Objective To evaluate the diagnostic value of MR arthrography for rotator cuff tear. Methods A prospective study was undertaken in 32 patients with shoulder diseases using MR arthrography. Abnormalities revealed on MR arthrography of the rotator cuff, the labrum, and the tendon of the long head of the biceps brachii muscle were recorded. The results of MR arthrography were compared with those of arthroscopy and surgery. Results Based on the results of arthroscopy and surgery, 32 patients comprised 14 complete rotator cuff tear, 6 partial rotator cuff tear, and 12 subjects without tear. For detecting rotator cuff tear, the sensitivity, specificity, and accuracy of MR arthrography were 100%, 100%, 100% respectively. For detecting complete rotator cuff tear, the sensitivity, specificity, and accuracy of MR arthrography were 100%, 94%, 97% respectively. Meanwhile, MR arthrography revealed all multi tendon tear and all abnormalities of the labrum and the tendon of the long head of the biceps brachii muscle before arthroscopy. Conclusion MR arthrography is an accurate and comprehensive method for evaluating rotator cuff tear.

Objective To compare the diagnostic value of conventional MRI, X ray arthrography, and MRI arthrography in revealing rotator cuff injuries. Methods Thirty two patients with suspected rotator cuff tears were prospectively examined by conventional MRI, X ray arthrography, and MRI arthrography before the examination of shoulder arthroscope. Based on the results of the arthroscopy, the diagnostic sensitivity, specificity and accuracy of those three different methods were determined for rotator cuff tears. Results The arthroscopic findings included 14 full thickness tears, 6 partial thickness tears, and 12 without tears. For the diagnosis of rotator cuff tears,the sensitivity,specificity and accuracy were 80%(16/20), 83%(10/12), and 81%(26/32) for conventional MRI,respectively; the figures were 80%(16/20),100%(12/12), and 86%(28/32)for X ray arthrography,respectively; while the data were 100%(20/20),100%(12/12), 100%(32/32) for MRI arthrography,respectively. For the diagnosis of complete tears, the sensitivity, specificity and accuracy were 79%(11/14), 83%(15/18), and 81%(26/32) for conventional MRI, respectively; the figures were 93%(13/14),94%(17/18), and 94%(30/32) for X ray arthrography, respectively; while the parameters were 100%(14/14),94%(17/18), 97%(31/32) for MRI arthrography, respectively. Conclusion MRI arthrography is one of the best methods for the diagnoses of rotator cuff tears.

Objective To determine the diagnostic value of indirect MRI arthrography for meniscal tears.Methods 75 cases of routine MRI of the knee and 64 cases of indirect MRI arthrography of the knee were retrospectively reviewed.These patients all had subsequently arthroscopic examination.Based on the results of arthroscopic examination,the diagnostic value for meniscal tear of routine MRI and indirect MRI arthrography were compared.Results For medial meniscal tears,the indirect MRI arthrography gave a sensitivity of 72%,specificity of 100%,accuracy of 89.1%,positive predictive value of 100% and negative predictive value of 84.8%.For lateral meniscal tears,the indirect MRI arthrography gave a sensitivity of 83.8%,specificity of 90.9%,accuracy of 87.5%,positive predictive value of 89.6% and negative predictive value of 85.7%.No matter for medical meniscal tears or lateral meniscal tears,the diagnostic differences between the indirect MRI arthrography and the routine MRI were not statistical significant.Conclusion Although the diagnostic value of indirect MRI arthrography for meniscal tears was quite high,it was not different with routine MRI statistically.

