Study Design. A scanning electron microscopic study performed on three cadaveric specimens focused on the human suboccipital region, specifically, myodural bridge (MDB). Objective. This study showed the connection form of the MDB among the suboccipital muscles, the posterior atlanto-occipital membrane (PAOM) and the spinal dura mater (SDM), and provided an ultrastructural morphological basis for the functional studies of the MDB. Summary of Background Data. Since the myodural bridge was first discovered by Hack, researches on its morphology and functions had been progressing continuously. However, at present, research results about MDB were still limited to the gross anatomical and histological level. There was no research report showing the MDB's ultrastructural morphology and its ultrastructural connection forms between PAOM and SDM. Methods. A scanning electron microscope (SEM) was used to observe the connection of myodural bridge fibers with PAOM and SDM in atlanto-occipital and atlanto-axial interspaces, and the connection forms were analyzed. Results. Under the SEM, it was observed that there were clear direct connections between the suboccipital muscles and the PAOM and SDM in the atlanto-occipital and atlanto-axial spaces. These connections were myodural bridge. The fibers of the myodural bridge merged into the spinal dura mater and gradually became a superficial layer of the spinal dura mater. Conclusion. MDB fibers merged into the SDM and became part of the SDM in the atlanto-occipital and atlanto-axial space. MDB could transfer tension and pulling force to the SDM effectively, during the contraction or relaxation of the suboccipital muscles. Level of Evidence: N/A
Background: There has been a lot of research on physical therapy for tension-type headaches. However, the efficacy of physical therapy on the suboccipital region remains unclear. Objective: To establish the effectiveness of physical therapy on the suboccipital area of patients with tension-type headache. Methods: Databases including Cochrane Library, Medline/Pubmed, CNKI, Embase, and Google Scholar were searched. After independent study selection by 2 authors, data were extracted and collected independently. On 1 hand, authors compared the treatment of the suboccipital area with control group. On the other hand, the efficacy of several physical therapy techniques on the suboccipital region was compared. The quality of the included studies was assessed using the Cochrane Handbook. RevMan 5.3 software was used for data analysis. The primary outcome measures were the cervical range of motion, the visual analog scale, and headache disability inventory. Results: Six randomized controlled trials with a total of 505 participants were included. Suboccipital soft-tissue inhibition technique (SIT) + occiput-atlas-axis global manipulation (OAA) was more effective than SIT in increasing craniocervical extension at 4 weeks post-treatment, the overall mean differences (MD) was 3.61, 95% confidence interval (CI) (0.89–6.34). There was no difference at 8 weeks post-treatment (MD 2.38, 95% CI −1.02 to 5.78, P = .17). SIT was more effective than SIT + OAA in increasing cervical flexion at 4-week post-treatment (MD −3.36, 95% CI −6.65 to −0.05). SIT + OAA was more effective than SIT on decreasing intensity of pain at 4-week post-treatment (MD −0.91, 95% CI −1.78 to −0.04), but no difference at 8-week (MD −0.43, 95% CI −1.18 to 0.33, P = .27). SIT + OAA was more effective than SIT in reducing the functional score of the headache disability inventory at 4-week post-treatment (MD −4.47, 95% CI −8.44 to −0.50). These results may indicate that the SIT + OAA combined therapy is more effective in short term (4-week), no major difference in longer term (8-week). Conclusion: Combined therapy may be more suitable for the treatment of tension-type headache.
Background The fibula is only indirectly involved in the composition of the human knee joint and has therefore been neglected in the research on knee osteoarthritis. Nonuniform settlement of the proximal tibia plateau is clinically defined as when the height of the medial tibial plateau is lower than that of the lateral side in medial compartment knee osteoarthritis (KOA). The non-uniform settlement of the proximal tibia plateau may be caused by fibular support on the lateral side. Orthopedic surgeons practice partial fibulectomy based on the clinical manifestation of nonuniform settlement, and this technique has been shown to reduce pain and improve function in patients with medial compartment KOA. However, this hypothesis of the mechanism of nonuniform settlement lacks an anatomical basis. Methods The P45 polyester plastination technique was used to prepare sections of the proximal tibiofibular joint to investigate the distribution of the bone trabeculae in the region of the lateral tibial plateau. Results There was uneven distribution of trabeculae in the lateral condyle of the tibia and the head and neck of the fibula. The fibula and the posterolateral cortex of the shaft of the tibia united to form an arch beam via the tibiofibular joint. Many thick, dense trabeculae were present in a longitudinal direction above the tibiofibular arch. Conclusions The fibula supports the lateral tibial plateau, and the trabeculae were concentrated above the tibiofibular arch.
Background: Craniosacral therapy (CST) has remained controversial in the treatment of musculoskeletal disorders. To our knowledge, there is no larger sample size of research to demonstrate the effectiveness of craniosacral therapy in the human suboccipital region on hamstring muscle. Methods: To study whether the CST in the human suboccipital region could have a remote effect on the flexibility of the hamstring muscles, the Cochrane Library, Medline/Pubmed, CNKI, Embase, and Google Scholar were searched. Clinical trials assessing the effects of CST in short hamstring syndrome patients were eligible. Mean differences (MD) and 95% confidence intervals (CI) were calculated for the straight leg raise test (primary outcomes). The quality of the included studies was assessed using the Newcastle-Ottawa Scale. RevMan 5.3 software was used for data analysis. Results: Five controlled trials with a total of 238 participants were included. CST could effectively relieve the symptoms of short hamstring syndrome patients [the overall MD −9.47, 95% confidence interval (CI) −15.82 to −3.12, P < .000001]. The CST was better than the proprioceptive neuromuscular facilitation technique (MD 3.09, 95% CI 1.48–4.70, P = .0002). Sensitivity analysis shows that the frequency of treatment and who did the experiment might be the main sources of impact results. Conclusion: CST could change the flexibility of the hamstring muscles. CST had a better curative effect when compared to proprioceptive neuromuscular facilitation technique on the hamstring muscles.
In 2016, two adult male sperm whales beached off of Yangkou Port in Nantong City, Jiangsu Province, China. The local government planned to preserve them as specimens, one was entrusted to Dalian Hoffen Biological Co., Ltd., and thus became the first sperm whale to be preserved by plastination. The other sperm whale was preserved in Nantong by the traditional stripping method (The skin was preserved, and then the prosthesis was filled into the skin to preserve the specimens.
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