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This paper proposes a novel finger-individuating exoskeleton system with a non-contact leader-follower control strategy that effectively combines motion functionality and individual adaptability. Our solution comprises the following two interactive components: the leader side and the follower side. The leader side processes joint angle information from the healthy hand during motion via a Leap Motion Controller as the system input, providing more flexible and active operations owing to the non-contact manner. Then, as the follower side, the exoskeleton is driven to assist the user's hand for rehabilitation training according to the input. The exoskeleton mechanism is designed as a universal module that can adapt to various digit sizes and weighs only 40 g. Additionally, the current motion of the exoskeleton is fed back to the system in real time, forming a closed loop to ensure control accuracy. Finally, four experiments validate the design effectiveness and motion performance of the proposed exoskeleton system. The experimental results indicate that our prototype can provide an average force of about 16.5 N for the whole hand during flexing, and the success rate reaches 82.03% in grasping tasks. Importantly, the proposed prototype holds promise for improving rehabilitation outcomes, offering diverse options for different stroke stages or application scenarios.
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OBJECTIVE: To evaluate the impact of Triangle theory-based continuity of care on postoperative malnutrition in pancreatic cancer patients. METHODS: We retrospectively analyzed the data from 184 patients with pancreatic cancer admitted to The Second People's Hospital of Lanzhou City from January 2020 to May 2023. Patients were divided into a control group receiving conventional care (n = 114) and a study group receiving Triangle theory-based care (n = 70). Postoperative nutritional status and prognosis were compared between the two groups. Nutritional indexes included serum total protein (STP), albumin (ALB), and hemoglobin (HB). Self-care ability was assessed using the Exercise of Self-care Agency (ESCA). Quality of life was measured using the Quality-of-Life Questionnaire for Pancreatic Cancer 26 (QLQ-PAN-26), and the incidence of malnutrition was evaluated using the Patient-Generated Subjective Global Assessment (PG-SGA). Multifactorial logistic regression was applied to analyze risk factors for malnutrition. RESULTS: At ten days post-operation, the study group showed significantly better nutritional levels (P < 0.05). After three months, the, study group also exhibited superior self-care ability and quality of life scores (all P < 0.001). The incidence of malnutrition was 42.39%. Independent risk factors for malnutrition included routine care (OR = 3.459), operation time ≥ 90 min (OR = 2.277), intraoperative bleeding ≥ 200 mL (OR = 2.590), postoperative day 1 ALB < 37.5 g/L (OR = 3.975), and HB < 95.5 g/L (OR = 6.068). CONCLUSION: Triangle theory-based continuity of care significantly improves nutritional status and quality of life in postoperative pancreatic cancer patients, demonstrating its potential for broader clinical use.
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BACKGROUND: Left lateral hepatic resection is the preferred surgical approach for treating left hepatolithiasis. However, it is not clear whether cholangioscopy via left hepatic duct (LHD) orifice can replace conventional common bile duct (CBD) approach during laparoscopic procedures. METHODS: We performed a comprehensive literature search by screening medical databases, then compared perioperative outcomes and occurrence of recurrent stones between LHD and CBD approaches. RESULTS: A total of five studies, comprising 345 patients, were included in this meta-analysis. The reported operative times, intra-operative blood loss and incidence of post-operative complications were comparable between the approaches. Pooled results revealed a positive correlation between LHD approach with shorter length of hospital stay (standard mean difference = -1.36; 95% confidence interval: -2.10, -0.61; P < 0.001). Additionally, bile duct exploration via LHD orifice was associated with similar rate of recurrent stones and cholangitis across both groups. CONCLUSIONS: Our results demonstrated that biliary tract exploration via LHD stump can be safely performed in left-sided hepatolithiasis. Additionally, the LHD approach was associated with comparable intra-operative outcomes and shorter post-operative hospitalization relative to CBD approach, and does not increase incidence of stone recurrence.