Artificial Intelligence Rehabilitation Evaluation and Training System for Degeneration of Joint Disease

Degeneration of joint disease is one of the problems that threaten global public health.Currently,the therapies of the disease are mainly conservative but not very effective.To solve the problem,we need to find effective,convenient and inexpensive therapies.With the rapid development of artificial intelligence,we innovatively propose to combine Traditional Chinese Medicine(TCM)with artificial intelligence to design a rehabilitation assessment system based on TCM Daoyin.Our system consists of four subsystems:the spine movement assessment system,the posture recognition and correction system,the background music recommendation system,and the physiological signal monitoring system.We incorporate several technologies such as keypoint detection,posture estimation,heart rate detection,and deriving respiration from electrocardiogram(ECG)signals.Finally,we integrate the four subsystems into a portable wireless device so that the rehabilitation equipment is well suited for home and community environment.The system can effectively alleviate the problem of an inadequate number of physicians and nurses.At the same time,it can promote our TCM culture as well.

Recovery of hearing loss in atypical Meniere’s disease after treatment with orofacial and neck massage: A case report

BACKGROUND A 48-year-old female presented with sudden-onset right-sided aural fullness,low-frequency hearing loss,and tinnitus.Medical history included right-sided tempo-romandibular joint disorder(TMJD)with crepitation,and retro-orbital headaches.The patient was diagnosed with atypical Meniere’s disease(MD)and received in-tratympanic steroids,prednisone,betahistine,and began a low-sodium diet;how-ever,the patient’s symptoms worsened.CASE SUMMARY The patient sought physical therapy for TMJD;testing revealed reduced motion and dysfunction with vertical opening,lateral excursion of the mandible to the right,and tenderness to palpation.Treatment included soft tissue mobilization of right facial structures and temporal fossa,intraoral massage of the right pterygoid musculature,and massage of right neck structures.After 4 weeks,the patient noticed subjective improvement in hearing and decreased headaches.After 11 weeks,an audiogram showed that the hearing loss had recovered.The patient has continued the daily at-home intraoral/neck massage therapy and maintained normal hearing over 4 years to date.The temporal relationship between physical therapy and recovery of hearing loss suggests muscular or inflammatory etiology as at least partially causative of this patient’s symptoms.The mechanism of healing may have been due to decreased inflammation,improved blood flow,restored function of cranial nerves,or some combination of these and other unknown factors.CONCLUSION This report suggests that orofacial physical and massage therapy may be an effective treatment for the cochlear symptoms associated with MD.

Calcium pyrophosphate deposition disease of the temporomandibular joint invading the middle cranial fossa:Two case reports

BACKGROUND Pseudogout is a benign joint lesion caused by the deposition of calcium pyrophosphate dihydrate crystals,but it is invasive.Pseudogout of the temporomandibular joint(TMJ)is uncommon,and it rarely invades the skull base or penetrates into the middle cranial fossa.The disease has no characteristic clinical manifestations and is easily misdiagnosed.CASE SUMMARY We present two cases of tophaceous pseudogout of the TMJ invading the middle cranial fossa.A 46-year-old woman with a history of diabetes for more than 10 years was admitted to the hospital due to swelling and pain in the right temporal region.Another patient,a 52-year-old man with a mass in the left TMJ for 6 years,was admitted to the hospital.Maxillofacial imaging showed a calcified mass and severe bone destruction of the skull base in the TMJ area.Both patients underwent excision of the lesion.The lesion was pathologically diagnosed as tophaceous pseudogout.The symptoms in these patients were relieved after surgery.CONCLUSION Tophaceous pseudogout should be considered when there is a calcified mass in the TMJ with or without bone destruction.A pathological examination is the gold standard for diagnosing this disease.Surgical treatment is currently the recommended treatment,and the prognosis is good after surgery.

