Objective To probe into the remodeling and maturity process along with extension of time in anterior cruciate ligament (ACL) reconstruction with hamstring autograft in order to confirm the date of maturity postoperatively. Methods Thirty-three patients after arthroscopic ACL reconstruction with hamstring autograft, were undergone second-look arthroscopical surgery. Meantime, biopsy specimens were obtained from the mid-zone of the hamstring graft. As a control group, specimens of normal ACL were obtained from total knee replacement of four cases, and specimens of semitendinous tendons obtained from ACL reconstruction of the four cases. The interval from initial reconstruction to second-look arthroscopy ranged from 2 to 36 months(mean 11.9 months). Patients were divided into different groups by postoperative time such as 1-, 4-, 7-, 10-, 13-, 18- and 25- month group. Thirty-three specimens were ordinarily sliced up into longitudinal sections. The sections were stained with hematoxylin and eosin so that cell and collagen fibrils were observed under light microscope, then compared the results with those of control group. Results Under microscopical observation, it was showed that tissue of hamstring graft was remodeled from more blood vessels and cellular amount to normal one, and from an irregular orientated crimp pattern of collagen to regular orientated crimp pattern of collagen in a time-dependent manner. Decreasing cellular amount, changing cell type, and a regular orientated crimp pattern of collagen of the hamstring graft were observed in 7- month group primarily, comparing with the original ACL. However, there existed a slower process in the other groups that are older than that of 7- month. Conclusion There are well histological features in the process of remodeling and maturation of the hamstring autograft after operation following extension of time, such as better survival of early period, and remodel of vessels and collagen. The process of remodeling and maturation in the hamstring autograft is similar to BPB autograft. The maturation period of the hamstring autograft after ACL reconstruction in human patients appears between 7 month and 9 month postoperatively.

Objective To explore the therapeutic method and efficacy of discoid meniscus urder arthroscope. Methods 37 patients with 37 discoid menisci underwent arthroscopic lateral partial or total meniscectomy. 33 cases were operated on by reshaping (partial meniscectomy) and 4 cases with extensive laceration in the joint capsule rim of hastring tendon underwent total meniscectomy under arthroscope. Results Bases on Ikeuchi's grading, 19 cases were excellent (51.4%), 13 cases good (35.1%) and 5 cases fair(13.5%). Conclusions Arthroscopic reshaping for discoid meniscus can obtain excellent and good efficacy, so it is recommended that patients with discoid menisci should be treated by reshaping.

Objective To explore the surgical technique and clinical effect of arthroscopic hamstring tendon autograft on reconstruction anterior cruciate ligament (ACL). Methods 22 patients underwent ACL reconstruction with hamstring tendon autograft under arthroscopy. The mean age was 30 7 years (17years～50 years). Results The motion range of knee joint of all cases was normal or nearly normal. The postoperative Lachman test was ≤1+ in 19 patients, 2+ in 2 patients and 3+ in 1 patient. 20 patients also showed an absent pivot shift. The postoperative Lysholm score was (87 7?9 6)points, and the postoperative score increased significantly compared with the preoperative score ( t =2 33, P

Objective To arthroscopically re-observe the remodeling and maturity process following anterior cruciate ligament(ACL) reconstruction with a hamstring tendon autograft.Methods Thirty-three patients who had undergone a previous arthroscopic ACL reconstruction with a homolateral hamstring autograft were given a second observation under arthroscope.The interval from initial reconstruction to second-look arthroscopy ranged 2~36 months(mean,11.9 months).According to different intervals,the patients were grouped as 1~,4~,7~,10~,13~,18~,and 25~ months.The shape,color,tension,covering synovial tissue,and vascularity of the grafts were evaluated.Results As the interval increased,the hamstring grafts tended to progress to normal ACL morphologically.Under arthroscopic observation,the tendon grafts were characterized as grayish-white thick ligamentous tissues without synovial membrane and blood vessels after 7 months following initial reconstruction,which corresponded with the maturation period of autogenous grafts and simulated normal ACL.Conclusions Remodeling and maturation of the hamstring autografts progresses with time,which is comparable to patellar tendon autografts.

