A New Intramedulary Locking Plate for the Osteotomy of the V. Metatarsal in the Correction of the Tailors Bunion. Midterm Results of 21 Patients

Background: Since we are very successful in the operation of hallux valgus using a transverse sub-capital osteotomy fixated with an intramedullary angle-stable locking plate, and a tailors bunion is understood as a reversed hallux valgus, we have applied the operation also for such indication. Method: The osteotomy was carried out at a straight V. metatarsal subcapitally, and in case of an outwardly curved V. metatarsal at the bending location. The intramedullary plates are available in different designs and the plate and screws disappear completely in the bone, so the soft tissues are not disturbed. The head of the plate is either straight or curved in order to shift the distal fragment sufficiently. Results: 26 patients were operated within a period of 5 years (2008-2012). 21 patients were followed up after an average of 34.4 months. The IM angle IV/V could be improved by an average of 11.76 to an average of 4.10. This is a highliy significant pre- to postoperative difference of 7.66 (t = 15.07, p < 0.001). The AOFAS score was improved by an average of 42.24 points from 55.76 points preoperatively to 98.00 points postoperative. There was no pseudo-arthrosis and no wound healing impairment. All patients were either satisfied or very satisfied with the surgery. Conclusion: This method does not have the disadvantages of the other common operations of the Tailors bunion and is applied now as a standard method in this deformity.

Atomically Substitutional Engineering of Transition Metal Dichalcogenide Layers for Enhancing Tailored Properties and Superior Applications

Transition metal dichalcogenides(TMDs)are a promising class of layered materials in the post-graphene era,with extensive research attention due to their diverse alternative elements and fascinating semiconductor behavior.Binary MX2 layers with different metal and/or chalcogen elements have similar structural parameters but varied optoelectronic properties,providing opportunities for atomically substitutional engineering via partial alteration of metal or/and chalcogenide atoms to produce ternary or quaternary TMDs.The resulting multinary TMD layers still maintain structural integrity and homogeneity while achieving tunable(opto)electronic properties across a full range of composition with arbitrary ratios of introduced metal or chalcogen to original counterparts(0–100%).Atomic substitution in TMD layers offers new adjustable degrees of freedom for tailoring crystal phase,band alignment/structure,carrier density,and surface reactive activity,enabling novel and promising applications.This review comprehensively elaborates on atomically substitutional engineering in TMD layers,including theoretical foundations,synthetic strategies,tailored properties,and superior applications.The emerging type of ternary TMDs,Janus TMDs,is presented specifically to highlight their typical compounds,fabrication methods,and potential applications.Finally,opportunities and challenges for further development of multinary TMDs are envisioned to expedite the evolution of this pivotal field.

Tailoring Iron-Ion Release of Cellulose-Based Aerogel-Coated Iron Foam for Long-Term High-Power Microbial Fuel Cells

The presence of iron(Fe) has been found to favor power generation in microbial fuel cells(MFCs). To achieve long-term power production in MFCs, it is crucial to effectively tailor the release of Fe ions over extended operating periods. In this study, we developed a composite anode(A/IF) by coating iron foam with cellulose-based aerogel. The concentration of Fe ions in the anode solution of A/IF anode reaches 0.280 μg/mL(Fe^(2+) vs. Fe^(3+) = 61%:39%) after 720 h of aseptic primary cell operation. This value was significantly higher than that(0.198 μg/mL, Fe^(2+) vs. Fe^(3+) = 92%:8%) on uncoated iron foam(IF), indicating a continuous release of Fe ions over long-term operation. Notably, the resulting MFCs hybrid cell exhibited a 23% reduction in Fe ion concentration(compared to a 47% reduction for the IF anode) during the sixth testing cycle(600-720 h). It achieved a high-power density of 301 ± 55 mW/m^(2) at 720 h, which was 2.62 times higher than that of the IF anode during the same period. Furthermore, a sedimentary microbial fuel cell(SMFCs) was constructed in a marine environment, and the A/IF anode demonstrated a power density of 103 ± 3 mW/m^(2) at 3240 h, representing a 75% improvement over the IF anode. These findings elucidate the significant enhancement in long-term power production performance of MFCs achieved through effective tailoring of Fe ions release during operation.

