OBJECTIVE:To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.METHODS:There were 50 stroke patients were randoml...OBJECTIVE:To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.METHODS:There were 50 stroke patients were randomly divided into an experimental group(acupuncture combined with upper limb rehabilitation robot assisted training)and a control group(upper limb rehabilitation robot assisted training).Various assessments were conducted to compare the effects of the two treatments on neural remodeling and functional recovery.Functional near-infrared spectroscopy technology was used to assess the effects of different treatments on neural plasticity and their impact on upper limb function and activities of daily living.RESULTS:The experimental group showed significantly higher concentrations of oxygenated hemoglobin and total hemoglobin in specific brain regions compared to the control group(P<0.05).Additionally,the experimental group had significantly lower concentrations of deoxygenated hemoglobin(P<0.05).After treatment,both groups showed improvements in various measures,but the experimental group had significantly greater improvements(P<0.05).CONCLUSION:Acupuncture combined with upper limb rehabilitation robot can effectively improve upper limb function and neural remodeling in stroke patients.This study supports the integration of Traditional Chinese and Western Medicine in improving limb dysfunction poststroke.展开更多
Background:The aim of the study was to explore a feasible method for alleviating limb ischemia-reperfusion injury(LI/RI)through the use of a high-concentration citrate solution(HC-A solution)for limb perfusion(LP).Met...Background:The aim of the study was to explore a feasible method for alleviating limb ischemia-reperfusion injury(LI/RI)through the use of a high-concentration citrate solution(HC-A solution)for limb perfusion(LP).Methods:Eighteen pigs were divided into three groups:the Sham group,LI/RI group,and HCA group.The Sham group underwent exposure of the iliac artery and vein.The LI/RI group underwent tourniquet placement and clamping of the iliac artery and vein to simulate LI/RI.The HCA group received HC-A solution LP for 30 min through the left iliac artery below the level of blood flow occlusion based on the LI/RI group.Oxidative stress markers and inflammatory response markers were compared among the three groups.Results:Compared to the LI/RI group,the HCA group showed significantly lower levels of serum creatine kinase(CK),lactate dehydrogenase(LDH),malondialdehyde(MDA),tumor necrosis factor-α(TNF-α),aspartate aminotransferase(AST),and ala-nine aminotransferase(ALT),and significantly greater activities of serum superoxide dismutase(SOD)(p<0.05).There were no significant differences in serum interleukin-6(IL-6)or in muscle MDA,SOD,TNF-α,and IL-6 between the HCA group and the LI/RI group(p>0.05).Compared to the LI/RI group,MDA,TNF-α,and IL-6 levels in the liver were significantly lower in the HCA group(p<0.05),while SOD activities were not significantly different(p>0.05).Histopathological examination revealed reduced skeletal muscle and liver damage in the HCA group compared to the LI/RI group.Conclusions:HC-A solution LP can alleviate liver damage caused by LI/RI in pigs.展开更多
Stroke,as a highly prevalent cerebrovascular disease,often leads to limb dysfunction in patients,severely affecting their quality of life.Seeking effective rehabilitation nursing methods is of great significance for p...Stroke,as a highly prevalent cerebrovascular disease,often leads to limb dysfunction in patients,severely affecting their quality of life.Seeking effective rehabilitation nursing methods is of great significance for patient recovery.This article deeply analyzes various aspects such as intelligent rehabilitation technology,traditional Chinese medical therapies,Western medical therapies,and rehabilitation training methods.It explores the characteristics,effectiveness,and application prospects of various rehabilitation nursing approaches,providing a reference for clinical rehabilitation nursing of limb dysfunction after stroke,and helping to improve the quality of patient recovery and enhance their self-care ability and quality of life.展开更多
Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its effi...Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its efficacy.Objective This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis(3DKA)results to select additional acupoints,and investigated the feasibility,efficacy and safety of this approach.Design,setting,participants and interventions This single-blind,single-center,randomized,controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis.The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio.Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks.The main acupoints in both groups were the same,while participants in the intervention group received additional acupoints selected on the basis of 3DKA results.Follow-up assessments were conducted for 8 weeks after the treatment.Main outcome measures The primary outcome was the Fugl-Meyer Assessment for Upper Extremity(FMA-UE)response rate(≥6-point change)at week 4.Secondary outcomes included changes in motor function(FMA-UE),Brunnstrom recovery stage(BRS),manual muscle test(MMT),spasticity(Modified Ashworth Scale,MAS),and activities of daily life(Modified Barthel Index,MBI)at week 4 and week 12.Results Sixty-four participants completed the trial and underwent analyses.Compared with control group,the intervention group exhibited a significantly higher FMA-UE response rate at week 4(χ^(2)=5.479,P=0.019)and greater improvements in FMA-UE at both week 4 and week 12(both P<0.001).The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4(P=0.007,P=0.049,P=0.019,P=0.008,P=0.029,respectively).The intervention group showed a better change in the MBI at both week 4 and week 12(P=0.004 and P=0.010,respectively).Although the intervention group had a higher BRS for the hand at week 12(P=0.041),no intergroup differences were observed at week 4(all P>0.05).The two groups showed no differences in MAS grades as well as in BRS for the arm at weeks 4 and 12(all P>0.05).Conclusion Semi-personalized acupuncture prescription based on 3DKA results significantly improved motor function,muscle strength,and activities of daily living in patients with PSSP-UL.展开更多
Phantom limb pain(PLP)is not only a physical pain experience but also poses a significant challenge to mental health and quality of life.Currently,the mechanism of PLP treatment is still unclear,and there are many met...Phantom limb pain(PLP)is not only a physical pain experience but also poses a significant challenge to mental health and quality of life.Currently,the mechanism of PLP treatment is still unclear,and there are many methods with varying effects.This article starts with the application research of extended reality technology in PLP treatment,through describing the application of its branch technologies(virtual reality,augmented reality,and mixed reality technology),to lay the foundation for subsequent research,in the hope of finding advanced and effective treatment methods,and providing a basis for future product transformation.展开更多
Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives ...Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.展开更多
Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age w...Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age was 8 years with a sex ratio of 2.45. In 68.4% of cases, trauma occurred in road traffic accidents. Average consultation time was 2.4 hours. Trauma mainly affected the leg in 39.5% of cases, and the thigh in 34.2%. Soft tissue wounds occurred in 52.6% of cases, and open fractures in 47.4%. Average response time was one hour. Wound trimming and suturing were performed in 76.3% of cases and combined with bone nailing in 15.8%. The outcome was favorable in 92.1% of cases. Average hospital stay was 4.37 days. Conclusion: Open trauma to the lower limb is a frequent and occurs mainly in road traffic accidents. Management was early, with a favorable outcome for most patients and a short hospital stay.展开更多
Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical managemen...Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical management of varicose pathology of the IM in Dakar. We enrolled 280 patients, with a mean age of 36 and a sex ratio of 2. Factors favouring venous disease were dominated by prolonged orthostatism and multiparity. The average consultation time was 6 years. The reasons for consultation were functional manifestations, progressive complications and aesthetics. The venous trunks concerned were the great saphenous vein (GSV) in 58.9% of cases, the small saphenous vein (SSV) in 29% of cases, perforating veins and varicose veins were unsystematized in 28.5% of cases. Surgery was performed under spinal anaesthesia. Surgical procedures were dominated by stripping of the GSV, crossectomy of the SSV and staged ligations. One patient developed meningismus immediately after the operation. Average follow-up was 2 years. Mortality was null.展开更多
This study describes the use of the weighted multiplicative algebraic reconstruction technique(WMART)to obtain vertical ozone profiles from limb observations performed by the scanning imaging absorption spectrometer f...This study describes the use of the weighted multiplicative algebraic reconstruction technique(WMART)to obtain vertical ozone profiles from limb observations performed by the scanning imaging absorption spectrometer for atmospheric chartography(SCIAMACHY).This technique is based on SaskMART(the combination of the multiplicative algebraic reconstruction technique and SaskTRAN radiative transfer model),which was originally developed for optical spectrometer and infrared imaging system(OSIRIS)data.One of the objectives of this study was to obtain consistent ozone profiles from the two satellites.In this study,the WMART algorithm is combined with a radiative transfer model(SCIATRAN),as well as a set of measurement vectors comprising five Hartley pairing vectors(HPVs)and one Chappuis triplet vector(CTV),to retrieve ozone profiles in the altitude range of 10–69 km.Considering that the weighting factors in WMART have a significant effect on the retrievals,we propose a novel approach to calculate the pair/triplet weighting factors using wavelength weighting functions.The results of the application of the proposed ozone retrieval scheme are compared with the SCIAMACHY v3.5 ozone product by University of Bremen and validated against profiles derived from other passive satellite observations or measured by ozonesondes.Between 18 and 55 km,the retrieved ozone profiles typically agree with data from the SCIAMACHY ozone product within 5%for tropics and middle latitudes,whereas a negative deviation exists between 35 and 50 km for northern high latitudes,with a deviation of less than 10%above 50 km.Comparison of the retrieved profiles with microwave limb sounder(MLS)v5.0 indicates that the difference is within±5%between 18 and 55 km,and an agreement within 10%is achieved in other altitudes for tropics and middle latitudes.Comparison of the retrieved profiles with OSIRIS v7.1 indicates that the average deviation is within±5%between 20 and 59 km,and difference of approximately 10%is achieved below 20 km.Compared with ozonesondes data,a general validity of the retrievals is no more than 5%between 15 and 30 km.展开更多
BACKGROUND Phocomelia is a rare congenital disorder characterized by the absence or under-development of the proximal limbs.Phocomelia can occur as a syndrome or a limb-specific deformity.While historically linked to ...BACKGROUND Phocomelia is a rare congenital disorder characterized by the absence or under-development of the proximal limbs.Phocomelia can occur as a syndrome or a limb-specific deformity.While historically linked to thalidomide,non-thalido-mide causes include genetic mutations,vascular disruptions,and teratogenic exposures.This case highlights the diagnostic and therapeutic challenges in a neonate with bilateral phocomelia,low birth weight,asphyxia and jaundice.CASE SUMMARY We report a 2-week-old term neonate with bilateral phocomelia,micrognathia,jaundice,and low birth weight.The pregnancy was unremarkable,with no tha-lidomide exposure.The mother had a history of early pregnancy losses.Clinical evaluation revealed absent humeri and radii bilaterally,with hands attached proximally to the trunk.Genetic testing was not performed,limiting the identi-fication of underlying etiology.The patient was managed with supportive care,parental counseling,and planning for long-term rehabilitation.This case un-derscores the importance of multidisciplinary care in managing congenital ano-malies.Genetic evaluation is crucial in unexplained congenital anomalies.Routine detailed ultrasounds in high-risk pregnancies aid in early diagnosis and parental preparedness.CONCLUSION Bilateral phocomelia presents significant functional challenges.Comprehensive diagnostic workups and early rehabilitation strategies are essential for optimizing patient outcomes.展开更多
Objective:To explore the rehabilitation effect of upper limb rehabilitation robots combined with isokinetic muscle strength training on hemiplegic patients in the recovery phase of stroke,and to provide a more effecti...Objective:To explore the rehabilitation effect of upper limb rehabilitation robots combined with isokinetic muscle strength training on hemiplegic patients in the recovery phase of stroke,and to provide a more effective intervention plan for clinical rehabilitation treatment.Methods:One hundred and sixty type 2 stroke patients with hemiplegia in recovery phase treated at Jintan First People’s Hospital from May 2020 to May 2025 were selected as the research subjects.They were divided into a control group(n=80)and an observation group(n=80)using a random number table method.The control group received isokinetic muscle strength training,while the observation group received additional upper limb rehabilitation robot-assisted intervention based on the control group’s treatment.The general information(age,gender,course of disease),Brunnstrum staging,Barthel index,FMA score,and facial expression pain score were compared between the two groups.Results:After treatment,the indicators of both groups improved compared to before treatment.The observation group showed significant advantages in improving various indicators.In terms of Brunnstrum staging,the number of patients in stage IV and above was significantly higher than that in the control group;in terms of the Barthel index,the increase was more significant than that of the control group(P=0.000<0.001).In terms of the FMA score,the increase was more pronounced(P=0.000<0.001);and in terms of facial expression pain assessment,the decrease was more evident(P=0.000<0.01).Conclusion:The combination of upper limb rehabilitation robots and isokinetic muscle strength training can significantly improve the recovery of limb function and activities of daily living in hemiplegic patients during the recovery phase of stroke,and reduce pain.Compared with simple isokinetic muscle strength training,the rehabilitation effect is better,and it is worthy of clinical application.展开更多
