BACKGROUND:The essence of cell differentiation is a selectively intra-cellular gene expression,which results in specific proteinic synthesis and causes changes in biochemistry,structure and function.Thus,original proteomics and a single protein analysis can not meet the requirement in study.Proteomics technology provides a powerful tool due to the large scale,systemical study of protein transformation and interaction,which can be used for exploring molecular mechanism of bone mesenchymal stem cells(BMSCs)during directional differentiation.OBJECTIVE:To introduce proteomics,to summarize the research of proteomics in directional differentiation of BMSCs,and to forecast the development of proteomics research methods.METHODS:To search articles highly related with BMSCs,cell differentiation,and proteomics published on CNKI (www.cnki.net/index.htm),Sciencedirect(http://www.Sciencedirect.com),I.S.I(http://www.isiwebofknowledge.com)were searched,and the key achievements were included in the analysis.RESULTS AND CONCLUSION:A total of 29 documents were reviewed,and the experiences in the application of proteomics technology in the directional differentiation of BMSCs were summarized.With the innovation and development in methodology and technology,proteomics will become a powerful tool for us to study the potential mechanisms of BMSCs directional differentiation.

Heterotopic ossification is the abnormal formation of true bone within extraskeletal soft tissues, which frequently showing a predilection instead for fascia, tendons, and other mesenchymal soft tissues. This paper summarized differential types and quantities of regulatory proteins expression at different stages of heterotopic ossification by proteomics techniques, and screened differential expression of functional proteins at different time points. Further more, identificated and validated certain proteins, which helpful to discovery new regulatory proteins and explore the mutual relationships among the proteins. Proteomics has extensive applications in regulatory proteins research of post-traumatic heterotopic ossification, can further elucidate the mechanism of post-traumatic ectopic bone formation and search for new regulatory biomolecule regulatory sites.

BACKGROUND:The tumor tissue engineering can build an integrated culture model to ful y simulate the in vivo microenvironment of tumor growth, which can be used to study tumor developmental dynamics and related treatment strategies.
OBJECTIVE:To review the three-dimensional culture of tumor cells using tumor engineering technology.
METHODS:PubMed database was retrieved for articles related to tumor engineering, three-dimensional culture of tumor cells, biological scaffold materials and tumor microenvironment published from January 1992 to March 2013.
RESULTS AND CONCLUSION:Three-dimensional culture, because of its reproducible tissue and cellgrowth in vivo, has become an important platform for study of tumor resistance, invasiveness and tumor microenvironment. The three-dimensional culture has showed a trend to gradual y replace the flat culture technique in many fields, and provides a research platform which is very close to in vivo environment. In recent years, with the development of tumor engineering, a variety of new polymer materials have been used in the three-dimensional culture of tumor cells. Three-dimensional culture technology is becoming a hotspot in the field of tumor biology, in which, using a variety of methods and materials, the cells show a growth in the spatial manner to form a biological support or matrix similar to in vivo growth environment. Biomaterials have become the soil on which seed cells can grow wel , and plays an alternative to the extracellular matrix or the matrix of tissues and organs in the tumor engineering. Therefore, the three-dimensional cellculture has been widely used in cancer research, which has become a powerful tool to tumor drug resistance, angiogenesis, cel-cellinteraction, signal transduction, stem cells and other research.

Objective To study the relationship between intraoperative findings during knee joint replacement and clinical manifestations in elderly patients with knee osteoarthritis.Methods A total of 150 cases of senile knee osteoarthritis(182 knee joints) was selected for total knee replacement.Their X-ray examination results were gathered for recording the impairment of the articular surface,the joint space narrowing,and the location and amount of osteophytes.An MRI examination was performed in some of the cases for recording changes of fibrocartilage and locations of meniscus.Results Out of the 150 cases,there were 108 cases of genu varum(mean inversion angle,12.5?;range,0?~25?),21 cases of genu valgum(mean eversion angle,18.3?;range,15?~25?),and 21 cases of flexion contracture (mean angle,15.3?;range,0?~40?).The X-ray findings showed varying degrees of joint space narrowing in all the 150 cases,and osteophytes on the posterior border or at lateral part of the knee joint in 131 cases(152 joints).MRI examinations were performed in 11 cases(15 joints),in which discontinuous,cystoid,and worn-out fibrocartilages were seen.Radial displacement of the meniscus was found.Intraoperative findings proved that the fibrocartilage on the articular surface on the side with joint space narrowing was severely worn away,the collateral ligaments were contracted,the osteophytes were seen at the posterior part of the tibia and the femur,and abrasion or radial displacement of the meniscus on the side with joint space narrowing.Conclusions Joint space narrowing,varus or valgus deformity,osteophytes,and radial displacement of the meniscus are usually found in aged patients with knee osteoarthritis.

[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 systematically assess the efficacy of endoscopic operation and open operation for treating carpal tunnel syndrome .Methods The computer retrieval from MEDLINE ,EMBASE ,Cochrane August ,CNKI ,VIP ,Wanfang databases were conducted for collecting all related randomized controlled trials (RCT ) from February 1989 to February 2012 .The included litera-tures were performed the data extraction ,assessment of bias risk and the quality evaluation .Mata analysis was performed by the RevMan 5 .1 .6 software .Results 21 RCTs including 1 863 operations ,982 cases endoscopic carpal tunnel release (ECTR) and 881 cases of open carpal tunnel release(OCTR) ,met the inclusion criteria .Meta analysis showed that the differences in terms of postop-erative grip strength ,two points discrimination ,incidence of complications ,satisfaction rate ,postoperative symptom relief rate and operation time between the ECTR group and the OCTR group had no statistical significance .The ECTR group was better than the OCTR in the aspects of the time returnning to work ,pinch strength ,postoperative pain rate .Conclusion The ECTR group is supe-rior to the OCTR group in terms of the time returnning to work ,pinch strength ,postoperative pain rate .The other related indexes have no obvious differences between the two kinds of operation procedures .Due to the poor quality of some RCTs ,the above conclu-sion needs more high-quality ,large-sample clinical researches to confirm .

