西北地区中老年人正常膝关节的影像学测量及临床意义

目的 通过膝关节X线片的测量,完善西北地区人群的膝关节影像学资料,为国人(特别是西北地区)的全膝关节置换术提供参考.方法 随机选取200例西北地区中老年人,年龄大于40岁,男女各半,拍摄膝关节正、侧位X线片.用AutoCAD软件系统标识并且分别测量记录:胫骨平台内翻角(PT角)、小腿机械轴垂直线与双侧股骨髁远端切线的夹角(FT角)、髌骨厚度和胫骨内侧平台最低点至腓骨头尖端高度的差距(DPF).将所得数据分别按男女组及左右侧进行统计学处理,并将所得数值同国外相关研究所得的数据进行统计学比较.结果 PT角及FT角、髌骨厚度(H)及DPF在肢别上没有统计学差别(P>0.05).PT角及FT角在性别上无统计学差异(P>0.05);髌骨厚度(H)及DPF在性别上有统计学差别(P<0.05).本次测得的PT角、FT角、髌骨厚度与国外所报道的数值进行统计学分析,发现均存在着统计学差异(P<0.05).结论 在进行膝关节置换手术前,应该常规测量胫骨平台内翻角、髌骨厚度、DPF等影像学参数,保证手术的顺利进行.     

Effectiveness of different orthoses on joint moments in patients with early knee osteoarthritis: Lateral wedge versus valgus knee bracing

The purpose of the study was to test the biomechanical differences between a lateral wedge and a valgus knee bracing on the knee joint moment during walking in patients with early stage of medial compartment knee osteoarthritis (OA). We conducted a crossover randomized design to compare gait parameters of 32 patients (with early stage medial compartment knee OA) in three different conditions during walking: with a custom-made lateral wedge of 5° (in standard shoes), with a valgus knee bracing (in standard shoes), and with control condition (in standard shoes). Both two-orthose conditions showed decreased loading patterns (knee adduction moment and knee adduction angular impulse) on the knee joint in dynamic condition (statistic probability P < 0.05). The decreased loading on OA knee in wedge condition was associated with a laterally shifted location of centre of pressure and increased ankle valgus degree and moment at the same foot (P < 0.05). It was not found significant differences in loading of the knee between these two-orthose conditions. These results indicated that, under dynamic condition, patients wearing lateral wedge and valgus knee bracing showed changes of moments on knee joints. Lateral wedge was as effective as valgus knee bracing in the treatment of early stage of knee OA.     

PERIPANCREATIC ARTERIAL LIGATION COMBINED WITH ARTERIAL INFUSION REGIONAL CHEMOTHERAPY FOR TREATING PATIENTS WITH ADVANCED PANCREATIC CARCINOMA

Ｔｈｅｄｅｔｅｃｔｉｏｎｒａｔｅｏｆｒｅｓｅｃｔａｂｌｅｓｍａｌｌｐａｎｃｒｅａｔｉｃｃａｒ ｃｉｎｏｍａｉｓｉｎｃｒｅａｓｉｎｇａｓａｒｅｓｕｌｔｏｆｒｅｃｅｎｔａｄｖａｎｃｅｓｉｎｖａｒｉ ｏｕｓｄｉａｇｎｏｓｔｉｃｉｍａｇｉｎｇｔｅｃｈｎｉｑｕｅｓ,ｈｏｗｅｖｅｒ ,ｒｅｓｅｃｔｉｏｎａｔｔｈｅｔｉｍｅｏｆｄｉａｇｎｏｓｉｓｉｓｐｏｓｓｉｂｌｅｉｎｏｎｌｙ 5 %- 2 2 %ｏｆｔｈｅｐａｔｉｅｎｔｓ[1] ,ａｎｄｍｏｓｔｏｆｔｈｅｐａｔｉｅｎｔｓｂｅｌｏｎｇｔｏａｄｖａｎｃｅｄｐａｎｃｒｅａｔｉｃｃａｒ…     

Central pattern generator based gait control for planar quadruped robots

In this paper, a gait control scheme is presented for planar quadruped robots based on a biologic concept, namely central pattern generator （CPG）. A CPG is modeled as a group of the coupled nonlinear oscillators with an interaction weighting matrix which determines the gait patterns. The CPG model, mapping functions and a proportional-differential （PD） joint controller compose the basic gait generator. By using the duty factor of gait patterns as a tonic signal, the activity of the CPG model can be modulated, and as a result, a smooth transition between different gait patterns is achieved. Moreover, by tuning the parameters of the CPG model and mapping functions, the proposed basic gait generator can realize adaptive workspace trajectories for the robot to suit different terrains. Simulation results illustrate and validate the effectiveness of the proposed gait controllers.     

