丙泊酚复合瑞芬太尼用于无肌松药气管插管的临床研究

目的:探讨丙泊酚复合瑞芬太尼用于无肌松药气管插管的最佳剂量,评估诱导期应用此种方法的有效性。方法:择期全麻的患者100例,ASAⅠ~Ⅱ级,随机分为三组。麻醉诱导为丙泊酚2 mg/kg,瑞芬太尼为2μg/kg(Ⅰ组)、3μg/kg(Ⅱ组)和4μg/kg(Ⅲ组),待两种药物达到药效高峰时行气管插管。观察诱导期和插管后1 min,3 min的血流动力学的变化情况,评估插管满意度。结果:各组的插管满意度如下:Ⅰ组54.2%(19/35)、Ⅱ组83.3%(25/30)、Ⅲ组97.1%(34/35),随着瑞芬太尼剂量的增加,气管插管满意度增高,气管插管操作时间缩短(P0.05)。在诱导过程中,三组患者的MAP和HR下降幅度均较显著(P0.05)。结论:丙泊酚复合瑞芬太尼用于无肌松药气管插管是可行的,与复合瑞芬太尼2μg/kg或3μg/kg相比,丙泊酚2 mg/kg复合瑞芬太尼4μg/kg能明显提供更好的气管插管条件,且插管操作时间明显缩短。     

Comparison of effects of static,proprioceptive neuromuscular facilitation and Mulligan stretching on hip flexion range of motion: a randomized controlled trial

The aim of this study was to compare the effects of static stretching, proprioceptive neuromuscular facilitation (PNF) stretching and Mulligan technique on hip flexion range of motion (ROM) in subjects with bilateral hamstring tightness. A total of 40 students (mean age: 21.5±1.3 years, mean body height: 172.8±8.2 cm, mean body mass index: 21.9±3.0 kg · m^-2) with bilateral hamstring tightness were enrolled in this randomized trial, of whom 26 completed the study. Subjects were divided into 4 groups performing (I) typical static stretching, (II) PNF stretching, (III) Mulligan traction straight leg raise (TSLR) technique, (IV) no intervention. Hip flexion ROM was measured using a digital goniometer with the passive straight leg raise test before and after 4 weeks by two physiotherapists blinded to the groups. 52 extremities of 26 subjects were analyzed. Hip flexion ROM increased in all three intervention groups (p<0.05) but not in the no-intervention group after 4 weeks. A statistically significant change in initial–final assessment differences of hip flexion ROM was found between groups (p<0.001) in favour of PNF stretching and Mulligan TSLR technique in comparison to typical static stretching (p=0.016 and p=0.02, respectively). No significant difference was found between Mulligan TSLR technique and PNF stretching (p=0.920). The initial–final assessment difference of hip flexion ROM was similar in typical static stretching and no intervention (p=0.491). A 4-week stretching intervention is beneficial for increasing hip flexion ROM in bilateral hamstring tightness. However, PNF stretching and Mulligan TSLR technique are superior to typical static stretching. These two interventions can be alternatively used for stretching in hamstring tightness.     

Biceps femoris and semitendinosus tendon/aponeurosis strain during passive and active (isometric) conditions

The purpose of this study was to quantify strain and elongation of the long head of the biceps femoris (BFlh) and the semitendinosus (ST) tendon/aponeurosis. Forty participants performed passive knee extension trials from 90° of knee flexion to full extension (0°) followed by ramp isometric contractions of the knee flexors at 0°, 45° and 90° of knee flexion. Two ultrasound probes were used to visualize the displacement of BFlh and ST tendon/aponeurosis. Three-way analysis of variance designs indicated that: (a) Tendon/aponeurosis (passive) elongation and strain were higher for the BFlh than the ST as the knee was passively extended (p < 0.05), (b) contraction at each angular position was accompanied by a smaller BFlh tendon/aponeurosis (active) strain and elongation than the ST at higher levels of effort (p < 0.05) and (c) combined (passive and active) strain was significantly higher for the BFlh than ST during ramp contraction at 0° but the opposite was observed for the 45° and 90° flexion angle tests (p < 0.05). Passive elongation of tendon/aponeurosis has an important effect on the tendon/aponeurosis behavior of the hamstrings and may contribute to a different loading of muscle fibers and tendinous tissue between BFlh and ST.     

