Objective To compare the clinical results of arthroscopic rotator cuff repair using a suture bridge technique and conservative therapy as treatment of traumatic shoulder dislocation combined with rotator cuff injury in older patients. Methods From August 2010 to August 2013 a total of 63 patients were prospectively enrolled. In the case of documented tears of the rotator cuff in combination with symptoms persisting after conservative therapy, patients were free to decide between arthroscopic rotator cuff repair using a suture bridge technique and conservative treatment. Patients were monitored for changes in visual analogue scale (VAS) scores, range of motion, the Simple Shoulder Test (SST), the Constant score and recurrences over a minimum follow-up period of 1 year. Results 60 pa-tients (30 in surgical group and 30 in conservative treatment group) were follow-up for at least 1 year. There was no significant difference between the two groups at baseline. The surgical group resulted in better improvements in pre-operative to postoperative VAS scores, range of motion, SST scores and the Constant score. There were five recur-rences in the conservative treatment group, while no recurrences were documented in surgical group. Conclusion In this selected patient group, we believe arthroscopic repair using a suture bridge technique for the treatment of symp-tomatic rotator cuff tear can improve shoulder function and decrease recurrences in older patients suffered from trau-matic shoulder dislocation combined with rotator cuff injury. The long-term outcomes remain to be determined.

Objective To investigate the clinical outcomes of arthroscopic rotator cuff repair using improved-press-ift double-row technique for patients of large rotator cuff tear.Methods From December 2013 to November 2014, 52 patients (20 males, 32 females) with a full-thickness large rotator cuff tear underwent arthroscopic improved-press-ift double-row repair were retrospectively analyzed. The mean age of the patients was 65.6 years (range 51 to 76 years). The visual analog pain scale scores (VAS), the range of motion (ROM), University of California at Los Angeles (UCLA), and American Shoulder and Elbow Surgeons (ASES) were used for clinical and functional evaluations before surgery and at the time of 6 months after arthroscopy.Results The mean duration of follow-up was 10.9 months (range 6 to 17 months). At the time of 6 months after arthroscopy, the mean subjective pain score (VAS) was (1.6 ± 0.9), the mean active forward flexion was (145.6 ± 10.7)°, whereas the mean external rotation at the side was (30.8 ± 8.5)°. The mean UCLA score improved to (32.3 ± 3.5), the mean ASES score improved to (81.8 ± 8.7). There was significant difference postoperatively (P < 0.05). No re-tear occurred.Conclusion The improved-press-ift DR technique is effective in arthroscopic large rotator cuff repairing. Compared with suture-bridge technique, this technique can decrease operation time, costs, and is much easier to process.

Objective To study the treatment effect of synovectomy under arthroscope on elbow rheumatoid arthritis.Methods 38 patients with elbow rheumatoid arthritis were selected as the research subjects,received arthroscopic synovial treatment,surgical procedures require more than one direction into the intra -articular,cleaning elbow joint synovial,complete removal of the foreign body cavity.Postoperative follow -up for 30 months,and com-pared the patients'Mayo elbow performance score and joint activity situation before and after surgery.Results After surgery,Elbow pain score[(30.12 ±8.11)points],activity level[(17.01 ±2.88)points],joint function[(20.67 ± 5.01)points]and total score[(73.04 ±12.01)points]were significantly higher than the pre -operative[(3.98 ± 3.89)points,(9.78 ±5.02)points,(13.77 ±3.69)points,(33.04 ±10.01)points](t =18.38,P <0.05;t =7.90, P <0.05;t =7.01,P <0.05;t =16.18,P <0.05 ).After surgery,elbow flexion activity score [(113.12 ± 15.11)points]was significantly higher than the preoperative flexion elbow activity score[(93.03 ±19.89)points] (t =5.09,P <0.05 ).Conclusion Treated elbow rheumatoid arthritis by synovectomy under arthroscope could effectively improve the disease status of patients,relieve pain,enhance mobility,allowing patients to gradually return to normal life,and it can be widely used in clinical practice.

