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1.
PLoS One ; 15(6): e0234747, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584845

RESUMO

SUMMARY OF BACKGROUND DATA: The vascular buds in the vertebral endplate (VEP) are the structural foundation of nutrient exchange in the intervertebral disc (IVD). VEGF is closely related to angiogenesis in the endplate and intervertebral disc degeneration (IDD). OBJECTIVE: To investigate the effects of static load on vascular buds and VEGF expression in the VEP and to further clarify the relation between IDD and VEGF. METHODS: IVD motion segments were harvested from rabbit lumbar spines and cultured under no-loading conditions (controls) or in custom-made apparatuses under a constant compressive load (0.5 MPa) for up to 14 days. Tissue integrity and the number of vascular buds were determined, and the concentrations and expression of Aggrecan, COL2a1, and VEGFA in the VEPs were assessed after 3, 7, and 14 days of culturing and then compared with those of fresh tissues. RESULTS: Under the constant compression, the morphological integrity of the VEPs was gradually disrupted, and immunohistochemistry results showed a significant decrease in the levels of Agg and COL2a1. During the static load, the number of vascular buds in the VEPs was gradually reduced from the early stage of culture, and ELISA showed that the constant compressive load caused a significant decrease in the VEGFA and VEGFR2 protein concentrations, which were consistent with the immunohistochemistry results. Western blot and RT-PCR results also showed that the loading state caused a significant decrease in VEGFA expression compared with that of fresh and control samples. CONCLUSIONS: Constant compression caused degeneration of the VEP as well as a decreased number of vascular buds, thereby accelerating disc degeneration. VEGFA is involved in this process. We anticipate that regulating the expression of VEGFA may improve the condition of the lesions to the vascular buds in the endplates, thus enhancing the nutritional supply function in IVD and providing new therapeutic targets and strategies for the effective prevention and treatment of IDD.

3.
Zhongguo Gu Shang ; 33(4): 348-52, 2020 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-32351089

RESUMO

OBJECTIVE: To evaluate the clinical effect of arthroscopic 360° capsular release with concomitant rotator cuff repair for patients with rotator cuff tears in global stiff shoulder. METHODS: From December 2016 to December 2018, 247 patients full-thickness rotator cuff tear were treated with arthroscopic rotator cuff repair. Among them, 42 patients (17%) with global limitation of shoulder movement were treated with arthroscopic 360° capsular release operation at the same time of rotator cuff repair. The function of shoulder was evaluated by Constant-Murley score and visual analogue scales (VAS), flexion, abduction and external rotation on body side before and after operation. Sugaya classification was used to evaluatethe healing of rotator cuff. The number of shoulder dislocations during follow-up was recorded. RESULTS: Thirty nine of the 42 patients were followed up for 12 to 36 (22±6) months. The patients were 43 to 73 (57±7) years old at the time of operation. The Constant- Murley score increased from (43.6±6.3) before operation to (87.5±2.8) at final follow-up (P<0.001). VAS score decreased from (7.2±1.5) before operation to (1.0±0.9) at final follow-up (P<0.001). The flexion of shoulder increased from (46±14)° before operation to (148±11)° after operation (P<0.001), the abduction from (36±6)° before operation to (121±10)° after operation (P<0.001), and the external rotation on body side from (5±10)° before operation to (42±8)° after operation(P<0.001). One year after the operation, MRI showed thatⅠ-Ⅲ of Sugaya classification was clinical healing, 38 cases in total. CONCLUSION: Arthroscopic 360° capsular release with concomitant rotator cuff repair was used to treat rotator cuff tear in global stiff shoulder. Themain observation indexes were improved after operation, and the clinical effect was definite.


