Objective To study the maneuver of diagnosis and management of anterior cruciate ligament (ACL) partial tears. Methods 24 cases of ACL partial tears confirmed by arthroscopy including anteromedial band (AMB) tear in 7 cases and posterolateral bulk (PLB) tear in 17 cases were investigated, from Mar 2000 to Jun 2002. ACL reconstruction was performed in 16 cases under arthroscopy. Clinical findings including symptoms or signs, physical examinations and MRI were collected for differential diagnosis of AMB and PLB tear. The efficiency of ACL reconstruction was evaluated by Lysholm scale with average follow-up of 11 months. Results 28.5% AMB and 98.2% PLB tear cases showed knee instability. Regarding the results of anterior drawer test, Lachman test and pivot shift test, it is positive 71.4%, 14.3% and 0 in AMB tears respectively; and 17.6%, 98.2%, 76.5% in PLB tears. The Lysholm scores were significantly increased from preoperative 63.53?8.11 to postoperative 93.47?2.62(P

Arthroscopic rotator cuff repairs are preformed due to growing knowledge of rotator cuff tears among surgeons as well as patients.However,it is unavoidable and may sometimes very common that some patients develop structural failures or retears after surgical repairs because of unique blood supply and healing procedure of the rotator cuff,on which there is still much debate focusing on problems that one needs to deal with in clinical practice.Retears often occur,if without new trauma,during early postoperative period,or more specifically within the first 6 months after repair and are more frequently observed in those with old ages,diabetes or osteoporosis.In addition,risk factors of retears consist of longer preoperative duration of symptoms,larger primitive tear sizes,higher grades of fatty infiltration of muscles on preoperative imaging examinations,excessive tension within reconstructed structures,deteriorated quality of rotator cuff tissues and special shapes of the acromion,etc.Diagnosis is recently based on results of postoperative magnetic resonance imaging or echogram examination.MR/CT arthrography is also used.Each instrument has its advantages and limitations.However,the lack of a golden standard when establishing a diagnosis of rotator cuff retears makes integrating evaluations and comparisons of different methods a difficult question.It has been reported by many that the onset of retear leads to obvious shoulder pain or weakness,whereas more than a few studies demonstrated that very limited influences of retears in spite of generally unaffected shoulder functions,like decreased muscle strength on certain motions.The disagreement is possibly caused by specific methods of diagnosis,function instruments and time point of assessments used by different researchers as studies have displayed that feelings of patients after surgery and results attained by objective examinations are not always parallel.Moreover,some long-time follow-ups studies indicated that the impact posted by retears on shoulder functions evolves over a period of time.Owing to the varied opinions on actual symptoms and final functional outcomes caused by structural failure,the mainstay of treatment for rotator cuff tears are still conservative protocols,including observation and symptoms relief instead of second surgery.Second surgery could be an effective choice for certain patients,especially for those who have apparent symptoms.

Objectives To study the anatomic characteristic of medial patellar retinaculum and its function in patellar stability. Methods Anatomic dissection of the medial patellar retinaculum was performed on 26 knees of 13 embalmed cadaveric specimens,and its composition and conducted functional studies of the several parts were observed respectively. Results The medial patellar retinaculum comprises patellofemoral ligament, patellotibial ligament and patellomeniscal ligament. The medial patellofemoral ligament which is the thickest part in the medial patellar retinaculum contributes to the major restraints to the lateral patellar displacement.

Objective To construct a eukaryotic expression vector of huma n insuli n-like growth factor-1 (hIGF-1) gene,and to investigate the transfection and ex pression of pcDNA3.1(-)/hIGF-1 eukaryotic expression plasmid in myoblast cells. Methods pcDNA3.1(-)/hIGF-1 eukaryotic expression plasmid was co nstructed. Myobl ast C2C12 cells were transiently transfected with lipofectamine. RT-PCR a nd immunohistochemical methods were used to detect the expression of hIGF-1 gene . MTT test was used to detect the biological activity of the conditioned medium after the transfection. Results There were significant increas es of hIGF-1 mRN A and protein in the myoblast cells transfected with pcDNA3.1(-)/hIGF-1. The con ditioned medium after the transfection showed the biological activity which coul d stimula te the proliferation of fibroblast cells. Conclusion The pcDNA 3.1(-)/hIGF-1,a eukaryotic expression plasmid for hIGF-1 gene is constructed. High levels of hI GF-1 mRNA and protein expression can be obtained in the myoblast cells transfect ed with pcDNA3.1(-)/hIGF-1 eukaryotic expression plasmid. The expressed protein has the biological activity.

