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By analyzing the physiological structure and motion characteristics of human ankle joint, a four degree of freedom generalized spherical parallel mechanism is proposed to meet the needs of ankle rehabilitation. Using the spiral theory to analyze the motion characteristics of the mechanism and based on the method of describing the position with spherical coordinates and the posture with Euler Angle, the inverse solution of the closed vector equation of mechanism position is established. The workspace of mechanism is analyzed according to the constraint conditions of inverse solution. The workspace of the moving spherical center of the mechanism is used to match the movement space of the tibiotalar joint, and the workspace of the dynamic platform is used to match the movement space of subtalar joint. Genetic algorithm is used to optimize the key scale parameters of the mechanism. The results show that the workspace of the generalized spherical parallel mechanism can satisfy the actual movement space of human ankle joint rehabilitation. The results of this paper can provide theoretical basis and experimental reference for the design of ankle joint rehabilitation robot with high matching degree.
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Humans , Ankle Joint , Biomechanical Phenomena , Movement , Range of Motion, ArticularABSTRACT
OBJECTIVE:To systematically review therapeutic efficacy of Haikun shenxi capsule in the treatment of chronic renal failure (CRF).METHODS:Retrieved from Central,PubMed,EMBase,CJFD,CBM,VIP and Wanfang database,randomized clinical trials (RCTs) about Haikun shenxi capsule combined with routine treatment (trial group)vs.single routine treatment (control group) in the treatment of CRF were collected.Meta-analysis was performed by Rev Man 5.3 software after screening literature,extracting data and evaluating quality by using risk bias evaluation of Cochrane collaboration network.RESULTS:A total of 10 RCTs were included eventually,involving 704 patients.The results of analysis showed that compared to general therapy,Haikun shenxi capsule could improve total effective rate [RR =4.42,95 ％ CI (2.70,7.22),P＜ 0.001],and could reduce SCr[MD =-140.37,95 ％ CI (-191.72,-89.03),P＜ 0.001],BUN[MD =-5.49,95 ％ CI (-8.36,-2.63),P＜ 0.001] and 24 h-Upro [MD =-0.43,95 ％ CI (-0.62,-0.23),P＜ 0.001],with statistical significance.CONCLUSIONS:The clinical efficacy of Haikun shenxi capsule in the treatment of CRF is good and significantly improve related indexes of renal function.
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OBJECTIVE:To systematically review therapeutic efficacy of Haikun shenxi capsule in the treatment of chronic renal failure (CRF).METHODS:Retrieved from Central,PubMed,EMBase,CJFD,CBM,VIP and Wanfang database,randomized clinical trials (RCTs) about Haikun shenxi capsule combined with routine treatment (trial group)vs.single routine treatment (control group) in the treatment of CRF were collected.Meta-analysis was performed by Rev Man 5.3 software after screening literature,extracting data and evaluating quality by using risk bias evaluation of Cochrane collaboration network.RESULTS:A total of 10 RCTs were included eventually,involving 704 patients.The results of analysis showed that compared to general therapy,Haikun shenxi capsule could improve total effective rate [RR =4.42,95 ％ CI (2.70,7.22),P＜ 0.001],and could reduce SCr[MD =-140.37,95 ％ CI (-191.72,-89.03),P＜ 0.001],BUN[MD =-5.49,95 ％ CI (-8.36,-2.63),P＜ 0.001] and 24 h-Upro [MD =-0.43,95 ％ CI (-0.62,-0.23),P＜ 0.001],with statistical significance.CONCLUSIONS:The clinical efficacy of Haikun shenxi capsule in the treatment of CRF is good and significantly improve related indexes of renal function.
