Objective To test the strength of different suture fixation of tendon or ligament end and evaluate appropriate stitches number in cruciate ligament reconstruction. Methods Twenty-four specimens of patellar tendon with free ends, which was, divided into 3 groups according 2 or 3 stitches and 6 subgroups using different suture materials, either with No1 Ethilon or 0.4 mm diameter stainless steel wire, fixed with Krackow locking stitch, the tensile test were undertaken respectively, so as to find out the least stitches and efficient suture pattern. Results Two Krackow locking stitches had more strength than that of 0.4 mm diameter stainless steel wire itself, the fixation strength of 2 stitches which used No1 Ethilon was more than 80 N, superior to the failure strength of material itself, it still maintained the same strength if the first stitch was across the tendon tissue transversely. On the basis of testing results, this modified stitches pattern was used in 17 cases, all could be well withstand an accelerated postoperative ROM rehabilitation program in clinical practice. Conclusion There is no significant difference between 2 and 3 Krackow locking stitches in suture strength statistically, the fixation strength is superior to the suture material, it can lessen the suture exposure when the first stitch is across the tendon tissue while maintains a comparable strength to other suture. If attempt to make a higher strength of suture, one should focus on selecting a stronger materials or adding the suture materials in number, therefore, a rapid early ROM rehabilitation is possible and reliable in practice.

Objective To summarize complications of knee arthroscopic surgery and the prevention and treatment for the complications. Methods A review of 679 knee arthroscopic operations in 658 patients from March 1997 to March 2002 was carried out. Results The incidence of all complications was 6.8% (46 of 679). Incidences of hemarthrosis, superficial infection, fibroarthrosis, tourniquet paresis, instrument breakage and accidental damage were 2.7% (8 of 679), 0.4%(3 of 679), 1.5%(10 of 679), 0.6%(4 of 679), 1.2% (8 of 679) and 0.4% (3 of 679), respectively. No popliteal vessel injury, intra-articular infection, neurological injury, deep venous thrombosis or compartment syndrome occurred in this group. Conclusions The incidence of complications of knee arthroscopy is relatively low. Most of them are mild and curable, if prompt treatment is given.

Objective To investigate the correlation between the results of HBsAg positive results among different detection systems,and provide reference for the analysis of clinical test results and the publication of the report.Methods The HBsAg positive serum specimens with the quantitation result lower than 80 COI were detected by Roche Cobas e602 electrochemical luminescence analyzer.All the specimens were also detected by Roche Modular e170 electrochemical luminescence analyzer.The differences of detecting results were compared and performed the linear correlation analysis.Results The experimental results of two detection systems are R2 =0.933.The positive coincidences of Group A,B,C,D and E were 60.60％,92.72％,96.66％,96.66％ and 100％,respectively.The positive coincidence of the males was 87.66％,while the positive coincidence of the females was 70.96 ％.The positive coincidence of the males was significantly higher than the females (P＜0.05).Conclusion The HBsAg detecting results of Roche Cobas e602 and Roche Modular e170 electrochemical luminescence analyzer had high correlation.The results higher than 10 COI had 100％ positive coincidence rate,however the results between 1 and 10 COI were not.The result between 1 and 10 COI may lead to controversial results,suggestions for further checks.

