This paper presents our efforts to explain why mammals have large thigh muscles while insects have small ones. After a discussion of this observation a definition of body foot ratio is defined which describes how anim...This paper presents our efforts to explain why mammals have large thigh muscles while insects have small ones. After a discussion of this observation a definition of body foot ratio is defined which describes how animals stand and how their legs are arranged. To investigate the mechanics, we present a closed optimum solution of the body foot ratio for a 2D two-leg walking machine. A multi-walker is used as a case for 3D general analysis, and the numerical simulation is presented. Both 2D and 3D case studies can explain the above observations of mammals and insects. These findings can also be used as a guide for the design of man-made limbed machines.展开更多
Introduction: The practice of auto-medication is on the rise in most sub-Saharan countries. The effects of these may be associated with increased drug resistance in the future, complication of the course of a disease,...Introduction: The practice of auto-medication is on the rise in most sub-Saharan countries. The effects of these may be associated with increased drug resistance in the future, complication of the course of a disease, adverse drug interactions etc. Auto-medication is of course a global public health concern, which requires appropriate attention to evade future undesirable effects. Aim: The aim of this study was to investigate the knowledge, prevalence and associated determinants of auto-medication in the Limbe municipality. Method: This was a community-based cross-sectional study, conducted among 284 enrolled participants in Limbe Health District between January to August 2021. A structured questionnaire-based interview was used to collect data from each study subject. Then, data were categorised and analysed using SPSS version 20 software. Results: Majority of 213 (75%) of the participants practised auto-medication. The most frequently reported auto-medication symptoms were fever and headache 202 (71.1%). 95 (15.6%) practised auto-medication because they believed it saved time, meanwhile 5 (0.8%) had the belief that health personnel are too busy in the hospital with lots of patients to serve. Concerning knowledge, 68.9%, 13.1% and 18.2% had grading as Good, Poor and uncertain respectively. 58.3% of participants had a positive attitude towards auto-medication while 12.7% were indifferent. Factors associated with the use of auto-medication included: Age (p Conclusion: The prevalence of auto-medication remains increasingly high;there is a need for community sensitization to avert the negatives of such practices. The knowledge on auto-medication is fairly above average.展开更多
Background: Traumatic injuries constitute a leading cause of mortality and morbidity worldwide with a global burden that is on the rise. The aim of this study is to analyse preliminary data of the Limbe trauma registr...Background: Traumatic injuries constitute a leading cause of mortality and morbidity worldwide with a global burden that is on the rise. The aim of this study is to analyse preliminary data of the Limbe trauma registry, to describe the injury patterns and determine the outcome of care of the injured who were treated in the emergency department of the regional hospital Limbe in Cameroon. Methodology: This was a descriptive secondary analysis of prospective data collected on injury at Limbe Regional Hospital in two years, between October 2008 and October 2010. All cases of injury presenting to the emergency department of Limbe Regional Hospital were included in a prospective trauma registry. Data was collected with a pre-tested data entry form and included the age, sex, mechanism of injury, delay before arrival to hospital, body part injured, description of lesions and outcome at the emergency. Descriptive analyses were done using STATA 14. Comparisons between groups were evaluated using Chi-squared test or Kruskal-Wallis and p-values <0.05 were considered statistically significant. Results: A total of 2400 cases of injury were recorded during the study period with more males (68%) than females. The ages ranged from 0 to 90 years with a peak between 20 to 39 years. Road traffic crash was the most common cause of injury representing 60.81% of the population (n = 1434);other causes were burns, falls, domestic injuries, assaults, and labour accidents. The accidents mostly involved motor cycle alone (42.03%). Concerning the outcome of care at the emergency department, 88.73% (n = 1260) were discharged. Conclusion: The burden of road traffic injuries in south west Cameroon is high. Motorcycles are mostly involved alone or with pedestrians and/or cars.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
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
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: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
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
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
Objective:Limb ischemia-reperfusion injury(LIRI)may lead to tissue necrosis and loss of function,even life-threatening.Our previous study found that Tao-Hong-Si-Wu decoction(THSWD)had some efficacy in treating of LIRI...Objective:Limb ischemia-reperfusion injury(LIRI)may lead to tissue necrosis and loss of function,even life-threatening.Our previous study found that Tao-Hong-Si-Wu decoction(THSWD)had some efficacy in treating of LIRI.Quercetin,the major component of THSWD,was selected further to uncover the molecular mechanism underlying its treatment of LIRI.Methods:In this study,myoblasts were isolated fromrat gastrocnemiusmuscle tissue,and an in vitro LIRI model was established.The cell counting kit-8(CCK-8)and colony formation assay were used to evaluate the impact of quercetin on LIRI-induced myoblast viability and proliferation.Lactate dehydrogenase(LDH)activity wasmeasured to detectmyoblast injury in the LIRI model.Theapoptosis ofmyoblasts was evaluated byHoechst staining and flow cytometry.In addition,molecular