陈旧性肘关节脱位并骨性强直的治疗研究

目的研究陈旧性肘关节脱位并骨性强直的手术治疗和康复方法。方法采用MeConnell肘后皮肤切口结合Campbell后侧入路显露肘关节及肱三头肌腱延长,肘关节松解复位术,并早期进行康复训练。结果全部患者的伤口均一期愈合,无明显异位骨再生,活动无疼痛,无并发症,短期随访功能恢复良好。结论后入路松解复位术适于陈旧性肘关节后脱位并伸肘位骨性强直未超过12周的病例,结合康复治疗能有效减轻组织反应,促进功能恢复。     

Formación de cuidadores en un programa de estimulación cognitiva: efectos diferenciales según el tipo de cuidador

Background and objectivesThe ageing population and the increasing dependency associated with it, makes the caregiver a highly relevant figure nowadays. The present study analyzes the socio-demographic differences between family and professional caregivers and their satisfaction and implication in a training program for caregivers.MethodsThe sample consisted of 59 caregivers of older people (37 were family caregivers and 22 professional caregivers) which received and implemented a caregivers training program in their daily care functions. These caregivers were trained in communication skills and cognitive stimulation strategies so they could use them in their daily care activities with the older adults under their care during a period of 3 months. All the participants were assessed with a socio-demographic questionnaire, 2 questionnaires to analyze their satisfaction with their work and the training received and one questionnaire to analyze their ability to detect and react to memory and behavior problems in the older adults they attended.ResultsThe results showed socio-demographic differences, improvements in satisfaction in family caregivers and a greater commitment in their daily work after the treatment in both groups although these effects could be due to different reasons.ConclusionsThe research shows the benefits of carrying out training programs for caregivers as they significantly increase the quality and satisfaction with caregiving. The study also displays the need to adjust such programs taking into account that the socio-demographic characteristics and training needs are different depending on whether de caregiver is a family member or a professional.     

Aerobic training increases the expression of adiponectin receptor genes in the peripheral blood mononuclear cells of young men

Little is known about the effect of exercise training on the expression of adiponectin receptor genes in peripheral blood mononuclear cells (PBMCs). In this study, we investigated the effects of aerobic training on the expression of AdipoR1 and AidpoR2 mRNAs in PBMCs, whole body insulin sensitivity, and circulating adiponectins in men. Thirty young men were randomly assigned to either a control (n=15) or an exercise (n=15) group. Subjects assigned to the exercise group underwent a 12-week jogging and/or running programme on a motor-driven treadmill at an intensity of 60%-75% of the age-based maximum heart rate with duration of 40 minutes per session and a frequency of 5 days per week. Two-way mixed ANOVA with repeated measures was used to test any significant time-by-group interaction effects for the measured variables at p=0.05. We found significant time-by-group interaction effects for waist circumference (p=0.001), VO_2max (p<0.001), fasting insulin (p=0.016), homeostasis model assessment for insulin resistance (HOMA-IR) (p=0.010), area under the curve (AUC) for insulin response during the 75-g oral glucose tolerance test (p=0.002), high-molecular weight (HMW) adiponectin (p=0.016), and the PBMC mRNA levels of AdipoR1 (p<0.001) and AdipoR2 (p=0.001). The exercise group had significantly increased mRNA levels of AdipoR1 and AdipoR2 in PBMCs, along with increased whole body insulin sensitivity and HMW adiponectin, decreased waist circumference, and increased VO_2max compared with the control group. In summary, the current findings suggest that exercise training modulates the expression of AdipoR1 and AdipoR2 mRNAs in PBMCs, implying that manipulation of the expression of these genes could be a potential surrogate for lifestyle intervention-mediated improvements of whole body insulin sensitivity and glucose homeostasis.     

Similar hypotensive responses to resistance exercise with and without blood flow restriction

Low intensity resistance exercise (RE) with blood flow restriction (BFR) has gained attention in the literature due to the beneficial effects on functional and morphological variables, similar to those observed during traditional RE without BFR, while the effects of BFR on post-exercise hypotension remain unclear. The aim of the present study was to compare the blood pressure (BP) response of trained normotensive individuals to RE with and without BFR. In this cross-over randomized trial, eight male subjects (23.8 ± 4 years, 74 ± 3 kg, 174 ± 4 cm) completed two exercise protocols: traditional RE (3 x 10 repetitions at 70% one-repetition maximum [1-RM]) and low intensity RE (3 x 15 repetitions at 20% 1-RM) with BFR. Blood pressure measurements were performed after 15 min of seated rest (0), immediately after and 10 min, 20 min, 30 min, 40 min, 50 min and 60 min after the experimental sessions. Similar hypotensive effects for systolic BP (SBP) were observed for both protocols (P < 0.05) after exercise, with no differences between groups (P > 0.05) and no statistically significant difference for diastolic BP (P > 0.05). These results suggest that in normotensive trained individuals, both traditional RE and RE with BFR induce hypotension for SBP, which is important to prevent cardiovascular disturbances.     

