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.

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.

To study the chemical constituents of Senecio nemorensis.,12 known compounds were isolated and identified,which were niacinamide(Ⅰ),vanillin(Ⅱ),syringic acid(Ⅲ),syringalddehyde(Ⅳ),3-acetyl-4-hydroxy-benzoic acid(Ⅴ),4,4-dimethyl-1,7-heptanedioic acid(Ⅵ),1H-indole-3-carboxaldehyde(Ⅶ),ethyl caffeate(Ⅷ),1-0-(E)-p-methoxycinnamoyl-β-D-glucopyranoside(Ⅸ),(6S,7E)-6-hydroxy-4,7-megastigmadien-3,9-dione(Ⅹ),Annuionone D(Ⅺ),and(1 'S,6'R)-abscisic acid(Ⅻ),respectively.

Objective To investigate the relationship between interleukin-18(IL-18)and the pathogenesis of type 2 diabetes melli-tus.Methods 72 healthy Sprague-Dawlay male rats were randomly divided into four groups, NC group,NCS group,HF group and HFS group.At the end of the 8th week,NCS group and HFS group were injected with STZ(25mg/kg)into abdominal cavity.At the end of the 10th week,diabetic rats were screened by oral glucose tolerance test(OGTT).The blood sample was collected when the rats were killed at the end of the 14th and 20th week.The levels of serum IL-18,IL-6 and tumor necrosis factor-α(TNF-α)were assayed with ELISA.Results Most rats in HFS group were achieved the diagnostic standard of diabetic rat, and their insulin sensitivity index(ISI)were decreased.At the end of the 14th week and 20th week,the levels of serum IL-18,IL-6 and TNF-α in HFS group were significantly higher than those in NC group(P＜0.01).In HFS group,the levels of serum IL-18,IL-6 and TNF-α at the end of the 20th week were higher than those at the end of the 14th week,but it had no statistic significance(P＞0.05).Pearson linear correlation analysis showed that the level of serum IL-18 in HFS group was positive correlated with FBG,IL-6,and TNF-α(r=0.90,P＜0.01 or r≥0.73,P＜0.05),and negative correlated with ISI(r=-0.86,P＜0.01).Condusions Our results show that IL-18 is related with the pathogenesis of type 2 diabetes mellitus and chronic inflammation plays an important role in the development of type 2 diabetos mellitus.

ObjectiveTo study the mechanism of myocardial dielectric property changes in radio frequency during hypothermic preservation and explore myocardial viability evaluative method. Methods Hybrid young pigs (20-30 kg) were used in the experiment. Heart arrest was induced with GIK solution. According to preservative temperature, the animals were divided into three groups: group A (4 ℃),group B (15 ℃) and group C (25 C). The heart was preserved in saline for 12,6 and 4 h respectively. Myocardial dielectric properties and ATP content were tested every 5 and 30 min during hypothermic preservation respectively. The relationship between tanoδm and ATP content was analyzed. ResultsTanδm of three groups was decreased significantly at the beginning, most slightly in group A and most obviously in group C. There was no significant difference in Tanδm between group B and group C with group A at 1 h,but there was obvious difference at 2,3 and 4 h (P＜0. 05,P＜0. 05,P＜0. 01 ). There was correlation between tanδm and ATP in the three groups. ConclusionTanδm in three groups is dropped with preservation time and temperature, and tanδm had a correlation with ATP content. Detection of myocardial dielectric property in radio frequency is a kind of quick, accurate and noninvasive method.

Vena cava filter (VCF)has been increasingly applied in clinical to efficiently prevent the pulmonary embolism (PE) with the rapid development of VCF. This article summarized the development of VCF, analyzed the relationship between structure and function, described the clinical behaviour of VCF, and final y forecasted the development trend of VCF products.

Objective To explore the effect of iron overload on the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) patiems with non-hepatitis related severe aplastic anemia (SAA).Methods The clinical data were retrospectively analyzed for 98 patients with non-hepatitis related SAA undergoing allo-HSCT from July 2012 to late July 2018 at a single center.Serum ferritin (SF) was measured within 2 momhs before HSCT.They were divided into iron overload (SF＞800.0 ng/ml,n =49) and control (SF＜800.0 ng/ml,n =49) groups according to SF level.Overall survival (OS),hematopoietic reconstitution and common complications after allo-HSCT were analyzed.Results The median pre-transplantation SF value was 798.7 (52.0-11060.01) ng/ml.Patients with pre-transplantation iron overload had a higher incidence of cytomegaloviremia (P =0.041),delayed recovery of neutrophil/platelet (P =0.001,P =0.005 respectively) and transfusion-dependence in donor-recipient blood group-matched patients (P =0.043) after allo-HSCT.The 3-year OS was (65.1 ± 7.1) ％ in iron overload group and (93.3 ± 3.7) ％ in control group (P =0.001).Multivariate analysis indicated that 3-year OS was independently correlated with pre-transplantation iron overload (P =0.022),blood group of donor & recipient (P =0.015),early bacteremia (P=0.003) and cytomegaloviremia (P =0.003).Conclusions Iron overload is common in patients with non-hepatitis-related SAA before transplantation.Pre-transplantation iron overload has a significant impact on OS,hematopoietic reconstitution and cytomegaloviremia after allo