Objective To explore the effect of low-load resistance training on physical fitness in aged adults. Methods Select the aged adults who will go to the outpatient Department of Rehabilitation Medicine of Peking Union Medical College Hospital between June 1, 2020 and May 31, 2021. The aged adults were randomly divided into three groups by using the method of random number table: medium intensity aerobic training group (aerobic training group), standard-load resistance training group (standard-load group) and low-load resistance training group (low-load group). The basic information, exercise endurance (peak power, peak oxygen uptake), exercise cardiopulmonary function [peak heart rate, predicted peak heart rate, peak minute ventilation (VE), ventilatory equivalent for carbon dioxide at anaerobic threshold (EqCO2 during AT)], muscle strength, and muscle oxygen related indexes were collected blindly before the first exercise and after 12 weeks of training, respectively. To compare the differences of the indexes before and after training. Results A total of 90 patients were enrolled, 30 in each group. There was no significant difference in age, sex, height, weight and body mass index among the three groups (P>0.05). There was no significant difference in cardiopulmonary endurance, cardiopulmonary function, muscle strength, muscle oxygen related indexes between the groups before and after training (P>0.05). Except for the indexes related to cardiac function (peak heart rate, predicted peak heart rate) and resting muscle oxygen level (P>0.05), other indexes related to pulmonary function, cardiopulmonary endurance, muscle strength, and time of muscle oxygen falling to the valley in the three groups were statistically significant compared with those before training (P<0.05). Except for peak power, peak oxygen uptake and time of muscle oxygen falling to the valley (P>0.05), the difference of muscle strength before and after training in the three groups was statistically significant (P<0.05), including grip strength, chest push, sitting rowing, leg extension, hip abduction, body bending and horizontal push and push, and the low-load group was better than the aerobic training group (P<0.05), but the improvement of body bending and horizontal push and push in the standard-load group was better than the low-load group (P<0.05). Conclusions Low-load resistance training, standard-load resistance training and aerobic training have almost the same effect on improving the physical fitness of the elderly. Low-load resistance training is superior to medium intensity aerobic training in improving muscle strength, which is an effective method to improve the physical fitness of the aged adults.
Abstract: Objective To evaluate the results of surgical treatment of tetralogy of Fallot in adults． Methods From July 2002 to August 2009，75 adult patients with tetralogy of Fallot received surgical treatment in Xijing Hospital, ForthMilitary Medical University．There were 35 males and 40 females, with age at l7 to 37 years (23.30±3.50 years), and eoperativehemoglobin at 143 to 231 g/L(172.00±31.00 g/L)．All these patients were diagnosed by.echocardiograph before operation. All the patients were received tetralogy of Fallot of corrective operation in the hypothermia cardiopulmonary bypass. A total of 46 patients had a transannular right ventricular outflow tract patch，and 29 patients had a non ansannular patch． Results Operation time was 157 to 276 min(221.32±41.34 min), cardiopulmonary bypass time was 68 to 163 min(91.71±28.35 min) and aorta intercepted time was 37 to 96 min（55.47±23.61 min）. There were 6 operative deaths with an operative mortality at 8.00％. The causes of death were low output syndrome(n=3)，acute renal failure(n=2)， and multiple organ failure(n=1)．Nine patients needed reoperation for postoperative bleeding(12.00％)．We followed up 69 patients from 3 to 56 months (26.31±7.40 months). There were 2 patients with trivial residual shunt. The cardiac function status were New York Heart Association(NYHA) Ⅰ to Ⅱ in the 69 patients．No late death occured． Conclusion The effectiveness of surgical treatment for adults with tetralogy of Fallot is satisfactory．
ObjectiveTo summarize the research progress of medial buttress plate assisted fixation for femoral neck fractures in young adults.MethodsThe literature about buttress plate assisted fixation for femoral neck fractures in young adults was widely reviewed and analyzed. The design principle, background, biomechanical characteristics, and clinical results of buttress plate were summarized.ResultsMedial buttress plate assisted fixation is the latest treatment of femoral neck fractures in young adults, which can convert the shear force at the fracture sides into compression force and promote fracture healing. Medial buttress plate can improve the biomechanical stability of femoral neck fractures and reduce the maximum stress of fixation implants. In clinical, the medial buttress plate can maintain fracture reduction, reduce the incidences of nonunion and surgical failure, and improve hip joint function.ConclusionMedial buttress plate assisted fixation can achieve good effectiveness for femoral neck fractures in young adults. However, due to the preliminary application, its indications, fixation implants, and long-term effectiveness need to be further studied and improved.
