Comparison of Efficacy between Acupuncture Therapies in Improving Sacroiliac Joint Malposition: A Systematic Review and Meta-Analysis

Aim. To provide available quantitative evidence of efficacy and safety of acupuncture treatments for improving sacroiliac joint malposition. Methods. Databases such as the China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (CQVIP), Wanfang Database (Wanfang), China Biology Medicine disc (CBMdisc), PubMed, Web of Science, EMBASE, and Cochrane Library were searched by computer to collect the reports on acupuncture treatment of sacroiliac joint malposition from the database creation to July 20, 2021. The selection of included studies, data extraction and coding, and bias risk assessment were conducted independently by two reviewers. RevMan5.4 software was used for meta-analysis, and the results were expressed as mean difference (MD) or standardized mean difference (SMD), with a confidence interval (CI) of 95%. Results. A total of 10 randomized controlled clinical trials (RCTs) with 1019 participants were included. Their overall quality of methodology was not high, and there may be publication bias. Meta-analysis showed that the total effective rate of the treatment group was higher than that of the control group ( OR = 2.74 , 95% CI 2.00 to 3.74, P < 0.00001 ). The treatment group was better than the control group in improving VAS score ( WMD = − 1.56 , 95% CI -2.18 to -0.94, P < 0.00001 ). The ODI score of the treatment group was lower than that of the control group ( WMD = − 6.04 , 95% CI -7.05 to -5.02, P < 0.00001 ). With the improvement of the JOA score, the difference of iliac transverse diameter of sacroiliac joint dislocation and the index of sacroiliac joint malposition in the treatment group were better than those in the control group ( P < 0.05 ). There was no significant heterogeneity among the studies. Conclusion. Acupuncture may have therapeutic advantages in improving sacroiliac joint malposition. Acupuncture and acupotomy provide a safe way to improve the related clinical symptoms and functional disorders in activity of sacroiliac joint dislocation. However, due to the low quality of the included literature, this conclusion still needs to be further verified by more high-quality and large-sample RCTs.

CT-Assisted Improvements in the Accuracy of the Intraoperative Frozen Section Examination of Ground-Glass Density Nodules

Objectives. The intraoperative frozen section examination (IFSE) of pulmonary ground-glass density nodules (GGNs) is a great challenge. In the present study, through comparing the correlation between the computed tomography (CT) findings and pathological diagnosis of GGNs, the CT features as independent risk factors affecting the examination were defined, and their value in the rapid intraoperative examination of GGNs was explored. Methods. The relevant clinical data of 90 patients with GGNs on CT were collected, and all CT findings of GGNs, including the maximum transverse diameter, average CT value, spiculation, solid component, vascular sign, air sign, bronchus sign, lobulation, and pleural indentation, were recorded. All the cases received thoracoscopic surgery, and final pathological results were obtained. The cases were divided into three groups on the basis of pathological diagnosis: benign/atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS)/microinvasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC). The CT findings were analyzed statistically, the independent risk factors were identified through the intergroup bivariate logistic regression analysis on variables with statistically significant differences, and a receiver operating curve (ROC) was plotted to establish a logistic regression model for diagnosing GGNs. A retrospective analysis was conducted on the coincidence rate of the rapid intraoperative and routine postoperative pathological examinations of the 90 cases with GGNs. The relevant clinical data of 49 cases with GGNs were collected. Conventional rapid intraoperative examination and CT-assisted rapid intraoperative examination were performed, and their coincidence rates with routine postoperative pathological examinations were compared. Results. No statistical differences in the onset age, gender, smoking history, and family history of malignant tumors were found among cases with GGNs in the identification of benign/AAH, AIS/MIA, and IAC ( P = 0.158 , P = 0.947 , P = 0.746 , P = 0.566 ). No statistically significant difference was found among the three groups in terms of CT findings, such as lobulation, bronchus sign, pleural indentation, spiculation, vascular sign, and solid component ( P > 0.05 ). The air sign, the maximum transverse diameter of GGNs, and average CT value showed statistically significant differences among the groups ( P < 0.001 , P < 0.05 , P < 0.001 ). Bivariate logistic regression analysis was performed on three risk factors, and the predicted probability value was obtained. A ROC curve was plotted by using the maximum transverse diameter as a predictor for analysis between the groups with benign/AAH and AIS/MIA, and the results demonstrated that the area under the curve (AUC) was 0.692. A ROC curve was plotted by using the predicted probability value, maximum transverse diameter, and average CT value as predictors for distinguishing between the groups with AIS/MIA and IAC, and the results showed that the AUC values of the predicted probability value, maximum transverse diameter, and CT value were 0.920, 0.816, and 0.772, respectively. A regression model Logit P = 2.304 − 2.689 X 1 + 0.302 X 2 + 0.011 X 3 was established to identify GGNs as IAC, obtaining AUC values of up to 0.920 for the groups with AIS/MIA and IAC, the sensitivity of 0.821, and the specificity of 0.894. The coincidence rate of rapid intraoperative and routine postoperative pathological examinations taken for modeling was 79.3%, that of conventional IFSE and postoperative pathological examination in prospective studies was 83.7%, and that of CT-assisted rapid intraoperative and postoperative pathological examinations was 98.0%. The former two were statistically different from the last one ( P = 0.003 and P = 0.031 , respectively). Conclusion. The air sign, maximum transverse diameter, and average CT value of the CT findings of GGNs had superior capabilities to enhance the pathologic classification of GGNs. The auxiliary function of the comprehensive multifactor analysis of GGNs was better than that of single-factor analysis. CT-assisted diagnosis can improve the accuracy of rapid intraoperative examination, thereby increasing the accuracy of the selection of operative approaches in clinical practice.

