目的:分析成人退行性脊柱侧凸(adult degenerative scoliosis,ADS)患者椎旁肌(多裂肌、竖脊肌)和腰大肌退变的不对称性及其与脊柱-骨盆冠状位参数之间的关系,为ADS患者冠状位失平衡的评估和预测提供新的思路。方法:回顾性分析96例ADS患...目的:分析成人退行性脊柱侧凸(adult degenerative scoliosis,ADS)患者椎旁肌(多裂肌、竖脊肌)和腰大肌退变的不对称性及其与脊柱-骨盆冠状位参数之间的关系,为ADS患者冠状位失平衡的评估和预测提供新的思路。方法:回顾性分析96例ADS患者,测量并计算患者腰椎MRI顶椎层面椎旁肌和腰大肌的横截面积(cross-sectional area,CSA)、脂肪化比例(fat saturation fraction,FSF)、凹侧与凸侧横截面积之比(ratio of CSAconcave to CSAconvex,rCSA)、凹侧与凸侧脂肪化比例之比(ratio of FSFconcave to FSFconvex,rFSF),并在脊柱全长X线片上测量冠状位影像学参数,包括冠状位Cobb角(coronal Cobb angle,CA)和冠状面平衡距离(coronal balance distance,CBD)。根据C7铅垂线(C7PL)与骶骨中垂线(CSVL)的相对位置,将22例CBD≥30mm的患者分为两组:A组(C7PL在凸侧边,13例)和B组(C7PL在凹侧边,9例)。采用配对样本t检验分析顶椎层面凹凸两侧椎旁肌和腰大肌CSA和FSF的差异、Pearson相关分析肌肉影像学参数与脊柱-骨盆冠状位参数之间的相关性。结果:在顶椎层面,多裂肌、竖脊肌、腰大肌、椎旁肌凹侧CSA均显著大于凸侧(P<0.05),多裂肌凹侧FSF显著大于凸侧(P<0.01),竖脊肌凸侧FSF显著大于凹侧(P<0.05),腰大肌、椎旁肌两侧FSF无统计学差异(P>0.05)。CA与多裂肌凸侧CSA、竖脊肌和椎旁肌双侧CSA呈负相关(r=-0.233、-0.346、-0.211、-0.387、-0.232,P<0.05),与多裂肌凹侧FSF、rCSA和椎旁肌rCSA呈正相关(r=0.360、0.424、0.259,P<0.05)。A组CBD与各个肌肉的影像学参数均无相关性(P>0.05)。B组CBD与竖脊肌凹侧CSA,腰大肌凹侧FSF,多裂肌、竖脊肌、腰大肌和椎旁肌rCSA,腰大肌rFSF呈正相关(r=0.720、0.768、0.720、0.752、0.738、0.721、0.893,P<0.05)。结论:ADS患者椎旁肌和腰大肌影像学参数与脊柱-骨盆冠状位参数有明显的相关性,其中多裂肌rCSA与CA的相关性最强,在CBD超过30mm且C7PL在凹侧边的ADS患者中�展开更多
Denervation-induced skeletal muscle atrophy can potentially cause the decline in the quality of life of patients and an increased risk of mortality.Complex pathophysiological mechanisms with dynamic alterations have b...Denervation-induced skeletal muscle atrophy can potentially cause the decline in the quality of life of patients and an increased risk of mortality.Complex pathophysiological mechanisms with dynamic alterations have been documented in skeletal muscle atrophy resulting from innervation loss.Hence,an in-depth comprehension of the key mechanisms and molecules governing skeletal muscle atrophy at varying stages,along with targeted treatment and protection,becomes essential for effective atrophy management.Our preliminary research categorizes the skeletal muscle atrophy process into four stages using microarray analysis.This review extensively discusses the pathways and molecules potentially implicated in regulating the four stages of denervation and muscle atrophy.Notably,drugs targeting the reactivare oxygen species stage and the inflammation stage assume critical roles.Timely intervention during the initial atrophy stages can expedite protection against skeletal muscle atrophy.Additionally,pharmaceutical intervention in the ubiquitin-proteasome pathway associated with atrophy and autophagy lysosomes can effectively slow down skeletal muscle atrophy.Key molecules within this stage encompass MuRF1,MAFbx,LC3II,p62/SQSTM1,etc.This review also compiles a profile of drugs with protective effects against skeletal muscle atrophy at distinct postdenervation stages,thereby augmenting the evidence base for denervation-induced skeletal muscle atrophy treatment.展开更多
目的对比肩峰下撞击综合征(SIS)的康复治疗方案,旨在寻找一种更为合理、更为有效、更为可行、重复性高的保守治疗SIS的方案。方法应用Biodex system 4多关节等速测评肩部肌群肌力及姿势评估,发现失衡的肩部肌肉,观察组48例应用肌肉调衡...目的对比肩峰下撞击综合征(SIS)的康复治疗方案,旨在寻找一种更为合理、更为有效、更为可行、重复性高的保守治疗SIS的方案。方法应用Biodex system 4多关节等速测评肩部肌群肌力及姿势评估,发现失衡的肩部肌肉,观察组48例应用肌肉调衡训练结合神经肌肉关节促进法治疗SIS,并与46例应用神经肌肉关节促进法治疗对照,并用HSS肩关节评分系统、JOA肩关节疾患治疗成绩判定标准评分评估疗效,应用SPSS 20.0版统计学软件进行统计分析。结果94例患者完成评估治疗,其中观察组完成48例,对照组完成46例。观察组治疗后HSS评分(86.40±8.83)分,JOA评分(88.25±7.33)分;对照组治疗后HSS评分(68.93±11.84)分,JOA评分(78.09±6.79)分。经统计学计算,两组治疗后HSS评分、JOA评分均上升(t=-32.881、-28.098、-22.680、-26.646,P<0.05),且观察组的HSS评分、JOA评分均高于对照组(t=8.130、6.965,P<0.05)。结论治疗SIS的两种保守方案均有效,但应用肌肉调衡训练结合神经肌肉关节促进法的疗效明显优于单一应用神经肌肉关节促进法,且经济有效、容易掌握、利于推广,是一种较合理的可行的SIS的康复治疗方案。展开更多
