MODIFICATION OF MULTI-WALLED CARBON NANOTUBES WITH POLY(NITRILOETHYLENENITRILOVINYLENE)“GRAFTING TO”THE SURFACE

A mild and facile way was used to prepare poly(nitriloethylenenitrilovinylene)-grafted multi-walled carbon nanotubes(MWCNTs-g-PNENV)nanocomposites via the"grafting to"method.The MWCNTs-g-PNENV nanocomposites are well dispersible in polar solvents such as water,tetrahydrofuran and ethanol.Chemical structure of the resulting product was characterized by Fourier transform infrared(FTIR)spectroscopy,transmission electron microscopy(TEM)and thermal gravimetric analysis(TGA).FTIR showed that the"grafting to"process belonged to covalent attachment mechanisms.TEM observations indicated that the MWCNTs were coated with a uniform PNENV layer,and the MWCNTs existed as a hard backbone.TGA data also showed that the PNENV shell was successfully grafted to the side wall of MWCNTs.

Autologous scalp skin grafting to treat toxic epidermal necrolysis in a patient with a large skin injury:A case report

BACKGROUND Toxic epidermal necrolysis(TEN)is often associated with skin wounds affecting large areas.Healing of this type of wound is difficult because of pressure,infection and other factors.It can increase the length of hospital stay and result in wound sepsis and even death.CASE SUMMARY A 49-year-old woman developed a skin lesion covering 80%of the total body surface area after using a kind of Chinese medicinal ointment on a burn wound on her back;she developed life-threatening wound sepsis and septic shock.Methicillin-resistant Staphylococcus aureus,carbapenem-resistant Acinetobacter baumannii,carbapenem-resistant Pseudomonas aeruginosa and other bacteria were cultured from wound tissue,deep venous catheter and blood samples.Imipenem cilastatin sodium,tigecycline and teicoplanin were used for anti-infection therapy.Finally,the patient was transferred to the burn department because of severe wound sepsis.In the burn intensive care unit,pain-free dressing changes and autologous scalp skin grafting were performed to heal the wound in addition to reasonable and effective antibacterial treatment according to microbial susceptibility test results.After three operations within 2 wk,the wound healed and sepsis resolved.CONCLUSION TEN patients with large areas of skin injury may develop wound infection and life-threatening wound sepsis.Autologous scalp skin grafting may be beneficial for rapid wound healing and reducing the risk of sepsis in TEN patients,and it leaves no scar at the donor site.

Comparison of Chromatographic Performance for L-Phenylalanine-Derived Organic Phases on Silica by “Grafting from” and “Grafting to” Strategies

L-phenylalanine-derived polymerizable organogel, N’-octadecyl-Nα-(4-vinyl)-benzoyl-L-phenylalanineami- de (4) has been prepared according to the procedure described elsewhere. Compound 4 was successfully polymerized by surface initiated atom transfer radical polymerization (ATRP) from the initiator grafted silica particles (sil-poly4). It was also telomerized with 3-mercaptopropyltrimethoxysilane (MPS) and the telomer (T4) was grafted on to silica (sil-T4). TGA and elemental analysis measurement revealed that higher amount of polymer can graft by ATRP process than that of “grafting to” strategy. The results of 13C CP/MAS NMR measurement showed that the N-alkyl chain of the grafted polymers for both sil-poly4 and sil-T4 remained as less ordered gauche conformational form on silica surface and no inversion to trans form was occurred until temperature is increased up to 50?C. The retention of alkylbenzene samples showed that sil-poly4 prepared by “grafting from” method yielded extremely higher retention than conventional C18 phase however, sil-T4 prepared by conventional “grafting to” method showed lower retention than C18 phase. Aspects of molecular recognition were evaluated by the retention studies of a series of polycyclic aromatic hydrocarbons (PAHs) and aromatic positional isomers. We have observed sil-T4 yielded slightly higher selectivity for PAHs than sil-poly4 regardless the fact that it has low surface coverage and lower hydrophobic interactions. The enhanced selectivity observed for sil-T4 than C18 phases and sil-poly4 can be explained by the π - π interactions between the guest PAHs and carbonyl groups present in the polymer chain. In addition the aromatic moieties of compound 4 that aggregates through π - π interactions also contribute to the separation of PAHs for both sil-poly4 and sil-T4. The minimal π - π interactions between the carbonyl groups and guest molecules for sil-poly4 probably due to the presence of long chain initiator which restrict the polymer to form order thin layer over silica surface.

