高强度间歇游泳训练对衰老小鼠骨骼肌蛋白质合成的影响研究

目的:探讨高强度间歇训练对衰老小鼠快缩骨骼肌蛋白质合成的影响。方法:16月龄雄性C57BL/6小鼠,20只据体重随机纳入对照组(C组)与高强度间歇运动干预组(CE组)。CE组小鼠每周一至五晚七点进行高强度间歇训练,为期8周。训练时小鼠在尾根绑缚相当于10%体重的负荷,游泳20s后休息10s,重复4组。每周增加1组训练,第8周时每次训练12组。实验前及训练后第2、4、6、8周的周日采用抓握力计测定肌力。末次训练24h后处死全部小鼠,同位素示踪法测定腓肠肌蛋白质合成率,Bradford法测定总蛋白、肌原纤维与肌浆蛋白浓度,Western blotting法检测mTOR~(Ser2448)、4E-BP1~(Thr37/46)与p70S6K~(Thr389)磷酸化率及MHCⅡ蛋白表达。结果:8周高强度间歇训练导致腓肠肌蛋白质合成率、肌原纤维、肌浆蛋白质含量及蛋白质总量增加,mTOR~(Ser2448)、p70S6K~(Thr389)及4E-BP1~(Thr37/46)磷酸化率与MHCⅡ蛋白表达均升高,后肢抓握力亦有增长,且变化均具有显著性意义(P=0.000)。结论:高强度间歇训练能够显著促进衰老小鼠腓肠肌骨骼肌蛋白质合成,并最终导致肌力增长,具有干预衰老性肌肉萎缩的潜力,其作用机理涉及骨骼肌内mTOR~(-p70S6K)/4E-BP1的活化。     

Effect of combined interval training on the cardiorespiratory fitness in heart failure patients: a systematic review and meta-analysis

BackgroundThe combination of interval training and resistance training has showed interesting results in chronic heart failure patients, corroborating the benefits of physiological adaptations of both protocols.ObjectiveTo evaluate the effect of the combination of interval training and resistance training program when compared to interval training alone and/or without intervention group on cardiorespiratory fitness in patients with chronic heart failure.MethodsWe search MEDLINE via PubMed, ScienceDirect, Sportdiscus, BIREME and Scielo, from their inception to December 2018. Were included both randomized and non-randomized controlled trials comparing the effect of combined training, interval training alone and/or WI group on VO_2peak (expressed in ml/kg/min), in people with chronic heart failure patients. The meta-analysis was conducted via Review Manager v 5.3 software, using random effect model.ResultsTen articles were selected (nine randomized controlled trial), involving 401 participants. Six studies compared combined training with interval training and six studies compared combined training with the without intervention group. Eighty percent of the trials presented moderate risk of bias and twenty percent low risk of bias. Data showed significant difference and major increase in VO_2peak in favor to combined training group compared to interval training group (SMD = 0.25; CI = 0.04–0.46) and without intervention group (SMD = 0.46; CI = 0.29–0.64), respectively.ConclusionThe combination of interval training and resistance training showed more effective in increasing cardiorespiratory fitness in patients with heart failure than interval training alone and non-exercise therapy. However, further studies should be conducted to increase the understanding of this combined training method.     

等速训练对乳腺癌术后患者上肢功能的影响

目的 探讨等速运动对乳腺癌术后患者上肢功能的影响。 方法 选取乳腺癌女性患者70例,按随机数字表法分为等速组（36例）和对照组（34例）。2组患者均给予常规康复治疗,等速组在此基础上进行等速肌力训练。分别于治疗前和治疗2个月后（治疗后）,采用放射性核素淋巴扫描观测2组患侧上肢淋巴流量的变化,在腕横纹上10cm处测量2组双侧上臂周径,应用ISOMED2000为等速组记录等速肌力测定值,采用Constant-Murley肩功能评定标准对患者进行上肢功能的评定,采用测角器测量肩关节活动度。 结果 ①治疗后,等速组和对照组的上肢淋巴流量分别为（16.8±2.5）和（10.9±3.4）,较组内治疗前［（7.6±3.4）和（7.7±3.2）］明显增加（P<0.05）,等速组治疗后的上肢淋巴流量明显大于对照组治疗后（P<0.05）;双侧上臂周径差值［（2.1±0.2）和（4.5±0.3）cm］均较组内治疗前［（5.5±0.4）和（5.2±0.8）cm］减小（P<0.05）,等速组治疗后的双侧上臂周径差值明显小于对照组治疗后（P<0.05）。②等速组患者治疗后的等速肌力测量值（峰力矩、总功率、平均功率）均较治疗前明显增加（P<0.05）。③2组患者治疗后的上肢功能评分均较组内治疗前明显增加（P<0.05）,等速组患者治疗后的上肢功能评分总分［（96.74±12.23）分］明显高于对照组治疗后［（84.17±12.16）分］,差异有统计学意义（P<0.05）。④2组患者治疗后的肩关节活动度均较组内治疗前明显增加（P<0.05）,等速组治疗后的肩关节活动度［前屈（150.25±16.13）°、后伸（46.83±8.52）°、外展（169.38±14.53）°、内收（35.93±5.62）°］明显高于对照组治疗后［前屈（144.67±19.15）°、后伸（39.84±6.93）°、外展（137.13±11.67）°、内收（31.68±5.29）°］,且差异有统计学意义（P<0.05）。 结论 等速运动可以提高乳腺癌术后患者的上肢功能。     

