Geniposide attenuates cadmium­induced oxidative stress injury via Nrf2 signaling in osteoblasts.

Geniposide, as a type of iridoid glycoside, has antioxidative capacity. However, the mechanism underlying the effect of geniposide in cadmium (Cd)­induced osteoblast injury remains only partly elucidated. In the present study, Cell Counting Kit­8 (CCK­8) was used to determine MC­3T3­E1 cell viability. Flow cytometry was used to determine the rate of apoptosis and levels of reactive oxygen species (ROS). Oxidative stress­related factors were assessed using enzyme­linked immunosorbent method (ELISA). Quantitative real­time polymerase chain reaction (qPCR) and western blotting were used to evaluate apoptosis­ and bone formation­related genes and nuclear factor erythroid 2­related factor (Nrf2) signaling. It was demonstrated that geniposide increased the viability of the Cd­treated MC­3T3­E1 cells. Geniposide decreased apoptosis and ROS accumulation compared to these parameters in the Cd group. Geniposide attenuated oxidative stress­related factors, malondialdehyde and lactate dehydrogenase and increased antioxidant key enzyme superoxidase dismutase (SOD). The expression levels of Bax, Bcl­2 and survivin were modulated by geniposide. Additionally, the mRNA and protein expression of the receptor activator of NF­κB ligand (RANKL) and osterix were significantly increased, while osteoprotegerin was decreased by geniposide treatment compared to the Cd groups. Geniposide also enhanced Nrf2, heme oxygenase­1 (HO­1) and NAD(P)H quinone dehydrogenase 1 (NQO1) expression. The present study identified a potential agent for the treatment of Cd­induced osteoblast injury.

[Traumatic dislocation of superior tibiofibular joint].

OBJECTIVE: To explore the characteristics, diagnosis and treatment on traumatic dislocation. METHODS: From April 2000 to August 2010, 12 patients with acute traumatic dislocation of superior tibiofibular joint were treated including 10 males and 2 females with an average age of 30.6 years old ranging from 18 to 60 years. According to Ogden classification, 8 cases were the anterolateral dislocation, 2 were posterior-medial dislocation, and 2 were upward dislocation. All patients had swelling in lateral-inferior of knee, fibular head prominent, fibular head pain, floating feeling in head of fibula. One case was treated by conservative treatment, and the remaining 11 cases by surgical treatment. RESULTS: All patients were followed-up for 10 months to 3 years (means 18 months). Evaluation by Lysholm scoring,the total scores were 95.08 +/- 2.02, involving limbing 4.92 +/- 0.28, support 4.92 +/- 0.28, interlocking 15.00 +/- 0.00, instability 24.58 +/- 0.79, pain 22.50 +/- 1.24, swell 8.50 +/- 0.90, climbing stairs 9.75 +/- 0.62, squatting 4.92 +/- 0.28; 11 cases achieved excellent results and 1 good. Nerve functional recovered. X-ray was no longer dislocation. CONCLUSION: The diagnosis of traumatic dislocation is easy misseddiagnosis, surgery is the main treatment method, the prognosis is good.

[Coracoclavicular ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation].

OBJECTIVE: To investigate clinical effects of coracohumeral ligament reconstruction with autologous double-strand of long palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation. METHODS: From April 2006 to June 2009, 31 patients with acromioclavicular joint dislocation were treated with coracohumeral ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament. There were 18 males and 13 females, ranging in age from 18 to 60 years, with an average of 35 years. Twenty-six patients were acute trauma and other 5 patients were chronic trauma. Preoperative symptoms included different degrees of pain, restricted movement, and instability of acromioclaviecular joint. The X-ray showed acromioclavicular joint dislocation. RESULTS: The patients had good incision union without vascular and nerve injuries. All the patients were followed up, and the average duration was 23 months. The JOA scores decreased from preoperative (38.8 +/- 1.5) to (73.2 +/- 1.1) at 1 month after operation,and (93.5 +/- 0.8)at the last follow-up. Twenty-eight patients got an excellent result, 2 good and 1 fair. CONCLUSION: The reconstruction of coracohumeral ligament using autologous double-strand palmaris longus tendon and artificial ligament is an effective method for the treatment of acromioclavicular joint dislocation.

[Unilateral external fixator combined with simple internal fixation for severe open tibia-fibular fracture].

OBJECTIVE: To improve the treatment for severe open tibia-fibular fracture. METHODS: From 1994 to 2000, 146 patients with severe open tibia-fibular fracture were treated. According to Gustilo classification, all patients were of type III. Among them, 96 patients belonged to III A, 36 III B, and 18 III C. One hundred and eight patients were male and 38 female, aged from 11 to 68 years, with an average of 31. All patients were treated with unilateral external fixator combined with simple internal fixation (general screw or Kirschner wire). Thirty patients were treated with secondary flap operation. Among them, 19 patients received pedicle gastrocnemius muscle flaps, 9 free vastus lateralis muscle flaps, and 2 free latissimus dorsi muscle flaps. RESULTS: Three patients of type IIIB were subjected to amputation because of advanced age and associated cerebral or thoraco-abdominal injury. Five patients of type III C had amputation because of insufficient postoperative blood supply and necrosis. The rupture of other 138 patients was well reduced, and firmly fixed. They were followed up for 6 months-6 years, with an average of 2.5 years. The average time of fracture-union was 27 weeks, and the average time for removal of fixtors was 28 weeks. The motion of knee joint ranged from 0 to 120 degree in 110 patients; from 0 to 100 degrees in 25, and from 0 to 90 degrees. The motion of ankle joint was approximately normal. CONCLUSIONS: For patients with severe open tibia-fibular fracture, comprehensive analysis should be made for preservation of the wounded limb or amputation as for elderly patients with vessel-nerve injury or with cerebral- thoracoabdominal injury, emergency amputation should be done. Unilateral external fixator combined with simple internal fixation (general screw or Kirschner wire) for severe open tibia-fibular fracture is advantageous for a simple and reliable fixation. It is less traumatic.