Characteristics of retinal microcirculation after phacoemulsification and factors affecting visual acuity / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the changes of retinal microcirculation after phacoemulsification and the influencing factors of visual acuity.METHODS: Retrospective analysis. A total of 264 cataract patients(264 eyes)who underwent phacoemulsification in our hospital from January 2022 to December 2022 were selected as the study objects. Patients were divided into < 0.3 group(66 eyes)and ≥0.3 group(198 eyes)according to the recovery of best corrected visual acuity(BCVA)at 3 mo after surgery. The changes of retinal microcirculation indexes were compared before and after treatment. Logistic regression and LASSO regression models were used to screen the influencing factors of postoperative BCVA. A nomogram prediction model of postoperative BCVA was constructed and verified. A restricted cubic spline Logistic regression model was established to analyze the dose-response relationship between end-diastolic velocity(EDV), peak systolic velocity(PSV)and the risk of BCVA recovery.RESULTS: At 3 mo postoperatively, EDV and PSV were significantly improved compared with those before treatment, and resistance index(RI)levels were significantly lower than those before treatment(all P<0.05). Preoperative EDV, PSV, aqueous humor cell grade, fundus lesion grade, advanced age and Emery grade were influencing factors for poor BCVA recovery after phacoemulsification in cataract patients(P<0.05). The AUC before and after validation of the nomogram model by Bootstrap method were 0.869(95%CI: 0.815-0.903)and 0.866(95%CI: 0.802-0.895), respectively. The sensitivity was 88.36% and 88.27%, and the specificity was 91.82% and 91.78%, respectively. Restricted cubic spline model analysis showed no nonlinear dose-response relationship between EDV and PSV levels and the risk of poor BCVA recovery in either male or female(P>0.05).CONCLUSION: After phacoemulsification, retinal microcirculation in cataract patients improved significantly. EDV, PSV, aqueous humor cell grade, fundus lesion grade, advanced age and Emery grade are all factors influencing poor BCVA recovery after cataract surgery.

Functional and Hemodynamic Efficacy of Non-Poliferative Diabetic Retinopathy Treatment by Endonasal Electrophoresis of Tanakan

Aims: To study the effectiveness of the treatment of patients with non-proliferative diabetic retinopathy by tanakan endonasal electrophoresis according to functional and hemodynamic data.Study Design: Cross-sectional comparative analysis.Place and Duration of Study: Department of Ophthalmology, clinic of Tashkent Medical Academy, between 2017 and 2020.Methodology: We included 66 patients (123 eyes), 23 men and 43 women; age range 18-75 years with non-proliferative diabetic retinopathy. The patients were divided into 2 groups: to receive daily tablets of Tanakan (control), or daily endonasal electrophoresis of Tanakan (main) within ten days. Before and after the course of therapy, the patients underwent determination of visual acuity, Doppler ultrasound imaging of the eye and computer static perimetry.Results: Improvements in visual acuity were observed in 87,3% of the main group patients, and in 22% of the control group. Statistically significant increase in blood flow velocity and a decrease in the resistance index were observed in the main group (P < 0.05). Retinal photosensitivity increased by 22% in the main group, and by 10% in the control group. The mean deviation from the age norm decreased by 33% in the main group and by 12% in the control group. Among the patients of the main group, 30% experienced a decrease in absolute scotomas and 100% in relative scotomas. Among the patients of the control group, 21% and 83% experienced a decrease in absolute and relative scotomas, respectively.Conclusion: Treatment with tanakan endonasal electrophoresis significantly improved visual acuity, eye hemodynamics, and retinal photosensitivity. This treatment is more effective than the traditional use of ginkgo- biloba tablets.

Anti-infectious pneumonia target discovery and molecular mechanism study of Jingfang Granules / 中国中药杂志

This study aimed to identify the direct pharmacological targets of Jingfang Granules in treating infectious pneumonia via "target fishing" strategy. Moreover, the molecular mechanism of Jingfang Granules in treating infectious pneumonia was also investigated based on target-related pharmacological signaling pathways. First, the Jingfang Granules extract-bound magnetic nanoparticles were prepared, which were incubated with lipopolysaccharide(LPS)-induced mouse pneumonia tissue lysates. The captured proteins were analyzed by high-resolution mass spectrometry(HRMS), and the target groups with specific binding to the Jingfang Granules extract were screened out. Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analysis was used to identify the target protein-associated signaling pathways. On this basis, the LPS-induced mouse model of infectious pneumonia was established. The possible biological functions of target proteins were verified by hematoxylin-eosin(HE) staining and immunohistochemical assay. A total of 186 Jingfang Granules-specific binding proteins were identified from lung tissues. KEGG pathway enrichment analysis showed that the target protein-associated signaling pathways mainly included Salmonella infection, vascular and pulmonary epithelial adherens junction, ribosomal viral replication, viral endocytosis, and fatty acid degradation. The target functions of Jingfang Granules were related to pulmonary inflammation and immunity, pulmonary energy metabolism, pulmonary microcirculation, and viral infection. Based on the in vivo inflammation model, Jingfang Granules significantly improved the alveolar structure of the LPS-induced mouse model of infectious pneumonia and down-regulated the expressions of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6). Meanwhile, Jingfang Gra-nules significantly up-regulated the expressions of key proteins of mitochondrial function COX Ⅳ and ATP, microcirculation-related proteins CD31 and Occludin, and proteins associated with viral infection DDX21 and DDX3. These results suggest that Jingfang Gra-nules can inhibit lung inflammation, improve lung energy metabolism and pulmonary microcirculation, resist virus infection, thus playing a protective role in the lung. This study systematically explains the molecular mechanism of Jingfang Granules in the treatment of respiratory inflammation from the perspective of target-signaling pathway-pharmacological efficacy, thereby providing key information for clinical rational use of Jingfang Granules and expanding potential pharmacological application.

