脊柱侧凸常用步态特征评估参数应用及研究进展

脊柱侧凸是一种脊柱的三维畸形,其导致一系列健康问题,如疼痛、姿势异常、步行模式异常等。步态评估有助于评估脊柱畸形改变对患者生活质量和日常活动能力障碍。三维步态分析系统包含时空参数、运动学和动力学评估方法,为脊柱侧凸患者提供客观的、量化的步态分析方法。其中,表面肌电和能量监测反映脊柱侧凸患者与健康人相比步行时肌肉生理学和能量变化。本综述对脊柱侧凸的三维步态分析、表面肌电和能量监测的研究进行总结,以全面客观的反映脊柱侧凸患者步行的生物力学改变     

约束摆臂对优选步态转换速度的影响

目的：研究约束摆臂对优选步态转换速度的影响。方法：12位成年人在跑步机上作正常摆臂和约束摆臂两种模式的变速和匀速步态运动实验，采集步态运动数据，建立人体多刚体模型，分析计算走-跑转变（WRT）和跑-走转变（RWT）速度，以及步态时空和运动学参数。结果：正常摆臂的WRT和RWT速度（m·s^-1）分别为1.99±0.14和1.89±0.16，约束摆臂的WRT和RWT速度（m/s）分别为1.84±0.14和1.74±0.13，两种摆臂模式下的WRT和RWT速度差异显著。结论：约束摆臂导致优选步态转换速度减小。     

基于三维步态分析仪对社区老人平衡能力与步态时空参数的相关性分析

目的通过三维步态分析仪系统采集社区老人步态时空参数,探讨其中影响老人平衡能力的相关指标。方法根据纳入及排除标准,选择在广州市区内居住的社区老人94例,有跌倒史39例,无跌倒史55例,进行Berg（Berg balance scale,BBS）量表评分,通过三维步态分析仪系统采集社区老人步态时空参数,采用t检验、Person相关性分析及逐步多元回归分析研究步态时空参数中影响平衡能力的相关指标。结果有跌倒史老人与无跌倒史老人Berg评分、步态周期、步速、步幅、步频、左步长、右步长、左支撑相、左摆动相、右支撑相、右摆动相、双支撑相均差异有统计学意义（P<0.05）。相关性分析提示：步态周期、左支撑相、右支撑相、双支撑相与Berg量表评分负相关（P<0.05）,步速、步幅、步频、左步长、右步长、左摆动相、右摆动相与Berg量表评分呈正相关（P<0.05）。逐步多元回归分析提示步速、双支撑相是影响老人平衡能力的主要因素（P<0.05）,步态周期、步幅、步频、左步长、右步长、左支撑相、左摆动相、右支撑相、右摆动相不是老人平衡能力的影响因素（P＞0.05）。结论步态时空参数中步速、双支撑相是影响老人平衡能力的主要因素。     

Different optical properties between human hepatocellular carcinoma tissues and non-tumorous hepatic tissues <Emphasis Type="Italic">In Vitro</Emphasis>

There has been an ongoing search for clinically acceptable methods for the accurate,efficient and simple diagnosis and prognosis of hepatocellular carcinoma(HCC).Optical spectroscopy is a technique with potential clinical applications to diagnose cancer diseases.The purpose of this study was to obtain the optical properties of HCC tissues and non-tumorous hepatic tissues and identify the difference between them.A total of 55 tissue samples(HCC tissue,n=38;non-tumorous hepatic tissue,n=17) were surgically resected from patients with HCC.The optical parameters were measured in 10-nm steps using single-integrating-sphere system in the wavelength range of 400 to 1800 nm.It was found that the optical properties and their differences varied with the wavelength for the HCC tissue and the non-tumorous hepatic tissue in the entire wavelength range of research.The absorption coefficient of the HCC tissue(1.48±0.99,1.46±0.88,0.86±0.61,2.15±0.53,0.54±0.10,0.79±0.15 mm-1) was significantly lower than that of the non-tumorous hepatic tissue(2.79±1.73,3.13±1.47,3.06±2.79,2.57±0.55,0.62±0.10,0.93±0.16 mm-1) at wavelengths of 400,410,450,1450,1660 and 1800 nm,respectively(P<0.05).The reduced scattering coefficient of HCC tissue(5.28±1.70,4.91±1.54,1.26±0.35 mm-1) and non-tumorous hepatic tissue(8.14±3.70,9.27±3.08,2.55±0.57 mm-1) was significantly different at 460,500 and 1800 nm respectively(P<0.05).These results show different pathologic liver tissues have different optical properties.It provides a better understanding of the relationship between optical parameters and physiological characteristics in human liver tissues.And it would be very useful for developing a non-invasive,real-time,simple and efficient way for medical management of HCC in the future.     

