1.Changes in balance and lower limb biomechanics of spastic hemiplegia under different visual deprivation and task conditions
Guanjun LIANG ; Huanlan XU ; Hewei ZHANG ; Dali ZHANG ; Qin GU ; Mingdi LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):345-355
ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.
2.Changes in balance and lower limb biomechanics of spastic hemiplegia under different visual deprivation and task conditions
Guanjun LIANG ; Huanlan XU ; Hewei ZHANG ; Dali ZHANG ; Qin GU ; Mingdi LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):345-355
ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.
3.Changes in balance and lower limb biomechanics of spastic hemiplegia under different visual deprivation and task conditions
Guanjun LIANG ; Huanlan XU ; Hewei ZHANG ; Dali ZHANG ; Qin GU ; Mingdi LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):345-355
ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.
4.Early prediction and warning of MODS following major trauma via identification of cytokine storm: A prospective cohort study.
Panpan CHANG ; Rui LI ; Jiahe WEN ; Guanjun LIU ; Feifei JIN ; Yongpei YU ; Yongzheng LI ; Guang ZHANG ; Tianbing WANG
Chinese Journal of Traumatology 2025;28(6):391-398
PURPOSE:
Early mortality in major trauma has decreased, but MODS remains a leading cause of poor outcomes, driven by trauma-induced cytokine storms that exacerbate injuries and organ damage.
METHODS:
This prospective cohort study included 79 major trauma patients (ISS >15) treated in the National Center for Trauma Medicine, Peking University People's Hospital, from September 1, 2021, to July 31, 2023. Patients (1) with ISS >15 (according to AIS 2015), (2) aged 15-80 years, (3) admitted within 6 h of injury, (4) having no prior treatment before admission, were included. Exclusion criteria were (1) GCS score <9 or AIS score ≥3 for TBI, (2) confirmed infection, infectious disease, or high infection risk, (3) pregnancy, (4) severe primary diseases affecting survival, (5) recent use of immunosuppressive or cytotoxic drugs within the past 6 months, (6) psychiatric patients, (7) participation in other clinical trials within the past 30 days, (8) patients with incomplete data or missing blood samples. Admission serum inflammatory cytokines and pathophysiological data were analyzed to develop machine learning models predicting MODS within 7 days. LR, DR, RF, SVM, NB, and XGBoost were evaluated based on the area under the AUROC. The SHAP method was used to interpret results.
RESULTS:
This study enrolled 79 patients with major trauma, and the median (Q1, Q3) age was 51 (35, 59) years (52 males, 65.8%). The inflammatory cytokine data were collected for all participants. Among these patients, 35 (44.3%) developed MODS, and 44 (55.7%) did not. Additionally, 2 patients (2.5%) from the MODS group succumbed. The logistic regression model showed strong performance in predicting MODS. Ten key cytokines, IL-18, Eotaxin, MCP-4, IP-10, CXCL12, MIP-3α, MCP-1, IL-1RA, Cystatin C, and MRP8/14 were identified as critical to the trauma-induced cytokine storm and MODS development. Early elevation of these cytokines achieved high predictive accuracy, with an AUROC of 0.887 (95% CI 0.813-0.976).
CONCLUSION
Trauma-induced cytokine storms are strongly associated with MODS. Early identification of inflammatory cytokine changes enables better prediction and timely interventions to improve outcomes.
Humans
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Prospective Studies
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Middle Aged
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Male
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Female
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Adult
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Aged
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Cytokine Release Syndrome/etiology*
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Adolescent
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Young Adult
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Aged, 80 and over
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Wounds and Injuries/complications*
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Cytokines/blood*
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Multiple Organ Failure/diagnosis*
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Machine Learning
5.Advances in Surface Modification Techniques of Ureteral Stents.