Vertebrate limbs have undergone profound morphological diversification,enabling adaptations to a broad spectrum of ecological niches.In marine mammals,the evolution of highly specialized flipper-like forelimbs represe...Vertebrate limbs have undergone profound morphological diversification,enabling adaptations to a broad spectrum of ecological niches.In marine mammals,the evolution of highly specialized flipper-like forelimbs represents a profound structural transformation associated with aquatic habitats.This adaptation has been hypothesized to result,in part,from the inhibition of interphalangeal cell apoptosis during limb development,although the underlying genetic mechanism remains poorly understood.This study investigated the evolutionary dynamics and functional consequences of three key bone morphogenetic protein genes,BMP2,BMP4,and BMP7,which regulate apoptosis in interphalangeal mesenchymal stromal cells during embryonic limb development to ensure proper differentiation of interphalangeal tissues.Comparative genomic analysis revealed significantly accelerated evolution for BMP4 and BMP7 in the cetacean ancestral lineage,with two positively selected sites(V79I and H247R)involved in cetacean-specific amino acid substitutions located in the TGF-βpropeptide functional domain in BMP4.In vitro assays confirmed that cetacean-specific BMP4 mutations significantly disrupted normal cell apoptosis and proliferation and altered the transcription and protein expression of downstream apoptosis-related factors,including cytochrome c(Cyt c),BCL2 associated X,and B-cell lymphoma 2,within the BMP signaling pathway.The significant influence of BMP4 mutations on apoptotic inhibition highlights a potential role in the development of limb bud mesenchymal tissue and the emergence of the flipper forelimb phenotype in cetaceans.展开更多
Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three st...Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.展开更多
Limb movement disorder after stroke is one of the main causes of disability,seriously affecting patients’quality of life.Although modern medical treatment can alleviate some symptoms,it has limitations.Traditional Ch...Limb movement disorder after stroke is one of the main causes of disability,seriously affecting patients’quality of life.Although modern medical treatment can alleviate some symptoms,it has limitations.Traditional Chinese medicine,with an overall perspective and syndrome differentiation and treatment as its core,intervenes in the disease through various therapies,such as acupuncture,Chinese herbal medicine,Tuina massage,and traditional exercise,demonstrating unique advantages.This article reviews the understanding of the etiology and pathogenesis of limb movement disorders after stroke in traditional Chinese medicine,systematically summarizes the clinical application and research progress of main treatment methods such as acupuncture,Chinese herbal medicine,and Tuina massage,analyzes the problems existing in current research,and looks forward to future development directions,aiming to provide references for clinical treatment.展开更多
To overcome the limitations of traditional exoskeletons in complex outdoor terrains,this study introduces a novel lower limb exoskeleton inspired by the snow leopard’s forelimb musculoskeletal structure.It features a...To overcome the limitations of traditional exoskeletons in complex outdoor terrains,this study introduces a novel lower limb exoskeleton inspired by the snow leopard’s forelimb musculoskeletal structure.It features a non-fully anthropomorphic design,attaching only at the thigh and ankle with a backward-knee configuration to mimic natural human knee movement.The design incorporates a single elastic element at the hip for gravity compensation and dual elastic elements at the knee for terrain adaptability,which adjust based on walking context.The design’s effectiveness was assessed by measuring metabolic cost reduction and motor output torque under various walking conditions.Results showed significant metabolic cost savings of 5.8–8.8%across different speeds and a 7.9%reduction during 9°incline walking on a flat indoor surface.Additionally,the spring element decreased hip motor output torque by 7–15.9%and knee torque by 8.1–14.2%.Outdoor tests confirmed the design’s robustness and effectiveness in reducing motor torque across terrains,highlighting its potential to advance multi-terrain adaptive exoskeleton research.展开更多
Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods...Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods:A prospective study was conducted with eighty-six hemiplegic patients with hypertensive intracerebral hemorrhage admitted to Taikang Xianlin Drum Tower Hospital from October 2021 to October 2023.The patients were randomly divided into a study group(43 cases)and a control group(43 cases).After 6 months of intervention,neurological function,motor and limb function,psychological state,and quality of life scores were compared between the two groups to assess the effects of the intervention.Results:After the intervention,neurological function indexes in the study group,including S100B protein,myelin basic protein and National Institutes of Health Stroke Scale score,were significantly lower than those in the control group(all P<0.05).In contrast,brain-derived neurotrophic factor and Mini-Mental State Examination scores were significantly higher in the study group(all P<0.05).Additionally,motor function,Barthel score,Fugl-Meyer score,and muscle strength(grades V and IV)were significantly higher in the study group compared to the control group(all P<0.05).Psychological resilience,including scores for toughness,optimism,and strength,as well as the total resilience score,were significantly higher in the study group(all P<0.05).Moreover,the Generic Quality of Life Inventory score was also significantly higher in the study group(P<0.05).Conclusion:Cognitive intervention combined with aerobic limb rehabilitation exercises can alleviate neurological damage in hemiplegic patients with hypertensive intracerebral hemorrhage,enhance muscle strength,promote limb and motor function recovery,and improve psychological state and quality of life.展开更多
BACKGROUND Serum retinol-binding protein(RBP)is the primary transport protein of circulating vitamin A.RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis.Several studies have indicat...BACKGROUND Serum retinol-binding protein(RBP)is the primary transport protein of circulating vitamin A.RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis.Several studies have indicated that serum RBP participates in the progression of diabetes and diabetes-related complications.However,the impact of serum RBP on lower limb atherosclerosis has not been determined in individuals with type 2 diabetes mellitus(T2DM).AIM To determine the association between serum RBP and lower limb atherosclerosis in individuals with T2DM.METHODS This retrospective study enrolled 4428 eligible T2DM patients and divided the patients into non-lower limb atherosclerosis(n=1913)and lower limb atherosclerosis groups(n=2515)based on lower limb arterial ultrasonography results.At hospital admission,baseline serum RBP levels were assessed,and all subjects were categorized into three groups(Q1-Q3)based on RBP tertiles.Logistic regression,restricted cubic spline regression,subgroup analysis,and machine learning were used to assess the association between RBP levels and lower limb atherosclerosis risk.RESULTS Among 4428 individuals with T2DM,2515(56.80%)had lower limb atherosclerosis.Logistic analysis showed that lower limb atherosclerosis risk increased by 1%for every 1 unit rise in serum RBP level(odds ratio=1.01,95%confidence interval:1.00-1.02,P=0.004).Patients in the highest tertile group(Q3)had a higher lower limb atherosclerosis risk compared to the lowest tertile group(Q1)(odds ratio=1.36,95%confidence interval:1.12-1.67,P=0.002).The lower limb atherosclerosis risk gradually increased with an increase in RBP tertile(P for trend=0.005).Restricted cubic spline analysis indicated a linear correlation between serum RBP levels and lower limb atherosclerosis risk(non-linear P<0.05).Machine learning demonstrated the significance and diagnostic value of serum RBP in predicting lower limb atherosclerosis risk.CONCLUSION Elevated serum RBP levels correlate with an increased lower limb atherosclerosis risk in individuals with T2DM.展开更多
