医疗用超硬质热塑性聚氨酯TPU的抗肿瘤药物溶剂耐受性研究

研究四种类型热塑性聚合物的6种常见医用输液接头材料对抗肿瘤药物溶剂的耐受性。将这些材料的标准测试样条固定在弯曲应变为1.5%的自制夹具上,分别浸泡在Etoposide?药物溶剂、Busulflex?药物溶剂或DMSO(以50%为例)等3种抗肿瘤药物溶剂,然后观察试样的外观,测试试样的拉伸强度、断裂伸长率和缺口冲击强度等性能的变化情况,采用定量化的评分,对6种材料的抗肿瘤药物溶剂的耐受性进行了评价。结果表明,两款超硬质热塑性聚氨酯(TPU)材料对三种抗肿瘤药物溶剂的耐受性均优于其他4种评价的材料,为接触抗肿瘤药物类的医疗器械产品的较优选择,比如PICC,CVC,输液器等。     

医防融合背景下基层卫生技术人员的培训现状和相关知识需求调查

目的 调查5省基层卫生技术人员医防融合相关培训状况以及相关知识能力的需求状况,为完善我国基层医防融合建设,提高基层卫生服务机构防病治病能力提供参考建议。方法 对五个省15个区县的乡镇卫生院和社区卫生服务中心（站）的卫生技术人员进行分层抽样问卷调查,对调查数据进行描述并对各种医防融合相关知识能力需求进行单因素χ²检验和多因素logistic分析。结果 76.0%的基层卫生技术人员近一年参加过培训,乡镇卫生院卫生技术人员培训参与率（73.2%）低于社区卫生服务中心（站）（84.3%）（χ²= 83.812,P＜0.001）,不同特征基层卫生技术人员培训参与率不同（P＜0.01）。各类培训参与率均低于相关知识技能的需求率,公共卫生相关知识技能的需求率最高。χ²检验和多因素logistic分析显示不同特征基层卫生技术人员对各类知识技能的需求率不同:相对于社区卫生服务中心（站）,乡镇卫生院人员对传染病防控技能（OR = 0.756,95%CI:0.666～0.858）和一般病与常见病诊疗技能（OR = 0.860,95%CI:0.762～0.971）的需求程度更高;临床医疗岗位人员对传染病防控技能及一般病与常见病诊疗技能、的需求程度更高（P＜0.001）;年轻人员对慢病管理与病因监测技能的需求更高（OR = 0.937,95%CI:0.885～0.992）;公共卫生岗位人员（OR = 1.346,95%CI:1.114～1.626）和专职管理岗位人员（OR = 2.334,95%CI:1.707～3.191）对信息化技能的需求程度更高。结论 应以需求为导向,加强基层卫生技术人员的培训强度,提升培训内容和知识技能需求的匹配程度,建立完善医防交叉培训机制和医防能力兼备的复合型人才培养供给体系。     

糖尿病患者药物治疗认知、态度与依从性研究

目的 了解糖尿病患者药物治疗依从性现状及其影响因素,探讨药物治疗认知、态度与依从性之间的关系,为改善药物治疗依从性提供参考。方法 采用分层抽样方法,在山东省东中西部地区选取900名纳入基本公共卫生服务的糖尿病患者进行问卷调查,对842份有效问卷进行描述性分析、χ2检验以及多因素logistic回归分析。结果 842名糖尿病患者中,52.7%的患者药物治疗依从性较好。年龄越大的患者药物治疗依从性越差（OR = 0.66,95%CI:0.46～0.94,P = 0.022;OR = 0.46,95%CI:0.30～0.71,P＜0.001）;病程5～10年的患者比小于5年的患者药物治疗依从性更好（OR = 1.43,95%CI:1.03～1.98,P = 0.034）;药物治疗认知水平越高的患者药物治疗依从性越好（OR = 2.78,95%CI:1.21～6.38,P = 0.016;OR = 2.89,95%CI:1.27～6.58,P = 0.012）;药物治疗态度较好的患者比较差的患者药物治疗依从性更好（OR = 2.58,95%CI:1.28～5.18,P = 0.008）。结论 糖尿病患者的药物治疗依从性仍有待提升;提高患者的药物治疗认知水平与治疗态度有助于提高药物治疗依从性;应加强对糖尿病患者的健康知识教育,转变患者的药物治疗态度。     

