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Objectives

Short successive periods of skeletal muscle disuse have been suggested to substantially contribute to the observed loss of skeletal muscle mass over the life span. Hospitalization of older individuals due to acute illness, injury, or major surgery generally results in a mean hospital stay of 5 to 7 days, during which the level of physical activity is strongly reduced. We hypothesized that hospitalization following elective total hip arthroplasty is accompanied by substantial leg muscle atrophy in older men and women.

Design and participants

Twenty-six older patients (75 ± 1 years) undergoing elective total hip arthroplasty participated in this observational study.

Measurements

On hospital admission and on the day of discharge, computed tomographic (CT) scans were performed to assess muscle cross-sectional area (CSA) of both legs. During surgery and on the day of hospital discharge, a skeletal muscle biopsy was taken from the m. vastus lateralis of the operated leg to assess muscle fiber type–specific CSA.

Results

An average of 5.6 ± 0.3 days of hospitalization resulted in a significant decline in quadriceps (?3.4% ± 1.0%) and thigh muscle CSA (?4.2% ± 1.1%) in the nonoperated leg (P < .05). Edema resulted in a 10.3% ± 1.7% increase in leg CSA in the operated leg (P < .05). At hospital admission, muscle fiber CSA was smaller in the type II vs type I fibers (3326 ± 253 μm2 vs 4075 ± 279 μm2, respectively; P < .05). During hospitalization, type I and II muscle fiber CSA tended to increase, likely due to edema in the operated leg (P = .10).

Conclusions

Six days of hospitalization following elective total hip arthroplasty leads to substantial leg muscle atrophy in older patients. Effective intervention strategies are warranted to prevent the loss of muscle mass induced by short periods of muscle disuse during hospitalization.  相似文献   
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ABSTRACT

Abortion is legal in South Africa, but negative abortion attitudes remain common and are poorly understood. We used nationally representative South African Social Attitudes Survey data to analyze abortion attitudes in the case of fetal anomaly and in the case of poverty from 2007 to 2016 (n = 20,711; ages = 16+). We measured correlations between abortion attitudes and these important predictors: religiosity, attitudes about premarital sex, attitudes about preferential hiring and promotion of women, and attitudes toward family gender roles. Abortion acceptability for poverty increased over time (b = 0.05, p < .001), but not for fetal anomaly (b = ?0.008, p = .284). Highly religious South Africans reported lower abortion acceptability in both cases (Odds Ratio (OR)anomaly = 0.85, p = .015; ORpoverty = 0.84, p = .02). Premarital sex acceptability strongly and positively predicted abortion acceptability (ORanomaly = 2.63, p < .001; ORpoverty = 2.46, p < .001). Attitudes about preferential hiring and promotion of women were not associated with abortion attitudes, but favorable attitudes about working mothers were positively associated with abortion acceptability for fetal anomaly ((ORanomaly = 1.09, p = .01; ORpoverty = 1.02, p = .641)). Results suggest negative abortion attitudes remain common in South Africa and are closely tied to religiosity, traditional ideologies about sexuality, and gender role expectations about motherhood.  相似文献   
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Abstract