Adaptations to isolated shoulder fatigue during simulated repetitive work. Part I: Fatigue

Upper extremity muscle fatigue is challenging to identify during industrial tasks and places changing demands on the shoulder complex that are not fully understood. The purpose of this investigation was to examine adaptation strategies in response to isolated anterior deltoid muscle fatigue while performing simulated repetitive work. Participants completed two blocks of simulated repetitive work separated by an anterior deltoid fatigue protocol; the first block had 20 work cycles and the post-fatigue block had 60 cycles. Each work cycle was 60 s in duration and included 4 tasks: handle pull, cap rotation, drill press and handle push. Surface EMG of 14 muscles and upper body kinematics were recorded. Immediately following fatigue, glenohumeral flexion strength was reduced, rating of perceived exertion scores increased and signs of muscle fatigue (increased EMG amplitude, decreased EMG frequency) were present in anterior and posterior deltoids, latissimus dorsi and serratus anterior. Along with other kinematic and muscle activity changes, scapular reorientation occurred in all of the simulated tasks and generally served to increase the width of the subacromial space. These findings suggest that immediately following fatigue people adapt by repositioning joints to maintain task performance and may also prioritize maintaining subacromial space width.     

Tendon reflex is suppressed during whole-body vibration

In this study we have investigated the effect of whole body vibration (WBV) on the tendon reflex (T-reflex) amplitude. Fifteen young adult healthy volunteer males were included in this study. Records of surface EMG of the right soleus muscle and accelerometer taped onto the right Achilles tendon were obtained while participant stood upright with the knees in extension, on the vibration platform. Tendon reflex was elicited before and during WBV. Subjects completed a set of WBV. Each WBV set consisted of six vibration sessions using different frequencies (25, 30, 35, 40, 45, 50 Hz) applied randomly. In each WBV session the Achilles tendon was tapped five times with a custom-made reflex hammer. The mean peak-to-peak (PP) amplitude of T-reflex was 1139.11 ± 498.99 µV before vibration. It decreased significantly during WBV (p < 0.0001). The maximum PP amplitude of T-reflex was 1333 ± 515 μV before vibration. It decreased significantly during WBV (p < 0.0001). No significant differences were obtained in the mean acceleration values of Achilles tendon with tapping between before and during vibration sessions. This study showed that T-reflex is suppressed during WBV. T-reflex suppression indicates that the spindle primary afferents must have been pre-synaptically inhibited during WBV similar to the findings in high frequency tendon vibration studies.     

Mutations in the Drosophila alphaPS2 integrin subunit uncover new features of adhesion site assembly

The Drosophila alphaPS2betaPS integrin is required for diverse development events, including muscle attachment. We characterized six unusual mutations in the alphaPS2 gene that cause a subset of the null phenotype. One mutation changes a residue in alphaPS2 that is equivalent to the residue in alphaV that contacts the arginine of RGD. This change severely reduced alphaPS2betaPS affinity for soluble ligand, abolished the ability of the integrin to recruit laminin to muscle attachment sites in the embryo and caused detachment of integrins and talin from the ECM. Three mutations that alter different parts of the alphaPS2 beta-propeller, plus a fourth that eliminated a late phase of alphaPS2 expression, all led to a strong decrease in alphaPS2betaPS at muscle ends, but, surprisingly, normal levels of talin were recruited. Thus, although talin recruitment requires alphaPS2betaPS, talin levels are not simply specified by the amount of integrin at the adhesive junction. These mutations caused detachment of talin and actin from integrins, suggesting that the integrin-talin link is weaker than the ECM-integrin link.     

