Acute Soft Tissue Injuries Research Articles

Navicular bone oedema and sclerosis: current concepts on best management

Pathology associated with the navicular bone remains a common cause of forelimb lameness in horses. Since the introduction of advanced imaging modalities (particularly magnetic resonance imaging) it is now recognised that pathology of the navicular bone rarely occurs in isolation; concurrent abnormalities of the structures of the podotrochlear apparatus are often present. Different pathological processes of the navicular bone can have the same radiological appearance. Identifying the underlying disease process, as well as concurrent injuries, is essential for implementing the most appropriate management strategies in horses with navicular bone pathology. Horses with acute onset lameness or soft tissue injuries will often require a period of rest initially, whereas horses with chronic insidious lameness and no soft tissue pathology may be able to continue in work following treatment. Management should be focused on reduction of pain and inflammation which is often achieved with systemic non-steroidal anti-inflammatories, and intra-articular or intra-bursal medication in combination with reducing concussive forces acting on the navicular bone through alterations in shoeing and modification of exercise.

Ligustilide covalently binds to Cys703 in the pre-S1 helix of TRPA1, blocking the opening of channel and relieving pain in rats with acute soft tissue injury

Ethnopharmacological relevanceThe natural anodyne Ligustilide (Lig), derived from Angelica sinensis (Oliv.) Diels and Ligusticum chuanxiong Hort., has been traditionally employed for its analgesic properties in the treatment of dysmenorrhea and migraine, and rheumatoid arthritis pain. Despite the existing reports on the correlation between TRP channels and the analgesic effects of Lig, a comprehensive understanding of their underlying mechanisms of action remains elusive. Aim of the studyThe objective of this study is to elucidate the mechanism of action of Lig on the analgesic target TRPA1 channel. MethodsThe therapeutic effect of Lig was evaluated in a rat acute soft tissue injury model. The analgesic target was identified through competitive inhibition of TRP channel agonists at the animal level, followed by Fluo-4/Ca2+ imaging on live cells overexpressing TRP proteins. The potential target was verified through in-gel imaging, colocalization using a Lig-derived molecular probe, and a drug affinity response target stability assay. The binding site of Lig was identified through protein spectrometry and further analyzed using molecular docking, site-specific mutation, and multidisciplinary approaches. ResultsThe administration of Lig effectively ameliorated pain and attenuated oxidative stress and inflammatory responses in rats with soft tissue injuries. Moreover, the analgesic effects of Lig were specifically attributed to TRPA1. Mechanistic studies have revealed that Lig directly activates TRPA1 by interacting with the linker domain in the pre-S1 region of TRPA1. Through metabolic transformation, 6,7-epoxyligustilide (EM-Lig) forms a covalent bond with Cys703 of TRPA1 at high concentrations and prolonged exposure time. This irreversible binding prevents endogenous electrophilic products from entering the cysteine active center of ligand-binding pocket of TRPA1, thereby inhibiting Ca2+ influx through the channel opening and ultimately relieving pain. ConclusionsLig selectively modulates the TRPA1 channel in a bimodal manner via non-electrophilic/electrophilic metabolic conversion. The epoxidized metabolic intermediate EM-Lig exerts analgesic effects by irreversibly inhibiting the activation of TRPA1 on sensory neurons. These findings not only highlight the analgesic mechanism of Lig but also offer a novel nucleophilic attack site for the development of TRPA1 antagonists in the pre-S1 region.

Wound Irrigation Using Normal Saline 0.9% Versus Tap Water: A Review for Street Medicine and Low-resource Providers

Patients experiencing homelessness are a vulnerable cohort who suffer from disproportionate skin disease burden. Acute and chronic wounds represent high morbidity conditions with severe consequences. Adequate management in the form of cleansing and irrigation is necessary for removing cellular debris, bacteria and contaminants. Providers in low-resource street medicine settings may be the first point of contact in the management of wounds encountered by unhoused patients. This review determines the feasibility of improvised irrigation techniques that can be used in street settings to irrigate wounds. A MEDLINE search was conducted and yielded randomized controlled trials, laboratory studies and case-control studies. No significant difference in wound infection and healing rates was found when normal saline 0.9% or tap water was used in wound irrigation. Improvised cleansing devices with suitable irrigation pressure included water bottles punctured with 14-18-gauge needles, 10-mL syringes and 50-syringes. Lower and upper extremity wounds were found to be at higher risk of infection, requiring judicious management and cleaning. Street medicine providers should consider weighing the benefits versus risks of on-site, improvised wound irrigation for acute soft tissue injuries, especially in the setting of limited resources.

