BACKGROUNDThere are few effective methods for treating injuries to the lower trunk of brachial plexus, and the curative effect is usually poor. The purpose of this study was to provide anatomic references for transferring the brachialis muscle branch of musculocutaneous nerve (BMBMCN) for selective neurotization of finger flexion in brachial plexus lower trunk injury, and to evaluate its clinical curative effects.

METHODSMicroanatomy and measurement were done on 50 limbs from 25 adult human cadavers to observe the origin, branch, type of the BMBMCN and median nerve, as well as their adjacent structures. Internal topographic features of the fascicular groups of the median nerve at the level of the BMBMCN were observed. In addition, the technique of BMBMCN transfer for selective neurotization of finger flexion of the median nerve was designed and tested in 6 fresh adult human cadavers. Acetylcholinesterase (AchE) staining of the BMBMCN and median nerve was done to observe the features of the nerve fibers. This technique was clinically tried to restore digital flexion in 6 cases of adult brachial plexus lower trunk injury. These cases were followed up for 3, 6, 9 and 12 months postoperatively. Recovery of function, grip strength, nerve electrophysiology and muscle power of the affected limbs were observed and measured.

RESULTSThe brachialis muscle was totally innervated by the musculocutaneous nerve (MCN). Based on the Hunter's line, the level of the origin of the BMBMCN was (13.18 +/- 2.77) cm. AchE histochemical staining indicated that the BMBMCN were totally made up of medullated nerve fibers. At the level of the BMBMCN, the median nerve consistently collected into three fascicular groups as shown by microanatomy in combination with AchE stain. The posterior fascicular group was mainly composed of anterior interosseous nerves and branches to the palmaris longus. The technique was tested in six fresh cadavers successfully, except that stoma split occurred in one case. Five of the six cases recovered digital flexion 12 months after operation, and at the same time grip strength, muscle power, and nerve electrophysiology also recovered markedly.

CONCLUSIONSThe technique of transferring the BMBMCN for selective neurotization of finger flexion is anatomically safe and effective, with satisfactory clinical outcomes.

Acetylcholinesterase ; analysis ; Adult ; Brachial Plexus ; anatomy & histology ; injuries ; Brachial Plexus Neuropathies ; surgery ; Clinical Trials as Topic ; Female ; Humans ; Male ; Middle Aged ; Musculocutaneous Nerve ; transplantation ; Nerve Transfer ; methods ; Retrospective Studies

OBJECTIVETo observe the effects on the lower limbs function after lumbar or sacral nerve root transferring to reconstruct urination function.

METHODSNine patients with bladder dysfunction and normal lower limb function after spinal cord injury were treated with anastomosis the S2 or S3 nerve root with the normal lumbar or sacral nerve root to reconstruct a new bladder artificial reflex arc. Then the alterations on the sensation and motor function of the lower limb after the surgery were observed.

RESULTSMyodynamia of the legs decreased slightly, and the decreasing about half grade of the myodynamia in the plantar flexion of the ankles were detected in 4 of 9 patients with S1 transferring. And the myodynamia recovered 3 months postoperatively. No obvious decreasing of the myodynamia appeared in the other cases.

CONCLUSIONNo obvious effects on the motor function can be found after the single lumbar or sacral nerve root transferring to reconstruct urination function.

Adult ; Exercise ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; innervation ; physiopathology ; Lumbosacral Region ; Male ; Middle Aged ; Reflex ; Rhizotomy ; Spinal Cord Injuries ; complications ; physiopathology ; Spinal Nerve Roots ; surgery ; Treatment Outcome ; Urinary Bladder ; innervation ; physiopathology ; Urinary Bladder, Neurogenic ; etiology ; physiopathology ; surgery

BACKGROUNDTissue Doppler imaging (TDI) has provided an objective means to quantify global and regional left ventricular (LV) and right ventricular (RV) function with improved accuracy and greater reproducibility than conventional echocardiography. This study was conducted to assess RV myocardial systolic activation by TDI in subjects with pulmonary arterial hypertension (PAH).

METHODSA total of 30 patients with PAH and 30 healthy volunteers, all comparable in age and sex, underwent standard Doppler echo and TDI. Using pulsed Doppler echocardiography combined with TDI, the following regional parameters were evaluated in three different myocardial segments (RV basal lateral wall, basal septal, and LV basal lateral) on apical 4-chamber view: systolic (Sm), early- and late-diastolic (Em and Am) peak velocities. RV myocardial systolic activation delay was defined as the difference in time to peak TDI systolic velocities between the RV basal lateral wall and basal septal. In addition, RV end-diastolic and end-systolic areas were measured to calculate RV fractional area change from the same apical 4-chamber view.

RESULTSCompared with the control group, patients with PAH showed increased RA and RV end-diastolic diameter (RA: (4.5 +/- 1.2) cm vs (3.0 +/- 0.8) cm, P < 0.05 and RV: (4.8 +/- 1.9) cm vs (3.4 +/- 0.5) cm, P < 0.05) and reduced RV fractional area change; (35 +/- 14)% vs (56 +/- 9)%, P < 0.05. These PAH patients showed lower myocardial peak velocities and a significant activation delay compared with controls (P < 0.05). Moreover, a strong correlation between RV myocardial systolic activation delay and RV fractional area change was shown in patients with pulmonary arterial hypertension (r = -0.82).

