Objective:To observe the efficacy of arthroscopic LUtarjet procedure in the treatment of recurrent anterior shoulder dislocation combined with a glenoid bone defect.Methods:A retrospective study was conducted to analyze the data of 15 patients with recurrent anterior shoulder dislocation combined with a glenoid bone defect who had been treated by the arthroscopic LUtarjet procedure at Department of Orthopedics, The 928th Hospital of PLA Joint Logistics Support Force from September 2022 to November 2023. All patients were male, aged (25.0±1.9) years, involving 10 left and 5 right sides. The anterior fear test for the affected shoulder was positive in all cases before surgery, and the dislocations averaged (13.8±5.4) times. By comparing the three-dimensional CT scans of both shoulders before surgery, the severity of the glenoid bone defect was calculated as over 20% wider than the width of the healthy glenoid. The shoulder function was evaluated at 6 and 18 months after operation using the American Shoulder and Elbow Surgeons score (ASES), Rowe score, Walch-Duplay score and shoulder active range of motion. Comparisons were made between preoperation and postoperation. CT plain scan and three-dimensional reconstruction were used to evaluate the location and resorption of the transferred bone block of the coracoid process.Results:All patients were followed up for (19.8±1.1) months. The operation time for the 15 patients was (117.6±13.8) min. Re-dislocation occurred in none of the patients during postoperative follow-up. There was no significant difference in the flexion elevation, lateral external rotation, internal rotation or abduction 90° external rotation between preoperation, 6 months or 18 months after operation ( P>0.05). Respectively, the ASES, Rowe and Walch-Duplay scores were (93.3±2.3) points, (90.8±2.6) points, and (95.9±1.0) points at 18 months after operation, and (89.6±3.8) points, (84.5±2.7) points, and (87.2±3.9) points at 6 months after operation, showing significant improvements compared with the preoperative values [(70.9±6.1) points, (42.9±6.0) points, and (66.2±11.0) points] ( P<0.05). In the 3 patients whose immediately postoperative CT scan showed that their bone blocks were slightly lower in position, the bone blocks grew and shaped well at the last follow-up. The last follow-up observed partial bone resorption in one patient. Conclusion:In the treatment of recurrent anterior shoulder dislocation combined with a glenoid bone defect, the arthroscopic LUtarjet procedure can restore satisfactory stability of the shoulder joint, leading to good short- and mid-term efficacy.

Objective To analyze the relationship between the expression of ferroptosis markers in the tumor microenvironment(TME)and the prognosis of transcatheter arterial chemoembolization(TACE)for hepatocellular carcinoma(HCC).Methods This prospective observational study included 100 HCC patients who received TACE treatment at Langfang Hospital of Traditional Chinese Medicine from March 2019 to June 2021 as the study subjects.The levels of 8-isoprostaglandin F2α(8-iso-PGF2α),4-hydroxy-2-nonenal(4-HNE),8-hydroxy-2'deoxyguanosine(8-OH-dG)and hepcidin in plasma were evaluated by ELISA kit at baseline(1 day before TACE),1 day after TACE and 4～8 weeks.The changes of ferroptosis related markers during TACE treatment were compared.The difference between the level of 8-iso-PGF2α,4-HNE and the baseline 1 day after TACE treatment was recorded as △8-iso-PGF2α,△4-HNE.Results Compared with the baseline,the levels of 8-iso-PGF2α and 4-HNE increased significantly and the level of hepcidin decreased significantly one day after TACE treatment,and the differences were statistically significant(t=8.03,16.29,2.92,all P<0.05).Compared with 1 day after treatment,the levels of 8-iso-PGF2α,4-HNE decreased and the level of 8-OH-dG increased at 4～8 weeks after TACE treatment,and the differences were statistically significant(t=9.12,17.17,2.63,all P<0.05).Multivariate COX analysis showed that △8-iso-PGF2α,△4-HNE and 8-iso-PGF2α 1 day after TACE treatment were independent factors affecting the overall survival after TACE(Wald χ2=5.205,13.801,6.054,all P<0.05).The survival time of patients with △4-HNE>2.01 μg/ml was significantly longer than that of patients with △4-HNE≤2.01 μg/ml(Log-rank=5.718,P=0.017),and that of patients with△8-iso-PGF2α>1.75ng/ml was sig-nificantly longer than that of patients with△8-iso-PGF2≤1.75ng/ml(Log-rank=4.163,P=0.041).Conclusion The prognosis of HCC patients who are in a state of high ferroptosis(4-HNE and 8-iso-PGF2 increased)at 1 day after TACE treatment is better,which indicate that ferroptosis mediated HCC death induced by TACE treatment.

