In order to characterize the characteristics of pathological tremor of human upper limb, a simulation system of pathological tremor of human arm was provided and its dynamic response was analyzed. Firstly, in this study, a two-degree-of-freedom human arm dynamic model was established and linearized according to the arbitrary initial angle of joints. After solving the analytical solutions of steady-state responses of the joints, the numerical solution was used to verify it. The results of theoretical analysis show that the two natural frequencies of the developed dynamic model are 2.9 Hz and 5.4 Hz, respectively, which meet the characteristic frequency range of pathological tremors. Then, combined with the measured parameters of human arm, a tremor simulation system was built, and the measured results of joint responses are in good agreement with the theoretical and simulation analysis results, which verifies the effectiveness of the theoretical model. The results show that the human arm pathological tremor simulation system designed in this paper can characterize the frequency and response amplitude of the human upper limb pathological tremor. Moreover, the relevant research lays a theoretical foundation and experimental conditions for the subsequent development of wearable tremor suppression devices.
Humans ; Tremor/physiopathology* ; Computer Simulation ; Arm/physiopathology* ; Joints/physiopathology* ; Biomechanical Phenomena ; Upper Extremity/physiopathology* ; Models, Biological

Objective:To investigate the feasibility and clinical efficacy of side-to-side anastomosis of superficial temporal artery (STA) and middle cerebral artery (MCA) bypass using in-situ intravascular suture technique.Methods:A retrospective analysis was conducted on the clinical data of 10 adult patients who were treated with side-to-side microvascular anastomosis of STA-MCA bypass to improve intracranial blood supply, between February 2024 and September 2024 in the Department of Neurosurgery of the Fourth Affiliated Hospital of Soochow University. Among the patients, 2 were of symptomatic MCA occlusion and 8 of Moyamoya disease. Diameter of STA and MCA, length of anastomosis and blocking time of MCA were recorded. Indocyanine green video angiography (ICG-VA) was performed to evaluate the immediate patency of the STA-MCA side-to-side anastomosis. Digital subtracted angiography (DSA) was performed at 1 week after the surgery to evaluate the patency of the STA-MCA bypass anastomosis, then follow-up DSA was performed at 1, 3 and 6 months after surgery to further evaluate the postoperative anastomotic patency. Neurological function was evaluated regularly with the modified Rankin Scale (mRS).Results:All of the 10 side-to-side STA-MCA bypass anastomoses were successfully performed using in-situ intravascular suture technique. The scalps of all patients healed well. The diameters of STA and MCA were 1.4-2.0 (1.76±0.27) mm and 0.8-1.4 (0.98±0.20) mm, respectively. The average length of the anastomoses was 3.5-5.0 (4.45±0.60) mm. The blocking time of MCA was 12.0-29.0 (21.50±6.62) min. A 100% vessel patency rate was achieved immediately after vessel anastomosis and at 1 month after surgery. DSA examinations were performed at 3 months after surgery on 6 patients and at 6 months after surgery on 1 patient, and all the anastomoses were found in full patency. All patients were included in the postoperative follow-up that lasted for 3 to 7 months. All patients recovered well without new neurological dysfunction. The mRS of 8 patients remained at 0 point before and after surgery. Two patients had improved postoperative mRS of 1 point from that of 2 points before surgery.Conclusion:STA-MCA side-to-side microvascular bypass anastomosis can be performed safely and efficiently using in-situ intravascular suture technique. It could efficiently reduce the incidence of perioperative complications. Meanwhile, it can self-regulate the blood flow and maximise the potential capability of STA.

