Diagnosis and treatment of upper arm radial neuritis by ultrasonography / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the application of ultrasonography in diagnosis and treatment of the upper arm radial neuritis.</p><p><b>METHODS</b>From 2005.12 to 2011.7, 10 patients of the upper arm radial neuritis were selected and included 6 males and 4 females with an average age of 32 years old ranging from 20 to 40 years. The course of disease ranged from 4 months to 2 years. All patients feel pain on the outside of upper arm. Medical examination showed Tinel's sign masculine, and the muscle force included extension of wrist and fingers were reduced. Upper arm radial neuritis were diagnosed by clinical sign and medical examination. All patients underwent ultrasonography examination, electrophysiology examination and operation. The ultrasonography were compared to the results of electrophysiology examination,and ultrasonography were compared to intra-operative findings and pathology examination.</p><p><b>RESULTS</b>The ultrasound images showed average diameter of affected limb radial nerve were (0.29+/-0.04) cm, average area were (0.23+/-0.05) cm2, and all of these were greater than uninjured side. Ultrasonograghic findings and orientation of radial neuritis were consistent with intra-operative findings,and the results of ultrasonography were consistent with the results of pathology examination.</p><p><b>CONCLUSION</b>Ultrasonography examination provide morphological evidence for the diagnosis and treatment of the upper arm radial neuritis.</p>

Etiologic investigation of chronic granulomatous inflammation of hand by polymerase chain reaction and DNA sequencing / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the causative pathogens in littoral hand infections which exhibited chronic granulomatous inflammation, the relationship between chronic granulomatous inflammation and mycobacteria and to discuss the prospects of PCR in clinical application for diagnosis of granulomatous inflammation.</p><p><b>METHOD</b>With 16S-rDNA as the target sequence, Nest-PCR was used to detect mycobacteria directly from 37 cases of chronic granulomatous inflammations, and identified them by gene sequencing.</p><p><b>RESULTS</b>Twenty-four of 37 cases were positive for mycobacteria by Nest-PCR, in which 17 were M.marinum, 1 M.chelonae, 2 M.avium, 2 M.kansasii, and 2 M.tubercular through gene sequencing.</p><p><b>CONCLUSIONS</b>Nest-PCR combining gene sequencing proved to be a liable and sensitive method to detect Non-tubercular mycobacteria (NTM) in fresh tissue. NTM is the major factor of hand specific chronic infections other than tubercular. Pathological changes are difficult to differentiate TB from NTM and bacterial evidence was necessary.</p>

Restoration of shoulder abduction by transfer of the spinal accessory nerve to suprascapular nerve through dorsal approach: a clinical study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In recent years, transfer of the spinal accessory nerve to suprascapular nerve has become a routine procedure for restoration of shoulder abduction. However, the operation via the traditional supraclavicular anterior approach often leads to partial denervation of the trapezius muscle. The purpose of the study was to introduce transfer of the spinal accessory nerve through dorsal approach, using distal branch of the spinal accessory nerve, to repair the suprascapular nerve for restoration of shoulder abduction, and to observe its therapeutic effect.</p><p><b>METHODS</b>From January to October 2003, a total of 11 patients with a brachial plexus injury and an intact or nearly intact spinal accessory nerve were treated by transferring the spinal accessory nerve to the suprascapular nerve through dorsal approach. The patients were followed up for 18 to 26 months [mean (23.5 +/- 5.2) months] to evaluate their shoulder abduction and function of the trapezius muscle. The outcomes were compared with those of 26 patients treated with traditional anterior approach. And the data were analyzed by Student's t test using SPSS 10.5.</p><p><b>RESULTS</b>In the 11 patients, the spinal accessory nerves were transferred to the suprascapular nerve through the dorsal approach successfully. Intact function of the upper trapezius was achieved in all of them. In the patients, the location of the two nerves was relatively stable at the level of superior margin of the scapula, the mean distance between them was (4.2 +/- 1.4) cm, both the nerves could be easily dissected and end-to-end anastomosed without any tension. During the follow-up, the first electrophysiological sign of recovery of the infraspinatus appeared at (6.8 +/- 2.7) months and the first sign of restoration of the shoulder abduction at (7.6 +/- 2.9) months after the operation, which were earlier than that after the traditional operation [(8.7 +/- 2.4) months and (9.9 +/- 2.8) months, respectively; P < 0.05]. The postoperative shoulder abduction was 62.8 degrees +/- 12.6 degrees after transfer of the spinal accessory nerve, better than that after the traditional (51.6 degrees +/- 15.7 degrees). All the 11 patients could extend and externally rotate the shoulder almost normally.</p><p><b>CONCLUSIONS</b>The accessory nerve transfer through dorsal approach is a safe and reliable procedure for the treatment of brachial plexus injury. Its postoperative effect is confirmed, which is better than that of the traditional operation.</p>

The etiological study, diagnose and therapy of hand special chronic infections in littoral area / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the etiological factors of hand special chronic infections and their relationship with tuberculosis, and to give evidence for clinical diagnosis as well as treatments.</p><p><b>METHODS</b>From 2002 to 2004 pathologic inspection, acid-fast stain, bacterial cultication, mycobacterial cultivation were performed in all 29 cases of hand special chronic infections.</p><p><b>RESULTS</b>All cases showed granulomatous lesions in pathological appearance, 2 positive in acid-fast stain, 12 positive in bacteria cultivation, and 1 nocardiosis, 1 staphylococcus epidermidis, 7 M.marinum, 1 M.tuberculosis, 1 M.fortuitum, 1 M.kansasii.</p><p><b>CONCLUSIONS</b>Non-tuberculo-mycobacterium (NTM) especially M.marinum are far more important as the major factor than tuberculosis and other bacterial in hand special chronic infections. Bacteria cultivation should be routine examined for all cases.</p>

Effect of extract of leave Ginkgo biloba(EGb_(50))on sciatic nerve regeneration in rats and its doseeffect relationship / 中华显微外科杂志

Objective To provide the promoting effect of extract of leave Ginkgo biloba(EGb_(50))on nerve regeneration and the dose-effect relationship.Methods Sciatic nerve injury model was set up in 96 male Spraque-Daweiy rats and then randomly divided into four groups:normal saline (NS) group,the low dose EGb_(50) group (50mg?kg~(-1)?d~(-1)),the moderate dose EGb_(50) group (100 mg?kg~(-1)?d~(-1)) ,the high dose EGb_(50) group (200 mg?kg~(-1)?d~(-1)).Electrophysiological,histological examinations and functional eval- uation were used to assess nerve regeneration and the functional recovery in 2,4,6,8 weeks of operative inter- vals respectively.Results The recovery rate of sciatic functional index(SFI),tetanic tension,motor nerve conduction velocity,muscle cell cross-section area of triceps surae and the passing rate of myelinated nerve were significantly higher in EGb_(50) group in all the time point than in control(P＜0.01).Except the recovery rate of sciatic functional index (SFI),there was significant difference between high dose group and moderate, low dose group.(P＜0.01,P＜0.05).Conclusion EGb_(50) has the effect of promoting regeneration of in- juried peripheral nerve and the high dose can get the best result.