Is the 'safe zone' identified in preoperative computed tomography helpful for choosing optimal implant for fixation of radial head fracture?

The purpose of this study is to assess the clinical significance of the radiologic safe zone based on computed tomography and to compare the outcomes of three different implants for fixation of isolated radial head fractures. We retrospectively reviewed 367 patients who underwent internal fixation for isolated radial head fractures. We newly defined two subtypes of Mason type II fractures associated with the radiographic safe zone (IIA, two-part fracture allowing for safe fixation of plate; IIB, two-part fracture not allowing for safe fixation). 170 patients (CCS group, n = 82; HCS group, n = 31; plate group, n = 57) were investigated with no significant differences in demographics. The range of pronation and supination at 1 month postoperatively (P = 0.04 and P = 0.04) and the range of supination at 6 and 12 months postoperatively (P = 0.03 and P = 0.03) were significantly smaller in the plate group. In Mason type IIB fractures, the average MEPS was higher in the CCS and HSC groups than in the plate group (P = 0.01 and P = 0.02). And the average DASH score was lower in the CCS and HCS groups (P < 0.01 and P < 0.01). Evaluation of the radiologic safe zone is potentially helpful in selecting better surgical fixation option. For type III fractures, 2.3-mm cortical screws would be a better option than Acutrak screws. Plates would not be suitable for type IIB radial head fractures.

Advancement of Photospheric Radius Expansion and Clocked Type-I X-Ray Burst Models with the New

We report the first (in)elastic scattering measurement of ^{25}Al+p with the capability to select and measure in a broad energy range the proton resonances in ^{26}Si contributing to the ^{22}Mg(α,p) reaction at type I x-ray burst energies. We measured spin-parities of four resonances above the α threshold of ^{26}Si that are found to strongly impact the ^{22}Mg(α,p) rate. The new rate advances a state-of-the-art model to remarkably reproduce light curves of the GS 1826-24 clocked burster with mean deviation <9% and permits us to discover a strong correlation between the He abundance in the accreting envelope of the photospheric radius expansion burster and the dominance of ^{22}Mg(α,p) branch.

Cryptococcus neoformans var grubii meningoencephalitis in a patient on fingolimod for relapsing-remitting multiple sclerosis: Case report and review of published cases.

INTRODUCTION: Fingolimod, a sphingosine-1-phosphate modulator used in the treatment of relapsing-remitting multiple sclerosis, has been associated with several cases of cryptococcosis. CASE REPORT: We present a case of Cryptococcal meningoencephalitis attributable to Cryptococcus neoformans var. grubii, in a 58-year-old bird-keeper from Australia, after 7 years of fingolimod therapy. We discuss this in the context of previously reported cases, our understanding of fingolimod immune modulation, and known Cryptococcus pathobiology. CONCLUSION: We suggest consideration of harm minimisation behaviours in patients requiring fingolimod, particularly in those with profound CD4 lymphopenia. Furthermore, we echo the call for improved post-marketing surveillance systems to determine the epidemiology of atypical infections with novel immunomodulatory treatments.

[Genotyping and drug susceptibility of Mycobacterium tuberculosis isolated in Changping district in Beijing, 2011-2015].

Objective: To understand the genotype distribution of Mycobacterium tuberculosis and the drug susceptibility of M. tuberculosis with different genotypes in Changping district of Beijing and evaluate the application of genotyping of M. tuberculosis in local tuberculosis (TB) prevention and control. Methods: A total of 1 099 M. tuberculosis strains isolated in Changping from 2011 to 2015 were used. Spoligotyping and 12-locus VNTR recommended by Gao were used for the genotyping of these isolates. In addition, the susceptibility of the M. tuberculosis isolates to rifampin (RFP), isoniazid (INH), ethambutol (EMB), streptomycin (SM), amikacin (AMK) and ofloxcin (OFX) were detected by using conventional drug susceptibility test. Results: From 2011 to 2015, the detection rate of OFX-resistance increased from 2.9% to 8.9% (P=0.01). Of all the M. tuberculosis isolates, 976 belonged to Beijing genotype (88.8%), and the other 123 belonged to non-Beijing genotype (11.2%). In addition, there were 189 ancient Beijing genotype isolates and 787 modern Beijing genotype isolates, respectively. The proportion of Beijing genotype strains showed no significant increase in the past five years (81.1% in 2011 vs. 82.0% in 2015). On the basis of VTNR genotyping, only 2 isolates belonged to one cluster (0.1%). In addition, the AMK resistant rate of Beijing genotype strains (1.7%) was significantly lower than that of non-Beijing genotype strains (4.9%, P=0.02). Compared with modern Beijing genotype strains, the SM resistant rate of ancient Beijing genotype strains was significantly higher (28.0% vs. 15.7%, P=0.01). Conclusions: In the past five years, the OFX- resistant rate of M.tuberculosis in Changping was in increase. There was no significant difference in the detection of Beijing genotype strains during this period. In addition, the low clustering rate indicated that the TB transmission rate was low in Changping.