Guanjun MA ; Hua XIE ; Chao ZHOU ; Guangtai ZHOU ; Haijun ZHANG
Chinese Journal of Medical Instrumentation 2025;49(4):406-414
The article introduces the formation process of bacterial infection and encrustation on the surface of ureteral stents, elaborates in detail on six surface modification methods for ureteral stents, namely impregnation, spraying, vapor deposition, chemical grafting, self-assembly, and electrospinning, then analyzes the advantages and limitations of each technique during application. Meanwhile, it introduces three commonly used materials for ureteral stents, namely polymers, metals, and biodegradable materials, and further explains the commonly used surface modification methods corresponding to different materials. Looking ahead, with the continuous strengthening of the multi-technology integration trend and the continuous advancement of new material research and development, it is expected that a more ideal ureteral stent can be developed.
Stents
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Ureter
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Surface Properties
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Humans
6.Quantitative evaluation of left ventricular remodeling in left bundle branch block induced cardiomyopathy by multimodal imaging
Xiaoxian WANG ; Changqing MIAO ; Beibei GE ; Mingxia LI ; Fen CHEN ; Fang XU ; Ning ZHANG ; Guanjun GUO ; Wei XU ; Wenzhi SHEN ; Yingming ZHAO ; Jing YAO
Chinese Journal of Ultrasonography 2025;34(1):26-32
Objective:To quantitatively evaluate the effects of left bundle branch block(LBBB)on left ventricular structure,function and myocardial perfusion using left ventricular pressure-strain loop and single photon emission computed tomography(SPECT),and to investigate the relationship between myocardial work,myocardial perfusion and pathological changes of left ventricular remodeling in left bundle branch block induced cardiomyopathy(LBBB-CM).Methods:Fourteen male beagle dogs were selected,and the main trunk of the left bundle branch was ablated to create an LBBB dog model. Electrocardiogram(ECG),transesophageal echocardiography and arterial blood pressure data of LBBB dogs were collected before and 12 months after the ablation of left bundle branch trunk. Global and segmental myocardial work parameters were obtained by left ventricular pressure-strain loop. The differences of above parameters between baseline and 12 months after the ablation of left bundle branch were compared. SPECT was performed in LBBB dogs 12 months after the creation of LBBB. The hearts were harvested for anatomy observation and histopathological analysis in LBBB dogs and another 7 male beagle dogs(normal control group)matched by age and weight. The correlation between myocardial perfusion(percentage of regional tracer uptake)and myocardial work parameters,myocardial fibrosis in LBBB dogs were analyzed.Results:Compared with baseline,the left ventricular end-diastolic volume of 12 months after the ablation increased[(20.78 ± 5.32)ml vs(26.71 ± 7.94)ml, P = 0.003],left ventricular ejection fraction decreased[(59.17 ± 5.67)% vs(47.69 ± 5.45)%, P<0.001];left ventricular global/segmental longitudinal strain,global/segmental constructive work and global/segmental work efficiency decreased(all P<0.05),left ventricular global/segmental wasted work increased(all P<0.001). Heterogenous perfusion defect was observed in LBBB dogs by SPECT,compared with lateral wall segments,the percentage of regional tracer uptake of septum was decreased(all P<0.05). Gross anatomical and myocardial pathological changes were manifested as cardiomegaly,flaky or focal grayish thickening of endocardium,cardiomyocyte degeneration and fibrosis. Compared with normal control group,the collagen fiber volume fraction(CVF)in all segmental endocardium and partial segmental myocardium of LBBB dogs were significantly increased(all P<0.05). Percentage of regional tracer uptake was positively correlated with segmental myocardial work(SMW)and segmental myocardial efficiency(SWE)( r s = 0.49,0.31;both P<0.001),and negatively correlated with CVF and segmental wasted work(SWW)( r s = -0.51,-0.49;both P<0.001). Conclusions:Isolated LBBB is not benign,which can result in left ventricular remodeling,decreased cardiac constructive function,abnormal myocardial perfusion,endocardial fibrosis and myocardial fibrosis.The parameters of myocardial work assecsed by echocardiograpgy and myocardial perfusion,as non-invasive examination,can to some extent reflect the degree of left ventricular remodeling in LBBB-CM.
