Effects of a Short-Term “Fat Adaptation with Carbohydrate Restoration” Diet on Metabolic Responses and Exercise Performance in Well-Trained Runners

Periodized carbohydrate availability can enhance exercise capacity, but the effects of short-term fat adaptation carbohydrate restoration (FACR) diets on metabolic responses and exercise performance in endurance athletes have not been conclusively determined. This study aimed to investigate the effect of a FACR diet on measures of resting metabolism, exercise metabolism, and exercise performance. Well-trained male runners (n = 8) completed a FACR dietary intervention (five days’ carbohydrate < 20% and fat > 60% energy, plus one-day carbohydrate ≥ 70% energy), and a control high-carbohydrate (HCHO) diet for six days (carbohydrate > 60% energy; fat < 20% energy) in a randomized crossover design. Pre- and post-intervention metabolic measures included resting metabolic rate (RMR), respiratory quotient (RQ), maximum fat oxidation rate during exercise (MFO), and maximum fat oxidation intensity (FATmax). Measures of exercise performance included maximal oxygen uptake (VO₂max), running economy (RE), and 5 km running time trial (5 km-TT). In FACR compared with HCHO, there were significant improvements in FATmax (p = 0.006) and RE (p = 0.048). There were no significant differences (p > 0.05) between FACR and HCHO in RMR, RQ, VO₂max, or 5 km-TT. Findings suggest that a short-term (six days) FACR diet may facilitate increased fat oxidation and submaximal exercise economy but does not improve 5 km-TT performance.     

A cost-minimization analysis of measures against metallic dental restorations for head and neck radiotherapy

The aim of this study was to compare the estimated public medical care cost of measures to address metallic dental restorations (MDRs) for head and neck radiotherapy using high-energy mega-voltage X-rays. This was considered a first step to clarify which MDR measure was more cost-effective. We estimated the medical care cost of radiotherapy for two representative MDR measures: (i) with MDR removal or (ii) without MDR removal (non-MDR removal) using magnetic resonance imaging and a spacer. A total of 5520 patients received head and neck radiation therapy in 2018. The mean number of MDRs per person was 4.1 dental crowns and 1.3 dental bridges. The mean cost per person was estimated to be 121 720 yen for MDR removal and 54 940 yen for non-MDR removal. Therefore, the difference in total public medical care cost between MDR removal and non-MDR removal was estimated to be 303 268 800 yen. Our results suggested that non-MDR removal would be more cost-effective than MDR removal for head and neck radiotherapy. In the future, a national survey and cost-effectiveness analysis via a multicenter study are necessary; these investigations should include various outcomes such as the rate of local control, status of oral mucositis, frequency of hospital visits and efforts of the medical professionals.     

咽丛神经切断术在发音重建中的作用

目的　为解除咽缩肌的痉挛 ,提高喉全切除术后用发音管发音重建的成功率。方法　在一侧舌骨大角后内侧咽缩肌的后表面 6 5mm左右 ,可找到咽丛神经支配咽下缩肌的主支或分支 ,将其切断。结果　 16例中 15例咽丛神经切断术后发音重建成功 ,成功率为 93 8%。结论　咽丛神经切断术取代咽缩肌切断术是可行的。咽丛神经切断术能提高Blom Singer发音管发音重建的成功率 ,值得推广应用。     

灭鼠后家鼠数量恢复的研究

目的 :探讨灭鼠后家鼠数量恢复情况和规律 ,为制定灭鼠巩固措施提供依据。方法 :采用 0 .0 0 5 %溴敌隆毒米饱和投毒灭鼠 ,后逐月用粉迹法和笼夜法测定鼠密度。结果 :灭鼠较彻底、环境卫生条件好的住宅区 ,低鼠密度可保持 5～ 6个月 ,8个月后鼠密度即恢复到灭鼠前的水平。环境卫生差 ,鼠密度高的农村 ,仅通过毒鼠难以把鼠密度降到较低水平 ;即使通过连续灭鼠把密度大幅度降下来 ,但 1～ 2个月后又恢复至灭鼠前的水平。不同季节灭鼠效果有明显差异。结论 :灭鼠后家鼠数量恢复的速度与灭鼠率、环境卫生条件有关 ,即灭鼠率高、环境卫生条件好的恢复慢 ;否则 ,恢复快。农村灭鼠必须把毒鼠和改造环境结合起来 ,方能有效控制鼠害。     

Face lifting with suspensory restoration of the fibromuscular tissues of the face and neck

A series of before and after slides are shown of patients who have had the author's wall type restoration of the fibro-fatty musculo-fascial restoration of the face and neck in conjunction with face lifting. Several sutures (2–0 white Dacron usually 8 to 10 in all) are placed together so as to tighten the fibro-fatty musclo-fascial layer of the neck and face to as nearly as possible that which it had in youth. These are not the typical plication sutures but are sturdy suture material and are tied tightly. Furthermore, the tension on the tissues is distributed evenly by a whole series of sutures which additionally gives a smoother wall type reconstruction.The technique decreases the dead space in the cervico-facial dissection by at least 50 per cent and avoids suture ridging. Since using this technique and subsequent to the submission of this paper, there have been no hematomata in over 150 consecutive face lifts.     

