Caliper-based precise positioning of the target(CALIPPOT)for transcranial magnetic stimulation without neuronavigation system

To the editor:Transcranial magnetic stimulation(TMS)is a non-invasive brain modulation technique.One important usage of TMS is the transient interruption of cognitive brain function(also named virtual lesion)for investigating precisely where and when a specific cortical region contributes to a specific cognitive function.1 A more important usage of TMS is the treatment of brain disorders by repetitive TMS(rTMS).

Modulating Effects of Chlorogenic Acid on Lipids and Glucose Metabolism and Expression of Hepatic Peroxisome Proliferator-activated Receptor-α in Golden Hamsters Fed on High Fat Diet

Objective To examine the effects of chlorogenic acid （CGA） on lipid and glucose metabolism under a high dietary fat burden and to explore the possible role of peroxisome proliferator-activated receptor-α （PPAR-α） in these effects. Methods Twenty male golden hamsters were randomly divided into CGA treatment group （n=10, given peritoneal injection of CGA solution prepared with PBS, 80 mg CGA/kg body weight daily）, and control group （n=10, given PBS i.p. at the average volume of the treatment group）. Animals in both groups were given 15% high fat diet. Eight weeks after treatment with CGA, the level of biochemical parameters in fasting serum and tissues and the expression of hepatic mRNA and protein PPAR-α were determined. Results Eight weeks after treatment with CGA, the levels of fasting serum triglyceride （TG）, free fatty acid （FFA）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, glucose （FSG）, and insulin （FSI） were significantly lower in the GGA treatment group than in the control group. CGA also led to higher activity of hepatic lipase （HL） lower contents of TG and FFA in liver, and lower activity of lipoprotein lipase （LPL） in skeletal muscle. Furthermore, CGA significantly elevated significantly elevated the expression level of mRNA and protein expression in hepatic PPAR-α. Conclusion CGA can modify lipids and glucose metabolism, which may be attributed to PPAR-α facilitated lipid clearance in liver and improved insulin sensitivity.

Fitness and health benefits of team handball training for young untrained women--A cross-disciplinary RCT on physiological adaptations and motivational aspects

Purpose: The present study evaluated the effects of regular participation in small-sided team handball training on body composition, osteogenic response, physical performance, and cardiovascular risk factors, as well as well-being and motivation, in young untrained women.Methods: Twenty-eight untrained 20- to 30-year-old women were randomized to a handball training group(HG; n = 14, height 170 ± 5 cm, weight 73 ± 11 kg, VO_(2peak) 37.7 ± 4.1 mL/min/kg) that trained 1.7 ± 0.3 times per week over 12 weeks(70 min 4 v 4 handball sessions) or an inactive control group(CG; n = 14, 169 ± 5 cm, 71 ± 12 kg, 38.1 ± 3.7 mL/min/kg). Physiological and psychological and motivational training adaptations were assessed pre-and post-intervention by dual-energy X-ray Absorptiometry(DXA) scans, blood sampling, physical tests, and questionnaires.Results: The average heart rate(HR) over all training sessions was equal to 85% ± 6% HR_(max). Between-group intervention effects were observed in favor of HG for muscle mass(2.1%, p = 0.024), proximal femur bone mineral density(0.8%, p = 0.041), Yo-Yo IE1 intermittent endurance test level 1(IE1) performance(35%, p < 0.001), and incremental treadmill test performance(11.5%, p = 0.003), but not total fat mass(p = 0.176),mean arterial blood pressure(p = 0.328), resting HR(p = 0.219), or blood lipids(p = 0.298—0.854). In CG, no changes were observed in any of the measured physiological variables after the training period. Compared to CG, HG had an increase in intrinsic motivation(p < 0.001) and in the well-being subscale "energy"(p = 0.010).Conclusion: Participation in regular recreational team handball training organized as small-sided games has marked beneficial effects on physical performance, musculoskeletal fitness, well-being, and motivation in untrained young women.

