Stiletto needle and needle-knife for influence of gravity index in treating knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To explore stiletto needle and needle-knife for influence of double sufficient weight in treating knee osteoarthritis patients.</p><p><b>METHODS</b>One hundred and thirteen early and medium term knee osteoarthritis patients were randomly divided into three groups, including stiletto needle group(38 cases), needle-knife group (38 cases) and voltaren group (37 cases). In stiletto needle group, there were 13 males and 25 females with an average of(55.87±7.72) years old, treated by stiletto needle once a week, and 2 weeks were a course; there were 11 males and 27 females in needle-knife group with an average of(57.11±7.07) years old, treated by acupotome once a week, and 2 weeks were a course; there were 12 males and 25 females in voltaren group with an average age of(57.62±8.08) years old, treated by votalin emulsion smearing 3 to 5 cm on painful area of knee joint, three times a day for 2 weeks; 36 patients in normal group, including 11 males and 25 females with a mean age of (55.28±7.55) years old, treated with nothing. Gravitational four lattice used to measure bipedal back and forth load before and after treatment in further observe weight-bearing situation among three groups, d value, which was the distance from center of gravity to original point, was measured as a obvervational index, JOA score was used to evaluate clinical effect.</p><p><b>RESULTS</b>Five patients were fall out, including 2 patients in stiletto needle group, 2 patients in needle-knife group and 1 patient in voltaren group. Other 108 patients were followed-up from 28 to 35 d with an average of 30 d, and without untoward effect. There was significant difference in d value between treatment group and control group at 1 month after treatment(<0.05); there was significant difference in d value among treatment group at 1 month after treatment(>0.05), and d value was decreased before treatment than that of after treatment. There was no significant difference in JOA score among treatment group after treatment at 1 month(<0.05); while had significant difference between groups(>0.05) after treatment at 1 month.</p><p><b>CONCLUSIONS</b>Stiletto needle, needle-knife and voltaren for the treatment of knee osteoarthritis at early and middle stage, center of gravity is closer to original point, and weight-bearing is improved. It is a easy method of four lattice to measure change of weight-bearing in KOA patients after treatment.</p>

Case-control study on the treatment of patients with scapular muscle fasciitis by Pizhen / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate and analyze the mechanism of Pizhen for the treatment of patients with scapular muscle fasciitis.</p><p><b>METHODS</b>One hundred and sixteen patients were divided into two groups according to random number table method, 58 cases in the treatment group and 58 cases in the control group. After treatment, 109 patients were followed up, and 7 patients lost follow-up (2 cases in the treatment group and 5 patients in the control group). In the treatment group, there were 15 males and 41 females, with a mean age of (28.02 +/- 4.85) years; the course of disease ranged from 0.25 to 3 years; and the patients were treated by Pizhen once a week,and 2 weeks were one treatment course. In the control group, there were 19 males and 34 females, with a mean age of (27.23 +/- 4.54) years old; the course of disease ranged from 0.25 to 1 year; and the patients were treated by acupuncture massage instrument, 20 minutes at a time,once a day for 2 weeks. Soft tissue displacement and banana area were tested by a soft tissue tension tester, pressure value was measured by pressure measuring instrument, and VAS was recorded by pain visual analog scale record.</p><p><b>RESULTS</b>There were significant differences in tissue displacement, banana area, pressure value and VAS between two groups before and after treatment. The tissue displacement and pressure value in the treatment group were higher than those in the control group,while banana area and VAS were lower than those in the control group. In the treatment group, 30 patients healed, 13 patients got marked improvement, 12 good and 1 poor;while 16 patients healed, 19 patients got marked improvement,11 good and 7 poor in the control group. The therapeutic effects in the treatment group was better than that in the control group.</p><p><b>CONCLUSION</b>Pizhen is an effective method to treat pain in patients with scapular muscle fasciitis by relaxing tendon of soft tissue around pain point of scapular and relaxing compress and stimulation of nerves.</p>

Clinical evaluation of stiletto needle for pain of knee osteoarthritis / 中国针灸

<p><b>OBJECTIVE</b>To objectively evaluate the clinical efficacy of stiletto needle for pain of knee osteoarthri tis (KOA), and analyze its function mechanism.</p><p><b>METHODS</b>Seventy-six cases of KOA (76 knees) were selected. Under the guide of Jingjin theory in TCM, stiletto needle was applied at pain point of Jingjin in extra-articular area to have a loose solution effect, 1 to 3 points were selected each time, 1 to 2 times of treatment were required. The results of tenderness measurement instrument was adopted as main evaluation index of joint pain, and all data of evaluation indices before and after the treatment were statistical analyzed.</p><p><b>RESULTS</b>There were significant differences in visual analogue scale (VAS) score, tenderness score, HSS function score and movement range of joint before and after the treatment (all P < 0.05). The effective rate of stiletto needle therapy was 89.5%. There was apparent regression trend between VAS score and tenderness score with Y (VAS) = 7.841-1.569 X (tenderness score) as its regressive equation.</p><p><b>CONCLUSION</b>The stiletto needle therapy is an effective method to relieve the pain of knee osteoarthritis, and its clinical efficacy evaluation could be more objective and digital with tenderness measurement instrument.</p>

