Comparison of Three Screening Methods for Sarcopenia in Community-Dwelling Older Persons

ObjectiveThe 2019 Asian Working Group on Sarcopenia in Older People (AWGS 2019) recommends using either calf circumference or the strength, assistance in walking, rising from a chair, climbing stairs, and falls (SARC-F) or SARC-F combined with calf circumference (SARC-CalF) questionnaires for sarcopenia screening. The aim of this study was to compare the ability and applicability of calf circumference, SARC-F, and SARC-CalF for screening sarcopenia among community-dwelling older adults.DesignCross-sectional study.Setting and ParticipantsA total of 1050 community-dwelling older people were enrolled.MethodsSarcopenia was diagnosed according to the AWGS 2019 criteria: bioimpedance analysis for appendicular skeletal muscle index, hand grip, and 6-m gait speed test. Participants also completed the SARC-F questionnaire and calf circumference measurement. The screening tools’ performances were evaluated through receiver operating characteristic (ROC) curves, area under the ROC curves (AUC), and sensitivity/specificity analyses.ResultsSarcopenia was identified in 263 (25.0%) participants by the AWGS 2019 criteria. Calf circumference had a sensitivity of 81.4% and a specificity of 77.0%. Sensitivity and specificity of SARC-F for screening sarcopenia were 17.9% and 93.7%, respectively. SARC-CalF improved the sensitivity of SARC-F (47.5%) while keeping similar specificity (92.0%). The AUCs of calf circumference, SARC-F, and SARC-CalF were 0.79 [95% confidence interval (CI), 0.77–0.82], 0.56 (95% CI, 0.52–0.59), and 0.70 (95% CI, 0.67–0.73), respectively. The differences across ROC curves were statistically significant among 3 screening tools (P < .001).Conclusions and ImplicationsThe overall screening ability of calf circumference was better than that of SARC-F and SARC-CalF for sarcopenia in community-dwelling older persons despite gender, age, and cognitive function. SARC-F and SARC-CalF have high specificity but are susceptible to the preceding factors.     

Augmentation of Shoulder Contour Using a Calf Implant

Sprengel deformity is a rare orthopedic condition that is associated with functional and cosmetic impairment. Results of orthopedic procedures are usually inconsistent and cosmetic results are far from satisfactory in these patients. A silicone-gel-filled calf prosthesis was used to correct the shoulder contour in a patient with Sprengel deformity. Cosmetically the deformity can be restored by using a calf implant for patients in whom orthopedic procedures are not likely to yield a satisfactory outcome.     

Maximal calf circumference reflects calf muscle mass measured using magnetic resonance imaging

BackgroundCalf circumference (CC) has been used as a surrogate for calf muscle mass, which facilitates venous blood return to the heart through active skeletal muscle. However, the correlation between CC and calf muscle mass has not been extensively examined. This study aimed to examine the relationship between CC and calf muscle mass considering differences in sex and physique in elderly individuals.MethodsA total of 124 community-dwelling elderly individuals ≥60 years of age (61 men, mean [±SD] age 74.3 ± 5.7 years) were enrolled. Maximal CC was measured using a tape measure with the subject supine. The cross-sectional area of skeletal muscle tissues was measured using magnetic resonance imaging from the point of greatest calf circumference to 5 cm proximal and distal. Calf muscle mass was calculated by multiplying the area of each slice by slice thickness (5 mm).ResultsCC was strongly correlated with calf muscle mass in male and female subjects (male: r = 0.908, P < 0.001; female: r = 0.892, P < 0.001). Multiple regression analysis revealed that CC and body mass index (BMI) were independent associate factors of calf muscle mass. The following estimation formulae were derived: (male) calf muscle mass (cm³) = 47.82 × CC (cm)−12.50 × BMI (kg/m²) −732.80; (female) calf muscle mass (cm³) = 32.23 × CC (cm) −4.85 × BMI (kg/m²) −429.94.ConclusionsA strong correlation was found between CC and calf muscle mass according to magnetic resonance imaging. Sex differences and BMI should be considered for accurate estimation of calf muscle mass using CC.     