Cyclostationary Modeling of Surface Electromyography Signal During Gait Cycles and Its Application for Cerebral Palsy Diagnosis

Cerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood. The electromyography (EMG) signal analysis and the gait analysis are two most commonly used methods in the clinic. In this paper, a cyclostationary model of the EMG signal is proposed. The model can combine the aforementioned two methods. The EMG signal acquired during the gait cycles is assumed to be cyclostationary due to the physiological characteristics of the EMG signal production. Then, the spectral correlation density is used to analyze the cyclic frequency (corresponding to the gait cycles) and spectral frequency (the frequency of EMG signal) in a waterfall representation of the two kinds of frequencies. The experiments show that the asymptomatic (normal) subjects and symptomatic subjects (with CP) can be distinguished from the spectral correlation density in a range of cyclic frequencies.     

硒对大鼠心肌细胞膜Na~+,K~+—ATP酶及5'—核苷酸酶活性的影响

本文用克山病病区低硒粮、病区粮加Na_2SeO_3及常备饲料分别喂养Sprague—Dawley纯种大鼠1～3个月,动态观察了大鼠心肌细胞膜Na~+,K~+—ATP酶(Na~+,K~+—ATPase)及5'一核苷酸酶(5'—ND)活性变化。结果发现低硒组大鼠心肌细胞膜Na~+,K~+—ATPase和5'—ND活性从实验的第1到第3个月均明显低于补硒组和常备饲料组大鼠;低硒组大鼠肝脏和血浆硒含量及红细胞和肝脏的GSH—px活性也明显降低。补硒可使上述各项指标接近常备饲料组大鼠水平,表明硒对心肌细胞膜有稳定和保护作用。     

较高剂量的缬沙坦与贝那普利对IgA肾病的疗效对比

目的观察较大剂量的缬沙坦与贝那普利对IgA肾病的疗效和安全性。方法61例患者随机分为三组：缬沙坦组（对照1组）（n=20），服用缬沙坦160mg／d，贝那普利组（对照2组）（n=20）服用盐酸贝那普利20mg／d。联合组（治疗组）（n=21）服用缬沙坦160mg／d联合盐酸贝那普利20mg／d，疗程6个月，观察24h尿蛋白定量、血清肌肝、血压及血钾等变化及不良反应情况。结果6个月时三组24h尿蛋白定量均有明显下降，尤以治疗组明显，与其他两组比较差异显著（P〈0．05），总有效率分别为治疗组85．7％，对照1组45．0％，对照2组40．0％，均以治疗组最显著；与其他两组比较差异显著（P〈0．01），而对照1组与对照2组比较无明显差异（P〉0．05）。三组均能有效降低血压且副作用较轻，三组之间比较无显著性差异（P〉0．05）。结论较大剂量血管紧张素受体拮抗剂联合较大剂量转换酶抑制剂治疗IgA肾病安全有效，其疗效优于单用盐酸贝那普利或单用缬沙坦。     

急性心肌梗塞溶栓前后凝血纤溶指标的变化及临床意义

目的　探讨急性心肌梗塞 (AMI)患者溶栓治疗对其凝血纤溶功能的影响及临床意义。方法　选择 1 2h内急性心肌梗塞患者 3 0例 ,用重组链激酶 (r SK) 1 5 0万U进行溶栓治疗 ,并按临床判断再通标准将其分为溶栓再通组和未通组 ,观察其溶栓前后血浆组织型纤溶酶原激活物 (t PA)、纤溶酶原激活抑制物 (PAI)活性 ,D 二聚体 (D Dimer)及纤维蛋白原 (Fg)含量变化。结果　溶栓再通组溶栓后血浆t PA活性较溶栓前明显升高 ,PAI活性明显减低 ,而未通组溶栓前后t PA、PAI活性无明显变化。两组溶栓后血浆D Dimer较溶栓前均有明显升高 ,且组间升高程度无显著差异。结论　①溶栓后t PA活性升高 ,PAI活性减低可能预示冠脉再通。②溶栓后D Dimer含量升高提示溶栓后有凝血酶的进一步激活 ,但该项指标不能视为溶栓效果的判定标准     

