Objective To investigate the efficacy of using the extensor carpi ulnaris as the motor tendon in correcting claw hand deformity and improving hand function.Methods A total of 12 patients with ulnar nerve palsy and claw finger deformity were included into this study from October, 2009 to September, 2011.Results All ceses had an average followed-up of 15.5 months, ranging from 12 months to 24 months.According to the Total Active Movement (TAM) score, there were 4 cases receiving excellent results, 6 cases receiving good results and 2 cases receiving fair results.The claw finger deformity was corrected and intrinsic hand function improved significantly.The average increase in grip strength was 41％ at the 12 months post operation, compared with the preoperative data (P ＜ 0.05).The mean DASH score decreased from 53.6 ± 11.4 preoperatively to 20.4 ± 6.8 postoperatively (P ＜ 0.05).Conclusion The technique of using the extensor carpi ulnaris as the motor tendon is effective in correcting claw fingers, increasing the grip strength and improving overall hand function.This surgical procedure is also beneficial for patients accompanied by the median nerve injury.

OBJECTIVE:To establish the method for the content determination of2,3,5,4'—tetrahydro-xystilbene—2—O—?—D—glucoside in Yangxueshengfa capsules by RP-HPLC.METHODS:Alltima-C 18 was used as the chromatographic column;the acetonitrile-water(15∶85)was taken as the mobile phase with flow speed at1.0ml/min and detection wave?length at320nm.RESULTS:In the range of0.45?g～2.26?g,2,3,5,4'—tetrahydro-xystilbene—2—O—?—D—glucoseide were in direct proportion to the peak area value(r=0.9996),the mean recovery rate was98.32%(RSD=1.58%,n=6). CONCLUSION:This method was simple,convenient and accurate,which can be used for the content determination and the quality control of Yangxueshengfa capsules.

Objective To design an arthroscopic universal aiming device for cruciate ligament repairing and evaluate its clinical efficacy. Methods The aiming device was designed on the principle of “a line crossing any point on a spherical surface and perpendicular to it must cross the sphere center”, which enables the surgeon to locate the ligamentous attachment of cruciate ligament precisely for reconstruction. Twelve cases of PCL injuries have been treated with this method. Results The average follow up period was 12.1 months (5-19 months). According to Lysholm scoring system, the average score was improved from 59.2 points to 92.7 points, increased by 33.5 points. Lachman test turned negative in all patients, the average range of motion was 120?. Conclusion The instrument was reasonably designed for easy handling and precise orientation. It is particularly preferable to locate the tibial attachment of cruciate ligament for endoscopic reconstruction on the posteromedial approach.

Objective To introduce a new technique for vascular pedicle elongation in island flap transplantation, and evaluate its clinical results. Methods From February 1994 to October 2001, 16 cases were treated with island flap transplantation with Y-V vascular pedicle elongation technique. There were 10 males and 6 females with the age ranging from 19 to 45 years ( average 26.8 years). The locations of the primary injury were as follows: the fingers in 6 cases, the great toe in 2 cases, the other toes in 2 cases, the knee joint in 3 cases and the proximal tibia in 1 case. The flaps vascularized by a branch of "Y" pattern bifurcation were used. Both branches of "Y" shaped vascular pedicle arising form the same main vessel trunk were dissected, then the main vessel trunk was severed at the division of the branches, the arc of "Y" bifurcations was then turned into "V" pattern, the length of pedicle was significantly elongated than the original pedicle. Results The operative procedures were smooth in the patients, and all of the flaps were successfully transferred, the elongated length of pedicle ranged from 3 cm to 12 cm, with the average length of 6 cm. The transplanted island flaps were rich in blood supply, and the vascular pedicle were not tight. No vascular crisis signs occurred, and the island flaps survived in all patients with stage I of wound healing. The quality and color of the flaps were similar to the skin of receptive area. Conclusion The lengthening technique of Y-V vascular pedicle can enlarge not only the scope of application for island flaps, but also improve the success rate of flap transplantation.

Objective To investigate the frequency of ocular complication and the quality of patient's life after radiation therapy in nasopharyngeal carcinoma ( NPC ) . Methods 254 NPC patients who initially received radiation were followed and analysed. Visual acuity, automational visual field, slit-lamp microscopic findings, pattern visual evoked potential ( P-VEP ) and fundal findings were determined before, during and after radiation therapy. The severity of retinal impairment was assessed according to the international criteria on late tissue effects. Results The radiation dose was more than 70 Gy in 241 (94.9%)NPC patients, giving a radiation retinopathy incidence of 8. 7 % (22) patients after a mean of 46. 8 ? 14. 4 months. After being diagnosed as radiation retinopathy, 16 patients received combined-modality therapy of the modern medicine and Chinese traditional medicine. The disease condition was controlled in 56% (9) patients but progressed into optic neuropathy in 7 patients, 3 of whom developed radiation encephalopathy in 14 to 20 months after onset of retinopathy. The morbidity of radiation retinopathy was not associated with the patient' s age, but was related to the radiation dose. The retinopathy rate was as high as 13.6% in the 75-79 Gy group, which is significantly higher than 5.6% in the 70-74 Gy group ( P

