OBJECTIVE: To investigate the effectiveness of three-dimentional (3D) printed personalized guide plate-assisted wrist arthroscopic repair for Palmer type ⅠB triangular fibrocartilage complex (TFCC) injury. METHODS: A retrospective analysis was conducted on the clinical data of 20 patients with Palmer type ⅠB TFCC injuries admitted between January 2023 and March 2024 who met the selection criteria. Among them, 13 were male and 7 were female; ages ranged from 23 to 35 years, with a mean age of 30.3 years. All patients had a history of trauma, 12 cases involved falls and 8 cases involved sprains. All patients demonstrated a positive "piano key sign". MRI revealed deep ulnar-side tears of the TFCC. Conservative treatment for 6 weeks yielded poor or no clinical improvement. The interval from injury to surgery ranged from 2 to 9 months, with a mean of 5.0 months. Patients underwent wrist arthroscopic repair assisted by 3D printed personalized guide plate. Functional recovery was assessed preoperatively and postoperatively using the visual analogue scale (VAS) score for pain, modified Mayo wrist score, and range of motion (ROM) measurements for wrist flexion-extension, ulnar-radial deviation, and pronation-supination. At last follow-up, MRI was performed to evaluate the healing of TFCC. RESULTS: All 20 patients underwent successful surgery without complications such as vascular or nerve injury, fracture, incisional infection, or joint stiffness. All patients were followed up 9-18 months (mean, 12.4 months). At last follow-up, patients demonstrated significant improvements in VAS scores, modified Mayo wrist scores, wrist flexion-extension ROM, ulnar-radial deviation ROM, and pronation-supination ROM compared to preoperative levels ( P<0.05). MRI at last follow-up showed preserved TFCC continuity, excellent healing, and secure fixation. CONCLUSION 3D-printed personalized guide plate significantly improve outcomes in wrist arthroscopic TFCC repair for Palmer type ⅠB injuries. They enable high-quality suturing, facilitate anatomical reconstruction, and markedly enhance wrist function.
Humans ; Arthroscopy/methods* ; Male ; Adult ; Triangular Fibrocartilage/diagnostic imaging* ; Female ; Retrospective Studies ; Printing, Three-Dimensional ; Wrist Injuries/diagnostic imaging* ; Young Adult ; Bone Plates ; Treatment Outcome ; Wrist Joint/surgery* ; Magnetic Resonance Imaging ; Range of Motion, Articular

Objective To evaluate the clinical outcomes of 514 cases of anterior cruciate ligament(ACL)reconstruction using hamstring tendon autograft and to observe postoperative changes and recovery of the grafts through second-look arthroscopy.Methods This retrospective study collected data from 514 patients who underwent ACL reconstruction with hamstring tendon autograft between May 2015 and June 2018,with a follow-up of at least one year.Knee function recovery and stability were assessed using the Lysholm score,International Knee Documentation Committee(IKDC)score,and Tegner score,along with the pivot shift test and Lachman test.During the second-look arthroscopy,key observations included the synovial coverage,continuity of the reconstructed ligament,and any intra-articular abnormalities.Results The time interval between ACL reconstruction and second-look arthroscopy ranged from 12 to 28 months,with an average of 20 months.Postoperative infection occurred in 2 cases,both of which were successfully treated with arthroscopic debridement and drainage.No other patients experienced infections,graft resorption,or other complications.At the second-look arthroscopy,the Lysholm score significantly improved from(43.56±9.89)preoperative to(92.21±6.12)postoperatively,the difference was statistically significant(P<0.05);The IKDC score increased from(20.32±7.87)to(85.67±10.43),the difference was statistically significant(P<0.05);The Tegner score improved from(4.31±0.82)to(6.61±1.21),the difference was statistically significant(P<0.05).Second-look arthroscopy revealed that the ligament remained intact in 375 patients,with partial tears in 139 patients,ligament tension was maintained in 447 patients,while 67 patients had laxity,the reconstructed ACL graft was deemed to be in good condition in 435 patients and suboptimal in 79 patients,there were significant differences observed in pre-and post-pivot shift test and Lachman test(P<0.05);Among the 514 patients,188(36.58%)successfully returned to sport.Conclusion ACL reconstruction using hamstring tendon autograft effectively restores knee function and stability.In patients followed for more than one years,the grafts show good vascularization and synovial coverage.Emphasis should be placed on systematic postoperative rehabilitation to optimize recovery.

