Of 20 cases of rupture of tendo calcaneus following sports activity, 19 were complete and required surgi-cal repair, tbe other being incomplete, was treated with a cast with the foot in plantar flexion for 6 wk. Recovery was seen in all within half a year. Rupture in the mid-portion constituted 85%. Microangiog-raphy of amputation specimens and cadaveric tendons and histological study of cadaveric tendons showed thatblood supply was poorest in the mid-portion. Electronmicroscopy revealed hyaline degeneration in the tendon,which might account for the rupture. Mo-target X-ray was helpful in the early diagnosis of rupture and tendinitis calcaneus in 88 patients(170 films ). Early sutgical repair is preferred if indicated. Overloading should be avoided to prevent rup-ture. A 500-m. jogging daily helps the sufferers of tendinitis with better circulation. Local application ofsteroids should be administered with caution.

BACKGROUND: Very satisfactory clinical effects have been achieved in treatment of osteoarthritis of knee with intraarticular injection of sodium hyaluronate (SH) allied with steroid hormones for nerve block. How will such allied treatment be used for periarthritis of shoulder?OBJECTIVE: To probe into the improvement of pain and joint function in periarthritis of shoulder treated with integration of intraarticular injection of SH with nerve and pain block with betamethasone.DESIGN: Self-control was designed before and after experiment.SETTING: Beijing Tiantan Hospital, Capital University of Medical Sciences PARTICIPANTS: Twenty patients with periarthritis of shoulder were included, aged from 40 to 65 years from Pain Clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences from January to October 2004.METHODS: Integration of intraarticular injection of SH with nerve and pain block with betamethasone was applied to treat 20 cases of periarthritis of shoulder and the record was done before treatment and 1in which, "no any pain sensation" was 0 score, "unable to bear pain with imagination" was 10 scores. Pain score was recorded during quiet involved. 4 scores indicated being impossible completely, 3 scores indicate being possible with help, 2 scores indicate being possibled reluctantly and mostly feeling inconvenient, 1 score indicated being possible reluctantly without inconvenience and 0 score indicated being possible as healthy person.of daily life activity.RESULTS: According to practical management and analysis, 20 cases enment compared with that before treatment [(4.34±1.33),(8.27±1.37)scores,compared with that before treatment [(4.73±1.31), (8.49±1.35)scores,ment compared with that before treatment [ ( 1.10 ±0.74), (3.30 ±0.48 )scores, P ＜ 0.01]. CONCLUSION: Integration of intraarticular injection of SH with nerve and pain block with betamethasone treats effectively periarthritis of shoulder, without remarkably harmful reaction and it is worth in popularization in treatment of pain.

Objective To reconstruct three-dimensional (3D) image of heart and coronary artery on internet and explore the reliability. Methods After the contrast medium was injected into coronary artery of 2 heart specimens, hearts were scanned by UFCT with enhancement volume. One patient's UFCT images of coronary artery angiography were also chosen.Then the primitive images were transposed format, removed noise, specified interesting areas. 3D software on server was applied to reconstruct heart and coronary artery. Results The reconstructed 3D images of the heart and coronary artery were realistically displayed, freely rotated and transected.Main parts and branches of coronary artery were similar to those in the images of the UFCT. Conclusion Heart and coronary artery can be reconstructed on internet,which offers a new approach for reconstructing organs and tissues of human being.;

Objective To explore the effect of preoperative local blocking with compound lidocaine hydrochloride (CLH) on postoperative pain of patients undergoing craniotomy.Methods40 patients suffered from superatentorial occupying lesion and scheduled for craniotomy were randomly divided into the CLH group and control group with 20 cases in each group. In the CLH group, local blocking with CLH was performed just before craniotomy, while in control group local blocking with 0.5% procaine was performed preoperatively and all patients of two groups used patient-controlled intravenous analgesia (PCIA) with fentanyl postoperatively. Postoperative pain was assessed for 48 hours according to visual analogue scale (VAS), and the comparison of analgesia-related postoperative complications of the two groups was demonstrated.ResultsThere was no significant difference in VAS postoperatively and incidence rate of complications between two groups ( P>0.05).ConclusionCompound lidocaine hydrochloride local infiltration may provide a safe and effective analgesia for postoperative pain in patients after craniotomy.

Objective To explore the analgesic mechanisms of sufentanil. Methods 17 (8 male, 9 female) healthy right-handed volunteersreceived functional magnetic resonance imaging (fMRI) scan before and after sufentanil 0.2 ng/ml administration respectively. Thalamuswas as the region of interest (ROI). All the processing works were carried out using the Statistical Parametric Mapping. Results Comparedwith the basic state, significantly weaker functional connectivity was mainly found in the region of bilateral rectal gyrus and the left inferiaorbital gyrus of the frontal lobe, while significantly greater functional connectivity was found in bilateral cerebellum, the right cingulategyrus and the left middle temporal gyrus (P<0.001, cluster>13 mm3). Conclusion Thalamus plays a key role in the central analgesia ofsufentanil, which associated with the functional connectivity of bilateral rectal gyrus and the left inferia orbital gyrus of the frontal lobe, bilateralcerebellum, the right cingulate gyrus and the left middle temporal gyrus.

Objective To explore the analgesic mechanisms of sufentanil. Methods 17 (8 male, 9 female) healthy right-handed volunteersreceived functional magnetic resonance imaging (fMRI) scan before and after sufentanil 0.2 ng/ml administration respectively. Thalamuswas as the region of interest (ROI). All the processing works were carried out using the Statistical Parametric Mapping. Results Comparedwith the basic state, significantly weaker functional connectivity was mainly found in the region of bilateral rectal gyrus and the left inferiaorbital gyrus of the frontal lobe, while significantly greater functional connectivity was found in bilateral cerebellum, the right cingulategyrus and the left middle temporal gyrus (P<0.001, cluster>13 mm3). Conclusion Thalamus plays a key role in the central analgesia ofsufentanil, which associated with the functional connectivity of bilateral rectal gyrus and the left inferia orbital gyrus of the frontal lobe, bilateralcerebellum, the right cingulate gyrus and the left middle temporal gyrus.

