OBJECTIVE: To standardize the operative procedure for tissue-engineered cartilage repair, by demonstrating surgical technique of arthroscopic implantation of decalcified cortex-cancellous bone scaffolds, and summarizing the surgical experience of the sports medicine department team at Peking University Third Hospital. METHODS: This article elaborates on surgical techniques and skills, focusing on the unabridged implantation technology and surgical procedure of decalcified cortex-cancellous bone scaffolds under arthroscopy: First, the patient was placed in the supine position. After anesthesia had been established, the surgeon established an arthroscope and explored the damaged area under the scope. After confirming the size and location of the injury site, the surgeon cleaned the damaged cartilage, and also trimmed the edges of the cartilage to ensure that the cut surface was smooth and stable. the surgeon performed the micro-fracture surgery in the area of cartilage injury, and then measured the size of the injured area under the scope. Next, the surgeon manually trimmed the tissue-engineered scaffold based on the measurements taken under the arthroscope, and then directly implanted the scaffold using a sleeve. A honeycomb-shaped fixator was used to implant absorbable nails to fix the scaffold. After the scaffold was installed, the knee was repeatedly flexed and extended for 10-20 times to ensure stability and range of motion. Finally, the arthroscope was withdrawn and the wound was closed. RESULTS: Decalcified cortex-cancellous bone scaffolds possessed unparalleled advantages over synthetic materials in terms of morphology and biomechanics. The cancellous bone part of the scaffold provided a three-dimensional, porous space for cell growth, while the cortical bone part offered the necessary mechanical strength. The surgery was performed entirely under arthroscopy to minimize invasiveness to the patient. Absorbable pins were used for fixation to ensure the stability of the scaffold. This technique could effectively improve the prognosis of the patients with cartilage injuries and standardized the surgical procedures for arthroscopic tissue-engineered scaffold operations in the patients with cartilage damage. CONCLUSION With the standard arthroscopic tissue-engineered scaffold repair technique, it is possible to successfully repair damaged cartilage, alleviate symptoms in the short term, and provide a more ideal long-term prognosis. The author and their team explain the surgical procedures for tissue-engineered scaffolds under arthroscopy, with the aim of guiding future clinical practice.
Tissue Engineering/methods* ; Humans ; Tissue Scaffolds ; Arthroscopy/methods* ; Cartilage, Articular/surgery*

Objective:To further understand the current status of diagnosis and treatment of endometriosis in China, the implementation of guideline in different levels of hospitals, and the need for continuing education in endometriosis among primary doctors.Methods:The survey was conducted in the form of convenience sampling questionnaire among the Wechat public platform. The doctors were free to participate in the investigation without any reward. All questions answered were assessed as valid questionnaire. The datas were collected on the questionnaire network platform and analyzed by SPSS 19.0.Results:Totally 1 494 valid questionnaires were collected in this survey. 60.17% (899/1 494) of them were from tertiary hospital, and 32.60% (487/1 494) were from grade two hospital. Only the hospitals where 9.97% (149/1 494) participants based opened the specialist clinic for endometriosis. 70.35% (1 051/1 494) of participants said they had read the second edition of guideline for the diagnosis and treatment of endometriosis which published in 2015. The American Society for Reproductive Medicine (ASRM) staging system was adopted in the clinical practices of only 25.03% (374/1 494) participants. And 18.74% (280/1 494) participants used the endometriosis fertility index (EFI) scoring during the laparoscopic surgery for endometriosis with infertility. 45.18% (675/1 494) of participants said they had not attended any academic conference on endometriosis in the past six months. 64.46% (963/1 494) of the participants believed their diagnosis and treatment in practice should be improved and standardized. 87.15% (1 302/1 494) of the participants expressed the hope that more conferences or workshops on endometriosis would be held.Conclusions:At presents, the diagnosis and treatment of endometriosis in China has been greatly improved, but the implementation of guidelines and the new concept is still a long-term job. The specialist clinic are held only in a few hospitals. It’s the expectation and voice of primary doctors to the association to organize the more academic congresses on endometriosis.

