膳食营养干预联合抗阻力训练治疗老年男性肌少症患者的临床效果分析

目的:分析膳食营养干预联合抗阻力训练治疗老年男性肌少症患者的临床效果。方法:选取200例老年男性肌少症患者作为研究对象,应用随机数字表法将其分为研究组和对照组,每组各100例。对照组患者给予常规营养和运动知识宣教干预,研究组给予膳食营养干预联合抗阻力训练,两组患者均连续干预6个月。检测和比较两组患者干预前后的握力、简短肌肉功能测试(SPPB)评分、日常生活能力(ADL)评分、左心室射血分数(LVEF)、蒙特利尔认知评估量表(MoCA)评分、简易智能状态检查量表(MMSE)评分的变化和认知功能损害的发生率。结果:干预后,研究组患者的握力、SPPB评分、ADL评分、LVEF、MoCA评分、MMSE评分均较干预前明显改善,且均明显优于对照组,差异均有统计学意义(P0.05)。结论:膳食营养干预联合抗阻力训练可以改善老年男性肌少症患者的肌力,提高日常生活能力,增强心肌射血功能,并改善患者的认知功能。     

低强度脉冲超声波联合股四头肌肌力强化训练治疗膝骨关节炎患者的临床疗效观察

目的:观察低强度脉冲超声波联合股四头肌肌力强化训练治疗膝骨关节炎(KOA)患者的临床疗效。方法:选取我院于2016年1月～2018年1月收治的98例KOA患者。根据乱数表法将其分为研究组(n=49,低强度脉冲超声波联合股四头肌肌力强化训练治疗)、对照组(n=49,常规物理治疗)。比较两组临床疗效、Lysholm评分、膝关节日常活动能力(ADL)评分、视觉模拟评分量表(VAS)评分以及滑液中白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)水平及不良反应。结果:研究组的临床总有效率为91.84%(45/49),高于对照组的69.39%(34/49)(P0.05)。治疗8周后,两组ADL、VAS评分均降低,且研究组较对照组低(P0.05);两组Lysholm评分均升高,且研究组较对照组高(P0.05);两组滑液中IL-1β、TNF-α、VEGF水平均降低,且研究组低于对照组(P0.05)。两组均未见严重的不良反应。结论:低强度脉冲超声波联合股四头肌肌力强化训练治疗KOA患者,可迅速改善患者症状,提高膝关节功能,同时可改善滑液中IL-1β、TNF-α、VEGF水平,具有一定的临床应用价值。     

Relationship between plasma potassium and ventilation during successive periods of exercise in men

During and after two successive incremental cycle ergometer tests (tests A and B), plasma potassium concentration ([K+]p), plasma pH (pHp), plasma partial pressure of carbon dioxide, blood lactate concentration ([Lac-]b) and ventilation (VE) were measured. While there was a good correlation between the increase in [K+]p and VE or pHp, respectively, in test A, in test B a close correlation was found only between the increase in VE and [K+]p (r greater than 0.9 for nearly all single cases; r was 0.84 and 0.89 for all (pooled) cases in tests A and B, respectively; the correlation coefficients between changes in pHp and VE in tests A and B were r = 0.74 and r = 0.28, respectively, and r = 0.89 and r = 0.10 between the changes in [Lac-]b and VE in tests A and B). The close relationship for individuals between VE and [K+]p in tests A and B supported the hypothesis that the extracellular increase in [K+] may contribute to the ventilatory drive during exercise. The comparison of the results of tests A and B further indicated that the relationship between pHp and VE was dependent on the experimental design, and that pHp and VE changes are unlikely to be cause and effect.     

Effects of conditioning history on selective stimulus control by elements of compound discriminative stimuli

Effects of prior discrimination training on stimulus control by color and shape dimensions of compound stimuli were studied with college students. In Phase 1, single-stimulus discrimination training was conducted for two values of color and shape. Phase 2 discrimination training employed two 2-dimensional compound stimuli composed of the color and shape stimuli trained in Phase 1. For conflict-compound stimuli, the stimulus-response-consequence contingency was altered between phases for one stimulus dimension (target dimension), but not for the other, non-target, dimension. Level of congruence (100%, 25%, and 0%) of the contingency for the target dimension between phases was manipulated across groups. When each stimulus value was tested in Phase 3, level of Phase-2-consistent responding to the target dimension varied with level of Phase-1-to-Phase-2 congruence. In Experiment 2, training history for the non-target dimension was altered across three conditions: (a) Correlated with reinforcement, as in Experiment 1, (b) No-Training, or (c) Not-Correlated. Phase-2-consistent responding to the target cue in Phase 3 was lower under the latter conditions than under the Correlated condition, indicating that the non-target dimension modulated control by the target dimension, consistent with stimulus competition. The data suggest elemental, rather than configural processing of the compound stimuli during Phase 2.     

