Background: Chronic low back pain is a common musculoskeletal disease. With the increasing number of patients, it has become a huge economic and social burden. It is urgent to relieve the burden of patients. There are many common rehabilitation methods, and aquatic physical therapy is one of them. The purpose of this systematic review and meta-analysis is to summarize the existing literature and analyze the impact of aquatic physical therapy on pain intensity, quality of life and disability of patients with chronic low back pain. Methods: Through 8 databases, we searched randomized controlled trials on the effect of aquatic physical therapy on patients with chronic low back pain. These trials published results on pain intensity, quality of life, and disability. This review is guided by Cochrane Handbook for systematic reviews of interventions version 5.1.0. The level of evidence was assessed through GRADE. Results: A total of 13 articles involving 597 patients were included. The results showed that compared with the control group, aquatic physical therapy alleviated the pain intensity (Visual Analogue Scale: SMD = -0.68, 95%CI:-0.91 to -0.46, Z = 5.92, P < 0.00001) and improved quality of life (physical components of 36-Item Short Form Health Survey or Short-Form 12: SMD = 0.63, 95%CI:0.36 to 0.90, Ζ = 4.57, P < 0.00001; mental components of 36-Item Short Form Health Survey or Short-Form 12: SMD = 0.59, 95%CI:0.10 to 1.08, Ζ = 2.35, P = 0.02), and reduced disability (Roland Morris Disability Questionnaire: SMD = -0.42, 95%CI:-0.66 to -0.17, Ζ = 3.34, P = 0.0008; Oswestry Disability Index or Oswestry Low Back Pain Disability Questionnaire: SMD = -0.54, 95%CI:-1.07 to -0.01, Ζ = 1.99, P = 0.05). However, aquatic physical therapy did not improve patients' pain at rest (Visual Analogue Scale at rest: SMD = -0.60, 95%CI:-1.42 to 0.23, Ζ = 1.41, P = 0.16). We found very low or low evidence of effects of aquatic physical therapy on pain intensity, quality of life, and disability in patients with chronic low back pain compared with no aquatic physical therapy. Conclusions: Our systematic review showed that aquatic physical therapy could benefit patients with chronic low back pain. However, because the articles included in this systematic review have high bias risk or are unclear, more high-quality randomized controlled trials are needed to verify.

Background: The aim of this study was to examine how body image, Disease Activity Score in 28 joints, the feeling of being anxious, depression, fatigue, quality of sleep, and pain influence the quality of life (QoL) in patients with rheumatoid arthritis (RA).Methods: A multicenter cross-sectional survey with convenience sampling was conducted from March 2019 and December 2019, 603 patients with RA from five hospitals were evaluated using the Body Image Disturbance Questionnaire, Disease Activity Score in 28 joints, Hospital Anxiety and Depression Scale, Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Short Form 36 Health Survey, and Global Pain Scale. The relationship between quality of life and other variables was evaluated by using the structural equation model (SEM).Results: A total of 580 patients were recruited. SEM fitted the data very well with a root mean square error of approximation (RMSEA) of 0.072. Comparative fit index of 0.966, and Tucker-Lewis index of 0.936. The symptoms and the normalized factor load of six variables showed that the normalized factor load of pain was 0.99.Conclusions: The QoL model was used to fit an SEM to systematically verify and analyze the population disease data, biological factors, and the direct and indirect effects of the symptom group on the QoL, and the interactions between the symptoms. Therefore, the diagnosis, treatment and rehabilitation of RA is a long-term, dynamic, and complex practical process. Patients' personal symptoms, needs, and experiences also vary greatly. Comprehensive assessment of patients' symptoms, needs, and experiences, as well as the role of social support cannot be ignored, which can help to meet patients' nursing needs, improve their mood and pain-based symptom management, and ultimately improve patients' QoL.

