Objective To explore the treatment method and clinical effect of LARS artificial ligament in treatment of combined anterior cruciate ligament(ACL) and posterior crueiate ligament (PCL) injuries of the knee under arthroscope. Methods Thirteen cases of ACL and PCL injuries were reconstructed with LARS ligament. The patients were followed up for 12-36 months. The International Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for functional evaluation. In the meantime, KT-1000 was employed to check anterior and posterior laxation of the knee. Results No knee infection or limitation of knee extension occurred. Knee flexion was 105° -125° (average 117°). At termination of follow up, 10 cases (77%) was graded as A and 3 (23%) as B according to IKDC. KT-1000 examination at 25° flexion showed that the difference of anterior laxation was less than 2 mm in 12 cases and 3-5mm in 1. KT-1000 examination at 70°flexion showed that the difference of anterior laxation was less than 2mm in 12 cases and 2-4 mm in 1. The Lysholm score was (63.8±2.9) points (49459 points) before operation and (91.1 ±2.7) points (88-95 points) at follow up, with statistical difference (P ＜0.01). Conclusion Reconstruction of ACL and PCL by using LARS ligament under arthroscope is a kind of minimally invasive, safe and effective method to treat ACL and PCL injuries of the knee, with good short term outcome.

Objective:To explore the molecular mechanism of Gold Theragran in the protection of renal function,and the inhibition of renal local rennin angiotensin(RA)system in the early diabetic nephropathy(DN),and to provide the theoretical and experimental data for clinical application to prevent the DN.Methods:The experimental rats consisted of 64 healthy SD rats,average 180-220g,female and male both a half,rat model of DN was established by improved method of YANG Junwei,s method of intraperitoneal injection of STZ after nephrectomy.8 Rats was taken as normal group,the rest of them were randomly divided into 5 groups:high,middle and low dose groups of Gold Theragran,Valsartan group,model group.In each group,blood glucose,blood lipids,urine microalbumin per 24 hours,KW/BW,renal angiotensin converting enzyme,plasma and renal angiotensin Ⅱ,and its type 1 receptor were observsd and measured.Results:①Rat's general status in each treatment group was improved compared with the DN model group.②The levels of serum glucose decreased in all treatment groups,especially the high-dose group and mid-dose group were significant(P0.05).③The levels of abnormally high lever of TG,TC decreased in treatment groups,especially the high-dose group and mid-dose group were significant(P0.05).The high-dose group had further function to regulate the lipids in the 28th day than in the 7th day(P0.05).Conclusion:Firstly,Gold Theragran had a therapeutic effect of protecting the renal function on the experimental DN rats;Secondly,Gold Theragran can inhibit the abnormal state of activated rennin angiotensin system in diabetic nephropathy,delay the development of diabetic nephropathy;Thirdly,with the treatment course prolonged,the effective of Gold Theragran might be more obvious,and different dose groups show dose-effect-dependent relationship.

Physical activity is closely related to the quality of life of postoperative patients with breast cancer, which is expressed in fre-quency, duration, intensity, and others factors. There is no uniform measurement of physical activity, the common measurements may be classified as subjective and objective, such as exercise log, physical activity questionnaire and self-reported physical activities of the former;doubly labeled water, indirect calorimetry, motion sensors and heart rate monitors of the latter. The age, educational level, social and eco-nomic status, and body mass index are related to the level of physical activity in patients post operation for breast cancer, while illness and treatment, psychological and social support, and health-related quality of life also affect the level of physical activity, which suggest that such patients need to improve their physical activity before operation.

