OBJECTIVE: To standardize the operative procedure for tissue-engineered cartilage repair, by demonstrating surgical technique of arthroscopic implantation of decalcified cortex-cancellous bone scaffolds, and summarizing the surgical experience of the sports medicine department team at Peking University Third Hospital. METHODS: This article elaborates on surgical techniques and skills, focusing on the unabridged implantation technology and surgical procedure of decalcified cortex-cancellous bone scaffolds under arthroscopy: First, the patient was placed in the supine position. After anesthesia had been established, the surgeon established an arthroscope and explored the damaged area under the scope. After confirming the size and location of the injury site, the surgeon cleaned the damaged cartilage, and also trimmed the edges of the cartilage to ensure that the cut surface was smooth and stable. the surgeon performed the micro-fracture surgery in the area of cartilage injury, and then measured the size of the injured area under the scope. Next, the surgeon manually trimmed the tissue-engineered scaffold based on the measurements taken under the arthroscope, and then directly implanted the scaffold using a sleeve. A honeycomb-shaped fixator was used to implant absorbable nails to fix the scaffold. After the scaffold was installed, the knee was repeatedly flexed and extended for 10-20 times to ensure stability and range of motion. Finally, the arthroscope was withdrawn and the wound was closed. RESULTS: Decalcified cortex-cancellous bone scaffolds possessed unparalleled advantages over synthetic materials in terms of morphology and biomechanics. The cancellous bone part of the scaffold provided a three-dimensional, porous space for cell growth, while the cortical bone part offered the necessary mechanical strength. The surgery was performed entirely under arthroscopy to minimize invasiveness to the patient. Absorbable pins were used for fixation to ensure the stability of the scaffold. This technique could effectively improve the prognosis of the patients with cartilage injuries and standardized the surgical procedures for arthroscopic tissue-engineered scaffold operations in the patients with cartilage damage. CONCLUSION With the standard arthroscopic tissue-engineered scaffold repair technique, it is possible to successfully repair damaged cartilage, alleviate symptoms in the short term, and provide a more ideal long-term prognosis. The author and their team explain the surgical procedures for tissue-engineered scaffolds under arthroscopy, with the aim of guiding future clinical practice.
Tissue Engineering/methods* ; Humans ; Tissue Scaffolds ; Arthroscopy/methods* ; Cartilage, Articular/surgery*

The anterior cruciate ligament (ACL) injury is a common sports injury, which can lead to the knee unstable, make it difficult for the patient to return to sports, and cause post-traumatic osteoarthritis. The difficulty of its clinical diagnosis and treatment has always been the focus of sports medicine research. In August 2022, the American Association of Orthopaedic Surgeons updated and published "evidence-based clinical practice guideline on management of ACL injuries (2022 version)" based on the "evidence-based clinical practice guideline on management of ACL injuries (2014 version)". In the prevention, diagnosis and treatment of ACL injuries, the new guideline offers 8 recommendations and 7 options according to different evidence strength. To assist clinicians in the diagnosis and treatment of ACL injuries, this article provides an interpretation of the new guideline. In comparison to the 2014 version, the new guideline does not recommend allografts any more, shortens the time for reconstruction after ACL injury from 5 months to 3 months, adds advice that ACL reconstruction can be combined with anterolateral ligament reconstruction or lateral extra-articular tenodesis, and does not recommend ACL repair. The new guideline also shares many similarities with the domestic "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)", both of which advocate history and physical examination at diagnosis, early reconstruction, the use of autologous bone-patellar tendon-bone or hamstring tendon, and either single-bundle or double-bundle ACL reconstruction. The new ACL guidelines of the American Association of Orthopaedic Surgeons lack specific recommendations on artificial ligaments, techniques for bone tunnel creation, and rehabilitation programs, all of which are of concern to domestic physicians because they are based on evidence-based research from abroad. Therefore, in order to improve the diagnosis and treatment of ACL injuries in China, clinicians should not only follow the new ACL guidelines of the American Association of Orthopaedic Surgeons, but also combine the characteristics of Chinese patients, clinical practice, and pertinent domestic guidelines when diagnosing and treating ACL injuries.

