Objective:To observe the impact of Yi Jin Jing(Sinew-transforming Exercise)plus individualized exercise prescription combining treadmill training and strength training on geriatric female patients with primary osteoporosis(POP).Methods:Seventy-five geriatric female POP patients were recruited and randomized into a control group,an exercise therapy group,or a combined group,with 25 cases in each group.The control group received regular treatment,including health education and oral administration of calcium carbonate and vitamin D3 granules and alendronate sodium.The exercise therapy group received treadmill-based exercise and strength training 3 times weekly in addition to the intervention given to the control group.The combined group underwent treadmill-based exercise,strength training,and Yi Jin Jing training 3 times weekly in addition to the intervention given to the control group.The intervention lasted 24 weeks in each group.Before and after treatment,the visual analog scale(VAS)score,grip strength,bone density of L1-L4 and femoral neck,and serum levels of parathyroid hormone(PTH),25-hydroxyvitamin D3[25(OH)D3],osteocalcin(OC),procollagen Ⅰ N-terminal propeptide(PINP),and beta C-telopeptide of type Ⅰ collagen(β-CTX)were compared.Results:After treatment,the combined group and exercise therapy group showed a significant decrease in the VAS score and an increase in the grip strength(P<0.05).The bone density of L1-L4 and femoral head rose in all three groups after the intervention(P<0.05),together with markedly decreased serum PTH,OC,PINP,and β-CTX levels(P<0.05)and a notably increased 25(OH)D3 level(P<0.05).After treatment,the combined and exercise therapy groups had a significantly lower VAS score and higher grip strength(P<0.05)compared to the control group;the former two groups also had a higher bone density of L1-L4 and femoral head(P<0.05),lower serum PTH,PINP,and β-CTX levels(P<0.05)and a higher 25(OH)D3 level(P<0.05).Compared to the exercise therapy group,the combined group had a lower VAS score,higher L1-L4 and femoral head bone density,and lower serum PINP and β-CTX levels.Conclusion:Based on regular treatment,personalized exercise prescriptions centered on Yi Jin Jing can alleviate pain,enhance grip strength and bone density,and correct abnormal expression of bone metabolism markers in geriatric females with POP.

BACKGROUND:Unilateral knee osteoarthritis patients experience abnormal alterations in lower extremity gait biomechanics,yet few studies have analyzed changes in gait dynamics and muscle activation in knee osteoarthritis patients from the perspective of gait asymmetry.OBJECTIVE:To explore the effects of unilateral knee osteoarthritis on gait dynamics and muscle activation asymmetry in elderly women.METHODS:Thirty female patients with unilateral knee osteoarthritis attending Beijing Jishuitan Hospital Guizhou Hospital from October 2023 to March 2024 were selected as the knee osteoarthritis group,and 30 healthy elderly females without musculoskeletal disorders from the neighboring community were recruited as the control group.The kinetic and muscle activation levels of the subjects in both groups during walking were synchronously collected by a P-6000 force platform and a Free EMG300 surface EMG device.Kinetic parameters included the first and second peak forces of vertical ground reaction force.Muscle activation indexes included normalized root mean square values of rectus femoris,long head of biceps femoris,and lateral gastrocnemius muscle during the braking and pushing phases.Asymmetry index of the kinetic and muscle activation indexes were calculated separately in patients with K-L grade Ⅱ and Ⅲ knee osteoarthritis and controls and compared between groups by independent samples t-test and one-way analysis of variance.RESULTS AND CONCLUSION:(1)The difference between the second peak of vertical ground reaction force of both limbs in the knee osteoarthritis group was statistically significant(P＜0.05),as well as the difference between the standardized root mean square of rectus femoris in the braking phase and gastrocnemius and biceps femoris in the pushing phase(P＜0.05).(2)In terms of asymmetry index,the difference between the asymmetry index values of the first peak of vertical ground reaction force between the two groups of subjects was not statistically significant(P＞0.05),while the difference between the second peak asymmetry index values was statistically significant(P＜0.05).The difference in asymmetry index values of standardized root mean square of rectus femoris muscle during the braking phase as well as gastrocnemius and biceps femoris muscles during the pushing phase was statistically significant between the two groups of subjects(P＜0.05).(3)The asymmetry index of the standardized root mean square values of the second peak of vertical ground reaction force,rectus femoris in the braking phase,gastrocnemius in the pushing phase,and biceps femoris in the osteoarthritis group of the knee with K-L classification grade Ⅱand Ⅲ were significantly higher than those of the control group(P＜0.05).The asymmetry indices of standardized root mean square values of the second peak of vertical ground reaction force,rectus femoris in the braking phase and biceps femoris in the pushing phase were higher in the osteoarthritis group of the knee with K-L classification Ⅲ than in the osteoarthritis group of the knee with classification Ⅱ(P＜0.05).(4)The asymmetry indices of the second peak of vertical ground reaction,the rectus femoris muscle in the braking phase,and the muscle activation of the biceps femoris and gastrocnemius muscles in the pushing phase can be used as an important index for identifying gait asymmetry in the knee osteoarthritis,which is helpful in providing a theoretical basis for the development of rehabilitation treatment programs.It is also worth noting that extra attention should be paid to patients with higher severity of knee osteoarthritis in the clinical monitoring of gait asymmetry.

