Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-t...Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.展开更多
Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rat...Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.展开更多
Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspeci...Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods:Using the FDK 20 pressure algometer,the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain.The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi.The needles were retained for 30 min.TDP irradiation was concurrently administered.The treatment was administered once daily on weekdays(Monday to Friday) and discontinued for 2 days during the weekend(Saturday and Sunday).The treatment lasted for 2 consecutive weeks.The changes in the range of motion(ROM) of the lumbar vertebrae,visual analogous scale(VAS) score,and the Oswestry disability index(ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results:Compared with the data before treatment,the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments,with statistical significance(all P<0.05).Compared with that before treatment,the immediate VAS score showed statistically significant reduction after 5 treatment sessions(P<0.05).Moreover,compared with the score after 5 treatment sessions,the immediate VAS score reduced after 10 treatment sessions,but without any statistical significance.After 5 and 10 treatment sessions,the ODI score was reduced in the patients and it was significantly different from that before treatment(both P<0.05).Conclusion:Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain.Thus,further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.展开更多
A study on the nonspecific immunity of Litopenaeus vannamei ever inhabiting freshwater and seawater was carried out at different molt stages by comparing their total hemocyte count(THC) and respiratory burst(RB) and a...A study on the nonspecific immunity of Litopenaeus vannamei ever inhabiting freshwater and seawater was carried out at different molt stages by comparing their total hemocyte count(THC) and respiratory burst(RB) and activity of phenol oxidase(PO), nitric oxide synthase(NOS) and lysozyme(LY). Two-way ANOVA showed that salinity and molt stage independently affected THC and RB and the activity of PO, NOS and LY of juvenile L. vannamei significantly(P < 0.05). The THC and RB and the activity of NOS gradually increased from the post-molt stages(A and B) to the pre-molt stages(D0–D3), which were common in shrimps inhabiting freshwater and seawater. The activity of PO peaked at the inter-molt stage(C), and touched the lowest at the post-molt stage in freshwater and pre-molt stage in seawater. The activity of LY was stable over the molt cycle. The RB and the activity of PO, NOS and LY of juvenile L. vannamei were significantly lower in freshwater than in seawater; whereas THC was significantly higher in freshwater than in seawater(P < 0.05). It was concluded that the post-molt stage(especially stage A) was critical to shrimp culture, which should be intensively attended when L. vannamei was cultured in freshwater.展开更多
The present study evaluated ef fects of ultrafine powder of the green macroalgae E nteromopha prolifera as dietary supplement on growth performance, digestive enzyme activities and serum nonspecific immune responses o...The present study evaluated ef fects of ultrafine powder of the green macroalgae E nteromopha prolifera as dietary supplement on growth performance, digestive enzyme activities and serum nonspecific immune responses of the red tilapia(O reochromis mossambicus × Oreochromis niloticus). The red tilapia were fed five diets supplemented with different levels of E. prolifera ultrafine powder as well as a control diet containing no E. prolifera for seven weeks(Diets 0–6 contained 0(control), 10, 20, 30, 40 and 50 g/kg of E. prolifera ultrafine powder, respectively). The results showed that diets supplemented with E. prolifera ultrafine powder generally improved growth, immunity and digestive enzyme activities of the red tilapia. In particular, the fish fed the diet incorporated 50 g/kg (5%) E. prolifera ultrafine powder(Diet 5) achieved the highest percentage weight gain, specific growth rate and the condition factor(increased by 15.4%, 8.0% and 5.7%, respectively when compared to the control). Feeding the diet also led to significantly increases( P <0.05) in serum nonspecific immune responses, including total superoxide dismutase, acid phosphatase, alkaline phosphatase, lysozyme activities and serum total protein(increased by 19.4%, 48.1%, 29.5%, 30.3% and 8.7%, respectively) as well as digestive enzyme activities of erepsin, gastric amylase, gastric lipase, pepsin, intestinal amylase and gastric lipase(increased by 15.7%, 33.3%, 16.3%, 21.3%, 52.3% and 28.2%, respectively) than those of the control. Based on these results, it is recommended that the inclusion level of E. prolifera ultrafine powder in the diet of the red tilapia should be 50 g/kg(or 5%).展开更多
This study was conducted to evaluate the effects of plant/animal(P/A) protein ratios(viz.1:4, 1:3, 1:2, 1:1,2:1, 3:1, 4:1) on growth performance, body composition, apparent digestibility of diets, and nonspecific immu...This study was conducted to evaluate the effects of plant/animal(P/A) protein ratios(viz.1:4, 1:3, 1:2, 1:1,2:1, 3:1, 4:1) on growth performance, body composition, apparent digestibility of diets, and nonspecific immunity of juvenile sea cucumber(Apostichopus japonicus). Sea cucumbers were divided into 21 plastic tanks, and each tank was stocked with 15 individuals(initial weight: about 23.73 g). Each feed was allocated to three replicates of sea cucumbers. The feeding experiment lasted for 50 days. Results indicated that weight gain rate(WGR) and body wall weight(BWW) significantly increased as dietary ratio of P/A increased from 1:4 to 3:1, and then decreased significantly with further increase of this ratio(P < 0.05). The body wall coefficient(BWC) showed a similar tendency to WGR and BWW, but no significance was detected among dietary treatments(P > 0.05). The apparent digestibility of dry matter, protein and lipid increased with ratio of P/A increasing from 1:4 to 2:1(P < 0.05), and then decreased with further increase of this ratio. Correspondingly, activities of trypsin and amylase were significantly increased as P/A increased from 1:4 to 2:1(P < 0.05). The activities of SOD and CAT showed a similar trend with WGR, with the highest value observed in the ratio of 1:2 and 1:1, respectively. Results above showed that moderate or relatively higher ratio of P/A protein(1:1-3:1) significantly increased the growth performance, apparent digestibility, and nonspecific immunity of sea cucumber. This will contribute to improving the feed formulation for juvenile cucumbers.展开更多
