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This paper introduces a compact end-effector ankle rehabilitation robot (CEARR) system for addressing ankle range of motion (ROM) rehabilitation. The CEARR features a bilaterally symmetrical rehabilitation structure, with each side possessing three degrees of freedom (DOF) driven by three independently designed actuators. The working intervals of each actuator are separated by a series connection, ensuring they operate without interference to accommodate the dorsiflexion/plantarflexion (DO/PL), inversion/eversion (IN/EV), and adduction/abduction (AD/AB) DOF requirements for comprehensive ankle rehabilitation. In addition, we integrated an actuator and foldable brackets to accommodate patients in varied postures. We decoded the motor intention based on the surface electromyography (sEMG) and torque signals generated by the subjects' ankle joints in voluntary rehabilitation. Besides, we designed a real-time voluntary-triggered control (VTC) strategy to enhance the rehabilitation effect, in which the root mean square (RMS) of sEMG was utilized to trigger and adjust the CEARR rehabilitation velocity support. We verified the consistency of voluntary movement with CEARR rehabilitation support output for four healthy subjects on a nonlinear sEMG signal with an R 2 metric of approximately 0.67. We tested the consistency of triggering velocity trends with a linear torque signal for one healthy individual with an R 2 metric of approximately 0.99.
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We reported a rare ß-thalassemia patient, a 41-year-old Chinese male with small cell hypopigmentation anemia, jaundice and splenomegaly as the main clinical symptoms. By using Next-Generation Sequencing (NGS), we identified a novel de novo HBB mutation(c.358_365dup, p.Phe123Alafs*39) which resulted in an abnormally prolonged ß-globin chain comprising 159 amino acid residues. The secondary and three-dimensional structures of the ß-globin predicted that the novel prolonged ß-globin chain has a considerable risk of instability in the hemoglobin, and leads to clinical phenotype. This study contributes to the enrichment of the genetic pathogenic mutation database for thalassemia and underscores the significance of NGS in the screening of mutations for thalassemia families.
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BACKGROUND AND AIMS: Thrombolytic therapy is widely used to treat acute ischemic stroke (AIS) patients. As intracerebral hemorrhage is a life-threatening complication of this therapy, monitoring the fibrinolytic and coagulation systems is imperative. However, existing studies on plasmin inhibitor complex (PIC) and thrombin-antithrombin III complex (TAT) mostly apply the enzyme-linked immunosorbent assay (ELISA) method. The aim of this study is to establish the baseline of thrombolytic treatment for AIS patients; to monitor the fibrinolytic and coagulation system following alteplase administration; to ascertain the proper time point to predict intracerebral hemorrhage. METHODS: The method used to assess a patient's intravascular situation, namely chemiluminescence, was used to quantitatively assess the PIC, TAT, and thrombomodulin (TM). Immuno-turbidimetric was used to assess the concentration of D-dimer, fibrin/fibrinogen degradation products (FDP), and the Von Willebrand factor (vWF). The Clauss clotting method was used to assay the activated partial thromboplastin time (APTT), prothrombin time (PT) and FIB. RESULTS: PIC increased to its peak concentration at 3 hours post intravenous (IV) alteplase infusion and decreased by nearly 50% every 3 hours thereafter. After 24 hours, PIC returned to its normal range, while D-dimer and FDP decreased 3 hours later compared to PIC. PT and APTT exhibited no obvious change during the 24-hour period. TM also exhibited no changes during the treatment. CONCLUSION: PIC decreased 3 hours earlier than D-dimer and FDP. The combined test of PIC, D-dimer, and fibrinogen can be used to monitor the fibrinolytic system after the IV alteplase infusion. The use of IV alteplase had no impact on the endothelium. Creating a patient's individual data curve could assist in the prediction of hemorrhagic transformation (HT) and a stroke occurring.
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Statistical Shape Models (SSMs) have achieved considerable success in medical image segmentation. A high quality SSM is able to approximate the main plausible variances of a given anatomical structure to guide segmentation. However, it is technically challenging to derive such a quality model because: (1) the distribution of shape variance is often nonlinear or multi-modal which cannot be modeled by standard approaches assuming Gaussian distribution; (2) as the quality of annotations in training data usually varies, heavy corruption will degrade the quality of the model as a whole. In this work, these challenges are addressed by introducing a generic SSM that is able to model nonlinear distribution and is robust to outliers in training data. Without losing generality and assuming a sparsity in nonlinear distribution, a novel Robust Kernel Principal Component Analysis (RKPCA) for statistical shape modeling is proposed with the aim of constructing a low-rank nonlinear subspace where outliers are discarded. The proposed approach is validated on two different datasets: a set of 30 public CT kidney pairs and a set of 49 MRI ankle bones volumes. Experimental results demonstrate a significantly better performance on outlier recovery and a higher quality of the proposed model as well as lower segmentation errors compared to the state-of-the-art techniques.
