Pulp or Peel? Comparative Analysis of the Phytochemical Content and Selected Cosmetic-Related Properties of Annona cherimola L., Diospyros kaki Thumb., Cydonia oblonga Mill. and Fortunella margarita Swingle Pulp and Peel Extracts.

Fruit peels might be a valuable source of active ingredients for cosmetics, leading to more sustainable usage of plant by-products. The aim of the study was to evaluate the phytochemical content and selected biological properties of hydroglycolic extracts from peels and pulps of Annona cherimola, Diospyros kaki, Cydonia oblonga, and Fortunella margarita as potential cosmetic ingredients. Peel and pulp extracts were compared for their antiradical activity (using DPPH and ABTS radical scavenging assays), skin-lightening potential (tyrosinase inhibitory assay), sun protection factor (SPF), and cytotoxicity toward human fibroblast, keratinocyte, and melanoma cell lines. The total content of polyphenols and/or flavonoids was significantly higher in peel than in pulp extracts, and the composition of particular active compounds was also markedly different. The HPLC-MS fingerprinting revealed the presence of catechin, epicatechin and rutoside in the peel of D. kaki, whereas kaempferol glucoside and procyanidin A were present only in the pulp. In A. cherimola, catechin, epicatechin and rutoside were identified only in the peel of the fruit, whereas procyanidins were traced only in the pulp extracts. Quercetin and luteolinidin were found to be characteristic compounds of F. margarita peel extract. Naringenin and hesperidin were found only in the pulp of F. margarita. The most significant compositional variety between the peel and pulp extracts was observed for C. oblonga: Peel extracts contained a higher number of active components (e.g., vicenin-2, kaempferol rutinoside, or kaempferol galactoside) than pulp extract. The radical scavenging potential of peel extracts was higher than of the pulp extracts. D. kaki and F. margarita peel and pulp extracts inhibited mushroom and murine tyrosinases at comparable levels. The C. oblonga pulp extract was a more potent mushroom tyrosinase inhibitor than the peel extract. Peel extract of A. cherimola inhibited mushroom tyrosinase but activated the murine enzyme. F. margarita pulp and peel extracts showed the highest in vitro SPF. A. cherimola, D. kaki, and F. margarita extracts were not cytotoxic for fibroblasts and keratinocytes up to a concentration of 2% (v/v) and the peel extracts were cytotoxic for A375 melanoma cells. To summarize, peel extracts from all analyzed fruit showed comparable or better cosmetic-related properties than pulp extracts and might be considered multifunctional active ingredients of skin lightening, anti-aging, and protective cosmetics.

Effects of thumb-tack needling combined with sporting on older adult patients with knee osteoarthritis: A randomized active-control clinical trial.

AIM: The aim of this clinical study was to explore the effects of thumb-tack needling combined with sporting (TTNS) therapy on the improvement of pain and joint function in older adult patients with knee osteoarthritis (KOA). METHODS: A total of 120 older adult patients with KOA were randomly assigned to receive TTNS therapy or medicine treatment (Med group) only for 1 month. The patients were followed up for 3 months and clinical efficacies were evaluated using a visual analog scale to assess pain, the Lequesne scoring system to assess motor function, and the Western Ontario and McMaster University Osteoarthritis Index to assess KOA severity. Blood was collected to measure the levels of interleukin-6 and tumor necrotic factor-alpha using enzyme-linked immunosorbent assay. RESULTS: The data suggested that TTNS therapy resulted in a significantly higher clinical efficacy (P = 0.012). Visual analog scale score, Lequesne index, and Western Ontario and McMaster University Osteoarthritis Index of the TTNS group at the time of post-treatment (1 month) and post-follow-up (3 months) were also lower compared with the Med group. Patients in the TTNS group also showed lower levels of serum tumor necrotic factor-alpha and interleukin-6. CONCLUSIONS: TTNS therapy is more efficacious than pharmacological treatment in improving the clinical outcomes of patients with KOA, which suggests its clinical utility in the management of KOA. Geriatr Gerontol Int 2024; 24: 415-420.

