BACKGROUND: Donor complications have been detected following autologous tendon transplantation for posterior cruciate ligament reconstruction. Although artificial tendon development and tissue-engineered tendon have achieved great progresses, there are some issues in clinical application. Since 1980's, allogenic tendon transplantation has aroused increasing attention. OBJECTIVE: To explore the selection of allogenic tendon materials and the effect of their application on reconstructing posterior cruciate ligament. METHODS: A total of 17 patients with posterior cruciate ligament injury of knee joint were treated with cryopreserved allogenic tendon by Tibial-inlay technique. During the operation, two tracts of tendons soaked in gentamicin saline for 15 minutes were conduplicated, and one end of the tendon was cancellous bone screw and fixed to the tibia attachment point of posterior cruciate ligament, and the other end was introduced into the joint through retention suture. The posterior joint capsule was repaired. The patient was placed at supine position, and the knee was flexed for 90°. The other end of the graft was introduced to femoral tunnel, and anterior drawer was tensed, and fixed by screw. RESULTS AND CONCLUSlN: The preoperative posterior drawer test of patients was >2+, including 7 cases of 3+ and 6 of 4+. The postoperative posterior drawer test was 0 in 4 cases, 1+ in 8 cases, 2+ in 4 cases and 3+ in 1 case, suggesting the posterior movement of the knee joint was significantly improved. Lysholm scores of patients were (48.5±4.3) points before operation and (88.3±5.4) points after operation. Results show that cryopreserved allogenic tendon by Tibial-inlay technique could restored function of posterior cruciate ligament with a favorable effect.

BACKGROUND:Obsolete lateral ankle ligament injury is frequently treated by Chrisman-Snook operation.However,this operation destructs some peroneus brevis tendon,and affects the function of peroneus brevis tendon for foot valgus.OBJECTIVE:Based on previous research,to investigate the effect of allogeneic tendon for reconstruction of ankle lateral ligaments.METHODS:A total of 17 cases of ankle lateral ligament injured were selected,with a course of disease from 3 to 6 months.All lateral ligaments were reconstructed by allogeneic tendon & anchors.During the operation,a drill,4.5 rnm diameter,was used to drill a hole on the lateral ankle;one anchor was drilled into the talus at the end of anterior talofibular ligament,another one was threaded on the calcaneus;the allogeneic tendon was permeated through the hole on the lateral ankle,maintaining ankle neutral and moderate valgus position.The allogeneic tendon was sutured with the thread of the anchors.Following operation,the ankle was fixed in neutral position and slightly valgus position;wound healing,AOFAS score and stress radiograph were observed.RESULTS AND CONCLUSION:All 17 patients showed no rejection,and the wound healing well at the primary stage.At 6,12,24 after operation,all patients were followed-up.According to AOFAS criteria,function of ankle in all patients was significantly improved.No patients complained of instability of the ankle,end stress radiograph confirmed this improvement.Reconstruction of lateral ligaments of the ankle with allogeneic tendon and anchors is a practical treatment,which restores stability and function of ankle without long incision or damaging normal tendons.

Objective To evaluate the effects of pregabalin combined with hydrochloric oxycodone on patients with ma-lignant neuropathic pain (MNP). Methods A total of 66 patients with MNP was divided into control group or treatment group randomly. The patients in control group received only hydrochloric oxycodone, and treatment group were treated with the combina-tion of pregabalin and hydrochloric oxycodone. Numeric rating scale (NRS) score was used to evaluate the analgesic effects. Med-ical outcomes study sleep scale (MOS-SS,Chinese version) was used to evaluate the improvement of sleep disorder. The changes of depression or anxiety were investigated by 17-item Hamilton Depression Rating Scale (HAMD-17) or Hamilton Anxiety Scale (HAMA), respectively. Side effects were accessed by Acute and Subacute Toxicity Grading Criteria of Anticancer Drugs (WHO). Results The pain control rate of treatment group was 87. 1% , which was superior to that of control group (58. 6% ) (P<0. 05). The improvement of sleep interference, and the quality and quantity of sleep in treatment group were also superior to that in control group (P<0. 05). After the treatment, depression and anxiety was attenuated in both groups, and the improvement degree in treatment group was higher than that in control group (P<0. 05). No obvious side effects were found in either groups. Conclusion The combination therapy of pregabalin and hydrochloric oxycodone is the better way to treat MNP.