Assuntos
Lesões do Manguito Rotador , Articulação do Ombro , Adulto , Idoso , Artroscopia , Humanos , Liberação da Cápsula Articular , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Manguito Rotador , Lesões do Manguito Rotador/cirurgia , Ombro/cirurgia , Resultado do Tratamento
4.
Orthop Traumatol Surg Res ; 106(4): 671-680, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32446811

RESUMO

INTRODUCTION: Recurrence rates after primary traumatic shoulder dislocation are distinctly high. Whether the early external immobilization (ER) is better than the internal immobilization (IR) is still controversial. HYPOTHESIS: To perform a systematic review of randomized clinical trials (RCTs) that assessed the ability of external immobilization to reduce the recurrence in patients with primary anterior shoulder instability. MATERIAL AND METHOD: As with the original review, we used the search strategies recommended by the Cochrane Back Review Group for the identification of RCTs. Thirteen RCTs were included in the systematic review, and 11 studies were included in the quantitative synthesis. RESULT: A total of 1042 participants with primary shoulder dislocation were involved. The meta-analysis of 11 trials revealed that ER therapy leading to less recurrence rates than participants treated with IR therapy (RR=0.55; 95%CI: 0.36 to 0.82; Z=2.88; p=0.004), and less complications (RR=0.6; 95%CI: 0.39 to 0.92; Z=2.33; p=0.02) from the 5 independent trials. The meta-analysis of three trials revealed that there are not statistically significant in compliance rate (RR=1.08; 95%CI: 0.89 to 1.29; Z=0.78; p=0.44). The GRADE level of evidence is high for adverse events, but moderate for recurrence rate and Compliance rate. The Begg test showed that no significant publication bias was detected (p=0.062). DISCUSSION: This meta-analysis suggests that external immobilization is recommended to reduce the recurrence rate and prevent complications. LEVEL OF PROOF: II, low-powered systematic review and meta-analysis (systematic review, meta-analysis).

5.
Medicine (Baltimore) ; 99(18): e0037s, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358384

RESUMO

BACKGROUND: Cervical spondylotic radiculopathy (CSR) is one of the most common public health concerns in the world. Baduanjin is very widely and popularly practiced for the management of CSR. Therefore, we conducted a systematic review and meta-analysis to investigate the efficacy of Baduanjin exercise for patients with CSR. METHODS: The PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, Clinical Trials.gov, Cochrane Library, SinoMed, Chinese National Knowledge Infrastructure Database, Wan Fang database, and VIP databases were searched from inception to July 2019 to identify potentially eligible studies. The methodological quality of the included studies using the risk bias assessment tool of Cochrane. All statistical analysis are conducted with Revman 5.3. RESULTS: This systematic review and meta-analysis will provide a synthesis of existing evidences for the treatment of Baduanjin on CSR. CONCLUSION: The conclusions of this study will provide evidence to evaluate the effectiveness of Baduanjin for CSR, which can further guide the promotion and clinical decisions. PROSPERO REGISTRATION NUMBER: CRD42020149659.


Assuntos
Qigong/métodos , Radiculopatia/terapia , Espondilose/terapia , Humanos , Metanálise como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
6.
Virology ; 546: 122-126, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32452410

RESUMO

Since SARS-CoV-2 spreads rapidly around the world, data have been needed on the natural fluctuation of viral load and clinical indicators associated with it. We measured and compared viral loads of SARS-CoV-2 from pharyngeal swab, IgM anti-SARS-CoV-2, CRP and SAA from serum of 114 COVID-19 patients on admission. Positive rates of IgM anti-SARS-CoV-2, CRP and SAA were 80.7%, 36% and 75.4% respectively. Among IgM-positive patients, viral loads showed different trends among cases with different severity, While viral loads of IgM-negative patients tended to increase along with the time after onset. As the worsening of severity, the positive rates of CRP and SAA also showed trends of increase. Different CRP/SAA type showed associations with viral loads in patients in different severity and different time after onset. Combination of the IgM and CRP/SAA with time after onset and severity may give suggestions on the viral load and condition judgment of COVID-19 patients.


