In this paper 12 cases of pigmented villonodular synovitis are reported, among which are 10 cases of knee joints, The clinic manifestations are mainly knee joint swelling pain, the function of the joints usually having no limitation. The liquor of blood colour or brown yellow colour is commonly pumped out through arthrocentesis. The shadow of soft tissue swelling could only be seen by X-ray. The X-ray examination 3 and therapy so on are mainly discussed in this paper. From therapy we stress the priority of completely synovium resection at early stage. During the operation one should do his best not to damage the patient's sport system muscle tendon. After the operation early dirigation is necessary.

Most of patients received in hospital with the upper and lower extremity fracture are caused by the earthquake.These fractures have apparent characters,such as:the serious situation,complexity and lots of complications which can be divided two periods:the early and the late.These complications include shock,the nerve and vascular injury,the acute kidney failure,fat embolism,infection,deep venous thrombosis,decubitus ulcer and so on.These complications should be known completely and the therapy should be given early.Practice can not be taken because of pain and some other reasons,and this will lead to the muscle atrophy,adynamia and the joint disfuction.Finally the abilty to work was lost partly or completely.If some measures about rehabilitation were taken early,we can reduce the complication and the disability possibly.

Most of patients received in hospital with the upper and lower extremity fracture are caused by the earthquake.These fractures have apparent characters,such as:the serious situation,complexity and lots of complications which can be divided two periods:the early and the late.These complications include shock,the nerve and vascular injury,the acute kidney failure,fat embolism,infection,deep venous thrombosis,decubitus ulcer and so on.These complications should be known completely and the therapy should be given early.Practice can not be taken because of pain and some other reasons,and this will lead to the muscle atrophy,adynamia and the joint disfuction.Finally the abilty to work was lost partly or completely.If some measures about rehabilitation were taken early,we can reduce the complication and the disability possibly.

[Objective]To evaluate the comprehensive clinical management of posttraumatic knee joint dysfunction(PKJD).[Method]From 2001 to 2005,40 patients(42 knees) with posttraumatic knee joint dysfunction were treated with conservative procedures including training of muscle strength,range of motion(ROM),proprioception or neuromuscular control,general physical condition;and surgical procedures including Thompson's procedures,improved Judet's technique,extra-articular mini-invasive quadricepsplasty + intra-articular arthrofibroticlysis,Ilizarov technique.[Result]All of the 42 cases did not receive systematic rehabilitation therapy before they came in hospital.At our center,30 of them were managed conservatively and 12 of them surgically.The average ROM of the involved knee was 0?-9.2?-58.1 at the time of admission,and 0?-4.9?-88.9? when they were discharged,the difference is significant statistically(P

Objective To investigate new methods of osteonecrosis of femoral head (ONFH) with retrospective analysis of the clinical cases with technique of rotary cutting pressure-relief,impacted graft,and tantalum rod supporting treatment of early-stage femoral head necrosis.Methods From June 2010 to June 2014,32 cases (38 hips,23 males and 9 females) with ONFH were treated with technique of rotary cutting pressure-relief,impacted graft,and tantalum rod supporting,with the mean age of 24 ～ 52 (36.2 ± 3.8) years old.According to the Association Research Circulation Osseous (ARCO) classification,there were 11 hips on Ⅱ A stage,12 hips Ⅱ B,8 hips Ⅱ c,7 hips Ⅲ A.The averaged Harris score of all cases was 65 ～ 81 (72.5 ± 5.8) points.All cases were cured with minimally invasive technique,rotary cutter pressure-relief in femoral head,thoroughly remove sequestrum and implant allogeneic bone.Postoperative patients laid in bed for 1 month,after 1 month hold crutch gradually began to functional training.Postoperative 1 month,X ray film was reviewed every 3 months.According to the clinical symptoms,imaging findings,Harris scoring system was graded to evaluate the effectiveness.Results All the cases were followed up for average of 12 ～32 (20.2 ± 2.6) months,31 hips Kept hips succeed,hips pain; lame line symptoms were reduced or disappeared; x-ray showed femoral head necrosis area formed new bone,Harris scoring was upgraded to 75 ～ 95 (87.7 ± 6.4) points ; and seven hips failed with operation of total hip arthroplasty.The overall good rate was promoted from 26.3％ to 84.2％.Conclusions The technique treating for early-stagefemoral head necrosis with minimally invasive,rotary cutting pressure-relief,impacted graft,and tantalum rod supporting had a good short-term effects.

Orthopaedic rehabilitation mainly focuses on the improvement and reconstruction of the musculoskeletal dysfunctions of patients with chronic diesaes and trauma of bones, joints, muscles and nervous system. It involves a multidisciplinary team approach in which the orthopaedic surgeon is considered as a main part. The therapeutic strategies of orthopaedic rehabilitation comprises three subspecialties, including kinesiotherapy, prothetic and orthotic management, and operative methods. The principal aim of this report is to present the current status and trends in bone and joint rehabilitation of limbs.

