[Summary] Ankle joint injury is one of the most common sports injuries , and some patients with chronic ankle instability need surgical treatment .Traditional incision surgeries are characterized with traumatic performance and high complication rates , and the exploration of the joint lesion is not comprehensive .With the development of minimally invasive surgery , the application of arthroscopy in the treatment of chronic ankle instability is increasing , which is conducive to the treatment of intra-articular lesions , while reducing the surgical trauma and improving the postoperative effects .In this paper , we summarized the current status of the application of arthroscopy in the surgery for chronic ankle instability from two aspects , which were arthroscopic surgery in the diagnosis and treatment of the disease, and total arthroscopic repair technology of ankle ligament .We also introduced domestic and overseas operation effects and new concepts .

We have established a computer model of calculating the normal tissue complication probability (NTCP) in line with the current primary methods and have designed the relevant software. Consequently, the complex calculation becomes easy, thus facilitating the clinical use of NTCP and improving the model step by step.
Algorithms ; Humans ; Probability ; Radiation Injuries ; epidemiology ; Radiotherapy ; adverse effects ; Radiotherapy Planning, Computer-Assisted ; Software Design

Objective To explore the feasibility and application skills of transabdominal preperitoneal prosthesis (TAPP) with cross-encircling arms of mesh.Methods From Septemer 2009 to February 2012,46 cases were given TAPP with cross-encircling arms of mesh.The clinical data and surgery videos were retrospectively analyzed.Results All of the 46 cases with 53 inguinal hernias were successful in TAPP.The mean operative time of unilateral hernia was (57.74 ± 11.89) min,the mean operative time of 7 cases with biliateral hernia was (83.86 ±20.42) min and the longest time was 125 min.There were 6 cases with the contralateral hidden hernia,2 cases with hematoma,1 case with paresthesias of skin,no realpse.Conclusion The mesh with cross-encircling arms can be exactly fixed by spermatic cord,ductus deferens or round ligament of uterus,without stitching and stappling.

Objective To seek a rational method of estimating the demands for medical services so as to work out regional health planning in a scientific way. Methods A metropolis including 19 counties and districts was selected as a region and demands for medical services were forecasted via retrospective analysis and the econometric model. Results A model of the demands for outpatient and inpatient services was obtained based on the impact of many social and economic factors on medical health services, and illustrations were given to indicate the demands for medical health services in the 19 counties and districts in future when prices should rise by 15% and 20%. Conclusion The econometric model can be used as a tool for estimating the demands for medical health services, and yet improvements need to be made.

Objective To investigate the clinical effects and postoperative complications of arthrotomy and arthroscopy in repair of 170 menisci in 168 cases.Methods One hundred and sixty-eight patients with meniscus injury were repaired by arthrotomy or arthroscopy.They were 121 males and 47 females.There were 77 left knees and 91 right knees;117 medial menisci and 53 lateral ones.Their average age was 25.5?8.4 years old.Arthro- scopic repair methods included puncture and grinding,bio-absorbable meniscus arrow fixation,Outside-In suturing, Inside-Out suturing,Elite scuff instrument repairing,T-Fix fixation and FasT-Fix fixation techniques.The clinical results were assessed on the basis of symptoms,physical signs,Tegner scores and Lysholm scores of the cases. Postoperative complications were also investigated.Re-arthroscopic exploration was done for patients with obvious symptoms and physical signs.Results The average folluw-up time was 49.3?28.8 months.Their mean pre- operative Tegner score was 3.3?2.3,and their postoperative one 6.8?2.1 (P＜0.05).Their preoperative Lysholm score was 30.1?18.2,and their postoperative one 87.5?22.5 (P＜0.01).There were significant differences in Tegner and Lysholm scores before operation and after operation.Ninety-eight repaired menisci were rated as excellent(57.7%),57 as good (33.5%),10 as fair (5.9%),and five as poor (2.9%).The total ex- cellent and good result was 91.2%.Of the 19 patients with obvious symptoms and physical signs,re-arthroscopic exploration found no healing in five and partial healing in six.Postoperative complications included pain at the Outside-In suture nodes in three cases,referred pain at posterior articular capsule resulted from failed Outside-In meniscus anterior horn suturing in one case,and twinge at the meniscus arrow site in the posterior capsule in five cases.No serious lesion occurred at blood vessels or nerves.The postoperative complication incidence was 5.3%. Conclusion The eight methods of arthrotomy and arthroscopy to repair injured menisci investigated in our study can have a high successful rate and low perioperative and postoperative risk.

Objective To explore the effect of psychological nursing intervention on the pain, sleep quality and life quality of patients with gastric cancer. Methods A total of 84 cases of gastric cancer patients from January 2013 to January 2014 were randomly divided into intervention group and control group, 42 cases in each group, the control group was received conventional care, while the intervention group focused on the implementation of psychologicalnurs-ing intervention, SAS, SDS scores, VAS scores and PSQI scores before and after the intervention, and the general health, physiological function, physiological function, body pain, vitality, social function, emotional function, mental health quality of life scores were compared before and after intervention between two groups. Results After intervention, the SAS scores, SDS scores, VAS scores decreased significantly than before intervention and intervention group were lower than control group(P<0.05),the PSQI scores were significantly lower than before the intervention and intervention group were lower than the control group (P<0.05), after the intervention,the physical function, physical function, bodily pain, vitality, social functioning, role emotional, mental health scores were significantly higher than before intervention and intervention group were higher than the control group(P<0.05). Conclusion Positive psychological nursing interven-tion for gastric cancer helps to alleviate patients anxiety, depression and other negative psychological, reduce pain and improve sleep quality in patients, to further improve the quality of life of patients.

