Objective To evaluate the efficacy of radiofrcquency combined with ozone in the treatment of lumbar disc herniation using infrared thermography,and discuss the application value.Methods A total of 160 patients with lumbar disc herniation were randomly divided into observation group (80 cases) and control group (80 cases).The observation group was treated with continuous radiofrequency combined with ozone injection,and the control group was treated with pulse radiofrequency combined with ozone injection.Pain visual analogue (VAS) score,Oswestry dysfunction index (ODI) score,and Japanese Orthopaedic Association (JOA) score of the patients were compared before and 1 and 3 months after the treatment.The mean temperature and temperature difference of the lower body were compared by infrared thermography before and 3 months after the treatments.The overall clinical efficacy was evaluated 3 months after the treatments using the modified Macnab criteria.Results The comparison within groups showed that the VAS,ODI and JOA scores were significant changed after 1 and 3 months of the treatment (all P＜0.05).The average temperature of lower body from the infrared thermography was decreased after 3 months of the treatment (P＜0.05).The comparison among groups showed that the VAS,ODI and JOA scores after 1 and 3 months of the treatment had differences between the observation group and the control group,and all the differences were statistically significant (all P＜0.05).Moreover,the difference in the mean temperature of the low body after 3 months of the treatment was not statistically significant (P＞0.05),and in the temperature difference value was statistically significant between the two groups (P＜0.05).The overall clinical efficacy of the observation group was better than that of the control group after 3 months of the treatment (P＜0.05).Conclusions Radiofrequency combined with ozone injection is satisfactory for the treatment of lumbar disc herniation,and the continuous radiofrequency is superior to pulse radiofrequency.The clinical efficacy of radio-frequency combined with ozone injection can be effectively evaluated by Infrared thermography.

Cervical spondylotic radiculopathy is a common and frequently-occurring disease in the clinical department of orthopedics.It has the highest incidence of cervical spondylosis and has been classified as a difficult disease by the World Health Organization.Cervical spondylotic radiculopathy mainly manifests as root symptoms and signs consistent with the diseased segment,and the symptoms of stiffness,pain and numbness,which seriously affect the physical and mental health and life quality of patients.In clinical practice,the symptoms of cervical spondylotic radiculopathy can be alleviated by physical therapy,acupuncture,etc.Therefore,searching for more effective treatments has become a hot topic of current researches.Manipulations have the advantages of simple operation,quickness,quick effect and high recognition degree,and can achieve therapeutic purpose by improving the dynamic and static balance of cervical spines,correcting joint dislocation and improving blood circulation.Among them,the curative effect of rotational manipulations is more remarkable.The researches on rotational manipulations by domestic and foreign scholars mainly focus on the in vitro and in vivo biomechanics of cervical spines,and the biomechanical researches on the rotational manipulation itself were different.At present,the mechanical research on the rotational manipulation is still in the development stage,and there is no clear conclusion on the similarities and differences of the mechanical parameters and their influence on the mechanical environment of the cervical spine.In this paper,the research progress of biomechanical properties of cervical spine rotational manipulation was summarized to provide a theoretical basis for the mechanism of the rotational manipulation treatment of cervical spondylotic radiculopathy.

