Monocyte to high-density lipoprotein ratio as a novel-potential biomarker for predicting prognosis of Bell's palsy.

OBJECTIVES: In several disorders, the monocyte to high-density lipoprotein ratio (MHR) has been considered a biomarker of systemic inflammation and oxidative stress. However, its role in Bell's palsy (BP) remains unclear. This study investigates the relationship between elevated MHR and poor recovery in BP patients. METHODS: The clinical data of 729 BP patients were analyzed retrospectively. The House-Brackmann Facial Nerve Grading System (H-B) was utilized to assess the severity of facial motor dysfunction during admission and the follow-up period after discharge. According to the 6 months follow-up data, H-B grades 1-2 were classified as recovered (n = 557), and H-B grades 3-6 as unrecovered (n = 172). The patients were split into MHR ≤ 0.26 (n = 361) and MHR > 0.26 (n = 368) groups based on the median MHR to further analyze the connection between different MHRs and prognosis. RESULTS: The level of MHR was substantially greater in the unrecovered group of BP patients than in the restored group (medians[interquartile range], 0.32[0.20, 0.49] vs 0.24[0.11, 0.39], P < 0.001). MHR was an independent risk factor for BP prognosis as indicated by the multivariate logistic regression analysis (OR = 4.467, 95% CI = 1.875-10.646, P = 0.001). The area under the curve (AUC) was 0.615 (95% CI = 0.566-0.664, P < 0.001). The initial H-B score did not differ significantly between MHR ≤ 0.26 (n = 361) and MHR > 0.26 (n = 368) groups. However, after 6 months of follow-up, the high-MHR group's H-B score was considerably greater than the low-MHR group's. CONCLUSIONS: MHR is expected to be an accessible and effective biomarker of BP. In BP patients, elevated MHR is related to an increased chance of poor recovery.

Effect of temperature and air pressure on the incidence of Bell's palsy in Hangzhou: a distributed lag non-linear analysis.

The etiology of Bell's palsy (BP) is currently unknown, and the findings from previous studies examining the association between seasonal or meteorological factors and BP have been inconsistent. This research aims to clarify this relationship by analyzing a larger dataset and employing appropriate statistical methods. Data from 5387 patients with BP treated at Zhejiang Provincial Hospital of Traditional Chinese Medicine in Hangzhou, Zhejiang Province, from May 1, 2018, to June 30, 2023, was gathered. We assessed the temporal distribution of meteorological factors and the incidence of BP across seasons and months. A distributed lag non-linear model was used to further investigate the lagged and overall effects of temperature and air pressure on the onset of BP. The temporal distribution of BP incidence revealed the highest average number of cases occurring in December and the lowest in June. A correlation existed between BP episodes and temperature or air pressure. The model revealed a higher relative risk during periods of low temperature and high air pressure, characterized by a time lag effect. This correlation was notably more pronounced in female patients and individuals in the young and middle-aged groups. Our findings suggest that exposure to low temperatures and high air pressure constitute risk factors for BP development.

The impact of Chinese COVID-19 pandemic on the incidence of peripheral facial nerve paralysis after optimizing policies.

Objective: To evaluate the impact of the COVID-19 pandemic on the occurrence of Peripheral Facial Nerve Paralysis (PFNP) in Chinese patients, identify contributing factors, and explore the relationship between COVID-19 and PFNP. Methods: We conducted a retrospective study covering the years 2020 to 2023, categorizing patients into three groups based on their visit dates: Group 1 (December 8, 2020 to February 28, 2021), Group 2 (December 8, 2021 to February 28, 2022), and Group 3 (December 8, 2022 to February 28, 2023). We collected and compared data on disease onset and patient characteristics among these groups. Results: In Group 3, following the widespread COVID-19 outbreak, there was a significant increase of 22.4 and 12.1% in PFNP cases compared to the same periods in the preceding 2 years (p < 0.001). Group 3 patients were more likely to be aged between 30 and 60 years, experience onset within 7 days, present with Hunter syndrome, and have a higher H-B score of VI compared to the previous 2 years (p < 0.017). Logistic regression analysis revealed a strong association between the COVID-19 pandemic and the incidence of Hunter syndrome in PFNP (OR = 3.30, 95% CI 1.81-6.03, p < 0.001). Conclusion: The incidence of PFNP increased in China after the COVID-19 pandemic, particularly in patients with Hunter syndrome, indicating that COVID-19 infection can trigger and worsen PFNP.

