OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.

METHODSFrom March 2008 to August 2012,22 patients (16 males and 6 females, ranging in age from 20 to 53 years old, with an average of 30.5 years old) with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL, combined with the repair of injuries in the posteromedial complex and soft-tissue. Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down. The ACL was reconstructed using the gracilis and semitendinosus tendons. The PCL was reconstructed using LARS artificial ligaments (14 cases), or gracilis and semitendinosus tendons (8 cases). Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients. Continuouspassive montion (CPM) and active exercises were executed after operation at early stage. The IKDC and Lysholm system were used to evaluate therapeutic effects.

RESULTSAll the patients were regularly followed up, and the duration ranged from 11 to 56 months (averaged, 39 months). According to the IKDC scale,9 patients got a grade A result, 10 got a grade B result, and 3 got a grade C result. The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up, which were both better than those before operation.

CONCLUSIONReconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; methods ; Female ; Humans ; Knee Dislocation ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To study the correlation between cognitive distress and tinnitus related handicaps.Methods One hundred and ninety-two primary tinnitus subjects ninety-nine males and ninety-three females were included in this study.The average age was 45±15.52 years old.The average durations of tinnitus for male and female were 25.67±37.71 months and 27.12±45.42 months, respectively.The patients were asked to fill the Mandarin tinnitus questionnaire (MTQ) and Mandarin (Chinese) tinnitus handicap inventory (THI-CM).The correlation between cognitive distress (CD) and tinnitus related handicap was studied.Results The average score of MTQ was 36.95±20.06.The average score of CD (Q17,18,23,41, and 42)was 2.61.The average score of question 17,18, 23,41, and 42 of MTQ was 2.81,2.63,2.59,2.40, and 2.41,respectively.The average score of THI-CM was 23.89±20.06.The correlation between CD and THI-CM was 0.64(P<0.01);for male and female were 0.63 and 0.66(P<0.01),respectively.The correlations between CD and THI-CM among young, middle and old age groups were 0.02,0.07 and 0.38(P>0.01),respectively.The correlations between CD and THI-CM among the nondisabled, mild, moderate and severe groups according to the scores of THI-CM were 0.30(P<0.01),0.29(P>0.01),-0.12(P>0.01), and 0.23(P>0.01),respectively.Conclusion No strong correlation was demonstrated between the CD and the THI-CM.The same results were shown for males and female.No correlation was demonstrated between ages and cognitive distress.Correlation coefficient of cognitive distress was increased with age.The tinnitus handicaps of patients might be vulnerable to cognitive distress with ageing.

Objective To study the relationship between psychological capital and quality of life (QL) in cancer patients and search for better corresponding nursing strategies. Methods Investigating psychological capital state in cancer patients, and analyzing the relationship between social support score and QL. Results Cancer patients′ positive psychological capital score were low: The total score were 74.33 ± 20.04, self-efficacy 20.87 ± 6.64, hope 22.12 ± 6.04, toughness 20.35 ± 5.65, and optimism 12.36 ± 5.55. Cancer patients had low quality of life, quality of life scores were 59.57±0.57, body condition 15.32± 5.90, psychological condition 47.74 ± 10.22, social function 20.46 ± 5.19,family situation 18.93 ± 8.89, total score 115.48±20.19;The psychological capital and quality of life of cancer patients were positively related (r = 0.517, P < 0.01), cancer patients dimensions of psychological capital was positively correlated with the dimensions of quality of life (r =0.189-0.517, P < 0.01). Conclusions Cancer patients′ positive psychological capital and the quality of life both need to be improved; Cancer patients′ psychological capital are closely related to the quality of life and we should pay attention to improve the patients′psychological capital so as to better their quality of life during the care process.

Objective To explore the real ear to coupler difference (RECD) changes in children with hearing aids .Methods 132 severe to profound hearing impaired children who came to hearing center for hearing aids exami-nation and adjustment were recruited into the study .They were put into 6 groups according to the test age ,<1 yr group(15 cases) ,1 yrs group(26 cases) ,2 yrs group(36 cases) ,3 yrs group(29 cases) and 4 yrs group(26 cases) . And all of them had the RECD tests for both ears with custom earmolds .Results The average RECDs for both ears decreased with the age increased .There were statistically differences for the same lateral ears when age differences surpass 2 years except for the difference for left ears between the children in the <1 yr group and 2 yrs group .This study showed there were statistically differences between left and right ears for majority of groups (except for 2 yrs group) .Conclusion RECD is an important factor for individual adjustment .The current results show that the chil-dren with hearing aids should have RECD tests for both ears at least once per two years .