Effects of Different Doses of Caffeinated Coffee on Muscular Endurance,Cognitive Performance,and Cardiac Autonomic Modulation in Caffeine Naive Female Athletes

Caffeine is widely consumed among elite athletes for its well-known ergogenic properties, and its ability to increase exercise performance. However, studies to date have predominantly focused on the anhydrous form of caffeine in male participants. The aim of the study was to investigate the effect of caffeinated coffee ingestion on lower-upper body muscular endurance, cognitive performance, and heart rate variability (HRV) in female athletes. A total of 17 participants (mean ± standard deviation (SD): age = 23 ± 2 years, body mass = 64 ± 4 kg, height = 168 ± 3 cm) in a randomized cross-over design completed three testing sessions, following the ingestion of 3 mg/kg/bm of caffeine (3COF), 6 mg/kg/bm of caffeine (6COF) provided from coffee or decaffeinated coffee (PLA) in 600 mL of hot water. The testing results included: (1) repetition number for muscular endurance performance; (2): reaction time and response accuracy for cognitive performance; (3): HRV parameters, such as standard deviation of normal-to-normal (NN) intervals (SDNN), standard deviation of successive differences (SDSD), root mean square of successive differences (RMSSD), total power (TP), the ratio of low- and high-frequency powers (LF/HF), high-frequency power (HF), normalized HF (HFnu), low-frequency power (LF), and normalized LF (LFnu). A one-way repeated measures ANOVA revealed that 3COF (p = 0.024) and 6COF (p = 0.036) improved lower body muscular endurance in the first set as well as cognitive performance (p = 0.025, p = 0.035 in the post-test, respectively) compared to PLA. However, no differences were detected between trials for upper body muscular endurance (p = 0.07). Lastly, all HRV parameters did not change between trials (p > 0.05). In conclusion, ingesting caffeinated coffee improved lower body muscular endurance and cognitive performance, while not adversely affecting cardiac autonomic function.     

A Vicious Cycle of Osteosarcopenia in Inflammatory Bowel Diseases—Aetiology,Clinical Implications and Therapeutic Perspectives

Sarcopenia is a disorder characterized by a loss of muscle mass which leads to the reduction of muscle strength and a decrease in the quality and quantity of muscle. It was previously thought that sarcopenia was specific to ageing. However, sarcopenia may affect patients suffering from chronic diseases throughout their entire lives. A decreased mass of muscle and bone is common among patients with inflammatory bowel disease (IBD). Since sarcopenia and osteoporosis are closely linked, they should be diagnosed as mutual consequences of IBD. Additionally, multidirectional treatment of sarcopenia and osteoporosis including nutrition, physical activity, and pharmacotherapy should include both disorders, referred to as osteosarcopenia.     

Sarcopenia Risk Evaluation in a Sample of Hospitalized Elderly Men and Women: Combined Use of the Mini Sarcopenia Risk Assessment (MSRA) and the SARC-F

