BACKGROUND:Early knee ioint prosthesis is used to relieve severe pain of patients．With continuous modification，the knee joint prosthesis with high flexion has developed．OBJECTIVE：To compare the clinical outcome between fixed platform high—flexion prosthesis and rotating platform high-flexion prosthesis following total knee arthroplasty．DESIGN：Non-randomized concurrent control trial of patients．PARTICIPANTS：Thirty-four patients(50 knees)with severe osteoarthritis underwent total knee replacement in Department of Bone and Joint,Tianjin Union Medicine Center from January to December 2006．METHODS：Of 34 patients，16(25 knees)underwent fixed platform high-flexion prosthesis replacement(LPS flexion，Zimmer，USA)，and 18(25 knees)underwent rotating platform high-flexion prosthesis replacement(PFC sigma RPF prosthesis．Johnson & Johnson,USA)．MAIN OUTCOME MEASURES：Knee joint function was evaluated using Hospital for Special Surgery Knee Score (HSS)before and 2 weeks，1，3 and 6 months after surgery．In addition，range of flexion of the knee was observed at 6 months postoperatively．RESULTS：Thirty-four cases completed the treatment and were followed up for 6 months．HSS scores of patients undergoing rotating platform high-flexion prosthesis replacement were higher than fixed platform high·flexion prosthesis replacement group at 2 weeks postoperatively(P<0．05)，while no differences were found in HSS scores at 1，3 and 6 months after surgery(P>0．05)．In addition，there were no significant differences in the range of flexion of the knee at 6 months postoperatively[(130．4±15．2)°，(129．9±13．8)°，P>0．05]．CONCLUSION：Fixed platform and rotating platform high-flexion prosthesis replacement exhibit similar early effects on severe osteoarthritis．

BACKGROUND: Anterior cruciate ligament injury accompanied by unstable rotation is a hotspot in sports medicine. Further understanding of the anatomy and biomechanics of the anterolateral ligament can play a guiding significance for the recovery of knee joint rotational stability.
OBJECTIVE:To systematicaly review current literature on the anterolateral ligament of the knee and to understand the incidence, anatomy, morphology and histology of the anterolateral ligament as wel as mechanism of anterolateral ligament injury.
METHODS: The first author searched the PubMed, Medline, CNKI, Wanfang, VIP databases for articles specificaly addressing the anterolateral ligament. Data extraction related to the incidence, anatomy, morphometry, biomechanics, and histology of the anterolateral ligament and its relation to the “Segond” fracture was performed. The retrieve time ranged from 1878 to 2015. Totaly 362 literatures were retrieved, including 342 articles in English and 20 in Chinese. According to inclusive and exclusive criteria, 42 articles were included in result analysis.
RESULTS AND CONCLUSION:The occurrence rate of the anterolateral ligament ranges from 83% to 100%, and this range occurs because of smal discrepancies in the definition of the bony insertions of the anterolateral ligament. The anterolateral ligament originates anterior and distal to the femoral attachment of the lateral colateral ligament. It spans the joint in an oblique fashion and inserts between the fibular head and Gerdy tubercle of the tibia. Exact anatomic and morphometric descriptions vary in the literature, and there are discrepancies regarding the anterolateral ligament attachment to the capsule and lateral meniscus. The anterolaterial ligament is a contributor to the stability of tibial internal rotation, and histologicaly, it exhibits paralel, crimped fibers consistent with a ligamentous microstructure. The footprint of the anterolateral ligament has been shown to be at the exact location of the Segond fracture. The anterolateral ligament is a distinct ligamentous structure at the anterolateral plane of the knee, and it is likely involved in the control of excessive tibial internal rotation that can cause the Segond fracture.

Objective To evaluate the clinical effects of medial patellofemoral ligament reconstruction using the semitendinosus tendon autograft for the treatment of the patellar dislocation.Methods From January 2007 to January 2010,16 cases of patellar dislocation were included in this group.Lysholm score was averaged preoperatively.Arthroscopic-assisted in the semitendinosus tendon autograft reconstruction of the medial patellofemoral ligament,the central graft were fixed on the inner edge of the patellar in the upper 1/3 and the mid-point location,the end were fixed on the channel of femoral epicondyle and adductor tubercle.Results All the patients that lined progressive knee rehabilitation after operation,returned to normal walking for 3 months,6 months could be sports.Followed up for 7-54( 26.36 ± 20.48 ) months,all of patients incision were healed as grade Ⅰ,knee function were normal.Postoperative Lysholm score (93.21 ± 4.68) scores compared with preoperative ( 76.53 ± 8.35 ) scores was significant difference (P ＜ 0.05 ).Conclusions Using the semitendinosus tendon autograft for the treatment of the patellar dislocation method is simple and can effectively restore normal patellar trajectory.At the same time,which is an effective surgical method to treat recurrentdislocation of the patellar.

