OBJECTIVE: To investigate the effect of autologous osteochondral tissue and periosteum transplantation on tendon-bone healing of rotator cuff in rabbits. METHODS: Twenty-four male New Zealand white rabbits were randomly divided into autologous osteochondral tissue and periosteum transplantation group (experimental group, n=12) and simple suture group (control group, n=12). Both groups were subjected to acute supraspinatus tendon injury and repaired with corresponding techniques. At 4, 8, and 12 weeks after operation, 4 specimens from each group were taken from the right shoulder joint for histological examination (HE staining, Masson staining, and Safranin O-fast green staining), and the left shoulder was subjected to biomechanical tests (maximum tensile load and stiffness). RESULTS: Both groups of animals survived until the completion of the experiment after operation. At 4 weeks after operation, both groups showed less collagen fibers and disorder at the tendon-bone junction. At 8 weeks, both groups showed reduced inflammation at the tendon-bone junction, with more organized and denser collagen fibers and chondrocytes. The experimental group showed better results than the control group. At 12 weeks, the experimental group showed typical tendon-bone transition structure, with increased generation of collagen fibers and chondrocytes, and the larger cartilage staining area. Both groups showed an increase in maximum tensile load and stiffness over time ( P<0.05). The stiffness at 4 weeks and the maximum tensile load at 4, 8, and 12 weeks in the experimental group were superior to control group, and the differences were significant ( P<0.05). There was no significant difference in stiffness at 8, 12 weeks between the two groups ( P>0.05). CONCLUSION Autologous osteochondral tissue and periosteum transplantation can effectively promote the fiber and cartilage regeneration at the tendon-bone junction of rotator cuff and improve the biomechanical effect of shoulder joint in rabbits.
Animals ; Rabbits ; Male ; Wound Healing ; Transplantation, Autologous ; Periosteum/transplantation* ; Rotator Cuff Injuries ; Rotator Cuff/surgery* ; Tendons/surgery* ; Biomechanical Phenomena ; Chondrocytes/transplantation* ; Tendon Injuries/surgery* ; Tensile Strength

OBJECTIVE: To observe the clinical efficacy of 3D printing spinal external fixator combined with McKenzie therapy for patients with lumbar dics herniation (LDH). METHODS: Sixty patients with LDH between January 2022 and January 2023 were enrolled. Among them, 30 patients were given McKinsey training. According to different treatment methods, all patients were divided into McKenzie group and McKenzie + 3D printing group, 30 patients in each group. The McKenzie group provided McKenzie therapy. The McKenzie + 3D printing group were treated with 3D printing spinal external fixation brace on the basis of McKenzie therapy. Patients in both groups were between 25 and 60 years of age and had their first illness. In the McKenzie group, there were 19 males and 11 females, with an average age of (48.57±5.86) years old, and the disease duration was (7.03 ±2.39) months. The McKenzie + 3D printing group, there were 21 males and 9 females, with an average age of (48.80±5.92) years old, and the disease duration was(7.30±2.56) months. Pain was evaluated using the visual analogue scale (VAS), and lumbar spine function was assessed using the Oswestry disability index (ODI) and the Japanese Orthopaedic Association (JOA) score. VAS, ODI and JOA scores were compared between two groups before treatment and at 1, 3, 6, 9 and 12 months after treatment. RESULTS: All patients were followed up for 12 months. The VAS for the McKenzie combined with 3D printing group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were(6.533±0.860), (5.133±1.008), (3.933±0.868), (2.900±0.759), (2.067±0.640), (1.433±0.504), respectively. In the McKenzie group, the corresponding scores were (6.467±0.860), (5.067±1.048), (4.600±0.968), (3.533±1.008), (2.567±0.728), (1.967±0.809), respectively. The ODI of the McKenzie group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were (41.033±6.810)%, (37.933±6.209)%, (35.467±6.962)%, (27.567±10.081)%, (20.800±7.531)%, (13.533±5.158)%, respectively. For the McKenzie combined with 3D printing group, the corresponding ODI were(38.033±5.605)%, (33.000±6.192)%, (28.767±7.045)%, (22.200±5.517)%, (17.700±4.836)%, (11.900±2.771)%, respectively. The JOA scores of the McKenzie combined with 3D printing group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were(8.900±2.074), (13.133±2.330), (15.700±3.583), (20.400±3.480), (22.267±3.084), (24.833±2.640), respectively. In the McKenzie group, the corresponding scores were(9.200±2.091), (12.267±2.406), (15.333±3.198), (18.467±2.240), (20.133±2.751), (22.467±2.849), respectively. Before the initiation of treatment, no statistically significant differences were observed in the VAS, ODI, and JOA scores between two groups (P>0.05). At 3, 6, 9, and 12 months post-treatment, the VAS in the McKenzie combined with 3D printing group was significantly lower than that in the McKenzie group, and the difference was statistically significant (P<0.05). The comparison of ODI between two groups at 1, 3, 6, 9, and 12 months post-treatment revealed statistically significant differences (P<0.05). At 6, 9, and 12 months post-treatment, the JOA score in the McKenzie combined with 3D printing group was significantly higher than that in the McKenzie-only group, and the difference was statistically significant (P<0.05). CONCLUSION The combination of 3D printed functional spinal external fixation brace with McKenzie therapy can significantly improve and maintain lumbar function in patients with LDH.
Humans ; Male ; Female ; Middle Aged ; Printing, Three-Dimensional ; Intervertebral Disc Displacement/surgery* ; External Fixators ; Lumbar Vertebrae/surgery* ; Adult ; Braces ; Treatment Outcome

