肿瘤多药耐药机制的研究进展

多药耐药 (Multi drugresistance ,MDR)是肿瘤化疗失败的主要原因之一。从药物转运、药物代谢、药物靶、细胞凋亡及凋亡相关基因 4个方面 ,全面复习近年来有关MDR的机制 ,为肿瘤临床化疗及临床MDR研究提供重要的理论依据     

Are voice endurance tests able to assess vocal fatigue?

Voice endurance tests are often used to evaluate vocal fatigue or to test the suitability of an individual for voice demands. It is assumed that these tests help to identify subjects with laryngeal or vocal fatigue out of a population of persons with complaints of discomfort in the throat, recurrent hoarseness and decreased voice power. In this study we evaluated the Voice Interval Test with respect to its discriminative power by comparison of voice performances in 20 patients with a history of vocal fatigue with that in 12 healthy subjects. Voice performance was studied during the Voice Interval Test as well as during regular use of the voice on a working day by electroglottography (EGG), acoustic analysis and a self-rating scale for pain and fatigue. Despite the number of tests the data did not reveal any significant difference between the patients and the healthy subjects. Voice fatigue could therefore not be identified and the clinical relevance of the Voice Interval Test appears to be questionable.     

Substance use and misuse in a mountain ultramarathon: new insight into ultrarunners population?

Endurance and ultra-endurance events have become increasingly popular. The aim of our study was to explore the use of medication among endurance runners participating in the 2014 Infernal Trail des Vosges. Among the 389 runners engaged, 297 (76.3%) completed a specific questionnaire dealing with substance use/misuse. Our results show a 27% (before the race) and 18% (during the race) prevalence of substance use. The two major classes of substances used were non-steroidal anti-inflammatory drugs (NSAIDs; 9.8%) and painkillers (6.7%), principally because of osteo-articular pain (29.6%) or to prevent pain (28.2%). A positive correlation was found between substance consumption before (past month) and during the race (overall medication: p < 0.0001; NSAIDs: p = 0.008). Our results could be explained by the specific characteristics of ultrarunners predominantly motivated by personal achievement and general health (recreational approach). However, education interventions should further be delivered regarding the risks of substance use in ultra-endurance events.     

中国10～17岁中小学生耐力素质影响因素分析

目的 探讨中国10～ 17岁中小学生耐力素质的影响因素.方法 利用2010年中国学生体质与健康调研数据,选取资料完整的10 ～ 17岁中小学生为研究对象,共68 458名,将耐力跑测试时间≤同年龄、同性别第25位百分数(P25)时间值确定为耐力素质好,耐力跑测试时间≥同年龄、同性别P75时间值确定为耐力素质差.比较不同耐力素质者,耐力跑时间的差异,同时,采用x2检验、logistic回归及多水平模型分析城乡、BMI、饮食、运动、锻炼意愿等因素对耐力素质的影响.结果 68 458名研究对象中,耐力素质好者有34 239名(50.0％),耐力素质差者有34 219名(50.0％).耐力素质好者的比例,乡村学生为53.8％(18 285/33 996),高于城市学生的46.3％(15 954/34 462)(x2=384.16,P＜0.01)；肥胖学生为12.2％(448/3660),低于BMI正常[55.2％(28 183/51 028)]、超重[29.3％ (2012/6874)]和消瘦的学生[52.1％ (3596/6896)],差异有统计学意义(x2=3840.08,P＜0.01).；每天吃早餐的学生为52.5％(25 534/48 679),高于从来不吃或每周吃1～2次早餐的学生[41.3％(3209/7768)](x2=438.31,P＜0.01)；每天喝牛奶的学生为51.7％(11 580/22 379),高于从来不喝或有时喝牛奶的学生[49.2％(22 659/46 079)](x2=39.84,P＜0.01)；体育课充足的学生为55.3％(18 961/34 314),高于体育课不足的学生[44.7％(15 278/34 144)] (x2 =756.41,P＜0.01)；每天体育锻炼lh及以上的学生占58.6％ (9484/16 195),高于锻炼lh以下学生[47.4％ (24 755/52 263)](x2=619.82,P＜0.0l)；愿意参加长跑锻炼学生占60.1％(19 287/32 118),高于意愿为“一般”[45.4％(10 569/23 272)]和“不愿意”[33.5％(4383/13068)]学生(x2 =2909.61,P＜0.01).多水平分析显示,耐力素质差的风险,乡村学生低于城市学生(OR=0.80,95％CI:0.77～0.82)；消瘦(OR=1.11,95％CI:1.05～1.17)、超重(OR =2.69,95％CI:2.55～2.85)及肥胖(OR =7.71,95％ CI:6.97 ～8.52)学生高于BMI正常的学生；从不吃早餐或每周吃1～2次早餐(OR=1.20,95％CI:1.13 ～ 1.26)、每周吃3～5次早餐的学生(OR=1.13,95％ CI:1.08～1.18)高于每天吃早餐的学生；每天喝l袋牛奶的学生(OR=1.09,95％CI:1.02～1.17)高于每天喝2袋牛奶的学生；体育课不足的学生(OR=1.20,95％CI:1.16～ 1.24)高于体育课充足的学生；每天体育锻炼不足lh的学生(OR=1.34,95％CI:1.29 ～ 1.40)高于每天锻炼lh及以上的学生；长跑锻炼意愿为“一般”(OR=1.67,95％CI:1.61～ 1.73)和“不愿意”的学生(OR =2.72,95％ CI:2.60 ～2.85)高于“愿意”的学生.结论 城乡居住差异、BMI、吃早餐、喝牛奶、体育课、运动时间及锻炼意愿与中小学生耐力素质相关.     