docking analysis was performed to predict the interaction between quercetin and NADPH oxidase 2(NOX-2).Subsequently,we investigated the molecular mechanism of quercetin in LIRI-induced myoblasts by overexpressing NOX-2.Results:The myogenic marker Desmin was highly expressed in isolatedmyoblasts.In the LIRImodel,myoblast viability and proliferation were decreased,and cell injury and apoptosis levels were increased.In addition,NOX-2 was highly expressed in the LIRI model.At the same time,LIRI induction promoted the up-regulation of oxidative stress and inflammatory response.Quercetin significantly reversed the effects of LIRI treatment on myoblasts in a concentration-dependent manner.Molecular docking suggested an interaction between quercetin and NOX-2.Further overexpression of NOX-2 inhibited the effect of quercetin on LIRI-induced myoblasts.Conclusion:Quercetin could reduce inflammatory response and oxidative stress by inhibiting NOX-2,thus playing a therapeutic role in treating LIRI.展开更多
Pentadactyl limbs represent a conserved morphological feature among tetrapods,with anterior digits considered more important than posterior digits for refined movement.While posterior digit formation is governed by gr...Pentadactyl limbs represent a conserved morphological feature among tetrapods,with anterior digits considered more important than posterior digits for refined movement.While posterior digit formation is governed by graded expression of the Shh and 5’Hox genes,the regulatory mechanisms underlying anterior digit development,especially digit I(DI),remain poorly defined.This study identified an anterior expression pattern of Zic3 in the limb buds of representative tetrapods,including humans,which exerted an inhibitory effect on skeletal development.Zic3 was highly expressed in the anterior region of limb buds at early developmental stages,with species-specific divergence emerging during later development.Overexpression of Zic3 significantly delayed chondrogenesis and ossification,leading to bone shortening but not loss.Furthermore,RNA sequencing demonstrated that Zic3 down-regulated key genes associated with skeletal development,including Cytl1,Sox9,Ihh,Ptch1,Runx2,and Wnt16.These findings demonstrate that Zic3 acts as a conserved inhibitor of anterior skeletal maturation and contributes to the molecular asymmetry of tetrapod limb development.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
Muscle Shortening Maneuver(MSM)is a rehabilitation technique successfully applied to several pathological conditions.The concept is to passively elongate and shorten the target muscle group of the affected limb.As a r...Muscle Shortening Maneuver(MSM)is a rehabilitation technique successfully applied to several pathological conditions.The concept is to passively elongate and shorten the target muscle group of the affected limb.As a result,the functionality(muscle strength and range of motion)of that limb is improved.The existing system induces these oscillations manually or without any feedback control,which can compromise the effectiveness and standardization of MSM.In this paper,we present a mechatronic system that can precisely deliver motion oscillations to the upper limb for a controllable execution of MSM.First,we collected the parameters(frequency and amplitude of the oscillations)from a system where a motor was heuristically used by a well-experienced therapist to induce the oscillations(without any feedback control).Based on these specifications,we chose the motor and rebuilt the experimental setup,implementing a sliding mode control with a sliding perturbation observer.With our system,the operator can choose a given frequency and amplitude of the oscillations within the range we experimentally observed.We tested our system with ten participants of different anthropometry.We found that our system can accurately reproduce oscillations in the frequency range 0.8 to 1.2 Hz and amplitude range 2 to 6 cm,with a maximum percentage normalized root mean square error around 7%.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
Objective:To explore the key points of early identification and comprehensive nursing intervention strategy for necrotizing fasciitis patients,to improve the efficiency of clinical diagnosis and treatment and the qual...Objective:To explore the key points of early identification and comprehensive nursing intervention strategy for necrotizing fasciitis patients,to improve the efficiency of clinical diagnosis and treatment and the quality of prognosis.Methods:The clinical data of a 70-year-old female patient with right-hand trauma complicated by infection progressing to necrotizing fasciitis were reviewed and analyzed.Laboratory,imaging,and surgical findings were integrated to summarize the early identification features and key nursing considerations.Results:The patient retained the affected limb,albeit with some functional limitations,following early identification,timely surgical debridement,broad-spectrum anti-infective therapy,and comprehensive nursing care.Conclusion:The early clinical manifestations of necrotizing fasciitis are often subtle,and the disease progresses rapidly.This necessitates heightened vigilance among medical staff in all healthcare settings.Implementing multidisciplinary collaboration and systematic nursing interventions can improve patient prognosis while reducing amputation rates and mortality.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
文摘This paper presents our efforts to explain why mammals have large thigh muscles while insects have small ones. After a discussion of this observation a definition of body foot ratio is defined which describes how animals stand and how their legs are arranged. To investigate the mechanics, we present a closed optimum solution of the body foot ratio for a 2D two-leg walking machine. A multi-walker is used as a case for 3D general analysis, and the numerical simulation is presented. Both 2D and 3D case studies can explain the above observations of mammals and insects. These findings can also be used as a guide for the design of man-made limbed machines.