Qian Lie Xian Yan Suppository (前列腺炎栓) was rectally applied to treat 104 patients with nonspecific chronic prostatitis ( damp-heat syndrome with blood stasis) in contrast to 30 patients treated with traditional Ch...Qian Lie Xian Yan Suppository (前列腺炎栓) was rectally applied to treat 104 patients with nonspecific chronic prostatitis ( damp-heat syndrome with blood stasis) in contrast to 30 patients treated with traditional Chinese drug Ye Ju Hua Shuan (野菊花栓Suppository of Flos Chrysanthemi Indici). The results show that chronic prostatitis is markedly improved by using Qian Lie Xian Yan suppository, with a short-term cure rate of 23.1% and a total effective rate of 84.6%, superior to that of the control group. The animal experiment indicates that Qian Lie Xian Yan suppository has better anti-inflammatory and analgesic effects, with an action of promoting blood circulation.展开更多
Objective:Toobserve the clinical effect of extracorporeal shock wave combined with hot magner therapy for nonspecific chronic neck pain.Methods:A total of 60 patients with nonspecific chronic neck pain were randomly d...Objective:Toobserve the clinical effect of extracorporeal shock wave combined with hot magner therapy for nonspecific chronic neck pain.Methods:A total of 60 patients with nonspecific chronic neck pain were randomly divided into treatment group and control group.Patients in the treatment group were treated with extracorporeal shock wave combined with hot magner therapy,and patients in the control group were treated with hot magner therapy.Visual analogue scale(VAS)and Neck disability index(NDI)were used before treatment,2 weeks after treatment,and 3 months after treatment.Results:Two weeks after treatment,the VAS and NDI scores were improved(P<0.05),and the VAS and NDI scores of the treatment group were lower than those of the control group(P<0.05),and the improvement rate of the treatment group was significantly better than that of the control group(P<0.05).3 months after follow up treatment,VAS and NDI scores in the treatment group showed statistically significant differences with those before treatment(P<0.05),and those at 2 weeks after treatment(P﹥0.05),while VAS and NDI scores in the control group showed no statistically significant differences with those before treatment(P﹥0.05),and those at 2 weeks after treatment(P<0.05).The VAS and NDI scores in the treatment group were significantly better than those in the control group(P<0.05).Conclusion:The clinical efficacy of extracorporeal shock wave combined with hot magner treatment for nonspecific chronic neck pain is better than that of hot magner therapy.展开更多
OBJECTIVE:To compare the therapeutic effects of nine acupuncture-related therapies(acupuncture,scrapping therapy,catgut embedding,blood-letting,electro-acupuncture,warm acupuncture,cupping,moxibustion,and needle knife...OBJECTIVE:To compare the therapeutic effects of nine acupuncture-related therapies(acupuncture,scrapping therapy,catgut embedding,blood-letting,electro-acupuncture,warm acupuncture,cupping,moxibustion,and needle knife)in the treatment of nonspecific low back pain(NLBP),providing evidence-based medical support for clinical treatment.METHODS:Randomized controlled trials evaluating various acupuncture therapies for NLBP were screened from the China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,PubMed,Web of Science,Chinese Biomedical Literature Database,Embase,and the Cochrane Library.Methodological quality was assessed using the Cochrane 5.1.0 risk of bias assessment tool,and the data were analyzed using STATA 15.1.RESULTS:This study included 19 randomized controlled trials involving 1356 participants and assessing pain using the visual analog scale(VAS),improvement in dysfunction using the oswestry disability index(ODI),and the effective rate.Blood-letting[surface under the cumulative ranking curve(SUCRA)=81.4]exhibited a significant clinical effect in relieving NLBP in studies with the VAS score as the outcome indicator,followed by cupping(SUCRA=70.4)and moxibustion(SUCRA=58.5).Scrapping therapy(SUCRA=77.7)had the most significant effect on improving NLBP-related functional impairment,followed by moxibustion(SUCRA=59.8),and then bloodletting(SUCRA=58.2).The effective rates of warm acupuncture(SUCRA=78.0),scrapping therapy(SUCRA=77.2)and blood-letting(SUCRA=58.6)were better than those of acupuncture(SUCRA=12.0),especially for cold and wet NLBP.These findings demonstrate the importance of syndrome differentiation during clinical decision making when determining diagnosis and treatment.CONCLUSION:Blood-letting was the most effective treatment for relieving pain,and scrapping therapy was the most effective treatment for improving dysfunction.Warm acupuncture was the preferred treatment for cold and wet NLBP.However,further high-quality clinical studies are needed for validation.展开更多
The capture of circulating tumor cells(CTCs)is of great significance in reducing cancer mortality and complications.However,the nonspecific binding of proteins and white blood cells(WBCs)weakens the targeting capabili...The capture of circulating tumor cells(CTCs)is of great significance in reducing cancer mortality and complications.However,the nonspecific binding of proteins and white blood cells(WBCs)weakens the targeting capabilities of the capture surfaces,which critically hampers the efficiency and purity of the captured CTCs.Herein,we propose a liquid-like interface design strategy that consists of liquid-like polymer chains and anti-EpCAM modification processes for high-purity and high-efficiency capture of CTCs.The dynamic flexible feature of the liquid-like chains endows the modified surfaces with excellent antiadhesion property for proteins and blood cells.The liquid-like surfaces can capture the target CTCs and show high cell viability due to the environmentfriendly surface modification processes.When liquid-like surface designs were introduced in the deterministic lateral displacement(DLD)-patterned microfluidic chip,the nonspecific adhesion rate of WBCs was reduced by more than fivefold compared to that in the DLD chip without liquid-like interface design,while maintaining comparable capture efficiency.Overall,this strategy provides a novel perspective on surface design for achieving high purity and efficient capture of CTCs.展开更多
