Patient suffering from lymphedema in both lower extremities was treated,acupuncture was carried out at Zhōngwǎn（中脘 CV 12）,Shuǐfēn（水分 CV 9）,ShuǐDào（水道 ST 28）,Zúsānlǐ（足三里 ST 36）,Yīnl&#...Patient suffering from lymphedema in both lower extremities was treated,acupuncture was carried out at Zhōngwǎn（中脘 CV 12）,Shuǐfēn（水分 CV 9）,ShuǐDào（水道 ST 28）,Zúsānlǐ（足三里 ST 36）,Yīnlíngquán（阴陵泉 SP 9）,Sānyīnjiāo（三阴交 SP 6）,Yánɡlínɡquán（阳陵泉 GB 34）,Tàichōng（太冲 LR 3） and Tàixī（太溪穴 KI 3）,and local TDP irradiation was also carried out to improve local blood circulation and promote lymph fluid backflow,and thus effectively alleviate lymphedema in both lower extremities. The treatment courses were short and painless,and no adverse eff ect was detected.展开更多
[Objectives]To observe the effect of motor relearning combined with transcranial direct current stimulation on the motor function of lower extremities in patients with cerebral infarction,and to observe its effect on ...[Objectives]To observe the effect of motor relearning combined with transcranial direct current stimulation on the motor function of lower extremities in patients with cerebral infarction,and to observe its effect on gait by 3D gait analysis.[Methods]60 patients with cerebral infarction who met the inclusion criteria were randomly divided into 3 groups according to the order of treatment(n=20).Group A received motor relearning treatment,group B received transcranial direct current stimulation treatment,group C received motor relearning combined with transcranial direct current stimulation,and the curative effect was observed after 5 courses of treatment.[Results]Before treatment,FMA,MBI,spatio-temporal parameters for 3D gait analysis(gait frequency,gait cycle,stride length,gait speed,stride length deviation,double support)and lower limb joint motion parameters(affected side stride length,maximum hip flexion,maximum hip extension,maximum knee flexion,maximum knee extension,stance phase,swing phase)were compared among the three groups.After treatment,the FMA and MBI of the three groups increased,and the spatio-temporal parameters for 3D gait analysis(gait frequency,gait cycle,gait speed,double support)and the lower limb joint motion parameters(affected side stride length,maximum hip flexion,maximum hip extension,maximum knee flexion,swing phase)were all improved,while the spatio-temporal parameters(stride length and stride length deviation)and the lower limb joint motion parameters(maximum knee extension and stance phase)decreased.Compared with those before treatment,there were significant differences among the three groups(P<0.05).Through the comparison between groups,it was found that the FMA,MBI,spatio-temporal parameters for 3D gait analysis(gait frequency,gait cycle,gait speed,double support)and lower limb joint motion parameters(affected side stride length,maximum hip flexion,maximum hip extension,maximum knee flexion,swing phase)in group C were significantly higher than those in group A and B,while the spatio-temporal parameters(stride length and stride length deviation)and lower limb joint motion parameters(maximum knee extension and stance phase)in group C were significantly lower than those in group A and group B,and the difference was statistically significant(P<0.05).[Conclusions]Motor relearning combined with transcranial direct current stimulation could increase MBI and FMA,improve gait spatio-temporal parameters and lower limb joint motion parameters,and correct abnormal gait in patients with cerebral infarction.展开更多
Objective: To test the therapeutic effect of integrated traditional Chinese and western medicine on venous ulcer of lower limbs by Meta analysis method, and then to propose the best clinical treatment scheme. Methods:...Objective: To test the therapeutic effect of integrated traditional Chinese and western medicine on venous ulcer of lower limbs by Meta analysis method, and then to propose the best clinical treatment scheme. Methods: Domestic databases in the past 20 years (January 1999-December 2019) were searched by computer, including China Journal Full-text Database (CNKI), VIP, Wanfang and CBM. Literature was screened according to inclusion and exclusion criteria. Cochrane risk assessment tool was used to evaluate the quality of the included literature. Two-classification method was used to extract data. RevMan 5.3 software was used to make statistical analysis of the data. Results: Eleven articles were finally included, totaling 1,576 patients, 804 cases in the treatment group and 772 cases in the control group. Meta-analysis results show that there is no difference in heterogeneity and bias among the included literatures. The total effective rate (risk ratio [RR]=1.12, 95% confidence interval [CI]=1.09-1.15) of integrated traditional Chinese and western medicine in treating venous ulcer of lower limbs is higher, which is obviously better than that of western medicine alone. Conclusion: Through data analysis, it is concluded that in the study population, the treatment of integrated traditional Chinese and western medicine has a significant effect on venous ulcer of lower limbs. Make up for the deficiency of simple western medicine treatment, improve the cure rate and reduce the recurrence rate. However, there is currently a lack of relevant high-quality literature, so a large sample size, rigorous and standardized experimental design and randomized double-blind clinical study are needed to further test the conclusions.展开更多
[Objectives]To explore the clinical nursing value of predictive nursing intervention in patients with deep venous thrombosis of lower extremities after cesarean section.[Methods]From December 2022 to April 2023,105 pr...[Objectives]To explore the clinical nursing value of predictive nursing intervention in patients with deep venous thrombosis of lower extremities after cesarean section.[Methods]From December 2022 to April 2023,105 pregnant and lying-in women who were hospitalized in the Gynecology Department of Pingquan Hospital and underwent cesarean section and met the inclusion criteria were included as the study objects.According to the medical records,they were divided into observation group(n=52 cases)and control group(n=53 cases).The clinical experimental subjects were divided into two groups.One group was the control group with routine nursing,and the other group was the observation group with predictive nursing intervention.The number of cases of deep venous thrombosis of lower extremities in the two groups was recorded to evaluate the clinical value.[Results]The incidence of deep venous thrombosis of lower extremities in the two groups after cesarean section was compared,and it was suggested that the incidence of the observation group was lower than that of the control group(P<0.05).[Conclusions]Special predictive nursing intervention can greatly reduce the incidence of deep venous thrombosis of lower extremities after cesarean section,improve nursing satisfaction,and improve clinical efficacy,which is worthy of recommendation.展开更多
Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 20...Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 2022 to December 2023, 70 patients with traumatic fractures of long bones in the lower extremities were admitted to the hospital and randomly divided into two groups: the control group and the observation group, each consisting of 35 cases. The control group underwent traditional closed interlocking intramedullary nailing, while the observation group received internal fixation with steel plates and screws. Relevant surgical indicators, treatment effectiveness, and postoperative complication rates were compared between the two groups. Results: The observation group exhibited significantly short surgical duration (80.65 ± 5.01 vs. 88.36 ± 5.26 minutes), fracture healing time (13.27 ± 0.32 vs. 15.52 ± 0.48 weeks), and hospitalization days (10.49 ± 1.13 vs. 16.57 ± 1.15 days) compared to the control group (P = 0.000). The effective treatment rate was significantly higher in the observation group (29/82.86%) than in the control group (21/60.00%), with a significant difference observed (χ2 = 4.480, P = 0.034). Additionally, the complication rate in the observation group (2/5.71%) was significantly lower than that in the control group (8/22.86%), with a correlated difference (χ2 = 4.200, P = 0.040). Conclusion: The plate screw internal fixation technique demonstrates significant clinical efficacy in treating traumatic fractures of long bones in the lower extremities. It improves the healing rate, reduces complications, and represents a safe and effective treatment strategy worthy of widespread use and application.展开更多
Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein th...Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein thrombosis (DVT) in the lower extremities treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively. Results: The thrombolytic effect was significant. After treatment, the deep veins were recanalized without regurgitation in 75.3% of the patients. The total effective rate was 100%. Only three patients had hemorrhagic complication, but none of the patients died. Conclusion: Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.展开更多
Purpose:Deep vein thrombosis(DVT)of the left and right lower extremities was treated in the same way,but the left and right extremities received different levels of attention.This study aimed to investigate the differ...Purpose:Deep vein thrombosis(DVT)of the left and right lower extremities was treated in the same way,but the left and right extremities received different levels of attention.This study aimed to investigate the differences between the right and left lower extremity deep vein thrombosis(LEDVT).Methods:Clinical characteristics of LEDVT patients from July 2020 to June 2022 were retrospectively analyzed to compare the incidence of LEDVT on different limbs,demographics,predisposing factors,and anatomical characteristics.The exclusion criteria were bilateral LEDVT and recurrent thrombosis.Measured data was analyzed using independent samples t-test or Mann-Whitney test.Count data were analyzed by Chi-square test.A p<0.05 was considered a statistically significant difference.Results:There were 478 patients included in this study and the ratio of left to right LEDVT on the left and right limbs was 3.16:1(363:115).Left LEDVT predominantly affected female,with the major aged>50 years(50-60 years:16.80%;>60 years:57.30%).The primary predisposing factor was iliac vein compression syndrome,with iliofemoral thrombosis being the main type.Male patients with LEDVT on the right limb were predominant and the age of onset was usually≤60 years(52.17%).The main predisposing factor was recent surgery or trauma(<30 days)and femoropopliteal thrombosis was the main type.In more detail,the left iliac vein was compressed mainly in the proximal segment,and the right iliac vein was compressed mainly in the intermediate and distal segments.Recent surgery or trauma to the locomotor system and genitourinary system often induced LEDVT.Conclusion:The incidence of LEDVT on the left is significantly higher than that on the right.LEDVT on different sides has different characteristics,which is crucial for prevention and diagnosis in the relevant population so there are also differences in treatment of the affected limbs.展开更多
Objective. To investigate the role of amputation in management of severely injured extremities and factors that may influence decision making. Methods. Thirty six patients with amputations...Objective. To investigate the role of amputation in management of severely injured extremities and factors that may influence decision making. Methods. Thirty six patients with amputations following severe injuries of the lower extremities were retrospectively reviewed. Results. There was one death from multiple organ failure. Among the remaining 35 cases, primary and delayed wound healing was achieved in 22 and 13 patients, respectively. Conclusion. Amputation is an important means for management of severely injured lower extremities. When salvage is unlikely to lead to the functional reconstruction of the limb, amputation should be indicated.展开更多
It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with parti...It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus （a comminuted fracture in the right ankle joint） and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient＇s feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon.展开更多
BACKGROUND Peripheral artery disease(PAD)affects millions globally,with a 5.6%prevalence in 2015 impacting 236 million adults,rising above 10%in those over 60 due to factors like diabetes and smoking.Post-revasculariz...BACKGROUND Peripheral artery disease(PAD)affects millions globally,with a 5.6%prevalence in 2015 impacting 236 million adults,rising above 10%in those over 60 due to factors like diabetes and smoking.Post-revascularization,single antiplatelet therapy(SAPT)is standard,but dual antiplatelet therapy(DAPT)may improve outcomes,though duration and bleeding risks are unclear.The 2024 American College of Cardiology/American Heart Association guidelines endorse short-term DAPT,yet evidence gaps remain in comparative efficacy and safety.We hypothesized that DAPT reduces cardiovascular events and reinterventions vs SAPT without significantly elevating bleeding in PAD patients’post-lower extremity revascularization.AIM To evaluate the efficacy and safety of DAPT vs SAPT in PAD patients’post-revascularization.METHODS This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,searching PubMed,EMBASE,and ScienceDirect up to July 2025.Included were randomized controlled trials(RCTs)and cohort studies from various global settings(e.g.,hospitals,tertiary care)comparing DAPT(aspirin plus P2Y12 inhibitor for>1 month)to SAPT in symptomatic PAD patients undergoing endovascular or surgical revascularization(n up to 28244 participants selected via eligibility criteria).Data were pooled using random-effects models for risk ratio(RR)with 95%CI;heterogeneity was assessed via the I²statistic.Quality appraisal used Risk of Bias in Non-randomized Studies of Interventions for cohorts and Risk of Bias 2.0 for RCTs;certainty was evaluated via Grading of Recommendations Assessment,Development and Evaluation(GRADE).RESULTS Twelve studies(3 RCTs,9 cohorts,conducted 2010–2025 with follow-ups of 6 months to 5 years)were included.DAPT showed no significant difference but a trend toward reduced all-cause mortality(RR:0.52,95%CI:0.27–1.01,P=0.05,DAPT of 298/9545 events vs SAPT of 165/566 events)or stroke(RR:0.72,95%CI:0.30–1.72,P=0.46,DAPT of 16/3729 events vs SAPT of 41/7673 events)vs SAPT.DAPT significantly reduced cardiac mortality(RR:0.46,95%CI:0.27–0.80,P=0.006,DAPT of 78/2903 events vs SAPT of 171/1465 events,risk difference:-5.4%),myocardial infarction(RR:0.82,95%CI:0.71–0.94,P=0.004,DAPT of 233/7704 events vs SAPT of 262/9130 events,risk difference:-1.8%),and major reintervention(RR:0.58,95%CI:0.35–0.98,P=0.04,DAPT of 803/205 events vs SAPT of 1197/4 events,risk difference:-42%).Bleeding showed no difference(RR:1.12,95%CI:0.42–3.03,P=0.82,DAPT of 195/2775 events vs SAPT of 202/8234 events).Heterogeneity was high(I^(2)=59%–97%).Quality revealed moderate to serious bias in cohorts and some concerns in RCTs;GRADE certainty moderate for cardiac mortality,myocardial infarction,reintervention,low for others due to inconsistency and imprecision.CONCLUSION DAPT reduces cardiac mortality,myocardial infarction,and major reintervention risks compared to SAPT in PAD post-revascularization without apparent bleeding increase,though limited by heterogeneity and low certainty for some outcomes.展开更多
BACKGROUND The prevalence of lower extremity arteriosclerosis obliterans(LEASO)in China is progressively increasing with the increment in age.Certain patients may be diagnosed with lower extremity arterial stenosis an...BACKGROUND The prevalence of lower extremity arteriosclerosis obliterans(LEASO)in China is progressively increasing with the increment in age.Certain patients may be diagnosed with lower extremity arterial stenosis and occlusion that resist complete curative efforts,which will invariably impose a substantial psychological strain on them.AIM To investigate the anxiety and depression conditions among patients with LEASO and analyze the associated risk factors.METHODS The Affiliated Hospital of Bengbu Medical University from January 2019 to December 2022.Their demographic and clinical data were obtained through the basic information questionnaire.The social support situation was assessed with the social support rating scale,and the hospital anxiety and depression scale were used to analyze their depression and anxiety levels.RESULTS The prevalence rate of anxiety was 44.0%among the 159 patients,with a total Self-Rating Anxiety Scale score of 49.01±9.65.The incidence of depression was 40.9%,and the total self-rating depression scale score reached 49.91±9.18.The overall social support score for all participants averaged 24.82±5.80.The correlation analysis between social support scores and anxiety and depression scores revealed that the total social support score,subjective social support,objective social support,as well as the degree of social support utilization,all exhibited a significant negative correlation with the anxiety and depression scores,which was statistically significant(P<0.05).The univariate analysis revealed statistically significant differences in the depression and anxiety states among patients with varying pain