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: To observe the effect of LMWH followed by rivaroxaban for the prevention of DVT after TKA. Between June 2015 and November 2017 as well as in accordance with the inclusion criteria, 118 patients undergoing TKA were randomly allocated to two groups. Patients in group A were applied LMWH, whereas patients in group B received LMWH followed by rivaroxaban postoperatively. The two groups were foIlowed up and compared for the incidence of DVT by color Doppler ultrasonography scan. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin (ALB), Hb and D-Dimer were also compared. No statistically significant differences of ESR, CRP, and Hb was found between the two groups (P > 0.05), while higher levels of ALB and D-D in postoperation were observed in group B (ALB: 7 and 10 days after operation, D-D: 4, 7 and 10 days after operation). The overall DVT rate of group B (46.67%) is significantly higher than that of A (25.86%; P = 0.019, η = 0.216). Moreover, the occurrence rate of DVT in group A was 18.75% (3/16) and in group B is 16.67% (3/18) (P = 0.0445, η = 0.027) for men. The DVT rate of group A and B was 28.57 and 59.52%, respectively, with statistical difference (P = 0.002, η = 0.312) for female. The DVT rate of LMWH followed by rivaroxaban group is significantly higher than that of LMWH group, especially in female group, so it is not recommend to take rivaroxaban following injection of LMWH for the prevention of DVT after TKA.

Objective: We aimed to identify factors that affect pain, complications, and function following elbow arthroscopy for elbow synovial chondromatosis., Methods: We retrospectively reviewed the cases of all patients with elbow synovial chondromatosis treated by arthroscopic synovectomy and loose body removal between January 2000 and January 2016 at our institution. Eleven patients were enrolled (8 male; mean age, 41.7 years). The mean duration of symptoms was 13.7 months, and all patients had a decreased range of motion (ROM) in the affected elbow. By Milgram criteria, there was 1 phase II case, and 10 cases were phase III., Results: All patients were followed postoperatively (mean follow-up, 65 months). The preoperatively restricted ROM of 100° flexion (range, 78°-120°) and extension of 30° (range, 15°-40°) were improved to 130° flexion (range, 120°-140°) and -5° hyperextension (range, -10°-0°). Pain, recorded as the pain subscore of the American Shoulder and Elbow Surgeons questionnaire for elbows, was significantly improved from 32 points (range, 20-50) preoperatively to 85 (range, 70-100) postoperatively (on a scale ranging from 0 [worst pain] to 100 [pain-free]). Recurrence occurred in 2 patients (18.2%) who then received arthroscopic synovectomy and loose body removal again. There were no fractures or neurovascular complications, and no patient developed an infection., Conclusion: Arthroscopic management of synovial chondromatosis of the elbow was an effective and safe therapeutic method. After the intervention, immediate and durable improvement of elbow function can be expected.

Background: Doxorubicin is the preferred chemotherapeuticdrug for osteosarcoma treatment of which clinical efficacy is limited because of its chemo-resistance and cardiac toxicity. It is necessary to develop the combination regimen with complementary molecular mechanisms to reduce the side effects and enhance sensitivity of Doxorubicin. EGCG is a polyphenol in green tea with antitumor bioactivity,which has been found that its combination with certain chemotherapeutic drugs could improve the antitumor efficiency., Methods: In this study, MTT assay was used to detect the cell growth inhibition The CD133+/CD44+ cells were isolated from U2OS and SaoS2 cell lines using magnetic-activated cell sorting and identified by flow cytometry analysis. qRT-PCR was used for determining the relative mRNA levels of key genes. Immunofluorescence was performed to evaluate the autophagy flux alterations. Self-renewal ability was accessed by sphere-forming assay. Tumorigenicity in nude mice was preformed to evaluate tumorigenicity in vivo., Results: We found that EGCG targeting LncRNA SOX2OT variant 7 produced synergistic effects with Doxorubicin on osteosarcoma cell growth inhibition. On the one hand, EGCG could reduce the Doxorubicin-induced pro-survival autophagy through decreasing SOX2OT variant 7 to improve the growth inhibition of Doxorubicin. On the other hand, EGCG could partially inactivate Notch3/DLL3 signaling cascade targeting SOX2OT variant 7 to reduce the stemness then abated drug-resistance of osteosarcoma cells., Conclusions: This study will help to reveal the molecular mechanisms of synergistic effects of EGCG and Doxorubicin on OS chemotherapy and improve the clinical efficacy of chemotherapy as well as provide a basis for developing antitumor drugs targeting osteosarcoma stem cells.