Background: SARC-F and Mini Sarcopenia Risk Assessment (MSRA) questionnaires have been proposed as screening tools to identify patients at risk of sarcopenia. The aim of this study is to test the use of SARC-F and MSRA, alone and combined, as a pre-screening tool for sarcopenia in geriatric inpatients. Methods: 152 subjects, 94 men and 58 women, aged 70 to 94, underwent muscle mass evaluation by dual energy X-ray absorptiometry (DXA), muscle strength evaluation by handgrip, and completed the MSRA, SARC-F and Activity of daily living (ADL) questionnaires. Results: 66 subjects (43.4%) were classified as sarcopenic according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. The 7-item SARC-F and MRSA and 5-item MSRA showed an area under the curve (AUC) of 0.666 (95% confidence interval (CI): 0.542–0.789), 0.730 (95% CI: 0.617–0.842) and 0.710 (95% CI: 0.593–0.827), respectively. The optimal cut-off points for sarcopenia detection were determined for each questionnaire using the Youden index method. The newly calculated cut-off points were ≤25 and ≤40 for MSRA 7- and 5-items, respectively. The ideal cut-off for the SARC-F was a score ≥3. Applying this new cut-off in our study population, sensitivity and specificity of the 7-item MSRA were 0.757 and 0.651, and 0.688 and 0.679 for the 5-item MSRA, respectively. Sensitivity and specificity of SARC-F were 0.524 and 0.765, respectively. The combined use of the 7-item SARC-F and MSRA improved the accuracy in sarcopenia diagnosis, with a specificity and sensitivity of 1.00 and 0.636. Conclusion: 7-item SARC-F and MSRA may be co-administered in hospital wards as an easy, feasible, first-line tool to identify sarcopenic subjects.     

Detraining Effects on Muscle Quality in Older Men with Osteosarcopenia. Follow-Up of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)

The present study aimed to determine the effect of detraining on muscle quality (MQ) in older men with osteosarcopenia. Forty-three community-dwelling older men (78 ± 4 years) were randomly allocated to a consistently supervised high-intensity resistance exercise training (HIRT) group (n = 21) or a control group (CG, n = 22). The HIRT scheduled a periodized single set protocol twice weekly. After the intervention, the men were subjected to six months of detraining. Muscle quality (MQ), defined as maximum isokinetic hip/leg extensor strength per unit of mid-thigh intra-fascia volume, was determined by magnetic resonance imaging (MRI) or per unit of thigh muscle mass assessed by dual-energy X-ray absorptiometry (DXA). Intention-to-treat analysis with multiple imputations was applied. We observed significant exercise effects for MQ (p = 0.001). During detraining, the HIRT group lost about one-third of the intervention-induced gain and displayed significantly (p = 0.001) higher MQ reductions compared to the CG. Nevertheless, after training and detraining, the overall intervention effect on MQ remained significant (p ≤ 0.004). In summary, six months of absence from HIRT induce a significant deleterious effect on MQ in older osteosarcopenic men. We conclude that intermitted training programs with training breaks of six months and longer should be replaced by largely continuous exercise programs, at least when addressing MQ parameters.     

Prevalence and Associated Factors of Sarcopenia in Singaporean Adults—The Yishun Study

ObjectivesTo describe the normative values of sarcopenia among community-dwelling adults (≥21 years of age); compare the prevalence of sarcopenia using Asian Working Group for Sarcopenia criteria, 2014 (AWGS2014), Asian Working Group for Sarcopenia criteria, 2019 (AWGS2019), and European Working Group on Sarcopenia in Older People criteria, 2018 (EWGSOP2) guidelines; and identify factors associated with sarcopenia.DesignParticipants were recruited through random sampling. Sarcopenia assessments were performed using a dual-energy x-ray absorptiometry scan (muscle mass), handgrip test (muscle strength), and usual walking test (physical performance). Questionnaires were administered to evaluate lifestyle and cognition.Setting and ParticipantsIn total, 542 community-dwelling Singaporeans were recruited (21?90 years old, 57.9% women).MethodsWe assessed anthropometry, body composition, and questionnaire-based physical and cognitive factors, and estimated sarcopenia prevalence according to the AWGS2014, AWGS2019, and EWGSOP2 recommendations, and examined associations using logistic regression.ResultsAccording to AWGS2019, the Singapore population-adjusted sarcopenia prevalence was 13.6% (men 13.0%; women 14.2%) overall, and 32.2% (men 33.7%, women 30.9%) in those aged 60 years and above. The cut-offs derived from young adult reference group for low appendicular lean mass index were 5.28 kg/m2 for men and 3.69 kg/m2 for women (lower than AWGS recommended cut-off); for gait speed it was 0.82 m/s, (AWGS2019 recommended cut-off 1.0 m/s, AWGS2014 cut-off was 0.8 m/s); and for handgrip strength it was 27.9 kg/m2 for men and 16.7 kg/m2 for women (close to AWGS2019 recommendation). Age, sex, marital status, alcoholism, physical activity, body mass index, waist circumference, and global cognition were associated with sarcopenia (P < .05).Conclusions and ImplicationsThis is the first study to provide reference values of muscle mass, strength, and gait speed across the adult lifespan of Singaporeans. Using AWGS2019 criteria, sarcopenia is prominent in older age (32.2% in ≥60 years old), but it is already nontrivial (6.9%) among young and middle-age persons. Multidomain lifestyle modifications addressing muscle strength, cognition, and nutrition over the adult lifespan are important to delay the development of sarcopenia.     

