测量并分析上楼梯过程中下肢关节角变化

目的获取上楼梯运动过程中国人下肢关节活动范围的统计学数据,从而为大屈曲度人工关节设计提供依据。方法设计常规楼梯实验装置,利用运动捕捉系统(Optotrak Certus,NDI)和三维测力台(AMTI,Bertec),建立系统地测量上楼梯过程中下肢运动的方法,并应用此方法对40例样本进行测量。结果计算获得了40例样本在上楼梯过程中,髋关节、膝关节及踝关节在1个运动周期内沿各方向上关节角的变化规律及活动范围,其中髋、膝、踝关节在矢状面上活动范围分别是-1.6°～66.7°,0°～91.4°,-20.8°～22.4°。结论上楼梯运动过程中,髋、膝、踝关节在矢状面上活动度最大,且髋关节和膝关节屈曲度最大。与水平路面上正常行走和慢跑运动中关节运动范围比较,上楼梯运动中,髋关节和膝关节在矢状面上运动范围均较大。     

足部跖趾关节约束对人体步态稳定性的影响

目的 研究足部跖趾关节约束对人体步态稳定性的影响。 方法 在水平湿滑试验台上进行足部跖趾关节有、无约束两种状态下的步态实验,分析时空步态参数、运动学参数、动力学参数以及利用摩擦因数( utilization coefficient of friction,UCOF)差异。 结果 跖趾关节有约束状态下,人体行走平均步速减小 50 mm/ s,跨步长度缩小0. 22 m,双支撑相时间缩短 70 ms;跖趾关节约束会使髋、膝关节在矢状面内的活动范围显著增大,而踝关节活动范围减小。 同时,跖趾关节约束状态 UCOF 幅值是无约束状态的 1. 15 倍,表明人体滑跌的概率增大以及行走不稳定性增加。 结论 足部跖趾关节约束会降低行走稳定性。 研究结果为足部趾屈运动康复设备的研发提供数据和理论支持     

坡面步行中青年女性下肢关节角及肌肉激活度

目的通过定量分析关节角及主要肌肉激活度的变化来说明步行速度和路面坡度对下肢运动的影响。方法首先按由慢到快选择了共5种步行速度,由低到高选择3种坡度,并利用运动捕捉系统对15各青年女性的步态进行测量,同时对影响下肢运动的8块主要肌肉的肌电信号进行了采集。然后通过计算分析获得她们在不同步行速度和路面坡度下髋、膝及踝关节矢状面的关节角度变化的均值,从测量数据中寻找出一个最接近这个均值曲线的研究对象。结果计算获得了该研究对象不同步行速度和路面坡度下踝关节、膝关节及髋关节在一个步态周期内的矢状面关节角的变化曲线以及主要肌肉的激活度变化曲线。结论每个步态周期内,关节角及肌肉激活度在5种不同速度下的变化很小;而在3种不同路面坡度下的变化仅趋势基本一致,峰值的差异却非常明显。     

基于矢量编码技术研究功能性踝关节不稳者下肢协调性和变异性

目的 探索功能性踝关节不稳(functional ankle instability, FAI)人群在地面行走时的下肢协调性和协调变异性。 方法 12 名右侧 FAI 男性受试者(FAI 组)及配对招募 15 名健康男性受试者(对照组),以自选速度在地面上行走,运用 Qualisys 红外高速光学运动捕捉系统采集 5 min 步行的运动学数据,运用 Matlab 软件自编代码计算下肢关节间的耦合角及耦合角标准差。 耦合角采用圆形分布资料统计,耦合角标准差采用独立样本 t 检验。 使用Cohen’s d 评价效应量。 结果 FAI 组髋-膝关节矢状面耦合角在步态支撑中期前 1 / 2 和摆动期最后 1 / 4 均大于对照组;FAI 组髋-踝关节矢状面耦合角在支撑末期前 1 / 2 也大于对照组;膝-踝关节矢状面耦合角在支撑中期后 1 / 2和支撑末期前 1 / 2 均小于对照组。 FAI 组髋-踝关节冠状面耦合角在承重期 FAI 组比及摆动期最后 1 / 4 小于对照组。 在支撑末期及预摆期,FAI 组髋-踝关节冠状面和膝-踝关节矢状面耦合角标准差大于对照组。 结论 FAI 患者与正常人群的步态模式存在差异。 协调模式表现为某种代偿保护策略。 支撑末期及预摆期较大的协调变异性提示 FAI 患者踝关节感觉知觉的变化使髋、膝、踝关节的运动控制发生适应性变化     