Anesthesia for bronchoscopic amniotic membrane grafting to treat non-healing bronchial dehiscence

Airway complications after lung transplantation remain a significant cause of morbidity and mortality. Many of these occur at the anastomotic sites, which are susceptible due to poor collateral circulation. Of the possible complications, bronchial dehiscence is particularly formidable. These cases have been successfully treated bronchoscopically with metallic stents, which likely promote healing through granulation tissue formation. However, limited options exist in cases where the dehiscence fails to heal following stent placement. Here, we present the case report of a 65-year-old male who developed bronchial dehiscence status post bilateral lung transplantation for idiopathic pulmonary fibrosis that failed to heal with simple stent placement. Eventually, the patient underwent amniotic membrane grafting with stenting as a novel therapy for non-healing bronchial dehiscence, for which we describe the anesthetic management. His anesthetic plan included inhalational induction with sevoflurane, propofol infusion for total intravenous anesthesia, rocuronium for muscle relaxation, and closed-circuit assisted ventilation. His existing tracheostomy was used as the airway for oxygenation and induction. In summary, our anesthetic plan for the lung transplant patient was effective; future amniotic membrane grafting for bronchial dehiscence through bronchoscopy may follow a similar technique. Ultimately, the choice of anesthesia in this patient population requires judicious consideration of the requirements of the procedure as well as the pathophysiology of the transplanted lung.

A novel strategy to enhance resistance to Cucumber mosaic virus in tomato by grafting to transgenic rootstocks

Cucumber mosaic virus（CMV） can infect a wide range of host species. For the lacking of CMV resistant varieties of tomato, RNA interference（RNAi） can be used as a fast and effective method for the generation of transgenic resistant varieties. In this current study, five intron-spliced hairpin RNA（ihp RNA） plant expression vectors aimed at five genes of CMV have been constructed. Transgenic tomatoes were obtained by Agrobacterium tumefaciens-mediated transformation with expression vectors. Highly resistant generations of transgenic plants were employed as rootstocks and grafted onto non-transgenic tomatoes that resulted in the successful transfer of resistance to the scions. Using a novel method of plant cuttings for rootstock propagation, we obtained large quantities of disease-resistant material. Further, this method produces scions that can remain undetectable for transgenic resistance marker genes that may provide novel approaches to evade collective concerns about genetically-modified organism（GMO） biosafety.

Clinical effect of botulinum toxin type A combined with autologous fat grafting in patients with nasolabial fold depression

BACKGROUND Nasolabial fold(NLF)depression can affect the facial appearance of patients to some extent and increase their psychological burdens.In recent years,autologous fat grafting(AFG)combined with botulinum toxin A(BTX-A)injection(AFG+BTX-A injection)has been gradually applied in the treatment of patients with NLF depression.Although studies have been conducted on the efficacy and safety of AFG+BTX-A injection in treating NLF depression,the experimental design,observational indicators,and sample enrollment criteria vary remarkably,making it difficult to draw convincing and consistent conclusions.Thus,further relevant research is warranted.AIM To assess the esthetic improvement,efficacy,and safety of AFG+BTX-A injections in patients with NLF depression.METHODS This study included 60 patients with NLF depression who were treated in our hospital from February 2019 to April 2021.These patients were categorized into control(n=30)and observation(n=30)groups.The observation group received AFG+BTX-A injection,whereas the control group underwent AFG only.All patients were evaluated using the wrinkle severity rating scale(WSRS)and global aesthetic improvement scale.The compactness of facial contours,skin evaluation indexes,adverse reactions,and satisfaction of the two groups were evaluated 3 months postoperatively.RESULTS The WSRS scores of the observation group at 1,3,and 6 months postoperatively were lower than those of the control group(P<0.05).Three months postoperatively,facial fine lines and pores showed obvious improvement and the skin index score was higher in the observation group than in the control group(P<0.05).The compactness of facial contours was better in the observation group than in the control group(P<0.05).In addition,no remarkable differences were noted in the incidence of postoperative adverse reactions such as facial stiffness,facial asymmetry,facial bruising,and facial concavity inequality(P>0.05).CONCLUSION AFG+BTX-A injection is a highly safe,cost-effective,effective,and long-lasting treatment for NLF depression with high esthetic value,which should be promoted in the future.