Objective To detect the expression of type Ⅰ interferon in monocyte-derived dendritic cells(MoDCs)after Toll like receptor(TLR)3 triggered in patients with chronic hepatitis B(CHB),and to evaluate immune responses of CHB patients and its roles in the mechanisms of persistent infection of hepatitis B virus(HBV)and chronicity of hepatitis.Methods Peripheral blood mononuclear cells(PBMCs)were isolated and purified using magnetic beads(plasma was saved simultaneously)from 26 CHB patients and 18 healthy volunteers(HV).Dendritic cells(DCs)were induced and proliferated in a culture medium with recombinant human granulocyte macrophage colony stimulating factor(rhGM-CSF)and recombinant human interleukin(rhIL-4).EX3s were stimulated with Poly Ⅰ:C and the supernatants were collected at 0 h and 24 h after stimulation.Type Ⅰ interferon(IFN-α and IFN-β)in plasma and supernatants were examined by enzyme linked immunosorbent assay (ELISA).Results The levels of type Ⅰ interferon in plasma were not significantly different in groups of HV and CH B.IFN-α and IFN-β expressions in supernatants before Poly Ⅰ:C stimulation were(80.00±16.15)ng/L,(36.39±13.90)ng/L in CHB group and(76.76±15.90)ng/L,(37.14±13.68)ng/L in HV group,respectively.And there were no statistical differences between two groups(t=1.651,t=0.178;both P＞0.05).IFN-α expressions in supernatants at 24 h after stimulation in two groups were both higher than those before stimulation(at 0 h),but there were no statistical differences(t=1.534,t=1.243;both P＞0.05).IFN-β expressions in supernatants at 24 h after stimulation in HV group was(54.57±16.80)ng/L,which was significantly higher than that at 0 h(37.14±13.68)ng/L(t=4.061,P＜0.05).However,there was no significant difference at 24 h than tht at 0 h in CHB group(t=1.796,P＞0.05).At 24 h after stimulation.IFN-β level was(54.57±16.80)ng/L in HV group,which was significantly higher than that[(41.64±12.57)ng/L]in CHB group(t=2.921,P＜0.05).Conclusions Functions of MoDCs from CHB patients are impaired and MoDCs could not express type Ⅰ interferon normally.Expression of type Ⅰ interferon after TLR3 triggered in CHB patients is mainly IFN-β.

Objective To elucidate the expression of Toll-like receptor 3 (TLR3) on dendritic cells(DCs) in patients with chronic hepatitis B (CHB), and to explore the correlation between hepatitis B virus (HBV) persistent infection and TLR3 expression. Methods Sixty CHB patients (CHB group) and 20 healthy controls (control group) were enrolled. The peripheral blood mononuclear cells (PBMCs) were isolated and CD14~+ monocytes were sorted by immunomagnetic beads. Immature DCs (imDC) were induced and proliferated in vitro and mature DCs (mDC) were obtained after the poly I:C stimulation. The expression of intracellular TLR3 mRNA was detected by real-time polymerase chain reaction (PCR), and surface markers [CD80 and human leucocyte antigen (HLA)-DR] were determined by flow cytometry after 48 h of stimulation. The comparison of quantitative data was done using t test. The qualitative data were compared using chi-square test.Results The mean fluorescence intensities (MFI) of intracellular TLR3 of imDC before poly I:C stimulation in CHB group and control group were 1212.05 ± 250.80 and 1192.95 ± 301.40,respectively, which were not significantly different (t = 0. 280, P>0. 05). While after stimulation,those were 1352.98± 313.67 and 1593. 00± 349. 65, respectively, the latter was significantly higher than the former (t = 2. 880, P<0. 05). The levels of TLR3 mRNA inside mDCs in both groups were increased after poly I:C stimulation, which were 0. 1204 ±0.0267 and 0. 1780 ± 0.0664, respectively in CHB group and control group, and that in control group was significantly higher (t = 3. 909, P<0.05). Furtherly, patients in CHB group were divided into HBeAg(+ ) and HBeAg( -) subgroups.After stimulation, the MFI and mRNA of TLR3 inside mDC were greatly elevated in both subgroups,but there were no difference between these two subgroups (t = 0. 366, P>0. 05). Conclusions The intracellular expressions of TLR3 in mDC in CHB group and control group are obviously increased after the poly I:C stimulation, but the increased level in CHB group is lower than that in control group. The results suggest that the insufficiency of TLR3 synthesis may be related to the HBVpersistent infection.

