The control strategy of rehabilitation robots should not only adapt to patients with different levels of motor function but also encourage patients to participate voluntarily in rehabilitation training.However,existing control strategies usually consider only one of these aspects.This study proposes a voluntary and adaptive control strategy that solves both questions.Firstly,the controller switched to the corresponding working modes(including challenge,free,assistant,and robot-dominant modes)based on the trajectory tracking error of human-robot cooperative movement.To encourage patient participation,a musculoskeletal model was used to estimate the patient's active torque.The robot's output torque was designed as the product of the active torque and a coefficient,with the coefficient adaptively changing according to the working mode.Experiments were conducted on two healthy subjects and four hemiplegic patients using an ankle rehabilitation robot.The results showed that this controller not only provided adaptive the robot's output torque based on the movement performance of patients but also encouraged patients to complete movement tasks themselves.Therefore,the control strategy has high application value in the field of rehabilitation.

【Objective】 To investigate the independent risk factors of urinary tract infection (UTI) in recipients under-going renal transplantation of donation after brain death (DBD), so as to provide a theoretical basis for the prevention and control of postoperative UTI. 【Methods】 A retrospective study was conducted for recipients who received renal transplantation of DBD in our hospital during Jan.2021 and Dec.2021. The recipients were divided into the infection group (n=26) and non-infection group (n=74) according to the incidence of UTI 3 months after operation. The risk factors of UTI were identified with univariate and multivariate analyses. 【Results】 The incidence of UTI was 26%. Univariate analysis showed that gender, postoperative urinary fistula, time of indwelling catheter and time of indwelling double J tube were the influencing factors of UTI (P<0.05). Forward stepwise regression analysis showed time of indwelling double J tube (OR=1.086,95%CI:1.003-1.177,P=0.042) and time of indwelling catheter(OR=4.687,95%CI:2.064-10.645, P<0.010) were the independent risk factors of UTI (P<0.05). 【Conclusion】 The time of indwelling catheter and time of indwelling double J tube are the independent factors of UTI after renal transplantation of DBD.

Objective:To study the clinical characteristics and imaging features of neonatal ovarian cysts and to analyze treatment and prognosis of ovarian torsion.Methods:From January 2011 to December 2021,neonates with ovarian cysts admitted to the department of neonatology and pediatric surgery of our hospital were retrospectively studied. They were assigned into ovarian torsion group and non-torsion group. Their clinical manifestations, imaging features, pathological results, treatment and prognosis were reviewed and compared.Results:A total of 44 neonates with ovarian cysts were included, all without specific clinical manifestations. 10 neonates were treated with conservative therapy and 34 received surgery. Ovarian torsion were confirmed during surgery in 23 patients. All 34 patients received abdominal ultrasound preoperatively and 31 (91.2%, 31/34) were diagnosed with ovarian cysts. The accuracy rates of ultrasound for cyst location and ovarian torsion were 85.3% (29/34) and 82.6% (19/23),respectively. 30 patients received abdominal CT scan and 23 (76.7%, 23/30) were diagnosed with ovarian cysts. The accuracy rates of CT scan for cyst location and ovarian torsion were 53.3% (16/30) and 47.8% (11/23), respectively. Among the 34 patients treated with surgery, ovarian cyst dissection was performed in 11 patients and cyst resection in 23 patients with torsion necrosis. 24 patients had simple cysts including 15 torsion necrosis (62.5%, 15/24) and 10 had complicated cysts including 8 torsion necrosis(80.0%, 8/10). The average diameter of ovarian cysts was significantly larger in the torsion group [(8.4±1.6) cm] than the non-torsion group [(4.7±1.2) cm] ( P<0.05). Conclusions:Neonatal ovarian cysts are mostly unilateral without specific clinical manifestations. Large, bilateral and complex cysts are prone to torsion necrosis. Abdomen ultrasound has advantages than CT scan for the localization of the ovarian cyst and diagnosis of ovarian torsion. Surgical treatment is necessary after diagnosis.

