Analysis and suggestions on the development trend of drug innovation in China / 中国药科大学学报

@#In order to comprehensivehy evaluate the stage of China in the global drug innovation, to further optimize the environment for drug innovation in China, and to unleash the vitality of drug innovation, this article mainly analyzes through comparison China''s situation of drug innovation in global competition from such perspectives as the current situation of the global drug R&D innovation market, R&D investment, product pipeline, policy support, and development trends, combined with the characteristics of China''s drug innovation development.It can be seen that China''s pharmaceutical innovation is faced with such practical problems as lagging behind some developed countries in terms of innovation development, companies bunching into research and development innovation, sudden research and development rush, and excessive dependence on capital markets for pharmaceutical innovation.Accordingly, this paper puts forward suggestions on continuously improving China''s new drug innovation environment, rationally selecting differentiated competition and new tracks, reasonably formulating drug innovation development strategies, guiding capital to return to innovative research and development, and constructing a "double cycle" strategy for drug innovation.

Magnet Quench Factors in Ramping-up Procedure / 中国医疗器械杂志

Ramping-up is the magnet current injection procedure which is under the control of resistance, voltage, current lead temperature, magnet pressure, temperature and so on. In this procedure, the factors related to the stability of the magnet such as, magnet temperature, pressure and currents are constantly changing. This procedure is the main step which the magnet-quench occurs in. This study uses the data collected during 7 years and SIMENS MRI ramping-up theory, in order to help engineers understand the key factors to reduce the magnet quench during the ramping up procedure.

Study on the R&D Contribution Rate of Listed Pharmaceutical Enterprises in Southwest China Based on Super-efficiency DEA Model / 中国药房

OBJECTIVE： To provide reference for pharmaceutical enterprises to enhance the R&D capability and improve the R&D investment strategy. METHODS： The annual report data of 13 listed pharmaceutical enterprises in southwest China were collcted. Taking fixed assets， operating costs， the number of employees in service and the amount of R&D investment as input indicators， net profit， operating income and earnings per share as output indicators， the efficiency values were calculated by using MyDEA 1.0 software based on super-efficiency DEA model. The operating efficiency of enterprises with or without R&D input were compared； the contribution rate of R&D investment to enterprises were calculated. Finally， Wilcoxon symbolic rank test was carried out by using SPSS 20.0 software to compare the difference. RESULTS： From 2013 to 2015， 10 of the 13 listed pharmaceutical enterprises had increased their R&D investment， which indicated that listed pharmaceutical enterprises in southwest China paid more attention to R&D investment. For three consecutive years， the efficiency value of R&D investment of the 13 listed pharmaceutical enterprises was significantly higher than that of the enterprises without R&D investment， and the number of the former reaching DEA efficiency was more， indicating that R&D investment was positively correlated with the operational efficiency of pharmaceutical enterprises. The Wilcoxon symbol rank test also confirmed that R&D investment was an effect input. After three enterprises joined the R&D input index， their operational efficiency was improved， and their R&D contribution was greater. Five enterprises had zero R&D contribution， their efficiency value remained unchanged whether or not they joined R&D input. The R&D contribution of other listed pharmaceutical enterprises varied greatly in each year. CONCLUSIONS： At the overall level of the industry， enterprises should increase their R&D investment and pay attention to improving R&D efficiency， establish a sound R&D innovation system and R&D personnel training mechanism， establish an integrated training mode of production， learning and research； the government should create an environment to support R&D activities of pharmaceutical enterprises. For individual enterprises， different strategies should be adopted based on practical situation in order to improve the pulling effect of R&D input on the operational efficiency of enterprises.

Lesiones meniscales ramp, y lesiones del ligamento meniscotibial posteromedial / Meniscal ramp lesions, and posteromedial meniscotibial ligament lesions

Las lesiones meniscales son las lesiones más frecuentemente asociadas a lesiones del Ligamento Cruzado anterior (LCA), encontrándose 9,3 a 16,9% en el segmento posteromedial y comprometiendo el ligamento meniscotibial. Descritas por Strobel por su apariencia artroscópica de rampa, se ha presentado su importancia dado el subdiagnóstico y el efecto biomecánico de una lesión posteromedial del menisco sobre el LCA y que su reparación restaura la traslación nativa de la tibia en conjunto con la reconstrucción del pivote central. Se ha demostrado que la mejor forma para diagnosticar lesiones ramp, es por visiones artroscópicas accesorias, una a través del surco intercondíleo y la otra por un portal posteromedial, logrando diagnosticar y manejar aquellas lesiones que sean inestables, a través de suturas dentro tanto por el portal anterior como por el posterior. Los resultados quirúrgicos son buenos, con mayor riesgo de falla en casos que la lesión se extiende al cuerpo meniscal. Es una lesión que debe buscarse bajo lupa, ya que pasarla por alto puede llevar a progresión de la lesión y a un mayor riesgo de rerotura del ligamento cruzado reconstruido.