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Objective To evaluate the efficacy and safety of Sanqi Granules (SG) for the treatment of chronic glomerulonephritis(CGN).Methods A prospective randomized controlled trial was carried out in 60 CGN patients with qi deficiency and blood stasis syndrome.The included patients were assigned into SG group,losartan group,and SG plus losartan group,20 cases in each group.The course of intervention was 24 weeks.Before and after treatment,24-hour urine protein quantity,serum creatinine (SCr),estimated glomerular filtration rate (eGFR) and the scores of traditional Chinese medical syndromes were observed.The clinical efficacy of Chinese medicine and western medicine,and the safety was evaluated after treatment.Results (1) After treatment for 12 and 24 weeks,the scores of traditional Chinese medical syndromes in the three groups were markedly improved (P ＜ 0.05),and the improvement in SG group and SG plus losartan group was superior to that in losartan group (P ＜ 0.05).(2) After treatment for 24 weeks,24-hour urine protein quantity in losartan group was significantly decreased (P ＜0.05),while SG group and SG plus losartan group only showed a decreasing trend(P ＞ 0.05).(3) After treatment for 24 weeks,renal function indexes of SCr and eGFR in SG group and SG plus losartan group were improved to some degrees,and the difference of eGFR in SG group was significant (P ＜ 0.05 compared with that before treatment),while the renal function injury in losartan group showed a deteriorative trend.SG group and SG plus losartan group had better effect on improving SCr and eGFR than losartan group (P ＜ 0.05).(4) After treatment for 24 weeks,the total effective rate of Chinese medicine in losartan group,SG group,SG plus losartan group was 50.00％,90.00％,84.21％,and the total effective rate of western medicine was 88.89％,75.00％,63.16％,respectively.SG group and SG plus losartan group had better clinical efficacy of Chinese medicine than losartan group (P ＜ 0.05),while the difference of clinical efficacy of western medicine among the three groups was insignificant (P ＞ 0.05).(5) During the follow-up,no severe adverse events were shown in the three groups.Conclusion SG exert certain therapeutic effect on improving the scores of traditional Chinese medical syndromes and protecting renal function,while have no obvious effect on decreasing urine protein.
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This study was aimed to observe the clinical effect and quality of life (QOL) of Si-Zi (SZ) powder for hot compress to improve gastrointestinal functions of hemodialysis patients.A total of 60 hemodialysis patients were randomly divided into the treatment group and the control group.Gastrointestinal Symptom Rating Scale (GSRS) and QOL of both groups before and after the treatment of SZ powder were compared continuously.The results showed that after intervention,the total relieve rate was 96.7％ in treatment group,and 53.3％ in the control group.The effect of SZ powder group was to obviously improve the gastrointestinal symptoms and QOL (P ＜ 0.05).It was concluded that SZ powder for hot compress can improve gastrointestinal functions and increase QOL of hemodialysis patients.
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This study was aimed to analyze the pathogen distribution,drug resistance and traditional Chinese medicine (TCM) syndrome of patients with primary nephrotic syndrome complicated with pulmonary infection for the guidance of clinical practice.The clinical data of 180 patients with primary nephrotic syndrome complicated with pulmonary infection were analyzed.The results showed that among 180 patients,117 were male,accounting for 65％;73.33％ of them were over 40 years old.Membranous nephropathy was the most common pathological type,accounting for 40％.Gram-negative bacteria were the main pathogen,accounting for 51.72％.The drug resistance rates of piperacillin/tazobactam,imipenem,amikacin,gentamicin were the lowest.The drug resistance rates of third generation of cephalosporins and quinolone antibiotics were in the middle.In TCM syndrome differentiation,central qi deficiency and phlegm syndrome occupied the highest proportion,accounting for 25.56％;and the phlegm heat in the lung syndrome,accounting for 17.78％;wind evil attacking the lung syndrome,accounting for 13.33％;qi deficiency and phlegm syndrome,accounting for 9.45％;qi deficiency,blood stasis and water stagnation syndrome,accounting for 8.89％;the mixture of deficiency and excess syndrome,accounting for 59.45％,with qi deficiency as the main part.It was concluded that middle-aged and older men,pathologic type of membranous nephropathy had the higher rate of suffering pulmonary infection.Gram-negative bacteria were the main pathogen.The choice of antibiotics should be based on piperacillin/tazobactam,and third generation of cephalosporins.Qi deficiency and phlegm syndrome was the most common TCM syndrome.
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This study was aimed to evaluate the apocatastasis effect and adverse reaction of external application of mirabilite in the treatment of patients with renal edema.Randomized controlled trials (RCTs) were conducted.Patients in the control group were treated with routine treatment plus prescribed diuretics.In the test group,patients were treated with routine nursing,prescribed diuretics,and the external application of mirabilite.The results showed that there was significant difference in the changes of body weight and circumference of the leg.There was no significant difference in the change of urine volume.In the experimental group,2 patients had adverse reactions of the lower limb pruritus,which may be related to the sensitivity of the bag material.It was concluded that a noninvasive external therapy of TCM,mirabilite had quickly apocatastasis effect in the treatment of renal edema patients.Meanwhile,it does not affect the treatment effect of diuretics.The adverse reaction is less.It is an effective method which should be promoted to use.