踝足矫形器对脑卒中后偏瘫患者步态稳定性恢复的影响

目的 探讨佩戴踝足矫形器对脑卒中后偏瘫患者步态稳定性和平衡控制能力恢复的影响.方法 首次发病、慢性单侧偏瘫脑卒中患者25例.采用功能评定和运动解析系统评测佩戴踝足矫形器前后及4周随访时的平衡控制和步态时相参数.结果 对偏瘫患者佩戴踝足矫形器前、即刻和4周时最大步行速度[(27±11)m/min,(34±13)m/min,(39±10)m/min]、步行能力分级(4.2±0.6,4.3±0.5,4.7±0.5)、Berg平衡量表(48±4,48±4,50±4)、5次坐立试验(24.0±1.6,24.1±1.6,20.4±3.1)和步态不对称指数(0.197±0.035,0.169±0.026,0.135±0.027)进行重复测量方差分析,差异均有统计学意义(均P＜0.01).佩戴即刻最大步行速度和步行能力分级提高,步态不对称指数减小,差异有统计学意义(P＜0.05).使用4周后所以测量指标均有改善,差异具有显著统计学意义(P＜0.01).结论 佩戴踝足矫形器后,步行能力和步态稳定性即刻就有明显改善;而经适应训练使用4周后,步行能力和步态稳定性继续提高,平衡控制能力也得到改善.

Abstract：

Objective To quantitatively analyze the effects of ankle-foot orthosis (AFO) on gait stability and explore its use for walking capacity, gait stability and balance control in post-stroke patients.Methods A total of 25 inpatients with prior chronic hemiparesis from stroke who could walk at least 10meters without assistance were recruited. The maximal walking speed and gait asymmetry index were examined by a motion analysis system. Functional balance was assessed by the Functional Ambulation Categories, Berg Balance Scale and Five-Times-Sit-to-Stand Test. Results AFO had positive effects on the hemiplegic gait parameters of improving walking speed, gait stability and functional balance ( P ＜ 0. 01 ).Pair wise comparisons suggested that there were significant differences in the maximal walking speed,Functional Ambulation Categories and gait asymmetry index after an immediate use of AFO ( P ＜ 0.05 ). At Week 4, there were significant differences in the parameters of walking speed, gait asymmetry index and functional balance control ( P ＜ 0.01 ). Conclusion The use of AFO may compensate the instability of gait and balance. Functional tests improve significantly with orthosis.     

Development of Abnormal Gait Detection and Vibratory Stimulation System on Lower Limbs to Improve Gait Stability

