Objective:To investigate the management options for loop plate cutting of the tibial cortex during reconstruction of the anterior cruciate ligament (ACL) by the all-inside technique.Methods:From January 2022 to December 2024, a total of 13 patients with ACL injury who underwent all-inside reconstruction with tibial lateral loop plate cutting of the cortex and immediate revision for ACL injuries at Department of Sports Medicine, the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed (cut group). There were 5 males and 8 females with an average age of 28.7±9.1 years (range, 17-39 years). During the revision, a transverse tunnel was drilled at the distal end of the tibial tunnel, and the loop plate was fixed to the lateral tibial cortex through the transverse tunnel. Matched by gender, age, and side, the patients who underwent ACL reconstruction with all-inside loop steel without cutting the tibial cortex during the same period (the uncut group) were selected as the control group at a ratio of 1∶2, including 10 males and 16 females, aged 29.1±9.3 years (range, 17-39 years). The visual analogue scale (VAS), Tegner score, International Knee Documentation Committee (IKDC) and Lysholm score for knee pain before and after surgery were compared between the two groups, and bone tunnel enlargement was assessed using the Peyrache grading scale.Results:All patients were successfully operated and followed up for 13.1±2.5 months and 13.3±2.6 months, respectively. The Lysholm scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 35.44±15.69, 75.21±16.77, and 93.47±18.56 respectively, while those of the uncut group were 37.81±17.33, 71.45±15.82, and 91.05±19.54. The Lysholm scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Lysholm scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Lysholm scores between the two groups before and after surgery ( P>0.05). The IKDC scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 39.12±14.28, 69.52±15.36, and 84.24±17.91 respectively, while those of the uncut group were 37.46±11.55, 72.81±17.73, and 87.62±18.52. The IKDC scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the IKDC scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the IKDC scores between the two groups before and after surgery ( P>0.05). The Tegner scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 1.61±1.11, 3.59±1.66, and 5.59±1.79 respectively, while those of the non-cutting group were 1.57±1.05, 3.47±1.51, and 5.41±1.63. The Tegner scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Tegner scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Tegner scores between the two groups before and after surgery ( P>0.05). According to Peyrache's grading criteria, 7 cases in the cutting group had femoral side bone tunnel enlargement and 8 cases had tibial side bone tunnel enlargement; 12 cases in the non-cutting group had femoral side bone tunnel enlargement and 15 cases had tibial side bone tunnel enlargement, with no statistically significant differences (χ 2=0.205, P=0.650; χ 2=0.053, P=0.818). At the last follow-up, there were 2 cases of Lachman grade I in the cutting group and 3 cases in the non-cutting group, 1 case of joint stiffness in the cutting group and 2 cases in the non-cutting group. None of the patients in the two groups had vascular nerve injury, deep vein thrombosis, or intra-articular infection. Conclusion:The method of drilling a transverse tunnel at the distal end of the outer opening of the tibial tunnel and fixing the loop plate to the lateral tibial cortex through the transverse tunnel, along with cutting the tibial cortex, can improve the knee joint function.

Objective:To investigate the management options for loop plate cutting of the tibial cortex during reconstruction of the anterior cruciate ligament (ACL) by the all-inside technique.Methods:From January 2022 to December 2024, a total of 13 patients with ACL injury who underwent all-inside reconstruction with tibial lateral loop plate cutting of the cortex and immediate revision for ACL injuries at Department of Sports Medicine, the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed (cut group). There were 5 males and 8 females with an average age of 28.7±9.1 years (range, 17-39 years). During the revision, a transverse tunnel was drilled at the distal end of the tibial tunnel, and the loop plate was fixed to the lateral tibial cortex through the transverse tunnel. Matched by gender, age, and side, the patients who underwent ACL reconstruction with all-inside loop steel without cutting the tibial cortex during the same period (the uncut group) were selected as the control group at a ratio of 1∶2, including 10 males and 16 females, aged 29.1±9.3 years (range, 17-39 years). The visual analogue scale (VAS), Tegner score, International Knee Documentation Committee (IKDC) and Lysholm score for knee pain before and after surgery were compared between the two groups, and bone tunnel enlargement was assessed using the Peyrache grading scale.Results:All patients were successfully operated and followed up for 13.1±2.5 months and 13.3±2.6 months, respectively. The Lysholm scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 35.44±15.69, 75.21±16.77, and 93.47±18.56 respectively, while those of the uncut group were 37.81±17.33, 71.45±15.82, and 91.05±19.54. The Lysholm scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Lysholm scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Lysholm scores between the two groups before and after surgery ( P>0.05). The IKDC scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 39.12±14.28, 69.52±15.36, and 84.24±17.91 respectively, while those of the uncut group were 37.46±11.55, 72.81±17.73, and 87.62±18.52. The IKDC scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the IKDC scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the IKDC scores between the two groups before and after surgery ( P>0.05). The Tegner scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 1.61±1.11, 3.59±1.66, and 5.59±1.79 respectively, while those of the non-cutting group were 1.57±1.05, 3.47±1.51, and 5.41±1.63. The Tegner scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Tegner scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Tegner scores between the two groups before and after surgery ( P>0.05). According to Peyrache's grading criteria, 7 cases in the cutting group had femoral side bone tunnel enlargement and 8 cases had tibial side bone tunnel enlargement; 12 cases in the non-cutting group had femoral side bone tunnel enlargement and 15 cases had tibial side bone tunnel enlargement, with no statistically significant differences (χ 2=0.205, P=0.650; χ 2=0.053, P=0.818). At the last follow-up, there were 2 cases of Lachman grade I in the cutting group and 3 cases in the non-cutting group, 1 case of joint stiffness in the cutting group and 2 cases in the non-cutting group. None of the patients in the two groups had vascular nerve injury, deep vein thrombosis, or intra-articular infection. Conclusion:The method of drilling a transverse tunnel at the distal end of the outer opening of the tibial tunnel and fixing the loop plate to the lateral tibial cortex through the transverse tunnel, along with cutting the tibial cortex, can improve the knee joint function.

