Han's technique: a new reduction technique for acute anterior shoulder dislocation.

INTRODUCTION: Acute anterior shoulder dislocation (AASD) is the most common joint dislocation. Here, we introduced a new reduction technique for AASD, named "Han's technique" (or "Touch overhead technique"). METHODS: Patients diagnosed with AASD were treated with "Han's technique" in the orthopaedic department of our hospital from October 2018 to November 2020. An orthopedic surgeon performed the reduction maneuver without any anesthesia or sedation throughout the reduction process. The fundamental information and related data were recorded, including patients' age, sex, dislocation side, previous dislocations history, reduction time, number of attempts at reduction, success rate of the reduction, intensity of pain during reduction using the 10-point visual analogue scale score (VAS), any complications, with or without the fracture and neurovascular examination results. RESULTS: Forty-one patients with AASD were involved in our study. Thirty-nine cases (95%) were primary dislocation. Eleven patients (27%) were complicated with large tubercle fracture and one patient (2%) complicated with inferior glenoid fractures. All patients were successfully reduced by Han's technique with mean reduction time was 138 s. The pain score during the reduction operation is only1.83 ± 0.83 points. No neurovascular injury or iatrogenic fracture was found after reduction in all patients. CONCLUSIONS: Han's technique (or Touch overhead technique) is a simple, safe, effective, mild and easy to master which can be operated by one surgeon without anesthesia or sedation for AASD.

OptADMET: a web-based tool for substructure modifications to improve ADMET properties of lead compounds.

Lead optimization is a crucial step in the drug discovery process, which aims to design potential drug candidates from biologically active hits. During lead optimization, active hits undergo modifications to improve their absorption, distribution, metabolism, excretion and toxicity (ADMET) profiles. Medicinal chemists face key questions regarding which compound(s) should be synthesized next and how to balance multiple ADMET properties. Reliable transformation rules from multiple experimental analyses are critical to improve this decision-making process. We developed OptADMET ( https://cadd.nscc-tj.cn/deploy/optadmet/ ), an integrated web-based platform that provides chemical transformation rules for 32 ADMET properties and leverages prior experimental data for lead optimization. The multiproperty transformation rule database contains a total of 41,779 validated transformation rules generated from the analysis of 177,191 reliable experimental datasets. Additionally, 146,450 rules were generated by analyzing 239,194 molecular data predictions. OptADMET provides the ADMET profiles of all optimized molecules from the queried molecule and enables the prediction of desirable substructure transformations and subsequent validation of drug candidates. OptADMET is based on matched molecular pairs analysis derived from synthetic chemistry, thus providing improved practicality over other methods. OptADMET is designed for use by both experimental and computational scientists.

Dose-dependent effects of nicotine on proliferation and differentiation of human bone marrow stromal cells and the antagonistic action of vitamin C.

A range of biological and molecular effects caused by nicotine are considered to effect bone metabolism. Vitamin C functions as a biological antioxidant. This study was to evaluate the in vitro effects of nicotine on human bone marrow stromal cells and whether Vitamin C supplementation show the antagonism action to high concentration nicotine. We used CCK-8, alkaline phosphatase (ALP) activity assay, Von Kossa staining, real-time polymerase chain reaction and Western Blot to evaluate the proliferation and osteogenic differentiation. The results indicated that the proliferation of BMSCs increased at the concentration of 50, 100 ng/ml, got inhibited at 1,000 ng/ml. When Vitamin C was added, the OD for proliferation increased. For ALP staining, we found that BMSCs treated with 50 and 100 ng/ml nicotine showed a higher activity compared with the control, and decreased at the 1,000 ng/ml. Bone morphogenetic protein-2 (BMP-2) expression and the calcium depositions decreased at 100 and 1,000 ng/ml nicotine, while the addition of Vitamin C reversed the down regulation. By real-time PCR, we detected that the mRNA expression of collagen type I (COL-I) and ALP were also increased in 50 and 100 ng/ml nicotine groups (P < 0.05), while reduced at 1,000 ng/ml (P < 0.05). When it came to osteocalcin (OCN), the changes were similar. Taken all together, it is found that nicotine has a two-phase effect on human BMSCs, showing that low level of nicotine could promote the proliferation and osteogenic differentiation while the high level display the opposite effect. Vitamin C could antagonize the inhibitory effect of higher concentration of nicotine partly.