Objective: To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods: From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same group of doctors at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right. The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment-Achilles(VISA-A), the Achilles tendon Total Rupture Score(ATRS) and the Tegner Activity Score of patients were collected and compared by paired-t test. Results: The patients were followed up for (45.6±17.2) months (range:17-28 months).No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow-up,the VAS decreased from 1.0(2.0) (M(Q_R) preoperative to 0.0(0.8)(Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359, P=0.00), VISA-A increased from 51.3±9.8 to 87.8±18.0(t=-17.656, P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=-12.524, P=0.00) and ATRS increased from 40.0±3.5 to 97.9±3.9(t=-64.133, P=0.00). Twenty-eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner-Lindholm curative effect evaluation criteria, 32 cases(91.4%) gained the excellent results, 1 case (2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%.All except 2 patients with bad results could perform a single-limb heel rise painlessly. Conclusions Primary repair is an efficient approach for chronic Achilles tendon rupture.The mid-and-long curative effect is satisfactory and stable. Compared with other surgical techniques, operation is relatively simple and economical.The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Objective To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same group of doctors at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right. The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle?Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment?Achilles(VISA?A), the Achilles tendon Total Rupture Score(ATRS) and the Tegner Activity Score of patients were collected and compared by paired?t test.Results The patients were followed up for (45.6±17.2)months(range:17-28 months).No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow?up, the VAS decreased from 1.0(2.0) (M(QR) preoperative to 0.0(0.8) (Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359, P=0.00), VISA?A increased from 51.3±9.8 to 87.8±18.0(t=-17.656,P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=-12.524,P=0.00) and ATRS increased from 40.0 ± 3.5 to 97.9 ± 3.9(t=-64.133, P=0.00). Twenty?eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner?Lindholm curative effect evaluation criteria, 32 cases(91.4%) gained the excellent results, 1 case (2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%.All except 2 patients with bad results could perform a single?limb heel rise painlessly.Conclusions Primary repair is an efficient approach for chronic Achilles tendon rupture.The mid?and?long curative effect is satisfactory and stable. Compared with other surgical techniques, operation is relatively simple and economical.The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Objective To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same group of doctors at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right. The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle?Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment?Achilles(VISA?A), the Achilles tendon Total Rupture Score(ATRS) and the Tegner Activity Score of patients were collected and compared by paired?t test.Results The patients were followed up for (45.6±17.2)months(range:17-28 months).No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow?up, the VAS decreased from 1.0(2.0) (M(QR) preoperative to 0.0(0.8) (Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359, P=0.00), VISA?A increased from 51.3±9.8 to 87.8±18.0(t=-17.656,P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=-12.524,P=0.00) and ATRS increased from 40.0 ± 3.5 to 97.9 ± 3.9(t=-64.133, P=0.00). Twenty?eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner?Lindholm curative effect evaluation criteria, 32 cases(91.4%) gained the excellent results, 1 case (2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%.All except 2 patients with bad results could perform a single?limb heel rise painlessly.Conclusions Primary repair is an efficient approach for chronic Achilles tendon rupture.The mid?and?long curative effect is satisfactory and stable. Compared with other surgical techniques, operation is relatively simple and economical.The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Objective To investigate the correlations among homocysteine(Hcy)level,serum cystatin C (Cys-c)and diabetic peripheral neuropathy(DPN).Methods Two hundred and three diagnosed cases of type 2 diabetes were enrolled,including 123 DPN patients(DPN+)and 80 non-DPN(DPN-)patients.Levels of serum Hcy,Cys-c,high-sensitivity C-reactive protein(hs-CRP)and fiber fibrinogen(Fg)were detected.The above indi-cators and the baseline data such as sex,age,duration,BMI,WHR,HOMA-IR(CP),HOMA-islet(CP)were statistically analyzed. Results Hcy,Cys-c,and the duration of the DPN+ group were significantly higher than those in the DPN-group(P<0.05,respectively).HOMA-islet(CP)in the DPN-group was markedly higher than that in the DPN+group(P<0.01).The prevalence of DPN in the high level of Hcy group was much higher than that in the low and the normal level of Hcy group.Hcy was still significantly correlated with the Cys-c after taking the controlled procedure such as duration and fibrinogen. Conclusion High levels of Hcy and Cys-c are the criti-cal risk factors of DPN,collaborative determination of Hcy and Cys-c level might be of quitevaluable in early diag-nosis of DPN.

