764 m3/(kg × s), respectively. It indicates the sensor is sensitive to acoustic impedance changes of the solution and equally suitable for sensing other solutions. The simulation results reveal the phononic crystal sensor possessed high-performance in composition capture in pharmaceutical production and petrochemical industry, which can provide theoretical reference for the design of new biochemical sensors for reliable detection of solution concentration.

14.
Angew Chem Int Ed Engl ; 62(13): e202219299, 2023 Mar 20.
Article in English | MEDLINE | ID: mdl-36734471

ABSTRACT

The activation of water molecules in thermal catalysis typically requires high temperatures, representing an obstacle to catalyst development for the low-temperature water-gas shift reaction (WGSR). Plasmonic photocatalysis allows activation of water at low temperatures through the generation of light-induced hot electrons. Herein, we report a layered double hydroxide-derived copper catalyst (LD-Cu) with outstanding performance for the low-temperature photo-driven WGSR. LD-Cu offered a lower activation energy for WGSR to H2 under UV/Vis irradiation (1.4 W cm-2 ) compared to under dark conditions. Detailed experimental studies revealed that highly dispersed Cu nanoparticles created an abundance of hot electrons during light absorption, which promoted *H2 O dissociation and *H combination via a carboxyl pathway, leading to the efficient production of H2 . Results demonstrate the benefits of exploiting plasmonic phenomena in the development of photo-driven low-temperature WGSR catalysts.

15.
ACS Catal ; 13(1): 248-255, 2023 Jan 06.
Article in English | MEDLINE | ID: mdl-36644650

ABSTRACT

The α-haloketones are important precursors for synthetic chemistry and pharmaceutical applications; however, their production relies heavily on traditional synthetic methods via halogenation of ketones that are toxic and environmentally risky. Here, we report a heterogeneous photosynthetic strategy of α-haloketone production from aromatic olefins using copper-modified graphitic carbon nitride (Cu-C3N4) under mild reaction conditions. By employing NiX2 (X = Cl, Br) as the halogen source, a series of α-haloketones can be synthesized using atmospheric air as the oxidant under visible-light irradiation. In comparison with pristine carbon nitride, the addition of Cu as a cocatalyst provides a moderate generation rate of halogen radicals and selective reduction of molecular oxygen into •OOH radicals, thus leading to a high selectivity to α-haloketones. The Cu-C3N4 also exhibits high stability and versatility, rendering it a promising candidate for solar-driven synthetic applications.

16.
Phys Chem Chem Phys ; 25(5): 4313-4322, 2023 Feb 01.
Article in English | MEDLINE | ID: mdl-36688704

ABSTRACT

The carbonization of iron is a very important early phenomenon in the field of heterogeneous catalysis and the petrochemical industry, but the mechanism is still controversial. In this work, the carbonization mechanism and carbonization structure of iron nanoparticles by different carbon sources (CH4, C2H6, C2H4, C2H2) were systematically investigated using the reactive molecular dynamics method. The results show that saturated alkanes are dehydrogenated while adsorbed, but unsaturated olefins and alkynes undergo bond-breaking while adsorbed. The C-H bond is more likely to break than the C-C bond. Hydrocarbons with high carbon content have a strong ability to carbonize Fe nanoparticles under the same conditions. For C2H4 and C2H2, the C atoms generated from dissociation form a large number of long carbon chains intertwined with branched chains and multiple carbon rings. The C2 species formed by C2H2 after complete dehydrogenation diffuse rapidly to the interior of the nanoparticles, releasing the surface active sites and accelerating the carbonization process. Carbon-rich iron carbides (FeCx) with different Fe/C ratios were obtained by carbonization with different carbon sources. In addition, the Fe(110) surface exhibits the strongest carburizing ability. These findings provide systematic insights into the initial stages of metal Fe carburization.

17.
J Am Chem Soc ; 144(40): 18485-18493, 2022 Oct 12.
Article in English | MEDLINE | ID: mdl-36161870

ABSTRACT

The atomically dispersed metal catalyst or single-atom catalyst (SAC) with the utmost metal utilization efficiency shows excellent selectivity toward ethylene compared to the metal nanoparticles catalyst in the acetylene semi-hydrogenation reaction. However, these catalysts normally work at relatively high temperatures. Achieving low-temperature reactivity while preserving high selectivity remains a challenge. To improve the intrinsic reactivity of SACs, rationally tailoring the coordination environments of the first metal atom by coordinating it with a second neighboring metal atom affords an opportunity. Here, we report the fabrication of a dual-atom catalyst (DAC) that features a bonded Pd1-Cu1 atomic pair anchoring on nanodiamond graphene (ND@G). Compared to the single-atom Pd or Cu catalyst, it exhibits increased reactivity at a lower temperature, with 100% acetylene conversion and 92% ethylene selectivity at 110 °C. This work provides a strategy for designing DACs for low-temperature hydrogenation by manipulating the coordination environment of catalytic sites at the atomic level.