Objective To establish an expert consensus on the management of mini-midline catheters(hereinafter referred to as the'consensus')to guide nurses in standardizing the insertion and maintenance of mini-midline catheters.Methods Evidence was systematically retrieved,scientifically evaluated,and synthesized using evidence-based methods to draft the initial version of the consensus.From December 2023 to July 2024,totally 2 rounds of expert correspondence and 2 rounds of expert panel discussions were conducted to revise the content,resulting in the final version.Results There were 17 experts from tertiary A general hospitals in Beijing,Shanghai,Hunan,Hubei,Sichuan,Jiangsu,Hainan,Guangxi Zhuang Autonomous Region,and Shandong participating in the consultation,with a 100％response rate.In the 2 rounds of expert correspondence,the authority coefficients were 0.947 and 0.962,respectively.The mean importance scores of all items exceeded 4.00 points.The coefficients of variation(CV)were 0-0.32(first round)and 0-0.15(second round).Kendall's concordance coefficients were 0.097 and 0.101(both P＜0.001).The consensus covers 11 sections,including definition,indications,contraindications,qualification training,pre-insertion preparation,catheter insertion,catheter use,catheter maintenance,catheter removal,prevention and management of common complications,and health education.Conclusion The Consensus demonstrates scientific rigor and comprehensively addresses key procedures before,during,and after the insertion of mini-midline catheters,providing actionable guidance for nurses in catheter insertion and maintenance.

A medical group functions as a network of responsibility among various medical institutions within an urban setting.Group management aids in constructing and refining the region's infectious disease prevention and control network,en-hancing the public health level of the city.This article examined the development of an infectious disease prevention and control management system within the medical group.By implementing a comprehensive organizational framework,standardizing stand-ardized management protocols,advancing information technology infrastructure,enhancing personnel training,promoting collabo-ration between hospital specialists and primary care practitioners,and offering remote support services,the group achieved con-sistent improvements in the management of infectious disease personnel,facilities,and protocols across all tiers.The rate of time-ly reporting rate for infectious diseases increased from 97.25％to 99.93％,while the under-reporting rate decreased from 0.25％to 0.00％,resulting in a reporting completeness rate of 100.00％.Furthermore,the introduction of a hierarchical diagnosis and treatment system led to a reduction referrals for key infectious diseases from 47.19％to 17.43％,thereby significantly enhancing disease management and treatment capabilities.Through this construction,the scale of the medical group's infectious disease prevention and control management system has begun to take shape,laying a solid foundation for the construction of a graded,comprehensive,and major epidemic response system in the region,and providing momentum for the healthy development of the construction of the infectious disease discipline.

Objective:To compare the arthroscopic autologous osteochondral transfer (AOT) and arthroscopic subscapularis augmentation (ASA) in the treatment of recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20%.Methods:A retrospective analysis was conducted of the clinical data of 42 patients who had been treated at Department of Orthopaedics, The Second Hospital of Lanzhou University for recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20% from January 2022 to January 2023. There were 30 males and 12 females, with an age of (32.2±15.2) years. Altogether 12 left shoulders and 30 right shoulders were affected. The patients were divided into 2 groups according to their surgical methods: an AOT group in which 15 cases were treated with AOT and an ASA group in which 27 cases treated with ASA. The Rowe score, American Shoulder and Elbow Surgeons (ASES) score, visual analogue scale (VAS), and shoulder range of motion were compared between groups at the last follow-up. All the above indexes were compared between pre-surgery and post-surgery in each group. The incidence of complications in the 2 groups was recorded.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, indicating comparability ( P > 0.05). A total of 42 patients were followed up for (17.2±5.9) months after surgery. At the last follow-up, in the ASA group and the AOT group respectively, the Rowe score was (97.0±4.4) points and (98.3±2.4) points, the ASES score (97.9±5.2) points and (99.1±3.7) points, and the VAS score 0 (0, 0) point and 0 (0, 1) point, showing no significant difference between the 2 groups ( P > 0.05). The above items in the 2 groups were significantly improved compared with those before surgery ( P < 0.05). At the last follow-up, in ASA group and AOT group respectively, shoulder abduction was 169.2°±3.0° and 168.3°±3.1°, and flexion 171.9°±4.0° and 173.3°±4.1°, showing no significant difference between the 2 groups ( P > 0.05); the abduction 90° external rotation was 67.3°±3.2° in the AOT group, significantly better than that in the ASA group (64.4°±3.5°) ( P < 0.05). The above items in the 2 groups were significantly improved compared with those before operation ( P < 0.05). Follow-ups revealed no infection or osteoarthritis. After surgery, 1 case of shoulder re-dislocation and 6 cases of shoulder pain occurred in the ASA group, while no cases of shoulder re-dislocation or shoulder pain occurred in the AOT group. There was no significant difference between the 2 groups in the incidence of complications ( P > 0.05). Conclusions:In the treatment of patients with recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20%, both AOT and ASA can improve shoulder function, but AOT is superior to ASA in 90° external rotation.

