Progress of improvement of pain and joint function of knee osteoarthritis treated with thunder-fire moxibustion in the last five years

Objective:To summarize the clinical research of improvement of pain and joint function of knee osteoarthritis treated with thunder-fire moxibustion in the last five years,in order to provide more objective and scientific theoretical basis for the clinical use of thunderfire moxibustion in the treatment of knee osteoarthritis.Methods:By using"thunder-fire moxibustion"and"knee osteoarthritis"as keywords,the clinical literature on the treatment of knee osteoarthritis mainly by thunder-fire moxibustion in the past 5 years in PubMed,CNKI,WF and VIP were analyzed.Results:Thunderfire moxibustion and its compound therapy,including internal use of traditional Chinese medicine,external use of traditional Chinese medicine,drug injection,physical therapy,acupuncture,heat sensitive moxibustion,pricking collaterals,acupoint application and ozone,could relieve pain,improve joint function,improve joint activity,improve patients daily life ability and have less adverse reactions.Conclusion:Thunder-fire moxibustion was a safe,non-invasive and effective treatment for knee osteoarthritis.However,further research is necessary due to the non-rigidity of the current clinical trial design.

Meta-analysis and trial sequential analysis on blood uric acid and joint function in gouty arthritis treated with fire needling therapy in comparison with western medication

Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire needling therapy on gouty arthritis so as to provide the medical evidences of the extensive application of this therapy in treatment of gouty arthritis.Methods:The relevant clinical trials of fire needling therapy for treatment of gouty arthritis were searched from China National knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Science and Technology Journal Database,American Medical Online,Dutch Medical Literature Database and International Evidence-Based Medical library.Using Review Manager 5.3 software,the quality of the included trials was assessed and meta-analysis was performed.With TSA v0.9 software,the trial sequential analysis was conduced on the appropriate outcomes.Results:A total of 10 trials were included with 775 patients involved.The analysis results showed that compared with the western medication,the total effective rate(RR=1.14’95%CI [1.09,1.20]),the curative rate(RR=1.59’95%CI [1.33,1.89]),the reduced VAS score(MD=-1.44’ 95%CI [-1.93,-0.951]) and the reduced incidence of adverse reaction(RR=0.27’ 95% CI [0.09,0.76]) of the fire needling therapy were different significantly(all P <0.05).Regarding the reduction of blood uric acid(MD=-40.47’ 95%CI [-80.21,-0.72]) and the score of symptoms and physical signs(MD=-1.38’95% CI [-3.71,0.95]),the effect of fire needling therapy was similar to that of western medication group(both P≥0.05).The trial sequential analysis suggested that the result was reliable,in which,the total effective rate of fire needling therapy was much higher than the western medication.But,it was potentially a false-positive finding,in which,fire needling therapy was much more advantageous at reducing blood uric acid as compared with the western medication.Conclusion:Based on the analytic results,it can be determined that fire needling therapy,as an effective approach to the treatment of gouty arthritis,has a certain advantage as compared with western medication.Given the low overall quality of trials,it still needs high-quality clinical trial to verify the findings of this study results.

Influence of stuck-needle technique on joint function and related inflammatory markers in patients with knee osteoarthritis:A randomized controlled trial

Objective:To observe the differences of clinical effect and influence on joint function and inflammatory markers in joint fluid between stuck-needle technique and regular acupuncture in patients with knee osteoarthritis.Methods:Seventy-two patients with knee osteoarthritis were randomly divided into a stuck-needle technique group and a regular acupuncture group,with 36 cases in each one.The selection of acupoints,retaining time of needles,and treatment course were all the same in both groups.The visual analog scale(VAS)score,Lequesne index score,and the content of related inflammatory indexes in joint fluid before and after treatment were observed,and the therapeutic effect were evaluated.Results:After treatment,the VAS scores,Lequesne index scores,interleukin-1 beta(IL-1β),and the tumor necrosis factor a(TNF-α)of the two groups were all lower than those before treatment(all P<0.05).After treatment,the VAS scores,Lequesne index scores,IL-1β,and TNF-αof the stuck-needle technique group were all lower than those of the regular acupuncture group(all P<0.05).The total effective rate of the stuck-needle technique group was 96.97%(32/33),higher than 93.75%(30/32)of the regular acupuncture group(P<0.05).Conclusion:Stuck-needle technique can effectively relieve the pain and improve the joint functions,being more effective than regular acupuncture for the treatment of knee osteoarthritis.

Effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries

BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe.

