UNASSIGNED: The purpose of the research is to explore post-thrombotic syndrome (PTS) after catheter-directed thrombolysis (CDT) treatment for acute lower extremity deep vein thrombosis (DVT) risk factors.
UNASSIGNED: We retrospectively selected 171 patients with acute lower extremity DVT undergoing CDT treatment, collected clinical data of the patients, grouped them according to the follow-up results of 1 year after treatment, and included patients with PTS into the concurrent group and patients who did not develop PTS assigned to the unconcurrent group. Univariate analysis and Logistic regression were applied to analyze the risk factors of PTS after catheterization and thrombolytic therapy for acute lower extremity DVT. We applied R4.2.3 software to build three hybrid machine-learning models, including a nomogram, decision tree, and random forest with independent influencing factors as predictive variables.
UNASSIGNED: The incidence of PTS after CDT in acute lower extremity DVT was 36.84 %. BMI >24.33 kg/m2, disease time >7 d, mixed DVT, varicose vein history, stress treatment time>6.5 months, and filter category were independent risk factors for PTS after CDT treatment for acute lower extremity DVT. The AUC value predicted by the random forest model was higher than that of the nomogram model (Z = -2.337, P = 0.019) and the decision tree model (Z = -2.995, P = 0.003).
UNASSIGNED: The occurrence of PTS after CDT treatment of acute lower extremity DVT is closely related to many factors, and the established random forest model had the best effect in predicting PTS complicated with PTS.

Varicose veins of the lower extremities (VVs) is a common chronic vascular disease, with high prevalence rates in some countries; however, their pathogenesis remains unclear. Some studies have identified associations between changes in specific plasma lipid molecules, such as phosphatidylethanolamine (PE), phosphatidylcholine (PC), and sphingomyelin (SM), and the onset of VVs, but due to confounders and reverse causality, the causal relationship remains unclear. Meanwhile, studies on the potential link between other plasma lipids beyond PE, PC, and SM and the risk of VVs in the lower extremities are lacking. This study aimed to explore the potential causal relationship between VVs and plasma lipid levels to provide theoretical insights into the interrelation of plasma lipids and VVs in their occurrence and progression. We conducted a two-sample Mendelian randomization (MR) analysis to assess the potential connection between genetically predicted levels of individual plasma lipids and the risk of developing VVs. We utilized data from a large-scale genome-wide association study involving 7174 Finnish individuals for 179 plasma lipidomes along with VVs genome-wide association study data from 408,455 UK individuals. MR analysis employed methods, such as inverse-variance weighting, weighted median, Bayesian Weighted Mendelian Randomization, and MR-Egger regression. The inverse-variance weighting method was primarily used to assess causality. The validity of the results was demonstrated through sensitivity analysis. In total, 12 lipids were found to have their plasma levels associated with an increased risk of VVs. This includes 3 types of PE, 7 types of PC, and 2 types of phosphatidylinositol. However, no significant causal relationship was found between the plasma levels of 11 types of SM and VVs. These results support the existence of a potential causal relationship between specific types of lipid levels and the risk of VVs, which can provide clues for further studies on biological mechanisms and the exploration of potential therapeutic targets.

