ABSTRACT
Objective: To introduce the method of prior-localization femoral tunnel by using a special positioning tool under the C-arm radiographic machine before surgery, and to study the effect on the knee function recovery after medial patellofemoral ligament (MPFL) reconstruction. Methods: Between January 2014 and January 2016, 32 patients with recurrent unilateral knee patellar dislocation were treated by arthroscopic patellofemoral lateral retinaculum release and MPFL reconstruction. The femoral tunnel position during MPFL reconstruction was prior-localizated under C-arm radiographic machine before operation. There were 8 males and 24 females, aged from 15 to 37 years, with an average of 23.8 years. The time from injury to admission ranged from 1 to 24 months, with an average of 9.7 months. Isometric point distance was measured on CT three-dimensional reconstruction image after operation to evaluate whether the position of femoral tunnel was isometric, and knee joint function was evaluated by Lysholm score. Spearman correlation analysis was performed between isometric point distance and Lysholm score. Results: All the 32 patients were followed up 12-18 months (mean, 14.2 months). No symptoms of patellar subluxation or dislocation was found during follow-up. Patellar extrapolation test and patellar extrapolation fear test were negative. The isometric point distance was 1.5-5.9 mm (mean, 3.44 mm) at 3 days after operation. All femoral tunnels were located in equidistant tunnels. At last follow-up, the Lysholm score of the patients was 92.8±2.1, which was significantly improved when compared with preoperative score (54.4±2.8) ( t=61.911, P=0.000). Isometric point distance was negatively correlated with Lysholm score ( r=-0.454, P=0.009). Conclusion: C-arm radiographic machine can locate the femoral tunnel position of MPFL easily and accurately before operation. The short-term and medium-term effectiveness are satisfactory, and the ionizing radiation injury caused by multiple fluoroscopy during operation is avoided.
ABSTRACT
Objective To explore effect of irregular chemotatic factor fractalkine(FKN),phosphatidyl inositol 3 kinase and nuclear factor?κB(NF?κB)on interleukin?6(IL?6)expression in peripheral blood monocytes and the effect of valsartan intervention,so as to research the signal conduc?tive mechanism of FKN impacting on IL?6. Methods Peripheral blood monocytes were isolated from fresh blood of healthy volunteers by the densi?ty gradient centrifugation. The extractive peripheral blood monocytes were divided into seven groups:the control group,the FKN group,the LY294002 group(PI3K inhibitors),the PDTC group(NF?κB inhibitors),the FKN+valsartan group,the FKN+LY294002 group,and the FKN+PDTC group,the latter two were pretreated by LY294002 and PDTC respectively before FKN inducing PBMC cells. The IL?6 expression in cell me?dium was measured in each group by ELISA at 12 hours and 24 hours after PBMC treatment. Results After 12 hours of culture,compared with the control group,the expression of IL?6 in the FKN group was decreased(P0.05). Compared with the FKN group,the expression of IL?6 was decreased in the FKN+valsartan group(P0.05). Conclusion FKN can adjust the expression of peripheral blood PBMC IL?6 in a two?way pattern, inhibiting the expression of IL?6 by PI3K pathway and promoting the expression of IL?6 by NF?κB pathway,overall,FKN can inhibit the expression of IL?6. Valsartan can increase FKN to inhibit the expression of IL?6.
ABSTRACT
Clinical practice is a special learning phase. Interns, as both students and doctors are confronted with multiple pressures from studies, employment and examination. Their ideology tends to fluctuate due to the influence of the society. Therefore, it's very important to strengthen the ideo-logical and political education. It is relatively difficult in managing interns due to their dispersed loca-tion and unfixed daily schedule. Internet not only expands the space and time of the ideological edu-cation, but also it has the features of vivid, interesting, timely, open and resource conservation. On the basis of analyzing the characteristics and difficulties of the clinical ideological education and the pros and cons of the network, we proposed the methods to utilize the advantages of network informa-tion technology to enhance the ideological and political education of clinical interns.