BACKGROUND: Knee joint trauma results in knee instability and movement track changes, which lead to the degradation of articular cartilages. The main component of articular cartilages, such as chondrocytes, collagen and proteoglycan, are also change during this process.OBJECTIVE: To compare the content changes of collagen, proteoglycan and the apoptosis of chondrocytes on two model groups of knee joint instability, additionally, to investigate the occurrence mechanism of early articular cartilages changes in rabbits with knee joint instability.METHODS: A total of 50 white rabbits were randomly divided into anterior cruciate ligament transection group, medial collateral ligament transection + meniscectomy group and normal control group. The specimens were harvested at weeks 1, 2, 3, 4, and 5 after operation. The osteocartilaginous section of the medial femur condyles were observed by gross observation, histological examination, and Markin scores. The contents of proteoglycan and collagen fiber were also measured.RESULTS AND CONCLUSION: Chondrocytes apoptosis were found with certain degrees at different stages of knee joint instability models. The Mankin score of the anterior cruciate ligament transection group was greater than the medial collateral ligament transection + meniscectomy group at each time point except the 1<'st>week (P ＜ 0.05), which was notably greater in the 5~(th) week. At weeks 3 and 4 after operation, the chondrocytes degenerated with proteoglycan lost in the anterior cruciate ligament transection group, and the chondrocytes degeneration was predominant at 5th week. The changes were more seriously in the medial collateral ligament transection + meniscectomy group. Meantime, the collagen fiber content of two experimental groups were less than the normal control group at Weeks 3, 4, 5 after operation (P < 0.05). The results demonstrated that at early knee joint instability, the articular cartilages degenerated extent is related to the number of chondrocytes, the collagen network disrupts and lost of proteoglycan. During chondrocytes degeneration, cartilage repair simultaneously occurred.

Objective To investigate multi-slice spiral computer tomography(MSCT)images of gastrointestinal lymphoma.Methods MSCT data of 23 cases with primary gastrointestinal lymphoma verified by pathology were retrospectively analyzed. Results Non-Hodgkin'S lymphoma was confirmed in all of the 23 cases.For all of the cases a B-cell origin was in 22 cases and a T-cell origin in 1 case localized in transverse colon.CT images of gastric lymphoma included three kinds:diffuse thickening(n=13,81.2%),segmental thickening(n=2,12.5%),and mass(n=1,6.3%).Median thickness of gastric wall was 3.3cm (0.6～6.8 cm).CT scan of intestinal lymphoma showed irregular thickening of intestinal wall,and mass was visualized in I case of ileum lymphoma and I case of ileocecal lymphoma.Median thickness of intestinal wall was 2.8cm(0～7.0 cm).Of all the cases lesions appeared a common density by conventional CT scan,and low or moderate intensification by contrast-enhanced CT. Conclusions With its character-istic information MSCT remains the method of choice for the diagnosis of gastrointestinal lymphoma.

Objective To analyze the clinical features and image manifestations of hepatic inflammatory myofibro-blastie tumor( HIMT), and to investigate the optimal management of this disease. Methods From January 2000 to January 2007, clinical data with HIMT verified by pathology were retrospectively analyzed. Results Eight patients 5 men, 3 women were included in the analysis. The mean age was 41.3 years. All eases did not have a history of previous hepatitis and liver cirrhosis, and 6 with no typical clinical symptoms. Hepatic functions, serum levels of AFP, CEA, CA199 in these patients were all within the normal ranges. Preoperative imaging by ultrasonography and computed tomography(CT) were not indicative of HIMT. Morphologic features by CT scan were summarized: at nonenhanced CT, the masses appeared as low density lesions. At contrast enhanced CT, the masses exhibited mod-erate intensification in the solitary areas, and the intensification peak appeared during the period of artery. During the period of portal vein and delayed scan, the masses showed low to moderate intensification in the solitary areas, in which the degree of intensification was a little lower than that in peripheral liver parenchyma. Gross specimens showed single solid masses, 3～12 cm, without classic envelope. All the patients underwent surgery whereas no incidence of perioperative death. Diagnosis of HIMT was confirmed by pathology of surgical specimens. Condusion Although typical presentation and the diagnostic workup are still lacking for HIMT, CT is helpful in diagnosing HIMT as well as combined with clinical findings. Surgical management would be likely the optimal treatment of this disease.