Enhancing peak landing forces and ensuring faster stabilization in the lower limbs during jumping activities can significantly improve performance and decrease the risk of injury among basketball players. This study aimed to compare the effects of unilateral (uPJT) and bilateral plyometric jump training (bPJT) programs on various performance measures, including countermovement jump (CMJ), squat jump (SJ), and single-leg land and hold (SLLH) test outcomes, assessed using force plates. A randomized multi-arm study design was employed, comprising two experimental groups (n = 25; uPJT and n = 25; bPJT) and one control group (n = 25), conducted with youth male regional-level basketball players (16.3 ± 0.6 years old). Participants underwent assessment twice, both before and after an 8-week intervention training period. The uPJT program exclusively involved plyometric drills (e.g., vertical jump exercises; horizontal jump exercises) focusing on single-leg exercises, whereas the bPJT program utilized drills involving both legs simultaneously. The outcomes analyzed included CMJ peak landing force, CMJ peak power, SJ peak force, SJ maximum negative displacement, SLLH time to stabilization, and SLLH peak landing force. The control group exhibited significantly greater SLLH time to stabilization compared to both the uPJT (p < 0.001) and bPJT (p < 0.030) groups. Additionally, time to stabilization was also significantly higher in bPJT than in uPJT (p = 0.042). Comparisons between groups in regards SLLH peak landing force after intervention revealed that the value was significantly smaller in uPJT than in bPJT (p = 0.043) and control (p < 0.001). In the remaining outcomes of CMJ and SJ, both uPJT and bPJT showed significant improvement compared to the control group (p > 0.05), although there was no significant difference between them. In conclusion, our study suggests that utilizing uPJT is equally effective as bPJT in enhancing performance in bilateral jump tests. However, it significantly outperforms bPJT in improving time to stabilization and peak landing forces during single-leg land and hold test. uPJT could be advantageous not for maximizing performance but also for potentially decreasing injury risk by enhancing control and balance during single-leg actions, which are common in basketball.

BACKGROUND: Posterolateral decompression and fusion with internal fixation is a commonly used surgical approach for treating degenerative lumbar spinal stenosis (DLSS). This study aims to evaluate the impact of preserving a portion of the unilateral facet joint during decompression on surgical outcomes and long-term recovery in patients.
METHODS: This study analyzed 73 patients with DLSS accompanied by bilateral lower limb neurological symptoms who underwent single-level L4/5 posterolateral decompression and fusion surgery from January 2022 to March 2023. Patients were categorized into two groups based on the type of surgery received: Group A comprised 31 patients who underwent neural decompression without facet joint preservation, while Group B consisted of 42 patients who underwent neural decompression with preservation of partial facet joints on one side. Regular follow-up evaluations were conducted, including clinical and radiological assessments immediately postoperatively, and at 3 and 12 months thereafter. Key patient information was documented through retrospective chart reviews.
RESULTS: Most patients in both groups experienced favorable surgical outcomes. However, four cases encountered complications. Notably, during follow-up, Group B demonstrated superior 1-year postoperative interbody fusion outcomes (P < 0.05), along with a trend towards less interbody cage subsidence and slower postoperative intervertebral disc height loss. Additionally, Group B showed significantly reduced postoperative hospital stay (P < 0.05).
CONCLUSIONS: Under strict adherence to surgical indications, the posterior lateral lumbar fusion surgery, which preserves partial facet joint unilaterally during neural decompression, can offer greater benefits to patients.

Purpose: Iliac vein stenting is the primary treatment for patients with iliac vein compression syndrome (IVCS). However, post-stent placement, patients often experience in-stent restenosis and thrombosis. Despite this, the role of lower limb movements in the functioning of stents and veins in IVCS patients remains unclear. This study aimed to address this knowledge gap by developing a computational model using medical imaging techniques to simulate IVCS after stent placement. Methods: This research used a patient-specific model to analyze the effects of lower extremity exercises on hemodynamics post-stent placement. We conducted a comprehensive analysis to evaluate the impact of specific lower limb movements, including hip flexion, ankle movement and pneumatic compression on the hemo-dynamic characteristics within the treated vein. The analysis assessed parameters such as wall shear stress (WSS), oscillatory shear index (OSI), and residence time (RRT). Results: The results demonstrated that hip flexion significantly disrupts blood flow dynamics at the iliac vein bifurcation after stenting. Bilateral and left hip flexion were associated with pronounced regions of low WSS and high OSI at the iliac-vena junction and the stent segment. Additionally, active ankle exercise (AAE) and intermittent pump compression (IPC) therapy were found to enhance the occurrence of low WSS regions along the venous wall, potentially reducing the risk of thrombosis post-stent placement. Consequently, both active joint movements (hip and ankle) and passive movements have the potential to influence the local blood flow environment within the iliac vein after stenting. Conclusions: The exploration of the impact of lower limb movements on hemodynamics provides valuable insights for mitigating adverse effects associated with lower limb movements post iliac-stenting. Bilateral and left hip flexions negatively impacted blood flow, increasing thrombosis risk. However, active ankle exercise and intermittent pump compression therapies effectively improve the patency.