Objective To investigate the detection rate and missed diagnosis reason of sacral canal cyst with sacroiliac joint CT scan.Methods Retrospectively analyzed the changes of sacral canal in 1 286 cases with sacroiliac joint CT scan.CT scanning included bone algorithm reconstruction and standard algorithm reconstruction.Results Among 1 025 patients who had negative sacroiliac joint CT scan were found in 36 cases of sacral canal cyst,the detection rate was 3.5％ (36/1 025).Single cyst in 34 cases and multiple cysts in 2 cases.Cyst in S1 level 5 cases,S1-2 level 4 cases,S2 level 22 cases,S2-3 level 4 cases,S3 level 3 cases.The minimal short diameter of the cysts was 0.5 cm and the maximal diameter was 3.2 cm,average 1.2 cm.CT scan showed a round uniform cystic low density,and combined with sacral canal expansion in 19 cases.CT scan used bone algorithm reconstruction in 29 cases,used standard and bone algorithm reconstruction in 7 cases.Clinical findings and correctly diagnosed in 11 cases,accounted for 30.6％ (11/36),about 69.4％ (25/36) cases were missed diagnosis.Conclusions About 3.5％ patients are found sacral canal cyst who have negative sacroiliac joint CT scan.Both the standard and bone algorithm reconstruction should be used to avoid the missed diagnosis of sacral canal cyst.

Background The pathogenesis of age-related cataract is associated with the apoptosis of lens epithelial cells (LECs) caused by oxidative stress.Previous studies showed that intracellular focal adhesion kinase (FAK) pathway can be activated by H2O2 in vitro,which induced apoptosis of cells.To investigate the effect of oxidative on FAK expression in LECs is one of important studies in the prevention of age-related cataract.Objective This study was to investigate the expression and function of FAK in human LECs treated by H2O2.Methods Human LECs strain (HLECs-B3) were cultured in vitro in the low glucose DMEM with 10％ fetal bovine serum.Different concentrations (0,30,50,70,100,300,500,700,1000 μmol/L) of H2O2 were added into the culture medium for 24 hours.The survival rate of the cells was detected by Cell Counting Kit-8 (CCK-8) assay.Cell morphology as well as the expression and distribution of FAK in the cells were observed by immunofluorescent staining under the laser confocal microscope.Apoptosis was observed by hoechst33258 staining,and Western blot assay was used to quantitatively detect the expression and phosphorylation of FAK.Results The survival rate of the cells was (1.00±0.03) ％,(1.24±0.03)％,(1.36±0.24) ％,(0.93±0.02)％,(1.75±0.19)％,(1.37±0.18) ％,(0.64±0.01)％,(0.59±0.11)％,(0.14±0.05)％ in 0,30,50,70,100,300,500,700,1000 μmol/L H2O2 groups,with a significant difference among them (F =95.30,P =0.00).The survival rates of the cells in the below 300 μmol/L H2O2 groups were significantly higher than those in the 0 μmol/L H2O2 group,and survival rates of the cells in the above 500 μmol/L H2O2 groups were significantly lower than those in the 0 μmol/L H2O2 group(all at P＜0.05).After H2 O2 treatment for 24 hours,HLECs-B3 cells transformed from polygon shape to spindle shape and extended pseudopodiums,meanwhile the green fluorescence for FAK exhibited in the cytoplasm.Cell apoptosis was found in the 1000 μ mol/L H2O2 group.Western blot assay revealed that the expressing levels (grey scale) were significantly different among the various groups (F=28.08,P=0.00),and FAK expressing levels in the below 300 μmol/L H2O2 groups were significantly higher than those of the 0 μmol/L H2O2 group; while the expressing levels in the above 500 μmol/L H2O2 groups were lower than those of the control 0 μmol/L H202 group (all at P＜0.05).After treated by different concentrations of H2O2,the phosphorylation level of intracellular FAK (p-FAK) was significantly higher in 3 hours group than that in 30 minutes group (all at P＜0.05).Conclusions H2 O2 can affect the survival,proliferation and morphology of human LECs by activating the intracellular FAK pathway,indicating that FAK may play roles in the regulation process of cell biological behavior.

Background Protein kinase B (Akt) is the center of multiple cellular signaling pathways,and it participates in the regulation of cell function,such as proliferation,migration,and metabolism of cells.Phosphoinositide 3-kinase (PI3K) promotes activation of Akt and therefore triggers many signal pathways.PI3K inhibitor can silent Akt,but whether it can affect the biological behavior of lens epithelial cells (LECs) during the posterior capsular opacity (PCO) is worthy of investigation.Objective This study was to explore the effect of LY294002,a PI3K inhibitor,on Akt activation in human LECs.Methods Human LECs strain,HLEC-B3 cells,were cultured and passaged.The cells were incubated to 96-well plate for 24 hours,then LY294002 was added with the final concentration at 0,10,20,30,40,50,60,70,80 μmol/L,respectively.After incubation for 24 hours,cell counting kit-8 (CCK-8) was used to detect the inhibitory rate of cell proliferation.Transforming growth factor-β2 (TGF-β2) of 10 μg/L was added in the medium of cells as TGF-β2 group,TGF-β2 + LY294002 (20 μmol/L) was used to coculture the other group of cells,and the cells without TGF-β2 and LY294002 served as the control group.Phosphorylation of Akt (p-Akt) in the cells was detected by laser scan confocal immunofluorescence microscope.The expression level of p-Akt was evaluated using Western blot.Results CCK-8 assay showed that the A value of the cells was gradually reduced with the increase of LY294002 concentration (Fgroup =9.72,P =0.00),but the A value was significant raised along with the lapse of time (Ftime =1737.54,P=0.00).Confocal immunofluorescence revealed that a little of p-Akt was expressed in the control cells.After induced by TGF-β2,lots of red fluorescence of p-Akt was seen in cells around the cell membranes.But in the TGF-β2+LY294002 co-culture cells,the fluorescence of Akt was much weaker.Western blot showed that the expression level of p-Akt was 0.91±0.08,1.48±0.13 and 0.95±0.19 in the control group,TGF-β2 group and TGF-β2 +LY294002 group,respectively,with a significant difference among the three groups (F =15.04,P =0.00).Conclusions LY294002 can inhibit the activation of Akt induced by TGF-β2.LY294002 may have utility in the prevention and treatment of PCO.