manifestations,disease stages,disease durations,and social support magnitudes(P<0.05).The multivariate analysis further demonstrated that patients presenting with intermittent claudication,rest pain,and pain,whose disease course was within half a year,and who had relatively low social support,were more predisposed to anxiety.Intriguingly,a monthly income of>6000 yuan was considered a protective factor in this context(P<0.05).Similarly,patients with intermittent claudication,rest pain,gangrene,and pain,and who had relatively low social support,were more liable to succumb to depressive moods(P<0.05).CONCLUSION Patients with LEASO typically receive relatively scant social support.Notably,those who concurrently present with symptoms,such as pain,claudication,and gangrene,are at a substantially increased risk of developing depression and anxiety disorders.A significant negative correlation is manifested between the social support level that patients receive and the severity of their anxiety and depression symptoms.Hence,the lower the social support score,the greater the propensity for patients to experience anxiety and depressive emotions.Therefore,during clinical practice,the crucial role that social support plays in safeguarding patients’physical and mental well-being as well as facilitating the effectiveness of disease treatment needs to be particularly emphasized.展开更多
Objective: to discuss the value of xiaoshuanTongmai decoction in the treatment of venous thrombosis of lower limbs. Methods: from June 2020 to June 2021, 68 patients with lower extremity deep vein thrombosis in our ho...Objective: to discuss the value of xiaoshuanTongmai decoction in the treatment of venous thrombosis of lower limbs. Methods: from June 2020 to June 2021, 68 patients with lower extremity deep vein thrombosis in our hospital were selected and randomly assigned to the control group (conventional treatment) and the observation group (XiaoshuanTongmai decoction), and the efficacy of treatment, the incidence of adverse reactions and the satisfaction of patients and their families with treatment were compared between the two groups. Results: the overall therapeutic effectiveness of observation group was significantly better than that of control group (P<0.05). The overall incidence of adverse reactions in observation group was significantly lower than that in control group (P<0.05). Conclusion: XiaoshuanTongmai decoction can improve the effectiveness of treatment and reduce the risk of adverse reactions in the treatment of venous thrombosis of lower limbs.展开更多
Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial ...Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial magnetic stimulation(rTMS)on motor function in stroke patients.There have been relatively few studies on the effects of different modalities of rTMS on lower extremity motor function and corticospinal excitability in patients with stroke.The MEDLINE,Embase,Cochrane Library,ISI Science Citation Index,Physiotherapy Evidence Database,China National Knowledge Infrastructure Library,and ClinicalTrials.gov databases were searched.Parallel or crossover randomized controlled trials that addressed the effectiveness of rTMS in patients with stroke,published from inception to November 28,2019,were included.Standard pairwise meta-analysis was conducted using R version 3.6.1 with the“meta”package.Bayesian network analysis using the Markov chain Monte Carlo algorithm was conducted to investigate the effectiveness of different rTMS protocol interventions.Network meta-analysis results of 18 randomized controlled trials regarding lower extremity motor function recovery revealed that low-frequency rTMS had better efficacy in promoting lower extremity motor function recovery than sham stimulation.Network meta-analysis results of five randomized controlled trials demonstrated that highfrequency rTMS led to higher amplitudes of motor evoked potentials than low-frequency rTMS or sham stimulation.These findings suggest that rTMS can improve motor function in patients with stroke,and that low-frequency rTMS mainly affects motor function,whereas high-frequency rTMS increases the amplitudes of motor evoked potentials.More highquality randomized controlled trials are needed to validate this conclusion.The work was registered in PROSPERO(registration No.CRD42020147055)on April 28,2020.展开更多
Background: The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health ...Background: The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries.Methods: This observational(cross-sectional) study recruited a sample of 103 soldiers who required medical attention,from a total 202 new battalion soldiers. The medical records(paper and online) had a form of running text. All data collected were recorded by the registered physicians of the battalion medical post. The records were analyzed by the following variables: medical diagnosis, injury site, mechanism, type of treatment, time loss, existence of previous injury,and recurring injury.Results: A total of 112 musculoskeletal injuries were diagnosed in 71 soldiers, and other types of diseases/injuries were diagnosed in the other soldiers. Joint pain accounted for 55.4% of the diagnoses. The knee was the most affected site, while trauma and overload were the most common mechanisms of injury. Drug treatment was used most frequently, accounting for 58% of the cases. The majority of the sample obtained a temporary leave of absence for1 to 6 days or not at all. Previous injuries and recurrence were not presented as risk factors for injury. With the data received, a protocol for the prevention of injuries to the lower limbs was proposed.Conclusions: This study indicated that the most frequent site of injury is the knee, and joint pain is the most common diagnosis. These results may support the necessity to develop a neuromuscular training protocol to prevent lower limb injuries, which we suggest to be applied in future studies.展开更多
BACKGROUNDDiabetes mellitus causes a large majority of non-traumatic major and minoramputations globally. Patients with diabetes are clinically complex with amultifactorial association between diabetic foot ulcers (DF...BACKGROUNDDiabetes mellitus causes a large majority of non-traumatic major and minoramputations globally. Patients with diabetes are clinically complex with amultifactorial association between diabetic foot ulcers (DFU) and subsequentlower extremity amputations (LEA). Few studies show the long-term outcomeswithin the cohort of DFU-associated LEA.AIMTo highlight the long-term outcomes of LEA as a result of DFU.METHODSPubMed/MEDLINE and Google Scholar were searched for key terms, “diabetes”,“foot ulcers”, “amputations” and “outcomes”. Outcomes such as mortality, reamputation,re-ulceration and functional impact were recorded. Peer-reviewedstudies with adult patients who had DFU, subsequent amputation and follow upof at least 1 year were included. Non-English language articles or studiesinvolving children were excluded.RESULTSA total of 22 publications with a total of 2334 patients were selected against theinclusion criteria for review. The weighted mean of re-amputation was 20.14%,29.63% and 45.72% at 1, 3 and 5 years respectively. The weighted mean of mortality at 1, 3 and 5 years were 13.62%, 30.25% and 50.55% respectively withsignificantly higher rates associated with major amputation, re-amputation andischemic cardiomyopathy.CONCLUSIONPrevious LEA, level of the LEA and patient comorbidities were significant riskfactors contributing to re-ulceration, re-amputation, mortality and depreciatedfunctional status.展开更多