2-D DIGE analysis of the mitochondrial proteome from human skeletal muscle reveals time course-dependent remodelling in response to 14 consecutive days of endurance exercise training

Adaptation of skeletal muscle to repeated bouts of endurance exercise increases aerobic capacity and improves mitochondrial function. However, the adaptation of human skeletal muscle mitochondrial proteome to short‐term endurance exercise training has not been investigated. Eight sedentary males cycled for 60 min at 80% of peak oxygen consumption (VO_2peak) each day for 14 consecutive days, resulting in an increase in VO_2peak of 17.5±3.8% (p<0.01). Mitochondria‐enriched protein fractions from skeletal muscle biopsies taken from m. vastus lateralis at baseline, and on the morning following the 7th and 14th training sessions were subjected to 2‐D DIGE analysis with subsequent MS followed by database interrogation to identify the proteins of interest. Thirty‐one protein spots were differentially expressed after either 7 or 14 days of training (ANOVA, p<0.05). These proteins included subunits of the electron transport chain, enzymes of the tricarboxylic acid cycle, phosphotransfer enzymes, and regulatory factors in mitochondrial protein synthesis, oxygen transport, and antioxidant capacity. Several proteins demonstrated a time course‐dependent induction during training. Our results illustrate the phenomenon of skeletal muscle plasticity with the extensive remodelling of the mitochondrial proteome occurring after just 7 days of exercise training suggestive of enhanced capacity for adenosine triphosphate generation at a cellular level.     

Time–frequency analysis of variabilities of heart rate, systolic blood pressure and pulse transit time before and after exercise using the recursive autoregressive model

Time–frequency (T–F) analysis is often used to study the non-stationary cardiovascular oscillations such as heart rate and blood pressure variabilities in dynamic situations. This study intends to use the T–F recursive autoregressive technique to investigate variability in pulse transit time (PTT), which is a cardiovascular parameter of emerging interest due to its potential to estimate blood pressure non-invasively, continuously and without a cuff. Recent studies suggest that PTT is not only related to systolic blood pressure (SBP) but also to heart rate. Therefore, in this study, variability of PTT is analyzed together with the variabilities of R–R interval (RRI) from electrocardiogram and beat-to-beat SBP on 9 normotensive subjects before and shortly after three successive bouts of treadmill exercise. The results showed that both low frequency (LF) and high frequency (HF) components were found in the spectra of RRI, SBP and PTT in the 5-min recordings collected before and after exercise. Compared to the baseline, a decrease in the power of the HF component of RRI followed by an increase in its LF component indicated firstly a vagal withdrawal and then sympathetic activity enhancement after successive bouts of exercise. On the other hand, although changes in the LF and HF components of PTT were more similar to those of SBP than of RRI, the LF/HF ratio of SBP was almost 4 times higher than that of PTT. Based on the results, it is therefore suggested that the relationship between SBP and PTT is frequency-dependent.     

Embryo recovery from exercised mares

The effect of exercise on mare reproductive efficiency was evaluated by comparing rates of embryo recovery from mares assigned to either an exercise regimen or a non-exercise (control) regimen. Exercised mares were worked daily for 30 min under average ambient conditions of >30 °C and >50% humidity. Mares were inseminated during estrus and subjected to uterine flush for embryo recovery on d 7 after ovulation for two consecutive cycles. After this, mares were allocated to the opposite group and allowed an estrous cycle without reproductive manipulation; then insemination and uterine flushing were conducted on two more consecutive cycles. Prostaglandin F_2α was administered on the day of uterine flush. Mare rectal temperature increased during exercise from a mean of 38 °C to a mean of 39.9 °C. Mares had ovulations from smaller follicles when exercised than they did under control conditions (39.8 ± 0.5 compared with 41.5 ± 0.5 mm diameter; P < 0.05), and had an increased time from PGF_2α administration to subsequent ovulation (8.47 ± 0.337 compared with 9.27 ± 0.294 d; P < 0.05). Embryo recovery from control mares was 22 of 35 (63%). Fewer embryos were recovered from exercised mares (11 of 32, 34%; P < 0.05). The proportion of embryos classified as Grade 1 tended to be less in exercised than in non-exercised mares (4 of 11, 36% compared with 16 of 22, 73%; P = 0.051). These data indicate that exercising mares in a hot and humid environment are associated with changes in ovarian follicle development and ovulation, and a reduction in embryo recovery.     