The deep trabecular structure of first metacarpals in extant hominids.

OBJECTIVES: Recent studies have associated subarticular trabecular bone distribution in the extant hominid first metacarpal (Mc1) with observed thumb use, to infer fossil hominin thumb use. Here, we analyze the entire Mc1 to test for interspecific differences in: (1) the absolute volume of trabecular volume fraction, (2) the distribution of the deeper trabecular network, and (3) the distribution of trabeculae in the medullary cavity, especially beneath the Mc1 disto-radial flange. MATERIALS AND METHODS: Trabecular bone was imaged using micro-computed tomography in a sample of Homo sapiens (n = 11), Pan paniscus (n = 10), Pan troglodytes (n = 11), Gorilla gorilla (n = 10) and Pongo sp., (n = 7). Using Canonical Holistic Morphometric Analysis (cHMA), we tested for interspecific differences in the trabecular bone volume fraction (BV/TV) and its relative distribution (rBV/TV) throughout the Mc1, including within the head, medullary cavity, and base. RESULTS: P. paniscus had the highest, and H. sapiens the lowest, BV/TV relative to other species. rBV/TV distribution statistically distinguished the radial concentrations and lack of medullary trabecular bone in the H. sapiens Mc1 from all other hominids. H. sapiens and, to a lesser extent, G. gorilla also had a significantly higher trabecular volume beneath the disto-radial flange relative to other hominids. DISCUSSION: These results are consistent with differences in observed thumb use in these species and may also reflect systemic differences in bone volume fraction. The trabecular bone extension into the medullary cavity and concentrations beneath the disto-radial flange may represent crucial biomechanical signals that will aid in the inference of fossil hominin thumb use.

Clinical study of low-frequency acupoint electrical stimulation to improve thumb-to-finger movements after stroke: A randomized controlled trial.

OBJECTIVE: To examine the effect of low-frequency acupoint electrical stimulation (LFES) on the surface electromyographic (sEMG) signals of the thumb-to-finger movement muscles in stroke patients, and to evaluate the clinical efficacy of LFES on hand function recovery after stroke. METHODS: Sixty patients who met the inclusion criteria were randomly assigned to a LFES group or an electroacupuncture (EA) group, with 30 patients in each group. Both groups received conventional treatment, and the EA group was treated with acupoints from the book of Acupuncture and Moxibustion, while the LFES group was treated with acupoints from a previous study. The sEMG characteristic values (maximum value and RMS), Chinese Stroke Clinical Neurological Deficit Scale (CSS), Brunnstrom Motor Function Evaluation, Modified Ashworth Scale (MAS), Lindmark Hand Function Score and Lovett Muscle Strength Classification were measured before and after treatment. RESULTS: After treatment, both groups showed improvement in sEMG characteristic values, Brunnstrom motor function score, Lindmark hand function score, and Lovett muscle strength classification compared with before treatment, and the improvement in the LFES group was significantly better than that in the EA group (P < .05). The CSS score and MAS classification of both groups decreased compared with before treatment, and the decrease in the LFES group was significantly better than that in the EA group (P < .05). The total effective rate of the LFES group was 92.86%, and that of the EA group was 79.31%. The difference between the 2 groups was statistically significant (P < .05). CONCLUSION: Both LFES and EA were effective in restoring thumb-to-finger movement function after stroke, as evidenced by the increased maximum value and root mean square values of the first dorsal interosseous muscle and the extensor pollicis brevis muscle, the decreased CSS score, the increased Brunnstrom motor function score, the decreased MAS classification, the increased Lindmark hand function score, and the increased Lovett muscle strength classification. However, LFES showed more obvious improvement and better efficacy than EA, which is worthy of clinical promotion.

Regenerative Therapies for Basal Thumb Arthritis-A Systematic Review.

