Objective To analyze the burden and trend of musculoskeletal diseases(including gout,low back pain,neck pain,osteoarthritis,and rheumatoid arthritis)in China from 1990 to 2021,and to provide reference for formulating and adjusting prevention strategies for musculoskeletal diseases.Methods The Global Burden of Disease(GBD)in 2021 database was used to analyze the status and trend of the incidence and disability-adjusted life years(DALYs)rate of musculoskeletal diseases in China.Annual percentage change(EAPC)was used to comprehensively evaluate the trend of the burden of musculoskeletal diseases from 1990 to 2021.Gender and age-specific incidence and DALYs rate of musculoskeletal diseases were analyzed.Results In 2021,the number of cases of gout,low back pain,neck pain,osteoarthritis,and rheumatoid arthritis in China was 3,079,836,43,374,995,10,292,099,11,652,721,and 247,307,respectively.Among the 5 major musculoskeletal conditions,low back pain had the greatest incidence and DALYs rate.From 1990 to 2021,the age-standardized incidence of gout,osteoarthritis,and rheumatoid arthritis showed an upward trend,that of neck pain remained relatively stable,and that of low back pain showed a downward trend.The age-standardized DALYs rates of gout and osteoarthritis showed an increasing trend,that of neck pain and rheumatoid arthritis remained relatively stable,and that of low back pain showed a decreasing trend.The results of the stratified analysis by gender and age indicated that,the age-standardized incidence rate and age-standardized DALYs rate of gout were higher in men than in women,while the age-standardized incidence rate and age-standardized DALYs rate of low back pain,neck pain,osteoarthritis,and rheumatoid arthritis were higher in women than in men.The age groups with the burden of the five major musculoskeletal diseases were relatively consistent,mainly in the 40-75 years old.Conclusion From 1990 to 2021,the disease burden of gout,osteoarthritis,and rheumatoid arthritis increased significantly in China,while the disease burden of neck pain remained relatively stable,while the disease burden of low back pain showed a certain improvement.In addition,the burden of musculoskeletal diseases in China varies greatly by gender and age.Targeted intervention measures should be implemented as soon as possible based on the stratification results by gender and age,and health education and basic healthcare should be improved to effectively reduce the burden of musculoskeletal diseases.

Objective To analyze the burden and trend of musculoskeletal diseases(including gout,low back pain,neck pain,osteoarthritis,and rheumatoid arthritis)in China from 1990 to 2021,and to provide reference for formulating and adjusting prevention strategies for musculoskeletal diseases.Methods The Global Burden of Disease(GBD)in 2021 database was used to analyze the status and trend of the incidence and disability-adjusted life years(DALYs)rate of musculoskeletal diseases in China.Annual percentage change(EAPC)was used to comprehensively evaluate the trend of the burden of musculoskeletal diseases from 1990 to 2021.Gender and age-specific incidence and DALYs rate of musculoskeletal diseases were analyzed.Results In 2021,the number of cases of gout,low back pain,neck pain,osteoarthritis,and rheumatoid arthritis in China was 3,079,836,43,374,995,10,292,099,11,652,721,and 247,307,respectively.Among the 5 major musculoskeletal conditions,low back pain had the greatest incidence and DALYs rate.From 1990 to 2021,the age-standardized incidence of gout,osteoarthritis,and rheumatoid arthritis showed an upward trend,that of neck pain remained relatively stable,and that of low back pain showed a downward trend.The age-standardized DALYs rates of gout and osteoarthritis showed an increasing trend,that of neck pain and rheumatoid arthritis remained relatively stable,and that of low back pain showed a decreasing trend.The results of the stratified analysis by gender and age indicated that,the age-standardized incidence rate and age-standardized DALYs rate of gout were higher in men than in women,while the age-standardized incidence rate and age-standardized DALYs rate of low back pain,neck pain,osteoarthritis,and rheumatoid arthritis were higher in women than in men.The age groups with the burden of the five major musculoskeletal diseases were relatively consistent,mainly in the 40-75 years old.Conclusion From 1990 to 2021,the disease burden of gout,osteoarthritis,and rheumatoid arthritis increased significantly in China,while the disease burden of neck pain remained relatively stable,while the disease burden of low back pain showed a certain improvement.In addition,the burden of musculoskeletal diseases in China varies greatly by gender and age.Targeted intervention measures should be implemented as soon as possible based on the stratification results by gender and age,and health education and basic healthcare should be improved to effectively reduce the burden of musculoskeletal diseases.

