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Spinel-type CuFe2O4 nanoparticles were synthesized by a solvothermal method using ethylene glycol as solvent and polyvinylpyrrolidone (PVP) as dispersant. The characterization results showed that the average diameter of the hollow-spherical CuFe2O4 was approximately 100 nm with homogeneous morphology and negligible agglomeration. CuFe2O4 was used as the active electrode material to explore its supercapacitive properties in different concentrations of KOH electrolytes. It was found that the CuFe2O4 hollow-spherical nanoparticles exhibit potential electronic performance in supercapacitor, with a specific capacitance of 368.2 F/g and capacitance stability retention of 91.0% after 2000 cycles at the current density of 5 A/g in 3 mol/L KOH electrolyte. The present findings demonstrate that the CuFe2O4 electrode materials can have important implications with practical prospects in energy storage systems. [ABSTRACT FROM AUTHOR]

Seagrass meadows are important carbon sinks in the global coastal carbon cycle yet are also among the most rapidly declining marine habitats. Their ability to sequester carbon depends on flow–sediment–vegetation interactions that facilitate net deposition, as well as high rates of primary production. However, the effects of seasonal and episodic variations in seagrass density on net sediment and carbon accumulation have not been well quantified. Understanding these dynamics provides insight into how carbon accumulation in seagrass meadows responds to disturbance events and climate change. Here, we apply a spatially resolved sediment transport model that includes coupling of seagrass effects on flow, waves, and sediment resuspension in a seagrass meadow to quantify seasonal rates of sediment and carbon accumulation in the meadow. Our results show that organic carbon accumulation rates were largely determined by sediment accumulation and that they both changed non‐linearly as a function of seagrass shoot density. While seagrass meadows effectively trapped sediment at meadow edges during spring–summer growth seasons, during winter senescence low‐density meadows (< 160 shoots m−2) were erosional with rates sensitive to density. Small variations in winter densities resulted in large changes in annual sediment and carbon accumulation in the meadow; meadow‐scale (hundreds of square meters) summer seagrass dieback due to marine heatwaves can result in annual erosion and carbon loss. Our findings highlight the strong temporal and spatial variability in sediment accumulation within seagrass meadows and the implications for annual sediment carbon burial rates and the resilience of seagrass carbon stocks under future climate change. [ABSTRACT FROM AUTHOR]

Storm surge has the potential to significantly increase suspended sediment flux to microtidal marshes. However, the overall effects of storm surge on microtidal marsh deposition have not been well quantified, with most modeling studies focusing on regular (astronomical) tidal flooding. Here we applied the Delft3D model to a microtidal bay‐marsh complex in Hog Bay, Virginia to quantify the contributions of storm surge to marsh deposition. We validated the model using spatially distributed hydrodynamic and suspended sediment data collected from the site and ran model simulations under different storm surge conditions with/without storm‐driven water level changes. Our results show that episodic storm surge events occurred 5% of the time at our study site, but contributed 40% of marsh deposition during 2009–2020. Our simulations illustrate that while wind‐driven waves control sediment resuspension on tidal flats, marsh deposition during storms was largely determined by tidal inundation associated with storm‐driven water levels. A moderate storm surge event can double sediment flux to most marshes around the bay and deliver more sediment to the marsh interior compared to simulations that include wind waves but not storm surge variations in water levels. Simulations of bay and marsh response to different storm surge events with varying magnitude of storm surge intensity reveal that total marsh deposition around the bay increased linearly with storm surge intensity, suggesting that future changes to storm magnitude and/or frequency would have significant implications for sediment supply to marshes at our study site. Plain Language Summary: Storm surge is a rise of water level beyond normal tidal levels caused by a storm. It can result in longer and deeper inundation on the marsh platform and potentially provide more sediment for microtidal marshes (tidal range <2 m) to gain elevation at a rate comparable to sea level rise. However, the overall importance of storm surge to sediment deposition on these marshes is not well understood. Here we used a well‐tested coastal model in a shallow microtidal bay fringed by intertidal salt marshes to run model simulations for different storm surge events with varying magnitude of storm surge intensity to determine the contributions of storm surge to marsh deposition. Our simulation results show that infrequently occurring storm surge events contributed ∼40% of marsh deposition at our study site and that total mass of marsh deposition around the bay increased linearly with the magnitude of storm surge events. Our findings have significant implications for predicting marsh change, especially if we experience a stormier future climate. Modeling studies that do not resolve storm surge effects on marsh deposition will likely underestimate rates of marsh elevation change. Key Points: A numerical model was used to quantify the contributions of storm surge on marsh deposition in a microtidal bay‐marsh complexStorm surge events occurred 5% of the time, but contributed 40% of marsh deposition during 2009–2020Marshes will likely be supplied with more sediment during storms if storm magnitudes and/or frequencies increase in the future [ABSTRACT FROM AUTHOR]