CT评价腹股沟疝患者肌肉质量方法的前瞻性研究

目的　应用CT技术评价老年腹股沟疝患者的肌肉质量。方法　拟接受腹股沟疝手术、年龄在70~90岁的男性住院患者30例为研究对象,40~50岁10名男性健康受试者为成人对照组,10名同年龄段接受健康查体老年人为老年对照组,记录一般资料,应用CT技术扫描腹部和大腿,通过专用软件计算相应肌肉面积。结果　研究组握力（36.44±14.15）kg明显少于成人对照组（77.30±22.69）kg （P=0.001）,研究组小腿围（25.18±2.31）cm 明显少于成人对照组（27.62±2.33）cm （P=0.006）。CT扫描显示研究组与成人对照组L3（第3腰椎）平面腹部面积、皮下脂肪面积、腹腔脂肪面积和竖脊肌总面积相近,研究组腹部肌肉面积（12 094.23±1 970.30）mm2和竖脊肌肌肉面积（1 642.60±266.90）mm2明显少于成人对照组的（17 462.00±1 600.58）mm2和（2 003.50±350.91）mm2（P=0.001, P=0.007）。L3骨骼肌指数为50.64±7.52,存在肌肉减少症（≤52.4）为66.7 %（20/30）。与同年龄正常查体老人腹部肌肉CT结果相似。研究组下肢骨骼肌面积明显少于成人对照组（P=0.001）,下肢脂肪和股骨面积两组比较差异无统计学意义（P＞0.05）。结论　老年腹股沟疝患者肌肉质量和力量明显低于成人对照组,CT技术可作为评价工具。     

Expression of Insulin-like Growth Factors (IGF)-1 and -2, IGF-binding Proteins-2 and -3, and Receptors for Growth Hormone,IGF Type-1 and -2 and Insulin in the Gastrointestinal Tract of Neonatal Calves

Growth hormone (GH), insulin-like growth factors (IGFs) and insulin influence post-natal gastrointestinal development and function. We have measured by real-time PCR the mRNA levels of IGF-1 and -2, IGF-binding proteins (IGFBPs)-2 and -3, and receptors for GH, IGF type-1 and -2, and insulin in esophagus, rumen, fundus, pylorus, duodenum, jejunum, ileum and colon of calves on days 1 and 5 of life. Levels of mRNA of measured traits were different (P<0.05) at different gastrointestinal sites. Furthermore, mRNA levels of IGFs, IGFBPs and of receptors for GH and IGF type-1 and -2 and insulin differed (P<0.05) on days 1 and 5. Differences in mRNA abundance of IGFs, IGFBPs and of receptors for GH, IGFs, and insulin among gastrointestinal sites on days 1 and 5 of life suggest site-specific functional importance and demonstrate that changes are the consequence of ontogenetic development and/or due to feeding.     

Electrochemical,spectroscopic, and molecular docking studies of the interaction between the anti-retroviral drug indinavir and dsDNA

In this study, an electrochemical DNA biosensor was developed using a straightforward methodology to investigate the interaction of indinavir with calf thymus double-stranded deoxyribonucleic acid (ct-dsDNA) for the first time. The decrease in the oxidation signals of deoxyguanosine (dGuo) and deoxyadenosine (dAdo), measured by differential pulse voltammetry, upon incubation with different concentrations of indinavir can be attributed to the binding mode of indinavir to ct-dsDNA. The currents of the dGuo and dAdo peaks decreased linearly with the concentration of indinavir in the range of 1.0–10.0 μg/mL. The limit of detection and limit of quantification for indinavir were 0.29 and 0.98 μg/mL, respectively, based on the dGuo signal, and 0.23 and 0.78 μg/mL, respectively, based on the dAdo signal. To gain further insights into the interaction mechanism between indinavir and ct-dsDNA, spectroscopic measurements and molecular docking simulations were performed. The binding constant (K_b) between indinavir and ct-dsDNA was calculated to be 1.64 × 10⁸ M⁻¹, based on spectrofluorometric measurements. The obtained results can offer insights into the inhibitory activity of indinavir, which could help to broaden its applications. That is, indinavir can be used to inhibit other mechanisms and/or hallmarks of viral diseases.     

