OBJECTIVE: To investigate the effectiveness of modified single patellar tunnel medial patella femoral ligament (MPFL) reconstruction in the treatment of recurrent patellar dislocation. METHODS: Between January 2023 and June 2023, a total of 61 patients with recurrent patellar dislocation who underwent MPFL reconstruction with autologous semitendinosus were enrolled and divided into 2 groups using random number table method. In the patellar anchor group, 31 patients were treated with MPFL reconstruction with double medial patellar anchors, and 30 patients in the patellar tunnel group were treated with MPFL reconstruction with single patellar tunnel. The femoral ends of both groups were fixed with absorbable compression screws. There was no significant difference in baseline data such as gender, age, side, tibial tubercle-trochlear groove (TT-TG), Q angle, Caton-Deschamps index, number of dislocation, and preoperative Kujala score, preoperative patellar inclination angle ( P>0.05). Patellar tunnel, patellar anchor position, patellar reduction, and the patellar inclination angle were measured by CT scan after operation. Kujala score was used to evaluate the function of knee joint before operation, at 2 weeks and 1, 3, 6, 12 months after operation. Incision aesthetic satisfaction score was performed at 3 months after operation. The signal-to-noise quotient (SNQ) of the transplanted tendon was measured by knee MRI at 12 months after operation to compare the maturity of the graft between the two groups. RESULTS: There was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). Knee CT reexamination showed that the patellar tunnel and the patellar anchor position were consistent with the intraoperative fluoroscopy. There was no significant difference in the difference of the patellar inclination angle between the two groups before and after operation ( P>0.05). All patients were followed up 12-14 months (mean, 12.8 months). There was 1 case of patellar anchor suture rejection in patellar anchor group, and the wound healed after debridement and dressing change. During the follow-up, there was no complication such as recurrence of patellar dislocation, infection and postoperative stiffness. The Kujala scores of the two groups significantly improved at each time point after 1 month of operation when compared with those before operation ( P<0.05), and the Kujala scores of the two groups returned to normal levels at 3 months after operation. The Kujala score in the patellar tunnel group was significantly higher than that in the patellar anchor group in the very early stage (2 weeks) ( P<0.05), and there was no significant difference between the two groups at other time points ( P>0.05). Patients in the patellar tunnel group were significantly better than those in the patellar anchor group in the score of incision aesthetic satisfaction at 3 months after operation and the SNQ at 12 months after operation ( P<0.05). CONCLUSION Modified single patellar tunnel MPFL reconstruction was used to treat patients with recurrent patellar dislocation without pathological TT-TG. The slide-fixation structure formed by single patellar tunnel positioning provides a variable degree of freedom for the reconstructed MPFL, which shows good effectiveness in the very early stage of the rehabilitation process.
Humans ; Patellar Dislocation/surgery* ; Male ; Female ; Plastic Surgery Procedures/methods* ; Adult ; Patellar Ligament/surgery* ; Recurrence ; Treatment Outcome ; Young Adult ; Adolescent ; Patella/surgery* ; Suture Anchors ; Hamstring Tendons/transplantation* ; Knee Joint/surgery* ; Transplantation, Autologous

Objective To explore the biomechanical responses of the cupula of the human semicircular canal to three basic rotational perception processes.Methods A one-dimensional visual semicircular canal model was successfully fabricated using three-dimensional printing and hydrogel physical cross-linking technologies,and the response deformation of the cupula was explored by applying constant angular velocity,constant angular acceleration,and sinusoidal oscillation stimulations.Results The time constant of the biomimetic semicircular canal model was stable at approximately 3 s and close to the human time constant.The displacement deformation of the ampullary cupula was proportional to the angular acceleration applied.Under sinusoidal oscillation stimulation of 0.07-5.00 Hz,the gain of the semicircular canal increased from 1.54 um/° rises to 42.34 μm/°,but the phase difference decreased from 109.72° to 11.27°.Conclusions The biomimetic semicircular canal model prepared in this study can accurately simulate the working mechanism of the human semicircular canal and is expected to play a role in mechanism research and disease diagnosis of the human vestibular semicircular canal.

