腰椎旋转手法所致咔哒声与拇指最大推扳力的量效关系研究

目的:研究腰椎定点旋转手法作用时咔哒声响与拇指最大推扳力的量效关系,为推拿手法的量化提供定量化依据。方法:应用压力传感器检测系统,检测并记录旋转手法作用时出现咔哒声响时术者拇指推扳腰椎棘突的最大推扳力。结果:以出现咔哒声响作为腰椎旋转手法成功的标志,此刻术者左右手拇指的最大平均推扳力分别为5.1±1.3kg和6.6±1.5kg。结论:利手对拇指的推扳力有显著的影响(P<0.001),咔哒声响的发生与拇指推扳力的大小无直接关系。     

一指禅推法不同作用力下上肢肌群运动方式及肌电信号

目的观察不同手法力量下一指禅推法上肢肌电信号特征,找出手法操作关键技术上肢肌群协同运动方式。方法采集专家组、熟练组和初学组手法肌电信号数据。每位测试者按手法力量分轻、中、重3种类型操作,选择连续稳定的数据采用MyoResearch软件进行分析。结果上肢各测试肌群肌电积分(iEMG)比较有显著差异(P<0.05);不同手法力量肌群iEMG比值比较,专家组和熟练组无显著差异(P>0.05),比值前3位为尺侧腕屈肌群、三角肌、桡侧伸肌群;手法核心主动肌群参与运动方式基本一致。初学组在不同手法力量下iEMG比值前3位肌肉群各不相同,差异较明显。专家组、熟练组和初学组之间协同收缩率比较差异均显著(P<0.01),初学组协同收缩率最大,专家组协同收缩率最小,且协同收缩率随手法力量增加逐渐下降。6 min操作三角肌肉中位频率斜率比较,专家组测试者耐疲劳度较好。结论专家组和熟练组手法肌电信号有共同特征,存在手法操作的核心肌群。上肢核心肌群运动方式具有规律性,并且iEMG比值、中位频率斜率、协同收缩率等指标可作为评价手法持久性、均匀性,以及施力方式是否规范的参考标准。     

基于力矩感知的多指精准抓握协调控制研究

探讨不同手指组合和多指抓取不同质心的抓握装置过程中手指力量的控制。选取30名健康受试者使用3种手指组合进行抓握:一是拇指与食指双指抓握,二是拇指、食指和中指三指抓握,三是拇指、食指、中指和无名指四指抓握。随机在抓握装置底座的中部、近端、远端、尺侧、桡侧各增加一额定砝码,产生不同方向的偏转力矩,改变抓握装置的重心位置,使用六维力-力矩传感器记录各手指的力与力矩。以握力的均值(mean)、标准差(SD)与平均功率频率(MPF)为参数,分析抓握过程中抓握力的大小变化。结果表明,仅双指抓握时抓握力的MN与SD存在显著性差异(p<0.05),而在三指抓握与四指抓握时没有发现显著性差异(P>0.05)。当额定砝码位于远端时,双指抓握的拇指与食指的抓握力的MN和SD均显著大于砝码位于其他位置时的数值(P<0.05),这表明手部运动控制对于左右方向上的扰动相比前后向上的扰动有更高的鲁棒性。另外,在所有实验中,拇指抓握力的MN显著大于其他手指的值(P<0.05),且SD与MPF显著小于其他手指的值(P<0.05)。结果表明,拇指在抓握过程中主要起稳定作用,其他手指有更强的灵活性,主要起调控作用。该研究为功能性的多指抓握过程中手指力的控制能力的量化评估提供新的思路。     

