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 construct the performance evaluation index system of specialist cooperation alliance in hos-pital-community in order to scientifically evaluate the effect of the construction of the specialist cooperation alliance.Methods By searching literature related to the construction of specialized league,sort out national and local policy documents,and the"structure-process-result"model was adopted to initially construct the index system.The ex-pert letter consultation form of the indicator system was formed through the discussion of the special group,two rounds of Delphi expert consultation were carried out to determine the evaluation indicator system,and the weight coefficient of each indicator was determined by the simultaneous application of analytic hierarchy process.Results The effective recovery rates of the two rounds of questionnaire were 84.62％and 100.00％,respectively.The positive de-gree of experts was high,and the average authority degree of experts was 0.864.The importance,operability,sen-sitivity Kendall's W coefficient and x2 test value of all indexes were P＜0.05.Finally,an evaluation index system covering 9 first-level indicators and 25 second-level indicators was established.Conclusion The constructed perfor-mance evaluation index is scientific and reliable.The practical application shows that it can be used as a tool to evalu-ate the effect of integrated,continuous and collaborative health service delivery in hospital-community.

Objective To explore the effects of drug-coated balloons(DCB)on the patency rate of target lesion vessels,coagulation function and vascular endothelial function in patients with in-stent restenosis(ISR)after percutaneous endovascular angioplasty(PTA)for lower extremity arteriosclerosis obliterans(ASO).Methods A total of 62 patients with ISR and ASO admitted to the hospital were retrospectively enrolled between March 2020 and March 2022.According to different treatment methods,they were divided into DCB group(n=38)and common balloon(SAB)group(n=24).All were followed up for 12 months after surgery.The changes in primary patency rate of target lesion vessel,clinically driven-target lesion revascularization(CD-TLR)rate,late loss of values in the lumen(LLL),ankle-brachial index(ABI),coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)]and vascular endothelial function indexes[serum endothelin-1(ET-1),nitric oxide(NO),flow-mediated dilatation(FMD)]were observed,and the occurrence of postoperative complications in the two groups was recorded.Results At 12 months after surgery,primary patency rate of target lesion vessels in DCB group was higher than that in SAB group(86.84％vs 50.00％),CD-TLR rate,LLL and ABI were lower than those in SAB group[13.16％,(1.39±0.52)mm,(0.76±0.12)vs 50.00％,(1.79±0.64)mm,(0.62±0.11);P＜0.05].At24h and 2 weeks after surgery,there was no significant difference in PT,APTT,FIB or D-D between the two groups(P＞0.05).At 24h and 2 weeks after surgery,levels of serum ET-1 in DCB group were lower than those in SAB group[(66.65±7.12)pg/ml,(65.58±6.98)pg/ml vs(71.74±6.92)pg/ml,(68.84±6.51)pg/ml)],while NO levels were higher than those in SAB group[(32.21±4.17)pg/ml,(34.62±3.32)pg/ml vs(28.53±5.23)pg/ml,(31.21±4.19)pg/ml;P＜0.05].At 2 weeks after surgery,FMD in DCB group was higher than that in SAB group[(12.49±5.33)％vs(9.14±4.42)％,P＜0.05].There was no significant difference in the total incidence of complications between the two groups(21.50％vs 12.50％,P＞0.05).Conclusion Compared with SAB,DCB can effectively protect vascular endothelial function and improve the primary patency rate of ISR after PTA in patients with lower extremity ASO.