Background： This study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain （LBP）, after 5 years of follow-up. Methods： From Septembe...Background： This study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain （LBP）, after 5 years of follow-up. Methods： From September 2004 to November 2006, 172 patients underwent percutaneous nucleoplasty for chronic LBP in our department. Forty-one of these patients were followed up for a mean period of 67 months. Nucleoplasty was performed at L3/4 in 1 patient; L4/5 in 25 patients; L5/$1 in 2 patients; L3/4 and L4/5 in 2 patients; L4/5 and L5/$1 in 7 patients; and L3/4, L4/5, and L5/$1 in 4 patients. Patients were assessed preoperatively and at 1 week, 1 year, 3 years, and 5 years postoperatively. Pain was graded using a 10-cm Visual Analogue Scale （VAS） and the percentage reduction in pain score was calculated at each postoperative time point. The Oswestry Disability Index （ODI） was used to assess disability-related to lumbar spine degeneration, and patient satisfaction was assessed using the modified MacNab criteria. Results： There were significant differences among the preoperative, 1-week postoperative, and 3-year postoperative VAS and ODI scores, but not between the 3- and 5-year postoperative scores. There were no significant differences in age, sex, or preoperative symptoms between patients with effective and ineffective treatment, but there were significant differences in the number of levels treated, Pfirrmann grade of intervertebral disc degeneration, and provocative discography findings between these two groups. Excellent or good patient satisfaction was achieved in 87.9% of patients after 1 week, 72.4% after 1 year, 67.7% after 3 years, and 63.4% at the last follow-up. Conclusions： Although previously published short- and medium-term outcomes after percutaneous nucleoplasty appeared to be satisfactory, our long-term follow-up results show a significant decline in patient satisfaction over time. Percutaneous nucleoplasty is a safe and simple technique, with therapeutic effectiveness for the treatment of chronic LBP in selected patients. The technique is minimally invasive and can be used as part of a stepwise treatment plan for chronic LBP.展开更多
Objective To investigate the manifestations,pulmonary function test(PFT)characteristics and imaging features of patients with nonspecific pulmonary function(NSPF).Methods All the data from the same PFT apparatus in Be...Objective To investigate the manifestations,pulmonary function test(PFT)characteristics and imaging features of patients with nonspecific pulmonary function(NSPF).Methods All the data from the same PFT apparatus in Beijing Hospital were collected from January2003 to December 2012.NSPF was defined as展开更多
Clinical Practice Guideline on Acupuncture and Moxibustion:Nonspecific low back pain was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies(WFAS)on October...Clinical Practice Guideline on Acupuncture and Moxibustion:Nonspecific low back pain was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies(WFAS)on October 9,2023.This is the first clinical practice guideline(CPG)on acupuncture and moxibustion for nonspecific low back pain approved by an international academic organization,which provides the evidence-based recommendations and practical therapeutic protocols for international acupuncture practitioners.This CPG was developed by following Grades of Recommendation,Assessment,Development,and Evaluation(GRADE)methodology,and the Principles of the World Health Organization Handbook for Guideline Development.The guideline development group(GDG)from different countries,with different professions,played a critical role in the formulation of clinical questions,recommendations,and therapeutic protocols.Recommendations are the key content of a CPG and the direct answers to clinical questions.Hence,this article focuses on the recommendations of this CPG.The recommendations were formulated using the modified Delphi method and the GRADE grid rules,based on the updated systematic reviews of clinical evidence.A total of seven recommendations for ten clinical questions were formulated in this CPG,including one conditional recommendation for either the intervention or the comparison based on very low quality of evidence,and six conditional recommendations for the intervention based on very low quality of evidence.展开更多
Objective:To investigate the relationship between coronavirus disease 2019(COVID-19)and non-specific interstitial pneumonia(NSIP),with a focus on the clinical features of COVID-19 and NSIP,and the key points of differ...Objective:To investigate the relationship between coronavirus disease 2019(COVID-19)and non-specific interstitial pneumonia(NSIP),with a focus on the clinical features of COVID-19 and NSIP,and the key points of differential diagnosis.Methods:The clinical data of 20 patients with common-type COVID-19 and NSIP admitted to Linyi People’s Hospital from January 21,2020,to June 21,2022,were retrospectively analyzed.Gender,age,history of residence in Hubei province,underlying diseases,clinical manifestations,laboratory test results(including blood routine indexes,inflammatory markers,liver function indexes,and coagulation indexes),and computed tomography(CT)scan images were compared between the two groups.Results:COVID-19 patients were younger than NSIP patients(P<0.05).Nine COVID-19 patients had a travel history to Hubei province,while none of the NSIP patients did(P<0.05).Eight COVID-19 patients had underlying chronic conditions,fewer than the NSIP group(12 patients;P<0.05).Both groups experienced symptoms such as shortness of breath,expectoration,fatigue,and runny nose,but fever and cough were more severe and more frequent in the COVID-19 group.Compared to normal reference ranges,both groups exhibited normal white blood cell counts(WBC)and liver function indexes,but elevated lymphocyte counts(LYMP),inflammatory markers,and coagulation indexes,with reduced neutrophil counts(NE).WBC and LYMP were higher in the COVID-19 group compared to the NSIP group.Male patients in the COVID-19 group had higher erythrocyte sedimentation rates and C-reactive protein values than those in the NSIP group,while procalcitonin levels were lower in the COVID-19 group,although the differences were not statistically significant(all P>0.05).The NE count in the COVID-19 group was significantly lower than in the NSIP group(P<0.05).Alanine aminotransferase,total bilirubin,and indirect bilirubin were significantly higher in the COVID-19 group compared to the NSIP group(P<0.05).Chest CT scans of both groups showed bilateral patchy ground-glass opacities,but the lesions in COVID-19 patients were scattered.NSIP patients’chest CTs showed diffuse lesions centered around the hilum or multiple lesions in both lungs,with pleural involvement being rare.Conclusion:While there are certain specific clinical,laboratory,and imaging findings in both COVID-19 and NSIP,the specificity of these features is not high.Differentiating the two requires careful consideration of epidemiological history,nucleic acid testing,and antigen-antibody levels.展开更多
