[Objective]To examine the mechanism and clinical outcome of the traction reduction method in treating the adult shoulder dislocation.[Method]From January 1997 to August 2007,68 patients diagnosed with shoulder-dislocation received reduction with this method.A retrospective and observational study of the outcomes was assessed in a number of patients.There were altogether 68 patients,51 male and 17 female,with an average age of 49(ranging from 16-82 years old).Forty of the cases occurred in the right shoulder and 28 others in the left,all caused by trauma:15 in traffic accidents,32 by injuries from falls,and 21 by sports injuries.Forty of the dislocations lied under the processus coracoideus,17 under the glenoid,6 under the collar bone and 5 post dislocation.Seventeen of the patients had recurrent dislocation,13 with nodules avulsion fracture of the humerus,2 with brachial plexus injury,3 with surgical neck of humerus fractures.The shortest time of restoration after injury was 30 minutes,and the longest 10 days,with an average of 2.1 days.[Result]Patients that had received the reduction method for 30 seconds to 5 minutes were all recovered with one treatment,the result being confirmed by X-rays.Sixty-four of the patients were followed up for 6-24 months and the clinical results were:61 cured and 3 turned to the better.[Conclusion]This method is easy and flexible in the reduction of adult shoulder dislocation,with fewer complications than other traditional methods.It accords with the shoulder anatomy and principles of bio-mechanics,and it is suitable to popularizing.

[Objective]To compare the complications of simultaneous versus staged bilateral total knee arthroplasty.[Methods]The databases of Cochrane library,Medline,Embase and Chinese Biomedical Databases were searched online.All the trials comparing simultaneous versus staged bilateral total knee arthroplasty were included.Methodology quality of the trials was assessed and the data of the complications in both groups was extracted,and the RevMan 5.0.18 was used for data-analysis.[Results]In this study,18 controlled trials and 101 084 cases were included(26 536 SB-TKA /74 548 Staged B-TKA).The result of Meta-analysis showed that the 30-day mortality(OR=2.92),3-month mortality(OR=2.11) and pulmonary embolism(OR=2.46) were higher in the SB-TKA group than in the staged B-TKA group.[Conclusion]Campared with staged B-TKA,SB-TKA has a higher risk of mortality and pulmonary embolism.The predominant cause of death after TKA was the cardiopulmonary complications.More and stronger evidence will be needed for supporting the outcomes.

Objective To assess the conscious sedative effect of midazolam during the procedure of ERCP, in terms of general stress responses of the patients, the circulatory change, tolerance, patient cooperation and safety during and after the procedure. Method One hundred twenty patients undergoing standard ERCP using the same model of endoscope. Each patient received intramuscular injection of midazolam at 0. 15mg/kg 20 min before starting the procedures. The sedative score (OAA/S) and the major vital signs (mean arterial pressure( MAP) ,heart rate(HR) and atrerial oxygen saturation (SpO2) ) were recorded during and after the endoscopic procedure. The degree of amnesia of the patients and the extent of satisfaction on both patient and physician sides were also assessed. Results The procedures were successfully completed in all patients. There was no significant change in MAP,HR and SpO2 in these patients. The adverse reactions to the procedures were significantly reduced. No signs of respiratory suppression was observed among this group of patients during and in the immediate post procedure period. Conclusion Conscious sedation by intramuscular injection of midazolam at a dose of 0. 15mg/kg 20min before the ERCP ameliorates the stress of the patients , maintained and steady hemodynamic condition for the procedure and an amnesia status after the procedure. Hence, midazolam is a satisfactory consions selative agent applicable in the ERCP examination.

