[Objective]To discuss the result of using latissimus dorsi musculocutaneous flap which function was recovered by repairing the thoracodorsal nerve with nerve transfering for reconstruction of flexor of elbow or digits in brachial plexus injury patients.[Method]From march 2000 to June 2003,eight patients with brachial plexus total roots avulsion were treated by mlutiple donor nerves transfer.The function of latissimus dorsi muscle recorved well but not the biceps muscle in five patients.The function of flex digits did not recover while the latissimus dorsi muscule recorverd well in three patients.All of them had the aid of latissimus dorsi musculocutaneous flap to reconstruct the flexor of elbow or digits.[Result]The patients were followed up for one year to half past three years,all of musculocutaneous flap were survived,the muscle strenght graded 3 to 4 and the active motion of the elbow was over 100 degrees in flexion and 10 degrees to 25 degrees in extension.All the digits can grasp,the fist closure was about 2 cm and the muscle strenght was grade 3 of the involved digits.[Conclusion]It is a good method to reconstruct the flexor of elbow or digits by the recovered latissimus dorsi musculocutaneous flap in brachial plexus total roots avulsion patients.When treating brachial plexus total roots avulsion patients,it is necessary to repair the thoracodorsal nerve.

[Objective]To observe the complications after surgical treatment of thoracic outlet syndrome and to analyze causes and prevention of complications.[Methods]A retrospective review was done for 62 cases of thoracic outlet syndrome which had been treated by operation from January 2002 to January 2006.All the complications occrred were collected in the following time.[Results]Follow up time was 14 months to 30 months.According to assessment standard described by Wood,treatment outcome was excellent in 26 cases,good in 16 cases,fair in 11 cases and poor in 9 cases.Nine of all the 62 patients had been found complications,including hematoma in 3 cases,lymphadenectomy in 2 cases,cervical plexus injury in 2 cases,phrenic nerve injury in 1 case,brachial plexus injury in 1 case and pneumothorax in 1 case.All the patients were successfully treated.[Conclusions]The occurrences of complications are related to the skill of operation and individual differences of patients.In order to decrease and finally prevent these complications,operative experiences and preventive measures are needed.

BACKGROUND: With good biocompatibility, osteoconduction and biodegradability, calcium phosphate ceramics is considered as a substitute of autologous bone; furthermore, it also has the potentiel of osteoinduction after structure optimization. OBJECTIVE: To review the physicochemical properties of calcium phosphate ceramic and its osteoinduction. METHODS: A computer-based search of databases such as PubMed, Springer, ResearchGate and Baidu Academic was performed for articles relevant to calcium phosphate ceramics published from January 2000 to October 2015. And the keywords were “calcium phosphate, osteoinduction, tissue engineering, scaffolds” in English. RESULTS AND CONCLUSION: To date, there are four ideal kinds of calcium phosphate materials including hydroxyapatite, tricalcium phosphate, amorphous calcium phosphate and hydroxyapatite/tricalcium phosphate biphasic ceramic material. Hydroxyapatite has better strength and cel adsorption capacity, but has poor biodegradation. Tricalcium phosphate has good abilities of osteogenesis and degradation, but its degradation rate is hard to match the new bone formation,and its strength is also relatively poor. Amorphous calcium phosphate has neither strength nor solubility. In contrast, biphasic calcium phosphate ceramics has moderate degradation rate between hydroxyapatite and tricalcium phosphate, and therefore, it either can be replaced by autologous bone after degradation or exhibits proper strength. While how to further improve the physical properties and promote osteogenesis stil need much deeper research.

Long non-coding RNA (lncRNA) is a class of RNA molecules, transcripted by RNA polymeraseⅡ, which consists of more than 200 nucleotides and protein-coding function. Many studies have indicated that lncRNA plays an important role in epigenetics, transcription and post-translational processing. The abnormal expression of lncRNA significantly correlates with occurence,development, and metastasis of renal cell carcinoma (RCC) and prognosis of the patients with RCC. This paper summarizes the advances in the research on lncRNA in RCC to reveal the mechanisms of the disease at the molecular level, in order to provide new methods of prevention, diagnosis, treatment and prognostic assessment of RCC.