Placebo control is designed to evaluate the specific effect of one intervention.Relevant studies showed that acupuncture has a considerable placebo effect affected by many factors.In this paper,the relevant articles o...Placebo control is designed to evaluate the specific effect of one intervention.Relevant studies showed that acupuncture has a considerable placebo effect affected by many factors.In this paper,the relevant articles of acupuncture placebo studies all around the world were reviewed comprehensively to clarify the definition of acupuncture placebo effect and its psychological mechanism.The factors of acupuncture placebo effect were discussed in view of three aspects,i.e.types of sham acupuncture as control,patient-doctor interaction and outcome types.Eventually,the issues encountered in current studies of acupuncture placebo effect were described,e.g.lack of relevant studies especially with systematic and in-depth approaches in this field,inappropriate classification of specific non-needling effect relevant with acupuncture theory,and inaccurate assessment of acupuncture placebo effect due to the dificulty of sham-acupuncture design.In order to drive the future research direction of acupuncture placebo effect,it is suggested that more attention should be paid on the topic,including but not limited to correct recognition of the holistic effect of acupuncture,the appropriate design of sham acupuncture and in-depth research of mechanism of acupuncture placebo effect and its contributing factors.展开更多
成年人中60%—80%有下背痛（1ow back pain,LBP）患病史,美国统计资料显示,其发病率仅次于上呼吸道感染,列第2位[1]。50%以上的下背痛初次发病4—8周内可自愈,但复发率达85%[2]。LBP中约85%原因不明,称为非特异性下背痛（nonspecific lo...成年人中60%—80%有下背痛（1ow back pain,LBP）患病史,美国统计资料显示,其发病率仅次于上呼吸道感染,列第2位[1]。50%以上的下背痛初次发病4—8周内可自愈,但复发率达85%[2]。LBP中约85%原因不明,称为非特异性下背痛（nonspecific low back pain,NLBP）,其病因复杂,治疗方法虽多,但并无特效方法且治愈后复发率高,故如何提高NLBP患者疗效及降低复发率具有重要临床意义。展开更多
Orbital inflammatory disease(OID) represents a collec tion of inflammatory conditions affecting the orbit. OID is a diagnosis of exclusion, with the differential diagno sis including infection, systemic inflammatory c...Orbital inflammatory disease(OID) represents a collec tion of inflammatory conditions affecting the orbit. OID is a diagnosis of exclusion, with the differential diagno sis including infection, systemic inflammatory conditions and neoplasms, among other conditions. Inflammatory conditions in OID include dacryoadenitis, myositis, cel lulitis, optic perineuritis, periscleritis, orbital apicitis, and a focal mass. Sclerosing orbital inflammation is a rare condition with a chronic, indolent course involving dense fibrosis and lymphocytic infiltrate. Previously though to be along the spectrum of OID, it is now considered a distinct pathologic entity. Imaging plays an importan role in elucidating any underlying etiology behind orbita inflammation and is critical for ruling out other condi tions prior to a definitive diagnosis of OID. In this re view, we will explore the common sites of involvemen by OID and discuss differential diagnosis by site and key imaging findings for each condition.展开更多
BACKGROUND We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2 A1 gene(CEAS).Crohn's disease(CD...BACKGROUND We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2 A1 gene(CEAS).Crohn's disease(CD)is a major differential diagnosis of CEAS,because these diseases share some clinical features.Therefore,there is a need to develop a convenient screening test to distinguish CEAS from CD.AIM To examine whether prostaglandin E major urinary metabolites(PGE-MUM)can serve as a biomarker to distinguish CEAS from CD.METHODS This was a transactional study of 20 patients with CEAS and 98 patients with CD.CEAS was diagnosed by the confirmation of homozygous or compound heterozygous mutation of SLCO2 A1.We measured the concentration of PGEMUM in spot urine by radioimmunoassay,and the concentration was compared between the two groups of patients.We also determined the optimal cut-off value of PGE-MUM to distinguish CEAS from CD by receiver operating characteristic(ROC)curve analysis.RESULTS Twenty Japanese patients with CEAS and 98 patients with CD were enrolled.PGE-MUM concentration in patients with CEAS was significantly higher than that in patients with CD(median 102.7 vs 27.9μg/g×Cre,P<0.0001).One log unit increase in PGE-MUM contributed to 7.3 increase in the likelihood for the diagnosis of CEAS[95%confidence interval(CI)3.2-16.7].A logistic regression analysis revealed that the association was significant even after adjusting confounding factors(adjusted odds ratio 29.6,95%CI 4.7-185.7).ROC curve analysis revealed the optimal PGE-MUM cut-off value for the distinction of CEAS from CD to be 48.9μg/g×Cre with 95.0%sensitivity and 79.6%specificity.CONCLUSION PGE-MUM measurement is a convenient,non-invasive and useful test for the distinction of CEAS from CD.展开更多
The widespread use of capsule endoscopy and balloonassisted endoscopy has provided easy access for detailed mucosal assessment of the small intestine. However, the diagnosis of rare small bowel diseases, such as crypt...The widespread use of capsule endoscopy and balloonassisted endoscopy has provided easy access for detailed mucosal assessment of the small intestine. However, the diagnosis of rare small bowel diseases, such as cryptogenic multifocal ulcerous stenosing enteritis(CMUSE), remains difficult because clinical and morphological features of these diseases are obscure even for gastroenterologists. In an issue of this journal in 2017, Hwang et al reviewed and summarized clinical and radiographic features of 20 patients with an established diagnosis of CMUSE. Recently, recessive mutations in the PLA2G4A and SLCO2A1 genes have been shown to cause small intestinal diseases. The small bowel ulcers in each disease mimic those in the other and furthermore those found in nonsteroidal anti-inflammatory drug-induced enteropathy. These recent and novel findings suggest that a clinical diagnosis exclusively based on the characteristics of small bowel lesions is possibly imprecise. Genetic analyses seem to be inevitable for the diagnosis of rare small bowel disorders such as CMUSE.展开更多
文摘Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.
基金supported by the 13th Five-Year Army Key Discipline Construction Project(No.2020SZ06-17).
文摘Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.
