BACKGROUND & AIMS: OBJECTIVE:The aim of the present investigation was to characterize the effects of supraphysiological doses of the anabolic androgenic steroid nandrolone decanoate (ND) on the fertility of female rats, as well as on the morphology of their uterus. STUDY DESIGN:Female Wistar rats (n=15) received a subcutaneous injection of ND (15 mg/kg) once daily during a 2-week period, while the control animals (n=10) were administered vehicle alone (arachidis oleum) in the same manner. Estrus behavior was evaluated 4 weeks after termination of this treatment and in cases where signs of receptivity were present, the female rat was given the opportunity to copulate with a male. After breeding, the female animals were sacrificed and their uteri examined histomorphologically. RESULTS:All ND-treated animals exhibited abnormal vaginal smears, whereas all of the control smears were normal. Most (73%) of the treated females demonstrated normal estrus behavior (i.e., willingness) on the day of mating, but none got pregnant; whereas all of the control rats became pregnant. The female rats receiving the ND showed an enhanced rate of weight gain and the myometrium thickness of their uteri was significantly increased, while the endometrium was significantly thinner. Furthermore, ND caused a significant proportion of the treated animals to display tortuous and irregularly branching endometrial glands, as well as a lack of the physiologically normal infiltration of eosinophilic leukocytes into the endometrium (endometrial eosinophilic homing), a finding that has not been reported previously. CONCLUSION:The present findings indicate that high doses of ND cause morphological and physiological alterations in the uterus of female rats that are associated with a suppression of their reproductive capacity.

背景与目标： 目的：本研究的目的是表征同化雄性类固醇癸酸nandrolone癸酸酯的超生理剂量对雌性大鼠生育能力以及子宫形态的影响。
研究设计：Wistar雌性大鼠（n = 15）在2周内每天一次皮下注射ND（15 mg / kg），而对照组（n = 10）单独给予媒介物（花生油）。同样的方式。终止该治疗4周后评估发情行为，并且在出现接受迹象的情况下，给予雌性大鼠与雄性交配的机会。繁殖后，将雌性动物处死并对其子宫进行组织形态学检查。
结果：所有接受ND治疗的动物均表现出异常的阴道涂片，而所有对照涂片均正常。接受治疗的大多数女性（73％）在交配当天表现出正常的发情行为（即意愿），但没有人怀孕；而所有对照大鼠都怀孕了。接受ND的雌性大鼠体重增加率增加，子宫肌层厚度明显增加，而子宫内膜明显变薄。此外，ND导致相当一部分被治疗的动物表现出曲折和不规则分支的子宫内膜腺体，并且缺乏正常的嗜酸性白细胞进入子宫内膜的生理正常浸润（子宫内膜嗜酸性归巢），这一发现此前尚未见报道。 。
结论：本研究结果表明，高剂量的ND可导致雌性大鼠子宫形态和生理改变，从而抑制其生殖能力。

BACKGROUND & AIMS: :Glycogen storage disease type II (GSDII) is a lysosomal disorder caused by the deficient activity of acid alpha-glucosidase (GAA) enzyme, leading to the accumulation of glycogen within the lysosomes. The disease has been classified in infantile and late-onset forms. Most late-onset patients share a splicing mutation c.-32-13T > G in intron 1 of the GAA gene that prevents efficient recognition of exon 2 by the spliceosome. In this study, we have mapped the splicing silencers of GAA exon 2 and developed antisense morpholino oligonucleotides (AMOs) to inhibit those regions and rescue normal splicing in the presence of the c.-32-13T > G mutation. Using a minigene approach and patient fibroblasts, we successfully increased inclusion of exon 2 in the mRNA and GAA enzyme production by targeting a specific silencer with a combination of AMOs. Most importantly, the use of these AMOs in patient myotubes results in a decreased accumulation of glycogen. To our knowledge, this is the only therapeutic approach resulting in a decrease of glycogen accumulation in patient tissues beside enzyme replacement therapy (ERT) and TFEB overexpression. As a result, it may represent a highly novel and promising therapeutic line for GSDII.