Genetic diversity of nuts traits and fatty acids of pecan (Carya illinoinensis) germplasm resources

Pecan (Carya illinoinensis) is the most economically valuable nut tree growing in many countries of the world. 10 nut quantitative traits and 15 fatty acid components of 112 pecan accessions were determined to analyze the morphometric and fatty acids genetic diversity in this study. The measured nuts traits of single nut mass, nut transverse, longitudinal and lateral diameter, nut aspect ratio, single nuts kernel mass, kernel yield and shell thinness were found highly variable. 15 fatty acids were detected among 36 tested fat acids in the nut kernel of pecan, and 14 fatty acids were found high variation except for the C12:0. Plenty of these traits are significant economic importance and could be used as breeding targets to improve the pecan variety. The positive correlations were observed between each pair of single nut mass, nut transverse diameter, nut longitudinal diameter and nut lateral diameter. Single nuts kernel mass is significantly positively correlated with single nut mass, nut transverse diameter, nut longitudinal diameter and nut lateral diameter. The 2D PCA plot successfully grouped the samples according to their phenotypic resemblance and morphological characteristics. 112 accessions were grouped into 4 and 3 major clusters according to the nut quantitative traits and fatty acids components and contents, respectively. Based on these results, we suggest that multidisciplinary research team should be set for genetic breeding of pecan to promote the conservation of local genetic diversity and improve the nuts production and commercialization in China.

Morphometric study of sacrum and its clinical implications in population in Bihar

The sacrum is a large triangular bone formed by fusion of five sacral vertebrae and wedged between two hip bones. Dimension of sacrum varies from region to region therefore morphometric study of sacrum in population of Bihar is important for proper fixation during orthopedic procedure in trauma patients. : The objectives of this study was to evaluate the morphometric parameters of sacrum so that a data can be generated from local population. M: The present study was done on 110 human sacra of known sex (62 male and 48 female) collected from department of Anatomy, IGIMS, Patna and also from other medical colleges of Bihar. Maximum length of sacrum, curved length of sacrum, maximum breadth of sacrum, antero-posterior diameter of the body of first sacral vertebra, transverse diameter of the body of first sacral vertebra and maximum length of articular surface of sacrum were measured. Mean value of sacral straight length were 104.55 cm in male and 94.66 cm in female, Curve length 112.03 cm in male and 103.98 cm in female, Width of sacrum 101.53 cm in male and 105.67 cm in female. Transverse diameter of body of 1st sacral vertebra were 46.53 cm and 40.85 cm in male and female respectively, antero-posterior diameter of body of 1st sacral vertebra were 29.89 cm and 27.73 cm in male and female respectively, Length of auricular surface were 56.08 cm and 54.77 cm respectively. Sacral index, curvature index, index of body of first sacral vertebra, corpora-basal index and auricular index were calculated. Morphometric study of sacrum in population of Bihar is important because dimension of sacrum varies from region to region and this is important for proper fixation during orthopedic procedure in trauma patients.

