Efficient degradation of tetrabromobisphenol A using peroxymonosulfate oxidation activated by a novel nano-CuFe2O4@coconut shell biochar catalyst.

In this study, a novel bimetallic complexation-curing nucleation-anaerobic calcination method was developed to synthesize a nano-CuFe2O4@coconut shell biochar (CuFe2O4@CSBC) catalyst to activate peroxymonosulfate for degradation of tetrabromobisphenol A (TBBPA). The reaction processes of the TBBPA on CuFe2O4@CSBC have been investigated using in situ characterization and metal leaching. The effects of initial reaction conditions and degradation mechanism were investigated. Greater than 99% degradation of TBBPA at 10 mg L-1 was achieved in 30 min under the condition of pH 11, a total organic carbon removal rate of up to 70.67% was achieved and the degradation efficiency was 90% after 5 cycles of CuFe2O4@CSBC use. The degradation was in a second-order reaction at a constant of 0.797 M-1 min-1 (R2 = 0.993). The degradation was attributed to the main active species (SO4·-≈·OH < 1O2), and the surface active site of CuFe2O4@CSBC was the key role. The degradation process involved three main degradation pathways. Path A: ·OH attacked the C-Br bonds (TBBPA→TriBBPA→DBBPA→MBBPA→BPA); Path B: Hydroxylation and decarboxylation; Path C: Dehydrocoupling of TBBPA. What's more, the practical application of the system was very positive, achieved >77% degradation in sewage and industrial wastewater.

Zn and N co-doped three-dimensional honeycomb-like carbon featured with interconnected nano-pools for dendrite-free zinc anode.

The zinc-ion battery (ZIB) has been extensively researched as one of the promising electrochemical power sources. However, the problem of Zn-dendrite formation during repeated plating and stripping process seriously hinders the development of ZIBs. Herein, three-dimensional (3D) honeycomb-like porous carbon (HPC) with co-doping of zinc and nitrogen is prepared through confining growth of nanoscale zeolite imidazole framework-8 (ZIF-8) on the well-designed nano-pools walls of HPC followed by pyrolysis at 600 ℃ to obtain the final product ZnN/HPC-600, which exhibits large surface area and abundant zincophilic interfaces, ensuring homogeneous distribution of electronic field and low polarization during cycling process. Importantly, ZnN/HPC-600 facilitates the uniform distribution and migration of Zn2+ in this nano-pools structure, avoiding the growth of dendritic Zn crystal during charging stage. The symmetric and asymmetric cells with Zn/ZnN/HPC-600 anodes are assembled, demonstrating excellent cycling reversibility, good rate performance and long-term stability. Besides, a Zn||MnO2 full cell with Zn/ZnN/HPC-600 anode also exhibits robust cycling stability, fast reaction kinetics and almost 100 % coulombic efficiency. This work offers a novel and efficient carbonaceous nano-pools strategy to realize dendrite-free zinc anode in ZIBs.

Role of hsa_circ_0066966 in proliferation and migration of hepatitis B virus-related liver cancer cells.

A large proportion of liver cancer cases is caused by hepatitis B virus (HBV) infection. In recent years, an increasing number of reports have indicated that circular RNAs (circRNAs) exert regulatory effects in cancer development, whereas the role of circRNAs in HBV-positive liver cancer requires further investigation. In the present study, abnormally expressed circRNAs were identified in HBV-positive liver cancer cells through microarray analysis. A total of 1,493 differentially expressed circRNAs [absolute fold-change (FC) ≥2] in HBV-positive liver cancer cells were detected, of which 171 were upregulated and 1,322 were downregulated. Subsequently, Gene Ontology enrichment analysis indicated that the genes of dysregulated circRNAs were mainly involved in regulating Sertoli cell differentiation and development, as well as telomeric DNA binding. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that most of these genes were enriched in cancer-related signaling pathways, including the MAPK and Hippo signaling pathways. Next, the expression levels of the top-10 dysregulated circRNAs were verified in HBV-positive liver cancer cells through reverse transcription-quantitative PCR. Among them, hsa_circ_0066966 had the highest absolute Log2FC value and was abnormally increased in HBV-positive liver cancer cells. Functional experiments further verified that knockdown of hsa_circ_0066966 had a significant inhibitory effect on the proliferation and migration of HBV-positive liver cancer cells. By contrast, overexpression of hsa_circ_0066966 in HBV-negative liver cancer cells resulted in the opposite effect. In conclusion, in the present study, comprehensive circRNA profiling in HBV-positive liver cancer cells indicated that hsa_circ_0066966 may regulate the progression of HBV-positive liver cancer.