Correlation analysis of national elite Chinese male table tennis players’ shoulder proprioception and muscle strength

BACKGROUND Shoulder is the most injured part in table tennis players,and it takes multiple roles in transmitting power and striking the center of the ball during the stroke.Proprioception is strongly correlated with high level of athletic performance.It is customary to assume that there is a correlation between proprioception and muscle strength and therefore proprioceptive assessment and rehabilitation is often neglected.AIM To investigate the correlation between isokinetic muscle strength and proprioception in the internal and external rotation muscle groups of elite Chinese male table tennis players,to provide reference for physical training and rehabilitation of elite table tennis players.METHODS A total of 19 national elite table tennis players from the Chinese National Table Tennis Team were recruited in this research.All of them had more than 10 years training experience and had participated major competitions such as the National Games and World Youth Championships.IsoMed 2000 was used to test the peak torque of internal and external rotation isokinetic concentric contraction of the athletes'bilateral shoulder joints at low speed(60°/s)and high speed(180°/s)respectively;IsoMed 2000 was used to conduct the Joint Position Reproduction test to evaluate the athletes'proprioceptive ability capacity at low speed(60°/s)and high speed(180°/s)respectively.If the data satisfied the normal distribution,the correlation between the differences in peak torque s and angles in different directions was analyzed using a Pearson simple linear model;otherwise,Spearman correlation analysis was used.The comparison of proprioceptive ability between the table tennis racket-holding hand and non-racket-holding hands was performed using independent samples t-test if the data satisfied a normal distribution;otherwise,the Mann-Whitney U test was used.RESULTS There was no direct linear correlation between the strength and proprioceptive correlation analysis at slow speed(60°/s)and fast speed(180°/s)in the racket-holding hand;At the slow speed(60°/s)and fast speed(180°/s),there was no correlation between muscle strength and proprioception in the non-racket-holding hand except for the internal rotation variable error(VE)and external rotation relative peak torque,which showed a moderate positive correlation(r=0.477,P<0.05),(r=0.554,P<0.05).The internal rotation’s constant error(CE)and VE were 1.06±3.99 and 2.94±2.16,respectively,for the racket-holding hand,and-3.36±2.39 and 1.22±0.93,respectively,for the non-racket-holding hand;the internal rotation’s CE,VE of the racket-holding hand was lower than that of the non-racket-holding hand,and there was a highly significant difference(P<0.01).CONCLUSION There was no correlation between muscle strength and proprioceptive function in the internal and external rotation of the racket-holding hand’s shoulder in elite Chinese male table tennis players.These results may be useful for interventions for shoulder injuries and for the inclusion of proprioceptive training in rehabilitation programs.

Effects of cardiac rehabilitation qigong exercise in patients with stable coronary artery disease undergoing phase Ⅲ rehabilitation: A randomized controlled trial (with video)

Objective:To explore the effectiveness and safety of cardiac rehabilitation qigong exercise in stable coronary artery disease(CAD)patients undergoing phaseⅢrehabilitation.Methods:This was a randomized controlled trial.A total of 59 stable CAD patients undergoing phaseⅢrehabilitation treated in Sports Medicine Hospital from March 2017 to September 2017 were enrolled after meeting the inclusion criteria and then divided into cardiac rehabilitation qigong exercise group(n=30)receiving a 12-week intervention and control group(n=29).All participants were assessed at baseline and at 12-week intervention for the primary outcome,that was treadmill test parameter and the secondary outcomes including physical fitness,body composition,bone mineral density,and cardiac ultrasound B-mode imaging.Results:There were no significant differences in baseline demographics between the two groups.After a 12-week cardiac rehabilitation qigong exercise intervention,compared with the control group,ΔV02(initial 1352.63±340.95 vs 12 weeks 1594.57±467.14)vs(initial 1363.83±322.90 vs 12 weeks 1323.76±318.92)(P=.003),ΔVO2/kg(initial 21.23±3.56 vs 12 weeks 24.75±5.11)vs(initial 21.01±3.71 vs 12 weeks 20.35±3.66)(P=.002),ΔMETS(initial 6.19±1.12 vs 12 weeks 7.16±1.60)vs(initial 6.00±1.19 vs 12 weeks 5.86±1.23)(P=.001),ΔVO2/HR(P=.027),ΔSV(P=.014),ΔOUES(P=.012),Δhand-grip strength(P=.002),Δflexibility(P=.001),Δbalance(P=.002),ΔT-score(P=.042),ΔBQI(P=.018).However,Δresting systolic blood pressure(P=.004)andΔresting diastolic pressure(P=.012)decreased in the cardiac rehabilitation qigong exercise group.Conclusion:Cardiac rehabilitation qigong exercise can improve cardiopulmonary aerobic capacity,physical fitness,bone mineral density in patients with stable CAD,suggesting that certain effect and safety for stable CAD patients undergoing phaseⅢrehabilitation can be obtained.

