Objective To identify whether the branches of cervical nerve roots joined into the accessory nerve trunk or not.Methods In 10 adult cadavers (7 males and 3 females, including 20 laterals of brachial plexus nerves), we observe source of cervical plexus branches to the accessory nerve anatomically.In 10 clinical cases of males with brachial plexus nerve injures, in the supraclavicular approach of brachial plexus exploration, the part of the supraclavicular cutaneous nerve for histological specimen were cut off;in the posterior approach, electrical stimulation of the trunk and branches of cervical plexus were performed to observed istaltrapezius muscle contraction.After accessory nerve transfer, the residual terminal accessory nerve and branch of cervical plexus were taked for histological specimens;and observed and judged of each nerve sample by acetylcholinesterase (AchE) immunohistochemical staining.Results In 10 of 20 lateral cases, cervical plexus communicating branches were derived from the fourth cervical nerve root.The intraoperative electrical stimulation of the accessory nerve trunk, 10 cases of distal trapezius muscle were significantly shrink;electrical stimulation of the cervical plexus branch, 2 cases after stimulation of the mild distal trapezius contraction, the remaining 8 cases without trapezius muscle contraction.10 cases of supraclavicular nerve staining for AchE were negative, 10 cases of accessory nerve terminal branches of AchE staining were mixed,10 cases of branch AchE cervical plexus to the accessory nerve staining were negative.Conclusion The branches of the fourth cervical nerve root constantly joins into the accessory nerve, participating in the trapezius muscle inner vation, the fibers of the branches are sensorial fibers.

BACKGROUND:Recently, the clinical repair methods of irregular wound on fingers primarily include local pedicled flap and free mini-flap of upper extremities or lower extremities.
OBJECTIVE:To discuss the application of free mini-flap derived from upper limb in repairing the wound on fingers.
METHODS:From December 2010 to February 2014, 12 patients with irregular wounds on 12 fingers were selected from Department of Traumatic Orthopaedics and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, China. The size of wounds ranged from 1.5 cm × 2.0 cm to 3.0 cm × 4.5 cm with different degrees of bone or tendon exposure. After the debridement, 12 patients were treated by free mini-flaps of upper limb. The donor sites were directly sutured.
RESULTS AND CONCLUSION:Among the 12 patients, al the wounds at recipient and donor sites were healed at stage I, and the free mini-flags survival completely. Al of patients were fol owed up for 3-6 months (average 4.5 months). Free mini-flags had good appearance and needn’t undergo secondary trimming. The active motion of fingers was improved dominantly. According to the criteria of Hand Surgery Association Society of Chinese Medical Association Society for the function evaluation of upper limb, three cases were excellent, eight were good, and only one was bad. The excellent and good rate was 91%. Free mini-flaps of upper limb are an ideal method for repair of wounds on fingers. It has no injury to normal tissue in hands, donor site is very secluded, and the short-term curative effect is good.

Objective To investigate the changes of expression of N-methyl-D-aspartate receptor(NMDAR)and mitogen activated protein kinase(MAPK)in Alzheimer disease(AD)rat model. Methods AD rat model was established by injection of amyloid-beta protein 1-40 1?l(10 g/L)into hippocampus of rat.NMDAR-mRNA and MAPK protein were immunostained by in situ hybradization histochemistry and immunohistochemistry respectively.Learning and memory ability,LTP were determined by Morris water maze and electrophysiological methods respectively. Results The escape latent was prolongated in Alzheimer rats two weeks after injection of A? than in control rats and in rats before the injection of A?(P

OBJECTIVE: To explore the effect of vinyl chloride on the blood sex hormones and liver function of male workers. METHODS: A total of 129 male vinyl chloride workers(exposure group) and 128 male office workers who were not exposed to occupational hazards(control group) were selected as study subjects by judgment sampling method. The time weighted average concentration(C_(TWA)) of vinyl chloride in the workplace air was measured. The level of urine thiodiglycolic acid(TDGA), blood routine, electrocardiogram and liver B-ultrasound were performed on the subjects. The serum levels of liver function and sex hormones were measured. RESULTS: The median of C_(TWA) of vinyl chloride in the workplace was 0.90 mg/m~3, and the geometric mean was 1.40 mg/m~3. The level of urine TDGA in the exposed group was higher than that of the control group(median: 0.68 vs 0.02 mg/g Cr, P<0.01). The abnormal rate of hemoglobin level, erythrocyte count, leukocyte count, hematocrit, mean platelet volume, aspartate transaminase, total bilirubin, indirect bilirubin and liver B-ultrasound increased in the exposure group than that of the control group(P<0.05). The levels of serum prolactin, leuteinizing hormone(LH), follicle-stimulating hormone and estradiol in the exposure group increased, the abnormal rates of prolactin, LH and estradiol increased, and the level of testosterone decreased compared with the control group(P<0.05). The levels of prolactin in the low-, medium-and high-TDGA subgroups in the exposure group increased(P<0.05), and the abnormal rates increased compared with the control group(P<0.017). CONCLUSION: Vinyl chloride can cause liver function damage in male workers and have reproductive toxicity. Prolactin can be used as a biomarker of reproductive toxicity of vinyl chloride.

