Objective To reconstruct three-dimensional femoral footprint of the anterior cruciate ligament(ACL) by dual-source CT(DSCT),which can provide a novel positioning system particularly applicable in the anatomic ACL reconstruction under arthroscopy. Methods DSCT scanning was performed for the bilateral knees of 30 healthy volunteers.Three-dimensional reconstruction of the lateral wall of the intercondylar notch was done with 64-slice spiral CT workstation(GE,Volume Share2-AW 4.4 version).Double-bundle footprints of the ACL femoral insertions were identified, outlined and marked on the three-dimensional models.The over-the-top junction of the distal femur and the trochlea of femoral lateral condyle was dotted as a reference point O.The femoral footprint long and short axes,the footprint angle between the line passing through 2 centers of anteromedial and posterolateral bundles and the femoral shaft,the distance between 2 bundle centers,the shortest distance from the footprint edge to the distal femoral cartilage,and the shortest distance from the footprint edge to the posterior margin of the femoral cartilage were measured on the models with a standardized scale. Results All the ACL femoral footprints were successfully reconstructed by DSCT in the 60 knee joints.They were relatively protruding,plain,irregular in shape but identical in grey scale,distinct areas on the image. On the three-dimensional models of femoral lateral condyle,a 3-point-2-angle positioning system applicable in arthroscopic anatomic ACL reconstruction was successfully established and used to define and describe the double-bundle insertions of ACL.The mean long and short axes of ACL femoral footprint were respectively 16.5 ± 1.8 mm and 8.0 ± 1.3 mm; the mean ACL footprint angle was 8.3° ±4.9°; the mean distance between 2 bundle centers was 7.8 ± 1.0 mm; the mean shortest distance from the footprint edge to the distal femoral cartilage was 1.6 ± 1.5 mm; the mean shortest distance from the footprint edge to the posterior margin of the femoral cartilage was 1.7 ± 0.9 mm. Conclusions Three-dimensional ACL femoral footprints can be clearly reconstructed with DSCT.Natural ACL femoral footprints vary from person to person,which indicates a need of individualized reconstruction in order to restore the anatomy in maximum.The 3-point-2-angle positioning system we have developed is just suitable for arthroscopic ACL reconstruction.

Background/Aims: Abdominal bloating or distension (AB/D) is a common complaint in the outpatient of gastroenterology department. Since the potential contributors are numerous and complex, a longitudinal study on the disease spectrum and natural history of patients was performed to better understand the key factors of AB/D. Methods: Consecutive patients with the chief complaint of AB/D referred to the outpatient clinic were screened. Functional gastrointestinal disorders (FGIDs) were diagnosed according to Rome IV criteria. A 3-year follow-up was performed to seek for the changes in symptoms as well as disease spectrum. Results: A total of 261 participants were enrolled and 139 completed the follow-up. Most patients suffered from moderate to severe symptoms more than 1 day per week. Common causes of AB/D were FGIDs (51.7%) and organic diseases (17.2%). The latter group was older with lower body mass index (BMI). Functional dyspepsia was the most common type of FGIDs in AB/D. The symptoms of 18.0% of participants failed to improve at the end of the 3-year follow-up, and those diagnosed with FGIDs were most likely to continue to suffer. Abdominal pain was a positive predictive factor for good prognosis in the FGIDs group. Besides, only 22.7% of participants had a consistent diagnosis of FGIDs during follow-up. Conclusions FGIDs are the most common diagnosis in patients with AB/D. Symptoms were especially hard to be improved. Classification diagnoses of FGIDs in AB/D patients fluctuated significantly over time.

Objective: To investigate the impact of transitional care based on IMB model on caregivers of patients with hematological malignancies. Methods: A total of 200 patients with hematological neoplasms who were treated with chemotherapy in our hospital from May 2017 to September 2018 were selected, their caregivers were also selected as the research objects, and they were randomly divided into the study group with 82 cases and control group with 85 cases. The study group used a transitional care based on IMB model to intervene the patient caregivers, and the control group received routine nursing care. The general data questionnaire, the Caregiver Positive Feeling Scale (PAC), the Chinese version of Benefit Finding Scale (BFS), the nursing quality satisfaction questionnaire were used to investigate the caregivers. Results: After nursing intervention, the self-affirmation and self-expected dimension scores of PAC in the study group were 18.41±5.65, 18.87±4.23, which were higher than those in the control group (14.56±5.83, 15.24±4.59), the difference was statistically significant (t=2.476, 5.287, P<0.05 or 0.01). The acceptance, family relationship, personal growth, social relations and health behaviors dimension scores of BHS scale in the study group were 10.41±3.12, 9.87±3.93, 22.41±5.12, 10.22±3.52, 9.65±3.17, which were higher than those in the control group 9.06±3.87, 8.14±4.19, 19.51±5.24, 8.47±3.61, 7.52±3.74, the difference was statistically significant (t=2.476-3.963, P<0.05 or 0.01). The nursing satisfaction degree of caregivers in the study group was 75.61% (62/82), which was higher than that in the control group 42.35% (36/85), the difference was statistically significant (χ²=19.039, P < 0.01). Conclusions Transitional care based on the IMB model can improve the positive feelings in hematological neoplasms caregivers, enhance their benefit findings, and improve the quality of nursing care.