BACKGROUND Lower limb atherosclerotic occlusive disease(LAOD)is a common complication in diabetic patients,leading to significant symptoms and reduced quality of life.AIM To investigate the efficacy of autologous plat...BACKGROUND Lower limb atherosclerotic occlusive disease(LAOD)is a common complication in diabetic patients,leading to significant symptoms and reduced quality of life.AIM To investigate the efficacy of autologous platelet-rich gel(APRG)as an innovative treatment for LAOD,focusing on clinical outcomes such as symptom relief,flow values,ankle-brachial index(ABI),walking distance,and claudication severity.METHODS This retrospective study involved an analysis of electronic medical records(EMR)from 150 patients diagnosed with LAOD.Participants were assigned to either a treatment group(n=80)or a control group(n=70).Both groups received standard care and underwent dressing changes.In addition,the treatment group was given APRG.Primary outcomes included changes in pain levels,wound healing rates,flow values assessed by plethysmography,ABI measurements,walking distance,and claudication severity.Statistical analyses were conducted to determine the significance of the results.RESULTS The APRG group showed significant improvements after 12 weeks,including a 70%reduction in pain,a 65%increase in wound healing rates,and an average walking distance increase of 150 meters.Flow values improved by 20%,with significant enhancements in ABI measurements(P<0.01).Additionally,patient satisfaction was higher,and 60%of patients reported improved claudication severity,confirming the efficacy of APRG in enhancing clinical outcomes for lower LAOD.CONCLUSION The APRG demonstrates significant efficacy in managing LAOD in diabetic patients,improving key clinical parameters including flow values,ABI,walking distance,and claudication.These findings support the need for further prospective studies to validate long-term efficacy and optimize treatment strategies.展开更多
The lower limb assisted exoskeleton is a prominent area of research within the field of exoskeleton technology.However,several challenges remain,including the development of flexible actuators,high battery consumption...The lower limb assisted exoskeleton is a prominent area of research within the field of exoskeleton technology.However,several challenges remain,including the development of flexible actuators,high battery consumption,the risk of joint misalignment,and limited assistive capabilities.This paper proposes a compact flexible actuator incorporating two elastic elements named Adjustable Energy Storage Series Elastic Actuator(AES-SEA),which combining an adjustable energy storage device with a series elastic actuator for application in exoskeleton hip joints.This design aims to enhance energy efficiency and improve assistive effects.Subsequently,we introduce a novel knee joint bionic structure based on a pulley-groove configuration and a four-link mechanism,designed to replicate human knee joint motion and prevent joint misalignment.Additionally,we propose an innovative controller that integrates concepts from Linear Quadratic Regulator(LQR)control and virtual tunnel for level walking assistance.This controller modulates the assisted reference trajectory using the virtual tunnel concept,enabling different levels of assistance both inside and outside the tunnel by adjusting the parameters Q and R.This approach enhances the assisting force while ensuring the safety of human-computer interaction.Finally,metabolic experiments were conducted to evaluate the effectiveness of the exoskeleton assistance.展开更多
OBJECTIVE:To evaluate the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral h...OBJECTIVE:To evaluate the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage through a network Meta-analysis.METHODS:A computer-based search was conducted in 8 databases,including China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,Pub Med,Cochrane Library,Web of Science,Scopus,and Embase,from their inception until February 19,2023.Randomized controlled trials(RCTs)investigating the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage were included.Two researchers independently screened the literature,extracted data from the included studies,and performed quality assessment using the Cochrane Collaboration's standards.The software Stata 17.0 was used to create a network evidence graph for each combination of Traditional Chinese Medicine external treatment methods and rehabilitation training,and to generate a publication bias funnel plot.Network Meta-analysis was conducted using Rev Man 5.3 to assess the risk of bias in the included studies,with mean difference(MD)used for continuous variables and odds ratio(OR)used for dichotomous variables.If there was good consistency among the included studies(P>0.05),a consistency model was applied for data analysis.If there was poor consistency among the included studies(P<0.05),an inconsistency model was used.RESULTS:A total of 27 studies involving 2113 patients with limb dysfunction caused by cerebral hemorrhage were included.The results of the network Meta-analysis indicated that the combined use of 7 Traditional Chinese Medicine external treatment methods and rehabilitation training was more effective in improving limb function in patients with cerebral hemorrhage compared to rehabilitation training alone.In terms of improving simplified Fugl-Meyer Assessment(FMA)scores,the effectiveness ranking was as follows:acupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>massage+rehabilitation training>electroacupuncture+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training>Chinese herbal fumigation+rehabilitation training.In terms of improving Barthel Index(BI)scores,the effectiveness ranking was as follows:electroacupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>acupuncture+rehabilitation training>massage+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine fumigation+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training.CONCLUSION:Based on existing literature evidence,our findings suggest the following:(a)The combination of the seven commonly used external treatment methods with rehabilitation training is superior to using rehabilitation training alone for the treatment of hemiplegia resulting from cerebral hemorrhage.(b)In terms of improving FMA scores,the combination of acupuncture and rehabilitation training shows the most significant effectiveness.(c)In terms of improving BI scores,the combination of electro-acupuncture and rehabilitation training demonstrates the most significant effectiveness.Therefore,we still need more multicenter,large-sample,high-quality randomized controlled trials to further validate the findings of this study.展开更多
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Project(2024ZL769):Effect of Xingshen Kaiqiao Acupuncture Method combined with Upper Limb Robot-assisted Training on Upper Limb Function and Neuroplasticity Mechanism of Hemiplegia after Stroke based on Functional Near-Infrared Spectroscopy Technology。
文摘OBJECTIVE:To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.METHODS:There were 50 stroke patients were randomly divided into an experimental group(acupuncture combined with upper limb rehabilitation robot assisted training)and a control group(upper limb rehabilitation robot assisted training).Various assessments were conducted to compare the effects of the two treatments on neural remodeling and functional recovery.Functional near-infrared spectroscopy technology was used to assess the effects of different treatments on neural plasticity and their impact on upper limb function and activities of daily living.RESULTS:The experimental group showed significantly higher concentrations of oxygenated hemoglobin and total hemoglobin in specific brain regions compared to the control group(P<0.05).Additionally,the experimental group had significantly lower concentrations of deoxygenated hemoglobin(P<0.05).After treatment,both groups showed improvements in various measures,but the experimental group had significantly greater improvements(P<0.05).CONCLUSION:Acupuncture combined with upper limb rehabilitation robot can effectively improve upper limb function and neural remodeling in stroke patients.This study supports the integration of Traditional Chinese and Western Medicine in improving limb dysfunction poststroke.