Assuntos
Anticorpos Antivirais/sangue , Infecções por Coronavirus/diagnóstico , Imunoglobulina M/sangue , Pneumonia Viral/diagnóstico , Carga Viral , Adolescente , Adulto , Idoso , Betacoronavirus , Biomarcadores/sangue , Proteína C-Reativa/análise , Criança , Infecções por Coronavirus/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Faringe/virologia , Pneumonia Viral/sangue , Proteína Amiloide A Sérica/análise , Adulto Jovem
7.
Zhongguo Zhong Yao Za Zhi ; 45(5): 1159-1166, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32237460

RESUMO

To evaluate the clinical efficacy and safety of Shentong Zhuyu Decoction in the treatment of lumbar disc herniation, in order to provide evidence for its clinical application. PubMed, Cochrane Library, EMbase, CNKI, WanFang, VIP, CBM and Clinical Trials.gov databases were sysmatically retrieved. Two researchers independently searched, screened and extracted data. Randomized controlled trials in line with the inclusion criteria were included in the study. The article quality was assessed with the bias risk tool in the Cochrane Handbook. Meta-analysis was performed using RevMan 5.3. A total of 604 articles were obtained from the retrieval, and 824 patients in 9 studies were finally selected through screening. The course of treatment was about 1 month, and all of the studies were completed in China. Meta-analysis showed that the efficacy of Shentong Zhuyu Decoction in the treatment of lumbar disc herniation was better than that of the control group(RR=1.19, 95%CI[1.12, 1.26], P<0.000 01), including the comparison with Yaotongning Capsules(RR=1.10, 95%CI[1.02, 1.19], P=0.01) and diclofenac sodium tablets(RR=1.26, 95%CI[1.11, 1.44], P=0.000 4). In VAS pain score, Shentong Zhuyu Decoction had also obvious advantages(MD=-3.70, 95%CI[-6.31,-1.09], P=0.005). In addition, the number of adverse events in the Shentong Zhuyu Decoction group was lower than that in the control group. Shentong Zhuyu Decoction can effectively alleviate discomfort symptoms of patients with LDH. It has an obvious clinical efficacy and less adverse reactions. However, restricted by the quality of the included literatures, prospective, multi-center, large-sample-size randomized controlled trials are still needed to further improve the clinical evidence of the effect of Shentong Zhuyu Decoction in the treatment of LDH.

8.
Zhongguo Zhong Yao Za Zhi ; 45(3): 609-616, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-32237520

RESUMO

The aim of this paper was to investigate the key targets and mechanism of "Epimedii Folium-Paeoniae Radix Alba" in the treatment of lumbar disc herniation by means of network pharmacology. The currently recognized databases and analysis software at home and abroad were used to construct the network from drugs and diseases. The chemical components of Epimedii Folium and Paeo-niae Radix Alba were collected by using databases such as TCMSP, while their active components were determined and the action targets were predicted according to threshold screening and literature reports. The genes for lumbar disc herniation were collected by using GeneCards, OMIM, and DisGeNET databases. The drug targets were mapped to disease targets, and protein interaction network analysis for key targets, GO function enrichment analysis and KEGG signaling pathway enrichment analysis were performed. Finally, 23 active components of Epimedium Folium and 13 active components of Paeoniae Radix Alba were determined, and a total of 624 drug targets were obtained. After standardization, 214 drug targets were obtained. In addition, 306, 2 and 5 related targets of lumbar disc herniation were collected from GeneCards, OMIM, and DisGeNET database, respectively, and a total of 293 disease targets were obtained after deduplication. After the mapping of drug target and disease target, 44 common targets were obtained. PPI protein interaction network analysis showed that IL-6, TNF, AKT1, MAPK1, and VEGFA may be the core targets for the treatment of lumbar disc herniation. GO enrichment analysis identified 56 items(P<0.05), among which biological processes mainly included immune response, apoptosis, etc.; cell components mainly included extracellular space, extracellular region, etc.; molecular functions mainly included cytokine activity, metallopeptidase activity and so on. Through KEGG pathway enrichment analysis, 91 signaling pathways related to inflammation, metabolism, and senescence were identified, mainly including IL-17 signaling pathway and TNF signaling pathway and so on. "Epimedii Folium-Paeoniae Radix Alba" showed the characteristics of multi-channel and multi-target for the treatment of lumbar disc herniation. This study preliminarily explored the key targets for its role and the biological processes and signaling pathways involved. It was found that it may play a therapeutic role by affecting inflammation and immune regulation, which laid the foundation for further experimental verification.

