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The aim of this review was to verify the effects of aerobic exercise combined with blood flow restriction on older adult functionality. Systematic searches were performed in PubMed, Web of Science, and Embase between July and December 2023. Randomized studies with participants aged ≥ 60 years who were evaluated before and after the experimental protocols were included. We registered this systematic review at the International Prospective Register (PROSPERO CRD42022347205). The search strategy identified 2698 studies, four of which were included in the review, with 80 participants. The results suggested that aerobic exercise combined with blood flow restriction increased performance on specific functional tests. However, these results should be interpreted with caution due to the low-to-moderate study quality, as well as the low number of participants and studies. In conclusion, aerobic exercise and blood flow restriction may increase functional capacity in older adults. Further studies are needed to confirm such findings. (AU)
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Humanos , Idoso , Idoso de 80 Anos ou mais , Treino Aeróbico , Terapia de Restrição de Fluxo Sanguíneo , IdosoRESUMO
Resumen Antecedentes: El pronóstico de los pacientes con infarto agudo de miocardio con elevación del segmento ST (IAMCEST) y antecedente de intervención coronaria percutánea (ICP) es incierto. Objetivos: Evaluar si la ICP previa en pacientes con IAMCEST incrementa el riesgo de eventos cardiovasculares mayores y si el flujo final epicárdico varía según la estrategia de reperfusión. Material y métodos: Subestudio de PHASE-MX, observacional, longitudinal y comparativo, de pacientes con IAMCEST reperfundidos en menos de 12 horas de iniciados los síntomas, divididos conforme el antecedente de ICP. El acaecimiento del criterio de valoración principal (muerte cardiovascular, reinfarto, insuficiencia cardíaca y choque cardiogénico) dentro de los 30 días se comparó con estimaciones de Kaplan-Meier, prueba de rangos logarítmicos y modelo de riesgos proporcionales de Cox. El flujo epicárdico final se evaluó con el sistema de clasificación del flujo TIMI después de la reperfusión. Resultados: Se incluyeron 935 pacientes, 85.6 % del sexo masculino, 6.9 % de los cuales tenía antecedente de ICP; 53 % recibió terapia farmacoinvasiva y 47 %, ICP primaria. La incidencia del criterio de valoración principal en pacientes con ICP previa fue de 9.8 % versus 13.3 % en aquellos sin ese antecedente (p = 0.06); 87.1 % de los pacientes con ICP previa obtuvo flujo final de grado TIMI 3 versus 75 % del grupo con estrategia farmacoinvasiva (p = 0.235). Conclusiones: El antecedente de ICP no incrementa el riesgo de eventos cardiovasculares mayores a los 30 días en pacientes con IAMCEST; sin embargo, impacta negativamente en el flujo sanguíneo angiográfico final de los pacientes que recibieron terapia farmacoinvasiva (en comparación con ICP primaria).
Abstract Background: The prognosis of patients with ST-segment elevation myocardial infarction (STEMI) and previous percutaneous coronary intervention (PCI) is uncertain. Objectives: To evaluate if previous PCI in patients with STEMI increases the risk of major cardiovascular events, and if final epicardial blood flow differs according to the reperfusion strategy. Material and methods: Observational, longitudinal, comparative sub-study of the PHASE-MX trial that included patients with STEMI and reperfusion within 12 hours of symptom onset, who were divided according to their history of PCI. The occurrence of the composite primary endpoint (cardiovascular death, re-infarction, congestive heart failure and cardiogenic shock) within 30 days was evaluated using Kaplan-Meier estimates, log-rank test and Cox proportional hazards model. Final epicardial blood flow was assessed using the TIMI grading system after reperfusion. Results: A total of 935 patients were included; 85.6% were males, and 6.9% had a history of PCI; 53% underwent pharmacoinvasive therapy, and 47%, primary PCI. The incidence of the composite primary endpoint at 30 days in patients with a history of PCI was 9.8% vs. 13.3% in those with no previous PCI (p = 0.06). Among the patients with previous PCI, 87.1% reached a final TIMI grade 3 flow after primary PCI vs. 75% in the group with pharmacoinvasive strategy (p = 0.235). Conclusions: A history of PCI does not increase the risk of major cardiovascular events at 30 days; however, it impacted negatively on the final angiographic blood flow of patients that received pharmacoinvasive therapy (compared to primary PCI).