Objective:To evaluate the effects of chlorinated organophosphate flame retardants (Cl-OPFRs) via respiratory and digestive tract exposure on multiple organs in mice.Methods:A short-term repeated exposure model of tris(2-chloroethyl) phosphate (TCEP), tris(1-chloro-2-propyl) phosphate (TCIPP) and tris(1, 3-dichloro-2-propyl) phosphate (TDCIPP) in mice was established through intratracheal instillation and oral gavage administration. The exposure doses were 0.7, 1 and 2 mg·kg -1·day -1, respectively, with continuous administration for 14 days. The organs of the heart, liver, spleen, lung, kidney, stomach, large intestine, small intestine, bladder and testis were collected and weighed to calculate the organ coefficients. The pathological and histological changes were observed by hematoxylin-eosin staining to quantitatively assess the effects of the three Cl-OPFRs on the various organs by using the pathology score. Results:Analysis of organ coefficients in tracheal drip-treated mice showed that the organ coefficients in the testes of the TCEP, TCIPP and TDCIPP groups were lower than those in the control group ( PTCEP-testis=0.045, PTCIPP-testis=0.012 and PTDCIPP-testis<0.001). The organ coefficients were lower in the lungs and small intestines of the TCEP group ( PTCEP-lung=0.006, PTCEP-small intestine=0.042). The organ coefficients for the stomach and large intestine were higher in the TDCIPP group ( PTDCIPP-stomach=0.014, PTDCIPP-large intestine=0.049). Analyses of gavage-contaminated mice showed that the organ coefficients for liver, stomach and small intestine in the TCEP and TDCIPP groups were higher than those in the control group ( PTCEP-liver=0.007, PTCEP-stomach=0.003, PTCEP-small intestine<0.001, PTDCIPP-liver=0.001, PTDCIPP-stomach=0.004, and PTDCIPP-small intestine<0.001). Histopathological analyses of the organs of tracheal drip dyed mice showed significant pathological damage in the lung tissue of the TCIPP group, mainly in the form of thickening of the interstitium, infiltration of inflammatory cells and alveolar collapse. The results of the analysis of gavage poisoned mice showed that TCIPP exposure could lead to blurring of the red and white medullary boundaries of spleen tissues, destruction of white medullary structures, etc., and induce small intestinal cryptitis. TDCIPP induced significant pathological damage to the liver tissues of mice, which mainly included cytoplasmic washout, infiltration of inflammatory cells, acute inflammation, and other injurious effects. Significant pathological damage to the intestinal tissues of mice was also observed. Conclusions:This study demonstrates that the toxic effects of Cl-OPFRs are significantly associated with exposure routes and compound specificity. Respiratory exposure predominantly induces TCIPP-mediated pulmonary injury, while digestive exposure causes TDCIPP-driven hepatointestinal toxicity. These findings provide preliminary evidence for the toxicity screening of Cl-OPFRs.

Objective:To understand the current status of family resilience in children with autism and explore its influencing factors, providing a basis for developing intervention measures to improve family resilience in these families.Methods:Convenience sampling was used to select children with autism and their caregivers who underwent rehabilitation training at the Department of Child Developmental Behavior, Third Affiliated Hospital of Zhengzhou University from March to September 2023. A cross-sectional survey was conducted using a general information questionnaire, the Chinese version of the Family Resilience Assessment Scale, the Chinese version of the Parenting Burnout Scale, and the Caregiver Stress Scale.Results:A total of 280 questionnaires were distributed, and 271 valid questionnaires were collected. Among the 271 children with autism, 210 were male and 61 were female, with the majority aged 3-5 years old (169 cases). Among the 271 caregivers, 21 were male and 250 were female, with the majority aged 30-39 years old (149 cases). The total score of the Chinese version of the Family Resilience Assessment Scale was (70.59 ± 14.08) points, with scores of (49.96 ± 10.23) points for family communication and problem-solving, (7.13 ± 1.62) points for social resource utilization, and (13.52 ± 3.31) points for maintaining a positive attitude. Multiple linear regression analysis showed that the child′s age, disease duration, reimbursement method, parenting burnout, and caregiver stress were influencing factors of family resilience in children with autism ( t values were -10.40-3.48, all P<0.05). Conclusions:The level of family resilience in children with autism needs improvement. Higher levels of parenting burnout and caregiver stress are associated with lower levels of family resilience. Future interventions should be developed based on these influencing factors to promote the physical and mental health of children with autism and their caregivers.

