OBJECTIVE: To investigate the effect of different heat-stimulating time lengths on lower back pain.METHODS: Forty participants were randomly assigned to four groups of various heating time lengths. The short heating t...OBJECTIVE: To investigate the effect of different heat-stimulating time lengths on lower back pain.METHODS: Forty participants were randomly assigned to four groups of various heating time lengths. The short heating time length group(SL),moderate heating time length group(ML), and long heating time length group(LL) respectively received 15, 30, and 60 min of moxibustion therapy stimulating the acupoint Guanyuan(CV 4). The conventional acupuncture group(CA) received needle acupuncture treatment as a control group. The participants were treated continuously over a 2-week treatment period for a total of 10 sessions, with five sessions given per week. Participants were assessed weekly by blinded assessors, using the visual analogue scale(VAS) and Roland Morris Questionnaire(RMQ).RESULTS: The VAS and RMQ scores reduced in all four groups during treatment. There were significant differences in VAS scores(P < 0.01) and RMQ scores(P < 0.01) between before treatment and after 2 weeks of treatment in the LL group. After treatment, the LL group reported significantly lower VAS scores compared with the CA group, ML group,and SL group(P < 0.05).CONCLUSION: The long and moderate lengths of heat-stimulating time of 30 and 60 min may be more effective for relieving lower back pain than that of short stimulating time lengths.展开更多
BACKGROUND Chondroid syringoma(CS)is a rare tumor of the apocrine or eccrine glands.CS of the lower back is rare,and its clinical manifestations are similar to those of lipoma,which is a common misdiagnosis for this d...BACKGROUND Chondroid syringoma(CS)is a rare tumor of the apocrine or eccrine glands.CS of the lower back is rare,and its clinical manifestations are similar to those of lipoma,which is a common misdiagnosis for this disease.CASE SUMMARY A 39-year-old woman presented with a 2-year history of an asymptomatic subcutaneous mass on the lower back.The lesions increased progressively over time.The patient denied any history.Dermatological examination showed that there was a subcutaneous mass,ranging from 3-4 cm in diameter,with a clear boundary on the lower back.The surface of the skin was smooth without ulceration or scaling.Histopathologic examination was consistent with the diagnosis of CS.CONCLUSION CS is a rare tumor of the apocrine or eccrine glands.It usually presents as a wellcircumscribed and single subcutaneous masses.Histopathology showed the tumor was located in the dermis,with nests,sheets,and cords of basal-like cells,mucin deposition,and chondroid structures.We herein report a case of CS located in the lower back.CS of the lower back is rare,and its clinical manifestations are similar to those of lipoma,for which it is commonly misdiagnosed.展开更多
In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with ...In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess stenosis.The impact of spinal pain-related disability extends significantly,causing substantial human suffering and medical costs.Each county has its preferred treatment strategies for spinal pain.Here,we explore the lower back pain(LBP)treatment algorithm recommended in France.The treatment algorithm for LBP recommended by the French National Authority for Health emphasizes early patient activity and minimal medication use.It encourages the continuation of daily activities,limits excessive medication and spinal injections,and incorporates psychological assessments and non-pharmacological therapies for chronic cases.However,the algorithm may not aggressively address acute pain in the early stages,potentially delaying relief and increasing the risk of chronicity.Additionally,the recommended infiltrations primarily involve caudal epidural steroid injections,with limited consideration for other injection procedures,such as transforaminal or interlaminar epidural steroid injections.The fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain,potentially delaying the exploration of alternative therapies.Despite these limitations,understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally,potentially enhancing patient outcomes and satisfaction across diverse healthcare systems.展开更多
We present a case of a woman with refractory lower back pain and forearm tendinitis, which improved dramatically after morphological modification of natural teeth. The subject was a 35-year-old Japanese woman, who was...We present a case of a woman with refractory lower back pain and forearm tendinitis, which improved dramatically after morphological modification of natural teeth. The subject was a 35-year-old Japanese woman, who was suffering from lower back pain when bending forward and she had severe pain from her right thumb to her wrist. These symptoms were not improved by massage and orthopedic treatment. On the other hand, once modifying the morphology of natural teeth, those symptoms improved dramatically. No side effects were observed, and the prognosis was good. Our observation suggested a close relationship between the oral situation and remote musculoskeletal conditions, and further multidisciplinary studies are needed to clarify the mechanisms.展开更多
The attrition of professional nurses is a sad reality. Work-related musculoskeletal lower back pain (WRMLBP) among nurses has been cited as a factor of increased sick leave and poor health. Occupational predisposing f...The attrition of professional nurses is a sad reality. Work-related musculoskeletal lower back pain (WRMLBP) among nurses has been cited as a factor of increased sick leave and poor health. Occupational predisposing factors of lower back pain are strenuous physical stresses of nursing, obesity and poor physical conditioning. Regular stretching and strengthening exercises dissipate lower back pain. This commentary’s objectives are to explain the association between obesity and lower back pain and the exercise mechanism that dissipates this pain, thereby concluding that nurses should consider regular exercise as a therapeutic option.展开更多
BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neu...BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.展开更多
Chronic lower back pain(LBP)is the leading cause of disability worldwide.Due to its close relationship with intervertebral disc(IVD)degeneration(IVDD),research has historically focused more on understanding the mechan...Chronic lower back pain(LBP)is the leading cause of disability worldwide.Due to its close relationship with intervertebral disc(IVD)degeneration(IVDD),research has historically focused more on understanding the mechanism behind IVDD while clinical efforts prioritize pain management.More recently,there has been a shift toward understanding LBP as a distinct pathological entity.This review synthesizes current knowledge on discogenic LBP,combining known pathophysiology,molecular mechanisms,risk factors,diagnostic challenges,and available experimental models.IVDD is a complex,multifactorial process involving biochemical,mechanical,and inflammatory changes within the disc,leading to structural breakdown and potential discogenic pain.Key mechanisms include extracellular matrix degradation,upregulation of inflammatory mediators,immune cell infiltration,and aberrant nerve and vascular ingrowth.However,not all cases of IVDD result in LBP,highlighting the need for further investigation into the cellular,molecular,and biomechanical factors contributing to symptom development.Current diagnostic tools and experimental models for studying discogenic LBP remain limited,impeding the development of targeted treatments.Existing therapies primarily focus on symptom management rather than addressing underlying disease mechanisms.展开更多
The sedimentary environment, formation conditions, sedimentary characteristics and the basin evolution model of high-frequency oscillatory lake in arid climatic background of the Lower Eocene in the Dongying depressio...The sedimentary environment, formation conditions, sedimentary characteristics and the basin evolution model of high-frequency oscillatory lake in arid climatic background of the Lower Eocene in the Dongying depression were studied through the analysis of drilling cores, sporepollen, geochemistry and geophysics data. During the sedimentary period of the Eocene Ek^3-Es^4x formations, because of the frequent alternation between dry and wet climates in the arid climatic background and the gentle paleo- geomorphology, the lake level and salinity of the Early Eocene Dongying depression frequently and rap- idly increased and decreased, which is referred to as a high-frequency oscillatory lake. The sedimentation and distribution of sediments in this high-frequency oscillatory lake basin were controlled by the fre- quently alternating dry-wet climates. During periods with relatively wet climate, the seasonal floods and unstable rivers led to the formation of over-flooding lake deltas in the gentle slope belt, and fine-grained clastic sediments, with minor thin layers of gypsum-salt rocks in the sag belt. During the relatively arid climatic periods, sedimentation occurred mainly in the limited area of the sag belt with thick gypsum-salt rocks. Because of the impact of the salinity stratification of the lake water, these gypsum-salt rocks exhibit annular structural features. A sedimentary cycle of the oscillatory lake began with isochronous flood channels and ended with relatively thick gypsum rocks and salt rocks. The thickness of one oscillatory cy- cle is generally 4-20 m. The superposition of multiple sedimentary cycles of the oscillatory lake constitutes the overall vertical idling sequence of the high-frequency oscillatory lake basin.展开更多
Exoskeletons generally require accurate dynamic models to design the model-based controller conveniently under the human-robot interaction condition.However,due to unknown model parameters such as the mass,moment of i...Exoskeletons generally require accurate dynamic models to design the model-based controller conveniently under the human-robot interaction condition.However,due to unknown model parameters such as the mass,moment of inertia and mechanical size,the dynamic model of exoskeletons is difficult to construct.Hence,an enhanced whale optimization algorithm(EWOA)is proposed to identify the exoskeleton model parameters.Meanwhile,the periodic excitation trajectories are designed by finite Fourier series to input the desired position demand of exoskeletons with mechanical physical constraints.Then a backstepping controller based on the identified model is adopted to improve the human-robot wearable comfortable performance under cooperative motion.Finally,the proposed Model parameters identification and control are verified by a two-DOF exoskeletons platform.The knee joint motion achieves a steady-state response after 0.5 s.Meanwhile,the position error of hip joint response is less than 0.03 rad after 0.9 s.In addition,the steady-state human-robot interaction torque of the two joints is constrained within 15 N·m.This research proposes a whale optimization algorithm to optimize the excitation trajectory and identify model parameters.Furthermore,an enhanced mutation strategy is adopted to avoid whale evolution’s unsatisfactory local optimal value.展开更多
The paper systematically deals with the background of regional isotopic compo-sitions in the lower and middle reaches of the Yangtze River and neighbouring areas. It isshown that the lead isotopic compositions of diff...The paper systematically deals with the background of regional isotopic compo-sitions in the lower and middle reaches of the Yangtze River and neighbouring areas. It isshown that the lead isotopic compositions of different geological formations and units are con-trolled by the primary mantle heterogeneity, dynamic process of crust-mantle interchange,abundances of uraninm, thorium and lead of various layers of the earth and timing. Studies onthe background of regional isotopic compositions may offer significant information forgeochemical regionalization, tracing of sources of ore-forming materials, and regionalprognosis of ore deposits.展开更多