BACKGROUND Lower extremity fractures are mainly treated by surgical reduction,but this operation is often affected by the patient’s level of agitation and the type of anesthesia used.The main treatment for lower-extr...BACKGROUND Lower extremity fractures are mainly treated by surgical reduction,but this operation is often affected by the patient’s level of agitation and the type of anesthesia used.The main treatment for lower-extremity fractures is operative reduction.However,operations can often be affected by both agitation and the degree of anesthesia.Therefore,it is of great importance to develop an effective anesthesia program to effectively ensure the progress of surgery.AIM To discuss the effect of ultrasound-guided nerve block combined with dexmedetomidine anesthesia in lower extremity fracture surgery.METHODS A total of 120 hospital patients with lower extremity fractures were selected for this retrospective study and divided into an observation group(n=60)and a control group(n=60)according to the anesthesia scheme;the control group received ultrasound-guided nerve block;the observation group was treated with dextromethomidine on the basis of the control group,and the mean arterial pressure,heart rate(HR),and blood oxygen saturation were observed in the two groups.RESULTS The mean arterial pressure of T1,T2 and T3 in the observation group were 94.40±7.10,90.84±7.21 and 91.03±6.84 mmHg,significantly higher than that of the control group(P<0.05).The observation group’s HR at T1 was 76.60±7.52 times/min,significantly lower than that of the control group(P<0.05);The observation group’s HR at T2 and T3 was 75.40±8.03 times/min and 76.64±7.11 times/min,significantly higher than that of the control group(P<0.05).The observation group’s visual analog score at 2 h,6 h and 12 h after operation was 3.55±0.87,2.84±0.65 and 2.05±0.40.the recovery time was 15.51±4.21 min,significantly lower than that of the control group(P<0.05).Six hours post-anesthesia,epinephrine and norepinephrine in the observation group were 81.10±21.19 pg/mL and 510.20±98.27 pg/mL,significantly lower than that of the control group(P<0.05),and the mini-mental state exam score of the observation group was 25.51±1.15,significantly higher than that in the control group(P<0.05).CONCLUSION Ultrasound-guided nerve block combined with dexmedetomidine has a good anesthetic effect in the operation of lower limb fractures and has little effect on the hemodynamics of patients.展开更多
BACKGROUND Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons.Because of poor blood supply,less tissue coverage,and easy exposure,the lower leg is a common site for chronic...BACKGROUND Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons.Because of poor blood supply,less tissue coverage,and easy exposure,the lower leg is a common site for chronic refractory wounds.The current therapeutic regimens often lead to prolonged hospital stay and higher healthcare costs.Concentrated growth factor(CGF)is a novel blood extract that contains various growth factors,platelets,and fibrins to promote wound healing process.However,there has been little research reported on the treatment of lower extremity wounds with CGF.CASE SUMMARY A 37-year-old man,without any past medical history,presented an ulcerated chronic wound on his right lower leg.The skin defect exhibited clear boundaries,with a size of 2.0 cm×3.5 cm.The depth of wound was up to the layer of deep fascia.Staphylococcus aureus was detected by bacterial culture.The final diagnosis was right lower extremity ulcers with infection.Cefathiamidine,silver sulfadiazine,and mupirocin cream were applied to control the infection.CGF gel was prepared from the patient’s blood sample,and was used to cover the wound after thorough debridement.The skin wound was successfully healed after three times of CGF treatment.CONCLUSION CGF displays an excellent wound healing promoting effect in patients with lowerextremity chronic refractory wounds.展开更多
Lower extremity robotic exoskeletons(LEEX)can not only improve the ability of the human body but also provide healing treatment for people with lower extremity dysfunction.There are a wide range of application needs a...Lower extremity robotic exoskeletons(LEEX)can not only improve the ability of the human body but also provide healing treatment for people with lower extremity dysfunction.There are a wide range of application needs and development prospects in the military,industry,medical treatment,consumption and other felds,which has aroused widespread concern in society.This paper attempts to review LEEX technical development.First,the history of LEEX is briefy traced.Second,based on existing research,LEEX is classifed according to auxiliary body parts,structural forms,functions and felds,and typical LEEX prototypes and products are introduced.Then,the latest key technologies are analyzed and summarized,and the research contents,such as bionic structure and driving characteristics,human–robot interaction(HRI)and intentawareness,intelligent control strategy,and evaluation method of power-assisted walking efciency,are described in detail.Finally,existing LEEX problems and challenges are analyzed,a future development trend is proposed,and a multidisciplinary development direction of the key technology is provided.展开更多
OBJECTIVE: To assess the clinical curative effect of fuzi-cake-separated moxibustion at Zhongji(CV 3)and Guanyuan(CV 4) for preventing dysuria after internal fixation of lower limb fractures.METHODS: Sixty patients co...OBJECTIVE: To assess the clinical curative effect of fuzi-cake-separated moxibustion at Zhongji(CV 3)and Guanyuan(CV 4) for preventing dysuria after internal fixation of lower limb fractures.METHODS: Sixty patients conforming to the inclusion standards were randomly divided into a treatment group(n=30) and a control group(n=30).Fuzi-cake-separated moxibustion was performed at Guanyuan(CV 4) and Zhongji(CV 3), 20 min at a time, twice a day, for 3 days before operation in the treatment group. No fuzi-cake-separated moxibustion was performed in the control group. After treatment, the score for symptoms of first urination, urinary time, urinary volume, 24 h remaining urinary volume, incidence of uroschesis, and rate of controlling dysuria were compared to evaluate the curative effect of preventing post-operative dysuria.RESULTS: The score for symptoms of first urination,24 h remaining urinary volume(maximum 120 m L vs 250 m L, and less than 10 m L in 24 cases vs 15 cases), and the rate of controlling dysuria(83.34% vs30%) were significantly better(P<0.05, P<0.05, and P<0.001, respectively) in the treatment compared with the control group. There was no statistical difference(P>0.05) between the two groups in first post-operative urinary time, urinary volume, or incidence of 24 h uroschesis.CONCLUSION: Fuzi-cake-separated moxibustion at Zhongji(CV 3) and Guanyuan(CV 4) can better prevent post-operative dysuria, effectively promote the functional restoration of the urinary bladder,and control the incidence of post-operative dysuria.展开更多
BACKGROUND Through significant advances in the treatment of peripheral arterial occlusive disease,acute ischemia of the lower extremity is still associated with significant morbidity,limb threat and mortality.The two ...BACKGROUND Through significant advances in the treatment of peripheral arterial occlusive disease,acute ischemia of the lower extremity is still associated with significant morbidity,limb threat and mortality.The two main causes of acute ischemia in lower extremities are arterial embolism and atherosclerotic arteries.Timely recognition and treatment of acute limb ischemia in emergency situations is essential in order to minimize the duration of ischemia.AIM To investigate the application effect of angiojet thrombolysis in the treatment of acute lower extremity arterial embolization.METHODS Sixty-two patients with acute lower extremity arterial embolization admitted to our hospital from May 2018 to May 2020 were selected.Among them,the observation group(twenty-eight cases)had received angiojet thrombolysis,and the control group(thirty-four cases)had received femoral artery incision and thrombectomy.After thrombus clearance,significant residual stenosis of the lumen was combined with balloon dilation and/or stent implantation.When the thrombus removal was not satisfactory,catheter-directed thrombolysis was performed.The incidence of postoperative complications,recurrence rate and recovery of the two groups were compared.RESULTS There were no significant differences in postoperative recurrence(target vessel reconstruction rate),anklebrachial index and the incidence of postoperative complications between the two groups(P>0.05);there were statistically significant differences in postoperative pain score and postoperative rehabilitation between the two groups(P<0.05).CONCLUSION The application of angiojet in the treatment of acute lower limb artery thromboembolism disease is safe and effective,minimally invasive,quicker recovery after operation,less postoperative complications,which is more suitable for the treatment of femoral popliteal arterial thromboembolism lesions.If the thrombus removal is not satisfactory,the combination of coronary artery aspiration catheter and catheterized directed thrombolysis can be used.Balloon dilation and stent implantation can be considered for obvious lumen stenosis.展开更多
文摘Patient suffering from lymphedema in both lower extremities was treated,acupuncture was carried out at Zhōngwǎn（中脘 CV 12）,Shuǐfēn（水分 CV 9）,ShuǐDào（水道 ST 28）,Zúsānlǐ（足三里 ST 36）,Yīnlíngquán（阴陵泉 SP 9）,Sānyīnjiāo（三阴交 SP 6）,Yánɡlínɡquán（阳陵泉 GB 34）,Tàichōng（太冲 LR 3） and Tàixī（太溪穴 KI 3）,and local TDP irradiation was also carried out to improve local blood circulation and promote lymph fluid backflow,and thus effectively alleviate lymphedema in both lower extremities. The treatment courses were short and painless,and no adverse eff ect was detected.
