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。     

大黄素-8-O-β-D-葡萄糖苷的体内外遗传毒性评价

目的:评价大黄素-8-O-β-D-葡萄糖苷(EG)的体内外遗传毒性,并比较体外细胞试验及大鼠体内实验评价结果的差异。方法:采用体外二维(2D)、三维(3D)细胞培养法分别构建2D、3D HepaRG细胞模型,造模成功后,分别将2D、3D HepaRG细胞分为空白对照组[0.5%二甲基亚砜(DMSO)]、丝裂霉素C组(阳性对照,0.1μg/mL)和EG低、中、高剂量组(10、50、200μg/mL),然后检测各组HepaRG细胞的微核形成率和尾DNA百分含量。将SD大鼠分为空白对照组(0.5%羧甲基纤维素钠)、甲磺酸乙酯组(阳性对照,200 mg/kg)和EG低、中、高剂量组(100、300、1 000 mg/kg),每组6只,连续灌胃给药15 d,每天1次;15 d后检测各组大鼠骨髓嗜多染红细胞、肝细胞的微核形成率及外周血淋巴细胞、肝细胞的尾DNA百分含量、尾距。结果:在体外2D HepaRG细胞模型中,与空白对照组比较,丝裂霉素C组HepaRG细胞的微核形成率和尾DNA百分含量均显著升高(P<0.01),EG各剂量组HepaRG细胞的微核形成率和尾DNA百分含量差异无统计学意义(P>0.05);在3D HepaRG细胞模型中,与空白对照组比较,丝裂霉素C组HepaRG细胞的微核形成率和尾DNA百分含量均显著升高(P<0.01或P<0.001),EG高剂量组HepaRG细胞的尾DNA百分含量显著升高(P<0.01)。在大鼠体内实验中,与空白对照组比较,甲磺酸乙酯组大鼠骨髓嗜多染红细胞、肝细胞的微核形成率和外周血淋巴细胞、肝细胞的尾DNA百分含量、尾距均显著升高(P<0.01),EG高剂量组大鼠外周血淋巴细胞尾DNA百分含量显著升高(P<0.01),EG各剂量组大鼠骨髓嗜多染红细胞、肝细胞的微核形成率和肝细胞尾DNA百分含量、尾距差异无统计学意义(P>0.05),但随剂量增加有升高趋势。结论:本研究结果提示在2D细胞模型中,EG未导致染色体断裂及DNA损伤,但3D细胞模型长期给药和体内重复给药结果均显示EG存在一定DNA损伤风险,故3D HepaRG细胞模型的评价结果更接近大鼠体内实验结果。     

植入式心律转复除颤器手术前后患者确定感、焦虑与性格乐观状态的研究

目的研究比较植入式心律转复除颤器(ICD)作为心源性猝死的一级预防(primary prevention,PP)和二级预防(secondary prevention,SP),在植入前、植入后1周以及植入后1个月对患者情绪的不同影响。方法选择15例患者应用植入式心律转复除颤器作为心源性猝死的PP,15例患者应用植入式心律转复除颤器作为心源性猝死的SP,应用描述性横断面调查法,利用Mishel-疾病不确定感量表(Mishel’s Uncertainty in Illness Scale,MUIS-C),特质状态焦虑量表(State-Trait Anxiety Inventory,STAI)和生活目标量表(the Life Orientation Test,LOT-R),通过晤谈行半结构访问。结果在植入式心律转复除颤器植入前,两组患者的MUIS-C分值都较高(PP=67.67±13.36;SP=70.27±6.80,P=0.507);LOT-R分值为PP=15.67±3.8,SP=16.47±3.6,P=0.557;STAI分值为PP=37.40±10.0,SP=37.73±13.6,P=0.940。在植入式心律转复除颤器植入后1个月,PP患者的MUIS-C分值明显低于SP患者(PP=62.33±4.17,SP=67.87±4.61,P=0.002)。结论利用植入式心律转复除颤器作为SP的患者护理时更应该引起护士的重视。     

监测中心动脉压对预防颈动脉斑块形成的研究进展

颈动脉斑块能够有效预测心脑血管疾病的发生,故寻找其相关危险因素、防止斑块形成对心脑血管疾病的预防有非同寻常的作用。本文将详细说明颈动脉斑块形成发展过程中各种影响因素及中心动脉压的病理生理特点,两者之间的联系及监测中心动脉压对预防劲动脉斑块形成的意义。     

Healing responses following transverse root fracture: a historical review and case reports showing healing with (a) calcified tissue and (b) dense fibrous connective tissue

Background

The understanding and management of transverse intra‐alveolar root fractures has evolved to its current high level of sophistication and clinical success from foundations laid down by histological studies as early as the mid‐nineteenth century.

