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Objective: To determine the asymmetry in the paraspinal muscle before pregnancy and evaluate its association with pregnancy‐associated lumbopelvic pain (LPP). Methods: This was a prospective case–control study conducted from January 2017 and December 2018. A total of 171 subjects (mean age ± SD, 27.4 ± 5.8 years) were finally divided into the LBP group, PGP group, and no LPP group. Each subject was asked to follow a standardized clinical imaging protocol before the pregnancy. The area of muscles (multifidus, erector spinae, and psoas muscles) on the axial slice at mid‐disc of L4–L5 and L5–S1 were segmented and then the cross‐sectional area (CSA) of a particular muscle was measured by outlining the innermost fascial border surrounding each muscle. The mean value of F‐CSA's ratio to T‐CSA (F/T CSA) was used to determine whether the bilateral paraspinal muscle was asymmetrical. Total muscle CSA (T‐CSA) represents the sum of CSA of interested three muscles. The signal intensity can distinguish fat and muscle tissue in a different range. Based on this, functional CSA (F‐CSA), represented by fat‐free area, was evaluated quantitively by excluding the signal of the deposits of intramuscular fat. Total muscle CSA (T‐CSA), functional CSA (F‐CSA), and the ratio of F‐CSA to T‐CSA (F/T CSA) were measured unilaterally and compared between groups. Logistic regression was performed to determine the risk factors for pregnancy‐associated LPP. The Pearson correlation coefficient was performed to test the relationship between asymmetry in F/T‐CSA and pain rating. Results: A total of 124 subjects (72.5%) (28.5 ± 5.2 years) had LPP during pregnancy. Forty‐eight (38.7%) individuals had low back pain (LBP) and 76 (61.3%) had pelvic girdle pain (PGP). Seventy‐six women (44.4%) were determined to have asymmetry in paraspinal muscle according to the definition in this methods section. The duration of follow‐up was 24 months postpartum. A total of 39 (31.5%) women unrecovered from LPP. F/T‐CSA was significantly decreased for LBP in the PGP group than in the and control group (0.03 ± 0.02 vs 0.05 ± 0.03 vs 0.12 ± 0.05, P < 0.001). Meanwhile, significant differences were detected in both groups (all P < 0.001). In patients with LBP, the level of paraspinal asymmetry, represented by the difference in F/T‐CSA, was positively correlated with pain scores (r = 0.52, P < 0.01). However, no statistically significant correlation between pain scores and paraspinal asymmetry was found in PGP (r = 0.42, P > 0.05). Asymmetry in the paraspinal muscle (adjusted OR = 1.5), LBP (adjusted OR = 1.6), LPP in a previous pregnancy (adjusted OR = 1.4), sick leave ≥90 days (adjusted OR = 1.2), and heavy labor (adjusted OR = 1.2) were risk factors for the unrecovered LPP during pregnancy. Conclusions: Asymmetrical muscular compositions could lead to abnormal biomechanics for the segmental motions. Lateral‐directed physical training and stretching may help decrease the occurrence and severity of this condition. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of different skin incisions on recovery from total knee arthroplasty (TKA). Methods: This is a retrospective study conducted in a tertiary hospital. A total of 1210 patients accepted primary and unilateral total knee arthroplasty (TKA) at the authors' affiliated institutions between January 2015 and January 2019. Patients who accepted primary and unilateral TKA due to OA under epidural anesthesia were included. Excluded cases included patients who had no completed follow‐up; preoperative flexion contracture greater than 15° and preoperative flexion less than 90°; paresthesia in lower limb; scar within the knee area; patella alta or baja. We recorded and analyzed the following data, including each patient's characteristics, incision stretching index (IS index), perioperative information, and follow‐up assessments. Patients were grouped by trisecting the range of IS index we observed in the present study. The primary outcome measure was the visual analog scale (VAS) pain score rated on a scale of 0–10 from no pain to severe pain. Secondary outcome measures include knee girth reflecting postoperative swelling, knee range of motion (ROM), sensory testing, and the strength of quadriceps. These measures were completed 2 weeks postoperatively. Results: A total of 1089 patients undergoing primary and unilateral TKA in our two institutions were screened for final analysis, and 121 ones were excluded. The patients were followed up for an average of 13.3 months postoperatively. The mean length of FL was 28.3 cm (range: 21.0–38.8 cm). The mean IS index was 2.7 cm (range: 0.4–5.1 cm). We found no significant difference in those data among groups (P > 0.05). VAS pain scores among group IS A, IS B, and IS C were significantly different (2.3 ± 0.6 vs 3.4 ± 1.6 vs 3.9 ± 1.5, P = 0.0001). Similar situations were seen in knee circumference, ROM, area of abnormal sensation, and quadriceps strength among groups (all P < 0.05). With the increase in the IS index, VAS pain score, knee circumference, area of abnormal sensation, and incision problems were significantly increased (P < 0.05). At the same time, ROM and the strength of quadriceps decreased (P < 0.05). With the increase in the IS index, the number of patients with incision problems was increased significantly (P < 0.05). Besides, no significant difference in PJI and DVT among groups was observed (P > 0.05). Conclusions: Proper incision stretching can improve postoperative pain relief, surgical swelling, ROM, sensory disturbance of the knee, and the strength of quadriceps with reduced risk of incision complications. