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Several clinical trials have reported that patients with cancer cachexia can benefit from n-3 polyunsaturated fatty acids (n-3 PUFAs) supplements; however, the results have been conflicting. This systematic review and meta-analysis aimed to evaluate the effect of n-3 PUFAs on cancer cachexia. A search of the PubMed, Embase, and Cochrane Library databases was performed to identify the included randomized controlled trials. Trials including patients with cancer cachexia who were administered a course of n-3 PUFAs were included. A meta-analysis on body weight, lean body weight, proinflammatory factors, quality of life, and median duration of survival was conducted. A total of 12 randomized controlled trials with 1184 patients were included. No effect on body weight (standard mean difference [SMD], 0.10; 95% CI, -0.06 to 0.26; P = .236), lean body weight (SMD, -0.17; 95% CI, -0.36 to 0.03, P = .095), or proinflammatory factors (interleukin-6: SMD, 0.31; 95% CI, -0.14 to 0.75; P = .18; tumor necrosis factor-α: SMD, -0.85; 95% CI, -2.39 to 0.69; P = .28) was observed. The use of n-3 PUFAs was associated with a significant improvement in quality of life (SMD, 0.70; 95% CI, 0.01-1.40; P = .048) and median duration of survival (median survival ratio, 1.10; 95% CI, 1.02-1.19; P = .014). For patients with cancer cachexia, our meta-analysis indicated that n-3 PUFAs improved quality of life and survival, but not body weight.

MicroRNA (miRNA) has emerged as an important gene-regulator that shows great potential in gene therapy because of its unique roles in gene-regulation. However, the knowledge on their function and transportation in vivo is still lacking, and there are limited obvious evidences to define intracellular transportation of miRNA. In this study, the dynamics of exogenous miR-21 transfected into HeLa cells was traced by live-cell microscopy. Their transportation at key time points was recorded and dynamic properties were analyzed by single particle tracking (SPT) and mean square displacement (MSD) calculation. Results showed that the exogenous miRNAs bounded to cells quickly and went through lysosome into cytosol, where they were subsequently recruited into p-body. They finally were degraded, otherwise went back to cytosol in some way. Long time observation and analysis of motion mode showed that the miRNAs were confined in a small region and their motion modes were flexible in different intracellular microenvironment after entering the cells.

Cancer-associated fibroblasts (CAFs) are a major contributor to tumor stromal crosstalk in the tumor microenvironment (TME) and boost tumor progression by promoting angiogenesis and lymphangiogenesis. This study aimed to identify prognostic genes associated with CAFs that lead to high morbidity and mortality in ovarian cancer (OC) patients. We performed bioinformatics analysis in 16 multicenter studies (2,742 patients) and identified CAF-associated hub genes using the weighted gene co-expression network analysis (WGCNA). A machine learning methodology was used to identify COL16A1, COL5A2, GREM1, LUM, SRPX, and TIMP3 and construct a prognostic signature. Subsequently, a series of bioinformatics algorithms indicated risk stratification based on the above signature, suggesting that high-risk patients have a worse prognosis, weaker immune response, and lower tumor mutational burden (TMB) status but may be more sensitive to routine chemotherapeutic agents. Finally, we characterized prognostic markers using cell lines, immunohistochemistry, and single-cell sequencing. In conclusion, these results suggest that the CAF-related signature may be a novel pretreatment guide for anti-CAFs, and prognostic markers in CAFs may be potential therapeutic targets to inhibit OC progression.

To compare computed tomography (CT) measurement results of external deviation angle of patellar tendon and tibia tubercle-trochlea groove (TT-TG), as well as the diagnostic ability and pathology in recurrent patellar dislocation threshold.From January 2015 to March 2020, 46 patients with recurrent patella dislocation and 112 patients with non-patella dislocation were retrospectively analyzed. Forty-six patients with recurrent patella dislocation were divived into 2 groups according to TT-TG value, 11 patients with patellar dislocation with TT-TG≥20 mm(group A), including 7 males and 4 females, aged from 16 to 27 years old with an average of(21.00±3.98) years old; 35 patients with patellar dislocation with TT-TG20 mm(group B), including 14 males and 21 females, aged from 16 to 37 years old with an average of(22.83±6.09) years old. While 112 patients with non-patella dislocation(group C) included 63 males and 49 females, aged 16 to 36 years old with an average of(22.87±5.69) years old. The measurement data of external deviation angle of patellar tendon and TT-TG value among three groups were compared. Spearman analysis was used to analyze correlation among them. Intraclass correlation coefficient (ICC) was used to determine repeatability within group. Receiver operating characteristic (ROC) area under the curve was used to evaluate diagnostic ability of parameters, and calculate osteotomy parameters of external deviation angle of patellar tendon, as well as external deviation angle of patellar tendon and TT-TG value in the diagnosis of recurrent patella diagnostic parameters of dislocation.External deviation angle of patellar tendon in group A, B and C was (22.04±3.09)°, (17.20±4.43)°and (10.22±3.45)° respectively;while TT-TG value was(21.15±0.71) mm, (15.97±2.69) mm and (11.12±3.77) mm, there were significance among three groups (CT imaging could reliably measure external deviation angle of patellar tendon.There is a strong positive correlation between external deviation angle of patellar tendon and value of TT-TG, which could be used to determine pathological state of recurrent patellar dislocation, and external deviation angle of patellar tendon is superior to the TT-TG value in the diagnosis of recurrent patellar dislocation. The external deviation angle of patellar tendon could also be used to guide the formulation of the tibial osteotomy plan for recurrent patellar dislocation.

