Cell-type-specific optogenetic fMRI on basal forebrain reveals functional network basis of behavioral preference.

The basal forebrain (BF) is a complex structure that plays key roles in regulating various brain functions. However, it remains unclear how cholinergic and non-cholinergic BF neurons modulate large-scale functional networks and their relevance in intrinsic and extrinsic behaviors. With an optimized awake mouse optogenetic fMRI approach, we revealed that optogenetic stimulation of four BF neuron types evoked distinct cell-type-specific whole-brain BOLD activations, which could be attributed to BF-originated low-dimensional structural networks. Additionally, optogenetic activation of VGLUT2, ChAT, and PV neurons in the BF modulated the preference for locomotion, exploration, and grooming, respectively. Furthermore, we uncovered the functional network basis of the above BF-modulated behavioral preference through a decoding model linking the BF-modulated BOLD activation, low-dimensional structural networks, and behavioral preference. To summarize, we decoded the functional network basis of differential behavioral preferences with cell-type-specific optogenetic fMRI on the BF and provided an avenue for investigating mouse behaviors from a whole-brain view.

Comparison of Arthroscopic Single-row and Double-row Repair for Rotator Cuff Injuries With Different Tear Sizes: A Systematic Review and Meta-analysis.

Background: There is no clinical gold standard for the indications for single-row (SR) versus double-row (DR) repair according to small, large, or massive rotator cuff tear size. Purpose: To conduct a meta-analysis to compare the clinical outcomes and retear rates after arthroscopic SR and DR repair for rotator cuff injuries with different tear sizes. Study Design: Systematic review; Level of evidence, 3. Methods: On the basis of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria, the PubMed, Embase, Cochrane Library databases, Web of Science, China National Knowledge Infrastructure, and China BioMedical Literature database were searched for relevant studies published before November 1, 2021, using the following search terms: "Rotator Cuff Injuries," "Rotator Cuff Tears," "Arthroscopy," "Arthroscopic Surgery," "single-row," and "double-row"; a total of 489 articles were retrieved. Quality evaluation was conducted for all the studies that met the inclusion criteria. This study evaluated the Constant-Murley score, American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, and range of motion (ROM) as well as retear rate. A fixed-effects or random-effects model was adopted to calculate the results and assess risk. Results: A total of 10 clinical studies were included, with 404 cases of DR and 387 cases of SR. Regarding overall results, DR had better forward elevation ROM (mean difference [MD] = -4.03° [95% CI, -6.00° to -2.06°]; P < .0001; I 2 = 46%) and a lower retear rate (MD = 2.39 [95% CI, 1.40 to 4.08]; P = .001; I 2 = 0%) compared with SR repair. With regard to small tears (<3 cm), there was no noticeable difference on any of the 3 outcome scores between SR and DR. For large rotator cuff tears (≥3 cm), DR repair showed significantly better ASES scores (MD = -3.09 [95% CI, -6.19 to 0.02]; P = .05; I 2 = 73%) and UCLA scores (MD = -1.47 [95% CI, -2.21 to -0.72]; P = .0001; I 2 = 31%) compared with SR repair. Conclusion: Our meta-analysis revealed that DR had better UCLA scores, ASES scores, and ROM in forward elevation and lower retear rates. In rotator cuff tears <3 cm, there were no statistical differences in clinical outcome between SR and DR.

Instantaneous antidepressant effect of lateral habenula deep brain stimulation in rats studied with functional MRI.

The available treatments for depression have substantial limitations, including low response rates and substantial lag time before a response is achieved. We applied deep brain stimulation (DBS) to the lateral habenula (LHb) of two rat models of depression (Wistar Kyoto rats and lipopolysaccharide-treated rats) and observed an immediate (within seconds to minutes) alleviation of depressive-like symptoms with a high-response rate. Simultaneous functional MRI (fMRI) conducted on the same sets of depressive rats used in behavioral tests revealed DBS-induced activation of multiple regions in afferent and efferent circuitry of the LHb. The activation levels of brain regions connected to the medial LHb (M-LHb) were correlated with the extent of behavioral improvements. Rats with more medial stimulation sites in the LHb exhibited greater antidepressant effects than those with more lateral stimulation sites. These results indicated that the antidromic activation of the limbic system and orthodromic activation of the monoaminergic systems connected to the M-LHb played a critical role in the rapid antidepressant effects of LHb-DBS. This study indicates that M-LHb-DBS might act as a valuable, rapid-acting antidepressant therapeutic strategy for treatment-resistant depression and demonstrates the potential of using fMRI activation of specific brain regions as biomarkers to predict and evaluate antidepressant efficacy.

