With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objectives To introduce arthroscopic posterior cruciate ligament (PCL) reconstruction with the tendon through the middle gap of remnant fiber and evaluate the recovery of postoperative knee function and the preliminary proprioception. Methods 17 cases of eligible patients of posterior cruciate ligament ruptures were performed arthro-scopic Single-beam type anatomical reconstruction with the tendon throung the middle gap of remnant fiber from August 2012 to March 2014. The tendon is fixed in operation through suspension of end-button and extrusion of bioabsorbable interference screw. The recovery of Knee function is assessed with comparative analyzing the preoper-ative and postoperative Lysholm and The International Knee Documentation Committee knee nation form (IKDC) subjective scores and KT-1000 (Joint stability measuring apparatus, PMENT NO 4.563 555, MEDmetric Corporation, San Diego, California, America) scores, and the postoperative proprioception of knee is assessed through measureing the time threshold to detection of passive motion(TTDPM) and the passive re-positioning (PRP) scores. Results There was no serious complications for all patients during the postoperative 12 month follow-up. Subjective scores showed:Lysholm scores from an average of (54.41 ±8.00) scores increased to (90.12±2.69) scores for 12 months followed up ( <0.05);IKDC knee scores from preoperative average (60.29 ±3.48) scores increased to (87.00 ±1.46) scores af-ter follow-up ( < 0.05). All patients reached the pre-injury level of daily life. The results appear as objective scores: preoperative KT-1000 measured mean scores (8.71 ± 2.17) mm, followed up 12 months measured the mean scores(1.88±0.78) mm, proprioception tests follow up 12 months showed, the knee PRP mean Angles respectively in 15o, 45o, 75oand the mean TTDPM Angles test at 45oCompared with the contralateral showed no significant differ-ence ( > 0.05). Conclusion Arthroscopic posterior cruciate ligament reconstruction with tendon throughing remnant fiber can effectively restore the stability of the knee and improve knee function, preserving remnant stubs and syn-ovial of PCL may be beneficial recovery of proprioception and healing of reconstruction tendon.

Thirty-five patients who underwent Scandinavian total ankle replacement (STAR) in the Union Hospital, Huazhong University of Science and Technology & First Affiliated Hospital of Nanchang University between March 1999 and November 2006 were recruited for this study. The patients averaged 50.5 years old ranging from 27 to 68 years old. STAR was performed on the left side in 20 cases and on the right side in 15 cases. Among these patients, 12 suffered from posttraumatic arthritis, 8 osteoarthritis, and 15 rheumatic arthritis. All patients complained of ankle joint pain and different degrees of swelling as well as limited motion of joint. During the operation, some complications appeared, including medial malleolus fractures 2 patients, unstable ankle joint introversion 2 patients, limited ankle joint dorsiflextion 1 pateint. Symptomatic treatments were performed in these patients. Postoperatively, injury of superficial peroneal nerve occurred in 1 patient, but this did not cause an obvious motor dysfunction, so no special treatment was given. In addition, infection of incisional wound appeared in 2 patients and late healed subsequent to another dressing. Thirty-three cases presented with primary healing of incision. Among 35 total ankle arthroplasties, 28 had detained 43.5-month follow up (range 3-80 months). The ankles were scored with Kofoed total scoring system. The average postoperative ankle score was 85.5 (range 58-95), pain degree score was 48.3 (range 35-50), joint function score was 20.7 (range 18-30), and range-of-motion score was 17.2 (range 16-20). There was significant difference in these scores as compared to preoperative scores (P < 0.01). None of prosthetic loosening and migration was found radiologically. All these indicated that standardized and normalized operative technique as well as operative tools closely matched to the prosthesis and used to prevent and treat postoperative infection, dislocation, and prosthetic loosening as well as histocompatibility between material and host are the essential conditions for enhancing the success rate of prosthetic replacement.