Trans-facet joints approach to treat thoracic degenerative diseases with anterior compression

Objective To investigate the clinical outcomes of trans-facet joints approach to treat thoracic degenerative disease with anterior compression.Methods From January 2003 to December 2009,22 patients with thoracic myelopathy caused by

MRI在Legg-Calve-Perthes disease中的应用

目的探讨LCP病的MRI表现和诊断价值。方法回顾性分析14例LCP病(15髋)临床和MRI资料,研究LCP病不同分期MRI影像学表现。结果缺血坏死期,2髋;血运重建期,6髋;修复期,7髋。MRI显示髋关节滑膜炎(15髋),关节积液(15髋),关节面滑膜侵蚀(5髋),骨髓水肿(7髋),髋臼和股骨头软骨增厚(6髋),扁平髋(2髋),股骨干骺端和股骨头骨骺间骨桥(3髋)。结论 MRI是评价LCP病有效工具,可应用于诊断股骨头坏死,为疾病准确分期、各种并发症的发现及患者预后,提供重要信息;指导制定非手术和手术治疗方案具有重要意义。此外MRI还可以鉴别其它儿童髋关节疾病。

Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype:Results of a 25-year follow-up study

AIM:IBD is a systemic disease associated with a large number of extraintestinal manifestations (EIMs).Our aim was to determine the prevalence of EIMs in a large IBD cohort in Veszprem Province in a 25-year follow-up study. METHODS:Eight hundred and seventy-three IBD patients were enrolled (ulcerative colitis/UC/:619,m/f:317/302, mean age at presentation:38.3 years,average disease duration:11.2 years;Crohn's disease/CD/:254,m/f:125/129, mean age at presentation:32.5 years,average disease duration:9.2 years).Intestinal,extraintestinal signs and laboratory tests were monitored regularly.Any alteration suggesting an EIMs was investigated by a specialist. RESULTS:A total of 21.3% of patients with IBD had EIM (UC:15.0%,CD:36.6%).Age at presentation did not affect the likelihood of EIM.Prevalence of EIMs was higher in women and in CD,ocular complications and primary sclerosing cholangitis (PSC) were more frequent in UC.In UC there was an increased tendency of EIM in patients with a more extensive disease.Joint complications were more frequent in CD (22.4% vsUC 10.2%,P<0.01).In UC positive family history increased the risk of joint complications (OR:3.63).In CD the frequency of type-1 peripheral arthritis was increased in patients with penetrating disease (P=0.028).PSC was present in 1.6% in UC and 0.8% in CD.Dermatological complications were present in 3.8% in UC and 10.2% in CD,the rate of ocular complications was around 3% in both diseases.Rare complications were glomerulonephritis,autoimmune hemolytic anaemia and celiac disease. CONCLUSION:Prevalence of EIM in Hungarian IBD patients is in concordance with data from Western countries.The high number of EIM supports a role for complex follow-up in these patients.

Typical gastroduodenal endoscopic findings in a Crohn's disease patient in remission stage

A 39-year-old patient with Crohn's disease (CD) was referred to our hospital for maintenance treatment of CD.He was diagnosed as having CD of the small and large intestines at 32 years old.He underwent partial resection of the ileum at 35 years old because of ileal perforation.He had received enteral nutritional supplement (1200 kcal/d) and metronidazole preparation (500 mg/d),and was in remission Crohn's disease activity index 73.We performed a routine gastroduodenal endoscopic examination,which revealed the representative endoscopic findings of gastroduodenal lesions in CD,namely,bamboo-joint-like appearance of the gastric body and cardia and a notched sign in the duodenum.These findings were clearly observed by using indigo carmine dye spraying.In our patient,typical gastroduodenal findings were observed even in the remission stage,suggesting that these findings would contribute to the early diagnosis of CD not only in the active stage but also during remission.

Multilevel Cervicothoracic and Lumbar Pott’s Disease: About Three New and Unusual Cases in the Rheumatology Department of the Teaching Hospital of Cocody in Abidjan (Côte d’Ivoire)

Pott’s disease usually affects two contiguous vertebrae or two spinal levels. The involvement of the three cervicothoracic and lumbar levels is rarely described. Only three cases have been described in the literature to our knowledge. The authors report three new cases of tuberculous spondylodiscitis of cervicothoracic and lumbar site. Our three cases were characterized by symptoms similar to the other topographical forms of Pott’s disease. A predisposing factor is often identified like the infection with human immunodeficiency virus. The definitive diagnosis was made in two cases by identifying acid and alcohol-fast bacilli for one case and by histology for the other case. For the third case, there was a diagnostic presumption reinforced by the satisfactory outcome on tuberculosis chemotherapy for a period of 12 months. The multilevel nature of diseases does not influence the effectiveness of treatment of this form of spinal tuberculosis.