Efficacy and safety of Wuhu oral liquid in treating acute soft tissue injuries: a multicenter, randomized, double-blind, double-dummy, parallel-controlled trial.

Background: Wuhu Oral Liquid (WHOL) is a modified preparation derived from the famous Wuhu Powder, which has a long history of use in treating traumatic injuries. This preparation has anti-inflammatory and analgesic properties and accelerates recovery following acute soft tissue injuries. Aims: To evaluate the efficacy and safety of WHOL in treating acute soft tissue injury associated with qi stagnation and blood stasis syndrome and to provide a basis for applying for the protection of varieties of Chinese medicine for WHOL. Methods: This study was a randomized, controlled, double-blind, multicenter clinical trial in which Fufang Shang Tong Capsule (FFSTC) was selected as the control drug. A total of 480 subjects with acute soft tissue injury associated with qi stagnation and blood stasis syndrome were randomly divided into a test and control group in a 3:1 ratio. The duration of drug treatment was 10days. The primary outcome was Visual Analogue Scale (VAS) score for pain (including pain at rest and pain on activity). Secondary outcomes included the disappearance time of the pain at rest and on activity; the curative effect of TCM syndrome and improvement in the individual symptoms of TCM (swelling, ecchymosis, and dysfunction); and changes in C-reactive protein (CRP) and interleukin-6 (IL-6) levels. Safety was assessed using vital signs, laboratory examinations, electrocardiograms, and physical examinations. Results: Patient compliance was satisfactory in both groups (all between 80% and 120%). After 4days of treatment, the WHOL group was superior to the FFSTC group in decreasing the VAS scores for pain at rest (-1.88 ± 1.13 vs. -1.60 ± 0.93, p < 0.05) and on activity (-2.16 ± 1.18 vs. -1.80 ± 1.07, p < 0.05). After 7 days of treatment, the WHOL group was superior to the FFSTC group in decreasing the VAS scores for pain on activity (-3.87 ± 1.60 vs. -3.35 ± 1.30, p < 0.01) and improving swelling (cure rate: 60.4% vs. 46.2%, p < 0.05; obvious effective rate: 60.7% vs. 47.0%, p < 0.05). After 10 days of treatment, the WHOL group was superior to the FFSTC group in decreasing the levels of CRP (-0.13 ± 2.85 vs. 0.25 ± 2.09, p < 0.05) and improving the TCM syndrome (cure rate: 44.1% vs. 30.8%, p < 0.05) and swelling (cure rate: 75.6% vs. 67.5%, p < 0.01; obvious effective rate: 75.6% vs. 68.4%, p < 0.05; effective rate: 77.0% vs. 71.8%, p < 0.05). The disappearance time of pain at rest was 8days in both groups and 9days on activity in both groups. In addition, there was no statistical difference between the incidence of adverse events (4.5% vs. 2.6%, p > 0.05) and adverse reactions (0.3% vs. 0%, p > 0.05) between the WHOL group and the FFSTC group. No serious adverse events occurred in either group, and no subjects were withdrawn because of adverse events. Conclusion: WHOL relieves the symptoms caused by acute soft tissue injury associated with qi stagnation and blood stasis syndrome more rapidly than FFSTC, and it is effective and safe in the treatment of acute soft tissue injury. Future studies still need a larger sample size to verify its efficacy and safety. Clinical Trial Registration: https:// www.chictr.org.cn/showproj.html?proj=149531, Identifier ChiCTR2200056411.