9.
Medicine (Baltimore) ; 99(16): e19840, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32312007

RESUMO

To determine the levels of parathyroid hormone (PTH) in the fluids of various tissues for identification of parathyroid glands during thyroidectomy.Our study comprised 31 patients with thyroid cancer who underwent lobectomy with central compartment dissection at our hospital from October 2014 to February 2015. A total of 186 tissue samples, including 28 from parathyroid glands and 158 from non-parathyroid tissues, were obtained during the operations. Tissue fluids were collected via fine-needle aspiration to measure PTH levels; the tissue was punctured 3 times with a 26-gauge syringe needle and washed with 0.5 mL normal saline. Tissues were also prepared for pathological examination.PTH concentrations were significantly higher in parathyroid tissues than non-parathyroid tissues. None of the patients had irremediable parathyroid dysfunction after surgical resection.Use of fine-needle aspiration for quantification of PTH levels in tissue fluids rapidly, safely, and effectively identifies the parathyroid glands during thyroidectomy.


Assuntos
Biópsia por Agulha Fina/métodos , Glândulas Paratireoides/cirurgia , Hormônio Paratireóideo/análise , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Adulto , Idoso , Feminino , Humanos , Hipotireoidismo/epidemiologia , Hipotireoidismo/prevenção & controle , Excisão de Linfonodo/métodos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória/normas , Doenças das Paratireoides/diagnóstico , Doenças das Paratireoides/fisiopatologia , Glândulas Paratireoides/patologia , Período Pós-Operatório , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/efeitos adversos
11.
Opt Lett ; 45(8): 2335-2338, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32287227

RESUMO

Terahertz (THz) sensing of molecular fingerprint enables wide applications in biomedicine and security detection. Conventional detection approaches face big barriers in trace analysis of analyte due to the difficulties of enhancing the broadband molecular absorption. In order to achieve strong broadband wave-matter interaction for the analyte, we propose a method based on THz wave angular scanning on a dielectric metagrating. In virtue of the guided-mode resonance, one can strengthen the local electric field in various trace-amount analytes by tuning the polarization and incident angle, which leads to significant enhancement on the broadband signal of molecular fingerprint. The study paves the way for more applications of THz trace-amount detection.

12.
Medicine (Baltimore) ; 99(9): e19310, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118755

RESUMO

BACKGROUND: Lumbar disc herniation (LDH) is 1 of the most common diseases in orthopedics, which seriously affects people's daily life and brings a heavy burden on society and families. Chinese herbal medicine has been used in clinical practice for a long time and Duhuo Jisheng Decoction (DHJSD) is believed to help alleviate the symptoms of LDH. This systematic review aims to collect evidences from randomized clinical trials and evaluate the efficacy of DHJSD on LDH in order to provide a reference for clinicians and researchers. METHODS: We will comprehensively search the 8 electronic databases until December 2019 to identify related randomized controlled trials, including 4 foreign databases (PubMed, MEDLINE, EMBASE, Cochrane Library) and 4 Chinese databases (China National Knowledge Infrastructure Database, VIP Database, Wanfang Database and China Biology Medicine disc). The data of the World Health Organization International Clinical Trial Registry Platform and the Chinese Clinical Trial Registry also will be searched. The primary outcomes are Japanese Orthopaedic Association scores and visual analog scale scores. The risk of bias will be assessed using the Cochrane Collaboration tool. RevMan (V.5.3) software will be used for meta-analysis. RESULTS: This study will report the results of DHJSD for the treatment of LDH from the literature screening, the basic information of the included studies, the risk of bias of the included studies, treatment effects, safety, and so on. CONCLUSION: This systematic review will evaluate the effectiveness and safety of DHJSD for the treatment of LDH and provide the latest evidence for its clinical application. ETHICS AND DISSEMINATION: This is a literature-based study, therefore it does not require ethical approval. PROSPERO REGISTRATION NUMBER: CRD42019147302.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Deslocamento do Disco Intervertebral/tratamento farmacológico , Região Lombossacral/lesões , Medicina Tradicional Chinesa/normas , Protocolos Clínicos , Medicamentos de Ervas Chinesas/normas , Humanos , Deslocamento do Disco Intervertebral/fisiopatologia , Medicina Tradicional Chinesa/métodos , Resultado do Tratamento
14.
Medicine (Baltimore) ; 99(7): e19137, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049834

