Robot-assisted radical prostatectomy （RARP） is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the ...Robot-assisted radical prostatectomy （RARP） is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the acceptance of this technology in Europe and the rest of the world has been somewhat slower. This article reviews the current literature on RARP with regard to oncological, continence and potency outcomes-the so-called ＇trifecta＇. Preliminary data appear to show an advantage of RARP over open prostatectomy, with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most studies show good postoperative continence and potency with RARP; however, this needs to be viewed in the context of the paucity of randomized data available in the literature. There is no definitive evidence to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging. Finally, evolving techniques of single-port robotic prostatectomy, laser- guided robotics, catheter-free prostatectomy and image-guided robotics are discussed.展开更多
The human foot is a very complex structure comprising numerous bones, muscles, ligaments and synovial joints. As the only component in contact with the ground, the foot complex delivers a variety of biomechanical func...The human foot is a very complex structure comprising numerous bones, muscles, ligaments and synovial joints. As the only component in contact with the ground, the foot complex delivers a variety of biomechanical functions during human locomotion, e.g. body support and propulsion, stability maintenance and impact absorption. These need the human foot to be rigid and damped to transmit ground reaction forces to the upper body and maintain body stability, and also to be compliant and resilient to moderate risky impacts and save energy. How does the human foot achieve these apparent conflicting functions？ In this study, we propose a phase-dependent hypothesis for the overall locomotor functions of the human foot complex based on in-vivo measurements of human natural gait and simulation results of a mathematical foot model. We propse that foot functions are highly dependent on gait phase, which is a major characteristics of human locomotion. In early stance just after heel strike, the foot mainly works as a shock absorber by moderating high impacts using the viscouselastic heel pad in both vertical and horizontal directions. In mid-stance phase （-80% of stance phase）, the foot complex can be considered as a springy rocker, reserving external mechanical work using the foot arch whilst moving ground contact point forward along a curved path to maintain body stability. In late stance after heel off, the foot complex mainly serves as a force modulator like a gear box, modulating effective mechanical advantages of ankle plantiflexor muscles using metatarsal-phalangeal joints. A sound under- standing of how diverse functions are implemented in a simple foot segment during human locomotion might be useful to gain insight into the overall foot locomotor functions and hence to facilitate clinical diagnosis, rehabilitation product design and humanoid robot development.展开更多
As one of the most important daily motor activities, human locomotion has been investigated intensively in recent decades. The locomotor functions and mechanics of human lower limbs have become relatively well underst...As one of the most important daily motor activities, human locomotion has been investigated intensively in recent decades. The locomotor functions and mechanics of human lower limbs have become relatively well understood. However, so far our understanding of the motions and functional contributions of the human spine during locomotion is still very poor and simultaneous in-vivo limb and spinal column motion data are scarce. The objective of this study is to investigate the delicate in-vivo kinematic coupling between different functional regions of the human spinal column during locomotion as a stepping stone to explore the locomotor function of the human spine complex. A novel infrared reflective marker cluster system was constrncted using stereophotogrammetry techniques to record the 3D in-vivo geometric shape of the spinal column and the segmental position and orientation of each functional spinal region simultaneously. Gait measurements of normal walking were conducted. The preliminary results show that the spinal column shape changes periodically in the frontal plane during locomotion. The segmental motions of different spinal functional regions appear to be strongly coupled, indicating some synergistic strategy may be employed by the human spinal column to facilitate locomotion. In contrast to traditional medical imaging-based methods, the proposed technique can be used to investigate the dynamic characteristics of the spinal column, hence providing more insight into the functional biomechanics of the human spine.展开更多
Objective ：To overall evaluate the change of global cardiac systolic performance and diastolic filling in hypovoleamia by LBNP, Methods：10 healthy male subjects were placed in a standard LBNP chamber. Baseline haemo...Objective ：To overall evaluate the change of global cardiac systolic performance and diastolic filling in hypovoleamia by LBNP, Methods：10 healthy male subjects were placed in a standard LBNP chamber. Baseline haemodynamic and echocardiographic measurements were made after a period of least 10 min resting supine within the chamber. Pressure was then decreased to -10,-20 and -30 mmHg, with each pressure maintained for 15 rain. The indices of four transvalvular and SVC flow were measured using Doppler echocardiography. Results ：The results showed that S wave, Re wave ,and VTI of SVC progressively decreased with increasing LBNP. At -30 mmHg