基于文献分析提出健脾防治运动性疲劳的思路,并基于网络药理学方法,以健脾代表方补中益气汤为例探讨健脾法防治运动性疲劳的可能作用机制.有关运动性疲劳的中西医发病机制的文献分析显示,脾虚是运动性疲劳的重要病机,线粒体功能障碍在运动性疲劳的发生发展过程中发挥关键作用.网络药理学研究表明,补中益气汤防治运动性疲劳的主要活性成分为槲皮素、β-谷甾醇和豆甾醇,关键靶点主要为白细胞介素6(IL-6)、肿瘤坏死因子(TNF)和白细胞介素1β(IL-1β),靶点可能涉及甲状腺激素、5-羟色胺能突触、缺氧诱导因子(HIF)等信号通路.结果提示,中医健脾法对防治运动性疲劳具有明显优势,而调节线粒体功能可能成为中医防治运动性疲劳的疗效机制研究的切入点.

Objective: To explore the protective effect of glycyrrhizin on gastric mucosal injury. Methods:Glycyrrhizin was extracted from the traditional Chinese medicine licorice and identified as authentic, with purity＞90%. Thirty two healthy male SD rats with SPF were randomly divided into blank group, model group, glycyrrhizin group（20 mg/kg） and positive control group（omeprazole, 10 mg/kg）,with 8 rats in each group. The drug was administered by gavage every morning, once a day for 7 days. Except for the blank group, the other groups carried out one-time weight-bearing exhaustive swimming after intragastric gavage for 1 h at the 7th day. All rats were killed after anesthesia, and the gastric ulcer index（UI） was calculated.After HE staining, the tissue morphology of gastric mucosa was observed under light microscope. Enzyme linked immunosorbent assay（ELISA） was used to detect tumor necrosis factor-α（TNF-α）, interleukin-1β（IL-1β）, interleukin-6（IL-6） and other protective factors such as epidermal growth factor（EGF） and prostaglandin E2（PGE2） in gastric mucosa. Results: Compared with the blank group, the UI value and the levels of TNF-α, IL-1β and IL-6 increased significantly（P＜0.01）, and the contents of EGF and PGE2decreased significantly（P＜0.01） in the model group’s gastric mucosa. Meanwhile, the pathological changes of gastric mucosa in the model group were observed. Compared with the model group, the UI value and the levels of TNF-α, IL-1β and IL-6 were significantly decreased（P＜0.01）, and the contents of EGF and PGE2 were significantly increased（P＜0.01） in the glycyrrhizin group’s gastric mucosa, and the pathological damage of gastric mucosa was reduced. Conclusion: Glycyrrhizin can correct the abnormal secretion of factors such as TNF-α, IL-1β, IL-6, PGE2 and EGF in gastric mucosa caused by exercise stress, reduce the occurrence of gastric ulcer, and has an obvious protective effect on gastric mucosal injury. We should promote the application of glycyrrhizin in the development of health food to help protect gastric mucosa.

该文通过问卷调查法、文献资料法、数理统计法,对广东高校大学生关于舞狮认知度进行调查研究,结果显示:大学生对舞狮了解度较好,关注度较低,对舞狮文化价值和运动价值认知较薄弱.建议:学校提高学生对舞狮的关注度,开设舞狮特色课程,加强舞狮文化价值和运动价值的宣传,以弘扬中华民族传统体育精神为己任,开创南狮运动发展的新局面.

At present, four operating modes have been explored for physical-medical integration in China: hospital health guidance center, sports club health guidance, community health monitoring center and industry-university-research cooperation on the integration of physical and medical services. However, physical-medical integration is still in its infancy, the cultivation of physical-medical integration talents has been a key to the deep development of "physical-medical integration". The researches show that the current training mode of integrative talents mainly focuses on on-the-job training, which is faced with many problems such as serious shortage of specialized talents, imperfect certification system and single talent training mode. It is suggested that the training system, the curriculum system, the public opinion system and the professional standards should be improved so as to realize the scientific and sustainable development of physical-medical talents.

