RESUMEN
Background: Cervicogenic headache (CEH) is a secondary headache caused by lesions of the cervical spine and surrounding soft tissues. Cervical muscle dysfunction may be related to the onset of CEH. However, whether cervical muscle stiffness changes in patients with CEH has not been well studied. The purpose of this study was to explore changes in superficial cervical extensor muscle stiffness in patients with CEH using shear wave elastography (SWE). Methods: In this study, 19 patients with CEH and 20 healthy controls were recruited. Superficial cervical extensor muscle stiffness was obtained from SWE, and the SuperLinear SL10-2 MHz linear array probe in the musculoskeletal muscle mode was chosen as the transducer. Regions of interest in the trapezius (TRAP), splenius capitis (SPL), semispinalis capitis (SCap), and semispinalis cervicis (SCer) were manually segmented. Correlations between superficial cervical extensor muscle stiffness and visual analog scale (VAS) scores, age, and body mass index (BMI) were analyzed using Pearson's correlation. Receiver operating characteristic (ROC) curve was used to investigate the diagnostic ability of superficial cervical extensor stiffness for CEH. Results: Superficial cervical extensor muscle stiffness on the headache side of patients with CEH was higher than that on the non-headache side and in healthy controls (p < 0.05). Increased stiffness was also observed in SCer on the non-headache side of patients with CEH compared to healthy controls (p < 0.01). In patients with CEH, SCer stiffness was positively correlated with VAS scores (r = 0.481, p = 0.037), but no correlation was found between other muscles and VAS scores (p > 0.05). The areas under the curve of TRAP, SPL, SCap, and SCer in diagnosing CEH were 0.766, 0.759, 0.964, and 1.000, respectively. Conclusions: Increased stiffness was observed in the superficial cervical extensor muscles on the headache side of patients with CEH. SCer stiffness was correlated with headache intensity in patients with CEH and may provide clues for the diagnosis of CEH.
RESUMEN
In two growing seasons of wheat (2016-2018), a field trial with Jimai 22 as test mate-rial was conducted in Shijiawangzi Village, Yanzhou City, Shandong Province. Under three nitrogen levels of 150 (N1), 180 (N2) and 210 (N3) kg·hm-2, two irrigation-fertilization methods were designed at jointing as border irrigation and broadcasting of fertilizer (W1), micro spraying irrigation and water-fertilizer integration (W2), to examine the effects of irrigation-fertilization methods on water use, photosynthetic characteristics, and dry matter accumulation and transport of wheat. The results showed that under the same nitrogen level, seven days average soil evaporation of W2 treatment in filling period was significantly lower than that of W1 treatment, and that soil water consumption in the 60-160 cm soil layer was significantly higher than that in W1 treatment. The flag leaf net photosynthetic rate, stomatal conductance and transpiration rate of W2 treatment were signi-ficantly higher than W1 treatment from 14 to 28 days after anthesis. The amount of dry matter in anthesis and maturity stage and the allocation to grain of post-anthesis assimilates of W2 treatment were significantly higher than those in W1 treatment. There was no difference in total water consumption between W2 and W1 treatments. Grain yield, water use efficiency and nitrogen use efficiency of W2 treatment were significantly higher than W1 treatment. The highest grain yield, water use efficiency and nitrogen use efficiency were obtained at the nitrogen level of 210 kg·hm-2. By comprehensive considerations, under the same nitrogen level, treatment of micro spraying irrigation and water-fertilizer integration was better than border irrigation and broadcasting of fertilizer. The W2N3 treatment under the nitrogen level of 210 kg·hm-2 and with the application of micro spraying irrigation and water-fertilizer integration at jointing was the optimal treatment to save water and fertilizer.
