Tricuspid valve, also known as "forgotten valve" because of the high natural and surgical mortality. Transcatheter tricuspid valve replacement is an innovative surgical method to treat tricuspid regurgitation, which improves the prognosis of patients and is gradually being popularized in clinics. However, postoperative pulmonary complications are still the main causes affecting the rapid recovery and death. More and more medical experts begin to use preoperative inspiratory muscle training to reduce postoperative pulmonary complications and improve the quality of life of patients after cardiac surgery. However, there was no report on the effect of preoperative inspiratory muscle training on pulmonary complications after transcatheter tricuspid valve replacement. Therefore, for the first time, we boldly speculate that inspiratory muscle training can reduce pulmonary complications after transcatheter tricuspid valve replacement, and put forward suggestions for its treatment mechanism and strategy. But this rehabilitation intervention lacks practical clinical research. Unknown challenges may also be encountered, which may be a new research direction.

Lateral epicondylitis is a common clinical disease with characteristics of lateral elbow pain, insidious onset and easy recurrence, which can cause forearm pain and decreased wrist strength, seriously affecting patients′ daily life and work. Although there are various treatment methods for lateral epicondylitis with different effects, standard treatments are still lacking nowadays. Platelet-rich plasma (PRP) has good effects on bone and tendon repair, and is now widely used in the treatment of lateral epicondylitis. However, there is a lack of a unified understanding of the technology and specifications of PRP in the treatment of lateral epicondylitis. Therefore, the Sports Medicine Branch of the Chinese Medical Association and Physical Medicine and Rehabilitation Branch of the Chinese Medical Association organized experts in the fields of sports medicine and rehabilitation medicine in China to formulate the "clinical expert consensus on platelet-rich plasma treatment for lateral epicondylitis (2022 version)", and proposed suggestions based on evidence-based medicine mainly from the concept, epidemiology and pathophysiology of lateral epicondylitis, symptoms, signs and imaging manifestations of lateral epicondylitis, PRP concept and application component requirements, quality control of PRP preparation technology, indications and contraindications of PRP in the treatment of lateral epicondylitis, PRP injection in the treatment of lateral epicondylitis, application of PRP in the operation of lateral epicondylitis, related problems after PRP treatment of lateral epicondylitis, evaluation of the results after PRP treatment of lateral epicondylitis, and health and economic evaluation of PRP treatment of lateral epicondylitis, so as to provide guidance for clinical diagnosis and treatment.

Objective To analyze the clinical efficacy of using virtual reality ( VR) to improve the upper limb function of hemiplegic persons. Methods A search was conducted in the PubMed, Cochrane Library, EM-BASE, CNKI and Wanfang Data as well as VIP for reports of randomized and controlled studies of using VR in train-ing upper limb function after stroke. A meta-analysis was then performed using version 5. 3 of the Review Manager software. Results Ninety studies involving 879 patients were found and analyzed. The data showed that VR was sig-nificantly more effective than conventional training in improving Fugl-Meyer assessment scores. It was not superior, however, in improving average Functional Independence Measure scores or performance in the box and blocks test. Conclusion VR is superior to conventional training in promoting the recovery of upper limb function after a stroke.

We investigated the effects and optimal treatment frequency of pulsed electromagnetic fields (PEMFs) on postmenopausal osteoporosis (PMO). A comparison was performed with the cyclical alendronate and a course of PEMFs in the treatment for postmenopausal osteoporosis on bone mineral density (BMD), pain intensity and balance function. There was no significant difference between the two groups on mean percentage changes from baseline of BMD within 24 weeks after random treatments (P > or = 0.05). However, at the ends of 48 weeks and 72 weeks, the BMD of the PEMFs group were significantly lower than that of the alendronate group (P < 0.05). No significant difference was detected between the two groups with regard to treatment effects on Visual Analogue Scale score, the Timed Up & Go Test and Berg Balance Scale score. Compared with cyclical alendronate, a course of PEMFs was as effective as alendronate in treating PMO for at least 24 weeks. So its optimal treatment frequency for PMO may be one course per six months.
Alendronate ; therapeutic use ; Bone Density ; Bone Density Conservation Agents ; therapeutic use ; Electromagnetic Fields ; Female ; Humans ; Magnetic Field Therapy ; Osteoporosis, Postmenopausal ; therapy

