BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

BACKGROUND:The number of patients receiving total knee arthroplasty has been increasing globally each year.Pain management is a crucial aspect following total knee arthroplasty,as effective pain control can facilitate early mobilization,reduce complications,enhance patient satisfaction,and accelerate the rehabilitation process.OBJECTIVE:To construct a visual map of post-total knee arthroplasty pain,understand the international research status and trends in this field,and provide a reference for future studies.METHODS:Relevant research articles on post-total knee arthroplasty pain were retrieved from the CNKI,WanFang Data,and Web of Science core databases,covering the period from January 2000 to December 2023.The CiteSpace software(version 6.2.3)was used to analyze the annual publication output,authors,institutions,countries,keywords,and references.Utilizing R programming language(version 4.4.1),a database was established to create line charts and bar graphs.RESULTS AND CONCLUSION:(1)Our analysis included 3 796 publications,predominantly in Chinese(3 509 articles)with the remainder in English(287 articles).(2)The United States was the most productive country in English literature,with Harvard University leading institutional output.Guangzhou University of Chinese Medicine was the top publishing institution in Chinese literature.(3)Keyword clustering identified"quality of life,""phobia,"and"acupuncture"as emerging focal points in Chinese literature,while"satisfaction"and"psychological factors"were prominent in English literature over the past five years.Co-occurrence and clustering analysis revealed dense internal connections among institutions,authors,and publications,but sparse external collaborations.(4)The study's bias on visualization analysis may have introduced bias by excluding less influential papers.(5)Regarding research hotspots,domestic research emphasized the efficacy and exploration of analgesic methods,in contrast to international research that focused on pain mechanism subtyping and analgesic drug innovation.Future research is expected to trend towards traditional Chinese medicine for postoperative pain,multimodal analgesia,and the investigation and prevention of pain typing mechanisms.

BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

BACKGROUND:The number of patients receiving total knee arthroplasty has been increasing globally each year.Pain management is a crucial aspect following total knee arthroplasty,as effective pain control can facilitate early mobilization,reduce complications,enhance patient satisfaction,and accelerate the rehabilitation process.OBJECTIVE:To construct a visual map of post-total knee arthroplasty pain,understand the international research status and trends in this field,and provide a reference for future studies.METHODS:Relevant research articles on post-total knee arthroplasty pain were retrieved from the CNKI,WanFang Data,and Web of Science core databases,covering the period from January 2000 to December 2023.The CiteSpace software(version 6.2.3)was used to analyze the annual publication output,authors,institutions,countries,keywords,and references.Utilizing R programming language(version 4.4.1),a database was established to create line charts and bar graphs.RESULTS AND CONCLUSION:(1)Our analysis included 3 796 publications,predominantly in Chinese(3 509 articles)with the remainder in English(287 articles).(2)The United States was the most productive country in English literature,with Harvard University leading institutional output.Guangzhou University of Chinese Medicine was the top publishing institution in Chinese literature.(3)Keyword clustering identified"quality of life,""phobia,"and"acupuncture"as emerging focal points in Chinese literature,while"satisfaction"and"psychological factors"were prominent in English literature over the past five years.Co-occurrence and clustering analysis revealed dense internal connections among institutions,authors,and publications,but sparse external collaborations.(4)The study's bias on visualization analysis may have introduced bias by excluding less influential papers.(5)Regarding research hotspots,domestic research emphasized the efficacy and exploration of analgesic methods,in contrast to international research that focused on pain mechanism subtyping and analgesic drug innovation.Future research is expected to trend towards traditional Chinese medicine for postoperative pain,multimodal analgesia,and the investigation and prevention of pain typing mechanisms.