The purpose of this study is to develop an abnormal gait detection algorithm and a vibratory stimulation system on a lower limb to improve gait stability and prevent falls. The system consists of a gait measurement module, an abnormal gait detection module, and a vibratory stimulation module. The gait measurement module measures the vertical acceleration of the ankle during walking using an accelerometer. The measured acceleration values are sent to a portable microcontroller, which controls vibratory stimulations to the ankles based on an algorithm that detects the peak acceleration values. If the acceleration peaks are found to occur irregularly, the abnormal gait detection algorithm activates the vibratory stimulation module. To determine the effect of vibratory stimulations under dynamic condition, this study investigated the contribution of ankle muscle proprioception on the control of dynamic stability and lower limb kinematics while walking using vibratory stimulation to alter the muscle spindle output of individuals’ left lower limb. Vibrators were attached to the left ankle joint (tibialis anterior, triceps surae). Participants were required to walk along a travel path and step over an obstacle placed in their way. There were four task conditions; an obstacle (10%, 20%, and 30% of the participants’ height) was positioned at the midpoint of the walkway, or the participants’ walking path remained clear. For each obstacle condition, participants experienced either no vibration, or vibration of the tibialis anterior muscle and the triceps surae muscle of the left lower limb. Vibration began upon detection of an abnormal gait and continued for one second. Vibrating the ankle muscles of the left lower limb while stepping over an obstacle resulted in significant changes in COM behavior on both the anterior/posterior (A/P) and medial/lateral (M/L) planes. The results provide strong evidence that the primary endings of the ankle muscle spindles play a significant role in the control of posture and balance during the swing phase of locomotion by providing information on the movement of the body’s COM with respect to the support foot.     

THE COMPUTERIZED GAIT ANALYSIS SYSTEM AND THREE DIMENSIONAL ANALYSIS OF FOOT-GROUND REACTION FORCES DURING LEVEL WALKING

A S9-2 computerized gait analysis system developed by us is reported. The advantages of the system are: synchronous measurement of the forces, angles and time parameters; high efficiency, accuracy and good repeatability; low cost and easy to operate. A three dimensional analysis of the foot-ground reaction forces of 41 normal subjects during level walking was carried out by the S9-2 system and a series of normal values of parameters and characteristic curves were obtained. The mechanism of formation of the parameters and curves and the sex influence were investigated and discussed. In old subject, before the development of "cautious gait", most values of the parameters did not differ significantly from those of the young subjects, except that the centre of gravity of the body crossing the hip earlier with a slight decrease in the medio-lateral balance capacity.     

基于悬吊疗法的神经肌肉激活技术对脑卒中偏瘫患者运动功能的影响

  目的  探讨基于悬吊疗法的神经肌肉激活技术对脑卒中偏瘫患者躯干控制、步态以及平衡等运动功能的临床应用疗效。  方法  选取2019年1—11月于湖南省人民医院康复医学科住院的80例脑卒中偏瘫患者,采用随机数字表法分为对照组和观察组,各40例。对照组采用常规康复训练,观察组采用基于悬吊疗法的神经肌肉激活技术训练。训练前后评定患者的平衡、躯干控制、下肢运动功能、平衡和生活质量以及行走过程中下肢的步态时空参数。  结果  观察组治疗后的平衡能力、躯干控制能力、下肢运动功能和步行功能[(37.61±4.36)分、(83.41±8.61)分、(80.71±9.19)分、(3.86±0.23)分]均高于对照组[(34.86±4.11)分、(76.83±7.36)分、(72.37±9.57)分、(3.66±0.34)分,均P＜0.05];观察组生活质量得分均高于对照组(均P＜0.05);步态时空参数的步速、步频和跨步长均大于对照组(均P＜0.05);跨步时间和支撑相占比均低于对照组(均P＜0.05)。  结论  基于悬吊疗法的神经肌肉激活技术可有效优化脑卒中偏瘫患者的步态功能,改善其躯干控制能力、平衡能力、步行能力和生活质量,值得临床推广。      