Sport science applied to basketball refereeing: a narrative review

ABSTRACT

Objectives: The present review provides a summary of basketball referees’ game activities, fitness assessment, cognitive function, and energy expenditure (EE) during official games.

Methods: Analyzing the literature on basketball referees. Literature review conducted using Pub Med, WOK, SCOPUS, and Google Scholar, with search criteria including the terms ‘referees’, ‘game officials’, ‘basketball’ and performance terms such as ‘physiological’, ‘physical demands’, ‘decision-making’, and ‘mental fatigue’.

Results: the relevant studies (n = 19) showed that referees cover ~5000 m during a game with mean heart rates (HR) of ~140 beats.min^?1 (>75% HR_max) and oxygen uptake (VO₂) of ~52 ml.min^?1.kg^?1 (~86.19% VO₂max). The YO-YO intermittent recovery test level 1 (YO-YO-IRT1) performance has revealed a direct validity to assess the intermittent aerobic activity as it was correlated to the on-field activity of the referees. The estimated referees' EE during a game exceeds 500 kcal (~5 kcal.kg-1.h^?1). The threshold of low intensity and high intensity could be considered as lower than 3.8 METs and higher than 9.8 METs, respectively. The physical abilities of referees decrease gradually with the chronological age. However, older referees (>32 years old) have a significantly better quality of officiating than young referees. The perceptual-cognitive demands of basketball refereeing are also discussed in the present review.

Conclusion: Basketball referees’ game-analysis showed an intermittent activity (~1:12 ratio of high-intensity effort/recovery). The YO-YO-IRT1 could be used as a specific fitness test to estimate their aerobic capacity. The referees’ EE showed a “moderate energy intensity“ when expressed by the metabolic equivalent (~5 METs). A specific training program should be prescribed for the referees, taking into consideration their age. The cognitive processes influencing basketball referees’ decisions should be studied in further researches.     

Inspiratory Muscle Training Potentiates the Beneficial Effects of Proportional Assisted Ventilation on Exertional Dyspnea and Exercise Tolerance in COPD: A Proof-of-Concept Randomized and Controlled Trial

Abstract

During pulmonary rehabilitation, a subset of subjects with COPD requires adjunct therapy to achieve high-intensity training. Both noninvasive ventilation (NIV) and inspiratory muscle training (IMT) are available to assist these subjects. We aimed to prime the respiratory muscles before NIV with IMT, anticipating additive effects for maximal exercise tolerance (T _lim) and dyspnea/leg fatigue relief throughout the exercise as primary outcomes. Changes in the respiratory pattern were secondary outcomes. COPD subjects performed a total of four identical constant work rate tests on a cycle ergometer at 75% of maximum work rate, under control ventilation (SHAM, 4?cm H₂O) or proportional assisted ventilation (PAV, individually adjusted), before and after 10 sessions of high-intensity IMT (three times/week) during 30?days. Two-way RM ANOVA with appropriate corrections were performed. Final analysis in nine subjects showed improved T _lim (Δ = 111?s) and lower minute-ventilation (Δ = 4?L^.min^?1) at exhaustion, when comparing the IMT effects within the PAV modality (p?=?0.001 and p?=?0.036, respectively) and improved T _lim for PAV vs. SHAM (PAV main-effect, p?=?0.001; IMT main-effect, p?=?0.006; PAV vs. IMT interaction, p?=?0.034). In addition, IMT?+?PAV association, compared to PAV alone, resulted in lower respiratory frequency (IMT main-effect, p?=?0.009; time main-effect, p?<?0.0001; IMT vs. time interaction, p?=?0.242) and lower inspiratory time related to duty cycle (IMT main-effect, p?=?0.018; time main-effect, p?=?0.0001; IMT vs. time interaction, p?=?0.004) throughout exercise. The addition of IMT prior to a PAV-supported aerobic bout potentiates exercise tolerance and dyspnea relief and induces favourable changes in ventilatory pattern in severe COPD during high-intensity training (Brazilian Registry of Clinical Trials, number RBR-6n3dzz).     

