BACKGROUND:During autologous tendon grafting, the ultimate tensile strength used for suturing the end of the ligament is important for successful surgery. Improving suturing strength and increasing the number of stitches is a good choice for increasing the fixed intensity. But excess amount of stitches can produce too many thread residues, thereby affecting tendon healing.
OBJECTIVE:To investigate the essential number of suturing pins for the anterior cruciate ligament revascularization in ligament end suture fixation to reduce suturing thread exposure.
METHODS:(1) In vitro biomechanics test:12 patel ar ligament specimens were divided into two groups:the specimens were sutured with 5 or 3 stitches using Krackow suture method. The suturing thread was J&J tendon suture thread. The strength of tensile was compared between the two groups by Tensile mechanical test was conducted to compare the strength of tensile between the two groups and to explore the optimal number of stitches and suturing method. (2) Clinical application:According to the results of in vitro experiments, modified Krackow suture method was used clinical y for arthroscopic anterior cruciate ligament reconstruction in 125 cases, including 62 cases receiving 3-stitch suture, and 63 cases undergoing 5-stitch suture.
RESULTS AND CONCLUSION:The fixed strength of tensile at suture sites was over 100 N for 3-stitch double-lock suture and 110 N for 5-stitch double-lock suture. There was no significant difference in the fixed strength between the two groups, but their strength values were both over the breaking strength of suturing materials. Moreover, the fixed strength could not be reduced by suturing throughout the ligament at the first stitch. Al the 125 cases were fol owed for 6.4 months averagely, and both 3-stitch and 5-stitch suture methods achieved good outcomes. The satisfaction rate was up to 99%, and no suture breakage or loosing occurred at early and late stages. These findings suggest that, using 3-stitch double-lock suture method, a satisfactory fixed strength can be achieved with reduced thread exposure. The suturing thread can run through the ligament at the first stitch, which can reduce thread exposure but not reduce the fixed strength.

Objective To evaluate the changes of hepatic blood perfusion of liver cirrhosis patients and the role of pericardial devascularization (PCDV)on them.Methods Hepatic artery and portal vein perfusions of 22 liver cirrhotic patients (LC) pre and post P CDV compared with control were evaluated with rheohepatogram(RHG) and ultrasonogram(USG).Results Compared with control,both hepatic and portal effective perfusion of LC were decreased on RHG, PCDV could increase portal perfusion of LC patients without significant effect on hepatic artery.USG showed that portal vein diameter and blood quantity of LC increased and PCDV didn't influence liver perfusion;No correlation between RHG and USG parameters were seen by STATA analysis. Conclusions RHG is an effective way to evaluate comprehensive blood perfusion of cirrhotic livers,the effect of operation on blood perfusion and prognosis.

Objective To investigate the influence of need for cognitive closure on academic performance,interpersonal relationships and subjective well-being of undergraduates.Methods 250 undergraduates from Xinxiang Medical University and 200 undergraduates from Henan Normal University were tested by questionnaires,including of need for cognitive closure scale,interpersonal relationships subscale of SCL-90 and undergraduates＇subjective well-being scale.Results ①The scores in the need for cognitive closure of the better academic-performance undergraduates were significant higher than those of the undergraduates with no better academic-performance ( t =2.21,P ＜ 0.05 ).②Decisiveness of need for cognitive closure was a negative predicator of interpersonal relationships(β =-0.34,P ＜ 0.01 ).③Need for cognitive closure,decisiveness and need for structure factor were significant positive predicators of self-satisfaction,life satisfaction,social behavior,and energy factors in undergraduates＇subjective well-being (β =0.13 ～ 0.32,P ＜ 0.01 ).Need for cognitive closure was a significant predicator of negative emotions and positive emotions (β =-0.13,β =0.13,P ＜ 0.01 ).Decisiveness-factor was a negative predicator of negative emotions and interpersonal relationships in undergraduates＇subjective well-being,and was a positive predicator of family satisfaction(β =-0.22,β =-0.19,β =0.26,P＜0.01 ).Need for structure factor was a significant positive predicator of positive emotions (β =0.13,P ＜ 0.01 ).Conclusion Need for cognitive closure has some influence on undergraduates' academic performance,interpersonal relationships and subjective well-being.

