Arthroscopic rotator cuff repairs are preformed due to growing knowledge of rotator cuff tears among surgeons as well as patients.However,it is unavoidable and may sometimes very common that some patients develop structural failures or retears after surgical repairs because of unique blood supply and healing procedure of the rotator cuff,on which there is still much debate focusing on problems that one needs to deal with in clinical practice.Retears often occur,if without new trauma,during early postoperative period,or more specifically within the first 6 months after repair and are more frequently observed in those with old ages,diabetes or osteoporosis.In addition,risk factors of retears consist of longer preoperative duration of symptoms,larger primitive tear sizes,higher grades of fatty infiltration of muscles on preoperative imaging examinations,excessive tension within reconstructed structures,deteriorated quality of rotator cuff tissues and special shapes of the acromion,etc.Diagnosis is recently based on results of postoperative magnetic resonance imaging or echogram examination.MR/CT arthrography is also used.Each instrument has its advantages and limitations.However,the lack of a golden standard when establishing a diagnosis of rotator cuff retears makes integrating evaluations and comparisons of different methods a difficult question.It has been reported by many that the onset of retear leads to obvious shoulder pain or weakness,whereas more than a few studies demonstrated that very limited influences of retears in spite of generally unaffected shoulder functions,like decreased muscle strength on certain motions.The disagreement is possibly caused by specific methods of diagnosis,function instruments and time point of assessments used by different researchers as studies have displayed that feelings of patients after surgery and results attained by objective examinations are not always parallel.Moreover,some long-time follow-ups studies indicated that the impact posted by retears on shoulder functions evolves over a period of time.Owing to the varied opinions on actual symptoms and final functional outcomes caused by structural failure,the mainstay of treatment for rotator cuff tears are still conservative protocols,including observation and symptoms relief instead of second surgery.Second surgery could be an effective choice for certain patients,especially for those who have apparent symptoms.

Objective To detect the expressions of BMPR Ⅰa of BMPs/BMPR/Smads signaling transduction pathway in human brain glioma ,to research the role of its in tumorigenesis and progression of brain glioma and its correlation to clinical pathology . Methods The mRNA and protein expressions of BMPR Ⅰa was detected in 20 normal brain tissues and 40 samples with human glioma by RT-PCR and SABC immunohistochemical methods ,repectively ,and analyzed the correlation with the patient′s age ,gender and pathological grade .Results Compared with normal brain tissues ,BMPR Ⅰa mRNA and protein expressions in human glioma were reduced significantly ,especially in Ⅲ and Ⅳ stage tumor tissues .The difference was not related with the patient′s age and gender .Conclusion In progression of glioma ,BMPR Ⅰa may play a role in restraining ,and has nothing to do with age and sex .

Objective To compare the outcomes of arthroscopic single-row and suture-bridge repair of medium-sized rotator cuff tears through clinical and MRI assessment.Methods Forty-five patients with medium-sized rotator cuff tears who underwent arthroscopic repair using single-row (SR,n=29) or suture-bridge (SB,n=26) technique between July 2014 to June 2015 in our hospital,were retrospectively enrolled in this study.All surgeries were performed by the same senior doctor.The functional outcomes were assessed using the rating scale of the University of California at Los Angeles (UCLA),American Shoulder and Elbow Surgeons shoulder index (ASES),Fudan University Shoulder Score (FUSS),visual analog pain scale score (VAS),and range of motion (ROM) before the operation and at the last follow-up.MRI examination was performed at the final follow-up.Results Finally 50 patients were followed up successfully,24 in SB group and 26 in SR group.There were no significant differences between the two groups in terms of age,sex,follow-up duration,and the affected side.Before the operation,no significant differences were observed between the 2 groups in all the measurements.After more than 1-year follow-up,significant improvement was found in all measurements for both groups,but without significant differences between them.MRI examination showed no re-tears in either group.According to the Sugaya's classification,there were more type Ⅰ patients in SB group than SR group (83.3％ vs 61.5％),but the difference was not significant.Conclusion Arthroscopic suture-bridge repairing of medium-sized rotator cuff tears results in safe and good early clinical outcomes.However,compared with the single-row technique,there was no significant advantage.Although the MRI examination showed a better result of rotator cuff healing in the early stage,its long-term outcomes need further studying.