Background

Comorbidities are commonly seen in patients with coronavirus disease 2019 (COVID-19), but the clinical implication is not yet well-delineated. We aim to characterize the prevalence and clinical implications of comorbidities in patients with COVID-19.  相似文献   
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目的 探讨类风湿关节炎患者外周血miR-150-5p、细胞因子信号抑制因子1(suppressor of cytokine signaling 1,SOCS1)mRNA的表达及对类风湿关节炎(Rheumatoid Arthritis,RA)疾病诊断、中医证型判断的意义。方法 纳入符合诊断标准的RA患者57例及健康对照组19例,根据《22个专业95个病种中医诊疗方案》有关RA的中医证候诊断标准,判断RA的中医证型。qPCR检测RA患者及健康对照组miR-150-5p、SOCS1mRNA的相对表达水平,同时检测血常规、肝功能、肾功能等常规指标。双荧光素酶分析方法判断两者是否存在靶向关系。统计分析miR-150-5p、SOCS1 mRNA对RA疾病的诊断意义及其与中医证型的相关性。结果 RA患者外周血miR-150-5p的相对表达水平下调,低于正常人群(t = -19.019,P < 0.05);其表达水平随疾病活动度升高,有下降趋势;患者外周血SOCS1 mRNA的相对表达水平上调,低于正常人群(t = 5.333,P < 0.05);其表达水平随疾病活动度升高,有上升趋势。MiR-150-5p与SOCS1 mRNA有靶向结合关系(P < 0.05)。通过AUC曲线比较,miR-150-5p的相对表达水平区分RA的敏感性及特异性分别为98.1%、92.1%(AUC = 0.972,P < 0.05);SOCS1 mRNA的相对表达水平无法区分RA(AUC = 0.472,P > 0.05)。RA患者中miR-150-5p的相对表达水平低于3.06,RA患者风湿痹阻证、寒湿痹阻证的相对风险分别为8.33、250.00(P < 0.05)。结论 miR-150-5p、SOCS1 mRNA在RA患者中有差异性表达,且有靶向结合关系。miR-150-5p可能是RA的疾病诊断及中医风湿痹阻证、寒湿痹阻证证型诊断的潜在生物标志物。  相似文献   
68.
目的探讨自血穴位注射疗法联合马来酸茚达特罗治疗老年稳定期慢性阻塞性肺疾病(COPD)的临床疗效及其对患者炎性因子、免疫功能及肺功能的影响。 方法将2015年5月至2016年5月我院收治的86例老年缓解期COPD患者分为观察组与对照组。对照组给予马来酸茚达特罗治疗,观察组在对照组治疗基础上另给予自血穴位注射疗法。治疗12周后,评价2组临床疗效。治疗前及治疗12周后,分别检测2组患者肺功能指标(FEV1、FVC与PEF),炎性因子(IL-8、α1-AT、IL-6及TNF-α),免疫功能指标(IgG、IgA、CD3及CD4)水平。治疗期间,对2组患者的不良反应进行密切观察。 结果治疗后二组患者各项检测指标均优于治疗前。治疗12周后,观察组总有效率为90.7%,明显高于对照组的72.1%(P<0.05)。治疗12周后,观察组FEV1、FVC与PEF等肺功能指标,IgG、IgA、CD3及CD4等免疫功能指标水平均明显高于对照组(P<0.05),而IL-8、α1-AT、IL-6及TNF-α含量分别为(23.23±3.87)ng/L、(3.43±0.41)g/L、(52.25±5.38)ng/L及(43.12±3.98)ng/L,改善程度均明显优于对照组(P<0.05)。治疗期间,2组患者均未出现严重不良反应。 结论自血穴位注射疗法联合马来酸茚达特罗治疗老年稳定期COPD疗效确切,可有效改善患者炎症水平,值得进行深入研究。  相似文献   
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Ferroptosis is an iron-dependent novel cell death pathway. Deferoxamine, a ferroptosis inhibitor, has been reported to promote spinal cord injury repair. It has yet to be clarified whether ferroptosis inhibition represents the mechanism of action of Deferoxamine on spinal cord injury recovery. A rat model of Deferoxamine at thoracic 10 segment was established using a modified Allen's method. Ninety 8-week-old female Wistar rats were used. Rats in the Deferoxamine group were intraperitoneally injected with 100 mg/kg Deferoxamine 30 minutes before injury. Simultaneously, the Sham and Deferoxamine groups served as controls. Drug administration was conducted for 7 consecutive days. The results were as follows:(1) Electron microscopy revealed shrunken mitochondria in the spinal cord injury group.(2) The Basso, Beattie and Bresnahan locomotor rating score showed that recovery of the hindlimb was remarkably better in the Deferoxamine group than in the spinal cord injury group.(3) The iron concentration was lower in the Deferoxamine group than in the spinal cord injury group after injury.(4) Western blot assay revealed that, compared with the spinal cord injury group, GPX4, xCT, and glutathione expression was markedly increased in the Deferoxamine group.(5) Real-time polymerase chain reaction revealed that, compared with the Deferoxamine group, mRNA levels of ferroptosis-related genes Acyl-CoA synthetase family member 2(ACSF2) and iron-responsive element-binding protein 2(IREB2) were up-regulated in the Deferoxamine group.(6) Deferoxamine increased survival of neurons and inhibited gliosis. These findings confirm that Deferoxamine can repair spinal cord injury by inhibiting ferroptosis. Targeting ferroptosis is therefore a promising therapeutic approach for spinal cord injury.  相似文献   
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