基金Supported by Special Funds of Fujian Provincial Finance Department and Education Department:x2018002Clinical Special Project of School Management of Fujian University of Traditional Chinese Medicine:xb2020150。
文摘Objectives:To investigate the clinical and therapeutic effects of acupuncture at the pain-sensitive points of patients with chronic nonspecific low back pain and optimize the acupuncture treatment for chronic nonspecific low back pain.Methods:Using the FDK 20 pressure algometer,the pain-sensitive points were probed in 30 patients with chronic nonspecific low back pain.The top 5 points that elicited the most painful reaction were selected and stimulated with an even-needling technique after deqi.The needles were retained for 30 min.TDP irradiation was concurrently administered.The treatment was administered once daily on weekdays(Monday to Friday) and discontinued for 2 days during the weekend(Saturday and Sunday).The treatment lasted for 2 consecutive weeks.The changes in the range of motion(ROM) of the lumbar vertebrae,visual analogous scale(VAS) score,and the Oswestry disability index(ODI) score of the lumbar vertebrae were assessed before treatment and after 5 and 10 treatment sessions.Results:Compared with the data before treatment,the spinal ROM increased after 5 and 10 treatment sessions in the patients with chronic nonspecific low back pain.The ROM after 10 treatment sessions was remarkably wider than that after 5 treatments,with statistical significance(all P<0.05).Compared with that before treatment,the immediate VAS score showed statistically significant reduction after 5 treatment sessions(P<0.05).Moreover,compared with the score after 5 treatment sessions,the immediate VAS score reduced after 10 treatment sessions,but without any statistical significance.After 5 and 10 treatment sessions,the ODI score was reduced in the patients and it was significantly different from that before treatment(both P<0.05).Conclusion:Acupuncture at the pain-sensitive points alleviates pain and improves lumbar vertebral function in patients with chronic nonspecific low back pain.Thus,further research is needed to confirm whether acupuncture can be a better intervention for chronic nonspecific low back pain.
基金supported by a project of The Major State Basic Research of China (2009CB118706)
文摘A study on the nonspecific immunity of Litopenaeus vannamei ever inhabiting freshwater and seawater was carried out at different molt stages by comparing their total hemocyte count(THC) and respiratory burst(RB) and activity of phenol oxidase(PO), nitric oxide synthase(NOS) and lysozyme(LY). Two-way ANOVA showed that salinity and molt stage independently affected THC and RB and the activity of PO, NOS and LY of juvenile L. vannamei significantly(P < 0.05). The THC and RB and the activity of NOS gradually increased from the post-molt stages(A and B) to the pre-molt stages(D0–D3), which were common in shrimps inhabiting freshwater and seawater. The activity of PO peaked at the inter-molt stage(C), and touched the lowest at the post-molt stage in freshwater and pre-molt stage in seawater. The activity of LY was stable over the molt cycle. The RB and the activity of PO, NOS and LY of juvenile L. vannamei were significantly lower in freshwater than in seawater; whereas THC was significantly higher in freshwater than in seawater(P < 0.05). It was concluded that the post-molt stage(especially stage A) was critical to shrimp culture, which should be intensively attended when L. vannamei was cultured in freshwater.
基金Supported by the Natural Science Foundation of Fujian Province(No.2017J01638)the Science and Technology Project Grant of Xiamen City,China(No.3502Z20113029)the Key Project of Technology Grant of Fujian Province(No.2012N0018)
文摘The present study evaluated ef fects of ultrafine powder of the green macroalgae E nteromopha prolifera as dietary supplement on growth performance, digestive enzyme activities and serum nonspecific immune responses of the red tilapia(O reochromis mossambicus × Oreochromis niloticus). The red tilapia were fed five diets supplemented with different levels of E. prolifera ultrafine powder as well as a control diet containing no E. prolifera for seven weeks(Diets 0–6 contained 0(control), 10, 20, 30, 40 and 50 g/kg of E. prolifera ultrafine powder, respectively). The results showed that diets supplemented with E. prolifera ultrafine powder generally improved growth, immunity and digestive enzyme activities of the red tilapia. In particular, the fish fed the diet incorporated 50 g/kg (5%) E. prolifera ultrafine powder(Diet 5) achieved the highest percentage weight gain, specific growth rate and the condition factor(increased by 15.4%, 8.0% and 5.7%, respectively when compared to the control). Feeding the diet also led to significantly increases( P <0.05) in serum nonspecific immune responses, including total superoxide dismutase, acid phosphatase, alkaline phosphatase, lysozyme activities and serum total protein(increased by 19.4%, 48.1%, 29.5%, 30.3% and 8.7%, respectively) as well as digestive enzyme activities of erepsin, gastric amylase, gastric lipase, pepsin, intestinal amylase and gastric lipase(increased by 15.7%, 33.3%, 16.3%, 21.3%, 52.3% and 28.2%, respectively) than those of the control. Based on these results, it is recommended that the inclusion level of E. prolifera ultrafine powder in the diet of the red tilapia should be 50 g/kg(or 5%).
基金financially supported by the Natural Public Sciences and Technology Research Funds Projects of Ocean(201405003-3)
文摘This study was conducted to evaluate the effects of plant/animal(P/A) protein ratios(viz.1:4, 1:3, 1:2, 1:1,2:1, 3:1, 4:1) on growth performance, body composition, apparent digestibility of diets, and nonspecific immunity of juvenile sea cucumber(Apostichopus japonicus). Sea cucumbers were divided into 21 plastic tanks, and each tank was stocked with 15 individuals(initial weight: about 23.73 g). Each feed was allocated to three replicates of sea cucumbers. The feeding experiment lasted for 50 days. Results indicated that weight gain rate(WGR) and body wall weight(BWW) significantly increased as dietary ratio of P/A increased from 1:4 to 3:1, and then decreased significantly with further increase of this ratio(P < 0.05). The body wall coefficient(BWC) showed a similar tendency to WGR and BWW, but no significance was detected among dietary treatments(P > 0.05). The apparent digestibility of dry matter, protein and lipid increased with ratio of P/A increasing from 1:4 to 2:1(P < 0.05), and then decreased with further increase of this ratio. Correspondingly, activities of trypsin and amylase were significantly increased as P/A increased from 1:4 to 2:1(P < 0.05). The activities of SOD and CAT showed a similar trend with WGR, with the highest value observed in the ratio of 1:2 and 1:1, respectively. Results above showed that moderate or relatively higher ratio of P/A protein(1:1-3:1) significantly increased the growth performance, apparent digestibility, and nonspecific immunity of sea cucumber. This will contribute to improving the feed formulation for juvenile cucumbers.
