Advantages and application strategies of machine learning in diagnosis and treatment of lumbar disc herniation / 中国组织工程研究

BACKGROUND:Based on different algorithms of machine learning,how to carry out clinical research on lumbar disc herniation with the help of various algorithmic models has become a trend and hot spot in the development of intelligent medicine at present. OBJECTIVE:To review the characteristics of different algorithmic models of machine learning in the diagnosis and treatment of lumbar disc herniation,and summarize the respective advantages and application strategies of algorithmic models for the same purpose. METHODS:The computer searched PubMed,Web of Science,EMBASE,CNKI,WanFang,VIP and China Biomedical(CBM)databases to extract the relevant articles on machine learning in the diagnosis and treatment of lumbar disc herniation.Finally,96 articles were included for analysis. RESULTS AND CONCLUSION:(1)Different algorithm models of machine learning provide intelligent and accurate application strategies for clinical diagnosis and treatment of lumbar disc herniation.(2)Traditional statistical methods and decision trees in supervised learning are simple and efficient in exploring risk factors and establishing diagnostic and prognostic models.Support vector machine is suitable for small data sets with high-dimensional features.As a nonlinear classifier,it can be applied to the recognition,segmentation and classification of normal or degenerative intervertebral discs,and to establish diagnostic and prognostic models.Ensemble learning can make up for the shortcomings of a single model.It has the ability to deal with high-dimensional data and improve the precision and accuracy of clinical prediction models.Artificial neural network improves the learning ability of the model,and can be applied to intervertebral disc recognition,classification and making clinical prediction models.On the basis of the above uses,deep learning can also optimize images and assist surgical operations.It is the most widely used model with the best performance in the diagnosis and treatment of lumbar disc herniation.The clustering algorithm in unsupervised learning is mainly used for disc segmentation and classification of different herniated segments.However,the clinical application of semi-supervised learning is relatively less.(3)At present,machine learning has certain clinical advantages in the identification and segmentation of lumbar intervertebral discs,classification and grading of the degenerative intervertebral discs,automatic clinical diagnosis and classification,construction of the clinical predictive model and auxiliary operation.(4)In recent years,the research strategy of machine learning has changed to the neural network and deep learning,and the deep learning algorithm with stronger learning ability will be the key to realizing intelligent medical treatment in the future.

Proprioceptive training after anterior cruciate ligament reconstruction:improving joint stability and motor balance ability / 中国组织工程研究

BACKGROUND:Anterior cruciate ligament rupture is one of the injuries that seriously affect life and sports performance,and the anterior cruciate ligament as a stabilizing structure is irreplaceable in maintaining sports performance.In view of its severe injury manifestations,the current treatment for anterior cruciate ligament rupture is a surgery for anterior cruciate ligament reconstruction.Since an anterior cruciate ligament injury can cause loss of mechanoreceptors,which in turn causes a reduction in proprioception,it is a great problem for patients to recover their motor performance. OBJECTIVE:To summarize the effects of proprioceptive training on clinical outcomes after anterior cruciate ligament reconstruction and to explore the underlying mechanisms,thereby providing more references for clinical prevention and treatment. METHODS:A computerized search of PubMed,CNKI,WanFang Data,and VIP databases was conducted for literature(from January 2013 to March 2023)related to proprioceptive training after anterior cruciate ligament reconstruction that improves joint stability and motor balance ability.A total of 108 articles were finally included for review. RESULTS AND CONCLUSION:Proprioceptive training can effectively improve the proprioceptive functions of patients,such as positional sense and kinesthetic sense after anterior cruciate ligament reconstruction,and improve joint stability,postural control and motor ability.The proprioceptive training improves the proprioceptive function through three mechanisms:stimulation of periprosthetic receptors around the knee joint,activation of spinal reflex stimulation,reinforcement of motor control in the brain,and enhancement of cognitive processing.The proprioceptive training may improve proprioceptive functions by activating the potential mechanisms of growth associated protein-43 activity,Piezo2 mechanotransducer,and NT-3/TrkC signaling pathway.Hydrotherapy is the mainstay in the early stages,while neuromuscular training,individual strength training and visual feedback training are prioritized in the middle and late stages.There exists an as-yet-unsegmented reconstructive surgery graft,sex,and a lack of devices or proprioceptive training methods based on the idea of combining multiple sensory stimuli.