精细化护理在脑小血管病患者护理管理中的应用效果

目的 近年来,随着生态环境的恶化,各种疾病发生率不断升高,我国每年发生脑小血管疾病人数也随之增加,所以加强对脑小血管疾病的治疗和护理对改善患者预后十分重要。本次研究通过对医院收治脑小血管患者进行精细化护理干预,旨在探讨其应用价值。方法 选择2019 年5 月至2020 年5 月本院脑卒中偏瘫足下垂患者60 例,按照1～60 号进行编号,并由护理人员随机抽取,其中1～30 号为对照组,31～60 号为观察组。对照组患者进行常规护理;观察组患者进行精细化护理干预。干预前后分别测量两组步宽、步速和步幅;采用简明运动试验（SPPB）评估患者步态及平衡状况;采用Tinetti 量表评估步行质量和动态平衡能力;评估护理质量、护理满意度和护理依从度。结果 观察组患者干预后步宽为（20.76±1.15）cm,低于对照组（22.69±1.37）cm,观察组患者干预后步速和步幅分别为（32.69±1.67）cm/s 和（54.89±4.02）cm,高于对照组（26.95±1.74）cm/s 和（47.63±3.69）cm,差异有统计学意义（P＜0.05）;观察组患者干预后SPPB 总评分和Tinetti 总评分分别为（10.13±0.80）分和（23.39±0.85）分,高于对照组（9.01±0.74）分和（21.06±0.91）分,差异有统计学意义（P＜0.05）;观察组护理质量、护理满意度和护理依从度评分分别为（97.96±2.01）分、（95.82±2.81）分和（93.91±4.02）分,高于对照组（94.11±1.82）、（91.63±2.58）和（84.22±3.38）分,差异有统计学意义（P＜0.05）。结论 精细化护理干预可显著改善脑小血管患者步态和平衡障碍,效果显著,获得患者肯定。     

检测尿液中生存素蛋白对膀胱癌诊断价值的系统评价

目的系统评价检测尿液中生存素蛋白诊断膀胱癌的临床价值。方法检索PubMed、EMBASE、Cochrane Library、中国生物医学文献数据库、中文科技期刊数据库等数据库,全面搜集1997-2009年所有相关诊断性研究,由两位评价者依据QUADAS标准独立评价纳入文献方法学质量。用RevMan5.0软件检验研究间异质性,Meta-Disc软件对结果指标进行统计分析。结果 16个研究符合纳入标准,共1 611例。统计分析结果显示：酶联免疫吸附法和免疫组织化学法检测尿液中生存素蛋白诊断膀胱癌的合并敏感度、合并特异度及受试者工作曲线下面积分别为0.76（95%可信区间0.72～0.80）、0.86（95%可信区间0.82～0.90）、0.921 4和0.91（95%可信区间0.87～0.93）、0.93（95%可信区间0.89～0.96）、0.969 6。Western Blot法也显示了较高的敏感度和特异度。结论与病理检查相比,免疫组织化学法检测尿液中生存素蛋白对膀胱癌的诊断价值较高,可作为重要的无创性检测手段用于膀胱癌筛选及术后监测;酶联免疫吸附法检测尿液中生存素蛋白对膀胱癌的诊断效能不及免疫组织化学法。     

膝骨关节炎患者的三维运动解析

背景　膝骨关节炎（KOA）患者发生膝关节变形、活动受限、步态异常等改变,预示KOA是与运动学、动力学等生物力学因素关系密切的一种疾病。而目前临床上缺乏对这些运动学、动力学指标的客观定量评定指标。目的　应用VICON三维运动捕捉系统解析KOA患者的病情,为临床医生治疗、康复计划的制定和实施提供新的重要参考依据。方法　2010年10月-2017年6月,选择上海交通大学医学院附属瑞金医院门诊及住院的双KOA患者10例作为KOA组,另外招募无膝关节疼痛的健康中老年人10例作为对照组。采用英国VICON三维运动捕捉系统对两组受试者进行行走测试,并分析受试者的步行情况和膝关节的生物力学（运动学、动力学）特征。结果　与正常人比较,KOA患者存在明显的步态和生物力学特征：步频、跛行指数、步长、步幅、步速均缩短,双足支撑期、单足支撑期、一步时间、步行周期均延长（P<0.05）;膝关节屈曲角峰值,冠状面最初角度,矢状面、冠状面、水平面膝关节最大活动范围均减小（P<0.05）;膝关节角速度、膝关节角加速度峰值和平均值均减小（P<0.05）;膝关节伸展力矩峰值减小（P<0.05）;Y轴和Z轴方向地板反作用力峰值减小（P<0.05）。结论　KOA患者关节内及其周围生物力学环境发生了明显变化,同时下肢运动出现了异常。而采用VICON运动捕捉系统对KOA患者和正常人进行三维步态分析,有助于更好地了解膝关节运动学和动力学等指标,为KOA诊断、治疗及研究提供重要的参考依据。     