Background There has been no ideal treatment for freezing-phase frozen shoulder to rapidly relieve pain and improve joint mobility. No any other team directly compared the effectiveness of combination of arthroscopic release and corticosteroid hydrodilatation with corticosteroid hydrodilatation only in treatment of freezing-phase frozen shoulder. Methods Seventy-two patients with freezing-phase frozen shoulder were randomly assigned to combined arthroscopic release with corticosteroid hydrodilatation (group A) or corticosteroid hydrodilatation only (group B). Clinical states were examined at baseline and periodically (Weeks 1, 4, 12, 24 and 1 year) after intervention by passive ROM; visual analog scale (VAS); UCLA and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Results The passive ROM, VAS, UCLA and DASH scores always improved along the time points (all p p p p > 0.01), the differences between group A and group B were all lower than minimal clinically important difference (MCID). At Week 12, the UCLA sores and DASH scores were 26.8 ± 3.8, 14.2 ± 2.0 in group A versus 22.3 ± 3.4, 22.5 ± 3.1 in group B (all p p p Conclusions Combined arthroscopic release with corticosteroid hydrodilatation would yield better results in passive ROM and function than corticosteroid hydrodilatation only. Trial registration ChiCTR1900024235, July 2, 2019 (Retrospectively registered).

Four undescribed flavonoid glucosides (iridins B-C, tectoridin A and ampelopsinin A); one undescribed phenolic glucoside (diplostephioside B); one undescribed phenolic compound (phenanthrenetriol A); and seventeen known compounds were isolated from the rhizomes of Iris domestica. The chemical structures of the undescribed compounds were established by spectroscopic/spectrometric data interpretation using HRESIMS, NMR, and ECD. Tectoridin A, nigricin A and naringenin exhibited anti-inflammatory activities with inhibition rates of 53.71%, 57.68% and 88.71%, respectively, against the NF-κB signaling pathway at a concentration of 10 μM. 4'-O-methylnyasol (10 μM) exhibited 84.91% antiproliferative activity against the K562 human leukemia cell line with an IC

Background To investigate the effects of autologous meniscus fragment (AMF) implantation on injury in the meniscal avascular zone in mature rabbits. Methods Adult New Zealand white rabbits were randomly divided into two groups. Massive one-piece meniscus tissue was implanted in situ as control. In the experimental group, AMF was used to repair the meniscal injury in the avascular zone. Meniscal damage was assessed by gross observation of the degree of healing and histological semi-quantitative evaluation within 12 weeks postoperatively. The healing of meniscus interface was assessed by gross observation semiquantitative scoring and microscopic examination hematoxylin and eosin (H&E) staining at 2, 4, 8, and 12 weeks after surgery. The expressions of proliferating cell nuclear antigen (PCNA), collagen type I (COL1A1), and collagen type II (COL2) were detected by immunohistochemical staining. Results The degree of healing in the AMF group showed a significant increase over time (P P P P P P Conclusions Our study demonstrated that the AMF method can promote the repair of rabbit meniscal injury in the avascular zone, and this method may potentially be used for clinical application.

Clinical trials have reported that a four-oil intravenous lipid emulsion (SMOFlipid) play a positive role in immune function, but showed inconsistent outcomes compared to other lipid emulsions. A systematic review and meta-analysis was conducted to evaluate the effect of SMOFlipid on liver function, triglycerides (TG), inflammatory markers, and clinical outcomes in hospitalized adults after short-term use compared to others. A search of the PubMed, Medline, Embase, China National Knowledge Infrastructure, and Wanfang databases was performed to identify the included randomized controlled trials. Trials with adults who were administrated a short-term course of SMOFlipid were included. A meta-analysis on liver function markers, TG, inflammatory markers, and clinical outcomes was conducted. A total of 18 randomized controlled trials with 1188 patients were included. Compared to other lipid emulsions, SMOFlipid was associated with a significant reduction in ALT, AST, γ-glutamyltransferase, total bilirubin, TG, C-reactive protein and length of hospital stay. No effect on serum interleukin-6 levels or adverse events were observed. For adult patients, our meta-analysis indicated that SMOFlipid may be beneficial to the liver and prone to prevent hyperlipidemia. The SMOFlipid also shortened length of hospital stay.

