Objective To investigate the outcome of augmentation of posterior cruciate ligament (PCL) using suture fixation technique. Methods Thirteen cases of simple PCL raptures were treated arthroscopically with suture fixation to maintain tibial neutralization and augment PCL. The patients were followed up for 12 to 18 months. The IKDC and Lysholm knee score were used for function evaluation. The posterior knee laxity was examined by KT-1000. Results There was no limitation to knee extension.Knee flexion was between 120° and 140°, with an average of 128°. The final IKDC grade was A in 6 cases and B in 7 cases. The IKDC subjective score increased from preoperative 67.4±3. 3 to postoperative 92.5±4. 5 (t=9. 837, P < 0. 01) . The average side-to-side difference in maximal manual test with KT-1000 arthremeter at 90° flexion decreased from 8. 1±1.7 mm to 2.0±1.3 mm ( t = 12. 230, P < 0. 01) . The Lysholm score in the 4 chronic cases was 87.5±3. 1 before surgery and 95.8±3.5 at the last follow-up( t = 5. 376, P < 0.01 ). Conclusion In some cases of PCL injury, excellent clinical results and good posterior stability can be achieved by augmentation of the tom PCL using suture fixation technique.

Objective To investigate the feasibility and clinical effect of the posterolateral depressed tibial plateau fracture by arthroscopically assisted treatment. Methods From March 2006 to September 2007, 26 patients with the posterolateral depressed tibial plateau fracture were reduced by arthroscopy and fixed laterigradely with lag screw through the capitulum fibulae. There were 17 males and 9females, and the patient age at surgery ranged from 19 to 58 years (mean, 34.5 years). According Schatzker classification, type Ⅱ for 21 patients, type Ⅲ for 5 patients. The injury mechanism included traffic injury for 15 cases, building injury for 4 cases, and sport injury for 7 cases. All patients were performed arthroscopy mean 8 days after injury. The operation time, bone union time, full weight-bearing time, range of motion, and related complications in all patients were observed, and HSS scores were used to evaluate the knee function. Results All patients got followed up. The follow-up periods ranged from 4 to 11 months (mean, 9 months). The mean operation time was 35 minutes (range, 20 to 50 minutes). The mean full weight-bearing time and radiographic bone union time were 11 and 13.1 weeks respectively, and the average ROM was 135°. None of the cases was found for infection, deep vein thrombosis, compartment syndrome, screw loosing and broken. The average HSS scores was 93 at the ultimated follow up (range, 84 to 98). There were 25 excellent cases, and 1 good case. The excellent and good rate was 100%. Conclusion Arthroscopically assisted treatment of the posterolateral depressed tibial plateau fracture was an very effective treatment methods, which showed less invasive and direct good reduction.

Objective To investigate effects of arthroscopic reconstruction of medial patellofemoral ligament (MPFL) using partial peroneus longus tendon autograft in treating recurrent patellar dislocation.Methods Forty-six patients (53 knees) with recurrent dislocation of patella received autologous partial peroneus longus tendon grafting for MPFL reconstruction after arthroscopic lateral retinaculum release from May 2009 to April 2010.Anatomic relation between femoral trochlea and patella,and motion path of patella were observed arthroscopically in adjustment of flexion and extension strength of grafted tendon in different angles.Successively,the tendon ends were fixed within bone tunnel of medial femoral condyle by using absorbable interface screws with synchronous superomedial displacement of tibial tuberosity.Stability of patellofemoral joint,dislocation recurrence,subjective symptoms of affected knees and general function recovery condition of affected limbs were studied.Results All patients were followed up for average 18 months (range,12-24 months),which showed the improvement of knee joint stability,without recurrence of patellar dislocation.Apprehensive test was negative.Axial X-ray films and CT of patella showed normal anatomical relation of patellofemoral joint.The Kujala patellar stability questionnaire scored (54.6 ±5.4) points before operation and (92.3 ±8.9) points after operation (t =55.41,P ＜ 0.01).All patients showed some improvement of motor ability after operation.CT examination showed that the congruence angle of patella and femoral trochlea was improved from preoperative (27.8 ± 8.1) ° to postoperative (2.3 ± 9.4) ° (t =20.87,P ＜ 0.01).Otherwise,ankle joint in the tendon donor site acted well,with normal function.Conclusion Arthroscopic lateral patellar retinaculum release and MPFL reconstruction using partialperoneus longus tendon autograft are effective in treatment of recurrent patellar dislocation in combination with superomedial displacement of tibial tuberosity,and avoid potential complications in tendon removal from around knee joint.