背景与目标： ：II型糖原贮积病（GSDII）是一种溶酶体疾病，由酸性α-葡萄糖苷酶（GAA）酶的活性不足引起，导致糖原在溶酶体内积累。该疾病已被分类为婴儿期和晚期发作形式。大多数晚期发病的患者在GAA基因内含子1中共有一个剪接突变c.-32-13T> G，该剪接突变阻止剪接体有效识别外显子2。在这项研究中，我们已经绘制了GAA外显子2的剪接沉默子的图谱，并开发了反义吗啉代寡核苷酸（AMO）来抑制那些区域并在存在c.-32-13T> G突变的情况下拯救正常的剪接。通过使用小基因方法和患者成纤维细胞，我们通过结合AMO靶向特定的沉默子，成功增加了外显子2在mRNA和GAA酶生产中的含量。最重要的是，在患者的肌管中使用这些AMO会导致糖原积累减少。据我们所知，这是唯一一种减少酶替代疗法（ERT）和TFEB过表达的导致患者组织中糖原积累减少的治疗方法。结果，它可能代表了GSDII的一种非常新颖和有希望的治疗方法。

BACKGROUND & AIMS: :With recent advances in synthetic biology, CO2 could be utilized as a carbon feedstock by native or engineered organisms, assuming the availability of electrons. Two key enzymes used in autotrophic CO2 fixation are the CO dehydrogenase (CODH) and acetyl coenzyme A (acetyl-CoA) synthase (ACS), which form a bifunctional heterotetrameric complex. The CODH/ACS complex can reversibly catalyze CO2 to CO, effectively enabling a biological water-gas shift reaction at ambient temperatures and pressures. The CODH/ACS complex is part of the Wood-Ljungdahl pathway (WLP) used by acetogens to fix CO2, and it has been well characterized in native hosts. So far, only a few recombinant CODH/ACS complexes have been expressed in heterologous hosts, none of which demonstrated in vivo CO2 reduction. Here, functional expression of the Clostridium carboxidivorans CODH/ACS complex is demonstrated in the solventogen Clostridium acetobutylicum, which was engineered to express CODH alone or together with the ACS. Both strains exhibited CO2 reduction and CO oxidation activities. The CODH reactions were interrogated using isotopic labeling, thus verifying that CO was a direct product of CO2 reduction, and vice versa. CODH apparently uses a native C. acetobutylicum ferredoxin as an electron carrier for CO2 reduction. Heterologous CODH activity depended on actively growing cells and required the addition of nickel, which is inserted into CODH without the need to express the native Ni insertase protein. Increasing CO concentrations in the gas phase inhibited CODH activity and altered the metabolite profile of the CODH-expressing cells. This work provides the foundation for engineering a complete and functional WLP in nonnative host organisms.IMPORTANCE Functional expression of CO dehydrogenase (CODH) from Clostridium carboxidivorans was demonstrated in C. acetobutylicum, which is natively incapable of CO2 fixation. The expression of CODH, alone or together with the C. carboxidivorans acetyl-CoA synthase (ACS), enabled C. acetobutylicum to catalyze both CO2 reduction and CO oxidation. Importantly, CODH exhibited activity in both the presence and absence of ACS. 13C-tracer studies confirmed that the engineered C. acetobutylicum strains can reduce CO2 to CO and oxidize CO during growth on glucose.

背景与目标： ：随着合成生物学的最新进展，假设电子的可用性，CO2可以被天然或工程有机体用作碳原料。自养性CO2固定中使用的两个关键酶是CO脱氢酶（CODH）和乙酰辅酶A（乙酰-CoA）合酶（ACS），它们形成了双功能异四聚体复合物。 CODH / ACS复合物可以可逆地将CO2催化转化为CO，从而有效地实现了在环境温度和压力下进行生物水煤气变换反应。 CODH / ACS复合物是乙酸原用于固定CO2的Wood-Ljungdahl途径（WLP）的一部分，并且在天然宿主中已得到很好的表征。迄今为止，在异源宿主中仅表达了少数重组CODH / ACS复合物，但均未显示体内CO2减少。在此，在溶剂原丙酮丁醇梭菌（Clostridium acetobutylicum）中证明了碳氧化梭菌CODH / ACS复合物的功能表达，该溶剂被改造成单独或与ACS一起表达CODH。两种菌株均表现出CO 2还原和CO氧化活性。使用同位素标记对CODH反应进行了询问，从而验证了CO是CO2还原的直接产物，反之亦然。 CODH显然使用天然的丙酮丁醇梭菌铁氧还蛋白作为电子载体来减少CO2。异源CODH活性取决于活跃生长的细胞，并需要添加镍，而无需表达天然Ni插入酶蛋白即可将其插入CODH。气相中CO浓度的增加会抑制CODH活性并改变表达CODH的细胞的代谢产物谱。这项工作为在非天然宿主生物中工程化完整且功能性的WLP提供了基础。重要提示在丙酮丁醇梭菌中证明了碳氧化梭菌中CO脱氢酶（CODH）的功能性表达，这本来就无法进行CO2固定。 CODH的表达，单独或与碳氧化单胞菌乙酰辅酶A合酶（ACS）一起表达，可使丙酮丁醇梭菌既催化CO2还原又催化CO氧化。重要的是，在有或没有ACS的情况下，CODH均具有活性。 13C示踪剂研究证实，工程改造的丙酮丁醇梭菌菌株可以在葡萄糖生长期间将CO2还原为CO，并氧化CO。

