Rotator cuff injury is a shoulder disease most commonly seen with the elderly, and as China enters an aging society, the number of patients with rotator cuff injury is rapidly increasing. For patients with poor results of conservative treatment and serious conditions, arthroscopic rotator cuff repair has become the first choice due to less trauma and better efficacy. However, the rehabilitation exercise time required for postoperative functional recovery is long, and at the same time, the existence of a series of complications seriously affects patients' postoperative recovery and quality of life. The purpose of this article is to summarize the complications and preventive measures after arthroscopic rotator cuff injury repair, and to provide help for the diagnosis and treatment of postoperative complications and postoperative rehabilitation.

Gongfa is an essential approach to prevent and treat diseases in traditional Chinese medicine(TCM),often used to prevent a disease before it arises.Guided by TCM and modern scientific theories,the Tuina(Chinese therapeutic massage)Gongfa prescription theory implements the principle,method,prescription,and form in clinical pattern-identified treatment to prescribe the corresponding Tuina Gongfa prescription,i.e.,to prescribe a basic Tuina Gongfa prescription,specifically for a systemic disease,and modify Gongfa forms based on the basic prescription according to different patterns.The Gongfa prescription for pulmonary diseases designs corresponding Gongfa forms from six perspectives:lifting Yang,securing the exterior,opening the orifices,soothing the chest,harmonizing the stomach,and regulating Qi to prevent and treat diseases.The application of the pulmonary Gongfa prescription indicates the potential to apply the Tuina Gongfa prescription theory for the clinical prevention,treatment,and rehabilitation of disorders of other systems,thereby fully realizing the unique role of TCM Gongfa.

Objective:To explore the clinical efficacy of suture-bridge techniques assisted by our self-designed novel auxiliary sleeve in arthroscopic repair of large rotator cuff tear.Methods:A retrospective analysis was conducted of the clinical data of 35 patients with large rotator cuff tear who had been treated by the arthroscopic suture-bridge technique assisted by our novel auxiliary sleeve at Department of Orthopaedics, The People’s Hospital of Shanxi Province from July 2022 to January 2024. The 35 patients were set as an observation group [14 males and 21 females with an age of (58.3±10.3) years]. According to a 1:1 ratio, another 35 patients with large rotator cuff tear who had been treated by simple arthroscopic suture-bridge technique from January 2021 to June 2022 were selected as a control group [15 males and 20 females with an age of (55.3±10.5) years]. The perioperative efficacy between the 2 groups was evaluated by comparing operation time, total length of incision, and disparity in hemoglobin level between preoperation and postoperative day 1. The American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, and visual analogue scale (VAS) pain score at 3 months after operation were compared between the 2 groups to evaluate the functional recovery and shoulder pain relief, and comparisons of the 3 scores were also made between preoperation and 3 months after operation in each group.Results:There were no statistically significant differences in the general preoperative data between the 2 groups, indicating comparability ( P > 0.05). The 70 patients were followed up for 5.7 (5.0, 7.0) months after operation. No such complications as recurrent rotator cuff tear, poor wound healing, infection, or anchor withdrawal occurred in either group after operation. The operation time in the observation group was 133.3 (120.0, 140.0) min, significantly shorter than 171.7 (140.0, 200.0) min in the control group ( P < 0.05). In the control group, the ASES and UCLA scores increased significantly from 29.1 (27.5, 31.4) points and 11.8 (10.0, 13.0) points before operation to 56.0 (51.9, 59.5) points and 24.6 (22.0, 27.0) points at 3-month follow-up, respectively, and the VAS pain score decreased significantly from preoperative 8.1 (7.0, 10.0) points to 2.0 (2.0, 2.0) points at 3-month follow-up ( P < 0.05). In the observation group, the ASES and UCLA scores increased significantly from 29.9 (29.1, 31.2) points and 12.6 (11.0, 14.0) points before operation to 58.8 (53.1, 62.2) points and 26.7 (25.0, 29.0) points at 3-month follow-up, respectively, and the VAS pain score decreased significantly from preoperative 8.0 (7.0, 9.0) points to 1.9 (2.0, 2.0) points at 3-month follow-up ( P < 0.05). At 3 months after operation, the UCLA score for the observation group was significantly better than that for the control group ( P < 0.05). There were no significant differences between the 2 groups in total length of incision, hemoglobin level disparity, ASES score or VAS pain score at 3 months after operation ( P > 0.05). Conclusion:In arthroscopic repair of large rotator cuff tear with suture-bridge techniques, application of our novel auxiliary sleeve can shorten operation time, simplify surgical procedures, and achieve good shoulder joint function and efficacy without increasing the length of surgical incision.

