A型肉毒毒素治疗上肢痉挛的应用进展

脑瘫、脑卒中、颅脑外伤、多发性硬化等疾病引起上运动神经元病损均可出现肌肉痉挛,给患者的肢体功能造成不良影响。肉毒毒素是肉毒梭状芽孢杆菌产生的一种毒力极强的嗜神经生物毒素,可阻断神经肌肉接头处的乙酰胆碱的释放,导致肌肉松弛性麻痹。一些临床专家利用肉毒毒素(主要为A型肉毒毒素Botulinum toxin type A,BTX-A)的这种生物活性,来治疗肢体肌肉痉挛,已成为相关医学生物学和临床研究的热点之一。     

Quantitative assessment of upper limb muscle fatigue depending on the conditions of repetitive task load

The aim of this study was to discriminate fatigue of upper limb muscles depending on the external load, through the development and analysis of a muscle fatigue index. Muscle fatigue is expressed by a fatigue index based on an amplitude parameter (calculated in the time domain) and a fatigue index based on a frequency parameter (a parameter calculated in the frequency domain). The fatigue index involves a regression function that describes changes in the EMG signal parameter, time elapsing before muscle fatigue and the probability of specific trends in changes in EMG parameters for the population under study.

The experimental study covered a group of 10 young men. During the study, they exerted force at a specific level and for a specific time in 12 load variants. During the study, EMG signals from four muscles of the upper limb were recorded (trapezius pars descendents, biceps brachii caput breve, extensor carpi radialis brevis, flexor carpi ulnaris). For each variant and for each examined muscles, the value of the fatigue index was calculated. Values of that index quantitatively expressed fatigue of a specific muscle in a specific load variant.

A statistical analysis indicated variation in the fatigue of the biceps brachii caput breve, extensor carpi radialis brevis, and flexor carpi ulnaris muscles depending on the external load (load variant) according to the task performed with the upper limb.

The study demonstrated usefulness of the fatigue index in expressing quantitatively muscle fatigue and in discriminating muscle fatigue depending on the external load.     

Kinematic models of the upper limb joints for multibody kinematics optimisation: An overview

Soft tissue artefact (STA), i.e. the motion of the skin, fat and muscles gliding on the underlying bone, may lead to a marker position error reaching up to 8.7 cm for the particular case of the scapula. Multibody kinematics optimisation (MKO) is one of the most efficient approaches used to reduce STA. It consists in minimising the distance between the positions of experimental markers on a subject skin and the simulated positions of the same markers embedded on a kinematic model. However, the efficiency of MKO directly relies on the chosen kinematic model. This paper proposes an overview of the different upper limb models available in the literature and a discussion about their applicability to MKO.The advantages of each joint model with respect to its biofidelity to functional anatomy are detailed both for the shoulder and the forearm areas. Models capabilities of personalisation and of adaptation to pathological cases are also discussed. Concerning model efficiency in terms of STA reduction in MKO algorithms, a lack of quantitative assessment in the literature is noted. In priority, future studies should concern the evaluation and quantification of STA reduction depending on upper limb joint constraints.     

Aspects of dental development in the orangutan prior to eruption of the permanent dentition

In spite of a resurgence of interest in the interpretation of the sequences of dental development and eruption in various Plio-Pleistocene hominoids as being either “modern human” or “ape-like,” the body of comparative material on the extant hominoids remains deficient in critical areas. In concert with recent attempts to rectify this situation, we present the results of our studies on dental morphogenesis in the orangutan. We have focused on the growth and eruption of the deciduous dentition as well as early stages of permanent tooth formation and have found that 1) many permanent teeth develop earlier than was thought, 2) differences exist between development in the upper and in the lower jaw, and 3) states of tooth formation can vary significantly among individuals of similar chronological age or tooth eruption status.     

