Objective： To investigate the risk factors related to the development of pressure sores in critically ill surgical patients and to establish a basis for the formulation of effective precautions. Methods： A questionn...Objective： To investigate the risk factors related to the development of pressure sores in critically ill surgical patients and to establish a basis for the formulation of effective precautions. Methods： A questionnaire regarding the factors for pressure sores in critically ill surgical patients was created using a case control study with reference to the pertinent literature. After being exam- ined and validated by experts, the questionnaire was used to collect data about critically ill surgical patients in a grade A tertiary hospital. Among the 47 patients enrolled into the study, the 14 who developed nosocomial pressure sores were allocated to the pressure sore group, and the remaining 33 patients who met the inclusion criteria and did not exhibit pressure sores were allocated to the control group. Univariate and multivariate logistic regression analyses were employed to examine the differences in 22 indicators between the two groups in an attempt to identify the risk factors for pressure sores. Results： According to the univariate analyses, the maximum value of lactic acid in the arterial blood, the number of days of norepinephrine use, the number of days of mechanical ventilation, the number of days of blood purification, and the number of days of bowel incontinence were statistically greater in the pressure sore group than in the control group （P〈0.05）. The multivariate logistic regression analysis revealed that the number of days of norepinephrine use and the level of lactic acid in the arterial blood were high risk-factors for pressure sores （P〈0.05）. Conclusions： The best method for preventing and control pressure sores in surgical critically ill patients is to strongly emphasize the duration of the critical status and to give special attention to patients in a continuous state of shock. The adoption of measures specific to high-risk patient groups and risk factors, including the active control of primary diseases and the application of decompression measures during the treatment of the patients, are helpful for improving the quality of care in the prevention and control of pressure sores in critically ill patients.展开更多
BACKGROUND: Post operative sore throat (PST) is one of the most common complaints after tracheal intubation. In this study we compared the effects of curved and straight laryngoscope blades on severity and incidence o...BACKGROUND: Post operative sore throat (PST) is one of the most common complaints after tracheal intubation. In this study we compared the effects of curved and straight laryngoscope blades on severity and incidence of PST. METHOD: In this prospective randomized clinical trial we evaluated incidence and severity of PST in 147 ASA physical status I–II, aged 18 – 62 y (group Miller, n = 71), (group Macintosh, n = 76) following intubation with Miller and Macintosh laryngoscope blades by using Visual Analog Scale (VAS). RESULTS: The overall incidence of PST in our study was 35.4% (Macintosh group = 39.5% and in Miller group = 31% and P = 0.829). The incidence of PST was not statistically different between two kinds of laryngoscope blades and the mean rank of pain score was not statistically different in recovery room and up to 48 hours after surgery. CONCLUSIONS: Our study showed these types of laryngoscope blade had not association with incidence and severity of PST. .展开更多
Background Specific nutrients combined with exercise may prevent a loss of lean body mass and consequently prevent sarcopenia.We examined the effects of 2 weeks of supplementation with L-carnitine and a single dose of...Background Specific nutrients combined with exercise may prevent a loss of lean body mass and consequently prevent sarcopenia.We examined the effects of 2 weeks of supplementation with L-carnitine and a single dose of branched-chain amino acids(BCAAs)on energy metabolism and body composition before and after exercise and on post-exercise muscle soreness in healthy subjects.Methods A total of 12 young,untrained,healthy women were randomly assigned to two groups who received either 2 weeks of supplementation with L-carnitine(1000 mg/day)and a single dose of BCAAs plus 200 kcal energy(LCAR+BCAA