Objective To explore the influence of Da Vinci robot-assisted different approaches of laparoscopic partial nephrectomy(LPN)on the renal function and intestinal function recovery in the treatment of central renal tumors.Methods Totally 100 patients with central renal tumors who received Da Vinci robot-assisted LPN in the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture were selected from November 2022 to March 2024.According to the consent of the patients,they were divided into transperitoneal group and retroperitoneal group by envelope drawing method,with 50 cases in each group.The transperitoneal group adopted transperitoneal approach,while the retroperitoneal group received retroperitoneal approach.The surgical status and postoperative recovery status,renal function[serum creatinine(Scr),glomerular filtration rate(GFR)and blood urea nitrogen(BUN)],intestinal function recovery status[restore exhaust time,plasma diamine oxidase(DAO),D-lactic acid and urinary lactulose/mannose(L/M)]and complications were compared between groups.Results The surgical time,intraoperative blood loss,renal warm ischemia time,restore exhaust time,urinary catheter indwelling time and hospitalization time with(126.76±23.89)h,(115.86±6.93)ml,(25.41±6.57)min,(2.29±0.56)d,(4.89±0.93)d and(11.08±1.92)d in transperitoneal group were longer or more than the retroperitoneal group[(111.58±21.86)h,(86.27±6.71)ml,(17.08±5.16)min,(1.73±0.43)d,(3.16±0.62)d and(9.29±2.07)d,all P＜0.05].1 month after surgery,the SCr level in transperitoneal group with(83.04±10.13)μmol/L was lower than(88.55±9.16)μmol/L in retroperitoneal group while the GFR value with(58.27±6.19)ml/min was higher than(54.36±6.05)ml/min in retroperitoneal group(P＜0.05).The levels of DAO,D-lactic acid and the value of urine L/M with(3.39±0.57)mg/L,(2.09±0.31)mg/L and(0.08±0.02)in transperitoneal group at 24 hours after surgery,which were higher than the retroperitoneal group[(3.07±0.46)mg/L,(1.72±0.25)mg/L and(0.05±0.02),P＜0.05].The total incidence rates of postoperative complications in transperitoneal group and retroperitoneal group were 12.00％and 8.00％(P＞0.05).Conclusion The two approaches of LPN assisted by Da Vinci robot have their own advantages in the treatment of central renal tumors.Transperitoneal approach is more conducive to improving renal function,but retroperitoneal approach is more conducive to shortening the postoperative recovery time and promoting the intestinal function recovery and has lower incidence rates of complications.

Objective:To analyze the impact of serum alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) on the prognosis of patients with combined hepatocellular-cholangiocarcinoma (CHC) after radical surgery.Methods:Clinical data of 100 patients diagnosed with CHC by postoperative pathology in Hunan Provincial People's Hospital from January 2009 to January 2019 were retrospectively analyzed, including 73 males and 27 females, aged (52.0±10.9) years. Univariate and multivariate Cox regression analysis were conducted to try to find out the effects of AFP and CA19-9 on postoperative disease-free survival (DFS) of patients with CHC. Subgroup analysis was also performed to analyze the DFS among patients with different levels of AFP and CA19-9. Kaplan-Meier method and log-rank test were used to plot and compare the survival curves between groups.Results:Univariate analysis showed that levels of AFP, CA19-9, alanine transaminase, aspartate transaminase, American Joint Committee on Cancer (AJCC) TNM staging, portal vein invasion, tumor number are associated with postoperative DFS in CHC patients (all P<0.05). The multivariate Cox analysis showed that AFP≥20.6 μg/L ( HR=6.686, 95% CI: 1.985-9.582), CA19-9≥35.2 U/L ( HR=5.790, 95% CI: 1.197-8.855), AJCC tumor TNM staging stage Ⅱ( HR=6.384, 95% CI: 2.069-11.532), and portal vein invasion ( HR=2.384, 95% CI: 1.100-10.125) were risk factors for a shortened DFS in CHC patients after surgery (all P<0.05). Subgroup analysis showed that patients with AFP≥20.6 μg/L and CA19-9≥35.2 U/L ( n=14) had a lower DFS compared to patients with AFP<20.6 μg/L and CA19-9≥35.2 U/L ( n=32), and patients with AFP≥20.6 μg/L and CA19-9<35.2 U/L ( n=20) ( χ2=6.23, 4.98, P=0.014, 0.043). Conclusion:AFP and CA19-9 are risk factors for DFS in CHC patients. Patients with AFP≥20.6 μg/L and CA19-9≥35.2 U/L showed a worse prognosis.

