BACKGROUND: Lower limb motion is complex.Proper human motion parameters detection is important for knee prosthesis control.Current lower limb prosthesis control information source is physical quantity related to motion information,which can directly reflect biomechanical characteristics of human motion.It is simple to collect and applicable for real-time control.The lower limb prosthesis utilizes one or several sensors to detect human motion information.OBJECTIVE: To develop a sensor system that can collect human motion information controlled by intelligent lower limb prosthesis.METHODS: Relationship between pivot axis installation potentiometer and knee joint flexion angle was acquired from analysis of four-bar linkage with a fixed pneumatic cylinder.In addition,the proper hall sensor installation position was selected to solve the two-solution problem.A sensor signal acquisition experiment was designed.The treadmill ensure that walking speed was completely under control.Knee joint flexion angle at toe-off in different walking speeds was measured.Curve fitting process provided the correspondence between them.RESULTS AND CONCLUSION: Knee joint flexion angle at toe-off increased with increasing walking speed.Quadratic curve fitting obtained a good effect.Results show that under horizontal walking state,potentiometers and Hall-sensors can be used to detect walking speed of lower limb prosthesis,and distinguish support phase and swing phase.

Objective To investigate the application of statins in secondary prevention of ischemic stroke and transient ischemic attacks (TIA) in different risk groups,and to identify the factors influencing the compliance of statins. Methods Data were prospectively collected on consecutively encountered ischemic stroke or TIA patients admitted to the First Affiliated Hospital of Zhengzhou University from April 2009 to January 2010.All clinical characteristics and possible factors influencing the compliance of statins were collected; the application of statins was investigated at 3-month follow-up.The multivariate Logistic regression analysis was used for the analysis of influence factors of the compliance of statins.Results All 369 patients were collected,52.8％ of cases were prescribed statins for therapy during hospitalization.The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 25.0％ (16/64),44.1％ (30/68) and 71.4％ (135/189),respectively. Logistic regression analysis showed that the statins application during hospitalization was associated with diabetes history ( P =0.032,OR =1.789,95％ CI 1.052-3.043 ) and the presence of carotid vulnerable plaques(P =0.000,OR =5.308,95％ CI 3.340-8.434).The general application rate of statins was 22.3％ (81/363),which was significantly lower than that during hospitalization. The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 9.7％ ( 6/62 ),25.8％ (17/66) and 29.4％ (55/187) respectively.Logistic regression analysis showed that good compliance of statins was associated with discharge instructions on statins application ( P =0.000,OR =34.852,95％ CI 14.673-175.452 ). Conclusions The compliance of statins in secondary prevention of ischemic stroke and TIA is poor,and there is still a large gap between clinical practice and guidelines; Discharge instructions on statins application increase the compliance of statins.

Objective To investigate the predictive value of the modified National Institutes of Health Stroke Scale ( mNIHSS),measured within 9 days after stroke,for the outcome in terms of modified Rankin Scale (mRS) at 6 months after stroke.Methods AII 161 patients with acute anterior circulation ischemic stroke were recruited consecutively from July 2010 until November 2010.The mNIHSS score was assessed within 3 days,4 to 6 days and 7 to 9 days after stroke,and the mRS score at 6 months after stroke was assessed by a neurology resident.Spearman rank correlation and ROC curve were used for statistic analysis.Results One hundred and sixty-one patients were assessed within 3 days,at 4 to 6 days and 7 to 9 days after stroke.Significant Spearman rank correlation coefficients were found between mRS at 6 months and mNIHSS scores within 3 days (rs =0.592,P＜0.01 ),4 to 6 days (rs =0.597,P＜0.01 ) and 7 to 9days (rs =0.595,P＜0.01).At 6 months after stroke,the AUC ranged from 0.789 (95％ CI 0.708-0.856) for measurements within 3 days to 0.792 (95％ CI 0.712-0.857 ) and 0.799 ( 95％ CI 0.721-0.864) for 4 to 6 days and 7 to 9 days,respectively. There was no significant difference for the AUCbetween them.The optimal cut-off values for the prediction of prognosis at 6 months were 8,7 and 6 points of mNIHSS score within 3 days,4 to 6 days and 7 to 9 days,respectively.The negative predictive value gradually increased from 0.847 for assessment within 3 days to 0.867 ( 95％ CI 0.578-0.765 ) for 7 to 9 days,whereas positive predictive value declined from 0.601 for assessment within 3 days to 0.533 for 7 to 9 days.The overall accuracy of predtictions decreased from 0.753 for assessment within 3 days to 0.709 for 7 to 9 days.Conclusions When measured within 9 days,the mNIHSS has a good predictive value for final outcome in terms of mRS at 6 months after stroke.However,the optimal cut-off values for the prediction of prognosis at 6 months are different when early mNIHSS scores were assessed at different periods.