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Objective To explore the application value of ultrasonic measurement of optic nerve sheath diameter(ONSD)and cerebral blood flow parameters in intracranial hypertension caused by AIDS cryptococ-cal meningitis.Methods A total of 27 patients with cryptococcal meningitis diagnosed by Chongqing Public Health Medical Center from February to July,2022 were included.All patients were examined with ultrasound measurement of ONSD and ultrasound measurement of cerebral blood flow of intracranial middle cerebral ar-tery(MCA),including peak systolic velocity(PSV),end diastolic velocity(EDV),peak systolic velocity/end diastolic velocity(S/D)and resistance index(RI),and then lumbar puncture was performed and intracranial pressure(ICP)was recorded.The ICP≥200 mmH2O was defined as the ICP increased group,ICP＜200 mmH2O was defined as the ICP normal group,and 17 AIDS patients without complications were selected as the control group.The baseline data,ONSD and MCA cerebral blood flow parameters of the three groups were compared,and the statistically significant indexes were correlated with ICP,and the receiver operating charac-teristic(ROC)curve of the subjects was drawn to analyze the diagnostic efficacy of ONSD value in predicting intracranial hypertension caused by AIDS cryptococcal meningitis.Results There were no significant differ-ences in gender,age,systolic blood pressure or diastolic blood pressure among the ICP increased group,the ICP normal group and the control group(P＞0.05).There were no significant differences in PSV,EDV,S/D and RI among the three groups of MCA(P＞0.05),but there was significant difference in ONSD among the three groups(P＜0.05).There was a positive correlation between ICP and ONSD in the patients with AIDS cryptococcal meningitis(P＜0.01,r=0.736).The ROC curve analysis showed that when the ONSD cutoff value was 3.965 mm,it predicted the highest efficacy of intracranial high pressure in the patients with AIDS cryptococcal meningitis.The area under the ROC curve was 0.90(95％CI:0.714-1.000,P=0.001),the sensitivity was 90％,and the specificity was 100％.Conclusion Ultrasonic measurement of ONSD can effec-tively predict ICP in patients with AIDS cryptococcal meningitis and guide clinical decompression measures in time,which is worthy of clinical application.
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Objective To explore the pharmacokinetic changes of single dose of fentanyl in rats in a simulated high-altitude and contributing factors.Methods Thirty-six healthy female SD rats(6～8 weeks old,250±20 g)were randomly divided into high-altitude-acute-exposure group(group A),high-altitude-chronic-exposure group(group S)and control group(group C)through random number table,with 12 rats in each group.The group A and S were housed in a low-pressure chamber simulating the high altitude of 5000 m above sea level for 3 and 30 d respectively,and the group C was housed out of the chamber(at an altitude of 300 m).A single dose of fentanyl was administered through the femoral vein to 6 rats randomly selected from each group.Liquid chromatography tandem mass spectrometry(LC-MS/MS)was used to detect blood concentrations of fentanyl and WinNonlin 8.2 software was used to calculate the pharmacokinetic parameters,while blood samples were taken through the femoral artery before and in 1,2,4,8,15,30,60,120 and 180 min after administration.The remaining 6 rats were ultrasonographically assessed for portal vein internal diameter(PVD),peak flow velocity(PVV)and blood flow(PVF),and liver tissues were collected for CYP3A1 protein content assay.Results The blood drug concentrations of fentanyl in the group A and group S were significantly lower than those in the group C at 60,120,and 180 min(P=0.002,P＜0.001,P= 0.001).Compared with the group C,the clearance rate(CL)of the group A was increased by 54.06%(P=0.021),and the mean residence time(MRTlast)was shortened by 24.21%(P=0.033);CL of the group S was increased by 50.10%(P=0.041),the area under the concentration-time curve(AUC0-t,AUC0-∞)and MRTlast were reduced by 18.92%(P=0.039),27.54%(P=0.018)and 33.61%(P= 0.004),respectively.PVD and PVF in the group S increased by 10.87%(P=0.006)and 42.50%(P= 0.006)when compared with the group C.The CYP3A1 protein content in the group A was 28.74%,which was higher than that in the group C(P=0.048).Conclusion Fentanyl is cleared significantly faster after a single dose in rats in simulated high-altitude,which may be related to the increased liver blood flow and increased CYP3A1 protein expression in liver.
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Objective To investigate the efficacy of Dingxuan Decoction combined with vestibular function rehabilitation training in the treatment of Meniere's disease and to observe its effect on clinical symptoms and blood flow of vertebral artery.Methods A total of 100 patients with Meniere's disease of liver-kidney yin deficiency complicated with wind-water upward stirring type were randomly divided into an observation group and a control group,with 50 patients in each group.The control group was given conventional treatment and vestibular function rehabilitation training,and the observation group was treated with Dingxuan Decoction on the basis of treatment for the control group.The two groups were treated for 4 weeks and then were followed up for 6 months.The changes of traditional Chinese medicine(TCM)syndrome score,Dizziness Handicap Inventory(DHI)score,Tinnitus Handicap Inventory(THI)score,hearing visual analogue scale(VAS)score and vertebral artery blood flow in the two groups were observed before and after the treatment.After treatment,the TCM syndrome efficacy,hearing improvement and follow-up results were compared between the two groups.Results(1)After 4 weeks of treatment,the total effective rate for TCM syndrome efficacy of the observation group was 86.00%(43/50),and that of the control group was 62.00%(31/50),and the intergroup comparison showed that the TCM syndrome efficacy in the observation group was significantly superior to that in the control group(P＜0.01).(2)After 4 weeks of treatment,the hearing of patients in both groups was improved,and the total effective rate for the efficacy of hearing improvement in the observation group was 76.00%(38/50),while that in the control group was 46.00%(23/50).The intergroup comparison showed that the efficacy of hearing improvement in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the TCM syndrome scores,DHI score,THI score and hearing VAS scores in the two groups were all decreased compared with those before treatment(P＜0.05 or P＜0.01),and the decrease in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the average blood flow velocity of the left vertebral artery(LVA)and the right vertebral artery(RVA)in the two groups were both increased compared with those before treatment(P＜0.05),and the increase in the observation group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(5)The results of 6-month follow-up after treatment showed that the incidence of Meniere's disease and the frequency of attack in the observation group were significantly reduced compared with those in the control group,and the episode duration in the observation group was significantly shorter than that in the control group,the differences being all statistically significant(P＜0.05 or P＜0.01).Conclusion Dingxuan Decoction combined with vestibular function rehabilitation training exert certain effect in treating patients with Meniere's disease of liver-kidney yin deficiency complicated with wind-water upward stirring type,and the therapy is effective on improving patients'clinical symptoms and vertebral artery blood flow,reducing the risk of recurrence and improving the quality of life of the patients.