Objective To determine the val ue of five MR imaging signs in diagnosing the bucket handle tears (BHT) of menisci of the knee. Methods MR imaging of 139 knees with subsequent arthroscope exams were retrospectively evaluated. Based on the results of arthroscopy, 19 knees had BHT of menisci. Two radiologists evaluated each MR exam independently, with discrepancies resolved by consensus. Each MR exam was analyzed for five signs: a double posterior cruciate ligament sign, a flipped meniscus sign, an absent bow tie sign, an internal displaced fragment sign, and an abnormal circumferential meniscus sign. Sensitivity, specificity, positive and negative predictive values, and accuracy for diagnosing BHT of menisci were calculated for the presence of each individual sign. Results The sensitivities of these five signs ranged between 52.6% and 89.5%, and specificities ranged between 83.3% and 98.3%, respectively. Positive and negative predictive values ranged between 42.9% and 88.2%, and between 92 7% and 98.3%, respectively. The accuracy of these five signs ranged between 82.7% and 96 4%. Conclusion BHT of menisci may have many signs on MR imaging. The diagnostic sensitivities of the internal displaced fragment sign and the abnormal circumferential meniscus sign are the highest. The double posterior cruciate ligament sign has the highest specificity and positive predictive value, while the internal displaced fragment sign has the highest negative predictive value and accuracy.

Objective To report a new surgical approach (modified anconeus flap approach) in which the anconeus and part of triceps are reflected in the treatment of distal intercondylar humerus fracture (AO type C).Methods To design the modified anconeus flap approach,the anatomy of the distal tendon of the triceps brachii and the anconeus was studied using 15 cadaveric adult specimens (30 sides).The new surgical approach was compared with the triceps-reflecting anconeus pedicle (TRAP) approach in terms of the area of exposure at the distal humeral articular surface.Furthermore,the new surgical approach was applied in 16 patients who had been treated for intercondylar humerus fracture (AO type C) from May 2005 to May 2013.The clinical outcomes were evaluated using the Mayo elbow performance score (MEPS) and Broberg-Morrey scoring systems.Results The blood supply and innervation of the anconeus was interrupted minimally during incision along the radical edge of triceps tendon.The area of exposure at the distal humeral articular surface provided by the part triceps and anconeus reflecting approach and the medial humerus approach was 42.66％ ± 0.03％ at the elbow flexion from 0° to 50°.This was significantly smnaller than that provided by the TRAP approach (46.11％ ±0.03％) (P ＜0.05).Of the 16 patients,15 obtained complete follow-ups from 6 months to 4 years(average,16.5 months).The mean MEPS at the last follow-up was 90.5 points (range,from 82 to 93 points),with 10 excellent and 4 good cases and one poor case.The Broberg & Morrey score system showed 11 patients with no articular cartilage degeneration (level-0),3 patients with level-1 degeneration,and 2 patients with level-2 degeneration.Conclusion The modified anconeus flap approach proposed in the present study provides clear surgical vision and needs no olecranon osteotomy or olecranon dissection or ablation of the major triceps brachii tendon for intercondylar humerus fractures,thereby leading to early active motion and satisfactory clinical outcomes.

Purpose:To investigate the relationship between the expression tansforming growth factor ?(TGF ?) and the differentiation, invasion of colorectal adenocarcinoma.Methods:To observe the expression of transforming growth factor ? and transforming growth factor ? receptor in 68 samples of colorectal adenocarcinoma with immunohistochemical technique. Results:The cells with positive reaction of TGF ? antibody were scattered in the stroma. The cells with infiltrative growth had positive TGF ? staining.Conclusions:It was indicated that TGF ? might play an important role in the invasion and metastasis of colorectal adenocarcinoma.

OBJECTIVEThis study aimed to explore the differences of membrane thickness and pressure on the paranasal sinus membrane in goats and analyze their causes. The results can provide theoretical basis and guidance for the issues of the maxillary sinus floor augmentation related to the membrane.

METHODSThe membrane was cut into two sizes from every sinus membrane. The membrane was fixed in formalin to obtain tissue specimens for the membrane thickness study and pressure study. The correlation between the two parameters was then analyzed, and appropriate statistical methods and software were selected.

RESULTSThe top of maxillary sinus, the bottom of maxillary sinus and the frontal sinus membrane thickness were (410.03 ± 65.97), (461.33 ± 91.37), (216.90 ± 46.47) µm. The pressure were (260.08 ± 80.12), (306.90 ± 94.37), (121.72 ± 31.72) kPa. The mean differences of the membrane thickness between the top of the maxillary sinus and the frontal sinus, bottom and frontal, and top and bottom were statistically significant (P < 0.05). The mean differences in membrane pressure were also statistically significant (P < 0.05).