两足机器人步态综合研究进展

把两足机器人步态综合方法分为参考轨迹法和自然动力学法两大技术流派.根据参考轨迹获得方法的不同,参考轨迹法又分为步行数据法、中枢模式发生器法和动力学模型法.自然动力学法也可分为被动动力学法和虚拟模型法.在总结两大流派研究进展的基础上,分析了它们各自的优势和不足,指出了今后工作的重点,即参考轨迹法需要提高步行效率和轨迹的生成速度,而自然动力学法需要增加功能.最后分析了强制学习技术在步态综合中应用的适应性和多自由度造成的组合爆炸问题.     

Review on the interlimb neural coupling and its potential usage in walking rehabilitation

Human performs bipedal gait with synchronized arm swing. Apart from the observation that arm movement during gait is the outcome of a mechanical and energetic optimization, the synergetic upper and lower limb movement during gait is a neutrally coordinated motor output, that is, the interlimb movement is neutrally coupled. Patients with injuries to the central nervous system demonstrate the interlimb neural coupling. Researches on central pattern generator and the reflex studies reveal that the interlimb neural coupling is a quadrupedal heritage. Based on the theory of the interlimb neural coupling, both the upper and lower limbs should be practiced synchronously during regular gait training to promote walking rehabilitation for patients with gait disorders. Frther development of a gait robotic system with synchronized arm swing is required to test the clinical application of the neural coupling in gait restoration.     

Model-based gait representation via spatial point reconstruction

This paper proposed a novel model-based feature representation method to characterize human walking properties for individual recognition by gait. First, a new spatial point reconstruction approach is proposed to recover the coordinates of 3D points from 2D images by the related coordinate conversion factor (CCF). The images are captured by a monocular camera. Second, the human body is represented by a connected three-stick model. Then the parameters of the body model are recovered by the method of projective geometry using the related CCF. Finally, the gait feature composed of those parameters is defined, and it is proved by experiments that those features can partially avoid the influence of viewing angles between the optical axis of the camera and walking direction of the subject. Foundation item: the National Natural Science Foundation of China (No. 60675024)     

特发性膜性肾病与膜增生性肾炎的比较

目的对比分析特发性膜性肾病(IMN)与原发性膜增生性肾炎(PMPGS)的临床与病理资料,了解其特点及两者的区别。方法对比分析我院近20年来IMN(551例)与PMPGS(105例)的临床病理资料。结果①IMN和PMPGS均为男性多于女性,两组男女比例比较差异无统计学意义(P>0.05);②IMN及PMPGS的平均年龄分别为(47.22±16.32)岁、(39.10±15.47)岁,差异有统计学意义(P<0.01);③IMN的病程中位数为4月,其中50%的病例在(1～11)月,PMPGS病程中位数为6月,其中50%的病例在(3～24)月,两组差异有统计学意义(P<0.01);④IMN及PMPGS均以肾病综合征为主,两组差异无统计学意义;⑤IMN及PMPGS有血尿者分别占33.76%(186/551)及56.19%(59/105),差异有统计学意义(P<0.01);⑥两组血压、尿蛋白定量、血白蛋白浓度、血IgG、IgA浓度比较差异无统计学意义(P>0.05),但血中IgM、C3、C4的浓度及补体(C3)降低的比例比较,差异有统计学意义(P<0.01);⑦两组合并肾功能不全以及血中尿素氮、肌酐的浓度比较,差异有统计学意义(P<0.01);⑧总体疾病危险度比较,两组差异有统计学意义(P<0.01);⑨两组在肾脏免疫病理表现方面,均有较强的免疫球蛋白沉积,但IMN较PMPGN免疫荧光沉积强,两组比较差异有统计学意义(P<0.01)。结论①两种疾病均为男性多于女性;②临床主要表现为肾病综合征;③PMPGS较IMN血尿常见,补体(C3)降低的比例高;④IMN在肾功能损害合并肾功能不全及疾病危险度的评价较PMPGS轻。     

Histologic changes in the sinus membrane after maxillary sinus augmentation with simultaneous implant placement using engineered bone graft material

