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Background: Lateral elbow tendinopathy (LET) is a disabling overuse injury with a significant healthcare burden. Despite the fact that exercise interventions are considered the best recommended treatment option of LET, their effectiveness in reducing pain and improving function remains debatable. The aim of our study is to evaluate the immediate effects of a new method of exercise using blood flow restriction (BFR) on pain perception and pain-free grip strength in patients with LET. Methods: This study was designed as a cross-over randomized controlled trial. We will compare an intervention using wrist extensors training with (WET-BFR) to a control intervention using WET-without-BFR in patients with LET. All measurements will be taken by a blinded assessor pre- and post-intervention. Primary outcome measures will be the changes in pressure pain thresholds at the lateral epicondyle, extensor carpi radialis brevis, C4 vertebra and tibialis anterior. Secondary outcome measure will be the changes in pain-free grip strength ratio. Conclusions: New approaches are needed to improve the treatment outcomes in LET. Although BFR training was found more effective in improving function and treatment success than conventional training, the effects on pain intensity were poor. Our hypothesis is that using the best BFR practice guidelines for wrist extensors training might be more effective to reduce pain sensitivity compared with non-BFR training in patients with LET. The trial will provide new research data to inform clinical practice regarding the effects of using BFR training in the current patient group. Trial registration: University of West Attica ethics committee: 9150/01-02-2023, ClinicalTrials.gov: NCT05919914
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Objective To investigate the health status of workers exposed to noise in a brewery in Beijing and to analyze the relationship between hearing loss and blood pressure. Methods A total of 949 noise-exposed workers in a brewery who participated in occupational health examination were selected as the investigation subjects. A survey was conducted to investigate the pure tone hearing threshold and abnormal blood pressure of the workers with different characteristics, and to analyze the relationship between the two. Results Among the noise-exposed workers, the detection rates of hearing abnormality, hypertension, and increased systolic and diastolic blood pressure were 73.55%, 52.37%, 43.84% and 46.47%, respectively. The detection rates of hearing abnormality, indicators of hypertension, high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average in males were higher than those in females (P 0.05), the detection rates of other hearing abnormality, indicators of hypertension, speech frequency hearing threshold abnormality, high frequency hearing threshold abnormality,increased binaural high frequency hearing threshold on average and the weighted value of the better ear's hearing threshold all increased or had an increasing trend with the increase of age or working years (P< 0.05). The detection rates of hypertension in the groups with high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average were higher than those in the normal group (P<0.05). Conclusion The noise-exposed workers in the brewery have hearing impairment, which is related to the occurrence of hypertension. It is recommended to strengthen the publicity and education on noise protection and take protective measures to reduce the occurrence of occupational noise injury.
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Objective To study the application of CE-Chirp in the evaluation of hearing impairment in forensic medicine by testing the auditory brainstem response(ABR)in adults using CE-Chirp to ana-lyze the relationship between the V-wave response threshold of CE-Chirp ABR test and the pure tone hearing threshold.Methods Subjects(aged 20-77 with a total of 100 ears)who underwent CE-Chirp ABR test in Changzhou De'an Hospital from January 2018 to June 2019 were selected to obtain the V-wave response threshold,and pure tone air conduction hearing threshold tests were conducted at 0.5,1.0,2.0 and 4.0 kHz,respectively,to obtain pure tone listening threshold.The differences and statistical differences between the average pure tone hearing threshold and V-wave response threshold were compared in different hearing levels and different age groups.The correlation,differences and statistical differences between the two tests at each frequency were analyzed for all subjects.The lin-ear regression equation for estimating pure tone hearing threshold for all subjects CE-Chirp ABR V-wave response threshold was established,and the feasibility of the equation was tested.Results There was no statistical significance in the CE-Chirp ABR response threshold and pure tone hearing threshold dif-ference between different hearing level groups and different age groups(P>0.05).There was a good correlation between adult CE-Chirp ABR V-wave response threshold and pure tone hearing threshold with statistical significance(P<0.05),and linear regression analysis showed a significant linear correla-tion between the two(P<0.05).Conclusion The use of CE-Chirp ABR V-wave response threshold can be used to evaluate subjects'pure tone hearing threshold under certain conditions,and can be used as an audiological test method for forensic hearing impairment assessment.