Objective To explore the predictive value of response to neoadjuvant chemotherapy(NAC)in local advanced breast cancer with contrast-enhanced ultrasound(CEUS)of axillary lymph node.Methods CEUS of metastatic axillary lymph nodes in 58 patients stacng Ⅱ-Ⅲ breast cancer was performed before and after NAC treatment. The enhancement patterns and parameters of time-intensity curve were assessed and compared with the pathology.Results The clinic response evaluation were drug-effective in 35 cases and no change in 23 ones.There Were no significant differences in enhancement patterns between no-change and drugeffective groups.Lymph node cortex arriving time was longer in drug-effective cases than that in no-change ones after NAC,whereas it showed no significant differences before NAC.Statistical significant difierence in enhancement duration(ED)was found between the two groups before NAC,which decreased markedly in drug-effective case8 after NAC.Histopatholngic response could be predicted with a sensitivity of 77% and a specificity of 90% by standardized ED below 275 seconds after NAC.No significant difference was found in time to peak(TP),peak intensity(PI)between the two groups.Conclusion The perfusion pattern of axillary lymph node CEUS after NAC Was insufficient to predict curative effect.But the lymph node cortex arriving time and enhancement duration may be of value in the prediction of clinical response to chemotherapy.

Objective To discuss the clinical effect of Da Vinci robot-assisted free fibula flap for the management of mandibular and mouth segmental defect.Methods There was a patient with malignant neoplasm of lower gum,which underwent robot-assisted free fibula flap for the management of mandibular and mouth segmental defect,was analyzed.The surgery was divided into two groups:a group resected the primary tumors,another group cut fibula free flap.Use of Da Vinci robotic surgical system for vascular anastomosis and suture of the oral mucosa.Results Four weeks after surgery,the free fibula flap survived completely.There was no infection in the mouth.The patient can walk freely and eating semifluid.Conclusion The Da Vinci robotic surgical system is a stable,minimally invasive,clear and safe method for microsurgery.

Objective To investigate the clinical efficacy of using the tissue engineering bone loaded with adipose derived stem cells (ADSCs)and perforator flap in the treatment of composite tissue defects.Methods From April,2013 to June,2015,there were 9 cases of traumatic bone and skin composite tissue defects,including 7 males and 2 females,with an averaged age of 43 years old.The ADSCs were isolated,induced and co-cultured with demineralized bone scaffold.The tissue engineering bone and deep inferior epigastric artery perforator (DIEP) flap were adopted for reconstruction of composite tissue defects.Results All 9 patients were followed up for 12-36 months,averaged of 18 months.The bone growth was obviously for 5 cases with bone defects at the middle and lower part of the tibia.They tolerated full weight bearing walking.One case of middle humeral bone defect demonstrated normal bone tissue growth,and the 2/3 of cross section had been restored.One case of humeral bone defect and 1 case of radial bone defect reached bone union.The remaining 1 with skull defect showed new bone growth,but it had not yet achieved complete bone healing.Conclusion The combination of tissue engineering bone and perforator flap is a minimally invasive,easy accessible and effective method for reconstruction of composite tissue defects.

Objective To explore the establishment of an new artificial bladder reflex arc for controlled micturition function in the conical spinal cord injury(SCI). Methods One conical SCI patients were included by lateral microanastomosis of the L6 ventral root to S2 ventral root. After several months of axonal regeneration, the function of bladder were examined clinically and urodynamically. Results Stimulation of the new artificial reflex are could inuduce controlled voiding, and could cause detrusor contraction when following 55 months of one patient. Conclusions Establishing of an new artificial reflex arc may effective for controlled micturition in conical SCI.

Objective To evaluate the clinical value of ~(99m)Tc-MAA imaging in patients with lower extremital posttraumatosis and postoperation(LEPP).Methods 21 LEPP patients with clinical highly suspected acute pulmonary embolism(APE) underwent ~(99m)Tc-MAA veins imaging and pulmonary perfusion imaging(PPI).Vena caval filters were inserted and thrombolysis were given in patients with big area APE and/or iliofemoral vein thrombosis indicated by ~(99m)Tc-MAA imaging.Thrombolysis was given in patients with small area APE and/or subpopliteal vein thrombosis.PPI was reexamined after 2～4weeks` treatment.The lung segments with 100% lack of perfusion were marked 3,those with 25%～75% were marked 2,those with less than 25% were marked 1 and normal was marked 0.The therapeutic results were assessed using this marking system.Results There were 13 patients with big area APE,8 with small area APE,14 with iliofemoral vein thrombosis,and 7 with subpopliteal vein thrombosis.2 cases(9.5%) died before thromobolytic therapy.The marks were significant different before(10.2?3.8) and after(2.8?1.4) treatment(t=7.75,P