Shod versus unshod: The emergence of forefoot pathology in modern humans?

BackgroundPathologies of the metatarsal bones in contemporary humans are common yet it remains unclear from an evolutionary perspective to what extent, if any, footwear and other environmental factors such as modern substrates have contributed to the emergence of common metatarsal pathological changes.ObjectivesTo investigate the frequency of metatarsal bone pathologies in contemporary and habitually unshod pre-historic people in order to ascertain whether these frequencies are affected by variation in habitual behaviour, the wearing of footwear and/or exposure to modern substrates.MethodThe metatarsal elements from four human groups were examined for pathological variation. Three of these skeletal samples were from recent rural and urban shod populations (Sotho, Zulu and European) and one from habitually unshod pre-pastoral Holocene people who practiced a subsistence hunter gatherer lifestyle.ResultsThe trends in the dominance of pathological lesions between the five metatarsal bones were broadly similar in all four samples. In all groups the first metatarsal presented with the greatest number of pathological lesions; more specifically, at the first metatarsal head. The Sotho and European groups presented with notably greater frequencies of pathological changes followed by the Zulu group and then the pre-pastoral.ConclusionsThe pathological lesions found in the metatarsals of the three recent human groups generally appeared to be more severe than those found in the pre-pastoral group. This result may support the hypothesis that pathological variation in the metatarsus was affected by habitual behaviour including the wearing of footwear and exposure to modern substrates.     

个体化护理干预对习惯性流产者社会支持水平及负性情感状态的影响

目的 探究个体化护理干预应用于习惯性流产者对其社会支持水平及负性情感状态的影响.方法 选取该科收治的习惯性流产者156例作为研究对象,根据时间的不同分为两组:其中对照组为2015年1~6月期间采取常规护理的习惯性流产者78例;研究组为2015年7~12月期间在对照组基础上引入个体化护理干预后的习惯性流产者78例,两组患者均于来院当天及术后一周接受焦虑自评量表(SAS)、抑郁自评量表(SDS)及社会支持测评.结果 两组干预前的SAS和SDS评分无统计学差异(P>0.05);干预后,研究组SAS和SDS评分均低于对照组(均P<0.05).两组患者于干预前的主观支持、客观支持及社会支持评分无统计学差异(P>0.05);干预后,研究组患者于干预后的主观、客观及社会支持评分高于对照组,差异有统计学意义(P<0.05).结论 个体化护理干预应用于习惯性流产者,能有效提高其社会支持水平,亦能改善其负性情感状况,值得在临床上进一步推广.     

Meta analysis for insomnia Guizhi Gancao Longgu Muli decoction for insomnia A meta-analysis

BackgroundGuizhi Gancao Longgu Muli Decoction can make a good effect on the insomnia under the catalogue of traditional Chinese medicine.MethodTo search the databases:Pubmed, Web of Science, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), the China Biology Medicine disc (CBMdisc), the China Science and Technology Journal Database (VIP), the Wanfang.ResultsFifteen randomized controlled trials were included, totally including 1164 participants. After summarizing the observational index revised according to the “Guiding Principles for Clinical Research of New Chinese Medicines”, we found that the curative effect of the trial group is 2.29 times that of the control group in the fixed effect model which had a statistically significant difference [OR = 2.293681, 95%CI = 0.3266112–5.83]. And the Pittsburgh Sleep Quality Index (PSQI) which had 7 different dimensions, including subjective sleep quality[p = 0.001 < 0.05], sleep latency, sleep duration[p = 0.000 < 0.05], habitual SE[p = 0.000 < 0.05], sleep disorders[p = 0.002 < 0.05], use of sleep medications[p = 0.000 < 0.05], and daytime dysfunction[p = 0.000 < 0.05], showed a higher scores in the trial group than the one in the control group in every dimension. The final results of the total scores in PSQI also showed a higher scores in trial group with a p = 0.000 < 0.05 (Test of WMD), suggest a statistically significant difference. While the adverse effects showed a lower rate in the trial group than the one in the control group under a fixed-effect model, with a p = 0.000 < 0.05, indicate a statistically significant difference.ConclusionThe efficacy and safety of GGLMD in the trial groups are better than the modern western medicine in the control groups.     

Habitual physical activity score as a predictor of the 6-min walk test distance in healthy adults

BackgroundThe 6-min walk test (6MWT) is a simple, inexpensive test of functional exercise capacity. The 6MWT distance (6MWD) in healthy adults varies geographically, emphasizing the need for population-specific reference equations. The purpose of the present study was to investigate the influences of the habitual physical activity (HPA) score and other anthropometric and demographic parameters on the variability of the 6MWD among healthy adults and to propose a reference equation.MethodsThis was a prospective, cross-sectional, observational study. The 6MWT was conducted in a 30-m hospital corridor on 201 healthy volunteers, 125 men and 76 women, aged 20–60 years. The HPA in the previous 6 months was assessed using Baecke's questionnaire. Univariate analysis followed by multiple regression analysis was performed to analyze the significance levels of different probable predictors.ResultsThe 6MWD was significantly greater in more active than in less active subjects (663.8±55.4 m vs. 599.9±67.8 m, p<0.001). The regression analysis showed that the subject's age in years (p=0.017), gender (p=0.006), height in cm (p=0.004), weight in kg (p<0.001), total activity score (TS) (p<0.001), and absolute difference in heart rate before and after exercise (p<0.001) could explain 48.9% of the variability in the 6MWD in healthy adults.ConclusionsThe HPA score is probably the most appropriate variable to include in the reference equation predicting the 6MWD in healthy adults from the Indian subcontinent.