Basal thumb arthritis is a painful and debilitating pathology that can severely reduce a patients' quality of life. Common therapies include oral pain control, local steroid injections and/or surgery. Yet, therapeutic data on long-term improvement and even cartilage repair are scarce. This review aims to present the currently available literature on novel therapies for basal thumb arthritis, including platelet-rich plasma (PRP), fat grafting and phototherapy, and investigate their potential efficacy. The entire OVID database and PubMed were searched for studies containing the topics PRP injection, lipofilling, laser treatment and regenerative treatment for carpometacarpal arthritis. Seven studies on the effect of fat tissue on basal thumb arthritis were found. Four authors reported on PRP injections, one RCT examined a combinational treatment of PRP and fat grafting, another phototherapy for the thumb joint and one prospective trial on chondrocyte transplantation was found. Pain improvement and decreased impairment were reported in the majority of PRP and/or fat grafting studies as well as after chondrocyte implantation. Phototherapy did not significantly improve the condition. This review revealed that only limited data on regenerative therapies for carpometacarpal arthritis are currently available, yet PRP and lipofilling show promising results and merit further investigation.

[Effect of thumb-tack needle on gastrointestinal function recovery after cesarean section under the concept of enhanced recovery after surgery].

OBJECTIVE: To observe the synergistic effect and safety of combined use of houpo paiqi mixture and thumb-tack needle on promoting gastrointestinal function recovery after cesarean section. METHODS: Parturients receiving cesarean section were randomly divided into the control group (29 cases), the traditional Chinese medicine (TCM) group (30 cases) and needle+TCM group (30 cases). The control group received only routine postoperative treatment. Besides the treatment as the control group, parturients in the TCM group were given 50 mL houpo paiqi mixture 6 h and 10 h after cesarean section respectively. Besides the treatment as the TCM group, parturients in the needle+TCM group received thumb-tack needle treatment at bilateral Zusanli(ST36), Tianshu(ST25), Shangjuxu(ST37) and Sanyinjiao(SP6), Zhongwan(CV12), Qihai(CV6), with auricular pressure at bilateral otopoints Zigong(Uterus), Wei(Stomach) and Dachang(Large intestine), within 1 h after the parturients returned to the ward after the operation. Each acupoint was pressed for 10 s and performed acupressure every 4 h (except sleeping hours), continuously for 3 d. The time of bowel sound recovery, the time to the first postoperative exhaust and defecation, the time of postoperative semi-fluid diet recovery, incidence of postoperative nausea and vomiting (PONV) and abdominal distention, and abdominal pain VAS score were recorded and analyzed. The safety of the treatments was also evaluated. RESULTS: Compared with the control group, the time of bowel sounds recovery, the time to the first postoperative exhaust and the time of postoperative semi-fluid diet recovery were significantly shortened in the TCM and needle+TCM groups (P<0.01); the time to the first postoperative defecation were significantly shortened (P<0.01), incidence of both abdominal distention and PONV were significantly decreased in the needle+TCM group (P<0.05, P<0.01); incidence of abdominal distention were significantly decreased in TCM group (P<0.05). Compared with the TCM group, the time of bowel sounds recovery, the time to the first postoperative exhaust and defecation, and the time of postoperative semi-fluid diet recovery were significantly shortened (P<0.01), and incidence of both abdominal distention and PONV were significantly decreased in the needle+TCM group (P<0.05). VAS scores of the three groups decreased gradually over time (P<0.01). Compared with the control and TCM groups, VAS scores of the needle+TCM group significantly decreased at 24 h, 48 h and 72 h after operation (P<0.01). No treatment-related adverse reactions were observed during the whole trial. CONCLUSION: On the base of the treatment with houpo paiqi mixture, the addition of thumb-tack needle treatment exerted positive synergistic effect on gastrointestinal function recovery after cesarean section, with high safety, which is worthy of clinical application.

