The value of 3 dimensional-fat suppression-spoiled gradient-recalled acquisition sequence on single compartment osteoarthritis for unicompartmental arthroplasty preoperative assessment / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the 3 dimensional-fat suppression-spoiled gradient-recalled acquisition (3D-FS-SPGR) sequence in the diagnosis of knee articular cartilage injury.</p><p><b>METHODS</b>A total of 56 knee osteoarthritis patients (26 males, 30 females, ages 52-73 years, mean 61.8 years) treated in Department of Orthopedics, Chinese People's Liberation Army General Hospital between June 2013 and May 2014 were involved in this study. All patients underwent knee MRI, plus 3D-FS-SPGR sequence, arthroscopic exploration, and in contrast to the results of MRI results analysis, evaluation 3D-FS-SPGR and conventional sequence of cartilage damage consistent with the arthroscopic accuracy.</p><p><b>RESULTS</b>Divided 56 knee joints into 336 cartilage articular surface, included 55.1% normal articular surface, 21.4% early osteoarthritis and 23.5% advanced osteoarthritis. The accordance of 3D-FS-SPGR sequence grading and arthroscopic was 90.2%. The sensitivity of 3D-FS-SPGR sequence was 93.1%, specificity was 98.3%, and Kappa value was 0.849. The sensitivity of T2WI sequence was 84.4%, specificity was 96.9%, and the Kappa value was 0.671.</p><p><b>CONCLUSION</b>For unicompartment osteoarthritis , MRI 3D-FS-SPGR sequence is effective in sensitivity and specificity of cartilage damage.</p>

Arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Patellofemoral osteoarthritis commonly occurs in older people, often resulting in anterior knee pain and severely reduced quality of life. The aim was to examine the effectiveness of arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis (PFOA).</p><p><b>METHODS</b>A total of 156 PFOA patients (62 males, 94 females; ages 45-81 years, mean 66 years) treated in our department between September 2012 and March 2013 were involved in this study. Clinical manifestations included recurrent swelling and pain in the knee joint and aggravated pain upon ascending/descending stairs, squatting down, or standing up. PFOA was treated with arthroscopic patelloplasty and circumpatellar denervation. The therapeutic effects before and after surgery were statistically evaluated using Lysholm and Kujala scores. The therapeutic effects were graded by classification of the degree of cartilage defect.</p><p><b>RESULTS</b>A total of 149 cases were successfully followed up for 14.8 months, on average. The incisions healed well, and no complications occurred. After surgery, the average Lysholm score improved from 73.29 to 80.93, and the average Kujala score improved from 68.34 to 76.48. This procedure was highly effective for patients with cartilage defects I-III but not for patients with cartilage defect IV.</p><p><b>CONCLUSIONS</b>For PFOA patients, this procedure is effective for significantly relieving anterior knee pain, improving knee joint function and quality of life, and deferring arthritic progression.</p>

Mechanical tests on the reconstructed anterior cruciate ligament fixed with allogenetic cortical bone cross-pin on the femoral side / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Anterior cruciate ligament reconstruction (ACLR) has developed dramatically in the last century. Now, ACLR has become a reliable and productive procedure. Patients feel satisfied in >90% cases. The aim of this study was to evaluate the feasibility of allogenetic cortical bone cross-pin (ACBCP) used as a clinical fixation method in anterior cruciate ligament reconstruction on the femoral side based on biomechanical tests in vitro.</p><p><b>METHODS</b>The specimens were provided by the bone banks of the First Affiliated Hospital of People's Liberation Army of General Hospital from September 2011 to June 2012. Fresh deep frozen human allogenetic cortical bone was machined into cross-pins which is 4.0 mm in diameter and 75.0 mm in length. Biomechanical parameters compared with Rigidfix were collected while cross-pins were tested in double-shear test. The load-to-failure test and cycling test were carried out in a goat model to reconstruct anterior cruciate ligament with Achilles tendon autograft on the femoral side fixed by human 4.0 mm ACBCP and 3.3 mm Rigidfix served as control. Maximum failure load, yield load, and stiffness of fixation in single load-to-failure test were compared between the two groups. Cycle-specific stiffness and displacement at cycles 1, 30, 200, 400, and 1 000 were also compared in between.</p><p><b>RESULTS</b>In double-shear test both maximum failed load and yield load of 4.0 mm human ACBCP were (1 236.998±201.940) N. Maximum failed load and yield load of Rigidfix were (807.929±110.511) N and (592.483±58.821) N. The differences of maximum failed load and yield load were significant between ACBCP and Rigidfix, P < 0.05. The shear strength of ACBCP and Rigidfix were (49.243±8.039) MPa and (34.637±3.439) MPa, respectively, P < 0.05. In the load-to-failure test ex vivo, yield load and maximum failed load of ACBCP fixation complexity ((867.104±132.856)N, (1 032.243±196.281) N) were higher than those of Rigidfix ((640.935±42.836) N, (800.568±64.890) N, P < 0.05). However, stiffness did not differ significantly between ACBCP group ((247.116±31.897)N/mm) and Rigidfix group ((220.413±51.332) N/mm, P > 0.05). In the cycling test, the cycle-specific stiffness and displacement at cycles 1, 30, 200, 400, and 1 000 did not differ significantly between the ACBCP group and Rigidfix group, P > 0.05.</p><p><b>CONCLUSIONS</b>Allogenetic cortical bone cross-pin possesses satisfactory biomechanical profile which is safe for ACLR and suitable for an aggressive rehabilitation program. Animal and clinical tests should be recommended before clinical use to secure the ACBCP could successfully substituted by host new bone in vivo.</p>

