运动训练对糖尿病大鼠糖代谢和下丘脑神经肽Y mRNA的影响

目的:探讨运动训练对糖尿病大鼠糖代谢及其下丘脑神经肽Y(NPY)mRNA表达的影响。方法:30只SD大鼠随机分为对照组、糖尿病组(由链脲佐菌素诱导)和糖尿病 运动训练组(糖尿病大鼠进行无负重游泳运动,第1天游泳10min,以后每天递增10min,直到每天60min,每周5天,共10周)。10周后检测各组大鼠安静时血糖、血清胰岛素含量及下丘脑NPY mRNA表达。结果:与对照组相比,糖尿病组大鼠血糖显著升高,血清胰岛素水平显著降低;与糖尿病组相比,糖尿病 运动训练组大鼠血糖显著下降,血清胰岛素水平显著上升。糖尿病组大鼠下丘脑NPY mRNA表达显著高于对照组,糖尿病 运动训练组大鼠下丘脑NPY mRNA表达显著低于糖尿病组。结论:适宜的运动训练可能通过下调下丘脑NPY mRNA表达来改善糖尿病大鼠糖代谢异常。     

Changing physician practice of physical activity counseling

We conducted a prospective controlled trial to determine whether an educational intervention could improve resident physician self-efficacy and counseling behaviors for physical activity and increase their patients' reported activity levels. Forty-eight internal medicine residents who practiced at a Department of Veterans Affairs hospital received either two workshops on physical activity counseling or no intervention. All residents completed questionnaires before and 3 months after the workshops. The 21 intervention physicians reported increased self-efficacy for counseling and increased frequency of counseling compared with the 27 control physicians. Approximately 10 patients of each resident were included in the study and surveyed before and 6 months after the intervention. Of 560 patients, 465 (83%) returned both questionnaires. Following the intervention, there were no significant differences between patients of intervention and control physicians on any outcome measures. We conclude that educational interventions can improve physicians' reported self-efficacy of physical activity counseling but may not increase patient physical activity levels. Alternative approaches that emphasize overcoming the substantial barriers to exercise in chronically ill outpatients clearly will be important for facilitating changes in physical activity.     

Effect of an α2 agonist (mivazerol) on limiting myocardial ischaemia in stable angina

A specific α₂ agonist, mivazerol, known to be effective in reducing myocardial ischaemia when given intravenously immediately before an exercise tolerance test, produced a significant increase in exercise duration and time to the onset of angina when given orally over a two week period to 25 patients with stable angina. A non-significant trend to reduction in electrocardiographic signs of ischaemia was also noted. The clinical relevance of this improvement now needs to be tested in larger numbers.


Keywords: α₂ agonist; sympathetic activity; myocardial ischaemia; stable angina; exercise tolerance test     

Effects of high-fat mixed-lipid diet and exercise on the antioxidant system in skeletal and cardiac muscles of rats with colon carcinoma

Epidemiological and experimental studies suggest that eating habits and a sedentary lifestyle play a critical role in the incidence of colon carcinoma. In order to investigate the effects of high-fat mixed-lipid (HFML) diet in conjunction with long-term swimming, the antioxidant capacity of skeletal and cardiac muscles were observed in rats with 1,2-dimethylhydrazine (DMH)-induced colon carcinoma. Male Wistar rats were randomly divided into one control group and four cancer groups: sedentary and swimming groups fed low fat corn oil diet and sedentary and swimming groups, fed a HFML diet. After 6 months of swimming, rats were sacrificed and the blood, cardiac and soleus muscle were taken for analysis. Serum cholesterol, triglyceride and glucose concentrations were measured and the activity of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase as well as levels of malondialdehyde and glutathione were determined.The results showed that endurance swimming prevented lipid peroxidation in the soleus muscle of HFML diet rats due to elevated activities of antioxidant enzymes. On the other hand, increased lipid peroxidation in the hearts of all cancer groups indicated that DMH-induced colon carcinoma impaired the antioxidant status of the heart. This failure in heart tissue indicated that enhanced antioxidant capacity after regular physical activity is not sufficient to offset oxidative stress caused by DMH-induced colon carcinoma.     

运动性骨骼肌损伤评价指标——血清CK、LDH、Mb的比较

目的:探讨不同类型运动中更为适用的评价运动性骨骼肌损伤的敏感指标。方法:15名体育学院男生(年龄23.40±1.06岁,身高180.03±3.51cm,体重75.93±6.70kg)分别进行大强度离心运动及耐力运动,测试运动前后血清CK、LDH和Mb。结果:大强度离心运动后,各指标在运动后48~72小时达最高,耐力训练后则在6~24小时达峰值。血清Mb在离心运动及耐力运动后产生变化的时间均早于CK、LDH。结论:血清Mb是最敏感的指标,而血清CK则在测试简便性方面有优势,同时敏感性也较高,是评价运动性骨骼肌损伤最实用的指标。     