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BACKGROUND:Research on foot and ankle proprioception is crucial for the rehabilitation of chronic ankle instability and geriatric diseases as well as for the improvement of body posture control and motor performance.Previous studies have often studied the sensory evaluation of the foot and ankle joints separately,which has limitations for a comprehensive understanding of their sensory function. OBJECTIVE:The foot and ankle complex is the only part in direct contact with the support surface,and plays an important role in the collective sensory feedback and regulation and balance control.By combing the existing investigation and research of foot and ankle ontology,the measurement and evaluation methods of the sensation of the foot and ankle complex are combed,in order to pave the way and provide the theoretical basis for future related studies. METHODS:Chinese terms"(foot OR foot ankle OR ankle)AND(sensation OR proprioception)"and English terms"(foot OR ankle)AND(feel OR proprioception)"were used as the keywords for retrieving relevant literature in the Web of Science,PubMed,and CNKI.We understood the basic concepts,current status and scope of research on the foot and ankle,summarized and evaluated the proprioceptive evaluation methods of the foot and ankle,and finally included 57 papers for further review. RESULTS AND CONCLUSION:The evaluation of foot and ankle complex sensation was mainly divided into sensory evaluation of the foot and proprioceptive evaluation of the ankle joint.The sensory evaluation of the foot mainly describes the sensation of the skin and the sensory feedback under the intervention conditions.The methods mainly include the pressure sensory threshold test,the two-point discrimination test of the foot(planar and plantar),and the duration test of skin vibration sensation.Ankle joint proprioception evaluation focuses on the description of joint position,motion range,force value and functional performance.The methods are mainly divided into static joint angle reset test,motion minimum threshold test,force perception reproduction test and dynamic balance,speed and walking ability tests.The report of quantitative results is generally expressed by"an error,"which is generally divided into absolute error,relative error,constant error,etc.To conclude,the foot and ankle complex has specific sensory capabilities,including foot sensation and ankle proprioception,which affect the quality of life and athletic performance of humans.Weakness of both foot sensation and ankle proprioception is associated with reduced human balance,and the combined measurements of the two can comprehensively and effectively evaluate foot and ankle function.The combination of foot and ankle sensory measures is selected according to different research needs and various influencing factors such as environment,emotion and reporting style are fully considered,to improve the validity of measurement and evaluation.
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BACKGROUND:Patients with degenerative cervical spondylosis often suffer from changed varicosity of the cervical spine,unbalanced neck-shoulder muscular strength,and descending power. OBJECTIVE:To probe into the correlation between sagittal curvature parameters and pain threshold for neck-shoulder muscles in degenerative cervical spondylosis. METHODS:Totally 50 patients with degenerative cervical spondylosis received treatment at the 3D Printed Outpatient Center of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2022 to March 2023 were included in the study.After excluding the 10 patients of cervical lateral projection that failed to meet the measurement conditions,the cervical lateral projections were shot to measure the following iconography parameters:Borden value and C2-7 Cobb angle as well as pain thresholds on the midpoint of the superior trapezius muscle in bilateral bundles and at 1 cm beside the C5-6 interspike.The correlation between sagittal curvature parameters and pain threshold of neck-shoulder muscles in degenerative cervical spondylosis was analyzed. RESULTS AND CONCLUSION:(1)The Borden value of sagittal curvature showed a moderately positive correlation with the bundle pain threshold in the left upper trapezius muscle,the bundle pain threshold in the right upper trapezius muscle,and the pain threshold at the 1 cm of the left side beside the C5-6 interspike(r=0.498,P<0.01;r=0.448,P<0.05;r=0.405,P<0.05)and a weak positive correlation with the pain threshold at the 1 cm of the right side beside the C5-6 interspike(r=0.322,P<0.05).(2)The C2-7 Cobb angle showed a weak positive correlation with the left squared myalgia threshold(r=0.355,P<0.05),and there was no correlation with the pain threshold of the left trapezius muscle and the pain threshold at the 1 cm of both sides beside the C5-6 interspike.(3)There was a correlation between the pain threshold of the neck-shoulder muscles,and a high correlation between the pain threshold of the left and right muscles and the pain threshold within the left and right side muscles,indicating that the neck-shoulder muscles are consistent and may be related to the coordination of the neck-shoulder movements.
