Background： The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty （TKA）.This study investigated a customized guide ...Background： The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty （TKA）.This study investigated a customized guide plate for osteotomy placement in TKAs with the aid of the statistical shape model technique using weight-bearing lower-extremity X-rays and computed tomography （CT） images of the knee.Methods： From October 2014 to June 2015, 42 patients who underwent a TKA in Guizhou Provincial People＆#39;s Hospital were divided into a guide plate group （GPG, 21 cases） and a traditional surgery group （TSG, 21 cases） using a random number table method.In the GPG group, a guide plate was designed and printed using preoperative three-dimensional measurements to plan and digitally simulate the operation.TSG cases were treated with the conventional method.Outcomes were obtained from the postoperative image examination and short-term follow-up.Results： Operative time was 49.0 ＆#177; 10.5 min for GPG, and 62.0 ＆#177; 9.7 min in TSG.The coronal femoral angle, coronal tibial angle, posterior tibial slope, and the angle between the posterior condylar osteotomy surface and the surgical transepicondylar axis were 89.2 ＆#177; 1.7＆#176;, 89.0 ＆#177; 1.1＆#176;, 6.6 ＆#177; 1.4＆#176;, and 0.9 ＆#177; 0.3＆#176; in GPG, and 86.7 ＆#177; 2.9＆#176;, 87.6 ＆#177; 2.1＆#176;, 8.9 ＆#177; 2.8＆#176;, and 1.7 ＆#177; 0.8＆#176; in TSG, respectively.The Hospital for Special Surgery scores 3 months after surgery were 83.7 ＆#177; 18.4 in GPG and 71.5 ＆#177; 15.2 in TSG.Statistically significant differences were found between GPG and TSG in all measurements.Conclusions： A customized guide plate to create an accurate osteotomy in TKAs may be created using lower-extremity X-ray and knee CT images.This allows for shorter operative times and better postoperative alignment than the traditional surgery.Application of the digital guide plate may also result in better short-term outcomes.展开更多
BACKGROUND Underdiagnosis of peripheral arterial disease results in inadequate treatment and more serious consequences.Hence,clinicians have focused on early diagnosis and treatment.AIM To investigate the effectivenes...BACKGROUND Underdiagnosis of peripheral arterial disease results in inadequate treatment and more serious consequences.Hence,clinicians have focused on early diagnosis and treatment.AIM To investigate the effectiveness of the combination of doppler ultrasonography(DUS),three-dimensional dynamic contrast-enhanced magnetic resonance an-giography(CE-MRA),and CT angiography(CTA)in assessing lower extremity arterial disease in diabetes mellitus(DM).METHODS This study retrospectively analyzed the imaging and clinical data of 116 patients diagnosed with DM complicated with lower extremity vascular diseases from January 2021 to June 2023.All patients underwent unilateral or bilateral DUS,CTA,and CE-MRA as well as invasive digital subtraction angiography(DSA).The application values of DUS,CE-MRA,and CTA were compared.RESULTS A total of 152 lower extremity arteries in the 116 patients were graded following the classification of vascular branches.The Kappa values between DUS and DSA were 0.780,0.755,and 0.806 for diagnosing moderate stenosis and 0.484,0.699,and 0.449 for severe stenosis of grade 1 arteries,grade 2 arteries,and grade 3 arteries,respectively.The Kappa values between CE-MRA and DSA were 0.784,0.814,and 0.835 for diagnosing moderate stenosis and 0.694,0.748,and 0.606 for severe stenosis of grade 1 arteries,grade 2 arteries,and grade 3 arteries,respectively.The Kappa values between CTA and DSA were 0.900,0.858,and 0.878 for diagnosing moderate stenosis and 0.882,0.823,and 0.756 for severe stenosis of grade 1 arteries,grade 2 arteries,and grade 3 arteries,respectively.CONCLUSION DUS,CE-MRA,and CTA demonstrated comparable accuracy in diagnosing lower extremity arterial disease in DM,and the consistency between CTA and DSA diagnoses was higher than the other two imaging methods.展开更多
For intelligent transportation systems(ITS),understanding pedestrian motion intention is crucial for enhancing traffic safety,enabling human-centered mobility services,and facilitating adaptive vehicle-pedestrian inte...For intelligent transportation systems(ITS),understanding pedestrian motion intention is crucial for enhancing traffic safety,enabling human-centered mobility services,and facilitating adaptive vehicle-pedestrian interactions.This paper proposes a pedestrian gait recognition method based on a modified particle swarm optimization-support vector machine(MPSO-SVM),utilizing fused surface electromyography(sEMG)signals and ankle joint angles.Seven lower-limb gait features were extracted from these signals to characterize walking patterns.The MPSO algorithm optimizes the support vector machine(SVM)parameters to improve classification performance.Experimental results based on data collected from healthy subjects demonstrate a recognition accuracy exceeding 92.5%across four gait phases.The proposed method offers significantly enhanced accuracy and robustness compared to traditional classifiers.These results suggest that the method is suitable for deployment in intelligent traffic control systems,autonomous vehicle navigation,and urban pedestrian behavior prediction.展开更多
