Objective:To explore the application value of arthroscopic tunnel pulling and suturing methods in West type Ⅱ and Ⅲ lateral meniscus posterior root injuries.Methods:A total of 184 patients with West Ⅱ ( n=92) and Ⅲ ( n=92) lateral meniscus posterior root injuries who underwent surgical treatment in Second Affiliated Hospital of Xi′an Jiaotong University from May 2022 to June 2023 were selected as the study subjects, by adopting a retrospective controlled study method. Using a random number table method, West Ⅱ and Ⅲ patients were divided into a tunnel method group and a suture method group, with 46 patients in each group. There were 23 male and 23 female patients in the West Ⅱ tunnel method group, with an age of (48.36±2.52) years. There were 25 male and 21 female patients in the suture method group, with an age of (48.61±2.21) years. There were 24 male and 22 female patients in the West Ⅲ tunnel method group, with an age of (48.53±2.36) years. There were 24 male and 22 female patients in the suture method group, with an age of (46.38±2.67) years. The tunnel method group used arthroscopic tibial tunnel cable fixation method, while the suture method group used arthroscopic full internal meniscus suture method. Compared the surgical time, length of hospital stay, and first postoperative time of getting out of bed between the tunnel method group and the suture method group of patients with different subtypes. Compared the knee joint function scores (Lysholm, Tegner, IKDC, VAS) before and after surgery. Used MRI to examine the compression of the patient′s lateral meniscus. Compared the incidence of adverse reactions. Measurement data with normal distribution were represented as mean ± standard deviation( ± s), and the comparison between groups was conducted using the t-test; the comparison of count data were represented as [ n(%)] and was conducted by chi-square test or Fisher exact probability. The skewness data were expressed by M( Q1, Q3), and rank-sum test was used for inter-group comparison. Results:There was no significant difference in surgical time, length of hospital stay, and first postoperative bed time between the West type Ⅱ, Ⅲ tunel method group and the suture method group ( P>0.05). At 12 months after surgery, there was no statistically significant difference in the Lysholm score, Tegner score, IKDC score, and VAS score between the West Ⅱ type patients in the tunnel method group and the suture method group ( P>0.05). However, the Lysholm score and IKDC score in the West Ⅲ type tunnel method group were significantly higher than those in the suture method group, and the difference was statistically significant( P<0.05). However, there was no statistically significant difference in the Tegner score and VAS score ( P>0.05). At the 12th months after surgery, there was no statistically significant difference in the overall width of the meniscus between the tunnel method group and the suture method group for patients with different West classifications( P>0.05). However, the relative percentage of meniscus compression in the tunnel method group was significantly lower than that in the suture method group, and the difference was statistically significant ( P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the tunnel method group and the suture method group in patients with different West subtypes ( P>0.05). Conclusions:The arthroscopic tibial tunnel wire fixation method is effective, safe, and reliable in treating patients with West Ⅱ and West Ⅲ lateral meniscus posterior root injuries promoting kneejoint function recovery. It is expected to become a high-quality treatment plan for patients with West Ⅱ and West Ⅲ meniscus injuries.

Objective:To investigate the application of three-dimensional image reconstruction combined with problem-based learning (PBL) in the teaching of physicians receiving continuing education in thoracic surgery.Methods:A total of 68 physicians who received continuing education in Department of Thoracic Surgery in our hospital were selected as research subjects, and they were divided into control group and observation group using a random number table, with 34 physicians in each group. The physicians in the control group received traditional teaching, while those in the observation group received three-dimensional image reconstruction combined with PBL teaching. A questionnaire survey, theoretical assessment, and assessment of practical skills were performed to evaluate the effect of teaching. SPSS 22.0 was used to perform the t-test. Results:Compared with the control group, the observation group had significantly higher degrees of satisfaction with each item of the questionnaire survey ( P<0.05). Compared with the control group, the observation group had significantly higher scores of theoretical assessment [(94.07±6.03) vs. (86.34±5.46), P<0.001] and the assessment of practical skills [(95.20±5.48) vs. (84.71±6.14), P<0.001]. Conclusion:The application of three-dimensional image reconstruction combined with PBL teaching can help to improve the comprehensive ability of physicians receiving continuing education.

Objective:To evaluate the effectiveness and safety of the home-made umbrella-shaped Octoparms inferior vena cava filter in the prevention of pulmonary embolism.Methods:A multicenter, randomized, positive parallel controlled, non-inferiority clinical trial was conducted in ten hospitals in China from October 2017 to March 2019. A total of 188 subjects were enrolled according to the same inclusion and exclusion criteria in different institutes. The 188 subjects were randomly divided into the trial group or the control group according to 1∶1 by the central randomization system, with 94 cases in each group. Octoparms inferior vena cava filter was used in the trial group, and the Celect inferior vena cava filter in the control group. The primary effective index was clinical success rate,including the clinical success rate of filter placement and filter retrieval. The secondary index included the rate of manual success of the delivery sheath system,incidence of pulmonary embolism(within 6 months), incidence of filter fracture,migration (>20 mm),tilt(>15°) on insertion/retrieval,and the situation of inferior vena cava flow(within 6 months). Safety evaluation included the incidence of filter related complications and device-related adverse events immediately after surgery and during follow-up.Results:The success rate of implantation was 100% in 188 subjects. Filter retrieval was performed in 87 cases (92.55%) in the trial group and 91 cases (96.81%) in the control group. The clinical success rate of the trial group was 97.87%(92/94) and that of the control group 98.94%(93/94). There was no significant difference between the two groups (χ 2=0.77, P=0.380). The success rate of delivery sheath system was 96.81%(91/94) and 98.94%(93/94) in the trail group and the control group,respectively. There was no significant difference between the two groups( P=0.621). There was 1 case (1.22%) of new asymptomatic pulmonary embolism in the trial group after filter placement and 2 cases (2.44%) in the control group. There was no significant difference between the two groups ( P>0.05). No filter fracture or migration (>20 mm) occurred in either group. The tilting of filter (>15°) was found in 1 case (1.06%) in the test group and 1 case (1.06%) in the control group when the filter was placed. The tilting of filter (>15°) was found in 0 case in the test group and 2 cases (2.44%) in the control group when the filter was retrieved. There was no significant difference between the two groups ( P>0.05). Inferior vena cava thrombosis before filter retrieval was found in 5 cases (5.75%) in trial group and 3 cases (3.30%) in control group. There was no significant difference between the two groups ( P=0.489). There were no immediate serious complications during filter placement/removal in either group. No filter obstruction,migration,deformation,penetration and occlusion of inferior vena cava. The incidence of device-related adverse events was low in both group. There was no significant difference between the two groups ( P>0.05). Conclusion:The home-made umbrella-shaped Octoparms inferior vena cava filter is effective and safe in preventing pulmonary embolism, and is not worse than Celect filter.