Objective:To investigate the effect of nuclear factor-erythroid 2-related factor 2 (Nrf2) gene on the proliferation and apoptosis of colorectal adenocarcinoma cells in vitro, and the role of Nrf2 gene in regulation of epithelial-mesenchymal transition (EMT) pathway.Methods:Three Nrf2 small interfering RNA (siRNA) sequences were designed and synthesized, namely siRNA-223, siRNA-538 and siRNA-756, and the unrelated sequences were designed and synthesized. The plasmids carrying various siRNA sequences of Nrf2 were constructed, and the plasmids carrying siRNA sequences and the plasmids carrying unrelated sequences were transfected into human colorectal adenocarcinoma Caco-2 cells, namely interference group and empty vector group, respectively. Additionally, Caco-2 cells without any treatment were used as the control group. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) and Western blotting (WB) methods were used to detect the relative expression of Nrf2 gene in transcription and translation levels in each group of cells, in order to verify the interference effect of Nrf2; the siRNA with the best interference effect was selected for subsequent experiments. CCK-8 method was used to detect the proliferation ability of each group of cells (expressed as absorbance value); RT-qPCR was used to detect the relative expression of EMT pathway-related factors [vimentin (Vim), N-cadherin (N-cad) and E-cadherin (E-cad)] in transcription level in each group of cells; WB method was used to detect the expression of pro-apoptotic protein Bax in each group of cells.Results:The results of RT-qPCR and WB methods showed that compared with the control group and the empty group, the relative expression of Nrf2 gene in transcription and translation levels in Caco-2 cells of the siRNA-756 interference group were the lowest, and the differences were statistically significant (all P < 0.05). The CCK-8 results showed that the absorbance values of Caco-2 cells in the control group, empty group and siRNA-756 interference group after 48 hours of culture were (100±5)%, (94±4)% and (82±5)%, respectively; compared with the control group and the empty group, the siRNA-756 interference group had lower absorbance value, and the differences were statistically significant (all P < 0.05). The results of RT-qPCR method showed that the relative expression of Vim and N-cad in transcription level in the siRNA-756 interference group were higher than those in the control group and the empty vector group, and the differences were statistically significant (all P < 0.05); the relative expression of E-cad in transcription level was lower than those in the control group and the empty vector group, and the differences were statistically significant (both P < 0.05). The results of WB method showed that the relative expression of Bax protein in the siRNA-756 interference group was higher than that in the control group, and the difference was statistically significant ( P < 0.05). Conclusions:Interference with Nrf2 expression in vitro can weaken the proliferation and anti-apoptotic abilities of human colorectal adenocarcinoma Caco-2 cells. The mechanism may be that Nrf2 regulates the expression of Vim, N-cad and E-Cad in the EMT pathway to enhance the EMT ability of tumor cells.

