Objective To explore the entrapment to the deep branch of the ulnar nerve at the wrist,to assist the surgeon in diagnosis and treatment of Guyon canal syndrome.Methods Twenty fresh upper limbs were dissected on loupe(?5),to record the relationship between the ulnar nerve and the hypothenar muscles,the course of the ulnar nerve at the wrist.Results The deep branchs of the ulnar nerve go through an intermuscular space after runing out of the Guyon canal.The intermuscular space consisits of the superficial and deep head of the opponens digiti minimi and the hook of the hamate,which has one entrance and one exit.We named the intermuscular space as the hiatus of opponens digiti minimi,and named the proximal edge of the superficial head of the opponens digiti minimi as the fascial arch of the opponens digiti minimi.Conclusion We found that the fascial arch of the opponens digiti minimi can compress the deep branch of the ulnar nerve causing motor deficit of the intrinsic muscles of hands.

Objective To study the rehabilitative effect of velvet antler polypeptides-PLGA compound membrane on peripheral nerve injury.Methods Two doses(3 and 15 mg?g~(-1)) of velvet antler polypeptides-PLGA compound membrane(thickness 50 ?m) were used to wrap the sutures of severed sciatic nerves,which were compared with nerve sutures only.2,4 and 6 weeks post-operation,general morphological,electrophysiological,histological and electron microscopic observations and examinations were investigated.Results There were no ulcers in the nars and toes in the treatment group,light conglutination appeared in nerve anastomosis and around tissues.At 6th week post-operation,conglutination was alleviated obviously than 2 weeks post-operation;findings from latency inducing potentials of calf triceps dominated by sciatic nerves showed that recover ratios(%) in treatment group((2 weeks:)9.07?1.44,8.02?1.41;6 weeks: 49.87?9.69,50.11?6.11) were better than those in control group((2 weeks:)2.52?1.83;6 weeks:30.31?6.32) obviously in each time(P

Objective To investigate the anti-rejection effect of T cell vaccination combined with FK506 of heterogenic transplantation on rat nerve. Methods SD rats were vaccinated by the spleen cells of BABL/c mice; T cell vaccines were activated and vaccinated in the spleen cells of these SD rats. The SD rats of nerve transplantation recipient were vaccinated with T cells combined with FKS06. The mixture lymphocytes culture, microcytotoxicity assay, histological alteration of nerves, humid weights of tibial anterior muscle were observed to confirm the anti-rejection effect of T cell vaccination combined with FK506 treatment. Results The humid weights of tibial anterior muscle of the vaccinated rats combined with FKS06 treatment were statistically different from those in control group (P ＜ 0.05), and so as the index of rejection (e.g. lymphocytes transformation efficiency) (P ＜ 0.05). Conclusion T cell vaccination combined with FK506 treatment can inhibit the rejection of heterogenic transplantation on rat peripheral nerve.

Objective To analyze the long term outcomes of antebrachial flap with a pedicle of the posterior interosseous artery Methods Ninety cases were followed up for 1～16 years, the indication and long term outcomes and dorsal aspect of the forearm were analyzed and evaluated retrospectively Results Eighty nine cases survived, except one case, the conteur of forearm and hand were satisfied Conclusion Antebrachial flap with a pedicle of the posterior interosseous artery is an optimal method to repair soft tissue defects of hand.

[Objective]To study the influence of VAP(velvet antler polypeptide)-chitosan-honey suspension on decubitus ulcer.[Method]Swines'pressure ulcers were used as decubitus ulcer model.Honey was used as solvent carrier.VAP and chitosan were put into the honey in different proportion.The suspension was applied to the ulcer once a day for seven days.The dressings were changed once every other day.The healing state of the ulcer was observed and the area of the ulcer was calculated.The changes of the ulcer histopathology were observed.[Result]In the group of the suspension proportion of the VAP to the chitosan was 4:1,the wounds had little effusion and the granulation tissues grew fast with the scars falling off early and Absolutely.Pathology results indicated that in the group of the suspension proportion of the VAP to chitosan was 4:1,none necrosis was found,the epithelization was apparent,and the inflammatory cells were fewer.There was no edema,but more newly born blood vessles.[Conclusion]The VAP-chitosan-honey suspension could apparently promote the healing of decubitus ulcer,but the possible mechanism needs to be further studied.