This study examined the biomechanics of the lower limbs during four typical Tai Chi (TC) movements: wave hand in cloud, leaning fly side, repulse monkey, and brush knee and twist step, in order to provide biomechanical evidence-based recommendations for patients with knee osteoarthritis (OA) practicing TC. Joint angles and joint moments of the hip, knee, and ankle in frontal and sagittal plane as well as ground reaction forces were examined while performing TC and regular walking in an experienced 38 years old TC master. The results showed that relative to walking, the four TC movements are characterized by a wide motion range of lower limbs, slow increase in joint loading, and strong muscle activity during performance. Therefore, these TC movements could be suitable for patients with knee OA to practice for improving the muscle strength of their lower limbs and functional ability. [ABSTRACT FROM AUTHOR]

Objective. This meta-analysis aimed to evaluate the effects of manual therapy (MT) on cancer pain, so as to provide clinical evidence for application. Methods. Five English and Chinese databases were searched until February 29, 2020, for randomized controlled trials (RCTs) of MT for cancer pain. Articles published in the English or Chinese language were included. Two authors independently reviewed all articles and extracted the data, and any disagreements in the above process were discussed with other reviewers until the authors reached consensus. Review Manager 5.3 was used to calculate the effect size and 95% confidence intervals. This review was registered in PROSPERO, number CRD42020172053. Results. The intensity of cancer pain is our primary outcome measure, and compared with standard care, MT can significantly relieve the pain of patients with cancer (SMD, 0.63; 95% CI [0.18, 1.08]; P = 0.006 < 0.01); the effects of MT plus active activity were significantly different from AT alone (SMD, 0.79; 95% CI [0.28, 1.30]; P = 0.002 < 0.01); there was no statistical difference in the efficacy of MT and AT alone (SMD, -0.24; 95% CI [-1.09, 0.62]; P = 0.53 > 0.05). In other related symptoms, the above evidence cannot support that MT had a good effect on fatigue (SMD, 0.77; 95% CI [-0.09, 1.63]; P = 0.08 > 0.05), nausea (SMD, 0.24; 95% CI [-0.00, 0.48]; P = 0.05), anxiety (SMD, 0.76; 95 % CI [-0.32, 1.84]; P = 0.17 > 0.05), and depression (SMD, 0.67; 95 % CI [-0.28, 1.62]; P = 0.17 > 0.05); however, MT intervention can improve physical function (n = 271; SMD, 0.35; 95 % CI [-0.04, 0.74]; P = 0.04 < 0.05) and global well-being (SMD, 0.50; 95 % CI [0.02, 0.98]; P = 0.04 < 0.05). In addition, MT had a significant effect on pain relief (SMD, 0.52; 95% CI [0.03, 1.01]; P = 0.04 < 0.05) and improvement of physical function (SMD, 0.28; 95% CI [0.02, 0.53]; P = 0.03 < 0.05) even after a period of time after treatment. Conclusion. MT was an effective intervention, which may have immediate effect on cancer pain and may improve physical function and global well-being. In the view of follow-up effects, MT had good effects for the reduction of pain and the recovery of physical function. However, because of limitations, the seemingly promising results should be interpreted with caution. [ABSTRACT FROM AUTHOR]

