The effects of increased forward trunk lean during stair ascent on hip adduction and internal rotation in asymptomatic females

BackgroundIncreased hip adduction and internal rotation can lead to excessive patellofemoral joint stress and contribute to patellofemoral pain development. The gluteus maximus acts as a hip extensor, abductor, and external rotator. Improving hip extensor use by increasing one’s forward trunk lean in the sagittal plane may improve frontal and transverse plane hip kinematics during stair ascent.Research questionDoes increasing forward trunk lean during stair ascent affect peak hip adduction and internal rotation?MethodsTwenty asymptomatic females performed five stair ascent trials (96 steps/min) on an instrumented stair using their self-selected and forward trunk lean postures. Three-dimensional kinematics (200 Hz) and kinetics (2000 Hz) were recorded during the stance phase of stair ascent. Biomechanical dependent variables were calculated during the stance phase of stair ascent and included peak forward trunk lean, hip flexion, hip adduction, hip internal rotation angles, and the average hip extensor moment.ResultsDuring the forward trunk lean condition, decreases were observed for peak hip adduction (MD = 2.8˚; 95% CI = 1.9, 3.8; p < 0.001) and peak hip internal rotation (MD = 1.1˚; 95% CI = 0.1, 2.2; p = 0.04). In contrast, increases were observed during the forward trunk lean condition for the peak forward trunk lean angle (MD = −34.7˚; 95% CI = −39.1, −30.3; p < 0.001), average hip extensor moment (MD = −0.5 N·m/kg; 95% CI = −0.5, −0.4; p < 0.001), and stance time duration (MD = −0.02 s; 95% CI = −0.04, 0.00; p = 0.017).SignificanceIncreasing forward trunk lean and hip extensor use during stair ascent decreased peak hip adduction and internal rotation in asymptomatic females. Future studies should examine the effects of increasing forward trunk lean on hip kinematics, self-reported pain, and function in individuals with patellofemoral pain.     

Renpenning syndrome in an Indian patient

Renpenning syndrome is one of the well‐characterized causes of X‐linked intellectual disability and is associated with microcephaly and various visceral malformations. Face is considered characteristic but the dysmorphism is subtle. Here we report an Indian adult with a very lean habitus, progressive atrophy of the upper back muscles, microcephaly, loss of cervical lordosis, and upper thoracic scoliosis. Using whole‐exome sequencing, a hemizygous deletion was identified in PQBP1 that leads to a frameshift and premature termination of translation. The loss of normal curvatures of cervical and upper thoracic spine due to muscular atrophy is a characteristic feature, though it may be age dependent.     

基于精益六西格玛管理的门诊服务流程优化实践

目的探索精益六西格玛管理在综合医院门诊服务流程优化中的效果,提升门诊服务,改善患者就医体验。方法运用精益六西格玛管理体系5个阶段,选取2019年5—12月168万人次门诊患者为对照组、2020年1—8月120万人次门诊患者为观察组。对照组采用常规门诊管理,观察组采用精益六西格玛管理。比较两组门诊患者就诊时间、等候时间、取药时间、满意度。结果观察组门诊患者就诊时间、等候时间、取药时间均明显小于对照组,患者满意度高于对照组,差异有统计学意义(P<0.05)。结论基于精益六西格玛管理,门诊服务流程取得了较好的改进效果,不断优化门诊资源配置,患者满意度提高,最终得出一套适用于综合医院推广和借鉴的门诊服务优化流程。     

中国竞技健美运动员身体成分调查分析

目的:研究我国竞技健美运动员身体成分的特点,为我国竞技健美运动的发展及增强国民体质提供研究和实践参考。方法:采用生物电阻抗法,对参加2004年全国健美锦标赛和全国健身先生、健身小姐大赛的168名运动员进行体成分测试,并按照性别、项目以及参赛级别的不同进行统计分析。结果:(1)与成年男子健美组小级别运动员相比,中级别运动员体脂百分比无明显增加(P>0.05),但是瘦体重和体液总量明显增加(P<0.01);与前两者相比,大级别运动员体脂百分比、瘦体重以及体液总量均明显增加(P<0.01)。(2)健身先生组运动员与成年男子健美组中级别运动员相比,体脂百分比无明显变化(P>0.05),但瘦体重和体液总量明显减小(P<0.01)。(3)与成年女子健美组小级别运动员相比,大级别运动员和健身小姐组运动员体脂百分比增加不多(P>0.05),但瘦体重和体液总量明显增加(P<0.05)。     

建立院领导周查房制度 提升精细化管理水平

某大型公立医院通过实施院领导周查房制度,并结合该制度实施一段时间后的结果,阐述了查房工作有效督促了科室落实基本规章制度,并且要紧密围绕以患者为中心。认为院领导周查房制度可有效提升医院精细化管理水平,查房制度发挥作用的基础在于有规范的核心业务流程体系,同时指出院领导周查房制度的不足之处。     

肝脏18F-FDG PET半定量方法比较分析

 目的  比较肝脏18氟脱氧葡萄糖正电子发射体层摄影/计算机体层摄影［2-(fluorine-18)-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography,18F-FDG PET/CT］半定量方法及其受血糖、血脂、肝酶、体质指数 (body mass index,BMI)、年龄及性别等因素的影响。方法  回顾性分析678例健康人群PET/CT、常见血液化验结果及基本信息等资料,测量肝脏平均标准化摄取值 (standardized uptake value,SUV)和基于瘦质体重 (lean body mass,LBM)与体表面积 (body surface area,BSA)校正的SUVLBM和SUVBSA。比较三者的变异系数大小,并采用相关、偏相关和多元线性回归分析比较三者受血液化验指标的影响程度。结果  SUV、SUVLBM和SUVBSA的变异系数 (23.3%、23.4%和24.7%)相当。SUV受年龄、BMI、高密度脂蛋白 (high density lipoprotein,HDL)和三酰甘油 (triglyceride,TG)的影响 (P值均<0.05),SUVBSA受性别、年龄、BMI和HDL的影响 (P值均<0.05),而SUVLBM仅与性别和年龄有关 (β=0.092和0.004,P=0.002和0.007),不受常见血液化验指标的影响。结论  肝脏SUV和SUVBSA均受常见血液指标的影响,而SUVLBM不受血液化验指标的影响,有望用于18F-FDG PET半定量评估。     

Plasma Transthyretin as a Biomarker of Lean Body Mass and Catabolic States

Plasma transthyretin (TTR) is a plasma protein secreted by the liver that circulates bound to retinol-binding protein 4 (RBP4) and its retinol ligand. TTR is the sole plasma protein that reveals from birth to old age evolutionary patterns that are closely superimposable to those of lean body mass (LBM) and thus works as the best surrogate analyte of LBM. Any alteration in energy-to-protein balance impairs the accretion of LBM reserves and causes early depression of TTR production. In acute inflammatory states, cytokines induce urinary leakage of nitrogenous catabolites, deplete LBM stores, and cause an abrupt decrease in TTR and RBP4 concentrations. As a result, thyroxine and retinol ligands are released in free form, creating a second frontline that strengthens that primarily initiated by cytokines. Malnutrition and inflammation thus keep in check TTR and RBP4 secretion by using distinct and unrelated physiologic pathways, but they operate in concert to downregulate LBM stores. The biomarker complex integrates these opposite mechanisms at any time and thereby constitutes an ideally suited tool to determine residual LBM resources still available for metabolic responses, hence predicting outcomes of the most interwoven disease conditions.