Objective To evaluate the clinical efficacy of transjugular intrahepatic portosystemic shunt(TIPS)combined with stomach and esophageal variceal embolization(SEVE)for gastric variceal haem-orrhage,and the efficacy with or without a gastrorenal shunt. Methods A total of 52 patients with gastric variceal bleeding history and portal hypertension treated with TIPS combined with SEVE were included from October 2013 to March 2015.Patients were divided into two groups according to preoperateive CT angiogra-phy,27 cases with gastric variceal haemorrhage associated with a gastrorenal shunt in group A,and 25 gastric varices bleeding cases without gastrorenal shunt in group B. During the follow-up,the incidence of the total rates of rebleeding,TIPS primary patency and hepatic encephalopathy,and the survival rates were compared between group A and group B. Results In all patients,the average portal vein pressure decreased from 36. 50±7. 00 cmH2 O(1 cmH2 O= 0. 098 kPa)before operation to 28. 15±6. 27 cmH2 O after TIPS combined with SEVE,with significant difference(t= 10. 357,P= 0. 001). Fifty two patients were followed up for 1 to 18 months(1-18 months in group A;1-15 months in group B).The total rates of rebleeding,TIPS primary patency,hepatic encephalopathy and survival were 11. 54%(6/ 52),86. 54%(45/ 52),11. 54%(6/ 52) and 92. 31%(48/ 52),respectively. There were no significant differences between the two groups in the total rates of rebleeding[11. 11%(3/ 27)VS 12. 00%(3/ 25),P = 1. 000],TIPS primary patency[88. 89%(24/ 27)VS 84. 00%(21/ 25),P= 1. 000],hepatic encephalopathy[14. 81%(4/ 27)VS 8. 00%(2/ 25), P= 0. 738]or total survival rate[92. 59%(25/ 27)VS 92. 00%(23/ 25),P = 1. 000]after TIPS combined with SEVE. Conclusion TIPS combined with SEVE is effective for gastric varices,and equally effective in the treatment of both gastric variceal haemorrhage associated with a gastrorenal shunt and gastric varices bleeding without gastrorenal shunt.

Objective To investigate the influence of knee joint instability induced by the rupture of anterior cruciate ligament (ACL) on the meniscus and cartilage. Methods Forty-eight consecutive patients with rupture of ACL from 1998 to 2002 were retrospectively studied upon the relationship of distribution, severity and incidence of meniscal tears and cartilage injuries with different period of time post injury. Results The incidence of meniscal injury was increased from six cases (55%, 6/11) in acute period, 13 (68%, 13/19) in subchronic period to 17 (94%, 17/18) in chronic period with a significant difference (P

Objective To describe the clinical feature ,therapeutic approach and prognosis of histoplasmosis for improving clinicians’ awareness of this disease .Methods The clinical data of 7 cases of histoplasmosis treated in Shanghai Huashan Hospital from 2001 to 2014 were reviewed retrospectively .Relevant reports about histoplasmosis from 2001 to 2014 in Chinese mainland were comprehensively reviewed .Results The major clinical manifestations of progressive disseminated histoplasmosis included fever ,hepatosplenomegaly ,lymphadenopathy ,and pancytopenia .Skin lesions and pancytopenia were more common in the patients complicated with HIV/AIDS .The patients with local infection were lack of systemic symptoms or signs . Histological examination found Histoplasmacapsulatum in macrophages in bone marrow or biopsy tissues .Amphotericin B was used most frequently to treat histoplasmosis .Itraconazole was appropriate in mild patients .Conclusions Histoplasmosis is caused by H .capsulatum .The golden standard of diagnosis is any culture positive for H .capsulatum .Antifungal treatments such as amphotericin B and itraconazole are very important .

Object To determine the structures of three saponins isolated from leaves of Aralia elata (Miq ) Seem Methods HPLC and electrospray ionization and tandem mass spectrometry were used for purification and structure identification Results Three saponins were identified as congmunoside Ⅴ, congmunoside Ⅶ, and congmunoside Ⅹ Conclusion These saponins are obtained from the leaves of A elate for the first time

Objective To study the relationship of age and high risk behaviors (HRBs) related to HIV/AIDS among men who have sex with men (MSM) in China. Methods One thousand one hundred and nine anonymous questionnaires were collected from MSM in 1999. Univariate analyses were applied to clarify the relation of the age and HRBs. Results The numbers of accumulative partners and oral intercourse behavior were higher in 35 ~ 44 age group (P