Alternative therapies in health and medicine最新文献

Objective: The study aimed to investigate the effect of Transcranial Direct Current Stimulation combined with cervical stabilization exercises on functional status, cognitive functions, and sleep quality in individuals with chronic neck pain.

Materials and methods: The study involved 29 individuals (mean age 33.06 ± 14.81 years). The experimental group (n=10) received combined Transcranial Direct Current Stimulation (2 mA/20 min) with cervical stabilization exercises, while the control group (n=10) received only cervical stabilization exercises. The sham group (n=9) received placebo Transcranial Direct Current Stimulation (0 mA/20 min) with cervical stabilization exercises. Assessments were conducted before and after completing 8 weeks with 2 days per week of intervention, i.e., 16 sessions.

Primary outcome measures: Pain severity was assessed using the 10 cm Visual Analogue Scale and the Neck Bournemouth Questionnaire. Muscle endurance was measured by testing cervical flexors, extensors, and deep flexor muscles. Functional limitations were evaluated with the Profile Fitness Mapping neck questionnaire. Cognitive status was assessed using the Montreal Cognitive Assessment and the Trail Making Test. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index.

Results: After 16 sessions, all groups demonstrated a significant increase in cervical flexor muscle endurance (P < .05) and a significant decrease in Visual Analogue Scale pain scores at rest and at activity. Additionally, the experimental group exhibited a significant improvement in Visual Analogue Scale with activity, Profile Fitness Mapping neck questionnaire, and Montreal Cognitive Assessment scores. No significant difference was found between the groups in cognitive function or sleep quality (P > .05).

Conclusion: The importance of Transcranial Direct Current Stimulation combined with cervical stabilization exercises as a tool for pain management and rehabilitation of impaired motor control in cervical muscles in individuals with chronic neck pain is emphasized. It is suggested that combined approaches are considered instead of cervical stabilization exercises alone.

Objective: This study aims to investigate the expression levels of soluble CD40L (sCD40L), matrix metalloproteinase 2 (MMP2), and matrix metalloproteinase 9 (MMP9) in the serum of patients experiencing recurrent abortion and their impact on uterine artery blood flow.

Methods: A cohort of 200 patients with recurrent abortion was selected for this investigation. The levels of sCD40L, MMP2, and MMP9 in serum were assessed using ELISA, while ultrasound was employed to measure the pulsatility index (PI) and resistance index (RI) in uterine artery blood flow. Pregnancy outcomes were observed, and the expression of CD40/CD40L and MMP2/MMP9 in villi tissues was compared between patients experiencing recurrent abortion failure and those with normal pregnancies.

Results: In the successful pregnancy group of patients with recurrent spontaneous abortion (RSA), serum levels of sCD40L, MMP2, and MMP9 were significantly lower than those in the failed pregnancy group. Additionally, both RI and PI were notably reduced. The expression of each gene showed a correlation with RI and PI. Furthermore, the expression levels of CD40, CD40L, MMP2, and MMP9 in the pregnancy failure group were significantly higher than in the normal voluntary termination group.

Conclusion: Serum levels of sCD40L, MMP2, and MMP9, along with non-invasive and easily accessible indicators such as PI and RI in uterine artery blood flow measured by ultrasound, emerge as potential predictive markers for the outcome of recurrent miscarriage pregnancies. Moreover, these indicators can serve as valuable evaluation markers in clinical practice, facilitating the monitoring of treatment effectiveness for recurrent miscarriage.

Objective: It aimed to investigate the difference in clinical efficacy between posterior cervical endoscopic discectomy (PCED) and Fenestration laminectomy discectomy (FLD) in cervical disc herniation (CDH).

Methods: This retrospective study analyzed 100 CDH patients undergoing nucleotomy and assigned them into the FLD and PCED groups, 50 cases for each group. The differences in operation time, intraoperative blood loss, skin incision, off-bed time, and hospital stay were evaluated. Numeric rating scales (NRS), Oswestry disability Index (ODI), Japanese Orthopaedic Association (JOA), excellent and good clinical efficacy, quality of life (QoL) SF-36 score, and complication rate were compared.

Results: The results showed that compared with the FLD group, the PCED group had increased operation time, decreased intraoperative blood loss, skin incision length, off-bed time, and hospital stay (P < .01). Compared with the FLD group, the PCED group had decreased NRS and ODI scores and increased JOA scores at 1 d, 3 d, 1 month, 3 months, 6 months, 12 months, and 24 months after operation (P < .05). Compared with the FLD group, the excellent and good rate of the PCED group increased significantly after 6 months, 1 year, and 2 years (52.0% vs 64.0%, 58.0% vs. 80.0%, 68.0% vs 90.0%, P < .05). Relative to the FLD group, the physical function, emotional function, vitality, social function, and mental health score of the PCED group increased obviously at 2 years after operation (P < .01). The postoperative complication rate was 0% in both FLD and PCED groups. PCED has good long-term clinical efficacy in the treatment of CDH, with excellent recovery and high safety.

