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Abstract Background Both massage and topically administered NSAIDs are safe and effective treatments for knee osteoarthritis (KOA); however, different massage technique sects in China caused assessment difficulties for the treatment of KOA. In order to standardize the massage techniques and procedures, we organized multi-disciplinary experts in China to acquire an evidence-based traditional Chinese medicine massage treatment of knee osteoarthritis. The purposes of this study will be to provide clinicians a complementary and alternative therapy for patients and to evaluate the efficacy and safety of evidence-based traditional Chinese medicine massage treatment of KOA compared to External Diclofenac Diethylamine Emulgel. Methods and design A randomized controlled trial in which 300 participants diagnosed with KOA will be recruited and randomly allocated to either the experimental group or the control group in a ratio of 2:1. Two hundred participants will receive evidence-based traditional Chinese medicine massage 2 sessions per week for 10 weeks as the experimental group, and 100 participants will receive External Diclofenac Diethylamine Emulgel 3–4 times per day for 10 weeks as the control group. The patients in the two groups will receive follow-up at two time points at 5 weeks and 10 weeks from the beginning of treatment, respectively. The MRI scans and X-ray will be performed at baseline and at the end of the intervention. The primary outcome will be the changes in the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Secondary outcomes will be measured by the PRO scale for knee osteoarthritis based on the concept of traditional Chinese medicine (Chinese scale for knee osteoarthritis (CSKO)), X-ray evaluation, and MRI scan evaluation. The data of WOMAC and CSKO will be analyzed at the baseline, 5 weeks, and 10 weeks from the beginning of treatment. The data from MRI scans and X-rays will be analyzed at baseline and at the end of the intervention. The significance level sets as 5%. The safety of interventions will be evaluated after each treatment session. Discussion This study will provide clinicians with much-needed knowledge for the treatment of KOA through a controlled trial. Trial registration Chinese Clinical Trial Registry ChiCTR1800014400 . Registered on 10 January 2018

Yunfuconcha bimenta , a new genus and species of bivalve from the Ordovician of western Guangdong, China, is described. Its unusual hinge consists of a palaeotaxodont-like dentition anteriorly and a heteroconch-like dentition posteriorly. The posterior hinge area exhibits a remarkable, broad, deeply inset, concave ligament area, which is reminiscent of the ventrally expanded ligament of some Recent and fossil lucinoids and the triangular resilifer in late Palaeozoic crassatellid heteroconchs. Lamellar posterior teeth and sockets complete the posterior dentition. The unusual combination of features, normally associated with either the Order Cardiolariatida (used here in place of Order 'Afghanodesmatida'—the type genus Afghanodesma , is known only from wax impressions rendering it and its nominal higher taxa invalid) or various crassatelloids and lucinoids, make systematic placement of Yunfuconcha n. gen. uncertain below subclass rank. In view of presumed derived heteroconch-like characters of the posterior hinge, we place Yunfuconcha n. gen. in the Subclass Autobranchia, possibly as a stem archiheterodont or a stem heteroconch. [ABSTRACT FROM AUTHOR]

Sedimentary successions of the Frasnian–Tournaisian (Late Devonian to Earliest Carboniferous) and their spatial distributions in the Hainan Island, South China are critically reviewed based on updated information of the previously published data and newly obtained fossils. The Upper Devonian strata are assigned to the Frasnian Lanyang Formation and Famennian Changjiang Formation, which are distributed in north‐western Hainan Island. The Lanyang Formation is represented by limestone, siltstone, slate, and intercalated with tuff, and yields tentaculites: Polycylindrites sp., stromatoporoids, and tabulate corals. The Changjiang Formation yields abundant conodonts Palmatolepis gracilis sigmoidalis and Polynodosus germanus, typical of Famennian assemblages, and the associated faunas include corals, radiolarians, foraminifers, and calcareous algae of Famennian age. Of these, corals are assignable to the upper Famennian Cystophrentis Zone of South China. The strata of the Tournaisian Jishi Formation are categorized into two types, typically exposed in the Shilu and Jinbo areas, respectively, both of which are located north to the Gancheng‐Wanning Fault. The lower Jishi Formation yields brachiopods Unispirifer (Unispirifer) extensus, Unispirifer sp., Schuchertella magna, and gastropods. The middle Jishi Formation yields conodonts: Siphonodella isosticha and S. levis, brachiopods: Unispirifer (Unispirifer) forbesi, Atylephorus tornacensis, coral: Pseudouralinia irregularis, trilobite: Weberiphillipsia linguiformis, ostracods, bryozoans, and foraminifers. The conodonts are assignable to the zonation equivalent to the Siphonodella sulcata Zone, implying the Devonian–Carboniferous boundary is placed at the base of the middle part of the formation. The upper part of the Jishi Formation yields abundant brachiopods characterized by Mesochorispira subgrandis, Atylephorus tornacensis, and Marginatia huaqiaoensis. The presence of corals Cystophrentis, Pseudouralinia, Zaphrentites, and Kueichowpora, and trilobite Hunanoproetus, endemic to South China from the Changjiang and Jishi formations implies that the Hainan Island was palaeobiogeographically close to the South China Block of the Tethyan Realm, rather than of Gondwana affinity during the Late Devonian and Tournaisian. Identification of Xinanosprifer flabellum and Homotoma sp., typical of early Silurian from the 'Nanhao Formation' previously assigned to the Tournaisian suggests that no Carboniferous strata are distributed in southern Hainan Island and the area south of the Gancheng‐Wanning Fault. [ABSTRACT FROM AUTHOR]