Neural adaptations after 4 years vs 12 weeks of resistance training vs untrained

The purpose of this study was to compare the effect of resistance training (RT) duration, including years of exposure, on agonist and antagonist neuromuscular activation throughout the knee extension voluntary torque range. Fifty‐seven healthy men (untrained [UNT] n = 29, short‐term RT [12WK] n = 14, and long‐term RT [4YR] n = 14) performed maximum and sub‐maximum (20%‐80% maximum voluntary torque [MVT]) unilateral isometric knee extension contractions with torque, agonist and antagonist surface EMG recorded. Agonist EMG, including at MVT, was corrected for the confounding effects of adiposity (ie, muscle‐electrode distance; measured with ultrasonography). Quadriceps maximum anatomical cross‐sectional area (QACSA_MAX; via MRI) was also assessed. MVT was distinct for all three groups (4YR +60/+39% vs UNT/12WK; 12WK +15% vs UNT; 0.001 < P ≤ 0.021), and QACSA_MAX was greater for 4YR (+50/+42% vs UNT/12WK; [both] P < 0.001). Agonist EMG at MVT was +44/+33% greater for 4YR /12WK ([both] P < 0.001) vs. UNT, but did not differ between RT groups. The torque‐agonist EMG relationship of 4YR displayed a right/down shift with lower agonist EMG at the highest common torque (196 Nm) compared to 12WK and UNT (0.005 ≤ P ≤ 0.013; Effect size [ES] 0.90 ≤ ES ≤ 1.28). The torque‐antagonist EMG relationship displayed a lower slope with increasing RT duration (4YR < 12WK < UNT; 0.001 < P ≤ 0.094; 0.56 ≤ ES ≤ 1.31), and antagonist EMG at the highest common torque was also lower for 4YR than UNT (?69%; P < 0.001; ES = 1.18). In conclusion, 4YR and 12WK had similar agonist activation at MVT and this adaptation may be maximized during early months of RT. In contrast, inter‐muscular coordination, specifically antagonist coactivation was progressively lower, and likely continues to adapt, with prolonged RT.     

北京地区住院药师规范化培训学员满意度调查分析

目的调查参加住院药师规范化培训的学员对带教师资教学工作和培训管理的满意度,为进一步提高培训质量提供依据。方法采用自制问卷对北京地区17家培训基地的143名学员进行问卷调查,对收集的数据进行统计学分析。结果学员对培训的总体满意度评分为(4.52±0.65)分(满分为5分),带教师资、培训活动及支撑条件3大类、10个项目的评分差异无统计学意义;不同部门带教师资的满意度评分以及不同培训基地的满意度评分相比,差异有统计学意义(P<0.05)。结论各培训基地应提高学员培训待遇,保证培训待遇同等,加强带教师资队伍建设,加强培训质量的监督和反馈,以促进住院药师规范化培训工作进一步完善和推广。     

Trend of immunity against measles and varicella zoster virus in healthcare workers in Korea

ObjectiveTo examine the seroprevalence of measles and varicella zoster virus (VZV) among healthcare workers (HCW) and evaluate the concordance between self-reported history of previous disease or vaccination and seropositivity.DesignA seroprevalence study and survey.SettingA university-affiliated tertiary care hospital.ParticipantsAll HCWs working in high-risk services in 2017 underwent serologic tests and survey; all new HCWs employed in the subsequent years, serologic tests only.MethodsA serologic study was conducted using chemiluminescence immunoassay (2017) or enzyme immunoassays (2018 and later). HCWs who underwent serological testing in 2017 completed a self-administered questionnaire on their history of infection and vaccination.ResultsA total of 10,278 and 9607 HCWs underwent serologic tests for measles and VZV IgG, respectively, from 2017 to 2022. The overall seropositivity rates for measles and VZV were 78.1 % and 92.8 %, respectively. Measles seropositivity declined gradually from >90 % in the HCWs born in the 1960s to <80 % in those born in the 1990s. There was a significant difference in measles seropositivity between the birth cohorts (BCs) 1967–1984 and 1985–1999 (P < 0.001; odds ratio, 1.16; 95 % confidence interval, 1.14–1.18). The seropositivity for VZV was stable, at >90 % in all BCs. The self-reported vaccination history was not independently associated with seropositivity, and the negative predictive value of the survey was very low (9.6 % and 13.1 %, respectively).ConclusionsMeasles seropositivity showed a substantial decline among HCWs born in 1985 or later, while varicella seropositivity remained high. The self-reported vaccination history was not sufficiently reliable for screening HCWs.     