Objective:To evaluate the effects of chlorinated organophosphate flame retardants (Cl-OPFRs) via respiratory and digestive tract exposure on multiple organs in mice.Methods:A short-term repeated exposure model of tris(2-chloroethyl) phosphate (TCEP), tris(1-chloro-2-propyl) phosphate (TCIPP) and tris(1, 3-dichloro-2-propyl) phosphate (TDCIPP) in mice was established through intratracheal instillation and oral gavage administration. The exposure doses were 0.7, 1 and 2 mg·kg -1·day -1, respectively, with continuous administration for 14 days. The organs of the heart, liver, spleen, lung, kidney, stomach, large intestine, small intestine, bladder and testis were collected and weighed to calculate the organ coefficients. The pathological and histological changes were observed by hematoxylin-eosin staining to quantitatively assess the effects of the three Cl-OPFRs on the various organs by using the pathology score. Results:Analysis of organ coefficients in tracheal drip-treated mice showed that the organ coefficients in the testes of the TCEP, TCIPP and TDCIPP groups were lower than those in the control group ( PTCEP-testis=0.045, PTCIPP-testis=0.012 and PTDCIPP-testis<0.001). The organ coefficients were lower in the lungs and small intestines of the TCEP group ( PTCEP-lung=0.006, PTCEP-small intestine=0.042). The organ coefficients for the stomach and large intestine were higher in the TDCIPP group ( PTDCIPP-stomach=0.014, PTDCIPP-large intestine=0.049). Analyses of gavage-contaminated mice showed that the organ coefficients for liver, stomach and small intestine in the TCEP and TDCIPP groups were higher than those in the control group ( PTCEP-liver=0.007, PTCEP-stomach=0.003, PTCEP-small intestine<0.001, PTDCIPP-liver=0.001, PTDCIPP-stomach=0.004, and PTDCIPP-small intestine<0.001). Histopathological analyses of the organs of tracheal drip dyed mice showed significant pathological damage in the lung tissue of the TCIPP group, mainly in the form of thickening of the interstitium, infiltration of inflammatory cells and alveolar collapse. The results of the analysis of gavage poisoned mice showed that TCIPP exposure could lead to blurring of the red and white medullary boundaries of spleen tissues, destruction of white medullary structures, etc., and induce small intestinal cryptitis. TDCIPP induced significant pathological damage to the liver tissues of mice, which mainly included cytoplasmic washout, infiltration of inflammatory cells, acute inflammation, and other injurious effects. Significant pathological damage to the intestinal tissues of mice was also observed. Conclusions:This study demonstrates that the toxic effects of Cl-OPFRs are significantly associated with exposure routes and compound specificity. Respiratory exposure predominantly induces TCIPP-mediated pulmonary injury, while digestive exposure causes TDCIPP-driven hepatointestinal toxicity. These findings provide preliminary evidence for the toxicity screening of Cl-OPFRs.

