Objective To evaluate the operation and review the clinical effectiveness of arthroscopic tenodesis through double-needles positioning approach to treat proximal lesions of Biceps tendon.Methods From January 2010 to January 2013,55 patients (25 men,30 women) with the mean age of 52.4 (range,37-65) years old who underwent arthroscopic tenodesis through double-needles positioning portal to treat proximal lesions of Biceps tendon were retrospectively analyzed.Shoulder pain of all the patients occurred in pre-operation and aggravated at the time of abduction shoulder joint,which affected the normal life for reasons of weakness.Diagnosis of magnetic resonance imaging (MRI) was proximal lesions of Biceps tendon,which was failed to respond to conservative management of six months.All patients underwent biceps tenodesis under arthroscopy with fixation of two suture anchors through bone,and removed tendon stump finally.All the portals of operation and observation of tendon fixation used double-needles positioning portal.We recorded the general condition of shoulder as the level of pain,sphere of activity,active forward flexion and intensity of adduction in pre-operation,3 months,6 months,12 months and 18 months after operation with American Shoulder and Elbow Surgeons (ASES),shoulder function score of Constant-Murley (Constant) and University of California,Los Angeles (UCLA).Then all data were analyzed statistically.Results All patients were operated successfully and got the mean follow-up of 20 months (range,18-24).The result of MRI showed well healing of tendon without rupture.The shoulder function had basically recovered.In pre-operation,ASES,constant and UCLA scores was 10.22±3.02,35.89±7.25,8.53±2.07 respectively.In 18 months after operation,the scores were 32.07± 1.26,89.75±4.07,31.87±2.07 respectively.The outcomes demonstrated that all scores in 18 months after operation had significantly improved,compared to pre-operation.Conclusion The technique of arthroscopic tenodesis through double-needles positioning approach to treat proximal lesions of Biceps tendon is reliable and simple,and can achieve satisfactory clinical outcomes.

Objective To introduce the arthroscopic treatment of acute tibial insertion avulsion fracture of posterior cruciate ligament through double posteromedial portal and "Y" shaped bony tunnel, and to evaluate the clinical results. Methods 33 cases of acute tibial insertion avulsion fracture of posterior cruciate ligament were treated arthroscopically through routine portal and double posteromedial portal. The high posteromedial portal was 4 cm proximal to the joint line, and the low posteromedial portal was just at the level of the joint line. The posterior cruciate ligament and avulsion bone fragment were held together with two USP 6 Aesculap polyester threads, which were first wrapped around the posterior cruciate ligament from anterior to posterior, and then tied behind the posterior cruciate ligament and over the bone fragment. The "Y" shaped bone tunnel was made with the common opening at the anteromedial aspect of the tibia and the tunnel arms opened backward at the inferomedial and inferolateral side of the tibial bed respectively. The threads were pulled out through the "Y" shaped bony tunnel and fixed on titanic button. With twisting of the button the threads were tightened and the fixation was insured. The patients were followed up for six months. Fracture reduction and union, knee stability, range of motion, as well as the total knee function were evaluated. Results All fractures were united without displacement. Six months postoperatively, except for one case with Ⅰ degree of positive posterior drawer test, no knee instability was detected; knee extension restored to normal in all cases and average range of flexion were 139??4.1?. 10? to 15? flexion limitation was found in 3 cases. The mean Lysholm knee score was 91.4?3.6. Conclusion Arthroscopic treatment of acute tibial insertion avulsion fracture of posterior cruciate ligament is minimally invasive. The procedure through double posteromedial portal is appropriate, the use of "Y" shaped bony tunnel and button twisting are useful to assure the fixation.

Objective To introduce the way of arthroscopic patellar retinaculum adjustment and Fulkerson osteotomy, and to study its clinical results. Methods 35 cases of recurrent patella dislocation were treated by modified Fulkerson tibial tubercle anteromedial transfer, and arthroscopic patellar retinaculum adjustment including the medial retinaculum plication and lateral retinaculum releasing. The tibial tubercle was transferred 1.5 cm anteriorly and medially, and fixed with three Kirschner wires. The patients were followed for 25 months in average. The rate of reccurence, the subjective symptoms and the function of the injured leg were evaluated according to the IKDC and Lysholm rating scale. X-ray examination was taken to evaluate the patella-femur congruence. Results There were no recurrence at the last follow-up. Anterior knee pain, though in slight degree, still existed in 8 cases. The IKDC subjective knee scores were 37.4?4.9 and 92.1?5.3(P