Fe-ZIF8 Coating Cu Foil Derived Carbon as A pH-Universal Electrocatalyst for Efficient Oxygen Reduction Reaction.

It is a great challenge to fabricate highly efficient pH-universal electrocatalysts for oxygen reduction reaction (ORR). Herein, a facile strategy, which includes coating the Fe modified ZIF8 on Cu foil and in situ pyrolysis to evaporate and dope Cu into the MOF derived carbon, is developed to fabricate Fe/Cu-N co-doped carbon material (Cu/Fe-NC). Profiting from the modulated electron distribution and textual properties, well-designed Cu/Fe-NC exhibits superior half-wave potential (E1/2 ) of 0.923 V in alkaline, 0.757 V in neutral and comparable 0.801 V in acid electrolytes, respectively. Furthermore, the ultralow peroxides yield of ORR demonstrates the high selectivity of Cu/Fe-NC in full pH scale electrolytes. As expected, the self-made alkaline and neutral zinc-air batteries equipped with Cu/Fe-NC cathode display excellent discharge voltages, outstanding peak power densities and remarkable stability. This work opens a new way to fabricate highly efficient and pH-universal electrocatalysts for ORR through strategy of Fe/Cu-N co-doping, Cu foil evaporation and carbon defects capture.

Low Molecular Pectin Inhibited the Lipid Accumulation by Upregulation of METTL7B.

Inhibition of lipid accumulation is the key step to prevent nonalcoholic fatty liver (NAFL) progressing to nonalcoholic steatohepatitis. We aimed to study the effect of low-molecular-weight citrus pectin (LCP) against lipid accumulation and the underlying mechanism. Oleic acid (OA)-induced lipid deposition in HepG2 cells was applied to mimic in vitro model of lipid accumulation. Oil Red O (ORO) stain result showed lipid accumulation was significantly reduced, and levels of adipose triglyceride lipase (ATGL) and carnitine palmitoyltransferase-1 (CPT-1), involved in triacylglycerol catabolism and fatty acid ß-oxidation, detected by RT-qPCR were increased after OA-stimulated HepG2 cells treated with LCP. RNA sequencing analysis identified 740 differentially expressed genes (DEGs) in OA-stimulated HepG2 cells treated with the LCP group (OA+LCP group), and bioinformatics analysis indicated that some DEGs were enriched in lipid metabolism-related processes and pathways. The expression of the top 8 known DEGs in the OA+LCP group was then verified by RT-qPCR, which showed that fold change (abs) of METTL7B was the highest among the 8 candidates. In addition, overexpression of METTL7B in HepG2 cells significantly inhibited the lipid accumulation and enhanced levels of ATGL and CPT-1. In conclusion, LCP inhibited lipid accumulation through the upregulation of METTL7B, and further enhancement of ATGL and CPT-1 levels. LCP is expected to develop as a promising agent to ameliorate fat accumulation in NAFL.

Effects of LPS on the Secretion of Gonadotrophin Hormones and Expression of Genes in the Hypothalamus-Pituitary-Ovary (HPG) Axis in Laying Yangzhou Geese.

