BACKGROUND & AIMS: OBJECTIVE:To evaluate whether an 8-week whole-body vibration training program may improve recovery of knee flexion/extension muscular strength in athletes after arthroscopic anterior cruciate ligament (ACL) reconstruction. DESIGN:Randomized controlled trial. SETTING:Single outpatient rehabilitation center. PARTICIPANTS:Thirty-eight female volleyball/basketball players (aged between 20 and 30), randomized into 2 treatment groups. INTERVENTIONS:During a standardized six-month rehabilitation program, from week 13 to week 20 after surgery, the whole-body vibration group (n = 19) and the control group (n = 19) performed additional static knee flexor/extensor exercises on a vibration platform. For the whole-body vibration group, the vibration platform was set to 2.5 mm of amplitude and 26 Hz of frequency. The control group followed the same whole-body vibration board training with no vibrations. MAIN OUTCOME MEASURES:All patients were evaluated using an isokinetic strength test with a Biodex dynamometer at the beginning and at the end of the additional treatment protocol. The parameters tested were the peak torque and the maximum power of knee flexor and extensor muscles performing strength and endurance tests. RESULTS:No vibration-related side effects were observed. Improvements were noticed in both groups, but increase in knee muscle isokinetic strength values was statistically significant in the whole-body vibration group when compared with the control group (differences in extension: peak torque 11.316/10.263 N·m and maximum power 13.684/11.211 W; flexion: peak torque 9.632/11.105 N·m and maximum power 10.158/9.474 W; P < 0.001). CONCLUSIONS:When combined with a standardized rehabilitation program, whole-body vibration may increase muscular strength and be an effective additional treatment option in the rehabilitation of athletes after ACL arthroscopic reconstruction.

背景与目标： 目的：评估为期8周的全身振动训练计划是否可以改善关节镜前交叉韧带（ACL）重建后运动员屈膝/伸展肌肉力量的恢复。
设计：随机对照试验。
地点：单个门诊康复中心。
参与者：38名女子排球/篮球运动员（年龄在20至30岁之间），随机分为2个治疗组。
干预措施：在标准化的六个月康复计划中，从手术后第13周到第20周，全身振动组（n = 19）和对照组（n = 19）进行了额外的静态膝屈肌/伸肌练习。振动平台。对于全身振动组，将振动平台设置为2.5毫米的振幅和26赫兹的频率。对照组接受相同的全身振动板训练，无振动。
主要观察指标：在其他治疗方案的开始和结束时，均用Biodex测功机通过等速肌力测试对所有患者进行评估。测试的参数是执行力量和耐力测试的峰值扭矩和膝盖屈肌和伸肌的最大力量。
结果：未观察到与振动相关的副作用。两组均注意到改善，但与对照组相比，全身振动组膝部肌肉的等速肌力值在统计学上具有显着意义（延伸差异：峰值扭矩11.316 / 10.263 N·m和最大功率13.684 / 11.211 W；屈曲：峰值扭矩9.632 / 11.105 N·m，最大功率10.158 / 9.474 W； P <0.001）。
结论：与标准的康复计划结合使用时，全身振动可能会增加肌肉力量，并成为ACL关节镜重建术后运动员康复的有效附加治疗选择。

BACKGROUND & AIMS: :Fractures of the posterior wall are the most common of the acetabular fractures. The aim of this study was to assess the medium-term results of reconstruction of comminuted posterior wall fractures of the acetabulum by using the buttress technique. This is a retrospective review conducted at a level 1 trauma centre. Thirty-two patients (25 men, 7 women, mean age 41 years, range 14-80 years) with comminuted posterior wall fracture of the acetabulum underwent reconstruction of the posterior wall during the period of July 1998 to February 2004. The average follow-up was 43 months (range 24-70 months). Clinical evaluation was based on modified Merle d'Aubigne and Postel scoring. Radiographic evaluation was according to criteria developed by Matta. The postoperative reduction was graded as anatomical in 28 patients (88%) and imperfect in 4 patients (12%). The clinical outcome was excellent in 11 (34% ), very good in 9 (28%), good in 4 (12%), fair in 3 (9%) and poor in 5 (15%). Radiological grading at the final follow-up was excellent 12 (37%), good 11 (34%), fair 4 (12%) and poor 5 (15%). Reconstruction of comminuted posterior wall acetabular fractures by buttress technique can be expected to produce good results. It can provide a stable fixation of the posterior wall amenable to early range of motion and weight bearing.