Novel Assessment Technique: Ring Gauge Measurement of Finger Joint Circumference Changes in Patients with Rheumatoid Arthritis

Objectives: As therapeutic modalities for rheumatoid arthritis (RA) advance, immediate and quantitative determination of RA disease status is becoming increasingly important. The purpose of this study was to validate the usefulness of a ring gauge as a simple semiquantitative method for assessing hand swelling in patients with RA. Methods: We enrolled patients diagnosed with RA either initiated or switched to a biological therapeutic agent. The circumference of the interphalangeal (IP) joint and the proximal interphalangeal (PIP) joint was measured using a ring gauge. Assessments of the joint echocardiography, incorporating both Gray Scale (GS) and Power Doppler (PD) imaging, were conducted. These evaluations were performed both before the initiation of biological agent treatment and 28 days after the initial dose. Results: Following the treatment intervention, a significant reduction was observed in the circumference of the joint from the thumb to the little finger (p Conclusions: Our study demonstrated the effectiveness of using a ring gauge as a simple assessment tool for RA, revealing that a change in the ring gauge number by 2 or more corresponded to either improvement or deterioration in synovial thickening detected via joint echocardiography.

老年人群骨关节疾病流行特征及其影响因素研究

背景骨关节疾病是老年人群常见、多发的慢性疾病,其与更高的死亡率、更多的致残率、功能状态的下降和较低的生命质量显著相关,产生巨大的疾病负担。目前尚无河南省该病流行情况及其影响因素的研究。目的了解河南省老年人群骨关节疾病流行特征及其影响因素,为其实施精准防控提供科学依据。方法采用多阶段随机整群抽样方法,通过调查问卷、医学体检、实验室检测等方法,获取2018年河南省≥18岁常住居民人口学特征、既往疾病史、身体活动及身体指标等,本研究纳入1055名≥60岁居民为研究对象。运用多因素Logistic回归分析探讨河南省不同特征老年人群骨关节疾病特征及其影响因素。结果2018年河南省老年人群骨关节疾病患病率(加权后)为28.13%(95%CI=28.10%~28.15%)。其中女性、城市、超重或肥胖、中心性肥胖、血脂异常或高脂血症、无吸烟史、有打鼾史、中等强度活动的老年人群骨关节疾病患病率更高(P<0.05)。多因素Logistic回归分析显示,男性(OR=0.717,95%CI=0.550~0.933,P=0.013)是老年人群骨关节疾病的保护因素;超重或肥胖(OR=1.329,95%CI=1.050~1.684,P=0.018)、中心性肥胖(OR=1.305,95%CI=1.047~1.626,P=0.018)是老年人群骨关节疾病的危险因素。结论河南省老年人群骨关节疾病与性别、BMI和中心性肥胖相关,应对老年人群中女性、超重或肥胖和中心性肥胖者开展针对性健康教育及综合干预。

铁路运营隧道病害整治技术

分析了运营期间的隧道拱部渗漏水、拱部空洞、混凝土厚度不足、拱部衬砌开裂等四种常见病害的成因,并针对性地提出了整治方案,介绍了病害整治方案及施工方法,形成了隧道常见病害整治技术,可为隧道的设计与施工提供有益的参考。

益肾壮骨活血方联合针刀疗法治疗髌骨骨性关节炎临床观察

目的探讨髌骨骨性关节炎患者采用益肾壮骨活血方联合针刀疗法的临床效果。方法从南昌市洪都中医院2021年6月—2022年6月收治的髌骨骨性关节炎患者中抽取70例作为研究对象,使用随机数字表法将其分为对照组和观察组,每组35例。对照组和观察组的治疗方法分别为常规西医治疗、益肾壮骨活血方联合针刀治疗,对比两组治疗前后的炎性因子水平和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分。结果治疗后,观察组的白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平均较对照组低(P<0.05),WOMAC评分较对照组低(P<0.05)。结论髌骨骨性关节炎患者采用益肾壮骨活血方与针刀联合治疗效果较显著,不仅能有效减轻炎症反应,还能改善关节功能,临床可进一步推广。

A radiologic analysis of 136 cases of bone and joint lesions following burn

This paper reviewed 136 cases with definite bone and joint lesions selected froma total of 4286 burn patients.The clinical appearance,blood and urine biochemistry,blood cultures,gross and histological autopsy examination as well as surgical and biopsyspecimens were studied with emphasis on X-ray manifestations.The lesions were classi-fied,according to their X-ray appearances,into four types:alterations limited to thebone,alterations involving periarticular structures,changes of the joint and deformity ofthe bone and joint.The pathogenesis and radiological appearances of osteoporosis,mutila-tion of the fingers as well as incidence and pathogenesis of heterotopic para-articularossification were analysed and discussed.