Cisplatin is an effective chemotherapeutic agent for osteosarcoma (OS) and has been shown to induce endoplasmic reticulum (ER) stress-associated apoptosis in human cancer cells. Ganglioside GD2-specific antibodies can inhibit tumor cell viability without involvement of the immune system. A recent study has shown that antiGD2 monoclonal antibody (mAb) 14G2a effectively inhibits the viability and invasiveness of human OS cells. In this study, we explored the effect of anti-GD2 mAb and cisplatin alone and in combination on ER stress-associated apoptosis in osteosarcoma cells. MG-63 and Saos-2 human OS cells were treated with cisplatin and/or an-GD2 mAb 14G2a for 48 hours. Cisplatin and 14G2a dose-dependently induced apoptosis in MG-63 and Saos-2 cells. They in combination induced 70%-77% of apoptosis in MG-63 cells and 79%-85% of apoptosis in Saos-2 cells, exhibiting a synergistic effect stronger than addition of their individual effects over the control level. Showing no significant effect on the expression of protein kinase RNA-like ER kinase (PERK), cisplatin and 14G2a exhibited a marked synergistic effect on inducing phosphorylation/activation of PERK, phosphorylation/inactivation of eukaryotic translation initiation factor 2α (eIF2α), expression of CHOP, in parallel to inducing the caspase-3 activity and apoptosis in MG-63 and Saos-2 cells. The effects were abolished by lentivirus-mediated knockdown of PERK. Particularly, PERK knockdown abolished 63% and 65% of the combined apoptotic effect of cisplatin and 14G2a on MG-63 and Saos-2 cells, respectively. In conclusion, this study provides the first evidence supporting that cisplatin and 14G2a synergize to induce ER stress-associated apoptosis in human OS cells through activating the PERK ER stress pathway by synergistically inducing phosphorylation/activation of PERK. Our findings add new insights into the pharmacologic effects of anti-GD2 mAb in anticancer treatment and suggest that cisplatin plus anti-GD2 mAb could be a new effective therapeutic strategy for OS.

Accumulating evidence indicated that inhibiting the expression of a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-5 ameliorate cartilage degradation, suggesting ADAMTS-5 as an effective target for treating osteoarthritis (OA). A recent study has identified long noncoding RNA (lncRNA) HOTAIR and ADAMTS-5 as the most up-regulated lncRNA and the most upregulated gene, respectively, in human OA cartilage compared with normal cartilage. In the present study, we explored the regulatory effect of HOTAIR on the expression of ADAMTS-5 as well as the underlying mechanisms in human normal and OA articular chondrocytes. We found that human OA articular chondrocytes had significantly higher basal expression levels of HOTAIR and ADAMTS-5 than normal articular chondrocytes. Tumor necrosis factor (TNF)-α significantly enhanced the basal expression of HOTAIR and ADAMTS-5 in OA but not in normal articular chondrocytes. Lentiviral overexpression and knockdown of HOTAIR markedly increased and decreased the expression of ADAMTS-5, respectively, in OA but not in normal articular chondrocytes in the presence or absence of TNF-α. Neither overexpression/ knockdown of HOTAIR nor TNF-α showed a significant effect on the ADAMTS-5 gene promoter in OA articular chondrocytes. Although HOTAIR showed no significant effect on the stability of ADAMTS-5 mRNA in normal articular chondrocytes, HOTAIR overexpression and knockdown respectively increased and decreased the ADAMTS-5 mRNA stability in OA articular chondrocytes. TNF-α enhanced the protective effect of HOTAIR on the ADAMTS-5 mRNA stability. In conclusion, this study provides the first evidence supporting that HOTAIR strongly promotes the expression of ADAMTS-5 by increasing its mRNA stability in human OA articular chondrocytes; this effect is enhanced by TNF-α. It adds new insights into the pathogenesis of OA and suggests that HOTAIR could be a new therapeutic target for ADAMTS-5 inhibition in human OA cartilage.