Mandibular advancement devices(MADs)are widely used treatments for obstructive sleep apnea.MADs function by advancing the lower jaw to open the upper airway.To increase patient comfort,most patients allow the mouth to...Mandibular advancement devices(MADs)are widely used treatments for obstructive sleep apnea.MADs function by advancing the lower jaw to open the upper airway.To increase patient comfort,most patients allow the mouth to be opened.However,not all systems maintain the lower jaw in a forward position during mouth opening,which results in the production of a retrusion that favors the collapse of the upper airway.Furthermore,the kinematic behavior of the mechanism formed by the mandible-device assembly depends on jaw morphology.This means that,during mouth opening,some devices cause lower jaw protrusion in some patients,but cause its retraction in others.In this study,we report the behavior of well-known devices currently on themarket.To do so,we developed a kinematic model of the lower jawdevice assembly.Thismodelwas validated for all devices analyzed using a high-resolution camera system.Our results show that some of the devices analyzed here did not produce the correct behavior during patient mouth opening.展开更多
It is very important to study the archaeological culture and origin of civilization in ancient China.The changes of the channels in the lower reaches of the Yellow River in the prehistoric period are part of the natur...It is very important to study the archaeological culture and origin of civilization in ancient China.The changes of the channels in the lower reaches of the Yellow River in the prehistoric period are part of the natural environmental background of the development of the ancient civilization in that area to be explored.This paper presents a series of legends,indications,scientific evidence,and macroscopic geographical background information of the evolution in the lower reaches of the Yellow River during the Longshan period.At first the river flowed from Northern Henan and Hebei to southwestern Shandong Province and Northern Anhui–Jiangsu provinces,and the mainstream of the Yellow River changed from the southeast to return to the north and flowed into the Bohai Sea in the late Longshan Period.During this period,floods were frequent.Various ethnic groups in the northern China plains suffered natural disasters and made great migrations which also contributed to the ethnic exchanges and integration.The people of the Central Plains made more dynamic adjustments in the relationship between mankind and the land by primitively escaping from the water and self–defensively controlling the rivers then to maintaining the local ecological environment by large–scale flood control measures,which promoted the settlement of Shandong,Henan,Jiangsu and Anhui provinces,the urban cultural development,and social evolution.Based on these events,the culture symbol of Dayu's Flood Control could be formed.展开更多
Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze...Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.展开更多
BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the cli...BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the clinical symptoms of achalasia associated with increased LES pressure.AIM To identify the safety and efficacy of POEM for patients with normal LES integrated relaxation pressure(LES-IRP).METHODS The clinical data of patients who underwent POEM successfully in The First Medical Center of Chinese PLA General Hospital were retrospectively analyzed.A total of 481 patients who underwent preoperative high-resolution manometry(HRM)at our hospital were ultimately included in this research.According to the HRM results,the patients were divided into two groups:71 patients were included in the normal LES-IRP group(LES-IRP<15 mmHg)and 410 patients were included in the increased LES-IRP group(LES-IRP≥15 mmHg).Clinical characteristics,procedure-related parameters,adverse events,and outcomes were compared between the two groups to evaluate the safety and efficacy of POEM for patients with normal LES-IRP.RESULTS Among the 481 patients included in our study,209 were males and 272 were females,with a mean age of 44.2 years.All patients underwent POEM without severe adverse events.The median pre-treatment Eckardt scores of the normal LES-IRP and increased LES-IRP groups were 7.0 and 7.0(P=0.132),respectively,decreasing to 1.0 and 1.0 post-treatment(P=0.572).The clinical success rate of the normal LES-IRP group was 87.3%(62/71),and that of the increased LES-IRP group was 91.2%(374/410)(P=0.298).Reflux symptoms were measured by the GerdQ questionnaire,and the percentages of patients with GerdQ scores≥9 in the normal LES-IRP and increased LES-IRP groups were 8.5%and 10.7%,respectively(P=0.711).After matching,the rates of clinical success and the rates of GerdQ score≥9 were not significantly different between the two groups.CONCLUSION Our results suggest that POEM is safe and effective for achalasia and patients with normal LES-IRP.In addition,in patients with normal LES-IRP,compared with those with increased LES-IRP,POEM was not associated with a greater incidence of reflux symptoms.展开更多
