Clinical anatomical study on the treatment of carpal tunnel syndrome with classic Acupotomy / 中国骨伤

OBJECTIVE@#To explore the safety of classic Acupotomy in the treatment of carpal tunnel syndrome.@*METHODS@#Twenty six adult specimens (15 males and 11 females), aged 60 to 95(82.54±6.94) years old, were selected from 10% formalin antiseptic fixation. There were 52 sides(two of them could not be tested). The study period was from November 2017 to May 2018. The specimens were collected from the body donation center of the school of basic medicine, Peking University. The operation of releasing the transverse carpal ligament on the human body specimen was simulated by the classic acupotomy, and the distance from the four points to the surrounding anatomical structure was measured to calculate the direct injury rate to the nerve and blood vessels, and the shortest distance between the acupotomy and the nerve and blood vessels was defined as ≥2 mm as safety.@*RESULTS@#In the experimental operation, the direct injury rate of nerve and blood vessel was 14% and 12% respectively. There was significant difference in the rate of direct nerve injury between the four injection points (0.05). Among the four points, there was a statistically significant difference in the safety of nerves(<0.05), and the safety of point 1 and point 3 of radial injection was higher than that of point 2 and point 4 of ulnar injection(<0.05). There was significant difference in the safety of blood vessels between the four points(<0.05), and the safety of radial point 1 was higher than that of ulnar point 2 and point 4 (<0.05).@*CONCLUSION@#The safety of the classic Acupotomy for carpal tunnel syndrome is related to the location of the needle entry point, and the safety of theradial proximal end of the needle is the highest.

Clinical manifestations and imaging analysis of cervicogenic headache / 中国骨伤

OBJECTIVE@#To investigate the clinical characteristics and mechanism of cervicogenic headache.@*METHODS@#Fifty-seven patients with cervicogenic headache who were treated from May 2013 to December 2017 and had complete imaging data were selected, including 18 males and 39 females with an average age of(43.26±10.39) years old ranging from 20 to 63 years old. The duration of the disease was 4 months to 35 years with a mean of (11.74±9.47) years. The pain situation, iconography and Tinel sign were analyzed.@*RESULTS@#The patients with cervicogenic headache often had bilateral pain. The regions mainly concentrated in the temporal region, with occipital, head or orbit pains. The VAS scores decreased with the duration of the disease. There were many cases of disc herniation(91.30%), vertebral instability(73.91%), atlantoaxial displacement(56.52%), curvature change of cervicogenic vertebra(54.35%). The number of positive Tinel sign points was between 3 and 24 (13.58±5.8) per patient. The number and extent of Tinel sign were significantly different between the affected side and healthy side(<0.05). C₂,₃ facet joints(92.98%), post mastoid(89.47%), occipital concavity(89.47%), C₃,₄ facet joints(84.21%), third occipital nerve(80.70%) were the positive Tinel sign points in patients with cervicogenic headache.@*CONCLUSIONS@#The iconography changes of cervicogenic headache and Tinel sign may contribute to the clinical diagnosis and mechanism of the disease.

Research progress of stenosing tenosynovitis of radial styloid process based on anatomical structure / 中国骨伤

Stenosing tenosynovitis of styloid process of radius(de Quervain's disease) which abductor pollicis longus and extensor pollicis brevis in the first extensor chamber are affected by resistance when sliding, the incidence is affected by anatomical variations. Symptoms, signs and auxiliary examinations can diagnose the disease. Slight dQS can be improved by rest, brace, restriction activities, and oral medications. Chinese medicine and physiotherapy also reduce the disease. Needle knife therapy is a Traditional Chinese medicine minimally invasive surgery, which is also a step-by-step treatment between conservative treatment and open surgery to loosening the compression of the first extensor chamber. Steroid injection is a more common treatment in this disease, and its efficacy is related to the accuracy of the injection and is affected by the severity of the patient's anatomical variation. Identifying the spacing within the first extensor chamber under ultrasound can help patients better choose conservative or surgical treatment. Surgical treatment can more completely change the condition of dQD from anatomical structure, and clinical should pay attention to the choice of surgical procedure to improve the efficacy and reduce the occurrence of surgical complications. This article discusses the pathogenesis, diagnosis and treatment of the disease from the perspective of anatomical structure. It mainly analyzes the therapeutic targets and the clinical application, which aims to provide reference for the diagnosis and treatment of de Quervain disease.