BACKGROUND & AIMS: INTRODUCTION:The present study examined seizure clusters as a primary outcome in patients receiving treatment for PNES. Cluster reduction is examined longitudinally using frequency threshold and statistical definitions of seizure cluster for patients. Possible risk factors for clustering will be examined along with clustering as a risk factor for poorer secondary outcomes. METHODS:Participants were from a pilot randomized treatment trial for PNES where they received cognitive behavioral therapy-informed psychotherapy (CBT-ip), sertraline, combination therapy, or treatment as usual. Seizure data are from patients' seizure dairies. RESULTS:Cluster reduction was observed for those receiving CBT-ip or combination treatment using all definitions of daily clusters and weekly clusters. No risk factors of clustering were observed. Those who were identified as having clusters during the trial had poorer secondary outcomes on several measures at baseline relative to those who were not identified as having clusters. DISCUSSION:This is the first study known to the authors to not only examined seizure clusters as a primary outcome for those with PNES, but also the first study to suggest that CBT-ip and combination therapy may be effective in reducing the frequency of clusters.

背景与目标： 简介：本研究检查癫痫发作簇是接受PNES治疗的患者的主要结局。使用频率阈值和癫痫发作簇的统计定义纵向检查簇减少。将对可能的聚类风险因素以及聚类作为次要结局较差的风险因素进行研究。
方法：参与者来自PNES的一项随机随机试验试验，他们接受了认知行为疗法知情的心理治疗（CBT-ip），舍曲林，联合治疗或照常治疗。癫痫发作数据来自患者的癫痫发作乳制品。
结果：使用每日集群和每周集群的所有定义，接受CBT-ip或联合治疗的人的集群减少。没有观察到聚集的危险因素。在试验中被确定为具有聚类的那些人，在基线时在一些指标上的次要结局要比那些未被确定为具有聚类的人低。
讨论：这是作者所知的第一项研究，不仅将癫痫发作作为PNES患者的主要结局进行检查，而且还是第一项表明CBT-ip和联合疗法可能有效减少癫痫发作频率的研究。

BACKGROUND & AIMS: :Mitochondrial dysfunction is part of many pathological states in patients, such as sepsis or stroke. Presently, the monitoring of mitochondrial function in patients is extremely rare, even though NADH redox state is routinely measured in experimental animals. In this article, we describe the scientific backgrounds and practical use of mitochondrial NADH fluorescence measurement that was applied to patients in the past few years. In addition to NADH, we optically measured the microcirculatory blood flow and volume, as well as HbO(2) oxygenation, from the same tissue area. The four detected parameters provide real time data on tissue viability, which is critical for patients monitoring.

背景与目标： ：线粒体功能障碍是患者许多病理状态的一部分，例如败血症或中风。目前，即使常规地在实验动物中测量NADH氧化还原状态，对患者线粒体功能的监测也极为罕见。在本文中，我们描述了过去几年应用于患者的线粒体NADH荧光测量的科学背景和实际应用。除了NADH，我们光学测量了来自同一组织区域的微循环血流量和体积以及HbO（2）氧合。四个检测到的参数提供有关组织生存力的实时数据，这对于监测患者至关重要。