The aim of this review was to examine the effects of shoes and insoles on low back pain (LBP). Seven electronic databases were searched from their inception to May 2020. The methodological quality of the 14 included studies was assessed by PEDro scale. Quality of evidence was assessed using GRADE. Moderate evidence on the disability questionnaire score (SMD, 0.52; 95% CI, 0.28 to 0.77; P < 0.001) and pain score (SMD, 0.61; 95% CI, 0.36 to 0.85; P < 0.001) of the custom-made orthotics for chronic LBP compared with no orthotics/insoles intervention was found. Meta-analysis results also showed moderate evidence on the disability questionnaire score (SMD, 0.44; 95% CI, 0.05 to 0.82; P =0.03) in patients who wore unstable shoes compared with regular shoes. Pain and life quality scores showed low-quality evidence of unstable shoes for chronic LBP. Custom-made orthotics and unstable shoes can be recommended to patients as a management option of chronic LBP. [ABSTRACT FROM AUTHOR]

Low back pain (LBP) is one of the major concerns of the current health care. The guidelines for chronic LBP recommend traditional Chinese exercise as an effective treatment. As one of the representatives of traditional Chinese exercise, Wuqinxi has been famous in China for its effects on improving health and treating chronic diseases for thousands of years. The objectives of the study were to assess the effects of Wuqinxi in the patients with chronic LBP on pain intensity, trunk muscle strength, and quality of life. The primary outcome measure was assessed by the Short-Form McGill Pain Questionnaire (SF-MPQ), including the Visual Analog Scale (VAS) and Present Pain Intensity (PPI) as the subtables. The effects of Wuqinxi on the quality of life were also assessed by the Short-Form Health Survey (SF-36) and the Pittsburgh Sleep Quality Index (PSQI) from physical component summary (PCS), mental component summary (MCS), and sleep quality. Besides, the electrical activities of the rectus abdominis (RA), obliquus externus abdominis (OEA), lumbar erector spinae (ES), and multifidus (MF) were assessed by integrated electromyogram (iEMG) after the end of the intervention. Both the groups showed statistically significant improvement in SF-MPQ, SF-36, PSQI, and iEMG at 12 weeks and 24 weeks when compared with baseline (P < 0.05). However, Wuqinxi demonstrated better effects in SF-MPQ and MCS after 24 weeks of intervention compared with the general exercise (P < 0.05). The patients in the Wuqinxi group (WQXG) also showed a significantly higher iEMG on OEA than the general exercise group (GEG) in 30°/s and 90°/s (P < 0.05). Our results showed that Wuqinxi had better effects on chronic LBP for a long time compared with general exercise, including pain intensity and quality of life. Thus, Wuqinxi should be recognized as a possible standalone therapy and self-management skill in chronic LBP, which is suitable for long-term practice. [ABSTRACT FROM AUTHOR]

The evaluation on sinews and bones in tuina of traditional Chinese medicine (TCM) refers to a systematic approach to evaluate the patient's physical state, so as to select appropriate tuina therapies and achieve safe and efficient goals. Through summarizing the characteristics of evaluation on sinews and bones in main schools of modern TCM tuina including assessments of bone landmarks, soft tissues and pain, and Western manual therapies including assessments of palpation of spine, postures (positions), pain and surrounding soft tissues, the key elements of promotion mode of evaluation on sinews and bones in TCM tuina are proposed, namely the evaluation on muscle tissue morphology, postures, tenderness points and joint motions. The purpose is to provide a reference for establishing a scientific, standard and feasible mode of evaluation on sinews and bones. [ABSTRACT FROM AUTHOR]

Human activities, such as tidal sluice gate construction and reclamation, are prevalent along northern coastline of China and influence significantly sedimentary environments. The Sheyang River estuary is a small estuary situated on the Jiangsu coast. For the objective of storing fresh water, maintaining river channel depth and managing the land resource, a tidal sluice gate was constructed. At the same time, estuarine wetlands have been reclaimed extremely in recent decades. A numerical model based upon Delft3D was developed to quantify the impact of these human activities, and four simulation schemes were designed (a) tidal sluice gate present, but always closed; (b) tidal sluice gate not present; (c) tidal sluice gate present, but closed during flood and open during the ebb; and (d) intertidal area reclamation taking place in the estuary. A bathymetric survey confirmed the erosion and deposition results of the simulation. The rate of sediment deposition increased significantly after the gate was closed. However, during the third scheme, the sediment deposition rate reduced considerably; that was because the ebb current increased the scouring force when the gate was open, especially within the channel area close to the gate. Meanwhile, reclamation lessened erosion behind the gates and may have been enhanced by siltation. The coastline shifted seaward as the siltation area increased; it extended farther because of reclamation. Appropriate coastal management planning strategies must be developed to reduce negative effects of the channel siltation, resulting from the various forms of human activity. The results of this study can provide input to governmental recommendations on more effective tidal gate management strategies. [ABSTRACT FROM AUTHOR]