Implications of Elevated Serum Cortisol in the Onset of Postoperative Delirium Following Off-Pump Coronary Artery Bypass Grafting: Insights from a Bangladesh-Based Single Center Experience

Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CABG. Methods: Conducted in the Department of Cardiac Surgery at BSMMU from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CABG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group B (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the Richmond Agitation Sedation score (RASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. Results: Group-A had a mean age of 54.50 ± 17.97, and Group-B had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group B (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group B patients, statistically significant compared to the 4.5% in Group A. However, patients in Group B who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group B, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period and the occurrence of postoperative delirium after off-pump coronary artery bypass grafting.

Grafting effects on bioactive compounds,chemical and agronomic traits of‘Corbarino’tomato grown under greenhouse healthy conditions

In tomatoes,grafting onto resistant rootstocks represents an effective strategy to control several soil-borne diseases that reduce crop profitability,especially for landraceswith little or no resistance tomultiple pathogens/pests.In this study,the high-value‘Corbarino’tomato landrace was grafted onto seven commercial Solanum interspecific rootstocks to evaluate graft compatibility,yield performance,and qualitative characteristics under greenhouse healthy conditions.Three rootstocks were themost effective in improving fruit yield without negatively affecting the carpometric,technological,and health-related traits of the traditional tomato.‘Dinafort’rootstock increased fresh and dry yield,harvest index,and fruit/clusters,while mean fruit weight,shape index,total and soluble solid content,simple sugars,organic acids,flavonoids,ascorbic acid,and trans-lycopene content did not differ with respect to the ungrafted‘Corbarino’.‘Interpro’rootstock also showed promising results for the overall yield and quality traits,although it reduced the trans-lycopene content in the fruit.‘Silex’rootstock showed the highest harvest index as result of decreased vigour.The fruit quality induced by‘Silex’was satisfactory and high levels of simple sugars,flavonoids,ascorbic acid,and trans-lycopene were also observed.However,graft success,especially for‘Dinafort’and‘Silex’,needs to be improved by investigating more suitable methods for seedling production,grafting,acclimatization,etc.

“Grafting from”法制备高载量大孔弱阳离子交换层析介质

针对大孔聚合物层析介质孔径大、比表面积低而导致的蛋白结合容量低的问题,采用“graftingfrom”策略,以大孔聚丙烯酸酯微球为基质,通过氧化还原引发甲基丙烯酸在微球表面接枝聚合,制备了高载量弱阳离子交换层析介质.研究了单体浓度、过硫酸钾浓度及反应温度等因素对蛋白结合容量的影响.所得介质的蛋白静态结合容量和动态结合容量分别达到252.21和157.25mg/mL;同时发现具有一定离子交换容量的该类介质能够在0.2 mol/L NaCl缓冲液中保持100 mg/mL的蛋白结合容量.将该层析介质用于鸡卵清中溶菌酶的纯化,获得了较高的纯化效率.