文摘Qian Lie Xian Yan Suppository (前列腺炎栓) was rectally applied to treat 104 patients with nonspecific chronic prostatitis ( damp-heat syndrome with blood stasis) in contrast to 30 patients treated with traditional Chinese drug Ye Ju Hua Shuan (野菊花栓Suppository of Flos Chrysanthemi Indici). The results show that chronic prostatitis is markedly improved by using Qian Lie Xian Yan suppository, with a short-term cure rate of 23.1% and a total effective rate of 84.6%, superior to that of the control group. The animal experiment indicates that Qian Lie Xian Yan suppository has better anti-inflammatory and analgesic effects, with an action of promoting blood circulation.
基金The military medical science and technology youth breeding program top-notch project(NO.9QNP072).
文摘Objective:Toobserve the clinical effect of extracorporeal shock wave combined with hot magner therapy for nonspecific chronic neck pain.Methods:A total of 60 patients with nonspecific chronic neck pain were randomly divided into treatment group and control group.Patients in the treatment group were treated with extracorporeal shock wave combined with hot magner therapy,and patients in the control group were treated with hot magner therapy.Visual analogue scale(VAS)and Neck disability index(NDI)were used before treatment,2 weeks after treatment,and 3 months after treatment.Results:Two weeks after treatment,the VAS and NDI scores were improved(P<0.05),and the VAS and NDI scores of the treatment group were lower than those of the control group(P<0.05),and the improvement rate of the treatment group was significantly better than that of the control group(P<0.05).3 months after follow up treatment,VAS and NDI scores in the treatment group showed statistically significant differences with those before treatment(P<0.05),and those at 2 weeks after treatment(P﹥0.05),while VAS and NDI scores in the control group showed no statistically significant differences with those before treatment(P﹥0.05),and those at 2 weeks after treatment(P<0.05).The VAS and NDI scores in the treatment group were significantly better than those in the control group(P<0.05).Conclusion:The clinical efficacy of extracorporeal shock wave combined with hot magner treatment for nonspecific chronic neck pain is better than that of hot magner therapy.
基金Supported by the National Natural Science Foundation of China:Novel Dynamic Regulation Method of Acupoint Stimulation Based on Injectable Magnetic Gel for Myocardial Ischemia-Reperfusion Injury (No. 82074560)Effect Evaluation of Different Combinations of Acupuncture Techniques (No. 8207152951)Sanqin Talent Special Support Program:Leading Talent Project for Technological Innovation (No. 2024)
文摘OBJECTIVE:To compare the therapeutic effects of nine acupuncture-related therapies(acupuncture,scrapping therapy,catgut embedding,blood-letting,electro-acupuncture,warm acupuncture,cupping,moxibustion,and needle knife)in the treatment of nonspecific low back pain(NLBP),providing evidence-based medical support for clinical treatment.METHODS:Randomized controlled trials evaluating various acupuncture therapies for NLBP were screened from the China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,PubMed,Web of Science,Chinese Biomedical Literature Database,Embase,and the Cochrane Library.Methodological quality was assessed using the Cochrane 5.1.0 risk of bias assessment tool,and the data were analyzed using STATA 15.1.RESULTS:This study included 19 randomized controlled trials involving 1356 participants and assessing pain using the visual analog scale(VAS),improvement in dysfunction using the oswestry disability index(ODI),and the effective rate.Blood-letting[surface under the cumulative ranking curve(SUCRA)=81.4]exhibited a significant clinical effect in relieving NLBP in studies with the VAS score as the outcome indicator,followed by cupping(SUCRA=70.4)and moxibustion(SUCRA=58.5).Scrapping therapy(SUCRA=77.7)had the most significant effect on improving NLBP-related functional impairment,followed by moxibustion(SUCRA=59.8),and then bloodletting(SUCRA=58.2).The effective rates of warm acupuncture(SUCRA=78.0),scrapping therapy(SUCRA=77.2)and blood-letting(SUCRA=58.6)were better than those of acupuncture(SUCRA=12.0),especially for cold and wet NLBP.These findings demonstrate the importance of syndrome differentiation during clinical decision making when determining diagnosis and treatment.CONCLUSION:Blood-letting was the most effective treatment for relieving pain,and scrapping therapy was the most effective treatment for improving dysfunction.Warm acupuncture was the preferred treatment for cold and wet NLBP.However,further high-quality clinical studies are needed for validation.
基金supported by the National Natural Science Foundation of China(grant nos.52025132,21975209,22275156,21621091,22021001,22005255,and T2241022)the National Science Foundation of Fujian Province of China(grant no.2022J02059)+4 种基金the Fundamental Research Funds for the Central Universities of China(grant nos.20720220019 and 20720220085)the 111 Project(grant nos.B17027 and B16029)the Science and Technology Projects of Innovation Laboratory for Sciences and Technologies of Energy Materials of Fujian Province(grant no.RD2022070601)the State Key Laboratory of Bio-Fibers and Eco-Textiles(Qingdao University)(grant no.KFKT202221)the Tencent Foundation(The XPLORER PRIZE).
