Objective To introduce and evaluate arthroscopic release technique for treatment of knee stiffness due to arthrofibrosis after total knee arthroplasty (TKA). Methods Five patients with mean age of 56 years (41－ 70 years) underwent knee arthroscopy for a history of arthrofibrosis following TKA. There was no painful stiff total knee or infected total knee in this series. All of 5 cases had good range of motion in the operation room after total knee replaced. The arthroscopy was performed at 6 months (3－ 12 months) after the TKA, and at this time the flexion was limited to 70 degrees (60－ 85 degrees).In 2 cases,the extension was limited to 10 degrees and 30 degrees. With 3 standard portals, we examined the knee joint and found the adhesions and fibrous band formed in the suprapatellar pouch and two gutters. By resection of those fibro- band and passive flexion of the knee, the satisfactory range of motion(ROM)could be achieved. For the 2 cases of extension limited, CR prothesis was replaced. We released the posterior cruciate ligaments through the anterior portals. Continuous passive motion was started immediately postoperatively at the first day. The patients were evaluated at an average time of 20 months (8－ 46 months) after the arthroscopy. Results The mean knee ROM was 116 degrees (100－ 130 degrees) at the end of arthroscopy and was 105 degrees (90－ 115 degrees)at the last review.The mean ROM was improved by 35 degrees (15－ 50 degrees). There were no complications in this series. Conclusion Arthroscopic release for the treatment of knee stiffness due to arthrofibrosis without pain and infection following TKA is a useful, reliable and safe technique, compared with closed or open procedure. The arthrolysis should be done at 3 to 6 months after the TKA in order to obtain better results.

Objective To evaluate the effect of arthroscopic reshaping procedures on symptomatic discoid meniscus and compare the outcomes between children and adults. Methods The medical records of those who had undergone arthroscopic reshaping procedures for symptomatic discoid meniscus between January 1997 to December 2000 were reviewed. Results Fifty-four patients had been followed up more than 7 years, including 38 children and 16 adults. The average Lysholm score increased from (65.0?10.0) preoperatively to (72.0?10.0) postoperatively. The average 8.2-year follow-up showed no obvious clinical symptoms and signs or osteoarthritis in children. Fourteen knees in adults were found osteoarthritis on X-ray film, of which 6 showed the symptoms and signs of osteoarthritis. Conclusion The midterm efficacy of arthroscopic surgery for symptomatic discoid menisci and the occurrence of postoperative osteoarthritis are related to age and injury course.

Aim To study the relationship between Helicobacter pylori (H. pylori) infection and genetic factor-ABO blood group. Methods 177 cases of peptic ulcer were studied, including 127 cases with H. pylori infection in Group A and 50 cases without H. pylori infection in Group B. The percentages of ABO blood group in two groups were compared each other and were compared with that of the control group(the material of ABO blood group percentages of the people in the easten China) respectively. Results ①The percentage of blood group O in group A(53. 54％) was significantly higher than that of the control (P＜0. 01). ②No significant difference was observed between Group B and the control(P＞0.05) or Group A(P＞0. 05). Conclusion There is the relationship between H. pylori infection and blood group O.

Objective To investigate the relationship among the content of serum HBV-DNA and the different degree of chronic liver damage,and the marks of hepatitis B virus and to explore its value in the evaluation of therapy.Method Fluorescence quantitative PCR was used to measure the concentration of sera HBV-DNA in 113 patients infected by HBV.Results The serum HBV-DNA in mild chronic hepatitis group was the highest.In the patients with aggravating liver damage,the serum HBV-DNA concentration was decreased gradually.It was indicated that serum HBV-DNA concentration in the patients with HBeAg positive was significantly higher than that of HBeAg negative.However,there were no evident relationship among HBV-DNA concentration,ALT,AST activities and different Child's classification of cirrhosis.The patients with lower serum HBV-DNA concentration before treatment had a better outcome.The therapeutical effects were correlated with the serum of viral DNA concentrations.Conclusions The quantitative detection of serum HBV-DNA has instructive value in understanding the relationship among the clinical status of chronic hepatic disease,the duplication level of hepatitis virus and evaluating therapy.