Coupling Agent Grafting Assisted Synthesis of C3N4-ZrO_(2) Heterojunction Composites with Enhanced Photocatalytic Performance

Heterojunction composites were prepared by silane coupling agent grafting from synthesized graphitic carbon nitride(g-C_(3)N_(4))and commercially available zirconia(ZrO_(2)).The samples were characterized by X-ray diffraction(XRD),scanning electron microscopy(SEM),Fourier transform infrared(FT-IR)spectroscopy,UV-vis diffuse reflectance spectroscopy(DRS),photoluminescence(PL)spectroscopy,and electrochemical impedance spectroscopy(EIS).The photocatalytic activity of the composites was evaluated by the degradation of methylene blue(MB)under visible light irradiation.The results showed that heterojunction composites of g-C_(3)N_(4) and ZrO_(2) could be successfully prepared by coupling agent grafting.The optimal mass ratio of g-C_(3)N_(4) and ZrO_(2) was 2:1,with an activity that was 3.8 times higher than g-C_(3)N_(4) and 15.3 times higher than ZrO_(2).This was ascribed to the stronger light absorption,faster interfacial charge transfer,and lower photogenerated carrier recombination of the heterojunction composites.

Using Magnesium Sulfate to Prevent Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery: A Single Centre Experience in Bangladesh

Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preventing postoperative atrial fibrillation. This study aimed to assess the impact of intravenous magnesium infusion in preventing atrial fibrillation after off-pump coronary artery bypass grafting, where maintaining stable cell membranes is crucial in averting this complication. Methods: A cross-sectional study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, from March 2020 to February 2022. Sixty-six patients who underwent off-pump coronary artery bypass grafting were enrolled and divided into two groups. Group A (n = 33) received intravenous magnesium sulfate (10 mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the Intensive Care Unit (ICU) within three days after surgery was evaluated using convenient sampling. Statistical analysis was performed with SPSS version 26.0, utilizing independent Student’s t-test for continuous data and Chi-square and Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered statistically significant. Results: No significant differences in age or gender were observed between the two groups. Group B exhibited significantly lower magnesium levels than Group A on the 0th, 1st, 2nd, and 3rd days post-surgery. Additionally, Group B experienced a higher incidence of postoperative atrial fibrillation, longer ICU stays, and two mortalities. The study did not detect any adverse effects associated with magnesium infusion. Conclusion: It has been demonstrated that administering magnesium intravenously after off-pump coronary artery bypass grafting can lower the chances of developing atrial fibrillation. This demonstrates the potential advantages of using magnesium as a preventative measure for postoperative atrial fibrillation in such cases.

What factors control plant height?

Plant height(PH)is one of the most important components of the plant ideotype,and it affects plant biomass,yield,lodging resistance,and the ability to use mechanized harvesting.Since many complex pathways controlling plant growth and development remain poorly understood,we are still unable to obtain the most ideal plants solely through breeding efforts.PH can be influenced by genotype,plant hormonal regulation,environmental conditions,and interactions with other plants.Here,we comprehensively review the factors influencing PH,including the regulation of PH-related developmental processes,the genetics and QTLs contributing to PH,and the hormone-regulated molecular mechanisms for PH.Additionally,the symbiotic influence of grafting on PH is discussed,focusing on the molecular regulation of gene expression and genetics.Finally,we propose strategies for applying recent findings to breeding for better PH,highlight some knowledge gaps,and suggest potential directions for future studies.

Characteristics of long-distance mobile mRNAs from shoot to root in grafted plant species

Thousands of long-distance mobile mRNAs were identified from different grafting systems,based on high-throughput sequencing technology.Moreover,the long-distance delivery of RNAs was proved to involve multiple mechanisms.Here,we analyzed the homology,motif,and tRNA-like structure(TLS)of long-distance mobile mRNAs identified by RNA-seq as well as the RNA-binding protein(RBP)in nine grafting combinations including Arabidopsis thaliana,Vitis vinifera,Cucumis sativus,Citrullus lanatus,Nicotiana benthamiana,Malus domestica,Pyrus spp.,Glycine max and Phaseolus vulgaris.Although several mRNAs were found to be shared in herbaceous,woody,and related species,the vast majority of long-distance mobile mRNAs were species-specific.Four non-specific movement-related motifs were identified,while the TLS was not necessary for mRNA long distance mobility.In addition,we found that RBPs were conserved among herbaceous and woody plants as well as related species.This paper reports a further in-depth analysis of the endogenous mechanisms by which the species-specific transportable m RNAs were selected by bioinformatics,in order to provide insights for future research on long-distance mobile mRNAs.