Objective To explore the effects of drug-coated balloons(DCB)on the patency rate of target lesion vessels,coagulation function and vascular endothelial function in patients with in-stent restenosis(ISR)after percutaneous endovascular angioplasty(PTA)for lower extremity arteriosclerosis obliterans(ASO).Methods A total of 62 patients with ISR and ASO admitted to the hospital were retrospectively enrolled between March 2020 and March 2022.According to different treatment methods,they were divided into DCB group(n=38)and common balloon(SAB)group(n=24).All were followed up for 12 months after surgery.The changes in primary patency rate of target lesion vessel,clinically driven-target lesion revascularization(CD-TLR)rate,late loss of values in the lumen(LLL),ankle-brachial index(ABI),coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)]and vascular endothelial function indexes[serum endothelin-1(ET-1),nitric oxide(NO),flow-mediated dilatation(FMD)]were observed,and the occurrence of postoperative complications in the two groups was recorded.Results At 12 months after surgery,primary patency rate of target lesion vessels in DCB group was higher than that in SAB group(86.84％vs 50.00％),CD-TLR rate,LLL and ABI were lower than those in SAB group[13.16％,(1.39±0.52)mm,(0.76±0.12)vs 50.00％,(1.79±0.64)mm,(0.62±0.11);P＜0.05].At24h and 2 weeks after surgery,there was no significant difference in PT,APTT,FIB or D-D between the two groups(P＞0.05).At 24h and 2 weeks after surgery,levels of serum ET-1 in DCB group were lower than those in SAB group[(66.65±7.12)pg/ml,(65.58±6.98)pg/ml vs(71.74±6.92)pg/ml,(68.84±6.51)pg/ml)],while NO levels were higher than those in SAB group[(32.21±4.17)pg/ml,(34.62±3.32)pg/ml vs(28.53±5.23)pg/ml,(31.21±4.19)pg/ml;P＜0.05].At 2 weeks after surgery,FMD in DCB group was higher than that in SAB group[(12.49±5.33)％vs(9.14±4.42)％,P＜0.05].There was no significant difference in the total incidence of complications between the two groups(21.50％vs 12.50％,P＞0.05).Conclusion Compared with SAB,DCB can effectively protect vascular endothelial function and improve the primary patency rate of ISR after PTA in patients with lower extremity ASO.

Objective To construct the performance evaluation index system of specialist cooperation alliance in hos-pital-community in order to scientifically evaluate the effect of the construction of the specialist cooperation alliance.Methods By searching literature related to the construction of specialized league,sort out national and local policy documents,and the"structure-process-result"model was adopted to initially construct the index system.The ex-pert letter consultation form of the indicator system was formed through the discussion of the special group,two rounds of Delphi expert consultation were carried out to determine the evaluation indicator system,and the weight coefficient of each indicator was determined by the simultaneous application of analytic hierarchy process.Results The effective recovery rates of the two rounds of questionnaire were 84.62％and 100.00％,respectively.The positive de-gree of experts was high,and the average authority degree of experts was 0.864.The importance,operability,sen-sitivity Kendall's W coefficient and x2 test value of all indexes were P＜0.05.Finally,an evaluation index system covering 9 first-level indicators and 25 second-level indicators was established.Conclusion The constructed perfor-mance evaluation index is scientific and reliable.The practical application shows that it can be used as a tool to evalu-ate the effect of integrated,continuous and collaborative health service delivery in hospital-community.

OBJECTIVETo study the effects of RhoA down-regulation by RNA interference on the invasion of tongue carcinoma Tca8113 and SCC-4.

METHODSDetermination of the human RhoA sequence as well as the design and constructionof a short specific small interfering RNAs (siRNA) were performed. The siRNA of RhoA gene was transfected into humantongue squamous cell carcinoma Tca8113 and SCC-4 cells line by Lipofectamine 2000. Quantitative real-time polymerasechain reaction was used to examine the mRNA expressionlevels of RhoA. Protein expressions of mRNA, galectin-3,and matrix metalloproteinase (MMP)-9 were evaluated byWestern blot. Transwell invasion assay was performed toassess the invasion ability of tongue carcinoma.

RESULTSRhoA expressions in Tca8113 and SCC-4 cells were reducedsignificantly after transfection of RhoA-siRNA. Protein levels f galectin-3 and MVP-9 were also down-regulated significantly. Invasion ability was inhibited as well.