衰弱状态和步行速度对老年人下肢关节运动学特征的影响

目的 研究衰弱状态和步行速度对老年人步行时下肢关节运动学特征的影响。 方法 招募 59 名 60 岁及以上老年人,根据衰弱指数清单将受试者分为非衰弱组、衰弱前组和衰弱组,采用 Xsens MVN 运动捕捉惯性传感器采集 3 组老年人慢速、习惯速度、快速行走时的运动学数据,应用双因素重复测量方差分析比较不同衰弱状态和步速下老年人行走时的下肢关节运动学特征差异。 结果 衰弱组老年人的年龄显著高于非衰弱组(P<0. 01),膝关节最大屈角、膝关节和踝关节活动范围(range of motion,ROM)显著低于非衰弱组和衰弱前组(P<0. 05);同时,衰弱组老年人踝关节最大跖屈角显著低于非衰弱组(P<0. 05);随着步速增加,衰弱组老年人的单支撑相时间显著增加(P<0. 05),3 组老年人髋关节矢状面最大角及其 ROM、膝关节最大屈角、踝关节最大跖屈角及其 ROM 显著增加(P<0.05),双支撑相时间、踝关节最大背屈角度和膝关节 ROM 显著减小(P<0. 05);所有关节角度中只有髋关节最大伸角及其 ROM、膝关节最大屈角在慢速与习惯速度之间出现显著差异(P<0. 05)。 相关性分析显示,衰弱前组和衰弱组老年人不同速度步行时髋、膝关节 ROM 均显著正相关(P<0. 01),衰弱组老年人在习惯速度和快速行走时膝、踝关节 ROM 显著正相关(P<0. 05)。 结论 随着衰弱程度的进展,老年人下肢关节矢状面角度持续降低,主要集中于膝、踝关节。 在行走时两个关节间同步性增强,自由度降低,但在提高步行速度时,衰弱状态基本不影响老年人的步行策略。 研究结果有助于对衰弱老年人群进行筛查及康复指导。     

基于视频图像边缘检测的人体下肢运动步态

背景：步态规律主要应用人体行走的运动学、动力学等参数进行描述。目前在运动医学、康复工程和仿生学等领域,步态分析可为确定疾病诊断、康复和治疗方案提供重要依据。 目的：应用基于人体运动图像的测量装置系统,采集人体在跑步机上行走的下肢运动步态视频,分析人体步态运动规律。 方法：采用基于双摄影机的人体运动图像捕捉系统,在人体的左右髋关节、膝关节、踝关节及脚板设置标识点,对人体在跑步机上行走的下肢运动步态视频进行采集。应用图像边缘检测的原理,对测量数据进行了图像处理和分析,得到人体正常步速行走时,左右大腿与竖直方向夹角、小腿与竖直方向夹角、脚板与竖直方向夹角及膝关节、踝关节标识点的关节角度变化规律。 结果与结论：基于视频图像边缘检测人体下肢的运动步态,成本相对低廉,数据误差较小,精度与进口设备较接近。应用该测量结果初步构建了人体步态行走数据库,为建立步态评定标准、异常步态判别以及进一步的康复治疗提供了依据。     