基金Supported by Scientific Research Project of Chinese Medicine of Hubei Provincial Health Commission(ZY2021Q015)Project of Taihe Hospital(2021JJXM077,2019JJXM099,2016JJXM023)。
文摘[Objectives]To observe the effect of motor relearning combined with transcranial direct current stimulation on the motor function of lower extremities in patients with cerebral infarction,and to observe its effect on gait by 3D gait analysis.[Methods]60 patients with cerebral infarction who met the inclusion criteria were randomly divided into 3 groups according to the order of treatment(n=20).Group A received motor relearning treatment,group B received transcranial direct current stimulation treatment,group C received motor relearning combined with transcranial direct current stimulation,and the curative effect was observed after 5 courses of treatment.[Results]Before treatment,FMA,MBI,spatio-temporal parameters for 3D gait analysis(gait frequency,gait cycle,stride length,gait speed,stride length deviation,double support)and lower limb joint motion parameters(affected side stride length,maximum hip flexion,maximum hip extension,maximum knee flexion,maximum knee extension,stance phase,swing phase)were compared among the three groups.After treatment,the FMA and MBI of the three groups increased,and the spatio-temporal parameters for 3D gait analysis(gait frequency,gait cycle,gait speed,double support)and the lower limb joint motion parameters(affected side stride length,maximum hip flexion,maximum hip extension,maximum knee flexion,swing phase)were all improved,while the spatio-temporal parameters(stride length and stride length deviation)and the lower limb joint motion parameters(maximum knee extension and stance phase)decreased.Compared with those before treatment,there were significant differences among the three groups(P<0.05).Through the comparison between groups,it was found that the FMA,MBI,spatio-temporal parameters for 3D gait analysis(gait frequency,gait cycle,gait speed,double support)and lower limb joint motion parameters(affected side stride length,maximum hip flexion,maximum hip extension,maximum knee flexion,swing phase)in group C were significantly higher than those in group A and B,while the spatio-temporal parameters(stride length and stride length deviation)and lower limb joint motion parameters(maximum knee extension and stance phase)in group C were significantly lower than those in group A and group B,and the difference was statistically significant(P<0.05).[Conclusions]Motor relearning combined with transcranial direct current stimulation could increase MBI and FMA,improve gait spatio-temporal parameters and lower limb joint motion parameters,and correct abnormal gait in patients with cerebral infarction.
基金National Natural Science Foundation of China Youth Program(No.81804095)Project of Collaborative Innovation Center for Traditional Chinese Medicine Health Services in Shanghai(No.ZYJKFW201701002)
文摘Objective: To test the therapeutic effect of integrated traditional Chinese and western medicine on venous ulcer of lower limbs by Meta analysis method, and then to propose the best clinical treatment scheme. Methods: Domestic databases in the past 20 years (January 1999-December 2019) were searched by computer, including China Journal Full-text Database (CNKI), VIP, Wanfang and CBM. Literature was screened according to inclusion and exclusion criteria. Cochrane risk assessment tool was used to evaluate the quality of the included literature. Two-classification method was used to extract data. RevMan 5.3 software was used to make statistical analysis of the data. Results: Eleven articles were finally included, totaling 1,576 patients, 804 cases in the treatment group and 772 cases in the control group. Meta-analysis results show that there is no difference in heterogeneity and bias among the included literatures. The total effective rate (risk ratio [RR]=1.12, 95% confidence interval [CI]=1.09-1.15) of integrated traditional Chinese and western medicine in treating venous ulcer of lower limbs is higher, which is obviously better than that of western medicine alone. Conclusion: Through data analysis, it is concluded that in the study population, the treatment of integrated traditional Chinese and western medicine has a significant effect on venous ulcer of lower limbs. Make up for the deficiency of simple western medicine treatment, improve the cure rate and reduce the recurrence rate. However, there is currently a lack of relevant high-quality literature, so a large sample size, rigorous and standardized experimental design and randomized double-blind clinical study are needed to further test the conclusions.
基金Chengde Science and Technology Plan Self-financing Project(202303A084).
文摘[Objectives]To explore the clinical nursing value of predictive nursing intervention in patients with deep venous thrombosis of lower extremities after cesarean section.[Methods]From December 2022 to April 2023,105 pregnant and lying-in women who were hospitalized in the Gynecology Department of Pingquan Hospital and underwent cesarean section and met the inclusion criteria were included as the study objects.According to the medical records,they were divided into observation group(n=52 cases)and control group(n=53 cases).The clinical experimental subjects were divided into two groups.One group was the control group with routine nursing,and the other group was the observation group with predictive nursing intervention.The number of cases of deep venous thrombosis of lower extremities in the two groups was recorded to evaluate the clinical value.[Results]The incidence of deep venous thrombosis of lower extremities in the two groups after cesarean section was compared,and it was suggested that the incidence of the observation group was lower than that of the control group(P<0.05).[Conclusions]Special predictive nursing intervention can greatly reduce the incidence of deep venous thrombosis of lower extremities after cesarean section,improve nursing satisfaction,and improve clinical efficacy,which is worthy of recommendation.
文摘Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 2022 to December 2023, 70 patients with traumatic fractures of long bones in the lower extremities were admitted to the hospital and randomly divided into two groups: the control group and the observation group, each consisting of 35 cases. The control group underwent traditional closed interlocking intramedullary nailing, while the observation group received internal fixation with steel plates and screws. Relevant surgical indicators, treatment effectiveness, and postoperative complication rates were compared between the two groups. Results: The observation group exhibited significantly short surgical duration (80.65 ± 5.01 vs. 88.36 ± 5.26 minutes), fracture healing time (13.27 ± 0.32 vs. 15.52 ± 0.48 weeks), and hospitalization days (10.49 ± 1.13 vs. 16.57 ± 1.15 days) compared to the control group (P = 0.000). The effective treatment rate was significantly higher in the observation group (29/82.86%) than in the control group (21/60.00%), with a significant difference observed (χ2 = 4.480, P = 0.034). Additionally, the complication rate in the observation group (2/5.71%) was significantly lower than that in the control group (8/22.86%), with a correlated difference (χ2 = 4.200, P = 0.040). Conclusion: The plate screw internal fixation technique demonstrates significant clinical efficacy in treating traumatic fractures of long bones in the lower extremities. It improves the healing rate, reduces complications, and represents a safe and effective treatment strategy worthy of widespread use and application.
