Management of restless legs syndrome in chronic liver disease:A challenge for the correct diagnosis and therapy

AIM To investigate the association between restless legs syndrome(RLS) and well-defined chronic liver disease, and the possible therapeutic options. METHODS Two hundred and eleven patients with chronic liver disease, complaining of sleep disturbances, painful leg sensation and daily sleepiness, were included. Patients with persistent alcohol intake, recent worsening of clinical conditions, or hepatitis C virus were excluded. Diagnosis of RLS was suggested by the Johns Hopkins questionnaire and verified by fulfilling the diagnostic criteria by Allen. All patients were tested, both at baseline and during follow-up, with the Hamilton rating scale for depression, sleep quality assessment(PSQI), Epworth sleepiness scale(ESS), International Restless Legs Syndrome Study Group evaluation, and international RLS severity(IRLS) scoring system. Ironfree level, ferritin, folate, vitamin B12 and D-OH25 were detected. Neurological examinations and blood testoccurred at the beginning of the therapy, after 2 wk, and at the 28^(th), 75 th, 105 th, 135 th, 165 th and 205 th day. Regarding therapy, pramipexole or gabapentin were used.RESULTS Patients were moderately depressed, with evident nocturnal sleep problems and concomitant daily sleepiness. Sleep problems and involuntary leg movements had been underestimated, and RLS s yndrome had not be e n c ons ide re d be fore t he neurological visit. All(211/211) patients fulfilled the RLS diagnostic criteria. Twenty-two patients considered their symptoms as mild, according to IRSL, but 189 found them moderate to very severe. No correlation was found between ammonium level and ESS or PSQI. Augmentation was rather precocious in our patients(135 th day), and more frequent(35%) than previous data(8.3%-9.1%). The dosage of dopamine agonists was found to be associated with augmentation and appears in range with the literature. Previous intake of alcohol and lower levels of vitamins have been related to the phenomenon in our study.CONCLUSION RLS is a common disorder, requiring rapid diagnosis and treatment. Further research is therefore fundamental.

CLINICAL STUDY OF 108 RESTLESS LEGS CASES BY ACUPUNCTURE OR EAR ACUPUNCTURE

108 cases of restless legs syndrome were treated , out of which, 56 cases withacupuncture, 52 cases with ear acupuncture. The therapeutical effects of acupuncture are superior tothat of ear acupuncture.

Prevalence of Restless Legs Syndrome in Patients Treated with Peritoneal Dialysis: Clinical and Biochemical Characteristics among Patients with and without Restless Legs Syndrome

Introduction and Aims:This is a prospective study identifying prevalence of Restless Legs Syndrome (RLS) in patients ongoing peritoneal dialysis (PD) due to end stage renal disease (ESRD) and comparing clinical and biochemical characteristics among patients with and without RLS. Methods: Two hundred ESRD patients who received PD at least six months assessed by neurologist and nephrologist with regards to presence of RLS. Also, clinical and biochemical features of these patients are determined. One hundred and forty four patients were excluded from study because they had other secondary causes of RLS except for ESRD. Results: Thirteen of 56 patients (23.2%) had RLS. The use of vitamin B + folic acid supplements was significantly lower in patients with RLS than in those without RLS (69.2% vs 97.7%;p = 0.008). There was no significant difference between patient groups with and without RLS in terms of age, gender, body mass index, cause of ESRD, peritoneal membrane transport characteristic, smoking, consuming alcohol, use of erythropoietin, duration of PD, hemoglobin, serum calcium, serum phosphorus, serum albumin, levels of serum iron, total iron binding capacity, ferritin, folic acid and vitamin B12, transferrin saturation, weekly Kt/V urea value, and amount of residual urine volume (p > 0.05). Conclusion: RLS is more common among PD patients than general population. Although essential cause is not exactly known, use of folic acid and vitamin B complex decrease the RLS prevalence in this particular patient group.

Restless Legs Syndrome in Liver Transplant Recipients

Background: The prevalence of restless legs syndrome (RLS) is approximately 10% in general population. This condition is more prevalent in certain diseases and we previously reported the prevalence of RLS in chronic liver disease population to be 62%. Objectives: Our aim was to assess the self-reported prevalence of RLS using an RLS symptom specific questionnaire in liver transplant patients. Methods: Subjects were a convenience sample in transplant clinic. They completed a validated survey for core RLS symptoms and if positive went on to completed a telephone survey using the validated International RLS Severity Scale Questionnaire (IRLS) and the Johns Hopkins RLS QoL survey to measure the effect of RLS symptoms on daily activities. Results: 40 patients surveyed, RLS was found in 16 subjects (40%) with moderate severity {17 (SD + 7.2, high score 31)}. Hepatitis C as indication for liver transplant was more likely associated with RLS (p = 0.05). Calcium channel blockers were protective (p = 0.032) while antidopaminergic agent use was statistically significant for RLS symptom (p = 0.005). On multiple linear regression analysis, diabetes (p = 0.024) and use of antidepressants/antihistamines (p = 0.049) were associated with RLS. Quality of Life (QoL) surveys specific to RLS suggested RLS symptoms resulted in significantly diminished QoL, with an average QoL score of 80 (SD + 11.7). Conclusion: There was a very high prevalence of RLS in our liver transplant patients with majority experiencing moderate or severe symptoms. The explanation for this higher prevalence is likely due to combination of comorbidites as well as medications that can trigger RLS.

