A rare case of prostatic malakoplakia with multidrug-resistant Escherichia coli: a case report.

Prostatic malakoplakia is an uncommon chronic inflammatory disorder, tumor-like but non-cancerous, the diagnosis of which pivots crucially on the identification of characteristic Michaelis-Gutmann bodies within the pathological tissue. We hereby present an inaugural case report of prostatic malakoplakia concurrent with sepsis caused by multidrug-resistant Escherichia coli, verified through blood culture and metagenomic next-generation sequencing (mNGS). The pathogenesis might be associated with infections by Escherichia coli, immune system irregularities, or lysosomal dysfunction. Although the patient had no chronic underlying diseases, he presented early with sepsis and multi-organ dysfunction. This case emphasizes the imperative to further investigate the association between malakoplakia and Escherichia coli, the necessity for prompt diagnosis, and the supportive role of mNGS, and the treatment strategy focuses on rapid control of infection and systemic inflammatory response.

A novel approach for anterior cruciate ligament tibial avulsion fracture: arthroscopic modified suture bridge fixation technique.

INTRODUCTION: Anterior cruciate ligament (ACL) tibial avulsion fracture is a rare injury, which usually happens in adults with traffic accidents or sports injuries. Surgery interventions are common treatment methods, they can restore knee function and help to return to normal life. In this study, we described an arthroscopic modified suture bridge fixation technique for ACL tibial avulsion fractures and explored the feasibility and therapeutic effects. MATERIALS AND METHODS: This retrospective study reviewed data from January 2020 to May 2022. Data were collected on 18 patients (10 males and 8 females) with ACL tibial avulsion fractures and underwent arthroscopic modified suture bridge fixation technique. The study analyzed surgical data about intraoperative blood loss, operation time, hospital stay, fracture healing time, and visual analog scale (VAS). Functional evaluation of the knee joint was performed using the anterior drawer test, Lysholm knee scoring scale, International Knee Documentation Committee (IKDC), and knee range of motion (ROM). RESULTS: All 18 patients were followed up between 12 and 20 months, with an average of 15.22 ± 1.96 months. The intraoperative blood loss was approximately 15-40 mL, averaging 25.78 ± 6.19 mL. The operation time was 65-85 min, with a mean of 74.89 ± 4.86 min. The hospital stay of patients was 3-5 days, with a mean of 3.89 ± 0.76 days. The mean fracture healing time was 8-12 weeks after surgery, with a mean of 9.22 ± 1.7 weeks. All incisions healed grade I without infection. There were no internal fixation failures, neurovascular injuries, and lower extremity deep venous thrombosis. The anterior drawer test was negative in all patients. At the final follow-up, the mean VAS score was 0-3, averaging 1.56 ± 0.71. The Lysholm score of the injured knee was 89-96, with an average of 92.50 ± 2.50; the IKDC score was 88-93, with an average of 90.44 ± 1.89; the knee ROM was 110-126°, with an average of 120.67° ± 4.31°. CONCLUSION: Results demonstrated that the modified suture bridge fixation technique under arthroscope could provide reliable fixation and favorable clinical effects for ACL tibial avulsion fractures. This is a simple, minimally invasive, effective, and clinically applicable surgical method for ACL tibial avulsion fracture.

A new method of anterior talofibular ligament reconstruction: Arthroscopically artificial ligament reconstruction with tensional remnant-repair.