group,n=6)or 200 kcal energy alone(control group,n=6)before 60 min of exercise.Energy substrate metabolism and body composition by bio-impedance were examined before and after exercise.Delayed-onset muscle soreness(DOMS)was evaluated by using a visual analogue scale for 3 days after exercise.Results Serum concentrations of free and acyl-L-carnitine in the LCAR+BCAA group were not significantly different from those in the control group.There were no significant differences in body composition before or after exercise between the two groups.Although serum free fatty acid levels 120 min after the oral ingestion of BCAAs were significantly lower in the LCAR+BCAA group than in the control group,there were no significant differences in serum free fatty acid levels immediately after and 60 min after exercise.DOMS for 3 days after exercise was lower in the LCAR+BCAA group than in the control group,but this difference was not significant.Conclusion Continuous supplementation with L-carnitine combined with a dose of BCAAs in young,untrained,healthy subjects caused a blunted response of stimulated lipolysis after exercise.展开更多
背景:不习惯的运动使骨骼肌损伤,但可以产生一种减轻肌肉再损伤减轻疼痛的特定训练效果-肌肉记忆。目的:基于延迟性肌肉酸痛的病因,综述延迟性肌肉酸痛中骨骼肌记忆的存在及其可能机制,提出防治延迟性肌肉酸痛的新见解。方法:第一作者以...背景:不习惯的运动使骨骼肌损伤,但可以产生一种减轻肌肉再损伤减轻疼痛的特定训练效果-肌肉记忆。目的:基于延迟性肌肉酸痛的病因,综述延迟性肌肉酸痛中骨骼肌记忆的存在及其可能机制,提出防治延迟性肌肉酸痛的新见解。方法:第一作者以“DOMS,Skeletal muscle memory,Exercise Skeletal muscle adaptation,Repeat turn effect,exercise and autophagy,Autophagy and inflammation”为英文检索词,“延迟性肌肉酸痛,骨骼肌记忆,运动性骨骼肌适应,重复回合效应,运动与自噬,自噬与炎症”为中文检索词,检索PubMed、Embase、Web of Science、中国知网及万方数据库1990年1月至2022年12月发表的相关文献,最终纳入102篇文献进行综述。结果与结论:目前认为延迟性肌肉酸痛是由于代谢紊乱、机械损伤和氧化应激所致的急性期炎症反应,而运动性骨骼肌记忆具有减轻延迟性肌肉酸痛、减轻运动再损伤的作用,当离心训练的持续时间、频率和强度逐渐增加时,损伤症状可以被最小化,甚至可以避免。因此基于运动性骨骼肌记忆机制,寻找防治或减轻延迟性肌肉酸痛及运动性肌肉损伤的方法是未来的研究方向。综述的主要目的:①明确运动性骨骼肌记忆的存在;②探讨运动性骨骼肌记忆的可能机制,并提出该记忆与骨骼肌自噬的关系;③通过改善骨骼肌自噬水平为延迟性肌肉酸痛的防治提供新策略。展开更多
The preference for a specific head shape can be influenced by people's culture,religious beliefs and race.Modern Chinese people prefer a"talented"head shape,which is rounded and has a long profile.To obt...The preference for a specific head shape can be influenced by people's culture,religious beliefs and race.Modern Chinese people prefer a"talented"head shape,which is rounded and has a long profile.To obtain their preferred head shape,some parents try to change their neonates'sleeping position.Due to these forced sleeping positions,positional skull deformities,such as plagiocephaly,may be present during the first few months of life.In this article,we report two neonatal cases,of Hui nationality and Dongxiang nationality,with occipital pressure sores that were caused by using hard objects as pillows with the intention of obtaining a flattened occiput.The pressure sores were deep to the occipital bone and needed surgical management.These pressure sores caused wounds that were repaired by local skin flaps,after debridement,and the use of external constraints from a dense sponge-made head frame for approximately two weeks.One case recovered with primary healing after surgical operation.The other case suffered from a disruption of the sutured wound,and a secondary operation was performed to cover the wound.These occipital pressure sores are avoidable by providing guidance to the parents in ethnic minorities'area regarding the prevention,diagnosis and management of positional skull deformity.展开更多
Methods for pressure sore monitoring remain both a clinical and research challenge.Improved methodologies could assist physicians in developing prompt and effective pressure sore interventions.In this paper a techniqu...Methods for pressure sore monitoring remain both a clinical and research challenge.Improved methodologies could assist physicians in developing prompt and effective pressure sore interventions.In this paper a technique is introduced for the assessment of pressure sores in guinea pigs,using captured color images.Sores were artificially induced,utilizing a system particularly developed for this purpose.Digital images were obtained from the suspicious region in days 3 and 7 post-pressure sore generation.Different segments of the color images were divided and labeled into three classes,based on their severity status.For quantitative analysis,a color based texture model,which is invariant against monotonic changes in illumination,is proposed.The texture model has been developed based on the local binary pattern operator.Tissue segments were classified,using the texture model and its features as inputs to a combination of neural networks.Our method is capable of discriminating tissue segments in different stages of pressure sore generation,and therefore can be a feasible tool for the early assessment of pressure sores.展开更多