The application value of tibial transverse transport microvascular reconstruction combined with antibiotic bone cement in the limb salvage of diabetic foot / 中国医师进修杂志

Objective:To analyze the application value of tibial transverse transport (TTT) microvascular reconstruction combined with antibiotic bone cement in the limb salvage of diabetic foot.Methods:Seventy-seven patients with diabetic foot admitted to the Traditional Chinese Medicine Hospital of Zhongshan from January 2018 to January 2021 were enrolled retrospectively, and they were divided into the control group (performed TTT microvascular reconstruction, 47 cases) and the combined group (performed TTT microvascular reconstruction combined with antibiotic bone cement, 30 cases) according to the surgical method. Wound healing rate, limb salvage rate, the ulcer healing time, bone window healing time, wound infection control status, affected side lower limb vascular blood supply situation, and peripheral nerve function recovery were compared between the two groups.Results:The amputation rate between the two groups had no significant difference ( P>0.05), but the healing rate in the combined group was higher than that in the control group: 90.00%(27/30) vs. 68.08%(32/47); and the ulcer healing time, bone window healing time in the combined group were shorter than those in the control group: (12.55 ± 2.14) weeks vs. (15.01 ± 3.17) weeks, (17.47 ± 2.09) weeks vs. (19.00 ± 2.58) weeks, there were statistical differences ( P<0.05). The positive percentage of bacteria culture in wound secretions in the combined group after the surgery for 6 d was lower than that in the control group: 20.00%(6/30) vs. 44.68%(21/47), there was statistical difference ( P<0.05). After the surgery for 3 months, the dorsal skin temperature and ankle brachial index in the combined group were higher than those in the control group: (31.05 ± 1.74) ℃ vs. (29.27 ± 1.66) ℃, 0.93 ± 0.29 vs. 0.80 ± 0.19, there were statistical differences ( P<0.05), but the scores of visual analog scale (VAS) and 10 g nylon line test values between the two groups had no significant differences ( P>0.05). Conclusions:TTT combined with antibiotic bone cement can achieve better wound healing and infection control effect in the limb salvage of diabetic foot, and the blood supply improvement of the affected limb is more significant.

Relationship between posterior staphyloma and fundus structure and microcirculation in high myopia / 中华实验眼科杂志

Posterior staphyloma (PS) refers to the local abnormal bulge of the posterior wall of the eyeball, which is one of the common pathological changes in high myopia.The appearance of PS is often accompanied by changes in fundus microstructure such as sclera, choroid and Bruch membrane.The abnormality of fundus microstructure leads to the decrease of its resistance to the expansion of ocular axis, or causes the remodeling of tissue structure in the corresponding area, resulting in the change of microvascular structure, and then giving rise to abnormal blood circulation in the posterior pole.The microcirculatory changes may be followed by changes in fundus microstructure, seriously affecting the visual acuity of the affected eyes.There is still no clear conclusion on the pathogenesis of PS in the world, and there are no good preventive measures or treatment methods.This article reviewed and summarized the interaction between PS, fundus structure and microcirculation in high myopia, so as to provide a theoretical basis for exploring the pathogenesis, prevention and treatment of PS and improving the visual function of high myopia.

The guiding role of microcirculation monitoring in the treatment of septic shock / 中国小儿急救医学

Septic shock is the most critical stage of sepsis, and the core of the treatment is improving tissue hypoperfusion.In addition to the improvement of large circulation by fluid resuscitation, the microcirculation also need to be improved, then proper vasoactive drugs should be applied to different types of shock to meet the needs of the body for perfusion.The condition of septic shock progresses rapidly, and the microcirculation in different pathophysiological stages is different, which increases the difficulty of rational use of vasoactive drugs.Monitoring and accurate evaluation of peripheral microcirculation may provide guidance for individualized treatment of septic shock.

