[Construction of a human cervical spine with bilateral vertebral artery fluid-solid coupling model].

OBJECTIVE: To construct a human cervical spine with bilateral vertebral artery fluid-solid coupling model. METHODS: Helical CT images under the principle of reverse engineering and meshed in finite element model（FEM） related software were used to establish a human cervical spine with bilateral vertebral artery fluid-solid coupling model. In the process of modeling of vertebral body, vertebral artery, ligament, intervertebral disc, cartilage and endplate large anatomic data and cadaver experiments results were referenced. From the morphology and function the simulation of model with real physiological status was tested. RESULTS: The study showed that the stress concentration on the surface of vertebral body and the blood wall of the bilateral vertebral artery, and the result of the volume flow rate-time curve of bilateral vertebral artery of the model were consistent with the published literatures. This model was well consistent with the clinical phenomenon. CONCLUSION: The three-dimensional FEM of the human cervical spine established by the introduced method has been effectively verified. The modeling method would provide a new tool for research on the cervical spine biomechanics.

[Effect of spinal manipulation on brain functional activity in patients with lumbar disc herniation].

OBJECTIVE: To investigate the effects of spinal manipulation (SM) on brain functional activity in patients with lumbar disc herniation (LDH). METHODS: Eleven patients with LDH were recruited in the study. All patients received 6 times of lumbar SM treatment and then clinical efficacy was evaluated. All patients received brain functional magnetic resonance imaging (fMRI) scans before and after SM treatment. RESULTS: Three subjects dropped out and 8 subjects completed the study, among whom 4 cases were effective and 4 ineffective after SM treatment. The required pressure value producing the same level (VAS 50) pain was (7.43 ± 1.47) kg and (10.53 ± 0.55) kg before and after SM treatment in effective patients(P<0.05); however, there was no significant difference in ineffective patients (P>0.05). Compared to pre-treatment level, the brain functional activity in effective patients was mainly inhibited, the inhibited areas were located in the right side of prefrontal cortex and cerebellum; while the brain functional activity was generally enhanced in ineffective patients. CONCLUSION: SM can affect the brain functional activity of patients with LDH, the inhibited areas is mainly located in prefrontal cortex and cerebellum when SM treatment is effective.

Efficacy and Safety of Tongning Gel for Knee Osteoarthritis: A Multicentre, Randomized, Double-Blinded, Parallel, Placebo-Controlled, Clinical Trial.

OBJECTIVE: To evaluate the efficacy and safety of Tongning Gel (TNG) compared to placebo-controlled (PC) for knee osteoarthritis (KOA). METHODS: A multicentre, randomized, double-blinded, parallel, placebo-controlled, clinical trial was performed in 576 patients (432 patients in the TNG group, 144 patients in the PC group), and 1 in the experimental group withdrew due to nonuse of drug. Patients were randomized to receive TNG or PC applied to knee skin at 3g per time, 2 times per day, which lasted for 3 weeks. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score was used to evaluate the primary efficacy of TNG and WOMAC stiffness and physical function and total scores were used to evaluate the secondary efficacy of TNG. All participants who received at least one dose of study drug were included in the safety analysis. This trial has been registered in Chinese Clinical Trial Registry (no. CTR20131276). RESULTS: Primary efficiency outcome: there were significant differences in the decreased value of WOMAC pain score between two groups (P < 0.05), and the decreased value of WOMAC pain score in the TNG group were better than those in the PC group (P < 0.05). Secondary efficiency outcome: the WOMAC total score, WOMAC stiffness score, WOMAC physical function score, and the decrease of the above indexes of the two groups of patients after treatment were statistically significant (P < 0.05), and the improvement of the above indexes in the TNG group was better than that of the PC group (P < 0.05). Safety Evaluation. A total of 42 adverse events were reported by 29 patients: 25 adverse events reported by 16 patients (3.71%) in the experimental group and 17 adverse events were reported by 13 patients (9.03%) in the control group. And 8 adverse reactions were reported by 6 patients including 2 adverse reactions by 2 patients (0.46%) in the experimental group and 6 adverse reactions by 4 patients (2.78%) in the control group. Two cases of significant adverse events occurred in the experimental group. Both groups had one serious adverse event, respectively, which were not relevant to the intervention. CONCLUSION: These results of the trial demonstrate that TNG is superior to placebo in the treatment of patients with KOA, and TNG can improve other symptoms of KOA, such as stiffness and physical function. TNG is safe for the treatment of knee osteoarthritis as a whole.

[Effects of electroacupuncture (EA) at early stage on functions of the limbs in the postoperative patient of hypertensive hemorrhage].

OBJECTIVE: To investigate the rehabilitation effect of electroacupuncture (EA) at early stage on hemiplegia in the postoperative patient of hypertensive hemorrhage. METHODS: Seventy-two cases of postoperative patient of hypertensive hemorrhage were divided into an EA group (n = 42) treated with EA at Quchi (LI 11), Shousanli (LI 10), Hegu (LI 4), Zusanli (ST 36), etc., from 1-3 days after operation, twice each day; and a control group (n = 30) with functional exercises. Their rehabilitation effects were compared after treatment of one month. RESULTS: The rehabilitation effect in the EA group was significant better than that in the control group (P < 0.01). CONCLUSION: EA at early stage has good recovery effect for the patient of hemiplegia after operation of hypertensive hemorrhage.