OBJECTIVE： To evaluate the effects of Zingiber cassumunar（Plai cream） in either 7% or 14% concentration on delayed onset muscle soreness（DOMS）.METHODS： Seventy-five untrained healthy volunteers（28 males and 47 ...OBJECTIVE： To evaluate the effects of Zingiber cassumunar（Plai cream） in either 7% or 14% concentration on delayed onset muscle soreness（DOMS）.METHODS： Seventy-five untrained healthy volunteers（28 males and 47 females）, performed 4 sets of 25 eccentric repetitions of the dominant quadriceps muscle on an isokinetic dynamometry machine. Participants were then randomized into 3 groups： 14% Plai cream, 7% Plai cream and placebo cream. Two grams of the cream（strips of 5-cm long） were gently rubbed into the quadriceps muscles for 5 min immediately following the exercise and every 8 h thereafter for 7 d in all groups. Muscle soreness, muscle strength, jump height, thigh circumference and creatine kinase were measured before and after eccentric exercise.RESULTS： Compared to the placebo cream the 14% Plai cream substantially reduced muscle soreness over the 7 d by –82%（95% CI = –155% to –6%, P = 0.03）, but had similar muscle soreness effects to 7% Plai cream（–34%, –96% to 27%, P = 0.2）. Compared to the placebo cream the 7% Plai cream resulted in a small non-significant reduction in muscle soreness levels over the following 7 d（–40%, –116% to 36%, P = 0.3）. Compared to placebo cream there was little effect of Plai cream（7% or 14%） on muscle strength, jump height, thigh circumference or creatine kinase concentration. CONCLUSION： Using 14% Plai cream over a 7-day period substantially reduced muscle soreness symptoms compared to 7% Plai cream or a placebo cream. The authors suggest that the administration of 14% Plai cream is a useful alternative in the management of DOMS.TRIAL REGISTRATION： Thai Clinical Trial Registry TCTR20140215001.展开更多
文摘Objective： To investigate the risk factors related to the development of pressure sores in critically ill surgical patients and to establish a basis for the formulation of effective precautions. Methods： A questionnaire regarding the factors for pressure sores in critically ill surgical patients was created using a case control study with reference to the pertinent literature. After being exam- ined and validated by experts, the questionnaire was used to collect data about critically ill surgical patients in a grade A tertiary hospital. Among the 47 patients enrolled into the study, the 14 who developed nosocomial pressure sores were allocated to the pressure sore group, and the remaining 33 patients who met the inclusion criteria and did not exhibit pressure sores were allocated to the control group. Univariate and multivariate logistic regression analyses were employed to examine the differences in 22 indicators between the two groups in an attempt to identify the risk factors for pressure sores. Results： According to the univariate analyses, the maximum value of lactic acid in the arterial blood, the number of days of norepinephrine use, the number of days of mechanical ventilation, the number of days of blood purification, and the number of days of bowel incontinence were statistically greater in the pressure sore group than in the control group （P〈0.05）. The multivariate logistic regression analysis revealed that the number of days of norepinephrine use and the level of lactic acid in the arterial blood were high risk-factors for pressure sores （P〈0.05）. Conclusions： The best method for preventing and control pressure sores in surgical critically ill patients is to strongly emphasize the duration of the critical status and to give special attention to patients in a continuous state of shock. The adoption of measures specific to high-risk patient groups and risk factors, including the active control of primary diseases and the application of decompression measures during the treatment of the patients, are helpful for improving the quality of care in the prevention and control of pressure sores in critically ill patients.
