Volume and fat infiltration of spino-pelvic musculature in adults with spinal deformity

AIM: To investigate fat infiltration and volume of spino-pelvic muscles in adults spinal deformity(ASD) with magnetic resonance imaging(MRI) and 3D reconstructions.METHODS: Nineteen female ASD patients(mean age 60 ± 13) were included prospectively and consecutively and had T1-weighted Turbo Spin Echo sequence MRIs with Dixon method from the proximal tibia up to T12 vertebra. The Dixon method permitted to evaluate the proportion of fat inside each muscle(fat-water ratio). In order to investigate the accuracy of the Dixon method for estimating fat vs water, the same MRI acquisition was performed on phantoms of four vials composed of different proportion of fat vs water. With Muscl'X software, 3D reconstructions of 17 muscles or group of muscles were obtained identifying the muscle's contour on a limited number of axial images [Deformation of parametric specific objects(DPSO) Method]. Musclar volume(Vmuscle), infiltrated fat volume(Vfat) and percentage of fat infiltration [Pfat, calculated as follow: Pfat = 100 ×(Vfat/Vmuscle)] were characterized by extensor or flexor function respectively for the spine, hip and knee and theirs relationship with demographic data were investigated. RESULTS: Phantom acquisition demonstrated a non linear relation between Dixon fat-water ratio and the real fat-water ratio. In order to correct the Dixon fatwater ratio, the non linear relation was approximated with a polynomial function of degree three using the phantom acquisition. On average, Pfat was 13.3% ± 5.3%. Muscles from the spinal extensor group had a Pfat significantly greater than the other muscles groups, and the largest variability(Pfat = 31.9% ± 13.8%, P < 0.001). Muscles from the hip extensor group ranked 2nd in terms of Pfat(14% ± 8%), and were significantly greater than those of the knee extensor(P = 0.030). Muscles from the knee extensor group demonstrated the least Pfat(12% ± 8%). They were also the only group with a significant correlation between Vmuscle and Pfat(r =-0.741, P < 0.001), however this correlation was lacking in the other groups. No correlation was found between the Vmuscle total and age or body mass index. Except for the spine flexors, Pfat was correlated with age. Vmuscle and Vfat distributions demonstrated that muscular degeneration impacted the spinal extensors most.CONCLUSION: Mechanisms of fat infiltration are not similar among the muscle groups. Degeneration impacted the spinal and hip extensors most, key muscles of the sagittal alignment.

Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome

Objective： To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome （OSAHS）. Methods： We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus （exercising group）. Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale （ESS）, checked patients＇ polysomnography, and took 320- detector computed tomography （CT） before treatment. Six and twelve months later, we made records of apnea hypopnea index （AHI）, lowest arterial oxygen saturation （LSaO2）, body mass index （BMI）, the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment （control group） at the same time. SPSS 10.0 was used to analyze the data. Results： Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group （P〈0.05）. However, there was no statistical difference in all the parameters between 6 and 12 months of exercising. The effective rates were 70.37% and 74.07% after 6- and 12-month exercising, respectively. There were significant differences between the exercising and control groups （P〈0.0001）. There was no statistical difference in the effective rate of the exercising group between 6 and 12 months of exercising （P〉0.05）. At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower （P〈0.01） than that before treatment. There was no significant change of BMI in either group. Conclusions： Exercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without surgical complications, and especially mild and moderate OSAHS patients who do not want to take surgery and continuous positive airway pressure （CPAP） treatment. In addition, exercising pharyngeal musculature and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapies.

Dragon Tails:Convergent Caudal Morphology in Winged Archosaurs

In the tails of dromaeosaurid dinosaurs and rhamphorhynchid pterosaurs, elongate osteological rods extend anteriorly from the chevrons and the prezygapophyses. These caudal rods are positioned in parallel and are stacked dorsoventrally. The fully articulated and three-dimensionally preserved caudal series of some dromaeosaurid specimens show that individually these caudal rods were flexible, not rigid as previously thought. However, examination of the arrangement of the caudal rods in cross-section indicates that the combined effect of multiple caudal rods did provide substantial rigidity in the dorsoventral, but not in the lateral, plane. The results of digital muscle reconstructions confirm that dromaeosaurids and rhamphorhynchids also shared greatly reduced caudofemoral muscles in the anterior tail region. The striking similarities between the tails of dromaeosaurids and rhamphorhynchids suggest that both evolved under similar behavioral and biomechanical pressures. Combined with recent discoveries of primitive deinonychosaurs that phylogenetically bracket the evolution of dromaeosaurid caudal rods between two arboreal gliding/flying forms, these results are evidence that the unique caudal morphologies of dromaeosaurids and rhamphorhynchids were both adaptations for an aerial lifestyle.

