Objective To evaluate the mid-term(44 months) outcomes of meniscus allograft transplantation in four patients.Methods Between June and July 2005,four patients(3 medial and 1 lateral;3 men and 1 women;aged 21,27,35,38 years) underwent arthroscopy-assisted meniscus allograft transplantation in our hospital.The clinical outcome of the patients was evaluated by assessing the symptoms and signs,IKDC,Lysholm,and Tegner scores and examining the anteroposterior and lateral radiographs of the transplanted knee,weight-bearing radiographs of the both knees,anteroposterior radiographs of the lower extremities as well as magnetic resonance imaging(MRI).One patient underwent second-look arthroscopy. Results The follow-up time was 44-45 months.During the period,all the patients showed a normal motion range of the knee without pain or effusion of the knee joints.The mean IKDC,Lysholm,and Tegner scores of the patients were 84.75?2.63,91.50?4.43 and 7.00?0.82 respectively,which were significantly higher than those detected before the operation(60.50?14.06,69.25?22.04 and 4.00?0.82).The radiological results revealed no obvious degeneration or alignment changes though a 2-mm narrowing was shown in one of the patients.MRI showed mild extrusion for the body of the transplanted medial menisci and Ⅱ to Ⅲ stage signal for the body and the posterior horn.Almost normal performance and tension of the transplanted meniscus was shown by arthroscopy. Conclusions Meniscus allograft transplantation shows good outcomes in mid-term follow-up.MRI is valuable for evaluating the implanted meniscus.

Objective To investigate endometrium receptivity in patients with luteinized unruptured follicle(IUF)by measuring the expression of estrogen receptor(ER),progesterone receptor(PR)and integrin αVβ3 in the endometriunm Methods From May 2007 to Nov.2007,17 infertile women with LUF were selected as LUF group matched with 13 infertile cases with normal ovulation as control group.They all underwent frozen-thawed embryo transfer in Reproductive Medicine Center.Renmin Hospital of Wuhan University.Endometrial tissue in anterior and posterior wall of uterus of LUF group and control group were biopsied by a small curettage between 7 and 11 days after luteinizing hormone(LH)surge.The expression of ER,PR and integrin αVβ3 in endometriam were detected by immunohistochemistry staining.The level of estrogen and progesterone were measured by chemiluminescence assay.Then,the relationship between αVβ3 expression in endometrium and the level of estrogen/progesterone were analyzed in LUF patients.Results (1)There was no remarkable difference in the level of estrogen between LUF [(656±299)pmol/L]and control group[(727±275)pmol/L,P>0.05].However,the level of progesterone were(23±8)nmol/Lin LUF group and(35±10)nmol/L in control group,which reached statistical difference(P<0.01).(2) The expression of ER,PR in endometrium of LUF patients were 183.9±2.4 and 168±3.which were significantly higher than 109.4±6.3 and 106±4 in control group(P<0.01).The expression of integrin α Vβ3 in endometrium of 115±11 in LUF group were significantly lower than 191±9 in control group(P< 0.01).(4)In LUF group,the expression of αVβ3 in endometrium waft correlated positively with the level of progesterone(r=0.77,P<0.01)and irrelevant with the level of estrogen(r=0.01,P>0.05).Conclusion The higher expression of estrogen and progesterone and lower expression of integrin αVβ3 misht confer impaired receptivity of endometrium and interfere with embryo implantation.