The safety and efficacy of intravenous insulin injection coupled with subsequent milk consumption was evaluated for high-quality cardiac viability F-18-fluorodeoxyglucose (A total of 328 patients with known/suspected coronary artery disease received intravenous insulin injection with or without subsequent milk consumption for cardiacIntravenous insulin injection supplemented with subsequent milk consumption is a safer formulation for cardiac viability

This study was undertaken to elucidate the clinical significance of widening of the popliteal hiatus on magnetic resonance imaging (MRI) after a torn discoid lateral meniscus (DLM). Included are 125 knees with meniscal disorders after arthroscopic surgery, divided according to preoperative MRI and symptoms into group A (torn DLM with mechanical symptoms,11 knees); group B (torn DLM without mechanical symptoms,41 knees); group C (asymptomatic DLM, 19 knees); and group D (medial meniscal tears, 54 knees). Popliteal hiatus width was measured on sagittal and coronal MRI. During arthroscopy, total meniscectomy or central partial meniscectomy combined repair of the remaining part was performed in group A and group B. Outcomes were evaluated with MRI, the Tegner, Lysholm Knee Scoring Scale, and visual analog scale (VAS) scores. The preoperative width of the popliteal hiatus was significantly larger in group A than in groups C and D (P

An open-label, single-center, randomized controlled prospective trial was performed to assess the efficiency and safety of an insulin loading procedure to obtain high-quality cardiacBetween November 22, 2018 and August 15, 2019, 60 patients with CAD scheduled for cardiacThe ratio of interpretable cardiac PET images in the insulin loading group surpassed the glucose loading group (30/30 vs. 25/30, P = 0.026). Preparation time was 71±2 min shorter for the insulin loading group than for the glucose loading group (P0.01). Two and six hypoglycemia cases occurred in the insulin and glucose loading groups, respectively.The insulin loading protocol was a quicker, more efficient, and safer preparation for gaining high-quality cardiac

We established an effective finite element model of knee joint for observation of stress and displacement of meniscus related changes after medial meniscus injury. Different types of medial meniscus injury can lead to varied meniscus stress and displacement changes. Stress and displacement concentration were found in fissure tip of meniscus tear compared to normal meniscus. The posterior horn injury of medial meniscus may initiate combined injury of medial meniscus posterior horn (MMPH) and that of medial meniscus body, and combined injury of MMPH and that of lateral meniscus anterior horn; fissure expansions regarding horizontal fissure, longitudinal fissure and grip-shaped fissure of MMPH were spotted.

Yun Kang oral liquid is a listed proprietary Chinese Medicine. To further evaluate its efficacy, this experiment established a kidney deficiency and luteum inhibition threatened abortion rat model to observe the effects of Yun Kang oral liquid.Sixty pregnant rats were randomly divided into normal control group (NC), model group (MG), dydrogesterone group (DT, 3.02 mg/kg), and Yun Kang oral liquid low-dose group (YK-L, 4 ml/kg), medium dose group (YK-M, 6 ml/kg), high dose group (YK-H, 9 ml/kg), 10 in each group. On the first day of pregnancy, each administration group was treated with the test drug at the prescribed dose every morning, and the NC group and the MG group were given an equal volume of purified water for 10 days; the rats were intragastrically administrated every afternoon, except for the NC group. In addition, the other groups were intragastrically administered with hydroxyurea at a dose of 450 mg/kg for 9 days, and mifepristone was administered at a dose of 4.0 mg/kg on the 10th day. On the 9th day of pregnancy, behavioral signs such as back temperature, grasping force, pain threshold, and autonomic activity were measured in each group. On the 11th day of pregnancy, blood was collected from the abdominal aorta in each group to determine serum levels of estradiol (ECompared with the NC group, the back temperature, grip, pain threshold, number of spontaneous activities, number of embryos, embryo diameter, uterus index and serum EYun Kang oral liquid has a clear kidney-filling effect on rats with threatened abortion caused by kidney deficiency-luteal suppression. The mechanism may be related to raising serum E

To explore the clinical effects of combined operation involving tibial tubercle distalization for the recurrent patellar dislocation with patella alta.Between April 2010 and May 2016, 14 cases of recurrent patellar dislocation with patella alta were treated with combined operation involving tibial tubercle distalization. There were 5 males and 9 females with an average age of 18.5 years (range, 13-26 years). The left knee was involved in 9 cases and the right knee in 5 cases. The patella had dislocated 3.3 times on average (range, 2-5 times). The interval between the first dislocation and admission was 19.7 months on average (range, 4-60 months), and the main symptoms were knee pain and limited knee movement. Preoperative X-ray films, CT, and MRI examinations of knee joint showed that the epiphyseal plate closed in all patients. Of all patients, 3 patients had avulsion fracture of the inner edge of patella, and 2 patients had free body in articular cavity. The tibial tuberosity-trochlear groove (TT-TG) distance, patellar-trochlear-groove distance, Caton-Deschamps index, knee range of motion (ROM), Lysholm score, International Knee Documentation Committee (IKDC) score, Kujala score, and Tegner score were compared pre- and post-operation.All patients had primary wound healing. All patients were followed up 24-72 months with an average of 34.6 months. X-ray film and CT examination showed that the patellar dislocation was corrected and the osteotomy of the tibial tubercle healed with an average healing time of 3.8 months (range, 3-5 month). At 1 day and 1 year after operation, the TT-TG distance, patellar-trochlear-groove distance, and Caton-Deschamps index showed significant differences when compared with preoperative values (Combined operation involving tibial tubercle distalization is a safe and reliable method, which has satisfactory short-term effectiveness for the recurrent patellar dislocation with patella alta.探讨包含胫骨结节下移的联合手术治疗合并高位髌骨的复发性髌骨脱位的手术技术及临床疗效。.2010 年 4 月—2016 年 5 月，采用包含胫骨结节下移的联合手术治疗 14 例合并高位髌骨的复发性髌骨脱位患者。男 5 例，女 9 例；年龄 13～26 岁，平均 18.5 岁。左膝 9 例，右膝 5 例。髌骨脱位 2～5 次，平均 3.3 次；首次脱位至该次就诊时间为 4～60 个月，平均 19.7 个月。患者主要症状为膝关节疼痛、活动受限。术前膝关节 X 线片、CT、MRI 检查示骺板均已闭合；3 例存在髌骨内缘撕脱性骨折，2 例关节腔内有游离体。比较手术前后胫骨结节-股骨滑车沟（tibial tuberosity-trochlear groove，TT-TG）间距、髌骨滑车沟间距、Caton-Deschamps 指数以及膝关节活动度、Lysholm 评分、国际膝关节文献委员会（IKDC）评分、Kujala 评分、Tegner 评分。.术后切口均Ⅰ期愈合。所有患者均获随访，随访时间 24～72 个月，平均 34.6 个月。术后复查 X 线片及 CT 提示髌骨脱位均纠正；胫骨结节截骨移位处均愈合，愈合时间 3～5 个月，平均 3.8 个月。术后 1 d 及 1 年时 TT-TG 间距、髌骨滑车沟间距、Caton-Deschamps 指数与术前比较，差异均有统计学意义（采用包含胫骨结节下移的联合手术治疗合并高位髌骨的复发性髌骨脱位，安全可靠，近期疗效满意。.

