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.

Hepatic myelopathy is one of special category changes of nervous system,which was secondary to the end-stage hepatic diseases and is a syndrome of myeleterosis.It usually occurred after portosystemic shunt surgery or collateral circulation of portosystemic vein.The prognosis of hepatic myelopathy is poor,and the progression of this disease is slow.Surgical approaches such as dissociation of colon and anastomosis of ileum and rectum aimed at reducing the absorption of toxic substance and thus to breakdown the blood ammonia and improve the symptoms of nervous system,but the effects are not satisfactory.The clinical data of 1 patient with hepatic myelopathy who received liver transplantation at the Second Affiliated Hospital of Dalian Medical University in April 2012 were retrospectively analyzed.The clinical symptoms and physical signs were improved,and muscle strength was effectively recovered in the patient.Liver transplantation might be an effective method for the treatment of hepatic myelopathy.

Objective To study the effect of dexmedetomidine and midazolam on hemodynamics and sedation in patients with nasal intubation.Methods Forty patients whose ASA grade Ⅰ-Ⅱ and anticipated difficult airway were randomly divided into dexmedetomidine group(group D,20 cases)and midazolam group(group M,20 cases)according to the admission number.In group D,dexmedetomidine 1 μ g/kg were constant speed pumped in 10 minutes.In group M,midazolam 0.03 mg/kg were intravenous injected.Then nasal intubation were carried.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial blood pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO2),Ramsay sedation score,rate-pressure product(RPP),tip perfusion index(TPI)were recorded and compared before anesthesia (T0),fiberoptic bronchoscope pass by later nostril(T1),to spy on epiglottis(T2),intubation succeed(T3),after intubation 1 minute(T4)and after intubation 3 minutes(T5).Airway score and postoperative visit were evaluated.Results SBP,DBP,MAP,HR,RPP in group M were significantly higher at T1-T3 than those at T0 (P＜0.05),and were significantly higher than those in group D at the same time(P＜ 0.05).There was no significant difference in group D(P ＞ 0.05).Ramsay sedation score and TPI at T1-T3 in group M were significantly lower than those at To(P ＜0.05).Ramsay sedation score and TPI at T1-T5 in group D were significantly higher than those at T0(P ＜ 0.05),and were significantly higher than those in group M at the same time(P ＜ 0.05).The rate of airway score 1 score and intubation satisfaction in group D were significantly higher than those in group M[100％(20/20)vs.30％(6/20),90％(18/20)vs.50％(10/20)](P＜ 0.05).The rate of throat ache in group D was significantly lower than that in group M[5％(1/20)vs.35％(7/20)](P ＜0.05).Conclusions For difficult airway patients with nasal intubation during dexmedetomidine infusion,hemodynamics is stable and sedation is satisfied.

Objective To solve the problems of clinical laboratory module in mobile medical unit such as miscellaneous and mixed equipment,disordered packages,and weak mobility and responsiveness.Methods The concept of modularization was used for the secondary optimization of clinical laboratory equipment and consumables.The specialized vehicle for clinical laboratory was designed with considerations on the advantages of clinical laboratory shelter in equipment and medical vehicle in mobility,so as the values of clinical laboratory module were enhanced in mobile medical unit.Results Modular and standardized management of clinical laboratory equipment was realized to solve the existing problems of equipment.Conclusion The equipment supportability and mobility are enhanced in mobile medical unit,so that the requirements can be fulfilled for medical support missions at peace time and wartime.

Histone methyltransferase SMYD3 (SET and MYND domain containing 3) is a protein which has the function of histone methylation found in recent years,it has an important role in transcriptional regulation.The research shows that SMYD3 inhibit apoptosis and promote cell proliferation,invasion and metastasis.More and more data shows SMYD3 highly expressed in liver cancer and is low in normal tissues which is even undetectable.SMYD3 level was significantly associated with prognosis,and gene silencing experiments in SMYD3 tumor cell growth was inhibited.Therefor,SMYD3 is closely related with the development and prognosis of HCC occurrence,which suggests that people can suppress the expression SMYD3 to block tumor cell growth,migration and improve prognosis to provide new goals and direction for the future of cancer treatment.