Meniscal tears are the most frequently associated lesions in Anterior Cruciate Ligament (ACL) rupture, 9.3 to 16.9% on them in the posteromedial segment compromising the meniscotibial ligament. Described by Strobel for its arthroscopic ramp appearance, has gained importance given the underdiagnosis and biomechanical effect of a posteromedial meniscal lesion on the ACL, and that its repair restores the native anterior tibial translation when the central pivot is also reconstructed. It has been shown that the best way to diagnose ramp lesions is by accessory portals, one through the intercondylar notch and the other through a posteromedial portal, useful to diagnose and repair those lesions that are unstable, through all-inside sutures within both Anterior and posterior portals. Surgical results are good, with increased risk of failure in cases where the lesion extends to the meniscal body. It is a lesion that must be looked for in a direct way, since misdiagnosing it can lead to ramp lesion progression and increased risk of re rupture of the reconstructed ACL.

Effects of the bioactive parts of Xiongma Decoction on CGRP-CRLR/RAMP1 pathway in TCC of rats with nitroglycerin-induced migraine / 西安交通大学学报(医学版)

Objective To explore the effects of bioactive parts of Xiongma Decoction (parts of ethyl acetate and n-butanol extract) on the CGRP-CRLR/RAMP1 signal pathway so as to clarify its therapeutic mechanism on migraine.Methods We randomly divided 36 male SD rats into 6 groups with 6 in each:blank group,model group,groups of low-,medium-and high-dose Xiongma Decoction bioactive parts,and Sumatriptan group.By giving hypodermic injection of 10 mg/kg nitroglycerin,the migraine rat model was copied;Only 18 rats were found to have positive expressions of CGRP,CRLR,and RAMP1 in TCC with immunohistochemistry staining after heart perfusion.For the remaining 18 rats,TCC was stripped directly from the whole brain and divided into two parts,one part used to detect CGRP,CRLR,RAMP1 mRNA expressions by qPCR,and the other part to detect CGRP,CRLR,RAMP1 protein expressions by Western blot.Results The number of CGRP,CRLR and RAMP1 immunoreactive cells,the mRNA and protein expressions on TCC in model group were effectively increased,compared with those in the blank group (P＜0.05),indicating that the model copying was successful.Compared with those in the model group,the number of CGRP,CRLR and RAMP1 immunoreactive cells in Xiongma Decoction bioactive parts was significantlv decreased,and the expressions of CGRP,CRLR and RAMP1 mRNA and protein were reduced (P＜0.05).Conclusion The bioactive parts of Xiongma Decoction can reduce the activity of CGRP-CRLR/RAMP1 signal pathway in TCC of migraine rats.

Association of CALCA and RAMP1 gene polymorphisms with migraine in a Chinese population

Background & Objective: The calcitonin gene-related peptide (CGRP) has a central role in the pathogenesis of migraine, but variations in CGRP-related genes, including the calcitonin gene-related polypeptide-alpha (CALCA) gene and the receptor activity modifying 1 (RAMP1) gene, have not been found to link with migraine in Australian population. The goals of this study were to determine whether variants in the two genes are related to migraine in Chinese population. Methods: Using a case-control approach, rs3781719 and rs145837941 in the CALCA gene and rs3754701 and rs7590387 at the RAMP1 locus was analyzed in a cohort of 504 migraine cases and 529 ethnically matched controls. Genotyping was performed using Sequenom MALDI-TOF mass spectrometry iPLEX platform. Results: The CALCA gene rs145837941 variant was not found in migraine or control group. No significant difference in genotypic and allelic distribution was observed in the other three polymorphisms between migraine cases and controls. All the three SNPs were also not selected as significant factors that independently contributed to susceptibility to migraine in multivariate analysis. In the subgroup analysis, the CALCA rs3781719 seemed to be a significant risk for migraine with aura, but was not statistically significant after FDR correction. Moreover, there was no synergistic relationship between the three SNPs in the multifactor dimensionality reduction analysis for explore locus–locus interactions. Conclusion: Our data suggested that variants in CALCA gene and RAMP1 gene were not associated with migraine in the Han-Chinese population.

