The ulnar collateral ligament (UCL) of the elbow is the primary stabilizer to resist valgus stress. Its injury is common in overhead throwing athletes, mainly caused by repeated valgus forces, and can cause elbow pain and affect the career of athletes. A common treatment of ulnar collateral ligament injury for overhead throwing athletes is ulnar collateral ligament reconstruction (UCLR). At present, the UCLR techniques have been constantly improved, mainly in graft structure, incision exposure, management of the ulnar nerve, and methods of humeral and ulnar fixation. This paper is to review the anatomy and biomechanics of UCL, as well as techniques, key points, postoperative complications and rehabilitation of UCLR so as to deepen the understanding of UCLR in clinicians.

Breast Neoplasms ; pathology ; radiotherapy ; surgery ; Cone-Beam Computed Tomography ; Dose Fractionation ; Female ; Humans ; Mastectomy, Segmental ; adverse effects ; Neoplasm Staging ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Conformal ; methods ; Respiration ; Seroma ; etiology ; pathology ; Surgical Instruments ; Tumor Burden

Purpose:To discuss the function of Gd-BOPTA on the deferment of manifestation of MRI,which bring influence to the immune mensuration of antigen PCNA,PTEN.Materials and Methods:Scanning with MRI on the 35 patients with pathologically verified HCC the image were analyzed concretely.Pathologic diagnose was made with Edmondson pathologic classification standard,and it was expressed with index of PCNA and PTEN of immune quantitative analysis.Results: HCC was negatively related to the index of PCNA,and most patients with high index were lightly or not deferred enhanced(13/16),Patients with low index were evidently enhanced ( 10/19).The degree of HCC deferred enhancing was positively related to the expression of PTEN.Most HCCs( 15/17) with negative PTEN were lightly or not deferred enhanced,while positive patients of PTEN were mostly enhanced obviously(11/18).Conclusion: Deferment of Gd-BOPTA can be used to basically estimate the tincture of tumor biology,therefore,the enhanced degree of which,the PCNA,PTEN,can offer great help in choosing the therapuetic method and estimating the outcome of the the therapy.

Objective To study the immunophenotypic features of NK/T cell lymphoma in children and its association with Epstein-Barr virus (EBV) infection. Methods Five cases of children′s NK/T cell lymphoma were studied. CD45RO, CD3?, CD56, CD20, TIA-1 and granzyme B were detected by immunohistochemistry staining for investigating immunophenotype. The expression of EBV-latent membrane protein (LMP-1) were detected by immunohistochemistry. EBV-encoded RNA (EBER1/2) were detected by in situ hybridization (ISH). Results CD45RO, CD3?, TIA-1 and granzyme B were positive in 5 cases, CD56 was positive in 2 cases, while CD20 negative in 5 cases.EBER1/2 positive in 4 cases and LMP-1 positive in 3 cases.Conclusions NK/T cell lymphoma in children is strong associated with EBV infection,and EBV infection may play an important role in the pathogenesis of children NK/T cell lymphoma.

Objective:To analyze the effects of essential medicine system on revenue structures at primary med-ical institutions. Methods:Data on revenue status and structures from 58 township health centers in Shanxi Province was collected to analyze changes and trends. Results:Along with growing government investments in primary medical institutions, the essential medicine system has fundamentally realized full coverage. The percentage of essential medi-cine revenue to pharmaceutical revenue rose from 20 . 45% in 2009 to 97 . 03% in 2013 , though the percentage of pharmaceutical revenue to total revenue dropped by 18 . 43%. The percentage of fiscal subsidy revenue in total reve-nue rose from 25 . 77% in 2009 to 54 . 16% in 2013 , though the percentage of business revenue to total revenue dropped in general. Conclusions:The essential medicine system requires the government’s financial support. Essen-tial medicine lists and primary financial aid policies should be further improved;doctor reimbursement and incentive mechanisms should be improved as well and unreasonable doctor service pricing and reimbursement mechanisms should be reformed.