综合医院住院医师规范化培训管理实践与探索

国家对住院医师规范化培训项目越来越重视,芜湖市第二人民医院紧随政策导向,贯彻实施住院医师规范化培训。通过以芜湖市第二人民医院住院医师规范化培训管理实践为例,介绍住院医师规范化培训背景、现状及管理实践,为持续改进培训管理工作提供参考。     

医学工程人员培训及工作满意度现状分析

目的 对医学工程人员的基本情况、培训情况、培训需要以及工作满意度情况调查,为医学工程人员的继续教育和管理提供建议。方法 取武汉三级医院8家、二级医院2家,在每家医院的医学工程部门中随机抽取15名进行问卷调查。结果 调查医学工程人员138名,大专及以下学历占47.9%;97.8%的医学工程人员愿意接受在职教育和培训的意愿;对职称、收入、在医院的地位、晋升机会满意的比例为17.4%、13.1%、15.2%、19.6%。讨论 医学工程人员整体学历偏低;医学工程人员培训需求较大;医学工程人员对职称、收入、在医院的地位、晋升机会、在职教育和培训的机会等满意度均较低。医院应建立科学的职业晋升制度、激励制度、培训方案,同时鼓励医学工程人员积极参加培训。     

住院医师/专科医师通科培训必要性的探讨

当前医学生临床实践活动在时间上不能保证,质量上又明显下滑的情况下,增加住院医师/专科医师通科培训是十分必要的。不仅能弥补临床实践的不足,而且也能为医学生向住院医师平稳顺利过度作铺垫。住院医师/专科医师培养是医学生向临床医师角色转换的一个重要的过度阶段,因此,培训时间、学习内容安排的科学、合理与否将直接影响培养效果。住院医师/专科医师通科培训应为培养具有较高临床综合能力的医学人才奠定基础。     

迷迭香对运动大鼠肝脏组织脂质过氧化损伤保护作用的研究

本实验选用SD(Sprague Dawley)大鼠,建立大强度耐力训练模型,研究迷迭香对运动大鼠肝脏组织脂质过氧化损伤保护作用。结果显示,1)迷迭香可降低血清丙氨酸氨基转移酶活性,升高肝组织丙氨酸氨基转移酶的活性,都有显著性差异(P<0.05);2)迷迭香可以不同程度地增强肝脏组织中抗氧化酶SOD(superoxide dis-mutase)、CAT(catalase)和GSH-Px(glutathione peroxidase)的活性,其中SOD和CAT的活性增加在安静和运动状态下都有显著性差异(P<0.05),GSH-Px的活性增加在运动状态下具有显著性差异(P<0.05);3)迷迭香可以降低肝脏组织中MDA(malondialdehyde)的含量,无显著性差异(P>0.05)。结论:迷迭香可以增加肝脏组织中的抗氧化酶活性,减轻大强度耐力训练对大鼠肝脏组织造成的脂质过氧化损伤。并且在同一状态下对不同的抗氧化酶活性影响不同。     

有氧运动对高蛋氨酸饮食大鼠血浆NO、ET和NO/ET系统的影响

目的：探讨有氧运动对高蛋氨酸饮食大鼠血浆总一氧化氮合成酶（T-NOS）、一氧化氮（NO）、内皮素（ET）和NO/ET系统的影响。方法：雄性Wistar大鼠随机分为正常饮食对照组（对照组）、高蛋氨酸饲料组（高蛋氨酸组）和有氧运动＋高蛋氨酸饮食组（运动干预组）。对照组喂饲普通饲料,高蛋氨酸组和运动干预组喂饲含3%蛋氨酸的高蛋氨酸饲料,运动干预组同时每日同时进行90 min无负重游泳运动,实验共8周。分别测定血浆同型半胱氨酸（Hcy）、ET、NO和T-NOS含量。结果：高蛋氨酸组血浆Hcy含量显著高于对照组达2倍以上（P〈0.01）,T-NOS和NO含量显著降低,ET含量显著升高（P〈0.01）,且NO/ET比值均显著降低（P〈0.05）;与高蛋氨酸组相比,运动干预组血浆Hcy含量显著下降（P〈0.05）,T-NOS,NO含量和NO/ET比值显著升高（P〈0.05）,且与对照组相比上述各项指标无显著差异。结论：高蛋氨酸饮食可诱发大鼠高同型半胱氨酸血症,血浆NO/ET失衡;有氧运动可降低高蛋氨酸饮食大鼠血浆Hcy水平,改善NO/ET失衡,预防高同型半胱氨酸血症。