OBJECTIVE To analyze the prevalence of pathogens in liver abscess and their resistance.METHODS All specimens of liquor puris were collected from patients with liver abscess by liver puncture in Union hospital,Fujian Medical University from Jan 2002 to Dec 2007.Pathogens were isolated,and followed by antibiotics resistance assay.RESULTS The key pathogens of liver abscess were Gram-negative bacteria.The main Gram-negative bacteria were Escherichia coli and Klebsiella pneumoniae.The main Gram-positive bacteria were Streptococcus,Enterococcus and Staphylococcus.The resistance of K.pneumoniae was increased in recent years.CONCLUSIONS The bacterial species in the liver abscess are varying in recent six years,the ESBLs are the important factor of the resistance to antibiotics.

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.

BACKGROUND:To construct tissue engineering cartilage would open up a novel way for the repair of cartilage damage in avoidance of the disadvantages of traditional therapeutic method.OBJECTIVE: To probe the techniques for the isolation of mesenchymal stem cells (MSCs) from bone marrow, as well as the in vitro differentiation into chondrocytic phenotype in a specific culture fluid.DESIGN:A complete randomized experimentSETTING:The Department of Traumatic Orthopedics and Hand Surgery of the First Affiliated Hospital of Guangxi Medical University, and Teaching and Research Faculty of Histology and Embryology of Guangxi Medical University.METHODS: The experiment was carried out at Guangxi Medical University between August 2002 and April 2003. Twenty SD neonatal weaning rats were selected. Bone marrow was aspirated from the bones of rat limbs and was isolated by gradient centrifugation in Percoll, and MSCs could be obtained in combination with adherent screening method, which were then cultured in DMEM-LG with 15% fatal bovine serum (FBS) in the incubator of 37℃ with 5% CO2 for 10-14 days. The passage cells were induced in DMEM-HG with 15% FBS (containing TGF-β1 10 μg/L, 10-7 mol/L dexamethasone, 50 mg/L VitC).MAIN OUTCOME MEASURES :The morphology, growth, as well as proliferation and specific expression of chondrogenic matrix of in vitro cultured MSCs due to specific induction.RESULTS: Totally 20 SD rats were observed and analyzed with no loss SCs grew in visible symmetric colonies, displaying a long-spindle shape,and the morphological characteristics of marrow-derived MSCs had no obvious changes during passage-culture, but its proliferation time was found from a shuttle fibroblastic appearance to polygonal shape, displaying posiHC staining of type Ⅱ collagen of cartilage specific matrix.bronectin adherent screening technique is a convenient, effective and practical method to separate and collect MSCs from rat bone marrows in chondrogenic phenotype when induced by a specific medium and can secrete cartilage specific matrix, and they can be the optimal seed cells for cartilage tissue engineering.

Objective To analyze the efficacy and safety of catheter-directed thrombolysis (CDT) for acute lower extremity deep venous thrombosis (DVT) in patients aged 70 years and over.Methods Clinical data of 109 cases who had acute lower extremity DVT and had been treated with CDT from March 2011 to September 2014 were retrospectively analyzed.Results Inferior vena cava filters (IVCF) were implanted in 109 patients.A thrombolytic catheter was inserted from the contralateral femoral vein (21 cases),ipsilateral popliteal vein (44 cases),posterior tibial vein (28 cases) or small saphenous vein (16 cases).The duration of thrombolysis was (5.47±2.13) d.The dosage of urokinase was (3.80 ± 0.56) million units.Forty-two cases underwent balloon dilatation alone,and 67 cases combined balloon dilatation with stent implantation.Gingival bleeding occurred in 7 patients and gross hematuria occurred in 4 patients during thrombolysis,which disappeared after medication adjustment.No symptomatic pulmonary embolism (PE) or other serious complications were found in any patients.There were significant differences in the venous patency score and lower limb circumferences at 10 cm above and below the knee one week after treatment (t=3.874,P=0.031).Ninety-seven cases were followed up for a mean period of (20.76.5) months,and the vein patencyrate was (77.9± 10.5) ％ and (73.1±9.4) ％ at 6 and 18 months after treatment,respectively.Recurrence of deep vein thrombosis was found in 6 cases,of which 2 cases had recurrent stent thrombosis,and treatment with CDT again was successful.No severe deep venous thrombosis syndrome (PTS) was found during the follow-up.Conclusions CDT is a minimally invasive procedure and can rapidly resolve limb venous drainage disorders.CDT is safe,has few complications and usually generates satisfactory outcomes.For very-old elderly patients who have no anticoagulation and thrombolytic contraindications,CDT is a useful option for the treatment of acute lower limb DVT.