Objective:To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) combined with resistance training on stroke related muscle atrophy(SRS) based on propensity score matching (PSM) method.Methods:A retrospective analysis was conducted on the clinical data of 150 cases of SRS patients in our hospital from September 2022 to September 2024. The patients were divided into an observation group of 78 cases and a control group of 72 cases according to the treatment method. Using PSM method to balance the confounding factors before treatment in a 1:1 ratio, 40 cases were successfully matched in each group. The control group received resistance training, while the observation group received TEAS treatment in addition to the control group. Both groups received continuous treatment for 12 weeks. Before and after treatment, the MedTrack Length isokinetic muscle strength testing system was used to measure the patients' knee extension and flexion axis muscle strength values, and the body composition analyzer was used to measure the patients' muscle weight and muscle index. The Berg Balance Scale (BBS), Fugl Meyer Motor Function Scale (FMA), and Simplified Upper Limb Function Scale (STEF) were used to evaluate limb motor function. ELISA method was used to detect the levels of muscle growth inhibitor (MSTN), growth differentiation factor 15 (GDF-15), and insulin-like growth factor-1 (IGF-1). The occurrence of adverse reactions during the treatment of two groups and the clinical efficacy was evaluated.Results:The total effective rate of the observation group was 92.50% (37/40), while that of the control group was 75.00% (30/40), with statistical significance ( χ2=4.50, P=0.034). After treatment, the observation group showed higher levels of knee extension [(78.25 ± 6.11) Nm vs. (74.02 ±6.02) Nm, t=3.11], flexion axis muscle strength [(32.84 ± 4.11) Nm vs. (29.35 ± 3.94) Nm, t=3.88], muscle weight [(41.42 ± 3.06) kg vs. (38.29 ± 3.12) kg, t=4.53], and muscle index [(7.11±1.17) kg/m 2vs. (6.56 ± 1.05) kg/m 2, t=2.21] compared to the control group ( P<0.01 or P<0.05). After treatment, the BBS, FMA and STEF scores in the observation group were higher than those in the control group ( t=4.57, 3.23,2.73, respectively, P<0.01), and the levels of serum MSTN [(46.34 ± 5.98) μg/L vs. (51.44 ± 6.04) μg/L, t=3.79] and GDF-15 [(67.44±7.21) μg/L vs. (72.28 ± 8.04) μg/L, t=2.83] in the observation group were lower than those in the control group after treatment ( P<0.01); the level of IGF-1 [(37.92 ±5.66) ng/L vs. (31.09 ± 4.22) ng/L, t=6.11] was higher than that of the control group ( P<0.01). During the treatment period, the incidence of adverse reactions in the observation group was 10.00% (4/40), while in the control group it was 7.50% (3/40), without statistical significance ( χ2=0.16, P=0.692). Conclusion:TEAS combined with resistance training can improve muscle strength and weight in SRS patients, improve limb motor function, reduce serum markers related to muscle attenuation, and have good treatment safety.

Objective:To investigate the feasibility and clinical efficacy of side-to-side anastomosis of superficial temporal artery (STA) and middle cerebral artery (MCA) bypass using in-situ intravascular suture technique.Methods:A retrospective analysis was conducted on the clinical data of 10 adult patients who were treated with side-to-side microvascular anastomosis of STA-MCA bypass to improve intracranial blood supply, between February 2024 and September 2024 in the Department of Neurosurgery of the Fourth Affiliated Hospital of Soochow University. Among the patients, 2 were of symptomatic MCA occlusion and 8 of Moyamoya disease. Diameter of STA and MCA, length of anastomosis and blocking time of MCA were recorded. Indocyanine green video angiography (ICG-VA) was performed to evaluate the immediate patency of the STA-MCA side-to-side anastomosis. Digital subtracted angiography (DSA) was performed at 1 week after the surgery to evaluate the patency of the STA-MCA bypass anastomosis, then follow-up DSA was performed at 1, 3 and 6 months after surgery to further evaluate the postoperative anastomotic patency. Neurological function was evaluated regularly with the modified Rankin Scale (mRS).Results:All of the 10 side-to-side STA-MCA bypass anastomoses were successfully performed using in-situ intravascular suture technique. The scalps of all patients healed well. The diameters of STA and MCA were 1.4-2.0 (1.76±0.27) mm and 0.8-1.4 (0.98±0.20) mm, respectively. The average length of the anastomoses was 3.5-5.0 (4.45±0.60) mm. The blocking time of MCA was 12.0-29.0 (21.50±6.62) min. A 100% vessel patency rate was achieved immediately after vessel anastomosis and at 1 month after surgery. DSA examinations were performed at 3 months after surgery on 6 patients and at 6 months after surgery on 1 patient, and all the anastomoses were found in full patency. All patients were included in the postoperative follow-up that lasted for 3 to 7 months. All patients recovered well without new neurological dysfunction. The mRS of 8 patients remained at 0 point before and after surgery. Two patients had improved postoperative mRS of 1 point from that of 2 points before surgery.Conclusion:STA-MCA side-to-side microvascular bypass anastomosis can be performed safely and efficiently using in-situ intravascular suture technique. It could efficiently reduce the incidence of perioperative complications. Meanwhile, it can self-regulate the blood flow and maximise the potential capability of STA.