Recently , the country actively explores the pattern of an integrated healthcare which enables the as-sociation among hospitals of different levels , aimed to achieve maximum utilization of medical resources and lead a reasonable distribution of the patients .By reviewing the practices related to the integration of healthcare in Beijing , Shanghai , Zhenjiang and Wuhan city , this paper sums up in five typical mechanisms , i.e.organization and manage-ment mechanism , human resource management mechanism , interest distribution mechanism , service continuity and resources sharing mechanism .The effects of these practices were analyzed and the faced challenges were discussed . The following points were made clear during analysis and discussion:the sustainability of the collaboration mode and organization structure , human resource supports and incentive methods , health insurance guidance for hospitals and patients , two-way referral system and supporting measures , and building of information system .Then we put forward some suggestions , hoping to offer some references to the establishment of integrated healthcare in other regions .

BACKGROUND:In the orthodontic treatment, double wire technique is commonly used to correct the torque of anterior teeth;however, the underlying mechanical mechanisms remain unclear. OBJECTIVE:To study the torque capabilities of DamonQ system through the three-dimensional finite element method. METHODS:Three-dimensional finite element models of Damon Q brackets with different dimension arch wires were established and were grouped according to arch wire with different dimensions. The torque capabilities of Damon Q system with different dimensions and materials arch wire were analyzed. RESULTS AND CONCLUSION:The Damon Q brackets with single or double wires had the same variation of torque, torque angle curve changes under the condition of different size and material arch wires. Torque moment increased gradually with increasing torque angle. Rectangular-round double wires produced larger torque moment compared with single rectangular wire, whereas double round wires produced smal er torque moment compared with single rectangular wire. The torque moment produced by rectangular-round double wires or by single rectangular wire was approximately 2-8 times or 1-5 times more than that by double round wires. The torque moment that rectangular-round double wires produced was larger than that single wire produced in the DamonQ system. In the early clinical practice, we can use double round wires to control root movement. In the middle-term of the treatment, we can use rectangular-round double wires to control root movement as the mild forces produced by them reduce root absorption. This study lays a foundation for the application of Damon Q bracket with double wire technology in the clinic.

Objective To establish a scald-induced pain model using a constant-temperature electrical scald instrument in rats.Methods Thirty-six pathogen-free male Sprague-Dawley rats, weighing 200-250 g, were randomly divided into 4 groups (n =9 each) using a random number table: control group (group C), scald for 5 s group (group S5), scald for 10 s group (group S10), and scald for 15 s group (group S15).The rats were anesthetized with intraperitoneal chloral hydrate.In S5, S10 and S15 groups, the plantar surface of the left hindpaw of rats were exposed to a constant-temperature electrical scald instrument (85 ℃) for 5, 10 and 15 s, respectively.The plantar surface of the left hindpaw of rats was exposed to an electrical scald instrument (room temperature) for 10 s in group C.At 1 day before treatment (T0),and 1, 3, 5, 7 and 14 days after treatment (T1-5), the mechanical and thermal pain thresholds were measured.Immediately after treatment, and at 24 h after treatment, the total body condition, wound color, and shape of the margin of the wound were observed and recorded.At 24 h after treatment, 3 rats were randomly sacrificed, and the skin from the plantar surface of the left hindpaw was removed for microscopic examination.Results Compared with group C, the thermal pain threshold at T1-2, and the mechanical pain threshold at T1-3 were significantly decreased in group S5, and the thermal pain threshold,and mechanical pain threshold were significantly decreased at T1-4 in group S10 (P＜0.05).The thermal pain threshold ＞ 25 s, and the mechanical pain threshold ＞30 g at T1-5 in group S15.The swelling in foot was bovious, burn blister appeared, and the degree of damage was aggravated in group S10 compared with S5 and S15 groups.Conclusion The scald-induced pain model is successfully established using a constant-temperature electrical scald instrument in rats.

Objective To analyze the diagnostic sensitivity and related impact factors of T cell spot test of tuberculosis (T‐SPOT .TB ) test in acquired immunodeficiency syndrome (AIDS )/tuberculosis (TB) patients .Methods Ninety‐two confirmed cases with AIDS/TB coinfection were tested by T‐SPOT . TB ,and the impact of CD4+ T cells counts on the diagnostic sensitivity was analyzed .Multivariate Logistic analysis was used for the analysis of impact factors of T‐SPOT .TB sensitivity .Blood samples of 19 cases with advanced stage AIDS/TB from January 2015 to January 2016 were collected ,and peripheral blood mononuclear cell (PBMC ) were isolated by Ficoll method , and lymphocytes were isolated by Percoll method .McNemar test was used for the comparison of these two methods .Results Among the 92 patients with AIDS/TB ,T‐SPOT .TB tests were positive in 51 cases ,with positive rate of 55 .4% .The sensitivity was 26 .3% (10/38) when CD4+ T cell count less than 20/μL ,and that was 92 .9% (13/14) when CD4+ T cell more than 200/μL .In Logistic analysis ,the sensitivity of T‐SPOT .TB test in patients with extra‐pulmonary tuberculosis was better than that in pulmonary tuberculosis patients (OR=3 .042 , P=0 .038) .The sensitivity of T‐SPOT .TB was positively correlated with CD4+ T cell count ,and the sensitivity increased by 2 .889 times when CD4+ T cells increasing 100/μL (OR=3 .889 ,P=0 .016) .The percentage of lymphocytes in PBMC was also positively correlated with T‐SPOT .TB positivity ,and the sensitivity increased by 1 .393 times when the percentage increasing 30% (OR=2 .393 ,P=0 .045) .When Percoll was used for lymphocytes isolation ,the T‐SPOT .TB sensitivity was 52 .6% (10/19) ,and when Ficoll was used for PBMC isolation ,the sensitivity was 36 .8% (7/19) .The difference was not statistically significant (P=0 .375) .Conclusion The sensitivity of T‐SPOT .TB test based on lymphocytes is higher than that based on PBMC .