二肽基肽酶6在难治性颞叶癫痫患者中的表达

目的 探讨难治性癫痫患者颞叶皮质中二肽基肽酶6(DPP6)的表达情况。方法 在重庆医科大学建立的脑组织库中,按照随机化原则抽取27例癫痫患者的脑组织(癫痫组)和15例脑外伤患者的脑组织(对照组),应用免疫组织化学染色、蛋白质印迹杂交、RT-PCR法检测DPP6的表达水平。结果 DPP6表达于两组大脑神经元的细胞膜,蛋白质印迹杂交结果显示,癫痫组和对照组DPP6的平均光密度(OD)值分别为0.86±0.04和0.37±0.02,差异有统计学意义(P<0.001)。癫痫组和对照组脑组织DPP6 mRNA的相对表达量分别为0.74±0.03和0.35±0.03,差异有统计学意义(P<0.001)。结论 异常表达的DPP6可能参与了难治性癫痫的形成。     

膝骨性关节炎患者膝关节疼痛指数与足底压力变化的相关性研究

目的：探讨膝骨性关节炎患者足底压力改变及疼痛对足底压力的影响。方法运用足底压力测试系统对28例单侧膝骨性关节炎疼痛患者自然行走时的步态进行测试,观察受试者单足支撑分期时段参数、足角及膝关节疼痛指数,对健、患侧足底压力各指标进行统计学分析并分析膝关节疼痛指数与各指标相关性。结果膝骨性关节炎患者患侧前足着地阶段时间百分比为（57.90±32.93）、全足支撑阶段时间百分比为（57.93±2.93）低于健侧对应百分比（60.26±2.66,P =0.007;51.53±3.84,P <0.001）;患侧足角（16.24±4.50）明显高于健侧足角（14.67±4.09）,差异有统计学意义（P =0.014）;膝关节疼痛指数与患侧前足着地阶段时间百分比（r =-0.53,P =0.004）、全足支撑阶段时间百分比（r =-0.56,P =0.002）呈负相关;与患侧足角无明显相关性（r =0.245,P =0.193）。结论膝骨性关节炎患者足底压力具有特征性,前足着地时段、全足支撑时段明显缩短、足角变大,疼痛严重影响膝骨性关节炎患者步态。     

An Automatic 3-D Reconstruction of Coronary Arteries by Stereopsis

Stereopsis of X-ray images can produce 3D tree of coronary arteries up to a certain accuracy level with a lower dose of radiation when compared to computer tomography (CT). In this study, a novel and complete automatic system is designed that covers preprocessing, segmentation, matching and reconstruction steps for that purpose. First, an automatic and novel pattern recognition technique is applied for extraction of the bifurcation points with their diameters recorded in a map. Then, a novel optimization algorithm is run for matching the branches efficiently which is based on that map and the epipolar geometry of stereopsis. Finally, cut branches are fixed one by one at the bifurcations for completing the 3D reconstruction. This method prevails the similar ones in the literature with this novelty since it automatically and inherently prevents the wrong overlapping of branches. Other essential problems like correct detection of the bifurcations and accurate calibration parameters and fast overlapping of matched branches are addressed at acceptable levels. The accuracy of bifurcation extraction is high at 90 % with 96 % sensitivity. Accuracy of vessel centerlines has rootmean-square (rms) error smaller than 0.57 mm for 20 different patients. For phantom model, rms error is 0.75?±?0.8 mm in 3D localization.     