Development of the orangutan permanent dentition: Assessing patterns and variation in tooth development

This study examines dental formation and alveolar emergence in a large cross-sectional sample composed primarily of wild-reared orangutans (N = 89) in order to provide information on the development of the permanent dentition in this hominoid and to address questions of variation in individual tooth formation, between teeth and between individuals. All specimens have been radiographed in lateral aspect and stages of crown and root formation recorded for all teeth. The ranges of crown and root formation of I¹₁, C¹₁, P⁴₄, and M³₃ have been calculated relative to the stage of M₁¹ development within a specific tooth quadrant. Then, for each specimen, BMDP scatterplot and nonparametric statistics have been used to graph changes in stages of these teeth relative to M¹₁ stages and to examine relationships between pairs of upper and lower dental counterparts and between teeth of each jaw. Results indicate 1) high correlations between upper and lower tooth pairs and between many of the permanent teeth within individuals, 2) a relatively large range of variability in individual tooth development (multistage ranges relative to M¹₁), 3) greater variation in root development at emergence than earlier reports, and 4) evidence of variability within the sequence emergence pattern of the orangutan. © 1996 Wiley-Liss, Inc.     

North American orangutan species survival plan: Current status and progress in the 1980s

The SSP program for orangutan (Pongo pygmaeus ssp.) was initiated in 1982. Since that time, the Propagation Group has dealt with issues related to improving captive management of the species. Prior to 1982, most orangutans in North America were managed as a single species, though a number of institutions did house their Bornean and Sumatran specimens separately. However, the determination of race at that time was made largely on the basis of physical appearance, a method subsequently proven imprecise. A major achievement of the SSP has been the refinement of orangutan subspecies determination; SSP-sponsored karotyping has determined, on a chromosomal level, the true subspecies of virtually every orangutan managed by the SSP. The validity of these results has been confirmed by recent fieldwork, also completed under the auspices of the SSP. Since 1985, as a result of these captive and field data, the SSP has held to the policy that subspecific hybrid orangutans should not be produced; to that end, there is a moratorium on the breeding of hybrid animals. Another significant step taken by the SSP group is the completion of the sophisticated demographic and genetic analyses, leading to the development of a Masterplan for this species and its captive management. Goals for the near future include refinement of the Masterplan analyses and publication of a new international studbook for the species.     

Growth and sexual dimorphism in orangutan crania: a three-dimensional approach

New insights may be gleaned by taking an ontogenetic approach to investigations of adult dimorphism. Previous work in this area relied on traditional, caliper-based, morphometric methods, and produced conflicting results. This study uses a three-dimensional (3-D) approach for both local and global form comparisons of sex-specific growth and growth patterns. 3-D coordinate data were collected for 20 landmarks on 94 orangutan crania divided into five developmental stages. Data were analyzed using Euclidean distance matrix analysis (EDMA). Results indicate that differences in growth patterns between male and female orangutans exist in the youngest age intervals. Dimorphic patterns are strongest in the face and basicranium at the youngest age intervals, and in the face and neurocranium during adult stages. Females grow substantially more in the cranial base and face during the youngest age groups, while males grow more than females in all anatomical regions later in development. Growth in the palate was similar between sexes. Sexual dimorphism may be produced through the continued growth of one sex relative to the other, representing differences in timing, or growth duration. Dimophism may also result from different growth rates between sexes, where one sex develops faster than the other sex in the same time interval. Orangutan males and females differ in both the rate and duration of their craniofacial development. The data analysis technique used here, EDMA, was integral in identifying dynamic growth processes rather than just the static end results of each developmental stage.     

Control of intragroup aggression by a captive male orangutan

An adult male orangutan, housed with two adult females, intervened in female-female aggressive interactions at least seven times over a 4.5-year period. Five of these seven episodes involved multiple interventions rather than a single act. One series of interventions was directly observed during an ongoing study of spatial relationships, and six other episodes were described in the zoo records. The intervention that was observed directly began with one female displacing the other, after which the male located himself between the two females. He remained nearer the displaced female than he did to the other female. These seven episodes demonstrate the male's mediation and regulation of intragroup aggression. Whereas the opportunities for the control of aggression are limited in the wild, the conditions of captivity likely allowed for the expression of this behavior pattern.     