Objective To analyze the relationship between the expression of ferroptosis markers in the tumor microenvironment(TME)and the prognosis of transcatheter arterial chemoembolization(TACE)for hepatocellular carcinoma(HCC).Methods This prospective observational study included 100 HCC patients who received TACE treatment at Langfang Hospital of Traditional Chinese Medicine from March 2019 to June 2021 as the study subjects.The levels of 8-isoprostaglandin F2α(8-iso-PGF2α),4-hydroxy-2-nonenal(4-HNE),8-hydroxy-2'deoxyguanosine(8-OH-dG)and hepcidin in plasma were evaluated by ELISA kit at baseline(1 day before TACE),1 day after TACE and 4～8 weeks.The changes of ferroptosis related markers during TACE treatment were compared.The difference between the level of 8-iso-PGF2α,4-HNE and the baseline 1 day after TACE treatment was recorded as △8-iso-PGF2α,△4-HNE.Results Compared with the baseline,the levels of 8-iso-PGF2α and 4-HNE increased significantly and the level of hepcidin decreased significantly one day after TACE treatment,and the differences were statistically significant(t=8.03,16.29,2.92,all P<0.05).Compared with 1 day after treatment,the levels of 8-iso-PGF2α,4-HNE decreased and the level of 8-OH-dG increased at 4～8 weeks after TACE treatment,and the differences were statistically significant(t=9.12,17.17,2.63,all P<0.05).Multivariate COX analysis showed that △8-iso-PGF2α,△4-HNE and 8-iso-PGF2α 1 day after TACE treatment were independent factors affecting the overall survival after TACE(Wald χ2=5.205,13.801,6.054,all P<0.05).The survival time of patients with △4-HNE>2.01 μg/ml was significantly longer than that of patients with △4-HNE≤2.01 μg/ml(Log-rank=5.718,P=0.017),and that of patients with△8-iso-PGF2α>1.75ng/ml was sig-nificantly longer than that of patients with△8-iso-PGF2≤1.75ng/ml(Log-rank=4.163,P=0.041).Conclusion The prognosis of HCC patients who are in a state of high ferroptosis(4-HNE and 8-iso-PGF2 increased)at 1 day after TACE treatment is better,which indicate that ferroptosis mediated HCC death induced by TACE treatment.

Objective:To observe the efficacy of arthroscopic LUtarjet procedure in the treatment of recurrent anterior shoulder dislocation combined with a glenoid bone defect.Methods:A retrospective study was conducted to analyze the data of 15 patients with recurrent anterior shoulder dislocation combined with a glenoid bone defect who had been treated by the arthroscopic LUtarjet procedure at Department of Orthopedics, The 928th Hospital of PLA Joint Logistics Support Force from September 2022 to November 2023. All patients were male, aged (25.0±1.9) years, involving 10 left and 5 right sides. The anterior fear test for the affected shoulder was positive in all cases before surgery, and the dislocations averaged (13.8±5.4) times. By comparing the three-dimensional CT scans of both shoulders before surgery, the severity of the glenoid bone defect was calculated as over 20% wider than the width of the healthy glenoid. The shoulder function was evaluated at 6 and 18 months after operation using the American Shoulder and Elbow Surgeons score (ASES), Rowe score, Walch-Duplay score and shoulder active range of motion. Comparisons were made between preoperation and postoperation. CT plain scan and three-dimensional reconstruction were used to evaluate the location and resorption of the transferred bone block of the coracoid process.Results:All patients were followed up for (19.8±1.1) months. The operation time for the 15 patients was (117.6±13.8) min. Re-dislocation occurred in none of the patients during postoperative follow-up. There was no significant difference in the flexion elevation, lateral external rotation, internal rotation or abduction 90° external rotation between preoperation, 6 months or 18 months after operation ( P>0.05). Respectively, the ASES, Rowe and Walch-Duplay scores were (93.3±2.3) points, (90.8±2.6) points, and (95.9±1.0) points at 18 months after operation, and (89.6±3.8) points, (84.5±2.7) points, and (87.2±3.9) points at 6 months after operation, showing significant improvements compared with the preoperative values [(70.9±6.1) points, (42.9±6.0) points, and (66.2±11.0) points] ( P<0.05). In the 3 patients whose immediately postoperative CT scan showed that their bone blocks were slightly lower in position, the bone blocks grew and shaped well at the last follow-up. The last follow-up observed partial bone resorption in one patient. Conclusion:In the treatment of recurrent anterior shoulder dislocation combined with a glenoid bone defect, the arthroscopic LUtarjet procedure can restore satisfactory stability of the shoulder joint, leading to good short- and mid-term efficacy.

Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the long-term effects of modified Bristow-Latarjet operation for treatment of recurrent inferoanterior shoulder dislocation.Methods A retrospective case series study was done on 90 patients with recurrent inferoanterior shoulder dislocation treated by modified Bristow-Latarjct procedure from January 2001 to January 2016.There were 72 males and 18 females,with an average age of 36.8 years.There were 59 fight shouders and 31 left shoulders,with dislocation for 4-32 times (mean,13 times).Shoulder instability severity index score (ISIS) was 3-10 points (mean,6.4 points).The duration of disease was 6-26 months (mean,13 months).The operation methods were coracoid lateral incision with modification,rotator cuff interval approach,double hollow compression screw fixation,and bone congruent-arc technique in standing position.Clinical evaluation was done on postoperative recurrence of shoulder joint dislocation/subluxation,bone healing evaluated by X-ray and CT,Rowe score,simple shoulder function Test (SST) score,shoulder osteoarthritis score (Samilson-Prieto),bodv side shoulder external rotation angle and the subscapularis muscle strength.Results All patients were followed up for 1-15 years (mean,5.6 years).The rate of redislocation or subluxation during follow-up was zero.All transpositions of the coracoid got bone healing at postoperative 3-6 months.The Rowe score was increased significantly from (45.6 ± 9.4) points preoperatively to (92.6 ± 3.5) points postoperatively (P ＜0.01);SST score was increased significantly from (5.6 ± 1.2)points preoperatively to (9.6 ± 2.8) points postoperatively at final follow-up) (P ＜ 0.01).Samilson-Prieto score was mild in 2 patients (2％).The body side shoulder external rotation angles were (56.7 ± 13.9) ° preoperatively and (54.6 ±14.1) ° postoperatively (P ＞ 0.05).With regards to subscapularis strength,the lift-off and belly-press in injured side were (4.9 ± 0.9) kg and (4.4 ± 1.0) kg,respectively (P ＞ 0.05).Lift-off and belly-off in normal side were (5.1 ± 0.5) kg and (4.7 ± 1.1) kg,respectively (P ＞ 0.05).Conclusion The modified Bristow-Latarjet operation is a reproducible and effective technique that can restore shoulder stability,with advantages of sound bone healing,free shoulder external rotation,low incidence of shoulder joint osteoarthritis,remaining of myodynamia under scapula and hence has long-term effects and is worth of clinical applicaiton.