Discussion on the mechanism of Yanghe Decoction in treating chronic osteomyelitis based on network pharmacology and molecular docking / 国际中医中药杂志

Objective:To study the active components and their potential mechanism of Yanghe Decoction for the treatment of chronic osteomyelitis (CO) via the methods of network pharmacology and molecular docking.Methods:Active components and action targets of Yanghe Decoction were screened from TCMSP, BATMAN-TCM and relevant literature. GeneCards, OMIM, DisGeNET, and PharmGKB databases were used to predict the targets for the CO. Cytoscape 3.8.0 software and STRING database were used to build the networks of "Chinese materia medica-active components-potential targets" and "protein-protein interaction", and according to topological parameters in the network, the core active components as well as Hub genes were screened. MCODE plug was used to accomplish clustering analysis of protein modules in PPI network. Then, intersection targets were enriched and analyzed by GO and KEGG in KOBAS database. Finally, molecular docking was carried out with the help of Autodock tool platform to predict the binding ability between the main active components and key targets.Results:A total of 120 active components of Yanghe Decoction and 402 targets were obtained; 1 464 CO-related targets were screened, and there were 103 intersection target genes of Yanghe Decoction-CO, 110 active components related to intersection targets, which mainly contained some flavonoids and Phytosterols, such as quercetin, Kaempferol, and Beta-Sitosterol. There were 9 Hub genes, including TNF, IL6, AKT1, etc., and 4 protein modules which involved the regulation of immune inflammatory response, vascular microcirculation, bone development, and formation, material synthesis and metabolism and other physiological processes. 193 signaling pathways and 1 552 GO results were acquired in KOBAS database. Molecular docking results showed that the active compounds had good binding activity with key targets based on the minimum binding energy of less than - 5 kcal/mol.Conclusion:The mechanism in the treatment of CO with Yanghe Decoction is a complex process of multiple components, multiple targets, and multiple pathways. It mainly regulates targets such as TNF, IL-6, CXCL8, VEGFA, and AKT1 through pathways such as TNF signaling pathway, IL-17 signaling pathway, and Toll-like receptors, participating in local inflammatory reactions, microcirculation, and bone cell metabolism in chronic osteomyelitis, and interfering with the immune escape mechanism of pathogenic bacteria.

Relationship among fasting plasma glacose coefficient of variation and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the relationship among the fasting plasma glucose coefficient of variation(FPG-CV)and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy(NPDR).METHODS: A retrospective analysis of 82 cases(82 eyes)with NPDR admitted to our hospital from February 2018 to June 2022 was the research object, and another 82 cases(82 eyes)of non-diabetic retinopathy(NDR)patients during the same period were selected as the control group, and the clinical data of the two groups of patients were analyzed. Multivariate Logistic regression was used to analyze the risk factors affecting the incidence of NPDR, and the back propagation(BP)neural network model was established and evaluated. Pearson correlation was used to analyze the correlation among FPG-CV and macular morphology and microcirculation in patients. RESULTS: The results of multivariate Logistic regression analysis showed that the disease duration ≥7.2a, glycated hemoglobin A1c(HbA1c)≥7.7%, triglyceride(TG)≥1.9 mmol/L, microalbuminuria(MALB)≥24.5 mg/L, FPG-CV ≥9.8%, superficial capillary plexus-vessel density(SCP-VD)&#x0026;#x003C;27.6%, deep capillary plexus-vessel density(DCP-VD)&#x0026;#x003C;47.7%, foveal avascular zone(FAZ)area ≥0.38 mm2, central retinal thickness(CRT)≥197.7 μm and subfoveal choroidal thickness(SFCT)&#x0026;#x003C;227.7 μm were risk factors for NPDR(P&#x0026;#x003C;0.05). The number of hidden layer nodes is 5, and the receiver operating characteristic(ROC)curve, calibration curve and clinical decision curve show that the prediction model has good discrimination, accuracy and validity. The results of Pearson correlation analysis showed that FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT(P&#x0026;#x003C;0.05); FPG-CV was positively correlated with FAZ area and CRT(P&#x0026;#x003C;0.05).CONCLUSION: The course of disease, HbA1c, TG, MALB, FPG-CV, SCP-VD, DCP-VD, FAZ area, CRT and SFCT are all related to the pathogenesis of NPDR. With the increase of FPG-CV, the indexes of macular morphology and microcirculation changed. FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT and positively correlated with FAZ area and CRT.

Progress in the role of peritubular capillary injury in kidney transplantation / 器官移植

Kidney is a highly vascularized organ and peritubular capillary network constitutes the critical component of its microvascular system. Peritubular capillaries, as the main vessels for blood supply in renal tubules and renal interstitium, involve in important physiological processes in renal tubules such as energy metabolism, substance secretion and reabsorption. In recent years, it has been demonstrated that ischemia-reperfusion injury, rejection and renal fibrosis during kidney transplantation would result in compromised structural integrity and decreased number in peritubular capillaries, thus leading to interstitial fibrosis in renal allograft, which would seriously affect the long-term stability of renal function in the renal allograft. Therefore, we reviewed the structure and function of peritubular capillary, peritubular capillary and ischemia-reperfusion injury, rejection and renal allograft fibrosis, focusing on the mechanism for peritubular capillary injury in kidney transplantation and the specific changes manifested, with the aim of providing a reference for preventing and treating perioperative complications in kidney transplantation and improving the long-term prognosis of grafts.