Efficient and selective removal of Pb(Ⅱ) from landfill leachate using L-serine-modified polyethylene/polypropylene nonwoven fabric synthesized via radiation grafting technique

In this study,to efficiently remove Pb(Ⅱ) from aqueous environments,a novel L-serine-modified polyethylene/polypropylene nonwoven fabric sorbent(NWF-serine)was fabricated through the radiation grafting of glycidyl methacrylate and subsequent L-serine modification.The effect of the absorbed dose was investigated in the range of 5–50 kGy.NWF-serine was characterized by Fourier transform infrared spectroscopy,thermogravimetric analysis,and scanning electron microscopy.Batch adsorption tests were conducted to investigate the influences of pH,adsorption time,temperature,initial concentration,and sorbent dosage on the Pb(Ⅱ) adsorption performance of NWF-serine.The results indicated that Pb(Ⅱ) adsorption onto NWF-serine was an endothermic process,following the pseudo-second-order kinetic model and Langmuir isotherm model.The saturated adsorption capacity was 198.1 mg/g.NWF-serine exhibited Pb(Ⅱ) removal rates of 99.8% for aqueous solutions with initial concentrations of 100 mg/L and 82.1% for landfill leachate containing competitive metal ions such as Cd,Cu,Ni,Mn,and Zn.Furthermore,NWF-serine maintained 86% of its Pb(Ⅱ) uptake after five use cycles.The coordination of the carboxyl and amino groups with Pb(Ⅱ) was confirmed using X-ray photoelectron spectroscopy and extended X-ray absorption fine structure analysis.

Late infection after peri-orbital autologous micro-fat graft:a case presentation and literature review

Citation:Pakdel F,Asadigandomani H,Arab Bafrani M,Nozarian Z,Abedinifar Z,Pirmarzdashti N,Jafari B,Siami Z.Late infection after peri-orbital autologous micro-fat graft:a case presentation and literature review.Int J Ophthalmol 2024;17(3):603-606.

Histological Assessment of Bone Regeneration in the Maxilla with Homologous Bone Graft:A Feasible Option for Maxillary Bone Reconstruction

Bone biomaterials have been increasingly used to reconstruct maxillary atrophic ridges.Thus,the aim of this study was to evaluate bone reconstruction in the maxilla using a homologous cortico-cancellous FFB(lyophilized)graft and verify its reliability.Eight individuals were included from 2014 to 2018.The first surgery was performed to install homologous bone blocks in the maxilla.The period of the second intervention varied between 5 months and 15 days to 11 months(≈7.93 months).The biopsies were taken from the central region of the matured graft during the surgery for implant placement.All patients presented clinical and radiographic conditions for the installation of dental implants.There was a 100%of survival rate.The histological assessment showed that the homologous block bone graft was an osteoconductive biomaterial,with connective tissue present,and newly formed bone juxtaposed on its surface.There were bone trabeculae with osteocytes and active osteoblasts with connective tissue in the mineralization process;the remodeling process can be found through the reverse lines.A limited focus of necrosis with fibrosis was detected,with small resorption and areas of inflammatory infiltrate,but without clinical significance.The homologous block bone graft can be considered a feasible option to substitute the autogenous bone graft(gold standard),with predictable clinical and favorable histological results.The patients had a shorter surgical period,low morbidity,and an unlimited amount of biomaterial available at an accessible cost.