ObjectiveTo explore the effectiveness of modified internal fixation and fusion in treatment of type Ⅱ painful accessory navicular (PAN) in adults.MethodsBetween January 2016 and December 2017, 29 patients (37 feet) with type Ⅱ PAN were treated with modified internal fixation and fusion. There were 12 males and 17 females with an average age of 41.4 years (range, 18-50 years). The injury caused by sprain in 24 cases and no obvious inducement occurred in 5 cases. All patients received conservative treatment for more than 6 months with no significant improvement. The effectiveness was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score before operation and at last follow-up. The inclination angle of calcaneus, the first metatarsal angle of talus, the inclusion angle of talonavicular joint, and the second metatarsal angle of talus were measured on X-ray films.ResultsSuperficial infection of incision occurred in 1 case after operation, and the incision healed after enhanced dressing change. The incisons of the other patients healed by first intention. There was no deep infection or osteomyelitis. All patients were followed up 12-33 months (mean, 25.1 months). X-ray films showed that the articular surfaces healed at 2-5 months after operation, with an average of 3.4 months. No loosening or rupture of internal fixator was found during the follow-up. At last follow-up, the pain, function, alignment scores, and total score of AOFAS were significantly improved when compared with those before operation (P<0.05). The inclusion angle of talonavicular joint, the first metatarsal angle of talus, and the second metatarsal angle of talus were also significantly improved when compared with those before operation (P<0.05). But there was no significant difference in the inclination angle of calcaneus between pre- and post-operation (t=1.097, P=0.276).ConclusionModified internal fixation and fusion in treatment of type Ⅱ PAN can effectively relieve the symptoms and obtain good recovery of feet function with less complications.
ObjectiveTo systematically evaluate the correlation between interpersonal stress and suicidal ideation. MethodsThe PubMed, EMbase, Cochrane Library, CBM, WanFang Data and CNKI databases were searched to collect studies on the correlation between interpersonal pressure and suicidal ideation from database inception to April 27, 2022. Two researchers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 14.0 software. ResultsA total of 42 studies including 3 cohort studies, and 39 cross-sectional studies, with a total sample size of 193 810 participants were included. Meta-analysis showed that the risk of suicidal ideation was higher in people who had experienced interpersonal pressure than in people who had not (OR=2.11, 95%CI 1.99 to 2.23, P<0.01). Subgroup analysis showed that people in the Americas who had experienced interpersonal pressure were more strongly associated with suicidal ideation than people in other regions of the studied area. Young adults in the study who had experienced interpersonal pressure were more strongly associated with suicidal ideation than other studied age groups; People who had experienced partner pressure were more strongly associated with suicidal ideation than those who had experienced other types of interpersonal pressure. ConclusionThis study shows that people who have experienced interpersonal pressure are at greater risk of suicidal ideation, and there are certain differences among study areas, subjects and types of interpersonal pressure. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo summarize the experience of treating adult recurrent pectus excavatum without plate turnover.MethodsTwenty-seven patients with recurrent pectus excavatum treated by thoracoscopy-assisted placement without plate turnover from 2010 to 2019 in our hospital were enrolled. There were 23 males and 4 females with the age of 3-29 (12.81±7.79) years at the first operation, and 18-29 (21.74±3.56) years at this operation. Incision of 2-3 cm at bilateral axillary midline of the deepest point of pectus excavatum was made, and an auxiliary incision under xiphoid process was adopted according to the intraoperative situation.ResultsAll patients underwent thoracoscopy-assisted correction of pectus excavatum without bar turnover, and subxiphoid incision was performed in 11 patients. Twenty-five patients had one bar placed, and two patients required two bars. The operation time was 28-45 (33.00±6.44) min. Postoperative Haller index (2.95±0.40) was improved compared with preoperation (4.63±1.03). The postoperative hospital stay was 4-6 (4.00±0.32) day. All patients were followed up for 1-8 years. Complications included poor wound healing in 1 patient, and steel wire fracture and displacement in 1 patient. There was no plate rotation or bar displacement. Fourteen patients removed the bar 29-84 (40.36±13.93) months after the placement. Haller index was improved to 2.43-3.61 (2.86±0.35) during removal of steel plate. Untill June 2020, there was no recurrence of pectus excavatum.ConclusionThe treatment of adult recurrent pectus excavatum without plate turnover is satisfactory, and the protection of intercostal muscle and firm fixation is the key to ensure the success of operation and long-term effects.
ObjectiveTo provide reference for the formulation of public health policies through exploring the disease burden of aortic aneurysm (AA) in Chinese young adults. MethodsWe analyzed sex-specific mortality rates and years of life lost (YLLs) among Chinese young adults with AA in Global Burden of Disease (GBD) from 1990 to 2019, and compared with global and young adult AA data stratified by sociodemographic index (SDI). Joinpoint was used to analyze the time trend of AA burden among young males and females in China. The attributable risk factors for AA burden in young adults and its characteristics were analyzed. ResultsAmong young adults (15-39 years old) in China, the total of AA deaths in 2019 was 657 (95%UI 549-791), with an increase of 16.90% compared with 1990. The mortality rate in 2019 was 0.13 per 100 000 (95%UI 0.11-0.16), with an increase of 30.00% compared with 1990. In 2019, a total of 36921 YLLs (95%UI 30 865-44 445) were produced by young adults in China, with an increase of 13.21% compared with 1990. The YLLs rate in 2019 was 7.42 per 100 000 (95%UI 6.20-8.93), with an increase of 24.92% compared with 1990. The male YLLs rate was 11.49 per 100 000 (95%UI 9.22-14.28), with an increase of 35.18%. The female YLLs rate was 3.11 per 100 000 (95%UI 2.36-3.98), with a decrease of 3.12%. Both the AA mortality rate and YLLs rate in male young adults were higher than those in female young adults, and the growth rate from 1990 to 2019 was significantly higher than that in females. ConclusionThe disease burden of AA among young adults in China increases significantly from 1990 to 2019, mainly among males. The time trend of male and female AA YLLs in Chinese young adults is obviously inconsistent. The AA YLLs of Chinese male young adults are positively correlated with economic development and the progress of medical technology, and are in the process of gradual increase. The AA YLLs of Chinese female young adults are much lower than the average level, which is closely related to the low smoking rate.
