Objective To study the effect of Botulinum toxin type A (BTX-A) on lower limbs spasticity after stroke. Methods 109 convalescent patients after stroke were randomly divided into treatment group and the control group. All the patients accepted routine treatment and rehabilitation, the treatment group accepted BTX-A injected in spastic muscles in addition. They were assessed with Fugl-Meyer assessment (FMA), modified Ashworth scale (MAS), Berg Balance Scale (BBS) before, 4 weeks and 12 weeks after treatment. Results The scores of MAS, BBS and FMA improved more in the treatment group than in the control group (P<0.05) after treatment. Conclusion Combination of local BTX-A injection can significantly release the lower limbs spasticity, and improve the motor and balance ability for patients after stroke.

Trunk muscle activity is important to functional assessment, and predicts a variety of key outcomes, such as post-operative complications, functional decline and other important indicators. Trunk muscle activity and its control were reviewed in this paper.

Objective: To compare the effects of different types of strength training on upper limbs’ body composition and maximum strength and bone density of male university students, so as to provide a reference for college students to choose reasonable resistance training methods. Methods: Forty-two male university students were randomly divided into three experimental groups: maximum-strength group, MS(n=12); speed-strength group, SS(n=15); strength-endurance group, SE(n=15). All subjects were subject to resistance training for 6 weeks, twice a week. Incremental load method was used to determine the maximum strength of the subject to develop a training program. Upper limbs’ Body Composition and BMD were performed by Dual energy X-ray absorptionmetry. Results: After the continuous training for 6 weeks, maximum strength of upper limbs increased significantly with training time，SE grows faster[(51.00±4.81)(67.20±5.66)(76.87±6.21)kg]; The body fat percentage of SS group and SE group decreased significantly[(13.50±4.10)%，(12.60±2.80)%；(13.70±3.80)%，(12.70±3.10)%](t=2.35，2.30，P<0.05), while LM of upper limb increased significantly[(5.19±0.59)(5.86±0.61)；(5.27±0.72)(6.21±0.59)kg](t=-2.48，-2.94，P<0.05). There was no significant difference in the body fat percentage and LM of upper limb between MS group[(14.0±3.3)%，(13.6±2.3)%] and SE group[(5.33±0.81)(5.41±0.79)kg](t=0.31，-0.22，P>0.05); BMC and BMD of upper limbs increased in all groups, but the increase of SS group and SE group was statistically significant(t=-3.07，-2.43，P<0.05). Conclusion Strength endurance resistance training for male college students can effectively promote muscle strength growth, increase bone density and improve upper limb composition.

The non-randomized controlled study design was adopted. A total of 90 patients with knee osteoarthritis treated in Beijing Yuetan Community Health Service Center from September 2021 to August 2022 were enrolled in the study, including 45 patients received patellar loosening and then the quadriceps femoris pain point release (successive group) and remaining 45 patients received two manipulations simultaneously (simultaneous group). Patients were treated 3 times in a week, and each time received 5 groups of manipulation. The Visual Analogue Scale (VAS) and Lysholm scores were measured before treatment, immediately after treatment and 3 months after treatment. There was no exfoliation and no adverse events in both groups. There were no significant differences in VAS and Lysholm scores between the two groups before treatment ( P>0.05). Immediately after treatment, the VAS pain score in the simultaneous group was lower than that in the successive group ((3.36±1.12) vs.(2.24±0.93), P<0.01), while the Lysholm score in the simultaneous group was higher than that in the successive group ((89.76±6.61) vs.(74.07±16.80), P<0.01); the proportion of VAS score as“painless/mild pain”(88.9% (40/45) vs.64.4% (29/45), P<0.01) and Lysholm score as “excellent/good”(91.1% (41/45) vs. 44.4% (20/45), P<0.01) in the simultaneous group was significantly higher than that in the successive groups. At 3 months after treatment, there were still significant differences in VAS and Lysholm scores between the two groups. The simultaneous manipulations of patellar loosening and quadriceps femoris pain point release can better relieve the pain of patients with knee osteoarthritis.

BACKGROUND:Studies have reported that alendronate intake significantly increases bone mineral density in patients with osteoporosis. OBJECTIVE:To analyze and compare the changes in metabolites before and after alendronate intervention in ovariectomized rats by chromatography-mass spectrometry,and to further explore the specific mechanism and target of alendronate in the treatment of osteoporosis. METHODS:A total of 36 female Sprague-Dawley rats were randomly divided into model group,alendronate sodium group and sham operation group.The osteoporosis model was established by ovariectomy in the first two groups.Four weeks after modeling,the rats in the alendronate group were intragastrically given alendronate sodium,while those in the sham operation group and model group were given equal volume of normal saline.After 12 weeks of continuous gavage,the metabolites of the lumbar spine were analyzed by chromatography-mass spectrometry,and the common differential metabolites were obtained,which were analyzed by bioinformatics such as Kyoto Gene and Genome Encyclopedia pathway. RESULTS AND CONCLUSION:Totally 17 different metabolites were obtained in the three groups.The enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes showed that alendronate sodium could regulate unsaturated fatty acid biosynthesis,linoleic acid metabolism and other pathways to protect ovariectomized rats.These results indicate that alendronate sodium may exert its anti-osteoporosis effect by interfering with unsaturated fatty acid bioanabolism and linoleic acid metabolism,so as to achieve the purpose of preventing osteoporosis