Autoimmune hepatitis:Towards a personalized treatment

Autoimmune hepatitis is an uncommon condition that affects both adults and children and is characterized by chronic and recurrent inflammatory activity in the liver.This inflammation is accompanied by elevated IgG and autoantibody levels.Historically,treatment consists of steroids with the addition of azathioprine,which results in remission in approximately 80%of patients.Despite significant advancements in our understanding of the immune system over the past two decades,few modifications have been made to treatment algorithms,which have remained largely unchanged since they were first proposed more than 40 years ago.This review summarized the various treatment options currently available as well as our experiences using them.Although steroids are the standard treatment for induction therapy,other medications may be considered.Cyclosporin A,a calcineurin inhibitor that decreases T cell activation,has proven effective for induction of remission,but its long-term side effects limit its appeal for maintenance.Tacrolimus,a drug belonging to the same family,has been used in patients with refractory diseases with fewer side effects.Sirolimus and everolimus have interesting effects on regulatory T cell populations and may become viable options in the future.Mycophenolate mofetil is not effective for induction but is a valid alternative for patients who are intolerant to azathioprine.B celldepleting drugs,such as rituximab and belimumab,have been successfully used in refractory cases and are useful in both the short and long term.Other promising treatments include anti-tumor necrosis factors,Janus kinases inhibitors,and chimeric antigen receptor T cell therapy.This growing armamentarium allows us to imagine a more tailored approach to the treatment of autoimmune hepatitis in the near future.

Correction method for moderate and severe degrees of hallux valgus associated with transfer metatarsalgia

BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a deformity that is charac-terized by the involvement of lesser rays and requires complex surgical treatment.In this study,we attempted to develop a procedure for this condition.AIM To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot deformity.METHODS We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated problems.This method included a modified Lapidus procedure,M2M3 tarsometatarsal arthrodesis,intermetatarsal fusion of the M4 and M5 bases,and the use of an original external fixation apparatus to enhance correction power.Preoperative,postoperative,and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society(AOFAS)scores were compared,and P values<0.05 were considered to indicate statistical significance.RESULTS The study included 28 females(93.3%)and 2 males feet(6.7%),20(66.7%)of whom had a moderate degree of HV and 10(33.3%)of whom had severe deformity.M2 and M3 metatarsalgia was observed in 21 feet,and 9 feet experienced pain only at M2.The mean follow-up duration was 11 months.All patients had good correction of the HV angle[preoperative median,36.5 degrees,interquartile range(IQR):30-45;postoperative median,10 degrees,IQR:8.8-10;follow-up median,11.5 degrees,IQR:10-14;P<0.01].At follow-up,metatarsalgia was resolved in most patients(30 vs 5).There was a clinically negligible decrease in the corrected angles at the final follow-up,and the overall AOFAS score was significantly better(median,65 points,IQR:53.8-70;vs 80 points,IQR:75-85;P<0.01).CONCLUSION The developed method showed good sustainability of correction power in a small sample of patients at the one-year follow-up.Randomized clinical trials with larger samples,as well as long-term outcome assessments,are needed in the future.

基于增量方法的均匀B样条曲线快速生成算法

E-mail:hfgdhbt@163.com摘要论文在分析函数的Tailor级数展开后,给出了一种基于增量方法的均匀B样条曲线的生成算法。该算法在初始化后,只用到加法运算,效率极高。该算法还可推广到非均匀B曲线曲面的生成,具有广泛的应用价值。

SJM Tailor环三尖瓣成形术治疗三尖瓣关闭不全

目的探讨使用SJM Tailor环行三尖瓣成形术治疗风湿性瓣膜病合并功能性三尖瓣关闭不全的疗效。方法从2007年6月到2011年4月共使用SJM Tailor环行三尖瓣成形术治疗27例风湿性瓣膜病合并的三尖瓣关闭不全的患者，对其进行回顾性分析。结果全组患者围手术期无死亡，术后恢复顺利，三尖瓣返流程度明显减轻，术后心功能分级较术前提高Ⅰ～Ⅱ级。结论SJM Tailor环行三尖瓣成形术治疗风湿性瓣膜病合并的功能性三尖瓣关闭不全，安全有效，近中期效果满意。

基于Tailor基数的B样条曲线节点插入快速生成算法

通过对Tailor级数展开的分析,给出了一种三次均匀B样条曲线节点插入的生成算法.与Oslo算法的递推过程相比,本算法大大简化了运算过程,有效地提高了算法的生成效率.

