微信随访管理对全膝关节置换术后患者的影响

目的:探讨微信随访管理对全膝关节置换(TKA)术后患者的影响。方法:选取180例初次行单侧TKA术的患者作为研究对象,根据微信随访管理推行时间分组;将2019年1月1日~10月31日收治的90例分为对照组,给予常规随访管理;将2019年11月1日~2021年12月31日收治的90例分为观察组,在常规随访管理的基础上给予微信随访管理。比较两组手术前(T0)及手术后2周(T1)、1个月(T2)、3个月(T3)时静息、活动状态下的疼痛情况[采用视觉模拟评分法(VAS)评分]、患肢肿胀程度、日常生活活动能力[采用Barthel指数评定量表(MBI)]、膝关节功能[采用关节活度(ROM)、Lysholm膝关节评分]评估结果,记录术后3个月内并发症发生情况。结果:T2、T3时,观察组静息、活动VAS评分均低于对照组(P<0.05);T1时,观察组患肢小腿周径小于对照组(P<0.05);T1、T2、T3时,观察组MBI、ROM、Lysholm评分均高于对照组(P<0.05);观察组并发症总发生率低于对照组(P<0.05)。结论:微信随访管理可以缓解患者疼痛,改善患者膝关节功能,减少并发症发生。

CLINICAL REPORT ON IMPROVEMENT OF MOBILITY OF AFFECTED SHOULDER JOINT CAUSED BY ACUTE CEREBRAL INFARCTION TREAT-ED WITH ACUPUNCTURE AND MASSAGE

Objective To observe the effects of acupuncture and massage to improve the mobility of affected shoulder joint caused by acute cerebral infarction. Methods 120 cases of acute cerebral infarction were randomized into two groups, named treatment group with acupuncture and massage and control group with western medicine. Acupoint selection of treatment group with acupuncture and massage： Yōngquán （涌泉 KI1）, Láogōng （劳宫 PC8）, Hòuxī （后溪SI3）, Gōngsūn （公孙 SP4）, Fēngchī （风池 GB20）, Jiānyú （肩髃 LI15）, Qūchí （曲池 LI11）, Hégǔ （合谷 LI4）, Huántiào （环跳 GB30）, Zúsānlǐ （足三里 ST36）, Tàichōng （太冲 LR3）, Anterior Oblique Line of Vertex-Temporal and Posterior Oblique Line of Vertex-Temporal. Massage techniques： roll for relax, hold and press, flick and fiddle, and shake. Control group with western medicine was treated with mannitol ＋ low molecular weight dextran ＋ CDP-choline. Results Compared with control group, treatment group could apparently improve the mobility of shoulder joint and lower the injury percentage （P〈0. 01） ; and the therapeutic effect of treatment group is better than that of control group （P〈0. 05） for treating acute cerebral infarction. Conclusion The therapy of acupuncture combined with massage could improve the function of the affected shoulder joint caused by acute cerebral infarction, and enhance therapeutic effect.

Clinical observation of cerebral palsy treated with Chinese massage for promoting the Governor Vessel, benefiting the kidney and strengthening the spleen combined with music therapy

Objective To observe the effects on the range of motion （ROM） of ankle joint and muscular spasm of the lower limbs treated with Chinese massage for promoting the Governor Vessel, benefiting the kidney and strengthening the spleen combined with music therapy in infantile cerebral palsy （CP）. Methods In 286 cases of spasmodic CP, 7 kinds of Chinese massage were adopted, named massage on acupoints to promote circulation of the Governor Vessel, massage for strengthening the spleen and benefiting qi, spine-pinching therapy, segmental massage, foot massage, massage for promoting the recovery of muscle strength and massage for promoting ROM of joints. Chinese massage was applied in musical background. Buddha music and five-element music of Chinese medicine （music of the Heart, Liver and Kidney Meridians） were optioned. The treatment was given once or twice a day and 30 days made one course. The angles of femoral adductor and dorsal flexion of foot as well as the score of composite spasticity scale （CSS） were observed before and after treatment so that the therapeutic effect was assessed. Results In 30 days of treatment, 106 cases （37. 1%） were effective markedly, 172 cases （60. 1%） effective and 8 cases （2.8%） failed. The angle of dorsal flexion of foot was （105.64± 12.66）° and （76.58± 9.89）° before and after treatment respectively; the angle of femoral adductor was （119.89±25.47）° and （158.99± 18.66）° before and after treatment respectively; the score of CSS was （12.39±2.56） and （7. 069 ± 2.97） before and after treatment respectivel, there was significant difference before and after treatment （all P〈0.01）. Conclusion Chinese massage for promoting the Governor Vessel, benefiting the kidney and strengthening the spleen combined with music therapy brings the extremely active effect into play on the recovery of sitting, kneeling, standing and walking for children with CP.