Thermodynamics-based rules of thumb to evaluate the interaction of chelators and kinetically-labile metal ions in blood serum and plasma.

Metal ions play a very important role in nature and their homeostasis is crucial. A lot of metal-related chemical research activities are ongoing that concern metal-based drugs or tools, such as chelation therapy, metal- and metabolite sensors, metallo-drugs and prodrugs, PET and MRI imaging agents, etc. In most of these cases, the applied chelator/ligand (L) or metal-ligand complex (M-L) has at least to pass the blood plasma to reach the target. Hence it is exposed to several metal-binding proteins (mainly serum albumin and transferrin) and to all essential metal ions (zinc, copper, iron, etc.). This holds also for studies in cultured cells when fetal calf serum is used in the medium. There is a risk that the applied compound (L or M-L) in the serum is transformed into a different entity, due to trans-metallation and/or ligand exchange reactions. This depends on the thermodynamics and kinetics. For kinetically-labile complexes, the complex stability with all the ligands and all metal ions present in serum is decisive in evaluating the thermodynamic driving force towards a certain fate of the chelator or metal-ligand complex. To consider that, an integrative view is needed on the stability constants, by taking into account all the metal ions present and all the main proteins to which they are bound, as well as the non-occupied metal binding site in proteins. Only then, a realistic estimation of the complex stability, and hence its potential fate, can be done. This perspective aims to provide a simple approach to estimate the thermodynamic stability of labile metal-ligand complexes in a blood plasma/serum environment. It gives a guideline to obtain an estimation of the plasma and serum complex stability and metal selectivity starting from the chemical stability constants of metal-ligand complexes. Although of high importance, it does not focus on the more complex kinetic aspects of metal-transfer reactions. The perspective should help for a better design of such compounds, to perform test tube assays which are relevant to the conditions in the plasma/serum and to be aware of the importance of ternary complexes, kinetics and competition experiments.

Outcomes of Wide-Awake Flexor Tendon Repairs in 58 Fingers and 9 Thumbs.

PURPOSE: The purpose of this study was to present the outcomes of wide-awake flexor tendon repairs in zones 1 and 2 in a major hand trauma referral center. METHODS: Zone 1 and zone 2 wide-awake flexor tendon repairs performed between August 2018 and March 2020 were analyzed retrospectively. Outcomes were assessed by the original Strickland-Glogovac criteria for fingers and Buck-Gramcko scoring system for thumbs. Further descriptive analysis of the groups according to potential negative factors, such as injury mechanism, concomitant neurovascular injury, and the extent of injury in zone 2, were performed. RESULTS: A total of 94 tendons were repaired in 67 digits (58 fingers, 9 thumbs) of the 61 patients included in the study. Satisfactory results were achieved in 89.6% of the fingers and 77.8% of the thumbs. Intraoperative gapping was corrected after active digital extension-flexion test in 1 patient. Rupture was seen in 1 patient for a rate of 1.5%. The tenolysis indication rate was 5.1% for fingers and 11.1% for thumbs. CONCLUSIONS: In our series, functional outcome scores, tenolysis, and rupture rates remained similar with findings in the literature. The outcome of a flexor tendon repair is influenced by many factors that cannot be controlled intraoperatively. To assess the effect of performing the repair in a wide-awake setting on the outcome, clinical trials with large patient groups are needed. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Highly Effective Pressure Point Applied Between the Thumb and Index Finger for the Treatment of Migraine Attacks.

An acute migraine attack is a very painful condition and can be difficult to treat. Pharmacological treatments are limited by significant side effects and limited efficacy. There are anecdotal reports suggesting that acute migraine attacks could be treated using pressure point stimulation between the thumb and index fingers. There are no scientific published data to evaluate the effectiveness of this trigger point. Using rhythmic pressure applied to the trigger point between the index finger and thumb, we report the effectiveness of this method in 6 of 7 cases. This technique can effectively break acute migraine attacks in a matter of minutes. The pressure must be applied in a rhythmic cycle without causing significant pain. A detailed description of this technique in successfully treated cases is described in this manuscript.