Effect of various upper limb multibody models on soft tissue artefact correction: A case study

Soft tissue artefacts (STA) introduce errors in joint kinematics when using cutaneous markers, especially on the scapula. Both segmental optimisation and multibody kinematics optimisation (MKO) algorithms have been developed to improve kinematics estimates. MKO based on a chain model with joint constraints avoids apparent joint dislocation but is sensitive to the biofidelity of chosen joint constraints. Since no recommendation exists for the scapula, our objective was to determine the best models to accurately estimate its kinematics. One participant was equipped with skin markers and with an intracortical pin screwed in the scapula. Segmental optimisation and MKO for 24-chain models (including four variations of the scapulothoracic joint) were compared against the pin-derived kinematics using root mean square error (RMSE) on Cardan angles. Segmental optimisation led to an accurate scapula kinematics (1.1° ≤ RMSE ≤ 3.3°) even for high arm elevation angles. When MKO was applied, no clinically significant difference was found between the different scapulothoracic models (0.9° ≤ RMSE ≤ 4.1°) except when a free scapulothoracic joint was modelled (1.9° ≤ RMSE ≤ 9.6°). To conclude, using MKO as a STA correction method was not more accurate than segmental optimisation for estimating scapula kinematics.     

The behavior of a zoo-housed infant orangutan after the death of its mother

The behavior of an infant female orangutan at Dublin Zoo before and after the death of her mother was recorded using scan sampling and compared. Social interactions and associations of the infant with the other individuals in the group were also compared before and after the death of her mother. Increases in climbing and object manipulation were observed, and a decrease in resting occurred. The infant orangutan significantly increased the amount of time she spent in close contact with another related adult female in the group after her mother's death. This case study describes an example of a zoo‐housed infant orangutan being successfully fostered by a related female without human intervention. It also provides a quantification of the behavior of an infant orangutan before and after being orphaned. Zoo Biol 30:205–211, 2011. © 2010 Wiley‐Liss, Inc.     

Muscle architecture and out‐force potential of the thoracic limb in the eastern mole (Scalopus aquaticus)

Moles have modified thoracic limbs with hypertrophied pectoral girdle muscles that allow them to apply remarkably high lateral out‐forces during the power stroke when burrowing. To further understand the high force capabilities of mole forelimbs, architectural properties of the thoracic limb muscles were quantified in the Eastern mole (Scalopus aquaticus). Architectural properties measured included muscle mass, moment arm, belly length, fascicle length, and pennation angle, and these were used to provide estimates of maximum isometric force, joint torque, and power. Measurements of muscle moment arms and limb lever lengths were additionally used to analyze the out‐force contributions of the major pectoral girdle muscles. Most muscles have relatively long fascicles and little‐to‐no pennation. The humeral abductor/rotators as a functional group are massive and are capable of relatively high force, power, and joint torque. Of this group, the bipennate m. teres major is the most massive and has the capacity to produce the highest force and joint torque to abduct and axially rotate the humerus. In general, the distal limb muscles are relatively small, but have the capacity for high force and mechanical work by fascicle shortening. The muscle architectural properties of the elbow extensors (e.g., m. triceps brachii) and carpal flexors (e.g., m. palmaris longus) are consistent with the function of these muscles to augment lateral out‐force application. The humeral abductor/rotators m. latissimus dorsi, m. teres major, m. pectoralis, and m. subscapularis are calculated to contribute 13.9 N to out‐force during the power stroke, and this force is applied in a ‘frontal’ plane causing abduction of the humerus about the sternoclavicular joint. Moles have several specializations of their digging apparatus that greatly enhance the application of out‐force, and these morphological features suggest convergence on limb form and burrowing function between New and Old World moles. J. Morphol. 274:1277–1287, 2013. © 2013 Wiley Periodicals, Inc.     

