• 【CRB1杂合子与区域性视网膜功能障碍:对leber先天性黑病的基因检测的意义。】 复制标题 收藏 收藏
    DOI:10.1167/iovs.05-1637 复制DOI
    作者列表:Yzer S,Fishman GA,Racine J,Al-Zuhaibi S,Chakor H,Dorfman A,Szlyk J,Lachapelle P,van den Born LI,Allikmets R,Lopez I,Cremers FP,Koenekoop RK
    BACKGROUND & AIMS: PURPOSE:To test human CRB1 heterozygotes for possible clinical or functional retinal changes and to evaluate whether a patient with Leber congenital amaurosis (LCA) with CRB1 mutations not consistent with previously described CRB1 phenotypes carried a modifier allele in another LCA gene. METHODS:Seven unrelated heterozygous carriers of CRB1 mutations underwent phenotyping by full eye examinations (indirect ophthalmoscopy and slit lamp biomicroscopy) and functional testing (standard full-field electroretinography [ERG] and multifocal ERG). For genotyping of the LCA patients and their parents, denaturing high-performance liquid chromatography (dHPLC) analyses were performed, followed by sequence analysis of CRB1, followed by sequence analysis of the AIPL1 and CRX genes to identify a putative modifier effect in a patient with an atypical CRB1 phenotype. RESULTS:Reduced full-field ERG b-wave amplitudes were observed with scotopic -2 dB flash (140 microV; P < 0.05), normal full-field cone ERGs, and significant regional retinal dysfunction on mfERG in five of seven carriers of CRB1 mutations. A known AIPL1 mutation (p. R302L) was identified as a potential modifier allele in a patient with LCA carrying two CRB1 mutations and with a prominent maculopathy. CONCLUSIONS:In human heterozygotes of CRB1 mutations (parents of offspring with LCA), distinctive regional retinal dysfunctions were found by multifocal ERG measurements that were consistent with the focal histologic abnormalities reported for the two CRB1 knockout mice models. This phenotypic finding may identify CRB1 carriers and point to the causal gene defect in affected LCA offspring, significantly facilitating the molecular diagnostic process. Evidence suggests a modifier allele in AIPL1 in a patient with LCA with prominent atrophic macular lesions and homozygous defects in CRB1.
    背景与目标: 目的:测试人CRB1杂合子可能的临床或功能性视网膜变化,并评估患有CRB1突变的Leber先天性黑蒙病(LCA)患者是否与先前描述的CRB1表型不一致,是否在另一个LCA基因中携带修饰等位基因。
    方法:通过全眼检查(间接检眼镜和裂隙灯生物显微镜)和功能测试(标准全视野视网膜电图[ERG]和多焦点ERG)对7个无关的CRB1突变杂合子进行表型分析。为了对LCA患者及其父母进行基因分型,先进行变性高效液相色谱(dHPLC)分析,然后对CRB1进行序列分析,然后对AIPL1和CRX基因进行序列分析,以鉴定在患有LCA患者中的假定修饰子作用非典型CRB1表型。
    结果:在七个CRB1突变携带者中的五个携带者中,暗视-2 dB闪光(140 microV; P <0.05),正常的全视场ERGs和mfERG上的显着区域性视网膜功能障碍,观察到全视场ERG b波振幅降低。 。在患有携带两个CRB1突变且患有明显的黄斑病的LCA患者中,已知的AIPL1突变(p。R302L)被确定为潜在的修饰等位基因。
    结论:在人的CRB1突变杂合子(LCA后代的父母)中,通过多焦点ERG测量发现了独特的区域性视网膜功能障碍,这与两个CRB1基因敲除小鼠模型报道的局部组织学异常一致。此表型发现可能会识别出CRB1携带者,并指出受影响的LCA后代中的因果基因缺陷,从而大大促进了分子诊断过程。有证据表明,患有明显萎缩性黄斑病变和CRB1纯合缺陷的LCA患者中AIPL1的修饰等位基因。
  • 【运动对高甘油三酯血症男性餐后血脂的影响。】 复制标题 收藏 收藏
    DOI:10.1007/s00421-006-0304-8 复制DOI
    作者列表:Zhang JQ,Ji LL,Fretwell VS,Nunez G
    BACKGROUND & AIMS: :We examined the effect of exercise on postprandial lipemia (PPL) and insulin resistance in individuals with metabolic syndrome. Subjects were 10 hypertriglyceridemia (HTG) males with insulin resistance [age = 40.1 +/- 2.2 years, body weight = 96.3 +/- 3.3 kg, fasting triglyceride (TG) = 263 +/- 25 mg/dl, VO(2)max = 37 +/- 1.1 ml/kg/min, and Homeostatic Model Assessment (HOMA-IR, an index of insulin resistance) = 3.05 +/- 0.40]. Each subject performed a control trial (Ctr, no exercise), and three exercise trials at 40% (40%T), 60% (60%T), and 70% (70%T) of their VO(2)max. The order of trials was randomized and there were 1-2 weeks wash-out period between the trials. All subjects had a fat-meal in each trial. In the exercise trials, subjects jogged on a treadmill for 1 h at a designated intensity 12 h prior to a fat-meal ingestion. Blood samples were taken at 0 h (before the meal), and 2, 4, 6, and 8 h after the meal. The plasma TG, area score under TG concentration curve for over an 8 h-period (TG AUC) after the meal, and HOMA-IR were analyzed. The TG AUC score in 40%T was 30% lower (P = 0.003), 60%T was 31% lower (P = 0.02), and 70%T was 39% lower (P = 0.02) than Ctr. There were no significant differences in the TG AUC scores among the exercise trials (P > 0.05). The insulin concentrations in both 60 and 70%T were lower than Ctr (P < 0.01) which did not differ from 40%T. HOMA-IR in both 60%T (P = 0.041) and 70%T (P = 0.002) were lower than Ctr, but not different from 40%T (HOMA-IR: Ctr = 3.05 +/- 0.40, 40%T = 2.67 +/- 0.35, 60%T = 2.49 +/- 0.31, 70%T = 2.21 +/- 0.27). The results suggest that for physically inactive individuals with metabolic syndrome, exercising at low to moderate intensity may be sufficient to attenuate PPL and increase insulin sensitivity, whereas higher intensity exercise may be needed to normalize blood glucose.