Sleep fMRI with simultaneous electrophysiology at 9.4 T in male mice.

Sleep is ubiquitous and essential, but its mechanisms remain unclear. Studies in animals and humans have provided insights of sleep at vastly different spatiotemporal scales. However, challenges remain to integrate local and global information of sleep. Therefore, we developed sleep fMRI based on simultaneous electrophysiology at 9.4 T in male mice. Optimized un-anesthetized mouse fMRI setup allowed manifestation of NREM and REM sleep, and a large sleep fMRI dataset was collected and openly accessible. State dependent global patterns were revealed, and state transitions were found to be global, asymmetrical and sequential, which can be predicted up to 17.8 s using LSTM models. Importantly, sleep fMRI with hippocampal recording revealed potentiated sharp-wave ripple triggered global patterns during NREM than awake state, potentially attributable to co-occurrence of spindle events. To conclude, we established mouse sleep fMRI with simultaneous electrophysiology, and demonstrated its capability by revealing global dynamics of state transitions and neural events.

Multimodal analysis demonstrating the shaping of functional gradients in the marmoset brain.

The discovery of functional gradients introduce a new perspective in understanding the cortical spectrum of intrinsic dynamics, as it captures major axes of functional connectivity in low-dimensional space. However, how functional gradients arise and dynamically vary remains poorly understood. In this study, we investigated the biological basis of functional gradients using awake resting-state fMRI, retrograde tracing and gene expression datasets in marmosets. We found functional gradients in marmosets showed a sensorimotor-to-visual principal gradient followed by a unimodal-to-multimodal gradient, resembling functional gradients in human children. Although strongly constrained by structural wirings, functional gradients were dynamically modulated by arousal levels. Utilizing a reduced model, we uncovered opposing effects on gradient dynamics by structural connectivity (inverted U-shape) and neuromodulatory input (U-shape) with arousal fluctuations, and dissected the contribution of individual neuromodulatory receptors. This study provides insights into biological basis of functional gradients by revealing the interaction between structural connectivity and ascending neuromodulatory system.

Aberrant brain functional and structural developments in MECP2 duplication rats.

Transgenic animal models with homologous etiology provide a promising way to pursue the neurobiological substrates of the behavioral deficits in autism spectrum disorder (ASD). Gain-of-function mutations of MECP2 cause MECP2 duplication syndrome, a severe neurological disorder with core symptoms of ASD. However, abnormal brain developments underlying the autistic-like behavioral deficits of MECP2 duplication syndrome are rarely investigated. To this end, a human MECP2 duplication (MECP2-DP) rat model was created by the bacterial artificial chromosome transgenic method. Functional and structural magnetic resonance imaging (MRI) with high-field were performed on 16 male MECP2-DP rats and 15 male wildtype rats at postnatal 28 days, 42 days, and 56 days old. Multimodal fusion analyses guided by locomotor-relevant metrics and social novelty time separately were applied to identify abnormal brain networks associated with diverse behavioral deficits induced by MECP2 duplication. Aberrant functional developments of a core network primarily composed of the dorsal medial prefrontal cortex (dmPFC) and retrosplenial cortex (RSP) were detected to associate with diverse behavioral phenotypes in MECP2-DP rats. Altered developments of gray matter volume were detected in the hippocampus and thalamus. We conclude that gain-of-function mutations of MECP2 induce aberrant functional activities in the default-mode-like network and aberrant volumetric changes in the brain, resulting in autistic-like behavioral deficits. Our results gain critical insights into the biomarker of MECP2 duplication syndrome and the neurobiological underpinnings of the behavioral deficits in ASD.

Cold-sensitive ventromedial hypothalamic neurons control homeostatic thermogenesis and social interaction-associated hyperthermia.