Lower limb exoskeleton rehabilitation robots are used to improve or restore the walking and movement ability of people with lower limb movement disorders. However, the required functions for patients differ based on various diseases. For example, patients with weak muscle strength require power assistance, patients with spinal cord injuries require motion compensation, patients with gait abnormalities require gait correction, and patients with strokes require neural rehabilitation. To design a more targeted lower limb exoskeleton rehabilitation robot for different diseases, this article summarised and compared existing lower limb exoskeleton rehabilitation robots according to their main functions and the characteristics and rehabilitation needs of various lower limb movement disorders. The correlations between the functions of existing devices and diseases were summarised to provide certain references for the development of new lower limb exoskeleton rehabilitation robots.
下肢外骨骼康复机器人应用于下肢运动功能障碍人群，使患者能够通过机器恢复或改善行走和运动能力。但是，基于不同疾病，患者所需求的功能是不同的，比如肌力不足的患者需要增强助力，脊髓损伤患者需要运动代偿，步态异常患者需要步态矫正，脑卒中患者需要神经康复。为了设计对疾病更有针对性的下肢外骨骼康复机器人，本文根据各类下肢功能障碍的特点与康复需求，按照设备所提供的主要功能，对现有的下肢外骨骼康复机器人进行汇总和分析比较，总结现有设备的功能与疾病的相关性，为研究设计新型下肢外骨骼康复机器人提供一定参考。.

Traditional gait analysis systems are typically complex to operate, lack portability, and involve high equipment costs. This study aims to establish a musculoskeletal dynamics calculation process driven by Azure Kinect. Building upon the full-body model of the Anybody musculoskeletal simulation software and incorporating a foot-ground contact model, the study utilized Azure Kinect-driven skeletal data from depth videos of 10 participants. The in-depth videos were prepossessed to extract keypoint of the participants, which were then adopted as inputs for the musculoskeletal model to compute lower limb joint angles, joint contact forces, and ground reaction forces. To validate the Azure Kinect computational model, the calculated results were compared with kinematic and kinetic data obtained using the traditional Vicon system. The forces in the lower limb joints and the ground reaction forces were normalized by dividing them by the body weight. The lower limb joint angle curves showed a strong correlation with Vicon results (mean ρ values: 0.78 ~ 0.92) but with root mean square errors as high as 5.66°. For lower limb joint force prediction, the model exhibited root mean square errors ranging from 0.44 to 0.68, while ground reaction force root mean square errors ranged from 0.01 to 0.09. The established musculoskeletal dynamics model based on Azure Kinect shows good prediction capabilities for lower limb joint forces and vertical ground reaction forces, but some errors remain in predicting lower limb joint angles.
传统的步态分析系统往往操作复杂、便携性差且设备成本高。本研究拟基于Azure Kinect深度视频数据，结合足地接触模型，建立基于Azure Kinect运动捕捉系统的下肢肌骨动力学分析流程。实验采集了10名受试者的深度视频数据，通过预处理获取骨架结构，以此作为肌骨模型输入，计算得到下肢关节角度、关节接触力和地面反作用力，并将其计算结果与传统的Vicon系统获取的运动学和动力学数据进行对比。所计算的下肢关节力和地面反作用力除以每位受试者体重，进行归一化处理。下肢关节角度曲线与Vicon得到的结果强相关（ ρ平均值为0.78～0.92），但均方根误差高达5.66°。在下肢关节力预测方面，Azure Kinect模型均方根误差平均值范围为0.44～0.68，而地面反作用力均方根误差平均值范围为0.01～0.09。研究表明，所建立的基于Azure Kinect的肌骨动力学模型能较好地预测下肢关节力和垂直地面反作用力，但在下肢关节角度预测方面还存在一定误差。.

