索控式中央驱动上肢康复机器人

目的根据居家康复的要求与趋势,针对国内外上肢康复机器人体积庞大、传动链复杂以及驱动噪声大的缺点,设计了一款索控式中央驱动上肢康复机器人。方法首先采用钢丝绳和同步带组成的传动系统进行动力传递,并采用中央驱动式设计,即将电机驱动设备统一安置于远离患者的底座上;然后通过Solidworks建立三维模型,并设计动力传递系统的总体方案;最后通过Solidworks中的Motion模块对机器人肩关节屈曲/伸展运动、肩关节内收/外展运动、肘关节屈曲/伸展运动以及肩肘关节联动运动进行运动学仿真,验证所设计的上肢康复机器人机械臂结构的合理性及设定轨迹的可行性。结果肩关节、肘关节以及腕关节运动学仿真曲线证实了该上肢康复机器人能够平稳地完成规划的轨迹动作,从而验证了机械结构设计合理,方案可行。结论索控式中央驱动上肢康复机器人具有动力传递系统轻便以及结构简单的优点,可以协助患者完成各种康复运动。     

可穿戴上肢康复机器人的设计及其运动仿真和动力学分析

目的针对目前台式上肢康复机器人体积庞大、不便移动的缺点,设计了一款新型的可穿戴式上肢康复机器人,并通过对其运动特性的分析和关节力矩的计算,验证设计的合理性。方法首先,根据模块化设计原理,进行总体结构设计;然后,利用SOILDWORKS进行三维建模,并运用SOILDWORKS Motion对机器人肘关节屈曲/伸展运动、肩关节屈曲/伸展运动、肩肘关节联动运动进行运动仿真;最后,基于拉格朗日方法建立系统的动力学方程,并应用MATLAB软件计算得到机械臂关节力矩的变化曲线。结果仿真结果证实了肩关节、肘关节、腕关节运动仿真曲线平滑,动力学分析证实关节力矩变化曲线平滑且最大关节力矩均小于电机经减速后输出的额定转矩。结论该可穿戴式上肢康复机器人设计合理,为后续上肢康复机器人的研究奠定了理论基础。     

基于光学运动捕捉的上肢康复机器人可用性测试研究

目的对一款上肢康复机器人进行可用性测试研究,验证其安全性、有效性和舒适性,并提出改进设计的意见。方法运用光学式运动捕捉系统采集受试者进行康复训练时的角度数据,再对受试者进行主观问卷调查。结果快速上肢评估量表结果显示上肢康复机器人配置相对合适,但需要进一步深入研究。角度数据在肩关节内收外展运动和肘关节屈伸运动上表现出显著相关性,而在腕关节数据的统计结果上表现出无相关性。主观问卷调查总得分表明上肢康复机器人舒适性总体上是令人满意的,但在手臂固定装置的舒适性、训练过程中肌肉拉伸程度和座位高度设置的问题上存在设计不合理。结论运用光学式运动捕捉系统可以定量评价上肢康复机器人的性能,对康复机器人的设计及改进具有重要意义。     

MPU6050在评定人体上肢关节角度中的应用

该文开发了一套上肢康复评定仪器,用于评定肘关节及肩关节的关节活动度。该仪器包括下位机硬件和上位机评定软件,通过MPU6050传感器采集关节运动的加速度和角速度信号,并将数据经蓝牙串口传输至上位机评定软件。该仪器实现了实时评定上肢关节的运动参数,并能动态显示上肢关节运动状态。对仪器进行可靠性测试,组内相关系数均大于0.6,说明该仪器具有良好的可靠性,能准确地输出患者关节运动角度,对临床上制定合理的康复训练计划有重要意义。     

基于Kinect的上肢康复训练系统开发与应用

脑卒中等心脑血管疾病导致的上肢功能障碍严重影响了患者的生活质量。为帮助患者在社区家庭环境进行上肢康复训练,开发了基于Kinect的上肢康复训练系统。系统通过人体关节点数据与场景中对象模型的绑定实现了患者运动与虚拟模型运动的同步,利用体感方式实现与训练场景的动态交互。系统设计了分别用于肩、肘关节及上肢综合能力的康复训练项目,选取8名志愿者分两组（计算机辅助组和专业治疗师组）对系统进行功能测试,并对治疗前后患者的运动表现进行评定（Fugl-Meyer上肢运动功能评估和Wolf 运动功能的测试）。经过2周的治疗后,两组患者Fugl-Meyer上肢运动功能评分及Wolf 运动功能测试评定结果均较治疗前有明显进步,且计算机辅助组患者进步幅度大于专业治疗师组。以上实验结果表明,该系统对提高患者肩、肘关节活动度及上肢综合能力具有潜在的效果,可用于上肢运动功能的康复训练。     