Study on the Effect of Repetitive Peripheral Magnetic Stimulation Combined with Conventional Rehabilitation Measures on Shoulder Dysfunction in Early Stroke

Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.

Joint probability density function of the stochastic responses of nonlinear structures

The joint probability density fimction （PDF） of different structural responses is a very important topic in the stochastic response analysis of nonlinear structures. In this paper, the probability density evolution method, which is successfully developed to capture the instantaneous PDF of an arbitrary single response of interest, is extended to evaluate the joint PDF of any two responses. A two-dimensional partial differential equation in terms of the joint PDF is established. The strategy of selecting representative points via the number theoretical method and sieved by a hyper-ellipsoid is outlined. A two-dimensional difference scheme is developed. The free vibration of an SDOF system is examined to verify the proposed method, and a flame structure exhibiting hysteresis subjected to stochastic ground motion is investigated. It is pointed out that the correlation of different responses results from the fact that randomness of different responses comes from the same set of basic random parameters involved. In other words, the essence of the probabilistic correlation is a physical correlation.

Stepwise joint inversion of surface wave dispersion,Rayleigh wave ZH ratio,and receiver function data for 1D crustal shear wave velocity structure

Accurate determination of seismic velocity of the crust is important for understanding regional tectonics and crustal evolution of the Earth. We propose a stepwise joint linearized inversion method using surface wave dispersion, Rayleigh wave ZH ratio （i.e., ellipticity）, and receiver function data to better resolve 1D crustal shear wave velocity （Vs） structure. Surface wave dispersion and Rayleigh wave ZH ratio data are more sensitive to absolute variations of shear wave speed at depths, but their sensi- tivity kernels to shear wave speeds are different and complimentary. However, receiver function data are more sensitive to sharp velocity contrast （e.g., due to the existence of crustal interfaces） and Vp/Vs ratios. The stepwise inversion method takes advantages of the complementary sensitivities of each dataset to better constrain the Vs model in the crust. We firstly invert surface wave dispersion and ZH ratio data to obtain a 1D smooth absolute vs model and then incorporate receiver function data in the joint inver- sion to obtain a finer Vs model with better constraints on interface structures. Through synthetic tests, Monte Carlo error analyses, and application to real data, we demonstrate that the proposed joint inversion method can resolve robust crustal Vs structures and with little initial model dependency.

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

止血带在导航系统下行全膝关节置换的应用时机选择:一项单中心、回顾性分析

背景:传统全膝关节置换过程中应用止血带的时机已有明确报道,随着关节相关技术不断精进,导航系统下全膝关节置换应用止血带的时机却鲜有报道。目的:评估采用全程与半程止血带对Brainlab导航系统下行全膝关节置换疗效的影响。方法:回顾性分析2022年1-12月在河北省沧州中西医结合医院行导航系统下全膝关节置换患者的资料,选择符合条件的145例患者进行分析,按松开止血带时机分为全程组(n=71)和半程组(n=74)。收集患者一般资料、围术期情况、术后膝关节周围肿胀情况、下肢深静脉血栓发生情况、目测类比评分、美国特种外科医院膝关节评分和关节遗忘评分,评估膝关节功能并进行比较。结果与结论:①与半程组相比,全程组患者的手术时间更短、下肢深静脉血栓发生率更高、术后膝关节肿胀情况更重(P<0.001,P=0.027,P<0.001),术中出血量更少(P<0.001),但隐匿性失血量更多(P<0.001),且差异有显著性意义;②术后1周时,全程组目测类比评分高于半程组,差异有显著性意义(P<0.001);③术后3个月、6个月、1年两组关节遗忘评分相比,差异均无显著性意义(P>0.05);④提示采用导航系统行全膝关节置换的患者中,半程使用止血带隐匿性失血量少、术后患肢肿胀程度及下肢深静脉血栓发生率低,膝关节功能恢复更快。