Background and purpose: Recent literature has high lighted an important role of inflammation in promoting cancer. CRP (C reactive protein) is a way of building the bridge between inflammation and cancer. We aimed to explore correlations between CRP levels and clinical stages of nasopharyngeal carcinoma(NPC). Methods: We analyzed 108 cases, among which 68 cases were NPC, 20 cases were benign inflammatory diseases of nasopharynx, and another 20 were healthy volunteers as control. We detected the level of CRP using immunoturbidimetry (ITM), q test was calculated by SPSS. Results: The mean concentrations of CRP in NPC[(19.8±4.7) mg/L] were significantly increased compared to those in the control group[(6.2±1.8) mg/L], while they were significantly lower than those in benign inflammatory group[(45.6±7.9) mg/L]. In NPC, The mean concentrations of CRP in T4[(25.6±3.9) mg/L] were higher than those in T1[(17.4±5.8) mg/L], T2[(18.6±8.5) mg/L] and T3[(15.6±1.8) mg/L] respectively. The mean concentrations of CRP in N3[(28.0±7.1) mg/L] were higher than those in N0[(17.6±6.8) mg/L], N1[(21.3±5.1) mg/L] and N2[(18.6±5.6) mg/L] respectively. The mean concentrations of CRP in 1V[(25.7±5.5) mg/L] were higher than those in Ⅰ[(14.2±1.9) mg/L], Ⅱ[(16.1±3.9) mg/L] and Ⅲ[(23.0±7.7) mg/L] respectively (P<0.05). There were no statistic differences between the other groups. Conclusion: The serum CRP level is associated with the occurrence of NPC and benign inflammatory disease of nasopharynx. In NPC, the higher the CRP level is, the more advanced the TNM stage will be.

Objective To build the schema of combination between commercially available ultrasound contrast agent SonoVue and self-made liposomes,and determine its efficiency. Methods Microbubbles was labeled by carbocyanines dye DiI. The effect of DSPE-PEG-FITC labelling was determined by flow cytometer to evaluate the insertion efficiency of the amphipathic molecule DSPE-PEG(2000)Amine into lipid monomers shell. Aminated fluorescent liposomes were prepared by rotary evaporation and their size were determined by laser particle size analyzer. Liposomes and microbubbles were combined by two-step glutaraldehyde crosslinking. The impact of liposome concentration and DSPE-PEG (2000)Amine concentration on the construction efficiency of the complex of SonoVue conjugated to liposomes was determined by flow cytometer and multifunctional ELIASA respectively. Results The configuration of SonoVue microbubbles labeled by DiI and DSPE-PEG-FITC showed fine. The combination between liposomes and microbubbles was realized by glutaraldehyde crosslinking. The flow cytometer showed that 200 μl liposomes solution per 200 μl microbubbles suspension was the optimal proportion, with the peak positive rate as (87.80 ± 5.91)%. Multifunctional ELIASA showed that 150 μl DSPE-PEG (2000)Amine (100 μm) solution per 200 μl microbubbles suspension was the optimal proportion, with the peak carry efficiency as (83.41±2.21)%. Conclusions The amination of commercially available SonoVue is realized by the insertion of DSPE-PEG (2000) Amine molecule. Glutaraldehyde crosslinking the liposomes and microbubbles is feasible. Moreover, we can choose other active groups to modify the microbubbles and liposomes, construct more convenient methods with higher efficiency.

