OBJECTIVE: To explore the relationship between the effect of acupuncture and layered localization of computed tomography (CT) in treatment of lumbar disc herniation. METHODS: Based on the CT layered localization, the herniated lumbar discs were positioned in 5 layers, A, B, C, D and E among 300 patients with lumbar disc herniation. Combined with the horizontal and the frontal planes, the three-dimensional location was formed. Acupuncture was delivered at acupoints including bilateral Shenshu (BL23), Dachangshu (BL25), and Huantiao (GB30), Weizhong (BL40) on the affected side. One intervention of acupuncture was 30 min, once daily; 1 course of treatment was composed of 10 interventions and 2 courses were required. Before and after treatment, Japanese orthopaedic association (JOA) score was recorded, and the effect was evaluated. The curative effect was classified and compared with the CT layered localization. RESULTS: Of 300 patients, 226 cases were effective and the effective rate was 75.33%. The JOA scores of all patients, and in the effective group and the non-effective group were higher compared with the scores before treatment (P<0.05). With the layered localization considered, acupuncture was more effective on the cases positioned in C layer. Regarding the horizontal plane, the effect was better on the cases with zone 1 and zone 1-2 involved. In terms of the grade of frontal plane, acupuncture was more effective on the cases graded Ⅰ and Ⅱ. CONCLUSION The clinical effect of acupuncture on lumbar disc herniation is related with the layer and the horizontal zone of herniated disc positioned, as well as to the grade of the frontal plane.
Humans ; Acupuncture Therapy ; Intervertebral Disc Displacement/diagnostic imaging* ; Male ; Female ; Middle Aged ; Adult ; Tomography, X-Ray Computed ; Lumbar Vertebrae/diagnostic imaging* ; Acupuncture Points ; Aged ; Young Adult ; Treatment Outcome

Objective To investigate the effect of early stability rehabilitation exercises in elderly patients after the surgery for degenerative lumbar disease and to provide effective guidance for the postoperative rehabilitation.Methods From February 2023 to May 2024,a convenience sampling method was used to select 121 patients who received surgery for degenerative lumbar disease in our hospital as the study subjects.The patients were randomly divided into two groups with a random number table:a control group(n=61)and an intervention group(n=60).Patients in the control group received routine nursing care and rehabilitation exercises,while the patients in the intervention group received 2 weeks of early stability rehabilitation exercises on top of the control group.Lumbar spine function,daily living self-care ability and score of pain were recorded and compared between the two groups on day 1 or day 3 before surgery and at 2 weeks and 4 weeks after surgery.Results JOA scores of the intervention group were found higher than those of the control group at 2 and 4 weeks after surgery,all with significant differences between the groups(P<0.05).VAS scores of the intervention group were lower than those of the control group at 3 days,2 weeks,and 4 weeks after surgery,all with significant differences(P<0.05).Scores for daily living self-care ability of the intervention group were higher than those of the control group at 2 weeks and 4 weeks after surgery,all with significant differences(P<0.05).The repeated measures analysis of variance showed that the time main effect and inter group main effect of JOA score,VAS score and self-care ability score in daily life of different time all showed statistical significance between the groups(all P<0.001).Conclusion An early stability rehabilitation exercise can improve the postoperative lumbar function,pains,and self-care ability in daily life in elderly patients after the surgery for degenerative lumbar diseases,as well as accelerate the postoperative recovery,while ensuring the safety of patients.

Objective To investigate the effect of early stability rehabilitation exercises in elderly patients after the surgery for degenerative lumbar disease and to provide effective guidance for the postoperative rehabilitation.Methods From February 2023 to May 2024,a convenience sampling method was used to select 121 patients who received surgery for degenerative lumbar disease in our hospital as the study subjects.The patients were randomly divided into two groups with a random number table:a control group(n=61)and an intervention group(n=60).Patients in the control group received routine nursing care and rehabilitation exercises,while the patients in the intervention group received 2 weeks of early stability rehabilitation exercises on top of the control group.Lumbar spine function,daily living self-care ability and score of pain were recorded and compared between the two groups on day 1 or day 3 before surgery and at 2 weeks and 4 weeks after surgery.Results JOA scores of the intervention group were found higher than those of the control group at 2 and 4 weeks after surgery,all with significant differences between the groups(P<0.05).VAS scores of the intervention group were lower than those of the control group at 3 days,2 weeks,and 4 weeks after surgery,all with significant differences(P<0.05).Scores for daily living self-care ability of the intervention group were higher than those of the control group at 2 weeks and 4 weeks after surgery,all with significant differences(P<0.05).The repeated measures analysis of variance showed that the time main effect and inter group main effect of JOA score,VAS score and self-care ability score in daily life of different time all showed statistical significance between the groups(all P<0.001).Conclusion An early stability rehabilitation exercise can improve the postoperative lumbar function,pains,and self-care ability in daily life in elderly patients after the surgery for degenerative lumbar diseases,as well as accelerate the postoperative recovery,while ensuring the safety of patients.

