Presently,with anterior cruciate ligament reconstruction using autogeneic hamstring tendon graft is generally developed,the influencing factors and promotion methods of tendon-bone healing become a research focus of sports medicine.The influencing factors include the graft fixation,the character of bone,stress stimulation and the matching relation between graft and bone tunnel and so on.The promotion methods include applying growth factors,metalloprotease blocking agent,osteoprotegerin,mesenchyme stem cells,physical methods.Some prospective methods of promoting tendon-bone healing have been found,but these methods are in animal study or involving complex laboratory technique.Thus,these methods require further studies before clinical application.

Objective The purpose of this study was to investigate the relationship between oxygen consumption (VO2) after recovery from incremental maximal exercise and the levels of the blood lactate (HLa), glucose and alanine metabolism. Method The VO2, HLa and plasma alanine were obtained using a modified version of Bruce' s protocol 30 min after exhaustion for 10 men. Result The VO2 after recovery has returned to the pre - exercise, but the HLa concentrations and plasma alanine were significantly increased from rest to maximal exercise, and were significantly decreased thereafter, but remained above resting values for 30 min after maximal stage. Conclusion we conclude that oxygen consumption after exhaustive maximal exercise is related to glucose resyntbesis through alanine metabolism, as compared with that from lactate metabolism.

Small knife needle plus manual reduction method was used to treat the transverse process syndrome of the third lumbar vertebra. The small knife needle was adopted to loosen the third vertebra with little invasion and manual reduction method to remove adhesion by pulling back and forth. Among 859 cases treated, 652 cases were cured and 196 cases improved, with the total effective rate of 98.8%. It is indicated that small knife needle plus manual reduction method has positive effects on the transverse process syndrome of the third lumbar vertebra as well as other soft tissues injury.

Objective To discuss the diagnosis and treatment of partial-thickness rotator cuff tears.Methods A total of 14 cases of partial-thickness rotator cuff tears from April 1999 to January 2004 were surgically treated in this hospital.Before operation,X-ray examinations at anteroposterior view and at scapular outlet view were conducted in all cases,B-ultrasonography was conducted in 11 cases,and magnetic resonance imaging(MRI) or magnetic resonance arthrography(MRA),in 14 cases.Subacromial decompression and tear debridement was performed in 5 cases,while subacromial decompression and rotator cuff repair was performed in 9 cases.The University of California Los Angeles(UCLA) shoulder scoring system was used to evaluate the outcomes.Results The partial tears were identified at bursal-side in 7 cases and at articular-side in 7 cases.The 14 cases were followed for 1~6 years(mean,38 months).The UCLA scores were elevated from 15.9?3.9 preoperatively to 30.9?5.2 postoperatively(t=15.000,P=0.000).The curative results were classified as "good" in 13 cases and "poor" in 1 case.Conclusions Arthroscopy is a reliable method for the diagnosis of partial-thickness rotator cuff tears,which can be effectively treated with rotator cuff repairs.Arthroscopic repair gives little invasion and quick recovery.

Objective To study clinical results of arthroscopically assisted mini-open rotator cuff repair.Methods Twenty-two patients with rotator cuff tears were treated with arthroscopically assisted mini-open rotator cuff repair from March 1999 to March 2004.Thirteen patients underwent arthroscopic inspection,mini-open subacromial decompression,and rotator cuff repair.Nine patients underwent arthroscopic subacromial decompression and mini-open repair.The UCLA scoring system was used for outcome assessment.Results The 22 patients were followed for 12-72 months(mean,47 months).The UCLA scores were increased from 14.8?3.8 preoperatively to 32.0?4.7 postoperatively(t=15.086,P=0.000).The results were classified as excellent in 7 patients,good in 13 patients,fair in 1 patient,and poor in 1.Twenty patients were satisfied with the operative outcomes.Conclusions Arthroscopically assisted mini-open rotator cuff repair is an effective procedure for rotator cuff tears,with simplicity of performance and little invasion.

Objective To investigate the predictive value of mnodified early warning score (MEWS) in predicting emergency potential in critically ill patients and its feasibility.Methods A total of 298 patients in the emergency department and emergency room were evaluated using the MEWS.The distribution of transfer to cadiopulmanary resuscitation (CPR),intensive care unit (ICU) and high dependency unit (HDU),length of hospital stay ( more than 1 month or not) and transferred to advanced hospital,death were recorded,and all patients were followed up.Results Patients with different MEWS were treated significantly differently ( x2=258.697,P ＜ 0.001 ),and their prognosis were also significantly different ( x2=115.938,P ＜ 0.001 ).the condition of patiens were significantly correlated with MEWS ( r=0.848,P ＜ 0.001 ).Conclusion The MEWS in the prediction of potential in critically ill patients in emergency department is feasible as a special emergency assessment system and is recommended for promotion.