Objective:To understand the epidemiological characteristics and changing trends of injury-related deaths in local residents in Qingdao from 2014 to 2023, and provide evidence for development of injury prevention and control measures.Methods:The incidence data on fatal injury in residents of Qingdao from 2014 to 2023 were used to describe the epidemiological characteristics of fatal injury by using fatal injury rate, standardized fatal injury rate, proportion, and death order. The average annual percentage change (AAPC) was used to describe the annual change in fatal injury rates, and the trend of fatal injury was analyzed.Results:From 2014 to 2023, a total of 23 533 residents died of injury in Qingdao, with a crude fatal injury rate of 28.74/100 000 and a standardized fatal injury rate of 27.64/100 000. The total fatal injury rate showed a downward trend (AAPC: -5.06%, P<0.05). The top three causes of fatal injury in the residents were road traffic accident (40.85%), suicide (15.80%), and accidental falls (12.92%). In terms of gender specific fatal injury cause, the top one in both men and women was road traffic accident injury. In terms of age specific fatal injury cause, the top one was road traffic accident in the all age groups, except age group 5-14 years with top cause of drowning. From 2014 to 2023, the fatal injury rates of road traffic accident, suicide, and accidental poisoning in the top five fatal injury causes showed a downward trend year by year (AAPC:-7.42%, -6.54%, -13.95%, P<0.05). Conclusions:The fatal injury rate showed a downward trend in the residents in Qingdao from 2014 to 2023. It is necessary to strengthen the prevention and control of road traffic accident injury, suicide, falls in the elderly, and drowning in adolescents.

Objective:To understand the epidemiological characteristics and changing trends of injury-related deaths in local residents in Qingdao from 2014 to 2023, and provide evidence for development of injury prevention and control measures.Methods:The incidence data on fatal injury in residents of Qingdao from 2014 to 2023 were used to describe the epidemiological characteristics of fatal injury by using fatal injury rate, standardized fatal injury rate, proportion, and death order. The average annual percentage change (AAPC) was used to describe the annual change in fatal injury rates, and the trend of fatal injury was analyzed.Results:From 2014 to 2023, a total of 23 533 residents died of injury in Qingdao, with a crude fatal injury rate of 28.74/100 000 and a standardized fatal injury rate of 27.64/100 000. The total fatal injury rate showed a downward trend (AAPC: -5.06%, P<0.05). The top three causes of fatal injury in the residents were road traffic accident (40.85%), suicide (15.80%), and accidental falls (12.92%). In terms of gender specific fatal injury cause, the top one in both men and women was road traffic accident injury. In terms of age specific fatal injury cause, the top one was road traffic accident in the all age groups, except age group 5-14 years with top cause of drowning. From 2014 to 2023, the fatal injury rates of road traffic accident, suicide, and accidental poisoning in the top five fatal injury causes showed a downward trend year by year (AAPC:-7.42%, -6.54%, -13.95%, P<0.05). Conclusions:The fatal injury rate showed a downward trend in the residents in Qingdao from 2014 to 2023. It is necessary to strengthen the prevention and control of road traffic accident injury, suicide, falls in the elderly, and drowning in adolescents.

