Comparison of Muscle Energy Technique, Myofascial Release, and Combined Techniques for Glenohumeral Internal-Rotation Deficit. An Interventional Study / Comparación de Técnica de Energía Muscular, Liberación Miofascial y Técnicas Combinadas para el Déficit de Rotación Interna Glenohumeral. Un Estudio Intervencionista

SUMMARY: This study aimed to determine the benefits of a combined technique of muscle energy with and myofascial release more effective than using each in isolation in glenohumeral internal rotator deficits. An interventional study was designed for this study. Thirty-eight patients were diagnosed with painful shoulder syndrome. Patients were randomly allocated into 4 groups where Group A was treated with combined muscle energy and myofascial release; Group B with muscle energy technique; Group C with myofascial release and Group D used as control. The evaluation of the passive joint range of the glenohumeral internal rotation and sociodemographic data for each of the groups were measured, before and after interventions. Despite the use of myofascial release and muscle energy techniques being significantly beneficial in their respective groups, when both were combined; it outcomes were highly successful. A combination therapy treatment applied with the Muscle Energy and Myofascial Release Techniques in patients with painful shoulder syndrome will be more effective in increasing the range of motion of the glenohumeral internal rotation joint than any of the techniques applied individually.

Este estudio tuvo como objetivo determinar los beneficios de una técnica combinada de energía muscular con liberación miofascial más efectiva que usar cada una de manera aislada en los déficits de los músculos rotadores internos glenohumerales. Para este estudio se diseñó un protocolo de intervención. En 38 pacientes se diagnosticó síndrome de hombro doloroso. Los pacientes fueron asignados aleatoriamente a 4 grupos; el grupo A fue tratado con energía muscular combinada y liberación miofascial; Grupo B con técnica de energía muscular; Grupo C con liberación miofascial y Grupo D utilizado como control. Se midió la evaluación del rango articular pasivo de la rotación interna de la articulación glenohumeral y datos sociodemográficos de cada uno de los grupos, antes y después de las intervenciones. A pesar de que el uso de técnicas de liberación miofascial y energía muscular resultó significativamente beneficioso en sus respectivos grupos, cuando ambas se combinaron; Sus resultados fueron muy exitosos. Un tratamiento de terapia combinada aplicado con las Técnicas de Energía Muscular y Liberación Miofascial en pacientes con síndrome de hombro doloroso será más efectivo para aumentar el rango de movimiento de la articulación de rotación interna glenohumeral que cualquiera de las técnicas aplicadas individualmente.

Stress Field of the Meniscus under Different Knee Brace Conditions in Jumping Motion:A Numerical Study / 医用生物力学

Objective The biomechanical model for the musculoskeletal system of a human knee joint was established using a numerical simulation method.The kinematic and dynamic information captured during jumping motion simulated by the human dynamic model was used as driven data of the knee biomechanical model,followed by further analysis of the stress field distribution characteristics of the meniscus under different thermal-force coupling knee brace conditions.Methods Based on computed tomography and magnetic resonance imaging of the subject,a realistic human knee model,including bone,articular cartilage,meniscus,ligaments and peripheral soft tissues of the knee joint,was constructed.Furthermore,two gaits,namely taking-off and landing-on,of jumping motion with an increased risk of meniscus injuries were selected according to mechanical features in full-cycle jumping motion.Subsequently,the stress field characteristics of the knee meniscus under four different thermal-force coupling knee braces were analyzed,the changes of the peak stress of the meniscus and its stress concentration area were discussed,and the protective efficacy and mechanical basis of meniscal injuries and wearing knee braces were explored.Results The anterior part of the medial knee meniscus was a vulnerable area under concentrated stress.Under the knee brace thermal-force coupling condition,the stress concentration area of the medial meniscus was transferred from its narrow and weak anterior part to its wide and thick middle part,and the peak stress was also significantly reduced.The peak stress on the medial meniscus and that on the lateral meniscus were similar,indicating that the two parts of the meniscus bore the external load evenly,and the meniscus stress concentration area decreased.Conclusions Thermal-force coupling knee braces have good protective effects against knee meniscus injury.The numerical simulation provides theoretical support and technical guidance for the design of multifunctional thermal knee braces.

Relationship between serum miR-505,miR-15 and endoscopic activity of ulcerative colitis / 中国内镜杂志