Sleep characteristics and risk of osteoarthritis:a two-sample and multivariate Mendelian randomization study / 中国组织工程研究

BACKGROUND:In recent years,epidemiological studies have shown that sleep patterns are risk factors for osteoarthritis,but the causal relationship between sleep characteristics and osteoarthritis remains unknown. OBJECTIVE:To investigate the causal relationship between seven sleep phenotypes and osteoarthritis,thereby providing a theoretical foundation for clinical prevention and intervention of osteoarthritis. METHODS:Seven sleep-related features,namely sleep duration,wake-up time,daytime napping,morning/evening preference,snoring,insomnia,and hypersomnia,were selected from published genome-wide association studies.Instrumental variables for these sleep-related features were extracted.Instrumental variables for knee osteoarthritis and hip osteoarthritis were obtained from publicly available genome-wide association studies.Causal relationships between sleep characteristics and outcome risks were evaluated using two-sample and multivariable Mendelian randomization analyses.The inverse variance weighted method was employed as the primary Mendelian randomization approach.Various methods,including weighted median,weighted mode,Mendelian randomization-Egger regression,Mendelian randomization pleiotropy-residual sum and outlier,were utilized to detect and correct for the presence of pleiotropy. RESULTS AND CONCLUSION:The results of the inverse variance-weighted method in the two-sample Mendelian randomization study revealed a detrimental causal association between the duration of sleep and the incidence risk of knee osteoarthritis[odds ratio(OR)=0.621,95%confidence interval(CI):0.470-0.822,P=0.001].Concurrently,insomnia displayed a positive causal connection with hip osteoarthritis risk(OR=2.016,95%CI:1.249-3.254,P=0.005).Sensitivity analysis affirmed the robustness of these causal relationships,and Mendelian randomization-Egger intercept analysis found no evidence of potential horizontal pleiotropy(knee osteoarthritis:P=0.468,hip osteoarthritis:P=0.551).Moreover,the results from the multivariable Mendelian randomization analysis showed that the causal association between insomnia and hip osteoarthritis lacked statistical significance(P=0.715).In contrast,sleep duration exhibited a direct negative causal relationship with the incidence risk of knee osteoarthritis(OR=0.526,95%CI:0.336-0.824,P=0.005).Reverse Mendelian randomization analysis indicated that knee osteoarthritis did not influence sleep duration(P=0.757).These findings indicate a negative correlation between sleep duration and incidence risk of knee osteoarthritis,suggesting that correcting insufficient sleep might mitigate the incidence risk of knee osteoarthritis.

Application of intelligent robot system in teaching cervical spine manipulation / 国际生物医学工程杂志

Objective:To explore the application effect of an intelligent teaching robot system of lifting manipulation in cervical spine manipulation teaching.Methods:60 doctors were randomly divided into an experimental group ( n = 30) and a control group ( n = 30). The control group was taught by a certified chief physician using a combination of "PowerPoint presentations, video demonstrations, and operation demonstrations" . Each part is 5 min. The experimental group was taught by the intelligent teaching robot system with a spinning technique. The teaching time is 15 min for both groups. At the end of the two teaching sessions, the two groups were trained five times under different BMIs and passed the system assessment. The qualified rates of pre-traction force, lifting and pulling force, maximum force, pre-traction time, lifting and pulling time, rotation amplitude, and pitch amplitude were compared between the two groups. Results:In normal, there was significant differences between the qualified rates of pre-traction force, lifting and pulling force, maximum force, pre-traction time, lifting and pulling time, rotation amplitude, and pitch amplitude in two groups (all P<0.05). For overweight people, there were significant differences in pre-traction force, pulling force, maximum force, and rotation amplitude (all P <0.05), while there were no significant differences in pre-traction time, pulling time, or pitching amplitude (all P >0.05). In obesity, there were significant differences in pre-traction force, lifting and pulling force, maximum force, and pitch amplitude (all P <0.05), but no significant differences in pre-traction time, lifting and pulling time, or rotation amplitude (all P >0.05). Conclusions:The proposed system can improve the pass rate of spinning manipulation, especially by effectively controlling the pre-traction force, pulling force, and maximum force.