Objective To assess the utility of single fiber electromyography (SFEMG) in the differential diagnosis of amyotrophic lateral sclerosis (ALS) and cervical spondylotic radiculopathy and myelopathy. Methods SFEMG was performed in extensor digitorum communis muscles (EDC) of 3 groups of patients, including 61 ALS patients with findings of cervical spendylosis on MRI, 59 ALS patients with normal MRI of cervical spine, and 55 patients with cervical spendylotic radiculopathy and myelopathy. The parameters of SFEMG between different groups were compared. Results The mean jitter was (81.2± 25.9), (91.6 ± 32. 4) and (40. 9 ± 11.8) μ in ALS patients with finding of cervical spondylosis on MRI, ALS patients with normal MRI of cervical spine, and patients with cervical spondylosis respectively. M50 of the percentage of jitter >55 μs was 73%, 80% and 5% in the 3 groups respectively. M50 of the percentage of block was 10%, 20% and 0 in the 3 groups respectively. Fiber density was 2.9±0.5, 2.9±0.6 and 2. 4 ± 0. 6 in the 3 groups respectively. There was no significant difference in those parameters of SFEMG between the ALS with findings of cervical spondysosis and those with normal MRI. There was significant difference in those parameters of SFEMG between the patients with ALS (the mean jitter: (86. 3± 29. 6) μs; M50 of the percentage of jitter > 55 μs: 80% ; M50 of the percentage of block: 14% ; fiber density: 2. 9±0. 5) and those with cervical spondylosis (t = 14.49, Z = 8.96, 7. 68,t = 5. 83, all P = 0. 000). In 18 patients with ALS, conventional EMG studies showed active and chronic denervation in only 1 region at the first visit. SFEMG was performed in EDC which had normal Medical Research Council Scale and EMG. SFEMG showed increased fiber density in 16 patients, increased jitter in 13 patients and impulse block in 6 patients. Conclusion SFEMG shows significantly increased jitter and block in ALS whether there is MRI findings of cervical spondysosis or not, which can help to differentiate ALS from cervical spondysotic radiculopathy and myelopathy.

Objective To assess the utility of changes of muscle strength and compound muscle action potential (CMAP) of abductor digiti minimi (ADM) muscle after the exercise test in diagnosis of hypokalaemic periodic paralysis during inter-attack period. Methods Exercise test was applied on 59 patients with hypokalaemic periodic paralysis and 38 control subjects during inter-attack period. The changes of CMAP amplitude, muscle strength and the range of abduction of ADM muscle at 120 minutes after exercise were calculated and compared between the two groups. Results At 120 minutes after exercise, the M50 (M25, M75 ) of decrease in amplitude of CMAP recorded in ADM muscles were 54. 1% ( 43.1%,66. 3% ) in patients with periodic paralysis and 11.1% (2. 0%, 21.3% ) in control subjects(Z =6. 731,P=0.000), M5o(M25,M75) of decrease in range of abduction of ADM muscles were 39.4% (26.3% ,48. 9% ) in patients with periodic paralysis and 7. 8% ( 1.3%, 13.7% ) in control subjects ( Z = 5. 519,P=0. 000). The muscle strength of ADM muscle was less than Ⅳ grade in 96. 3% (52/54) patients with periodic paralysis and 8.6% ( 3/35 ) in control subjects ( x2 = 68.2, P = 0. 000 ). The sensitivity and specificity for decrease in CMAP amplitude ( best cutoff = 30% ) in diagnosis of hypokalaemic periodic paralysis were 87.5% and 93.7%, respectively. The sensitivity and specificity for decrease in range of abduction of ADM muscle ( best cutoff = 20% ) were 87.5% and 90. 5%, respectively. Conclusion Exercise test is recommended to apply on patients with suspected hypokalaemic periodic paralysis during inter-attack period. The decrease in range of abduction of ADM muscle more than 20% at 120 minutes after exercise supports the diagnosis of hypokalaemic periodic paralysis.