PURPOSE: To investigate the clinical effects of arthroscopically artificial ligament reconstruction with tensional remnant-repair in patients who are obese, and/or with demand for highly intensive sports, and/or with poor-quality ligament remnants. METHODS: A retrospective case series study was performed on patients treated by arthroscopically anterior talofibular ligament (ATFL) reconstruction with tensional remnant repair technique from January 2019 to August 2021. General data, including demographics, surgical time, and postoperative adverse events, were recorded. The American Orthopaedic Foot and Ankle Society score (AOFAS), foot and ankle ability measure (FAAM), visual analog scale (VAS), and anterior talar translation were measured preoperatively and at 6 weeks, 3 months, and 2 years postoperatively. Ultrasonography examination was performed preoperatively and 2 years postoperatively to evaluate the ATFL. Data were analyzed using SPSS 19.0. F test was used to analyze the pre- and postoperative VAS, FAAM, and AOFAS scores. The significance was set at p < 0.05. RESULTS: There were 20 males and 10 females among the patients with a mean age of (30.71 ± 5.81) years. The average surgical time was (40.21 ± 8.59) min. No adverse events were observed after surgery. At 2 years postoperatively, the anterior talar translation test showed grade 0 laxity in all patients. VAS score significantly decreased from preoperatively to 6 weeks, 3 months, and 2 years postoperatively (p < 0.001). Improvement of FAAM score and the AOFAS score from preoperatively to 6 weeks, 3 months, and 2 years postoperatively was statistically significant (p < 0.001). At 3 months postoperatively, most patients (23/30) could return to their pre-injured activities of daily living status. At 2 years postoperatively, all patients were able to return to their pre-injured activities of daily living status, and almost every patient (18/19) who expected highly intensive sports returned to sports with only 1 obese patient failing to achieve the goal. The ultrasonography examination at 2 years postoperatively showed that there was a linear band structure of soft tissue on the tension-rich fiber tape image from the fibular to the talar attachment sits of ATFL. CONCLUSION: The novel arthroscopically artificial ligament reconstruction with tensional remnant-repair technique for ATFL achieved satisfactory clinical outcomes in the short and medium term after operation, and allowed early return to pre-injured activities, which could be a reliable option for patients with chronic lateral ankle instability.

Bankart Repair With Remplissage Restores Better Shoulder Stability Than Bankart Repair Alone, and Medial or Two Remplissage Anchors Increase Stability but Decrease Range of Motion: A Finite Element Analysis.

PURPOSE: To investigate the effects of the number and location of anchors for remplissage on postoperative glenohumeral biomechanics. METHODS: A biomechanical study was conducted involving finite element model constructed based on data from the intact glenohumeral joint. Seven models were established, including a normal model, a model of Bankart lesion combined with "off-track" Hill-Sachs lesion, a model of Bankart repair alone, and 4 models of Bankart repair with remplissage based on different remplissage anchor numbers and locations. The effects of the number and location of the remplissage anchors on glenohumeral stability were studied through calculation and comparison of (1) the stress and its distribution on the joint capsule, cartilage, labrum and anchors as well as (2) the displacement of the humeral head. RESULTS: Finite element analysis demonstrated that contact stress on the glenohumeral cartilage decreased when medial or 2 anchors were used and was minimized in the combined repair model with 2 medial anchors. The stress on remplissage anchors was greater when the anchors were placed medially. The humeral head displacement was maximized in the combined lesion model. The combined repair models with 2 medially placed anchors showed the largest slope on the force-displacement curve, indicating the largest strain on the humeral head. CONCLUSIONS: Based on a finite element analysis, Bankart repair with remplissage restored better shoulder stability compared with Bankart repair alone in the treatment of anterior shoulder instability involving Bankart lesion combined with "off-track" Hill-Sachs lesion. When the anchor for remplissage was medially placed or 2 anchors were used, the stability of the glenohumeral joint increased but with a loss of range of motion. CLINICAL RELEVANCE: The results of this study will assist in choosing the number and location of anchors for remplissage during shoulder stabilization surgery although with some limitations.

Tetrel bonding interaction: an analysis with the block-localized wavefunction (BLW) approach.

In this study, fifty-one iconic tetrel bonding complexes were studied using the block localized wave function (BLW) method which can derive the self-consistent wavefunction for an electron-localized (diabatic) state where charge transfer is strictly deactivated. Energy decompositions based on the BLW method (BLW-ED in short) show that the frozen energy, which is mostly composed of the Pauli repulsion and electrostatic components, plays the dominating role in thirty-one out of these fifty-one systems. A further quantitative study of electrostatic potential (ESP) was carried out by analyzing the variation of ESP along the binding direction for each monomer. In general, a Lewis base with the stronger ESP leads to higher stabilizing frozen and polarization energies. In addition, the relative strengths for complexes constructed with different carbon group elements are also examined qualitatively using the ESP model. The positive contribution of the charge transfer interaction is confirmed by both the BLW-ED results and the weakening of bond strengths after the charge transfer interaction is disabled. Finally, by replacing all atoms of a monomer with σ-holes (Lewis acid) with empirical point charges, attractive electrostatic interaction was observed in all cases, providing us a simple electrostatic explanation for the tetrel bonding, though the anisotropy of electron density associated with the σ-holes is unconsidered.