Objective:To explore the clinical value of modified upper urinary tract video urodynamics in evaluating the surgical effect and guiding the follow-up treatment after ureteral reconstruction.Methods:From December 2018 to November 2020, sixty-nine patients underwent upper urinary tract reconstruction and received modified video urodynamics at the time of nephrostomy removal 3 months after the surgery in the RECUTTER database (29 cases in Peking University First Hospital, 22 cases in Emergency General Hospital, and 18 cases in Beijing Jiangong Hospital). There were 39 males and 30 females, with an average age of (40.4±12.7)years. The stricture was located in left in 34 patients, right side in 27 patients, and bilateral sides in 8 patients. The upper, middle, and lower thirds of the ureter were affected in 26, 10, and 33 cases, respectively. The preoperative creatinine was (92.3±26.9)μmol/L, and the estimated glomerular filtration rate (eGFR) was (85.1±23.2)ml/(min·1.73m 2). The upper urinary tract reconstruction included ileal replacement of ureter in 25 cases (36.2%), pyeloplasty in 8 cases (11.6%), ureteroneocystostomy in 9 cases (13.0%), boari flap in 6 cases (8.7%), lingual mucosal graft ureteroplasty in 9 cases (13.0%), appendiceal onlay ureteroplasty in 3 cases (4.3%), ureteroureterostomy in 3 cases (4.3%), and balloon dilation in 6 cases (8.7%). Based on the pressure and imaging, the results could be divided into three types, type Ⅰ, the pressure difference remained stable near baseline, and the renal pelvis pressure was below 22 cmH 2O(1 cmH 2O=0.098 kPa), and the reconstructed ureter is well visualized during the whole perfusion process; type Ⅱ, the pressure difference increases with the perfusion, but it can decrease to a normal level with the ureteral peristalsis; type Ⅲ, the pressure difference exceeds 15 cmH 2O, and the ureteral peristalsis is weak or disappears at the same time. The management strategies and treatment effects of different subtypes were analyzed. Successful treatment was defined as no further treatment required, the absence of hydronephrosis-related symptoms, and the improved or stabilized degree of hydronephrosis. Results:All 69 patients successfully completed upper urinary tract video urodynamics. The pressure difference was higher than 15 cmH 2O in 8 patients, and the median pressure difference was 37(19-54)cmH 2O. The renal pelvis pressure exceeded 22 cmH 2O in 10 patients, and the median pressure was 63.5 (24-155) cmH 2O. Video urodynamic results of upper urinary tract were classified as type Ⅰ in 60 cases, type Ⅱ in 5 cases, and type Ⅲ in 4 cases. Patients in type Ⅰ do not require other treatment after nephrostomy tube removal. Patients in type Ⅱ should avoid holding urine after the removal of nephrostomy and D-J tubes. All patients in type Ⅲ received further treatment, of which 2 patients replaced D-J tube regularly, 1 patient underwent long-term metal ureteral stent replacement, and 1 patient underwent ureteroscopic balloon dilation. The median follow-up time was 24 (18-42) months. All patients in type Ⅰ met the criteria for surgical success, The pre-and postoperative creatinine in type Ⅰ patients were (88.71±23.09)μmol/L and (88.75±23.64)μmol/L ( P=0.984), and eGFR were (88.06±22.66)ml/(min· 1.73m 2)and (87.97±23.01)ml/(min·1.73m 2), respectively( P=0.969). For type Ⅱ patients, ultrasound showed that the degree of hydronephrosis improved in 3 cases and remained stable in 2 cases. The pre-and postoperative creatinine were (105.97±7.75)μmol/L and (97.63±7.56)μmol/L ( P=0.216), and eGFR were (69.08±14.74)ml/(min·1.73m 2)and (75.95±14.02)ml/(min·1.73m 2)( P=0.243), respectively. For type Ⅲ patients, ultrasound showed that the degree of hydronephrosis remained stable. The pre-and postoperative creatinine were (105.14±44.34)μmol/L and (101.49±57.02)μmol/L ( P=0.684), and eGFR were (65.32±19.85)ml/(min·1.73m 2) and (73.42±27.88) ml/(min·1.73m 2), respectively( P=0.316). Conclusions:The pressure and imaging results of modified upper urinary tract video urodynamics can assist in evaluating the surgical effect of ureteral reconstruction, and the classification has certain guiding significance for further treatment.