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Severe IV-degree thermal crush injury of limbs involved the subcutaneous fascia, muscle and bone, which may lead to amputation and has a great impact on the patient's quality of life. We can repair wounds with pedicle flaps or even free flaps, However, there are still huge challenges in bone defect of extremities and functional reconstruction. In recent years, with the development of functional prostheses, we have reconstructed limb functions in many patients helping them to complete their daily lives. We report a case where the right upper arm was injured by thermal crush, leading severe burns to the skin, fascia, muscle and bone. We applied a pedicled latissimus dorsi flap and a free anterolateral thigh flap to repair the wound, and realized the function of limb salvage and movement of the right upper arm by implanting 3D printed scapula, upper arm, and elbow joint prostheses. This case illustrates that IV-degree burns involving bones have new technologies to repair and achieve mobility now. [ABSTRACT FROM AUTHOR]

Objective: To compare the therapeutic effect of yin - yang balance penetrating acupuncture combined with rehabilitation training and single rehabilitation training on upper limb spasticity in patients with stroke hemiplegia., Methods: A total of 60 patients with upper limb spasticity of stroke hemiplegia were randomized into an observation group and a control group, 30 cases in each one. On the basis of conventional western medication, rehabilitation training was adopted in the control group. On the basis of treatment in the control group, yin - yang balance penetrating acupuncture was applied from Jianyu (LI 15) to Binao (LI 14), Quchi (LI 11) to Shaohai (HT 3), Yanglingquan (GB 34) to Yinlingquan (SP 9), Xuanzhong (GB 39) to Sanyinjiao (SP 6), etc. of the affected side in the observation group. The treatment was given once a day, 5 days were as one course, with a 2-day interval between two courses, 4 courses were required in both groups. The classification of modified Ashworth spasticity scale (MAS), surface integrated electromyogram (iEMG) of affected upper limb and the scores of National Institute of Health stroke scale (NIHSS), Fugl-Meyer assessment (FMA) of upper limb and modified Barthel index (MBI) before and after treatment were observed, the therapeutic effect was evaluated in both groups., Results: ①After treatment, the MAS classification reduced in both groups ( P <0.05), the cases of grade 0 to Ⅰ + in the observation group were more than those in the control group ( P <0.05); iEMG values of the maximum isometric voluntary contraction of affected usculus biceps brachii, musculus triceps brachii, musculus flexor carpi, musculus extensor carpi, extensor digitorum, aductor pollicis brevis were increased in both groups ( P <0.05), and the variations of iEMG of above muscles on the affected side in the observation group were larger than those in the control group ( P <0.05). ②After treatment, the scores of NIHSS were decreased ( P <0.05), the scores of FMA, MBI were increased in both groups ( P <0.05), and the variations of NIHSS, FMA and MBI scores were larger than those in the control group ( P <0.05). ③The total effective rate was 93.3% (28/30) in the observation group, which was superior to 70.0% (21/30) in the control group ( P <0.05)., Conclusion: Yin - yang balance penetrating acupuncture combined with rehabilitation training can improve upper limb spasticity, heighten the motor function of upper limb and daily self care in patients with stroke hemiplegia, its therapeutic effect is superior to single rehabilitation training.

Objective: To observe the effect of electroacupuncture (EA) of Jiaji (EX-B 2) on the contents of extracellular matrix metalloproteinase (MMP)-1, MMP-3 and tissue inhibitor of matrix metalloproteinase (TIMP)-1 in the cervical intervertebral disc (OIVD) tissue in rats with CIVD degeneration so as to explore its mechanism in relieving intervertebral disc degeneration., Methods: SD rats were randomized into control (n = 15), model (n = 14), EA (n = 13) and medication (n = 14) groups. CIVO model was established according to Wang's and Shi's method. EA (10/20 Hz, 1 - 3 mA) was applied to Jiaji (EX-B 2) for 10 min, once daily for 30 days. The rats of medication group were fed with Fenbid (15 mg/kg/d) and Jingfukang (0.5 g/kg/d) for 30 days. Extracellular matrix MMP-1, MMP-3 and TIMP-1 levels of the intervertebral disc tissue (C4-6) were detected by ELISA., Results: The contents of MMP-1 and MMP-3 in model group were increased significantly compared with control group (P < 0.05), while TIMP-1 in model group was markedly lower than that of control group (P < 0.05). Compared with model group, both MMP-1 and MMP-3 levels in EA group and MMP-1 in medication group were reduced considerably (P < 0.05), while TIMP-1 of EA group increased significantly (P < 0.05). No significant differences were found between medication and model groups in MMP-3 and TIMP-1 levels (P > 0.05). Under optical microscope, the injured degrees of the fibrous ring and nucleus pulposus, and the outline of the intervertebral disc of both EA and medication groups were evidently lighter than those of model group, but the degeneration severity of the intervertebral disc of EA group was lighter than that of medication group., Conclusion: EA of Jiaji (EX-B 2) can effectively relieve the degeneration degree of cervical intervertebral disc in the rat, which is probably related to its effect in regulating extracellular matrix system.