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1.
目的:观察推拿手法联合腰椎牵引治疗腰椎间盘突出症急性发作期患者的效果。方法:选取90例腰椎间盘突出症急性发作期患者为研究对象,按照随机数字表法分为对照组和观察组各45例。对照组采用腰椎牵引治疗,观察组在对照组基础上联合推拿治疗,两组均治疗4周。比较两组治疗前后视觉模拟评分法(VAS)评分、腰椎功能[日本骨科协会评估治疗分数(JOA)]评分、腰椎活动度、炎性因子[白细胞介素-1β(IL-1β)、IL-6、肿瘤坏死因子-α(TNF-α)]水平和治疗总有效率。结果:治疗后,两组VAS评分均低于治疗前,且观察组低于对照组,两组JOA评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组腰椎前屈、后伸、左弯、右弯角度均大于治疗前,且观察组大于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为95.56%,高于对照组的82.22%,差异有统计学意义(P<0.05);治疗后,两组IL-1β、TNF-α、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:推拿手法联合腰椎牵引治疗腰椎间盘突出症急性发作期患者可提高治疗总有效率、JOA评分,改善腰椎活动度,降低疼痛评分和炎性因子水平,优于单纯腰椎牵引治疗效果。 相似文献
2.
目的分析肌骨超声在肩周炎诊断以及引导注射治疗方面的应用价值。方法76例肩周炎患者,按照随机数字表法分为参照组及观察组,每组38例。参照组患者予以小针刀治疗,观察组患者予以针刀松解治疗联合肌骨超声引导下注射治疗。对比两组治疗前后肩关节功能评分及视觉模拟评分法(VAS)评分。结果参照组治疗前肌力评分为(15.56±2.49)分、关节活动度评分为(15.21±3.08)分、日常生活能力评分为(8.51±3.42)分、疼痛评分为(5.67±2.95)分,治疗后分别为(18.22±2.51)、(32.14±2.67)、(15.84±2.58)、(10.45±3.52)分;观察组治疗前肌力评分为(15.48±2.75)分、关节活动度评分为(15.43±3.12)分、日常生活能力评分为(8.47±3.38)分、疼痛评分为(5.56±2.87)分,治疗后分别为(20.57±2.81)、(36.78±2.49)、(17.37±2.62)、(13.47±3.39)分。治疗前,两组肌力、关节活动度、日常生活能力及疼痛评分比较差异均无统计学意义(P>0.05);治疗后,观察组肌力、关节活动度、日常生活能力及疼痛评分均高于参照组,差异有统计学意义(P<0.05)。治疗前,两组VAS评分比较差异无统计学意义(P>0.05);治疗后4、12周,观察组VAS评分分别为(2.59±0.59)、(2.21±0.52)分,均低于参照组的(3.45±0.63)、(2.99±0.52)分,差异有统计学意义(P<0.05)。结论肩周炎患者应用肌骨超声进行病情诊断及引导注射治疗可促进疼痛缓解并可显著改善其肩关节功能,具有临床采纳和应用价值。 相似文献
3.
目的 研究葡萄糖在目标范围内时间(TIR)与2型糖尿病患者心脏自主神经病变(DCAN)的相关性。方法 选取2019年11月至2021年3月在安徽医科大学附属合肥医院内分泌科住院的343例2型糖尿病患者,根据Ewing试验结果将患者分为糖尿病心脏自主神经病变组(DCAN组,n=201)与无糖尿病心脏自主神经病变组(NDCAN组,n=142),比较两组患者临床基本资料及多种指标的差异,采用多因素logistic回归分析DCAN患者的危险因素,通过受试者工作特征(ROC)曲线分析影响因素对DCAN的预测价值。结果 DCAN组患者年龄、糖尿病病程、尿白蛋白肌酐比、平均血糖波动幅度(MAGE)、血糖标准差、血糖变异系数、平均血糖水平指标均较NDCAN组患者高,TIR指标较NDCAN组患者低,两组差异有统计学意义(P<0.05)。logistic回归分析显示糖尿病病程、MAGE是DCAN的危险因素(优势比分别为1.055,1.319),TIR 是其保护因素(优势比0.963) (P<0.05)。ROC曲线显示,糖尿病病程预测DCAN的曲线下面积(AUC)为0.643, 最佳诊断值为4.50年,敏感度和特异度分别为72.60%、53.50%,MAGE预测DCAN的AUC为0.630,最佳诊断值为4.46 mmol/L,敏感度和特异度分别为50.70%、69.00%,TIR预测DCAN的AUC为0.684,最佳诊断值为76.48%,敏感度和特异度分别为71.10%、59.20% (P<0.05)。结论 TIR与2型糖尿病患者DCAN发病密切相关,是其保护因素,TIR数据的获取有助于临床上DCAN的风险评估。 相似文献
4.