Nisin is a cationic antimicrobial peptide produced by some lactic acid bacteria. However, expression of nisin resistance protein (NSR) could confer nisin resistance on some non-nisin-producing Lactococcus lactis. To deeply elucidate molecular mechanism underlying NSR-mediated nisin resistance, an NSR mutant with N-terminal 38 amino acid residues deleted (NSR?38) was overexpressed in Escherichia coli by fusion with GST. Purified NSR?38 was obtained through glutathione (GSH) affinity chromatography followed by cleavage of GST tag. Putative proteolytic activity of NSR?38 was determined in vitro against nisin. Antimicrobial activity analysis revealed that nisin lost its bactericidal activity after incubation with NSR?38. Further reversed-phase high performance liquid chromatography (RP-HPLC) analysis indicated that NSR?38 displayed proteolytic activity against nisin, thus inactivating the antimicrobial peptide. The current study paves the way for in-depth functional studies on NSR.

BACKGROUND: It is necessary to keep a good cervical curvature for improving nerve symptom in patients with cervical spondylotic myelopathy (CSM). It is verified that cervical anterior plate internal fixation implant is effective to restore the physiological curvature of cervical vertebra.OBJECTIVE: To assess the physiological lordosis of cervical vertebra in CSM patients after cervical anterior plate internal fixation implantation.DESIGN: Observational study.SETTING: First Affiliated Hospital of Nanchang University.PARTICIpANTS: Totally 72 CSM patients were enrolled at Department of Orthopaedics, First Affiliated Hospital,Nanchang University from February 2003 to January 2006, including 46 males and 26 females, aged 45-70 years,averagely 54 years, with the history of 2-6 years. Inclusive criteria included ①cervical spinal cord compression shown in MRI, and ②using autogenous iliac bone. The experiment was approved by Hospital Ethics Committee, and all patients signed the informed consent. Cervical anterior plate was Orion locking plate offered by Shufamo Company. There were single segmental discectomy group (n =32) and two-level segmental discectomy group (n =40) according to experimental requirement.METHODS: ①Anterior decompression plus autogenous iliac bone implant plus titanium plate internal fixation were utilized.The patients were in supine position; shoulder and back were blocked up; neck backward, and endotracheal tube was done under general anesthesia. Transverse or oblique incision was made at right anterior neck. Discectomy decompression was performed with Caspar vertebra ecarteur. Three-dimensional autogenous iliac bone was implanted in decompressed intervertebral space. Immediate stability was obtained after Orion locking titanium plate was fixed, with placement drainage, and then the incision was sutured. ②Postoperative daily activities were conducted with cervical gear, which was removed 8 weeks later. ③Lateral cervical vertebrae X-rays were taken before operation, immediately after operation, 6 and 12 months after operation. Lordosis of the fusion segment was measured with Cobb's angle, and lordosis of cervical vertebra was assessed with D value. These data were analysed by statistic software. ④Bone fusion of the patients was followed up for 12 months after operation. Vertebral fusion standards included no abnormity between two spinous processes of the fusion segment, no lucency between implant and vertebra, as well as bone trabecula across the interface between implant bone and vertebra. ⑤Biocompatibility between material and host was observed during follow-up.MAIN OUTCOME MEASURES: ①Changes of Cobb's angle and D value at different time points before and after operation,and ②Bone fusion and rejection were followed up.RESULTS: Totally 72 patients were involved in the result analysis. ①Cobb's angle was larger and D value was higher immediately after operation, 6 and 12 months after operation than those before operation in the single segmental discectomy group and the two-level segmental discectomy group (P＜0.05). ②Findings of 12-month follow-up showed that bone fusion appeared in all patients of the two groups. ③No significant rejection was found after titanium plate internal fixation implantation. It was found that material and host had a good biocompatibility.CONCLUSION: It is satisfactory to restore physiological lordosis of cervical spine by using cervical anterior plate internal fixation plus autogenous iliac bone for CSM.

[Objective] To investigate the clinical results of two-level lumbar total disc replacement with SB Charit? Ⅲ prosthesis at early metaphase and discuss the indication.[Method]From October 2000 to August 2006,22 patients who suffered degenerative disc disease from L4 to S1 underwent two level artificial lumbar disc replacement with SB Charit? Ⅲ prosthesis.There were 16 men and 6 women.The average age of the patient at surgery was 48 years(range,43 to 54 years).The duration of follow-up evaluation ranged 24 to 94 months,with an average of 59.5 months.JOA score and radiological outcomes were used to access the curative effect.[Result]The average postoperative JOA score was statistically significantly higher than preoperative JOA score(P