Case-control study on stiletto needle and Dichofenac Diethylammon for the treatment of knee osteoarthritis pain / 中国骨伤

<p><b>OBJECTIVE</b>To investigate therapeutic effects of stiletto needle and Dichofenac Diethylammon in treating knee osteoarthritis pain at early and medium-term.</p><p><b>METHODS</b>Sixty-seven patients with early and medium-term knee osteoarthritis were randomly divided into two groups, 34 cases in stiletto needle group (treatment group) and 33 cases in Dichofenac Diethylammon (control group). Among them, 60 patients finished treatment and followed-up for 1 months (7 cases fall off totally, 4 cases in treatment group and 3 cases in control group). In treatment group, there were 5 males and 25 females with a mean age of (55.90 +/- 9.34) years (ranged, 40 to 68 years), the course of disease for 0.25 to 1 year, mean (0.87 +/- 0.34) years, treated by stiletto needle once a week, and 3 weeks were a course. In control group, there were 6 males and 24 females with a mean age of (58.67 +/- 7.39) years (ranged, 40 to 70 years), the course of disease for 0.25 to 2 years, mean (0.93 +/- 0.60) years, treated by Dichofenac Diethylammon, three times a day for 3 weeks. Soft tissue displacement and banana area were tested by soft tissue tension tester, pressure value were measured by pressure measuring instrument, VAS score were recorded by pain visual analog scale record, HSS scoring and effects were used to evaluated and statistical analyzed.</p><p><b>RESULTS</b>There were significant differences in tissue displacement, banana area, pressure value, VAS scoring and HSS scoring between two groups before and after treatment, and tissue displacement, pressure value, HSS scoring in treatment group were higher than control group, while banana area and VAS scoring were lower than control group. According to HSS scoring and VAS scoring, 3 cases were healed, 8 cases were markedly improved, 18 cases were effective and 1 case was effectiveless in treatment group;while 1 case was healed, 4 cases were markedly improved, 20 cases were effective and 5 cases were effectiveless in control group. There was no significant meaning in therapeutic effects.</p><p><b>CONCLUSION</b>Stiletto needle for knee osteoarthritis pain can effectively reduce high tension of local soft tissue ,alleviate symptom of pain, and improve knee function.</p>

Case-control study on the treatment of pain in patients with knee osteoarthritis by Pizhen / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate and analyze mechanism of Pizhen for the treatment of pain in patients with knee osteoarthritis.</p><p><b>METHODS</b>Eighty-five patients (85 knees) were divided into two groups according to random number table method. Among 35 patients in the experimental group, 6 patients were male and 29 patients were female, 1 patient lost follow-up, the average age was (56.65 +/- 4.89) years, and the patients were treated with Pizhen. Among 50 patients in the control group,there were 6 males and 44 females, the average age was (57.54 +/- 4.91) years, and the patients were treated with intra-articular injection with sodium hyaluronate. The VAS score and the data of algometer from the most obvious tenderness around the knee were used to evaluate the clinical effects.</p><p><b>RESULTS</b>There were significant differences of scores in the experimental group before and after treatment (P<0.01). There were significant differences of scores in the control group before and after treatment (P<0.01). After treatment, there were no statistical differences of VAS score and the data of algometer between experimental and control groups ( P>0.01). There was negative correlation between VAS score and the data of algometer.</p><p><b>CONCLUSION</b>The Pizhen is an effective method to treat pain in patients with knee osteoarthritis by relaxing tendon of soft tissue around pain point of knee joint, and relaxing compress and stimulation of nerves.</p>