(-)-Epigallocatechin-3-gallate (EGCG), the most abundant and active polyphenol in green tea, has been demonstrated to have anticancer effects in a wide variety of human cancer. MicroRNAs (miRNAs) are a class of short noncoding RNAs and play important role in gene regulation and are critically involved in the pathogenesis and progression of human cancer. This study aims to investigate the effects of EGCG on osteosarcoma (OS) cells and elucidate the underlying mechanism. Cellular function assays revealed that EGCG inhibited cell proliferation, induced cell cycle arrest and promoted apoptosis of OS cells in vitro, and also inhibited the growth of transplanted tumors in vivo. By miRNA microarray and RT-qPCR analysis, miR-1 was found to be significantly upregulated in MG-63 and U-2OS treated by EGCG in dose- and time-dependent manners, and miR-1 downregulation by inhibitor mimics attenuated EGCG-induced inhibition on cell growth of OS cells. We also confirmed that miR-1 was also frequently decreased in clinical OS tumor tissues. Moreover, both EGCG and miR-1 mimic inhibited c-MET expression, and combination treatment with EGCG and c-MET inhibitor (crizotinib) had enhanced inhibitory effects on the growth of MG-63 and U-2OS cells. Taken together, these results suggest that EGCG has an anticancer effect on OS cells, at least partially, through regulating miR-1/c-MET interaction.

Under the guidance of meridian theory, the acupoints heat-sensitive moxibustion is a treatment method which applies moxa stick to perform mild moxibustion at heat-sensitive acupoints, which can arouse the meridian sensation transmission and promote the movement of meridian qi; consequently, the qi can be extended to the diseases. For its many advantages, such as no direct contact on skin, no injuries, no pains, fewer side effects, easy operating and moderate cost, the acupoints heat-sensitive moxibustion is widely accepted in dermatology, male urology disease, rectum and anus diseases and breast diseases. The application and research status of the acupoints heat-sensitive moxibustion in traditional Chinese surgery in recent years is reviewed, and several problems and suggestions in its clinical application and research are proposed, aiming to provide clinical basis for its further development and clinical application in traditional Chinese surgery.

Objective: To investigate the eff ect of icaritin on proliferation and apoptosis in rat chondrocytes and to provide new theory for osteochondropathy treatment., Methods: Icaritin (with a purity of 99%) at different concentrations (0, 4, 8, 16, 32, 64 μmol/L) was incubated with rat chondrocytes for different time. The cell proliferation and apoptosis was assayed by MTT and fl ow cytometry, respectively., Results: Compared with the control group, the cell proliferation was increased in the groups with icaritin at 4 or 8 μmol/L (P<0.05), whereas the proliferation was decreased in the groups with icaritin at 16, 32 or 64 μmol/L groups compared to the control group (P<0.05); the cell apoptosis ratio in the group with icaritin at 4 μmol/L was obviously lower than that in the control group aft er incubation of icaritin for 24 h and 48 h. Beyond 4 μmol/L, the higher concentration of icaritin, the higher apoptosis ratio of cell. However, it did not show a time-dependent manner at a same concentration of icaritin., Conclusion: The icaritin at low concentration (4 or 8 μmol/L) can promote rat chondrocyte proliferation and inhibit cell apoptosis, while the effect of icaritin on rat chondrocyte at high concentration was reversed.