Voting with Their Thumbs: Assessing Communication Technology Use by Medical, Nursing, Midwifery, and Allied Health Clinicians.

BACKGROUND: Timely multidisciplinary communication is crucial to prevent patient harm related to miscommunication of clinical information. Many health care organizations provide secure communications systems; however, clinicians often use unapproved platforms on personal devices to communicate asynchronously. OBJECTIVE: The aim of the study is to assess clinical communication behaviors by clinicians in a hospital setting. METHODS: Medical, nursing and allied health staff working across seven hospital sites of a large health care organization were invited to complete an anonymous survey on the methods, behaviors, and rationale for clinical communication technology use. The survey included questions on communication methods used by clinicians for intra- and inter-disciplinary communication and sending and receiving clinical information or images. Demographics and qualitative comments were also collected. RESULTS: A total of 836 surveys were completed (299 medical, 317 nursing, and 220 allied health staff). Staff in all clinical groups reported using an unapproved messaging platform to communicate patient information more than three times per day (medical staff n = 167, 55.9%; nursing staff n = 106, 33.4%; allied health staff n = 67, 30.5%). Not one medical staff member indicated they only use the approved methods (n = 0, 0%) while one-third of nursing and allied health respondents only used approved methods (n = 118, 37.2% and n = 64, 29.1%, respectively). All clinician groups reported wasted time from communications sent with missing information, or time spent waiting for responses for further information. Qualitative comments expressed dissatisfaction and frustration with current clinical communication methods and a desire for improved systems. CONCLUSION: Workarounds are being used by all clinician groups to send text and image clinical communications. There are high levels of dissatisfaction with this situation and clinicians are keen for consistency and to have the right tools available. There is a need to ensure standardized clinical communication methods and approved digital platforms are in place and utilized to provide safe, high-quality patient care.

Clinical effects of proprioceptive thumb exercise for individuals with carpometacarpal joint osteoarthritis: A randomized controlled trial.

STUDY DESIGN: Randomized Control Trial. INTRODUCTION: Thumb CMC joint OA is a common diagnosis. Currently there is no evidence available to under if proprioceptive neuromuscular training is an effective intervention for this population. PURPOSE OF THE STUDY: To establish the effectiveness of a proprioceptive training program as a complementary therapy for patients with thumb CMC joint OA. METHODS: Standard conservative thumb CMC joint OA treatments were received by both the control (n = 26) and experimental groups (n = 26) for a period of 12 weeks. The experimental group received a proprioceptive training program during the same intervention period. Outcome measures included severity of pain with activity according to the numerical rating scale (NRS), QuickDASH, Canadian Occupational Performance Measure (COPM), and proprioception via joint position sense (JPS). RESULTS: Fifty-two females participated in the study. Both the experimental and control group made both clinically and statistically significant changes in the mean VAS and COPM scores over time. Only the experimental group achieved a statistically and clinically significant change in JPS error score over time. DISCUSSION: Experimental group achieved a statistically significant change in JPS over time in concordance with previous investigations. Changes in pain scores differed from prior investigations and the between-group comparison was not statistically significant. Changes in the Quick DASH was similar to previous findings. CONCLUSION: Proprioceptive training in addition to a traditional rehabilitation program decreased error scores on the joint position sense test.

[Thumb-tack needles based on "Biaoben acupoint compatibility" for sequela of COVID-19 during recovery period].

