Objective:To describe the clinical results of a one-stage operation for posterior cruciate ligament reconstruction and a posterolateral corner reconstruction of popliteus tendon reconstruction,com-pared with an open popliteofibular ligament reconstruction.Methods:Our study included 33 patients who had undergone posterior cruciate ligament reconstruction with use of an achilles tendon-bone allograft and posterolateral corner reconstruction with arthroscopic anatomical reconstruction of popliteus tendon or open reconstruction of popliteofibular ligament.The patients were assessed for knee instability with use of the dial test at 30°and 90°,together with posterior stress radiography and KT-1000 measurement.Re-sults:The mean time of follow-up was more than 2 years.At the final follow-up evaluation,the tibial posterior translation as measured by stress radiography at 90°of knee flexion,the anterior-posterior trans-lation as measured by KT-1000,and the external rotation of tibia as measured by dial test were reduced postoperatively (P<0.001 )in both groups.Between the two groups,the preoperative tibial posterior translation as measured by stress radiography and the preoperative mean anterior-posterior translation as measured by KT-1000 in the popliteofibular ligament group were a little more than those in the popliteus tendon group (P=0.014,P<0.001).But the other comparisons were not significantly different (P>0.05).The final flexion losses were 3.33°±4.88°and 3.06°±3.38°for the two groups.Conclusion:Combined with posterior cruciate ligament reconstruction,anatomical posterolateral corner reconstruc-tion of the popliteus tendon and open reconstruction of popliteofibular ligament showed similar out-comes.This study demonstrated that both posterolateral corner reconstruction techniques were a reliable alternative method in addressing posterolateral corner and posterior cruciate ligament insufficiency of the knee.

Objective To evaluate the early clinical outcomes of anterior cruciate ligament(ACL)reconstruction combined with anterolateral tenodesis procedure in patient with high grade pivot-shift after ACL injuries.Methods Among the 140 patients diagnosed as ACL injury and undergoing operations in our hospital between June and December 2015,18 presenting high grade pivot-shift 2+ or 3+ under anesthesia were included into this study.During their surgeries,the anterolateral tenodesis procedure using iliotibial tract ITB was applied together with ACL reconstruction.The anteroposterior stability of the knee was examined and pivot-shift test was conducted right after the operation as well as 6 and 12 months after that.The Lysholm score was used to evaluate the clinical function of their knees.Results The mean follow-up period of the 18 patients was 12.7 ± 2.4 months.There were 14 males and 4 females,with an average of 28.3 ± 7.1 years.No patients complained about unstable symptoms during the follow-up.The mean side-to-side difference of anteroposterior knee laxity assessed using KT1000 at 30 degree knee flexion was 2.3 ± 0.7 mm,which was significantly improved compared with preoperative assessment(9.2 ± 2.6 mm)(P＜0.01).For the preoperative examination,the pivot-shift examination indicated 2+ in 13 patients and 3+ in 5 patients.However,all were negative right after the operation.Seventeen patients presented negative pivot-shift at the final follow-up,while 1 had 1+ rotational laxity.Significant differences were found in the Pivot-shift test before and after the operation.The average Lysholm score improved significantly from 67.7 ± 5.9(ranging from 55 to 78)before the operation to 89.0-± 4.6(ranging from 75 to 95)after that.Conclusion The high grade pivot-shift rotational instability could be effectively restored using the anterolateral tenodesis procedure,in addition to ACL reconstruction.The early stage clinical outcomes indicate significant improvement of the knee stability postoperatively.