文摘BACKGROUND: Post operative sore throat (PST) is one of the most common complaints after tracheal intubation. In this study we compared the effects of curved and straight laryngoscope blades on severity and incidence of PST. METHOD: In this prospective randomized clinical trial we evaluated incidence and severity of PST in 147 ASA physical status I–II, aged 18 – 62 y (group Miller, n = 71), (group Macintosh, n = 76) following intubation with Miller and Macintosh laryngoscope blades by using Visual Analog Scale (VAS). RESULTS: The overall incidence of PST in our study was 35.4% (Macintosh group = 39.5% and in Miller group = 31% and P = 0.829). The incidence of PST was not statistically different between two kinds of laryngoscope blades and the mean rank of pain score was not statistically different in recovery room and up to 48 hours after surgery. CONCLUSIONS: Our study showed these types of laryngoscope blade had not association with incidence and severity of PST. .
文摘Background Specific nutrients combined with exercise may prevent a loss of lean body mass and consequently prevent sarcopenia.We examined the effects of 2 weeks of supplementation with L-carnitine and a single dose of branched-chain amino acids(BCAAs)on energy metabolism and body composition before and after exercise and on post-exercise muscle soreness in healthy subjects.Methods A total of 12 young,untrained,healthy women were randomly assigned to two groups who received either 2 weeks of supplementation with L-carnitine(1000 mg/day)and a single dose of BCAAs plus 200 kcal energy(LCAR+BCAA group,n=6)or 200 kcal energy alone(control group,n=6)before 60 min of exercise.Energy substrate metabolism and body composition by bio-impedance were examined before and after exercise.Delayed-onset muscle soreness(DOMS)was evaluated by using a visual analogue scale for 3 days after exercise.Results Serum concentrations of free and acyl-L-carnitine in the LCAR+BCAA group were not significantly different from those in the control group.There were no significant differences in body composition before or after exercise between the two groups.Although serum free fatty acid levels 120 min after the oral ingestion of BCAAs were significantly lower in the LCAR+BCAA group than in the control group,there were no significant differences in serum free fatty acid levels immediately after and 60 min after exercise.DOMS for 3 days after exercise was lower in the LCAR+BCAA group than in the control group,but this difference was not significant.Conclusion Continuous supplementation with L-carnitine combined with a dose of BCAAs in young,untrained,healthy subjects caused a blunted response of stimulated lipolysis after exercise.
文摘背景:不习惯的运动使骨骼肌损伤,但可以产生一种减轻肌肉再损伤减轻疼痛的特定训练效果-肌肉记忆。目的:基于延迟性肌肉酸痛的病因,综述延迟性肌肉酸痛中骨骼肌记忆的存在及其可能机制,提出防治延迟性肌肉酸痛的新见解。方法:第一作者以“DOMS,Skeletal muscle memory,Exercise Skeletal muscle adaptation,Repeat turn effect,exercise and autophagy,Autophagy and inflammation”为英文检索词,“延迟性肌肉酸痛,骨骼肌记忆,运动性骨骼肌适应,重复回合效应,运动与自噬,自噬与炎症”为中文检索词,检索PubMed、Embase、Web of Science、中国知网及万方数据库1990年1月至2022年12月发表的相关文献,最终纳入102篇文献进行综述。结果与结论:目前认为延迟性肌肉酸痛是由于代谢紊乱、机械损伤和氧化应激所致的急性期炎症反应,而运动性骨骼肌记忆具有减轻延迟性肌肉酸痛、减轻运动再损伤的作用,当离心训练的持续时间、频率和强度逐渐增加时,损伤症状可以被最小化,甚至可以避免。因此基于运动性骨骼肌记忆机制,寻找防治或减轻延迟性肌肉酸痛及运动性肌肉损伤的方法是未来的研究方向。综述的主要目的:①明确运动性骨骼肌记忆的存在;②探讨运动性骨骼肌记忆的可能机制,并提出该记忆与骨骼肌自噬的关系;③通过改善骨骼肌自噬水平为延迟性肌肉酸痛的防治提供新策略。