Structure-activity relationship analysis of novel farnesyl transferase inhibitors / 药学学报

Farnesyltransferase (FTase) was selected as a target for virtual screening of inhibitors using the Glide v4.0 program in the Schrödinger software package. We discovered 13 novel structures as farnesyltransferase inhibitors (FTIs) with moderate potency. By analyzing the binding modes of representative compounds 8 (IC50 = 2.29 μmol·L-1) and 18 (IC50 = 0.41 μmol·L-1) with farnesyltransferase, it was found that compounds 8 and 18 didn't coordinate with Zn2+, indicating that the coordination between FTIs with Zn2+ is not essential for the bioactivity of the inhibitors. The structure-activity relationship was summarized by analyzing the predicted binding modes of representative compounds. It was found that the scaffolds of the discovered FTIs had room for structural optimization, which lay foundation for obtaining highly active and selective FTIs.

Study of protein interaction based on the triplets combination pairs of the residue groups / 药学学报

The protein-protein interactions play an important role in life science. At present, many methods are developed with preferences of the amino acid residues, which do not offer the relative spatial information for the residue groups. However, the spatial information for the residue groups is important in the design of the protein-protein interactions. We proposed a new model, which is named ‘tri-prism’ model, by deep mining the existing protein-protein interaction patterns and refining the preference and the relative spatial information for the combination pairs of the residue groups. The model not only provided the preferences, but also offered the relative spatial information for the triplets combination pairs of the residue groups. The model was able to analyze the triplets combination pairs of the residue groups based on the preference factor, amino acid composition, and protein secondary structure. The model was applied to the interface of the PD-1/PD-L2 protein. According to the diversity characters of the composition and the spatial information between the combination pairs of the residue groups at the interface of the PD-1/PD-L2 protein and the predicted ones, we put forward the suggestions for the mutations of the residues, which offered a new view in the study of protein-protein interactions.

Clinical study on acupotomy of occipitalia on the treatment of cervicogenic headache / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effects of acupotomy on cervicogenic headache and explore the function of cutaneous nerve entrapment in the mechanism of cervicogenic headache.</p><p><b>METHODS</b>From October 2008 to June 2009, 82 patients with cervicogenic headache were treated with acupotomy. There were 23 males and 59 females, ranging in age from 17 to 73 years (averaged 41.57 years). The course of disease ranged from 0.5 to 50 years,with an average of 10.4 years. The location of treatment was occipitalia, both of left and right side: altogether were 8 points, including tenderness point of postmastoid; the mid-point between mastoid and C2 spinous process; the internal 1/3 attachment between occipital protuberance and mastoid process; the posterior midline of C2 spinous process open to 1.5-2 cm. The chief complaint of all patients was headache. PPI assessment rating was observed.</p><p><b>RESULTS</b>The total effective rate at 1 month after treatment was 81.70% (67/82). Recurrence of headache within 3 months after treatment was obvious. However, 17.07% (14/82) patients did not reoccur at 6 months after treatment.</p><p><b>CONCLUSION</b>17.07% patients with cervicogenic headache recovered by acupotomy, so it shows cutaneous nerve entrapment plays an important role in the mechanism of cervicogenic headache. For the patients whose headache recurred at 3 months after treatment, increasing the treatment time and therapeutic range is suggested.</p>

Effects of acupotomy lysis on local soft tissue tension in patients with the third lumbar vertebrae transverse process syndrome / 中国针灸

