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

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.

Existing reporting guidelines for systematic reviews/Meta-analysis (SRs/MAs) cannot meet the requirements of clinical practice and scientific research, so based on evidence, methods and thoughts on establishing reporting guidelines for TCM-featured acupuncture systematic reviews/Meta-analysis were proposed. Through literature analysis, according to evidence-based principle, preliminary ideas on methodology of establishing reporting guidelines for TCM-featured acupuncture systematic reviews /Meta-analysis were proposed. With consensus as one main research method, it was proposed that in the consensus that was selected and established by experts, the pro- portion of Chinese scholars should be increased to fully declare the opinions of Chinese acupuncturists, and by verification of practice and application, the reporting guidelines for TCM-featured acupuncture systematic reviews/Meta-analysis can be finally made.
Acupuncture Therapy ; methods ; standards ; Evidence-Based Medicine ; methods ; standards ; Humans ; Medicine, Chinese Traditional ; methods ; standards

Objective To explore the interaction characters of fluoride and aluminum by analyzing the changes of bone metabolism in mice. Methods Kunming mice were randomly divided into nine groups according to the factorial experiment, design of two factors and three levels. The animals in different groups were fed with various doses of fluoride(NaF, 0,50,150 mg/L) and/or aluminum(AlCl3, 0,200,600 mg/L) in drinking water for 24 weeks. Serum calcium, phosphor, magnesium, alkaline phosphatase, osteoealine, parathyroid, and urinary calcium and phosphor were tested. Results We found interaetians of fluoride and aluminum with serum calcium, osteoealine and urine calcium(F=17.370,4.399,9.448, P<0.01), but not with serum phosphor, magnesium, alkaline phosphatase, parathyroid or urinary phospbor(F=0.416,0.415,1.921,1.362, 1.630, P 0.05). The serum levels of calcium and osteoealine in high fluoride group were (1.13±0.27)mmol/L and (6.56±5.74)μg/L, respectively, which were lower than in the control group[ (1.82±0.37)mmol/L and (23.45±15.40)laeJL, respectively], but the levels were elevated to (1.76±0.36)mmol/L and (10.57±4.28)μg/L when high fluoride was combined with low aluminum, and further elevated to (2.10±0.51)mmol/L and (15.73±3.15)μg/L when high fluoride was combined with high aluminum. The urinary calcium level in low fluoride group [ (6.24±2.61)retool/retool Cr] was higher than that in the control group[ (3.12±2.04)retool/retool Cr], but it was decreased in low fluoride and aluminum groups[ (0.81±0.44), (1.23± 0.41)mmol/mmoi Cr, respectively]. On the other hand, the levels of serum ealeium and osteocaline in high aluminum group were (1.07±0.68)mmol/L and (7.21±5.22)μg/L, elevated to (1.47±0.18)mmol/L and (10.98±4.35) μg/L when low fluoride was combined wth high aluminum, and further elevated to (2.10±0.51)mmol/L and (15.73± 3.15)μg/L when high fluoride was.combined with high aluminum, respectively, and the combined effects showed the same trend of higher aluminum. Conclusions Aluminum antagonized fluoride-induced effects, whereas fluoride aggravated the effects caused by aluminum in this experimental conditions. The biomarkers of bone formation and mineralization were suppressed in the combined groups, so the combined effects could interfere with the course of bone turnover by inhabiting bone formation and mineralization, leading to the disorder of bone metabolism eventually.

Objective To study on the metal clip installation to avoid post-operative bleeding in pa- tients accepted papilla sphinctecotomy.Methods One hundred and eighty five patients who accepted ERCP +EST were divided into two groups:Group 1 was given routine regimen alone(N=95),group 2,given routine regimen and metal clip to prevent post-operative bleeding.Results The postoperative bleeding hap- pened in 3(3.2%)cases of Group 1 and none in Group 2,there is significant difference between these two groups(P＜0.05).The breeding cases in group 1 were controlled by metal clip under endoscopy successful- ly.Conclusion Preventive usage of metal clip was significantly decreased the incidence of post-operative bleeding in EST patients.

Objective The aim of this study was to evaluate the optimal time for decompression in a 24-hour lasting porcine model.Methods After baseline data were recorded,24 pigs were randomly allocated into three groups as follows:one SAP-alone group,and two SAP + ACS groups (decompression at 6 and 12 hours,respectively).We used a N2 pneumoperitoneum to increase the intra-abdominal pressure to 25 mmHg and retrograde intra-ductal infusion of sodium taurocholate to induce severe acute pancreatitis (SAP).Systemic hemodynamic profiles,urine output,systemic oxygenation,and serum biochemical parameters of the animals were obtained.Results After induction of ACS,the hemodynamics and oxygenation of the study animals deteriorated significantly.The survival time of the 12-hour group was significantly shortened (P =0.008 vs.6 hours).Early decompression (6 h) restored systemic hemodynamics,oxygenation,organ function,and inflammatory intensity to a level comparable to that of the SAP-alone group.In contrast,animals in 12-hour group developed more severe hemodynamic suppression,oxygenation and organ dysfunction and inflammatory process.For instance,the cardiac output levels in the three groups were 2.70 ±0.50 for the SAP group,2.75 ±0.48 for the 6 hour-group and 2.19 ±0.43 for the 12 hour-group.Conclusion Early decompression could significantly reduce the mortality in a porcine model of SAP incorporating ACS,and also improve systemic hemodynamics,organ function and inflammatory intensity.

