Efficacy and safety of topical NSAIDs combined with physiotherapy for frozen shoulder: a randomized controlled trial.

OBJECTIVE: Frozen shoulder is a prevalent condition among individuals in their middle and later years. Invasive therapy has shown promising results in the treatment of frozen shoulders, but its widespread adoption has been hampered by high costs and the need for advanced medical technology. As a result, patients with frozen shoulders often turn to non-steroidal anti-inflammatory drugs (NSAIDs) for symptomatic relief. However, the oral administration of NSAIDs can lead to troublesome adverse effects on the gastrointestinal, cardiovascular, and urinary systems. In contrast, topical NSAIDs have gained attention for their excellent efficacy and lower adverse effects in various chronic pain conditions. Therefore, our study aimed to investigate the efficacy and safety of topical NSAIDs in improving pain and mobility among patients with frozen shoulders. PATIENTS AND METHODS: A total of 108 patients experiencing moderate to severe pain and mobility impairment due to frozen shoulder were enrolled in this study. The participants were randomly assigned to either the experimental group (n=72) or the control group (n=36). The experimental group received daily treatment with the loxoprofen hydrogel patch (LOX-P) in addition to basic rehabilitation physiotherapy. The control group was treated with flurbiprofen cataplasm (FLU-C) twice a day, along with rehabilitation physiotherapy. The primary endpoint for evaluating the efficacy of the two patches was the Constant-Murley score (CMS). Clinical symptom data, adverse events, and patient satisfaction were also recorded. RESULTS: After 14 days of treatment, the effective rate was 66.67% (n=48) in the experimental group and 41.67% (n=15) in the control group. The overall difference in the effective rates was 25.00% (95% CI=5.20-42.52; p=0.013). The safety profiles of the two topical agents were similar, with only a few adverse events reported. CONCLUSIONS: The loxoprofen hydrogel patch demonstrates a significant ability to alleviate shoulder pain and restore shoulder function in the treatment of frozen shoulder, with minimal adverse reactions. Chictr.org.cn ID: ChiCTR2100052375.

A new and improved acetabular cup digital templating method and its clinical application.

BACKGROUND AND OBJECTIVE: Preoperative acetabular cup templating has an important auxiliary effect on hip surgery. The traditional acetabular cup templating method requires the measuring person to have some experience in total hip replacement (THA) surgery since the measurement results vary from person to person with differences between different measuring persons. To obtain stable templating results, we designed a new acetabular cup templating method and tested the inter-person measuring differences and measurement accuracy of this method. Meanwhile, the clinical application of this method was preliminarily explored. MATERIALS AND METHODS: The pattern of this new method was manual labeling of imaging characteristic points and then programmed automatic measurements. The measurement process was performed entirely by orthopedic graduate students without any experience in hip replacement surgery. The inter-person measuring difference was evaluated by comparing the templating results of three measuring persons. The accuracy of the templating was evaluated by comparing the templating results with the actual size of the prosthesis in the surgery. The correlation between the position of the acetabular cup and the templating error was analyzed to explore the clinical significance of the templating results. This study was a retrospective study which included templating in a total of 406 cases for total hip replacement with cementless cup prosthesis. Digital measurements were performed using the Matlab software from MathWorks. The statistical comparison was performed using Kendall's W test. RESULTS: The results of the three measuring persons were completely identical in 61.8% (251/406) of cases, and the variation in 38.2% (155/406) of cases did not exceed one size of the acetabular cup. The Kendall's W coefficient was 0.977, and p < 0.01. The measurement accuracy is not as good as the traditional method in exactly accurate measurement and ±1 cup size, but it is similar to the traditional method in the ±2 cup sizes. The correlation between the templating error and the position evaluation of the implanted acetabular cups reveals: (1) larger the templating error, larger the proportion of the acetabular cups with poor position; (2) the proportion of acetabular cup with poor position slowly increased when the templating error was from 0 to 1 size, and the proportion rapidly increased when the templating error was from 1 to 2 size. CONCLUSION: All the patients with clear teardrop bottom and lateral superior edge of acetabulum were able to use our method to predict the size of the acetabular cup. The method has the following advantages: (1) it does not require the measuring person to have any previous experience of the THA surgery, which reduces the labor cost of the templating; (2) the differences between the measuring persons is small, the measurement result can be repeated; (3) it can predict the probability of acetabular cup with poor positioning according to the templating error, and thereby reminding the surgeon to recheck and correct the position of the acetabular cup in time during the surgery.

