BACKGROUND:Nonunion is a common clinical problem of bone fracture. For decades, with the help of
internal/external fixation materials, popularization of microsurgical technique, innovation of bone graft materials, especial y molecular biology techniques, breakthrough progress has been made in the treatment of nonunion. OBJECTIVE:To summarize the research progress of treatment in nonunion and to provide better technology theory and choices of method for the treatment of nonunion in future.
METHODS:The PubMed database and CNKI database were retrieved by the first author for the articles related to reason and treatment method of nonunion published from January 1990 to May 2013. The key words were
“fracture nonunion, treatment, progress”. For the articles in the same field, those published recently or in authorized journals were selected.
RESULTS AND CONCLUSION:The repetitive and old articles were eliminated, and final y 48 articles were selected for further analysis. At present, two methods can be used in the treatment of nonunion, including
nonsurgical method and surgical method, the surgical method is utilized more frequently and more efficiency in clinic. Fracture healing is the complex process involving various aspects, and once the nonunion occurred,
different patients should be treated with different methods, and the combination of various surgical and
nonsurgical methods can be used if necessary to obtain satisfactory effect. But al the treatment methods should pay attention to soft tissue protection.

Objective: To study the effect of steam-heated procedure on immunogenicity of major antigenic proteins in soybean. Method: Twelve newborn calves were randomly divided into 3 groups (Group A, B and C). Each group of the calves were fed on the diets containing raw soybean flour, heated soybean flour and whole milk, respectively. The glycicin, ?-conglycinin and neighbor collection as antigens, antibodies specific to soy allergens were detected by ELISA. Results: (1) The weight gain was A

Objective To evaluate the endoscopic tendon sheath release for stenosing tenovaginitis (trigger finger). Methods Five patients with stenosing tenovaginitis (2 in thumbs, 1 in middle finger, and 2 in ring fingers) underwent operations by Smith & Nephew Endoscopic Trigger Finger Release system. After two 3.0mm transverse incisions were made, the window cannula assembly was inserted subcutaneously along the sheath from the proximal portal and advanced until it passed through the distal portal. Then a 2.7 mm endoscope was passed into from the proximal portal and a retrograde knife was introduced into the operative site from the distal portal. Finally the entire length of sheath was sectioned under direct endoscopic vision. Results All operations were successfully completed. Finger's flexion and extension function recovered immediately after the operations. All the patients restarted their employment one week postoperatively. There were no complications such as distinct pain or delayed wound healing in these patients. Conclusions This method has the advantages of minimal invasion, safety, effectiveness and quick recovery, especially suited to diabetic patients or multiple trigger fingers.

Objective To introduce our surgical experience and techniques of endoscopic carpal tunnel release (ECTR) by Chow technique (two-portal technique). Methods A total of 30 endoscopic procedures in 25 patients with carpal tunnel syndrome (CTR) were performed. Results Follow-up evaluations for 1～12 months were made in all the patients. The sensibility of radial 3 fingers and a half returned to normal at postoperative 4～6 weeks in 20 sides of 18 patients. The greater thenar atrophy and opposition dysfunction in 10 sides of 7 patients disappeared at 8～12 postoperative weeks. No serious complications occurred in this series. Conclusions ECTR by Chow method has advantages of short incision, minimal invasion and rapid recovery, being an easy, safe and reliable minimally invasive procedure.

Objective To investigate the necessity of releasing the distal holdfast fibers of the flexor retinaculum(DHFFR) during endoscopic carpal tunnel release(ECTR).Methods The Experiment Group included 16 cases.The operation was conducted under brachial plexus anesthesia without the use of tourniquet.A 1 cm skin incision was made.The USE system(Universal Subcutaneous Endoscope System) was employed.Both flexor retinaculum(FR) and distal holdfast fibers of the flexor retinaculum were cut off.Postoperative outcomes were compared with another 16 cases of flexor retinaculum release only(Control Group).Results Follow-up evaluation was carried out at 6 postoperative months.According to the Kelly's criteria,there were 13 cases of excellent results and 3 cases of good results in the Experiment Group,and 8 cases of excellent,5 cases of good,and 3 cases of fair results in the Control Group.Significant difference was obser red in flameda Ⅱ or Ⅲ grade patients between the two groups in carative effects(?~2=6.278,P=0.043).No serious complications or postoperative recurrence occurred.Conclusions Flexor retinaculum is not the only structure existing in the carpal canal to be released.More attention should be paid to complete decompression of both flexor retinaculum and distal holdfast fibers of the flexor retinaculum,especially in those who have serious symptoms.

