The rotator cuff is prone to tear under degenerative changes or mechanical injury, leading to excessive inflammation, extracellular matrix degradation, and unsatisfactory prognosis. Interleukin-4 (IL-4) was used to induce macrophages polarization toward M2 phenotype. By mapping IL 4-activated pathways and applying peptidome profiling, macrophage-derived peptide 1 (MDP1) was identified and shown to promote the phosphorylation of STAT3 and STAT6, thereby inducing the polarization of M0 macrophages toward the anti-inflammatory M2 phenotype. A functionally graded scaffold woven from electrospun nanofiber yarns was developed, with MDP1 and hydroxyapatite (HA) loaded onto its corresponding interfaces. During rotator cuff repair process, the scaffold functioned as an augmentation patch, with mechanical properties (Young's modulus, ca. 280 MPa) comparable to native tendons, prevented rotator cuff re-tearing in an early stage. MDP1 was incorporated into scaffolds to modulate an excessive inflammatory response, while HA was used to enhance bio-mineralization for enhanced osteointegration. Through a multidimensional collaborative repair strategy, this functionally graded scaffold not only mimicked the tendon–bone interface, but also significantly suppressed local inflammation at the interface, as evidenced by a 60.6 % and 66.5 % reduction in IL-6–positive areas at 2 and 4 months, respectively, compared with the control group. Furthermore, it promoted tissue regeneration in the damaged region, resulting in a 32.6 % increase in Young's modulus, thereby ultimately enhancing rotator cuff performance. The multifunctionally graded scaffold may offer an invaluable solution to promote rotator cuff tear healing and potentially other related disciplines.

Objective: The study explored the knowledge, attitude, and practice (KAP) toward severe craniocerebral trauma perioperative management among anesthetists in China. Methods: This cross-sectional study recruited anesthetists from 15 provinces in China between October 17, 2022, and November 09, 2022. Pearson’s correlation was used to assess the relationships between KAP dimension scores, and multivariable linear regression was performed to identify factors associated with higher KAP scores. Results: The study included 200 anesthetists (122 females). The mean knowledge, attitude, and practice scores were 50.41± 7.36 (possible range, 0– 84), 20.23± 2.72 (possible range, 0– 24), and 11.85± 4.54 (possible range, 2– 28), respectively. The knowledge scores were positively correlated with the attitude scores (r=0.522, P< 0.001), but the practice scores were not significantly correlated with the knowledge or attitude scores. Anesthetists with experience in 100– 300 craniocerebral trauma surgeries (B = 3.728, 95% confidence interval [CI]: 0.271– 7.186, P = 0.035) or more than 300 surgeries (B = 7.680, 95% CI: 2.684– 12.675, P = 0.003) were significantly more likely to achieve higher overall KAP scores compared to those with experience in fewer than 100 surgeries. Conclusion: Anesthetists in China exhibit moderate knowledge, a positive attitude, and inadequate practice regarding perioperative management of severe craniocerebral trauma. Greater clinical experience in managing craniocerebral trauma perioperatively is associated with higher KAP scores. The results highlight the need for targeted training and experience-based education to improve perioperative outcomes, which could translate into better clinical outcomes for the patients. Policymakers should be aware of those gaps and include additional training as necessary.

Objectives This cross-sectional study aimed to explore the knowledge, attitude and practice (KAP) of patients with rotator cuff tears towards arthroscopic shoulder surgery (ASS), based on the hypothesis that the knowledge of the procedure among patients would be sufficient, which in turn might influence their practice and attitude. Design Cross-sectional study. Setting Patients were recruited from Tong Ren Hospital between September and October 2022. Participants A total of 588 patients were included in the study. Interventions No interventions were administered. Primary and secondary outcome measures Knowledge, attitude and practice scores were measured using a self-administered questionnaire. Results Out of 588 patients included, 50.51% had undergone ASS. Lower education level and monthly income, shorter weekly exercise time and shorter disease duration were identified as independent risk factors for the KAP total score. Structural equation modelling revealed a direct positive effect of knowledge on attitude, but neither knowledge nor attitude influenced practice scores. Conclusions Patients with rotator cuff tears demonstrated relatively poor knowledge, a neutral attitude and moderate practice towards ASS, highlighting the need for patient education and counselling to enhance understanding and decision-making regarding ASS.