Objective To evaluate the combination of the mortality in emergency department sepsis (MEDS) score with blood lactate level in the risk stratification of patients with severe sepsis in the emergency department (ED).Methods 665 adult patients with severe sepsis admitted from May 2011 to December 2012 in ED were found to be eligible for the study.MEDS score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,and arterial blood lactate was determined,and the outcomes in 28 days were recorded.Logistic regression analysis was used to evaluate the relationship between each predictive factor score and prognosis.Each predictive factor was compared with the areas under the receiver operating characteristics (ROC) curve (AUC).Results The mortality in 28 days was 34.6％ in 665 patients.The mortality in group of MEDS score 12-27 was significantly higher than that group of MEDS score＜12 [51.0％ (156/306) vs.20.6％ (74/155),x2=28.414,P=0.000].In the meantime,APACHE Ⅱ score and blood lactate level were also significantly higher in group of MEDS score 12-27 than those in group with MEDS score＜12 [APACHE Ⅱ score:26.4 ± 10.6 vs.21.7 ± 8.1,t=-3.555,P=0.002; lactate (mmol/L):4.9 (2.3,9.9)vs.3.9 (1.5,8.9),Z=-2.352,P=0.023].Kaplan-Meier survival analysis showed significantdifference in the two groups (the Log Rank test 36.71,P ＜0.01).The levels of 3 predictive factors were predominantly higher in non-survivors than survivors [MEDS score:14.1 ± 6.7 vs.8.2 ± 4.5,t=-6.929,P=0.000; APACHE Ⅱ score:28.1 ±7.1 vs.22.2± 11.3,t=-6.472,P=0.000; lactate (mmol/L):5.4 (2.9,11.0) vs.3.8 (1.2,9.1),t=-6.472,P=0.004].The AUCs were 0.813,0.706 and 0.727 for MEDS score,APACHE Ⅱ score and blood lactate respectively.The predictive ability for 28-day mortality of MEDS score was better than blood lactate (P=0.008) and APACHE Ⅱ score (P=0.005).The AUC of MEDS score combined with lactate was 0.865,and 28-day mortality prediction was better than MEDS score (AUC 0.865 vs.0.813,P＜0.001).The sensitivity (83.1％),specificity (93.2％),positive prediction value (PPV,62.4％),and negative prediction value (NPV,92.1％) for MEDS score combined with lactate were highest among all predictors.Conclusion MEDS score combined with lactate is a good risk stratification tool for emergency patients with severe sepsis,and its prognostic capability is better than either MEDS score,APACHE Ⅱ score or blood lactate.

Objective:To attaine a new mode of pathological data managed by computer. Methods:All pathological data were collected into the system of pathological data management. Results:It was helpful to phomote the work officiency and easy for pathological data check up. Conclusion:By using computer operation, we can update the document collection efficiently. It is helpful for data review, and research.

This paper introduces the designing concept of the ECG treadmill system and discusses the methods of its realization.
Amplifiers, Electronic ; Computer Simulation ; Computer Systems ; Coronary Disease ; diagnosis ; Electrocardiography ; instrumentation ; methods ; Equipment Design ; Exercise Test ; instrumentation ; methods ; Humans ; Microcomputers ; Signal Processing, Computer-Assisted ; Software

Objective When pathologists from hospitals at various levels encounters pathological sections diffcult to make clear diagosis, it is necessary to invite pathologists from higher hosiptals or special hospitals for pathologic consultation.In the study, we compared the pathological diagnosis of cases sent to other hospitals for pathological consultation with the original diagnostic result to analyze the differences by the evaluation on the impact of these differences on the treatment and prognosis of these patients, which would provide an effective evidence for the quality control of pathological diagnosis. Methods Cases initially diagnosed at the de-partment of Nanjing General Hospital and later sent to other hospitals for pathological consultation from 2010 to 2014 were collected. All the diagnostic results were examined by at least 3 senior pathologists to find exact diffrences between consultation results and origi-nal diagnostic results. Results Among 2055 cases, it was found that there were 1813 cases (88.2%) without diagnostic discrepan-cy, while 218 cases (10.6%) with minor diagnostic discrepancy and 24 cases (1.2%) with completely distinct diagnostic results. Conclusion The diagnostic results of the vast majority of consultation cases are in accordance with the original results, despite of di-agnostic discrepancies in some cases due to the complexity of disease. Expert consultation has reference for the pathological diagnosis of complicated cases, which also plays a potent supervisory role on the quality control of original pathologic results.

Objective To investigate the effects of early rehabilitative training program on patients with acute myocardial infarction(AMI).Methods One hundred and twenty-two patients with AMI were randomly divided into early rehabilitation group(n=62)and control group(n=60).In addition to routine treatment,patients in rehabilitation group received early rehabilitative training mainly by walking exercise for two weeks.Results There were no significant differences in ventricular arrhythmia(Lown≥Ⅲ), extension of infarction and heart rate variability(HRV)between the two groups(P＞0.05).Forty of 62 patients(64.5%)in rehabilitation group had their left ventricular ejection fraction(LVEF)more than or equal to 50% in the 3~(rd)～4~(th)week after admission,significantly higher than that in control group(45.0%, 27/60 ;P＜0.01 ).By the end of the 4~(th)week after admission,25.8% of the patients in rehabilitation group showed positive in treadmill test,significantly lower than that in control group(38.3%,P＜0.01). Occurrence of angina pectoris and reinfarction and fatality in rehabilitation group were significantly lower than those in control group(P＜0.05)during their hospitalization and follow-up period.Patients in rehabilitation group stayed at hospital for(16?3)days in average,significantly less than that in control group[(27?4) days],with statistically significant difference(P＜0.05).Conclusion Early rehabilitative training for patients with uncomplicated AMI is not only safe and feasible,but also useful in improvement for their prognosis and quality of life.

Objective In order to play the role of pathological network management system better in pathological examination, this study explore the present status of new pathology network management system, give an objective evaluation for the operation condition, reveal the effectiveness and the existing problems of this system, and provide reference for its development and improvement.Methods The software of pathological network management system was applied to the pathological specimen reception, patient information and examination status query, pathological diagnosis and technology process, as well as the paraffin block archive, statistical analysis, data recording, and so on.At last, we recorded all the information and made a classification and arrangement.Results Pathological network management system was running normally through the whole process of pathologic examination, including specimen receiving, all examinations, print of pathological applications and spontaneous print of pathological reports in ward, which really achieve one-stop services.But the system has unstable phenomenon occasionally.Conclusion Pathological network management system links each examination process closely, which can improve the work efficiency, and provide scientific basis for pathology quality control.