[Objective]To compare the immediate therapeutic effects of the treatment of gluteal muscle constracture(GMC)with arthroscopic release of contractured tissue and conventional surgery.To investigate the indications of arthroscopic surgery.[Method]Ninty-six limbs of 48 patients with traditional surgery and 84 limbs of 42 patients with arthroscopic surgery were analyzed in terms of operation time,length of the incision,postoperative pain,complications,the time of exercise,postoperative hospital stay and one-year recurrence rate.[Result]Arthroscopic surgery group had smaller incisions,earlier exercise,less postoperative pain and shorter hospital stay than conventional surgery group,but the two groups showed no significant difference in operative time,complications,effects of operation and one-year recurrence rate.[Conclusion]Arthroscopic release of contracture tissue is a safe,effective,economical and cosmetic way to treat the gluteal muscle contracture.This method is worthy of wide promotion.

BACKGROUND:Young patients with cruciate ligament injury and high activity levels are prone to grade III medial colateral ligament injury in knee joint. Conventional construction methods such as direct restoration of injured ligaments and muscle-tendon transposition may induce the loosening of medial colateral ligament complex. OBJECTIVE:To explore the clinical effect of autologous tendon transplantation for grade III medial colateral ligament injury of the knee joint. METHODS: Forty-seven patients with grade III medial colateral ligament rupture were treated by operative repair and reconstruction. After repairing the anatomical structure of medial colateral ligaments, we liberated organic semitendinous tendon, bone-patela tendon-bone, and hamstring tendon, to reconstruct superficial medial colateral ligament. RESULTS AND CONCLUSION:Thirty-seven patients were folowed up for 48 months. Preoperative Lysholm score, IKDC score, Tegner score at the final folow-up, and the widened medial joint space on valgus stress X-Ray films were significantly improved compared with before reconstruction (P < 0.05). According to clinical efficacy scores, 12 cases achieved excelent reconstruction, 18 cases achieved good reconstruction, 4 cases achieved moderate reconstruction, and 3 cases achieved poor reconstruction. The excelent and good rate was 82%. Medial colateral ligament reconstruction based on repairing the anatomical structure is effective and satisfactory. Autologous bone-patela tendon-bone or semitendinous tendon is a good choice for medial colateral ligament reconstruction.

Objective To investigate the clinical effects and related complications of surgical and endovascular treatments of paraclinoid aneurysms. Methods Seventy-two consecutive patients with paraclinoid aneurysm admitted to the Department of Neurosurgery, the First Affiliated Hospital of Soochow University were enrolled retrospectively. They were confirmed by head and neck CT angiography and DSA examination,including 45 females and 27 males. According to the different treatment modalities, 72 patients were divided into endovascular embolization group ( n=38,stent-assisted coil embolization) and microsurgery group (n=34,including aneurysm clipping or intracranial and extracranial vascular bypass plus trapping of aneurysms). The baseline data and aneurysm diameter of both groups were recorded and analyzed. Baseline data included age,sex,cranial nerve injury,Hunt-Hess grade,etc. The new cranial nerve injury,aneurysm recurrence and Glasgow outcome scale ( GOS) scores were compared between the two groups,and the size of recurrent and non-recurrent aneurysms were analyzed. The age, aneurysm diameter,and prognostic score were compared in patients with Hunt-Hess grade Ⅲ-Ⅳ in both groups. Results (1 ) The age of patients in the endovascular embolization group was older than that in the microsurgery group (60 ±10 years vs. 54 ± 10 years,t= -2. 490),the diameter of aneurysms was smaller than that of microsurgery group (5[4,8] mm vs. 9[5,16] mm,Z=3. 026). There were significant differences between the two groups ( all P <0. 05 ) . There were no significant differences in gender, incidence of visual impairment and Hunt-Hess grading between the two groups (all P >0. 05). (2) The patients of both groups were followed up for 6 months. There were no significant differences in GOS score, improvement of postoperative visual acuity,and immediate visual impairment after surgery ( all P>0. 05). The recurrence rate of aneurysms in the endovascular embolization group was higher than that in the microsurgery group. The difference was statistically significant between the two groups (18. 4%[7/38] vs. 2. 9%[1/34], χ2=4. 350,P<0. 05). (3) In the endovascular embolization group, the diameter of aneurysm in recurrent patients was larger than that in non-recurrent patients,and the difference was statistically significant between the two groups (10[8,15] mm vs. 5[3,7] mm,Z = -2. 356, P<0. 05). (4) For aneurysm patients with Hunt-Hess grade Ⅲ-Ⅳ, the GOS score of the endovascular embolization group was lower than that of the microsurgery group,and the difference was statistically significant (4[3,4] vs. 5[4,5],Z= -2. 282,P<0. 05]. Conclusion For paraclinoid aneurysms,the recurrence rate of aneurysms with microsurgical treatment is lower than that of endovascular embolization,and is beneficial to the prognosis of patients with Hunt-Hess grade Ⅲ-Ⅳ.