Background: Piriformis syndrome (PS) is a painful musculoskeletal condition characterized by a deep gluteal pain that may radiate to the posterior thigh and leg. This study was designed to compare ...the effectiveness of ozone and BTX to lidocaine injection in treating piriformis syndrome that was resistant to medication and/or physical therapy. Study design: Between November 2018 and August 2019, we involved eighty-four subjects diagnosed with piriformis syndrome in a double-blinded, prospective, randomized comparative study to receive an ultrasound-guided injection of lidocaine (control group), botulinum toxin A, or local ozone (28 patients each group) in the belly of the piriformis muscle. Pain condition evaluated by the visual analog score (VAS) was used as a primary outcome, and the Oswestry Disability Index (ODI) as a secondary outcome, before, at one month, two months, three months, and six months following the injection. Results: The majority (58.3%) of patients were male, while (41.7%) were female. At one month, a highly significant decrease occurred in VAS and ODI in the lidocaine and ozone groups compared to the botulinum toxin group (p < 0.001). At six months, there was a highly significant decrease in VAS and ODI in the botulinum toxin group compared to the lidocaine and ozone groups (p < 0.001). Conclusion: Botulinum toxin may assist in the medium- and long-term management of piriformis syndrome, while lidocaine injection and ozone therapy may help short-term treatment in patients not responding to conservative treatment and physiotherapy.
Abstract Sudden stratospheric warmings (SSWs) are the most dramatic events in the wintertime stratosphere. Such extreme events are characterized by substantial disruption to the stratospheric polar ...vortex, which can be categorized into displacement and splitting types depending on the morphology of the disrupted vortex. Moreover, SSWs are usually followed by anomalous tropospheric circulation regimes that are important for subseasonal-to-seasonal prediction. Thus, monitoring the genesis and evolution of SSWs is crucial and deserves further advancement. Despite several analysis methods that have been used to study the evolution of SSWs, the ability of deep learning methods has not yet been explored, mainly due to the relative scarcity of observed events. To overcome the limited observational sample size, we use data from historical simulations of the Whole Atmosphere Community Climate Model version 6 to identify thousands of simulated SSWs, and use their spatial patterns to train the deep learning model. We utilize a convolutional neural network combined with a variational auto-encoder (VAE)—a generative deep learning model—to construct a phase diagram that characterizes the SSW evolution. This approach not only allows us to create a latent space that encapsulates the essential features of the vortex structure during SSWs, but also offers new insights into its spatiotemporal evolution mapping onto the phase diagram. The constructed phase diagram depicts a continuous transition of the vortex pattern during SSWs. Notably, it provides a new perspective for discussing the evolutionary paths of SSWs: the VAE gives a better-reconstructed vortex morphology and more clearly organized vortex regimes for both displacement-type and split-type events than those obtained from principal component analysis. Our results provide an innovative phase diagram to portray the evolution of SSWs, in which particularly the splitting SSWs are better characterized. Our findings support the future use of deep learning techniques to study the underlying dynamics of extreme stratospheric vortex phenomena, and to establish a benchmark to evaluate model performance in simulating SSWs.
Background:
Diabetic peripheral neuropathy (DPN) characterized by nerve damage is a common and disabling chronic microvascular complication in patients with type 2 diabetic mellitus (T2DM), affecting ...at least half of patients diagnosed with T2DM. Unfortunately, the current treatment for DPN is not ideal. Traditional Chinese medicine (TCM), with a unique theoretical system, has made outstanding contributions in the treatment of T2DM and related complications. Mudan granule, a Chinese patent medicine, has been previously validated that could ameliorate the symptoms, promote nerve tissue repair, increase nerve conduction velocity (NCV) in patients with DPN. However, the previous studies are of variable quality, which limits the clinical application of Mudan granule. Therefore, we designed a double-blind, randomized, placebo-controlled, parallel-arm, multi-center trial to estimate the safety and efficacy of Mudan granule in conjunction with methylcobalamin in individuals suffering from type 2 diabetic peripheral neuropathy.