Effect of AQP4 and its palmitoylation on the permeability of exogenous reactive oxygen species: Insights from computational study.

Aquaporin 4 (AQP4) facilitates the transport of reactive oxygen species (ROS). Both cancer cells and the ionizing radiation microenvironment can induce posttranslational modifications (PTMs) in AQP4, which may affect its permeability to ROS. Because this ROS diffusion process is rapid, microscopic, and instantaneous within and outside cells, conventional experimental methods are inadequate for elucidating the molecular mechanisms involved. In this study, computational methods were employed to investigate the permeability of exogenous ROS mediated by radiation in AQP4 at a molecular scale. We constructed a simulation system incorporating AQP4 and AQP4-Cysp13 in a complex lipid environment with ROS. Long-timescale molecular dynamics simulations were conducted to assess the structural stability of both AQP4 and AQP4-Cysp13. Free energy calculations were utilized to determine the ROS transport capability of the two AQP4 proteins. Computational electrophysiology and channel structural analysis quantitatively evaluated changes in ROS transport capacity under various radiation-induced transmembrane voltage microenvironments. Our findings demonstrate the distinct transport capabilities of AQP4 channels for water molecules and various types of ROS and reveal a decrease in transport efficiency when AQP4 undergoes palmitoylation modification. In addition, we have simulated the radiation-induced alteration of cell membrane voltage, which significantly affected the ROS transport capacity. We propose that this research will enhance the understanding of the molecular mechanisms governing the transport of exogenous ROS by AQP4 and elucidate the influence of palmitoylation on ROS transport. This study will also help clarify how different structural features of AQP4 affect the transport of exogenous ROS mediated by radiotherapy, thereby providing a theoretical molecular basis for the development of new treatment strategies that combine with radiotherapy.

Nicotine-induced chondrogenic differentiation of human bone marrow stromal cells in vitro.

PURPOSE: Nicotine has been reported that it has a dose-dependent effect on matrix mineralization by human bone marrow cells. However, there is no relevant research concerning on chondrogenic differentiation potential of bone marrow stromal stem cells (BMSCs) treated with nicotine in vitro. The aims of the study were to examine the effects of nicotine (0, 10(-7), 10(-6) and 10(-5) M) on the proliferation and chondrogenic differentiation of BMSCs from three healthy donors in vitro. METHODS: BMSCs proliferation was analyzed by CCK8 assay and real-time polymerase chain reaction was used to assay the expression of type II collagen, aggrecan, type I collagen and type X collagen. The proteoglycan content was stained by Alcian blue, and the sulfated glycosaminoglycan (sGAG) content of BMSCs was quantified spectrofluorometrically using dimethylmethylene blue. RESULTS: The cell viability was not significantly impaired until up to a concentration of 10(-5) M nicotine. Nicotine promoted the proliferation and enhanced the expression of type II collagen at the level up to 10(-6) M (P < 0.05). The expression of aggrecan was reduced at the concentration of 10(-5) M nicotine at day 14 (P < 0.05), and there was no significant difference in aggrecan gene expression at 10(-7) and 10(-6) M nicotine levels compared to control group (n.s.). Also the fibroblastic and hypertrophic gene expressions were down-regulated in the chondrogenic medium with 10(-7)-10(-5) M nicotine (P < 0.05). CONCLUSION: It was implied that local application of nicotine at an appropriate concentration may be a promising approach for enhancing chondrogenic differentiation capacity of BMSCs in cell-based cartilage tissue engineering. Also these results indicate that nicotine maybe a potentially useful drug for the treatment of Osteoarthritis.

Application Value of Total Knee Arthroplasty plus Platelet-Rich Plasma Therapy in Traumatic Arthritis of the Knee.