AIM:To observe and compare clinical effects of coaxial 1. 8mm microincision phacoemulsification and 3. 2mm small incision phacoemulsification.
●METHODS:A total of 117 eyes of 85 patients with age-related cataract in our hospital were divided randomly into two groups:43 patients (59 eyes) in the coaxial 1. 8 mm microincision cataract surgery group ( C - MlCS ) , 42 patients (58 eyes) in the coaxial 3. 2 mm traditional small incision cataract surgery group (C-SlCS). A total of 117 eyes were received phacoemulsification with intraocular lens implantation. Uncorrected visual acuity was recorded preoperatively and postoperatively at 1, 7, 30 and 90d. The effective phacoemulsification time and average ultrasound energy were recorded in surgery. Corneal endothelial cell and corneal topography were recorded preoperatively and postoperatively at 90 d.
●RESULTS:Uncorrected visual acuity ( logMAR) was no overall statistical significance difference between C-MlCS group and C-SlCS group (P>0. 05), but was significant statistical difference in different time-point within both groups(P<0. 05). Uncorrected visual acuity in different time-point had nothing to do with corneal wound size in cataract surgery(P>0. 05). On the 1 day after surgery, uncorrected visual acuity was 0. 16±0. 11 in C-MlCS group and 0. 22±0. 18 in C-SlCS group(P<0. 05). AVE was (7. 00± 2.72)% in C-MlCS group and (6. 16±3. 16)% in C-SlCS group (P>0. 05). EPT was (3. 09±1. 61)s in C-MlCS group and (3. 20±1. 92)s in C-SlCS group (P>0. 05). At 90 d after surgery, corneal endothelial cell loss percentage was (5. 81±2. 28)% in C-MlCS group and (5. 69±2. 38)% in C-SlCS group (P>0.05), SlA was (0.35±0.11) Din C-MlCS group and (0. 61±0. 13) D in C-SlCS group (P<0. 05).
● CONCLUSION: Compared with coaxial 3. 2mm traditional small incision cataract surgery, 1. 8mm coaxial microincision cataract surgery can get earlier visual rehabilitation and significantly reduce SlA. The coaxial 1. 8mm microincision cataract surgery is safe, effective and deserves further clinical applications.

Objective: To observe the effects of moxibustion at Shenshu (BL 23), Zusanli (ST 36) and Shenque (CV 8) on the energy metabolism and endocrine metabolism indicators of rats undergoing one-time exhaustive swimming, and to explore the differences between moxibustion at different points in the effects on anti-exercise fatigue. Methods: Forty-eight male SPF rats were randomly divided into a blank group, a model group, a non-meridian and non-acupoint group, a Shenshu (BL 23) group, a Zusanli (ST 36) group, and a Shenque (CV 8) group using random number table method, with eight rats in each group. Except for the blank group, rats in the other groups were subjected to replicating the one-time exhaustive model using the weight-bearing swimming experiment. Except for the model group, the other model rats received mild moxibustion immediately after swimming. Rats in the non-meridian and non-acupoint group received mild moxibustion at bilateral subcostal non-meridian and non-acupoint points, those in the Shenshu (BL 23) group received mild moxibustion at bilateral Shenshu (BL 23), those in the Zusanli (ST 36) group received mild moxibustion at bilateral Zusanli (ST 36), and those in the Shenque (CV 8) group received mild moxibustion at Shenque (CV 8) for 15 min. Four hours after the exhaustive swimming, femoral artery blood was collected to detect blood lactate (BLA), lactate dehydrogenase (LDH), creatine kinase (CK), creatinine (CRE), blood urea nitrogen (BUN), cortisol (C) and testosterone (T) levels, and calculate the T/C ratio. Results: Compared with the blank group, rat's serum levels of BLA, LDH, CK, BUN and C in the model group and the non-meridian and non-acupoint group were increased, and serum levels of CRE and T, and T/C ratios were decreased (P<0.01 or P<0.05); compared with the model group and the non-meridian and non-acupoint group, the serum levels of BLA, LDH, CK, BUN and C in the Shenshu (BL 23) group, Zusanli (ST 36) group and Shenque (CV 8) group were decreased, and the serum CRE and T levels, and the T/C ratios were increased (all P<0.01); compared with the Shenshu (BL 23) group, the serum CK level was decreased in the Shenque (CV 8) group (P<0.01), the serum levels of T and C were decreased in the Zusanli (ST 36) group and Shenque (CV 8) group (P<0.01 or P<0.05), and the T/C ratio was increased in the Shenque (CV 8) group (P<0.01); compared with the Zusanli (ST 36) group, the serum CK and BUN levels were decreased (P<0.01, P<0.05), and the T/C ratio was increased in the Shenque (CV 8) group (P<0.05). Conclusion: Moxibustion at Shenshu (BL 23), Zusanli (ST 36) and Shenque (CV 8) shows different anti-fatigue effects by regulating the energy metabolism and endocrine metabolism in rats undergoing one-time exhaustive swimming. Moxibustion at Shenshu (BL 23) is better in promoting energy synthesis. Moxibustion at Shenque (CV 8) is more effective in regulating synthesis and decomposition of the skeletal muscle proteins.