Pathogenesis and Treatment of Coronary Microvascular Disease in Traditional Chinese and Western Medicine： A Review / 中国实验方剂学杂志

In recent years， coronary microvascular disease （CMVD）， a main type of ischemic heart disease with high incidence and low diagnosis rate， has become a new research hotspot and received much clinical attention. The etiology of CMVD is complex and the symptoms are various. Traditional Chinese and Western medicine have different opinions on its pathogenesis and treatment plan. Western medicine believes that CMVD is related to structural abnormalities （such as microvascular remodeling， vascular invasion， lumen obstruction， sparse vascular vessel and perivascular fibrosis） and functional abnormalities （such as endothelial dysfunction， smooth muscle cell dysfunction， microvascular constriction， microvascular spasm， inflammation and autonomic nervous dysfunction） of coronary microvascular vessels as well as the extravascular factors （such as heart rate and blood pressure）. In clinics， conventional western medicines are usually used for empirical treatment， but with undesirable effects. Traditional Chinese medicine （TCM） believes that CMVD belongs to the category of "chest impediment"， "heart pain" and "collateral disease"， and the common syndromes include Qi deficiency and blood stasis， Qi stagnation and blood stasis， Qi and Yin deficiency， congealing cold in heart vessel， heart and spleen deficiency， blood stasis obstructing collaterals， combined phlegm and blood stasis， and liver and kidney deficiency， with a variety of treatment methods. Specifically， Chinese patent medicines， self-designed prescriptions， modified classical prescriptions and TCM characteristic therapies have achieved certain effects. This review discussed the risk factors， pathological mechanism， TCM etiology and pathogenesis and traditional Chinese and Western medicine treatment of CMVD， to provide reference for the study and treatment of CMVD.

The skin surface microcirculation of conception vessel, governor vessel and thoroughfare vessel in patients with primary dysmenorrhea / 中国针灸

OBJECTIVE@#To observe the skin surface microcirculation of acupoints of conception vessel, governor vessel and thoroughfare vessel in patients with primary dysmenorrhea using laser speckle contrast imaging (LSCI), and provide acupoint selection basis of acupuncture-moxibustion for primary dysmenorrhea.@*METHODS@#Ninety-nine healthy female college students with regular menstrual cycles (normal group) and 94 female college students with primary dysmenorrhea (dysmenorrhea group) were recruited. Before menstrual period, on the first day of menstruation, and on the third day after menstruation, LSCI was used to observe the surface microcirculation at the abdominal acupoints of conception vessel, i. e. Yinjiao (CV 7), Qihai (CV 6), Shimen (CV 5), Guanyuan (CV 4), Zhongji (CV 3) and Qugou (CV 2), acupoints of thoroughfare vessel, i. e. Huangshu (KI 16), Zhongzhu (KI 15), Siman (KI 14), Qixue (KI 13), Dahe (KI 12), Henggu (KI 11) and acupoints of lumbosacral region of governor vessel, i. e. Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3), Yaoshu (GV 2) as well as two non-acupoints.@*RESULTS@#Before menstrual period, there was no significant difference in the surface blood perfusion of the acupoints between the dysmenorrhea group and the normal group (P>0.05). On the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) and right Huangshu (KI 16) in the dysmenorrhea group was higher than that in the normal group (P<0.05, P<0.01). On the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) in the dysmenorrhea group was lower than that in the normal group (P<0.05).@*CONCLUSION@#In patients with primary dysmenorrhea, on the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) of governor vessel, and the right Huangshu (KI 16) of thoroughfare vessel is increased, while on the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) of thoroughfare vessel is decreased. These findings might provide a basis for acupoint selection in the acupuncture-moxibustion treatment of primary dysmenorrhea.