Objective: to analyze the clinical value of biofeedback training in elderly stroke patients to promote the recovery of their lower extremity motor dysfunction. Methods: from January 2021 to January 2022, 76 cases of s...Objective: to analyze the clinical value of biofeedback training in elderly stroke patients to promote the recovery of their lower extremity motor dysfunction. Methods: from January 2021 to January 2022, 76 cases of senile stroke were diagnosed in our hospital. They were divided into two groups: control group and observation group. There were 38 cases in each group. The control group was treated with conventional drugs and rehabilitation training. The observation group further increased biofeedback training Lower limb motor dysfunction and daily living ability were evaluated and compared. Results: the difference of Fugl-Meyer scale score between the two groups before treatment was small (P>0.05), and the score of Fugl-Meyer scale in the observation group was higher than that in the control group after treatment (P<0.05);The difference of Barthel index between the two groups before treatment was small (P>0.05), and the Barthel index in the observation group was higher than that in the control group after treatment (P<0.05);The difference of NIHSS scores between the two groups before treatment was small (P>0.05), and the NIHSS scores in the observation group were lower than those in the control group after treatment (P<0.05). Conclusion: the combined use of biofeedback training for elderly stroke patients can effectively promote the rehabilitation of patients, improve their neurological function, enhance the motor function of lower limbs and the ability of self-care in life.展开更多
Here we report a left cheek plate of Psarolepis,a postparietal shield of Youngolepis,a skull of Diabolepis,and a scale of Styloichthys from the Lianhuashan and Nahkaoling formations(Lochkovian,Lower Devonian)of Nannin...Here we report a left cheek plate of Psarolepis,a postparietal shield of Youngolepis,a skull of Diabolepis,and a scale of Styloichthys from the Lianhuashan and Nahkaoling formations(Lochkovian,Lower Devonian)of Nanning,Guangxi.This marks the first report of Diabolepis and Styloichthys beside Qujing,Yunnan,and the latest occurrence of Psarolepis to date.The fossil community displays significant similarities to the Xujiachong Assemblage,and provides new data for the Lower Devonian stratigraphic correlation between southwestern China and northern Vietnam.Given the latest dating constraint based on the conodont evidence,we regard that the Xujiachong Assemblage has a much longer range than previously supposed,extending from the latest Lochkovian to the end of Pragian.We propose that the transition of the Nahkaoling and Lianhuashan formations in Nanning might correspond to the Guijiatun Formation in Qujing.The relatively large size of fish individuals from Guangxi is probably attributed to the increase in the oxygen content of the ocean.展开更多
Shale gas is abundant in the Paleozoic of the Yangtze Platform,and several high-yield shale gas fields have been built in the Upper Yangtze Platform,China.The Permian of the South Yellow Sea Basin(SYSB)in the Lower Ya...Shale gas is abundant in the Paleozoic of the Yangtze Platform,and several high-yield shale gas fields have been built in the Upper Yangtze Platform,China.The Permian of the South Yellow Sea Basin(SYSB)in the Lower Yangtze area is considered a potential target for shale gas exploration;however,the fundamental geological conditions of shale gas have not been studied.Based on the first whole-cored scientific drilling borehole(CSDP-2)in the SYSB,detailed tests involving petrology,organic geochemistry,and reservoir physical properties were conducted to evaluate the shale gas potential of the Lower Permian.The Lower Permian is dominated by organic-rich siliceous,clay,and clay-mixed shales.The average total organic carbon content is 5.99%,and the organic matter is mainly type Ⅱ_(1)−Ⅱ_(2),which has entered the high-over mature evolution stage.The pore types of organic-rich shales mainly include organic pores,dissolution pores,and intergranular pores,of which the meso-/macropores are well developed.The average porosity is 3.04%,and the total specific surface area and pore volume are 3.47 m^(2)/g and 7.21×10^(−3) cm^(3)/g,respectively.The average Langmuir volume obtained from the methane adsorption isotherms is 2.70 cm^(3)/g,and methane is mainly adsorbed in the meso-/macropores.The lower Permian shales are rich in methane as indicated by gas logging results,with an average content of 7.3%,which can reach up to 65.9%.A comparison of the study area with typical shale gas fields shows that the Lower Permian is brittle and shallowly buried and has a high potential for shale gas exploration and low-cost development.The depression areas of the SYSB are overlain by thick Mesozoic-Cenozoic sediments,show higher organic matter maturity,and may have greater shale gas potential.The shale gas exploration breakthrough of the study area is of great significance to ensure the energy supply of economically developed areas on the east China.展开更多
Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients....Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients.Methods We performed a retrospective analysis of the National Inpatient Sample(2016–2021)to identify adult patients with CAD who underwent lower limb amputation.Frailty was defined using the Johns Hopkins Adjusted Clinical Groups(ACG)frailty indicator.Multivariable logistic regression was used to assess the independent association of frailty with in-hospital outcomes,and propensity score matching(PSM)was performed to further account for confounding factors.Results After PSM,9,990 patients were included in each cohort.Frail patients experienced higher rates of in-hospital mortality(3.9%vs.1.5%,P<0.001),acute limb ischemia(3.8%vs.3.1%,P=0.015),fasciotomy(2.1%vs.1.4%,P<0.001),stump infection(7.9%vs.6.6%,P<0.001),cardiogenic shock(0.9%vs.0.7%,P=0.032),sudden cardiac arrest(2.7%vs.2.1%,P=0.004),mechanical circulatory support(0.3%vs.0.2%,P=0.028),major adverse cardiac and cerebrovascular events(7.7%vs.5.4%,P<0.001),and sepsis(18.3%vs.13.8%,P<0.001).In multivariable logistic regression analysis,frailty remained an independent predictor of inhospital mortality and major complications.Conclusion Frailty is independently associated with increased in-hospital mortality and adverse events among CAD patients undergoing lower limb amputation.Incorporating frailty assessment into preoperative evaluation may improve risk stratification and guide clinical decision-making in this high-risk population.展开更多
