The vessels and nerves in the pectoacromial region were dissected under an operative microscope on 50 human specimens. The main blood supply of this region comes from the thoracoacromial artery. Its deltoid, pectoral, and clavicular branches all have secondary branches to the pectoralis major. In 94% of the cases, the .deltoid branch sends out a cutaneous branch known as the thoracoacromial cutaneous branch. Its external caliber is 1.22mm in average and it distributes over the cutaneous region covering the anterior portion of the del-toideus, the subclavian fossa, and the upper portion of the pectoralis major with an average area of 80.63cm2.An extended pectoralis major myocutaneous flap can be designed taking the thoracoacromial artery or its deltoid branch as its pedicle. This myocutaneous flap can contain an axial skin flap supplied by the thoracoacromial cutaneous branch.

Objective This article provides a reform operative method for repairing non union in proximal or middle ulna Methods According to anatomical stady of recurrent interosseous artery from both blood supply and biology strength designs the transposition of proximal ulna periosteal bone flap, combining external fixator to repair non union in ulna Results Twelve cases of non union in proximal or middle ulna were treated by this means, these results were encouraging Conclusions Periosteal bone flap based on recurrent interosseous artery has a stable position, reliable blood supply and no injuring main vessel Moreover external fixator has many advanture, such as steady fixation, rarely damage, simply operation, function train early to prevent producing stiff joint, activate fracture with physiological force, Both can prompt the healing of fracture, It is an efficient method to cure non union in proximal or middle ulna

Objective To investigate the current situation and relevant factors related to the onset of Keshan disease (KSD) in Ju County of Shandong Province.Methods In 2012,one natural village was selected by means of random number table as the investigating site in Qishan,Anzhuang and Longshan towns,respectively,in KSD endemic areas of Ju County.Permanent residents of all age groups were taken as observation subjects.Then,clinical examination including electrocardiography (ECG) and X-ray for suspected patients was carried out.Fifteen hair samples were collected in every investigating site for detecting selenium content by fluorescence method.At the same time,economic income and per capita share of grain were investigated.Results There were 925 residents investigated in the 3 investigation sites and 27 cases of KSD were found; the total incidence rate was 2.92％.Among the 925 residents investigated,158 cases showed abnormal ECG,and total incidence of abnormal ECG was 17.08％.Among 11 X-ray films,5 cases of cardiac enlargement were found.The selenium content of hair was (0.430 ± 0.062) mg/kg; the average economic income was 9 561 yuan,and the per capita share of grain was 820 kg.Conclusions The incidence rate of KSD in Ju County is low and steady.Keshan disease is controlled in Ju County.

Objective To investigate the clinical values of sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients.Methods From June 2012 to September 2015 in Taihe Hospital Affiliated to Hubei Medical College,136 patellofemoral arthritis knee pain patients were selected and randomly divided into treatment group (68 cases) and control group (68 cases).All patients were given arthroscopic joint clean-up surgery,the control group were given the postoperative glucosamine sulfate capsules treatment,and the treatment group were given the postoperative intra-articular injection of sodium hyaluronate choose treatment,the treatment period was 5 weeks.Results Five weeks after treatment,the response rates in the treatment group and control group were 98.5％ (67/68) and 89.7％ (61/68),and the effect of the treatment group was better(x2 =4.202,P＜0.05).The pain scores in the treatment and control group were (1.34±0.45) points and (2.89±0.62) points,significandy lower than that of before operation ((7.30 ± 0.76) points and (7.31 ± 0.56) points;t =34.855,25.142;P ＜ 0.05).The Lysholm score in the treatment and control group were (88.87 ± 6.33) points and (76.13 ± 5.98) point,significantly higher than before operation ((44.23 ± 4.29) points and (44.67 ± 5.13) point;t =14.875,8.113;P＜0.05).The incidence of adverse events during the treatment in the treatment group and the control group were 8.8％(6/68) and 13.2％(9/68) respectively,there was no significant differemce between the two groups (x2 =0.391,P＞0.05).All adverse reactions after symptomatic treatment were improved.Conclusion Sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients can effectively play the role of promoting the knee pain and function,and has good efficacy and safety,and is worth popularizing and applying.