Comparison of Trunk Strategy to Maintain Balance during the One-Leg Stance on a Medio-Lateral Ramp and an Anterior-Posterior Ramp

PURPOSE: This study examined two trunk strategies - medio-lateral ramp and anterior-posterior ram - and their effects on pelvis and trunk movements, providing basic material for safe ramp utilization. METHODS: The present study included 20 asymptomatic males recruited from a local university. Participants were asked to stand with their feet shoulder-width apart. Their dorsal side faced the camera, and measurements were performed while standing in a neutral double stance, one leg stance, 15° of medial and lateral ramp, and 15° of anterior and posterior ramp. Participants were allowed to practice for 3 minutes, and each participant had a 30 seconds rest between the two ramp conditions. One-way repeated measures analysis of variance was used to determine the effects the ramp conditions on spinal alignment. In all analyses, p<0.05 was used to indicate statistical significance. RESULTS: The trunk-inclination angle on the posterior ramp was significantly lower than that of the double stance position (p<0.05). The trunk imbalance angle was significantly higher on the medial ramp, than that on the double stance position (p<0.05). The pelvic position and pelvic torsion angles were significantly higher in the medial, lateral, and anterior ramp positions than that of the double stance position (p<0.05). The pelvic rotation angles on the medial, lateral, and anterior ramps were significantly lower than that of the double stance position (p<0.05). CONCLUSION: These findings suggest that when people are exposed to the same form of ramp for an extended period, posture modifications may be triggered.

Punto de quiebre del doble producto como indicador de transición metabólica durante el ejercicio en pacientes coronarios / Double product breakpoint as an indicator of metabolic transition during exercise in coronary patients / Ponto de quebra do duplo produto como um indicador de transição metabólica durante o exercício em pacientes com doenças coronárias

El umbral anaeróbico ha sido utilizado como un buen indicador de capacidad funcional y de implicancias pronósticas en pacientes cardíacos. El objetivo fue evaluar un método no invasivo como el punto de quiebre del doble producto (PQDP) durante el ejercicio, punto en el cual se produjo un aumento claro y sostenido de la pendiente de doble producto (DP) durante la prueba de esfuerzo incremental. DP= frecuencia cardiaca (FC) x presión arterial sistólica (PAS), que podría ser aplicado para el entrenamiento físico y de información pronóstica en pacientes con enfermedad coronaria (EC). Material y métodos. Se evaluaron 33 hombres y 9 mujeres de 64,8 ± 7,6 años con EC documentada, clínicamente estables con tratamiento médico y en ritmo sinusal. Todos realizaron una PEG en cinta deslizante. El ejercicio consistió en un período inicial de entrada en calor (1 km/h) con cargas crecientes por etapa de 0,4 km/h cada minuto hasta el límite de tolerancia del sujeto. El consumo de oxígeno (VO2) se midió con un sistema portátil (COSMED), la FC con un ECG de 12 derivaciones y la presión arterial por esfigmomanometría en cada etapa. El DP vs VO2 fue sometido a 3 evaluadores independientes para la determinación visual del VT1 y PQDP. El test de Student se utilizó para comparar velocidad (km/h) en VT1 y PQDP y el coeficiente de correlación de Pearson entre ambos parámetros (p<0,05). Resultados. Los pacientes no tuvieron síntomas. Se determinó el VT1 y PQDP en todos ellos. La velocidad del PQDP fue de 2,6 ± 0,5 km/h y la velocidad en VT1 2,6 ± 0, 6 km/h, sin diferencias significativas entre ambos. Encontramos una correlación positiva comparando VT1 vs PQDP (r2=0,6). Conclusiones. Se pudo medir el PQDP en pacientes coronarios con una buena correlación positiva con VT1. Esta variable podría ser eficaz en el pronóstico de esta enfermedad y seguimiento con el entrenamiento físico, pero requerirá más sujetos con diferentes condiciones físicas para ser analizada como un parámetro relevante.