基于多传感器信息的新型穿戴式上肢外骨骼康复机器人

目的 设计基于多传感器信息的新型穿戴式上肢外骨骼康复机器人,以解决上肢外骨骼康复机器人便携性不佳、患者参与度较低、训练模式自适应不足等问题,并探究受试者穿戴外骨骼时肌肉激活程度、肌电信号预测关节角度的准确性以及实现上肢康复训练的可行性.方法 该设备机械结构包括肘关节和腕关节,采用模块化设计并结合3D打印技术;控制系统包括肌电采集、应力采集、姿态采集等单元,并设计主动、被动和助动三种训练模式.受试者穿戴外骨骼机器人后进行屈-伸肘实验,对比有、无辅助力时手臂肌肉激活程度;分析肘关节角度,并对比肌电信号预测的关节运动角度;验证机器人运行性能与应力检测效果.结果 受试者穿戴外骨骼康复机器人安全可靠地完成了屈-伸肘动作,受试者肱二头肌、肱三头肌肌肉激活程度在有、无辅助力时分别减弱约32％、11％,肌电信号预测关节角度准确度约95％,应力测量值误差均低于5％.结论 上肢外骨骼机器人可以给人体提供辅助力、预测关节角度,机器人通过肌电、应力以及位置信息辅助患者实现上肢康复训练具有可行性.     

具备力传感监测的上肢外骨骼康复系统的设计与实现

目的 近年来,外骨骼机器人正逐渐走入临床康复实践,自由度、运动模式和力反馈评价是影响外骨骼机器人康复效果的重要因素,实验设计并实现了多抗阻训练模式的上肢外骨骼康复系统,该系统具备6个自由度并可全程跟踪用户与外骨骼间的接触力。方法 通过人体上肢运动学分析,对上肢外骨骼康复系统的关节和自由度进行设计,主要由配重箱体、升降台、横梁、外骨骼机械臂组成;考虑不同体型患者要求,配置可调节长度导轨;硬件系统采用主控板、节点板的分层控制方法;软件系统使用模块化设计。在上肢外骨骼康复系统与人体接触处设置多个三维力传感器。使用角度和力传感器对上肢外骨骼康复系统的运动角度空间、疲劳测试下控制稳定度及主、被动模式下的接触力分布进行分析。最终征募17例受试者进行肩关节的伸展运动,采集不同阻抗等级下的力传感器数据,并进行主观体验问卷调查。结果 上肢外骨骼康复系统工作空间角度幅值与设计要求相同,误差小于5%;连续工作4 h情况下,运动角速度变化率不超过1%。主动运动模式下,17例受试者人机接触力男性测量值（23.63±5.26） N,女性（21.54±5.16） N;人机接触力较小,其中15例受试者给出了舒适度较高...     

脑卒中患者上肢康复机器人及评价方法综述

利用机器人技术进行上肢康复训练是脑卒中患者进行康复治疗的重要手段之一。本文根据中枢神经系统具有高度的可塑性,分析了机器人辅助康复训练的理论依据。并且依据康复机器人的社会需求和研究意义,归纳总结了5种上肢康复机器人的研究进展和研究成果,其中包括上肢康复机器人、功能性电刺激辅助上肢康复机器人、基于虚拟现实技术的上肢康复机器人、基于sEMG的上肢康复训练机器人、基于BCI上肢康复训练机器人。为完善康复机器人的功能,实现对脑卒中患者上肢运动功能的量化评估,本文还分析了目前临床上常用的几种评价方法,即Brunnstrom等级评价法、Fugl?Meyer量表评价法、上田敏评价法和Bobath评价法。最后分析了上肢康复机器人在机械设计、控制策略和评价方法等方面的发展趋势。     

人体肩关节运动功能康复评估研究

目的针对上肢运动功能障碍患者康复治疗中,常规康复评价方法繁琐费时的问题,探讨人体肩关节运动功能康复评价的新方法。方法选取20名健康志愿者,利用上肢多关节复合运动训练系统(multi-joint system,MJS)进行上肢运动功能评价实验,并对肩关节运动功能评价参数进行统计。选取在临床进行康复治疗的20例偏瘫患者作为常规评价组,采用上肢Fugl-Meyer评分(Fugl-Meyerassessment,FMA)评定患者的上肢运动功能,并对上肢运动功能评分的参数数据进行统计分析。结果在健康人MJS运动功能评价实验中,经参数间的相关性分析,统计无显著意义(P005)。在多元逐步回归分析时,只引进了水平外展活动度,差异有统计学意义(P005)。在对偏瘫患者上肢运动功能的评估数据分析中,在多元逐步回归分析时,只引进了水平外展活动度,差异有统计学意义(P005)。结论肩关节外展活动度对肩关节运动评估等级划分和上肢FMA评分影响最大。     

摆幅可调型足部康复机器人的生物力学特性分析

目的基于人机工程学和生物力学仿真技术,对人体肌肉进行生物学评价,研究摆幅可调型足部康复机器人的康复策略。方法在Any Body中建立人体和摆幅可调型足部康复机器人的人机耦合模型,并对耦合模型进行运动学仿真,将仿真结果与理论计算结果相比,验证耦合模型的可靠性;再利用Any Body中的参数研究机制对验证后的耦合模型进行生物力学仿真,以足部康复机器人的运动速度和摆幅为变量,分析在不同变量组合下的肌肉活动度和肌肉力。结果在康复运动中足部相关肌肉的拉伸性能得到有效训练,不同的运动速度和摆幅对肌肉的影响不同,并得出运动速度和摆幅调节的安全范围。结论实现了不同运动速度和摆幅下肌肉活动度和肌肉力的组合分析,研究结果对足部康复机器人的临床应用和被动康复模式下康复策略的制订具有一定指导意义。     

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.     

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.     

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.     

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.