Quantitative analysis of macular microcirculation changes in diabetic retinopathy patients by optical coherence tomography angiography / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the macular microcirculation changes in patients with diabetic retinopathy(DR)by optical coherence tomography angiography(OCTA), and correlate the risk factors that may affect the macular microcirculation, so as to provide a clinical basis for early screening, diagnosis and therapeutic intervention for DR.METHODS: Retrospective study. A total of 75 patients(75 eyes)with type 2 diabetes mellitus(DM)who came to the ophthalmology outpatient clinic and ward of Xi'an Central Hospital from May to October 2022 were collected, and the DM patients were further divided into non-DR(NDR)group, non-proliferative DR(NPDR)group and proliferative DR(PDR)group, with 28 eyes, 25 eyes and 22 eyes in each group respectively. OCTA was applied to perform a 3mm×3mm blood flow imaging scan of the macular retina to automatically obtain the vascular density(VD)of the superficial retinal macular foveal, the parafoveal(1～3mm), as well as the macular 3mm×3mm and the area of macular foveal avascular zone(FAZ). Furthermore, the alteration of these parameters in patients with different degrees of DR was analyzed.RESULTS: Compared with the NDR group, the VD of the 3mm×3mm superficial retinal capillary(SCP)in the macular region was decreased in both PDR and NPDR group(all P&#x003C;0.017), and the VD of the parafoveal was decreased in each quadrant(P&#x003C;0.017), with the most significant decrease in the PDR group. The FAZ area of patients in the PDR and NPDR groups was significantly larger than that in the NDR group(P&#x003C;0.017). Age, homocysteine, best corrected visual acuity(LogMAR), axial length and glycosylated hemoglobin(HbA1c)of patients with DR were negatively correlated with VD in the macular foveal(P&#x003C;0.05), while homocysteine, best corrected visual acuity(LogMAR), axial length, and the duration of diabetes were negatively correlated with VD in the macular 3mm×3mm(P&#x003C;0.05). Triglycerides, best corrected visual acuity(LogMAR), and HbA1c were negatively correlated with VD in the parafoveal(P&#x003C;0.05), while total cholesterol and central macular thickness had no significant correlation with VD(P&#x003E;0.05).CONCLUSION: The microcirculation changes in the macular area of DR patients can be monitored by OCTA, and the systemic condition of DR patients is closely related to their macular microcirculation.

Changes of Macular Microcirculation After Near Work in Myopic Patients / 中山大学学报(医学科学版)

ObjectiveTo compare the changes of retinal microcirculation indexes in the anterior and posterior macular areas of the eyes used at close range and to explore the possible causes of myopia affected by near work. MethodsWatching mobile phone video for 1 hour at close range was used as the method of defining near work. The OCTA technology was used to measure the superficial retinal microcirculation indexes within 6 by 6 mm macular area before and after near work， including the superficial retinal VLD from the nerve fiber layer to the inner boundary of the outer plexiform layer， the VPD， nonperfusion area of FAZ， FAZ-P and FAZ circulation，. The FAZ was divided int center， inner layer， outer layer and overall according to the region， and 11 microcirculation indexes were obtained to compare the differences between before and after near work. ResultsThe indexes of superficial retinal microcirculation in the macular area generally decreased after near work， except for FAZ-A and FAZ-P（P = 0.148， 0.975）. The largest differences among both VLD and VPD occurred between the central and inner layer（Difference = 1.00， 0.80， 0.02， 0.02，P = 0.001， 0.008， 0.001， 0.008）. No differences in microcirculation indexs were observed in the macular area after near work with different diopters and axial lengths. ConclusionNear work may affect the occurrence and development of myopia by affecting the changes of retinal microcirculation in the superficial layer of macula， leading to ischemia and hypoxia.

Discussion on Coronary Microcirculation Disorder after Myocardial Ischemia Reperfusion Based on “Collaterals-Sweat Pore Qi and Fluid” Theory / 中医杂志

Coronary microcirculation disorder after myocardial ischemia reperfusion （MIR） is a prominent problem in the treatment of coronary heart disease. According to the physiological commonality between “collaterals-sweat pore qi and fluid” and coronary microcirculation， and the evolution of the course of MIR， it is believed that “heart collateral stasis obstruction， sweat pore constraint and block” is the cause of coronary microcirculation disorder. The evolution of the pathogenesis can be divided into three periods. During the myocardial ischemia period， the pathogenesis is heart collaterals obstruction and sweat pores empty， while during the ischemia reperfusion period， it is internal formulation of deficiency wind， spasms of collaterals or slight heart collaterals obstruction； in the coronary microcirculation disorder period， sweat pores constraint and block， constraint transforming into heat， qi and fluid failing to diffuse are the pathogenesis. The corresponding treatment principle is assisting dredge with supplementation， and supplementing deficiency to dispel stasis； treating wind and blood simultaneously， and extinguishing wind to arrest convulsion； clearing heat and cooling blood， and diffusing qi and unblocking qi and fluid. Moreover， it is recommended to treat the heart and lungs simultaneously， and regulate the heart and liver at the same time.