A Survey of Medication Taken by Chinese Athletes

Objective To make a survey of medication taken by Chinese athletes and a comparison between Chinese athletes and athletes from other countries in order to get information about how to improve Chinese athletes’ performance. Method The information came from the forms"Doping Control Sample Collection" in which athletes answered the question: "What medications have you taken in the past 3 days?" The medicines taken by athletes were classified and statistically analyzed.Results 2,330 athletes and 25 kinds of sports were involved in. Medicines were statistically analyzed with 4 classes: profiling of declaration, vitamins and minerals, medicines for treatments, alternative medicine. Conclusion The survey recorded the types of supplements and medications taken by athletes in China in 1999. Chinese athletes took less vitamins and more alternative medicines than athletes from other countries.

Advances in the Application of Three-dimensional Printing for the Clinical Treatment of Osteoarticular Defects

As a promising manufacturing technology,three-dimensional(3D)printing technology is widely used in the medical field.In the treatment of osteoarticular defects,the emergence of 3D printing technology provides a new option for the reconstruction of functional articular surfaces.At present,3D printing technology has been used in clinical applications such as models,patient-specific instruments(PSIs),and customized implants to treat joint defects caused by trauma,sports injury,and tumors.This review summarizes the application status of 3D printing technology in the treatment of osteoarticular defects and discusses its advantages,disadvantages,and possible future research strategies.

An evaluation of prevention initiatives by 53 national anti-doping organizations: Achievements and limitations

Background: One main purpose of the World Anti-Doping Agency was to harmonize anti-doping efforts, including the provision of anti-doping education. A multifaceted approach to doping prevention can play a key role in preventing intentional and unintentional doping. This article aimed to systematically record and evaluate doping prevention approaches in the form of information and education activities of national antidoping organizations(NADOs) and assess the extent to which a multifaceted doping prevention approach has been realized.Methods: Data on anti-doping information and education activities of 53 NADOs were collected via a survey and an online search of the NADOs' websites. Prevention activities were classified into knowledge focused, affective focused, social skills, life skills, and ethic-and valuebased.The implementation of the prevention activities was assessed by 4 independent raters using a modified visual analogue scale.Results: In total, 59% of the NADOs(n = 38) returned the survey and 70%(n = 45) had information available online. The data were combined for the visual analogue scale assessment. Overall, 58% of the NADOs(n = 37) reported offering activities including elements of all 5 approaches.Results of the raters' assessments indicated that the knowledge-focused approach was best implemented;the implementation of the other 4 approaches was largely unsatisfactory. The most common barriers to implementing doping prevention programs reported by the NADOs were lack of resources(n = 26) and difficulties in collaborating with sports organizations(n = 8).Conclusion: Results show a discrepancy between NADOs' self-report data and the implementation assessment. Even though the NADOs indicated otherwise, most of their education-based approaches did not address aspects of the visual analogue scale(e.g., resisting peer pressure) and only a few programs were ongoing. Possible explanations might be found in the reported barriers(e.g., financial). Concrete guidelines defining multifaceted, values-based education, and best practice examples should be developed to indicate how to include all 5 approaches in prevention.

