OBJECTIVE:To systematically evaluate the clinical effectiveness of rehabilitation robots in treating lower limb motor dysfunction in patients with cerebral palsy,and to compare the differences in therapeutic effects among different robots.METHODS:PubMed,Web of Science,Embase,Cochrane Library,CNKI,CBM,VIP and WanFang databases were searched to collect randomized controlled trials on rehabilitation robotics for the treatment of motor dysfunction in patients with cerebral palsy,published from database inception to April 10,2024.The main outcome indicators included muscle strength,muscle tension,balance function,step speed,step frequency,step length,walking endurance,lower limb motor function,and activities of daily living.The above indicators were coded according to the International Classification of Functioning,Disability and Health.Meta-analysis was performed to evaluate the clinical efficacy and compare the therapeutic efficacy of different rehabilitation robots.Literature search and screening were performed by two researchers,and the quality of the included literature was evaluated using the Cochrane 5.1.0 risk of bias assessment tool.Meta-analysis was performed using RevMan 5.4 software and Stata 16.0 software.RESULTS:(1)Fifteen articles were finally included,involving 512 patients with 260 in the experimental group and 252 in the control group.(2)The Meta-analysis results showed that rehabilitation robots could improve body structure and function[standardized mean difference=0.41,95%confidence interval(CI):0.24-0.58,P<0.05],activities(standardized mean difference=0.53,95%CI:0.41-0.65,P<0.05)and participation ability(mean difference=7.86,95%CI:1.54-14.18,P<0.05).In particular,the rehabilitation robot improved lower limb muscle strength,balance function,step speed,walking endurance,lower limb gross motor function,and activities of daily living in patients with cerebral palsy,but showed insignificant effects on step frequency,step length,and muscle tension.(3)The network Meta-analysis results showed that:step speed:Innowalkpro>Gait Trainer>Lokomat>3DCalt;6-minute walk test score:Gait Trainer>Lokomat>Lokohelp>Innowalkro;Gross Motor Function Measure-88D score:Lokohelp>Lokomat>KidGo>Innowalkpro>3DCalt;Gross Motor Function Measure-88E score:Lokomat>Lokohelp>KidGo>3DCalt>Innowalkpro.CONCLUSION:Based on the International Classification of Functioning,Disability,and Health,rehabilitation robot training can improve the lower limb motor function and activities of daily living in patients with cerebral palsy.The Innowalkpro robot was more effective in improving step speed;the Gait trainer robot was more effective in improving 6-minute walk test scores;the Lokohelp robot was more effective in improving Gross Motor Function Measure-88D zone scores;and the Lokomat robot was more effective in improving Gross Motor Function Measure-88E zone scores.

OBJECTIVE:To systematically evaluate the clinical effectiveness of rehabilitation robots in treating lower limb motor dysfunction in patients with cerebral palsy,and to compare the differences in therapeutic effects among different robots.METHODS:PubMed,Web of Science,Embase,Cochrane Library,CNKI,CBM,VIP and WanFang databases were searched to collect randomized controlled trials on rehabilitation robotics for the treatment of motor dysfunction in patients with cerebral palsy,published from database inception to April 10,2024.The main outcome indicators included muscle strength,muscle tension,balance function,step speed,step frequency,step length,walking endurance,lower limb motor function,and activities of daily living.The above indicators were coded according to the International Classification of Functioning,Disability and Health.Meta-analysis was performed to evaluate the clinical efficacy and compare the therapeutic efficacy of different rehabilitation robots.Literature search and screening were performed by two researchers,and the quality of the included literature was evaluated using the Cochrane 5.1.0 risk of bias assessment tool.Meta-analysis was performed using RevMan 5.4 software and Stata 16.0 software.RESULTS:(1)Fifteen articles were finally included,involving 512 patients with 260 in the experimental group and 252 in the control group.(2)The Meta-analysis results showed that rehabilitation robots could improve body structure and function[standardized mean difference=0.41,95%confidence interval(CI):0.24-0.58,P<0.05],activities(standardized mean difference=0.53,95%CI:0.41-0.65,P<0.05)and participation ability(mean difference=7.86,95%CI:1.54-14.18,P<0.05).In particular,the rehabilitation robot improved lower limb muscle strength,balance function,step speed,walking endurance,lower limb gross motor function,and activities of daily living in patients with cerebral palsy,but showed insignificant effects on step frequency,step length,and muscle tension.(3)The network Meta-analysis results showed that:step speed:Innowalkpro>Gait Trainer>Lokomat>3DCalt;6-minute walk test score:Gait Trainer>Lokomat>Lokohelp>Innowalkro;Gross Motor Function Measure-88D score:Lokohelp>Lokomat>KidGo>Innowalkpro>3DCalt;Gross Motor Function Measure-88E score:Lokomat>Lokohelp>KidGo>3DCalt>Innowalkpro.CONCLUSION:Based on the International Classification of Functioning,Disability,and Health,rehabilitation robot training can improve the lower limb motor function and activities of daily living in patients with cerebral palsy.The Innowalkpro robot was more effective in improving step speed;the Gait trainer robot was more effective in improving 6-minute walk test scores;the Lokohelp robot was more effective in improving Gross Motor Function Measure-88D zone scores;and the Lokomat robot was more effective in improving Gross Motor Function Measure-88E zone scores.

Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines

OBJECTIVE To study the immunotherapeutic effect of chimeric virus-like particles(VLPs) based on hepatitis E virus(HEV) against human papillomavirus type 16(HPV 16) tumor. METHODS HPV16 E7 was inserted into the p239 protein of HEV to form the recombinant chimeric protein p239-HPV16 E7. The constructed recombinant protein was expressed by Escherichia coli, purified, and then refolded, and the protein was detected by electron microscopy and dynamic light scattering to confirm size and shape. Then, the C57B/L mice were immunized with the protein grain, and the lymphocyte differentiation of mouse spleen was detected by flow cytometry and enzyme-linked immune spot immunoassay; in addition, TC-1 tumor cells were used to construct tumor models in C57B/L mice to evaluate the anti-tumor immune effect of protein particles in mice. RESULTS After refold in vitro, the structure of chimeric protein was observed under electron microscopy, and the size of particle was 22.80 nm. The obtained protein particles induced favorable specific cellular immune response in C57B/L mice. Compared with the control group, the proportions of CD3+/CD4+ and CD3+/CD8+ in spleen lymphocytes of experimental groups were significantly different(P＜0.05), and effector T cells secreting IFN-γ interferon were also increased remarkably. At the same time, the obtained protein particles could effectively inhibit the growth of tumor cells in TC-1 tumor-bearing mice, and the mice did not die during the experimental period, while the tumors in the control mice grew rapidly and all died after 6 weeks. CONCLUSION Chimeric protein p239-HPV16E7 which was expressed in prokaryotes can form virus-like particles and effectively induce anti-tumor immunity against HPV16.

Aiming at the problems of individual differences in the asynchrony process of human lower limbs and random changes in stride during walking, this paper proposes a method for gait recognition and prediction using motion posture signals. The research adopts an optimized gated recurrent unit (GRU) network algorithm based on immune particle swarm optimization (IPSO) to establish a network model that takes human body posture change data as the input, and the posture change data and accuracy of the next stage as the output, to realize the prediction of human body posture changes. This paper first clearly outlines the process of IPSO's optimization of the GRU algorithm. It collects human body posture change data of multiple subjects performing flat-land walking, squatting, and sitting leg flexion and extension movements. Then, through comparative analysis of IPSO optimized recurrent neural network (RNN), long short-term memory (LSTM) network, GRU network classification and prediction, the effectiveness of the built model is verified. The test results show that the optimized algorithm can better predict the changes in human posture. Among them, the root mean square error (RMSE) of flat-land walking and squatting can reach the accuracy of 10 ^-3, and the RMSE of sitting leg flexion and extension can reach the accuracy of 10 ^-2. The R ² value of various actions can reach above 0.966. The above research results show that the optimized algorithm can be applied to realize human gait movement evaluation and gait trend prediction in rehabilitation treatment, as well as in the design of artificial limbs and lower limb rehabilitation equipment, which provide a reference for future research to improve patients' limb function, activity level, and life independence ability.
Algorithms ; Gait ; Humans ; Machine Learning ; Neural Networks, Computer ; Walking