CONCLUSIONSIn PAH, RV myocardial systolic activation was markedly delayed, which was directly related to the RV fractional area change. RV myocardial systolic activation delay assessed by TDI could offer a unique approach to predict RV dysfunction.

Adolescent ; Adult ; Diastole ; Echocardiography, Doppler ; Female ; Humans ; Hypertension, Pulmonary ; physiopathology ; Male ; Middle Aged ; Systole ; Ventricular Dysfunction, Right ; etiology ; Ventricular Function, Right

OBJECTIVETo observe the therapeutic effect of shengxuening (SXN) in treating iron-deficiency anemia (IDA) and to explore its molecular mechanism on iron metabolism balance regulation.

METHODSPatients with IDA were randomly divided into the treated group and the control group, 50 in each group. They were treated with SXN (0.1 g, three times per day) and ferrous gluconate (0.1 g, three times per day) respectively, for 30 days. Levels of serum iron (Fe), total iron binding capacity (TIBC), transferrin saturation (TS), serum ferritin (SF), transferrin (Tf), soluble transferrin receptor (sTfR) and blood routine test, as well as scoring of TCM qi-blood deficiency Syndrome were conducted before and after treatment.

RESULTSThe total effective rate in the treated group reached 92%, it was shown that SXN could improve the iron metabolism, increase levels of Fe, TS, SF and reduce levels of TIBC, Tf, sTfR, it has obvious effect in promoting erythrocyte generation and could promote formation of leucocytes and platelets. The total effective rate in the control group was 32%, which was significantly lower than that in the treated group (P < 0.01).

CONCLUSIONThe effect of SXN in treating IDA and qi-blood deficiency Syndrome is evident, it could improve the iron metabolism, increase levels of Fe, TS, SF and lower levels of TIBC, Tf, sTfR.

Adolescent ; Adult ; Anemia, Iron-Deficiency ; blood ; drug therapy ; Child ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Ferritins ; blood ; Humans ; Iron ; blood ; Male ; Middle Aged ; Phytotherapy ; Receptors, Transferrin ; blood

Objective To explore the clinical effect of closed reduction and internal fixation with percutaneous cannulated screws through posterior to anterior(PA)approach with reference to posteromedial vertical syndesmotic line(PVSL)for the treatment of posterior malleolus fractures.Methods A total of 23 patients with posterior malleolus fractures in our hospital from January 2020 to January 2022 were slected,and received closed reduction and internal fixation with percutaneous cannulated screws through PA approach with reference to PVSL.The fracture reduction,functional recovery of ankle joint,occurrence of complications,and rehabilitation of patients after surgery were recorded.Results After surgery,23 patients were followed up for 6 to 20 months.After surgery,the posterior malleolar fracture fragments of all patients were of good reduction,with the displacement less than 2 mm.The X-ray showed that all fractures healed,with the fracture healing time of 3 to 6 months.The American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot scores ranged from 76 to 100 points,with an average of(89.8±8.2)points;the ankle joint function was excellent in 17 cases,good in 5 cases,and moderate in 1 case,with an excellent and good rate of 95.7%.No complications such as screw loosening or breakage occurred in all cases.Conclusion The closed reduction and internal fixation with percutaneous cannulated screws through PA approach with reference to PVSL has a significant surgical effect for posterior malleolus fractures,which is worthy of clinical promotion and application.

Oval cells have a potential to differentiate into a variety of cell lineages including hepatocytes and biliary epithelia. Several models have been established to activate the oval cells by incorporating a variety of toxins and carcinogens, alone or combined with surgical treatment. Those models are obviously not suitable for the study on human hepatic oval cells. It is necessary to establish a new and efficient model to study the human hepatic oval cells. In this study, the hepatocyte growth factor (HGF) and epidermal growth factor (EGF) were used to induce differentiation of mouse embryonic stem (ES) cells into hepatic oval cells. We first confirmed that hepatic oval cells derived from ES cells, which are bipotential, do exist during the course of mouse ES cells' differentiation into hepatic parenchymal cells. RT-PCR and transmission electron microscopy were applied in this study. The ratio of Sca-1+/CD34+ cells sorted by FACS in the induction group was increased from day 4 and reached the maximum on the day 8, whereas that in the control group remained at a low level. The differentiation ratio of Sca-1+/CD34+ cells in the induction group was significantly higher than that in the control group. About 92.48% of the sorted Sca-1+/CD34+ cells on the day 8 were A6 positive. Highly purified A6+/Sca-1+/CD34+ hepatic oval cells derived from ES cells could be obtained by FACS. The differentiation ratio of hepatic oval cells in the induction group (up to 4.46%) was significantly higher than that in the control group. The number of hepatic oval cells could be increased significantly by HGF and EGF. The study also examined the ultrastructures of ES-derived hepatic oval cells' membrane surface by atomic force microscopy. The ES-derived hepatic oval cells cultured and sorted by our protocols may be available for the future clinical application.
Animals ; Antigens, CD34 ; genetics ; metabolism ; Antigens, Ly ; genetics ; metabolism ; Cell Differentiation ; drug effects ; genetics ; physiology ; Cell Line ; Embryonic Stem Cells ; cytology ; metabolism ; ultrastructure ; Epidermal Growth Factor ; pharmacology ; Flow Cytometry ; Gene Expression Regulation, Developmental ; drug effects ; Hepatocyte Growth Factor ; pharmacology ; Liver ; cytology ; metabolism ; Membrane Proteins ; genetics ; metabolism ; Mice ; Mice, Inbred BALB C ; Microfilament Proteins ; metabolism ; Microscopy, Atomic Force ; Microscopy, Electron, Transmission ; Reverse Transcriptase Polymerase Chain Reaction ; Stem Cells ; cytology ; metabolism ; ultrastructure ; Time Factors