Objective:To study the effects of umbilical cord mesenchymal stem cells (UCMSCs) loaded by graphene oxide (GO) on cartilage repair in two KOA animal models.Methods:30 male New Zealand rabbits aged 12 weeks were randomly divided into A group ( n=15) and B group ( n=15). In the A group, the KOA model was established by the improved Hulth and cartilage defect method, and in the B group, the KOA model was established by the modified papain controlled-release injection method. After the modeling, the rabbits model in each group were divided into 4 subgroups, including blank control group ( n=3), GO group ( n=4), UCMSCs group ( n=4) and GO+UCMSCs group ( n=4). In these subgroups, the rabbit models were respectively treated injected with 0.5 ml of NaCl solution with 9 g/L, GO granular lubricant (GO with 30 μg/ml and solvent with hyaluronic acid with 0.25%), UCMSCs suspension (5×10 6 /ml), and mixed suspension of UCMSCs loaded by GO (GO with 30 μg/ml and UCMSCs with 5×10 6/ml) in right knee joint cavity. The serum levels of NO, collagen type Ⅱ(COL-Ⅱ), glycosaminoglycan (GAG), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA). Results:Eight weeks after the treatment, the serum levels of NO, IL-6 and TNF-α in GO+UCMSCs group were lower than those of the blank control group (all P<0.01), and the serum levels of COL-Ⅱ and GAG in GO+UCMSCs group were higher than those of the blank control group (all P<0.01). The serum NO level of the blank control group in group A was lower than that of the blank control group in group B [(22.097±0.352) ng/ml vs (23.662±0.056) ng/ml, P<0.05]. The serum COL-Ⅱ levels of the UCMSCs group and GO+UCMSCs group in group A were higher than those of group B respectively [(15.589±0.063) ng/ml vs (14.429±0.092) ng/ml, and (19.372±0.063) ng/ml vs (16.257±0.416) ng/ml, all P<0.01]. The serum GAG levels of the blank control group and the GO+UCMSCs group in group A were higher than those in group B respectively [(23.832±0.891) ng/ml vs (18.709±0.552) ng/ml, and (37.439±2.155) ng/ml vs (26.554±0.450) ng/ml, all P<0.01). The serum IL-6 levels of the blank control group and the GO+UCMSCs group in group A were lower than those in group B respectively [(16.082±0.323) ng/ml vs (18.367±0.861) ng/ml, P<0.05; (7.426±0.294) ng/ml vs (8.680±0.242) ng/ml, P<0.01]. The serum TNF-α levels of the blank control group and the GO+UCMSCs group in group A were lower than those in group B respectively [(9.466±0.177) ng/ml vs (10.013±0.197) ng/ml, P<0.05; (5.139±0.183) ng/ml vs (6.210±0.058) ng/ml, P<0.01]. Conclusions:GO loaded UCMSCs can promote the secretion of chondrocytes in rabbit KOA models, reduce inflammatory levels in joints, and play a role in cartilage repair.

Objective:To study the clinical efficacy and lower limb temperature difference of bipolar radiofrequency combined with ozone in the treatment of lumbar disc herniation(LDH).Methods:A retrospective study was conducted on 105 inpatients with LDH. All patients were treated with bipolar radiofrequency combined with ozone. The interdisc impedance of the main electrode was measured before and after treatment, and the absolute temperature difference of infrared thermal imaging of both lower extremities before and after treatment was analyzed. Vasual analogue scale (VAS) score, JOA score and modified Macnab standard were used to evaluate the curative effect after treatment.Results:The VAS score after treatment was significantly lower than that before treatment( P<0.05), and the JOA score after treatment was significantly higher than that before treatment( P<0.05). The intervertebral disc impedance after treatment was significantly lower than that before treatment( P<0.05). The temperature difference between leg and plantar after treatment was significantly lower than that before treatment (all P<0.05). Conclusions:Bipolar radiofrequency combined with ozone therapy can relieve pain and improve function in patients with LDH. Infrared thermal imaging can sensitively reflect the changes of body surface temperature of lower extremities in patients with LDH, and has a certain value in the diagnosis and curative effect evaluation of LDH.