背景与目标： ：后壁骨折是最常见的髋臼骨折。这项研究的目的是评估通过使用支撑技术重建髋臼粉碎性后壁骨折的中期结果。这是在1级创伤中心进行的回顾性审查。 1998年7月至2004年2月，对髋臼粉碎性后壁骨折的32例患者（25例男性，7例女性，平均年龄41岁，范围14-80岁）进行了后壁重建。平均随访如下：延长了43个月（范围为24-70个月）。临床评估基于改良的Merle d'Aubigne和Postel评分。射线照相评估是根据Matta制定的标准进行的。术后减少的程度在解剖学上分为28例（88％），在不完善中有4例（12％）。临床预后良好，其中11例（34％），非常好9例（28％），好4例（12％），一般3例（9％），差5例（15％）。最后一次随访的放射学评分为优12分（37％），好11分（34％），中4分（12％）和差5分（15％）。通过支撑技术重建粉碎性后壁髋臼骨折有望产生良好的效果。它可以为后壁提供稳定的固定，以适应早期运动和负重。

BACKGROUND & AIMS: INTRODUCTION:Orbital exenteration is a highly disfiguring procedure which, although providing local control of invasive orbital malignancy also results in marked visual, psychological and social disability. We present three consecutive total exenteration cases over 1 year where all 3, including extended exenteration defects, were repaired by primary closure by way of cheek advancement. This technique may be considered where succinct management with minimal follow-up is required and maybe preferable if considering rapidity of rehabilitation with a short time to fitting definitive prostheses. METHODS:Retrospective review of three consecutive patients who presented with neglected basal cell carcinoma with orbital invasion and subsequently underwent total orbital exenteration with repair by cheek advancement flap. RESULTS:All underwent repair with primary skin closure using a cheek advancement flap. Patient 2 developed a small area of central flap dehiscence noted at 2 months with almost complete granulation of the orbital cavity at 3 months. Patients 1, 2 and 3 were fitted with final prosthesis at 7, 6 and 12 months, respectively. CONCLUSIONS:Reconstruction of the exenterated orbit using cheek advancement represents an evolution of the cervico-facial flap repair. The cheek advancement avoids creating a secondary defect and because it involves less dissection and additional skin incisions, is an easier procedure to perform with fewer facial scars. It does not preclude osseointegration if required at a later date and as such we recommend it as an option in repairing the exenterated orbit.

背景与目标： 引言：眼眶消融是高度毁容性的过程，尽管对浸润性眼恶性肿瘤提供了局部控制，但也会导致明显的视觉，心理和社会残疾。我们介绍了1年中连续发生的3例总根除病例，其中全部3例（包括根深蒂固的缺损）均通过面颊推进术通过一次闭合术进行了修复。在需要简短随访的情况下进行简洁管理的情况下，可以考虑使用这种技术；如果考虑到在短时间内适应最终假体的康复速度，则可能更可取。
方法：回顾性回顾性分析三例连续被忽略的基底细胞癌伴有眶侵犯的患者，随后进行了全颊面全瓣切除术，并进行了面颊前移皮瓣修复。
结果：所有患者均使用脸颊推进瓣进行了初次皮肤闭合修复。患者2在2个月时出现小片中央皮瓣裂开，并在3个月时眼眶肉芽几乎完全形成。患者1、2和3分别在第7、6和12个月安装了最终的假体。
结论：利用面颊推进重建伸入的眶代表了颈面部皮瓣修复的发展。脸颊的进展避免了继发性缺损，并且因为它涉及较少的解剖和额外的皮肤切口，因此是执行起来更容易且面部疤痕更少的手术。如果以后需要的话，它并不排除骨整合，因此，我们建议将其作为修复过度弯曲的轨道的一种选择。

BACKGROUND & AIMS: :Iterative reconstruction has a wide spectrum of proven advantages in the field of conventional X-ray absorption-based computed tomography (CT). In this paper, we report on an algebraic iterative reconstruction technique for grating-based differential phase-contrast CT (DPC-CT). Due to the differential nature of DPC-CT projections, a differential operator and a smoothing operator are added to the iterative reconstruction, compared to the one commonly used for absorption-based CT data. This work comprises a numerical study of the algorithm and its experimental verification using a dataset measured at a two-grating interferometer setup. Since the algorithm is easy to implement and allows for the extension to various regularization possibilities, we expect a significant impact of the method for improving future medical and industrial DPC-CT applications.