Grading treatment of hip osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate therapeutic effects of intra-articular injection of sodium hyaluronate, arthroscopy and total hip replacement for the treatment of different severity hip osteoarthritis.</p><p><b>METHODS</b>Eighty-nine patients were treated with the three methods from June 2004 to August 2008. There were 33 males and 56 females, ranging in age from 30 to 72 years, averaged 51.8 years. The disease course ranged from 3 to 360 months, with a mean of 58.7 months. All the patients had hip pain and limited movement of hip joint. The patients were treated according to ISOA score and Kellgren-Lawrance (K-L) grades of hip osteoarthritis. The preoperative and postoperative Harris scores were compared.</p><p><b>RESULTS</b>After the operation, 83 patients were followed up, and the duration ranged from 3 to 58 months. The Harris scores results: the patients with slight hip osteoarthritis and K-L grade I got an averaged preoperative score of (70.50 +/- 4.62) and postoperative score of (91.75 +/- 4.01); the patients with slight hip osteoarthritis and K-L grade II got an averaged preoperative score of (70.15 +/- 3.79) and postoperative score of (82.18 +/- 3.92). The patients with moderate hip osteoarthritis and K-L grade III got an averaged preoperative score of (57.12 +/- 2.19) and postoperative score of (89.94 +/- 1.13) score. The patients with serious hip osteoarthritis and K-L grade IV got an averaged preoperative score of (48.63 +/- 2.21) and postoperative score of (90.76 +/- 1.14); the patients with very serious hip osteoarthritis and K-L grade IV got an averaged preoperative score of (42.67 +/- 3.17) and postoperative score of (91.97 +/- 2.24); the patients with extremely serious hip osteoarthritis and K-L grade IV got an averaged preoperative score of (36.46 +/- 2.96) and postoperative score of (82.69 +/- 1.19). There were significant differences in scores of all groups before and after treatment.</p><p><b>CONCLUSION</b>The hip osteoarthritis should be treated according to its serious degree such as slight, moderate and severe, as well as based on its X-ray classification, which is the best method to get satisfactory results.</p>

Study on midterm follow-up results of arthroscopic debridement for knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the effect of arthroscopic debridement for knee osteoarthritis.</p><p><b>METHODS</b>The medical records of 56 patients (56 knees) who underwent arthroscopic debridement procedures for knee osteoarthritis from 2000 to 2004 were reviewed. Among the patients, 15 patients were male and 41 patients were female,ranged in age from 39 to 76 years, with an average of (55.23 +/- 10.26) years. The duration of the disease ranged from 1 to 25 months, with an average of 5.75 months. The chief symptoms were pain, swelling and dysfunction of the knees. According to Kellgren-Lawrence classification grade, 17 patients were grade I ,39 patients were grade II. Lysholm score was used to evaluate the postoperative effects, and the statistics analysis was carried out with SPSS 13.0.</p><p><b>RESULTS</b>All the patients were followed up more than 5 years. Three patients underwent total knee replacement respectively at 5.5, 7.8 and 8.3 years after the arthroscopic debridement, the average Lysholm score of other 53 patients increased from (42.40 +/- 6.78) preoperatively to (75.53 +/- 8.23) postoperatively. There were significant difference between preoperative score and postoperative score (t = -22.62, P < 0.01).</p><p><b>CONCLUSION</b>The good midterm follow-up results of arthroscopic debridement for knee osteoarthritis are related to the appropriate indications selections, limited debridement, good patient education, systemic rehabilitation and chondroprotective agents.</p>

Alterations of DPC4/SMAD4/MADH4 gene detected in paraffin-embedded tissues of human pancreatic carcinomas / 中国医学科学院学报

<p><b>OBJECTIVE</b>To demonstrate the alterations of DPC4/SMAD4/MADH4 gene in paraffin-embedded tissues of pancreatic carcinomas.</p><p><b>METHODS</b>Forty-six cases of resected specimens containing carcinomatous tissue and normal pancreatic tissue were analysed for possible DPC4 gene mutations by polymerase chain reaction (PCR)and single-strand conformation polymorphism (SSCP). The DNA sequencing technique was applied to determine the patterns of gene mutation in the PCR-SSCP positive cases. Fifty-six cases of pancreatic carcinoma along with the specimens corresponding normal pancreatic tissues were studied by in situ hybridization (ISH) and immunohistochemistry (IHC) techniques for gene expression in mRNA and protein level.</p><p><b>RESULTS</b>The homozygous deletion rate of exon 1, 2, 3, 4, 8, 11 of DPC4 gene in pancreatic carcinoma was 28.26%, while the mutation rate of DPC4 gene was 21.74%. In these tumors, there were 3 cases of nonsense mutation, 5 cases of missense mutation, 1 case of deletion and missense mutation, 1 case of insertion mutation. Positive rates of SMAD4 in carcinomatous tissues detected by the ISH and IHC were 53.57% and 58.93% respectively, whereas they were 91.07% and 89.29% in the matched normal tissue respectively. There were significant difference between cancer and normal tissue (P < 0.05). Thrity-two cases were positive of DPC4/SMAD4 with all methods mentioned above, the coincident rate was 87.50% (28/32). The coincidence between gene detection and ISH of SMAD4 was 87.50%, and it was 96.88% between gene detection and IHC of SMAD4. Of all 56 cases, the coincidence of the positive rates of SMAD4 detected by ISH and IHC was 91.07%. No significant difference among the positive rates of DPC4/SMAD4 as detected by the three different techniques (P > 0.05).</p><p><b>CONCLUSIONS</b>The main mechanisms of inactivation of DPC4 gene in pancreatic carcinoma are homozygous deletion and mutation. The product of DPC4 expression is significantly decreased in cancer group compared with the normal tissues. As a tumor suppressor gene, DPC4 alteration is an important molecular event in pancreatic carcinoma, and probably plays a crucial role in cancer development and progression.</p>