Objective To study the activation of macrophage and upregulation of CD40 in neutropenic and nonneutropenic lipopolysaccharide (LPS)-induced acute lung injury (ALI).Methods Forty mice were randomly divided into four groups (neutropenic septic group,neutropenic control group,non neutropenic septic group and normal control group).The pathologic changes of mice lungs were observed after hematoxylin and eosin staining.CD40 expression was determined by flow cytometry.Cytokine tumor necrosis factor-α levels from bronchoalveolar lavage fluid (BALF) and serum were measured by ELISA.Results The average weight and peripheral blood white cell counts were increased significantly in the neutropenic group as compared to the non neutropenic group before the rats were sacrificed [(181.13 ± 16.94) g vs (168.56 ±5.03) g,(9.54 ± 1.25) × 109/L vs (2.56 ± 1.12) × 109/L,P ＜0.05,respectively].The cell counts in BALF were higher in neutropenic septic and non neutropenic septic groups compared to the normal control group [(3.33 ±0.26) × 106/L,(3.23 ± 0.06) × 106/L,(1.68 ± 0.23) × 106/L,P ＜ 0.05].The concentration of tumor necrosis factor-α from serum were increased significantly in neutropenic septic and non neutropenic septic groups as compared to the normal control group [(2 337.08 ± 1 148.85) pg/ml,(2 274.01 ± 1 569.37) pg/ml,(96.20 ± 93.69) pg/ml,P ＜ 0.05].The CD40 molecular expressions were higher in neutropenic septic and non neutropenic septic groups compared to the normal control group [(42.06 ± 11.90) ％,(46.38 ±7.42) ％,(21.62 ± 4.86) ％,P ＜ 0.01].Conclusion Upregulation of CD40 molecule induces the inflammatory cytokines releasing,then leads to ALI.Therefore both the inflammatory cytokines and CD40 play vital role in the pathogenesis of ALI.

Objective To investigate and evaluate the biomechanical property of the skin in pig's back in order to provide the essential theoretical basis for clinical and skin products.Method Taking the skin in pig's back as experimental material,the monotonic tensile and cyclic tension-tension tests with difierent loading rates was researohed respectivaly.Meanwhile,with different loading directions and stress levels the creep and cy-clic tension-tension tests were also been studied experimentally.Result The capacity of resisting tensile,creep and cyclic deformation of pig's skin in the direction along the Langer's line is stronger than that perpen-dicuiar to the Langer's line.The creep curve of pig's skin is load-dependent and consisted of three phases a-bout deceleration phase,stabilization phase and destruction stage.Pig's skin exhibits apparent ratcheting un-der asymmetry stress cycle.Ratcheting deformation displays significant mean stress,stress amplitude and loading speed dependence.Condusion Based on the experiment,the biomechanics property of skin's vis-coelasticity and anisotropic feature have been sysmarie stadied,it's provide necessaw theoretical fundation for clinical and leather products.

Objective To introduce the Bernese periacetabular osteotomy through ilioinguinal approach for the treatment of adult acetabular dysplasia. Methods From October 1997 to April 2001, 51 patients(53 hips) with acetabular dysplasia were operated upon with Bernese periacetabular osteotomies through ilioinguinal approach. The mean age of the patients at the time of surgery was 30.6 years(range, 13-48 years). Male∶female= 1∶10. Preoperatively, the average duration of the symptoms was 3.4 years(3 months to 15 years), the range of motion(ROM) of the hip was normal in most patients. Average CE angle was 1.1?(?15?-15?); the Tonnis osteoarthritis grade was Ⅰto Ⅱ. Fifty three percent of the hips had Shentons line broken. Results Twenty four hips had 12 to 38 months followed up. Most patients were pain free; the hip ROM remained normal. Harris hip score increased from 79.8(64-83) pre operatively to 93.8(75-100) post operatively. CE angle increased to 40?(20?to 60?). Shentons line broken rate decreased to 33%. The complications include: 1 femoral nerve damage, 1 bladder malfunction and 2 skin incision hernia. Conclusion The Bernese periacetabular osteotomy through ilioinguinal approach is a safe and efficient procedure for the treatment of adult acetabular dysplasia. The deformities could be easily corrected, the anatomic relations could be restored nicely, the pelvic ring and the abductor muscles are reserved. The post operative recovery is fast, and it is efficient to prevent the development of osteoarthritis of the hip joint.