Objective: To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR). Methods: Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives. All patients were given persistent external compression, airway open, tube intubation, and mechanical ventilation, vasoactive drugs application, defibrillation if required. STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines. On the basis of the standard CPR, IAPP-CPR group was recovered using abdominal lifting and compressing CPR instrument to press down to lift the upper abdomen continuously, when the chest compressing relaxed (frequency 100 times/min, down and lift time ratio 1:1, compressing strength 50 kg, lifting strength 30 kg). The patients' gender, age and CA etiology were recorded in the two groups. The vital signs and blood flow of carotid artery were monitored with ultrasonic Doppler during the CPR. The return of spontaneous circulation (ROSC) rate and 48-hour survival rate were observed in patients. The influence factors of ROSC were screened by Logistic regression analysis. Results: The data of 75 patients with CA were enrolled finally, with STD-CPR group of 38 patients and IAPP-CPR group of 37 patients. There were no significant differences in patients' gender, age or CA etiology between the two groups. Comparing with STD-CPR group, the peak blood flow velocity of carotid artery in IAPP-CPR group was speeded up significantly (cm/s: 107.16±13.75 vs. 78.99±14.77, P < 0.01), the overall blood flow volume of carotid artery was increased significantly (mL/min: 989.06±115.88 vs. 751.62±118.92, P < 0.01), but there was no significant difference in inner diameter of carotid artery between the two groups (mm: 4.55±0.25 vs. 4.61±0.21, P > 0.05) . During the CPR, the mean arterial pressure (MAP) and the transcutaneous oxygen saturation (SpO₂) in IAPP-CPR group were significantly higher than those of STD-CPR group, but no significant difference was found in heart rate between the two groups. Four patients in STD-CPR group got ROSC, and 3 survived over 48 hours (1 myocardial infarction patient died of ventricular fibrillation) while 6 patients in IAPP-CPR group got ROSC and survived over 48 hours. There was no significant difference in ROSC rate or 48-hour survival rate between the two groups, but data of IAPP-CPR group was slightly higher than that of STD-CPR group [ROSC rate: 16.22% (6/37) vs. 10.53% (4/38), 48-hour survival rate: 16.22% (6/37) vs. 7.89% (3/38), both P > 0.05]. Multivariate Logistic regression analysis showed that the higher the MAP during CPR, the greater the possibility of ROSC was [odds ratio (OR) = 1.361, 95% confidence interval (95%CI) = 1.182-1.669, P = 0.030]. Conclusions IAPP-CPR was superior to traditional STD-CPR in improving arterial blood flow and resuscitation effect, but no superiority was found in ROSC rate and survival rate, which may be relate to the small number of patients that included in this study. More clinic trials are needed.

OBJECTIVE: To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR). METHODS: Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives. All patients were given persistent external compression, airway open, tube intubation, and mechanical ventilation, vasoactive drugs application, defibrillation if required. STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines. On the basis of the standard CPR, IAPP-CPR group was recovered using abdominal lifting and compressing CPR instrument to press down to lift the upper abdomen continuously, when the chest compressing relaxed (frequency 100 times/min, down and lift time ratio 1:1, compressing strength 50 kg, lifting strength 30 kg). The patients' gender, age and CA etiology were recorded in the two groups. The vital signs and blood flow of carotid artery were monitored with ultrasonic Doppler during the CPR. The return of spontaneous circulation (ROSC) rate and 48-hour survival rate were observed in patients. The influence factors of ROSC were screened by Logistic regression analysis. RESULTS: The data of 75 patients with CA were enrolled finally, with STD-CPR group of 38 patients and IAPP-CPR group of 37 patients. There were no significant differences in patients' gender, age or CA etiology between the two groups. Comparing with STD-CPR group, the peak blood flow velocity of carotid artery in IAPP-CPR group was speeded up significantly (cm/s: 107.16±13.75 vs. 78.99±14.77, P < 0.01), the overall blood flow volume of carotid artery was increased significantly (mL/min: 989.06±115.88 vs. 751.62±118.92, P < 0.01), but there was no significant difference in inner diameter of carotid artery between the two groups (mm: 4.55±0.25 vs. 4.61±0.21, P > 0.05). During the CPR, the mean arterial pressure (MAP) and the transcutaneous oxygen saturation (SpO₂) in IAPP-CPR group were significantly higher than those of STD-CPR group, but no significant difference was found in heart rate between the two groups. Four patients in STD-CPR group got ROSC, and 3 survived over 48 hours (1 myocardial infarction patient died of ventricular fibrillation) while 6 patients in IAPP-CPR group got ROSC and survived over 48 hours. There was no significant difference in ROSC rate or 48-hour survival rate between the two groups, but data of IAPP-CPR group was slightly higher than that of STD-CPR group [ROSC rate: 16.22% (6/37) vs. 10.53% (4/38), 48-hour survival rate: 16.22% (6/37) vs. 7.89% (3/38), both P > 0.05]. Multivariate Logistic regression analysis showed that the higher the MAP during CPR, the greater the possibility of ROSC was [odds ratio (OR) = 1.361, 95% confidence interval (95%CI) = 1.182-1.669, P = 0.030]. CONCLUSIONS IAPP-CPR was superior to traditional STD-CPR in improving arterial blood flow and resuscitation effect, but no superiority was found in ROSC rate and survival rate, which may be relate to the small number of patients that included in this study. More clinic trials are needed.
Cardiopulmonary Resuscitation ; Electric Countershock ; Heart Arrest ; Humans ; Ultrasonics ; Ventricular Fibrillation

