Background： Various training schemes have sought to improve golf-related athletic ability. In the golf swing motion, the muscle strengths of the core and arms play important roles, where a difference typically exists...Background： Various training schemes have sought to improve golf-related athletic ability. In the golf swing motion, the muscle strengths of the core and arms play important roles, where a difference typically exists in the power of arm muscles between the dominant and non- dominant sides. The purposes of this study were to determine the effects of exercises strengthening the core and non-dominant arm muscles of elite golf players （handicap 〈 3） on the increase in drive distance, and to present a corresponding training scheme aimed at improving golf performance ability. Methods： Sixty elite golfers were randomized into the control group （CG, n = 20）, core exercise group （CEG, n = 20）, and group receiving a combination of muscle strengthening exercises of the non-dominant arm and the core （NCEG, n = 20）. The 3 groups conducted the corresponding exercises for 8 weeks, after which the changes in drive distances and isokinetic strength were measured. Results： Significant differences in the overall improvement of drive distance were observed among the groups （p 〈 0.001）. Enhancement of the drive distance of NCEG was greater than both CG （p 〈 0.001） and CEG （p = 0.001）. Except for trunk flexion, all variables of the measurements of isokinetic strength for NCEG also showed the highest values compared to the other groups. Examination of the correlation between drive distance and isokinetic strength revealed significant correlations of all variables except trunk flexion, wrist extension, and elbow extension. Conclusion： The combination of core and non-dominant arm strength exercises can provide a more effective specialized training program than core alone training for golfers to increase their drive distances.展开更多
A novel 5-DOF exoskeletal rehabilitation robot for upper limbs of hemiplegic patients caused by stroke is proposed in this paper. Its hardware structure is introduced and the control methods are ana- lyzed. To impleme...A novel 5-DOF exoskeletal rehabilitation robot for upper limbs of hemiplegic patients caused by stroke is proposed in this paper. Its hardware structure is introduced and the control methods are ana- lyzed. To implement intelligent and interactive rehabilitation exercises, motion intention of patients＇ up- per limb is introduced into control methods of rehabilitation exercises. In passive motions, according to the character of unilateral impaired, multi-channels surface electromyogram （sEMG） signals of patients＇ healthy arm muscles are acquired and analyzed to recognize the upper limb motions, then drive the robot and assist paralysis ann＇s rehabilitation exercises. In active-resistant motions, because patients are re- covered with some muscle forces and active motion ability after a rehabilitation period, the terminal force loaded on the robot by an impaired arm are estimated with multi-channel joint torque sensors, according to which, the terminal velocity of the robot is controlled to drive the joint motions with a damp controller.展开更多
Objective: To explore the postoperative clinical characteristics and outcomes of myasthenia gravis with and without thymoma. Methods: Two hundred and forty-three patients with myasthenia gravis(MG) surgically treated ...Objective: To explore the postoperative clinical characteristics and outcomes of myasthenia gravis with and without thymoma. Methods: Two hundred and forty-three patients with myasthenia gravis(MG) surgically treated in our department from 1978 to 2003 were studied retrospectively. The clinical characteristics, complication, remissions and survival rates were compared between MG with and without thymoma. Results: The patients of MG with thymoma were significantly older (P<0.01), had shorter duration of symptom(P<0.01), and higher myasthenia crisis rates after operation(P<0.01) than those without thymoma. No difference of Osserman classification was found between the 2 groups. The complete remission rates and partial remission rates of MG with thymoma were significantly lower than those without thymoma at 1 and 3 years(P=0.049, P=0.000, P=0.015, P=0.010), but no differences at 5 years(P=0.457, P=0.699). The survival rates were lower in MG with thymoma than without thymoma(Log rank=18.58,P=0.000). Conclusion: The clinical characteristics are different between MG with and without thymoma. The remission of symptom of MG with thymoma is worse than that of MG without thymoma in the near future, but similar in the long future. In a long-term, the death rate of MG with thymoma is significantly higher than that of MG without thymoma.展开更多