基金Supported by the National Natural Science Foundation of China(Study the Mechanism Based On the P38mapk Signal Pathway Mediated by Cautery Moxibustion Therapy of Hui Medicine Treatment Idd,No.81360567 And Research on Mechanism of Koa Treated By Cautery Moxibustion of Hui Medicine Based on Wnt/β-catenin Signaling Pathway,No.81460757)Ningxia Natural Science Foundation(Evaluation of Different Moxibustion Doses for Low Back Pain,No.NZ11208)
文摘OBJECTIVE: To investigate the effect of different heat-stimulating time lengths on lower back pain.METHODS: Forty participants were randomly assigned to four groups of various heating time lengths. The short heating time length group(SL),moderate heating time length group(ML), and long heating time length group(LL) respectively received 15, 30, and 60 min of moxibustion therapy stimulating the acupoint Guanyuan(CV 4). The conventional acupuncture group(CA) received needle acupuncture treatment as a control group. The participants were treated continuously over a 2-week treatment period for a total of 10 sessions, with five sessions given per week. Participants were assessed weekly by blinded assessors, using the visual analogue scale(VAS) and Roland Morris Questionnaire(RMQ).RESULTS: The VAS and RMQ scores reduced in all four groups during treatment. There were significant differences in VAS scores(P < 0.01) and RMQ scores(P < 0.01) between before treatment and after 2 weeks of treatment in the LL group. After treatment, the LL group reported significantly lower VAS scores compared with the CA group, ML group,and SL group(P < 0.05).CONCLUSION: The long and moderate lengths of heat-stimulating time of 30 and 60 min may be more effective for relieving lower back pain than that of short stimulating time lengths.
基金Supported by Shenzhen Sanming Project,No.SZSM201812059Shenzhen Key Medical Discipline Construction Fund,No.SZXK040。
文摘BACKGROUND Chondroid syringoma(CS)is a rare tumor of the apocrine or eccrine glands.CS of the lower back is rare,and its clinical manifestations are similar to those of lipoma,which is a common misdiagnosis for this disease.CASE SUMMARY A 39-year-old woman presented with a 2-year history of an asymptomatic subcutaneous mass on the lower back.The lesions increased progressively over time.The patient denied any history.Dermatological examination showed that there was a subcutaneous mass,ranging from 3-4 cm in diameter,with a clear boundary on the lower back.The surface of the skin was smooth without ulceration or scaling.Histopathologic examination was consistent with the diagnosis of CS.CONCLUSION CS is a rare tumor of the apocrine or eccrine glands.It usually presents as a wellcircumscribed and single subcutaneous masses.Histopathology showed the tumor was located in the dermis,with nests,sheets,and cords of basal-like cells,mucin deposition,and chondroid structures.We herein report a case of CS located in the lower back.CS of the lower back is rare,and its clinical manifestations are similar to those of lipoma,for which it is commonly misdiagnosed.
基金Supported by The National Research Foundation of Korea Grant funded by the Korea Government,No.00219725.
文摘In this editorial we comment on the article published in a recent issue of the World Journal of Clinical Cases.This article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess stenosis.The impact of spinal pain-related disability extends significantly,causing substantial human suffering and medical costs.Each county has its preferred treatment strategies for spinal pain.Here,we explore the lower back pain(LBP)treatment algorithm recommended in France.The treatment algorithm for LBP recommended by the French National Authority for Health emphasizes early patient activity and minimal medication use.It encourages the continuation of daily activities,limits excessive medication and spinal injections,and incorporates psychological assessments and non-pharmacological therapies for chronic cases.However,the algorithm may not aggressively address acute pain in the early stages,potentially delaying relief and increasing the risk of chronicity.Additionally,the recommended infiltrations primarily involve caudal epidural steroid injections,with limited consideration for other injection procedures,such as transforaminal or interlaminar epidural steroid injections.The fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain,potentially delaying the exploration of alternative therapies.Despite these limitations,understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally,potentially enhancing patient outcomes and satisfaction across diverse healthcare systems.
文摘We present a case of a woman with refractory lower back pain and forearm tendinitis, which improved dramatically after morphological modification of natural teeth. The subject was a 35-year-old Japanese woman, who was suffering from lower back pain when bending forward and she had severe pain from her right thumb to her wrist. These symptoms were not improved by massage and orthopedic treatment. On the other hand, once modifying the morphology of natural teeth, those symptoms improved dramatically. No side effects were observed, and the prognosis was good. Our observation suggested a close relationship between the oral situation and remote musculoskeletal conditions, and further multidisciplinary studies are needed to clarify the mechanisms.
文摘The attrition of professional nurses is a sad reality. Work-related musculoskeletal lower back pain (WRMLBP) among nurses has been cited as a factor of increased sick leave and poor health. Occupational predisposing factors of lower back pain are strenuous physical stresses of nursing, obesity and poor physical conditioning. Regular stretching and strengthening exercises dissipate lower back pain. This commentary’s objectives are to explain the association between obesity and lower back pain and the exercise mechanism that dissipates this pain, thereby concluding that nurses should consider regular exercise as a therapeutic option.