Objective:To investigate the effects of different labeling conditions on the yield of Al 18F-labeled 1, 4, 7-triazacylononane-1, 4, 7-triaceticacid (NOTA)-prostate specific membrane antigen (PSMA)-137, and to determine the experimental condition for obtaining Al 18F-PSMA-137 probe in high yield. Methods:The effects of different pH values, buffer systems (acetic acid-sodium acetate buffer system and potassium hydrogen phthalate (KHP) buffer system), AlCl 3-ligand ratios, ligand amounts, ethanol volumes and reaction temperatures on the labeling rate were investigated in detail. Results:The pH value of the reaction solution had a significant effect on the labeling rate, and the optimal range was 4.0-4.5. When the pH value was higher than 4.5, the labeling rate decreased significantly. Both the acetic acid-sodium acetate buffer system and the KHP buffer system could be used to label NOTA-PSMA-137 with Al 18F, and the KHP buffer system obtained higher labeling rate. The ratio of AlCl 3-ligand affected the labeling rate, and the highest labeling rate could be obtained when the ratio of AlCl 3-ligand was 0.54-0.62. When the ratio of AlCl 3-ligand was fixed, increasing the amount of ligand could improve the labeling yield. Adding hydrophilic organic solvent ethanol to the reaction system could significantly increase yield, with the highest labeling rate being achieved at a volume of 100 μl ethanol. The most suitable reaction temperature was 100 ℃, and when the temperature raised to 110 ℃, the labeling rate decreased significantly. The most suitable labeling conditions for NOTA-PSMA-137 were as following: 25 μl KHP buffer (0.50 mol/L, pH=4.0), 7.0 μl AlCl 3 solution (20 mmol/L), 200 μl Na 18F solution (74-80 MBq) and 230 μg ligand NOTA-PSMA-137 were mixed in a vial, then stood for 5 min and 100 μl ethanol was added, and all reagents were heated at 100 ℃ for 10 min. The yield of Al 18F-PSMA-137 under above conditions were 85.7%-88.5%. Conclusion:Optimization of labeling condition can improve the yield of Al 18F-PSMA-137 and the stability of the labeling.

Objective: To determine the clinical problems and outcome indicators that need to be included in the expert consensus of 5-aminolevulinic acid (ALA) photodynamic therapy in the treatment of oral potential malignant diseases. Methods: Based on the relevant literature, the clinical problems and outcome indicators were drafted during the meeting. The Delphi method was used for expert consultation and expert opinion collection. The average and standard deviation of the voting results were calculated to determine the importance of the indicators, and the positive coefficient, variation coefficient and coordination coefficient were calculated for quality control. Results: In the first round of the Delphi method, 12 outcome indicators (the main reference elements include photon integral flux, power density, illumination time, and spot diameter were identified; the specific parameters are photon integral flux of 100 J/cm2 and power density of 100-600 mW/cm2. A diode laser of (630 ± 5) nm wavelength should be chosen. The analgesic regimen is local anesthesia supplemented by hypothermia and intermittent laser irradiation before treatment. Lesions with hyperkeratotic require pretreatment. The concentration of ALA administered was set at 20%. Eight clinical problems (main reference elements of photodynamic irradiation dose, specific parameters, choice of light source, evaluation criteria of efficacy, prevention of adverse effects, dosing concentration, whether oral potentially malignant diseases with hyperkeratosis should be pretreated, administration of photosensitizers) were included according to the literature and expert discussion. In the second round, 89 experts completed the questionnaire and gave very important evaluations of 9 outcome indicators (the main reference elements included photon integral flux, power density and illumination time; the specific parameters were a photon integral flux of 100 J/cm 2 and a power density of 100-600 mW/cm2). A diode laser of (630 ± 5)nm wavelength should be chosen. The concentration of ALA administered was set at 20%. Six clinical problems (main reference elements of photodynamic irradiation dose, specific parameters, choice of light source, evaluation criteria of efficacy, dosing concentration, administration of photosensitizers), and the remaining 3 were given important evaluations, with good consistency. Conclusion In this study, the irradiation dose, mode of administration and concentration, evaluation criteria of efficacy, prevention of adverse effects and pretreatment regimen of ALA photodynamic therapy for oral potentially malignant diseases determined by the Delphi method had good agreement among experts.

