舌三针联合康复训练对脑梗死后假性延髓麻痹所致构音障碍的疗效观察

目的:探讨舌三针联合康复训练对脑梗死后假性延髓麻痹所致构音障碍疗效,以期提高脑卒中后患者生命质量。方法:选取2016年12月至2019年1月海南省人民医院收治的脑梗死后假性延髓麻痹所致构音障碍患者78例进行回顾性分析,按照治疗方法不同分为对照组和观察组,每组39例。对照组常规西医+康复训练治疗,观察组在以上基础上加用舌三针治疗,均连续治疗6周。观察2组治疗前、完成治疗后血脂、Frenchay构音评分、血液流变学、言语空气动力学指标变化并比较。完成治疗后总结疗效情况。结果:1)2组治疗完成后反射、呼吸、唇、颌、软腭、喉、舌、言语评分和治疗前比较均显著上升(P<0.05),且观察组上升幅度显著高于对照组(P<0.05)。2)2组治疗完成后三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)较治疗前均显著下降,高密度脂蛋白胆固醇(HDL-C)较治疗前比较均显著上升(P<0.05),且观察组上升幅度显著高于对照组(P<0.05)。3)2组治疗完成后全血高低切黏度、血浆黏度、红细胞压积较治疗前均显著下降(P<0.05),且观察组优于对照组(P<0.05)。4)对照组治疗前、完成治疗后各指标比较差异无统计学意义(P>0.05),观察组治疗完成后平均声压级(MSDV)、音调(P)、最长发声时间(MPT)、平均气流率(MFR)、声门下压(SGP)、声门阻力(GR)、发声效率(VE)较治疗前均显著升高(P<0.05),且观察组优于对照组(P<0.05)。5)观察组治愈率38.46%、总有效率89.74%,显著高于对照组治愈率23.08%、总有效率79.49%(P<0.05)。结论:舌三针联合康复训练能通过促进脑微循环,改善血脂,促进言语功能来改善脑梗死后假性延髓麻痹所致构音障碍症状,提高生命质量。     

Validation of the virtual elevation field test method when assessing the aerodynamics of para-cyclists with a uni-lateral trans-tibial amputation

Lower-limb amputees typically require some form of prosthetic limb to ride a bicycle for recreation or when competing. At elite-level racing speeds, aerodynamic drag can represent the majority of the resistance acting against a cyclists’ forward motion. As a result, the reduction of such resistance is beneficial to an amputee whereby the form and function of the prosthetic limb can be optimized through engineering. To measure the performance of such limbs, field testing provides a cost-effective and context-specific method of aerodynamic drag measurement. However, few methods have been formally validated and none have been applied to amputees with lower-limb amputations. In this paper, an elite level para-cyclist wore two different prosthetic limb designs and had their total aerodynamic drag of a wind tunnel reference method statistically correlated against a velodrome-based virtual elevation field test method. The calculated coefficient of variation was in the range of 0.7–0.9% for the wind tunnel method and 2–3% for the virtual elevation method. A 0.03?m² difference was identified in the absolute values recorded between the two methods. Ultimately, both methods exhibited high levels of precision, yet relative results to each other. The virtual elevation method is proposed as a suitable technique to assess the aerodynamic drag of amputee para-cyclists.

• Implications for rehabilitation

• This assessment method will provide practitioners a reliable means of assessing the impact of changes made to prosthetics design for cyclists with limb absence.

• The proposed method offers a low cost and geographically accessible solution compared to others proposed in the past.

• This assessment method has significant potential for impact among prosthetic limb users looking to improve their cycling performance whereas previous attention in this field has been extremely limited.

     

高速气流吹袭时人上肢气动力特性

目的研究抬腿和不抬腿两种姿态下有 /无防护时 ,人上肢的气动力特性。方法在FL 2 4风洞中进行 1 /5人椅模型跨超声速风洞试验 ,研究人上肢各部的气动力特性。马赫数M =0 .4～ 2 .0 ,俯仰角α =5°～ 30°,侧滑角 β=0°～ 90°,雷诺数Re =( 0 .93～ 3.1 )× 1 0 6。结果 1 )抬腿对上肢气动特性有明显影响 ,其影响大小与抬腿状态有关 ;2 )侧滑一般使上肢气动载荷明显增加 ,特别是 β =5 0°是试验中上肢载荷比较严重的状态 ;3)所研究的防护装置 ,特别是导流板 ,对上肢的保护作用明显 ;4)提出了人上肢气动力的计算公式。结论 1 )本研究的防护装置 ,特别是导流板 ,对上肢的保护作用明显。 2 )本研究可为研制人上肢高速气流吹袭防护装置和制定相关标准提供可靠依据 ;3)人上肢气动力的计算可使用本文公式。     

