Hand-grip strength is an important assessment of strength of upper extremity, which also can predict the clinical outcomes, such as postoperative complications, mortality, and disability and so on, especially for the elderly population. This article would review the advance of study on the measurement of grip strength, the norms and the application in elderly in recent years.

Objective To investigate the therapeutic effect of ozone in treating the recurrent herniated lumbar disc after surgery.Methods Thirty-seven lumbar discs in 37 patinets with recurrent lumbar disc herniation after surgery were injected with ozone under CT-guided.The operative approaches were via lateroposterior position of lumbar vertebrae in 30 and via posterior position in 7 cases.Results The process of injection was done successfully in all patients.Followed-up for three months to one year after the treatment,the cases of clinical therapeutic efficacy of excellent results were 9,the cases of good results were 22,no changes in 6 cases.Conclusion Ozone in treatment of recurrent herniated lumbar disc after surgery is a safe and effective method.

Objective To investigate the effect of types of pinch on the measurement of pinch strength in healthy young subjects.Methods All anthropometric factors of 20 right-handed young volunteers(10 males,and 10 females)were recorded.Their pinch strength in 3 types(I.e.Pulp2,Chuck,and Lateral)were measured with digital pinch dynamometer in standardized position.Results For both genders,the pinch strength of Lateral was the largest,followed by Chuck,Pulp2 and the dominant hand was stronger(P<0.01).Men were stronger than women in all types of pinch strength(P<0.01).Correlation among the 3 types of pinch strength were presented(r=0.568～0.707,P<0.01).The correlation were found between the pinch strength of 3 types and weight in women(r=0.764～0.807).No correlation has been found among the pinch strength of 3 types and age,height,the thickness of palm in both the males and the females.Conclusion The sex and types of pinch significantly impact pinch strength in healthy young subjects,but the correlation between pinch strength and anthropometry should be further surveyed.

Objective To evaluate the difference in isokinetic strength of the knee muscles between knee osteoarthritis (KOA) patients aged 80 years and over and matched healthy controls,and to establish the association of isokinetic strength with pain and functional status in patients with KOA.Methods The study enrolled 32 patients aged 80 and over diagnosed with unilateral knee OA and 10 matched controls.Pain was evaluated by the visual analogue scale (VAS),the pain intensity scale and the Lequesne index for patients with knee OA.Functional status was assessed by the Timed Up and Go Test (TUGT),the Five Times Sit to Stand Test (FTSST) and the Timed 10 Meter Walk Test (TWT).Muscle strength was measured using the isokinetic dynamometer Biodex System 4 Pro.Bilateral isokinetic (concentric) knee flexion and extension with the protocol of 60 degrees/sec,180 degrees/sec was also performed.Results The difference in two angular velocities of extensor and flexor peak torques between the knee OA group and the control group was statistically significant (t=2.747,P＜ 0.05).The extensor peak torque was negatively correlated with age,Liquesce index scores,FTSST,TUGT and TWT (r=-0.39～～-0.75,P＜0.05),but had no correlation with the VAS score or the Lequesne index pain score (r=-0.23～ 0.31,P＞0.05).The regression analysis results suggested that the extensor peak torque and the VAS score together were important predictors for the Liquesce index (adjusted R2 =0.41).Conclusions The degree of knee muscle damage is closely related to the functional performance of the muscles in knee OA patients aged 80 years or over.The strength of the quadriceps and the intensity of pain are important predictors of disability for those patients.

Background and purpose: Collecting duct carcinomas of the kidney are a rare malignant tumor accounting for<1%of renal malignancies. It is associated with aggressive nature and more than 50%of patients have metastatic disease at the time of initial diagnosis. The diagnosis of collecting duct carcinoma is often dififcult and to some extent is one of exclusion. This study aimed to study the clinicopathologic features of collecting duct carcinoma of the kidney. Methods:We retrieved the data of ifve cases of collecting duct carcinomas of the kidney from pathology ifles, and determined the expressions of CK19, CAM5.2, CK7, Vimentin, CD10, P63 and PaX-8 by pathohistological observation and immunohistochemical examination. Results: The most common symptoms were blood urine, bellyache and abdomen mass. The tumor originated from the medulla of the kidney central zone. Histologically, the tumors demonstrated irregular tubular or papillary architecture with the stroma of inflammatory cells and fibrous tissue proliferation. Immunohistochemically, the tumor cells were positive for CK19(5/5), CAM5.2(5/5), PaX-8(5/5), Vimentin(2/5), CK7(1/5), and negative for P63, CD10. Conclusion: The correct diagnosis in collecting duct carcinomas of the kidney is based on characteristic morphological features and immunophenotype labeling.