Investigation of the Booroola (FecB) and Inverdale (FecX(I)) mutations in 21 prolific breeds and strains of sheep sampled in 13 countries.

Twenty-one of the world's prolific sheep breeds and strains were tested for the presence of the FecB mutation of BMPR1B and the FecX(I) mutation of BMP15. The breeds studied were Romanov (2 strains), Finn (2 strains), East Friesian, Teeswater, Blueface Leicester, Hu, Han, D'Man, Chios, Mountain Sheep (three breeds), German Whiteheaded Mutton, Lleyn, Loa, Galician, Barbados Blackbelly (pure and crossbred) and St. Croix. The FecB mutation was found in two breeds, Hu and Han from China, but not in any of the other breeds. The 12 Hu sheep sampled were all homozygous carriers of FecB (FecB(B)/FecB(B)) whereas the sample of 12 Han sheep included all three genotypes (FecB(B)/FecB(B), FecB(B)/FecB+, FecB+/FecB+) at frequencies of 0.33, 0.58 and 0.08, respectively. There was no evidence of FecX(I) in any of the breeds sampled.

Effect of experimental fasciolosis on antipyrine metabolism and clearance in water buffaloes.

The effect of chronic Fasciola hepatica infection on the metabolism of antipyrine, a marker of microsomal oxidative metabolism, was investigated in male water buffaloes dosed daily with 60 F. hepatica metacercariae over 20 days. The plasma elimination half-life of antipyrine was significantly elevated by 23% at 11 weeks postinfection (p.i.) but did not significantly differ from the control period at 20 weeks p.i. The systemic clearance of antipyrine decreased by 48% at 11 weeks p.i. and then returned to normal. The renal clearance for each of the main antipyrine metabolites decreased at 11 weeks p.i. (hydroxymethylantipyrine (HMA), -42%; norantipyrine (NORA), -58%; and 4-hydroxyantipyrine (OHA), -70%) and did not significantly differ from the control period at 20 weeks p.i. These findings indicate that experimental subclinical fasciolosis leads to altered antipyrine kinetics and to an inhibition of the different antipyrine metabolic pathways in water buffaloes.

Plasma aspartate aminotransferase (AST), glutamate dehydrogenase (GLDH) and gamma-glutamyl transpeptidase (GGT) activities in water buffaloes with experimental subclinical fasciolosis.

The effect of chronic Fasciola hepatica infection on the activity of plasma aspartate aminotransferase (AST), glutamate dehydrogenase (GLDH) and gamma-glutamyl transpeptidase (GGT) was investigated in water buffaloes dosed daily with 60 F. hepatica metacercariae over 20 days. Experimental fluke infection caused no clinical signs but provoked an increase in plasma level of IgG directed against F. hepatica from 4 weeks after infection. There was a significant increase in plasma AST from 6 weeks post-infection. Maximal values were reached at 14 weeks and remained significantly elevated by 23 weeks. Plasma GLDH was significantly elevated from 6 to 21 weeks post-infection. Significant increases in plasma GGT occurred from 8 to 26 weeks post-infection, reaching maximal values at 15 weeks. This study shows that plasma enzyme activities may be useful in studies of fluke-induced liver damage in water buffaloes.

Some characteristics of nutrition metabolism and hormone control during the first 24 hours in neonatal calves.

Six male Holstein calves of spontaneous delivery and with jugular vein catheter were chosen to study the characteristics of nutrition metabolism and hormone control during the first 24 h of age after birth. The results showed that plasma fructose (Fru) and lactic acid (LA) concentrations were highest at birth, fell significantly during the first 2 h of life, and then dropped further until 24 h. Glucose (Glu) increased at 0.5 h after birth, followed by a gradual decrease until 8 h, with a general upward trend thereafter. Free fatty acid (FFA) was very low at birth, rose rapidly within 2 h of live, and kept a relatively high concentration thereafter. Total protein (TP) had not obvious change and fluctuated at a low level during the first 24 h of age. The rise of insulin (Ins) at 1 h of age was observed, with a downward tendency thereafter. Plasma cortisol (Cort) level was high during 1 h of age and tend to drop thereafter. An obviously rising tendency of T4 and T3 was found during the first 4 h of life, followed by their keeping relatively high levels although decreasing constantly in neonatal calves.