Medical students’ learning processes the first time they role-play in psychiatry: A grounded theory study

BackgroundRecent changes in psychiatric care and teaching that limit patient contact for medical students can be overcome in part by simulation-based education. Understanding the learning processes of medical students involved in psychiatric simulation-based programmes could usefully inform efforts to improve this teaching. This study explored the learning processes of medical students the first time they role-play in psychiatry.MethodsWe used constructivist grounded theory to analyse semi-structured interviews of 13 purposively sampled medical students and the six psychiatrists who trained them. To improve the triangulation process, the results of this analysis were compared with those of the analyses of the role-play video and the debriefing audio-tapes.ResultsFive organising themes emerged: improving the students’ immediate perception of patients with mental disorders; cultivating clinical reasoning; managing affect; enhancing skills and attitudes and fostering involvement in learning psychiatry.ConclusionResults suggest that psychiatric role-playing can improve students’ progressive understanding of psychiatry through the development of intuition and by allaying affects. Emotional elaboration and student involvement appear to be key features.     

负压治疗联合盆底肌训练对前列腺癌根治术后患者控尿功能及性功能的影响

目的探讨负压治疗联合盆底肌训练对前列腺癌根治术后患者控尿功能及主观幸福感的影响。 方法将中山大学附属第三医院2016年10月至2019年4月泌尿外科确诊为前列腺癌并行腹腔镜下前列腺癌根治术治疗的70例患者,按随机数字表法分为干预组和对照组各35例,其中对照组35例采用常规护理（盆底肌功能锻炼）,干预组35例在常规护理基础上,术后6周起再增加负压治疗。比较对照组和干预组术后6周、10周、18周控尿功能恢复情况,同时进行国际勃起功能评分表（IIEF-5）评分及主观幸福感调查,观察其治疗效果。 结果干预组术后6周、10周、18周尿失禁评分中位值分别2分、1分与0分,低于对照组的2分、2分与2分,提示干预组术后平均控尿功能恢复时间较对照组短,差异有统计学意义（P<0.05）;此外干预组相比对照组,IIEF-5评分及主观幸福感评分上升速度较快,提示干预组术后勃起功能和生活质量改善情况明显优于对照组。 结论负压治疗联合盆底肌训练对前列腺癌根治术后患者的控尿功能和性功能有明显改善,且缩短其恢复时间。     

点阵CO2激光治疗女性轻中度压力性尿失禁的临床疗效分析

目的探究经阴道点阵CO₂激光治疗女性轻、中度压力性尿失禁（SUI）的临床疗效。 方法回顾性研究本院2017年1月至2020年12月收治的轻中度SUI女性患者。激光治疗组41例,进行点阵CO₂激光联合盆底肌训练治疗,每月治疗1次,共治疗3次;生物反馈治疗组20例,采用生物反馈电刺激联合盆底肌训练。比较两组患者治疗后临床疗效、国际尿失禁委员会尿失禁问卷简表（ICI-Q-SF）、尿失禁生活质量问卷（I-QOL）及女性性功能量表（FSFI）评分。 结果治疗后,激光治疗组总有效率为92.68%,疗效强于生物反馈组（P<0.05）;治疗后ICI-Q-SF、I-QOL、FSFI评分均得到改善（P<0.01）;与生物反馈治疗组比较,激光治疗组I-QOL、FSFI增加更显著（P<0.05）,ICI-Q-SF评分明显降低（P<0.01）。3例患者治疗时述阴道烧灼感,休息后好转,5例患者出现一过性的尿急,部分患者阴道分泌物增多后自行恢复,整个治疗过程无其他不良事件发生。 结论点阵CO₂激光治疗能够有效改善轻、中度SUI患者的临床症状,提高患者性功能和生活质量,具有良好临床疗效。     

镜像运动的研究进展

镜像运动作为一种异常运动现象,可见于脑卒中及帕金森氏病,它的存在对于康复预后有何种影响尚有争论。近年来已有人利用镜像运动的研究成果对卒中后患者进行双侧运动训练并已取得初步效果。