BACKGROUND: The Bristow-Lataijet technique is a reliable treatment for recurrent anterior shoulder instability. However, it as been reported 1.6% of patients suffering nerve injury. Thereafter, the all-arthroscopic Latarjet procedure has been gaining popularity, but the surgeon is unable to palpate the nerves, and their localization, so protection is a difficulty. OBJECTIVE: To investigate the CT localization of suprascapular nerve on the posterosuperior scapular neck, and to improve the safety and quality in Bristow-Latarjet surgery. METHODS: This study was carried out on 12 normal formalin fixed adult cadaveric upper limb specimens (8 males and 4 females). The study was in accordance with the ethical requirements of Dongguan Hospital of Traditional Chinese Medicine. The nerve trunk and branches were marked with developing lines to examine the position and course of nerve on the posterosuperior scapular neck. CT localization was used to measure the distance, angle and height ratio to glenoid from the superior pole of scapula, spinoglenoid notch, the entry point of outermost nerve branch to anterior and posterior margin of the glenoid, through internally and externally rotating 45 degrees of should joints. The data were statistically analyzed. RESULTS AND CONCLUSION: (1) Pearson correlation analysis: The height of glenoid was positively correlated with the distance from the spinoglenoid notch and entrance point to the articular surface. (2) Comparison between internal and external rotation 45 degrees: Distance of superior pole of scapula and angles showed no significant difference (all P > 0.05). There were significant differences in the distance and angle in the spinoglenoid notch (all P < 0.01), but height ratio was not significantly different (P > 0.05). There were significant differences in distance, angle, and height ratio at entrance point (all P < 0.01), suggesting that external rotation had larger angle and safer range of distance than internal rotation. In the position of internal and external rotation 45 degrees, the distance, angle and height ratio of spinoglenoid notch and entrance point showed significant differences (P < 0.01), indicating that compared with spinoglenoid notch, the angle between entrance point and articular surface was smaller, the distance from entrance point to articular surface was shorter, and the height ratio was higher. (4) Therefore, external rotation is recommended in the case of internal fixation of the bony tunnel for the posterior glenoid so as to reduce the incidence of nerve injury.

Objective To observe the therapeutic effect of arthroscopic debridement combined with oral use of Chinese medicine Guanjietong Tablets ( GT) for knee osteoarthritis in the early and middle stage. Methods Ninety knee osteoarthritis patients in the early and middle stage were evenly randomized into three groups, namely GT group, glucosamine sulfate group and blank control group. All of the three groups received arthroscopic debridement, and additionally, GT group and glucosamine sulfate group were given the corresponding medicine orally. We observed Lysholm knee scores of the three groups before operation, and 2 weeks, 3 months and one year after operation, and compared the knee joint space before operation and one year after operation showed by digital X-ray photograpy. Results ( 1) Lysholm knee scores in the three groups were increased 2 weeks, 3 months and one year after operation when compared with those before operation, the difference being significant (P<0.05) . Three months and one year after operation, the scores of GT group and glucosamine sulfate group differed from those of the blank control group (P<0.01). One year after operation, the scores of GT group differed from those of glucosamine sulfate group ( P<0.05). ( 2) The results of knee joint space showed by digital X-ray photography at knee position of weight loading indicated that the difference was insignificant between GT group and glucosamine sulfate group one year after operation ( P> 0.05) , but the difference between the two groups and the blank control group was significant (P<0.05). The difference of knee joint space was insignificant before operation and one year after operation in GT group and glucosamine sulfate group ( P>0.05) , while was significant in the blank control group ( P<0.05). Conclusion Arthroscopic debridement alone has certain short-term curative effect in treating knee osteoarthritis in the early and middle stage, but the effect will decline with the extension of time. Arthroscopic debridement combined with Guanjietong Tablets could delay the narrowing of joint space and maintain the clinical curative effect, which will delay the time for artificial joint replacement.

Objective To study the anti-inflammatory and analgesic effects of Baihuadan Analgesic Spray, so as to provide theoretical basis for further development of new drugs. Methods Prostaglandin E2 (PGE2) in the inflammatory tissues of mice with xylene-induced auricular inflammation and in the rats with albumen-induced pedal swelling were measured for the observation of anti-inflammation action of Baihuadan Analgesic Spray. The pain threshold in mouse hot-plate test and mouse acetic acid writhing test was determined to observe the analgesic effect of Baihuadan Analgesic Spray. Results Middle dose of Baihuadan Analgesic Spray (1 mg/mL) significantly reduced the auricular swelling rate induced by xylene in mice, improved the pain threshold of mice and prolonged pain latency in hot plate test (P < 0.05 or P < 0.01). High dose of Baihuadan Analgesic Spray (2 mg/mL) reduced the content of PGE2 in pedal inflammatory tissues (P < 0.05), and the effect on reducing the times of mouse writhing was obviously superior to that of the Voltaren Gel group. Conclusion Baihuadan Analgesic Spray has obvious anti-inflammatory and analgesic effects.