A home‐based progressive resistance exercise programme for patients with venous leg ulcers: a feasibility study

This study aimed to assess the feasibility of a home‐based exercise programme and examine the effects on the healing rates of venous leg ulcers. A 12‐week randomised controlled trial was conducted investigating the effects of an exercise intervention compared to a usual care group. Participants in both groups (n = 13) had active venous ulceration and were treated in a metropolitan hospital outpatients clinic in Australia. Data were collected on recruitment from medical records, clinical assessment and questionnaires. Follow‐up data on progress in healing and treatments were collected fortnightly for 12 weeks. Calf muscle pump function data were collected at baseline and 12 weeks from recruitment. Range of ankle motion data were collected at baseline, 6 and 12 weeks from recruitment. This pilot study indicated that the intervention was feasible. Clinical significance was observed in the intervention group with a 32% greater decrease in ulcer size (P = 0·34) than the usual care group, and a 10% (P = 0·74) improvement in the number of participants healed in the intervention group compared to the usual care group. Significant differences between groups over time were observed in calf muscle pump function parameters [ejection fraction (P = 0·05), residual volume fraction (P = 0·04)] and range of ankle motion (P = 0·01). This pilot study is one of the first to examine and measure clinical healing rates for participants involved in a home‐based progressive resistance exercise programme. Further research is warranted with a larger multi‐site study.     

纳洛酮联合小牛血清去蛋白治疗急性颅脑损伤的临床研究

目的探讨纳洛酮联合小牛血清去蛋白治疗急性颅脑损伤的临床效果。方法选取2015年8月—2017年8月重庆市开州区人民医院收治的急性颅脑损伤患者122例,随机分为对照组(61例)和治疗组(61例)。对照组静脉滴注小牛血清去蛋白注射液,30 m L加入5%葡萄糖注射液250 m L,1次/d。治疗组在对照组基础上静脉滴注盐酸纳洛酮注射液,0.3mg/(kg·d)。两组患者均连续治疗7 d。观察两组临床疗效,比较治疗前后两组格拉斯哥昏迷量(GCS)评分、血液流变学指标、及肿瘤坏死因子(TNF)-α、IL-6和神经元特异性烯醇化酶(NSE)水平。结果治疗后,对照组和治疗组临床总有效率分别为78.7%、93.4%,两组比较差异具有统计学意义(P0.05)。治疗后,两组GCS评分中运动、语言、睁眼及GCS总评分均显著升高(P0.05);且治疗组GCS评分明显高于对照组(P0.05)。治疗后,两组全血黏度(WBV)、血浆黏度(PV)和红细胞聚集指数(EAI)值均显著下降(P0.05);且治疗组比对照组降低的更显著(P0.05)。治疗后,两组血清TNF-α、IL-6、NSE水平均明显降低(P0.05);且治疗组比对照组降低的更明显,(P0.05)。结论纳洛酮联合小牛血清去蛋白治疗急性颅脑损伤可迅速缓解患者症状体征,减轻炎性损伤,改善神经功能,具有一定的临床推广应用价值。     

小牛脾提取物注射液联合他克莫司乳膏治疗儿童寻常型进展期白癜风

目的 观察小牛脾提取物注射液联合他克莫司乳膏治疗儿童寻常型进展期白癜风的疗效及安全性.方法 A组43例采用小牛脾提取物注射液肌肉注射和他克莫司乳膏外涂,B组25例他克莫司乳膏外涂;疗程6个月;对该68例作统计学分析.结果 A组治愈率、显效率优于B组（P＜0.05）.结论 小牛脾提取物注射液和他克莫司乳膏治疗儿童寻常型进展期白癜风安全有效;合并应用近期疗效显著.     

注射用牛肺表面活性剂联合CPAP治疗早产儿特发性呼吸窘迫综合征的效果

目的探讨注射用牛肺表面活性剂联合持续正压通气（CPAP）治疗早产儿特发性呼吸窘迫综合征（IRDS）的临床效果。方法以2010年3月～2013年6月本院收治的28例早产儿IRDS患者为研究对象,观察和比较治疗前后动脉血气指标以及CPAP参数的变化情况。结果患儿的临床症状明显改善,动脉血气指标和CPAP参数与用药前比较,差异有统计学意义（P〈0．05）。结论注射用牛肺表面活性剂联合CPAP治疗早产儿IRDS效果良好,可使患儿的症状、动脉血气指标、CPAP参数明显改善。