Homeostatic thermogenesis is an essential protective feature of endotherms. However, the specific neuronal types involved in cold-induced thermogenesis remain largely unknown. Using functional magnetic resonance imaging and in situ hybridization, we screened for cold-sensitive neurons and found preprodynorphin (PDYN)-expressing cells in the dorsal medial region of the ventromedial hypothalamus (dmVMH) to be a candidate. Subsequent in vivo calcium recording showed that cold temperature activates dmVMHPdyn neurons, whereas hot temperature suppresses them. In addition, optogenetic activation of dmVMHPdyn neurons increases the brown adipose tissue and core body temperature, heart rate, and blood pressure, whereas optogenetic inhibition shows opposite effects, supporting their role in homeostatic thermogenesis. Furthermore, we found that dmVMHPdyn neurons are linked to known thermoregulatory circuits. Importantly, dmVMHPdyn neurons also show activation during mouse social interaction, and optogenetic inhibition suppresses social interaction and associated hyperthermia. Together, our study describes dual functions of dmVMHPdyn neurons that allow coordinated regulation of body temperature and social behaviors.

Effect of pectoralis minor relaxation on the prognosis of rotator cuff injury under arthroscopy.

BACKGROUND: Rotator cuff injury is the main cause of shoulder joint pain. Rotator cuff tear is a serious stage of rotator cuff injury. The purpose of this study was to observe the effect of pectoralis minor relaxation on the prognosis of rotator cuff injury under arthroscopy. METHODS: The clinical data of patients with rotator cuff injury admitted to our department from March 2019 to August 2020 were retrospectively analyzed. These patients were divided into a conventional arthroscopy surgery group and a pectoralis minor relaxation group. The American Shoulder and Elbow Surgeons' Form (ASES) and University of California at Los Angeles Shoulder Scores (UCLASS) were used to assess shoulder joint function during the postoperative and follow-up periods, and the visual analogue scale (VAS) was used to assess shoulder joint pain. RESULTS: Shoulder joint function of the two groups of patients was significantly improved at 1 week postoperatively compared with that before surgery (P<0.05). The shoulder joint function of the pectoralis minor relaxation group was better than that of the conventional arthroscopy surgery group (P<0.05). Also, the shoulder joint function of patients in pectoralis minor relaxation group was better than that in conventional arthroscopy surgery group at 6 weeks, 12 weeks and 6 months after surgery (P<0.05). The UCLASS evaluation results were consistent with the ASES results. At 1 week after surgery, the pain of the two groups of patients was significantly less than before the operation, but the degree of pain relief was greater at 6 weeks postoperatively. Starting at 6 weeks after surgery, the shoulder joint pain of the pectoralis minor relaxation group was less than that of conventional arthroscopy surgery group (P<0.05). The healing of the incision was observed after the operation. No incision infection or exudation was found in the two groups of patients. CONCLUSIONS: The addition of pectoralis minor relaxation on the basis of conventional arthroscopic surgery is beneficial to the further recovery of shoulder joint function and pain reduction in patients with rotator cuff injury.

Constructing the hierarchy of predictive auditory sequences in the marmoset brain.

Our brains constantly generate predictions of sensory input that are compared with actual inputs, propagate the prediction-errors through a hierarchy of brain regions, and subsequently update the internal predictions of the world. However, the essential feature of predictive coding, the notion of hierarchical depth and its neural mechanisms, remains largely unexplored. Here, we investigated the hierarchical depth of predictive auditory processing by combining functional magnetic resonance imaging (fMRI) and high-density whole-brain electrocorticography (ECoG) in marmoset monkeys during an auditory local-global paradigm in which the temporal regularities of the stimuli were designed at two hierarchical levels. The prediction-errors and prediction updates were examined as neural responses to auditory mismatches and omissions. Using fMRI, we identified a hierarchical gradient along the auditory pathway: midbrain and sensory regions represented local, shorter-time-scale predictive processing followed by associative auditory regions, whereas anterior temporal and prefrontal areas represented global, longer-time-scale sequence processing. The complementary ECoG recordings confirmed the activations at cortical surface areas and further differentiated the signals of prediction-error and update, which were transmitted via putative bottom-up γ and top-down ß oscillations, respectively. Furthermore, omission responses caused by absence of input, reflecting solely the two levels of prediction signals that are unique to the hierarchical predictive coding framework, demonstrated the hierarchical top-down process of predictions in the auditory, temporal, and prefrontal areas. Thus, our findings support the hierarchical predictive coding framework, and outline how neural networks and spatiotemporal dynamics are used to represent and arrange a hierarchical structure of auditory sequences in the marmoset brain.

Traditional Chinese medicine classification of knee osteoarthritis with proteomics analysis.