Advanced gastric cancer without distant metastasis remains a potentially curable disease, but the prognosis is poor in this condition because of the high unresectability rate at presentation and the high recurrence rate after radical surgery. Administration of neoadjuvant chemotherapy has several potential benefits for advanced gastric cancer. This treatment can decrease tumor stage and improve R0 resection rate. Neoadjuvant chemotherapy has higher patient tolerability and a higher rate of chemotherapy completion than adjuvant chemotherapy. In vivo drug sensitivity tests can also be conducted to avoid unnecessary surgeries. Although high-intensi-ty chemotherapy results in a high overall response rate, a few advanced gastric patients can achieve a pathologically complete re-sponse. However, no standardized treatment has been achieved. This article introduces five cases of advanced gastric cancer treated with neoadjuvant chemotherapy in the Affiliated Tumor Hospital of Guangxi Medical University. The five cases achieved a pathological complete response. This article also aims to explore the clinicopathological characteristics of these patients, proper cooperative treat-ment practices, and prognostic factors for the benefit of future patients.

Objective To assess the relationship between muscle strength , creatine kinase ( CK) and electromyography ( EMG) in patients with lipid storage myopathy ( LSM).Methods Motor and sensory nerve conduction study, F wave, and quantity EMG were performed in 30 patients with LSM.Muscle strength and CK were studied before EMG.The relationship between EMG , muscle strength and CK were analyzed.Results EMG showed myopathic changes in 19 patients,myopathic coexistence with neuropathic changes in five , and neuropathic changes in two.Four patients had normal EMG.Motor nerve conduction studies showed decreased compound muscle action potential amplitude in seven nerves of two patients , while abnormal sensory nerve conduction in 16 nerves of five patients.Quantity EMG was performed in 78 muscles.Thirty-eight muscles of 21 patients had decreased amplitude and short duration motor unit potential ( MUP) , 6 muscles of 2 patients had increased amplitude and long duration MUP , and 30 muscles of 16 patients had normal MUP.Abnormal spontaneous activities ( SA) were detected in 16 muscles.The M( Q25 , Q75 ) of serum CK was 295.5 (201.0, 4 845.8) U/L in patients with abnormal SA in EMG , and 482.0 (292.8, 963.8) U/L in patients without abnormal SA in EMG (Z=0.281, P=0.778).Medical Research Council ( MRC) Scale in deltoid muscle was 4.3 ±0.7 in muscles with SA and 4.1 ±0.8 in muscles without SA (t=0.490, P=0.628), and that in quadriceps femoris was 3.9 ±0.6 for muscles with SA and 3.7 ± 0.6 for muscles without SA ( t =0.725 , P =0.474 ).MRC Scale in deltoid muscle was 4.1 ±0.7 in muscles with myogenic MUP and 4.1 ±0.9 in muscles without myogenic MUP ( t=0.101, P=0.920), which in quadriceps femoris was 3.8 ±0.6 for muscles with myogenic MUP and 3.7 ±0.7 for muscles without myogenic MUP ( t=0.368 , P=0.716 ).Conclusions Neurogenic or normal MUP and abnormal sensory nerve conduction can be presented in some patients with LSM , while SA is not common.The changes in MUP and SA are neither correlated with CK nor with muscle strength.