A Randomized Trial of Therapeutic Ultrasound on Pain, Tenderness, and Muscle Stiffness Using a High and Low Intensity Model of Delayed Onset Muscle Soreness

Purpose: This study evaluated ultrasound (US) effectiveness in an experimental model of soft tissue injury, and examined the model, delayed onset muscle soreness (DOMS), as a variable in the outcome. Methods: One hundred and twenty females completed 30 repetitions (low-DOMS) or 70 repetitions (high-DOMS) of eccentric contractions of biceps brachii muscles and received one of four protocols: no US (control), placebo US, or 3 MHz US, pulsed 20% duty cycle, at either 0.6 W/cm2, spatial-average temporal-peak intensity (SATP) (0.12 W/cm2, spatial-average temporal-average intensity (SATA)) or 1.0 W/cm2, SATP (0.2 W/cm2 SATA). A further 60 females completed a low-DOMS protocol and received one of three protocols: placebo US, or continuous wave 3 MHz US at either 0.2 or 0.4 W/cm2, SATP/SATA. US was applied to biceps muscles for 5 minutes on days 1 to 3. Muscle soreness, tenderness, and stiffness were measured pre-DOMS induction and at 24, 48, and 72 hours post-induction. Results: Pulsed US, 20% duty cycle, at 0.6 W/cm2, SATP, (0.12 W/cm2, SATA) reduced muscle soreness in a low-DOMS but not in a high-DOMS protocol. Continuous wave US at 0.4 W/cm2, SATP/SATA reduced tenderness. Continuous US at 0.2 W/cm2, SATP/SATA was marginally effective on stiffness and tenderness. Conclusion: The results have implications for US management of acute soft tissue injury and the use of DOMS as an experimental model for soft tissue inflammation.

Can Acute Soft Tissue Injuries of the Knee in Adults be SAFELY Managed through a Virtual Fracture Clinic?

Can Acute Soft Tissue Injuries of the Knee in Adults be SAFELY Managed through a Virtual Fracture Clinic?

Study on anti-inflammatory effect of Shangkehuangshui in vitro and in vivo based on TLR4/TLR2-NF-κB signaling pathway

Ethnopharmacological relevanceShangkehuangshui (SK) has been traditionally used to treat traumatic injury, soft tissue and bone injury in Foshan hospital of traditional Chinese medicine for more than 60 years, which composed of many Chinese herbs such as Coptis chinensis Franch., Gardenia jasminoides Ellis, Phellodendron chinense Schneid. and etc. SK exhibits heat-clearing and detoxifying, enhancing blood circulation to eliminate blood stasis properties, and demonstrates noteworthy clinical efficacy. Nevertheless, the underlying mechanism remains uncertain. Aim of the studyThe early study found that SK had good anti-inflammatory effects in acute soft tissue injury model. This research is to verify the anti-inflammatory properties of SK both in vitro and in vivo via TLR4/TLR2-NF-κB signaling pathway, to clarify the underlying mechanisms responsible for the curative effect of SK. MethodsThe RAW264.7 cells inflammatory model was established with lipopolysaccharide (LPS) in vitro. NO and TNF-α, IL-6, IL-1β were determined with Griess method and ELISA method respectively. The mRNA and protein expression levels of TLR4/TLR2-NF-κB pathway were evaluated by qPCR and Western blot method. In vivo experiment, chronic soft tissue injury rat models were established by tracking gastrocnemius muscle with electrical stimulation, then local appearance and pathological changes were observed and recorded, the contents of inflammatory factors in serum and tissue were performed. Moreover, we also measured and contrasted the expression of TLR4/TLR2-NF-κB related factors. ResultsSK effectively inhibited the LPS-induced generation of inflammatory cytokines, including NO, TNF-α, IL-6 and IL-1β in RAW264.7 cells, and significantly suppressed the expression of TLR4, TLR2, MyD88, IκB, and NF-κB. In vivo, SK remarkably decreased the damage appearance scores after 4 and 14 days of administration and inhibit the quantity of NO and leukocytes present in the serum. Additionally, the inflammatory infiltration in the pathological section was alleviated, myofibrillar hyperplasia and blood stasis were reduced. SK markedly downregulated NO, TNF-α, IL-6 and IL-1β in injured tissues of rats, also declined the expression of TLR4, TLR2, MyD88, IκB, NF-κB, IL-6, TNF-α and IL-1β. ConclusionThis study revealed that SK had obvious effects of anti-inflammatory actions in vivo and vitro, effectively reduced acute and chronic soft tissue injury in clinical, this might be attributed to inhibit the TLR4/TLR2-NF-κB pathway, further inhibit the expression of downstream relevant pro-inflammatory cytokines.

