[Tiaohe Yinyang acupotomy for knee osteoarthritis: a randomized controlled trial].

OBJECTIVE: To observe the clinical efficacy of Tiaohe Yinyang acupotomy (acupotomy for regulating and harmonizing yin and yang) for knee osteoarthritis (KOA). METHODS: A total of 88 patients with KOA were randomized into a acupotomy group and a sham-acupotomy group, 44 cases in each group. In the acupotomy group, acupotomy was applied at yin side (4-5 high stress points i.e. pes anserinus and terminal of popliteus) and yang side (1-2 high stress points i.e. stimulation point of infrapatellar ligament and suprapatellar bursa) of knee joint. In the sham-acupotomy group, sham-acupotomy was applied at the same points as the acupotomy group. The treatment was given once a week for 2 weeks in the two groups. Before and after treatment, the Western Ontario and McMaster Universities arthritis index (WOMAC) score, visual analogue scale (VAS) score, thickness of medial and lateral collateral ligaments of knee joint, motion range of knee joint and plantar pressure distribution were observed in the two groups. In the follow-up of 3 months after treatment, the WOMAC and VAS scores were recorded in the acupotomy group. RESULTS: After treatment, the sub item scores (pain, stiffness and function) and total scores of WOMAC and VAS scores were decreased in the both groups (P<0.05), pain score, function score and total score of WOMAC and VAS score in the acupotomy group were lower than those in the sham-acupotomy group (P<0.05). Before and after treatment, there were no statistical differences in thickness of medial and lateral collateral ligaments of knee joint and motion range of knee joint between the two groups (P>0.05). After treatment, the plantar medial pressure was increased while the plantar lateral pressure was decreased (P<0.05), and the plantar force line moved medially in the acupotomy group. In the follow-up, the sub item scores and total score of WOMAC and VAS score were lower than those before and after treatment in the acupotomy group (P<0.05). CONCLUSION: Tiaohe Yinyang acupotomy can improve the clinical symptoms of knee joint in patients with KOA by changing the local biological stress.

Association Between Serum Uric Acid and Intracranial Arterial Stenosis in a Korean Population: A Secondary Analysis Based on a Cross-Sectional Study.

Background and purpose: Intracranial arterial stenosis (ICAS) is a common cause of cerebrovascular disease. Studies have shown that the disease may be associated with elevated serum uric acid. However, the results remain inexact and controversial. To provide theoretical support for clinical practice, we assessed the relationship between uric acid and ICAS based on previous literature. Materials and Methods: A total of 1,011 samples were included in the secondary cross-sectional study we investigated. We evaluated the relationship between uric acid level and ICAS using multivariable logistic regression analysis. Results: The mean age of patients was 64.16 ± 9.13 years, and 35.51% (n = 359) were male in the study. One hundred and one (10%) of the included participants had ICAS. In the unadjusted model, uric acid level was positively associated with ICAS [odds ratio (OR) = 1.23, 95% confidence interval (CI): 1.07-1.42, p < 0.01]. After adjusting for potential confounders (sex, age, diabetes mellitus, coronary artery occlusive disease, hyperlipidemia, statin medication, hypertension, and fasting glucose), a positive relationship was observed between uric acid and ICAS (OR = 1.26, 95% CI: 1.08-1.47, p < 0.05). Conclusion: There was a positive relationship between uric acid levels and ICAS in neurologically healthy Korean participants.

Ultrasound-guided percutaneous microwave ablation of adenomyosis: a narrative review.

OBJECTIVE: The purpose of the present review is to analyze and summarize the feasibility, effectiveness, and safety of ultrasound-guided percutaneous microwave ablation (MWA) for adenomyosis according to largest studies available in current literature, so as to provide a more robust foundation for its use in the treatment of patients with this condition. BACKGROUND: Adenomyosis is a common and frequently occurring gynecological disease. It can lead to clinical symptoms such as dysmenorrhea, menostaxis, menorrhagia, and anemia, and can seriously affect patients' quality of life. Treatments for adenomyosis include drug, minimally invasive, and surgical therapies. Among them, ultrasound-guided percutaneous microwave ablation has become a new hotspot in the minimally invasive treatment of adenomyosis in recent years, with its advantages of small trauma and a good therapeutic effect. METHODS: Relevant studies were retrieved from the CNKI (Chinese National Knowledge Infrastructure), CQVIP, Wanfang, PubMed, Web of Science, Cochrane Library, EMBASE, ClinicalTrials.gov, and Google Scholar databases. The retrieval time range was from January 2000 to June 2021. Chinese search terms included "adenomyosis", "microwave ablation", and "ultrasound". English search terms included "microwave ablation", "ultrasound", "(adenomyosis) OR (endometrioma) OR (adenomyoma)". CONCLUSIONS: Ultrasound-guided percutaneous microwave ablation therapy is a feasible, safe, and effective technique for the treatment of adenomyosis, and is worthy of clinical application and promotion.

Retrospective study of the ultrasound characteristics of the tibial nerve in patients with type 2 diabetic peripheral neuropathy.