7.Right heart contrast-enhanced echocardiographic diagnosis of a left superior vena cava aneurysm
Hui CHEN ; Aijuan FANG ; Ning ZHANG ; Guanjun GUO ; Lei LIU ; Jing YAO
Chinese Journal of Ultrasonography 2025;34(4):352-353
Permanent left superior vena cava aneurysm is a rare mediastinal venous lesion,the majority of the literature is in the form of case reports. In this article,a 50-year-old female with an incidental permanent left superior vena cava aneurysm discovered on echocardiography in Nanjing Gulou Hospital,and the right heart contrast-enhanced echocardiographic played an important role in the process of clear diagnosis. The patient was observed without intervention. No complications were attributable to the permanent left superior vena cava aneurysm during follow-up.
8.Disinfection effect of low-temperature plasma air sterilizer in the orthopedic ward
Pan DIAO ; Bo ZHANG ; Yuhao SUN ; Hang ZHAO ; Guimin XU ; Xingmin SHI ; Guanjun ZHANG ; Haopeng LI
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(1):52-58
Objective To satisfy the normalized disinfection in the orthopedic ward,an air sterilizer based on low-temperature plasma has been developed to investigate its sterilization results in a dynamic environment of hospitalization where patients,companions and medical workers are involved.Methods This study took an orthopedics ward in the Secondary Affiliated Hospital of Xi'an Jiaotong University,as the research object,where a home-made low-temperature plasma air sterilizer was utilized.A six-stage viable Andersen cascade impactor was used to sample the natural bacteria in the ward before and after machine operation for three hours.The species and quantity of bacteria in the ward were analyzed.Results The ozone concentration in the indoor dynamic environment decreased to below 5 ppbv.After three-hour disinfection,the elimination rate of natural bacteria reached 92.35%.The final colony forming unit decreased to~150 CFU/m3;the extinction rates of Staphylococcus hominis,Bacillus cereus,molds,and Micrococcus luteus were 90.48%,80.90%,87.50%,and 92.82%respectively.Even all Haemophilus massiliensis disappeared after two-hour treatment.Conclusion Intermittent disinfection of the dynamic environment in the ward using low-temperature plasma synergistic catalyst has enabled the indoor ozone concentration to reach the first-level national standard line,effectively suppressing secondary pollution caused by ozone leakage while efficiently killing suspended microorganisms in the air,which is close to the disinfection level Ⅰenvironment specified in Hygienic Standard for Disinfection in Hospitals(GB 15982-2012).The results also show that the plasma catalytic synergistic disinfection and sterilization has the technical advantages of efficient disinfection and human-machine coexistence,which can ensure indoor air quality safety,reduce the workload of nursing staff,and thus is an effective method to assist or even replace the existing physical and chemical means.
9.Disinfection effect of low-temperature plasma air sterilizer in the orthopedic ward
Pan DIAO ; Bo ZHANG ; Yuhao SUN ; Hang ZHAO ; Guimin XU ; Xingmin SHI ; Guanjun ZHANG ; Haopeng LI
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(1):52-58
Objective To satisfy the normalized disinfection in the orthopedic ward,an air sterilizer based on low-temperature plasma has been developed to investigate its sterilization results in a dynamic environment of hospitalization where patients,companions and medical workers are involved.Methods This study took an orthopedics ward in the Secondary Affiliated Hospital of Xi'an Jiaotong University,as the research object,where a home-made low-temperature plasma air sterilizer was utilized.A six-stage viable Andersen cascade impactor was used to sample the natural bacteria in the ward before and after machine operation for three hours.The species and quantity of bacteria in the ward were analyzed.Results The ozone concentration in the indoor dynamic environment decreased to below 5 ppbv.After three-hour disinfection,the elimination rate of natural bacteria reached 92.35%.The final colony forming unit decreased to~150 CFU/m3;the extinction rates of Staphylococcus hominis,Bacillus cereus,molds,and Micrococcus luteus were 90.48%,80.90%,87.50%,and 92.82%respectively.Even all Haemophilus massiliensis disappeared after two-hour treatment.Conclusion Intermittent disinfection of the dynamic environment in the ward using low-temperature plasma synergistic catalyst has enabled the indoor ozone concentration to reach the first-level national standard line,effectively suppressing secondary pollution caused by ozone leakage while efficiently killing suspended microorganisms in the air,which is close to the disinfection level Ⅰenvironment specified in Hygienic Standard for Disinfection in Hospitals(GB 15982-2012).The results also show that the plasma catalytic synergistic disinfection and sterilization has the technical advantages of efficient disinfection and human-machine coexistence,which can ensure indoor air quality safety,reduce the workload of nursing staff,and thus is an effective method to assist or even replace the existing physical and chemical means.
