Hemodynamic analysis of thoracic endovascular aortic repair with left subclavian artery reconstructed by chimney stent.

OBJECTIVES: The purpose of this study was to investigate the hemodynamic consequences of thoracic endovascular aortic repair which reconstructed left subclavian artery by chimney stent (ch-TEVAR). METHODS: Two patients who underwent thoracic endovascular aortic repair (TEVAR) and left subclavian artery (LSA) reconstruction using chimney stents were selected. Preoperative and postoperative CTA images were collected to reconstruct hemodynamic models for comparing and analyzing blood pressure, blood flow velocity, and wall shear stress in the aortic arch and its major branches. Concurrently, morphological alterations and position of chimney stent were also assessed. RESULTS: After the reconstruction of LSA in ch-TEVAR, no endoleak was seen, but the stent in LSA was compressed. The blood flow velocity of the LSA increased and disordered, the pressure was reduced, and the WSS was increased. Even more, there were a large amount of turbulence found in the LSA of one case, and its LSA was blocked. CONCLUSION: Chimney stent reduces the occurrence of endoleak due to its excellent deformation ability, but the compressed stent has a greater impact on the hemodynamics of LSA and eventually leads to LSA occlusion; in order to keep the LSA unobstructed, it is necessary to pay attention to the position of the chimney stent and keep it straight and do not fold or twist. Chimney stent has little influence on the aortic arch and the rest of the aortic arch branches.

Primary cilia support cartilage regeneration after injury.

In growing children, growth plate cartilage has limited self-repair ability upon fracture injury always leading to limb growth arrest. Interestingly, one type of fracture injuries within the growth plate achieve amazing self-healing, however, the mechanism is unclear. Using this type of fracture mouse model, we discovered the activation of Hedgehog (Hh) signaling in the injured growth plate, which could activate chondrocytes in growth plate and promote cartilage repair. Primary cilia are the central transduction mediator of Hh signaling. Notably, ciliary Hh-Smo-Gli signaling pathways were enriched in the growth plate during development. Moreover, chondrocytes in resting and proliferating zone were dynamically ciliated during growth plate repair. Furthermore, conditional deletion of the ciliary core gene Ift140 in cartilage disrupted cilia-mediated Hh signaling in growth plate. More importantly, activating ciliary Hh signaling by Smoothened agonist (SAG) significantly accelerated growth plate repair after injury. In sum, primary cilia mediate Hh signaling induced the activation of stem/progenitor chondrocytes and growth plate repair after fracture injury.

Assessment of the Physicochemical Properties of Fragrant Rapeseed Blended Hotpot Oil by Principal Component Analysis.

In this study, a nutritious, healthy Chongqing hotpot oil with excellent flavor was blended while considering nutrition, flavor, and health aspects. Four blended hotpot oils prepared from fragrant rapeseed, palm, sesame, and chicken oils were analyzed to determine their physicochemical properties, antioxidant capacities, levels of harmful substances, and nutritional compositions, and their sensory qualities were evaluated. Principal component analysis was performed to identify the best hotpot oil (10% chicken oil + 20% palm oil + 10% sesame oil + 60% fragrant rapeseed oil), which exhibited good antioxidant capacity (Oxidation Stability Index: 7.95 h; 2,2-diphenyl-1-picrylhydrazyl: 168.6 µmol/kg, 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulfonate): 116.7 µmol/kg, and ferric-reducing/antioxidant power: 63.9 µmol/kg), a high sensory score (7.7/10), stable physicochemical properties (acid value: 0.27 mg/g and peroxide value: 0.01 g/100 g), and high tocopherol (54.22%), and phytosterol retention (98.52%) after boiling for 8 h. Although the 3,4-benzopyrene content of this hotpot oil exceeded the EU standard after boiling for 7 h, the increase in the amount of harmful substances was the lowest.

Comparison of Fish, Krill and Flaxseed as Omega-3 Sources to Increase the Omega-3 Index in Dogs.