Evolution of Mobility Function in Chinese Elders during the 6 Months of Nutritional Supplementation and Age-adapted Physical Activities: A Feasibility Study

Knee pain and discomfort appear at the early stages of normal aging,which lead to impaired mobility and reduced quality of life(QOL).Among age-related conditions,osteoarthritis(OA)is considered the most significant cause of disability The acceleration of the aging process in China has troubled the middle-aged and elderly with a relatively high prevalence of OA,as recently reported in a meta-analysis pooling and analyzing epidemiological publications on OA in the middleaged and elderly Chinese published from 2000 to2018[1].

Scapular bone grafting with allograft pin fixation for repair of bony Bankart lesions: A biomechanical study

BACKGROUND Severe bony Bankart lesions are a difficult challenge in clinical treatment and research.The current treatment methods consist mostly of Latarjet-Bristow surgery and its modified procedures.While good results have been achieved,there are also complications such as coracoid fracture,bone graft displacement,and vascular and nerve injury.AIM To analyze the techniques and biomechanical properties of transversely fixing a bone block from the scapular spine using bone allograft pins with suture threads to repair bony Bankart lesions.METHODS Fresh human shoulder joint specimens and a cadaver specimen model for scapular bone grafting with allograft pin fixation for repair of bony Bankart lesions were used.When the humeral rotation angles were 0°,30°,60°and 90°,and the axial loads were 30 N,40 N,and 50 N,the humerus displacement was studied by biomechanical experiments.RESULTS When the angle of external rotation of the humerus was 0°,30°,60°,and 90°,with axial loads of 30 N,40 N,and 50 N,the data of the normal control group,allograft pin repair group,and titanium alloy hollow screw repair group were compared with each other by the q-test,which showed that there were no statistically differences among the three groups(P>0.05).CONCLUSION The joints repaired with bone block from the scapular spine transversely fixed with allograft bony pins to repair bony Bankart lesions show good mechanical stability.The bone block has similar properties to normal glenohumeral joints in terms of biomechanical stability.

Reproducibility and Variability of the Conconi Test Analysis

The Conconi test is an incremental exercise test characterised by stages of equal work.For analysis PO(power output)and HR(heart rate)are used.The deflection point of the HR/PO graph marks the point where the linear relation between PO and HR changes to a curvilinear one.HR at deflection point correlates with the anaerobic threshold.The objective of this study was to evaluate the reproducibility of HR at deflection point of tests in cycling.In literature,only one study with tests in running examined the reproducibility of the Conconi test.Nineteen trained subjects performed 4 Conconi tests on an electronically breaked cycle ergometer on different days.Finally,68 graphs of the PO/HR relationship were analysed by computer software as well as by three different observers.HRs at deflection point of the 4 Conconi tests of every subject were compared and coefficients of variation(CVs)were calculated.Mean CVs of HR at deflection point per subject were 3.36%for the computer program and for the three observers 2.99%,2.51%and 2.53%,respectively.CVs below 3.5%represent a good reproducibility.The agreement between the three observers was statistically good with an ICC(intraclass correlation coefficients)of 0.828.The mean range of HR at deflection point per Conconi test comparing the three observers was 4.5 bpm corresponding 2.7%of HR at deflection point.

Medical Additive Manufacturing: From a Frontier Technology to the Research and Development of Products

1.Research and development(R&D)and the challenges of raw materials for medical additive manufacturing Raw materials for medical additive manufacturing have a wide range of commonalities that are also seen in many other fields,making them an important basis in the field of three-dimensional(3D)printing.Problems and challenges related to material types,powder properties,formability,viscoelasticity,and so forth also share common features.For example,many metal materials are used in the field of aviation,while metals,polymers,and inorganic materials are used in the field of biomedicine.The most widely used materials in biomedicine are biocompatible.Various homogeneous and non-homogeneous composites are also available for 3D printing,and impose an additional challenge in additive manufacturing;the use of heterogeneous composites in 3D printing is particularly challenging.

