针灸治疗慢性非特异性腰痛随机对照试验结局指标的现状研究

背景 针灸是治疗慢性非特异性腰痛(CNSLBP)的重要方法。随着研究的发展,大量针灸治疗CNSLBP的随机对照试验(RCT)已经发表,但由于在结局指标选择方面存在一定的问题,严重限制了高质量临床证据的产生。目的 评价针灸治疗CNSLBP RCT选用的结局指标情况,为针灸治疗CNSLBP相关研究提供参考依据。方法 系统检索4个中文数据库(中国知网、维普网、万方数据知识服务平台、中国生物医学文献服务系统)、3个英文数据库(PubMed、Embase、Cochrane Library)2017-01-01至2022-03-15发布的针灸治疗CNSLBP的文献,以及自建库以来至2022-03-15发表的非特异性腰痛(NSLBP)的核心结局指标集(COS)。对纳入的针灸治疗CNSLBP的文献基本特征进行分析,对文献的临床结局指标进行归类,对文献中的结局指标及《中医病证诊断疗效标准》的应用现状进行分析。分析NSLBP研究的COS现状,比较其与现有针灸治疗CNSLBP文献结局指标的异同。结果 本研究纳入的针灸治疗CNSLBP的49篇文献均为RCT,共包含4篇英文文献和45篇中文文献。共包含4 272...     

脂质比值与代谢综合征的关联及预测价值评价：基于多阶段横断面研究

背景 随着代谢性疾病发病率的上升,代谢综合征(MS)的预防与控制引起广泛的关注。而脂质比值是重要的筛查指标之一,与MS之间的关系成为热点研究话题。目的 基于贵州省多阶段横断面研究人群分析三酰甘油/高密度脂蛋白胆固醇(TG/HDL-C)、总胆固醇/HDL-C(TC/HDL-C)、低密度脂蛋白胆固醇/HDL-C(LDL-C/HDL-C)及非高密度脂蛋白胆固醇(non-HDL-C)与MS发病风险的关联及预测价值评价。方法 回顾性选取贵州省参与2010年全国疾病监测地区慢性病及危险因素调查、2013年中国慢性病及其危险因素监测、2015年中国成人慢性病与营养监测和2018年中国成人慢性病与营养监测的21 727例自然人群为研究对象,收集研究对象的基线资料,根据是否患有MS将研究对象分为MS组(n=4 981)和非MS组(n=16 746)。绘制受试者工作特征曲线(ROC曲线)分别评价男性和女性TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和non-HDL-C对MS的预测价值。通过Delong检验比较脂质比值预测MS发生的ROC曲线下面积(AUC)的差异。采用多因素Logistic回...     

Dietary factors and progression of diabetic nephropathy

The role of dietary factors in patients with type 1 (insulin-dependent) diabetes is reviewed by examining three different aspects: the effect of an acute protein load, the effect of dietary protein restriction on the progression of nephropathy and the metabolic effects of low-protein diets. After an acute protein load some impairment of the renal functional reserve may be observed only in patients with type 1 diabetes and overt nephropathy. However, the renal functional reserve is not able to give useful indications of the extent of renal damage and the prognosis of the disease. Both short-term and long-term dietary protein restriction are followed by a significant decrease in glomerular filtration rate (GFR) and albuminuria in type 1 diabetics with incipient nephropathy. In patients with overt nephropathy the long-term administration of a low-protein diet is followed by significant reductions in the rate of decline of GFR and in urinary protein excretion only when started at GFR values higher than 45 ml/min. The rate of functional deterioration when dietary treatment is prescribed seems critical in modulating the effects of a low-protein diet. In addition, low-protein diets may exert important metabolic and clinical effects beyond their supposed effect on progression. Clearly, an adequate dietary regimen is only part of the medical treatment in patients with diabetic nephropathy.     