(1) Background: it is only the longer chain omega-3 polyunsaturated fatty acids (n-3 PUFAs), eicosapentaenoic acid (20:5n-3, EPA), and docosahexaenoic acid (22:6n-3, DHA) and not the shorter chain α-linolenic acid (ALA, 18:3n-3) that have been linked to health benefits. (2) Methods: 45 dogs divided into three groups were first given premium dry food for 38 days (baseline). The O3I was then used as a diagnostic tool to provide a measure of the sum of EPA + DHA in red blood cell membranes given as a percentage of all fatty acids. The dogs were subsequently fed with either krill meal (krill), fishmeal/oil (fish) or flaxseed cake (flax) included in raw food providing daily 416 mg EPA + DHA (971 mg ALA), 513 mg EPA + DHA (1027 mg ALA) and 1465 mg ALA (122 mg EPA + DHA), respectively. (3) Results: the average baseline O3I level of all dogs was low (1.36%), warranting n-3 supplementation. After four weeks, O3I levels were significantly increased in the krill (from 1.36 ± 0.44 to 2.36 ± 0.39%) and fish (from 1.35 ± 0.22 to 1.9 ± 0.35%) groups (p < 0.001). No significant modification of the O3I was detected in the flax animals. (4) Conclusions: only marine n-3 PUFAs resulted in a significantly increased O3I, with dietary krill meal providing the highest increase.

Hierarchically Structured Carbon Nanofiber-Enabled Skin-Like Strain Sensors with Full-Range Human Motion Monitoring and Autonomous Self-Healing Capability.

Flexible strain sensors that mimic the properties of human skin have recently attracted tremendous attention. However, integrating multiple functions of skin into one strain sensor, e.g., stretchability, full-range motion response, and self-healing capability, is still an enormous challenge. Herein, a skin-like strain sensor was presented by the construction of hierarchically structured carbon nanofibers (CNFs), followed by encapsulation of elastic self-healing polyurethane (PU). The hierarchical sensing structure was composed of diversified CNFs with orientations from highly aligned to randomly oriented, and their different fracture mechanisms enabled the resultant strain sensor to successfully integrate key sensing properties including high sensitivity (gauge factor of 90), wide sensing range (∼80% strain), and fast response (52 ms). These properties, combined with high stretchability (870%) and excellent stability (>2000 cycles), allowed the sensor to precisely detect full-range human motions from large joint motions to subtle physiological signals. Moreover, the strain sensor had spontaneous self-healing capability at room temperature with high healing efficiencies of 97.7%, while the healing process could substantially be accelerated by the natural sunlight (24 h → 0.5 h). The healed sensor possessed comparable stretchability, sensing performance, and accurate monitoring ability of subtle body signals with the original sensor. The biomimetic self-healing functionality along with skin-like sensing properties makes it attractive for next-generation wearable electronics.

Strengthening and Toughening CNTs/Mg Composites by OpTimizing the Grinding Time of Magnesium Powder.

In this paper, CNT/Mg composites with high compressive properties were prepared by using Ni-plated CNT and pure magnesium powder as raw materials through the grinding of magnesium powder, ball-milling mixing and hot-pressing sintering. The effect of grinding time for finer magnesium powder on the microstructure and properties of the final composites was studied mainly by SEM, XRD, HRTEM and compression tests. The results show that with the prolongation of milling time, the magnesium particle size decreases gradually and the CNT dispersion becomes more uniform. Moreover, the nickel layer on the surface of CNT reacts with highly active broken magnesium powder in the sintering process to generate MgNi2 intermediate alloy, which significantly improves interface bonding. The strength and fracture strain of composites are significantly increased by the combined action of the uniform distribution of CNTs and strong interface bonding from the MgNi2 phase. The compressive strength, yield strength and fracture strain of the composites, prepared with a 60 h grinding of magnesium powder, reached 268%, 272% and 279% of those in composites without the grinding of magnesium powder.