Excessive theta (θ) frequency oscillation and synchronization in the basal ganglia (BG) has been reported in elderly parkinsonian patients and animal models of levodopa (L-dopa)-induced dyskinesia (LID), particularly the θ oscillation recorded during periods when L-dopa is withdrawn (the off L-dopa state). To gain insight into processes underlying this activity, we explored the relationship between primary motor cortex (M1) oscillatory activity and BG output in LID. We recorded local field potentials in the substantia nigra pars reticulata (SNr) and M1 of awake, inattentive resting rats before and after L-dopa priming in Sham control, Parkinson disease model, and LID model groups. We found that chronic L-dopa increased θ synchronization and information flow between the SNr and M1 in off L-dopa state LID rats, with a SNr-to-M1 flow directionality. Compared with the on state, θ oscillational activity (θ synchronization and information flow) during the off state were more closely associated with abnormal involuntary movements. Our findings indicate that θ oscillation in M1 may be consequent to abnormal synchronous discharges in the BG and support the notion that M1 θ oscillation may participate in the induction of dyskinesia.

OBJECTIVE: To explore short-term clinical effect of surgical treatment for ankle fracture with complete rupture of deltoid ligament in young and middle-aged patients. METHODS: From January 2016 to March 2019, 21 young and middle-aged patients with ankle joint fracture and complete rupture of the deltoid ligament were treated with internal fixation and repair of the medial deltoid ligament, including 16 males and 5 females, aged from 21 to 52 years old with an average of (38.6±7.3) years old, the time from injury to operation ranged from 1 to 7 days with an average of (3.8±1.5) days. Fracture healing time and complications were observed, changes of medial malleolus clearance before and after operation were compared, American Orthopaedic Foot and Ankle Society (AOFAS) score wasused to evaluate function of ankle joint at 18 months after operation. RESULTS: Twenty-one patients were followed up from 18 to 26 months with an average of (21.7±1.2) months. The incisions were healed at stageⅠ, and fracture healing time ranged from 8 to 12 weeks with an average of (9.5±1.6) weeks. No wound infection, failure of internal fixation, and nerve injury occurred. Medial malleoius space decreased from (5.83±0.32) mm before operation to (2.69±0.25) mm after operation. Postoperative AOFAS score at 18 months was 91.43±4.14, 14 patients got excellent results, 6 good and 1 fair. CONCLUSION On the basis of stable fixation of fracture, repair of deltoid ligament could help restoring the medial anatomy of ankle joint in young and middle-aged patients, and could achieve good short term clinical effect.
Adult ; Ankle Fractures ; Ankle Injuries ; Ankle Joint ; Female ; Fracture Fixation, Internal ; Humans ; Ligaments ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective:To analyze the related risk factors for vertebral artery tortuosity, and explore the mechanism of vertebral artery tortuosity.Methods:Two hundred and eighty-two patients accepted head/neck and MR angiography in our hospital from October 2016 to October 2017 were selected. The tortuosity degrees of vertebral artery were measured and calculated by PACS system. The differences of tortuosity degrees of vertebral arteries in different age groups were compared. Correlation analysis was performed to determine the correlation between vertebral artery tortuosity and both clinical data and and biochemical levels, and multivariate linear regression analysis was performed to determine the independent risk factors for vertebral artery tortuosity.Results:The tortuosity degrees of the left and right vertebral arteries in these patients ranged from 5.1% to 72.6%. The tortuosity degrees of vertebral arteries in patients aged 40-49 years were significantly higher than those in patients aged 20-29 years and 30-39 years ( P<0.05). Correlation analysis showed that the tortuosity degree of the right vertebral artery was positively correlated with age and triglyceride level ( r=0.232, P=0.000; r=0.172, P=0.004); the tortuosity degree of the left vertebral artery was positively correlated with triglyceride level ( r=0.123, P=0.043). Multivariate regression analysis showed that age ( 95%CI: 0.059-0.194, P=0.000) and triglyceride level ( 95%CI: 0.173-1.942, P=0.019) were independent risk factors for right vertebral artery tortuosity. Triglyceride level ( 95%CI: 0.041-2.559, P=0.043) was independent risk factor for left vertebral artery tortuosity. Conclusion:There are congenital developmental factors associated with vertebral artery tortuosity; some nurture factor, as triglyceride level, may promote its development.