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Modelos Estadísticos , Análisis de Componente Principal , Tobillo/diagnóstico por imagen , Conjuntos de Datos como Asunto , Humanos , Riñón/diagnóstico por imagen , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Hepatic fibrosis is a reversible pathological process. Inflammatory responses are the prevailing reactions during hepatic fibrosis. Decoy receptor 3 (DcR3) has been reported to have an anti-inflammatory effect. OBJECTIVES: The aim of the study was to investigate the preventive effects of DcR3 on hepatic fibrosis. MATERIAL AND METHODS: Hepatic fibrosis was induced in rats by administering intraperitoneally (ip.) 1% dimethylnitrosamine (DMN). DcR3 plasmid was delivered into rats by intravenous injection. After 4 weeks, the expression of DcR3, TNF-like molecule 1A (TL1A) and α-SMA of the liver tissue were checked. The levels of inflammatory cytokines such as TNF-α, IL-6 and IL-1ß were detected using western blotting and quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR). Masson's trichrome staining for histopathological changes of the liver tissue was observed. Finally, the activity of NF-κB in the liver was examined by enzyme-linked immunosorbent assay (ELISA). RESULTS: A higher expression of DcR3 was observed in rats treated with DcR3 (p < 0.05). Histological results showed that DcR3 significantly attenuated pathology in hepatic fibrosis rats. Consistently, mRNA and protein levels of α-SMA, TL1A, TNF-α, IL-6, and IL-1ß were repressed in the liver tissue after treatment with DcR3 (p < 0.05). Moreover, DcR3 also inhibited the activation of NF-κB in the liver tissue (p < 0.05). CONCLUSIONS: This study demonstrated that DcR3 attenuated liver injury and inflammatory responses in rats with hepatic fibrosis. We suggest DcR3 may be a prophylactic and promising therapeutic agent in the treatment of hepatic fibrosis.
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Inflamación/prevención & control , Cirrosis Hepática/prevención & control , FN-kappa B/inmunología , Miembro 6b de Receptores del Factor de Necrosis Tumoral/farmacología , Animales , Western Blotting , Ensayo de Inmunoadsorción Enzimática , Inflamación/genética , FN-kappa B/metabolismo , Ratas , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Transducción de Señal/inmunologíaRESUMEN
The mechanisms of hepatitis B virus (HBV) persistent infection are not completely understood. Interleukin (IL)-35, which is a newly identified cytokine belongs to IL-12 family, has been demonstrated to induce immunotolerance. Thus, the aim of current study was to investigate the role of IL-35 during chronic HBV infection. A total of 61 patients with chronic HBV infection [37 chronic hepatitis B (CHB) and 24 asymptomatic HBV carriers (ASC)] and 20 healthy individuals were enrolled. IL-35 concentration as well as the modulatory function of IL-35 on CD4+CD25+CD127dim/- regulatory T cells (Tregs) and on HBV antigen-specific CD8+ T cells was investigated. IL-35 expression was significantly increased in both CHB and ASC, and was positively correlated with the levels of HBV DNA. Inhibition of viral replication induced the reduction in serum levels of IL-35. IL-35 stimulation led to inhibition of proinflammatory cytokine productions and elevation of apoptosis in peripheral blood mononuclear cells (PBMCs), but not in HepG2.2.15 cells. Moreover, IL-35 stimulation not only robustly inhibited cellular proliferation, but also up-regulated the production of IL-10 and IL-35 in a HBV antigen-specific and non-specific manner in Tregs/CD4+CD25- T cells coculture system, which indicated enhancement of suppressive function of Tregs. Furthermore, IL-35 also reduced both cytolytic activity (direct lysis of HepG2.2.15 cells) and noncytolytic function (IFN-γ and TNF-α production) of HBV antigen-specific CD8+ T cells. The current data suggested that IL-35 contributed to maintain viral persistence by suppressing antiviral immune responses and reducing inflammatory responses in chronic HBV infection.