The anaerobic threshold has been used as a good indicator of functional capacity and prognostic implications in cardiac patients. The aim of our study was to evaluate an alternative and non invasive method like the double product break point (DPBP), as the point at which a clear and sustained increase in double product (DP) slope occurred during incremental exercise test. DP= heart rate (HR) x systolic blood pressure (SBP), that could be applied for physical training and prognosis information in patients with coronary heart disease (CHD). Material and methods. We evaluated 33 male and 9 female patients mean age 64.8 ± 7.6 years with documented CHD, clinically stables with medical treatment and sinus rhythm, in conditions to walk in a treadmill using an incremental test until exhaustion. The exercise consisted of an initial period of warm up (1 km/h) followed by the work rate being increased by 0.4 km/h each 1 minute stage to the limit of the subject’s tolerance. Oxygen consumption (VO2) was measured with a portable system (COSMED), HR trough a 12 lead ECG (SCHILLER) and blood pressure with sphygmomanometer each stage. Double product vs VO2 for each subject was submitted to 3 blind evaluators for visual determination of the ventilatory threshold (VT1) and DPBP, respectively. A Student t test was used to compare speed (km/h) at VT1 and DPBP and Pearson’s product-moment correlation to assess the relationship between both parameters (p<0.05). Results. Patients completed the evaluation without symptoms. We could determine VT1 and DPBP in all of them. Speed at DPBP was 2.6 ± 0.5 km/h and speed at VT1 2.6 ± 0.6 km/h, with no significant difference between both values. We found a positive linearship correlation comparing VT1 vs DPBP (r2=0.6). Conclusions. We could measure the DPBP in coronary patients with strong positive correlation with VT1, and could be used as effective variable in the prognosis of this disease and monitoring physical training, but it will require more subjects with different physical conditions to be analyzed as a relevant parameter.

O limiar anaeróbico tem sido usado como um indicador bom da capacidade pulmonar e das suas implicâncias em pacientes cardíacos. O objetivo da nossa pesquisa foi avaliar um método alternativo e não invasivo como o ponto de quebra do duplo produto (PQDP), expressado como o ponto de inflexão na curva do produto da frequência cardíaca (FC) e da pressão arterial sistólica (PAS) durante o exercício que poderia ser aplicada para o treinamento físico e da informação prognóstica em pacientes com doenças coronárias (DC). Material e métodos. Avaliaram-se 33 homens e 9 mulheres de média idade 64,8 ± 7,6 anos com DC documentada, clinicamente estável com tratamento médico e em ritmo sinusal. Todos eles em condições de caminhar numa esteira e, após sua adaptação, usando uma prova incremental hasta o esgotamento extremo. O exercício consistiu num período inicial de preaquecimento (1 km/h) com cargas crescentes por etapa de 0,4 km/h a cada minuto hasta o limite de tolerância do paciente. O consumo de oxigênio (VO2) foi medido com um sistema portátil (COSMED), a FC com um registro ECG de 12 derivações (SCHILLER) e a pressão arterial por esfigmomanometria em cada etapa. O duplo produto vs VO2 para cada paciente foi submetido a 3 avaliadores independentes para a determinação visual do limiar ventilatório (VT1) e PQDP, respectivamente. Uma prova de t de Student foi usada para comparar velocidade (km/h) em VT1 e PQDP e o coeficiente de correlação de Pearson entre ambos os parâmetros (p<0,05). Resultados. Os pacientes completaram a avaliação sem sintomas. Foi obtido o VT1 e PQDP para todos eles. A velocidade no PQDP foi de 2,6 ± 0,5 km/h e a velocidade em VT1 2,6 ± 0,6 km/h, sem diferenças significativas entre ambos os valores. Foi observada uma correlação positiva comparando VT1 vs PQDP (r2=0,6). Conclusões. Foi medido o PQDP em pacientes coronários com uma boa correlação positiva com VT1 e esta variável poderia ser eficaz no prognóstico de esta doença e no seguimento do treinamento físico, porém se precisara de um número maior de indivíduos com diferentes condições físicas para ser analisada como um parâmetro relevante.

Genetic characterization and authentication of Gardenia jasminoides in different regions of China by using improved RAPD analysis.

