ObjectiveTo observe the accuracy of location and operation of traditional blind acupotomy lysis in the treatment of scapulohumeral periarthritis by using the high-frequency ultrasound.MethodsForty-two patients with scapulohumeral periarthritis diagnosed in the First Affiliated Hospital of Xinjiang Medical University and Urumqi Hospital of Traditional Chinese Medicine from February to April 2018 were selected. Four common sites of needle knife in the treatment of scapulohumeral periarthritis were operated blindly, and the process of the needle insertion points location and needle perform were both observed by high-frequency ultrasound.ResultsUsing high-frequency ultrasound to observe and confirm the bare-handed positioning point and needle-knife operating point, we found that the accuracy rate of bare-handed positioning needle-point was 100.0% (42/42). In the process of needling, the accuracies of needle insertion at the point of small tubercle of humerus and the point of bursa of deltoid muscle were high, which was 95.2% (40/42) and 100.0% (42/42), respectively. However, because of the deviation of the needle depth and direction, the accuracies of needle insertion at the coracoid point and the sulcus point between the humeral tubercles were low, which was 45.2% (19/42) and 4.8% (2/42), respectively.ConclusionsTraditional acupotomy lysis is a commonly used method of needle knife treatment. Using high-frequency ultrasound, it is found that even by experienced needle knife doctors, there may still be positioning deviation when using blind method to insert needles. Because the visualization of clinical needle knife is difficult to be carried out universally due to the limitations of time and technology, it is suggested that high-frequency ultrasound could be used as a visualization teaching tool in the training of needle knife operation to assist the training of blind needle knife operation technology, which may improve the accuracy of blind needle knife operation.
ObjectiveTo investigate the perioperative hemodynamic changes of off-pump coronary artery bypass grafting (OPCABG) patients monitored by pulse recorded analysis method (MostCare/PRAM devices) and its relationship with the prognosis.MethodsA total of 89 patients who underwent OPCABG from October 2016 to January 2017 in Beiijng Anzhen Hospital were included, including 53 males and 36 females aged 60.50±8.40 years. The hemodynamic changes were recorded. The patients were divided into two groups (a major adverse cardiovascular events group and a stable group) according to whether major adverse cardiovascular events occurred or not. The difference of hemodynamic changes between the two groups was analysed.ResultsThe mean percentage increases of stroke volume (SV) in the passive leg raising (PLR) test before opening chest and after chest closure were 23.00%±3.20% and 29.40%±3.70%, respectively. Hemodynamic data were analysed seven times, namely, anaesthesia, opening chest, heparin administration, coronary artery bypass grafting, protamine administration, thoracic closure and after operation. SV was significantly decreased during above periods, while systemic vascular resistance index (SVRI) was significantlyincreased. Cardiac circle efficiency (CCE) and maximum pressure gradient (dP/dT) were decreased after anaesthesia, and decreased to the lowest value during the procedure of bypass grafting, and then they began to increase gradually after the manipulation of bypass grafting was finished. Stroke volume variation (SVV) and pulse pressure variation (PPV) were slightly decreased during anaesthesia, then increased significantly through the whole surgery. Major adverse cardiovascular events occurred in 9 patients and 4 of them died. The basic mean values of SVRI, SVV and PPV of patients in the major adverse cardiovascular events group before opening chest were significantly higher than those of patients in the stable group. There was no significant difference in the mean values of CCE, dP/dT or SV between the two groups. There was no significant correlation between the prognosis and the mean values of SVRI, SVV, PPV, CCE, dP/dT or SV.ConclusionThe hemodynamic indexes are not stable, thus, it is necessary to monitor the perioperative hemodynamic changes of OPCABG patients timely by MostCare/PRAM device and adjust treatment measures accordingly.