Purpose: This work is aimed at determining the application value of platelet-rich plasma (PRP) therapy plus total knee arthroplasty (TKA) in traumatic arthritis (TA) of the knee. Methods: A retrospective study was conducted on 78 cases of TA of the knee admitted between March 2021 and January 2022 to the Quanzhou First Hospital Affiliated to Fujian Medical University. Based on different treatment methods, 38 cases treated with TKA were assigned to the control group, and 40 cases intervened by PRP+TKA were included in the observation group. The operation time (OT), drainage volume (DV), total blood loss (TBL), incision inflammatory reaction rate, and grade A healing rate were recorded. Besides, preoperative and postoperative knee joint Hospital for Special Surgery (HSS) scores, knee joint pain assessed by visual analogue scale (VAS), knee joint range of motion (ROM), and bone metabolism parameters (osteocalcin (OST), total N-terminal propeptide of type I procollagen (tPINP), and ß-isomerized C-terminal telopeptides (ß-CTX)) were recorded. Results: The observation group showed reduced postoperative DV and TBL than the control group (P < 0.05). The two cohorts differed insignificantly in OT, incision inflammatory response rate, and grade A healing rate (P > 0.05). The observation group also had better improvement in the HSS score, pain VAS score, and knee ROM (P < 0.05). And higher postoperative OST and tPINP levels while lower ß-CTX were determined in the observation group (P < 0.05). Conclusions: PRP+TKA can validly improve the levels of bone metabolism markers in patients with TA of the knee and promote their knee functional recovery, with favorable safety.

Effect of Vacuum Sealing Drainage on Soft Tissue Injury of Traumatic Fracture and Its Effect on Wound Recovery.

Purpose: The current work is mainly to explore the effect of vacuum sealing drainage (VSD) on soft tissue injury (STI) caused by traumatic fractures (TFs) and its effect on wound recovery. Methods: We first selected 90 patients with TF STI from May 2019 to May 2021, of which 40 patients (control group) received routine treatment, and the other 50 patients (observation group) were treated with VSD. The curative effect, rehabilitation (changing dressing frequency, healing time, and hospitalization time), pain severity, patient comfort, and complications were evaluated and compared. Results: The observation group exhibited a higher total effective rate, lower dressing change frequency, complication rate, and shorter healing time and hospital stay than the control group, which are statistically significant. Statistically milder pain sensation and better patient comfort were also determined in the observation group. Conclusions: VSD is effective and safe in the treatment of TF-induced sexually transmitted infections, which can effectively accelerate wound recovery while reducing pain sensation and improving patient comfort, with clinical promotion value.

Lithium ion sieve modified three-dimensional graphene electrode for selective extraction of lithium by capacitive deionization.

Faced with the strong demand of clean energy, development of lithium source is becoming exceedingly vital. Spinel-type manganese oxide (λ-MnO2) is a typical lithium ion sieve material. Herein, the conductive three-dimensional (3D) lithium ion sieve electrode material was fabricated by in-situ growth of λ-MnO2 on 3D reduced graphene oxide (3D-rGO) matrix for Li extraction by capacitive deionization (CDI). The λ-MnO2 modified rGO (λ-MnO2/rGO) retained the 3D network structure with uniform distribution of λ-MnO2 nanosheets on rGO. Electrochemical characterization demonstrated its high conductivity and fast lithium ion diffusion rate. By adjusting the rGO concentration, λ-MnO2 activity was improved significantly. With λ-MnO2/rGO as a positive electrode (activated carbon as negative electrode), the corresponding CDI system was successfully applied for the selective extraction of Li+. The final rGO content in the λ-MnO2/rGO was attained by thermogravity analysis. With the appropriate rGO content (15.5%), the obtained λ-MnO2/rGO electrode achieved the optimal Li+ adsorption amount. The corresponding λ-MnO2/rGO-based CDI cell showed good selectivity and high cycle stability. When applied to the extraction of lithium from synthetic salt lake brine, the electrode also obtained high Li+ adsorption amount with good selectivity.

Enhanced capacitive removal of hardness ions by hierarchical porous carbon cathode with high mesoporosity and negative surface charges.

Capacitive deionization (CDI), as a promising desalination technology, has been widely applied for water purification, heavy metal removal and water softening. In this study, the hierarchical porous carbon (HPC) with extremely large specific surface area (∼1636 m2 g-1), high mesoporosity and negative surface charges, was successfully prepared by one-step carbonization of magnesium citrate and acid etching. HPC carbonized at 800 ℃ exhibited an excellent specific capacitance (207.2 F g-1). The negative surface charge characteristic of HPC was demonstrated by potential of zero charge test. With HPC-800 as a CDI cathode, the super high adsorption capacity of hardness ions (Mg2+: 472 µmol g-1, Ca2+: 425 µmol g-1) with ultrafast adsorption rate was realized, attributed to its abundant mesoporous structure and negative surface charges. The priority order of ion adsorption on HPC in the multi-component salt solution was Mg2+ > Ca2+ > K+ ≈ Na+. The desalination and softening of the actual brackish water have been simultaneously achieved by three-cell CDI stack after four times of adsorption, with 63% decrease of total dissolved solids and 76% reduction of hardness. The current HPC material with outstanding adsorption performance for hardness ions shows great potential in brackish water purification.