AIM: To study the therapeutic effect of Angeng Recipe(AGR) on the female climacteric rats. METHODS: Female SD rats were collected and randomly divided into climacterium,AGR(low dose,medium dose and high dose),nilestriol and young control groups.The level of hormone in serum and hypothalamus was analyzed after using AGR,the alteration of organ coefficient of uterus,adrenal,appendix cerebri and thymus were detected,the apoptosis of ovary granulosa cells was detected by fluorescence microscope and flow cytometer. RESULTS: E_2 contents in high dose group were higher than those in the climacterical group.FSH contents in high dose group were lower than those in the climacterical group.Uterus and adrenal gland viscera coefficient of high dose group,medium dose and low dose group were higher than that of climacterical group,The apoptosis of cells in medium dose group showed lower than that in the climacterical group. CONCLUSION: AGR could adjust the function of endocrine secretion by the effect on ovaries and appendices suprasphenoidalis directly or indirectly,and the mechanism of action was multitarget and the regulation was entirety.AGR could relieve the degeneration of sexual gland axis,and improve symptomatic in climacteric.

Objective To detect the change of hepatitis C virus (HCV)RNA in the peripheral blood mononuclear cells (PBMC)and serum of patients with chronic hepatitis C (CHC)during treatment with peg-interferon α-2a (Peg IFNα-2a)plus ribavirin (RBV),and to analyze the clinical significance of HCV RNA detection in PBMC.Methods The peripheral blood samples of 20 CHC patients who visited Department of Infectious Diseases in Guangzhou No.8 People′s Hospital from June 2013 to December 2014,were collected during treatment with Peg IFNα-2a+RBV at different time points (week 0,2,4, 12,24,36 and 48).Serum and PBMC were separated.Accurate fluorescence quantification assay (Cobas TaqMan real time polymerase chain reaction[PCR])was used to detect HCV RNA level in serum,while real-time PCR and nest-PCR were applied to detect HCV RNA in PBMC.Categorical data were analyzed byχ2 test.Results Accurate fluorescence quantification of serum HCV RNA showed that HCV RNA level decline rapidly after treatment (F = 148.06,P < 0.01 ),and 18 patients achieved HCV RNA undetectable at week 12 of treatment.The positive rate of nest-PCR was higher than real-time PCR (all P <0.01).Comparison of HCV RNA levels in serum and PBMC from 20 cases found that,the clearance rate of HCV RNA in PBMC was postponed.Two patients whose HCV RNA in PBMC kept detectable relapsed at week 24 after end of treatment.Conclusions HCV RNA can be detected in PBMC of CHC patients and the positive rate of nest-PCR is higher than real-time PCR.Antiviral therapy is effective on HCV both inside and outside PBMC,but the clearance rate of HCV RNA in PBMC is postponed compared with that in serum.Slow clearance of HCV in PBMC may be a risk factor for relapse after end of treatment.

ObjectiveTo explore the relationship of body fat distribution with serum lipid and its potentially predictive value for dyslipidemia.MethodsA total of 784 Beijing rural residents were enrolled in this study using a cluster sampling method.The body height,weight,waist circumference (WC),hip circumference,body composition,high-density lipoprotein cholesterol ( HDL-C ),low-density lipoprotein cholesterol ( LDL-C),total cholesterol ( TC),and triglycerides (TG) were measured.The body mass index (BMI) and waist to hip ratio (WHR) were calculated.ResultsThe age-adjusted partial correlation analysis showed that WC had the best correlation with HDL-C ( r =- 0.310) and LDL-C ( r =0.204 ),while WHR with TC ( r =0.151 ) and TG ( r =0.271 ).Subgroup analysis with different BMI,WC,WHR,and trunk fat mass (TFM) showed that WC,WHR,and TFM sensitively reflected the changes of body lipids,whereas BMI,WC,WHR,and TFM sensitively reflected the low HDL,high TG,and risk of dyslipidemia.Receiver operating characteristic curve analysis showed that the predictive curves of WC,WHR,BMI,and TFM were above the reference line,and the areas under the receiver operating characteristic curves of WHR (0.684,0.630),WC (0.667,0.616),and TFM (0.661,0.604) showed high tendencies than BMI (0.629,0.597) for both male and female subjects,although no statistically significant differences were found ( all P ＞ 0.05 ).ConclusionsCompared with BMI,the body fat distribution indicators including WHR,WC,and TFM have higher predictive values in evaluating the risk of dyslipidemia.When the maximum Youden index for predicting the risk of dyslipidemia is applied,the ideal cutoff points was 24 kg/m2 for BMI,0.91 for WHR,85cm for WC,7.5kg for TFM in males,and 25 kg/m2,0.91,87cm,and 9.5 kg,respectively,in females.