Objective To explore the efficacy of the soft-tissue fixation in reconstruction of the medial patellofemoral ligament(MPFL) in treating the recurrent dislocation of patella in adolescents.Methods A total of 12 adolescents undergoing MPFL reconstruction for the recurrent dislocation of patella between March 2014 and October 2015 were included.The autologous hamstring tendon was harvested and fixated using the soft-tissue fixation method in the MPFL reconstruction.A rapid rehabilitation program was carried out postoperatively.Clinical outcomes were evaluated using the Lysholm,international knee documentation committee(IKDC),Kujala knee scores preoperatively and during the postoperative follow-up.Moreover,the degree of satisfaction to the surgery and the restoration of sports activities were also surveyed.Results All patients were followed up for 6 to 18 months,with an average of 12 months.There was no recurrence of dislocation.During the final follow-up,all patients restored the full range of activity and normal medial patellar stability.The Lysholm,IKDC and Kujala knee scores were significantly improved postoperatively compared with those preoperatively (P＜0.01).Ten patients were very satisfied with the operation and the other 2 were satisfied with the surgery.Among all the patients (non-professional athletes),75％(9/12) fully regained their sport abilities in 6 months after the surgery.Conclusions Reconstruction of MPFL with the soft-tissue fixation method has achieved remarkable clinical results without severe complications associated with bony procedures.For the adolescent patients with open growth plates,this is a safe,effective and reliable surgical technique.

In recent years, with the in-depth study of PD-1 and PD-L1 and the development of immunotherapy, the first problem is how to screen the beneficiaries. Recent clinical studies have shown that the expression level of PD-L1 in circulating tumor cells (CTC) can be used as a potential biomarker to play a guiding role in immunotherapy of malignant tumors. This article reviews the latest clinical research progress on the expression of PD-L1 in circulating tumor cells in various solid tumors.

Objective:To analyze the prevalence and clinical features of respiratory syncytial virus (RSV) in Chengde city.Methods:From August 2022 to June 2023, throat swabs and clinical data of 478 hospitalized children with respiratory tract infection in the Chengde Central Hospital were collected. Real-time quantitative PCR was used to detect the molecular epidemiology of RSV-A and RSV-B subtypes and analyze the clinical features of patients with RSV infection.Results:Among the hospitalized children, 67.57% (323/478) tested positive for RSV. The outbreak of RSV infection was caused by RSV-A subtype. The peaks of RSV-A infection occurred from November to December, 2022 and May to June, 2023. There were 86.07% (278/323) of the RSV-A-positive cases had mixed infection with other pathogens, primarily bacterial pathogens with Streptococcus pneumoniae being the most common, followed by Klebsiella pneumoniae. Influenza virus A was the most common viral pathogens causing mixed infection. The level of lactate dehydrogenase was higher in the patients with single RSV-A infection than in those with mixed infection ( Z=2.396, P=0.017), and higher than the normal upper limit. Compared with the single infection group, the mixed infection group had higher white blood cell count ( Z=2.417, P=0.016), neutrophil ratio ( Z=3.218, P=0.001), C-reactive protein level ( Z=1.998, P=0.046) and creatinine level ( Z=2.107, P=0.035), and lower lymphocyte ratio ( Z=3.205, P=0.001), but they were all within the normal range. There were no significant differences in the clinical features between RSV-A-positive patients co-infected with bacteria or other viruses (all P>0.05). Conclusions:RSV-A is the leading cause of respiratory tract infection in children in Chengde from 2022 to 2023, and often co-detected with bacteria. The mixed infection with other respiratory pathogens is related to the clinical features of patients with RSV-A infection.