HAMS+LEGS

如果你想要煎炸你的股二头肌来作为早餐,那么稍等,请你先品尝一下这个股后肌群与大腿的组合训练。

An Analysis of Medication Rules of Chinese Medicine for Restless Legs Syndrome Based on Data Mining

Objective: Based on data mining, to explore the medication rules of Chinese medicine for the treatment of restless legs syndrome(RLS). Methods: The CNKI, WANFANG, and VIP were taken as data sources, and "restless legs syndrome, RLS" as the key words, and "Chinese medicine, Chinese materia medica, traditional Chinese medicine(TCM), traditional Chinese and Western medicine" as sub key words, the data was extracted from the journals and literature related to the treatment of RLS by TCM from the establishment of the database to 2020, and data mining techniques(frequency analysis, cluster analysis, association rules) were used to analyze the core drugs and drug pair(group) rules. Results: A total of 87 prescriptions met the requirements of this study, involving 142 Chinese herbal medicines. The top 5 Chinese herbal medicines with a higher frequency of use were Radix Paeoniae Alba, Radix Glycyrrhizae, Radix Angelicae Sinensis, Fructus Chaenomelis and Radix Astragali seu Hedysari. The four Qi(气) of the medicine were mainly warm and neutral, the five flavors were mainly sweet, bitter, and pungent. The main channels of the meridian were mainly the liver meridian, spleen meridian and heart meridian. The medication categories were mainly tonifying deficiency herbs, blood activating and removing blood stasis herbs, and eliminating wind and dampness herbs. The association rule analysis yielded 24 Chinese medicine combinations with high support, and the hierarchical cluster analysis yielded a total of 5 clusters. Conclusion: TCM treatment of RLS is based on tonifying deficiency herbs, especially to replenish Qi and blood throughout the course of the disease, supplemented by herbs for promoting blood circulation and removing blood stasis, and herbs for eliminating wind and dampness, as well as combined with herbs for reliving superficies and herbs for calming the liver to stop the wind.

Picking Out Meat from Crab's Legs──The Jiangsu Oilfield

ＰｉｃｋｉｎｇＯｕｔＭｅａｔｆｒｏｍＣｒａｂ＇ｓＬｅｇｓ──ＴｈｅＪｉａｎｇｓｕＯｉｌｆｉｅｌｄ（Ｔｒｙｉｎｇｔｏｓｑｕｅｅｚｅｏｎｅｌａｓｔｂｏｎａｎｚａｆｒｏｍａｐａｔｃｈｏｆｓｏｉｌｔｈａｔ＇ｓａｌｒｅａｄｙｔｅｅｎｖｅｒｙｋｉｎｄｔｏＣｈｉｎ...

Legs Are Back!

When I was in elementary school, my classmates made fun of me for always wearing leggings.'Why don’t you wear jeans?' They asked, pointing to their own denim-clad, prepubescent legs.

Type Synthesis of Walking Robot Legs

Walking robots use leg structures to overcome obstacles or move on complicated terrains. Most robots of current researches are equipped with legs of simple structure. The specific design method of walking robot legs is seldom studied. Based on the generalized-function(GF) set theory, a systematic type synthesis process of designing robot legs is introduced. The specific mobility of robot legs is analyzed to obtain two main leg types as the goal of design.Number synthesis problem is decomposed into two stages, actuation and constraint synthesis by name,corresponding to the combinatorics results of linear Diophantine equations. Additional restrictions are discussed to narrow the search range to propose practical limb expressions and kinematic-pair designs. Finally, all the fifty-one leg structures of four subtypes are carried out, some of which are chosen to make up robot prototypes, demonstrating the validity of the method. This paper proposed a novel type synthesis methodology, which could be used to systematically design various practical robot legs and the derived robots.