10.Quantitative evaluation of left ventricular remodeling in left bundle branch block induced cardiomyopathy by multimodal imaging
Xiaoxian WANG ; Changqing MIAO ; Beibei GE ; Mingxia LI ; Fen CHEN ; Fang XU ; Ning ZHANG ; Guanjun GUO ; Wei XU ; Wenzhi SHEN ; Yingming ZHAO ; Jing YAO
Chinese Journal of Ultrasonography 2025;34(1):26-32
Objective:To quantitatively evaluate the effects of left bundle branch block(LBBB)on left ventricular structure,function and myocardial perfusion using left ventricular pressure-strain loop and single photon emission computed tomography(SPECT),and to investigate the relationship between myocardial work,myocardial perfusion and pathological changes of left ventricular remodeling in left bundle branch block induced cardiomyopathy(LBBB-CM).Methods:Fourteen male beagle dogs were selected,and the main trunk of the left bundle branch was ablated to create an LBBB dog model. Electrocardiogram(ECG),transesophageal echocardiography and arterial blood pressure data of LBBB dogs were collected before and 12 months after the ablation of left bundle branch trunk. Global and segmental myocardial work parameters were obtained by left ventricular pressure-strain loop. The differences of above parameters between baseline and 12 months after the ablation of left bundle branch were compared. SPECT was performed in LBBB dogs 12 months after the creation of LBBB. The hearts were harvested for anatomy observation and histopathological analysis in LBBB dogs and another 7 male beagle dogs(normal control group)matched by age and weight. The correlation between myocardial perfusion(percentage of regional tracer uptake)and myocardial work parameters,myocardial fibrosis in LBBB dogs were analyzed.Results:Compared with baseline,the left ventricular end-diastolic volume of 12 months after the ablation increased[(20.78 ± 5.32)ml vs(26.71 ± 7.94)ml, P = 0.003],left ventricular ejection fraction decreased[(59.17 ± 5.67)% vs(47.69 ± 5.45)%, P<0.001];left ventricular global/segmental longitudinal strain,global/segmental constructive work and global/segmental work efficiency decreased(all P<0.05),left ventricular global/segmental wasted work increased(all P<0.001). Heterogenous perfusion defect was observed in LBBB dogs by SPECT,compared with lateral wall segments,the percentage of regional tracer uptake of septum was decreased(all P<0.05). Gross anatomical and myocardial pathological changes were manifested as cardiomegaly,flaky or focal grayish thickening of endocardium,cardiomyocyte degeneration and fibrosis. Compared with normal control group,the collagen fiber volume fraction(CVF)in all segmental endocardium and partial segmental myocardium of LBBB dogs were significantly increased(all P<0.05). Percentage of regional tracer uptake was positively correlated with segmental myocardial work(SMW)and segmental myocardial efficiency(SWE)( r s = 0.49,0.31;both P<0.001),and negatively correlated with CVF and segmental wasted work(SWW)( r s = -0.51,-0.49;both P<0.001). Conclusions:Isolated LBBB is not benign,which can result in left ventricular remodeling,decreased cardiac constructive function,abnormal myocardial perfusion,endocardial fibrosis and myocardial fibrosis.The parameters of myocardial work assecsed by echocardiograpgy and myocardial perfusion,as non-invasive examination,can to some extent reflect the degree of left ventricular remodeling in LBBB-CM.

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