CONCLUSIONRhoA-siRNA can effectively inhibit RhoA expression in Tca8113 and SCC-4 cells. The invasion ability of tongue carcinoma cells decreased with down-regulation of the protein expressions of galectin-3 and MMP-9, indicating that RhoA-siRNA can inhibit invasion of tongue carcinoma. Results show that RhoA may play an important role in the processes of invasion and metastasis of tongue carcinoma.

Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Down-Regulation ; Galectin 3 ; metabolism ; Gene Silencing ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; RNA Interference ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Tongue Neoplasms ; genetics ; metabolism ; pathology ; Transfection

In order to improve the clinical skills of medical students,the First Clinical School of Tongji Medical College,Huazhong University of Science and Technology strengthened the construction of teaching base,teaching materials,teaching team,curriculum and assessment methods,and established a comprehensive experimental teaching system of clinical skills.

OBJECTIVETo evaluate the therapeutic effects of strontium-89 on osseous metastases of prostate cancer by bone scanning and bone alkaline phosphatase (B-AKP) measurement.

METHODSOne week before and within 6 months after strontium-89 therapy, bone scanning and B-AKP measurement were performed in 73 patients with bone metastases of prostate cancer. 1. According to the number of osseous lesions on bone imaging, the patients were divided into Grade 0, 1, 2 and 3, and the numbers of bone lesions before and after therapy were compared by t-test. 2. Tumor to non-tumor ratios(T/NT) before and after treatment were calculated and compared. 3. Changes in B-AKP before and after therapy were compared.

RESULTS1. Among the 73 patients, bone scanning revealed 618 bone lesions, averaging 8.6 +/- 7.4 before treatment. The number decreased to 349, averaging 3.8 +/- 6.7 after treatment, which showed a significant reduction (t = 4.079, P < 0.01). 2. After therapy, T/NT of bone lesions decreased significantly (t = 7.907, P < 0.01) from 5.36 +/- 4.67 to 3.17 +/- 2.95. 3. B-AKP decreased significantly (t = 3.349, P < 0.002) from (28.4 +/- 14.8) microgram/L to (20.9 +/- 11.7) microgram/L. 4. By bone scanning combined with B-AKP measurement, 5 false positive cases and 6 false negative cases were corrected.

CONCLUSIONThere is certain complementarity between bone scanning and B-AKP measurement, and they should be used in a combined way to achieve accurate evaluation of the therapeutic effects of strontium-89.

Aged ; Alkaline Phosphatase ; analysis ; Bone Neoplasms ; enzymology ; radiotherapy ; secondary ; Bone and Bones ; diagnostic imaging ; enzymology ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; radiotherapy ; Radionuclide Imaging ; Strontium ; therapeutic use

Objective To evaluate the surgical technique and clinical application of retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy with no suture of the incision. Methods Twenty-five patients who had upper urinary tract calculi with the course from 10 months to 6 years were enrolled.The size of the calculi was 1.2 to 3.1 cm in diameter.ESWL was ineffecative in 14 of the patients and ureteroscopic lithotomy failed in 2 of them.Then the 25 patients underwent retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy.Details of the procedure were presented. Results All the operations were successful in the 25 patients. The operations took 60 to 190 min with a mean time of 105 min.All the patients fully recovered with no complication observed during the 9～12 months' follow-up. Conclusions Retroperitoneal laparoscopy surgery with no suture of the incision has advantages of minimal invasive,safe,effective and rapid postoperative rehabilitation.The surgical procedure has a good prospect in the urologic clinical practice.

This paper presents a discussion on the tracing algorithms of the extraction of Electrocardiogram(ECG) data from scanned image of hardcopy ECG. We have advanced a new algorithm integrated by seek-and-predict method and polygon model method, which can tolerate crossing of two leads, fault-line and disturbing of grid lines. Two practical situations that may be encountered while processing hardcopy ECG are discussed in detail. Furthermore, the after-treatment of extraction-filtering is considered and an SVD-based filter designed to smooth ECG signal is analyzed.