基金Supported by the Central Guided Local Science and Technology Development Fund Project for Science and Technology Innovation Base Construction,No.Guike ZY24212046National Natural Science Foundation of China,No.U22A2092+3 种基金Guangxi Education Science“the 14th Five-Year Plan”2024 Special Project“Research on Steam Education Practice in Rehabilitation Engineering”,No.2024ZJY304the Research Basic Ability Enhancement Program for Young and Middle-aged Teachers of Guangxi,No.2025KY2255the Innovation Project of GUET Graduate Education,No.2025YCXB010Natural Science Research Project of Guilin Life and Health Career Technical College,No.2025GKKY04.
文摘BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.
基金supported by the California Institute for Regenerative Medicine under EDUC4-12751(Giselle Kaneda)DISC2-14049(Dmitriy Sheyn)+1 种基金Additional support was provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award numbers R01AR066517(Debiao Li)R01AR082041(Dmitriy Sheyn).
文摘Chronic lower back pain(LBP)is the leading cause of disability worldwide.Due to its close relationship with intervertebral disc(IVD)degeneration(IVDD),research has historically focused more on understanding the mechanism behind IVDD while clinical efforts prioritize pain management.More recently,there has been a shift toward understanding LBP as a distinct pathological entity.This review synthesizes current knowledge on discogenic LBP,combining known pathophysiology,molecular mechanisms,risk factors,diagnostic challenges,and available experimental models.IVDD is a complex,multifactorial process involving biochemical,mechanical,and inflammatory changes within the disc,leading to structural breakdown and potential discogenic pain.Key mechanisms include extracellular matrix degradation,upregulation of inflammatory mediators,immune cell infiltration,and aberrant nerve and vascular ingrowth.However,not all cases of IVDD result in LBP,highlighting the need for further investigation into the cellular,molecular,and biomechanical factors contributing to symptom development.Current diagnostic tools and experimental models for studying discogenic LBP remain limited,impeding the development of targeted treatments.Existing therapies primarily focus on symptom management rather than addressing underlying disease mechanisms.
基金supported by the National Natural Science Foundation of China(Nos.41402095,U1262203)the Chinese Postdoctoral Science Foundation(No.2014M550380)the China National Science and Technology Special Funds(Nos.2011ZX05051-001,2011ZX05006-003)
文摘The sedimentary environment, formation conditions, sedimentary characteristics and the basin evolution model of high-frequency oscillatory lake in arid climatic background of the Lower Eocene in the Dongying depression were studied through the analysis of drilling cores, sporepollen, geochemistry and geophysics data. During the sedimentary period of the Eocene Ek^3-Es^4x formations, because of the frequent alternation between dry and wet climates in the arid climatic background and the gentle paleo- geomorphology, the lake level and salinity of the Early Eocene Dongying depression frequently and rap- idly increased and decreased, which is referred to as a high-frequency oscillatory lake. The sedimentation and distribution of sediments in this high-frequency oscillatory lake basin were controlled by the fre- quently alternating dry-wet climates. During periods with relatively wet climate, the seasonal floods and unstable rivers led to the formation of over-flooding lake deltas in the gentle slope belt, and fine-grained clastic sediments, with minor thin layers of gypsum-salt rocks in the sag belt. During the relatively arid climatic periods, sedimentation occurred mainly in the limited area of the sag belt with thick gypsum-salt rocks. Because of the impact of the salinity stratification of the lake water, these gypsum-salt rocks exhibit annular structural features. A sedimentary cycle of the oscillatory lake began with isochronous flood channels and ended with relatively thick gypsum rocks and salt rocks. The thickness of one oscillatory cy- cle is generally 4-20 m. The superposition of multiple sedimentary cycles of the oscillatory lake constitutes the overall vertical idling sequence of the high-frequency oscillatory lake basin.
基金Supported by National Key Research and Development Program of China(Grant No.2022YFF0708903)Ningbo Municipal Key Technology Research and Development Program of China(Grant No.2022Z006)Youth Fund of National Natural Science Foundation of China(Grant No.52205043)。
文摘Exoskeletons generally require accurate dynamic models to design the model-based controller conveniently under the human-robot interaction condition.However,due to unknown model parameters such as the mass,moment of inertia and mechanical size,the dynamic model of exoskeletons is difficult to construct.Hence,an enhanced whale optimization algorithm(EWOA)is proposed to identify the exoskeleton model parameters.Meanwhile,the periodic excitation trajectories are designed by finite Fourier series to input the desired position demand of exoskeletons with mechanical physical constraints.Then a backstepping controller based on the identified model is adopted to improve the human-robot wearable comfortable performance under cooperative motion.Finally,the proposed Model parameters identification and control are verified by a two-DOF exoskeletons platform.The knee joint motion achieves a steady-state response after 0.5 s.Meanwhile,the position error of hip joint response is less than 0.03 rad after 0.9 s.In addition,the steady-state human-robot interaction torque of the two joints is constrained within 15 N·m.This research proposes a whale optimization algorithm to optimize the excitation trajectory and identify model parameters.Furthermore,an enhanced mutation strategy is adopted to avoid whale evolution’s unsatisfactory local optimal value.