运动疗法对前交叉韧带重建后康复疗效影响的网状Meta分析

目的:运动干预被认为是前交叉韧带重建后康复的基础。然而,关于何种运动疗法在改善前交叉韧带重建后患者膝关节肌肉力量和功能方面更有效,目前仍未得出明确结论。为此,文章采用网状Meta分析方法,比较运动疗法治疗前交叉韧带重建后的疗效,为选择最佳运动疗法提供循证医学依据。方法:计算机检索PubMed,Web of Science,Embase,The Cochrane Library及EBSCO数据库运动疗法治疗前交叉韧带重建后的随机对照试验,检索时限均从建库至2023-11-20。结局指标包括股四头肌肌力、腘绳肌肌力、膝关节功能评分3个连续性变量。运用EndNote X9.1软件筛选文献。采用Cochrane风险偏倚评估工具对纳入的文献进行质量评价,根据GRADE评分对文章结果的证据强度进行评级,采用Stata 16.0进行网状Meta分析。结果:①共纳入36项随机对照试验,包括1179例前交叉韧带重建后患者,纳入文献整体质量中等;涉及9种运动疗法:等速训练、交叉训练、离心训练、水中康复、血流限制训练、运动控制训练、增强式训练、全身振动训练和综合训练;对照措施为常规康复训练。②网状Meta分析结果显示:与常规康复训练相比,离心训练(SMD=2.08,95%CI:0.56-3.60,P=0.007)对前交叉韧带重建后患者股四头肌肌力的改善效果最佳,其次是综合训练(SMD=1.69,95%CI:0.11-3.27,P=0.249)和全身振动训练(SMD=0.81,95%CI:0.11-1.51,P=0.042);在提升患者腘绳肌肌力方面,综合训练(SMD=2.08,95%CI:0.30-3.86,P=0.022)效果最佳,其次是增强式训练(SMD=1.51,95%CI:0.18-2.84,P=0.026)和等速训练(SMD=1.37,95%CI:0.06-2.67,P=0.039);综合训练(SMD=4.60,95%CI:2.40-6.80,P<0.001)改善膝关节功能评分最有效,其次是离心训练(SMD=1.75,95%CI:0.24-3.25,P=0.023)和水中康复(SMD=1.65,95%CI:0.07-3.24,P=0.041)。结论:低到中等强度的临床证据证实,在改善前交叉韧带重建后患者膝关节肌肉力量和功能方面,综合训练可能是最有效的运动疗法,其次是离心训练、增强式训练、等速训练、全身振动训练、水中康复。未来仍需更多高质量的临床随机对照试验来验证结论的可靠性。

踝关节骨折术后踝穴冠状位角度波动与关节功能恢复的关系

背景:踝关节骨折术后的踝穴形态指标会出现相应变化,而其中踝穴冠状位角度变化与踝关节的功能恢复之间存在一定的关联,既往研究大多探讨患者术后踝穴高度恢复,故研究踝关节骨折术后踝穴冠状位角度的波动与关节功能恢复的相关性具有一定参考意义。目的:探讨踝关节骨折术后踝穴冠状位角度变化对关节功能恢复的影响。方法:纳入进行手术治疗的86例踝关节骨折患者为研究对象,根据末次随访美国骨科足踝外科协会踝-后足评分结果分为优良组(n=45)和可差组(n=41),比较两组患者的一般资料。根据踝关节的踝穴位及侧位X射线片对比术后患者患侧和健侧的踝穴形态指标:包括踝穴宽度和深度、冠状位角度及矢状位角度,以及上述指标患侧和健侧之间的差值,并进一步进行组内比较分析。构建联合模型,利用Cox回归分析评估冠状位角度波动与关节功能恢复情况的关系。利用最小绝对收缩选择算子回归法和多因素Logistic回归分析影响患者关节功能恢复的危险因素。按踝穴冠状位角度从低到高等分为5分位数组(Q1-Q5),比较5组患者的临床资料特征,并采用多因素Logistic回归分析踝穴冠状位角度变化与关节功能恢复不良风险的相关性,建立限制性立方样条Logistic回归模型分析其剂量-反应关系。建立回归方程y=1-1/(1+e^(-z))预测模型并进行验证。结果与结论:①患者患侧的踝穴宽度和深度、冠状位角度及矢状位角度均显著大于健侧(P均<0.05);且与优良组患者相比,可差组患者踝穴宽度差值、深度差值、冠状位角度差值及矢状位角度差值均更大(P<0.05);②联合模型显示无论冠状位角度是否在正常范围内,冠状位角度每纵向增加1˚,关节功能恢复不良的风险增加3%;③最小绝对收缩选择算子回归和多因素Logistics回归分析显示,调整潜在混杂因素后发现年龄过大、早期功能锻炼缺乏、无跟骨牵引、内固定物未取出、术后并发症、踝冠状位角度增大均为影响患者关节功能恢复的独立危险因素(P<0.05);④术后3个月内的冠状位角度与关节功能恢复效果不良风险存在独立相关性(OR=1.57,95%CI:1.38-1.76,P=0.002),且术后各时间段冠状位角度从低到高5分位数组趋势性检验差异有统计学意义(P趋势<0.001);⑤限制性立方样条模型分析显示,男性或女性的踝穴冠状位角度变化与关节功能恢复效果不良风险均不存在非线性关系;经Bootstrap自抽样,预测模型区分度、准确度较好;⑥提示踝关节骨折术后踝穴冠状位角度减小对关节功能恢复起到明显的促进作用,因此在踝关节骨折术后重点检测踝穴冠状位角度有助于了解患者关节功能恢复情况。

