BACKGROUND:The cruciate ligament of the knee joint has a poor capacity of self-healing after injury, and the main treatment is grafting to reconstruct cruciate ligament.
OBJECTIVE:To summarize the structure, function, and mechanical characteristics of anterior cruciate ligament of the knee joint, the present research of artificial ligament reconstruction fol owing damage, and to provide evidences for clinical application of artificial ligament.
METHODS:An online computer-based retrieval was performed with the key words of“artificial y synthetic materials, knee joint cruciate ligament, exercise, ligament repair, ligament reconstruction”. Articles related to knee ligament treatment approach, materials science characteristics, biocompatibility and application were included. A total of 25 articles addressing the properties of biological materials applied in knee cruciate ligament reconstruction were screened.
RESULTS AND CONCLUSION:As an effective treatment for anterior cruciate ligament injuries, technique of anterior cruciate ligament reconstruction has been developed in recent years. Implants for repairing anterior cruciate ligament injuries include autologous ligaments, ligament al ograft, artificial ligaments, and tissue engineered ligament. Artificial materials and tissue engineered ligaments are the hotspots in recent years. Biological artificial ligament is effective to treat the knee ligament injury. celland molecular biology techniques as wel as the use of gene therapy wil become a new direction in the treatment of knee ligament injury and rehabilitation.

Objective:To observe the clinical effects of tuina manipulations plus the functional training on scapulohumeral periarthritis (SP), and provide the better therapeutic plan for SP patients. Methods: A total of76 cases with SP in conformity with the inclusion criteria were randomly divided into a tuina group and an acupuncture group, 38 patients in each group. All the patients were instructed to do functional training under the guidance of the professional medical practitioners. The patients in the tuina group were treated additionally with tuina manipulations, while the patients in the acupuncture group were added with acupuncture treatment. The two groups were treated once every day. After ten sessions, the changes in the scores of visual analog scale (VAS) and Melle were observed, and the clinical effect was compared. Results:After the treatment, VAS and Melle scores were all lower in the tuina group than those in the acupuncture group, with statistical significances between the two groups (P<0.05). The remarkable effective rate was 5.3% in the acupuncture group and 21.1% in the tuina group. The remarkable effective rate was higher in the tuina group than that in the acupuncture group, with a statistical significance (P<0.05). Conclusion:Tuina manipulations plus functional training for SP can effectively alleviate pain and restore the functions of the shoulder joint, with a better effect than acupuncture plus functional training.

Objective:To explore the main influencing factors for cardiopulmonary resuscitation (CPR ) in patients with perioperative cardiac arrest .Methods:A total of 168 patients ,who received surgery and suffered from cardiac arrest during perioperative period in our hospital from Jun 2012 to Jun 2014 ,were selected .According to recovery outcome of spontaneous circulation ,they were divided into success group (n=67) and failure group (n=101) .Case information were retrospectively analyzed in two groups ,including American Society of Anesthesiologists (ASA) class at hospitalization ,surgical sites ,monitor before cardiac arrest ,location when cardiac arrest occurred , dose of amiodarone ,volumes of bleeding and blood transfusion ,time of cardiac arrest during surgery ,CPR duration and timing etc .,and they were statistically analyzed between two groups .Results:There were significant difference in ASA class ,location when cardiac arrest occurred ,baseline ECG rhythm ,shock before cardiac arrest ,adrenaline dose ,CPR duration and timing between two groups ,P<0.05 or <0.01. Multifactor Logistic regression analysis in‐dicated that being outside operating room when cardiac arrest occurred (OR=9.72 ,95% CI=3.16~67.33) ,non-shockable rhythm (OR=8.33 ,95% CI=2.77~22.87) ,shock before cardiac arrest (OR=5.17 ,95% CI=3.23~16.13) ,adrenaline dose (OR=6.84 ,95% CI=2.61~44.75) ,CPR duration (OR=6.14 ,95% CI=1.77~17.21) and CPR timing >1min (OR=7.51 ,95% CI=2.57~41.93) were independent risk factors for prognosis of periop‐erative CPR , P< 0.05 or < 0.01. Conclusion:Being outside operating room when cardiac arrest occurs , non -shockable rhythm ,shock before cardiac arrest ,adrenaline dose ,CPR duration and CPR timing > 1min are inde‐pendent risk factors for prognosis of perioperative CPR . Cardioc arrest calls for instant CPR .