BACKGROUND:Whole body vibration training, a recently developed method of neuromuscular training, is a useful method to improve muscle strength and postural control in the elderly. Recently, researchers attempt to explore whether whole body vibration training can reduce motor dysfunction for stroke patients.
OBJECTIVE:To summarize clinical progress in whole body vibration treatment on stroke patients with limb motor dysfunction, including muscle strength of the affected limbs, muscle tension, balance and gait.
METHODPubMed, EBSCO, Medline database were searched for articles relate to whole body vibration training intervention for stroke patients with motor dysfunction published from January 2002 to June 2014. Final y, 34 articles were included in result analysis.
RESULTS AND CONCLUSION:Whole body vibration training is feasible and safe for stroke patients has the feasibility and safety. For therapeutic efficacy, we focus on the muscle strength, muscle tone, balance, posture control ability, but there is no sufficient evidence to support that the whole body vibration training can improve the motor dysfunction. There is also no recognized standard on specific intervention protocols, such as vibration type, treatment frequency, treatment amplitude, treatment time. Many researchers aim to observe the clinical curative effect at present, but rarely explore the intervention mechanism of the whole body vibration. Further large-sample, multi-center randomized control ed experiments are required to test the validity.

Background and objective It is unknown that the postoperation fast-track recovery and in hospital cost of the lobectomy in lung cancer, we explored the inlfuencing factor of postoperative fast-track recovery and in hospital cost atfer undergoing lobectomy for lung cancer. Methods We retrospectively reviewed the medical records of all patients (n=176) who underwent lobectomy for lung cancer between January 2010 and November 2011 by a thoracic surgeon. Results hTe hospital costs of video-assisted thoracic surgery (VATS) lobectomy (47,308.21 ￥) is signiifcantly higher than open lobectomy (45,664.31 ￥)(P=0.007). hTe hospital costs of body mass index (BMI)≥24 kg/m2 (51,186.99 ￥) is signiifcantly higher than BMI<24 kg/m2 (41,701.64 ￥)(P=0.032). hTe hospital stay of VATS lobectomy (5.70 d) is signiifcantly less than open lobectomy (7.10 d)(P<0.001). Conclusion hTese ifndings indicate that preoperative pulmonary rehabilitation and VATS lobectomy is contrib-uted to fast-track recovery for patients who undergo lobectomy, but increase the hospital costs.

Objective To determine normal reference values for conduction in the posterior antebrachial cutaneous nerve.Methods Antidromic sensory conduction examinations of the bilateral posterior antebrachial cutaneous nerve were conducted with fifty-eight healthy subjects.The onset latency,peak latency,peak-to-peak amplitude and conduction velocity of the sensory nerve action potentials (SNAPs) were recorded and the inter-side ratios of the peak-to-peak amplitudes were calculated.Results The observed means (and standard deviations) of the onset time,the peak latency,the amplitude and the conduction velocity were 1.96 (0.12) ms,2.48 (0.14) ms,7.39 (2.36) μV and 61.39 (3.69) m/s,respectively.The side-to-side amplitude ratio (smaller/larger) was 0.88 ± 0.09,and no significant difference was observed between the left and right side.The average peak latency and amplitude were significantly different for different age groups.There was no statistically significant difference among the age groups with regard to onset latency or conduction velocity.Conclusion Conduction in the posterior antebrachial cutaneous nerve is easy to study.The peak latency is prolonged and the amplitude decreases with age,suggesting that different normal reference values should be established for different age groups.

Objective To characterize the static balance and limits of stability (LOS) of postmenopausal women and evaluate the relationship between bone mineral density (BMD) and balance.Methods Sixty women more than 12 months past menopause and aged 50 to 60 years were included in the study.Group 1 (n =20) consisted of women with normal BMD,group 2 (n =20) women with osteopenia,and group 3 (n =20) women with osteoporosis.The static balance of all the participants was evaluated in upright postural situations for 60 s with the eyes open and with the eyes elosed.Their LOS was quantified using a force platform.Results There was no significant difference in static balance parameters or LOS among the 3 groups.The static balance parameters were not significantly different in either the eyes-open or eyes-closed situation in the osteoporosis and osteopenia groups.The medial and lateral LOS were greater than the anterior and posterior limits in all 3 groups.The anterior LOS was greater than the posterior limits among the women with osteopenia and normal density.Conclusion In postmenopausal women aged 50 to 60 years,BMD did not show any significant association with static balance or LOS.Postmenopausal women had better postural control in the mediolateral than in the anteroposterior direction.In postmenopausal women with osteoporosis,postural control in the anterior direction deteriorates from age 50 to 60.