BACKGROUND: Osteoarthritis (OA) is a heterogeneous disease caused by the pathology of the synovial joint. About 10-12% of adults have symptomatic OA. In this study, the proteomics method was used to find differentially expressed proteins and to explore the material basis of traditional Chinese medicine (TCM) classification in knee OA patients. METHODS: Fifteen patients of the treatment group with knee OA of three different classifications were divided into three groups according to the dialectical classification of TCM: kidney deficiency type (5 cases), Yang deficiency type (5 cases), blood stasis type (5 cases). Also, five patients with traumatic synovitis were enrolled as the control group. The joint fluids were drawn separately. The joint fluids before treatment were Aa, Ba, and Ca groups. After one week of medication, the three joint fluid types were drawn again, and they were Ab group, Bb, and Cb groups. Liquid from the control group was named group D. Quantitative analysis of protein expression was conducted to find out the differently expressed proteins. The treatment group was treated with prescriptions for syndromes according to the TCM classification. RESULTS: The proteomics analysis identified 251 differentially expressed protein groups, and the number of groups with quantitative information for all seven channels was 246. The three treatment groups and the control group had 32 differential proteins (P<0.01), of which nine might be differential proteins between OA and traumatic synovitis. Histone H4, histone H2A, S100 calbindin A8, fibrinogen γ, fiber protein α, cDNA (FLJ92148), C4b binding protein, and partial transketolase variants were down-regulation, and basement membrane glycan was up-regulation in the treatment group compared with the control group (P<0.01). HIST1H2BC and myeloperoxidase levels in the Aa group were less than those in the D and Ab groups. The serum amyloid P and apolipoprotein CI variants in the Ba group were less than those in the D and Bb groups. Histone H2A and C-reactive protein, Fibrinogen α levels in the Ca group were less than those in the D and Cb groups. CONCLUSIONS: Nine proteins are closely related to OA of different TCM classification.

An orbitron-like 3D DNA clip-based nanomachine and its application for sensitive fluorescent bioassay of MicroRNA.

Herein, an orbitron-like three-dimensional (3D) DNA clip-based nanomachine was proposed for ultrasensitive fluorescent bioassay of microRNA, which was constructed by mechanically interlocking double-DNA-ring with two single-stranded DNAs, performing an orbitron-like 3D structure with double freely rotated DNA rings as the open state. In the presence of target microRNA, the proposed orbitron-like 3D DNA clip can alter its structure from open to closed state in identification of the target microRNA, generating the closure between the previously modified fluorescent dyes and the quenchers to perform a "signal off" fluorescent signal correlated with the concentration of target microRNA. Compared with the normal DNA nanomachines, such as DNA tweezers constructed by self-assembly of three single-stranded DNAs which regulated the open and closed states on the basis of linear conformational changes, the proposed 3D DNA clip-based nanomachine with high mechanical rigidity realized the conformational changes in 3D space with the assistance of target microRNA, which could effectively increase the adjustable distance range and reduce the background signal. Furthermore, the 3D DNA clip-based nanomachine was applied in the fluorescent detection of microRNA-21 with favorable performances for the sensitive detection of microRNA in cells, providing a new avenue for early clinical diagnoses of disease.

Isolation of hierarchical cellulose building blocks from natural flax fibers as a separation membrane barrier.

Cellulose nanofibrils (CNF) is a natural nanomaterial composed of biomacromolecules that can be extracted from plants and has great potential applications in many fields due to its excellent regenerative, sustainable, and biodegradable properties. In this work, the flax CNF with hierarchical scales was obtained by using the flax fibers (FF) treated with different concentrations of alkaline solution, followed by the TEMPO-mediated ternary oxidation and mechanical treatment. Subsequently, the resultant CNF was implanted on the commercial filter paper as a surface barrier for oil/water preparation. The changes of cellulose crystal form and crystallinity caused by alkali treatment on FF were studied by Fourier transform infrared spectroscopy and X-ray diffraction. Morphological changes of FF before and after alkali treatment were observed. The morphology of obtained CNF was examined. Moreover, the transmittance of the prepared CNF suspension and films was also investigated by a UV spectroscopy. The prepared modified filter paper can effectively separate the oil/water mixture, which gives themselves promise as candidates in practical applications of oil/water separation.

Sensory evoked fMRI paradigms in awake mice.

