[Objective] To evaluate the curative effect of anterior cruciate ligament(ACL)reconstruction for remaining anteromedial or posterolateral bundle and ruptured fiber.[Method]Among 89 cases of ACL rupture,there were 32 cases of sports injury,24 cases training injury,23 cases traffic accidents and 10 cases sprained in daily life.ACL ruptured at the notch of the femur in 24 cases,and at the intercondyle of the tibial in 28 cases.Thirty-two cases were reconstructed with quadri-bundle Hamstring tendon knot press-fit technique and 20 cases were reconstructed with quadriceps tendon press-fit technique with autogenetic patellar bone.ACL anteromedial bundle(AMB)ruptured in 14 cases and posterolateral bundle(PLB)ruptured in 23 cases.The intact bundle and the remnants of ACL were preserved.AMB and PLB were reconstructed with double-bundle Hamstring tendon knot press-fit technique in 37 cases.Absorbable interference screws were used at the tibial tunnel and sutured tendon was knotted across the tibial bone bridge.[Result]The average duration of follow-up were 25 months(14-37 months).Lysholm knee function score increased by 27.7 scores,from average 67.5 scores of pre-operation to average 95.2 scores at the end of the follow-up.Rulermetr examination tibial translation was 4 mm?2 mm in 72 cases and 6 mm?3 mm in 17 cases.Lachman test was negative in 79 case,weakly positive in 8 cases and positive in 2 cases.The function of the knees were improved and the stabilization was strengthened after operation.According to knee therapeutic effect evaluation criterion,76 cases were excellent and 13 cases were good.[Conclusion]To keep the remaining of anteromedial or posterolateral bundle and ruptured fiber for ACL reconstruction is beneficial for the graft revascularization or healing,and is helpful for the position sense or rehabilitation.

Objective To assess the left ventricular contraction asynchrony in patients with acute myocardial infarction(AMI) by velocity vector imaging(VVI).Methods Sixty AMI patients and 40 healthy volunteers were included.Using VVI,the time to peak longitudinal systolic velocity (TL-V) was measured in the left ventricular long axis views,the time to peak radial systolic velocity (TR-V) was measured in parasternal short axis views.The deviation of the earliest and the latest TL-V and TR-V (Ts max-min) was measured,and the standard deviation of TL-V and TR-V (TS-SD) was also measured.Results ①TL-V ,TR-V of the infarcted and non-infarcted segments in patients with acute myocardial infarction were longer than those of the normal segments (P ＜0.05).②The longitudinal Tsmax-min,Ts-SD and the radial Tsmax-min,Ts-SD in infarcted patients were increased compared with the healthy volunteers (P ＜0.001).③Ts of the infarcted segments was increased in turn from the class Ⅰ to class Ⅳ of the cardiac function (P ＜0.001).Conclusions VVI could be used to assess the left ventricular contraction asynchrony in patients with AMI.VVI is a new useful method to determine the infarcted segments.

Objective:To study the feasibility,safety and effectiveness of intrapericardial injection with a trans-diaphragmatic approach in rats and its value in the study of heart diseases. Methods:Blue-black ink,recombinant adeno-associated virus carrying enhanced green fluorescent protein((eGFP)) gene,0.9% sodium chloride solution were respectively injected into pericardium of rats in three different groups(Group ink,Group eGFP and Group sodium chloride) by intrapericardial injection with a trans-diaphragmatic approach.Autopsy was done and hemodynamic parameters were measured and cryosection was analyzed by fluorescence microscopy. Results:The injection was proved successful in all rats in Group ink.Green fluorescence was detected in cryosection of all hearts in Group eGFP and the expression of green fluorescent protein was ubiquitously,but not homongeneous.No rat died during and after the operation among the operated rats(rats in Group eGFP and Group sodium chloride).There was no difference between hemodynamic parameters of the operated rats and those of the controls.Conclusion:The intrapericardial injection with a trans-diaphragmatic approach is a simple,feasible,safe and valid operation and suitable for small experimental animals.And it suggests an easy, safe,efficient and cheap technique in the study of heart diseases.