Effects of yoga practice on muscular endurance in young women

The aim of this study was to verify the effects of a systematized yoga practice on muscular endurance in young women. Twenty six women (24 ± 3.5 years old) participated in six weeks of yoga classes, and twenty one women (25 ± 5.1 years old) participated as the control group. The yoga intervention was composed of eighteen sessions, three times per week, at 1 h per session. The muscular endurance of upper limbs (push-up) and abdominal (sit-up) was assessed through the protocol suggested by Gettman (1989) [1] and Golding, Myers and Sinning (1989) [2] to the maximum repetitions performed in 1 min. To verify the significant differences intra groups and between groups a SPANOVA was performed, and the level of significance was p ≤ 0.05. The findings suggest that yoga provides improvement in upper limb and in abdominal muscular endurance.     

Comparison of metabolic adaptations between endurance‐ and sprint‐trained athletes after an exhaustive exercise in two different calf muscles using a multi‐slice 31P‐MR spectroscopic sequence

Measurements of exercise‐induced metabolic changes, such as oxygen consumption, carbon dioxide exhalation or lactate concentration, are important indicators for assessing the current performance level of athletes in training science. With exercise‐limiting metabolic processes occurring in loaded muscles, ³¹P‐MRS represents a particularly powerful modality to identify and analyze corresponding training‐induced alterations. Against this background, the current study aimed to analyze metabolic adaptations after an exhaustive exercise in two calf muscles (m. soleus – SOL – and m. gastrocnemius medialis – GM) of sprinters and endurance athletes by using localized dynamic ³¹P‐MRS. In addition, the respiratory parameters VO₂ and VCO₂, as well as blood lactate concentrations, were monitored simultaneously to assess the effects of local metabolic adjustments in the loaded muscles on global physiological parameters. Besides noting obvious differences between the SOL and the GM muscles, we were also able to identify distinct physiological strategies in dealing with the exhaustive exercise by recruiting two athlete groups with opposing metabolic profiles. Endurance athletes tended to use the aerobic pathway in the metabolism of glucose, whereas sprinters produced a significantly higher peak concentration of lactate. These global findings go along with locally measured differences, especially in the main performer GM, with sprinters revealing a higher degree of acidification at the end of exercise (pH 6.29 ± 0.20 vs. 6.57 ± 0.21). Endurance athletes were able to partially recover their PCr stores during the exhaustive exercise and seemed to distribute their metabolic activity more consistently over both investigated muscles. In contrast, sprinters mainly stressed Type II muscle fibers, which corresponds more to their training orientation preferring the glycolytic energy supply pathway. In conclusion, we were able to analyze the relation between specific local metabolic processes in loaded muscles and typical global adaptation parameters, conventionally used to monitor the training status of athletes, in two cohorts with different sports orientations.     

FINDING THE POSSIBLE IN THE IMPOSSIBLE: THE CLINICAL AND THEORETICAL WORK OF NINA FARHI

In a psychoanalytic career spanning three decades, Nina Farhi (1943–2009) worked primarily with people who had survived near impossible emotional and psychological circumstances. In a series of clinical papers, she theorized the ways in which her patients had managed to preserve embryonic self‐states against all odds and the arduous, imaginative and resourceful psychoanalytic work required to transform these vestiges of survival into creative living. This paper traces the evolution of Farhi's clinical thought, from her surprising and fresh uses of particular concepts of Winnicott's to her original re‐working of some of Marion Milner's foundational insights. It explores the ways in which Farhi's clinical practice was original and the clinical and theoretical legacy she leaves.