Objective To explore the heme oxygenase-1 (HO-1) content of carbon monoxide (CO) levels and clinical significance of Mycoplasma pneumoniae infection in children.Methods 219 cases of mycoplasma pneumonia from October 2013 to June 2015 in our hospital were divided into two groups,which were non-asthmatic group (156 cases) and wheezing group (63 cases),and the wheezing group were divided into two groups according to the presence or absence of hypoxemia and mild asthmatic group (39 cases) and severe asthmatic group (24 cases).HO-1 content in the blood was measured by enzyme-linked immunosorbent assay,using dual-wavelength spectrophotometric determination of hemoglobin oxygen percentage of broken (COHb％),analysis of the differences between the groups.Results Children with blood COHb content wheezing group were (2.59 ± 0.40)％ and HO-1 levels were (1 813.24 ± 28.34)ng/L and non-respite group were significantly increased,it had significant differences between the two groups (P＜ 0.05).Group of children with severe wheezing COHb content were (3.63 ± 0.45)％ and HO-1 levels were (2 594.34±23.94)ng/L and mild wheezing group were significantly increased,it had significant differences between the two groups (P＜0.05).Positive correlation between blood COHb content and HO-1 levels were significantly (r=0.733,P＜0.05).Conclusion Mycoplasma pneumoniae infection in children with wheezing blood COHb content and HO-1 levels were significantly increased,and with wheezing exacerbation and showed an increasing trend,suggesting that CO and HO-1 may be involved in Mycoplasma pneumoniae infection in children in the pathogenesis of wheezing,should lead to clinical attention.

Objective To explore the role of transforming growth factor (TFG) -β and matrix metalloproteinases( MMPs) in the development of frozen shoulder. Methods Twenty-four patients who underwent shoulder arthroscopy were included, and were divided into frozen shoulder group (n = 12) and control group ( n = 12; n = 2 for shoulder instability, n = 5 for rotator cuff tear and n = 5 for subacromial impingement) . Joint capsule tissues at the rotator cuff interval were obtained, and the expression of TGF-β, MMP-1, MMP-2, MMP-3, MMP-9 and MMP-12 mRNA and protein was detected by Real-time PCR and Western blotting, respectively. Results The expression of TGF-p mRNA in frozen shoulder group and control group was 3.36 × 10~4 ±2.18 × 10~3 and 1.85 × 10~4 ±3.31×10~3, respectively, the expression of TGF-p protein was 1.55 ± 0.33 and 1.13 ±0.21, respectively, and there were significant differences between these two groups (P < 0.05). The expression of MMP1, MMP2, MMP3, MMP9 and MMP12 mRNA and protein in frozen shoulder group was significantly higher than that in control group(P <0.05) . Conclusion The higher expression of TGF-β and MMPs in joint capsule of frozen shoulder may be associated with the development of frozen shoulder.