Objective:To understand the current status of family resilience in children with autism and explore its influencing factors, providing a basis for developing intervention measures to improve family resilience in these families.Methods:Convenience sampling was used to select children with autism and their caregivers who underwent rehabilitation training at the Department of Child Developmental Behavior, Third Affiliated Hospital of Zhengzhou University from March to September 2023. A cross-sectional survey was conducted using a general information questionnaire, the Chinese version of the Family Resilience Assessment Scale, the Chinese version of the Parenting Burnout Scale, and the Caregiver Stress Scale.Results:A total of 280 questionnaires were distributed, and 271 valid questionnaires were collected. Among the 271 children with autism, 210 were male and 61 were female, with the majority aged 3-5 years old (169 cases). Among the 271 caregivers, 21 were male and 250 were female, with the majority aged 30-39 years old (149 cases). The total score of the Chinese version of the Family Resilience Assessment Scale was (70.59 ± 14.08) points, with scores of (49.96 ± 10.23) points for family communication and problem-solving, (7.13 ± 1.62) points for social resource utilization, and (13.52 ± 3.31) points for maintaining a positive attitude. Multiple linear regression analysis showed that the child′s age, disease duration, reimbursement method, parenting burnout, and caregiver stress were influencing factors of family resilience in children with autism ( t values were -10.40-3.48, all P<0.05). Conclusions:The level of family resilience in children with autism needs improvement. Higher levels of parenting burnout and caregiver stress are associated with lower levels of family resilience. Future interventions should be developed based on these influencing factors to promote the physical and mental health of children with autism and their caregivers.

Objective:To evaluate the efficacy and safety of chimeric antigen receptor T-cell (CAR-T) therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with Ph-like acute lymphoblastic leukemia (Ph-ALL) .Methods:Patients with Ph-ALL who underwent CAR-T therapy followed by allo-HSCT from March 2018 to August 2023 at the First Affiliated Hospital of Soochow University were included, and their clinical data were retrospectively analyzed.Results:Of the 21 patients, 14 were male and 7 were female. The median age at the time of CAR-T therapy was 22 (6-50) years. Seven patients had ABL1-like rearrangements, and 14 had JAK-STAT rearrangements. Prior to CAR-T therapy, 12 patients experienced hematologic relapse; 7 were multiparameter flow cytometry minimal residual disease (MFC-MRD) -positive and 2 were MFC-MRD-negative. CAR-T cells were derived from patients’ autologous lymphocytes. Nine patients were treated with CD19 CAR-T cells, and 12 were treated with CD19/CD22 CAR-T cells. After assessment on day 28 after CAR-T therapy, 95.2% of the patients achieved complete remission, with an MRD-negative remission rate of 75%. Nineteen patients developed grade 0–2 cytokine release syndrome (CRS) and 2 patients suffered grade 3 CRS, all cases of which resolved after treatment. All patients underwent allo-HSCT after CAR-T therapy. The median time from CAR-T therapy to allo-HSCT was 63 (38-114) days. Five patients experienced relapse after CAR-T therapy, including four with hematologic relapse and one with molecular relapse. The 3-year overall survival (OS) rates in the ABL1 and JAK-STAT groups were (83.3±15.2) % and (66.6±17.2) %, respectively ( P=0.68) . The 3-year relapse-free survival (RFS) rates were (50.0±20.4) % and (55.6±15.4) % in the ABL1 and JAK-STAT groups, respectively. There was no significant difference in 3-year OS or RFS between the two groups. Conclusions:CAR-T therapy followed by allo-HSCT leads to rapid remission in most patients with Ph-ALL and prolongs leukemia-free survival.