Therapeutic observation of Fu's subcutaneous needling for scapulohumeral periarthritis

Objective： To observe the therapeutic efficacy of Fu＇s subcutaneous needling（FSN） in treating scapulohumeral periarthritis（SP）.Methods： Eighty patients with SP were randomly divided into an observation group and a control group, 40 cases in each group. Patients in the observation group received FSN treatment while those in the control group received conventional acupuncture treatment. Visual analogue scale（VAS） and range of motion（ROM） were observed before and after the treatment, and the therapeutic efficacy was also evaluated.Results： After the treatment, the VAS scores decreased significantly in the two groups, and the VAS score in the observation group was significantly lower than that in the control group（P〈0.01）. After the treatment, the ROM increased significantly in both groups（both P〈0.01）, and the ROM in the observation group was significantly higher than that in the control group（P〈0.01）. The recovery rate and the total effective rate in the observation group were respectively 40.0% and 95.0%,significantly higher than 12.5% and 77.5% in the control group（P〈0.01, P〈0.05）.Conclusion： FSN can effectively relieve pain and improve the joint motion in treating SP, thus offering a novel option to the treatment of this kind of musculoskeletal disorder.

Therapeutic observation of arthrolysis under brachial plexus anesthesia for adhesivecapsulitis of the shoulder

Objective:To objectively evaluate the short-term and long-term efficacies of arthrolysis under brachial plexus anesthesia in treating adhesive capsulitis of the shoulder(ACS).Methods:One hundred patients diagnosed with ACS were divided into two groups using the random number method.The two groups both received same active rehabilitation exercises.Besides,55 cases in the treatment group were given one session of arthrolysis under brachial plexus anesthesia,and 45 cases in the control group were given tuina treatment.Changes in the visual analog scale(VAS)score,Melle score and pressure pain index were observed I month and 3 months after treatment.The therapeutic efficacies were also compared.Results:The total effective rate was 96.4%at the 1-month follow-up and 96.4%at the 3-month follow-up in the treatment group.The total effective rate was 33.3%at the 1-month follow-up and 28.9%at the 3-month follow-up in the control group.There were significant differences between the two groups comparing the total effective rate at the two time points(both P<0.05).The scores of VAS,Melle and pressure pain were significantly different at the 1-month and 3-month follow-ups from those before treatment in the treatment group(all P<0.05);the three scores did not show significant differences at the 1-month and 3-month follow-ups compared with those before treatment in the control group(all P>0.05).Conclusion:Based on the active rehabilitation exercises,one session of arthrolysis under brachial plexus anesthesia can release the adhesion and restore the range of motion and function of shoulder joint in ACS patients.It is superior to rehabilitation exercises plus tuina treatment comparing both short-term and long-term efficacies.

Interleukin-1 gene polymorphism disease activity and bone mineral metabolism in rheumatoid arthritis

Objective To determine whether interleukin-1α and 1β gene polymorphism is associated with rheumatoid arthritis disease activity and bone mineral metabolism, and whether there is any relationship between IL-1β and rheumatoid arthritis (RA) motif gene. Methods IL-1 gene polymorphisms were analyzed in 65 RA patients who met American College of Radiology (ACR) criteria and 60 controls. From genomic DNA, 2 polymorphisms in each gene for IL1α-889 and IL-1β+3953 were typed by PCR-RFLP and HLA-DRB1 allele typing was also undertaken by PCR-SSOP. Some clinical and laboratory parameters were collected. The allelic frequencies and carriage rates were compared between RA patients and controls and between patients with active and quiescent disease. Comparison was also made between IL-1 polymorphism and parameters of bone mineral metabolism and between patients with the HLA-DRB1 RA motif plus IL-1β 2 and patients without the two alleles. Fisher test and the analysis of variance was used to analyze the data.Results There was no significant difference in the frequency and carriage rate of IL-1α polymorphisms between RA patients and the controls. The β2/2 genotype of IL-1β was more common in female RA patients compared with controls (P=0.001). A lower carriage rate of IL-1β 2 occurred in male RA patients (P=0.001). A higher carriage rate of IL-1α2 is associated with a higher ESR (P=0.008), HAQ score (P=0.03), and vit-D 3 (P【0.001), but conversely a lower SJC (p=0.002), a lower RF (P=0.002) and a lower BMD at the lumbar spine (P=0.001). A higher frequency of IL-1α1 is associated with a lower CRP value (P=0.009). An increased IL-1β2 carriage is associated with active rheumatoid disease as indicated by a higher CRP (P【0.001), ESR (P【0.001) and pain score (P=0.001) and a higher BMD at the lumbar spine (P=0.007), lower vit-D 3 and. Udpd/Crea level The presence of the HLA DRB1 RA motif and IL-1β allele 2 at same time did not contribute to disease activity.Conclution Polymorphisms of the IL-β gene may affect the RA occurrence. Carriage of IL-1β2 polymorphisms is associated with more active disease in RA and the presence of both the IL-1α2 and the IL-1β1 allele in RA influences bone resorption.