Objective To evaluate the diagnostic value of Achilles tendon rupture by using X-ray plain films and MR images. Methods The plain films and MRI findings in 21 patients with operation proved acute Achilles tendon rupture were analyzed, and every manifestation on MR and operation were compared.Results The Achilles tendon rupture was diagnosed on MRI in all 21 cases. Complete rupture of Achilles tendon was showed in 7 and partial rupture in 14. MRI appearance of the rupture represented as thickening of Achilles tendon, hyperintensity in the tendon, and completely or partly discontinuance of the fibrous bundle. X-ray showed Achilles tendon rupture in 5, suspicious rupture in 12, and normal in 4. Operation showed Achilles tendon complete rupture in 9 and partial rupture in 12.Conclusion MRI can accurately show the degree and location of acute Achilles tendon rupture, which is very helpful for treatment. X-ray is the adminicular method in detecting Achilles tendon rupture and the diagnosis should be depended on MRI to confirm the the acute Achilles tendon rupture.

Dihydroartemisinin is an important derivative of artemisinin. We used dihydroartemisinin as the starting material, through esterification, amination and acylation, a series of novel piperazine-sulfonamide contained dihydroartemisinin derivatives were firstly synthesized and their chemical structures were confirmed by IR, 1H NMR, 13C NMR and HR-MS. X-diffraction was used to determine the final configuration of the compound 3c. And the in vitro anti-HeLa activities of compounds 3 were analyzed with CCK-8 method. The preliminary bioassay test shows that compound 3 showed the best inhibition activities against HeLa with IC50 values of 0.14 micromol x L(-1).

Objective To study the condition and method of hydrodynamics-based transgene(HDT) in rat fatty liver. Methods Inject different dosages and concentrations of green fluorescent protein plasmid pEGFP-C1 at different speeds, then collect 4 rats' liver leaves at different time points after injection and prepare their frozen section, finally observe and quantify the GFP expression with fluo rescence microscope at 488 nm excitation wavelength. Results Plasmid pEGFP-C1 concentration 33mg/L, injection speed 2ml/s, injection volume 8.5%of rat body weight, injected plasmid. After 6 hours of injection, GFP-positive cells rate of pedicel leaf is about 18%, left leaf about 14%, middle leaf about 12.5%;R3ight leaf about 10% and tail leaf about 8%. GFP begin to gradually reduce since 24 hours, until 72 hours almost no GFP-positive cells were checked in all liver leaves. Conclusion Hydrodynamics-based transgene can be applied to rat fatty liver, the appropriate conditions of this method are 33mg/L plasmid concentration, 8.5% rat avoirdupois, 2ml/s injection speed, and the suitable time to observe the proportion of GFP-positive cells is 6-24 hours after gene injection.

Objective To analyze MRI findings and its clinical significance in complications of polyamide hydrogel injection for augmentation mammoplasty. Methods The complication findings of MR imaging in 20 cases with polyamide hydrogel injection for augmentation mammoplasty were retrospectively reviewed and analyzed. Results In 20 patients, 26 breasts suffered from complications, including infection (n=5) with pieces of long T_1and long T_2 signals, aseptic inflammation (n=2) with pieces of slight long T_1and moderate T_2 signals, hard nodule (n=10) with long T_1 and long T_2 signals, and rupture (n=5) with pieces and nodes of long T_1 and long T_2 signals on MR images. Conclusion MRI has the great diagnostic value in the detection of complications after polyamide hydrogel injection for augmentation mammoplasty, and it should be taken as the first diagnostic choice.

Objective To investigate the effects of attention training, spatial and position sensation training and lower limb coordination training on balance and movement coordination of post-stroke patients. Methods 100 stroke patients were randomly divided into control group and observation group with 50 in each. The control group received routine rehabilitation, and the observation group received attention training, spatial and position sensation training and lower limb coordination training additionally. Both groups were assessed with Static Balance Test Equipment and Berg Balance Scale (BBS) before and 1 month after training. Results The balance function improved after training (P<0.05). Compared with the control group, the length of path (L), the covered area (A) and L/A in observation group significantly decreased (P<0.001), and the BBS score significantly increased (P<0.001) after training. Conclusion Strategic and targeted training such as attention training, spatial and position sensation training and coordination training, could improve static balance of post-stroke patients.

Objective: To explore the effect of single-nostril transsphenoidal approach on pituitary adenoma. Methods: We retrospectively analyzed 46 cases of pituitary tumors treated with single-nostril transsphenoidal approach and the effects and complications of surgery.Dunng the surgery,a nasal speculum was inserted through right nostril slowly towards the anterior wall of sphenoid sinus.A nasal mucosa incision of about 1.5cm was made in the right nasal cavity at the level of the middle nasal turbinate.With a fracture of the bony septum,a space was developed between the bilateral nasal mucosa and bony septum to the sphenoid sinus.Then,the face of the sphenoid sinus was exposed.The remainder of the bony septum,the anterior sphenoid sinus wall,and the sphenoid mucosa were removed.The antenor sphenoidotomy should be less than 1.5cm wide.After confirming the tumor by dural puncture,a cross incision of dura was made and the tumor was removed.The saddle was usually Collapsed and visible after total tumor removal.When the tumor was resected,sevaral gelatin sponges were stuffed into the Surgical cavity to stop bleeding. Results: Thirty-four cases had total resection and 12 cases had subtotal resection.No deaths or disability occurred.Hormone levels in almost all patients were improved.Seventeen cases had a sign of diabetes insipidus.Electrolyte disturbance occuwed in 5 cases.NO postoperative cerebrospinal fluid rhinorrhea was observed. Conclusion: Single-nostril transsphenoidal approach has many advantages in treating pituitary adenomas such as simplified approach,brief technology and high security.

