[Comparative study of minimally invasive titanium elastic nail and steel plate on the treatment of fracture of tibiofibular fracture in adults].

OBJECTIVE: To compare the clinical outcomes of using elastic intramedullary nail and plate to fix fibular fracture. METHODS: The 60 patients with tibiofibular fractures admitted from January 2015 to December 2022 were divided into two groups:intramedullary nail group and plate group, 30 cases each, intramedullary nail group was treated with elastic intramedullary nail fixation group, plate group was treated with steel plate and screw fixation group. Intramedullary nail group, there were 18 males and 12 females, aged from 22 to 75 years old with an average of (39.4±9.8) years old, including 24 cases of traffic accidents injury, 6 cases of falling injury, 23 cases of closed fractures, 7 cases of open fractures. Steel plate group, there were 15 males and 15 females, aged from 24 to 78 years old with an average of (38.6±10.2) years old. The 22 cases were injured by traffic accident, 8 cases were injured by falling. The 24 cases were closed fractures and 6 cases were open fractures. The operation time, intraoperative bleeding, American Orthopedic Foot and Ankle Society (AOFAS) ankle and hind foot scores, clinical healing time of fibula and the incidence of wound complications were compared between the two groups. RESULTS: The patients in both groups were followed up for 6 to 21 months, with an average of (14.0±2.8) months. Compared with plate group, intramedullary nail group had shorter operative time, less bleeding, shorter clinical healing time of fibula, and lower infection rate of incision, and the difference was statistically significant (P<0.05). There were 2 cases of delayed healing in intramedullary nail group, 1 case of nonunion in plate group, and 2 cases of delayed healing in plate group, and there was no statistically significant difference between the two groups (P>0.05). In the last follow-up, according to the AOFAS scoring standard, the ankle function in intramedullary nail group was excellent in 17 cases, good in 12 cases, fair in 1 case, with an average of (88.33±4.57) points, while in plate group, excellent in 16 cases, good in 10 cases, fair in 4 cases, with an average of (87.00±4.14) points;There was no statistical difference between the two groups (P>0.05). CONCLUSION: Elastic intramedullary nail has the advantages of short operation time, less intraoperative bleeding, short fracture healing time and less incision complications in the treatment of fibular fracture, which is worthy of clinical application.

Mechanism of Dendrobium Nobile Polysaccharide Inhibition of Ferroptosis in Rats with Spinal Cord Injury.

BACKGROUND: It has been reported that ferroptosis participates in the pathophysiological mechanism of spinal cord injury (SCI). Our preliminary experiments verified that dendrobium nobile polysaccharide (DNP) improved the behavioral function of SCI rats. Therefore, the purpose of this study was to examine the role of DNP on ferroptosis and its neuroprotective mechanism in SCI rats. METHODS: Adult female sprague dawley (SD) rats were exposed to SCI by Allen's method, followed by an intragastric injection of 100 mg/kg DNP per day for 2 weeks. Behavioral features were verified by the Basso-Beattie-Bresnahan (BBB) scale and footprint evaluation. Iron content and glutathione (GSH) were assessed spectrophotometrically. Mitochondrial morphology was examined by transmission electron microscopy. The expression of ferroptosis-related genes, including System Xc- light chain (xCT), G-rich RNA sequence binding Factor 1 (GRSF1) and glutathione peroxidase 4 (Gpx4), was examined by real-time polymerase chain reaction (PCR) and western blot. The spinal cavity was defined using hematoxylin-eosin (HE) staining, and neuronal modifications were detected by immunofluorescence. RESULTS: Compared with the SCI group, the BBB score of rats in the DNP group increased at 7 d, 14 d, 21 d, and 28 d. The differences between the two groups were statistically significant. At 12 h post-injury the iron content began to decrease. At 24 h post-injury the iron content decreased significantly in the DNP group. The morphological changes of the mitochondrial crest and membrane in the DNP group were ameliorated within 24 h. Compared with the sham group, the expression of xCT, GSH, Gpx4, and GRSF1 were significantly reduced after SCI. After DNP treatment, the expression of xCT, Gpx4, and GSH were higher. The tissue cavity area was significantly reduced and the amount of NeuN+ cells was increased in the DNP group at 14 d and 28 d after SCI. CONCLUSIONS: DNP facilitated the post-injury recovery in SCI rats via the inhibition of ferroptosis.