Strengthening Ni-Coated CNT/Mg Composites by Optimizing the CNT Content.

The dispersion of carbon nanotubes (CNTs) is the bottleneck in CNT-reinforced metal matrix composites. In this work, CNT/Mg composites were prepared by grinding Mg powder and then dispersing CNTs via ball milling and hot pressing. The uniform distribution of Ni-coated CNTs in the matrix was achieved by optimizing the content of CNTs. Scanning electron microscope, high-resolution transmission electron microscopy and X-ray diffraction, optical microscopy, and compression tests were employed. With the CNT content being less than 1%, the CNTs can be evenly distributed in CNT/Mg composites, resulting in a sharp increase in strength. However, with the higher CNT content, the CNTs gradually cluster, leading decreased fracture strain and strength. Furthermore, the coated Ni in the CNTs reacts with the magnesium matrix and completely transforms into Mg2Ni, significantly enhancing the interface bonding. This strong interface bonding and the diffusely distributed Mg2Ni in the matrix significantly strengthen the CNT/Mg composite.

Vertebral artery course variation leading to an insufficient proximal anchoring area for thoracic endovascular aortic repair.

BACKGROUNDS: We aimed to demonstrate the feasibility of thoracic endovascular aortic repair for type B aortic dissection in patients with an insufficient proximal anchoring area due to the vertebral artery originating from the aortic arch. METHODS: In this study, we report two patients with type B aortic dissection who were complicated with left vertebral artery course variation. Specifically, the left vertebral artery originated from the aortic arch. In these patients, the anchoring area (<15 mm) was not sufficient between the left vertebral artery and the ruptured aortic dissection. RESULT: We reconstructed the left vertebral artery during horacic endovascular aortic repair. Both patients recovered well and were discharged without any adverse events. CONCLUTION: Our experience shows that horacic endovascular aortic repair is feasible in patients with type B aortic dissection who have an insufficient proximal anchoring area due to the left vertebral artery originating from the aortic arch.

Influence of Soft Phase and Carbon Nanotube Content on the Properties of Hierarchical AZ61 Matrix Composite with Isolated Soft Phase.

Carbon nanotube-reinforced magnesium matrix (CNTs/Mg) composite has great application potential in the transportation industry, but the trade-off between strength and ductility inhibits its widespread application. In order to balance the strength and plasticity of the composite, in this work, on the basis of the AZ61 matrix composite homogeneously reinforced by Ni-coated CNTs (hard phase), 30 vol.% large-size AZ61 particles are introduced as an isolated soft phase to fabricate hierarchical CNTs/AZ61 composites. The compression tests show the fracture strain and compressive strength of this composite increases by 54% and 8%, respectively, compared with homogeneous CNTs/AZ61 composite. During deformation, the hard phase is mainly responsible for bearing the load and bringing high strength, due to the precipitation of the Mg17Al12 phase, uniformly dispersed CNT and strong interfacial bonding of the CNTs/Mg interface through nickel plating and interfacial chemical reaction. Furthermore, the toughening of the soft phase results in high ductility. With the increase in CNT content, the compressive strength of composites is nearly unchanged but the fracture strain gradually decreases due to the stress concentration of CNT and its agglomeration.

Effect of CNT Content on Microstructure and Properties of CNTs/Refined-AZ61 Magnesium Matrix Composites.

Carbon nanotubes (CNTs) reinforced magnesium matrix composites have great application potential in the transportation industry, but the low absolute strength is the main obstacle to its application. In this paper, copper-coated CNTs and AZ61 powder were used as raw materials to prepare CNTs/refined-AZ61 composites with good interfacial bonding, uniformly dispersed CNTs and fine grains by the process of ball milling refinement of AZ61 powder, ball milling dispersion and hot-pressing sintering. When the volume fraction of CNTs is less than or equal to 1 vol.%, CNTs can be uniformly dispersed and the yield strength and compressive strength of composites increase with higher CNT content. When the volume fraction of CNTs is 1 vol.%, the compressive strength and yield strength of composites reach 439 MPa and 361 MPa, respectively, which are 14% and 9% higher than those of matrix composites with nearly the same value of fracture strain. When the volume fraction of CNTs is greater than 1 vol.%, with the increase in CNT content, CNT clustering becomes more and more serious, resulting in a decrease in the strength and fracture strain of composites.

