[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.

Two mutations in the transforming growth factor beta-induced gene associated with familial Lattice corneal dystrophy.

AIM: To report a phenotypic variant pedigree of lattice corneal dystrophy (LCD) associated with two mutations, R124C and A546D, in the transforming growth factor beta-induced gene (TGFBI). METHODS: A detailed ocular examination was taken for all participants of a LCD family. Peripheral blood leukocytes from each participant were extracted to obtain the DNA. Polymerase chain reaction (PCR) of all seventeen exons of TGFBI gene was performed. The products were sequenced and analyzed. Histological examination was carried out after a penetrating keratoplasty from the right eye of proband. RESULTS: Genetic analysis showed that the proband and all 6 affected individuals harbored both a heterozygous CGC to TGC mutation at codon 124 and a heterozygous GCC to GAC mutation at codon 546 of TGFBI. None of the 100 control subjects and unaffected family members was positive for these two mutations. Ocular examination displayed multiple refractile lattice-like opacities in anterior stroma of the central cornea and small granular deposits in the peripheral cornea. The deposits were stained positively with Congo red indicating be amyloid in nature and situated mainly in the anterior and middle stroma. CONCLUSION: We observed a novel LCD family which carried two pathogenic mutations (R124C and A546D) in the TGFBI gene. The phenotypic features were apparently different from those associated with corresponding single mutations. The result reveals that although the definite mutation is the most important genetic cause of the disease, some different modifier alleles may influence the phenotype.