10.3969/j.issn.2095-4344.2013.24.001

BACKGROUND: Autoallergic ligments is used widely in arthroscopic cruciate ligaments reconstruction. However, the therapeutic effect of the surgery is affected severely by the complication at drawing place of the autoallergic ligaments. OBJECTIVE: To explore the application and therapeutic effect of homologous ligaments in arthroscopic reconstruction of cruciate ligments. METHODS: A total of 60 patients who received homologous ligaments at the Second Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University from December 2006 to December 2006 were selected, including 42 males and 18 females, aged 20-42 years. Totally 46 cases had anterior cruciate ligament injury, and 14 cases had posterior cruciate ligament injury. All patients received arthroscopic cruciate ligaments construction under arthroscopy. Physical and clinical examination and Lysholm score had been performed prior to and at 6-12 months after construction. RESULTS AND CONCLUSION: A total of 57 cases (60 cases) were followed up 6-21 months. The incision healed well, without serve immunological rejection. Four cases had hematocele-of the articular cavity, which were regressed after puncturing of the articular cavity and packing with compression. All preoperative symptoms got better apparently. The Lysholm score was obvious elevated than that prior to operation (P < 0.05). The results demonstrated that reconstruction of cruciate ligaments with homologous ligments can recovery the stability and knee function, avoid the complications of autografts. It also has advantages in terms of easy operation, small injury and less complication.

AIM:Discoid meniscus is named because its width and height are abnormally increased like a disc.In this study,we observed the injury classification and special features of discoid meniscus and natural meniscus,and compare the postoperative outcome of arthroscopy comparatively.METHODS:①360 cases of meniscus injury in knee joint were selected from the First Affiliated Hospital of Anhui Medical University from June 2001 to September 2006.They were divided into natural meniscus injury group(n =300),and discoid lateral meniscus injury(n =60).People with complete clinical data before operation and following data,confirmed by arthroscopy were selected.The written informed consent was obtained from them.②Meniscus injury in 360 cases was examined by arthroscopy,and plasty,or partial excision or incomplete resection or full resection was performed according to the injury types and surgical circumstance.③All subjects were followed for 6 months to 2 years.The knee function was evaluated by the criteria of Ikeuchi.RESULTS:300 cases of natural meniscus injury and 60 of discoid lateral meniscus injury were all included in the result analysis.①Five tear types of natural meniscus were as follows:43.7% longitudinal,30% radial,12.3% horizontal,7.5% transverse,and 6.5% complex.Four tear types of discoid meniscus were as follows:68.3% horizontal,6.7% radial,3.3% longitudinal,and 21.7% complex tear.②The surgical pattern was determined by the injury types,and all patients were followed up.In 300 cases of natural meniscus,there were 62 knees with excellent function,190 with good,34 with fair and 14 with poor.The excellent and good rate was 85%.In 60 cases of discoid meniscus,there were 19 knees with excellent function,34 with good,5 with fair and 2 with poor.The excellent and good rate was 90% approximately.CONCLUSION:Discoid meniscus is different in anatomical feature and histological structure from natural meniscus;therefore the arthroscopic surgery for discoid meniscus is also different.

Objective To investigate the application of multi-slice spiral computed tomography(MSCT) in the diagnosis of solid pseudopapollary tumor of the pancreas (SPTP). Methods Clinical data and CT films of 12 patients with SPTP were retrospectively analyzed from January 2003 to December 2008. Results SPTP presented a typical cystic lesion with well-limited silhouette and no intensification in the cyst on enhanced CT scan. However, a slight to moderate enhancement in the solid components and a markedly enhanced envelope could be seen. Three dimensional images of MSCT can reveal clearly an anatomic relationship of the lesions with surrounding organs and blood vessels. Of 12 cases, there was one case showed that the envelope was incomplete, 3 with duodenal invasion, 2 with superior mesenteric vein involvement, and 1 with closed adhesion with spleen. All 12 patients underwent surgery and had only one tumor, tumor diameter ranged from 4 cm to 18 cm. The location of tumor in pancreas, the relation with surrounding tissue and the pathological presentation were helpful to make peroperative diagnosis. Three dimensional imaging technology of MSCT can offer important referrence for the preroperative evaluation and increase the diagnosis accuracy.