Chemotherapy-induced immunogenic cell death (ICD) may offer a strategy to improve the effect of the therapeutic treatment of triple-negative breast cancer (TNBC) by eliciting broad antitumor immunity. However, chemotherapy shows a limited therapeutic effect because of multi-drug resistance and the immunosuppressive tumor microenvironment (TME) of TNBC. The unique pharmacological actions of sunitinib (SUN) indicate its possible synergies with paclitaxel (PTX) to enhance chemo-immunotherapy for TNBC. Here, we prepared a co-delivery platform composed of poly(styrene-co-maleic anhydride) (SMA) via a self-assembly process for a combination of PTX and SUN, which was able to induce a higher synergistic ICD. The nanomicellar delivery of PTX and SUN loaded at an optimal ratio of 1:5 (PTX:SUN) presented the characteristics of an appropriate particle size, long-term stability, and time sequence release which synergistically promoted the apoptosis of MDA-MB-231 tumor cells. Moreover, we demonstrated that the combination of PTX and SUN could significantly induce a synergistic effect because it promoted an ICD response, improved tumor immunogenicity, and regulated immunosuppressive factors in the TME. Overall, PTX and SUN with synergistic effects entrapped in a self-assembly nano-delivery system could offer the potential for clinical applicationof a combination chemo-immunotherapy strategy to improve the effect of the therapeutic treatment of TNBC.

This study analyzed the efficacy and safety of arthroscopic outside-in repair of the anterior horn of the lateral meniscus that includes covering the lesion with an infrapatellar pedicle fat flap in patients with chronic tears. This retrospective study reviewed 87 patients with chronic tears of the anterior horn of the lateral meniscus who underwent arthroscopic outside-in repair, which included covering the lesion with an infrapatellar pedicle fat flap (group A, n=45) or not (group B, n=42). The 2 groups were similar in terms of age, sex, body mass index, and disease duration. Patient results were assessed with Tegner, Lysholm, and visual analog scale scores; healing criteria; magnetic resonance imaging; and complication rates. Mean follow-up was 38.2 months. Tegner and Lysholm scores improved postoperatively in both groups (all P P >.05). Visual analog scale scores were reduced postoperatively in both groups ( P P >.05). Healing rates and complication rates did not differ between the 2 groups (all P >.05), but healing on magnetic resonance imaging was better in group A than group B ( P Orthopedics . 2018; 41(3):e360–e364.]

Popliteal meniscal fiber bundle injury is relatively infrequent in clinic, which can be either isolated or associated with anterior cruciate ligament rupture, lateral meniscus injury and so on. Popliteal meniscal fiber bundle injury often leads to instability of lateral meniscus. Because of the lack of specific symptoms and signs of injury, the imaging changes are subtle, and it is easy to miss diagnosis and misdiagnosis in clinical. Timely diagnosis and treatment are essential to prevent the chronic pain and instability of the knee joint. This paper summarizes the anatomical characteristics, biomechanics, injury mechanism, diagnostic points and surgical treatment of the popliteal meniscus fiber bundle injury, in order to guide the diagnosis and treatment of the injury of the popliteal meniscus fiber bundle in the clinical work.

