Objective To study the effects of continuous passive motion(CPM)on tissue blood oxygen saturation(StO2)in the edge of wound after anterior cruciate ligament(ACL)reconstruction in rabbits.Methods Twenty male New Zealand rabbits,aged 8 months,received an ACL reconstruction by using double semitendinous tendon autograft in the right hind leg.The rabbits were randomly divided into 2 groups postoperatively,namely Cage activity group(n=10)and CPM group(n=10),treated with cage activity and activity by rabbit knee joint continuous passive motion apparatus respectively.On the following day after operation,a near-infrared optical device and ODISseyTM Tissue Oximeter were applied to measure the changes of tissue oxygen saturation(StO2)in the edge of the wound in each cycle(with flexion of 30?-110?)and various CPM speeds(2.35?/s,3.2?/s,and 8?/s),and the optimal CPM range and speed was thus selected for analyzing the changes of StO2 in local tissues of wounds with various angles of CPM in knee joint before the operation and on the 2nd,4th,6th,8th,10th,and 14th postoperative days.Results There was a significant difference with regard to StO2 between CPM group and Cage activity group(P0.05),however,a significant difference was observed among different time points(before the operation,and 2,4,6,8,10,14 days after the operation)(P

OBJECTIVE To describe the clinical, CT or MRI, pathological characteristics of desmoplastic fibroblastoma for helping the diagnosis and treatment. METHODS The clinical data of 4 cases with desmoplastic fibroblastoma were retrospectively analyzed. RESULTS The tumors of all 4 cases were found in the compartment of muscles, and can be removed by conservative excision. The 4 cases were followed up for 38, 7, 6, 3 months respectively, and no local recurrences were found. CONCLUSION Desmoplastic fibroblastoma is a benign fibroblastic neoplasm with distinctive clinical, CT or MRI imaging and pathological characteristics. Optimal management is conservative excision with functional preservation. Needle aspiration cytology and immunohistochemistry are of non-diagnostic value.

Objective:To evaluate the change in hamstring ( H ):quadriceps ( Q ) ratio following anterior cruciate ligament ( ACL) rupture during isokinetic knee extension and flexion at 30 degrees of flexion which is important for knee dynamic function .Methods:A study was performed in 25 male com-plete unilateral ACL ruptures .Isokinetic concentric and eccentric quadriceps and hamstring muscle tests in both the deficient knees and intact knees were performed at 60°/s, respectively.At 30 degrees of flexion, the average torque of quadriceps and hamstring , Qe∶Qc ratios ( ratios of eccentric quadriceps to concentric quadriceps muscle torque ) , He∶Hc ratios ( eccentric hamstring to concentric hamstring ) , Hc∶Qc ratios ( concentric hamstring to concentric quadriceps ) , He∶Qc ratios ( eccentric hamstring to con-centric quadriceps ) , and Hc∶Qe ratios ( concentric hamstring to eccentric quadriceps ) were calculated . Wilcoxon matched-pairs signed-ranks test was used .Results:At 30 degrees of knee flexion , a significant reduction ( P<0.05) in the average torque of quadriceps was observed at concentric and eccentric 60°/s produced by the deficient-side compared with the intact side .In addition, Hc∶Qc, He∶Qc, and Qe∶Qc significantly increased on the ACL-deficient side .Conclusion:The change in H ∶Q ratio in the mode of isokinetic 60 °/s at 30 degrees of knee flexion might therefore be a new tool to objectively document muscle function in ACL-deficient knee .

Objective:To evaluate the clinical value of endoscopic release therapy for fecal impaction in the colorectal diverticulum.Methods:Data of patients with fecal impaction in the colorectal diverticulum who received endoscopy in Shantou Central Hospital from January 2018 to September 2020 were included in this study. Among them, 85 patients treated with endoscopic release therapy were assigned to the observation group (2 patients were excluded from the observation group due to acute appendicitis), and 43 patients receiving no treatment were assigned to the control group. The relief of abdominal symptoms was used as an index to evaluate the clinical value of endoscopic release therapy for fecal impaction in the colorectal diverticulum.Results:In the observation group, 42.2% (35/83) were successfully released at one time. The successful comprehensive measures accounted for 25.0% (12/48) of the first release failure, and the total success rate was 56.6% (47/83). There were no complications related to endoscopy in the observation group. One week after the treatment, patients in the observation group were followed up by telephone. Among the 45 patients who were successfully released, positive symptoms of 30 patients disappeared or significantly improved with the effective rate of 90.9% (30/33). Among the 38 patients who failed to release the fecal impaction, 19 had positive symptoms and 16 improved in varying degrees with the effective rate of 55.2% (16/29). The overall effective rate of the observation group was higher than that of the control group [55.4% (46/83) VS 7.0% (3/43)], showing significant difference( χ2=23.354, P<0.01). The effective rate were significant differences in the successful release group [65.2% (30/46)], unsuccessful release group [29.7% (11/37)] and the control group [7.0% (3/43), χ2=33.792, P<0.01]. By pairwise comparison, the effective rate of the successful release group was the highest, followed by the unsuccessful release group, and that of the control group was the lowest with significant difference ( P<0.017). Conclusion:The endoscopic release therapy for fecal impaction in the colorectal diverticulum is relatively simple, which can relieve and reduce related symptoms, avoid complications, missed diagnosis and misdiagnosis, and show definite curative effects. When colorectal diverticulum with fecal impaction is found in the process of endoscopy, it is of great practical significance to release the incarcerated feces by means of different methods.