This study was aimed to explore the features of clustered regularly interspaced short palindromic repeats (CRISPR) structures in Shigella by using bioinformatics. We used bioinformatics methods, including BLAST, alignment and RNA structure prediction, to analyze the CRISPR structures of Shigella genomes. The results showed that the CRISPRs existed in the four groups of Shigella, and the flanking sequences of upstream CRISPRs could be classified into the same group with those of the downstream. We also found some relatively conserved palindromic motifs in the leader sequences. Repeat sequences had the same group with corresponding flanking sequences, and could be classified into two different types by their RNA secondary structures, which contain "stem" and "ring". Some spacers were found to homologize with part sequences of plasmids or phages. The study indicated that there were correlations between repeat sequences and flanking sequences, and the repeats might act as a kind of recognition mechanism to mediate the interaction between foreign genetic elements and Cas proteins.
Base Sequence ; Clustered Regularly Interspaced Short Palindromic Repeats ; Computational Biology ; Genome, Bacterial ; Plasmids ; Shigella ; genetics

Objective To study the main pharmacodynamics effect of compound lavender ointment on the scald, anti-inflammation and analgesia.Methods Sixty guinea pigs were divided into normal groups,model groups( superficialⅡ°scalding models) ,compound lavender ointment high,median,low dose groups,and jing wan hong ointment groups,then observation of the wounds and healing was made and recorded.Histopathological examination was made to examine the wounds,and ELISA to analyze serum TNF-α、IL-6、IL-8.Xylene ear swelling model and writhing test were used to observe the analgesic and anti-inflammatory effects of the compound lavender ointment.Results Compound lavender ointment can relieve the wounds swelling and exudation,which may be related to the decrease of proinflammatory cytokines(P <0.01), and promote the wound healing significantly( P <0.01) ,that the side-effects were not observed.High dose of compound lavender ointment can inhibit ear swelling and have certain analgesia with the writhing tests.Conclusion Compound lavender ointment have the promoting wound healing,anti-infectious and antalgic effects on the scald.

OBJECTIVETo detect the distribution of clustered regularly interspaced short palindromic repeat (CRISPR) associated protein genes cas1 and cas2 in Shigella and to understand the characteristics of CRISPR with relationship between CRISPR and related characteristics on drug resistance.

METHODSCRISPR associated protein genes cas1 and cas2 in Shigella were detected by PCR, with its products sequenced and compared.

RESULTSThe CRISPR-associated protein genes cas1 and cas2 were found in all the 196 Shigella isolates which were isolated at different times and locations in China. Consistencies showed through related sequencing appeared as follows: cas2, cas1 (a) and cas1 (b) were 96.44%, 97.61% and 96.97%, respectively. There were two mutations including 3177129 site(C→G)and 3177126 site (G→C) of cas1 (b) gene in 2003135 strain which were not found in the corresponding sites of Z23 and 2008113.

RESULTSshowed that in terms of both susceptibility and antibiotic-resistance, strain 2003135 was stronger than Z23 and 2008113.

CONCLUSIONCRISPR system widely existed in Shigella, with the level of drug resistance in cas1 (b) gene mutant strains higher than in wild strains. Cas1 (b) gene mutation might be one of the reasons causing the different levels of resistance.

Bacterial Proteins ; genetics ; CRISPR-Associated Proteins ; genetics ; Clustered Regularly Interspaced Short Palindromic Repeats ; Drug Resistance, Bacterial ; genetics ; Mutation ; Shigella ; genetics

Objective To detect the distribution of clustered regularly interspaced short palindromic repeat(CRISPR)associated protein genes cas1 and cas2 in Shigella and to understand the characteristics of CRISPR with relationship between CRISPR and related characteristics on drug resistance. Methods CRISPR associated protein genes cas1 and cas2 in Shigella were detected by PCR,with its products sequenced and compared.Results The CRISPR-associated protein genes cas1 and cas2 were found in all the 196 Shigella isolates which were isolated at different times and locations in China. Consistencies showed through related sequencing appepared as follows:cas2,cas1 (a) and cas1(b)were 96.44%,97.61%and 96.97%,respectively. There were two mutations including 3177129 site(C→G)and 3177126 site(G→C)of cas1(b)gene in 2003135 strain which were not found in the corresponding sites of Z23 and 2008113. Results showed that in terms of both susceptibility and antibiotic-resistance,strain 2003135 was stronger than Z23 and 2008113. Conclusion CRISPR system widely existed in Shigella,with the level of drug resistance in cas1(b) gene mutant strains higher than in wild strains. Cas1(b)gene mutation might be one of the reasons causing the different levels of resistance.