The bottom friction velocity (U*), which controls seabed erosion and deposition, plays a critical role in sediment transport in tidal coastal bottom boundary layers. Approaches have been proposed to calculate U*, including the log profile (LP) estimation, the direct covariance (COV) measurement, and the turbulent kinetic energy (TKE) method. However, the LP method assumes homogeneous flow and the effects of stratification need to be taken into account. Here, field investigations of hydrodynamics and sediment dynamics were carried out on the Jiangsu Coast, China. Two acoustic Doppler velocimeters (ADV) velocity measurements at 0.2 and 1 m above the seabed have been used to estimate U*, based on the aforementioned three methods. The COV and TKE methods provided reasonable estimations of U*, while a pronounced overestimation was identified when using the LP method. This overestimation can be attributed to the stratification effects associated with the vertical suspended sediment concentration (SSC) gradient near the bottom. Then, three models were utilized to correct the overestimation, in which the gradient/flux Richardson number was modified with empirical constants α, β, and A to parameterize the stratification effects in the logarithmic velocity distribution. The values of α, β, and A derived from the observation are smaller than the results from previous investigations. These modified logarithmic velocity distribution models can be applied in numerical simulations when sediment stratification is important. [ABSTRACT FROM AUTHOR]

Fine-grained sediments suspended in coastal waters play an important role in submarine topography evolution and associated environment changes. The convergence of suspended sediments concentrated near the seabed results in high sediment concentration, and contributes significantly to sediment transport. In order to investigate the mechanism triggering high suspended sediment concentration (SSC), we deployed a tripod to the seabed to obtain in situ bottom boundary layer measurements of sediment dynamics and a buoy to the sea surface to collect meteorological and wave data at the northern Changjiang River mouth from December 20, 2015 to January 20, 2016. The high SSC (e.g. >3 g/L) events were observed together with fluid mud (thicknesses of 4–16 cm) near the seabed during neap tides when cold air intrusion generated winter storms and strong waves. Further, we found that the high SSC event was mainly resulted from wind waves and sediment resuspension supported by local benthic fluid mud, which was associated with three stages. At the setting up stage, the winter storm brought long duration of strong-waves (e.g. significant wave height >1.5 m) more than 15 h, resulting in a maximum wave-current combined bottom shear stress of 3.2 Pa and the increase of SSC to >1 g/L. At the reinforcement stage, the strong waves and bottom shear stress lasted for several hours, and further increased the SSC to >3 g/L. At the final decay stage, wind waves and the maximum wave-current shear stresses decreased significantly, with the disappearance of high SSC. Thus, there was no high SSC event observed even with strong wind waves during spring tides because strong wave duration was too short for the reinforcement process. The sediment source for the high SSC events was mainly from bottom fluid mud resuspension, as well as the advection transport from the adjacent subaqueous Changjiang River delta. • Tripod deployment obtains bottom sediment dynamics under winter storm conditions. • Resuspension SSC peaks supported by wind waves and local benthic fluid mud. • High SSC events formed through the setting up to reinforcement and decay stages. • Reinforcement determined by winter storm induced long duration of strong waves. [ABSTRACT FROM AUTHOR]