Gardenia jasminoides is a common garden medicinal plant known for its anticancer, anti-inflammatory, anti-thrombic, anti-fibrotic, antiviral, hepatoprotective, lung-protective, renal-protective, retina-protective and neuroprotective activities. It is found in several regions of the world, including China, but information about its genetic characteristics is limited. Here, we employed an improved method of random amplified polymorphic DNA (RAPD) analysis (with increased RAMP time) to investigate the genetic link between G. jasminoides samples collected from six different regions of Southern China. Total 26 RAPD primers were selected randomly, among which 23 primers generated reproducible polymorphic amplification bands. A total of 174 bands were obtained, where each primer had amplified 5-13 bands with an average of 7.56 bands per primer. The band size ranged approximately 150-2200 bp. Cluster dendrogram was obtained based on the improved RAPD amplification profiles, which showed that the similarity coefficients among six varieties of G. jasminoides ranged 0.67-0.88. To our knowledge, this is the first report of genetic characterization of G. jasminoides using improved RAPD analysis, which may be useful for the preservation of genetic diversity and identification of Gardenia population.

The FasT-Fix Repair Technique for Ramp Lesion of the Medial Meniscus

INTRODUCTION: This technical note describes a new arthroscopic technique to repair the peripheral attachment lesion of the posterior horn of the medial meniscus. The operation was performed under arthroscopy using a standard anterior portal. SURGICAL TECHNIQUE: A FasT-Fix needle was inserted obliquely close to the tibial plateau and the first implant was inserted into the joint capsule depending on its bending angle underneath the meniscus. The second implant was inserted through 1/3 periphery of the meniscus into the meniscocapsular area. The pre-tied self-sliding knot was tensioned to achieve secure fixation of the posterior meniscal peripheral attachment at the original attachment point. MATERIALS AND METHODS: From August 2011 to February 2014, 23 knees were diagnosed as ramp lesion, underwent meniscal repair using FasT-Fix technique. RESULTS: All patients were followed up for average 14 months. The Lysholm score improved from preoperative 64.4+/-4.52 to postoperative 91.2+/-4.60. CONCLUSIONS: We believe that the FasT-Fix technique via the standard anterior portal can be a more convenient and less traumatic alternative for repair of the peripheral attachment lesion of the posterior horn of the medial meniscus in the anterior cruciate ligament deficient knee.

Experimental study on the effect of RAMP1 -siRNA on CGRP-induced proliferation of MG-63 cells / 实用口腔医学杂志

Objective:To investigate the effect of blocking the expression of receptor activity modifying protein 1 (RAMP1 )on calcito-nin gene-related peptide(CGRP)-induced MG-63 cell proliferation.Methods:RAMP1 siRNA was synthesized and screened by tran-scription in vitro.The subcultured MG-63 cells were divided into the following groups:RAMP1 siRNA interference group,empty vector group and blank control group.The mRNA expression and the membrane distribution changes of the calcitonin receptor-like receptor (CRLR)and the receptor component protein (RCP)in MG-63 cells were examined by real-time PCR and immunofluorescence method respectively.Results:RAMP1 and CRLR mRNA and the fluorescence intensity of MG-63 cells decreased after transfection by RAMP1 siRNA(P <0.05).In RAMP1 interference group,the expression of RCP mRNA and the fluorescence intensity were higher than those in the other two groups(P <0.05).After RAMP1 siRNA interference,the proliferation of MG-63 cells was inhibited(P <0.05). Conclusion:RAMP1 siRNA transfection may reduce CRLR expression and inhibite the proliferation of MG-63 cell.

Technical analysis of low molecule weight heparins patents and R&D suggestions / 中国药科大学学报

@#An analysis of low molecule weight heparins(LMWH)patents throughout China and aroud the world is made. The suggestion, in terms of patent technical solution, is given to the R&D of LMWH, especially the enoxaparin, dalteprin and nadroparin.

