The present paper is to study the center line of the plantar pressure of normal young people, and to find the relation between center line of the plantar pressure and gait stability and balance. The paper gives the testing principle and calculating methods for geometric center of plantar pressure distribution and the center of pressure due to the techniques of footprint frame. The calculating formulas in both x direction and y direction are also deduced in the paper. In the experiments carried out in our laboratory, the gait parameters of 131 young subjects walking as usual speed were acquired, and 14 young subjects of the total were specially analyzed. We then provided reference data for the walking gait database of young people, including time parameters, space parameters and plantar pressure parameters. We also obtained the line of geometry center and pressure center under the foot. We found that the differences existed in normal people's geometric center line and the pressure center line. The center of pressure trajectory revealed foot movement stability. The length and lateral changes of the center line of the plantar pressure could be applied to analysis of the plantar pressure of all kinds of people. The results in this paper are useful in clinical foot disease diagnosis and evaluation of surgical effect.
Foot ; physiology ; Gait ; Humans ; Pressure ; Reference Values ; Walking

Objecfive To investigate the change of V-ATPase B subunits on epithelial to mesenchymal transition (EMT)in rat renal tubular epithelial cells (NRK52E) stimulated by transforming growth factor β1 (TGF-β1). Methods NRK52E cells were stimulated by TGF-β1 (10 μg/L)for O h(control),12 h,24 h,48 h,72 h after sefrum-free culture for 24 h.The mRNA and protein expression of E-cadherin,α-SMA,B2 and B1 subunits of V-ATPase were detected by real-time PCR,Western blotting and immunofluorescence. Results After stimulated by TGF-β1 (10 μg/L)for 48 h,the expression of α-SMA was markedly increased(P<0.05),but the expression of E-cadherin was dramatically decreased(P<0.05).Meanwhile,the expressions of V-ATPase subunit B2 was significantly increased (P<0.05).However,the B1 subunit distributed rarely in NRK 52E cells,and did not increase after TGF-β1 stimulation.Double-label immunofluoerscence staining also showed that the V-ATPase B2 subunit was increased in the cytosol.tending to accumulate to the cell membrane after TGF-β1 stimulation. Conclusions The main isoform of V-ATPase distributed in NRK52E cells is B2 subunit.B2 subunit is increased alone with TGF-β1-induced EMT.It may suggest that V-ATPase B2 subunit may play a potential role in TGF-β1-induced tubular EMT and renal fibrosis.

Objective:To explore the competency for the assistant general practitioners in China to provide theoretical support for the construction of the post competence model of assistant general practitioners and training and evaluation of assistant general practitioners.Methods:During January 22 to June 18, 2019, Using snowball sampling method and behavioral event interviews, 23 general practitioners and assistant general practitioners were interviewed in China, including 14 general practitioners in the superior performance group and 9 assistant general practitioners in the average performance group. The interview contents were coded and analyzed, and the statistical methods of t test and rank sum test of two independent samples were used to screen competency characteristics and construct the competence model of assistant general practitioners.Results:The total classification consistency and the total coding reliability coefficient was respectively 0.79, 0.87. 59 competency characteristics of assistant general practitioners were obtained including 3 differentiated competency characteristics "Understanding the medical and health system and related policies", "Critical thinking skills" and "General practitioner clinical thinking" and 10 baseline competency characteristics. There was no statistically significant difference between the average performance group and the superior performance group in the total frequency of competency [(29.4±12.7) times to (23.4±7.0) times, t=1.27, P=0.22]. Conclusion:The preliminary competency characteristics of assistant general practitioners have good reliability and can provide references for further exploration of the competency model.

Objective To investigate the effects of hemodialysis (HD) and peritoneal dialysis (PD) on the complications and outcomes after renal transplantation. Methods Clinical data of 402 renal transplant recipients maintained on dialysis for more than 3 months were retrospectively studied and divided into 2 groups: HD group(n=303)and PD group(n=99). Among them, 345 recipients were followed up for an average of (30.2±15.2) months. The impact of HD and PD on the acute rejection, delayed graft function (DGF), infection, chronic rejection and the graft and patient survival rates were analyzed. Results The mean dialysis duration was significantly longer in PD group and the hepatitis B infection rate was significantly higher in HD group. There were no signiticant differences between the HD and PD groups in regarding to primary disease for end-stage renal disease, age, gender, blood pressure, hemoglobin, HLA match, hot and cold ischemia time, and hepatitis C vires infection. The incidence of DGF, acute and chronic rejection, and cytomegalovirus and other infections between HD and PD groups were not significantly different. However, the graft loss happened more frequently in hepatatis B patients than that in non hepatitis B patients (19.23% vs 8.86%, P=0.021), and the post-transplant infection ocurred less in non hepatits B patients with PD. The acute rejection episodes were higher in HD patients who received pretransplant dialysis for more than 12 months (P<0.05). The overall recipients survival rates of HD and PD groups were similar (1-year: HD 94.34%, PD 91.25%;5-year: HD 92.83%, PD 90%), and the same as the graft survival rates in HD and PD groups (1-year: HD 93.21%, PD 96.25%;5-year: HD 87.17%, PD 91.25%). Conclusions The influences of PD and HD on the complications after renal transplantaton, 1-year and S-year recipients and graft survival rates are similar, so both HD and PD can be chosen as the pretransplant dialysis modality. As the incidence of acute rejection increases with time in HD, it is better to shorten the time of pretransplant dialysis to decrease the complication.

