Effects of adjuvant application of corticosteroid and ozone after ultrasound-guided puncture and lavage for the treatment of rotator cuff calcific tendinitis: study protocol for a non-inferiority randomized controlled trial.

BACKGROUND: Steroid injection after percutaneous irrigation of calcific deposits is a common method for the treatment of rotator cuff calcific tendinitis (RCCT). However, steroids may prevent calcification resorption and cause potentially irreversible damage to tendons. Recent studies have confirmed the positive effects of ozone injection in shoulder tendinopathies, but no RCCTs have been reported. Thus, our study aims to evaluate the non-inferiority of ozone versus steroid injection. METHODS: This is a prospective, randomized, parallel control and non-inferiority trial. A total of 100 patients with unilateral symptomatic RCCT will be enrolled and randomized in a 1:1 ratio to two groups: ultrasound-guided injection with ozone or corticosteroid. The primary outcome is the numeric rating scale for pain (NRS) at 1 week and 3 months following the procedure. Secondary outcomes include a multi-dimensional evaluation of shoulder disability and quality of life improvement, the degree of calcification absorption after treatment, and the number of multiple treatments. DISCUSSION: The results of this study will provide short-term and long-term evidence for the effectiveness of ozone treatment in RCCT in relieving pain or improving shoulder function. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200063469. Registered on 7 September 2022.

Comparison of two different uses of underbody forced-air warming blankets for the prevention of hypothermia in patients undergoing arthroscopic shoulder surgery: a prospective randomized study.

BACKGROUND: Forced-air warming (FAW) is an effective method of preventing inadvertent perioperative hypothermia (IPH). However, its warming effects can be influenced by the style and position of the FAW blanket. This study aimed to compare the effects of underbody FAW blankets being placed under or over patients in preventing IPH. METHODS: Patients (n=100) undergoing elective arthroscopic shoulder surgery in the lateral decubitus position were randomized into either under body (UB) group or the over body (OB) group (50 per group). The body temperature of the patients was recorded from baseline to the end of anesthesia. The incidences of postoperative hypothermia and shivering were also collected. RESULTS: A steady decline in the body temperature was observed in both groups up to 60 minutes after the start of FAW. After 60 minutes of warming, the OB group showed a gradual increase in the body temperature. However, the body temperature still decreased in UB group until 75 minutes, with a low of 35.7℃ ± 0.4℃. Then the body temperature increased mildly and reached 35.8℃ ± 0.4℃ at 90 minutes. After 45 minutes of warming, the body temperature between the groups was significantly different (P < 0.05). The incidence of postoperative hypothermia in the UB group was significantly higher than that in the OB group (P = 0.023). CONCLUSIONS: The body temperature was significantly better with the use of underbody FAW blankets placed over patients than with them placed under patients. However, there was not a clinically significant difference in body temperature. The incidence of postoperative hypothermia was much lower in the OB group. Therefore, placing underbody FAW blankets over patients is recommended for the prevention of IPH in patients undergoing arthroscopic shoulder surgery. TRIAL REGISTRATION: This single-center, prospective, RCT has completed the registration of the Chinese Clinical Trial Center at 13/1/2021 with the registration number ChiCTR2100042071 . It was conducted from 14/1/2021 to 30/10/2021 as a single, blinded trial in Sichuan Provincial Orthopedic Hospital.

Clinical application of ultrasound-guided selective proximal and distal brachial plexus block in rapid rehabilitation surgery for hand trauma.

BACKGROUND: Anesthesia plays an essential role in the successful surgical procedures for hand trauma. Compared with general anesthesia, brachial plexus block shows lots of benefits for the upper extremity. Specifically, ultrasound-guided selective proximal and distal brachial plexus block may overcome the issues of incomplete block and failure of anesthesia in such circumstances. The present study assessed the efficacy of ultrasound-guided selective proximal and distal brachial plexus block in clinical practice. AIM: To explore the efficacy of ultrasound-guided selective proximal and distal brachial plexus block in rapid recovery surgery for hand trauma. METHODS: A total of 68 patients with traumatic hand injuries treated at our hospital from January 2018 to June 2019 were selected. They were divided into an observation group and a control group with 34 patients in each group. The observation group underwent selective brachial plexus block guided by ultrasound and the control group underwent conventional brachial plexus block. The analgesic efficacy, intraoperative complications, wound healing time, and length of hospital stay were compared between the two groups under different anesthesia. RESULTS: The percentage of cases with analgesia graded as "excellent or very good" was higher in the observation group than in the control group (P < 0.05). Moreover, the incidence of intraoperative complications was lower and the wound healing time and length of hospital stay were shorter in the observation group than in the control group (P < 0.05). CONCLUSION: Ultrasound-guided selective proximal and distal brachial plexus block has remarkable analgesic efficacy in patients with traumatic hand injuries. It can reduce the incidence of intraoperative complications, promote wound healing, and shorten the length of hospital stay.