BACKGROUND:Microtubule-associated protein-2 is a kind of important regulatory factor in regulating tubulin assembly. As one of the main members of microtubule-associated proteins, microtubule-associated protein-2 plays an important role in the repairing and development of the nervous system function. It has been found that microtubule-associated protein-2 can promote the repair and rebuilding of injured nerves. OBJECTIVE:To summarize the relationship between microtubule-associated protein-2 and nerve injury as wel as the mechanism of action. METHODS:The PubMed database and CNKI database were retrieved by the fist author for the articles related to microtubule-associated protein-2 published from January 1976 to January 2015. The key words were“microtubule-associated protein-2 (MAP-2), nerve injury, progress”in English and Chinese, respectively. In the same field, articles published recently or in authorized journals were preferred. Repetitive or old articles were excluded, and final y 82 articles were included in result analysis. RESULTS AND CONCLUSION:Microtubule-associated protein-2 is involved in nerve repair, and plays a promoting role in neuronal morphology and plasticity. To increase the concentration of microtubule-associated protein-2 contributes to the recovery of neurologic function in the early stage after nerve injury.

Objective To study the ulnar nerve and its adjacent structures in the forearm and understand the anatomic basis for endoscopic harvesting of the ulnar nerve for the treatment of brachial plexus avulsion injury. Methods Ulnar nerves and their adjacent structures in 6 formaldehyde solution fixed upper limb specimen and 26 fresh upper limb specimens were carefully dissected and observed and measured. The entry path and implementation were designed according to the observations. Simulated operation was performed in 6 fresh autopsy specimens Results In the forearm, ulnar nerve passes through the flexor carpi ulnaris under the medial epicondyle of the humerus and the dorsal branch of the hand passes between the ulnar bone and flexor carpi ulnaris. Also the ulnar nerve descends through intermuscular space, accompaning the ulnar artery in the distant part of the forearm and the artery lies laterally along the nerve. The simulated operations were successfully done in all the 6 specimens. Conclusions The anatomy of the ulnar nerve in the forearm is fairly fixed with no crossing with important structures in its path, incisions of 1～2cm are made above the pisiform bone and under the medial epicondyle of the humerus 3～5cm respecitvely, After isolation of the ulnar nerve's two crosses from the muscle, the remaining part of the ulnar nerve and its adjacent structures are easily dissected. It is concluded that it is safe and reliable to harvest the ulnar nerve in the forearm with endoscopy.

Objective To introduce a new technique--Carpal tunnel release by Okutsu's technique Methods A 1cm skin incision was made under local anaesthesia without tourniquet. The procedure was performed by system (Universal Subcutaneous Endoscope System). Postoperative functional assessment was done by Kelly's standards. Follow-up was conducted in the first, third and twelve month after the operation. Results One hundred and forty-nine sides of 126 cases of CTS were treated with this method. And seventy eight sides of 69 cases of CTS were followed up. 54 cases were excellent; 19 cases good; 3 cases fair; 2 cases poor. The average time of the operation was ten minutes. There was less blood lost in the procedure. Complication occurred in one case. Conclusions As compared with open procedure, the method has advantage of minimal incision,less tissue damage, shorter operation time, less skin scar and no postoperatioven plastic splint. The therapeutic results was as efficient as routine procedure.

BACKGROUND: Internal fixations with plate and screw or K-wira tension band are widely used in treating olecranon fracture; however, the internal fixations need to remove by a second surgery. OBJECTIVE: To retrospective analyze the therapeutic effect of treating olecranon fracture using biodegradable tension band. METHODS: Nine olecranon fracture patients received at the Shanghai East Hospital of Tongji University from July 2006 to April 2009 were selected. All patients were treated by biodegradable tension band fixation which comprises absorbable screw and absorbable suture. Elbow joint functional exercises were performed at 3 weeks after plaster extema! fixation. The patients were followed up for 12 months, and the therapeutic effect was measured by X-ray films and Mayo score of elbow joint function. RESULTS AND CONCLUSION: Imaging examination showed that the fracture healing well in all cases, and the fracture line was blurred. No ulnar nerve compression, fracture, or fracture displacement could be seen. Biodegradable tension band fixation can provide adequate intensity for functional exercises, which has the virtue of effective fixation without a second surgery to remove fixation. It is believed to be a good method for the treatment of olecranon fractures.

AIM: To establish a method of simultaneously determining 5 components in Muxiang Fenqi Pill(Flos Caryophylli,Radix Aucklandiae,Cortex Magnoliae Officinalis). METHODS: Five components :eugenol,(costunolide),dehydrocostuslactone,magnolol and honokiol in Muxiang Fenqi Pill were determined simultaneously by HPLC,using a Kromasil C_(18) column(250 mm?4.6 mm,5.0 ?m),acetonitrile-menthanol-water(50∶8∶42) as a mobile phase.The detection wavelength was at 210 nm. RESULTS: The relationship between the concentrations and the peak areas of eugenol,costunolide,dehydrocostuslactone,magnolol and honokiol were linear respectively.The RSD of precision,repeatability and recovery were all less than 1.5%. CONCLUSION: The method is simultaneous determination for five components in Muxiang Fenqi Pill,and can be applied to the quality control of Muxiang Fenqi Pill.