背景与目标： 在传统的基于X射线吸收的计算机断层扫描（CT）领域中，迭代重建具有广泛的公认优势。在本文中，我们报告了一种基于光栅的差分相衬CT（DPC-CT）的代数迭代重建技术。由于DPC-CT投影的微分性质，与通常用于基于吸收的CT数据相比，微分算子和平滑算子被添加到迭代重建中。这项工作包括对该算法的数值研究及其使用在两光栅干涉仪设置下测得的数据集进行的实验验证。由于该算法易于实现，并且可以扩展到各种正则化可能性，因此，我们期望该方法对改善未来的医疗和工业DPC-CT应用具有重大影响。

BACKGROUND & AIMS: :Orthopedic reconstruction of blunt chest trauma can aid restoration of pulmonary function to reduce the mortality associated with serial rib fractures and flail chest injuries. Contemporary chest wall reconstruction requires contouring of generic plates to the complex surface geometry of ribs. This study established a biometric foundation to generate specialized, anatomically contoured osteosynthesis hardware for rib fracture fixation. On human cadaveric ribs three through nine, the surface geometry pertinent to anatomically conforming osteosynthesis plates was characterized by quantifying the apparent rib curvature C(A), the longitudinal twist alpha(LT) along the diaphysis, and the unrolled curvature C(U). In addition, the rib cross-sectional geometry pertinent to intramedullary fixation strategies was characterized in terms of cross-section height, width, area, and cortex thickness. The rib surface exhibited a curvature C(A) ranging from 3.8 m(-1) in the anteromedial section of rib seven to 17.3 m(-1) in the posterior section of rib three. All ribs had in common a longitudinal twist alpha(LT), ranging from 41-60 degrees. The unrolled curvature C(U) decreased gradually from ribs three to five, and increased gradually with reversed orientation from rib six to nine. The cross-sectional area remained constant along the rib diaphysis. However, the medullary canal increased in size from 29.9 mm(2) posteriorly to 41.2 mm(2) in anterior rib segments. Results of this biometric rib characterization describe a novel strategy for intraoperative plate contouring and provide a foundation for the development of specialized rib osteosynthesis strategies.

背景与目标： ：钝性胸部创伤的整形外科手术可以帮助恢复肺功能，从而降低与连续肋骨骨折和连fl胸伤相关的死亡率。当代的胸壁重建需要仿照普通板的轮廓以适应复杂的肋骨表面几何形状。这项研究建立了生物特征基础，以生成用于解剖肋骨骨折的专用的，解剖学上轮廓化的骨合成硬件。在三到九个人的尸体肋骨上，通过量化视在肋骨曲率C（A），沿骨干的纵向扭曲alpha（LT）和展开曲率C（U）来表征与解剖学上相符的骨合成板相关的表面几何形状。另外，与髓内固定策略有关的肋骨横截面几何形状以横截面高度，宽度，面积和皮质厚度为特征。肋骨表面的曲率C（A）在肋骨7的内侧区域中的范围为3.8 m（-1），在肋骨3的后部区域中的曲率C（A）为17.3 m（-1）。所有的肋骨都有一个共同的纵向扭曲α（LT），范围为41-60度。展开曲率C（U）从第3肋逐渐减小到第5肋，并随着从第6肋向第9肋的反向取向而逐渐增大。沿肋骨骨干的横截面面积保持恒定。但是，在前肋骨节段中，髓管的大小从后方的29.9 mm（2）增加到41.2 mm（2）。这种生物特征肋骨表征的结果描述了一种术中板轮廓的新策略，并为发展专门的肋骨合成策略提供了基础。

BACKGROUND & AIMS: PURPOSE OF REVIEW:To examine the recent literature concerning advances in tongue reconstruction after tumor resection. RECENT FINDINGS:Reconstruction following resection of malignant tongue tumors remains one of the most difficult problems in head and neck oncology. Recent trends in tongue reconstruction have focused on optimizing speech and swallowing function and maximizing quality of life. In the recent literature, several new reconstructive strategies including omohyoid musculocutaneous and myofascial flaps overlayed with radial forearm free flaps have been described. In addition, several older reconstructive options, such as trapezius and pectoralis rotational flaps, have been revisited. There has also been a trend toward restoring innervation to these flaps rather than leaving them insensate. SUMMARY:Tongue cancer resection and subsequent reconstruction pose interesting challenges to the surgeon to maximize postoperative function and quality of life. Attention to the principles of tongue reconstruction and knowledge of the range of available reconstructive options can result in more favorable functional outcomes.

