Objective To analyse the graft impingement after anterior cruciate ligament (ACL) reconstruction based on three-dimensional graft and tunnel images of dual-source computer tomography (DSCT).Methods From November 2012 to November 2014,a consecutive 134 cases of ACL reconstruction with various techniques had their knees scanned by DSCT.Graft and femoral as well as tibial tunnel images were three-dimensionally reconstructed and carefully inspected if there was any impinging on the graft at knee extension,meanwhile the femoral and tibial tunnel location were measured.Of these 134 cases,a serial of 118 patients had been single-bundle reconstructed with same type of graft material.There were 83 males and 35 females aged from 15 to 64 years old (mean,32 years old).Special attention had been paid to examine if there was any graft impinging,and their origin and finally impingement types were identified and classified according to the position and origin of impingement.Bernard and Lorenz method were used to measure the relative locations of femoral and tibial tunnel respectively.Difference was statistically compared between impingement-free and impingement groups.Results Patients were divided into two groups,impingement-free group and impingement group according to graft impinging based on graft visible 3D-CT imaging postoperatively.Of 118 cases,39 (33％) were impingement-free and 79 (67％) existed various types of impingement.Impingement group was further divided into two subgroups according to different impingement location,outlet impingement of intercondylar notch group (77 cases,account for 65％ of total and 97％ of impingement group,respectively) and mid-way impingement of intercondylar notch group (2 cases,account for 2％ of total and 3％ of impingement group,respectively).The outlet impingement group was more further classified into three subtypes,bird beak impingement,10 cases (13％,10/77),tibial plateau impingement,46 cases (60％,46/77) and clamp impingement,21 cases (27％,21/77).Statistic analysis with NAONA revealed that no significant difference between impingement group and impingement-free group regardless of femoral or tibial tunnel placement.Conclusion Three new types of impingements are found based on visible 3D-CT graft imaging after ACL reconstruction which are mid-way impingement of intercondylar notch,tibial plateau impingement and clamp impingement.

Objective To investigate the risk factors of articular cartilage damage secondary to anterior cruciate ligament (ACL) rupture.Methods Clinical data of 490 patients sustaining ACL rupture from July 2008 to July 2014 were collected for a retrospective cohort study.The factors relating to the incidence and degree of the secondary articular carticular damage were analyzed,including gender,age,weight,blood group,places of residence,causes of injury,complication of meniscus tear,damage part and duration of disease.Results Factors associated with the incidence of secondary articular cartilage damage were blood type O (OR =0.605,95％ CI 0.381-0.960,P ＜ 0.05) and complication of meniscus tear(OR =2.241,95％ CI 1.378-3.643,P ＜0.01).Factors associated with the degree of articular cartilage damage were duration of disease (rs =0.168 7,P ＜0.01),damage part (Hc =53.237,P＜0.01),and complication of meniscus tear (x2 =16.944,P＜0.01).Conclusions Meniscus tear is the moderate risk factor for the incidence of secondary articular cartilage damage while blood type O has weak protective effect.Damage part,course of disease,and meniscus tear are factors associated with the degree of secondary articular cartilage damage.

Sleep deprivation (SD) has a profound impact on the central nervous system, resulting in an array of mood disorders, including depression and anxiety. Despite this, the dynamic alterations in neuronal activity during sleep deprivation have not been extensively investigated. While some researchers propose that sleep deprivation diminishes neuronal activity, thereby leading to depression. Others argue that short-term sleep deprivation enhances neuronal activity and dendritic spine density, potentially yielding antidepressant effects. In this study, a two-photon microscope was utilized to examine the calcium transients of anterior cingulate cortex (ACC) neurons in awake SD mice in vivo at 24-hour intervals. It was observed that SD reduced the frequency and amplitude of Ca2+ transients while increasing the proportions of inactive neurons. Following the cessation of sleep deprivation, neuronal calcium transients demonstrated a gradual recovery. Moreover, whole-cell patch-clamp recordings revealed a significant decrease in the frequency of spontaneous excitatory post-synaptic current (sEPSC) after SD. The investigation also assessed several oxidative stress parameters, finding that sleep deprivation substantially elevated the level of malondialdehyde (MDA), while simultaneously decreasing the expression of Nuclear Factor erythroid 2-Related Factor 2 (Nrf2) and activities of Superoxide dismutase (SOD) in the ACC. Importantly, the administration of gallic acid (GA) notably mitigated the decline of calcium transients in ACC neurons. GA was also shown to alleviate oxidative stress in the brain and improve cognitive impairment caused by sleep deprivation. These findings indicate that the calcium transients of ACC neurons experience a continuous decline during sleep deprivation, a process that is reversible. GA may serve as a potential candidate agent for the prevention and treatment of cognitive impairment induced by sleep deprivation.