BACKGROUND & AIMS: OBJECTIVE:Urinary tract infections (UTIs) are the most common type of hospital-acquired infection, and most are associated with indwelling urinary catheters, that is, catheter-associated UTIs (CAUTIs). Our goal was to reduce the CAUTI rate. DESIGN: SETTING: INTERVENTIONS:We retrospectively examined the feasibility and cost-effectiveness of a bundle of four evidence-based interventions upon the incidence rate (IR) of CAUTIs in a community hospital. The first intervention was the exclusive use of silver alloy catheters in the hospital's acute care areas. The second intervention was a securing device to limit the movement of the catheter after insertion. The third intervention was repositioning of the catheter tubing if it was found to be touching the floor. The fourth intervention was removal of the indwelling urinary catheter on postoperative Day 1 or 2, for most surgical patients. MAIN OUTCOME MEASURE:Rates of CAUTI per 1000 catheter days were estimated and compared using the generalized estimating equations Poisson regression analysis. RESULTS:During the study period, 33 of the 2228 patients were diagnosed with a CAUTI. The CAUTI IR for the pre-intervention period was 5.2/1000. For the 7 months following the implementation of the fourth intervention, the IR was 1.5/1000 catheter days, a significant reduction relative to the pre-intervention period (P = 0.03). The annualized projection for the cost of implementing this bundle of four interventions is $23 924. CONCLUSION:A bundle of four evidence-based interventions reduced the incidence of CAUTIs in a community hospital. It is relatively simple, appears to be cost-effective and might be sustainable and adaptable by other hospitals.

背景与目标： 目的：尿路感染（UTIs）是医院获得性感染的最常见类型，且多数与留置导尿管（即导管相关的UTIs（CAUTIs））相关。我们的目标是降低CAUTI率。
设计：
环境：
干预措施：我们回顾了社区医院中CAUTI发生率（IR）的四种循证干预措施的可行性和成本效益。最初的干预措施是在医院的急诊区域独家使用银合金导管。第二种干预措施是固定装置，以限制插入后导管的运动。第三次干预是重新定位导管管道，如果发现导管管道接触地面。对于大多数外科手术患者，第四项干预措施是在术后第1天或第2天取下留置导尿管。
主要观察指标：采用广义估计方程泊松回归分析法估算并比较每1000导管日的CAUTI率。
结果：在研究期间，2228例患者中有33例被诊断出患有CAUTI。干预前的CAUTI IR为5.2 / 1000。在实施第四次干预后的7个月中，IR为1.5 / 1000导管天，相对于干预前期显着减少（P = 0.03）。实施这四项干预措施的年度成本预测为23 924美元。
结论：四种基于证据的干预措施减少了社区医院中CAUTI的发生。它相对简单，似乎具有成本效益，并且可能是可持续的并且可以被其他医院适应。

BACKGROUND & AIMS: :We report a patient with severe obstructive sleep apnea syndrome, diabetes mellitus, and hypertension, with postoperative complications following tracheostomy. His stormy postoperative course is presented with emphasis on glycemic control and hypertension. We present a cautionary tale of a significant reduction in medications to control blood pressure and hyperglycemia following tracheostomy for severe OSA. The severe reduction in blood pressure and hypoglycemia could mimic sepsis and clinicans need to be vigilant to these dramatic effects following tracheostomy and appropriately adjust baseline medications.

背景与目标： ：我们报告了一名患有严重阻塞性睡眠呼吸暂停综合症，糖尿病和高血压的患者，其气管切开术后出现并发症。介绍了他风雨如磐的术后过程，重点是血糖控制和高血压。我们提出一个警告性的故事，指出严重OSA气管切开术后控制血压和高血糖的药物显着减少。血压和低血糖的严重降低可以模仿败血症，临床医生需要警惕气管切开术后的这些巨大影响，并适当调整基线药物。

BACKGROUND & AIMS: BACKGROUND:Apathy is a common non-motor symptom in Parkinson's disease (PD), but little is known about apathy and white matter (WM) change. In this study, we investigated whether fractional anisotropy (FA) of the WM can distinguish apathetic patients from non-apathetic PD patients, and whether the FA value correlates with the severity of apathy in PD. METHODS:Thirty-nine PD patients participated in our study, of which 18 participants were with apathy symptom, and 21 without apathy symptom. Diffusion tensor imaging was performed on all the subjects. RESULTS:Compared to non-apathetic PD patients, the apathetic group had reduced FA values in the genu and body of corpus callosum, bilateral anterior corona radiata, left superior corona radiata and left cingulum. Furthermore, in these WM regions, the FA values were negatively correlated with the Lille Apathy Rating Scale scores in apathetic subjects. CONCLUSION:The WM change is associated with apathy in PD patients. In addition, the FA values of specific regions of WM could be a promising marker to predict the severity of apathy.