Objective:To investigate the correlation between MRI features of breast cancer and the expression of CBL-B, AXL and ITGB2, and further to provide new imaging ideas for the early diagnosis of breast cancer, the designation of treatment plan and the preoperative non-invasive assessment of breast cancer prognosis.Methods:204 female patients with breast cancer who visited Linyi Central Hospital from Sep. 2017 to Sep. 2020 and received surgical treatment were selected as research objects. A total of 204 lesions were selected. Scanning was performed using Philips All-digital Ingenia3.0T MRI. Tumor diameter, shape, edge, intensity pattern, time-signal intensity curve (TIC) type, early intensity rate and ADC value were recorded. Immunohistochemical SP method was used to detect the expression levels of CBL-B, AXL and ITGB2 in breast cancer tissues and adjacent tissues.Results:The proportion of patients with low expression of CBL-B, high expression of AXL and high expression of ITGB2 in breast cancer tissues was significantly higher than that in adjacent tissues (All P<0.05) . Univariate analysis showed that tumor diameter, shape, early enhancement rate and ADC value in MRI features were correlated with the expression of CBL-B protein in breast cancer (All P<0.05) . The tumor diameter, shape and TIC typing in MRI features were associated with AXL protein expression in breast cancer. The tumor diameter, TIC typing, early enhancement rate and ADC value in MRI features were related to ITGB2 protein expression. Binary Logistic regression analysis showed that tumor diameter ≥3 cm and early enhancement rate ≥100% were independent risk factors for low expression of CBL-B in breast cancer ( P<0.05) . Tumor diameter ≥3 cm, and irregular shape or burr were independent risk factors for AXL high expression ( P<0.05) . Tumor diameter ≥3 cm, early enhancement rate ≥100%, ADC value ≥1.12×10 -3 mm 2/s were independent risk factors for high ITGB2 expression in breast cancer ( P<0.05) . Conclusion:MRI features of breast cancer can be used to predict the expression of CBL-B, AXL, and ITGB2, so as to provide reference for clinical diagnosis, treatment and prognosis assessment of the disease.

AIM: To evaluate the analgesic effects of combining application of low-dose morphine and diprospan in intra-articular injection after knee arthroscopy.METHODS: ① A total of 100 patients with knee arthroscopy were selected from the Surgery of Joint, Department of Orthopaedics, Changzheng Hospital, the Second Military Medical University of Chinese PLA from February 2002 to January 2003, including 52 males and 48 females aged from 16 to 56 years. All of them did not have a history of administration of pain-killer before operation. Patients were classified from grade Ⅰ to grade Ⅱ based on American Society of Anesthesiologists (ASA) before operation. Meanwhile, all the patients did not have obvious histories of heart,lung and liver diseases, and all patients provided informed consent. ② All patients were randomly divided into two groups, including combination group and morphine group with 50 in each group. Patients in the combination group were given intra-articular injection with 1 mg morphine hydrochloride and 1 mL compound diprospan [Xianling Baoya Pharmaceutical Factory, Belgian; batch number: 4JBBKA35A; qualification: 1 mL (5 mg/2 mg)/ampoule] after operation.In addition, patients in morphine group were injected with 1 mg morphine hydrochloride [the First Pharmaceutical Factory, Shenyang; batch number: 020316; qualification: 1 mL (10 mg)/ampoule]. ③ At 8 and 24 hours after administration, when patients maintained the status of standing with both feet and unfolding knee joint, analgesic effect was evaluated by visual analogue scale (VAS). Scores ranged from 0 to 10. The higher the scores were, the severer the painfulness was. Moreover, various side effects were observed at 48 hours after operation. ④ Differences of data were compared with one-way analysis of variance and deep differences between the two groups were compared with q test.RESULTS: A total of 100 patients received knee arthroscopy were involved in the final analysis. ① Visual analogue scale: At 8 hours after administration, scores were similar in combination group to those in morphine group, and the scores were 1.41 ±0.74 and 1.52±0.65, respectively (q =2.72, P ＞ 0.05). At 24 hours after administration, scores were remarkably lower in combination group than those in morphine group, and the scores were 1.46±0.61 and 2.53±1.24,respectively (q =3.42, P ＜ 0.05). ② Adverse events and side effects: Side effects, which were always found out in the application of morphine in vein, were not observed in both combination group and morphine group.CONCLUSION: Combining application of low-dose morphine and compound diprospan has an excellent analgesic effect with intra-articular injection, which is superior to that of the single application of morphine. Meanwhile, the combining application of low-dose morphine and compound diprospan is safe.

The common therapy of colorectal cancer is FOLFOX scheme,which contains flurouracil,leucovorin and oxaliplatin.Numerous clinical trials have demonstrated that bevacizumab combined with FOLFOX scheme in cancer's therapy is safe and effective.But the adverse reactions including hypertension,neurovirulence,gastrointestinal bleeding and perforation are raised up.Scholars have carried out a series of studies for the overall survival times,tumor response rates and survival qualities for the patients with metastatic colorectal cancer which using the joint scheme,but they draw different conclusions the usefulness and safety of the joint scheme still need more RCT and meta-ananlysis to be proved.