Objective To investigate the clinical results of arthroscopic FaxT -Fix technology vertical mat-tress suture for patients with meniscal tear Ⅲ level.Methods 50 cases with the level of meniscal Ⅲ orthopedic treatment of torn were divided into two groups using random number table,25 cases in each group.The control group received a simple meniscectomy,the observation group was given arthroscopic FaxT -Fix technology vertical mattress suture.Surgery and prognosis function were observed and compared in the two groups during recovery.Results The operation time (26.53 ±7.34)min,postoperative functional activity recovery time (25.01 ±9.55)d and hospital stay (5.68 ±2.01)d of the observation group were significantly shorter than the control group[(46.66 ±12.28)min, (39.53 ±11.28)d,(9.98 ±3.34)d],the differences were statistically significant (t =7.04,4.91,5.52,all P <0.05).3,6,12,18 months after operation,the improvements of Lysholm and IKDC scores of the observation group were significantly better than the control group (t =3.60,2.64,2.81,3.03,4.94,2.12,2.28,2.32,all P <0.05). During the postoperative follow -up period,the incidence rate of complications of the observation group (4.00%) was significantly lower than the control group (24.00%)(χ2 =4.15,P <0.05).Conclusion For patients with level of Ⅲ meniscus tear,arthroscopic FaxT -Fix technology vertical mattress suture can effectively reduce the surgery and hospitalization time,promote functional recovery of the patients 'knee,significantly improve the postoperative Lysholm knee score and IKDC,but also significantly reduce postoperative wound infection,hematoma,nerve damage vascular complication rate.

Objective To evaluate the early clinical outcomes of arthroscopic suture-bridge repair of media to large full-thickness rotator cuff tear.Methods One hundred patients that underwent arthroscopic suture-bridge (suture-bridge group,n =50) or single-row repair (single-row suture group,n =50) for media to massive full-thickness rotator cuff tear from June 2010 to June 2014 were enrolled in this study.The patients (63 males and 37 females),aged 58.7 years (range,46 to 75 years),were all available to the follow-up.Thirty-one patients were injured in traffic crashes,30 in falls,27 in strains and 12 with no apparent reasons.Early passive activity was allowed in suture-bridge group,while shoulder abduction was maintained for 6 weeks postoperatively in control group.Clinical and functional outcomes were measured using the visual analogue scale (VAS),range of motion,University of California at Los Angeles (UCLA) score,and American Shoulder and Elbow Surgeons (ASES) score.Results Mean duration of follow-up was 16.7 months (range,8 to 24 months).Prior to the surgery,these measurements were similar between the two groups.After a follow-up of 3 months,the differences were significant in suture-bridge group compared to control group:VAS [(1.7 ± 1.5) points vs (3.9 ± 2.1) points],forward flexion [(168.3 ± 30.2)° vs (120.2 ± 51.6)°],external rotation [(47.0 ± 11.0)° vs (31.8 ± 13.8)°],UCLA score [(31.7±4.2) points vs (18.2±4.8) points],ASES score [(86.2±14.6) points vs (35.9 ±17.7) points] (P ＜0.05).No re-tear occurred after operation.Conclusion Arthroscopic suture-bridge repair of moderate to massive full-thickness rotator cuff tear results in significant improvement of function outcomes and clinical results,indicating a reliable and effective treatment technique.

Background Formaldehyde is a common air pollutant in residential buildings, and the health risks caused by formaldehyde in residential buildings can not be ignored. Objective This study aims to evaluate the air concentration of formaldehyde in non-newly decorated houses in Ningbo and its possible health risks. Methods A total of 72 houses without any decoration in the past one year in Ningbo were selected by multi-stage random sampling method. From July 2018 to January 2019, the air samples of living rooms and bedrooms were collected and their temperature and humidity were also measured. The concentrations of formaldehyde were detected by AHMT method according to Standred method for hygienic examination of formaldehyde in air of residential areas — Spectrophotometric method (GB/T 16129—1995) , the health risk assessment model of U.S. Environmental Protection Agency was used to evaluate the non-carcinogenic risk and carcinogenic risk of formaldehyde, and Monte Carlo simulation was used for sensitivity analysis. Results The median (P₂₅, P₇₅) of formaldehyde concentration in the 72 houses was 0.019 (0.012,0.026) mg·m⁻³. Only one house showed a formaldehyde concentration that exceeded the national standard in the living room, and the total qualified rate of formaldehyde concentration was 98.61%. The median (P₂₅, P₇₅) of formaldehyde concentration in the bedroom was 0.019 (0.011, 0.031) mg·m⁻³, which was higher than that in the living room, 0.015 (0.010, 0.024) mg·m⁻³, and the difference was statistically significant. The median and 90th percentile of non-cancer risk (hazard quotient, HQ) of the 72 houses were 1.35 and 2.80, respectively, and the proportion of the houses with HQ>1 was 62.50%. The median and 90th percentile of cancer risk (CR) of the 72 houses were 1.12×10⁻⁴ and 2.32×10⁻⁴, respectively, and the proportions of the houses with CR>1×10⁻⁶, CR>1×10⁻⁵, and CR>1×10⁻⁴ were 100.00%, 100.00%, and 54.20%, respectively. After using Monte Carlo simulation, the median (90th percentile) of non-carcinogenic risk was reduced to 0.91 (1.94), where the median was lower than the national limit, and the proportion of samples with HQ>1 was 44.73%; the carcinogenic risk was reduced to 7.52×10⁻⁵ (1.79×10⁻⁴), and the proportions of samples with CR>1×10⁻⁶, CR>1×10⁻⁵, and CR>1×10⁻⁴ were 100.00%, 98.96%, and 34.37%, respectively. Conclusion The concentration of formaldehyde in non-newly decorated houses in Ningbo basically meets the national requirements, but it is still necessary to pay attention to the non-carcinogenic risk and carcinogenic risk caused by indoor formaldehyde, among which the carcinogenic risk is more important. Residents should prevent the harm of formaldehyde from its source by considering clean decoration materials and environmentally friendly furniture.