Objective:To identify risk factors influencing clinical efficacy of endoscopic resection of small rectal neuroendocrine tumor (NETs).Methods:A retrospective analysis was conducted on patients with rectal NETs ≤10 mm who underwent endoscopic resection from 2013 to 2022. Patients were divided into the endoscopic submucosal dissection (ESD) group and the endoscopic mucosal resection with ligation (EMRL) group according to the treatment methods. After comparing the baseline data, propensity score matching was performed to compare the rates of R1 resection and adequacy of vertical margin distance.Results:A total of 186 patients were included in this study, with 139 receiving ESD and 47 receiving EMRL. The R1 resection rates were 12.2% (17/139) and 2.1% (1/47) in the ESD and EMRL group, respectively ( χ2=3.027, P=0.082). A significant difference in vertical margin adequacy was observed between the two groups [69.1% (96/139) VS 85.1% (40/47), χ2=4.598, P=0.032]. After propensity score matching, 46 pairs of cases were included, and there were no significant differences in the R1 resection rate [6.5% (3/46) VS 2.2% (1/46), χ2=0.261, P=0.609] and vertical margin adequacy [78.3% (36/46) VS 84.8% (39/46), χ2=0.649, P=0.420] between the two groups. Univariate and multivariate Logistic regression analyses revealed that operator experience and preoperative biopsy were independent risk factors for inadequate margin. Conclusion:Treatment method may not be the key factor affecting the distance of the vertical margin after endoscopic resection, but preoperative biopsy and operator experience have a significant impact on margins. Biopsy before endoscopic resection should be avoided, and less experienced doctors are recommended to use EMRL method for small NETs due to its ease of execution.

A medical group functions as a network of responsibility among various medical institutions within an urban setting.Group management aids in constructing and refining the region's infectious disease prevention and control network,en-hancing the public health level of the city.This article examined the development of an infectious disease prevention and control management system within the medical group.By implementing a comprehensive organizational framework,standardizing stand-ardized management protocols,advancing information technology infrastructure,enhancing personnel training,promoting collabo-ration between hospital specialists and primary care practitioners,and offering remote support services,the group achieved con-sistent improvements in the management of infectious disease personnel,facilities,and protocols across all tiers.The rate of time-ly reporting rate for infectious diseases increased from 97.25％to 99.93％,while the under-reporting rate decreased from 0.25％to 0.00％,resulting in a reporting completeness rate of 100.00％.Furthermore,the introduction of a hierarchical diagnosis and treatment system led to a reduction referrals for key infectious diseases from 47.19％to 17.43％,thereby significantly enhancing disease management and treatment capabilities.Through this construction,the scale of the medical group's infectious disease prevention and control management system has begun to take shape,laying a solid foundation for the construction of a graded,comprehensive,and major epidemic response system in the region,and providing momentum for the healthy development of the construction of the infectious disease discipline.

Objective To establish an expert consensus on the management of mini-midline catheters(hereinafter referred to as the'consensus')to guide nurses in standardizing the insertion and maintenance of mini-midline catheters.Methods Evidence was systematically retrieved,scientifically evaluated,and synthesized using evidence-based methods to draft the initial version of the consensus.From December 2023 to July 2024,totally 2 rounds of expert correspondence and 2 rounds of expert panel discussions were conducted to revise the content,resulting in the final version.Results There were 17 experts from tertiary A general hospitals in Beijing,Shanghai,Hunan,Hubei,Sichuan,Jiangsu,Hainan,Guangxi Zhuang Autonomous Region,and Shandong participating in the consultation,with a 100％response rate.In the 2 rounds of expert correspondence,the authority coefficients were 0.947 and 0.962,respectively.The mean importance scores of all items exceeded 4.00 points.The coefficients of variation(CV)were 0-0.32(first round)and 0-0.15(second round).Kendall's concordance coefficients were 0.097 and 0.101(both P＜0.001).The consensus covers 11 sections,including definition,indications,contraindications,qualification training,pre-insertion preparation,catheter insertion,catheter use,catheter maintenance,catheter removal,prevention and management of common complications,and health education.Conclusion The Consensus demonstrates scientific rigor and comprehensively addresses key procedures before,during,and after the insertion of mini-midline catheters,providing actionable guidance for nurses in catheter insertion and maintenance.