Objective To investigate the clinical outcome of dual?plane high tibial osteotomy to treat posterolateral corner injuries combined with varus and/or hyperextension deformity. Methods From October 2008 to March 2014, there were 12 patients (13 knees) undergoing high tibial osteotomy. All the patients were double or triple varus knee combined with posterior cruciate ligament and posterolateral corner (PLC) injuries. During the surgery, the weight bearing line of lower extremity was set to 62%position of the tibial plateau on the coronal plane. The tibial slope was increased to diminish the hyperextension on the sagit?tal plane. Full?length weight bearing X?ray was used to evaluate the position of weight bearing line, femoral?tibial angle and tibial slope pre? and post?operatively. The stress radiograph was used to evaluate the posterior and posterolateral stability. The Op?ti_knee gait analysis system was used to evaluate the varus of angle during weight bearing stage. Results The weight bearing line was corrected from 19.6%±19.1% preoperatively to 42.6%±17.9% postoperatively (t=-4.178, P=0.002). The femoral?tibial angle was 172.8°±4.2° preoperatively and improved to 178.1°±4.2° postoperatively (t=-4.520, P=0.001). The tibial slope was increased from 10.2° ± 5.3° preoperatively to 18.4° ± 6.3° postoperatively (t=-5.735, P=0.000). The tibial posterior translation was decreased from 11.4±5.3 mm preoperatively to 8.1±6.9 mm postoperatively (t=2.415, P=0.042) in 9 patients. The separa?tion of lateral compartment was decreased from 16.3 ± 6.5 mm preoperatively to 14.2 ± 4.9 mm postoperatively (t=3.194, P=0.019). Gait analysis was performed in 7 patients and showed that the varus was improved from 3.0° ± 2.6° preoperatively to-2.7°±2.5° postoperatively during weight bearing stage (t=-8.500,P=0.014). Eight patients had sufficient improvement in knee function so that a subsequent posterolateral corner reconstruction was not necessary. Conclusion The dual?plane medial open wedge high tibial osteotomy can improve the alignment of lower extremity and the stability of knee joint, and 67%patients do not need a staged PLC and posterior cruciate ligament reconstruction.

Objective: To explore the correlation of plasma level N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with non-diabetic acute myocardial infarction (AMI) combining stress hyperglycemia.
Methods: A total of 327 non-diabetic AMI patients treated in our hospital from 2012-02 to 2014-05 were studied. The patients were divided into 2 groups according to fasting blood glucose level:Stress group, the patients with blood glucose≥7.0 mmol/L, n=182 and Non-stress group, the patients with blood glucose<7.0 mmol/L, n=145. The basic clinical condition, laboratory tests within 24 hours of onsets, echocardiography and 24 h dynamic electrocardiogram were examined;the incidence of major adverse cardiovascular events (MACE) including arrhythmia, heart failure, cardiac shock and sudden cardiac death in 2 weeks of onsets were analyzed and compared between 2 groups.
Results: The patients’ age, gender, history of hypertension, smoking, drinking, and blood levels of TC, TG, HDL-C, LDL-C were similar between 2 groups, P>0.05. Plasma levels of NT-proBNP, CK-MB, MYO, ultra-TnI, ALT, AST and blood glucose level were signiifcantly different between 2 groups P<0.01. NT-proBNP level was positively related to
ultra-TnI (r2=0.811, r=0.901, P<0.01). Stress group presented obviously higher incidence of MACE (P<0.05), lower LVEF (P<0.01), and signiifcantly increased left ventricular end diastolic diameter, left ventricular end systolic diameter (P<0.01) than those in Non-stress group.
Conclusion: Plasma levels of NT-proBNP may judge the severity and evaluate recent prognosis in patients with non-diabetic AMI combining stress hyperglycemia, it could be used as a risk indicator for relevant patients in clinical practice.

