Crustal and uppermost mantle structure of the northeastern Qinghai-Xizang Plateau from joint inversion of surface wave dispersions and receiver functions with P velocity constraints

Lithospheric structure beneath the northeastern Qinghai-Xizang Plateau is of vital significance for studying the geodynamic processes of crustal thickening and expansion of the Qinghai-Xizang Plateau. We conducted a joint inversion of receiver functions and surface wave dispersions with P-wave velocity constraints using data from the Chin Array Ⅱ temporary stations deployed across the Qinghai-Xizang Plateau. Prior to joint inversion, we applied the H-κ-c method(Li JT et al., 2019) to the receiver function data in order to correct for the back-azimuthal variations in the arrival times of Ps phases and crustal multiples caused by crustal anisotropy and dipping interfaces. High-resolution images of vS, crustal thickness, and vP/vSstructures in the Qinghai-Xizang Plateau were simultaneously derived from the joint inversion. The seismic images reveal that crustal thickness decreases outward from the Qinghai-Xizang Plateau. The stable interiors of the Ordos and Alxa blocks exhibited higher velocities and lower crustal vP/vSratios. While, lower velocities and higher vP/vSratios were observed beneath the Qilian Orogen and Songpan-Ganzi terrane(SPGZ), which are geologically active and mechanically weak, especially in the mid-lower crust.Delamination or thermal erosion of the lithosphere triggered by hot asthenospheric flow contributes to the observed uppermost mantle low-velocity zones(LVZs) in the SPGZ. The crustal thickness, vS, and vP/vSratios suggest that whole lithospheric shortening is a plausible mechanism for crustal thickening in the Qinghai-Xizang Plateau, supporting the idea of coupled lithospheric-scale deformation in this region.

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.

Multidirectional 3D printed functionally graded modular joint actuated by TCPFL muscles for soft robots

Highly deformable bodies are essential for numerous types of applications in all sorts of environments. Joint-like structures comprising a ball and socket joint have many degrees of freedom that allow mobility of many biomimetic structures. Recently, soft robots are favored over rigid structures for their highly compliant material, high-deformation properties at low forces, and ability to operate in di fficult environments. However, it is still challenging to fabricate complex designs that satisfy application constraints due to the combined e ffects of material properties, actuation method, and structural geometry on the performance of the soft robot. Therefore, a combination of a rigid joint and a soft body can help achieve modular robots with fully functional body morphology. Yet, the fabrication of soft parts requires extensive molding for complex shapes, which comprises several processes and can be time-consuming. In addition, molded connections between extremely soft materials and hard materials can be critical failing points. In this paper, we present a functionally graded 3D-printed joint-like structure actuated by novel contractile actuators. Functionally graded materials (FGMs) via 3D printing allow for extensive material property enhancement and control which warrant tunable functionalities of the system. The 3D-printed structure is made of 3 rigid ball and socket joints connected in series and actuated by integrating twisted and coiled polymer fishing line ( TCPFL) actuators, which are con fined in the FGM accordion-shaped channels. The implementation of the untethered T CPFL actuation system can be highly bene ficial for deployment in environments that require low vibrations and silent actuation. The fishing line TCP actuators produce an actuation strain up to 40% and bend the joint up to 40° in any direction. The T CPFL can be actuated individually or as a group to control the bending trajectory of the modular joint, which is bene ficial when deployed in areas that contain small crevices. Obtaining complex modes of bending, the FGM multidirectional joint demonstrated a great potential to achieve di fferent functionalities such as crawling, rolling, swimming, or underwater exploration.

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.

Numerical modelling of resonance mechanisms in jointed rocks using transfer functions

Resonance effects in parallel jointed rocks subject to stress waves are investigated using transfer functions,derived from signals generated through numerical modelling.Resonance is important for a range of engineering situations as it identifies the frequency of waves which will be favourably transmitted.Two different numerical methods are used for this study,adopting the finite difference method and the combined discrete element-finite difference method.The numerical models are validated by replicating results from previous studies.The two methods are found to behave similarly and show the same resonance effects;one operating at low frequency and the other operating at relatively high frequency.These resonance effects are interpreted in terms of simple physical systems and analytical equations are derived to predict the resonant frequencies of complex rock masses.Low frequency resonance is shown to be generated by a system synonymous with masses between springs,described as spring resonance,with an equal number of resonant frequencies as the number of blocks.High frequency resonance is generated through superposition of multiple reflected waves developing standing waves within intact blocks,described as superposition resonance.While resonance through superposition has previously been identified,resonance based on masses between springs has not been previously identified in jointed rocks.The findings of this study have implications for future analysis of multiple jointed rock masses,showing that a wave travelling through such materials can induce other modes of propagation of waves,i.e.spring resonance.