【Objective】 To investigate the serological and molecular genetic characteristics of B(A) and cisAB blood groups discovered in our laboratory. 【Methods】 ABO blood group serology and genetic tests were used to identify blood groups of 6 blood samples, submitted by blood center and hospitals in Shandong, and pedigree investigation was carried on 2 of them. 【Results】 Among the 6 samples, serological results were B(A) in 5 cases and cisAB in 1 case. The results of genetic tests were consistent with the serological results, as the alleles included B(A)04, B(A)02 and cisAB01, and all genotypes were heterozygous with O. Serological pedigree study was conducted on 2 samples: One cisAB patient with his 4 relatives(cisAB type father and three O type relatives) and one B(A)02/O1 donor with his 3 relatives[ B(A) type father/brother and O type mother). For B(A)02/O1 donor, the results of genetic testing were consistent with the serological results, as the paternal genotype was the same as that of the proband, the younger brother was B(A)02/O2, and the maternal genotype was O1/O2. 【Conclusion】 The cisAB and B(A) blood groups are often indistinguishable by serological phenotypes and require genetic confirmation. CisAB pedigree investigation revealed 2 cases of cisAB blood type and B(A) pedigree investigation revealed 3 cases of B(A). The genotyping of cisAB and B(A) in this region were cisAB01/O2, B(A)02/O1, B(A)02/O2, B(A)04/O1 and B(A)04/O2. B(A)and cisAB subtypes can be accurately identified through genetic testing and pedigree investigation, which can provide a reliable basis for blood transfusion selection and ensure the safety of clinical blood transfusion.

Objective To compare the femur tibia angle(FTA) and tibia tubercle to trochlear groove (TT-TG) measured on the magnetic resonance imaging(MRI) between patients with anterior cruciate ligament(ACL) rupture and healthy controls with intact ACL,and to observe the change of the tibia-femur rotation and explore its relationship with the patellofemoral cartilage injury.Methods Fifty patients with ACL ruptures were divided into an experimental group,while another 50 healthy counterparts were chosen into a control group.All subjects were given MRI to get FTA and TT-TG.For the experimental group,all parameters were measured before and after ACL reconstruction.The results were analyzed by variance analysis and t test.Results MRI measurements showed that the average FTA in the experimental group was 6.5° ± 6.1° and 6.0° ± 5.6° before and after the ACL reconstruction,significantly higher than that in the control group,which was 3.6° ± 4.9° (P=0.0003 and P=0.033,respectively).No significant differences were found in the average TT-TG of the experimental group,6.4 ± 3.3 mm before ACL reconstruction and 6.9 mm ± 4.0 mm after ACL reconstruction,and that of the control group,6.3 ± 3.6 mm(P=0.678).Moreover,all patients in the experimental group underwent a second check under the arthroscopy,which revealed that the patellofemoral cartilage injury was aggravat ed in 26 patients measured by the Outerbridge grading.However,there was no significant difference in FTA and TT-TG between patients with and without aggravated patellofemoral cartilage degeneration.Conclusions After ACL reconstruction,the external rotation angle of the knee could not completely recover to the normal level with the knee extension at 0°.Patellofemoral cartilage degeneration after the ACL reconstruction is caused by many factors.The results of the second arthroscopy after the ACL reconstruction find no relationship between patellofemoral cartilage degeneration and the increased tibia external rotation angle relative to the femur.Moreover,after the ACL reconstruction,if the femur tibia angle is bigger than the range of motion of the knee,it cannot be concluded that the anterior cruciate ligament is reruptured.