Purpose To investigate the expression of the protein of Ezrin and AQP5 in the normal, dysplasia gastric and carcinoma of esophagogastirc junction tissues and to find out their relationship with the biologic behavior of the carcinoma of esophagogastirc junction in the southern area of Hebei Province. Methods Ezrin and AQP5 proteins were detected by immunohistochemical staining in 10 ca-ses of normal gastric tissue, 40 cases dysplasia and 165 cases of the carcinoma of esophagogastirc junction tissues, respectively. Re-sults All of the expression levels of Ezrin and AQP5 protein were increasing according to the order of normal-dysplsia-carcinoma. The expression rate of Ezrin was 10%, 45% and 72. 7%, while the rate of AQP5 with 20%, 32. 5% and 65. 5% in the normal, dysplasia and carcinoma subgroup. The expression rates of each protein were significantly different among the three groups (P<0. 05). The ex-pression of them in the subgroup of poorly-differentiated with serosa invasion and lymph nodes metastasis was significantly higher than the other subgroup of well-differentiated with non serosa invasion or lymph nodes metastasis (P<0. 05). There was a positive correla-tion between the expression of Ezrin and AQP5 proteins in the carcinoma of esophagogastirc junction (P<0. 05). Conclusions Over-expression of Ezrin and AQP5 is detected in the carcinoma of esophagogastirc junction, with positive relationships, which probably helps the invasiveness and metastasis in the carcinoma of esophagogastirc junction synergistically.

OBJECTIVETo observe the effect of purgation and detoxification therapy on gastrointestinal dysfunction of critically ill patients undergoing abdominal surgery.

METHODSTotally 56 inpatients with severe gastrointestinal dysfunction after abdominal surgery at ICU of Guangdong Provincial Hospital of Traditional Chinese Medicine were assigned to the treatment group and the control group, 28 in each group. All patients received routine Western medical treatment. Patients in the treatment group additionally took Modified Huanglian Jiedu Decoction (MHJD) and received electroacupuncture (EA) for 7 days. The first exhaust time, defecation time, scores for gastrointestinal dysfunction, mechanical ventilation time, ICU hospitalization time, and 28-day fatality rate were observed. Furthermore, serum levels of diamine oxidase (DAO) and D-lactic acid were detected at day 1, 3, and 7 after treatment.

RESULTSThe first exhaust time and the first defecation time in the treatment group were ahead of schedule, when compared with those of the control group (P <0. 05). Scores for gastrointestinal dysfunction, mechanical ventilation time, serum levels of DAO obviously decreased in the treatment group (P <0. 05). There was no statistical difference in serum levels of D-lactic acid, ICU stay time, the incidence of pulmonary infection, and 28-day mortality between the two groups (P >0. 05). Results of Logistic analysis showed that scores for gastrointestinal dysfunction were related with the incidence of pulmonary infection (P <0. 05).

CONCLUSIONMHJD combined EA could promote the recovery of gastrointestinal function in critically ill patients after abdominal surgery via improving intestinal barrier function, which was benefit for shortening mechanical ventilation time.

Critical Illness ; Defecation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Electroacupuncture ; Gastrointestinal Diseases ; drug therapy ; Humans ; Lactic Acid ; Medicine, Chinese Traditional

OBJECTIVETo explore the effect of Shoutai Pill (STP) containing serum on bioactivity behaviors of trophoblast cells in spontaneous abortion (SA) patients such as cell proliferation, invasion, migration and secretion.