Mouse fMRI has become increasingly popular in the small animal imaging field. However, compared to the more commonly used rat fMRI, it is challenging for mouse fMRI to obtain robust and specific functional imaging results. In the meantime, in other neuroscience modalities such as optical imaging, functional recording in the awake mice is common and becoming standard. Therefore, in the current study we developed comprehensive setups and analysis pipeline for multi-sensory fMRI paradigms in the awake mice. Customized setups of somatosensory (whisker), auditory and olfactory stimulation were developed for use in the cryogenic coil in the awake mouse fMRI setting. After carefully evaluating head motion and motion artefacts, the nuisance regression approach was optimized for reducing the confounding effect of motion. The high temporal resolution data (TR = 0.35 s) revealed fast temporal dynamics (time-to-peak ~2 s) of evoked BOLD responses in most brain regions. Using the derived awake mouse specific hemodynamic response functions, high spatial resolution data revealed robust, specific and consistent cortical and subcortical activations in response to somatosensory, auditory and olfactory stimulations, respectively. Overall, we present comprehensive methods for acquiring and analyzing sensory evoked awake mouse fMRI data. The establishment of multi-sensory paradigms in awake mouse fMRI provides valuable tools for examining spatiotemporal characteristics and neural mechanisms of BOLD signals in the future.

Shixiang Plaster, a Traditional Chinese Medicine, Promotes Healing in a Rat Model of Diabetic Ulcer Through the receptor for Advanced Glycation End Products (RAGE)/Nuclear Factor kappa B (NF-κB) and Vascular Endothelial Growth Factor (VEGF)/Vascular Cell Adhesion Molecule-1 (VCAM-1)/Endothelial Nitric Oxide Synthase (eNOS) Signaling Pathways.

BACKGROUND Shixiang plaster is a traditional Chinese medicine has been used to treat chronic ulcers, including diabetic ulcers. Aminoguanidine is a hydrazine derivative that inhibits the formation of advanced glycosylation end products (AGEs). This study aimed to investigate the effects of shixiang plaster and aminoguanidine on wound healing in the streptozotocin-induced rat model of diabetes and the molecular mechanisms involved. MATERIAL AND METHODS Sprague-Dawley rats treated with intraperitoneal streptozotocin and given surgical wounds were divided into the untreated chronic ulcer group (n=10), the aminoguanidine group (n=10), the shixiang plaster group (n=10), and the control group with sham surgery (n=10). Granulation tissue samples underwent light microscopy to evaluate angiogenesis and immunohistochemistry to identify AGE, vascular endothelial growth factor (VEGF), and CD34 expression. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot measured mRNA and protein expression of receptor for advanced glycation end products (RAGE), vascular cell adhesion molecule-1 (VCAM-1), nuclear factor kappa B (NF-kappaB) and endothelial nitric oxide synthase (eNOS). RESULTS The shixiang plaster group showed a significant increase in angiogenesis in ulcer granulation tissue, significantly reduced expression of AGEs and increased expression of VEGF and CD34 expression in granulation tissue compared with the untreated chronic ulcer group (p<0.05). The shixiang plaster group showed significantly down-regulated expression of RAGE and VCAM-1 compared with the untreated chronic ulcer group (p<0.05). Shixiang plaster promoted angiogenesis by activating the NF-kappaB p65 associated pathway and eNOS activation. CONCLUSIONS Shixiang plaster promoted healing in a rat model of diabetic ulcer through the RAGE/NF-kappaB and VEGF/VCAM-1/eNOS signaling pathways.

Differential coupling between subcortical calcium and BOLD signals during evoked and resting state through simultaneous calcium fiber photometry and fMRI.

Task based and resting state fMRI has been widely utilized to study brain functions. As the foundation of fMRI, the underlying neural basis of the BOLD signal has been extensively studied, but the detailed mechanism remains elusive, particularly during the resting state. To examine the neurovascular coupling, it is important to simultaneously record neural and vascular signals. Here we developed a novel setup of camera based, scalable simultaneous calcium fiber photometry and fMRI in rats. Using this setup, we recorded calcium signals of superior colliculus (SC) and lateral geniculate nucleus (LGN) and fMRI simultaneously during visual stimulation and the resting state. Our results revealed robust, region-specific coupling between calcium and BOLD signals in the task state and weaker, whole brain correlation in the resting state. Interestingly, the spatial specificity of such correlation in the resting state was improved upon regression of white matter, ventricle signals and global signals in fMRI data. Overall, our results suggest differential coupling of calcium and BOLD signals for subcortical regions between evoked and resting states, and the coupling relationship in the resting state was related with resting state BOLD preprocessing strategies.