BACKGROUND:Many middle-aged and older adults have more than one chronic health condition. It is therefore important to explore the effectiveness of interventions for multiple chronic conditions. Tai Chi is widely used in China and other countries, and many studies have examined the effect of Tai Chi on anxiety and depression. However, there are no systematic reviews of the effect of Tai Chi on anxiety and depression in various chronic conditions. This systematic review and meta-analysis aimed to evaluate the effects of Tai Chi on anxiety and depression symptoms in four chronic conditions: cancer, stroke, heart failure (HF), and chronic obstructive pulmonary disease (COPD). METHODS:We searched Chinese and English databases (Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Database, and Sinomed) from inception to October 2020. Review Manager version 5.2 and Stata version 12.0 were used to perform a systematic review. The quality of the included studies was evaluated using the Cochrane risk of bias tool. The study was registered with the PROSPERO database (number CRD42020209594). RESULTS:Of the 596 studies identified, we included 25 randomized controlled trials involving 1819 participants. Combined analysis of the four diseases showed statistically significant differences between the Tai Chi and control groups for anxiety symptoms (SMD -0.99, 95%CI: -1.5, -0.47; P < 0.01) and depressive symptoms (SMD 0.70, 95%CI: -1.01, -0.39; P < 0.01). Subgroup analyses showed statistically significant differences between the Tai Chi and control groups for depressive symptoms in stroke (SMD -0.43, 95%CI: -0.67, -0.18; P < 0.01) and HF (SMD -0.57, 95%CI: -0.8, -0.33; P < 0.01). However, no statistically significant differences were found for depressive symptoms in COPD or cancer. There were statistically significant differences between the Tai Chi and control groups for anxiety symptoms in stroke (SMD -0.60, 95%CI: -0.88, -0.32; P < 0.01) and cancer (SMD -0.69, 95%CI: -1.22, -0.17; P < 0.01), but not in COPD or HF. Subgroup, sensitivity, meta regression, and publication bias analyses showed high heterogeneity correlated with a single study and study quality. Sensitivity analysis showed that most meta-analysis results had good stability, but those for anxiety symptoms in COPD were unstable; therefore, careful interpretation is required. CONCLUSION:Tai Chi has a positive effect on anxiety and depression, especially for patients with cancer, stroke, and HF. However, given the weak evidence, this approach is not a substitute for psychiatric treatment.

目的 探讨半夏生物总碱对运动氧化应激大鼠胃黏膜的保护作用及机制.方法 将32只SD大鼠随机分为空白组、模型组、半夏生物总碱组(20 mg·kg-1)和阳性对照组(奥美拉唑,10mg·kg-1),每组8只.灌胃给药,每日1次,连续7d.第7天灌胃给药1h后,进行一次性负重力竭游泳运动造模.麻醉后处死所有大鼠,计算胃溃疡指数(UI),采用HE染色法观察胃黏膜组织病理形态;采用酶联免疫吸附法(ELISA)检测血清一氧化氮(NO)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)等氧化应激指标水平,以及胃黏膜组织胃泌素(GAS)、胃动素(MTL)含量.结果 与空白组比较,模型组大鼠的UI值与胃黏膜组织GAS、MTL含量,以及血清NO、MDA含量均显著升高(P＜0.01),血清SOD、GSH-Px水平显著降低(P＜0.01).与模型组比较,半夏生物总碱组大鼠的UI值与胃黏膜组织GAS、MTL含量,以及血清NO、MDA含量均显著降低(P＜0.01),血清SOD、GSH-Px水平显著升高(P＜0.01).结论 半夏生物总碱具有抗氧化作用,能纠正运动应激导致的胃黏膜组织GAS、MTL分泌异常状态,逆转运动氧化应激对胃黏膜的损伤,减少胃溃疡的发生.

肺康复应用于慢性阻塞性肺疾病的治疗已得到广泛研究,其疗效也得到肯定,但对其他慢性呼吸系统疾病的疗效尚不明确,由于相关高质量研究较少,缺少适用于不同疾病的肺康复方案及康复疗效评价体系.本文通过阅读近年国内外关于肺康复治疗各种慢性呼吸系统疾病的疗效研究,综述研究成果,报告肺康复治疗慢性呼吸系统疾病的研究现状.

目的:观察八段锦联合持续气道正压通气(CPAP)治疗老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效.方法:将90例老年OSAHS患者随机分为对照组和试验组,两组均给予健康教育、饮食及生活干预,对照组予CPAP治疗,治疗组在此基础上进行八段锦功法练习,两组均连续治疗12周.比较两组OSAHS老年患者Epworth嗜睡量表(ESS)评分、睡眠呼吸暂停呼吸暂停低通气指数(AHI)、最长呼吸暂停持续时间、最低血氧饱和度(LSaO2),以及肿瘤坏死因子-α(TNF-α)、白细胞介素-18 (IL-18)、丙二醛(MDA)和超氧化物歧化酶(SOD)水平.结果:与本组治疗前比较,治疗后两组ESS评分、AHI、最长呼吸暂停时间、MDA、TNF-α和IL-18均显著下降(P＜0.05),LSaO2和SOD显著上升(P＜0.05);治疗后与对照组同期比较,试验组ESS评分、AHI、最长呼吸暂停时间、MDA、TNF-α和IL-18均显著下降(P＜0.05),LSaO2和SOD显著上升(P＜0.05).结论:八段锦联合CPAP治疗老年OSAHS临床疗效更显著.