Influence of exercise modality on agreement between gas exchange and heart rate variability thresholds

The main purpose of this study was to investigate the level of agreement between the gas exchange threshold (GET) and heart rate variability threshold (HRVT) during maximal cardiopulmonary exercise testing (CPET) using three different exercise modalities. A further aim was to establish whether there was a 1:1 relationship between the percentage heart rate reserve (%HRR) and percentage oxygen uptake reserve ( % V ˙ O 2  R ) at intensities corresponding to GET and HRVT. Sixteen apparently healthy men 17 to 28 years of age performed three maximal CPETs (cycling, walking, and running). Mean heart rate and V ˙ O 2 at GET and HRVT were 16 bpm (P<0.001) and 5.2 mL·kg-1·min-1 (P=0.001) higher in running than cycling, but no significant differences were observed between running and walking, or cycling and walking (P>0.05). There was a strong relationship between GET and HRVT, with R2 ranging from 0.69 to 0.90. A 1:1 relationship between %HRR and % V ˙ O 2  R was not observed at GET and HRVT. The %HRR was higher during cycling (GET mean difference=7%; HRVT mean difference=11%; both P<0.001), walking (GET mean difference=13%; HRVT mean difference=13%; both P<0.001), or running (GET mean difference=11%; HRVT mean difference=10%; both P<0.001). Therefore, using HRVT to prescribe aerobic exercise intensity appears to be valid. However, to assume a 1:1 relationship between %HRR and % V ˙ O 2  R at HRVT would probably result in overestimation of the energy expenditure during the bout of exercise.

Establishment and optimization of RAMP-PCR reaction system for DNA of Eupolyphaga sinensis / 中草药

Objective: To provide the basis for the genetic diversity research of Eupolyphaga sinensis by establishing and optimizing the random amplified microsatellite polymorphism RAMP-PCR reaction system and amplification procedure for genomic DNA. Methods: Phenol chloroform extraction of genomic DNA was performed on female E. sinensis. Based on RAMP Primer (ISSR807 + RAPD A5), the orthogonal test was adopted to optimize the RAMP-PCR amplification system on E. sinensis in five factors (Mg2+, dNTPs, primer, Taq DNA polymerase, and template DNA) at four levels, and the suitable anneal temperature of the primer was selected. Results: The optimal Primer (ISSR807+RAPD A5) for RAMP-PCR system (25 μL reaction volume) of E. sinensis was: 10 × PCR buffer (2.5 μL), Mg2+ (1.0 mmol/L), dNTPs (2.0 mmol/L), primer (0.5 μmol/L), Taq DNA polymerase (1 U), and template DNA (1.5 ng/μL); The optimized anneal temperature was 46.8°C. Conclusion: The established and optimized RAMP-PCR reaction system is stable and repeatable, which could provide the basis for the analysis of germplasm resources and genetic diversity of E. sinensis.

Predicted maximal oxygen consumption (VO2MAX) values obtained during the maximal treadmill test using different protocols.

Background: VO2MAX is the sole major criterion for endurance assessment. By using the regression equation the necessity of the sophisticated gas analyzer is eliminated. The usability and applicability of such equations are questioned due to non-uniformity, standardization and other variables. Methods: 100 healthy young male subjects were recruited and each performed all the four selected treadmill protocol viz. Bruce, Modified Bruce, Ellestad and Balke. VO2MAX was calculated for each person for each protocol by using regression equation. Results: Mean and SD values of VO2MAX of each protocol were, Balke (41.94 ± 2.15), Bruce (64.55 ± 6.7), Ellestad (61.17 ± 7.5), Modified Bruce (64.36 ± 5.4). There was difference among different protocols (p<0.05), except between Bruce and Modified Bruce (p>0.05). These were compared with ACSM predicted equation based on age and height (51.5+7.4). Later Paired t-test was applied. There is no statistically significant difference between the Bruce and Modified Bruce protocols. Highest difference was observed between the Balke and Bruce protocol and between Balke and Modified Bruce, as was the difference between Balke and Ellestad protocol. Conclusion: For endurance testing Ellestad protocol can be a suitable option in resource crunch settings as the Balke protocol underestimates and Bruce overestimates the VO2MAX. Devising a ramp protocol for the population subset’s need can be the best option.

