不同压力血流限制结合低强度抗阻训练对大学生下肢肌肉及心肺功能影响*

目的:探讨不同压力血流限制(BFR)结合低强度抗阻训练对男性大学生下肢肌肉及心肺功能影响。方法:27名健康男性大学生随机分为对照组(C组)、低压组(L组)、高压组(H组),每组9人,受试者大腿近端放置可充气非弹性袖带后分别进行无压力、120 mmHg、180 mmHg,进行20%1次重复最大力量(1RM)强度的负重半蹲训练,比较每周3次,共12周训练前后及各组间股直肌、股中肌肌肉厚度(MTH)、相对伸膝峰值力矩(rM)、峰值功率(P)、相对最大摄氧量(rVO₂max)、每搏输出量(SV)、心输出量(CO)、射血分数(EF)等指标的变化。结果:与训练前比较,12周训练后L组和H组股直肌MTH、股中肌MTH、rM、rVO₂max、SV、EF均显著提高(P＜0.05,P＜0.01),且显著高于训练后C组(P＜0.05,P＜0.01),而L组与H组之间无显著性差异。结论:12周120 mmHg或180 mmHg压力下20%1RM强度BFR训练均可有效提高男性大学生股四头肌肌肉厚度及力量并显著提高心肺功能。     

举重训练对男子肌比力、肌纤维的影响

安排9名有一定训练的青少年运动员参加10周举重训练。每周6次,每次8小时。训练前后用电子计算机—X线断层扫描技术(CT)测量大腿肌肉横断面积,股外肌针刺活检取样测定Ⅰ、Ⅱ型肌纤维％和面积。测定大腿伸膝肌最大随意等长力量。将结果(实验前、后)与对照组(13名无训练者)和优秀举重运动员(健将3人、一级4人)进行比较。结果表明,有训练人(实验前、后和优秀)与没有训练人(对照)在肌比力上存有差别。短、长期举重训练后,肌比力与Ⅱ型肌纤维％呈正相关。短、长期举重训练不曾改变肌纤维类型分布。举重训练对Ⅱ型肌纤维有选择性作用,且这个作用不受年龄的影响。结果还提示,肌比力的变化及肌比力与肌纤维之间的关系都会受运动项目专项特点的影响。     

蚂蚁水提取物抗疲劳的研究

目的:研究蚂蚁水提取物抗疲劳作用及其机制,为提高运动员训练效果及比赛成绩提供科学方法。方法:将80只小鼠随机分为4组(n=20):阴性生理盐水对照组、蚂蚁水提取物分为高、中、低三个剂量组,比较各组小鼠力竭游泳时间、肝糖原、肌糖原、乳酸脱氢酶、超氧化物歧化酶、血乳酸和血尿素氮的差异,研究蚂蚁水提取物抗疲劳的效果和机制。结果:与阴性生理盐水对照组比较,蚂蚁水提取物中高剂量组能够延长小鼠负重游泳时间(P<0.01),提高小鼠乳酸脱氢酶、超氧化物歧化酶活力(P<0.01),降低血乳酸和血尿素氮含量(P<0.01),提高小鼠肌糖原储备量,但对肝糖原的储备量影响不大。结论:蚂蚁水提取物能起到抗疲劳作用,其原因可能是它提高了乳酸脱氢酶、超氧化物歧化酶活力,使得代谢产物的分解加快,从而小鼠在耐力运动中坚持更久的时间。     

生物反馈电刺激联合Kegel训练对产后盆底功能障碍性疾病患者盆底功能电生理指标和生活质量的影响

目的:观察生物反馈电刺激联合Kegel训练对产后盆底功能障碍性疾病(PFD)患者盆底功能电生理指标和生活质量的影响。方法:研究对象为2018年3月~2020年12月我院收治的80例产后PFD患者。采用双色球随机分组法将患者分为对照组(n=40)和研究组(n=40)。对照组给予Kegel训练,研究组给予生物反馈电刺激联合Kegel训练,两组均治疗8周。对比两组治疗8周后的疗效和尿失禁、盆底器官脱垂程度的改善情况。对比两组治疗前、治疗8周后的盆底功能电生理指标、日常生活质量和性生活质量。结果:治疗8周后,研究组的临床总有效率较对照组高(P<0.05)。治疗8周后,研究组I类肌纤维疲劳度、Ⅱ类肌纤维疲劳度、快肌最大肌电值及阴道动态压力均优于对照组(P<0.05)。研究组治疗8周后尿失禁、盆底器官脱垂程度的改善情况优于对照组(P<0.05)。治疗8周后,研究组盆底功能影响问卷简表(PIFQ-7)评分、盆腔器官脱垂-尿失禁性功能问卷(PISQ-12)评分均低于对照组(P<0.05)。结论:产后PFD患者采用生物反馈电刺激联合Kegel训练治疗疗效明确,可促进尿失禁、盆底器官脱垂程度情况及盆底功能改善,提高患者日常生活质量和性生活质量。     