Effects of higher femoral tunnels on clinical outcomes,MRI,and second-look findings in double-bundle anterior cruciate ligament reconstruction with a minimal 5-year follow-up

Background:To perform anatomical anterior cruciate ligament reconstruction(ACLR),tunnels should be placed relatively higher in the femoral anterior cruciate ligament(ACL)footprint based on the findings of direct and indirect femoral insertion.But the clinical results of higher femoral tunnels(HFT)in double-bundle ACLR(DB-ACLR)remain unclear.The purpose was to investigate the clinical results of HFT and lower femoral tunnels(LFT)in DB-ACLR.Methods:From September 2014 to February 2016,83 patients who underwent DB-ACLR and met the inclusion and exclusion criteria were divided into HFT-ACLR(group 1,n=37)and LFT-ACLR(group 2,n=46)according to the position of femoral tunnels.Preoperatively and at the final follow-up,clinical scores were evaluated with International Knee Documentation Committee(IKDC),Tegner activity,and Lysholm score.The stability of the knee was evaluated with KT-2000,Lachman test,and pivot-shift test.Cartilage degeneration grades of the International Cartilage Repair Society(ICRS)were evaluated on magnetic resonance imaging(MRI).Graft tension,continuity,and synovialization were evaluated by second-look arthroscopy.Return-to-sports was assessed at the final follow-up.Results:Significantly better improvement were found for KT-2000,Lachman test,and pivot-shift test postoperatively in group 1(P>0.05).Posterolateral bundles(PL)showed significantly better results in second-look arthroscopy regarding graft tension,continuity,and synovialization(P<0.05),but not in anteromedial bundles in group 1.At the final follow-up,cartilage worsening was observed in groups 1 and 2,but it did not reach a stastistically significant difference(P>0.05).No statistically significant differences were found in IKDC subjective score,Tegner activity,and Lysholm score between the two groups.Higher return-to-sports rate was found in group 1 with 86.8%(32/37)vs.65.2%(30/46)in group 2(P=0.027).Conclusion:The HFT-ACLR group showed better stability results,better PL,and higher return-to-sports rate compared to the LFT-ACLR group.

A simplified noncryogenic strategy to transport mesenchymal stem cells: Potential applications in cell therapy and regenerative medicine

With the rapid advances in stem cell research and po-tential cell-based therapies,there is an urgent need to develop safe and reliable cell transport strategies.Except for autologous stem cell-based therapies,allogeneic stem cell therapies and ex vivo genetically engineered cell therapies would require safe,efficient,and reliable cell preservation and transport methods.

Application of traditional Chinese therapy in sports medicine

Chinese herbs have been used as dietary supplements to improve exercise performance.However,evidence-based studies for the use of Chinese herbs in sports remain scarce.Traditional Chinese therapy(TCT),a form of traditional Chinese non-pharmacological intervention,has remained in use for thousands of years in sports medicine.TCT is beneficial for sports injuries and in enhancing skill development,and is becoming increasingly popular among athletes,fitness enthusiasts,and individuals who regularly exercise.The therapeutic effects of TCT have been demonstrated by clinical and experimental studies,but using these modalities still is associate with potentially adverse effects.Further well-designed studies are necessary to confirm the efficacy of TCT in sports medicine.This review aims to summarize the application of TCT,discuss the issues surrounding TCT clinical research,and provide suggestions for applying traditional Chinese methods in the field of sports medicine.

Physical activity guidelines for Chinese children and adolescents:The next essential step

1.Introduction Because of the joint efforts of Active Healthy Kids Global Alliance,the results from the Global Matrix 2.0,involving 38countries,provide a timely insight into physical activity(PA)in children and adolescents worldwide.1All the 38 countries,including China,published a report card on 9 PA indicators.1,2Surprisingly,92%of the countries had average grades of C or

Bone mineral density in lifelong trained male football players compared with young and elderly untrained men