Peripheral nerve injuries, the worldwide difficult and complicated diseases, cause serious dysfunction but without ideal strategies to assist the successful treatment and recovery. The primary strategy to repair the peripheral nerve injuries is to bridge the lesions by promoting axon regeneration. The importance of mechanical factors in the nervous system has been appreciated only recently. It has been demonstrated that the application of external mechanical force is able to direct axonal outgrowth and to stimulate axonal elongation. For this purpose, to direct axonal growth cones in vivo with accurate force appears to be a challenge that must be resolved. Bionanotechnology is promising a new tool that offers the possibility to influence the process of axonal regeneration. The magnetic force generated by the interaction between Magnetic nanoparticles (MNPs) and magnetic fields provides remote, non-invasive, accurate, and controllable lead and control of neuronal axon regeneration.

Objective To analyze the clinical results of surgical treatment of nerve compression of the upper limb.Methods The clinical characterisitcs treatment methods and prognosis of nerve compres sion of the upper Iimbs in 646 padents were analyzed.Results Four hundred and of them were followed up for from 6 months to 3 years.The numbness disappcared and the function five of the nerve innervation area became normal or near normal after operation in 252 cases(62.2%),improved in 124 cases(30.6%),no change or worse in 29 cases(7.2%).The excellent rate of nerve funcfion recovery were 93%after rehabilitation teatment.Conclusions The loss degree of sensorimotor function of the effected limbs provides reference for operating mode and iS closely related to nerve functional restoration.The evaluation of the loss degree of sensorimotor function of the affected limbs before the operation should be taken into account.Rehabilitation teatment after operation can promote functional restoration and prevent teratogencsis.

Objective To investigate the surgical indications and repair methods for the treatment of electrical bums in the limbs.Methods Thirty-eight cases since May,1997 to June,2014 who underwent flap treatment in 7-14 days after electrical bums was summarized.Among these patients,4 cases were treated by local flaps,1 case was treated by thenar flap,2 cases were treated by dorsal island skin flap of the index finger,1 case was treated by cross-leg flap,1 case was treated by medial plantar skin flap;2 cases were treated by pedicle latissimus dorsi flaps,4 cases were treated by antebrachial flap with a pedicle of the posterior interosseous artery,4 cases were treated by metacarpal artery reversed island flaps,10 cases were treated by groin flaps;1 case was treated by free radial artery flap,1 case was treated by free latissimus dorsi flap,3 cases were treated by free anterolateral thigh flaps;1 case was treated by reverse island forearm posterior interosseous flap,2 cases were treated by posterior perforator reversed island flaps of the lower leg,1 case was treated by anterolateral perforator reversed island flaps of the lower leg.The area of flap was from 42.0 cm × 13.0 cm to 6.0 cm × 3.0 cm.The survival rate of the flap,the appearance and function of limb were observed.Results All these patients were followed up from 4 months to 3 years 6 months,the mean time was 6 months and 20 days.Thirty-five flaps survived completely,accounting for 92.1％,and 3 cases suffered partial necrosis at the distal end,accounting for 7.9％.Secondary healing was achieved by dress changing.The appearance of the limbs was satisfactory.Among the 28 cases whose bums were on the hands,the total number of excellent and good was 15,medium was 8,and 5 poor cases.The excellent and good rate was 57.1％.Conclusion Early repairing of the electrical burns with flaps is the effective method for protecting the deep structures of the limb,preventing and control the secondary infections and preserve the function of the limbs.

10.3969/j.issn.2095-4344.2013.25.013

Objective To report the long-term outcomes of repairing finger soft tissue defects using the dorsal metacarpal flap and compund flap. Methods Through a review of 122 cases,who were treated using the dorsal metacarpal flap and compound flap,the indication and long-term outcomes of the flap and characteristics of blood supply and compound tissues transferred and venous return were analyzed. Results All cases survived unevently.The fingers which were repaired using the flap were normal,and the contours of the donor sites were normal. Conclusions The dorsal metacarpal flap and compund flap are an optimal method to repair finger soft tissue defects.