OBJECTIVETo observe the long-term outcome of implantable cardioverter-defibrillator (ICD) implantation in Brugada syndrome patients and to explore how to reduce the frequency of ICD nappropriate schocks.

METHODSThis study included 14 symptomatic patients (mean age (44.3 ± 8.3) years old; all males) with Brugada syndrome implanted with ICD in our hospital between 1998 and 2012, and these patients were followed up routinely every 6 months. The initial ICD parameters were set according o conventional experience. The ventricular tachycardia (VT) zone was programmed to ventricular rate 150-188 bpm/cycle length (CL) 400-320 ms and the ventricular fibrillation (VF) zone was programmed to ventricular rate ≥ 188 bpm/CL ≤ 320 ms. The total events were recorded by ICD. The ICD parameters revision was made by electrophysiological (EP) experts in case of inappropriate shocks.

RESULTSPatients were followed up for mean (43.0 ± 28.3) months. A total of 297 VF/VT events were recorded by ICD. Electrophysiological experts found that 90% (178/198) episodes were true VF ( CL 130-250 ms) among of 198 VF episodes and 147 VF episodes were terminated by one shock and 21 VF events were terminated by two or more shocks, and the rest 10 VF terminated spontaneously. Only 9% (9/99) VT events were true VT (CL 320-360 ms) among of 99 VT episodes. Eight VT episodes were converted by antitachycardia pacing therapy (ATP) and the other one terminated spontaneously. The rest 90 VT episodes (91%) were supraventricular arrhythmias (SVT, CL 340-390 ms). About 90% inappropriate shocks can be reduced by Wavelet discrimination function and optimal programming (VF zone ventricular rate ≥ 222 bpm/CL ≤ 270 ms and/or VT zone ventricular rate 167-222 bpm/CL 270-360 ms ) according to the characteristics of arrhythmia of individual patient.

CONCLUSIONICD can effectively prevent sudden cardiac death and syncope in high-risk patients with Brugada syndrome. The most common complication is inappropriate shock due to SVT. Optimal ICD programming with Wavelet discrimination function can effectively reduce the frequency of inappropriate shock rate.

Adult ; Brugada Syndrome ; Cardiac Conduction System Disease ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Humans ; Male ; Syncope ; Tachycardia, Ventricular ; Treatment Outcome ; Ventricular Fibrillation

BACKGROUND:From the biological structure, the posterior cruciate ligament is surrounded by the synovial folds of posterior capsule, arising from the inner side of the medial femoral condyle to the posterior part of tibial intercondyloid spine. The main traditional treatment method for posterior cruciate ligament tibial avulsion fracture is open operation, but it is difficult in anatomic reduction, cannot ful y restore knee joint stability and has a great negative impact on the normal function of posterior cruciate ligament. OBJECTIVE:To investigate the effects of arthroscopic implant internal fixation in the treatment of tibial avulsion fracture of the posterior cruciate ligament. METHODS:120 patients with tibial avulsion fracture of the posterior cruciate ligament were randomly assigned into treatment group and control group, with 60 cases in each group. The control group was given the traditional open surgery, and the treatment group was given the arthroscopic surgery. After 3 months, International Knee Documentation Committee (IKDC) scores and Lysholm scores were detected in the two groups;the knee joint range of motion was determined before and 3 months after treatment. RESULTS AND CONCLUSION:Wounds were healed at stage I in al patients with no serious complications. There was no difference in the knee joint range of motion between the two groups before treatment, but the range of motion was increased significantly in both two groups at 3 months after treatment (P<0.05), meanwhile which was higher in the treatment group than the control group (P<0.05). At 3 months after treatment, the excel ent knee function rate was significantly higher in the treatment group (97%) than the control group (88%) according to the Lysholm scores;the IKDC scores were significantly higher in the treatment than the control group in terms of claudication, support, pain, swel ing, and squat (P<0.05). These results indicate that the arthroscopic implant fixation of tibial avulsion fracture of the posterior cruciate ligament has better short-term effects to promote recovery of knee joint function, but no serious complications.

Objective To investigate the role of interleukin 17 in the differentiation of macrophages from monocyte in vivo and its applicability in Obliterative bronchiolitis (OB).Methods Pathogen-free male C57BL/6 (n =20),IL-17-defcient C57BL/6 (n =10) and BALB/c (n =10) weighing 20-25 g.Weight-matched mice were assigned to three experimental groups.Experimental group A:BALB/c (n =5) →C57 BL/6 (n =10).Experimental group B:BALB/c (n =5) →IL-17-defcient C57BL/6(n =10).Normal control group:C57BL/6(n =10).The CD80 expression in macrophages in spleens were analysed by flowcytometry 7 days after operation.Native and transplanted lungs were harvested after 14 days and 28 days,stained with HE,and examined under light microscopy.Results Compared to experimental group A,CD80 expression of macrophages reveales a significant decrease in spleen of experimental group B.Furthermore,airway obliteration and destruction of the epithelium in experimental group A were significantly better compared with that of experimental group B on day 14 and 28 after transplantation.Conclusion IL-17 deficiency decreased the polarization of monocytes to macrophages and attenuate the pathology of obliteral bronchiolitis in murine model after trachea transplantaion.