关于席瓦尔兹引理的推广

推广了席瓦尔兹引理到原点为函数 f( z)的λ重零点 。

应用增量法生成非均匀B样条曲线曲面

应用基于展开的增量法生成非均匀B样条曲线曲面以及NURBS曲线,给出一个较简单高效的算法.此算法仅在初始化时进行乘除运算而后均为加法迭代,相较于deBoor算法效率更高.

一种基于节点插入技术的B样条曲线平滑方法

三次均匀B样条曲线是工程上广泛采用的曲线绘制方法。提高节点插入算法的效率,实现B样条曲线的平滑效果,是广大学者所关注的问题。文章给出了一种基于Tailor级数展开的三次均匀B样条曲线节点插入的生成算法,并利用该算法提供的节点插入技术来实现三次均匀B样条曲线的平滑效果。与Oslo算法的递推过程相比,该节点插入算法在一定程度上简化了运算过程,提高了算法的生成效率。

律师工作成果豁免原则评介

证据开示是为了避免诉讼突袭而设计的一种制度,但在运作过程中却出现了种种与其初衷相反的结果,为了平衡证据开示制度所要追求的价值目标,各国对该制度都进行了一系列的修正和完善,律师工作成果豁免原则就是其中一项非常重要的制度。在构建适合我国国情的证据开示制度时也应充分吸收律师工作成果豁免原则的合理内核,使得我们的证据开示制度更加的科学和合理。

Efficacy of tailored Helicobacter pylori eradication therapy based on antibiotic susceptibility and CYP2C19 genotype

The cure rates of Helicobacter pylori (H. pylori) eradication therapy using a proton pump inhibitor (PPI) and antimicrobial agents such as amoxicillin, clarithromycin, and metronidazole are mainly influenced by bacterial susceptibility to antimicrobial agents and the magnitude of the inhibition of acid secretion. Annual cure rates have gradually decreased because of the increased prevalence of H. pylori strains resistant to antimicrobial agents, especially to clarithromycin. Alternative regimens have therefore been developed incorporating different antimicrobial agents. Further, standard PPI therapy (twice-daily dosing) often fails to induce a long-term increase in intragastric pH &#x0003e; 4.0. Increasing the eradication rate requires more frequent and higher doses of PPIs. Therapeutic efficacy related to acid secretion is influenced by genetic factors such as variants of the genes encoding drug-metabolizing enzymes (e.g., cytochrome P450 2C19, CYP2C19), drug transporters (e.g., multidrug resistance protein-1; ABCB1), and inflammatory cytokines (e.g., interleukin-1&#x003b2;). For example, quadruple daily administration of PPI therapy potently inhibits acid secretion within 24 h, irrespective of CYP2C19 genotype. Therefore, tailored H. pylori eradication regimens that address acid secretion and employ optimal antimicrobial agents based on results of antimicrobial agent-susceptibility testing may prove effective in attaining higher eradication rates.

Study of residual stresses in tailor rolled blanked Al5J32-T4 sheets

Several automotive parts such as door panels have been manufactured by using load-adapted blanks for crash optimization and weight minimization. Recently, Tailor Rolled Blanks (TRB) has been introduced to remove the disadvantages of a welding process which was used in joining panel components. TRB offers better structural design capabilities due to the seamless transitions on the panels with different thicknesses. In spite of the advantages of the process, TRB leaves internal stresses in the panel. This residual stresses lower the formability of Tailor Rolled Blanked (TRBed) parts and cause cracks near severe curvature during subsequent forming processes. In this research, the residual stresses of TRBed Al5J32-T4 sheets were studied by X-ray stress analysis, and also microstructure was observed along the rolling direction. In addition, heat treatment was done after TRB process in order to compare the residual stresses to that of the TRBed sheets before the heat treatment.

3D printing of calcium phosphate bioceramic with tailored biodegradation rate for skull bone tissue reconstruction

The bone regenerative scaffold with the tailored degradation rate matching with the growth rate of the new bone is essential for adolescent bone repair.To satisfy these requirement,we proposed bone tissue scaffolds with controlled degradation rate using osteoinductive materials(Ca-P bioceramics),which is expected to present a controllable biodegradation rate for patients who need bone regeneration.Physicochemical properties,porosity,compressive strength and degradation properties of the scaffolds were studied.3D printed Ca-P scaffold(3DS),gas foaming Ca-P scaffold(FS)and autogenous bone(AB)were used in vivo for personalized beagle skull defect repair.Histological results indicated that the 3DS was highly vascularized and well combined with surrounding tissues.FS showed obvious newly formed bone tissues.AB showed the best repair effect,but it was found that AB scaffolds were partially absorbed and degraded.This study indicated that the 3D printed Ca-P bioceramics with tailored biodegradation rate is a promising candidate for personalized skull bone tissue reconstruction.

