Vacuum myofascial therapy device for non-specific neck pain. A single blind randomized clinical trial

ObjectivesThis study aimed to investigate the efficacy of a vacuum myofascial therapy device (VT) for improving pressure pain thresholds (PPTs), range of motion (ROM), neck pain-related disability, pain, and quality of life in patients with non-specific neck pain.MethodsA randomized controlled trial in which thirty-eight participants with non-specific neck pain (NP) were randomly assigned to either an experimental (VT) or a comparison physical therapy program (PTP) group. The VT group (n = 19) received five sessions of treatment with a vacuum myofascial therapy device while the PTP group (n = 19) received five sessions of massage, ultrasound therapy (US), and transcutaneous electric nerve stimulation (TENS) over two weeks. The outcome measures were the numerical pain rating scale (NPRS), range of motion, quality of life (SF-12), neck disability Index (NDI), and PPTs at the end of treatment and at one-month follow-up.ResultsAlthough both groups experienced improvements in pain, neck disability, range of motion, and pressure pain, these only were statistically significant in the VT group. At one-month follow-up, the VT group still showed improvements in pain, neck disability, and range of motion.DiscussionVacuum myofascial therapy applied with a device offers similar results to other vacuum-based techniques such as cupping therapy. Moreover, in this device the parameters are digitally controlled, which allows for the precise reproduction of treatment.     

多发性硬化诊断标准的进展与解读

多发性硬化是一种中枢神经系统脱髓鞘性疾病,临床特点是病灶播散广泛。本文复习了近30年来多发性硬化诊断标准的进展,并作解读。     

Comparison of total hip arthroplasty with minimally invasive SuperPath approach vs. conventional posterolateral approach in elderly patients: A one-year follow-up randomized controlled research

ObjectiveTo compare difference between SuperPath approach and conventional posterolateral approach in total hip arthroplasty (THA) in elderly patients.MethodsThe present prospective randomized controlled single blinded study enrolled a total of 96 elderly patients who received THA in our hospital during April 2015 to December 2018. All patients were randomly divided into the SuperPath group and the conventional group. General demographic characteristics and intraoperative data, as well as hospitalization time were recorded. Harris scores were used for measurement of hip function and visual analogue scale (VAS) was used for pain measurement. Serum levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and creatine phosphokinase (CK) were measured before and 24 h after surgery. Gait analysis was conducted by the method of footprints.ResultsThe mean surgical time was remarkably longer, the mean blood loss and incision length were significantly lower and the hospitalization time was also shorter in the SuperPath group compared with the conventional group. Both levels of CRP and CK were remarkably lower in the SuperPath group. At time points of 7 d and 1 mon after surgery, the VAS scores were significantly lower, and at 7 d, 1 mon and 3 mon the Harris scores were markedly higher in the SuperPath group compared with the conventional group. The step length and stride speed were significantly larger in the SuperPath group at 7 d and 1 mon after surgery than the conventional group. Joint dislocation was found in 2 cases of patients in the conventional group and no dislocation case was found in the SuperPath group. The angles of anteversion showed no significant difference, while the angles of abduction were significantly lower in the SuperPath group.ConclusionPatients with SuperPath approach had lower levels of CRP, ESR and CK, better hip function and less pain, as well as better gait condition than patients with conventional posterolateral approach in elderly patients.     

老年卒中后抑郁与血清同型半胱氨酸水平的相关性研究

目的 研究老年急性期脑梗死患者发生卒中后抑郁(post-stroke depression, PSD)与其血清同型半胱氨酸(serum homocysteine, Hcy)水平的相关性。方法 选177例住院的急性期缺血性卒中的老年患者,并根据中国精神障碍分类与诊断标准第3版(CCMD-3)[1]中抑郁发作的诊断标准将病例分成PSD组96例和非PSD组(对照组)81例。对所有入选患者在入院的次日进行血清同型半胱氨酸水平测定,比较两组患者血清Hcy的水平,并与PSD进行相关分析。结果 卒中抑郁组与卒中后非抑郁组血清同型半胱氨酸水平分别(21.44±7.35)μmol/L、(10.69±3.32)μmol/L,两组比较差异有统计学意义(P<0.01)。在卒中后抑郁组,血清同型半胱氨酸水平与抑郁程度(r=0.428,P<0.01)相关。结论 卒中急性期血清Hcy水平与卒中急性期抑郁有相关性。     

