儿童胃石症9例诊治经验

目的 总结儿童胃石症的临床特点及治疗经验.方法 回顾性分析郑州大学第一附属医院2009年6月至2020年6月收治的9例胃石症患儿临床资料.结果 9例胃石症患儿均为女性,年龄为4～13岁,其中8例有异食癖,1例发病前曾大量进食柿子.7例经内镜检查确诊,1例经CT确诊,1例经消化道造影确诊.4例经内镜取石治疗,5例经外科手术治疗,最终8例确诊为毛发性胃石症,1例为植物性胃石症.随访1～2 a,9例患儿均恢复良好,胃石症未复发,贫血及营养不良状况均有不同程度改善.结论 儿童胃石症常见于女童,多伴有异食癖,一经诊断应及时治疗,首选内镜取石,内镜取出失败可考虑外科手术治疗,治疗效果及患儿预后好.     

Modular hip exoskeleton improves walking function and reduces sedentary time in community-dwelling older adults

Numerous studies showed that postural balance improves through light touch on a stable surface highlighting the importance of haptic information, seemingly downplaying the mechanical contributions of the support. The present study examined the mechanical effects of canes for assisting balance in healthy individuals challenged by standing on a beam. Sixteen participants supported themselves with two canes, one in each hand, and applied minimal, preferred, or maximum force onto the canes. They positioned the canes in the frontal plane or in a tripod configuration. Statistical analysis used a linear mixed model to evaluate the effects on the center of pressure and the center of mass. The canes significantly reduced the variability of the center of pressure and the center of mass to the same level as when standing on the ground. Increasing the exerted force beyond the preferred level yielded no further benefits, although in the preferred force condition, participants exploited the altered mechanics by resting their arms on the canes. The tripod configuration allowed for larger variability of the center of pressure in the task-irrelevant anterior–posterior dimension. High forces had a destabilizing effect on the canes: the displacement of the hand on the cane handle increased with the force. Given this static instability, these results show that using canes can provide not only mechanical benefits but also challenges. From a control perspective, effort can be reduced by resting the arms on the canes and by channeling noise in the task-irrelevant dimensions. However, larger forces exerted onto the canes can also have destabilizing effects and the instability of the canes needs to be counteracted, possibly by arm and shoulder stiffness. Insights into the variety of mechanical effects is important for the design of canes and the instructions of how to use them.