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In order to improve the wearing comfort and bearing effectiveness of the exoskeleton, based on the prototype and working mechanism analysis of a relaxation wearable system for knee exoskeleton robot, the static optimization synthesis and its method are studied. Firstly, based on the construction of the virtual prototype model of the system, a comprehensive wearable comfort evaluation index considering the factors such as stress, deformation and the proportion of stress nodes was constructed. Secondly, based on the static simulation and evaluation index of system virtual prototype, multi-objective genetic optimization and local optimization synthesis of armor layer topology were carried out. Finally, the model reconstruction simulation data confirmed that the system had good wearing comfort. Our study provides a theoretical basis for the bearing performance and prototype construction of the subsequent wearable system.
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Humans , Exoskeleton Device , Computer Simulation , Emotions , Knee JointABSTRACT
Objective:To establish and validate a preoperative differentiateon model of intrahepatic cholangiocarcinoma (ICC) and combined hepatocellular carcinoma (CHC) based on the inflammatory markers and conventional clinical indicators.Methods:The clinical data of 116 patients with ICC or CHC admitted to Henan Provincial People's Hospital from January 2018 to March 2023 were retrospectively analyzed, including 74 males and 42 females, aged (58.5±9.4) years old. The data of 83 patients were used to establish the differentiation model as the training group, including 50 cases of ICC and 33 cases of CHC. The data of 33 patients were used to validate the model as the validation group, including 20 cases of ICC and 13 cases of CHC. The clinical data including the platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), prognostic inflammatory index (PII), prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were collected and analyzed. The receiver operating characteristic (ROC) curve was used to analyze the best cut-off values of PLR, SII, PII, PNI, NLR and LMR. Univariate and multivariate logistic regression analysis were used to determine the differential factors between ICC and CHC. The R software was used to draw the nomogram, calculate the area under the curve (AUC) to evaluate the model accuracy, and draw the calibration chart and the decision curve to evaluate the predictive efficacy of the model.Results:Univariate logistic regression analysis showed that liver cirrhosis, history of hepatitis, alpha fetoprotein, carbohydrate antigen 199, gamma-glutamyltransferase (GGT), PLR, PNI and inflammation score (IS) could be used to differentiate ICC from CHC (all P<0.05). The indicators identified in univariate analysis were included in multivariate logistic regression analysis. The results showed that absence of liver cirrhosis, GGT>60 U/L, PNI>49.53, and IS<2 indicated the pathology of ICC (all P<0.05). Based on the above four factors, a nomogram model was established to differentiate the ICC and CHC. The AUC of ROC curve of the nomogram model in the training and validation groups were 0.851 (95% CI: 0.769-0.933) and 0.771 (95% CI: 0.594-0.949), respectively. The sensitivities were 0.760 and 0.750, and the specificities were 0.818 and 0.769, respectively. The calibration chart showed that the predicted curve fitted well to the reference line. The decision curve showed that the model has a clear positive net benefit. Conclusion:The nomogram model based on inflammatory markers showed a good differentiation performance of ICC and CHC, which could benefits the individualized treatment.
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Objective:To study the feasibility and safety in treatment of trauma to right posterior liver using laparoscopic surgery with patients in the left semiprone position.Methods:The clinical data of consecutive patients who were diagnosed to have trauma to the right posterior liver and were treated with laparoscopic surgery with patients in the left semiprone position at the Department of Hepatobiliary Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities between February 2016 and August 2020 were retrospectively analysed. The patients’ gender, age, mechanisms of injury, operative methods, operative time, amounts of abdominal effusion, degrees of liver injury, extents of intraoperative bleeding, amounts of postoperative drainage, lengths of postoperative hospital stay, and major postoperative complications were recorded and analyzed.Results:Among the 18 patients, there were 16 males and 2 females, aged (41.6±14.4) years. The mechanisms of liver trauma were caused by fall injury ( n=10), traffic accidents ( n=4), blunt injury ( n=2) and penetrating injury ( n=2). The levels of injuries were level Ⅲ in 16 patients and level Ⅳ in 2 patients. Laparoscopic suture repair was performed in 8 patients, partial hepatectomy in 4 patients, electrocoagulation hemostasis in 4 patients and ligation of bleeding vessels in 2 patients. All were successful in hemostasis. Abdominal effusion was (1 528.8±373.2) ml, intraoperative blood loss (80.6±16.7) ml, operation time (88.5±9.1) min, postoperative hospital stay 7 days and postoperative total drainage (93.8±13.6) ml. Ten patients were complicated with right pleural effusion, and they recovered with conservative treatment. There were no bile leakage, infection and other complications. Conclusion:Trauma to right posterior liver treated with laparoscopic with surgery patients in the left semiprone position had the advantages of adequate exposure which facilitated surgical hemostasis, resulting in minimal collateral damages and short hospital stay. The treatment was feasibility and safe.