Objective To measure and determine the position of the tibial attachment of the anterior cruciate ligament (ACL)in relation to its anterior ridge on the magnetic resonance imaging (MRI)of normal knee joints,and to explore the clinical role of the anterior ridge in guiding tunnel positioning during ACL reconstruction as well as in facilitating postoperative radiographic evaluation.Methods The knee MRI of one hundred young adult patients with an intact ACL and normal knee joint (mean age:25.1 years,range:18-40 years)was retrospectively reviewed.All MR images were obtained at full extension of the knee on the same MRI machine.Using digital image software on MRI,the measurements in the sagittal view were taken,including the depth of the tibia,the distance from the anterior edge of the tibial plateau to the most anterior and posterior portions of the ACL insertion on the tibia and the anterior ridge according to Staubli and Rauschning's method.Results The center of the tibial insertion of the ACL is located between 28.43％ and 50.94％ of the total anterior-posterior depth of the tibia,which was less than 43.3％ in 58 patients.The average distance from the anterior edge of the tibial plateau to the anterior ridge was 13.61 ± 2.17 mm (ranging from 8.03 to 18.65 mm),26.80％ ±3.89％ (ranging from 17.74％ to 33.94％)across the tibial plateau.There were significant positive correlations between the distance from the anterior edge of the tibial plateau to the most anterior portion of the ACL insertion and that to the anterior ridge.The distance from the most anterior portion of the ACL insertion to the anterior ridge was averaged 0.56 ± 0.68 mm (ranging from-0.28 to 2.71 mm).During the ACL reconstruction,with the anterior edge of the tibial tunnel determined at posterior 0.5 mm to the anterior ridge,the graft size as 8 mm,and the tibial guider angle set as 55 degree,96of the patients (96％)would have the center of the tibial tunnel located before the center of their native ACL attachment.Conclusions On sagittal MR images,the location of the anterior ridge and the most anterior portion of the ACL insertion correlated well,with the average distance between them of 0.56 mm.The study indicates that during ACL reconstruction,tibial tunnel drilling with the anterior edge of the ACL graft positioned at the anterior ridge can achieve a more anterior position than the traditional methods to orientate according to the center of the bone tunnel.

Objective·To investigate and compare the clinical characteristic of non-organic dyspnea and asthma both with complaint of dyspnea.Methods·Seventy-four consecutive patients with non-organic dyspnea,and 74 age-,height-,weight and sex-matched patients with asthma were recruited for investigation in the study.The self-assessment surveys were conducted for the two groups by means of Hospital Anxiety and Depression Scale,Nijmegen Questionnaire and Athens Insomnia Scale.The words for describing dyspnea,clinical symptoms,effective sleep hours and items of pulmonary function test were collected and analyzed Results·Non-organic dyspnea patients tended to describe psychogenic aspects.Asthma patients tended to describe airflow limitation.Non-organic dyspnea group mainly performed psychogenic symptoms.The sleeping time in non-organic dyspnea group was significantly lower than that in asthma group(P＜0.05).The score of anxiety,depression,Nijmegen Questionnaire,Athens Insomnia Scale,FEV1,FEV1％Pred,FVC％Pred,FEV1/FVC in non-organic dyspnea group were significantly higher than those in asthma group (P＜0.05).There was no significant difference in FVC between two groups(P＞0.05).Conclusion·The non-organic group feel more anxiety,depressed and insomnic than the asthma group.Lung function test of asthma group is often abnormal.To discriminate non-organic dyspnea with asthma,clinicians should pay more attention to emotion,sleep,somatoform symptoms,medical history and so on,and do pulmonary function test,improve the understanding of the characteristics of the two diseases,decrease misdiagnosis and wrong diagnosis.

Objective To evaluate the diagnostic value of different sequences of magnetic resonance imaging (MRI) in repaired meniscus.Methods From September 2002 to December 2008,118 patients (130 menisci) underwent arthroscopic meniscus suture in our hospital,including 94 males and 24 females,aged from 15 to 50 years (average,25.7t7.5 years).All patients underwent MRI and second-look arthroscopy postoperatively.Different sequences of MRI were taken to evaluate the grade of meniscal signal at repaired site and the slices involved by grade 3 signal.The diagnostic sensitivity,specificity,accuracy,positive predict value (PPV) and negative predict value (NPV) were calculated for each sequence by using second-look arthroscopy as the gold standard.Results The total healing rate was 80.8％ (105/130) by second-look arthroscopy,which was higher than that by different sequences of MRI.The integrated T2 sequence held the highest diagnostic value,and the sensitivity,specificity,accuracy,PPV and NPV were 76.0％,71.4％,72.3％,38.8％ and 92.6％,respectively.According to the second-look arthroscopy result,the menisci were divided into the healed group and unhealed group.In the healed group,28.6％ of cases (30/105) showed grade 3 signal in MRI,which was less than that (76.0％) in the unhealed group.The rate of the new grade 3 signal (8.6％) and the slices involved by grade 3 signal (0.8±1.0) in the healed group were less than those (16.0％ and 3.0±2.0) in the unhealed group.Conclusion The diagnostic value of the integrated T2 sequence is encouraging with high sensitivity,specificity and accuracy.The new grade 3 signal in the repaired meniscus usually implies that the meniscus is not healed.