The aim of the study was to analyze the histologic and ultrastructural changes after maxillary sinus augmentation with simultaneous implant placement using engineered bone graft material. In this study, calcium phosphate cement (CPC) scaffolds combined with goat bone marrow stromal cells (BMSCs) were used to fill goat sinus floor space after maxillary sinus floor elevation with simultaneous implant placement comparing with those not filled any grafted materials and used as controls. After a healing period of 3 months, the goat maxillary sinus membrane was examined using light microscopy and scanning electronic microscopy. The results showed that the connective tissue thickness and the epithelium thickness of mucosa were not statistically significant difference between two groups. The tissue engineered bone complex might be an ideal graft for the sinus floor elevation and have no influence on the sinus membrane under the histological and ultrastructural observation.     

关节内注射川芎嗪对兔膝关节软骨退变的影响

目的观察川芎嗪关节腔内注射对骨关节炎过程中软骨退变的保护作用,探讨川芎嗪关节腔注射治疗骨关节炎的应用前景。方法健康成熟新西兰大白兔26只,设立正常组、模型组、对照组和实验组。模型组、对照组及实验组建立骨关节炎模型。对照组与实验组分别关节腔注射地塞米松0.3 mL和川芎嗪0.3 mL。每周一次。在模型建立6周和9周时各组分别处死一半动物,去除关节炎模型,取材进行大体标本病理学观察,并经光镜和透射电镜观察膝关节软骨的病理变化。结果在6和9周时,实验组的大体标本软骨损伤分级明显优于其他3组;Mankin软骨组织学评分与上述两组相比,有非常显著性差异(P<0.01);电镜超微结构观察其病理改变明显轻于对照组和模型组。对照组大体标本软骨损伤分级与模型组基本相同;Mankin软骨组织学评分与模型组比较无显著性差异(P>0.05);电镜超微结构观察对照组与模型组在细胞形态、细胞内细胞器改变等方面相似。结论关节腔内注射川芎嗪能减轻兔膝关节炎模型的关节软骨退变程度,并可促进软骨的自身修复;激素关节腔内注射对损伤软骨的修复作用不明显。     

电控发动机故障诊断属性约简算法应用研究

利用粗糙集理论中的区分矩阵属性约简算法对电控发动机的几种典型故障参数进行属性约简,为验证约简结果是否有利于下一步的故障诊断,采用较成熟的BP神经网络对其进行诊断验证,将约简结果作为网络的输入,待诊断故障作为网络的输出。通过学习训练结果表明:利用区分矩阵方法所获得的核约简不能作为故障诊断的特征参量,其导致网络不收敛,而其它3组约简可以用于区分现有故障。为获得最优的属性约简结果,利用二进制粒矩阵的方法进行了最优属性约简的证明。     

糖尿病性白内障超声乳化术后泪膜稳定性的动态变化

目的观察糖尿病性白内障术后泪膜稳定性的变化规律,了解糖尿病患者术后泪膜功能的改变及其影响因素。方法设计自身配对研究。选2型糖尿病性白内障患者(随机检查48例48只眼),无糖尿病者设为对照组(随机检查80例90只眼)。采取透明角膜切口超声乳化白内障吸除及折叠式后房型人工晶体植入术,术前、术后1 d、7 d、1月、3月依次行Schirmer试验(Sit)、泪膜破裂时间(BUT)、角膜荧光素染色并对其泪膜稳定性的变化进行分析。结果术前两组SIt、BUT有明显差异(P<0.001),其中糖尿病组的患者泪膜稳定性较差。与术前相比,术后1 d两组BUT均明显缩短,Schirmer-I值明显增加,角膜荧光素染色为(+);与对照组相比,糖尿病组下降明显(BUT:P<0.05;Schirmer-1P<0.001)。两组Schirmer-I值术后7d恢复至术前水平,两组恢复有显著性差异(P<0.001)。对照组BUT术后1个月恢复至术前水平(P>0.001),糖尿病组BUT术后3个月恢复至术前水平(P<0.05),两组恢复程度有明显差异(P<0.05)。术前两组的角膜荧光素染色为阴性~+,无显著性差异;术后1 d两组亦无显著性差异。与对照组相比,糖尿病组角膜荧光素染色术后1个月恢复至术前水平。结论糖尿病患者泪膜稳定性较差,术后其泪膜稳定性较对照组下降明显,恢复较慢,部分患者术后出现眼干涩、畏光、视力波动等。术前应常规检查SIt、BUT、角膜荧光素染色,有助于早期发现、及时治疗。     

Probabilistic model-based silhouette refinement for gait recognition

An algorithm to refine and clean gait silhouette noises generated by imperfect motion detection techniques is developed,and a relatively complete and high quality silhouette is obtained.The silhouettes are sequentially refined in two levels according to two different probabilistic models.The first level is within-sequence refinement.Each silhouette in a particular sequence is refined by an individual model trained by the gait images from current sequence.The second level is between-sequence refinement.All t...     