Neural basis of reward anticipation and its genetic determinants.

Dysfunctional reward processing is implicated in various mental disorders, including attention deficit hyperactivity disorder (ADHD) and addictions. Such impairments might involve different components of the reward process, including brain activity during reward anticipation. We examined brain nodes engaged by reward anticipation in 1,544 adolescents and identified a network containing a core striatal node and cortical nodes facilitating outcome prediction and response preparation. Distinct nodes and functional connections were preferentially associated with either adolescent hyperactivity or alcohol consumption, thus conveying specificity of reward processing to clinically relevant behavior. We observed associations between the striatal node, hyperactivity, and the vacuolar protein sorting-associated protein 4A (VPS4A) gene in humans, and the causal role of Vps4 for hyperactivity was validated in Drosophila Our data provide a neurobehavioral model explaining the heterogeneity of reward-related behaviors and generate a hypothesis accounting for their enduring nature.

Surgical exposures of the distal humeral fractures: An anatomical study of the anterior, posterior, medial and lateral approaches.

PURPOSE: Exposure of the articular surface is the key to the successful treatment of intra-articular fractures of distal humerus. Anterior, posterior olecranon osteotomy as well as medial and lateral approaches are the four main approaches to the elbow. The aim of this study was to compare the exposure of distal articular surfaces of these surgical approaches. METHODS: Twelve cadavers were used in this study. Each approach was performed on six elbows according to previously published procedures. After completion of each approach, the exposed articular surfaces were marked by inserting 0.5 mm K-wires along the margins. The elbow was then disarticulated and the exposed articular surfaces were painted. The distal humeral articular surfaces were then closely wrapped using a piece of fibre-glass screen net with meshes. The exposed articular surfaces and the total articular surfaces were calculated by counting the number of meshes, respectively. RESULTS: The average percentages of the exposed articular surfaces for the anterior, posterior olecranon osteotomy, medial and lateral approaches were 45.7% ± 2.0%, 53.9% ± 7.1%, 20.6% ± 4.9% and 28.5% ± 6.3%, respectively. CONCLUSION: The anterior and posterior approaches provide greater exposures of distal humeral articular surface than the medial and lateral ones in the treatment of distal humeral fractures.

Separate neural systems for behavioral change and for emotional responses to failure during behavioral inhibition.

To analyze the involvement of different brain regions in behavioral inhibition and impulsiveness, differences in activation were investigated in fMRI data from a response inhibition task, the stop-signal task, in 1709 participants. First, areas activated more in stop-success (SS) than stop-failure (SF) included the lateral orbitofrontal cortex (OFC) extending into the inferior frontal gyrus (ventrolateral prefrontal cortex, BA 47/12), and the dorsolateral prefrontal cortex (DLPFC). Second, the anterior cingulate and anterior insula (AI) were activated more on failure trials, specifically in SF versus SS. The interaction between brain region and SS versus SF activations was significant (P = 5.6 * 10-8 ). The results provide new evidence from this "big data" investigation consistent with the hypotheses that the lateral OFC is involved in the stop-related processing that inhibits the action; that the DLPFC is involved in attentional processes that influence task performance; and that the AI and anterior cingulate are involved in emotional processes when failure occurs. The investigation thus emphasizes the role of the human lateral OFC BA 47/12 in changing behavior, and inhibiting behavior when necessary. A very similar area in BA47/12 is involved in changing behavior when an expected reward is not obtained, and has been shown to have high functional connectivity in depression. Hum Brain Mapp 38:3527-3537, 2017. © 2017 Wiley Periodicals, Inc.

