BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neu...BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.展开更多
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 We aimed to translate and culturally adapt the LIMB-Q Kids questionnaire for use in the Netherlands.The LIMB-Q Kids is a patient-reported outcome measure designed to assess functional,psychosocial,and aesth...BACKGROUND We aimed to translate and culturally adapt the LIMB-Q Kids questionnaire for use in the Netherlands.The LIMB-Q Kids is a patient-reported outcome measure designed to assess functional,psychosocial,and aesthetic aspects of living with a limb difference in paediatric populations.AIM To investigate the feasibility of a questionnaire in the Netherlands,which was translated into Dutch after having already been successfully translated and validated in several other languages.METHODS The translation and adaptation process followed best practice guidelines,including forward and backward translation,expert panel review,and cognitive debriefing interviews with patients.The interviews focused on the clarity and comprehensibility of the instructions,response options,and questionnaire items.RESULTS The rigorous process resulted in a linguistically and conceptually equivalent Dutch version of the LIMB-Q Kids questionnaire.While some challenges were encountered,no major difficulties were reported.The constructs and cultural relevance were found to be relatable to the Dutch context.Minor adjustments were made based on patient feedback,such as clarifying questions and modifying translations for technical terms.CONCLUSION We demonstrated the successful translation and cultural adaptation of the LIMB-Q Kids questionnaire for use in the Netherlands.By following best practices,the researchers have developed a version that is conceptually and linguistically equivalent to the original English version.The availability of this Dutch version will facilitate the assessment of outcomes in paediatric populations with limb differences,and potentially enable cross-cultural comparisons.展开更多
Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients....Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients.Methods We performed a retrospective analysis of the National Inpatient Sample(2016–2021)to identify adult patients with CAD who underwent lower limb amputation.Frailty was defined using the Johns Hopkins Adjusted Clinical Groups(ACG)frailty indicator.Multivariable logistic regression was used to assess the independent association of frailty with in-hospital outcomes,and propensity score matching(PSM)was performed to further account for confounding factors.Results After PSM,9,990 patients were included in each cohort.Frail patients experienced higher rates of in-hospital mortality(3.9%vs.1.5%,P<0.001),acute limb ischemia(3.8%vs.3.1%,P=0.015),fasciotomy(2.1%vs.1.4%,P<0.001),stump infection(7.9%vs.6.6%,P<0.001),cardiogenic shock(0.9%vs.0.7%,P=0.032),sudden cardiac arrest(2.7%vs.2.1%,P=0.004),mechanical circulatory support(0.3%vs.0.2%,P=0.028),major adverse cardiac and cerebrovascular events(7.7%vs.5.4%,P<0.001),and sepsis(18.3%vs.13.8%,P<0.001).In multivariable logistic regression analysis,frailty remained an independent predictor of inhospital mortality and major complications.Conclusion Frailty is independently associated with increased in-hospital mortality and adverse events among CAD patients undergoing lower limb amputation.Incorporating frailty assessment into preoperative evaluation may improve risk stratification and guide clinical decision-making in this high-risk population.展开更多
BACKGROUND Peripheral endovascular intervention(PEVI)is performed using radiation.Radiation has deleterious health consequences for patients and operators.AIM To investigate the gender radiation disparities and proced...BACKGROUND Peripheral endovascular intervention(PEVI)is performed using radiation.Radiation has deleterious health consequences for patients and operators.AIM To investigate the gender radiation disparities and procedural outcomes in PEVI.METHODS A prospective observational study was performed in 186 consecutive patients(65±12 years)at an academic medical center from January 2019 to April 2020(mean follow-up of 3.9±3.6 months)comparing the gender radiation disparity and outcomes of PEVI(n=147 underwent intervention,79.0%).Groups were divided into women(n=99,53.2%)and men(n=87,48.4%).Primary endpoints included air kerma,dose area product(DAP),fluoroscopy time,and contrast use.Secondary endpoints included all-cause mortality,acute myocardial infarction,acute kidney injury,stroke,repeat revascularization,major adverse limb event,and the composite of complications.RESULTS Men showed increased DAP compared with women(15221.2±25858.5µGy×m^(2) vs 9251.7±9555.3µGy×m^(2),P=0.047),but no significant difference in air kerma or any other primary endpoints.In the secondary endpoints,no significant diffe-rence was found between gender.CONCLUSION Men had increased DAP indicating more radiation absorption in the exposed area.Gender outcomes showed no difference in complications.Thus,PEVI can be safely performed in men or women.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
To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center...To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables and χ^(2) or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.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
基金Supported by the Central Guided Local Science and Technology Development Fund Project for Science and Technology Innovation Base Construction,No.Guike ZY24212046National Natural Science Foundation of China,No.U22A2092+3 种基金Guangxi Education Science“the 14th Five-Year Plan”2024 Special Project“Research on Steam Education Practice in Rehabilitation Engineering”,No.2024ZJY304the Research Basic Ability Enhancement Program for Young and Middle-aged Teachers of Guangxi,No.2025KY2255the Innovation Project of GUET Graduate Education,No.2025YCXB010Natural Science Research Project of Guilin Life and Health Career Technical College,No.2025GKKY04.