补中益气汤合小柴胡汤治疗机械通气重症监护室获得性衰弱患者的临床疗效观察

[目的] 探讨补中益气汤合小柴胡汤治疗机械通气重症监护室获得性衰弱（ICU-AW）的疗效。[方法] 选择2019年10月—2022年10月河北省沧州中西医结合医院收治的82例行机械通气治疗的重症监护室获得性衰弱（ICU-AW）患者，随机数字表法将患者分为两组，每组各41例。对照组给予常规治疗，观察组在对照组基础上给予补中益气汤合小柴胡汤治疗14 d。比较两组疗效、机械通气时间、ICU住院时间、下床活动时间、中医证候积分、衰弱、肌力状态、运动耐力、日常生活能力以及并发症和不良反应差异。[结果] 观察组治疗总有效率高于对照组（95.12% vs. 73.17%，P＜0.05），机械通气时间、重症监护室（ICU）住院时间、下床活动时间短于对照组（P＜0.01），6 min步行距离、Barthel指数（BI）指数高于对照组（P＜0.05），Borg评分、呼吸机相关性肺炎发生率低于对照组（P＜0.05）。两组治疗后体倦乏力、食欲不振、胁胀作痛、情志抑郁、面色萎黄积分、心血管健康研究指数（CHS）评分均较治疗前降低（P＜0.01），医学研究委员会（MRC）评分较治疗前增高（P＜0.01），观察组治疗后上述中医证候积分、CHS评分低于对照组（P＜0.01），MRC评分高于对照组（P＜0.01）。[结论] 与常规治疗比较，补中益气汤合小柴胡汤更有助于改善衰弱和疲劳症状，提高运动耐力和日常生活能力，临床疗效更显著。     

富氧水对高原移居半年青年运动后肾功的影响

目的探讨在高原口服富氧水对移居半年青年运动后肾功的影响。方法在海拔3700 m选择10名已习服半年的健康男性青年,采用口服富氧水前(对照组)后(实验组)的自身对比运动负荷双盲实验。实验组口服富氧水,对照组口服5%葡萄糖注射液,每次500 ml,2次/d,连续服用3 d。运动结束后检测血中肌酐(CRE)、尿素氮(BUN)及尿酸(UA)在口服富氧水前后的变化。结果实验组较对照组CRE、BUN和UA均降低,有显著性差异(P<0.01)。结论富氧水可改善低氧环境下肾组织的损害,对高原低氧环境下的肾脏有保护作用。     

次极量活动平板运动试验QTc离散度与心律失常的关系

目的 :探讨在次极量活动平板运动试验中 QTc离散度与心律失常的关系。方法 :观察 174例患者活动平板运动试验后有无心肌缺血性心律失常并测量 QTc离散度。结果 :次极量活动平板运动试验阳性者 70例 ,其 QTc离散度明显增大 ,而且 70 %出现心律失常。而阴性组 Q- T离散度不增大 ,仅 2例出现房早。结论 :QTc离散度可以作为次极量活动平板运动试验预测心律失常的一个参考条件     

Moderate physical exercise: a simplified approach for ventricular rate control in older patients with atrial fibrillation

Aims  This prospective pilot-study was performed to assess whether regular moderate physical activity elevates the parasympathetic tone to the atrio-ventricular node and decreases VR during permanent AF. Background  Adequate ventricular rate (VR) control in patients with permanent atrial fibrillation (AF) is not easy to accomplish. Methods  10 patients (mean age 59 ± 10 years) with permanent AF (duration: 10 ± 8 years) underwent moderate physical exercise adjusted to their individual physical capability (45 min walking/jogging twice a week). To analyze VR control physical exercise tests and Holter-ECG recordings were performed before and after 4 months. In addition, stepwise lactate tests and psycho-pathometric examinations were obtained. Results  After 4 months of training, there was a trend toward a decrease of mean VR in 24 h Holter-ECGs by 12% from 76 ± 20 to 67 ± 12 bpm (P = 0.05) while there was no significant decrease of the minimal VR (38 ± 8 vs. 36.3 ± 4.5 bpm, P = 0.54). At a lactate threshold of 2 mmol/l there was a trend towards an increase of the running speed from 105 ± 11 to 116 ± 12 m/min (P = 0.05). A significant VR decrease of 8% (range 5–10%) was observed at almost all exercise levels during exercise treadmill testing. Increases of exercise capacity and decreases of VR were accompanied by subjective improvements of health perception. Conclusion  Regular moderate physical activity decreases VR at rest and during exercise while increasing exercise capacity. Physical training should be taken into account for ventricular rate control during AF. The study was supported by the German Atrial Fibrillation Competence Network (AFCN) funded by the Fedral Ministry of Education and Research (FMBI). A. Blumberg and J. Plisiene contributed equally to this study.     

Relationship between strenuous physical exercise and immediate type allergy

Daily intense exercise prevents the development of immediate type allergy in subjects of any age due to inhibition of all three stages of allergy mechanism.