Objective To evaluate and compare the clinical effects of forward and reverse anterior cruciate ligament (ACL) reconstruction through the arthroscopy. Methods From April 2008 to August 2009,97 cases with simple ACL injures were treated with eight strands of hamstring tendons in way of two-bundle and four-tunnel reconstruction. The patients were randomly divided into two groups according to the number of hospital admissions: odd numbers (A group, 47 cases) were treated with forward double-bundle reconstruction and even (B group,50 cases) were treated with reverse. The grafts were fixed with a suspension technique by mini-plates and mini-buttons. Mean follow-up exceeded one year. The function of knee joint were assessed by the IKDC, Lysholm and Tegner rating scale. Results Mean follow-up was 13.71 months.At the last follow-up, 2 patients in A group had a 10°extension deformity and 5 had a less than 15° flexion limitation. All patients in B group showed normal knee extension, and 4 had a 5° flexion limitation. According to Lachman test, there were one case with one plus positive and one with two plus positive in A group,and one with two plus in B. KT-1000 examination (30° flexion and 30 N) showed the side to side mean difference of anterior knee laxity was (1.04±1.11) mm in A group and (0.86±1.12)mm in B. According to objective IKDC evaluation, the results were graded as normal or nearly normal in 46 patients in A group and 48in B. There were no statistical differences in the IKDC, Lysholm, and Teguer scores between two groups.Conclusion Forward or reverse ACL double-bundle reconstruction with eight strands of hamstring tendons can both restore knee stability, and there is no significant deviation between the two techniques.

Biopsy ; methods ; Drainage ; Humans ; Jaundice, Obstructive ; etiology ; therapy ; Lymph Node Excision ; methods ; Neoplasm Staging ; Pancreatic Neoplasms ; complications ; diagnosis ; pathology ; surgery ; Pancreaticoduodenectomy ; methods ; Salvage Therapy

Objective The study was aimed to investigate the effects of transforming growth factor beta1(TGF-?1)on acute graft-versus-host disease(aGVHD)after allogeneic bone marrow transplantation(allo-BMT).Methods The recipient was male BABL/C.The donor was male C57BL/6.The murine model of aGVHD had been established by allo-BMT with donor derived T cells.There were four groups in this study:control group,radiation group,transplantation control group and TGF-?1 group.The mice in TGF-?1 group were administered TGF-?1[1 ?g/(kg?d)]subcutaneously two days before transplantation until seven days after it.Results The study showed that the survival time of TGF-?1 group was significantly longer than the transplantation control group,and the aGVHD pathological changes were milder in TGF-?1 group than in transplantation control group.Seven days after transplantation,the level of IL-2 of TGF-?1 group was higher than control group,but significantly lower than transplantation control group.The level of IL-10 of TGF-?1 group was significantly higher than transplantation control group.Conclusion TGF-?1 can prevent the lethal aGVHD and raise the survival rate after allo-BMT in murine model.It may prevent the lethal aGVHD by accommodating the Th1 and Th2 cytokine level in vivo.

The DNA microarray study showed that in STZ-induced diabetic rats the elevatedexpression of 42 genes in artery were depressed markedly after atorvastatin treat ment .This suggeststhat atorvastatin may have the protective effects on the diabetic vascular lesion.

Objective　To study the changes of quantitative expression,adhering activity and genomic density polymorphism of complement type 1 in erythrocytes (CR1) of patients with liver cancer (104 patients) and their clinical significance.Methods　Polymerase chain reaction (PCR),HindIII restriction enzyme digestion,the quantitative assay of ECR1 and the adhering activity assay of CR1 in erythrocytes were used.Results　No difference was observed between the patients with liver cancer (29.8%) and healthy individuals (25.3%) in the spot mutation rate of CR1 density gene (χ2 =0.537,P>0.05).The number and the adhering activity of CR1 in patients with liver cancer (0.83±0.22 and 47.1±6.5) were significantly lower than those in healthy individuals (1.26±0.33 and 62.4±7.6; t=10.5,P<0.0001).The number and the adhering activity of ECR1 in high expression genomic type (HH) liver cancer were obviously lower than those of healthy individuals,expecially those of the patients with advanced liver cancer.There was a good relationship between quantitative expression,adhering activity of ECR1 and liver cancer development.Conclusion　Defective expression of CR1 in liver cancer is mostly acquired through central peripheral mechanisms.The changes of CR1 quantitative expression and adhering activity are consanguineously related to the severity and the activity of the development in patients with liver cancer.

