Funding for this research was provided by intramural funds from the Division of Infectious Diseases.

该研究得到了美国亚利桑那大学的机构审查委员会。与会者提供他们签字同意参加。 1.招募艾滋病病毒感染参与者<ol><li>招募艾滋病患者参加的横幅大学医学中心的森校园&gt; 50岁的彼得森诊所，能够在没有援助步行至少15英尺，承诺参加培训任命为30-60分钟，每周两次，连续六周。 </li><li>屏幕与流行病学研究中心抑郁量表（CES-D）27问卷抑郁症的新兵。 （这是收集队列代表更郁闷HIV人群子集的）。如果中度或重度抑郁（在CES-D的得分&gt; 16）问人参加学习。 </li></ol> 2.油炸等方法略有评估参与者的脆弱状态。28对于HIV人口29修改<ol><li>衡量（1）收缩或无意减肥科目; （2）运行缓慢或下降的步态速度; （3）弱点被握力测量; （4）卡路里低体力活动水平; （5）通过回答CES-D问卷用尽或抑郁症。27 </li><li> （FES-I:短期瀑布效能量表-国际）用问卷评估震落一起收集人口数据干预前30，和生活质量（短健康调查表，SF-12 31），秋史，疼痛评估用视觉模拟评分（每日的活动Barthel指数32生活）日常生活活动。 </li></ol> 3.开始训练干预<ol><li>行为训练3分钟-60在6周的时间内，如表1。 <ol><li>已经科目执行所有的练习和提高exe文件的难度rcises。 </li><li>附上5惯性传感器到被检者的身体，允许联合三维角度的估计实时33和四元参数一起提供三轴加速度计，陀螺仪和磁强计的数据。34,35在柄，大腿连接传感器和下背部用自我坚持带。 </li></ol></li><li>在基线，测量主体的平衡和步态。还可以测量平衡和步态的中点与上次会话。 <ol><li>测量平衡通过反馈来自生物传感器提供的质量中心（COM）的影响力。 <ol><li>让主体30秒，脚在双stance-第一睁眼然后用眼睛反复关闭;其次英尺半串联立场 - 眼睛打开，然后关闭。 </li><li>观察生物传感器的数据，并要求受试者在测量过程中，以保持视力墙上简单。 </li><li>收集使用放置在脚踝和传感器测量平衡腰。35,36平衡的主要成果包括在前后和中间-横向睁着眼睛和眼睛测量COM挥洒变化闭幕。 </li></ol></li><li>由具有执行主体10米步行评估步态。培训师可以观察生物传感器的数据，但这个问题不能。 <ol><li>收集步态测量单任务（一个正常水平高出10米步行），双重任务（10米步行在执行任务的认知（1从给定数量的倒数）和快速步行（快节奏10米步行路程）。 </li><li>通过在脚踝和大腿传感器所收集的评估步态速度和变化的主要步态结果。37,38 </li></ol></li><li>在基线和后续会议，给这个主题的上衣穿48小时有显示器39,40收集正常的身体活动数据。 注:以上的练习提高患者的周围神经病变的平衡24,41。 </li></ol></li><li>在会议1-12中，执行一个脚踝到达任务（ 图1）。 <ol><li>解释练习，然后让主体进行脚踝深远的任务，需要前进/后退/侧面/对角线斜塔和部分重量转移的主体，而在电脑屏幕前站立。 注:数据来自柄装传感器提供有关二维的脚踝轨迹的实时视觉反馈。踝关节的旋转被转换为在计算机屏幕上的直线的光标（ 图1）。有在屏幕上的两个圆，一个是起始圆，另一个是目标圈（它们是在计算机屏幕上，一个在底部和一个在顶部上隔开）。 </li><li>有主体移动光标从开始圆到目标圆的中间的中间（其表示该主题的屏幕上的一个点）。光标在屏幕上的位置由生物传感器确定，使得通过移动脚踝光标将移动Øn个屏幕。 <ol><li>有须经踝关节旋转导航从一开始圈光标到目标圈，而与植根于地方的脚站立。转发/移动光标落后，有与会者移动臀部在前后方向上产生踝关节背屈屈曲或跖屈。内侧，臀部外侧移动侧身导航光标。在相反方向A任务重复完成一个周期。 </li></ol></li><li>有从一个圆到另一个主题导航快速（&lt;1秒），并精确地（在圆的中间）。