Longitudinal Changes in Muscle Mass,Muscle Strength,and Physical Performance in Acutely Hospitalized Older Adults

ObjectivesAcute hospitalization may lead to a decrease in muscle measures, but limited studies are reporting on the changes after discharge. The aim of this study was to determine longitudinal changes in muscle mass, muscle strength, and physical performance in acutely hospitalized older adults from admission up to 3 months post-discharge.DesignA prospective observational cohort study was conducted.Setting and ParticipantsThis study included 401 participants aged ≥70 years who were acutely hospitalized in 6 hospitals. All variables were assessed at hospital admission, discharge, and 1 and 3 months post-discharge.MethodsMuscle mass in kilograms was assessed by multifrequency Bio-electrical Impedance Analysis (MF-BIA) (Bodystat; Quadscan 4000) and muscle strength by handgrip strength (JAMAR). Chair stand and gait speed test were assessed as part of the Short Physical Performance Battery (SPPB). Norm values were based on the consensus statement of the European Working Group on Sarcopenia in Older People.ResultsA total of 343 acute hospitalized older adults were included in the analyses with a mean (SD) age of 79.3 (6.6) years, 49.3% were women. From admission up to 3 months post-discharge, muscle mass (?0.1 kg/m²; P = .03) decreased significantly and muscle strength (?0.5 kg; P = .08) decreased nonsignificantly. The chair stand (+0.7 points; P < .001) and gait speed test (+0.9 points; P < .001) improved significantly up to 3 months post-discharge. At 3 months post-discharge, 80%, 18%, and 43% of the older adults scored below the cutoff points for muscle mass, muscle strength, and physical performance, respectively.Conclusions and ImplicationsPhysical performance improved during and after acute hospitalization, although muscle mass decreased, and muscle strength did not change. At 3 months post-discharge, muscle mass, muscle strength, and physical performance did not reach normative levels on a population level. Further research is needed to examine the role of exercise interventions for improving muscle measures and physical performance after hospitalization.     

产后妇女盆底肌损伤发生情况调查研究

目的 探讨产后妇女盆底肌功能情况并分析造成妇女产后盆底肌损伤的相关因素,为预防妇女因生产造成盆底肌损伤提供科学依据。方法 以2019年1月至2020年11月在湖南省长沙市和株洲市各1家医院产科进行6~8周产后复查的产妇为研究对象进行资料收集及盆底肌力测定,采用描述流行病学分析方法进行盆底肌力异常情况分析,并采用单、多因素分析方法对产后妇女盆底肌异常影响因素进行分析。结果 本研究共对1 628名产妇进行调查,年龄22~38岁,平均（29.68±5.36）岁;孕次1~5次,平均孕次（2.43±1.16）次;产次1~5次,以1~2次为主,占72.4%。检出1 142例产后6~8周产妇为盆底肌力异常,异常率为70.2%。年龄30~38岁（OR=3.766）、产次≥3次（OR=2.633）、阴道分娩（OR=7.478）、孕期增重过多（OR=1.597 ）及胎儿出生体重≥4 kg（OR=5.078）的产后妇女盆底肌力异常的风险较高。结论 湖南省产后妇女盆底肌力异常率较高,年龄、产次、分娩方式、孕期增重及胎儿体质量是造成产妇产后发生盆底肌损伤的重要原因,应采取相应措施,降低产后妇女发生盆底肌损伤风险。