Lipopolysaccharide (LPS) from gram-negative bacteria was found to be involved in the decrease in laying performance in goose flocks with high stocking density during summer months. LPS injection delayed the increase in the laying rate and altered hierarchical follicle morphology. While there is evidence that LPS exerts suppressive effects on goose reproduction, the time course effects of LPS on the hypothalamus-pituitary-ovary (HPG) axis remain elusive. In this study, we investigated the expression of genes in the HPG axis and the plasma gonadotrophin hormone concentrations in breeding geese at 0, 6, 12, 24, and 36 h after intravenous injection with LPS. The results showed that LPS treatment enhanced and suppressed expression of hypothalamic gonadotropin-inhibiting hormone (GnIH) and gonadotrophin-releasing hormone (GnRH) mRNA, respectively, and similar effects were observed on the mRNA expression of their receptors, GnIHR and GnRHR, in the pituitary. LPS treatment transiently increased follicle FSHß mRNA expression at 12 h and exerted no significant effect on LHß mRNA expression in the pituitary. Regardless of the expression of FSHß and LHß, plasma follicle stimulating hormone (FSH) and luteinizing hormone (LH) concentrations were significantly increased during 24-36 h after LPS treatment. In the ovary, StAR and Cyp11a1 were mainly expressed in the granulosa layer (GL) of hierarchical follicles, while Cyp17a1 and Cyp19a1 were mainly expressed in white follicles (WFs) and yellowish follicles (YFs), and to a lesser extent in the theca layer (TL). After LPS treatment, the mRNA levels of Cyp11a1 in the GLs, Cyp17a1 in the WFs and TL, and Cyp19a1 in the WFs, YFs, and TL were significantly decreased. However, LPS treatment transiently upregulated StAR expression at 12 h. These results indicate that the exposure of laying geese to LPS may impair the HPG axis and disturb ovarian steroidogenesis. Our research provides new insights into reproductive dysfunction caused by LPS and the immune challenge in birds.

lncRNA TMPO-AS1 Exerts Oncogenic Roles in HCC Through Regulating miR-320a/SERBP1 Axis.

BACKGROUND: Previous evidence have shown that long non-coding RNA (lncRNA) TMPO antisense RNA 1 (TMPO-AS1) is involved in the aggressiveness of several cancers. Nevertheless, the precise functions of TMOP-AS1 in hepatocellular carcinoma (HCC) are still unresolved. MATERIALS AND METHODS: The expressions of TMPO-AS1 and miR-320a were detected in HCC tissues and cells by qRT-RCR. The cell growth, migration and invasion were detected by colony formation, wound healing assay and Transwell assay, respectively. The targeting relation between miR-320a and TMPO-AS1 was predicted by bioinformatics analysis and identified by luciferase reporter gene as well as FISH assay. The expression of SERPINE1 MRNA Binding Protein 1 (SERBP1) was detected by Western blot. The growth of HCC cell was analyzed using transplanted tumor model. RESULTS: Currently, we revealed that TMPO-AS1 was overexpressed in clinical HCC samples and a panel of HCC cell lines. Clinically, a higher level of TMPO-AS1 was connected to the advanced stage of HCC and worse prognosis of patients. Depletion of TMPO-AS1 repressed HCC cell viability, migration ability and invasiveness. Nevertheless, upregulation of TMPO-AS1 caused opposite results. Further studies revealed that lncRNA TMPO-AS1 was largely located in the cytoplasm of HCC cell and sponge miR-320a, resulting in increasing the level of SERBP1 in HCC cell. Finally, TMPO-AS1 silencing suppressed tumor growth of HCC cell in vivo. CONCLUSION: Collectively, our results suggested that TMPO-AS1 was a promoting factor for the aggressive behaviors of HCC cell.

Multitarget stool DNA test compared with fecal occult blood test for colorectal cancer screening.

Patient screening is important for early diagnosis of colorectal cancer (CRC). The present study aimed to compare the multitarget stool DNA (mt-sDNA) test with the fecal occult blood test (FOBT) for CRC screening. A total of 151 individuals were screened using colonoscopy, mt-sDNA and FOBT for the detection of CRC and adenoma. The results of the mt-sDNA test and FOBT were compared with colonoscopy to examine their sensitivity and specificity. Subsequently, the sensitivity and specificity of the mt-sDNA test were compared with those of FOBT in CRC and large adenoma. Stool samples were collected from patients with CRC (n=50) or large adenoma (n=51), as well as from normal controls (n=50). The mt-sDNA test outperformed FOBT in detecting CRC with a sensitivity of 90.0% (45/50) vs. 42.0% (21/50), advanced adenoma with a sensitivity of 70.6% (36/51) vs. 19.6% (10/51), stage I-III CRC with a sensitivity of 91.9% (34/37) vs. 29.7% (11/37), and stage IV CRC with a sensitivity of 84.6% (11/13) vs. 76.9% (10/13). In addition, the mt-sDNA test exhibited a specificity of 94.0% (47/50) in detecting CRC, which was superior to FOBT with a specificity of 90.0% (45/50). Therefore, the mt-sDNA test may have higher sensitivity and specificity compared with FOBT in diagnosing both CRC and advanced adenoma.

lncRNA-ATB promotes stemness maintenance in colorectal cancer by regulating transcriptional activity of the ß-catenin pathway.