Gongfa is an essential approach to prevent and treat diseases in traditional Chinese medicine(TCM),often used to prevent a disease before it arises.Guided by TCM and modern scientific theories,the Tuina(Chinese therapeutic massage)Gongfa prescription theory implements the principle,method,prescription,and form in clinical pattern-identified treatment to prescribe the corresponding Tuina Gongfa prescription,i.e.,to prescribe a basic Tuina Gongfa prescription,specifically for a systemic disease,and modify Gongfa forms based on the basic prescription according to different patterns.The Gongfa prescription for pulmonary diseases designs corresponding Gongfa forms from six perspectives:lifting Yang,securing the exterior,opening the orifices,soothing the chest,harmonizing the stomach,and regulating Qi to prevent and treat diseases.The application of the pulmonary Gongfa prescription indicates the potential to apply the Tuina Gongfa prescription theory for the clinical prevention,treatment,and rehabilitation of disorders of other systems,thereby fully realizing the unique role of TCM Gongfa.

Rotator cuff injury is a shoulder disease most commonly seen with the elderly, and as China enters an aging society, the number of patients with rotator cuff injury is rapidly increasing. For patients with poor results of conservative treatment and serious conditions, arthroscopic rotator cuff repair has become the first choice due to less trauma and better efficacy. However, the rehabilitation exercise time required for postoperative functional recovery is long, and at the same time, the existence of a series of complications seriously affects patients' postoperative recovery and quality of life. The purpose of this article is to summarize the complications and preventive measures after arthroscopic rotator cuff injury repair, and to provide help for the diagnosis and treatment of postoperative complications and postoperative rehabilitation.

Objective:To explore the clinical efficacy of suture-bridge techniques assisted by our self-designed novel auxiliary sleeve in arthroscopic repair of large rotator cuff tear.Methods:A retrospective analysis was conducted of the clinical data of 35 patients with large rotator cuff tear who had been treated by the arthroscopic suture-bridge technique assisted by our novel auxiliary sleeve at Department of Orthopaedics, The People’s Hospital of Shanxi Province from July 2022 to January 2024. The 35 patients were set as an observation group [14 males and 21 females with an age of (58.3±10.3) years]. According to a 1:1 ratio, another 35 patients with large rotator cuff tear who had been treated by simple arthroscopic suture-bridge technique from January 2021 to June 2022 were selected as a control group [15 males and 20 females with an age of (55.3±10.5) years]. The perioperative efficacy between the 2 groups was evaluated by comparing operation time, total length of incision, and disparity in hemoglobin level between preoperation and postoperative day 1. The American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, and visual analogue scale (VAS) pain score at 3 months after operation were compared between the 2 groups to evaluate the functional recovery and shoulder pain relief, and comparisons of the 3 scores were also made between preoperation and 3 months after operation in each group.Results:There were no statistically significant differences in the general preoperative data between the 2 groups, indicating comparability ( P > 0.05). The 70 patients were followed up for 5.7 (5.0, 7.0) months after operation. No such complications as recurrent rotator cuff tear, poor wound healing, infection, or anchor withdrawal occurred in either group after operation. The operation time in the observation group was 133.3 (120.0, 140.0) min, significantly shorter than 171.7 (140.0, 200.0) min in the control group ( P < 0.05). In the control group, the ASES and UCLA scores increased significantly from 29.1 (27.5, 31.4) points and 11.8 (10.0, 13.0) points before operation to 56.0 (51.9, 59.5) points and 24.6 (22.0, 27.0) points at 3-month follow-up, respectively, and the VAS pain score decreased significantly from preoperative 8.1 (7.0, 10.0) points to 2.0 (2.0, 2.0) points at 3-month follow-up ( P < 0.05). In the observation group, the ASES and UCLA scores increased significantly from 29.9 (29.1, 31.2) points and 12.6 (11.0, 14.0) points before operation to 58.8 (53.1, 62.2) points and 26.7 (25.0, 29.0) points at 3-month follow-up, respectively, and the VAS pain score decreased significantly from preoperative 8.0 (7.0, 9.0) points to 1.9 (2.0, 2.0) points at 3-month follow-up ( P < 0.05). At 3 months after operation, the UCLA score for the observation group was significantly better than that for the control group ( P < 0.05). There were no significant differences between the 2 groups in total length of incision, hemoglobin level disparity, ASES score or VAS pain score at 3 months after operation ( P > 0.05). Conclusion:In arthroscopic repair of large rotator cuff tear with suture-bridge techniques, application of our novel auxiliary sleeve can shorten operation time, simplify surgical procedures, and achieve good shoulder joint function and efficacy without increasing the length of surgical incision.

