步行量和体成分的中日比较研究

目的 为了解中日儿童及成人的步行和体成分及其相互关系.方法 以中国上海市和日本琦玉县的小学生和成人为对象,采用西铁城 TW02-001电子式步数计测定步行量,FUTREX-5000A体成分测定仪测量体脂百分比.结果 1.中国男女小学生的平均每日步行量分别为12426步和10387步,低于日本小学生(男15 340步,女11 617步),体脂百分比中国男女生分别为21.2%和15.8%,高于日本(男18.9%,女13.1%).中国男女成人的平均每日步行量分别为9826步和8748步,高于日本成人(男:8411步,女7599步);体脂百分比分别为17.5%(男)和25.8%(女),而日本男性为19.8%,女性为26.0%.2.不同活动水平的小学生和成人,其血压和体成分均有差异,步行量高者的血压和体脂百分比都较低.本研究还计算出以肱三头肌皮脂厚度以(X)推测儿童体脂百分比(Y)的回归方程为:Y=10.6646+0.5856X.结论 作为日常生活的步行可促进肥胖发生率的降低.     

椎弓根内固定在下腰椎失稳伴椎管狭窄手术中的应用

目的：探讨下腰椎失稳伴椎管狭窄的手术要点及椎弓根内固定在手术中的作用和意义。方法：总结2001年5月～2004年6月采用后路椎管减压、椎弓根内固定及椎间关节融合、横突间植骨治疗的32例下腰椎失稳伴椎管狭窄病例的临床资料。结果：32例随访6个月-40个月，平均19．5个月，术后跛行改善者32例（100％），下肢肌力障碍恢复22例（68．7％），肌萎缩14例均有所恢复；28例感觉障碍者，完全恢复18例（64．3％），部分恢复6例（21．4％）。无明显恢复2例（7．1％）。结论：下腰椎失稳伴椎管狭窄可分别表现为结构性和动力性腰椎滑脱，椎弓根内固定对病人可起到使滑脱椎体复位、相邻椎体间稳定及椎间融合的作用，并可使摘除椎间盘后的相关间隙高度得到维持。充分解除神经受压症状。     

Femoral Stem Cementation in Hip Arthroplasty: The Know-How of a “Lost” Art

Purpose of ReviewTo describe the (1) indications, (2) preoperative precautions, and (3) stepwise technical details of modern femoral stem cemented fixation.Recent FindingsFemoral stem cementation provides excellent implant longevity with a low periprosthetic fracture rate among patients with compromised bone quality or aberrant anatomy. Unfamiliarity with the details of modern cementation techniques among trainees who may lack frequent exposure to cementing femoral stems may preclude them from offering this viable option to suitable patients in later stages of their careers. As such, maximizing benefit from cemented femoral stem fixation among suitable candidates is contingent upon the meticulous use of modern cementation techniques.SummaryIn addition to proper patient selection, modern cementation techniques emphasize the use of (1) pulsatile lavage of the femoral canal, (2) utilization of epinephrine-soaked swabs, (3) vacuum cement mixing, (4) retrograde cement introduction, (5) cement pressurization, and (6) the use of stem centralizers. Furthermore, identifying and optimizing the preoperative status of at-risk patients with pre-existing cardiopulmonary compromise, in addition to intraoperative vigilance, are essential for mitigating the risk of developing bone cement implantation syndrome. Further research is required to assess the utility of cemented femoral stem fixation among younger patients.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12178-020-09681-5.     

Comparison of wrist-worn and hip-worn activity monitors under free living conditions

Purpose: Current recommendations state that individuals engage in 150?min of moderate or 75?min of vigorous intensity physical activity (PA) each week. Commercial PA monitors are becoming popular for everyday use. The accuracy of these devices, however, is not well understood. We sought to examine the accuracy of two commercial devices, one wrist and one hip-worn, under free-living conditions.

Methods: Twenty-two subjects wore two commercially available devices and one ActiGraph (AG) for seven consecutive days under normal activity.

Results: Mean steps per day between all three devices differed significantly. No differences were found in moderate-to-vigorous intensity physical activity (MPVA). Daily energy expenditure (EE) also differed significantly between the AG and the commercial devices. Bland–Altman analysis found poor agreement between the AG and the commercial devices with regards to steps and EE, but good agreement in MVPA.

Conclusion: Results suggest that the commercial devices are less accurate in estimating steps and EE. These devices did show good agreement with regards to MVPA, suggesting that they may provide useful feedback for individuals seeking to achieve the current PA guidelines for MVPA. Improvements are needed with regards to steps and EE estimation.     