Objective:To investigate the effects of psychological state on the setup errors of radiotherapy for breast cancer patients.Methods:A prospective cohort study was conducted. A total of 193 breast cancer patients in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from October 2022 to May 2023 were selected. Radiotherapy was performed after fixation with an integrated multi-functional device for the head, chest and abdomen. Psychological status of patients was assessed by using 9-item health questionnaire (PHQ-9) and generalized anxiety disorder 7 self-rating scale (GAD-7) before first radiotherapy, the 10th radiotherapy and the last radiotherapy. Based on the results of the questionnaires, patients were divided into psychological problem (anxiety or depression) group and non-psychological problem group. The general data and setup errors of radiotherapy in both groups were compared.Results:All the 193 patients were female, with a median age of 47 years. There were 53 patients in psychological problem group and they underwent a total of 507 image-guided procedures, with setup errors [ M ( Q1, Q3)] of 0.18 (0.07, 0.33), 0.20 (0.10, 0.33) and 0.19 (0.09, 0.30) in the left-right (X), superior-inferior (Y), and anterior-posterior (Z) directions, respectively; the remaining 140 patients in non-psychological problem group underwent 1 240 image-guided procedures, with setup errors [ M ( Q1, Q3)]of 0.17 (0.08, 0.30), 0.20 (0.10, 0.30) and 0.18 (0.09, 0.28) in the X, Y, and Z directions, respectively, and the differences were statistically significant ( Z values were -3.78, -2.00; P < 0.001, P = 0.046). Conclusions:Anxiety and depression have an influence on the setup errors of radiotherapy in patients with breast cancer. In the processs of radiotherapy for breast cancer, it is important to pay attention to the psychological status of patients.

This paper summarizes Professor SUN Yuanzheng's academic thought and clinical experience in treating diabetic retinopathy (DR) with yuan-primary and luo-connecting meridian-regulating acupuncture. Professor SUN considers that the fundamental cause of DR lies in visceral dysfunction, with stagnation in the ocular collateral vessels and impairment of the mysterious orifices being the core pathogenesis. He proposes the treatment model of "regulating viscera, unblocking ocular collaterals, and opening mysterious orifices" based on yuan-primary and luo-connecting meridian-regulating acupuncture. Yuan-primary and luo-connecting points are used to balance qi, blood, yin, and yang of the viscera. Baihui (GV20) is stimulated with transcranial repetitive acupuncture to activate the yang qi of the governor vessel and invigorate qi in the twelve meridians, improving systemic microcirculation. Combining this with stimulation of ocular areas, Fengchi (GB20), and periocular points, the stasis in the ocular collaterals are cleared and the mysterious orifices are unblocked, addressing both the root and manifestations of DR.
Humans ; Diabetic Retinopathy/physiopathology* ; Acupuncture Therapy/history* ; Meridians ; Acupuncture Points ; Qi