Current advancements in therapeutic approaches in orthopedic surgery: a review of recent trends.

Recent advancements in orthopedic surgery have greatly improved the management of musculoskeletal disorders and injuries. This review discusses the latest therapeutic approaches that have emerged in orthopedics. We examine the use of regenerative medicine, including stem cell therapy and platelet-rich plasma (PRP) injections, to accelerate healing and promote tissue regeneration. Additionally, we explore the application of robotic-assisted surgery, which provides greater precision and accuracy during surgical procedures. We also delve into the emergence of personalized medicine, which tailors treatments to individual patients based on their unique genetic and environmental factors. Furthermore, we discuss telemedicine and remote patient monitoring as methods for improving patient outcomes and reducing healthcare costs. Finally, we examine the growing interest in using artificial intelligence and machine learning in orthopedics, particularly in diagnosis and treatment planning. Overall, these advancements in therapeutic approaches have significantly improved patient outcomes, reduced recovery times, and enhanced the overall quality of care in orthopedic surgery.

In Situ Electrospinning MOF-Derived Highly Dispersed α-Cobalt Confined in Nitrogen-Doped Carbon Nanofibers Nanozyme for Biomolecule Monitoring.

Designing a metal-organic framework (MOF)-derived nanozyme with highly dispersed active sites and high catalytic activity as well as robust structure for colorimetric biosensing of diverse biomolecules remains a substantial challenge. Here, an MOF-derived highly dispersed and pure α-cobalt confined in a nitrogen-doped carbon nanofiber (α-Co@NCNF) nanozyme with superior glucose oxidase (GOD)- and peroxidase (POD)-like activities was constructed for colorimetric assay of multiple biomolecules. Specifically, the α-Co@NCNF nanozyme was synthesized, utilizing in situ electrospinning Co-MOFs into polyacrylonitrile nanofiber (PAN) followed by a pyrolysis process. Taking advantage of the in situ electrospinning strategy, the α-Co nanoparticles were confined in continuous porous NCNF to restrict the growth and prevent the aggregation and oxidation during the pyrolysis process. The resulting special structure considerably improved the enzyme-like performance. A series of experiments validate that the enzyme-like activity of the α-Co@NCNF nanozyme was superior to that of Co@CoO@NCNF (derivatives from Co-MOFs grown on the surface of PAN nanofiber) and nature enzymes. Furthermore, α-Co@NCNF nanozyme-based colorimetric biosensing was developed for monitoring glucose, hydrogen peroxide (H2O2), and glutathione (GSH) and the corresponding linear ranges are 0.1-50 and 50-900 µM and 5-55 and 0.1-20 µM accompanied by the corresponding low detection of 0.03, 1.66, and 0.03 µM. The proposed method for the construction of α-Co@NCNF nanozyme with dual enzyme-like properties provides a new insight for designing novel nanozymes and has prospects for application in colorimetric biosensing.

The impact of Parkinson's disease-associated gut microbiota on the transcriptome in Drosophila.

Parkinson's disease (PD) is a common neurodegenerative disease in middle-aged and elderly people, and many studies have confirmed that the disorder of gut microbiota is involved in the pathophysiological process of PD. However, the molecular mechanism of gut microbiota in regulating the pathogenesis of PD is still lacking. In this study, to investigate the impact of PD-associated gut microbiota on host transcriptome, we established various PD models with fecal microbiota transplantation (FMT) in the model organism Drosophila followed by integrative data analysis of microbiome and transcriptome. We first constructed rotenone-induced PD models in Drosophila followed by FMT in different groups. Microbial analysis by 16S rDNA sequencing showed that gut microbiota from PD Drosophila could affect bacterial structure of normal Drosophila, and gut microbiota from normal Drosophila could affect bacterial structure of PD Drosophila. Transcriptome analysis revealed that PD-associated gut microbiota influenced expression patterns of genes enriched in neuroactive ligand-receptor interaction, lysosome, and diverse metabolic pathways. Importantly, to verify our findings, we transplanted Drosophila with fecal samples from clinical PD patients. Compared to the control, Drosophila transplanted with fecal samples from PD patients had reduced microbiota Acetobacter and Lactobacillus, and differentially expressed genes enriched in diverse metabolic pathways. In summary, our results reveal the influence of PD-associated gut microbiota on host gene expression, and this study can help better understand the link between gut microbiota and PD pathogenesis through gut-brain axis. IMPORTANCE Gut microbiota plays important roles in regulating host gene expression and physiology through complex mechanisms. Recently, it has been suggested that disorder of gut microbiota is involved in the pathophysiological process of Parkinson's disease (PD). However, the molecular mechanism of gut microbiota in regulating the pathogenesis of PD is still lacking. In this study, to investigate the impact of PD-associated gut microbiota on host transcriptome, we established various PD models with fecal microbiota transplantation in the model organism Drosophila followed by integrative data analysis of microbiome and transcriptome. We also verified our findings by transplanting Drosophila with fecal samples from clinical PD patients. Our results demonstrated that PD-associated gut microbiota can induce differentially expressed genes enriched in diverse metabolic pathways. This study can help better understand the link between gut microbiota and PD pathogenesis through gut-brain axis.