S-wave velocity structure in Tangshan earthquake region and its adjacent areas from joint inversion of receiver functions and surface wave dispersion

Using the seismic records of 83 temporary and 17 permanent broadband seismic stations deployed in Tangshan earthquake region and its adjacent areas(39°N–41.5°N,115.5°E–119.5°E),we conducted a nonlinear joint inversion of receiver functions and surface wave dispersion.We obtained some detailed information about the Tangshan earthquake region and its adjacent areas,including sedimentary thickness,Moho depth,and crustal and upper mantle S-wave velocity.Meanwhile,we also obtained the vP/vS structure along two sections across the Tangshan region.The results show that:(1)the Moho depth ranges from 30 km to 38 km,and it becomes shallower from Yanshan uplift area to North China basin;(2)the thickness of sedimentary layer ranges from 0 km to 3 km,and it thickens from Yanshan uplift region to North China basin;(3)the S-wave velocity structure shows that the velocity distribution of the upper crust has obvious correlation with the surface geological structure,while the velocity characteristics of the middle and lower crust are opposite to that of the upper crust.Compared with the upper crust,the heterogeneity of the middle and lower crust is more obvious;(4)the discontinuity of Moho on the two sides of Tangshan fault suggests that Tangshan fault cut the whole crust,and the low vS and high vP/vS beneath the Tangshan earthquake region may reflect the invasion of mantle thermal material through Tangshan fault.

Comparison of joint function and trauma severity after arthroscopic headless compression screw fixation and conventional open reduction and internal fixation treatment of patellar transverse fracture

Objective:To study the differences in joint function and trauma severity after arthroscopic headless compression screw fixation and conventional open reduction and internal fixation treatment of patellar transverse fracture.Methods: 58 patients with patellar transverse fracture who accepted operative treatment in our hospital between August 2012 and December 2015 were collected and divided into open surgery group (n=30) and arthroscopic surgery group (n=28) according to the surgical approach. Before operation and 3 months after operation, the knee joint function of two groups of patients was evaluated respectively;3 d after operation, enzyme-linked immunosorbent assay (ELISA) was used to detect serum pain mediators, stress hormones and other trauma-related indicators.Results:Differences in the knee joint function index levels were not statistically significant between two groups of patients before operation (P>0.05);3 months after operation, the maximal knee joint flexibility and maximal extension levels of arthroscopic surgery group were higher than those of open surgery group (P<0.05);3 d after operation, serum prostaglandin (PGI2), dopamine (DA), neuropeptide Y (NPY), substance P (SP), glucocorticoid (Cor), renin (R), angiotensin 1 (Ang1), angiotensin 2 (Ang2), epinephrine (E), norepinephrine (NE) and aldosterone (ALD) levels of arthroscopic surgery group were significantly lower than those of open surgery group (P<0.05).Conclusions:Arthroscopic headless compression screw fixation can optimize the knee joint function and reduce the surgical trauma in patients with patellar transverse fracture.

Cardiotoxicity concerns in total joint arthroplasty

This editorial examines the cardiotoxic effects of elevated metal concentrations in patients who received total joint arthroplasty,as detailed in the study of Brennan et al.The study findings reveal that elevated cobalt and titanium levels may affect the cardiac structure and function,providing crucial insights for clinical practice and research.This editorial suggests that the close monitoring of metal ion levels in patients undergoing arthroplasty is necessary to reduce cardiovascular risk.