BACKGROUND: Ultrasound is a promising imaging examination for type 2 diabetic peripheral neuropathy (DPN). This study aimed to explore the risk factors of ultrasound diagnostic characteristics in the tibial nerves of patients with type 2 DPN. METHODS: The Michigan Neuropathy Screening Instrument (MNSI) was used for neuropathy evaluation, and 520 patients with type 2 diabetes were divided into a DPN group and non-DPN (NDPN) group with 2 points as the cut-off value. The two groups were matched at a ratio of 1:1 according to age, BMI, calf circumference, and gender, resulting in 44 matched pairs. The dependent variable was type 2 DPN and the concomitant variables were the width, thickness, cross-sectional area, and unclear honeycomb-like structure of the tibial nerve. A 1:1 matched conditional logistic regression model was established to analyze which ultrasound diagnostic characteristics of the tibial nerve were risk factors for type 2 DPN. RESULTS: The thickness (OR =5.176, P=0.043) and cross-sectional area (OR =1.659, P=0.030) of the tibial nerve were risk factors for the diagnosis of DPN, while the width and unclear honeycomb-like structure of the nerve were not (P>0.05). In the diagnosis of DPN, the area under the receiver operating characteristic (ROC) curve of the cross-sectional area of the tibial nerve was 0.747, and the sensitivity, specificity, positive predictive value, and negative predictive value were 61.36%, 95.45%, 93.10%, and 71.20%, respectively. The area under the ROC curve of tibial nerve thickness was 0.867, and the sensitivity, specificity, positive predictive value, and negative predictive value were 81.82%, 90.91%, 90.00%, and 83.30%, respectively. The area under the ROC curve of thickness was larger than that of cross-sectional area of the tibial nerve (z statistic =1.800, P=0.07). CONCLUSIONS: The thickness and cross-sectional area of the tibial nerve measured by ultrasound are risk factors for type 2 DPN. The diagnostic sensitivity of the thickness is higher than the cross-sectional area, while the diagnostic specificity of the cross-sectional area is higher than the thickness.

Effect of acupotomy in knee osteoarthritis patients: study protocol for a randomized controlled trial.

BACKGROUND: Symptomatic knee osteoarthritis (KOA) is common in China. Pharmacological therapy is not the first recommendation because of its safety issues. Nonpharmacological therapy, such as lifestyle adjustments, weight loss, muscle strengthening, and aerobic exercise programs, is strongly recommended for KOA. However, these approaches may fail due to poor patient compliance. There is a lack of high-quality randomized controlled trials of acupotomy, an effective treatment for KOA. This study was designed to investigate the efficacy of acupotomy in patients with KOA. METHODS: A total of 136 patients will be enrolled at the First Affiliated Hospital of Guangzhou University of Chinese Medicine and assigned to the acupotomy group or sham acupotomy group according to the block randomization scheme. Patients in the acupotomy group will receive 2 sessions of acupotomy for 2 weeks (once a week). Patients in the sham group will receive 2 sessions of sham stimulation for 2 weeks (once a week). All patients will use indomethacin cream externally. The primary outcome will be the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the secondary outcomes will be the visual analog scale (VAS) score, plantar pressure distribution test result, X-ray examination findings, musculoskeletal ultrasound findings, maximum knee circumference, joint mobility, and quality of life. Measurements will be taken at baseline, 1 week after the end of treatment, and at the 3- and 6-month follow-ups. DISCUSSION: To the best of our knowledge, this will be the first single-blind, sham-controlled study of acupotomy. The outcome assessors will also be blinded. The aim of this work is to demonstrate the efficacy of acupotomy in treating KOA. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000033047 . Registered on 18 May 2020.

Association between fasting blood glucose and intracranial cerebral artery stenosis: a secondary analysis based on a retrospective cross-sectional study in Korean adults.

AIMS: Diabetes mellitus (DM) is one of the main risk factors for intracranial cerebral artery stenosis (ICAS), and fasting blood glucose (FBG) might be an effective predictor of ICAS. However, there are a few studies revealing the relationship between FBG and ICAS. We aim to identify the association between FBG and ICAS in Koreans. METHODS: This was a secondary study based on a cross-sectional study. A total of 1011 Korean individuals who were asymptomatic but with high cerebrovascular risk underwent an examination in a Korean medical centre from March 2008 to December 2014. The main measure was FBG, while the main outcome was ICAS. Multivariate logistic regression analyses of FBG in the presence of ICAS were performed to examine the potential association. The author used the data provided by the paper "Association between Serum Alkaline Phosphatase Level and Cerebral Small Vessel Disease" for secondary analysis. RESULTS: The average age of the participants was 64.2 ± 9.1 years old, and approximately 35% of them were males. There were 24 participants suffering from ICAS in the first FBG tertile (< 5.4 mmol/L), while there were 26 in the second tertile (5.4-7.1 mmol/L) and 50 in the third tertile (≥ 7.1 mmol/L). The non-adjusted relationship between FBG and ICAS was positive. After controlling potential confounders, the association of FPG with ICAS remained positive, as well as in subgroups analysis, such as age, sex, hypertension, diabetes mellitus, hyperlipidaemia and COAD. The association remained unchanged after adjusted sex, age, hypertension, DM, uric acid, hyperlipidaemia, and CAOD (OR = 1.08, 95% CI = 1.02-1.15). The analyses also showed that the positive association was statistically significant (P < 0.05) among individuals without diabetes. CONCLUSIONS: This study showed a positive relationship between FBG and ICAS, which suggests that clinicians may need to be simultaneously concerned about FBG and ICAS.

