Objectives:To study the clinical results and feasibility of continuous brachial plexus nerve block and postoperative anagesia with catheters located by nerve stimulator in interscalene approach. Methods:60 ASAⅠ~Ⅱ patients receiving continuous interscalene brachial plexus block and postoperative analgesia for forearm,wrist or hand surgery were randomized into two groups.In group I,nerve blocks were performed using a normal venous needle located with traditional method which elicites numbness of the limb. Then a epidural catheter was passed and secured. Group Ⅱ were guided by nerve stimulator and special catheters were placed. Results:Compared with group I,time to perform the block,time to block and time to obtain satisfactory sensory and motor blockade in group II were shorter(P

BACKGROUND:Anterior cervical discectomy and bone graft fusion are effective method to treat cervical spondylosis. This method can provide firm fixation and the fusion rate is high. However, for cervical vertebra involved in more than two segments, the stability of fixator and bone graft is poor due to big bone graft span, which may easily cause fusion failure and pseudarthrosis, and impact curative effects. OBJECTIVE:To investigate biomechanical stability of anterior cervical pedicle screw implantation for osteoporosis in the vertebra. METHODS:A total of 12 human cervical vertebrae were col ected, including 6 vertebrae with normal bone density and 6 vertebrae with osteoporosis. Data of 60 vertebra specimens were analyzed. 30 osteoporotic specimens implanted in anterior cervical pedicle screw were set as anterior cervical pedicle screw group. 30 normal specimens implanted in anterior cervical pedicle screw were set as anterior vertebral screw group. According to bone density, 40 vertebrae were col ected in above two groups, and were considered as normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group (n=10). Bone mineral density of each vertebra was detected using dual-energy X-ray absorptiometry. Biomechanical index of two kinds of screws was detected using ElectroForce 3510 material testing machine. RESULTS AND CONCLUSION:Bone mineral content, vertebral screw pul-out strength, vertebral screw pul-out stiffness, pedicle screw pul-out strength, and pedicle screw pul-out stiffness were significantly higher in the anterior cervical pedicle screw group than in the anterior vertebral screw group (P<0.05). The maximum axial pul-out strength of normal bone mineral density group, instant osteoporosis group, fatigue normal bone mineral density group, and fatigue osteoporosis group was significantly higher than in the anterior vertebral screw group (P<0.05). The results confirmed that osteoporotic vertebral biomechanical performance is more stable in anterior pedicle screws compared with the anterior vertebral screw.

Innovation team is an independent and open complex adaptive system, which provides new ideas for recognizing and understanding the inner operating mechanism of innovation teams. This article analyzed the mechanisms of communication and exchange, competition and cooperation, incentive and con-straint as well as the conflict management from the perspective of complex adaptive system.

Objective To Discuss the Clinical Recognition of Acute Myocardial Infarction(AMI) caused by aortic valve incompetence.Methods Data of 275 AMI patients in our hospital recent two years,7 of them were caused by aortic valve incompetence; all of patients(7 AMI) were received coronary artery angioplasty,ultrasound,left ventricular angiography examination,its clinical feature was analyzed.Results All of 7AMI patients have normal coronary without limited constriction or plaque and with aortic valve incompetence.

Objective To observe the expression and the distribution of Netrin-1 in the spastic and normal segment of colon in patients with Hirschsprungs disease (HD) and investigate the relationship between Netrin-1 and development of HD.Methods Colon specimens of 36 cases with HD were selected for this study.Normal segment of colon served as the control group,while the spastic segments of colon as the lesion group.Immunohistochemical staining was applied to detecte the expression and the distribution of Netrin-1.Results Immunohistochemical staining showed that the expression of netrin-1 was positive in the intestinal muscular layers (longitudinal muscle,circular muscles),myenteric ganglias and mucosal layers in the control group.However,the expression of Netrin-1 was also positive in muscular layers and mucosal layer in the lesion group.There was no significant difference in the expression intensity of Netrin-1 between the two groups (P ＞0.05).Conclusion The expression of Netrin-1 in both the control group and the lesion group may indicate that netrin-1 have no significant correlation with genesis of HD.

Objective To discuss and summarize the effects of arthroscopic treatment of posterior ankle impingement syndrome.Methods The study enrolled 30 patients with posterior ankle impingement syndrome treated from January 2008 to November 2015.There were 18 males and 12 females,aged 19-58 years old (mean,37.6 years old).Right ankle injury was noted in 19 patients and left in 11 patients.A total of 27 patients had a history of obvious ankle injury (7 cases of acute sprains and 20 cases of chronic sprains).Arthroscopic surgery,including osteophyte removal,cartilage formation and joint clearance,was performed through the posterolateral and posteromedial approaches.Postoperative outcome was evaluated by using the American Orthopedic Foot and Ankle Society (AOFAS) scores and visual analogue scale (VAS) scores.Results All the patients were followed up for 8-27 months (mean,22 months).These patients got a good healing without nervous and vascular injuries.At the last follow up,the AOFAS score was (89.8 ± 3.8) points,significantly higher than before operation [(35.0 ± 10.1) points,t =-26.456,P =0.000].The VAS score was (2.5 ± 1.3) points,significantly lower than before operation [(6.6 ± 1.9) points,t =12.427,P =0.000].The ankle joint flexion angle was improved significantly from 29.4° ± 2.3° to 43.4° ± 1.4° as compared to preoperative status (t =-32.625,P =0.000).There were 21 cases of excellent result and 9 cases of good result,with an excellent and good rate of 100％.Conclusion Debridement and treatment of complications under arthroscopy is one of the effective methods for the posterior ankle impingement syndrome,which has advantages of minimal invasion,safety,targeted operation,and fast postoperative recovery.