Objective To investigate the relationship between serum miR-505,miR-15 and endoscopic activity of ulcerative colitis(UC).Methods 98 patients with UC from May 2020 to May 2022 were selected as the observation group,and 80 patients with irritable bowel syndrome(IBS)were selected as the control group during the same period.The modified Mayo score was used to evaluate the endoscopic activity in patients with UC,and the relationship among the changes of serum miR-505 and miR-15 levels and the endoscopic activity in patients with UC was analyzed.Results The level of serum miR-505 in observation group was lower than that in control group,while the level of miR-15 in observation group was higher than that in control group(P<0.05).The level of serum miR-505 in patients with active UC was lower than that in patients with the healing stage,while the level of serum miR-15 in patients with active UC was higher than that in patients with healing stage(P<0.05).The serum miR-505 level of E3 type was lower than that of E2 type and E1 type,and the serum miR-15 level of E3 type was higher than that of E2 type and E1 type(P<0.05).The Mayo score of type E3 was higher than that of type E2 and E1(P<0.05).Pearson correlation analysis showed that serum miR-505 was negatively correlated with Mayo score(r =-0.51,P<0.05),while serum miR-15 was positively correlated with Mayo score(r = 0.54,P<0.05).Receiver operator characteristic curve(ROC curve)results showed that the cut-off value of miR-505 was 0.93,and the area under the curve(AUC)for evaluating the endoscopic activity of patients with UC was 0.67(95%CI:0.659～0.785),and the sensitivity and specificity were 73.24%and 68.55%,respectively.The cut-off value of miR-15 was 0.85,and the AUC for evaluating the endoscopic activity of patients with UC was 0.69(95%CI:0.672～0.814),and the sensitivity and specificity were 76.38%and 69.72%,respectively.The AUC for the joint evaluation of UC by both was 0.82(95%CI:0.809～0.912),and the sensitivity and specificity were 84.56%and 68.49%,respectively.Conclusion Serum miR-505 levels decrease and serum miR-15 levels increase in UC patients than IBS,and the level is closely related to patients'pathological conditions and endoscopic activity.Combined detection of serum miR-505 and miR-15 has a good value in evaluating endoscopic activity in UC patients.

Effects of glenosphere offsets on impingement-free range of motion in reverse total shoulder arthroplasty: a standardized computer simulation study / 中华创伤骨科杂志

Objective:To compare the effects of glenosphere offset positions on the impingement-free range of motion (ROM) in reverse total shoulder arthroplasty (RTSA).Methods:Shoulder joint models were reconstructed using shoulder CT scans of 6 patients with primary osteoarthritis. RTSA was performed virtually according to standard surgical procedures, and shoulder movements were simulated. Reverse shoulder models were constructed with 2 lateral offsets (0 and 4 mm) and 6 positional offsets (center, inferior, posterior, anterior, anterior-inferior, and posterior-inferior). The impingement-free ROM and impingement sites for abduction-adduction, flexion-extension, total rotation (sum of internal and external rotation), and total ROM (sum of ROM in all movement modes) were evaluated.Results:All the 12 combinations of different glenosphere offsets achieved 50% of the original shoulder ROM in all movements. In the abduction-adduction motion with 0 and 4 mm lateral offsets, the anterior-inferior offset provided the largest ROM (94.4°±8.7° and 105.3°±6.9°, respectively), but there was no significant difference between the positions ( P>0.05). In the flexion-extension motion with 0 and 4 mm lateral offsets, the posterior-inferior offset showed the largest ROM (194.1°±6.9° and 196.9°±9.7°, respectively), but there was no significant difference between the positions ( P>0.05). In the total rotation motion with 0 and 4 mm lateral offsets, the anterior-inferior offset had the largest ROM (141.5°±5.9° and 160.6°±8.5°, respectively), showing significant advantages over the center, anterior, and posterior offsets ( P<0.05), but insignificant advantages over the inferior and posterior-inferior offsets ( P>0.05). In total ROM, the anterior-inferior offset provided the largest ROM. When the lateral offset was 0 mm, the anterior-inferior offset provided a ROM of 421.8°±16.4°, showing significant advantages over the center and posterior offsets ( P<0.05). Compared with the lateral glenosphere offset of 0 mm, the lateral glenosphere offset of 4 mm significantly improved total shoulder ROM (122.8°±10.6° versus 145.8°±4.8°) and total ROM (390.9°±11.6° versus 428.4°±19.8°) ( P<0.05). Conclusions:The anterior-inferior, inferior, and posterior-inferior glenosphere offsets can improve ROM in all movement patterns. The position and lateral offset of the glenosphere significantly affect the total rotation and total ROM of the shoulder joint. Specifically, the anterior-inferior and inferior offsets show significant advantages over the center position in total rotation and total ROM of the shoulder joint.

Research advances on the applications of functional magnetic resonance imaging for evaluating kidney transplant function / 中华器官移植杂志

After kidney transplantation , timely detection of changes in transplanted kidney function may guide clinical managements and prevent or delay irreversible damage to transplanted kidney. Functional magnetic resonance imaging (fMRI) of transplanted kidney is a promising non-invasive technique of acquiring microstructural and microfunctional profiles of transplanted kidney. In recent years, various diffusion imaging modalities, arterial spin labeling (ASL) and blood oxygen level dependent-magnetic resonance imaging (BOLD-MRI) have gradually been applied for transplant kidneys. Transplant kidney function may be evaluated non-invasively from such microscopic perspectives as water molecule diffusion, blood flow perfusion and blood oxygen level. This review focused upon evaluating the renal function and identifying the causes of the renal function decline of transplanted kidney through various fMRI techniques and provide new rationales for clinical diagnosis.