Transcranial Sonography in the Diagnosis of Pituitary Tumor—A Direct Comparison With MRI

BackgroundTranscranial sonography (TCS) is a convenient tool for detecting certain brain diseases, such as brain tumors. Few studies have reported on the use of TCS in the area of Sella turcica. The accuracy and repeatability of Sella turcica with or without pituitary tumor is not clear.PurposeThis study aimed to investigate the feasibility and accuracy of TCS to measure the size of Sella turcica according to the measurement in MRI and determine its diagnostic performance in individuals with pituitary tumor.Materials and MethodsIn this cross-sectional comparative study, healthy volunteers and patients with pituitary tumor were enrolled for examination of TCS and MRI between October 2020 and July 2021. The transverse diameter (D1, cm) of Sella turcica and the volume of the pituitary tumor were measured by TCS and MRI, respectively, and compared by using Student’s t-test or Mann–Whitney test, using the receiver operating characteristic (ROC) curve to analyze the diagnostic value of D1 in TCS for pituitary tumor.ResultsA total of 75 healthy volunteers and 51 patients with pituitary tumor were evaluated. In healthy volunteers, the mean D1 was 1.30 ± 0.35 (range, 0.82–3.22) by TCS and 1.32 ± 0.29 (range, 0.94–3.02) by MRI (P = 0.054). In patients with pituitary tumor, the mean D1 was 2.0 ± 0.65 (range, 0.90–3.48) by TCS and 2.42 ± 1.0 (range, 0.80–4.70) by MRI (P = 0.000). The median measurement volume was 4.41 and 6.59 cm3 in TCS and MR, respectively (P = 0.000). The mean D1 was 1.31 ± 0.35 in healthy volunteers and 2.0 ± 0.65 cm in patients with pituitary tumor (P = 0.000). In the ROC curve analysis, the area under the curve was 0.836, and the optimal cutoff value (1.56) exhibited a sensitivity and specificity of 67.31 and 88.0%, respectively.ConclusionThe consistency between the two imaging technologies performed well in D1 measurement, while the volume of the pituitary tumor was smaller as assessed by TCS than by MRI. D1 in TCS had good diagnostic performance in pituitary tumor.

BIOLOGICAL SEXUAL PROFILE BASED ON LINEAR DIMENSIONS OF HUMERI AND FEMURS OF ADULT BRAZILIAN HUMAN SKELETONS

This research aimed to assess the predictive ability and applicability for sexual diagnosis of algorithms developed from measurements of humeri and femurs from skeletons belonging to the CEAF Identified Skeletal Collection of the University of Pernambuco, Brazil. The sample was composed of 483 humeri and 452 femurs, obtained from 401 skeletons, 208 male and 193 female, with ages ranging from 15 to 109 years. The variables used were the transverse and vertical diameters of the humeral and femoral heads and the epicondylar width of these bones. The data collected were analyzed using R software (version 3.6.1, R Foundation for Statistical Computing). Only the univariate logistic regressions were considered predictive, making it possible to estimate sex based on any single variable in this study. The accuracy ranged from 93.8% to 97.5% for the humerus evaluation and from 92.9% to 95.6% for femurs, with the transverse diameter of the right humeral head being the most dimorphic measurement. Therefore, it is inferred that the sexual dimorphism present in the measurements of the humeri and femurs of our sample is high and enables the classification of sex reliably and assertively using the algorithms created.

OV06 EXTENDING THE INDICATIONS OF TRANSVERSUS ABDOMINIS RELEASE: SUBLAY MESH REPAIR FOR A RARE CASE OF ACQUIRED DIAPHRAGMATIC HERNIA

Aim Acquired diaphragmatic hernia (ADH) is rare and its treatment is challenging. Posterior component separation (PCS) with transversus abdominis release (TAR) is gaining wide acceptance for the repair of complex abdominal hernia, including those located in proximity of the abdominal borders. In this view the central tendon of the diaphragm could be intended as the rooftop border of the peritoneal sac. We describe an original application of TAR for the treatment of an unusual case of ADH. Material and Methods a 54 year-old man was referred to our department for an ADH, following two previous sternotomies for an aortic aneurysm, conditioning respiratory symptoms. A thoraco-abdominal contrast enhanced CT-scan confirmed an anterior left diaphragmatic defect with a transverse diameter of 8.5 cm and a huge sac containing the great omentum and the distal transverse colon, with atelectasis of the inferior lobe of the lung. A subxiphoid M1W2L2 incisional hernia was also detected. The patient underwent a midline xipho-umbilical laparotomy and a repair by partial TAR with posterior rectus sheath release and progressive dissection of the diaphragmatic muscular fibers far beyond the DH. A sublay repair with a large dual layer PVDF mesh was then accomplished. Results Postoperative course was uneventful and no recurrence was recorded at 6 months follow up. Conclusions partial-TAR could be a good option for repair of anteriorly placed ADH, ensuring a stable anatomical repair with an overlap that is usually wider than after laparoscopic IPOM repair. This novel indication confirms the extreme versatility of TAR for the repair of complex ventral hernia