    背景与目标: :我们研究了运动对代谢综合征患者餐后血脂(PPL)和胰岛素抵抗的影响。受试者为10名高甘油三酸酯血症(HTG)男性,其胰岛素抵抗[年龄= 40.1 /-2.2岁,体重= 96.3 /-3.3 kg,空腹甘油三酸酯(TG)= 263 /-25 mg / dl,VO(2)max = 37 -/-1.1 ml / kg / min,并且稳态模型评估(HOMA-IR,胰岛素抵抗指数)= 3.05 /-0.40]。每个受试者进行了一项对照试验(Ctr,无运动),并进行了三项运动试验,试验的最大VO(2)最大为40%(40%T),60%(60%T)和70%(70%T)。试验顺序是随机的,两次试验之间有1-2周的清除期。所有受试者在每次试验中均吃一顿胖饭。在运动试验中,受试者在摄入脂肪餐之前12小时以指定的强度在跑步机上慢跑1小时。在0小时(饭前),饭后2、4、6和8小时采集血样。分析餐后8 h内血浆TG,TG浓度曲线下的面积分数(TG AUC)和HOMA-IR。与Ctr相比,在40%T中的TG AUC得分降低了30%(P = 0.003),在60%T中降低了31%(P = 0.02),在70%T中降低了39%(P = 0.02)。在运动试验之间,TG AUC评分无显着差异(P> 0.05)。 60%和70%T中的胰岛素浓度均低于Ctr(P <0.01),与40%T无差异。 60%T(P = 0.041)和70%T(P = 0.002)的HOMA-IR均低于Ctr,但与40%T相同(HOMA-IR:Ctr = 3.05 /-0.40,40%T = 2.67 /-0.35,60%T = 2.49 /-0.31,70%T = 2.21 /-0.27)。结果表明,对于缺乏运动能力的代谢综合征患者,低强度至中等强度的运动可能足以减弱PPL和增加胰岛素敏感性,而可能需要更高强度的运动才能使血糖正常化。
  • 【通过Farr和ELISA技术进行的抗dsDNA抗体测试并不等效。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Neogi T,Gladman DD,Ibanez D,Urowitz M
    BACKGROUND & AIMS: OBJECTIVE:To determine the degree of correlation between Farr and ELISA methods of detecting anti-dsDNA antibodies in patients with systemic lupus erythematosus (SLE), and their association with measures of disease activity. METHODS:Anti-dsDNA antibodies were assayed using the Farr and ELISA methods in patients followed between January 1, 2000, and December 31, 2002. Statistical correlations between Farr and ELISA were determined. Relationships between the 2 assays and measures of disease activity [SLE Disease Activity Index 2000 (SLEDAI-2K-DNA), renal, central nervous system (CNS), and vasculitis] were determined for the same clinic visit. RESULTS:550 patients with 2940 clinic visits met the inclusion criteria. Correlation between Farr and ELISA levels was 0.46 using the first visit for each patient. When the Farr was abnormal, the ELISA was equally likely to be normal or abnormal. Abnormal Farr results were associated with higher SLEDAI-2K scores than normal Farr results (6.2 vs 4.3, respectively; p < 0.0001). There was less of a distinction with ELISA results (5.9 vs 4.8; p = 0.04). Farr levels were significantly associated with the presence of renal disease and vasculitis, while ELISA levels were not. Neither Farr nor ELISA results correlated with the presence of active CNS involvement. CONCLUSION:Farr and ELISA techniques for the detection of anti-dsDNA antibodies in patients with SLE are poorly correlated. The Farr is superior to the ELISA in correlating with measures of global disease activity, as well as renal and vasculitis involvement. The Farr technique should continue to be used in clinical practice. The ELISA adds no additional information.
    背景与目标: 目的:探讨系统性红斑狼疮(SLE)患者中Farr法和ELISA法检测抗dsDNA抗体之间的相关程度,以及它们与疾病活动性的相关性。
    方法:在2000年1月1日至2002年12月31日之间,采用Farr和ELISA方法对患者的抗dsDNA抗体进行检测。在同一门诊就诊时,确定了两种测定与疾病活动度之间的关系[SLE疾病活动指数2000(SLEDAI-2K-DNA),肾,中枢神经系统(CNS)和血管炎]。
    结果:550名患者进行了2940次门诊就诊,符合入选标准。首次就诊时,Farr和ELISA水平之间的相关性为0.46。当Farr异常时,ELISA同样可能是正常的或异常的。与正常的Farr结果相比,异常的Farr结果与更高的SLEDAI-2K得分相关(分别为6.2和4.3; p <0.0001)。 ELISA结果几乎没有区别(5.9 vs 4.8; p = 0.04)。 Farr水平与肾脏疾病和血管炎的存在显着相关,而ELISA水平则不相关。 Farr或ELISA结果均与主动中枢神经系统受累无关。
    结论:远距离和ELISA技术检测SLE患者抗dsDNA抗体的相关性较弱。 Farr在整体疾病活动以及肾脏和血管炎受累方面具有优于ELISA的能力。 Farr技术应继续在临床实践中使用。 ELISA没有添加其他信息。
  • 【ATP诱导的腿部血管舒张对人体最大运动过程中VO2峰值和腿部O2提取的影响。】 复制标题 收藏 收藏
    DOI:10.1152/ajpregu.00746.2005 复制DOI
    作者列表:Calbet JA,Lundby C,Sander M,Robach P,Saltin B,Boushel R
    BACKGROUND & AIMS: :During maximal whole body exercise VO2 peak is limited by O2 delivery. In turn, it is though that blood flow at near-maximal exercise must be restrained by the sympathetic nervous system to maintain mean arterial pressure. To determine whether enhancing vasodilation across the leg results in higher O2 delivery and leg VO2 during near-maximal and maximal exercise in humans, seven men performed two maximal incremental exercise tests on the cycle ergometer. In random order, one test was performed with and one without (control exercise) infusion of ATP (8 mg in 1 ml of isotonic saline solution) into the right femoral artery at a rate of 80 microg.kg body mass-1.min-1. During near-maximal exercise (92% of VO2 peak), the infusion of ATP increased leg vascular conductance (+43%, P<0.05), leg blood flow (+20%, 1.7 l/min, P<0.05), and leg O2 delivery (+20%, 0.3 l/min, P<0.05). No effects were observed on leg or systemic VO2. Leg O2 fractional extraction was decreased from 85+/-3 (control) to 78+/-4% (ATP) in the infused leg (P<0.05), while it remained unchanged in the left leg (84+/-2 and 83+/-2%; control and ATP; n=3). ATP infusion at maximal exercise increased leg vascular conductance by 17% (P<0.05), while leg blood flow tended to be elevated by 0.8 l/min (P=0.08). However, neither systemic nor leg peak VO2 values where enhanced due to a reduction of O2 extraction from 84+/-4 to 76+/-4%, in the control and ATP conditions, respectively (P<0.05). In summary, the VO2 of the skeletal muscles of the lower extremities is not enhanced by limb vasodilation at near-maximal or maximal exercise in humans. The fact that ATP infusion resulted in a reduction of O2 extraction across the exercising leg suggests a vasodilating effect of ATP on less-active muscle fibers and other noncontracting tissues and that under normal conditions these regions are under high vasoconstrictor influence to ensure the most efficient flow distribution of the available cardiac output to the most active muscle fibers of the exercising limb.