背景与目标： 背景：冷漠是帕金森氏病（PD）的常见非运动症状，但对冷漠和白质（WM）改变知之甚少。在这项研究中，我们调查了WM的分数各向异性（FA）是否可以区分无情感障碍的患者和无情感障碍的PD患者，以及FA值是否与PD的情感障碍的严重程度相关。
方法：39例PD患者参加了我们的研究，其中18例有冷漠症状，21例无冷漠症状。对所有受试者进行扩散张量成像。
结果：与非精神分裂症PD患者相比，精神分裂症组call体，双侧前冠状放射线，左上冠状放射线和左扣带的FA和值均降低。此外，在这些西医区，FA值与冷漠受试者的里尔冷漠评定量表得分负相关。
结论：WM改变与PD患者的冷漠有关。此外，WM特定区域的FA值可能是预测冷漠严重程度的有前途的标志。

BACKGROUND & AIMS: :Catalysing the reduction of oxygen in acidic media is a standing challenge. Although activity of platinum, the most active metal, can be substantially improved by alloying, alloy stability remains a concern. Here we report that platinum nanoparticles supported on graphite-rich boron carbide show a 50-100% increase in activity in acidic media and improved cycle stability compared to commercial carbon supported platinum nanoparticles. Transmission electron microscopy and x-ray absorption fine structure analysis confirm similar platinum nanoparticle shapes, sizes, lattice parameters, and cluster packing on both supports, while x-ray photoelectron and absorption spectroscopy demonstrate a change in electronic structure. This shows that purely electronic metal-support interactions can significantly improve oxygen reduction activity without inducing shape, alloying or strain effects and without compromising stability. Optimizing the electronic interaction between the catalyst and support is, therefore, a promising approach for advanced electrocatalysts where optimizing the catalytic nanoparticles themselves is constrained by other concerns.

背景与目标： ：在酸性介质中催化氧的还原是一项长期挑战。尽管可以通过合金化显着提高最活泼的金属铂的活性，但合金的稳定性仍然值得关注。在这里，我们报告说，与商业碳载铂纳米颗粒相比，负载在富含石墨的碳化硼上的铂纳米颗粒在酸性介质中的活性提高了50-100％，并且循环稳定性得到了改善。透射电子显微镜和X射线吸收精细结构分析证实了两种载体上相似的铂纳米颗粒形状，大小，晶格参数和簇堆积，而X射线光电子和吸收光谱表明电子结构发生了变化。这表明纯电子金属-载体相互作用可以显着改善氧还原活性，而不会引起形状，合金或应变效应，并且不会损害稳定性。因此，优化催化剂和载体之间的电子相互作用是用于高级电催化剂的有前途的方法，其中优化催化纳米颗粒本身受到其他问题的限制。

BACKGROUND & AIMS: BACKGROUND:CT radiation dose reduction results in increased noise or graininess of images which affects the diagnostic information. One of the approaches to lower radiation exposure to patients is to reduce image noise with the use of image processing software in low radiation dose images. PURPOSE:To assess image quality and accuracy of non-linear adaptive filters (NLAF) at low dose chest CT. MATERIAL AND METHODS:In an IRB approved prospective study, 24 patients (mean age, 63 ± 7.3 years; M:F ratio, 11:13) gave informed consent for acquisition of four additional chest CT image series at 150, 110, 75, and 40 mAs (baseline image series) on a 64-slice MDCT over an identical 10-cm length. NLAF was used to process three low dose (110, 75, and 40 mAs) image series (postprocessed image series). Two radiologists reviewed baseline and postprocessed images in a blinded manner for image quality. Objective noise, CT attenuation values, patient weight, transverse diameters, CTDIvol, and DLP were recorded. Statistical analysis was performed using parametric and non-parametric tests for comparing postprocessed and baseline images. RESULTS:No lesions were missed on baseline or postprocessed CT images (n = 80 lesions, 73 lesions <1 cm). At 40 mAs, subjective noise in mediastinal window settings were graded as unacceptable in baseline images and acceptable in postprocessed images. Visibility of smaller structures improved from suboptimal visibility in baseline images at 40 mAs to excellent in postprocessed images at 40 mAs. No major artifacts were seen due to NLAF postprocessing, except for minor beam hardening artifacts not affecting diagnostic decision-making (14/22) in both baseline and postprocessed image series. Diagnostic confidence for chest CT was improved to fully confident in postprocessed images at 40 mAs. Compared to baseline images, postprocessing reduced objective noise by 26% (14.2 ± 4.7/19.2 ± 6.4), 31.5% (15.2 ± 4.7/22.2 ± 5.7), and 41.5% (16.9 ± 6/28.9 ± 10.2) at 110 mAs, 75 mAs, and 40 mAs tube current-time product levels. CONCLUSION:Applications of NLAF can help reduce tube current down to 40 mAs for chest CT while maintaining lesion conspicuity and image quality.

