Objective To explore the peak moment characteristics of lower limb joints,as well as the contribution rate and compensation mechanism of lower limb joints when older adults with a history of falls cross obstacles at different paces.Methods Thirty healthy older adults and 30 eldely fallers were recruited.The Qualisys infrared high-speed motion capture system and the Kistler three-dimensional force platform were used to collect the biomechanical data of the older adults when they crossed an obstacle with a height of 15％of their height at three walking speeds(1.05,1.41,1.74 m/s).The data were then modeled and analyzed using Visual 3D software.Results As walking speed increased,the peak knee extension moment,peak ankle plantar flexion moment,and double peak value of hip flexion moment in healthy group all increased significantly(P＜0.05).Compared with healthy group,the double peak values of hip flexion moment in faller group were significantly smaller than those in healthy group(P＜0.05).During walking at moderate speed,the contribution rate of the left hip joint in faller group was significantly higher than that of healthy group(P=0.025),while the contribution rate of the ankle joint was significantly lower(P=0.044).The margin of stability in the anterior-posterior direction at the moment of ground contact of the stance leg and the stride leg increased with walking speed(P=0.007,P=0.002).Conclusions Compared with healthy older adults,the elderly fallers have lower peak torque,peak ground reaction force,and dynamic stability in the anterior-posterior direction.As the walking speed increases,the mechanical parameters and the margin of stability of older adults increase significantly,and walking stability is improved.Compared with healthy older adults,elderly fallers usually rely more on the contribution of hip joint movements and reduce the involvement of ankle joints.It is recommended to incorporate fast walking exercises into the daily fall prevention exercise program for older adults,with combination of coordinated training of the hip,knee,and ankle joints.

Objective:To retrospectively analyze the efficacy and feasibility of surgical management in patients with cervical dysphagia secondary to Diffuse idiopathic skeletal hyperostosis(DISH)of the cervical spine.Methods:A retrospective analysis was conducted on 6 patients who presented with dysphagia as the primary symptom, were diagnosed with cervical DISH, and underwent surgical treatment in the Department of Otorhinolaryngology Head and Neck Surgery of The Second Xiangya Hospital of Central South University from January 2018 to February 2024. There were 5 males and 1 female, aged from 65 to 78 years (70.2±4.7 years). The duration of dysphagia prior to admission was 13 to 18 months (14.7±2.2 months). All patients had the symptom of dysphagia, and at least one other clinical manifestation of cervical DISH (dyspnea, restricted neck mobility, sleep apnea, odynophagia). One patient had undergone tracheotomy due to laryngeal obstruction before surgery. Surgical intervention was performed after failure of conservative management in all patients. All patients underwent anterior cervical osteophyte resection via the Smith-Robinson approach without concomitant spinal fusion. In the patient with prior tracheotomy for airway obstruction, epiglottoplasty and right arytenoidectomy were performed simultaneously. The swallowing function was evaluated by water swallow test, FEES, M. D. Anderson Dysphagia Inventory. Clinical and imaging evaluations were conducted for follow-uppostoperatively. Preoperative and 30-day post operative data were statistically analyzed using paired samples t-test.Results:Cervical computed tomography revealed osteophyte involvement from C2 to T1 with a median of 4 vertebral segments affected. The most frequently involved vertebral segments were C4-C6 (all 6 patients were involved). The anteroposterior diameter of the most prominent osteophyte was 12.0 to 20.0 mm (16±3.1 mm). The time to resumption of a regular diet was 6 to 20 days(12.7±5.3 days), and the time to remove the nasogastric tube was 8 to 25 days(15.2±6.2 days). In the patient with prior tracheotomy, the tracheostomy tube was successfully decannulated 30 days after initial tube capping following conversion to a metal tube. All cervical DISH-related symptoms except for limited neck mobility improved postoperatively. Both water swallow test and the Rosenbek Penetration-Aspiration Scale showed significant improvement postoperatively. At 30 days postoperatively, MDADI scores significantly improved in all domains: l global (73.33±10.33), emotional (85.56±8.35), functional (83.33±5.89), and physical (82.08±6.60). No major perioperative complications occurred. and the length of hospital stay was 7 to 10 days (7.8±1.2 days). The follow-up time was 12 to 84 months (43.7±27.2 months). All patients maintained sustained symptom relief, with no evidence of osteophyte recurrence during follow-up.Conclusion:Cervical DISH is an under-recognized causes of dysphagia in elderly patients and warrants attention from otolaryngologists. For patients erefractory to conservative treatment, anterior resection of cervical osteophytes via the Smith-Robinson approach is a safe, minimally invasive procedure with favorable short-and long-term outcomes in improving swallowing function.