Objective: Advanced glycation end products (AGEs) play a pivotal role in the initiation and progression of osteoarthritis (OA). Peroxisome proliferator-activated receptor-γ (PPARγ) has been shown to exhibit anti-inflammatory and anticatabolic properties and to be protective in animal models of OA. This study was aimed to investigate the possible protective effect of the PPARγ agonist pioglitazone on AGE-induced chondrocyte damage., Methods: Cultured chondrocytes were stimulated with AGEs in the presence or absence of an antibody against the receptor for AGEs (anti-RAGE), an inhibitor of NF-κB (pyrrolidine dithiocarbamate) and pioglitazone. The RNA expression levels of TNF-α, matrix metalloproteinase (MMP)-13 and PPARγ were detected by RT-PCR. The expression of nuclear p65 was determined by Western blot analysis., Results: Upregulation of TNF-α and MMP-13 as well as downregulation of PPARγ were induced by AGEs in a time- and dose-dependent manner. The maximum effect was induced by 100 μg/ml AGEs. This effect can be inhibited by anti-RAGE. Pioglitazone dose-dependently inhibited the expression of TNF-α and MMP-13 induced by AGEs, which was combined with the inhibition of nuclear p65 expression., Conclusion: The PPARγ agonist pioglitazone modulates TNF-α and MMP-13 expression in cultured rabbit chondrocytes via NF-κB signaling. It indicates that pioglitazone may have therapeutic potential in OA., (© 2014 S. Karger AG, Basel.)

Objective: To evaluate the effect of age and gender on the femoral morphology to guide prosthesis selection in operation and design., Methods: A total of 500 females and males were collected from the departments of orthopedics and medical radiology, Second Xiangya Hospital, Central South University. Informed consent was obtained from all subjects. All patients underwent anteroposterior position scan of the left or right hip joint using Philips Digital Diagnost DR system. The shooting range included the hip joint and at least 2/3 of the proximal femur. The images were measured with Onis 2.3 software. We measured 13 parameters from the patients, including the external parameters of the femur, radius-length parameters of femoral medullary cavity, and morphological parameters of the femoral medullary cavity., Results: Compared with Westeners, the offset was smaller, while the neck shaft angle was significantly larger in Chinese population (P<0.05). Most parameters of the proximal femoral medullary cavity diameter were significantly smaller in Chinese population than those in Westerners (P<0.05). The canal flare index in Chinese population was significantly larger than that in the Westerners (P<0.01). According to the Noble classification, in Chinese population, the proportion of champagne flute type was significantly larger, while the proportion of standard type was significantly smaller than that in Westerners. There was significant difference in the proximal femur between Chinese population and Westerners. The largest difference of the proximal morphology was presented between males and females in the 31-50 years old people (P<0.05), while the smallest was in the over 70 years old population (P>0.05). The main differences between 31 and 70 years old were the diameter of femoral head, the offset of isthmus, the medullary cavity diameter and extracortical width at isthmus level and the medullary cavity diameter at the level of the lesser trochanter (P<0.05). The modullary transverse diameter at 20 mm below the lesser trochanter and isthmus and extracortical width of isthmus in the male and female group was positively correlated with age (P<0.01), while the parameters of the proximal femoral canal morphology in the female group were negatively correlated with age. The female canal parameters had a stronger correlation., Conclusion: Chinese proximal femoral parameters are significantly different from Westerners. When people, especially females, get older, the medullary cavity diameter of the isthmus and proximal femur becomes wider and the morphology of the femur becomes straight. The difference in the femoral morphology between the male and female decline with the age. There is almost no difference for the over 70 years old. For the 31-70 years old, The male femoral cavity diameter is larger and the position of isthmus is lower than in the females.

