Lumbar manipulation plays an important role in the non-surgical treatment of lumbar degenerative diseases.Lumbar manipulation is a compound technique that contains many mechanical elements and motion characteristics at the moment of operation.Quantifying and objectifying parameters of the manipulation,summarizing technical characteristics of the operation,and discussing biomechanical mechanism of the manipulation in-depth,can contribute to teaching assessment and clinical diagnosis and treatment standards of the manipulation,making the manipulation safer and efficient,and further promoting inheritance and development of the traditional Chinese medicine manipulation.This article reviews and synthesizes domestic and foreign biomechanical research papers on lumbar manipulation for the treatment of lumbar degenerative diseases in recent years.The biomechanical effects on the lumbar spine and its accessory structures under manual transient loading,the measurement of technical parameters,and the characteristics of manual operation are summarized.

[Objective]To analyze the effect of lever positioning manipulation(LPM)on the stress and strain of lumbar spine and intervertebral disc in different regions by using three-dimensional finite element technique,so as to reveal the biomechanical mechanism of manipulation.[Methods]A three-dimensional finite element model of the whole lumbar spine was constructed based on lumbar CT images,and the validity of the model was verified.The finite element model was used to analyze and compare the differences in the stress and strain of lumbar vertebrae and intervertebral discs by LPM at different manipulation points.[Results]The finite element model constructed indicates the point of manipulation is about 15 mm beside the L4 spinous process,the stress around the L4-5 intervertebral disc is large and the intermediate stress is small.The minimum strain point of the L4-5 intervertebral disc is about the lateral area of the intervertebral disc.The stress and strain of other intervertebral discs are similar to those of L4-5 intervertebral discs.The nucleus pulposus of L4-5 intervertebral disc move forward relatively to the lumbar spine;the stress under the lumbar pedicle is large,L4 has a certain degree of activity in the direction of extension,left bending and right rotation.Manipulation point is in the L4 spinous process,the stress around the L4-5 intervertebral disc is large and the intermediate stress is small.The minimum strain point of the L4-5 intervertebral disc is about the central area of the intervertebral disc.The stress and strain of other intervertebral discs are similar to those of L4-5 intervertebral discs.The nucleus pulposus of L4-5 intervertebral disc move forward relatively to the lumbar spine;the stress under the lumbar pedicle is large,and L4 has activity in the extension direction,and the activity in other directions is almost zero.[Conclusion]The LPM has the tendency to restore lumbar curvature and correct lumbar scoliosis and rotation.It can make the lumbar intervertebral disc move closer to the middle and make the nucleus pulposus move forward relatively to the posterior edge of the lumbar spine to reduce disc herniation and release compression.In the treatment of lumbar disc herniation,the manipulation points of the corresponding position can be selected according to the prominent position.

[Objective]To analyze the effect of lever positioning manipulation(LPM)on the stress and strain of lumbar spine and intervertebral disc in different regions by using three-dimensional finite element technique,so as to reveal the biomechanical mechanism of manipulation.[Methods]A three-dimensional finite element model of the whole lumbar spine was constructed based on lumbar CT images,and the validity of the model was verified.The finite element model was used to analyze and compare the differences in the stress and strain of lumbar vertebrae and intervertebral discs by LPM at different manipulation points.[Results]The finite element model constructed indicates the point of manipulation is about 15 mm beside the L4 spinous process,the stress around the L4-5 intervertebral disc is large and the intermediate stress is small.The minimum strain point of the L4-5 intervertebral disc is about the lateral area of the intervertebral disc.The stress and strain of other intervertebral discs are similar to those of L4-5 intervertebral discs.The nucleus pulposus of L4-5 intervertebral disc move forward relatively to the lumbar spine;the stress under the lumbar pedicle is large,L4 has a certain degree of activity in the direction of extension,left bending and right rotation.Manipulation point is in the L4 spinous process,the stress around the L4-5 intervertebral disc is large and the intermediate stress is small.The minimum strain point of the L4-5 intervertebral disc is about the central area of the intervertebral disc.The stress and strain of other intervertebral discs are similar to those of L4-5 intervertebral discs.The nucleus pulposus of L4-5 intervertebral disc move forward relatively to the lumbar spine;the stress under the lumbar pedicle is large,and L4 has activity in the extension direction,and the activity in other directions is almost zero.[Conclusion]The LPM has the tendency to restore lumbar curvature and correct lumbar scoliosis and rotation.It can make the lumbar intervertebral disc move closer to the middle and make the nucleus pulposus move forward relatively to the posterior edge of the lumbar spine to reduce disc herniation and release compression.In the treatment of lumbar disc herniation,the manipulation points of the corresponding position can be selected according to the prominent position.

Lumbar manipulation plays an important role in the non-surgical treatment of lumbar degenerative diseases.Lumbar manipulation is a compound technique that contains many mechanical elements and motion characteristics at the moment of operation.Quantifying and objectifying parameters of the manipulation,summarizing technical characteristics of the operation,and discussing biomechanical mechanism of the manipulation in-depth,can contribute to teaching assessment and clinical diagnosis and treatment standards of the manipulation,making the manipulation safer and efficient,and further promoting inheritance and development of the traditional Chinese medicine manipulation.This article reviews and synthesizes domestic and foreign biomechanical research papers on lumbar manipulation for the treatment of lumbar degenerative diseases in recent years.The biomechanical effects on the lumbar spine and its accessory structures under manual transient loading,the measurement of technical parameters,and the characteristics of manual operation are summarized.