[Objective]To review and summarize the different explanations of the pathway of Qi theory from various physicians and scholars,thereby promoting the broader clinical application of the pathway of Qi theory.[Methods]Relevant passages on the pathway of Qi in classical medical texts and interpretations from various historical physicians were reviewed and analyzed.Contemporary research findings were integrated to explore the unique functions of the pathway of Qi in conjunction with modern anatomical discoveries,hypothesizing its potential structures.Existing clinical applications of the pathway of Qi theory were compiled,and its possible mechanisms of action were preliminarily analyzed.[Results]The pathway of Qi theory integrates the meridian system with the principles of Biao-Ben-Gen-Jie,establishing a bidirectional pathway connecting internal organs,meridians and body cavity spaces.The pathway of Qi exhibits the following characteristics:As a lateral"shortcut",it directly links pathological regions with stimulation points,shortening the pathway of Qi flow;Under stress conditions,it serves as a channel for Qi circulation,maintaining continuity of Qi flow;Through cavity structures,it forms a network connecting internal organs and meridians,providing reserves and regulatory spaces for Qi and blood circulation;It stimulates and regulates Qi flow,related to the phenomena such as heat-sensitive acupoints and the mechanisms of acupuncture and moxibustion.Based on the physiological characteristics of the pathway of Qi,the flexible application of the pathway of Qi theory can provide support for clinical practices such as Shu-Mu point selection and region-specific treatment.[Conclusion]As a crucial component of meridian theory,the pathway of Qi theory has made significant strides in research of conceptualization,semantics and anatomical delineation.Further exploration is warranted to enhance its guidance in clinical applications.

Objective To evaluate the clinical outcomes of 514 cases of anterior cruciate ligament(ACL)reconstruction using hamstring tendon autograft and to observe postoperative changes and recovery of the grafts through second-look arthroscopy.Methods This retrospective study collected data from 514 patients who underwent ACL reconstruction with hamstring tendon autograft between May 2015 and June 2018,with a follow-up of at least one year.Knee function recovery and stability were assessed using the Lysholm score,International Knee Documentation Committee(IKDC)score,and Tegner score,along with the pivot shift test and Lachman test.During the second-look arthroscopy,key observations included the synovial coverage,continuity of the reconstructed ligament,and any intra-articular abnormalities.Results The time interval between ACL reconstruction and second-look arthroscopy ranged from 12 to 28 months,with an average of 20 months.Postoperative infection occurred in 2 cases,both of which were successfully treated with arthroscopic debridement and drainage.No other patients experienced infections,graft resorption,or other complications.At the second-look arthroscopy,the Lysholm score significantly improved from(43.56±9.89)preoperative to(92.21±6.12)postoperatively,the difference was statistically significant(P<0.05);The IKDC score increased from(20.32±7.87)to(85.67±10.43),the difference was statistically significant(P<0.05);The Tegner score improved from(4.31±0.82)to(6.61±1.21),the difference was statistically significant(P<0.05).Second-look arthroscopy revealed that the ligament remained intact in 375 patients,with partial tears in 139 patients,ligament tension was maintained in 447 patients,while 67 patients had laxity,the reconstructed ACL graft was deemed to be in good condition in 435 patients and suboptimal in 79 patients,there were significant differences observed in pre-and post-pivot shift test and Lachman test(P<0.05);Among the 514 patients,188(36.58%)successfully returned to sport.Conclusion ACL reconstruction using hamstring tendon autograft effectively restores knee function and stability.In patients followed for more than one years,the grafts show good vascularization and synovial coverage.Emphasis should be placed on systematic postoperative rehabilitation to optimize recovery.

