Adaptive optimal tracking control for multi-joint manipulator on space robot

This paper aims to address the tracking control problem for the multi-joint manipulator on a space robot subject to model uncertainties and external disturbances. A Gauss-Newton interactive optimization algorithm is used to obtain the desired joint angle for each joint. In order to formulate the optimization problem, the Denaait-Hartenberg (D-H) method is employed to describe the model of the multi-joint manipulator. Subsequently, an adaptive controller is developed to achieve tracking control, where controller parameters updated in real time are introduced to handle the nondeterminacy of the multi-joint manipulator. Moreover, a fuzzy control strategy is composed such that our designed controller is robust against the complex environment as well. The controller design is performed by means of the Lyapunov techniques. Meanwhile, its effectiveness is verified through numerical simulations. Finally, some concluding remarks close the paper.     

Nonremission and Recurrent Tumor-Induced Osteomalacia: A Retrospective Study

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome. It is curable by excision of the causative tumor. However, a few cases may persist or relapse after tumor resection. We aimed to investigate the rate of these events and related factors. We retrospectively studied TIO patients treated with surgery in a tertiary hospital. TIO was established based on a pathologic examination or the reversion of hypophosphatemia. Refractory TIO patients consisted of those with nonremission or recurrent hypophosphatemia after surgery. A total of 230 patients were confirmed as having TIO. After primary surgery, 26 (11.3%) cases persisted, and 16 (7.0%) cases recurred. The overall refractory rate was 18.3%. The median time of recurrence was 33 months. Compared with patients in the recovery group, patients in the refractory group were more likely to be female (59.5% versus 41.0%, p = .029) and have a lower serum phosphate level (0.44 ± 0.13 versus 0.50 ± 0.11 mmol/L, p = .002). The refractory rate was lowest in head/neck tumors (7.5%) and highest in spine tumors (77.8%). Regarding the tissue involved of tumor location, the refractory rate was higher in tumors involving bone than tumors involving soft tissue (32.7% versus 7.0%, p < .001). The outcomes of malignant tumors were worse than those of benign tumors (p < .001): nonremission rate, 21.4% versus 9.7%; recurrence rate, 28.6% versus 6.5%. In the multivariate regression analysis, female sex, spine tumors, bone tissue-involved tumors, malignancy, and low preoperation serum phosphorus levels were identified as risk factors for refractory outcomes. High preoperative fibroblast growth factor 23 (FGF23) levels were also associated with refractory after adjusting for involving tissue and tumor malignancy. In summary, we are the first to report the rate and clinical characteristics of refractory TIO in a large cohort. For patients with multiple risk factors, especially spine tumors, clinical practitioners should be aware of a poor surgical prognosis. © 2019 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.     

Changes in corneal innervation and pain responses in fungal keratitis

AIM: To characterize changes in the cornea nerve and pain responses in fungal keratitis (FK). METHODS: A retrospective analysis of in vivo confocal microscopy images of 11 FK corneas was performed, and the results were compared with those for 11 normal corneas. Subbasal corneal nerves were analyzed for total nerve number, main nerve trunk number, branching patterns and tortuosity. C57BL/6 mice were infected with Aspergillus fumigatus. Disease severity was determined through clinical scoring and slit lamp photography. Corneas were harvested at 1, 3, 5, and 7d post infection (p.i.) and assessed for β III tubulin. Corneal mechanical sensitivity thresholds were detected by von Frey test. β-endorphin (β-EP) and μ receptor protein expression was detected through Western blotting. RESULTS: Total nerve number, main nerve trunk number, and nerve branching were significantly lower in FK patients than in controls, but tortuosity was not significantly different. In infected mice, subbasal nerve density decreased from 1d p.i., reaching a minimum at 5d p.i. Clinical scores rose at 1d p.i., peaked at 3d p.i., and decreased at 5d p.i. Mechanical sensitivity thresholds showed the same trends. β-EP and μ receptor protein expression increased after infection. CONCLUSION: Corneal nerve density is lower in FK patients and Aspergillus fumigatus-infected mice than in controls. Pain sensitivity decreases with postinfection corneal ulcer aggravation. β-EP and μ receptor proteins are both upregulated in infected mouse corneas.     