OBJECTIVE: To observe the effect of thumb-tack needles based on "Biaoben acupoint compatibility" on sequela symptoms, mental state and pulmonary ventilation function in patients with coronavirus disease 2019 (COVID-19) during recovery period. METHODS: Fifty cases of COVID-19 during recovery period were randomly divided into an observation group and a control group, 25 cases in each group. The patients in the observation group were treated with thumb-tack needles at Guanyuan (CV 4), Zusanli (ST 36) and Taiyuan (LU 9). The patients in the control group were treated with sham thumb-tack needles at identical acupoints as the observation group. The treatment in the two groups was given once a day, 7-day treatment was taken as a course of treatment, and totally two courses of treatment were given. The TCM symptom score, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, pulmonary function (forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], peak expiratory flow [PEF]), the severity of pulmonary ventilation dysfunction and pulmonary imaging changes in the two groups were compared before and after treatment. RESULTS: Compared before treatment, the total scores and each item scores of TCM symptom scale, HAMA scores and HAMD scores in the two groups were reduced after treatment (P<0.05). Except for the symptom scores of dry throat and dry stool, the total score and each item score of TCM symptom scale, HAMA score and HAMD score in the observation group were lower than those in the control group (P<0.05). Compared before treatment, FVC, FEV1 and PEF in the two groups were increased after treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The severity of pulmonary ventilation dysfunction in the two groups was reduced after treatment (P<0.05), and the severity in the observation group was better than that in the control group (P<0.05). After treatment, the lung shadow area in the two groups was decreased (P<0.05), and that in the observation group was smaller than the control group (P<0.05). The improvement of imaging change in the observation group was better than that in the control group (P<0.05). CONCLUSION: The thumb-tack needles based on "Biaoben acupoint compatibility" could significantly reduce the sequela symptoms, anxiety and depression in patients with COVID-19 during recovery stage, and improve the pulmonary ventilation function.

Effectiveness of manual therapy in patients with thumb carpometacarpal osteoarthritis: a systematic review and meta-analysis.

BACKGROUND: The effectiveness of Manual Therapy (MT) in thumb carpometacarpal osteoarthritis (OA) is unclear. OBJECTIVE: This study aimed to determine the effectiveness of MT for functional outcomes in patients with thumb carpometacarpal OA. DESIGN: Systematic review and meta-analysis of randomized clinical trials. METHODS: An electronic search was performed in the Medline, Central, Embase, PEDro, Lilacs, Cinahl, SPORTDiscus, and Web of Science databases. The eligibility criteria for selecting studies included randomized clinical trials that compared MT versus other interventions in functional outcomes, such as thumb and/or hand function questionnaires, pinch and/or grip strength, thumb and/or hand range of motion, and pain intensity or pressure pain threshold in patients with thumb carpometacarpal OA. RESULTS: Five clinical trials met the eligibility criteria; for the quantitative synthesis, four studies were included. The mean difference (MD) for grip strength was 0.87kg (95% CI = 0.29-1.44, p = .003), for pinch strength was 0.10kg (95% CI = -0.01-0.20, p = .06), and for the pressure pain threshold was 0.64kg/cm2 (95% CI = 0.07-1.20, p = .03). All differences were in favor of the MT group. CONCLUSIONS: In the short-term, there was moderate to high evidence, with statistically significant differences in the functional outcomes, in favor of MT versus sham interventions in patients with thumb carpometacarpal OA. However, these differences are not clinically important.

[Thumb-tack needle based on Biaoben Genjie theory for dry eye: a randomized controlled trial].