<p><b>OBJECTIVE</b>To explore the mechanism of acupotomy lysis in treatment of the third lumbar vertebrae transverse process syndrome.</p><p><b>METHODS</b>One hundred and eighty patients were randomly assigned into an acupotomy group and an electroacupuncture (EA) group, 90 cases in each group. The acupotomy group was treated with acupotomy on the tip of the 3rd lumbar vertebrae transverse process (tender point) combination with massage manipulation of hyperflexion and hyperextension on the waist, once a week for 3 weeks. The EA group was treated with EA at bilateral Shenshu (BL 23), Yaoyangguan (GV 3), Ashi point (local tender point) and ipsilateral Weizhong (BL 40), 3 times a week for 3 weeks. The 500 g pressure displacement and the energy absorption ratio were measured by JZL-II soft tissue tension meter and the clinical effect was evaluated by JOA low back pain scale before treatment, after treatment and 6 months after treatment.</p><p><b>RESULTS</b>After treatment and at follow-up visit, the 500 g pressure displacement in the acupotomy group increased significantly (both P < 0.01), but it was decreased significantly in the EA group (P < 0.05, P < 0.01). The energy absorption ratio in the acupotomy group after treatment and at follow-up visit increased significantly (both P < 0.01), and in the EA group, there was no significant difference after treatment as compared with that before treatment (P > 0.05), but it was increased significantly at follow-up visit (P < 0.01). The total therapeutic level distribution in the acupotomy group was better than that in the EA group after treatment and 6 months after treatment (P < 0.05, P < 0.01).</p><p><b>CONCLUSION</b>Acupotomy therapy can significantly increase the 500 g pressure displacement and the energy absorption ratio of the local soft tissue around the third lumbar vertebrae transverse process, decrease the local soft tissue tension so as to alleviate pain. The clinical effect of the acupotomy is superior to that of electroacupuncture.</p>

T cell receptor constant alpha chain gene +1592C/T polymorphism may not be associated with IgA nephropathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the relationship between T cell receptor constant alpha chain (TCRCα) gene +1592C/T polymorphism and IgA nephropathy.</p><p><b>METHODS</b>TCRCα +1592C/T genotypes were identified by PCR-RFLP and direct sequencing in 244 Chinese Han patients with IgA nephropathy, who were classified according to their genotype into CC (188 cases), CT (54 cases) and TT (2 cases) groups. The clinical and pathological data of the patients were analyzed in relation to the TCRCα +1592C/T genotypes.</p><p><b>RESULTS</b>No significant differences in the clinical and biochemical indices were found in these patients with different TCRCα gene +1592C/T genotypes. TCRCα +1592C/T polymorphism was not found to contribute to severity or manifestations of renal pathology.</p><p><b>CONCLUSIONS</b>TCRCα+1592C/T polymorphism may not be associated with the susceptibility to IgA nephropathy in the Chinese Han population.</p>

Study on diagnostic criteria of cervicogenic headache: a report of retrospective analysis on 330 cases / 中国骨伤

<p><b>OBJECTIVE</b>To improve the diagnostic criteria of cervicogenic headache by summary the clinical features of cervicogenic headache in patients.</p><p><b>METHODS</b>Among 448 patients with the chief complaint of headache for the first visit from October 2008 to June 2009, 399 cases meet the diagnostic criteria, 330 cases were diagnosed as cervicogenic headache. There were 97 males and 233 females, ranging in age from 14 to 76 years, with an average of 46.1 years. The duration of the disease ranged from 0.33 to 50 years, with an average of 13.4 years. The gender, age, occupation, headache characteristics of the patients were recorded, and the tenderness point position and the range of diffuse pain were summarized for analysis.</p><p><b>RESULTS</b>There were 89.1% headache patients were cervicogenic headache, the male to female ratio was 1:2.4, 78.8% (260 cases) patients aged 21 to 60 years old, especially those 41 to 50 years old was the majority. There were 97.3% (321 cases) patients with paroxysmal headache, and only 2.7% (9 cases) patients had persistent headache. Majority patients had swelling pain (181 cases, accounting for 54.8%) or pulsatile pain (135 cases, accounting for 40.9%). Above two types pain may coexist, and other types were few. The position of headache concentrated at occiput, corona capitis and tempus, and could spread to the forehead, fossa orbitalis, or eye (about 1/3 patiens), very few spread to the ears, nasal wing or bridge of the nose, etc. There were 76.4% (252 cases) patients with full or bilateral headache, and only 12.1% (40 cases) with unilateral headache. Almost all the patients had symptoms of occipital nerve entrapment, among which about 73.3% (242 cases) patients had greater and lesser occipital large involved. There were 82.7% (273 cases) patients showing radiating pain by pressing the special point of occiput.</p><p><b>CONCLUSION</b>(1) Cervicogenic headache patients accounted for a higher proportion; (2) The existing diagnostic criteria is not perfect, and need to be improved; (3) Radiating pain occurred when pressing the specific location is an important diagnosis criteria.</p>