血清PCT、TNF-α、CD14+/CD16+联合检测对新生儿败血症的诊断价值

目的：探讨联合检测血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、CD14+/CD16+水平对新生儿败血症的诊断价值。方法选取2012年9月至2015年12月期间我院确诊的败血症新生患儿80例作为败血组,同期选取健康新生儿40例作为健康组,采用流式细胞技术检测CD14+/CD16+、免疫发光法检测PCT、酶联免疫吸附法(ELISA)检测TNF-α,采用ROC曲线评估新生儿败血症的诊断效能,统计分析所有受检者的血清PCT、TNF-α、CD14+/CD16+水平及三者联合检测对新生儿败血症的诊断价值。结果败血组患儿发病时血清PCT、TNF-α、CD14+/CD16+水平分别为(6.57±2.38) ng/mL、(28.69±8.13) pg/mL、(11.35±3.21)%,感染控制后分别为(1.63±0.67) ng/mL、(9.36±3.97) pg/mL、(8.23±2.27)%,健康组血清PCT、TNF-α、CD14+/CD16+水平分别为(0.86±0.43) ng/mL、(6.29±2.01) pg/mL、(7.67±1.13)%,败血组患儿发病时和感染控制后上述因子水平均明显高于健康组,败血组患儿感染控制后上述因子水平明显低于发病时,差异均有统计学意义(P<0.05);ROC曲线显示,血清PCT以1 ng/mL、TNF-α以7.5 pg/mL、CD14+/CD16+以8.5%为临界值时,三者联合检测诊断新生儿败血症的敏感度、特异度、阳性预测值、阴性预测值、准确度及曲线下面积分别为93.75%(75/80)、92.50%(37/40)、96.13%(75/78)、88.10%(37/42)、93.33%(112/120)、0.836,与出生后实验诊断基本相同,差异无统计学意义(P>0.05)。结论血清PCT、TNF-α、CD14+/CD16+水平与新生儿败血症的发生发展有关,联合检测三者水平有利于医师评估新生儿败血症的病情变化,且在诊断该疾病中具有良好的特异性、敏感性和准确性,可作为一种重要的诊断方法。     

脑白质疏松症患者步态障碍与认知损害的关系

目的 探讨脑白质疏松症(LA)患者步态障碍的特点及其与认知的关系.方法 选取42例LA患者作为LA组,另选择13例无LA正常老年人作为对照组(NC组),依据头颅MRI扫描结果,LA组按照Wahlund分级方法分为轻度(LA1)、中度(LA2)和重度(LA3)3组.对所有受试者进行神经心理学评估和步态测定.神经心理学评估采用简易精神状态检查量表(MMSE)和剑桥老年认知检查表-中国修订版(CAMCOG-C).步态测定包括计时“起立-行走”测试(TUG)和P-WALK平板压力测试系统精确测量步长、步幅、步宽、步频、步速、单支撑相、双支撑相、步行周期等.比较LA组和NC组、LA各亚组与NC组间认知功能和步态参数,选取显著性差异指标进行相关及多元回归分析.结果 LA组患者MMSE评分及CAMCOG-C评分均显著低于NC组,差异有统计学意义(Z=-2.411,P=0.016;t=2.510,P=0.015);LA组患者较NC组TUG时间延长、步长、步幅缩短、步速减慢,差异均有统计学意义(Z=-3.269、-2.239、-2.219、-3.686,P =0.001、0.025、0.027、P＜0.001). LA各亚组与NC组比较:随LA程度增加,患者MMSE及CAM-COG-C评分降低,4组间差异有统计学意义(x2=11.051、4.870,P=0.011、0.005);各步态参数中,随LA程度增加,患者TUG时间延长、步长、步幅缩短、步速降低、步宽增加与步频增快以LA3组较为明显,四组间差异有统计学意义(x2=19.143、8.588、8.992、21.486、13.044、3.095,P＜0.001、0.035、0.029、＜0.001、0.005、0.035).对LA患者进行相关性分析显示,TUG与MMSE、CAMCOG-C评分呈负相关性(r=-0.399、-0.404,P=0.003、0.002),并与CAMCOG-C子项中记忆和执行呈负相关(r=-0.321、-0.433,P=0.021、0.001).步速与MMSE、CAMCOG-C评分呈正相关性(r=0.409、0.308,P=0.002),并与CAMCOG-C中执行功能呈正相关性(r =0.535,P＜0.001).校正LA等级分级后多元回归分析显示,步态参数与执行功能无相关性.结论 LA患者存在步态障碍,以步速降低最为显著;LA患者步态障碍与LA程度、认知功能损害有关.     