Objective:To analyze the prevalence of drug-resistant Mycobacterium tuberculosis in Songjiang District, Shanghai.Methods:A retrospective analysis of 1 105 strains of Mycobacterium tuberculosis, which was positive in culture from January 2014 to December 2018 in Songjiang District, Shanghai, was carried out for strain identification (PNB method, TCH method and 28℃ culture test) and drug susceptibility test (four first-line anti-tuberculosis drugs).Results:The total drug resistance rate was 18.8% (208/1 105), of which the resistance rate of newly diagnosed patients was 17.9%(189/1 058), and the resistance rate of retreated patients was 40.4% (19/47). The total multidrug resistance rate was 4.0% (44/1 105), of which the multidrug-resistant rate of newly diagnosed patients was 3.4% (36/1 058), and the multidrug resistance rate of retreated patients was 17.0% (8/47). The five-year total drug resistance rate, the drug resistance rate of newly diagnosed patients, the drug resistance rate of retreatment patients, the total multidrug resistance rate, the multidrug resistance rate of newly diagnosed patients, and the multidrug resistance rate of retreated patients had no upward trend (χ 2 trend values: 4.229, 3.871, 6.862, 2.764, 4.930, 1.955, all P>0.05). In the past five years, the multi-drug resistance rates were 2.6%, 3.5%, 4.4%, 4.5%, and 5.4%, respectively, increased year by year.Logistic regression analysis showed that males, elderly people, retreated patients and floating population were the main factors of tuberculosis in our district, and patients with retreatment were more likely to develop drug resistance ( OR=0.321, 95% CI: 0.175-0.586, P<0.01) and multidrug-resistant ( OR=0.172, 95% CI: 0.075-0.394, P<0.01). Conclusion:In the past five years, the prevalence of M. tuberculosis in Songjiang District of Shanghai has been relatively stable, and the rate of multidrug resistance has increased year by year.

Objective    To investigate the predictive value of volatile organic compounds (VOCs) on pulmonary nodules in people aged less than 50 years. Methods    The 147 patients with pulmonary nodules and aged less than 50 years who were treated in the Department of Thoracic Surgery of Sichuan Cancer Hospital from August 1, 2019 to January 15, 2020 were divided into a lung cancer group and a lung benign disease group. The lung cancer group included 36 males and 68 females, with the age of 27-49 (43.54±5.73) years. The benign lung disease group included 23 males and 20 females, with the age of 22-49 (42.49±6.83) years. Clinical data and exhaled breath samples were collected prospectively from the two groups. Exhaled breath VOCs were analyzed by gas chromatography mass spectrometry. Binary logistic regression analysis was used to select variables and establish a prediction model. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve of the prediction model were calculated. Results    There were statistically significant differences in sex (P=0.034), smoking history (P=0.047), cyclopentane (P=0.002), 3-methyl pentane (P=0.043) and ethylbenzene (P=0.009) between the two groups. The sensitivity, specificity and area under the ROC curve of the prediction model with gender, cyclopentane, 3-methyl pentane, ethylbenzene and N,N-dimethylformamide as variables were 80.8%, 60.5% and 0.781, respectively. Conclusion    The combination of VOCs and clinical characteristics has a certain predictive value for the benign and malignant pulmonary nodules in people aged less than 50 years.

Objective To observe the efficacy and safety of in-center nocturnal hemodialysis (INHD) in uremic patients. Methods Thirty-two maintenence hemodialysis (MHD) patients received INHD (3 times per week and 7.5 hours each session) for 6 months.Before and 1, 3 and 6 months after entering INHD, blood routine, hepatic and renal function,serum electrolyte, lipids, parathyroid hormone and β2-microglobulin(β2-MG) were assayed, Kt/V and URR were calculated. Blood pressure of each dialysis session 2 months before and 6 months after INHD was recorded. Cardiac ultrasound and SF-36 questionnaire before and after INHD were performed. Use of drugs was recorded. Results Compared with 2 months before INHD, predialysis BP decreased [(130.3/86.0) vs (139.3/88.6) mm Hg, P＜0.01], while post-dialysis BP raised significantly [(121.1/80.5) vs (115.0/77.8) mm Hg, P＜0.01] 6 months after INHD.Intradialysis hypertension (9.8%vs 24.0%) and hypotension (7.3% vs 14.9%) both reduced (all P＜0.01). Serum phosphorus [(1.37±0.27) vs (2.08±0.49) mmol/L, P＜0.01] and iPTH [(355.4±139.6) vs (632.3±750.0) ng/L, P＜0.01] decreased, while calcium increased [(2.64±0.25) vs (2.28±0.37) mmol/L, P＜0.01], HDL[(1.27±0.29) vs (0.75±0.08) mmol/L] increased, LDL [(2.04±0.52) vs (2.75±0.75) mmol/L] decreased (all P＜0.05). URR [(79.7±0.1)% vs (64.7±4.7)%] and Kt/V (1.40±0.44 vs 0.89±0.25, P＜0.01) increased. Serum β2-MG decreased [(17.3±3.9) vs (24.6±5.9) mg/L, P＜0.01]. LVMI decreased [(99.8±29.0) vs (114.8±72.7), P＜0.05]. Physical functioning, role-physical and role-emotional of SF-36 increased (all P＜0.01). The types of antihypertension drug, dosage of EPO, Vitamin D3 and phosphorus binder decreased (all P＜0.01).Patients of drug withdrawal increased (P＜0.05). Conclusion The hypertension, anemia,calcium-phosphorus metabolism, lipid disorder, cardiac malfunction and the quality of life are improved in INHD patients.