OBJECTIVE:How to explain and predict individual difference of artificial cochlea so as to evaluate rehabilitative effect of implant has been paid much attention by audiological scholars,clinical physicians,patients,and their relatives. This study was designed to analyze and evaluate rehabilitative status of patients accepting artificial cochlea implantation to investigate the relative influential factors of auditory rehabilitation. METHODS:A total of 28 patients were selected from Department of Otolaryngology Head and Neck,Affiliated Hospital of Qingdao Medical College from June 2002 to April 2008. They were accessed by age,time of rehabilitation training,usage of hearing aids,audiology and aural image before surgery,and NRT monitoring in cochlear implantation so as to observe auditory improvement. The clinical results were analyzed to detect the effect of various factors on auditory rehabilitation. RESULTS:Age,preoperative preparations and good audiology and aural image are important premises for a successful rehabilitation. Longer the time of using hearing aids and language rehabilitation are,and better results will get. NRT response during operation is also an important factor for good auditory rehabilitation. CONCLUSION:The influential factors of auditory rehabilitation after cochlear implant included the age,audition remains,usage of hearing aids,NRT response during operation,and the time after the cochlear implant operation.

Objective To investigate the effect of rehabilitation nursing system of manipulative reduction and tradi-tional Chinese medicine fumigation treatment to alleviate the clinical stage of lumbar intervertebral disc protrusion promoting effect.Methods 200 cases of remission in patients with lumbar disc herniation were divided into intervention group and con-trol group with 100 cases in each group, the control group of the implementation of general nursing, intervention group re-ceived rehabilitation nursing system based on general nursing.Results 20 days later, compare the lumbar function score, the intervention group was significantly better than the control group, and the difference was statistically significant (p<0.01). The intervention group: the total efficiency of 98%.Control group: the total efficiency of 85%.The total efficiency of two groups were significant difference ( p <0.05 ) .Conclusion rehabilitation nursing treatment to alleviate the superposition effect of lumbar disc herniation, has an important significance to improve the clinical efficacy and quality of life.

Objective To analyse the clinical features,imaging characteristics diversity of deep cerebral veins thrombosis (DCVT).Methods From 2004 to 2013,6 patients diagnosed as DCVT were recorded and a retrospective review of the cases were undertaken for the purpose of this analysis.Results Among the 6 patients with DCVT,4 were male and 2 were female,aged from 28 to 69 years old.The disease duration of 4 cases ranged from 2 to 7 days,remnants were 20 days and 3 months respectively.The first symptoms of 4 cases were headache,1 was feeblemindedness,and the other was hemiplegia.The secondary symptoms were disturbance of consciousness,apathy,diplopia and non-infectious fever.Non-contrast computed tomography showed low signal in the bilateral thalamus in four patients,high signal in the transverse sinus and straight sinus in one patient and high signal in torcular in one patient.Abnormal signal was found in bilateral thalamus on magnetic resonance imaging in all patients and some of them had abnormal signal in the mesencephalon or basal ganglia.The patients were definitely diagnosed as DCVT by magnetic resonance venography (MRV) or digital subtraction angiography (DSA).Among them,2 patients were confirmed by brain biopsy.Four patients were followed up with good outcome and 2 were lost to follow-up.Conclusions The clinical manifestations of DCVT are not specific.For acute-onset DCVT patients,the first symptoms are always headache and vomiting,while the main symptoms are declined cognition and slow reaction for chronic-onset ones.Along with the progress,the main symptoms of DCVT are disturbance of consciousness,psychiatric symptoms and intracranial hypertension.Changes in the bilateral thalamus and basal ganglia are especially main characteristics which are easily misdiagnosed as brain tumor according to the images.DCVT can be definitely diagnosed by no signal of deep cerebral veins on MRV or DSA.

ObjectiveTo design the scale of death attitude for Chinese nurses and evaluate its validity and reliability.MethodsThe scale draft was formed through the literature review,the formal scale was got via expert consultation and interview survey of 20 cases of small sample.120 clinical nurses were selected for investigation.Then item analysis,factor analysis,correlation analysis and reliability analysis were applied to establish the scale′s validity and reliability.ResultsThe nursing staff death attitude scale consisted of 25 items,the varimax rotation factor analysis of the scale identified seven principal factors and explained for 63.732％ variances.The correlation coefficient between each item and its domain was 0.498～0.808,the Cronbach′s α coefficient of five domains was 0.595～0.774,the Cronbach′s α and split-half coefficient for the whole scale were 0.824 and 0.868 respectively.ConclusionsThe scale has high reliability and validity,and it can be the effective test instrument for death attitude of nurses in China.