Objective To explore the role of continuous pulse output (PICCO) monitoring in treatment of patients with traumatic acute diffuse brain swelling (PADBS). Methods Eighty-six PADBS patients, admitted to our hospital from January 2014 to October 2017, were routinely given brain invasive intracranial pressure (ICP) monitoring after admission. At the same time, the patients were given bone flap decompression and hematoma clearance according to the condition of the diseases. After surgery, according to the wishes of family members, patients were divided into two groups (n=43):patients from treatment group accepted PICCO monitoring on the basis of ICP monitoring, and the treatment plan was adjusted according to the monitoring results; and the treatment plan in patients from control group was adjusted according to traditional central venous pressure (CVP) monitoring results on basis of ICP monitoring. Results One week after operation, the ICP in the treatment group was (14.36±2.82) mmHg when the cerebral perfusion pressure (CPP) was controlled between 50 and 70 mmHg, which was significantly different from the ICP in the control group (18.58±2.25) mmHg (P<0.05). Two weeks after treatment, Glasgow Coma Scale (GCS) scores of the treatment group (10.87±1.72) were significantly higher than those of the control group (8.18±1.16, P<0.05). The incidences of posttraumatic cerebral infarction (PTCI) and neurogenic pulmonary edema (NPE) in the treatment group (11.6％, 18.6％) were significantly lower than those of the control group (25.6％, 34.9％, P<0.05); the recovery rate (76.7％) in the treatment group was significantly higher than that in the control group (60.5％, P<0.05); the mortality rate (9.3％) was significantly lower than that in the control group (18.6％, P<0.05). Conclusion On the basis of intraventricular ICP monitoring, combined PICCO monitoring can effectively control ICP, improve cerebral perfusion, reduce the incidence of PTCI and NPE, improve the prognosis, and reduce the mortality in PADBS patients.

Objective To explore the value of controlled decompression under intracranial pressure monitoring in craniotomy of patients with severe cerebral hemorrhage.Methods One hundred and six patients with severe cerebral hemorrhage,admitted to our hospital from January 2015 to July 2018,were prospectively enrolled.These patients were divided into control group (n=5 l) and treatment group (n=55) according to their families' wishes.The patients in the control group were treated with traditional craniotomy and hematoma removal;the patients in the treatment group were treated with controlled decompression combined with craniotomy and hematoma clearance under intracranial pressure monitoring,and intracranial pressure monitoring and management were carried out after operation.The rate of bone flap acceptance during operation,incidences of complications such as re-bleeding,scalp exudation,intracranial infection and cerebral infarction after operation,rate of re-operation and Glasgow outcome scale scores 6 months after injury were compared and analyzed between the two groups.Results Five patients had midway withdrawal (2 from the control group and 3 from the treatment group),and 101 patients (49 from the control group and 52 from the treatment group) were included in the statistical analysis.The rate of bone flap acceptance in the treatment group (69.2％) was significantly higher than that in the control group (24.5％,P＜0.05).The incidences of complications such as bleeding,scalp exudation,intracranial infection and cerebral infarction (11.5％,7.7％,3.8％,and 13.5％) were significantly lower than those in the control group (30.6％,22.4％,16.3％,and 34.7％,P＜0.05).The re-operation rate (3.8％) was significantly lower than that in the control group (16.3％,P＜0.05).Good recovery rate in the treatment group (76.9％) was significantly higher than that in the control group (55.1％,P＜0.05).The mortality rate (7.7％) was significantly lower than that of the control group (22.4％,P＜0.05).Conclusion For patients with severe cerebral hemorrhage,controlled decompression under intracranial pressure monitoring combined with craniotomy and hematoma removal can significantly improve the rate of bone flap acceptance,reduce the rate of second-stage cranioplasty,reduce the incidence of complications and re-operation rate,and more effectively improve the quality of life and prognosis of patients.

