肱二头肌额外头变异的探讨

目的:探讨肱二头肌额外头变异现象对人体科学、临床外科学、中医腧穴学等的影响与意义。方法:解剖42具男尸、22具女尸的双上肢肱二头肌,观察该肌肉的起点额外头发生率,测量额外头、长头的长度、额外头起点至肌肉止点之间的长度(A值)、额外头起点至长头起点的长度(B值)等数值,并分别比较A值与B值的比值、B值与肌肉全长(A+B值)比值之间的关系。结果:国人的肱二头肌变异主要是起始端出现第三个头(额外头),且全为男性,发生机率为9.52%,女性尚未发现有此变异;A/B值、B/(A+B)值均近似黄金分割率(0.618)。结论:肱二头肌额外头变异是以黄金分割的关系出现,符合该肌肉的力学工程学要求,以进一步加强肌肉的屈肘功能,属于进化发展的结果;臂部手术时需注意该额外头肌组织、血管及神经,避免因损伤而产生功能障碍。     

A comparative study of Thai massage and muscle energy technique for chronic neck pain: A single-blinded randomized clinical trial

BackgroundMyofascial pain syndrome (MPS) is the most common form of muscle disorders. Traditional Thai massage (TM) and muscle energy (ME) technique have been used to treat patients with MPS for long time but head-to-head comparisons of these interventions have not been established.AimThe aim of the current study was to compare the effects of TM and the ME technique on pain intensity (PI), pressure pain threshold (PPT), neck disability (ND), and neck flexion range of motion (NFROM) in patients with chronic neck pain associated with myofascial trigger points (MTrPs).DesignA randomized, single-blinded clinical trial.SettingDepartment of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University.PopulationForty-five patients with chronic neck pain associated with MTrPs were recruited.MethodsThe patients were randomly allocated to the TM, ME, or control groups, with each having eight treatment sessions over a period of two weeks. PI, PPT, ND, and NFROM were assessed before, immediately after the first treatment session, and one day after the last treatment session.ResultsBased on the results, both TM and the ME technique resulted in a significant improvement in all parameters (p < 0.05) compared to the control group. Additionally, no significant difference was observed between TM and the ME technique in all parameters.ConclusionsThe application of TM or the ME technique can be a practical alternative approach for the treatment of chronic neck pain associated with MTrPs.     

Life-threatening complications after microvascular decompression procedure: Lessons from a consecutive series of 596 patients

The microvascular decompression procedure (MVD) is widely utilized on patients with neurovascular compression syndromes, such as trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia, which have failed medical therapy. However, surgical complications are an ongoing problem. We retrospectively reviewed a total of 596 patients undergoing MVD in the Affiliated Hospital of Qingdao University from January 2008 to December 2018. Furthermore, we discussed the cases with life-threatening complications to determine the potential causes, aiming to achieve the goal of safer microvascular decompression. There were seven cases with life-threatening complications. Of those complications, one was cerebellar infarction with acute hydrocephalus, one was infarction of the cerebellum and the brain stem with acute hydrocephalus and serious intracranial infection, two were cerebellar haematoma, one was multiple haemorrhage with acute hydrocephalus, one was supratentorial subdural haematoma, and one was cerebellar swelling with acute hydrocephalus. After therapy, one patient died, one was in a persistent vegetative state, and five were discharged from the hospital upon recovery. In brief, MVD is a safe operation, and life-threatening complications accompanying MVD are rare, but require attention. The causes of some life-threatening complications are still not completely clear. Surgeons should continuously improve surgical techniques and perioperative care to reduce potential risks.     

Female athletes with ligament dominance exhibiting altered hip and ankle muscle co-contraction patterns compared to healthy individuals during single-leg landing

