Electrosurgery enquipments include high-frequency electric knife, argon plasma coagulation, and bipolar vessel-sealing devices. This article introduced the principles and advances of electrosurgery equipments for better understanding and proper use.

Rotator cuff tear is a common shoulder disease, especially among athletes and middle-aged and elderly individuals. With the accelerating trend of aging population, the number of patients with rotator cuff tears is increasing. For massive rotator cuff tears, there is a high risk of re-tear after surgery and poor prognosis, which poses a significant clinical challenge. In recent years, surgical techniques for massive rotator cuff tears have continued to innovate, including superior capsule reconstruction, subacromial balloon spacer implantation, tendon transfer, and reverse shoulder arthroplasty. This article summarized the biomechanical effects of massive rotator cuff tears on the shoulder joint and focused on the latest treatment advancements, aiming to provide new reference for clinical treatment.

Triangular fibrocartilage complex (TFCC) is located on the ulnar side of wrist,and is composed of triangular fibrocartilage and its surrounding ligaments.It is an important structure to stabilize distal radioulnar joint.Traumatic or degenerative injury of TFCC is one important cause of wrist pain.In the treatment of clinical wrist joint injury and pain,the factors of TFCC lesions are easily neglected by clinicians,and there are no systematic and standard diagnosis and treatment,which may have adverse effects on the treatment of wrist joint injury and pain.Researches on the diagnosis and treatment of TFCC injury in recent years in this paper were reviewed.

Objective To select an appropriate surgical procedure according to the different classification of concealed penis.Methods 122 patients with concealed penis underwent surgical treatment in our hospital from Mar.1998 to Jun.2012 were reviewed and analyzed.According to different pathological change of concealed penis,122 patients were classified into four types,phimosis type,fascia bands type,micropenile skin sleeve type and obesity type.Different surgical methods were reviewed respectively for their different classification.The phimosis type patients were mainly treated by relaxing the narrow prepuce ring,and penile dorsal Y-V plasty for inadequate penile skin.The fascia bands type patients by removing the dysgenic dartos fascia bands,the micropenile skin sleeve type patients by penile dorsal and ventral Y-V plasty and the serious obesity type patients by fixing the penile skin onto the lateral Buck’s fascia at the base of the penis.Results All patients with concealed penis were improved in appearance and accessibility after corresponding surgery.Conclusion The classification of the concealed penis patients is helpful to clinical diagnosis and surgical treatment selection.

Renal cell carcinoma is a common type of urinary cancer with insidious onset and rapid progression. Advanced renal cell carcinoma has poor prognosis and primarily depends on systemic therapy which mainly composed of targeted therapy and immunotherapy. Recently, new targeted drugs, immuno-targeted combination therapy, HIF-2α inhibitors, and probiotic combination therapy provide more possible options for the treatment. In this review, we gave an overview of the advances in systemic therapy of advanced renal cell carcinoma, aiming to help make clinical decisions.

Objective To assess the efficacy of aescuven forte in combination with hemorrhoids lotion on patients with edema and pain after mixed hemorrhoids surgery.Methods A total of 120 cases after mixed hemorrhoid surgery were randomly divided into treatment group,who received oral aescuven forte and hemorrhoids lotion,and control group,who received hemorrhoids lotion only.Curative effects were compared between the two groups.Results The treatment group showed a higher cure rate of edema and greater changes in edema and pain scores than the control group (P<0.05).Conclusion Aescuven forte in combination with hemorrhoids lotion is effective for the treatment of edema and pain after mixed hemorrhoid surgery and has no adverse effects; therefore,it is worth to clinical application.

Peroneal tendons dislocation refers to slip the external ankle peroneal tendons in the rear of the fibula groove,inducing a series of symptoms such as instability and pain in the external ankle.There are variously different surgical methods of treating the dislocation of peroneal tendons,each with distinct characteristics.Operation styles mostly consist of soft tissue repair,fibular groove deepening,fibular osteotomy,tissue graft,peroneal tendons rerouting and using of endoscopy in treatment of dislocation.The method of treating peroneal tendons dislocation depend on injury mechanism and patients individual condition for achieving high healing rate,less complications and rapid recovery.

