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BACKGROUND: The purpose of this study was to introduce the mechanism and clinical application of muscular atrophy that is a hotspot in the 65th Annual Meeting of American College of Sports Medicine and the 9th World Conference on Exercise Is Medicine and the World Conference of Basic Science of Muscle Hypertrophy and Atrophy. OBJECTIVE: To summarize and analyze the frontiers and hotspots of research findings on muscular atrophy, in order to provide new ideas for further research of exercise improving muscle function and the mechanism and application in this field, and provide a reference for the study on sports science, sports medicine, and sports rehabilitation in China. METHODS: Related reports and cutting-edge research findings in 65th Annual Meeting of American College of Sports Medicine were collected. Meanwhile, PubMed database between January 1993 and August 2018 was retrieved. The keywords were "skeletal muscle, muscle atrophy, movement and muscle, resistance movement". Thirty-five articles related to the molecular mechanism and clinical application of muscle atrophy were included for analysis and discussion. RESULTS AND CONCLUSION: The World Congress is a unique opportunity to bring together interdisciplinary investigators for the most comprehensive meeting ever held on this topic. The program will include a keynote lecture, tutorials, and symposia from leading experts. The meeting focused on the intrinsic and extrinsic variables that regulate skeletal muscle hypertrophy and atrophy. How exercise brings about skeletal muscle atrophy and its application in clinical problems such as aging, disease, injury, chronic diseases, and how these changes may relate to chronic disease were discussed as well. The research on muscle hypertrophy is mostly concentrated in the field of competitive sports.
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To analyze the correlation between transcutaneous oxygen pressure (PtcO2) and blood lactate in patients with septic shock. Fifty-sixpatients with septic shock were prospectively investigated. PtcO2 was monitored continuously for 6 hours, and arterial blood gas was measured at baseline (T0) and 6 hours (T6). Records of PtcO2, were analyzed for the correlation with lactate level and lactate clearance rate. PtcO2 valuesin the high lactate clearance group and the low one were compared.The lowest value of PtcO2 at T6 and duration of PtcO2<40 mmHg (1 mmHg=0.133 kPa) were both correlated with lactate level and lactate clearance rateat T6. The low predictive value of PtcO2 was 29 mmHg of lactate clearance under 20％with a sensitivity 85.2％and a specificity 65.5％. The low predictive value of PtcO2 in high lactate clearance group was significantly higher than that in low lactate clearance group, while the duration of PtcO2<40 mmHg was shorter than the latter. During 6 h continuous monitoring, patients with a significant low PtcO2 or prolonged duration of low PtcO2 have relatively high lactate or low lactate clearance after resuscitation.
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Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.