等速肌力训练联合有氧运动对脑卒中患者肺功能、下肢运动功能及生活质量的影响

目的:探讨有氧运动联合等速肌力训练对脑卒中患者下肢运动功能、肺功能及生活质量的影响。方法:选取2016年8月～2019年9月期间我院收治的脑卒中患者130例,根据随机数字表法分为对照组(n=65,常规康复训练)和研究组(n=65,等速肌力训练联合有氧运动),比较两组患者肺功能、下肢运动功能及生活质量。结果:两组治疗8周后膝关节峰力矩(PT)、膝屈伸PT、膝屈伸耐力指数(ER)、Fugl-Meyer下肢运动功能量表(FMA-LE)评分均较治疗前升高,且研究组高于对照组(P0.05)。两组治疗8周后社会功能、躯体疼痛、精神健康、活力、健康状况、生理职能、生理机能、情感职能维度评分均较治疗前升高,且研究组高于对照组(P0.05)。两组治疗8周后用力肺活量(FVC)、第一秒用力呼气量(FEV1)、最大呼气流量(PEF)均较治疗前升高,且研究组高于对照组(P0.05)。结论:脑卒中患者给予等速肌力训练联合有氧运动,可有效改善其肺功能、下肢运动功能及生活质量,临床应用价值较高。     

MVIC运动不能提高大学生篮球运动员的激活后增强效应

本研究旨在探讨激活后增强效应(post-activation potentiation, PAP)对大学生篮球运动员上肢力量表现和肌肉损伤指标的影响,以及不同最大自主等长收缩(maximal voluntary isometric contraction, MVIC)时间诱发激活后增强效应后,对卧推(bench press throw, BPT)表现的影响。本研究招募30名大学生男性篮球运动员进行重复交叉实验。所有受试者均接受3组3 s卧推MVICs (3 MVICs)、3组5 s卧推MVICs (5 MVICs)、对照控制(CON)共3次干预,记录推掷高度与杠铃腾空时间,并分析推掷高度、力量与功率的峰值。研究表明:3 MVICs、5 MVICs、CON处理后,卧推高度在后测各时间点皆显著低于前测平均值,功率峰值在第4分钟、第8分钟及后测平均值上,皆显著低于前测平均值。但是,力量峰值在后测各时间点与前测平均值均无显著性差异。本研究初步认为给予较长的组间恢复时间,3 MVICs、5 MVICs产生肌肉疲劳的程度可能高于诱发PAP的程度,进而无法提升训练良好运动员的上肢爆发力表现。     

龙虎交战针法联合悬吊训练对腰椎间盘突出症患者腰背伸肌群功能、神经传导速度和血清炎症因子的影响

摘要 目的：观察龙虎交战针法联合悬吊训练对腰椎间盘突出症（LDH）患者腰背伸肌群功能、神经传导速度和血清炎症因子的影响。方法：纳入我院2018年4月-2021年8月期间接收的LDH患者82例。按照随机数字表法将患者分为对照组（悬吊训练,n=41）和实验组（龙虎交战针法联合悬吊训练,n=41）。观察两组患者腰椎功能恢复情况、疼痛症状改善情况以及腰背伸肌群功能、神经传导速度和血清炎症因子的变化情况。结果：实验组的临床总有效率高于对照组（P<0.05）。治疗后,两组日本骨科协会下腰痛评价表（JOA）评分升高,且实验组高于对照组（P<0.05）。治疗后,两组Oswestry功能障碍指数（ODI）、视觉疼痛模拟评分法（VAS）评分下降,且实验组低于对照组（P<0.05）。治疗后,两组平均功率、腰背伸状态下峰力矩升高,且实验组高于对照组（P<0.05）。治疗后,两组腰背屈伸比下降,且实验组较对照组低（P<0.05）。治疗后,两组腓总神经和胫神经的传导速度均升高,且实验组较对照组高（P<0.05）。治疗后,两组血清白细胞介素-1β（IL-1β）、白介素-1（IL-1）、基质金属蛋白酶 3（MMP-3）、肿瘤坏死因子-α（TNF-α）水平均下降,且实验组低于对照组（P<0.05）。结论：龙虎交战针法联合悬吊训练可促进LDH患者腰椎功能改善,减轻疼痛症状,改善腰背伸肌群功能和腓总神经、胫神经的神经传导速度,降低机体血清炎症因子水平,具有较好的临床应用价值。     