The study evaluates the lipolysis rate and extent of type Ⅲ lipid formulations using testosterone undecanoate as a model drug after digestion with in vitro lipolysis model, and studies the digestive regularity with optical microscope and electrical conductivity. The results showed that for testosterone undecanoate type Ⅲ lipid formulations with castor oil as oil phase and Transcutol HP as latent solvent, the lipolysis rate and extent were increased with the increase of oil phase proportion and were decreased with excessive proportion of surfactant, in which can see liquid crystal phase during lipolysis process. The lipolysis rate of type ⅢB lipid preparations with different surfactant were ordered as Labrasol > Tween 80 > Cremophor EL, but the rate of type ⅢA is different in quick digestion phase and slow digestion phase. The lipolysis extent of type Ⅲ lipid formulations with different surfactant were ordered as Cremophor EL > Tween 80 > Labrasol. These may be related to the digestive effect of pancreatic lipase on different surfactants. This study implied that the lipolysis rate and extent of type Ⅲ lipid formulations are greatly influenced by the proportion of oil phase and surfactant, and the surfactant structure. These factors will affect the in vivo digestion and should be taken into account when screening type Ⅲ lipid formulations.

?AIM:To evaluate the objective visual quality of patients who underwent corneal cross-linking for the keratoconus using double-pass analysis system.? METHODS: Advanced keratoconus patients who underwent UV - riboflavin corneal cross - linking from January to July 2015 were included. The outcomes of their objective scattering index ( OSI ) , predicted visual acuity ( VA ) , the cut - off frequency of modulation transfer function ( MTF cut- off ) , the Strehl ratio ( SR ) were compared before and 6mo after corneal cross-linking.?RESULTS: A total of 13 patients ( 16 eyes ) were included. There was no statistically significant difference between pre- and 6mo postoperative data in uncorrected visual acuity, best corrected visual acuity, refractions and mean value of Sim-k (P>0. 05). Non-invasive average tear film break up time ( NIAvg-BUT ) detected by the Sirius system decreased after corneal cross-linking ( P<0. 05 ) . Using double - pass analysis system, no statistically significant change was found in MTF cut off, Strehl Ratio, OSI before and after treatment(P>0. 05). Tear Film Analysis Mean OSI increased at 6mo postoperatively (P<0. 05).? CONCLUSION: The subjective visual quality isn’t effected by corneal cross-linking. The tear stabilities of patients are influenced by these operations at 6mo postoperatively. More observations on long-term effect are needed to be taken in the future.

Background Some aboard studies showed that polyatomic pathway play an important role in the microsvasculopathy of type 2 diabetes,and sorbitol dehydrogenase (SDH) gene is involved in the pathogenesis of diabetic retinopathy(DR).There is no relevant research at home up to now.Objective This study was to investigate the correlation of sorbitol dehydrogenase (SDH) G-888C gene polymorphism with diabetic retinopathy (DR) in type 2 diabetes mellitus.Methods The SDH genotypes were determined by polymerase chain reactionreaction fragment length polymorphism (PCR-RFLP) in 187 patients with diabetes and 123 normal contrels.Patients were divided into two groups depending on the presence or absence of DR(DR:n=118;NDR:n=69).The frequencies of SDH genotype and allele were assayed and compared among these groups.This study was approved by Ethic Committee of Guangdong General Hospital.Written informed consent was obtained from each individual prior to any relevant medical procedure.Results The disease course in the DR group was significantly longer than that in NDR group(t=2.070,P=0.042),and other clinical features in both groups were non-significant (all P>0.05).The genotype frequencies in the DR group,NDR group and normal control group were 24.6%,8.7% and 8.1%,respectively,and frequencies of the G allele were 42.4%,25.4% and 29.7%,showing statistically significant differences among these three groups.The GG genotype and G allele frequencies were significantly higher in the DR group than those in the NDR group and normal control group (GG:P=0.007,P=0.001;G:P=0.001,P=0.004).There were no significant differences in the frequencies of the GG genotype and G allele between the NDB group and normal control group ( P>0. 05) as well as the proliferative DR group and non-proliferative DR group (P>0.05).Conclusion SDH G-888C gene polymorphism is associated with the development of diabetic retinopathy in southern Chinese.