Short-term strength training improves muscle quality and functional capacity of elderly women

To assess effects of a short-term strength training (ST) program on muscle quality (MQ) and functional capacity, 36 sedentary elderly women (age = 66.0 ± 8 year, height = 159.1 ± 9.2 cm, body mass = 68.3 ± 12.1 kg, body fat = 37.0 ± 4.2 %) were randomly divided into an experimental group (EG; n = 19) or a control group (CG; n = 17). The EG performed two to three sets of 12–15 repeats of leg press, knee extension, and knee flexion exercises, 2 days/week for 6 weeks. Before and after training, lower body one repetition maximum (1RM), functional performance tests, quadriceps femoris muscle thickness (MT), and muscle quality (MQ) (1RM and quadriceps MT quotient) were assessed. After training, only the EG showed significant improvements in 1RM (p < 0.05), 30-s sit-to-stand (p < 0.001), and 8 foot up-and-go (p < 0.001). In addition, only in the EG, significant increases in all quadriceps femoris MT measurements (vastus lateralis, vastus medialis, vastus intermedius, and rectus femoris) (p ≤ 0.05), and MQ (p < 0.001) were demonstrated. No changes were observed in the CG. Furthermore, there were significant associations between individual changes in MQ and corresponding changes in 30-s sit-to-stand (r = 0.62, p < 0.001), and 8 foot up-and-go (r = −0.71, p < 0.001). In conclusion, a ST program of only 6 weeks was sufficient to enhance MQ of the knee extensors in elderly women, which resulted in beneficial changes in functional capacity.     

OGTT 0.5h血糖切点值在诊断糖尿病及糖尿病前期中的临床意义

目的 确定口服葡萄糖耐量试验(OGTT)负荷后0.5 h血糖(0.5 hPG)诊断糖尿病和糖尿病前期(preDM)的切点值及0.5 hPG与β细胞功能、胰岛素敏感性的关系.方法 4 351名受试者行OGTT,以2008年美国糖尿病协会(ADA)糖代谢异常诊断标准为参考标准,应用受试者工作特征(ROC)曲线分析0.5 hPG诊断糖尿病和preDM的切点值.将受试人群先按照2008年ADA糖代谢异常诊断标准分为正常糖耐量组(NGT组)、preDM组、糖尿病组,再按研究得出的切点值将NCT组中0.5 hPG＜诊断preDM切点值者作为N-NGT组,0.5 hPG≥诊断preDM切点值者则为H-NGT组;将preDM组中0.5 hPG＜诊断糖尿病切点值者作为N-preDM组,0.5 hPG≥诊断糖尿病切点值者则为H-preDM组.比较5组的血糖、胰岛素水平、胰岛素敏感性、早时相及总时相胰岛素分泌功能等指标,并进行0.5 hPG与上述指标的相关性分析.结果 以2008年ADA糖尿病诊断标准为参考标准,由ROC得出诊断糖尿病最佳的0.5 hPG切点值为10.79 mmol/L,灵敏性为80.6％,特异性为86.1％,曲线下面积0.92±0.00;以2008年ADA关于preDM的诊断标准为参考标准,得出诊断preDM最佳的0.5 hPG切点值为8.69 mmol/L,灵敏性为74.7％,特异性为70.9％,曲线下面积0.79±0.01.随着糖代谢异常的进展,5组的早时相胰岛素分泌指数、30 min处置指数(DI30)及总时相胰岛素分泌指数、120 min处置指数(DI120)、稳态模型评估-胰岛β细胞分泌指数(HOMA-β)逐渐下降(F =412.25～2 113.02,P均＜0.01),而稳态模型评估-胰岛素抵抗指数(HOMA-IR)逐渐升高(F=151.78,P＜0.01).0.5 hPG与HOMA-β(r =-0.69)、胰岛素生成指数(r=-0.71)、Matsuda胰岛素敏感指数(r=-0.21)、早时相胰岛素分泌指数(r =-0.48)、总时相胰岛素分泌指数(r=-0.54)、DI30(r=-0.62)、DI120(r =-0.70)呈负相关(P均＜0.01),与HOMA-IR呈正相关(r=0.34,P＜0.01).结论 0.5 hPG≥10.79 mmol/L可诊为糖尿病,8.69 mmol/L≤0.5 hPG＜ 10.79 mmol/L可诊为preDM.0.5 hPG在一定程度上可反映胰岛素敏感性及胰岛β细胞功能,随着0.5 hPG的升高,胰岛素敏感性逐渐下降,早时相胰岛素分泌缺陷亦逐渐加重,这种相关性独立于胰岛素敏感性.     