The residual sand (D > 62.5 μm) transport (RST) refers to the tidally averaged rate of horizontal sand transport. Albeit much smaller than the peak rates, it determines the morphological evolution. The analytical expression for the tide-induced RST has been reported in the condition of one-dimensional tidal currents by van de Kreeke and Robaczewska (1993). Here we extended the analytical solution to two-dimensional. The constituents of the residual, M 2 , and M 4 tidal current velocities were used to characterize the collinear tidal current in the orthogonal X and Y directions, i.e., cross-shore and alongshore, respectively, while the M 2 tidal constituent is dominant in both directions. Based on the solution, RST is controlled by a series of triple interactions of the M 2 tidal velocity in the X direction, M 2 tidal velocity in the Y direction, and the residual or M 4 velocity in the X or Y direction. The solution was applied to the tide-dominated continental shelf of the Jiangsu coast, China, where the alongshore current is much stronger than the cross-shore component. The results show that the triple interactions of the cross-shore M 2 tidal velocity (U M2), the alongshore M 2 tidal velocity (V M2), and the alongshore residual velocity account for the major parts of both the alongshore and cross-shore RST in the nearshore area. The RST patterns promote sand accumulation in the shallow nearshore area and generate a narrow and active conduit of coastal alongshore sand transport. These findings can be applied in similar marine environments to understand the effects of non-linear tidal interactions in RST. ● The mechanisms of two-dimensional tide-induced residual sand transport (RST) are revealed by the analytical solution. ● Interaction of the cross-shore M 2 , the alongshore M 2 , and the alongshore M 0 accounts for the most part of RST in the nearshore area of the Jiangsu coast, China. ● The RST patterns promote sand accumulation in the shallow nearshore area and generate a narrow and active conduit of coastal alongshore sand transport. [ABSTRACT FROM AUTHOR]

Deltas are threatened by erosion due to climate change and reduced sediment supply, but their response to these changes remains poorly quantified. We investigate the abandoned Yellow River delta that has transitioned from rapid growth to ongoing deterioration due to a river avulsion removing the sediment supply. Integrating bathymetric data, process observations, and sediment transport modeling, we find that while the subaerial delta was stabilized by engineering measures, the subaqueous delta continued to erode due to intensified storms, losing 39% of its mass deposited before the avulsion. Long-term observations show that winter storms initiate scouring of the subaqueous delta, contributing up to 70% of seabed erosion. We then analyze 108 global deltas to assess subaqueous delta erosion risks and identify 17 deltas facing similar situations of sediment decline and storm intensification during the past 40 years. Our findings suggest that subaqueous delta erosion must be integrated into delta sustainability evaluations.

Introduction: Non-pharmacological interventions play a crucial role in the management of non-specific chronic low back pain (NSCLBP). One prime example is Tuina, a traditional Chinese manual therapy that incorporates pressing, kneading and rubbing techniques to alleviate physical discomfort and enhance overall well-being. It serves as a widely used technique in China and other East Asian countries. However, the effectiveness and safety of Tuina for managing NSCLBP have not been substantiated through rigorous clinical research. We sought to carry out a randomised controlled trial with an open-label design, blinded assessors and parallel arms to assess the effectiveness and safety of Tuina as a treatment for NSCLBP. The trial aims to provide high-quality evidence regarding the efficacy and safety of Tuina in improving outcomes for patients with NSCLBP., Methods and Analysis: A total of 150 patients aged 18-60 years with NSCLBP will be recruited. Participants will be randomly assigned to one of the two groups. Both groups will receive standard health education. In addition, the treatment group will receive Tuina therapy, while the control group will participate in core stability exercises. Each group will undergo a total of 18 interventions over 6 weeks, with the interventions administered three times per week. The primary outcome measure is the patient's pain intensity, assessed using the Numerical Rating Scale, at week 6 following randomisation. Secondary outcomes encompass disability (measured by the Roland-Morris Disability Questionnaire), quality of life (assessed using the EuroQoL-5 dimensions questionnaire), adverse emotions (evaluated with the Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia and Depression Anxiety Stress Scale), biomechanical outcomes, socioeconomic indicators (medication use, healthcare utilisation and absenteeism), patient satisfaction, treatment adherence and other relevant factors.The statistical analysis will follow the intention-to-treat principle. Two-way repeated measures analysis of variance will be used to compare the clinical data across different time points within both groups., Ethics and Dissemination: The study protocol has received approval from the Ethics Committee of Shuguang Hospital, Shanghai University of Traditional Chinese Medicine (2023-1366-133-01). All study participants will be required to give written informed consent. The findings of the study will be submitted to a peer-reviewed journal for publication and presented at scientific conferences. Additionally, the participants will receive copies of the results., Trial Registration Number: ChiCTR2300076257., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Tuina, a method of traditional Chinese manual manipulation, is an effective alternative therapy for neuropathic pain (NP), but its analgesic mechanism remains unclear. In this study, we used resting-state functional magnetic resonance imaging (R-fMRI) to explore the analgesic mechanism of Tuina in an NP rat model. After undergoing surgery to induce chronic compression of the dorsal root ganglion (CCD), one group of rats underwent Tuina at the ipsilateral BL40 acupoint once a day for 10 min during the 25 days following surgery while another group did not. Behavioral tests were performed at baseline, on the third day following surgery, and once a week for the next 4 weeks. R-fMRI was performed at baseline and 7 days and 28 days following surgery. Behavioral testing revealed that the Tuina group presented a significant response improvement to mechanical and thermal nociception stimuli compared to the untreated group 2 weeks following CCD surgery. Interestingly, rats submitted to Tuina presented higher measures of spontaneous neuronal activity in basal forebrain region, primary somatosensory cortex barrel field, dentate gyrus, secondary somatosensory cortex, striatum, descending corticofugal pathways, and globus pallidum of the left hemisphere 4 weeks after the CCD surgery compared to rats having undergone CCD only. In addition, on the 28th day, the ALFF signals of the left dentate gyrus, left secondary somatosensory cortex, left striatum, and bilateral primary cingulate cortex were significantly increased while those in the right dentate gyrus and bilateral periaqueductal gray were significantly decreased compared to those on the 7th day. Correlation analysis showed that the ALFF values of the left descending corticofugal pathways and globus pallidum had a positive correlation with mechanical withdrawal threshold and paw withdrawal thermal latency tests. Altogether, these results indicate that NPP induced by CCD surgery affects the plasticity of the cerebral cortex, and that Tuina alleviate pain behavior by promoting cortical remodeling., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wu, Guo, Zhang, Li, He, Zhu, Kong and Fang.)