Objective To explore the peak moment characteristics of lower limb joints,as well as the contribution rate and compensation mechanism of lower limb joints when older adults with a history of falls cross obstacles at different paces.Methods Thirty healthy older adults and 30 eldely fallers were recruited.The Qualisys infrared high-speed motion capture system and the Kistler three-dimensional force platform were used to collect the biomechanical data of the older adults when they crossed an obstacle with a height of 15％of their height at three walking speeds(1.05,1.41,1.74 m/s).The data were then modeled and analyzed using Visual 3D software.Results As walking speed increased,the peak knee extension moment,peak ankle plantar flexion moment,and double peak value of hip flexion moment in healthy group all increased significantly(P＜0.05).Compared with healthy group,the double peak values of hip flexion moment in faller group were significantly smaller than those in healthy group(P＜0.05).During walking at moderate speed,the contribution rate of the left hip joint in faller group was significantly higher than that of healthy group(P=0.025),while the contribution rate of the ankle joint was significantly lower(P=0.044).The margin of stability in the anterior-posterior direction at the moment of ground contact of the stance leg and the stride leg increased with walking speed(P=0.007,P=0.002).Conclusions Compared with healthy older adults,the elderly fallers have lower peak torque,peak ground reaction force,and dynamic stability in the anterior-posterior direction.As the walking speed increases,the mechanical parameters and the margin of stability of older adults increase significantly,and walking stability is improved.Compared with healthy older adults,elderly fallers usually rely more on the contribution of hip joint movements and reduce the involvement of ankle joints.It is recommended to incorporate fast walking exercises into the daily fall prevention exercise program for older adults,with combination of coordinated training of the hip,knee,and ankle joints.

Objective:To retrospectively analyze the efficacy and feasibility of surgical management in patients with cervical dysphagia secondary to Diffuse idiopathic skeletal hyperostosis(DISH)of the cervical spine.Methods:A retrospective analysis was conducted on 6 patients who presented with dysphagia as the primary symptom, were diagnosed with cervical DISH, and underwent surgical treatment in the Department of Otorhinolaryngology Head and Neck Surgery of The Second Xiangya Hospital of Central South University from January 2018 to February 2024. There were 5 males and 1 female, aged from 65 to 78 years (70.2±4.7 years). The duration of dysphagia prior to admission was 13 to 18 months (14.7±2.2 months). All patients had the symptom of dysphagia, and at least one other clinical manifestation of cervical DISH (dyspnea, restricted neck mobility, sleep apnea, odynophagia). One patient had undergone tracheotomy due to laryngeal obstruction before surgery. Surgical intervention was performed after failure of conservative management in all patients. All patients underwent anterior cervical osteophyte resection via the Smith-Robinson approach without concomitant spinal fusion. In the patient with prior tracheotomy for airway obstruction, epiglottoplasty and right arytenoidectomy were performed simultaneously. The swallowing function was evaluated by water swallow test, FEES, M. D. Anderson Dysphagia Inventory. Clinical and imaging evaluations were conducted for follow-uppostoperatively. Preoperative and 30-day post operative data were statistically analyzed using paired samples t-test.Results:Cervical computed tomography revealed osteophyte involvement from C2 to T1 with a median of 4 vertebral segments affected. The most frequently involved vertebral segments were C4-C6 (all 6 patients were involved). The anteroposterior diameter of the most prominent osteophyte was 12.0 to 20.0 mm (16±3.1 mm). The time to resumption of a regular diet was 6 to 20 days(12.7±5.3 days), and the time to remove the nasogastric tube was 8 to 25 days(15.2±6.2 days). In the patient with prior tracheotomy, the tracheostomy tube was successfully decannulated 30 days after initial tube capping following conversion to a metal tube. All cervical DISH-related symptoms except for limited neck mobility improved postoperatively. Both water swallow test and the Rosenbek Penetration-Aspiration Scale showed significant improvement postoperatively. At 30 days postoperatively, MDADI scores significantly improved in all domains: l global (73.33±10.33), emotional (85.56±8.35), functional (83.33±5.89), and physical (82.08±6.60). No major perioperative complications occurred. and the length of hospital stay was 7 to 10 days (7.8±1.2 days). The follow-up time was 12 to 84 months (43.7±27.2 months). All patients maintained sustained symptom relief, with no evidence of osteophyte recurrence during follow-up.Conclusion:Cervical DISH is an under-recognized causes of dysphagia in elderly patients and warrants attention from otolaryngologists. For patients erefractory to conservative treatment, anterior resection of cervical osteophytes via the Smith-Robinson approach is a safe, minimally invasive procedure with favorable short-and long-term outcomes in improving swallowing function.