文摘The capture of circulating tumor cells(CTCs)is of great significance in reducing cancer mortality and complications.However,the nonspecific binding of proteins and white blood cells(WBCs)weakens the targeting capabilities of the capture surfaces,which critically hampers the efficiency and purity of the captured CTCs.Herein,we propose a liquid-like interface design strategy that consists of liquid-like polymer chains and anti-EpCAM modification processes for high-purity and high-efficiency capture of CTCs.The dynamic flexible feature of the liquid-like chains endows the modified surfaces with excellent antiadhesion property for proteins and blood cells.The liquid-like surfaces can capture the target CTCs and show high cell viability due to the environmentfriendly surface modification processes.When liquid-like surface designs were introduced in the deterministic lateral displacement(DLD)-patterned microfluidic chip,the nonspecific adhesion rate of WBCs was reduced by more than fivefold compared to that in the DLD chip without liquid-like interface design,while maintaining comparable capture efficiency.Overall,this strategy provides a novel perspective on surface design for achieving high purity and efficient capture of CTCs.
文摘Background： This study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain （LBP）, after 5 years of follow-up. Methods： From September 2004 to November 2006, 172 patients underwent percutaneous nucleoplasty for chronic LBP in our department. Forty-one of these patients were followed up for a mean period of 67 months. Nucleoplasty was performed at L3/4 in 1 patient; L4/5 in 25 patients; L5/$1 in 2 patients; L3/4 and L4/5 in 2 patients; L4/5 and L5/$1 in 7 patients; and L3/4, L4/5, and L5/$1 in 4 patients. Patients were assessed preoperatively and at 1 week, 1 year, 3 years, and 5 years postoperatively. Pain was graded using a 10-cm Visual Analogue Scale （VAS） and the percentage reduction in pain score was calculated at each postoperative time point. The Oswestry Disability Index （ODI） was used to assess disability-related to lumbar spine degeneration, and patient satisfaction was assessed using the modified MacNab criteria. Results： There were significant differences among the preoperative, 1-week postoperative, and 3-year postoperative VAS and ODI scores, but not between the 3- and 5-year postoperative scores. There were no significant differences in age, sex, or preoperative symptoms between patients with effective and ineffective treatment, but there were significant differences in the number of levels treated, Pfirrmann grade of intervertebral disc degeneration, and provocative discography findings between these two groups. Excellent or good patient satisfaction was achieved in 87.9% of patients after 1 week, 72.4% after 1 year, 67.7% after 3 years, and 63.4% at the last follow-up. Conclusions： Although previously published short- and medium-term outcomes after percutaneous nucleoplasty appeared to be satisfactory, our long-term follow-up results show a significant decline in patient satisfaction over time. Percutaneous nucleoplasty is a safe and simple technique, with therapeutic effectiveness for the treatment of chronic LBP in selected patients. The technique is minimally invasive and can be used as part of a stepwise treatment plan for chronic LBP.
文摘Objective To investigate the manifestations,pulmonary function test(PFT)characteristics and imaging features of patients with nonspecific pulmonary function(NSPF).Methods All the data from the same PFT apparatus in Beijing Hospital were collected from January2003 to December 2012.NSPF was defined as
基金Supported by the National Key Research and Development Program of China:2019YFC1712200,2019YFC1712203。
文摘Clinical Practice Guideline on Acupuncture and Moxibustion:Nonspecific low back pain was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies(WFAS)on October 9,2023.This is the first clinical practice guideline(CPG)on acupuncture and moxibustion for nonspecific low back pain approved by an international academic organization,which provides the evidence-based recommendations and practical therapeutic protocols for international acupuncture practitioners.This CPG was developed by following Grades of Recommendation,Assessment,Development,and Evaluation(GRADE)methodology,and the Principles of the World Health Organization Handbook for Guideline Development.The guideline development group(GDG)from different countries,with different professions,played a critical role in the formulation of clinical questions,recommendations,and therapeutic protocols.Recommendations are the key content of a CPG and the direct answers to clinical questions.Hence,this article focuses on the recommendations of this CPG.The recommendations were formulated using the modified Delphi method and the GRADE grid rules,based on the updated systematic reviews of clinical evidence.A total of seven recommendations for ten clinical questions were formulated in this CPG,including one conditional recommendation for either the intervention or the comparison based on very low quality of evidence,and six conditional recommendations for the intervention based on very low quality of evidence.
基金Linyi Key Research and Development Program(Medical)(Project No.2023YX0137)General Research Project of Linyi Science and Technology Association(Project No.2024kxy109)。
文摘Objective:To investigate the relationship between coronavirus disease 2019(COVID-19)and non-specific interstitial pneumonia(NSIP),with a focus on the clinical features of COVID-19 and NSIP,and the key points of differential diagnosis.Methods:The clinical data of 20 patients with common-type COVID-19 and NSIP admitted to Linyi People’s Hospital from January 21,2020,to June 21,2022,were retrospectively analyzed.Gender,age,history of residence in Hubei province,underlying diseases,clinical manifestations,laboratory test results(including blood routine indexes,inflammatory markers,liver function indexes,and coagulation indexes),and computed tomography(CT)scan images were compared between the two groups.Results:COVID-19 patients were younger than NSIP patients(P<0.05).Nine COVID-19 patients had a travel history to Hubei province,while none of the NSIP patients did(P<0.05).Eight COVID-19 patients had underlying chronic conditions,fewer than the NSIP group(12 patients;P<0.05).Both groups experienced symptoms such as shortness of breath,expectoration,fatigue,and runny nose,but fever and cough were more severe and more frequent in the COVID-19 group.Compared to normal reference ranges,both groups exhibited normal white blood cell counts(WBC)and liver function indexes,but elevated lymphocyte counts(LYMP),inflammatory markers,and coagulation indexes,with reduced neutrophil counts(NE).WBC and LYMP were higher in the COVID-19 group compared to the NSIP group.Male patients in the COVID-19 group had higher erythrocyte sedimentation rates and C-reactive protein values than those in the NSIP group,while procalcitonin levels were lower in the COVID-19 group,although the differences were not statistically significant(all P>0.05).The NE count in the COVID-19 group was significantly lower than in the NSIP group(P<0.05).Alanine aminotransferase,total bilirubin,and indirect bilirubin were significantly higher in the COVID-19 group compared to the NSIP group(P<0.05).Chest CT scans of both groups showed bilateral patchy ground-glass opacities,but the lesions in COVID-19 patients were scattered.NSIP patients’chest CTs showed diffuse lesions centered around the hilum or multiple lesions in both lungs,with pleural involvement being rare.Conclusion:While there are certain specific clinical,laboratory,and imaging findings in both COVID-19 and NSIP,the specificity of these features is not high.Differentiating the two requires careful consideration of epidemiological history,nucleic acid testing,and antigen-antibody levels.