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OBJECTIVES@#Due to the genetic feature of high diversity than other DNA markers, short tandem repeat (STR) plays key roles in forensic, anthropology, and population genetics. Newly introduced multiple STR kit is more valuable because of the greatly improved discriminatory power with the increase in the number of STR loci. The genetic polymorphic data are essential for the application and research in specific population. This study aims to investigate the genetic polymorphism of Han population residing in Yuncheng district, Shanxi Province, to evaluate the application of 23 STR loci in forensic personal identification and paternity test, and to explore the genetic relationship of Han population between Yuncheng and other populations.@*METHODS@#A total of 23 STR loci were amplified from 525 healthy unrelated individuals from the Han nationality in Yuncheng, Shanxi Province using the AGCU EX25 amplification kit. The products were detected and separated by ABI 3500 Genetic Analyzer. Alleles were genotyped by GeneMapper ID (Version 3.2) software, and corresponding frequencies and forensic parameters were calculated. We calculated the genetic distance and plotted the neighboring-joining tree with other 13 population.@*RESULTS@#The allele frequency of the 23 STRs ranged from 0.0010 to 0.5090. No deviation from Hardy-Weinberg equilibrium (@*CONCLUSIONS@#These 23 STRs are highly genetic polymorphic and informative in the Han population of Yuncheng, Shanxi Province, which can provide basic data for forensic personal identification, paternity testing, and population genetic research.
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Humans , Asian People/genetics , China , Ethnicity/genetics , Gene Frequency , Genetic Loci , Genetics, Population , Microsatellite Repeats/genetics , Polymorphism, GeneticABSTRACT
Objective To investigate the clinical characteristics of skull cranial langerhans cell histiocytosis in children and improve clinical understanding and therapeutic effect Methods A retrospective clinical study was conducted in 29 cases of skull cranial langerhans cell histiocytosis treated in Shengjing Hospital Affiliated to China Medical University from January 2012 to January 2018. Results The main lesion of skull bone was dissolved bone. Among them, there were 5 cases of frontal bone lesions, 10 cases of temporal bone lesions, 2 cases of occipital lesions, and 12 cases of multiple lesions in the skull;There were 10 cases of vertebral lesions and 5 cases of multiple bone lesions involved around the body. Other clinical manifestations included insipidus in 4 cases, erythra in 3 cases, hepatosplenomegaly in 2 cases and lymphadenectasis in 1 case. All cases were followed up for 0.5 to 5.0 years. In the group of combined surgery and chemotherapy treatment, the prognosis of single system involvement cases was that 9 patients were cured, 2 patients were stable and 1 patients were progressing, while the prognosis of multiple systems involvement cases was that 1 patient was cured, 2 patients were stable and 3 patients were progressing. The prognosis of patient with multiple systems lesions was relatively poor compared to that of the cases of single system lesion and there was statistical difference. In the pure operation group , the prognosis of single system involvement cases was that 5 patients were cured, 1 patient was stable and 1 patient was progressing, while the prognosis of multiple systems involvement cases was that 1 patient was stable and 3 patients were progressing. Conclusions Children with skull cranial langerhans cell histiocytosis present single or multiple cranial osteolytic lesions. It is often accompanied by multiple systems lesions around the body, and prognosis of children with multiple systems lesions was is relatively poor.