This study aimed to investigate the effects of total alkaloids from Picrasma quassioides(TAPQ)on collagen-induced arthritis(CIA)in rats. TAPQ were prepared by acid extraction and alkali precipitation. The qualitative analysis of TAPQ by HPLC-Q-TOF-MS/MS was carried out. Fourteen alkaloids were obtained and three of them were quantitatively analyzed by HPLC. The anti-inflammatory activity of TAPQ was investigated on RAW264. 7 induced by LPS. Dexamethasone was used as a positive control. The model of bovine type II collagen-induced rheumatoid arthritis in SD rats was established. Daily tail intravenous injection of 0. 907 or 1. 814 mg/kg of TAPQ was administered for 18 days continuously, using dexamethasone as a positive control. The changes of mean arthritis scores in the paw of the rats and the volume of the paw were measured every day. Compared with the model group, the TAPQ significantly reduced the degree of paw swelling(P< 0. 001). After the rats were sacrificed, the levels of TNF-α and IL-6 in the serum were measured. The TAPQ could significantly reduce the level of TNF-α(P< 0. 01)and IL-6(P< 0. 001). The pathological changes of the joints were observed by HE staining, the anti-inflammatory activity of TAPQ was good, and the degree of joint damage in rats was obviously reduced.

A new method based on rat liver microsomes and chromatographic fingerprint comparison was established to investigate the possible herb-drug interactions between Liuwei Dihuang Pills(LDP)and nifedipine(NIF). LDP and NIF were incubated simultaneously with rat liver microsomes at 37 °C for 60 min in a shaking water bath. The separation was achieved on a C18 column using 0. 1% formic acid solution and acetonitrile as mobile phase with a liner gradient program. The flow rate was set at 1. 0 mL/min. Detection was achieved by UV light at 240 nm. To evaluate the interactions between LDP and NIF, the similarity of the fingerprinting chromatograms before and after co-incubation was calculated by similarity evaluation system for chromatographic fingerprint of TCM. Furthermore, pharmacokinetic experiments in rat suggested that there was no significant difference in the pharmacokinetic parameters of the typical components in LDP.

Objective:To explore the efficacy of neurolysis or nerve grafting in the treatment of the conducting neuroma of Narakas II obstetric brachial plexus palsy (OBPP), and provide the reference basis for choosing an optimal method.Methods:From January, 2009 to December, 2014, 32 patients undergoing surgical treatment due to Narakas II OBPP were included in this study. Neurolysis was performed in 15 patients, and the procedure of nerve grafting was performed in 17 patients. The general information included gender, age, birth weight, injury cause, etc. were recorded and compared to each other between 2 groups. A followed-up study had been conducting after surgery, the functional rating systems of Gilbert and Raimondi were used for quantitative comparison between preoperative function and postoperative function of shoulder joint, elbow joint and hand. In addition, the differences of the measurement data were compared with the single factor analysis of variance and paired t-test by using SPSS 22.0 statistical software. When P<0.05, it was considered statistically significant. Results:There was no statistically significant difference in the baseline information between 2 groups ( P>0.05). The average time of follow-up was 58.44 (48-96) months. And the fourth year' average score of shoulder joint, elbow joint, hand of the neurolysis group improved from preoperative (1.07±0.85) , (2.07±0.77) and (3.47±0.62) score to (3.00±0.73), (4.13±0.62) and (4.53±0.72) score ( P<0.05), and the nerve grafting group rose from an average of (0.76±0.73), (1.71±0.46) and (3.71±0.67) score to (3.24±0.55), (4.29±0.46) and (4.65±0.48) score ( P<0.05). But the different score between 2 groups was no statistically significant ( P>0.05), respectively. In addition, the proportion of the patients who needed the secondary operation about functional reconstruction in the neurolysis group and the nerve grafting group was 73.33% and 35.29% respectively, besides the proportion of the shoulder joint and elbow joint in the surgical sites accounted for 82.35%, 17.65% respectively. Conclusion:Nerve grafting is a better choice for the treatment of conducting neuroma of Narakas II OBPP at present.