Objective: To investigate the effect and mechanism of herpes simplex virus type 1 (HSV-1) based vector mediated interlukin-1 receptor antagonist (IL-1Rα) gene for knee osteoarthritis in rabbits., Methods: HSV-1 vectors containing IL-1Rα genes were constructed and injected into the joint space of the osteoarthritis knee in rabbits for 4 weeks. The rabbits were sacrificed, and the knees were lavaged, dissected and the effect of transgene expression was analyzed. Levels of IL-1Rα and IL-1 expression in the recovered lavage fluids were measured with a cytokine ELISA kit. Cartilage from the lesion areas of medial femoral condyle and synovium were observed with hematoxylin and eosin (cartilage and synovium) and toluidine blue (cartilage). The blank control group was injected pHSV-LacZ vector into rabbit knees., Results: Intra-articular delivery of pHSV-IL-1Rα-LacZ resulted in a significant inhibition of IL-1 level and cartilage degradation compared with those in the blank control group (P<0.05)., Conclusion: pHSV-LacZ is an ideal vector to mediate intra-articular gene delivery in the rabbit model of osteoarthritis. Continuous intra-articular expression of IL-1Rα can treat knee osteoarthritis by inhibiting IL-1.

Objective: To investigate the effect of C23 down-regulation on proliferation inhibition and apoptosis induced by cisplatin in human osteosarcoma SaOS-2 cells., Methods: SaOS-2 cells were randomly divided in to 5 groups: a control group, a DDP group, an S+DDP group, an AS+DDP group, and an R+DDP group. Cell growth suppression of each group was analyzed by MTT assay. RT-PCR and Western blot were used to detect the expression of C23, Bcl-2 and Bax mRNA and protein in each group. Morphologic character of apoptosis was evaluated by DAPI staining. The percentage of apoptotic cells was analyzed by flowcytometer assay., Results: C23 antisense oligonucleotides remarkably inhibited the expression of C23 mRNA and protein in SaOS-2 cells (P<0.01). The proliferation of SaOS-2 cells was remarkably inhibited in the AS+DDP group compared with the DDP group (P<0.01). The expression of C23, Bcl-2 mRNA and protein was weaker and that of Bax mRNA and protein was stronger in the AS+DDP group compared with the DDP group (P<0.01). Cisplatin-mediated apoptosis neclei in SaOS-2 cells and the rate of apoptotic cells were higher in the AS+DDP group than those of the DDP group (P<0.01)., Conclusion: Down-regulation of C23 can contribute to cisplatin-mediated proliferation inhibition and apoptosis in SaOS-2 cells.

Objective: To investigate the reversion of P-gp mediated multidrug resistance of U-2OS/ADM cells with curcumin in vitro., Methods: With doxorubicin as induction drugs, human osteosarcoma cell line U-2OS was induced object, multi-drug resistant of human osteosarcoma cell line model (U-2OS/ADM) were established by high-dose method, The before and after reversal efficacy of curcumin for U-2OS/ADM cells to chemotherapeutic drugs were measured by MTT assay. The effects of curcumin on Rh-123 uptake and efflux were analyzed by flow cytometer., Results: (1) MTT demonstrates curcumin (20 micromol/L) can increase the cytotoxicity of Adriamycin to U-2OS/ADM cells. (2) The result of FCM shows that Curcumin can increase the accumulation of Rh-123 and increase the cytotoxicity of Adriamycin to U-2OS/ADM cells in a dose-dependent manner., Conclusion: The reversal mechanism of curcumin was blocked the function of P-gp in U-2OS/ADM cellular membrane.

Objective: To establish a 3-dimensional (3-D) finite element knee model in healthy Chinese males, to verify the validity of the model, and to analyze the biomechanics of this model under axial load, flexion moment, varus/valgus torque, and internal/external axial torque., Methods: A set of consecutive transectional computerized tomography images of normal male knee joints in upright weight-bearing position was selected. With image processing and inversion technology, the 3-D finite element model of the normal knee joint was established through the software ABAQOUS/STANDARD Version-6.5.Biomechanical analysis of this model was processed under axial load, flexion moment, varus/valgus torque, and internal/external axial torque., Results: A 3-D finite element model of healthy Chinese males was successfully established. The ranges of motion of varus and valgus were both small and the difference between them has no statistical significance (P>0.05). The motion of internal and external rotation of the knee took place only in flexion situation.The range of motion of external rotation was larger than that of internal rotation in the same knee (P<0.05)., Conclusion: The 3-D geometrical model of the knee resembles the actual knee segments. It can imitate the knee response to different loads. This model could be used for further study on knee biomechanics.