BACKGROUND:The pathogenesis of knee osteoarthritis is stil not very clear, and there is a lack of early diagnosis methods. Because it is more common in middle-aged women, it is suggested that the pathogenesis of knee osteoarthritis may be closely related to serum estradiol levels in the human body. OBJECTIVE:To explore the correlation between the level of serum estradiol and the severity of osteoarthritis in female patients with knee osteoarthritis. METHODS:Seventy-six female patients with knee osteoarthritis admitted in the First Affiliated Hospital of Guangxi Medical University from February 2012 to December 2013 were enroled, and divided into premenopause group (n=42) and postmenopause group (n=34). According to Kelgren-Lawrence (K-L) grading, both two groups were subdivided into K-L 0, II and IV groups. The knee function was evaluated with Hospital for Special Surgery (HSS) Knee Score Standard in USA, the serum estradiol levels were detected with electrochemiluminescence immunoassay. Then, the correlation analysis was performed. RESULTS AND CONCLUSION: The serum estradiol levels of the premenopause group and postmenopause group were decreased significantly with the increase of K-L grade and age (P < 0.05). Under the same K-L grade, the serum estradiol levels in the postmenopausal patients were significantly lower than those in the premenopausal patients. Linear regression analysis showed that there was a negative relationship between age and serum estradiol level (R2=0.222,P < 0.05), and there was a positive correlation between HSS scores and serum estradiol levels (R2=0.415,P < 0.05). The severity of knee osteoarthritis in female patients shows a negative correlation with the level of serum estradiol but a positive correlation with age.

BACKGROUND:Hypoxic death limits application of cells in transplantation and tissue regeneration.
OBJECTIVE:To investigate the protective effects of mangiferin on bone marrow-derived mesenchymal stem cells against hypoxia injury-induced apoptosis resulted from cobalt chloride.
METHODS:Rat bone marrow-derived mesenchymal stem cells were in vitro cultured and hypoxia cellmodel was established by cobalt chloride. Model cells were treated with mangiferin. Protective effects of mangiferin were detected using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide;cellapoptosis and mitochondrial membrane potential were detected using flow cytometry.
RESULTS AND CONCLUSION:Cobalt chloride significantly inhibited growth of bone marrow-derived mesenchymal stem cells in a dose-dependent manner. The apoptosis rate of cells was (42.49±3.96)%after treated with 200μmol/L cobalt chloride for 12 hours, (46.37±4.49)%after treated for 24 hours. With increasing concentration of mangiferin, apoptosis of bone marrow-derived mesenchymal stem cells in hypoxic model was gradual y reduced (P<0.01), indicating that mangiferin has a protective effect in a concentration-dependent manner on rat bone marrow-derived mesenchymal stem cells in hypoxic injury. Cobalt chloride can induce hypoxic model successful y in bone marrow-derived mesenchymal stem cells. There are some advantages of accurate dose control, no special equipment requirements, and easy operation. Mangiferin can effectively inhibit bone marrow-derived mesenchymal stem cells apoptosis under hypoxic injury.

BACKGROUND:There is lack of effective diagnostic methods for early knee osteoarthritis. Proteomics refers to the large-scale experimental analysis of proteomes from the overal level of intracel ular protein compositioon, expression and modification, based on which, we can understand protein-protein interaction and relationship, thereby revealing protein functions and cel activity patterns. OBJECTIVE:To apply the isobaric tags for relative and absolute quantitation (iTRAQ) to identify proteins differential y in serums of osteoarthritis Kel gren-Lawrence classification at each stage, and to find out potential molecular markers at each stage of osteoarthritis. METHODS:Sixty patients with knee osteoarthritis were enrol ed, and according to Kel gren-Lawrence (K-L) grading, they were subdivided into K-L 0, II and IV groups. There were 10 males and 10 females randomly selected in each group. Proteins differential y regulated in serums were identified by the stable isotopes 116, 117, 118 of the iTRAQ labeled, reversed-phase column separation, mass spectrometry and Swissport database search, after the serums were subjected to high abundance proteins depletion. Final y, we analyzed the proteins identified by using bioinformatics software. RESULTS AND CONCLUSION:Total y 169 proteins were identified through iTRAQ peptides experiments of different sample tags, Q-star mass spectrum identification and MASCOT library search. 153 proteins were identified as K-L 0 to K-L IV, 153 proteins were identified as K-L 0 to K-L II, and 145 proteins were identified as K-L II to K-L IV. iTRAQ technology may help to identify novel serum markers for early diagnosis of knee osteoarthritis, indicating iTRAQ technology for proteomics serum biomarkers of osteoarthritis study has good application prospect.