To explore the treatment methed of recurrent patellar dislocation associated with old osteochondral fracture and to evaluate its effectiveness.Between August 2010 and August 2014, 12 cases of recurrent patellar dislocation with old osteochondral fracture were treated. There were 4 males and 8 females with an average age of 18.3 years (range, 15-24 years). The left knee was involved in 7 cases and the right knee in 5 cases. All the patients had a history of patellar dislocation, the average interval from injury to first hospitalization was 7.6 months (range, 6-13 months). At preoperation, the range of motion (ROM) of the injured knee was (89.17 ± 13.11)degrees; the Lysholm score was 56.67 ± 18.91; the Q-angle was (17.50 ± 5.28)degrees; and tibial tuberosity-trochlear groove (TT-TG) distance was (18.33 ± 4.03) mm. The Q-angle was more than 20 degrees and TT-TG distance was more than 20 mm in 6 of 12 cases. There were 6 cases of patellar osteochondral fracture, 5 cases of lateral femoral condylar osteochondral fracture, and 1 case of patellar osteochondral fracture combined with lateral femoral condylar osteochondral fracture. After osteochondral fracture fragments were removed under arthroscope, lateral patellar retinaculum releasing and medial patellar retinaculum reefing was performed in 2 cases, medial patellofemoral ligament (MPFL) reconstruction combined with both lateral patellar retinaculum releasing and medial patellar retinaculum reefing in 4 cases, and MPFL reconstruction, lateral patellar retinaculum releasing, medial patellar retinaculum reefing, and tibial tubercle transfer in 6 cases. Results All wounds healed by first intention with no complication of infection, haematoma, skin necrosis, or bone nonunion. All patients were followed up 12-60 months with an average of 24.2 months. At 3 months after operation, all patellar dislocations were corrected; the Q-angle was (13.33 ± 1.37)degrees and the TT-TG distance was (12.17 ± 1.17) mm in 6 patients undergoing tibial tubercle transfer, showing significant differences when compared with preoperative values [(22.50 ± 2.17)degrees and (21.33 ± 2.34 mm (t = 15.25, P = 0.00; t = 8.27, P = 0.00. All patients achieved relief of knee pain and knee locking; the knee ROM and the Lysholm score at last follow-up were (120.42 ± 11.57)degrees and 89.25 ± 9.71, showing significant differences when compared with preoperative ones (t = -11.61, P = 0.00; t = -8.66, P = 0.00).It gas satisfactory short-term effectiveness to remove old osteochondral fragments that can not be rest and to correct patellar dislocation for recurrent patellar dislocation with old osteochondral fracture.

To observe the effectiveness of 360 degrees internal fixation by anteromedial and posterior-lateral approaches for high-energy closed Pilon fractures.Between February 2013 and February 2015, 18 cases of high-energy closed Pilon fractures were treated. There were 11 males and 7 females with an average age of 40.5 years (range, 20-65 years). The causes were falling injury in 10 cases and traffic accident injury in 8 cases. All fractures were Rüedi-Allgower type III Pilon fracture combined with ipsilateral fibula fracture. The average interval from injury to operation was 8 days (range, 5-13 days). Reduction of fracture was performed by anteromedial and posterior-lateral approaches and the fracture fragments were fixed by 360 degrees internal fixation. The effectiveness was assessed by ankle X-ray film and Mazur score at last follow-up.Two cases had skin necrosis and received flap surgery, the other cases obtained primary healing of incision. All the cases were followed up 11.2 months on average (range, 3-27 months). X-ray film showed that all fractures healed at 3-4 months after operation (mean, 3.6 months). No deep infection or plate exposure occurred. According to Mazur score, the results were excellent in 8 cases, good in 7 cases, fair in 2 cases, and poor in 1 case, and the excellent and good rate was 83.3%.The effectiveness of the 360 degrees internal fixation for treatment of high-energy closed Pilon fractures has the advantages of reliable fixation, early functional exercise, and good functional recovery of the ankle joint.

To explore the technique of arthroscopic resection of benign tumor in the knee posterior septum and to evaluate its clinical results.Between June 2008 and June 2012, 12 cases of benign tumor in the knee posterior septum were treated by arthroscopic surgery. There were 8 males and 4 females with an average age of 36.5 years (range, 22-50 years). The average disease duration was 8.4 months (range, 3 months to 2 years). Of 12 cases, there were 2 cases of chronic synovitis, 5 cases of ganglion, 4 cases of tenosynovial giant cell tumor, and 1 case of synovial hemangioma; solitary tumor involved in the knee posterior septum in 10 cases, and in the posterior septum and other part of the knee in 2 cases. All the patients underwent tumor removal under arthroscope with routine anterolateral and anteromedial portal, additional posteromedial portal and/or posterolateral portal. Trans-septal approach was used in 6 cases because the tumors located in the middle of the posterior septum.All wounds healed by first intention with no complications such as infection, haematoma in the knee, injury of vessels and nerves, deep vein thrombosis, osteofascial compartment syndrome, or cutaneous necrosis. All patients were followed up 12-46 months with an average of 18.5 months. All patients achieved relief of knee pain and improvement of knee movement. The range of motion of the knee was significantly improved from (57.08 ± 12.52) degrees at pre-operation to (120.83 ± 13.95) degrees at last follow-up (t = -12.84, P = 0.00). The visual analogue scale (VAS) score was significantly reduced from 5.00 ± 1.04 at pre-operation to 1.50 ± 0.91 at last follow-up (t = -18.00, P = 0.00). The Lysholm score was significantly improved from 49.50?9.07 at pre-operation to 84.58 ± 6.82 at last follow-up (t = -8.04, P = 0.00).The benign tumor in the knee posterior septum can be completely resected under arthroscope, and the procedure is minimally invasive and useful to the restore knee function.