Amelotin is expressed and secreted by ameloblasts in tooth development, but amelotin distribution during enamel development is not clear. In this report, we first investigated amelotin expression in developing teeth by immunohistochemistry. Amelotin was detected in the enamel matrix at the secretion and maturation stages of enamel development. Amelotin was also observed at Tomes' processes on the apical ends of secretory ameloblasts. We then compared amelotin gene expression with those of amelogenin, enamelin, and ameloblastin in the mandibles of postnatal mice by RT-PCR. The expression of amelotin was detected as early as in postnatal day 0 mandibles and amelotin was coexpressed with amelogenin, ameloblastin, and enamelin during tooth development. These data strongly suggest that amelotin is an enamel matrix protein expressed at the secretion and maturation stages of enamel development., ((c) 2009 Wiley-Liss, Inc.)

Objective: To explore the clinical effect of particulate bone grafting on reconstruction of femoral defects in revision total hip arthroplasty., Methods: Fifteen patients (20 hips) with femoral defects were treated by revision total hips arthroplasty with particulate bone grafting. After the operations, 14 patients (19 hips) were evaluated by X-rays and the Harris score., Results: During a follow-up of 43.6 months (11 approximately 65 months), 17 hips (89.5%) were cured, without obvious bone absorption or prosthesis sinking. Harris scores improved from 34.18 pre-operation to 86.6 post-operation., Conclusion: Reconstruction of femoral defects with particulate bone grafting is an effective method for bone defects in revision total hip arthroplasty.

An ultra performance liquid chromatography-tandem mass spectrometric method (UPLC-MS/MS) has been developed for the simultaneous determination of eight pesticide residues from seed coating in fruits, vegetable and grain. The sample was extracted by methanol-water (1:1, v/v) and determined by ultra performance liquid chromatography-electrospray ionization tandem mass spectrometry in positive mode (ESI+) and multiple reaction monitoring (MRM) mode. The UPLC analyses were performed on an Acquity UPLC C18 column with gradient eluation. The utility of the method was demonstrated by the analysis of crude extracts, with no sample clean up, from soybean. The linear range was 1 - 200 microg/L. The correlation coefficients (r) were under 0.997. The average recoveries of eight pesticides in samples (from 0.006 to 1.2 mg/kg) ranged from 60% to 110%, and the relative standard deviations (RSDs) were less than 10%. The results indicate that the method is easier, faster, more sensitive, and suitable for the qualitative and quantitative confirmation of pesticide residues from seed coating reagent in fruit, vegetable and grain samples.

Objective: To compare the single femoral tunnel split-double-bundle posterior cruciate ligament (PCL) reconstruction with the single-bundle PCL reconstruction and to discuss the advantages of the modified reconstruction method., Methods: Fourteen donated fresh-frozen human knee specimens were biomechanically tested, which included knee specimens from 12 males and 2 females, and their ages ranged from 20 to 31 years. The specimen length of the femur and the tibia was 20 cm. The tibial posterior translation and the PCL strains were first measured when PCL was in an intact state (the intact group, n=14). Then, PCL was cut (the cut group, n=14). The posterior translation was measured when a posterior load was applied. After that, the specimens were randomly divided into two groups: the single-bundle group (n=7) and the double-bundle group (n= 7). When the posterior load was applied to the tibia, the bundle strain and the tibial posterior translation were measured with the knees flexed at 0, 30, 60, 90 and 120 degrees, respectively., Results: While a 100 N posterior force was applied, the posterior tibial displacement of the intact PCL knee ranged from 1.97+/-0.29 mm to 2.60+/-0.23 mm at the different knee flexion angles. In the PCL-cut state, the tibial displacement increased significantly from 11.27+/-1.06 mm to 14.94+/-0.67 mm (P<0.05). After the single-bundle reconstruction, the posterior tibial translation ranged from 1.99+/-0.19 mm to 2.72+/-0.38 mm at the different knee flexion angles. In the split-double-bundle reconstruction, the posterior tibial translations ranged from 2.27+/-0.32 mm to 3.05 +/- 0.44 mm. The graft of the single-bundle reconstruction was tensioned from 0 degrees to 120 degrees, and the tibial displacement increased significantly at 90 degrees compared with that at the other angles (P<0.05). In the double-bundle reconstruction, the anterolateral bundle and the posteromedial bundle were tensioned in a reciprocal fashion, and the tibial displacement had no significant difference at the five kinds of the flexion angles., Conclusion: The single femoral tunnel split-double-bundle PCL reconstruction can restore the posterior tibial displacement at different flexion angles, and the tibial displacement in the single-bundle PCL reconstruction knee can be increased when the knee flexion is at 90 degrees. In the double-bundle reconstruction, the graft can be tensioned in a reciprocal fashion and the biomechanical features can be nearer to those of the normal PCL bundles.