[Objective]To discuss the diagnosis and treatment of lumbar disc herniation from the theory of kidney governor Qi pulse founded by Professor LYU Lijiang.[Methods]Firstly,analyze the relationship among the kidneys,the Governing Vessel and the spine,clarify the roles of the kidneys and the Governing Vessel on the spine,and understand the theoretical basis of the theory of kidney governor Qi pulse.Then the etiology and pathogenesis of lumbar disc herniation were analyzed based on the theory of kidney governor Qi pulse.Finally,the treatment principles of lumbar disc herniation were analyzed from different treatment methods.[Results]The three elements of kidney-Governing Vessel-spine are closely related to each other.The fundamental pathogenesis of lumbar disc herniation lies in the deficiency of the kidney and stagnation of Governing Vessel.Deficiency of the kidney results in emptiness of Governing Vessel,while Governing Vessel stagnation leads to a dysfunction in the ascending and descending of Yin and Yang in Governing Vessel.This disruption causes an inadequate circulation of Qi,blood,essence and body fluids,leading to a lack of nourishment for the tendons and bones and an obstruction in the flow of Qi and vessels.The treatment principle is to benefit the kidney and pass the Governing Vessel.By supplementing and tonifying the kidney Qi and replenishing the kidney essence,the Governing Vessel becomes filled,allowing the ascent of Governing Vessel Yang Qi and the descent of Governing Vessel Yin Qi.This facilitates the transformation of essence and marrow,promoting the smooth circulation of Qi,blood,essence and body fluids.Consequently,the lumbar vertebrae becomes stable,the lumbar muscles strengthen,the meridians and collaterals regulate properly,and the flow of Qi and vessels becomes unobstructed.[Conclusion]The theory of kidney governor Qi pulse can guide the clinical diagnosis and treatment of lumbar disc herniation,benefiting the kidney and passing the Governing Vessel is an important principle of treating lumbar disc herniation,and it can be carried through the whole process of treating lumbar disc herniation.

[This corrects the article DOI: 10.1016/j.apsb.2024.04.021.].

PURPOSE: Coronary flow reserve (CFR) in the non-infarcted myocardium is often impaired following acute myocardial infarction (AMI). However, the clinical significance of CFR in the non-infarcted myocardium is not fully understood. The objective of the present study was to assess whether a relationship exists between CFR and left ventricular remodeling following AMI. MATERIALS AND METHODS: We enrolled 18 consecutive patients undergoing coronary intervention. Heart function was analyzed using real-time myocardial contrast echocardiography at one week and six months after coronary angioplasty. Ten subjects were enrolled as the control group and were examined using the same method at the same time to assess CFR. Cardiac troponin I (cTnI) levels were routinely analyzed to estimate peak concentration. RESULTS: CFR was 1.55+/-0.11 in the infarcted zone and 2.05+/-0.31 in the remote zone (p<0.01) at one week following AMI. According to CFR values in the remote zone, all patients were divided into two groups: Group I (CFR <2.05) and Group II (CFR >2.05). The levels of cTnI were higher in Group I compared to Group II on admission (36.40 vs. 21.38, p<0.05). Furthermore, left ventricular end diastolic volume was higher in Group I compared to Group II at six months following coronary angioplasty. CONCLUSION: Microvascular dysfunction is commonly observed in the remote myocardium. The CFR value accurately predicts adverse ventricular remodeling following AMI.
Aged ; Coronary Angiography ; Coronary Circulation/physiology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*physiopathology/radiography ; Myocardium/*pathology ; Ventricular Remodeling/*physiology

PURPOSE: Coronary flow reserve (CFR) in the non-infarcted myocardium is often impaired following acute myocardial infarction (AMI). However, the clinical significance of CFR in the non-infarcted myocardium is not fully understood. The objective of the present study was to assess whether a relationship exists between CFR and left ventricular remodeling following AMI. MATERIALS AND METHODS: We enrolled 18 consecutive patients undergoing coronary intervention. Heart function was analyzed using real-time myocardial contrast echocardiography at one week and six months after coronary angioplasty. Ten subjects were enrolled as the control group and were examined using the same method at the same time to assess CFR. Cardiac troponin I (cTnI) levels were routinely analyzed to estimate peak concentration. RESULTS: CFR was 1.55+/-0.11 in the infarcted zone and 2.05+/-0.31 in the remote zone (p<0.01) at one week following AMI. According to CFR values in the remote zone, all patients were divided into two groups: Group I (CFR <2.05) and Group II (CFR >2.05). The levels of cTnI were higher in Group I compared to Group II on admission (36.40 vs. 21.38, p<0.05). Furthermore, left ventricular end diastolic volume was higher in Group I compared to Group II at six months following coronary angioplasty. CONCLUSION: Microvascular dysfunction is commonly observed in the remote myocardium. The CFR value accurately predicts adverse ventricular remodeling following AMI.
Aged ; Coronary Angiography ; Coronary Circulation/physiology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*physiopathology/radiography ; Myocardium/*pathology ; Ventricular Remodeling/*physiology