Objective To investigate the effect of body weight on the induction of mild hypothermia in a rabbit model of asphyxia cardiac arrest. Methods Twenty-four rabbits were randomized into two groups: the ice bag group and the intravenous 4℃ saline group. Cardiac arrest was induced and after 3 minutes of cardiac arrest, cardiopulmonary resuscitation was begun. Simultaneously, mild hypothermia was induced by putting an ice bag over the abdomen or infusion of 4℃ saline via an ear vein. A 2℃ decrease of rectal temperature was considered as the completion of hypothermia induction. Induction times were recorded, compared, and analyzed with respect to body weight. Results All rabbits had restoration of spontaneous circulation (ROSC) and ROSC lasted during the experiment. Induction time in the ice bag group was significantly shorter than that in the intravenous 4℃ saline group (22.8±4.7 min VS 42.5±4.0 min, P< 0.001). Induction time significantly correlated with body weight in the ice bag group (Pearson Correlation: r = 0.725, P = 0.029), but not in the intravenous 4℃ saline group (Pearson Correlation: P = 0.418). Conclusions In a rabbit model, induction of mild hypothermia with an ice bag is faster than with intravenous 4℃ saline; induction time positively correlates with body weight when an ice bag is used, but not when intravenous 4℃ saline used. The effect of body weight should be considered when choosing an appropriate method to achieve early induction of mild hypothermia.

Objective To describe the surgical technique and outcomes of arthroscopic reconstruction anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) and repair of the injured posteromedial complex (PMC) or posterolateral complex (PLC) structures of the knee joint in treatment of multiple ligaments injuries of knee. Methods From March 2005 to May 2007, 43 patients with multiple ligaments injuries of knee underwent arthroscopic reconstruction. Twenty-four patients were treated with arthroscopic reconstruction of combined ACL and PCL with allograft tendons and augmentation of PMC. The other 19 patients were treated with repair the PLC in addition to reconstruction of ACL and PCL. The International Knee Documentation Committee (IKDC) and Lysholm knee score were used for function evaluation. Results All patients were followed up for 24 to 48 months with an average of 33.10±9.65 months. The stability recovered when stress was applied to the knee at 0° and 20° of flexion. According to IKDC there was a significant improvement from severely abnormal (graded D) in 43 cases before surgery to normal (graded A) in 29 cases (67%), nearly normal (graded B) 11 cases (26%) and abnormal (graded C) 3 cases (7%) at follow-up. The average Lysholm score of the all cases were 46.7±4.2 and 89.6±2.8 before operation and at final follow-up, respectively (t=8.563, P＜0.01). Conclusion Excellence clinical results and good stability were achieved with arthrescopic reconstruction of ACL and PCL combined with repair or augmentation of the PMC and PLC simultaneously.

Objective To introduce an augmentation technique with 4-strand semitendinesus ten-don in treatment of partial anterior cruciate ligament (ACL) injury of under arthroscope and investigate the clinical outcome of the technique. Methods A total of 26 patients with posterolateral bundle rup-tures of ACL were treated arthroscopically with 4-strand semitendinosus tendon augmentation. The Inter-nationnal Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for evaluation of knee function. The side-to-side difference in anterior knee laxity was examined by KT-1000 (25 de-grees flexion and 301b). Results There was no knee extension limitation, with knee flexion of 130°-150 °(average 142°). The patients were followed up for 12-18 months, which showed grade A in 25 pa-tients (96%) and grade B in one (4%) according to IKDC grade at final follow-up. The subjective IK-DC score was increased from preoperative (71.4±3.7) points to (95.8±3.4) points at final follow-up (t =9.836,P <0.01). The average side-to-side difference in maximal manual test with KT-1000 ar-thrometer at 25° flexion decreased from preoperative (5.1±1.2) mm to (2.1±1.3)mm at final follow-up (t = 10.48 ,P < 0.01). The Lysholm score of all patients was (76.7±3.2) preoperatively and (95. 7±2.4) at final follow-up (t =7.356,P<0.01). Conclusion Augmentation with 4-strand semiten-dinosus tendon under arthroscope can attain excellent clinical results and good anterior stability in treat-ment of partial tears of posterolateral bundle of ACL.