Long non-coding RNA activated by transforming growth factor-ß (ATB) was recently reported to be involved in a wide range of physiological and pathological processes. However, the role of ATB in colorectal cancer (CRC) stemness remains unclear. In the present study, the functional role of ATB in maintaining stemness of CRC was determined using colony formation and sphere formation assays, and xenograft models. Reverse transcription-quantitative PCR, western blotting and immunohistochemistry were performed to investigate the mechanisms underlying the effects of ATB. Knockdown of ATB impaired colony formation and sphere formation in CRC cells, accompanied by an inhibition of colon tumor growth. Further results suggested that ATB regulated the transcriptional activity of the ß-catenin pathway by inhibiting ß-catenin expression. In addition, the results confirmed the role of ß-catenin in ATB-mediated regulation of stemness in CRC. Collectively, the results indicated that ATB is a promising therapeutic target for CRC.

Silencing long non-coding RNA, differentiation antagonizing non-protein coding RNA promotes apoptosis and inhibits tumor growth in colon cancer.

The long non-coding RNA (lncRNA) differentiation antagonizing non-protein coding RNA (DANCR) has been reported to be a novel potential biomarker for colon cancer prognosis. However, its functional role in colon cancer remains unknown. In the present study, DANCR expression in colon cancer cell lines was determined by reverse transcription-quantitative polymerase chain reaction. Cell Counting kit-8 assay, colony formation assay, flow cytometry, Hoechst 33258 staining and western blotting were utilized to investigate the effect and mechanism of DANCR in the regulation of colon cancer growth. Establishment of a xenograft tumor model followed by terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling assay and immunohistochemical staining were performed to confirm the findings in vitro. DANCR was revealed to be overexpressed in all human colon cancer cell lines. Silencing DANCR by small interfering RNA significantly inhibited cell proliferation and colony formation. Flow cytometry analyses and Hoechst 33258 staining revealed that apoptosis was induced upon DANCR-knockdown. Silencing DANCR was revealed to efficiently impair colon tumor growth by promoting caspase 3 expression and tumor apoptosis. In summary, the results of the present study demonstrated that DANCR is a potential therapeutic target in colon cancer.

Hydrogen-motivated electrolysis of sodium carbonate with extremely low cell voltage.

Hydrogen-motivated electrolysis of Na2CO3 for energy-saving production of NaOH and CO2/NaHCO3 is realized by the hydrogen oxidation reaction to insert proton into anolyte and the hydrogen evolution reaction to extract proton out of catholyte. Electrolytic voltage at 100 mA cm-2 is as low as 0.88 V; this voltage is only 35% of the voltage used in the traditional electrolysis.

Hierarchical Porous Carbon Doped with Iron/Nitrogen/Sulfur for Efficient Oxygen Reduction Reaction.

Hierarchical porous Fe/N/S-doped carbon with a high content of graphitic nitrogen (FeNS/HPC) has been successfully synthesized by a facile dual-template method. FeNS/HPC shows not only macropores resulting from the dissolution of the SiO2 template, but abundant mesopores were also obtained after removing the in situ generated Fe2O3 nanoparticles on the ultrathin (∼4 nm) carbon shell of the macropores. Moreover, micropores are produced during the thermal pyrolysis of the carbon precursors. With respect to the electrochemical performance in the oxygen reduction reaction (ORR), FeNS/HPC not only exceeds other prepared porous carbon materials completely but also shows higher onset potential (0.97 vs 0.93 V), half-wave potentials (0.87 vs 0.83 V), and diffusion current density (5.5 vs 5.3 mA cm-2) than those of Pt/C. Furthermore, FeNS/HPC also exhibits outstanding stability and methanol tolerance, making it a competent candidate for ORR. The following aspects contribute to its excellent ORR performance. (1) High content of graphitic N (5.1%) and codoping of pyridinic N species, thiophene-S, FeNx, and graphitic carbon-encapsulated iron nanoparticles, providing highly active sites. (2) The hierarchical porous mesh structure with micro-, meso-, and macroporosity, accelerating the mass transfer and facilitating full utilization of the active sites. (3) The high specific surface area (1148 m2 g-1) of the graphitic carbon shell, assuring a large interface and rapid electron conduction for ORR.

