With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To analyze the biomechanical characteristics of bilateral lumbo-iliac fixation by finite element analysis after digital optimization of a safe screw pathway.Methods:Firstly, a healthy adult male volunteer was recruited for this study who underwent CT scanning of the lumbus and pelvis, with a slice thickness of 0.625 mm.The original data were imported into Mimics 16.0 software for 3D lumbar and pelvic reconstruction.At the same time, a geometric screw pathway and a free screw pathway were generated in the pedicles of L4 and L5 and ilium.Secondly, all 3D models were imported into Ansys 12 software to assemble a finite element model.The displacements and von Misses stress distribution were measured in the conditions of forward bending, backward extending, lateral bending to the left and right, and left and right rotations in the models of 2 kinds of pathway after gravity axial load of 500 N was applied.Results:The models of 2 different pathways were similar in comprehensive displacement and stress in the conditions of forward bending, lateral bending and backward extending, and in the maximum stress of the screw in the conditions of forward bending and lateral bending.However, the comprehensive displacement and stress in the condition of rotation and the stress of the screw in the conditions of backward extending and rotating in the model of geometric screw pathway were obviously smaller than those in the model of free screw pathway.The maximum pelvic stress was on the screw surface between 190 and 260 MPa, concentrated on the bending area of the 2 screws connecting the sacrum and vertebral body.The lumbar-iliac fixation model showed high com-pressive stiffness.The maximum von Misses stress appeared in the L4-L5 pedicle screw on the longitudinal rod.Under rotational loading, the upper longitudinal rod connecting the L4-L5 pedicle screw and the iliac bone screw bore the maximum stress.Conclusions:Our finite element analysis shows that double verte-bral bodies and long screw fixation are effective ways of iliolumbar fixation.The geometric screw path optimized by digital analysis exhibits better fatigue resistance, rotation resistance and overall stability.Internal lum-bo-iliac fixation can effectively share the stress of vertebral bodies.

Objective　To study the experience in surgical treatment of gastric mucosa-associated lymphoid tissue lymphoma (GMALTL). Methods　The clinical data of 69 cases of GMALTL from 1984 to 1996 were reviewed. Results　In this series, there were 26 cases in stage Ⅰ, 21 in stageⅡ, 13 in stage Ⅲ and 9 in stage Ⅳ. Diagnosis was proved by both surgery and pathology in all the cases. 61 cases underwent curative resection, 4 incomplete resect and 4 unresectable. Among them, 5 cases were treated by surgery only, surgery plus postoperative radiotherapy used in 25 cases, 19 received surgery plus postoperative chemotherapy, and 20 cases received surgery plus chemotherapy and radiotherapy. 57 cases (82.6%) were following up for 1 to 12 years.The 5,10-year survival rate was 71%(49/69)and 31.9%(22/69) respectively. Conclusions　Clinical stage and therapeutic modality adopted do the major prognostic foctors ,while age and gender do not count much to the recovery. Surgery remains to be the most important treatment model.

Objective To improve the safety and decrease the blood loss during resection of retroperitoneal tumour (RRT).[WT5”HZ]Method [WT5”BZ]We analysed retrospectively 54 patients whose blood loss were over 3?000?ml during RRT in our hospital from 1983 to 1998.The blood loss was over 5?000?ml each in 22 patients,and over 8?000?ml each in 7 patients, the maximum blood loss was 10?000?ml.[WT5”HZ]Result [WT5”BZ]Among the 54 patients whose blood loss were over 3?000?ml and up during RRT, 17 sank into shock and 2 of them died.[WT5”HZ]Conclusion [WT5”BZ]The preoperative evaluation and preparation are important to operative safety.We emphasize intraoperative management of massive bleeding during RRT.

Objective To explore the clinical and pathological characteristics and surgical treatment of primary retroperitoneal neurogenic tumor(PRNT). Methods 93 cases of PRNT were confirmed by operation and pathology from 1990 to 2003, and their clinical data were analyzed retrospectively. Results Primary neurogenic tumor accounted for 93 of 452 patients with primary retroperitoneal tumor in the same period. They included 24 cases of neurilemoma(25.8%), 19 cases of malignant neurilemoma(20.4%), 14 cases of chemodectoma(15.1%), 16 cases of neurofibroma(17.2%), and 20 cases of other rare tumors (21.5%) . The diagnostic rate of CT and MRI was 65.6% and 73.9%, respectively. In all but two patients the tumors were resectable. The resectability rate was 97.9%(91/93). The 3-year and 5-year survival rate in patients with benign and malignant tumors were 95.9%,80.1% and 42.4%,10.5%, respectively. There were 8 cases(13.1%) and 14 cases(43.8%) with recurrence after operation in benign and malignant tumors respectively. Conclusions CT and MRI are helpful in diagnosis. Surgical resection is the first choice of treatment. Prognosis in benign tumor is good, but postoperative recurrence of malignant tumor is frequent.

Objective To explore the surgical manipulation of inferior vena cava(IVC) invaded by retroperitoneal tumors(RPT) in order to raise the resection rate and improve the operative safety. Methods The clinical data of 41 cases undergoing resection of retroperitoneal tumor along with the reconstruction of IVC in our hospital from January 1990 to April 2003 were retrospectively analyzed. ResultsAll the patients were cured by operation. Management of IVC included partial excision and repairement(17 cases), partial IVC resection and right kidney excision(11 cases), partial excision and ligation(10 cases), partial excision and artificial vascular grafting(3 cases). ConclusionBUS, CT, MRI and selective angiography were essential for diagnosis and helpful for treatment. It is not an operative contraindication for RPT cases in which IVC was invaded. Resection and reconstruction of IVC is safe, effective and practical to raise the excision rate and decrease the recurrence rate.