RESUMO

BACKGROUND: Huangqi Guizhi Wuwu Decoction (HGWD) is a common prescription for the treatment of cervical radiculopathy (CR). And the effectiveness and safety of HGWD for CR were assessed in this study. METHODS: Seven databases were searched. Randomized controlled trials involving HGWD alone or HGWD combined with conventional treatment were enrolled. The authors in pairs independently assessed the risk of bias and extracted the data. RESULTS: Eight studies involving 783 participants with CR were included. Meta-analysis revealed that the efficacy of HGWD for CR was significantly superior compared with control treatment (risk ratio = 1.12, 95% confidence interval [CI]:1.06-1.19, Z = 3.71; P = .0002). Compare with control group, there is an increase in visual analog scale (mean difference [MD] = 0.99; 95% CI: 0.83-1.14; Z = 12.57; P < .00001). There was also an improvement of neck disability index (MD = 9.2; 95% CI: 8.28-10.11; Z = 19.75; P < .00001). Adverse events were not mentioned in the 8 trials. CONCLUSION: HGWD alone or HGWD plus other treatment may be helpful to patients with CR. However, the methodological quality of the randomized controlled trials was generally low. Larger and better-designed randomized controlled trials are recommended.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Radiculopatia/tratamento farmacológico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
15.
J Photochem Photobiol B ; 204: 111782, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32062389

RESUMO

BACKGROUND: Ultraviolet (UV) fluorescent lamp (FL) was applied in mainstream riboflavin photochemical method (RPM) to inactivate pathogens in blood components. Low UV irradiance emitted by UV-FL resulted in more time to achieve effective inactivation. MATERIALS AND METHODS: A novel light emitting diode (LED) UV illumination with adjustable irradiance was developed by us. Two strains of drug-resistant bacteria (DRB), pan-drug resistant Acinetobacter baumannii (PDRAB) and methicillin-resistant Staphylococcus aureus (MRSA) were cultured and used for evaluating the inactivation effectiveness of RPM using UV-LED or UV-FL against DRB in plasma or platelets. Three plasma factors and four platelet parameters were measured after treatments. RESULTS: There was a linear relationship between UV-LED irradiance and electric current, the minimum UV irradiance was 24 mW/cm2, and the maximum was 258 mW/cm2. At the same UV dose of 15 J/cm2, inactivation effectiveness of UV-LED with 258 mW/cm2 against PDRAB in plasma or platelets were comparable to that of UV-FL with 16 mW/cm2, both above 98%. UV-FL treatment required 10-15 min, but UV-LED only required 1-2 min. However, MRSA showed a resistance to UV-LED (inactivation effectiveness was around 40%) compared with UV-FL (inactivation effectiveness was above 98%). The retention of fibrinogen, factor V, factor VII in plasma and platelet counts in platelets with UV-LED treatment were significantly higher than UV-FL at the same UV dose. CONCLUSION: The treatment of RPM using UV-LED with high UV irradiance was able to dramatically shorten inactivation time against PDRAB in plasma or platelets and improve retention of blood components compared with UV-FL.