On Dinosaur Reconstruction: The Head

This paper presents the current knowledge about the reconstruction of dinosaur heads. To reconstruct the dinosaur head, several features and functions of the head must be studied, namely osteology, musculature and soft tissue of the head, cranial kinesis, craniodental biomechanical characteristics, posterior part of the cranium, skin, and others. The main steps and points resulting from the study are the following. Firstly, the osteological remains of the head are studied for reconstruction according to the correct size and form in comparison with known remains belonging to the same family in case the remains were not complete. As the dinosaurs did not have facial muscles, their skin was pressed directly to the skull. The skin covering the large openings in front of the orbits of many dinosaurs probably bulged gently outward, and similarly, the jaw muscles bulged gently from the skull openings. Also, an investigation is performed to decide if sauropods were terrestrial or aquatic animals. Then, the individual characteristics of the head are examined in detail. These concern: 1) endocranial cast and nerves, 2) nostrils position, 3) the existence and kind of cheeks and lips, 4) Teeth types and function, 5) the palate shape and skin covering, 6) hyoid apparatus and tongues, 7) the details of the ear, 8) sclerotic rings and eyes, 9) skin and color. With the knowledge gathered about the various parts of the head in mind, decisions are made about the Amargasaurus (a sauropod) head in order to reconstruct a 3D, actual size head, as a worked example. Finally, the reconstruction procedure is described in detail.

Aligned Acupuncture at Muscle Regions plus Cutaneous Needle for Upper Limb Spasticity After Stroke: A Multicenter Randomized Controlled Trial

Objective: To evaluate the clinical efficacy of aligned acupuncture at the muscle regions plus cutaneous needle for post-stroke upper limb spasticity.Methods: By adopting a design of multicenter randomized controlled clinical trial, 488 patients with post-stroke upper limb spasticity were randomized into a treatment group and a control group, 244 in each group. In addition to rehabilitation training, the treatment group received aligned acupuncture at the muscle regions plus cutaneous needle therapy and the control group received conventional Western medicine. After successive 3-week treatments, the clinical efficacy, spasticity degree of the upper limb, joint function, and neurological defect degree were evaluated in the two groups. Results: The total effective rate was 93.4% in the treatment group versus 61.5% in the control group, and the difference was statistically significant(P < 0.05). The upper-limb spasticity degree, joint function, and neurological defect degree were improved significantly in both groups after intervention(P<0.05), and the improvements in the treatment group were more significant than those in the control group(P<0.05 or P<0.01). Conclusion: Aligned acupuncture at the muscle regions plus cutaneous needle therapy is effective in treating post-stroke upper limb spasticity.

Clinical observation on muscle regions of meridians needling method in improving upper limb function for children with cerebral palsy of spastic hemiplegia type

Objective:To observe the improving effect of muscle regions of meridians needling method on the upper limb function in children with cerebral palsy of spastic hemiplegic type.Methods:A total of 100 children with cerebral palsy of spastic hemiplegia type were divided into a treatment group and a control group according to the visiting sequence,with 50 cases in each group.The control group was treated with conventional rehabilitation plus conventional acupuncture treatment.The treatment group was treated with conventional rehabilitation plus muscle regions of meridians needling method.The electromyography(EMG)signal values of triceps brachii and pronator teres were detected before treatment,and 3 months and 6 months after treatment.The clinical efficacy was evaluated by Peabody developmental motor scale-fine motor(PDMS-FM)and fine motor function measure(FMFM).Results:Three and six months after treatment,the EMG signal values of triceps brachii and pronator teres,grasping scores and visual-motor integrated scores of PDMS-FM and the FMFM scores in both groups increased to varying degrees compared with the same group before treatment,and the intra-group differences were all statistically significant(all P<0.05).Six months after treatment,the results of the above three items in the treatment group were all better than those in the control group,and the differences between the groups were statistically significant(all P<0.05).Conclusion:Muscle regions of meridians needling method added on the basis of conventional rehabilitation can effectively reduce the muscle tone of upper limb and enhance the muscle strength,and improve the upper limb function in children with cerebral palsy of spastic hemiplegia type.The efficacy is superior to that of the conventional rehabilitation plus conventional acupuncture treatment.