OBJECTIVETo investigate the effect of cartilage-derived growth factor (CDGF) on cultured rabbit chondrocytes, and the relation between CDGF, insulin-like growth factor-I (IGF-I), and proliferation and metabolism of chondrocytes.

METHODSCDGF was extracted from chicken xiphoid in our laboratory. Chondrocytes were isolated from 3-week-old New Zealand male rabbits, and cultured in Ham's F-12 medium containing 10% fetal calf serum. The chondrocyts of second generation were treated with CDGF and/or IGF-I of different concentrations. With chloramine T method and MTT method, we compared the content of hydroxyproline in Ham's F-12 medium and observed proliferation and energy synthesis of chondrocytes.

RESULTSCDGF and IGF-I both stimulated the proliferation and synthesis of hydroxyproline of chondrocytes dose-dependently. The optimal concentration of CDGF was 16 ng/ml and 32 ng/ml respectively, and that of IGF-I was 30 ng/ml. There was obvious synergic effect between CDGF and IGF-I.

CONCLUSIONCDGF can stimulate the proliferation and collagen synthesis of chondrocytes and has synergistic effect with IGF-I.

Animals ; Cartilage ; metabolism ; Cell Division ; drug effects ; Chondrocytes ; drug effects ; physiology ; Dose-Response Relationship, Drug ; Drug Synergism ; Hydroxyproline ; biosynthesis ; Insulin-Like Growth Factor I ; pharmacology ; Male ; Proteins ; pharmacology ; Rabbits

: Rehabilitation medicine is a medical branch which focused on functional recovery. Function Evaluation is very important in assessing the function of patients, the effect of treatment and the efficiency of rehabilitation. Comprehensive Function Evaluation includes evaluation of physical, psychological, speech and society. Vocal, mental and social evaluation have deep cultural and national background. Therefore every country must have its own Function Evaluation Method. Now we present our design for Comprehensive Evaluation. Based on the cooperation of Department of Rehabilitation, Department of Neurology, Department of Spinal Cord Injury, Department of Speech Therapy and Department of Psychology. The advantages of this method are as follows: 1. The style of ADL, speech and thinking are suitable for the condition of our country. 2. The evaluation result adopts hundred work system, it is easy for medical staff, patients and their family to understand and communicate the result. 3. We make it more accurate, comprehensive and reliable by some simple tests on speech pathology and psychology. 4. We overcome some disadvantages of evaluation indexes because it is not correct and is difficult to be understood before. Now every evaluation index has quantity standard. 5. It is simple and practical. Each subtest takes 20 minutes or more. 6. It has been tested by normal people. The norm and severity grade had been developed. 7. The reliability is tested and is proved to be dependable.

康复医学是以恢复患者功能为中心的医学分支。因此，功能评定无论是在客观地评定患者的功能方面，还是在最终评定治疗结果和康复效率方面都是极为重要的。全面的功能评定包括躯体、精神、言语和社会四个方面。其中，言语、社会功能和认知功能中的思维方式，都具有强烈的民族文化色彩。因此，每个国家都应该有切合自己国情的功能评定方法。但由于我国康复医学发展较晚，至今尚无一套既切合国情，又全面、实用和可靠的功能评定方法。有鉴于此，我们在“中心”顾问室、神经康复科、脊髓损伤康复科、言语治疗科、心理科和老年病科的通力合作下，经过近2年的研究，在吸收国际先进经验的基础上，密切结合国情，设计了本文所述的综合功能评定法。其优点有：1．在饮食、起居等生活方式方面以及在言语、社会、思维等方面，均切合我国国情。2．评定结果采用群众熟悉的100分制，使医务人员、患者和患者家属均易于理解，便于交流和沟通。3．在言语、认知等功能的评定方面，直接由言语和心理学家选择一些简易的言语和心理学测试项目，提高了量表的准确性、全面性和可靠性。4．各项评定指标的量化程度高，在言语、认知和社会方面尤其如此，克服了一些量表中对此类项目的评定指标不够具体和不易掌握的不足。5.简便实用，一次检查对正常人仅需20分钟左右，对患者则无负担。6.本法已在128名正常人中应用，并求出了正常值，据此拟定了功能障碍严重程度的等级，可供参考和应用。7.信度经过检验，证明可靠。 综合功能评定法的正常值、功能障碍严重程度分级及信度研究结果，将陆续报道。