ObjectiveTo explore the safety and efficacy of endoscopic dilatation combined with submucosal injection of triamcinolone acetonide in treatment of benign esophageal stricture.MethodsThe patients of benign esophageal stricture proved by biopsy were randomly divided into three groups.Group A were treated by expansion only,group B were injected with triamcinolone acetonide submucosal combined with expansion,and we treated group C by another injection a week later on the basis of treatment in group B.A 12 months' follow-up was conducted,the dysphagia score,the cure rate.time to sustained symptom relief,re-expansion time interval and adverse reactions were recorded.ResultsSome patients experienced chest pain and regurgitation after the procedure and all improved by corresponding managements.No complications including massive bleeding,infection,perforation or local tissue atrophy were observed.The dysphagia scores in 3 groups after the procedure were all improved ( P ＜ 0.05 ),and no significant difference was noticed between 3 groups (P ＞ 0.05 ).At the end of the follow-up,the duration of dysphagia remission and the interval between 2 consecutive dilatation in Group A were 14.4 ± 3.2 weeks and 18.2 ± 3.7 weeks,respectively,which were significant shorter than those in Group B ( 19.3 ±3.9 weeks and 24.6 ±4.2 weeks,respectively) and those in Group C (20.2 ±4.2 weeks and 26.1 ±4.5 weeks,respectively),while there was no difference between Groups B and C.The cure rate in Group C (43.5％,10/23) was significantly higher than that of Group A (29.2％,7/24) or Group B (27.3％,6/22),while there was no difference between Groups A and B.ConclusionEndoscopic dilatation combined with submucosal injection of triamcinolone acetonide is safe and may improve the symptoms of dysphagia and delay the re-stenosis for patients with benign esophageal stricture,meanwhile,multi-frequency treatment may improve the cure rate.

One hundred and forty six elderly patients with constipation undergoing colonoscopy during March 2012 and August 2013 were randomly assigned to trial and control groups.Seventy patients in trial group received Macrogol electrolytes powder combined with Chinese herb medicine Simo decoction for bowel preparation and 76 patients in control group received macrogol electrolytes powder only.The first defecation,times of defecation and tolerance of patients were compared between two groups.The quality of bowel preparation was evaluated by endoscopists with Boston Bowel Preparation Scale (BBPS).The first defecation time was shorter in trial group than that in control group (55.7 ± 27.9 vs.72.9 ± 34.8,P ＜ 0.05).However,no statistical significance was found in the times of defecation and tolerance of patients between two groups.The mean BBPS score in trial groups was higher than that in control group (7.87 ± 1.08 vs.6.97 ± 0.96,P ＜ 0.05).Chinese herb medicine Simo decoction combined with conventional method shows satisfactory result for bowel preparation in elderly patients with constipation undergoing colonoscopy.

Objective To analyze the clinical effect of biliary-enteric anastomosis and biliary stent to palliative treatment of malignant obstructive jaundice.Methods A total of 40 patients with inoperable malignant obstructive jaundice were enrolled in this study,and 20 patients were performed biliary stent placement (stent group),simultaneously 20 patients were performed biliary-enteric anastomosis (operation group).The fatality rate after operation,the level of total bilirubin before treatment and after treatment for 4,7,14 d,the rate of hyperpyrexia,nausea and vomiting,postoperative recurrence of jaundice were compared between two groups.Results There were no dead in two groups.The level of total bilirubin was decreased after treatment,and there was no significant in two groups before treatment and after treatment for 4,7,14 d (P ＞ 0.05).The rate of hyperpyrexia in operation group was significantly lower than that in stent group (0 vs.4/20) (P ＜ 0.05).Conclusion For palliative treatment of malignant obstructive jaundice,the biliary-enteric anastomosis should be performed first if there is no significant contraindication.

Objective To study the clinical significance of the expression of D-amino acid oxidase(DAO) in hepatocellular carcinoma(HCC) tissues.Methods The gene expression profiles and related clinical data of 214 HCC cases were collected.Univariate and multivariate analyses were conducted to investigate the association between DAO expression levels,clinical traits,the prognosis.Results Univariate analysis indicated that there were a lower level of blood alpha fetoprotein(AFP,P=0.001),a smaller number of nodules(P=0.042),a better TNM stage(P=0.014),a lower metastasis risk(P=0.001) and a better prognosis(P=0.011)in the samples with high DAO expression.Multivariate analysis also indicated a lower AFP level(OR:0.162,95%CI:0.078-0.336) and metastasis risk(OR:0.140,95%CI:0.069-0.284) in the samples with high DAO expression,as well as a better prognosis(OR:0.833,95%CI:0.700-0.992).Conclusion DAO expression was associated with blood AFP levels,metastasis risk and prognosis in HCC,and its high expression was a protective factor for HCC.

10.3969/j.issn.2095-4344.2013.26.013