Objective To compare arthroscopic double-pulley knotless suture bridge with conven tional arthroscopic suture bridge in repair of rotator cuff tear.Methods From May 2013 to May 2015,70patients with rotator cuff tear were repaired at our department.They were 38 males and 32 females,with a mean age of 53.7 years.They were randomized into 2 equal groups to receive repair either using arthroscopic double-pulley knotless suture bridge (the experimental group) or using conventional arthroscopic suture bridge (the control group).The 2 groups were compared postoperatively in terms of VAS (visual analogue scale),Constant,ASES (American Shoulder and Elbow Surgeons) and UCLA (University of California at Los Angeles) scores,shoulder range of motion,and rotator cuff retear.Results The 2 groups were compatible with no significant differences in gender,age,laterality,tear type,or preoperative function or range of motion of the shoulder joint (P ＞ 0.05).At 12 months postoperatively,the VAS,Constant,ASES and UCLA scores and shoulder range of motion in the experimental group were respectively 1.1 ± 1.3,86.0 ±8.9,13.3 ± 0.8,32.0 ± 2.9,156.8° ± 15.0° and 55.9° ± 5.8°,significantly improved than the preoperative values (P ＜0.05).At 12 months postoperatively,the VAS,Constant,ASES and UCLA scores and shoulder range of motion in the control group were respectively 1.3 ± 1.3,86.6 ±4.2,13.1 ± 1.0,31.1 ±2.6,153.3°±10.0° and 55.7° ± 5.1 °,significantly improved than the preoperative values (P ＜ 0.05).At 12 months postoperatively,there were no significant differences between the 2 groups in VAS,Constant,ASES or UCLA scores or shoulder range of motion (P ＞ O.05).No case of rotator cuff retear occurred in the experimental group while 5 cases were observed in the control group,showing a significant difference (0 versus 14.3％) (P ＜ 0.05).Conclusions Compared with conventional arthroscopic suture bridge,arthroscopic double-pulley knotless suture bridge presents no significant differences in range of motion or function of the shoulder joint in repair of rotator cuff tear.However,the latter may lead to a lower incidence of rotator cuff retear and,additionally,is less skillfully demanding.

Objective:To evaluate the efficacy and safety of lenvatinib combined with camrelizumab as the second-line treatment for advanced intrahepatic cholangiocarcinoma (ICC).Methods:The clinical data of patients with advanced ICC undergoing the second-line treatment of lenvatinib combined with camrelizumab in the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from June 2021 to June 2022 were screened and analyzed. A total of 12 patients were enrolled, including seven males and five females, aged (67.5±8.6) years. Response evaluation criteria in solid tumor 1.1 was used to evaluate the efficacy of treatment. The safety assessment adopts the Adverse Event Evaluation Standard 5.0. Kaplan-Meier method was conducted to plot survival curves.Results:Among the 12 patients (after 1-7 cycles of immune and targeted therapy), three achieved partial response, four achieved stable disease, and five were defined as progression disease. Adverse events of different degrees occurred in seven cases, among which three patients had adverse events of grade ≥ 3: one with hypertension, which was managed after antihypertensive and symptomatic treatment; one with elevated serum total bilirubin, which was improved after reducing the dose of lenvatinib; one with liver dysfunction, which was considered as immune-related liver toxicity and alleviated after discontinuing camrelizumab. The 1-month, 3-month, and 6-month survival rates and progression-free survival rates of the patients were 100.0%, 91.7%, 66.7%, and 83.3%, 41.7%, and 25.0%, respectively. The median overall survival of patients was 14.7 months (95% CI: 9.2-21.2) and the median time to progression was 8.0 months (95% CI: 4.1-11.9). Conclusion:Combination of lenvatinib and camrelizumab could bring survival benefits with controllable adverse events as the second-line treatment of patients with advanced ICC.