背景与目标： 审查的目的：审查有关肿瘤切除术后舌重建的最新文献。
最近的发现：切除恶性舌头肿瘤后的重建仍然是头颈肿瘤学中最困难的问题之一。舌头重建的最新趋势集中在优化言语和吞咽功能以及最大限度地提高生活质量上。在最近的文献中，已经描述了几种新的重建策略，包括乳突肌肌皮瓣和肌筋膜瓣覆盖有放射状前臂游离瓣。另外，一些较旧的重建方案，例如斜方肌和胸大肌旋转皮瓣也已被重新考虑。还存在恢复这些瓣的神经支配而不是使它们变得不灵敏的趋势。
摘要：舌癌切除术和随后的重建术对外科医生提出了有趣的挑战，以最大程度地提高术后功能和生活质量。注意舌头重建的原理和对可用重建选项范围的了解可以带来更有利的功能结果。

BACKGROUND & AIMS: BACKGROUND:Organ motion during treatment delivery in radiotherapy (RT) may lead to deterioration of the planned dose, but can be mitigated by dynamic multi-leaf collimator (DMLC) tracking. The purpose of this study was to implement and experimentally validate a method for time-resolved motion including dose reconstruction for volumetric modulated arc therapy (VMAT) treatments delivered with and without DMLC tracking. MATERIAL AND METHODS:Tracking experiments were carried out on a linear accelerator (Trilogy, Varian) with a prototype DMLC tracking system. A motion stage carrying a biplanar dosimeter phantom (Delta4PT, Scandidos) reproduced eight representative clinical tumor trajectories (four lung, four prostate). For each trajectory, two single-arc 6 MV VMAT treatments with low and high modulation were delivered to the moving phantom with and without DMLC tracking. An existing in-house developed program that adds target motion to treatment plans was extended with the ability to split an arc plan into any number of sub-arcs, allowing the calculated dose for different parts of the treatment to be examined individually. For each VMAT sub-arc, reconstructed and measured doses were compared using dose differences and 3%/3 mm γ-tests. RESULTS:For VMAT sub-arcs the reconstructed dose distributions had a mean root-mean-square (rms) dose difference of 2.1% and mean γ failure rate of 2.0% when compared with the measured doses. For final accumulated doses the mean rms dose difference was 1.6% and the γ failure rate was 0.7%. CONCLUSION:The time-resolved motion including dose reconstruction was experimentally validated for complex tracking and non-tracking treatments with patient-measured tumor motion trajectories. The reconstructed dose will be of high value for evaluation of treatment plan robustness facing organ motion and adaptive RT.

背景与目标： 背景：放射治疗（RT）进行治疗期间的器官运动可能会导致计划剂量的恶化，但可以通过动态多叶准直仪（DMLC）跟踪来缓解。这项研究的目的是实施并通过实验验证一种用于时间分辨运动的方法，包括采用和不采用DMLC跟踪进行体积调制电弧治疗（VMAT）治疗的剂量重建。
材料与方法：跟踪实验是在具有原型DMLC跟踪系统的线性加速器（Trilogy，Varian）上进行的。携带双平面剂量计体模（Delta4PT，Scandidos）的运动台可再现八种代表性的临床肿瘤轨迹（四肺，四前列腺）。对于每个轨迹，在有和没有DMLC跟踪的情况下，将具有低调制和高调制的两种单弧6 MV VMAT处理传递给运动体模。现有的内部开发程序可以将目标运动添加到治疗计划中，并且可以将电弧计划划分为任意数量的子弧线，从而可以单独检查治疗不同部分的计算出的剂量，从而扩展了功能。对于每个VMAT子电弧，使用剂量差异和3％/ 3 mmγ测试比较重建和测量的剂量。
结果：对于VMAT亚弧，与测量剂量相比，重建的剂量分布的平均均方根（rms）剂量差异为2.1％，平均γ失效率为2.0％。对于最终累积剂量，平均均方根剂量差异为1.6％，γ失效率为0.7％。
结论：包括剂量重建在内的时间分辨运动已通过实验验证，可用于采用患者测量的肿瘤运动轨迹进行复杂的跟踪和非跟踪治疗。重建的剂量对于评估面向器官运动和适应性RT的治疗计划的鲁棒性将具有很高的价值。

BACKGROUND & AIMS: :Deep sequencing of viral genomes is a powerful tool to study RNA virus complexity. However, the analysis of next-generation sequencing data might be challenging for researchers who have never approached the study of viral quasispecies by this methodology. In this work we present a suitable and affordable guide to explore the sub-consensus variability and to reconstruct viral quasispecies from Illumina sequencing data. The guide includes a complete analysis pipeline along with user-friendly descriptions of software and file formats. In addition, we assessed the feasibility of the workflow proposed by analyzing a set of foot-and-mouth disease viruses (FMDV) with different degrees of variability. This guide introduces the analysis of quasispecies of FMDV and other viruses through this kind of approach.