Objective:To investigate the effect of cold compress of cooling paste on postoperative nasal symptoms of patients undergoing neuroendoscopic transsphenoidal approach surgery.Methods:From June 2019 to June 2020, the convenient sampling method was used to select 86 patients undergoing neuroendoscopic transsphenoidal approach surgery who were hospitalized in the Third Ward of Department of Neurosurgical Oncology in Beijing Tiantan Hospital affiliated to Capital Medical University as the research objects. The patients were divided into the control group and the observation group by the random block method, with 43 cases in each group. The control group was given routine perioperative nursing care. The patients in the experimental group were given cooling paste cold compress on the nose after operation. First, the patients' nasal skin was cleaned, and the refrigerated cooling paste was applied on both sides of the patient's nose alar to the root of the nose and replaced every 8 hours for 7 consecutive days. If it fell off, it was subsidized immediately. The Sino-Nasal Outcome Test-22 (SNOT-22) and General Comfort Questionnaire (GCQ) were used to compare the nasal and sinus outcomes and comfort of the two groups before surgery, 24 hours after surgery and 7 days after surgery.Results:The total score of SNOT-22, physiological function, emotional outcome and functional limitation scores of patients in the observation group were lower than those in the control group at 24 h after operation, and the differences were statistically significant ( P<0.05) . The total score of SNOT-22, emotional outcome and functional limitation score of the observation group 7 days after operation were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The comfort score of the observation group at 24 hours after operation was higher than that of the control group, and the difference was statistically significant ( P<0.05) . But there was no statistically significant difference in the comfort score between the two groups at 7 days after operation ( P>0.05) . Conclusions:Cold compress of cooling paste can effectively improve the nasal cavity and sinus outcomes and comfort of 24 hours after neuroendoscopic transsphenoidal approach surgery.

OBJECTIVE: To explore the genetic basis for a patient featuring multiple carboxylase deficiency (MCD). METHODS: PCR and Sanger sequencing were used to detect variant in the coding region of BT and HLCS genes in the patient. Suspected variants were verified in her parents and 80 unrelated healthy controls by a PCR-restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: The patient was found to carry compound heterozygous variants of the HLCS gene, namely c.286delG (p.Val96Leufs*162) and c.1648G>A (p.Val550Met). The c.286delG (p.Val96Leufs*162) was verified to be novel variant based on the result of PCR-RFLP analysis. No variant was found in the coding regions of BT gene in the patient. CONCLUSION The compound c.286delG (p.Val96Leufs*162) and c.1648G>A (p.Val550Met) variants probably underlie the MCD disorder in this patient. Above results have enriched the variant spectrum of MCA.
Carbon-Nitrogen Ligases ; genetics ; Exons ; Female ; Humans ; Multiple Carboxylase Deficiency ; genetics ; Mutation ; Open Reading Frames ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Sequence Analysis, DNA