    背景与目标: :在最大程度的全身运动过程中,VO2峰值受O2释放量的限制。反过来,虽然必须在交感神经系统的约束下进行接近最大运动量的血流以维持平均动脉压。为了确定在近乎最大和最大运动量的情况下,增强腿部血管舒张程度是否会导致较高的O2输送量和腿部VO2,七名男性在自行车测功计上进行了两次最大的增量运动测试。以随机顺序进行一项试验,一项试验不进行(对照运动)以80 microg.kg体重-1.min-的速率向右股动脉中输注ATP(1毫升等渗盐溶液中8毫克)。 1。在接近最大运动量(VO2峰值的92%)期间,输注ATP可增加腿部血管电导率(43%,P <0.05),腿部血流量(20%,1.7 l / min,P <0.05)和腿部O2递送(20%,0.3l / min,P <0.05)。没有观察到对腿或全身VO2的影响。输注腿中的腿部O2分数提取率从85 / -3(对照)降至78 / -4%(ATP)(P <0.05),而在左腿中则保持不变(84 / -2和83 /- 2%;对照和ATP; n = 3)。进行最大运动量的ATP输注可使腿部血管电导增加17%(P <0.05),而腿部血流则倾向于增加0.8 l / min(P = 0.08)。但是,在对照和ATP条件下,由于O2提取量分别从84 / -4降低到76 / -4%,全身和腿部VO2峰值均未升高(P <0.05)。总之,在人类进行近乎最大或最大运动时,下肢骨骼肌的VO2不会因肢体血管扩张而得到增强。 ATP输注导致运动腿上的O2提取减少的事实表明ATP对不太活跃的肌纤维和其他非收缩性组织的血管舒张作用,并且在正常情况下,这些区域处于高血管收缩作用下,以确保最有效的血流有效心输出量到运动肢体最活跃的肌肉纤维的分布。
  • 【原住民社区控制的卫生服务中的衣原体前哨监测发现年轻人的检测率和阳性率更高。】 复制标题 收藏 收藏
    DOI:10.1111/j.1753-6405.2012.00929.x 复制DOI
    作者列表:Goller JL,Ward J,Saunders M,Couzos S,Kaldor J,Hellard MA,Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance System (ACCESS) Collaborative.
    BACKGROUND & AIMS: OBJECTIVE:To measure chlamydia testing and positivity rates among 16-39 year olds attending Aboriginal Community Controlled Health Services (ACCHSs). METHODS:Retrospective non-identifiable computerised records containing consultation and chlamydia testing data were collected for patients (16-39 years) attending eight ACCHSs during 2008-09 in urban, regional and remote settings for the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) system. Annual chlamydia testing and positivity rates were estimated. RESULTS:Over two years, 13,809 patients aged 16-39 years (57.8% female, 82.3% Aboriginal or Torres Strait Islander) attended. The annual overall chlamydia testing rate was 13.0% (2008) and 16.0% (2009). Testing rates were higher among females (p<0.001) and among patients aged 16-29 than 30-39 years (males: p=0.01; females: p<0.001). Chlamydia positivity was 8.5% overall; similar in females (8.7%) and males (7.8%) (p=0.46); highest among 16-19 years (females: 17.4%; males: 13.0%), declining to 1.5% among females 35-39 years (p<0.001) and 4.8% among males 30-34 years (p<0.001). CONCLUSIONS:Chlamydia testing at these ACCHSs approached recommended levels among some patient groups, however, it should increase. High positivity among younger people highlights they should be targeted. IMPLICATIONS:Young people should be targeted for sexual health interventions. ACCHSs are well placed to provide enhanced sexual health services if appropriately resourced.
