BACKGROUND:Anterior cruciate ligament (ACL) reconstruction is the primary treatment method for ACL rupture. Currently, studies on ACL reconstruction involve histology and embryology, anatomical structure, biomechanics, reconstruction materials, operating technology, and rehabilitation after reconstruction. However, clinical epidemiological studies describing ACL rupture and reconstruction remain scarce. OBJECTIVE:To analyze the clinical epidemiological characteristics of ACL rupture and reconstruction to provide guidance for prevention and treatment of ACL rupture. METHODS:Data of 352 patients forage, gender, cause and mechanism of injury,treatment time, and the impact of ACL rupture on menisci and articular cartilage were gathered. Meanwhile, the events during surgery, operation methods and reconstruction materials were analyzed. RESULTS AND CONCLUSION:ACL rupture mostly occurred in young men,andhappened more often to theleft knee; male patients got hurt in basketbal, footbal and accidental injuries,whilefemale patients got hurt in the accidental injuries, badminton and sking injuries, internal rotation with valgus stress accounted for the predominant injury mechanism. The ACL reconstruction wasmostlyperformedwithin1-3 months after ACL rupture, often accompanied by meniscal and articular cartilage damage. Lateral meniscus injury incidence was relatively stable, medial meniscusinjury incidence increased significantly over the half year after ACL rupture. Most articular cartilage injury occurred to patelar cartilage.Asignificant increase in medial condylar cartilage damage over 1 year after ACL rupturewas often observed. Anatomic single-bundle ACL reconstruction was the primary surgical approach, the resident ridge and the lateral bifurcate ridge could be used to position bone tunnel and autogenous semitendinosus and gracilis tendon were the most commonly used reconstructionmaterials. Our results indicate that anatomic ACL reconstruction should be performed as early as possibleinrestore knee joint stability and prevent secondary injury of the medial meniscus and cartilage of medial femoral condyle.

Objective To assess whether 5-HTR1A C( - 1019) G and GNβ3 C825T gene polymorphisms are associated with post-stroke depression (PSD) and explore the genetic mechanism of the pathogenesis of post-stroke depression. Methods All 159 patients with first stroke were divided into the PSD group and the control group according to HAMD scores. Their genotypes were determined with polymerase chain reaction and allele-specific restriction enzyme analysis. Results The frequency of 5-HTR1A (-1019) GG genotype(8/53,15. 1% ), G allele (44/106,41.5%)and GNβ3 825T allele(68/106,64. 2% ) were significantly higher in the post-stroke depression group than in the controls (5/106,4.7% ;35/212, 16. 5%; 113/212, 53.3%; ×2 = 23.204, 23. 655, 3. 392, all P ＜ 0. 05 ). Combined genotype analysis showed that individuals with both 5-HTR1A ( - 1019) G and GNβ3 825T allele ( OR =4. 980,95% CI 2. 429-10. 210,P =0. 000) had a higher risk than those with 5-HTR1 A (-1019) G allele ( OR = 3. 589,95% CI 2. 113-6. 096, P = 0. 000) or GNβ3 825T allele ( OR = 0. 638,95% CI 0.395-1. 031 ,P =0. 042) only for post-stroke depression. Conclusion The 5-HTR1A C( - 1019)G and GNβ3 C825T polymorphisms are predisposing genes of post-stroke depression. Our data also suggest a significant interaction between the 5-HTR1A ( - 1019)G allele and GNβ3 825T allele in post-stroke depression.

Objective To investigate the effect of extracorporeal shock waves (ESWs) combined with expanding bone marrow autografts in treating nonunion of femoral shaft fractures with interlocking intramedullary nails.Methods Thirty patients with femoral shaft fractures which had not united were divided into an ESW group,an expanding bone marrow group,and a combined treatment group using a table of random numbers.Each group had 10 cases.In the ESW group,no expanding bone marrow was employed in fixing the intramedullary nails and ESW therapy was begun at day 14 after the operation.In the expanding bone marrow group,bone marrow was grafted around the broken ends of fractured bones.In the combined treatment group patients underwent both treatments.The conditions of the callus and the fracture lines in the 3 groups were separately evaluated using X-rays at the 4th,8th,12th and 16th week after the operation.Results At week 4,the average callus and fracture line scores in the combined treatment and expanding bone marrow groups were significantly better than those in the ESW group.At the 8th week after the operation,the average callus and fracture line scores in the combined treatment group were significantly higher than in the ESW group and expanding bone marrow groups.Later,the callus and fracture scores in all 3 groups continued to rise significantly.At the 12th and 16th week the scores in the combined treatment group were significantly better than those in the ESW group and the expanding bone marrow group,while the scores in the ESW group were significantly better than those in the expanding bone marrow group.The cure rates in the ESW,bone marrow and combined treatment groups were 60％,50％ and 100％ respectively at week 16.Conclusions The combined treatment was significantly more effective than either treatment alone.There was no significant difference in effectiveness between the ESW and expanding bone marrow treatments.ESW combined with expanding bone marrow autograft is an effective way to promote bone knitting in the treatment of nonunion of femoral shaft fractures with interlocking intramedullary nails.