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BACKGROUND:Short-term wearing of cervical brace combined with shoulder and neck muscle exercise can significantly improve the symptoms of early cervical spondylosis.After stopping wearing cervical brace,patients'symptoms are easy to recur,which may be due to the lack of cervical curvature correction function. OBJECTIVE:To analyze the effect of 3D printed personalized cervical orthopedic brace for adjusting cervical curvature in the treatment of early cervical spondylosis. METHODS:From January 2021 to January 2023,30 patients with early cervical spondylosis in the Shanghai Fifth People's Hospital,Fudan University were studied,including 11 males and 19 females,with a mean age of(31.7±6.6)years old.All patients customized and wore 3D printed personalized cervical orthopedic braces for 3 hours a day for continuous 12 weeks.Borden value of cervical curvature,pain threshold of shoulder and neck muscles,cervical dysfunction index,and visual analog scale score in 30 patients were recorded before and 4 and 8 weeks after treatment. RESULTS AND CONCLUSION:(1)Compared with before treatment,the difference of Borden value of cervical curvature,right trapezius tenderness threshold,and cervical dysfunction index was not significant in 30 patients after 4 weeks of treatment(P>0.05).Visual analog scale score,left trapezius tenderness threshold,left and right C5C6 tenderness threshold were significantly improved(P<0.05).(2)Compared with before treatment,the cervical curvature Borden value,left and right trapezius tenderness threshold,visual analog scale score,left and right C5C6 tenderness threshold,and cervical dysfunction index of 30 patients were significantly improved after 12 weeks of treatment(P<0.05).(3)Compared with 4 weeks after treatment,the Borden value of cervical curvature,right trapezius tenderness threshold,visual analog scale score,left and right C5C6 tenderness threshold and cervical dysfunction index of 30 patients after 12 weeks of treatment were significantly improved(P<0.05).(4)The results show that short-term wearing of 3D printed personalized cervical orthopedic brace can improve the pain of patients with early cervical spondylosis,while long-term application has certain effect on the recovery of cervical curvature.
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BACKGROUND:Red light therapy has the non-invasive and cost-effective characteristics,and is widely used in various acute and chronic pains in clinic.However,currently,the phototherapy equipment used in clinic is expensive and has certain site limitations,so it is necessary to explore more convenient and economical phototherapy applications. OBJECTIVE:To observe the clinical efficacy of a self-developed photon cervical vertebra massage instrument for chronic neck pain. METHODS:From November 2022 to February 2023,24 patients with chronic neck pain were recruited from the Department of Rehabilitation Medicine,Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,including 18 females and 6 males,with a mean age of(29.67±6.40)years.The body mass index was(21.39±3.52)kg/m2.Photon cervical vertebra massage instrument was used twice a day for 20 minutes each time for four weeks.The changes in visual analog scale score,pressure pain threshold,neck active activity,neck disability index,and Pittsburgh sleep quality index were observed before,after 2 and 4 weeks of treatment. RESULTS AND CONCLUSION:(1)Compared with before treatment,after four weeks of treatment,visual analog scale score,pressure pain threshold,neck disability index,and Pittsburgh sleep quality index were all improved(P<0.05),while some cervical motion(extension,left and right rotation)improved(P<0.05)after 4 weeks of treatment.(2)Bilateral visual analog scale scores,left trapezius muscle pressure pain threshold,C5C6 pressure pain threshold,and neck disability index improved after 2 weeks of treatment(P<0.05).(3)It is indicated that the application of photon cervical vertebra massage instrument can improve the pain score,muscle tenderness,sleep quality,functional level,and partial active activity of patients with chronic neck pain in a short period,and is a convenient,effective,and safe treatment method.
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Objective To compare the accuracy of consolidation/tumor ratio(CTR)measured at different CT thresholds for the prediction of invasiveness in small lung cancer with diameter≤2 cm using artificial intelligence-assisted measurements,and to explore the CTR thresholds and the corresponding CT thresholds for predicting lung cancer invasiveness.Methods Clinical data from 59 lung cancer patients(78 lung nodules in total)treated at Wuwei Hospital of Traditional Chinese Medicine from January 2021 to May 2023 were collected to analyze the prediction efficacy of CTR on invasiveness in small lung cancer with diameter≤2 cm measured at CT thresholds of-400,-350,-300,-250,-200,-150 HU.ROC curves were plotted to determine the optimal critical value for invasiveness prediction,followed by the corresponding CT threshold.Results The highest diagnostic efficacy for the invasiveness of lung nodules was achieved at a CT threshold of-250 HU,with an area under the curve of 0.931,sensitivity of 77.5%,specificity of 100%,and an optimal CTR threshold of 0.322.Conclusion For small lung cancers with a maximum diameter≤2 cm,CTR measured at a CT threshold of-250 HU can accurately predict lung cancer invasiveness.At CTR>0.322,the nodule is more likely to be microinvasive or invasive adenocarcinoma.