Objective To compare the early curative effects of arthroscopic modified suture bridge and single-row modified Mason-Allen suture in repair of supraspinatus tendon tears.Methods A retrospective case-control analysis was made on 28 patients with supraspinatus tendon tears admitted between June 2012 and June 2015.There were 16 males and 12 females,aged 43-63 years (mean,54.2 years).Thirteen patients (13 shoulders) were repaired using the arthroscopic modified suture bridge technique (Group A),and 15 patients (15 shoulders) were treated using the single-row modified Mason-Allen technique (Group B).Operation time and intraoperative blood loss were recorded.American shoulder and elbow surgeons (ASES) score,Constant score and visual analogue score (VAS) were used to evaluate the function and subjective outcomes preoperatively.Meanwhile,MRI was used for analysis of tendon integrity postoperatively.Results The operation time of Group A and B were (56.1 ± 23.2) minutes and (36.1 ± 15.6) minutes,respectively (P ＜ 0.05).The intraoperative blood loss was (30.3 ± 20.5) ml and (28.5 ± 18.2) ml,respectively (P ＞ 0.05).The average follow-up time for Groups A and B were 12 months and 12.6 months,respectively.The symptoms of 28 cases were alleviated after surgery,and the functions were obviously recovered.In Group A,thc VAS was decreased significantly from (7.0 ± 0.8) points preoperatively to (0.8 ± 0.8) points at final follow-up,ASES score was improved from (39.8 ± 3.1) points to (88.1 ± 4.8) points,and Constant score was improved from (54.8 ± 2.7) points to (88.2 ± 3.1) points (all P ＜ 0.05).In Group B,the VAS was decreased significantly from (6.8 ± 0.8) points preoperatively to (0.9 ± 0.8) points at final follow-up,ASES score was improved from (40.7 ± 2.5) points to (89.5 ± 3.2) points,and Constant score was improved from (56.0 ± 4.5) points to (89.3 ± 3.4) points (all P ＜ 0.05).There was no significant difference in the clinical outcomes between the two groups (P ＞ 0.05).The retear rate in Group B was 20％ (3/15),while no retear was presented in Group A (P ＜ 0.05).Conclusion Arthroscopic modified suture bridge technique and single-row modified Mason-Allen technique are both clinically effective for function recovery and pain relief in patients with supraspinatus tendon tears,but the former associated with lower incidence of tendon re-tear is preferred for moderate to large rotator cuff injury or rotator cuff injury with large insertion avulsion.

Objective To evaluate the short-term effects of total knee arthroplasty ( TKA) , and to detect the causes and prevention of major complications. Methods It was a retrospective study since January 2010 to December 2013. There were 63 patients with 70 knees re-ceived primary TKA. KSS knee scores, HSS knee scores, and range of motion ( ROM) before the operation and during the follow-up were as-sessed and analysed. Results According to the results of follow-up and the X-ray observation, the anteroposterior radiographs showed that the artificial prosthesis were placed well and the joint gap were balanced;the lateral radiographs showed that the artificial joint prosthesis we-rer of appropriate size, good tilt angle, and good package effect. There were two cases developed peroneal nerve palsy and they gradually re-stored in 4 to 6 months after surgery. 5 cases were of poor postoperative ROM (0~60 ± 10)°. Strong analgesic medication-assisted release were conducted in 2 to 3 weeks after surgery. 1 case had patellar pain and resorted by arthroscopic lateral ligament of patellar releasing sur-gery. During the follow-up period, TKA significantly improved HSS and KSS scores compared to preoperative scores. ROM was increased from (78. 3 ± 18. 6)° preoperatively to (109. 2 ± 19. 9)° postoperative (P<0. 01). Conclusion TKA was effective to release knee pain, improve ROM and reduce the incidence of postoperative complications.

Objective To introduce a new modified Bristow operation with mini-open incision and evaluate jts clinical outcomes in treatment of recurrent anteroinferior shoulder dislocation. Methods A total of 11 patients with recurrent anteroinferior shoulder dislocation were treated with modified Bristow op-eration with mini-open incision.The anterior skin incision with 3-5 mm was made to explore the coracoid process with"moving window"technique.Then.the coracoid process and its short head of biceps were os-teotornjed.transferred and fixed on the anteroinferior potion of scapular neck through the rotator cuff inter-space.All patients were followed up for an average period of 15.8 months(6-48 months)by using modified Rowe score. Results The average operation time was 45 minutes(40-65 minutes).The modified Rowe 8core ranged from 80 to 95 points.excellent in all patients, with SUCCESS rate of 100% and without any re-currence or complication. Conclusions Compared with traditional operation.the modified Bristow oper-ation has smaller incision,less trauma.shorter operation duration and better clinical results.