Objective To investigate the value of ultrasonic direct signs and indirect signs in diagnosis of rotator cuff tears (RCTs).Methods Fifty-two patients underwent ultrasonography before arthroscopy were enrolled.The efficacy of ultrasonic direct and indirect signs in diagnosis of RCTs was calculated,and the accuracy of ultrasonic direct signs in diagnosis of subtypes for RCTs was compared with arthroscopic results.Results The accuracy of ultrasonic direct signs in diagnosis of the presence of tears,full-thickness tears and partial-thickness tears was 90.38％ (47/52),96.15％ (50/52)and 86.54％ (45/52),respectively.Additionally,the consistency of ultrasonic direct signs in diagnosis of subtypes for RCTs with arthroscopic results was good.With regard to ultrasonic indirect signs,the specificity of effusions including all subacromial/subdeltoid bursa effusions,intra-articular fluid and biceps tendon sheath effusions,subdeltoid bursa hernia and cartilage demarcation sign was 80.95％(17/21),90.48％ (19/21) and 95.24％ (20/21),respectively.Conclusion Ultrasonic direct signs combined with indirect signs have high clinical value in diagnosis of subtypes for RCTs.

Objective To observe the value of ultrasound-guided intra-articular injection of hypertonic glucose(HG)for treating knee osteoarthritis in plateau area.Methods Ninety-one patients with knee osteoarthritis in plateau area(124 affected knee joints)were enrolled.The knee joints were divided into 20％HG group(n=67),25％HG group(n=42)or sodium hyaluronate group(n=15)based on the medication.Clinical and ultrasound scores were compared before and after treatment,and the efficacy of injection of HG was evaluated.Results At the 12th and 48th weeks after treatment,visual analog scale(VAS)scores decreased in all 3 groups(all P＜0.05),and Lysholm scores of 20％HG group and 25％HG group increased compared to those before treatment(all P＜0.05).The difference of Lysholm score before and in the 12th week after treatment,and of VAS score before and in the 48th week after treatment of 25％HG group were higher than those of 20％HG group(both P＜0.05).The joint exudation score of 20％HG group decreased in the 48th week after treatment compared to that before treatment(P＜0.05),and the synovial blood flow score decreased in the 12th and 48th weeks after treatment compared to those before treatment(both P＜0.05).The joint exudation score of 25％HG group decreased in the 48th week after treatment compared to that before treatment(P＜0.05),and the synovial hyperplasia and synovial blood flow score decreased in the 12th and 48th weeks after treatment compared to before treatment(all P＜0.05).The joint exudation score of sodium hyaluronate group decreased in the 48th week after treatment compared to that before treatment(P＜0.05),and the synovial hyperplasia score decreased in the 12th and 48th weeks after treatment compared to that before treatment(both P＜0.05).Conclusion Ultrasound-guided intra-articular injection of HG,esp.25％HG,had certain value for treating knee osteoarthritis in plateau area.

Objective To discuss the microanatomy features of jugular foramen region in transpetrosal-presigmoidal minimally invasive approach based on virtual reality image models.Methods CT and MRI scans were performed to fifteen adult cadaver heads,and then,imaging data were inputted into Vitrea virtual reality system to establish three-dimensional anatomy models of jugular foramen region.Different minimally invasive transpetrosal-presigrnoidal approaches exposing superior edge of internal acoustic meatus (route A),anterior edge of jugular foramen (route B),and posterior edge of jugular foramen (route C) were simulated by selecting osseous landmark points.Anatomic exposures in surgical trajectory following alternation of minimally invasive approach were observed,measured and compared.Results Spacial sequence of nerves and vessels in the route simulating transpetrosal-presigmoidal approach for exposure of jugular foramen region was displayed clearly;route A had the highest location and route C was the lowest.Volumes of route and petrosal osseous structure involved in route A was the largest,and then,volumes of route and osseous structure involved in route B was larger than those in route C,with significant differences (P＜0.05).Volumes of involved venous sinus were as follow:route B＞route A＞route C,with significant differences (P＜0.05).Volumes of facial-acoustic nerve complex and anterior inferior cerebellar artery involved in route A were (53.32± 5.54) mm3 and (30.55±3.51) mm3,respectively.Volumes of lower cranial nerves involved in route B were (84.59±9.23) mm3.Conclusion There are different impacts on the osseous structures and venous sinus for the minimally invasive routes of transpetrosal-presigmoidal approach exposing different targets,of which combinations are helpful to utilize respective advantages.

Objective To evaluate the effect of preoperative metabolic syndrome on early function of renal allografts in allogeneic kidney transplant recipients. Methods Clinical data of 117 kidney transplant recipients were retrospectively analyzed. According to the renal allograft function, they were divided into the delayed graft function (DGF) group (n=29) and non-DGF group (n=88). Relevant risk factors of DGF in recipients undergoing allogeneic kidney transplantation were assessed by univariate and multivariate regression analyses. The effect of preoperative metabolic syndrome on early function of renal allografts was analyzed. Results Among 117 kidney transplant recipients, 47 cases were complicated with preoperative metabolic syndrome, and 29 cases developed postoperative DGF. In the DGF group, 83% of the recipients were complicated with preoperative metabolic syndrome, higher than 74% in the non-DGF group (P<0.05). Univariate analysis showed that the body mass index (BMI) and terminal serum creatinine (Scr) level of the donors, and BMI, blood glucose level, triglyceride level and the proportion of preoperative metabolic syndrome of the recipients in the DGF group were higher than those in the non-DGF group (all P<0.05). Multivariate logistic regression analysis revealed that high Scr levels of the donors, high hemoglobin levels of the recipients and preoperative metabolic syndrome of the recipients were the independent risk factors for DGF after kidney transplantation (all P<0.05). Conclusions Preoperative metabolic syndrome is an independent risk factor for DGF in allogeneic kidney transplant recipients. Corresponding measures should be taken to lower the incidence of DGF and other metabolic complications.