Objective:To explore the application of spiral tracheoplasty in the repair of large tracheal defects after the resection of trachea invaded by thyroid cancer.Methods:A retrospective analysis was performed on the clinical data of 11 patients, including 4 males and 7 females, aged from 36 to 67 years old, with large tracheal defects after tracheal resection due to thyroid papillary carcinoma invading the trachea in the Department of Otorhinolaryngology Head and Neck Surgery, Second Xiangya Hospital, Central South University from January 2019 to January 2022. The range of tracheal defects, time of tracheal reconstruction, postoperative complications and airway were recorded, and the patients were followed up for more than 24 months.Results:All patients underwent total thyroidectomy and tracheal resection and spiral reconstruction, and 2 of the cases underwent cricoid cartilage resection on the invaded side of cartilage. The tracheal defect accounted for 40%-60% of the circumference, and the lengths of the tracheal defects were 5.0 cm×7.5 cm and 6-9 tracheal rings, with 2 cases combined with partial defects of the cricoid cartilage. The reconstruction time was 30-60 min, with an average of 41.81 min. Among the 11 patients, 3 had recurrent laryngeal nerve paralysis, and 2 underwent tracheotomy. Four patients presented with hypocalcemia within one month after the operation. Followed up for 24-60 months, no tracheal stenosis occurred, the 2-year survival rate was 100%, the 2-year local control rate of the trachea was 100%, and the 2-year tumor-free survival rate was 81.8%.Conclusion:Spiral tracheoplasty is a safe and effective method that can reduce the tension at the tracheal anastomosis and expand the tracheal cavity, which can be used for tracheal reconstruction after extensive resection of trachea invaded by locally advanced thyroid cancer.

Objective:To explore the application of spiral tracheoplasty in the repair of large tracheal defects after the resection of trachea invaded by thyroid cancer.Methods:A retrospective analysis was performed on the clinical data of 11 patients, including 4 males and 7 females, aged from 36 to 67 years old, with large tracheal defects after tracheal resection due to thyroid papillary carcinoma invading the trachea in the Department of Otorhinolaryngology Head and Neck Surgery, Second Xiangya Hospital, Central South University from January 2019 to January 2022. The range of tracheal defects, time of tracheal reconstruction, postoperative complications and airway were recorded, and the patients were followed up for more than 24 months.Results:All patients underwent total thyroidectomy and tracheal resection and spiral reconstruction, and 2 of the cases underwent cricoid cartilage resection on the invaded side of cartilage. The tracheal defect accounted for 40%-60% of the circumference, and the lengths of the tracheal defects were 5.0 cm×7.5 cm and 6-9 tracheal rings, with 2 cases combined with partial defects of the cricoid cartilage. The reconstruction time was 30-60 min, with an average of 41.81 min. Among the 11 patients, 3 had recurrent laryngeal nerve paralysis, and 2 underwent tracheotomy. Four patients presented with hypocalcemia within one month after the operation. Followed up for 24-60 months, no tracheal stenosis occurred, the 2-year survival rate was 100%, the 2-year local control rate of the trachea was 100%, and the 2-year tumor-free survival rate was 81.8%.Conclusion:Spiral tracheoplasty is a safe and effective method that can reduce the tension at the tracheal anastomosis and expand the tracheal cavity, which can be used for tracheal reconstruction after extensive resection of trachea invaded by locally advanced thyroid cancer.

Objective To explore dynamic characteristics of the gait for the elderly with different fall risks before and after obstacle crossing. Methods Twenty-seven elderly people in community were graded as fall risk by using the time up and go test and five-time sit to stand test. The plantar pressure parameters of the elderly before and after obstacle crossing were measured and analyzed by foot pressure measurement system. Results There was no significant difference in the characteristic value of bimodal curve of overall plantar pressure between the high and low fall risk groups before and after obstacle crossing(P>0.05). The center of pressure (COP) trajectory in X direction of high fall risk group after obstacle crossing was significantly greater than that of low fall risk group (P<0.05). Before obstacle crossing, the peak pressure of the 3rd metatarsal of supporting foot was higher in high fall risk group than that in low fall risk group (P<0.05). After obstacle crossing, the peak pressure of the 1st phalanx of supporting foot was significantly lower than that in high fall risk group (P<0.05), while the lateral heel impulse in high fall risk group was significantly larger than that in low fall risk group (P<0.05).The distribution patterns of contact area of the foot for the elderly in two groups before and after obstacle crossing were basically the same, and there was no significant difference in contact area of each plantar region (P>0.05). Conclusions The support time of the elderly with high fall risk is longer than that of the elderly with low fall risk during obstacle crossing, the peak pressure of plantar metatarsal region of the crossing leg increases, and the plantar COP curve shows asymmetry, with an increase in transverse range of the coronal plane. In clinical evaluation, plantar pressure characteristics of people with fall risks during obstacle crossing should be focused on.