OBJECTIVETo investigate the chemical constituents of the aerial parts of Polygala sibirica systematically.

METHODSThe chemical constituents were isolated by various column chromatographic methods. The structures were identified by spectral data.

RESULTTen compounds were isolated and identified as 6-hydroxy-1, 2, 3, 7-tetramethoxy xanthone (1); 1, 2, 3, 6, 7-heptamethoxy xanthone (2); 1, 7-didydroxy-2, 3-methylenedioxy xanthone (3); 1, 7-dihydroxy-2, 3-dimethoxy xanthone (4); 1, 3, 7-trihydroxy-2-methoxy xanthone (5); 1, 6, 7-trihydroxy-2, 3-dimethoxy xanthone (6); alpha-spinasterol (7); alpha-spinasterolic-3-O-beta-D-glucoside (8); squalene (9) and polygital (10).

CONCLUSIONCompounds 1-10 were isolated from this species for the first time.

Objective: To investigate clinical outcomes of modified reattachment of superior peroneal retinaculum (SPR) for patients with recurrent peroneal tendon dislocation. Methods: A total of 24 cases with recurrent peroneal tendon dislocation from December 2012 to June 2017 were treated with modified reattachment of SPR. There were 20 males and 4 females. The average age was 24.9±9.3 years (14-48 years). The average BMI was 23.18±3.50 kg/m² (15.8-32.2 kg/m²). A 4-5 cm incision was made along the lateral margin of the fibula and curved distally around the fibular tip in line with the peroneal excursion. The superior peroneal retinaculum, peroneus longus and peroneus brevis were exposed. The periosteum and SPR were stripped from the fibula. The false pouch was formed. Two suture anchors were inserted into the postero-lateral ridge of the lateral malleolus without damaging the cartilaginous ridge, after which the SPR was reattached to the lateral malleolus with the anchored suture. The inner layer of the false pouch was incised, while the outer layer (periosteum) was sutured with the SPR in a pants-over-vest style. The following items, including American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), rate of return to previous sports level, time to return to sports activity, complication, and patients satisfaction were evaluated preoperatively and at the final follow-up. Results: The average operation duration was 36.1±8.8 min (20-51 min). The blood loss was 1-10 ml, average 4.1±2.7 ml. The follow-up was carried out in 22 cases for mean 33.9±15.7 months (13-61 months). AOFAS score was improved from 77.8±7.8 points to 95.5±4.3 points significantly (t=-11.89, P<0.001). VAS score was reduced from 4.2±2.4 to 0.3±0.8 significantly (t=7.69, P<0.001). Mean duration return to sports activity was 5.0±1.9 months (3-10 months). A total of 20 patients (91%) returned to their previous sports level. Only one patient (5%) was found with limitation of range of motion, while two patients (9%) reported pain at the scar site without recurrence. The satisfaction rate was 91%. Conclusion Clinical outcomes of modified reattachment of SPR for patients with recurrent peroneal tendon dislocation was safe and effective.

Nine compounds were isolated from the n-butanol extract of the aerial parts of Polygala sibirica by various column chromatographic methods. Their structures were identified by MS and NMR spectroscopic data as sibiricaxanthone F (1), amentoflavone (2), linarin (3), zigu-glucoside I (4), 3, 6'-disinapoyl sucrose (5), tenuifoliside A (6), 2, 4, 4-trimethyl-3-formyl-6-hy-droxy-2, 5-cyclohexadien-1-one (7), lanierone (8), and aralia cerebroside (9) , respectively. Compounds 2, 3, 4, 7, 8 were isolated from the genus Ploygala for the first time, and compound 9 was firstly isolated from the title plant.
Butanols ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Plant Components, Aerial ; chemistry ; Polygala ; chemistry

Objective:To compare the mid-to long-term clinical outcomes between suture anchor and simple suture for acute injury to lateral ankle ligament (cauda equina tear near the insertion).Methods:This retrospective study included 146 patients (professional and semi-professional athletes) who had been treated for acute injury to lateral ankle ligament (cauda equina tear near the insertion) at Department of Sports Medicine, The Third Hospital Affiliated to Peking University from June 2007 to May 2017.They were 101 males and 45 females, with an age of (27.1±10.3) years (from 12 to 62 years). Depending on ligament repair techniques, the patients were divided into a suture anchor group of 81 cases subjected to reconstruction of the torn ligament with a 1.8 mm suture anchor, and a simple suture group of 65 cases subjected to direct suture of the torn ligament with a braided thread. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores and Tegner scores at preoperation and the last follow-up, time and level of postoperative motion recovery, proportion of limited joint motion, incidence of re-sprain and patient satisfaction.Results:There was no significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P>0.05). The mean follow-up duration was (46.1±14.1) months (from 36 to 132 months). The VAS pain score, AOFAS ankle-hindfoot score and Tegner score at the last follow-up were significantly improved than those before operation in all the patients ( P<0.05). Postoperatively, there was no significant difference between the 2 groups in VAS pain score, AOFAS ankle-hindfoot score, Tegner score, incidence of re-sprain or proportion of limited joint motion ( P> 0.05). The suture anchor group was significantly better than the simple suture group in the level of postoperative motion recovery (92%±13% versus 89%±13%) and time of postoperative motion recovery [(4.2±1.1) months versus (4.6±1.0) months] ( P<0.05). Conclusions:Ligament repair, either by suture anchor or by simple suture, is a reliable procedure for patients with high sports demands after severe acute injury to the lateral ankle ligament. Compared with simple suture, suture anchor may accelerate postoperative motion recovery to the pre-injury level.