Objective To investigate the influencing factors of pain during ultrasound-guided puncture sclerotherapy in the treatment of ovarian chocolate cyst(OEC).Methods A retrospective cohort study was conducted on 209 OEC patients undergoing ultrasound-guided puncture sclerotherapy in our department from September 2021 to September 2023.Demographic data,medical history and surgical information were collected.According to surgical approach,they were divided into transabdominal surgery group(n=57)and transvaginal surgery group(n=152).Pain scores were assessed at 5 surgical time points:needle insertion,irrigation,displacement,sclerosis,and needle withdrawal.Pain scores were compared between the 2 groups at each surgical moment.According to the pain scores at the moments of needle insertion and replacement,the patients were divided into the no/mild pain group(pain score ≤ 3)and the moderate/severe pain group(pain score ≥4),and the related factors of the incidence of moderate/severe pain were analyzed.Results There was no statistical difference in intraoperative pain between different surgical approaches(transabdominal/transvaginal)in treating OEC under the guidance of ultrasound.At the moment of needle insertion,significantly higher incidence of moderate/severe pain was observed in the patients with a body mass index(BMI)＞23.9 kg/m2 than those with BMI ≤23.9 kg/m2,and those with a history of dysmenorrhea than those without(P＜0.05).At the time point of displacement,BMI and history of dysmenorrhea had no correlation with the incidence of moderate/severe pain.Age,obstetric history,mode of delivery,time of menarche,menstrual volume,history of pelvic surgery,history of combined adenomyosis,size of cysts,duration of surgery,and surgical approach had no notable impacts on intraoperative pain.Conclusion Different surgical approaches for ultrasound-guided puncture sclerotherapy of OEC have no effect on pain levels at various surgical moments.From the aspect of humanistic care,transabdominal puncture should be preferred.During needle insertion and displacement,particular attention should be given to the overweight patients and those with a history of dysmenorrhea,and appropriate pain intervention measures should be formulated.

BACKGROUND:One of the main goals after anterior cruciate ligament reconstruction is to restore normal gait patterns.However,to date,a limited number of studies have examined changes in gait asymmetry after anterior cruciate ligament reconstruction.OBJECTIVE:To explore asymmetric changes in knee kinematics and dynamics under different stride length conditions.METHODS:Thirty subjects(15 males and 15 females)3 months after anterior cruciate ligament reconstruction of the single knee were included in this study.Among them,each subject received the walking test with three different stride lengths,a normal stride length and a 30％as well as a 50％increase in the normal stride length.Knee kinematic and kinetic indices were collected by means of an Italian BTS infrared motion capture system and a dynamometer table,where kinematic indices included knee flexion,extension,and adduction angles,and kinetic indices included ground reaction forces,knee flexion moments,knee extension moments,and knee adduction moments.The asymmetry index values of the kinematic and kinetic indices were calculated.A one-way analysis of variance was used to compare the differences in asymmetry of each parameter under different stride length conditions.RESULTS AND CONCLUSION:(1)Compared with the asymmetry indices of normal step length,the indices of knee flexion angle,knee flexion moments,knee adduction moments,knee extension moments,and ground reaction forces were significantly lower when the step length was increased by 30％(P＜0.05);the indices of knee adduction angle,knee flexion angle,knee extension angle,knee adduction moments,knee extension moments,knee flexion moments,and ground reaction forces were significantly lower when the step length was increased by 50％(P＜0.05).(2)When the step length was increased by 50％,the indexes of knee adduction angle,knee extension moments,and ground reaction forces were significantly lower than when the step length was increased by 30％(P＜0.05).(3)These findings suggest that increasing stride length improves gait asymmetry after anterior cruciate ligament reconstruction,but an increase of 50％is superior,which in turn relieves the loads placed on the anterior cruciate ligament during walking.Meanwhile,step length can be used as an adjustable variable in gait to prevent and relieve symptoms of pain,improve knee function,and enhance quality of life in patients with post-anterior cruciate ligament reconstruction injuries in future clinical work.