Characteristics and Antioxidant Activity of Walnut Oil Using Various Pretreatment and Processing Technologies.

This study was the first time the effects of pretreatment technology (microwave roasting, MR; oven roasting, OR; steaming roasting, SR) and processing technology (screw pressing, SP; aqueous enzymatic extraction, AEE; subcritical butane extraction, SBE) on the quality (physicochemical properties, phytochemical content, and antioxidant ability) of walnut oil were systematically compared. The results showed that the roasting pretreatment would reduce the lipid yield of walnut oil and SBE (59.53−61.19%) was the processing method with the highest yield. SR-AEE oil provided higher acid value (2.49 mg/g) and peroxide value (4.16 mmol/kg), while MR-SP oil had the highest content of polyunsaturated fatty acid (73.69%), total tocopherol (419.85 mg/kg) and total phenolic compounds (TPC, 13.12 mg/kg). The DPPH-polar and ABTS free radicals' scavenging abilities were accorded with SBE > AEE > SP. SBE is the recommended process for improving the extraction yield and antioxidant ability of walnut oil. Hierarchical cluster analysis showed that processing technology had a greater impact on walnut oil than pretreatment technology. In addition, multiple linear regression revealed C18:0, δ-tocopherol and TPC had positive effects on the antioxidant ability of walnut oil, while C18:1n-9, C18:3n-3 and γ-tocopherol were negatively correlated with antioxidant activity. Thus, this a promising implication for walnut oil production.

Tracing PRX1+ cells during molar formation and periodontal ligament reconstruction.

Neural crest-derived mesenchymal stem cells (MSCs) are known to play an essential function during tooth and skeletal development. PRX1+ cells constitute an important MSC subtype that is implicated in osteogenesis. However, their potential function in tooth development and regeneration remains elusive. In the present study, we first assessed the cell fate of PRX1+ cells during molar development and periodontal ligament (PDL) formation in mice. Furthermore, single-cell RNA sequencing analysis was performed to study the distribution of PRX1+ cells in PDL cells. The behavior of PRX1+ cells during PDL reconstruction was investigated using an allogeneic transplanted tooth model. Although PRX1+ cells are spatial specific and can differentiate into almost all types of mesenchymal cells in first molars, their distribution in third molars is highly limited. The PDL formation is associated with a high number of PRX1+ cells; during transplanted teeth PDL reconstruction, PRX1+ cells from the recipient alveolar bone participate in angiogenesis as pericytes. Overall, PRX1+ cells are a key subtype of dental MSCs involved in the formation of mouse molar and PDL and participate in angiogenesis as pericytes during PDL reconstruction after tooth transplantation.

Krill-Oil-Dependent Increases in HS-Omega-3 Index, Plasma Choline and Antioxidant Capacity in Well-Conditioned Power Training Athletes.

There is evidence that both omega-3 polyunsaturated fatty acids (n-3 PUFAs) and choline can influence sports performance, but information establishing their combined effects when given in the form of krill oil during power training protocols is missing. The purpose of this study was therefore to characterize n-3 PUFA and choline profiles after a one-hour period of high-intensity physical workout after 12 weeks of supplementation. Thirty-five healthy power training athletes received either 2.5 g/day of Neptune krill oilTM (550 mg EPA/DHA and 150 mg choline) or olive oil (placebo) in a randomized double-blind design. After 12 weeks, only the krill oil group showed a significant HS-Omega-3 Index increase from 4.82 to 6.77% and a reduction in the ARA/EPA ratio (from 50.72 to 13.61%) (p < 0.001). The krill oil group showed significantly higher recovery of choline concentrations relative to the placebo group from the end of the first to the beginning of the second exercise test (p = 0.04) and an 8% decrease in total antioxidant capacity post-exercise versus 21% in the placebo group (p = 0.35). In conclusion, krill oil can be used as a nutritional strategy for increasing the HS-Omega-3 Index, recover choline concentrations and address oxidative stress after intense power trainings.

