Objective To determine the efficacy and safety of reamed versus nonreamed intramedullary nailing for femoral fractures in adults on the rates of nonunion, the rates of implant failure, the rates of pulmonary implications, infections, the time of union, et al. Methods According to Cochrane Systematic Review, Medline, Embase, Cochrane Library and CBM disc were searched for RCTs without limitation of language, and gray literatures had been also searched, furthermore, the bibliographies of retrieved papers and content experts were consulted for additional references. Methodology quality of literatures used simple evaluate method the Cochrane Collaboration recommended, which was graded to A, B, C. Data was extracted by two reviewers for inclusion using the designed extraction form. Revman 4.2.3 the Cochrane Collaboration provided were used for data management and analysis, and obtained evidences for the efficacy and safety of reamed versus nonreamed intramedullary nailing for femoral fractures in adults. Results Five RCTs were included by total retrieve and riddling. For methodology quality of literatures, one was A scale, two was B, and two was C. The combined results showed that reamed intramedullary nailing for femoral fractures in adults reduce the rates of nonunion RR=0.38, 95% CI(0.17, 0.88), P=0.02 , implant failure RR=0.45,95% CI (0.21,1.00), P=0.05 and the time to union WMD=-10.90,95% CI (-18.16,-3.64), P=0.003 . Conclusion To compare with nonreamed intramedullary nailing for femoral fractures in adults, reamed intramedullary nailing can reduce the rates of nonunion. However, the relation between reaming or not and implant failure, the time to union, pulmonary complications, infection etc needs further study.

Objective To obtain the peptide mass fingerprintings(PMF)of serums of the patients with bone metastasis and with-out metastasis and to filtrate and identify the differential serum proteins of patients with bone metastasis after radical mastectomy . To establish diagnostic models for diagnosis of bone metastasis after breast cancer operation .Methods Two groups of serum sam-ples were analyzed by ClinprotTM MALDI-TOF MS and gain PMF ,18 samples from patients with merely bone metastasis and 18 samples from patients without metastasis .Characteristic protein peaks were analyzed and selected by analyses software within Clin-prot system .Every group was repeated 2 times .Results All serum samples were repeated after 5 days and the fingerprintings were similar to the former .4 protein peaks were selected randomly to compute coefficient of variation which are less than 30% .The Clin-prot system has excellent repeatability .No differential protein was detected by analyzing PMF (P>0 .05) .Conclusion No differen-tial serum protein exists in patients with bone metastasis and without metastasis and detecting differential protein in peripheral blood may be impossible .