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Objective:To observe the clinical efficacy of filiform needle combined with fire needles for cervical radiculopathy(CR)due to wind-cold obstructing the meridians. Methods:A total of 60 patients with CR due to wind-cold obstructing the meridians were randomized into an observation group and a control group,with 30 cases in each group.The control group was treated with filiform needle treatment,and the observation group was treated with additional fire needle point-pricking treatment.The visual analog scale(VAS)and 20-point scale of CR developed by Yasuhisa TANAKA(YT-20)were scored before treatment and after 1,2,3,and 4 weeks of treatments.The tenderness threshold was measured.The local skin temperature was measured by an infrared thermal imager.A safety evaluation was performed after treatment. Results:After treatment,the VAS score in the observation group at each time point was lower than that in the control group(P<0.05).The YT-20 score,tenderness threshold,and local skin temperature in the observation group were all higher than those in the control group(P<0.05).The VAS score in the observation group at each time point after treatment was lower than that before treatment(P<0.05),and the YT-20 score,tenderness threshold,and local skin temperature at each time point were higher than those before treatment(P<0.05).After 3 and 4 weeks of treatments,the VAS score in the control group was lower than that before treatment(P<0.05),and the YT-20 score,tenderness threshold,and local skin temperature were higher than those before treatment(P<0.05).The group factor effects of VAS and YT-20 scores,tenderness threshold,and local skin temperature between the two groups were statistically significant(P<0.05).There was no significant difference in the time effect and the interaction effect between time and group(P>0.05). Conclusion:Filiform needle combined with fire needle or applied alone both can relieve neck pain in patients with CR due to wind-cold obstructing the meridians,and improve the temperature of the neck.The combination of filiform needle and fire needle works more quickly and has better efficacy.
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ObjectiveTo explore the possible mechanism of Chuanxiong (Rhizoma Chuanxiong) & Tianma (Rhizoma Gastrodiae) herbal pair in treating migraines based on AMP-activated protein kinase (AMPK)/transient receptor potential A1 channel (TRPA1) pathway. MethodsForty-eight healthy male SD rats were randomly divided into control group, model group, and Chuanxiong Tianma medication group, with 16 rats in each group. The control group and model group were given 10 ml/kg of normal saline by gavage, while the Chuanxiong Tianma medication group was given 0.675 g/kg of Chuanxiong Tianma herbal pair by gavage, once daily for 8 consecutive days in both groups. Migraime model was performed before the last administration, with subcutaneous injection of 10 ml/kg of normal saline in the control group, and subcutaneous injection of 10 ml/kg of nitroglycerin in the model group and Chuanxiong Tianma medication group. The Von Frey filament was used to measure the periorbital mechanical pain threshold of rats. The enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of calcitonin gene-related peptide (CGRP) in rat serum and cerebrospinal fluid. The nitric oxide (NO) assay kit was used to determine the NO level in serum and cerebrospinal fluid. RT-PCR was usedto detect the mRNA expression levels of immediate-early genes in the trigeminal ganglion of rats (c-Fos), CGRP, transient receptor potential V1 channel (TRPV1), AMPK alpha subunit (PRKAA), and TRPA1. Immunofluorescence was used to detect the number of c-Fos-positive cells in the trigeminal cervical complex (TCC) and the protein expression levels of phosphorylated AMPK (pAMPK) and TRPA1 in the trigeminal ganglion. ResultsCompared to those in the control group, the mechanical stimulation threshold and pAMPK protein expression in the model group decreased, while the levels of CGRP and NO in serum, c-Fos, CGRP, TRPV1 and TRPA1 mRNA levels in the trigeminal ganglion, TRPA1 protein expression, and the number of c-Fos-positive cells in the TCC significantly increased (P<0.05). Compared to those in the model group, the mechanical stimulation threshold and pAMPK protein expression in the Chuanxiong Tianma medication group significantly increased, while the levels of CGRP and NO in serum, c-Fos, CGRP, TRPV1 and TRPA1 mRNA levels in the trigeminal ganglion, TRPA1 protein expression, and the number of c-Fos-positive cells in the TCC significantly decreased (P<0.05). ConclusionChuanxiong Tianma herbal pair may improve migraine symptoms by regulating the AMPK/TRPA1 pathway in the trigeminal ganglion and increasing the mechanical pain threshold.