Assuntos
Proteínas Sanguíneas/metabolismo , Riboflavina/química , Raios Ultravioleta , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/efeitos da radiação , Plaquetas/citologia , Plaquetas/efeitos dos fármacos , Plaquetas/efeitos da radiação , Farmacorresistência Bacteriana/efeitos dos fármacos , Fator V/metabolismo , Fibrinogênio/metabolismo , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/efeitos da radiação , Contagem de Plaquetas , Riboflavina/farmacologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-31995363

RESUMO

Dynamic tuning of terahertz (THz) wave has a great potential application as smart THz devices, such as switches, modulators, sensors, and so on. However, the realization of flexible THz modulation with high efficiency is rarely observed, which is nearly absent from the booming development and demands on flexible electronics. Here, we report a flexible THz modulation based on conductive polymer composites composed of thermoplastic polyurethane (TPU) and conductive particles (Ni). By designing the additive content of Ni particles, such a flexible layer exhibits resistivity change of 6-7 orders under tensile strain due to the formation of an electron-transport channel provided by the in situ evolution of the Ni network. It could be used to dynamically control the THz transmission with a giant modulation depth of around 96%, at a high strain operation (up to around 58.5%). Moreover, these characteristics are demonstrated to be available for highly tension sensitive THz spectroscopy and imaging. This work opens up a connection between flexible polymer-based composites and THz dynamic devices. It proposes an unprecedented flexible THz modulation with giant tuning efficiency and provides a scheme for contactless and passive tension sensors.

17.
J Mol Model ; 26(2): 25, 2020 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-31927630

RESUMO

Based on the unique advantages of terahertz (THz) spectrum on the detection of energetic cocrystals, the low-temperature dependent THz spectra of CL-20/TNT cocrystal were investigated by using molecular dynamics (MD) simulations from 5 to 296 K, as well as three different crystal faces, (001), (120), and (010). When the temperature decreases below 95 K, we have observed two new peaks for CL-20/TNT cocrystal, at 4.58 and 5.99 THz, respectively. Also, the THz peaks below 1.5 THz gradually disappear under cooling from 296 to 5 K, and they should originate from the lattice thermal vibrations. THz absorption peaks of CL-20/TNT cocrystal reveal frequency shifting, linearly dependent on temperature. Four of them are red shift and other two are blue shift of THz vibrational peaks of CL-20/TNT cocrystal with the temperature increase. The frequency shifts can be attributed to the effects of lattice thermal expansion on inter-/intramolecular vibrational modes as well as their coupling. From the temperature-dependent THz spectra of different crystal faces, we further confirm the response of different kinds of intermolecular interactions on the THz spectrum of CL-20/TNT cocrystal. Graphical abstractThe intermolecular interactions and peak positions of THz spectra of CL-20/TNT cocrystal in the range of 0-6 THz versus temperature.

18.
Medicine (Baltimore) ; 98(49): e18135, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804324

RESUMO

BACKGROUND: Degenerative lumbar spondylolisthesis (DLS) is one of the common orthopedic diseases which causes low back pain in patients, which seriously affects people's daily life and work. As a method of conservative treatment of this disease, manipulation is widely used in clinical practice. We will summarize the current published evidence of manipulation in the treatment of DLS, and evaluate the effectiveness and safety of manipulation through systematic review and meta-analysis, so as to provide more reliable evidence for future clinical practice. METHODS: We will conduct a comprehensive search of the following 9 databases until January 2019: PubMed, Embase, Cochrane Library, ClinicalTrials.gov, Web of Science, Chinese National Knowledge Infrastructure, Chinese Science and Technique Journals Database, Wan Fang Database, and Chinese Biomedical Database. The 2 researchers will independently search, screen, extract data, and evaluate the quality of the literatures. The primary outcomes include clinical effectiveness, Japanese Orthopaedic Association scores, and the secondary outcomes include visual analog scale scores, symptom scores, and adverse events. Bias risk tools provided by Cochrane Collaboration will be used for literature quality assessment, and RevMan 5.3 software will be used for meta-analysis. RESULTS: The results of this study will systematically evaluate the effectiveness and safety of manipulation intervention for people with DLS, especially in improving lumbar function scores and pain scores. CONCLUSION: The systematic review of this study will summarize the current published evidence of manipulation for the treatment of DLS, which can further guide the promotion and application of it. ETHICS AND DISSEMINATION: This study does not require ethical approval and the results will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42019139933.


