需氧厌氧瓶配对在血与体液病原菌培养中的临床价值

目的探讨需氧和厌氧培养方式的选择对不同种属病原菌检出率、检测时间的影响及常规使用的临床价值。方法使用mini VITAL或BacT/ALERT 3D血培养仪,及VITEK-32自动细菌鉴定仪对1999年1月-2009年12月38 839份血液与体液临床标本需氧和厌氧配对培养的检测结果作回顾性分析。结果 38 839份标本培养阳性7241例占18.64%,共分离出各种细菌56属171种7327株;在需氧和厌氧培养瓶中的阳性检出率差异有统计学意义(2χ=7.14,P<0.01),非发酵菌、微球菌属、真菌、厌氧菌阳性检出率差异有统计学意义(P<0.01),葡萄球菌属、棒杆菌属阳性检出率差异有统计学意义(P<0.05),沙门菌属和棒杆菌属细菌在需氧和厌氧培养两种瓶子的阳性检测速度差异有统计学意义(P<0.01)。结论采用需氧和厌氧瓶配对培养,既解决了培养结果的早期快速问题,又可提高阳性检出率,是一种理想的组合,在临床上有良好的应用价值。     

有氧运动结合耳穴贴压法对医学生失眠干预效果研究

目的寻求一种简便有效方法,为防治医学生失眠提供有效数据和理论支持。方法2007年3月-2009年5月,以随机整群抽样的方法,用匹兹堡睡眠质量指数（PSQI）评价华北煤炭医学院985名学生的睡眠状况,从睡眠差的147人中随机抽取120人为干预对象。随机分为4个组,I组进行有氧运动练习,注重运动强度的控制;11组实施耳穴贴压治疗,坚持按揉次数;Ⅲ组有氧运动练习的同时耳穴贴压治疗;IV组为对照组不予干预。比较不同方法对医学生失眠的干预效果。结果干预4周后,对4个组进行PSQI问卷测试,I、Ⅱ、Ⅲ、Ⅳ组PSQI总分分别为6．83±1．27、6．52±1．28、6．00±1．25、9．17±1．27,I、Ⅱ、Ⅲ组分别与Ⅳ组比较,PSQI总分差异均有统计学意义（P〈0．05或P〈O．001）。Ⅲ组与I组或Ⅱ组比较,PSQI总分、入睡时间、日间功能差异均有统计学意义（P〈O．05）。干预结束3个月后再次对I、Ⅱ、Ⅲ组进行PSQI问卷测试,PSQI各成分与干预结束时的结果相比较,无统计学意义。结论有氧运动结合耳穴贴压的方法,对改善医学生失眠具有较好效果,特别是对入睡时间、日间功能的改善。     

Walking with a rollator and the level of physical intensity in adults 75 years of age or older

OBJECTIVE: To determine whether walking with a rollator by persons 75 years of age or older is of sufficient intensity to improve aerobic fitness. DESIGN: A cross-sectional cohort study. SETTING: University movement laboratory. PARTICIPANTS: Fifteen subjects 75 years of age or older (mean age, 83.7 y) who could only walk by using a rollator. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: During 6 minutes of self-paced treadmill walking using a rollator at a mean walking speed of 0.6 m/s, oxygen uptake (Vo2), carbon dioxide production, and heart rate were determined. Respiratory exchange ratio (RER) and energy expenditure were calculated. The energy expenditure was expressed as the number of metabolic equivalents (METS), the percentage of estimated maximal Vo2 (Vo2max), the percentage of estimated Vo2max reserve, and the percentage of estimated maximal heart rate. RESULTS: Mean Vo2 was .718 L/min. Mean RER was .93 (95% confidence interval [CI], .89-.97). Thirteen participants showed an RER below 1.0, which indicates a negligible contribution of anaerobic expenditure. Walking with a rollator required a mean of 2.8 (95% CI, 2.4-3.2) METS, 71.9% of Vo2max (95% CI, 65.2%-78.6%), 50.5% (95% CI, 39.4%-61.5%) of Vo2 reserve, and 75.2% (95% CI, 67.6%-82.8%) of estimated maximal heart rate. CONCLUSIONS: For people 75 years of age or older, walking with a rollator is an activity of moderate to high level of intensity, with the capacity of improving aerobic fitness.     

Impact of moderate versus mild aerobic exercise training on inflammatory cytokines in obese type 2 diabetic patients: a randomized clinical trial

Background

Recently some plasma biomarkers of inflammation have been recognized as important cardiovascular risk factors. There is little information about the effects of aerobic exercise training on these biomarkers and the risk of metabolic complications in obese type 2 diabetes patients.

Objective

To compare the impact of moderate versus mild aerobic exercise training on the inflammatory cytokines in obese type 2 diabetic patients.

Methods

Fifty obese type 2 diabetic patients of both sexes with body mass index (BMI) varying from 31 to 36 kg/m², non smokers, free from respiratory, kidney, liver, metabolic and neurological disorders, participated in this study. Their age ranged from 40 to 55 years. The subjects were included into two equal groups; the first group (A) received moderate aerobic exercise training. The second group (B) received mild aerobic exercise training, three times / week for 3 months.

Results

The mean values of leptin, TNF- alpha, IL2, IL4, IL6, HOMA-IR and HBA1c were significantly decreased in group (A) and group (B). Also, there were significant differences between both groups after treatment.

Conclusion

Moderate aerobic exercise training modulates inflammatory cytokines more than mild aerobic exercise training in obese type 2 diabetic patients.     

