Background: Osteoarthritis is a common degenerative disease with a high incidence, high disability rate, and poor prognosis. Clinical studies have shown that Bushen Huoxue formula can relieve joint swelling and pain and improve limb function and joint mobility, but there is a lack of high-quality scientific basis. Using network pharmacology and molecular docking technology to study the mechanism of Bushen Huoxue formula in the treatment of osteoarthritis. Methods: First, the active ingredients and corresponding target predictions of the formula were obtained through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and the China National Knowledge Infrastructure. Meanwhile, the osteoarthritis disease targets were obtained through the genome annotation database platform (GeneCards) and the DrugBank database, and the target proteins obtained above were standardized using the Uniprot (https://www.uniprot.org) database standardization of names. Then, the Venn diagram was created by taking the intersection of the active ingredient and the target of the disease, and the “active ingredient-target” network was constructed and analyzed using Cytoscape 3.7.2 software. At the same time, the intersecting targets were imported into the Search Tool for the Retrieval of Interaction Gene/Proteins database to build a protein-protein interaction network and to screen the core targets; the intersecting targets were visualized by using the Database for Annotation, Visualization and Integrated Discovery 6.8 database for gene ontology functional analysis and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, and construct the “active ingredient-target-pathway” network. Finally, the main active ingredients of the formula for tonifying the kidney and invigorating the blood were validated by molecular docking with the core targets. Results: A total of 194 active ingredients and 365 targets of the Bushen Huoxue formula were collected, 776 targets for osteoarthritis diseases and 96 targets for the intersection of active ingredients and diseases. The Kyoto Encyclopedia of Genes and Genomes enrichment analysis yielded 104 relevant pathways, including tumor necrosis factor signaling pathways, cancer signaling pathways, nucleotide-binding oligomerization domain-like receptor signaling pathways, Toll-like receptors signaling pathways, and osteoclast differentiation, apoptosis, T-cell receptor signaling pathway, and other related pathways. The molecular docking results showed good binding of the main active ingredients to the core targets. Conclusion: This study shows that the treatment of osteoarthritis involves multicomponent, multitarget, and multipathway processes. The mechanism of anti-inflammatory, antioxidant, inhibition of cartilage matrix degradation, and reduction of subchondral bone destruction may be an important mechanism for the therapeutic effect.

Plantar fasciitis (PF) is the most common cause of chronic heel pain among adults. Extracorporeal shock wave therapy (ESWT) is the recommended in the current guidelines, and the small needle-knife yields acceptable clinical effects for musculoskeletal pain. To systematically compare the efficacy of the small needle-knife versus ESWT for the treatment of PF. The present review was registered in the International Prospective Register of Systematic Reviews (i.e., "PROSPERO", CRD42023448813). Two of the authors searched electronic databases for randomized controlled trials (RCTs) comparing the small needle-knife versus ESWT for the treatment of PF, and collected outcomes including curative effect, pain intensity, and function. Risk of bias was assessed using the Cochrane Handbook Risk of Bias tool and the quality of the RCTs was evaluated according to the Jadad Scale. The same authors independently performed data extraction from the included studies, which were imported into Review Manager version 5.4.1(Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2020) for meta-analysis. The initial literature search retrieved 886 studies, of which 6 were eventually included in this study. Meta-analysis revealed no significant difference in curative effect (OR = 1.87; 95 % CI [0.80, 4.37], p = .15) nor short-term pain improvement (MD = 2.20; 95 % CI [-2.77, 7.16], p = .39) between the small needle-knife and ESWT. However, the small needle-knife may be more effective than ESWT for pain improvement in mid-term (MD = 9.11; 95 % CI [5.08, 13.15], p＜ .00001) and long-term follow-ups (MD = 10.71; 95 % CI [2.18, 19.25], p＜ .00001). Subgroup analysis revealed that the small needle-knife combined with a corticosteroid injection yielded a statistically significant difference in reduction of pain intensity at all follow-ups (MD = 4.84; 95 % CI [1.33, 8.36], p = .007; MD = 10.99; 95 % CI [8.30, 13.69], p＜ .00001; MD = 17.87; 95 % CI [15.26, 20.48], p＜ .00001). Meta-analysis revealed no statistical differences in short-term (MD = 1.34; 95 % CI [-3.19, 5.86], p = .56) and mid-term (MD = 2.75; 95 % CI [-1.21, 6.72], p = . 17) functional improvement between the needle-knife and ESWT groups. In a subgroup analysis of moderate-quality studies, the small needle-knife demonstrated a favorable effect on mid-term functional improvement (MD = 1.58; 95 % CI [0.52, 2.65], p = .004), with low heterogeneity (χ² = 0.77, p = .038, I² = 0 %). Conclusion: Pain reduction and functional improvement are essential for the treatment of PF. Therefore, treatment using the small needle-knife may be superior to ESWT. Results of this systematic review and meta-analysis may provide alternative treatment options for patients with PF as well as more reliable, evidence-based recommendations supporting use of the small needle-knife.