Utility of Spiral Computed Tomography in the Study of Dislocation of Cricoarytenoid Joint

The cricoarytenoid relationship presented with spiral computed tomography was demonstrated and the reconstruction of arytenoid dislocation was presented by using multiplanar reconstruction algorithms. Fifteen patients with arytenoid dislocation documented by fiberoptic laryngoscopy and strobovideolaryngoscopy and 10 normal persons were displayed by spiral computed tomography (CT). A making design of our own had been used to diagnose arytenoid dislocation on axial CT image. Results showed that dislocation of cricoarytenoid joint was consistently demonstrated on several of the overlapping thin axial reconstructions in each of the 15 patients, in whom asymmetry of the bilateral cricoarytenoid joints was noted on axial images. It was found that on the glottic-fissure level the basal angle on abnormal side was larger in 8 patients than that on the normal side and smaller in 7 patients in patient group, whereas right basal angle was equal to the left in 8 subjects, except 2 in control group. There was statistically significant difference in the number of the equal to two basal angles of glottic fissure between control group and patient group (P<0.025). High-quality sagittal and coronal reconstructive images often were helpful in confirming or clarifying the complex arytenoid orientations. The findings that two-side basal angle was not equal in triangle of glottic fissure can be used as an objective parameter to diagnose arytenoid dislocation. Spiral CT is a useful adjunct in the diagnosis and treatment of dislocation of cricoarytenoid joint.

CLINICAL STUDY ON MANIPULATIVE TREATMENT OF DERANGEMENT OF THE ATLANTOAXIAL JOINT

The derangement of the atlantoaxial joint is one of main cervical sources of dizziness and headache, which were based on the observation on the anatomy of the upper cervical vertebrae, analysis of X-ray film of the atlantoaxial joint, and the manipulative treatment in 35 patients with cervical spondylosis. The clinical diagnosis of derangement consists of: dizziness, headache, prominence and tenderness on one side of the affected vertebra, deviation of the dens for 1 mm-4 mm on the open-mouth X-ray film, abnormal movement of the atlantoaxial joint on head-rotated open-mouth X-ray film. An accurate and delicate adjustment is the most effective treatment.

应用阴阳锉跖趾关节成形治疗Freiberg病的临床研究

目的 探讨应用阴阳锉辅助进行跖趾关节成形配合间质填充治疗Freiberg病的临床疗效。方法 选取2019年8月至2023年9月郑州市骨科医院收治的30例Freiberg病患者。其中,男6例,女24例;年龄17~45岁,平均(26.5±6.8)岁。根据Smillie分期:Ⅲ期13例,Ⅳ期9例,Ⅴ期8例。均采用阴阳锉辅助进行跖趾关节成形配合间质填充治疗。术后采用AOFAS评分系统及跖趾关节屈伸活动度进行评价手术效果。结果 所有患者均获得随访,随访时间6~36个月,平均(26.5±13.9)个月。所有患者伤口均Ⅰ期愈合;AOFAS评分由术前(55.3±6.2)分提高到术后6个月的(90.8±5.9)分,差异有统计学意义(P<0.05),所有患者症状得到明显改变;跖趾关节活动度术前跖屈(20.3±5.3)°、背伸(15.2±5.6)°与术后6个月随访测量跖屈(18.9±5.1)°、背伸(14.1±5.2)°相比较,差异无统计学意义(P>0.05)。结论 采用阴阳锉辅助进行跖趾关节成形配合间质填充来治疗该疾病,该术式创伤小,操作简单,既减轻的疼痛症状,又保留了跖趾关节的外形及活动度,改善了患者的生活质量,是较为可靠的一种治疗方案,值得推广应用。

白带常规与阴道炎六联检在阴道感染性疾病病原体检测中的价值

目的探讨白带常规及阴道炎六联检对阴道感染性疾病中病原体的检测价值。方法以2022年11月—2023年4月在厦门市第三医院接受妇科检查的500例白带异常患者为观察对象,均先后接受白带常规和阴道炎六联检。对比分析单一方法检查和联合检查在阴道感染病原体检测和临床诊断中的效能。结果白带常规检查显示,白细胞(white blood cell,WBC)计数增高141例(28.2%),细菌性感染91例(18.2%),念珠菌感染12例(2.4%),滴虫性感染15例(3.0%),阴道炎检出259例(51.8%);阴道炎六联检显示,WBC计数增高156例(31.2%),细菌性感染95例(19.0%),念珠菌感染35例(7.0%),滴虫性感染28例(5.6%),阴道炎检出314例(62.8%);2项联合检查显示,WBC计数增高158例(31.6%),细菌性感染117例(23.4%),念珠菌感染43例(8.6%),滴虫性感染40例(8.0%),阴道炎检出358例(71.6%),联合检查的细菌性感染、念珠菌感染、滴虫性感染的检出率及阴道炎检出率高于单一检查(P<0.05)。白带常规、阴道炎六联检及联合检测的白带清洁度比较,差异有统计学意义(P<0.05)。结论白带常规联合阴道炎六联检可提高阴道感染性疾病病原体检出率。