OBJECTIVE To identify the pop strain of Staphylococcus aureus hospital acquired infection by random amplification of polymorphic DNA(RAPD),and to study the molecular mechanism of antibiotic(resistance),so as to reduce the occurrence of drug resistance and infection acquired in hospital.METHODS 1.DNA from 21 strains of S.aureus were extracted by the phenol-chloroform method and analyzed by using arbitrary(primer) polymerase chain reaction(AP-PCR).2.Amplifying mecA,GyrA and GrlA by PCR,and testing the(variation) of these genes by using Hinf Ⅰ-digested analysis.RESULTS Twenty one S.aureus strains were divided into 3(genetic) types.Type Ⅰ is the pop strain in our hospital which including 12 strains.Fourteen from 17 clinical stains were resistant to meticillin and quinolones,of which 13 strains had mecA except isolate 13064.And they all had(variation) in(GyrA) and/or GrlA.CONCLUSIONS RAPD provides markers for the typing of clinical strains and is suitable for(molecular) epidemiologic studies with high type ability,powerful discrimination,simplicity and(rapidness). Type Ⅰ is the pop S.aureus strain in hospital-acquired infection of our hospital.The majority of these strains are multi-(resistant) to meticillin,quinolones and other antibiotics.

OBJECTIVE To study the molecular mechanism of antibiotic resistance in hospital acquired(Staphylococcus) epidermidis infection,so as to reduce the occurrence of drug resistance and infection(acquired) in hospital.METHODS DNA from 18 strains of S.epidermidis were extracted by the phenol-chloroform method,and mecA,gyrA and grlA were amplified by PCR,then the variation of gyrA and grlA was tested by Hinf Ⅰ-(digested)(analysis).RESULTS Fifteen from 18 S.epidermidis strains were resistant to meticillin,and all of them had mecA gene. Eleven from 18 S.epidermidis strains were resistant to meticillin,quinolones and other(antibiotics).And they all had a mutant in gyrA and/or grlA.The mutated spots were gyrA Ser84(TCA→TTA) and GrlA Ser80(TCC→TTC).CONCLUSIONS The majority of hospital acquired S.epidermidis strains are multi-resistant to meticillin,quinolones and other antibiotics,which are caused by acquirement of drug-resistance gene or(mutation) of drug-targeting genes.Medical institutions must strictly standardize the application of antibiotics to(reduce)(development) of drug resistance.

Objective:To investigate the correlation between lumbar degenerative disease and bone mineral density in postmenopausal women.Methods:A total of 97 patients with postmenopausal lumbar degenerative degeneration who were admitted to our hospital from Jan. 2019 to Mar. 2022 were selected for study, and the average bone mineral density of L1-L4 vertebral bodies was measured by lumbar dual-energy X-ray absorptiometry (DXA) . BMD T values divided them into normal bone mass (group A, n = 28) , low bone mass (group B, n = 30) and osteoporosis group (group C, n = 39) . All patients underwent lumbar spine MRI, and the degree of lumbar intervertebral disc degeneration (L1/2, L2/3, L3/4, L4/5, L5/S1) was evaluated by the Pfirrmann grading system, and the relationship between lumbar spine degeneration and bone loss was analyzed. density relationship.Results:In this study, the incidence of osteoporosis in postmenopausal women was 40.21%. The ages of group A, group B and group C were (66.08±4.05 vs 56.78±3.97 vs 52.34±3.17) years, respectively. Menopause time was (14.05± 2.08 vs 8.04±2.04 vs 4.06±1.02) years, respectively. BMI was (22.02±1.68 vs 24.05±1.52 vs 26.47±1.67) kg/m2, respectively. The menopause time and age of group C were significantly longer than those of group A and B (P<0.05) , the BMI of group C and B was significantly lower than that of group A, and the BMI of group C was significantly lower than that of group B, with statistical significance (P < 0.05, Table 1) . Group A, group B and group C lumbar intervertebral disc degeneration score: L1/2: (1.80±0.47) points, (2.25±0.48) points, (2.62±0.58) points, L2/3: (1.97±0.44 vs 2.49±0.51 vs 2.97±0.47) points, L3/4: (2.61±0.22 vs 2.97±0.34 vs 3.96±0.25) points, L4/5: (3.45±0.32 vs 3.78±0.34 vs 3.88±0.24) points, L1/S1: (3.52±0.46 vs 3.77±0.52 vs 3.97±0.47) points, L5/S1: (2.64±0.43 vs 3.05±0.52 vs 3.34±0.74) points, the mean values of L1/2, L2/3, L3/4, L1-S1 and disc degeneration scores in groups C and B were higher than those in group A ( P<0.05) , and the scores in group C were higher than those in group B ( P<0.05) . L4/5 and L5/S1 disc degeneration scores in group C were higher than those in group A ( P<0.05) , there was no statistical significance between group C and group B ( P>0.05) , there was no statistical significance between group B and group A ( P>0.05) , and there was statistical significance between group B and group A in L4/5 lumbar disc degeneration scores ( P=0.018) . The L5-S1 lumbar disc degeneration score was significantly different among the three groups ( P=0.012) . BMD was positively correlated with BMI, and negatively correlated with menopause time, age, L1/2, L2/3, L3/4, L4/5, L5/S1 and L1-S1 intervertebral disc degeneration degree. Conclusion:In postmenopausal women, BMD was negatively correlated with menopause time, age, and degree of lumbar intervertebral disc degeneration, and was positively correlated with BMI. The lower the BMD, the more severe the lumbar degenerative disease.