腰椎定点旋转手法操作中拇指推力的有限元分析

背景：腰椎定点旋转手法操作过程中需要医生双手协同操作，进而输出旋扳力和拇指推力，通过对椎间盘产生位移和调节应力分布来治疗腰椎间盘突出，但是对于拇指推力的力学作用及其加载方向对手法效应的生物力学影响目前尚不清楚。目的：比较拇指不同推力方向下，腰椎定点旋转手法治疗腰椎间盘突出的生物力学差异。方法：构建L3-5正常三维有限元模型并进行有效性验证，然后参考椎间盘退变Pfirrmann分级，通过修改L4/5椎间隙高度、髓核体积以及纤维环、髓核、韧带材料参数来模拟椎间盘退变，最终构建L4/5椎间盘中度退变伴左旁中央型突出病理模型；然后以病理模型为研究对象，模拟手法向右侧旋扳，以改变拇指推力方向为条件，建立3种操作模式(M1：拇指向左推；M2：拇指向右推；M3：不施加推力)，对比3种操作模式下突出物的位移和椎间盘应力，以及小关节软骨的应力、应变。结果与结论：(1)L4/5椎间盘突出物最大位移值：M1位移为2.672 3 mm,M2为1.1561 mm,M3为1.826 4 mm,M1>M3>M2；(2)L4/5椎间盘最大Von Mises应力：M1为1.846 7 MPa,M2为0.41...     

广西壮族和苗族人扣手、交叉臂、惯用手、环食指长及拇指类型的研究

目的探讨广西壮、苗族人5项人类遗传学经典指标的规律。方法对聚居于广西的1046名壮、苗族学生进行调查。结果(1)广西壮、苗族R型扣手、R型交叉臂和R型惯用手百分率,民族间差异均无显著性(P>0.05):扣手和交叉臂与性别无关;(2)广西壮族环指长和直型拇指类型百分率均高于苗族,差异有显著性或高度显著性(P<0.05或P<0.001);(3)苗族男性环指长百分率高于女性,壮族女性直型拇指类型百分率高于男性(P<0.05)。结论广西壮、苗族人扣手、交手臂、惯用手、环食指长和拇指类型有其规律性。     

力学刺激对MG-63成骨样细胞增殖分化的影响

为探讨力学刺激对成骨细胞增殖分化的影响,应用根据四点弯曲原理设计的加力装置对MG-63成骨样细胞进行力学刺激,观察不同大小和作用时间的机械应变对成骨细胞增殖分化的影响。本研究中蛋白表达、碱性磷酸酶(ALP)活性测定分别采用Western blot、α-磷酸奈酚法,采用茜素红染色观察矿化结节的形成。结果发现:⑴与对照组相比,加力组增殖细胞核抗原(PCNA)蛋白表达、ALP活性均明显增加,但这种作用并不随着力刺激大小的增加而增加。⑵在适宜的力刺激(2 000μstrain)下,随着加力时间的增加,PCNA、Ⅰ型胶原(COLⅠ)蛋白表达及ALP活性逐渐增加,并且适宜的力刺激也促进了矿化结节的形成。该结果提示适宜的力学刺激能够促进成骨细胞的增殖分化。     

单手操作手机时常见拇指动作关节角度与接触力测量和分析

目的 研究单手操作手机时拇指的关节角度与接触力,分析拇指关节的关节角度与接触力的生物力学特征以及影响因素,为拇指狭窄性腱鞘炎的预防、康复以及治疗提供生物力学依据。方法 使用Vicon光学运动捕捉系统和电阻式薄膜力传感器采集大学生志愿者单手操作手机时拇指关节角度和指尖接触力,并对人体参数、关节角度和接触力进行统计学多因素相关性分析。结果 通过仪器测量得到单手手机操作时上滑、顺时针转、右点、左点、左滑等动作的关节角度与接触力;统计分析表明,手长、拇指总长对各关节角度均值和最大接触力有显著影响(P<0.05),且手长与掌指关节角度均值、最大接触力基本呈负相关。结论 减小拇指运动幅度避免拇指过伸或过屈,或减少使用手机的频率,或减少操作手机的作用力,可以一定程度上减少拇指屈肌腱和腱鞘与骨纤维管道的摩擦力以及相互之间的挤压力,从而可以减少拇指狭窄性腱鞘炎的形成。     