Effect of "patellar pushing and knee extension" manipulation on integrin β1 and p-FAK in articular cartilage of rabbit model of knee osteoarthritis / 国际生物医学工程杂志

Objective:To observe the effects of "pushing patella and extending knee" manipulation on the protein and mRNA expression levels of integrin β1 (ITGβ1) and phosphorylated adhesion plaque kinase (p-FAK) in rabbit knee osteoarthritis (KOA) model, and to investigate the mechanism of manipulations in the treatment of KOA.Methods:Twenty healthy 6-month-old New Zealand rabbits were divided into the normal group, the model group, the acupuncture group, and the manipulation group according to the random number table method. Among them, the model group, the acupuncture group, and the manipulation group were modeled using the modified Hulth method for KOA. After 7 d of successful modeling, the normal group and the model group did not receive any intervention, while the acupuncture group and the manipulation group received one acupuncture intervention and one "pushing patella and extending knee" manipulation intervention daily, respectively. After 2 weeks of treatment, the rabbit KOA model was executed by air embolization, and the protein and mRNA expression levels of ITGβ1 and p-FAK in knee cartilage were measured by Western blot and real-time polymerase chain reaction (PCR), respectively.Results:Compared with the normal group, the ITGβ1 protein expression level was decreased ( P<0.05) and p-FAK protein expression level was increased ( P<0.05), and the mRNA expression levels of ITGβ1 and p-FAK did not change significantly (all P>0.05) in the model group. Compared with the model group, the ITGβ1 protein expression level was increased ( P<0.05), the p-FAK protein expression level decreased ( P<0.05), and the mRNA expression levels of both ITGβ1 and p-FAK increased (all P<0.05) in the acupuncture group. Compared with the acupuncture group, ITGβ1 protein expression level increased ( P<0.05), p-FAK protein expression level decreased ( P<0.05), and mRNA expression levels of both ITGβ1 and p-FAK increased (all P<0.01) in the manipulation group. Conclusions:The "pushing patella and extending knee" manipulation can optimize the protein and mRNA expression levels of ITGβ1 and p-FAK in the articular cartilage of the rabbit KOA model.

Effects of Fixed-Point Lateral Flexion and Rotation Manipulation on Intervertebral Foramina Morphology of Cervical Spondylotic Radiculopathy / 医用生物力学

Objective To analyze the changes in morphology of intervertebral foramina in patients with cervical spondylotic radiculopathy (CSR) treated with fixedpoint lateral flexion and rotation manipulation based on three-dimensional (3D) reconstruction technology, so as to provide references for the effectiveness of manipulation treatment. MethodsForty patients with CSR were treated with fixed point lateral flexion and rotation manipulation once every other day for a total of 7 times and 2 weeks as a course of treatment. CT data of the patients before and after treatment were analyzed by using multifunctional CT, Mimics 21.0, Geomagic and SolidWorks 2017. The area of the intervertebral foramen, anterior and posterior diameter of the intervertebral foramen, upper and lower diameter of the intervertebral foramen were measured before and after treatment, as well as the infrared thermal imaging temperature differences of the bilateral neck and shoulder, front and back of the upper limb, and the VAS scores of the patients were observed before treatment, 7 d after treatment, 14 d after treatment and 1 month follow-up. Results Foraminal area, anterior and posterior diameters, upper and lower diameters of 40 patients were improved after treatment, and the temperature differences of infrared thermal imaging of patients before and after treatment were statistically significant. The VAS score of the patients decreased progressively. Conclusions Fixed point lateral flexion manipulation can significantly improve the shape of the intervertebral foramen in patients with CSR, so as to achieve the treatment purpose of relieving nerve compression.