IFI30 as a prognostic biomarker and correlation with immune infiltrates in glioma.

BACKGROUND: Increased evidence indicates that the tumour microenvironment (TME) plays an essential role in the development, treatment and prognosis of glioma. High expression of interferon-gamma-inducible protein 30 (IFI30) is associated with the malignant phenotype, but the effect of IFI30 on the tumour immune microenvironment and its potential role in the carcinogenesis of glioma remain unknown. METHODS: The RNA sequencing (RNA-seq) data of 33 types of human cancer were obtained from The Cancer Genome Atlas (TCGA) Genomic Data Commons (GDC). R software was used to perform analyses, such as the expression of IFI30 in pan-cancer, evaluation of IFI30 as a prognostic biomarker in glioma, the relationship between IFI30 expression and clinical characteristics, and immune checkpoint. TIMER was used to analyse the correlation of IFI30 expression level with immune cell infiltration, and also to conduct survival analysis for immune cells and IFI30 in low grade glioma (LGG). DAVID was used for Gene Ontology (GO) functional annotations and Kyoto Encyclopedia of Genes and Genomes (KEGG) for pathway analysis of the genes similar to IFI30 in glioma. The differentially expressed genes (DEGs) between the high- and low-IFI30 expression groups were determined by DESeq2. Gene set enrichment analysis (GSEA) was then conducted to identify IFI30-related functional significance based on the hallmark gene set. RESULTS: Dysregulated expression of IFI30 was associated with human cancers. High IFI30 expression was associated with poor overall survival (OS), disease-specific survival (DSS) and progression-free interval (PFI). Univariate and multivariate analyses identified IFI30 as an independent predictor for glioma. Meanwhile, IFI30 overexpression significantly correlated with high-grade tumours, poor OS, and immune infiltration. In addition, IFI30-associated genes significantly enriched the hallmark tumour progression-related clusters and cancer pathways. CONCLUSIONS: IFI30 is a prognostic biomarker correlated with immune infiltrates and acts as an oncogene in glioma.

Ultrasound features and the diagnostic strategy of subhepatic appendicitis.

BACKGROUND: This study aimed to compare the differences of ultrasound findings between subhepatic appendicitis and appendicitis at a normal position, then discuss the diagnostic strategies and improve the accuracy of diagnosis. METHODS: A retrospective analysis was performed in our hospital. One thousand five hundred ninety-one patients with appendicitis were diagnosed from January 2014 to January 2018. Eighteen patients with subhepatic appendicitis and 25 patients with appendicitis with regular positions were selected randomly as the control group. The difference in ultrasound features between the two groups was studied. Comparisons between the two groups showed statistically significant differences in the frequencies of the fishbone sign, enlarged appendix, appendicoliths, and hyperechoic omental cap (P<0.05). RESULTS: Statistical significance was not observed with the difference in the frequency of whether there was lymphadenectasis (P>0.05) in the abdominal cavity between the two groups. The Pareto chart was drawn to look for the main factors associated. The results of interpretation on the critical points of diagnosis for subhepatic appendicitis: (I) the fishbone sign of a dilated ileum in the right lower abdomen; and (II) the fishbone sign of a dilated ileum in the right lower abdomen + presence of an enlarged appendix in the right upper abdomen. CONCLUSIONS: An abnormally dilated ileum in the right lower abdomen - the fishbone sign, is a vital sign leading to the diagnosis of subhepatic appendicitis. The fishbone sign of a dilated ileum in the right lower abdomen + whether there is a vermiform structure is an important diagnostic indicator for subhepatic appendicitis.

[Application of laser speckle contrast imaging technology to researches on acupuncture and microcirculation].

The therapeutic effect of acupuncture is often closely related to the improvement of microcirculation. Acupuncture stimulation can adjust pathophysiological changes of microcirculation in the human body through multiple ways, multiple links and multiple levels, healing disorders at last. Laser speckle contrast imaging (LSCI), an emerging technology, can be used to study the effect of acupuncture on microcirculation. In this paper, retrieving the related literature published in recent years, we found that LSCI technology has already been applied to the following aspects 1) acupoint-viscera and microcirculation, 2) stimulation-induced transmission of sensations along the meridian and microcirculation, 3) non-meridians or non-acupoints and microcirculation, 4) specific acupoints and microcirculation, as well as 5) different acupuncture needle manipulations and microcirculation. However, most of the studies focused on animal experiments and healthy subjects, observing microcirculatory effects under normal physiological conditions, and the sample size of participants was smaller. In the future, we highly recommend that increasing the sample size and further studying the local microcirculation are necessary in the pathological state of diseases.