An electromyographic analysis of two handwriting grasp patterns

BackgroundHandwriting is a fundamental skill needed for the development of daily-life activities during lifetime and can be performed using different forms to hold the writing object. In this study, we monitored the sEMG activity of trapezius, biceps brachii, extensor carpi radialis brevis and flexor digitorum superficialis during a handwriting task with two groups of subjects using different grasp patterns.Subjects and methodsTwenty-four university students (thirteen males and eleven females; mean age of 22.04 ± 2.8 years) were included in this study. We randomly invited 12 subjects that used the Dynamic Tripod grasp and 12 subjects that used the Static Tripod grasp.ResultsThe static tripod group showed statistically significant changes in the sEMG activity of trapezium and biceps brachii muscles during handwriting when compared to dynamic tripod group’s subjects. No significant differences were found in extensor carpi radialis brevis and flexor digitorum superficialis activities among the two groups.ConclusionThe findings in this study suggest an increased activity of proximal muscles among subjects using a transitional grasp, indicating potential higher energy expenditure and muscular harm with the maintenance of this motor pattern in handwriting tasks, especially during the progression in academic life.     

Facultative terrestrial hand postures in an orangutan (Pongo pygmaeus) and pongid evolution

An adult male orangutan at the Chicago Zoological Park utilizes various knuckle-walking hand postures in terrestrial bipedal-squatting and quadrupedal diagonal-sequence, diagonal-couplet gaits. A study was conducted in order to discern the circumstances surrounding the subject's terrestrial locomotor modes. It was found that various locomotor behaviors correlate with specific conditions of the substrate and the subject's motivation. Biomechanical properties of orangutan knuckle-walking are discussed in terms of their relevance for modelling hominoid phylogeny.     

体外反搏对颅脑外伤术后早期上肢功能恢复的影响

目的:探讨体外反搏对颅脑外伤术后患儿早期上肢功能恢复的影响。方法:选择2016年1月～2018年1月在上海市儿童医院康复科就诊的36例颅脑外伤术后患儿,将其随机分成观察组和对照组,每组18例患者。对照组患儿给予常规作业治疗,治疗组患儿在对照组的基础上增加体外反搏治疗。治疗3个月后,比较两组患儿治疗前后精细运动能力(FMFM)和改良Barthel指数评分。结果:经3个月治疗后,两组患儿精细功能和日常生活活动能力均较治疗前有所提高,观察组和对照组FMFM评分和Barthel指数明显高于治疗前,且观察组明显FMFM评分和Barthel指数优于对照组(142.43±18.65 vs. 136.48±15.67;81.19±10.60 vs.74.52±12.93),差异均有统计学意义(P0.05)。结论:联合体外反搏能更好地改善颅脑外术后早期的上肢功能。     

A new child-friendly 3D bimanual protocol to assess upper limb movement in children with unilateral cerebral palsy: Development and validation

Unilateral cerebral palsy (uCP) causes upper limb movement disorders that impact on daily activities, especially in bimanual condition. However, a few studies have proposed bimanual tasks for 3D motion analysis. The aim of this study was to validate the new version of a child-friendly, 3D, bimanual protocol for the measurement of joint angles and movement quality variables. Twenty children with uCP and 20 typically developing children (TDC) performed the five-task protocol integrated into a game scenario. Each task specifically targeted one or two upper limb degrees of freedom. Joint angles, smoothness and trajectory straightness were calculated. Elbow extension, supination, wrist extension and adduction amplitudes were reduced; hand trajectories were less smooth and straight in children with uCP compared to TDC. Correlations between the performance-based score and kinematic variables were strong. High within and between-session reliability was found for most joint angle variables and lower reliability was found for smoothness and straightness in most tasks. The results therefore demonstrated the validity and reliability of the new protocol for the objective assessment of bimanual function in children with uCP. The evaluation of both joint angles and movement quality variables should increase understanding of pathological movement patterns and help clinicians to optimize treatment.ClinicalTrials.gov identifier: NCT03888443.     

A possible case of hantavirus infection in a Borneo orangutan and its conservation implication

Background Natural infection of hantavirus in orangutans has never been reported. Methods Enzyme‐linked immunosorbent assays (ELISA), Indirect immunofluorescence assay (IFA), and RT‐PCR were used to diagnosis a suspected case in a pet orangutan in southern Taiwan. Results Although the RT‐PCR result was negative, the high IgG titer in the beginning and its dramatic drop after treatments suggested a recent Seoul‐type hantavirus infection. Conclusions Hantavirus transmission and its potential damage to wild orangutans should not be overlooked.