等速肌力训练联合时空针灸灵龟八法治疗老年肝肾亏虚型膝骨关节炎的疗效及对血清细胞因子的影响

摘要 目的：观察老年肝肾亏虚型膝骨关节炎（KOA）患者经时空针灸灵龟八法联合等速肌力训练治疗后疗效情况及血清细胞因子的变化。方法：此次临床研究病例为从2019年7月~2021年7月间我院老年医学科收治的100例老年肝肾亏虚型KOA患者。将患者根据随机数字表法分为研究组（50例,基础治疗及等速肌力训练联合时空针灸灵龟八法）、对照组（50例,基础治疗及等速肌力训练）。比较两组中医临床疗效,中医证候评分,视觉模拟评分法（VAS）评分、西安大略和麦克马斯特大学骨关节炎指数量表（WOMAC）评分、Lysholm膝关节评分,膝关节伸肌、屈肌峰力矩（PT）、总功量（TW）,血清白细胞介素-18（IL-18）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平。结果：研究组的临床总有效率较对照组明显升高（P<0.05）。研究组治疗后Lysholm膝关节评分高于对照组,中医证候、WOMAC、VAS评分低于对照组（P<0.05）。研究组治疗后IL-6、TNF-α、IL-18低于对照组（P<0.05）。研究组治疗后膝关节伸肌、屈肌PT、TW高于对照组（P<0.05）。结论：等速肌力训练联合时空针灸灵龟八法治疗老年肝肾亏虚型KOA患者疗效显著,可改善临床症状,促进膝关节功能恢复,同时还可有效降低血清IL-6、IL-18、TNF-α水平,具有一定临床应用价值。     

腰腹肌运动联合超声波对非特异性下腰痛的治疗效果及机制

为了解腰腹肌运动联合超声波治疗的效果,本研究对腰腹肌运动联合超声波治疗非特异性下腰痛进行了探讨。研究显示,治疗4周后,腰腹肌运动+超声波治疗组的疼痛评分(0.73)显著低于超声波治疗组(1.22)(p<0.05)。腰腹肌运动+超声波治疗组的立位体前屈活动幅度(2.35 cm)显著低于超声波治疗组(6.23 cm)(p<0.05)。腰腹肌运动+超声波治疗组的屈伸肌总功和屈伸肌峰值力矩比显著高于超声波治疗组(p<0.05)。腰腹肌运动+超声波治疗组的Oswestry功能障碍指数问卷表(ODI)评分显著低于超声波治疗组(p<0.05)。治疗4周后,腰腹肌运动+超声波治疗组的血清超氧化物歧化酶(SOD)和过氧化氢酶(CAT)水平显著高于超声波治疗组,而丙二醛(MDA)水平显著低于超声波治疗组(p<0.05)。为了进一步考察运动联合超声波疗法对下腰痛的治疗机制,本研究建立了完全弗氏佐剂诱导的腰椎间盘退变大鼠模型。采用阿利新蓝染色检测大鼠椎间盘纤维环区和髓核区蛋白多糖的水平,并采用免疫组化染色检测蛋白聚糖和Ⅱ型胶原的表达,发现运动联合超声波治疗可明显提高大鼠蛋白多糖、Ⅱ型胶原和蛋白聚糖水平。本研究表明,与超声波治疗相比,腰腹肌运动联合超声波治疗可更大程度地降低非特异性下腰痛患者的疼痛,提高肌肉功能和腰椎功能,增强血清抗氧化能力,并减少氧化应激损伤。此外,该联合疗法可明显提高腰椎间盘退变大鼠椎间盘中的蛋白多糖、Ⅱ型胶原和蛋白聚糖水平。     

Program review. Challenges and opportunities for training the next generation of biophysicists: perspectives of the directors of the Molecular Biophysics Training Program at Northwestern University

Molecular biophysics is a broad, diverse, and dynamic field that has presented a variety of unique challenges and opportunities for training future generations of investigators. Having been or currently being intimately associated with the Molecular Biophysics Training Program at Northwestern, we present our perspectives on various issues that we have encountered over the years. We propose no cookie-cutter solutions, as there is no consensus on what constitutes the "ideal" program. However, there is uniformity in opinion on some key issues that might be useful to those interested in establishing a biophysics training program.     