Abstract: To explore the effect of eriodictyol(Eri) on the proliferation and apoptosis of triple-negative breast cancer MDA-MB-231 cells and its possible mechanism. Methods: MDA-MB-231 cells were treated with different concentrations of Eri. MTT method was used to detect the level of cell proliferation. Plate clone method was used to detect the the level of cell clonality. The apoptosis level was detected by flow cytometry. Western blot was used to detect protein expression levels of Cleaved-caspase-3, Bax, Bcl-2, c-Myc and AR. MDA-MB-231 cells were transfected with si-c-Myc and then combined treatment with 50 μmol/L Eri. MTT method was used to detect the level of cell proliferation. The apoptosis level was detected by flow cytometry. Western blot was used to detect protein expression levels of c-Myc and AR. Results: Eri inhibited the proliferation activity of MDA-MB-231 cells in a dose and time-dependent manner. Treatment with different concentrations of Eri reduced cloning ability of MDA-MB-231 cells, promoted cell apoptosis, up-regulated the protein expression levels of Cleaved-caspase-3 and Bax, and down-regulated the protein expression level of Bcl-2, c-Myc and AR. Knockdown of c-Myc expression inhibited MDA-MB-231 cells growth, promoted cell apoptosis, and down-regulated the protein expression level of c-Myc and AR, while combined treatment with 50 μmol/L Eri could not enhance the situation. Conclusion Er inhibits proliferation and induces apoptosis in triple-negative breast cancer MDA-MB-231 cells, which may be achieved by inhibiting c-Myc/AR axis.

Objective To evaluate the clinical value of CT urography (CTU) in quantitative analysis of single?kidney renal glomerular filtration rate (GFR) in patients with renal tumor and hydronephrosis.Methods A total of 49 patients with renal tumor or hydronephrosis from January 2018 to September 2018 in the Second Hospital of Tianjin Medical University were prospectively collected. In all cases, the CT urography and 99mTc?DTPA renal dynamic imaging data and related clinical data were collected. All patients were divided into two groups: the experimental group (39 patients with a total of 78 kidneys) and the validation group (10 patients with a total of 20 kidneys). According to the presence or absence of renal diseases, the kidneys of the experimental group and the validation group were further divided into four groups, namely, the single kidney group, the tumor group, the stagnant water group and the healthy group. The CT urography protocol consisted of noncontrast, arterial phase, nephrographic, and excretory phase imaging. The total renal GFR was determined by CT measurement of renal clearance of contrast media (CM), and the total CT?GFR was then split into single?kidney CT?GFR by a left and right kidney proportionality factor. Differences between CT?GFR and SPECT?GFR measurements in each group of the experimental group was compared by paired?sample t test. Correlations between CT?GFR and SPECT?GFR in the experimental group and their correlations with RPV was analyzed by Pearson method. The Bland?Altman mapping method was used to evaluate the consistency between CT?GFR and SPECT?GFR in the experimental group. Results Paired difference between single?kidney CT?GFR (48.76 ± 18.50) ml·min-1·1.73 m-2 and single?kidney SPECT?GFR (45.68±17.95) ml·min-1·1.73 m-2 in the experimental group, P<0.05, demonstrating 6.8% systemic overestimation. A good correlation(r=0.80, P<0.01) and consistency (± 22.50 ml·min-1·1.73 m-2, ± 49.2% measurement deviations) was revealed between both measurements. There were positive correlations between CT?GFR and SPECT?GFR in the renal tumor group, hydronephrosis group, and healthy kidney group (r=0.67, 0.92, 0.80; P<0.01) respectively, and with good agreement (95% CI measurement deviation<30 ml·min-1·1.73 m-2). In all validation groups, there was no statistical difference between the estimated and true values of the Gates?GFR (all P>0.05). Pearson Correlation analysis showed that the correlations between CT?GFR and RPV in all experimental groups were better than the correlation between Gates?GFR and RPV (P<0.05). Conclusions This study demonstrated the feasibility of using CT urography to measure single?kidney GFR, verifying its application value in diseases such as kidney tumors and obstructive hydronephrosis, and proved that the proposed single?kidney CT?GFR correlates better than the SPECT?GFR with RPV.

OBJECTIVE: To establish a method for measuring the photoelectric performance index (luminance response characteristic and luminance tolerance) of medical electronic endoscope. METHODS: Based on the clinical application and product features of medical electronic endoscope, the umbrella grayscale test chart and the adjustable gray scale test chart are designed and made from two aspects of distribution and density differential. RESULTS: The influence of gray scale arrangement, background illumination intensity and illumination spectrum on photoelectric performance measurement of electronic endoscope is verified by test. CONCLUSIONS It is a reference for the design analysis, evaluation and modification of electronic endoscope product photoelectric part, whether it is suitable for fast detection of umbels and more accurate gray scale test chart.
Electronics, Medical ; Endoscopes ; Light ; Quality Control