The safe screw path along inferior border of the arcuate line at acetabular area: an anatomical study based on CT scans.

BACKGROUND: Misplaced screw during the internal fixation of acetabular fractures may penetrate the hip joint which might cause chondrolysis and traumatic osteoarthritis in the future. This study aims to acquire the safe path for screw insertion along inferior border of the arcuate line fixation route at acetabular area. METHODS: Computed tomography (CT) scans of 98 patients without pelvic trauma were rebuilt for three-dimensional models of pelvis. After depicting the fixation route curve, five cross-sections perpendicularly to the curve were established from the anterior of pelvis to the posterior along inferior border of the arcuate line. The safe screw lengths for section 1 and 5 were measured from the computer models. In section 2, 3 and 4, a line from the screw entry point tangent to the inferior edge of the acetabulum was depicted and the measurements of minimum safe direction of screw insertion were performed then marked with angle θ. RESULTS: The safe screw lengths for section 1 and 5 were 22.29 ± 4.41 mm and 32.64 ± 4.70 mm (n = 98). The minimum safe angles of screw insertion for the middle three sections 2, 3, and 4 were 65.38 ± 10.23°, 74.20 ± 10.20°, and 57.88 ± 11.11°(n = 98), respectively. The results for the male group (n = 98) indicated smaller minimum safe angles in these three sections compared with the female (n = 98). CONCLUSIONS: Compared to male, the minimum safe angles of screw placement at acetabular area for female should be more away from inferior edge of acetabulum and tilt to the bottom of pelvis along inferior border fixation route in surgical management of acetabular fractures.

Digital anatomical measurements and crucial bending areas of the fixation route along the inferior border of the arcuate line for pelvic and acetabular fractures.

BACKGROUND: Better understanding of three-dimensional (3D) morphology of the pelvis at the area of inferior border of the arcuate line is very important, which could guide the surgeons to treat pelvic and acetabular fractures more efficiently. The objective of this study is to provide references for screw placement and design of anatomical internal fixators for the fixation route along the pelvic inferior border of the arcuate line. METHODS: Seventy five cases of computed tomography (CT) scan data were collected using Medical Image Database in Shanghai General Hospital between December 2009 and November 2010. 44 males and 31 females, aging from 21 to 91 years (average: 57.8 years) were enrolled. Using MIMICS 13.0, these data were used for three dimensional (3D) reconstructions of pelvic model. A curve from the pubic tubercle, along the inferior border of the arcuate line, to the sacroiliac joint was depicted and then divided into 11 equal parts. The measurements of whole length of the curve, the radius of the curvature and the thickness of bone at each decile point were performed, respectively. RESULTS: The thinnest bone thickness at acetabular area was 17.24 ± 2.90 mm and 9.94 ± 2.69 mm for male and female, respectively. The radius of curvature at the decile points 1, 8 and 10 were smaller compared with the surrounding points. CONCLUSIONS: Using a screw shorter than 10 mm perpendicular to the bone surface along the inferior border of the arcuate line can avoid intra-articular screw penetration. There should be more recontouring of the plate at the areas of pubic tubercle and posterior edge of the acetabulum when placing a fixator along this fixation route. This study provides solid guidance for pelvic and acetabular surgeries as well as designing of anatomical fixators along inferior border fixation route at this area.

Digital anatomical measurements of safe screw placement at superior border of the arcuate line for acetabular fractures.