    背景与目标: 目的:测量参加原住民社区控制健康服务(ACCHS)的16-39岁人群的衣原体检测和阳性率。
    方法:收集了2008-09年间在城市,区域和偏远地区参加澳大利亚AC衣原体加强前哨监视协作组织(ACCESS)的八个ACCHS的患者(16-39岁)的回顾性,不可识别的计算机记录,其中包含咨询和衣原体检测数据系统。估计每年的衣原体检测和阳性率。
    结果:在过去的两年中,共有13809名16-39岁的患者(女性占57.8%,原住民或托雷斯海峡岛民占82.3%)参加了研究。每年的衣原体总检出率分别为13.0%(2008年)和16.0%(2009年)。女性和16-29岁患者的测试率高于30-39岁(男性:p = 0.01;女性:p <0.001)。衣原体阳性率为8.5%。女性(8.7%)和男性(7.8%)相似(p = 0.46);在16-19岁之间最高(女性:17.4%;男性:13.0%),在35-39岁的女性中下降到1.5%(p <0.001),在30-34岁的男性中下降到4.8%(p <0.001)。
    结论:在这些患者中,衣原体检测在某些患者组中已达到推荐水平,但应增加。年轻人中的高度积极性凸显了他们应该成为目标。
    后果:应该针对年轻人进行性健康干预。如果资源适当,ACCHS可以提供​​更好的性健康服务。
  • 【社交,运动,饮食和年龄对食蟹猴发展中和未治疗的糖尿病的作用。】 复制标题 收藏 收藏
    DOI:10.1016/j.exger.2017.06.010 复制DOI
    作者列表:Yue F,Zhang G,Quintero JE,Gash DM,Zhang Z
    BACKGROUND & AIMS: :Type 2 diabetes mellitus is the most common form of diabetes that occurs in both human and nonhuman primates. Although spontaneously diabetic nonhuman primates are used extensively in diabetic related research and are a proven valuable tool for the study of the natural history of diabetes, little is known about the key factors that can cause this metabolic disorder and the preventative measures that could be employed to minimize the consequences of diabetes. Using a model of developing and untreated diabetes, this study describes the effects of housing arrangement (socially group- versus individually single-housed), exercise, diet, age, and sex on fasting plasma glucose, key lipids associated with diabetes, and bodyweight in two large cohorts of nonhuman primates. Key findings include exercise/housing arrangement's contribution to significant differences in bodyweight, levels of fasting plasma glucose, total cholesterol, and high- and low-density lipoproteins. Age also had profound effects on glucose, triglyceride and high-density lipoproteins, particularly in single-caged animals. Moreover, females had higher fasting glucose, total cholesterol and triglyceride levels than male counterparts within the same housing situations. These factors may be critical to identifying preventive measures that could eventually be used to minimize obesity and diabetes in humans.
    背景与目标: 2型糖尿病是人类和非人类灵长类动物中最常见的糖尿病形式。尽管自发性糖尿病非人类灵长类动物在糖尿病相关研究中被广泛使用,并且是研究糖尿病自然史的一种有价值的工具,但对引起这种代谢紊乱的关键因素以及可以用于预防该疾病的预防措施知之甚少最大限度地减少糖尿病的后果。本研究使用发展中的糖尿病和未经治疗的糖尿病模型,描述了住房安排(集体居住与个人独居),运动,饮食,年龄和性别对空腹血糖,糖尿病相关的主要脂质和体重的影响。两个大型的非人类灵长类动物。主要发现包括运动/住房安排对体重,空腹血糖水平,总胆固醇以及高密度和低密度脂蛋白的显着差异的贡献。年龄对葡萄糖,甘油三酸酯和高密度脂蛋白也有深远的影响,特别是在单笼动物中。此外,在相同的居住环境下,女性的空腹血糖,总胆固醇和甘油三酸酯水平高于男性。这些因素对于确定预防措施至关重要,这些预防措施最终可用于最大程度地减少人类的肥胖和糖尿病。
  • 【咖啡因对血压正常健康年轻人运动过程中血压反应的影响。】 复制标题 收藏 收藏
    DOI:10.1016/0002-9149(90)91435-9 复制DOI
    作者列表:Sung BH,Lovallo WR,Pincomb GA,Wilson MF
    BACKGROUND & AIMS: :The possible combined effects of caffeine and exercise on blood pressure (BP) regulation were examined in 34 healthy, normotensive (BP less than 135/85 mm Hg) young men (mean age 27 +/- 3 years) in a placebo-controlled, double-blind crossover design. Each subject performed submaximal and symptom-limited maximal supine bicycle exercise 1 hour apart after ingestion of placebo or caffeine (3.3 mg/kg). Heart rate, BP, cardiac output and peripheral vascular resistance were compared for placebo and caffeine days. Postdrug baseline showed that caffeine increased systolic and diastolic BP and peripheral vascular resistance (p less than 0.001 for each) and decreased heart rate (p less than 0.01) but did not change stroke volume or cardiac output. BP and vascular resistance effects of caffeine remained during submaximal exercise resulting in an additive increase in BP while negative chronotropic effects of caffeine disappeared. At maximal exercise substantially more subjects (15 on caffeine vs 7 on placebo, p less than 0.02) had systolic BP greater than or equal to 230 mm Hg and/or greater than or equal to 100 mm Hg for diastolic BP. Plasma norepinephrine levels were not significantly different across days, but epinephrine was higher at maximal exercise and cortisol was increased post-drug and throughout maximal exercise on caffeine days. Data indicate that caffeine increases BP additively during submaximal exercise and may cause excessive BP responses at maximal exercise for some individuals. The pressor effects of caffeine appear to be due to increasing vascular resistance rather than cardiac output.