NLRP3炎症小体的激活在骨关节疾病中的研究进展

炎症是对多种刺激的关键反应,细胞因子等炎症分子在包括骨和关节疾病在内的多种疾病的发病机制中发挥核心作用。促炎性细胞因子主要由免疫细胞产生,介导炎症和先天免疫反应。炎症小体是新近公认的先天免疫的重要参与者。最典型的是NOD样受体蛋白3(NLRP3)炎症小体,NLRP3检测外源性致病性侵袭和内源性细胞损伤,并通过形成NLRP3炎症小体做出反应。NLRP3炎症小体的3个主要成分是NLRP3(捕获危险信号并募集下游分子)、半胱氨酸天冬氨酸蛋白水解酶-1[caspase-1,引起细胞因子白细胞介素-1β(IL-1β)和IL-18的成熟以介导细胞因子释放和焦亡]和含有半胱天冬酶募集结构域的细胞凋亡相关斑点样蛋白(ASC,是连接NLRP3和caspase-1的桥梁)。此外,促炎性细胞因子加速骨吸收和软骨破坏,导致骨和关节组织破坏。因此,促炎性细胞因子参与调节骨和关节疾病的发病机制。该文综述了近年来关于NLRP3炎症小体在骨关节疾病中激活和功能等方面的研究进展。

徒手治疗联合运动疗法对慢性肩袖损伤患者肩关节功能的影响

目的探讨徒手治疗联合运动疗法对慢性肩袖损伤患者肩关节功能的影响。方法选取2022年5月—2023年7月本院收治的60例慢性肩袖损伤疾病患者为研究对象,采用随机数字表法将其分为研究组和对照组,每组30例。研究组采用徒手治疗联合运动疗法,对照组采用电针治疗法,对比两组的治疗有效性。结果治疗后,研究组肩关节功能评分高于对照组(P<0.05);研究组不良反应发生率较对照组低(P<0.05)。结论慢性肩袖损伤疾病采用徒手治疗+运动疗法,可促进肩关节功能恢复,显著改善肩关节功能,减少疼痛感,降低不良反应发生率。

外泌体微小RNA与骨关节疾病:作用与机制

背景:外泌体是一种细胞以胞吐形式分泌到胞外的囊泡状结构,其中包含了大量的微小RNA,具有重要的细胞间通讯作用。外泌体中的微小RNA依靠外泌体运输,能够进入靶细胞发挥重要的生物学调控效应。在常见的骨关节疾病中,由于骨骼代谢异常或受损会释放大量的外泌体,其中一些外泌体微小RNA促进骨关节疾病的进展。因此,外泌体微小RNA与骨骼系统关系密切,对许多骨关节疾病的发生发展以及诊疗都具有重要意义。目的:综述外泌体微小RNA在骨代谢和骨关节疾病中的研究进展。方法:以“外泌体,细胞外囊泡,微小RNA,miRNA,骨,骨疾病,骨形成,骨再生,骨吸收,骨破坏”为中文检索词,“exosomes,extracellular vesicle,microRNA,miRNA,bone,bone diseases,bone formation,bone regeneration,bone resorption,bone destruction”为英文检索词,在中国知网、迈特思创和PubMed数据库进行检索,最终纳入86篇文献进行归纳总结。结果与结论:外泌体中的微小RNA可以通过影响骨形成和骨吸收调控骨代谢,并且与骨折愈合、骨质疏松症、骨关节炎、类风湿性关节炎、股骨头坏死和骨肉瘤等骨关节疾病的发生发展关系密切,外泌体微小RNA将是未来诊治某些骨关节疾病的有效手段。但目前关于外泌体微小RNA在骨关节疾病中的研究有限,想要利用外泌体微小RNA诊断治疗骨关节疾病仍然需要更多的探索和研究。