基金Natural Science Foundation of Fujian Province,Grant/Award Number:2021J011262 and 2022J011095Youth Independent Innovation and Incubation Special Project,Grant/Award Number:2022QC07The project of 900th Hospital,Grant/Award Number:2021MS02 and 2023GK01。
文摘Background:The aim of the study was to explore a feasible method for alleviating limb ischemia-reperfusion injury(LI/RI)through the use of a high-concentration citrate solution(HC-A solution)for limb perfusion(LP).Methods:Eighteen pigs were divided into three groups:the Sham group,LI/RI group,and HCA group.The Sham group underwent exposure of the iliac artery and vein.The LI/RI group underwent tourniquet placement and clamping of the iliac artery and vein to simulate LI/RI.The HCA group received HC-A solution LP for 30 min through the left iliac artery below the level of blood flow occlusion based on the LI/RI group.Oxidative stress markers and inflammatory response markers were compared among the three groups.Results:Compared to the LI/RI group,the HCA group showed significantly lower levels of serum creatine kinase(CK),lactate dehydrogenase(LDH),malondialdehyde(MDA),tumor necrosis factor-α(TNF-α),aspartate aminotransferase(AST),and ala-nine aminotransferase(ALT),and significantly greater activities of serum superoxide dismutase(SOD)(p<0.05).There were no significant differences in serum interleukin-6(IL-6)or in muscle MDA,SOD,TNF-α,and IL-6 between the HCA group and the LI/RI group(p>0.05).Compared to the LI/RI group,MDA,TNF-α,and IL-6 levels in the liver were significantly lower in the HCA group(p<0.05),while SOD activities were not significantly different(p>0.05).Histopathological examination revealed reduced skeletal muscle and liver damage in the HCA group compared to the LI/RI group.Conclusions:HC-A solution LP can alleviate liver damage caused by LI/RI in pigs.
文摘Stroke,as a highly prevalent cerebrovascular disease,often leads to limb dysfunction in patients,severely affecting their quality of life.Seeking effective rehabilitation nursing methods is of great significance for patient recovery.This article deeply analyzes various aspects such as intelligent rehabilitation technology,traditional Chinese medical therapies,Western medical therapies,and rehabilitation training methods.It explores the characteristics,effectiveness,and application prospects of various rehabilitation nursing approaches,providing a reference for clinical rehabilitation nursing of limb dysfunction after stroke,and helping to improve the quality of patient recovery and enhance their self-care ability and quality of life.
基金funded by Science Foundation for Youth supported by Shanghai Municipal Health Commission(No.20204Y0313)Sailing Program with the support of Science and Technology Commission of Shanghai Municipality(No.21YF1443800).
文摘Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its efficacy.Objective This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis(3DKA)results to select additional acupoints,and investigated the feasibility,efficacy and safety of this approach.Design,setting,participants and interventions This single-blind,single-center,randomized,controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis.The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio.Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks.The main acupoints in both groups were the same,while participants in the intervention group received additional acupoints selected on the basis of 3DKA results.Follow-up assessments were conducted for 8 weeks after the treatment.Main outcome measures The primary outcome was the Fugl-Meyer Assessment for Upper Extremity(FMA-UE)response rate(≥6-point change)at week 4.Secondary outcomes included changes in motor function(FMA-UE),Brunnstrom recovery stage(BRS),manual muscle test(MMT),spasticity(Modified Ashworth Scale,MAS),and activities of daily life(Modified Barthel Index,MBI)at week 4 and week 12.Results Sixty-four participants completed the trial and underwent analyses.Compared with control group,the intervention group exhibited a significantly higher FMA-UE response rate at week 4(χ^(2)=5.479,P=0.019)and greater improvements in FMA-UE at both week 4 and week 12(both P<0.001).The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4(P=0.007,P=0.049,P=0.019,P=0.008,P=0.029,respectively).The intervention group showed a better change in the MBI at both week 4 and week 12(P=0.004 and P=0.010,respectively).Although the intervention group had a higher BRS for the hand at week 12(P=0.041),no intergroup differences were observed at week 4(all P>0.05).The two groups showed no differences in MAS grades as well as in BRS for the arm at weeks 4 and 12(all P>0.05).Conclusion Semi-personalized acupuncture prescription based on 3DKA results significantly improved motor function,muscle strength,and activities of daily living in patients with PSSP-UL.
文摘Phantom limb pain(PLP)is not only a physical pain experience but also poses a significant challenge to mental health and quality of life.Currently,the mechanism of PLP treatment is still unclear,and there are many methods with varying effects.This article starts with the application research of extended reality technology in PLP treatment,through describing the application of its branch technologies(virtual reality,augmented reality,and mixed reality technology),to lay the foundation for subsequent research,in the hope of finding advanced and effective treatment methods,and providing a basis for future product transformation.
基金supported by the National Natural Science Foundation of China,Nos.82071426,81873784Clinical Cohort Construction Program of Peking University Third Hospital,No.BYSYDL2019002(all to DF)。
文摘Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.
