BACKGROUND:Femoral tunnel suspensory fixation device for anterior cruciate ligament reconstruction has a certain clinical comparison. However, there are a few fixture researches on the expansion of bone tunnel and graft changes.
OBJECTIVE:To observe the short-period effect of femoral tunnel side fixtures Endobutton and Tightrope used in autologous hamstring anterior cruciate ligament reconstruction on bone tunnel and implant change.
METHODS:Twenty-three patients with anterior cruciate ligament injuries received one-stage hamstring reconstruction, including 13 cases of femoral tunnel fixation with Endobutton and 10 cases with Tightrope. Tibial tunnel used extrusion screws. We observed operation time, recent effects after operation (Lysholm knee score, IKDC score) and the postoperative change of femoral tunnel diameter and graft length.
RESULTS AND CONCLUSION:(1) Twenty-three cases were fol owed up for 9-12 months, averagely 10 months. (2) Joint motion was not limited in both groups. No significant difference in IKDC and Lysholm scores was determined between the two groups (P>0.05). (3) Graft length and femoral tunnel diameter were significantly higher in the Endobutton group during final fol ow-up compared with that at 1 week postoperatively (P<0.05). (4) These results suggested that the recent effects were similar between Tightrope and Endobutton fixation, but Tightrope fixation device reduces the length of graft and the extent of bone tunnel enlargement.

Objective: To observe the clinical efficacy of moxibustion at Baihui (GV20) plus Tuina (Chinese therapeutic massage) for children with postnasal drip syndrome (PNDS).Methods: A total of 60 cases were divided into an observation group and a control group according to the random number table method, with 30 cases in each group. Cases in the control group received mometasone furoate nasal spray and nasal irrigation with 0.9％ normal saline. Cases in the observation group received additional moxibustion at Baihui (GV20) plus Tuina at the head and face. All the cases were treated for four consecutive weeks. The clinical efficacy and traditional Chinese medicine (TCM) symptoms score were compared between the two groups. Results: The total effective rate of the observation group was 93.3％ while that of the control group was 70.0％. The difference between the two groups was statistically significant (P<0.05). After treatment, the TCM symptom scores in both groups declined significantly, showing a statistical difference from that before treatment (P<0.05), and the score of the observation group was notably lower than that of the control group (P<0.05). Conclusion: The clinical efficacy of moxibustion at Baihui (GV20) plus Tuina at the head and face on the basis of nasal spray with Western medicine is more significant than that of Western medicine alone for PNDS in children.

Objective: To observe the efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate for hip involvement in ankylosing spondylitis (AS). Methods: A total of 60 patients with hip involvement in AS were randomly divided into a control group and an observation group, with 30 cases in each group. The patients in the control group were given an intra-articular injection of sodium hyaluronate, once a week. The patients in the observation group were given additional warm needling moxibustion, once a day, with a 2-day interval after five consecutive days of treatment. After 5 weeks, changes in such indicators as visual analog scale (VAS) score, Harris score, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), serum cartilage oligomeric matrix protein (COMP), interleukin (IL)-17 were observed, and the efficacy was evaluated. Six months after treatment, Bath ankylosing spondylitis radiology index-hip (BASRI-hip) was evaluated. Results: After treatment, the total effective rate in the observation group was higher than that in the control group (P<0.05). After treatment, the VAS scores in both groups were lower than those before treatment (P<0.05), and the score of the observation group was lower than that of the control group (P<0.05). After treatment, the Harris scores of both groups were higher than those before treatment (P<0.05), and the score of the observation group was higher than that of the control group (P<0.05). Six months after treatment, the BASRI-hip score of the control group was higher than that before treatment (P<0.05), while the score of the observation group was not significantly different from that before treatment (P>0.05) and was lower than that of the control group (P<0.05). After treatment, the scores of BASDAI and BASFI of both groups were lower than those before treatment (P<0.05), and the scores of the observation group were lower than those of the control group (P<0.05). After treatment, the levels of serum COMP and IL-17 of both groups were lower than those before treatment (P<0.05), and the levels of the observation group were lower than those of the control group (P<0.05). Conclusion: The efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate for hip involvement in AS is better than the intra-articular injection of sodium hyaluronate alone. This combined approach can alleviate hip pain, improve hip functions, delay the destruction of the hip, prevent AS development, and reduce the levels of serum COMP and IL-17.