基金Supported by The National Natural Science Foundation of China:82174234.
文摘Placebo control is designed to evaluate the specific effect of one intervention.Relevant studies showed that acupuncture has a considerable placebo effect affected by many factors.In this paper,the relevant articles of acupuncture placebo studies all around the world were reviewed comprehensively to clarify the definition of acupuncture placebo effect and its psychological mechanism.The factors of acupuncture placebo effect were discussed in view of three aspects,i.e.types of sham acupuncture as control,patient-doctor interaction and outcome types.Eventually,the issues encountered in current studies of acupuncture placebo effect were described,e.g.lack of relevant studies especially with systematic and in-depth approaches in this field,inappropriate classification of specific non-needling effect relevant with acupuncture theory,and inaccurate assessment of acupuncture placebo effect due to the dificulty of sham-acupuncture design.In order to drive the future research direction of acupuncture placebo effect,it is suggested that more attention should be paid on the topic,including but not limited to correct recognition of the holistic effect of acupuncture,the appropriate design of sham acupuncture and in-depth research of mechanism of acupuncture placebo effect and its contributing factors.
文摘成年人中60%—80%有下背痛（1ow back pain,LBP）患病史,美国统计资料显示,其发病率仅次于上呼吸道感染,列第2位[1]。50%以上的下背痛初次发病4—8周内可自愈,但复发率达85%[2]。LBP中约85%原因不明,称为非特异性下背痛（nonspecific low back pain,NLBP）,其病因复杂,治疗方法虽多,但并无特效方法且治愈后复发率高,故如何提高NLBP患者疗效及降低复发率具有重要临床意义。
文摘Orbital inflammatory disease(OID) represents a collec tion of inflammatory conditions affecting the orbit. OID is a diagnosis of exclusion, with the differential diagno sis including infection, systemic inflammatory conditions and neoplasms, among other conditions. Inflammatory conditions in OID include dacryoadenitis, myositis, cel lulitis, optic perineuritis, periscleritis, orbital apicitis, and a focal mass. Sclerosing orbital inflammation is a rare condition with a chronic, indolent course involving dense fibrosis and lymphocytic infiltrate. Previously though to be along the spectrum of OID, it is now considered a distinct pathologic entity. Imaging plays an importan role in elucidating any underlying etiology behind orbita inflammation and is critical for ruling out other condi tions prior to a definitive diagnosis of OID. In this re view, we will explore the common sites of involvemen by OID and discuss differential diagnosis by site and key imaging findings for each condition.
基金Supported by the Practical Research Project for Rare/Intractable Diseases from the Japan Agency for Medical Research and Development(AMED),No.15ek0109053h0002 to Matsumoto Tby grants from the Japan Society for the Promotion of Science(JSPS)KAKENHI,No.25460953,to Umeno J,Esaki M,and Matsumoto T
文摘BACKGROUND We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2 A1 gene(CEAS).Crohn's disease(CD)is a major differential diagnosis of CEAS,because these diseases share some clinical features.Therefore,there is a need to develop a convenient screening test to distinguish CEAS from CD.AIM To examine whether prostaglandin E major urinary metabolites(PGE-MUM)can serve as a biomarker to distinguish CEAS from CD.METHODS This was a transactional study of 20 patients with CEAS and 98 patients with CD.CEAS was diagnosed by the confirmation of homozygous or compound heterozygous mutation of SLCO2 A1.We measured the concentration of PGEMUM in spot urine by radioimmunoassay,and the concentration was compared between the two groups of patients.We also determined the optimal cut-off value of PGE-MUM to distinguish CEAS from CD by receiver operating characteristic(ROC)curve analysis.RESULTS Twenty Japanese patients with CEAS and 98 patients with CD were enrolled.PGE-MUM concentration in patients with CEAS was significantly higher than that in patients with CD(median 102.7 vs 27.9μg/g×Cre,P<0.0001).One log unit increase in PGE-MUM contributed to 7.3 increase in the likelihood for the diagnosis of CEAS[95%confidence interval(CI)3.2-16.7].A logistic regression analysis revealed that the association was significant even after adjusting confounding factors(adjusted odds ratio 29.6,95%CI 4.7-185.7).ROC curve analysis revealed the optimal PGE-MUM cut-off value for the distinction of CEAS from CD to be 48.9μg/g×Cre with 95.0%sensitivity and 79.6%specificity.CONCLUSION PGE-MUM measurement is a convenient,non-invasive and useful test for the distinction of CEAS from CD.
基金Supported by the Practical Research Project for Rare/Intractable Diseases from Japan Agency for Medical Research and Development(AMED),No.15ek0109053h0002the Japan Society for the Promotion of Science(JSPS)KAKENHI,No.25460953
文摘The widespread use of capsule endoscopy and balloonassisted endoscopy has provided easy access for detailed mucosal assessment of the small intestine. However, the diagnosis of rare small bowel diseases, such as cryptogenic multifocal ulcerous stenosing enteritis(CMUSE), remains difficult because clinical and morphological features of these diseases are obscure even for gastroenterologists. In an issue of this journal in 2017, Hwang et al reviewed and summarized clinical and radiographic features of 20 patients with an established diagnosis of CMUSE. Recently, recessive mutations in the PLA2G4A and SLCO2A1 genes have been shown to cause small intestinal diseases. The small bowel ulcers in each disease mimic those in the other and furthermore those found in nonsteroidal anti-inflammatory drug-induced enteropathy. These recent and novel findings suggest that a clinical diagnosis exclusively based on the characteristics of small bowel lesions is possibly imprecise. Genetic analyses seem to be inevitable for the diagnosis of rare small bowel disorders such as CMUSE.