OBJECTIVE: To compare the clinical efficacy of thumb-tack needle and sodium hyaluronate eye drops for dry eye. METHODS: A total of 60 patients with dry eye were randomly divided into a thumb-tack needle group and a western medication group, 30 cases in each group. Based on Biaoben Genjie theory, thumb-tack needle was applied at Zhiyin (BL 67), Lidui (ST 45), Fuyang (BL 59), Yanglao (SI 6), Jingming (BL 1) and Cuanzhu (BL 2) in the thumb-tack needle group, 2 times a week. In the western medication group, 0.1% sodium hyaluronate eye drops were applied, 3 times a day. Both groups were treated for 4 weeks. Before and after treatment, TCM symptom score, tear film break-up time (BUT), SchirmerⅠtest (SⅠT), corneal fluorescein sodium staining (FL) score and 36-item short form health survey (SF-36) score were observed, and the clinical efficacy was evaluated in the two groups. RESULTS: After treatment, the total scores and each item score of TCM symptom in the two groups were decreased compared with before treatment (P<0.05); except for score of visual fatigue and photophobia, the total score and each item score of TCM symptom in the thumb-tack needle group were lower than the western medication group (P<0.05). After treatment, the BUT, SⅠT and SF-36 scores were increased and the FL scores were decreased in the two groups (P<0.05); the BUT, SⅠT and SF-36 score were higher than the western medication group (P<0.05), and the FL score was lower than the western medication group (P<0.05) in the thumb-tack needle group. The total effective rate in the thumb-tack needle group was 93.3% (28/30), which was higher than 80.0% (24/30) in the western medication group (P<0.05). CONCLUSION: Thumb-tack needle based on Biaoben Genjie theory could effectively relieve clinical symptoms of dry eye patients, prolong tear film break-up time, increase tear secretion, improve tear film function and quality of life, and its curative effect is better than sodium hyaluronate eye drops.

The Evolution of the Human Hand From an Anthropologic Perspective.

Coupled with the developing brain and freed from ambulatory responsibilities, the human hand has experienced osteologic and myologic changes throughout evolutionary time that have permitted manipulative capacities of social, functional, and cultural importance in modern-day human life. Hand cupping, precision gripping, and power gripping are at the root of these evolutionary developments. It is in appreciation of the evolutionary trajectory that we can truly understand how 'form is function.' The structure of the human hand is distinct in many ways from that of even our closest relatives in the primate order (ie, chimpanzees). We present some of the key anatomic changes and evolutionary anatomic remnants of the human hand. The human hand is truly an amazing organ-the product of millions of years of selective changes.

Thumb-tack needles based on "Biaoben acupoint compatibility" for sequela of COVID-19 during recovery period / 中国针灸

OBJECTIVE@#To observe the effect of thumb-tack needles based on "Biaoben acupoint compatibility" on sequela symptoms, mental state and pulmonary ventilation function in patients with coronavirus disease 2019 (COVID-19) during recovery period.@*METHODS@#Fifty cases of COVID-19 during recovery period were randomly divided into an observation group and a control group, 25 cases in each group. The patients in the observation group were treated with thumb-tack needles at Guanyuan (CV 4), Zusanli (ST 36) and Taiyuan (LU 9). The patients in the control group were treated with sham thumb-tack needles at identical acupoints as the observation group. The treatment in the two groups was given once a day, 7-day treatment was taken as a course of treatment, and totally two courses of treatment were given. The TCM symptom score, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, pulmonary function (forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], peak expiratory flow [PEF]), the severity of pulmonary ventilation dysfunction and pulmonary imaging changes in the two groups were compared before and after treatment.@*RESULTS@#Compared before treatment, the total scores and each item scores of TCM symptom scale, HAMA scores and HAMD scores in the two groups were reduced after treatment (P<0.05). Except for the symptom scores of dry throat and dry stool, the total score and each item score of TCM symptom scale, HAMA score and HAMD score in the observation group were lower than those in the control group (P<0.05). Compared before treatment, FVC, FEV1 and PEF in the two groups were increased after treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The severity of pulmonary ventilation dysfunction in the two groups was reduced after treatment (P<0.05), and the severity in the observation group was better than that in the control group (P<0.05). After treatment, the lung shadow area in the two groups was decreased (P<0.05), and that in the observation group was smaller than the control group (P<0.05). The improvement of imaging change in the observation group was better than that in the control group (P<0.05).@*CONCLUSION@#The thumb-tack needles based on "Biaoben acupoint compatibility" could significantly reduce the sequela symptoms, anxiety and depression in patients with COVID-19 during recovery stage, and improve the pulmonary ventilation function.