Research progress on the mechanism of tonifying kidney and activating blood Chinese medicine for knee osteoarthritis / 国际中医中药杂志

The important pathogenesis of knee osteoarthritis (KOA) lies in kidney deficiency and blood stasis. Therefore, Traditional Chinese Medicine (TCM) for tonifying the kidney and activating blood circulation is widely used in clinical practise with high response. The existing literature mainly focuses on single medicine for tonifying the kidney and activating blood circulation, as well as TCM compounds, such as classic prescriptions Yougui Pill, Duhuo Jisheng Decoction, which contain TCMs for tonifying the kidney and activating blood circulation, or self-made empirical prescriptions Bushen Huoxue Recipe and Bushen Tongluo Recipe, which are based on the idea of tonifying the kidney and activating blood circulation. The above TCMs mainly regulate oxidative stress response, inflammatory cytokine level, no level, lymphatic function and microcirculation Inhibit chondrocyte apoptosis, regulate cartilage metabolism, protect and repair cartilage, and inhibit matrix degrading enzymes to play a therapeutic role.

Research progress of Piezo mechanosensitive ion channels in bone and joint tissues / 国际生物医学工程杂志

Mechanosensitive ion channels are mechanoreceptors that convert mechanical stimulation on the cell surface into intracellular electrical signal or chemical signal. In recent years, Piezo protein as a mechanically activated cation channel in eukaryotes has gradually become a research hotspot. Piezo1 and Piezo2 proteins are expressed in different organs and tissues of mammals, and tissues such as bones and joints are directly related to mechanical conduction. The intracellular effects caused by the conduction of mechanical force play a very important role in the treatment and prevention of orthopedic diseases. In this paper, the researches on Piezo protein mechanically activated cation channels in bone tissue, cartilage tissue, bone marrow tissue, intervertebral disc tissue and orthopedic diseases were reviewed.

Exploring the incidence characteristics of KOA based on the theory of "bone-restoration and tendon-softening" / 国际生物医学工程杂志

Knee osteoarthritis (KOA) is a kind of degenerative osteoarthrosis, which usually involves articular cartilage, subchondral bone, meniscus and quadriceps femoris, which is equivalent to the change of "tendon" in traditional Chinese medicine. The occurrence and development of the change of "tendon" can be explained by the theory of "bone-restoration and tendon-softening" in traditional Chinese medicine. If the force line of the lower limb of the knee joint is normal, it can be indicated by "bone-restoration" in traditional Chinese medicine, that is, the blood around the knee joint runs smoothly, and the "tenons" such as meniscus, ligaments, cartilage, etc. are softened by the blood. This condition of the knee joint can be manifested by the balance of the surrounding soft tissue state. If the force line of the lower limb of the knee joint changes, showing a medial offset and misalignment of the knee joint, it can be indicated by "bone is out of alignment" in traditional Chinese medicine, that is, the structure of the soft tissue around the knee joint and its mechanical characteristics have changed. This condition of the knee joint can be manifested by "the tendons lose their flexibility". In this paper, the theories of modern biomechanics and "bone-restoration and tendon-softening" in traditional Chinese medicine were comprehensively analyzed, the characteristics of the "tenons" when knee osteoarthritis occurs were analyzed, and the characteristics of the occurrence and development of knee osteoarthritis from the perspective of Chinese and Western medicine were discussed.

Diagnostic value of genexpert MTB/RIF in tuberculosis and population characteristics of retreated patients / 中国医师杂志

Objective:To explore the reliability of Xpert MTB/RIF (Xpert) in the diagnosis of pulmonary tuberculosis and to understand the characteristics of retreated patients, so as to provide clues for the investigation of retreated patients.Methods:905 patients sputum with suspected tuberculosis from July 2019 to December 2019 were collected from the Tuberculosis Department of Changsha Central Hospital. Xpert was used for rapid screening of tuberculosis. MGIT960 and Roche culture method were used for rapid sputum culture and drug sensitivity, respectively. Rifampin (RIF) resistance was compared between Xpert and Roche culture. The gender, age, RIF resistance, occupation and diabetes mellitus of patients with positive Xpert were compared, and the risk factors of RIF resistance were analyzed by binary logistic regression.Results:The total detection rate of Xpert was 28.7%(260/905) in 905 suspected pulmonary tuberculosis patients; RIF resistance rate accounted for 20.8%(54/260) in 260 positive patients, and the main mutation types were probe-E and probe-D. There was no significant difference between traditional drug sensitivity and Xpert method in RIF resistance detection ( P>0.05); There was no significant difference between Xpert method and traditional drug sensitive cases in predicting isoniazid (INH) resistance ( P=0.293); there were significant differences in age ( t=-3.835, P<0.05), gender, RIF resistance rate and proportion of farmers between newly treated and retreated patients (χ 2=5.091, 16.862, 4.808, P<0.05); Binary logistic regression showed that retreatment was a risk factor for RIF resistance ( OR=3.739, P=0.004). Conclusions:Xpert has high clinical value in the diagnosis of pulmonary tuberculosis and RIF resistance; The retreated patients were older, and the proportion of male farmers was larger, with higher resistance rate to RIF.