背景与目标： ：病毒基因组的深度测序是研究RNA病毒复杂性的有力工具。然而，对于从未使用这种方法进行病毒准种研究的研究人员而言，下一代测序数据的分析可能具有挑战性。在这项工作中，我们提供了一个合适且价格合理的指南，以探讨亚共识变异性并从Illumina测序数据重建病毒准种。该指南包括完整的分析流程以及对软件和文件格式的用户友好描述。此外，我们通过分析一组具有不同程度变异性的口蹄疫病毒（FMDV），评估了提出的工作流程的可行性。本指南通过这种方法介绍了对FMDV和其他病毒的准种的分析。

BACKGROUND & AIMS: :Psychiatric well-being impacts on general satisfaction and quality of life. This study explored how the presence of psychiatric diagnoses affects patient-reported outcomes in breast reconstruction and on selection of reconstructive modality. Patients who received breast reconstruction at a tertiary hospital between 2013 and 2018 and completed the BREAST-Q survey were included. BREAST-Q module scores were compared between patients who had a psychiatric diagnosis at presentation and the remaining cohort using t tests. General linear models (GLMs) were used to control for confounding factors. A chi-squared test was used to assess the effect on reconstructive modality, and binary logistic regression was used to control for confounding factors. Of the 471 patients included, 93 (19.7%) had at least one psychiatric diagnosis. Cohorts did not differ significantly by age, BMI, race, ASA classification, or insurance status. Patients with a psychiatric diagnosis experienced a decrease in BREAST-Q scores for the Psychosocial Wellbeing (B = 9.16, P = .001) and Sexual Wellbeing (B = 9.29, P = .025) modules. On binary logistic regression, patients with a psychiatric diagnosis were less likely to receive autologous reconstruction compared with implant reconstruction (OR = 0.489, P = .010). The presence of psychiatric diagnoses is an independent predictor of decreased BREAST-Q. Furthermore, there is a significant disparity in modality of reconstruction given to patients with psychiatric diagnoses. Further study is needed to evaluate interventions to improve satisfaction among at-risk populations and evaluate the reason for low autologous reconstruction in this population.

背景与目标： ：精神健康会影响总体满意度和生活质量。这项研究探讨了精神病学诊断的存在如何影响乳房重建和重建方式选择中患者报告的结局。纳入2013年至2018年期间在三级医院接受乳房再造并完成BREAST-Q调查的患者。比较BREAST-Q模块评分，在出现时有精神病诊断的患者与其余队列使用t检验进行比较。通用线性模型（GLM）用于控制混杂因素。卡方检验用于评估对重建模态的影响，二元逻辑回归用于控制混杂因素。在包括的471位患者中，有93位（19.7％）至少有一项精神病诊断。队列在年龄，BMI，种族，ASA分类或保险状态方面无显着差异。患有精神病诊断的患者的心理社会幸福感（B = 9.16，P = .001）和性健康幸福感（B = 9.29，P = .025）模块的BREAST-Q得分降低。在二元logistic回归分析中，有精神病诊断的患者与植入物重建相比，接受自体重建的可能性较小（OR = 0.489，P = .010）。精神病学诊断的存在是BREAST-Q降低的独立预测因子。此外，精神病诊断患者的重建方式也存在很大差异。需要进行进一步的研究，以评估可提高高危人群满意度的干预措施，并评估该人群自体重建能力低的原因。

BACKGROUND & AIMS: Background:Recent interest in the return to sports, following anterior cruciate ligament reconstruction, has focused on the influence of psychological factors. However, many factors contribute to this endpoint. This study aimed to investigate the ability of nonprofessional athletes to return alongside the reasons for failure. Materials and Methods:We retrospectively studied 101 postreconstruction patients with followup in excess of 12 months. All patients underwent hamstring autograft anterior cruciate reconstruction. The Cincinnati Sports Activity Scale was used to define activity level preinjury, postinjury, and postreconstruction. Structured questionnaires were used to identify factors in those who did not return to the same level. Results:Seventy percent of patients returned to their preinjury activity score. Of the 30% of patients who failed, age, reconstruction type, and associated pathology were unrelated. However, reconstruction within 6 months of injury resulted in increased return to preinjury score (P < 0.05). Failure was associated with continued knee symptoms (57%), lifestyle changes (27%), anxiety (27%), fear (23%), and other musculoskeletal problems (10%). Considerable interplay was found between these factors. Failure to return was associated with increased further surgery, but this was successful in only one-third of patients. Conclusion:Psychological factors are important (and may require targeted input), but return-to-sport is multifactorial. Ongoing symptoms may prompt further surgery, but this is frequently unsuccessful in achieving return. Patient-specific goals should be sought and revisited throughout the rehabilitation program. Acknowledging psychological barriers, in those aiming to return to the same level, may help achieve this goal. In other patients, success may be return to a desired lower level. Understanding the patient's expectations is important in goal setting.