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【Objective】 To analyze the application value of penile vibrating perception threshold measurement in the diagnosis of erectile dysfunction (ED) and provide reference for the seversity of ED patients. 【Methods】 The clinical data, Erectile Hardness Scale (EHS) score, International Index of Erectile Function Questionnaire-5 (IIEF-5) score, and the vibrating perception threshold (VPT) of the penis of 257 patients with decreased erectile function as the main complaint or accompanying symptoms treated during Jan. and Dec.2021 were retrospectively collected and analyzed.Patients with EHS=4 and IIEF-5≥22 were classified into the normal group, and the rest into the ED group.The differences in VPT in patients with different EHS scores were compared, and the correlation between IIEF-5 and VPT was analyzed.The diagnostic value of VPT for ED was evaluated with receiver operating characteristic (ROC) curve. 【Results】 The difference in penile VPT among patients with different EHS scores was statistically significant (P<0.05).With the decrease of EHS score, VPT showed an increasing trend.Glans VPT was negatively correlated with IIEF-5 score (ρ=-0.22, P<0.001), and penile shaft VPT was also negatively correlated with IIEF-5 score (ρ=-0.26, P<0.001).The VPT of glans penis [(4.17±1.37) V vs.(3.47±1.24) V, P=0.009] and the VPT of penis body [(3.73±1.41) V vs.(2.99±1.14)V, P=0.003] in the ED group were both higher than those in the normal group.The area under the ROC curve (AUC) of the glans VPT was 0.642.When the cut-off value was 3.537 V, the sensitivity was 63.4%, and the specificity was 63.6%.The AUC of the penile shaft VPT was 0.659.When the cut-off value was 2.775 V, the sensitivity was 72.3%, with a specificity of 54.5%. 【Conclusion】 The penile VPT of ED patients is higher than that of normal ones, and there is a correlation between VPT and the severity of ED.Severe ED is associated with higher VPT.The measurement of penile VPT is helpful for the clinical diagnosis of ED patients.
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Objective@#To investigate the effect of fluid flow shear stress (FFSS) on the fluid mechanic threshold of high-mobility group box 1 (HMGB1) release by synovial cells and chondrocytes. Moreover, the mechanism of chondrocyte and synovial cell damage induced by abnormal mechanical force was investigated to provide an experimental basis for exploring the pathogenesis and pathology of temporomandibular joint osteoarthritis.@*Methods@#With the approval of the Ethics Committee for Animal Experiments of the hospital, synovial tissue and cartilage tissue blocks were obtained from the knee joints of Sprague-Dawley (SD) rats, and synovial cells and chondrocytes were cultured and digested for subsequent experiments. Synovial cells and chondrocytes of 3-4 generations were acquired, and FFSS was applied to synovial and cartilage cells using a fluid shear mechanical device. The cells were divided according to the FFSS values of different sizes. Synovial cells were stimulated for 1 h with 1, 3, 5, or 10 dyn/cm2 of FFSS, and chondrocytes were stimulated for 1 h with 4, 8, 12, or 16 dyn/cm2 of FFSS. Resting cultures (0 dyn/cm2) were used as the control group. Changes in the morphology of the cells were observed. The expression and distribution of HMGB1 and interleukin-1β (IL-1β) were observed by immunohistochemistry. The expression of HMGB1 and IL-1β in the supernatant was analyzed by ELISA. The protein expression levels of intracellular HMGB1 and IL-1β were detected by Western blot.@*Results@#With increasing FFSS, the synovial cells and chondrocytes gradually swelled and ruptured, and the number of cells decreased. With increasing FFSS, the localizationof HMGB1 and IL-1β gradually shifted from the nucleus to the cytoplasm. In synovial cells, compared with those in the control group, the expression levels of HMGB1 and IL-1β were increased both in the supernatant and cells in the 1, 3, 5 and 10 dyn/cm2 intervention groups (P<0.01). In chondrocytes, compared with those in the control group, the expression levels of HMGB1 in the supernatant were increased in the 4, 12 and 16 dyn/cm2 intervention groups (P<0.05), and the protein expression levels of HMGB1 were significantly increased (P<0.01). The expression levels of HMGB1 in the supernatant were significantly increased in the 8 dyn/cm2 intervention groups (P<0.01); however, the protein expression levels of HMGB1 were significantly decreased. Compared with those in the control group, the expression levels of IL-1β in the supernatant gradually increased in the 4, 8, 12 and 16 dyn/cm2 intervention groups (P<0.01). With the exception of those in the 4 dyn/cm2 group, the protein expression levels of IL-1β gradually increased with increasing FFSS (P<0.05).@*Conclusion@#With increasing FFSS, synovial cells and chondrocytes gradually swelled and burst, and the hydromechanical thresholds of HMGB1 release were 1 dyn/cm2 and 8 dyn/cm2, respectively. Therefore, upon stimulation with a mechanical force, synovial damage was damaged before chondrocytes.
