Non-linear cardiac output dynamics during ramp-incremental cycle ergometry

Published literature asserts that cardiac output (=O₂×1/C_(a-v)O₂) increases as a linear function of oxygen uptake with a slope of approximately 5–6 during constant work rate exercise. However, we have previously demonstrated that C_(a-v)O₂ has a linear relationship as a function of O₂ during progressively increasing work rate incremental exercise. Therefore, we hypothesized that may indeed have a non-linear relationship with respect to O₂ during incremental, non-steady state exercise. To investigate this hypothesis, we performed five maximal progressive work rate exercise studies in healthy human subjects. was determined every minute during exercise using measured breath-by-breath O₂, and arterial and pulmonary artery measurements of PO₂, hemoglobin saturation, and content. was plotted as a function of O₂ and the linear and non-linear (first order exponential and hyperbolic) fits determined for each subject. Tests for linearity were performed by assessing the significance of the quadratic terms added to the linear relation using least squares estimation in linear regression. Linearity was inadequate in all cases (group P<0.0001). We conclude that cardiac output is a non-linear function of O₂ during ramp-incremental exercise; the pattern of non-linearity suggests that while the kinetics of are faster than those of O₂ they progressively slow as work rate (and O₂) increases.     

The effects of age on health-related quality of life in cancer populations: A pooled analysis of randomized controlled trials using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 involving 6024 cancer patients

BackgroundCancer incidence increases exponentially with advancing age, cancer patients live longer than in the past, and many new treatments focus on stabilizing disease and HRQOL. The objective of this study is to examine how cancer affects patients' HRQOL and whether their HRQOL is age-dependent.MethodsData from 25 EORTC randomized controlled trials was pooled. EORTC QLQ-C30 mean scores for the cancer cohort and five general population cohorts were compared to assess the impact of cancer on patients' HRQOL. Within the cancer cohort, multiple linear regressions (two-sided level P-value = 0.05 adjusted for multiple testing.) were used to investigate the association between age and HRQOL, adjusted for gender, WHO performance status (PS), distant metastasis and stratified by cancer site. A difference of 10 points on the 0–100 scale was considered clinically important.ResultsCancer patients generally have worse HRQOL compared to the general population, but the specific HRQOL domains impaired vary with age. When comparing the cancer versus the general population, young cancer patients had worse financial problems, social and role functioning, while the older cancer groups had more appetite loss. Within the cancer cohort, HRQOL was worse with increasing age for physical functioning and constipation, and better with increasing age for social functioning, insomnia and financial problems (all p < 0.05).ConclusionHRQOL is impaired in cancer patients compared to the general population, but the impact on specific HRQOL domains varies by age. Within the cancer population, some HRQOL components improve with age while others deteriorate. Optimal care for older cancer patients should target HRQOL domains most relevant to this population.     

早产儿、低出生体重儿喂养方式与体重增长关系的探讨

目的探讨早产儿、低出生体重儿喂养方式与体重增长关系。方法选择 98例早产儿 ,分成三组 ,一组采用静脉内营养 ,其余两组在消化道喂养同等条件下 ,对其中一组采取头高脚低 (成 2 0°角 )斜坡位。结果观察组与对照组比较体重增长有明显差异 (P <0 .0 5) ;消化道喂养组与静脉内营养组比较体重增长无明显差异 (P >0 .0 5)。结论通过对早产儿及低出生体重儿喂养方式的改进 ,配合全面的综合护理 ,可防止生理性体重下降和维持正常体重的增长。     

针药结合的科学基础及基本原则

本文分析了最近10多年来国内外针药结合临床循证证据和作用机制研究新进展,认为证据表明针药结合在重大疾病、药源性疾病方面的实践及研究产生的高质量证据进一步证明了其潜在的重要临床价值;针药结合的机制研究已经从关注针灸对药物作用过程的影响向针药不同机制协同作用方向发展。论文针对针药结合规律研究的内容及存在问题分析,提出了针药结合及其研究的四项基本原则,即针药结合增效原则、协同原则、量效原则、时空原则,以期为本领域的发展提供思路。     

针药结合治疗糖尿病胃轻瘫研究进展

糖尿病胃轻瘫(DGP)是糖尿病患者中发病率较高的慢性胃肠道并发症,其发病原因及机制十分复杂,目前临床尚无针对性的治疗方案,其治疗一直为临床所重视。目前研究表明,针药结合较单纯用药及单纯针灸具有明显优势,但大多属于临床小样本观察,机制尚不明确。     