Nutlin-3a-PLGA微球促大鼠脊髓损伤后的运动功能恢复

目的 探讨Nutlin-3a-PLGA微球对大鼠脊髓损伤后运动功能恢复的影响.方法 采用单乳化法制备Nutlin-3a-PLGA微球.健康成年SD大鼠采用随机数字表法分为单纯损伤组、生理盐水微球治疗组和Nutlin-3a-PLGA微球治疗组,每组12只;另取3只大鼠进行正常脊髓铬化青染色.对T1o脊髓进行右半横断损伤.单纯损伤组仅行脊髓右半横断损伤而不给予干预,生理盐水微球治疗组术后予以生理盐水微球治疗,Nutlin-3a-PLGA微球治疗组术后予以Nutlin-3 a-PLGA微球治疗.术后2、4周行铬化青染色观察脊髓脱髓鞘情况,术前1d,伤后2、3、4周行Catwalk步态分析正常步序比、站立时间、足印平均强度、两后爪脚间距离以及相对足印距离5个时间-空间参数评价大鼠运动功能变化.结果 伤后4周与单纯损伤组(1 461.44±123.46)和生理盐水微球治疗组(1 347.33±114.42)比较,Nutlin-3a-PLGA微球治疗组(1 879.46±115.41)铬花青染色显示脱髓鞘病变较轻(P＜0.05),髓鞘排列较为紧密.与术前比较,术后2周单纯损伤组和生理盐水微球治疗组Catwalk步态分析各项行为学参数差异有统计学意义(P＜0.05);Nutlin-3 a-PLGA微球治疗组正常步序比、两后爪脚间距离以及相对足印距离差异有统计学意义(P＜0.05),左后肢站立时间和前肢足印平均强度差异无统计学意义(P＞0.05).与单纯损伤组和生理盐水微球治疗组比较,Nutlin-3 a-PLGA微球治疗组伤后2周左后肢站立时间、左右前肢足印平均强度降低,正常步序比增加;伤后4周单纯损伤组、生理盐水微球治疗组和Nutlin-3a-PLGA微球治疗组两后爪脚间距离分别为3.20±0.89 cm,3.23±0.90 cm,2.29±0.36 cm,Nutlin-3a-PLGA微球治疗组与其余两组比较差异有统计学意义(P＜0.05);单纯损伤组、生理盐水微球治疗组和Nutlin-3a-PLGA微球治疗组左侧相对足印距离分别为10.17±6.40 cm、9.75±6.92 cm和2.85±1.72cm,右侧分别为7.63±4.78 cm、8.21±4.82 cm和3.00±2.07 cm;Nutlin-3a-PLGA微球治疗组与其余两组比较左右两侧相对足印距离差异均有统计学意义(P＜0.01).结论 Nutlin-3a-PLGA微球局部作用能促进脊髓后半损伤大鼠传导功能及运动功能的恢复,对损伤节段轴突的再生可能有促进作用.     

