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.

Acute Disease ; Adult ; Female ; Herbicides ; poisoning ; Humans ; Male ; Middle Aged ; Paraquat ; poisoning ; Retrospective Studies ; Young Adult

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 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 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.

Objective To investigated the efficacy of celecoxib for postoperative analgesia after endoscopic nasal surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes aged 18-64 yr were randomly assigned to one of three groups ( n = 40 each): control group ( group C); celecoxib 200 group ( group CEL1 ) and celecoxib 400 group ( group CEL2 ). The patients took celecoxib 200 and 400 mg by mouth at 1 h before induction of anesthesia in group CEL1 and CEL2 respectively. Anesthesia was induced with midazolam,propofol, remifentanil and rocuronium and maintained with iv propofol and remifentanil infusion. VAS was used to assess postoperative pain (0 = no pain, 10 = worst pain). In PACU when VAS score ≥3, the patients were given fentany125 μg iv every 5-10 min until the VAS score ＜ 3. After being discharged from PACU, the patients received celecoxib 200 mg every 12 h for 5 days in the 2 celecoxib groups. Oxycodone 5 mg was used as rescue analgesic when VAS score ≥ 4 until the VAS score ＜ 4. The number of patients who needed fentanyl for analgesia in PACU, the number of patients who needed oxycodone within 6 h, 6-24 h and day 2-5 after operation and side effects after operation were recorded. Analgesic efficacy was assessed at day 5 after operation and the satisfactory rate of patients calculated. Blood samples were obtained at 0, 6 and 48 h after operation for determination of PGE2,6-k-PGF1α and TXB2 concentrations. TXB2/6-k-PGF1α was calculated. Results The number of patients who needed fentanyl in PACU and the number of patients who needed oxycodone within 6 h and 6-24 h after operation were less, the satisfactory rate was significantly higher, and PGE2 concentrations in blood were significantly lower at 48 h after operation in the 2 celecoxib groups than in group C ( P ＜ 0.05 or 0.01 ). There was no significant difference in each index between the 2 celecoxib groups ( P ＞ 0.05 ). There was no significant difference in TXB2/6-k-PGF1α at each time point among the three groups. Nausea and vomiting occurred in one patient after operation in group C, but side effects were not observed in the 2 celecoxib groups. Conclusion Celecoxib given before and after operation can effectively relieve postoperative pain after endoscopic nasal operation by reducing PGE2 concentrations in blood.

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.