Objective:To explore the diagnosis and treatment of the multi-segment injury of brachial plexus and provide reference for diagnosis and treatment in clinical practice.Methods:From October, 2012 to January, 2015, 24 patients (21 males and 3 females, aged 7-46, average at 25.06±13.01 years) who suffered multi segments injury of brachial plexus were treated by surgical operations. Time from injury to surgery was 7 days to 7 months, with (2.43±2.15) months in average. The general data, injuries and surgical procedures of the patients were recorded. Muscle strength grading was used to evaluate and analyse the curative effect.Results:Twenty-four cases were followed-up for 3.1-7.2 years, with 4.3 years in average. Of the patients, 58.3% of the injuries were caused by mechanical traction. Combined injuries were counted for 83.3%, of which 62.5% combined with ipsilateral limb fractures, 20.8% (5/24) involved in the root of brachial plexus, 79.2% (19/24) with upper part of the clavicle, 91.6% (22/24) with lower part of the clavicle, 16.7% (4/24) with branches of the brachial plexus and 91.7% (22/24) with injuries of 2 segments, 8.3% (2/24) with injuries of 3 segments. At the last followed-up, 55.0% of the patients achieved better than M 3 in total muscle strength. The excellent and good rate was 70.8% in neurolysis group and 42.9% in multiple segment injury group. Conclusion:The mechanism of multi segments injury of brachial plexus is special, and the actual injury is difficult to be located. For patients with multi segments injury, surgical operation should be carried out as early as possible, and the correct surgical procedure can only be determined after the exploration of all sections of the brachial plexus.

Objective:To investigate the expression level of TRPM7 in breast cancer tissues and adjacent carcinoma tissues and to analyze its clinicalpathological characteristics.Methods:The expressions of TRPM7 in 87 breast cancer and 47 adjacent tissues were detected by immunohistochemistry, and then the relationship between expression and clinicopathological characteristics was analyzed.Results:The positive rate of TRPM7 in breast cancer tissues was 66.7%, significantly higher than that in para-cancer tissues (10.6%) ( P<0.001) . Meanwhile, TRPM7 expression was much higher in those with tumor diameter≥2 cm ( P=0.023) , TNM stage III ( P=0.001) and lymph node metastasis ( P=0.015) . The expression of TRPM7 has nothing to do with patients’ age ( P=0.455) or histological grade ( P=0.577) . Conclusions:High expression of TRPM7 is associated with the development of breast cancer. TRPM7 may become a potential biological indicator to monitor the prognosis of breast cancer in the future.

Objective:To evaluate the application effect of mini-clinical exercise assessment (Mini-CEX) in clinical teaching of pediatrics of Chinese medicine, further optimize Mini-CEX scale with characteristics of pediatrics of Chinese medicine, and improve teachers' understanding of its connotation.Methods:A total of 50 pediatric clinical practice undergraduates were randomly divided into Mini-CEX group and control group, 25 in each group, with a total of 4 weeks of practice. The application effect of Mini-CEX was evaluated by clinical comprehensive ability assessment, and the students' evaluation on the introduction of Mini-CEX in clinical teaching was understood through questionnaire survey on the recognition, advantages and existing problems of various contents of Mini-CEX. SPSS 17.0 was used for t test and chi-square test. Results:Total scores and sub-item scores of clinical comprehensive ability examination in Mini-CEX group were higher than those in control group ( P < 0.05), and the satisfaction with teaching in Mini-CEX group was significantly higher than that in control group ( P < 0.05). Through the questionnaire, it was found that the students had a high degree of recognition for the items in the improved Mini-CEX scale, and thought it was more suitable for the internship study and effect evaluation of pediatrics of Chinese medicine, especially in the aspects of clinical communication skills and humanistic care. Conclusion:Mini-CEX has many advantages, such as improving the clinical comprehensive ability of undergraduates, teaching effect, flexible teaching methods, objective evaluation methods and focusing on the cultivation of doctor-patient communication skills, which is worthy of clinical promotion.