慢性乙肝合并肺结核患者外周血单个核细胞HBV pgRNA的表达与免疫功能的相关性

目的研究慢性乙肝(CHB)合并肺结核患者外周血单个核细胞(PBMCs)HBV前基因组RNA(pgRNA)的表达及其与免疫功能的相关性。方法将2018年3月-2019年3月我院结核门诊新确诊的40例CHB合并肺结核患者随机分为两组,对照组(n=20)采用2HRZE/4HR方案进行常规抗结核治疗,治疗组(n=20)在此基础上采用拉米夫定预防性抗病毒,连续治疗6个月。比较两组患者PBMCs中HBV DNA、HBV RNA表达水平,以及CD3⁺、CD4⁺、CD8⁺T细胞水平,分析HBV DNA、HBV RNA与CD3⁺、CD4⁺、CD8⁺T细胞相关性。结果治疗后2个月,两组PBMCs中HBV DNA、HBV RNA水平较治疗前显著升高,治疗组治疗后6个月PBMCs中HBV DNA、HBV RNA水平较治疗后2个月显著下降,与治疗前比较均差异无显著性(P>0.05),且均显著低于对照组(P<0.05)。治疗后2个月,两组免疫功能指标均较治疗前有不同程度下降,治疗后6个月,免疫功能指标均较治疗前、治疗后2个月显著下降(P<0.05);治疗组治疗后2、6个月CD3⁺、CD4⁺、CD8⁺T、IFN-γ均显著高于对照组(P<0.05)。PBMCs中HBV DNA、HBV RNA与CD3⁺、IFN-γ呈显著负相关(P<0.05)。结论预防性抗病毒治疗可有效降低PBMCs中HBV pgRNA表达,抑制抗结核治疗过程中CHB再激活,改善机体免疫功能。     

涎腺混合瘤与Warthin瘤超声造影对比研究

目的总结涎腺混合瘤与Warthin瘤的超声造影特征,分析二者的差异。方法回顾性分析我院经手术病理证实的17个涎腺混合瘤和16个Warthin瘤的超声造影特征。结果混合瘤超声造影表现以同进(76.5%)、向心性(64.7%)、不均匀性(76.5%)、低增强(70.6%)为主,增强后边界多清晰(88.2%),大部分可见增强环(94.1%),增强后肿块范围多不增大(88.2%)。Warthin瘤超声造影表现以快进(50.0%)、非向心性(87.5%)、不均匀性(62.5%)、高增强(56.3%)多见,大部分增强后边界清晰、可见增强环和增强后肿块范围不增大(均为93.8%)。涎腺混合瘤与Warthin瘤的增强方向和增强强度比较差异均有统计学意义(均P<0.05)。以非向心性增强诊断Warthin瘤的敏感性、特异性和准确率分别为87.5%、64.7%、75.8%;以高增强诊断Warthin瘤的敏感性、特异性和准确率分别为56.3%、100%、78.8%。以向心性增强诊断涎腺混合瘤的敏感性、特异性和准确率分别为64.7%、87.5%、75.8%;以低增强诊断涎腺混合瘤的敏感性、特异性和准确率分别为70.6%、87.5%、84.9%。结论涎腺混合瘤与Warthin瘤的超声造影表现具有一定的特征性,增强方向和增强强度指标有助于二者的鉴别诊断。     

白细胞介素-1基因多态性及幽门螺旋杆菌感染与健康中年人群动脉粥样硬化程度的相关性

目的探讨白细胞介素（IL）-1基因IL-1β-511、IL-1 RN VNTR位点多态性在幽门螺旋杆菌（HP）感染加重健康中年人群动脉粥样硬化程度中的作用。方法以聚合酶链反应限制性片段长度多态性分析法检测227名健康中年人IL-1β-511、IL-1 RN VNTR位点多态性,ELISA法检测HP IgG及CagA、VacA抗体,通过臂踝指数（ABI）评估受试者动脉粥样硬化程度。结果IL-1β-511多态性分别为CT（64.8%）、TT（22.3%）,IL-1RN VNTR片段倍数多态性分别为IL-1RN*1（68.7%）、2倍重复（IL-1RN*2）（29.2%）。不同IL-1基因多态性受试者的ABI差异无统计学意义（P>0.05）。HP阳性受试者ABI明显低于阴性者（P < 0.01）。校正年龄、性别、高血压、糖尿病、抽烟状态、BMI、高脂血症及IL-1基因多态性后,ABI在HP阴性组及阳性组间差异无统计学意义（P>0.05）,HP CagA抗体阳性是低ABI的危险因素（P < 0.01）。结论HP感染,尤其是CagA抗体阳性HP感染,可能是中国南方汉族中年人群动脉粥样硬化的一个危险因素,与2种IL-1基因位点多态性无明显相关性。     