Objective To investigate the effect of circadian rhythm disorder on rat knee cartilage and the mechanism of basic helix-loop-helix ARNT like 1 (Bmal1) on the regulation of cell cycle-related genes. Methods Forty rats were randomly divided into normal group, circadian rhythm disorder group (disorder group), Bmal1 overexpression lentivirus infection circadian rhythm disorder group (Bmal1 up-regulated group) and Bmal1 overexpression lentivirus negative infection circadian rhythm disorder group (Bmal1 negative infection group), with 10 rats in each group. Saffron fast green staining, TdT-mediated dUTP nick-end labeling staining, immunohistochemical staining, reverse transcription polymerase chain reaction and Western blotting were used to compare the pathological changes of cartilage tissue, the apoptosis of chondrocytes, and the relative mRNA expression levels of Bmal1, WEE1 G2 checkpoint kinase (Wee1), cyclin-dependent kinase 1 (Cdk1), cyclin B1 (Ccnb1), BCL2-associated X protein (Bax), apoptosis regulator 2 (Bcl2), interleukin 1 (Il1), interleukin 6 (Il6), tumor necrosis factor (Tnf) and matrix metallopeptidase 13 (Mmp13) among different groups. The relative expression levels of BMAL1, WEE1, CDK1, CCNB1, BAX and BCL2 proteins were detected, and correlation analysis was performed according to the relative expression of mRNA. Results Safranine fast green staining showed that the thickness of cartilage matrix in the normal group was normal and uniform red. The cartilage matrix in the disorder group and the Bmal1 negative infection group was destroyed, and the proteoglycan was lost obviously, showing uneven red. The thickness of cartilage matrix in the Bmal1 up-regulated group was basically normal, and the proteoglycan was not lost obviously, and the red was slightly less uniform. Compared with those of the normal group, the positive rates of apoptotic cells in articular cartilage of the disorder group and the Bmal1 negative infection group increased significantly, the mRNA and protein expression levels of Bmal1, Wee1, and Bcl2 were down-regulated, the mRNA and protein expression levels of Cdk1, Ccnb1, and Bax were up-regulated, the mRNA expression levels of Il1, Il6, Tnf and Mmp13 were up-regulated, the differences were statistically significant (P<0.05); there was no significant change in the positive rate of apoptotic cells in the articular cartilage of the Bmal1 up-regulated group, and there was no significant difference in the mRNA or protein expression of Bmal1, Wee1, Bcl2, Cdk1, Ccnb1 or Bax, nor the mRNA expression of Il1, Il6, Tnf or Mmp13 (P>0.05). Correlation analysis showed that Bmal1 was positively correlated with Wee1 and Bcl2 (r=0.84, 0.44; P<0.01), and negatively correlated with Cdk1, Ccnb1 and Bax (r=–0.55, –0.72, –0.41; P<0.01). Conclusion Chronic circadian rhythm disorder can cause the increase of chondrocyte apoptosis and osteoarthritis-like changes of articular cartilage through the expression changes of circadian clock gene Bmal1 and cell cycle-related genes and proteins.
Objective To explore the effect of self-designed early rehabilitation procedure of frozen shoulder incorporating high-frequency ultrasound technology in the outpatient treatment of patients with early frozen shoulder. Methods One hundred and eighty-two consecutive patients who attended the outpatient clinic of the Department of Rehabilitation Medicine of the First Affiliated Hospital of Xinjiang Medical University and were diagnosed with frozen shoulder between January 2018 and May 2021 were selected and randomly divided into the trial group and the control group, with 91 patients in each group. Patients in the trial group received early rehabilitation procedures for frozen shoulder, and patients in the control group received conventional physiotherapy. The Visual Analogue Scale (VAS) (including VAS score for resting pain and VAS score for active motion), active range of motion of the shoulder joint (external rotation, forward flexion, and abduction), Shoulder Pain and Dysfunction Index (SPADI) (including pain subscale score, dysfunction subscale score, and total score) were compared between the two groups before treatment (Week 0) and 4 and 8 weeks after the start of treatment (Week 4 and 8). Results A total of 143 patients (74 in the trial group and 69 in the control group) completed the study. There was no significant difference in any assessment index between the two groups in Week 0 (P>0.05). The results of the within-group comparison after treatment showed that the VAS score for resting pain (F=44.359, P<0.001), VAS score for active motion (F=158.458, P<0.001), anterior shoulder flexion (F=123.334, P<0.001), abduction mobility (F=117.539, P<0.001), total SPADI score (F=133.814, P<0.001), SPADI pain subscale score (F=74.093, P<0.001), and SPADI dysfunction subscale score (F=145.336, P<0.001) in Week 4 and 8 were better than those in Week 0, and the assessments in Week 8 were better than those in Week 4 in each group (P<0.05); in the control group, there was no statistically significant difference in the external rotation mobility of the shoulder in Week 4 compared with that in Week 0 (P=0.599), and the external rotation in Week 8 improved significantly compared with that in Week 0 (P<0.001), whereas the external rotation of the shoulder in Week 4 and 8 in the trial group improved significantly compared with that in Week 0 (P<0.001). The results of the between-group comparison after treatment showed that the two groups had statistically significant differences in resting shoulder pain VAS score (F=93.712, P<0.001), active motion VAS score (F=103.565, P<0.001), external shoulder rotation (F=13.388, P<0.001), anterior shoulder flexion (F=66.375, P<0.001), abduction mobility (F=110.253, P<0.001), total SPADI score (F=7.917, P=0.006), and SPADI pain subscale score (F=39.091, P<0.001); the SPADI dysfunction subscale score was lower in the trial group than that in the control group in Week 4 (P=0.002), but by Week 8 there was no statistically significant difference between the two groups (P=0.352). Conclusion The early rehabilitation program for frozen shoulder incorporating high-frequency ultrasound technology is more effective than conventional physiotherapy in the intervention of patients with early frozen shoulder, and may provide a referenceable example for the combined application of high-frequency ultrasound technology and physiotherapy.