Objective To investigate the effect of arthroscopic reconstruction of anterior cruciate ligament on the expression of serum osteopontin (OPN) and CD44.Methods Ninety-six cases patients with joint cross ligament injury who were teated in Taihe Hospital Affiliated to Hubei University of Medicine from February 2013 to June 2015 were selected and randomly equally divided into treatment group and control group.Two groups were adopted arthroscopic surgical treatment,and the control group were given the singletunnel reconstruction,the treatment group were given the double-tunnel reconstruction.Results The IKDC scores of 3 months after operation in the treatment group and control group were (92.44±5.13)points and (85.25±4.67) points,both significantly lower than before operation ((57.24 ± 4.19) points,(57.10 ± 4.87)points;P ＜ 0.05)),while there was statistically significant difference between groups (P ＜ 0.05).The total complication rate after 3 months operation in the treatment group was 6.3％,significantly less than that of the control group (35.4％;x2 =5.838,P＜0.05).The OPN expression levels of before and 3 months after operation in the treatment group were (31.98±4.21) μg/L,(7.13±2.89) μg/L,and CD44 were (419.45±20.45) μg/L,(167.24± 18.46) μg/L,the differences were significant (t =34.214,21.774;P＜ 0.05).The OPN expression levels of before and 3 months after operation in the control group were (32.09 ± 3.98) μg/L,(15.98 ± 3.67) μg/L,and CD44 were (421.87 ± 19.45) μg/L,(245.98 ± 20.56) μg/L,the differences were significant (t=21.833,14.099;P＜0.05).There were significant differences on OPN and CD44 of after operation between the two groups (t =12.847,7.498;P＜ 0.05).Conclusion Compare to single-tunnel reconstruction,double-tunnel reconstruction for the anterior cruciate ligament endoscopic surgery can increase restore knee function and reduce postoperative complications,and its mechanism may effectively reduce the levels of OPN and CD44 expression.

Objective To explore the improvement effect of SLOT Scan technology (narrow seam exposure capture technology) and the radiography techniques on the quality of the scoliosis X-ray films in teenagers. Methods The Sonialvision Satire Ⅱ equipment of Shimadzu corporation and SLOT Scan were applied to take the radiography for 60 patients taller than 1.50 metres. All the data were collected through a continual exposure, and the images were sewn up through a seamless connec-tion software. Results Cervical, thoracic, and lumbar and sacral segments could clearly present at the same time on one X-ray film by seamless splicing, and the quality of one time radiograph was as good as one film. Conclusion As a new radiology technique, SLOT Scan can wipe off splitting arti-fact effectively and make the whole spine seamless present on one X-ray film. It helps the spinal sur-geons to observe, calculate and measure accurately. It is useful to choose the operation mode and judge the curative effect.

Objective To study the effects of marrow mesenchymal stem cells on heart functions and ventricular remodeling after myocardial infarction in rats. Methods Myocardial infarction model was established by ligation of the left anterior descending coronary artery (LAD) in adult SD rats. 4 and 8 weeks after MMSCs implantation, he-modynamic evaluations, left ventricular weight/body weight ratio and heart weight/body weight ratio were determined. HE staining was performed for counting microvasculars and Van Gieson staining was used for measurements and calculation of the myocardial fibrillar collagen. Then we investigated the migration and evolution of MSCs in vivo by fluorescent microscope. Results HR was significantly decreased in transplantation MMSCs group. Eight weeks after transplantation, body weight in transplantation MMSCs group reached that of control group. At the same time, SBP, DBP and MBP were significantly increased in transplantation MMSCs group. HR was significantly decreased in transplantation MMSCs group. Secondly, left ventricular weight/body weight ratio and heart weight/body weight ratio were significantly decreased 4 weeks after transplantation MMSCs. Then the ratio was significantly decreased 8 weeks after transplantation MMSCs. Thirdly density of microvasculars was increased at the boundary of infarction site in the animals transplanted MMSCs. Finally, total volume of the myocardial fibrillar collagen was reduced in the MMSCs treated groups after MI. Conclusion Transplanting MMSCs can improve the ventricular remodeling and heart functions in acute MI rat models.