Feasibility and nutritional impact of laparoscopic assisted tailored subtotal gastrectomy for middle-third gastric cancer

BACKGROUND Laparoscopic assisted total gastrectomy(LaTG)is associated with reduced nutritional status,and the procedure is not easily carried out without extensive expertise.A small remnant stomach after near-total gastrectomy confers no significant nutritional benefits over total gastrectomy.In this study,we developed a modified laparoscopic subtotal gastrectomy procedure,termed laparoscopicassisted tailored subtotal gastrectomy(LaTSG).AIM To evaluate the feasibility and nutritional impact of LaTSG compared to those of LaTG in patients with advanced middle-third gastric cancer(GC).METHODS We retrospectively analyzed surgical and oncological outcomes and postoperative nutritional status in 92 consecutive patients with middle-third GC who underwent radical laparoscopic gastrectomy at Department of Pancreatic Stomach Surgery,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,and Peking Union Medical College between 2013 and 2017.Of these 92 patients,47 underwent LaTSG(LaTSG group),and the remaining underwent LaTG(LaTG group).RESULTS Operation time(210±49.8 min vs 208±50.0 min,P>0.05)and intraoperative blood loss(152.3±166.1 mL vs 188.9±167.8 mL,P>0.05)were similar between the groups.The incidence of postoperative morbidities was lower in the LaTSG group than in the LaTG group(4.2%vs 17.8%,P<0.05).Postoperatively,nutritional indices did not significantly differ,until postoperative 12 mo.Albumin,prealbumin,total protein,hemoglobin levels,and red blood cell counts were significantly higher in the LaTSG group than in the LaTG group(P<0.05).No significant differences in Fe or C-reaction protein levels were found between the two groups.Endoscopic examination demonstrated that reflux oesophagitis was more common in the LaTG group(0%vs 11.1%,P<0.05).Kaplan–Meier analysis showed a significant improvement in the overall survival(OS)and disease free survival(DFS)in the LaTSG group.Multivariate analysis showed that LaTSG was an independent prognostic factor for OS(P=0.048)but not for DFS(P=0.054).Subgroup analysis showed that compared to LaTG,LaTSG improved the survival of patients with stage III cancers,but not for other stages.CONCLUSION For advanced GC involving the middle third stomach,LaTSG can be a good option with reduced morbidity and favorable nutritional status and oncological outcomes.

Surface-tailored PtPdCu ultrathin nanowires as advanced electrocatalysts for ethanol oxidation and oxygen reduction reaction in direct ethanol fuel cell

The development of advanced electrocatalysts for efficient catalyzing ethanol oxidation reaction(EOR)and oxygen reduction reaction(ORR) is significant for direct ethanol fuel cells(DEFCs).However,in many previous studies,the major difficulties including lower utilization efficiency and weaker anti-CO-poison ability of Pt hamper the practical testing of such DEFCs,Herein,ternary Pt22Pd27C51 ultrathin(~5 nm)NWs are fabricated via a facile surfactant-free strategy.The surface and electronic structures of Pt22Pd27Cu51 NWs are further tailored via acid-etching treatment.The resulted PtPdCu NWs with an optimal atomic Pt/Pd/Cu ratio of 36:41:23 display excellent specific activities towards EOR(4.38 mA/cm^(2))and ORR(1.16 mA/cm^(2)),which are 19.8-and 5.7-folds larger than that of Pt/C,respectively.A singlecell was fabricated using Pt36Pd41Cu23 NWs as electrocatalyst in both anode and cathode with Pt loading of 1.2 mgpt/cm^(2).The power density measured at 80 ℃ is 21.7 mW/cm^(2),which is ~3.9 folds enhancement relative to that fabricated by using Pt/C(2 mgPt/cm^(2)).The enhanced catalytic performance of Pt36Pd41Cu23NWs could be attributed to that synergistic effect between Pt,Pd and Cu enhances CO anti-poisoning ability and promotes the C-C bond cleavage.This work provides a promising strategy for developing efficient electrocatalysts for DEFCs.

Noninvasive molecular analysis of Helicobacter pylori : Is it time for tailored first-line therapy?