CNT-Strung LiMn2 O4 for Lithium Extraction with High Selectivity and Stability.

LiMn2 O4 is of great potential for selectively extracting Li+ from brines and seawater, yet its application is hindered by its poor cycle stability and conductivity. Herein a two-step strategy to fabricate highly conductive and stable CNT-strung LiMn2 O4 (CNT-s-LMO) is reported, by first stringing Mn3 O4 particles with multiwalled carbon nanotube (CNT), then converting the hybrids into CNT-s-LMO through hydrothermal lithiation. The as-synthesized CNT-s-LMO materials have a net-like structure with CNTs threading through LMO particles. This unique structure has endowed the CNT-s-LMO electrode with excellent conductivity, high specific capacitance, and enhanced rate performance. Because of this, the CNT-s-LMO electrode in the hybrid capacitive deionization cell (HCDI) can deliver a high Li+ extraction percentage (≈84%) in brine and an outstanding lithium selectivity with a separation factor of ≈181 at the Mg2+ /Li+ molar ratio of 60. Significantly, the CNT-s-LMO-based HCDI cell has a high stability, evidenced by 90% capacity retention and negligible Mn loss in 100 cycles. This method has paved a new way to fabricate carbon-enabled LMO-based absorbents with tuned structure and superior capacity for electrochemical lithium extraction with high Li+ selectivity and exceptional cycling stability, which may help to tackle the shortage in supply of Li-ion batteries in industry in the future.

Steered sample algorithm for acoustic source localization.

High-precision source localization depends on many factors, including a suitable location method. Beamforming-based methods, such as the steered response power (SRP), are a common type of acoustic localization methods. However, these methods have low spatial resolution. The SRP method with phase transform (SRP-PHAT) improves the spatial resolution of SRP and is one of the most effective and robust methods for source localization. However, the introduction of a phase transform to SRP might amplify the power of the noise and result in many local extrema in the SRP space, which has a negative impact on source localization. In this paper, a steered sample algorithm (SSA) based on the reciprocity of wave propagation for acoustic source localization is proposed. The SSA localization process is similar to the hyperbolic Radon transform, which is theoretically analyzed and is the most essential difference form the SRP/SRP-PHAT. Compared with the SRP-PHAT, the experimental results demonstrate that the SSA perform better when it comes to array signal positioning with limited array elements and narrow azimuth signal, where SSA can achieve high precision positioning with lower SNR.

Less mechanical loading attenuates osteoarthritis by reducing cartilage degeneration, subchondral bone remodelling, secondary inflammation, and activation of NLRP3 inflammasome.

AIMS: Osteoarthritis (OA) is a disabling joint disorder and mechanical loading is an important pathogenesis. This study aims to investigate the benefits of less mechanical loading created by intermittent tail suspension for knee OA. METHODS: A post-traumatic OA model was established in 20 rats (12 weeks old, male). Ten rats were treated with less mechanical loading through intermittent tail suspension, while another ten rats were treated with normal mechanical loading. Cartilage damage was determined by gross appearance, Safranin O/Fast Green staining, and immunohistochemistry examinations. Subchondral bone changes were analyzed by micro-CT and tartrate-resistant acid phosphatase (TRAP) staining, and serum inflammatory cytokines were evaluated by enzyme-linked immunosorbent assay (ELISA). RESULTS: Our radiographs showed that joint space was significantly enlarged in rats with less mechanical loading. Moreover, cartilage destruction was attenuated in the less mechanical loading group with lower histological damage scores, and lower expression of a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-5, matrix metalloproteinase (MMP)-3, and MMP-13. In addition, subchondral bone abnormal changes were ameliorated in OA rats with less mechanical loading, as reduced bone mineral density (BMD), bone volume/tissue volume (BV/TV), and number of osteophytes and osteoclasts in the subchondral bone were observed. Finally, the level of serum inflammatory cytokines was significantly downregulated in the less mechanical loading group compared with the normal mechanical loading group, as well as the expression of NACHT, LRR, and PYD domains-containing protein 3 (NLRP3), caspase-1, and interleukin 1ß (IL-1ß) in the cartilage. CONCLUSION: Less mechanical loading alleviates cartilage destruction, subchondral bone changes, and secondary inflammation in OA joints. This study provides fundamental insights into the benefit of non-weight loading rest for patients with OA. Cite this article: Bone Joint Res 2020;9(10):731-741.

