BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

Objective:To compare the differences in clinical characteristics among the patients at clinical high risk for bipolar disorder(CHR-BD),the patients with bipolar disorder(BD),and the healthy controls(HC)at low risk,and to provide the basis for the diognasis and treatment of CHR-BD.Methods:For the first time,the BD risk criteria and prospective structured assessment tools were jointly used in outpatients aged 16-30 years,and 43 CHR-BD patients were included to ensure the accuracy of the assessment.Meanwhile,33 BD patients and 32 HC subjects were also enrolled.The clinical symptoms,neurocognitive function,and global functional levels of the subjects in the three groups were evaluated using observer-rated and self-rated tools.The CHR-BD and BD groups were combined,and Logistic regression analysis was used to identify the independent influencing factors related to diagnostic status;Pearson or Spearman correlation analysis was used to analyze the correlations between the global functional levels and the symptoms or neurocognitive characteristics of the patients in CHR-BD and BD groups.Results:There were statistically significant differences in the scores of symptom and global functional level scales among HC,CHR-BD,and BD groups(P<0.05).Compared with HC group,the scores of mood symptoms(anxiety,depression,and mania/hypomania),psychotic symptoms,total affective temperament questionnaire scores,and some dimensions(cyclothymic,depressive,irritable,and anxious temperaments)in CHR-BD and BD groups were significantly increased(P<0.001),while the global functional levels were significantly decreased(P<0.001).Compared with BD group,the lowest global functional level score in the past year in CHR-BD group was significantly increased(P=0.022),while the current global functional level score was significantly decreased(P=0.005).No significant differences were observed in neurocognitive function scores among the three groups(P>0.05).The lowest global functional level score in the past year was an independent influencing factor for BD diagnosis[odds ratio(OR)=0.952,95%confidence interval(CI):0.917-0.988,P=0.010].In both CHR-BD and BD patients,the current global functional levels were negatively correlated with depressive(r=-0.417,P=0.005;r=-0.617,P<0.001)and anxiety symptoms(r=-0.360,P=0.018;r=-0.506,P=0.003).In BD patients,the current global functional level was negatively correlated with lifetime manic/hypomanic symptoms(r=-0.360,P=0.039),psychotic symptoms(r=-0.502,P=0.003),and affective temperament scores(r=-0.479,P=0.005),while the lowest global functional level in the past year was negatively correlated with lifetime manic/hypomanic symptoms(r=-0.391,P=0.024).Conclusion:CHR-BD patients share similar mood symptom characteristics with BD patients,and their global functional levels are negatively correlated with depressive and anxiety symptoms.BD patients exhibit worse lowest global functional levels in the past year,and their global functional levels are negatively correlated with manic/hypomanic symptoms.

This article summarizesd Professor Li Zhigang's experience in treating limb dysfunction after acute disseminated encephalomyelitis(ADEM)by acupuncture.Prof.Li respected the classical theory of Chinese medicine,which is to seek the root cause of the disease,clarified the disease mechanism of"deficiency of Yangming leads to longitudinal tendons and unfavorable belt veins",and followed the principle of"treating flaccidity syndrome only by taking advantage of Yangming",and combined with the morbidity characteristics of ADEM that occurs in children,emphasized the important influence of regulating the root of innate and acquired in the treatment of the disease.The importance of regulating the essence of congenital and acquired constitution in the treatment of this disease was emphasized,taking into account the importance of regulating the mind and spirit.The main acupoints of Yangming Stomach Meridian,Large Intestine Meridian,Spleen Meridian,and Governor Vessel,together with the five main points of the lower limbs and the main points of water-inducing,all together play the role of tonifying the middle energizer,benefiting the essence and filling in the marrow,and strengthening the muscles and bones.

Objective:To search, evaluate, and summarize evidence regarding strategies to promote pelvic floor muscle contraction (PFMC) function in postpartum women, providing a basis for clinical practice.Methods:A comprehensive search was conducted in computer decision support systems, guideline websites, relevant professional association websites, and English and Chinese databases for evidence related to strategies to promote PFMC function in postpartum women. The sources included guidelines, expert consensus, evidence summaries, systematic reviews, and original studies, with the search period from June 2014 to January 2025. Two researchers independently assessed the quality of the included articles and extracted data for the evidence summary.Results:A total of 24 articles were included: nine guidelines, five expert consensus, three evidence summaries, two systematic reviews, and five original studies. The evidence was summarized across four domains: screening and assessment, team building, intervention strategies, and outcome evaluation, resulting in 25 key pieces of evidence.Conclusions:This study summarizes the best evidence for strategies to promote PFMC function in postpartum women, providing scientific and rigorous evidence for clinical practice. It supports the development of effective training programs to enhance postpartum women's quality of life.

This article summarizesd Professor Li Zhigang's experience in treating limb dysfunction after acute disseminated encephalomyelitis(ADEM)by acupuncture.Prof.Li respected the classical theory of Chinese medicine,which is to seek the root cause of the disease,clarified the disease mechanism of"deficiency of Yangming leads to longitudinal tendons and unfavorable belt veins",and followed the principle of"treating flaccidity syndrome only by taking advantage of Yangming",and combined with the morbidity characteristics of ADEM that occurs in children,emphasized the important influence of regulating the root of innate and acquired in the treatment of the disease.The importance of regulating the essence of congenital and acquired constitution in the treatment of this disease was emphasized,taking into account the importance of regulating the mind and spirit.The main acupoints of Yangming Stomach Meridian,Large Intestine Meridian,Spleen Meridian,and Governor Vessel,together with the five main points of the lower limbs and the main points of water-inducing,all together play the role of tonifying the middle energizer,benefiting the essence and filling in the marrow,and strengthening the muscles and bones.