文摘Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein thrombosis (DVT) in the lower extremities treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively. Results: The thrombolytic effect was significant. After treatment, the deep veins were recanalized without regurgitation in 75.3% of the patients. The total effective rate was 100%. Only three patients had hemorrhagic complication, but none of the patients died. Conclusion: Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.
基金supported by Natural Science Foundation of Chongqing,China(grant No.CSTB2023NSCQ-MSX0723).
文摘Purpose:Deep vein thrombosis(DVT)of the left and right lower extremities was treated in the same way,but the left and right extremities received different levels of attention.This study aimed to investigate the differences between the right and left lower extremity deep vein thrombosis(LEDVT).Methods:Clinical characteristics of LEDVT patients from July 2020 to June 2022 were retrospectively analyzed to compare the incidence of LEDVT on different limbs,demographics,predisposing factors,and anatomical characteristics.The exclusion criteria were bilateral LEDVT and recurrent thrombosis.Measured data was analyzed using independent samples t-test or Mann-Whitney test.Count data were analyzed by Chi-square test.A p<0.05 was considered a statistically significant difference.Results:There were 478 patients included in this study and the ratio of left to right LEDVT on the left and right limbs was 3.16:1(363:115).Left LEDVT predominantly affected female,with the major aged>50 years(50-60 years:16.80%;>60 years:57.30%).The primary predisposing factor was iliac vein compression syndrome,with iliofemoral thrombosis being the main type.Male patients with LEDVT on the right limb were predominant and the age of onset was usually≤60 years(52.17%).The main predisposing factor was recent surgery or trauma(<30 days)and femoropopliteal thrombosis was the main type.In more detail,the left iliac vein was compressed mainly in the proximal segment,and the right iliac vein was compressed mainly in the intermediate and distal segments.Recent surgery or trauma to the locomotor system and genitourinary system often induced LEDVT.Conclusion:The incidence of LEDVT on the left is significantly higher than that on the right.LEDVT on different sides has different characteristics,which is crucial for prevention and diagnosis in the relevant population so there are also differences in treatment of the affected limbs.
文摘Objective. To investigate the role of amputation in management of severely injured extremities and factors that may influence decision making. Methods. Thirty six patients with amputations following severe injuries of the lower extremities were retrospectively reviewed. Results. There was one death from multiple organ failure. Among the remaining 35 cases, primary and delayed wound healing was achieved in 22 and 13 patients, respectively. Conclusion. Amputation is an important means for management of severely injured lower extremities. When salvage is unlikely to lead to the functional reconstruction of the limb, amputation should be indicated.
文摘It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus （a comminuted fracture in the right ankle joint） and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient＇s feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon.
文摘BACKGROUND Peripheral artery disease(PAD)affects millions globally,with a 5.6%prevalence in 2015 impacting 236 million adults,rising above 10%in those over 60 due to factors like diabetes and smoking.Post-revascularization,single antiplatelet therapy(SAPT)is standard,but dual antiplatelet therapy(DAPT)may improve outcomes,though duration and bleeding risks are unclear.The 2024 American College of Cardiology/American Heart Association guidelines endorse short-term DAPT,yet evidence gaps remain in comparative efficacy and safety.We hypothesized that DAPT reduces cardiovascular events and reinterventions vs SAPT without significantly elevating bleeding in PAD patients’post-lower extremity revascularization.AIM To evaluate the efficacy and safety of DAPT vs SAPT in PAD patients’post-revascularization.METHODS This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines,searching PubMed,EMBASE,and ScienceDirect up to July 2025.Included were randomized controlled trials(RCTs)and cohort studies from various global settings(e.g.,hospitals,tertiary care)comparing DAPT(aspirin plus P2Y12 inhibitor for>1 month)to SAPT in symptomatic PAD patients undergoing endovascular or surgical revascularization(n up to 28244 participants selected via eligibility criteria).Data were pooled using random-effects models for risk ratio(RR)with 95%CI;heterogeneity was assessed via the I²statistic.Quality appraisal used Risk of Bias in Non-randomized Studies of Interventions for cohorts and Risk of Bias 2.0 for RCTs;certainty was evaluated via Grading of Recommendations Assessment,Development and Evaluation(GRADE).RESULTS Twelve studies(3 RCTs,9 cohorts,conducted 2010–2025 with follow-ups of 6 months to 5 years)were included.DAPT showed no significant difference but a trend toward reduced all-cause mortality(RR:0.52,95%CI:0.27–1.01,P=0.05,DAPT of 298/9545 events vs SAPT of 165/566 events)or stroke(RR:0.72,95%CI:0.30–1.72,P=0.46,DAPT of 16/3729 events vs SAPT of 41/7673 events)vs SAPT.DAPT significantly reduced cardiac mortality(RR:0.46,95%CI:0.27–0.80,P=0.006,DAPT of 78/2903 events vs SAPT of 171/1465 events,risk difference:-5.4%),myocardial infarction(RR:0.82,95%CI:0.71–0.94,P=0.004,DAPT of 233/7704 events vs SAPT of 262/9130 events,risk difference:-1.8%),and major reintervention(RR:0.58,95%CI:0.35–0.98,P=0.04,DAPT of 803/205 events vs SAPT of 1197/4 events,risk difference:-42%).Bleeding showed no difference(RR:1.12,95%CI:0.42–3.03,P=0.82,DAPT of 195/2775 events vs SAPT of 202/8234 events).Heterogeneity was high(I^(2)=59%–97%).Quality revealed moderate to serious bias in cohorts and some concerns in RCTs;GRADE certainty moderate for cardiac mortality,myocardial infarction,reintervention,low for others due to inconsistency and imprecision.CONCLUSION DAPT reduces cardiac mortality,myocardial infarction,and major reintervention risks compared to SAPT in PAD post-revascularization without apparent bleeding increase,though limited by heterogeneity and low certainty for some outcomes.
基金Supported by the Key Project of Natural Science Research in Universities of Anhui Province,No.2023AH051985Key Project of Natural Science Research at Bengbu Medical University,No.2023byzd038Anhui Provincial Health Research Project,No.AHWJ2024BAc30042.
