Objective To investigate a modified robotized hydraulictensor for management of the ligament balance in the total knee arthroplasty. Methods The effect of the modified robotized hydraulic tensor on the mechanical behaviour of the ligament system balance in the total knee arthroplasty was analyzed andthe related information was obtained. Results The robotized hydraulic tensor acted as a tensorsensor system, which could assist the surgeon by providing thequantitative information to align the lower limb in extension, equalize the articular spaces in extension and flexion, balance the internal and external forces, and define the femoral component rotation, and by providing the information toplan the releasing of the soft tissues and the rotating of the femoral component. Conclusion The modified robotized hydraulic tensor can enable the surgeon to properly manage the ligament balance in the total knee arthroplasty.
Aiming at the gait instability phenomenon under disturbed conditions, domestic and foreign scholars have done some research works, but the relationship between the independent balancing act with the surface electromyographic and gait parameters in the process of instability has yet rarely been involved. In this study, using the gait analysis combined with electromyographic signal analysis, we investigated balance adjustment mechanism of joints and muscles of the human lower limb under the condition of walking on the level trail and after foot heel touching the ground and unexpected sliding. Studying 10 healthy subjects with the unified shoes, we acquired and analyzed the changing rule of the lower limb joint torque, joint angle, and the surface electromyographic of the main muscle groups involved in situations of dry or oid trails. Studies showed that when accident sliding happened, the body would increase ankle dorsiflexion torque moment, knee unbend torque and straight angle, and meanwhile increase the torque of hip extension, and timely adjust muscle activation time (Followed by activation of Tibialis anterior muscle→Rectus femoris→Gastrocnemius→Femoral biceps) to adjust the center of gravity, to maintain balance of the body, and to avoid falling down. The results of the research could be used to explore new ideas and to provide a certain reference value for preventing slip damage, rehabilitation training and development of lower limb walker.
At present, balanced scorecard is widely used in hospital performance management, but because of the difficulty in selecting indicators and the ambiguity of causality, its implementation on the application level is limited. Based on the theory of “competitive advantage” and resource arrangement, this study constructs an improved balanced scorecard index system for discipline performance evaluation from the perspective of improving discipline competitiveness of Ningbo No.2 Hospital. The index system mainly includes the dimensions of discipline quality development, resource allocation efficiency and so on, with the characteristics of “focusing on advantages, accurate positioning” and innovation, and has achieved good results in practical application.
This article reviews Chinese nomenclature of renal replacement therapy and extracorporeal blood purification currently utilized to manage acute kidney injury and other organ dysfunction syndromes in critically ill patients, based on the recent reports of a consensus expert conference of Nomenclature Standardization Initiative Alliance. We provide a detailed description of the performance characteristics of membranes, filters, transmembrane transport of solutes and fluid, flows, and methods of measurement of delivered treatment, common definitions, components, techniques, and operations of the machines and platforms as well as the renal replacement therapy techniques in detail with the relevant technologies, procedures, operations, and recent developments in other extracorporeal therapies, including therapeutic plasma exchange, multiple organ support therapy, liver support, lung support, and blood purification in sepsis. We believe this nomenclature review will serve future use of terminology in publications, research, clinical operations and therapy platforms to enable consistent data collection and comparison.
This article shows a new design of telerehabilitation system for balance function assessment and training in our laboratory. The system is based on C/S network architecture, and realizes the telecommunication through socket network communication technology. It implements the teletransmission of training data and assessment report of sit-down and stand-up, online communication between doctors and patients, and doctors' management of patient information. This system realizes remote evaluation and telerehabilitation of patients, and brings great convenience for the patients.
Lower limb alignment and soft tissue balance are important factors affecting patient satisfaction, clinical functional outcome, and prosthetic long-term survival rate after total knee arthroplasty (TKA). Robot-assisted TKA (rTKA) has the advantages of achieving precise osteotomy and soft tissue balance. However, rTKA under the guidance of classic mechanical alignment principles does not significantly improve the functional outcome after operation. The new TKA alignment principles, such as kinematic alignment (KA) and functional alignment (FA), can better consider the patient’s own knee joint morphology and kinematic characteristics, which may help improve the clinical results of TKA. With the help of more objective and accurate soft tissue balance assessment tool such as pressure sensors, KA and FA have been proven to better achieve soft tissue balance. rTKA can achieve non-neutral alignment goals such as KA or FA more accurately and reproducibly. The use of these lower limb alignment and soft tissue balancing strategies will be expected to further increase the patients’ satisfaction rate after rTKA.