背景与目标： 背景：前十字韧带重建后，人们对恢复运动的最新兴趣集中在心理因素的影响上。但是，许多因素导致了此终点。这项研究旨在调查非职业运动员返回的能力以及失败的原因。
材料与方法：我们回顾性研究了101名重建后随访超过12个月的患者。所有患者均进行了绳肌自体前交叉重建术。辛辛那提体育活动量表用于定义受伤前，受伤后和重建后的活动水平。使用结构化的问卷来确定那些未回到同一水平的人的因素。
结果：百分之七十的患者恢复了他们的损伤前活动评分。在失败的30％患者中，年龄，重建类型和相关病理学无关。但是，在受伤后6个月内进行重建可增加受伤前评分的恢复（P <0.05）。失败与持续的膝关节症状（57％），生活方式改变（27％），焦虑症（27％），恐惧（23％）和其他肌肉骨骼问题（10％）相关。在这些因素之间发现了很大的相互作用。返回失败与进一步手术增加有关，但这仅在三分之一的患者中成功。
结论：心理因素很重要（可能需要有针对性的投入），但运动回报是多因素的。持续出现的症状可能会提示进一步手术，但这通常无法成功获得回报。在整个康复计划中，应寻求并重新制定针对患者的目标。在那些旨在回到同一水平的人中，认识到心理障碍可能有助于实现这一目标。在其他患者中，成功可能会恢复到期望的较低水平。在设定目标时，了解患者的期望很重要。

BACKGROUND & AIMS: :This paper proposes a new sequential weighted least squares (SWLS) method for positron emission tomography (PET) reconstruction. The SWLS algorithm is noniterative and can be considered as equivalent to the penalized WLS (PWLS) method under certain initial conditions. However, a full implementation of SWLS is computationally intensive. To overcome this problem, we propose a simplified SWLS as a reasonable alternative to the SWLS. The performance of this SWLS method is evaluated in experiments using both simulated and clinical data. The results show that the method can be advantageously compared with the original SWLS both in computation time and reconstruction quality.

背景与目标： ：本文提出了一种用于正电子发射断层扫描（PET）重建的新的顺序加权最小二乘（SWLS）方法。 SWLS算法是非迭代的，在某些初始条件下可以视为等同于惩罚WLS（PWLS）方法。但是，SWLS的完整实现需要大量的计算。为了克服这个问题，我们提出了一种简化的SWLS作为SWLS的合理替代方案。使用模拟和临床数据在实验中评估此SWLS方法的性能。结果表明，该方法在计算时间和重建质量上均可以与原始SWLS进行比较。

BACKGROUND & AIMS: :We present a new arthroscopic technique for chronic AC joint dislocations with coracoacromial ligament transposition and augmentation by the Tight Rope device (Arthrex, Naples, USA). First the glenohumeral joint is visualised to repair concomitant lesions, such as SLAP lesions, if needed. Once the rotator interval is opened and the coracoid is identified, the arthroscope is moved to an additional anterolateral portal. A 1.5 cm incision is made 2 cm medial to the AC joint. After drilling a 4 mm hole with a cannulated drill through the clavicle and coracoid a Tight Rope is inserted, the clavicule is reduced and stabilized with the implant. The arthroscope is moved to the subacromial space and a partial bursectomy is performed to visualise the CA ligament and lateral clavicle. The CA ligament is armed with a strong braided suture using a Lasso stitch and dissected from the undersurface of the acromion. It is then reattached to the distal part of the clavicle by transosseous suture fixation after abrasion of its undersurface. Although this combined arthroscopic procedure of AC joint augmentation with a Tight Rope combined with a ligament transposition is technically demanding, it is a safe method to reconstruct the coracoclavicular ligaments and achieve a sufficient reduction of the clavicle without the need of further implant removal or autologous tendon transplantation.

