Objective The attempts was made to compare the results of a quadruple-strand semi-tendinosus tendon versus patellar tendon reconstruction for anterior cruciate ligament by arthroscopy in chronic complete anterior cruciate ligament injury.Methods60patients were enrolled in a prospective,ran-domized,controlled study.30patients underwent reconstruction with a quadruple-strand semitendinosus tendon autograft,30patients were treated with a bone-patellar tendon-bone autograft.The surgery was car-ried out in an alternating sequence with two autograft constructed materials.At the time of arthoscopy,the knee was examined totally,associated joint pathology was documented,and irreparably torn meniscal frag-ments were removed.60patients were followed up14to30months after operation,and evaluated in terms of the clinical test findings,the activity level,the functional status in daily activities,the range of motion,the stability of the knee,the level of return to sports and the patellofemoral crepitus at final follow-up.Results The objective outcome of replacement with a bone-patellar tendon-bone graft was identical to that obtained with a quadruple-strand semitendinosus tendon graft.The stability of the knee in the quadrupled-strand semitendinosus reconstruction was equal with that in the bone-patellar tendon-bone autograft.The return to sport was more frequent in the quadrupled-strand semitendinosus group comparing with in the bone-patellar tendon-bone group,there was80%and73%in each group respectively with no significant difference.A mild loss(≤3?)of knee extension was more frequent in the patellar tendon group than that in the quadru-pled-strand semitendinosus group,there was40%and6%in each group respectively,the difference was sig-nificant statistically.KT-2000arthrometer side-to-side difference of anterior displancement was13%versus20%in the quadrupled-strand semitendinosus group and patellar tendon group at133.4N.Patellofemoral crepitus was6%and17%in the quadrupled-stranded semitendinosus group and patellar tendon group re-spectively.Conclusion In a chronic complete injury of anterior cruciate ligament,the clinical results of re-construction with a quadrupled-strand semitendinosus tendon or patellar tendon by arthroscopy were satis-factory without significant differences between the two operative procedures.

A brief introduction to the development milestones of postgraduate medical education in the world, highlighting the present details of such systems in the United States, United Kingdom, France, Germany and some Asian countries.It is held that common patterns can be identified despite the gaps found in such systems of these countries.In view of the training management system cornmonalities of thecountries,the authors proposed the development directions of residency training in China to enhance thehands-on capability and competence of clinical doctors in a standardized manner.

Objective:To investigate whether intestinal rehabilitation therapy (IRT)could optimize the effectiveness of IRT in patients with short bowel syndrome (SBS) caused by acute mesenteric ischemia (AMI) with chronic multivessel lesions.Methods:Clinical data of 18 hospitalized patients diagnosed with AMI leading to SBS and undergoing IRT at the Eastern Theater General Hospital of the People's Liberation Army from Jan 2012 to Oct 2023 was retrospectively analyzed.Result:Following IRT, the revascularization group showed significantly greater increases in ASMI and grip strength compared to the control group [(0.28±0.26) kg/m 2vs. (0.02±0.21) kg/m 2, P=0.033, and (0.97±0.33) kg vs. (0.48±0.34) kg, P=0.007, respectively]. Similarly, the increase in EN intake was significantly higher in the revascularization group compared to the control group [(572.5±93.6) ml/d vs. (375.2±176.3) ml/d, P=0.012], accompanied by a greater improvement in intestinal nitrogen absorption rate [(25.06±14.06)% vs. (13.84±4.62)%, P=0.034] and a more substantial decrease in GSRS scores [(-15.88±3.94) vs. (-6.33±5.13), P=0.030]. Moreover, there were significant differences in the composition of EN formulations between the two groups after IRT ( P=0.046). Additionally, SF-36 scores at discharge were significantly higher in the revascularization group than that in the control group for five indicators including BP, GH, VT, SF, and MH ( P<0.05). Conclusions:For patients with SBS resulting from AMI by chronic multivessel lesions, revascularization therapy may not leading to higher growth in weight and hematological nutritional indicators during IRT, but it is beneficial for improving muscle function, improving EN absorption, increasing the likelihood of PN independence, relieving gastrointestinal symptoms, and enhancing overall quality of life.