Purpose: The purpose of the present controlled cross-sectional study was to investigate proximal femur and whole-body bone mineral density(BMD), as well as bone turnover profile, in lifelong trained elderly male football players and young elite football players compared with untrained age-matched men.Methods: One hundred and forty healthy, non-smoking men participated in the study, including lifelong trained football players(FTE, n = 35)aged 65—80 years, elite football players(FTY, n = 35) aged 18—30 years, as well as untrained age-matched elderly(UE, n = 35) and young(UY,n = 35) men. All participants underwent a regional dual-energy X-ray Absorptiometry(DXA) scan of the proximal femur and a whole-body DXA scan to determine BMD. From a resting blood sample, the bone turnover markers(BTMs) osteocalcin, carboxy-terminal type-1 collagen crosslinks(CTX-1), procollagen type-1 amino-terminal propeptide(P1NP), and sclerostin were measured.Results: FTE had 7.3%—12.9% higher(p < 0.05) BMD of the femoral neck, wards, shaft, and total proximal femur in both legs compared to UE,and 9.3%—9.7% higher(p < 0.05) BMD in femoral trochanter in both legs compared to UY. FTY had 24.3%—37.4% higher(p < 0.001) BMD in all femoral regions and total proximal femur in both legs compared to UY. The whole-body DXA scan confirmed these results, with FTE showing similar whole-body BMD and 7.9% higher(p < 0.05) leg BMD compared to UY, and with FTY having 9.6% higher(p < 0.001) wholebody BMD and 18.2% higher(p < 0.001) leg BMD compared to UY. The plasma concentration of osteocalcin, CTX-1, and P1NP were 29%,53%, and 52% higher(p < 0.01), respectively, in FTY compared to UY.Conclusion: BMD of the proximal femur and whole-body BMD are markedly higher in lifelong trained male football players aged 65—80 years and young elite football players aged 18—30 years compared to age-matched untrained men. Elderly football players even show higher BMD in femoral trochanter and leg BMD than untrained young despite an age difference of 47 years.

振兴中国足球:公共健康的机遇与挑战(英文)

Dear editor,In 2015,a national reform plan was implemented by the central government that covers not only professional clubs and leagues but also campus and grassroots football,to develop football(soccer)in China.1According to the plan of

“中国心血管病人生活质量评定问卷”常模的测定(英文)

目的：就高血压、冠心病、充血性心力衰竭（CHF）患者测定＂中国心血管病人生活质量评定问卷＂（CQQC）的常模,并分析其影响因素。方法：采用整群随机抽样的方法,对地跨中国各大区的19个城市28所医院的7937名对象的生活质量进行调查,建立全国常模,并比较性别、年龄、运动、心理状态、教育、家庭以及医疗条件所致的差异。结果：1、正常人平均得分（国家常模）为（95.74±23.21）分;2、高血压患者平均得分为（73.75±23.62）,高血压3级患者生活质量（69.06±21.78）明显低于其他患者（P〈0.01）;3、冠心病患者的平均得分为（64.67±20.59）,其中不稳定型心绞痛患者的生活质量（55.37±18.62）最差（P〈0.01）;4、CHF患者的平均得分为（40.36±17.24）,显著低于高血压和冠心病患者（P〈0.01）;5、影响因素：（1）性别、年龄：所有人的总体得分为（71.41±27.8）分,男性得分非常显著高于女性（P=0.000）;正常人随着年龄增加,得分逐渐减少（P〈0.05）,除≥70岁组,其他各年龄组男性得分显著高于女性得分（P〈0.05）;（2）运动：参加运动者的得分（72.64±21.87）非常显著高于未参加运动者（66.91±23.13）,P=0.000;（3）心理：心理健康者的得分（70.13±25.66）非常显著高于心理有障碍者（68.91±20.44）,P=0.001;（4）其他：受教育程度越高,得分越高;家庭成员为1个人的得分明显低于2人组和3人及以上组的得分;自费患者的得分低于医保或公费患者的得分（P〈0.05~〈0.001）。结论：本研究样本量大,数据可靠;中国心血管病人生活质量评定问卷能反映年龄、性别、运动、心理、家庭、受教育程度、医疗条件和疾病对生活质量的影响,条目简短明了,可操作性好,值得推广。