    背景与目标: :在安慰剂对照下,对34名健康,血压正常(血压低于135/85 mm Hg的年轻人)(平均年龄27 /-3岁)中的咖啡因和运动对血压(BP)调节的可能联合作用进行了研究,双盲交叉设计。服用安慰剂或咖啡因(3.3 mg / kg)后,每位受试者间隔1小时进行次最大和症状受限的最大仰卧自行车运动。比较安慰剂和咖啡因天的心率,血压,心输出量和外周血管阻力。药物后基线显示,咖啡因可增加收缩压和舒张压以及外周血管阻力(每个P值均小于0.001)和降低心率(P值均小于0.01),但并未改变中风量或心输出量。在次最大运动量下,咖啡因的血压和血管阻力作用仍然存在,从而导致血压增加,而咖啡因的负变时效作用消失了。在最大程度的运动中,更多受试者(咖啡因为15,安慰剂为7,p小于0.02)的收缩压大于或等于230 mm Hg和/或舒张压大于或等于100 mm Hg。血浆去甲肾上腺素水平在各天之间无显着差异,但在最大运动量时,肾上腺素较高,而在咖啡因日后和整个最大运动量中,皮质醇增加。数据表明,咖啡因在次最大运动量时会增加BP,并且可能对某些个体在最大运动量时导致过度的BP反应。咖啡因的升压作用似乎是由于血管阻力增加而非心输出量增加所致。
  • 【上下文对运动对健康的益处的影响:运动等级假说。】 复制标题 收藏 收藏
    DOI:10.1123/jsep.34.6.828 复制DOI
    作者列表:Maltby J,Wood AM,Vlaev I,Taylor MJ,Brown GD
    BACKGROUND & AIMS: :Many accounts of social influences on exercise participation describe how people compare their behaviors to those of others. We develop and test a novel hypothesis, the exercise rank hypothesis, of how this comparison can occur. The exercise rank hypothesis, derived from evolutionary theory and the decision by sampling model of judgment, suggests that individuals' perceptions of the health benefits of exercise are influenced by how individuals believe the amount of exercise ranks in comparison with other people's amounts of exercise. Study 1 demonstrated that individuals' perceptions of the health benefits of their own current exercise amounts were as predicted by the exercise rank hypothesis. Study 2 demonstrated that the perceptions of the health benefits of an amount of exercise can be manipulated by experimentally changing the ranked position of the amount within a comparison context. The discussion focuses on how social norm-based interventions could benefit from using rank information.
    背景与目标: :许多关于运动参与的社会影响的描述描述了人们如何将自己的行为与他人的行为进行比较。我们开发并测试了这种比较如何发生的新假设,即运动等级假设。运动等级假说是从进化理论和抽样判断模型的决策中得出的,表明个人对运动的健康益处的看法受个人相信运动量与他人运动量的比较方式的影响。研究1表明,个人对自己当前运动量的健康益处的认识与运动等级假说是相符的。研究2表明,可以通过在比较情况下实验性地改变一定量运动的排名位置来操纵对一定运动量的健康益处的认识。讨论的重点是基于社会规范的干预措施如何从使用职级信息中受益。
  • 【探索关于运动训练和体育锻炼的已发布指南的横截面样本的方法学质量和临床实用性,用于冠心病的二级预防。】 复制标题 收藏 收藏
    DOI:10.1186/s12872-017-0589-z 复制DOI
    作者列表:Abell B,Glasziou P,Hoffmann T
    BACKGROUND & AIMS: BACKGROUND:Clinicians are encouraged to use guidelines to assist in providing evidence-based secondary prevention to patients with coronary heart disease. However, the expanding number of publications providing guidance about exercise training may confuse cardiac rehabilitation clinicians. We therefore sought to explore the number, scope, publication characteristics, methodological quality, and clinical usefulness of published exercise-based cardiac rehabilitation guidance. METHODS:We included publications recommending physical activity, exercise or cardiac rehabilitation for patients with coronary heart disease. These included systematically developed clinical practice guidelines, as well as other publications intended to support clinician decision making, such as position papers or consensus statements. Publications were obtained via electronic searches of preventive cardiology societies, guideline databases and PubMed, to November 2016. Publication characteristics were extracted, and two independent assessors evaluated quality using the 23-item Appraisal of Guidelines Research and Evaluation II (AGREE) tool. RESULTS:Fifty-four international publications from 1994 to 2016 were identified. Most were found on preventive cardiology association websites (n = 35; 65%) and were freely accessible (n = 50; 93%). Thirty (56%) publications contained only broad recommendations for physical activity and cardiac rehabilitation referral, while 24 (44%) contained the necessary detailed exercise training recommendations. Many were labelled as "guidelines", however publications with other titles (e.g. scientific statements) were common (n = 24; 44%). This latter group of publications contained a significantly greater proportion of detailed exercise training recommendations than clinical guidelines (p = 0.017). Wide variation in quality also existed, with 'applicability' the worst scoring AGREE II domain for clinical guidelines (mean score 53%) and 'rigour of development' rated lowest for other guidance types (mean score 33%). CONCLUSIONS:While a large number of guidance documents provide recommendations for exercise-based cardiac rehabilitation, most have limitations in either methodological quality or clinical usefulness. The lack of rigorously developed guidelines which also contain necessary detail about exercise training remains a substantial problem for clinicians.
