BACKGROUND:Problems can occur at the donor site where the autologous tendon graft is taken. Alogenic tissue has become an important graft option for the reconstruction of the anterior cruciate ligament.
OBJECTIVE: To study the clinical curative effect and immune rejection of arthroscopic reconstruction of the anterior cruciate ligament by alogeneic tendon graft.
METHODS:The 120 included patients with anterior cruciate ligament injury were randomized into autologous tendon graft and alogeneic tendon graft groups, respectively, with 60 patients in each group. The autologous semitendinosus-gracilis graft at the affected side or the alogeneic anterior cruciate ligament was implanted into the knee joint in autologous tendon graft group or alogeneic tendon graft group, respectively. Lachman test results, Lysholm and Larson scores of joint function, and postoperative immune rejection were observed and assessed during 2-year folow-up.
RESULTS AND CONCLUSION: Lysholm and Larson scores in autologous tendon graft and alogeneic tendon graft groups were significantly increased after the reconstruction compared with before the reconstruction; however, there was no difference in the scores between both two groups at 2 years after the reconstruction (P > 0.05). At the end of the folow-up, the normal function of the knee joint was restored, and no lag and flexion constraint of the knee joint were observed. No significant differences were observed in Lachman test results between both groups (P> 0.05). Compared with the autologous tendon graft group, immune rejection rates were higher in the alogeneic tendon graft group; however, no significant differences were observed between both groups (P > 0.05). In summary, the alogeneic tendon graft may be a candidate for the reconstruction of the anterior cruciate ligament due to its similar clinical curative effect to the autologous tendon graft and low immune rejection rates.

Objective To study the rapid detection of mycobacterium tuberculosis resistance to streptomycin by reverse dot blot hybridization technique. Methods The oligonucleotide probes of streptomycin-resistant genes (rpsL and rrs) were prepared and dropped on nitrocellulose membrane. The target DNA fragments of M. tuberculosis clinical isolates were labeled with biotin by PCR amplification, and then hybridized with the oligonucleotide probes on the membranes. PCR-SSCP and PCR-direct sequencing (PCR-DS) techniques were used to detect the target fragment of M.tuberculosis as control. Results In 53 M. tuberculosis clinical isolates, the consistent rate of three detection methods was 100%. Both the SSCP mapping of rpsL and rrs genes and the results of membrane hybridization in 9 drug-sensitive strains were identical to those in M. tuberculosis standard strain H37Rv. Of 44 streptomycin-resistant strains, 33 strains had AAG→AGG mutation at the codon 43 of rpsL gene, 6 strains had A→C mutation at the 513 site of rrs gene, 1 strain had A→T mutation at the 513 site of rrs gene, and the detection rate of the target genes mutation was 90 9%. In 53 M.tuberculosis clinical isolates, 40 resistant strains and 9 sensitive strains to streptomycin could be detected using dot blot hybridization and the consistent rate with the in vitro susceptibility test was 92 6%(49/53). Conclusion The reverse dot blot hybridization technique showed high sensitivity and specificity to detect Mycobacterium tuberculosis resistance to streptomycin. It possessed the simple and rapid characteristics, and could be used to detecte streptomycin-resistant M.tuberculosis clinical strains.

Objective To investigate the correlation factors for surgical outcome of sacral decompression and lumbopelvic fixation in H-shaped sacral fracture and the methods to prevent and treat the complications.Methods From January 2008 to January 2016,45 patients with H-shaped sacral fracture treated by sacral decompression and lumbopelvic fixation were respectively analyzed,including 29 men and 16 women,mean age 41.2 (range,24-53 years),mean follow-up time 52.6 months (range,16-93 months).The surgical outcome was evaluated by pelvic outcome score,and correlation factors were analyzed.We analyzed whether each factor was in correlation with pelvic outcome score.Then we integrated the statistically significant indicators into Logistic regression equation to determine the related factors.Postoperative complications were all recorded.Results The average operation time was 161.2 min (range,100-220 min),average blood loss was 491.6 ml (range,370-1 000 ml),injury-surgery interval was 7.2 d (range,1-23 d).In terms of pelvic outcome score,31 (68.9％) patients had satisfactory result and 14 (31.3％) patients had unsatisfactory result.Univariate x2 analysis suggested that cauda equina injury,Roy-Camille classification,L5S1 facet injury,fracture line,kyphotic angle,injury-surgery interval,decompression approach and inserting sacral screws were correlated with pelvic outcome score,but gender,age,injury mechanism and L5 pedicle fracture had no relation with pelvic outcome score.The multivariate Logistic regression analysis showed that cauda equina injury,Roy-Camille classification,fracture line,kyphotic angle,injury-surgery interval,decompression approach and inserting sacral screws were closely related to pelvic outcome score,but L5S1 facet injury was excluded.2 patients required early surgical procedures with proper antibiotics for deep wound infection;3 patients complained pain related to hardware prominence and the pain subsided after removal of implants;1 patient got unilateral rod breakage at 3-6 months and achieved bony fusion after nine months of observation.Conclusion Sacral decompression and lumbopelvic fixation is effective in neurological recovery and early ambulation in treating H-shaped sacral fracture.Better surgical outcome is related to timely surgery,preoperative or intraoperative bone traction,sacral screws insertion,incomplete cauda equina injury,Roy-Camille type Ⅱ,fracture line penetrating S2 and kyphotic angle less than 40°.