The right ventricle was considered had not played a major role in the achievement of the whole cardiac function.With the progress of researches on right ventricular structure and function,people are gradually aware of the important role of right ventricular morphology and function in clinical and prognostic evaluation.As a result,a variety of imaging technologies for overall evaluating the right ventricular functions have been developed.With the development of echocardiography,speckle tracking imaging (STI) technology has been widely used in right ventricular function evaluation.The STI technology provides a new simple and practical method for right ventricular function evaluation and research,as well as the diagnosis and prognosis evaluation of the right ventricular function associated heart and lung diseases.In this paper,the principle,method and importance of STI technology in right ventricular function evaluation and the problems in clinical application were summarized.

Objective To analyze the effect of Prolift pelvic floor reconstruction on pelvic organ prolapse and its influence on quality of life (P-QOL) score and pelvic floor muscle strength level.Methods From April 2014 to February 2017,63 patients with pelvic organ prolapse were selected and randomly divided into two groups.The patients in the control group were treated with traditional vaginal hysterectomy and anterior and posterior vaginal wall repair,while the patients in the observation group were treated with Prolift pelvic floor reconstruction.The clinical effect of two methods after treatment were compared.Results The operative time of the observation group was shorter than that in the control group.The amount of intraoperative bleeding and residual urine after operation in the observation group were lower than those in the control group.The pelvic floor muscle strength level in the observation group was superior to that in the control group.Besides,the quality of life in the observation group was higher than that in the control group one year after operation.The rate of postoperative dysuria and recurrence were lower than that of the control group (P ＜ 0.05),but there was no significant difference between the two groups (P ＞ 0.05).Conclusions Prolift pelvic floor reconstruction is a simple,less invasive and safe procedure for the correction of pelvic organ prolapse.It can promote the recovery of pelvic floor muscle function,and the curative effect is better than that of traditional surgery.

Objective: To compare the early and mid-term postoperative changes of left ventricular structure and function beteen mitral repair and replacement in patients with mitral regurgitation. Methods: 100 patients with degenerative mitral regurgitation underwent mitral valve replacement and mitral repair from January 2008 to January 2018 were retrospectively studyed. Of them, 46 patients underwent mitral repair and(repair group) 54 patients underwent mitral valve replacement(replacement group). The results of color Doppler echocardiography before, one week after, 12 months after and 24-36 months after operation were collected. Left atrial diameter(LAD), left ventricular end diastolic diameter(LVEDD) and left ventricular end systolic diameter(LVESD) were selected to evaluate left ventricular structure, fraction shortening(FS)、left ventricular stroke volume( SV )and left ventricular ejection fraction(LVEF) to evaluate left ventricular function. The data were analyzed by SPSS 22.0. Results: In left ventricular structural parameters, LAD, LVEDD and LVESD in mitral repair group and replacement group were significantly improved compared with those before operation(P<0.05). There was no significant difference in LAD, LVEDD and LVESD between the two groups at 12 months after operation(P>0.05). There were significant differences in LAD(42.26 mm vs 47.15 mm), LVEDD(52.97 mm vs 60.18 mm) and LVESD(31.34 mm vs 34.82 mm) between the two groups at 24-36 months of follow-up(P<0.05). Among the left ventricular function indicators, the early and mid-term SV of the two groups were significantly improved compared with that of the preoperative group(P<0.05). LVEF(0.64 vs 0.59、0.64 vs 0.58)was significantly improved in the 12 and 24-36 months after the operation, and FS(36.18% vs 31.47%) was significantly different in the 24-36 months after the operation(P<0.05). Conclusion Mitral repair has high technical requirements and long operation time, but it has obvious advantages over mitral valve replacement in maintaining left ventricular structure and function in the middle and late period after operation.

Objective:To investigate the changes of dynamic functional connectivity between the default mode network (DMN) and executive control network (ECN) in the resting state in patients with alcohol use disorder (AUD).Methods:From September 2018 to June 2019, 23 cases of AUD group and 24 cases of healthy control (HC) group matched with age, gender, education level and handedness were collected at Renmin Hospital of Wuhan University. Mini-mental state examination (MMSE) and Michigan alcoholism screening test (MAST) were performed in all subjects for cognition and alcohol dependence score. All the subjects underwent T 1WI-3D structural imaging and resting state functional MRI (rs-fMRI) examination. Group spatial independent component analysis (ICA) was used to select the independent components of DMN and ECN. Then dynamic changes in the functional connectivity between the DMN and the DMN were obtained by sliding window approach and clustering method. Finally, the independent sample t test was used to compare the difference of general clinical data between the two groups, the linear correlation analysis was conducted in the parameter value and MMSE and MAST scores. Results:Compared with the HC group, the static functional connectivity analysis showed that the precuneus and posterior cingulate gyrus of the DMN were enhanced in the AUD group ( P=0.016, t=2.496). The DMN and ECN functional connectivity showed four different brain activity states, the proportion of state1 increased by 6.81% and state2 decreased by 6.83% in the AUD group, state3 and state4 were relatively stable. In state1, the internal functional connectivity of the DMN in the AUD group was enhanced, while the functional connectivity between DMN and ECN was mainly enhanced. In state2, the internal functional connectivity of the ECN was enhanced, and the connectivity between the DMN and ECN was mainly weakened. The mean dwell of state2 in the AUD group was negatively correlated with the MAST score ( r=-0.433, P=0.039). Conclusions:Dynamic functional connectivity patterns between DMN and ECN have been changed in patients with AUD. Dynamic functional connectivity can reveal transient changes in brain activity, which can provide certain imaging evidence for finding changes in AUD deep brain activity.