Objective To identify the differences of three-dimensional knee kinematics of unilateral anterior cruciate ligament (ACL) deficient patients with and without the meniscus injury.Methods A total of 39 subjects including unilateral isolate ACL-deficient patients (ACL group,n=13),ACL deficient patients combined with meniscus tear (ACL+M group,n=13) and healthy controls (C group,n=13) participated in this study.In the gait analysis,three-dimensional knee kinematic and kinetic parameters were collected synchronously and compared.Results The peak knee flexion angles were greater in the ACL+M group and C group compared with the ACL group (P=0.001,P=0.001),with no significant differences between the former two groups (P=0.847).Lower first peak vertical ground reaction force,peak posterior ground reaction force,sagittal plane knee excursions and peak knee extension moment were found in ACL-injured side compared with the contralateral side (P=0.001,P＜0.001,P=0.006,P=0.001).Greater peak knee abduction moment was found in group ACL+M compared with both the ACL and C groups (P=0.045,P=0.014).However,no significant difference was observed between the ACL group and C group in peak knee abduction moment (P=0.616).Conclusions The altered loading in unilateral ACL deficient patients can lead to lower ground reaction force in injured knee and greater ground reaction force in the contralateral side,which may increase the risk of developing knee osteoarthritis.The greater internal knee abduction moment in ACL deficient patients combined with meniscus injury may be a risking factor for the knee osteoarthritis.

Objective:To investigate the correlation of isokinetic thigh muscle asymmetry with gait asymmetry at one year after anterior cruciate ligament (ACL) reconstruction.Methods:A retrospective case series analysis was made on 25 patients treated by ACL reconstruction in Third Hospital of Peking University from January 2014 to January 2019. All the subjects were male, aged 17-47 years [(29.4±5.2)years]. Standard rehabilitation treatment procedures were conducted after surgery. The isokinetic muscle strength of the thigh was collected at one year after operation to evaluate knee extensor and flexor concentric strength at 60°/s, 180°/s and 300°/s, and knee extensor and flexor eccentric strength at 60°/s. The maximum concentric and eccentric strength of the knee extensor and flexor were analysed between the injured and intact side. The three-dimensional motion information and ground reaction force was collected during the stance phase of gait, and knee kinematic and kinetic parameters were calculated by inverse dynamics analysis, including the peak flexion moment, peak extension moment, first and second peak adduction moment, peak external and internal rotation moment, peak flexion angle, peak extension angle during the terminal stance phase, flexion angle at heel strike, peak abduction angle, and peak external rotation angle during terminal stance phase. Spearman correlation analysis was used to study the correlation between limb symmetry index (LSI) of isokinetic muscle strength and LSI of gait parameters.Results:One year after ACL reconstruction, the maximum concentric strength of the knee extensor and flexor at 60°/s, 180°/s and 300°/s and maximum eccentric strength of the knee flexor and extensor at 60°/s on the injured side were significantly lower than those on the normal side (all P<0.01). Compared with the intact side, the peak knee extension moment on the injured side was significantly lower during the stance phase of gait ( P<0.01), and the extension angle was insufficient during the terminal stance phase ( P<0.01). There were no significant differences between the injured and intact side in terms of peak flexion moment, first and second peak adduction moment, peak external and internal rotation moment, peak flexion angle, flexion angle at heel strike, peak abduction angle, and peak external rotation angle during terminal stance phase (all P>0.05). One year after ACL reconstruction, Spearman correlation analysis during gait stance phase showed that the LSI of 60°/s concentric strength of the isokinetic knee extensor was significantly related to LSI of peak internal rotation moment ( R=0.42, P<0.05), the LSI of 180°/s concentric strength of the isokinetic knee extensor was significantly related to LSI of peak flexion moment ( R=0.45, P<0.05), the LSI of 180°/s concentric strength of the isokinetic knee flexor was significantly correlated with LSI of peak flexion angle ( R=0.46, P<0.05), the LSI of 300°/s concentric strength of the isokinetic knee extensor was significantly correlated with LSI of peak knee flexion angle ( R=0.42, P<0.05), and the LSI of 60°/s eccentric strength of the isokinetic flexor was significantly correlated with LSI of peak knee flexion angle ( R=0.54, P<0.01). Conclusions:For patients following ACL reconstruction at one year postoperatively, a significant correlation of isokinetic thigh extensor strength asymmetry with peak knee flexion and rotation moment and peak knee flexion angle, and that of isokinetic thigh flexor strength asymmetry with peak knee flexion angle are observed during the stance phase of gait, which suggests that patients with ACL reconstruction still need systematic rehabilitation training one year postoperatively to improve muscle strength and motor function so as to reduce the risk of ACL reinjury and secondary injury.

Lateral ankle avulsion fracture is a common sports injury that can lead to chronic lateral ankle instability and substantial deterioration of the joint function. Currently, problems such as misdiagnosis, inappropriate treatment, disparate outcomes and lack of standardization are usually met in the diagnosis and treatment of lateral ankle avulsion fracture. The Foot and Ankle Committee of Chinese Association of Sports Medicine Physicians thus organized a working group of experts in the field of sports medicine and ankle surgery from China to develop "An evidence-based clinical guideline for the diagnosis and treatment of lateral ankle avulsion fractures (2022 version)" in accordance with the principle of evidence-based medicine and scientificity and practicability. The guideline covered the topics of imaging diagnosis, indications and methods of non-operative and operative treatment as well as postoperative rehabilitation, in order to provide guidance for the diagnosis and treatment of lateral ankle avulsion fracture.