文摘The preference for a specific head shape can be influenced by people's culture,religious beliefs and race.Modern Chinese people prefer a"talented"head shape,which is rounded and has a long profile.To obtain their preferred head shape,some parents try to change their neonates'sleeping position.Due to these forced sleeping positions,positional skull deformities,such as plagiocephaly,may be present during the first few months of life.In this article,we report two neonatal cases,of Hui nationality and Dongxiang nationality,with occipital pressure sores that were caused by using hard objects as pillows with the intention of obtaining a flattened occiput.The pressure sores were deep to the occipital bone and needed surgical management.These pressure sores caused wounds that were repaired by local skin flaps,after debridement,and the use of external constraints from a dense sponge-made head frame for approximately two weeks.One case recovered with primary healing after surgical operation.The other case suffered from a disruption of the sutured wound,and a secondary operation was performed to cover the wound.These occipital pressure sores are avoidable by providing guidance to the parents in ethnic minorities'area regarding the prevention,diagnosis and management of positional skull deformity.
文摘Methods for pressure sore monitoring remain both a clinical and research challenge.Improved methodologies could assist physicians in developing prompt and effective pressure sore interventions.In this paper a technique is introduced for the assessment of pressure sores in guinea pigs,using captured color images.Sores were artificially induced,utilizing a system particularly developed for this purpose.Digital images were obtained from the suspicious region in days 3 and 7 post-pressure sore generation.Different segments of the color images were divided and labeled into three classes,based on their severity status.For quantitative analysis,a color based texture model,which is invariant against monotonic changes in illumination,is proposed.The texture model has been developed based on the local binary pattern operator.Tissue segments were classified,using the texture model and its features as inputs to a combination of neural networks.Our method is capable of discriminating tissue segments in different stages of pressure sore generation,and therefore can be a feasible tool for the early assessment of pressure sores.
文摘OBJECTIVE： To evaluate the effects of Zingiber cassumunar（Plai cream） in either 7% or 14% concentration on delayed onset muscle soreness（DOMS）.METHODS： Seventy-five untrained healthy volunteers（28 males and 47 females）, performed 4 sets of 25 eccentric repetitions of the dominant quadriceps muscle on an isokinetic dynamometry machine. Participants were then randomized into 3 groups： 14% Plai cream, 7% Plai cream and placebo cream. Two grams of the cream（strips of 5-cm long） were gently rubbed into the quadriceps muscles for 5 min immediately following the exercise and every 8 h thereafter for 7 d in all groups. Muscle soreness, muscle strength, jump height, thigh circumference and creatine kinase were measured before and after eccentric exercise.RESULTS： Compared to the placebo cream the 14% Plai cream substantially reduced muscle soreness over the 7 d by –82%（95% CI = –155% to –6%, P = 0.03）, but had similar muscle soreness effects to 7% Plai cream（–34%, –96% to 27%, P = 0.2）. Compared to the placebo cream the 7% Plai cream resulted in a small non-significant reduction in muscle soreness levels over the following 7 d（–40%, –116% to 36%, P = 0.3）. Compared to placebo cream there was little effect of Plai cream（7% or 14%） on muscle strength, jump height, thigh circumference or creatine kinase concentration. CONCLUSION： Using 14% Plai cream over a 7-day period substantially reduced muscle soreness symptoms compared to 7% Plai cream or a placebo cream. The authors suggest that the administration of 14% Plai cream is a useful alternative in the management of DOMS.TRIAL REGISTRATION： Thai Clinical Trial Registry TCTR20140215001.