A suitable electrolyte is crucial to enhancing the electrochemical performance of magnesium (Mg) batteries. Here, the influence of Na 2 SiO 3 on the electrochemical behavior of AZ31B Mg alloy in the Na 2 SO 4 -NaNO 3 composite electrolyte was investigated. The results revealed that the activation potential of the AZ31B Mg alloy first represented a negative shift and then a positive shift with the increase in Na 2 SiO 3 . The most negative activation potential (-1.51 V) and the lowest polarization (-3.20 V) were found when 6 mM of Na 2 SiO 3 was added; no discharge hysteresis was observed, and the polarization resistance value ( R 1 ) was 3,806 Ω. After 24 h immersion in the composite electrolyte with Na 2 SiO 3 , more and wider cracks appeared on the alloy surface, where a thick, dense film was formed, showing excellent discharge performance and corrosion resistance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Zhu, Su and Li.)

Background: Herniation of the nucleus pulposus caused by disc degeneration and other reasons can cause low back pain and disability. In China, traditional Chinese exercises (TCEs) and traditional Chinese massage (TCM) are widely used to improve symptoms of pain and disability in patients with lumbar disc herniation (LDH). The safety and efficacy of combination therapy have not been studied., Objectives: To assess the effect of traditional Chinese exercise combined with massage vs. traditional Chinese massage alone on pain, disability, lumbar mobility and gait performance in patients with LDH., Methods: Multi-center, randomized clinical trial conducted at 4 hospitals in China and enrolling 272 patients with LDH. Participants were randomly assigned to TCEs plus TCM group or TCM alone group. The combined therapy group received 18 Tai Chi training sessions (30-min sessions 3 times a week) and regular TCM treatments over 6 weeks. The control group received TCM therapy alone and was instructed to maintain their usual daily physical activity. Outcome variables measured included Visual Analog Scale (VAS), Short Form of McGill Pain Questionnaire (SF-MPQ), Oswestry Disability Index (ODI), lumbar spine range of motion (ROM) and gait performance., Results: Among the 272 randomized participants, 259 completed the study. The mean VAS score was 51.77 mm at baseline in the TCEs plus TCM group, and 50.93 mm for the TCM alone group. The reduction in the VAS score at week 6 was greater in the TC group than in the TCM group with a mean difference of 4.05 (95% CI, 2.15-5.95; P < 0.001), and the ODI score with between-group differences of 3.57 points (95% CI, 2.84-4.30 points; P < 0.001). Similar significantly different results were observed in SF-MPQ, walking speed, cadence, and lumbar ROM. No serious adverse events were reported throughout the study period., Conclusion: Compared with TCM alone, TCEs combined with TCM treatment performed better in reducing pain and improving disability. The combination therapy could be considered a valuable treatment option for LDH patients, with potential therapeutic utility for middle-aged and elderly patients with LDH., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhou, Kong, Ren, Song, Wu, He, Lv, Zhang, Sun, Zhang, Cai, Zhu and Fang.)