Research progress in the treatment of discogenic low back pain / 国际生物医学工程杂志

Discogenic low back pain (DLBP) is a common clinical degenerative disease of lumbar intervertebral disc, and its incidence rate is as high as 39%. The DLBP has become one of the major public health problems in the world. After the onset of DLBP, the patient's mental health, quality of life and work are seriously affected. At present, the diagnosis and treatment of DLBP are clinical problems and controversies, and the pathogenesis of DLBP is still not fully understood. The clinical manifestations of DLBP are atypical and lack specificity. In recent years, DLBP has received extensive attention from researchers, and a large number of studies have been conducted on clinical diagnosis and treatment methods and pathogenesis. In this paper, the research progress in the treatment of DLBP treatment methods reported in the literature was reviewed, in order to provide help for the selection of clinical treatment methods.

Clinical efficacy of pulsed radiofrequency in the treatment of knee osteoarthritis: a meta-analysis / 国际生物医学工程杂志

Objective:To evaluate the clinical efficacy of pulsed radio-frequency(PRF) for knee osteoarthritis(KOA) using Meta-analysis.Methods:The literature of controlled clinical studies on PRF in the treatment of KOA was retrieved, the retrieval databases included China Biomedical Literature Database, The Cochrane Library, PubMed, Web of Science, Medline, Embase, CNKI, Wanfang Database, VIP Database, CBM, EBSCO and Network database. The retrieval period was the time of inception to February 2021. The retrieved literature was screened, quality evaluated and data extracted by two researchers. Statistical analysis was performed using Review Manager 5.3 software.Results:A total of 8 studies were included, including 411 patients with KOA. The 200 patients in the trial group were underwent PRF treatment and the 211 patients in the control group were underwent conventional treatment. Meta-analysis results showed that the experimental group was superior to the control group in terms of knee VAS score, WOMAC score, Lysholm score and effective rate, and the differences were statistically significant (all P<0.05). Conclusions:PRF is more effective in treating KOA than conventional treatment. The quality of the literature research in this study that met the inclusion criteria was low, and a large number of high-quality studies are needed to evaluate the efficacy and safety of PRF treatment.

Experimental study on the treatment of knee osteoarthritis based on oxidized graphene granule lubricant and umbilical cord mesenchymal stem cells / 国际生物医学工程杂志