stage, S wave decreased by 35.4 % （change of 0.21±0.03 m/s, P 〈 0.001）. This reduction in pre-load Was associated with a progressive decrease in SV（by 21.5 ± 4.5 ml at -30 mmHg,P 〈 0.001 ）, decrease in CO（by 1.2 ± 0.2 L min^-1 at -30 mmHg LBNP,P 〈 0.001 ）. The diastolic filling of mitral and tricuspid flow also reduced significantly. At -30 mmHg stage, the E wave of MVF and TVF decreased 31% and 32% respectively （change of 0.23 ± 0.05 m/s,P 〈 0.001 and 0.18 ± 0.01 m/s,P 〈 0.001）. VTI of MVF and TVF decreased 27% and 27.7% respectively（change of 5.55 ± 1.41cm,P 〈 0.01 and 4.25 ± 0.44 cm,P 〈 0.01）. A wave of both sides did not change significantly. Conclusion：Doppler indices changes in different LBNP stage can roughly reflect the degree of hypovoleamia caused by blood volume redistribution. The indices of Doppler echocardiography are more sensitive than traditional physiological indexes in evaluating cardiovascular responses of LBNP. Echocardiography techniques overall can evaluate the global cardiac function including systolic performance and diastolic filling.展开更多
Asthma is a common disease in the worldwide and it affects over 3.5 million adults and children in the UK. Asthma is a chronic disease characterized by airway hyperresponsiveness, airway inflammation, airway remodelli...Asthma is a common disease in the worldwide and it affects over 3.5 million adults and children in the UK. Asthma is a chronic disease characterized by airway hyperresponsiveness, airway inflammation, airway remodelling and reversible airway obstruction. Inflammatory cells, cytokines, chemokines, adhesion molecules, and mediators are involved in pathogenesis of asthma. Chronic airway inflammation and remodelling are the major characters in asthma, which result in decreased pulmonary function. The precise processes are far understood at moment. Although corticosteroid therapy plus other exiting drugs （bronchodilators and oral leukotriene receptor antagonists） influences many different inflammatory and structural cell types and continues to be as the ＂gold standard＂ of therapy in asthma, many thousands have chronic, severe diseases and suffer daily symptoms which make their lives a misery. There remains a clear need for novel approaches to therapy, which will be informed by a clearer understanding of disease pathogenesis, particularly in the target organ where airway inflammation and remodelling, the hallmarks of asthma occur. Cellular ＆ Molecular Immunology.展开更多
文摘Robot-assisted radical prostatectomy （RARP） is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the acceptance of this technology in Europe and the rest of the world has been somewhat slower. This article reviews the current literature on RARP with regard to oncological, continence and potency outcomes-the so-called ＇trifecta＇. Preliminary data appear to show an advantage of RARP over open prostatectomy, with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most studies show good postoperative continence and potency with RARP; however, this needs to be viewed in the context of the paucity of randomized data available in the literature. There is no definitive evidence to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging. Finally, evolving techniques of single-port robotic prostatectomy, laser- guided robotics, catheter-free prostatectomy and image-guided robotics are discussed.
文摘The human foot is a very complex structure comprising numerous bones, muscles, ligaments and synovial joints. As the only component in contact with the ground, the foot complex delivers a variety of biomechanical functions during human locomotion, e.g. body support and propulsion, stability maintenance and impact absorption. These need the human foot to be rigid and damped to transmit ground reaction forces to the upper body and maintain body stability, and also to be compliant and resilient to moderate risky impacts and save energy. How does the human foot achieve these apparent conflicting functions？ In this study, we propose a phase-dependent hypothesis for the overall locomotor functions of the human foot complex based on in-vivo measurements of human natural gait and simulation results of a mathematical foot model. We propse that foot functions are highly dependent on gait phase, which is a major characteristics of human locomotion. In early stance just after heel strike, the foot mainly works as a shock absorber by moderating high impacts using the viscouselastic heel pad in both vertical and horizontal directions. In mid-stance phase （-80% of stance phase）, the foot complex can be considered as a springy rocker, reserving external mechanical work using the foot arch whilst moving ground contact point forward along a curved path to maintain body stability. In late stance after heel off, the foot complex mainly serves as a force modulator like a gear box, modulating effective mechanical advantages of ankle plantiflexor muscles using metatarsal-phalangeal joints. A sound under- standing of how diverse functions are implemented in a simple foot segment during human locomotion might be useful to gain insight into the overall foot locomotor functions and hence to facilitate clinical diagnosis, rehabilitation product design and humanoid robot development.
基金supported by the Key Project of National Natural Science Foundation of China (No. 50635030)the National Basic Research Program ("973" Program) of China (No. 2007CB616913)+2 种基金was also supported by the China Scholarship Council (CSC)We also would like to thank Karin Jespers and Sharon Warner of the Structure and Motion Laboratory for their support of the experimental workJRH’s con-tributions were supported by research grants BB/C516844/1 and BB/F01169/1 from the BBSRC, whom we thank.
