OBJECTIVE: To investigate the surgical method and short-term effectiveness of arthroscopy edge-to-edge #-shaped suture in the treatment of the complete radial tear of the lateral meniscus body. METHODS: The clinical data of 13 patients with complete radial tear of lateral meniscus body between May 2020 and August 2023 were retrospectively analyzed. There were 10 males and 3 females, aged 15-38 years (mean, 24.2 years). There were 11 cases of acute injury and 2 cases of chronic injury, with time from injury to admission ranging from 2 days to 5 months. All patients had tenderness in the lateral joint space, and 2 patients with chronic injury had positive McMurray's sign. All patients were treated with arthroscopic edge-to-edge #-shaped suture technique. The knee joint activity and tenderness in the lateral joint space were detected, and the healing of the incision and the occurrence of complications were observed. X-ray films and MRI of the knee joint were performed to evaluate joint degeneration and meniscus healing. Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Tegner score, and visual analogue scale (VAS) score were used to evaluate the functional recovery before and after operation. RESULTS: The operation time ranged from 46 to 100 minutes (mean, 80.08 minutes). All the incisions healed by first intention, and no complication such as intraoperative vascular and nerve injury or postoperative infection occurred. All 13 patients were followed up 20-59 months (mean, 29.3 months). All patients had no limitation of knee extension and flexion. One patient with chronic injury continued to have tenderness in the lateral space of the knee joint, while the remaining patients had no tenderness, swelling, and locking in the lateral space. Immediate postoperative MRI of knee joint showed continuous recovery of the lateral meniscus. At last follow-up, no degenerative changes were observed in X-ray films of knee joint. Except for 1 patient with chronic injury, the MRI of the other patients showed the healing performance after lateral meniscus suture. Lysholm score, IKDC subjective score, Tegner score, and VAS score all significantly improved when compared with those before operation (P<0.05). CONCLUSION The edge-to-edge #-shaped suture technique can effectively repair the complete radial tear of the lateral meniscus body, and the short-term effectiveness is satisfactory.
Humans ; Male ; Female ; Adult ; Tibial Meniscus Injuries/surgery* ; Arthroscopy/methods* ; Retrospective Studies ; Adolescent ; Young Adult ; Suture Techniques ; Treatment Outcome ; Menisci, Tibial/surgery* ; Sutures ; Knee Joint/surgery* ; Magnetic Resonance Imaging

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

The comprehensive establishment of the basic medical and health system with Chinese characteristics is key to the healthcare reform. Taking the basic medical and health system as the specific research object, this paper elaborated the system examples of various countries' health systems. It also, using the classic system theory as the theoretical research basis, defined the connotation of the basic medical and health system with Chinese characteristics and described such characteristics. The purpose is to lay a theoretical foundation for the development of such a system, and provide references for the healthcare reform and Healthy China initiative.

From the perspective of the government′s positioning of public hospitals, the basic problems of functional positioning of public hospitals are clarified. According to different positioning subjects, the positioning of public hospitals is divided into three categories: government positioning, social positioning and self-positioning. By analyzing the connotation of the positioning mechanism of public hospitals, the outstanding performance of the insufficient realization of the government′s positioning of public hospitals, and the influencing factors of the government′s positioning of public hospitals, this paper tries to provide a theoretical basis for formulating a scientific and comprehensive reform plan of public hospitals.

BACKGROUND: Human acellular amniotic membrane is a kind of extracellular matrix material with good biocompatibility and biological activity. It has been widely used in various clinical studies because of its low immunogenicity, small rejection and easy preparation.OBJECTIVE: To review the applications of human acellular amniotic membranes in tissue engineering field, such as skin, blood vessel, cornea, cartilage and bone.METHODS: CNKI (from January 2005 to May 2017), CBMdisc (from January 2005 to May 2017), PubMed (from January 1990 to May 2017) and Elsevier (from January 1990 to May 2017) were retrieved for articles addressing the application of human acellular amniotic membrane as a tissue-engineered scaffold in the bone, cartilage, skin, and blood vessels.The keywords were acelluar amniotic membrane, scaffold, material, tissue engineering ECM in Chinese and English, respectively.RESULTS AND CONCLUSION: Human acellular amniotic membrane owns the structure and function of the natural extracellular matrix, which can be combined with stem cells from different sources to differentiate into different tissues and organs, such as bone, cartilage, skin, blood vessel, and corneal tissues. As a tissue-engineered scaffold, human acellular amniotic membrane has good biocompatibility, biodegradability and low immunogenicity, although it has some shortcomings, such as poor strength and post-transplantation rejection reactions. Therefore, the future studies are mainly focused on shortening the adhesion time between cells and scaffolds, increasing the own mechanical strength of human acellular amniotic membrane, optimizing the cell growth microenvironment, and combining human acellular amniotic membrane with other tissue-engineered scaffolds.