Effect of aerobic exercise on microcirculation in sedentary college students / Efeito do exercício aeróbico sobre a microcirculação em estudantes universitários sedentários / Efecto del ejercicio aeróbico sobre la microcirculación en estudiantes universitarios sedentarios

ABSTRACT Introduction Due to economic development and technological progress, more attention has been given to intellectual education in detriment of physical conditioning, a phenomenon that has corroborated to raise obesity to a contemporary concern in public health. In this sense, studies that can provide reference to guide the scientific sport intervention behavior of college students are the focus of the current research. Objective Explore the effect of different doses of aerobic exercise on microcirculation function in sedentary college students. Methods 69 students from Minzu University were recruited and randomly divided into exercise groups A, B and control. The exercise group received 12 weeks of aerobic exercise intervention. Among them, group A practiced 1-2 times per week, group B practiced ≥ 3 times per week. The control group did not practice any sport. Results After testing, microvascular reactivity showed an interaction to group and time (p<0.01). Among them, exercise group B was higher than control group and exercise group A (p<0.01), with no significant differences between exercise group A and control group (p>0.05). Conclusion Aerobic exercise affects body microvascular response and endogenous NO level. Aerobic exercise lasting 12 weeks with frequency equal to or greater than three times per week can improve the microvascular response of sedentary college students by promoting endogenous NO production. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução Com o desenvolvimento econômico e o progresso tecnológico, mais atenção foi dada à educação intelectual em detrimento do condicionamento físico, fenômeno que corroborou para elevar a obesidade a uma preocupação contemporânea na saúde pública. Nesse sentido, estudos que possam fornecer referência para orientar o comportamento de intervenção esportiva científica de estudantes universitários são o foco da pesquisa atual. Objetivo Explorar o efeito de diferentes doses de exercício aeróbico sobre a função da microcirculação em estudantes universitários sedentários. Métodos Foram recrutados 69 estudantes da Universidade de Minzu, divididos aleatoriamente em grupos de exercícios A, B e controle. O grupo de exercícios recebeu 12 semanas de intervenção de exercícios aeróbicos. Entre eles, o grupo A praticou 1-2 vezes por semana, o grupo B praticou ≥ 3 vezes por semana. O grupo controle não praticou nenhum esporte. Resultados após o teste, a reatividade microvascular mostrou uma interação ao grupo e ao tempo (p<0,01). Entre eles, o grupo de exercícios B foi superior que o grupo controle e o grupo de exercícios A (p<0,01), sem diferenças significativas entre o grupo de exercícios A e o grupo controle (p>0,05). Conclusão O exercício aeróbico afeta a resposta microvascular corporal e o nível endógeno de NO. O exercício aeróbico com duração de 12 semanas com frequência igual ou superior de três vezes por semana pode melhorar a resposta microvascular de estudantes universitários sedentários, promovendo a produção de endógenos NO. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción Con el desarrollo económico y el progreso tecnológico, se prestó más atención a la educación intelectual en detrimento del acondicionamiento físico, fenómeno que corroboró elevar la obesidad a una preocupación contemporánea en la salud pública. En este sentido, los estudios que pueden servir de referencia para orientar el comportamiento científico de intervención deportiva de los estudiantes universitarios son el centro de la investigación actual. Objetivo Explorar el efecto de diferentes dosis de ejercicio aeróbico sobre la función microcirculatoria en estudiantes universitarios sedentarios. Métodos Se reclutaron 69 estudiantes de la Universidad de Minzu y se dividieron aleatoriamente en los grupos de ejercicio A, B y control. El grupo de ejercicio recibió 12 semanas de intervención de ejercicio aeróbico. Entre ellos, el grupo A practicaba 1-2 veces por semana, el grupo B practicaba ≥ 3 veces por semana. El grupo de control no practicó ningún deporte. Resultados Tras las pruebas, la reactividad microvascular mostró una interacción con el grupo y el tiempo (p<0,01). Entre ellos, el grupo de ejercicio B fue superior al grupo de control y al grupo de ejercicio A (p<0,01), sin diferencias significativas entre el grupo de ejercicio A y el grupo de control (p>0,05). Conclusión El ejercicio aeróbico afecta a la respuesta microvascular corporal y al nivel de endógeno NO. El ejercicio aeróbico de 12 semanas de duración con una frecuencia igual o superior a tres veces por semana puede mejorar la respuesta microvascular de los estudiantes universitarios sedentarios al promover la producción endógena de NO. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study / Relação entre reserva microvascular isquêmica periférica, hiperlactatemia persistente e sua dinâmica temporal na sepse: um estudo post hoc