噪声干扰下健康成人发声空气动力学分析

目的探讨健康成年人发声空气动力学检测的性别差异及噪声干扰下的改变。方法采用言语发声空气动力学系统6600对37例健康成年受试者分别在无噪声干扰(舒适发声)及70dB言语噪声干扰下(响亮发声)进行发声空气动力学测试,对声强、音频、平均气流率、声门下压、空气动力功率、声门阻力和发声效率进行比较分析。结果无噪声干扰下,女性发声音频、声门阻力明显高于男性,平均气流率、空气动力功率则明显低于男性,差异均有统计学意义(P<0.05);噪声干扰下响亮发声时男性各项空气动力学指标均显著提高,女性音频则下降,差异均有统计学意义(P<0.05),但平均气流率无明显变化;两种发声状态下空气动力学指标的变化率,除音频变化率有统计学意义外(P<0.05),其他指标变化率无明显性别差异。结论空气动力学指标存在明显的性别差异;噪声环境下,健康成人会通过空气动力学的改变调整发声,男性响亮发声的代偿能力较女性强,但两者的发声效率均超过正常范围,故声带损伤的风险增加。     

干粉吸入剂空气动力学分散模型的建立和验证

在Weiler干粉粒子聚集体全分散理论模型基础上,以硫酸沙丁胺醇为模型药物,建立了一种更加深入的千粉吸入剂空气动力学分散模型.硫酸沙丁胺醇干粉吸入剂体外沉积试验表明,该模型可预测干粉粒子的空气动力学分散行为,并可结合计算流体动力学,估算干粉吸入剂在吸入装置中的分散及微细粒子分数.     

杓状软骨内移术对改善声带麻痹患者发音功能的作用

目的 :评价杓状软骨内移术对声带麻痹患者发音功能的疗效。方法 :用喉空气动力学检查及嗓音分析方法 ,对 5 6例杓状软骨内移术患者手术前后最大发声时 (MPT)、平均呼气流率 (MFR)、声强 (SPL )、发音时呼气压 (EP) ,以及用 GRBAS法进行的嗓音听觉评价的嘶哑度 (G)进行了比较。结果 :术后 :MPT平均值男延长了3.1倍 ,女延长了 2 .7倍 ;MFR平均值显著下降 ,男从 82 7.3ml/ s下降到 34 0 .3ml/ s,女从 477.1m l/ s下降到 15 8ml/ s(P <0 .0 1) ;SPL平均值升高 ;EP平均值下降 ;G的平均值从 2 .8下降到 1.7(P <0 .0 1) ,改善程度在 1级以上的占 71%。结论 :杓状软骨内移术可使喉的发音功能得到显著改善 ,是非常安全、有效的手术方法之一。     

Pigeons steer like helicopters and generate down- and upstroke lift during low speed turns

Turning is crucial for animals, particularly during predator-prey interactions and to avoid obstacles. For flying animals, turning consists of changes in (i) flight trajectory, or path of travel, and (ii) body orientation, or 3D angular position. Changes in flight trajectory can only be achieved by modulating aerodynamic forces relative to gravity. How birds coordinate aerodynamic force production relative to changes in body orientation during turns is key to understanding the control strategies used in avian maneuvering flight. We hypothesized that pigeons produce aerodynamic forces in a uniform direction relative to their bodies, requiring changes in body orientation to redirect those forces to turn. Using detailed 3D kinematics and body mass distributions, we examined net aerodynamic forces and body orientations in slowly flying pigeons (Columba livia) executing level 90° turns. The net aerodynamic force averaged over the downstroke was maintained in a fixed direction relative to the body throughout the turn, even though the body orientation of the birds varied substantially. Early in the turn, changes in body orientation primarily redirected the downstroke aerodynamic force, affecting the bird's flight trajectory. Subsequently, the pigeon mainly reacquired the body orientation used in forward flight without affecting its flight trajectory. Surprisingly, the pigeon's upstroke generated aerodynamic forces that were approximately 50% of those generated during the downstroke, nearly matching the relative upstroke forces produced by hummingbirds. Thus, pigeons achieve low speed turns much like helicopters, by using whole-body rotations to alter the direction of aerodynamic force production to change their flight trajectory.     

Dust mite allergens are carried on not only large particles

The major obstacle for the successful measurement of airborne mite allergen is its very low concentration in the absence of vigorous disturbance. The aim of this study was to investigate the particle size distribution of group 2 dust mite allergen using an amplified ELISA system. Air sampling was performed using an Andersen sampler placed in the centre of the room, 1.2 m above floor level (airflow rate28.7 l/min). This is a multistage, multiorifice cascade impactor that is comprised of six stages. Any particle greater that 4.7 μm should impact on stages 1 and 2, whilst stages 3–6 measure the predominantly respiratory range. The sampling was carried out for 30 min after 15 min of vigorous disturbance (vacuum cleaning without bag and filter). Der p 2 was measured using mAb‐based ELISA with the AmpliQ amplification kit (Dako Ltd, Cambridgeshire, UK). The sensitivity was increased ˜15‐fold as compared with standard assay, bringing the level of detection to 300 pg/ml. The majority of airborne Der p 2 (79.4%) was carried on large particles (> 4.7 µm). However, a small but important proportion of airborne Der p 2 (20.6%) was associated with small particles(1.1–4.7 µm). It is worth noting that all the levels measured were below the detection limit of standard assay. In conclusion, we have shown that using an amplification system, airborne mite allergen previously undetectable owing to its low concentration can be quantified. Group 2 dust mite allergen is carried not only on large particles. A small, but potentially significant proportion of this airborne allergen is associated with small particles which, when inhaled, may penetrate deep into the human respiratory tract.