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Objective To measure and compare the cerebral blood flow(CBF)of children with autism spectrum disorder(ASD),global developmental delay(GDD),and ASD with GDD groups via arterial spin labeling(ASL)technique,and to evaluate the diag-nostic value of CBF values.Methods ASL images of ASD,GDD,and ASD with GDD groups of children were firstly acquired,and the CBF values of frontal lobe,temporal lobe,parietal lobe,occipital lobe,striatum and thalamus region of interest(ROI)were fur-ther measured,respectively.One-way analysis of variance or Kruskal-Wallis H test was used to compare the differences in CBF values among these three groups,and the receiver operating characteristic(ROC)curve was used to analyze the efficacy of CBF values in distinguishing ASD with GDD from without GDD.Results ASD with GDD had significantly lower CBF values in the left and right frontal lobes than those with ASD or GDD alone,and the differences were statistically significant(P<0.05).The CBF values in the left and right frontal lobes effectively distinguished ASD with GDD from without GDD[area under the curve(AUC)>0.7].Conclusion ASL technique can noninvasively assess CBF in children with or without GDD,helping to understand the pathophysiology of ASD with GDD and improving diagnostic accuracy.
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BACKGROUND:The use of blood flow restriction training in clinical rehabilitation is becoming more common,in part due to technological advances and increased interest in research and medicine. OBJECTIVE:To explore the global trend and development prospects of clinical rehabilitation-related blood flow restriction training application,identify research gaps,and propose future research directions. METHODS:Web of Science,PubMed,and Elsevier were searched for literature related to clinical rehabilitation using blood flow restriction training published from 2001 to 2022.A total of 515 articles were included for further review.Bibliometrics,exploratory factor analysis and cluster analysis were used to reveal the emerging research fields and topics. RESULTS AND CONCLUSION:First of all,the overall research trend of the number of published articles shows a steady rise.The United States is the main research area in this field,and universities contribute the most to journals.Secondly,a core group of authors,led by Loenneke JP,Abe T and Dankel SJ,has been formed,with less collaboration among highly productive authors.Finally,research on blood flow restriction training focuses on skeletal muscle rehabilitation,cognitive functional activity,and chronic disease rehabilitation in clinical rehabilitation,with particular attention to the application of blood flow restriction in the recovery of symptoms such as muscle atrophy,knee pain,and joint effusion after anterior cruciate reconstruction surgery.Theoretical research on low-pressure blood flow restriction that is effective in relieving musculoskeletal symptoms has been hot in recent years,which can systematically guide the musculoskeletal rehabilitation in clinical practice.In the future,clinicians will extend follow-up periods,register larger and more diverse sample sizes,and use randomization techniques to determine appropriate prescribing indications for rehabilitating patients,ensure clinical safety,and quantitatively analyze and develop rehabilitation protocols with the maximum effect at the minimum effective dose for different clinical populations.
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BACKGROUND:Tissue flossing is a new injury prevention tool and auxiliary exercise training strategy.Tissue flossing can increase joint range of motion,improve athletic performance,and relieve pain,and is increasingly widely used in the field of sports and rehabilitation. OBJECTIVE:To review the mechanism of tissue flossing and its application in sports and rehabilitation to provide a reference for follow-up research. METHODS:"Tissue flossing;compression tissue flossing;floss band;voodoo flossband;blood flow restriction;shearing of fascia;musculoskeletal rehabilitation;sport injury"were used as Chinese and English search terms to search on the databases of CNKI,WanFang,VIP,PubMed and EBSCO databases.Relevant articles from January 2000 to October 2022 were retrieved,and 86 articles were finally included according to inclusion and exclusion criteria. RESULTS AND CONCLUSION:Tissue flossing intervention can improve lower limb joint motion,improve sprint and jump performance,promote joint injury rehabilitation,and relieve pain subjectively.However,tissue flossing intervention did not improve the range of motion of the upper limb.There is still controversy on the acute enhancement of lower limb muscle strength.It has a good tendency to improve lower limb balance and stability and improve mental state,but more studies are needed to confirm.The possible mechanisms of tissue flossing intervention are mainly fascia shear,pain gating,blood flow restriction and reperfusion,and compression.Tissue flossing is a useful treatment option that can provide important contributions in the future in the areas of sports training,sports injury prevention and rehabilitation,but more long-term in-depth studies are needed.