Awake and behaving mouse fMRI during Go/No-Go task.

Functional magnetic imaging (fMRI) has been widely used to examine the functional neural networks in both the evoked and resting states. However, most fMRI studies in rodents are performed under anesthesia, which greatly limits the scope of their application, and behavioral relevance. Efforts have been made to image rodents in the awake condition, either in the resting state or in response to sensory or optogenetic stimulation. However, fMRI in awake behaving rodents has not yet been achieved. In the current study, a novel fMRI paradigm for awake and behaving mice was developed, allowing functional imaging of the mouse brain in an olfaction-based go/no-go task. High resolution functional imaging with limited motion and image distortion were achieved at 9.4T with a cryogenic coil in awake and behaving mice. Distributed whole-brain spatiotemporal patterns were revealed, with drastically different activity profiles for go versus no-go trials. Therefore, we have demonstrated the feasibility of functional imaging of an olfactory behavior in awake mice. This fMRI paradigm in awake behaving mice could lead to novel insights into neural mechanisms underlying behaviors at a whole-brain level.

Treatment of compartment syndrome of the thigh associated with acute renal failure after the Wenchuan earthquake.

Compartment syndrome of the thigh is a rare emergency often treated operatively. The purpose of this study was to evaluate the effects of nonoperative treatment for compartment syndrome of the thigh associated with acute renal failure after the 2008 Wenchuan earthquake. Nonoperative treatment, which primarily involves continuous renal replacement therapy, was performed in 6 patients (3 men and 3 women) who presented with compartment syndrome of the thigh associated with acute renal failure. The mean mangled extremity severity score (MESS) and laboratory data regarding renal function were analyzed before and after treatment, and the clinical outcome was evaluated at 17-month follow-up. Laboratory data regarding renal function showed improvements. All 6 patients survived with the affected lower limbs intact after nonoperative treatment. Follow-up revealed active knee range of motion and increased muscle strength, as well as a recovery of sensation. A positive linear correlation was found between MESS and the time required to achieve a reduction in swelling, as well as the time required for the recovery of sensation and knee range of motion (r>0.8; P<.05). Satisfactory clinical outcomes were obtained in patients with compartment syndrome of the thigh associated with acute renal failure.Urine alkalization, electrolyte and water balance, and continuous renal replacement therapy have played an important role in saving lives and extremities. Nonoperative treatment should be considered in the treatment of compartment syndrome of the thigh associated with acute renal failure.

Surgical technique and clinical results for scapular allograft reconstruction following resection of scapular tumors.

BACKGROUND: Progress in developing effective surgical techniques, such as scapular allograft reconstruction, enhance shoulder stability and extremity function, in patients following scapular tumor resection. METHODS: Case details from seven patients who underwent scapular allograft reconstruction following scapular tumor resection were reviewed. A wide marginal resection (partial scapulectomy) was performed in all patients and all affected soft tissues were resected to achieve a clean surgical margin. The glenoid-resected and glenoid-saved reconstructions were performed in three and four patients, respectively. The residual host scapula were fixed to the size-matched scapular allografts with plates and screws. The rotator cuff was affected frequently and was mostly resected. The deltoid and articular capsule were infrequently involved, but reconstructed preferentially. The remaining muscles were reattached to the allografts. RESULTS: The median follow-up was 26 months (range, 14-50 months). The average function scores were 24 points (80%) according to the International Society of Limb Salvage criteria. The range of active shoulder abduction and forward flexion motion were 40 degrees -110 degrees and 30 degrees -90 degrees, respectively. There was no difference between the glenoid-saved and glenoid-resected reconstructions in the total scores (mean, 24.5 points/81% versus 24 points/79%), but the glenoid-saved procedure was superior to the later in terms of abduction/flexion motion (mean, 72 degrees /61 degrees versus 55 degrees /43 degrees). During the study follow-up period, one patient died following a relapse, one patient lived despite of local recurrence, and five patients survived with no evidence of recurrence of the original cancer. Post-surgical complications such as shoulder dislocations, non-unions, and articular degeneration were not noted during this study period. CONCLUSION: Scapular allograft reconstruction had a satisfactory functional, cosmetic, and oncological outcome in this case series. Preservation and reconstruction of the articular capsule and deltoid are proposed to be a prerequisite for using scapular allografts and rotator cuff reconstruction is recommended, although technically challenging to perform.