加味桂枝甘草龙骨牡蛎汤治疗心胆气虚型失眠疗效观察

目的观察加味桂枝甘草龙骨牡蛎汤治疗心胆气虚型失眠的疗效。方法选取2017年10月—2019年4月闵行区中心医院收治的84例辨证符合心胆气虚型的失眠症患者作为研究对象,采用随机数字表法将其随机分为治疗组42例和对照组42例。对照组患者采用艾司唑仑片进行治疗,治疗组患者在此基础上采用加味桂枝甘草龙骨牡蛎汤进行治疗。比较两组患者治疗前后匹兹堡睡眠质量指数(PSQI)、睡眠状态自评量表(SRSS)评分、炎症因子水平以及治疗后的临床疗效。结果治疗后,治疗组心胆气虚型失眠患者PSQI各项评分及SRSS评分降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗组心胆气虚型失眠患者的睡眠改善总有效率88.23%优于对照组64.71%,差异有统计学意义(P<0.05)。治疗后,治疗组和对照组心胆气虚型失眠患者TNF-α和IL-6水平均显著降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。结论加味桂枝甘草龙骨牡蛎汤可降低心胆气虚型失眠患者炎症反应,改善其睡眠质量,疗效确切。     

数字图像相关法在光固化复合树脂收缩变形测量中的应用

目的:探讨数字图像相关法在研究光固化复合树脂光照收缩变形产生和演化中的价值.方法:6颗新鲜、完整的离体磨牙,随机分为2组,邻面片切平整,制备2.0 mm×2.0 mm×2.0 mm的邻(牙合)面洞形,洞面酸蚀冲洗,涂黏结剂光照,第1组充填3M Z350纳米树脂,第2组充填3M Valux Plus(V.P)通用型树脂.邻面快速制造散斑,固定于微型试验夹中,光照40s,同步数码相机采集表面散斑序列图,以数字图像分析软件计算序列图各像素点水平方向(x)和垂直方向(y)位移、应变,采用SPSS 12.01软件包统计线性收缩率,并对20 s时游离面各点位移进行配对t检验.结果:序列图经处理后,相关系数R均＞0.98.树脂光照40 s内表现为各向异性收缩,2组材料x方向线收缩率分别为0.439％～0.75％ 、0.526％～0.834％,y方向线收缩率分别为0.253％～1.34％、0.355％～1.51％.20 s时,游离面Z350组在x和y方向变形均较V.P组小(P＜0.05).结论:应用数字图像相关法研究光固化复合树脂光照过程中的聚合收缩,能有效动态记录、计算全域收缩变形量,为提高临床使用效果提供依据.     

LED固化灯光照强度对光固化复合树脂聚合收缩的影响

目的采用数字图像相关法动态研究LED光固化灯不同光照强度对光固化复合树脂聚合收缩的影响。方法收集12颗大小接近的新鲜离体磨牙,随机分为3组,制备大小为2.0 mm×2.0 mm×2.0mm的邻(?)面洞形,洞面酸蚀冲洗后涂粘接剂光照10 s,充填3M Z350纳米复合树脂,邻面快速制造散斑,LED固化灯垂直(?)面光照40s,3组光照强度分别为300 mW/cm~2、500 mW/cm~2和800 mW/cm~2,数码相机同步实时采集光照过程中试件表面散斑的变化序列图像,用数字图像相关法计算获得各序列图上逐个像素点水平方向(x)和垂直方向(y)位移,统计线性收缩率,描绘各像素点的时域变化曲线,并用SPSS 12.01统计软件包进行方差分析和配对t检验。结果 3种光照强度下树脂x方向线收缩率分别为0.081%～0.486%、0.004%～0.316%和0.063%～0.560%,y方向线收缩率分别为0.088%～0.981%、0.003%～0.77%和0.157%～1.252%,3组之间差异有统计学意义(P<0.05);3组第20 s树脂游离面收缩x方向位移差异无统计学意义,y方向位移差异有统计学意义。结论 LED光固化灯500 mW/cm~2光照时引起的树脂聚合收缩最小。