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of different acupuncture treatments in the treatment of lumbar disc herniation. Methods: Searching PubMed, EMBASE, Cochrane Library, web of by computer Science, Chinese Journal Full-text Database, Wanfang database, VIP database and Chinese biomedical literature database, the retrieval time is from the establishment of the database to January 1, 2020. Two researchers conducted literature screening, quality evaluation and data extraction according to the nano platoon standard, and used stata16.0 for network meta-analysis. Results: a total of 69 RCTs were included, involving 6168 patients with lumbar disc herniation, 5 kinds of acupuncture therapy (warm acupuncture, fire acupuncture, electroacupuncture, acupuncture thread embedding, general acupuncture). The results of network meta-analysis showed that the effect of electroacupuncture was inferior to that of warm acupuncture, acupuncture thread embedding, and the effect of general acupuncture was inferior to that of warm acupuncture, fire acupuncture, electroacupuncture, acupuncture thread embedding, and the difference was statistically significant. In terms of efficiency, acupuncture and moxibustion embedding thread > warming acupuncture and moxibustion > fire acupuncture > electroacupuncture > ordinary acupuncture. Conclusion: in the treatment of lumbar disc herniation, the clinical effect of acupuncture thread embedding is better than the other four interventions. However, the quality and quantity of literature in this study are limited, and the conclusion of this study needs to be verified by high-quality RCT with multiple centers and large samples. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical effect of Duhuo Jisheng Decoction in the treatment of lumbar disc herniation. Methods: CNKI, VIP, Wan Fang Data, Pubmed, Cochrane Library, Medline Complete and Embase databases were searched by computer. The randomized controlled trial (RCT) of Duhuo Jisheng Decoction combined with western medicine in the treatment of lumbar intervertebral disc herniation was studied. The searching time was from the establishment of the database to July 20, 2019. Data were extracted and analyzed by Revman 5.3 software. Results: Twenty-four literatures involving 1980 patients were included. Meta-analysis showed that the total effective rate of Duhuo Jisheng Decoction group was significantly higher (OR = 5.26, 95% CI (4.13, 6.69), Z = 13.47, P < 0.00001) and the incidence of adverse reactions was significantly lower (OR = 0.45, 95% CI (0.23, 0.87), Z = 2.36, P = 0.00001) than that of Western medicine group. 02). Conclusion: Duhuo Jisheng Decoction is effective and safe in the treatment of lumbar intervertebral disc herniation. However, the literature included in this study is limited, and the quality of the literature is low. It is necessary to carry out in-depth verification of high-quality, large-sample RCT. [ABSTRACT FROM AUTHOR]

By consulting and collating the relevant literatures on the treatment of fluorosis in Traditional Chinese medicine, the research progress of TCM in the treatment of fluorosis was summarized. This paper summarizes the treatment of fluorosis in traditional Chinese medicine from the aspects of the traceability of TCM theory, etiology and pathogenesis, syndrome differentiation and cure, special disease specialty and foreign medicine, so as to guide clinical practice. TCM treatment of fluorosis more use of tonifying kidney and bone, activating blood circulation stasis, cold moisturizing, Tongluo pain relief and other methods, based on dispelling evil and tonifying kidney, combined with a variety of treatment methods, in relieving clinical symptoms and improving the quality of life of patients have an irreplaceable role, has been widely recognized, but most of the research reports are their own work experience summary, Lack of uniform diagnosis and treatment standards, and small sample size, data repeatability is weak, future research needs to further enhance the scientific and objective of the experiment, for TCM treatment of fluorosis to provide a scientific and reasonable diagnosis and treatment program, give full play to the advantages of TCM therapy. [ABSTRACT FROM AUTHOR]