[Treatment of severe acromioclavicular joint dislocation with double strand titanium cable and clavicular hook plate guided by self-made guide device].

OBJECTIVE: To compare the clinical efficacy of titanium cable biomimetic reconstruction of coracoclavicular ligament and clavicular hook plate in the treatment of acromioclavicular joint dislocation. METHODS: The clinical data of 39 patients with severe acute acromioclavicular joint dislocation from January 2017 to December 2018 were retrospectively analyzed, 19 patients in double strand titanium cable group, including 13 males and 6 females, aged from 26 to 67 years old; Rockwood classification:10 cases of type Ⅲ, 4 cases of type Ⅳ and 5 cases of type Ⅴ;8 cases of traffic injury and 11 cases of fall injury;the time from injury to operation was 3 to 6 days. There were 20 patients in steel plate group, including 15 males and 5 females, aged from 25 to 71 years old. Rockwood classification:11 cases of type Ⅲ, 4 cases of typeⅣ, 5 cases of type Ⅴ;7 cases of traffic injury, 13 cases of fall injury;the time from injury to operation was 2 to 7 days. The length of incision, operation time, intraoperative blood loss, cost, VAS score before and after operation, and Constant-Murley score before and after operation were compared between two groups. Postoperative X-ray films were taken to observe the reduction and maintenance of acromioclavicular joint dislocation. Complications were recorded. RESULTS: Thirty-six patients were followed up for 12 to 14 months. The amount of intraoperative blood loss in the two groups was basically the same. The operation incision in double strand titanium cable group was shorter, the operation time in steel plate group was shorter, and the operation cost in double strand titanium cable group was less. One week and one year after operation, the pain of double strand titanium cable group was less than that of steel plate group. One year after operation, the Constant-Murley score of double strand titanium cable group was higher than that of steel plate group. The postoperative X-ray showed that the acromioclavicular joint in double strand titanium cable group was well reduced, and there was 1 case with slight reduction loss. In the plate group, there was no reduction loss after removal of the clavicular hook plate, and 8 patients had distal clavicular bone atrophy or acromion bone resorption. In steel plate group, 4 cases had long-term postoperative pain, postoperative dysfunction and other complications. CONCLUSION: The clinical effect of coracoclavicular ligament reconstruction with double strand titanium cable is better than that of clavicular hook plate in the treatment of severe acute acromioclavicular joint dislocation, with less trauma (no secondary operation) and lower cost.

Improved proteomic analysis pipeline for LC-ETD-MS/MS using charge enhancing methods.

Electron transfer dissociation (ETD) is a useful and complementary activation method for peptide fragmentation in mass spectrometry. However, ETD spectra typically receive a relatively low score in the identifications of 2+ ions. To overcome this challenge, we, for the first time, systematically interrogated the benefits of combining ion charge enhancing methods (dimethylation, guanidination, m-nitrobenzyl alcohol (m-NBA) or Lys-C digestion) and differential search algorithms (Mascot, Sequest, OMSSA, pFind and X!Tandem). A simple sample (BSA) and a complex sample (AMJ2 cell lysate) were selected in benchmark tests. Clearly distinct outcomes were observed through different experimental protocol. In the analysis of AMJ2 cell lines, X!Tandem and pFind revealed 92.65% of identified spectra; m-NBA adduction led to a 5-10% increase in average charge state and the most significant increase in the number of successful identifications, and Lys-C treatment generated peptides carrying mostly triple charges. Based on the complementary identification results, we suggest that a combination of m-NBA and Lys-C strategies accompanied by X!Tandem and pFind can greatly improve ETD identification.