Objective:To systematically evaluate predictive models for stress urinary incontinence (SUI) in pregnant and postpartum women, providing a reference for model development, application, and promotion.Methods:A comprehensive literature search was conducted in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biology Medicine disc for studies on SUI predictive models in pregnant and postpartum women. The search period was from database inception to September 30, 2024. Two researchers independently screened the literature and extracted data according to inclusion and exclusion criteria. The risk of bias in the predictive models was assessed using the prediction model risk of bias assessment tool.Results:A total of 23 studies were included, covering 31 predictive models for SUI, with a combined sample size of 14 473 women. Among them, six models focused on predicting SUI in pregnant women, while 25 models were developed for postpartum SUI. The predictive factors identified in these models were categorized into nine groups, including: general information for pregnant and postpartum women, delivery data, neonatal data, past history, abortion history, lifestyle data, pelvic floor muscle screening results, 2D and 3D ultrasound data, and serological indicators. Among these, age, mode of delivery, parity, body mass index, history of SUI, and neonatal weight were widely recognized as key predictive factors. External validation was performed in five studies. Five studies showed good applicability and low bias risk, except for one study that had limitations in both bias risk and applicability, and the remaining studies exhibited a high risk of bias but demonstrated good applicability.Conclusions:The methodological quality of SUI predictive models for pregnant and postpartum women needs further improvement. External validation remains insufficient. Future model development should be based on large-sample, prospective studies, incorporating appropriate predictive factors and stratifying SUI risk in different populations to enhance clinical applicability.

Objective:To systematically evaluate predictive models for stress urinary incontinence (SUI) in pregnant and postpartum women, providing a reference for model development, application, and promotion.Methods:A comprehensive literature search was conducted in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biology Medicine disc for studies on SUI predictive models in pregnant and postpartum women. The search period was from database inception to September 30, 2024. Two researchers independently screened the literature and extracted data according to inclusion and exclusion criteria. The risk of bias in the predictive models was assessed using the prediction model risk of bias assessment tool.Results:A total of 23 studies were included, covering 31 predictive models for SUI, with a combined sample size of 14 473 women. Among them, six models focused on predicting SUI in pregnant women, while 25 models were developed for postpartum SUI. The predictive factors identified in these models were categorized into nine groups, including: general information for pregnant and postpartum women, delivery data, neonatal data, past history, abortion history, lifestyle data, pelvic floor muscle screening results, 2D and 3D ultrasound data, and serological indicators. Among these, age, mode of delivery, parity, body mass index, history of SUI, and neonatal weight were widely recognized as key predictive factors. External validation was performed in five studies. Five studies showed good applicability and low bias risk, except for one study that had limitations in both bias risk and applicability, and the remaining studies exhibited a high risk of bias but demonstrated good applicability.Conclusions:The methodological quality of SUI predictive models for pregnant and postpartum women needs further improvement. External validation remains insufficient. Future model development should be based on large-sample, prospective studies, incorporating appropriate predictive factors and stratifying SUI risk in different populations to enhance clinical applicability.

Objective:To search, evaluate, and summarize evidence regarding strategies to promote pelvic floor muscle contraction (PFMC) function in postpartum women, providing a basis for clinical practice.Methods:A comprehensive search was conducted in computer decision support systems, guideline websites, relevant professional association websites, and English and Chinese databases for evidence related to strategies to promote PFMC function in postpartum women. The sources included guidelines, expert consensus, evidence summaries, systematic reviews, and original studies, with the search period from June 2014 to January 2025. Two researchers independently assessed the quality of the included articles and extracted data for the evidence summary.Results:A total of 24 articles were included: nine guidelines, five expert consensus, three evidence summaries, two systematic reviews, and five original studies. The evidence was summarized across four domains: screening and assessment, team building, intervention strategies, and outcome evaluation, resulting in 25 key pieces of evidence.Conclusions:This study summarizes the best evidence for strategies to promote PFMC function in postpartum women, providing scientific and rigorous evidence for clinical practice. It supports the development of effective training programs to enhance postpartum women's quality of life.

Objective To observe the effect of traditional Chinese medicine(TCM)syndrome differentiation treatment of insomnia on depressive symptoms and interleukin(IL)-6 level and tumor necrosis factor(TNF)-α level in serum.And then to discuss the effect of TCM syndrome differentiation treatment of insomnia on reducing the occurrence and development of depression.Methods Sixty patients with insomnia disorder in Hangzhou Hospital of Traditional Chinese Medicine from September 2020 to July 2022 were selected as research objects,and they were divided into intervention group and blank group 30 patients for each group,according to their treatment intention and they were treated with sleep hygiene education plus TCM syndrome differentiation treatment and sleep hygiene education alone respectively.The changes of sleep,depression,serum IL-6 level and TNF-α level were compared between two groups.Results After 2 weeks of intervention,the intervention group's Pittsburgh sleep quality index score,patient health questiomnare-9 score,TCM symptom score,and serum IL-6 and TNF-α level were all significantly reduced,and the difference was statistically significant(P＜0.05).Conclusion TCM syndrome differentiation treatment can effectively improve insomnia and depression,thus delaying the occurrence and development of depression,and is an effective method for early intervention of depression.