BACKGROUND:In recent years,the use of blood flow restriction training in the rehabilitation of ankle injuries has gradually increased,and this technique can improve muscle strength,and can achieve a similar effect of high-load resistance training when combined with low-intensity resistance training. OBJECTIVE:To elucidate the current application status of blood flow restriction training in the prevention and rehabilitation of foot and ankle injuries. METHODS:A literature search was conducted on CNKI,PubMed,and Web of Science databases. The Chinese search terms were "blood flow restriction training,pressure training,ankle,ankle joint," and the English search terms were "blood flow restriction,BFR,KAATSU,ankle,foot." Relevant literature from database inception to July 2023 was retrieved,and 50 articles were ultimately included according to inclusion and exclusion criteria. RESULTS AND CONCLUSION:In foot and ankle applications,blood flow restriction training is primarily used in studies of Achilles tendon thickness and ankle muscle strength in healthy individuals,as well as in chronic ankle instability,after Achilles tendon ruptures,and after external ankle fractures. Single blood flow restriction training can reduce the thickness of Achilles tendon in healthy individuals,while long-term training can make it thicker. Blood flow restriction training can prevent muscle strength decline in healthy individuals,while low-intensity blood flow training can promote ankle muscle strength recovery in injured patients. In current research,few adverse events related to blood flow restriction have been found,and future research should compare the efficacy of different training programs in different populations and optimize the research content.

BACKGROUND:One of the main goals after anterior cruciate ligament reconstruction is to restore normal gait patterns.However,to date,a limited number of studies have examined changes in gait asymmetry after anterior cruciate ligament reconstruction.OBJECTIVE:To explore asymmetric changes in knee kinematics and dynamics under different stride length conditions.METHODS:Thirty subjects(15 males and 15 females)3 months after anterior cruciate ligament reconstruction of the single knee were included in this study.Among them,each subject received the walking test with three different stride lengths,a normal stride length and a 30％as well as a 50％increase in the normal stride length.Knee kinematic and kinetic indices were collected by means of an Italian BTS infrared motion capture system and a dynamometer table,where kinematic indices included knee flexion,extension,and adduction angles,and kinetic indices included ground reaction forces,knee flexion moments,knee extension moments,and knee adduction moments.The asymmetry index values of the kinematic and kinetic indices were calculated.A one-way analysis of variance was used to compare the differences in asymmetry of each parameter under different stride length conditions.RESULTS AND CONCLUSION:(1)Compared with the asymmetry indices of normal step length,the indices of knee flexion angle,knee flexion moments,knee adduction moments,knee extension moments,and ground reaction forces were significantly lower when the step length was increased by 30％(P＜0.05);the indices of knee adduction angle,knee flexion angle,knee extension angle,knee adduction moments,knee extension moments,knee flexion moments,and ground reaction forces were significantly lower when the step length was increased by 50％(P＜0.05).(2)When the step length was increased by 50％,the indexes of knee adduction angle,knee extension moments,and ground reaction forces were significantly lower than when the step length was increased by 30％(P＜0.05).(3)These findings suggest that increasing stride length improves gait asymmetry after anterior cruciate ligament reconstruction,but an increase of 50％is superior,which in turn relieves the loads placed on the anterior cruciate ligament during walking.Meanwhile,step length can be used as an adjustable variable in gait to prevent and relieve symptoms of pain,improve knee function,and enhance quality of life in patients with post-anterior cruciate ligament reconstruction injuries in future clinical work.