Objective To observe the clinical efficacy of pulsed radiofrequency combined with fixed-point lateral flexion and rotation realignment cervical manipulation in the treatment of cervical spondylotic radiculopathy (CSR). Methods Sixty-three patients with CSR were randomly divided into observation group (n=32) and control group (n=31). The observation group was given pulse radiofrequency combined with fixed-point lateral flexion and rotation realignment cervical manipulation, and the control group was given the pulsed radiofrequency treatment. Visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores were obtained before the treatment, 7 days and 3 months after the treatment. The temperature differences of bilateral upper limbs infrared thermal imaging were observed before and 3 months after the treatment in the two groups. The clinical efficacy of the two groups was evaluated by using TCM disease and syndrome diagnosis criteria. Results After 7 days and 3 months of the treatment, the VAS scores of the two groups were lower than those before treatments, the VAS scores of the observation group were lower than the control group, and all the differences were statistically significant (all P<0.05). The JOA scores in the two groups were higher than those before treatment, the JOA scores of the observation group were higher than the control group , and the differences were statistically significant (all P<0.05). There was no statistically significant difference in the infrared temperature difference between the upper limbs of the observation group and the control group before treatments [(0.83±0.27) °C vs (0.87±0.29) °C, P>0.05]. Three months after the treatment, the temperature difference of infrared thermography in the upper limbs of the observation group was better than that of the control group (P<0.05), and the cure rate of the observation group was better than that of the control group, and the difference was statistically significant (68.75％vs 22.58％, P<0.05). There was no statistically significant difference in the total effective rate between the two groups (93.75％vs 90.32％, P>0.05). Conclusions The pulsed radiofrequency combined with the fixed-point lateral flexion and rotation realignment cervical manipulation in the treatment of radiculopathic cervical spondylosis was effective in improving pain, function and infrared imaging temperature of upper limbs.

Objeetive To investigate tear film lipid layer thickness (LLT) and its association with clinical symptom and sign in different types of dry eye patients.Methods A serial case-observational study was carried out.Three hundred and six eyes of 306 dry eye patients were included in Beijing Tongren Hospital from April to August 2016.Ocular surface disease index (OSDI) questionnaire,eyelid slit lamp examination,the measurement of tear film lipid thickness (LLT),tear film break-up time (TBUT),Schirmer Ⅰ test (S Ⅰ t) and the infrared meibomian photography were performed on the patients.The 157 patients with OSDI ＞12 and eyelid score ≥2 served as the MGD group;53 patients with OSDI ＞12 and S Ⅰ t value ＜ 5 mm/5 minutes served as ADDE group;96 patients with OSDI＞12,eyelid score ≥2 and S Ⅰ t value ＜ 5 mm/5 minutes served as MGD/ADDE group.Tear film LLT was detected with LipiView(R) ocular surface interferometer and the association of LLT with clinical characteristics of the patients was analyzed.This study protocol was approved by Ethic Committee of Beijing Tongren Hospital and written informed consent was obtained from each patient prior to any relative medical examination.Results Tear film LLT of the participants was normally distributed with the average was (60.41±18.57)nm.LLT in the MGD group,ADDE group,MGD/ADDE group were (57.04 ± 18.26),(63.52 ± 18.44) and (60.56 ± 18.71) nm,respectively,with a significant difference among the three groups (F =2.347,P =0.035),and the LLT value was significantly lower in the MGD group than that in the ADDE group (t =2.077,P =0.039).The LLT value showed negative correlations with the severity of dry eye symptom,S Ⅰ t and meibomian gland loss rate (r=-0.201,P=0.003;r=-0.146,P=0.005;r=-0.156,P=0.046).OSDI score was significantly correlated with LLT only in the MGD group (r =-0.285,P =0.000).No significant correlation was seen between LLT and S I t in all the groups (all at P＞0.05).In the MGD/ADDE group and MGD group,the correlation between LLT and meibomian gland loss rate was significantly greater than the overall correlation (r=-0.335,-0.248,-0.156).The dry eye symptoms in OSDI questionnaire like foreign body sensation,eye pain,discomfort when watching TV or computer showed significant correlations with LLT (r =-0.243,-0.205,-0.223,-0.258,all at P ＜0.05).Conclusions The tear LLT is appeared to be varied in different types of dry eye.The LLT is thinner in the dry eyes with MGD and thicker in the dry eyes with ADDE.There are association between tear LLT and foreign body sensation,eye pain,discomfort when watching TV or computer.

