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.

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:3D printing technology for preoperative planning has been a trend at present. Moreover, this technology has been extensively used in bone tumor resection and maxilofacial surgery, but seldom used in fracture repair. OBJECTIVE: To explore the value of 3D printing technology application in preoperative evaluation of pelvic fracture, planning and during surgery. METHODS:Pelvic fracture patients underwent preoperative CT scan. Pelvic models of the patients were printed using 3D printing technology at 1:1. Preoperative processing was conducted, including choice of approach, design of incision exposure range, design of fracture reduction, pre-implantation position of the steel plate, optimal plastic design of steel plate, measurement of screw length and design of screw direction. Matta score of pelvic fracture reduction and Majeed score of pelvic function after repair were measured during folow-up. RESULTS AND CONCLUSION:The operation time was 55-130 minutes, averagely (84.75±20.15) minutes. Intraoperative blood loss was 200-800 mL, averagely (417.00±173.58) mL. After operation, no incision infection, fracture nonunion, fixator loosening or breakage appeared. Al patients were folowed up for 8-24 months. The fracture healing time was 10-16 weeks, averagely 12.5 weeks. Fracture reduction was assessed according to Matta scoring: excelent in 15 cases, good in 3 cases, average in 2 cases, and poor in 0 case, with an excelent and good rate of 90%. Postoperative function was assessed according to Majeed scoring: excelent in 13 cases, good in 5 cases, average in 2 cases, and poor in 0 case, with an excelent and good rate of 90%. These findings showed that the application of 3D printing technology in pelvic fracture can determine the fracture’s displacement, is helpful for accurate reduction and plate modeling, reduces surgery duration and intraoperative blood loss and complication, finaly achieves better surgical result. 3D printing technology can better evaluate and plan the pelvic fracture before repair, and can be used as a routine project preparation of pelvic fracture repair.

Objective To study nano-structured porous polycaprolactone combined with bone marrow stromal cells on CTGF expression in rabbit impaired cartilage. Methods 50 rabbits were randomly divided into normal group, model group, NSP-PCL group, BMSCs group, or NSP-PCL + BMSCs group. A model of rabbit impaired cartilage was surgically established. Then NSP-PCL, BMSCs, and NSP-PCL + BMSCs were separately administered to the latter three groups once a week from the 2nd week to the 5th week after the procedure. The impaired cartilage tissues were collected 24 h after the last administration. The cartilage tissues were pathologically examined by H & E staining. Number of surviving BMSCs was detected by Hoeehst33342 Markers 1 week and 3 weeks after transplantation. Levels of CTGF protein in cartilage were determined by immunohistochemistry and Western blotting. Results In the model group, cartilage layer became thinner, with proliferation of fibroblast cells and a obvious cartilage surface hollow; New cartilage cells appeared in the surface hollow of the impaired cartilage in each treatemnt group, with a thicker layer. The number of transplanted BMSCs after 3 weeks was significantly increased in BMSCs group and NSP-PCL + BMSCs group. As compared with the model group, levels of CTGF protein were increased in each treatment group, with significant differences (P < 0.05). Conclusions Nano-porous polycaprolactone combined with bone marrow mesenchymal stem cells can repair cartilage damage by enhancing the expression of CTGF protein.

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.