Clinical study on Tuina plus physical agents for lateral collateral ligament injury of ankle in gymnasts / 针灸推拿医学（英文版）

Objective: To compare the efficacy of Tuina (Chinese therapeutic massage) plus physical agents and physical agents alone for lateral collateral ligament injury of ankle in gymnasts, and to explore the feasibility of Tuina for injury intervention in competitive athletes.Methods: A total of 64 gymnasts with types Ⅰ-Ⅱ lateral collateral ligament injury of ankle were selected and divided into a control group and an observation group according to a full analysis set based on the intention-to-treat principle, with 32 cases in each group. Patients in the control group received ultrasound and microwave treatment, while those in the observation group received additional Tuina manipulations. The efficacy was evaluated by total effective rate, visual analog scale (VAS) score, and American Orthopedic Foot and Ankle Society ankle-hindfoot scale (AOFAS-AHS) score. Results: The total effective rate was 96.9％ in the observation group and 90.6％ in the control group. There was no statistical difference in the total effective rate between the two groups (P>0.05). The markedly effective rate was 75.0％ in the observation group and 46.9％ in the control group. The markedly effective rate in the observation group was higher than that in the control group (P<0.05). After treatment, the VAS scores of both groups showed a downward trend, and there were statistical differences between different treatment time points in the same group (P<0.05). After one and three months of treatment, the VAS scores of the observation group were lower than those of the control group (P<0.05). There were statistical differences in the AOFAS-AHS score before and after treatment within the same group (P<0.05). After one month of treatment, there was no statistical difference in the AOFAS-AHS score between the two groups (P>0.05). After three months of treatment, the AOFAS-AHS score in the observation group was higher than that in the control group, indicating statistical significance (P<0.05). There was an interaction between time and group (P<0.05). Conclusion: Tuina plus physical agents can improve the symptoms of lateral collateral ligament injury of ankle in gymnasts. This combined treatment is superior to physical agents alone in relieving pain and improving joint functions. Therefore, Tuina plus physical agents can be used as a treatment for lateral collateral ligament injury of ankle in gymnasts.

Research Progress of Granular Corneal Dystrophy / 现代生物医学进展

Granular corneal dystrophy is a rare autosomal dominant genetic disease in clinic.Due to the TGFBI mutation on the 5q31 chromosome,the TGFBIp abnormally aggregates in the Bowman layer and the matrix layer and metabolic disorders,patients' bilateral cornea arise opacity,making visual acuity Progressive impairment.At present,there are at least 66 TGFBI mutations,at least 10 of which are related to granular corneal dystrophy,due to variation in genotype and the difference between homozygous and heterozygous,the patients' phenotype shows a significant difference.Along with the improvement of people's cognition,and the application of laser scanning confocal microscope and the gene diagnosis,More and more patients get the correct diagnosis,Current treatment methods mainly include corneal transplantation and laser ablation,patients are not satisfied because of the postoperative recurrence and aggravated.Due to the establishment of granular corneal dystrophy animal model,lithium and gene therapy will show a good application prospects.

Dosimetric calibration of CT pencil chamber in cobalt beams / 中国医疗器械杂志

<p><b>OBJECTIVE</b>To explore the dose-length product calibration method for pencil ionization chamber in cobalt beams.</p><p><b>METHODS</b>The PTW TM30009 ionization chamber was placed into the central hole of T40017 head phantom and irradiated 60 s in 20 cm x 20 cm cobalt beam. The charge was collected with UNIDOS electrometer. Absorbed doses were measured with TM30013 0.6 mL farmer-type chamber under the same condition. The CT chamber calibration factor was expressed in dose-length product. Dose linearity and spatial response were also investigated.</p><p><b>RESULTS</b>The calibration factor in dose-length product was derived from measured data. Dose linearity and spatial response were good in cobalt beams.</p><p><b>CONCLUSION</b>It is feasible to calibrate the CT chamber in cobalt beams for patient dose evaluation in MVCT.</p>