Objective: To describe an extended whole upper limb liposuction technique and evaluate its clinical effect. Methods: 34 patients who underwent upper limb liposuction from February 2018 to February 2019 were selected and the clinical data were retrospectively summarized. Patients were treated with upper arm ring/upper arm ring + forearm 1/3 rings/whole arm ring aspiration combined with accessory mammary gland, armpit, scapula and other adjacent aesthetic parts of extended liposuction. The preoperative and postoperative maximum circumference, thickness of the anterior and posterior subcutaneous tissue and skin laxity were measured and compared. analysis of complications, and evaluation of patients′ satisfaction through satisfaction questionnaire. Results: The arm shape of all patients was significantly improved, the maximum circumference of the arm was reduced (16.2±4.0)%, the distance of the upper arm was reduced (29.5±8.9)%, the thickness of the posterior subcutaneous tissue was reduced (56.6 ±6.2)%, and the thickness of the anterior subcutaneous tissue was reduced (44.7±9.6)%. There were three cases of mild anemia after operation, and no other serious complications occurred. Patient satisfaction was very high. Conclusions This is an innovative arm liposuction technique with hidden incision. The effect of improvement is remarkable. The patient′s satisfaction is high.

Objective To study the effect of using different tibial nerve proximal muscle branchs to repair deep peroneal nerve injury in animal experiment, and to screen out the most optimal donor nerve branch. Methods From June, 2016 to August, 2016, 64 adult female SD rats were randomly divided into 4 groups, which were LHG (using lateral head of gastrocnemius to repair peroneal nerve), MHG(using medial head of gastrocnemius to repair peroneal nerve), SNB (using soleus nerve branch to repair peroneal nerve), and blank. There were16 rats in each group. At 4 and 8 weeks after surgery, each group were tested on behavior, electrophysiology, muscle tension, muscle wet weight and histology, to evaluate function recovery of the muscles controlled by deep peroneal nerve in each group, and to compare recovery of the deep peroneal nerve repaired by different tibial nerve branches. Results Eight weeks after surgery,right foot of the rats in LHG,MHG and SNB group can be extended,toes can be completely opened. Rats in blank group showed limping gait, whose right foot can not be extended, right toe can not be opened, and muscle atrophied. At 4 and 8 weeks after the operation, the recovery rate of LHG, MHG, SNB group (at 4th weeks, 33.60 ±2.22)%, 33.07 ±2.38% and 35.91 ±2.02%; at 8th weeks, 67.16 ±5.74)%, 66.56 ±3.18% and 73.17 ± 5.33%, respectively)was higher than blank group(7.71±1.05% and 7.84±0.78%, respectively)on CMAP amplitude, tibialis anterior muscle contractility, tibialis anterior muscle cell area, muscle cell area. SNB group was superior to the LHG group and LHG group.And the difference was statistically significant(P<0.05). Conclusion All the proxi-mal tibial nerve muscle branchs can be used to repair the deep peroneal nerve injury, and the soleus nerve branch is the preferred donor nerve.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.