1.The dynamic plantar pressure distribution of persons with chronic plantar fasciitis
Xiulan HAN ; Shanshan ZHANG ; Guifang ZHANG ; Zhiwei LIAN ; Shanshan BAO ; Zhenfa ZHANG ; Chuhuai WANG
Chinese Journal of Physical Medicine and Rehabilitation 2025;47(8):721-726
Objective:To analyze the dynamic plantar pressure distribution of persons with chronic plantar fasciitis (PF).Methods:Twenty persons with unilateral, chronic PF were recruited as the PF group, while twenty-three healthy counterparts were recruited as the control group. A foot-pressure measurement system was used to collect data describing the plantar pressure for each subject with or without PF while walking. The pressure data included the load of peak plantar pressure (PP), the mean plantar pressure (MP), the total foot ground contact area (TCA), and the load percentage and the foot ground contact area beneath the medial heel (MH), the lateral heel (LH), the medial longitudinal arch (MLA), the lateral longitudinal arch (LLA), the first metatarsal head (M1), the second to third metatarsal heads (M2-3), the fourth to fifth metatarsal heads (M4-5), the hallux (T1), and toes two to five (T2-5).Results:In the PF group, significant differences were observed during walking between the affected and unaffected feet in terms of PP [(2.41±0.44)kg/cm 2 versus (3.02±0.63)kg/cm 2]. Both were significantly greater than among the control group. Asymmetry in the load distribution was identified beneath the MH, M2-3, M1, MLA, M4-5 and T2-5 among the chronic PF group. There were also significant differences between the affected foot of the chronic PF group and the non-dominant foot of the control group with regard to the load percentage beneath the LH, M4-5, T2-5, M2-3 and T1. The load percentage under the LH was significantly higher under the unaffected foot of the PF group than under the dominant foot of the control group. In terms of ground contact area, the T2-5 area of the affected foot of the PF group was significantly smaller than that of the unaffected foot, as well as compared to the non-dominant foot of the control group. The TCA of both feet among the PF group was significantly smaller than under the corresponding feet of the control group. Conclusions:Patients with chronic plantar fasciitis apply plantar pressure asymmetrically during walking. They tend to shift their weight laterally onto the asymptomatic foot. During walking, those with PF apply higher plantar pressure over a smaller ground contact area.
2.Changes of electromyographic characteristics of the thoracolumbar paraspinal muscles in adolescents with moderate S-shaped idiopathic scoliosis
Shanshan ZHANG ; Zhenfa ZHANG ; Yi XU
Chinese Journal of Rehabilitation Medicine 2025;40(10):1482-1489
Objective:To explore the changes in time-frequency and nonlinear indicators of thoracolumbar paraspinal mus-cle electromyographic activity in adolescents with moderate S-type idiopathic scoliosis(AIS)using surface elec-tromyography(sEMG)technology.Method:Nineteen AIS adolescent patients(age:11-17 years old,male:4,female:15)and twenty-one healthy adolescents(age:12-17 years old,male:7,female:14)were separately performed EMG signals of maximum isometric voluntary contraction of the thoracic and lumbar paraspinal muscles.The data were ana-lyzed with independent samples t-test to compare time-frequency changes of EMG activity of the lumbar multif-idus.Two-way repeated measures analysis of variance(ANOVA)was adopted to compare Lempel-Ziv(LZ)complexity values in different states between two groups,with Bonferroni correction for multiple comparisons to assess differences in group means.Result:Compared with healthy controls,patients with moderate,S-shaped AIS showed significant decrease in average EMG(AEMG)and root mean square(RMS)of the concave side thoracic paraspinal muscles,and de-crease median frequency(MF)and mean power frequency(MPF)of the convex side lumbar paraspinal mus-cles in the EMG measurements(P<0.05).There were significant differences among LZ complexity in three states of resting state,maximum strength and strength endurance in AIS(P<0.001).LZ complexity during rest-ing state was significantly lower than that in contraction state(P<0.05).Conclusion:Adolescents with moderate S-shaped exhibit significant abnormalities in the thoracolumbar paraspi-nal muscle electromyographic activity,which serves as important indicators for early functional assessment,treatment evaluation,and disease prognosis.This study provides new insights for enhancing AIS prevention,re-habilitation,and the development of targeted,effective therapeutic strategies.