OBJECTIVE： To identify muscle imbalances and pelvic tilt with implications for low back pain in Keirin cyclists. METHODS： We enrolled 16 Keirin cyclists （mean age, 32.2 ±8.6 years） and 16 college students as ...OBJECTIVE： To identify muscle imbalances and pelvic tilt with implications for low back pain in Keirin cyclists. METHODS： We enrolled 16 Keirin cyclists （mean age, 32.2 ±8.6 years） and 16 college students as controls （24.3 ± 2.3 years）. We measured pelvic tilt, heel-buttock distance （HBD）, iliopsoas flexibility （using the Thomas test）, hamstring flexibility （using the straight-leg-raise [SLR] test）, finger floor distance （FFD）, and isometric and isokinetic hamstring and quadriceps muscle strength. These parameters were compared between the two groups, as well as between the right and left sides, by using the Mann-Whitney U test or unpaired t test. RESULTS： The results of this study revealed a significant anterior pelvic tilt at standing position and significantly higher HBD, SLR, and FFD in the Keirin cyclists than in the controls. The isokinetic muscle strength of the quadrieeps and hamstring, and the hamstring-to-quadriceps ratio at high angular velocity were significantly greater in the Keirin cyclists. No significant differences were found between the right and left sides. CONCLUSION： This study revealed that the Keirin cyclists had an anterior pelvic tilt and imbalance in hip muscle flexibility, but the difference between the right and left sides were not significant.展开更多
We report three patients with cervical neuromuscular syndrome (CNMS) who followed similar courses. Autonomic imbalance may occur following neck muscle pain, and a wide variety of somatic symptoms including headache an...We report three patients with cervical neuromuscular syndrome (CNMS) who followed similar courses. Autonomic imbalance may occur following neck muscle pain, and a wide variety of somatic symptoms including headache and vertigo appear and a generalized poor condition may continue for long periods. If many such somatic symptoms persist for months to years, symptoms of depression are exacerbated. The patients end up in psychiatric clinics, where they are diagnosed with depression, but they do not respond to antidepressants. Thus, they continue to suffer for many years. These patients eventually were completely cured with the resolution of neck pain by neck muscle treatment, using two types of special low-frequency therapy equipment, far-infrared radiation and acupuncture. When treatment for the neck muscles is initiated, symptoms of depression are quickly relieved, and diverse somatic symptoms disappear one after another as neck muscle tension is gradually alleviated (the number of abnormal neck muscle checkpoints decreases). Such a course suggests that neck muscle tension and chronic pain are closely related to depression. Neck muscle-related depression due to CNMS