Characteristics and developmental changes of some plasma nutrition metabolites in neonatal lambs.

Twelve spontaneously delivered Hu sheep neonatal lambs with a birth weight of 1.5-4.5 kg were used to study the characteristics and developmental changes of plasma nutrition metabolites during postnatal period in 7 days of age. The results showed that plasma glucose (Glu) concentration rose significantly within 4 h after lambing and then maintained a fluctuent upward tendency until day 7 of age. Fructose (Fru) and lactic acid (LA) concentrations were highest at 1 h after birth, tended to drop thereafter, and remained relatively stable levels after day 3 of age. Free fatty acid (FFA) tended to increase within 12 h after birth, followed by keeping comparatively high levels although decreasing fluctuently. An obvious increase of total protein (TP) occurred within 8 h after birth and then remained a relatively high concentration until day 7 of age. a-Amino nitrogen (a-NH2N) tended to rise by 4 h and fell slightly thereafter, urea nitrogen (UN) had an elevated concentration from birth to 8 h and then dropped obviously. Both a-NH2N and UN appeared to be fairly stable during the first week of age in neonatal lambs.

The development changes and correlations of some blood hormone levels and immune indexes during the postnatal period in neonatal calves.

The developmental changes and correlations of some hormone levels and immune parameters in six spontaneously delivered Holstein calves with a birth weight of 40-50 kg were studied for a postnatal period of 1-15 days after birth. The mean levels of insulin (I), glucagon (Gc), cortisol (C) and growth hormone (GH) before feeding on day 1 were 9.68 +/- 3.27 muu/ml, 685.39 +/- 95.42 pg/ml, 14.27 +/- 5.58 micrograms/dl and 0.85 +/- 0.10 ng/ml respectively. I and GH increased on day 2 and then decreased to a steady level. Gc and C fell fluctuantly within week 1 and remained at a stable level after then. WBC, neutrophil percentage, B-lymphocyte percentage, albumin percentage decreased with day of age in 1st week and lymphocyte percentage, T-lymphocyte percentage, T-G (total globulin) percentage and gamma-G percentage increased with day of age in 1st week and then reached a steady level. The correlations between some hormone levels and immune parameters indicated that C and Gc have significantly negative correlations with gamma-G (%), T-G (%) and T-lymphocyte (%) respectively. WBC is positively correlated to C and Gc significantly. The correlations of I and GH with some immune parameters have no significance.

Effects of pancreatectomy on the growth and metabolite concentrations of the sheep fetus.

The effects of fetal pancreatectomy on the growth and metabolism of the fetal sheep were investigated in chronically catheterized animals during the last third of gestation. Fetal pancreatectomy reduced body weight and crown-rump length at delivery near term (term 145 days). Body weight was affected more than body length so the ratio of weight to length was significantly less after pancreatectomy than in intact animals (P less than 0.05). Pancreatectomized fetuses appeared to maintain a normal growth rate for 5-10 days after surgery but thereafter showed no further significant increase in body weight. When all the data from the intact and pancreatectomized fetuses were combined, there was a significant positive correlation between the plasma insulin concentration in utero and the body weight at delivery near term. The majority of organs studied were reduced in absolute weight after pancreatectomy but only the spleen and thymus were proportionally lighter when the weights were expressed as a percentage of body weight. Brain and placental weights were similar in intact and pancreatectomized fetuses. Over the range of values observed in utero, there were significant inverse correlations between the log plasma insulin level and the mean plasma concentrations of glucose, lactate, fructose and alpha-amino-nitrogen in individual intact and pancreatectomized fetuses. Insulin infusion into pancreatectomized fetuses restored the metabolite concentrations to their normal values within 48 h of infusion. The results demonstrate that insulin has a vital role in regulating fetal growth and metabolism in utero.