Thumb Injuries and Instabilities. Part 1: Anatomy, Kinesiology, and Imaging Techniques of the Thumb.

The unique anatomical characteristics of the thumb offer a broad range of motion and the ability to oppose thumb and finger, an essential function for grasping. The motor function of the thumb and its orientation make it particularly vulnerable to trauma. Pathologic lesions encountered in this joint are varied, and imaging techniques play a crucial role in injury detection and characterization. Despite advances in diagnostic accuracy, acute thumb injuries pose a challenge for the radiologist. The complex and delicate anatomy requires meticulous and technically flawless image acquisition. Standard radiography and ultrasonography are currently the most frequently used imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations, and magnetic resonance imaging may be useful in equivocal cases. In this article, we present the relevant anatomy and imaging techniques of the thumb.

"Mind the thumb": Judging hand laterality is anchored on the thumb position.

People can decide whether the image of a hand represents a left or a right one. The laterality judgment mainly implies mentally imaging own hand movement (motor simulation) if the stimulus represents a palm, or analysing visual cues, as hand asymmetry, if the stimulus reproduces a dorsum. Here, by capitalizing on evidence underscoring the key role of thumb-palm complex in motor dexterity of human hand, we hypothesise that activation of motor or visual processes when judging hand laterality is due to the different relevance of palm-thumb and dorsum-thumb combinations to hand action. To test this thumb-anchored strategy, in a laterality judgment experiment, we concurrently manipulated the thumb position (flexed or extended) with respect to palm and dorsum, and the human likeness of the hand shape (influencing the salience of the thumb with respect to the hand shape). The main results demonstrated that viewing the flexed thumb from palm or dorsum elicited motor simulation, while viewing the extended thumb activated motor simulation when combined with palm but not dorsum. The present data highlight the pivotal role of the thumb in hand laterality judgments, consistent with its key role in human in-hand manipulation.

Comparison of the on-line effects of different motor simulation conditions on corticospinal excitability in healthy participants.

In healthy participants, corticospinal excitability is known to increase during motor simulations such as motor imagery (MI), action observation (AO) and mirror therapy (MT), suggesting their interest to promote plasticity in neurorehabilitation. Further comparing these methods and investigating their combination may potentially provide clues to optimize their use in patients. To this end, we compared in 18 healthy participants abductor pollicis brevis (APB) corticospinal excitability during MI, AO or MT, as well as MI combined with either AO or MT. In each condition, 15 motor-evoked potentials (MEPs) and three maximal M-wave were elicited in the right APB. Compared to the control condition, mean normalized MEP amplitude (i.e. MEP/M) increased during MI (P = .003), MT (P < .001) and MT + MI (P < .001), without any difference between the three conditions. No MEP modulation was evidenced during AO or AO + MI. Because MI provided no additional influence when combined with AO or MT, our results may suggest that, in healthy subjects, visual feedback and unilateral movement with a mirror may provide the greatest effects among all the tested motor simulations.

Pyrocarbon implants for the basal thumb arthritis.

Silicone implants for the treatment of basal thumb arthritis were first proposed in the 1970's by Swanson. They became extremely popular and despite good functional results, the high rate of complications such as instability, material breakage and foreign body reactions led to them being progressively abandoned by most surgeons. Pyrocarbon implants were introduced at the beginning of the 2000's. A large range of different implant models that can be used for either hemiarthroplasty or interposition arthroplasty. For some implants, a supplemental ligamentoplasty procedure is required to avoid instability. Miniaturization of some implants provides new options for minimally invasive surgery, which is relevant in low and medium grades of osteoarthritis, especially for young, active patients. Medium- and long-term follow-up have now been reached by some pyrocarbon interpositions. Their results confirm that these implants are a reliable alternative to other techniques. This paper focuses on the surgical techniques and outcomes of pyrocarbon implants for the treatment of basal thumb arthritis. It is based on published data and the author's experience.