背景与目标： 背景：降低CT辐射剂量会导致图像的噪点或颗粒感增加，从而影响诊断信息。降低对患者辐射的方法之一是在低辐射剂量图像中使用图像处理软件来降低图像噪声。
目的：评估低剂量胸部CT下非线性自适应滤波器（NLAF）的图像质量和准确性。
材料与方法：在一项IRB批准的前瞻性研究中，有24例患者（平均年龄63±7.3岁； M：F比为11:13）在150、110、75，在64片MDCT上，在相同的10厘米长度上为40 mAs（基准图像系列）。 NLAF用于处理三个低剂量（110、75和40 mAs）图像系列（后处理图像系列）。两位放射科医生以不知情的方式检查了基线和后处理图像的图像质量。记录客观噪声，CT衰减值，患者体重，横向直径，CTDIvol和DLP。使用参数测试和非参数测试进行统计分析，以比较后处理图像和基线图像。
结果：在基线或后处理的CT图像上均未遗漏任何病变（n = 80个病变，73个<1 cm的病变）。在40 mA时，纵隔窗口设置中的主观噪声在基线图像中被评定为不可接受，而在后处理图像中则被评定为可接受。较小结构的可见性从40 mAs的基线图像中的次佳可见度提高到40 mAs的后处理图像中的出色。由于NLAF后处理，没有看到主要的伪影，除了较小的光束硬化伪影不会影响基线和后处理图像系列中的诊断决策（14/22）。胸部CT的诊断置信度提高到40 mAs的后处理图像完全置信度。与基线图像相比，后处理在110 mAs时降低了26％（14.2±4.7 / 19.2±6.4），31.5％（15.2±4.7 / 22.2±5.7）和41.5％（16.9±6 / 28.9±10.2）的客观噪声， 75 mAs和40 mAs的管电流时间乘积电平。
结论：NLAF的应用可帮助将胸部CT的管电流降低至40 mAs，同时保持病变的显眼性和图像质量。

BACKGROUND & AIMS: :The purpose of this study was to assess the possible role of muscles in offsetting the anterior shear forces caused by the load and upper body mass and their accelerations that act on the L 4L 5, intervertebral joint during dynamic squat lifts. Fifteen males lifted five loads from 5.8 to 32.4 kg. Anterior shear forces estimated to be acting on the lumber spine, based on model output, ranged from 492 N at 5.8 kg to 736 N at 32.4 kg. However, the peak shear force that had to be supported by the facets and possibly the disc remained relatively constant at approximately 200 N, regardless of the load mass. The posteriorly directed fascicles of the lumbar portions of the iliocostalis lumborum and longissimus thoracis muscles increased their force output, as estimated from an EMG driven model, in proportion to the anterior load shear force demands, thereby sharing the load on the intervertebral joint. It appears that the combination of anatomical design and neural control of the musculature leads to a situation where the resultant shear force on the joint can be maintained at a relatively constant and safe level in the types of lifts studied. This 'safety' mechanism is useful only with the preservation of lordosis during lifting, when the muscles must provide the majority of the support moment.

背景与目标： ：这项研究的目的是评估在动态下蹲举升过程中，肌肉在抵消由负荷和上半身及其在L 4L 5椎间关节上作用的加速度所引起的前剪切力中的可能作用。 15头雄性将五种负载从5.8公斤提升至32.4公斤。根据模型输出，估计作用在木材脊柱上的前剪力范围从5.8 kg的492 N到32.4 kg的736N。然而，无论负载质量如何，必须由刻面支撑并可能由圆盘支撑的峰值剪切力保持相对恒定，约为200N。根据肌电图驱动模型估计，the肌和腰最长肌的腰部向后束束的力输出与前部剪切力需求成正比，从而分担了椎间关节的负荷。看起来，肌肉组织的解剖学设计和神经控制的结合导致了这样一种情况，在所研究的举重类型中，在关节上产生的剪切力可以保持在相对恒定和安全的水平。这种“安全”机制仅在举重过程中保留脊柱前凸肌时有用，此时肌肉必须提供大部分的支撑力矩。