Mineralization of pyrene induced by interaction between Ochrobactrum sp. PW and ryegrass in spiked soil.

This study was conducted to investigate the capability of pyrene-degrading bacterium Ochrobactrum sp. PW and ryegrass (Lolium multiflorum) grown alone and in combination on the degradation of pyrene in soil. After 60 days of ryegrass growth, plant biomass, pyrene-degrading microbial mass, soil enzyme activity (catalase activity and polyphenol oxidase activity) and residual concentration of pyrene in soils were determined. Higher dissipation rates were observed in PW inoculation treatments: ryegrass+PW rhizosphere soil (RP-r) and ryegrass+PW non-rhizosphere soil (RP-nr), than planting of ryegrass alone, rhizosphere (R-r) or non-rhizosphere (R-nr). The inoculation with PW significantly (p<0.05) increased the dry weight of ryegrass root and shoot, nearly 2.8 and 3.3 times higher than ryegrass treatment. The pyrene-degrading microbial mass indicated that a much larger mass of bacteria, actinobacteria were present in RP treatment. The catalase activity in all different treatments were significantly (p<0.05) higher than in with treatment R-nr, and the polyphenol oxidase activity was also significantly (p<0.05) increased by inoculation with PW, leading to enhanced mineralization of pyrene from soil. Our results suggest that adding of PAHs-degrading bacteria to soil can enhance remediation of PAHs contaminated soil, while improving plant growth.

Comparison of different noninvasive diagnostic methods for biliary atresia: a meta-analysis.

BACKGROUND: This study was undertaken to retrospectively analyze the accuracy of different methods in differentiating biliary atresia from neonatal jaundice. METHODS: A search was made in MEDLINE, and the Web of Science for relevant original articles published in English; methodological quality of the included studies was also assessed. Two reviewers extracted data independently. Studies were pooled, summary receiver operating characteristics curve and diagnostic odds ratio (DOR) with corresponding confidence intervals were calculated. RESULTS: For diagnosis of biliary atresia, ultrasonography (US), hepatic scintigraphy (HBS), and magnetic resonance cholangiography (MRCP) had a pooled sensitivity of 74.9% (range: 70.4%-79.1%), 93.4% (range: 90.3%-95.7%) and 89.7% (range: 84.8%-93.4%), a specificity of 93.4% (range: 91.4%-95.1%), 69.2% (range: 65.1%-73.1%) and 64.7% (range: 58.0%-71.0%), a positive likelihood ratio of 12.16 (range: 6.41-23.08), 3.01 (range: 2.15-4.20) and 3.10 (range: 1.59-6.06), a negative likelihood ratio of 0.23 (range: 0.13-0.38), 0.13 (range: 0.06-0.25) and 0.16 (range: 0.06-0.44), DOR of 72.56 (range: 27.34-192.58), 29.88 (range: 12.82-69.64) and 32.48 (range: 8.22-128.29), with an area under the curve of 0.96, 0.91, and 0.92, and Q value of 0.90, 0.85, and 0.85, respectively. CONCLUSIONS: US, HBS and MRCP can be very useful for the diagnostic work-up of neonatal cholestasis. To improve the sensitivity and specificity, several additional measures can be used.

[APPLICATION OF DIGITAL PLANNING WITH BONE PARAMETERS IN DETERMINING OPTIMAL SIZE OF PROSTHESIS].