BACKGROUND:Osteoporosis is a condition resulting in an increased risk of skeletal fractures due to a reduction in bone mass and degradation in bone microstructure. Treatment of osteoporosis usual y involves the application of pharmacological agents as the first choice. Pharmacotherapy alone is not sufficient for the comprehensive management of osteoporosis, as pharmacotherapy has no effect on increasing muscle strength, improving balance ability, and preventing fal s. Exercise, considered as an important non-pharmacologic therapy, plays a considerable role in the prevention of osteoporosis. The importance of therapeutic exercises in the treatment of osteoporosis has been recognized gradual y.
OBJECTIVE:To discuss the effect of exercise in the treatment of osteoporosis combined with some of the latest research literatures.
METHODS:Clinical reports and mechanism researches about effects of different types of exercise on bone strength especial y the treatment of osteoporosis were retrieved from CNKI database and Medline database with the key words of“osteoporosis, bone mineral density, bone strength, treatment, exercise, stress, tai chi, muscle, bone architecture”in both Chinese and English from January 2001 to February 2013. The repetitive researches and atypical reports were eliminated.
RESULTS AND CONCLUSLON:Therapeutic exercises including aerobic exercise, resistance, impact movement, and vibration, which can safely increase bone strength and muscle strength, improve equilibrium function, and prevent fal s and fractures. For spinal deformity patients, appropriate orthotics can improve the security and promote exercise therapy. As with drug therapy, therapeutic exercises are also individualized. Exercise program should be selected under the insurance of good compliance and security. Exercises that involve high strain rates seem to be more effective than others. However, al these benefits are comparatively smal , and should be maintained by continuous exercises.

BACKGROUND:Ultrasound therapy can relieve pain and improve the movement function in patients with knee osteoarthritis, but there lacks of consistency in the literatures of ultrasound therapy.
OBJECTIVE:To further identify the effectiveness of ultrasound therapy in the treatment of knee osteoarthritis.
METHODS:Twenty-four rabbits were randomly divided into three groups:normal group, model group and ultrasound group. The rabbit in the normal group received no intervention;rabbits in the model group received anterior cruciate ligament transaction to establish the knee osteoarthritis model without any treatment;the rabbit in the ultrasound group received ultrasound therapy after modeling for 10 minutes once time, once per day, 0.3 W/cm2 , 1 MHz and treated for 10 times. Hematoxylin-eosin staining was conducted for histological observation of rabbit articular cartilage;western blot and reverse transcription PCR assessment were used to assess the expressions of caspases-3 and caspases-8 in rabbit articular cartilage, while Terminal deoxynucleotidyl transferase dUTP nick end labeling was used to assess the ratio of chondrocytes apoptosis of rabbit knee articular cartilage.
RESULTS AND CONCLUSION:The normal rabbit cartilage tissues and chondrocytes were neatly arranged in column;the middle cartilage layer of the model was thin;the chondrocytes were arranged disorderly and became less. After ultrasound therapy, the chondrocytes were rearranged neatly, and the number was increased. Compared with the normal group, the Mankin scores in the model group and ultrasound group were higher;the apoptotic rate of chondrocytes was higher in the model group and ultrasound group than in the normal group, and was also higher in the model group than in the ultrasound group. Compared with the normal group, the expressions of caspases-3 and caspases-8 were higher in the model group and the ultrasound group, while decreased after ultrasound therapy. The results indicate that ultrasound can improve the structure of cartilage tissues, decrease the expressions of caspases-3 and caspases-8 and reduce the apoptosis rate of chondrocytes. It is effective for the treatment of knee osteoarthritis with ultrasound therapy.