Objective: Although Traditional Chinese Yijinjing Qigong Exercise (YJJQE) as mind-body intervention is popularly used among adults to ameliorate depressive symptoms in China, no randomized controlled trials (RCTs) are available to evaluate the effects of YJJQE in patients with poststroke depression (PSD). This study aims to explore the clinical efficacy and the neurological and psychiatric mechanism in brain network functional connectivity underlying electroencephalography (EEG)., Materials and Methods: A total of 60 patients, diagnosed with mild PSD, were randomly (1:1) assigned to YJJQE group ( n = 30) and control group of routine segmental rehabilitation training group ( n = 30) for a 60-min exercise session once a day for 3 weeks. All outcome measures were collected at baseline and 3-weeks ending intervention. The primary outcome was the 24-item Hamilton Depression Scale (HAMD-24) score, evaluation at more time points for 1 month of follow-up. The secondary outcomes were EEG data in four frequency domains (δ, θ, α, and β), global efficiency (GE), local efficiency (LE), GE/LE curve [areas under the curve (AUC)], Phase Lag Index (PLI), (HAMD-24) Score and EEG correlation analysis., Results: All patients showed no significant differences in baseline data. After 3 weeks and 1 month of follow-up, the YJJQE group demonstrated significant decreasing changes compared to the control group on the HAMD-24 scores ( p < 0.001). Furthermore, the YJJQE group also showed a significant reduction in θ wave, and an increase in both GE and LE. Compared to the control group, the YJJQE Qigong group showed significantly greater functional connectivity in the δ, θ, and β frequency bands in the brain network of the degree of phase synchronization ( p < 0.001). HAMD-24 Score and EEG correlation analysis negative correlation in the Qigong group θ wave ( p < 0.001)., Conclusion: Our findings demonstrated that YJJQE is estimated to effectively alleviate the depressed mood of patients with PSD by promoting the efficiency in information transmission of network functional connectivity and its integration ability in different brain regions. Therefore, the YJJQE would be useful as a non-pharmacological treatment to prevent PSD., Clinical Trial Registration: [http://www.chictr.org.cn/showproj.aspx?proj=55789], identifier [ChiCTR2000035588]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Sun, Zhang, Jiang, Ma, Yao, Zhu and Fang.)

With the increasing burden of a globally aging population, low back pain has become one of the most common musculoskeletal disorders, caused mainly by intervertebral disc (IVD) degeneration. There are currently several clinical methods to alleviate back pain, but there is scarce attention paid as to whether they can improve age-related IVD degeneration. It is therefore difficult to conduct an in-depth evaluation of these methods. A large number of clinical studies have shown that manual therapy (MT), a widely used comprehensive alternative method, has effects on pain, the mechanisms of which require further study. In this study, MT was performed on aging rats for 6 months, and their behaviors were compared with those of a non-intervention group of aging and young rats. After the intervention, all rats were examined by X-ray to observe lumbar spine degeneration, and the IVD tissues were dissected for detection, including pathological staining, immunofluorescence, Western bolt, etc. This study demonstrated the possibility that MT intervention delay the lumbar IVD degeneration in aging rats, specifically improving the motor function and regulating senescence-associated β-galactosidase, p53, p21, p16, and telomerase activity to retard the senescence of cells in IVDs. Moreover, MT intervention can modify oxidative stress, increase the expression of SIRT1 and FOXO1 in IVDs and decrease ac-FOXO1 expression, suggesting that MT can reduce oxidative stress through the SIRT1/FOXO1 pathway, thereby playing a role in delaying the aging of IVDs. This study shows that drug-free, non-invasive mechanical interventions could be of major significance in improving the physical function of the elderly.