Impact of Physical Activities on Frailty in Community-Dwelling Older Women

Aims: The aim of the study was to determine whether increased physical activities (PA) affect frailty for old women, 75 years and older (OO), compared to 60–74 years old (YO). Methods: This cross-sectional study measured 19 frailty indicators (muscle strength and endurance, balance, gait characteristics, and function), using 46 community-dwelling women. PA were divided into three levels by caloric expenditure per week (<2,000 kcal/week, 2,000–3,999 kcal/week, >4,000 kcal/week). Results: As PA level increased, a gap (=difference) between OO and YO narrowed for step length and function, but for quadriceps strength and endurance, a gap widened. Conclusions: Frailty progresses with aging but older women who engage in a high level of physical activity (>4,000 kcal/week) can increase mobility and functional capacity, but not for muscle strength and endurance. Starting regular resistance training activities early in the aging process is critical to improve or maintain muscle quality to offset age-related frailty.     

Step Away from Depression—Study protocol for a multicenter randomized clinical trial for a pedometer intervention during and after in‐patient treatment of depression

ObjectivesIncreasing the number of daily steps by using a pedometer and a diary leads to an activity increase and improved health outcomes in a variety of somatic disorders. Hence, for the inpatient treatment of depression, supervised exercise interventions are more widespread. We aim to examine if a self‐managed pedometer intervention (PI) with the option of being proceeded after discharge leads to reduction of depression and to a physical activity (PA) increase.MethodsThe Step Away from Depression (SAD) study is a multicenter randomized controlled trial targeting 400 patients with major depressive disorder. Treatment as usual (TAU) is compared to TAU plus PI after 4 weeks, at discharge, and 6 months after hospital admission. Primary outcomes are clinically rated depression severity and accelerometer‐measured step counts. Secondary outcomes include self‐reported depression symptoms and PA level, psychiatric symptoms, health‐related quality of life, self‐efficacy, and components of the Motivation Volition Process Model.ResultsWe report the design of the SAD study considering several methodological aspects for exercise studies, in general.ConclusionsResults of our study will provide information about efficacy of PI for inpatient treatment and about interrelating processes of change concerning depression, PA, and aspects of motivation and volition.     

Daily Physical Activity,Functional Capacity and Quality of Life in Patients with COPD

Introduction: In the therapy of chronic obstructive pulmonary disease (COPD), it is a major goal to improve health-related quality of life (HRQOL). Patients with COPD often suffer from exertional dyspnea and adopt a sedentary lifestyle, which could be associated with poorer HRQOL. The aim of this study was to investigate the independent association of objectively measured daily physical activity and functional capacity with HRQOL in patients with COPD. Methods: In this cross-sectional study conducted at the University Hospital Basel, Switzerland, 87 stable patients (58.6% male, mean age: 67.3 ± 9.6 yrs) with COPD in GOLD grades I (n = 23), II (n = 46), III (n = 12) and IV (n = 6) were investigated. To assess HRQOL, the COPD assessment test (CAT) was completed. Patients performed spirometry and 6-min walk test. Physical activity was measured by the SenseWear Mini Armband on 7 consecutive days. By performing a multiple linear regression analysis, independent predictors of CAT score were identified. Results: Age (β = ?0.39, p = 0.001), average daily steps (β = ?0.31, p = 0.033) and 6-min walk distance (β = ?0.32, p = 0.019) were found to be independent predictors of CAT score, whereas physical activity duration above 3 METs (p = 0.498) and forced expiratory volume in 1 s in% of predicted (p = 0.364) showed no significant association. Conclusions: This study showed that average daily steps and functional capacity are independent determinants of HRQOL in patients with COPD. This emphasizes the importance to remain active and mobile, which is associated with better HRQOL.     

治崩三法在血精中的运用

血精是泌尿男科门诊常见的症状之一,诊断及治疗手段多样化,但目前临床缺乏完整、系统规范且行之有效的辨证论治思路。笔者在《丹溪心法附余》学识治崩三法,同时结合辨证论治血精的临床经验,明确"塞流""澄源""复旧"不仅是治疗血精的基本治则治法,而且是血精一病行之有效的辨证论治思路。塞流即急则治标,截流止血,固摄精微;澄源即辨证求因,审因论治,澄本清源;复旧即固本善后,通畅元真,阴阳调和。临床施治当在辨证论治与整体观指导下,灵活运用此三法,急性期治疗以"塞流为标,澄源为本",慢性期治疗以"澄源为标,复旧为本"。