Effect of the inactivated new tuberculosis vaccine strain(B/R strain)on the immune memory of T lymphocytes in mice / 中国人兽共患病学报

To investigate the effect of inactivated new tu-berculosis vaccine strain(B/R strain)on immune memory of T lymphocytes in mice,C57BL/6 mice were immunized with PBS,BCG strain,B/R strain and inactivated B/R strain.At week 9,12 and 15 after immunization,the spleens of each group were taken,and the spleen lymphocytes were extracted.Half of the spleen lymphocytes in each group were directly de-tected,and the rest were cultured in vitro and stimulated with PPD according to the experimental design.Flow cytometry was used to detect the number of central memory T cells(TCM)and effector memory T cells(TEM)in spleen lymphocytes of uns-timulated and stimulated mice.Without PPD stimulation after immunization,the CD4+TCM(F=13.20,P＜0.05)and CD4+TEM(F=28.15,P＜0.05)induced by inactivated B/R group,B/R group and BCG group was higher than that of PBS group at week 9.The induced CD8+TCM(F=8.92,P＜0.05)and CD8+TEM(F=6.13,P＜0.05)was higher than that of PBS group.At week 12,the CD4+TCM(F=15.97,P＜0.05)and CD4+TEM(F=13.60,P＜0.05)induced by each group was higher than that of PBS group.The induced CD8+TCM(F=5.52,P＜0.05)and CD8+TEM(F=20.15,P＜0.05)was higher than that of PBS group.At week 15,the CD4+TCM(F=15.40,P＜0.05)and CD4+TEM(F=7.43,P＜0.05)induced by each group was higher than that of PBS group.The induced CD8+TCM(F=6.57,P＜0.05)and CD8+TEM(F=9.27,P＜0.05)was higher than that of PBS group.At week 9,the CD4+TCM(F=9.66,P＜0.05)and CD4+TEM(F=11.20,P＜0.05)induced by inacti-vated B/R group,B/R group and BCG group was higher than that of PBS group.The induced CD8+TCM(F=7.24,P＜0.05)and CD8+TEM(F=9.30,P＜0.05)was higher than that of PBS group.At week 12,the CD4+TCM(F=9.33,P＜0.05)and CD4+TEM(F=6.94,P＜0.05)induced by each group was higher than that of PBS group.The induced CD8+TCM(F=67.71,P＜0.05)and CD8+TEM(F=10.86,P＜0.05)was higher than that of PBS group.At week 15,the CD4+TCM(F=39.88,P＜0.05)and CD4+TEM(F=11.93,P＜0.05)induced by each group was higher than that of PBS group.The induced CD8+TCM and CD8+TEM(F=38.47,P＜0.05)was higher than that of PBS group(F=138.80,P＜0.05).It is worth noting that at week 15,the CD8+TCM(qinactivated B/R=12.24,qB/R=12.61,P＜0.05)and CD8+TEM(qinactivated B/R=7.19,qB/R=5.00,P＜0.05)induced by inactivated B/R group and B/R group were higher than those of BCG group.The immunizing mice with inactivated B/R strain,the ability of inducing immune memory of T lymphocytes in mice was equivalent to that of B/R strain.Heat-inacti-vation did not affect the ability of B/R strain to induce immune memory in mice.