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OBJECTIVE:To systematically review the clinical effect of blood flow restriction training on rehabilitation after anterior cruciate ligament reconstruction to provide a reference for clinical practice. METHODS:Databases including CNKI,WanFang,PubMed,Web of Science and EBSCO were searched to collect randomized controlled trials of blood flow restriction training in the intervention of anterior cruciate ligament reconstruction from inception to August 10,2022.Outcomes included knee muscle strength,knee muscle mass,and knee function evaluation,all of which were continuous variables.Two reviewers independently screened the literature and extracted data.Cochrane bias risk assessment tool and Physiotherapy Evidence Database Scale were used to evaluate the bias risk of the included articles.Meta-analysis was then performed using RevMan 5.4 software. RESULTS:A total of 9 publications were included,including 226 subjects,114 in the trial group and 112 in the control group.Meta-analysis results showed that compared with conventional resistance training,the blood flow restriction training group could significantly improve knee muscle strength[SMD=0.54,95%CI(0.29,0.79),P＜0.01],muscle mass[SMD=0.26,95%CI(0.06,0.46),P=0.01]and knee joint function[SMD=1.17,95%CI(0.53,1.80),P＜0.01].Subgroup analysis showed that only when the intervention time was more than 4 weeks,there were significant improvements in knee joint muscle strength[SMD=0.68,95%CI(0.38,0.97),P＜0.01]and muscle mass[SMD=0.38,95%CI(0.09,0.68),P=0.01]. CONCLUSION:Current evidence shows that blood flow restriction training can improve muscle strength and knee function in patients with anterior cruciate ligament reconstruction and reduce muscle atrophy.It is recommended that the postoperative intervention time should be more than 4 weeks to achieve better muscle strength and muscle mass improvement.
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BACKGROUND:Blood flow restriction training has broad application prospects in improving limb muscle strength.It has ideal effects on the upper limbs is ideal,and the specific application scheme has high research value. OBJECTIVE:To explain the influence of blood flow restriction training on the fitness benefits of upper limb muscles and summarize the specific programs of blood flow restriction training for upper limb,attempting to give suggestions on application programs based on existing studies. METHODS:Literature on the application of upper limb blood flow restriction training were searched in CNKI,WanFang,VIP,CBM,PubMed,Embase,EBSCO,Cochrane Library and Web of Science databases.The search terms were"blood flow restriction,blood flow restriction training,pressure training,upper limb,upper arm,forearm,arm,forearm"in Chinese and"blood flow restriction training,blood flow restriction exercise,blood flow restriction therapy,BFR therapy,occlusion training,KAATSU training,BFRT,upper extremity,upper limb,arm,forearm"in English.The relevant articles on the application of blood flow restriction training in the upper limbs included in the database from database inception to December 2022 were selected and screened according to inclusion criteria and exclusion criteria. RESULTS AND CONCLUSION:Firstly,blood flow restriction training is mainly applied to healthy people,special athletes and people with upper limb injury.Secondly,the influence of blood flow restriction training on upper limb muscle fitness is mainly reflected in the increase of upper limb circumference,muscle strength,muscle endurance,muscle thickness,muscle cross-sectional area and explosive power of upper limb,followed by the cross migration phenomenon of the upper limbs.Thirdly,blood flow restriction training for the upper limbs mainly uses inflatable blood flow restriction devices:the cuff width was 3-5 cm,the pressure position was 1/3 of the upper arm,the limiting pressure was 40%-60%arterial occlusion pressure or 80-160 mmHg,the training load is 20%-30%1RM,the training volume is four sessions(30-15-15-15 times),the interval time was 30-60 seconds,and the training frequency was 2 or 3 times per week.
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BACKGROUND:The impact of the endometrium's structure and spiral artery blood flow parameters on the pregnancy rate of artificial insemination by husband remains unclear.This study identified the independent factors and constructed a prediction model with good clinical application efficacy after calibration of other confounding factors. OBJECTIVE:To construct and validate a clinical pregnancy prediction model for artificial insemination by husband based on endometrial structure and uterine spiral artery blood flow parameters. METHODS:A retrospective analysis was conducted on 1 299 patients who underwent artificial insemination by husband treatment at Changzhou Maternal and Child Health Hospital from January 2017 to January 2021.The non-pregnancy group consisted of 1 182 patients,while the pregnancy group included 117 patients.Out of these patients,93 cases were successfully matched between the pregnancy and non-pregnancy groups using a 1∶1 propensity score matching method.Single-factor and multi-factor analyses were used to screen the endometrial structure and uterine spiral artery blood flow parameters to determine their influence on artificial insemination by husband outcomes.The optimal cutoff value was established for each independent influencing factor through receiver operating curve analysis and their risk trend affecting artificial insemination by husband pregnancy outcomes was analyzed using a restricted cubic spline.The clinical efficacy of this combined forecast model was tested by using clinical decision curve and clinical influence curve methods. RESULTS AND CONCLUSION:(1)There was no statistical significance in non-endometrial factors between the pregnancy group and the non-pregnancy group,and the data had a good balance by propensity score matching(P>0.05).(2)Single-factor analysis identified several subendometrial parameters as significant influencing factors of artificial insemination by husband pregnancy outcomes,including vascularization index,flow index,vascular flow index,resistance index,pulsatility index,maximum systolic velocity/end-diastolic velocity,thickness of average junction zone and maximum junction zone from the basal endometrium to the outer myometrium inner layer(P<0.05).(3)Multivariate logistic regression analysis revealed that thickness of average junction zone,pulsatility index,and vascular flow index were independent influencing factors of pregnancy outcomes of artificial insemination by husband,vascular flow index>thickness of average junction zone>pulsatility index.(4)Receiver operating characteristic curve analysis indicated that the area under receiver operating characteristic curve of vascular flow index was 0.704(0.629,0.779),and the optimal cutoff value was 6.26;the area under receiver operating characteristic curve of thickness of average junction zone was 0.660(0.582,0.739),and the optimal cutoff value was 6.38;the area under receiver operating characteristic curve of pulsatility index was 0.642(0.563,0.721),and the optimal cutoff value was 1.18.(5)The restricted cubic spline analysis revealed that artificial insemination by husband pregnancy outcomes were significantly positively affected when the vascular flow index was>6.24 or the thickness of average junction zone was≤6.55 mm,while a negative risk was associated with pulsatility index>1.27.(6)The clinical decision curve and clinical influence curve analyses exhibited that the combined prediction model had the maximum clinical net benefit at the threshold probability value of 0.17-0.93,and the ratio of loss to benefit was consistently less than 1 in the threshold probability range,indicating that the model had good clinical efficacy.(7)It is concluded that after adjusting for other confounding factors outside of the endometrium using propensity score matching and multifactorial logistic regression,the thickness of average junction zone,pulsatility index and vascular flow index were independent factors that influenced pregnancy outcomes of artificial insemination by husband.Through determining their optimal cutoff values and assessing their risk trends,it was confirmed that the combined prediction model had good predictive value and clinical efficacy.