Objective To evaluate the results of treatment with the high tibial osteotomy and fixtation with the new Giebel blade plate for osteoarthritis of the knee, and to discuss the indication for this technique. Methods Seventy patients(108 knees), 14 male and 56 female, with an average age of 59.6 years (range 38-76)were reviewed. The average postoperative follow up was 12 months (from 6 to 20 months ). Pain was complained chiefly in the medial aspect of the knee joint and the majority of patients had slight degree of genu varum. This new Giebel blade plate acts as a tension band when it is placed on the site for fixation, the proximal tibial fibular joint was not exposed during surgery so that the fibular head was well preserved, avoiding common peroneal nerve injury. The periosteum opposite to the incision position was left intact for the sake of the stability and acted as a hinge around which the wedge osteotomy was closed. AP and lateral radiography of knee joint was taken pre and post operation for comparison. Results During the follow up, the patients show satisfied pain relief, improvement of joint function, correction of the deformity either genu varum or valgum. Earlier rehabilitation exercise should be carried out and the complication was rare. Conclusion The characteristics of this method are its convenient application, the stable fixation and the well preserved joint function. The advantage of high tibial osteotomy was shown sufficiently by the use of Giebel blade plate.

Objective To observe the expression and the clinical significance of P 170 and CD 34 in primary acute myeloblastic leukemia (AML)patients.Methods The expression of P 170 and CD 34 was determined by flow cytometry in 30 AML patients.Results The P 170 positive rate was 36.67%,the patients with the P 170 positive expression had higher resistant rate to chemotherapy as compared with P 170 negative group(P

Objective To investigate the changes of plasma activated protein C(APC)in the pediatric leukemia patients with acute lung injury(ALI),and the relationship with the outcome.Methods During the study period(from Jan to Dec 2009),17 pediatric leukemia patients with ALI were selected.They were divided into neutropenic(n =10)and non-neutropenic(n =7)group.We collected the basic data including the age,gender,stage of chemotherapy,pediatric critical illness score,mechanical ventilation time,ICU time.The blood gas and plasma APC levels were detected on day 1 and day 4 of ALI onset.Results Compared with the non-neutropenic group,the neutropenic group had a significantly longer mechanical ventilation time [(16.60 ± 1 0.83)d vs(3.79 ± 4.08)d,P =0.009 6],lower PaO2 level on day l[(54.90 ± 17.05)mm Hg vs (92.70 ± 27.53)mm Hg,P =0.009 7],and lower APC level on day 4[(193.06 ± 63.19)pg/mlvs(286.28 ±25.12)pg/ml,P =0.007 7].Conclusion The APC generation is severely impaired in the neutropenic group,especially in those who died.The lower APC level is,the longer is the mechanical ventilation time,the worse is oxygenation,the poorer is the prognosis.APC replacement therapy may be promising in these patients.

Objective To assess the nutritional risk of patients with inflammatory bowel disease (IBD).Methods The nutritional status of 112 IBD patients from PUMC Hospital were evaluated by Nutritional Risk Screening 2002 (NRS 2002).Using Chinese standard,a body mass index (BMI) that was lowered than 18.5 kg/m~2 according to clinical material was regarded as malnutrition,and the score was recorded as 3.The se-verity of ulcerative colitis (UC) was evaluated using True-Love criteria as mild,moderate,and severe.Crohn's disease (CD) was evaluated using Harvey-Bradshaw Index as in remission stage (≤4),moderately active stage (4-8),and severely actively stage (≥9).Results All these 112 patients,including 70 UC cases and 42 CD cases,were evaluated by NRS2002.Forty-five patients (40.2%) were judged as at the risk of malnutrition.The incidence of malnutrition was significantly higher in CD patients than in UC patients (52.4% vs.32.9%,P<0.05).It was also significantly correlated with the severity of disease.In patients with severe IBD,the rate of mal-nutrition evaluated by BMI according to clinical material was significantly lower than the rate of nutritional risk.Con-clusions The risk of malnutrition is high in IBD patients.NRS 2002 can be used for nutritional risk screening.