Assuntos
Vértebras Lombares , Manipulação da Coluna/métodos , Espondilolistese/terapia , Humanos , Manipulação da Coluna/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
19.
BMC Surg ; 19(1): 161, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690303

RESUMO

BACKGROUND: Wound-related complications are an inevitable issue faced by spinal surgeons. Negative pressure drainage remains the most commonly used method to prevent postoperative hematoma and related complications. This prospective, randomized, controlled study was conducted to evaluate the efficacy of compression therapy following posterior lumbar interbody fusion, with emphasis on pain, anemia, and inflammation. METHODS: Sixty consecutive patients who have undergone posterior lumbar interbody fusion in the age range 43-78 years, with an average age of 59 years, were selected and randomly assigned into two groups. Factors, such as drainage volume, visual analog scale (VAS) pain score for back pain, white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (Hb) levels, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels assessed on the 1st, 3rd, and 10th days postoperatively, were compared between the two groups. RESULTS: The average follow-up was 6 months, ranging from 3 to 11 months. Drainage volume, VAS score, and CRP levels on the 10th day after the surgery were found to be significantly lower in the treatment group than in the control group. RBC count and Hb levels on the 3rd and 10th postoperative days were observed to be significantly higher in the treatment group than in the control group (P < 0.05). During discharge, the wounds of the patients of the both groups had healed and neither showed any symptoms of infection, hematoma, or necrosis. CONCLUSION: Compression therapy relieves pain, alleviates anemia, and the inflammatory response following posterior lumbar interbody fusion. TRIAL REGISTRATION: ChiCTR1800015825 on chictr.org.cn, April 23, 2018, the trial registry is Chinese Clinical Trial Registry.


Assuntos
Dor nas Costas/cirurgia , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Adulto , Idoso , Feminino , Humanos , Inflamação/epidemiologia , Contagem de Leucócitos , Região Lombossacral , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Resultado do Tratamento
20.
Medicine (Baltimore) ; 98(45): e17733, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702624

RESUMO

BACKGROUND: Cervical radiculopathy (CR), which is most often stems from degenerative disease in the cervical spine, has increasingly become a common and frequently occurring disease in clinic due to the popularity of electronic products, such as computes and cell phones. Some studies have shown that exercise or exercise combined with other treatments can effectively decrease pain and improve functional status. The objective was to analyze the effects of exercise for treating patients with CR. METHODS: Seven databases were searched from inception to December 2018. Randomized controlled trials involving exercise alone or exercise combined with conventional treatment were enrolled. Data were pooled after trials quality assessment for meta-analysis. Outcomes were pain (visual analog scale [VAS]), quality of life (12-short form health survey, 36-short form health survey), and physical function accessed by neck disability index (NDI). RESULTS: Ten studies involving 871 participants with CR were included. Meta-analysis revealed that compared with control group, there was a reduction in VAS (standardized mean difference = -0.89; 95% confidence interval [CI]: -1.34 to -0.44; Z = 3.89; P < .001). There was also an improvement of NDI (mean difference = -3.60; 95% CI: -6.27 to -0.94; Z = 2.65; P = .008)]. Additionally, although the results of subgroup analyses were changed due to the paucity of the quantity and quality of the included studies. The pooled results were verified to be stable by sensitivity analyses. Besides, the grading of recommendations assessment, development, and evaluation level of evidence is low for each outcome. CONCLUSION: Exercise alone or exercise plus other treatment may be helpful to patients with CR. However, exercise option should be carefully considered for each patient with CR in accordance with their different situations. Large-scale studies using proper methodology are recommended.


Assuntos
Terapia por Exercício/métodos , Radiculopatia/reabilitação , Humanos , Medição da Dor , Qualidade de Vida , Resultado do Tratamento , Escala Visual Analógica
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