A cellular lineage analysis of the chick limb bud

The chick limb bud has been used as a model system for studying pattern formation and tissue development for more than 50 years. However, the lineal relationships among the different cell types and the migrational boundaries of individual cells within the limb mesenchyme have not been explored. We have used a retroviral lineage analysis system to track the fate of single limb bud mesenchymal cells at different times in early limb development. We find that progenitor cells labeled at stage 19-22 can give rise to multiple cell types including clones containing cells of all five of the major lateral plate mesoderm-derived tissues (cartilage, perichondrium, tendon, muscle connective tissue, and dermis). There is a bias, however, such that clones are more likely to contain the cell types of spatially adjacent tissues such as cartilage/perichondrium and tendon/muscle connective tissue. It has been recently proposed that distinct proximodistal segments are established early in limb development; however our analysis suggests that there is not a strict barrier to cellular migration along the proximodistal axis in the early stage 19-22 limb buds. Finally, our data indicate the presence of a dorsal/ventral boundary established by stage 16 that is inhibitory to cellular mixing. This boundary is demarcated by the expression of the LIM-homeodomain factor lmx1b.     

金皮猪肉质相关组织学特征与CAST基因HinfI多态性的关系研究

本实验选择具有优良肉质的本地金华猪与肉质较差的引进品种皮特兰猪杂交所产的金皮F2代为研究对象,利用PCR-RFLP的方法检测金皮F2代猪CAST基因型的频率,并以肌球蛋白重链（MHC）免疫组织化学、过碘酸希夫反应和苏木精-伊红等多种组织学方法,研究猪背腰最长肌的肌肉组织学特性,并对其进行图像分析,在此基础上采用SAS分析其相互关系。结果发现．PAS染色后肌纤维可区分为三种类型。PAS阴性（Ⅰ）、PAS反应强阳性（Ⅱ-a）和PAS反应强度中间型（Ⅱ-b）。利用肌球蛋白重链单克隆抗体MHCs和MHCf染色结果表明．金皮F2代杂交猪背腰最长肌MHCs阳性（慢肌）纤维的比例为7．62％,快肌纤维为92.38％。CAST基因的扩增产物具有524bp和632bp两个Hinfl多态性片段,定义等位基因为A（114＋192＋400＋632bp）,B（114＋192＋400＋524bp）。AA、BB和AB基因型频率分别为0．1795、0．5897和0．2308,A和B的基因型频率分别为0．4743和0．5256。AA、BB和AB单型对眼肌面积．系水率、pH值、导电率等参数均无显著的影响。CAST基因的HinfI多态性对肌纤维的轴比有显著影响,AA单型有产生较多轴比较大（近似椭圆形）肌纤维的倾向．而BB则控制形成更多的轴比更小（近似于圆形）的肌纤维。具有AA单型的个体具有更多的肌间结缔组织．而具有BB单型的个体的肌间结缔组织较少．AB单型的个体介于两者之间。     

Differential expression of sarcoplasmic proteins in four heterogeneous ovine skeletal muscles

Fiber-type distribution is known to vary widely within and between muscles according to differences in muscle functions. 2-DE and MALDI-MS were used to investigate the molecular basis of muscle fiber type-related variability. We compared four lamb skeletal muscles with heterogeneous fiber-type composition that are relatively rich in fast-twitch fiber types, i.e., the semimembranosus, vastus medialis, longissimus dorsi, and tensor fasciae latae (TL). Our results clearly showed that none of the glycolytic metabolism enzymes detected, including TL which was most strongly glycolytic, made intermuscular differentiation possible. Muscle differentiation was based on the differential expression of proteins involved in oxidative metabolism, including not only citric acid cycle enzymes but also other classes of proteins with functions related to oxidative metabolism, oxidative stress, and probably to higher protein turnover. Detected proteins were involved in transport (carbonate dehydratase, myoglobin, fatty acid-binding protein), repair of misfolding damage (heat shock protein (HSP) 60 kDa, HSP-27 kDa, alpha-crystallin beta subunit, DJ1, stress-induced phosphoprotein), detoxification or degradation of impaired proteins (GST-Pi, aldehyde dehydrogenase, peroxiredoxin, ubiquitin), and protein synthesis (tRNA-synthetase). The fractionating method led to the detection of proteins involved in different functions related to oxidative metabolism that have not previously been shown concomitancy.