Objective:Aging is associated with a progressive decline in muscle strength,muscle mass and impaired physical function,which reduces mobility and impairs quality of life in the elderly population.The 6–12 months of e...Objective:Aging is associated with a progressive decline in muscle strength,muscle mass and impaired physical function,which reduces mobility and impairs quality of life in the elderly population.The 6–12 months of exercise can enhance the muscle strength,but these improvements can only be maintained for a short period.In this study,we investigated the effects of long-term Tai Chi(TC)exercise on muscle strength of lower extremities.Methods:A cross-sectional study was conducted in 205 long-term TC practitioners(age:60–89 years)and 205 age and gentle matched controls who did not practice TC.Each of the activity group was further divided into three distinct age groups:G1,60–69 years;G2,70–79 years;and G3,80–89 years.Hand-held dynamometery was used to measure the maximum isometric strength of iliopsoas,quadriceps femoris,tibialis anterior and hamstrings in both sides of the participants.Unpaired t tests were performed to compare the difference of strength between the TC and non-Tai Chi(NTC)groups.Multivariate analysis of variance(MANOVA)was used to compare the lower muscle strengths among the different age groups in the TC and NTC groups.Pearson’s correlations were used to quantify the linear relationship between the months of TC practice and lower limbs muscle strength.Results:The inter-rater reliabilities of iliopsoas,quadriceps femoris,tibialis anterior and hamstrings were intraclass correlation coefficient(ICC)(1,1)=0.895(0.862–0.920),ICC(2,2)=0.905(0.874–0.928),ICC(3,3)=0.922(0.898–0.941)and ICC(4,4)=0.930(0.908–0.947).The strength of the muscles in the TC group did not differ among different age groups(P>0.05).The strength of iliopsoas,quadriceps femoris,tibialis anterior and hamstrings in TC group was higher than that in the NTC group(P<0.05).A correlation between muscle strength and extension of the exercise period was positive(P<0.05).Conclusion:Results shed light on the orientation and magnitude of long-term TC in preventing muscle strength loss with aging.TC might be a good form to slow down the trend of age-related decline in muscle strength in community-dwelling population.展开更多
Unlike other non-gynecologic solid tumors, such as breast cancer, lung cancer, metastasis to bone from endometrial carcinoma is rare, metastasis to extremity is extremely rare. We report a 51-year-old multiparous woma...Unlike other non-gynecologic solid tumors, such as breast cancer, lung cancer, metastasis to bone from endometrial carcinoma is rare, metastasis to extremity is extremely rare. We report a 51-year-old multiparous woman with FIGO Stage IVb Grade 2 endometrial adenocarcinoma which metastasized to left lower extremity bone. She received an amputation of left lower extremity below the knees, and a total abdominal hysterectomy and bilateral salpingo-oophorectomy, and followed by systemic chemotherapy, radiation therapy to the pelvis and progestational agent. She had a complete response to above treatments, and disease-free survival for 10 months. After recurrence, she received chemotherapy, radiotherapy and progestational agent once again. She had lived 56 months and is still alive by the time of report. Metastasis of endometrial carcinoma to extremity bone can rarely occur and should be considered when the patient with endometrial carcinoma complained of unexplained pain and swelling associated with extremity bone.展开更多
Purpose Jump-landing assessments provide a means to quantify an individual’s ability to attenuate ground reaction forces,generate lower limb explosive power and maintain joint alignment.In order to identify risk fact...Purpose Jump-landing assessments provide a means to quantify an individual’s ability to attenuate ground reaction forces,generate lower limb explosive power and maintain joint alignment.In order to identify risk factors that can be targeted through appropriate training interventions,it is necessary to establish which(scalar)objective kinetic,kinematic,and performance measures are most associated with lower-extremity injury.Methods Online searches of MEDLINE,SCOPUS,EBSCOHost,SPORTDiscus and PubMed databases were completed for all articles published before March 2020 in accordance with PRISMA guidelines.Results 40 articles investigating nine jump-landing assessments were included in