Preliminary evaluation of acupuncture and continuous multi-point pulse stimulation for treatment of subjective tinnitus / 中国针灸

<p><b>OBJECTIVE</b>To put forward a method for assessing therapeutic effect on tinnitus and to observe the therapeutic effects of acupuncture and continuous multi-point pulse stimulation on subjective tinnitus.</p><p><b>METHODS</b>Continuous multi-point pulse stimulation was given at Ermen (TE 21)/ Tinggong (SI 19)/ Tinghui (GB 2), Yifeng (TE 17), Shenting (GV 24), Baihui (GV 20), Cong'er No 1-3, etc., once every other day, thrice each week. The therapeutic effects were evaluated with a selfstipulated "tinnitus questionaire".</p><p><b>RESULTS</b>Of the 98 cases, 11 cases were cured, 36 cases were markedly effective, 28 cases were effective and 23 cases were ineffective with a cured rate of 11.2% and a total effective rate of 76.5%.</p><p><b>CONCLUSION</b>Combined acupuncture and continuous multi-point pulse stimulation has a better therapeutic effect on subjective tinnitus.</p>

Randomized controlled trials of acupuncture at Tiaokou (ST 38) for treatment of periarthritis of shoulder / 中国针灸

<p><b>OBJECTIVE</b>To study the basic therapeutic function of Tiaokou (ST 38).</p><p><b>METHODS</b>According to clinically multi-central randomized controlled and single-blind test principle, 257 cases of periarthritis of shoulder were divided into two groups, a test group (n = 124) treated with oral anti-inflammatory analgesic medicine combined with acupuncture at Tiaokou (ST 38), and a control group (n = 133) treated with oral anti-inflammatory analgesic medicine. Their therapeutic effects were compared.</p><p><b>RESULTS</b>The total effective rate for stopping pain was 96.0% in the test group and 91.7% in the control group with a very significant difference between the two groups (P< 0.01). And the total effective rate for improvement of shoulder activity was 86.3% in the test group and 59.4% in the control group with a very significant difference between the two groups (P<0.01).</p><p><b>CONCLUSION</b>Oral anti-inflammatory analgesic medicine combined with acupuncture has obvious therapeutic effect on periarthritis of shoulder, which is better than that of simple oral anti-inflammatory analgesic medicine.</p>

Effects of acupuncture and continuous multiple points pulse stimulation on linguistic frequency hearing loss in the patient of sensorineural hearing loss / 中国针灸

<p><b>OBJECTIVE</b>To explore effective therapeutic methods for sensorineural hearing loss (SNHL).</p><p><b>METHODS</b>Thirty-four cases of mild and moderate SNHL who were definitely diagnosed with pure tone test and by otologists, including 24 cases of insufficiency of the liver and kidney, 10 cases of excess of liver-fire. They were treated with acupuncture at main points, Ermen (TE 21) or Tinggong (SI 19) or Tinghui (GB 2), and Yifeng (TE 17), Shenting (GV 24), Baihui (GB 20), Houding (GV19), Touwei (ST 9), Conger 1-3, Congnao 1-2; and adjuvant acupoints: Huangshu (KI 16), Qihai (CV 6), Guanyuan (CV 4), Taixi (KI 3) were added for insufficiency of the liver and kidney; Zhongwan (CV 12), Tianshu (ST 25), Yanglingquan (GB 34) and Taichong (LR 3) were added for excess of liver-fire. Sequential multipoint pulse stimulation was adopted, twice each week, for 20 consecutive weeks (40 sessions) and then pure tone test was carried out repeatedly.</p><p><b>RESULTS</b>Of 34 cases (58 affected ears), 13 cases were cured and 21 improved, and the various linguistic frequency hearing threshold pure hearing values before and after treatment increased significantly (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture and continuous multipoint pulse stimulation has definite therapeutic effect on linguistic frequency hearing loss in the patient of SNHL.</p>