The real-time and wireless mobile has become the trend of electrocardiogram (ECG) monitoring system for atrial fibrillation (AF). At present, the ECG with multi-leads (12 leads) is needed by most of AF signal extraction algorithms in order to extract effective AF waves. However, it is not very convenient for patients' movements in a multi-lead ECG monitoring system. Although the traditional template matching method is for single-lead ECG extraction, it is less robust than blind source extraction algorithm, and is affected severely by noise. In view of this,we put forth a new real-time algorithm for extracting AF from the singlelead ECG, using non-stationary heartbeat series during AF to extend dimension (segmentation), and then applying a blind source extraction algorithm to extract the effective AF signal. Experiment results showed that this method could be used to extract AF signal effectively from a single-lead ECG data. Therefore, it is suitable to apply this method to Wireless Monitoring System using single-lead ECG.
Algorithms ; Atrial Fibrillation ; physiopathology ; Electrocardiography ; methods ; Humans ; Signal Processing, Computer-Assisted

Objective To investigate the effect of three-dimensional psychological intervention on anxiety and depression condition in patients with chronic heart failure ( CHF ) . Methods A total of 200 hospitalized patients with CHF in the cardiology department of Beijing Electric Power Hospital from January 2013 to January 2014 were selected and assigned to the control group and the intervention group according to random number table. Patients in the control group were given routine nursing, while patients in the intervention group were given three-dimensional psychological intervention on the basis of routine nursing. Self-rating anxiety scale (SAS) and self-rating depression scale ( SDS) scores before and after the intervention were compared between two groups.Results Before the intervention,there was no significant difference in SAS score and SDS score between two groups;after the intervention, SAS and SDS scores were significantly improved compared with the scores before intervention in two groups (P<0.05), and after the intervention, the improving degree of SAS and SDS scores in the intervention group was significantly better than the control group (P<0.05).Conclusions Three-dimensional psychological intervention can improve the anxiety and depression in patients with CHF.

Objective:To study the value of imaging features of extrapancreatic nerve plexus in predicting early postoperative recurrence of ductal adenocarcinoma of pancreatic head.Methods:The clinical, imaging and pathological data of patients with ductal adenocarcinoma of pancreatic head undergoing pancreati-coduodenectomy at the Hepatobiliary Pancreatic Center of Beijing Tsinghua Changgung Hospital, Tsinghua University from January 2014 to April 2022 were retrospectively analyzed. A total of 73 patients were included, including 51 males and 22 females, aged (66.1±9.0) years old. The patients were followed up by telephone or outpatient review, who were divided into two groups according to the recurrence within 6 months after surgery: the recurrence group ( n=26) and the non-recurrence group ( n=47). Streaks or soft-tissue densities in the distribution area of extrapancreatic nerve plexus, difference in CT values between the portal and arterial phases of the distribution area of extrapancreatic nerve plexus, maximum tumor diameter, and regional lymph node enlargement were compared between the two groups. Results:The incidences of streaks or soft-tissue densities showing in the distribution area of extrapancreatic nerve plexus were 80.8%(21/26) in the recurrence group and 51.1%(24/47) in the non-recurrence group, respectively. A CT value difference ≥15 HU between the portal and arterial phases of the distribution area of extrapancreatic nerve plexus occurred in 50.0%(13/26) patients of the recurrence group and 25.5%(27/47) of the non-recurrence group, respectively. Maximum tumor diameter ≥25 mm were found in 80.8% (21/26) patients of the recurrence group and 57.4% (27/47) of the non-recurrence group, respectively. ≥3 reginal lymph node enlargement showed in 65.4% (17/26) patients of the recurrence group and 31.9% (15/47) of the non-recurrence group, respectively (all P<0.05). The risk of early postoperative recurrence increased in patients with a CT value difference ≥15 HU between the portal and arterial phases of the distribution area of extrapancreatic nerve plexus ( OR=3.609, 95% CI: 1.099-11.855), and regional lymph node enlargement ≥ 3 ( OR=4.665, 95% CI: 1.400-15.545) (all P<0.05). And these two independent risk factors were combined to predict early postoperative recurrence of ductal adenocarcinoma of pancreatic head with an area under receiver operating characteristic curve of 0.748, sensitivity of 92.3%, and specificity of 48.9% ( P<0.001). Conclusion:≥ 15 HU CT value difference between the portal and arterial phases of the distribution area of extrapancreatic nerve plexus and ≥ 3 regional lymph node enlargement are independent risk factors for the early postoperative recurrence of pancreatic head ductal adenocarcinoma, which could provide more predictive information preoperatively.