振动疗法联合悬吊训练前交叉韧带重建后患者运动及膝关节功能的变化

背景:物理疗法对前交叉韧带重建术后恢复至关重要。近年来,许多医师都在优化前交叉韧带重建术后的物理康复方案,但仍然缺乏高效的前交叉韧带重建术后康复训练疗法。目的:探讨振动疗法联合悬吊训练对前交叉韧带重建患者术后运动及膝关节功能的影响。方法:纳入在上海体育大学附属体育医院就诊的80例首次行单侧前交叉韧带重建患者,按照随机数字表法将患者随机分为振动疗法组和振动疗法+悬吊训练组,每组40例。振动疗法组患者在前交叉韧带重建术后第13周开始进行振动疗法训练(每次10 min,1次/d,每周6次),振动疗法+悬吊训练组患者在前交叉韧带重建术后第13周开始进行振动疗法(每次10 min,1次/d,每周6次)联合悬吊训练(每周2次),共训练8周。训练前及训练8后,采用膝关节Lysholm评分评价膝关节功能,采用等速肌力评估训练系统评估屈膝对称性指数,采用平衡测试系统评估双侧多轴平均轨迹误差差值。结果与结论:(1)与训练前比较,两组患者训练8周后的膝关节Lysholm评分、屈膝与伸膝对称性指数均升高(P<0.05),双侧多轴平均轨迹误差差值降低(P<0.05);与振动疗法组比较,振动疗法+悬吊训练组患者膝关节Lysholm评分、屈膝与伸膝对称性指数均升高(P<0.05),双侧多轴平均轨迹误差差值降低(P<0.05);(2)结果表明,与单独进行振动疗法相比,振动疗法联合悬吊训练可显著改善前交叉韧带重建患者的膝关节功能,增加肌肉力量和对称性,提高平衡稳定性。

保留假体清创联合更换组配式部件治疗全髋关节置换后急性假体周围感染

背景:全髋关节置换后假体周围感染是影响假体使用寿命的常见原因,保留假体清创联合更换组配式组件成为治疗全髋关节置换后急性期假体周围感染的新方法。目的:观察采用保留假体清创联合更换组配式部件治疗人工全髋关节置换后急性期假体周围感染的临床疗效。方法:选择2018年7月至2022年2月在黄石市中心医院骨科进行手术治疗的22例初次全髋置换后急性期假体周围感染患者,所有患者感染时间均为初次置换3周以内,术中取关节液及感染滑膜行细菌培养均证实为急性期感染,采用保留假体清创联合更换组配式组件治疗。术前、术后3,6个月以及末次随访,以白细胞计数、血沉、C-反应蛋白评价感染情况,以Harris髋关节功能评分量表评价髋关节功能改善情况,以疼痛目测类比评分了解患者疼痛缓解情况,采用配对样本t检验分析手术前后各指标改善情况。结果与结论:(1)非假体周围感染原因死亡1例后失访,予以排除,其余21例患者均获得临床随访,随访时间均在1年以上,平均随访时间为(19.52±3.88)个月,其中20例患者手术治疗成功,1例失败,感染控制率为95%;(2)患者术后3,6个月以及末次随访的白细胞计数、血沉、C-反应蛋白水平均较术前下降(P<0.05),Harris髋关节功能评分均较术前提高(P<0.05),疼痛目测类比评分均较术前下降(P<0.05),差异均有显著性意义(P<0.05);(3)提示全髋关节置换后急性期假体周围感染患者选择保留假体清创联合更换组配式组件的治疗方法能有效控制髋关节感染,改善髋关节功能,缓解感染导致的髋部疼痛。