    背景与目标: 背景:鼓励临床医生使用指南来协助为冠心病患者提供循证二级预防。但是,提供有关运动训练指南的出版物数量不断增加,可能会使心脏康复临床医生感到困惑。因此,我们试图探讨已发表的基于运动的心脏康复指南的数量,范围,出版特征,方法学质量和临床实用性。
    方法:我们纳入了建议对冠心病患者进行体育锻炼,运动或心脏康复的出版物。这些包括系统开发的临床实践指南,以及旨在支持临床医生决策的其他出版物,例如立场书或共识声明。出版物通过预防性心脏病学会,指南数据库和PubMed的电子搜索获得,截止日期为2016年11月。提取了出版物的特征,两名独立评估者使用23项指南研究和评估II(AGREE)评估工具对质量进行了评估。
    结果:确定了1994年至2016年的54种国际出版物。大多数在预防心脏病学协会网站上发现(n = 35; 65%),并且可以免费访问(n = 50; 93%)。 30种(56%)出版物仅包含有关体育锻炼和心脏康复参考的广泛建议,而24种(44%)包含必要的详细运动训练建议。许多被标记为``指南'',但是带有其他标题(例如科学陈述)的出版物很常见(n = 24; 44%)。后一组出版物包含的详细运动训练建议所占比例比临床指南要大得多(p = 0.017)。质量也存在很大差异,其中“适用性”在临床指南中得分最差的AGREE II域(平均得分53%),在“发展的严谨性”中其他指南类型的得分最低(平均得分33%)。
    结论:尽管大量指导文件为基于运动的心脏康复提供了建议,但大多数在方法学质量或临床实用性方面均存在局限性。缺乏严格制定的指南,其中也包含有关运动训练的必要细节,这仍然是临床医生面临的重大问题。
  • 【儿童和青少年肥厚型心肌病的穿透性:一项为期12年的临床筛查和预测性基因检测随访研究。】 复制标题 收藏 收藏
    DOI:10.1161/CIRCULATIONAHA.111.090514 复制DOI
    作者列表:Jensen MK,Havndrup O,Christiansen M,Andersen PS,Diness B,Axelsson A,Skovby F,Køber L,Bundgaard H
    BACKGROUND & AIMS: BACKGROUND:The penetrance of hypertrophic cardiomyopathy (HCM) during childhood and adolescence has been only sparsely described. We studied the penetrance of HCM and the short- and long-term outcomes of clinical screening and predictive genetic testing of child relatives of patients with HCM. METHODS AND RESULTS:Ninety probands and 361 relatives were included in a family screening program for HCM (1994-2001). Eleven sarcomere genes, CRYAB, α-GAL, and titin were screened. Sixty-six relatives and 4 probands were <18 years of age at inclusion. Twelve child relatives were mutation carriers (age, 12 ± 5 years), and 26 had unknown genetic status, ie, relatives from families without identified mutations (n = 21) or not tested (n = 5) (age, 11 ± 5 years). Twenty-eight noncarriers (42%; age, 10 ± 4 years) served as control subjects. Two of 38 child relatives (5%) at risk of developing HCM fulfilled diagnostic criteria for HCM at inclusion. After 12 ± 1 years of follow-up, 2 of the 36 (6%; 95% confidence interval, 2-18) at-risk child relatives who were phenotype negative at inclusion had developed the HCM phenotype at 26 and 28 years of age. During follow-up, none of the child relatives experienced serious cardiac events. Participation in the screening program had no long-term negative psychological impact. CONCLUSIONS:The penetrance of HCM in phenotype-negative child relatives at risk of developing HCM was 6% after 12 years of follow-up. The finding of phenotype conversion in the mid-20s warrants continued screening into adulthood. Forty-two percent of the child relatives were noncarriers, and repeat clinical follow-up could be safely limited to the remaining children.
    背景与目标: 背景:在儿童和青少年时期肥厚型心肌病(HCM)的渗透率仅得到了很少的描述。我们研究了HCM的渗透率以及HCM患者的儿童亲属的临床筛查和预测性基因检测的短期和长期结果。
    方法与结果:1994年至2001年,在HCM家庭筛查计划中纳入了90名先证者和361名亲属。筛选了11个肌小节基因CRYAB,α-GAL和titin。六十六名亲戚和四名先证者年龄小于18岁。十二名儿童亲属是突变携带者(年龄为12±5岁),有26名遗传状况未知,即来自未发现突变的家庭的亲属(n = 21)或未经测试(n = 5)(年龄为11±5岁) )。对照组为28名非携带者(42%;年龄为10±4岁)。 38名患HCM的儿童亲属中有2名(5%)符合入选HCM的诊断标准。经过12±1年的随访,在纳入时表现型为阴性的36名高危儿童亲戚中,有2名(6%; 95%置信区间为2-18)在26岁和28岁时出现了HCM表型。 。在随访期间,没有任何一个儿童亲属经历过严重的心脏事件。参与筛查程序不会对心理产生长期负面影响。
    结论:随访12年后,表型阴性儿童亲属中HCM的外显率为6%。在20年代中期发现表型转化的情况值得继续筛选,直至成年。 42%的儿童亲属是非携带者,重复进行的临床随访可以安全地限于其余儿童。
  • 【运动心电图和th体层成像在糖尿病患者无症状冠状动脉疾病检测中的评估。】 复制标题 收藏 收藏
    DOI:10.1136/hrt.63.1.7 复制DOI
    作者列表:Koistinen MJ,Huikuri HV,Pirttiaho H,Linnaluoto MK,Takkunen JT
    BACKGROUND & AIMS: :Thallium tomographic imaging and exercise electrocardiography were performed on 136 diabetic patients without symptoms of heart disease. Thirty three patients had post-exercise thallium defects and 19 had ST 1 mm greater than or equal to segment depression during exercise electrocardiography. Both tests were positive in 13 patients. Coronary angiography was subsequently performed on 33 patients with either scintigraphic and/or electrocardiographic evidence of myocardial ischaemia. Angiographically significant coronary artery disease (greater than or equal to 50% narrowing of the coronary artery lumen) was detected in 13 patients. Six patients had minimal coronary artery stenosis (less than 50%), and 14 had normal coronary arteries. Six patients refused cardiac catheterisation. In 14 out of 27 patients with post-exercise thallium defects coronary angiography did not show any coronary artery stenoses (positive predictive accuracy 48%). Exercise electrocardiography showed only one false positive result (positive predictive accuracy 94%) but failed to detect coronary artery disease in three patients with a positive scintigraphic result. The accuracy of a positive exercise electrocardiographic test seems to be better than that of a positive thallium tomographic scan for detecting asymptomatic coronary artery disease in diabetic patients. The high number of false positive thallium defects may be the result of technical features inherent in thallium tomography and/or the possible disease of the small intramyocardial arteries in diabetic patients.
