Objective The purpose of this study is to evaluate the results of double-bundle anterior cruciate ligamen (ACL) reconstruction with remnant preservation and tensioning in acute stage. Methods Fifty-six cases of acute ACL injury were treated with double-bundle ACL reconstruction and tibial remnant preservation and tensioning. The double-bundle reconstruction is performed in a four-tunnel manner with eight-strands of hamstring tendon graft. The tibial remnant was tensioned with PDS sutures pulling through the femoral tunnel for the deep bundle. Fifty-three were followed up for a minimum of two years and evaluat-ed according to IKDC and Lysholm rating scale. Results At the last follow-up, all patients had negative Lachman test. KT-1000 examination in 25° knee flexion showed an average side-to-side difference of anterior laxity of (-0.44±1.53) mm compared with (8.01 1.83) mm before surgery (t=37.03, P=0.0001). Twenty-nine (54.7%) patients showed less than 0 mm side-to-side difference, which indicate a more stable or tight status of the injured knee compared with the normal side; 24(45.3%) patients showed 0 to 2 mm laxity. All patients showed negative pivot shift test. Forty-eight patients showed normal range of motion; 2 patients had 5° flexion deficit, 1 patient had less than 5° flexion deficit and 2 patients had 5° hyper-extension loss. In IKDC e-valuation 51 patients (96.2%) were graded as normal and 2 patients (3.8%) were graded as nearly normal. The IKDC subjective score was 95.6±3.1, and the Lysholm score was 94.8±2.9. The average Tegner score was 7.3 before injury and 7.1 at last follow-up. Conclusion Double-bundle ACL reconstruction with rem-nant preservation and tensioning in acute stage could get 96.2% normal and 3.8% nearly normal rates ac-cording to the IKDC scale at a minimum of two year follow-up.

Adolescent ; Adult ; Bacterial Infections ; Female ; Humans ; Infection ; Male ; Middle Aged ; Neck ; Young Adult

Objective To evaluate availability and outcomes of using anterior half of the peroneus longus tendon (AHPLT) in knee ligament reconstruction as an autograft source.Methods From July 2007 to January 2008,100 patients with knee ligament injuries were recruited in this study.There were 33 males and 67 females aging from 16 to 62 years (mean,32.3 years).49 cases had undergone medial patellofemoral ligament reconstruction,19 cases multiligament reconstruction,18 cases double-bundle posterior cruciate ligament (PCL) reconstruction and 14 cases double-bundle anterior cruciate ligament (ACL) reconstruction.AHPLT was used as sole (49 cases) or part (51 cases) of reconstruction materials.One-incision or two-incision striping techniques were adopted to harvest AHPLT.Ligaments were fixed with screws.Post-operative assessments included Kujala knee score,Lysholm knee score,Marx knee score,International Knee Documentation Committee (IKDC) subjective evaluation form and objective evaluation grade,the Foot and Ankle Disability Index (FADI) and the American Orthopedic Foot and Ankle Society (AOFAS) scale.Results 92 cases were followed up for more than 24 months.Postoperative Kujala score,IKDC subjective score,Lysholm score and Marx score were improved significantly in all four groups of patients.According to IKDC objective evaluation grade,the number of patients reaching Grade A (normal) or Grade B (near-normal) in multiligament,PCL and ACL reconstruction were 17,15 and 12,with an excellent rate of 89.5％ (17/19),93.7％ (15/16) and 100％ (12/12),respectively.Preoperative and postoperative AOFAS scores were 97.4±2.0 and 97.2±1.6,respectively,while the FADI scores preoperatively and postoperatively were 96.8±2.2 and 96.9±2.5,respectively.These results had no statistical significance.No signs of peroneal nerve injury or peroneus longus tendon rupture was found.Conclusion It is acceptable to use AHPLT as an autograft due to its feasibility to harvest,good clinical outcome,and low rate of donor site morbidity at a minimum of two-year follow-up.

Objective To investigate the outcome of augmentation of posterior cruciate ligament (PCL) using suture fixation technique. Methods Thirteen cases of simple PCL raptures were treated arthroscopically with suture fixation to maintain tibial neutralization and augment PCL. The patients were followed up for 12 to 18 months. The IKDC and Lysholm knee score were used for function evaluation. The posterior knee laxity was examined by KT-1000. Results There was no limitation to knee extension.Knee flexion was between 120° and 140°, with an average of 128°. The final IKDC grade was A in 6 cases and B in 7 cases. The IKDC subjective score increased from preoperative 67.4±3. 3 to postoperative 92.5±4. 5 (t=9. 837, P < 0. 01) . The average side-to-side difference in maximal manual test with KT-1000 arthremeter at 90° flexion decreased from 8. 1±1.7 mm to 2.0±1.3 mm ( t = 12. 230, P < 0. 01) . The Lysholm score in the 4 chronic cases was 87.5±3. 1 before surgery and 95.8±3.5 at the last follow-up( t = 5. 376, P < 0.01 ). Conclusion In some cases of PCL injury, excellent clinical results and good posterior stability can be achieved by augmentation of the tom PCL using suture fixation technique.