[The radiologic study of the nasolacrimal duct decompression surgery for treatment of chronic].

Objective:To explore the possibility of endoscopic nasolacrimal duct decompression surgery for the treatment of chronic dacryocystitis.Method:①Twenty-two eyes with chronic dacryocystitis were treated with 30% iohexol injection for lacrimal sac lithography. Contrast agents were taken from the lacrimal canal reflux to stop the injection. The CT scan for the lacrimal passage was performed immediately. ②Three-dimensional reconstruction of lacrimal duct and its surrounding structures was performed with Sinuses Trachea Ⅰ software. ③The lacrimal sac and nasolacrimal canal were cut and depressed using this software simulation.Result:①The incidence of lacrimal duct obstruction were 4.5% (1/22, in lacrimal duct), 22.7%(5/22, in lacrimal sac), 13.6%(3/22, transition section), 36.4%(8/22, in nasocrimal duct), and 22.7%(5/22, in Hasner valve) separately. The transitional section, nasolacrimal duct, Hasner valve section 72.7%(16/22) totally. ②The lateral wall of the nasolacrimal duct in 3D visual model is constructed of maxillary lacrimal process. The interior wall of the nasolacrimal duct is made of drop process of lacrimal bone and ascending lacimal process of the inferior turbinate. ③Observed from the inferior meatus, hard nasolacrimal duct is surrounded by inferior turbinate bone, and forms the inside wall of openings of the lacrimal duct. ④The removal of the front parts of the inferior turbinate attached to the lateral nasal can lead to the deperession of the membranous nasolacrimal duct sufficiently, and create the efficient space to eliminate nasolacrimal duct obstruction. Conclusion:Endoscopic nasolacrimal duct decompression surgery is efficacy for the treatment of chronic dacryocystitis. The integrity of the membranous lacrimal duct was reserved, and the complication such as lacrimal sac granulation hyperplasia, lacrimal duct obstruction again caused by scar formation was avoided.

Bax targets mitochondria by distinct mechanisms before or during apoptotic cell death: a requirement for VDAC2 or Bak for efficient Bax apoptotic function.

In non-apoptotic cells, Bak constitutively resides in the mitochondrial outer membrane. In contrast, Bax is in a dynamic equilibrium between the cytosol and mitochondria, and is commonly predominant in the cytosol. In response to an apoptotic stimulus, Bax and Bak change conformation, leading to Bax accumulation at mitochondria and Bak/Bax oligomerization to form a pore in the mitochondrial outer membrane that is responsible for cell death. Using blue native-PAGE to investigate how Bax oligomerizes in the mitochondrial outer membrane, we observed that, like Bak, a proportion of Bax that constitutively resides at mitochondria associates with voltage-dependent anion channel (VDAC)2 prior to an apoptotic stimulus. During apoptosis, Bax dissociates from VDAC2 and homo-oligomerizes to form high molecular weight oligomers. In cells that lack VDAC2, constitutive mitochondrial localization of Bax and Bak was impaired, suggesting that VDAC2 has a role in Bax and Bak import to, or stability at, the mitochondrial outer membrane. However, following an apoptotic stimulus, Bak and Bax retained the ability to accumulate at VDAC2-deficient mitochondria and to mediate cell death. Silencing of Bak in VDAC2-deficient cells indicated that Bax required either VDAC2 or Bak in order to translocate to and oligomerize at the mitochondrial outer membrane to efficiently mediate apoptosis. In contrast, efficient Bak homo-oligomerization at the mitochondrial outer membrane and its pro-apoptotic function required neither VDAC2 nor Bax. Even a C-terminal mutant of Bax (S184L) that localizes to mitochondria did not constitutively target mitochondria deficient in VDAC2, but was recruited to mitochondria following an apoptotic stimulus dependent on Bak or upon over-expression of Bcl-xL. Together, our data suggest that Bax localizes to the mitochondrial outer membrane via alternate mechanisms, either constitutively via an interaction with VDAC2 or after activation via interaction with Bcl-2 family proteins.

Epidemiological survey of blood pressure of pre-school children.

An epidemiological survey of blood pressure was carried out in 2301 pre-schoolers aged 2-6 years in 11 kindergartens of Guangzhou during 1984. Judging from the chart of selected percentile of blood pressure in relation to age plotted according to the mean blood pressure, the authors suggest that the upper limit of pre-schoolers' blood pressure is 115/75 mmHg. The blood pressure of growing children rises with increases in age, weight and height. Ponderosity Index (W/H3) reflects more precisely the influence of body weight and height on blood pressure. The results show that the percentage of children with high normal pressure is obviously higher in those with a family history of hypertension than in those without such a history. It is of great importance, in the prevention of primary hypertension, to practise medical surveillance and health care in children with high normal blood pressure, especially in those with a family history of hypertension.