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This paper was aimed to study the safety of moxibustion with FMEA method.Failure mode and effects analysis (FMEA) were used in every aspect of the operation process of moxibustion.And the local skin temperature was measured in 80 patients treated with moxa box moxibustion.The results showed that the skin temperature reached the highest when the moxibustion was given for 15 min,which was in consistence with the patients' chief complaints and their tolerances.It indicated that moxibustion for 15 min was the best moxibustion amount.Meanwhile,inspection should be made to avoid burning.After the application of FMEA,the RPN of the inspection activities,the temperature and distance of moxibustion were significantly decreased (P ＜ 0.05).It was concluded that the application of FMEA management mode strengthened the risk management of moxibustion treatment,standardized treatment process,provided the basis for the temperature and distance of moxibustion,and ensured the safety and efficacy of treatment.
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Chronic kidney disease (CKD) is a chronic renal structure change and dysfunction caused by a variety of causes.The incidence and prevalence of CKD have been on the rise,becoming a major global health problem.An increasing number of studies had shown that one of the important indicators of CKD progression was the disorder of gut microbiome and elevated levels of sernm endotoxin.Modern physicians of traditional Chinese medicine (TCM) believed that the main pathogenesis of CKD was spleen and kidney deficiency.And the therapeutic regimen was invigorating spleen and nourishing the kidney.Spleen is in the middle burner.It has the function of transportation and resistance to evil,which was extremely similar to the function of gut microbiome in metabolism and immunity.The latter might be one of the biological bases of physiological function of spleen.This comprehensive review presented the modern theoretical basis of spleen-based TCM treatment methods for CKD from the insight of modern gut microbiome and metabolism.Firstly,gut microbiome and its metabolism were associated with the spleen in TCM theory.Gut microbiome affected individual metabolism and immune function,which could provide a modern biological basis for explaining the physiological function of the spleen.Secondly,gut microbiome and its metabolism were correlated with CKD:intestinal flora disturbance occurred in CKD patients,producing enterogenous toxins as their metabolites,which become the important factors affecting prognosis.Thirdly,as for its origin,development and current status based on the spleen theory,CKD was one of various consumptive diseases.Spleen insufficiency was one of their critical pathogenic mechanisms.Therefore,tonifying the spleen should be a treatment method to maintain throughout the entire treatment.On the basis of our previous clinical studies and the hypothesis of gut microbiome and metabolism,we proposed further studies which were also based on system biology and its technology.
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This study was aimed to investigate the requirement of our hospital nurses in the effect evaluation of fifteen traditional Chinese medicine (TCM) nursing programs,and to make it as the basis for making feasible evaluation tables of TCM nursing programs.The investigation survey was given among 78 nurses from the internal medicine ward,surgical ward and the department of orthopedics in our hospital.The questionnaire was graded according to the Likert 5 scoring method,including 3 themes and 11 items.The SPSS 17.0 package was used for statistical processing.The results showed that 93％ nurses participated in the training of effect evaluation table of unified TCM nursing program in the hospital or department,but the overall attitude was negative in terms of the operability and objectivity on the effect evaluation of the program.Requirements of guidelines for effectiveness evaluation of TCM nursing program showed that most nurses agreed that the new TCM nursing program needed to increase quantifiable indicators and to increase its objectivity and reproducibility.It was concluded that nurses generally considered that the evaluation system of nursing program of TCM had no quantitative indicators,but with strong subjective.In the clinical practice,it is in urgent need of an objective TCM nursing program with quantitative indicators and strong operability.
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ABSTRACT:Objective To explore the relationship between clinical manifestations and pathological changes in patients with IgA nephrophathy.Methods To compare the clinical pathological data of 300 patients with primary IgA nephrophathy,who were diagnosised in the Shaanxi Chinese Hospital from Jan.2008 to Dec.2012.Results① The young and middle-aged had the highest incidence of IgA nephrophathy, about 9 0%, hematuria and proteinuria was the primary clinical manifestations among all ages,the incidence of hypertension and abnormal renal function was higher among 60-year age,about 29.3% and 28%.② The IgA+IgM deposition measured by immunofluorescence was the most common pathological type(3 6%).The ratio of IgA deposition was higher in LeeⅠ-Ⅲ of IgA nephrophathy,while IgA+IgM deposition was more common in Lee Ⅳ and Ⅴ (45.5% and 81.8%). The deposition of C3 was common in all IgA nephrophathy(6 3 .3%).③ Lee Ⅰ-Ⅳ grades were the more common grades,covered over 96.3%.Hematuria and proteinuria were the primary clinical manifestations inⅠ-Ⅴpathological changes grading.The incidence of hematuria,proteinuria,hematuria with proteinuria,and hypertension had no significant difference in all pathologic grading,but abnormal renal function had significant difference in Lee Ⅴ(P<0 .0 5 ).④ Abnormal of urine protein and RBC did not have significant difference in Lee Ⅰ-Ⅴ;C3 depositions in serum had significant difference in Ⅳ pathologic grading(P<0 .0 5 ).The elevation of IgA in serum had significant difference in Lee Ⅴ(P<0 .0 5 ).The proportion of abnormal serum creatinine(SCr)increased with the pathological grades,showing a rising trend.Conclusion IgA nephropathy has the characteristics of diversification of clinical manifestations and pathology changes. The incidences of hematuria, proteinuria and hypertension in IgA nephrophathy patients have no correlation with pathological grading;but with pathological grade promotion,the incidence of abnormal renal function increases.