Real-time nested multiplex PCR for the detection of herpes simplex virus types 1 and 2 and varicella zoster virus

One hundred forty-nine specimens were tested in a LightCycler nested multiplex polymerase chain reaction (LCnmPCR) for Herpes simplex virus (HSV)1, HSV2, and VZV. Eighty-one were from genitourinary medicine (GUM) patients and the other 68 specimens were from other patients with skin lesions. The results were compared to a conventional multiplex nested PCR (nmPCR) using agarose gel electrophoresis. Twenty-five specimens were positive in both assays for HSV1 and 29 were positive for VZV. For HSV2 there were 27 positive in the LCnmPCR and 26 positive in the nmPCR assay. The melting temperatures (Tms) of each target were different with a mean of 84.75 degrees C for HSV1, 88.57 degrees C for HSV2, and 83.62 degrees C for VZV. The melting curves of positive specimens directly overlaid the melting curves of the positive controls in the assay. The LCnmPCR assay is a convenient alternative to conventional PCR using agarose gel electrophoresis. It improves specimen turnaround time by eliminating the need for gel electrophoresis, transillumination, and gel photography. It also shows increased sensitivity for HSV2 over our standard assay. This LCnmPCR reduces further the possibility of amplicon contamination with nested PCR protocols.     

Effects of estrus cycle on thermoregulatory responses during exercise in rats

Summary In female rats, rectal temperature (T _re), tail vasomotor response, oxygen uptake , and carbon dioxide production were measured in proestrus and estrus stages during treadmill running at two different speeds at an ambient temperature (T _a) of 24° C. Experiments were performed at 2.00–6.00 a.m., when the difference inT _re was greatest between the two stages;T _re at rest in the estrus stage was 0.54° C higher than in the proestrus stage. In a mild warm environment, thresholdT _re for a rise in tail skin temperature (T _tail) was also higher in the estrus stage than in the proestrus stage. In contrast, no difference was seen in the thresholdT _re and steady stateT _re at the end of exercise between proestrus and estrus stages. These values were higher at the higher work intensity. was also similar between the two stages, except in the second 5 min after the beginning of exercise, when was greater andT _re rose more steeply in the proestrus stage. These data indicate that deep body temperature during exercise is regulated at a certain level depending on the work intensity and is not influenced by the estrus cycle.This study was supported in part by a Grant-in Aid for Scientific Research from the Ministry of Education, Science and Culture of Japan (Grant No. 62480114)     

Prediction of mean skin temperature in warm environments

Summary The data collected by the authors in four experimental series have been analysed together with data from the literature, to study the relationship between mean skin temperature and climatic parameters, subject metabolic rate and clothing insulation. The subjects involved in the various studies were young male subjects, unacclimatized to heat. The range of conditions examined involved mean skin temperatures between 33‡ C and 38‡ C, air temperatures (T_a) between 23‡ C and 50‡ C, ambient water vapour pressures (P_a) between 1 and 4.8 kPa, air velocities (V_a) between 0.2 and 0.9 m · s⁻¹, metabolic rates (M) between 50 and 270 W · m⁻², and Clo values between 0.1 and 0.6. In 95% of the data, mean radiant temperature was within ±3‡ C of air temperature. Based on 190 data averaged over individual values, the following equation was derived by a multiple linear regression technique: ˉT_sk=30.0+0.138T_a+0.254P_a−0.57V_a+1.28 · 10⁻³ M−0.553 Clo. This equation was used to predict mean skin temperature from 629 individual data. The difference between observed and predicted values was within ±0.6‡ C in 70% of the cases and within ±1‡ C in 90% of the cases. It is concluded that the proposed formula may be used to predict mean skin temperature with satisfactory accuracy in nude to lightly clad subjects exposed to warm ambient conditions with no significant radiant heat load.     

Intraperitoneal injection of cholecystokinin elicits sleep in rabbits

Cholecystokinin (CCK) reduces food intake and promotes non-rapid-eye-movement sleep (NREMS) in rats. The purpose of present experiments was to determine if CCK is somnogenic in rabbits; another species in which CCK suppresses feeding. White New Zealand rabbits were treated intracerebroventricularly (ICV; 0.05, 0.5 and 2 μg) or intraperitoneally (IP; 2.5, 10 and 40 μg/kg) with CCK or saline, and sleep-wake activity and brain temperature (T_br) were recorded for 6 h. Injections of 10 and 40 μg/kg CCK IP elicited a decrease in wakefulness and an increase in NREMS during the first hour postinjection. The hypnogenic effects were accompanied by a decrease in T_br. After the IP injection of a lower dose (2.5 μg/kg) a slight, nonsignificant increase in NREMS during the first hour postinjection was followed by a decrease in NREMS. ICV injections of CCK had relatively small inhibitory effects on sleep. We conclude that circulating, hormone CCK might be a hypnogenic signal with a peripheral site of action.     