Applications of Platelet-rich Plasma in the Treatment of Musculoskeletal Injuries

The use of platelet-rich plasma (PRP), which has the ability to hasten the repair of soft tissue, cartilage, and bone, has revolutionized musculoskeletal medicine. Applications include treatment of osteoarthritis, tendinopathy, chondropathy, acute and chronic soft tissue injuries, muscle or ligament tears, as well as enhancement of healing of cartilage joints. With the ability to promote safe and natural healing, PRP is considered a promising alternative to surgery. Recently, there is an emerging literature on the beneficial effects of PRP for chronic non-healing tendon injuries and cartilage degeneration. This review article provides an overview of recent basic science and clinical studies on the applications of PRP to the treatment of musculoskeletal injuries.

Sleep deprivation increases pain sensitivity following acute muscle soreness

ObjectiveThe aim of this cross-sectional group comparison study was to investigate whether sleep disturbance facilitates pain sensitivity caused by an acute muscle injury. MethodsThirty-six healthy individuals were included and randomly assigned to one of three groups in a non-balanced manner: a control group (n = 11) and two groups who performed eccentric exercise for quadriceps to cause delayed onset of muscle soreness (DOMS). The difference between the DOMS groups was that one followed their habitual sleep pattern (Sleep group, n = 12) and the other had their sleep withdrawn for one night (No-Sleep group, n = 13). The level of DOMS was indicated using a 6-point Likert Scale and pain sensitivity was assessed using Pressure Pain Thresholds (PPT) at the lower legs and shoulder at baseline (Day-1) and after 48 h (Day-3). Additionally, pain distribution following suprathreshold pressure stimulation (STPS) on the quadriceps muscle was assessed on the same days. ResultsPPTs were significantly reduced at Day-3 compared with Day-1 in both DOMS groups. The relative change between days was larger in the No-Sleep group compared with controls (P<0.05) whilst no significant change was seen in the Sleep group compared with controls. Furthermore, no significant differences were found between groups nor days for the subjective perception of DOMS (Likert Scale) and the size of the area of STPS. ConclusionsThe loss of sleep further increases pain sensitivity following an acute soft tissue injury, demonstrating a potential causative role of the lack of sleep on complex pain states following musculoskeletal injuries.

The Pattern of NSAIDs Drugs Use by Libyans Patients for Acute Tissue Injury

Introduction: NSAIDs are a family of drugs that have achieved widespread use in sports medicine in both prescription and over-the counter (OTC) forms. NSAIDs are often administered after acute soft tissue injury in an effort to reduce pain and inflammation and thus speed an injured athlete's return to competition. However, recent evidence suggests that the short term benefits of NSAID therapy may adversely affect the long-term healing of injured soft tissues. Method: The study was performed to test pattern of NSAIDs use by Libyan patients. Patients were asked to complete a self-report questionnaires while attending orthopedic clinic at Al-Haraysh hospital at Darna City (Libya) during the period from March to May 2022. Result: Panadol (acetaminophen) consumption was reported by 6 (40%). Equivalent data for ketoprofen (Fastum gel) were 6 (40%) for topical preparation. Tewinty percent (3) of the participants consumed Muscadol (Paracetamol 450mg + Orphenadrine citrate 35mg)-based drugs. These were ibuprofen (ketoprofen)-based drugs used by 3 (20%) of respondent . The 2 (13%) consumed Naproxen (Nopain) and only the 1 (6.6%) used Aspirin for their injuries. Conclusion: NSAIDs are commonly used in the treatment of acute soft tissue injuries in athletes. Because of the diverse of adverse effects associated with NSAIDs, athletic trainers must be aware of the potential benefits and liabilities of NSAIDs use by injured.

Assessment of Flap Viability and Post-operative Hand Function After Resurfacing of Acute Soft Tissue Injury onthe Palm of Hand byGroin Flap and Reverse Pedicled RadialForearm Flap