Objective To investigate the feasibility and clinical effect of the posterolateral depressed tibial plateau fracture by arthroscopically assisted treatment. Methods From March 2006 to September 2007, 26 patients with the posterolateral depressed tibial plateau fracture were reduced by arthroscopy and fixed laterigradely with lag screw through the capitulum fibulae. There were 17 males and 9females, and the patient age at surgery ranged from 19 to 58 years (mean, 34.5 years). According Schatzker classification, type Ⅱ for 21 patients, type Ⅲ for 5 patients. The injury mechanism included traffic injury for 15 cases, building injury for 4 cases, and sport injury for 7 cases. All patients were performed arthroscopy mean 8 days after injury. The operation time, bone union time, full weight-bearing time, range of motion, and related complications in all patients were observed, and HSS scores were used to evaluate the knee function. Results All patients got followed up. The follow-up periods ranged from 4 to 11 months (mean, 9 months). The mean operation time was 35 minutes (range, 20 to 50 minutes). The mean full weight-bearing time and radiographic bone union time were 11 and 13.1 weeks respectively, and the average ROM was 135°. None of the cases was found for infection, deep vein thrombosis, compartment syndrome, screw loosing and broken. The average HSS scores was 93 at the ultimated follow up (range, 84 to 98). There were 25 excellent cases, and 1 good case. The excellent and good rate was 100%. Conclusion Arthroscopically assisted treatment of the posterolateral depressed tibial plateau fracture was an very effective treatment methods, which showed less invasive and direct good reduction.

Background:Adipocytokines are associated with energy homeostasis and mediate various immune responses and inflammatory reactions.Vaspin is a novel adipocytokine that is thought to be associated with inflammatory reaction.Aims:To investigate the serum vaspin level and its clinical significance in patients with active ulcerative colitis (UC).Methods:Serum vaspin level was determined by ELISA in 150 patients with active UC and 150 healthy controls in Suzhou Municipal Hospital from January 2008 to April 2013,and the correlation of serum vaspin level with the clinical characteristics of UC was analyzed.Results:Serum vaspin level in patients with UC was significantly higher than that in normal controls [(1.86 ±0.38)μg/L vs.(0.96 ±0.43)μg/L,P <0.01].There was significant positive correlation between serum vaspin level and serum CRP and disease activity index in UC patients (r =0.628,P <0.01;r =0.514,P <0.05),but serum vaspin level was not correlated with serum ESR and location of UC (r =0.098,P >0.05;r =0.124,P >0.05).Conclusions:Vaspin may play an important role in the pathophysiology of UC.

Objective To assess the value of combined assays of anti Saccharomyces cerevisia antibody (ASCA) and perinuclear antineutrophil cytoplasmic antibody (pANCA) in differential diagnosis of inflammatory bowel disease (IBD). Methods Nineteen patients with IBD, including 9 patients with Crohn's disease(CD) and 10 patients with ulcerative colitis(UC), and 18 healthy subjects were enrolled into study. Serum levels of pANCA and ASCA (IgG and IgA) were measured by indirect immunofluorescence technique and a standardized ELISA, respectively. Results The serum levels of ASCA IgG and ASCA IgA in CD patients (18.51? 6.38 and 11.74 ? 5.46 ) were significantly higher than those in UC patients ( 6.98 ? 5.24 and 3.88 ? 3.52 ) and healthy subjects( 5.90 ? 4.12 and 4.62 ? 3.21 )respectively (P

With its important functions as load-bearing, shock absorption, stabilization, lubrication and congruency, the meniscus plays an important part in the complex biomechanics of the knee joint. Therefore it is still a challenging question for knee surgeons to reconstruct the function of meniscus which was injured or resected. This review details current efforts to transplant or to replace a meniscus.

It is suggested in this article that medical ethics should be conceived as the integral part of quality education for students of medical sciences,based on the high consistency of medical ethics with the quality education in higher educational institutions and its close relationship with the cultivation of the qualities of medical students.

Objective To explore the effect of doxazosin on rabbit bladder compliance after partial bladder outlet obstruction. Methods A total of 40 male New Zealand white rabbits were randomized into 4 groups, with 10 rabbits in each group. Partial bladder outlet obstruction was established in groups B and C, while groups A and D underwent the same operation but without partial bladder outlet obstruction. On the day after the operation, groups C and D received oral administration of doxazosin. After 14 weeks, urodynamic examinations were carried out in all groups, and the bladder was weighted after cystectomy. Results Bladder weight was (3.2±0.9) g in group A, (14.1±2.3) g in group B, (5.0±2.0) in group C,and (2.9±0.5) g in group D. The bladder weight in groups B and C increased significantly compared to groups A and D (P＜0.01), group B increased significantly over group C (P＜0.01), and there was no significant difference between groups A and D (P＞0.05).The detrusor leak point pressure was (10.2±2.5) cm H2O in group A, (18.8±6.1) cm H2O in group B, (13.5±4.7) cm H2O in group C,and (11.6±3.6) cm H2O in group D. The detrusor leak point pressure in group B was significantly higher than group A, group D (P＜0.01) and group C (P＜0.05). There was no significant difference between group A, group C and group D (P＞0.05). The bladder compliance was (2.86±0.56) ml/cm H2O in group A, (1.22±0.39) ml/cm H2O in group B, (4.25±2.19) ml/cm H2O in group C,and (2.90±0.53) ml/cm H2O in group D. The bladder compliance was significantly decreased in group B compared to groups A and D (P＜0.01). Bladder compliance in group C was significantly higher than in groups A and D (P＜0.05), and there was no significant difference between group A and group D (P＞0.05). Conclusion Early use of doxazosin can delay the occurrence of lower bladder compliance after partial bladder outlet obstruction, thus protecting the storage function of bladder.