To observe the characteristics of acetabular labrum injury in Pipkin fractures and the effectiveness of repairing the labrum with suture anchor.Between July 2010 and July 2013, 10 cases of Pipkin fractures accompanied by acetabular labrum injury were treated. There were 7 males and 3 females with an average age of 32.5 years (range, 24-56 years). The causes of injury included traffic accident in 8 cases and falling from height in 2 cases. According to the Pipkin classification criteria, there were 6 cases of type II, 2 cases of type III, and 2 cases of type IV. The average interval from injury to operation was 8 days (range, 6-14 days). All the patients underwent open reduction and internal fixation through transtrochanteric approach with trochanteric osteotomy, and repair the labrum with suture anchor. The effectiveness was evaluated according to the ThompsonEpstein scoring scales after operation.All incisions healed primarily without early complication of deep infection or deep vein thrombosis of lower limb. All the cases were followed up 22 months on average (range, 12-48 months). X-ray films showed that all osteotomies and acetabular fractures healed within 3-4 months, femoral head and femoral neck fracture healed within 6-11 months. MRI examinations showed that all repaired acetabular labrums well healed. One case had necrosis of the femoral head at 12 months after operation, and was treated by total hip arthroplasty. According to the ThompsonEpstein scoring scales at last follow-up, the results were excellent in 5 cases, good in 3 cases, fair in 1 case and poor in 1 case, with an excellent and good rate of 80%.The diagnosis of acetabular labrum injury can be easily missed during Pipkin fracture, preoperative diagnosis should be combined with hip MRI. Trochanteric osteotomy through transtrochanteric approach , and repairing the labrum with suture anchor can restore the hip function effectively.

Purpose: To compare the outcomes of contracture release by arthroscopic versus open surgical approach in patients with external snapping hip (ESH) caused by gluteal muscle contracture (GMC). Methods: Medical records of patients with ESH due to GMC who underwent open surgery (n = 44) or arthroscopic surgery (n = 48) between October 2008 and October 2014 were reviewed. Patients were followed up at 1, 3, 12, and 24 months postoperatively. Operation time, incision length, postoperative pain, postoperative complication rate, and recurrence rate were compared between the 2 groups. Hip adduction, and Harris Hip Scores (HHS) at 1 and 2 years postoperatively were compared between the groups and with preoperative data. Results: Mean operation time did not differ between the 2 groups (p>0.05). The arthroscopic surgery group had smaller incisions (p0.05). Hip adduction, and HHS 1 year and 2 years postoperatively were significantly better postoperatively than they had been preoperatively for both groups (all p0.05). Conclusions: Arthroscopic release of contracture tissue is a safe and effective approach for the treatment of ESH caused by GMC, with the advantages of small scars, less postoperative pain, fewer complications compared with open surgery.

To investigate the methods and effectiveness of surgical treatment for posteromedial corner (PMC) injury combined with anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) ruptures.Between February 2009 and February 2012, 15 patients (15 knees) with PMC injury combined with ACL and PCL ruptures underwent PMC repair with suture anchor and ACL and PCL reconstruction. There were 7 males and 8 females with an average age of 39 years (range, 15-59 years). The causes of injury were traffic accident injury in 6 cases, sport injury in 7 cases, and sprain injury in 2 cases. The disease duration was 3-15 days with an average of 7 days. All patients presented positive results of anterior drawer test, posterior drawer test and valgus stress test, and dysfunction of knee joint. Of 15 cases, 3 had ACL and PCL ruptures, 5 had ACL rupture, 3 had ACL injury at the attachment point of the condyles crest, and 4 had PCL rupture; 9 had PMC tear at the femur insertion, 5 had PMC tear at the tibia insertion, and 1had PMC tear in the body area.All incisions healed by first intention with no complication of infection or stiffness of knee. All cases were followed up 18.4 months on average (range, 10-36 months). At last follow-up, 14 cases had normal knee flexion and extension ranges, but 1 case had 10 degree limitation of the knee extension. Except 1 case which had weakly positive valgus stress test, the other patients showed negative results of anterior drawer test, posterior drawer test, and valgus stress test. Based on the improved Lysholm classification standard, the results were excellent in 8 cases, good in 5 cases, and fair in 2 cases; the excellent and good rate was 86.7%.Early repair of the PMC and reasonable reconstruction of cruciate ligament can effectively restore the knee stability for patients with PMC injury combined with ACL and PCL ruptures.

