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Objective Anterolateral coronal fractures are so rare that the mechanism of injury, the type of combined fracture and ligament injury, and the optimal treatment are unknown. To study the outcome of surgical treatments for anterolateral (AL) fracture of the ulna coronoid process (Adams Type IV) and summarize the characteristics of this type of fracture and to guide clinical applications. Methods From February 2015 to April 2021, 32 patients were included in the study. All patients had standard radiography with anteroposterior and lateral views, computed tomography, and intraoperative fluoroscopy. All patients were treated surgically. Surgery‐related information, including surgical approach, operation duration, blood loss, and repairing the lateral collateral ligament and the medial collateral ligament integrity, were recorded. The patient's clinical details, such as the final range of motion (ROM), the Broberg–Morrey scores and the visual analogue scale (VAS) at the last follow‐up, were described. The chi‐square test or Fisher's exact test was used for statistical analysis. Results We divided patients into two groups according to the anterolateral coronoid fracture morphology. In the intact group, 20 patients with an intact anterolateral coronoid fracture fragment. In the comminuted group, 12 patients with comminuted anterolateral coronoid fracture fragments extended the less sigmoid notch of the ulna. There was no difference in age, sex, total incision length, follow‐up duration, and recovery with rehabilitation among the two groups (all Ps >0.05). The other follow‐up outcomes, such as elbow ROM (Flexion, Extension, Posterior rotation, Anterior rotation), VAS score, or Broberg–Morrey scores, were not different between the two groups (all Ps >0.05). Both groups achieved relatively satisfactory clinical outcomes, and the Broberg–Morrey score and index excellence rate reached 84.38%. There is a statistical difference in the history of elbow dislocation (P = 0.017), radial head fracture type (P = 0.041), operation duration (P = 0.014) and blood loss at operation (P = 0.029) between the two groups. Cannulated screws, anchors, and sutures were used as point fixation in the coronoid process of the ulna. There was a statistical difference between the two groups in the choice of internal fixation (P = 0.020). Conclusions For anterolateral ulnar coronoid fractures with different degrees of comminution, effective and reliable surgical treatment can achieve better results and fewer complications.

In this paper, the longitudinal model of an uncertain aircraft is taken as the research object, and the aircraft path inclination is controlled by controlling the input rudder deflection angle. An adaptive iterative learning control (AILC) scheme is proposed to solve the accurate tracking control problem of the flight path inclination on a finite time interval. The aircraft track angle system is abstractly modeled to obtain a triangular model in the form of strict feedback. For the abstracted strict feedback model, the fuzzy logic is used to approximate the uncertain part of the model. A command filter and an error compensation mechanism are introduced to prevent the computational bloat problem caused by excessive system order, and a convergent series sequence is used to deal with the truncation error caused by the approximation of the fuzzy logic. Based on the Lyapunov stability theorem, all signals of the closed-loop system are bounded on the finite time interval 0,T, and the output of the system can track the desired trajectory accurately. Finally, the feasibility and effectiveness of the method are verified by MATLAB simulation results.

Background Restenosis is one of the main bottlenecks in restricting the further development of cardiovascular interventional therapy. New signaling molecules involved in the progress have continuously been discovered; however, the specific molecular mechanisms remain unclear. MTMR14 (myotubularin‐related protein 14) is a novel phosphoinositide phosphatase that has a variety of biological functions and is involved in diverse biological processes. However, the role of MTMR14 in vascular biology remains unclear. Herein, we addressed the role of MTMR14 in neointima formation and vascular smooth muscle cell (VSMC) proliferation after vessel injury. Methods and Results Vessel injury models were established using SMC‐specific conditional MTMR14‐knockout and ‐transgenic mice. Neointima formation was assessed by histopathological methods, and VSMC proliferation and migration were assessed using fluorescence ubiquitination‐based cell cycle indicator, transwell, and scratch wound assay. Neointima formation and the expression of MTMR14 was increased after injury. MTMR14 deficiency accelerated neointima formation and promoted VSMC proliferation after injury, whereas MTMR14 overexpression remarkably attenuated this process. Mechanistically, we demonstrated that MTMR14 suppressed the activation of PLK1 (polo‐like kinase 1) by interacting with it, which further leads to the inhibition of the activation of MEK/ERK/AKT (mitogen‐activated protein kinase kinase/extracellular‐signal‐regulated kinase/protein kinase B), thereby inhibiting the proliferation of VSMC from the medial to the intima and thus preventing neointima formation. Conclusions MTMR14 prevents neointima formation and VSMC proliferation by inhibiting PLK1. Our findings reveal that MTMR14 serves as an inhibitor of VSMC proliferation and establish a link between MTMR14 and PLK1 in regulating VSMC proliferation. MTMR14 may become a novel potential therapeutic target in the treatment of restenosis.

Abstract Aim To investigate the effect of social support on psychological distress among Chinese lung cancer patients and clarify the mediating role of self‐esteem. Design A cross‐sectional descriptive correlational survey of 441 Chinese lung cancer patients was designed. Methods Self‐esteem was supposed to play a mediating role in the association between social support and psychological distress. We collected demographic information, the Distress Thermometer, Multidimensional Scale of Perceived Social Support and Rosenberg Self‐Esteem Scale. Results Our revised model demonstrated an acceptable fit to the data (χ2 = 37.489, comparative fit index (CFI) = 0.965, Tucker‐Lewis index (TLI) = 0.926, root mean square error of approximation [RMSEA] = 0.099). Social support had a direct effect on self‐esteem and psychological distress, and self‐esteem had also a direct effect on psychological distress. Meanwhile, self‐esteem also partially mediated the relationship between social support and psychological distress among Chinese lung cancer patients.