文摘Introduction: The practice of auto-medication is on the rise in most sub-Saharan countries. The effects of these may be associated with increased drug resistance in the future, complication of the course of a disease, adverse drug interactions etc. Auto-medication is of course a global public health concern, which requires appropriate attention to evade future undesirable effects. Aim: The aim of this study was to investigate the knowledge, prevalence and associated determinants of auto-medication in the Limbe municipality. Method: This was a community-based cross-sectional study, conducted among 284 enrolled participants in Limbe Health District between January to August 2021. A structured questionnaire-based interview was used to collect data from each study subject. Then, data were categorised and analysed using SPSS version 20 software. Results: Majority of 213 (75%) of the participants practised auto-medication. The most frequently reported auto-medication symptoms were fever and headache 202 (71.1%). 95 (15.6%) practised auto-medication because they believed it saved time, meanwhile 5 (0.8%) had the belief that health personnel are too busy in the hospital with lots of patients to serve. Concerning knowledge, 68.9%, 13.1% and 18.2% had grading as Good, Poor and uncertain respectively. 58.3% of participants had a positive attitude towards auto-medication while 12.7% were indifferent. Factors associated with the use of auto-medication included: Age (p Conclusion: The prevalence of auto-medication remains increasingly high;there is a need for community sensitization to avert the negatives of such practices. The knowledge on auto-medication is fairly above average.
文摘Background: Traumatic injuries constitute a leading cause of mortality and morbidity worldwide with a global burden that is on the rise. The aim of this study is to analyse preliminary data of the Limbe trauma registry, to describe the injury patterns and determine the outcome of care of the injured who were treated in the emergency department of the regional hospital Limbe in Cameroon. Methodology: This was a descriptive secondary analysis of prospective data collected on injury at Limbe Regional Hospital in two years, between October 2008 and October 2010. All cases of injury presenting to the emergency department of Limbe Regional Hospital were included in a prospective trauma registry. Data was collected with a pre-tested data entry form and included the age, sex, mechanism of injury, delay before arrival to hospital, body part injured, description of lesions and outcome at the emergency. Descriptive analyses were done using STATA 14. Comparisons between groups were evaluated using Chi-squared test or Kruskal-Wallis and p-values <0.05 were considered statistically significant. Results: A total of 2400 cases of injury were recorded during the study period with more males (68%) than females. The ages ranged from 0 to 90 years with a peak between 20 to 39 years. Road traffic crash was the most common cause of injury representing 60.81% of the population (n = 1434);other causes were burns, falls, domestic injuries, assaults, and labour accidents. The accidents mostly involved motor cycle alone (42.03%). Concerning the outcome of care at the emergency department, 88.73% (n = 1260) were discharged. Conclusion: The burden of road traffic injuries in south west Cameroon is high. Motorcycles are mostly involved alone or with pedestrians and/or cars.
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.
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.
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.
基金supported by National Natural Science Foundation of China(Grant 82274541&81674008)Key Project of Hunan Provincial Health Commission(Grant 202204072465)Natural Science Foundation of Hunan Province(Grant 2020JJ4070).