Objective:To observe the expression of wnt1 in patients with oral submucous fibrosis(OSF) before and after treatment.Methods:40 patients with OSF were treated with triamcinolone acetonide combined with salvia miltiorrhiza,Before and after 4 weeks treatment,pain score of VAS and mouth opening(MO) were examined.wnt1 protein in saliva and gingival crevicular fluid(GCF) was examined by ELISA,wnt1 mRNA expression in buccal mucosa tissue was examined by real-time fluorescent quantitative PCR.20 healthy subjects were served as the controls.Results:The expression of wnt1 in OSF group[buccal tissue RT-PCR (36.89 ± 10.40) × 10-5,saliva ELISA (61.61 ± 4.45) ng/L,GCF ELISA (56.20 ± 3.65) ng/L] were significantly higher than that of control group [buccal tissue RT-PCR (4.63 ± 1.53) × 10-5,saliva ELISA (40.26 ± 3.00) ng/L,GCF ELISA (53.45 ± 1.74) ng/L)] (P ＜ 0.01).In OSF group,after treatment VAS was decreased(P ＜0.01),MO increased(P ＜0.01)),Buccal mucosa wnt1 mRNA level was positively correlated with wnt1 protein in saliva and GCF,negativity with MO (P ＜ 0.05),saliva wnt1 was positively correlated with VAS and GCF wnt1,negitively with MO(P ＜ 0.05).Conclusion:Wnt1 might take part in the occurrence and development of OSF.The detection of wnt1 in saliva and GCF might be a noninvasive method for the evaluation of OSF treatment.

Objective To investigate the association between phage-mediated shiga toxin and molecular distribution of CRISPR in Escherichia (E.) coli O26:H11 or NM.Methods A total of 135 E.coli O26:H11 or NM strains were collected from NCBI database.Software CRT and CRISPR Finder were used to extract CRISPR and Excel was used to assign the spacer of unique number and type CRISPR.And the relationship between CRISPR and stx phage was analyzed.Results All the 135 E.coli O26:H11 or NM strains had the CRISPR.For CRISPRI,CRISPR2.1,CRISPR2.2 and CRISPR3-4,19,22,1 and 1 subtypes were found,respectively.According to the four CRISPR sites,the strains could be divided into 40 subtypes.Stx-phage was only observed in the group C of CRISPR.Compared with E.coli of stx-phage negative,E.coli with stx-phage harbored more spacers.Conclusions CRISPR loci was extensively existed in E.coli O26:H11 or NM,and many subtypes were found in these strains.The presence of stx-phage was related to the molecular distribution of CRISPR in E.coli O26:H11 or NM.CRISPR might be a valuable biomarker to identify strains with high virulent potential.

Objective To explore the effects of rapid response first-aid case on bedside emergency gastroscopy hemostatic treatment. Methods A total of 52 patients with esophageal-fundal varices in liver cirrhosis from January 2014 to June 2015 were divided into control group (n=25) and experimental group (n=27). The patients of control group received the routine nursing; then we summarized the experience and mistakes of operation cooperation, optimized process;next we designed rapid response first-aid case and used in the experimental group. The blood transfusion time, goods preparation time, blood loss, blood transfusion volume were compared in two groups. Results The data of the experimental group in average bleeding to transfusion time (90. 22 ± 36. 47)min, materials preparation time (14. 66 ± 3. 48) min, the average amount of bleeding (369. 62 ± 158. 90) ml, average blood transfusion amount (322. 40 ± 117. 82) ml were lower than those of the control group [ average bleeding to blood transfusion time ( 123. 60 ± 51. 87 ) min, materials preparation time ( 22. 44 ± 2. 59 ) min, average bleeding volume ( 660. 20 ± 181. 82 ) ml, average blood transfusionamount(458.00±140.63)ml](P<0.05).Conclusions Theimplementationofrapidresponse first-aid case can effectively shorten the rescue time, reduce bleeding and blood transfusion time, the blood loss, the wastage of human resources and medical resources, improve the efficiency of nursing work in the department and the success rate of rescue.