Objective:To study the effects of umbilical cord mesenchymal stem cells (UCMSCs) loaded by graphene oxide (GO) on cartilage repair in two KOA animal models.Methods:30 male New Zealand rabbits aged 12 weeks were randomly divided into A group ( n=15) and B group ( n=15). In the A group, the KOA model was established by the improved Hulth and cartilage defect method, and in the B group, the KOA model was established by the modified papain controlled-release injection method. After the modeling, the rabbits model in each group were divided into 4 subgroups, including blank control group ( n=3), GO group ( n=4), UCMSCs group ( n=4) and GO+UCMSCs group ( n=4). In these subgroups, the rabbit models were respectively treated injected with 0.5 ml of NaCl solution with 9 g/L, GO granular lubricant (GO with 30 μg/ml and solvent with hyaluronic acid with 0.25%), UCMSCs suspension (5×10 6 /ml), and mixed suspension of UCMSCs loaded by GO (GO with 30 μg/ml and UCMSCs with 5×10 6/ml) in right knee joint cavity. The serum levels of NO, collagen type Ⅱ(COL-Ⅱ), glycosaminoglycan (GAG), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA). Results:Eight weeks after the treatment, the serum levels of NO, IL-6 and TNF-α in GO+UCMSCs group were lower than those of the blank control group (all P<0.01), and the serum levels of COL-Ⅱ and GAG in GO+UCMSCs group were higher than those of the blank control group (all P<0.01). The serum NO level of the blank control group in group A was lower than that of the blank control group in group B [(22.097±0.352) ng/ml vs (23.662±0.056) ng/ml, P<0.05]. The serum COL-Ⅱ levels of the UCMSCs group and GO+UCMSCs group in group A were higher than those of group B respectively [(15.589±0.063) ng/ml vs (14.429±0.092) ng/ml, and (19.372±0.063) ng/ml vs (16.257±0.416) ng/ml, all P<0.01]. The serum GAG levels of the blank control group and the GO+UCMSCs group in group A were higher than those in group B respectively [(23.832±0.891) ng/ml vs (18.709±0.552) ng/ml, and (37.439±2.155) ng/ml vs (26.554±0.450) ng/ml, all P<0.01). The serum IL-6 levels of the blank control group and the GO+UCMSCs group in group A were lower than those in group B respectively [(16.082±0.323) ng/ml vs (18.367±0.861) ng/ml, P<0.05; (7.426±0.294) ng/ml vs (8.680±0.242) ng/ml, P<0.01]. The serum TNF-α levels of the blank control group and the GO+UCMSCs group in group A were lower than those in group B respectively [(9.466±0.177) ng/ml vs (10.013±0.197) ng/ml, P<0.05; (5.139±0.183) ng/ml vs (6.210±0.058) ng/ml, P<0.01]. Conclusions:GO loaded UCMSCs can promote the secretion of chondrocytes in rabbit KOA models, reduce inflammatory levels in joints, and play a role in cartilage repair.

Research progress of Gait analysis in knee osteoarthritis diagnosis / 国际生物医学工程杂志

Knee Osteoarthritis (KOA) is a joint disease with the main pathological changes of knee articular cartilage degeneration, loss and gradual deterioration. Clinically, KOA is more common in the middle-aged and the elderly, mainly manifested as knee pain and limited mobility, and walking disabilities. Walking is the basis of human behavior, and gait is the characteristic of human behavior when walking. Gait analysis (GA) studies the characteristics of the human body's gait behavior while walking, and combines knowledge of kinematics, dynamics, and biomechanics to analyze and obtain digital information on gait characteristics. GA is an effective tool for quantitative assessment of gait disorders. In KOA patients, the knee dynamic and static systems are unbalanced, the lower limb force lines are abnormal, and then the lower limb movement abnormalities occur, which affects normal gait. Researchers have taken gait feature analysis of KOA patients as a research hotspot, hoping to grasp the condition of patients with GA at different stages of KOA diagnosis, treatment and rehabilitation. In this paper the research progress of the studies on the GA patients' gait characteristics obtained by gait analysis was reviewed. This paper is expected to provide a more accurate digital basis for the diagnosis, treatment and rehabilitation assessment of KOA, and make the patient's diagnosis and treatment plan more precise.

Research on clinical and thermal imaging changes in the treatment of LDH by bipolar radiofrequency combined with ozone / 国际生物医学工程杂志

Objective:To study the clinical efficacy and lower limb temperature difference of bipolar radiofrequency combined with ozone in the treatment of lumbar disc herniation(LDH).Methods:A retrospective study was conducted on 105 inpatients with LDH. All patients were treated with bipolar radiofrequency combined with ozone. The interdisc impedance of the main electrode was measured before and after treatment, and the absolute temperature difference of infrared thermal imaging of both lower extremities before and after treatment was analyzed. Vasual analogue scale (VAS) score, JOA score and modified Macnab standard were used to evaluate the curative effect after treatment.Results:The VAS score after treatment was significantly lower than that before treatment( P<0.05), and the JOA score after treatment was significantly higher than that before treatment( P<0.05). The intervertebral disc impedance after treatment was significantly lower than that before treatment( P<0.05). The temperature difference between leg and plantar after treatment was significantly lower than that before treatment (all P<0.05). Conclusions:Bipolar radiofrequency combined with ozone therapy can relieve pain and improve function in patients with LDH. Infrared thermal imaging can sensitively reflect the changes of body surface temperature of lower extremities in patients with LDH, and has a certain value in the diagnosis and curative effect evaluation of LDH.