Objective:To evaluate the efficacy of bupivacaine pamoate for sciatic nerve block in rats.Methods:Forty-eight SPF healthy male Sprague-Dawley rats, weighing 300-400 g, were divided into 6 groups using a random number table method: bupivacaine pamoate vehicle group (group VE), bupivacaine HCl group (group BH), liposomal bupivacaine group (group BL), low-dose bupivacaine pamoate group (group HL), moderate-dose bupivacaine pamoate group (group HM) and high-dose bupivacaine pamoate group (group HH), with 8 animals in each group.In VE, BH, BL, HL, HM and HH groups, bupivacaine pamoate vehicle 0.4 ml, bupivacaine HCl solution 0.4 ml, liposomal bupivacaine suspension 0.4 ml, and 1, 3 and 10 mg/ml bupivacaine pamoate suspension 0.4 ml were injected around the left sciatic nerve, respectively.The thermal paw withdrawal latency were measured before administration (T 0) and at 0.5, 1.5, 3, 5, 8, 12, 16, 24 and 48 h after injection (T 1-9). The percentage of maximum possible effect (MPE) of thermal paw withdrawal latency was calculated, and motor function score was simultaneously performed to evaluate the efficacy of sensory and motor block.Five and three rats in each group were sacrificed at 2 and 7 days after administration (T 9, 10), respectively, and the sciatic nerve at the injection site and the surrounding muscle tissues were harvested for microscopic examination (with a light microscope) after Luxol fast blue and HE staining.Nerve damage and inflammatory responses were assessed and scored to evaluate neurotoxicity. Results:Compared with group VE, the MPE was significantly increased at T 1-4 in group HL, at T 1-8 in group HM and at T 1-8 in group HH, the motor function scores were decreased at T 1-4 in group HL, at T 1-5 in group HM and at T 1-7 in group HH ( P<0.05), and no significant change was found in inflammatory response scores for the sciatic nerve and surrounding muscles at each time point in HL, HM and HH groups ( P>0.05). Compared with group BH, the MPE was significantly increased at T 3-8, motor function scores were decreased at T 3-5, and inflammatory response scores for the muscles around the sciatic nerve were decreased at T 9 in group HM ( P<0.05). Compared with group BL, the MPE was significantly increased at T 3-7, motor function scores were decreased at T 4, 5, and inflammatory response scores for the sciatic nerve and surrounding muscles were decreased at T 9 in group HM ( P<0.05). The nerve damage score was 0 in the six groups. Conclusion:Bupivacaine pamoate can block the sciatic nerve of rats, the duration of block is prolonged with the increase in the concentration, and the duration of motor block is not longer than that of sensory block; compared with the same concentration and equal volume of bupivacaine HCl and liposomal bupivacaine, bupivacaine pamoate produces longer duration of sciatic nerve block and less neurotoxicity.