Effect of sodium hyaluronate combined with rehabilitation training on knee joint injury caused by golf

BACKGROUND In high-intensity sports like golf,knee joints are prone to injury,leading to pain,limited mobility,and decreased quality of life.Traditional treatment methods typically involve rehabilitation exercises,but their effectiveness may be limited.In recent years,sodium hyaluronate has emerged as a widely used biomedical material in the treatment of joint diseases.AIM To explore the effect of sodium hyaluronate combined with rehabilitation training on pain degree,flexion range of motion and motor function of knee joint injured by golf.METHODS Eighty patients with knee joint injury caused by golf were randomly divided into control(group B)and observation group(group A).The group B was treated with rehabilitation training,and the group A was treated with sodium hyaluronate combined with rehabilitation training.The clinical efficacy,range of motion and function of knee joint,quality of life and inflammatory factors were compared.RESULTS The excellent and good rate of rehabilitation in the group A was raised than group B.At 6 weeks and 3 months after treatment,the range of motion of the two groups was raised than that before treatment,and that of the group A was raised than group B.After treatment,the scores of Lysholm and International Knee Documentation Committee(IKDC)in the group A were raised,and those in the group A were raised than group B.The VAS score of the two groups was reduced than that of the group B,and the SF-36 score of the group A was reduced than group B.The interleukin(IL)-1β,IL-8 and tumor necrosis factor-αin the two groups were reduced,and those in the group A were reduced than group B.CONCLUSION Sodium hyaluronate combined with rehabilitation training has a good clinical effect in the treatment of patients with knee joint injury caused by golf,which relieve pain,maintain knee joint function and improve patients'life quality.

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.

Response of the Ginseng C_(2)H_(2)-Type Zinc Finger Protein Family PgZFPs Gene to Methyl Jasmonate Regulation

The main active components of ginseng are ginsenosides,which play significant roles in treating cardiovascular diseases,cancer,and providing antioxidant effects.Ginsenosides are primarily synthesized through the mevalo-nate pathway and the methylerythritol phosphate pathway.Many key enzyme genes involved in this biosynthetic process have been cloned and validated,yet the regulatory functions of transcription factors remain unclear.The C_(2)H_(2)-type zincfinger protein family,one of the largest families of transcription factors,is crucial in plant growth and development,response to biotic and abiotic stresses,and regulation of secondary metabolism.This study,based on the ginseng transcriptome database from Jilin,conducted a correlation analysis between the expression levels of PgZFPs genes in the Jilin ginseng C_(2)H_(2)-type zincfinger protein family and ginsenoside content,a gen-ome-wide association study of PgZFPs,and co-expression analysis of PgZFPs with validated key enzyme genes.Ultimately,five candidate genes involved in ginsenoside biosynthesis were identified.The involvement of PgZFP27 and PgZFP-59-02 genes from the PgZFPs family in the biosynthesis of ginsenosides was validated through in vitro methyl jasmonate(MeJA)induction experiments.This result provides new genetic resources for the biosynthesis of ginsenosides.

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.

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。

推拿结合牵伸技术治疗慢性跖筋膜炎合并功能性腓肠肌挛缩的疗效观察

目的:观察推拿结合牵伸技术治疗慢性跖筋膜炎合并功能性腓肠肌挛缩的临床疗效。方法:采用随机化区组方法将70例慢性跖筋膜炎合并功能性腓肠肌挛缩患者分为对照组和治疗组各35例。对照组采用冲击波治疗,共治疗3次,间隔时间7天。治疗组则在此基础上联合推拿结合小腿三头肌、跖筋膜牵伸训练,其中牵伸训练每天3次,分早、中、晚3个时间段进行,跖筋膜牵伸及小腿三头肌牵伸每次各进行2遍,每遍连续牵拉10次,组间可适当休息,共牵拉4周;推拿治疗每日治疗1次,每周治疗5天,待足底疼痛症状缓解后每隔2天治疗1次,连续治疗4周,4周后每隔2天进行跖筋膜及小腿三头肌牵伸训练。对两组患者实施随访,对治疗前、治疗后4周、治疗后12周分别采用VAS评分评价疼痛程度,AOFAS-AHS评分对患足功能及测量踝关节背伸角度进行综合评价。结果:治疗后4周、治疗后12周,治疗组VAS评分、AOFAS-AHS评分、踝关节背伸角度改善程度均显著优于对照组(P<0.05)。结论:推拿结合牵伸技术治疗慢性跖筋膜炎合并功能性腓肠肌挛缩具有良好临床疗效,且效果优于单纯冲击波治疗,简便易操作,值得推广。

