Objective To evaluate the effect of locking plate in the treatment of proximal humerus fractures and to compare the results of two approaches used for fixation.Methods Surgical treatment of 47 cases of proximal humerus fractures in the elderly in Affiliated Hospital of Yan′an University from September 2014 to September 2015.All fractures were randomly divided into two groups and treated with Phlios plate.Deltoid splitting and deltopectoral approaches were used for fixation respectively 23 cases and 24 cases.Postoperative shoulder function was evaluated according to Neer Score.Results The operation time,length of incision,intraoperative bleeding,fracture healing time,length of hospitalization in thoracic deltoid muscle group were more than deltoid splitting pathway group((90.1±6.3) min vs.(73.0±9.5) min,(10.0±3.5) cm vs.(6.3±2.6) cm,(100.0±30.1) ml vs.(90.6±36.4) ml,(3.2±0.8) months vs.(3.0±0.7) months,(10.3±1.9) d vs.(10.1±1.9) d),the difference of operation time(t=2.133,P=0.042) and length of incision(t=2.236,P=0.036) was statistically significant between the two groups,while the difference of the intraoperative bleeding(t=1.867,P=0.063),fracture healing time(t=1.064,P=0.242) and length of hospitalization(t=0.667,P=0.256) were not statistically significant.Followed up for 6.0-12.0 months,the average was (9.0±2.0) months,all patients achieved the bony healing.During the followed up,5 complication(10.6%) were encountered,including 2 cases of varus malunion,1 case of acromial impingement(115°-124°),1 case of screw cut-out and 1 case of humerus head osteonecrosis.The patients with tow-or three parts fractrues in tow groups,Neer-Score scores were statistically significant ((76.8±2.8) points vs.(76.1±2.6) points,(78.9±2.3) points vs.(77.8±2.4) points,t=2.76,2.58,P<0.05).There was no statistically significant difference between the four parts ((71.9±2.3) points vs.(72.6±2.1) points,t=1.06,P>0.05).The excellent-good rate in triangle muscle splitting approach group was 91.3%(21/23),of thoracic deltoid muscle group was 58.3%(14/24),there were significant different existed in two groups(P=0.023).Conclusion Locking plate for the treatment of proximal humerus fractures has a good effect.Deltoid splitting approach in the prognosis of function recovery has more advantages.

Eukaryotic translation initiation factor eIF2B, the guanine nucleotide exchange factor (GEF) for eIF2, catalyzes conversion of eIF2·GDP to eIF2·GTP. The eIF2B is composed of five subunits, α, β, γ, δ and ɛ, within which the ɛ subunit is responsible for catalyzing the guanine exchange reaction. Here we present the crystal structure of the C-terminal domain of human eIF2Bɛ (eIF2Bɛ-CTD) at 2.0-Å resolution. The structure resembles a HEAT motif and three charge-rich areas on its surface can be identified. When compared to yeast eIF2Bɛ-CTD, one area involves highly conserved AA boxes while the other two are only partially conserved. In addition, the previously reported mutations in human eIF2Bɛ-CTD, which are related to the loss of the GEF activity and human VWM disease, have been discussed. Based on the structure, most of such mutations tend to destabilize the HEAT motif.
Amino Acid Motifs ; Amino Acid Sequence ; Catalytic Domain ; Crystallography, X-Ray ; Eukaryotic Initiation Factor-2B ; biosynthesis ; chemistry ; Humans ; Molecular Sequence Data ; Protein Structure, Tertiary ; Protein Subunits ; biosynthesis ; chemistry ; Recombinant Proteins ; biosynthesis ; chemistry ; Sequence Alignment ; Structural Homology, Protein ; Surface Properties

Objective:To analyze the relationship between arch index and foot kinematic parameters and their characteristics in stress fracture of lower extremity.Methods:A case-control study was performed for 108 recruits selected from a certain army unit in 2019. Before training, the recruits′ foot print images were collected by the capacitive plantar pressure measurement system to calculate their arch indices. The kinematic characteristics of the foot were analyzed by the dynamic gait posture analysis system. Spearman rank correlation analysis between arch index and foot kinematic parameters including landing elevation angle, toe-off angle, landing speed, landing varus angle, valgus amplitude and landing valgus speed were performed. Throughout the training, orthopedic physicians followed up the recruits, among whom 10 were excluded due to other types of lower extremity injuries. The arch index and foot kinematic characteristics were analyzed and compared between the remained recruits with stress fracture of lower extremity (fracture group, n=10) and those without lower extremity injury (control group, n=79). Results:(1) For the recruits, the arch index was 0.21(0.12,0.25), with landing elevation angle for (17.31±4.02)°, toe-off angle for (63.90±5.63)°, landing speed for (176.85±24.39)°/s, landing varus angle for (13.64±4.44)°, valgus amplitude for (12.16±3.42)°, and landing valgus speed for 382.50(311.05,474.80)°/s. (2) The landing varus angle ( r=0.25, P<0.01) and valgus amplitude ( r=0.14, P<0.05) were positively related to the arch index. (3) The arch index, toe-off angle and landing valgus speed were 0.20(0.07,0.24), (61.59±5.51)° and 336.00(251.02,428.67)°/s in fracture group, significantly lower than 0.23(0.17,0.26), (64.79±4.79)° and 381.20(313.63,470.92)°/s in control group ( P<0.05 or 0.01). There were no significant differences in the landing elevation angle, landing speed, landing varus angle and valgus amplitude between the two groups (all P>0.05). Conclusions:The change of the arch index can affect the landing varus angle and valgus amplitude of the foot. Recruits who suffer from stress fracture of lower extremity have the characteristics of higher arch, lower toe-off angle and lower landing valgus speed.