Ultrasound-guided injection acupotomy as a minimally invasive intervention therapy for cervical spondylotic radiculopathy: a randomized control trial.

OBJECTIVE: To explore the efficacy and safety of ultrasound-guided injection acupotomy as a minimally invasive intervention treatment of cervical spondylotic radiculopathy (CSR). METHODS: 160 CSR subjects were recruited who met the inclusion criteria in our hospital from October 2019 to December 2021. The subjects were randomly divided into the experimental and control group, with 80 cases in each. The experimental group received ultrasound-guided injection acupotomy as a minimally invasive intervention therapy. The control group received ultrasound-guided selective nerve root block (SNRB). The Odom's criteria clinical curative effect, visual analogue scale (VAS), neck disability index (NDI), and 36-Item Short Form Health Survey questionnaire (SF-36) were used to evaluate the outcome of subjects at several different points in time. RESULTS: At 30 min and 1 month after the end of treatment, there was no significant difference in any scores. However, after six months, the excellent and good rate was better in the experimental group compared to the control (RD = 0.175; 95% CI, 0.044-0.300, p = 0.009). The total effective rate was also better in the experimental group (RD = 0.126; 95% CI, 0.021-0.232, p = 0.018). In contrast, the VAS score (MD = -0.500; 95% CI, -1.000-0.000, p = 0.030) and NDI score (MD = -6.460; 95% CI, -11.067 to -1.852, p = 0.006) were lower in the experimental group compared to the control. The total SF-36 score was higher in the experimental group (MD = 7.568; 95% CI, 2.459-12.677, p = 0.004). CONCLUSION: Ultrasound-guided injection acupotomy minimally invasive interventional treatment of CSR has no significant difference in short-term curative effect compared with ultrasound-guided SNRB, but the data indicators are significantly better than the latter at 6 months after the end of the course of treatment, showing better long-term efficacy.

Nutrient removal effect and characteristics of integrated floating beds at low temperature.

To investigate the effect of combined floating beds on nutrient removal under low temperature, an integrated floating bed with corn flakes (IFB-CF) and an integrated floating bed with light ceramsite (IFB-LC) were constructed in parallel. IFB-LC was used as control group under water temperatures of 9.3-14 °C and a water exchange time of 168 h. Nitrogen and phosphorus removal efficiency, the nutrient level of a hydrophyte (Oenanthe javanica), and the microbial population characteristics of the combined floating bed were investigated. For IFB-CF removal efficiencies, the degradation quantities of total nitrogen (TN), NO3--N, and NH4+-N for IFB-CF were 13.58 ± 0.67 mg/L, 4.40 ± 0.61 mg/L, and 9.21 ± 0.38 mg/L, respectively; in contrast, degradation quantities for IFB-LC were lower (6.41 ± 1.47 mg/L, 2.15 ± 0.40 mg/L, and 5.95 ± 0.46 mg/L, respectively). The reductions in COD (Chemical Oxygen Demand, using K2Cr2O7 as oxidizer) for IFB-LC and IFB-CF were 86.89% and 66.06%, respectively. Using the MiSeq high throughput sequencing method, we analysed microbial community structure and diversity on the base material surface of the IFB-CF and IFB-LC. The results showed 15 phyla, 165 genera, and 78 families on the surface of the IFB-CF. The phylum, genus, and family with the highest abundances were Proteobacteria (48.29%), Trichococcus (10.39%), and Comamonadaceae (12.45%), respectively. We identified 15 phyla, 144 genera, and 93 families on the surface of the IFB-LC. The phylum, genus, and family with the highest abundances were Proteobacteria (46.10%), Dyadobacter (22.67%), and Cytophagaceae (28.75%), respectively. The Chao, ACE, and Shannon & Simpson indices for the IFB-LC were 4081, 6295, and 5.10, and 0.05, respectively; for the IFB-CF they were 4938, 7461, 5.77, and 0.02, respectively. Catalase (CAT) and Peroxidase (POD) concentrations in Oenanthe javanica for IFB-LC were 35.48 u/gFW/min and 1.03 u/gFW/min, respectively; for IFB-CF they were 32.33 u/gFW/min and 1.25 u/gFW/min, respectively. The nutritional energies of IFB-CF and IFB-LC were 107 kJ/100g and 84 kJ/100g. Using the Mondal model of TN removal, k (half-saturation constant) values for IFB-LC and IFB-CF were 35.67 mg/L and 39.23 mg/L, respectively, with a correlation coefficient (R2) of 0.97.

[Clinical application study of acupotomy-injection technique with targeted three-point in the treatment of frozen shoulder].

OBJECTIVE: To observe the clinical efficacy of minimally invasive acupotomy-injection technique with targeted three-point in the treatment of frozen shoulder. METHODS: From March 2017 to November 2018, a total of 140 patients with frozen shoulder were randomly divided into observation group and control group. The observation group was made up of 70 patients, including 30 males and 40 females; the mean age was (59.2±11.5) years old; the mean duration of disease was (6.76±4.14) months; the observed patients were treated with acupotomy-injection technique with targeted three-point. There were also 70 patients in the control group, made up of 29 males and 41 females; the mean age was (58.9±11.8) years old; the mean duration of disease was (6.65±3.98) months; the control group was treated with the small needle knife therapy. Before treatment and one month after the treatment, the pain levels of both groups were assessed using the short-form McGill pain questionnaire, and the shoulder function was evaluated using the Constant-Murley Shoulder Outcome Scoring. The clinical efficacy of between groups was compared after treatment, and finally, the improvement rate of pain degree was used to evaluate the therapeutic effect of the patients. RESULTS: The PRI, VAS, PPI and total pain scores of frozen shoulder patients in both groups decreased significantly one month after the treatment compared with those before treatment (P<0.01). Compared with the control group, the observation group exhibited a more significant decrease in pain scores (P<0.01). Furthermore, the shoulder pain, muscle strength, ADL, ROM and total function scores of frozen shoulder patients in the two groups were significantly improved one month after the treatment compared with those before treatment(P<0.01). The inter-group comparison indicated that the pain, ADL, ROM and total function scores were improved obviously in the observation group when compared to those in the control group(P<0.01), but no remarkable difference was found between muscle strength score and the control group(P>0.05). In addition, the markedly effective rate of pain improvement was 70.0% and 45.7% in the observation group and the control group, respectively, meanwhile, the corresponding total effective rate was 97.1% and 84.3%, respectively. CONCLUSIONS: The application of acupotomy-injection technique with targeted three-point in the treatment of frozen shoulder shows definite efficacy, easy operation, little pain and high safety. Therefore, it is an ideal method for minimally invasive treatment.