BACKGROUND: Neuron-specific enolase, γtype isoenzyme that is specially present in the cytoplasm of neurons and neuroendocrine cells, is considered as a sensitive predictor for neuronal damage.OBJECTIVE: To observe the changes of serum neuron-specific enolase in patients with transient brain ischemic attack, so as to explore its relationship with the degree of neuronal damage.DESIGN: Case-control observation.SETTING: Department of Neurology, Jinan No. 4 People's Hospital.PARTICIPANTS: A total of 29 patients who were hospitalized in the Department of Neurology, Jinan No. 4 People's Hospital, due to transient brain ischemic attack (all called for emergent medical treatment within the onset of 6 hours) between March 2002 and May 2004 were enrolled in this study. There were 18 males and 11 females with the average age of(60.36t11.67) years. According to the duration of neural functional deficits, all subjects were divided into two groups, namely, transient-symptom group (≤ 6 hours) of 19 cases and lasting-symptom group (＞ 6 hours)of 10 cases. At the same time, 25 healthy controls, 15 males and 10 females with the average age of (62.34±9.65) years, rere selected from those who came for routine health examination.METHODS: Fasting elbow venous blood of 1 mL was collected only once from the subjects in control group; the same amount of blood was collected from the patients in transient ischemic attack group immediately after hospitalization, and at days 2, 3, 4 and 5. Roche Elecsys 2010 automatic analyzer was used to detect serum neuron-specific enolase. Neuronal damage was assessed with neurological deficit scale (defined as practical recovery if scores were reduced by 90%-100%; remarkable improvement if scores were reduced by 46%-89%; improvement if scores were reduced by 18%-45%; ineffective if scores were reduced by less than 17% or even the disease aggravated).MAIN OUTCOME MEASURES: The daily changes of serum neuronspecific enolase.RESULTS: All the54 subjects remained in the final result analysis. [1]Comparison of neuron-specific enolase density: It was significantly higher in transient brain ischemic attack group than in control group [(23.53±12.35) vs(14.29±6.83) μg/L, t=2.678, P ＜ 0.01]. [2] Curve of neuron-specific enolase changes during the acute stage: It began to increase at the early stage,reached the peak level on the next day, and gradually declined to the normal level in 4-5 days. [3] The level of serum neuron-specific enolase in the two groups with various durations of neurological deficit symptoms: It was obviously higher in transient-symptom group than in control group [(19.24±8.95)vs (14.29±6.83) μg/L, t=1.893, P ＜ 0.05], and higher in lasting-symptom group than in control group [(28.87±13.15) vs (14.29±6.83) μg/L, t=4.367,P ＜ 0.001]. [4] The level of neuron-specific enolase was positively correlated with the duration of neuronal damage (r=0.815, P＜0.01).CONCLUSION: Serum neuron-specific enolase increases within a short term after transient brain ischemic attack and reaches the peak level at around 24-36 hours, suggesting that the detection of serum neuron-specific enolase has a guiding value in assessing the severity of transient brain ischemic attack.

Objective To determine the gross radioactivity in drinking water in Chifeng city and to estimate the annual effective dose associated with intake of radionuclides from drinking water.Methods Water samples were collected at locations distributed in 12 counties across Chifeng city, and radioactivity was measured with a low background α/β measuring instrument and HPGe γspectrometer.Results Gross α radioactivity in drinking water was in the range of 0.016-1.230 Bq/L and gross β radioactivity in the range of 0.039-0.878 Bq/L in Chifeng city.The average annual effective dose to the local population from gross α radioactivity was 0.071 mSv/a.Conclusions The grossα/β level in Chifeng city is lower than the World Health Organization-recommended value and the average annual effective dose due to drinking water is within the recommended safety level.

Objective To investigate the relationship between body mass index (BMI) and dose area product (DAP) as well as fluoroscopy time during coronary angiography (CAG) in Han nationality subjects in order to improve early judging and reducing high radiation risk. Methods CAG materials of 451 Han nationality subjects were retrospectively analyzed. The patients included 276 males (age 32-87 years) and 175 females (age 42-84 years), and the BMI values ranged from 17.30 to 35.42 kg/m2. According to BMI values, the patients were divided into group A(BMI<20 kg/m2,n=25), group B (BMI 20-24.9 kg/m2,n=204), group C (BMI 25-29.9 kg/m2,n=192) and group D (BMI>30 kg/m2,n=30). The mean DAP and fluoroscopy time of each group were calculated; the DAP values were compared between each other among the four groups by using nonparametric Kruskal-Wallis test, while the fluoroscopy time was compared between each other among the four groups by using single factor analysis of variance or LSD-t test. Results The mean DAP of group A, B, C and D was(1 070.07±541.33) μGym2,(1 326.82±606.91) μGym2,(1 937.99±1 030.31) μGym2 and (2 654.53±1 296.69) μGym2 respectively. The mean fluoroscopy time of group A, B, C and D was (3.53± 2.08) min, (2.70 ±1.80) min, (2.75 ±1.88) min and (2.71 ±1.69) min respectively. Statistically significant difference in DAP values existed between each other among the four groups (P<0.05) except between group A and group B (P=0.232). Statistically significant difference in fluoroscopy time existed between group A and other three groups (P<0.05), while the difference in fluoroscopy time between each other among B, C and D groups was not significant (P>0.05). Conclusion The DAP values of adult Han subjects receiving CAG are increased with the increase of BMI values; the fluoroscopy time is significantly prolonged in patients with BMI<20 kg/m2. In performing interventional procedure, the operator should not only understand that the increase of BMI can cause the increase of DAP, but also need to pay special attention to the increase of DAP value caused by operation difficulty when the patient’s BMI is <20 kg/m2.