Clinical observation of knee-balancing Tuina manipulation for pes anserina bursitis / 针灸推拿医学（英文版）

Objective:To observe the clinical efficacy and safety of knee-balancing Tuina(Chinese therapeutic massage)manipulation for pes anserina bursitis(PAB). Methods:A total of 64 patients with PAB were enrolled and divided into a Tuina group and a medication group by the random number table method,with 32 cases in each group.The medication group was given votalin for external use,and the Tuina group was given knee-balancing Tuina manipulation based on treatment according to structure differentiation.Both groups were treated for 7 consecutive days.The visual analog scale(VAS)score,Lyshlom score,knee joint range of motion(ROM),and total effective rate were compared between the two groups.Adverse reactions were observed in both groups. Results:During the treatment,there was 1 dropout case in the medication group.The total effective rate was 93.8%in the Tuina group and 83.9%in the medication group.The difference between the two groups was statistically significant(P<0.05).After treatment,the VAS score in both groups decreased significantly(P<0.05),and the Lyshlom score and knee joint ROM increased significantly(P<0.05).The differences in the VAS score,Lyshlom score,and knee joint ROM between the two groups were all statistically significant(P<0.05). Conclusion:The knee-balancing Tuina manipulation based on treatment according to structure differentiation can effectively relieve pain and improve knee function in PAB,and its efficacy is superior to that of external use of votalin.

Survey on joint range of motion and muscle atrophy in Kashin-Beck disease patients in Shaanxi Province / 西安交通大学学报(医学版)

【Objective】 To describe the distribution characteristics of knee and ankle joint range of motion and muscle atrophy related indexes in patients with Kashin-Beck disease (KBD) in Shaanxi Province so as to explore the correlation of knee and ankle joint range of motion (ROM) with muscle atrophy indexes and provide reference for clinical characteristics analysis of KBD patients. 【Methods】 To investigate the registered KBD patients from KBD areas in Shaanxi Province, we measured the general demographic data of the patients were collected and the ROM of the knee joint (flexion and extension), the ankle joint (dorsiflexion and plantar flexion), and the muscle atrophy related indexes such as the upper arm circumference, thigh circumference, calf circumference and grip strength. According to the population characteristics, i.e., gender, age, body mass index (BMI) and KBD grade, the median and quartile of joint ROM and muscle atrophy of KBD patients were reported, and then the differences in each index among different groups were analyzed. Partial correlation analysis was used to explore the correlation between indicators after controlling for variables such as gender, age and BMI. 【Results】 A total of 480 patients with KBD were investigated in this study, who consisted of 249 (51.9%) males and 231 (48.1%) females, with an average age of (63.10±7.32) years and an average BMI of (23.49±8.90) kg/m2. The knee flexion ROM, knee extension ROM, ankle dorsiflexion ROM and ankle plantar flexion ROM were [105.0 (95.0, 120.0)] °, [0.0 (-15.0, 0.0)] °, [5.0 (0.0, 15.0)] ° and [20.0 (15.0, 30.0)] °, respectively, in KBD patients in Shaanxi Province. The left thigh circumference, right thigh circumference, left calf circumference, right calf circumference, and upper arm circumference were [43.0 (40.0, 47.0)] cm, [43.0 (39.0, 47.0)] cm, [29.0 (27.0, 32.0)] cm, [29.5 (27.0, 32.0)] cm, [27.0 (25.0, 30.0)] cm, respectively. The left hand grip strength and right hand grip strength were [13.4 (9.5, 18.4)] kg and [13.9 (9.8, 18.2)] kg, respectively. With the increase of age, the extension range of the left and right knee joints of KBD patients showed a decreasing trend (H=31.499, 31.847; all P<0.001). The range of motion of bilateral knee flexion was higher in the normal BMI group than in the overweight or obese group, with statistically significant differences (H=7.753, 12.333; P=0.021, 0.002). The knee flexion, thigh circumference, and calf circumference of the left and right sides showed a decreasing trend under different KBD grades (H=14.345, 17.256, 8.000, 8.462, 8.558, 9.633; all P<0.05). Correlation analysis showed that knee flexion ROM was positively correlated with thigh circumference, calf circumference, and grip strength in patients with KBD (all P<0.05). There was a positive correlation between knee extension ROM and thigh circumference in patients with KBD (P<0.01). 【Conclusion】 The impaired joint ROM and muscle atrophy are serious in KBD patients in Shaanxi Province, and there is a correlation between joint motion and muscle atrophy.

Application effect of multimodal exercise on enteral nutrition during radiotherapy in patients with esophageal cancer complicating diabetes / 重庆医学

Objective To explore the effect of multimodal exercise combined with enteral nutrition dur-ing radiotherapy in the patients with esophageal cancer complicating diabetes.Methods A total of 52 patients with esophageal cancer complicating diabetes in Zhejiang Provincial Tumor Hospital from January to Decem-ber 2021 were selected as the study subjects and divided into the control group(n=27)and intervention group(n=25)by using the random number table method.The control group implemented the routine exercise scheme,while the intervention group was given the multimodal exercise intervention on the basis of routine exercise.The blood glucose metabolism indicators,related biochemical indicators during radiotherapy and the incidence rate of adverse events during exercise were compared between the two groups.Results The levels of fasting blood glucose,random blood glucose and blood glucose before sleep in the intervention group during radiotherapy were(7.79±1.61)mmol/L,(9.47±1.77)mmol/L and(9.97±3.02)mmol/L,which were lower than(11.84±3.47)mmol/L,(14.18±5.42)mmol/L and(14.62±3.83)mmol/L in the control group with statistically significant differences(P<0.05).During the radiotherapy period,the levels of albumin,total protein and prealbumin in the intervention group were(37.96±2.13)g/L,(68.13±5.02)g/L and(232.89±41.11)g/L,which were lower than(36.05±2.89)g/L,(64.96±5.95)g/L and(207.76±47.59)g/L in the control group with statistically significant differences(P<0.05).The incidence rates of adverse e-vents such as falls,hypoglycemia and accidental extubation during multimodal exercise in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The multimodal exercise could significantly improve the nutritional status during radiotherapy in the patients with esophageal cancer complicating diabetes,stabilize the blood glucose level of the patients,and has good feasibility and safety.