BACKGROUND: Screw penetration into hip joint is a severe complication during acetabular fracture surgery, which might result in osteoarthritis and chondrolysis. The purpose of this study was to obtain the safe and effective screw angles and lengths at acetabular area of the fixation route along the superior border of the arcuate line. METHODS: A total of 98 uninjured pelvises of Chinese adults were examined. Each person's computed tomography (CT) scans were reconstructed to create a three-dimensional pelvic model. A curve of the fixation route was delineated and five cross-sections from the pubic tubercle to the sacroiliac joint direction were constructed perpendicularly to the curve. The minimum safe direction, which was tangent to the acetabulum, was measured in the middle three sections and then recorded as the angle α. The maximum effective direction, which was determined by a 14 mm arc and the quadrilateral surface, was also measured in the above sections and then recorded as the angle ß. The maximum screw lengths for the five sections were measured. RESULTS: The ranges of safe and effective screw insertion angles for the 2nd, 3rd, 4th cross-sections were 21.09±13.57°~40.45±13.60°, 30.43±14.05°~47.54±12.67°, 23.84±11.60°~37.13±8.45°, respectively. The maximum screw lengths for the five sections were 15.89±3.80 mm, 58.83±27.66 mm, 42.94±22.41 mm, 72.43±6.73 mm, 40.99±6.33 mm. The male group showed significantly greater minimum safe angle compared to the female group in the 2nd, 3rd, and 4th sections (p<0.05). CONCLUSIONS: The screw insertion at the acetabular area for the female requires greater minimum safe angle towards the quadrilateral surface than the male.

Arthroscopic versus mini-open rotator cuff repair: an up-to-date meta-analysis of randomized controlled trials.

PURPOSE: The aim of this meta-analysis was to compare the clinical outcomes of arthroscopic and mini-open rotator cuff repairs based on recently published Level I randomized controlled trials (RCTs). METHODS: We systematically searched electronic databases to identify RCTs that compared arthroscopic and mini-open rotator cuff repairs from 1980 to October 2013. The clinical outcome scores, including the University of California, Los Angeles score and the Constant-Murley score, were converted to a common 100-point outcome score for further analysis. The results of the pooled studies were analyzed in terms of surgery time, weighted 100-point score, pain on a visual analog scale (VAS), and range of motion. Study quality was assessed and relevant data were extracted independently by 2 reviewers. RESULTS: Five RCTs, including 166 patients in the arthroscopic repair group and 163 patients in the mini-open repair group, were included in this meta-analysis. The results of the meta-analysis showed that there were no significant differences in surgery time (P = .11), weighted 100-point score (P = .65), VAS pain score (P = .87), or range of motion (P = .29 for forward flexion and P = .82 for external rotation). CONCLUSIONS: On the basis of current literature, no differences in surgery time, functional outcome score, VAS pain score, and range of motion were found at the end of follow-up between the arthroscopic and mini-open rotator cuff repair techniques. In addition, there was no significant difference in VAS pain score in the early phase between the 2 repairs. LEVEL OF EVIDENCE: Level I, meta-analysis of Level I studies.

Identification of interactions in fractional-order systems with high dimensions.

This article proposes an approach to identify fractional-order systems with sparse interaction structures and high dimensions when observation data are supposed to be experimentally available. This approach includes two steps: first, it is to estimate the value of the fractional order by taking into account the solution properties of fractional-order systems; second, it is to identify the interaction coefficients among the system variables by employing the compressed sensing technique. An error analysis is provided analytically for this approach and a further improved approach is also proposed. Moreover, the applicability of the proposed approach is fully illustrated by two examples: one is to estimate the mutual interactions in a complex dynamical network described by fractional-order systems, and the other is to identify a high fractional-order and homogeneous sequential differential equation, which is frequently used to describe viscoelastic phenomena. All the results demonstrate the feasibility of figuring out the system mechanisms behind the data experimentally observed in physical or biological systems with viscoelastic evolution characters.

Investigation into the effect of deltoid ligament injury on rotational ankle instability using a three-dimensional ankle finite element model.