Objective:To compare the arthroscopic autologous osteochondral transfer (AOT) and arthroscopic subscapularis augmentation (ASA) in the treatment of recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20%.Methods:A retrospective analysis was conducted of the clinical data of 42 patients who had been treated at Department of Orthopaedics, The Second Hospital of Lanzhou University for recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20% from January 2022 to January 2023. There were 30 males and 12 females, with an age of (32.2±15.2) years. Altogether 12 left shoulders and 30 right shoulders were affected. The patients were divided into 2 groups according to their surgical methods: an AOT group in which 15 cases were treated with AOT and an ASA group in which 27 cases treated with ASA. The Rowe score, American Shoulder and Elbow Surgeons (ASES) score, visual analogue scale (VAS), and shoulder range of motion were compared between groups at the last follow-up. All the above indexes were compared between pre-surgery and post-surgery in each group. The incidence of complications in the 2 groups was recorded.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, indicating comparability ( P > 0.05). A total of 42 patients were followed up for (17.2±5.9) months after surgery. At the last follow-up, in the ASA group and the AOT group respectively, the Rowe score was (97.0±4.4) points and (98.3±2.4) points, the ASES score (97.9±5.2) points and (99.1±3.7) points, and the VAS score 0 (0, 0) point and 0 (0, 1) point, showing no significant difference between the 2 groups ( P > 0.05). The above items in the 2 groups were significantly improved compared with those before surgery ( P < 0.05). At the last follow-up, in ASA group and AOT group respectively, shoulder abduction was 169.2°±3.0° and 168.3°±3.1°, and flexion 171.9°±4.0° and 173.3°±4.1°, showing no significant difference between the 2 groups ( P > 0.05); the abduction 90° external rotation was 67.3°±3.2° in the AOT group, significantly better than that in the ASA group (64.4°±3.5°) ( P < 0.05). The above items in the 2 groups were significantly improved compared with those before operation ( P < 0.05). Follow-ups revealed no infection or osteoarthritis. After surgery, 1 case of shoulder re-dislocation and 6 cases of shoulder pain occurred in the ASA group, while no cases of shoulder re-dislocation or shoulder pain occurred in the AOT group. There was no significant difference between the 2 groups in the incidence of complications ( P > 0.05). Conclusions:In the treatment of patients with recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20%, both AOT and ASA can improve shoulder function, but AOT is superior to ASA in 90° external rotation.

Objective:To identify risk factors influencing clinical efficacy of endoscopic resection of small rectal neuroendocrine tumor (NETs).Methods:A retrospective analysis was conducted on patients with rectal NETs ≤10 mm who underwent endoscopic resection from 2013 to 2022. Patients were divided into the endoscopic submucosal dissection (ESD) group and the endoscopic mucosal resection with ligation (EMRL) group according to the treatment methods. After comparing the baseline data, propensity score matching was performed to compare the rates of R1 resection and adequacy of vertical margin distance.Results:A total of 186 patients were included in this study, with 139 receiving ESD and 47 receiving EMRL. The R1 resection rates were 12.2% (17/139) and 2.1% (1/47) in the ESD and EMRL group, respectively ( χ2=3.027, P=0.082). A significant difference in vertical margin adequacy was observed between the two groups [69.1% (96/139) VS 85.1% (40/47), χ2=4.598, P=0.032]. After propensity score matching, 46 pairs of cases were included, and there were no significant differences in the R1 resection rate [6.5% (3/46) VS 2.2% (1/46), χ2=0.261, P=0.609] and vertical margin adequacy [78.3% (36/46) VS 84.8% (39/46), χ2=0.649, P=0.420] between the two groups. Univariate and multivariate Logistic regression analyses revealed that operator experience and preoperative biopsy were independent risk factors for inadequate margin. Conclusion:Treatment method may not be the key factor affecting the distance of the vertical margin after endoscopic resection, but preoperative biopsy and operator experience have a significant impact on margins. Biopsy before endoscopic resection should be avoided, and less experienced doctors are recommended to use EMRL method for small NETs due to its ease of execution.