Parosteal ossifying lipoma of the clavicle: A case report.

Lipomas are very common benign adipose tissue tumors that most often develop in subcutaneous tissue. A limited number of studies have described the characteristics of parosteal ossifying lipomas located in the fibula, cervical vertebrae and mandible. However, to the best of our knowledge, parosteal ossifying lipoma of the clavicle has not yet been reported. We herein describe the clinical symptoms, radiological and histological findings in a rare case of parosteal ossifying lipoma of the clavicle in a 40-year-old male patient. The characteristic histological appearance, together with computed tomography and/or magnetic resonance imaging characteristics, should aid in the accurate diagnosis of such cases.

Silibinin alleviates high glucose-suppressed osteogenic differentiation of human bone marrow stromal cells via antioxidant effect and PI3K/Akt signaling.

High glucose is one of the possible causes for osteoporosis and fracture in diabetes mellitus. Our previous study showed that silibinin can increase osteogenic effect by stimulating osteogenic genes expression in human bone marrow stem cells (hBMSCs). However, no study has yet investigated the effect of silibinin on osteogenic differentiation of hBMSCs cultured with high glucose. The aim of this study was to evaluate the influence of high glucose on osteogenic differentiation of hBMSCs and to determine if silibinin can alleviate those effects. In this study, the hBMSCs were cultured in an osteogenic medium with physiological (normal glucose, NG, 5.5mM) or diabetic (high glucose, HG, 30mM). The effects of silibinin on HG-induced osteogenic differentiation were evaluated by alkaline phosphatas (ALP) activity assay, Von Kossa staining and real time-polymerase chain reaction. HG-induced oxidative damage was also assessed. Western blot were performed to examine the role of PI3K/Akt pathway. We demonstrated that HG suppressed osteogenic differentiation of hBMSCs, manifested by a decrease in expression of osteogenic markers and an increase of oxidative damage markers including reactive oxygen species and lipid peroxide (MDA). Remarkably, all of the observed oxidative damage and osteogenic dysfunction induced by HG were inhibited by silibinin. Furthermore, the PI3K/Akt pathway was activated by silibinin. These results demonstrate that silibinin may attenuate HG-mediated hBMSCs dysfunction through antioxidant effect and modulation of PI3K/Akt pathway, suggesting that silibinin may be a superior drug candidate for the treatment of diabetes related bone diseases.

Effect of calcium citrate on bone integration in a rabbit femur defect model.

OBJECTIVE: To explore effect of calcium citrate on bone integration in a rabbit femur defect model, and to compare the bone formation with different sizes by radiological and histological study. METHODS: Twenty-four male Japanese white rabbits were randomly divided into three groups (Group A, B, C) in this study. Under anesthesia, defects of four sizes (1.2, 1.5, 2.0 and 2.5 mm) were created in each of the rabbits. Commercially pure calcium citrate powder was placed inside the medullary compartment of the femur (Experimental), while in the contralateral femur (Control) nothing was implanted. The defects were analyzed using radiography and histological analysis by using Imagepro-Plus 6.0 software after animal was sacrificed at 4th(Group A), 6th(Group B) and 8th(Group C) weeks postoperatively. Four samples were analyzed for each size of defect and each healing period. RESULTS: The histological and the radiologic evaluation were performed after sacrification of all rabbits on postoperative 4th and 6th weeks, It showed significant difference between the experimental group and the control group when these defects were less than or equal to 2.0 mm. No statistical difference was observed when these defects were larger than 2.0 mm at all healing periods except at the 4th week. CONCLUSIONS: Calcium citrate affects the early periods of bone defects healing mechanism in Japanese white rabbits positively, especially when the defect is not too large. We suggest further studies on calcium citrate to determine the effects of various dosages, administration ways and the experimental time on the bone defects.