    背景与目标: :对136例无心脏病症状的糖尿病患者进行了to体层断层显像和运动心电图检查。在运动心电图检查中,有33例运动后al缺陷患者,其中19例ST大于或等于节段压低1 mm。两项测试均阳性13例。随后对33例有心肌缺血的闪烁显像和/或心电图证据的患者进行了冠状动脉造影。在13例患者中发现了具有血管造影意义的冠状动脉疾病(大于或等于50%的冠状动脉腔狭窄)。 6例患者的冠状动脉狭窄程度最小(少于50%),而14例具有正常的冠状动脉。六名患者拒绝心脏导管插入术。在运动后th缺陷的27例患者中,有14例冠状动脉造影未显示任何冠状动脉狭窄(阳性预测准确性为48%)。运动心电图检查仅显示一个假阳性结果(阳性预测准确率94%),但在3个闪烁显像结果阳性的患者中未能检测到冠心病。积极的运动心电图检查的准确性似乎比阳性的X线体层摄影检查的准确性要好,以检测糖尿病患者的无症状冠状动脉疾病。大量假阳性positive缺陷可能是may断层扫描固有的技术特征和/或糖尿病患者心肌小动脉可能的疾病的结果。
  • 【锻炼小组的动力学有多动态?在基于班级的锻炼计划中检查内聚力的变化。】 复制标题 收藏 收藏
    DOI:10.1037/a0030412 复制DOI
    作者列表:Dunlop WL,Falk CF,Beauchamp MR
    BACKGROUND & AIMS: OBJECTIVE:Within exercise class settings, group cohesion has consistently been found to predict adherence behaviors, and has been identified as a salient target for intervention-based initiatives. Drawing upon theorizing from the field of group dynamics, exercise class cohesion is often conceptualized as a dynamic construct that requires several classes to form and once it is formed, continues to change over time. Despite the salience of this "dynamic" contention for informing physical activity interventions, this theorizing has yet to be empirically tested. METHOD:In this study a multilevel modeling framework was used to examine changes in exercise class cohesion over time. Exercisers (N = 395) completed measures of cohesion following the second, fifth, and eighth classes of their respective programs (N = 46). RESULTS:Mean levels of social cohesion changed significantly over time whereas mean levels of task cohesion did not. These patterns were largely consistent across persons and groups. CONCLUSIONS:These findings suggest that within group-based exercise programs social and task cohesion possesses different levels of dynamism, and that this dynamism (or lack thereof) might have important implications for future research and interventions involving physical activity groups.
    背景与目标: 目的:在锻炼班级设置中,始终发现小组凝聚力可以​​预测依从行为,并已被确定为基于干预措施的重要目标。借鉴团体动力学领域的理论,运动课的凝聚力通常被概念化为一种动态的构造,需要形成多个班级,一旦形成,它就会随着时间的推移而不断变化。尽管这种“动态”竞争对于体育锻炼的干预非常重要,但是这种理论化还没有经过经验检验。
    方法:在这项研究中,使用了一个多层次的建模框架来检验运动课内聚力随时间的变化。锻炼者(N = 395)在各自程序的第二,第五和第八类(N = 46)之后完成了对内聚力的测量。
    结果:社交凝聚力的平均水平随时间变化显着,而任务凝聚力的平均水平没有变化。这些模式在个人和群体之间基本保持一致。
    结论:这些发现表明,在基于小组的锻炼计划中,社交和任务的凝聚力具有不同程度的活力,这种活力(或缺乏这种活力)可能对涉及体育活动群体的未来研究和干预措施具有重要意义。
  • 【一次锻炼后的冷热环境对能量平衡调节的影响:小型复习。】 复制标题 收藏 收藏
    DOI:10.3390/nu9060592 复制DOI
    作者列表:Charlot K,Faure C,Antoine-Jonville S
    BACKGROUND & AIMS: :Understanding the regulation of human food intake in response to an acute exercise session is of importance for interventions with athletes and soldiers, as well as overweight individuals. However, the influence of hot and cold environments on this crucial function for the regulation of body mass and motor performance has not been summarized. The purpose of this review was to exhaustively search the literature on the effect of ambient temperature during an exercise session on the subsequent subjective feeling of appetite, energy intake (EI) and its regulation. In the absence of stress due to environmental temperature, exercise-induced energy expenditure is not compensated by EI during an ad libitum meal following the session, probably due to decreased acylated ghrelin and increased peptide tyrosine tyrosine (PYY), glucagon-like peptide 1 (GLP-1), and pancreatic polypeptide (PP) levels. No systematic analysis has been yet made for major alterations of relative EI in cold and hot environments. However, observed eating behaviors are altered (proportion of solid/liquid food, carbohydrate/fat) and physiological regulation appears also to be altered. Anorexigenic signals, particularly PYY, appear to further increase in hot environments than in those that are thermoneutral. Ghrelin and leptin may be involved in the observed increase in EI after exercise in the cold, in parallel with increased energy expenditure. The potential influence of ambient thermal environment on eating behaviors after an exercise session should not be neglected.
    背景与目标: :了解对急性运动做出反应的人的食物摄入量的调节对于运动员和士兵以及超重个体的干预非常重要。然而,尚未总结热和冷环境对调节体重和运动性能的这一关键功能的影响。这篇综述的目的是详尽搜索关于锻炼期间环境温度对随后的主观食欲,能量摄入(EI)及其调节的影响的文献。在没有因环境温度引起的压力的情况下,运动后随意进餐期间EI不能补偿运动引起的能量消耗,这可能是由于酰化的生长素释放肽减少和酪氨酸酪氨酸(PYY),胰高血糖素样肽1( GLP-1)和胰腺多肽(PP)的水平。尚未针对冷热环境中相对EI的重大变化进行系统分析。但是,观察到的饮食行为发生了变化(固体/液体食物,碳水化合物/脂肪的比例),并且生理调节似乎也发生了变化。与热中性信号相比,热环境中的厌食信号,尤其是PYY,似乎进一步增加。生长激素释放肽和瘦素可能参与了寒冷运动后EI的增加,同时增加了能量消耗。运动后饮食环境对饮食行为的潜在影响不容忽视。
  • 【生命体征:美国青少年中的HIV感染,检测和危险行为。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Centers for Disease Control and Prevention (CDC).