ObjectiveTo study the anatomical abnormalities of basal ganglia and research their influence on depression status in patients with post stroke depression (PSD)by diffusion tensor imaging (DTI) of MRI.MethodsPatients with basal ganglia infarction were recruited,and divided into groups of PSD and non depression control group by Hamilton Depression Rating Scale (HAMD) assessment. All the patients were evaluated with National Institute of Health Stroke Scale ( NIHSS). And the patients were checked by DTI sequence.Fractional anisotropy (FA),average diffusion coefficient (ADC) values and the number of nerve fiber were measured in bilateral caudatum,pallidum,putamen and thalamus.ResultsThe score of NIHSS (6.29 ± 3.45 ) was significantly higher in PSD group than that in non-depression group (3.95 ± 1.90 ;t =2.219,P =0.036). No significant difference was found between the two groups for the DTI data of the basal ganglia nuclei ( t =0.056-1.618,all P ＞ 0.05 ). Compared with contralateral construction (0.40 ± 0.02 ),the FA value decreased in the left putamen ( 0.37 ± 0.03 ) in the PSD group ( t =2.243,P =0.045 ).By Spearman correlations analysis,the HAMD score was positively correlated with NIHSS score ( r =0.464,P =0.017 ),and negatively correlated with the FA values of left pallidum (r=-0.563,P=0.005),right pallidum (r=-0.416,P=0.035) and left putamen (r =-0.428,P =0.029).Conclusions The occurrence of PSD was associated with neurological functional deficit following basal ganglia infarction.The depression level was correlated with the increasing of NIHSS score,the reductions in bilateral pallidum and left putamen FA values.This research contributes to evaluation of the PSD status in patients with basal ganglia infarction.

Burkholderia ; isolation & purification ; China ; Humans ; Melioidosis

Objective To understand the homology of sequence type 562 (ST562) strains of Burkholderia pseudomallei which circulated in two separate continents (Asia and Australia) at different times.Methods Spe Ⅰ restriction fragments and 4-locus multiple locus variable number tandem repeat analysis (MLVA-4) profiles were extracted from MSHR5858 (ST562 Australia strain) and 350105 (ST562 historical strain of Hainan) genomes respectively by in silico analysis and then compared with the PFGE and MLVA-4 results of five ST562 clinical isolates from Hainan to test their homology.Synteny and homology between MSHR5858 and 350105 genomes were evaluated with bioinformatics methods.Results Five ST562 clinical strains from Hainan shared same PFGE pattern (similarity ＞97％) and this pattern coincided to the map of Spe Ⅰ restriction fragments of Australian strain MSHR5858.The amounts of genomic restriction fragments (Spe Ⅰ) for MSHR5858 and 350105 were 31 and 34 respectively,with 31 of them matched by each other.Five ST562 clinical strains of Hainan were distinct by MLVA-4 profiles,among which HPPH43 (MLVA-4 profile:10,8,10,8) was close to Australia strain MSHR5858 (10,8,8,6),containing identical repeat numbers at VNTR loci 2341k and 1788k;while HK003 (11,8,15,7) and HK061 (11,8,17,7) similar to Hainan historical strain 350105 (11,8,11,8),with same repeat numbers at loci 2341k and 1788k also.High-degree synteny and consistency on genomic contents were observed between 350105 and MSHR5858,indicating a similar origin for the 2 strains.Conclusion All inter-continental and historical ST562 strains ofB.pseudomallei had similar genomic characteristics,supporting the assumption that they had a common origin.Also,it is possible that Hainan historical strain 350105 is the ancestor of all circulating ST562 strains.

BACKGROUNDThe tibial plateau is asymmetric with a larger medial plateau. We observed from clinical practice that the shape of the tibial plateau does not always present a larger medial plateau. Tibial plateau also showed other shapes. The purpose of this study was to analyze the anthropometric data of the proximal tibia in a large group of Chinese patients undergoing total knee arthroplasty and to investigate the morphology of the resected proximal tibial surface and its gender differences.

METHODSA total of 822 knees (164 males, 658 females) from the Chinese population were measured intraoperatively for medial anteroposterior (MAP) and lateral anteroposterior (LAP) dimensions of the resected proximal tibial surface. The difference of MAP and LAP (DML) was also calculated as MAP minus LAP. We then classified the data into three groups based on the DML (<-2, -2 to 2, and >2 mm) to analyze the morphology of the proximal tibia and its distribution between male and female.