The application of IVIM-DWI in evaluating the efficacy and prognosis of TACE using different embolization materials for hepatocellular carcinoma / 介入放射学杂志

Objective To discuss the clinical application of intravoxel incoherent motion-diffusion weighted imaging(IVIM-DWI)in evaluating the efficacy and prognosis of transcatheter arterial chemoembolization(TACE)using different embolization materials for the treatment of hepatocellular carcinoma(HCC).Methods The clinical data of a total of 84 patients with inoperable HCC,who received TACE treatment at the Second Affiliated Hospital of Shandong First Medical University of China and the First Affiliated Hospital of Xinjiang Medical University of China between June 30,2019 and December 30,2022,were collected.According to the patient's condition,different embolization materials were used during TACE.IVIM-DWI check-up was performed before treatment as well as at one,6,12 months after treatment.Based on the fixed b-value set by IVIM-DWI sequence,the ADC value of the order index model for different embolization materials and the pure diffusion coefficient of double exponential model(D value),the pseudo-diffusion coefficient(D*value)and perfusion fraction(f value)were analyzed.According to modified Response Evaluation Criteria in Solid Tumors(mRECIST)and the embolization material used,the patients were divided into the stable group and progression group,and the changes in the ADC value,D value,D*value and f value were compared between the two groups.Multivariate Cox regression analysis was used to analyze the four clinical parameters(including age,Child-Pugh grade,AFP level and tumor size)and the eight functional quantitative indexes(including preoperative and postoperative ADC value,D value,D* value and f value)so as to determine the IVIM parameters with prognostic predictive value.Receiver operating characteristic(ROC)was adopted to analyze the diagnostic value and cut-off value of IVIM parameters with predictive value.Results After treatment,the ADC value of drug-loaded microspheres group(n=36)was significantly higher than that of iodized oil group(n=27),the D*value of drug-loaded microspheres group and iodized oil group was remarkably lower than that of PVA particle group(n=21),and the f value of drug-loaded microspheres group was strikingly lower than that of iodized oil group,the differences were statistically significant(all P＜0.01).In the stable group,the efficacy of drug loaded microspheres group was obviously better than that of the iodized oil group and the PVA particle group.In the progression group,the iodized oil group was more likely to develop disease progression than the drug-loaded microspheres group and the PVA particle group.The preoperative f value in the stable group was prominently higher than that in the progression group(P=0.005),and the postoperative ADC value in the stable group was obviously higher than that in the progression group(P=0.029).ROC analysis showed that the median follow-up time in the drug-loaded microspheres group,iodized oil group,and PVA particle group was 30,19,and 26 months respectively,the overall average survival time was 25 months,and the difference was statistically significant(P＜0.01).Multivariate Cox regression analysis showed that the preoperative D value(AUC=0.878),D*value(AUC=0.554)and postoperative D value(AUC=0.791),D*value(AUC=0.552),f value(AUC=0.467)were the independent factors affecting the short-term efficacy of TACE(all P＜0.05).The preoperative and postoperative D value had higher diagnostic efficacy,while a preoperative D value of＜0.505×10-3 mm2/s and a postoperative D value of＜0.785×10-3 mm2/s predicted a poor prognosis.Conclusion The preoperative and postoperative D value is the optimal parameter for predicting the curative efficacy of TACE using different embolization materials for the treatment of HCC.

Application Effect of A New Modified 3D PSI in Total Knee Arthroplasty for Knee Osteoarthritis / 昆明医科大学学报

Objective To explore the application effect of new improved 3D printing individualized guidance(3D psi)in total knee arthroplasty(TKA)for knee osteoarthritis(KOA).Methods A total of 100 patients with KOA in 920th Hospital of Joint Logistics Support Force,PLA from January 2021 to January 2022 were selected,and were divided into 2 groups of 50 patients each using the randomized numerical table method.The control group was treated with conventional TKA,and the study group was treated with new improved 3D psi assisted TKA.The operation conditions,postoperative rehabilitation,complications,prosthesis component position deviation,knee range of motion(ROM),lower limb force line parameters[coronal distal femoral mechanical axis lateral angle(mldfa),lower limb mechanical axis angle(HKA)],gait parameters(percentage of support time,stride,pace),knee function(HSS score),quality of life(AIMS2 score)were observed.Results Com-pared with control group,the amount of intraoperative and postoperative blood loss and drainage volume 2 days after operation were less in the study group,and the operation time and hospital stay were shorter(P<0.05).The deviations of LTC Angle,FFC Angle,HKA Angle,LFC Angle and FTC Angle in the study group were smaller than those in the control group(P<0.05).At 3 months,6 months and 12 months after surgery,the percentage of knee ROM,supporting time,stride length and walking speed of the research group were higher than those of the control group,while the coronal-position mLDFA and HKA were lower than those of the control group(P<0.05).The proportion of WBC and PMN in joint fluid at 3 months,6 months and 12 months after surgery was lower than that in control group(P<0.05).The HSS score of the study group was higher than that of the control group at 3 months,6 months and 12 months after operation,and the AIMS2 score was lower than that of the control group(P<0.05).There was no statistically significant difference in the incidence of complications between the study group and the control group(P>0.05).Conclusion The new improved 3D PSI-assisted TKA treatment of KOA can optimize the surgical situation,improve operating accuracy,improve the patient's lower limb alignment,promote limb function recovery,help improve the quality of life,and has high safety.