Objective To review the process of radiographic measurements of sagittal balance and offer reference for the clinical practice. Methods The related literature of spino-pelvic sagittal parameters and their clinical application was reviewed and analyzed from the aspects such as the clinical application, the advantages and disadvantages, and how to use them effectively. Results All parameters have their advantages and disadvantages, and they are influenced by age and race. Sagittal vertical axis can only reflect the global balance, and T1 pelvic angle which accounts for both spinal inclination and pelvic tilt can’t be controlled in the surgery. The correction goal for western people may be not suitable for Chinese. Conclusion The parameters should be used wisely when evaluating the sagittal balance, the global balance and local balance should be considered together and the different groups of people need different correction goals.
Objective To research the effects of recombinant growth hormone (rhGH) with total parenteral nutrition (TPN) on nitrogen balance and nutritional state of the patients following major abdominal surgery. Methods We randomly selected 45 patients receiving TPN after major abdominal surgery and distributed them to study group (rhGH+TPN, n＝30) and control group (TPN only, n＝15). For 7 days after operation, every one was given rhGH 4u or replaced by hypodermic injection of normal saline (control group). Results TPN+rhGH promoted the rehabilitant of nitrogen balance, heightened the level of plasma albumin and transferrin and increased the weight and creatinin/height index (CHI), but the thickness of triceps skin fold (TSF) had no significant change in patients following major abdominal surgery. Conclusion The rhGH can improve the effects of TPN.
ObjectiveTo explore the effect on sagittal spine-pelvis balance of different fusion segments in anterior cervical discectomy and fusion (ACDF).MethodsThe clinical data of 326 patients with cervical spondylotic myelopathy, treated by ACDF between January 2010 and December 2016, was retrospectively analysed. There were 175 males and 151 females with an average age of 56 years (range, 34-81 years). Fusion segments included single segment in 69 cases, double segments in 85 cases, three segments in 90 cases, and four segments in 82 cases. Full spine anterolateral X-ray films were performed before operationand at 12 months after operation. The spine-pelvis parameters of fusion segments were measured and compared. The parameters included C0-2 Cobb angle, C2-7 Cobb angle, C2-7 sagittal vertical axis (C2-7 SVA), T1 slope (T1S), thoracic inlet angle (TIA), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), C7 sagittal vertical axis (C7 SVA), T1 pelvic angle (TPA). The Japanese Orthopaedic Association (JOA) score of cervical spine and visual analogue scale (VAS) scores of pain of cervical spine and upper extremity were compared before operation and at 12 months after operation. Pearson correlation analysis was performed on LL, PI, SS, C7 SVA, and TPA before and after operation to evaluate the changes of spine-pelvis fitting relationship after ACDF.ResultsAll 326 patients were followed up 12-32 months (mean, 18.5 months). During the follow-up period, internal fixator was in place, and no spinal cord nerve or peripheral soft tissue injury was found. JOA scores and cervical VAS scores improved significantly at 12 months after operation (P<0.05), no significant difference was found in VAS scores of upper extremity when compared with preoperative scores (P>0.05). The preoperative cervical VAS scores and the postoperative JOA scores at 12 months had significant differences between groups (P<0.05). At 12 months after operation, there was no significant difference in sagittal spine-pelvis parameters in the single segment group compared with preoperative ones (P>0.05); but the C0-2 Cobb angle, C2-7 Cobb angle, C2-7 SVA, T1S, TIA, C7 SVA, and TPA in the double segments, three segments, and four segments groups were significant larger than preoperative ones (P<0.05). The C0-2 Cobb angle, C2-7 Cobb angle, T1S, C7 SVA, and TPA among 4 groups had significant differences before operation and at 12 months after operation (P<0.05). At 12 months after operation, the changes of C7 SVA and TPA in the double segments, three segments, and four segments groups were significantly larger than those in the single segment group (P<0.05). PI had positive correlations with LL and SS before and after operation in 4 groups (P<0.05).ConclusionNormal fitting relationship between lumbar spine and pelvis in physiological state also exists in patients with cervical spondylotic myelopathy, and ACDF can not change this specific relationship. In patients with cervical spondylotic myelopathy, the sagittal spine-pelvis sequence do not change after ACDF single-level fusion, while the sagittal spine-pelvis balance change after double-level and multi-level fusion.
The acid-base balance of the brain is critical to the functioning of the nervous system. The mechanisms that maintain acid-base homeostasis in the brain are complex and regulated by a variety of transporter proteins and enzymes. Slight changes in acid-base balance can affect neuronal excitability and even lead to epilepsy. Epilepsy is a common neurological disease with complex pathogenesis and numerous causes. Drug therapy is still the main method, but the treatment effect is limited. Therefore, it is urgent to clarify the pathological mechanism of epilepsy and explore new treatment directions This study provides an overview of the transporter proteins (acid-sensing ion channel, Na+/H+ exchanger, Na+/HCO3- cotransporters, anion exchangers, carbonic anhydrases) and the regulation of acid-base balance in the lungs. This study also introduces how these transporters participate in the stable maintenance of brain acid-base balance and their influence in epileptogenesis from both basic and clinical aspects in detail, providing new targets for epilepsy treatment and intervention.