Objective:To compare the safety and efficacy of laparoscopic versus open pancreaticoduodenectomy.Methods:The clinical data of 989 patients who underwent pancreaticoduodenectomy at Hunan People's Hospital from January 2015 to December 2019 were analyzed retrospectively. There were 349 patients in the laparoscopic pancreaticoduodenectomy (LPD) group and 640 patients in the open pancreaticoduodenectomy (OPD) group. Propensity score matching (PSM) was used to match the baseline data of the two groups at a 1: 1 ratio. Data including operation time, intraoperative bleeding, postoperative hospital stay, bile leakage, pancreatic fistula and wound infection were compared between the two groups.Results:After PSM, there were 345 patients in each of the 2 groups. When the LPD group was compared with the OPD group, there were no significant differences in postoperative mortality, reoperation, intraoperative blood transfusion, pancreatic fistula, bile leakage, abdominal hemorrhage, abdominal abscess, severe complications, and pulmonary complication rates. The number of lymph node dissected, R 0 resection and overall survival rates between the two groups were also not significantly different ( P>0.05). However, the operation time of the LPD group (478.2±91.3) min was significantly longer than that of the OPD group (410.8±62.0) min ( P<0.05). On the other hand, the postoperative hospitalization time (10.8±4.3) d, intraoperative bleeding (322.0±362.6) ml, wound infection rate 1.2% (4/345) in the LPD group were significantly better than those in the OPD group [postoperative hospitalization time (12.5±7.9) d, intraoperative bleeding (478.8±570.2) ml, and wound infection rate 5.8% (20/345)] ( P<0.05) . Conclusion:LPD was safe and feasible, and it achieved similar curative effect as OPD.

Objective:To compare between laparoscopic and open pancreaticoduodenectomy in the treatment of distal cholangiocarcinoma.Methods:The clinical data of laparoscopic pancreaticoduodenectomy (LPD group, n=101) and open pancreaticoduodenectomy (OPD group, n=99) in patients with distal cholangiocarcinoma who underwent pancreaticoduodenectomy at Hunan people's Hospital from Jan 2015 to Dec 2019 were analyzed retrospectively. The operation time, intraoperative blood loss, number of lymph node dissection, R 0 resection rate, postoperative hospital stay, postoperative complications and overall survival rate were compared between the two groups. Results:The operation time was (475.0±90.7) min and (444.8±63.3) min, the intraoperative blood loss was (350.9±397.9) ml and (546.7±642.9) ml, the postoperative hospital stay was (11.5±4.7) d and (13.3±5.1) d, the differences were statistically significant ( P<0.05).The number of lymph node dissection was 14.8±3.0 and 15.4±2.4, the R 0 resection rate was 93.1% and 96.0%, respectively, and there was no significant difference ( P>0.05). There was no significant difference in the incidence of residual complications ( P>0.05). During the follow-up of 5-64 months, the OS of 1, 3 and 5 years in the two groups were 90.4%, 41.3%, 20.6% and 94.3%, 50.8% and 24.7%, respectively. ( P>0.05). Conclusions:LPD is safe and feasible in the treatment of distal cholangiocarcinoma, and its short-term curative effect, curative effect and long-term overall survival rate are similar to those of OPD.

Objective To investigate the effect of group cognitive behavioral therapy on anxiety and depression in patients with chronic heart failure ( CHF ) .Methods One hundred patients with CHF were recruited from January 2012 to December 2013 in cardiovascular department , and were divided into the intervention group and the control group , with 50 patients each .Comprehensive intervention including routine heart failure care and group cognitive behavioral therapy combined with other therapies was adopted on the patients in the intervention group .The Self-rating Anxiety Scale ( SAS ) and the Self-rating Depression Scale ( SDS) were used to compare the difference of anxiety and depression between groups .Results At the baseline, the incidence of anxiety was 25%, within which 11 patients had mild anxiety , and 10 patients had moderate anxiety, and 4 patients had severe anxiety.The incidence of depression was 39%, within which 19 patients had mild depression , and 14 patients had moderate depression , and 6 patients had severe depression .The score of SAS and SDS in the intervention group after intervention were (36.90 ±8.465) and (27.53 ±7.162), respectively, which were significantly lower than (40.91 ±8.019) and (36.78 ±10.562) in the control group (t=9.244,10.335, respectively;P<0.01).Conclusions Group cognitive behavioral therapy can effectively relieve the anxiety and depression in patients with chronic heart failure .