Comparison of HTO and UKA in the treatment of unicompartmental knee osteoarthritis:a Meta analysis / 国际生物医学工程杂志

Objective To evaluate the efficacy of high tibial osteotomy(HTO) and unicompartmental knee arthroplasty(UKA) for knee unicompartmental osteoarthrits(KOA) using Meta analysis. Methods The controlled clinical trial literatures of HTO and UKA treating KOA were retrieved, the database including Chinese Biomedical Literature Database, Wanfang Data, CNKI, VIP Data, PubMed, Cochrane Library, EBSCO and Embase, and the search period was limited to the beginning of the database to July 2018. The literature was screened and evaluated, and Review Manager 5.3 software was used for Meta analysis. Results A total of 19 articles including 1359 knee joints were included. Meta analysis results showed that HTO was superior to UKA in range of motion (ROM) (P<0.05). For the indicators, including excellent rate, Lysholm score, visual analogue scale (VAS) score, complications, repair rate, blood loss, length of stay, ambulation time, Hospital for Special Surgery (HSS) score and femorotibial angle (FTA), UKA was superior to HTO (all P<0.05). There was no significant difference in the repair rate between open wedge HTO (OWHTO) and UKA in the sub-group analysis. There were no significant differences in the operation time and Tegner exercise score between HTO and UKA ( all P>0 . 05 ) . Conclusions Both HTO and UKA have their own advantages and disadvantages. It is necessary to properly choose the operation according to the patient's condition and psychological expectation.

Clinical observation on the treatment of cervical spondylotic radiculopathy by the pulsed radiofrequency combined with the fixed-point lateral flexion and rotation realignment cervical manipulation / 国际生物医学工程杂志

Objective To observe the clinical efficacy of pulsed radiofrequency combined with fixed-point lateral flexion and rotation realignment cervical manipulation in the treatment of cervical spondylotic radiculopathy (CSR). Methods Sixty-three patients with CSR were randomly divided into observation group (n=32) and control group (n=31). The observation group was given pulse radiofrequency combined with fixed-point lateral flexion and rotation realignment cervical manipulation, and the control group was given the pulsed radiofrequency treatment. Visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores were obtained before the treatment, 7 days and 3 months after the treatment. The temperature differences of bilateral upper limbs infrared thermal imaging were observed before and 3 months after the treatment in the two groups. The clinical efficacy of the two groups was evaluated by using TCM disease and syndrome diagnosis criteria. Results After 7 days and 3 months of the treatment, the VAS scores of the two groups were lower than those before treatments, the VAS scores of the observation group were lower than the control group, and all the differences were statistically significant (all P<0.05). The JOA scores in the two groups were higher than those before treatment, the JOA scores of the observation group were higher than the control group , and the differences were statistically significant (all P<0.05). There was no statistically significant difference in the infrared temperature difference between the upper limbs of the observation group and the control group before treatments [(0.83±0.27) °C vs (0.87±0.29) °C, P>0.05]. Three months after the treatment, the temperature difference of infrared thermography in the upper limbs of the observation group was better than that of the control group (P<0.05), and the cure rate of the observation group was better than that of the control group, and the difference was statistically significant (68.75％vs 22.58％, P<0.05). There was no statistically significant difference in the total effective rate between the two groups (93.75％vs 90.32％, P>0.05). Conclusions The pulsed radiofrequency combined with the fixed-point lateral flexion and rotation realignment cervical manipulation in the treatment of radiculopathic cervical spondylosis was effective in improving pain, function and infrared imaging temperature of upper limbs.