The functional restoration approach for chronic spinal disability

The functional restoration approach to treating chronic spinal disability consists of a medically directed, interdisciplinary team approach to physical reconditioning and a cognitive-behavioral crisis intervention procedure for dealing with related psychosocial problems. One- and two-year follow-up studies have demonstrated the clinical efficacy of this approach. The present article describes this approach and summarizes the research documenting its success in treating patients with chronic spinal disability. This article also highlights the pitfalls in misunderstanding and misrepresenting the components of the functional restoration approach when evaluating treatment efficacy.     

134例头颈部肿瘤手术后缺损修复

目的：分析4种皮瓣修复头颈部缺损的效果、功能、并发症和供区创伤的大小，以为不同的缺损选择不同的皮瓣。方法：134例头颈部肿瘤患者，均行联合根治术加胸大肌肌皮瓣、颈阔肌肌皮瓣、额瓣、前臂皮瓣修复。结果：胸大肌皮瓣全部存活96例，部分坏死21例，坏死≥1／25例，全部坏死2例，颈阔肌皮瓣全部存活2例，部分坏死1例，全部坏死1例，4例额瓣和2例前臂皮瓣全部存活。结论：口腔及颈部大面积缺损需要胸大肌肌皮瓣修复，对需要洞穿修复的，尤其是女性，应尽量避免用胸大肌折叠瓣，可用复合瓣。对一般的口腔缺损用前臂皮瓣修复最为合适。     

食管充气试验在二期发音重建中的作用

目的尽快恢复无喉者语言功能，减少手术创伤，提高预测二期发音重建手术成功的准确性，客观评价食管充气试验的实际临床意义。方法对全喉切除术后无喉者行食管充气试验及二期发音重建，特别就食管充气试验阴性患者进行研究分析。结果４５例食管充气试验阴性患者行二期发音重建，而不行咽缩肌切断术的发音成功率９４％（３６／３８），阳性患者成功率１００％（７／７）；无论充气试验阴性或阳性患者术后发音效果均好于预测试验时。结论食管充气试验对预测术后发音具有一定参考意义，可作为ＢｌｏｍＳｉｎｇｅｒ法二期发音重建术前常规检查，但测试时因受诸多因素影响，不能作为判定术后发音效果的唯一依据。     

眶壁爆裂性骨折手术治疗的临床疗效观察

目的 评价眶壁修补术治疗眶壁爆裂性骨折的疗效。方法 采用眶壁修补术治疗30例眶壁爆裂性骨折。术后随访3～6月，平均4．5月。观察术后视力、眼球突出度、眼球活动度及其并发症。结果 视力：3例因伴有眼部有它病变，严重影响视力，治疗的视力有提高；余27例手术前后视力基本不变。跟球突出度：术后增加1mm者4例；增加2mm者9例；增加3mm者9例；增加4mm者8例。眼球活动度：术前上转或外转完全受限或部分受限者，术后均得到了不同程度的改善。结论 眶壁修补术是治疗眶壁爆裂性骨折的有效方法。     

银汞合金充填修复相关临床研究的循证医学分析

目的评价银汞合金充填修复各类牙体缺损的临床效果及其对人体的不良影响。方法检索中国医院数字图书馆数据库中从1994年至今与银汞合金充填修复各类牙体缺损相关的临床研究及流行病学研究文献,用循证医学的方法和Meta分析进行分析评价。结果共检索到与银汞合金充填修复各类牙体缺损相关的临床研究文章78篇,符合入选条件的25篇。研究的主要内容涉及4个方面①银汞合金充填修复与其他充填修复材料的效果比较;②粘接性银汞合金修复的疗效评价;③银汞合金与其他充填材料联合应用的研究;⑤银汞合金充填修复对人体不良影响和研究。结论①随着高分子材料的发展和进步,银汞合金充填逐渐失去其抗力性好、耐磨性能好等优势,但其在美观效果、边缘密合性、牙髓刺激性等方面明显逊于复合树脂、复合体、玻璃离子等充填修复;②粘接性银汞合金充填技术能有效地增强充填边缘密合性、减少继发龋的形成,使充填效果明显优于常规的银汞合金充填;③现有的研究尚不能证实银汞合金充填会对人体造成明显的损害。