Background: Injury to the lateral collateral ligament of the ankle may cause ankle instability and, when combined with deltoid ligament (DL) injury, may lead to a more complex situation known as rotational ankle instability (RAI). It is unclear how DL rupture interferes with the mechanical function of an ankle joint with RAI. Purpose: To study the influence of DL injury on the biomechanical function of the ankle joint. Methods: A comprehensive finite element model of an ankle joint, incorporating detailed ligaments, was developed from MRI scans of an adult female. A range of ligament injury scenarios were simulated in the ankle joint model, which was then subjected to a static standing load of 300 N and a 1.5 Nm internal and external rotation torque. The analysis focused on comparing the distribution and peak values of von Mises stress in the articular cartilages of both the tibia and talus and measuring the talus rotation angle and contact area of the talocrural joint. Results: The dimensions and location of insertion points of ligaments in the finite element ankle model were adopted from previous anatomical research and dissection studies. The anterior drawer distance in the finite element model was within 6.5% of the anatomical range, and the talus tilt angle was within 3% of anatomical results. During static standing, a combined rupture of the anterior talofibular ligament (ATFL) and anterior tibiotalar ligament (ATTL) generates new stress concentrations on the talus cartilage, which markedly increases the joint contact area and stress on the cartilage. During static standing with external rotation, the anterior talofibular ligament and anterior tibiotalar ligament ruptured the ankle's rotational angle by 21.8% compared to an intact joint. In contrast, static standing with internal rotation led to a similar increase in stress and a nearly 2.5 times increase in the talus rotational angle. Conclusion: Injury to the DL altered the stress distribution in the tibiotalar joint and increased the talus rotation angle when subjected to a rotational torque, which may increase the risk of RAI. When treating RAI, it is essential to address not only multi-band DL injuries but also single-band deep DL injuries, especially those affecting the ATTL.

Broken-fat pad sign: a characteristic radiographic finding to distinguish between knee rheumatoid arthritis and osteoarthritis.

OBJECTIVES: Diagnostic imaging plays an important role in the pre-treatment workup of knee osteoarthritis (OA) and rheumatoid arthritis (RA). Herein, we identified a useful MRI sign of infrapatellar fat pad (IPFP) to improve diagnosis. METHODS: Eighty-one age- and sex-matched RA and OA patients each, with pathological diagnosis and pre-treatment MRI were retrospectively evaluated. All randomized MR images were blinded and independently reviewed by two radiologists. The assessment process included initial diagnosis, sign evaluation, and final diagnosis, with a 3-week interval between each assessment. Broken-fat pad (BFP) sign was assessed on sagittal T2-weighted-imaging in routine MRI. The area under the curve and Cohen's kappa (κ) were used to assess the classification performance. Two shape features were extracted from IPFP for quantitative interpretation. RESULTS: The median age of the study population was 57.6 years (range: 31.0-78.0 years). The BFP sign was detected more frequently in patients with RA (72.8%) than those with OA (21.0%). Both radiologists achieved better performance by referring to the BFP sign, with accuracies increasing from 58.0 to 75.9% and 72.8 to 79.6%, respectively. The inter-reader correlation coefficient showed an increase from fair (κ = 0.30) to substantial (κ = 0.75) upon the consideration of the BFP sign. For quantitative analysis, the IPFP of RA had significantly lower sphericity (0.54 ± 0.04 vs. 0.59 ± 0.03, p < 0.01). Despite larger surface-volume-ratio of RA (0.38 ± 0.05 vs. 0.37 ± 0.04, p = 0.25) than that of OA, there was no statistical difference. CONCLUSIONS: The BFP sign is a potentially important diagnostic clue for differentiating RA from OA with routine MRI and reducing misdiagnosis. CRITICAL RELEVANCE STATEMENT: With the simple and feasible broken-fat pad sign, clinicians can help more patients with early accurate diagnosis and proper treatment, which may be a valuable addition to the diagnostic workup of knee MRI assessment. KEY POINTS: • Detailed identification of infrapatellar fat pad alterations of patients may be currently ignored in routine evaluation. • Broken-fat pad sign is helpful for differentiating rheumatoid arthritis and osteoarthritis. • The quantitative shape features of the infrapatellar fat pad may provide a possible explanation of the signs. • This sign has good inter-reader agreements and is feasible for clinical application.

Arthroscopic repair with transosseous sling-suture technique for acute and chronic bony Bankart lesions.