Clinical outcomes of early weight-bearing after arthroscopic microfracture during the treatment of osteochondral lesions of the talus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The time until weight-bearing after arthroscopic microfracture when treating osteochondral lesions of the talus (OLT) is very important to the clinical outcomes of the operation. However, there have been no consistent opinions regarding the optimal time to start weight-bearing postoperatively. Many opinions advocate that weight-bearing should begin not earlier than the sixth or eighth week postoperatively, whereas others point out that earlier weight-bearing could also obtain satisfactory outcomes. The purpose of our study was to evaluate the clinical outcomes of early weight-bearing after arthroscopic microfracture during the treatment of OLT.</p><p><b>METHODS</b>Fifty-eight ankles in 58 patients with a single OLT <2 cm(2) were retrospectively studied. All lesions were treated with arthroscopic debridement and microfracture under local anesthesia. After the operation, the patients were allowed to bear full weight under the protection of figure-8-shaped splints. The visual analog scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle--hindfoot scale were evaluated preoperatively and at six postoperative timepoints (1st day, 1st month, 3rd month, 6th month, 12th month, and 24th month). Patients were followed up for 24-52 months (mean (34.97 ± 7.33) months).</p><p><b>RESULTS</b>All 58 patients achieved excellent recovery with significant relief of their symptoms. The VAS score decreased from 7.31 ± 1.0 preoperatively to 0.95 ± 0.76 at the 24th month follow-up (P = 0.000), whereas the AOFAS score improved from 53.53 ± 8.57 preoperatively to 87.62 ± 5.42 at the 24th month follow-up (P = 0.000).</p><p><b>CONCLUSION</b>The successful clinical outcomes of this study demonstrated that early weight-bearing after the treatment of OLT with arthroscopic microfracture can be allowed.</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>

Comparison of dose distribution in gamma knife radiotherapy plan, conformal radiotherapy plan and intensity modulated radiotherapy plan for patients with small mass in lung / 中华放射肿瘤学杂志

Objective To compare dose distribution in gamma knife radiotherapy plan, conformal radiotherapy(CRT)plan and intensity modulated radiotherapy(MRT)plan for patients with small mass in lung, and evaluate their characters. Methods Fourteen patients with small mass in lung participated in the study. Gamma knife radiotherapy plan(plan 1), CRT plan(plan 2)and IMRT plan(plan 3)were made for each mass. The planning target volume(PTV)and the dose include 95% PTV were consistent.Conformal index(CI), homogeneity index(HI), lung V5 ,V10 ,V20 ,V30 and the max dose of esophagus and spinal cord were analyzed. Paired samples t-test was used for comparison between each two plans. Results The CI of the plan 1,2 and 3 were 0. 58,0. 46 and 0. 63, respectively. CI of the plan 1 ＞ that of the plan 2 (t= -3.95,P =0.000),plan 3 ＞ plan 2(t = -6.01 ,P =0.000),plan 1 =plan 3(t =1.64,P =0.116);HI of the plan 1,2 and 3 were 1.66,1.10 and 1.07 respectively. HI of the plan 1 ＞ plan 2 ,plan 1 ＞ plan 3(t= -20.52,21.41 respectively, both P=0. 000),plan 2 = plan 3(t= -1.08,P=0.294). The wholelung V5 ,V10 ,V20 and V30 were 10.0% ,5.6% ,2. 4% and 1.2%, respectively, in plan 1 ;20. 2% ,13. 4%,6. 9% ,3.0%, respectively, in plan 3; and 26. 5%, 18. 0%, 11.4% and 4. 6%, respectively, in plan 2.The V5, V10, V20 and V 30 of the plan 1 ＜ in plan 2(t = 9. 68,8. 41,5. 45,5. 14, all P = 0. 000), the V5,V10,V20 and V30 of the plan 1 ＜ in plan 3(t=7.58,8.95,6. 15,4.78, respectively, all P=0.000),the V5 ,V10, V20andV30 oftheplan2 ＞ inplan3(t =9. 71,5. 91,4. 13,3.91, respectively, allP =0.000).The max dose of esophagus in plan 1 ,2 and 3 were 24.93 ± 21.54, 31.90 ± 18. 75, 29. 19 ± 23.09 Gy,respectively, plan 1 ＜ plan 2(t = -2. 71 ,P=0.013),plan 1 = plan 3(t = - 1.49,P =0. 152),plan 2 =plan 3(t = 1.35, P = 0. 193). The max dose of spinal cord in plan 1,2 and 3 were 12.07 ± 10. 67,17.70 ±11.35 and 8.92 :± 10. 04 Gy, respectively, plan 2 ＞ plan 1 ＞plan 3(t = -2. 38,2. 29,4. 83,P=0. 1027,0.033,0.000);All three plans of each mass meet the needs that the max dose of the esophagus≤60 Gy and the max dose of spinal cord ≤40 Gy. Conclusions The dose of the normal lung was lower, but the HI and the max dose of spinal cord were higher in Gamma knife radiotherapy plan than those in the CRT and the IMRT plan of the small mass in lung.

Biomechanical study of different internal fixations with Chinese hamstring tendon in anterior cruciate ligament reconstruction / 中国矫形外科杂志

interface screw,with significant difference(P0.05).[Conclusion]All internal fixations in this study could meet biomechanical requirement,but Rigidfix and Intrafix showed more advantages.