成年国人内镜下食管长度的研究

目的探讨国人食管与身高、坐高、性别及年龄的相关性。方法应用前视式胃镜在直视下经食管内腔测量了613例(男378例,女235例)食管上口(咽部)至食管末端(齿状线最近侧缘)的长度。结果成年男性食管平均长度为(24.8±2.1)cm,成年女性食管平均长度为(22.8±1.9)cm,男、女性食管长度存在显著性差异(P<0.01)。同时发现,男女性食管长度与身高、坐高呈直线相关关系。但各年龄组间食管长度无显著性差异(P>0.05)。结论食管长度受多因素影响,其中身高和坐高是影响食管长度的最重要的两个因素。     

围绝经期妇女激素替代治疗的临床研究

目的　了解西安地区围绝经期妇女的心理状况及可接受激素替代治疗 (HRT)的程度 ,探讨HRT是否象在西方和国内其他地区妇女中一样 ,能保持或减少绝经后妇女骨密度的降低 ,改善血脂代谢。方法　采用前瞻性对照研究 ,实验组 3 0例病人采用激素补充疗法 ,3 0例未采用干预治疗的围绝经期妇女为对照组。首先进行心理问卷调查并进行评估 ,然后观察用药前后Kupperman评分、血脂、BMD、子宫内膜的变化。结果　心理咨询结果显示 ,实验组要求行HRT治疗者之文化程度及经济状况均优于对照组 ,但对HRT及围绝经期保健知识了解的程度均低。用药前后评分显示 ,实验组用药 1 2月后症状完全缓解率达 90 % ,而对照组中 6 6 %患者症状无改善。实验组用药后BMD保持不变 ,对照组明显下降 (P <0 0 5 )。实验组用药后TC、TG无变化 ,HDL水平上升 (P <0 0 0 1 ) ,LDL下降 (P <0 0 0 1 ) ,对照组无变化。两组子宫内膜均无明显变化。结论　①西安地区相应群体对HRT缺乏认识和了解 ,相关部门普及围绝经期保健工作的力度不够 ,需政府、社会和家庭的支持。②西安地区围绝经期妇女适宜HRT ,其可保持BMD ,改善血脂 ,保护心血管 ,提高该群体妇女的生活质量。     

The effect of Levocarnitine on nutritional status and lipid metabolism during long-term maintenance hemodialysis

Objective To investigate the effect of Levocarnitine on lipid metabolism and nutritional status of maintenance hemodialysis (MHD) patients and possible mechanism. Methods A total of 40 MHD patients [mean age (53.5±7.1) years] who underwent normal hemodialysis more than 6 months were randomly classified into two groups, Levocarnitine supplemented group (LS-G) (n=20; Levocarnitine supplementation after each normal hemodialysis session, at a dose of 1.0 g/day by intravenous administration) and control group (C-G) (n=20; normal hemodialysis). Before treatment, one month and three months after treatment we respectively measured or observed the following items, the tolerance to hemodialysis, carnitine level in plasma, C-reactive protein, IL-6, TNF-α, percentage of neutrophil, and some relevant nutritional parameters, such as lipid profile, transferrin, total protein, albumin and prealbumin levels. Comparative analysis was conducted between the two groups. Results In LS-G three months after treatment, the levels of carnitine, hemoglobin, and prealbumin in plasma were significantly increased (P<0.05), but C-reactive protein, neutrophil percentage, low-density lipoprotein and triglyceride were significantly decreased (P<0.05) in contrast to those in C-G and before treatment. Transferrin, total protein, and albumin were elevated in LS-G, with no statistical significance. Conclusion There was a significant improvement of lipid metabolism and nutritional status for the long-term maintenance hemodialysis patients with Levocarnitine supplementation. And this improvement is related to the decrease of inflammatory factors.