Background: Failure to fix the fractured fragment can result in bony fragment resorption and consequent glenoid bone loss. Current arthroscopic repair techniques might lead to insecure fixation and refracture. The purpose of this study was to evaluate the effectiveness of the transosseous sling-suture technique for bony Bankart lesions, and to compare the clinical outcomes for acute and chronic bony Bankart lesions treated with this technique. Methods: A retrospective case series consisting of 46 patients with bony fracture of the glenoid rim following traumatic injury was identified from May 2015 to August 2020. The patients were divided into the acute lesion group and the chronic lesion group according to the time from first injury to surgery. The size of bone fragment was used to group the patients into the small and the medium sized fragment groups. All the patients underwent arthroscopic repairs using the transosseous sling-suture technique. Preoperative and postoperative evaluations including Rowe score, West Ontario Shoulder Instability Index (WOSI), Visual Analogue Scale (VAS) for pain scores, ROMs and number of dislocations were recorded. No significant differences were found in the comparisons of postoperative ROMs ang functional outcomes regarding between the small and the medium sized fragment groups. Results: No dislocations occurred for both groups postoperatively. At the last follow-up, all the ROMs (including anterior flexion, abduction, external rotation and internal rotation at the side), the Rowe score, the WOSI score and the VAS score for pain in the both groups were significantly improved compared to the preoperative evaluations (all Ps < 0.001). In the comparisons between the acute and the chronic lesion groups, significantly greater anterior flexion (158.9 ± 8.9° vs. 153.0 ± 6.4°, P = 0.037), abduction (167.7 ± 10.1° vs. 161.0 ± 7.0°, P = 0.035) and external rotation at the side (88.3 ± 6.4° vs. 83.5 ± 5.5°, P = 0.024) were found in the acute lesion group. The comparisons of the Rowe score (86.0 ± 7.5 vs. 87.5 ± 10.6, P = 0.319), the WOSI score (223.5 ± 56.3 vs. 185.0 ± 79.9, P = 0.062), the VAS score for pain (0.4 ± 0.2 vs. 0.3 ± 0.2, P = 0.324) and the internal rotation at the side (74.6 ± 13.2° vs. 80.5 ± 11.1°, P = 0.116) between these two groups did not demonstrate significant differences between the two groups. Conclusion: This arthroscopic transosseous sling-suture repair technique for shoulder anterior instability with acute and chronic bony Bankart lesion can restore joint stability, improve clinical outcomes and range of motion postoperatively. The acute bony Bankart lesion using the current technique can produce better range of motion compared to the chronic lesion. Study design: Retrospective case series; Level of evidence, 4.

Safe Talar Tunnel Placement During Reconstruction of the Deep Layer of the Deltoid Ligament: A Comparison of 4 Different Anatomic Landmarks on the Lateral Malleolus.

Background: Deltoid ligament reconstruction of the ankle can be considered when the ruptured ligament is insufficient for direct repair. Purpose: To compare the safety of talar tunnels oriented toward 4 different anatomic landmarks on the lateral malleolus during reconstruction of the deep layer of the deltoid ligament (DDL). Study Design: Descriptive laboratory study. Methods: A total of 30 computed tomography scans of the ankle joint in healthy adults were collected to generate 3-dimensional models. Virtual talar tunnels with a diameter of 5 mm and with different lengths (20.0, 25.0, and 30.0 mm) were created from the talar insertion of the DDL and were oriented toward the talar neck as well as the most anterior, the most distal, and the most posterior points of the distal fibula. The minimal safe distance (MSD) of a drilling route was calculated for the tunnels, and the safe distance from the end of the tunnel to the bone surface was measured for each tunnel. The nonpaired Student t test was used to detect differences among the safe distances of the 4 different bone tunnels. Results: For the 20.0-mm tunnels, the safe distance of the tunnel oriented toward the talar neck (5.90 ± 1.16 mm) did not meet the MSD (6.0 mm). For the 25.0-mm tunnels, the safe distances of the tunnels oriented toward the talar neck (4.53 ± 1.13 mm) and the anterior point of the fibula (5.91 ± 1.52 mm) did not meet the MSD (6.9 mm). Conclusion: Tunnels that were 5 mm in diameter and 20.0 and 25.0 mm in length, oriented toward the most distal or most posterior point of the distal fibula, were safe for DDL reconstruction. Clinical Relevance: Knowledge of safe talar tunnel placement is important, especially to avoid bone surface penetration during DDL reconstruction.