Análise da marcha no plano inclinado e declinado de adultas e idosas com diferentes volumes de atividades semanais / Gait analysis on incline and decline surfaces of adult and elderly women with different volume of weekly activities

A marcha é um dos mais naturais movimentos humanos, porém com o envelhecimento, sua eficiência vai se reduzindo, principalmente durante a transposição de superfícies inclinadas, onde o risco de acidentes aumenta. OBJETIVO: Avaliar as diferenças do padrão da marcha de indivíduos idosos ativos (ATI) e sedentários (SED) em relação aos indivíduos adultos (ADU) durante a locomoção em um terreno inclinado (rampa). MÉTODOS: Quarenta e cinco indivíduos (15 ADU, 15 ATI e 15 SED) caminharam, subindo e descendo uma rampa com 10% de inclinação. A análise cinemática (Vicon MX-13) e cinética (Plataforma de Força AMTI) de variáveis relacionadas com a marcha foi realizada. RESULTADOS: Foram identificadas reduções na amplitude e potência do impulso ao redor do tornozelo dos indivíduos SED e ATI em comparação aos ADU durante a subida da rampa. Na descida, as principais diferenças entre o grupo ADU e os grupos SED e ATI foram com relação à velocidade de deslocamento, provavelmente por limitações musculares de ordem elástica, principalmente ao redor do quadril. CONCLUSÃO: Aparentemente, o nível de atividades físicas não influenciou a marcha dos SED e ATI; entretanto, uma limitação do IPAQ de conseguir classificar adequadamente diferentes níveis de atividades físicas pode ter influenciado o resultado. Futuros estudos longitudinais nos quais os indivíduos são submetidos a diferentes volumes de atividades físicas diárias são necessários para que os resultados aqui encontrados possam ser confirmados.

Walking is one of the most natural human movements; however, its efficiency decreases with age progression, mainly during the transposition of incline surfaces, where the risk of accident increases. OBJECTIVE: To evaluate the differences in gait patterns between active (ACT) and sedentary (SED) elderly compared to adult individuals (ADU) during locomotion on incline surface (ramp). METHODS: Forty-five subjects (15 ADU, 15 ACT and 15 SED) walked up and down a ramp with 10% of inclination. The kinematic (Vicon MX-13) and kinetic (Force Plate AMTI) analysis of the gait variables was performed. RESULTS: Reduction on amplitude and impulse power around SED and ACT ankle was identified during the incline gait on the ramp compared with ADU. Major differences between ADU and SED/ACT groups concerning displacement velocity during decline gait were identified, probably due to elastic muscle limitations around the hip. CONCLUSION: Apparently, the level of physical activity does not influence on the SED and ACT gait; however, an IPAQ limitation in accurately classify this level, may have affected the results. Future longitudinal studies in which individuals are submitted to different physical activity volume are necessary to confirm these findings.

Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

During cardiopulmonary exercise testing (CPET), stroke volume can be indirectly assessed by O2 pulse profile. However, for a valid interpretation, the stability of this variable over time should be known. The objective was to analyze the stability of the O2 pulse curve relative to body mass in elite athletes. VO2, heart rate (HR), and relative O2 pulse were compared at every 10 percent of the running time in two maximal CPETs, from 2005 to 2010, of 49 soccer players. Maximal values of VO2 (63.4 ± 0.9 vs 63.5 ± 0.9 mL O2•kg-1•min-1), HR (190 ± 1 vs188 ± 1 bpm) and relative O2 pulse (32.9 ± 0.6 vs 32.6 ± 0.6 mL O2•beat-1•kg-1) were similar for the two CPETs (P > 0.05), while the final treadmill velocity increased from 18.5 ± 0.9 to 18.9 ± 1.0 km/h (P < 0.01). Relative O2 pulse increased linearly and similarly in both evaluations (r² = 0.64 and 0.63) up to 90 percent of the running time. Between 90 and 100 percent of the running time, the values were less stable, with up to 50 percent of the players showing a tendency to a plateau in the relative O2 pulse. In young healthy men in good to excellent aerobic condition, the morphology of the relative O2 pulse curve is consistent up to close to the peak effort for a CPET repeated within a 1-year period. No increase in relative O2pulse at peak effort could represent a physiologic stroke volume limitation in these athletes.