文摘Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age was 8 years with a sex ratio of 2.45. In 68.4% of cases, trauma occurred in road traffic accidents. Average consultation time was 2.4 hours. Trauma mainly affected the leg in 39.5% of cases, and the thigh in 34.2%. Soft tissue wounds occurred in 52.6% of cases, and open fractures in 47.4%. Average response time was one hour. Wound trimming and suturing were performed in 76.3% of cases and combined with bone nailing in 15.8%. The outcome was favorable in 92.1% of cases. Average hospital stay was 4.37 days. Conclusion: Open trauma to the lower limb is a frequent and occurs mainly in road traffic accidents. Management was early, with a favorable outcome for most patients and a short hospital stay.
文摘Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical management of varicose pathology of the IM in Dakar. We enrolled 280 patients, with a mean age of 36 and a sex ratio of 2. Factors favouring venous disease were dominated by prolonged orthostatism and multiparity. The average consultation time was 6 years. The reasons for consultation were functional manifestations, progressive complications and aesthetics. The venous trunks concerned were the great saphenous vein (GSV) in 58.9% of cases, the small saphenous vein (SSV) in 29% of cases, perforating veins and varicose veins were unsystematized in 28.5% of cases. Surgery was performed under spinal anaesthesia. Surgical procedures were dominated by stripping of the GSV, crossectomy of the SSV and staged ligations. One patient developed meningismus immediately after the operation. Average follow-up was 2 years. Mortality was null.
基金supported by the National Science Foundations of China(No.61905256)the National Key Research and Development Program of China(No.2019YFC0214702)the Youth Innovation Promotion Association of Chinese Academy of Sciences(No.2020439)。
文摘This study describes the use of the weighted multiplicative algebraic reconstruction technique(WMART)to obtain vertical ozone profiles from limb observations performed by the scanning imaging absorption spectrometer for atmospheric chartography(SCIAMACHY).This technique is based on SaskMART(the combination of the multiplicative algebraic reconstruction technique and SaskTRAN radiative transfer model),which was originally developed for optical spectrometer and infrared imaging system(OSIRIS)data.One of the objectives of this study was to obtain consistent ozone profiles from the two satellites.In this study,the WMART algorithm is combined with a radiative transfer model(SCIATRAN),as well as a set of measurement vectors comprising five Hartley pairing vectors(HPVs)and one Chappuis triplet vector(CTV),to retrieve ozone profiles in the altitude range of 10–69 km.Considering that the weighting factors in WMART have a significant effect on the retrievals,we propose a novel approach to calculate the pair/triplet weighting factors using wavelength weighting functions.The results of the application of the proposed ozone retrieval scheme are compared with the SCIAMACHY v3.5 ozone product by University of Bremen and validated against profiles derived from other passive satellite observations or measured by ozonesondes.Between 18 and 55 km,the retrieved ozone profiles typically agree with data from the SCIAMACHY ozone product within 5%for tropics and middle latitudes,whereas a negative deviation exists between 35 and 50 km for northern high latitudes,with a deviation of less than 10%above 50 km.Comparison of the retrieved profiles with microwave limb sounder(MLS)v5.0 indicates that the difference is within±5%between 18 and 55 km,and an agreement within 10%is achieved in other altitudes for tropics and middle latitudes.Comparison of the retrieved profiles with OSIRIS v7.1 indicates that the average deviation is within±5%between 20 and 59 km,and difference of approximately 10%is achieved below 20 km.Compared with ozonesondes data,a general validity of the retrievals is no more than 5%between 15 and 30 km.
文摘BACKGROUND Phocomelia is a rare congenital disorder characterized by the absence or under-development of the proximal limbs.Phocomelia can occur as a syndrome or a limb-specific deformity.While historically linked to thalidomide,non-thalido-mide causes include genetic mutations,vascular disruptions,and teratogenic exposures.This case highlights the diagnostic and therapeutic challenges in a neonate with bilateral phocomelia,low birth weight,asphyxia and jaundice.CASE SUMMARY We report a 2-week-old term neonate with bilateral phocomelia,micrognathia,jaundice,and low birth weight.The pregnancy was unremarkable,with no tha-lidomide exposure.The mother had a history of early pregnancy losses.Clinical evaluation revealed absent humeri and radii bilaterally,with hands attached proximally to the trunk.Genetic testing was not performed,limiting the identi-fication of underlying etiology.The patient was managed with supportive care,parental counseling,and planning for long-term rehabilitation.This case un-derscores the importance of multidisciplinary care in managing congenital ano-malies.Genetic evaluation is crucial in unexplained congenital anomalies.Routine detailed ultrasounds in high-risk pregnancies aid in early diagnosis and parental preparedness.CONCLUSION Bilateral phocomelia presents significant functional challenges.Comprehensive diagnostic workups and early rehabilitation strategies are essential for optimizing patient outcomes.
基金Changzhou Applied Basic Research Program(Project No.:CJ20241042)。
文摘Objective:To explore the rehabilitation effect of upper limb rehabilitation robots combined with isokinetic muscle strength training on hemiplegic patients in the recovery phase of stroke,and to provide a more effective intervention plan for clinical rehabilitation treatment.Methods:One hundred and sixty type 2 stroke patients with hemiplegia in recovery phase treated at Jintan First People’s Hospital from May 2020 to May 2025 were selected as the research subjects.They were divided into a control group(n=80)and an observation group(n=80)using a random number table method.The control group received isokinetic muscle strength training,while the observation group received additional upper limb rehabilitation robot-assisted intervention based on the control group’s treatment.The general information(age,gender,course of disease),Brunnstrum staging,Barthel index,FMA score,and facial expression pain score were compared between the two groups.Results:After treatment,the indicators of both groups improved compared to before treatment.The observation group showed significant advantages in improving various indicators.In terms of Brunnstrum staging,the number of patients in stage IV and above was significantly higher than that in the control group;in terms of the Barthel index,the increase was more significant than that of the control group(P=0.000<0.001).In terms of the FMA score,the increase was more pronounced(P=0.000<0.001);and in terms of facial expression pain assessment,the decrease was more evident(P=0.000<0.01).Conclusion:The combination of upper limb rehabilitation robots and isokinetic muscle strength training can significantly improve the recovery of limb function and activities of daily living in hemiplegic patients during the recovery phase of stroke,and reduce pain.Compared with simple isokinetic muscle strength training,the rehabilitation effect is better,and it is worthy of clinical application.