Objective To explore the value of pulse index continuous cardiac output (PICCO) combined with intracranial pressure monitoring in patients with severe craniocerebral injury.Methods One hundred and thirty-eight patients with severe craniocerebral injury accepted controlling decompression surgical treatment in our hospital from February 2015 to February 2019 were prospectively chosen.According to patients' families will,postoperative application of PICCO combined with intracranial pressure monitoring for fluid management was performed in 72 patients (treatment group) and application of central venous pressure combined with intracranial pressure monitoring for fluid management was performed in 66 patients (control group).All patients were adjusted according to the monitoring results.The intracranial pressure and cerebral perfusion pressure one week after surgery,incidences of new traumatic cerebral infarction,neurogenic pulmonary edema,pulmonary infection,scalp exudation,and intracranial infection,average hospitalization days,total hospitalization costs,intensity of antimicrobial use,and Glasgow coma scale scores two weeks after operation were compared and analyzed between the two groups.Glasgow outcome scale was used to evaluate the prognoses of the patients 6 months after injury.Results There were 7 patients (3 from the control group and 4 from the treatment group) dropped out of the study due to various reasons and 131 patients (63 from the control group and 68 from the treatment group) included in the final statistical analysis;there was no significant difference in drop-out rate of the two groups (P＞0.05).The intracranial pressure in the treatment group ([14.28±2.98] mmHg) was significantly lower than that in the control group ([18.99±2.78] mmHg) and cerebral perfision pressure ([66.72±2.25] mmHg) was significantly higher than that in the control group ([52.96±3.12] mmHg) one week after operation (P＜0.05).During hospitalization,the incidences of new traumatic cerebral infarction,neurogenic pulmonary edema,pulmonary infection,scalp exudation and intracranial infection in the treatment group (8.8％,13.2％,11.8％,7.4％,and 2.9％) were significantly lower than those in the control group (22.2％,27.0％,25.4％,19.0％,and 12.7％,P＜0.05).The average hospitalization days,total hospitalization expenses and intensity of antimicrobial use in the treatment group were significantly shorter/lower than those in the control group (P＜0.05).Glasgow coma scale scores (11.88±1.78) and good recovery rate (76.5％) in the treatment group were significantly higher than those in the control group (8.06±1.12,54.0％) two weeks after operation (P＜0.05).Good recovery rate (76.5％) in the treatment group was significantly higher than that in the control group (54.0％,P＜0.05).The mortality rate (5.9％) was significantly lower than that in the control group (17.5％,P＜0.05).Conclusion PICCO combined with intracranial pressure monitoring can effectively improve intracranial pressure,optimize cerebral perfusion,reduce complications such as traumatic cerebral infarction,neurogenic pulmonary edema,pulmonary infection and intracranial infection in patients with severe craniocerebral injury,thereby improving prognosis and reducing mortality;besides that,it can reduce patients' exposure to anti-brain infection,and the breadth and intensity of bacterial drugs can reduce the length of hospitalization and total cost of hospitalization,thereby reducing the burden of family and society.

Objective:To investigate the application value of pre-suture craniotomy combined with intracranial pressure monitoring in surgery for posttraumatic acute diffuse brain swelling (PADBS).Methods:One hundred and fifty-seven patients with PADBS admitted to our hospital from February 2015 to December 2019 were chosen in our study; 68 patients (control group), admitted to our hospital from February 2015 to June 2017, underwent controlled decompression under intracranial pressure monitoring; and 89 patients (treatment group), admitted to our hospital from June 2017 to December 2019, were performed pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring. The craniotomy time, brain tissue exposure time, cranial closure time, incidence of acute encephalocele, and Glasgow outcome scale (GOS) scores at 6 months after injury were retrospectively analyzed and compared between the two groups.Results:As compared with those in the control group, the patients in the treatment group had significantly longer intraoperative craniotomy time ([19.2±1.6] min vs. [15.4±1.4] min), significantly shorter exposure time of brain tissues ([18.5±2.4] min vs. [26.3±2.2] min), significantly shorter time of cranial closure ([11.2±1.5] min vs. [18.3±2.1] min), and statistically lower incidence of acute encephalocele (22.5% vs. 38.2%), P<0.05). The good prognosis rate of the treatment group (70.8%) was significantly higher than that of the control group (50.0%), and the mortality rate (6.7%) was statistically lower than that of the control group (17.6%, P<0.05). Conclusion:Pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring can shorten the time of cranial closure and brain tissue exposure, reduce the incidence of acute encephalocele, and ultimately improve the prognosis of patients with posttraumatic acute diffuse brain swelling.