1 in 32; A/E

[Objective]To evaluate the effects of percutaneous plantar fasciotomy guided by real-time B-ultrasound in the treatment of recurrent plantar fasciitis. [Method]From June 1997 to May 2007,611 feet of 472 patients suffering from recurrent plantar fasciitis were treated with percutaneous plantar fasciotomy guided by real-time B-ultrasound.All the patients were aged from 20~71 years(mean 53.4 years) with the duration of disease from 6 months to 20 years(median 12 months).There were 177 males and 295 females.One foot was involved in 285 and two feet in 187 patients.A total of 611 feet,with the illness duration more than 6 months and VAS(Visual Analog Scale) ≥6 and having B-ultrasound manisfestations such as thickening of plantar fascia on calcaneum,were underwent percutaneous plantar fasciotomy guided by real-time B-ultrasound.Before operation VAS was 6 to 10(mean 8.4).Totally 376 patients were followed from 6 to 36 months(mean 18.4 months).[Result]Postoperative VAS was 0 in 349(92.8%),1~2 in 27 patients(7.2%).The time needed to achieve best postopetative effect was 7 days to 6 months.Of all the patients,302(80.3%) achieved the best effect within 7 to 14 days,56(14.9%) within 2 to 3 months and 18(4.8%) within 4~6 months.No patients were found to have complicated incision infection or injuries to medial or lateral plantar vessels and nerves.Incision scar was not obvious in all cases.[Conclusion]It can be concluded that percutaneous plantar fasciotomy guided by real-time B-ultrasound is a simple,safe and effective operative procedure in the treatment of recurrent plantar fasciitis.

Objective To analyse the mitral annular abnormal motion in patients with myocardial infarction by using M-mode and freguency spectrum Doppler tissue imaging (DTI-M), and study its clinical value in assessing the LV function. Methods The total systolic annular displacement (MD), early diastolic displacement (MDe), late diastolic displacement (MDa) of posterier valve of mitral annular, systolic and diastolic motion velocilies (V S,V E,V A), time velocity integrals (TV IS,TV IE,TV IA) of the lateral wall of the mitral annulus were determined with DTI-M mode and freguency spectrum from apical four-chamber view in 28 cases of patients with myocardial infarction. Results The MD, MDe, MDe/MDa in patients with myocardial infarction were found to be decreased significantly (P

Objective To study the features of abnormal left ventricular diastolic function in ischemic myocardium by DTI (Doppler Tissue Imaging). Methods Left ventricular diastolic function was studied before and after coronary angiography in 24 patients suspected to have myocardial ischemia, left ventricular pressure parameters were obtained by left cardiac catheterization and diastolic velocity of left ventricular posterior wall (LVPW) was measured by DTI at the same time. Results 1.The lowest left ventricular diastolic pressure increased significantly during ischemia of myocardium(P

Objective To identify the exact origin and insertion of plantar aponeurosis and the anatomic relationship of calcaneal spur to plantar aponeurosis. Methods Fourteen specimen of feet were dissected and radiographed. Three fetus feet were observed histologically. Sonographic evaluation was carried out on 20 normal adults and 52 patients with plantar fasciitis. Results (1) Anatomic observation found that plantar aponeurosis was located under the medial process of caleaneus but not attached to it, and proximally attached to the plantar aspect of calcaneal tuborosity. The insertion (origin) of plantar aponeurosis was not a point but a face. Posteriorly the plantar aponeurosis and fascia of Archlles heel were fused or transmigrated together,entirely covered and attached very coherently to the plantar and posterior aspect of calcaneal tuborosity. (2) Histological observation of heel of fetuses found plantar aponeurosis and fascia of Arehlles heel were eosinophil band-like structure. Both continued at the plantar and posterior aspect of calcaneus and attached closely to bone at this area. There were no significant demarcation between them. (3) Sonographic evaluation:normal plantar aponeurosis showed a thin band-like echo, its orgin attached to entire plantar aspect of calcaneal tuberosity and continued with fascia coming posteriorly from Archlles heel. No distinct boundary existed between these two fascias. When plantar fasciitis occurred, the orgin of plantar aponeurosis thickened significantly,this phenomenon could be detected in wholly plantar aspect of calcaneal tuberrosity. The heel spur didn't located within plantar aponeurosis. Conclusions Plantar aponeurosis orginates from entire plantar aspect of cancaneal tuberosity. Heel spur oeeures in the orgin of the intrinsic musculature, such as flexor digitorum brevis,and doesn't locate within plantar aponeurosis.

Aortic Valve ; Aortic Valve Insufficiency ; congenital ; Heart Defects, Congenital ; Heart Valve Diseases ; Humans

Objective:To analyze ultrasonic and clinical manifestation of noncompaction of the ventricular myocardi‐um (NVM) in order to guide clinical early diagnosis and treatment .Methods :Echocardiographic manifestations of 36 NVM patients were observed .Combined with electrocardiogram (ECG) ,cardiac MRI and coronary angiography (CAG) etc .,clinical manifestations of NVM were comprehensively analyzed .Results:Multiple coarse trabecular muscles and deep crypts among them were founded in heart chamber in all cases .Color Doppler showed that blood flow inside the crypts communicated with blood flow in heart chamber ,there were 33 cases (91.6% ) of left ventri‐cle type and three cases (8.4% ) of right ventricle type .Different types of abnormal ECG existed in all cases and at‐rial fibrillation occupied the largest proportion (50% ,18/36) .Some MRI results were accorded with those of ultra‐sound .In most cases ,CAG didn′t show coronary stenosis .Conclusion : Echocardiography is most convenient and effective examination ,which can provide important basis for diagnosis and treatment of noncompaction of ventricular myocardium .

Objective To investigate the effect of blockading OX40-OX40L co-stimulatory signaling on the survival time of liver allograft in rat.Methods siRNA-expression vectors were constructed to targeting OX40.3～5 minutes before DA to Lewis orthotopic liver transplantation was performed,5×109 pfu of targeting OX40 siRNA plasmid DNA were diluted in 5 ml of phosphate buffered saline(PBS)and inlected intravenously into recipient Lewis rat over a period of 10 seconds.Serum IL-2 and IFN-γ levels were assayed by ELISA,and mix lymphocyte response(MLR)were tested by 3H-thymidine.Results The survival time of recipients in siRNA treatment group(74.0±9.3)was significantly longer than that in control group[(7.3±0.5)days].In experiment group,the inflammatory cell infihration and liver tissue structure destruction were very slight.The concentration of serum IL-2 was much lower in siRNA treatment group[(46±8.4)pg/ml]than that in control group[(286.5±14.6)pg/ml].Meanwhile,the concentration of serum IFN-γ was much lower in siRNA treatment group [(202.7±14.6)pg/ml]than that in control group[(1682.7±87.9)pg/ml].Conclusion Administration of OX40-siRNA can blockade OX40-OX40L co-stimulatory signaling pathway.hence inhibit the rejection of liver allograft.