Background and Aims To elaborate on the development and characteristics of trauma orthopedic robots and their real curative effect in a clinical application through the collection and analysis of relevant literature and reported clinical results. Method We conducted the Embase, ScienceDirect, Pubmed, Medline, Wanfang, CNKI, and VIP search of the literature on robotic‐assisted surgery in trauma orthopedics in China. We combined search terms with “robotic surgery/artificial intelligence surgery/navigation surgery,” “trauma/trauma orthopedics,” and “China/Chinese.” The exclusion criteria were: (1) articles in languages other than English or Chinese, (2) articles focused on other topics other than robotic‐assisted surgery in trauma orthopedics of China, (3) article types were not clinical studies (reviews, basic research, etc.), and (4) articles were not included in the Chinese core journals or science citation index. Authors, type of surgery, robot type, and clinical research results were recorded and analyzed. Results There were three categories of surgical robots in the clinical application of trauma orthopedics (TiRobot, electromagnetic navigation surgical robots, and small medical robots developed by Beijing Jishuitan Hospital). In terms of blood loss, the fluoroscopy time, and fluoroscopy frequency, most studies found that the robot group was significantly better than the traditional group. Conclusions Robot‐assisted surgery has obvious advantages in accuracy, stability, and reducing intraoperative radiation exposure, but there is no final conclusion about functional recovery.
Intervertebral disc degeneration (IDD) is a chronic progressive condition mainly caused by excessive inflammatory cytokines. Berberine (BBR) exerts anti-inflammatory effect on diseases and protective effect against IDD. However, the mechanism is not uncertain. This study is aimed at investigating the molecular mechanism of BBR on IDD. Nucleus pulposus (NP) cells were treated with BBR at different concentrations. The IDD rat model was established by acupuncture. The effect of BBR on interleukin- (IL-) 1β-induced cell proliferation was measured by CCK-8 assay and BrdU staining. The role of BBR in IL-1β-induced apoptosis, autophagy repression, and extracellular matrix (ECM) degradation was measured by Annexin/PI staining, immunofluorescence, and immunoblot. The effect of BBR on IDD was investigated in rat. Our findings showed that BBR restored cell growth and attenuated apoptosis in IL-1β-induced NP cells. BBR also prevented the IL-1β-induced ECM degradation through regulating ECM-related enzymes and factors. Additionally, BBR significantly activated autophagy repressed by IL-1β. Autophagy stimulated by BBR was diminished by the inhibition of the AMPK/mTOR/Ulk1 signaling pathway. In vivo study also showed BBR attenuated intervertebral disc degeneration. BBR could attenuate NP cells apoptosis and ECM degradation induced by IL-1β through autophagy by the AMPK/mTOR/Ulk1 pathway. This study suggests BBR might function as an AMPK activator to alleviate IDD progression.
Subacromial impingement syndrome (SIS) after hook plate fixation for acromioclavicular joint (AC) dislocation was the most common complication. However, the researches on its’ influential factors were rare. The purpose of this study was to identify the risk factors by analyzing the influencing factors of postoperative SIS and minimize the incidence of SIS in clinical surgery. We retrospectively analyzed the prospectively collected data from 330 consecutive patients with AC joint dislocation between August 2014 and August 2017 at our institute. The SIS was presented as the dependent variable at the last follow-up when the internal fixation was removed. The independent variables included age, gender, body-mass index (BMI), smoking status, alcohol consumption, type of injury, Rockwood Classification, site of injury, operation time, injury-to-surgery, the distance between the hook body and the acromion (DBA), the depth of hook tip (DHT), the distance between the hook plate and the humeral head (DHH), the distance between the acromion and the humeral head (DAH), the hook plate angle (AHP) and acromial shape. Logistic regression analysis was performed to identify independent influential factors of SIS. A total of 312 cases were included and 18 cases were lost. The follow-up rate was 94.5%. In without SIS group, there were 225 cases (123 males and 102 females). In with SIS group, a total of 87 cases were included (56 males and 31 females). The incidence of SIS was 27.8%. DHT (OR = 9.385, 95% CI = 4.883 to 18.040, P < .001) and DBA (OR = 2.444, 95% CI = 1.591 to 3.755, P < .001) were the significant independent risk factor for SIS of AC dislocation treat with hook plate. DAH (OR = 0.597, 95% CI = 0.396 to 0.900, P = .014) and acromial shape with flat and straight (OR = 0.325, 95% CI = 0.135 to 0.785, P = .012) were also independent factors of SIS, but they were all protective. The SIS had a high incidence in fixation of clavicular hook plate for AC dislocation. DHT and DBA were two independent risk factors, DAH and acromial shape with flat and straight were two independent protective factors for SIS. In clinical surgery, we should avoid risk factors to reduce the incidence of SIS.
Background: Postoperative shoulder pain was a most common complication after clavicular hook plate treatment for acromioclavicular joint dislocation. However, the researches on its risk factors were rare. The purpose of this study was to evaluate the incidences of postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate and to identify risk factors in patients with an acute acromioclavicular joint dislocation. Method: We retrospectively analyzed the prospectively collected data from 310 consecutive patients with AC joint dislocation between December 2014 and August 2019 at our institute. Patients rated the average intensity of shoulder pain using an 11-point numerical rating scale (NRS). The dependent variable was the presence of moderate-to-severe neck pain (NRS ≥4) at the last follow-up when the internal fixation will be removed. The independent variables included age, gender, body-mass index (BMI), smoking status, alcohol consumption, type of injury, Rockwood Classification, site of injury, operation time, injury-to-surgery, DHA, DH and AHP. Logistic regression analysis was performed to identify independent risk factors of moderate-to-severe shoulder pain of acromioclavicular joint dislocation treat with hook plate. Results: A total of 292 patients were included in the study and 18 cases were lost to follow-up. The follow-up rate was 94.1%. In all cases, there were 166 male cases and 126 female cases. Of these cases, the NRS < 4 group had 219 patients. Among them, there were 120 males and 99 females. 12 patients were lost to follow-up. There were 73 patients in NRS ≥ 4 group, 46 males and 27 females. 6 cases were lost to follow-up. The number of patient in NRS ≥ 4 group accounted for about 25.0% of the total cases. DH was the significant independent risk factor for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate. DHA and AHP were also independent factors of postoperative shoulder pain, but they were all protective. Conclusions: DH was the significant independent risk factor for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate. DHA and AHP were also independent factors of postoperative shoulder pain, but they were all protective. We should try to refer to these factors to avoid postoperative shoulder pain when performing clinical operations.
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