Objective:To explore the prevalence and independent associated factors of vascular calcification (VC) in non-dialysis chronic kidney disease (CKD) patients of stage 3-5.Methods:It was a single-center cross-sectional observational study. Non-dialysis stage 3-5 CKD patients ≥18 years old who were admitted to the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University from May 1, 2022 to December 31, 2022 with VC evaluation were enrolled. The patients' general information, laboratory examination and imaging data were collected. Coronary artery calcification (CAC), thoracic aorta calcification (TAC), abdominal aorta calcification (AAC), carotid artery calcification and aortic valve calcification (AVC) were evaluated by cardiac-gated electron-beam CT (EBCT) scans, lateral lumbar x-ray, cervical macrovascular ultrasound and echocardiography, respectively. The differences in clinical data and the prevalence of VC at different sites of patients with different CKD stages were compared, and the prevalence of VC at different sites of patients in different age groups [youth group (18-44 years old), middle-aged group (45-64 years old) and elderly group (≥65 years old)] and patients with or without diabetes were compared. Multivariate logistic regression analysis was used to analyse the independent associated factors of VC for different areas.Results:A total of 206 patients aged (51±14) years were included, including 129 (62.6%) males. There were 44 patients with CKD stage 3 (21.4%), 51 patients with CKD stage 4 (24.8%), and 111 patients with CKD stage 5 (53.9%). CKD was caused by chronic glomerulonephritis [104 cases (50.5%)], diabetic kidney damage [35 cases (17.0%)], hypertensive kidney damage [29 cases (14.1%)] and others [38 cases (18.4%)]. Among 206 patients, 131 (63.6%) exhibited cardiovascular calcification, and the prevalence of CAC, TAC, AAC, carotid artery calcification, and AVC was 37.9%, 43.7%, 37.9%, 35.9% and 9.7%, respectively. The overall prevalence of VC in young, middle-aged and elderly patients was 24.6%, 73.6% and 97.4%, respectively. With the increase of age, the prevalence of VC in each site gradually increased, and the increasing trend was statistically significant (all P<0.001). The overall prevalence of VC in CKD patients with diabetes was 92.5% (62/67), and the prevalence of VC at each site in the patients with diabetes was significantly higher than that in the patients without diabetes (all P<0.001). Multivariate logistic regression analysis revealed that age (every 10 years increase, OR=2.51, 95% CI 1.77-3.56, P<0.001), hypertension ( OR=5.88, 95% CI 1.57-22.10, P=0.009), and diabetes ( OR=4.66, 95% CI 2.10-10.35, P<0.001) were independently correlated with CAC; Age (every 10 years increase, OR=6.43, 95% CI 3.64-11.36, P<0.001) and hypertension ( OR=6.09, 95% CI 1.33-27.84, P=0.020) were independently correlated with TAC; Female ( OR=0.23, 95% CI 0.07-0.72, P=0.011), age (every 10 years increase, OR=3.90, 95% CI 2.42-6.29, P<0.001), diabetes ( OR=5.37, 95% CI 2.19-13.19, P<0.001) and serum magnesium ( OR=0.01,95% CI 0-0.35, P=0.014) were independently correlated with AAC. Moreover, age and diabetes were independently correlated with carotid artery calcification, AVC and overall VC Conclusions:The prevalence of VC in non-dialysis CKD patients of stage 3-5 is 63.59%, of which CAC reaches 37.9%, TAC is the most common one (43.7%), while AVC is the least one (9.7%). Age and diabetes are the independent associated factors for VC of all sites except TAC, while hypertension is an independent associated factor for both CAC and TAC.