基金This study was co-supported by the State Eighth Five-Year Plan Scientific Project(No.85-901-03-08D)and National Natural Science Foundation of China(No.49473187).
文摘The paper systematically deals with the background of regional isotopic compo-sitions in the lower and middle reaches of the Yangtze River and neighbouring areas. It isshown that the lead isotopic compositions of different geological formations and units are con-trolled by the primary mantle heterogeneity, dynamic process of crust-mantle interchange,abundances of uraninm, thorium and lead of various layers of the earth and timing. Studies onthe background of regional isotopic compositions may offer significant information forgeochemical regionalization, tracing of sources of ore-forming materials, and regionalprognosis of ore deposits.
基金supported by the research contracts 806/31.4830 and 806/31.5511 between the private company Laboratorio Ortoplus S.L.and the University of Malaga.
文摘Mandibular advancement devices(MADs)are widely used treatments for obstructive sleep apnea.MADs function by advancing the lower jaw to open the upper airway.To increase patient comfort,most patients allow the mouth to be opened.However,not all systems maintain the lower jaw in a forward position during mouth opening,which results in the production of a retrusion that favors the collapse of the upper airway.Furthermore,the kinematic behavior of the mechanism formed by the mandible-device assembly depends on jaw morphology.This means that,during mouth opening,some devices cause lower jaw protrusion in some patients,but cause its retraction in others.In this study,we report the behavior of well-known devices currently on themarket.To do so,we developed a kinematic model of the lower jawdevice assembly.Thismodelwas validated for all devices analyzed using a high-resolution camera system.Our results show that some of the devices analyzed here did not produce the correct behavior during patient mouth opening.
文摘It is very important to study the archaeological culture and origin of civilization in ancient China.The changes of the channels in the lower reaches of the Yellow River in the prehistoric period are part of the natural environmental background of the development of the ancient civilization in that area to be explored.This paper presents a series of legends,indications,scientific evidence,and macroscopic geographical background information of the evolution in the lower reaches of the Yellow River during the Longshan period.At first the river flowed from Northern Henan and Hebei to southwestern Shandong Province and Northern Anhui–Jiangsu provinces,and the mainstream of the Yellow River changed from the southeast to return to the north and flowed into the Bohai Sea in the late Longshan Period.During this period,floods were frequent.Various ethnic groups in the northern China plains suffered natural disasters and made great migrations which also contributed to the ethnic exchanges and integration.The people of the Central Plains made more dynamic adjustments in the relationship between mankind and the land by primitively escaping from the water and self–defensively controlling the rivers then to maintaining the local ecological environment by large–scale flood control measures,which promoted the settlement of Shandong,Henan,Jiangsu and Anhui provinces,the urban cultural development,and social evolution.Based on these events,the culture symbol of Dayu's Flood Control could be formed.
基金supported by the National High Level Hospital Clinical Research Funding(No.BJ-2023-066).
文摘Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.
文摘BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the clinical symptoms of achalasia associated with increased LES pressure.AIM To identify the safety and efficacy of POEM for patients with normal LES integrated relaxation pressure(LES-IRP).METHODS The clinical data of patients who underwent POEM successfully in The First Medical Center of Chinese PLA General Hospital were retrospectively analyzed.A total of 481 patients who underwent preoperative high-resolution manometry(HRM)at our hospital were ultimately included in this research.According to the HRM results,the patients were divided into two groups:71 patients were included in the normal LES-IRP group(LES-IRP<15 mmHg)and 410 patients were included in the increased LES-IRP group(LES-IRP≥15 mmHg).Clinical characteristics,procedure-related parameters,adverse events,and outcomes were compared between the two groups to evaluate the safety and efficacy of POEM for patients with normal LES-IRP.RESULTS Among the 481 patients included in our study,209 were males and 272 were females,with a mean age of 44.2 years.All patients underwent POEM without severe adverse events.The median pre-treatment Eckardt scores of the normal LES-IRP and increased LES-IRP groups were 7.0 and 7.0(P=0.132),respectively,decreasing to 1.0 and 1.0 post-treatment(P=0.572).The clinical success rate of the normal LES-IRP group was 87.3%(62/71),and that of the increased LES-IRP group was 91.2%(374/410)(P=0.298).Reflux symptoms were measured by the GerdQ questionnaire,and the percentages of patients with GerdQ scores≥9 in the normal LES-IRP and increased LES-IRP groups were 8.5%and 10.7%,respectively(P=0.711).After matching,the rates of clinical success and the rates of GerdQ score≥9 were not significantly different between the two groups.CONCLUSION Our results suggest that POEM is safe and effective for achalasia and patients with normal LES-IRP.In addition,in patients with normal LES-IRP,compared with those with increased LES-IRP,POEM was not associated with a greater incidence of reflux symptoms.