Objective To determine the test-retest reliability of functional squat system (FSS) isometric muscle strength tests for patients with knee osteoarthritis. Methods The isometric muscle strength of thirty patientswith knee osteoarthritis (21 males and 9 females; age 45 to 89 years, mean age 68.73 ± 12.19 years) was tested twice within 1 week by the same tester. Three test results were obtained: maximum isometric extension strength, the time to initiate isometric extension and the average isometric extension strength. Intra-class correlation coefficients (ICCs) for the three tests were computed to evaluate their retest reliability. Results The ICCs of the maximum isometric extension strength and average isometric extension strength of the uninvolved and involved extremities were respectively 0.87, 0.88, 0.92 and 0.89. The ICCs of the initiation time for the uninvolved and involved legs were respectively 0.25 and 0.41. Conclusion In these tests of patients with knee osteoarthritis using the functional squat system, both the maximum isometric extension strength and the average isometric extension strength had very good test-retest reliability. These two test results could be used as reliable guidance for treatment and rehabilitation of osteoarthritic knees.

AIM To study the chemical constituents from twigs of Trigonostemon lutescens Y.T.Chang et J.Y.Liang.METHODS The ethyl acetate fraction of 95％ ethanol extract from T.lutescens twigs was isolated and purified by silica,Sephadex LH-20 and MCI column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and elucidated as 3-O-acetyloleanolic acid (1),methyl 3-acetoxy-12-enly-oleanen-28-oate (2),taraxerone (3),spiciflorin (4),simiarenol (5),β-sitosterol palmitate (6),3,3',4-tri-O-methylellagic acid (7),β-sitosterol (8),stigamasterol (9),palmitic acid (10).CONCLUSION Compounds 1-6 are isolated from genus Trigonostemon for the first time,compounds 7 and 9 are first obtained from this plant.

Objective To examine the test-retest reliability of 5 pain intensity assessment scales, i.e., Visual Analog Scale (VAS), Numeric Rating Scale (NRS), Verbal Descriptor Scale (VDS), Facial Pain Scale - Revised (FPS-R), and Mix Scale (MIX) in older adults with low back pain. Methods 30 older patients with low back pain volunteered in this study, and rated their pains with VAS, NRS, VDS, FPS-R, and MIX twice within 24 h. Test-retest reliability was assessed with intraclass correlation coefficient (ICC). Results ICC was in range of 0.543~ 0.754, and ranked as NRS, FPS-R, MIX, VAS, VDS from more to less. Conclusion All the assessments were appropriate to evaluate the intensity of back pain among elderly, recommending NRS and FPS-R.

ObjectiveTo investigate the test-retest reliability about the lower extremities static joint position sense which was tested with the Tetrax balance-test-training system, and the dynamic joint position sense which was tested with the Functional Squat System; and to investigate the relationship between the static and the dynamic joint position sense of lower extremities of the patients with knee osteoarthritis. Methods30 patients with knee osteoarthritis were tested with the lower extremities static and dynamic joint position sense twice within 7 d with the Tetrax balance-test-training system and the Functional Squat System. ResultsThe intraclass correlation coefficient (ICC) of the sum of the coefficient of medium-to-high-frequency in postural sway was 0.95 (P<0.001). The ICC of the reposition accuracy error mean of the unaffected/mild or affected/severe extremity were respectively 0.59 and 0.60 (P<0.001). The Pearson correlation coefficients of the sum of the coefficient of medium-to-high-frequency in postural sway and the reposition accuracy error mean of the unaffected/mild or affected/severe extremity were respectively 0.40 and 0.54 (P<0.05). ConclusionThe lower extremities static joint position sense test of the Tetrax balance-test-training system is well reliable, as well as the dynamic joint position sense of the Functional Squat System. They can be used together to evaluate the lower extremities proprioception in the patients with knee osteoarthritis.

Objective To evaluate the concurrent validity and preference of pain intensity assessment scales in elderly with back pain. Methods 30 elderly with back pain were asked to rate their pains by using Visual Analog Scale (VAS), Numeric Rating Scale (NRS), Verbal Descriptor Scale (VDS), Facial Pain Scale-Revised (FPS-R), and Mix scale (MIX). Concurrent validity was assessed using the Spearman correlations. The preference for using scales were collected. Results FPS-R、MIX、VAS and VDS correlated with NRS (r=0.753~0.957, P<0.001). The preference for using scales was ranked by FPS-R, NRS, VDS, MIX, VAS. Conclusion FPS-R、MIX、VAS and VDS show good concurrent validity, and they were appropriated to evaluate the back pain among elderly. FPS-R had the highest scale preference.