18F-FDG PET,the early phases and the delivery rate of 18F-AV45 PET as proxies of cerebral blood flow in Alzheimer's disease: Validation against 15O-H2O PET

IntroductionDual-biomarker positron emission tomography (PET), providing complementary information on cerebral blood flow and amyloid-β deposition, is of clinical interest for Alzheimer's disease (AD). The purpose of this study was to validate the perfusion components of early-phase ¹⁸F-florbetapir (eAV45), the ¹⁸F-AV45 delivery rate (R1), and ¹⁸F-FDG against ¹⁵O-H₂O PET and assess how they change with disease severity.MethodsThis study included ten controls, 19 amnestic mild cognitive impairment, and 10 AD dementia subjects. Within-subject regional correlations between modalities, between-group regional and voxel-wise analyses of covariance per modality, and receiver operating characteristic analyses for discrimination between groups were performed.ResultsFDG standardized uptake value ratio, eAV45 (0–2 min) standardized uptake value ratio, and AV45-R1 were significantly associated with H₂O PET (regional Pearson r = 0.54–0.82, 0.70–0.94, and 0.65–0.92, respectively; P < .001). All modalities confirmed reduced cerebral blood flow in the posterior cingulate of patients with amnestic mild cognitive impairment and AD dementia, which was associated with lower cognition (r = 0.36–0.65, P < .025) and could discriminate between patient and control groups (area under the curve > 0.80). However, eAV45 was less sensitive to reflect the disease severity than AV45-R1 or FDG.DiscussionR1 is preferable over eAV45 for accurate representation of brain perfusion in dual-biomarker PET for AD.     

清醒挪威褐鼠过敏性哮喘发作全程记录模型

目的 建立卵蛋白(OVA)致敏激发后, 在挪威褐鼠无创且清醒的状态下, 可观察和记录到过敏性哮喘发作全过程(速发相和迟发相)的动物模型。方法 66只挪威褐鼠按致敏液[OVA和Al(OH)₃]不同平均分为11组, 单纯注射OVA的4组(0.01、0.1、1.0和10.0 mg/只);OVA混合Al(OH)₃干粉的5组(0.1+100、1.0+100、10.0+100、1.0+52和1.0+4 mg/只);OVA 混合Al(OH)₃胶体的1组(10.0+4 mg/只);正常对照组1组。10个致敏组分别于第0天和第5天背部皮下2点注射相应致敏液, 每点注射0.2 mL, 正常对照组注射等量生理盐水。在第37天雾化吸入5% OVA激发10 min。然后立即放入体积描记器中连续记录16 h 呼气相延长参数(penh)值。采集第0、7、14、21、28、35、38天血清, ELISA法检测特异性IgE含量。HE染色观察肺病理变化。结果 除单纯注射OVA 0.01 mg组外, 其他各组大鼠血清特异性IgE含量均比正常对照组显著升高(P<0.05), 且在致敏1周后IgE开始大量产生, 直到第5周均呈持续增长趋势。观察到了哮喘发作的速发和迟发双相气道反应, 其特点表现在Penh值的显著增高, 且与正常对照组相比, 模型组(以OVA 10.0 & Al(OH)₃ 100、OVA 10.0 & Al(OH)₃ gel 4组为例)的速发相/迟发相峰值、面积均显著增大(P<0.05)。模型组(以OVA 10.0 & Al(OH)₃ 100组为例)有以气道周围嗜酸性粒细胞浸润为主的炎症表现。结论 成功建立了无创、清醒状态下挪威褐鼠过敏性哮喘发作全程记录模型。     

非酒精性脂肪肝与胰岛素抵抗的关系

目的研究非酒精性脂肪肝与胰岛素抵抗的相关性。方法非酒精性脂肪肝患者238例和健康体检者64例为研究对象,测定血糖、体质量指数(BMI)、腰臀比值(WHR)、丙氨酸氨基转移酶(ALT)、C反应蛋白(CRP)、血尿酸(UA)、纤维蛋白原(FIB)、胰岛素(FINS)、尿微量白蛋白/尿肌酐(uAlb/Ucr)值等、踝臂指数(ABI)、颈动脉内膜厚度(IMT),并行肝脏B超或CT检查,计算胰岛素抵抗指数(HOMA-IR)、β细胞功能指数(HBCI)、早相胰岛素分泌指数(ΔI30/ΔG30)、晚相胰岛素分泌指数(I30～120AUC/G30～120AUC)。结果非酒精性脂肪肝患者ALT、UAI、MT、ABI、FIB、mAlb/Cr、CRP、BMI、WHR均高于对照组(P<0.05)。不同程度的脂肪肝患者,其HOMA-IR、HBCI、ΔI30/ΔG30有显著性差异(P<0.05)。脂肪肝组患者HOMA-IR、HBCI、ΔI30/ΔG30的阳性率高于非脂肪肝组(P<0.05)。结论非酒精性脂肪肝患者胰岛素抵抗增加,且随着脂肪肝程度加重,胰岛素抵抗亦加重。     