Objective To explore the influence of Da Vinci robot-assisted different approaches of laparoscopic partial nephrectomy(LPN)on the renal function and intestinal function recovery in the treatment of central renal tumors.Methods Totally 100 patients with central renal tumors who received Da Vinci robot-assisted LPN in the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture were selected from November 2022 to March 2024.According to the consent of the patients,they were divided into transperitoneal group and retroperitoneal group by envelope drawing method,with 50 cases in each group.The transperitoneal group adopted transperitoneal approach,while the retroperitoneal group received retroperitoneal approach.The surgical status and postoperative recovery status,renal function[serum creatinine(Scr),glomerular filtration rate(GFR)and blood urea nitrogen(BUN)],intestinal function recovery status[restore exhaust time,plasma diamine oxidase(DAO),D-lactic acid and urinary lactulose/mannose(L/M)]and complications were compared between groups.Results The surgical time,intraoperative blood loss,renal warm ischemia time,restore exhaust time,urinary catheter indwelling time and hospitalization time with(126.76±23.89)h,(115.86±6.93)ml,(25.41±6.57)min,(2.29±0.56)d,(4.89±0.93)d and(11.08±1.92)d in transperitoneal group were longer or more than the retroperitoneal group[(111.58±21.86)h,(86.27±6.71)ml,(17.08±5.16)min,(1.73±0.43)d,(3.16±0.62)d and(9.29±2.07)d,all P＜0.05].1 month after surgery,the SCr level in transperitoneal group with(83.04±10.13)μmol/L was lower than(88.55±9.16)μmol/L in retroperitoneal group while the GFR value with(58.27±6.19)ml/min was higher than(54.36±6.05)ml/min in retroperitoneal group(P＜0.05).The levels of DAO,D-lactic acid and the value of urine L/M with(3.39±0.57)mg/L,(2.09±0.31)mg/L and(0.08±0.02)in transperitoneal group at 24 hours after surgery,which were higher than the retroperitoneal group[(3.07±0.46)mg/L,(1.72±0.25)mg/L and(0.05±0.02),P＜0.05].The total incidence rates of postoperative complications in transperitoneal group and retroperitoneal group were 12.00％and 8.00％(P＞0.05).Conclusion The two approaches of LPN assisted by Da Vinci robot have their own advantages in the treatment of central renal tumors.Transperitoneal approach is more conducive to improving renal function,but retroperitoneal approach is more conducive to shortening the postoperative recovery time and promoting the intestinal function recovery and has lower incidence rates of complications.

Objective:To analyze the impact of serum alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) on the prognosis of patients with combined hepatocellular-cholangiocarcinoma (CHC) after radical surgery.Methods:Clinical data of 100 patients diagnosed with CHC by postoperative pathology in Hunan Provincial People's Hospital from January 2009 to January 2019 were retrospectively analyzed, including 73 males and 27 females, aged (52.0±10.9) years. Univariate and multivariate Cox regression analysis were conducted to try to find out the effects of AFP and CA19-9 on postoperative disease-free survival (DFS) of patients with CHC. Subgroup analysis was also performed to analyze the DFS among patients with different levels of AFP and CA19-9. Kaplan-Meier method and log-rank test were used to plot and compare the survival curves between groups.Results:Univariate analysis showed that levels of AFP, CA19-9, alanine transaminase, aspartate transaminase, American Joint Committee on Cancer (AJCC) TNM staging, portal vein invasion, tumor number are associated with postoperative DFS in CHC patients (all P<0.05). The multivariate Cox analysis showed that AFP≥20.6 μg/L ( HR=6.686, 95% CI: 1.985-9.582), CA19-9≥35.2 U/L ( HR=5.790, 95% CI: 1.197-8.855), AJCC tumor TNM staging stage Ⅱ( HR=6.384, 95% CI: 2.069-11.532), and portal vein invasion ( HR=2.384, 95% CI: 1.100-10.125) were risk factors for a shortened DFS in CHC patients after surgery (all P<0.05). Subgroup analysis showed that patients with AFP≥20.6 μg/L and CA19-9≥35.2 U/L ( n=14) had a lower DFS compared to patients with AFP<20.6 μg/L and CA19-9≥35.2 U/L ( n=32), and patients with AFP≥20.6 μg/L and CA19-9<35.2 U/L ( n=20) ( χ2=6.23, 4.98, P=0.014, 0.043). Conclusion:AFP and CA19-9 are risk factors for DFS in CHC patients. Patients with AFP≥20.6 μg/L and CA19-9≥35.2 U/L showed a worse prognosis.