clearly differs from psychiatric conditions such as major and bipolar depression. In patients with neck muscle-related depression, symptoms of depression are not accompanied by ungrounded anxiety, a sense of emptiness, apathy, or self-rejection. Neck muscle abnormalities leading to CNMS are caused by head injury, whiplash injury, and a prolonged forward-bent-posture due to using a personal computer, playing computer games, texting, and engaging in machine-paced work such as assembly-line operation.展开更多
文摘目的:分析成人退行性脊柱侧凸(adult degenerative scoliosis,ADS)患者椎旁肌(多裂肌、竖脊肌)和腰大肌退变的不对称性及其与脊柱-骨盆冠状位参数之间的关系,为ADS患者冠状位失平衡的评估和预测提供新的思路。方法:回顾性分析96例ADS患者,测量并计算患者腰椎MRI顶椎层面椎旁肌和腰大肌的横截面积(cross-sectional area,CSA)、脂肪化比例(fat saturation fraction,FSF)、凹侧与凸侧横截面积之比(ratio of CSAconcave to CSAconvex,rCSA)、凹侧与凸侧脂肪化比例之比(ratio of FSFconcave to FSFconvex,rFSF),并在脊柱全长X线片上测量冠状位影像学参数,包括冠状位Cobb角(coronal Cobb angle,CA)和冠状面平衡距离(coronal balance distance,CBD)。根据C7铅垂线(C7PL)与骶骨中垂线(CSVL)的相对位置,将22例CBD≥30mm的患者分为两组:A组(C7PL在凸侧边,13例)和B组(C7PL在凹侧边,9例)。采用配对样本t检验分析顶椎层面凹凸两侧椎旁肌和腰大肌CSA和FSF的差异、Pearson相关分析肌肉影像学参数与脊柱-骨盆冠状位参数之间的相关性。结果:在顶椎层面,多裂肌、竖脊肌、腰大肌、椎旁肌凹侧CSA均显著大于凸侧(P<0.05),多裂肌凹侧FSF显著大于凸侧(P<0.01),竖脊肌凸侧FSF显著大于凹侧(P<0.05),腰大肌、椎旁肌两侧FSF无统计学差异(P>0.05)。CA与多裂肌凸侧CSA、竖脊肌和椎旁肌双侧CSA呈负相关(r=-0.233、-0.346、-0.211、-0.387、-0.232,P<0.05),与多裂肌凹侧FSF、rCSA和椎旁肌rCSA呈正相关(r=0.360、0.424、0.259,P<0.05)。A组CBD与各个肌肉的影像学参数均无相关性(P>0.05)。B组CBD与竖脊肌凹侧CSA,腰大肌凹侧FSF,多裂肌、竖脊肌、腰大肌和椎旁肌rCSA,腰大肌rFSF呈正相关(r=0.720、0.768、0.720、0.752、0.738、0.721、0.893,P<0.05)。结论:ADS患者椎旁肌和腰大肌影像学参数与脊柱-骨盆冠状位参数有明显的相关性,其中多裂肌rCSA与CA的相关性最强,在CBD超过30mm且C7PL在凹侧边的ADS患者中�
基金supported by the National Natural Science Foundation of China(Grant No.32200940)Science and Technology Bureau of Nantong(Grant Nos.JC2020101,JC2021085)Municipal Health Commission of Nantong(Grant No.MA2020019).
文摘Denervation-induced skeletal muscle atrophy can potentially cause the decline in the quality of life of patients and an increased risk of mortality.Complex pathophysiological mechanisms with dynamic alterations have been documented in skeletal muscle atrophy resulting from innervation loss.Hence,an in-depth comprehension of the key mechanisms and molecules governing skeletal muscle atrophy at varying stages,along with targeted treatment and protection,becomes essential for effective atrophy management.Our preliminary research categorizes the skeletal muscle atrophy process into four stages using microarray analysis.This review extensively discusses the pathways and molecules potentially implicated in regulating the four stages of denervation and muscle atrophy.Notably,drugs targeting the reactivare oxygen species stage and the inflammation stage assume critical roles.Timely intervention during the initial atrophy stages can expedite protection against skeletal muscle atrophy.Additionally,pharmaceutical intervention in the ubiquitin-proteasome pathway associated with atrophy and autophagy lysosomes can effectively slow down skeletal muscle atrophy.Key molecules within this stage encompass MuRF1,MAFbx,LC3II,p62/SQSTM1,etc.This review also compiles a profile of drugs with protective effects against skeletal muscle atrophy at distinct postdenervation stages,thereby augmenting the evidence base for denervation-induced skeletal muscle atrophy treatment.