基于局部欧拉角的下肢关节运动仿真模拟

目的 探讨局部欧拉角在下肢关节运动仿真模拟中的参数及效果.方法 下肢CT数据1套,分割并重建出髋骨、股骨、髌骨、胫骨、腓骨及足骨.将重建骨骼导入3DSMax中进行平滑、优化、轴转置等处理.将处理好的模型导入Unity3D中,结合局部欧拉角对髋、膝、踝和跖趾关节进行仿真模拟,对脚本进行测试并对相关参数进行调整.发布调整后的文件形成可执行文件.结果 髋关节、膝关节、踝关节和跖趾关节运动符合实际情况并且不超出真实运动的范围(髋关节屈伸-170°～170°,展收-30°～80°,旋内外-40°～60°,膝关节屈伸0°～140°,踝关节屈伸-60°～ 55°,内外翻-30° ～ 20°,跖趾关节屈伸-40～30度).结论 Unity3D中局部欧拉角及"父子关系"继承可适应下肢关节真实运动幅度和关系.     

基于局部欧拉角的下肢关节运动仿真模拟

目的 探讨局部欧拉角在下肢关节运动仿真模拟中的参数及效果.方法 下肢CT数据1套,分割并重建出髋骨、股骨、髌骨、胫骨、腓骨及足骨.将重建骨骼导入3DSMax中进行平滑、优化、轴转置等处理.将处理好的模型导入Unity3D中,结合局部欧拉角对髋、膝、踝和跖趾关节进行仿真模拟,对脚本进行测试并对相关参数进行调整.发布调整后的文件形成可执行文件.结果 髋关节、膝关节、踝关节和跖趾关节运动符合实际情况并且不超出真实运动的范围(髋关节屈伸-170°～170°,展收-30°～80°,旋内外-40°～60°,膝关节屈伸0°～140°,踝关节屈伸-60°～ 55°,内外翻-30° ～ 20°,跖趾关节屈伸-40～30度).结论 Unity3D中局部欧拉角及"父子关系"继承可适应下肢关节真实运动幅度和关系.     

痉挛型脑瘫患者功能性选择性脊神经后根切断术前后的三维步态特征分析

目的分析痉挛型脑瘫患者功能性选择性脊神经后根切断(functional selective posterior rhizotomy,FSPR)手术前后的步态特征,客观量化评估手术疗效。方法选取15名将要进行FSPR手术治疗的痉挛型脑瘫患者,应用VICON三维运动捕捉系统结合AMTI三维测力台对患者进行手术前后的步态采集,分析手术前后步态的时空、运动学及动力学参数。结果手术后,左、右支撑时间均大于手术前,左侧步长明显大于手术前,步高、步速及冠状面重心偏移均小于手术前;着地时的膝关节矢状面角度(即屈伸角度)出现明显提高,髋、踝关节未见明显差异。手术后,步行过程中左右侧髋、膝、踝关节活动范围(range of motion,ROM)在矢状面均出现不同程度的提高,且有统计学差异;右踝关节冠状面ROM也出现明显提高。手术后,右膝关节最小屈曲角度及左、右踝关节最大跖屈角度均出现显著减小;左、右侧支撑相最大垂直力较手术前明显提高,而下肢关节力矩未见明显差异。结论三维步态分析可以在一定程度上评估痉挛型脑瘫患者FSPR手术的疗效。术后痉挛型脑瘫患者的痉挛得到缓解,对步态的时空参数及下肢关节运动学参数改善比较明显,而对于动力学参数改善相对不明显,需进行进一步康复治疗。     

一种多自由度踝关节假肢的设计

为了适应不同的运动环境,设计了一款多自由度智能踝关节假肢.假肢具有球形踝关节结构,在运动过程中能实现矢状面和冠状面的自由运动,与配套控制系统共同作用,增加使用者的运动灵活性和稳定性,减少运动过程中的能量损耗,及时调整异常步态、步行速度、步幅等,辅助下肢截肢者自由行走.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

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 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.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'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 in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

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.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.