Methods:
This work is conducted as a 14-center, double-blind, randomized, placebo-controlled, parallel-arm trial. In all, 402 subjects (aged 30–70 years) will be recruited and randomized in a 1:1 ratio to an intervention group (
n
= 201; Mudan granule + methylcobalamin) and a control group (
n
= 201; placebo + methylcobalamin). Treatment
is
administered in 24 weeks cycles without any treatment interruption between cycles. Michigan Diabetic Neuropathy Score (MDNS) as the primary outcome will be evaluated at baseline, 12 weeks during the intervention period, and after 24 weeks of the intervention. Adverse events and safety assessments will be also documented. The analysis of all data will be carried out based on a predefined statistical analysis plan.
Discussion:
The outcomes from this study will offer important evidence regarding the safety and efficacy that Mudan granule can be used as an alternative and complementary therapeutic intervention in patients with type 2 diabetic peripheral neuropathy.
Clinical trial registration:
Registered at
https://clinicaltrials.gov/
. Trial registration number: NCT04711980. Registered January 2021.
The complex Dy
4
(
L1
)
2
(CH
3
COO)
4
(DMF)
3
(
1
) was obtained by using 2,6-bis(2-((
E
)-(8-hydroxyquinolin-2-yl)methylene)hydrazine-1-carbonyl)pyridine 1-oxide (H
4
L1
) and Dy(CH
3
COO)
3
·4H
2
...O under 100 in
N
,
N
-dimethylformamide (DMF) solvent. Structure analyzing showed that Dy(III) ions had two types of configuration with
D
2d
and
C
4v
. AC magnetic susceptibilities exhibited that complex
1
was an obvious single-molecule magnet (SMM) with obvious ac susceptibilities at zero Oe static magnetic field over the frequency range of 9–999 Hz. These findings demonstrated potential applications of polydentate ligands for the synthesis of SMMs.
We wished to elucidate a potential role of the tumor necrosis factor-like weak inducer of apoptosis (TWEAK)/fibroblast growth factor-inducible molecule 14 (Fn14) axis in myocardial fibrosis. ...Stimulation of neonatal rat cardiac fibroblasts (CFs) with TWEAK could increase CFs numbers and collagen synthesis. Conversely, when CFs were pretreated with siRNA against Fn14, induction of cell proliferation and collagen synthesis by TWEAK were inhibited. Pretreatment with TWEAK on CFs induced activation of the nuclear factor-kappaB (NF-кB) pathway and subsequently increased the production of metalloproteinase-9 (MMP-9). Cell treatment with siRNA against Fn14 led to inhibition of the NF-кB pathway. Additionally, after stimulation of cell with ammonium pyrrolidine dithiocarbamate, cell proliferation and collagen synthesis induced by NF-кB and the upregulation of MMP-9 production were inhibited. The present study suggested that the TWEAK/Fn14 axis increased cell proliferation and collagen synthesis by activating the NF-кB pathway and increasing MMP-9 activity. This axis may be important for regulating myocardial fibrosis.PUBLICATION ABSTRACT
The heliospheric radio emissions are the strongest radio emissions phenomenon in the solar system, with a radiation power of at least 1013 W, which can provide important physical information of high ...energy electron beam and magnetic plasma structure near the heliospheric boundary. Since the first detection by the Voyager spacecraft in 1983, those radio emissions have widely and continuously attracted much attention from researchers. There are generally two types of the heliospheric radio emissions: instantaneous or drifting emission with relatively high frequency, and continuous emission or non-drifting emission with relatively low frequency. Usually, both types of emissions start from about 2 kHz. For the drifting emission, it has the characteristic of drifting toward high frequency, the drifting rate is about 1–3 kHz/yr, the frequency range is 1.8–3.6 kHz, and the duration is about 100–300 days. For the non-drifting emission, it has no obvious frequency drift, the frequency range is 1.8–2.6 kHz, and the duration is about 3 yr. It is generally believed that the heliospheric radio emissions are related to shock. In this paper, the possible source region of the radio emissions, the emission mechanisms, and the source of shock related to the emissions are introduced. Furthermore, the existing scientific problems and the future perspectives on the research of heliospheric radio emissions are discussed.
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