Search

Background Traditional Chinese acupuncture has been widely applied for the treatment of knee osteoarthritis (KOA) with outstanding efficacy. However, recognized and unified outcome indicators remain to be absent, which impedes the translation of research into high-quality clinical evidence. Therefore, the establishment of core outcome indicators for acupuncture in KOA is conducive to enhance the scientific rigor, rationality, and feasibility of clinical research programs in traditional Chinese medicine (TCM) , provide higher quality evidence-based basis for clinical research. Objective To analyze the current status of the application of outcome indicators in randomized controlled trials (RCTs) of acupuncture for KOA, so as to provide a basis for the assessment method of clinical efficacy. Methods PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP and SinoMed were searched for clinical RCTs of acupuncture in the treatment of KOA from 2003 to 2022. Two researchers screened and extracted the characteristics of literature. The indicator domain, measurement tools and the time point of measurement of RCTs of acupuncture for KOA were analyzed. Results A total of 131 papers were included, with a sample size of 22 726 cases and 89 outcome indicators, which were classified into 40 (44.9%) items for symptoms and signs, 22 (24.7%) items for physical and chemical examinations, 5 (5.6%) items for quality of life, 5 (5.6%) items for psychological state, 3 (3.4%) items for satisfaction evaluation, 2 (2.2%) items for safety indicators, and 12 (13.5%) items for other indicators. Among the 131 articles, 23 measurement time points were included in the 131 articles, ranging from 1 hour to 3 years after treatment, 106 (80.9%) articles used "clinical efficacy" as the outcome indicator, 23 (17.6%) articles used safety evaluation and adverse event reports. Conclusion There are some problems in the use of outcome indicators in the RCTs of acupuncture for KOA, such as large variation in the use of outcome indicators, confounding of primary and secondary indicators, abuse of index combination, irregular use of composite indexes, inadequate safety evaluation, irregular measurement time points, insufficient evaluation of long-term prognosis, and failing to reflect the characteristics of TCM intervention of acupuncture. Future research should combine treatment based on syndrome differentiation characteristics of TCM, to evaluate the efficacy of acupuncture in the treatment of KOA by using scientific and reasonable outcome indicators. It is urgent to establish the core indicators set of TCM in the treatment of KOA, and to construct a standardized and recognized COS-TCM.

Free-space nonreciprocal transmission is a crucial aspect of modern optics devices. The implementation of nonreciprocal optical devices through optical nonlinearity has been demonstrated. However, due to the weak nonlinearity of traditional materials, most self-biased nonreciprocal devices are heavily dependent on the high Q strong resonances. In general, these resonances are frequently polarization sensitive. In this work, we propose ultrathin optical metasurface embedding Kerr nonlinearities to achieve nonreciprocal transmission and optical bistability for free-space propagation based on symmetry-protected bound states in the continuum (BICs). Since the structure of the metasurface retains C4ν symmetry, the symmetry-protected BIC is polarization-independent. It is also shown that the nonreciprocal intensity range could be largely tuned by the structure parameters. The demonstrated devices merge the field of nonreciprocity with ultrathin metasurface technologies making this design an exciting prospect for an optical switch, routing, and isolator with optimal performance.

Generally, the second-harmonic generation and slow light of multi-band topological edge states (TESs) have been studied separately. Therefore, the influence of simultaneous slow light and topology protection on second-harmonic generation (SHG) is deficient. Here, we propose a high-efficiency SHG using dual-frequency TESs in topological photonic crystals (TPCs) with slow-light conditions. The wave vector matching condition and energy conservation condition (frequency doubling) can be achieved by adequately adjusting the overall structural parameters of TPCs. The double-resonant nonlinear interaction between two TESs is enabled using a square lattice TPC. Due to the topological localization of the TES and the long interaction time of slow-light effect, the energy densities of the fundamental wave and SHG are significantly increased. Consequently, the high intrinsic efficiency of SHG can be obtained in the order of 7.40 × 10−4. Our work opens new avenues for using topological protected and slow light enhanced nonlinear frequency conversion in a TPC system. [ABSTRACT FROM AUTHOR]

The 8 × 8 magneto-optical matrix has been derived to discuss the Faraday rotation (FR) effect, which is induced by the linear polarization wave passing through a sandwich structure composed of a dielectric layer and two identical Weyl semimetals (WSMs). The giant enhanced FR angle about 45° can be realized at the resonant tunneling wavelength of right hand circularly polarization (RCP) waves by enlarging the difference of the resonant tunneling wavelength of RCP and left hand circularly polarization waves suitably. It is shown that the resonant wavelengths depend on the Weyl node separation and tilt degree of Weyl cones in both type-I and type-II WSMs. More importantly, there exists a tunable one-to-one relationship between the Weyl node separation and the wavelength of the resonant FR angle, as well as the tilt degree and the wavelength of the resonant FR angle, which enables the characteristic of the Weyl node separation and tilt degree. Our research reveals an available method to determine the Weyl node separation and tilt degree of Weyl cones in both type-I and type-II WSMs. [ABSTRACT FROM AUTHOR]

Abstract Background There is a great deal of controversy on whether routine MRI examination is needed for fresh fractures while the vast majority of patients with tibial plateau fractures (TPFs) receive preoperative X-ray and CT examinations. The purpose of the study was to analyze the exact correlation between CT images of lateral plateau and lateral meniscus injuries in Schatzker II TPFs. Methods A total of 296 patients with Schatzker II TPFs from August 2012 to January 2021 in two trauma centers were enrolled for the analysis. According to the actual situation during open reduction internal fixation (ORIF) and knee arthroscopic surgery, patients were divided into meniscus injury (including rupture, incarceration, etc.) and non-meniscus injury groups. The values of both lateral plateau depression (LPD) and lateral plateau widening (LPW) of lateral tibial plateau on CT images were measured, and their correlation with lateral meniscus injury was then analyzed. The relevant receiver operating characteristic (ROC) curve was drawn to evaluate the optimal cut-off point of the two indicators which could predict meniscus injury. Results The intra- and inter-observer reliabilities of LPD and LPW were acceptable (intraclass correlation coefficient (ICC) > 0.8). The average LPD was 13.2 ± 3.2 mm while the average value of the group without meniscus injury was 9.4 ± 3.2 mm. The difference between the two groups was statistically significant (P 7.9 mm and/or LPW > 7.5 mm on CT. These findings will definitely provide guidance for orthopedic surgeons in treating such injuries. During the operation, more attention is required be paid to the treatment of the meniscus and the possible fracture reduction difficulties and poor alignment caused by meniscus rupture and incarceration should be fully considered in order to achieve better surgical results.