Objective: The aim of the present study was to assess the early clinical outcome and risk factors in old patients with acute ST elevation myocardial infarction (STEMI) following primary percutaneous coronary intervent...Objective: The aim of the present study was to assess the early clinical outcome and risk factors in old patients with acute ST elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (PCI). Methods: A total of 136 patients older than 60 years with STEMI who received successful PCI were included in this study. The patients were classified in 2 age groups: patients ≥75 years and <75 years of age. The extent of coronary artery lesions was measured by quantitative coronary artery angiography (QCA). Subjects were tracked for subsequent cardiovascular events: cardiac death, myocardial infarction, heart failure, percutaneous coronary intervention, coronary artery bypass and stroke. Results: Though the older group had a higher prevalence of adverse baseline characteristics and lower final TIMI flow than patients<75y (P<0.05), the procedural success did not make difference between the two groups. In 12 months follow-up of 136 study participants, there occurred 39 CV events : cardiac death (five patients), heart failure (nineteen patients), and stroke (six patients). Three patients received coronary bypass grafts and six patients underwent PCI. Heart failure and overall cardiovascular event rates were higher in older patients compared with those in patients<75y. The main adverse clinical events (MACE) for the old group were a little higher comparing with the younger in 12-month follow-up (P=0.029 6 and P=0.043 4). Multivariate cox analysis identified that a diagnosis of diabetes (HR 2.495, 95%CI 1.224 to 5.083, P= 0.011 8) and time from symptom(HR 1.450, 95%CI 1.143 to 1.841, P= 0.008 2) to PCI as independent predictors of CV events after adjustment of all entered baseline variables. Conclusion: Our study suggests that drug-eluting stent implantation in older patients with acute ST elevation myocardial infarction has high initial procedural success rates despite having more severe baseline risk characteristics, and to shorten the time from symptom onset to PCI may decrease cardiovascular events in old patients following PCI.展开更多
Objective： To determine whether six weeks＇ of acupuncture has a positive effect on plantar flexion muscle strength and whether electroacupuncture （EA） has a greater effect than manual acupuncture （MA） on plantar...Objective： To determine whether six weeks＇ of acupuncture has a positive effect on plantar flexion muscle strength and whether electroacupuncture （EA） has a greater effect than manual acupuncture （MA） on plantar flexion, so that the most beneficial method of acupuncture can be established for strengthening muscles. Methods： A randomized controlled trial with parallel groups. A total of 20 participants were randomly assigned to three groups： a control/non-acupuncture group （n=6）, a manual acupuncture group （MAG） （n=8） and an electroacupuncture group （EAG） （n=6）. MAG and EAG received three 25-minute treatments per week for 6 weeks. The control group continued with their normal training activity and received no treatment. The maximal voluntary contraction （MVC） of the ankle plantar-flexors at 30~ per second was measured using Biodex system 3, Results： Both MA and EA had a positive effect in increasing plantar flexion strength. The likelihood for this happening was high; 69% for MA and 92% for EA when compared with the control group. However the effect size was small for both groups. There was only a trivial difference in the effect size between the EAG and the MAG in regards to average plantar flexion torque. Conclusion： EA and MA have a beneficial effect on plantar flexion muscle strength compared with the control group in healthy population.展开更多
Laparotomy or thoracolaparotomy is a traditional management approach for thoracoabdominal im- palement injury associated with major liver and diaphrag- matic injuries. We successfully treated the impalement in- jury w...Laparotomy or thoracolaparotomy is a traditional management approach for thoracoabdominal im- palement injury associated with major liver and diaphrag- matic injuries. We successfully treated the impalement in- jury with minimally invasive management. A male was brought to our trauma centre with the 15 cm long handle of the knife protruded from right lateral thoracoabdominal region. CT scan revealed that the knife blade traversed through the right costophrenic recess into segment 8 of the liver. There was an intraparenchymal haematoma and a col- lection of fluid in the abdominal cavity. The conservativemanagement plan consisting of removing the impaled knife, observing, monitoring and managing complications was undertaken. A multidisciplinary approach to manage a pa- tient with less invasive techniques yielded a good outcome. This management option may be considered as an alterna- tive for open surgery for hemodynamically stable patients in experienced centres.展开更多
Objective:Robot-assisted radical prostatectomy(RARP)requires pneumoperitoneum(Pnp)and a steep head-down position that may disturb respiratory system compliance(Crs)during surgery.Our aim was to compare the effects of ...Objective:Robot-assisted radical prostatectomy(RARP)requires pneumoperitoneum(Pnp)and a steep head-down position that may disturb respiratory system compliance(Crs)during surgery.Our aim was to compare the effects of different degrees of neuromuscular block(NMB)on Crs with the same Pnp pressure during RARP.Methods:One hundred patients who underwent RARP were enrolled and randomly allocated to a deep or moderate NMB group with 50 patients in each group.Rocuronium was administered to both groups:in the moderate NMB group to maintain 1–2 responses to train-of-four(TOF)stimulation;and in the deep NMB group to maintain no response