背景:假体周围感染是膝/髋关节置换最常见最严重的并发症之一,占全膝关节置换失败原因的25％,全髋关节置换失败的16％.因此,及时准确地诊断关节假体周围感染具有重要临床意义.目的:评估α防御素和C-反应蛋白对假体周围感染的诊断效应.方法:选取2014年9月到2016年9月初次关节置换或关节翻修手术后疼痛的患者,并检测所选患者滑膜液中α防御素和C-反应蛋白的表达情况,并与肌肉骨骼感染协会(MSIS)标准对比,分别计算检测的阳性预测值和阴性预测值.试验于2020-08-07经广州中医药大学伦理审查委员会批准,审批号K[2020]064.结果与结论:α防御素测试与滑膜液C-反应蛋白阳性联合测试的敏感性为81.1％(95％CI:64.8％-92.0％),特异性为95.9％(95％CI:91.3％-98.5％);滑膜液α防御素和C-反应蛋白联合测试的敏感性为73.0％(95％CI:55.9％-86.2％),特异性为99.3％(95％CI:96.2％-99.9％).提示滑膜液中α防御素和C-反应蛋白可用于关节周围感染的辅助诊断.

目的 系统评价弹性抗阻运动(弹力带/弹力管)对慢性阻塞性肺疾病(COPD)患者康复疗效的影响.方法 检索Cochrane Library、PubMed、Web of Science、中国知网、维普、万方和生物医学文献数据库中关于弹性抗阻运动治疗COPD患者的临床随机对照试验,检索时限自建库至2020年9月.最后纳入文献11篇,其中英文9篇,中文2篇,共485例患者.采用Cochrane风险偏倚评估工具及物理治疗证据数据库量表进行质量评价,采用RevMan 5.2软件进行分析.这一系统评价在PROSPERO(CRD42020208659)上登记.结果 弹性抗阻运动组与传统抗阻运动组(如举重训练机、体重训练)6 min步行试验距离(6WMD)(MD=1.19,95％CI-7.02～9.39,P=0.78)、COPD患者自我评估测试(CAT)(MD=-0.43,95％CI-2.42～1.57,P=0.68)和肌力(MD=0.23,95％CI-1.06～1.52,P=0.73)无显著性差异,两组间异质性不高.弹性抗阻运动组与非抗阻运动组6MWD(MD=18.30,95％CI-8.92～45.52,P=0.19)和CAT(MD=-0.59,95％CI-3.78～2.60,P=0.72)无显著性差异,研究间异质性较高.结论 弹性抗阻运动也许是一种潜在的替代传统抗阻训练的方法,但弹性抗阻运动对运动耐力、生活质量、肺功能的影响尚不明确.

目的 探究半夏泻心汤对大鼠运动应激性胃黏膜损伤的预防保护机制.方法 选用32只健康的雄性SD大鼠,随机分为空白对照组、模型组、实验组和阳性对照组,每组8只,空白组正常喂养,试验组予半夏泻心汤灌胃,阳性对照组予奥美拉唑溶液灌胃,模型组予蒸馏水灌胃,连续干预7天后,采用一次性游泳力竭方法建立运动应激性胃溃疡模型,计算胃溃疡指数(UI),电镜下观察胃粘膜组织形态,采用ELISA方法测定胃粘膜的TNF-α、IL-1β、IL-6.结果 空白组大鼠胃黏膜的UI显著低于模型组,差异有统计学意义(P<0.01);模型组UI显著高于中药组和西药组(P<0.01),中药组和西药组对比UI无明显差异(P>0.05).空白组大鼠胃黏膜的IL-1β、IL-6、TNF-α的表达量均明显低于模型组,差异有统计学意义(P<0.01).中药组和西药组的炎症因子IL-1β、IL-6、TNF-α表达量也明显低于模型组的表达量,差异有统计学意义(P<0.01);中药组的IL-1β、IL-6、TNF-α表达量与西药组的相比无明显差异(P>0.05).通过造模前给予半夏泻心汤或奥美拉唑灌胃,胃粘膜病理学形态改善明显.模型组TNF-α、IL-1β、IL-6的表达明显多于其余3组,其中实验组与阳性对照组的表达量无明显差异.结论 半夏泻心汤可提高机体免疫力,降低胃黏膜中TNF-α、IL-1β、IL-6的表达,抑制炎症反应,减少运动应激性胃溃疡的发生.