A rapid and simple ultra performance liquid chromatographic method for determination the specific migration of bisphenol A diglycidyl ether ( BADGE ) , bisphenol F diglycidyl ether ( BFDGE ) and their derivatives in food simulants was developed. Water, 3% acetic acid, 10% ethanol and sunflower oil were used as food simulants to simulate the specific migration of bisphenol diglycidyl ethers from interior coating of food cans after 10 days storage at 60℃. After the migration period, the aqueous food simulants were directly measured without any further purification, while the sunflower oil simulant was extracted by acetonitrile followed by cleaning up using solid phase extraction. Among the migration process, BADGE and bisphenol A (3-chloro-2-hydroxypropyl)glycidyl ether (BADGE·HCl) migrated into aqueous simulants were hydrolysed into bisphenol A bis ( 2, 3-dihydroxypropyl ) ether ( BADGE · 2H2 O ) and bisphenol A ( 3-chloro-2-hydroxypropyl) (2,3-dihydroxypropyl) ether (BADGE·H2O·HCl), respectively. However, BADGE and BADGE·HCl migrated into sunflower oil were not hydrolysed. The calibrating curves showed a good linearity from 0. 05 to 10 mg/L for all the 9 target compounds. The detection limits of the method for aqueous food simulants and sunflower oil stimulant were 5μg/L and 20μg/kg, respectively. The method was applied to the determination of bisphenol diglycidyl ethers migrated from 10 kinds of food cans which were intended to contact with food. The results indicate that BADGE and its derivatives were detected at 5 of the cans, and the specific migration of BADGE(or BADGE·2H2O)and BADGE·HCl(or BADGE·H2O·HCl)in 1 cans even exceed the responding limitation regulated in EC/1895/2005 .

Objective To retrospectively analyze the surgical methods and efficacy in 70 cases of type A aortic dissection patients over 65 years old.Methods From January 2005 to May 2012,70 type A aortic dissection patients over 65 years old received surgical treatment.Among them,there were 47 males aged 65 to 78 years old with mean 71,23 females,aged 65 to 72 years old with mean 68.55 cases were acute onset,while 15 cases were chronically onset.Different surgical methods were selected depend on patients' situations.We followed up all patients after discharged from hospital to continue to observe their health situation and evaluate the therapeutic effects.Results After surgery,eight patients died in the hospital,62 patients were recovered and discharged from the hospital.The mortality rate is 11.4％.During the follow up period from 3 to 72 months,there were no dead,aneurysm rupture and others severe complications.9 cases received endovascular graft exclusion within 6 months after discharged from hospital.The survival patients were satisfactory healed with their daily living activity resumed.Conclusion For over 65 years old patients with aortic dissection,the accurate and rapid selection of surgical method could improve the survival rate and the quality of life with a lower occurrence rate of complications.