Effect of flow rehabilitation nursing on functional recovery after replantation of severed finger / 中国现代医生

Objective To explore the effect of process rehabilitation nursing on the joint range of motion,grip strength,replantation survival rate and functional recovery of severed fingers after replantation.Methods A total of 70 patients undergoing replantation of severed fingers who were admitted to Linping District,the Second Affiliated Hospital of Zhejiang University School of Medicine from February 2019 to December 2022 were selected.The patients were divided into the control group(n=35)with routine nursing,and the research group(n=35)with routine rehabilitation nursing,and the nursing effects of the two groups were compared.Results After nursing,the excellent and good rate of the research group was 97.14％(34/35),which was significantly higher than that of the control group was 82.86％(29/35)(P<0.05);After nursing,the range of motion,grip strength,replantation survival rate and functional score of the finger joint in the study group were higher than those in the control group(P<0.05);After 3 months of nursing,the excellent and good rate of joint range of motion in the study group was 94.29％(33/35),which was significantly higher than that in the control group was 74.29％(26/35)(P<0.05).Conclusion The application of process rehabilitation nursing in patients with replantation of severed fingers has significantly improved joint activity and restored the function of severed fingers,which can be popularized.

Assessment of left ventricular longitudinal systolic function and its correlation with myocardial damage in patients with hyperthyroidism using tissue motion mitral annulus displacement technique / 中国现代医生

@#Objective The tissue motion mitral annular displacement(TMAD)technique was used to evaluate left ventricular longitudinal systolic function in patients with hyperthyroidism,and its correlation with myocardial damage was analyzed.Methods Sixty-nine cases of hyperthyroidism diagnosed in Affiliated Hospital of Youjiang Medical University for Nationalities from July 2021 to November 2022 were selected as the study objects.According to whether the patients were combined with hyperthyroidism heart disease,they were divided into simple hyperthyroidism group(n=43)and thyrotoxic heart group(n=26).35 healthy people who underwent physical examination in our hospital during the same period were selected as normal control group.Three-dimensional echocardiography was used to obtain the left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF)and TMAD parameters.The differences of above parameters among all groups were compared,and the correlations of TMAD parameters with creatine kinase isoenzymes(CK-MB)and high-sensitivity cardiac troponin T(hs-cTnT)were analyzed.Results The LVEDV,LVESV,LVEF,TMAD parameters,CK-MB and hs-cTnT of three groups were statistically significant(P<0.001),and LVEDV,LVESV,CK-MB and hs-cTnT of normal control group<simple hyperthyroidism group<thyrotoxic heart group,LVEF and TMAD parameters of normal control group>simple hyperthyroidism group>thyrotoxic heart group.All parameters of TMAD were positively correlated with LVEF(P<0.001),and some parameters of TMAD were negatively correlated with CK-MB(P<0.05).Conclusion TMAD technology can early evaluate left ventricular longitudinal systolic function in patients with hyperthyroidism,and is related to CK-MB and hs-cTnT.

Factors related to re-falling of knee range of motion after arthrolysis for post-traumatic knee stiffness / 中国康复理论与实践

ObjectiveTo observe the temporary loss (re-falling) of knee range of motion (ROM) during rehabilitation after arthrolysis for post-traumatic knee stiffness, and analyze the factors related to it. MethodsFrom July, 2016 to September, 2019, 64 patients (68 knees) in Beijing Bo'ai Hospital accepted minimally invasive arthrolysis for post-traumatic knee stiffness, and were followed up for twelve months. ROM of flexion and extension of knee was measured before operation, and one, six and twelve weeks, and six and twelve months after operation; while they were asssessed with Hospital for Special Surgery Knee Score (HSS). Multivariate Logistic regression was performed on re-falling. ResultsThe ROM and HSS score improved as a whole after operation; however, HSS score improved constantly, but ROM decreased six weeks after operation compared with that one weeks after operation, involving 46 knees of 44 cases. Arthrolysis longer than 12 months from primary injuries, multiple complicated fracture and history of infection were the risk factors for re-falling (OR > 8.058, P < 0.05). ConclusionMinimally invasive arthrolysis is effective on knee function after arthrolysis for post-traumatic knee stiffness. However, re-falling of ROM may happen during rehabilitation. Delay of operation, multiple complicated fracture and history of infection may increase the risk of re-falling.