下肢重复蹬伸至力竭过程中肌肉功能网络拓扑特性

背景:表面肌电已经被广泛用于监测肌肉疲劳,但传统肌电指标通常针对于单块肌肉,无法评价一组肌肉在疲劳过程中的变化。目的:建立肌肉功能网络,提取复杂网络参数,研究不同疲劳程度下的肌肉功能网络拓扑特性变化,为疲劳的监测、预防提供理论和方法依据。方法:11名受试者进行直到力竭的50%1RM单腿下肢蹬伸运动,同步采集股直肌、股外侧肌、股内侧肌、股二头肌长头、胫骨前肌、腓肠肌外侧肌、腓肠肌内侧肌7块肌肉的肌电信号,以及心电信号和Borg CR-10量表评分;根据Borg CR-10量表评分划分为轻度、中度和重度三个疲劳阶段,采用心率和心率变异性验证疲劳阶段划分的有效性;以7块肌肉为节点,使用肌肉信号的相干性构建肌肉功能网络,提取聚类系数、平均加权度、全局效率、特征向量中心性4个复杂网络参数;提取肌电信号的均方值振幅、中位频率、瞬时平均频率和共激活比4种指标,并在3种疲劳程度下进行比较。结果与结论:①3种疲劳阶段在心率及心率变异性上产生显著性差异,证明了疲劳阶段划分的有效性;②对于不同肌肉在3种疲劳程度下的肌电指标:均方值振幅和共激活比未表现出差异,中位频率在股外侧肌、股内侧肌和股二头肌长头表现出稳健的疲劳趋势,瞬时平均频率则在股直肌、股外侧肌、股内侧肌和股二头肌长头表现出稳健的疲劳趋势;瞬时平均频率的性能优于中位频率和均方值振幅,但三者仅在主要工作肌群能够获得较好的稳健趋势,共激活比不受疲劳因素的影响;③股外侧肌-股内侧肌、股外侧肌-股二头肌长头、股外侧肌-腓肠肌内侧肌和股内侧肌-股二头肌长头连接强度逐渐增加,平均加权度、聚类系数和全局效率在疲劳后表现出显著差异,并且与疲劳程度之间显著相关。结果表明:肌肉功能网络内的连通强度变化能够反映疲劳过程中肌肉间的协同性和互补性;聚类系数、平均加权度、全局效率可作为一组肌肉疲劳的监测指标。

Joint probability distribution of winds and waves from wave simulation of 20 years (1989-2008) in Bohai Bay

The joint probability distribution of wind speed and significant wave height in the Bohai Bay was investigated by comparing the Gurnbel logistic model, the Gumbel-Hougaard （GH） copula function, and the Clayton copula function. Twenty years of wind data from 1989 to 2008 were collected from the European Centre for Medium-Range Weather Forecasts （ECMWF） database and the blended wind data of the Quick Scatterometer （QSCAT） satellite data set and re-analysis data from the United States National Centers for Environmental Prediction （NCEP）. Several typhoons were taken into account and merged with the background wind fields from the ECMWF or QSCAT/NCEP database. The 20-year data of significant wave height were calculated with the unstructured-grid version of the third-generation wind wave model Simulating WAves Nearshore （SWAN） under extreme wind process conditions. The Gumbel distribution was used for univariate and marginal distributions. The distribution parameters were estimated with the method of L-moments. Based on the marginal distributions, the joint probability distributions, the associated return periods, and the conditional probability distributions were obtained. The GH copula function was found to be optimal according to the ordinary least squares （OLS） test. The results show that wind waves are the prevailing type of wave in the Bohai Bay.

Joint action of phoxim and fenvalerate on reproduction in male rats

Aim: To evaluate the joint action of phoxim and fenvalerate on the reproductive function in male Sprague-Dawley rats. Methods: The 2×2 factorial analysis experiment was used in the study. The pesticides were orally given at daily doses of phoxim (Pho) 8.2 nig/kg, fenvalerate (Fen) 3.3 mg/kg and Pho 8.2+Fen 3,3 mg/kg (Pho:Fen = 5:2), 5 days a week for 60 days. Sperm motility was measured with computer-assisted sperm motility analysis (CASA) and daily sperm production estimated. Immunoenzymatic method and electron microscopy were used to evaluate the serum testosterone and the testicular morphology, respectively. Results: There were significant decreases in sperm motility parameters in the treated animals, including straight line velocity (VSL), beat cross frequency (BCF), linearity (LIN) and straightness (STR). After treated with Fen, significant decreases in VSL, LIN and STR were demonstrated. Significant decreases of daily sperm production were seen in animals treated with Pho and Pho+Fen in comparison with the controls. Serum testosterone levels were not significantly changed in the treated groups. Factorial ANOVA showed that no significant interactions were noted between Pho and Fen in sperm motility, sperm production and serum testosterone. Both the single and mixed pesticides caused various degrees of testicular lesions, involving vacuolation of endoplasmic reticulum and necrosis of Sertoli cells. Conclusion: The pesticides may cause sperm motility changes and testicular lesions in male rats. The action of Pho and Fen may be additive.