早期胰岛素治疗对2型糖尿病患者并发症发生率和治疗费用的影响

目的观察早期胰岛素治疗对2型糖尿病患者并发症发生率和治疗费用的影响。方法 146例2型糖尿病患者随即分为早期胰岛素治疗组和口服降糖药物组,空腹血糖、餐后2h血糖、糖化血红蛋白测定评估血糖控制情况;眼底动脉血管检查和尿β2微球蛋白测定法评估并发症的发生率;对比两组因治疗糖尿病及其慢性并发症而花费的医疗费用（包括门诊及住院的医疗费用）。结果胰岛素组和口服降糖药物组其有并发症或并发症加重的比例分别为25.0和61.8%（χ2=20.99,P〈0.001）;口服降糖药物组总治疗总费用为胰岛素组的3.81倍,而口服降糖药物组并发症治疗费用为胰岛素组的4.20倍。结论早期胰岛素治疗可以延缓并发症的发生,从而减轻患者的身心痛苦和经济负担。     

Insight intoearly-phase trials forlung cancer inthe United States

Introduction:Few data have been published comparing early?phase trials for lung cancer between China and the United States (US). This study was to investigate the differences of phase 1 trials for lung...     

Angiographical severity of coronary atherosclerosis predicts death in the first year of hemodialysis

BACKGROUND: Cardiac deaths and events tend to cluster within the early-phase after starting dialysis. Our goal is to clarify the influence of severity of coronary atherosclerosis on early-phase death after starting hemodialysis (HD) therapy. PATIENTS AND METHODS: Eighty-three consecutive patients [mean age 62 years; male/female 64/19; diabetic nephropathy in 50 (54%)] with end-stage renal disease who admitted to our hospital to initiate regular HD treatment, and then received coronary angiography within 3 months after first dialysis therapy, were eligible for this study. Angiographical severity of coronary atherosclerosis was scored by numerically using Gensini scoring system. The patients who died within one year from starting HD were compared with those who survived as control by means of logistic regression analysis. RESULTS: Of 83 patients, 12 (14%) died less than one year after starting dialysis therapy. Of these 12 patients, nine died for cardiac causes. Confirmed predictors of death from cardiac cause were older age (>70 years), lower mean blood pressure (<100 mmHg), presence of ischemic heart disease (IHD), myocardial infarction (MI), angina pectoris (AP), chronic heart failure (CHF), poor cardiac function, abnormal wall motion of left ventricule (LV) and angiographical severity of coronary atherosclerosis by univariate model. Adjusting for confounding variables by multivariate model, only severity of coronary atherosclerosis (Gensini score >40 points) had a powerful influence, increasing risk for cardiac cause of early-phase death by about 17 times. CONCLUSIONS: Severity of coronary atherosclerosis predicts death in the first year of HD. These findings suggest that the strategy for prevention of coronary atherosclerosis should be instituted during the early phase of chronic renal failure.     

探讨早期气管切开术对防治重型颅脑损伤术后并发肺部感染的作用

目的研究早期气管切开术对防治重型颅脑损伤损伤术后并发肺部感染的作用。方法选取经手术治疗的重型颅脑损伤患者100例,随机分为观察组和对照组,各50例。观察组和对照组分别于伤后24h内及24 h后切开气管手术并给予抗感染治疗。结果共55例患者出现肺部感染,其中观察组的15例患者中有10例感染控制,感染控制时间为(7.2±2.52)d;对照组的40例患者中有8例感染控制,感染控制时间为(18.1±3.06)d;对照组组感染控制率显然低于观察组(P0.05),同时对照组控制感染平均时间和肺部感染率均显著高于观察组(P0.05)。结论早期气管切开对重型颅脑损伤术后并发肺部感染具有有效防止作用。     

初诊糖尿病及糖尿病前期早相胰岛分泌功能情况的调查

目的 探讨初诊糖尿病及糖尿病前期患者早相胰岛分泌功能的情况及其影响因素。方法 2019 年1～6 月从我院体检中心随机抽取龙岩市社区500 例既往无糖尿病史的体检居民进行调查,测定其空腹及OGTT 试验0.5 h、2 h 血糖、胰岛素、血脂,记录BMI、腰臀比（WHR）、年龄、平均收缩压（SBP）、平均舒张压（DBP）,计算早相胰岛分泌功能指数（△I30/△G30）、胰岛素抵抗指数（HOMA-IR）。结果 早相胰岛分泌功能,初诊DM 组＜IGT+IFG 组＜IGT组＜IFG 组＜NGT 组;胰岛素抵抗,初诊DM 组＞IGT+IFG 组＞IFG 组＞IGT 组＞NGT 组。多元逐步回归分析显示,WHR、SBP、TG、HOMA-IR 与△I30/△G30 呈显著负相关,HLD-C 与△I30/△G30 呈显著正相关（P＜0.05）;BMI、WHR、SBP、LDL-C 与HOMA-IR 呈显著正相关,而HLD-C 与HOMA-IR 呈显著负相关。结论IFG、IGT、IGT+IFG、初诊DM 的早相胰岛分泌功能呈进行性受损,其与胰岛素抵抗水平有关,控制BMI、WHR、血脂、收缩压达标具有重要意义。