Significance

The aim of the review was to highlight those earlier histological reports and studies that have contributed to the current understanding of the biological processes involved in the healing of transverse root fractures. Healing of a transverse root fracture by calcified tissue was demonstrated histologically by Howe in 1926, while Boulger in 1928 showed the two other patterns of root fracture healing, namely the interposition of fibrous connective tissue and the interposition of bone and periodontal ligament around both fractured segments. Other major histological reports around that time came from members of the so‐called ‘The Vienna group of Illinois’, who had a significant influence in the development of oral biology worldwide. Other important reports and an experimental study emanated from Germany and Switzerland in the late 30s and early 40s, followed in the 1950s and early 1960s by histological material principally from Sweden, Denmark, France, the USA and Britain. Jens Andreasen and Erik Hjörting‐Hansen's landmark paper in 1967 included new histological reports and a classification of healing responses following transverse root fractures. The expansion of knowledge related to root fractures since that time has been exponential, with major contributions from Scandinavia and several other countries.

Case reports

Accompanying the historical review are two case reports with histology of root fracture healing by (a) calcified tissue and (b) dense fibrous connective tissue. The role of the pulp and the periodontal ligament in the repair process is described and the clinical significance discussed with particular emphasis to diagnosis and orthodontic management.     

生脉注射液治疗急性心肌梗死后心源性休克的临床研究

目的研究生脉注射液治疗急性心肌梗死后心源性休克的临床疗效。方法选取2015年6月—2016年8月十堰市太和医院治疗的急性心肌梗死后心源性休克患者164例,随机分为对照组和治疗组,每组各82例,对照组给予常规治疗,治疗组在对照组的基础上静脉滴注生脉注射液,60 m L加入5%葡萄糖溶液250~500 m L,1次/d。两组均连续治疗7 d。治疗后,观察两组患者临床疗效,同时比较血清心肌肌钙蛋白I(c Tn I)、钙调蛋白(Ca M)及其基因表达,心功能指标左心室内压最大上升速率(dp/dtmax)、左心室内压最大下降速率(-dp/dtmax)、左室射血分数(LVEF)、舒张末期室间隔厚度(IVST)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、心脏指数(CI),及肺毛细血管楔压(PCWP)、心率(HR)、收缩压(SBP)、舒张压(DBP)、脉压(PP)和尿量(UV)的变化。结果治疗后,对照组和治疗组总有效率分别为60.97%和74.39%,两组总有效率比较差异有统计学意义(P0.05)。两组c Tn I、Ca M、c Tn I-m RNA和Ca MKII-m RNA均较治疗前显著降低,同组治疗前后差异有统计学意义(P0.05),且治疗组上述指标降低更明显,两组比较差异有统计学意义(P0.05)。两组±dp/dtmax、LVEF和CI均升高、LVEDD增大,IVST和LVESD均缩小(P0.05),且治疗组上述指标改善更明显(P0.05)。两组患者PCWP和HR均降低,SBP和DBP均升高,PP增大,UV增多(P0.05),且治疗组上述指标改善更明显(P0.05)。治疗组并发症中室间隔穿孔、急性肾衰竭和心律失常和死亡率明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论生脉注射液治疗急性心肌梗死后心源性休克疗效显著,纠正急性心肌梗死时心肌"钙超载"现象,明显增强心脏泵血功能,具有一定的临床推广应用价值。     

Comparison between self-reported physical activity (IPAQ-SF) and pedometer among overweight and obese women in the MyBFF@home study

Background

Several methods have been developed to determine a person’s physical activity level. However, there is limited evidence in determining whether someone is physically active or not. This study aims to determine the level of physical activity and to compare the usage of short version International Physical Activity Questionnaire (IPAQ-SF) and pedometer among overweight and obese women who were involved in the My Body is Fit and Fabulous at home (MyBFF@home) study.

Methods

Baseline and sixth month data from the MyBFF@home study were used for this purpose. A total of 169 of overweight and obese respondents answered the IPAQ-SF and were asked to use a pedometer for 7 days. Data from IPAQ-SF were categorised as inactive and active while data from pedometer were categorised as insufficiently active and sufficiently active by standard classification. Data on sociodemographic and anthropometry were also obtained. Cohen’s kappa was applied to measure the agreement of IPAQ-SF and pedometer in determining the physical activity level. Pre-post cross tabulation table was created to evaluate the changes in physical activity over 6 months.

Results

From 169 available respondents, 167 (98.8%) completed the IPAQ-SF and 107 (63.3%) utilised the pedometer. A total of 102 (61.1%) respondents were categorised as active from the IPAQ-SF. Meanwhile, only 9 (8.4%) respondents were categorised as sufficiently active via pedometer. Cohen’s κ found there was a poor agreement between the two methods, κ?=?0.055, p?>?0.05. After sixth months, there was +?9.4% increment in respondents who were active when assessed by IPAQ-SF but ??1.3% reductions for respondents being sufficiently active when assessed by pedometer. McNemar’s test determined that there was no significant difference in the proportion of inactive and active respondents by IPAQ-SF or sufficiently active and insufficiently active by pedometer from the baseline and sixth month of intervention.

Conclusion

The IPAQ-SF and pedometer were both able to measure physical activity. However, poor agreement between these two methods were observed among overweight and obese women.