目的:运用数学因子模型揭示"居家"下大学生负面心理特征.并遵照相应的数学模型精准施加不同运动方式进行改善干预.方法:对普通高校在读大学生590人进行了有效调查研究.采用"非接触"远程网络形式进行调查研究,运用"居家"心理自评量表并辅助网络语音、视频进行现场访谈.采用Forward逐步logistic回归分析筛选并建立不同心理等级得分学生负面心理的影响因素模型.精准施加不同运动组合方式缓解负面心理状况,并进行治疗缓解效果检验.结果:以心理测试等级Ⅰ级、Ⅱ级、Ⅲ级分别为因变量,以8种居家负面心理为自变量进行数学因子建模后不同对应因子进入数据模型.采用小空间氧运动与拉伸、自身力量与耐力素质、传统保健功法与呼吸放松操针对建立的不同等级负面心理和对应因子进行精准施加治疗,并根据负面心理状况程度辅助小组群陪伴训练与视频语音疏导.运动后负面心理Ⅱ级、Ⅲ级明显减少,与测试前呈显著性差异.结论:负面心理特征数学模型揭示了"居家"下大学生不同阶段心理应激的规律.小空间运动精准施加缓解了不同阶段大学生负面心理状态,对"居家"大学生心理健康改善具有重要现实意义.

目的 研究广州高校女教师的亚健康发生率与家庭、工作压力相关因素的关系.方法 从广州10所高校中随机抽取500名女教师,对其亚健康和家庭、工作压力相关因素进行调查.结果 高校女教师亚健康的发生率与年龄、学历、职称、家庭因素、人际交往情况、科研困扰、教学时长及学生评价有关(P＜0.05),与个人月薪及备课时长无关.结论 广州高校女教师亚健康发生率与家庭及工作压力关系密切.

Background: Chinese medicine Sangbaipi decoction is extensively applied to the therapy of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in China. However, owing to the low quality, small sample size, and methodological heterogeneity of these studies, this conclusion is not convincing. Consequently, it is necessary to systematically evaluate the clinical efficacy and safety of Sangbaipi Decoction in the treatment of AECOPD patients, and provide high-quality evidence for its clinical application. Methods: We will follow the preferred reporting items for systematic review and meta-analysis (PRISMA) for reporting the results of the review in this study. We will utilize the Review Manage software V5.3.0 (The Nordic Cochrane Center, The Cochrane Collaboration, 2014, Copenhagen, Denmark) to assess the risk of bias and visualize the results. We will use Stata software (version 15.0, StataCorp, College Station, TX) to perform the meta-analysis. Ethics and dissemination: This study is a systematic review and meta-analysis protocol of Sangbaipi decoction on AECOPD, participants were not recruited and data were not collected from participants, so ethical ratification is not required. Results: This study will provide high-quality synthesis of the effectiveness and safety of Sangbaipi decoction for AECOPD. Upon completion, the results will be submitted to a peer-reviewed journal. Conclusion: The efficacy and safety assessment of Sangbaipi decoction for AECOPD will be supported by this protocol. Registration number: PROSPERO CRD 42019138405.

文章运用问卷调查法、数理统计法,了解医学院校学生体质健康标准政策态度的现状与特点.对496名医学院校学生的调查数据进行分析,结果表明:1.医学院校学生对体质健康标准政策整体持积极态度,学生对体质健康标准的内容知晓度、执行过程和政策效果的认同度较高,愿意遵守体质健康测试中的规定和要求,对体质健康标准政策的满意度较好,但仍有一定的提升空间.2.医学院校学生体质健康标准政策态度存在显著的性别差异,男生政策态度得分高于女生.

目的 对比、分析八段锦与中等强度运动训练对稳定期慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)患者的肺康复疗效.方法 将符合纳入标准的患者按意愿分为八段锦组(27例)和中强度运动组(28例),八段锦组在常规治疗上予八段锦训练,中强度运动组在常规治疗上予中强度运动训练.观察指标:慢性阻塞性肺疾病评估测试(COPD assessment test,CAT)、改良版英国医学研究委员会呼吸问卷(mMRC)、肺功能等.结果 两组间疗效差异无明显统计学意义.治疗后两组CAT、mMRC、日常生活能力(Activities of daily living,ADL)、6 min步行试验(Six-minutes walking test,6MWT)指标均有改善,差异有统计学意义(P＜0.01).中强度运动训练干预前后肺功能差异无统计学意义,八段锦干预前后用力肺活量(Forced vital capacity,FVC)占预计值百分比(FVC％pred)改善,差异有统计学意义(P＜0.05).结论 八段锦与中强度运动均能改善临床症状、ADL及运动能力,八段锦训练在一定程度上可以改善肺功能.