to TOF stimulation and 1–2 responses in the post-tetanic count.Pnp pressure in both groups was 10 mm Hg(1 mm Hg=133.3 Pa).Peak inspiratory pressure(Ppeak),mean pressure(Pmean),Crs,and airway resistance(Raw)were recorded after anesthesia induction and at 0,30,60,and 90 min of Pnp and post-Pnp.Surgical space conditions were evaluated after the procedure on a 4-point scale.Results:Immediately after the Pnp,Ppeak,Pmean,and Raw significantly increased,while Crs decreased and persisted during Pnp in both groups.The results did not significantly differ between the two groups at any of the time points.There was no difference in surgical space conditions between groups.Body movements occurred in 14 cases in the moderate NMB group and in one case in the deep NMB group,and all occurred during obturator lymphadenectomy.A significant difference between the two groups was observed.Conclusions:Under the same Pnp pressure in RARP,deep and moderate NMBs resulted in similar changes in Crs,and in other respiratory mechanics and surgical space conditions.However,deep NMB significantly reduced body movements during surgery.展开更多
文摘Background： Various training schemes have sought to improve golf-related athletic ability. In the golf swing motion, the muscle strengths of the core and arms play important roles, where a difference typically exists in the power of arm muscles between the dominant and non- dominant sides. The purposes of this study were to determine the effects of exercises strengthening the core and non-dominant arm muscles of elite golf players （handicap 〈 3） on the increase in drive distance, and to present a corresponding training scheme aimed at improving golf performance ability. Methods： Sixty elite golfers were randomized into the control group （CG, n = 20）, core exercise group （CEG, n = 20）, and group receiving a combination of muscle strengthening exercises of the non-dominant arm and the core （NCEG, n = 20）. The 3 groups conducted the corresponding exercises for 8 weeks, after which the changes in drive distances and isokinetic strength were measured. Results： Significant differences in the overall improvement of drive distance were observed among the groups （p 〈 0.001）. Enhancement of the drive distance of NCEG was greater than both CG （p 〈 0.001） and CEG （p = 0.001）. Except for trunk flexion, all variables of the measurements of isokinetic strength for NCEG also showed the highest values compared to the other groups. Examination of the correlation between drive distance and isokinetic strength revealed significant correlations of all variables except trunk flexion, wrist extension, and elbow extension. Conclusion： The combination of core and non-dominant arm strength exercises can provide a more effective specialized training program than core alone training for golfers to increase their drive distances.
基金supported by the High Technology Research and Development Programme of China(No.2004AA421030)
文摘A novel 5-DOF exoskeletal rehabilitation robot for upper limbs of hemiplegic patients caused by stroke is proposed in this paper. Its hardware structure is introduced and the control methods are ana- lyzed. To implement intelligent and interactive rehabilitation exercises, motion intention of patients＇ up- per limb is introduced into control methods of rehabilitation exercises. In passive motions, according to the character of unilateral impaired, multi-channels surface electromyogram （sEMG） signals of patients＇ healthy arm muscles are acquired and analyzed to recognize the upper limb motions, then drive the robot and assist paralysis ann＇s rehabilitation exercises. In active-resistant motions, because patients are re- covered with some muscle forces and active motion ability after a rehabilitation period, the terminal force loaded on the robot by an impaired arm are estimated with multi-channel joint torque sensors, according to which, the terminal velocity of the robot is controlled to drive the joint motions with a damp controller.
文摘Objective: To explore the postoperative clinical characteristics and outcomes of myasthenia gravis with and without thymoma. Methods: Two hundred and forty-three patients with myasthenia gravis(MG) surgically treated in our department from 1978 to 2003 were studied retrospectively. The clinical characteristics, complication, remissions and survival rates were compared between MG with and without thymoma. Results: The patients of MG with thymoma were significantly older (P<0.01), had shorter duration of symptom(P<0.01), and higher myasthenia crisis rates after operation(P<0.01) than those without thymoma. No difference of Osserman classification was found between the 2 groups. The complete remission rates and partial remission rates of MG with thymoma were significantly lower than those without thymoma at 1 and 3 years(P=0.049, P=0.000, P=0.015, P=0.010), but no differences at 5 years(P=0.457, P=0.699). The survival rates were lower in MG with thymoma than without thymoma(Log rank=18.58,P=0.000). Conclusion: The clinical characteristics are different between MG with and without thymoma. The remission of symptom of MG with thymoma is worse than that of MG without thymoma in the near future, but similar in the long future. In a long-term, the death rate of MG with thymoma is significantly higher than that of MG without thymoma.