ObjectiveTo study the characteristic of apoptosis and the expression of inducible nitric oxide synthase(iNOS),as well as relation between them after spinal cord injury (SCI) in rats.Methods84 adult SD rats were randomly divided into three groups,and made into mild,moderate and severe acute SCI models.The rats were killed at 4h,8h,1d,3d,7d,14d and 21d after surgery.The histopathology changes in spinal cord tissue were observed with HE staining microscopic examination.The expression of iNOS was determined by immunohistochemistry and the apoptosis was labeled by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling(TUNEL).ResultsThe histopathology changes in spinal cord tissue deteriorated with increasing in injury degree.A little iNOS immunoreactivity (iNOS-IR) was detected in nerve cells,gliocytes,ependymocytes and blood vessel endotheliocytes of normal and vertebra shelf operated controls,increasing at 8 h, and in flood tide in 7 d. The expression of Bax and the rates of TUNEL positive cells were similar with that of iNOS after SCI. There was positive correlation between expression of iNOS and degree of primary SCI ,apoptosis index(r=0.414,P<0.01;r=0.854,P<0.01).Conclusions Expression of iNOS and Bax increase and a large number of TUNEL positive cells present after SCI in rats. There is positive correlation between expression of iNOS and degree of primary SCI,apoptosis index.

Objective To evaluate the safety, feasibility and clinical value of real-time navigation system with CT/MR and sonographic images for percutaneous ablation of hepatic malignancies poorly defined on conventional ultrasonography. Methods Fifteen patients with 22 hepatic malignant lesions underwent percutaneous ablation guided by virtual navigation system with ultrasonography. Treatment response was assessed by the contrast CT/MR followed up one month after procedures. Results Complete tumor necrosis was achieved in 20 lesions, but 2 lesions showed residual tumor in the ablation zone. No treatment associated complications were found. Conclusions The application of virtual navigation system is of clinical value in localization of lesions, guidance of biopsy and assessment of the interventional therapy in patient with hepatic malignancies, particularly for those with poorly identified lesions by conventional ultrasonography.

Objective:To evaluate the change in hamstring ( H ):quadriceps ( Q ) ratio following anterior cruciate ligament ( ACL) rupture during isokinetic knee extension and flexion at 30 degrees of flexion which is important for knee dynamic function .Methods:A study was performed in 25 male com-plete unilateral ACL ruptures .Isokinetic concentric and eccentric quadriceps and hamstring muscle tests in both the deficient knees and intact knees were performed at 60°/s, respectively.At 30 degrees of flexion, the average torque of quadriceps and hamstring , Qe∶Qc ratios ( ratios of eccentric quadriceps to concentric quadriceps muscle torque ) , He∶Hc ratios ( eccentric hamstring to concentric hamstring ) , Hc∶Qc ratios ( concentric hamstring to concentric quadriceps ) , He∶Qc ratios ( eccentric hamstring to con-centric quadriceps ) , and Hc∶Qe ratios ( concentric hamstring to eccentric quadriceps ) were calculated . Wilcoxon matched-pairs signed-ranks test was used .Results:At 30 degrees of knee flexion , a significant reduction ( P<0.05) in the average torque of quadriceps was observed at concentric and eccentric 60°/s produced by the deficient-side compared with the intact side .In addition, Hc∶Qc, He∶Qc, and Qe∶Qc significantly increased on the ACL-deficient side .Conclusion:The change in H ∶Q ratio in the mode of isokinetic 60 °/s at 30 degrees of knee flexion might therefore be a new tool to objectively document muscle function in ACL-deficient knee .