Objective To compare the early therapeutic effects of gentamycin combined with ropivacaine and triamcinolone on trigminal neuralgia.Methods Ninety patients with trigeminal neuralgia were randomly divided into the ropivacaine group and triamcinolone group.The received nerve block peripherally was performed with gentamycin combined with ropivacaine(in the ropivacaine group)or triamcinolone(in the triamcinolone group)respectively.The parameters included pain intensity before and 1 d,3 d,1 week,2 weeks,1 month,2 months and 3 months after treatment,pain relief rate and dosage of carbamazepine of two groups were compared.Results The pain intensity in all the groups decreased at each time point.The value of numeric rating scale(NRS)in the ropivacaine group was significantly less than that in the triamcinolone group at 1 d,1 month,2 months and 3 months.Conclusion Gentamycin combined with ropivacaine is more suitable for trigeminal neuralgia than triamcinolone.

Objective To investigate expressions of CDev6 and p-ERK1/2 in AML patients and its clinical significance.Methods Expressions of CD44v6 and p-ERK1/2 on bone marrow blasts in 152 AML patients and 22 normal controls were determined by flow cytometry.Meanwhile,the effects of CD44v6 expression(CD+44v6 and CD-44v6) on relapse rate and survival time were analyzed by following up of 129 AML patients.Results Double positive expressions of CD44v6 and p-ERK1/2 were observed in 4.5%(1/22) of the normal bone marrow blasts while single positive expression of CD44v6 and p-ERK1/2 was observed in 36.2%(55/162) and 64.5%(97/162) of AML patients,respectively.The MFI of p-ERK1/2 expression on blast cells in AML patients was [14(7 -58)],which was higher than that in normal controls [8(6 - 10),U =4.2,P＜0.01].Furthermore,MFI of p-ERK1/2 expression on blast cells in CD+44v6 AML patients was [28(15-61)] ,which was significantly higher than that in CD-44v6 AML patients [18(6- 37),U =6.7,P＜0.01].A strong correlation was obtained between CD44v6 and p-ERK1/2 expression(rs = 0.7,P＜ 0.01).Among 129 patients followed up for 4 to 65 months,the data also revealed that the relapse rate of CD-44v6 AML patients was 32.1%(26/81) ,which was much lower than that in CD44v6 AML patients [81.3%(39/48),x2 = 29.13,P＜ 0.01).And the overall survival in CD44v6 AML patients was(28.5 ± 1.8)months,which was significantly worse than that of CD44v6 AML patients [(51.2±2.0) months,x2 =48.2,P＜ 0.01).Conclusion CD44v6 expression was associated with a poor survival in AML patients,and CD44v6 might promote the expansion of leukemic blast cells by up-regulating p-ERK1/2.

Objective To explore the levels of IL-1β,IL-6 and tumor necrosis factor α (TNF α) in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage and their relationship with systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS).Methods The levels of interleukin-1β(IL-1β),interleukin-6(IL-6),and TNF α in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage were measured with enzyme-linked immunosorbent assay (ELISA).Results The levels of IL-1β,IL-6,and TNFα in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage were significantly higher than those of control group (P ＜ 0.05),but the increased time of these cytokines was different.Three cytokines in serum and the cerebrospinal fluid levels of IL-1β and IL-6 but not TNFα were significantly related to SIRS and MODS.Condusions The increased cytokine levels in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage may be related to SIRS and MODS,and the measurement of IL-1β,IL-6,and TNFαin serum,and IL-1β and IL-6 in cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage can be useful to predict and treat SIRS and MODS.

Objective To investigate the characteristics of immunophenotyping and clinical significance of MRD analysis in MM patients. Methods Multi-parameter flow cytometry was applied to analyze the immunophenotyping of malignant plasma cells from 172 MM patients, and normal plasma cells from 16 healthy individuals. MRD was analyzed in 32 MM patients with remission. Meanwhile, the effects of MRD status on the disease relapse and patient disease free survival ( DFS ) time was evaluated by following up patients. Results The immunophenotyping of normal plasma cells were CD38, CD138, CD19 and CD45 positive, while the predominant phenotype of MM cells were CD+38( 100.0% ), CD+138( 100.0% ), CD-19 ( 167/172, 97. 1% ), CD+56( 152/172, 88.4% ) and CD-45( 166/172, 96. 5% ). The characteristic markers for MM cells were CD+38, CD-138, CD-19, CD-45 and CD+56. MRD analysis revealed that, among 32 MM patients with remission, 14 patients were MRD negative and 18 patients were MRD positive. During follow-up of 2 to 16 months, the relapse rate in MRD negative patients was significantly lower ( 4/14, 28.6% ) than that of MRD positive patients ( 13/18, 72. 2% ;χ2 =6. 03, P ＜0. 05 ). Furthermore, the DFS time was significantly longer in MRD negative patients[ 16. 23( 10. 37-21.62 )months ] than that of the MRD positive patients [ 10. 07( 3. 79-16. 20 )months,χ2 =7. 53,P ＜0. 05 ]. Conclusions CD+38, CD+138, CD-19, CD-45 and CD+56 are the characteristic markers of MM cells compared to those of the normal plasma cells. MRD analysis is a valuable prognostic factor for MM patients.