Hot Oscillatory Pressing of Carbon Nanotube-Reinforced Copper Matrix Nanocomposite.

Carbon nanotube reinforced copper matrix nanocomposites have great potential in machinery, microelectronics, and other applications. The materials are usually prepared by powder metallurgy processes, in which consolidation is a key step for high performance. To improve the density and mechanical properties, the authors explored the use of hot oscillatory pressing (HOP) to prepare this material. A carbon nanotube reinforced copper matrix nanocomposite was synthesized by both HOP and hot pressing (HP) at various temperatures, respectively. The samples prepared by HOP exhibited significantly higher density and hardness than those prepared by HP at the same temperature, and this was because the oscillatory pressure of HOP produced remarkable plastic deformation in copper matrix during sintering. With the decrease of sintering temperature in HOP, the amount of deformation defect increased gradually, playing a key role in the increasing hardness. This work proves experimentally for the first time that HOP can produce much more plastic deformation than HP to promote densification, and that HOP could be a very promising technique for preparing high-performance carbon nanotube reinforced copper matrix nanocomposites.

Effect of Foliar Application of Various Nitrogen Forms on Starch Accumulation and Grain Filling of Wheat (Triticum aestivum L.) Under Drought Stress.

Foliar nitrogen (N) fertilizer application at later stages of wheat (Triticum aestivum L.) growth is an effective method of attenuating drought stress and improving grain filling. The influences or modes of action of foliar application of various nitrogen forms on wheat growth and grain filling need further research. The objective of this study was to examine the regulatory effects of various forms of foliar nitrogen [NO3 -, NH4 +, and CO(NH2)2] on wheat grain filling under drought stress and to elucidate their underlying mechanisms. The relative effects of each nitrogen source differed in promoting grain filling. Foliar NH4 +-N application notably prolonged the grain filling period. In contrast, foliar application of CO(NH2)2 and NO3 --N accelerated the grain filling rate and regulated levels of abscisic acid (ABA), z-riboside (ZR), and ethylene (ETH) in wheat grains. Analysis of gene expression revealed that CO(NH2)2 and NO3 --N upregulated the genes involved in the sucrose-starch conversion pathway, promoting the remobilization of carbohydrates and starch synthesis in the grains. Besides, activities of superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT) were increased, whereas the content of malondialdehyde (MDA) declined under foliar nitrogen application (especially NH4 +-N). Under drought stress, enhancement of carbohydrate remobilization and sink strength became key factors in grain filling, and the relative differences in the effects of three N forms became more evident. In conclusion, NH4 +-N application improved the antioxidant enzyme system and delayed photoassimilate transportation. On the other hand, foliar applications of NO3 --N and CO(NH2)2 enhanced sink capacity and alleviated drought stress injury in wheat.

Progress in the prevention and control of water-borne arsenicosis in China.

In this report, we provided an overview of the prevalence, control, and prevention of water-borne arsenicosis in China during 2001-2016. Random sampling was continuously performed during 2001-2010 to find villages having high levels of arsenic (>50 µg/L) in drinking water. The high-arsenic-exposure villages with more geographically dispersed water supplies were subsequently analyzed for characteristics of arsenic distribution, and villages with relatively large populations were investigated for arsenicosis. The results showed that among 32,673,677 inhabitants in 36,820 villages, 1,894,587 inhabitants in 2,476 villages were at risk of high arsenic exposure. Among the 33,318 drinking water sources surveyed in 625 high-arsenic-exposure villages, 9,807 drinking water sources that contained high levels of arsenic (>50 µg/L) were identified. The overall prevalence rate of arsenicosis was 1.93%. Further, some representative villages were chosen to monitor arsenicosis annually, showing that the prevalence rate of arsenicosis was lower in villages with arsenic-safe water supplies than in villages without arsenic-safe water supplies. To the best of our knowledge, this report provides the most comprehensive assessment of the distribution of high arsenic exposure and arsenicosis in China until now.