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Objective@#To determine the relationship between olfactory function threshold and quality of life (QOL) among adult Filipinos with perceived olfactory dysfunction (OD).@*Methods@#Design:Cross - Sectional Study. Setting:Tertiary Government Training Hospital. Participants: 98 adults who had self-perceived olfactory dysfunction described as “poor” or “no sense” of smell@*Results@#We analyzed data from 98 participants, with a mean age of 35.91 + 12.58 years old, composed of 46 men (47%) and 52 women (53%), with 82 normosmic, six hyposmic and ten anosmic as categorized by their BTT scores. Twenty-seven percent (27%) identified themselves as having poor QOL based on Fil 17 QODNS. Differences were exhibited between sexes’ BTT scores - [t(96) = -2.32; p = .022; females, M: 9.25; SD: 2.33 vs. males, M: 7.76; SD : 3.91], civil status - Fil17QODNS scores [t(96)= 3.05, p < .003; married M: 11.72, SD: 13.74 vs. single, M: 4.71; SD: 8.66), and the presence of ENT symptoms BTT [t(96) = -7.15; p < .0001; symptomatic, M: 5.62; SD: 4.54, vs. asymptomatic, M: 9.78; SD: 1.14] and Fil 17 QODNS scores [t(96)= 3.94; P < .00001; symptomatic, M: 14.86; SD: 13.97] vs. asymptomatic, M: 5.217; SD: 9.60]. Significant risk factors were the presence of ENT symptoms [OR= 0.15; 95% CI: 0.02-0.97; P = .046] for poor smell threshold, and comorbidities [OR= 3.36; 95% CI: 1.04-10.85; P = .043] for poor QOL. A negative correlation was observed between Fil-QOD-NS scores and BTT scores [r = -0.477, p < .001; rs = -0.292, p = .004], signifying that the presence of olfactory dysfunction has an inverse relationship with the quality of life.@*Conclusion@#Individuals with olfactory dysfunction in this study population had poor quality of life as determined by the translated Filipino 17-item QOD-NS which has an inverse relationship with their smell threshold as represented by the BTT results. Among the factors studied, significant differences were found between sexes, civil status and presence of ENT symptoms in the BTT and Fil 17 QODNS scores. However, only presence of comorbidities and ENT symptoms are significant risk factors for quality of life and smell threshold, respectively, in this population.
Subject(s)
Smell , Quality of Life摘要
Objective @#To investigate the pathological role of detect protein kinase C(PKC)/ transient receptor potential vanilloid subtype 1 ( TRPV1) pathway in trigeminal neuralgia ( TN) in rats.@*Methods @#The infraorbital nerve⁃chronic constriction injury (ION⁃CCI) was used to establish a rat model of TN. The rats were randomly divided into Sham group , CCI group , CCI + DMSO group and CCI + GF109203X ( a PKC inhibitor) group. The mechanical pain threshold of the rats was measured using a Von Frey brush. qRT⁃PCR and Western blot were used to detect PKC and TRPV1 in the trigeminal ganglion (TG) . HE staining was used to observe the pathological changes of TG.@*Results @#The mechanical pain threshold significantly decreased (P < 0. 05) , and the expression of phosphorylated PKC(p⁃PKC) and TRPV1 in TG significantly increased in the CCI group (P < 0. 05) . Histopathological results showed that compared with the Sham group , the CCI group observed significant changes in TG such as increased inflammatory cell infiltration and nerve cell swelling. Injection of GF109203X effectively reduced the phosphorylation of PKC and the expression of TRPV1 in the TG of rats , and the mechanical pain threshold of the rats increased (P < 0. 05) . Under the light microscope , cell swelling and inflammatory cells in the TG were reduced.@*Conclusion @#PKC/TRPV1 pathway may be involved in trigeminal neuralgia in rats.
