OBJECTIVE: To testify the spatial relationship between the subscapularis muscle splitting window and the axillary nerve in modified arthroscopic Latarjet procedure, which could provide anatomical basis for the modification of the subscapularis muscle splitting. METHODS: A total of 29 adult cadaveric shoulder specimens were dissected layer by layer, and the axillary nerve was finally confirmed to walk on the front surface of the subscapularis muscle. Keeping the shoulder joint in a neutral position, the Kirschner wire was passed through the subscapularis muscle from back to front at the 4 : 00 position of the right glenoid circle (7 : 00 position of the left glenoid circle), and the anterior exit point (point A, the point of splitting subscapularis muscle during Latarjet procedure) was recorded. The vertical and horizontal distances between point A and the axillary nerve were measured respectively. RESULTS: In the neutral position of the shoulder joint, the distance between the point A and the axillary nerve was 27.37 (19.80, 34.55) mm in the horizontal plane and 16.67 (12.85, 20.35) mm in the vertical plane. CONCLUSION In the neutral position of the shoulder joint, the possibility of axillary nerve injury will be relatively reduced when radiofrequency is taken from the 4 : 00 position of the right glenoid (7 : 00 position of the left glenoid circle), passing through the subscapularis muscle posteriorly and anteriorly and splitting outward.
Adult ; Humans ; Shoulder ; Rotator Cuff/surgery* ; Arthroscopy/methods* ; Scapula/surgery* ; Shoulder Joint/surgery* ; Cadaver ; Joint Instability/surgery*

Ambystoma mexicanum/immunology* ; Amputation ; Animals ; Biomarkers/metabolism* ; Blastomeres/immunology* ; Cell Lineage/immunology* ; Connective Tissue Cells/immunology* ; Epithelial Cells/immunology* ; Forelimb ; Gene Expression ; High-Throughput Nucleotide Sequencing ; Humans ; Immunity ; Peroxiredoxins/immunology* ; Regeneration/immunology* ; Regenerative Medicine/methods* ; Single-Cell Analysis/methods*

Objective To investigate whether platelet rich plasma (PRP) could prevent seawater immersion wound infection and promote wound healing.Methods New Zealand white rabbits were used to establish the seawater immersion injury model and were randomly divided into 3 groups:the saline immersion group,the seawater immersion group and the seawater immersion wound treated with platelet rich plasma (PRP) group (or simply the PRP treatment group).General medical data,wound outward appearance and healing of the rabbits after surgery were closely recorded at 3,7,14,21,28,35,42 days.Forty-two days after treatment,some tissues taken from the surgical sites were collected to perform histopathological detection by HE,and other tissues were ground to have bacteriological examination.Results Body temperature,body weight,and white blood cell level of the PRP treatment group were significantly superior to those of the seawater immersion group(P ＜ 0.05).After surgery,the wound in the seawater immersion group was obviously swollen,and there was a lot of purulent secretion.Though the wound could be healed at late stage,the healed wound was clearly swollen.On the other hand,there was no significant infection for the PRP treatment group after surgery,with good wound healing.Histopathological detection results showed that the structure of muscle fibers for the PRP treatment group remained intact,without obvious inflammatory cell infiltration.However,the structure of muscle fibers for the seawater immersed group was disrupted,dissolved and was in a state of disorder,with obvious inflammatory cell infiltration.Microbiological study indicated that the infecting bacterium genus was Coccus.The number of cultured bacterial colonies in the PRP treatment group was significantly smaller than that in the seawater immersion group (P ＜ 0.05).Conclusion PRP could prevent seawater immersion wound infection,promote wound healing,and had the potential for infection prevention and treatment of seawater immersion wound.

Objective To investigate whether platelet rich plasma (PRP) could prevent seawater immersion wound infection and promote wound healing.Methods New Zealand white rabbits were used to establish the seawater immersion injury model and were randomly divided into 3 groups:the saline immersion group,the seawater immersion group and the seawater immersion wound treated with platelet rich plasma (PRP) group (or simply the PRP treatment group).General medical data,wound outward appearance and healing of the rabbits after surgery were closely recorded at 3,7,14,21,28,35,42 days.Forty-two days after treatment,some tissues taken from the surgical sites were collected to perform histopathological detection by HE,and other tissues were ground to have bacteriological examination.Results Body temperature,body weight,and white blood cell level of the PRP treatment group were significantly superior to those of the seawater immersion group(P ＜ 0.05).After surgery,the wound in the seawater immersion group was obviously swollen,and there was a lot of purulent secretion.Though the wound could be healed at late stage,the healed wound was clearly swollen.On the other hand,there was no significant infection for the PRP treatment group after surgery,with good wound healing.Histopathological detection results showed that the structure of muscle fibers for the PRP treatment group remained intact,without obvious inflammatory cell infiltration.However,the structure of muscle fibers for the seawater immersed group was disrupted,dissolved and was in a state of disorder,with obvious inflammatory cell infiltration.Microbiological study indicated that the infecting bacterium genus was Coccus.The number of cultured bacterial colonies in the PRP treatment group was significantly smaller than that in the seawater immersion group (P ＜ 0.05).Conclusion PRP could prevent seawater immersion wound infection,promote wound healing,and had the potential for infection prevention and treatment of seawater immersion wound.