浮针治疗早中期膝骨关节炎对软骨厚度的影响

目的观察浮针疗法治疗早中期膝骨关节炎对关节软骨厚度的影响。方法将60例早中期膝骨关节炎患者随机分为治疗组和对照组,每组30例。治疗组采用浮针治疗,对照组采用电针治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、疼痛开始缓解时间、Lysholm膝关节功能评分、平衡功能及股骨内侧和外侧髁软骨厚度的变化。结果治疗组疼痛开始缓解时间短于对照组(P<0.05)。治疗后,两组VAS评分以及平衡功能的横向标准差和前后标准差均较治疗前降低(P<0.05),Lysholm膝关节功能评分、平衡功能的稳定极限均较治疗前升高(P<0.05)。治疗后3个月,两组VAS评分较治疗前降低(P<0.05),Lysholm膝关节功能评分较治疗前升高(P<0.05),膝关节内外侧髁软骨厚度均较治疗前增加(P<0.05)。治疗后和治疗后3个月,治疗组VAS评分均低于对照组(P<0.05),Lysholm膝关节功能评分均高于对照组(P<0.05)。治疗后,治疗组横向标准差低于对照组(P<0.05),稳定极限高于对照组(P<0.05)。结论浮针治疗早中期膝骨关节炎起效速度优于电针治疗,能有效缓解疼痛症状及提高膝关节功能,可改善软骨损伤。

关节镜下自体骨软骨移植对膝关节局限性软骨损伤的临床疗效评价

目的探讨关节镜下自体骨软骨移植术对膝关节局限性软骨损伤的临床疗效,并以磁共振成像(MRI)检查对疗效进行评价。方法选取2018年6月至2021年6月诊治的100例膝关节局限性软骨损伤患者,按随机数字表法分为研究组和对照组,每组各50例。研究组采取关节镜下自体骨软骨移植术,对照组采取微骨折术治疗。采用MRI评估其手术疗效,并记录其术后膝关节软骨愈合时间;采用Lysholm膝关节功能评分表、国际膝关节文献委员会(IKDC)膝关节评估表,评估患者治疗前后膝关节功能变化;统计患者术后并发症发生率。结果研究组关节软骨愈合优良率98.00%,高于对照组84.00%(P<0.05)。两组术前和术后3个月的Lysholm评分、IKDC评分比较差异无统计学意义(P>0.05);术后6、12、24个月,研究组Lysholm评分、IKDC评分均高于对照组(P<0.05)。两组患者术后均无严重并发症,且并发症发生率差异无统计学意义(P>0.05)。研究组术后膝关节软骨愈合时间短于对照组(P<0.05)。结论关节镜下自体骨软骨移植术对膝关节局限性软骨损伤的远期治疗效果显著,可有效改善患者术后膝关节功能,缩短膝关节软骨愈合时间,安全性高。

138例全膝关节置换患者术前护患信任度现状及影响因素分析

目的旨在调查全膝关节置换患者术前护患信任度现状,并对其影响因素进行分析。方法采用便利抽样法,选取2020年10月—2021年9月期间在我科在行全膝关节置换术的138例患者为研究对象,采用一般资料调查量表、焦虑自评量表、膝关节美国特种外科评分表、护患关系信任度量表对患者进行调查,并进行多元线性回归分析,探讨全膝关节置换患者术前护信任度现状及其影响因素。结果本组患者术前护患信任度总分为(136.75±7.93)分;Pearson相关性分析结果显示,本组全膝关节置换患者术前1 d护患信任度总分与其焦虑评分总分呈负相关(r=-0.419,P<0.01),与膝关节功能评分无相关性(r=0.063,P>0.05)。多元线性回归分析结果显示,既往有无住院经历、文化程度及术前焦虑评分进入回归方程(P<0.05),共解释总变异的66.9%。结论本组全膝关节置换患者术前护患信任度处于中等偏上水平,且受文化程度、既往有无住院经历、术前焦虑程度的影响,护理人员应重点关注文化水平低、无既往住院经历、焦虑程度高的患者,针对性的对以上患者进行干预,以减少患者术后焦虑及改善术后功能,促进医患关系,减少医疗纠纷,帮助患者尽早康复。