BACKGROUND: Previous studies have found that inhibitory priming with continuous theta burst stimulation (cTBS) can enhance the effect of subsequent excitatory conditioning stimuli with intermittent theta burst stimulation (iTBS) in the upper limbs. However, whether this combined stimulation approach elicits a comparable compensatory response in the lower extremities remains unclear. This study aimed to investigate how cTBS preconditioning modulated the effect of iTBS on motor cortex excitability related to the lower limb in healthy individuals.
METHODS: Using a randomised cross-over design, a total of 25 healthy participants (19 females, mean age = 24.80 yr) were recruited to undergo three different TBS protocols (cTBS + iTBS, sham cTBS + iTBS, sham cTBS + sham iTBS) in a random order. Each TBS intervention was administered with one-week intervals. cTBS and iTBS were administered at an intensity of 80% active motor threshold (AMT) delivering a total of 600 pulses. Before intervention (T0), immediately following intervention (T1), and 20 min after intervention (T2), the corticomotor excitability was measured for the tibialis anterior muscle of participants\' non-dominant leg using a Magneuro100 stimulator and matched double-cone coil. The average amplitude of the motor-evoked potential (MEP) induced by applying 20 consecutive monopulse stimuli at an intensity of 130% resting motor threshold (RMT) was collected and analysed.
RESULTS: Compare with T0 time, the MEP amplitude (raw and normalised) at T1 and T2 showed a statistically significant increase following the cTBS + iTBS protocol (p < 0.01), but no significant differences were observed in amplitude changes following other protocols (sham cTBS + iTBS and sham cTBS + sham iTBS) (p > 0.05). Furthermore, no statistically significant difference was found among the three protocols at any given time point (p > 0.05).
CONCLUSIONS: Preconditioning the lower extremity motor cortex with cTBS prior to iTBS intervention can promptly enhance its excitability in healthy participants. This effect persists for a minimum duration of 20 min.
BACKGROUND: No: ChiCTR2300069315. Registered 13 March, 2023, https://www.chictr.org.cn.

The study investigated the effects of unilateral and bilateral lower extremity fatigue on both postural stability and postural adjustments. Fourteen young male subjects performed unilateral and bilateral dynamic lower extremity pedaling exercises with 5 sets of 20 times at 50 % maximum voluntary contraction. Center of pressure (COP) signals were recorded before and after the fatigue exercise. Electromyography activities of six trunk and leg muscles were recorded and analyzed during the anticipatory (APAs) and compensatory (CPAs) postural adjustments. The results showed that both fatiguing exercises caused an increase in COP and larger APAs and CPAs in the rectus femoris and tibialis anterior during externally initiated perturbation. However, the observed indicators showed no clear difference between unilateral and bilateral fatigue. These results validated that when enlarged APAs were not sufficient to resist the external perturbation, the central nervous system increased the strength of CPAs to maintain the stability of the body. These findings provided a perspective on the association between APAs and CPAs, which may apply to the athletic training or rehabilitation on postural control.

Lower extremity nodular melanoma (NM) is a common malignant tumor with a poor prognosis. We aims to identify the prognostic factors and develop a nomogram model to predict overall survival (OS) in patients with lower extremity NM. A total of 746 patients with lower extremity NM were selected and randomly divided into a training set (522 cases) and a validation set (224 cases) from the Surveillance, Epidemiology, and End Results(SEER) database. The training set underwent univariate and multivariate Cox regression analyses to identify independent prognostic factors associated with patient outcomes, and to develop a nomogram model. The effectiveness of the nomogram was subsequently validated using the validation set. Multivariable Cox regression analysis of the training set indicated that age, ulceration, radiotherapy, chemotherapy, primary site of first malignant tumor, and Breslow thickness were independent variables associated with OS. In the training set, the area under the curve (AUC) of the nomogram for predicting 3-year and 5-year OS was 0.796 and 0.811, respectively. In the validation set, the AUC for predicting 3-year and 5-year OS was 0.694 and 0.702, respectively. The Harrell\'s C-index for the training set and validation set were 0.754 (95% CI: 0.721-0.787) and 0.670 (95% CI: 0.607-0.733), respectively. Calibration curves for both training and validation sets showed good agreement. In this study, we develop and validate a nomogram to predict OS in patients with lower extremity NM. The nomogram demonstrated reasonable reliability and clinical applicability. Nomograms are important tools assessing prognosis and aiding clinical decision-making.