18.
ACS Omega ; 7(15): 13290-13298, 2022 Apr 19.
Article in English | MEDLINE | ID: mdl-35474803

ABSTRACT

Electrides, a unique type of compound where electrons act as anions, have a high electron mobility and a low work function, which makes them promising for applications in electronic devices and high-performance catalysts. The discovery of novel electrides and the expansion of the electride family have great significance for their promising applications. Herein, we reported four three-dimensional (3D) electrides by coupling crystal structure database searches and first-principles electronic structure analysis. Subnitrides (Ba3N, LiBa3N, NaBa3N, and Na5Ba3N) containing one-dimensional (1D) [Ba3N]3+ chains are identified as 3D electrides for the first time. The anionic electrons are confined in the 3D interstitial space of Ba3N, LiBa3N, NaBa3N, and Na5Ba3N. Interestingly, with the increase of Na content, the excess electrons of Na5Ba3N play two roles of metallic bonding and anionic electrons. Therefore, the subnitrides containing 1D [Ba3N]3+ chains can be regarded as a new family of 3D electrides, where anionic electrons reside in the 3D interstitial spaces and provide a conduction path. These materials not only are experimentally synthesizable 3D electrides but also are promising to be exfoliated into advanced 1D nanowire materials. Furthermore, our work suggests a discovery strategy of novel electrides based on one parent framework like [Ba3N]3+ chains, which would accelerate the mining of electrides from the crystal structure database.

19.
Chin J Nat Med ; 20(3): 161-176, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35369960

ABSTRACT

Simiao Wan (SMW) is a traditional Chinese formula, including Atractylodis Rhizoma, Achyranthis Bidentatae Radix, Phellodendri Chinensis Cortex and Coicis Semen at the ratio of 1:1:2:2. It can be used to the treatment of diabetes. However, its bioactive compounds and underlying mechanism are unclear. This study aimed to screen the antilipolytic fraction from SMW and investigate its therapeutic mechanisms on hepatic insulin resistance. Different fractions of SMW were prepared by membrane separation combined with macroporous resin and their antilipolytic activities were screened in fasted mice. The effects of 60% ethanol elution (ESMW) on lipolysis were investigated in 3T3-L1 adipocytes stimulated by palmitic acid (PA) and high fat diet (HFD)-fed mice. In our study, ESMW is the bioactive fraction responsible for the antilipolytic activity of SMW and 13 compounds were characterized from ESMW by UHPLC-QTOF-MS/MS. ESMW suppressed protein kinase A (PKA)-hormone-sensitive lipase (HSL) related lipolysis and increased AMP-activated protein kinase (AMPK) phosphorylation in PA challenged 3T3-L1 adipocytes. AMPKα knockdown abolished the inhibitory effects of ESMW on IL-6 and HSL pSer-660, revealing that the antilipolytic and anti-inflammatory activities of ESMW are AMPK dependent. Furthermore, ESMW ameliorated insulin resistance and suppressed lipolysis in HFD-fed mice. It inhibited diacylglycerol accumulation in the liver and inhibited hepatic gluconeogenesis. Conditional medium collected from ESMW-treated 3T3-L1 cells ameliorated insulin action on hepatic gluconeogenesis in liver cells, demonstrating the antilipolytic activity contributed to ESMW beneficial effects on hepatic glucose production. In conclusion, ESMW, as the antilipolytic fraction of SMW, inhibited PKA-HSL related lipolysis by activating AMPK, thus inhibiting diacylglycerol (DAG) accumulation in the liver and thereby improving insulin resistance and hepatic gluconeogenesis.


Subject(s)
Insulin , Lipolysis , AMP-Activated Protein Kinases/metabolism , Animals , Insulin/metabolism , Lipolysis/physiology , Liver/metabolism , Mice , Tandem Mass Spectrometry
20.
BMC Musculoskelet Disord ; 23(1): 79, 2022 Jan 22.
Article in English | MEDLINE | ID: mdl-35065640

ABSTRACT

BACKGROUND: Traditional medial malleolar osteotomy combined with autologous osteochondral transplantation (AOT) is mostly used in the treatment of osteochondral lesions of the talus (OLTs), but with high osteotomy and donor site complications. We hypothesis a new triplane medial malleolar osteotomy combined with AOT from non-weight-bearing area of the talus could be a promising choice for OLTs. METHODS: We reviewed all the symptomatic OLTs patients who received AOT with triplane osteotomy of the medial malleolus between September 2015 and December 2017 in our department. According to the inclusion and exclusion criteria, 23 patients (23 ankles), including 14 males and 9 females, were included in the study. The mean age was 35.6 years. The mean size of the lesion area was 141.5 mm2. According Ferkel's classification, including 5 type I, 11 typeIIa and 7 typeIIb. The visual analog scale (VAS) for pain during walking and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used for the pre- and postoperative evaluations. In addition, the incorporation of the grafts was assessed by computed tomography (CT). RESULTS: All patients had a minimum follow-up of 22 months, with an average of 37.1 months. The mean time from osteotomy to full weight-bearing activity was 8.1 ± 2.3 weeks (range, 5-12 weeks). The mean VAS score improved from 5.6 ± 0.7 preoperatively to 0.7 ± 1.0 postoperatively (P < 0.01). The AOFAS ankle-hindfoot score improved significantly in all domains (P < 0.01). Twenty-one patients returned to sport at their previous level, and 2 returned at a lower level compared with preinjury (mean return to play, 7.4 months). According to CT, the medial malleolus recovered in all patients, and the graft was incorporated well. One patient suffered from flexor hallucis longus tendon discomfort due to internal fixation screw irritation posteromedial to the ankle. The general complication rate was 4.3% (1/23). CONCLUSIONS: These results indicate that AOT combined with medial malleolus triplane osteotomy maybe a viable option for OLTs. Patients could perform weight-bearing exercise and return to sport as early as possible, with a lower rate of complications at the osteotomy site and donor site. However, the large sample well-designed prospective comparative studies are still needed.


Subject(s)
Cartilage, Articular , Talus , Adult , Bone Transplantation , Female , Humans , Male , Osteotomy , Prospective Studies , Retrospective Studies , Talus/diagnostic imaging , Talus/surgery , Transplantation, Autologous
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