Functional Zonation Strategy of Heterodimer Nanozyme for Multiple Chemiluminescence Imaging Immunoassay.

Although nanozymes with intrinsic enzyme-like characteristics have aroused great interest in the biosensing field, the challenge is to keep high enzyme-like activity of the nanozyme after the modification of biomolecules onto nanozymes. Herein, a functional zonation strategy of a heterodimer nanozyme was proposed to tackle the challenge and further construct a multiple chemiluminescence (CL) imaging immunoassay. Here Fe3O4-Au as a heterodimer nanozyme model was divided into two zones, in which Fe3O4 nanoparticles (NPs) were regarded as a nanozyme zone and AuNPs were defined as an antibody immobilization zone. A signal amplification probe (Fe3O4-Au-Ab2) was prepared by modifying the secondary antibody (Ab2) on AuNPs of the Fe3O4-Au heterodimer owing to the Au-S bond. The exposed Fe3O4 of the Fe3O4-Au-Ab2 probe shows very high peroxidase-like activity and can efficiently catalyze H2O2-luminol to produce strong CL imaging signals for multiple antigens detection. Using chicken interleukin-4 (ChIL-4) and chicken gamma interferon (ChIFN-γ) as models, the proposed CL imaging immunoassay shows wide linear ranges (0.005-0.10 ng/mL for both ChIL-4 and ChIFN-γ) and low detection limits (0.58 pg/mL for ChIL-4, 0.47 pg/mL for ChIFN-γ) with the characteristics of high sensitivity, high specificity, and good stability. This work provides a promising functional zonation concept for nanozymes to construct new types of nanozyme probes for immunoassay of multiple biomolecules.

Effects of sulfation and carboxymethylation on Cyclocarya paliurus polysaccharides: Physicochemical properties, antitumor activities and protection against cellular oxidative stress.

The Cyclocarya paliurus polysaccharide (CP) was chemically modified to produce sulfated derivatives (S-CP) and carboxymethylated derivatives (CM-CP). Subsequently, the antioxidant activity, cytoprotective effect and antitumor activity of these derivatives were investigated to establish the relationship between their structure and functional activity. The results found that chemical modifications resulted in remarkable variations in the chemical compositions and apparent structures of CP. S-CP with the highest amount of glucose had the strongest antioxidant capacity to scavenge DPPH• and HO•, but CM-CP was lower than CP in terms of HO• scavenging. More importantly, S-CP and CM-CP more effectively protected RAW264.7 from H2O2-induced damage compared to CP by reducing the secretion of lactate dehydrogenase (LDH), intracellular reactive oxygen species (ROS) and malondialdehyde (MDA), enhancing phagocytosis and superoxide dismutase (SOD) levels, and suppressing abnormal apoptosis. Further experiments showed that the anti-apoptotic effect of S-CP and CM-CP was in intimate association with down-regulation of Caspase-9/3 activities and alleviation of cell cycle arrest in the S phase. In addition, S-CP and CM-CP decreased the cell viability of tumor cells. These findings suggest that the type of functional group plays important roles in the biological function of the derivatives and provide a theoretical basis for the development of novel natural anti-oxidants or low-toxicity anti-tumor drugs.

[A comparative study of vancomycin loaded bone cement in the treatment of Wagner â ¡-â £ diabetic foot].