[Objective]To review and summarize the different explanations of the pathway of Qi theory from various physicians and scholars,thereby promoting the broader clinical application of the pathway of Qi theory.[Methods]Relevant passages on the pathway of Qi in classical medical texts and interpretations from various historical physicians were reviewed and analyzed.Contemporary research findings were integrated to explore the unique functions of the pathway of Qi in conjunction with modern anatomical discoveries,hypothesizing its potential structures.Existing clinical applications of the pathway of Qi theory were compiled,and its possible mechanisms of action were preliminarily analyzed.[Results]The pathway of Qi theory integrates the meridian system with the principles of Biao-Ben-Gen-Jie,establishing a bidirectional pathway connecting internal organs,meridians and body cavity spaces.The pathway of Qi exhibits the following characteristics:As a lateral"shortcut",it directly links pathological regions with stimulation points,shortening the pathway of Qi flow;Under stress conditions,it serves as a channel for Qi circulation,maintaining continuity of Qi flow;Through cavity structures,it forms a network connecting internal organs and meridians,providing reserves and regulatory spaces for Qi and blood circulation;It stimulates and regulates Qi flow,related to the phenomena such as heat-sensitive acupoints and the mechanisms of acupuncture and moxibustion.Based on the physiological characteristics of the pathway of Qi,the flexible application of the pathway of Qi theory can provide support for clinical practices such as Shu-Mu point selection and region-specific treatment.[Conclusion]As a crucial component of meridian theory,the pathway of Qi theory has made significant strides in research of conceptualization,semantics and anatomical delineation.Further exploration is warranted to enhance its guidance in clinical applications.

Purpose To verify the safety and effectiveness of the Insight NM/CT Pro SPECT/CT Imaging System in clinical applications is verified through clinical validation of the acceptable rate of clinical image quality,commonly use features of the device,ease of use of the machine,satisfaction with the stability of the entire machine and safety evaluation.Materials and Methods A total of 79 subjects who voluntarily participated in the trial from July to October 2022 in the Affiliated Hospital of Inner Mongolia Medical University,were selected to undergo endocrine,circulatory,skeletal,respiratory and urological imaging for multiple systems using the Insight NM/CT Pro SPECT/CT,respectively.The quality of the images,the machine operation and safety were evaluated.Results The image quality of all 79 patients were evaluated.Of 36 cases,there were 35 cases of planar imaging were acceptable;Of 43 cases,there were 42 cases of tomographic imaging were acceptable,with an acceptability rate of 97.22%and 97.67%,respectively,and a lower limit of 95%CI of 85.47%and 87.71%,respectively,which were both higher than those of the target value(83.00%).When the operators performed imaging operations on 79 patients,the common functions of the equipment,the ease of use of the equipment and the stability of the whole machine were evaluated as a satisfaction rate of 100%,with no adverse events.Conclusion Insight NM/CT Pro SPECT/CT effectiveness fully meets the requirements of clinical applications,with clear images of tissue structure,full range of commonly used equipment features,stable system,and superior safety and reliability.

Objective:To analyze the influence of factors before initiation of extracorporeal cardiopulmonary resuscitation (ECPR) on the prognosis of patients, so as to explore the intervention timing and improvement strategy of ECPR.Methods:A retrospective analysis was performed on 29 patients who underwent ECPR in the First Affiliated Hospital of Hunan Normal University (Hunan people's Hospital)from July 2018 to April 2021. Patients were divided into the survival group ( n = 13) and death group ( n = 16) according to whether they survived at discharge. The duration of conventional cardiopulmonary resuscitation (CCPR), initial heart rate before ECPR, the ratio of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), and the ratio of transported cases outside the hospital were compared between the two groups. According to different CCPR time, the patients were divided into the ≤45 min group, 45-60 min group and >60 min group to compare the hospital survival and sustained return of spontaneous circulation (ROSC) rate . According to the location of cardiac arrest, the patients from emergency department and other department were divided to compare the survival of IHCA. Results:The total survival rate was 44.83%, the average duration of extracorporeal membrane oxygenation (ECMO) was 114 (33.5, 142.5) h, and the average duration of CCPR time was 60 (44.5, 80) min. The duration of ECMO was longer in the survival group than in the death group ( P = 0.001). The duration of CCPR (the time from CPR to ECMO) in the survival group was significantly shorter than that in the death group ( P = 0.010). Patients with defibrillatory rhythm had higher hospital survival rate ( P = 0.010). OHCA patients had higher mortality than IHCA patients ( P = 0.020). Mortality of patients transferred from other hospitals was higher ( P = 0.025). Hospital survival and ROSC decreased in turn by CCPR duration ≤ 45 min, 45-60 min, and > 60 min ( P = 0.001). The location of CA occurrence had no impact on the hospital survival rate of IHCA patients ( P=0.54). Conclusions:Hospital survival of ECPR is higher than that of CCPR. ECPR is effective for refractory cardiac arrest. The prognosis of ECPR is significantly related to the duration of CCPR, initial heart rate, and location of CA. Education and team training should be strengthened to improve the survival rate of ECPR.