Development of A Textile Capacitive Proximity Sensor and Gait Monitoring System for Smart Healthcare

Gait is not only one of the most important functions and activities in daily life but is also a parameter to monitor one‘s health status. We propose a single channel capacitive proximity pressure sensor (TCPS) and gait monitoring system for smart healthcare. Insole-type TCPS (270 mm in length) was designed consisting of three layers including two shield layers and a sensor layer. Analyzing the step count and stride time are the basic indicators in gait analysis, thus they were selected as evaluation indicators. A total of 12 subjects participated in the experiment to evaluate the resolution of our TCPS. To evaluate the accuracy of TCPS, step count and its error rates were simultaneously detected by naked eye, ZIKTO Walk (ZIKTO Co., Korea), and HJ-203-K pedometer (Omron Co., Japan) as reference. Results showed that the error rate of 1.77% in TCPS was lower than those of other devices and correlation coefficient was 0.958 (p-value?=?0.000). ZIKTO Walk and pedometer do not provide information on stride time, therefore it was detected by F-scan (Tekscan, USA) to evaluate the performance of TCPS. As a result, error rate of stride time measured by TCPS was found to be 1% and the correlation coefficient was 0.685 (p-value = 0.000). According to these results, our proposed system may be helpful in development of gait monitoring and measurement system as smart healthcare.     

PSAD联合DCE-MRI对前列腺癌诊断价值的研究

目的 探讨前列腺特异性抗原(PSA)、前列腺特异性抗原密度(PSAD)联合动态增强扫描磁共振成像(DCE-MRI)定量参数Ktrans、Kep、Ve对前列腺癌(PCa)的诊断价值.方法 选取马鞍山市人民医院2015年5月至2016年6月前列腺患者66例,其中PCa 25例、前列腺增生(BPH)41例.所有患者均行DCE-MRI检查、PSA检测,将得出结果按照11种组合方案,参照病理结果,绘制受试者特性曲线(ROC),比较所有诊断方案的灵敏度、特异度及准确度.结果 BPH组患者的PSA、PSAD、Ktrans、Kep、Ve分别为(14.72±12.86)ng/mL、(0.25±0.23)ng/(mL·cm3)、(0.22±0.10)/min、(1.35±0.59)/min、(0.17±0.07),PCa组患者分别为(30.42±23.90)ng/mL、(0.84±0.52)ng/(mL·cm3)、(0.52±0.18)/min、(2.51±1.10)/min、(0.24±0.10),BPH组患者的参数均低于PCa组,差异均有显著统计学意义(P<0.01).单参数诊断方案中Ktrans诊断价值最高,灵敏度、特异度、AUCROC分别为85.7%、90.2%、0.93.PSAD+Ktrans在11种组合方案中诊断价值最高,灵敏度、特异度、AUCROC分别为90.5%、95.1%、0.96.结论 PSAD及DCE-MRI定量参数Ktrans、Kep对前列腺癌有较好的诊断价值,PSAD联合Ktrans为前列腺良恶性病变的鉴别诊断提供了重要的参考.     

基于中医理论的恶性肿瘤生活质量评价体系之共性量表的研制:测量学特性评价

目的分析评价基于中医理论的恶性肿瘤生活质量评价体系之共性量表(QLASTCM-GM)的测量学特性(信度、效度与反应度)。方法通过240例肺癌和240例胃癌患者纵向的生命质量测定对QLASTCM-GM的测量学特性进行评价。结果各领域及总量表的重测信度均在0.93以上,内部一致性α值为0.86～0.93;相关分析与因子分析显示量表有较好的结构效度;与癌症患者生活质量测定量表(QLQ-C30)的相关分析显示具有较好的效标关联效度;治疗后各领域及总量表得分间差异均有统计学意义(P<0.05),且标准化反应均数(SRM)较QLQ-C30大。结论 QLASTCM-GM具有较好的信度、效度及一定的反应度,可用于癌症患者生命质量的测定。