Efficacy of Targeted Scapular Stabilization Exercise Versus Conventional Exercise for Patients With Shoulder Pain: A Randomized Clinical Trial.

OBJECTIVE: The aim of the study is to investigate the efficacy of targeted scapular stabilization exercise in shoulder pain. DESIGN: This is an evaluator-blinded, multicenter, randomized controlled trial. The scapular stabilization exercise group ( n = 45) received scapular stabilization exercise based on the type of scapular dyskinesis for 6 wks; the conventional exercise group ( n = 45) received pendulum, wall climbing and stick exercises for 6 wks. Constant-Murley score, numerical rating scale, range of motion, type of scapular dyskinesis, lateral scapular sliding test, pectoralis minor index, scapular index, and satisfaction were assessed at baseline, 2-, 4-, and 6-wk treatment as well as a 6-wk follow-up. RESULTS: After a 6-wk intervention, the improvement of Constant-Murley score was greater in the scapular stabilization exercise group than in the conventional exercise group, and improvement continued at the 6-wk follow-up ( F = 15.39, P < 0.001, partial η 2 = 0.17). The results were also significant for numerical rating scale during activity, lateral scapular sliding test, pectoralis minor index, type of scapular dyskinesis, and satisfaction in favor of the scapular stabilization exercise group ( P < 0.05). CONCLUSIONS: Targeted scapular stabilization exercise is an effective intervention program that might be applied to the rehabilitation of shoulder pain.

Can T-tube drainage be replaced by primary suture technique in laparoscopic common bile duct exploration? A meta-analysis of randomized controlled trials.

BACKGROUND: Although laparoscopic common bile duct exploration (LCBDE) is considered the best treatment and has the advantages of being minimally invasive for common bile duct (CBD) stones, the choice of T-tube drainage (TTD) or primary duct closure (PDC) after LCBDE is still controversial. Therefore, the aim of the study was to compare the superiority of PDC versus TTD after LCBDE for choledocholithiasis. METHODS: All potential studies which compare the surgical effects between PDC with TTD were electronically searched for in PubMed, Web of Science, and the Cochrane library databases up to November 2019. Data synthesis and statistical analysis were carried out using RevMan 5.3 software. RESULTS: In total, six randomized controlled trials with 604 patients (307 in the PDC group and 297 in the TTD group) were included in the current meta-analysis. As compared with the TTD group, the pooled data showed that PDC group had shorter operating time (WMD = -24.30; 95% CI = -27.02 to -21.59; p < 0.00001; I2 = 0%; p < 0.88), less medical expenditure (WMD = -2255.73; 95% CI = -3330.59 to -1180.86; p < 0.0001; I2 = 96%; p < 0.00001), shorter postoperative hospital stay (OR = -2.88; 95% CI = -3.22 to -2.54; p < 0.00001; I2 = 60%; p < 0.03), and lower postoperative complications (OR = 0.49; 95% CI = 0.31 to 0.78; p = 0.77; I2 = 0%; p = 0.003). There were no significant differences between the two groups concerning bile leakage (OR = 0.74; 95% CI = 0.36 to 1.53; p = 0.42; I2 = 0%; p = 0.90) and retained stones (OR = 0.96; 95% CI = 0.36 to 2.52; p < 0.93; I2 = 0%; p < 0.66). CONCLUSIONS: LCBDE with PDC should be performed as a priority alternative compared with TTD for choledocholithiasis.

[Analysis on regularity of prescriptions in "a guide to clinical practice with medical record" for diarrhoea based on traditional Chinese medicine inheritance support system].

To analyze the regularities of prescriptions in "a guide to clinical practice with medical record" (Ye Tianshi) for diarrhoea based on traditional Chinese medicine inheritance support system(V2.5), and provide a reference for further research and development of new traditional Chinese medicines in treating diarrhoea. Traditional Chinese medicine inheritance support system was used to build a prescription database of Chinese medicines for diarrhoea. The software integration data mining method was used to analyze the prescriptions according to "four natures", "five flavors" and "meridians" in the database and achieve frequency statistics, syndrome distribution, prescription regularity and new prescription analysis. An analysis on 94 prescriptions for diarrhoea was used to determine the frequencies of medicines in prescriptions, commonly used medicine pairs and combinations, and achieve 13 new prescriptions. This study indicated that the prescriptions for diarrhoea in "a guide to clinical practice with medical record" are mostly of eliminating dampness and tonifying deficienccy, with neutral drug property, sweet, bitter or hot in flavor, and reflecting the treatment principle of "activating spleen-energy and resolving dampness".

[Etiological analysis and individualized treatment of pharyngeal paraesthesia].

OBJECTIVE: To analyze the nosazontology of pharyngeal paraesthesia and investigate the treatment. METHOD: Two hundred and twelve misdiagnosed pharyngeal paraesthesia patients were investigated by history inquiry, routine examination, 24-hour esophageal pH monitoring, barium X-ray of the oesophagus, anxieties-athymic private measuring scale, coefficient of variation of the R-R (CVR-R), bioavailable testosterone detection (Bio-T), erection experiment and questionnaire about man climacteric syndrome. The concomitant symptoms and positions of pharyngeal paresthesia were also studied. We adopted individuallized sequential multi-therapy for every patient according to the cause of disease. RESULT: The cause of disease within 212 cases of pharyngeal paraesthesia included 62 psychic trauma, 32 endocrine system disease, 106 upper gastrointestinal disease, circulatory disease, 9 circulatory disease, 3 idiopathic. With individualized treatment, 110 cases had fully recovered, 63 cases excellence and 31 cases utility, and the efficiency rate was 96.23%. CONCLUSION: Pharyngeal paraesthesia can be caused by several factors. Thorough examination and comprehensive analysis should be applied to those incurable patient who has been treated for a long time. Short course of treatment and irrational drug use are the main causes of short-term recurrence and unsatisfactory curative effect.