Objective:To evaluate the change in hamstring ( H ):quadriceps ( Q ) ratio following anterior cruciate ligament ( ACL) rupture during isokinetic knee extension and flexion at 30 degrees of flexion which is important for knee dynamic function .Methods:A study was performed in 25 male com-plete unilateral ACL ruptures .Isokinetic concentric and eccentric quadriceps and hamstring muscle tests in both the deficient knees and intact knees were performed at 60°/s, respectively.At 30 degrees of flexion, the average torque of quadriceps and hamstring , Qe∶Qc ratios ( ratios of eccentric quadriceps to concentric quadriceps muscle torque ) , He∶Hc ratios ( eccentric hamstring to concentric hamstring ) , Hc∶Qc ratios ( concentric hamstring to concentric quadriceps ) , He∶Qc ratios ( eccentric hamstring to con-centric quadriceps ) , and Hc∶Qe ratios ( concentric hamstring to eccentric quadriceps ) were calculated . Wilcoxon matched-pairs signed-ranks test was used .Results:At 30 degrees of knee flexion , a significant reduction ( P<0.05) in the average torque of quadriceps was observed at concentric and eccentric 60°/s produced by the deficient-side compared with the intact side .In addition, Hc∶Qc, He∶Qc, and Qe∶Qc significantly increased on the ACL-deficient side .Conclusion:The change in H ∶Q ratio in the mode of isokinetic 60 °/s at 30 degrees of knee flexion might therefore be a new tool to objectively document muscle function in ACL-deficient knee .

Objective To investigate the diagnosis,differential diagnosis and treatment of gynecological acute abdomen,and provide a basis for treatment.Methods The clinical data of 749 cases with gynecological acute abdomen in our hospital were retrospectively analyzed.Results The diagnostic accuracy was 100％ of the preoperative uterine perforation,acute pelvic inflammatory disease,tubal ovarian abscess,ovarian cyst torsion and.ruptured ovarian cysts.19 cases with ovarian corpus luteum rupture were misdiagnosed for ectopic pregnancy,1 case with acute hemorrhagic salpingitis were misdiagnosed for ectopic pregnancy,1 case with IUD of ectopic pregnancy lead to pelvic abscess was misdiagnosed for ovarian cyst torsion secondary infection,the total misdiagnosis patients were 21 cases,and the misdiagnosis rate was 2.8％.217 cases with acute abdomen received the surgical treatment,532 cases were given non-surgical treatment.All patients were cured and discharged by the hospital treatment,the average hospitalization time was (8.2 ± 2.5) d.Conclusion In the diagnosis of gynecological acute abdomen,detailed ask the patients' medical history,symptoms,and comprehensive physical examination and collection of signs are important means.The understanding of acute hemorrhagic fallopian tubes,ovarian corpus luteum rupture and ovarian cyst torsion secondary infection should be further strengthened to reduce misdiagnosis rate.

Objective This study detects the expression of secreted frizzled-related protein 1 (SFRP1) in healthy patients and patients with chronic periodontitis (CP) and explores the relationship between SFRP1 and the occurrence and development of CP. Methods First, 28 patients forming the CP group were further divided into mild, moderate, and severe CP subgroups according to clinical attachment loss (CAL) data. Ten healthy volunteers were recruited in the control group. Gingival crevi-cular fluid (GCF) was collected from all of the patients, and the concentration of SFRP1 in the GCF samples was detected using enzyme-linked immunosorbent assay. Next, gingival lesions were obtained from 22 patients in the CP group and healthy gingival tissues were obtained from the 10 healthy patients in the control group. Immunohistochemical analysis for SFRP1 was used to analyze the correlation between the expression of SFRP1 and the severity of CP based on staining intensities. Results The concentration of SFRP1 in GCF samples taken from of the CP group (281.07 ng·L-1±33.37 ng·L-1) was signifi-cantly higher than that in samples taken from the control group (245.30 ng·L-1±35.69 ng·L-1) (P<0.05). A significant positive correlation was observed between the concentration of SFRP1 in GCF and CAL (r=0.651, P<0.001). Furthermore, the SFRP1 scores in the CP groups (4.500±0.913) were significantly higher than those in the control group (2.800±1.135) (P<0.001). SFRP1 scores did not vary significantly among the CP subgroups (P>0.05). Conclusion SFRP1 expression in the CP groups was significantly higher than that in the control group. Thus, SFRP1 may play a significant role in the development of CP.