this review.The 79%of studies using drop jump(n=14)observed an association with future injury,while only 8%of countermovement jump studies(n=13)observed an association with injury risk.The 57%of studies using unilateral assessments found associations with risk of injury(n=14).Studies using performance measures(jump height/distance)as outcome measure were only associated with injury risk in 30%of cases.However,those using kinetic and/or kinematic analyses(knee abduction moment,knee valgus angle,knee separation distance,peak ground reaction force)found associations with injury in 89%of studies.Conclusion The landing element of jump-landing assessments appears to be superior for identifying individuals at greater risk of injury;likely due to a closer representation of the injury mechanism.Consequently,jump-landing assessments that involve attenuation of impact forces such as the drop jump appear most suited for this purpose but should involve assessment of frontal plane knee motion and ground reaction forces.展开更多
文摘Background： The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty （TKA）.This study investigated a customized guide plate for osteotomy placement in TKAs with the aid of the statistical shape model technique using weight-bearing lower-extremity X-rays and computed tomography （CT） images of the knee.Methods： From October 2014 to June 2015, 42 patients who underwent a TKA in Guizhou Provincial People＆#39;s Hospital were divided into a guide plate group （GPG, 21 cases） and a traditional surgery group （TSG, 21 cases） using a random number table method.In the GPG group, a guide plate was designed and printed using preoperative three-dimensional measurements to plan and digitally simulate the operation.TSG cases were treated with the conventional method.Outcomes were obtained from the postoperative image examination and short-term follow-up.Results： Operative time was 49.0 ＆#177; 10.5 min for GPG, and 62.0 ＆#177; 9.7 min in TSG.The coronal femoral angle, coronal tibial angle, posterior tibial slope, and the angle between the posterior condylar osteotomy surface and the surgical transepicondylar axis were 89.2 ＆#177; 1.7＆#176;, 89.0 ＆#177; 1.1＆#176;, 6.6 ＆#177; 1.4＆#176;, and 0.9 ＆#177; 0.3＆#176; in GPG, and 86.7 ＆#177; 2.9＆#176;, 87.6 ＆#177; 2.1＆#176;, 8.9 ＆#177; 2.8＆#176;, and 1.7 ＆#177; 0.8＆#176; in TSG, respectively.The Hospital for Special Surgery scores 3 months after surgery were 83.7 ＆#177; 18.4 in GPG and 71.5 ＆#177; 15.2 in TSG.Statistically significant differences were found between GPG and TSG in all measurements.Conclusions： A customized guide plate to create an accurate osteotomy in TKAs may be created using lower-extremity X-ray and knee CT images.This allows for shorter operative times and better postoperative alignment than the traditional surgery.Application of the digital guide plate may also result in better short-term outcomes.
文摘BACKGROUND Underdiagnosis of peripheral arterial disease results in inadequate treatment and more serious consequences.Hence,clinicians have focused on early diagnosis and treatment.AIM To investigate the effectiveness of the combination of doppler ultrasonography(DUS),three-dimensional dynamic contrast-enhanced magnetic resonance an-giography(CE-MRA),and CT angiography(CTA)in assessing lower extremity arterial disease in diabetes mellitus(DM).METHODS This study retrospectively analyzed the imaging and clinical data of 116 patients diagnosed with DM complicated with lower extremity vascular diseases from January 2021 to June 2023.All patients underwent unilateral or bilateral DUS,CTA,and CE-MRA as well as invasive digital subtraction angiography(DSA).The application values of DUS,CE-MRA,and CTA were compared.RESULTS A total of 152 lower extremity arteries in the 116 patients were graded following the classification of vascular branches.The Kappa values between DUS and DSA were 0.780,0.755,and 0.806 for diagnosing moderate stenosis and 0.484,0.699,and 0.449 for severe stenosis of grade 1 arteries,grade 2 arteries,and grade 3 arteries,respectively.The Kappa values between CE-MRA and DSA were 0.784,0.814,and 0.835 for diagnosing moderate stenosis and 0.694,0.748,and 0.606 for severe stenosis of grade 1 arteries,grade 2 arteries,and grade 3 arteries,respectively.The Kappa values between CTA and DSA were 0.900,0.858,and 0.878 for diagnosing moderate stenosis and 0.882,0.823,and 0.756 for severe stenosis of grade 1 arteries,grade 2 arteries,and grade 3 arteries,respectively.CONCLUSION DUS,CE-MRA,and CTA demonstrated comparable accuracy in diagnosing lower extremity arterial disease in DM,and the consistency between CTA and DSA diagnoses was higher than the other two imaging methods.
基金partly supported by the Research Project of Higher Education in Henan Province(Grant no.23A413008)partly by the Project of the Science and Technology Department of Henan Province(Grant no.252102221011).