Effects of the Informed Health Choices primary school intervention on the ability of children in Uganda to assess the reliability of claims about treatment effects, 1-year follow-up: a cluster-randomised trial.

INTRODUCTION: We evaluated an intervention designed to teach 10- to 12-year-old primary school children to assess claims about the effects of treatments (any action intended to maintain or improve health). We report outcomes measured 1 year after the intervention. METHODS: In this cluster-randomised trial, we included primary schools in the central region of Uganda that taught year 5 children (aged 10 to 12 years). We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books and a teachers' guide). The primary outcomes, measured at the end of the school term and again after 1 year, were the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores. RESULTS: We assessed 2960 schools for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n = 60 schools; 76 teachers and 6383 children) or the control group (n = 60 schools; 67 teachers and 4430 children). After 1 year, the mean score in the multiple-choice test for the intervention schools was 68.7% compared with 53.0% for the control schools (adjusted mean difference 16.7%; 95% CI, 13.9 to 19.5; P < 0.00001). In the intervention schools, 3160 (80.1%) of 3943 children who completed the test after 1 year achieved a predetermined passing score (≥ 13 of 24 correct answers) compared with 1464 (51.5%) of 2844 children in the control schools (adjusted difference, 39.5%; 95% CI, 29.9 to 47.5). CONCLUSION: Use of the learning resources led to a large improvement in the ability of children to assess claims, which was sustained for at least 1 year. TRIAL REGISTRATION: Pan African Clinical Trial Registry (www.pactr.org), PACTR201606001679337. Registered on 13 June 2016.

In situ-generated NiCo@NiS nanoparticle anchored s-doped carbon nanotubes as dual electrocatalysts for oxygen reduction reaction and hydrogen evolution reaction.

Developing low cost and highly robust electrocatalysts for oxygen evolution reaction, hydrogen evolution reaction (HER), and oxygen reduction reaction (ORR) is of great importance for the efficient conversion of sustainable energy sources. Herein, we report a facile pyrolysis strategy for the controllable synthesis of NiCo@NiS/S-CNTs with NiCo@NiS nanoparticles anchored on sulfur-doped carbon nanotubes (CNTs). The obtained NiCo@NiS/S-CNT electrocatalyst exhibits excellent dual-functional catalytic activities under an alkaline condition, an ORR performance with an onset potential of -30 mV, and a half-wave potential of -150 mV (versus Ag/AgCl) while the overpotential for the HER is -1.16 V (versus Ag/AgCl) at a current density of 10 mA cm-2. It was found that the incorporation of sulfur can regulate the electronic structure of CNTs to accelerate the electron transfer performance and generate new catalytic sites, thus contributing to greatly enhancing both the activity and stability of the catalytic process. This work provides a promising way for the rational design of efficient and robust catalysts for sustainable energy conversion.

[Mid-term effectiveness of arthroscopic anterior cruciate ligament reconstruction combined with meniscus allograft transplantation].