Functional reconstruction of the medial collateral ligament with double-bundle allograft technique / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss a new technique about reconstruction of medial collateral ligament (MCL) with double bundle allograft and to evaluate the short-term clinical efficacy.</p><p><b>METHODS</b>All 53 patients who suffered from valgus instability of the knee were selected. All cases were diagnosed of MCL injury because the medial gap of the knee widened more than 5 mm compared with collateral knee by the stress X-ray, MRI displayed discontinuity of MCL and valgus stress test was positive. All patients were accepted arthroscopic evaluation through inferomedial and inferolateral arthroscopy portal incisions to ascertain whether there were intra-articular injuries. An 8 cm incision was made from 1 cm superior adductor tubercle to 5 cm proximal medial tibia joint line in a longitudinal fashion. The anterior tibia insertion was defined as 15 mm lateral from the medial tibia edge and 45 mm under the medial tibia joint line. The posterior tibia insertion was defined as 15 mm lateral from the medial tibia edge and 20 mm under the medial tibia joint line. We used 5 mm or 6 mm reamer to drill the tibia tunnel along with guide pin, and then drill the femur tunnel with 6 mm or 7 mm drill in the top of the adductor tubercle about 25 mm or 30 mm length. The allograft was pulled into the tunnel from tibia to the femur and fixed with absorbable interference screw. Patients carried out active rehabilitation program after operation. One year after the operation, IKDC score, Lysholm score were used to evaluate the clinical effect.</p><p><b>RESULTS</b>The IKDC score (A or B, 86.78% vs. 0), Lysholm scores (89.7 ± 3.4 vs. 51.8 ± 4.9, t = -79.724, P < 0.05) were significantly improved compared with preoperative in all patients. Medial joint widened gap decreased from (10.4 ± 2.4) mm preoperative to (2.8 ± 1.5) mm postoperative from X ray and the differences were significant (t = 41.727, P < 0.05). Among these patients, the medial joint widened gap of 46 cases were less than 3 mm, 7 cases were from 3 mm to 5 mm. The range of motion was 135.4° ± 2.5° preoperative and 132.7° ± 3.7° postoperative. The 9 patients still had medial tenderness 1 year after operation.</p><p><b>CONCLUSION</b>Application double bundle allograft technique to reconstruct MCL can significantly improve the stability of the knee and the short-term clinical efficacy was sure.</p>

Arthroscopic single-bundle anterior cruciate ligament reconstruction with six-strand hamstring tendon and patellar tendon allograft / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the outcome of arthroscopic single-bundle anterior cruciate ligament (ACL) reconstruction with six-strand hamstring tendon and patellar tendon allograft.</p><p><b>METHODS</b>From October 2006 to December 2009, 108 patients with arthroscopic single-bundle ACL reconstruction were retrospectively reviewed, with 58 patients with six-strand hamstring tendon (Group H), and 50 patients with patellar tendon allograft (Group P). Patients were available for clinical evaluation with KT-1000 arthrometer measurements, Lachman and pivot-shift test, and knee function with the International Knee Documentation Committee (IKDC), Lysholm scores.</p><p><b>RESULTS</b>All the patients were followed up at an average of 28.6 months (range 12 - 38 months). The average side-to-side difference was lesser for group H (1.2 ± 1.2) mm than group P (1.8 ± 1.5) mm (P < 0.05). On the pivot-shift test, 55 (94.8%) patients were negative and 3 (5.2%) were positive in group H, whereas 41 (82.0%) were negative and 9 (18.0%) were positive in group P, with significant difference between two groups (P < 0.05). All knee function scores were improved postoperatively, without statistically significant difference between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Arthroscopic single-bundle ACL reconstruction with six-strand hamstring tendon will achieve better knee stability than patellar tendon allograft.</p>

Comparison of clinical results between an isometric and an anatomic technique for medial patellofemoral ligament reconstruction / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the clinical results of single-stranded isometric with double-stranded anatomic reconstruction of medial patellofemoral ligament (MPFL) for recurrent patellar dislocation.</p><p><b>METHODS</b>Retrospective analysis of 60 consecutive patients (72 knees) with recurrent patellar dislocation underwent medial patellofemoral ligament reconstruction between August 2004 and October 2008, 22 cases (27 knees) with single-stranded isometric reconstruction, 38 cases (45 knees) with double-stranded anatomic reconstruction. Postoperatively patellar stability was examined, and recurrent rate was recorded. Patellar lateral shift ratio and tilt were measured on CT scans. Knee function was evaluated with subjective questionnaire and the Kujala score.</p><p><b>RESULTS</b>All patients were followed up for more than 12 months without recurrent redislocation. (1) Recurrent instability rate was 18.5% in single-stranded group and 2.2% in double-stranded group, with statistical difference (P < 0.05). (2) The patellar tilt and lateral shift ratio returned to normal, without statistical difference between groups (P > 0.05). (3) The Kujala score were 59 ± 9 and 62 ± 9 preoperatively and 87 ± 4 and 94 ± 6 postoperatively in single- and double-stranded group, with statistical difference (P < 0.05). (4) The excellect rate was 85.2% in single-stranded group, 97.8% in double-stranded group, with statistical difference(P < 0.05).</p><p><b>CONCLUSION</b>Both reconstruction can improve patellar stability and knee function significantly, with double-stranded anatomic reconstruction better in clinic evaluation.</p>