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Aim To investigate the mechanism of ligu aged 2 months of the same strain were used as the constilide (LIG) in delaying the senescence of auditory trol (Ctrl) group. Auditory brainstem response test was cortex and treating central presbycusis. Methods used to detect the auditory threshold of mice before and Forty C57BL/6J mice aged 13 months were randomly di after treatment. Levels of serum MDA and activity of vided into ligustilide low-dose(L-LIG) group, ligustil serum SOD were detected to display the level of oxidative ide medium-dose (M-LIG) group, ligustilide high-dose stress. The pathological changes of auditory cortex were (H-LIG) group and aging (Age) group, and 10 mice observed by HE staining. Ferroptosis was observed by
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The cost-effectiveness analysis policy for drugs was institutionalized in Japan since 2019, realizing quantitative adjustment of price across varieties. A hierarchical categorization approach was adopted to select medicines with high expected annual sales. For selected medicines, adjustments were made to the premium and profit components within the existing price structure based on a pre-defined incremental cost-effectiveness ratio (ICER) threshold, effectively resolving the issue of inconsistent criteria and magnitudes caused by subjective judgment. Meanwhile, incentive measures like evaluation exemption or threshold enhancement were granted for specific medicines. Besides, a price adjustment mechanism, which was allowed for upward and downward adjustments, involving tiered ICER threshold and quantified formulas, had been established for the premium and profit components of drug price. In China’s National Reimbursement Drug List (NRDL) access, certain issues remained to be addressed: insufficient clarity in the quantitative mechanism of price formation, incomplete price adjustment measures, and lagging in the communication channels. It is recommended that the following measures could be referred to when further improving the scientificity and fairness of drug pricing during China’s NRDL access, such as enhancing the ICER threshold for medicines catering to special populations, quantifying criteria and extents for price adjustment, granting preferential pricing policies to pharmaceutical companies that present high-quality evidence of effectiveness, preceding communication channels with pharmaceutical companies, as well as exploring a price floor mechanism for the drugs with excessive price reduction.
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Non-suicidal self-injury is a prevalent pathological behavior in clinical settings,significantly impacting both physical and mental health.Non-suicidal self-injury is closely associated with the abnormal perception of pain.Pain can be classified as physiological pain and social pain.In contrast to healthy people,individuals engaging in non-suicidal self-harm exhibit lower sensitivity to physiological pain but higher sensitivity to social pain.Their physiological pain thresholds are elevated,while their social pain thresholds are reduced.The alterations in pain sensitivity led them to alleviate emotions through a"pain to counter pain"approach.The abnormalities in pain sensitivity among individuals who engage in non-suicidal self-injury are closely linked to their social and psychological factors.Self-criticism,depressive symptoms,and adverse childhood experiences are all associated with the pain sensitivity of non-suicidal self-harm patients.
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Objective @#To obtain the peak skin dose (PSD) of patients with interventional cardiology procedures and toevaluate the risk of deterministic effects.@*Methods @# Gafchromic XR RV3 films were used in a Level A tertiary hospital inBeijing to measure the PSD of patients who underwent interventional cardiology procedures. The measurement focused onfour common types of procedures, including coronary angiography, percutaneous transluminal coronary angioplasty,cathet-er radiofrequency ablation, and congenital heart disease. The films were scanned by EPSON EXPRESSION 10000XL andanalyzed by FILM QA ProTM 2014 software.@*Results @#PSD was measured in 59 patients with interventional cardiologypro-cedures, including 23 with coronary angiography, 21 with percutaneous transluminal coronary angioplasty, 9 with catheterradiofrequency ablation, and 6 with congenital heart disease. The seven patients with PSD ≥ 2 Gy all underwentpercu-taneous transluminal coronary angioplasty, one with PSD > 3 Gy and six with PSD < 2 Gy.@*Conclusion @# The PSD of somepatients with interventional cardiology surgery exceeded the dose threshold of deterministic effects recommended by theICRP 118. There is a risk of deterministic effects in interventional cardiology surgery, especially in patients withpercu-taneous transluminal coronary angioplasty.