[Objective]To compare the differences of neuromyelitis optica spectrum disorder(NMOSD)and multiple sclerosis (MS) on pregnancy ,and analyze the mutual impact of pregnancy on the diseases.[Methods]Prospectively collected clinical information of 235 NMOSD patients and 125 MS patients ,including the annualized relapse rate (ARR),the Expanded Disability Status Scale(EDSS)and pregnancy outcomes. 70 NMOSD patients and 30 MS patients were screened out as information patients. The ARR and EDSS score in two groups were compared during the year before pregnancy,during pregnancy and after 1 year postpartum, respectively. 50 cases of normal pregnant women for the same period as the control group ,then to compared the difference of three groups on pregnancy outcomes.[Results]Attacks occurring during pregnancy or one year after childbirth/abortion in NMOSD and MS were 53.25%(41/77)and 20.00%(7/35)(P=0.001);The ARR during the first 3 months postpartum periods of NMOSD and MS group(2.65,2.51)was significantly higher than during the year before pregnancy(0.27,0.49,P < 0.001)and during pregnancy (0.32,0.2,P<0.001);The EDSS score of two groups increased after 1 year postpartum(3.06 ± 2.16,2.19 ± 1.28)than that during the year before pregnancy(1.58 ± 0.48,1.92 ± 1.29,P < 0.001)and during pregnancy(1.92 ± 1.35,1.67 ± 0.70,P < 0.001). There was no difference on ARR and EDSS score between NMOSD and MS group. NMOSD ,MS and normal control group had no dif?ference on pregnancy outcomes and neonatal weight.[Conclusions]Compared with MS,the attack of NMOSD had more closer relation?ship with pregnancy;both NMOSD and MS would increase the risk of disease relapsing and disability after pregnancy;the diseases had no effect on pregnancy outcomes.

OBJECTIVE: To evaluate the effect of integrated traditional Chinese and Western medicine therapy on the progression of acute renal failure in patients with chronic renal insufficiency. METHODS: Thirty-two patients with chronic renal insufficiency developed acute renal failure recently were treated with Chinese herbs and western drugs intravenously and clysterizing of Chinese herbs liquid for 30 minutes, and the treatment course was 14 days. Assessment of liver and renal function, blood routine, electrolytes and endogenous creatinine clearance rate (Ccr) was performed before and 2 weeks after the treatment. RESULTS: The levels of hemoglobin (HB), white blood cell count (WBC) and serum electrolytes showed no significant changes after the treatment. The levels of blood urea nitrogen (BUN) and serum creatinine (SCr) decreased, while the level of Ccr increased significantly (P<0.05) after the treatment. The total effective rate was 65.6%. CONCLUSION: The integrated traditional Chinese and Western medicine therapy can effectively delay the deterioration of renal function in patients with chronic renal insufficiency accompanied by acute renal failure.

Objective To evaluate carotid endarterectomy (CEA) for bilateral moderate to severe carotid stenosis.Methods The clinical data of 59 patients with bilateral moderate to severe carotid stenosis who were treated with CEA in our hospital from October 2010 to August 2014 were retrospectively analyzed.There were 50 males and 9 females age ranging 42-80 years (mean:65 ± 9 years).48 patientsunderwent ipsilateral CEA and 11 underwent staged bilateral CEA.In patients who were confirmed to have coronary artery disease or peripheral vascular disease by preoperative angiography,6 received coronary artery bypass graft (CABG)simultaneously,1 received iliac artery balloon angioplasty and stent implantation simultaneously,and 1 received renal artery stenting simultaneously.Results A total of 70 endarterectomies were performed,shunt and patching were used in all patients,the surgical success rate was 100％.2 patients suffered from vagus nerve injury,4 patients suffered from hypoglossal nerve injury,and 3 patients presented with hyperperfusion syndrome.Follow-up period was 2-36 months (mean:19 ± 10 months).1 patient died of heart attack during the follow-up,the other patients were relatively stable with no restenosis.Conclusion CEA should be performed in patients with bilateral moderate to severe carotid stenosis,and the prognosis is good.

The clinical data of 21 patients with carotid body tumor (CBT) were analyzed retrospectively.The lesions were unilateral (n =20) and bilateral (n =1).Among 20 surgical cases, the procedures included tumor resection alone (n =11) , tumor resection along with external carotid artery (n =6) and vascular reconstruction of carotid artery after resection of tumor body (n =3).No mortality occurred during perioperative period.CBT was confirmed by pathologic examination in all cases and 1 case was malignant.Follow-up period ranged from 3 months to 7 years and the follow-up rate was 85％.Five cases of cranial nerve impairment recovered completely over 3 months.One case of bilateral CBT underwent contralateral tumor resection at another hospital 1 year later and 1 case with malignant tumor died from metastases 3 years later.The remainder survived recurrence-free.CBT tends to be misdiagnosed.Therefore ultrasonography, digital subtraction angiography (DSA), CT angiography (CTA) or magnetic resonance angiography (MRA) are important for preoperative diagnosis and evaluation.Surgical resection is a first choice for CBT.