3.Changes of electromyographic characteristics of the thoracolumbar paraspinal muscles in adolescents with moderate S-shaped idiopathic scoliosis
Shanshan ZHANG ; Zhenfa ZHANG ; Yi XU
Chinese Journal of Rehabilitation Medicine 2025;40(10):1482-1489
Objective:To explore the changes in time-frequency and nonlinear indicators of thoracolumbar paraspinal mus-cle electromyographic activity in adolescents with moderate S-type idiopathic scoliosis(AIS)using surface elec-tromyography(sEMG)technology.Method:Nineteen AIS adolescent patients(age:11-17 years old,male:4,female:15)and twenty-one healthy adolescents(age:12-17 years old,male:7,female:14)were separately performed EMG signals of maximum isometric voluntary contraction of the thoracic and lumbar paraspinal muscles.The data were ana-lyzed with independent samples t-test to compare time-frequency changes of EMG activity of the lumbar multif-idus.Two-way repeated measures analysis of variance(ANOVA)was adopted to compare Lempel-Ziv(LZ)complexity values in different states between two groups,with Bonferroni correction for multiple comparisons to assess differences in group means.Result:Compared with healthy controls,patients with moderate,S-shaped AIS showed significant decrease in average EMG(AEMG)and root mean square(RMS)of the concave side thoracic paraspinal muscles,and de-crease median frequency(MF)and mean power frequency(MPF)of the convex side lumbar paraspinal mus-cles in the EMG measurements(P<0.05).There were significant differences among LZ complexity in three states of resting state,maximum strength and strength endurance in AIS(P<0.001).LZ complexity during rest-ing state was significantly lower than that in contraction state(P<0.05).Conclusion:Adolescents with moderate S-shaped exhibit significant abnormalities in the thoracolumbar paraspi-nal muscle electromyographic activity,which serves as important indicators for early functional assessment,treatment evaluation,and disease prognosis.This study provides new insights for enhancing AIS prevention,re-habilitation,and the development of targeted,effective therapeutic strategies.
4.The dynamic plantar pressure distribution of persons with chronic plantar fasciitis
Xiulan HAN ; Shanshan ZHANG ; Guifang ZHANG ; Zhiwei LIAN ; Shanshan BAO ; Zhenfa ZHANG ; Chuhuai WANG
Chinese Journal of Physical Medicine and Rehabilitation 2025;47(8):721-726
Objective:To analyze the dynamic plantar pressure distribution of persons with chronic plantar fasciitis (PF).Methods:Twenty persons with unilateral, chronic PF were recruited as the PF group, while twenty-three healthy counterparts were recruited as the control group. A foot-pressure measurement system was used to collect data describing the plantar pressure for each subject with or without PF while walking. The pressure data included the load of peak plantar pressure (PP), the mean plantar pressure (MP), the total foot ground contact area (TCA), and the load percentage and the foot ground contact area beneath the medial heel (MH), the lateral heel (LH), the medial longitudinal arch (MLA), the lateral longitudinal arch (LLA), the first metatarsal head (M1), the second to third metatarsal heads (M2-3), the fourth to fifth metatarsal heads (M4-5), the hallux (T1), and toes two to five (T2-5).Results:In the PF group, significant differences were observed during walking between the affected and unaffected feet in terms of PP [(2.41±0.44)kg/cm 2 versus (3.02±0.63)kg/cm 2]. Both were significantly greater than among the control group. Asymmetry in the load distribution was identified beneath the MH, M2-3, M1, MLA, M4-5 and T2-5 among the chronic PF group. There were also significant differences between the affected foot of the chronic PF group and the non-dominant foot of the control group with regard to the load percentage beneath the LH, M4-5, T2-5, M2-3 and T1. The load percentage under the LH was significantly higher under the unaffected foot of the PF group than under the dominant foot of the control group. In terms of ground contact area, the T2-5 area of the affected foot of the PF group was significantly smaller than that of the unaffected foot, as well as compared to the non-dominant foot of the control group. The TCA of both feet among the PF group was significantly smaller than under the corresponding feet of the control group. Conclusions:Patients with chronic plantar fasciitis apply plantar pressure asymmetrically during walking. They tend to shift their weight laterally onto the asymptomatic foot. During walking, those with PF apply higher plantar pressure over a smaller ground contact area.
