Role of the newly designed Ankle Foot Orthosis on balance related parametersin drop foot post stroke patients

BackgroundPassive and hybrid passive ankle foot orthoses (AFOs) are often prescribed in post stroke drop foot; however, the effects of these AFOs on balance related parameters in these patients seem unclear. Accordingly, the aim of current study was to evaluate the role of the newly designed hybrid passive and Posterior Leaf Spring (PLS) AFOs on balance related parameters including: self-reported balance confidence (ABC), Timed Up and Go Test (TUG) and Berg Balance Scale (BBS) in post stroke drop foot patients.MethodsFifteen post stroke drop foot patients were recruited in current study. Then, ABC, TUG and BBS were assessed with newly designed AFO and PLS AFO.ResultsThe results of this study were shown a significant improvement in ABC, TUG and BBS scores with the newly designed AFO than PLS AFO (p < 0.05).ConclusionThis study suggested that the newly designed AFO was improved the balance related parameters than PLS AFO.     

滋肾育胎丸加减方预防ACA阳性者不良妊娠结局的效果及机制研究＊

目的 探讨滋肾育胎丸加减方预防抗磷脂抗体（ACA）阳性者不良妊娠结局的效果及机制研究。方法 选取2016年2月至2019年2月我院收治的89例ACA阳性，先兆性流产或有习惯性流产（RSA）史患者，将采用西医治疗的40例作为对照组，将采用西医联合滋肾育胎丸加减方治疗的49例作为观察组，比较两组中医证候疗效、中医证候积分、ACA-IgA、ACA-IgM、ACA-IgG、凝血指标［血小板聚集功能（PAF）、活化蛋白C（PC）、抗凝血酶（AT）、纤溶酶原激活抑制物-1（PAI-1）］、Th1/Th2细胞因子［干扰素γ（IFN-γ）、白介素-2（IL-2）、白介素-4（IL-4）、白介素-10（IL-10）］、妊娠结局、安全性。结果 治疗2周后检测ACA，观察组2例未降低，对照组11例未降低，观察组未降低患者占比低于对照组（P<0.05）；观察组总有效率100.00%高于对照组85.00%（P<0.05）；观察组治疗4周、7周后中医证候积分低于对照组（P<0.05）；观察组治疗4周、7周后ACA-IgA、ACA-IgM、ACA-IgG低于对照组（P<0.05）；观察组治疗4周、7周后PAF、PAI-1低于对照组，PC、AT高于对照组（P<0.05）；观察组治疗4周、7周后IFN-γ、IL-2低于对照组，IL-4、IL-10高于对照组（P<0.05）；观察组活产率95.92%高于对照组80.00%（P<0.05）；组间不良反应总发生率比较，差异无统计学意义（P>0.05）。结论 动态监测ACA对滋肾育胎丸加减方精准应用具有指导意义，指导滋肾育胎丸加减方通过调理脏腑、气血、经络功能，改善先兆性流产或有RSA史患者临床症状及凝血因子指标，降低ACA水平，并可改善患者免疫耐受功能，提高胎儿活产率，且安全性高。     

Effects of anteriorly-loaded treadmill walking on dynamic gait stability in young adults

BackgroundAnteriorly-loaded walking is common in many occupations and may increase fall risk. Dynamic gait stability, defined by the Feasible Stability Region (FSR) theory, quantifies the kinematic relationship between the body’s center of mass (COM) and base of support (BOS). FSR-based dynamic gait stability has been used to evaluate the fall risk.Research questionHow does front load carriage affect dynamic gait stability, step length, and trunk angle among young adults during treadmill walking?MethodsIn this between-subject design study, 30 healthy young adults were evenly randomized into three load groups (0%, 10%, or 20% of body weight). Participants carried their assigned load while walking on a treadmill at a speed of 1.2 m/s. Body kinematics were collected during treadmill walking. Dynamic gait stability (the primary variable) was calculated for two gait events: touchdown and liftoff. Step length and trunk angle were measured as secondary variables. One-way analysis of variance was conducted to detect any group-related differences for all variables. Post-hoc analysis with Bonferroni correction was performed when main group differences were found.ResultsNo significant differences but medium to large effect sizes were found between groups for dynamic gait stability at touchdown (p = 0.194, η² = 0.114) and liftoff (p = 0.122, η² = 0.139). Trunk angle significantly increased (indicating backward lean) with the front load at touchdown (p < 0.001, η² = 0.648) and liftoff (p < 0.001, η² = 0.543). No significant between-group difference was found related to the step length (p = 0.344, η² = 0.076).SignificanceCarrying a front load during walking significantly alters the trunk orientation and may change the COM-BOS kinematic relationship and, therefore, fall risk. The findings could inform the design of future studies focusing on the impact of anterior load carriage on fall risk during different locomotion.     