ABSTRACT Objective: To measure the prognostic value of peripheral ischemic microvascular reserve in the context of persistent sepsis-induced hyperlactatemia and measure its influence on the temporal dynamics of lactate and the strength of association between these variables. Methods: This post hoc analysis of the peripheral perfusion index/postocclusive reactive hyperemia trial, an observational cohort study that enrolled patients with sepsis who persisted with lactate levels ≥ 2mmol/L after fluid resuscitation (with or without shock). Peripheral ischemic microvascular reserve was evaluated using the association of the peripheral perfusion index and postocclusive reactive hyperemia techniques. The cutoff point of ∆ peripheral perfusion index peak values (%) defined the groups with low (≤ 62%) and high peripheral ischemic microvascular reserve (> 62%). Results: A total of 108 consecutive patients with persistent sepsis-induced hyperlactatemia were studied. The high peripheral ischemic microvascular reserve group showed higher 28-day mortality than the low peripheral ischemic microvascular reserve group (p < 0.01). The temporal dynamics of lactate within the first 48 hours showed a rapid decrease in lactate levels in the low peripheral ischemic microvascular reserve group (p < 0.01). However, this result was not reproduced in the linear mixed effects model. A weak correlation between peripheral ischemic microvascular reserve (%) and lactate level (mmol/L) was observed within the first 24 hours (r = 0.23; p < 0.05). Conclusion: The prognostic value of high peripheral ischemic microvascular reserve was confirmed in the context of persistent sepsis-induced hyperlactatemia. Although there was a weak positive correlation between peripheral ischemic microvascular reserve value and lactate level within the first 24 hours of sepsis diagnosis, the low peripheral ischemic microvascular reserve group appeared to have a faster decrease in lactate over the 48 hours of follow-up.

RESUMO Objetivo: Avaliar o valor prognóstico da reserva microvascular isquêmica periférica no contexto da hiperlactatemia persistente induzida pela sepse, determinar sua influência na dinâmica temporal de lactato e analisar a força da associação entre essas variáveis. Métodos: Análise post hoc do estudo de índice de perfusão periférica/hiperemia reativa pós-oclusiva caracterizada por uma coorte observacional que incluiu pacientes com sepse que persistiram com níveis de lactato ≥ 2mmol/L após a ressuscitação volêmica (com ou sem choque). A reserva microvascular isquêmica periférica foi mensurada utilizando-se a associação dos métodos do índice de perfusão periférica e hiperemia reativa pós-oclusiva. O ponto de corte dos valores da ∆ índice de perfusão periférica de pico (%) definiu os grupos com baixa (≤ 62%) e alta (> 62%) reserva microvascular isquêmica periférica. Resultados: Estudaram-se 108 pacientes consecutivos com hiperlactatemia persistente induzida pela sepse. O grupo com alta reserva microvascular isquêmica periférica apresentou maior mortalidade aos 28 dias em relação ao grupo com baixa reserva microvascular isquêmica periférica (p < 0,01). A dinâmica temporal de lactato nas primeiras 48 horas mostrou redução rápida dos níveis de lactato no grupo com baixa reserva microvascular isquêmica periférica (p < 0,01). No entanto, esse resultado não foi reproduzido no modelo de efeitos mistos lineares. Observou-se fraca correlação (%) entre os valores da reserva microvascular isquêmica periférica e níveis de lactato (mmol/L) nas primeiras 24 horas (r = 0,23; p < 0,05). Conclusão: O valor prognóstico da alta reserva microvascular isquêmica periférica foi confirmado no contexto da hiperlactatemia persistente induzida por sepse. Embora tenha sido observada uma baixa correlação positiva entre os valores da reserva microvascular isquêmica periférica e os níveis de lactato nas primeiras 24 horas do diagnóstico de sepse, o grupo com baixa reserva microvascular isquêmica periférica pareceu apresentar redução mais rápida do lactato nas 48 horas de seguimento.

Effect of the problem-based learning method on student electroencephalograms and microcirculatory blood perfusion in the teaching of sports physiology / Efecto del método de aprendizaje basado en problemas en electroencefalogramas y perfusión sanguínea microcirculatoria de estudiantes en la enseñanza de la fisiología del deporte / Efeito do método de aprendizagem baseada em problemas em eletroencefalogramas e perfusão sanguínea microcirculatória de estudantes no ensino de fisiologia do esporte

ABSTRACT Introduction Applying the problem-based learning (PBL) method to the teaching of sports physiology. Objective This study explored the mechanism of the PBL method to improve the interest and learning effectiveness of students. Methods Twenty male students at the Physical Education College of Hubei Minzu University were randomly divided into a PBL group (10) and a traditional teaching method group (TTM). During the test, the subjects in the TTM group sat quietly listening to the experienced teacher, while the subjects in PBL group sat quietly and participated in a 20-minute group discussion under the guidance of the experienced teacher. Transcutaneous partial pressure of oxygen (TcPO2), microcirculatory blood perfusion (MBP), and alpha- and beta-band power were monitored at the beginning of and during the test. Results The mean of the PBL-group quiz score was significantly higher than that of the TTM group. In the PBL group, the alpha power of the students decreased statistically in the F3, T3, P3, and O1 channels and the beta power of the students increased statistically in the F7, F3, T3, C3, P3, and O1 as compared to the baseline values. Conclusion PBL can be an effective learning mechanism, since the students are actively engaged in the teaching of sports physiology. Level of Evidence I; Therapeutic studies - Investigating treatment results.