中医屈指推法的生物力学建模及分析

背景：推拿医学发展趋势是逐步摆脱单纯经验化的模式,走向客观化、精确化、量化和个体化,使推拿医师能控制手法的力量、时间、方向、频率等各项指标。 目的：建立中医一指禅推法(屈指)的生物力学模型,探索在体情况下无0法无创检测的关节作用力的计算方法。 方法：采用摄像技术,采集一指禅推法(屈指)的运动学数据,同时利用FZ-I型中医推拿手法测力分析仪采集作用力数据,依此建立手法的生物力学模型并计算各主要关节的作用力。 结果与结论：建立了4杆件、5结点的中医一指禅推法(屈指)生物力学模型,计算得到了拇指指间关节、拇指掌指关节、腕关节和肘关节的作用力,分析了各关节在手法运动中的作用,与操作医师的实际感受一致。提示由中医一指禅推法(屈指)的生物力学模型可计算推拿过程中各关节的作用力,可为手法教学和研究提供一定的帮助。     

精确抓握力量控制的脑动力学研究

精确抓握是人类完成多种精细复杂操作的基础,其神经控制机制极其复杂。目前对于精确抓握力量调节时大脑的动力学变化机制尚不明确。探究不同力幅度下精确抓握控制的指力行为和脑电动力学特征。12名健康右利手受试者被要求在10%、20%和30%最大自主收缩力(MVC)等3个力量水平下进行精确抓握的力量控制,同时采集运动过程中拇指和食指的力信号、压力中心点(COP)轨迹以及脑电信号(EEG), 并分别使用变异系数(CV)、COP速度和COP面积以及递归定量分析(RQA)进行量化评估。结果显示,拇指和食指的指尖力信号的CV与力量水平呈现线性正相关(拇指: r=0.624, P<0.001;食指: r=0.721, P<0.001);拇指和食指在30% MVC力量水平的COP面积分别为(1.94±1.21)和(2.02±1.45)mm²,显著大于在10% MVC((1.01±0.81)、(0.89±1.02)mm²)和20% MVC((1.20±0.62)、(1.16±0.63)mm²,P<0.05)时的COP面积。拇指在10%,20%和30% MVC下x和y轴的COP速度分别为(4.23±1.11)、(2.11±0.50)、(1.70±0.40)mm/s和(6.22±1.45)、(3.39±0.70)、(2.90±0.69)mm/s,呈现随着力量水平的增加而逐级下降的趋势(P<0.01),而10% MVC下的食指x和y轴的COP速度((4.95±1.34)、(7.04±1.75)mm/s)显著高于20% MVC((2.78±0.53)、(3.79±0.63)mm/s)和30% MVC((2.95±0.94)、(3.54±0.82)mm/s,P<0.05)。随着力量水平的增加,EEG信号α频带的RQA参数显著下降(P<0.05)。研究表明,随着力量水平的增加,力量波动性、EEG信号的复杂性增加,手指的调整速度和控制稳定性降低,EEG信号的α频带与精确抓握的运动控制密切相关。研究揭示精确抓握指力的指力控制与中枢神经系统的动力学行为有密切耦联,为深入研究中枢外周协同工作机制、定量评估神经肌肉系统功能提供新的路径。     

Edwards套棒方法治疗胸腰段脊柱不稳定损伤的生物力学实验研究

本文报告Edwards套棒装置及单纯Harrington分离棒治疗胸腰椎不稳定损伤的力学实验研究结果。取成年猪新鲜胸腰椎脊柱6具,切断前纵韧带、椎间盘纤维环、后纵韧带,造成前中柱不稳定损伤15处。测力传感器固定于椎体前缘并骑跨损伤处,使之检测纵向复位力。单侧内固定装置固定。实验结果表明:单侧Edwards套棒装置产生纵向复位力量89N,较Harrington分离棒48.7N提高82.7％(P<0.0005);二种内固定装置分别用于胸、腰椎时,纵向复位力均无显著差异(P<0.05),表明胸段肋骨对纵向复位力无影响。生物力学分析,纵向复位力与横向前推力成正比例关系,增大内固定装置对伤椎的横向前推力,可提高纵向复位力量。同时其它学者也报告Edwards套棒装置具有良好的脊柱三维稳定作用。所以,作者认为Edwards套棒装置集对脊柱骨折复位与稳定于一体,是理想的内固定装置。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.