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.

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.

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.

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.

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.

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.

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.

OBJECTIVETo investigate the feasibility and safety of membrane-based right-sided approach of laparoscopic suprapancreatic lymph node dissection for advanced distal gastric cancer.

METHODSThe clinical data of 41 patients with advanced distal gastric cancer who underwent laparoscopic gastrectomy using membrane-based right-sided approach for laparoscopic suprapancreatic lymph node dissection at the Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University from January 2016 to January 2018 were retrospectively analyzed. There were 24 males and 17 females with a mean age of 56.8 years and a mean body mass index of 22.6 kg/m². Membrane-based right-sided approach of laparoscopic suprapancreatic lymph node dissection contained 4 steps briefly: (1) dissection of mesenteria above the head of pancreas: the tri-junction of pancreas-duodenum was cut to expose and identify the logo of Benz;clearance of the membrane of No.5a was performed towards the left, and then expanded to the posterior layer of No.12a. (2) dissection of the V shape dorsal mesogastrium: membrane bridge at splenic artery trunk root was cut; in suprapancreatic space, clearance was performed towards to the left to the middle of the splenic artery trunk and expanded to the posterior Tolds plane upwards to the posterior phrenic angle and retroperitoneal esophagus, then the surrounding tissue of anterior abdominal aorta. (3) dissection of the U shape mesenteria:membrane bridge at common hepatic artery root was cut; mesentery was separated; the left gastric vein was freed and ligated at its root; in posterior pancreatic space, the mesentery of No.7, No.9 and No.8 was dissected in turns; the left gastric artery was high ligated and cut; the portal vein and posterior dorsal mesogastrium Toldt plane was routinely exposed; clearance was performed to right for No.8a and upward to the hepatic portal meeting at posterior mesentery No.12 plane. (4) dissection of the upper triangular area of pylorus: the trigone mesentery was cut along the upper edge of the pylorus; No.12a was swept upward along the gastric ventral mesentery; the upper boundary(No.8a) on the right side of the U-shaped membrane was joined. Intraoperative and postoperative presentations were analyzed.

RESULTSLaparoscopic gastrectomy for advanced distal gastric cancer with membrane-based right-sided approach of laparoscopic suprapancreatic lymph node dissection was successfully carried out in all the 41 patients. Distal gastric mesenteria en bloc resection was successfully performed. The operation time was (145.2±25.4) minutes and intraoperative blood loss was (53.3±18.3) ml without massive bleeding and severe complication. Number of lymph nodes dissected was 41.1±6.4, and number of suprapancreatic lymph node dissected was 23.3±3.7 without residual cancer at cut margin by pathology. Postoperative drainage volume was (65.8±21.7) ml; time to withdraw of catheter was (7.0±1.7) days; time to fluid intake was (3.5±1.8) days; postoperative hospital stay was (10.4±2.8) days; time to postoperative anal exhaust was (3.3±1.1) days. No complications, such as chyle leakage, postoperative massive bleeding, anastomotic leakage, abdominal cavity infection or gastroplegia occurred within 30 days after surgery.

CONCLUSIONMembrane-based right-sided approach of laparoscopic suprapancreatic lymph node dissection for advanced distal gastric cancer can achieve en bloc resection and conform to the radical principle of oncology, and is safe and feasible.

Objective: The expression of WNT5A is associated with aggressive tumor biology and poor clinical outcomes of various types of cancer. However, its function in the cell migration of small cell lung cancer (SCLC) should be elucidated. Methods:The expres-sion of WNT5A in SCLC and normal lung tissues was detected by immunohistochemisty. The correlation between the expression and clinical characteristics of WNT5A was analyzed. The function of WNT5A in regulating cell migration was studied in DMS153 cell line in vitro. Small interfering RNA (SiRNA) was used to knock down WNT5A. Wound healing and Transwell tests were used to determine the migration rate of DMS153. The phosphorylated JNK expression was detected by Western blot analysis. Results:The WNT5A expression was higher in SCLC tissues than that of normal lung tissues. WNT5A was correlated with clinical stages, lymph nodes, and distance me-tastasis in SCLC. The high expression of WNT5A was accompanied by abnormal levels of NSE and Pro-GRP. The WNT5A phosphoryla-tion of JNK promoted cell migration in vitro. Conclusion:The expression of WNT5A in SCLC is high and correlated with tumor metasta-sis. The influence of WNT5A/JNK on the cell migration property of DMS153 supports the concept that WNT5A can initiate the cell mi-gration of SCLC, which suggested that WNT5A may be a marker and can be potentially used as an effective therapeutic target for the SCLC metastasis.

[Objective] To explore the characteristics of the plantar pressure data of the patients with adolescent idiopathic scoliosis (AIS).[Methods] 56 AIS patients who were diagnosed from October 2015 to March 2017 in the East branch of the First Affiliated Hospital of Sun Yat-sen University divided into 3 groups,18 cases in spinal lateral bending to right,18 cases in spinal lateral bending to left,20 cases in type S who were thoracolumbar scoliosis.Another 19 healthy persons were as the control group.The left and right foot pressure,half foot pressure and other biomechanical data were compared.The changes of the plantar pressure and the Cobb angle were analyzed with the patients who wore orthopedic insoles.[Results] Compared with the control group,the mean pressure of the left foot and the pressure of the left anterior half of the right bending group were less than those of the control group,and the right half foot pressure were greater than those of the control group (P ＜ 0.017).To the left bending group,the mean pressure of right anterior half foot were less than those of the control group,and the right rear half foot pressure was greater than that of the control group (P ＜ 0.017).The pressure of the left anterior half foot of the S type scoliosis group was less than that of the control group.To the right bending group,the left foot average pressure (44.7％±6.0％) was significantly less than the average pressure of right foot (55.4％ ± 6.0％).There was no difference in bilateral plantar pressure of the left bending group,S type group and control group.There was difference with the plantar pressure distribution in patients with only one curve after they wore orthotic insoles,but there was no difference in patients with type S.There was no significant difference in the Cobb angle after the patients wearing the orthotic insoles (P =0.102).[Conclusions] The right and left foot pressure symmetry of the right bending patients is poor,but the left and right plantar pressure in the patients with type S is symmetrical.The orthotic insole can be used to adjust the plantar pressure distribution in patients with a single curved scoliosis (left or right),but their effect on the patient's spinal lateral curvature should be further observed.