Objective To investigate the mechanism of improvement of gait behavior in PD rat models by low frequency electrical stimulation of pedunculopontine tegmental nucleus (PPTN) by optogenetics method. Methods (1) Twenty-four healthy adult male SD rats were randomly divided into a sham-operated group 1, a lesion group 1 and a photoactivation group (n=8); normal saline was injected into the right medial frontal tract (MFB) of the sham-operated group 1; 6-hydroxydopamine (6-OHDA) was injected into the lesion group 1 and photoactivation group to induce PD models; two weeks after modeling, injection of adeno-associated virus hsynapsin-ChR2-mcherry into the right PPTN of the three groups was performed, and the photoactivation group received blue-ray stimulation by implanting optical fibers into the PPTN at the same time. (2) Twenty-four healthy adult male SD rats were randomly divided into a sham-operated group 2, a lesion group 2 and a photoinhibition group (n=8);normal saline was injected into right MFB of the sham-operated group 2; 6-OHDA was injected into the lesion group 2 and photoinhibition group to induce PD models; two weeks after modeling, injection of adeno-associated virus hsynapsin-NpHR-mcherry into the right PPTN of the three groups was performed, and the photoinhibition group received yellow-ray stimulation by implanting optical fibers into the PPTN at the same time. (3) Three weeks after injection of adeno-associated virus, Catwalk gait analysis was used to assess the behavioral ability of rats in each group. Results (1) As compared with the sham-operated group 1, lesion group 1 had significantly increased front claw spacing and back front claw spacing, and significantly decreased stride length and pressure of damaged lateral and contralateral limbs, and significantly decreased swing speed of contralateral limb (P<0.05); as compared with those in the lesion group 1, the front claw spacing and back claw spacing were significantly shortened, and stride length and pressure of damaged lateral and contralateral limbs were statistically increased in the photoactivation group (P<0.05). (2) As compared with the sham-operated group 2, lesion group 2 had significantly increased front claw spacing and back front claw spacing, significantly decreased stride length of damaged lateral limb, and significantly decreased pressure and swing speed of damaged lateral and contralateral limbs (P<0.05); no significant differences were noted on the front claw spacing and back front claw spacing, pressure and swing speed of damaged lateral and contralateral limbs between lesion group 2 and photoinhibition group (P>0.05). Conclusion The mechanism of low frequency electrical stimulation of PPTN improving gait behavior of PD rat models is related to activation of PPTN neurons.

OBJECTIVETo evaluate the therapeutic effects, larynx preservation and adverse events of non-surgical combined treatments for laryngeal organ preservation in locally advanced laryngeal squamous cell carcinomas(SCCs).

METHODSForty-six patients with locally advanced laryngeal carcinoma (T2-4, N0-N3) were treated individually with non-surgical combined treatments for larynx preservation (LP). These treatments included concurrent chemoradiotherapy (CCRT)(±epidermal growth factor receptor (EGFR) inhibitor), induction chemotherapy (ICT) followed by CCRT(± EGFR inhibitor), or concurrent radiotherapy and EGFR inhibitor. Radiation therapy was given to a total dose of 60-70 Gy. The Kaplan-Meier method was used to determine the overall survival. Side-effects were evaluated with the established Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.