Effects of breathing exercises on low back pain in clinical: A systematic review and meta-analysis.

OBJECTIVE: This study aims to systematically evaluate the effect of breathing exercises on the low back pain (LBP). METHODS: The studies of relevant randomized controlled trials (RCTs) testing the effect of breathing exercises on LBP were selected after strict screening from the establishment of PubMed, EMBASE, Cochrane Library, Web of Science, CBM, and CNKI databases until September 2022. The studies included were then independently assessed for risk bias by two investigators. The PRISMA 2020 statement was followed in this study. RESULTS: 11 RCTs involving 383 patients were included in this analysis. Results showed that the effective rate of LBP patients after breathing exercises was significantly higher than those in the control group, and the VAS (Visual Analogue Score) and ODI (Oswestry Disability Index) scores of LBP patients were significantly lower than those in the control group [VAS: MD = -0.50, 95% CI (-0.88, -0.11), I2 = 76%, p = 0.0009; ODI: MD = -2.46, 95% CI (-3.41, -1.52), I2 = 20%, p = 0.28]. The results of subgroup showed that the duration of treatment had little effect on the effect of breathing exercises, and breathing exercises alone could also have a positive effect on LBP. However, there were methodological limitations in the included studies, future studies should ensure blinded outcome assessors and full reporting to reduce bias risks. Because this review is a study of breathing exercises as an intervention without any adverse events, all studies did not involve safety assessments. CONCLUSIONS: The results indicated that breathing exercises have a positive effect on alleviating LBP, but due to the lack of methodological rigor and some limitations of the included studies, more critical RCTs are still needed in the future to verify the precision of this conclusion. The protocol was registered in PROSPERO (No. CRD42022345561).

Correlation between vital capacity and vertebra body translation during lumbar flexion and extension in adults aged between 60 and 69 years.

BACKGROUND: Low back pain is one of the most common musculoskeletal diseases in the modern society, causing a huge economic burden, and has become an important public health problem. Years lived with disability caused by low back pain increased rapidly as a result of population growth and ageing worldwide, with the biggest increase seen in low-income and middle-income countries. In this context, the prevention and treatment of low back pain in the elderly warrant attention and research. OBJECTIVE: The aim is to determine the correlation between vital capacity (VC) and vertebral body translation during lumbar flexion and extension in adults aged 60 to 69 years. METHODS: A total of 192 adults aged 60 to 69 years were selected by cluster sampling in Lishui City, Zhejiang Province, China. The VC of the study population was tested and the ratio of VC to body mass (BM) was calculated. The lumbar hyperextension and hyperflexion of the study population were radiographed using a Hitachi 500 mAs X-ray machine made in Japan to verify vertebral body translations in each segment. RESULTS: The differences of test values of VC (P= 0.004), VC/BM ratio (P= 0.012) and vertebral body translation in the L5-S1 segment during flexion and extension (P< 0.001) of the populations aged 60 to 64 and 65 to 69 years were all statistically significant. The vertebral body translation in the L5-S1 segment during lumbar flexion and extension in the population aged 60 to 69 years was negatively correlated with the VC (rs =-0.207 and P= 0.004) and VC/BM ratio (rs =-0.248 and P= 0.001), showing statistical significance. CONCLUSIONS: The vertebral body translation of during lumbar flexion and extension correlates with the VC in the population aged 60 to 69 years. Recognition of this correlation may help to guide further lumbar stabilization exercises.