西洋参喷施ABT生根粉增产试验

西洋参喷施ＡＢＴ生根粉能够促进生长发育，茎高、茎粗、叶长、叶宽都有明显增长，且减少发病率，叶绿素含量提高２．２７％。参根单产提高３１．５１％。     

The effects of increasing occlusal vertical dimension on the deep masseter of rat at different ages

ObjectiveTo investigate the influence of increasing the occlusal vertical dimension (iOVD) on the fibre-type distribution and ultrastructure of deep masseter of rat at different ages.DesignA total of forty-eight male Wistar rats were divided into two groups according to age: ‘teenage’ group (n = 24, 1.5 months) and ‘young adult’ group (n = 24, 8 months). Both the teenage and the young adult rats were then randomly divided into the control group (n = 12) and the experimental group (n = 12). The occlusal vertical dimensions of the rats in the experimental groups were increased by placing composite resin on all maxillary molars. The fibre-type distribution and ultrastructure of the deep masseter were subsequently observed on day 7 and day 14 after iOVD.ResultsIn the teenage experimental group, the proportion of type IIa fibres increased, while the proportion of type IIb and type IIx fibres decreased by day 7 after iOVD (P < 0.05). However, no significant fibre phenotype transformation was observed in the young adult experimental group until day 14 after iOVD. In addition, the proportion of type IIa in the teenage experimental group was higher than that of the young adult experimental group on day 7 and 14 (P < 0.05). Under the transmission electron microscope, muscle fibre reconstruction and the compensatory increase in the number and volume of mitochondria appeared earlier in the teenage experimental group. The cellular traumatic reaction was less than that in the young adult experimental group.ConclusionThe teenage rat alters masseter muscle structure to a slower phenotype earlier and to a greater degree than that of the young adult rat when increasing the occlusal vertical dimension.     

我国医疗器械面临的市场机遇和竞争压力

本文介绍了我国医疗器械行业良好的增长形势,展示了我国医疗器械广阔的市场机遇,指出了国产医疗器械存在的竞争压力。     

耐三代头孢菌素的肠道病原菌的增长趋势和耐药谱

目的监测我院2001—2010年与腹泻有关的耐三代头孢菌素肠道病原菌的增长趋势和耐药谱。为本地区的流行病学研究及临床合理用药提供依据。方法通过大便标本培养,致病菌经生化及血清学进一步鉴定到种或群．并以纸片扩散法测定抗菌药物的敏感性。采用WHONET5．3软件对药敏结果进行统计和分析。结果10年分离出219株耐三代头孢菌素的腹泻病原菌,占同期整个肠道致病菌的9．91％,包括沙门菌9株（4．11％）、志贺菌120株（54．79％）、气单胞菌20株（9．13％）、类志贺毗邻单胞菌2株（0．91％）、致泻大肠埃希菌40株（18．26％）及弧菌28株（12．79％）,检出率由2001年的1．5％上升至2010年的近30．0％。219株耐三代头孢菌素病原菌对广谱青霉素和复方新诺明的耐药率均在85．0％以上．对头孢吡肟、头孢美唑、氟喹诺酮类、氯霉素的耐药率在20．0％～36．5％,对磷霉素的耐药率最低（6．7％）。福氏志贺菌、致泻大肠埃希菌、气单胞菌和弧菌对氟喹诺酮类的耐药率明显高于宋内志贺菌;气单胞菌和弧菌对头孢美唑的耐药率高于福氏志贺菌、致泻大肠埃希菌和宋内志贺菌;气单胞菌对磷霉素的耐药率显著高于其他致病菌。结论耐三代头孢菌素的肠道病原菌上升迅速,耐药广泛,不同种属的耐药性不同,应重视监测,加强防治。     

中药联合奥沙利铂治疗癌症的增效减毒作用概述

摘 要奥沙利铂是继顺铂和卡铂之后的第三代铂类抗癌药物,虽其临床消化道反应、骨髓抑制及肾毒性的发生有所缓减,但外周神经毒性反应仍很突出,有效预防或减少其不良反应是临床面对的重要课题。大量研究表明,奥沙利铂与中药联合运用,能有效降低不良反应及提高疗效。本文拟从临床和实验研究方面,对近些年来中药联合奥沙利铂治疗癌症的增效减毒作用的研究报道进行述评,以为此类药物及其化疗方案的运用提供参考。