Wei Zhang Yuan-Yuan Li Qing-Hua Shang Lin Qi Mi-Mi Sun Gang Chen Yong An Jing-Xin Li Wang-Ping Jia Zhong-An Sun Hui-Bin Xu Qing-Mei Gao Li Tang Xiao-Wen Wang Ji-Yuan Zhang Yi-Ming Mu Fu-Sheng Wang 《Annals of hepatology》2022,27(6):100745
Introduction and ObjectivesHepatitis B surface antigen (HBsAg) clearance, indicating functional cure or resolved chronic hepatitis B (CHB), remains difficult to achieve via nucleos(t)ide analogue monotherapy. We investigated whether metformin add-on therapy could help achieve this goal in entecavir-treated patients with hepatitis B e antigen (HBeAg)-negative CHB.Patients and MethodsPatients with HBeAg-negative CHB who met eligibility criteria (entecavir treatment for > 12 months, HBsAg < 1000 IU/mL) were randomly assigned (1:1) to receive 24 weeks of either metformin (1000 mg, oral, once a day) or placebo (oral, once a day) add-on therapy. The group allocation was blinded for both patients and investigators. Efficacy and safety analyses were based on the intention-to-treat set. The primary outcome, serum HBsAg level (IU/mL) at weeks 24 and 36, was analysed using mixed models.ResultsSixty eligible patients were randomly assigned to the metformin (n = 29) and placebo (n = 31) groups. There was no substantial between-group difference in the HBsAg level at week 24 (adjusted mean difference 0.05, 95% confidence interval -0.04 to 0.13, p = 0.278) or week 36 (0.06, -0.03 to 0.15, p = 0.187), and no significant effect of group-by-time interaction on the HBsAg level throughout the trial (p = 0.814). The occurrence of total adverse events between the two groups was comparable (9 [31.0%] of 29 vs. 5 [16.1%] of 31, p = 0.227) and no patient experienced serious adverse events during the study.ConclusionAlthough it was safe, metformin add-on therapy did not accelerate HBsAg clearance in entecavir-treated patients with HBeAg-negative CHB. 相似文献
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7.
目的 研究山楂核干馏液抗炎和抗菌的主要物质基础。方法 使用干馏釜制备山楂核干馏液;通过大孔吸附树脂柱色谱对干馏液进行分离;基于气相色谱-质谱法对山楂核干馏液进行分析;以脂多糖诱导的小鼠单核巨噬细胞RAW264.7生成一氧化氮模型评价山楂核干馏液的抗炎作用,采用微稀释法评估其体外抑制白色念珠菌生长活性,采用灰色关联度分析法建立其谱效关系,以评估其抗炎和抗菌活性,并筛选主要活性化合物。结果 山楂核干馏液及其4个亚流分具有明显的抗炎作用和抑制白色念珠菌生长作用,其中Fr.B的抗炎和抗菌作用均较强。从山楂核干馏液4个流分的色谱图中确定12个共有峰,其中发挥主要抗炎作用的成分为4、6、2、9号峰,质谱分析鉴定4个峰分别对应2,6-二甲氧基-4-甲基苯酚、1,2,5-三甲氧基-3-甲基苯、2,6-二甲氧基苯酚和乙酰丁香酮;发挥主要抗菌作用的成分为4、2、9、11号峰,质谱分析鉴定这4个峰分别对应2,6-二甲氧基-4-甲基苯酚、2,6-二甲氧基苯酚、乙酰丁香酮和二氢芥子醇。结论 山楂核干馏液具有较好的抑制脂多糖诱导的RAW264.7细胞生成一氧化氮的作用,同时对白色念珠菌的生长具有显著的抑制作用,明确了山楂核干馏液中2,6-二甲氧基-4-甲基苯酚、1,2,5-三甲氧基-3-甲基苯、2,6-二甲氧基苯酚和乙酰丁香酮4个成分对其抗炎作用贡献最大,2,6-二甲氧基-4-甲基苯酚、2,6-二甲氧基苯酚、乙酰丁香酮和二氢芥子醇对其抗菌作用贡献最大。研究结果为山楂核资源的开发利用及相关产品质量标准的制定提供参考。 相似文献
8.