Objective To observe Rongxin Pills in the treatment of viral myocarditis in children (deficiency of both qi and yin and heart meridian stasis syndrome) and the effectiveness and clinical application of safety.Methods Viral myocarditis patients (280 cases,deficiency of both qi and yin and heart meridian stasis syndrome),according to 3:1 ratio as the test group (n =21 0) and control group (n =70).The test group took orally Rongxin pills each time 4.5～9 g,3 times daily;the control group oral coenzyme Q10 capsule each time 10 ～ 20 mg,twice daily.The course of treatment was 28 d.The experiment was carried out with the random and double blind method.The symptoms of myocarditis,integrated and electrocardiogram,echocardiography,myocardial enzymes,as well as the efficacy of traditional Chinese medicine and improvement of the effect of the disease were observed.Results The results of FAS (PPS) analysis showed that 28 d after treatment,the symptom score and mean of experimental group and control group were 5.975 (6.000) and 4.721 (4.788).The syndromes of the total effective rates were 91.62％ (90.59％) and 70.59％ (71.21％),curative effect the total effective rates were 90.14％ (92.08％) and 72.06％ (72.73％).The total effective rate of experimental group was higher than that of the control group,the difference was statistically significant.In this experiment,three cases of clinical adverse events were reported,which were not related to the experimental drug.It also not belongs to adverse drug reactions.Conclusion Rongxin Pill in the treatment of viral myocarditis in children (deficiency of both qi and yin and heart meridian stasis syndrome) is more effective than coenzyme Q 10 capsule,and there was no indication of higher risk of clinical application.

Background: Workers are often exposed to hazardous heat due to their work environment, leading to various injuries. As a result of climate change, heat-related injuries (HRIs) are becoming more problematic. This study aims to identify critical contributing factors to the severity of occupational HRIs. Methods: This study analyzed historical injury reports from the Occupational Safety and Health Administration (OSHA). Contributing factors to the severity of HRIs were identified using text mining and model-free machine learning methods. The Multinomial Logit Model (MNL) was applied to explore the relationship between impact factors and the severity of HRIs. Results: The results indicated a higher risk of fatal HRIs among middle-aged, older, and male workers, particularly in the construction, service, manufacturing, and agriculture industries. In addition, a higher heat index, collapses, heart attacks, and fall accidents increased the severity of HRIs, while symptoms such as dehydration, dizziness, cramps, faintness, and vomiting reduced the likelihood of fatal HRIs. Conclusions The severity of HRIs was significantly influenced by factors like workers’ age, gender, industry type, heat index , symptoms, and secondary injuries. The findings underscore the need for tailored preventive strategies and training across different worker groups to mitigate HRIs risks.

To investigate the mechanism of Wenshen Xuanbi Decoction (WSXB) in treating osteoarthritis (OA) via network pharmacology, bioinformatics analysis, and experimental verification. The active components and prediction targets of WSXB were obtained from the TCMSP database and Swiss Target Prediction website, respectively. OA-related genes were retrieved from GeneCards and OMIM databases.Protein-protein interaction and functional enrichment analyses were performed, resulting in the construction of the Herb-Component-Target network. In addition, differential genes of OA were obtained from the GEO database to verify the potential mechanism of WSXB in OA treatment. Subsequently, potential active components were subjected to molecular verification with the hub targets. Finally, we selected the most crucial hub targets and pathways for experimental verification in vitro. The active components in the study included quercetin, linolenic acid, methyl linoleate, isobergapten, and beta-sitosterol. AKT1, tumor necrosis factor (TNF), interleukin (IL)-6, GAPDH, and CTNNB1 were identified as the most crucial hub targets. Molecular docking revealed that the active components and hub targets exhibited strong binding energy. Experimental verification demonstrated that the mRNA and protein expression levels of IL-6, IL-17, and TNF in the WSXB group were lower than those in the KOA group (p < 0.05). WSXB exhibits a chondroprotective effect on OA and delays disease progression. The mechanism is potentially related to the suppression of IL-17 and TNF signaling pathways and the down-regulation of IL-6.