Research progress in the application of mesenchymal stem cells in the treatment of knee osteoarthritis / 国际生物医学工程杂志

Knee osteoarthritis (KOA) is the main cause of knee pain and disability in the elderly. KOA is a complex disease that is controlled by a variety of pathogenic factors, including general physical factors such as age, gender, obesity, family history, and mechanical factors, and unfavorable mechanical factors to the knee joint, such as trauma, sports injuries, and daily routines. The prevalence of KOA is related to genetic factors. Currently, conservative treatment has limited effects to this disease, and knee joint replacement is usually associated with many complications. Mesenchymal stem cells(MSCs) were first discovered in the bone marrow and subsequently found in peripheral blood, cord blood, skeletal muscle, heart and adipose tissue, which have high plasticity and pluripotency. The discovery of MSCs provides a new method for the treatment of KOA. Due to its powerful cartilage repair and regeneration function, researchers have conducted a large number of experimental studies on the efficacy, safety and mechanism of MSCs in the treatment of KOA in recent years. In this paper, the above studies presented were systematically reviewed.

Research progress of the biomechanics in the rotational manipulation treatment of cervical spondylotic radiculopathy / 国际生物医学工程杂志

Cervical spondylotic radiculopathy is a common and frequently-occurring disease in the clinical department of orthopedics.It has the highest incidence of cervical spondylosis and has been classified as a difficult disease by the World Health Organization.Cervical spondylotic radiculopathy mainly manifests as root symptoms and signs consistent with the diseased segment,and the symptoms of stiffness,pain and numbness,which seriously affect the physical and mental health and life quality of patients.In clinical practice,the symptoms of cervical spondylotic radiculopathy can be alleviated by physical therapy,acupuncture,etc.Therefore,searching for more effective treatments has become a hot topic of current researches.Manipulations have the advantages of simple operation,quickness,quick effect and high recognition degree,and can achieve therapeutic purpose by improving the dynamic and static balance of cervical spines,correcting joint dislocation and improving blood circulation.Among them,the curative effect of rotational manipulations is more remarkable.The researches on rotational manipulations by domestic and foreign scholars mainly focus on the in vitro and in vivo biomechanics of cervical spines,and the biomechanical researches on the rotational manipulation itself were different.At present,the mechanical research on the rotational manipulation is still in the development stage,and there is no clear conclusion on the similarities and differences of the mechanical parameters and their influence on the mechanical environment of the cervical spine.In this paper,the research progress of biomechanical properties of cervical spine rotational manipulation was summarized to provide a theoretical basis for the mechanism of the rotational manipulation treatment of cervical spondylotic radiculopathy.

Dose-effect relationships of bipolar radio frequency heating / 中华物理医学与康复杂志

Objective To study the effect of the preset temperature,heating time and the spacing of radio frequency electrodes.Methods Fresh egg white was used to study the effects of heater spacing,temperature and heating time.Two electrodes were fixed to keep the needles perpendicular to the center of egg white confined on a square plate.Temperatures from 50 to 90℃ were tested with heating times of 60 and 120 seconds and electrode spac ings of 2.0,1.0,0.5 and 0.25 centimetres.The real-time temperature and the time to the appearance of a spindleshaped bridge between the electrodes was observed.The egg white's impedance and resistance,the lowest temperature of denaturation,and the mass (or volume) denatured at different time points were also observed.Results With an electrode spacing of 2 cm and the thermostat set at 63℃,the true electrode temperatures were 63.7 and 52.6℃,with the secondary electrode the cooler.Significant differences between the secondary electrode temperature and the preset temperature as well as the temperature between the primary and the secondary electrodes were observed.It was also found that different electrode spacing caused significant differences between the preset temperature and the primary as well as the secondary electrode temperature.Denaturation began at 56℃ with a spacing of 0.25 cm.At spacings of 0.25 and 0.50 cm,a spindle-shaped connection between the two electrodes was observed at temperatures above 70℃,but higher temperature was required at 1.00 and 2.00 cm.When the spacing was 0.25 cm and the preset temperature was 75℃,the denatured volume after 60 s of heating was 90.21+0.64 mm3.Heating for 120 s denatured 95.08+ 0.53 mm3 and two 60.s heatings 92.88+0.74 mm3,all significant differences.There were no significant differences in the resistance of the egg white before and after a single heating for 60 s,but after a single heating lasting 120 s it had increased significantly from 128.41+8.04 to 121.29±8.04 Ω.Conclusion Bipolar radio frequency heating can denature egg white.Higher temperature,longer heating and smaller electrode spacing heat more effectively.