Objectives To systematically analyze the effect of high-intensity and low-intensity resistance training on glycosylated hemoglobin (HbA1c) in elderly patients with type 2 diabetes. Methods PubMed, EBSCO, Cochrane Library, Web of science, Wanfang, Chinese National Knowledge Infrastructure and Chongqing VIP were searched to collect randomized controlled trials of resistance training intervention in elderly patients with type 2 diabetes. The search time limit was from the establishment of the database to August 28, 2021, and the RevMan 5.3 and Stata 15.0 software were used for meta-analysis. Results A total of 415 patients in 8 articles were included in this study. A subgroup analysis based on control measures showed that compared with the resistance training group, the HbA1c level effect value of the non- training group was weighted mean difference (WMD) = ?0.54% [95% confidence interval (CI) (?1.06%, ?0.03%), P=0.04)], the HbA1c level effect value of the flexibility training group was WMD=?0.47% [95%CI (?1.05%, 0.12%), P=0.12], the HbA1c level effect value of the aerobic training group was WMD=?0.10% [95%CI (?0.71%, 0.51%), P=0.75]. Subgroup analysis of resistance strength showed that compared with the flexibility or non-resistance training group, both high-intensity [WMD=?0.99%, 95%CI (?1.16%, ?0.81%), P<0.00001] and low- and medium-intensity resistance training [WMD=?0.29%, 95%CI (?0.58%, ?0.01%), P=0.05] can reduce HbA1c. Compared with the high-intensity resistance training, the HbA1c level effect value of the low- and medium-intensity resistance training was WMD=0.03% [95%CI (?0.33%, 0.39%), P=0.88]. Compared with the low- and medium-intensity resistance training, the HbA1c level effect value of the low- and medium-intensity aerobic training was WMD=?0.10% [95%CI (?0.71%, 0.51%), P=0.75]. Among all the included studies, only the high-intensity resistance training group reported multiple adverse events.ConclusionsCurrent evidence suggests that elderly patients with type 2 diabetes are more suitable to choose low-to-medium-intensity resistance training to control HbA1c. It is recommended that elderly patients with type 2 diabetes take 60% to 75% of the maximum muscle strength of medium-intensity resistance training.
bjectiveTo evaluate the efficacy and limits of high intensity focused ultrasound (HIFU) in tumor treatment. MethodsThe references about the application of HIFU in tumor treatment in recent years were reviewed.ResultsHIFU caused localized hyperthermia at predictable depth in a few seconds to make the tumor tissue coagulative necrosis without injuring surrounding tissue. HIFU treatment had the advantages of low morbidity, noninvasiveness, avoidance of systemic side effects, and repeatitiveness. However, the utilization of HIFU sometimes could be limited by some factors such as imaging technique, organ movement, incomplete tissue destruction, etc.ConclusionHIFU is a promising noninvasive therapy for tumor treatment, though there are lots of problems to be further studied.
Objective To explore the effects of low-intensity pulsed ultrasound (LIPUS) on anabolism, apoptosis and intraflagellar transport 88 (IFT88) expression in mouse chondrocytes after interleukin (IL)-1β intervention, and the correlation of cartilage repairment by LIPUS with primary cilia. Methods IL-1β intervention, LIPUS intervention and lentiviral carrying IFT88-specifific short hairpin RNA (sh-IFT88) transfection were performed on mouse chondrocytes, respectively. The groups included: normal chondrocyte group (N group), chondrocyte after IL-1β intervention group (OA group), chondrocyte after IL-1β intervention+LIPUS group (OA+U group), sh-IFT88+IL-1β intervention chondrocyte group (KO+OA group), and sh-IFT88+LIPUS+IL-1β treated chondrocyte group (KO+OA+U group). Real-time polymerase chain reaction and immunofluorescence were used to determine the expression of collagen Ⅱ, aggrecan, and primary cilia, and apoptosis was measured by flow cytometry. All experimental data were statistically analyzed using the GraphPad Prism 9.5 software. Results The expression of collagen Ⅱ and aggrecan increased, the apoptosis decreased, and the incidence of primary cilia in chondrocytes of mice increased in the OA+U group compared with those in the OA group (P<0.05). The collagen Ⅱ and aggrecan expression decreased and the apoptosis increased in the KO+OA+U group compared with those in the OA+U group (P<0.05). Conclusion LIPUS can reduce the apoptosis of chondrocytes in C57 mice after IL-1β intervention, and increase the expression of collagen Ⅱ and aggrecan in chondrocyte matrix, and the effect is related to primary cilia.