多元化联合教学模式在超声引导下疼痛介入治疗中的应用

目的探讨多元化联合教学模式在超声引导下疼痛介入治疗教学中的应用效果。方法选择2018年1月至2020年12月在北京大学第三医院疼痛科进修的30名医师作为研究对象,将其分为对照组与观察组;对照组采用常规教学模式;观察组采用多元化联合教学模式,比较两组医师技能考核成绩、教学质量评分和满意度评分。结果观察组医师技能考核成绩优良率为93.3%,高于对照组的73.3%(P<0.05);观察组医师对基础理论知识掌握、临床思维能力的提高、学习兴趣的激发、疾病诊治能力的提高4个方面的评分均高于对照组(P<0.01)。结论多元化联合教学模式可促进超声引导下疼痛介入治疗技能的提高,有利于提高学员的综合临床能力。     

Unique Diagnosis of Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) at the Time of First-Trimester Ultrasound Imaging

BackgroundObstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is usually diagnose during adolescence due to pain-related symptoms; however, this syndrome can go unrecognized for several years, and unique presentations may occur later in life.CaseWe describe a 24-year-old-woman diagnosed with previously unknown OHVIRA syndrome and a 7-week intrauterine pregnancy in the obstructed side by the unique ultrasound image obtained during routine first-trimester ultrasonography. The patient was managed with single-stage vaginoplasty, and the rest of the pregnancy were uneventful.Summary and ConclusionThis report is unique in terms of showing that the pregnancy could develop in the uterine cavity on the side of the obstruction despite the blind hemivagina.     

Functional balance assessment in recreational college-aged individuals with a concussion history

Objectives

Despite evidence for increased musculoskeletal injury after concussion recovery, there is a lack of dynamic balance assessments that could inform management and research into this increased injury risk post-concussion. Our purpose was to identify tandem gait dynamic balance deficits in recreational athletes with a concussion history within the past 18-months compared to matched controls.

No evidence for the need of a routine renal transplant ultrasound after elective transplant ureteric stent removal—A retrospective cohort study

Transplant ureteric stent insertion reduces the incidence of MUCs, but it is not known whether routine PSRGU is needed to detect unmasked MUCs. This study evaluated whether routine PSRGU in the pRTR is a useful tool to identify MUCs before they become clinically apparent. A retrospective analysis was undertaken of the clinical outcomes following elective stent removal from pediatric kidney‐only transplant recipients at two London centers between 2012 and 2016. Our policy was to perform PSRGU either routinely or urgently if there were concerning symptoms or biochemical evidence of renal allograft dysfunction. Elective stent removal was performed in 86% (97 of 113 pRTR), and 75 (77%) of whom had routine PSRGU at a median (IQR) of 6 (2‐8) days after stent removal. There were changes to management in 3 (4%) of pRTR with PSRGU identifying no MUC. Nineteen patients (25%) had urgent PSRGU, most commonly due to renal allograft dysfunction, at a median (IQR) of 5.5 (2.7‐12.3) days after stent removal. Of these, two pRTR required ureteric intervention. For our current practice of removing transplant stents at 4‐6 weeks post‐transplantation, our study has found no evidence to support routine PSRGU after elective stent removal.     

胎儿小脑蚓部不同超声纹理特征与胎儿畸形关系的初探郭永华 肖宝军

目的：总结后颅窝正常和异常的胎儿小脑及小脑蚓部的矢状面的声像学特征,了解小脑细微结构的改变与胎儿畸形的关系。