Supra-acetabular external fixation for pelvic fractures: a digital anatomical study.

Supra-acetabular external fixation is an important tool for pelvic fractures. Understanding the anatomical characteristics of anterior inferior iliac spine (AIIS) is crucial for the operation. Here, we analyzed the morphology of AIIS and adjacent structures via a digital measurement mode. One hundred and twenty normal pelvic computed tomography (CT) scans were converted into three-dimensional digital models and their parameters were measured by Geomagics software. We obtained the values of 13 important AIIS anatomical characteristics, which were the perpendicular distance of the anterior superior iliac spine(ASIS) and AIIS (PDASIS-AIIS), the perpendicular distance between the AIIS and superior pubic tubercle (PDAIIS-PT), the distance between the AIIS and anterior median line (HDAIIS-ML), the angle of the pin tract line and the horizontal plane (AHOR), the transverse diameter of AIIS (TD), and the minimum diameter of the pin tract plane (DMIN), etc. Among them, six parameters showed significant difference between male and female (PDASIS-AIIS: P =0.040, PDAIIS-PT: P = 0.001, HDAIIS-ML: P = 0.019, AHOR: P = 0.021, TD: P < 0.001, and DMIN: P = 0.003, respectively). These results provided references in locating pinning site for a safer and more accurate supra-acetabular external fixation and also suggested that gender difference should be considered during the surgery.

Two novel zinc-based MOFs as luminescence sensors to detect phenylglyoxylic acid.

Automobile exhaust gases, plastic pollutants, smoking, and other harmful substances can cause serious harm to human beings and the environment. Styrene, as a common airborne toxin, enters the human body through breathing or the skin and is discharged in the form of phenylglyoxylic acid (PGA). Therefore, specific, sensitive and trace detection of PGA is particularly important. Here, two zinc-based metal-organic frameworks {[Zn2L1(DMF)2H2O](DMF)2H2O}n, {[Zn4(L2)2(DMF)2(H2O)3](DMF)8}n (L1 = 2,5-bis((3-carboxylphenyl)amino)terephthalic acid, L2 = 2,5-bis((4-carboxyphenyl)amino)terephthalic acid) have been reported as 1 and 2, respectively. Both 1 and 2 present 3D structures, which can both be simplified as 4,4,4-c net topology. It is worth mentioning that 2 has two different kinds of Zn SBUs as connecting nodes in the structure. Besides, compared with the other materials for the detection of PGA, 1 and 2 exhibit relatively low detection limits (LODs), both in water and in urine (where the LODs for 1 in water and urine were 0.33 µM and 0.43 µM in the range of 0-0.39 mM, and those for 2 were 0.28 µM and 0.49 µM in the range of 0-0.59 mM, respectively). In addition, the sensors have excellent anti-interference ability, high stability, rapid response, and can easily distinguish between different concentrations of PGA with the naked eye. The developed paper probes were suitable for practical sensing applications for portable detection of PGA in urine.

Two new lanthanide complexes with 5-(Pyrazol-1-yl)nicotinic acid: Structures and their anti-cancer properties.

Two new lanthanide complexes [PrL2(EA)2]NO3 (complex 1) and [SmL2(EA)2]NO3 (complex 2) (H2L = 5-(Pyrazol-1-yl)nicotinic acid, EA = CH3CH2OH) were synthesized. The structures were characterized by single crystal X-ray and elemental analysis. The interaction between the complex and fish sperm DNA(FS-DNA) was monitored using ultraviolet and fluorescence spectroscopy, and the binding constants were determined. Both complexes showed the ability to effectively bind DNA, and the molecular docking technology was used to simulate the binding of the complex and DNA. In addition, through the annexin V-Fluorescein Isothiocyanate(FITC)/ Propidium Iodide (PI) test experiment, tetrazollium [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) in vitro test, and cell morphology apoptosis studies, it was shown that the complex can effectively induce HeLa tumor cell apoptosis. Compared with cisplatin and complex, complex 1 shows significant cancer cell inhibition, and we hope that this new type of complex will open up new ways for the next generation of drugs in biomedical applications.