ObjectiveTo explore the effectiveness and safety of high intensity focused ultrasound (HIFU) in the treatment of pancreatic cancer, so as to provide references for its clinical application. MethodsPubMed, EMbase, The Cochrane Library (Issue 11, 2013), CBM, CNKI, VIP and WanFang Data were systematically searched up to November 2013 for randomized clinical trials (RCTs) and clinical controlled trials (CCTs) about HIFU in the treatment of pancreatic cancer. According to inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.0. ResultsA total of 23 studies (19 RCTs and 4 CCTs) were included, of which 14 studies reported safety. The results of meta-analysis showed that:survival rates at the 6th month and the 12th month, overall efficacy and clinical benefit rate in the HIFU plus radiation and chemotherapy group were significantly higher than those in groups treated with three dimensional conformal radiation therapy (3D-CRT) (P < 0.05), gemcitabine (GEM) (P < 0.05), GEM plus cisplatin (DDP) (P < 0.05), and GEM plus 5-fluorouracil (5-FU) (P < 0.05). The adverse effects (mainly including skin damage and fever) in the HIFU plus radiation and chemotherapy group was similar to those in the control group with no significant difference (P > 0.05). ConclusionCurrent evidence suggests that HIFU plus radiation and chemotherapy for pancreatic cancer is superior to other therapies with less adverse reaction. However, the poor quality of the included studies reduces the reliability of outcome to some extent. Thus, it is necessary to regulate and unify the criteria of diagnosis and outcome measures in the treatment of pancreatic cancer and improve the quality of study design and implementation in clinical studies, so as to provide high quality evidence for its clinical application.
In order to get high-resolution glomerulus image with large field of view (FOV), stitching multiple small FOV images with high-resolution is necessary. Directly stitching images without properly correction is not acceptable and cannot afford any significant assistance in pathological diagnosis for intensity inhomogeneity and geometric distortion. Therefore we proposed a method of distortion correction and intensity inhomogeneity correction of glomerulus transmission electron microscope (TEM) image. In this paper, we firstly describe how these two distortions degrade images. Secondly, based on the TEM imaging system, image acquisition model and distortion correction model were proposed. Then according to these two models, distortions were greatly degraded and stitching results were improved by respectively applying two corrections, intensity inhomogeneity correction and geometric distortion correction. With the method proposed here, the result was improved significantly and stripes, fuzzy and artifacts were decreased dramatically. Our method has been proved to be valid to solve the problems of TEM glomerulus image distortion and at the same time to improve the result of multiple TEM glomerulus image stitching.
Atherosclerotic plaque rupture is the main cause of many cardiovascular diseases, and biomechanical factors play an important role in the process of plaque rupture. In the study of plaque biomechanics, there are relatively few studies based on fatigue fracture failure theory, and most of them mainly focus on the whole fatigue propagation process from crack initiation to plaque rupture, while there are few studies on the influence of crack on plaque rupture at a certain time in the process of fatigue propagation. In this paper, a two-dimensional plaque model with crack was established. Based on the theory of fracture mechanics and combined with the finite element numerical simulation method, the stress intensity factor (SIF) and related influencing factors at the crack tip in the plaque were studied. The SIF was used to measure the influence of crack on plaque rupture. The results show that the existence of crack can lead to local stress concentration, which increases the risk of plaque rupture. The SIF at the crack tip in the plaque was positively correlated with blood pressure, but negatively correlated with fibrous cap thickness and lipid pool stiffness. The effect of the thickness and angle of lipid pool on the SIF at the crack tip in the plaque was less than 4%, which could be ignored. This study provides a theoretical basis for the risk assessment of plaque rupture with cracks.
Aiming at the disadvantages of traditional direct aperture optimization (DAO) method, such as slow convergence rate, prone to stagnation and weak global searching ability, a gradient-based direct aperture optimization (GDAO) is proposed. In this work, two different optimization methods are used to optimize the shapes and the weights of the apertures. Firstly, in order to improve the validity of the aperture shapes optimization of each search, the traditional simulated annealing (SA) algorithm is improved, the gradient is introduced to the algorithm. The shapes of the apertures are optimized by the gradient based SA method. At the same time, the constraints between the leaves of multileaf collimator (MLC) have been fully considered, the optimized aperture shapes are meeting the requirements of clinical radiation therapy. After that, the weights of the apertures are optimized by the limited-memory BFGS for bound-constrained (L-BFGS-B) algorithm, which is simple in calculation, fast in convergence rate, and suitable for solving large scale constrained optimization. Compared with the traditional SA algorithm, the time cost of this program decreased by 15.90%; the minimum dose for the planning target volume was improved by 0.29%, the highest dose for the planning target volume was reduced by 0.45%; the highest dose for the bladder and rectum, which are the organs at risk, decreased by 0.25% and 0.09%, respectively. The results of experiment show that the new algorithm can produce highly efficient treatment planning a short time and can be used in clinical practice.