目的:利用蒙特卡罗模拟探究空气间隙对点扫描质子治疗的剂量影响。方法:利用通用蒙特卡罗程序Geant4平台构建使用射程移位器的治疗头末端的点扫描质子束流模型,并进行验证。模拟计算不同能量、不同射程移位器、不同束斑尺寸、不同束斑数目在不同空气间隙条件下的质子束流在水模体中的剂量沉积,并通过获得的积分深度剂量生成剂量修正因子对剂量的差异进行比较。结果:不同空气间隙会造成剂量损失,随空气间隙增大而增大,随水模体中深度增加而减小。对于能量更高的射束和使用水等效厚度更薄的射程移位器,剂量损失越大。束斑尺寸改变和束斑数目增加较少时造成的剂量损失与同条件下单一束流无显著差别。结论:当使用射程移位器、肿瘤位置较浅、空气间隙较大时,建议建立剂量修正因子数据库应用于治疗计划系统对剂量进行修正。 相似文献
9.
《European journal of medical genetics》2022,65(7):104534
The clinical features associated with WAC haploinsufficiency include recognizable dysmorphic facial features, variable degrees of developmental delay and intellectual disability that were recently delineated as DeSanto-Shinawi syndrome (OMIM 616708). We describe a patient with DeSanto-Shinawi syndrome caused by a novel frameshift variant in WAC gene (NM_016628.4(WAC):c.1689del (p.Phe563Leufs*6)). As noted in cases previously reported, our patient phenotype included facial dysmorphism, intellectual disability, behavioral problems, feeding difficulties, hirsutism, constipation and astigmatism. She also had limited range of motion of joints since birth and Juvenile Idiopathic Arthritis diagnosed at eleven years old. Although in the last years some additional features were reported in DeSanto-Shinawi syndrome, joint manifestations have not been previously described. As limited range of motion of joints was reported since birth with no correlation with arthritis onset, it could be a new clinical feature. Polyarthritis in this patient can be only a coincidence, since there is a first degree relative with psoriasis, or might be related to WAC mutation. Indeed, WAC encodes a protein that plays a vital role in autophagy. It has already been demonstrated that WAC haploinsufficiency leads to increased autophagy and, according to different authors, increased autophagy may display a pathogenic role in several autoimmune disorders such as Rheumatoid Arthritis and Juvenile Idiopathic Arthritis. Thus, WAC haploinsufficiency may have contributed to autoimmune disorder in this patient. 相似文献
10.
Jennifer A Janowski Deanna M L Phelan-Smith Maria N Kroat Brady Kelsey L Michels Alexandra H Timm Nicole M Boucher Kedron D Casteen David Village Mark D Sleeper 《International Journal of Sports Physical Therapy》2021,16(2):418
BackgroundThere is convincing evidence that dancers suffer injuries to the triceps surae musculature. Research on the immediate effects of dry needling (DN) is limited, and it is important to understand the acute effects of this treatment prior to performance.PurposeThe purpose of this pilot study was to assess the immediate effects of DN on myofascial trigger points in terms of skin surface temperature, pain, active and passive range of motion, and torque production in the triceps surae of ballet dancers.Study DesignRandomized, double-blinded pilot studyMethodsProfessional ballet dancers that fit inclusion and exclusion criteria (n=11) were randomly assigned to an experimental or control group. The dancers had three pre-determined standard point (SP) measurement spots that were used as a baseline for surface temperature comparisons. The dancers were also palpated for trigger point (TP) spots. Both SP and TP spots were marked for future measurements. The experimental group received DN, while the control group received sham DN (SHAM) to their bilateral calves at the TP spots. Immediately prior to and following treatment, both DN and SHAM groups were tested for skin surface temperature, pain, range of motion, and plantar flexion torque by blinded assessors. Paired t-tests and independent t-tests were performed to examine for differences between groups.ResultsThe surface temperature for the TP was higher than the SP measurements prior to intervention (Right calf p= .014; Left calf p= .031). There were no significant changes in VAS scale reported pain and ROM. The plantar flexion torque measurements showed an increase in the DN group of the left calf at the angular velocity of 60 degrees/sec.ConclusionThis was a unique pilot study examining the acute effects of DN on professional ballet dancers. The results were limited due to low sample size. However, the methodology for this study and surface temperature results invites future research.Level of evidenceLevel 1b 相似文献