OBJECTIVE: To summarize the mid-term effectiveness of arthroscopic anterior cruciate ligament (ACL) reconstruction combined with meniscus allograft transplantation. METHODS: A clinical data of 21 patients treated with arthroscopic ACL reconstruction and meniscus allograft transplantation and followed up more than 5 years between February 2007 and December 2014 was retrospectively analyzed. There were 12 males and 9 females, aged from 18 to 45 years, with an average age of 23.5 years. The cause of injury was sport sprain in 15 cases, falling in 4 cases, and traffic accident in 2 cases. The time from injury to operation ranged from 2 to 36 months, with an average of 12 months. Among them, 15 patients underwent previous meniscectomy, with an average interval of 1.6 years (range, 3 months to 6.5 years). All patients were primary ACL reconstruction. Preoperative anterior drawer test, Lachman test, and pivot shift test were positive. Lysholm score was 43.6±10.2. International Knee Documentation Committee (IKDC) score was 60.50±14.06. Of the 21 patients, 10 were gradeⅠ-Ⅱcartilage injuries and 11 were grade Ⅲ cartilage injuries according to MRI. RESULTS: All patients were followed up 5.1-7.8 years, with an average of 5.5 years. There were 2 cases of numbness of lower extremity, 3 cases of slight exudation of incision, 2 cases of articular movement bounce, 5 cases of mild joint swelling and pain after exercise. At last follow-up, Lachman tests were negative in 18 cases and positive in 3 cases; anterior drawer tests were negative in 19 cases and positive in 2 cases; pivot shift tests were negative in all cases. Lysholm score was 84.5±16.5 and IKDC score was 85.25±4.60, which were significantly higher than those before operation ( P<0.01). The flexion and extension of the affected knee joint were (128±13) and (3±7)°, respectively, which were smaller than those of the healthy knee joint [(133±15), (0±5)°] ( P<0.01). The results of KT-1000 test showed that when knee flexion was 30 and 90°, tibial anterior displacement of affected side [(2.35±1.20), (1.60±1.15) mm] were not significantly different from those of healthy side [(1.20±1.10), (1.10±1.03) mm] ( P>0.01). MRI showed that the ACL graft was in normal position and meniscus survived well. Cartilage injuries were gradeⅠ-Ⅱ in 18 cases and grade Ⅲ in 3 cases. CONCLUSION: For patients with severe meniscus injury and ACL rupture, ACL reconstruction combined with meniscus allograft transplantation can restore the stability of the joint, recover the meniscus function which is conducive to the protection of articular cartilage and obtain satisfactory mid-term effectiveness.

Arthroscopic techniques and instruments for meniscal allograft transplantation using the bone bridge in trough method.

The aim of the current study was to investigate the construction of the bone bridge and tibial plateau under arthroscopy during meniscal allograft transplantation, in order to simplify and enhance the accuracy of bone bridge fixation intraoperatively. A traction line passed through the attachment of the anterior and posterior horns of the superior meniscus to the bone bridge was used to pull the bone bridge into the knee joint cavity and fix the anteroposterior horns of the meniscus. At the junction of the body of the meniscus and the posterior and anterior horns of the meniscus, a traction line was created at the anterior and posterior 1/3 of the meniscus to pull and fix the meniscus. Under the arthroscope, the aiming device was placed on the tibial plateau. The direction and width of the guide plate were identical to those of the bone trough of the tibial plateau. The bone tunnel was made using the guide needle and a 9-mm hollow drill, the piston rod was inserted, and the arch-shaped bone knife was inserted along with the piston rod to construct the 9-mm bone trough of the tibial plateau. The periphery of the meniscus was sutured to the joint capsule. These surgical techniques and instruments could standardize meniscal graft transplantation and avoid the incidence of surgical errors caused by mismatched size and shape of the bone bridge and bone trough. This would make the surgery more convenient, safe and accurate. The four-point fixation of the tibial plateau contributed to preventing the reversal of the meniscus during transplantation, and partially reconstructed the coronary ligament of the meniscal tibia, which probably enhanced the stability of the meniscus and minimized the risk of extrusion of the meniscal allograft. The bone bridge and bone trough of the tibial plateau were properly constructed under arthroscopy. Dynamic monitoring of surgical indications, explicit preoperative preparation and standardized surgical procedures could achieve high efficacy and excellent fixation effect during meniscal graft transplantation. The four-point fixation of the tibial plateau maintains and enhances the stability of the meniscal allograft, reduces the risk of meniscal extrusion and ensures the postoperative recovery of meniscal function.