基金supported by the National Key Programme of Research and Development,Ministry of Science and Technology of China(2022YFF1301600)National Natural Science Foundation of China(32030011,U24A20362,32070409)+2 种基金PI Project of Southern Marine Science and Engineering Guangdong Laboratory(Guangzhou)(GML2021 GD0805)Qing Lan Project of Jiangsu ProvincePriority Academic Program Development of Jiangsu Higher Education Institutions。
文摘Vertebrate limbs have undergone profound morphological diversification,enabling adaptations to a broad spectrum of ecological niches.In marine mammals,the evolution of highly specialized flipper-like forelimbs represents a profound structural transformation associated with aquatic habitats.This adaptation has been hypothesized to result,in part,from the inhibition of interphalangeal cell apoptosis during limb development,although the underlying genetic mechanism remains poorly understood.This study investigated the evolutionary dynamics and functional consequences of three key bone morphogenetic protein genes,BMP2,BMP4,and BMP7,which regulate apoptosis in interphalangeal mesenchymal stromal cells during embryonic limb development to ensure proper differentiation of interphalangeal tissues.Comparative genomic analysis revealed significantly accelerated evolution for BMP4 and BMP7 in the cetacean ancestral lineage,with two positively selected sites(V79I and H247R)involved in cetacean-specific amino acid substitutions located in the TGF-βpropeptide functional domain in BMP4.In vitro assays confirmed that cetacean-specific BMP4 mutations significantly disrupted normal cell apoptosis and proliferation and altered the transcription and protein expression of downstream apoptosis-related factors,including cytochrome c(Cyt c),BCL2 associated X,and B-cell lymphoma 2,within the BMP signaling pathway.The significant influence of BMP4 mutations on apoptotic inhibition highlights a potential role in the development of limb bud mesenchymal tissue and the emergence of the flipper forelimb phenotype in cetaceans.
文摘Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.
文摘Limb movement disorder after stroke is one of the main causes of disability,seriously affecting patients’quality of life.Although modern medical treatment can alleviate some symptoms,it has limitations.Traditional Chinese medicine,with an overall perspective and syndrome differentiation and treatment as its core,intervenes in the disease through various therapies,such as acupuncture,Chinese herbal medicine,Tuina massage,and traditional exercise,demonstrating unique advantages.This article reviews the understanding of the etiology and pathogenesis of limb movement disorders after stroke in traditional Chinese medicine,systematically summarizes the clinical application and research progress of main treatment methods such as acupuncture,Chinese herbal medicine,and Tuina massage,analyzes the problems existing in current research,and looks forward to future development directions,aiming to provide references for clinical treatment.
基金sponsored by the Fundamental Research Funds for the Central Universities[N2329001].
文摘To overcome the limitations of traditional exoskeletons in complex outdoor terrains,this study introduces a novel lower limb exoskeleton inspired by the snow leopard’s forelimb musculoskeletal structure.It features a non-fully anthropomorphic design,attaching only at the thigh and ankle with a backward-knee configuration to mimic natural human knee movement.The design incorporates a single elastic element at the hip for gravity compensation and dual elastic elements at the knee for terrain adaptability,which adjust based on walking context.The design’s effectiveness was assessed by measuring metabolic cost reduction and motor output torque under various walking conditions.Results showed significant metabolic cost savings of 5.8–8.8%across different speeds and a 7.9%reduction during 9°incline walking on a flat indoor surface.Additionally,the spring element decreased hip motor output torque by 7–15.9%and knee torque by 8.1–14.2%.Outdoor tests confirmed the design’s robustness and effectiveness in reducing motor torque across terrains,highlighting its potential to advance multi-terrain adaptive exoskeleton research.
文摘Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods:A prospective study was conducted with eighty-six hemiplegic patients with hypertensive intracerebral hemorrhage admitted to Taikang Xianlin Drum Tower Hospital from October 2021 to October 2023.The patients were randomly divided into a study group(43 cases)and a control group(43 cases).After 6 months of intervention,neurological function,motor and limb function,psychological state,and quality of life scores were compared between the two groups to assess the effects of the intervention.Results:After the intervention,neurological function indexes in the study group,including S100B protein,myelin basic protein and National Institutes of Health Stroke Scale score,were significantly lower than those in the control group(all P<0.05).In contrast,brain-derived neurotrophic factor and Mini-Mental State Examination scores were significantly higher in the study group(all P<0.05).Additionally,motor function,Barthel score,Fugl-Meyer score,and muscle strength(grades V and IV)were significantly higher in the study group compared to the control group(all P<0.05).Psychological resilience,including scores for toughness,optimism,and strength,as well as the total resilience score,were significantly higher in the study group(all P<0.05).Moreover,the Generic Quality of Life Inventory score was also significantly higher in the study group(P<0.05).Conclusion:Cognitive intervention combined with aerobic limb rehabilitation exercises can alleviate neurological damage in hemiplegic patients with hypertensive intracerebral hemorrhage,enhance muscle strength,promote limb and motor function recovery,and improve psychological state and quality of life.
基金The study was approved by the ethics committee of Southwest Hospital,the First Affiliated Hospital of Army Medical University of Chinese People's Liberation Army(No.KY2024007).
文摘BACKGROUND Serum retinol-binding protein(RBP)is the primary transport protein of circulating vitamin A.RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis.Several studies have indicated that serum RBP participates in the progression of diabetes and diabetes-related complications.However,the impact of serum RBP on lower limb atherosclerosis has not been determined in individuals with type 2 diabetes mellitus(T2DM).AIM To determine the association between serum RBP and lower limb atherosclerosis in individuals with T2DM.METHODS This retrospective study enrolled 4428 eligible T2DM patients and divided the patients into non-lower limb atherosclerosis(n=1913)and lower limb atherosclerosis groups(n=2515)based on lower limb arterial ultrasonography results.At hospital admission,baseline serum RBP levels were assessed,and all subjects were categorized into three groups(Q1-Q3)based on RBP tertiles.Logistic regression,restricted cubic spline regression,subgroup analysis,and machine learning were used to assess the association between RBP levels and lower limb atherosclerosis risk.RESULTS Among 4428 individuals with T2DM,2515(56.80%)had lower limb atherosclerosis.Logistic analysis showed that lower limb atherosclerosis risk increased by 1%for every 1 unit rise in serum RBP level(odds ratio=1.01,95%confidence interval:1.00-1.02,P=0.004).Patients in the highest tertile group(Q3)had a higher lower limb atherosclerosis risk compared to the lowest tertile group(Q1)(odds ratio=1.36,95%confidence interval:1.12-1.67,P=0.002).The lower limb atherosclerosis risk gradually increased with an increase in RBP tertile(P for trend=0.005).Restricted cubic spline analysis indicated a linear correlation between serum RBP levels and lower limb atherosclerosis risk(non-linear P<0.05).Machine learning demonstrated the significance and diagnostic value of serum RBP in predicting lower limb atherosclerosis risk.CONCLUSION Elevated serum RBP levels correlate with an increased lower limb atherosclerosis risk in individuals with T2DM.