Anterior cruciate ligament （ACL） is one of the most vulnerable structures during sports and an essential anterior stabilizing structure in the knee joint. ACL injury can impair a patient’s ability to move, and if not properly treated in time, it often results in serious adverse complications like meniscal and articular cartilage damage, and even traumatic osteoarthritis. Currently, ACL reconstruction is the standard treatment for ACL injury, and the choice of grafts has a significant impact on patients’ postoperative functional recovery and surgical success. Autografts are the most commonly used grafts and have the most stable efficacy, but they have drawbacks like limited sources and donor-site morbidity. Although having greater adaptability, allografts carry a risk of immune rejection and the spread of diseases. Artificial ligaments are appropriate for those who must quickly resume their athletic activities, but they are technically challenging and have not been shown to be long-term effective. Due to the numerous issues with traditional grafts, recent rapid advancements in tissue engineering techniques are generating novel ideas for ACL reconstruction. In order to aid in the treatment of ACL injury, this article discussed the benefits, drawbacks, and clinical effectiveness of different grafts used in ACL reconstruction.

Objective To explore the diagnostic significance of ratio of free prostate specific antigen to total prostate (fPSA/tPSA), prostate specific antigen density (PSAD), and prostate specific antigen transition zone density (PSATZ) in serum prostate specific antigen (PSA) gray area for prostate cancer (PCa).Methods A total of 173 cases with PCa and benign prostatic hyperplasia (BPH) whose tPSA levels were 4-10 ng/mL were selected in the study. Serum fPSA and tPSA were detected, and fPSA/tPSA ratio was calculated. Prostate volume was determined by transtectal ultrasound. PSAD and PSATZ were calculated.The diagnostic significance of fPSA/tPSA, PSAD, and PSATZ in PSA gray area for PCa were analyzed using Python 3.5 software.Results The PCa patients’ and the BPH patients’ fPSA/tPSA ratios were 0.17±0.072 and 0.2±0.085 respectively.Their PSADs were (0.25±0.11) μg/L and (0.14±0.054) μg/L respectively. Their PSADTZs were (0.53±0.31) μg/L and (0.25±0.14) μg/L respectively. The two groups showed significant differences in the above three indicators (P<0.05). The sensitivity of fPSA/tPSA and PSAD for PCa reached 79%.Conclusion Both PSAD and PSATZ in PSA gray area can increase sensitivity in the diagnosis of PCa. Moreover, fPSA/tPSA, PSAD, and PSADTZ are of great value for the diagnosis of PCa.

Objective To evaluate the efficacy and safety of FOLFOX regimen and XELOX regimen in the treatment of advanced colon cancer.Methods The following five databases were searched: VIP Database, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and PubMed.The quality assessment and meta analysis of the clinical studies meeting the inclusion criteria were performed using RevMan 5.3 software.Results A total of 12 articles were included in the study, with 1 614 colon cancer patients, 801 to the FOLFOX group and 813 to the XELOX group.There was no significant difference in overall response, complete response, partial response, overall survival, and progression-free survival between the two regimens.The incidence rate of grade Ⅲ/Ⅳ hand-foot syndrome caused by XELOX regimen (RR=0.2, 95% CI 0.08-0.51, P<0.001) was higher than that by FOLFOX regimen, while the grade Ⅲ/Ⅳ neutropenia caused by FOLFOX regimen (RR=5.47, 95%CI 3.42-8.76, P<0.001) was higher than that by XELOX regimen.Conclusion The efficacy of FOLFOX regimen on advanced colon cancer is similar to that of XELOX regimen, but it is worth noting that the risk of grade Ⅲ/Ⅳ hand-foot syndrome caused by XELOX regimen is higher, while the risk of grade Ⅲ/Ⅳ neutropenia caused by FOLFOX regimen is higher.