两种麻醉方法在老年患者髋关节部位手术中应用比较

目的对比腰硬联合麻醉和全身麻醉用于老年患者髋关节部位手术的影响。方法选择髋关节部位手术老年患者40例,随机分成腰硬联合麻醉组和全身麻醉组各20例,观察麻醉前后、手术开始前后、手术中、手术后的血压（收缩压）、动脉血氧分压和心率的变化,以及手术后的患者转归。结果两组均能完成手术,全身麻醉组麻醉前后血流动力学变化、血氧变化大于腰硬联合麻醉组,手术中腰硬联合麻醉组变化大于全身麻醉组,全身麻醉组手术后并发症多于腰硬联合麻醉组。结论全身麻醉有利于手术中血流动力学管理,腰硬联合麻醉有利于手术后患者恢复。     

五味子宁神口服液抗紫外辐射作用研究

目的：研究五味子宁神口服液对3T3细胞紫外辐射损伤的保护作用.方法：建立3T3细胞紫外辐射模型,采用流式细胞术检测高、中、低剂量组（12.5,25.0,50.0 mg·ml-1）五味子宁神口服液作用前后细胞内活性氧浓度的变化,检测胞质匀浆中的超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH--Px）和过氧化氢酶（CAT）活性以及丙二醛（MDA）含量变化.结果：与中波紫外线辐射组（UVB组）比较,高、中、低剂量组五味子宁神口服液的活性氧含量和MDA含量显著降低（P＜0.01）,SOD、CAT和GSH-Px活性显著升高（P＜0.01或0.05）.结论：五味子宁神口服液能提高SOD、CAT、GSH-Px等酶活性,降低活性氧和MDA含量,对UVB辐射造成的细胞损伤具有保护作用.     

基于基因型检测的药学干预对住院患者应用华法林疗效和安全性的影响

目的：探讨基于基因型检测的药学干预对住院患者应用华法林疗效和安全性的影响。方法收集2013年6月至2014年3月在北京大学第一医院住院并根据细胞色素P450（CYP）2C9＊2、CYP2C9＊3、维生素K环氧化物还原酶复合物1（VKORC1）G-1639A基因型检测结果调整华法林剂量患者（试验组）和2012年6至12月应用华法林但未进行基因型检测患者（对照组）的病历资料进行回顾性分析,比较2组患者的住院时间、服用华法林时间、国际标准化比值（ INR）曾出现≥3.0者占比、华法林相关出血发生率、出院时INR和出院时华法林剂量,对试验组患者分析出院时华法林剂量与临床药师给予的华法林建议剂量的相关性,并分析试验组患者上述指标与基因型的相关性。结果试验组102例,男性62例,女性40例,年龄14-88岁,平均（63±16）岁。对照组140例,男性89例,女性51例,年龄21-85岁,平均（64±13）岁。原发疾病包括心房颤动、深静脉血栓、肺栓塞和肾静脉血栓等。2组患者年龄和性别分布差异均无统计学意义。试验组平均住院时间和服用华法林时间明显长于对照组[（16.7±8.4）d比（12.6±6.0）d,（13.2±8.2）d比（9.9±6.1）d,均P＆lt;0.001]。2组中INR≥3.0者占比、华法林相关出血发生率、出院时INR的差异均无统计学意义。试验组携带CYP2C9＊1/＊3者（7例）出院时华法林剂量低于携带CYP2C9＊1/＊1者（95例）[（1.79±0.57）mg/d比（3.12±1.13）mg/d,P=0.003];携带VKORC1-1639 GG者（1例）和VKORC1-1639GA者（20例）出院时华法林剂量均高于携带VKORC1-1639AA者（81例）[6.00、（3.55±1.63）mg/d 比（2.87±0.92） mg/d,P=0.002]。试验组INR≥3.0者住院时间和服用华法林时间均多于INR＆lt;3.0者[（24.7±10.9）d比（15.2±6.9）d,（21.8±10.9）d比（11.6±6.4）d,均P＆lt;0.001],出院时华法林剂量低于INR＆lt;3.0者[（2.50±1.02）mg/     

多药耐药基因多态性与心脏移植术后环孢素肾毒性的相关性分析

目的：探讨多药耐药（ MDR1）基因多态性与心脏移植术后患者环孢素（ CsA）治疗所致肾损害的相关性。方法选取2004年1月至2012年12月在首都医科大学附属北京安贞医院行心脏移植术、术后应用含CsA的免疫抑制方案治疗并至少随访12个月的患者作为研究对象,根据CsA治疗后是否出现肾损害分为肾损害组和无肾损害组。应用患者心脏移植术后检测CsA全血浓度时留取血样提取白细胞基因组DNA。根据HapMap数据库提供的位点信息,采用基质辅助激光解析电离飞行时间质谱（ MALDI-TOF MS）技术测定MDR1基因16个标签SNP位点的基因型和等位基因频率。应用dbSNP数据库进行SNP位点等位基因频率的比对,应用非条件性二元Logistic回归分析方法分析SNP多态性与CsA所致肾损害的相关性。结果共入选65例患者。肾损害组19例,男性17例,女性2例;年龄18-59（44±13）岁。无肾损害组46例,男性39例,女性7例;年龄14-71（42±15）岁。2组患者年龄、性别分布差异均无统计学意义（均P〉0.05）。MALDI-TOF MS检测获得的2组患者16个tag SNP位点的等位基因频率与dbSNP数据库数据比较以及2组之间比较,差异均无统计学意义（均P〉0.05）。经非条件性二元Logistic回归分析,MDR1基因16个Tag SNP位点的基因型频率与肾损害组患者CsA肾毒性的发生无明显相关性。结论 MDR1基因多态性与心脏移植受者CsA治疗所致肾损害无明显相关性。     

