Black beans and red kidney beans induce positive postprandial vascular responses in healthy adults: A pilot randomized cross-over study

Background and aimsConsuming pulses (dry beans, dry peas, chickpeas, lentils) over several weeks can improve vascular function and decrease cardiovascular disease risk; however, it is unknown whether pulses can modulate postprandial vascular responses. The objective of this study was to compare different bean varieties (black, navy, pinto, red kidney) and white rice for their acute postprandial effects on vascular and metabolic responses in healthy individuals.Methods and resultsThe study was designed as a single-blinded, randomized crossover trial with a minimum 6 days between consumption of the food articles. Vascular tone (primary endpoint), haemodynamics and serum biochemistry (secondary endpoints) were measured in 8 healthy adults before and at 1, 2, and 6 h after eating ¾ cup of beans or rice. Blood pressure and pulse wave velocity (PWV) were lower at 2 h following red kidney bean and pinto bean consumption compared to rice and navy bean, respectively (p < 0.05). There was greater vasorelaxation 6 h following consumption of darker-coloured beans, as shown by decreased vascular tone: PWV was lower after consuming black bean compared to pinto bean, augmentation pressure was lower after consuming black bean compared to rice and pinto bean, and wave reflection magnitude was lower after consuming red kidney bean and black bean compared to rice, navy bean, and pinto bean (p < 0.05). LDL-cholesterol concentrations were lower 6 h after black bean consumption compared to rice (p < 0.05).ConclusionOverall, red kidney and black beans, the darker-coloured beans, elicited a positive effect on the tensile properties of blood vessels, and this acute response may provide insight for how pulses modify vascular function.     

Characterization of standing balance after incomplete spinal cord injury: Alteration in integration of sensory information in ambulatory individuals

BackgroundUp to one-third of individuals with a recent spinal cord injury (SCI) and most of the individuals with an incomplete lesion are able to regain partial balance and walking ability after the first-year post-injury. However, most individuals experience injurious falls while standing and frequent losses of balance post-rehabilitation, which can result in physical injuries and a fear of falling.Research questionControl of balance during quiet standing depends on the integration of sensory information. Since SCI causes sensory and motor impairments, understanding the underlying mechanisms of how postural control is regulated is of significant importance for targeted and guided rehabilitation post-SCI.MethodsWe characterized the impact of a variety of challenging conditions on the standing balance for eight participants with incomplete SCI with walking ability compared to twelve age-matched able-bodied individuals using a waist-mounted inertial measurement unit (IMU). We compared balance biomarkers derived from IMUs’ readouts under conditions that challenged balance by affecting somatosensory (i.e., standing on hard vs. foam surfaces) and visual (i.e., eyes open vs. closed) inputs. We performed a three-way ANOVA or a Kruskal-Wallis test to characterize changes in postural control post-SCI based on reliance on somatosensory and visual information using balance biomarkers.ResultsWe observed a reduced stability performance, an increased control demand, and a less effective active correction post-SCI in all standing conditions. Due to impaired somatosensory feedback, individuals with incomplete SCI showed a higher and lower reliance on visual and somatosensory information, respectively, for maintaining balance (p < 0.05).SignificanceUsing a single waist-mounted IMU, the proposed method could characterize standing balance in individuals with incomplete SCI compared to able-bodied participants. Having high clinical utility and sufficient resolution with discriminatory ability, our method could be used in the future to objectively evaluate the effectiveness of rehabilitative interventions on the balance performance of individuals with SCI.     