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BACKGROUND:Sarcopenia is a chronic condition that leads to strength loss and functional decline,increasing the risk of frailty,disability,falls,and death in older adults.Blood flow restriction training can be effective in the treatment of sarcopenia,but a comprehensive review of its advantages,disadvantages,biological mechanisms,and application options is lacking. OBJECTIVE:To review the advantages,limitations,and biological mechanisms of blood flow restriction training interventions for sarcopenia and to give recommendations for application protocols based on current published evidence. METHODS:A search of major databases was conducted for literature published in the time frame up to February 2023.The search terms were"blood flow restriction training,KAATSU,elderly,sarcopenia,muscle"in English and Chinese.Finally,82 included papers were compiled and analyzed. RESULTS AND CONCLUSION:Blood flow restriction training as an intervention for sarcopenia has been effective in peripheral muscle groups,but there are limitations in its application.Blood flow restriction training is highly operational and safe.This training can improve muscle strength and physical performance,but there are potential risks,including adverse events on skeletal muscle,cardiovascular and endothelial cells.Therefore,blood flow restriction training needs to be performed under scientific guidance and further studies are needed to verify its efficacy in patients with sarcopenia.The biological mechanisms of blood flow restriction training intervention in sarcopenia may include:increasing muscle hypertrophy due to reactive muscle congestion,improving muscle protein synthesis capacity,inducing metabolic stress adaptation,promoting skeletal muscle growth and repair,activating vascular endothelial growth factor signaling pathway to promote angiogenesis,and promoting satellite cell proliferation.However,these specific roles and combined effects of these mechanisms need to be determined by more in-depth studies.Blood flow restriction training interventions for sarcopenia are mainly influenced by training and cuffs.To avoid adverse events,it is recommended that 20%to 50%1RM,20 to 75 repetitions,2 to 3 times per week,30-60 seconds interval between sessions,smaller size cuffs with a pressurization value≤140 mmHg for upper limb training,and larger size cuffs with a pressurization value≤180 mmHg for lower limb training,usually 50%to 80%of the pressure value in the completely occluded artery.However,more research is needed on the training frequency and interval between sessions in older adults,and further research is needed on the optimal choice of cuff pressurization values.
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OBJECTIVE:To systematically assess the effect of blood flow restriction combined with endurance training on aerobic capacity,lower limb muscle strength,and sports performance of athletes using Meta-analysis. METHODS:3210 studies were searched in CNKI,VIP,WanFang,PubMed,Embase,Web of Science,ScienceDirect,and Cochrane databases before March 2023.After screening,12 studies and 14 research reports were included.The traditional Meta-analysis and network Meta-analysis were performed by Review Manager 5.4 and Stata 14. RESULTS:Endurance training with blood flow restriction had a medium effect size on maximal oxygen uptake(standardized mean difference(SMD)=0.59,95%confidence interval(CI):0.28-0.90,P＜0.05)and no heterogeneity.The effect of continuous pressure was better than the other pressure types(P＜0.05).Compared with sports events by anaerobic energy supply,sports events by aerobic energy supply showed better effects(P＜0.05),which was set as follows:4-8 weeks of aerobic training,20-30 minutes once,3 or more sessions per week,for a total of 12 or more sessions.Secondly,endurance training with blood flow restriction showed a large effect on the lower limb muscle strength(SMD=0.99,95%CI:0.61-1.37,P＜0.05)and no heterogeneity.A subgroup analysis showed muscle endurance was the best improved(SMD=1.11;95%CI:0.37-1.85),followed by knee extension strength(SMD=1.02,95%CI:0.37-1.67)and knee flexion strength(SMD=0.87,95%CI:0.24-1.51).Finally,endurance training with blood flow restriction showed a medium effect on sports performance(SMD=0.59,95%CI:0.13-1.06,P＜0.05),and the subgroup analysis showed a medium effect on running performance(SMD=0.55,95%CI:0.05-1.06,P＜0.05)and no heterogeneity.There was only one item of soccer specific performance that was not analyzed. CONCLUSION:Endurance training combined with blood flow restriction can improve the aerobic capacity,lower limb muscle strength,and sports performance of the athletes.And there is a large effect on lower limb muscle strength and a medium effect on aerobic capacity and sports performance.A training schedule of progressive mixed-intensity aerobic endurance training under continuous pressure for no less than 4 weeks,3 sessions per week,20-30 minutes per session,for 12 or more sessions in total is easy to obtain better training results.