Objective To explore pre-thrombosis state in patients with cor pulmonale and the efficacy of anticoagulant treatment with low molecular heparin(LME). Methods 54 patients with cor pulmonale were divided into LMH treatment group and routine treatment group, each group containing 27 patients. The concentrations of Von Willlebrand factor (VWF),prethrombin F 1+2 fragment(F 1+2 ),Fibrinogen(Fg),granule membrane protein(GMP-140)and D-dimer fragment(DD)were measured before and after treatment. Results The concentrations of WF,F 1+2 ,Fg,GMP-140 and DD in the patients with cor pulmonale were significantly higher than those in the controls. In LMH treatment group, the above indices and PaCO 2 markedly decreased and PaO 2 obviously increased, while in routine treatment group, PaCO 2 and PaO 2 slightly improved, and no change was observed in coagulation indices. Conclusion Early detection and diagnosis of pre-thrombosis state in patients with cor pulmonale and immediate treatment with LMH can be beneficial to the prognosis of these patients in acute stage.

Wear of polyethylene (PE) tibial inserts is a significant cause of implant failure of total knee arthroplasty (TKA). PE inserts wear measurement and evaluation is the key in TKA researches. There are many methods to measure insert wear. Qualitative methods such as observation are used to determine the wear and its type. Quantitative methods such as gravimetric analysis, coordinate measuring machines (CMM) and micro-computed tomography (micro-CT) are used to measure the mass, volume and geometry of wear. In this paper, the principle, characteristics and research progress of main insert wear evaluation method were introduced and the problems and disadvantages were analyzed.
Arthroplasty, Replacement, Knee ; Humans ; Knee Prosthesis ; Polyethylene ; Prosthesis Design ; Prosthesis Failure ; Tibia ; Tomography, X-Ray Computed ; X-Ray Microtomography

Objective To observe the specific expression of diphtheria toxin A chain gene(DTA) in Ewing's sarcoma nude mice models.Methods pS2DTA plasmid was constructed by the Lus gene in pS2 plasmid was replaced with the DTA gene in pIBI30 plasmid,and transformed into DH5?, then amplified.Five nude mice were injected with 2.4?10~(7) SKES1 cells,sacrificed on week 6,and the tumor tissues were implanted onto the back of another 20 nude mice.Till 6 weeks later the diameter of the tumor up to 0.8-1.0 cm,the Ewing's sarcoma nude mice models were successfully established and randomly assigned to receive the injection of 300 ?g lipidosome+100 ?l normal saline(control group) or 300 ?g lipidosome+100 ?l normal saline+100 ?g pS2DTA (experimental group) once a day for 5 d.On day 4 after the therapy finished,4 nude mice of each group were randomly sacrificed and the DTA expression in the tissue of tumor,liver and myocardium was detected by the immunohistochemistry and RTPCR.Results The immunochemical results showed DTA expression in the tissues of control group was all negative while the DTA expression in the experimental group was negative in the tissues of myocardium and liver,positive in tumor tissue.RTPCR showed DTA expression in control group was negative in all tissues while strongly positive in tumor tissue,weakly positive in liver tissue and negative in myocardiac tissue.Conclusion The pS2DTA regulated by the EWSFLI1 fusion gene has a specific expression in transplanted Ewing's sarcoma in mice.

Objective Pericardiocentesis and drainage are the common measures for the treatment of cardiac temponade and massive pericardial effusion. In this issue, the complications of pericardiocentesis and drainage were discussed. Methods 5 in-hospital cases of cardiac temponade or massive pericardial efiusion who had complications of pericardiocentesis and drainage were reported and analyzed. Results The complications were 2 cases with neural mediated syncope, 1 case with pleural efiusion, 1 case dead of acute right ventricular dilation, and 1 case with acute pulmonary edema and effusion leaking into the subcutaneous tissue. Conclusion The importance of hemodynamic change during pericardiocentesis and drainage could not be over-emphasized, and the patients whose hemodynamic status were unstable should be monitored by bedside hemodynamic monitoring or echocardiography. Also we should pay more attention to the drainage catheter per se, which may cause the complications.

Objective To investigate the effects of pulsed electromagnetic fields (PEMF) on osteogenic differentiation in demineralized bone matrix (DBM)-induced human marrow stromal cells (hMSCs).Methods hMSCs were obtained from iliac crest marrow aspirates of a healthy boy aged 14.Then 1?104 hMSCs per well were plated in 8 24-well tissue culture plates,and 1?105 hMSCs per well in 2 6-well plates after they were expanded until passage 2.Those 24-well plates and 6-well plates were divided into 4 groups,cell control group (C group),cell-material group (CD group),cell-PEMF group (CP group) and cell-material-PEMF group (CDP group).CD group and CDP group were added with one DBM (size of 5 mm?5 mm?3 mm),CP and CDP groups were exposed to the PEMF (frequency of 15 Hz,intensity of 5 Gs),and hMSCs were cultivated in subculture medium with full media exchange in every 3 d.Alkaline phosphatase (ALP) activity and osteocalcin (OC) level were performed at 1,7,14 and 21 d,and alizarin red staining and counting of calcium nodules were performed at 21 d.Results Significant differences in ALP activity and OC level were observed between cell control group and the other 3 groups in 7 d after treatment (P