OBJECTIVE: To investigate the clinical effect of vancomycin bone cement in the treatment of diabetic foot ulcer (DFU) ruptured Wagner gradeⅡ-Ⅳ. METHODS: From March 2019 to April 2021, 32 patients with Wagner gradeⅡ-Ⅳ diabetic foot were divided into vacuum sealing drainage (VSD) group and bone cement group according to different treatment methods. There were 16 cases in VSD group, 8 males and 8 females;the age ranged from 66 to 81 (70.50±7.20) years, and the course of disease ranged from 8 to 40 (27.56±8.55) months;Wagner gradeⅡin 2 cases, grade Ⅲin 7 cases and grade Ⅳin 7 cases;debridement and VSD were used. There were 16 cases in the bone cement group, 9 males and 7 females;the age ranged from 63 to 79 (69.56±7.29) years, and the course of disease ranged from 11 to 39(22.75±11.43) months;Wagner gradeⅡ in 2 cases, grade Ⅲin 5 cases and grade Ⅳ in 9 cases;vancomycin loaded bone cement was used for treatment. The types of bacteria, negative time of bacterial culture, skin healing time, hospital stay, operation times and complications were observed and compared between two groups. RESULTS: All patients were followed up for 3 to 6 (4.00±1.07) months. The bacterial negative time, skin healing time and hospital stay in bone cement group were significantly lower than those in VSD group (P<0.05). The median number of operations in both groups was 2, and there was no significant difference (P>0.05). According to the analysis of pathogens in two groups, there were 13 cases of G+ patients, 14 cases of G- patients and 5 cases of mixed bacteria. The number of G+, G- and mixed bacteria in bone cement group was 6, 7 and 3 cases respectively, and the number of G+, G- and mixed bacteria in VSD group was 7, 7 and 2 cases respectively. The wounds of 32 patientsin two groups healed completely without complications. CONCLUSION: Vancomycin loaded bone cement is effective in the treatment of Wagner grade Ⅱ-Ⅳ diabetic foot ulceration wounds. It can reduce the length of hospital stay, shorten the healing time of skin and kill pathogens as soon as possible. It is one of the effective methods to treat Wagner gradeⅡ-Ⅳdiabetic foot ulceration.

Gene expression profiling in peripheral blood lymphocytes for major depression: preliminary cues from Chinese discordant sib-pair study.

The etiology of major depressive disorder (MDD) involves many factors such as heredity and environment. There are very few MDD-related studies in Chinese population using twin or sib-pairs for depression-control samples. Here we used the microarray approach and compared gene expression profiling of peripheral blood lymphocytes from 6 sib-pairs discordant on lifetime history of MDD. Within sib-pair differentially expressed genes are obvious fewer in the 1st, 2nd, and 5th compared with those in the 3rd, 4th, and 6th sib-pairs. Gene expression pattern of these DEGs distinguished MDD individuals from the normal one in 3rd, 4th, and 6th sib-pair but not in the 1st, 2nd, and 5th pair, suggesting heterogeneity of different sib-pairs and somewhat commonalities among the 3rd, 4th, and 6th sib-pairs. Comprehensive protein interaction network analysis revealed two key genes PTH and FGF2 in a dominant network where the majority of the genes were significantly down-regulated. PTH was significantly down-regulated in all the sib-pairs while FGF2 was in the 3rd, 4th, and 6th sib-pairs. KEGG enrichment analysis of all the DEGs in networks showed that PTH and related genes were significantly enriched in the pathway of parathyroid hormone secretion, synthesis, and action while FGF2 and related genes were significantly enriched in the pathways of cancer and specifically breast cancer. Generally reduced expression of these genes in peripheral blood lymphocytes of MDD individuals implied their functional repression associated with MDD. Pending validation in more samples, the findings in this study provided valuable cues for understanding the potential mechanism of MDD, as well as potential markers for the diagnosis and treatment of depression in the Chinese population.

Corrigendum: Correlation Analysis Between Attentional Bias and Somatic Symptoms in Depressive Disorders.

[This corrects the article DOI: 10.3389/fpsyt.2019.00903.].

Correlation Analysis Between Attentional Bias and Somatic Symptoms in Depressive Disorders.

