Association between Deltoid Muscle Density and Proximal Humeral Fracture in Elderly Patients.

Background: The potential role of deltoid muscle density in the occurrence of proximal humeral fractures remains uncertain. Therefore, the primary objective of this study was to examine the correlation between deltoid muscle density, as measured by CT attenuation value in Hounsfield units (HU), and the incidence of proximal humeral fractures in elderly patients. By investigating this association, we aim to shed light on the possible influence of deltoid muscle density on fracture risk in this specific population. Methods: A total of 68 patients with computed tomography (CT) images were retrospectively reviewed. Among them, 34 patients presented with fractures following low-energy injuries, while the remaining 34 patients served as controls and underwent CT scans after low-energy injuries without any fractures. The muscle density of the deltoid muscles was assessed at the approximate tubercle of humerus. We compared these parameters between the two groups and conducted analyses considering factors such as age, sex, laterality, and deltoid muscle density of the shoulders. Results: The demographic factors related to the shoulder did not exhibit any significant association with proximal humeral fracture. However, we observed a noteworthy difference in deltoid muscle density between patients with fractures (40.85 ± 1.35) and the control group (47.08 ± 1.61) (p = 0.0042), indicating a lower muscle density in the fracture group. Conclusion: Based on the findings of this study, we can conclude that there exists a negative correlation between deltoid muscle density and the incidence of proximal humeral fractures. These results suggest that lower deltoid muscle density may be associated with an increased risk of proximal humeral fractures in the elderly population under investigation.

Epigallocatechin gallate protects MC3T3-E1 cells from cadmium-induced apoptosis and dysfunction via modulating PI3K/AKT/mTOR and Nrf2/HO-1 pathways.

Epigallocatechin gallate (EGCG), an active constituent of tea, is recognized for its anticancer and anti-inflammatory properties. However, the specific mechanism by which EGCG protects osteoblasts from cadmium-induced damage remains incompletely understood. Here, the action of EGCG was investigated by exposing MC3T3-E1 osteoblasts to EGCG and CdCl2 and examining their growth, apoptosis, and differentiation. It was found that EGCG promoted the viability of cadmium-exposed MC3T3-E1 cells, mitigated apoptosis, and promoted both maturation and mineralization. Additionally, CdCl2 has been reported to inhibit both the phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) and nuclear factor erythroid 2-related factor 2/heme oxygenase-1(Nrf2/HO-1) signaling pathways. EGCG treatment attenuated cadmium-induced apoptosis in osteoblasts and restored their function by upregulating both signaling pathways. The findings provide compelling evidence for EGCG's role in attenuating cadmium-induced osteoblast apoptosis and dysfunction through activating the PI3K/AKT/mTOR and Nrf2/HO-1 pathways. This suggests the potential of using EGCG for treating cadmium-induced osteoblast dysfunction.

A new species of the genus Achalinus (Squamata, Xenodermatidae) from southwest Hunan Province, China.

A new species of xenodermid snake, Achalinusnanshanensis H. Li, L.-Q. Zhu, Z.-Q. Zhang & X.-Y. Mo, sp. nov., is described based on three specimens collected from Nanshan National Park and Tongdao County of southwest Hunan Province. This new species is genetically distinct amongst its congeners with the mitochondrial COI uncorrected p-distance ranging from 4.4% (in A.yangdatongi) to 17.7% (in A.meiguensis). In addition, this new species can be distinguished from its congeners by a combination of the following morphological characters: (1) dorsal scales with 23 or 25 rows throughout and strongly keeled; (2) tail relatively longer so that TaL/ToL = 0.215-0.248; (3) length of suture between internasals significantly longer than that between prefrontals, LSBI/LSBP = 1.66-1.84; (4) single loreal scale present; (5) SPL 6 in number, with the fourth and fifth contacting eye; (6) IFL 6 in number, with the first three touching the first pair of chin shields; (7) TMP is 2-2-4/2-2(3)-4, with the anterior pair elongated and in contact with the eye; (8) ventrals 2 + 147-158; (9) subcaudals 64-77, unpaired; (10) dorsal body brownish black, with a bright yellow neck collar extending to the head and abdomen in the occipital region. The recognition of the new species increases the number of described Achalinus species to 28, of which 21 are found in China.