Gait analysis using three-dimensional motion and ground reaction force systems in patients with hemiplegia treated with botulinum toxin type A in ankle plantar flexors / Journal of Rural Medicine

Objective: The efficacy of botulinum toxin type A (BoNT-A) injection on spasticity has usually been measured using the range of motion (ROM) of joints and Modified Ashworth Scale (MAS); however, they only evaluate muscle tone at rest. We objectively analyzed the gait of three patients with hemiplegia using three-dimensional motion analysis and ground reaction force (GRF) systems to evaluate muscle tone during gait.Materials and Methods: We measured passive ankle dorsiflexion ROM with knee extension and the MAS score for clinical evaluation, and gait speed, stride length, single-leg support phase during the gait cycle, joint angle, joint moment, and GRFs for kinematic evaluation before and one month after BoNT-A injection.Results: All patients showed an increase in ankle dorsiflexion ROM, improvement in MAS score, and increase in stride length. Case 1 showed an increase in gait speed, prolongation of the single-leg support phase, increase in hip extension angle and moment, and improvement in the vertical and anterior-posterior components of the GRFs. Case 2 showed an increase in gait speed, improvement in double knee action, increase in ankle plantar flexion moment, and improvement in propulsion in the progressive component of the GRFs. Case 3 exhibited a laterally directed force in the GRFs.Conclusion: We evaluated the effects of BoNT-A injections in three patients with hemiplegia using three-dimensional motion analysis and GRFs. The results of the gait analysis clarified the improvements and problems in hemiplegic gait and enabled objective explanations for patients.

Patient with Heterotopic Ossification Post-SARS‑CoV‑2 Infection Regained Ability to Walk Independently Indoors after Rehabilitation and Drug Therapy：A Case Report / The Japanese Journal of Rehabilitation Medicine

A 31-year-old woman infected with severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) at 33-weeks pregnant was subject to cesarean delivery due to a worsening respiratory condition. On the fourth day of illness, the patient was placed on a ventilator, with extracorporeal membrane oxygenation (ECMO) treatment initiated on the ninth day. Passive range of motion (ROM) training started on the day 33 of illness. She was weaned off ECMO on day 55 of illness and taken off of the ventilator on day 8. The tracheostomy tube was replaced with a speech cannula on day 87 of illness, at which time the patient began to complain of pain during passive ROM training. Plain X-ray photography and computed tomography (CT) showed ossification around the bilateral shoulder and hip joints, as well as on medial thighs, accompanied by an alkaline phosphatase (ALP) value of 942 U/L. She was subsequently diagnosed with heterotopic ossification, after which passive ROM training was changed to protective ROM training, in addition to treatment with indomethacin farnesyl and etidronate disodium. The patient was transferred to our hospital on day 122 of illness for the purpose of continuing rehabilitation. On day 155 of illness, ossification decreased on the medial thighs, according to CT. She was able to walk independently indoors and was discharged home on day 181 of illness. This case demonstrates the importance of checking the ALP levels and palpating the periarticular area in patients infected with SARS‑CoV‑2 before initiating passive ROM training, as well as being aware of any pain experienced during training. In the case of any abnormalities, assessing the ossification around the joints of extremities by imaging examination is a priority.

Rehabilitative efficacy of kinesio taping following anterior cruciate ligament reconstruction:a Meta-analysis / 中国组织工程研究

OBJECTIVE:Some studies have shown that kinesio taping has positive effects in elevating muscle strength,improving joint stability and reducing pain and oedema in patients after anterior cruciate ligament reconstruction.However,existing studies have divergent results on the clinical efficacy of kinesio taping.In this study,a meta-analysis was conducted to systematically evaluate the effect of kinesio taping in postoperative rehabilitation period following anterior cruciate ligament reconstruction. METHODS:Randomized controlled trials about the effects of kinesio taping on anterior cruciate ligament reconstruction were electronically searched in PubMed,Web of Science,Embase,The Cochrane Library,EBSCO,CNKI,WanFang,and VIP databases,from database inception to December 06,2022.The outcome measures included six continuous variables:quadriceps strength,hamstring strength,knee swelling,knee range of motion,Lysholm knee function score,and Visual Analogue Scale score.EndNote X9.1 was used to screen the literature.The Cochrane Risk Bias Assessment Tool and Jadad Scale were used to evaluate the quality of the included literature.RevMan 5.3 software was used for Meta-analysis. RESULTS:A total of 6 randomized controlled trials involving 252 patients undergoing anterior cruciate ligament reconstruction were finally included.There were 126 cases in control group and 126 in kinesio taping group.The results of Meta-analysis showed that compared with the control group,kinesio taping significantly improved hamstring strength[standardized mean difference(SMD)=0.68,95%confidence interval(CI):0.12 to 1.23,P=0.02)and reduced Visual Analogue Scale score[mean difference(MD)=-0.56,95%CI:-1.04 to-0.08,P=0.02).However,for quadriceps strength,knee swelling,knee range of motion,and Lysholm knee function score,kinesio taping did not show significant difference from the control group(P＞0.05). CONCLUSION:Kinesio taping may help to improve hamstring strength and reduce pain in patients after anterior cruciate ligament reconstruction.However,it cannot significantly improve quadriceps strength,knee swelling,knee range of motion,and functional scores.