Objective To summarize the clinical experience of diagnosis and arthroscopic treatment of intratment of intra ular osteoid osteoma.Methods Seven patients(average 22.4 years old with range from 11～32 years)with intra-articular Osteoid osteoma who underwent arthroscopy treatment from March 2006 to June 2009 were studied respectively.Thin-section CT scanning was used to confirm diagnosis and determine surgery location.Results The time span between the appearance of clinical symptoms and confirmed diagnosis was 26.0 months on average(range from 18 to 36 months).At a mean 19-month follow-up,all patients showed significant improvements including VAS decrease,no recurrence,pain relief and normal range of motion.Conclusion The atypical clinical features and radiographic findings of osetoid osteoma might lead to the delayed diagnosis.Using arthroscopy to remove intro-articular osteoid ostema was a safe and effective way.

Objective To explore the clinical results of arthroscopic subacromial decompression (ASD) for treatment of subacromial impingement syndrome. Methods Twelve cases with subacromial impingement syndrome from October 1998 to November 2003 were retrospectively studied. There was one case at degree Ⅰ, five at degree Ⅱ and six at degree Ⅲ according to Neer classification. Preoperative X-ray of obverse shoulder joint and outlet supraspinatus muscle was made. Seven cases was examined with ultrasonography and 10 with MRI or MRA. All cases were treated with arthroscopic subacromial decompression and arthroscopic acromioplasty and six cases underwent simultaneously arthroscopic suture of the rotator cuff. Results The follow up for 1-6 years (average 26 months) showed significant statistical difference upon preoperative UCLA score and postoperative UCLA score that were 16.9?4.0 and 32.5?1.4, respectively (t=-14.027,P﹤0.01). The results were excellent in two cases and good in ten. All cases were satisfied with the operation. Conclusions ASD is shown to be an effective procedure for subacromial impingement syndrome and has the advantages of minimal trauma and rapid postoperative recovery.

Objective To study the frequency and characteristics of secondary monoclonal gammopathy of undetermined significance(sMGUS) in multiple myeloma (MM),and analyze the impact on survival.Methods The data of 515 patients with MM admitted were analyzed retrospectively.73 cases of patients underwent stem cell transplantation and 442 patients received thalidomide or bortezomib based chemotherapy.Immunofixation electrophoresis(IFE) and clinical characteristics were respectively analyzed,and the comparison of survival between sMGUS group and non-sMGUS group was performed.Results Thirty-five cases (6.8 ％) of myeloma patients with sMGUS were found in all patients.The incidence of sMGUS after hematopoietic stem cell transplantation treatment is significantly higher than that of receiving chemotherapy (19.2 ％ versus 4.8 ％,x2 =20.587,P =0.002).The CR rates of sMGUS group and non-sMGUS group were 45.7 ％ (16/35) and 14.3 ％ (59/480) (x2 =22.961,P ＜ 0.001).The median survival time of patients with sMGUS was much prolonged compared with the control cohort (42.0 versus 14.0 months,P ＜ 0.001).However,when the analysis was restricted on patients underwent stem cell transplant,patients with sMGUS had a negative impact on outcome,and the median overall survival was 30.8 and 39.3 months (P =0.002).Conclusion The sMGUS may be attributed to either immune reconstitution or immune system dysregulation after highly immunosuppressive therapy.The incidenceof sMGUS after auto-SCT treatment is higher than chemotherapy.The sMGUS group has the higher response rate and longer survival.But for auto-SCT treatment patients,sMGUS may be not a good prognostic factor.

Objective To analyze imaging infarct patterns and features in patients with severe stenosis or occlusion of internal carotid artery (ICA) and middle cerebral artery (MCA)from the point of view of diffusion-weighted imaging (DWI) and to investigate the infarction related mechanism. Methods Eighty-eight patients with acute ischemic stroke who had moderate to severe ICA or MCA stenosis or occlusion confirmed by cerebral angiography were analyzed retrospectively. They were divided into ICA lesion and MCA lesion groups. The infarct patterns were classified as single and multiple according to DWI. The former were reclassified as perforating artery infarct (PAI), pial infarct (PI), watershed infarct, and large infarct. Results There were 11 types of infarct patterns in MCA territories. The DWI multi-infarct pattern accounted for 62.5% of all patients (55/88). PI with watershed infarction appeared more often in the ICA lesion group (11/45, P=0. 040), and PI with PAI appeared more often in the MCA lesion group (10/43, P = 0. 037). Conclusions In patients with cerebral infarction associated with ICA or MCA severe stenosis or occlusion, most of them showed multi-infarct pattern,which suggested the mixed mechanisms such as embolization, hypoperfusion/impaired clearance of emboli, and local perforating branch occlusion were the main mechanisms of the occurrence of cerebral infarction. The main mechanism of cerebral infarction in the ICA lesion group was embolization combined with hypoperfusion/impaired clearance of emboli, while in the MCA lesion group was embolization combined with local perforating branch occlusion.