ObjectiveTo detect the mutations of GJB3 and GJB4 genes in two sporadic cases of erythrokeratodermia variabilis(EKV).MethodsGenomic DNA was extracted from two sporadic patients with EKV,their family members,and 100 normal human controls.All the exons and adjacent splice sites of GJB3 and GJB4 genes were amplified by PCR.Mutation scanning was carried out via direct bidirectional DNA sequencing.ResultsA G134C mutation was found at the GJB3 gene in patient 1,which caused a substitution of glycine by alanine at codon 45 (G45A).No mutation was found in the GJB4 gene in case 1 or GJB3 and GJB4 genes in case 2.ConclusionA missence mutation G45A in GJB3 gene is found in a patient with EKV.

BACKGROUND: It is a hot investigation to many scholars that how to cure and prevent renal ischemic reperfusion injury in a utility way, but the mechanism is unclear at present. The investigation indicates that aquaporiin-1 plays an important role during this process. OBJECTIVE: To research the correlation between aquaporin-1 expression and renal function change following renal ischemic reperfusion injury. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at Histology and Embryology Laboratory of Dalian Medical University from June 2007 to December 2008. MATERIALS: A total of 80 healthy female adult Wister rats were randomly divided into control group and ischemia-reperfusion group. Rats in each group were observed at days 1, 2, 3, 5, and 7 after operation, with 8 rats for each group. The ischemia-reperfusion injury was established on the left kidney. METHODS: Right kidney was removed. The left renal pedicle was freed and occlused to establish ischemia-reperfusion injury model. After 40 minutes, the blood was re-flowed. If the kidney colored from dark red to bright red within 2-5 minutes, the ischemia-reperfusion injury models were successfully established, and the thrombus was not formed in the kidney vessels. If the kidney was still dark red after 5 minutes, the thrombus was formed, and the rats were excluded from the ischemia-reperfusion group. The abdomen was sutured after 40 minutes.MAIN OUTCOME MEASURES: Rats were sacrificed at days 1, 2, 3, 5, and 7 after ischemia-reperfusion injury. Samples of urine, serum, and kidney were performed with the examinations of urine, renal function, renal pathology and morphology, immunohistological assay of aquaporiin-1, and RT-PCR assay. RESULTS: After ischemia-reperfusion injury, the rats had hydrouria, urine osmotic pressure depress, symptoms of carnine and urea nitrogen increasing. HE staining demonstrated that renal tubular epithelial cells were swelling, necrosis, and desquamate. Aquaporin-1 expression and its mRNA level was decreased; in particular, the expression and level were the lowest at day 1 after ischemia-reperfusion injury and recovered to normal value at day 5 after ischemia-reperfusion injury. CONCLUNSION: The down expression of aquaporin-1 maybe one of the important indicators to reflect renal functional changes of acute renal failure following renal ischemia-reperfusion injury.

Objective To characterize the viability and transgene expression of articular chon-drocytes cultured in 3-Dimensional scaffolds provided by four types of carriers.Methods Articular chondrocytes from rabbit knees were cultured and infected with adenovirus that could express green fluo-rescence protein (AdGFP) and GL3 luciferase (AdGL3-Luc).The viability and gene expression were determined with fluorescence microscopy and luciferase assays in four types of scaffolds;type I collagen sponge, fibrin glue, hyaluronan and open-cell polylactic acid (OPLA).Cartilage matrix production was assessed by Alcian blue staining.Results Articular chondrocytes of rabbits were effectively infected by AdGFP and exhibited sustained GFP expression.All the tested scaffolds supported the survival and gene expression of the infected chondrocytes.However, the highest transgene expression was observed in the OPLA carrier (P<0.01).Alcian blue-positive matrix materials were readily detected in OPLA cultures four weeks later.Conclusion OPLA supports the highest transgene expression and is the most conduc-tive scaffold for matrix production, suggesting that OPLA may be a suitable scaffold for cell-based gene therapy of articular cartilage repair.

Hepatocellular carcinoma (HCC) greatly threatens human health. In clinical treatment, the therapeutic strategies for HCC are attracting more attention. With the research advances in the pathogenesis of HCC and the rapid development of molecular biology techniques, the therapies with molecular-targeted antitumor drugs for advanced HCC have become a hot research topic, and significant efficacy has been achieved in clinical practice. This article summarizes the research advances in clinical application of molecular-targeted drugs for the treatment of HCC and related issues, discusses the future perspectives of therapeutic strategies, and provides a new direction and reference for the clinical treatment of HCC.