Effect of a high-intensity interval training on serum microRNA levels in women with breast cancer undergoing hormone therapy. A single-blind randomized trial

BackgroundThe role of microRNAs (miRs) in hormone therapy (HT) is of keen interest in developing biomarkers and treatments for individuals with breast cancer. Although miRs are often moderate regulators under homeostatic conditions, their function is changed more in response to physical activity.ObjectiveThis single-blind randomized trial aimed to explore the effect of high-intensity interval training (HIIT) on serum levels of miRs in individuals with early-stage breast cancer undergoing HT.MethodsHormone receptor-positive women with breast cancer and healthy women were randomly assigned to a healthy control group (n = 15), healthy group with HIIT (n = 15), breast cancer group with HT (HT, n = 26), and breast cancer group with HT and HIIT (HT + HIIT, n = 26). The exercise groups underwent interval uphill walking training on a treadmill 3 times a week for 12 weeks. At the end of the study, we analyzed changes in levels of cancer-related miRs (oncomiRs) and tumour suppressor miRs (TSmiRs) in response to the HT and HIIT.ResultsIn women with breast cancer versus healthy controls, the expression of some oncomiRs was significantly increased — miR-21 (P < 0.001), miR-155 (P = 0.001), miR-221 (P = 0.008), miR-27a (P < 0.001), and miR-10b (P = 0.007) — and that of some TSmiRs was significantly decreased — miR-206 (P = 0.048), miR-145 (P = 0.011), miR-143 (P = 0.008), miR-9 (P = 0.020), and let-7a (P = 0.005). Moreover, HT considerably downregulated oncomiRs and upregulated TSmiRs. HIIT for 12 weeks with HT significantly decreased the expression of the oncomiRs and significantly increased that of the TSmiRs as compared with HT alone.ConclusionsHITT could amplify the decrease and/or increase in expression of miRs associated with HT in women with breast cancer. A prospective trial could determine whether the use of circulating miRs for monitoring treatment can be useful in therapy decisions.Trial registrationIranian Registry of Clinical Trials (No.: IRCT201202289171N1).     

肌肉放松训练对乳腺癌患者围手术期生活质量的影响

目的探讨渐进性肌肉放松训练对围手术期乳腺癌患者抑郁、焦虑和生活质量的影响。方法选取西安市两所综合三级甲等医院围手术期的乳腺癌患者200名为研究对象,将其随机分为观察组和对照组各100名,对照组患者给予常规护理,观察组患者在常规护理基础上进行5周的渐进性肌肉放松训练,采用乳腺癌患者生命质量测定量表(FACT-B)、抑郁自评量表(SDS)与焦虑自评量表(SAS),分别在入院第1天及干预后第5周后测评研究对象的生活质量和抑郁及焦虑变化情况。结果观察组患者经5周的肌肉放松训练后,生活质量得分、抑郁及焦虑评分较对照组患者有显著改善,差异有统计学意义(P0.05)。结论渐进性肌肉放松训练能有效改善围手术期乳腺癌患者的生活质量,缓解其抑郁与焦虑等不良心理状态,应广泛应用到乳腺癌患者的术后康复护理中。     