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Antivirales/uso terapéutico , Virus de la Hepatitis B/inmunología , Hepatitis B Crónica/inmunología , Tolerancia Inmunológica/efectos de los fármacos , Interleucinas/inmunología , Interleucinas/farmacología , Adolescente , Adulto , Antígenos Virales/inmunología , Apoptosis/efectos de los fármacos , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , Proliferación Celular/efectos de los fármacos , Citocinas/metabolismo , ADN Viral , Femenino , Células Hep G2 , Virus de la Hepatitis B/patogenicidad , Hepatitis B Crónica/tratamiento farmacológico , Hepatitis B Crónica/virología , Humanos , Tolerancia Inmunológica/inmunología , Interferón gamma/metabolismo , Interleucina-10/metabolismo , Interleucina-12 , Interleucinas/sangre , Leucocitos Mononucleares/efectos de los fármacos , Masculino , Linfocitos T Reguladores/inmunología , Factor de Necrosis Tumoral alfa/metabolismo , Replicación Viral , Adulto JovenRESUMEN
Nonalcoholic fatty liver disease (NAFLD) is characterized by high levels of nonesterified fatty acids (NEFA), inflammation, and hepatic steatosis. Inflammation plays a crucial role in the development of fatty liver. Resveratrol (RSV) supplement could improve inflammatory response and hepatic steatosis, whereas the underlying mechanism was not well understood. In this study, mice fed with high-fat diet (HFD) exhibited severe hepatic injury and high blood concentrations of the inflammatory cytokines TNF-α, IL-6, and IL-1ß. Hepatic NF-κB inflammatory pathway was over-induced in HFD mice. In vitro, NEFA treatment further increased NF-κB pathway activation in mice hepatocytes, which then promoted the synthesis of inflammatory cytokines. Interestingly, RSV treatment significantly inhibited overactivation of NF-κB pathway and improved hepatic steatosis. Furthermore, RSV further increased the AMP-activated protein kinaseα (AMPKα) phosphorylation and sirtuin1 (SIRT1) protein levels to inhibit overactivation of NF-κB pathway induced by HFD or high levels of NEFA. AMPKα or SIRT1 inhibition significantly decreased the improvement effect of RSV on the NF-κB pathway induced by high levels of NEFA. Taken together, these findings indicate that RSV supplement decreases the inflammatory level and improves hepatic steatosis through activating AMPKα-SIRT1 pathway. Therefore, these data suggested an important clinical application of RSV in preventing NAFLD in humans.
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Proteínas Quinasas Activadas por AMP/metabolismo , FN-kappa B/metabolismo , Enfermedad del Hígado Graso no Alcohólico/tratamiento farmacológico , Transducción de Señal/efectos de los fármacos , Sirtuina 1/metabolismo , Estilbenos/farmacología , Animales , Citocinas/biosíntesis , Humanos , Ratones , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Fosforilación/efectos de los fármacos , ResveratrolRESUMEN
We investigated the efficacy and safety of a new type of dietary fiber (high specific volume polysaccharide) for use in treating constipation of different etiologies. Functional constipation patients and irritable bowel syndrome-constipation (IBS-C) patients were administrated high specific volume polysaccharide (HSVP) three times daily for a period of 2 wk to relieve their symptoms. Scores on a stool form scale, and patient reports of straining during a bowel movement, having sensations of an incomplete bowel movement or a blocked anorectum, and abnormal defecation intervals were recorded, graded, and scored by a functional constipation sample group. Similarly, a cohort of IBS-C patients reported their occurrence of abdominal discomfort or pain, abnormal stool formation, defecation frequency, and straining during a bowel movement. Additionally, both groups reported any adverse reactions associated with taking HSVP. All patients in both groups returned for follow-up visits, and no adverse reactions to treatment with HSVP were reported. In the functional constipation group, HSVP was effective for treating symptoms of constipation in 81.46% and 93.17% of patients after 7 and 14 d of dosing, respectively (both p<0.05). In the IBS-C group, symptoms of constipation were relieved in 71.67% and 88.34% of patients after 7 and 14 d of dosing, respectively (both p<0.05). High specific volume polysaccharide was shown be effective for treatment of functional constipation and IBS-C, without causing significant adverse events.