Objective: To explore the feasibility of needling the Belt Vessel (BV) for low back pain. Methods: The relevant literature was systematically reviewed; the relationship between the BV and low back pain was illustrated; the clinical features of BV-related low back pain as well as the key points of acupoint selection in treatment were summarized, and the efficacy of needling the BV for treating low back pain was observed. Results: The BV is closely related to low back pain. The main clinical manifestations of BV-related low back pain include sagging distension in the low back, enlarged abdomen, and pain radiating to the groin. The main acupoints for treating low back pain via needling the BV include Mingmen (GV4), Wushu (GB27) and Ashi points near the transverse process of the third lumbar spine. Needling the BV can swiftly and effectively relieve both the low back pain and associated symptoms. Conclusion: Needling the BV can effectively alleviate the typical BV-related low back pain.

Objective To evaluate the effect of tranexamic acid on the risk of venous thrombosis after operation in patients undergoing revision total hip arthroplasty.Methods Fifty-six ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 35-64 yr,with body mass index of 20-25 kg/m2,scheduled for elective revision total hip arthroplasty,were randomly divided into 2 groups (n =28 each):control group (group C) and tranexamic acid group (group T).After induction of anesthesia,the patients were tracheally intubated and mechanically ventilated.After intubation,tranexamic acid 15 mg/kg was injected intravenously followed by infusion at a rate of 10 mg·kg-1 ·h-1 in group T,while the equal volume of normal saline was given instead of tranexamic acid in group C.Before operation,at the end of operation,and at 6 and 24 h after operation,venous blood samples were obtained for routine blood test and for determination of parameters of coagulation.The intraoperative blood loss and blood salvage,volume of drainage within 24 h after operation and transfusion of allogeneic blood were recorded.The development of venous thrombosis in the lower extremity was recorded with Doppler ultrasound on 7th day after operation.Results Compared with group C,the intraoperative blood loss and blood salvage,volume of drainage within 24 h after operation and transfusion of allogeneic blood were significantly reduced,and hemoglobin and hematocrit were increased at the end of operation and different time points after operation (P ＜ 0.05),and no significant changes were found in activated partial thromboplastin time,prothrombin time and fibrinogen in group T (P ＞ 0.05).The incidence of venous thrombosis in the lower extremity was 18％ and 14％ in C and T groups,respectively,and there was no significant difference between the two groups (P ＞ 0.05).Conclusion Tanexamic acid infused at a rate of 10 mg· kg-1 · h-1 after a loading dose of 15 mg/kg injected during operation dose not increase the risk of venous thrombosis after operation in patients undergoing revision total hip arthroplasty.

BACKGROUND:Understanding the actions and underlying mechanisms of proteins in cel s and organisms and studies on the lumbar disc herniation (LDH)-associated proteins contribute to further clarify the LDH pathogenesis. OBJECTIVE:To analyze the serum proteome changes in LDH patients using two-dimensional gel electrophoresis-tandem mass spectrometry, and to screen the biomarkers for LDH diagnosis and treatment. METHODS:Twenty-five LDH patients were enrol ed and their serums were col ected before and after treatment. After removal of high abundant protein, the serum protein spectrum was compared after two-dimensional gel electrophoresis serum protein spectrum diagram, to look for differential protein spots. Subsequently, the differential protein spots were identified by MALDI-TOF/TOF technique combined with biology software and database retrieval. RESULTS AND CONCLUSION:Six differential protein spots were screened preliminarily, and three kinds of proteins were confirmed after mass spectrum detection, among which, acid glycoprotein was related to the LDH immune regulation and occurrence, development and targeting sites of chemical radiculitis. The expression level of acid glycoprotein was significantly decreased in LDH patients after treatment (P<0.05). These results suggest that acid glycoprotein is associated with LDH through gel electrophoresis-base proteome analysis.

Objective: To observe the clinical efficacy of row needling at the Governor Vessel on the head for poststroke insomnia, analyze the changes of sleep structure, serum amino acid neurotransmitters, vascular endothelial cell function and cognitive function, in order to explore the mechanism of this therapy.Methods: A total of 41 patients with poststroke insomnia were included in an observation group and treated with row needing at the Governor Vessel on the head; 33 patients with poststroke insomnia were included in a control group and given routine acupuncture treatment. The patients in both groups were treated consecutively for one month. The efficacy was observed and the changes of related indicators were compared. Results: After treatment, the efficacy of the observation group was better than that of the control group (P<0.05). The sleep latency in the observation group was shorter than that in the control group (P<0.05); the total sleep duration, deep sleep duration, light sleep duration and rapid eye movement sleep duration in the observation group were significantly longer than those in the control group (P<0.05); the total waking duration and the waking times over 5 min were significantly less than those in the control group (P<0.05). The serum glutamic acid, γ-aminobutyric acid, calcitonin gene-related peptide, brain-derived neurotrophic factor, nerve growth factor and nitric oxide levels were significantly higher than those in the control group (P<0.01). The tumor necrosis factor-α, interleukin-6, bradykinin, and endothelin-1 levels were lower than those in the control group (P<0.01). The Pittsburgh sleep quality index score in the observation group was lower than that in the control group (P<0.01), and the mini-mental state examination score was higher than that in the control group (P<0.05). Conclusion: Row needling at the Governor Vessel on the head can effectively improve the sleep structure, cognitive function, and sleep quality of patients with poststroke insomnia. The possible mechanisms are regulating serum amino acid neurotransmitters and improving the function of vascular endothelial cells.