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Objective:To study cerebral oxygen metabolism and cerebral blood flow in etomidate and sevoflurane anesthesia effects of perfusion and postoperative delusions.Methods:A prospective study was used. The 96 elderly patients who underwent elective spinal surgery in Guang′anmen Hospital, China Academy of Chinese Medical Sciences from March 2020 to May 2021 were selected as the study subjects. All patients were divided into sevoflurane group and etomidide group by random numbers table, each with 48 cases. The sevoflurane group was treated with sevoflurane inhalation for analgesia, with etomidate intravenous-controlled analgesia in the etomidate group. The recovery time of spontaneous respiratory, wake time, awake extubation time, numerical rating score (NRS; 1, 3, 6, 12, 24 and 48 h), incidence of postoperative delusion, internal jugular vein oxygen saturation (SjvO 2) were recorded. Arteriovenous oxygen content (AVDO 2) and cerebral oxygen intake rate (CERO 2) were calculated. The peak cerebral artery constriction rate (Vs-MCA), diastolic velocity (Vd-MCA) and mean flow rate (Vm-MCA) pre-induction of anesthesia (T 0), loss of consciousness (T 1), after fentanyl injection (T 3), endotracheal intubation (T 4), 30 min (T 5), 60 min (T 6) and postoperative (T 7) were recorded. Results:There were no significant differences in the recovery time of spontaneous breathing, wake time and awake extubation time between the two groups ( P>0.05). The resting NRS in sevoflurane group at 1, 3, 6, 12, 24 and 48 h after operation were (1.27 ± 0.12), (2.13 ± 0.22), (3.26 ± 0.23), (3.29 ± 0.22), (2.52 ± 0.11) and (2.02 ± 0.11) points, respectively. Etomidate group was (1.27 ± 0.13), (2.02 ± 0.21), (2.13 ± 0.13), (2.11 ± 0.26), (2.08 ± 0.17) and (1.02 ± 0.17) points, respectively. The results of repeated measurement ANOVA showed that there was significant difference in NRS between the two groups ( P<0.05). There were significant differences in postoperative resting NRS between the two groups at different time points ( P<0.05). The incidence of postoperative delusion in etomidate group was lower than that in sevoflurane group: 4.17% (2/48) vs. 16.67% (8/48), and the difference was statistically significant ( P<0.05). Postoperative SjvO 2 in sevoflurane group and etomidate group was higher than that before surgery: (69.96 ± 4.17)% vs. (58.26 ± 4.16)%, (61.22 ± 4.19)% vs. (58.25 ± 4.17)%. In addition, both AVDO 2 and CERO 2 were lower than those before operation: (60.23 ± 5.22)% vs. (64.22 ± 4.17)%, (50.23 ± 6.19)% vs. (64.23 ± 4.19)%, (37.22 ± 6.23)% vs. (40.23 ± 5.16)%, (31.26 ± 5.17)% vs. (40.27 ± 4.18)% ( P<0.05), postoperative SjvO 2 in etomidate group was higher than that in sevoflurane group, and AVDO 2 and CERO 2 were lower than that in sevoflurane group. The difference was statistically significant ( P<0.05). The results of repeated measurement ANOVA showed that there were statistically significant differences in cerebral blood perfusion indexes of Vs-MCA, Vd-MCA and Vm-MCA between the two groups ( P<0.05). There were statistically significant differences in Vs-MCA, Vd-MCA and Vm-MCA between two groups at different time points ( P<0.05). There were significant differences in Vs-MCA, Vd-MCA and Vm-MCA between the two groups at different time points ( P<0.05). Conclusions:Compared with sevoflurane, etomidate can reduce the postoperative delusion rate, improve cerebral oxygen metabolism and reduce cerebral blood flow perfusion.
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Objective To investigate the value of histone deacetylase 3(HDAC3)in evaluating the risk of slow/no reflow in AMI patients after PCI.Methods A total of 280 AMI patients undergo-ing PCI in our hospital from June 2020 to June 2022 were recruited,and according to TIMI blood flow grading,they were divided into slow/no reflow group(TIMI≤grade 11,n=54)and normal flow group(TIMI＞grade Ⅱ,n=226).The demographic characteristics,underlying diseases,baseline data at admission,and preoperative results of coronary angiography and laboratory tests were compared between the two groups.Multivariate logistic regression analysis was used to determine the influencing factors for slow/no reflow in AMI patients after PCI,and ROC curve was drawn to analyze the predictive value of related indicators for slow/no reflow.Results Obvi-ously larger proportions of smoking history and Killip grade Ⅱ,higher heart rate,longer reperfu-sion time,and higher serum levels of LDL-C,NLR,D-D and HDAC3 were observed in the slow/no reflow group than the normal flow group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that reperfusion time,NLR and HDAC3 were influencing factors for slow/no reflow in AMI patients after PCI(P＜0.05,P＜0.01).The AUC value of reperfusion time+NLR in predicting the slow/no reflow after PCI in AMI patients was 0.798(95％CI:0.664-0.922,P=0.002),with a sensitivity and specificity of 0.87 and 0.73,respectively.And when serum HDAC3 level was combined in the prediction,the AUC value was 0.903(95％CI:0.790-0.922,P＜0.01),with a sensitivity and specificity of 0.93 and 0.84,respectively.Conclusion Preoperative HDAC3 level is an influencing factor for slow/no reflow in AMI patients after PCI.Based on reperfusion time and NLR,combination of the 3 indicators can provide additional predictive value for slow/no reflow in these patients.