Integration of mental health into primary care in Sri Lanka

Introduction Sri Lanka has one of the highest suicide rates in the world, with recent protracted conflict and the tsunami aggravating mental health needs. This paper describes a project to establish a systematic “train the trainers” programme to integrate mental health into primary care in Sri Lanka''s public health system and private sector.Methods A 40 hour training programme was delivered to curriculum and teaching materials were adapted for Sri Lanka, and delivered to 45 psychiatrists, 110 medical officers of mental health and 95 registered medical practitioners, through five courses, each in a different region (Colombo, Kandy, Jaffna, Galle and Batticola). Participants were selected by the senior psychiatrist of each region, on the basis of ability to conduct subsequent roll out of the training. The course was very interactive, with discussions, role plays and small group work, as well as brief theory sessions.Results Qualitative participant feedback was encouraging about the value of the course in improving patient assessments and treatments, and in providing a valuable package for roll out to others. Systematic improvement was achieved between pre- and post-test scores of participants at all training sites. The participants had not had prior experience in such interactive teaching methods, but were able to learn these new techniques relatively quickly.Conclusions The programme has been conducted in collaboration with the Sri Lankan National Institute of Mental Health and the Ministry of Health, and this partnership has helped to ensure that the training is tailored to Sri Lanka and has the chance of long term sustainability.     

The role of agrin in synaptic development,plasticity and signaling in the central nervous system

Development of the neuromuscular junction (NMJ) requires secretion of specific isoforms of the proteoglycan agrin by motor neurons. Secreted agrin is widely expressed in the basal lamina of various tissues, whereas a transmembrane form is highly expressed in the brain. Expression in the brain is greatest during the period of synaptogenesis, but remains high in regions of the adult brain that show extensive synaptic plasticity. The well-established role of agrin in NMJ development and its presence in the brain elicited investigations of its possible role in synaptogenesis in the brain. Initial studies on the embryonic brain and neuronal cultures of agrin-null mice did not reveal any defects in synaptogenesis. However, subsequent studies in culture demonstrated inhibition of synaptogenesis by agrin antisense oligonucleotides or agrin siRNA. More recently, a substantial loss of excitatory synapses was found in the brains of transgenic adult mice that lacked agrin expression everywhere but in motor neurons. The mechanisms by which agrin influences synapse formation, maintenance and plasticity may include enhancement of excitatory synaptic signaling, activation of the “muscle-specific” receptor tyrosine kinase (MuSK) and positive regulation of dendritic filopodia. In this article I will review the evidence that agrin regulates synapse development, plasticity and signaling in the brain and discuss the evidence for the proposed mechanisms.     

Exercise induces renin–angiotensin system unbalance and high collagen expression in the heart of Mas-deficient mice

The renin–angiotensin system (RAS) is involved in the cardiac and vascular remodeling associated with cardiovascular diseases. Angiotensin (Ang) II/AT₁ axis is known to promote cardiac hypertrophy and collagen deposition. In contrast, Ang-(1–7)/Mas axis opposes Ang II effects in the heart producing anti-trophic and anti-fibrotic effects. Exercise training is known to induce cardiac remodeling with physiological hypertrophy without fibrosis. We hypothesize that cardiac remodeling induced by chronic exercise depends on the action of Ang-(1–7)/Mas axis. Thus, we evaluated the effect of exercise training on collagen deposition and RAS components in the heart of FVB/N mice lacking Mas receptor (Mas-KO). Male wild-type and Mas-KO mice were subjected to a moderate-intense swimming exercise training for 6 weeks. The left ventricle (LV) of the animals was sectioned and submitted to qRT-PCR and histological analysis. Circulating and tissue angiotensin peptides were measured by RIA. Sedentary Mas-KO presented a higher circulating Ang II/Ang-(1–7) ratio and an increased ACE2 expression in the LV. Physical training induced in Mas-KO and WT a similar cardiac hypertrophy accompanied by a pronounced increase in collagen I and III mRNA expression. Trained Mas-KO and trained WT presented increased Ang-(1–7) in the blood. However, only in trained-WT there was an increase in Ang-(1–7) in the LV. In summary, we showed that deletion of Mas in FVB/N mice produced an unbalance in RAS equilibrium increasing Ang II/AT₁ arm and inducing deleterious cardiac effects as deposition of extracellular matrix proteins. These data indicate that Ang-(1–7)/Mas axis is an important counter-regulatory mechanism in physical training mediate cardiac adaptations.