Objective Through the exploration of the reality technology to find the treatment of type Ⅱ odontoid fractures in anterior fixation of odontoid fractures with hollow screw .Methods Based on 64 row spiral CT continuous 2-dimensional images of akull ,atlas and axis were reconstructed by the Mimics software ,Mimics software reconstruction atlas ,the atlantoaxial 3D visualization structure in Mimics, simulated surgery was carried out in the MedCAD .Results The structure of three-dimensional reconstruction image was clear ,structure of hollow screw into pin-point was accurate in virtual simulation surgery ,the screw path is correct .Conclusion Mimics Software has great val-ues in the diagnosis of odontoid fractures ,preoperative risk evaluation ,place the hollow screw and clinical teaching ,which provides an objec-tive basis for choice of treatment program .

Objective Through the exploration of virtual simulation surgery to find a way to treat lumbar spinal metastases. Methods Based on 64 row spiral CT continuous 2-dimensional images of lumbar segments, normal lumbar vertebral, destruction of disease, abdominal aorta and kidneys were reconstructed by the Mimics software. 3D visualization structure was contemplated by anterior lesions clear, titanium mesh of bone cement support, and posterior pedicle screw fixation. Results The three-dimensional reconstruction distinctly displayed the structures of lumbar and its adjacent organs, and the entire virtual simulation surgery was intuitive. Conclusion The application of virtual simulation surgery ensures more accurate 3D model of lumbar establishment and its adjacent organs, and it provides an objective basis for in-dividualized treatment programs.

Objective To investigate the effect of lateral ventricle transplantation of neurotrophic factor-transfected cells derived from Glia cell line on vascular dementia in rats and gene expression of Drebrin in hippocampal region.Methods By using gene clone technique,the GDNF gene was transfected into SH-SY5Y cell lines.104 adult male Sprague-Dawley rats weighing (200± 20) gram were divided into groups:transplanted group,injected group,control group,all of which accepted operation by permanent ligation of left common carotid artery and clipping right common carotid artery repeatedly to build up model of vascular dementia,and sham operation group which accepted no ligation or clipping.6 rats from each group were decapitated on the third day,seventh day and tenth day after transplanting treatment were for fluorescence detection.The rest 20 rats in each group were used to detect learning and memory functions by Morris water maze on the third day and decapitated on the fourth day after transplanting treatment.Then GDNF level in temporal lobe were detected by enzyme-linked immunosorbent assay (ELISA),while Drebrin mRNA and protein levels in hippocampal region were detected by real time-PCR and Westernblot respectively.Results There was strong fluorescent light detected around lateral ventricle of rats in transplanted group on the third day after transplantation,which faded on the seventh day and disappeared on the tenth day.The learning and memory functions of rats in transplanted group were improved significantly.The escape latency was shorter in transplanted group than in injected group and control group [(34.89±4.15) s vs.(43.86±6.95) s,(50.89±3.66) s,both P＜0.05],while shuttle times through the third quadrant were more often in transplanted group than in injected group and control group [(11.00±1.49) vs.(9.26 ±1.38),(8.04 ± 1.12),both P＜0.05].GDNF level and Drebrin mRNA and protein levels were higher in transplanted group than in injected group and control group [GDNF:(315.71±27.43) vs.(256.26±19.90),(141.95±21.33),Drebrin mRNA:(5.54±0.35) vs.(3.10±0.33),(1.32±0.23),Drebrinprotein:(0.55±0.05) vs.(0.43±0.06),(0.26±0.06),all P＜0.05].Conclusions GDNF-transfected cells could survive in the lateral cerebral ventricle of rats for about seven days.The method for treating vascular dementia through the technique of transplanting GDNF-transfected cells is certain feasible,which has a better therapeutic effect than GDNF-injection directly into lateral cerebral ventricle.The therapeutic effect of GDNF on vascular dementia may be related to its action of regulating neural plasticity.