ORIGINAL ARTICLE ON THE MORPHOLOGICAL STUDY OF FORAMEN MAGNUM

Introduction: Centrally in the deepest part of posterior cranial fossa is the largest foramen, Foramen magnum surrounded by basilar part of occipital bone on either side. Because of relation between the FM and the vital structures passing through it, study on its morphometric features is of great signicance. Aim and objectives: The objectives were to study the various morphological features of the foramen magnum in dry skulls using an analogue Vernier calliper. Materials and methods: 50 dry skulls (8 base skulls, 42 full skulls) of human cadaver of unknown age and sex were obtained to study the morphometric features like shapes, anteroposterior and transverse diameters and FM index in the department of Anatomy, Kanyakumari Government medical college, Asaripallam. Results: The classication of determined shapes were round in 29.7%, hexagonal in 18.2%, egg shaped in 16.9%, oval in 12.7%, tetragonal in 11.4%, pentagonal in 3.7% and irregular in 7.4%. In 12% of the skulls the occipital condyles were found to protrude into the foramen. The mean value of anteroposterior and transverse diameter was found to be 35 ±1.2mm, and 28 ± 1.4 mm respectively and average foramen magnum index was 1.25 ± 0.8. Conclusion: Foramen magnum dimensions are used for sex determination. The structural integrity of foramen magnum is usually preserved in re accidents and explosions due to its resistant nature and secluded anatomical position. The data obtained from protrusion of occipital condyles would help in neurosurgical approach of foramen magnum meningiomas.

Productivity and quality of watermelon fruits as a function of doses potassium in the Western Amazon

Potassium is the nutrient most demanded by watermelon, performing various physiological and biochemical functions, and its availability in the soil influences the production and quality of fruits. However, there is no recommendation for specific fertilization for the state of Rondônia, which has limited the production and quality of the harvested fruits. The objective of this work was to evaluate the effects of potassium doses on the productivity and quality of watermelon fruits, cultivar Crimson Sweet, in southern Western Amazonia. The experiment was carried out at the Federal University of Rondônia, in the municipality of Rolim de Moura, in an experimental design in randomized blocks, with five treatments and four replications. The treatments were doses 0 (control), 50, 100, 150 and 200 kg ha-1 of K2O. The variables analyzed were fruit mass, longitudinal and transverse diameter of fruits, number of fruits per plant, soluble solids content, exocarp thickness and productivity. Potassium doses did not influence the mean mass and longitudinal and transverse diameter of the fruits. The number of fruits per plant increased linearly as a function of the potassium doses applied, and with 157 kg ha‑1 of K2O the highest values of °Brix were obtained. The dose of 147.2 kg ha-1 of K2O promotes yields 61.6% above the national average and 82% above the state average.

Morphometric study of upper end of tibia and its implications in total knee replacement

: Knee deformities can be reliably assessed by using morphometric parameters of upper end of tibia. Total knee arthroplasties are done to treat many types of arthritis and injuries involving knee joint. So, there is a need to have data of various morphometric parameters of upper end of tibia in order to have better surgical outcomes. The present study was attempted to provide values of different parameters in the population of Bihar.: The present study was a cross-sectional and prospective study conducted on 50 tibia of unknown gender and age in the Department of Anatomy, Indira Gandhi Institute of Medical Sciences, Patna. Fully ossified, dried, macerated and thoroughly cleaned tibia were taken to measure different parameters of upper end with the help of digital vernier calliper. The data thus obtained were tabulated and analysed statistically using Microsoft excel software.: It was found that the diameters of medial condyle were more than the lateral condyle. The antero-posterior diameter was more than the transverse diameter in case of both the condyles. But the difference between the right and the left side was not statistically significant.: The present study will help in providing a baseline data for designing of the prosthesis used in total knee replacement surgeries. It will also be helpful to anthropologists and forensic experts.