CONCLUSIONThe membrane thickness and pressure of the top and bottom of the maxillary sinus are higher than those of the frontal sinus membrane. However, the thickness and pressure of the bottom membrane are slightly higher than those of the top membrane. Pressure and membrane thickness are positively correlated in the sinus membrane.

ObjectiveTo evaluate the curative effect of reconstruction of the hand and foot defects with bones and tendons exposure using free medial sural artery perforator flap(MSAP). MethodsRadiographs of 2 cadavers injected with a modified lead oxide-gelatin mixture were digitally analyzed. Between April 2007 and December 2010, thirty-four patients with soft tissue defects in the distal limb were treated with the free MSAP flap transplantation. The sizes of the defect ranged 6 cm × 4 cm-13 cm × 8 cm, and the flaps ranged 7 cm× 5 cm-14 cm × 9 cm. These clinical cases included 25 hands and 9 feet, all of them with bones and tendons exposure.In these defects,twenty-two were clean,twelve got infections.In our cases, twenty-three flaps were nourished with single perforator vessel and else 11 with two;perforator vessel fifteen flaps were dissected one superficial vein to anastomose with that of the recipient sites in addition to accompanying vein anastomosis;The sensation of 9 flaps recovered the hands were reconstructed with cutaneous nerve anastomosis. ResultsA partition of the calf skin blood vessels,and three-dimensional reconstruction image of the sural artery were obtained.All flaps survived,five of them appeared partially violet and bubbles. Followed up 6-21 months, the cosmetic results were satisfactory and without apparent bulkiness.The flap colors were similar to recipient sites. The flap senses reconstructed with neural anastomosis recover to S2-S3. ConclusionThe new flap is very suitable to repair the soft tissue defect in the distal limbs,because the fairly constant perforator vessel,the reliable blood supply and the cosmetic shape of the MSAP flap are all advantages of it in addition to no damage to low leg chief artery and gastrocnemius.

OBJECTIVE To study the constituent ratio of the Gram-negative bacteria of blood culture in recent 36 months and their resistance.METHODS Blood culture of patients in our hospital was performed by BacT/Alert 3D and the isolated bacteria were identified by API identified tests(API Inc.France) and additional antibiotics sensitivity test by Kirby-Bauer(K-B).RESULTS Of the 13766 specimens,1468(10.6%) were positive,including 734 Gram-negative bacteria strains(50.0%),476 Gram-positive bacteria strains(32.4%),233 fungi strains(15.9%),and 25 others strains(1.7%).CONCLUSIONS It is important and necessary to monitor the circumstance of the Gram-negative bacteria of blood culture.

Objective: To study the effect of the modified preparation method with root canal flushing of different solutions on the anti-fracture properties of mechanical nickel-titanium filings. Methods: A transparent resin model of root canal was established. ProTaper Universal (PTU F1) instrument was used to prepare the root canals. The number of prepared root canals by each PTU F1 with the various solutions(n = 20) was recorded and compared among groups. Results: 6. 13 ± 3. 52 root canals were prepared in distilled water group, 6. 25 ± 1. 76 in 0. 9％saline group, 6. 27 ± 2. 07 of 0. 2％ chlorhexidine group, 6. 88 ± 3. 21 in 1％ sodium hypochlorite group, 4. 31 ± 2. 34 in 5％ sodium hypochlorite group and 3. 26 ± 2. 08 in dry drilling group. The number between each 2 of distilled water, 0. 9％saline group, 0. 2％chlorhexidine group and 1％ sodium hypochlorite group, and the number between 5％ sodium hypochlorite group and dry drilling group was not statistically significant(P＞ 0. 05). The number of prepared root canals in the first 4 groups was more than that in the latter 2 groups(P＜ 0. 05). Conclusion: Distilled water, 0. 9％ saline, 0. 2％ chlorhexidine or 1％ sodium hypochlorite for root canal irrigation can improve mechanical nickel-titanium instrument for fatigue resistance in root canal preparation, but 5％ sodium hypochlorite and dry drilling can not.