Objective To assess the short‐term efficacy of reverse shoulder arthroplasty in the treatment of complex proximal humeral fractures in the elderly. Methods Forty‐three elderly patients treated operatively for complex proximal humeral fractures with reverse shoulder arthroplasty from July 2017 to January 2019 were retrospectively reviewed. To be specific, 12 males and 31 females were reviewed with an average age of 72.0 years (range, 66–78 years). All fractures were attributed to trauma and treated for 8.0 days on average (range, 6–11 days). As suggested from Neer classification, 21 cases (48.8%, 21/43) were three‐part fractures, and 22 (51.2%, 22/43) were four‐part fractures. To assess the postoperative efficacy, Visual Analog Scale (VAS), American Society of Shoulder and Elbow Surgery Shoulder Joint Score (ASES), Constant–Murley score and radiological examination were adopted. The Neer three‐part fracture group and the Neer four‐part fracture group were compared. Results There was no significant difference in age, gender, operation time, and follow‐up period between Neer three‐part fracture group and Neer four‐part fracture group. All operations were successfully performed, and the average operation time was 120–170 min, with an average of 141.3 min. Besides, the mean blood loss was 407.0 mL (250–700 mL), and the average intraoperative blood transfusion reached 446.5 mL (400–800 mL). All patients received the follow‐up for 6 to 16 months, that is for 10.9 months on average. All patients were discharged in 7 days after operation, and no wound‐related complications were identified. In 8 weeks, the greater and lesser tuberosities of all patients healed completely. During the last follow‐up, no loosening or dislocation of prosthesis was detected, and the forward elevation of 133.0 (100°‐ 165°), the external rotation of 29.5° (20°–35°), the internal rotation of 46.7°(30°–60°), the VAS score of 0.8(0–3), the ASES score of 89.1(78.8–100.0) were achieved. Constant‐Murley score reached 88.7 (range, 70–98). There was no significant difference between Neer three‐part fracture group and Neer four‐part fracture group (P > 0.05). A 71‐year‐old patient developed the symptoms of axillary nerve injury after operation; he recovered completely at 6 weeks after the operation, which had not adversely affected the functional rehabilitation exercise or the stability of the prosthesis. At the follow‐up, no other complications (e.g., infection, acromial stress fracture, and scapular notching) were identified in all patients. Conclusion The short‐term efficacy of one‐stage reverse shoulder arthroplasty to treat complex proximal humeral fractures in the elderly is satisfactory.

Objective To figure out the difference between patients with posterior Monteggia fractures which were concomitant with proximal radioulnar joint (PRUJ) dislocation and posterior fracture‐dislocation of the proximal ulna that were not concomitant with PRUJ. Methods From January 2016 to January 2019, 37 consecutive adult patients who had posterior fracture‐dislocation of proximal ulna (no PRUJ dislocation, n = 16) and posterior Monteggia fractures (PRUJ dislocation, n = 21) were included. All patients had intraoperative fluoroscopy, computed tomography (CT) scans, and standard radiography (anteroposterior view and lateral view). The mechanism of injury, the cases with open fracture, sustained multiple injuries and classification of fracture was recorded. The clinical details of the patients such as the final range of motion (ROM) and the Broberg–Morrey scores were described. Results Patients with PRUJ dislocation (ten type A, five type B, and six type D) and those without concomitant PRUJ dislocation (fifteen type A and one type C) exhibited an obvious difference according to the classifications of Jupiter et al. (P = 0.010). Ninety‐five percent of patients who had PRUJ dislocation were accompanied by a metaphyseal fracture, while only 50% of the patients who did not have PRUJ dislocation were accompanied by a metaphyseal fracture (P = 0.002). Meanwhile, 16 of 20 metaphyseal fractures had more than one fragment in the group of dislocations, but five of eight metaphyseal fractures were comminuted in the control group. The two groups exhibited an obvious difference (P = 0.009). The 21 patients who sustained a radioulnar dislocation had less mean arc of flexion, pronation, and Broberg–Morrey scores were significantly less than the patients of the control group (flexion: 117.38 ± 14.46 vs 127.50 ± 13.416, P = 0.035; pronation: 59.76 ± 11.88 vs 67.50 ± 6.58, P = 0.017; Broberg–Morrey: 80.48 ± 12.17 vs 88.19 ± 10.28, P = 0.040). Conclusions Patients suffering posterior Monteggia fractures had more metaphyseal fractures, more comminuted fractures of the metaphysis, and worse ultimate ulnohumeral motion than patients of posterior fracture‐dislocation of proximal ulna.

The chitosan is a good flocculant for tap water treatment because of its properties such as faster deposition rate and higher removal efficiency for COD (organic matter), SS (suspended solids), and metal ions. However, its high price limits the use in tap water treatment. In this paper, in order to reduce costs, chitosan (CTS), polyaluminum chloride (CF-PAC), and modified rectorite (Al(OH)3 + HCl) were combined to prepare the flocculant for tap water treatment. In order to get the optimal composite flocculant formula, first, we combined these flocculants in two-by-two schema and then we combined all the three flocculants together with various dosing amounts. Through comparison between different combination schemas, the best formula of the composite chitosan flocculant was found to be CTS (ml) : CF-PAC (ml) : modified rectorite (Al(OH)3 + HCl) (ml) = 1 : 30 : 5, with a turbidity removal rate of 96.38% and a removal rate of aluminum up to 80.1%, while the treatment cost is the lowest. In addition, we have designed a cost-effective method for the treatment cost evaluation. As raw water, we used water from the Han River, which is used as raw water at Zonguan Waterworks. In order to show the effectiveness of our optimal composite chitosan formula, we have compared our treatment results to those of the aluminum polyaluminum chloride flocculant currently used in Zonguan’s water treatment plants.