Background: Many flaps have been described and used for coverage of various soft tissue defects of hand, which can be regional or distant. Objective: In this study main goal is to evaluate the assessment of flap viability and post-operative hand function by Total Active Motion (TAM) and Hand grip strength. Method: This was a comparative observational study, conducted at department of Orthopaedic Surgery and Burn and Plastic surgery in Sylhet MAG Osmani Medical College Hospital (SOMCH) from January 2018 to October, 2019. A total of 16 patients with acute hand injury or pathology in the palm which may create surgical wound, admitted in the study place during the study period were the study population. Where those who had Acute wound in palm with exposed tendon, nerve and bones or degloving hand injury were included in the study. Patient were divided into two group namely Group-A and Group-B. Patient chosen for groin flap were allocated in group-A and for reverse pedicled radial forearm flap were in group-B. Results: During the study, complete flap survival was 100% in both group A and B. At all the follow-ups hand grip strength was more in group B and the difference was statistically significant (p&lt;0.05, obtained by unpaired t-test). At final follow-up (12 weeks) hand grip strength was 22.38 (SD±5.26) kg in Group A and 30.13 (SD±10.15) kg in Group B.There is no(0.0%) excellent result of index and middle finger in group A patient compared to 3 (37.5%) and 6 (75.0%) patients respectively in group B. Ingroup A3 patient had excellent outcome in ring fingercompared to 7 (87.5%) patients in group B. Majority (87.5%) patient‘s little finger was excellent in group A and 8(100.0%) in group B.The difference of index finger and middle finger were statistically significant between groups (p&lt;0.05 obtained by Fisher Exact test). Conclusion: From this study we can say that, both the handgrip strength and TAM score was better in patients who underwent radial forearm flap and the difference was statistically significant (p&lt;0.05). It is concluded that reverse pedicled radial forearm flap has better outcome regarding flap viability and post-operative hand function than groin flap.

Mechanism of Xuanhuang Ointments for the Acute Soft Tissue Injury Based on Network Pharmacology

Mechanism of Xuanhuang Ointments for the Acute Soft Tissue Injury Based on Network Pharmacology

Evaluation of Sustained Acoustic Medicine for Treating Musculoskeletal Injuries in Military and Sports Medicine.

Musculoskeletal injuries are common in collegiate, professional, and military personnel and require expedited recovery to reduce lost work time. Sustained acoustic medicine (SAM) provides continuous long-duration ultrasound at 3MHz and 132mW/cm2. The treatment is frequently prescribed to treat acute and chronic soft tissue injuries and reduce pain. The objective of this study was to evaluate the efficacy of SAM treatment for musculoskeletal injuries and accelerated recovery. An 18-question electronic survey and panel discussion were conducted on Athletic Trainers (ATs) using SAM treatment in professional, collegiate, and military sports medicine. The survey included both qualitative and quantitative questions. In addition, a panel discussion discussed SAM effectiveness with expert ATs. Power calculation of sampling and statistical evaluation of data was utilized to generalize the results. Survey respondents (n=97) and panelists (n=142) included ATs from all National Athletic Trainers Association districts. SAM was primarily used for musculoskeletal injuries (83.9%, p<0.001) with a focus on healing tendons and ligaments (87.3%, p<0.001). SAM treatment was also used on joints (44.8%), large muscle groups (43.7%), and bone (41.4%). SAM provided clinical improvement in under 2 weeks (68.9%, p<0.001) and a 50% reduction in pain medication (63%, p<0.001). In addition, patients were highly receptive to treatment (87.3%, p<0.001), and ATs had a high level of confidence for improved function and returned to work after 30-days of SAM use (81.2%, p<0.001). SAM is an effective, safe, easy-to-use, noninvasive, comfortable, and versatile therapeutic for healing musculoskeletal injuries.

Update on the Use of Platelet-Rich Plasma Injections in the Management of Musculoskeletal Injuries: A Systematic Review of Studies From 2014 to 2021.