Objective: To investigate the relationship between attentional bias and the severity of depression as assessed by the TORAWARE state and physical symptoms. Methods: We enrolled 55 patients with depression and 60 healthy people. The Hamilton Depression Scale (HAMD-24), Somatic Self-Rating Scale (SSS), and the Chinese version of the Self-Rating Scale for the TORAWARE State of Neurosis (SSTN) were selected to assess the severity of psychological symptoms. Dot-probe tasks were used to detect attentional bias. We then analyzed the correlation of attentional bias with the total scores on the symptom scales. Results: The negative attentional bias and negative disengaging index scores were both greater than 0 (t = 3.15 and 2.78, respectively; all P < 0.01). The negative attention bias score was positively correlated with the SSTN and negative disengaging index scores (r = 0.29 and 0.53, respectively; all P < 0.05). SSTN score was positively correlated with the total HAMD and SSS scores (r = 0.34 and 0.38, respectively; all P < 0.05). Conclusion: There is no direct correlation between negative attentional bias and depression. It may be through the intermediate mechanism of TORAWARE state to influence symptoms.

[Stability of Nitritation Combined with Limited Filamentous Bulking Under Intermittent Aeration].

Limited filamentous bulking (LFB) combined with nitritation under low dissolved oxygen (DO) is a new technology for enhancing nitrogen removal and reducing aeration requirements. In order to investigate the feasibility and sustainability of this technology, two sequence batch reactors (SBRs) were operated under different regimes to stimulate different aeration modes under low DO (0.3-0.8 mg·L-1). Sludge settleability, nitrite accumulation ratio (NAR), total nitrogen (TN) removal rate, dynamic variation of dominant filaments, and nitrifying bacterial communities were investigated. The results indicated that short-cut nitrification combined with LFB could be achieved under intermittent aeration, and the ratio of anoxic/aerobic was 15 min/30 min, the value of sludge volume index (SVI) was maintained from 170 mL·g-1 to 200 mL·g-1. An NAR above 95% was achieved under real-time continuous aeration. Meanwhile, LFB was induced when nitrite started to accumulate, and the dominant filament was Type 0092. However, the limited bulking was not maintained for the long term. After a transfer from continuous aeration to intermittent aeration, LFB reappeared in 60 days and the value of SVI remained between 170 mL·g-1 and 200 mL·g-1. The process of nitritation combined with LFB was maintained stably for the next two months, and the TN removal rate was above 66%. FISH analysis indicated that the identical dominant filaments were M. parvicella and Type 0092 for maintaining limited bulking in the two reactors. qPCR results showed that proportion of AOB in the total bacteria increased from the previous 0.53% to 2.19% in the end, whereas that of NOB decreased from 17.5% to 3.2% in SBR A. Moreover, the proportion of AOB increased from 0.51% to 1.53%, whereas that of NOB decreased from 18.05% to 11.01% in SBR B.

The reduction of CSF tumor necrosis factor alpha levels in schizophrenia: no correlations with psychopathology and coincident metabolic characteristics.

AIM: The aim of this study was to assess whether tumor necrosis factor alpha (TNF-α) levels are correlated with the behavioral syndrome of schizophrenia and/or metabolic abnormalities. METHODS: Sixty patients with first-onset schizophrenia were recruited. The concentrations of TNF-α in the cerebrospinal fluid (CSF) were determined in 22 schizophrenia patients and ten patients with nonsuppurative appendicitis using a radioimmunoassay. Physiological characteristics such as fasting blood glucose, fasting insulin, triglycerides, corrected QT interval, waist circumference, and body mass index were measured prior to CSF collection. Subjects were screened for insulin resistance using the homeostasis model assessment. The extent of positive and negative behavioral symptoms was scored using the Positive and Negative Syndrome Scale. RESULTS: The CSF TNF-α levels in schizophrenic patients were significantly lower than those in the control group. The age of disease onset was positively correlated with the CSF TNF-α level using Pearson correlation analysis (r=0.37, P<0.05). There were no significant differences in CSF TNF-α levels in terms of age, duration of schizophrenia, or systolic and diastolic blood pressure. Furthermore, the CSF TNF-α levels were not significantly correlated with fasting blood glucose, fasting insulin, insulin resistance index, triglycerides, corrected QT interval, waist circumference, or body mass index. No significant correlation was found between CSF TNF-α levels and the Positive and Negative Syndrome Scale total scores or other factors scores. There were also no significant differences in CSF TNF-α levels between patients with schizophrenia types I and II. CONCLUSION: CSF TNF-α levels are decreased in schizophrenia, although this reduction does not correlate with the psychopathology or coincident metabolic characteristics of this disease.