Biomechanical characteristics of handstand walking initiation

BackgroundThe initiation in human locomotion is defined as the transition between upright stance and steady-state gait. While past literature abundantly investigated the initiation in bipedal gait, the initiation of handstand walking remains unexplored.Research questionThe current study aims to characterise the centre of pressure (CoP) and centre of mass (CoM) trajectory of handstand walking initiation as well as the spatiotemporal and kinematic parameters and balance strategy of this task. Also, the study examined the CoP trajectory similarity within- and between-participants using a coefficient of multiple correlation analysis.MethodsNineteen gymnasts took part in this study. Handstand walking initiation trials were recorded using force plates and a stereophotogrammetric system. CoM and CoP trajectories were analysed during the Baseline, Preparation and Execution phases of the motor task.ResultsWe found that to successfully perform the handstand walking initiation, a shift of the CoM forward and towards the stance hand is required as a result of a lateral and posterior CoP shift. All participants performed a similar CoP pattern in the mediolateral direction, whereas two anteroposterior CoP displacement strategies were identified across participants based on different timing execution of posterior CoP shift. While CoP and CoM kinematic differences were identified during the Preparation Phase due to the adopted strategy, no significant difference was found in the Execution Phase for the spatiotemporal and kinematic characteristics.SignificanceA better understanding of the required CoP/CoM patterns and balance control provides the basis for further neuromechanics research on the topic and could contribute to individualise training protocols to improve the learning of the task.     

The immediate effects of hallux valgus orthoses: A comparison of orthosis designs

BackgroundHallux valgus orthoses are available in a wide range of designs and materials, but the effects of their design on functional performance have not been fully investigated.Research questionThis present study aims to comprehensively analyze the immediate effects of soft and semi-rigid hallux valgus orthoses on balance, plantar pressure, hallux valgus angle, and subjective sensations.MethodsSixteen female subjects have participated in the study, including 10 subjects with healthy feet and 6 with hallux valgus. Three conditions are tested, including in the barefoot and using two types of commercially available hallux valgus orthoses. The subjects participate in static and dynamic (walking) tests with the use of the Novel Pedar® system. The peak pressure values in the hallux, lateral toes, first metatarsophalangeal joint, 2-4th metatarsal heads, 5th metatarsal head, medial midfoot, lateral midfoot and rearfoot in the various foot conditions are examined and compared. The hallux valgus angle of each subject is measured based on their footprint. Their subjective feelings towards the orthoses are also evaluated. A repeated-measures analysis of variance, and independent-sample t-test are performed.ResultsThe correction of the hallux valgus angle is statistically significant when the subjects with hallux valgus use the orthoses. In comparing the two types of orthoses, the use of the orthosis made of soft materials results in correction in the hallux valgus angle and higher wear comfort, and lower plantar pressure in hallux area.SignificanceThe results provide insights into the design of hallux valgus orthoses, thus offering practical reference for the selection of hallux valgus orthosis with compromise between functional performance and wear comfort.     

下肢静脉性溃疡诊治进展

下肢静脉性溃疡（VLU）是静脉疾病最严重的表现，属CEAP分级的C5或C6级。具有溃疡形成的慢性病程长、低愈合率、高复发率等特点。溃疡创面迁延不愈与巨额医疗费用，给病人生活质量造成严重影响，也会加重社会经济负担。VLU的病因复杂，各种慢性静脉疾病导致的静脉高压是其病理学基础。溃疡的病史、临床表现及体格检查有助于VLU的诊断。VLU的治疗选择包括药物治疗、压力治疗、外科治疗、溃疡创面处理等，应经仔细评估后，根据病人病情特点进行综合治疗。     

Could non-HDL-cholesterol be a better marker of atherogenic dyslipidemia in obstructive sleep apnea?

