To evaluate the effects of vibration on Achilles' tendon microcirculation and characteristics following surgical repair of Achilles' tendon rupture.
Cohort study with historical controls.
A ...university institute.
Participants (N=32), including 19 (16 men, 3 women; median range age: 43.0 25.0-57.0 years) and 13 (10 men, 3 women; 44.00 29.0-60.0 years) in the vibration (application to the ball of the foot, 30Hz, 2mm amplitude, 4kg pressure, and self-administration) and control groups, respectively, who underwent unilateral Achilles' tendon repairs were recruited.
A 4-week vibration intervention in the vibration group.
The tendon microcirculation was measured after the first session of vibration. The participants were evaluated repeatedly with bilateral follow-up measurements of tendon stiffness, 3 functional outcome tests, and a questionnaire survey.
Acute effects of the vibration were observed immediately after the 5-minute vibration (P≤.001). Lower total hemoglobin and oxygen saturation were respectively observed (P=.043) in the repaired legs 3 and 6 months postsurgery in the vibration group as compared with the control group. The vibration group also showed greater tendon stiffness, heel raising height and hopping distance 3 or 6 months postoperation in both the repaired and noninjured legs (all P<.05). The microcirculatory characteristics 2 months postoperation were correlated with the outcomes at 6 months postoperation.
Differences in microcirculatory characteristics and better rehabilitation outcomes were observed in the legs with an Achilles repair that underwent the early vibration intervention.
Background
Tricuspid annular plane systolic excursion (TAPSE) is a recommended quantitative measure of right ventricular (RV) longitudinal function assessed by M‐mode echocardiography. Offline ...alternatives are desirable when TAPSE is unavailable. This study aimed to assess the feasibility, reliability, and agreement between retrospectively obtained measures of tricuspid annular displacement using Doppler tissue imaging (TADDTI) and speckle tracking echocardiography (TADSTE) compared with reference TAPSE.
Methods
Consecutive subjects referred for evaluation of heart failure were enrolled. Subjects in atrial fibrillation, significant valvular disease, or with poor image quality were excluded. TAPSE was measured during the examination using M‐mode. TADSTE was measured as the maximal longitudinal displacement of the RV basal segment in systole using speckle strain imaging. TADDTI was derived offline from color‐DTI superimposed grayscale images.
Results
107 subjects (age 60 ± 16; 48% female) were analyzed. Both TADDTI and TADSTE demonstrated good feasibility and excellent intra‐ and inter‐observer concordances. Although both measures demonstrated strong association with TAPSE, TADDTI showcased lower specificity to identify RV dysfunction and higher false positives. Bland‐Altman analysis revealed a tendency of TADDTI to underestimate TAPSE (bias = 1.40; SD = 2.74 mm) as compared with TADSTE (bias = 0.27; SD = 2.30mm). Wide limits of agreement were observed for both methods.
Conclusions
TADSTE and TADDTI provide reproducible and feasible quantification of RV function. However, TADDTI significantly underestimates TAPSE limiting the interchangeability of these modalities.
Abstract Activation of the descending noradrenergic system inhibits nociceptive transmission in the spinal cord. Although both α1 - and α2 -adrenoceptors in the spinal cord are involved in the ...modulation of nociceptive transmission, it is not clear how α1 -adrenoceptors regulate excitatory and inhibitory synaptic transmission at the spinal level. In this study, inhibitory and excitatory postsynaptic currents (IPSCs and EPSCs, respectively) were recorded from lamina II neurons in rat spinal cord slices. The specific α1 -adrenoceptor agonist phenylephrine significantly increased the frequency of GABAergic spontaneous IPSCs in a concentration dependent manner, and this effect was abolished by the α1 -adrenoceptor antagonist 2-(2,6-dimethoxyphenoxy)ethylaminomethyl-1,4-benzodioxane (WB4101). Phenylephrine also significantly reduced the amplitude of monosynaptic and polysynaptic EPSCs evoked from primary afferents. The inhibitory effect of phenylephrine on evoked monosynaptic glutamatergic EPSCs was largely blocked by the GABAA receptor antagonist picrotoxin and, to a lesser extent, by the GABAB receptor antagonist CGP55845. Furthermore, blocking T-type Ca2+ channels with amiloride or mibefradil diminished the inhibitory effect produced by phenylephrine or the GABAA receptor agonist muscimol on monosynaptic EPSCs evoked from primary afferents. Collectively, these findings suggest that activation of α1 -adrenoceptors in the spinal cord increases synaptic GABA release, which attenuates glutamatergic input from primary afferents mainly through GABAA receptors and T-type Ca2+ channels. This mechanism of presynaptic inhibition in the spinal cord may be involved in the regulation of nociception by the descending noradrenergic system.