Conclusion: PCED showed favorable long-term clinical efficacy in the treatment of CDH, with excellent recovery and high safety. Compared to FLD, PCED resulted in reduced intraoperative blood loss, shorter incision length, and faster recovery. It also led to improved pain scores, functional outcomes, and quality of life measures. The absence of postoperative complications further supports the use of PCED as an effective treatment option for CDH.

Objective: To observe the effect of oral Quma Tongluo decoction on oxaliplatin-related chronic peripheral neuropathy.

Methods: A total of 64 patients who met the inclusion criteria were randomly divided into an experimental group and a control group, with 32 cases in each group. The experimental group took Quma Tongluo decoction granules orally (2 times a day, 1 package each time, morning and evening after meals), and the control group took mecobalamin tablets orally (1 tablet each time, 3 times a day, after meals). After 4 weeks of treatment, the quantitative score of chronic peripheral neuropathy severity, a quantitative score of numbness, a quantitative score of pain, a chemotherapeutic peripheral neurotoxicity score, comprehensive neuropathy score, peripheral neurotoxicity grade, KPS score, and neuropathy area range score were compared between the two groups before and after treatment.

Results: Before treatment, there were no significant differences between the two groups in the quantitative score of chronic peripheral neuropathy severity, quantitative score of numbness, chemotherapeutic peripheral neurotoxicity score, total neuropathy score, peripheral neurotoxicity grade, and chronic OIPN symptom range score (P > .05). After 4 weeks of treatment, there were significant differences in the quantitative score of chronic peripheral neuropathy severity, quantitative score of numbness, chemotherapeutic peripheral neurotoxicity score, total neuropathy score, peripheral neurotoxicity grade, and chronic OIPN symptom range score between the two groups (P < .05). There was no significant difference in pain quantification score and KPS score between the two groups before and after treatment (P > .05). The total effective rate of Quma Tongluo decoction in the treatment of oxaliplatin-related chronic peripheral neuropathy was higher than that of mecobalamin (87.1% > 20.6%), and no obvious adverse reactions such as Gastrointestinal reactions and allergic reactions were observed.One patient in the experimental group had diarrhea, the incidence of adverse reactions was about 3.2%, and the control group had no adverse reactions.

Conclusions: Quma Tongluo decoction can effectively treat oxaliplatin-related chronic peripheral neuropathy, reduce the symptoms while reducing the scope of symptoms, and has no obvious adverse reactions in clinical practice, with good safety.

Background: Deep vein thrombosis is a common complication after surgery, particularly in cancer patients, ‎necessitating efficient diagnostic methods for timely intervention.

Objective: This study aimed to investigate the potential of combining C-reactive protein (CRP) and interleukin-6 (IL-6) tests in diagnosing deep vein thrombosis (DVT) following endometrial cancer surgery.

Methods: A cohort of 60 patients who developed DVT post-endometrial cancer surgery and were admitted to the First Hospital of Hebei Medical University between March 2018 and March 2022 constituted the DVT group. Additionally, 60 patients who underwent endometrial cancer surgery during the same period but did not develop DVT formed the non-DVT group. Serum levels of CRP and IL-6 were quantified and compared between the two groups using reliable laboratory techniques. Subsequently, the diagnostic accuracy of single-parameter testing (CRP or IL-6 alone) versus combined testing (CRP and IL-6) for postoperative DVT was assessed.

Results: Analysis revealed significantly elevated levels of CRP and IL-6 in the serum of patients in the DVT group compared to those in the non-DVT group (P < .05). Furthermore, combined testing of CRP and IL-6 exhibited heightened sensitivity (0.85%), specificity (0.917%), and area under the curve (AUC) (0.952) compared to single-parameter testing alone, indicating its superiority in diagnosing postoperative DVT.

Conclusions: The combination of CRP and IL-6 testing presents a promising diagnostic strategy for identifying postoperative DVT in endometrial cancer patients. Implementing this approach in clinical practice could facilitate early detection and prompt management of DVT, thereby potentially reducing associated morbidity and mortality.

Background: Currently, there is a lot of discussion in clinical and scientific research over the best ways to delay meniscal degeneration and speed up its healing. Meniscal injury and degeneration are significant contributors to the development of knee osteoarthritis in a pathological state.

Objective: To isolate, culture and characterize rat meniscal fibrochondrocytes in vitro, and to provide a simple and feasible cell culture method for the study of damage repair of rat meniscal fibrochondrocytes.

Methods: The rat medial and lateral meniscus of both knees was surgically isolated. Trypsin and type II collagenase were used to remove the cells, and toluidine blue staining and type II collagen immunofluorescence were used to identify the cells. The cells were then routinely cultured in low-sugar DMEM complete culture medium.