To summarize the short-term effectiveness of type IV Pipkin fracture through transtrochanteric approach with trochanteric osteotomy.Between January 2007 and January 2010, 15 cases of type IV Pipkin fracture were treated through transtrochanteric approach with trochanteric osteotomy. There were 9 males and 6 females with an average age of 42.5 years (range, 27-55 years). The causes of fractures included traffic accident (12 cases), falling from height (2 cases), and heavy pound injury (1 case). The time from injury to hospitalization was 4 hours to 7 days (mean, 2.3 days). All patients had limitation of activity in the injured hips. The X-ray films and CT three-dimensional reconstruction indicated posterior dislocation of the hip joints and fractures of the femoral head and acetabulum, with no fracture of femoral neck. The locations of the femoral head fractures were under the round ligament in 9 cases and above the round ligament in 6 cases. Complications were treated firstly in all patients. The time from hospitalization to operation ranged from 2 to 10 days (mean, 4.5 days).All patients got primary wound healing with no early complication. All the patients were followed up 12-48 months with an average of 26 months. All osteotomies and acetabular fractures healed within 6 to 8 weeks. All patients achieved healing of femoral head fracture after 6-10 months. Mild heterotopic ossification occurred in 2 cases at 3 months after operation which were left untreated; and necrosis of the femoral head occurred in 1 case at 8 months after operation, was treated by total hip arthroplasty. At last follow-up, the flexion of the injuried hips ranged from 60 to 120 degrees (mean, 92.5 degrees). Based on Thompson et al. scoring scales, the results were excellent in 5 cases, good in 7 cases, fair in 2 cases, and poor in 1 case; the excellent and good rate was 80%.Treatment of type IV Pipkin fracture through transtrochanteric approach with trochanteric osteotomy can provide good visualization and protection of the blood supply of the femoral head.

To observe the effectiveness of traumatic dislocation of the knee joint combined with multiple ligament injuries treated by stages.Between june 2005 and November 2008, 13 cases of traumatic dislocation of the knee joint combined with multiple ligament injuries were treated by stages, including 9 males and 4 females with an average age of 30.7 years (range, 18-54 years). The dislocations were left knee in 3 cases and right knee in 10 cases. The causes of injury were sports injury in 8 cases, traffic accident injury in 2 cases, falling from height injury in 2 cases, and sprain injury in 1 case. The average time from injury to hospitalization was 9 hours (range, 6 hours to 2 days). Anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and medial collateral ligament (MCL) were involved in 8 cases; ACL, PCL, and lateral collateral ligament (LCL) in 3 cases; and ACL, PCL, MCL, and LCL in 2 cases. The valgus stress testing results of 10 knees were ++ to +++; the varus stress testing results of 5 knees were ++ to +++; all knees showed positive in the anterior or the posterior drawer test and ++ to +++ in Lachman test. The nerve, vessel, MCL, LCL, PCL, meniscus were repaired in the first operation. The functional exercise of knee joint was done after fixation for 3-4 weeks. During the second operation, the ACL was reconstructed under arthroscopy after the range of motion (ROM) of knee joint was good with anterior instability of knee within 4-6 months.All wounds healed by first intention after two operations; no complications of infection and compartment syndrome occurred. All cases were followed up 12-60 months with an average of 36 months. Joint effusion of knee occurred in 2 cases at 4 weeks after the first operation and was cured after removal of fluid. At 3 months after the second operation, the results of valgus stress testing and Lachman test were ++ in 1 case, respectively; the results of valgus stress testing, varus stress testing, and Lachman test were + in 1 case, respectively; and others showed negative results. After 12 months of the second operation, the mean flexion of the knee was 123.4 degrees (range, 100-135 degrees), and the mean extension of the knee was 2.3 degrees (range, 0-4 degrees). According to Lysholm evaluation system, 9 patients got excellent results, 2 good, and 2 fair; the excellent and good rate was 84.6%.It is an effective method in the treatment of traumatic dislocation of the knee joint combined with multiple ligament injuries by stages.

To observe the outcome of arthroscopic meniscal plasty and suture repair to treat torn discoid lateral meniscus involving popliteal hiatus.Between January 2008 and May 2009, 21 cases of torn discoid lateral meniscus involving popliteal hiatus were treated by arthroscopic surgery. There were 9 males and 12 females with an average age of 22.5 years (range, 12-45 years), including 12 left knees and 9 right knees. Seven cases had the history of injury and other 14 cases had uncertain trauma. The average disease duration was 6.4 months (range, 3 months to 2 years). All patients complained knee pain or locking with positive McMurray test and milling test before surgery. All cases had torn discoid lateral meniscus, and the tear extended to the popliteal hiatus, including 17 cases of complete type and 4 cases of incomplete type according to the Watanabe classification. After meniscal plasty, suture repair of torn popliteal lateral hiatus was performed. The anterior part to hiatus was repaired by the outside-in technique, and the posterior part underwent repair of all inside technique by FasT-Fix.All wounds healed by first intention with no complications such as infection, stiffness of knee, or injury of common peroneal nerve. All patients were followed up 12-28 months with an average of 18 months. The symptoms of knee pain or locking disappeared postoperatively with negative McMurray test and milling test in all patients. The Lysholm score was improved from 54.0 +/- 13.4 to 90.0 +/- 6.6 at 12 months postoperatively, showing significant difference (t = -12.00, P = 0.00). Based on the improved Lysholm classification standard, the results were excellent in 14 cases, good in 5, and fair in 2; the excellent and good rate was 90.5%.For torn discoid lateral meniscus involving popliteal hiatus, based on meniscal plasty, suture repair of the popliteal hiatus would contribute to preserve the peripheral part and restore its stability.