Objective:To study the related factors of early recurrence and long-term survival after hepatectomy for patients with colorectal cancer liver metastases (CRLM) with a low-risk on clinical risk score (CRS).Methods:The clinicopathological data of 983 consecutive patients with CRLM who underwent liver resection at Department of Hepatopanereatobiliary Surgery Ⅰ, Peking University Cancer Hospital & Institute between January 2000 and November 2018 were studied retrospectively. A total of 420 patients with a CRS of 0-2 met the inclusion criteria of this study. There were 272 males and 148 females, aged from 21 to 83 years, with a median age 59 years. Univariate and multivariate logistic regression analyses were performed to identify the related factors associated with early recurrence. Survival curves were generated by the Kaplan-Meier method and compared by the log-rank test.Results:Of 420 patients, 272(64.8%) patients developed recurrence, with 163 patients developing early recurrence. Multivariate analysis revealed synchronous liver metastasis ( OR=1.587, 95% CI: 1.021-2.467), number of liver metastases ≥3( OR=1.904, 95% CI: 1.091-3.324) and RAS mutation ( OR=1.774, 95% CI: 1.157-2.270) were independent risk factors of early recurrence. The 5-year overall survival of patients with early recurrence was significantly lower than those with non-early recurrence (33.4% vs 71.1%, P<0.05). For the 163 patients with early recurrence, 41(25.2%) underwent repeat liver resection. When compared with the remaining 122(74.8%) patients who underwent non-resectional treatment, these 41 patients had a significantly higher 5-year overall survival rate (63.5% vs 21.1%, P<0.05). Conclusions:In patients with colorectal cancer liver metastases with a low risk on CRS, the independent risk factors for early recurrence were synchronous liver metastasis, number of liver metastases ≥3, and RAS mutation. Re-resection of early recurrent disease achieved better survival outcomes.

Objective:To study the impact of surgical treatment on long-term survival in patients with colorectal cancer liver metastases, and to identify the associated risk factors.Methods:The clinical, pathological, and follow-up data were prospectively collected from 781 consecutive patients who underwent hepatic resection for colorectal liver metastases at Hepatopancreatobiliary Surgery Department Ⅰ, Peking Cancer Hospital from Jan 2000 to Nov 2018. There were 497 males and 284 females. The average age was 56.7 years (range 19 to 83 years). The tumor recurrence and survival outcomes on follow-up were analyzed. Survival curves were plotted using the Kplan-Meier mothod. Parametric survival analysis was used to identify predictors of cancer-specific survival.Results:The 1-, 3-, 5- and 10-year overall survival rates were 91.6%, 57.3%, 45.2% and 27.6%, respectively. The median survival was 46 months. The 1-, 3-, 5- and 10-year disease-free survival rates were 45.3%, 26.0%, 22.9%, and 19.5%, respectively. The median disease-free survival was 11 months. On multivariate analysis, 5 risk factors were found to be independent predictors of poor survival: RAS/BRAF gene mutation ( HR=1.650, 95% CI: 1.302-2.089), right-sided colonic primary ( HR=1.361, 95% CI: 1.151-1.667), node-positive primary ( HR=1.660, 95% CI: 1.284-2.146), largest hepatic tumor ≥3 cm ( HR=1.473, 95% CI: 1.157-1.874), and extrahepatic disease ( HR=1.610, 95% CI: 1.294-2.003). Conclusion:Surgery is the key to long-term survival for patients with liver metastases from colorectal cancer. Right colonic primary, RAS/BRAF gene mutation, primary lymph node metastasis, hepatic metastasis with a maximum diameter ≥3 cm and extrahepatic metastasis were factors associated with poor prognosis.

Objective:To investigate the clinical efficacy of liver resection for colorectal liver metastases(CRLM)in elderly patients and to analyze factors influencing prognosis.Methods:Clinicopathological and follow-up data of 476 CRLM patients undergone liver resection at our department between January 2000 and August 2016 were retrospectively analyzed.Patients were divided into two groups according their ages: the elderly group(n=112, aged 65 years or older)and the young and middle-aged group(n=364, aged less than 65 years). The safety of the surgical treatment and long-term survival were compared between the two groups.Results:The overall postoperative complication rate was 30.3%.There was no significant difference in postoperative complication rates between the elderly group and the young and middle-aged group(32.1% vs. 29.7%, P=0.618). The mortality within 90 days after surgery was 0.9% in the elderly group and 0.5% in the young and middle-aged group( P=0.688). The 5-year survival rates after surgery were similar between the elderly group and the young and middle-aged group(42.4% vs.44.3%, P=0.672). Multivariate analysis revealed that clinical risk score(CRS)≥3 and RAS mutation were independent risk factors for prognosis. Conclusions:Liver resection is safe in carefully selected elderly CRLM patients and can achieve good long-term outcomes.The CRS and RAS genotype can help predict prognosis in elderly CRLM patients.