Objective: To investigate the clinical outcomes of arthroscopic bridging reconstruction of irreparable massive rotator cuff tears using autogenous fascia lata. Methods: From July 2015 to July 2017, a total of 10 cases (4 male and 6 female) who were treated with arthroscopic bridging reconstruction for irreparable massive rotator cuff tears using autogenous fascia lata were retrospectively analyzed. The age before surgery was 61.3±2.9 years (range 57-67 years). There were 7 patients with right shoulders and 3 with left shoulders. The dominate sides were involved in 7 cases. The trauma history was documented in 2 shoulders. The duration of preoperative symptoms was 14.0±13.5 months (1-48 months). The case with revision surgery was not included. The patients were examined with magnetic resonance imaging (MRI) to evaluate the healing of fascia lata patch bridging in the joint at one week, six months, one year and two years after operation. The motion range of shoulder and the clinical scores, including visual analogue scale (VAS), University of California Los Angeles (UCLA) score, Constant-Murley score and American Shoulder & Elbow Surgeons (ASES) score, were measured before surgery and at follow-up duration. Results: All cases were reconstructed the horizontal couple. No perioperative complication was occurred and all surgery were completed safely and successfully. At the end of two years, the score of ASES was 92.2±3.5 (range 88.3-98.3), UCLA 31.6±2.0 (range 28-34), Constant-Murley 85.2±5.4 (range 78-93) with significant difference (t=11.254, P=0.000; t=12.111, P=0.000; t=8.948, P=0.00) comparing with that before surgery. The VAS pain score was 0.6±0.5 (range 0-1) which was significantly lower than that preoperatively (t=11.326, P=0.000). At 2 years after operation, MRI shows that fascia lata patches healed well in 9 patients. However, one case was with re-tear and patch absorption. The range of motion of shoulder was significantly improved in all patients but with different degrees of weakness (3-4). Conclusion Arthroscopic bridging reconstruction using autogenous fascia lata could effectively improve shoulder function in patients with irreparable massive rotator cuff tears. The autogenous fascia lata patch can heal with the help of rotator cuff tissue through bridging reconstruction.

Sarcomatoid carcinoma of the renal pelvis is rare. One case of sarcomatoid carcinoma of the left renal pelvis was reported. The patient was diagnosed as sarcomatoid carcinoma of left pyelonephrosis by left percutaneous nephrolithotripsy (PCNL) and biopsy of left pyelonephrosis in another hospital due to left lumbar pain.The patient came to our hospital for laparoscopic left hemiculturectomy and was pathologically diagnosed as left renal pelvic sarcomatoid carcinoma. The patient suffered left retroperitoneal recurrence and bilateral lung metastasis 7 months after surgery and died of cachexia 10 months later.

Objective To explore the effects of exercise instruction during the whole course of pregnancy by mobile phone APP on master of pregnancy motor knowledge, body movement during pregnancy and gestation related index. Methods Totals of 186 pregnant women who received prenatal examination during early pregnancy were selected. They were divided into intervention group (n=96) and control group (n=90) according to random number table. Patients in the intervention group received exercise instruction during the whole course by mobile phone APP involving pushing pregnancy motor knowledge at regular intervals, sharing authoritative movement method, reminding the time of further consultation and arranging experts for response to messages of pregnant women and so on. Patients in the control group accepted routine exercise instruction with the existing model of pregnancy movement. The master of pregnancy motor knowledge, body movement during pregnancy and gestation related index were compared. Results The total scores of the master of pregnancy motor knowledge in the intervention group and the control group were (77.22±7.07) and (63.31±5.91) with a significant difference (t=14.592, P< 0.001). There was a statistically significant difference in the average total energy consumed per week between the intervention group (154.62±20.74) MET-hours and the control group (105.48±15.81) MET-hours (t=18.240, P< 0.001). Besides, the differences in pregnancy weight gain, antenatal weight, postpartum BMI and pelvic floor muscle strength between two groups were significant (t=-7.715, -4.438, -9.805, 13.988; P< 0.001). The amount of vaginal bleeding, cesarean section rate, perineotomy rate with spontaneous labor during the second stage, total stage of labor and two hours after delivery in the intervention group were lower than those in the control group with significant differences (P< 0.05). Conclusions The exercise instruction during the whole course of pregnancy by mobile phone APP can improve the master of pregnancy motor knowledge and increase the energy consumed during pregnancy, so as to improve the gestation related index, reduce the cesarean section rate and perineotomy rate with spontaneous labor. It is better than the existing model of pregnancy movement.