文摘Objective:Limb ischemia-reperfusion injury(LIRI)may lead to tissue necrosis and loss of function,even life-threatening.Our previous study found that Tao-Hong-Si-Wu decoction(THSWD)had some efficacy in treating of LIRI.Quercetin,the major component of THSWD,was selected further to uncover the molecular mechanism underlying its treatment of LIRI.Methods:In this study,myoblasts were isolated fromrat gastrocnemiusmuscle tissue,and an in vitro LIRI model was established.The cell counting kit-8(CCK-8)and colony formation assay were used to evaluate the impact of quercetin on LIRI-induced myoblast viability and proliferation.Lactate dehydrogenase(LDH)activity wasmeasured to detectmyoblast injury in the LIRI model.Theapoptosis ofmyoblasts was evaluated byHoechst staining and flow cytometry.In addition,molecular docking analysis was performed to predict the interaction between quercetin and NADPH oxidase 2(NOX-2).Subsequently,we investigated the molecular mechanism of quercetin in LIRI-induced myoblasts by overexpressing NOX-2.Results:The myogenic marker Desmin was highly expressed in isolatedmyoblasts.In the LIRImodel,myoblast viability and proliferation were decreased,and cell injury and apoptosis levels were increased.In addition,NOX-2 was highly expressed in the LIRI model.At the same time,LIRI induction promoted the up-regulation of oxidative stress and inflammatory response.Quercetin significantly reversed the effects of LIRI treatment on myoblasts in a concentration-dependent manner.Molecular docking suggested an interaction between quercetin and NOX-2.Further overexpression of NOX-2 inhibited the effect of quercetin on LIRI-induced myoblasts.Conclusion:Quercetin could reduce inflammatory response and oxidative stress by inhibiting NOX-2,thus playing a therapeutic role in treating LIRI.
基金supported by the Department of Science&Technology of Liaoning Province(2024-MS-099,2024-BS-093)。
文摘Pentadactyl limbs represent a conserved morphological feature among tetrapods,with anterior digits considered more important than posterior digits for refined movement.While posterior digit formation is governed by graded expression of the Shh and 5’Hox genes,the regulatory mechanisms underlying anterior digit development,especially digit I(DI),remain poorly defined.This study identified an anterior expression pattern of Zic3 in the limb buds of representative tetrapods,including humans,which exerted an inhibitory effect on skeletal development.Zic3 was highly expressed in the anterior region of limb buds at early developmental stages,with species-specific divergence emerging during later development.Overexpression of Zic3 significantly delayed chondrogenesis and ossification,leading to bone shortening but not loss.Furthermore,RNA sequencing demonstrated that Zic3 down-regulated key genes associated with skeletal development,including Cytl1,Sox9,Ihh,Ptch1,Runx2,and Wnt16.These findings demonstrate that Zic3 acts as a conserved inhibitor of anterior skeletal maturation and contributes to the molecular asymmetry of tetrapod limb development.
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 European Union by the Next Generation EU Project ECS00000017‘Ecosistema dell’Innovazione’Tuscany Health Ecosystem(THE,PNRR,Spoke 9:Robotics and Automation for Health)by the Italian Ministry of Education and Research(MUR)in the framework of the FoReLab project(Departments of Excellence).
文摘Muscle Shortening Maneuver(MSM)is a rehabilitation technique successfully applied to several pathological conditions.The concept is to passively elongate and shorten the target muscle group of the affected limb.As a result,the functionality(muscle strength and range of motion)of that limb is improved.The existing system induces these oscillations manually or without any feedback control,which can compromise the effectiveness and standardization of MSM.In this paper,we present a mechatronic system that can precisely deliver motion oscillations to the upper limb for a controllable execution of MSM.First,we collected the parameters(frequency and amplitude of the oscillations)from a system where a motor was heuristically used by a well-experienced therapist to induce the oscillations(without any feedback control).Based on these specifications,we chose the motor and rebuilt the experimental setup,implementing a sliding mode control with a sliding perturbation observer.With our system,the operator can choose a given frequency and amplitude of the oscillations within the range we experimentally observed.We tested our system with ten participants of different anthropometry.We found that our system can accurately reproduce oscillations in the frequency range 0.8 to 1.2 Hz and amplitude range 2 to 6 cm,with a maximum percentage normalized root mean square error around 7%.
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Objective:To explore the key points of early identification and comprehensive nursing intervention strategy for necrotizing fasciitis patients,to improve the efficiency of clinical diagnosis and treatment and the quality of prognosis.Methods:The clinical data of a 70-year-old female patient with right-hand trauma complicated by infection progressing to necrotizing fasciitis were reviewed and analyzed.Laboratory,imaging,and surgical findings were integrated to summarize the early identification features and key nursing considerations.Results:The patient retained the affected limb,albeit with some functional limitations,following early identification,timely surgical debridement,broad-spectrum anti-infective therapy,and comprehensive nursing care.Conclusion:The early clinical manifestations of necrotizing fasciitis are often subtle,and the disease progresses rapidly.This necessitates heightened vigilance among medical staff in all healthcare settings.Implementing multidisciplinary collaboration and systematic nursing interventions can improve patient prognosis while reducing amputation rates and mortality.
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.