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。

温针灸联合悬吊运动训练治疗肩袖损伤对肩关节功能及肩袖生活质量的影响

目的:观察温针灸联合悬吊运动训练(SET)治疗肩袖损伤(RCI)对肩关节功能、肩袖生活质量的影响。方法:选取2022年3月—2023年3月在浙江中医药大学附属杭州市中医院针灸康复科门诊就诊的RCI患者60例,按随机数字表法分为治疗组和对照组,每组30例。2组皆予关节松动术治疗,在此基础上,对照组予温针灸疗法治疗,治疗组予温针灸联合SET治疗,2组均治疗6周。治疗6周后,比较2组视觉模拟评分法(VAS)评分、肩关节外展活动度(SAROM)、肩袖生活质量指数(RCQOL)评分。结果:治疗6周后,2组VAS评分均较治疗前降低(P<0.05),治疗组VAS评分低于对照组(P<0.05)。2组SAROM较治疗前增大(P<0.05),治疗组SAROM大于对照组(P<0.05)。2组RCQOL评分均较治疗前升高(P<0.05),治疗组RCQOL评分高于对照组(P<0.05)。结论:温针灸联合SET治疗可有效改善RCI患者肩关节功能,减轻疼痛,提高肩袖生活质量。

股骨颈骨折空心螺钉内固定术后供养血管注射富血小板血浆效果分析

目的分析股骨颈骨折空心螺钉内固定术后供养血管注射富血小板血浆(PRP)的临床效果。方法选取2019年6月至2021年6月郑州人民医院收治的106例股骨颈骨折患者作为研究对象,按照空心螺钉内固定术后供养血管是否注射PRP将其分为试验组(53例)和对照组(53例)。试验组患者空心螺钉内固定术后于供养血管注射PRP,对照组患者空心螺钉内固定术后不做处理,对比观察两组患者围手术期指标、骨折愈合时间、髋关节功能、骨痂生长情况以及不良事件发生情况。结果试验组患者手术时间明显长于对照组(t=16.915,P<0.001),完全负重所需时间、骨折愈合时间均明显短于对照组(t=12.610、8.213,P均<0.001),术中出血量与对照组无明显差异(t=1.685,P=0.095);术后1、3、6个月,试验组患者Harris评分、Fernandez-Esteve骨痂评分均明显高于对照组(术后1个月:t=8.919、6.118,P均<0.001;术后3个月:t=10.951、9.217,P均<0.001;术后6个月:t=7.024、6.937,P均<0.001);试验组患者术后不良事件发生率为9.43%,明显低于对照组患者的不良事件发生率30.19%(χ^(2)=7.185,P=0.007)。结论与单纯采用空心螺钉内固定治疗相比,于空心螺钉内固定术后给予供养血管注射PRP治疗股骨颈骨折,能够有效促进骨痂生长,明显缩短完全负重所需时间及骨折愈合时间,改善髋关节功能,减少股骨头坏死等不良事件的发生,临床应用价值更高。

火针联合董氏奇穴针刺治疗肩袖损伤的疗效观察及对关节功能及血清PGE_(2)和TGF-β1的影响

目的观察火针联合董氏奇穴针刺治疗肩袖损伤的临床疗效及对关节功能及血清前列腺素E_(2)(prostaglandin E_(2),PGE_(2))和转化生长因子-β1(transforming growth factor-β1,TGF-β1)的影响。方法将100例肩袖损伤患者随机分为对照组(50例)和观察组(50例)。对照组予以电针联合董氏奇穴针刺治疗,观察组予以火针联合董氏奇穴针刺治疗。检测视觉模拟量表(visual analog scale,VAS)和美国加利福尼亚大学洛杉矶分校(University of California,Los Angeles,UCLA)肩关节评分、肩关节活动度(range of motion,ROM)及血清PGE_(2)和TGF-β1水平。结果观察组总有效率高于对照组(P<0.05)。治疗后及4周随访时,两组VAS评分及血清PGE_(2)和TGF-β1水平均低于治疗前(P<0.05),且观察组均低于对照组(P<0.05);两组UCLA肩关节评分和肩关节ROM均高于治疗前(P<0.05),且观察组均高于对照组(P<0.05)。4周随访时,两组VAS评分、UCLA肩关节评分、肩关节ROM及血清PGE_(2)和TGF-β1水平与治疗后比较差异无统计系意义(P>0.05)。治疗后血清PGE_(2)、TGF-β1水平与VAS评分呈正相关,与UCLA肩关节评分呈负相关。结论火针和电针联合董氏奇穴针刺治疗肩袖损伤均可缓解疼痛、改善肩关节功能,但火针优于电针,其机制可能与降低血清PGE_(2)和TGF-β1水平有关。