During pregnancy, fetal growth could lead to changes in human biomechanics. If postpartum recovery was not properly managed, it could be exacerbated, resulting in myofascial system disorders and various functional impairments. Among them, pain-related functional disorders were an important issue affecting quality of life in postpartum women. The pathogenesis of these disorders remained unclear but it was primarily associated with changes in biomechanics, the endocrine system, and nervous function. However, postpartum pain-related dysfunction had been considered a normal physiological response to childbirth, leading to a lack of attention. Therefore, many postpartum women failed to receive timely, effective, and standardized treatment, hindering their ability to reintegrate into family and society, and causing severe damage to their physical and mental health. In clinical practice, myofascial therapy could effectively alleviate postpartum pain and muscle spasms, improve excessive tension injuries in myofascial, and had a good therapeutic effect on postpartum pain-related functional disorders. The mechanism of myofascial therapy involved improving core muscle strength, restoring normal body alignment, and promoting the remodeling of myofascial mechanical structures. This article explored the positive effects of myofascial therapy on postpartum pain-related functional disorders from a biomechanical perspective, aiming to provide diverse treatment approaches for clinical practitioners.

Background: The purpose of this study was to evaluate the effectiveness and safety of Joint mobilization in the treatment of frozen shoulder. Methods: To collect relevant literature, we will research following databases: Medicine, PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wan-Fang Database, Chongqing VIP Chinese Science and Technology Periodicaols Database, and China Biomedical Database; the time is from its creation to May 2021, and the language is limited to Chinese and English. In addition, we will retrieve other literature resources, including the Chinese Clinical Trial Register and conference articles. Two reviewers will independently complete the literature screen and data extraction and quality assessment of the included studies will be independently completed by 2 other researchers. The primary outcomes included joint ROM and Japanese Orthopedic Association score. Visual Analogue Scale score, Activities of Daily Living score and adverse reactions as secondary outcomes were assessed. RevMan V.5.4.1 software will be used for meta-analysis, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be used to assess the quality of evidence. Results: This systematic review will provide a high-quality synthesis to evaluate the efficacy and safety of joint mobilization in the treatment of frozen shoulder, providing a reference for the safe and effective treatment of frozen shoulder. Conclusion: This study provides evidence that joint mobilization in the treatment of frozen shoulder is effective. Ethics and dissemination: The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences. Systematic review registration: INPLASY202210075

Background: This study aimed to evaluate the methodological quality, report quality, and evidence quality of a meta-analysis (MA) and systematic review (SR) of the efficacy of acupotomy in the treatment of knee osteoarthritis (KOA), and provided a reference for clinical decision-making. Methods: We searched 8 databases to collect systematic reviews and meta-analyses on the efficacy of acupotomy in the treatment of KOA from January 30, 2018, to January 31, 2023. The methodological quality of the studies was assessed using the assessment of multiple systematic reviews (AMSTAR) 2 scale, the quality of the literature reports was scored using the Preferred Reporting Items for Systems Reviews and Meta-Analyses 2020 Version (PRISMA 2020),and the quality of the evidence was graded using the grading of recommendations assessment, development, and evaluation (GRADE) scale. Results: Nine systematic reviews including 35 outcome indicators were included. AMSTAR 2 evaluated the methodological quality of the included studies, and 1 was of low quality, 8 were of very low quality, and the entries with poor scores were 2, 3, 4, 8, 10, 12, and 13. By PRISMA 2020, there were some reporting deficiencies, and quality problems were mainly reflected in the abstract, information sources, search strategy, synthesis methods, reporting bias assessment, certainty assessment, reporting biases, certainly of evidence, registration and protocol. The GRADE classification results showed that there were 2 medium-quality evidences, 7 low-quality evidences, and 26 very low-quality evidences. The main factors of degradation were limitations, imprecision, and publication bias. Conclusion: Acupotomy had been a promising complementary treatment for KOA. However, due to the low quality of the SRs/MAs supporting these results, high-quality studies with rigorous study designs and larger samples were needed before widespread recommendations could be made.