音乐干预对乳腺癌术后化疗间歇期患者抑郁情绪的影响

目的探讨音乐干预对乳腺癌化疗间歇期患者抑郁情绪的影响。方法随机抽取乳腺癌术后化疗间歇期伴抑郁情绪患者60例,随机分为干预组和对照组,每组30例。对照组接受常规护理,干预组在接受常规护理的基础上,接受为期9周的音乐干预。在干预前和干预后分别用抑郁自评量表（SDS）对两组患者的抑郁情绪进行评价,分析音乐干预的效果。结果干预前两组患者抑郁发生率及SDS得分比较差异均无统计学意义（P〉0．05）;干预后干预组抑郁发生率为23．33％,SDS得分为（35．60±5．62）分,均低于对照组83．33％,（42．87±6．34）分,差异有统计学意义（X^2=21．90,t=-3．8;P〈0．01）;对照组患者干预前后SDS得分比较差异无统计学意义（P〉0．05）,干预组干预前后比较差异有统计学意义（t=-8．3,P〈0．01）。结论音乐干预可显著改善乳腺癌术后化疗间歇期患者的抑郁情绪。     

高强度间歇性训练对慢性心力衰竭患者心脏康复的效果观察

目的 探讨高强度间歇性训练(HIIT)对慢性心力衰竭(CHF)患者心脏康复中的有效性和安全性.方法 选择2020年3月—2021年1月医院心内科收治的CHF患者90例为研究对象,根据发病原因(缺血性和非缺血性)先进行中心分层,再按照性别、年龄、体质指数、病程、NYHA心功能分级匹配的原则分为对照组和观察组,每组45例....     

运动训练对乳腺癌术后患者生活质量影响的临床研究

目的 探讨运动训练对乳腺癌术后患者生活质量的影响作用.方法 将156例乳腺癌术后患者随机分为研究组(80例)和对照组(76例).研究组在常规护理的同时采取运动训练干预,对照组只给予常规护理,1个月后分别观察两组患者患侧上肢的水肿情况,1年后分别应用健康状况调查问卷(SF-36中文版)对乳腺癌术后患者进行测定,评价两组患者的生活质量(QOL),并进行比较.结果 研究组患者患侧上肢水肿发生率明显较对照组低(P＜0.01);研究组SF-36量表的各项评分均明显高于对照组(P＜0.01).结论 运动训练可明显消除乳腺癌术后患者患侧上肢的水肿,增强患者治疗的信心,从而促进康复,达到提高乳腺癌术后患者生活质量的目的.

Abstract：

Objective To study the effect of exercise training on the quality of life (QOL) of postoperative breast cancer parients. Methods The 156 postoperative breast cancer patients were divided into observation group (80 cases) and control group (76 cases) . The control group was given routine nursing, and the observation group was given exercise training on the basis of routine nursing. The QOL of the all the patients were evaluated by SF - 36 after 1 year. Results The incidence of edema of the upper extremity in observation group was lower than that of control group, the scores of SF-36 of observation group were higher than those of control group. Conclusions Exercise training can reduce the edema of the upper extremity of postoperative breast cancer patients, and enhance of therapic confidence, promote rehabilitation, improve the postoperative breast cancer patients'life quality.     

抗阻力训练对老年人心血管功能的影响及机制的初步研究

目的:探讨抗阻力训练对老年人肌肉力量、炎症因子及血管内皮功能的影响,揭示抗阻力训练改善老年人心血管功能的机制.方法:20例老年男性接受为期16周抗阻力训练,在训练前后采用超声诊断技术检测血流介导的血管舒张功能(flow-mediated dilation,FMD),并对其肌肉力量以及血清炎症因子(TNF-α、hsCRP...     

瑜伽联合冥想训练对乳腺癌化疗患者癌因性疲乏及负性情绪的影响

目的 观察瑜伽联合冥想训练对乳腺癌化疗患者癌因性疲乏及负性情绪的影响。 方法 选取2017年1-6月在我科接受化疗的90例乳腺癌患者为研究对象,采用随机数字表法将其分为对照组和干预组,每组45例。对照组给予肿瘤科常规护理,干预组在对照组基础上给予瑜伽联合冥想训练,比较2组患者的癌因性疲乏程度、焦虑程度和睡眠质量评分。 结果 干预后,干预组癌因性疲乏程度、焦虑程度均轻于对照组(Z=-2.124,P=0.034;Z=-2.283,P=0.022),睡眠质量评分高于对照组(t=2.682,P=0.031)。 结论 瑜伽联合冥想训练能降低乳腺癌化疗患者的癌因性疲乏,改善其焦虑情绪和睡眠质量。     

Physical activity during and after adjuvant chemotherapy in patients with breast cancer

Objectives

To describe changes in physical activity levels related to health-enhancing physical activity guidelines during and after adjuvant chemotherapy in a cohort of Swedish patients with breast cancer.

Design

Exploratory clinical prospective longitudinal study with 6 and 12 months of follow-up.

Participants

Forty women treated for breast cancer with adjuvant chemotherapy were included, and 33 women completed the study.