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Objective:To observe the clinical curative effect of long-time needle retaining at Baihui(GV20)combined with multidirectional point-toward-point needle insertion with needle shaking at Fengchi(GB20)for the treatment of cervical vertigo(CV)and its influence on the blood flow velocity of vertebrobasilar arteries. Methods:Seventy patients with CV were randomly divided into a treatment group(35 cases,1 dropout)and a control group(35 cases,2 dropouts)according to the random number table method.Those in the treatment group were treated with long-time needle retaining at Baihui(GV20)combined with multidirectional point-toward-point needle insertion with needle shaking at Fengchi(GB20),and those in the control group were treated with conventional acupuncture.The treatment was performed every other day,7 sessions as a treatment course,for a total of 2 courses.The clinical efficacy was compared between the two groups by observing changes in the evaluation scale for symptoms and functions of cervical vertigo(ESCV)and the mean blood flow velocity(Vm)of vertebrobasilar arteries. Results:The total effective rate and the cured plus markedly effective rate were 91.2%and 79.4%,respectively,in the treatment group,versus 78.8%and 54.5%in the control group,respectively,with a statistically significant difference in the cured plus markedly effective rate between the two groups(P<0.05).The ESCV score and the Vm of vertebrobasilar arteries in the two groups improved significantly after treatment.The Vm of the left vertebral artery(LVA),right vertebral artery(RVA),and basilar artery(BA)increased in patients with low and normal flow velocities(P<0.05),and the Vm of the LVA,RVA,and BA decreased in patients with a high flow velocity(P<0.05);the results in the treatment group were significantly better than those in the control group(P<0.05). Conclusion:Long-time needle retaining at Baihui(GV20)combined with multidirectional point-toward-point needle insertion with needle shaking at Fengchi(GB20)can significantly reduce the clinical symptoms of CV and regulate the blood flow rate of vertebrobasilar arteries bidirectionally,and thus is an effective therapy for CV.
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AIM: To assess the changes of vessel density in the optic disc and macular of the affected eye and the uninvolved contralateral eye in patients with idiopathic optic neuritis(ON)and to provide clinical guidance for the treatment and follow-up of idiopathic ON.METHODS: A total of 16 patients with first-episode monocular idiopathic ON ≤3 mo diagnosed between December 2019 and December 2021 were included in this cross-sectional study. The eye of patients was divided into 16 eyes in the affected eye group and 16 eyes in the uninvolved contralateral eye group, and 20 healthy age-matched eyes(n=20)served as controls. Optical coherence tomography angiography(OCTA)was performed in all eyes at 4.5 mm×4.5 mm region of the optical disc and 6 mm×6 mm region of the macular, and blood flow indicators were collected and compared. RESULTS: Compared with the control group and the uninvolved contralateral eye group, the density of all vessels and capillary were reduced in the whole area of optic disc, and all subdivisions of the peripapillary region in the ON group(all P<0.05). Compared with the uninvolved contralateral eye group, the density of superficial capillary plexus(SCP)was significantly lower in the whole area of macular and perifovea region, and its all subdivisions of the ON eye, as well as in the superior-hemi and superior subdivision of the parafovea region(all P<0.05). Compared with the control group, the density of SCP in the inferior-hemi, nasal, and inferior perifovea region was significantly reduced in the ON affected eye group(all P<0.05). Compared with the control group, the whole area of macular and its subdivisions in the uninvolved contralateral eye group showed an increase in the density of SCP(P<0.05)and an increase in the density of SCP in the parafovea region(P<0.05), but no significant change in the inferior-hemi and nasal subdivisions; the increase in the density of SCP in the perifovea region was only significant in the superior-hemi and superior subdivisions(P<0.05).CONCLUSION: Patients with ON in the duration of ≤3 mo may showed a decreased vessel density in all peripapillary subdivisions, and a decreased density of SCP in some subdivisions of the perifovea region, accompanied by an increased density of SCP in some subdivisions of the macular region of the contralateral eyes.
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Objective To analyze three-dimensional imaging characteristics and advantages for severe portal vein stenosis after liver transplantation, and to evaluate clinical efficacy of portal vein stent implantation. Methods Clinical data of 10 patients who received portal vein stent implantation for severe portal vein stenosis after liver transplantation were retrospectively analyzed. Imaging characteristics of severe portal vein stenosis, and advantages of three-dimensional reconstruction imaging and interventional treatment efficacy for severe portal vein stenosis were analyzed. Results Among 10 patients, 3 cases were diagnosed with centripetal stenosis, tortuosity angulation-induced stenosis in 2 cases, compression-induced stenosis in 2 cases, long-segment stenosis and/or vascular occlusion in 3 cases. Three-dimensional reconstruction images possessed advantages in accurate identification of stenosis, identification of stenosis types and measurement of stenosis length. All patients were successfully implanted with portal vein stents. After stent implantation, the diameter of the minimum diameter of portal vein was increased [(6.2±0.9) mm vs. (2.6±1.7) mm, P<0.05], the flow velocity at anastomotic site was decreased [(57±19) cm/s vs. (128±27) cm/s, P<0.05], and the flow velocity at the portal vein adjacent to the liver was increased [(41±6) cm/s vs. (18±6) cm/s, P<0.05]. One patient suffered from intrahepatic hematoma caused by interventional puncture, which was mitigated after conservative observation and treatment. The remaining patients did not experience relevant complications. Conclusions Three-dimensional visualization technique may visually display the location, characteristics and severity of stenosis, which is beneficial for clinicians to make treatment decisions and assist interventional procedures. Timely implantation of portal vein stent may effectively reverse pathological process and improve portal vein blood flow.