Parametric Vibration Analysis of Submerged Floating Tunnel Tension Legs

According to the characteristics of submerged floating tunnel anchored by tension legs,simplifying the tube as point mass and assuming that the tension leg is a nonlinear beam model hinged at both ends,the nonlinear vibration equation of the tension leg is derived.The equation is solved by the Galerkin method and Runge Kutta method.Subsequently,numerical analysis of typical submerged floating tunnel tension leg is carried out.It is shown that,the parametric vibration response of the submerged floating tunnel tension leg is related to the amplitude and frequency of the end excitation.Without considering axial resonance and transverse resonance,it is reasonable that higher order modes are abandoned and only the first three modes are considered.The axial resonance amplitude of the second or third order mode is equivalent to the first order mode axial resonance amplitude,which should not be ignored.

Finite Element Analysis of Deformed Legs of Offshore Platform Structures

The element stiffness matrix of the equivalent beam or pipe element of the deformed leg of the platform is derived by the finite element method. The stresses and displacements of some damaged components are calculated, and the numerical solutions agree well with those obtained by the fine mesh finite element method. Finally, as an application of this method, the stresses of some platform structures are calculated and analyzed.

The Calculating Model of Structural Analysis for Jack-Up Rig Legs

The selection or establishment of structural calculating model is a matter of primary importance in structural analysis. By analysing the irrationality of the calculating models used by some research organizations at home and abroad in structural analyses for truss jack-up rig legs, this paper introduces a new calculation model which is more reasonable. This model can simulate better the load situation of a rig reflecting more precisely the effects of the leg loads caused by the spring support of gearboxes of the jacking system and the secondary bending moment raised by hull displacement under extreme conditions. The rig conversion was completed in 1989. In July 1991 the rig safely stood the frontal hitting of Typhoon with the wind speed of 52 m / s, which shows that the checking on the structure is correct.

Estimation of Standard Operation Time of Flight Legs Based on Clustering and Probability Analysis

A clustering algorithm and a probability statistics method were applied to different phases of a flight to analyze operation time during aircraft ground taxiing and airborne flight.And the clustering pattern,distribution characteristics and dynamically changing rules of the two phases were identified.Further,an estimate method was established to measure operation time of flight legs,with creative steps of calculating individual segment separately and then integrating them accordingly.The method can both objectively and dynamically measure operation time,and accurately reflect real situation.It helps to better utilize airport slot resources and provides a strong support for air traffic flow management when scheduling flight plan in strategic and pre-tactic phases.

RESEARCH OF KINEMATIC CHARAC－TERISTICS FOR QUADRUPED WALKING VEHICLE WITH LEGS OF DIFFERENT DISPOSITIONS OF DOFS

Systematic analyses have been made to three typical dispositions of walking vehicle leg,and their kinematic characteristics are obtained respectively. a reliable theoretical guidance for theselection of the form is provided.

近海三角张力腿平台钢筋束假定失效研究

Offshore triceratops is one of the successful manifestations of the form-dominant design approaches deployable in ultra-deepwater oil and gas exploration.The deck’s geometric shape and partial isolation from the legs counteract lateral loads.Legs are position-restrained to the sea bed by taut-moored tendons,while ball joints partially isolate the deck from the buoyant legs.However,compliance in the horizontal plane imposes large displacements,intuiting the necessity to examine tendon failure.Numerical analysis of triceratops under wave and wind combined action is carried out under the postulated conditions of a tendon failure.10-yr,100-yr,and 1000-yr post-Katrina hurricane conditions are assumed as loading to the platform.Results confirm a marginal increase in the natural periods of stiff degrees of freedom even under postulated failure conditions,ensuring good adaptability to ultra-deep water.Under postulated failure,the tension of adjacent tendons varies significantly,causing a shift to the mean position of the platform.Fatigue life is significantly reduced under the postulated failure of tendons,making the platform free-floating without affecting its stability.Results also show that the pitch response of the deck is a clear manifestation of the postulated failure,which is otherwise absent due to the presence of ball joints.The attempted study deliberates on the fatigue life of tendons,assessing the platform’s suitability to ultra-deep waters and identifying the vulnerable legs for the chosen load combinations.

Repetitive Transcranial Magnetic Stimulation for the Treatment of Restless Legs Syndrome