背景与目标： ：我们提出了一种新的关节镜技术，用于通过锁紧韧带装置（Arthrex，那不勒斯，美国）进行伴有肩锁韧带移位和增生的慢性AC关节脱位。首先，如果需要，将肱肱关节可视化以修复伴随的病变，例如SLAP病变。一旦打开了转子间隔并确定了喙突，便将关节镜移至另一个前外侧门。在AC关节内侧2厘米处开一个1.5厘米的切口。用空心钻在锁骨和喙突上钻一个4毫米的孔后，插入一根紧绳，锁骨缩小并通过植入物稳定。将关节​​镜移至肩峰下间隙，并进行部分滑囊切除术以可视化CA韧带和外侧锁骨。 CA韧带采用拉索针法结扎有强力的编织线，并从肩峰下表面解剖。然后在其下表面磨损后，通过穿骨缝线固定将其重新连接到锁骨的远端。尽管在技术上要求将AC关节增强术与紧绳结合韧带移位的联合关节镜检查方法相结合，但这是一种安全的方法，可重建锁骨锁骨韧带并实现锁骨的充分复位，而无需进一步去除种植体或自体肌腱移植。

BACKGROUND & AIMS: :Wide en bloc excision of proximal ulna sections is used to treat traumatic and pathological fractures of the ulna, though poor standardization of clinical treatment often results in long-term failure of such reconstructed biomechanical structures. In order to provide insight into effective ulnar reconstructive treatments, the case of an 80-year-old Chinese Han male presenting with pathological fracture caused by a proximal ulnar metastatic tumor concurrent with metastatic renal cancer complicated by occurrence in the brain and lungs is reported and contrasted with alternative treatment techniques. Wide resectioning of the proximal ulna and reconstruction with local radius neck-to-humerus trochlea transposition resulted in preservation of functionality, sensitivity, and biomechanical integrity after postsurgical immobilization, 6 weeks of passive- and active-assisted flexion, and extension with a hinged brace. The resultant Musculoskeletal Tumor Society rating score was 25 of 30 (83 %). Full sensitivity and mobility of the left hand and elbow (10° to 90° with minimally impaired supination and pronation) was restored with minimal discomfort. No evidence of local recurrence or other pathological complications were observed within a 1-year follow-up period. Efficient reconstruction of osseous and capsuloligamentous structures in the elbow is often accomplished by allografts, prosthesis, and soft tissue reconstruction, though wide variations in risk and prognosis associated with these techniques has resulted in disagreements regarding the most effective standards for clinical treatment. Current findings suggest that radius neck-to-humerus trochlea transposition offers a superior range of elbow movement and fewer complications than similar allograft and prosthetic techniques for patients with multiple metastatic cancers.

背景与目标： ：尺骨近端全片切除术被用于治疗尺骨的创伤性和病理性骨折，尽管临床治疗标准化不佳通常会导致这种重建的生物力学结构长期失败。为了提供有效的尺骨重建治疗的见解，报道了一个80岁的中国汉族男性患者的病例，该患者因尺骨近端转移性肿瘤并发转移性肾癌并发于脑和肺而引起病理性骨折，与替代治疗技术形成对比。尺骨近端的广泛切除和局部radius颈到肱骨滑车转位的重建导致固定，术后固定，被动和主动辅助屈曲6周以及通过铰接支架伸展的功能，敏感性和生物力学完整性的保留。最终的肌肉骨骼肿瘤学会评分为30分中的25分（83％）。恢复了左手和肘部的完全灵敏度和活动性（10°至90°，旋后和旋前受累程度最小），同时使不适感降至最低。在一年的随访期内未观察到局部复发或其他病理并发症的迹象。肘关节骨和囊韧带结构的有效重建通常通过同种异体移植，假体和软组织重建来实现，尽管与这些技术相关的风险和预后差异很大，导致人们对临床治疗最有效标准存在分歧。当前的研究结果表明，与类似的同种异体移植和修复技术相比，radius骨颈到肱骨滑车移位可以提供更好的肘部运动范围和更少的并发症。

BACKGROUND & AIMS: :Several studies report that tendons can regenerate after harvesting. These studies have been performed especially in patellar and hamstring tendons. At our institution, 10 cm length of full thickness peroneus longus tendon has been harvested to reconstruct torn anterior cruciate ligament since 1997 as a different graft source. The aim of this study was to investigate whether the peroneus longus tendon used the anterior cruciate ligament reconstruction has a regeneration potential or not. Twelve patients, who had originally undergone harvesting of the peroneus longus tendon for the primary surgery of the anterior cruciate ligament reconstruction, underwent magnetic resonance imaging (MRI). Images of both legs were acquired simultaneously with the use of the scanner's extremity coil, as we aimed to compare harvested peroneus longus tendon with the other leg's peroneus longus tendon (healthy side) for evaluation of the regeneration potential. The average age of the patients was 31 years. There were eight right and four left legs. The average time interval was 52 months between ligament surgery and MRI. In all patients, a varying amount of the regeneration of the peroneus longus tendon was seen on the MRI images. Although the extent of PLT regeneration in proximal sections seemed better than in mid- and distal sections, there was no statistical difference between sections (P = 0.130). These data show that the peroneus longus tendon has a regeneration potential after harvesting for anterior cruciate ligament reconstruction.