文摘BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.
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.
文摘BACKGROUND We aimed to translate and culturally adapt the LIMB-Q Kids questionnaire for use in the Netherlands.The LIMB-Q Kids is a patient-reported outcome measure designed to assess functional,psychosocial,and aesthetic aspects of living with a limb difference in paediatric populations.AIM To investigate the feasibility of a questionnaire in the Netherlands,which was translated into Dutch after having already been successfully translated and validated in several other languages.METHODS The translation and adaptation process followed best practice guidelines,including forward and backward translation,expert panel review,and cognitive debriefing interviews with patients.The interviews focused on the clarity and comprehensibility of the instructions,response options,and questionnaire items.RESULTS The rigorous process resulted in a linguistically and conceptually equivalent Dutch version of the LIMB-Q Kids questionnaire.While some challenges were encountered,no major difficulties were reported.The constructs and cultural relevance were found to be relatable to the Dutch context.Minor adjustments were made based on patient feedback,such as clarifying questions and modifying translations for technical terms.CONCLUSION We demonstrated the successful translation and cultural adaptation of the LIMB-Q Kids questionnaire for use in the Netherlands.By following best practices,the researchers have developed a version that is conceptually and linguistically equivalent to the original English version.The availability of this Dutch version will facilitate the assessment of outcomes in paediatric populations with limb differences,and potentially enable cross-cultural comparisons.
文摘Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients.Methods We performed a retrospective analysis of the National Inpatient Sample(2016–2021)to identify adult patients with CAD who underwent lower limb amputation.Frailty was defined using the Johns Hopkins Adjusted Clinical Groups(ACG)frailty indicator.Multivariable logistic regression was used to assess the independent association of frailty with in-hospital outcomes,and propensity score matching(PSM)was performed to further account for confounding factors.Results After PSM,9,990 patients were included in each cohort.Frail patients experienced higher rates of in-hospital mortality(3.9%vs.1.5%,P<0.001),acute limb ischemia(3.8%vs.3.1%,P=0.015),fasciotomy(2.1%vs.1.4%,P<0.001),stump infection(7.9%vs.6.6%,P<0.001),cardiogenic shock(0.9%vs.0.7%,P=0.032),sudden cardiac arrest(2.7%vs.2.1%,P=0.004),mechanical circulatory support(0.3%vs.0.2%,P=0.028),major adverse cardiac and cerebrovascular events(7.7%vs.5.4%,P<0.001),and sepsis(18.3%vs.13.8%,P<0.001).In multivariable logistic regression analysis,frailty remained an independent predictor of inhospital mortality and major complications.Conclusion Frailty is independently associated with increased in-hospital mortality and adverse events among CAD patients undergoing lower limb amputation.Incorporating frailty assessment into preoperative evaluation may improve risk stratification and guide clinical decision-making in this high-risk population.
文摘BACKGROUND Peripheral endovascular intervention(PEVI)is performed using radiation.Radiation has deleterious health consequences for patients and operators.AIM To investigate the gender radiation disparities and procedural outcomes in PEVI.METHODS A prospective observational study was performed in 186 consecutive patients(65±12 years)at an academic medical center from January 2019 to April 2020(mean follow-up of 3.9±3.6 months)comparing the gender radiation disparity and outcomes of PEVI(n=147 underwent intervention,79.0%).Groups were divided into women(n=99,53.2%)and men(n=87,48.4%).Primary endpoints included air kerma,dose area product(DAP),fluoroscopy time,and contrast use.Secondary endpoints included all-cause mortality,acute myocardial infarction,acute kidney injury,stroke,repeat revascularization,major adverse limb event,and the composite of complications.RESULTS Men showed increased DAP compared with women(15221.2±25858.5µGy×m^(2) vs 9251.7±9555.3µGy×m^(2),P=0.047),but no significant difference in air kerma or any other primary endpoints.In the secondary endpoints,no significant diffe-rence was found between gender.CONCLUSION Men had increased DAP indicating more radiation absorption in the exposed area.Gender outcomes showed no difference in complications.Thus,PEVI can be safely performed in men or women.
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.
文摘To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables and χ^(2) or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.
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.