Background： Repetitive transcranial magnetic stimulation （rTMS） is a noninvasive technique used to alter cortex excitability that has been proposed as an efficient method for treating brain hyperexcitability or hypoexcitability disorders. Tile aim of this study was to investigate whether high-fi-equency rTMS could have any beneficial effects in restless legs syndrome （RLS）. Methods： Fourteen patients with RLS were given high-frequency rTMS （15 Hz, 100% motor threshold） to tile leg representation motor cortex area of the frontal lobe for 14 sessions over 18 days. Patients were diagnosed according to the international criteria proposed by the International Restless Legs Syndrome Study Group in 2003. The International RLS Rating Scale （1RLS-RS）, Pittsburgh Sleep Quality Index （PSQI）, Hamilton Anxiety Scale （llAMA） and Hamilton Depression Scale were used to evaluate the severity of RLS, sleep quality, anxiety and depression, respectively. The scale scores were evaluated at four-time points （baseline, end of the 14th session, and at 1- and 2-month posttreatrnent）. One-way analysis of variance was used to compare scale scores at different time points. Results： There was significant improvement in the 1RLS-RS （from 23.86 ± 5.88 to 11.21 ± 7.23, P 〈 0.05）, PSQ1 （frorn 15.00 ± 4.88 to 9.29 ± 3.91, P 〈 0.05）, and HAMA （from 17.93 ± 7.11 to 10.36 ± 7.13, P 〈 0.05） scale scores at the end of 14th session, with ongoing effects lasting for at least 2 months. Conclusions： High-17equency rTMS can markedly alleviate the motor system symptoms, sleep disturbances, and anxiety in RLS patients. These restllts suggest that rTMS might be an option for treating RLS.

Locomotion Performance of the Amphibious Robot on Various Terrains and Underwater with Flexible Flipper Legs

Amphibious robots are attracting more and more attentions from researchers worldwide tbr their broad appllcanons m resource exploration, disaster rescue, and reconnaissance. Amphibious robot with transformable flipper-leg composite propul- sion mechanisms can adapt various terrestrial and water environments. In this paper, we explored the locomotion performance of a amphibious robot with flexible flipper legs on various terrains and underwater through dynamical simulation. The influence of the stiffness of the flipper legs on the locomotion performance in various environments was investigated comprehensively. The results indicate that the locomotion with flexible flipper legs is very stable, and the stiffness of the flipper legs has a great impact on the locomotion performance. The verification experiments demonstrate the accuracy of the simulation results. The study facilitates the design of the amphibious robot and indicates that the passively transformable flipper-leg mechanisms also enable amphibious robot to conquer various complex terrestrial environments.

Design of Rehabilitation Robot with Combined Movement of Arms and Legs

Rehabilitation instruments are effective tools for patients to recover from disability. However, we still do not have a rehabilitation instrument which could provide combined movement with arms and legs. Rehabilitation with combined movement of arms and legs is completely a new method. In order to check the effect of this new rehabilitation method and to provide patients with more efficient rehabilitation instrument, we design a new rehabilitation robot. This robot lets patients practice when they lie down and stand up. This article explains the design of this instrument clearly. Using Unigraphics NX software to build 3D model, we have a complete design of this rehabilitation robot.

Smart Gait:A Gait Optimization Framework for Hexapod Robots

The current gait planning for legged robots is mostly based on human presets,which cannot match the flexible characteristics of natural mammals.This paper proposes a gait optimization framework for hexapod robots called Smart Gait.Smart Gait contains three modules:swing leg trajectory optimization,gait period&duty optimization,and gait sequence optimization.The full dynamics of a single leg,and the centroid dynamics of the overall robot are considered in the respective modules.The Smart Gait not only helps the robot to decrease the energy consumption when in locomotion,mostly,it enables the hexapod robot to determine its gait pattern transitions based on its current state,instead of repeating the formalistic clock-set step cycles.Our Smart Gait framework allows the hexapod robot to behave nimbly as a living animal when in 3D movements for the first time.The Smart Gait framework combines offline and online optimizations without any fussy data-driven training procedures,and it can run efficiently on board in real-time after deployment.Various experiments are carried out on the hexapod robot LittleStrong.The results show that the energy consumption is reduced by 15.9%when in locomotion.Adaptive gait patterns can be generated spontaneously both in regular and challenge environments,and when facing external interferences.

Effect of Skeleton Grain Size on the Saturation of Gas Hydrate in Natural Sediments

Natural gas hydrate is prospected as a new and promising,highly clean energy resource that mainly occurs in perma-frost or at continental margins.Its formation is subject to many soil conditions,such as grain size,matrix materials,pore morphology,and permeability.In this study,we propose that grain size is the most decisive parameter that affects the saturation of gas hydrate in sediments based on data from Ocean Drilling Program Leg 164 and Mallik 5L-38,which represent marine sediments and terrestrial sediments,respectively.Our study reveals that high gas hydrate saturation generally occurs in coarse-grained sand,regardless of whether sediment formation is homogeneous or inhomogeneous,and the sorting of sediments may affect the hydrate saturation to a certain degree.Using grain size and sorting of sediments may be the most intuitive proxy method for a rough estimation of hydrate saturation.Further study is necessary to fully understand the relationship between hydrate morphology and sediment grain size,even though massive hydrates are typically found in fine clayey-rich sediments.