Main outcome measures

The primary outcome was the proportion of participants meeting the health-enhancing physical activity guidelines, both in relative terms (perceived exertion using Borg's rate of perceived exertion scale) and absolute terms (metabolic equivalent).

Results

The proportion of participants meeting the guidelines when leisure-time physical activity was measured in terms of absolute intensity was 81 (25/31) to 94% (31/33) during chemotherapy, 93% (29/31) at 6-month follow-up and 87% (26/30) at 12-month follow-up. Women who had been physically active before their cancer diagnosis and women who had received information about physical activity were more physically active during chemotherapy.

Conclusions

Swedish patients with breast cancer are generally more physically active during adjuvant chemotherapy than has been reported previously in international studies. Physical activity habits prior to cancer diagnosis and information about the benefits of physical activity appear to be important factors for higher levels of physical activity during and after chemotherapy.     

早期系统康复训练在乳腺癌根治术病人中的应用效果研究

探讨早期系统康复训练对乳腺癌根治术病人应用效果。方法：将我院收治的109例实施乳腺癌根治术的病人随机分为试验组、对照组,两组病人均给予常规护理,试验组病人在此基础上实施早期系统康复训练,并对两组病人焦虑情况以及并发症的发生情况进行比较。结果：试验组病人SDS、SAS在干预3d后均低于对照组（P〈0．05）,并发症的发生明显低于对照组（P〈0．05）。结论：对实施乳腺癌根治术的病人采用早期系统康复训练,有助于改善病人预后,提高病人的治疗效果。     

Quality of life of breast cancer patients in the course of adjuvant radiotherapy

Goals of the work In cancer patients, there is an ongoing interest in evaluating the impact of therapeutic interventions on health-related quality of life (hrqol). However, only a few longitudinal studies are published being able to measure the influence of therapy for the patients’ quality of life. Based on these data, our aim was to evaluate changes of hrqol during the course of adjuvant radiotherapy in breast cancer patients with special focus on subgroup analysis. Materials and methods Sixty-one women undergoing radiotherapy after breast conserving surgery were asked to answer the EORTC Quality of life questionnaire (EORTC-QOL-C30) three times: at the beginning of radiotherapy, in the forth week and 6 weeks after the end of treatment. To identify patients with changes of their qol during the observation time, the function scale “Global health status/Quality of life” was used enabling us to classify three subgroups: (1) unchanged hrqol (NC), (2) increasing hrqol (INC), (3) decreasing of hrqol (DEC). Main results Patients with an increasing hrqol (N = 25) demonstrated a significant increase in the role as well as in the emotional functioning scales. In patients with a decreasing hrqol (N = 15), no changes in any of the function scales were found, while a significant decrease in their cognitive functioning was observed in patients with no change in hrqol (N = 21). Conclusions Although the interpretation of these data is difficult because only a few data are available to compare our results, it could be demonstrated that emotional support and the ability to maintain a daily routine in additionally irradiated breast cancer patients is important to optimise hrqol. If hrqol decreases during the course of radiotherapy, the function scales of the EORTC-QOL-C30 seem to be insensitive to reflect this decrease.     

乳腺癌患者对化疗不良反应的自我报告与护理记录的一致性研究

目的 调查并分析乳腺癌术后辅助化疗患者相关不良反应的自我报告与护理记录之间的一致性。方法 采用便利抽样法,选取2017年7月—2018年7月在江苏省某三级甲等肿瘤医院就诊的乳腺癌术后首次辅助化疗患者128例,采用一般资料调查表、乳腺癌患者对化疗不良反应的自我报告问卷对患者进行调查,同时从电子护理病历中提取患者不良反应的信息,与患者自我报告的结果进行比较,探讨两者一致性。结果 患者自我报告的化疗不良反应的发生率及严重程度均高于护理记录的数据（P<0.05）;仅呕吐这一不良反应,患者自我报告与护理记录之间的一致性一般;其余不良反应,两者之间的一致性均较差。结论 护理人员存在漏记录或低估患者不良反应的情况,甚至包括一些可能导致严重并发症的症状。应考虑将患者自我报告作为常规数据收集,以便促进患者参与决策,改善就医体验。     