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This paper was aimed to summarize professor Huang Chunlin’s medication experiences, rules and prescription characteristics in the treatment of chronic nephritis through data mining on patients’ records of chronic nephritis. The records of 92 outpatients which met the criteria were collected. The total treatment number was 276. Text conversion was made on patients’ records. And the archive of patients’ data was established. With the support of Traditional Chinese Medicine Inheritance Support System, the medication experiences and prescription rules of professor Huang were summarized. The results showed that the top 20 herbs with relatively high using frequencies were mostly sweet in flavor and neutral in nature. The meridian distributions were mostly the kidney, spleen and liver meridian. The medication effects were mainly qi-reinforcing, yang-reinforcing, water-clearing and dampness-removing. Results from data mining showed 5 couplet medicines and 8 new prescriptions in chronic nephritis treatment. It was concluded that in Professor Huang’s syndrome differentiation of chronic nephritis, it was related to the spleen and kidney, and also related to dampness and stasis. The characteristics in medication were “high-dose for severe conditions”, “sweet in flavor and neutral in nature with outstanding effects”, “always related to the spleen and kidney”, “always related to dampness and stasis”.
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Chronic kidney disease (CKD) is becoming a global social problem. It is important to slow down the progression of CKD for economic and social concerns. In recent years, it has been found that colon is one of the vital organs which produce uremic toxins. And enterogenous uremic toxins are closely related to the prognosis of CKD. Theory of gut-kidney axis for the slowdown of CKD progression was raised by foreign scholars and became the research hot spot. Colon therapy with traditional Chinese medicine (TCM) has been widely used in clinical practice and is believed to slow down the progression of CKD by numerous clinical reports. However, low re-search quality and ambiguous results limited its further application. Under the guidance of senior TCM Professor Huang Chunlin, who emphasized the method of draining turbidity through bowels in the management of CKD, from the Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine, as well as the modern theory of gut-kidney axis, we had carried out a series of exploratory researches which will provide data and methodology support for further confirmatory studies and improve its effectiveness.
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This paper summarized Professor Huang Chunlin's traditional Chinese medicine (TCM) medication expe-riences for patients with hypoalbuminemia in refractory nephrotic syndrome (RNS). This paper was divided into three parts. The first part was the overview of hypoalbuminemia in RNS. The second part was the TCM medica-tion experiences for patients with hypoalbuminemia in RNS which included the integrated application of tonifying the spleen, nourishing the liver and reinforcing the kidney. The third part was the explanation of the comprehen-sive application of Professor Huang Chunlin's TCM medication experiences for patients with hypoalbuminemia in RNS through the introduction of a typical case. TCM medication experiences for RNS treatment based on experi-ences of famous TCM doctors provided theoretical and practical basis for therapeutic regimen.
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IgA nephropathy is the most common primary glomerular disease in China without any specific treat-ment. Corresponding treatments are usually adopted according to different clinical types. Referred to the clinical classification principles and the experiences of his own, Professor Huang Chunlin presented traditional Chinese medicine (TCM) medication experiences for different clinical types of IgA nephropathy which had some clinical instructive significance .
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This study was aimed to analyze the formulas and classify the treatment of chronic kidney disease (CKD) by Dr. Huang Chunlin based on the data mining method. A total of 63 CKD outpatients' medical records by Dr. Huang were collected. And 226 formulas prescribed in the medical records were put in the Traditional Chinese Medicine Inheritance Support System (TCMISS). Data mining techniques were applied in the study of as-sociation rule mining algorithm and complex system entropy cluster, the usage frequency and the correlation of each single Chinese medicinal in order to sort out the prescription pattern of CKD. The results showed that to for-tify the spleen and tonify the kidney were found to be the basic method of CKD treatment . Through the applica-tion of TCMISS, the Chinese medicinals used in Dr. Huang's CKD treatment were Astragalus root, Eucommia, Epimedium, Cuscuta, Agastache, Danshen Root, Ligustrum. It was concluded that the TCMISS is of great value in the summarization of clinical experiences of well-known TCM doctors.