Objective: This study aims to search, evaluate, and consolidate the best evidence for resistance exercise in maintenance hemodialysis patients, providing evidence-based support for the clinical implementation of resistance exercise in these patients. Methods: We conducted a comprehensive search of literature in databases on resistance exercise for maintenance hemodialysis patients, including guidelines, expert consensus, evidence summaries, systematic reviews, and randomized controlled trials. The search spanned from the inception of the database to March 2023. During the process of evaluation and data extraction, two researchers rigorously assessed the quality of the literature. Results: A total of 24 articles were included in this review, consisting of 2 guidelines, 3 expert consensus documents, 9 systematic reviews, and 10 randomized controlled trials. From nine aspects, including target population, contraindications for exercise, pre-exercise assessment, exercise frequency, exercise intensity, exercise duration, exercise type, exercise benefits, and exercise precautions, we extracted a total of 23 pieces of best evidence. Conclusion: Given the findings of this study, we recommend that future researchers design and conduct larger-scale, multi-center, longitudinal studies to validate our results and further explore the long-term impacts of combined resistance and aerobic exercises on muscle strength and other health indicators. Such research will provide deeper insights and contribute to the development of evidence-based exercise programs.

Aging often leads to changes in hormone levels, particularly testosterone, which is thought to significantly affect bone health in older males. This study aimed to explore the link between testosterone levels and bone mineral density in men aged 60 and above. Data from the National Health and Nutrition Examination Survey 2013–2014 were used. Weighted multivariable linear regression models were employed to study the association between testosterone and bone mineral density. Furthermore, a weighted generalized additive model and smooth curve fitting were used to address potential nonlinear patterns in the data. The analysis included 621 elderly men. After accounting for various factors, the study uncovered a Inverted U-shaped correlation between testosterone levels and femoral neck density. Notably, a turning point was identified at the testosterone level of 406.4 ng/dL. Further examination, using different models, showed that testosterone levels in the third quartile (group Q3) were positively linked to bone density. However, contrasting trends were observed in the first (group Q1) and fourth quartiles (group Q4), where testosterone levels displayed a negative relationship with bone density. The results indicate a complex interplay between testosterone levels and bone mineral density in elderly men. The U-shaped trend suggests that both low and high testosterone levels could negatively impact bone health. These findings highlight the importance of maintaining testosterone levels within an optimal range to preserve bone health in aging men.

Aim: The burden of valvular heart disease (VHD), which is high amongst end‐stage kidney disease patients (ESKD), is less well defined in those referred to the transplant waitlist. We aimed to determine the prevalence, incidence, impact on survival and risk factors of VHD in ESKD patients who are referred for deceased donor kidney transplant (DDKT). Methods: This is a single‐centre retrospective cohort analysis of ESKD patients who were referred for waitlist placement between 2009 and 2017 and underwent at least 1 transthoracic echocardiogram (TTE), then followed up until death or transplantation. Significant VHD was defined as VHD that was moderate or worse in severity as assessed on echocardiography. Results: Of the 512 patients included, 89 (17.4%) had significant baseline VHD. Over a median follow‐up of 6.6 years, severe VHD (adjusted HR (aHR) 2.73, 95% CI 1.28–5.83, p = 0.009), severe tricuspid regurgitation (aHR 3.04, 95% CI 1.20–7.69, p = 0.02), significant aortic stenosis (aHR 2.93, 95% CI 1.15–7.45, p = 0.02), MS (aHR 3.83, 95% CI 1.54–9.50, p = 0.004) and AR (aHR 1.76, 95% CI 1.05–2.97, p = 0.03) were independently associated with all‐cause mortality. In 350 patients with repeat TTEs, 53 (15.1%) developed de novo significant VHD or progression of pre‐existing VHD, which was independently associated with all‐cause mortality (aHR 2.02, 95% CI 1.14–3.61, p = 0.02). Age, time on dialysis, and mineral bone disease were associated with baseline VHD and de novo or progression of pre‐existing VHD. Conclusion: VHD is common amongst ESKD patients referred for DDKT waitlist. Both baseline and progressive VHD predict worse survival.

Different approaches have been proposed to treat patients with pulseless supracondylar humeral fractures (SHF). We aim to analyze the current outcomes of p