Results: At different time points, cells showed different physiological shapes, from polygonal or short spindle to spindle shape, and finally to triangle or ellipse, and cell proliferation ability gradually increased with time. The OD values of cells cultured at 48h and 72h were higher than those at 24h. Comparing OD values of cells cultured for 48h and 72h, although OD value of 72h increased. Toluidine blue staining and type I collagen immunofluorescence staining were positive.

Conclusion: A more dependable technique for fibrochondrocyte isolation and culture is offered for the study of meniscus in molecular biology and tissue engineering. The cells cultured using this method are morphologically stable, have a strong proliferation ability, and possess the fundamental biological properties of fibrochondrocytes in vivo.

Objective: COPD patients have a high incidence of frailty and numerous complications, which seriously affect their quality of life. This study systematically evaluated and analyzed the current state of frailty incidence and risk factors in COPD patients to reduce the prevalence of frailty and enhance their quality of life.

Method: The Cochrane Library, PubMed, Embase, Web of Science, CBM, CNKI, VIP, and Wanfang databases were searched for relevant studies from the inception of each database until November 2022. A thorough literature screening, quality evaluation, and data extraction was conducted. Meta-analysis was performed using RevMan5.3Meta. Twelve articles were selected as most relevant to this review; 10 were in Chinese, and 2 were in English.

Results: The results showed that the incidence of asthenia in COPD patients was 26% (OR 0.26, 95% CI 0.17~0.34).

Discussion: The main risk factors for frailty in COPD patients were age (OR 1.32, 95% CI 1.30~1.34), GOLD pulmonary function class (OR 3.18, 95% CI 2.14~4.71), mMRC score (OR 3.90, 95% CI 1.53~9.92), comorbidity (OR 2.17, 95% CI 1.48~3.18), polypharmacy (OR 6.74, 95% CI 3.23~14.08), malnutrition (OR 3.32, 95% CI 1.77~6.24), depression (OR 1.37, 95% CI 1.07~1.76) and ≥2 admissions within 1 year (OR 4.84, 95% CI 2.45~9.57).

Conclusion: The study presented comprehensive evidence through meta-analysis and proposed that the prevalence of frailty in COPD patients is 26%. Risk factors were identified, including age, pulmonary function class according to GOLD criteria, mMRC score, comorbidity polypharmacy malnutrition, depression, or 2 or more hospital admissions within a year. It is recommended that clinical medical staff identify these risk factors at an early stage.

Objective: This study aimed to assess the correlation and consistency between quantitative CT (QCT) and MRI asymmetric echo least squares estimation iterative water-lipid separation sequence (IDEAL-IQ) in determining pancreatic fat content in patients with type 2 diabetes.

Methods: A total of 67 patients with type 2 diabetes mellitus who met the inclusion criteria were included in the study. QCT and MRIIDEAL-IQ technologies were utilized to evaluate the patients quantitatively. The pancreatic head, body, and tail regions were examined to measure the fat content and obtain the CT pancreatic fat fraction (CT-PFF) and MRI pancreatic fat fraction (MR-PFF). Pearson correlation analysis examined the relationship between diabetes-related factors and CT-PFF/MR-PFF. Additionally, Bland-Altman analysis assessed the consistency between CT-PFF and MR-PFF.

Results: Among the 67 patients, 33 were males and 34 were females. The average age was (66.55±6.23) years, with an average abdominal circumference of (83.34 ± 10.10) cm. The mean values for glycated hemoglobin, fasting blood glucose, BMI, and liver fat content were (6.97±1.07) mmol • L-1, (6.83±1.82) mmol • L-1, (24.02 ± 2.96) kg/m², and (5.28±2.76)%, respectively. Pearson correlation analysis indicated a significant correlation between abdominal circumference, liver fat content, and MR-PFF (r=0.261, 0.267, P < .05). However, no significant correlation was observed between age, glycated hemoglobin, fasting blood glucose, BMI, and MR-PFF (all, P > .05). The minimum and maximum values for CT-PFF among the 67 patients were 7.3% and 60.3%, respectively, with an average value of (19.90±10.61)%. For MR-PFF, the minimum and maximum values were 2% and 48%, respectively, with an average value of (12.21±10.71)%. Pearson correlation analysis demonstrated a significant correlation between CT-PFF and MR-PFF (r = .842, P < .05). Bland-Altman analysis revealed an average bias value of 7.7% and a standard deviation of 5.6% for CT-PFF and MR-PFF. The mean 95% confidence interval ranged from 4.15% to 19.75% (P < .05), with 64 cases falling within this interval and 3 cases falling outside.

Conclusion: A correlation exists between pancreatic fat content, abdominal circumference, and liver fat content. Both QCT and MRI can accurately quantify pancreatic fat content, and their correlation and consistency are relatively ideal. QCT technology is particularly suitable for patients with contraindications for magnetic resonance examination.