Objective To assess the improvement of different resistance training regimens on blood lipid metabolism and insulin resistance in patients with type 2 diabetes mellitus (T2DM). Methods PubMed, ProQuest, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP databases were searched to collect randomized controlled trials of resistance training intervention to improve blood lipids and insulin resistance in patients with T2DM. The search time range was from the establishment of the databases to May 2023. Two reviewers assessed the risk of bias of the included studies using the Physiotherapy Evidence Database scale, and performed a network meta-analysis of the extracted data using Stata 16.0 software. Results In the end, 24 articles were included, and a total of 983 participants were enrolled. The result of network meta-analysis showed that high-frequency and moderate-intensity resistance exercise significantly improved the levels of insulin resistance [standardized mean difference=?1.71, 95% confidence interval (CI) (?2.75, ?0.67)], triglycerides [weighted mean difference (WMD)=?0.27 mmol/L, 95%CI (?0.51, ?0.04) mmol/L], and total cholesterol [WMD=?0.16 mmol/L, 95%CI (?0.20, ?0.12) mmol/L], but had no significant effect on improving the level of high-density lipoprotein [WMD=0.05 mmol/L, 95%CI (?0.02, 0.11) mmol/L] or low-density lipoprotein [WMD=?0.20 mmol/L, 95%CI (?0.42, 0.03) mmol/L]. The results of cumulative probability ranking showed that high-frequency and moderate-intensity resistance exercise was the best in improving insulin resistance, triglycerides, high-density lipoprotein and low-density lipoprotein levels. Conclusion Based on current evidence, high-frequency and moderate-intensity resistance exercise may be the best resistance exercise regimen to improve insulin resistance and lipid metabolism in patients with T2DM.
Low-intensity ultrasound stimulation of the retina has the ability to modulate neural activity in the primary visual cortex (V1), however, it is currently unclear how different intensities and durations of ultrasonic stimulation of the retina modulate neural activity in V1. In this paper, we recorded local field potential (LFP) signals in the V1 brain region of mice under different ultrasound intensities and different stimulation times. The amplitude of LFP corresponding to 1 s before ultrasound stimulation to 2 s after stimulation (–1–2 s) was analyzed, including the power and sample entropy of delta, theta, alpha beta, and low gamma frequency bands. The experimental results showed that, as the stimulation intensity increased, the peak value of the LFP in the visual cortex showed a linear upward trend; the power in the delta and theta frequency bands showed a linear upward trend, and the sample entropy showed a linear downward trend. With increases of stimulation duration, the peak value of the LFP in the visual cortex showed an upward trend, and the upward trend gradually weakened; the power in the delta frequency band showed an upward trend, the sample entropy showed a linear upward trend, and the sample entropy in the theta frequency band showed a downward trend. The results show that low-intensity ultrasonic stimulation of the retina has a significant modulatory effect on neural activity in the visual cortex. The study provides insights into the mechanisms by which ultrasonic stimulation regulates visual system function. Furthermore, it clarifies the patterns of parameter selection, facilitating the development of personalized multi-parameter modulation for the treatment of visual neural degeneration, retinal disorders and related research areas.
Objective To explore the differential diagnosis significance of 3.0T MRI united-sequences examination in the diagnosis of benign and malignant breast lesions. Methods A total of 67 breast lesions of 59 patients were collected prospectively, which be treated at the Sichuan Provincial People’s Hospital during July 2015 to January 2017. All patients were underwent bilateral breast 3.0T magnetic resonance plain scan, diffusion weighted imaging, and dynamic enhanced scan successively before surgical operation. Analysis of morphological features of the benign and malignant breast lesions, the time-signal intensity curve (TIC), the apparent diffusion coefficient (ADC), and the combination diagnosis of them were performed. Results Of all 59 patients, 67 lesions were confirmed by histopathology, including 18 benign lesions and 49 malignant lesions. The morphological features (including margin, shape, border, and evenness), the types of TIC of dynamic enhancement, and ADC value between the benign lesions and malignant lesions were statistically significant (P<0.05). The sensitivity and specificity of Fischer scoring system was 89.8% (44/49) and 61.1% (11/18) respectively. The sensitivity and specificity of TIC types was 83.7% (41/49) and 77.8% (14/18) respectively. The diagnostic threshold of ADC value was 1.012×10–3 mm2/s, with the sensitivity and specificity for the diagnosis was 91.8% (45/49) and 83.3% (15/18) respectively. The sensitivity and specificity of the combination of Fischer scoring system and TIC type for diagnosis between benign and malignant breast lesions was 95.9% (47/49) and 72.2% (13/18) respectively. The sensitivity and specificity of the combination of Fischer scoring system, TIC type, and ADC value for benign and malignant breast lesions was 98.0% (48/49) and 83.3% (15/18) respectively. Conclusion The combination of Fischer scoring system, TIC type, and diffusion-weighted imaging for the differential diagnosis between benign lesions and malignant lesions was more effective than single imaging method.