Pattern of spatial distribution inDrosophila melanogaster

The effect of temperature and sex on spatial distribution ofDrosophila melanogaster adults was studied in a specially designed apparatus. It was observed that individuals tend to aggregate in sections of the sphere independently of sex and temperature. Nevertheless, decrease in temperature increase aggregation. The mobility of both males and females indicates a megative geotactic tendency.     

Back extensor muscle oxygenation and fatigability in healthy subjects and low back pain patients during dynamic back extension exertion

The purpose of this study was to assess if chronic low back pain patients have impaired paraspinal muscle O₂ turnover and endurance capacity as compared to healthy control subjects during dynamic exercise. Middle-aged healthy male subjects (n = 12, control) and male patients with chronic low back pain (n = 17, CLBP) participated in the study. L4–L5 level paraspinal muscle fatigue was objectively assessed during earlier validated 90 s dynamic back endurance test (spectral EMG, MPF_slope). Also EMG amplitude (EMG_amplitude) and initial MPF (MPF_initial) were assessed from the initial 5 s of the endurance contraction. Simultaneously near infrared spectroscopy (NIRS) was used for quantitative measurement of local L4–L5 paraspinal muscle O₂ consumption. Subcutaneous tissue thickness (ATT) was measured from the EMG and NIRS recording sites. The results indicated that control and CLBP groups were compatible as regarding anthropometric variables, paraspinal muscle activation levels (EMG_amplitude), initial MPF (MPF_initial) and ATT. When the ATT was used as a covariate in the ANOVA analysis, CLBP group did not show significantly greater paraspinal muscle fatigability (right MPF_slope – 12.2 ± 10.7%/min, left right MPF_slope – 12.6 ± 13.3%/min) or O₂ consumption (right NIRS_slope – 52.8 ± 79.6 μM/l/s) as compared to healthy controls (right MPF_slope – 11.9 ± 7.6%/min, left MPF_slope – 12.7 ± 8.6%/min, right NIRS_slope – 53.7 ± 95.2 μM/l/s). As a conclusion, these CLBP male patients did not show any impaired rate of paraspinal muscle oxygen consumption or excessive paraspinal muscle fatigability during dynamic exercise as compared with healthy controls. Subcutaneous tissue thickness has a strong influence on the NIRS and EMG amplitude measurements and, if unchecked, it could result in the false interpretation of the results.     

Inhibition of tumor necrosis factor in the brain suppresses rabbit sleep

Tumor necrosis factor (TNF) is a cytokine that possesses many biological activities, including enhancement of non-rapid-eye-movement sleep (NREMS). The role of endogenous TNF in the regulation of spontaneous sleep is unknown. If TNF is involved in sleep regulation, then reduction of endogenous TNF should suppress spontaneous sleep. A soluble TNF-binding protein I (TNF-BP I) and a synthetic fragment of TNF-BP I, TNF-R-(159–178), that contains the biologically active region of TNF-BP I, were used. These substances bind TNF and possess TNF-inhibitory activity; their effects on rabbit sleep after intracerebroventricular injection were determined across a 6-h recording period. Two doses of TNF-BP I (0.05 g and 0.5 g) were administered; the higher dose of TNF-BP I significantly decreased NREMS. Four doses of TNF-R-(159–178) (0.25 g, 2.5 g, 25 g and 50 g) were used. The 25 g and 50 g doses significantly suppressed NREMS. The highest dose (50 g) also decreased REM sleep. These results are consistent with the hypothesis that endogenous brain TNF is involved in the regulation of normal sleep.