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Objective@#To investigate the association between subthreshold depression, psychotic like experiences (PLEs), and their interactions with non suicidal self injury (NSSI) in adolescents from Shandong, so as to provide a reference for the prevention and early intervention of NSSI in adolescents.@*Methods@#A random cluster sampling method was used to select a total of 6 090 adolescents aged 13-22 from two cities along the coast and inland of Shandong Province. Electronic surveys were administered using the SelfInjurious Behavior Questionnaire, Community Assessment of Psychic Experiencepositive 8 items(CAPE-P8), and the Center for Epidemiological Studies Depression Scale(CES-D). The relationship between subthreshold depression, PLEs, and their interaction with NSSI was analyzed using multivariate Logistic regression.@*Results@#The detection rate of NSSI among adolescents was 21.3%. The highest NSSI reporting rate (27.9%) was found in the age group of 13-15 years.The NSSI reporting rates for those detected with subthreshold depression and PLEs were 49.9% and 30.7%, respectively. Multivariate analysis indicated that individuals with subthreshold depression were 3.47 times more likely to engage in NSSI [OR(95%CI)=3.47(2.68-4.50)]. Those identified with PLEs had 5.32 times higher risk of engaging in NSSI than those without such experiences [OR(95%CI)=5.32(4.10-6.89)]. When both subthreshold depression and PLEs coexist, the risk of engaging in NSSI was 18.47 times higher than in individuals with neither condition [OR(95%CI)=18.47(14.75-23.13)] (P<0.01). The relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) were 11.44, 0.61, and 2.89, respectively, indicating that the combined interaction of subthreshold depression and PLEs accounted for 61% of adolescent NSSI.@*Conclusions@#Subthreshold depression and psychoticlike experiences are associated NSSI in adolescents and exhibit an additive interaction. Alleviating subthreshold depression in adolescents and reducing psychotic experiences may play a positive role in preventing the occurrence of NSSI.
摘要
ABSTRACT BACKGROUND AND OBJECTIVES: Chronic nonspecific low back pain (CNLBP) is a public health issue. Dysfunctions in muscle activation and spinal stability are estimated to directly impact pain intensity. Additionally, senior women experience greater decline in muscle function due to aging, rendering this demographic more susceptible to developing low back pain. The aim of this study was to analyze the correlation between core muscle instability, strength, and endurance with pressure pain threshold in senior individuals with CNLBP. METHODS: This is a quantitative observational study, with a descriptive cross-sectional design, conducted on women aged 60 to 79 years. The pressure pain threshold (PPT). The pressure pain threshold (PPT) was assessed using a pressure algometer applied to the paravertebral and anterior tibial musculature. Trunk instability was assessed on both a stable and an unstable seat, positioned atop a force platform that provided real-time displacement of the pressure center. Maximum isometric strength and endurance of trunk flexors and extensors were assessed using the McGill protocol. Person's correlations coefficient (r) was calculated, and the data were presented as mean and standard deviation. The significance level was set at p<0.05. RESULTS: This study included 49 senior women (67,3±5,6 years; body mass index of 28,5±5,2 kg/m2; pain intensity of 4,6±2,3 on a 0-10scale). No correlation was observed between PPT at L3, L5 and TA with lumbar instability, maximum isometric strength and trunk muscle endurance. CONCLUSION: In this study, no correlation was found between lumbar instability, maximum isometric strength and trunk muscle endurance with the PPT in senior women with CNLBP.
RESUMO JUSTIFICATIVA E OBJETIVOS: A dor lombar crônica inespecífica (DLCI) é um problema de saúde pública. Estima-se que disfunções na ativação muscular e na estabilidade da coluna possam repercutir diretamente na intensidade da dor. Além disso, em decorrência da idade, as mulheres idosas apresentam maior declínio na função muscular, tornando esse público mais suscetível a desenvolver a dor lombar. O objetivo deste estudo foi analisar a correlação entre instabilidade, força e resistência dos músculos do core com o limiar de dor por pressão em idosas com DLCI. MÉTODOS: Trata-se de um estudo observacional quantitativo, com delineamento transversal descritivo, realizado em mulheres com idade entre 60 e 79 anos. O limiar de dor por pressão (LDP) foi avaliado com um algômetro de pressão na musculatura paravertebral (bilateralmente ao processo espinhoso nível de L3 a L5) e cinco cm abaixo da tuberosidade da tibial direita no tibial anterior. A instabilidade de tronco foi avaliada em um assento estável e outro instável, posicionados sobre uma plataforma de força para análise do deslocamento do centro de pressão em tempo real. A força isométrica máxima e a resistência de flexores e extensores do tronco foi avaliada por meio do protocolo de McGill. Foi calculado o coeficiente de correlação de Pearson (r), os dados foram expressos em média e desvio padrão e o valor considerado significativo quando p<0,05. RESULTADOS: Participaram deste estudo 49 mulheres (67,3±5,6 anos; índice de massa corporal de 28,5±5,2 kg/m2; intensidade da dor 4,6±2,3 em uma escala de 0- a 10). Não foi encontrada correlação entre o LDP em L3, L5 e TA com instabilidade lombar, força isométrica máxima e resistência dos músculos do tronco. CONCLUSÃO: Não foi encontrada, neste estudo, uma correlação entre a instabilidade lombar, a força isométrica máxima e a resistência dos músculos do tronco com o LDP em mulheres idosas com DLCI.