OBJECTIVE: To investigate the accuracy and value of digital planning with bone parameters in determining the appropriate prosthesis for total hip arthroplasty (THA). METHODS: The preoperative radiographs was taken in 13 cases scheduled for THA between September 2012 and June 2013; the bone parameters were measured by digital template, and the prosthesis was selected and preoperative plan was made. There were 4 males and 9 females with an average age of 54.08 years (range, 41-79 years), including 8 left hips and 5 right hips. The causes were osteonecrosis of the femoral head in 8 cases and femoral neck fracture in 5 cases (3 cases had osteonecrosis of the femoral head). RESULTS: The operation time was 140-254 minutes (mean, 191.8 minutes). Two cases received blood transfusion, and 6 patients received plasma substitutes transfusion. There was no intraoperative fractures or postoperative thrombosis; atherosclerotic plaque occurred in 2 cases. Thirteen cases were followed up 12-24 months with an average of 17.3 months. The pain was relieved and limb function was improved in all patients. Harris score was significantly improved from preoperative 54.0 ± 12.9 to 91.1 ± 4.1 at 3 months after operation (t = 7.259, P = 0.000). Compared with the actual implants, the appropriate sizes of femoral stem was selected in 12 cases (92.31%) (excellent in 9 cases, good in 3 cases, and poor in 1 case), and the appropriate sizes of acetabular cup was selected in 11 cases (84.62%) (excellent in 7 cases, good in 4 cases, and poor in 2 cases). CONCLUSION: Digital planning could increase the accuracy in choosing the size of prosthesis for THA.

Glomus mosseae enhances root growth and Cu and Pb acquisition of upland rice (Oryza sativa L.) in contaminated soils.

A pot culture experiment was carried out to investigate the roles of Glomus mosseae in Cu and Pb acquisition by upland rice (Oryza sativa L.) and the interactions between Cu and Pb. The soil was treated with three Cu levels (0, 100 and 200 mg kg(-1)) and three Pb levels (0, 300, and 600 mg kg(-1)). All treatments were designed with (+M) or without (-M) G. mosseae inoculation in a randomized block design. The addition of Cu and Pb significantly decreased root mycorrhizal colonization. Compared with -M, +M significantly increased root biomass in almost all treatments, and also significantly increased shoot biomass in the Pb(0)Cu(200), Pb(300)Cu(0), and all Pb(600) treatments. AM fungi enhanced plant Cu acquisition, but decreased plant Cu concentrations with all Cu plus Pb treatments, except for shoot in the Cu(200)Pb(600) treatment. Irrespective of Cu and Pb levels, +M plants had higher Pb uptakes than -M plants, but had lower root Pb and higher shoot Pb concentrations than those of -M plants. Another interpretation for the higher shoot Pb concentration in +M plants relied on Cu-Pb interactions. The study provided further evidences for the protective effects of AM fungi on upland rice against Cu and Pb contamination, and uncovered the phenomenon that Cu addition could promote Pb uptake and Pb partitioning to shoot. The possible mechanisms by which AM fungi can alleviate the toxicity induced by Cu and Pb are also discussed.

Review of the molecular pathogenesis of osteosarcoma.

Treating the osteosarcoma (OSA) remains a challenge. Current strategies focus on the primary tumor and have limited efficacy for metastatic OSA. A better understanding of the OSA pathogenesis may provide a rational basis for innovative treatment strategies especially for metastases. The aim of this review is to give an overview of the molecular mechanisms of OSA tumorigenesis, OSA cell proliferation, apoptosis, migration, and chemotherapy resistance, and how improved understanding might contribute to designing a better treatment target for OSA.

[Treatment of severe displaced proximal humeral fractures with titanium elastic nails in older children].