文摘BACKGROUND Lower limb atherosclerotic occlusive disease(LAOD)is a common complication in diabetic patients,leading to significant symptoms and reduced quality of life.AIM To investigate the efficacy of autologous platelet-rich gel(APRG)as an innovative treatment for LAOD,focusing on clinical outcomes such as symptom relief,flow values,ankle-brachial index(ABI),walking distance,and claudication severity.METHODS This retrospective study involved an analysis of electronic medical records(EMR)from 150 patients diagnosed with LAOD.Participants were assigned to either a treatment group(n=80)or a control group(n=70).Both groups received standard care and underwent dressing changes.In addition,the treatment group was given APRG.Primary outcomes included changes in pain levels,wound healing rates,flow values assessed by plethysmography,ABI measurements,walking distance,and claudication severity.Statistical analyses were conducted to determine the significance of the results.RESULTS The APRG group showed significant improvements after 12 weeks,including a 70%reduction in pain,a 65%increase in wound healing rates,and an average walking distance increase of 150 meters.Flow values improved by 20%,with significant enhancements in ABI measurements(P<0.01).Additionally,patient satisfaction was higher,and 60%of patients reported improved claudication severity,confirming the efficacy of APRG in enhancing clinical outcomes for lower LAOD.CONCLUSION The APRG demonstrates significant efficacy in managing LAOD in diabetic patients,improving key clinical parameters including flow values,ABI,walking distance,and claudication.These findings support the need for further prospective studies to validate long-term efficacy and optimize treatment strategies.
基金supported by Guangdong Provincial Key Laboratory of Minimally Invasive Surgical Instruments and Manufacturing Technology(MISIMT-2021-4)the Fundamental Research Funds for the Central Universities(N2329001).
文摘The lower limb assisted exoskeleton is a prominent area of research within the field of exoskeleton technology.However,several challenges remain,including the development of flexible actuators,high battery consumption,the risk of joint misalignment,and limited assistive capabilities.This paper proposes a compact flexible actuator incorporating two elastic elements named Adjustable Energy Storage Series Elastic Actuator(AES-SEA),which combining an adjustable energy storage device with a series elastic actuator for application in exoskeleton hip joints.This design aims to enhance energy efficiency and improve assistive effects.Subsequently,we introduce a novel knee joint bionic structure based on a pulley-groove configuration and a four-link mechanism,designed to replicate human knee joint motion and prevent joint misalignment.Additionally,we propose an innovative controller that integrates concepts from Linear Quadratic Regulator(LQR)control and virtual tunnel for level walking assistance.This controller modulates the assisted reference trajectory using the virtual tunnel concept,enabling different levels of assistance both inside and outside the tunnel by adjusting the parameters Q and R.This approach enhances the assisting force while ensuring the safety of human-computer interaction.Finally,metabolic experiments were conducted to evaluate the effectiveness of the exoskeleton assistance.
基金Supported by the Key Research and Development Plan Project of Shaanxi Province:Standardized Diagnosis and Treatment Protocol for Cerebral Hemorrhage with Integrated Traditional Chinese and Western Medicine and Research on its Therapeutic Mechanisms(No.2019ZDLSF04-06-01)the National Key Research and Development Plan Project:Development and Implementation of a Clinical Research Information Sharing System for Traditional Chinese Medicine(No.2017YFC1703500,No.2017YFC1703502)the Discipline Innovation Team Building Project of Shaanxi University of Chinese Medicine:Innovative Research Team for the Construction of Integrated Traditional Chinese and Western Medicine Cerebrovascular Disease Diagnosis and Treatment System and Its Clinical Application(No.2019-YL15)。
文摘OBJECTIVE:To evaluate the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage through a network Meta-analysis.METHODS:A computer-based search was conducted in 8 databases,including China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,Pub Med,Cochrane Library,Web of Science,Scopus,and Embase,from their inception until February 19,2023.Randomized controlled trials(RCTs)investigating the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage were included.Two researchers independently screened the literature,extracted data from the included studies,and performed quality assessment using the Cochrane Collaboration's standards.The software Stata 17.0 was used to create a network evidence graph for each combination of Traditional Chinese Medicine external treatment methods and rehabilitation training,and to generate a publication bias funnel plot.Network Meta-analysis was conducted using Rev Man 5.3 to assess the risk of bias in the included studies,with mean difference(MD)used for continuous variables and odds ratio(OR)used for dichotomous variables.If there was good consistency among the included studies(P>0.05),a consistency model was applied for data analysis.If there was poor consistency among the included studies(P<0.05),an inconsistency model was used.RESULTS:A total of 27 studies involving 2113 patients with limb dysfunction caused by cerebral hemorrhage were included.The results of the network Meta-analysis indicated that the combined use of 7 Traditional Chinese Medicine external treatment methods and rehabilitation training was more effective in improving limb function in patients with cerebral hemorrhage compared to rehabilitation training alone.In terms of improving simplified Fugl-Meyer Assessment(FMA)scores,the effectiveness ranking was as follows:acupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>massage+rehabilitation training>electroacupuncture+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training>Chinese herbal fumigation+rehabilitation training.In terms of improving Barthel Index(BI)scores,the effectiveness ranking was as follows:electroacupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>acupuncture+rehabilitation training>massage+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine fumigation+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training.CONCLUSION:Based on existing literature evidence,our findings suggest the following:(a)The combination of the seven commonly used external treatment methods with rehabilitation training is superior to using rehabilitation training alone for the treatment of hemiplegia resulting from cerebral hemorrhage.(b)In terms of improving FMA scores,the combination of acupuncture and rehabilitation training shows the most significant effectiveness.(c)In terms of improving BI scores,the combination of electro-acupuncture and rehabilitation training demonstrates the most significant effectiveness.Therefore,we still need more multicenter,large-sample,high-quality randomized controlled trials to further validate the findings of this study.