[Characteristics of Nitrogen and Phosphorus Formation in Atmospheric Deposition in Dianchi Lake and Their Contributions to Lake Loading].

To examine the effects of seasonal changes and precipitation on the concentrations of various nitrogen and phosphorus forms in Dianchi Lake, the concentrations of various nitrogen and phosphorus forms of atmospheric deposition were determined by UV spectrophotometry. Additionally, the contributions of nitrogen and phosphorus to water pollution in Dianchi Lake were discussed. The results showed that the atmospheric depositional nitrogen concentration in Dianchi Lake is generally consistent with the characteristics of the low rainy season and high dry season. The nitrogen and phosphorus load of atmospheric deposition was positively correlated with rainfall. Seasonal changes were mainly characterized by low dry season and high rainy season. The atmospheric depositional nitrogen load was dominated by dissolved inorganic nitrogen, which accounted for 63.70% of the total nitrogen deposition load. The phosphorus load was mainly PP, which accounted for 45.54% of the total phosphorus precipitation load. Excessive fertilization and loss of nitrogen and phosphorus from fertilizers are the major sources of nitrogen and phosphorus in atmospheric wet deposition. Combined with data from rivers entering the lake, the settlements of TN and TP in the atmospheric deposition of Dianchi Lake were 6.14% and 12.76% of the river load, respectively. Therefore, the primary source of pollution in Dianchi Lake was still the load brought by the river into the lake. However, the nitrogen and phosphorus fluxes in the atmospheric deposition of Dianchi Lake were at intermediate levels compared with other regions, so this contribution requires further investigation.

[Occurrence and Ecological Risk Assessment of Typical Persistent Organic Pollutants in Baiyangdian Lake].

A comprehensive survey of the pollution characteristics of persistent organic pollutants (POPs) in the surface water and surface sediment of Baiyangdian Lake was carried out. The survey showed that:① The concentrations of the polycyclic aromatic hydrocarbons(PAHs), organic chlorine pesticides (OCPs), and polybrominated diphenyl ethers (PBDEs) in the surface water of Baiyangdian Lake were 71.32-228.27 ng·L-1, 2.62-6.13 ng·L-1, and 0-6.5 ng·L-1, respectively, and those in the surface sediment were 163.20-861.43 ng·g-1, 2.25-6.07 ng·g-1, and 230.96-1224.13 pg·g-1, respectively. On comparison with historical data, the concentrations of PAHs and OCPs in both the surface water and surface sediment were found to be decreasing, while compared with the domestic and foreign lakes, the concentration of PBDEs in the surface sediment was at a low level. ② The main source of PAHs, both in the surface water and surface sediment in Baiyangdian Lake, originated from fuel discharge and combustion sources. HCHs compose the main part of OCPs in both the surface water (93.76%) and surface sediment (63.10%). In the surface water body, HCHs mainly originated from the degradation of industrial HCHs; in some sites HCHs originated from atmospheric long-distance transmission and the usage of Lindane, while DDTs originated from historical residues. In surface sediment, HCHs mainly originated from the usage of new Lindane, with little industrial HCHs, and DDTs mainly originated from historical residues, while new DDTs may have been used in some sites. BDE-2 (65.80%) composed the main part of PBEDs in the surface water, and it mainly originated from atmospheric long-distance transmission and degradation of high brominated diphenyl ethers; BDE-209 (63.82%) constituted the main part of PBDEs in the surface sediment, and it mainly originated from the commercial Deca-BDEs.③ Ecological Risk Assessment show that there was no obvious ecological risks in Baiyangdian Lake, but in some sites POPs may cause ecological risks; these sites should be monitored more frequently.