国内新型冠状病毒肺炎疫情得到有效控制,但该病患者存在不同程度的呼吸功能、身体功能及心理功能障碍,这是诊治过程中必须重视的问题.中华康复医学会指出“呼吸康复对处于临床治疗过程中的患者和治愈后患者的恢复至关重要”.但是新型冠状病毒肺炎是一种新发突发的疾病,呼吸康复对新型冠状病毒肺炎的治疗仍处于探索阶段.目前关于新型冠状病毒肺炎患者如何进行呼吸康复的文章较多,呼吸康复治疗新型冠状病毒肺炎的可行性的文章较少.本文基于文献与临床实践,探讨呼吸康复在治疗新型冠状病毒肺炎中的可行性,以期呼吸康复在患者治疗与康复中发挥作用.

目的 研究黄芪总皂苷对运动性疲劳雄性大鼠生殖激素的调控作用和可能机制.方法 36只雄性SD大鼠随机分为正常组、模型组和给药组(黄芪总皂苷)三组.给药组以50 mg/kg黄芪总皂苷灌胃,正常组和模型组以等量生理盐水灌胃,每天1次.模型组和给药组大鼠在灌胃1h后进行中等强度的水平跑台运动,每天1次,连续14天,正常组常规饲养.在实验最后一天断头取血,检测血清睾酮(T)、卵泡刺激素(FSH)和黄体生成素(LH)含量,血清和下丘脑促性腺激素释放激素(GnRH)含量,下丘脑谷氨酸(Glu)和 γ-氨基丁酸(GABA)含量的变化.结果 和正常组比较,模型组大鼠血清T含量、下丘脑GnRH和Glu含量显著降低,血清FSH、GnRH和下丘脑GABA含量显著升高;和模型组比较,给药组大鼠血清T和LH含量、下丘脑GnRH和Glu含量显著升高,血清FSH、GnRH和下丘脑GABA含量显著降低.结论 黄芪总皂苷通过纠正中枢Glu和GABA代谢失衡的情况,改善HPG轴抑制状态,从而调节运动性疲劳状态下外周生殖激素水平紊乱的情况,对机体生殖系统起到保护作用.

目的:研究太极拳运动对糖尿病前期(IGR)患者空腹血糖(FPG)和心肺耐力的影响.方法:纳入90例受试者,分为太极拳组和对照组,最终收集87例完整数据.于干预前和干预后的2、4、6个月测FPG、最大摄氧量(VO2peak)、负荷运动时间.结果:不同时点间的FPG、运动时间和VO2peak比较,差异有统计学意义(P=0.000);组间比较差异有统计学意义(P=0.000),且干预后太极拳组指标优于对照组(P＜0.05);组间变化趋势差异有统计学意义(P=O.000).干预2、4、6个月时,太极拳组各项指标均有改善(P＜0.01).结论:太极拳可有效降低IGR患者的FPG,增强心肺耐力,促进IGR患者的康复,值得在社区推广.

目的:观察八段锦对社区糖尿病前期(IGR)伴轻度高血压患者血糖和血压的控制效果.方法:在社区参与健康管理的居民中筛选出IGR合并轻度高血压患者90例,随机分为八段锦组、抗阻运动组和空白对照组.干预前和干预后2、4、6个月检测患者的空腹血糖(FBG)、糖化血红蛋白(HbA1c)和血压,最终收集到82例患者的的完整数据.结果:两运动组各时点血糖指标水平均较干预前降低(P＜0.01);两运动组血糖指标呈下降趋势,空白对照组血糖指标维持原有水平.两运动组干预后各时点血糖指标均低于同期对照组(P＜0.05).干预4、6个月时,抗阻运动组血糖指标水平均低于八段锦组(P＜0.05).干预后,各时点八段锦组收缩压(SBP)、舒张压(DBP)及抗阻运动组SBP均较干预前降低(P＜0.01);干预4、6个月时,抗阻运动组DBP均较干预前降低(P＜0.01).两运动组血压指标呈下降趋势,空白对照组DBP呈上升趋势,SBP维持原有水平.干预后,八段锦组各时点SBP、DBP及抗阻运动组SBP均低于同期对照组(P＜0.05);干预4、6个月时,抗阻运动组DBP低于同期对照组(P＜0.05),八段锦组SBP低于抗阻运动组(P＜0.05).结论:八段锦和抗阻运动均能安全有效地控制IGR合并轻度高血压患者的血糖和血压,八段锦对血压的控制效果优于抗阻运动.