文摘BACKGROUND The prevalence of lower extremity arteriosclerosis obliterans(LEASO)in China is progressively increasing with the increment in age.Certain patients may be diagnosed with lower extremity arterial stenosis and occlusion that resist complete curative efforts,which will invariably impose a substantial psychological strain on them.AIM To investigate the anxiety and depression conditions among patients with LEASO and analyze the associated risk factors.METHODS The Affiliated Hospital of Bengbu Medical University from January 2019 to December 2022.Their demographic and clinical data were obtained through the basic information questionnaire.The social support situation was assessed with the social support rating scale,and the hospital anxiety and depression scale were used to analyze their depression and anxiety levels.RESULTS The prevalence rate of anxiety was 44.0%among the 159 patients,with a total Self-Rating Anxiety Scale score of 49.01±9.65.The incidence of depression was 40.9%,and the total self-rating depression scale score reached 49.91±9.18.The overall social support score for all participants averaged 24.82±5.80.The correlation analysis between social support scores and anxiety and depression scores revealed that the total social support score,subjective social support,objective social support,as well as the degree of social support utilization,all exhibited a significant negative correlation with the anxiety and depression scores,which was statistically significant(P<0.05).The univariate analysis revealed statistically significant differences in the depression and anxiety states among patients with varying pain manifestations,disease stages,disease durations,and social support magnitudes(P<0.05).The multivariate analysis further demonstrated that patients presenting with intermittent claudication,rest pain,and pain,whose disease course was within half a year,and who had relatively low social support,were more predisposed to anxiety.Intriguingly,a monthly income of>6000 yuan was considered a protective factor in this context(P<0.05).Similarly,patients with intermittent claudication,rest pain,gangrene,and pain,and who had relatively low social support,were more liable to succumb to depressive moods(P<0.05).CONCLUSION Patients with LEASO typically receive relatively scant social support.Notably,those who concurrently present with symptoms,such as pain,claudication,and gangrene,are at a substantially increased risk of developing depression and anxiety disorders.A significant negative correlation is manifested between the social support level that patients receive and the severity of their anxiety and depression symptoms.Hence,the lower the social support score,the greater the propensity for patients to experience anxiety and depressive emotions.Therefore,during clinical practice,the crucial role that social support plays in safeguarding patients’physical and mental well-being as well as facilitating the effectiveness of disease treatment needs to be particularly emphasized.
文摘Objective: to discuss the value of xiaoshuanTongmai decoction in the treatment of venous thrombosis of lower limbs. Methods: from June 2020 to June 2021, 68 patients with lower extremity deep vein thrombosis in our hospital were selected and randomly assigned to the control group (conventional treatment) and the observation group (XiaoshuanTongmai decoction), and the efficacy of treatment, the incidence of adverse reactions and the satisfaction of patients and their families with treatment were compared between the two groups. Results: the overall therapeutic effectiveness of observation group was significantly better than that of control group (P<0.05). The overall incidence of adverse reactions in observation group was significantly lower than that in control group (P<0.05). Conclusion: XiaoshuanTongmai decoction can improve the effectiveness of treatment and reduce the risk of adverse reactions in the treatment of venous thrombosis of lower limbs.
基金supported by the 1·3·5 project for disciplines of excellence-Clinical Research Incubation Project,West China Hospital,Sichuan University,China,No.2020HXFH051(to QG).
文摘Transcranial magnetic stimulation,a type of noninvasive brain stimulation,has become an ancillary therapy for motor function rehabilitation.Most previous studies have focused on the effects of repetitive transcranial magnetic stimulation(rTMS)on motor function in stroke patients.There have been relatively few studies on the effects of different modalities of rTMS on lower extremity motor function and corticospinal excitability in patients with stroke.The MEDLINE,Embase,Cochrane Library,ISI Science Citation Index,Physiotherapy Evidence Database,China National Knowledge Infrastructure Library,and ClinicalTrials.gov databases were searched.Parallel or crossover randomized controlled trials that addressed the effectiveness of rTMS in patients with stroke,published from inception to November 28,2019,were included.Standard pairwise meta-analysis was conducted using R version 3.6.1 with the“meta”package.Bayesian network analysis using the Markov chain Monte Carlo algorithm was conducted to investigate the effectiveness of different rTMS protocol interventions.Network meta-analysis results of 18 randomized controlled trials regarding lower extremity motor function recovery revealed that low-frequency rTMS had better efficacy in promoting lower extremity motor function recovery than sham stimulation.Network meta-analysis results of five randomized controlled trials demonstrated that highfrequency rTMS led to higher amplitudes of motor evoked potentials than low-frequency rTMS or sham stimulation.These findings suggest that rTMS can improve motor function in patients with stroke,and that low-frequency rTMS mainly affects motor function,whereas high-frequency rTMS increases the amplitudes of motor evoked potentials.More highquality randomized controlled trials are needed to validate this conclusion.The work was registered in PROSPERO(registration No.CRD42020147055)on April 28,2020.
基金funded by the Coordination for the Improvement of Higher Level(CAPES)scholarship
文摘Background: The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries.Methods: This observational(cross-sectional) study recruited a sample of 103 soldiers who required medical attention,from a total 202 new battalion soldiers. The medical records(paper and online) had a form of running text. All data collected were recorded by the registered physicians of the battalion medical post. The records were analyzed by the following variables: medical diagnosis, injury site, mechanism, type of treatment, time loss, existence of previous injury,and recurring injury.Results: A total of 112 musculoskeletal injuries were diagnosed in 71 soldiers, and other types of diseases/injuries were diagnosed in the other soldiers. Joint pain accounted for 55.4% of the diagnoses. The knee was the most affected site, while trauma and overload were the most common mechanisms of injury. Drug treatment was used most frequently, accounting for 58% of the cases. The majority of the sample obtained a temporary leave of absence for1 to 6 days or not at all. Previous injuries and recurrence were not presented as risk factors for injury. With the data received, a protocol for the prevention of injuries to the lower limbs was proposed.Conclusions: This study indicated that the most frequent site of injury is the knee, and joint pain is the most common diagnosis. These results may support the necessity to develop a neuromuscular training protocol to prevent lower limb injuries, which we suggest to be applied in future studies.
文摘BACKGROUNDDiabetes mellitus causes a large majority of non-traumatic major and minoramputations globally. Patients with diabetes are clinically complex with amultifactorial association between diabetic foot ulcers (DFU) and subsequentlower extremity amputations (LEA). Few studies show the long-term outcomeswithin the cohort of DFU-associated LEA.AIMTo highlight the long-term outcomes of LEA as a result of DFU.METHODSPubMed/MEDLINE and Google Scholar were searched for key terms, “diabetes”,“foot ulcers”, “amputations” and “outcomes”. Outcomes such as mortality, reamputation,re-ulceration and functional impact were recorded. Peer-reviewedstudies with adult patients who had DFU, subsequent amputation and follow upof at least 1 year were included. Non-English language articles or studiesinvolving children were excluded.RESULTSA total of 22 publications with a total of 2334 patients were selected against theinclusion criteria for review. The weighted mean of re-amputation was 20.14%,29.63% and 45.72% at 1, 3 and 5 years respectively. The weighted mean of mortality at 1, 3 and 5 years were 13.62%, 30.25% and 50.55% respectively withsignificantly higher rates associated with major amputation, re-amputation andischemic cardiomyopathy.CONCLUSIONPrevious LEA, level of the LEA and patient comorbidities were significant riskfactors contributing to re-ulceration, re-amputation, mortality and depreciatedfunctional status.