5.The clinical effect of neurodynamic solutions combined with McKenzie diagnosis and therapy in patients with cervical spine radiculopathy
Zhenfa ZHANG ; Guifang ZHANG ; Shanshan ZHANG
Chinese Journal of Rehabilitation Medicine 2024;39(11):1588-1593
Objective:To observe the clinical effect of neurodynamic techniques combined with McKenzie diagnosis and therapy on patients with cervical spine radiculopathy,and to explore a better clinical treatment method for pa-tients with cervical spine radiculopathy. Method:Thirty-three patients with cervical spine radiculopathy who met the inclusion and matched the base-line characteristics were randomly divided into the two groups:the McKenzie treatment group(n=16)and the combined treatment group(n=17)according to the random number table.The patients in both groups received conventional physical treatment and Mechanical diagnosis and therapy,while the combined treatment group re-ceived neurodynamic techniques additionally.Before treatment and 2 weeks after treatment,the cervical range of motion(ROM)was measured,and the visual analogue scale(VAS)was used to evaluate the patients'pain level and the neck disability index(NDI)were used to assess the functional status and treatment outcome. Result:Before treatment,there were no significant differences in cervical ROM,VAS and NDI between two groups(P>0.05).After two weeks of treatment,the outcome of the combination group showed significant im-provements cervical ROM for flexion(42.65±3.12)°,extension(40.88±4.05)°,left lateral flexion(41.18±4.52)°,right lateral flexion(42.06±4.70)°,left rotation(73.53±5.80)°,and right rotation(74.71±7.39)°,the VAS score was 0.76±0.75,NDI score was 3.82±3.47,compared with both the baseline and the control group(P<0.05). Conclusion:Neurodynamic techniques combined with McKenzie diagnosis and therapy provide more effective relief of pain and ROM limitations in patients with cervical spine radiculopathy,accelerating the recovery of cervical function.The combination therapy is a useful clinical treatment option.
6.Comparison between laparoscopic-assisted natural orifice specimen extraction surgery and conventional laparoscopic surgery for left colorectal cancer: 5-year follow-up results of a randomized controlled study
Zhizheng CHEN ; Zhijie DING ; Zhenfa WANG ; Shuzhen XU ; Shifeng ZHANG ; Sibo YUAN ; Feng YAN ; Guoyan LIU ; Xingfeng QIU ; Jianchun CAI
Chinese Journal of Gastrointestinal Surgery 2023;26(8):768-772
Objective:To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer.Methods:This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m 2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results:Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7–83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively ( P=0.455); disease free survival was 90.0% and 83.3%, respectively ( P=0.455); overall recurrence rate 6.6% and 10.0%, respectively ( P=0.625); and local recurrence rate both were 3.3% ( P=0.990), respectively. None of these differences was statistically significant. Conclusions:NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.
7.Comparison between laparoscopic-assisted natural orifice specimen extraction surgery and conventional laparoscopic surgery for left colorectal cancer: 5-year follow-up results of a randomized controlled study
Zhizheng CHEN ; Zhijie DING ; Zhenfa WANG ; Shuzhen XU ; Shifeng ZHANG ; Sibo YUAN ; Feng YAN ; Guoyan LIU ; Xingfeng QIU ; Jianchun CAI
Chinese Journal of Gastrointestinal Surgery 2023;26(8):768-772
Objective:To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer.Methods:This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m 2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results:Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7–83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively ( P=0.455); disease free survival was 90.0% and 83.3%, respectively ( P=0.455); overall recurrence rate 6.6% and 10.0%, respectively ( P=0.625); and local recurrence rate both were 3.3% ( P=0.990), respectively. None of these differences was statistically significant. Conclusions:NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.
8.Nonlinear analysis of electromyography signals from the deep lumbar multifidus of patients with chronic low back pain
Shanshan ZHANG ; Zhenfa ZHANG ; Shimin HUANG ; Ying WU ; Lianghua FAN ; Wen WU ; Chuhuai WANG
Chinese Journal of Physical Medicine and Rehabilitation 2023;45(9):815-819
Objective:To explore any changes in the electromyographic (EMG) signals from the deep lumbar multifidus (DM) of patients with chronic low back pain (cLBP).Methods:Twenty-five cLBP patients formed the cLBP group, while twenty-eight healthy counterparts similar in sex, age and education background were chosen as the control group. EMG signals were recorded during maximum isometric voluntary contraction of the DM. Two-way repeated measures analysis of variance was applied to compare the two groups′ signals′ Lempel-Ziv (LZ) complexity values at rest and during the maximum strength, strength endurance and relaxation stages of contraction. Pearson correlation coefficients were computed relating the LZ complexity to pain duration and intensity, as well as to Oswestry disability index (ODI) values in the cLBP group.Results:The cLBP patients reported a mean symptom duration of 5.96±4.69 years, with an average VAS score of 4.00±1.04 and ODI of 17.12±10.49. They reported greater pain intensity during needle insertions, needle removal, muscle contraction and relaxation than the healthy controls. There were significant differences in LZ complexity among the four stages of contraction with all of the subjects. The LZ complexity was significantly lower in the maximum strength and strength endurance states, but higher in the relaxation after contraction states in the cLBP group. Pain duration was negatively correlated with the nonlinear index of DM during contraction.Conclusion:Continuous pain stimulation will affect the coordinated control of the deep multifidus muscle, leading to decreased control of core muscles via the central nervous system. That provides insight into the mechanisms underlying activation and coordinated control during chronic pain.