There has been expanding use of platelet-rich plasma (PRP) in the management of musculoskeletal soft tissue injuries. To determine if there are any recent studies that show any clear benefits regarding the use of PRP in the management of soft tissue injuries. Systematic review. This review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The EMBASE, MEDLINE, PubMed, and Cochrane Bone, Joint and Muscle Group Specialised Register databases were queried for randomized controlled trials comparing PRP with a non-PRP/placebo in participants >18 years of age with musculoskeletal soft tissue injuries. Exclusion criteria were non-soft tissue injuries and research published in journals with an impact factor <3.5. The main outcome measure analyzed across all injury types was the effect of PRP injections on pain and function. Of the 853 studies initially screened, 32 were included in this review. There were 13 studies that investigated the effects of PRP on the management of rotator cuff injuries; 7 studies that investigated PRP in conjunction with arthroscopy found no significant difference between PRP groups and controls, while 5 of 6 studies that investigated nonsurgical management showed positive results for PRP. Eight studies investigated various tendinopathies; of these, 2 studies demonstrated positive results for PRP in Achilles and gluteal tendinopathy management. Six studies examined PRP in acute soft tissue injuries, with 2 of these reporting significant improvements in recovery time for hamstring injuries and 1 study showing positive results for ankle ligament injuries. Two studies looked at acute rupture of soft tissues and found no benefit to PRP use. Two studies investigated PRP injections for chronic plantar fasciitis, and both reported positive results in pain and function with PRP. Finally, 1 study evaluated the effects of PRP on meniscal injuries and reported significant improvement in the healing rate and a decreased need for surgical repair. Currently, there is no research strongly advocating the use of PRP compared with traditional management strategies (rest, ice, corticosteroid injection, rehabilitation program). No long-term physiological benefits were reported to justify the invasive and costly technique of obtaining, producing, and implementing PRP.

Efficacy of Cryo-compression on Shin Splints in Female Amateur Marathon Runners

Background: Medial tibial stress syndrome (MTSS) or Shin splints is exercise-induced lower leg pain along the distal posterior-medial aspect of tibia caused by repetitive loading stress during running and jumping. It is one of the most common lower leg sports injury. Cryotherapy is the most commonly used treatment during immediate care of athletic injuries and acute soft tissue injuries and is also included as part of RICE (rest, ice, compression and elevation). Cryotherapy is helpful in reducing swelling as well as it exerts analgesic effect. The external compression is also used during immediate care phase and it helps in decrease tissue temperature and prevent oedema formation. Cryotherapy in combination with intermittent pneumatic compression hypothetically help in reducing the physiologic effects of traumatic tissue damage which is based on the models of cryotherapy and static compression therapy. This study aims to establish the efficacy of cryo-compression on shin splints in female amateur marathon runners. Methods: A total 30 subjects diagnosed with shin splints were selected for study. Subjects received cryo-compression for reducing pain and swelling and exercises to strengthen the muscles. Each session was conducted for 45 minutes duration, 5 days per week for 4 weeks. Outcome measure used was Numerical Pain Rating Scale (NPRS), Goniometry for ROM and Manual muscle testing (MMT). Results: According to statistical analysis, the results of the study demonstrate that there was a significant effect of the use of cryo-compression on numerical pain rating scale (p&lt;0.0001), range of motion (ankle plantarflexion, dorsiflexion, eversion and inversion) (p&lt;0.0001), manual muscle testing – ankle plantarflexors (p=0.0028) and ankle dorsiflexors (p&lt;0.0001) during the pre and post intervention assessment. Conclusion: The conducted study shows that efficacy of cryo-compression on shin splints in female amateur marathon runners is very effective in reducing pain, increasing range of motion (ROM) and strength of muscles along with other treatment program. KEYWORDS: Cryo-compression, shin splints, numerical pain rating scale (NPRS), range of motion, ankle plantarflexion, ankle dorsiflexion, ankle eversion, ankle inversion, manual muscle testing, ankle plantarflexors, ankle dorsiflexors.

Sport and exercise medicine approach to acute lower limb soft tissue injury management in the emergency department.

Sport and exercise medicine approach to acute lower limb soft tissue injury management in the emergency department.

Mechanism of Olibanum and Myrrha for the Acute Soft Tissue Injury Based on Network Pharmacology

Abstract Objective The objective of this study was to screen the therapeutic target of olibanum and myrrha on acute soft tissue injury (ASTI) by network pharmacology and to clarify their mechanisms. Methods The main chemical constituents and the targets of olibanum and myrrha were obtained by using traditional Chinese medicine systems pharmacology database and analysis platform database. The disease targets of ASTI were searched by GeneCards. The intersection targets of herbs and diseases were selected for protein interaction analysis, protein–protein interaction network was constructed, and potential protein functional modules in the network were explored. A compound–target–disease network was constructed using Cytoscape3.8.2 software. The targets were analyzed by gene ontology analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analysis based on the Metascape database. Results The core active components of olibanum and myrrha were quercetin, β-sitosterol, and stigmasterol. The core targets were PGR, NCOA2, PTGS2, PRKCA, and NR3C2. Pathways in cancer, AGE-RAGE signaling pathway in diabetic complications might play a potential role in olibanum and myrrha in the treatment of ASTI. Conclusion Olibanum and myrrha have the characteristics of multiple components, multiple targets, and overall regulation in the treatment of ASTI.