Objectives To understand the effect of intraperitoneal injection of naringenin,a SMAD3 inhibitor,on the skeletal muscle after acute contusion in a mouse model.Methods Seventy-two mice of 7-8 weeks old (20-24 g)were randomly divided into a control group,an acute contusion (B)group,an acute contusion+1％DMSO injection (C)group and an acute contusion+naringenin injection (D)group,each of 18.The acute contusion model was created by hitting the right tibialis anterior muscle in mice of all groups except the control group.Intraperitoneal injection of I％DMSO and naringenin were given to group C and D respectively every day until execution,while the 18 mice in the control group were fed without injury or injection.The time of injury was set as Day 0.After being fed for 28 days,all mice were executed and the right tibialis anterior was harvested.Western blotting was used to detect the difference of SMAD3,pSMAD3,Collagen Ⅰ,and α-SMA expression among the 3 groups.Hematoxylin-Eosin (HE)staining and Masson staining were used to detect the difference of pathological changes.Moreover,the appearance of fast twitch contraction and tetanic contraction were also documented to figure out the quality of the injured skeletal muscle.Results Compared with the control group,the SMAD3 and pSMAD3 level in injured skeletal muscle increased,but both were less in group D than group B and C.Similarly,the average level of Collagen Ⅰ and α-SMA in all three injury groups was higher than the control group,but the level of these indexes were lower in group D than that in group B and C.HE staining showed more mesenchyme in injury groups than the control group.Masson staining found the upregulation of fibrosis in injured muscles,with the area of fibrosis in group D significantly lower than group B and C.Compared with control,the injured skeletal muscle had significantly poorer fast twitch and tetanic contraction performance,with the condition of group D significantly better than group B and C.Conculsion The naringenin,a SMAD3 inhibitor,mitigates the phosphorylation of SMAD3 after acute contusion in a mouse model.The fibrosis and scar formation was alleviated,hence improving the healing of the injured skeletal muscles.

Objective To observe the effect of the injection of myoblast carrying human insulin-like growth factor-1(hIGF-1) on the expression of endogenous IGF-1 mRNA and IGF-1 level in mice skeletal muscle following injury.Methods Seventy two male C3H mice(20~30g,7~11w)were randomly divided into three groups(24 mice in each group) with four mice normal controls.Applied a falling hit from certain height at the medial calf of right lower limbs in three groups,the injured skeletal muscle model was successfully simulated.Three days following injury,the mice in group A and B were injected with 1?106 myoblasts either carried with or without hIGF-1 gene respectively and the mice in group C were injected with 100?l saline at the injured muscle.Three mice in each group were sacrificed randomly at day 2,5,10,15,20,30 after contusion.The expression level of mIGF-1 was assessed by immunohistochemical staining and real time PCR.Results mIGF-1 mRNA expression and mIGF-1 factor secretion were observed in all three groups;the amount of mIGF-1 mRNA expression and mIGF-1 secretion in group A were significant higher than that in group B and C.Conclusion Myoblast carrying hIGF-1 transplantation could promote endogenous IGF-1 secretion in injured skeletal muscle.

Objective To investigate the effects of Chinese medicine HUOXUESHENGJI(promoting blood flow and tissue regeneration) on the oxidative stress in rat skeletal muscles after acute contusion.Methods Seventy two male SD rats were randomly and equally divided into three groups:(1)Chinese medicine HUOXUESHENGJI group(A),(2)physiological saline group(B),(3)natural healing group(C),and(4)blank control group(D).The muscle contusion was produced at the gastrocnemius by specific device;Local injection at the injured site with Chinese medicine HUOXUESHENGJI in group A;local injection with physiological saline instead of HUOXUESHENGJI in group B,and natural healing group served as control.The muscles were sampled at day 1,4,7 and 14 respectively after contusion,and then the MDA and the activities of antioxidant enzymes(CAT,SOD and GSH-px)in gastrocnemius were investigated.Results As compared with the group B and group C,SOD and GSH-px activities in group A were significantly increased after contusion(P0.05).The con-centrations of MDA in group A were lower than that in group B and group C at day 4 and day 7 after contusion(P

Objective To compare the clinical results of Endobutton and Rigidfix graft fixation at the femoral tunnel after ACL reconstruction with hamstring autografts.Methods 48 patients accepting ACL reconstruction with hamstring autografts were retrospective studied.According to different fixation adopted at the femoral tunnel,they were divided into group A(24 patients,with Rigidfix cross pin)and group B(24 patients,with Endobutton).All cases were fixed with Intrafix interference screw and Spiked Washer screw at the tibial tunnel.The average follow-up time was 27 months.KT-1000 arthrometric measurement and the IKDC,Lysholm,Tegner scores were used for evaluation.The diameter of bone tunnel was also measured by MRI.Results Tunnel widening were found in both groups,but the increase of both the femoral and tibial tunnels in group B were significantly greater than group(P