Aerobic cervical bacteriology and antibiotic sensitivity patterns in patients with advanced cervical cancer before and after radiotherapy at a national referral hospital in Uganda

Objective

To determine prevalent aerobic cervical bacteria and sensitivity to commonly used antibiotics in patients with advanced cervical cancer before and after 4 weeks of external beam radiotherapy (EBRT).

Methods

Cervical swabs were collected prior to the initial radiation dose and after 4 weeks of radiotherapy at Mulago Hospital. Aerobic culture was performed on blood agar, chocolate agar, and MacConkey agar, and incubated at 35–37 ° for 24–48 hours. Isolates were identified using colonial morphology, Gram staining, and biochemical analysis. Sensitivity testing was performed via Kirby–Bauer disk diffusion and dilution. Differences in the proportions of bacteria isolated before and after radiotherapy were compared. Paired t test was used to obtain differences in sensitivity before and after radiotherapy.

Results

Normal flora increased significantly after EBRT (P = 0.02). There was no significant change in overall proportion of positive cultures. Sensitivity to commonly used antibiotics improved (P = 0.05) and resistance significantly decreased (P = 0.005). Significant differences were seen mainly with ciprofloxacin, ceftriaxone, and gentamicin.

Conclusion

Four weeks of EBRT did not sterilize the cervix but resulted in an increase in normal flora. Radiotherapy appeared to reduce resistance to commonly used antibiotics. Sensitivity to chloramphenicol was higher than for the more commonly used antibiotics.     

Regional brain activation as a biological marker of affective responsivity to acute exercise: influence of fitness

Previous research has shown that regional brain activation, assessed via frontal electroencephalographic (EEG) asymmetry, predicts affective responsivity to aerobic exercise. To replicate and extend this work, in the present study we examined whether resting brain activation was associated with affective responses to an acute bout of aerobic exercise and the extent to which aerobic fitness mediated this relationship. Participants (high-fit, n = 22; low/moderate-fit, n = 45) ran on a treadmill for 30 min at 75% VO2max. EEG and affect were assessed pre- and 0-, 10-, 20-, and 30-min postexercise. Resting EEG asymmetry predicted positive affect (as measured by the energetic arousal subscale of the Activation Deactivation Adjective Check List) postexercise. Furthermore, resting frontal EEG asymmetry predicted affect only in the high-fit group, suggesting the effect might be mediated by some factor related to fitness. It was also shown that subjects with relatively greater left frontal activation had significantly more energy (i.e., activated pleasant affect) following exercise than subjects with relatively greater right frontal activation. In conclusion, aerobic fitness influenced the relationship between resting frontal asymmetry and exercise-related affective responsivity.     

Energy system contribution in a maximal incremental test: correlations with pacing and overall performance in a 10-km running trial

This study aimed to verify the association between the contribution of energy systems during an incremental exercise test (IET), pacing, and performance during a 10-km running time trial. Thirteen male recreational runners completed an incremental exercise test on a treadmill to determine the respiratory compensation point (RCP), maximal oxygen uptake (V˙O2max), peak treadmill speed (PTS), and energy systems contribution; and a 10-km running time trial (T10-km) to determine endurance performance. The fractions of the aerobic (W_AER) and glycolytic (W_GLYCOL) contributions were calculated for each stage based on the oxygen uptake and the oxygen energy equivalents derived by blood lactate accumulation, respectively. Total metabolic demand (W_TOTAL) was the sum of these two energy systems. Endurance performance during the T10-km was moderately correlated with RCP, V˙O2maxand PTS (P<@0.05), and moderate-to-highly correlated with W_AER, W_GLYCOL, and W_TOTAL (P<0.05). In addition, W_AER, W_GLYCOL, and W_TOTAL were also significantly correlated with running speed in the middle (P<0.01) and final (P<0.01) sections of the T10-km. These findings suggest that the assessment of energy contribution during IET is potentially useful as an alternative variable in the evaluation of endurance runners, especially because of its relationship with specific parts of a long-distance race.     

Comparison of incremental and steady state tests of endurance training

Summary To compare the results obtained by incremental or constant work load exercises in the evaluation of endurance conditionning, a 20-week training programme was performed by 9 healthy human subjects on the bicycle ergometer for 1 h a day, 4 days a week, at 70–80% . Before and at the end of the training programme, (1) the blood lactate response to a progressive incremental exercise (18 W increments every 2nd min until exhaustion) was used to determine the aerobic and anaerobic thresholds (AeT and AnT respectively). On a different day, (2) blood lactate concentrations were measured during two sessions of constant work load exercises of 20 min duration corresponding to the relative intensities of AeT (1st session) and AnT (2nd session) levels obtained before training. A muscle biopsy was obtained from vastus lateralis at the end of these sessions to determine muscle lactate. AeT and AnT, when expressed as % , increased with training by 17% (p<0.01) and 9% (p<0.05) respectively. Constant workload exercise performed at AeT intensity was linked before training (60% ) to a blood lactate steady state (4.8±1.4 mmol·l^–1) whereas, after training, AeT intensity (73% ) led to a blood lactate accumulation of up to 6.6±1.7 mmol·l^–1 without significant modification of muscle lactate (7.6±3.1 and 8.2±2.8 mmol·kg^–1 wet weight respectively). It is concluded that increase in AeT with training may reflect transient changes linked to lower early blood lactate accumulation during incremental exercise. Nevertheless, the results obtained at the end of the constant work load exercises were assumed to be independant of these changes, the occurrence of blood lactate accumulation being postulated to reflect a decreased removal from the blood linked to a higher relative work intensity. So, the use of incremental exercise is an incomplete procedure when evaluating endurance training effects.