To observe the clinical results of treatment of Schatzker V/VI tibial plateau fracture involved posteromedial condyle through combined posteromedial and anterolateral approach and fixed with two or three plates.From April 2005 to April 2008, 18 cases of tibial plateau fracture involved posteromedial condyle were treated, including 14 males and 4 females with an average age of 38.5 years old (range, 18-62 years old). According to Schatzker classification, there were 12 cases of type V and 6 cases of type VI. The posteromedial condyle were involved in 13 cases and bilateral posterior condyle in 5 cases. All patients were given posteromedial fragment and medial condyle fracture reduction through posteromedial approach firstly, and then lateral condyle fracture reduction through anterolateral approach, and injury of meniscus and cruciate ligaments were treated at the same time. Three plates (lateral, medial, posterior) were used in 10 cases and two plates (lateral, posteromedial) in 8 cases.All wounds achieved healing by first intention without complications such as infection, flap necrosis, osteofascial compartment syndrome, chronic osteomyelitis, nonunion. All patients were followed up for 12 to 48 months with an average of 24.4 months. The mean flexion of the knee was 118.4 degrees (range, 100-130 degrees) 1 year after operation. According to Iowa evaluation system, 12 patients got excellent results, 4 good, and 2 fair; the excellent and good rate was 88.9%.Combined posteromedial and anterolateral approach and fixed with two or three plates is effective in treatment of the Schatzker V/VI tibial plateau fracture involved posteromedial condyle. Anatomical reduction and rigid internal fixation of the posteromedial fragment are critical to successful operation.

To analyze the quantitative differences between hepatitis B virus markers (HBV M) and HBV DNA in population with high-level or low-level HBsAg, and to reveal the characteristics of HBV DNA and HBV M in population with low-level HBsAg.A total of 264 chronic HBV-infected patients were enrolled in our study, and were divided into low-level HBsAg group (147 cases) and high-level HBsAg group (117 cases) based on the HBsAg level or were divided into immune tolerance stage, immune clearance stage and non-active stage based on the natural history. Real-time PCR and microparticle enzyme immunoassay (MEIA) were used to determine the content of HBV DNA and HBV M in serum samples of high-level and low-level HBsAg patients, respectively, then the quantitative results were compared.There were statistically significant differences between HBV DNA and HBV M (anti-HBs, HBeAg and anti-HBe) of low-level HBsAg patients in immune tolerance stage (7 cases) and immune clearance stage(4 cases) (t=2.531-9.181, P0.01-0.05). HBV DNA lower than 10(5) copies/L was found in 94.1% (128/136) of serum samples in non-active stage, and the detection rates of direct PCR and enriching PCR were 10.3% (14/136) and 10.3% (47/136) in low-level HBsAg group, respectively, and there were no correlations between HBV DNA and each of HBV M (P0.05). In high-level HBsAg group, HBV DNA was positively correlated with HBeAg and anti-HBe in 25 cases of immune tolerance stage (r=0.744-0.772, t(r)=3.858-4.207, P0.01), and was only negatively correlated with anti-HBs in 46 cases of immune clearance stage and 46 cases of non-active stage (r=-0.693 - -0.598, t(r)=-4.616 - -3.936, P0.01-0.05).Population with low-level HBsAg have specific serological characteristics, which may be correlated with organic immune tolerance and individualized immune responses.

To compare therapeutic effects of acupuncture on complicated facial paralysis in the patient with HIV/AIDS and in the patient with no HIV/AIDS.The observation group of 31 cases of facial paralysis with positive HIV/AIDS and the control group of 30 cases of facial paralysis with negative HIV/AIDS were treated with acupuncture at Yifeng (TE 17), Xiaguan (ST 7), Jiache (ST 6), Taiyang (EX-HN 5), Dicang (ST 4), Yuyao (EX-HN 4), Cuanzhu (BL 2), Yingxiang (LI 20), etc. and with individual treatment according to different periods of disease. The difference of therapeutic effects between the two groups were observed.The effective rate was 83.9% in the observation group and 96.7% in the control group, with no significant difference between the two groups; while the cured rate was 9.7% in the observation group and 73.3% in the control group with a very significant difference between the two groups (P0.01).Acupuncture with individual treatment has a satisfactory therapeutic effect on complicated facial paralysis in the patient of HIV/AIDS.

To evaluate the therapeutic effects of intraarticular injection of ligustrazine on knee osteoarthritis (OA).Seventy-one cases of knee osteoarthritis (82 knees) were randomly divided into ligustrazine (LI) group and sodium hyaluronate (SH) group. The patients were intraarticularly injected ligustrazine or sodium hyaluronate once a week for 5 consecutive weeks, and were followed-up for 3 months. Lequesneos protocol for the evaluation of OA severity and activity was used. The therapeutic effects and changes of Lequesneos index were observed after the treatment.There was significant decrease in Lequesneos index in SH group after the treatment (P0.01), but not in LI group (P0.05). Three weeks later, there was significant decrease in Lequesneos index in both groups after the treatment (P0.01), with no significant difference between SH and LI group (P0.05). After the 5-week treatment, the efficacy rate of the LI group was 82.1%, and that of the SH group was 87.2%. No serious toxic or side effect was observed during the treatment and the follow-up.Intraarticular injection of ligustrazine has a therapeutic effect on knee OA. No adverse effect is observed, but it needs long time to take effect.