Biomechanical characteristics of a novel interspinous distraction fusion device BacFuse for the repair of lumbar degenerative disease / 中国组织工程研究

BACKGROUND:Interspinous distraction fusion device BacFuse was used for the management of lumbar degenerative disease and obtained good clinical efficacy in recent years.However,the related biomechanical study was lacking. OBJECTIVE:To explore the related biomechanical characteristics of BacFuse,a novel interspinous distraction fusion device,which was used in lumbar degenerative disease. METHODS:After constructing the goat spinal models(L1-L6),they were grouped into four groups based on different simulated surgeries:the control group,the BacFuse group(L3/4),the screw-rod fixation group(L3/4)and the Topping-off group(L3/4 screw-rod fixation + L2/3 BacFuse fixation).The goat lumbar spine surgical model was assembled into a biomechanical testing system.A biomechanical machine was used for mechanical loading,simulating lumbar spine movement of flexion,extension,lateral flexion and rotation with a 4 Nm moment.A visual tracking system was used for positioning and capturing.Finally,mechanical and optical calibration was completed to calculate the range of motion of the L2/3,L3/4 and L4/5 segments. RESULTS AND CONCLUSION:(1)Compared with the control group,the range of motion of the L3/4 segment in the BacFuse group decreased 27.27%,70%,38.1%and 23.08%in the flexion,extension,lateral bending and rotation directions,respectively(P<0.05).The range of motion of L3/4 segment in the screw-rod fixation group decreased 72.73%,80%,71.43%and 73.08%in the flexion,extension,lateral bending and rotation directions,respectively(P<0.05).(2)Compared with the control group,the range of motion of the adjacent segment L2/3 increased by 33.33%,25%and 23.81%in the extension,lateral bending and rotation directions,respectively in the BacFuse group(P<0.05),with no significant change in flexion.In the screw-rod fixation group,there was a 50%,44.44%,50%and 58.96%increase in the adjacent segment L2/3 in the flexion,extension,lateral calibration and rotation directions,respectively(P<0.05).(3)Compared with the control group,the BacFuse group showed an increase in range of motion in proximal segment L4/5 in the extension and rotation directions by 27.3%and 17.39%(P<0.05)respectively,with no significant change in flexion or lateral bending.In the screw-rob fixation group,the proximal segment L4/5 demonstrated 38.89%,22.73%and 26.09%(P<0.05)increases in range of motion in the flexion,extension and rotation directions,respectively,with no significant change in lateral bending.(4)In the Topping-off group,the range of motion of L2/3 was reduced by 37.04%,73.08%,56.67%and 38.46%in flexion,extension,lateral flexion and rotation,respectively,compared to the screw-rob fixation group(P<0.05).Compared with the screw-rob fixation group,the Topping-off group showed a 20%reduction in the range of motion of the L4/5 in the flexion direction(P<0.05),with no significant differences seen in extension,lateral bending and rotation.(5)It is concluded that the interspinous distraction fusion device BacFuse significantly reduces the range of motion of the implanted segment and provides some stability.It still retains more mobility and reduces the impact on the adjacent segment compared to screw-rob fixation,while the Topping-off tip,which can be used for intervertebral fusion fixation,significantly reduces the range of motion of the adjacent segment and reduces the risk of adjacent segment degeneration.

Meta-analysis of the incidence and related factors for cervical spine instability in patients with rheumatoid arthritis / 中国组织工程研究

OBJECTIVE:At present,there are many reports on the related factors associated with the incidence of cervical spine instability in patients with rheumatoid arthritis,but there are problems such as small sample size and many confounding factors,and the research results of various studies on the same related factors are also different.This article analyzed the factors related to cervical spine instability in patients with rheumatoid arthritis by means of a systematic review. METHODS:Articles related to cervical spine instability in patients with rheumatoid arthritis were collected by searching both Chinese and English databases until March 2023.The outcome of cervical spine instability in patients with rheumatoid arthritis was used as the grouping criterion to abstract basic information,baseline patient characteristics,laboratory-related tests,medication use,and other relevant risk factors.Meta-analysis was done using Stata 14.0 software. RESULTS:(1)Sixteen relevant studies,all of moderate or above quality,were included,including seven studies with case-control studies and nine with cross-sectional studies.The overall incidence of cervical spine instability in patients with rheumatoid arthritis was 43.08%.(2)Meta-analysis showed:Related risk factors included female(OR=0.60,95%CI:0.44-0.82,P=0.002);age at disease onset(SMD=-0.52,95%CI:-0.86 to-0.18,P=0.003);duration of disease(SMD=0.58,95%CI:0.14-1.02,P=0.01);body mass index(OR=0.74,95%CI:0.63-0.88,P=0.001);rheumatoid factors positive univariate analysis subgroup(OR=1.33,95%CI:1.02 to 1.72,P=0.04),C-reactive protein(SMD=0.26,95%CI:0.16-0.35,P=0.00),erythrocyte sedimentation rate(SMD=0.15,95%CI:0.002-0.29,P=0.047),anti-cyclic-citrullinated peptide antibodies(OR=1.73,95%CI:1.19-2.51,P=0.004),28-joint Disease Activity Score(SMD=0.20,95%CI:0.04-0.37,P=0.02),destruction of peripheral joints(OR=2.48,95%CI:1.60-3.85,P=0.00),and corticosteroids(OR=1.91,95%CI:1.54-2.37,P=0.00)were strongly associated with the development of rheumatoid arthritis-cervical spine instability.Female and corticosteroid use were independently associated with the occurrence of rheumatoid arthritis-cervical spine instability. CONCLUSION:Based on clinical evidence from 16 observational studies,the overall incidence of rheumatoid arthritis-cervical spine instability was 43.08%.However,the incidence of cervical spine instability in rheumatoid arthritis patients varied greatly among different studies.Gender(female)and the use of corticosteroids were confirmed as independent correlation factors for the onset of cervical spine instability in patients with rheumatoid arthritis.The results of this study still provide some guidance for early clinical recognition,diagnosis,and prevention of rheumatoid arthritis-cervical spine instability.