Fractures of lunate bone are rare injuries of the wrist that are usually resulted from high-energy trauma and are typically accompanied by other carpal injuries, such as scaphoid bone, capitate bone, radial styloid, and distal radius fracture. Misdiagnosis,missed diagnosis or inappropriate treatment in clinical practice lead to a high nonunion rate of lunate fractures, which often affects the movement of the wrist and even leads to complications such as osteonecrosis or loss of wrist function. The potential pathogenesis, therapeutic method,and prognosis of lunate fractures are still controversial. This article reviewed domestic and foreign literature on the classification, imaging characteristics and treatment methods from the perspectives of anatomical characteristics and injury mechanism of the lunate, so as to provide guidance for improving the prognosis of lunate fractures.

Laparoscopic pancreaticoduodenectomy （LPD） is one of the most complex and risky operations in pancreatic surgery. LPD was once neglected due to high morbidity and mortality, but with the advancement of laparoscopic instruments and the improvement of surgical protocols, LPD has returned to the favor of surgeons. This paper focused on the history and development of LPD.

Objective To discuss diagnostic difference of pancreatic lesion by using CT scan and CT enhancement.Methods A toal of 63 patients from Shuyang Hospital Affiliated to Nanjing University of Traditional Chinese Medicine (Shuyang Hospital of Traditional Chinese Medicine) underwent CT scan and CT enhancement of abdomen.The images of blood supply, density, boundary, invasion of surrounding blood vessels, vascular cancer embolus, and surrounding lymph nodes as well as the detection rate of pancreatic lesion were analyzed.Results Among the 63 cases, there were 43 cases of pancreatic cancer, 10 cases of pancreatic cyst, 5 cases of pancreatic endocrine tumor, and 5 cases of serous cystadenoma.The detection rate of pancreatic lesion by CT scan(85.71% [30/35]) was significantly lower than that by CT enhancement(100% [28/28]).In addition, CT enhancement provided images of blood supply, invasion of surrounding blood vessels, vascular cancer embolus, and images and intensity surrounding lymph nodes.Conclusion CT enhancement can provide more diagnostic information for operation than CT scan.

Objective To analyze the incidence and risk factors of pulmonary infection after traumatic brain injury (TBI) surgery, in order to identify the risk factors and high-risk population of pulmonary infection after TBI surgery, and to provide more basis and support for the development of prevention and treatment plans of pulmonary infection after TBI surgery. Methods A total of 200 TBI patients who underwent surgical treatment from June 2019 to June 2022 were selected as study subjects, and their clinical data were retrospectively analyzed. Results The incidence of pulmonary infection after TBI was 30.00% (60/200). Univariate results showed that age, surgical risk, preoperative GCS score, surgical times, surgical duration, endotracheal intubation or incision, mechanical ventilation time, use of immunosuppressive agents, aspiration, drainage tube, ICU stay time, and postoperative hypoproteinemia were significantly different between the pulmonary infection group and the non-pulmonary infection group (P<0.05). Multivariate results showed that advanced age, ≥2 operations, long operation duration, endotracheal intubation or incision, long mechanical ventilation time, aspiration, indwelling drainage tube, long ICU stay time, and postoperative hypoproteinemia were all risk factors for pulmonary infection after TBI (P<0.05). Conclusion The occurrence of pulmonary infection after TBI is affected by many factors. Therefore, comprehensive evaluation and analysis should be carried out after admission, and measures should be taken as early as possible for high-risk groups to reduce the incidence of pulmonary infection after TBI and improve the prognosis of patients.

Objective：To study the influence and mechanism of bufalin on apoptosis and calcium metabolism in human colorectal cancer cell HCT 8. Methods：We used the method of CCK-8 to detect the proliferation of HCT 8 treated with bufalin of different concentrations at 24 hours or the same one at different time. And then , the apoptosis of the cell with different concentrations was detected by Annexin V / PI double staining apoptosis kit. Finally, we investigated the effect of different concentrations of bufalin on intracellular Ca2 + by using Ca2+ fluorescence probe Fluo-3 AM to mark its intracellular Ca2+. Results：The inhibition of human colorectal cancer cell HCT 8 with bufalin showed dose and time dependent manner obviously by the method of CCK-8. The result of apoptosis with flow cytometry illustrated that bufalin can induce apoptosis in the cell HCT 8, and represented a dose-dependent manner. According to the results of the intracellular Ca2+ labeled by calcium fluorescent probe calcium, there was a higher concentration of intracellular calcium when the cell treated at a higher concentration of bufalin. Conclusion：Bufalin can induce apoptosis in the cell of HCT 8, and it may be related to the metabolism of intracellular Ca2+.