Background/objectiveObstructive sleep apnea (OSA) is independently associated with dyslipidemia, a surrogate marker of atherosclerosis. Low-density lipoprotein (LDL)-cholesterol is accepted as a major independent risk factor for cardiovascular disease. However, non-high-density lipoprotein (HDL)-cholesterol is a better marker of atherogenic dyslipidemia and recommended as a target of lipid lowering therapy. We aimed to assess the prevalence of atherogenic dyslipidemia, and relationship between OSA severity and serum LDL-cholesterol and non-HDL cholesterol levels in OSA patients.MethodsWe retrospectively evaluated treatment naïve 2361 subjects admitted to the sleep laboratory of a university hospital for polysomnography. All subjects’ lipid profile including total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, and non-HDL-cholesterol were measured.ResultsOut of 2361 patients (mean age 49.6 ± 11.9 years; 68.9% male, apnea-hypopnea index 36.6 ± 28.4/h), 185 (7.8%) had no OSA and 2176 (92.2%) had OSA. Atherogenic dyslipidemia prevalence was high (57–66%) in OSA patients, and especially increased in severe OSA compared to other groups (p < 0.05). Though total and LDL-cholesterol did not differ between those with and without OSA, non-HDL-cholesterol (p = 0.020), and triglycerides (p = 0.001) were higher and HDL-cholesterol levels (p = 0.018) were lower in OSA patients than non-OSA. Non-HDL-cholesterol was significantly correlated with OSA severity (p < 0.001) and hypoxia parameters (p < 0.01), whereas LDL-cholesterol showed no correlation.ConclusionsAtherogenic dyslipidemia is highly prevalent and non-HDL-cholesterol levels are significantly increased, predominantly in severe OSA patients. Non-HDL-cholesterol but not LDL-cholesterol, is significantly correlated with OSA severity and hypoxia parameters. Therefore, it could be better to use non-HDL-cholesterol, which is a guideline recommended target of lipid therapy, as a marker of atherosclerotic cardiovascular risk in OSA patients.     

术中目标导向液体治疗在腹膜后巨大恶性肿瘤切除术患儿中的应用

目的:探讨基于脉压变异度（PPV）的目标导向液体治疗（GDFT）在腹膜后巨大恶性肿瘤切除术患儿中的应用。方法:择期行腹膜后巨大恶性肿瘤切除术患儿64例，年龄0.5~3岁，ASA Ⅱ-Ⅲ级。随机将患儿分为目标导向液体治疗组（G组）和常规液体治疗组（C组），每组32例。G组以PPV为指导，根据GDFT方案进行液体管理，C组采用常规液体管理。记录手术开始（T1）、手术开始后1 h（T2）、手术结束（T3）的MAP、CVP、PPV、Lac值、TNF-α、IL-6浓度。记录术中输注晶体液量、胶体液量、液体总量、出血量、尿量、手术时间、多巴胺使用率以及排气时间、术后住院时间和恶心呕吐发生率。结果:G组输注晶体液量显著少于C组（P＜0.05），而输注胶体液量显著多于C组（P＜0.05）。两组术中输注液体总量、出血量、尿量与多巴胺使用率方面差异无统计学意义。T2、T3时刻，G组PPV、TNF-α、IL-6显著低于C组（P＜0.05），而两组间MAP、CVP、Lac在各时点差异无统计学意义。G组术后排气时间明显短于C组（P＜0.05），而在术后恶心呕吐发生率和住院时间方面两组差异无统计学意义。结论:PPV指导的GDFT可以应用于腹膜后巨大恶性肿瘤切除术患儿，能维持其血流动力学稳定，减少炎症因子IL-6、TNF-α释放，促进胃肠功能恢复，但对术后转归无明显影响。     

李延应用泽泻汤合温胆汤治疗舒张压高的临床经验

随着社会的发展,人类生活方式的改变,高血压病越来越高发,具有低龄化趋势,代谢综合征常伴随发生,此种情况下的高血压往往是以舒张压升高为主,临床表现常与“亚健康”状态混淆,未能引起患者甚至部分医生的重视,然而事实上越来越多的科学研究证实舒张压高之危害十分明显,不容忽视。尽管现代医学对舒张压高的病因及病理机制有明确的阐述,但是暂时没有特效的药物。李延教授在治疗高血压病方面有着丰富的临床经验,临床中运用泽泻汤合温胆汤加减治疗舒张压高之眩晕,切中病机,加减灵活,屡有良效。文中从中医角度阐述舒张压高的病因病机,介绍李师辨病辨证思路,组方用药特点,附三则典型验案,另加个人心得体会,以期为舒张压高的有效治疗提供思路。