BACKGROUND & AIMS: PURPOSE:Determine if a "nondieting" intervention focused on intensive training in eliciting the relaxation response enhances health outcomes compared with nondieting interventions without such training. DESIGN:Randomized trial with follow-up at 10 weeks, 4 months, and 12 months. SETTING:General community. SUBJECTS:Total of 225 overweight and obese women with at least one other cardiovascular risk factor. INTERVENTIONS:Three 10-week nondieting interventions: a group program (P1) focused on intensive training in techniques for eliciting the relaxation response (n = 60), a group program (P2) focused on healthy eating and physical activity (n = 61), and a self-guided, mail-delivered version of P2 (P3; n = 101). MEASURES:The Revised Symptom Checklist measured psychological distress, the Medical Symptoms Checklist measured the experience of medical symptoms, and the Health-Promoting Lifestyle Profile measured a range of lifestyle behaviors. Self-efficacy for low-fat eating intuitive eating, and body mass index were also assessed. ANALYSIS:An intention-to-treat analysis was used. RESULTS:At 12 months, P1 produced statistically greater improvements in stress management behaviors and medical symptom discomfort and was the only program to significantly improve self-efficacy for low-fat eating. In P1, the effect sizes for reductions in depression (0.75) and interpersonal sensitivity (0.85) were large. At 12 months, mean weight was unchanged. CONCLUSION:Inclusion of intensive relaxation response training in a nondieting program for overweight women enhanced stress management and medical symptoms outcomes but not weight outcomes.

背景与目标： 目的：确定与不进行此类训练的非减肥干预措施相比，“非减肥”干预是否专注于强化训练以引起放松反应，从而改善健康结果。
设计：随机对照试验，在10周，4个月和12个月时进行随访。
地点：一般社区。
研究对象：总共225名超重和肥胖妇女中至少有其他心血管危险因素。
干预措施：三项为期10周的非节食干预措施：小组课程（P1）专注于引起放松反应的技术强化训练（n = 60），小组课程（P2）专注于健康饮食和体育锻炼（n = 61） ，以及P2的自指导邮件交付版本（P3； n = 101）。
措施：修订后的症状清单测量了心理困扰，医学症状清单测量了医学症状的经历，健康促进生活方式概况测量了一系列生活方式。还评估了低脂饮食直觉饮食的自我效能和体重指数。
分析：使用意向治疗分析。
结果：在第12个月时，P1在压力管理行为和医学症状不适方面产生了统计学上更大的改善，并且是唯一显着提高低脂饮食自我效能的计划。在P1中，减少抑郁症的效果大小（0.75）和人际敏感性（0.85）大。在12个月时，平均体重没有变化。
结论：将超重女性的强化放松反应训练纳入一项非节食计划中可增强压力管理和医学症状结果，但不能改善体重结果。

BACKGROUND & AIMS: PURPOSE:To assess if local intra-arterial administration of paclitaxel using drug-coated balloons or an admixture of paclitaxel to contrast medium inhibits stenosis after percutanous transluminal angioplasty (PTA) of peripheral arteries in a porcine overstretch model. METHODS:Neointimal proliferation and stenosis were induced by overstretch and stenting of 40 peripheral arteries in 20 pigs. Paclitaxel was administered locally during PTA using coated balloons (n = 20) or dissolved in contrast medium (n = 10). Conventional balloons and contrast medium were used in a control group (n = 10). Reangiography with quantitative analysis was performed after 5 weeks. RESULTS:On reangiography diameter stenosis and late lumen loss were significantly reduced by both methods of local drug delivery compared with control group; minimal luminal diameter was significantly larger in the treatment groups. CONCLUSIONS:Local short-term administration of paclitaxel during PTA of peripheral arteries using balloons or contrast medium as drug carriers reduced stenosis due to intimal hyperplasia.

背景与目标： 目的：评估在猪过度伸展模型中，经药物涂层的球囊局部使用紫杉醇或将紫杉醇与造影剂混合后是否能抑制周围动脉经皮腔内血管成形术（PTA）后的狭窄。
方法：过度拉伸和支架置入20只猪可诱导新内膜增生和狭窄。紫杉醇在PTA期间使用包被的球囊（n = 20）局部给药或溶解在造影剂中（n = 10）。对照组（n = 10）使用常规气球和造影剂。 5周后进行血管造影定量分析。
结果：与对照组相比，两种局部给药方式均显着降低了血管造影的直径狭窄和晚期管腔丢失。在治疗组中，最小管腔直径明显更大。
结论：在外周动脉PTA期间局部短期给予紫杉醇，使用球囊或造影剂作为药物载体减少了由于内膜增生引起的狭窄。