RESUMEN Introducción Aplicación del método de Aprendizaje Basado en Problemas (PBL), a la enseñanza de la fisiología del deporte. Objetivos Este estudio exploró el mecanismo del método PBL para ampliar el interés y la eficacia del aprendizaje de los estudiantes. Métodos Veinte estudiantes varones de la Facultad de Educación Física de la Universidad de Hubei Minzu fueron divididos aleatoriamente en el grupo PBL (10) y en un grupo de método de enseñanza tradicional (TTM). Durante la prueba, los participantes del grupo TTM permanecieron sentados y escuchando en silencio al profesor experimentado, mientras que los del grupo PBL permanecieron sentados y participaron en un debate de grupo de 20 minutos de acuerdo con la orientación del mismo profesor. La presión parcial de oxígeno transcutáneo (TcpO2), la perfusión sanguínea microcirculatoria (MBP) y la potencia de las bandas alfa y beta se monitorizaron al inicio y durante la prueba. Resultados La puntuación media del cuestionario del grupo PBL fue significativamente mayor que la del grupo TTM. En el grupo PBL, la potencia alfa de los estudiantes disminuyó estadísticamente en los canales F3, T3, P3 y O1 y la potencia beta de los estudiantes aumentó en los canales F7, F3, T3, C3, P3 y O1 en comparación con los valores de referencia. Conclusión El PBL puede ser un mecanismo de aprendizaje eficaz, ya que los estudiantes participan activamente en la enseñanza de la fisiología del deporte. Nivel de evidencia I; Estudios terapéuticos - Investigación de los resultados del tratamiento.

RESUMO Introdução Aplicação do método de aprendizagem baseada em problemas (PBL) ao ensino da fisiologia do esporte. Objetivos Este estudo explorou o mecanismo do método PBL para ampliar o interesse e a eficácia da aprendizagem dos estudantes. Métodos Vinte estudantes do sexo masculino da Faculdade de Educação Física da Universidade Hubei Minzu foram divididos randomicamente em um grupo PBL (10) e um grupo de método de ensino tradicional (TTM). Durante o teste, os participantes do grupo TTM ficaram sentados e em silêncio ouvindo o professor experiente, enquanto os do grupo PBL ficaram sentados e participaram de uma discussão em grupo de 20 minutos de acordo com a orientação do mesmo professor. A pressão parcial do oxigênio transcutâneo (TcPO2), a perfusão sanguínea microcirculatória (MPB) e a potência das bandas alfa e beta foram monitoradas no início e durante o teste. Resultados A média do escore do questionário do grupo PBL foi significativamente maior do que a do grupo TTM. No grupo PBL, o poder alfa dos estudantes diminuiu em termos estatísticos nos canais F3, T3, P3 e O1 e o poder beta dos estudantes aumentou nos canais F7, F3, T3, C3, P3 e O1 em comparação com os valores basais. Conclusão O PBL pode ser um mecanismo eficaz de aprendizagem, uma vez que os estudantes ficam ativamente engajados no ensino da fisiologia do esporte. Nível de Evidência I; Estudos terapêuticos - Investigação dos resultados do tratamento.

Assessment of Vasodilation Function in Diabetic Patients via Skin Temperature Variation Signals / 医用生物力学

Objective A program-controlled flexible multi-point temperature measurement device was self developed for collection and analysis of skin temperature signals of diabetic patients and healthy subjects under resting and heating conditions so as to assess vasodilation function of the microcirculation, Methods With reference to the endothelial regulation spectrum of human body, wavelet analysis was performed on skin temperature signals, and the temperature fluctuation amplitudes in diabetic group and healthy control group were compared at different time periods after thermal stimulation. Results The temperature fluctuation amplitude in endothelial spectrum of diabetic group was smaller than that of healthy control group, and the decrease in skin temperature fluctuation after the power-off of thermal stimulation was remarkably smaller than that of control group, indicating that the response to thermal stimulation for diabetic patients was slower. Conclusions Vasodilation function can be quantitatively evaluated by using the fluctuation of skin temperature signals in endothelial spectrum band. Skin temperature monitoring is a potentially easy-implemented method for the health management and early diagnosis of microvascular diseases in diabetic patients.

Symmetrical peripheral gangrene in a chronic kidney disease patient on hemodialysis

Symmetrical peripheral gangrene (SPG) is a rare but well-described condition characterized by ischemic changes in the distal limbs with preserved flow in the major vessels. It results from thrombosis of the microcirculation resulting from a complex interplay of infectious and non-infectious factors. Often described as a complication of disseminated intravascular coagulation (DIC), it has got multiple aggravating factors. Timely recognition and management is important as significant residual disability is noted in surviving patients. Here, we describe a patient with chronic kidney disease on maintenance hemodialysis presenting with SPG associated with spontaneous bacterial peritonitis and DIC. She had multiple aggravating factors such as hypotension, use of inotropes, and renal failure. As there were no evidence-based guidelines and since the general condition of the patient was poor, she was managed with supportive care.