A novel synergistic device for joint inflammation – efficacy on ankle sprain cases

Joint inflammation results from soft-tissue injuries and cartilage damage. PRICE is the standard treatment approach for acute soft tissue injuries like ankle sprain. Electrical stimulation, application of orthotic braces, etc. is also effective for this. In a synergistic device all these components are combined and applied simultaneously. This device was developed for joint inflammation and tested for grade I & II acute ankle joint sprain. To test a synergistic – semirigid device, combining PRICE & electrical stimulation for acute ankle sprains of grades I & II for pain, range of motion and swelling is a case series was the objective. Device was developed using novel concept of synergistic applications of PRICE with electrical stimulation. The joint contour of ankle and specific biomechanical bony surface landmarks were considered. Ethical approval was taken from NTCC committee, AIPT. Recordings were taken from eight patients of acute ankle sprain with – in two days of injury, after getting ethical approval. Elevation to the ankle was provided by keeping the part over the pillow and data was recorded with the help of: 1.VAS scale for pain; 2. Measuring tape; 3. Goniometry. t-test was used to find out the significant difference pre and post the application of device. There was a significant reduction in pain (p = 0.006), edema (p = 0.011), dorsi-flexion (p = 0.015), and plantar flexion (p =0.008). The synegistic device has been effective for acute ankle inflammation - grade I & II ankle sprains in 5 sessions; sufficient for the return of function.

The Efficacy in the Treatment of Acute Closed Soft Tissue Injury by Using Acupuncture and Diclofenac in Football Players

This study was aim to investigate the clinical treatment of acupuncture combined with diclofenac in the treatment of acute soft tissue injury in football players. This paperdivided100 patients with acute closed soft tissue injury caused by football into control group and treatment group randomly, 50 cases in each group. The control group was usually treated with PRICE, and the treatment group use PRICE combined with acupuncture and diclofenac to cure. One course for two weeks, treatment requires two courses. Before and after the patient was included in the study, record the scores of dynamic pain intensity, static pain intensity, local pain intensity and local sensitivity, and local swelling assessment. Improve clinical outcomes and record the treatment results after 3 days, 8 days, and 15 days. The results showed that there was a significant difference in the degree of symptomatic relief between the control group and the treatment group on days 3, 8 and 15 after treatment (P < 0.05). The difference between the two groups has statistically significant. The good rate and effective indicators of the treatment group were 65.6% and 92.1%, which was better than the control group (P <0.05) significantly. The results showed that acupuncture combined with diclofenac treatment can improve the pain symptoms of patients with soft tissue injury significantly, and its clinical superiority and overall efficacy are better than conventional PRICE treatment.

Acute soft tissue injury to the temporomandibular joint and posttraumatic assessment after mandibular condyle fractures: a longitudinal prospective MRI study.

Evaluation of acute soft tissue injury of the temporomandibular joint (TMJ) with type I-VI fractures immediately after trauma and investigation of the longitudinal evolution including response to conservative treatment using MRI. The joints of 24 patients with 33 condylar fractures (15 unilateral, nine bilateral) were imaged on a 1 Tesla MR system within the first 24 h post-trauma. 12 of these patients with 16 condylar fractures (eight unilateral, four bilateral) were clinically re-evaluated using MRI after 3 months of closed treatment. The position, morphology, and signal intensities of the disc, capsule, retrodiscal tissue, and osseous structures were documented. In the acute phase, disc displacements (DDs) were diagnosed in 8 out of 33 joints with fracture, including posterior DDs in two joints and tears of the inferior retrodiscal lamina in 11 joints. The follow-up MRI in 12 patients revealed new DD in four joints on the fractured side (FS) including a posterior DD and an increased degree of displacement, and new DDs in two joints in the non-fractured side (NFS). Preexisting and traumatic DD and soft tissue injuries are frequent findings in patients with condylar fracture. Independent of the degree of trauma, condylar fractures may determine the subsequent development of DD on both FS and NFS. Early MR imaging may help initiate well-directed specific measures for better outcomes in the acutely injured TMJ.