Opportunities to access equal health care services for people who are heavily disabled / Монголын Анагаах Ухаан

Background. There are at least 650 million people and one out or every 10 people worldwide has a disability. In Mongolia, around 128.000 people with disabilities and 12.000 are wheelchair users. Disabilities affect people in different ways. Causing trouble to their economy, their social life, mental and daily self care.The people with disabilities in Mongolia have much difficulties for their daily activities, have limited possibilities to be included in a health and social services equally and the status to become isolated from the society of them and their families are the invariable problem for them.Goal. To study and evaluate the daily embarrassments and problems of the disabled people and the standard medical environment for them.Results. The 55.8% were male and 4.2% were female of the participants in the survey 88.4% of them answered that they can use their wheelchairs in even land and square only. The 76.4% of the participants do not use public transportation and there is no road for the wheelchair users, no ramp is planned for the citizens with wheelchairs in service centers and organizations and so these are the facing problems for the disabled citizens in Mongolia.It demonstrates that the standard for the disabled citizens is not considered in the medical environmental standards seemingly from no ramp is planned for the citizens with wheelchairs in 92% of the hospitals, no elevator for the citizens with wheelchairs in 91% of the hospitals, 88% of the hospitals have not equipped their toilets with the equipments for the disabled citizens, and 91 % of the hospitals have not planned a room for the disabled citizens for the hospitals included in the surveys.Conclusions:1. Wheelchair users mostly dependent for daily and creative activities. Also they have limited social opportunities because there is no appropriate environment.2. Hospitals involved in the research showed that disabled people have limited health services, hospital environmental standard is not appropriate for them and 1,2 and 3 level of hospitals must setup infrastructure for the disabled people.

Long-term stability of the oxygen pulse curve during maximal exercise

INTRODUCTION: Exercise oxygen pulse (O2 pulse), a surrogate for stroke volume and arteriovenous oxygen difference, has emerged as an important variable obtained during cardiopulmonary exercise testing. OBJECTIVES: We hypothesized that the O2 pulse curve pattern response to a maximal cycling ramp protocol exhibits a stable linear pattern in subjects reevaluated under the same clinical conditions. METHODS: We retrospectively studied 100 adults (80 males), mean age at baseline of 59 + 12 years, who performed two cardiopulmonary exercise testings (median interval was 15 months), for clinical and/or exercise prescription reasons. The relative O2 pulse was calculated by dividing its absolute value by body weight. Subjects were classified into quintiles of relative O2 pulse. Cardiopulmonary exercise testing results and the O2 pulse curve pattern, expressed by its slope and intercept, were compared among quintiles of relative O2 pulse at both cardiopulmonary exercise testings. RESULTS: After excluding the first minute of CPX (rest-exercise transition), the relative O2 pulse curve exhibited a linear increase, as demonstrated by high coefficients of determination (R² from 0.75 to 0.90; p<0.05 for all quintiles). Even though maximum oxygen uptake and relative O2 pulse were significantly higher in the second cardiopulmonary exercise testing for each quintile of relative O2 pulse (p<0.05 for all comparisons), no differences were found when slopes and intercepts were compared between the first and second cardiopulmonary exercise testings (p>0.05 for all comparisons; except for intercept in the 5th quintile). CONCLUSION: Excluding the rest-exercise transition, the relative O2 pulse exhibited a stable linear increase throughout maximal exercise in adults that were retested under same clinical conditions.

The slope of the oxygen pulse curve does not depend on the maximal heart rate in elite soccer players

INTRODUCTION: It is unknown whether an extremely high heart rate can affect oxygen pulse profile during progressive maximal exercise in healthy subjects. OBJECTIVE: Our aim was to compare relative oxygen pulse (adjusted for body weight) curves in athletes at their maximal heart rate during treadmill cardiopulmonary exercise testing. METHODS: A total of 180 elite soccer players were categorized in quartiles according to their maximum heart rate values (n = 45). Oxygen consumption, maximum heart rate and relative oxygen pulse curves in the extreme quartiles, Q1 and Q4, were compared at intervals corresponding to 10 percent of the total duration of a cardiopulmonary exercise testing. RESULTS: Oxygen consumption was similar among all subjects during cardiopulmonary exercise testing; however subjects in Q1 started to exhibit lower maximum heart rate values when 20 percent of the test was complete. Conversely, the relative oxygen pulse was higher in this group when cardiopulmonary exercise testing was 40 percent complete (p<.01). Although the slopes of the lines were similar (p = .25), the regression intercepts differed (p<.01) between Q1 and Q4. During the last two minutes of testing, a flat or decreasing oxygen pulse was identified in 20 percent of the soccer players, and this trend was similar between subjects in Q1 and Q4. CONCLUSION: Relative oxygen pulse curve slopes, which serve as an indirect and non-invasive surrogate for stroke volume, suggest that the stroke volume is similar in young and aerobically fit subjects regardless of the maximum heart rate reached.