Analgesic effect of cocktail therapy combined with femoral nerve block in unicompartmental knee arthroplasty / 中国组织工程研究

BACKGROUND:With the further development of minimally invasive concepts,unicompartmental knee arthroplasty has become an important treatment for osteoarthritis of the knee;however,early postoperative pain adversely affects the recovery process,so effective analgesic measures are necessary.Femoral nerve block and cocktail therapy are common analgesic methods for unicompartmental knee arthroplasty,but there is a lack of studies confirming the analgesic effect and safety of their combined application. OBJECTIVE:To investigate the analgesic effect of cocktail therapy combined with femoral nerve block in unicompartmental knee arthroplasty. METHODS:One hundred patients who received unicompartmental knee arthroplasty from October 2021 to January 2023 were selected as the study subjects.They were divided into a control group(n=50)and a study group(n=50)using a random number table method.The femoral nerve block was used in the control group,while cocktail therapy combined with femoral nerve block was used in the study group during unicompartmental knee arthroplasty.Postoperative analgesia effect,analgesic frequency of dezocine injection within 2 days after surgery,motion range of affected knee joint,KSS function scores,and the occurrence of postoperative adverse reactions were compared between the two groups. RESULTS AND CONCLUSION:(1)Visual analog scale scores in the study group were lower than those in the control group at 12,24,and 48 hours after surgery(P<0.05).(2)The analgesic frequency of dezocine in the study group was less than that in the control group within 2 days after surgery(P<0.05).(3)The motion range in the study group was higher than that in the control group 1 and 3 days after surgery(P<0.05).On day 14 after surgery,there was no significant difference in motion range between the two groups(P>0.05).(4)The knee KSS score in the study group was higher than that in the control group at 2 weeks after surgery(P<0.05).There was no statistically significant difference in knee KSS scores between the two groups from 6 weeks to 6 months after surgery(P>0.05).(5)The difference in the occurrence of adverse reactions within 14 days after surgery was not significant between the two groups(P>0.05).(6)These results show that the use of cocktail therapy combined with femoral nerve block in unicompartmental knee arthroplasty can effectively reduce postoperative pain,improve the analgesic effect,reduce the frequency of analgesic drugs,and improve motion range of the early affected knee joint of patients.

Application advantages of Brainlab Knee 3 navigation combined with gap balance in total knee arthroplasty / 中国组织工程研究

BACKGROUND:In recent years,computer-assisted navigation has gradually attracted attention in the medical field.Some scholars have reported that the clinical effects of computer navigation in total knee arthroplasty vary.To explore the clinical effect of the new generation of Brainlab Knee 3 navigation system,this study is conducted. OBJECTIVE:To analyze the application effect of computer navigation system(Brainlab Knee 3)combined with gap balance technology in total knee arthroplasty. METHODS:A total of 71 patients received total knee arthroplasty at the Department of Joint Surgery of Dalian Second People's Hospital from November 2020 to May 2021.In the navigation group,35 patients underwent total knee arthroplasty by computer navigation combined with gap balance.In the traditional group,36 patients underwent osteotomy with traditional surgical instruments.The difference between medial and lateral joint spaces,knee range of motion,hospital for special surgery knee score,hip-knee-ankle angle,deviation values of coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle were compared between the two groups. RESULTS AND CONCLUSION:(1)In the navigation group,the differences of intraoperative medial and lateral joint gap at knee extension 0,1,and 2 mm were found in 19,14,and 2 cases,respectively.The gap difference was 0 mm in 18 cases,1 mm in 15 cases and 2 mm in 2 cases at 90° degree knee flexion.In the traditional group,the gap difference at knee extention was 0 mm in 10 cases,1 mm in 20 cases,and 2 mm in 6 cases.The gap difference at 90 degree knee flexion was 0 mm in 10 cases,1 mm in 15 cases and 2 mm in 8 cases.(2)The operation time in the navigation group was longer than that in the traditional group(P<0.05),and two patients in the navigation group developed lower limb intermuscular vein thrombosis after surgery,and none of the patients in the traditional group had complications.(3)The range of motion between the two groups increased significantly at 6 and 12 months after surgery,and the range of motion in the navigation group was higher than that in the traditional group(P<0.05).(4)At 12 months after surgery,the hospital for special surgery knee scores of both groups increased significantly,and the hospital for special surgery knee score in the navigation group was higher than that in the traditional group(P<0.05).(5)At 6 months after surgery,the deviation values of hip-knee-ankle angle,coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle of navigation group were significantly lower than those in the traditional group(P<0.05).(6)The results showed that computer navigation technique combined with gap balance in total knee arthroplasty had advantages in postoperative range of motion,lower limb alignment and the accuracy of tibial prosthesis component position,and joint function recovered well.