The main problem of Helicobacter pylori(H. pylori) infection management is linked to antibiotic resistances. This phenomenon has grown in the last decade, inducing a dramatic decline in conventional regimen effectiveness. The causes of resistance are point mutations in bacterial DNA, which interfere with antibiotic mechanism of action, especially clarithromycin and levofloxacin. Therefore, international guidelines have recently discouraged their use in areas with a relevant resistance percentage, suggesting first-line schedules with expected high eradication rates, i.e., bismuth containing or non-bismuth quadruple therapies. These regimens require the daily assumption of a large number of tablets. Consequently, a complete adherence is expected only in subjects who may be motivated by the presence of major disorders. However, an incomplete adherence to antibiotic therapies may lead to resistance onset, since sub-inhibitory concentrations could stimulate the selection of resistant mutants. Of note, a recent meta-analysis suggests that susceptibility tests may be more useful for the choice of first than second-line or rescue treatment. Additionally, susceptibility guided therapy has been demonstrated to be highly effective and superior to empiric treatments by both meta-analyses and recent clinical studies. Conventional susceptibility test is represented by culture and antibiogram. However, the method is not available everywhere mainly for methodology-related factors and fails to detect hetero-resistances. Polymerase chain reaction(PCR)-based, culture-free techniques on gastric biopsy samples are accurate in finding even minimal traces of genotypic resistant strains and hetero-resistant status by the identification of specific point mutations. The need for an invasive endoscopic procedure has been the most important limit to their spread. A further step has, moreover, been the detection of point mutations in bacterial DNA fecal samples. Few studies on clarithromycin susceptibility have shown an overall high sensitivity and specificity when compared with culture or PCR on gastric biopsies. On these bases, two commercial tests are now available although they have shown some controversial findings. A novel PCR method showed a full concordance between tissue and stool results in a preliminary experience. In conclusion, despite poor validation, there is increasing evidence of a potential availability of noninvasive investigations able to detect H. pylori resistances to antibiotics. These kinds of analysis are currently at a very early phase of development and caution should be paid about their clinical application. Only further studies aimed to evaluate their sensitivity and specificity will afford novel data for solid considerations. Nevertheless, noninvasive molecular tests may improve patient compliance, time/cost of infection management and therapeutic outcome. Moreover, the potential risk of a future increase of resistance to quadruple regimens as a consequence of their use on large scale and incomplete patient adherence could be avoided.

Ostensibly perpetual optical data storage in glass with ultra-high stability and tailored photoluminescence

Long-term optical data storage(ODS)technology is essential to break the bottleneck of high energy consumption for information storage in the current era of big data.Here,ODS with an ultralong lifetime of 2×10^(7)years is attained with single ultrafast laser pulse induced reduction of Eu^(3+)ions and tailoring of optical properties inside the Eu-doped aluminosilicate glasses.We demonstrate that the induced local modifications in the glass can stand against the temperature of up to 970 K and strong ultraviolet light irradiation with the power density of 100 kW/cm^(2).Furthermore,the active ions of Eu^(2+)exhibit strong and broadband emission with the full width at half maximum reaching 190 nm,and the photoluminescence(PL)is flexibly tunable in the whole visible region by regulating the alkaline earth metal ions in the glasses.The developed technology and materials will be of great significance in photonic applications such as long-term ODS.

Implications of clinical research on adjuvant chemotherapy for gastric cancer: Where to go next?

Postoperative adjuvant chemotherapy(ACT)confers superior gastric cancer(GC)survival in the Eastern cohort.However,is the current standard of ACT already excessive,or is it still necessary to increase its intensity for specific subgroups?Tailored ACT strategies for GC depend on gradual exploration by clinical trials in selected patients.Thus,understanding the implications of previous and current research can help us respond wisely and design effective,rational trials,save medical resources and make better decisions in clinical practice.After reviewing and analyzing studies on ACT for GC patients undergoing curative resection,we found that research strategies for conducting"addition""ACT for specific stages of the disease have achieved great progress in making ACT more tailored and personalized in consideration of pathology stages.Furthermore,trials indicate that"addition"ACT strategies for GC patient subgroups based on histological characteristics might be helpful to move toward a more specific tailored and personalized management approach.Designing ACT research focused on different node statuses should also be conducted according to the biological specificity of lymph node(LN)metastasis.Therefore,future trials designed to determine tailored treatment based on histological and biological characteristics for specific subgroups are urgently needed and conducted as the theme of the 2019 American Society of Clinical Oncology(ASCO):Caring for Every Patient,Learning from Every Patient.