文摘As one of the most important daily motor activities, human locomotion has been investigated intensively in recent decades. The locomotor functions and mechanics of human lower limbs have become relatively well understood. However, so far our understanding of the motions and functional contributions of the human spine during locomotion is still very poor and simultaneous in-vivo limb and spinal column motion data are scarce. The objective of this study is to investigate the delicate in-vivo kinematic coupling between different functional regions of the human spinal column during locomotion as a stepping stone to explore the locomotor function of the human spine complex. A novel infrared reflective marker cluster system was constrncted using stereophotogrammetry techniques to record the 3D in-vivo geometric shape of the spinal column and the segmental position and orientation of each functional spinal region simultaneously. Gait measurements of normal walking were conducted. The preliminary results show that the spinal column shape changes periodically in the frontal plane during locomotion. The segmental motions of different spinal functional regions appear to be strongly coupled, indicating some synergistic strategy may be employed by the human spinal column to facilitate locomotion. In contrast to traditional medical imaging-based methods, the proposed technique can be used to investigate the dynamic characteristics of the spinal column, hence providing more insight into the functional biomechanics of the human spine.
基金This work was supported by a grant from the Department of Science and Technology, Sichuan, P.R. China
This work was supported by a grant from the Department of Science and Technology, Sichuan, China. We would like to thank JIN Mei, LUO Dan, SANG Mu, WANG Mu, and Luo-sang-Jian-cai from Medical School of Tibet university for their assistance with the data collection.
文摘Objective ：To overall evaluate the change of global cardiac systolic performance and diastolic filling in hypovoleamia by LBNP, Methods：10 healthy male subjects were placed in a standard LBNP chamber. Baseline haemodynamic and echocardiographic measurements were made after a period of least 10 min resting supine within the chamber. Pressure was then decreased to -10,-20 and -30 mmHg, with each pressure maintained for 15 rain. The indices of four transvalvular and SVC flow were measured using Doppler echocardiography. Results ：The results showed that S wave, Re wave ,and VTI of SVC progressively decreased with increasing LBNP. At -30 mmHg stage, S wave decreased by 35.4 % （change of 0.21±0.03 m/s, P 〈 0.001）. This reduction in pre-load Was associated with a progressive decrease in SV（by 21.5 ± 4.5 ml at -30 mmHg,P 〈 0.001 ）, decrease in CO（by 1.2 ± 0.2 L min^-1 at -30 mmHg LBNP,P 〈 0.001 ）. The diastolic filling of mitral and tricuspid flow also reduced significantly. At -30 mmHg stage, the E wave of MVF and TVF decreased 31% and 32% respectively （change of 0.23 ± 0.05 m/s,P 〈 0.001 and 0.18 ± 0.01 m/s,P 〈 0.001）. VTI of MVF and TVF decreased 27% and 27.7% respectively（change of 5.55 ± 1.41cm,P 〈 0.01 and 4.25 ± 0.44 cm,P 〈 0.01）. A wave of both sides did not change significantly. Conclusion：Doppler indices changes in different LBNP stage can roughly reflect the degree of hypovoleamia caused by blood volume redistribution. The indices of Doppler echocardiography are more sensitive than traditional physiological indexes in evaluating cardiovascular responses of LBNP. Echocardiography techniques overall can evaluate the global cardiac function including systolic performance and diastolic filling.
基金TEDS has been funded since 1995 by a program grant from the U.K. Medical Research Council (G9424799, now G050079)+2 种基金
Funding has also been received to develop additional areas of research from the U.S. National Institute of Child Health and Human Development (HD) for a quantitative genetic study of school environments (HD44454) and of mathematics (HD46167), and for molecular genetic research on reading (HD49861)
the Wellcome Trust has also supported our molecular genetic research on cognitive abilities (GR75492)
文摘Asthma is a common disease in the worldwide and it affects over 3.5 million adults and children in the UK. Asthma is a chronic disease characterized by airway hyperresponsiveness, airway inflammation, airway remodelling and reversible airway obstruction. Inflammatory cells, cytokines, chemokines, adhesion molecules, and mediators are involved in pathogenesis of asthma. Chronic airway inflammation and remodelling are the major characters in asthma, which result in decreased pulmonary function. The precise processes are far understood at moment. Although corticosteroid therapy plus other exiting drugs （bronchodilators and oral leukotriene receptor antagonists） influences many different inflammatory and structural cell types and continues to be as the ＂gold standard＂ of therapy in asthma, many thousands have chronic, severe diseases and suffer daily symptoms which make their lives a misery. There remains a clear need for novel approaches to therapy, which will be informed by a clearer understanding of disease pathogenesis, particularly in the target organ where airway inflammation and remodelling, the hallmarks of asthma occur. Cellular ＆ Molecular Immunology.