Objective: To demonstrate the analgesic effect of Tuina mainly from mechanically sensitive ion channels in peripheral myelinated nerve fibers., Methods: A total of 40 healthy and pathogen-free adult male Sprague-Dawley rats were used in the study [weight: (220.0 ¡À 1.4) g, Shanghai Slac Laboratory Animal Co., Ltd., Shanghai, China; license No. Shanghai ICP 05033115]. The rats were housed in cages with free access to water and food in a temperature-controlled room [(22 ¡À 1) ¡æ and 12-h/12-h light-dark cycle. Thirty-two rats were randomly divided into five groups: naive, sham, chronic compression of dorsal root ganglion (CCD), Tuina (7 d) and Tuina (21 d). CCD rat model was established via unilateral DRG compression by ""L"" liked steel bar. Chinese Tuina treatment was accepted once per day. Behavior monitoring of paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were tested. The expression of Piezo1 and Piezo2 in myelinated nerve fiber were analyzed by immunohistochemistry and Western-blotting., Results: There was a high expression of Piezo2 and a low expression of Piezo1 in the naive and CCD groups. In contrast, the expression of Piezo2 was down regulated and Piezo1 was increased after a period of Tuina. There was significant difference (P¡Ü0.05) between the groups., Conclusion: Our findings suggest that Tuina therapy can increase the expression of Piezo2 and decrease the expression of Piezo1 in the test rats. The different changes in the expressions of Piezo1 and Piezo2 may play an important role in alleviating CCD-induced allodynia and hyperalgesia.

Objective: To determine the effects of Taijiquan practice on knee proprioception in patients with knee osteoarthritis (OA)., Methods: We conducted a randomized controlled trial comparing Taijiquan with a control condition (wellness education) in patients with knee OA. The patients participated in either a 60-min Taijiquan session three times weekly or a 60-min weekly educational session, for 24 consecutive weeks. The primary outcomes were changes in knee proprioception. Secondary outcomes were changes in the Western Ontario and McMaster University Osteoarthritis Index (WOMAC)., Results: After 24 weeks, compared with the control group, the Taijiquan group demonstrated better improvements in the joint position sense in knee flexion (left: -2.12?; right: -2.02?), and knee extension (left: -2.22?; right: -1.54?). In addition, the Taijiquan group showed significantly greater improvements in the WOMAC scores (P < 0.05) for knee pain (left: -3.17 points; right: -3.74 points), stiffness (left: -2.43 points; right: -2.13 points), and physical function (left: －10.99 points; right: －8.00 points), compared with the control group., Conclusion: A 24-week Taijiquan practice resulted in a significant improvement in knee proprioception in patients with knee OA. The present findings add increasing evidence regarding the clinical benefits of Taijiquan as a therapeutic modality for patients to improve the reflex protection of knee joints against potentially harmful forces.

Previous clinical trials have suggested that the Chinese Tuina massage may exert transient analgesic effects. However, further investigation regarding the underlying mechanism has been hindered by the lack of a suitable animal model of pain. The present study established a rat model of hind leg pain by injecting 5.8% hypertonic saline solution (HSS) into the left gastrocnemius muscle. The effects of various Tuina massages on the pain thresholds of the rats were then measured. In addition, the effects of ipsilateral and contralateral Tuina massages on C-fiber-evoked field potentials following electrical stimulation of the left sciatic nerve were determined. Alterations in the gastrocnemius muscle tissues following various Tuina applications were investigated using hematoxylin and eosin, and desmin staining, as well as malondialdehyde and superoxide dismutase assays. Heavy hand pressure transiently reduced the pain sensitivity of both posterior limbs, despite HSS only being injected into the left hind leg. Tuina massage treatments that lasted for 15 min were associated with the best results and an absence of local tissue changes. The results of electrical sciatic nerve stimulation demonstrated that ipsilateral and contralateral Tuina massage may decrease the level of peripheral nociceptive C-fiber activity. In the present study, the Chinese Tuina massage exerted analgesic effects in a rat model of pain, which did not involve tissue damage, following a 15 min massage. Therefore, the rat model of pain used in the present study may provide a novel approach for investigating the molecular and physiological mechanisms underlying the therapeutic effects of Tuina massage.