Objective To evaluate a novel lymph node (LN) sorting method on surgical resected sample guided by nanometer carbon staining and principle following the supplying artery tributory in rightsided colon carcinoma.Methods From May 2015 to June 2016,51 patients were randomly divided into two groups adopting traditional LN sorting method and that of a combination of nanometer carbon and artery guided.The final LN status were compared between the 2 groups.Results The total LN number and the positive LN in novel method group were higher than control group (437 vs.349,70 vs.54).The dissection time used,the number of harvested positive LN that was ＜ 5 mm were significantly different [(13.1 ± 3.2) minvs.(17.8 ±3.8)min,t=4.75,P=0.000;1.0±l.0vs.0.2 ±0.6,t=3.51,P=0.000].The number of patients with harvested LN less than 12,the rate of positive lymph nodes,the rate of metastasis were not significantly different (all P ＞ 0.05) between the two groups.Conclusions Use of nanometer carbon development combined with artery approach facilitates LN sorting,yielding more positive LNs,and increating the accuracy of pathological staging in right-sided colon cancer.

Objective To investigate the effect of interfering Hiwi gene on the apoptosis of MDA-MB-231 cells. Methods The mRNA and protein expression of Hiwi mRNA and its target protein were analyzed by qRT-PCR and Western Blot after transfection. MDA-MB-231 cells were divided into 6 groups according to the experimental design. Interference effects were screened as siRNA interference group (Hiwi10330 group), and then divided into 3 groups according to the experimental design: interference group, negative control group/NC, blank control group/Blank. The cell apoptosis rate was detected by flow cytometry after transfection. Results The expression of mRNA in the interference group was significantly lower than that in the siRNA group (P < 0.05), the expression of target protein of Hiwi gene was also significantly inhibited (P < 0.05). The apoptosis rate of MDA-MB-231 cells was significantly higher than that of NC and Blank groups (P<0.05). Conclusion The apoptosis rate of breast cancer cells MDA-MB-231 was significantly increased after siRNA targeting hiwi gene silencing.

Objective: To evaluate the efficacy of Tuina (Chinese therapeutic massage) manipulation plus horse-riding squat exercise in treating knee osteoarthritis (KOA) and optimize the combining protocol. Methods: Based on a 2×2 factorial design, 120 eligible KOA patients were randomized into a manipulation group (group A1B2), a manipulation plus horse-riding squat group (group A1B1), a sitting knee-adjustment group (group A2B2 group), and a sitting knee-adjustment plus horse-riding squat group (group A2B1), with 30 cases in each group. The intervention was conducted three times a week, lasting for four weeks. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) was taken as the major measure for efficacy evaluation (including three component scores, pain, stiffness, and daily function, and total score). Results: The three component scores (pain, stiffness, and daily function) and the total score of WOMAC showed significant differences after the intervention in the four groups (P<0.05). There were significant inter-group differences in the WOMAC stiffness score amongst the four groups after the intervention (P<0.05). In group A1B1, the step length, stride, walking speed, and knee joint flexion angle changed significantly after treatment (P<0.05). After the intervention, the step length changed significantly in group A1B2 (P<0.05), and the walking speed changed significantly in group A2B1 (P<0.05). There were no significant differences in the step length, stride, walking speed, or knee joint flexion angle among the four groups (P>0.05). The extensor peak torque at 180 °/s changed significantly in group A1B2 after treatment (P<0.05). Neither the intra-group nor the inter-group comparisons of the four groups revealed significant differences in the other isokinetic muscle strength parameters (P>0.05). The main effect of manipulation showed significant in affecting the WOMAC pain and total scores (P<0.05). The main effect of horse-riding squat exercise showed significant in affecting the WOMAC pain and stiffness scores (P<0.05). Conclusion: The four treatment protocols all can improve the symptoms of KOA, for instance, relieving pain and stiffness, and enhancing daily function. Group A2B1 produces the most eminent effect in relieving joint stiffness. The main effects of both manipulation and horse-riding squat exercise are significant in reducing pain. Besides, the main effect of horse-riding squat exercise is significant in relieving joint stiffness.