Advances in the differentiation of pluripotent stem cells into vascular cells

Blood vessels constitute a closed pipe system distributed throughout the body,transporting blood from the heart to other organs and delivering metabolic waste products back to the lungs and kidneys.Changes in blood vessels are related to many disorders like stroke,myocardial infarction,aneurysm,and diabetes,which are important causes of death worldwide.Translational research for new appro-aches to disease modeling and effective treatment is needed due to the huge socio-economic burden on healthcare systems.Although mice or rats have been widely used,applying data from animal studies to human-specific vascular physiology and pathology is difficult.The rise of induced pluripotent stem cells(iPSCs)provides a reliable in vitro resource for disease modeling,regenerative medicine,and drug discovery because they carry all human genetic information and have the ability to directionally differentiate into any type of human cells.This review summarizes the latest progress from the establishment of iPSCs,the strategies for differentiating iPSCs into vascular cells,and the in vivo trans-plantation of these vascular derivatives.It also introduces the application of these technologies in disease modeling,drug screening,and regenerative medicine.Additionally,the application of high-tech tools,such as omics analysis and high-throughput sequencing,in this field is reviewed.

Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study

BACKGROUND Prolonged donor hepatectomy time may be implicated in early and late complications of liver transplantation.AIM To evaluate the impact of donor hepatectomy time on outcomes of liver transplant recipients,mainly early allograft dysfunction.METHODS This multicenter retrospective study included brain-dead donors and adult liver graft recipients.Donor-recipient matching was obtained through a crossover list.Clinical and laboratory data were recorded for both donors and recipients.Donor hepatectomy,cold ischemia,and warm ischemia times were recorded.Primary outcome was early allograft dysfunction.Secondary outcomes included need for retransplantation,length of intensive care unit and hospital stay,and patient and graft survival at 12 months.RESULTS From January 2019 to December 2021,a total of 243 patients underwent a liver transplant from a brain-dead donor.Of these,57(25%)developed early allograft dysfunction.The median donor hepatectomy time was 29(23–40)min.Patients with early allograft dysfunction had a median hepatectomy time of 25(22–38)min,whereas those without it had a median time of 30(24–40)min(P=0.126).CONCLUSION Donor hepatectomy time was not associated with early allograft dysfunction,graft survival,or patient survival following liver transplantation.

Predicting outcomes after kidney transplantation: Can Pareto’s rules help us to do so?

Kidney transplantation is the best option for kidney replacement therapy,even considering that most of the times the grafts do not survive as long as their recipients.In the Khalil et al's experience,published in this issue of the Journal,they analyze their second kidney graft survival and describe those significant predictors of early loss.This editorial comments on the results and put in perspective that most of the times,long-term graft survival could be inadvertently jeopardized if the immunosuppressive therapy is reduced or withdrawn for any reason,and that it could happen frequently if the transplant physician intends to innovate with the clinical care without proper evidence-based data.

Surgical Treatment of Osteonecrosis of the Femoral Head Using Minimally Invasive Surgical Drilling and Cancellous Grafting at Brazzaville University Hospital

Introduction: Osteonecrosis of the femoral head (ONTF) is a debilitating condition. Several treatments have been proposed with controversial results. The aim of our study was to evaluate treatment by surgical drilling coupled with in situ cancellous grafting. Materials and methods: Our study was a case-control study conducted at Brazzaville University Hospital from 1st January 2018 to 31 December 2023. It compared two groups of patients with ONTF: non-operated (13 patients, 20 hips) and operated (22 patients, 35 hips). We used the visual digital scale (VDS) for pain assessment, the Merle D’Aubigne-Postel (MDP) scoring system for clinical and functional assessment, and the evolution of necrosis. Results: The group of non-operated patients had a mean age of 35.69 ± 3.4 years, no improvement in pain with an EVN above seven at the last recoil and a mean global MDP score falling from 12.7 before offloading to 10.13 at one year. The group of patients operated on had a mean age of 37.86 ± 7.02 years, a significant reduction in pain (p = 0.00004) and a significantly increased MDP score (p = 0.0034). A comparison of the two groups of patients showed significant stabilization of the necrotic lesions in the operated patients (p = 0.00067), with better satisfaction in the same group. Conclusion: Surgical drilling combined with grafting in the treatment of early-stage ONTF has improved progress in our series. The technique is reproducible and less invasive. It has made it possible to delay unfavorable progression and, consequently, hip replacement surgery.