METHODSTrophoblast cells in artificial abortion in normal pregnancy and SA patients were isolated and cultured in vitro, which were then treated with STP containing serum at various concentrations (5%, 10%, 20%, respectively). Blank serum was taken as the normal control group and dydrogesterone containing serum as the dydrogesterone control group. The proliferation, cycle distribution, invasion and migration capacity, and beta human chorionic gonadotropin (p-HCG) level were detected by methyl thiazolyl tetrazolium (MTT) colorimetry, flow cytometry (FCM), Transwell experiments, and ELISA, respectively.

RESULTSCompared with the normal control group, the activity of cell proliferation obviously decreased, ratios of apoptotic cells (SubGO/G1) and G2/M phase were obviously elevated, S phase cell ratio was obviously reduced (all P < 0.05). Transwell experiments indicated invasion and migration capacity obviously decreased, secreted beta-HCG level were obviously reduced after 72-h intervention (P < 0.05). Compared with the SA group, the activity of cell proliferation obviously increased, ratios of apoptotic cells and G2/M phase were obviously reduced, S phase cell ratio was obviously elevated, invasion and migration capacity were obviously enhanced, secreted beta-HCG level were obviously elevated after 72-h intervention in the dydrogesterone control group and each STP containing serum group (all P < 0.05). The activity of trophoblastic cell proliferation, S phase cell ratio, invasion and migration capacity, and secreted beta-HCG level were strengthened along with increased STP containing serum. Besides, the effects of 20% STP containing serum group were significantly superior to those of the dydrogesterone control group (P < 0.05).

CONCLUSIONSTP containing serum could dose-dependently enhance the proliferative activity of trophoblastic cells, invasion and migration capacity, secretion of beta-HCG, and reduce the apoptosis of trophoblast cells, which might be one of mechanisms for STP preventing and treating SA.

Abortion, Spontaneous ; Apoptosis ; Cell Cycle ; Cell Proliferation ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Dydrogesterone ; pharmacology ; Female ; Humans ; Pregnancy ; Trophoblasts ; drug effects

OBJECTIVE: To explore the application of mixed reality technique for the surgery of oral and maxillofacial tumors. METHODS: In this study, patients with a diagnosis of an oral and maxillofacial tumor who were referred to Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from December 2018 to January 2020 were selected. The preoperative contrast-enhanced computed tomography data of the patients were imported into StarAtlas Holographic Medical Imaging System (Visual 3D Corp., Beijing, China). Three-dimensional (3D) model of tumor and key structures, such as skeleton and vessels were reconstructed to three-dimensionally present the spatial relationship between them, followed with the key structures delineation and preoperative virtual surgical planning. By using mixed reality technique, the real-time 3D model was displayed stereotactically in the surgical site. While keeping sterile during operation, the surgeon could use simple gestures to adjust the 3D model, and observed the location, range, and size of tumor and the key structures adjacent to the tumor. Mixed reality technique was used to assist the operation: 3D model registration was performed for guidance before tumor excision; intraoperative real-time verification was performed during tumor exposure and after excision of the tumor. The Likert scale was used to evaluate the application of mixed reality technique after the operation. RESULTS: Eight patients underwent mixed reality assisted tumor resection, and all of them successfully completed the operation. The average time of the 3D model registration was 12.0 minutes. In all the cases, the surgeon could intuitively and three-dimensionally observe the 3D model of the tumor and the surrounding anatomical structures, and could adjust the model during the operation. The results of the Likert scale showed that mixed reality technique got high scores in terms of perceptual accuracy, helping to locate the anatomical parts, the role of model guidance during surgery, and the potential for improving surgical safety (4.22, 4.19, 4.16, and 4.28 points respectively). Eight patients healed well without perioperative complications. CONCLUSION By providing real-time stereotactic visualization of anatomy of surgical site and guiding the operation process through 3D model, mixed reality technique could improve the accuracy and safety of the excision of oral and maxillofacial tumors.
Augmented Reality ; China ; Humans ; Imaging, Three-Dimensional ; Neoplasms ; Retrospective Studies ; Surgery, Computer-Assisted