文摘Objective: to analyze the clinical value of biofeedback training in elderly stroke patients to promote the recovery of their lower extremity motor dysfunction. Methods: from January 2021 to January 2022, 76 cases of senile stroke were diagnosed in our hospital. They were divided into two groups: control group and observation group. There were 38 cases in each group. The control group was treated with conventional drugs and rehabilitation training. The observation group further increased biofeedback training Lower limb motor dysfunction and daily living ability were evaluated and compared. Results: the difference of Fugl-Meyer scale score between the two groups before treatment was small (P>0.05), and the score of Fugl-Meyer scale in the observation group was higher than that in the control group after treatment (P<0.05);The difference of Barthel index between the two groups before treatment was small (P>0.05), and the Barthel index in the observation group was higher than that in the control group after treatment (P<0.05);The difference of NIHSS scores between the two groups before treatment was small (P>0.05), and the NIHSS scores in the observation group were lower than those in the control group after treatment (P<0.05). Conclusion: the combined use of biofeedback training for elderly stroke patients can effectively promote the rehabilitation of patients, improve their neurological function, enhance the motor function of lower limbs and the ability of self-care in life.
文摘Here we report a left cheek plate of Psarolepis,a postparietal shield of Youngolepis,a skull of Diabolepis,and a scale of Styloichthys from the Lianhuashan and Nahkaoling formations(Lochkovian,Lower Devonian)of Nanning,Guangxi.This marks the first report of Diabolepis and Styloichthys beside Qujing,Yunnan,and the latest occurrence of Psarolepis to date.The fossil community displays significant similarities to the Xujiachong Assemblage,and provides new data for the Lower Devonian stratigraphic correlation between southwestern China and northern Vietnam.Given the latest dating constraint based on the conodont evidence,we regard that the Xujiachong Assemblage has a much longer range than previously supposed,extending from the latest Lochkovian to the end of Pragian.We propose that the transition of the Nahkaoling and Lianhuashan formations in Nanning might correspond to the Guijiatun Formation in Qujing.The relatively large size of fish individuals from Guangxi is probably attributed to the increase in the oxygen content of the ocean.
基金supported by the Natural Science Foundation of Shandong Province(ZR2023MD112)financially supported by Laoshan Laboratory(LSKJ202203401).
文摘Shale gas is abundant in the Paleozoic of the Yangtze Platform,and several high-yield shale gas fields have been built in the Upper Yangtze Platform,China.The Permian of the South Yellow Sea Basin(SYSB)in the Lower Yangtze area is considered a potential target for shale gas exploration;however,the fundamental geological conditions of shale gas have not been studied.Based on the first whole-cored scientific drilling borehole(CSDP-2)in the SYSB,detailed tests involving petrology,organic geochemistry,and reservoir physical properties were conducted to evaluate the shale gas potential of the Lower Permian.The Lower Permian is dominated by organic-rich siliceous,clay,and clay-mixed shales.The average total organic carbon content is 5.99%,and the organic matter is mainly type Ⅱ_(1)−Ⅱ_(2),which has entered the high-over mature evolution stage.The pore types of organic-rich shales mainly include organic pores,dissolution pores,and intergranular pores,of which the meso-/macropores are well developed.The average porosity is 3.04%,and the total specific surface area and pore volume are 3.47 m^(2)/g and 7.21×10^(−3) cm^(3)/g,respectively.The average Langmuir volume obtained from the methane adsorption isotherms is 2.70 cm^(3)/g,and methane is mainly adsorbed in the meso-/macropores.The lower Permian shales are rich in methane as indicated by gas logging results,with an average content of 7.3%,which can reach up to 65.9%.A comparison of the study area with typical shale gas fields shows that the Lower Permian is brittle and shallowly buried and has a high potential for shale gas exploration and low-cost development.The depression areas of the SYSB are overlain by thick Mesozoic-Cenozoic sediments,show higher organic matter maturity,and may have greater shale gas potential.The shale gas exploration breakthrough of the study area is of great significance to ensure the energy supply of economically developed areas on the east China.
文摘Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients.Methods We performed a retrospective analysis of the National Inpatient Sample(2016–2021)to identify adult patients with CAD who underwent lower limb amputation.Frailty was defined using the Johns Hopkins Adjusted Clinical Groups(ACG)frailty indicator.Multivariable logistic regression was used to assess the independent association of frailty with in-hospital outcomes,and propensity score matching(PSM)was performed to further account for confounding factors.Results After PSM,9,990 patients were included in each cohort.Frail patients experienced higher rates of in-hospital mortality(3.9%vs.1.5%,P<0.001),acute limb ischemia(3.8%vs.3.1%,P=0.015),fasciotomy(2.1%vs.1.4%,P<0.001),stump infection(7.9%vs.6.6%,P<0.001),cardiogenic shock(0.9%vs.0.7%,P=0.032),sudden cardiac arrest(2.7%vs.2.1%,P=0.004),mechanical circulatory support(0.3%vs.0.2%,P=0.028),major adverse cardiac and cerebrovascular events(7.7%vs.5.4%,P<0.001),and sepsis(18.3%vs.13.8%,P<0.001).In multivariable logistic regression analysis,frailty remained an independent predictor of inhospital mortality and major complications.Conclusion Frailty is independently associated with increased in-hospital mortality and adverse events among CAD patients undergoing lower limb amputation.Incorporating frailty assessment into preoperative evaluation may improve risk stratification and guide clinical decision-making in this high-risk population.