Objective To investigate the efficacy and safety of full?thickness peroral endoscopic my?otomy( POEM) for achalasia in a follow?up period of 1 year. Methods Data of 28 patients who underwent full?thickness POEM in our hospital from July 2013 to June 2014 were retrospectively studied. Procedure completion and complications were assessed at the end of follow?up of 12 months. Results All patients were treated successfully by full?thickness POEM with the mean operation time of (61?7±15?6) minutes. Intraop?erative mucosal perforation occurred in 2( 7?1%) patients. Symptoms were relieved in 28 patients, but ster?num pain occurred in 6(21?4%) patients. POEM failed in one case in the first 3 months, and was successful in 27 other cases.treatment success rate (Eckardt≤3) was 89?3%(25/28). The incidences of postoperative reflux and esophagitis were 25?9%( 7/27 ) and 22?2%( 6/27 ) , respectively. Conclusion The full?thickness POEM is safe and effective with less complications, but further study is needed to evaluate long?term efficacy and complications.

OBJECTIVE:To study the inhibitory effects of sinomenine(SIN)-loaded polylactic-co-glycolic acid-D-α-tocopherol polyethylene glycol 1000 succinate(PLGA-TPGS)nanoparticles(SPTN)on the proliferation of HCa-F cells in lymph tubes and ec-topic transplantation tumors in mice. METHODS:HCa-F cell suspension were incubated with normal saline,5-fluorouracil(FS), sinomenine solutions (SS),sinomenine PLGA nanoparticles (SPN) and SPTN,with concentration of 80 μg/ml. The cells were marked with CFSE,and then were injected with suspension 50 μl via one footpad of mice. Inhibitory effect of above suspensions on the proliferation of HCa-F in lymph tubes of mice was observed by fluorescence inverted microscope at 3,6,9,12,24 h(n=15). Mice were divided into normal control group,blank PLGA-TPGS nanoparticles (EPTN) group,normal saline group,SPTN group,SPN group,SS group and FS group with 10 mice in each group. The latter 5 groups were injected with relevant medicine 15 mg/kg,once a day,via tail vein for consecutive 10 days after the model of HCa-F cells-bearing ectopic transplantation tumor mice was established. The serum content of ALT,AST,γ-glutamyltransferase(γ-GT),ALB and T-BIL were determined;solid tu-mors were taken,measured and weighed,and the inhibitory rate of tumor was also calculated. RESULTS:The inhibitory effect of above solution on the proliferation of HCa-F cells in descending order was as follows:SPTN>SPN>FS>SS>normal saline. Com-pared with normal saline group,the serum levels of ALT,AST,γ-GT and TBIL of SPTN group,SPN group,SS group and FS group decreased,while ALB level increased(P<0.05);the amount of tumor volume increase and tumor weight in SPTN group, SPN group and FS group decreased significantly (P<0.05). The inhibitory rate of tumor in 3 groups were 49.62%,40.53% and 33.90%. CONCLUSIONS:SPTN can inhibit the proliferation of HCa-F cells in lymph tubes of mice,and can improve HCa-F cells-bearing ectopic transplantation tumor in mice. It is better than SPN and FS.

OBJECTIVE: To summarize advances in clinical application of ureter stent and its biocompatibility. METHODS: A computer-based online search of CNKI (1989/2009) and Medline (1989/2009) was performed with the key words of "ureter, biocompatibility, stent, treatment, complications" in Chinese and English respectively. A total of 51 articles were collected. and 21 were included. The treatment advances and its biocompatibility of ureter stent were summarized, and clinical application advances, biocompatibility and complication prevention of ureter stent were explored. RESULTS: Ureter stent includes polymerizer, metal and degradable material stents. As the common implants in treatment of upper urinary tract diseases, ureter stent functions as stent and internal drainage, and relieve ureteral obstruction, prevent leakage of urine postoperatively and ureterostenosis. Complications following ureter stent implantation include stent shifting, urine reflux, irdtative symptoms of bladder, fouling and stone formation as well as infection. However, these complications can be relieved through positive treatment. CONCLUSION: Ureter stent is an effective approach to treat urologic disease, but the biocompatibility required improvement. Rigorous operation during stent implantation and positive treatment of complication can effectively prevent complications.