文摘BACKGROUND Lower extremity fractures are mainly treated by surgical reduction,but this operation is often affected by the patient’s level of agitation and the type of anesthesia used.The main treatment for lower-extremity fractures is operative reduction.However,operations can often be affected by both agitation and the degree of anesthesia.Therefore,it is of great importance to develop an effective anesthesia program to effectively ensure the progress of surgery.AIM To discuss the effect of ultrasound-guided nerve block combined with dexmedetomidine anesthesia in lower extremity fracture surgery.METHODS A total of 120 hospital patients with lower extremity fractures were selected for this retrospective study and divided into an observation group(n=60)and a control group(n=60)according to the anesthesia scheme;the control group received ultrasound-guided nerve block;the observation group was treated with dextromethomidine on the basis of the control group,and the mean arterial pressure,heart rate(HR),and blood oxygen saturation were observed in the two groups.RESULTS The mean arterial pressure of T1,T2 and T3 in the observation group were 94.40±7.10,90.84±7.21 and 91.03±6.84 mmHg,significantly higher than that of the control group(P<0.05).The observation group’s HR at T1 was 76.60±7.52 times/min,significantly lower than that of the control group(P<0.05);The observation group’s HR at T2 and T3 was 75.40±8.03 times/min and 76.64±7.11 times/min,significantly higher than that of the control group(P<0.05).The observation group’s visual analog score at 2 h,6 h and 12 h after operation was 3.55±0.87,2.84±0.65 and 2.05±0.40.the recovery time was 15.51±4.21 min,significantly lower than that of the control group(P<0.05).Six hours post-anesthesia,epinephrine and norepinephrine in the observation group were 81.10±21.19 pg/mL and 510.20±98.27 pg/mL,significantly lower than that of the control group(P<0.05),and the mini-mental state exam score of the observation group was 25.51±1.15,significantly higher than that in the control group(P<0.05).CONCLUSION Ultrasound-guided nerve block combined with dexmedetomidine has a good anesthetic effect in the operation of lower limb fractures and has little effect on the hemodynamics of patients.
基金Supported by Shenzhen Longhua District Science and Innovation Bureau for Key Laboratory Construction,No.20160919A0410022Shenzhen Longhua District Science and Innovation Bureau Fund for Medical Institutions,No.2020038 and No.2017136。
文摘BACKGROUND Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons.Because of poor blood supply,less tissue coverage,and easy exposure,the lower leg is a common site for chronic refractory wounds.The current therapeutic regimens often lead to prolonged hospital stay and higher healthcare costs.Concentrated growth factor(CGF)is a novel blood extract that contains various growth factors,platelets,and fibrins to promote wound healing process.However,there has been little research reported on the treatment of lower extremity wounds with CGF.CASE SUMMARY A 37-year-old man,without any past medical history,presented an ulcerated chronic wound on his right lower leg.The skin defect exhibited clear boundaries,with a size of 2.0 cm×3.5 cm.The depth of wound was up to the layer of deep fascia.Staphylococcus aureus was detected by bacterial culture.The final diagnosis was right lower extremity ulcers with infection.Cefathiamidine,silver sulfadiazine,and mupirocin cream were applied to control the infection.CGF gel was prepared from the patient’s blood sample,and was used to cover the wound after thorough debridement.The skin wound was successfully healed after three times of CGF treatment.CONCLUSION CGF displays an excellent wound healing promoting effect in patients with lowerextremity chronic refractory wounds.
基金the National Basic Research Program of China(Grant No.2016YFC0802700)the National Natural Science Foundation of China(Grant No.50975010,Grant No.51075017).
文摘Lower extremity robotic exoskeletons(LEEX)can not only improve the ability of the human body but also provide healing treatment for people with lower extremity dysfunction.There are a wide range of application needs and development prospects in the military,industry,medical treatment,consumption and other felds,which has aroused widespread concern in society.This paper attempts to review LEEX technical development.First,the history of LEEX is briefy traced.Second,based on existing research,LEEX is classifed according to auxiliary body parts,structural forms,functions and felds,and typical LEEX prototypes and products are introduced.Then,the latest key technologies are analyzed and summarized,and the research contents,such as bionic structure and driving characteristics,human–robot interaction(HRI)and intentawareness,intelligent control strategy,and evaluation method of power-assisted walking efciency,are described in detail.Finally,existing LEEX problems and challenges are analyzed,a future development trend is proposed,and a multidisciplinary development direction of the key technology is provided.
基金Supported by Shaoxing's Science and Technology Plan(No.2012D10020):Clinical research of fuzi-cake-separated moxibustion for preventing dysuria after operation for fracture
文摘OBJECTIVE: To assess the clinical curative effect of fuzi-cake-separated moxibustion at Zhongji(CV 3)and Guanyuan(CV 4) for preventing dysuria after internal fixation of lower limb fractures.METHODS: Sixty patients conforming to the inclusion standards were randomly divided into a treatment group(n=30) and a control group(n=30).Fuzi-cake-separated moxibustion was performed at Guanyuan(CV 4) and Zhongji(CV 3), 20 min at a time, twice a day, for 3 days before operation in the treatment group. No fuzi-cake-separated moxibustion was performed in the control group. After treatment, the score for symptoms of first urination, urinary time, urinary volume, 24 h remaining urinary volume, incidence of uroschesis, and rate of controlling dysuria were compared to evaluate the curative effect of preventing post-operative dysuria.RESULTS: The score for symptoms of first urination,24 h remaining urinary volume(maximum 120 m L vs 250 m L, and less than 10 m L in 24 cases vs 15 cases), and the rate of controlling dysuria(83.34% vs30%) were significantly better(P<0.05, P<0.05, and P<0.001, respectively) in the treatment compared with the control group. There was no statistical difference(P>0.05) between the two groups in first post-operative urinary time, urinary volume, or incidence of 24 h uroschesis.CONCLUSION: Fuzi-cake-separated moxibustion at Zhongji(CV 3) and Guanyuan(CV 4) can better prevent post-operative dysuria, effectively promote the functional restoration of the urinary bladder,and control the incidence of post-operative dysuria.
基金Supported by Hangzhou Medical Health Science and Technology Project,No.20220919Y001and No.20220919Y004.
文摘BACKGROUND Through significant advances in the treatment of peripheral arterial occlusive disease,acute ischemia of the lower extremity is still associated with significant morbidity,limb threat and mortality.The two main causes of acute ischemia in lower extremities are arterial embolism and atherosclerotic arteries.Timely recognition and treatment of acute limb ischemia in emergency situations is essential in order to minimize the duration of ischemia.AIM To investigate the application effect of angiojet thrombolysis in the treatment of acute lower extremity arterial embolization.METHODS Sixty-two patients with acute lower extremity arterial embolization admitted to our hospital from May 2018 to May 2020 were selected.Among them,the observation group(twenty-eight cases)had received angiojet thrombolysis,and the control group(thirty-four cases)had received femoral artery incision and thrombectomy.After thrombus clearance,significant residual stenosis of the lumen was combined with balloon dilation and/or stent implantation.When the thrombus removal was not satisfactory,catheter-directed thrombolysis was performed.The incidence of postoperative complications,recurrence rate and recovery of the two groups were compared.RESULTS There were no significant differences in postoperative recurrence(target vessel reconstruction rate),anklebrachial index and the incidence of postoperative complications between the two groups(P>0.05);there were statistically significant differences in postoperative pain score and postoperative rehabilitation between the two groups(P<0.05).CONCLUSION The application of angiojet in the treatment of acute lower limb artery thromboembolism disease is safe and effective,minimally invasive,quicker recovery after operation,less postoperative complications,which is more suitable for the treatment of femoral popliteal arterial thromboembolism lesions.If the thrombus removal is not satisfactory,the combination of coronary artery aspiration catheter and catheterized directed thrombolysis can be used.Balloon dilation and stent implantation can be considered for obvious lumen stenosis.