BACKGROUND:Differentiation of growth factor-induced cells into fibrocartilage is the hot topic in the research of meniscus tissue engineering. The in vitro construction and in vivo reconstruction of menisci are closely related with the effect of growth factors. OBJECTIVE:To review the current development of growth factors in meniscus tissue engineering, and to investigate the mechanism. METHODS:The VIP database (http://lib.cqvip.com), CNKI database (www.cnki.net) and PubMed database (http://www.ncbi.nlm.nih.gov/pubmed) were retrieved for the related articles from January 2008 to March 2013 with the key words of“meniscus tissue engineering, cartilage, growth factors”. A total of 53 articles on the research of growth factors in meniscus tissue engineering were included. RESULTS AND CONCLUSION:There were various growth factors in cartilage tissue engineering research, and the new growth factors have been found in the constant. The research on the regulation effect of growth factors on cartilage was changed from the research of single growth factor model to the research of the interactions between multiple growth factors;the molecular mechanisms of growth factors in regulating the cartilage have also been extensively studied. Growth factors have good application prospects in tissue engineering, but there are stil many problems to be solved, such as during the healing of menisci, the expressions and the effect of different growth factors are different in different time points. So how to play the interaction between growth factors timely and appropriately thus stimulating the in vivo microenvironment, investigating the molecular mechanisms of growth factors in regulating the cartilage, as wel as finding the new growth factors are the research focus in meniscus tissue engineering.

Objective To investigate the incidence of surgical site infection(SSI)following clean incision breast surgery under non-local anesthesia,and evaluate risk factors for SSI.Methods Clinical data of 3 327 patients who underwent clean incision breast surgery under non-local anesthesia in 22 hospitals in Fujian Province were surveyed retrospectively,SSI and risk factors were analyzed.Results Among 3 327 patients,1 502(45.19%)were with malignant tumors,the average dura-tion of surgery were (101.18 ±8.04)minutes;a total of 24 cases of SSI occurred,incidence of SSI was 0.72%;253 (7.60%)patients received pre-operative antimicrobial prophylaxis,62.66% used antimicrobial agents within 0.5-2 hours before surgery.The main pathogenic bacteria was Staphylococcus aureus .Univariate and logistic regression analysis re-vealed that malignant tumor,diabetes mellitus,and use of immunosuppressants were all risk factors for SSI (all P <0.05). Conclusion SSI following clean incision breast surgery under non-local anesthesia is well controlled,risk factors for SSI should be evaluated before operation,comprehensive preventive measures should be taken to reduce the incidence of SSI.

Objective To determine the measurement consistency of diffusion coefficient D, perfusion fraction f and pseudodiffusion coefficient D*in rectal cancers based on different ROIs. Methods Forty-three patients with histologically proven rectal cancers were examined using echo-planar DW-MRI with eight b values (0 to 1 000 s/mm2). Intravoxel incoherent motion parameters were measured on intravoxel
incoherent motion map that contained the largest tumor cross-section, according to two distinct ROI protocols:freehand outline ROI and semi-automatic tumor center ROI. The two protocols were compared for differences in IVIM parameters and the interclass correlation coefficient (ICC) were also calculated. intra-and inter-observer variability using paired t test and Bland-Altman plot. Results The IVIM parameters(D, f and D*) obtained by ROIs for outlined and center analysis were (1.08 ± 0.24) × 10-3mm2/s, (0.16 ± 0.06), (26.59 ± 19.54) × 10-3mm2/s and (1.06 ± 0.27) × 10-3mm2/s, (0.17 ± 0.07), (30.79 ± 20.85) × 10-3mm2/s, respectively. No significant differences were observed between the means of the IVIM parameters (D, f, D*) calculated by the two methods (t=1.113,-0.259,-1.660;P=0.272, 0.797,0.104, respectively),and the relative ICC were 0.863, 0.469, 0.663, respectively. The intra-observer 95% limits of consistency of IVIM parameters were (-0.012—0.038) × 10-3mm2/s, (-0.003—0.007), (-0.923—1.166) × 10-3mm2/s with ROI outline tumor, respectively;(-0.024—0.044)×10-3mm2/s, (-0.005—0.015), (-1.670—4.195)×10-3mm2/s with center ROI, respectively. The inter-observer 95% limits of consistency of perfusion parameters were (-0.047—0.009) × 10-3mm2/s, (-0.015—0.009), (-7.206—3.190) × 10-3mm2/s with ROI outlined tumor, respectively;(-0.068—0.048) × 10-3mm2/s, (-0.005—0.041), (-17.657—0.779) × 10-3mm2/s with center ROI, respectively. Conclusions There was no statistically significant difference between the outlined ROI and tumor center ROI analysis of rectal cancers' IVIM parameters. The tumor analysis by outlined ROI protocol appropriately improves intra-and inter-observer consistency and can provide more reproducible and stable results.