证实通过视觉线索（爆炸的目标）的正确执行和听觉线索（爆炸声）反馈。使用这些线索作为激励对象继续参与运动和感知运动过程中的改善。 </li><li>发送电机错误，由于导航到并及时在靶圆心停止向受试者的不准确通过在每次试验的执行结束的音频 - 视觉反馈。结合缺乏噪声的绿色圆圈的视觉提示表明太慢执行正确的动作。而在组合的蓝色圆圈与噪音的情况下的视觉提示指示正确的行动进行比程序预期的要快。 </li><li>对于每个会话，执行9块与脚踝达到20次。 <ol><li>在前后方向上进行块1 + 4 + 7。 </li><li>在用于对角运动的组合前 - 后和中间 - 横向方向执行块2 + 5 + 8。 </li><li>用visuomotor旋转任务42执行块3 + 6 + 9，以增加运动和认知的挑战。在这个任务中，通过20°旋转光标的轨迹。主题在演习中观察到的轨迹这种变化和调整脚踝协调，将光标导航向目标圈。 Visuomotor RO塔季翁提高适应姿势和姿势校正。37 </li><li>有与会者块之间休息，避免过度疲劳（30〜60秒）。 </li></ol></li><li>在会话9-12，实施更加困难脚踝达到锻炼，电动机 - 认知踝达到锻炼。 <ol><li>在这些练习中，目前5个圈屏幕和标签与编号或与原有的"家"圈子沿着字母上。给从圈将光标移动到圈以某种顺序的命令。例如，要求受光标从圈1移动到"家"2"家"3等或本命令，要求受记忆圈的顺序将光标移动到的一些变化。 注:此任务旨在增强中移动重任务踝，膝，髋关节和关节之间的协调24,41。 </li></ol></li></ol></li><li>在会议2-12，执行的障碍穿越increasi任务NG程度的困难。 <ol><li>在会话2-7，利用与在5％的障碍和主体的高度的10％的障碍物交叉的任务。在会话10 - 12日，在15％和主体的高度的20％的增加与障碍物的另一个障碍交叉任务。 </li><li>有主体面对电脑屏幕，其中受试者的化身是本表示臀部和下肢。有主体查看屏幕，同时执行此任务。 </li><li>解释后，让主体进行越障任务（ 图2）。在这个任务中的参与者穿过电脑屏幕上移动由右至左的虚拟障碍（巨石）。实时反馈使用表示参与者的髋关节和膝关节运动的简笔画头像给出。头像复制下肢运动，包括抬起腿指定到一个适当的高度跨越的障碍。 </li><li>对于每个会话，包括两个或四个系列障碍道口s的各10重复。要认知挑战的参与者，该计划要求他们越过障碍物或者与左或右小腿。如果腿升降的顺序是错误的，这个问题将通过视听反馈通知。在下一个障碍物仅在参加者之后发布要么越过或击中先前障碍物，并返回到双姿态至少2秒（对于安全性）。 </li><li>让参与者音频反馈于这说明他们是否成功横渡障碍与否每个障碍交叉试验结束。如果需要，他们可以留住一个坚固的办公桌支持。然而，获得信心后，鼓励他们不支持进行练习。 注:虚拟越障任务旨在增强下肢的位置感知，减少反应时间，提高单腿平衡。 </li></ol></li></ol> 4.培训师测量和记录所有Interventions <ol><li>收集与问卷调查评估震落沿线人口数据后干预（FES-I:短期瀑布效能量表-国际），30和生活质量（短健康调查表，SF-12 31），秋史，疼痛评估用视觉模拟评分，日常生活活动，并与CES-D抑郁问卷（生活日报32的活动Barthel指数）。27 </li></ol> 5.主题报酬他们的时间 6.所有主体及其测量的响应的任务进行统计分析<ol><li>使用配对样本学生的t检验和单因素方差分析测试基线比较患者的测量和后续对自己和随访组内（ 即抑郁/不郁闷，前体弱与非体弱等 。 ）， 分别。报告结果为+/- SEM。 </li><li>执行元线性回归分析探索响应于训练如用增量和基线步态速度抑郁症和虚弱状态假设的因素和结果。提供具有p &lt;0.05统计学显着性，并判定系数，R 2为模型拟合结果。 </li></ol>

The authors have no competing financial interests or Conflicts of Interest in this research.