Objective To speculate the contents changes and clinical significance of heme oxygenase-1(HO-1) and unconjugated bilirubin (UCB) in the patients with acute cerebral infarction.Methods HO-1 and UCB in blood serum were measured in these patients with acute cerebral infarction(ACI) and control group at one day, third day,and sixth day after the onset by ELISA and oxidation of vanadate. Results The content of HO-1 and UCB in serum decreased step by step at the first day, third day, and sixth day after the onset. The level of HO-1 displayed a positive correlation with the UCB in serum in the first day after the onset (r=0.645, P

Objective To study the short-term therapeutic effects of adeno-associated viral gene transfer of sarcoplasmic reticulum Ca2+-ATPase (SRCA2a) on chronic heart failure (CHF). Methods The rats were divided into four groups: control group, CHF group, CHF+eGFP group and CHF+SRCA2a group. CHF rats were obtained by creating descending aortic constriction. 0.9% sodium chloride solution, recombinant adeno-associated virus carrying enhanced green fluorescent protein (eGFP) gene, and recombinant adeno-associated virus carrying SRCA2a gene, were respectively injected into pericardium of heart failure rats in different groups by intrapericardial injection via trans-diaphragmatic approach. 10 days after gene transfer, hemodynamic parameters, the protein expression of SRCA2a and the SRCA2a activity were measured and analyzed respectively. Results 10 days after gene transfer, the protein expression and activity of SRCA2a were increased by 80.7% and 89.9% respectively, but still lower than those in the control rats. The heart function was also improved along with the increase of SRCA2a expression and activity. The left ventricular systolic pressure and the maximal rate of decline of left-ventricular pressure in CHF+SRCA2a group were similar with those of the controls. The left ventricular end-diastolic pressure and the maximal rate of rise of left-ventricular pressure were much improved, but did not reach the level of the controls. Conclusions SRCA2a protein levels and activity are significantly decreased in CHF rats. Adeno-associated viral gene transfer of SRCA2a can improve the function of the heart in short term.

[Objective]The purpose of this study is to investigate articular cartilage injuries in patients undergoing arthroscopy of knee joint.[Method]From November 2004 to September 2005,568 patients underwent arthroscopy in the orthopedic department of Chinese PLA General Hospital.[Result]Totally 923 cases of articular cartilage injuries in 389 patients were documented,with the incidence rate of 68%.The main articular cartilage injuries were found on the medial femoral condyle(26%)and patella(25%).The incidence rate had signicant difference between patients over and under 40 years(88% VS 36.5%).Patients between 40 and 60 years were most susceptable to articular cartilage injuries.[Conclusion]Articular cartilage injuries are common in patients after arthroscopy.Early arthroscopy and treatment may benefit the patients.

Cr. The potential ecological risk index of the whole regions had reached the middle level,and that of Hg had already reached the degree of strong hazard. Conclusion The long-term sewage irrigation has caused serious heavy metals pollution in the soil of irrigation regions.

Articular cartilage injury is a problem in the field of orthopedics,osteochondral allografis transplantation is an effective way in the treatment of articular cartilage injuries.The article summarizes the research advances of osteochondral allograft transplantation,including the indication and contraindication of the methods,currently application in clinical treatment,and further exploring three hot topics in the osteochondral allograft transplantation,such as the spread of diseases,immune rejection and graft preservation.These literature review showed that osteochondral allograft transplantation to repair cartilage damage has a specific advantage,but still has some problems for further promoting.

[Objective]To analyze the characteristics of articular cartilage lesions in knees and evaluate the therapeutic efficacy of microfracture technique under arthroscopy for articular carrtilage lesions.[Method]A total of seventy-nine patients with articular cartilage lesions were treated with the microfracture technique.Thirty-eight patients were males and forty-one were female,with the mean age of 38.3 years(15~57years).The averaged preoperative duration of symptoms was 11 months(3~23 months).After preparation of the lesion,used an arthroscopic awl to make multiple holes,results in microfracture holes approximately 3mm apart and the depth approximately 3 mm.[Result]A total of 131 articular cartilage lesions were found in Seventy-nine patients,for an average of 1.6 lesions per case.The main lesion was found on the medial femoral condyle in 33.6% and the patella in 22.1%;60.3% of lesions were grade Ⅳ according to Modified Outerbridge Scale;In 43.5% of the lesions the total area was from 1~2 cm2.Seventy-three patients were followed up for 17 months in average(10~33 months).At the time of the latest follow-up,79.7% of patients were satisfied with the results.According to Lysholm knee evaluation system,the mean scores was improved from 43 points preoperative to 88 points postoperative.[Conclusion]Arthroscopic microfrature is simple and effective to repair of articular cartilage lesions of knee joint.This method can release pain and improve joint function.