[Unilateral external fixation assisted with closed reduction and interlocking intramedullary nail fixation for the treatment of comminuted fracture of femoral shaft].

OBJECTIVE: To introduce the use of single arm external fixation assisted reduction and closed complex intramedullary nail fixation for the treatment of femoral shaft fracture operation method and to study its effects. METHODS: From June 2008 to October 2012, 24 patients with femoral shaft fractures were treated with unilateral external fixation assisted by closed reduction, interlocking intramedullary nail fixation. Among the patients, 19 patients were male and 5 patients were female, ranging in aged from 20 to 68 years,with an average of 45.6 years old. The fracture was caused by traffic accidents in 14 cases, by falling in 6 cases, by heavy bruising in 4 cases. Admission diagnosis was femoral shaft fracture. Operation was performed after traction from tibial tubercle for about 1 week. RESULTS: All the patients were followed up, and the duration ranged from 6 to 24 months, with a mean of 16.2 months. The X-ray showed fracture healing time ranging from 11 to 17 weeks, with an average of 13.8 weeks. All fractures healed without nails broken or close joint dysfunction. According to femoral shaft efficacy evaluation standards, 23 patients got an excellent result, 1 good. CONCLUSION: Unilateral fixator assisted closed reduction and interlocking intramedullary nail fixation for the treatment of femoral shaft fracture has following advantages: less trauma, simple operation, effective reduction, high rate of fracture healing, and low complication rate.

[Clinical application of blocking screws and rooting technique in the treatment of distal tibial fracture with interlocking intramedullary nail].

OBJECTIVE: To introduce the clinical method of blocking screws and rooting technique in the treatment of distal tibial fracture with interlocking intramedullary nails. METHODS: From June 2006 to March 2011, 26 patients with distal tibial fracture were treated with interlocking intramedullary nails using blocking screws and rooting technique, included 18 males and 8 females with an average age of 46.2 years old ranging from 24 to 64 years. According to AO classification: 10 cases of type A1, 4 cases of type A2, 8 cases of type B1, 4 cases of type B2. The average distance of the fractures end to the ankle joint was 85 mm ranging from 55 to 125 mm, the mean time between injured and operation was 4.5 days. The patients were evaluated with pain, range of motion, walking. RESULTS: All cases were followed-up for 6 to 22 months (averaged 15 months). According to Iowa ankle joint grading system,the score was improved from preoperative (66.8 +/- 8.2) to postoperative (94.6 +/- 4.8). All fractures had united, and got satisfactory reduction and stable fixation with no complications had happen such as breakage of screw. CONCLUSION: Fixation with interlocking intramedullary nail using blocking screws and rooting technique in treating distal tibial fracture, is a safe and effective technique for the improvement of stability.

Total laparoscopic hysterectomy after liver transplantation.

BACKGROUND: The number of females who undergo liver transplantation is growing and sometimes gynecologic operations are needed to control gynecologic diseases after liver transplantation. METHOD: Total laparoscopic hysterectomy was performed in 2 patients who had undergone liver transplantation, one for adenomyosis and the other for hysteromyoma. RESULTS: It was safe to create a pneumoperitoneum through the umbilical skinfold even though mild adhesion in the pelvic cavity occurred in one patient. The operative times were 95 and 90 minutes, with blood loss of about 100 and 60 ml, respectively. Oral intake, flatus passage, and ambulation recovered within a day, after the operation. No significant changes in liver function were observed except complication of diarrhea caused by Candida albicans in one patient. CONCLUSIONS: The result of the two patients suggest that total laparoscopic hysterectomy is a safe and effective surgical approach for patients who have undergone liver transplantation.

An embedded control system for intelligent wheelchair.

Due to recent advancement of AI and robotics technology, the research of intelligent wheelchair (iWheelChair) begins to draw attention from both scientific community and industry. iWheelchair is a kind of home welfare tools and can help the handicapped and elderly people to gain mobility and lead to independent life. This paper describes a newly developed intelligent wheelchair. The controller of the iWheelChair adopts the advanced DSP technology, and plays the role of data acquisition and processing of joystick and ultrasonic sensors. 8 ultrasonic sensors are mounted on iWheelchair and can detect the environment changes for safe operation. Experiments are presented to show that iWheelChair is able to avoid obstacles safely while controlled by its user via the joystick.