文摘目的对比肩峰下撞击综合征(SIS)的康复治疗方案,旨在寻找一种更为合理、更为有效、更为可行、重复性高的保守治疗SIS的方案。方法应用Biodex system 4多关节等速测评肩部肌群肌力及姿势评估,发现失衡的肩部肌肉,观察组48例应用肌肉调衡训练结合神经肌肉关节促进法治疗SIS,并与46例应用神经肌肉关节促进法治疗对照,并用HSS肩关节评分系统、JOA肩关节疾患治疗成绩判定标准评分评估疗效,应用SPSS 20.0版统计学软件进行统计分析。结果94例患者完成评估治疗,其中观察组完成48例,对照组完成46例。观察组治疗后HSS评分(86.40±8.83)分,JOA评分(88.25±7.33)分;对照组治疗后HSS评分(68.93±11.84)分,JOA评分(78.09±6.79)分。经统计学计算,两组治疗后HSS评分、JOA评分均上升(t=-32.881、-28.098、-22.680、-26.646,P<0.05),且观察组的HSS评分、JOA评分均高于对照组(t=8.130、6.965,P<0.05)。结论治疗SIS的两种保守方案均有效,但应用肌肉调衡训练结合神经肌肉关节促进法的疗效明显优于单一应用神经肌肉关节促进法,且经济有效、容易掌握、利于推广,是一种较合理的可行的SIS的康复治疗方案。
文摘OBJECTIVE： To identify muscle imbalances and pelvic tilt with implications for low back pain in Keirin cyclists. METHODS： We enrolled 16 Keirin cyclists （mean age, 32.2 ±8.6 years） and 16 college students as controls （24.3 ± 2.3 years）. We measured pelvic tilt, heel-buttock distance （HBD）, iliopsoas flexibility （using the Thomas test）, hamstring flexibility （using the straight-leg-raise [SLR] test）, finger floor distance （FFD）, and isometric and isokinetic hamstring and quadriceps muscle strength. These parameters were compared between the two groups, as well as between the right and left sides, by using the Mann-Whitney U test or unpaired t test. RESULTS： The results of this study revealed a significant anterior pelvic tilt at standing position and significantly higher HBD, SLR, and FFD in the Keirin cyclists than in the controls. The isokinetic muscle strength of the quadrieeps and hamstring, and the hamstring-to-quadriceps ratio at high angular velocity were significantly greater in the Keirin cyclists. No significant differences were found between the right and left sides. CONCLUSION： This study revealed that the Keirin cyclists had an anterior pelvic tilt and imbalance in hip muscle flexibility, but the difference between the right and left sides were not significant.
文摘We report three patients with cervical neuromuscular syndrome (CNMS) who followed similar courses. Autonomic imbalance may occur following neck muscle pain, and a wide variety of somatic symptoms including headache and vertigo appear and a generalized poor condition may continue for long periods. If many such somatic symptoms persist for months to years, symptoms of depression are exacerbated. The patients end up in psychiatric clinics, where they are diagnosed with depression, but they do not respond to antidepressants. Thus, they continue to suffer for many years. These patients eventually were completely cured with the resolution of neck pain by neck muscle treatment, using two types of special low-frequency therapy equipment, far-infrared radiation and acupuncture. When treatment for the neck muscles is initiated, symptoms of depression are quickly relieved, and diverse somatic symptoms disappear one after another as neck muscle tension is gradually alleviated (the number of abnormal neck muscle checkpoints decreases). Such a course suggests that neck muscle tension and chronic pain are closely related to depression. Neck muscle-related depression due to CNMS clearly differs from psychiatric conditions such as major and bipolar depression. In patients with neck muscle-related depression, symptoms of depression are not accompanied by ungrounded anxiety, a sense of emptiness, apathy, or self-rejection. Neck muscle abnormalities leading to CNMS are caused by head injury, whiplash injury, and a prolonged forward-bent-posture due to using a personal computer, playing computer games, texting, and engaging in machine-paced work such as assembly-line operation.
文摘目的:分析肩胛肌肉失衡(scapular muscle imbalance,SMI)的优秀乒乓球运动员运动员肩关节功能中心(functional joint center,FJC)的特点。方法:选择国家男子乒乓球优秀运动员25人,根据肩胛外向滑动(lateral scapular slide,LSS)测试和手臂与肩关节运动障碍(disabilities of the arm,shoulder and hand,DASH)及DASH运动部分评分分为肩胛失衡组(IA组,12人)和健康组(NA组,13人),另选择年龄、身高和体重与运动员组匹配的15名男性志愿者作为健康对照组(CON组)。采用三维动作分析系统测量所有实验对象优势侧FJC在X轴(内外)、Y轴(上下)和Z轴(前后)三个方向上相对于胸骨上窝参照点的平均位移(mm),分析肩胛骨姿势变化。结果:CON组FJC在内外、上下和前后等方向的位移与NA组相比均无显著性差异(分别为P=0.588,P=0.716,P=0.963)。IA组FJC在内外、上下、前后方向的位移较NA组和CON组均有显著性差异,在X轴上外移(P<0.001),在Y轴上下移(P<0.001),在Z轴上前移(P<0.001)。结论:相比健康乒乓球运动员和健康普通人,肩胛肌肉失衡乒乓球运动员肩胛静息姿势有前、下、外向相对位移。