Background Dominant eye is one of the functional asymmetric organ,and the dfference between dominant eye and undominant eye is a researching hotspot.But the study about accommodation in adult myopia is less.Objective This study was to determine the association between ocular dominances and accommodative factors in the subjects with adult myopia.Methods This study used prospective descriptive research method.Thirty-five subjects aged from 18 to 35 years with the myopia ranged from-2.00 D to-10.00 D and anisometropia less than 1.5 D,BCVA≥ 1.0 were recruited consecutively in this study.Ocular dominance was determined using the hole-inthe-card test and thumb test.Refractive error was measured with objective and subjective optometry,and amplitude of accommodation was measured by push-up test.Fusion cross cylinder(FCC) was used to measure the accommodative lag,and flipper test was applied to determine the accommodative facility.Oral informed consent was obtained from each subject before any relevant examination.Results No significant differences were found in the amplitude of accommodation (D),accommodative facility (cpm) and accommodative lag (D) between the dominant eye and undominant eye (accommodative amplitude:9.69 D±2.30 D vs.9.60 D±2.37 D,P =0.294 ;accommodative facility: 11.08 D±4.20 D vs.10.63 D± 4.60 D,P=0.260;accommodative lag:P=0.141).In the patients with the right eyes as dominance eyes,the accommodative amplitude of both eyes were (9.48±2.29) cpm and (9.33 ± 2.49) cpm,and accommodative facility were (10.50 ± 4.70) cpm and (9.99 ± 4.90) cpm.There were no significant differences between the right and left eyes in the accommodative amplitude,accommodative facility and accommodative lag (P =0.319,0.116,0.590).In the patients with the left eyes as dominant eyes,the accommodative amplitude of both eyes were (9.91±2.35)D and (9.88±2.26) D,and accommodative facility were (10.70±3.77)cpm and (11.25 ±4.27) cpm.No significant differences were seen between the right eyes and left eyes in the accommodative amplitude,accommodative facility and accommodative lag (P =0.749,0.295,0.238).Conclusions The amplitude of accommodation of the dominant eye is not significantly enhanced,and less accommodative lag and better accommodative facility also are found in the demonstrate eye in myopia adults with low anisometropia.

Objective To study the risk factors of skin lesion (keratosis and abnormal skin pigmentation) of population exposed to arsenic via drinking water in Inner Mongolia.Methods A cluster sampling method was used to select 902 cases from Linhe district,Hanghou and Wuyuan county in Inner Mongolia and physical examination was done.They were interviewed for information by questionnaire.The sample of fingernails and drinking water were collected.Water arsenic (As) was analyzed by inductively coupled plasma mass spectrometry (ICPMS); fingernail As and Se content were analyzed by instrumental neutron activation analysis(INAA).Data were analyzed by univariate and multivariate non-conditional Logistic regression.Results Single factor analysis showed that risk factors of keratosis were age,pesticide,arsenic in nails,smoking,years of smoking,drinking of alcohol,arsenic content in drinking water,fluorosis and duration of drinking arsenic-containing water,while occupation,nail selenium content and vitamin were protective factors.There were 10 risk factors for pigment abnormalities,which were age,pesticide,arsenic in nails,smoking,years of smoking,numbers of cigarette smoked daily,drinking of alcohol,fluorosis,the arsenic content in drinking water and duration of drinking arseniccontaining water,while sex,occupation and nails with selenium were protective factors.The multivariate factor analysis showed that the risk factors of keratosis were age,pesticide and arsenic content in drinking water(OR =1.387,1.583,1.321,all P ＜ 0.05),while occupation and vitamin were protective factors(OR =0.307,0.260,all P ＜ 0.05).The risk factors of abnormal skin pigmentation were age,pesticide,arsenic in nails,fluorosis and arsenic content in drinking water(OR =1.724,2.636,2.741,3.699,1.863,all P ＜ 0.05),while sex was protective factor(OR =0.255,P ＜ 0.01 ).Conclusions Many factors have influence on endemic arsenism and a composite measure should be implemented to prevent it such as excluding arsenic from drinking water,health education,and a reasonably intake of nutrients.

Adult ; Aged ; Aged, 80 and over ; Apoptosis Regulatory Proteins ; genetics ; metabolism ; Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; Exons ; genetics ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lung Diseases ; genetics ; metabolism ; Lung Neoplasms ; genetics ; metabolism ; Male ; Middle Aged ; Mutation ; Proto-Oncogene Proteins ; genetics ; metabolism ; RNA, Messenger ; metabolism

Objective To observe the effect of electroacupuncture on onset time and effectiveness of Paroxetine for mild or moderate depression patients and on the scores of Hamilton depression rating scale for depression(HAMD) and self-rating depression scale(SDS). Methods Fifty-five patients with mild or moderate depression were randomly divided into A group( Paroxetine group,29 patients) and B group (Electroacupuncture combining with Paroxetine group,26 patients). Therapeutic periods for the two groups were 6 weeks. HAMD and SDS were used to evaluate the efficacy before the research and after treatment on 1 week,2 weeks,4 weeks,6 weeks.Results HAMD scores and SDS scores for A group were significant difference after 2 weeks treatment compared with the beginning of the research (P＜ 0.05 ) ;HAMD scores and SDS scores for B group were significant difference after 1 week treatment compared with the beginning of the research(P＜0. 05 ). Total effective rate of HAMD for A group was 71.4% ,total effective rate of SDS for A group was 75% ,total effective rate of HAMD for B group was 88% ,total effective rate of SDS for B group was 84%. The total effective rate between the two groups ordered by the individual chi-square test was significant difference( X2 = 4. 1790, P= 0. 0408). Conclusion Electroacupuncture can shorten the onset time and increase the effectiveness of paroxetine for mild or moderate depression patients.