BACKGROUND:Pain is the significant cause for patients with early rehabilitation after total knee arthroplasty. Continuous epidural analgesia and continuous femoral nerve block are effective analgesic methods after total knee arthroplasty, however, which method has better effects and less complications remains controversial. OBJECTIVE:To compare the efficacy and safety of countious femoral nerve block and continuous epidural analgesia after total knee arthroplasty. METHODS:We searched Cochrane Library, PubMed, EMBASE, Web of Science, CBM, CNKI, VIP, and WangFang. Meanwhile, we also searched conference papers and academic dissertation. The retrieval time was from database establishment to October 1, 2014. Studies of randomized control ed trials on countious femoral nerve block and continuous epidural analgesia after total knee arthroplasty were included. We evaluated the quality of these included studies and analyzed data by Cochrane Col aboration’s RevMan 5.0 software. RESULTS AND CONCLUSION:A total of 12 randomized control ed trials (4 English articles and 8 Chinese articles) involving 680 patients were included. There were 343 patients with countious femoral nerve block and 337 patients with continuous epidural analgesia. Meta-analysis results revealed that no significant differences in visual analog scale scores were detected between the countious femoral nerve block and continuous epidural analgesia groups at 6, 12, 24 and 48 hours after total knee arthroplasty. However, compared with the continuous epidural analgesia group, countious femoral nerve block could decrease the incidences of nausea/vomiting (RR=0.36, 95%CI:0.21-0.63, P=0.003), urine retention (RR=0.08, 95%CI:0.04-0.16, P<0.001) and dizziness (RR=0.24, 95%CI:0.06-0.99, P=0.05). These results indicate that compared with epidural analgesia, countious femoral nerve block after total knee arthroplasty provided a strong analgesia effect, contributed to early functional training, had less adverse reactions, and was a safe and effective analgesic method.

OBJECTIVETo evaluate stress changes of intervertebral space and adjacent intervertebral space after artificial disc replacement with angles.

METHODSArtificial disc replacement with angles were designed according to existing data. Axial pressure, flexion/extension, lateral bending and torsion loading were applied on finite element models of normal cervical discs on C4,5 segments, C4,5 segments with 0 degrees artificial cervical discs and C4,5 segments with 10 degrees artificial cervical discs, then stress changes of C4,5 space was observed. The same loadings were applied on finite element models of normal cervical discs on C4-C6 segments, C4,5 segments with 0 degrees, C4,5 segments with 10 degrees, then stress changes of replaced segments space and adjacent segment space were observed.

RESULTSFor C4,5 segments, 80 MPa/0 degrees artificial discs and 80 MPa/10 degrees artificial discs had the similar equivalent shear stress (Se), and were both larger than that of normal discs, when lateral bending were performed, 80 MPa/0 degrees artificial discs were closed to normal discs when axial pressure and flexion/extension were carried out, while 80 MPa/10 degrees artificial discs had a larger Se than that of normal ones,when torsion loading were applied, Szx/Szy stress of 80 MPa/0 degrees and 80 MPa/10 degrees artificial discs were closed to normal ones. For C4-C6 segments, the axial pressure, flexion/extension and lateral bending of C5,6 were all lower than normal discs after C4,5 discs were replaced by 80 MPa/10 degrees artificial discs, while Szx/Szy of torsion loading were closed to normal ones.

CONCLUSIONArtificial discs with 10 degrees have less influences on stress of adjacent intervertebral space and closer to mechanical property after being implanted into intervertebral space.

Cervical Vertebrae ; surgery ; Humans ; Stress, Mechanical ; Total Disc Replacement ; methods

Osteochondroma is a common benign cartilage derived bone tumor -occurring childhood and youth.Metaphyseal lesion is especially located in the distal femur .Proximal tibia and proximal humerus is most prevalent .We report a case of malignant transformation in bilateral scapula and osteochondroma .