Objective To compare the clinical results of two bundle anterior cruciate ligament(ACL) reconstruction respectively with four and eight strands of hamstring tendons. Methods 76 patients with chronic ACL rupture were randomized separated in two groups for two bundle ACL reconstruction. In the first group the semitendinous tendon was used to make two two-stranded grafts. In the second group the semitendinous tendon was used to make one four-stranded graft, and the gracilis tendon was used to make the other four-stranded graft. 33 patients in the four-strands group and 35 patients in the eight-strands group were followed up for more than one year. IKDC and Lysholm scales were used to evaluate the clinical results. Results In the four-stranded graft group, the side to side difference was

Objective To explore the relationship between ULI43 sequence variability and clini-cal disease. Methods UL143 from samples obtained from suspected congenitally human cytomegalovirus (HCMV) infected symptomatic infants were PCR amplified and sequenced. Results There were not too much sequence variability of UL143 compared with Toledo. But no one was completely identical to Toledo, and all UL143 ORFs were shorter than Toledo for frame-shift. Conclusion HCMV-UL143 existed in moat of low passage isolates and sequences were variable. No obvious linkage was observed between UL143 poly-morphisms and outcome of suspected congenital HCMV infection.

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.

BACKGROUND: A novel biodegradable Mg-Zn alloy is designed which the density and the Young's modulus are proximal to human bone. At the same time, it depletes the toxicity of aluminium and rare earth element in commercial magnesium alloys. OBJECTIVE: To observe the effect of Mg-Zn alloy (Mg-6%Zn) on the integrin βi expression of preosteoblasts MC3T3-E1. DESIGN, TIME AND SETTING: A contrast study was performed at the Central Laboratory of the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University between March and May 2008. MATERIALS: The Mg-6% Zn was prepared by School of Materials Science and Engineering of Shanghai Jiao Tong University, which the density was 1.82 g/cm~3 and the Young's modulus was nearly 44 GPa. Poly-L-lactic acid (PLLA) was used as the controls. MC3T3-E1 cells were provided by Chinese Academy of Science Type Culture Collection. METHODS: The cell attachment was observed after cultured with Mg-Zn and PLLA at 2, 24 and 48 hours under scanning electron microscope; the integrin β1 mRNA expression of MC3T3-E1 cultured with Mg-Zn and PLLA was estimated by real-time fluorescent quantitative polymerase chain reaction (real-time PCR) at days 1, 3, 6, 9,12 and 15 after culture. MAIN OUTCOME MEASURES: The MC3T3-E1 cells attachment on the material surface and the integrin β1 mRNA expression. RESULTS: MC3T3-E1 cell adhesion was better on the Mg-Zn alloy surfaces than on the PLLA surface; The integrin (31 mRNA of osteoblasts on Mg-Zn kept on expressing during experiment and increased with time (P < 0.01), but there was no significantly difference between the two groups at the same time (P > 0.05). CONCLUSION: MC3T3-E1 cell adhesion is better on the Mg-Zn alloy surfaces than on the PLLA surface, but it is not mediated by inducing the integrin p1 mRNA expression.

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 identify the peptide that have strong ability binding to HCMV-UL149 encoded protein,and to analyze the characteristics of the amino acid sequence of UL149-binding peptides.Methods Expressed UL149 proteins of three genotypes were used to screen the binding peptide in the random peptide display library,then the encoding sequence of binding peptides in the selected clones were sequenced.The amino acid sequences of the binding peptides were analyzed for their homology,and were com pared with those of the known protein in protein banks.Results The homologous amino acid sequence W/A/F/V-D/E-D/E-G-W/F/I/L were found within the binding peptides selected by proteins of all the three UL149 genotypes proteins,and no difference between three groups was found.The alignment with amino acid sequences of the known proteins in protein banks showed that the binding peptides of UL149 putative protein have homologous amino acid sequences with immunoglobulin heavy chain variable region(IgHV),the serine/threonine protein kinases,compliment factor H,zinc finger protein,MHC Ⅰ molecule,eukaryotic translation initiation factor,nuclear factor and so on.Conclusion The UL149 encoding proteins have binding ability to proteins mentioned above,and might interfere with the immunity responds to HCMV infection through multiple mechanisms.

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.