BACKGROUND:Recently, the clinical repair methods of irregular wound on fingers primarily include local pedicled flap and free mini-flap of upper extremities or lower extremities.
OBJECTIVE:To discuss the application of free mini-flap derived from upper limb in repairing the wound on fingers.
METHODS:From December 2010 to February 2014, 12 patients with irregular wounds on 12 fingers were selected from Department of Traumatic Orthopaedics and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, China. The size of wounds ranged from 1.5 cm × 2.0 cm to 3.0 cm × 4.5 cm with different degrees of bone or tendon exposure. After the debridement, 12 patients were treated by free mini-flaps of upper limb. The donor sites were directly sutured.
RESULTS AND CONCLUSION:Among the 12 patients, al the wounds at recipient and donor sites were healed at stage I, and the free mini-flags survival completely. Al of patients were fol owed up for 3-6 months (average 4.5 months). Free mini-flags had good appearance and needn’t undergo secondary trimming. The active motion of fingers was improved dominantly. According to the criteria of Hand Surgery Association Society of Chinese Medical Association Society for the function evaluation of upper limb, three cases were excellent, eight were good, and only one was bad. The excellent and good rate was 91%. Free mini-flaps of upper limb are an ideal method for repair of wounds on fingers. It has no injury to normal tissue in hands, donor site is very secluded, and the short-term curative effect is good.

Objective:To investigate the improvement in antibiotics use in our hospital by comparing the prophylactic application of antibiotics in type I incision before and after antimicrobial drug special rectification. Methods:The medical records of 100 hospital-ized patients undergoing I incision respectively from May to December in 2011 (before the rectification), from May to December in 2012 ( during the rectification) and from May to December in 2013 ( after the rectification) were withdrawn randomly. The prophylactic application of antibiotics was statistically and comparatively analyzed. Results: After the antimicrobial drug special rectification, the prophylactic application rate of antibiotics was reduced from 100% to 28%, and in 7 kinds of operations stressed by the National Health and Family Planning Commission ( inguinal hernia repair, thyroid disease, breast disease, arthroscopy, carotid endarterectomy, skull tumor resection and endovascular interventional diagnosis) , the prophylactic use rate of antimicrobial drugs was reduced to 11%. The variety choice of antibiotics in type I incision was more reasonable. The irrationality rate of medication time and course was de-creased obviously, and the accuracy of dosage and usage was improved significantly. The combination of antibiotics was also notably decreased. Conclusion:The antimicrobial drug special rectification is effective, which can significantly improve the prophylactic appli-cation rationality of antibiotics for type I incision in our hospital.

BACKGROUND:Bone marrow mesenchymal stem cells have particularly applied prospects in tissue engineering. However, the death of transplanted cells limits the tissue regeneration. To search a new drug of anti-free radicals and protecting bone marrow mesenchymal stem cells is of great significance. OBJECTIVE:To investigate the protective effects of mangiferin on bone marrow mesenchymal stem cells against hypoxia. METHODS:Rat bone marrow mesenchymal stem cells were cultured in vitro and hypoxia cellmodel was established by cobalt chloride. cells were divided into normal control group, hypoxia group (treated with cobalt chloride), and mangiferin groups (cobalt chloride+20, 40, 80, 160 μmol/L mangiferin). After 12 and 24 hours of hypoxia, superoxide dismutase, malondialdehyde, and catalase levels in the cellsupernatant were determined. After 3, 6, 12, 24 hours of hypoxia, reactive oxygen species change was detected in each group. RESULTS AND CONCLUSION:Mangiferin significantly improved the survival rate of bone marrow mesenchymal stem cells exposed to hypoxia, increased the intracellular superoxide dismutase and catalase activities, decreased intracellular malondialdehyde and reactive oxygen species levels, thereby effectively protecting bone marrow mesenchymal stem cells against hypoxia. These findings indicate that mangiferin has effective protection against hypoxia and strong antioxidant ability, and can significantly reduce oxidative damage.

OBJECTIVE:Using in vitro studies,we evaluated the antibacterial activity of amoxicillin/tazobactam against 128 strains of pathogens isolated from patients and compared with amoxicillin/clavulanic acid and amoxicillin/sulbactam.METHODS:To detect the minimum inhibitory concentrations (MIC)of four ?-lactams against 128 clinically isolated strains with agar dilution method.RESULTS:The results indicated that the in vitro antibacterial activity of amoxicillin/tazobactam(2∶1) was the best.The MIC50 of amoxicillin/tazobactam(2∶1) is 1/4～1/8 times than those of amoxicillin/sulbutam and amoxicillin/clavulanic acid.The MIC90 of amoxicillin/tazobactam(2∶1) was 1/2～1/4 of those of amoxicillin/sulbutam and amoxicillin/clavulanic acid.The combination ratio 2∶1(amoxicillin/tazobactam)of the two compounds was more suitable than other combination ratios(4∶1 and 8∶1)for inactivating ?-lactamase.CONCLUSION:The in vitro antibacterial activities of amoxicillin/tazobactam(2∶1) against MRSA,MRSE,MSSA and E.coli are high.It showed that amoxicillin/tazobactam(2∶1)is stable to ?-lactamase and is an effective bactericidal agent.