Knee Osteoarthritis (KOA) is a joint disease with the main pathological changes of knee articular cartilage degeneration, loss and gradual deterioration. Clinically, KOA is more common in the middle-aged and the elderly, mainly manifested as knee pain and limited mobility, and walking disabilities. Walking is the basis of human behavior, and gait is the characteristic of human behavior when walking. Gait analysis (GA) studies the characteristics of the human body's gait behavior while walking, and combines knowledge of kinematics, dynamics, and biomechanics to analyze and obtain digital information on gait characteristics. GA is an effective tool for quantitative assessment of gait disorders. In KOA patients, the knee dynamic and static systems are unbalanced, the lower limb force lines are abnormal, and then the lower limb movement abnormalities occur, which affects normal gait. Researchers have taken gait feature analysis of KOA patients as a research hotspot, hoping to grasp the condition of patients with GA at different stages of KOA diagnosis, treatment and rehabilitation. In this paper the research progress of the studies on the GA patients' gait characteristics obtained by gait analysis was reviewed. This paper is expected to provide a more accurate digital basis for the diagnosis, treatment and rehabilitation assessment of KOA, and make the patient's diagnosis and treatment plan more precise.

Objective:To observe the effects of "pushing patella and extending knee" manipulation on the protein and mRNA expression levels of integrin β1 (ITGβ1) and phosphorylated adhesion plaque kinase (p-FAK) in rabbit knee osteoarthritis (KOA) model, and to investigate the mechanism of manipulations in the treatment of KOA.Methods:Twenty healthy 6-month-old New Zealand rabbits were divided into the normal group, the model group, the acupuncture group, and the manipulation group according to the random number table method. Among them, the model group, the acupuncture group, and the manipulation group were modeled using the modified Hulth method for KOA. After 7 d of successful modeling, the normal group and the model group did not receive any intervention, while the acupuncture group and the manipulation group received one acupuncture intervention and one "pushing patella and extending knee" manipulation intervention daily, respectively. After 2 weeks of treatment, the rabbit KOA model was executed by air embolization, and the protein and mRNA expression levels of ITGβ1 and p-FAK in knee cartilage were measured by Western blot and real-time polymerase chain reaction (PCR), respectively.Results:Compared with the normal group, the ITGβ1 protein expression level was decreased ( P<0.05) and p-FAK protein expression level was increased ( P<0.05), and the mRNA expression levels of ITGβ1 and p-FAK did not change significantly (all P>0.05) in the model group. Compared with the model group, the ITGβ1 protein expression level was increased ( P<0.05), the p-FAK protein expression level decreased ( P<0.05), and the mRNA expression levels of both ITGβ1 and p-FAK increased (all P<0.05) in the acupuncture group. Compared with the acupuncture group, ITGβ1 protein expression level increased ( P<0.05), p-FAK protein expression level decreased ( P<0.05), and mRNA expression levels of both ITGβ1 and p-FAK increased (all P<0.01) in the manipulation group. Conclusions:The "pushing patella and extending knee" manipulation can optimize the protein and mRNA expression levels of ITGβ1 and p-FAK in the articular cartilage of the rabbit KOA model.

Objective To analyze the changes in morphology of intervertebral foramina in patients with cervical spondylotic radiculopathy (CSR) treated with fixedpoint lateral flexion and rotation manipulation based on three-dimensional (3D) reconstruction technology, so as to provide references for the effectiveness of manipulation treatment. MethodsForty patients with CSR were treated with fixed point lateral flexion and rotation manipulation once every other day for a total of 7 times and 2 weeks as a course of treatment. CT data of the patients before and after treatment were analyzed by using multifunctional CT, Mimics 21.0, Geomagic and SolidWorks 2017. The area of the intervertebral foramen, anterior and posterior diameter of the intervertebral foramen, upper and lower diameter of the intervertebral foramen were measured before and after treatment, as well as the infrared thermal imaging temperature differences of the bilateral neck and shoulder, front and back of the upper limb, and the VAS scores of the patients were observed before treatment, 7 d after treatment, 14 d after treatment and 1 month follow-up. Results Foraminal area, anterior and posterior diameters, upper and lower diameters of 40 patients were improved after treatment, and the temperature differences of infrared thermal imaging of patients before and after treatment were statistically significant. The VAS score of the patients decreased progressively. Conclusions Fixed point lateral flexion manipulation can significantly improve the shape of the intervertebral foramen in patients with CSR, so as to achieve the treatment purpose of relieving nerve compression.