Etiological identification of 50 isolates from fungal corneal ulceration by semi-nested PCR amplification of ITS2 region / 中华检验医学杂志

Objective To identify the pathogens of 50 cases of fungal corneal ulceration by using semi-nested PCR amplification of ITS2 region.Methods Fifty isolates of fungal corneal ulceration and 3standard fungal strains cultures were collected and their DNAs were extracted.Their ITS2 regions were amplified by semi-nested PCR and sequenced.The results were compared with the nucleotide sequences in the NCBI GenBank.The pathogens of the fungi were identified and their distribution were analysed.Results The sequences results of the 3 standard fungal strains were consistent with the information in the GenBank.The pathological microorganisms of 50 cases of fungal corneal ulceration were:24 Fusarium (48％),including 17 Fusarium solani,6 Fusarium oxysporum and 1 Fusarium verticillioide; 10 Aspergillius (20％),including 5 Aspergillius flavus,3 Aspergillius sydowii and 2 Aspergillius nidulans; 6 Penicillium (12％),including 2 Penicillium citreo-viride,2 Penicillium multicolor and 2 Penicillium oxalicum ;5 Candida (10％),including 3 Candida albicans and 2 Candida parapsilosis; 3 Cladosporium (6％),including 2 Cladosporium herbarum and 1 case of Cladosporium cladosporioides ; 1 case of Neurospora crassa (2％) ;1 Alternaria alternata(2％).Conclusion Semi-nested PCR amplification of ITS2 region was proved to be a fast,simple and accurate method to identify pathogens of fungal corneal ulceration,and may be useful for personalized treatment and epidemiological investigation of local fungi.

Arthroscopic rotator cuff repair with double-row allograft bone suture anchor / 中华创伤杂志

Objective To discuss the value of double-row allograft bone suture anchor in repair of rotator cuff injury. Methods Under assistance of arthroseope, 16 cases of rotator cuff lesions were repaired by using double-row allograft bone suture anchors. There were 10 males and 6 females at average age of 44 years (32-58 years). According to Bigliani classification, there were 6 cases of small ruptures, 8 medial ruptures and 2 large ruptures. After rotator cuff was trimmed and acromial bone was re-shaped under arthroscopy, 2 bone anchors attached to suture lines were implanted in the attachment point of rotate cuff of humerus greater tuberosity side by side. Then, the 4 ends of the 2 suture lines were vertically sutured through tendon of supraspinatus mnscle and tied separately, crossing the 4 ends of 2 knots and penetrated each 2 ends into one bone anchor. Finally, these 2 bone anchors were embedded into 2 predrilled bone holes which were parallel to the former 2 anchors and lower in humerus greater tuberosity. Thus, a web was formed and overlapped on the ruptured rotator cuff. The number of bone anchors was according to the size of rupture. Results All cases were followed up for average 14 months (6-23 months). The mean UCLA score was (21.30±5.6) points preoperatively and (32.4±5.8) points postoperatively. The function of shoulders recovered well, with no pain, recurrence or pulling out of bone anchor. Function was excellent in 10 cases, good in 5 and fair in 1. Conclusions As for repair of rotator cuff injury, double-row bone-anchors under arthroscope can provide a tendon-bone interface better suited for biologic healing of rotator cuff. Bone suture anchor can not leave any foreign object residual and costs less.

Evaluation of Sterile Effect of Arthroscope Surgical Instruments Using Low-temperature Plasma Sterilizer / 中华医院感染学杂志

OBJECTIVE To evaluate the feasibility and sterile effect of low-temperature plasma sterilizer produced by Chinese Academy of Sciences for the sterilization of arthroscope surgical instruments.METHODS To explore the cleaning,package,arrangement and sterile effect monitoring of instruments in the process of arthroscope sterilization using low-temperature plasma sterilizer.RESULTS In the sterilization process of arthroscope surgical instruments using low-temperature plasma sterilizer,the chemical indicators and indicating patch were discolored,the monitoring of bio-box and the sterilization monitoring of surgical instruments were all negative.CONCLUSIONS Using the low-temperature plasma sterilizer machine for the sterilization of endoscope surgical instruments can ensure the security of sterilization,make less injury of precise instruments,shorten the sterilization time,accelerate the surgical turnover,enhance the frequency of surgical instruments application,and increase the efficiency.

Bacteriological Comparison Between Shaving and No-Shaving Before Knee Arthroscopy Surgery / 中华医院感染学杂志

OBJECTIVE To study the feasibility of no-hair-shaving before knee arthroscopy surgery.METHODS Totally 160 patients preparing for knee arthroscopy surgery were divided into both test and control groups randomly.The test group was no-hair-shaving before operation,and the control group was hair-shaving the day before their operation.Patients of the test group washed their skin with soap water or bathed at the operation day and patients in control group did this the day before operation.Bacterial culture was done in the operative site both before and after sterilization,and observed whether infection occurred in the incision after operation.RESULTS Bacterial culture in skin before sterilization was statistical significance between the two groups and no statistical significance after sterilization.All the incision healed well and no infection was found.CONCLUSIONS No-hair-shaving preoperatively can decrease patients′ discomfort and reduce colonies on skin surface effectively.The method is easy and safety manipulated.