背景与目标： ：一些研究报告说，肌腱在收获后可以再生。这些研究尤其是在pa骨和绳肌腱中进行的。在我们的机构中​​，自1997年以来，已经收获了10厘米长的全厚度腓骨长肌腱，以重建撕裂的前交叉韧带，作为不同的移植物来源。这项研究的目的是调查使用前交叉韧带重建的腓骨长肌腱是否具有再生潜力。十二名患者最初接受了腓骨长肌腱的收获，用于前十字韧带重建的一次手术，然后接受了磁共振成像（MRI）检查。使用扫描仪的四肢线圈同时获取双腿的图像，因为我们旨在比较收获的腓骨长肌腱与另一条腿的腓骨长肌腱（健康侧），以评估再生潜力。患者的平均年龄为31岁。一共有8条右腿和4条左腿。韧带手术与MRI检查之间的平均间隔时间为52个月。在所有患者中，在MRI图像上都可以看到不同程度的腓骨长肌腱再生。尽管近端部分的PLT再生程度似乎好于中端和远端部分，但各部分之间无统计学差异（P = 0.130）。这些数据表明，腓骨长肌腱在收获后用于前十字韧带重建后具有再生潜力。

BACKGROUND & AIMS: :We evaluated whether donor computed tomography (CT) with a combined technique of lower tube voltage and iterative reconstruction (IR) can provide sufficient preoperative information for liver transplantation.We retrospectively reviewed CT of 113 liver donor candidates. Dynamic contrast-enhanced CT of the liver was performed on the following protocol: protocol A (n = 70), 120-kVp with filtered back projection (FBP); protocol B (n = 43), 100-kVp with IR. To equalize the background covariates, one-to-one propensity-matched analysis was used. We visually compared the score of the hepatic artery (A-score), portal vein (P-score), and hepatic vein (V-score) of the 2 protocols and quantitatively correlated the graft volume obtained by CT volumetry (graft-CTv) under the 2 protocols with the actual graft weight.In total, 39 protocol-A and protocol-B candidates showed comparable preoperative clinical characteristics with propensity matching. For protocols A and B, the A-score was 3.87 ± 0.73 and 4.51 ± 0.56 (P < .01), the P-score was 4.92 ± 0.27 and 5.0 ± 0.0 (P = .07), and the V-score was 4.23 ± 0.78 and 4.82 ± 0.39 (P < .01), respectively. Correlations between the actual graft weight and graft-CTv of protocols A and B were 0.97 and 0.96, respectively.Liver-donor CT imaging under 100-kVp plus IR protocol provides better visualization for vascular structures than that under 120-kVp plus FBP protocol with comparable accuracy for graft-CTv, while lowering radiation exposure by more than 40% and reducing contrast-medium dose by 20%.

背景与目标： ：我们评估了结合较低管电压和迭代重建（IR）技术的供体计算机断层扫描（CT）是否可以为肝移植提供足够的术前信息。根据以下方案进行肝脏动态对比增强CT：方案A（n = 70），120 kVp，滤过背投影（FBP）；协议B（n = 43），具有IR的100-kVp。为了均衡背景协变量，使用了一对一的倾向匹配分析。我们在视觉上比较了两种方案的肝动脉（A评分），门静脉（P评分）和肝静脉（V评分）的评分，并定量关联了通过CT容量法（graft-CTv）获得的移植物体积在两种方案中均具有实际的移植物重量。总共有39名方案A和方案B的患者表现出可比的术前临床特征，并且倾向匹配。对于协议A和B，A得分是3.87±0.73和4.51±0.56（P <0.1.01），P分数是4.92±0.27和5.0±0.0（P = 0.77），V分数是分别为4.23±0.78和4.82±0.39（P ＜0.01）。方案A和B的实际移植物重量与移植物CTv之间的相关性分别为0.97和0.96.100kVp加IR方案下的肝-供体CT成像比120kVp加FBP方案下提供更好的可视化的血管结构。移植CTv具有相当的精度，同时将辐射暴露降低了40％以上，而造影剂的剂量降低了20％。