BACKGROUND & AIMS: :BK virus nephropathy (BKVN) is increasingly recognized as a major cause of renal allograft failure. Recent reports demonstrate that prompt reduction of immunosuppression upon detection of persistent viremia can be associated with resolution of viremia, with minimal risk of acute rejection (AR). However, these experiences in general have occurred in centers with low baseline risks of AR. It is possible that a finer balance between overimmunosuppression and the risk of AR may exist in centers that routinely transplant patients with higher risk of AR. Thus the risk/benefit of this strategy may be altered in these centers. We report a case of antibody-mediated rejection that followed reduction of immunosuppression for BKVN diagnosed more than 3 months after the onset of viremia. This rejection episode resulted in a greater decrease in graft function than the initial BKVN episode. Issues relevant to the management of these patients are discussed, including the need for improved immune monitoring assays to determine more accurately the balance between infection and rejection.

背景与目标： ：BK病毒性肾病（BKVN）被越来越多地认为是同种异体肾功能衰竭的主要原因。最近的报道表明，检测到持续的病毒血症后，免疫抑制的迅速降低可与病毒血症的消退相关，而急性排斥反应（AR）的风险最小。但是，这些经验通常发生在AR基线风险较低的中心。在常规移植AR风险较高的患者的中心中，过度免疫抑制和AR风险之间可能存在更好的平衡。因此，在这些中心可以改变这种策略的风险/利益。我们报告了一例抗体介导的排斥反应，随后在病毒血症发作后3个月内诊断为BKVN的免疫抑制降低。与最初的BKVN发作相比，该排斥发作导致移植物功能的下降更大。讨论了与这些患者的治疗有关的问题，包括需要改进免疫监测方法以更准确地确定感染和排斥反应之间的平衡。

BACKGROUND & AIMS: OBJECTIVE:Functional near-infrared spectroscopy (fNIRS) is a non-invasive optical technique for bedside evaluation of cerebral metabolism that has clinical potential for monitoring the efficacy of pharmacological treatment. In this pilot study, we investigated the cognitive effects of methylphenidate (MP) on prefrontal function using fNIRS in healthy subjects. METHODS:Thirteen right-handed healthy subjects underwent working memory tasks (0-back and 2-back) after a single oral dose of MP (20 mg) or placebo administered in a double-blind crossover design on two different days separated by 1-3 days. We measured changes in oxyhemoglobin (oxy-Hb) and deoxyhemoglobin (deoxy-Hb) concentrations during the tasks in bilateral prefrontal regions after MP or placebo administration using two-channel fNIRS. RESULTS:There were significantly more correct responses and fewer missed responses during the 2-back task performance after MP treatment as compared with placebo. Baseline-corrected oxy-Hb was significantly decreased after MP treatment compared with the placebo in the 2-back task in the right frontal region but was not different in the 0-back task. Baseline-corrected deoxy-Hb and total-Hb concentrations were not significant between MP and placebo conditions in either of the cognitive tasks. CONCLUSIONS:These data are consistent with previous positron emission tomography findings of MP-mediated reduction in lateral prefrontal activity accompanied by improved cognitive performance.

背景与目标： 目的：功能性近红外光谱法（fNIRS）是一种非侵入性光学技术，可在床头评估脑部新陈代谢，具有监测药理学疗效的临床潜力。在这项初步研究中，我们调查了健康受试者中使用fNIRS的哌醋甲酯（MP）对前额叶功能的认知作用。
方法：13名右撇子健康受试者在双日交叉设计中以单盲口服（20毫克）或安慰剂以双盲交叉设计方式给药后，分别在两个工作日内接受了工作记忆任务（0背和2背）。 3天。我们在使用双通道fNIRS进行MP或安慰剂给药后，测量了双侧前额叶区域任务期间氧合血红蛋白（oxy-Hb）和脱氧血红蛋白（deoxy-Hb）浓度的变化。
结果：与安慰剂相比，MP治疗后的2背任务执行过程中，正确的反应明显多，漏掉的反应少。与安慰剂相比，MP处理后基线校正的oxy-Hb在右额叶区域的2后卫任务中较安慰剂显着降低，但在0后卫任务中无差异。在任一认知任务中，MP和安慰剂条件之间经基线校正的脱氧血红蛋白和总血红蛋白浓度均不显着。
结论：这些数据与以前的正电子发射断层扫描所发现的MP介导的侧前额叶活动减少以及认知能力改善相一致。