ObjectiveTo investigate the current status of work readiness and its influencing factors among postoperative lung cancer patients returning to work. MethodsA retrospective study was conducted on young and middle-aged postoperative lung cancer patients who were treated at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to September 2023 and returned to their jobs. Data were collected through a general information questionnaire, readiness for return-to-work scale (RRTW), general self-efficacy scale (GSES), and simplified coping style questionnaire (SCSQ). Univariate and multivariate logistic regression analyses were used to explore the factors affecting the work adaptation of returning patients. ResultsA total of 219 patients were included, with 59 males and 160 females aged 18-60 years. Among the postoperative lung cancer patients returning to work, 73.1% were in the active maintenance stage of return-to-work readiness with a RRTW score of (17.59±1.48) points, and 26.9% were in the uncertain maintenance stage with a RRTW score of (16.22±1.50) points. Bivariate logistic regression analysis showed that patients aged≤30 years (OR=52.381), employees of enterprises and institutions (OR=7.682), agricultural, pastoral, fishery, forestry laborers (OR=15.665), and those with higher self-efficacy (OR=1.157) had higher return-to-work readiness, while patients with≥2 children (OR=0.055), positive coping (OR=0.022), and out-of-pocket expenses (OR=0.044) had lower return-to-work readiness. ConclusionThe return-to-work readiness of young and middle-aged postoperative lung cancer patients needs to be improved, and occupation, job nature, main coping styles, and general self-efficacy are associated with return-to-work readiness.
Objective To analyze the characteristics of femoral neck fractures in young and middle-aged adults by means of medical image analysis and fracture mapping technology to provide reference for fracture treatment. Methods A clinical data of 159 young and middle-aged patients with femoral neck fractures who were admitted between December 2018 and July 2019 was analyzed. Among them, 99 patients were male and 60 were female. The age ranged from 18 to 60 years, with an average age of 47.9 years. There were 77 cases of left femoral neck fractures and 82 cases of right sides. Based on preoperative X-ray film and CT, the fracture morphology was observed and classified according to the Garden classification standard and Pauwels’ angle, respectively. Mimics19.0 software was used to reconstruct the three-dimensional models of femoral neck fracture, measure the angle between the fracture plane and the sagittal plane of the human body, and observe whether there was any defect at the fracture end and its position on the fracture surface. Through reconstruction, virtual reduction, and image overlay, the fracture map was established to observe the fracture line and distribution. Results According to Garden classification standard, there were 6 cases of type Ⅰ, 61 cases of type Ⅱ, 54 cases of type Ⅲ, and 38 cases of type Ⅳ. According to the Pauwels’ angle, there were 12 cases of abduction type, 78 cases of intermediate type, and 69 cases of adduction type. The angle between fracture plane and sagittal plane of the human body ranged from –39° to +30°. Most of them were Garden type Ⅱ, Ⅳ and Pauwels intermediate type. The fracture blocks were mainly in the form of a triangle with a long base and mainly distributed below the femoral head and neck junction area. Twenty-six cases (16.35%) were complicated with bone defects, which were mostly found in Garden type Ⅲ, Ⅳ, and Pauwels intermediate type, located at the back of femoral neck and mostly involved 2-4 quadrants. The fracture map showed that the fracture line of the femoral neck was distributed annularly along the femoral head and neck junction. The fracture line was dense above the femoral neck and scattered below, involving the femoral calcar. Conclusion The proportion of displaced fractures (Garden type Ⅲ, Ⅳ) and unstable fractures (Pauwels intermediate type, adduction type) is high in femoral neck fractures in young and middle-aged adults, and comminuted fractures and bone defects further increase the difficulty of treatment. In clinical practice, it is necessary to choose treatment plan according to fracture characteristics. Anatomic reduction and effective fixation are the primary principles for the treatment of femoral neck fracture in young and middle-aged adults.
Anemia and coagulopathy are frequently presented in critically ill patients on the intensive care unit. Scientific use of blood products assist the treatment of critically ill patients. However, life-threatening adverse effects are also a risk. In 2020, the European Society of Critical Care Medicine (ESICM) published a clinical practice guideline on transfusion strategies for non-bleeding critically ill adults in an attempt to resolve the transfusion strategy problems of relevant critically ill patients. This paper interprets the key contents in order to assist Chinese clinicians for better understanding and using of the guideline.