[摘 要] 目的：探究浸润性复层产生黏液的复层上皮癌（ISMC）的临床组织及分子病理特征。方法： 回顾性分析2018年1月至2024年4月间安徽医科大学安庆医学中心/安庆市立医院及皖南医学院第一附属医院/弋矶山医院的病理数据库的11例ISMC和4例产生黏液的复层上皮内病变（SMILE）的临床病理资料、免疫组化、阿利新蓝（AB）/过碘酸雪夫（PAS）染色、分子学检测及PD-L1表达情况。结果：ISMC患者多表现为阴道不规则流血。细胞质内含有黏液的细胞呈复层排列，周围呈栅栏状，肿瘤细胞可呈印戒样或胞质透明。ISMC不仅存在单纯型，也可呈混合型。ISMC具有高侵袭性的生物学特性。CK7、p16，p40和（或）p63表达呈癌巢周栅栏状阳性或局灶表达。AB/PAS染色阳性。人乳头状病毒（HPV）检测结果：ISMC中HPV16/18阳性（1/4），术前检测出HPV16/18阳性（4/6）；SMILE组织中HPV阴性。ISMC均表达PD-L1。成功随访8例ISMC患者，时间4~39个月（平均20.50月），4例SMILE患者，时间1~25个月（平均8.25月），随访患者均存活，1例ISMC术后出现多脏器转移。结论：ISMC具有独特的形态学特征及免疫表型，表现为高侵袭性和不良预后。所有ISMC均呈PD-L1阳性，提示所有患者均可从PD-L1免疫治疗中获益。

Objective    To evaluate the efficacy of thoracoscopic complex segmentectomy for stageⅠnon-small cell lung cancer (NSCLC). Methods    We retrospectively reviewed the perioperative clinical data of patients with stageⅠNSCLC who underwent thoracoscopic complex segmentectomy (n=58) or simple segmentectomy (n=33) between January 2017 and March 2020 in our hospital. There were 36 males and 55 females with a median age of 57 years (range: 50-66 years). The clinical data of the two groups were compared. Results    There were no significant differences between the two groups in characteristics including age, sex, weight, comorbidities, preoperative pulmonary function, dominant composition of tumor, tumor histology and size, overall complications, estimated blood loss, prolonged air leakage, length of hospital stay, length of drainage, surgical margin distance or number of dissected lymph nodes. Only the operation time and number of staples for making intersegmental plane were significantly different between the two groups (P<0.05). There was no perioperative death in both groups. Conclusion    Thoracoscopic complex segmentectomy is a feasible and safe technique for stageⅠNSCLC.

Objective To compare the efficacy and complications among three surgical treatments of femoral intertrochanteric fractures in elderly patients.Methods Totally 209 elderly patients with femoral intertrochanteric fracture were divided into 3 groups:DHS group[n =115,patients treated with dynamic hip screws (DHS)],PFNA group [n=57,patients treated with proximal femoral nails anti-rotation (PFNA)] and SEFT group [n=37,patients treated with singlearm external fixator technique (SEFT)].The length of hospitalization,operative time,bleeding volume,hip function scores and complications were compared among the three groups.Results All patients were followed up for 5-12 months (10.6 months in average).The length of hospitalization,operative time,bleeding volume,weight-bearing time and Harris hip score in postoperative 3 months were (14.3±2.7) d,(102.4±22.7) min,(240.8±38.4) ml,(50.2±7.7) d,(88.7±12.8) min in DHS group,(11.2±3.4) d,(50.3±15.6) min,(80.5±18.7) ml,(22.6±4.8) d,(92.6±15.4)min in PFNA group,(15.1±3.3) d,(35.8±10.9) min,(52.6±12.9) ml,(55.4±10.1) d,(87.3 ± 12.6) min in SEFT group,respectively.There were significant differences in the length of hospitalization,operative time,bleeding volume,weight-bearing time and Harris hip score in postoperative 3 months among the three groups (all P ＜ 0.05),while there was no significant difference in healing time among the three groups (all P＞0.05).The incidence of complications was highest in DHS group,higher in SEFT group,and lowest in PFNA group (all P＜0.05).Conclusions DHS is more suitable for patients with good physical condition and stable fractures.SEFT is suitable for patients with poor condition,who can not tolerate trauma,anesthesia and bleeding.PFNA has more advantages including stable fixation,less invasive,less complications and wide indications,which is more suitable for femoral intertrochanteric fractures than the other two treatments.

Objective To investigate the effects of nitric-oxide synthase inhibitor on matrix metalloproteinases (MMPs) expression in osteoarthritis (OA) cartilage by Luminex analysis,and to explore the mechanism of nitric-oxide synthase inhibitor on modification of the metabolism of OA cartilage.Methods Fifteen specimens of articular cartilage taken from the patients with OA were cultured and divided in two groups.The control group was those with no intervention.L-NIL group was co-cultured with NOS inhibitor L-NIL.After 72 h cultivation,the release of NO and the activity of NOS on OA cartilage were measured by Griess reaction and spectrophotometric methods.MMPs (MMP-1,MMP-2,MMP-3,MMP-9,MMP-13) expression was measured by Luminex analysis.Comparisons between groups were performed with paired sampies t test.Results After cultured for 72 h,spectrophotometric analysis showed high concentration of NO release[(216±47) μmol/L ] and high level of active NOS [(5.7±1.3)U/ml]in supernatants of the control,1 mmol/L concentration L-NIL could evidently reduce NO release [(55±20)μmol/L,P<0.01] and NOS activity [(1.7±0.7)U/ml,P<0.01 ].Luminex analysis demonstrated high MMP-1,MMP-2,MMP-3,MMP-9,MMP-13 expression in cartilages of the control group [respectively for (10.8±5.4)ng/ml,(9.2±3.3) ng/ml,[11.6±4.2 )ng/ml,(1.27±1.07)ng/ml,(3.6±1.3)ng/ml] and 1 mmol/L concentration L-NIL could evidently inhibit MMP-1,MMP-2,MMP-3,MMP-9,MMP-13 expression [respectively for (3.6±1.8)ng/ml,(2.3±1.2)ng/ml,(3.6±1.4)ng/ml,(0.65±0.21)ng/ml,(1.8+0.5)ng/ml,P<0.05 ].Conclusion Luminex analvsis has shown that NOS inhibitor can reduce NO release and NOS activity and modify metabolism of articular cartilage by inhibiting the over-expression of MMPs.