Clinical Study on Zhuanyaotang Granules for the Treatment of Degenerative Lumbar Spinal Stenosis / 中国中医药信息杂志

Objective To observe the clinical efficacy of Zhuanyaotang Granules for the treatment of degenerative lumbar spinal stenosis(DLSS).Methods Using a randomized double blind controlled design,104 DLSS patients were divided into an experimental group and a control group using a random number table method,with 52 patients in each group.The treatment group took oral Zhuanyaotang Granules,methylcobalamin tablets and celecoxib capsule simulants.The control group used Zhuanyaotang Granules simulants,methylcobalamin tablets and celecoxib capsules.The course of treatment was 3 weeks for both groups.The follow-ups were conducted at 1 month and 3 months after treatment.The intermittent claudication distance,visual analogue scale(VAS)score and JOA efficacy rating criteria for low back pain score were observed in both groups before treatment,1,2,3 weeks of treatment and 1 month after treatment and 3 months after treatment.Adverse reactions during treatment were recorded.Results There were 5 cases of detachment and 2 cases of exclusion in the experimental group,and 5 cases of detachment and 1 case of exclusion in the control group.Compared with before treatment,there were statistically significant differences in intermittent claudication distance,VAS score,and JOA score between the two groups of patients at various time points during treatment and follow-up(P<0.05);there was no statistically significant difference in intermittent claudication distance,VAS score,and JOA score between the experimental group and the control group before treatment and 1 and 2 weeks of treatment(P>0.05);compared with the two groups at 3 weeks of treatment and 1 and 3 months after treatment,the intermittent claudication distance and JOA score in the experimental group were lower than those in the control group(P<0.05);There was no significant difference in VAS score between the two groups and the control group after 3 weeks of treatment(P>0.05).There were 2 adverse reactions(4.4%)in the experimental group and 5 adverse reactions(10.8%)in the control group,without statistical significance(P>0.05).Conclusion Zhuanyaotang Granules can effectively relieve pain and improve lumbar function in patients with DLSS,which is more effective and safer than oral celecoxib capsules and methylcobalamin tablets.

Application of intelligent robot system in teaching cervical spine manipulation / 国际生物医学工程杂志

Objective:To explore the application effect of an intelligent teaching robot system of lifting manipulation in cervical spine manipulation teaching.Methods:60 doctors were randomly divided into an experimental group ( n = 30) and a control group ( n = 30). The control group was taught by a certified chief physician using a combination of "PowerPoint presentations, video demonstrations, and operation demonstrations" . Each part is 5 min. The experimental group was taught by the intelligent teaching robot system with a spinning technique. The teaching time is 15 min for both groups. At the end of the two teaching sessions, the two groups were trained five times under different BMIs and passed the system assessment. The qualified rates of pre-traction force, lifting and pulling force, maximum force, pre-traction time, lifting and pulling time, rotation amplitude, and pitch amplitude were compared between the two groups. Results:In normal, there was significant differences between the qualified rates of pre-traction force, lifting and pulling force, maximum force, pre-traction time, lifting and pulling time, rotation amplitude, and pitch amplitude in two groups (all P<0.05). For overweight people, there were significant differences in pre-traction force, pulling force, maximum force, and rotation amplitude (all P <0.05), while there were no significant differences in pre-traction time, pulling time, or pitching amplitude (all P >0.05). In obesity, there were significant differences in pre-traction force, lifting and pulling force, maximum force, and pitch amplitude (all P <0.05), but no significant differences in pre-traction time, lifting and pulling time, or rotation amplitude (all P >0.05). Conclusions:The proposed system can improve the pass rate of spinning manipulation, especially by effectively controlling the pre-traction force, pulling force, and maximum force.

Integrative Bioinformatics Analysis Reveals Potential Gene Biomarkers and Analysis of Function in Human Degenerative Disc Annulus Fibrosus Cells.

Low back pain is a major cause of disability worldwide. Although numerous potential biomarkers for the early diagnosis or treatment of intervertebral disc degeneration (IDD) have been identified subsequent to the development of molecular biology technologies, the mechanisms of IDD remain unknown. Published studies found the unbalance of anabolism and catabolism of annulus fibrosus (AF) played an important role in it. The present study was aimed to identify the potential targets and signaling pathways of IDD, through the combined analysis of differential expression and based on the Gene Expression Omnibus (GEO) dataset from NCBI. PPI Networks Analysis indicated that MMP2 and AGE-RAGE signaling pathway and estrogen signaling pathway may play important roles in initiation and development of IDD. This study forecasted the pathogenesis molecular mechanism of IDD and the potential prognostic and diagnostic biomarkers, but we need to make further molecular biological experiments to confirm our assumptions.

Finite Element Analysis on Manual Reduction with Inverse Shift for Pronation-Extorsion Trimalleolar Fracture / 医用生物力学

Objective To investigate the feasibility of manual reduction with inverse shift for pronation-extorsion trimalleolar fracture by applying the finite element method combined with clinical experience. Methods Based on CT images and anatomical features of bone, ligaments and other tissues as well as material parameters, a normal ankle model with completed muscles and bones for a Chinese young male was established. According to the related characteristics of the pronation-extorsion trimalleolar fractures, fracture was simulated in the proper position to make osteotomy model. The finite element model of pronation-extorsion trimalleolar fractures was thus established and then applied with mechanical loading to simulate manual reduction with inverse shift. Results The established finite element model of pronation-extorsion trimalleolar fractures was effectively restored by the displacement loading. Conclusions The finite element analysis on pronation-extorsion trimalleolar fractures by inverse shift maneuver could further prove the feasibility, effectiveness and scientificity of manual reduction with inverse shift based on clinical experience.

Kinematics Analysis of Cervical Rotation-Traction Manipulation Measured by a Motion Capture System.

OBJECTIVES: To analyze the kinematics of cervical rotation-traction manipulation (CRTM). METHODS: An experimental study measuring the kinematics of CRTM was conducted. A total of 18 healthy volunteers participated in the study. A single manipulator operated the CRTM for all subjects. Motion capture technology was adopted to track the trajectory during the CRTM operation. RESULTS: The manipulated side did not influence the cervical spine motion. The motion ranges obtained during CRTM were well below the active range of motion reported in the literature. The head rotation angle after thrusting was less than the angle of the rotary-position (P < 0.05). There was no significant difference in the head rotation angle between pretraction and upward-thrust. The thrust direction of CRTM was mainly upward. The thrust operation was of high-velocity and low-amplitude (thrust velocity: 203.06 ± 49.95 mm/s; thrust acceleration: 3836.27 ± 1262.28 mm/s2; thrust displacement: 3.25 ± 1.30 mm). CONCLUSIONS: CRTM has clear operation steps and repeatability that is suitable for clinical application.