OBJECTIVE: To evaluate the effectiveness of titanium elastic nails for severe displaced proximal humeral fractures in older children. METHODS: Between April 2009 and July 2012, 31 cases of severe displaced proximal humeral fractures were treated with closed or open reduction and fixation with 2 titanium elastic nails, and the clinical data were retrospectively analyzed. There were 23 boys and 8 girls, aged from 10 to 15 years (mean, 12.8 years). The causes of injury were sports injury (16 cases), traffic accident (11 cases), and falling from height (4 cases). The interval from injury to operation was 6 hours to 7 days (mean, 72 hours). According to Neer-Horwitz classification, 17 cases were rated as type III fracture and 14 cases as type IV fracture. There were 21 cases of metaphyseal fractures and 10 cases of epiphyseal fractures. RESULTS: Satisfactory reduction of fracture and stable fixation were obtained in all patients (closed reduction in 23 cases and open reduction in 8 cases). Primary healing was achieved in all incisions; no infection and neurovascular injury occurred. All patients were followed up 12-36 months with an average of 20 months. X-ray films showed that all fractures healed at 7-10 weeks (mean, 8 weeks). During follow-up, no disturbance of development or angulation deformity caused by premature physeal closure or bone bridge formation was observed. At last follow-up, the average Neer score of the shoulder was 95.7 (range, 83-100). The appearance and motion of the shoulder were normal. There was no significant difference in the upper extremity length between affected side and contralateral side [(67.68 +/- 2.56) cm vs. (67.61 +/- 2.54) cm; t = 1.867, P = 0.072]. CONCLUSION: Titanium elastic nails for severe displaced humeral fractures in older children is a safe and effective method with a low complication incidence.

Closed/open reduction and titanium elastic nails for severely displaced proximal humeral fractures in children.

PURPOSE: The aim of the study was to evaluate the clinical outcome of closed/open reduction and titanium elastic nails (TENs) in children with severely displaced proximal humeral fractures. METHODS: A retrospective study was performed on 37 children suffering from proximal humeral fracture between April 2009 and July 2012. All these patients were treated by closed or open reduction with TEN fixation. The healing process was assessed by radiographic and clinical follow-up for up to 36 months. Radiographic assessment was performed on the scheduled follow-ups to examine fracture healing, remodelling, bone growth and residual deformity. The clinical outcomes were evaluated using the Neer shoulder score and patients' satisfaction report at the final follow-up. Complications related to the treatment were also recorded. RESULTS: All patients had a mean follow-up period of 24 months (12-36) after surgery. All fractures were healed, radiologically, at a median time of eight weeks (seven to ten weeks). There were no major complications related to the treatment. Two patients complained about skin irritation around the sides of the prominent distal ends of the nails. Implant removal took place at an average of 5.8 months post-operatively as an outpatient procedure. There were no observed complications in association with the removal of the hardware. At the final follow-up, the mean Neer shoulder score was 96.65 (range 83-100). Thirty patients were very satisfied with their surgical outcomes and the remaining seven were satisfied. Function of the affected arm returned to normal at the end of the follow-up period in all cases. CONCLUSIONS: Combining closed or open reduction with TEN fixation is recommended for treating severely displaced proximal humeral fractures in children. Our data showed evidence of satisfactory outcomes with a low complication rate and a fast return to normal mobility of the affected arms.

Biomechanical analysis of pinning configurations for a supracondylar humerus fracture with coronal medial obliquity.

Despite hundreds of studies of pinning configurations for transverse supracondylar humerus fractures, very few studies have investigated the optimal pin configurations in the treatment of supracondylar humerus fractures with coronal medial obliquity. The aim of this study was to develop a model of supracondylar humerus fractures with coronal medial obliquity and compare the stability of three various pin configurations to provide an acceptable pin placement. Oblique cuts were made in synthetic humeri at the level of the coronoid and olecranon fossae to simulate a humeral supracondylar fracture with coronal medial obliquity. Each fracture was reduced and fixed using two 0.062 inch K-wires in three different configurations, and sequentially tested in extension, varus, valgus, and internal and external rotations using an MTS 858 Minibionix materials testing load frame. We performed analysis of variance to compare construction stiffness of different pin configurations and the standard level of significant (P-value ≤ 0.05) was used indicate statistical significance. In resistance to extension and valgus loading, there was no statistical difference between all the three pin configurations (P=0.22 and 0.130, respectively). During the varus loading condition, the greatest stiffness values were obtained with the two crossed pin configuration, followed by the two medial pins, and the two lateral pin configuration showed the lowest values. For resistance in internal and external rotation testing, although there was no statistical difference between the two medial pins and the two crossed pins configurations (P=0.06 and 0.75, respectively), they were significantly greater than that of the two lateral pin configuration (P=0.003 and 0.004; P=0.001 and 0.02, respectively). In a synthetic humerus model of supracondylar humerus fractures with coronal medial obliquity, the two crossed pin configuration provided statistically greatest or comparable stability in the varus, and internal and external rotation loading conditions.