Objective: To observe the clinical effect of thumbtack needles combined with pediatric Tuina (Chinese therapeutic massage) for constipation in children caused by liver depression and Qi stagnation.Methods: A total of 60 children with constipation caused by liver depression and Qi stagnation were randomly divided into a combined group and a Tuina group, with 30 cases in each group. The cases in the Tuina group were treated with pediatric Tuina, while those in the combined group were treated with additional thumbtack needle therapy. We observed the clinical efficacy and the change in the number of spontaneous bowel movements per week before and after treatment. Results: After treatment, the cure rate and the total effective rate in the combined group were higher than in the Tuina group, showing statistical significance (P<0.05). Compared with the same group before treatment, the number of spontaneous bowel movements per week in both groups increased after treatment (P<0.05). With the progression of treatment, the number of spontaneous bowel movements per week increased in both groups, and the number in the combined group was more than that in the Tuina group, showing statistical significance (P<0.01). Conclusion: Thumbtack needles combined with pediatric Tuina is more effective than pediatric Tuina alone in the treatment of constipation in children caused by liver depression and Qi stagnation.

Objective:To observe the effect of acupuncture combined with vitamin B12 point injection on pain severity in patients with discogenic low back pain and to analyze its potential mechanisms. Methods:A total of 96 patients with discogenic low back pain were randomly divided into two groups.The control group received acupuncture treatment,while the combined group received vitamin B12 point injection in addition to the identical acupuncture treatment in the control group.Both groups were treated for 2 weeks.The visual analog scale(VAS)and Oswestry disability index(ODI)scores were compared before treatment,after 1 week of treatment,and after 2 weeks of treatment.The levels of such serum inflammatory factors as tumor necrosis factor(TNF)-α and interleukin(IL)-6,serum beta-endorphin(β-EP),and prostaglandin(PG)E2 were compared before and after treatment.Adverse reactions and clinical efficacy were compared between the two groups after treatment. Results:The total effective rate in the combined group was higher than that in the control group(P<0.05).The VAS and ODI scores in the combined group after 1 week and 2 weeks of treatment were lower than those in the control group at the same time point(P<0.05).The levels of TNF-α,IL-6,and PGE2 in the combined group were lower than those in the control group after treatment(P<0.05),while the level of β-EP was higher than that in the control group(P<0.05).There was no statistical difference in the overall incidence of adverse reactions between the two groups(P>0.05). Conclusion:Acupuncture combined with vitamin B12 point injection can alleviate pain and promote functional recovery in patients with discogenic low back pain;reducing the levels of TNF-α,IL-6,and PGE2 and increasing the level of β-EP may be part of the mechanism of the therapy.

Objective:To observe the effects of muscle regions of meridians needling method combined with auricular point sticking on pain and lumbar range of motion in patients with chronic nonspecific low back pain. Methods:A total of 100 patients with chronic nonspecific low back pain were randomly divided into a control group and an observation group,with 50 patients in each group.Both groups received auricular point sticking treatment,while the control group received additional conventional acupuncture treatment,and the observation group received additional muscle regions of meridians needling method.The total effective rate of the two groups was compared after 4 weeks of treatment.Before treatment and after 1 week and 4 weeks of treatment,the visual analog scale(VAS)score was used to assess the degree of low back pain,and the modified-modified Schober(MMS)score was used to evaluate the lumbar range of motion. Results:There was statistical significance in comparing the total effective rate between the two groups(P<0.01).During the treatment process,as the number of treatments increased,the VAS score gradually decreased,and the MMS score gradually increased in both groups.After 1 week and 4 weeks of treatment,the VAS score in the observation group was lower than that in the control group(P<0.01),and the MMS score in the observation group was higher than that in the control group(P<0.01).During the treatment period,no serious adverse reactions occurred in either group. Conclusion:Based on auricular point sticking treatment,muscle regions of meridians needling method is more effective than conventional acupuncture in treating chronic nonspecific low back pain since it is able to significantly reduce the pain and improve the lumbar range of motion.