Objective To investigate the serum levels and clinical significances of microRNA-335 (miR-335) and microRNA-155 (miR-155) in patients with primary gallbladder cancer (PCG).Methods A total of 96 PCG patients (PCG group) and 50 healthy controls (control group) admitted to the Second People's Hospital of Hainan Province from January 2016 to October 2018 were selected.Real-time quantitative PCR (RT-PCR) was used to detect the serum levels of miR-335 and miR-155 in each group.The relationships between miR-335 and miR-155 levels and clinical pathological characteristics of PCG patients were analyzed.The diagnostic value of miR-335 and miR-155 in PCG was analyzed by ROC curve.Results The serum level of miR-335 in PCG group was significantly lower than that in the control group (1.50 ± 0.42 vs.3.65 ± 1.18,t =10.319,P ＜0.001).The serum level of miR-155 in PCG group was significantly higher than that in the control group (3.18 ±0.61 vs.0.74±0.12,t =13.627,P＜0.001).The serum levels ofmiR-335 and miR-155 in PCG patients were correlated with TNM stage (t =4.863,P =0.024;t =5.117,P =0.008) and lymph node metastasis (t =5.725,P ＜ 0.001;t =6.802,P ＜ 0.001).ROC curve analysis showed that the critical values of serum miR-335 and miR-155 for diagnosing PCG were 1.18 and 2.35,respectively.The area under the curve of the two combined diagnosis of PCG (0.920,95％ CI:0.863-0.977) was the largest,with sensitivity and specificity of 93.8％ and 85.7％.Conclusion The low serum level of miR-335 and high level of miR-155 are associated with the higher TNM stage and lymph node metastasis of PCG,and the combined detection of the two is helpful to improve the diagnostic rate of PCG.

Objective To explore the diagnostic significance of CT and MRI in dermatofibrosarcoma protuberans.Methods Analyze the CT and MRI images of 16 cases which were confirmed as dermatofibrosarcoma protuberans by pathology.The medical imaging features of dermatofibrosarcoma protuberans were summarized.In the total 16 cases(including 6 male cases,10 female cases),15 cases had suffered from dermatofibrosarcoma protuberans for more than 1 year, 11 cases for more than 5 years, and 9 cases had history of recurrence.Results On MRI, the mass was slightly hypointense on T 1 WI, inhomogeneously hyperintense on T 2 WI with inhomogenous enhancement.The diameters of mass were less than 5 cm in 3 cases,and were more than 5cm in 13 cases.Fifteen cases had clear demarcation between the masses and their adjacent muscles , 7 cases had “suspension sign” in shapes, 10 cases had “sub-nodules outward” features at the edge of the tumors , 12 cases had “multinodular” features inside the tumor , and 8 tumors grew into the surrounding fat layer like roots.Conclusion Dermatofibrosarcoma protuberans can be diagnosed accurately based on the features displayed on CT and MRI.

Objective To observe the nursing efficacy of cluster-based care for bronchial asthma.Methods 100 cases with bronchial asthma were randomly divided into the study group and the control group with 50 patients in each group.The control group received usual care,and the study group received cluster-based care model.Curative effect,the total of the cases received inhalation therapy correctly,compliance of inhalation therapy,degree of satisfaction to nursing services in the two groups were compared.Results The curative effect in the study group were better significantly than the control group (86％ vs 58％).The cases received inhalation therapy correctly in the study group were more than the control group (92％ vs 72％).The compliance of inhalation therapy in the study group was significantly higher than the control group(90％ vs 80％).The degree of satisfaction to nursing services in the study group were significantly higher than the control group (98％ vs 86％).Conclusions Cluster-based care had good effect on patients with bronchial asthma.

OBJECTIVE To investigate the clinical feature and antimicrobial susceptibility of Stenotrophomonas maltophilia nosocomial infection or colonization,so as to give guidence of preventing and treating of it.METHODS The clinical and laboratory data of 128 cases with S.maltophilia nosocomial infection or colonization from Jan 1998 to Aug 2006 were reviewed retrospectively.RESULTS Of the total 128 strains,94.5% were isolated from lower respiratory tract and 68.8% were colonization.All of the strains,88.3% were isolated from intensive care unit,97.7% had the invasive operation,100% had the serious underlying diseases and 100% once applied the broad spectrum antibiotics,S.maltophilia was multi-drug resistant,its resistance rate to gentamicin,tobramycin,amikacin,cefepime,ceftazidine,ceftriuxone,imipenem,aztreonam,piperacillin were 92.2%,87.5%,82.0%,79.5%,55.1%,93.7%,99.2%,97.7% and 73.4% respectively.CONCLUSIONS The most of infections are in lower respiratory tract and the pathogens were colonized.The independent risk factor is staying in the ICU and another is treatment with broad spectrum antibiotics,especially used carbapenems.The S.maltophilia isolates are multi-drug resistant.ICU environment disinfection and the medical appliance sterilization,staff′s aseptic consciousness,the standardized operation and the reasonable antibiotics application are the effective actions for reducing S.maltophilia nosocomial infection or colonization.