Clinical application of Kirschner wires combined with 5-Ethibond fixation for patella fractures.

Background: Patella fractures that require surgery are conventionally treated using Kirschner wires (K-wires) and stainless steel wires. In recent years, the nonabsorbable polyester has been reported to have excellent outcomes clinically. Therefore, the goal of our study was to evaluate the effects of Kirschner wires combined with 5-Ethibond on treating patellar fractures. Methods: From July 2018 to January 2022, 22 patella fracture patients were treated with Kirschner wires combined with 5-Ethibond. Radiographs of the knees were used to evaluate fracture healing and hardware complications. The clinical results were evaluated through the functional score, knee joint range of motion (ROM), and Bostman patella fracture functional score. Results: The average age of patients was 57.4 ± 11.9 (range 33-74) years. The mean follow-up time was 15.2 ± 7.6 (range 4-36) months. The mean operation time was 56.8 ± 8.7 (range 45-80) min. The entire patients had bony union at an average of 10.5 ± 1.9 (range 8-14) weeks. At the final follow-up, the mean range of postoperative ROM was 123.4° ± 14.6° (range 95°-140°), and the functional score was 28.7 ± 1.2 (range 26-30) points. No patient exhibited internal fixation failure, and no symptomatic implants or skin complications were recorded. Conclusions: The fixation approach using K-wires combined with 5-Ethibond has a lower complication rate and delivers superior clinical results. This research reveals that such technology is a safe and prospective substitute for conventional metal fixation approaches.

[Treatment of old radial head dislocation in children].

OBJECTIVE: To evaluate the short-term effectiveness of transarticular fixation of humeroradial joint by Kirschner wire (or combined with proximal ulnar osteotomy) for old radial head dislocation after open reduction of the radial head in children. METHODS: A retrospective analysis was made on the clinical data of 25 children with old radial head dislocation between January 2008 and December 2010. There were 18 boys and 7 girls, aged 2 years and 5 months to 9 years and 5 months (mean, 5 years and 11 months). The left side was involved in 13 cases, and the right side in 12 cases. The interval of injury and operation was 3 weeks to 30 months (median, 14 months). The main presentations were abnormal mass in the anterior elbow, motion limitation of forearm pronation, and dorsiflexion inability of wrist and thumb. Three patients had radial nerve lesion. In 23 patients with simple radial head dislocation, transarticular fixation of humeroradial joint by Kirschner wire was used after open reduction of the radial head; in 2 patients with Monteggia fracture, transarticular fixation by Kirschner wire and additional proximal ulnar osteostomy were used. RESULTS: A primary healing of incision was obtained, without complication of infection, joint stiffness, or radial head necrosis. Twenty-four patients were followed up 29-58 months (mean, 44.3 months); one case had re-dislocation, failed to be followed up at 2.5 months postoperatively. In 3 patients with radial nerve injury, neural function recovery was obtained in 2 cases, and no improvement was observed in 1 case. Twenty-three had no pain, no deformity, and no motion limitation of elbow and forearm except 1 patient with no improvement of neural function. The mean range of montion (ROM) of elbow flexion was 134 degrees (range, 125 - 140 degrees), and the mean ROM of extension was -4 degrees (range, - 8-0 degrees); the mean ROM of forearm pronation was 74 degrees (range, 65-80 degrees ), and the ROM of supination was 90 degrees. According to Mackay's criteria, the results were excellent in 22 cases, good in 1 case, and poor in 1 case at 2 years after operation. CONCLUSION: The transarticular fixation of humeroradial joint by Kirschner wire (or combined with proximal ulnar osteotomy) is a feasible and effective method to treat old radial head dislocation in children based on a short-term follow-up.