RESULTSThe shape of proximal tibial plateau was of three types: larger medial plateau type, symmetric type, and larger lateral plateau type. There were significant differences between males and females in relation to the shape distribution of the proximal tibial plateau (P < 0.05). Most of the proximal tibial plateau was asymmetric, with 517 of 822 (62.9%) tibia having a DML >2 mm and 120 of 822 (14.6%) tibia having a DML<-2 mm. Only 185 of 822 (22.5%) tibia had a DML between -2 and 2 mm.

CONCLUSIONThe results of this study can be used as a guideline to design tibial components with different DMLs to better match the different anthropometry of the resected tibial surface.

Aged ; Anthropometry ; methods ; Arthroplasty, Replacement, Knee ; methods ; Asian Continental Ancestry Group ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Sex Factors ; Tibia ; surgery

OBJECTIVETo establish a gene identification method of Yersinia pestis and Yersinia pseudotuberculosis for plague surveillance.

METHODSAccording to the specific genomic sequences of Y. pestis and Y. pseudotuberculosis, i.e. "pestis Island (PeI)" and "pseudotuberculosis Island (PsI)" and the published genomic sequences of 12 strains of Y. pestis and 4 strains of Y. pseudotuberculosis, the specific identification primers of these sequences were designed.

RESULTSA total of 52 strains of Y. pestis and 57 strains of Y. pseudotuberculosis and other intestinal bacteria strains were tested with PCR. Of the 5 pairs of Y. pestis identification primers, PeI2 and PeI11 were specific for Y. pestis. Besides Y. pestis, the primers PeI1, PeI3 and PeI12 could detect part of 57 Y. pseudotuberculosis strains. Of the 5 pairs of Y. pseudotuberculosis identification primers, PsI1 could detect all the 52 strains of Y. pestis and 57 strains of Y. pseudotuberculosis. PsI7, PsI16, PsI18 and PsI19 were specific for Y. pseudotuberculosis.

CONCLUSIONThe primers PsI1, PeI 2 and PeI11, PsI7, PsI16, PsI18 and PsI19 can be used in the rapid identification of Y. pestis and Y. pseudotuberculosis, which can be also used to explore the circulation of atypical Y. pestis in quiescent plague foci.

Base Sequence ; China ; epidemiology ; DNA Primers ; Genomics ; Humans ; Plague ; diagnosis ; epidemiology ; Polymerase Chain Reaction ; Population Surveillance ; methods ; Yersinia pestis ; genetics ; Yersinia pseudotuberculosis ; genetics

OBJECTIVETo explore the spatial and temporal distributions of animal plague in Junggar Basin natural plague focus.

METHODSData regarding plague antibody (F1) in serum of Great Gerbil (Rhombomys opimus, R. opimus) which were collected from 2005 to 2012 in Junggar Basin and analyzed. The changing rates on the positivity of F1 that appeared spatially and temporally were also analyzed.

RESULTSA total of 4 825 R. opimus serum samples were collected in 13 administrative regions in Junggar Basin.

RESULTSshowed that plague R. opimus existed in two areas-Gurbantonggut desert in the eastern-center and the clay desert of western Junggar Basin. However, in these two areas, the intensity of animal plague prevalence was different. In the former region where Yesinia pestis positive serum was detected from R. opimus, the detected rate of R. opimus was 8.39%. However, in the latter areas, the average positive rate was 1.56%. The changing trends of R. opimus plague prevalence were also varied annually. In the western Junggar Basin, the trend showed a slowly downward profile. The serum positive rate of R. opimus for Yesinia pestis decreased, from 7.59% in 2005 to 0.61% in 2008, and appeared as a resting state that none of the positive sample could be found since then. However, in the eastern-center Junggar Basin area-also named as Gurbantonggut desert which had been divided into 3 segments(western, central and eastern, according to related geographical characteristics), the changing trends of animal plague seemed quite complex. In the western segment, the animal plague had two epidemic peaks-in 2006 and 2010, with the interval of 4 years, with the higher peak of all the three geographic segments as 45.65% in 2010 and the positive serum of R. opimus for plague could be detected each year from 2006 to 2012. However, there were 3 epidemic peaks in the same period in the central and eastern segments. In the central segment, the peaks appeared in 2006, 2009 and 2011, with the intervals as 2.5 years and the average positive rate 8.92% was seen the lowest in Gurbantonggut desert. In the eastern segment, the first 2 peaks appeared the same season as in the central segment, but the third peak appeared in 2012, with the peak interval as 3 years. The positive rate of R. opimus for plague was also different in seasons, with the positive rate higher in autumn than in spring. These findings showed that the animal plague could be continuously prevalent from spring to autumn in the natural foci of plague in the Junggar Basin.

CONCLUSIONBoth geographical and temporal fluctuations of animal plague existed in the natural foci of Junggar Basin which was also named as geographical heterogeneity. Consequently, animal plague could be divided into two areas-the clay plains desert in the western and the Gurbantonggut desert in the eastern-center Junggar Basin.

Animals ; Gerbillinae ; Plague ; epidemiology ; Time ; Yersinia pestis