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Objective To study the safety and efficacy of laparoscopic resection of hemangioma in the right posterior hepatic section without any blood flow occlusion.Methods Patients with hemangiomas in the right posterior section of liver operated from January 2016 to June 2018 in the Affiliated Hospital of Youjiang Medical College for Nationalities were studied retrospectively.There were 19 females and 9 males.The average age was (37.9 ± 6.1).The operation methods,perioperative factors,hospitalization cost and follow-up outcomes were recorded and analyzed.Results 28 patients with hemangiomas were treated with laparoscopic resection of right posterior hepatic section without any blood flow occlusion.An ultrasound scalpel was applied to split the liver in 27 patients,and ultrasound scalpel combined with Ligasure to split the liver in 1 patient.The mean diameter of the hepatic hemangiomas was (6.7 ± 1.3) cm.The intraoperative blood loss was (330.4 ± 139.0) ml and the operation time was (87.4 ±27.9) min.One patient required conversion to open surgery due to rupture and bleeding of the hemangioma.The conversion rate was 3.6％ (1/28).The postoperative drainage time was (45.4 ± 18.9) h.The postoperative hospitalization time was (7.5 ± 1.3) d,and the hospitalization cost was (3.1 ± 0.5) ten thousand yuan.No death or serious complications occurred.No reoperation was needed.The follow-up period ranged from 1 to 30 months,and all the patients were well on follow-up.Conclusions Laparoscopic resection of hemangioma in the right posterior hepatic section without any blood flow occlusion was safe and efficacious.This method can be used for hemangiomas in the right posterior section of liver.
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Objective To investigate the effects of different doses of oxaliplatin (L-OHP) chemotherapy regimen for treatment of colorectal cancer and its influence on the adverse reactions in the nervous system.Methods A total of 92 cases of colorectal cancer patients in Wuhan Wuchang Hospital from August 2013 to April 2016 were selected as the research objects, which were randomly divided into the observation group (46 cases) and the control group (46 cases) according to the random lottery envelopes. All the patients were given FOLFOX chemotherapy. The observation group was treated with small dose L-OHP chemotherapy(60 mg/m2),the control group was treated with routine dose of L-OHP chemotherapy(120 mg/m2), and the efficacies were evaluated after 3 cycles. Results All the patients completed chemotherapy. The observation group included 26 cases of complete remission(CR),11 cases of partial remission(PR),5 cases of stable disease (SD), 4 cases of progression of disease (PD). The control group included 28 cases of CR, 10 cases of PR, 3 cases of SD, 5 cases of PD. Overall response rate (ORR) in the observation group and the control group were 80.4 % (37/46) and 82.6 % (38/46) respectively, and there was no significant difference between the two groups (χ 2= 0.072, P > 0.05). Nervous system adverse reactions included 6 cases of gradeⅠ, 3 cases of grade Ⅱ, 1 case of grade Ⅲ in the observation group, and 12 cases of grade Ⅰ, 6 cases of gradeⅡ,4 cases of gradeⅢin the control group.The incidence rate in the observation group was lower than that in the control group [21.7 % (10/46) vs. 47.8 % (22/46), χ2= 6.900, P < 0.05]. Up to November 2017, PD and overall survival time in the observation group were longer than those in the control group [(19 ±4)months vs. (16±4) months, t= 4.314, P< 0.05; (24±4) months vs. (20±5) months, t = 4.170, P < 0.05]. Conclusion The low dose L-OHP chemotherapy regimen has a favorable effect in patients with colorectal cancer, and it can reduce the adverse reactions in the nervous system and prolong the survival time of patients.
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Objective: To examine the prevalence and risk factors of criminal behavior among persons with schizophrenia in a rural area. Methods: A 14-year prospective follow-up study (1994 - 2008) was conducted on criminal behavior, clinical symptoms, social functioning, treatment and caring status among 510 persons with schizophrenia in Xinjin County, Chengdu. The instruments included the Present State Examination (PSE-9), Social Disability Screening Schedule (SDSS), and Positive and Negative Syndrome (PANSS) .Results: Totally 489 patients (95.9%) were followed up. The life-time prevalence of criminal behavior among these patients was 13.5%. Criminal behavior was more likely to happen among the persons who were unmarried (19.1%), younger t (41.2 ± 16.6) years old], and had earlier onset age [(28.4 ± 10.4) years old] .In the follow-up data, the rates of patients'criminal behavior were relatively higher among these patients who had poor family economic status (16.6%), no caregiver (28. 6%), homelessness (25.0%), and higher positive (14.1 ± 7.4), negative (19.3±10.2) and total scores (68.7±28.7) of PANSS (P<0.05) .Conclusion: The criminal behavior in patients with schizophrenia is common in rural areas and may be affected by multi-factors. The risk factors of criminal behavior in persons with schizophrenia, such as their marriage, family intervention and social support services, should be considered for community mental health policy making, community mental health services and family interventions.