OBJECTIVETo evaluate salt tolerance of seedlings of 4 medicinal C. morifolium cultivars to be transplanted, and to expand the planting area.

METHODSeedlings were cultivated in hoagland nutrient solution containing various concentrations of NaCl for 30 days. The height, dry weight and chlorophyll content were investigated. Identification index mainly in relative growth rate, the evaluation of NaCl effects on the growth, K+, Na+ and Cl- distribution in seedlings were surveyed.

RESULT AND CONCLUSIONThe salt tolerance was difference among four cultivars of C. morifolium. The salt tolerance of "Dabaiju" and "Changbanju" was weak, while "Hongxinju" and "Xiaobaiju" was strong. "Hongxinju" and "Xiaobaiju" may be planted in salinte soil area.

Chlorine ; metabolism ; Chlorogenic Acid ; metabolism ; Chrysanthemum ; classification ; growth & development ; metabolism ; Plant Leaves ; chemistry ; Plant Roots ; chemistry ; Plant Stems ; chemistry ; Plants, Medicinal ; growth & development ; metabolism ; Potassium ; metabolism ; Seedlings ; growth & development ; metabolism ; Sodium ; metabolism ; Sodium Chloride ; pharmacology ; Species Specificity

Mr. LIU Zhang-jie, one of the disciples of CHENG Dan-an who is considered as the initiator of the Chengjiang acupuncture school, is a famous acupuncturist in Fujian Province. With the collection and arrangement of Mr. LIU's literatures, medical records, books and interview of his student. ZHANG Yong-shu, Mr. LIU's academic characteristics are analyzed and summarized in this paper, mainly including being focused on finger power and manipulating without pain; being good at direct moxibustion to elevate yang-qi and drive out evil spirits; highlighting meridian syndrome differentiation and combined use of the four diagnostic methods; each disease has its own pathogeny, eliminating pathogen is the key; valuing the curative effect with flexible apply of acupuncture and Chinese medicine. In a word, Mr. LIU, who inherited the school's scholarism and developed it into next level, is one of Chengjiang acupuncture school's representative figures.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; Humans ; Moxibustion ; history ; Schools ; history

OBJECTIVETo investigate the mechanism of anti-death receptor 5-10 (AD5-10) combined with epirubicin in treating rheumatoid arthritis (RA).

METHODSWe detected the cell viability of the fibroblast-like synoviocytes (FLS) from RA patients with MTT. The expression level of apoptosis signaling pathways protein, p53, and p21 were evaluated with Western blot.

RESULTSWe found that epirubicin, at different doses, could enhance the effect of AD5-10 on FLS, promoting the apoptosis of FLS. The expression levels of caspase-3, -8, -9, c-FLIP, Bcl-2, p53, and p21 in the FLS changed after epirubicin treatment.

CONCLUSIONEpirubicin may coordinate with AD5-10 in inducing FLS apoptosis through affecting the levels of p53, p21, c-FLIP, and Bcl-2.

Antibodies, Monoclonal ; pharmacology ; Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; metabolism ; Arthritis, Rheumatoid ; drug therapy ; metabolism ; pathology ; Cells, Cultured ; Epirubicin ; pharmacology ; Humans ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; immunology ; Synovial Membrane ; cytology ; drug effects ; metabolism

OBJECTIVETo observe the skin regeneration after hair follicle bulb cells were implanted into collagen/chitosan porous scaffolds in vitro.

METHODSThe cultured dorsal hair follicle bulb cells of 4d-old C57BL/6J mice were implanted into collagen/chitosan porous scaffolds in vitro. The skin regeneration was observed.

RESULTThe skin-like structure was formed on the collagen/chitosan porous scaffolds where were cultured the hair follicle bulb cells before 4th passages.

CONCLUSIONThe skin-like structure is generated in vitro when early passages of cultured hair bulb cells are implanted into collagen/chitosan porous scaffolds.

Animals ; Chitin ; analogs & derivatives ; Chitosan ; Collagen ; Hair Follicle ; cytology ; Mice ; Mice, Inbred C57BL ; Regeneration ; Skin ; cytology ; Tissue Engineering