Serum hormone concentrations during prolonged training in elite endurance-trained and strength-trained athletes

A study of 1 year was performed on nine elite endurance-trained athletes (swimmers) and on eight elite strength-trained athletes (weightlifters) in order to examine the effects of training on the endocrine responses and on physical performance capacity. The measurements for the determination of serum hormone concentrations were performed at about 4-month intervals during the course of the year. The primary findings demonstrated that during the first and most intensive training period of the year in preparing for the primary competitions similar but statistically insignificant changes were observed in the concentrations of serum testosterone, free testosterone and cortisol in both the endurance-trained and strength-trained groups. After that period the changes in hormonal response over the year were infrequent and minor. A significant (p less than 0.01) decrease occurred in the strength-trained group in serum-free testosterone during the second period, which was characterized by the highest overall amount of training. Over the entire year the concentrations of serum hormones remained statistically unaltered in both groups. Slight but statistically insignificant increases of 1.2% +/- 0.8% and 2.1% +/- 5.1% were observed in the competitive performances over the year in the endurance-trained and strength-trained groups, respectively. The present findings in the two groups of elite athletes, who differed greatly with regard to the type of physiological loading, demonstrated that the overall hormonal responses both during the most intensive and during prolonged training periods were rather similar and the infrequent small changes remained well within the normal physiological range.(ABSTRACT TRUNCATED AT 250 WORDS)     

The effect of unilateral training on contralateral limb power in young women and men

The purpose of this study was to determine the effect of training of one side of the body on the muscle torques and power output on the trained and untrained side. Seventeen female and twenty-two male students were subject to a four-week knee joint power training regimen on a specially designed stand. The subjects were divided into two groups: a training group (female – N = 11 and male – N = 16) and a control group (female – N = 6 and male – N = 6). Effectiveness of power training on the stand described previously was estimated based on bilateral knee torque and power under static and isokinetic conditions. The experiment lasted for 39 days and was preceded by preliminary studies (pre-training). Control measurements in training groups were made after four weeks of training (post-training) and after the next two weeks (de-training). Power training caused an insignificant increase in force and power in both groups for the untrained leg and a significant increase in RMS EMG. Therefore, the study confirmed the hypothesis that resistance training performed in dynamic conditions can affect the contralateral limb and may also trigger delayed adaptations to training conditions during the detraining phase. Sex differences in adaptation to power training are not clear; however, the differences in gains in contralateral effects between men and women were not confirmed.     

Effects of unilateral isometric strength training on joint angle specificity and cross-training

The purpose of this study was to examine the effects of unilateral isometric leg extension strength training on the strength and integrated electromyogram (IEMG) of both the trained and untrained limbs at multiple joint angles. A training (TRN) group [nine women; mean (SD) age, 20(1) years] exercised for 6 weeks with isometric leg extensions at 80% of maximal isometric torque. A control (CTL) group [eight women; 21(1) years] did not exercise. The training was performed three times per week on a Cybex II isokinetic dynamometer at a joint angle where the lever arm was 0.79 rad below the horizontal plane. The subjects were tested pre- and posttraining for maximal unilateral isometric torque in both limbs at joint angles of zero, 0.26, 0.79,1.31, and 1.57 rad below the horizontal plane. Bipolar surface electrodes were used to record the IEMG of the vastus lateralis (VL) and vastus medialis (VM) during the isometric tests. Three univariate (torque, IEMG-VL, and IEMG-VM) four-way (group x time x limb x angle) mixed factorial ANOVAs were used to analyze the data. The results indicated joint angle specificity for isometric torque in the TRN group only, with significant increases in torque at 0.79 (P = 0.0004) and 1.31 (P = 0.0039) rad. No significant increases in torque were found in the untrained limb of the TRN group or in either limb of the CTL group. Similarly, there were no significant changes in IEMG as a result of the training for the VL or VM. The joint-angle-specific strength increases without concomitant increases in IEMG were hypothesized to result from joint-angle-specific decreases in antagonistic co-contraction and/or preferential hypertropy of the quadriceps femoris at specific levels of the muscle group.     

Comparison of changes in testosterone concentrations after strength and endurance exercise in well trained men

Changes in the testosterone concentrations after single sessions of endurance and strength training were measured in seven well trained men, experienced in both forms of training. Both training sessions were rated as hard to very hard on the Borg scale. Blood samples for testosterone measurements were taken before, immediately after, and 2, 4 and 6 h after the training sessions as well as the next morning. The mean testosterone concentration increased 27% (P less than 0.02) and 37% (P less than 0.02) during the strength and endurance training session, respectively. Two hours after the training sessions the mean testosterone concentration had returned to the pre-training level and remained at that level for the length of the observation period. There were no significant differences in the changes in testosterone concentration after strength and endurance training but there were large differences in the testosterone response at the level of the individual. A high correlation (r = 0.98; P less than 0.001) for individuals was found between increases in testosterone concentration after strength and after endurance training. It was concluded that the changes in mean testosterone values followed the same timecourse after single sessions of strength and endurance training of the same duration and perceived exertion. The interindividual differences in testosterone response may be of importance for individual adaptation to training.     