文摘Objective: The aim of the present study was to assess the early clinical outcome and risk factors in old patients with acute ST elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (PCI). Methods: A total of 136 patients older than 60 years with STEMI who received successful PCI were included in this study. The patients were classified in 2 age groups: patients ≥75 years and <75 years of age. The extent of coronary artery lesions was measured by quantitative coronary artery angiography (QCA). Subjects were tracked for subsequent cardiovascular events: cardiac death, myocardial infarction, heart failure, percutaneous coronary intervention, coronary artery bypass and stroke. Results: Though the older group had a higher prevalence of adverse baseline characteristics and lower final TIMI flow than patients<75y (P<0.05), the procedural success did not make difference between the two groups. In 12 months follow-up of 136 study participants, there occurred 39 CV events : cardiac death (five patients), heart failure (nineteen patients), and stroke (six patients). Three patients received coronary bypass grafts and six patients underwent PCI. Heart failure and overall cardiovascular event rates were higher in older patients compared with those in patients<75y. The main adverse clinical events (MACE) for the old group were a little higher comparing with the younger in 12-month follow-up (P=0.029 6 and P=0.043 4). Multivariate cox analysis identified that a diagnosis of diabetes (HR 2.495, 95%CI 1.224 to 5.083, P= 0.011 8) and time from symptom(HR 1.450, 95%CI 1.143 to 1.841, P= 0.008 2) to PCI as independent predictors of CV events after adjustment of all entered baseline variables. Conclusion: Our study suggests that drug-eluting stent implantation in older patients with acute ST elevation myocardial infarction has high initial procedural success rates despite having more severe baseline risk characteristics, and to shorten the time from symptom onset to PCI may decrease cardiovascular events in old patients following PCI.
文摘Objective： To determine whether six weeks＇ of acupuncture has a positive effect on plantar flexion muscle strength and whether electroacupuncture （EA） has a greater effect than manual acupuncture （MA） on plantar flexion, so that the most beneficial method of acupuncture can be established for strengthening muscles. Methods： A randomized controlled trial with parallel groups. A total of 20 participants were randomly assigned to three groups： a control/non-acupuncture group （n=6）, a manual acupuncture group （MAG） （n=8） and an electroacupuncture group （EAG） （n=6）. MAG and EAG received three 25-minute treatments per week for 6 weeks. The control group continued with their normal training activity and received no treatment. The maximal voluntary contraction （MVC） of the ankle plantar-flexors at 30~ per second was measured using Biodex system 3, Results： Both MA and EA had a positive effect in increasing plantar flexion strength. The likelihood for this happening was high; 69% for MA and 92% for EA when compared with the control group. However the effect size was small for both groups. There was only a trivial difference in the effect size between the EAG and the MAG in regards to average plantar flexion torque. Conclusion： EA and MA have a beneficial effect on plantar flexion muscle strength compared with the control group in healthy population.
文摘Laparotomy or thoracolaparotomy is a traditional management approach for thoracoabdominal im- palement injury associated with major liver and diaphrag- matic injuries. We successfully treated the impalement in- jury with minimally invasive management. A male was brought to our trauma centre with the 15 cm long handle of the knife protruded from right lateral thoracoabdominal region. CT scan revealed that the knife blade traversed through the right costophrenic recess into segment 8 of the liver. There was an intraparenchymal haematoma and a col- lection of fluid in the abdominal cavity. The conservativemanagement plan consisting of removing the impaled knife, observing, monitoring and managing complications was undertaken. A multidisciplinary approach to manage a pa- tient with less invasive techniques yielded a good outcome. This management option may be considered as an alterna- tive for open surgery for hemodynamically stable patients in experienced centres.
基金Project supported by the Zhejiang Province Public Welfare Technology Application Research Project(No.LGF20H010006),China。
文摘Objective:Robot-assisted radical prostatectomy(RARP)requires pneumoperitoneum(Pnp)and a steep head-down position that may disturb respiratory system compliance(Crs)during surgery.Our aim was to compare the effects of different degrees of neuromuscular block(NMB)on Crs with the same Pnp pressure during RARP.Methods:One hundred patients who underwent RARP were enrolled and randomly allocated to a deep or moderate NMB group with 50 patients in each group.Rocuronium was administered to both groups:in the moderate NMB group to maintain 1–2 responses to train-of-four(TOF)stimulation;and in the deep NMB group to maintain no response to TOF stimulation and 1–2 responses in the post-tetanic count.Pnp pressure in both groups was 10 mm Hg(1 mm Hg=133.3 Pa).Peak inspiratory pressure(Ppeak),mean pressure(Pmean),Crs,and airway resistance(Raw)were recorded after anesthesia induction and at 0,30,60,and 90 min of Pnp and post-Pnp.Surgical space conditions were evaluated after the procedure on a 4-point scale.Results:Immediately after the Pnp,Ppeak,Pmean,and Raw significantly increased,while Crs decreased and persisted during Pnp in both groups.The results did not significantly differ between the two groups at any of the time points.There was no difference in surgical space conditions between groups.Body movements occurred in 14 cases in the moderate NMB group and in one case in the deep NMB group,and all occurred during obturator lymphadenectomy.A significant difference between the two groups was observed.Conclusions:Under the same Pnp pressure in RARP,deep and moderate NMBs resulted in similar changes in Crs,and in other respiratory mechanics and surgical space conditions.However,deep NMB significantly reduced body movements during surgery.