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This study was aimed to observe renoprotective effect and possible mechanism on Y i-Shui Sheng-Xin Yin in spontaneously hypertensive rats. Sixty 12-week male SHR rats were randomly divided into six groups , which were the Y i-Shui She ng-X in Y in low-dose group , middle-dose group , high-dose group , Benazepril group , model group and blank control group , and ten rats for each group . The SHR rats were sacrificed after eight weeks . The urine microalbumin , blood urea nitrogen and cystatin were tested in each rat . The HE and Masson staining method were used to observe changes of renal pathology . Changes of expression of transforming growth factor-β1 ( TGF-β1 ) , connective tissue growth factor ( CTGF ) , FN were detected by immunohistochemistry . The results showed that compared with the blank control group , blood pressure in model group was associated with a significant rise after 8 weeks. Compared with the model group, blood pressure in the Yi-Shui Sheng-Xin Yin middle-dose group, high-dose group and Benazepril group significantly decreased. Compared with the blank control group , urine microalbumin , blood urea nitrogen and cystatin in model group were associated with a significant rise . Compared with the model group , urine microalbumin , blood urea nitrogen and cystatin in the Y i-Shui She ng-X in Y in middle-dose group , high-dose group and Benazepril group significantly decreased . Pathological examinations showed that pathological changes in model group were faster than all drug-groups , appeared pathological changes of glomerular hypertrophy , glomerular basement membrane thickening of heterogeneity and extensive vacuoles degeneration . Immunohistochemical staining showed that compared with the blank control group , expressions of TGF-β1 , CTGF and FN of rat kidney tissue in model group were obviously up-regulated ( P < 0 . 05 ) . Compared with the model group , expressions of TGF-β1 , CTGF and FN in the Y i-Shui She ng-X in Y in , middle-dose group , high-dose group and Benazepril group were down-regulated ( P < 0 . 05 ) . It was concluded that Y i-Shui She ng-X in Y in can reduce SHR rats' early renal glomerulosclerosis and renal interstitial fibrosis , which play roles of delaying the progress of hypertension and protecting kidney . Its mechanism of action may be related to TGF-β1 , CTGF , FN signal pathways .
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Chronic renal failure ( CRF ) , which is a progressive disease , is difficult to be reversed after the pathological damage was formed . Hence , a variety of integrated and complementary therapies should be used for the lifelong treatment and regulation . This article suggested that therapeutic methods should be given ac-cording to different stages of CRF in its development . Chinese medicine comprehensive therapy should be given to the early and middle stage chronic renal failure patients in order to delay the disease progression . In the uremia stage , replacement therapy should also be used as the basic treatment in order to reduce the general complications of dialysis or a kidney transplant , thereby improving the quality of life of patients . The integra-tion of Chinese medicine therapy on CRF are from three aspects , which are Chinese medicine decoction based on syndrome differentiation , Chinese medicine external therapy and Chinese medicine featured CRF management in order to receive better therapeutic effects .
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Stage 4 of chronic kidney disease ( stage 4 CKD ) is induced by insufficiency of spleen and kidney , disorder of qi activity, poor circulation of blood and body fluid metabolic disorders. It is a disease due to the internal generation of dampness , turbid , stasis and toxin . Clinical observation has already demonstrated that in-sufficiency of spleen and kidney is the key pathogenesis and characteristics in stage 4 CKD . In this article , the necessity of regulating and nourishing spleen and kidney on stage 4 CKD was discussed from two aspects , which were the disease characteristics and the connotation of regulating and nourishing spleen and kidney . It provided brief and essential syndrome differentiation and treatment strategies in the clinical treatment of stage 4 CKD .
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This study was aimed to analyze the medication and herbal prescription rules in the treatment of nephrotic syndrome (NS) by Prof. Huang Chunlin with Traditional Chinese Medicine Inheritance Support System ( TCMISS ) . Prescriptions used for NS treatment were collected and the data was entered into the TCMISS . The commonly used herbs and herbal prescription rules in NS treatment by Prof. Huang were summarized through the association rules, revised mutual information, complex system entropy cluster and other unsupervised hierarchical clustering methods. The results showed that based on the analysis of 280 prescriptions from 68 patients, the fre-quency of each herb and association rules among herbs included in the database were identified. And the basic NS treatment prescription by Prof. Huang Chunlin and 8 new prescriptions were mined from the database. It was concluded that data mining is of great practical value to the summarization of clinical experiences of well-known TCM doctors.