The effects of exercise training programs on plasma concentrations of proenkephalin Peptide F and catecholamines

To determine if exercise training alters the pattern and magnitude of plasma concentrations of proenkephalin Peptide F and epinephrine, plasma proenkephalin [107–140] Peptide F_ir and catecholamines were examined pre-training (T-1), and after 4- (T-2), 8- (T-3), and 12-weeks (T-4) of training. 26 healthy men were matched and randomly assigned to one of three groups: heavy resistance strength training (Strength, n = 9), high intensity endurance training (Endurance, n = 8), or both training modalities combined (Combined, n = 9). Blood was collected using a syringe with a cannula inserted into a superficial arm vein with samples collected at rest, after each 7 min stage and 5 and 15 min into recovery. With training, all groups observed shifted plasma Peptide F responses to graded exercise, where significant increases were observed at lower exercise intensities. Increases in plasma epinephrine with exercise were observed in all groups. The Combined group saw increases at 25% at T-3 and for 50% at T-2, T-3, and T-4 which was higher than T-1. The Endurance group demonstrated increases for 50% at T-1, T-2, T-3 but not at T-4. The plasma epinephrine response to graded exercise was reduced in the Strength group. Increases in plasma norepinephrine above rest were observed starting at 50%

. The Strength group demonstrated a significant reduction in norepinephrine observed at 100% at T-3 and T-4. Peptide F and catecholamines responses to graded exercise can be altered by different types of physical exercise training. Simultaneous high intensity training may produce adrenal medulla exhaustion when compared to single mode training.     

临床专业学位研究生培养与住院/专科医师培训的比较研究

通过对临床专业学位研究生培养与住院/专科医师培训模式的比较研究,尝试对两者进行同一化管理,将利于量化临床型研究生临床能力培养情况,提高招生吸引力,利于挑选优秀临床型研究生,与住院医师规范化培训对象招录工作相衔接。     

论中外医院管理专业人才的培养模式

对国外医院管理人才培养模式和目前我国医院管理人才现状作了论述分析,通过借鉴国外的专业经验并结合我国的实际情况,就建立具有中国特色的医院管理专业人才培养机制提出了自己的看法。     

人文医院核心价值观的培育和实践

人文医院是新时期全面提升综合医疗服务水平的医院发展之路,而核心价值观的培育和实践是人文医院建设的关键。人文医院培育核心价值观,人文精神是其指导思想;人文医院实践核心价值观,人本管理和人文关怀是其对内对外的两大手段。无锡市人民医院人文医院建设突出人本管理和人文关怀,推出一系列先进的管理模式和服务举措,为人文医院建设作出了有益的探索。     

Effects of small-sided games and high-intensity interval training on physical performance in young female handball players

This study was designed to compare the effectiveness of small-sided handball games in combination with handball training (SSG group) versus high-intensity interval training in combination with handball training (HIIT group) on physical performance of young female handball players during pre-competitive period. Twenty-four young female handball players, who have a 6.17 ± 1.54 years training experience and competition in the national league participated in this study. SSG group (n = 12; age 16.06 ± 0.80 years, body mass 61.27 ± 3.68 kg, body height 1.64 ± 4.7 m, body mass index 22.7 kg/m²) while HIIT group (n = 12; 16.20 ± 1.28 years, body mass 62.46 ± 7.86 kg, body height 1.68 ± 6.8 m, body mass index 22 kg/m²). Both groups applied training programs twice-a-week for 8 weeks. Before and after the training programs physical performances were assessed: Countermovement jump (CMJ), Squat jump (SJ), Sprint on 0–10 m; Sprint on 0–20 m; Sprint on 0–30 m, Throwing medicine ball and total distance covered during the Yo-YoIRT1. After 8 weeks SSG and HIIT groups significantly improved CMJ, SJ, 0–20 m sprint, 0–30 m sprint, throwing medicine ball and Yo-YoIRT1 (p ≤ 0.05). However, significantly greater improvement was achieved in Yo-YoIRT1 (m) in HIIT group (28.40%) than SSG group (17.63%). These results indicate that SSG group and HIIT group equally improve of physical performances (jump, sprint and upper explosive strength) among young female handball players in pre-competitive period.