Objective To investigate the epidemiological characteristics of acquired immune deficiency syndrome (AIDS) in Shandong Province,and to provide scientific evidence for formulating prevention and control strategy and carrying out effective measures.Methods Epidemiological data of reported human immunodeficiency virus (HIV) infection and AIDS cases (HIV/AIDS) in Shandong Province from 1992 to 2011 were analyzed.Results A total of 4313 cases of HIV/AIDS were confirmed and reported by the end of 2011,with an average incidence of 2.39 parts per million (ppm) annually.An upward trend was showed for annual reported incidence.The top 5 cities of incidence were Ji'nan,Qingdao,Zibo,Weifang and Weihai,which were 5.72 ppm,4.39 ppm,3.29 ppm,3.10 ppm and 3.02 ppm,respectively.The average annual reported incidence was 3.74 ppm for male,which was significantly higher than that for female (1.39 ppm; x2 =743.96,P＜0.05).The reported incidence was highest among 20-29 age group (5.56 ppm),with 57.18％ of homosexual transmission.The proportion of homosexual transmission in annual reported cases increased from 1.82％ in 2004 to 37.49％ in 2011.Conclusions The epidemic situation of AIDS in Shandong Province is severe,with unbalanced geographical distribution.Sexual transmission is the main route of transmission,and cases of homosexual transmission increase sharply.

Glioma is one of the most common and invasive malignant tumors in the central nervous system. The Wnt-β-catenin signaling pathway is a classical Wnt pathway, which is involved in the occurrence and development of glioma and other tumors. Long non-coding RNA (LncRNA) is a functional RNA molecule without protein coding function, which plays a regulatory role in the occurrence and development of various tumors. Recent studies have shown that LncRNA and Wnt-β-catenin signaling pathways are jointly involved in glioma growth, invasion, migration and other processes, but the complex mechanism has not been thoroughly elaborated. In this paper, the influence of Wnt-β-catenin signaling pathway and its related LncRNA on glioma was reviewed, and the pathogenesis of glioma was deeply understood, so as to find a better way for the diagnosis and treatment of glioma.

OBJECTIVETo explore the influencing factors of AIDS pathogenesis using the Bayesian network.

METHODSBased on follow-up data of 2 431 cases of HIV/AIDS from 1992-2011 in Shandong province, this study constructed the network structure by NPC algorithm, and used the EM algorithm for parameter learning to construct the Bayesian network of influencing factors and AIDS pathogenesis, then did inference by the Bayesian network.

RESULTSA total of 49.77% (1 210/2 431) were AIDS. Get a Bayesian network with 7 nodes and 11 directed arcs and the related parameters by studying the follow-up data of 2 431 cases. The area under receiver operating curve(ROC) was 0.75. There was a direct causal association among sample resource, transmission route, CD4(+)T lymphocyte count of HIV-antibody confirmed positive, antiviral therapy, opportunistic infection therapy, follow-up intervention and AIDS pathogenesis. The incidence probability was 42.83% for those who received antiviral therapy and follow-up intervention, and it was 68.96% for those who received antiviral therapy without follow-up intervention. The probability to receive follow-up intervention was 68.96% for cases transmitted by homosexual behaviors, and it was 34.00%, 42.24%, 1.06% and 22.70% respectively to be reported by medical institutions, testing and counselling, supervision institutions and special surveys.

CONCLUSIONThe Bayesian network revealed the mutual relation and effect intension among multi-factors and multi-stages by network inference. It showed that the rate of AIDS pathogenesis was lower for those who received antiviral therapy and follow-up intervention.

Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bayes Theorem ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Lymphocyte Count ; Male ; Middle Aged ; Young Adult

Henoch-Sch?nlein purpura(HSP) is a common small vessel inflammation in childhood, and most of them have good prognosis.Due to too many inflammatory factors, the body injury will persist in some severe cases of HSP that hormone alone is difficult to improve symptoms in a short time.Recent studies have found that gamma globulin or blood purification combined with hormone can relieve clinical symptoms more quickly.Plasma exchange and hemoperfusion are commomly used.The purpose of this paper is to review the status of gamma globulin and blood purification treatment in severe HSP.