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Lumbar disc herniation (LDH) is a common clinical spine disease, which can lead to lower limb pain, weakness, numbness and even tingling and burning nerve paraesthesia, seriously affecting the quality of life of the patients. At present, X-ray, CT and MRI are commonly used in clinical imaging. However, in the process of diagnosis and treatment of LDH, clinical symptoms often do not coincide with imaging results, and MRI cannot show the degree of nerve injury. MRI diffusion imaging technique is currently the only method to measure the diffusion motion and imaging of water molecules in vivo, mainly including diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI). In recent years, with the improvement of pulse sequence technology and the application of high-intensity magnetic field, MRI diffusion imaging technology has been gradually applied to the diagnosis and treatment of lumbar nerve injury, which can obtain non-invasive images of the stenosis or interruption of the involved nerve fibers. Based on the principle of diffusion imaging technology, this article analyzes the current status of its application in the diagnosis and treatment of LDH, and analyzes its limitations and discusses the future development direction, in order to provide basis and ideas for the realization of accurate diagnosis and treatment of LDH.
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Objective To analyze the changes in morphology of intervertebral foramina in patients with cervical spondylotic radiculopathy (CSR) treated with fixedpoint lateral flexion and rotation manipulation based on three-dimensional (3D) reconstruction technology, so as to provide references for the effectiveness of manipulation treatment. MethodsForty patients with CSR were treated with fixed point lateral flexion and rotation manipulation once every other day for a total of 7 times and 2 weeks as a course of treatment. CT data of the patients before and after treatment were analyzed by using multifunctional CT, Mimics 21.0, Geomagic and SolidWorks 2017. The area of the intervertebral foramen, anterior and posterior diameter of the intervertebral foramen, upper and lower diameter of the intervertebral foramen were measured before and after treatment, as well as the infrared thermal imaging temperature differences of the bilateral neck and shoulder, front and back of the upper limb, and the VAS scores of the patients were observed before treatment, 7 d after treatment, 14 d after treatment and 1 month follow-up. Results Foraminal area, anterior and posterior diameters, upper and lower diameters of 40 patients were improved after treatment, and the temperature differences of infrared thermal imaging of patients before and after treatment were statistically significant. The VAS score of the patients decreased progressively. Conclusions Fixed point lateral flexion manipulation can significantly improve the shape of the intervertebral foramen in patients with CSR, so as to achieve the treatment purpose of relieving nerve compression.
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Objective:To observe the effects of "pushing patella and extending knee" manipulation on the protein and mRNA expression levels of integrin β1 (ITGβ1) and phosphorylated adhesion plaque kinase (p-FAK) in rabbit knee osteoarthritis (KOA) model, and to investigate the mechanism of manipulations in the treatment of KOA.Methods:Twenty healthy 6-month-old New Zealand rabbits were divided into the normal group, the model group, the acupuncture group, and the manipulation group according to the random number table method. Among them, the model group, the acupuncture group, and the manipulation group were modeled using the modified Hulth method for KOA. After 7 d of successful modeling, the normal group and the model group did not receive any intervention, while the acupuncture group and the manipulation group received one acupuncture intervention and one "pushing patella and extending knee" manipulation intervention daily, respectively. After 2 weeks of treatment, the rabbit KOA model was executed by air embolization, and the protein and mRNA expression levels of ITGβ1 and p-FAK in knee cartilage were measured by Western blot and real-time polymerase chain reaction (PCR), respectively.Results:Compared with the normal group, the ITGβ1 protein expression level was decreased ( P<0.05) and p-FAK protein expression level was increased ( P<0.05), and the mRNA expression levels of ITGβ1 and p-FAK did not change significantly (all P>0.05) in the model group. Compared with the model group, the ITGβ1 protein expression level was increased ( P<0.05), the p-FAK protein expression level decreased ( P<0.05), and the mRNA expression levels of both ITGβ1 and p-FAK increased (all P<0.05) in the acupuncture group. Compared with the acupuncture group, ITGβ1 protein expression level increased ( P<0.05), p-FAK protein expression level decreased ( P<0.05), and mRNA expression levels of both ITGβ1 and p-FAK increased (all P<0.01) in the manipulation group. Conclusions:The "pushing patella and extending knee" manipulation can optimize the protein and mRNA expression levels of ITGβ1 and p-FAK in the articular cartilage of the rabbit KOA model.
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Objective To explore the efficacy of lamivudine and interferon in sequential therapy for chronic hepatitis B.Methods 92 cases of chronic hepatitis B patients were randomly divided into treatment group(n=46) and control group(n=46).In the treatment group,the patients were treated with lamivudine 100mg/d for 5 months,then combined with recombinant ?-2b interferon(IFN) 5Mu/dose,muscle injection,once per two days.Then the lamivudine was discontinued at sixth month and the patients were continuously treated with only interferon for 5 months.In the control group,the patients were treated with only lamivudine 100mg/d for 18 months.Results At the end of treatment,the normalization rate of ALT,HBV-DNA negative conversion rate and HBeAg/anti-HBe seroconversion rate were 93.5%,89.1% and 54.3% in the treatment group,then they were 82.6%,71.7% and 19.6% in the control group.Six months later,the sustained response rate of HBV-DNA conversion between treatment group and control group were 84.8% and 32.6%.Conclusion Lamivudine and interferon has better short-term efficacy in sequential therapy for chronic hepatitis B and it is worth further studying.