High-frequency electric knife is one of the most widely used clinical medical equipments.Based on technical development,various types of high-frequency electric knives and their specific characteristics were analyzed.The article offered suggestions on choosing different high-frequency electric knives and accessories.

[Abstract] Objective To evaluate the clinical effect between primary radical operation and incision and drainage of the treatment on crissum abscess．Methods 84 cases of crissum abscess were randomly divided into treatment group (n=44) and control group (n=40). Patients in treatment group were received primary radical operation, patients in control group were only treated by incision and drainage. Results Compared with the control group, treatment group patients postoperative abscess recurrence rate forming the incidence of anal fistula, wound healing time significantly lower than the control group obviously(p<0.001)．Two groups were anal incontinence, anal stenosis and postoperative anal malformation, etc., were followed up for 1 year, anus function are normal．Conclusions It is suggested that primary radical operation can be primarily performed，lower the abscess recurrence and anal fistula incidence，which not only shorten treatment course，but also reduce pain of patients．Primary radical operation is a good method of crissum abscess therapy．

Breast cancer has become the most common women malignant tumor in the world. Nowadays, the diagnosis and treatment of breast cancer has gradually changed from traditional treatment methods to individualized and precise treatment methods. Interferon-stimulated gene 15 （ISG15） is related to the occurrence and development of many malignant tumors, and participates in tumor-related immune responses and the resistance of many chemotherapeutics. ISG15 can promote breast cancer cell movement, and participate in breast cancer-related tumor immunotherapy and various signaling pathways. These research findings provide new insights for breast cancer treatment. In this paper, the structure and function of ISG15, and its correlation with tumors, especially with breast cancer, were reviewed.

Objective To explore the application of Mulligan mobilisations with movement plus muscle energy techniques to cervical spondylotic radiculopathy (CSR). Methods A total of 86 CSR patients treated from February 2017 to February 2020 in our hospital were randomly assigned to two groups, with 43 cases in each group. The conventional group took conventional rehabilitation; the combined group took Mulligan mobilisations with movement and muscle energy techniques. Clinical assessment scale for cervical spondylosis (CASCS) scores, neck disability index (NDI) scores, active range of motion (AROM), Short-form 36 Health Survey Questionnaire (SF-36) scores, Visual Analogue Scale (VAS) scores, and muscle pressure pain threshold were compared before and after the treatment. Results The CASCS score, AROM, and SF-36 score were significantly higher and the NDI score and VAS score were significantly lower in the combined group than those in the conventional group (P<0.05). The pressure pain thresholds of trapezius, levator scapulae, and suboital muscles in the combined group were significantly lower than those in the conventional group (P<0.05). Conclusion Mulligan mobilisations with movement plus muscle energy techniques can relieve the clinical symptoms of cervical spondylosis, such as reducing neck disability, increasing the active range of motion, and reducing pain, and thereby improve the quality of life of patients.

Juxtapapillary duodenal diverticulum (JPDD) refers to the bursiform apophysis formed from the outward expansion of the part of intestinal wall caused by the defect of mucosal or submucosal muscular layer at in the paries medialis of the descendant duodenum juxtapapillary about 2~3 cm.With the endoscopic techniques especially endoscopic retrograde cholangiopancreatography (ERCP) launched extensively in recent years,JPDD cases increased gradually.JPDD such as its epidemiology,pathogenesis,clinical classification,relationship of biliary-pancreatic diseases,diagnosis and treatment are reviewed in this paper.