Objective: To summarize the experience in treatment and diagnosis of popliteal artery trauma and to determine the factors for amputation., Methods: From February 1995 to January 2006, 28 patients with popliteal artery trauma were treated. The disease course was more than 8 hours. Of them, there were 25 males and 3 females, aging from 3 to 53 years. Trauma was caused by traffic accident in 12 cases, by falling from height in 3 cases, by firearm in 2 cases, by sharp instruments in 3 cases, by strangulation in 2 cases and by others in 6 cases. No arteriopalmus or weak arteriopalmus were observed in 18 cases and in 8 cases respectively. Popliteal artery exposure or active bleeding was seen in 2 cases; the popliteal arteries were examined by operation in 8 cases; color ultrasound Doppler flow imaging showed color flood flow signals were through popliteal artery and its branches in 20 cases. Defect size of popliteal artery was less than 5 cm in 7 cases and more than 5 cm in 9 cases. End to end anastomosis reconstruction by saphenous vein graft and direct suture was performed in 16 cases and ampulation in 12 cases. The time of the revascularization of the leg was 8-150 hours (mean 31. 8 hours)., Results: All patients were followed up 6 months to 11 years with an average of 4.2 years. In 16 cases given end to end anastomosis reconstruction, 15 cases achieved revascularization and limb survival; lower limb function restored to normal within 1 year in 12 cases; foot drop and ankle joint contracture occurred in 3 cases and the survival rate of limbs was 94%. Amputation was given in 12 of 28 cases because of severe trauma. The rate of amputation was 43% and the rate of disability was 54%., Conclusion: Popliteal artery trauma should be treated as soon as the diagnosis is made. If the revascularization is more than 8 hours or circulatory compensation is not complete, it will affect the leg survival. Delayed diagnosis and severe traumas are the cause of high rate of amputation in popliteal artery trauma.

Objective: To explore the therapeutic efficacy of arthroscopic reconstruction of anterior cruciate ligament (ACL) with autologous multi-stranded semitendinous tendon (ST)., Methods: From September 2000 to December 2004, 50 cases of ruptures of ACLs were diagnosed by clinical and arthroscopic examinations. There were 32 males and 18 females with an average age of 26.3 years (18-51 years). The locations were left knee in 31 cases and right knee in 19 cases. All patients had the history of knee joint injury. Arthroscopy showed 26 cases of rupture, 14 cases of defect, 4 cases of avulsion and 6 cases of laceration. All patients were operated upon arthroscopically by using autologous multi-stranded ST. Plaster splints were used for 4 weeks after operation. The result was estimated by AO Yingfang's standards and Lysholm knee scores., Results: All patients achieved healing by the first intention. The extension and flexion function was restored normal at 8-10 weeks. The patients were followed up averagely 1 year and 8 months (6-48 months). The results of drawer test and Lachman test were positive in 3 cases and suspiciously positive in 8 cases. The results were excellent in 23 patients, good in 18 and fair in 9. Lysholm knee scores were 40.57+/-10.68 preoperatively and 86.43+/-9.33 postoperatively, showing significant difference (P < 0.01)., Conclusion: Arthroscopy reconstruction of ACL with autologous multi-stranded ST may be one of the excellent methods bringing less injury.