Objective To investigate the clinical efficacy of arthroscopy with anchor treatment on acute patellar dislo?cation. Methods Retrospective analysis of patient with acute patellar dislocation cases who visited our hospital from March 2010 to June 2013 and were followed up for 10 months or more after being discharged. Patients all underwent physical exami?nation and imaging examination before operations. All operations were performed under arthroscopy. Joint hematoma were first drained, then articular cartilage injury were explored and repaired. Corresponding relationship between patella and femo?ral condyle were observed. After that, lateral retinaculum was released and medial patellofemoral ligament was repaired by suture anchors. Finally patellar reduction and its corresponding relationship with femur were observed after operation. Re?sults Medial patella cartilage injury and bone contusion of femoral condyle were all observed under arthroscopy. Medial patellofemoral ligament damage and tensed lateral patellar retinaculum were combined. By the time of follow-up at 10~18 months later, no dislocation was found and fear test are all positive. No recurrence of patellar dislocation was observed. Compared the conditions before operation and the last follow-up, Lysholm score(91.38±1.65 vs 60.04±3.93), Kujala score (90.62±2.08 vs 55.27±3.00),patellar camber angle(11.96°±1.43° vs 25.15°±2.13°)were all imporved(P<0.01). Conclu?sion Arthroscopy with suture anchors present good clinical effect in the treatment of acute patellar dislocation, which in?cludes alleviating keen pain, stabilizing joint instability and restoring knee stretching. It also present with less recurrence of patellar dislocation.

Objective To study the mode and clinical implications of onset of spontaneous tosade de pointes in the congenital long QT syndrome. Methods We reviewed electrocardiograms (ECGs) of 55 patients with congenital QT syndrome for syncope. Documentation of the onset of tosade de pointes was available for 16 patients. All these patients had "definitive long QT syndrome" by accepted clinical and ECG criteria. Results One hundren and forty-nine runs of tosade de pointes were documented in 16 patients,of whom,there were 130 runs of pause-dependent tosade de pointes. Conclusion Our results show that the pause-dependent tosade de pointes,which has been recognized as a hallmark of tosade de pointes in the acquired long QT syndrome,plays a major role in the genesis of tosade de pointes in the congenital long QT syndrome.

Objective To investigate calcium-sensing receptor (CaSR) expression level in osteoarthritis (OA) carti-lage,and the relationship with OA pathogenesis thereof. Methods The degenerated human cartilage of distal femur and proximal tibia came from 5 patients with OA underwent total knee replacement surgery. The tissue specimens were stained by HE. According to the Collins histological grading standards, articular cartilage degeneration was classificated in speci-mens. Eight HE slices of Collins grade 0 were used as normal cartilage group. Eight HE slices of Collins gradeⅡwere used as degeneration cartilage group. The CaSR expression levels detected by immunohistochemical staining technique were com-pared between two groups. Results Expression of CaSR was detected in osteoarthritis cartilage. The expression intensity of CaSR was significantly lower in normal cartilage group than that of degeneration of cartilage group (score:1.63±0.95 vs 3.52± 0.78,t=8.99,P<0.05). Conclusion The activation of CaSR is associated with the degeneration of articular cartilage.

OBJECTIVELow or moderate consumption of red wine has a greater benefit than the consumption of other beverages in the prevention of atherosclerosis and coronary heart disease and this is increasingly attributed to the polyphenol compounds in red wine, such as resveratrol. In the present study, we investigated the effect of resveratrol on platelet aggregation in vitro and in vivo.

METHODSPlatelet aggregation in rabbits and normal subjects was measured using Born's method.

RESULTSResveratrol, at 10 - 1000 micromol/L, significantly inhibited platelet aggregation in vitro induced by collagen, thrombin, and ADP in healthy subjects. The inhibitory effect was concentration-dependent. Hypercholesterolemia induced by high-cholesterol diet enhanced ADP-induced platelet aggregation. Resveratrol 4 mg x kg(-1) x d(-1) inhibited ADP-induced platelet aggregation in vivo despite no changes in serum lipid levels.

CONCLUSIONSResveratrol inhibits platelet aggregation both in vitro and in vivo. This may be one of the mechanisms by which resveratrol prevents atherosclerosis.

Animals ; Arteriosclerosis ; prevention & control ; Cholesterol, LDL ; blood ; Humans ; Lipids ; blood ; Platelet Aggregation ; drug effects ; Platelet Aggregation Inhibitors ; pharmacology ; Rabbits ; Stilbenes ; pharmacology