The clinical efficacy of ozone combined with steroid in the treatment of discogenic low back pain: a randomized, double-blinded clinical study.

Objective: This randomized double-blinded clinical study is to investigate the clinical efficacy of per-paravertebral disk ozone injection combined with steroids in the treatment of patients with chronic discogenic low back pain (CDLBP). Methods: Group A (N = 60) received a per-paravertebral injection of a steroid mixture of 10 mL with pure oxygen 20 mL, while group B (N = 60) received a per-paravertebral injection of a steroid mixture of 10 mL combined with ozone 20 mL (30 µg/mL). Injections were administered once a week for 3 weeks, with a follow-up of 6 months. Clinical outcomes were assessed at week 1, month 3, and month 6 with the help of Visual Analog Scale (VAS) scores and Macnab efficacy evaluation. Results: The VAS score of both group A (1.65 vs. 6.87, p = 0.000) and group B (1.25 vs. 6.85, p = 0.000) at week 1 was significantly reduced compared to baseline. The effect was sustained at the 3- and 6-month follow-up periods (p < 0.05). Group B had significantly lower VAS scores at month 3 (1.53 vs. 3.82, p = 0.000) and month 6 (2.80 vs. 5.05, p = 0.000) compared to group A, respectively. Based on Macnab criteria, 95 and 96.7% of patients in groups A and B had good rates "excellent plus good" at week 1, respectively. Good rates were significantly higher in group B at month 3 (91.7 vs. 78.3%, p = 0.041) and month 6 (85.0 vs. 68.3%, p = 0.031) compared to group A, respectively. No serious adverse events were noted in both groups. Conclusion: Per-paravertebral injection of steroid and ozone combination resulted in better relief of CDLBP compared to pure oxygen plus steroid. Clinical Trial Registration: ChiCTR2100044434 https://www.chictr.org.cn/showproj.html?proj=121571.

Radiomics model based on contrast-enhanced computed tomography to predict early recurrence in patients with hepatocellular carcinoma after radical resection.

BACKGROUND: Radical resection remains an effective strategy for patients with hepatocellular carcinoma (HCC). Unfortunately, the postoperative early recurrence (recurrence within 2 years) rate is still high. AIM: To develop a radiomics model based on preoperative contrast-enhanced computed tomography (CECT) to evaluate early recurrence in HCC patients with a single tumour. METHODS: We enrolled a total of 402 HCC patients from two centres who were diagnosed with a single tumour and underwent radical resection. First, the features from the portal venous and arterial phases of CECT were extracted based on the region of interest, and the early recurrence-related radiomics features were selected via the least absolute shrinkage and selection operator proportional hazards model (LASSO Cox) to determine radiomics scores for each patient. Then, the clinicopathologic data were combined to develop a model to predict early recurrence by Cox regression. Finally, we evaluated the prediction performance of this model by multiple methods. RESULTS: A total of 1915 radiomics features were extracted from CECT images, and 31 of them were used to determine the radiomics scores, which showed a significant difference between the early recurrence and nonearly recurrence groups. Univariate and multivariate Cox regression analyses showed that radiomics scores and serum alpha-fetoprotein were independent indicators, and they were used to develop a combined model to predict early recurrence. The area under the receiver operating characteristic curve values for the training and validation cohorts were 0.77 and 0.74, respectively, while the C-indices were 0.712 and 0.674, respectively. The calibration curves and decision curve analysis showed satisfactory accuracy and clinical utilities. Kaplan-Meier curves based on recurrence-free survival and overall survival showed significant differences. CONCLUSION: The preoperative radiomics model was shown to be effective for predicting early recurrence among HCC patients with a single tumour.

Joint and plantar loading in table tennis topspin forehand with different footwork.

Table tennis players often execute one-step, side-step or cross-step to move to an appropriate position for topspin forehand. However, to our knowledge, no studies have investigated the footwork effects on lower-limb kinetics and kinematics, which are related to playing performance and injury prevention. This study examined the ground reaction forces, joint kinetics and in-shoe plantar pressure distribution during topspin forehand with three typical footwork patterns. Fifteen male table tennis players performed cross-court topspin forehands in one-step, side-step and cross-step. Force plate, motion capturing, and instrumented insole systems were used to measure ground reaction force, joint moments and plantar pressure variables. One-way ANONA with repeated measures was performed to determine any significant differences between footwork. Results indicated that participants exhibited significantly higher ground reaction force loadings, knee flexion angle, knee moment, ankle inversion and moment during side-step and cross-step compared with one-step footwork condition (p < .01). Plantar pressure data indicated that the significantly higher peak pressure were observed in the total foot, toe, 1st, 2nd and 5th metatarsal regions during side-step and cross-step (p < .01). Additionally, cross-step had induced higher peak pressure in medial midfoot and heel regions than one-step and higher peak pressure in total and 1st metatarsal regions than side-step (p < .01). These results suggest that foot orthotic designs should consider the stronger emphasis on those high-pressured areas and that the differential joint and plantar loadings in side-step and cross-step may provide useful insights to injury mechanism and training protocol development.