Evaluation of the clinical efficacy of muscle regions of meridians needling method for refractory facial paralysis based on infrared thermal imaging technology

Objective To explore the clinical efficacy of muscle regions of meridians needling method for refractory facial paralysis affecting different locations.Methods A total of 110 participants were randomized into an observation group and a control group,with 55 cases in each group.The observation group was treated with muscle regions of meridians needling method,and the control group was treated with conventional facial three-line needling method.The clinical efficacy was evaluated four weeks after the treatment.And the infrared imaging spectra of the two groups were examined.Results The total effective rate of the observation group was higher than that of the control group(P<0.05),and its curative effect for refractory facial paralysis located above the geniculate ganglion was better than that of the control group(P<0.05).The color scale distribution of different disease locations in the two groups varied significantly(P<0.05),the higher the disease location,the higher the occurrence rate of cool zone and low temperature zone.After treatment,the reductions of the facial and periotic temperature difference between the healthy side and the affected side in the observation group were statistically different from those in the control group(P<0.05).Conclusion Muscle regions of meridians needling method has a better effect than facial three-line needling method for refractory facial paralysis.It can promote the microcirculation of the affected side of the face,improve the blood and oxygen supply to local tissues,and thus promote the repair of the peripheral facial nerve.

Efficacy observation of combining tuina and Chinese herbal fumigation for chronic ankle sprain

Objective： To observe the clinical efficacy of combining tuina and Chinese herbal fumigation for chronic ankle sprain. Methods： A total of 93 cases were randomly allocated into an observation group（n=47） and a control group（n=46） according to the table of random number. Cases in the observation group received tuina combining with Chinese herbal fumigation, whereas cases in the control group received oral blood-circulating and pain-alleviating capsules combining with Chinese herbal fumigation. Both tuina and Chinese herbal fumigation were done once every other day and 10 times made up a course of treatment. The Baird-Jackson ankle scoring system and clinical efficacy were observed after 1 course of treatment.Results： After treatment, except for radiographic findings, there were significant intra-group differences in individual item scores of Baird-Jackson（P〈0.05, P〈0.01）; except for ankle joint range of motion（ROM）, there were significant betweengroup differences in individual item scores and total score（P〈0.01）. The excellence and good rate was 76.6% in the observation group, versus 54.4% in the control group, showing a statistical significance（P〈0.05）. Conclusion： Combining Chinese herbal fumigation and tuina based on the muscle region theory can obtain better effect than combining oral blood-circulating and pain-alleviating capsules and Chinese herbal fumigation for chronic ankle sprain.

A high-fidelity human cervical muscle finite element model for motion and injury studies

Active muscle response is a key factor in the motion and injury of the human head and neck.Due to the limitations of experimentation and the shortcomings of previous finite element models,the influence of material parameters of cervical muscle on motions of the head and neck during a car crash have not been comprehensively investigated.In the present work,a model of the cervical muscle in a 50th-percentile adult male was constructed.The muscles were modelled using solid finite elements,with a nonlinear-elastic and viscoelastic material and a Hill material modelling the passive and active parts of each muscle,respectively.The head dynamic responses of the model were validated using results obtained from volunteer sled tests.The influence of the material parameters of a muscle on head and neck motions were determined.Our key finding was that the greater the stiffness and the contraction strength of the neck muscles,the smaller the rotation angle of the head and the neck,and,hence,the lower the risk of head and neck injury to occupants in a car crash.

Design, fabrication, and characterization of a hydrostatic electroactive soft actuator for bio-inspired robots

In this paper,we design a hydrostatic electroactive soft actuator(HESA)inspired by octopus transverse musculature.We introduce the advantage of laser processing technology in HESA fabrication compared with existing similar actuators and discuss the effect of laser processing on the outer membrane of the actuator.In addition,a mathematical model is established for the single channel of the actuator,and the geometric parameters of the actuator are optimized by mathematical model simulation and experiments.We demonstrate the motion effect of the actuator.Our experiments show that the single piece of the actuator can achieve 32.2%strain in the axial direction and 7.8%strain in the radius direction.Furthermore,we stack three actuators together and describe their motion characteristics at different frequencies.The stacked actuators can realize axial elongation,radial shrinkage,and bend,which covers all the motion modes of the octopus biological transverse musculature.This study may lay a foundation for implementing the biomimetic soft actuator mimicking the octopus’s transverse musculature,which is one less discussed but crucial muscular composition in the octopus-inspired arm research.