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AIM:To measure the superficial capillary plexus(SCP)vessel density(VD), deep capillary plexus(DCP)VD, and the area, circumference, and roundness index of the foveal avascular zone(FAZ)in healthy individuals of four ethnic groups, namely, Uyghur, Han, Kazakh, and Hui by optical coherence tomography angiography(OCTA), and to investigate the differences of blood flow parameters in macular area of healthy individuals among different ethnic groups in China.METHODS: A total of 80 cases(80 eyes)of healthy subjects if each of the four ethnic groups who went to the Eye Center of the Friendship Hospital of Ili Kazak autonomous Prefecture from December 2022 to March 2023 and met the criteria were selected for the study, with 320 eyes totally. The patients were grouped and numbered according to their ethnicity, and the spherical equivalent and axial length were obtained by using an autorefractor and IOL Master. The blood flow images of the macular area in the range of 3 mm×3 mm were obtained by using a DRI Triton OCT detector, and the images were analyzed by using the built-in IMAGENET6 software to obtain the blood flow parameters. Furthermore, the differences in the blood flow parameters between different ethnic groups as well as the effects of gender, age, and axial length on macular blood flow parameters of different ethnic groups were compared.RESULTS:There were no statistically significant differences in gender, age, axial length, diopter, and image quality(IQ)among the four groups of subjects(all P>0.05). Ethnic differences: in SCP, Uyghur inferior VD is higher than Kazakh, Hui inferior VD is higher than Han and Kazakh, Han and Hui nasal VD is higher than Uyghur, Kazakh foveal VD is higher than Han and Hui, Kazakh FAZ area is smaller than the other 3 ethnic groups, Han and Hui FAZ perimeter is larger than Kazakh, and Hui FAZ circularity index is lower than the other 3 ethnic groups; in DCP, Uyghur foveal VD is higher than Han and Hui, Kazakh foveal VD is higher than Han and Hui, Kazakh FAZ area and perimeter are smaller than the other 3 ethnic groups and Kazakh FAZ circularity index is higher than the other 3 ethnic groups(all P<0.05). Sex differences: in SCP, FAZ area and perimeter of Han females were larger than those of males, and FAZ circularity index of Hui females was higher than that of males(all P<0.05); in DCP, parafoveal VD and whole VD in females of all four ethnic groups were higher than those of males(all P<0.05). Age correlation: in SCP, age was negatively correlated with the FAZ circularity index of Kazakh; in DCP, age was negatively correlated with the parafoveal and the whole VD of Han, Kazakh, and Hui(all P<0.05). Axial length correlation: in SCP, the axial length was negatively correlated with Kazakh and Hui foveal VD, Hui parafoveal VD, Uyghur, Kazakh and Hui whole VD, and positively correlated with Kazakh FAZ area and perimeter; in DCP, the axial length was negatively correlated with Uyghur, Kazakh, Hui foveal VD, Hui whole VD, and positively correlated with Kazakh and Hui FAZ area and perimeter(all P<0.05).CONCLUSION:There were differences in macular blood flow parameters among the Uyghur, Han, Kazakh, and Hui populations, with the area and perimeter of the FAZ of the Kazakh significantly smaller than those of the other three ethnic groups. Gender, age, and axial length are also related to macular blood flow parameters.
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AIM: To investigate the effects of 0.01% atropine eye drops on macular blood flow density and retinal thickness in children with different degrees of myopia. METHODS: This was a prospective case-control study. Sixty-four patients (112 eyes) diagnosed with myopia for the first time with 0.01% atropine eye drops before and 6 months after medication were investigated with the uncorrected distance visual acuity (UCVA), axial length (AL), spherical equivalent (SE), macular ganglion cell-inner plexiform layer thicknes (mGCIPL) using slit lamp examination and optical coherence tomography (OCT), vascular density in the macular area and the area of the avascular in the fovea using optical coherence tomography angiography (OCTA) . Changes in various indicators before and after medication were compared. RESULTS: Compared with before medication, the AL of the three groups of myopia patients increased significantly (P0.05). The difference was statistically significant between the moderate myopia group and the high myopia group (P0.05). After 6 months of medication, the central circle macular vessel density (cCVD) increased in the low myopia group and moderate myopia group (P0.05). Before and after medication, there was no significant difference in outer circle macular vessel density (oCVD), inner circle macular vessel density (iCVD), and whole circle macular vessel density (wCVD) among the three myopia groups (P>0.05). The increase in mGCIPL was statistically significant in the low myopia group (P0.05). There was no significant difference in foveal avascular zone (FAZ) among the three myopia groups before and after medication (P>0.05). There was no correlation between CVD, AL, and SE in the three myopia groups (P>0.01). There was a low correlation between CVD and mGCIPL in the low myopia group (r=0.442, P0.01). CONCLUSION: 0.01% atropine can significantly reduce the rate of axial and refractive growth in children with low to moderate myopia, increase the density of central macular vessels, and increase the thickness of mGCIPL in children with low to moderate myopia.