文摘For intelligent transportation systems(ITS),understanding pedestrian motion intention is crucial for enhancing traffic safety,enabling human-centered mobility services,and facilitating adaptive vehicle-pedestrian interactions.This paper proposes a pedestrian gait recognition method based on a modified particle swarm optimization-support vector machine(MPSO-SVM),utilizing fused surface electromyography(sEMG)signals and ankle joint angles.Seven lower-limb gait features were extracted from these signals to characterize walking patterns.The MPSO algorithm optimizes the support vector machine(SVM)parameters to improve classification performance.Experimental results based on data collected from healthy subjects demonstrate a recognition accuracy exceeding 92.5%across four gait phases.The proposed method offers significantly enhanced accuracy and robustness compared to traditional classifiers.These results suggest that the method is suitable for deployment in intelligent traffic control systems,autonomous vehicle navigation,and urban pedestrian behavior prediction.
文摘Objective:Aging is associated with a progressive decline in muscle strength,muscle mass and impaired physical function,which reduces mobility and impairs quality of life in the elderly population.The 6–12 months of exercise can enhance the muscle strength,but these improvements can only be maintained for a short period.In this study,we investigated the effects of long-term Tai Chi(TC)exercise on muscle strength of lower extremities.Methods:A cross-sectional study was conducted in 205 long-term TC practitioners(age:60–89 years)and 205 age and gentle matched controls who did not practice TC.Each of the activity group was further divided into three distinct age groups:G1,60–69 years;G2,70–79 years;and G3,80–89 years.Hand-held dynamometery was used to measure the maximum isometric strength of iliopsoas,quadriceps femoris,tibialis anterior and hamstrings in both sides of the participants.Unpaired t tests were performed to compare the difference of strength between the TC and non-Tai Chi(NTC)groups.Multivariate analysis of variance(MANOVA)was used to compare the lower muscle strengths among the different age groups in the TC and NTC groups.Pearson’s correlations were used to quantify the linear relationship between the months of TC practice and lower limbs muscle strength.Results:The inter-rater reliabilities of iliopsoas,quadriceps femoris,tibialis anterior and hamstrings were intraclass correlation coefficient(ICC)(1,1)=0.895(0.862–0.920),ICC(2,2)=0.905(0.874–0.928),ICC(3,3)=0.922(0.898–0.941)and ICC(4,4)=0.930(0.908–0.947).The strength of the muscles in the TC group did not differ among different age groups(P>0.05).The strength of iliopsoas,quadriceps femoris,tibialis anterior and hamstrings in TC group was higher than that in the NTC group(P<0.05).A correlation between muscle strength and extension of the exercise period was positive(P<0.05).Conclusion:Results shed light on the orientation and magnitude of long-term TC in preventing muscle strength loss with aging.TC might be a good form to slow down the trend of age-related decline in muscle strength in community-dwelling population.
文摘Unlike other non-gynecologic solid tumors, such as breast cancer, lung cancer, metastasis to bone from endometrial carcinoma is rare, metastasis to extremity is extremely rare. We report a 51-year-old multiparous woman with FIGO Stage IVb Grade 2 endometrial adenocarcinoma which metastasized to left lower extremity bone. She received an amputation of left lower extremity below the knees, and a total abdominal hysterectomy and bilateral salpingo-oophorectomy, and followed by systemic chemotherapy, radiation therapy to the pelvis and progestational agent. She had a complete response to above treatments, and disease-free survival for 10 months. After recurrence, she received chemotherapy, radiotherapy and progestational agent once again. She had lived 56 months and is still alive by the time of report. Metastasis of endometrial carcinoma to extremity bone can rarely occur and should be considered when the patient with endometrial carcinoma complained of unexplained pain and swelling associated with extremity bone.
文摘Purpose Jump-landing assessments provide a means to quantify an individual’s ability to attenuate ground reaction forces,generate lower limb explosive power and maintain joint alignment.In order to identify risk factors that can be targeted through appropriate training interventions,it is necessary to establish which(scalar)objective kinetic,kinematic,and performance measures are most associated with lower-extremity injury.Methods Online searches of MEDLINE,SCOPUS,EBSCOHost,SPORTDiscus and PubMed databases were completed for all articles published before March 2020 in accordance with PRISMA guidelines.Results 40 articles investigating nine jump-landing assessments were included in this review.The 79%of studies using drop jump(n=14)observed an association with future injury,while only 8%of countermovement jump studies(n=13)observed an association with injury risk.The 57%of studies using unilateral assessments found associations with risk of injury(n=14).Studies using performance measures(jump height/distance)as outcome measure were only associated with injury risk in 30%of cases.However,those using kinetic and/or kinematic analyses(knee abduction moment,knee valgus angle,knee separation distance,peak ground reaction force)found associations with injury in 89%of studies.Conclusion The landing element of jump-landing assessments appears to be superior for identifying individuals at greater risk of injury;likely due to a closer representation of the injury mechanism.Consequently,jump-landing assessments that involve attenuation of impact forces such as the drop jump appear most suited for this purpose but should involve assessment of frontal plane knee motion and ground reaction forces.