Objective To discuss the effect of a moving folding multifunction operating platform in operation room so as to solve time-consuming and efforts in the putting lithotomy position of repeating placement and removal surgery bed legs plate and supply the operating platform in the surgery of the upper limb, inva-sive puncture and anesthesia operation.Methods A moving folding multifunction operating platform was self-designed. A number of 160 cases undergoing operation in lithotomy position in the urology department from March to June 2016 were randomly divided into the experimental group (80 cases) and the control group (80 cases). The routine nursing method were carried out in patients in the control group, while adopted operating platform were used in patients in the experimental group. Time-consuming pre and post operation were investigated. Application effects of moving folding multifunction operating platform in 114 cases including the surgery of the upper limb, invasive puncture and anesthesia operation were evaluated.Results During continues lithotomy position surgery, time consuming of changing position and position placement in the experimental group were (209.41±33.36) s and (622.33±62.16) s respectively, while those in the control group were (665.83±90.92) s and (1118.33±88.86) s. The differences were statistically significant between two groups (t=16.324, 15.844;P<0.05). In one lithotomy position surgery, time consuming of position placement pre and post operation were reduced 44.03% (saved 8.16 minutes/surgery) compared to that in the control group. It alleviated 60 kg body burden of nurses. The safety and performance evaluation in the surgery of the upper limb, invasive puncture and anesthe-sia operation were in high levels with scores of (26.13±1.53) and (27.42±1.56) respectively.Conclusions The platform, which is practical and easy to use, contributes to meet the needs of a variety of technical operation in the operation room and helps optimizing procedure in transformation, reducing work load of nurse so as to im-prove efficiency and quality of work.

ObjectiveTo evaluate the effect of labor analgesia and the outcome of maternals and neonatals by applying the vitamin B6- folic acid mixture to combined with spinal-epidural analgesia(CSEA) in nulliparous women at latency.MethodsAll the 112 full-term nulliparous parturients were selected and divided into the treated group and controlled group.Nulliparous women in two groups received CSEA,with which the additional vitamin - folic acid mixture was used only in treatment group.The contrast between the analgesic effect in groups,and alalgesic effect-acting period,fentanyl Apgar score and newborn usage were compared between groups also.ResultsThe analgesic effect-acting period and fentanyl dosage in the treated group were significantly decreased.There was significant difference between the 2 ( P ＜ 0.05 ).ConclusionsIt could be effective applying vitamin B6- folic acid mixture at latency in nulliparous women based on CSEA,which could shorten the lumbar hemp effect-acting period and reduce fentanyl narcotic drugs dosage.

Objective To analyze and evaluate the effect of posterior circumferential fusion for treatment of the mechanical instability of lumbar spine, and discuss the relative merits,indications and contraindications in this procedure. Methods Two hundred and two patients with mechanical instability of lumbar spine treated by the posterior instrumented circumferential fusion technique from January 2001 to January 2007. One hundred and thirty-two patients were selected who were treated with only one segment fusion and followed up for at least 1 year, of them 97 patients suffered lumbar spondylolisthesis, 35 patients suffered degenerative lumbar instability. X-ray was used to evaluate the fusion condition of the bone graft, and VAS and ODI questionnaire were applied to assess the pain of back and leg,and the conventional function. Results All patients were followed up for 12-84 months, averaged (43±23) months,125 patients got bone fusion, accounted for 94.7%(125/132). The VAS of low back pain was (6.71 ± 1.31) points before operation, while (3.20 ± 1.14) points after operation (P < 0.05) ,and the VAS of leg pain was (8.33 ± 1.78) points before operation,while (4.31 ± 1.15) points after operation (P< 0.05). The ODI was (68.6 ± 14.7) % before operation, while (13.6 ± 1.5) % after operation (P < 0.05). Conclusions Posterior circumferential fusion is a positive and excellent treatment for the mechanical instability of lumbar spine. With its merits, the high fusion rate and good clinical results can be received.