Objective To investigate the clinical efficacy of arthroscopic double Endobutton plate internal fixation in the treatment of acute acromioclavicular joint dislocation.Methods A retrospective case series study was performed to analyze the clinical data of 32 patients with Rockwood type Ⅲ or Ⅴ acute acromioclavicular joint dislocation admitted to Foshan Hospital of TCM from May 2015 to February 2018.There were 26 males and six females,aged 22-56 years [(37.7 ± 1.6)years].There were 22 patients with Rockwood type Ⅲ and 10 patients with type Ⅴ.The duration from injury to operation was 2-5 days.All patients were treated with arthroscopic double Endobutton plate internal fixation for coracoclavicular ligament reconstruction.The operation time,hospitalization time,and postoperative shoulder joint braking time were recorded.The shoulder joint function was evaluated by the Constant-Murley score (CMS),visual analogue scale (VAS),American shoulder and elbow surgeons (ASES) score,University of California Los Angeles (UCLA) score and simple shoulder test (SST) before operation and at the last follow-up.Meanwhile,complications such as infection,loosening and joint dislocation were recorded.Results All patients were followed up for 8-48 months [(27.8 ± 11.6) months].The operation time was 48-93 minutes [(65.0 ± 24.6) minutes],the hospitalization time was 3.2-10 days [(6.5 ± 2.6)days],and the postoperative braking time was 21-35.3 days [(28.2 ± 7.1)days].All patients had a grade A healing of surgical incision.The VAS was decreased from preoperative (5.7 ±2.5)points to (1.2 ±0.8)points at the last follow-up (P ＜0.01);CMS wasvincreased from preoperative (29.3 ± 3.4) points to (93.2 ± 2.1) points at the last follow-up (P ＜0.05);ASES score was increased from preoperative (28.9 ± 10.1) points to (95.7 ± 5.6) points at the last follow-up (P ＜ 0.05);UCLA score was improved from preoperative (11.6 ± 2.8) points to (34.2 ±1.5)points at the last follow-up (P ＜0.05);SST score was improved from preoperative (3.5 ±1.2)points to (9.7± 1.4)points at the last follow-up (P ＜ 0.O1).The incidence of intraoperative and postoperative complications was 16％ (5/32).In two patients,the surgery was changed to U shape fixation circulating the coracoid base due to the coracoidbone tunnel cutting out.One patient was found to have insufficient reduction and received the acromioclavicular joint operation.One patient had reduction loss due to the clavicle button collapsing,and one patient had excessive reduction.Conclusions For Rockwood type Ⅲ or Ⅴ acute acromioclavicular dislocation patients,arthroscopic double Endobutton plates for coracoclavicular ligament reconstruction has the advantages of less intraoperative trauma,quick recovery and satisfactory clinical result.However,the incidence of intraoperative and postoperative complications is relatively high,and indications should be strictly controlled.

【Objective】 To observe the effect of electroacupuncture(EA) onlearning and memoryin vascular dementia (VD) rats andto explore its possible therapeutic mechanism.【Methods】Fifty specific pathogenfree(SPF) adult rats were randomizedintofour groups.Except the 8 rats in the pseudo-operation group(group A),the other 42 rats were induced cerebral ischemia by four-vessel occlusion method.Then the model rats were randomized into model group (group B),EAgroup(group C) and nimotop group(group D).Groups Aand B were fed with the same forage and received no medication.Group Creceived EAonthe acupoints of Baihui,Geshu,Pishu and Shenshu,and EAwas set in continuous wave with the frequency being 150Hz,once per day and lasting 15 consecutive days.Group Dreceived nimotop 12mg/kg,qd,for 15 consecutive days.After 15-day treatment,the learning and memory abilities of the rats were observed by Morris water test,the plasma carbon monoxide(CO) level was detected by double-wavelength spectrophotometer,and brain nitric oxide(NO) content was examined byspectrophotometry-colorimetry.【Results】The model rats had obvious disorders of learningand memory,their escapelatency was prolonged,thetimes swimmingacross the platforminthe original quadrant did not differ fromthose inthe other three quadrants,and plasma COand cerebral NOlevels were obviouslyincreased.In EAgroup,escapelatency was shortened,thetimes swimmingacrossthe platform inthe original quadrant were more thanthose inthe other three quadrants,and plasma COand cerebral NOlevels were obviously decreased(P