RESULTSThe average follow-up time was 31.8 months (range 6-95 months). All patients completed the planned radiotherapy without treatment breaks, and 45(97.8%) of 46 patients completed the planned chemotherapy.The 3-year and 5-year overall survival rates were 87.3%and 67.2%, respectively.The 5-year larynx preservation rate was 100.0%. The 3-year and 5-year progression free survival rates were 95.1% and 87.7%, respectively. The most common acute side effect in grade 3 was oropharyngeal mucositis. After treatment, tracheotomy was still required in 2 patients with glottis cancer for laryngeal edema or stenosis. No patient depended on a percutaneous gastrostomy and experienced speech impairment.

CONCLUSIONPatients with locally advanced laryngeal cancer can be offered non-surgical combined treatments for laryngeal preservation and the high quality of life, showing a higher laryngeal preservation survival rate with minimal toxicities.

Antineoplastic Agents ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; Chemoradiotherapy ; Combined Modality Therapy ; Disease-Free Survival ; Head and Neck Neoplasms ; drug therapy ; radiotherapy ; Humans ; Laryngeal Neoplasms ; drug therapy ; radiotherapy ; Larynx ; Organ Sparing Treatments ; Quality of Life ; Survival Rate

Objective To investigate the efficacy of induction chemotherapy (ICT) followed by concurrent chemotherapy and helical tomotherapy (HT) in the patients with T4b squamous cell carcinoma of nasal cavity and paranasal sinus (SCCNP) for orbital organ preservation and high quality of life.Methods A total of 26 patients with the orbital involvement of T4b SCCNP between May 2008 and March 2013 were analyzed retrospectively.There were 17 males and 9 females;the average age was 54.7 years.The median follow-up time was 25 months (range 4-77 months).The patients received 1-2 cycles ICT with TP (docetaxel 70 mg/m2 on day 1 and cisplatin 40 mg/m2 on day 1-2,every 3 weeks) or TPF (docetaxel 70 mg/m2 on day 1 and cisplatin 70 mg/m2 on day 1-2,5-fu 700 mg/m2 on day 1-5,every 3 weeks),followed by concurrent HT (60-70 Gy) and chemotherapy with TP and/or epidermal growth factor receptor (EGFR) inhibitor.The Kaplan-Meier method was used to determine the 3-year overall survival rate and local control rate.Side-effects were evaluated with the established common terminology criteria for adverse events (CTCAE) version 4.0 criteria.Results All patients completed the planned chemotherapy and 96.2％ (25/26)patients completed the planned radiotherapy.The 3-year overall survival rate,the local control rate and real orbital preservation rate were 56.7％,79.5％ and 80.0％ respectively.The most common acute side effects higher than grade 2 were oral mucositis,radiodermatitis and dry eye syndrome.Conclusion The strategy including ICT followed by CCRT and/or EGFR inhibitor is an effective treatment for T4b SCCNP patients,with minimal toxicities,higher 3-year OS rate and orbital preservation rate,and also provides a new treatment option for T4b SCCNP patients.

The changes in the tau protein phosphorylation and expression of bcl-2,and bax in rat parietal cortex neurons after focal cerebral ischemia-reperfusion(I/R)were explored,and the relationship between the tau protein phosphorylation and the expression of bax or apoptosis was clarified in order to elucidate the relationship between cerebral infarction and Alzheimer's disease.The rat focal cerebral I/R model was induced by occlusion of the right middle cerebral artery using the intraluminal suture method.The level of tau protein phosphorylation at Ser396,Ser404,Tyr231,Ser199/202 sites and the expression of bcl-2,bax and total tau 5 in rat parietal cortex during focal cerebral ischemia/reperfusion were detected by Western blot.The relationship between the tau protein phosphorylation and the expression of bax,or apoptosis was examined by TUNEL method and double-labeling immunofluorenscence method.The results showed that the level of tau hyperphosphorylation at Ser199/202,Ser396,Ser404,Tyr231 sites and the expression levels of bcl-2,and bax were significantly higher in I/R group than in the sham group,bat the ratio of bcl-2/bax was decreased.Neuronal apoptosis,bax expression and the tau protein hyperphosphorylation were co-localized.It is suggested that Alzheimer's disease-like pathological changes occur after cerebral I/R.The highly abnormal phosphorylation of tau protein plays a key role in cerebral I/R-induced apoptosis.The cerebral infarction may contribute to Alzheimer's disease occurrence and development.