首发脑卒中患者抑郁危险因素及生存质量分析

目的 探讨脑卒中患者抑郁危险因素,对患者生存质量进行分析.方法 300例脑卒中患者分为抑郁组和非抑郁组,对危险因素和患者生存质量进行分析.结果 ≥45岁患者汉密顿抑郁量表（HAMD）评分为（21.28 ±6.01）分,高于＜45岁患者[（16.09±4.15）分,t=3.64,P=0.02];医疗负担由轻到重依次为（12.53 ±2.96）分、（16.11 ±3.42）分和（24.39±6.11）分（=4.02,P=0.01）.患者有无合并症HAMD评分差异有统计学意义（t=3.96,P=0.01）.对患者抑郁影响因素进行Logistic回归分析,与年龄、医疗负担、合并症和神经功能缺损程度等相关影响因素有关（OR=1.26、1.19、1.24、1.12,P=0.02、0.01、0.01）.抑郁组巴氏指数、简式评分法和神经功能缺损程度分别为（57.19 ±6.27）分、（59.28 ±5.92）分和（21.52 ±4.63）分,与非抑郁组比较,差异有统计学意义（t=4.87、5.46、3.29,P=0.01、0.01、0.02）.结论 首发脑卒中患者抑郁影响因素与年龄、医疗负担、合并症和神经功能缺损程度等有关,抑郁组的生活质量明显低于非抑郁组.     

调节自噬提高人肝癌Bel-7402/FU细胞株对5-氟尿嘧啶的敏感性

目的：探讨细胞自噬对肝癌Bel-7402／FU细胞5-氟尿嘧啶敏感性的影响。方法：选取Bel-7402、Bel-7402／FU细胞株,分为对照组、5-氟尿嘧啶组、自噬抑制剂3-甲基腺苷组以及5-氟尿嘧啶＋3-甲基腺苷组,MTT法了解抑制细胞自噬对肝癌5-氟尿嘧啶IC50值的影响;流式细胞术检测抑制细胞自噬对细胞凋亡的影响;GFP-LC3质粒转染观察细胞浆中GFP-LC3分布情况。结果：Bel-7402细胞株与Bel-7402／FU细胞株5-氟尿嘧啶IC50值分别为4．66、68．14μg／mL,凋亡率分别为13．809／6、1.09％。3-甲基腺苷联合5-氟尿嘧啶作用后Bel-7402细胞株与Bel-7402／FU细胞株的氟尿嘧啶IC50值分别为4．31、29．44μg／mL,凋亡率分别为13．82％、6．86％。在3-甲基腺苷作用下,Bel-7402／5-FU细胞株5-氟尿嘧啶诱导的点状样GFP-LC3的细胞数量减少。结论：抑制细胞自噬可降低Bel-7402／FU对5-氟尿嘧啶IC50值,诱导细胞凋亡,从而有效地逆转Bel-7402／FU对5-氟尿嘧啶耐药。     

地西他滨治疗骨髓增生异常综合征和急性髓细胞白血病临床观察

目的探讨地西他滨治疗骨髓增生异常综合征（MDS）和急性髓细胞白血病（AML）的临床疗效和安全性。方法收集2011年1月至2013年7月接受地西他滨[15mg／（m2·d）,第1—5天,静脉滴注持续1h以上1单药或联合CAGf阿糖胞苷（Ara-C）、阿克拉霉素（Acla）、粒细胞集落刺激因子（G-CSF）]方案治疗的20例MDS和AML患者的临床资料,评价其疗效和不良反应。结果20例患者中完全缓解（CR）4例,部分缓解（PR）8例,稳定（SD）及进展（PD）8例,总有效率为60．0％（12／20）。其中12例AML患者中CR2例,PR5例,总有效率为58.3％（7／12）,8例MDS患者中CR2例,PR3例,总有效率为62．5％（5／8）。1例MDS．难治性贫血伴环状铁粒幼细胞患者和2例慢性粒一单核细胞性白血病患者输血依赖情况有所改善。14例患者出现Ⅲ－Ⅳ度骨髓受抑,发生率为70．O％（14／20）。总感染率为35．0％（7,20）,其中肺部感染率为20．0％（4／20）,患者经积极抗感染、刺激造血及输血等支持治疗后感染控制。1例患者出现化疗相关死亡。20例患者均未出现严重肝功能损害及出血。结论地西他滨单药或联合CAG方案治疗MDS和AML有一定疗效,可廷缓疾病进展;患者对化疗不良反应均能耐受．且化疗相关病死率低。