Highly electrophilic aryl(2,2,2-trifluoroethyl)iodonium triflates have been used for the first time as trifluoroethyl and aryl transfer reagents in Pd-catalyzed functionalization of arylboronic ...acids. Electron-rich arylboronic acids reacted with aryl(2,2,2-trifluoroethyl)iodonium triflates (2a-b) in CH3CN in the presence of Pd2(dba)3 and K3PO4 at room temperature to provide trifluoroethyl arenes in up to 82% yield, while the reactions of both electron-rich and -poor arylboronic acids with 2a-b in DMF in the presence of PdP(t-Bu)32 and Cs2CO3 at 40 °C afforded arylation products in up to 99% yield. This tunable protocol allows access to trifluoroethyl arenes or biaryls in good to excellent yields under mild conditions and without the addition of extra ligands.
Although ultrasound-guided transversus abdominis plane block (TAPB) is widely used in multimodal analgesia after cesarean delivery (CD), the complications of TAPB during analgesia after CD have ...rarely been reported.
A total of 84 cases of CD were randomly assigned to either a ropivacaine group (R group) or ropivacaine + dexamethasone group (RD group) in this double-blind trial. The pain site and pain degree at rest and during activity at 2 h, 6 h, 10 h, 12 h, 14 h, 16 h, 20 h, and 24 h after maternal surgery were recorded. The consumption of opioids at 24h, postoperative nausea, vomiting, exhaustion, and other adverse reactions were recorded.
A total of 80 patients were included in the analysis of results. A total of 19 patients developed ISP, 14 in the R group and 5 in the RD group. The incidence of ISP in the R and RD groups was 35% and 12.5%, respectively. The results described above showed that combining dexamethasone with ropivacaine reduced the incidence of ISP, and the difference was statistically significant (P<0.05). Two groups of women with positive ISP had higher values of opioid consumption than women with negative ISP, but the difference was not significant.
Dexamethasone as an adjuvant for ropivacaine can effectively relieve the ISP of ultrasound-guided TAPB after CD, and can enhance the analgesic effect of ropivacaine.
•A approach of reinforcing metals using a three-dimensional metallic glass lattice was developed.•Novel metal matrix composites with excellent mechanical properties were prepared.•The enhanced ...mechanical properties mainly originate from mutual-reinforcement mechanism and well-designed structure.•Yield strengths of the novel composites are strongly dependent on the structure of metallic glass lattices.
Although various methods have been developed to manufacture metal matrix composites (MMCs), most of the currently employed methods use discontinued crystalline ceramic particles as reinforcements. Herein, we report a new approach of reinforcing metals using a three-dimensional metallic glass (MG) lattice. Specifically, the processing route involves additive manufacturing of a stainless-steel matrix scaffold containing a continuous lattice-structured cavity and subsequent high-pressure injection of a Zr-based glass-forming liquid into the scaffold. Our results demonstrate that the as-produced composites reinforced with 30 vol% MG in the form of a body-centered-cubic lattice possess excellent mechanical properties. Remarkably, the plasticity is higher than those of some particle-reinforced stainless-steel composites and most conventional ex situ MG matrix composites. The enhanced performances mainly arise from the well-designed structure, good combination of the hard MG and soft stainless steel, and their mutual reinforcement mechanism. This study not only reveals a new class of composites reinforced with lattice-structured MG that overcome the limitation of MG reinforcement, rendering it suitable for reinforcing high-melting-point materials, but also provides a novel design concept and fabrication approach that could be extended to other alloy systems for achieving improved mechanical properties.
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To estimate the effect of daily diurnal temperature range (DTR) on mortality in different areas in China.
A time series study using the data collected from 66 areas in China was conducted, and ...Meta-analysis was used to analyze the estimates of associations between DTR and daily mortality. Modifying effects of extremely low and high DTR-mortality relationship by season and socioeconomic status (SES) were also evaluated respectively. Cumulative excess risk (
) was used as an index to evaluate the effects.
The information about 1 260 913 registered deaths were collected between 1 January 2006 and 31 December 2011, we found the relationship between extreme DTR and mortality was non-linear in all regions and the exposure-response curve was J-shaped. In central and south areas of China, the result indicated the obvious acute effect of extremely high DTR, and the mortality effect in central area (
=5.1%, 95
: 2.4%-7.9%) was significant higher than that in south area (
=4.5%, 95
: 1.7%-7.3%). Regarding to the modific
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