9.Acupuncture therapy reduces cervical and shoulder pain in patients with stroke
Yuan GUAN ; Zheqi WANG ; Chun HAN ; Zhenfa ZHANG ; Mengyun HU ; Zhiqi WANG
Chinese Journal of Primary Medicine and Pharmacy 2022;29(7):999-1002
Objective:To investigate the clinical effects of acupuncture therapy on post-hemiplegia neck and shoulder pain.Methods:Eighty patients with post-stroke hemiplegia with neck and shoulder pain who received treatment in Department of Acupuncture, Massage and Physiotherapy, Zhejiang Provincial Armed Police Corps Hospital between December 2020 and June 2021 were included in this study. They were randomly assigned to undergo either conventional rehabilitation treatment and analgesic tablets (control group, n = 40) or conventional rehabilitation treatment, analgesic tablets and acupuncture therapy in combination (observation group, n = 40). Traditional Chinese medicine efficacy, western medicine efficacy, degree of neurological deficits, ability of daily living, and the incidence of adverse reactions were compared between the two groups. Results:After treatment, traditional Chinese medicine efficacy and western Chinese medicine efficacy in the observation group were significantly higher than those in the control group (87.50% vs. 52.50%, 82.50% vs. 55.00%), and the incidence of adverse reactions in the observation group was significantly lower than that in the control group (17.50% vs. 42.50%, χ2 = 21.48, 16.33, 9.12, all P < 0.05). In the control group, National Institutes of Health Stroke Scale (NIHSS) score measured after treatment was significantly lower than that measured before treatment [(7.58 ± 1.87) points vs. (14.87 ± 1.36) points, t = -9.58, P < 0.001], and Barthel Index (BI) measured after treatment was significantly higher than that measured before treatment [(53.78 ± 1.34) points vs. (37.92 ± 1.74) points, t = 6.35, P < 0.001]. In the observation group, NIHSS score measured after treatment was significantly lower than that measured before treatment [(5.44 ± 2.11) points vs. (14.51 ± 0.34) points, t = -12.69, P < 0.001], and BI measured after treatment was significantly higher than that measured before treatment [(62.02 ± 0.68) points vs. (37.73 ± 1.58) points, t = 7.45, P < 0.05]. BI post-measurement in the observation group was significantly higher than that in the control group [(62.02 ± 0.68) points vs. (53.78 ± 1.34) points, t = 4.35, P < 0.05]; NIHSS score post-measurement in the observation group was significantly lower than that in the control group [(5.44 ± 2.11) points vs. (7.58 ± 1.87) points, t = -8.48, P < 0.05]. Conclusion:Acupuncture treatment for post-hemiplegia neck and shoulder pain can markedly reduce pain in patients, improve prognosis and increase clinical efficacy.
10.Progress advance in the application of immune checkpoint inhibitors in the treatment of non-small cell lung cancer
Lianmin ZHANG ; Dongsheng YUE ; Zhenfa ZHANG ; Changli WANG
International Journal of Biomedical Engineering 2019;42(3):239-244
Lung cancer is the most common malignant tumor in the world. In order to improve the survival rate of patients with advanced lung cancer, more effective treatment methods are needed,in which immunotherapy has a broad therapeutic prospect. In recent years, immune-checkpoint inhibitors have received extensive attention in the treatment of lung cancer. Significant progress has been made in the development of a variety of first-line and second-line treatments, and significant advances have been made in the treatment of advanced lung cancer. With the successful application of immune-checkpoint inhibitors, neoadjuvant therapy has attracted extensive attention. In addition, the successful application of combined therapies such as immune combined immunization, immune combined tyrosine kinase inhibitor (TKI) and immune combined chemotherapy improved the survival rate of patients to some extent. However, pseudo progression and drug resistance has become a non-negligible problem in the immunotherapy of non-small cell lung cancer, which is worthy of further study. Although immune-checkpoint inhibitors have once again brought attention to tumor immunotherapy, their side effects are also worthy of attention. The recent advances in the application of immune-checkpoint inhibitors in lung cancer were summarized in order to provide a theoretical basis for its clinical application.

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