Objective To study the effects of marrow mesenchymal stem cells on heart functions and ventricular remodeling after myocardial infarction in rats. Methods Myocardial infarction model was established by ligation of the left anterior descending coronary artery (LAD) in adult SD rats. 4 and 8 weeks after MMSCs implantation,hemodynamic evaluations,left ventricular weight/body weight ratio and heart weight/body weight ratio were determined. HE staining was performed for counting microvasculars and Van Gieson staining was used for measurements and calculation of the myocardial fibrillar collagen. Then we investigated the migration and evolution of MSCs in vivo by fluorescent microscope. Results HR was significantly decreased in transplantation MMSCs group. Eight weeks after transplantation,body weight in transplantation MMSCs group reached that of control group. At the same time,SBP,DBP and MBP were significantly increased in transplantation MMSCs group. HR was significantly decreased in transplantation MMSCs group. Secondly,left ventricular weight/body weight ratio and heart weight/bodyweight ratio were significantly decreased 4 weeks after transplantation MMSCs. Then the ratio was significantly decreased 8 weeks after transplantation MMSCs. Thirdly density of microvasculars was increased at the boundary of infarction site in the animals transplanted MMSCs. Finally,total volume of the myocardial fibrillar collagen was reduced in the MMSCs treated groups after MI. Conclusion Transplanting MMSCs can improve the ventricular remodeling and heart functions in acute MI rat models.

Objective To provide a scientific basis for prevention of Keshan disease by observing the changes of electrocardiogram in residents from Keshan disease area and urban residents in Ju County.Method In 2013,four countries (towns) of Sangyuan,Anzhuang,Qishan and Longshan were selected as the investigation sites across the Keshan disease areas in Ju County of Shandong Province,one village was selected in each country (town),no less than 200 people were chosen from each village.There were 36 residential communities in urban area in Ju County,one residential community was selected from 4 positions (east,west,south and north) in urban area,no less than 200 non-endemic urban residents were chosen from each residential community as control,the electrocardiogram examination was conducted.According to the Keshan Disease Diagnostic Standard (WS/T 210-2011),Keshan disease was diagnosed.Results Among the 964 inhabitants investigated in Keshan disease area,143 cases showed abnormal electrocardiogram and the detection rate was 14.83％;in the 926 cases of urban electrocardiogram,78 cases showed abnormal electrocardiogram,abnormal rate was 8.42％,the difference was statistically significant (x2 =18.80,P ＜ 0.01).There were 93 cases who met the 8 Keshan disease diagnostic criteria of abnormal electrocardiogram changes in the Keshan disease areas,abnormal rate was 9.65％;while there were 37 cases in urban residents,abnormal rate was 4.00％,the difference was statistically significant (x2 =23.55,P ＜ 0.01).Conclusion These residents who have lived in Keshan disease endemic areas have a higher rate of abnormal electrocardiogram in Ju County of Shandong Province,they are still threatened by the causative factors of Keshan disease,and the authority should strengthen the prevention measures of Keshan disease.

Objective To make sciatic nerve traction injury models of rabbit , in order to prospectively evaluate possibility and accuracy of diffusion tensor tracking (DTT) in sciatic nerve injures. Methods The right sciatic nerves of 32 New Zealand white rabbits were selected for traction injury , and the left sciatic nerves were the sham operation side. DTI scan was performed before and after the operation on 1st day , 3rd day, and 1 week, 2, 3, 4, 6 and 8th week respectively, and DTT was reconstructed. Then the length of reconstructed fiber tracts and fiber density index were calculated. After the MRI scan , the sciatic nerve was removed to perform pathologic examination at different time points. Results The difference of the length of reconstructed fiber tracts between nerve traction injury and sham operation side was significant at 1 day~2weeks after operation (P<0.05), while the difference was not significant at 3~8 weeks.The fiber density index of nerve traction injury and sham operation side was significantly different at 1 day~8 weeks(P<0.05). 1day after operation, myelin sheath of traction portion was obviously twisting. 3 days after operation , a large amount of myelin sheath broke down. 2 weeks after operation , axon, myelin sheath degeneration and regeneration coexisted at the same time. 8 weeks after operation , nerve fibers regenerated and restored to normal structure. Conclusion The length time curve and density index-time curve of nerve traction injury are consistent with the changes of pathology , which can be used as a supplementary method to evaluate the degeneration and regeneration in nerve injury.