乳腺癌患者保乳手术后联合放射治疗的临床治疗效果探讨

目的:分析乳腺癌患者实施保乳手术后联合放射治疗的临床价值。方法:纳入我院于2014年2月到2017年2月期间接收的乳腺癌患者148例为本次研究对象,通过抽签法形式分为研究组和对照组,其中研究组76例,对照组72例。对照组行乳腺癌根治术处理,研究组行保乳手术联合放射治疗,记录两组肿瘤转移率,肿瘤复发率,肿瘤生存率以及不良反应发生率。结果:研究组3年肿瘤转移率0.00%、生存率94.74%和对照组2.78%、91.67%比较不具有差异性(P>0.05),研究组3年肿瘤复发率2.63%低于对照组13.89%,组间比较存在差异性(P<0.05);对照组不良反应发生率27.78%和研究组23.68%对比,不具有统计学意义(P>0.05)。治疗前,研究组和对照组患者血清2-MG、CEA、CA15-3、CA125、YKL-40水平对比,不具有统计学意义(P>0.05);两组治疗后对比,存在统计学意义(P<0.05)。结论:乳腺癌患者实施保乳手术联合放射治疗,相比于乳腺根治术效果更为完善,有利于临床医学进一步推广分析。     

短期规范化培训教育模式对社区医师乳腺癌筛查知识水平的影响

目的 评估短期规范化培训对社区医师乳腺癌相关筛查知识的影响,为社区医师培训教育模式的优化提供依据.方法 在为期8学时的关于乳腺癌筛查规范化培训教育的课程前后,对127位社区医师进行乳腺癌筛查、诊治与预防知识的两次问卷调查;将收集到的资料录入计算机,对比短期规范化培训前后对问卷所涉及的22个问题的回答准确率.结果 问卷调查结果显示：培训课程后社区医师对于乳腺癌的好发年龄、症状与体征、早期诊断与治疗、以及靶与内分泌治疗方面,知晓率明显提高（P〈0.05）;在乳腺癌的筛查与预防方面,社区医师培训结束后对于肿瘤家族史、个人生育史、生活习惯、精神压力等乳腺癌高危因素的知晓率也获得显著改善（P〈0.05）.结论 短期规范化培训教育模式对社区医师乳腺癌筛查知识的影响是显著的,应成为未来培训社区医生的一个常规的继续教育模式.     

保护动机理论在乳腺癌患者功能锻炼中的应用

目的探讨保护动机理论(protection motivation theory,PMT)在乳腺癌患者功能锻炼中的应用效果。方法采用便利抽样法,选取2018年1—12月在郑州大学附属肿瘤医院(河南省肿瘤医院)接受乳腺癌改良根治术的110例乳腺癌患者作为研究对象,将2018年1—6月住院的55例患者作为对照组,将2018年7—12月住院的55例患者作为试验组。对照组于患者出院前采用常规功能锻炼指导,试验组采用PMT进行干预。采用乳腺癌术后患者院外功能锻炼依从性量表、DASH简式评分表、SAS比较两组的干预效果。结果对照组共获得完整资料50份,试验组共获得完整资料52份。干预后试验组患者的身体锻炼依从性、主动寻求建议依从性得分高于对照组,差异有统计学意义(P<0.05)。干预后试验组患者的上肢功能障碍得分低于对照组,差异有统计学意义(P<0.05)。干预后试验组患者的焦虑得分低于对照组,差异有统计学意义(P<0.05)。结论依据PMT制订的干预措施能够提高乳腺癌患者功能锻炼的依从性,改善患者的上肢功能,降低患者的焦虑状态。     

本体感觉强化训练联合肌力训练应用于全膝关节置换术患者中的效果评价

目的 探讨本体感觉强化训练联合肌力训练应用于全膝关节置换术患者中的效果。方法 选取2019年10月至2020年10月收治的全膝关节置换术患者124例,随机分为两组,各62例。对照组采取常规肌力训练,观察组采取本体感觉强化训练联合肌力训练,比较两组患肢股四头肌肌力改善情况、膝关节功能、并发症发生率与生活质量。结果 观察组干预后患肢股四头肌肌力改善情况优于对照组(P＜0.05);观察组干预后膝关节功能强于对照组(P＜0.05);观察组干预后并发症发生率低于对照组(P＜0.05);观察组干预后生活质量高于对照组(P＜0.05)。结论 本体感觉强化训练联合肌力训练应用于全膝关节置换术患者能够有效增强其患肢股四头肌肌力,促使其膝关节功能恢复,减少并发症发生,改善其生活质量。     

基于单中心的乳腺癌合并心房颤动患病率调查

目的:探讨乳腺癌患者的心房颤动(房颤)发生情况.方法:选择2020年7月至2020年12月上海交通大学医学院附属第九人民医院黄浦分院乳腺外科收治的经手术及病理确诊的乳腺癌患者706例,收集患者年龄、房颤病史、高血压病史、糖尿病病史、心衰病史、脑卒中病史等,对房颤患者进行CHADS2评分.结果:706例乳腺癌患者中,合并...