The thesis,from the aspect of professional guidance of education,focuses on the outstanding problems that exist in the work of professional guidance,analyzes the main reasons that caused those outstanding problems,and gives the feasible suggestions to professional guidance in current university education.

Objective To explore the histological properties of isolated chondrons and chondrocytes from rabbit knee cartilage,and to determine if these properties vary with age.Methods Three groups of rabbit knees were evaluated according to different age:(1) young (2 months,n=10);(2) adult (8 months,n=10);and (3) old (31 months,n=10).The cartilage structure,proteoglycan,collagen-2,and collagen-6 content were determined by light microscopic using hematoxylin-eosin (HE),Toluidine Blue,and col-2,6 staining.The chondrons were enzymatically isolated using 0.3 g/L dispase and 0.2 g/L collagenase-2 by shaking for 3 hours.The morphology and composition of isolated chondrons were observed by HE and collagen-6 immunostaining staining after overnight coverslip monolayer culture under a microscopy.Results The chondrocytes became sparser and the total content of proteoglycans and collagen-2 were decreased in the articular cartilage with age.Compared to the chondrocytes,the surrounding rim or capsule was more obvious in the isolated chondrons,and they exhibited obvious differences in shape.The cells within one cluster from different age groups were similar to the morphology observed in cartilage in situ.The adult and old chondrons generally possessed a thicker pericellular matrix with more enclosed cells,and the chondrons contained more cells can reach 47％.Conclusion These findings further suggest that the properties of the chondrons and pericellular matrix have an important influence on the biomechanical microenvironment of the knee joint cartilage degeneration that occurs with age.

Objective:To determine the effects of TPS on peripheral blood Tregs in sepsis mouse induced by burn plus P.aeruginosa infection.Methods: The experimental mice were separated into five groups randomly ,including sham burn group ,burn plus P.aeruginosa infection group ,burn plus P.aeruginosa infection with TPS (50,100,200 mg/kg) treatment group.Peripheral blood Tregs were isolated with Magnetic Microbeads and cultured in vitro from the day after burn (PBD0) to 4 days after burn(PBD4).IL-10, IFN-γ,IL-4 levels in Tregs culture supernatants were determined by sandwich enzyme-linked immunosorbent assays ( ELISA ) . Purification of CD4+CD25high Tregs and CD4+T cells in C57BL/6 mice were administrated by magnetic beads sorting .Tregs and CD4+T cells were cultured in vitro after joining TPS to without TPS cells as a control .The phenotypes of Tregs were analyzed by flow cytometry , and cytokines were measured by ELISA .Results:Vis-a-vis the results of the untreated group ,TPS could markedly decrease IL-4 and IL-10 secretion level and significantly increase the secretion of IFN-γ,and the secretion of IL-10 level and concentration of TPS dose effect.Vis-a-vis the results of the untreated group ,in vitro experiment ,without stimulation of TPS ,CD4+T cell proliferation and IFN-γwere significantly reduced ( P<0.05 ) and IL-4 levels increased significantly;CD4+T cell proliferation and IFN-γwere significantly increased and IL-4 levels were significantly reduced in the group of TPS with antibody-1;there was no significant difference in CD 4+T cell proliferation and the levels of IFN-γand IL-4 in the group of TPS with antibody-2.Conclusion:TPS could inhibit the abnormal ac-tivities of CD4+CD25highTregs in burn with P.aeruginosa infection mice,at least in part via inhibiting IL-10 secretion,and trigger a shift of Th2 to Th1 with activation of CD4+T cells in burn with P.aeruginosa infection mice.

Objective To compare the short-term effects of proximal humerus fractures by deltoid approach or delto-pectoral approach .Methods The clinical records of 53 patients with proximal humeral fracture for two kinds of different treatment were re-viewed :delto-pectoral approach with anatomical form plate(delto-pectoral group ,24 cases) or anterolateral deltoid approach with locking proximal humerus plate (anterolateral deltoid approach group ,29 cases) from May 2008 to May 2013 .The length of inci-sion ,bleeding volume ,postoperative painscores ,union of fracture time ,incidence of complications ,pain and function of shoulder score (Neer scores) were compared and recorded .Results All the patients were followed up for 6 - 24 months(mean 16 .3 month) , and all patients obtained bone union .The anterolateral deltoid approach was significantly higher than delto-pectoral approach in the operation fime ,the bleeding volume ,postoperative painscores ,union of fracture time ,pain and function of shoulder score(after a month)(P< 0 .05) .There were not significant differences of function of shoulder score (beyond 6 months)(P > 0 .05) .By delto-pectoral approach ,there were 2 cases with delayed wound healing ,3 cases underwent the loosening of screw ,4 cases humerus head varus and 2 cases necrosis of head of humerus ,with the rate of complications of 45 .8% .On the other hand ,deltoid approach group were 2 cases underwent screw cutting and 2 cases humerus head varus ,with the rate of complications of 13 .8% (P< 0 .05) .Conclu-sion The clinical results of anterolateraldeltoid approach group with locking proximal humerus plate had the advantage of reliable fixation ,less suffering ,less surgical trauma and less complication ,which was better the short-term effects than delto-pectoral ap-proach with atomical from plate .