BACKGROUND:Unilateral knee osteoarthritis patients experience abnormal alterations in lower extremity gait biomechanics,yet few studies have analyzed changes in gait dynamics and muscle activation in knee osteoarthritis patients from the perspective of gait asymmetry.OBJECTIVE:To explore the effects of unilateral knee osteoarthritis on gait dynamics and muscle activation asymmetry in elderly women.METHODS:Thirty female patients with unilateral knee osteoarthritis attending Beijing Jishuitan Hospital Guizhou Hospital from October 2023 to March 2024 were selected as the knee osteoarthritis group,and 30 healthy elderly females without musculoskeletal disorders from the neighboring community were recruited as the control group.The kinetic and muscle activation levels of the subjects in both groups during walking were synchronously collected by a P-6000 force platform and a Free EMG300 surface EMG device.Kinetic parameters included the first and second peak forces of vertical ground reaction force.Muscle activation indexes included normalized root mean square values of rectus femoris,long head of biceps femoris,and lateral gastrocnemius muscle during the braking and pushing phases.Asymmetry index of the kinetic and muscle activation indexes were calculated separately in patients with K-L grade Ⅱ and Ⅲ knee osteoarthritis and controls and compared between groups by independent samples t-test and one-way analysis of variance.RESULTS AND CONCLUSION:(1)The difference between the second peak of vertical ground reaction force of both limbs in the knee osteoarthritis group was statistically significant(P＜0.05),as well as the difference between the standardized root mean square of rectus femoris in the braking phase and gastrocnemius and biceps femoris in the pushing phase(P＜0.05).(2)In terms of asymmetry index,the difference between the asymmetry index values of the first peak of vertical ground reaction force between the two groups of subjects was not statistically significant(P＞0.05),while the difference between the second peak asymmetry index values was statistically significant(P＜0.05).The difference in asymmetry index values of standardized root mean square of rectus femoris muscle during the braking phase as well as gastrocnemius and biceps femoris muscles during the pushing phase was statistically significant between the two groups of subjects(P＜0.05).(3)The asymmetry index of the standardized root mean square values of the second peak of vertical ground reaction force,rectus femoris in the braking phase,gastrocnemius in the pushing phase,and biceps femoris in the osteoarthritis group of the knee with K-L classification grade Ⅱand Ⅲ were significantly higher than those of the control group(P＜0.05).The asymmetry indices of standardized root mean square values of the second peak of vertical ground reaction force,rectus femoris in the braking phase and biceps femoris in the pushing phase were higher in the osteoarthritis group of the knee with K-L classification Ⅲ than in the osteoarthritis group of the knee with classification Ⅱ(P＜0.05).(4)The asymmetry indices of the second peak of vertical ground reaction,the rectus femoris muscle in the braking phase,and the muscle activation of the biceps femoris and gastrocnemius muscles in the pushing phase can be used as an important index for identifying gait asymmetry in the knee osteoarthritis,which is helpful in providing a theoretical basis for the development of rehabilitation treatment programs.It is also worth noting that extra attention should be paid to patients with higher severity of knee osteoarthritis in the clinical monitoring of gait asymmetry.

Objective:To observe the impact of Yi Jin Jing(Sinew-transforming Exercise)plus individualized exercise prescription combining treadmill training and strength training on geriatric female patients with primary osteoporosis(POP).Methods:Seventy-five geriatric female POP patients were recruited and randomized into a control group,an exercise therapy group,or a combined group,with 25 cases in each group.The control group received regular treatment,including health education and oral administration of calcium carbonate and vitamin D3 granules and alendronate sodium.The exercise therapy group received treadmill-based exercise and strength training 3 times weekly in addition to the intervention given to the control group.The combined group underwent treadmill-based exercise,strength training,and Yi Jin Jing training 3 times weekly in addition to the intervention given to the control group.The intervention lasted 24 weeks in each group.Before and after treatment,the visual analog scale(VAS)score,grip strength,bone density of L1-L4 and femoral neck,and serum levels of parathyroid hormone(PTH),25-hydroxyvitamin D3[25(OH)D3],osteocalcin(OC),procollagen Ⅰ N-terminal propeptide(PINP),and beta C-telopeptide of type Ⅰ collagen(β-CTX)were compared.Results:After treatment,the combined group and exercise therapy group showed a significant decrease in the VAS score and an increase in the grip strength(P<0.05).The bone density of L1-L4 and femoral head rose in all three groups after the intervention(P<0.05),together with markedly decreased serum PTH,OC,PINP,and β-CTX levels(P<0.05)and a notably increased 25(OH)D3 level(P<0.05).After treatment,the combined and exercise therapy groups had a significantly lower VAS score and higher grip strength(P<0.05)compared to the control group;the former two groups also had a higher bone density of L1-L4 and femoral head(P<0.05),lower serum PTH,PINP,and β-CTX levels(P<0.05)and a higher 25(OH)D3 level(P<0.05).Compared to the exercise therapy group,the combined group had a lower VAS score,higher L1-L4 and femoral head bone density,and lower serum PINP and β-CTX levels.Conclusion:Based on regular treatment,personalized exercise prescriptions centered on Yi Jin Jing can alleviate pain,enhance grip strength and bone density,and correct abnormal expression of bone metabolism markers in geriatric females with POP.