BackgroundAnterior cruciate ligament (ACL) injury is one of the most serious knee injuries and occurs frequently during exercise. Altered hip and ankle muscle co-contraction patterns may contribute to dynamic knee valgus and ACL injury mechanisms. Lack of dynamic control of ground reaction force (GRF) is known to be contributing factor for ACL injury by placing excessive force on passive structures. Muscle co-contraction is a dynamic mechanism for GRF absorption. Therefore, any alterations in co-contraction might be a risk factor for ACL injury. Ligament dominance is a term to define individuals who rely more on ACL ligament for GRF control.Research questionThis study aimed to compare the muscle co-contraction patterns of distal and proximal knee muscles during single leg landing in female athletes with and without ligament dominance.MethodsThis is a cross-sectional study. A total of 54 female athletes were assigned to the healthy (n = 27) and ligament dominance (n = 27) group based on their Tuck Jump test scores. The electromyography activity of the gluteus medius, adductor longus, tibialis anterior, peroneus longus, medial and lateral gastrocnemius was measured by an electromyography in drop down a 30-cm-high stair. A Multivariate Analysis of Variance (MANOVA) was used for statistical analysis (p ≤ 0.05).ResultsThe two groups demonstrated an overall significantly different muscle co-contraction patterns (P < 0.05). There was a decreased in co-contraction of proximal group and an increased co-contraction in the distal muscles in ligament dominant group.SignificanceThe findings have provided evidence to support the notion of neuromuscular imbalances in ligament dominance deficit. These findings can be useful for the coaches and experts to design preventive exercises and modify the current programs for the people affected by ligament dominance.     

Repeatability of quantitative MRI in patients with rheumatoid arthritis

IntroductionRheumatoid arthritis (RA) affects 1% of the population and is principally associated with joint inflammation. It is suggested however that muscle involvement may be one of the earliest clinical features of RA. It is therefore important that techniques exist to accurately assess muscle health in those with RA to enable successful treatment. This study assesses the inter-rater and intra-rater repeatability of Diffusion Tensor MRI (DTI), 2-Point Dixon fat fraction, and T2 relaxation of the thigh muscle in patients with RA using manual regions of interest (ROI).MethodsNineteen patients (10/19 males; mean age 59; range 18–85) diagnosed with RA had an MRI scan of their hamstrings and quadriceps muscles to obtain fat fraction (FF), mean diffusivity (MD), fractional anisotropy (FA), and T2 quantitative measurements. Two raters DB & MF independently contoured ROIs for each patient. DB repeated the ROI for the same 19 patients after a 6-month hiatus to assess intra-rater repeatability. Inter-rater and intra-rater repeatability for the ROI measurements were compared using Inter Class Correlation (ICC) and Bland–Altman plots.ResultsThere was excellent agreement for both inter-rater and intra-rater repeatability. ICC results ranged from 0.900 to 0.998 (P < 0.001), and intra-rater ICC results ranged from 0.977 to 0.999 (P < 0.001). Bland–Altman plots also showed excellent agreement.ConclusionsICC measurements and Bland–Altman plots showed excellent repeatability and agreement with no statistically significant differences when assessing the inter-rater and intra-rater repeatability of FF, MD, FA, and T2 relaxation of the thigh muscle using manual regions of interest in patients with RA.Implications for practiceManual ROI drawing does not introduce significant errors obtaining FF, MD, FA, and T2 MRI measurements in an RA population.     

microRNA expression profile in Smooth Muscle Cells isolated from thoracic aortic aneurysm samples

PurposeThoracic aortic aneurysm (TAA) is a cardiovascular disease characterized by increased aortic diameter, treated with surgery and endovascular therapy in order to avoid aortic dissection or rupture. The mechanism of TAA formation has not been thoroughly studied and many factors have been proposed to drive its progression; however strong focus is attributed to modification of smooth muscle cells (SMCs). Latest research indicates, that microRNAs (miRNAs) may play a significant role in TAA development – these are multifunctional molecules consisting of 19–24 nucleotides involved in regulation of the gene expression level related to many biological processes, i.e. cardiovascular disease pathophysiology, immunity or inflammation.Materials and methodsPrimary SMCs were isolated from aortic scraps of TAA patients and age- and sex-matched healthy controls. Purity of isolated SMCs was determined by flow cytometry using specific markers: α-SMA, CALP, MHC and VIM. Real-time polymerase chain reaction (RT-PCR) was conducted for miRNA analysis.ResultsWe established an isolation protocol and investigated the miRNA expression level in SMCs isolated from aneurysmal and non-aneurysmal aortic samples. We identified that let-7 g (0.71-fold, p = 0.01), miR-130a (0.40-fold, p = 0.04), and miR-221 (0.49-fold, p = 0.05) significantly differed between TAA patients and healthy controls.ConclusionsFurther studies are required to improve our understanding of the pathophysiology underlying TAA, which may aid the development of novel, targeted therapies. The pivotal role of miRNAs in the cardiovascular system provides a new perspective on the pathophysiology of thoracic aortic aneurysms.