Objective:To evaluate the clinical efficacy of tendon-regulating manipulation plus kinesiotherapy in treating low back pain. Methods:Sixty patients were randomized into a treatment group and a control group by using the random number table, 30 cases in each group. The treatment group was intervened by tendon-regulating manipulation plus kinesiotherapy, while the control group was by the tendon-regulating manipulation alone. The lumbar lordosis was measured by X-ray (side view), the pain was evaluated by analgesy meter, the lumbar range of motion was by using goniometer, and the function was judged by Oswestry disability index (ODI) before and after treatment, and the therapeutic efficacy was also observed. Results:After treatment, the pain level was significantly reduced, lumbar lordosis was significantly increased, the lumbar range of motion was markedly improved, and the ODI score significantly dropped (allP<0.05) in both groups; the improvement of each item in the treatment group was more significant than that in the control group (allP<0.05). The total effective rate was 90.0% in the treatment group versus 63.3% in the control group, and the difference was statistically significant (P<0.05). Conclusion:In the treatment of low back pain, tendon-regulating manipulation plus kinesiotherapy can mitigate topical pain, improve the motion of low back, enhance the quality of life, and produce a more significant therapeutic efficacy compared to tendon-regulating manipulation alone.

Objective:To investigate the relationship between the expression levels of serum glycogen synthase kinase-3β (GSK-3β) and mothers against decapentaplegic homolog 4 (SMAD4) in patients with acute coronary syndrome (ACS) and the severity and prognosis of coronary artery disease.Methods:A total of 192 ACS patients admitted to Shandong First Medical University Affiliated Qingdao Hospital from June 2020 to May 2022 were selected as the ACS group, while 192 non ACS patients admitted to the same hospital were selected as the non ACS group. Enzyme-linked immunosorbent assay method was applied to determine the expression levels of serum GSK-3β and SMAD4 in two groups. The Gensini score was applied to evaluate the degree of coronary artery disease in patients, Spearman method was applied to analyze the correlation between serum GSK-3β, SMAD4 expression levels and Gensini score in ACS patients. Receiver operating characteristic (ROC) curve was applied to analyze the predictive efficacy of serum GSK-3β and SMAD4 levels on the prognosis of ACS patients.Results:The serum levels of GSK-3β and SMAD4 in the ACS group were significantly higher than those in the non ACS group: (2.70 ± 0.40) μg/L vs. (2.24 ± 0.41) μg/L, (12.19 ± 2.10) μg/L vs. (9.79 ± 2.82) μg/L, and there were statistical differences ( P<0.05). The serum levels of GSK-3β and SMAD4 in ACS patients with mild, moderate and severe coronary artery disease increased sequentially ( P<0.05). Spearman analysis showed that serum GSK-3β and SMAD4 levels in ACS patients were positively correlated with Gensini total score ( r = 0.569 and 0.587, P<0.01). In ACS patients, 48 cases had poor prognosis, and the incidence of poor prognosis was 25.00% (48/192); 144 cases had a good prognosis. The serum levels of GSK-3β and SMAD4 in ACS patients with poor prognosis were significantly higher than those in ACS patients with good prognosis: (3.15 ± 0.53) μg/L vs. (2.55 ± 0.36) μg/L, (14.03 ± 2.08) μg/L vs. (11.58 ± 2.11) μg/L, and there were statistical differences ( P<0.05). The ROC curve result indicated that the area under the curve (AUC) for predicting poor prognosis in ACS patients with serum GSK-3β and SMAD4 levels alone and in combination was 0.799, 0.784 and 0.858, respectively, the AUC predicted by the combination of the two was obviously higher than the AUC predicted separately ( Z = 2.04 and 2.75, P = 0.041 and 0.006). Conclusions:The expression levels of GSK-3β and SMAD4 in the serum of ACS patients are abnormally elevated. They are positively correlated with the degree of coronary artery disease in ACS patients, and both have good predictive power for adverse prognosis in ACS patients, while the combined use of the two has better predictive performance.