Through analyzing documents of healthcare departments, this paper explored the public benefit nature of the medical and health sector from such aspects as culture, philosophy, management, ethics,economy, politics and society. Furthermore, it analyzed the commonweal in the healthcare reform documents,including the commonweal in public health and medical services,basic medical care and health services,public hospitals and medical and health services. Public hospitals were cited as examples for an in-depth review of the profound connotation of commonweal in the medical and healthcare sector.

The financial compensation mechanism for public county hospitals are discussed and analyzed in the paper.Such a mechanism is analyzed by means of media coverage and literature consulting,along with field survey.Roadblocks have been found in implementation of the mechanism, namely delayed payment of capital expenditure compensation,poor support for medical equipment purchase,gaps in development key disciplines development,insufficient compensation for retirees expenses,poor definition of policy-incurred losses,and unclear compensation of public health services.in a word,it is imperative to change the unreasonable financial compensation mechanism,before the six financial compensation subsidies can be fully put in place and financial compensation made efficiently.

Given the significant improvement in terms of its coverage and compensation depth,China's basic medical insurance system has inherent setbacks in its structure as held by the authors.They hold that the medical insurance as the most important source of compensation for medical institutions,should further reform its structure of financing and reasonably raise the percentage of compensation; adjust the time reference and space reference for prepayment estimation such as the total prepaid amount; deepen supportive reforms for the payment manner.All these measures aim at minimizing impact of the payment control mechanism on routine medical activities and exploring diversified payment manners that are feasible.

The paper analyzed the compensation mechanism applied in public hospitals in different localities in China,which are currently experimenting with the zero price margin for drugs.It also introduced the revenue variations resulting from this practice.It is discovered that public hospitals can hardly make their ends meet with merely governmental financial input,and that lowered income of doctors and price distortion arc evident in those experimental hospitals,with little progress in overcoming the subsidization of medical services with drug sales.The authors recommended a comprehensive reform,the mechanism of diversified health input,change of internal incentive mechanism within the hospital,improvement in the healthcare service pricing mechanism,and exploration of new operation mechanisms for public hospitals.

Objective To analyze the efficacy and safety of glimepiride treatment as initial monotherapy in newly diagnosed patients with type 2 diabetes mellitus (T2DM).Methods This was a subgroup analysis of the GREAT study,which investigated the efficacy and safety of glimepiride as initial monotherapy in Chinese patients with T2DM.This analysis was performed in 209 patients with disease duration less than 6 months and never received any anti-diabetic drugs.The change of HbA1C,fasting plasm glucose (FPG),2 h postprandial blood glucose (2hPPG),homeostasis model assessment for β-cell function index (HOMA-β),homeostasis model assessment for insulin-resistance index(HOMA-IR),the percentage of patients with HbA1C ＜ 7.0％ at endpoint and the incidence of hypoglycemia were evaluated after 16-weeks treatment.Results After 16-weeks glimepiride treatment,HbA1C value reduced significantly from baseline to endpoint,the reduction was statistically significant (9.21％ ± 1.65％ to 6.69％±0.83％,P＜0.001),69.7％ of the patients achieved HbA1C ＜7.0％ at study endpoint.Glimepiride-treated patients also achieved a significant improvement in FPG [from (10.15 ± 2.13) mmol/L to (7.23 ± 1.50) mmol/L,P＜0.001] and 2hPPG [from (17.21 ±4.14) mmol/L to (11.62 ± 3.34) mmol/L].HOMA-β was improved from 17.21± 15.19 [11.62 (2.90,115.8)] to 41.13 ± 44.12 [28.00 (5.1,360.00)],and HOMA-IR was reduced from 2.32± 1.90 [1.76 (0.60,12.80)] to 2.07 ± 1.74 [1.63 (0.4,12.3)].The incidence of all reported symptomatic hypoglycemia was 18.2％,and the incidence of confirmed hypoglycemia was 3.8％.Conclusion This analysis showed that glimepiride treatment as an initial mono-therapy could effectively improve blood glucose control in newly diagnosed patients with T2DM,and the treatment may improve islet β cell function,and the safety profile is reasonably good.