    BACKGROUND & AIMS: BACKGROUND:In 2009, 6.7% of the estimated 1.1 million persons living with human immunodeficiency virus (HIV) infection in the United States were youths (defined in this report as persons aged 13-24 years); more than half of youths with HIV (59.5%) were unaware of their infection. METHODS:CDC used National HIV Surveillance System data to estimate, among youths, prevalence rates of diagnosed HIV infection in 2009 and the number of new infections (incidence) in 2010. To assess the prevalence of risk factors and HIV testing among youths, CDC used the 2009 and 2011 Youth Risk Behavior Surveillance System for 9th-12th grade students and the 2010 National Health Interview Survey (NHIS) for persons 18-24 years. RESULTS:Prevalence of diagnosed HIV was 69.5 per 100,000 youths at the end of 2009. Youths accounted for 12,200 (25.7%) new HIV infections in 2010. Of these, 7,000 (57.4%) were among blacks/African Americans, 2,390 (19.6%) among Hispanics/Latinos, and 2,380 (19.5%) among whites; 8,800 (72.1%) were attributed to male-to-male sexual contact. The percentage of youths tested for HIV overall was 12.9% among high school students and 34.5% among those aged 18-24 years; it was lower among males than females, and lower among whites and Hispanics/Latinos than blacks/African Americans. CONCLUSIONS:A disproportionate number of new HIV infections occurs among youths, especially blacks/African Americans, Hispanics/Latinos, and men who have sex with men (MSM). The percentage of youths tested for HIV, however, was low, particularly among males. Implications for Public Health: More effort is needed to provide effective school- and community-based interventions to ensure all youths, particularly MSM, have the knowledge, skills, resources, and support necessary to avoid HIV infection. Health-care providers and public health agencies should ensure that youths are tested for HIV and have access to sexual health services, and that HIV-positive youths receive ongoing health-care and prevention services.
    背景与目标: 背景:2009年,在美国估计有110万人患有人类免疫缺陷病毒(HIV)感染的人口中,有6.7%是青年(本报告中定义为13至24岁的人);一半以上的艾滋病毒青年(59.5%)没有意识到自己的感染。
    方法:疾病预防控制中心使用国家艾滋病毒监测系统的数据来估计年轻人中2009年确诊的艾滋病毒感染率和2010年的新感染人数(发病率)。为评估青少年中危险因素和艾滋病毒检测的患病率,疾病预防控制中心针对9至12年级学生的2009年和2011年青少年风险行为监控系统,以及针对18至24岁人群的2010年全国健康访问调查(NHIS)。
    结果:2009年底,诊断出的艾滋病毒患病率为每10万名青年中69.5名。2010年,青年新感染艾滋病毒的人数为12,200(25.7%)。其中,黑人/非裔美国人中有7,000(57.4%),2,390(19.6%)。 )在西班牙裔/拉丁裔中,白人中有2,380名(19.5%); 8,800(72.1%)来自男女之间的性接触。在高中生中,接受艾滋病毒检测的年轻人总体百分比为12.9%,在18-24岁年龄段的年轻人中为34.5%;男性比女性低,而白人和西班牙裔/拉丁美洲人比黑人/非裔美国人低。
    结论:年轻人中,尤其是黑人/非裔美国人,西班牙裔/拉丁裔和与男性发生性关系的男性中,新感染艾滋病毒的比例不成比例。但是,接受艾滋病毒检测的年轻人比例很低,尤其是在男性当中。对公共卫生的影响:需要付出更多的努力来提供有效的基于学校和社区的干预措施,以确保所有青年,尤其是男男性接触者,拥有避免感染艾滋病毒所需的知识,技能,资源和支持。卫生保健提供者和公共卫生机构应确保对青年进行艾滋病毒检测并获得性保健服务,并确保艾滋病毒呈阳性的青年得到持续的卫生保健和预防服务。
  • 【支气管内超声引导的经支气管针吸(EBUS-TBNA)-从形态学到分子检测。】 复制标题 收藏 收藏
    DOI:10.21037/jtd.2017.03.158 复制DOI
    作者列表:Righi L,Franzi F,Montarolo F,Gatti G,Bongiovanni M,Sessa F,La Rosa S
    BACKGROUND & AIMS: :In recent years, endobronchial ultrasound-guided TBNA (EBUS-TBNA) has emerged as an innovative technique for diagnosis and staging of lung cancer and has been successfully introduced into daily clinical practice with several advantages including minimally invasive approach, safe, cost-effective, real time image guidance, broad sampling capability, and rapid on-site evaluation (ROSE). Both cytological and histological approach could be useful to have material for diagnosis, immunohistochemical and molecular analyses which may be very important for targeted therapy with successful rate ranging from 89% to 98%. The utility of ROSE during EBUS-TBNA has been matter of debate. Indeed, although some evidence concluded that ROSE does not increase the diagnostic efficacy of EBUS-TBNA, other demonstrated that it improves the diagnostic yield of the procedure up to 30%, allows to avoid repetition of additional diagnostic procedures and reduces risk of complications. Furthermore the sample preparation by cytopathologist is optimized with the aid of direct macroscopic inspection, optimal smearing techniques, and triage of the sample permitting to obtain adequate tissue for diagnosis, ancillary techniques and molecular testing, when needed. Some pathological issues on EBUS-TBNA are reviewed and discussed with particular focus on ROSE and molecular testing.
    背景与目标: :近年来,支气管内超声引导下的TBNA(EBUS-TBNA)已成为诊断和分期肺癌的创新技术,并已成功引入日常临床实践中,具有多种优势,包括微创方法,安全,具有成本效益,实时图像导航,广泛的采样功能以及快速的现场评估(ROSE)。细胞学和组织学方法均可用于诊断,免疫组织化学和分子分析的材料,这对于靶向治疗非常重要,成功率从89%到98%不等。在EBUS-TBNA期间,ROSE的实用性一直存在争议。确实,尽管一些证据得出结论,ROSE不会增加EBUS-TBNA的诊断功效,但其他证据表明,ROSE可以将手术的诊断率提高多达30%,可以避免重复进行其他诊断程序并降低并发症的风险。此外,借助于直接的宏观检查,最佳的涂片技术和样品分类,可以优化细胞病理学家的样品制备,从而在需要时能够获得足够的组织用于诊断,辅助技术和分子检测。对EBUS-TBNA的一些病理学问题进行了回顾和讨论,特别是在ROSE和分子测试方面。

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