我们已经发现，身体虚弱的艾滋病患者中，由CES-D量表测量100％的郁闷; 30％是轻度抑郁和70％具有严重抑郁症。7强调的是在非体弱的HIV患者人群，抑郁是很常见的，以及用38％的被压下是很重要的。尽管所有的抑郁症患者availed咨询和抗抑郁药物本身，他们依然低迷，从而促进预体弱（具有油炸的5标准的1或2对受脆弱28或身体虚弱的状态，3个或更多的标准）。因为抑郁症是艾滋病患者中如此普遍，我们正试图改善情绪障碍和脆弱新颖的干预措施，如这里所描述。我们需要采用认知控制，涉及在那些经常在体弱前和体弱多病的状态受到影响艾滋病病毒感染者的平衡和步态，功能锻炼。此处所描述的健身游戏是在p非常低的冲击物质环境的意识，因此，对体弱患者风险不大。重要的是，所有的练习和会话顺序完成，因为它们变得越来越困难，特别是在认知输入的球体。例如，在以后的会话记忆通过移动脚踝移动光标的序列是成功完成重要。至关重要的是，每一个任务是为了完成要记录准确的数据，因此，有意义的比较可以受试者之间进行。 虚拟现实游戏，如任天堂Wii Exergames，能改善身体机能，认知和心理后果的老人。二十一43的研究中，60-95岁的人包括抑郁症筛查。这项研究并没有表现出在开始时测量老年抑郁量表分数任何显著差和研究结束。干预历时6周，每周由3天，35-45分会议3平衡的游戏。虽然44在该研究中，运动疗法是在长度上，在我们的研究中使用类似的商业游戏需要比在我们的研究中练习更有力的运动。此外，在我们的研究中的练习被校准到每个独特的个体，而，商业exergames都在一般人群中打算由任何人，因此，不具备的精度和准确度，这里报道的练习具备。 单独行使已显示防止抑郁症的发病。45运动可以改善抑郁症，但其效果不持久。46 HIV患者干预这里报告涉及校准到每个唯一患者虚拟现实练习。在选择如何改变患者的虚拟表示形式认知输入，动作，方向和大小的速度是主体的认知控制之下。虽然SImilar商业exergames方法的重要方式有所不同。例如，商业游戏是由大量的个体，而与我们的协议测量个体为每一个病人，被雇用在不同的身体部位要追求精确和准确的测量生物传感器的规范化使用。初步数据显示了这种形式，使得艾滋病毒感染者的抑郁和脆弱状态改进技术干预的承诺。初步结果是有希望在HIV人群的平衡和步态的改善和这种新的可穿戴式传感器虚拟现实基础的平衡点训练计划的有效性。步态是用于评估脆弱28和平衡的一种测量有助于步态的字符。在COM主导地位的显著减少和增加步行速度是有希望为这个持续时间的介入，显示改善脆弱的方面的潜力。 如疼痛，抑郁）的整体生活质量不断改进，以及客观的措施（ 即脆弱的状态，步速，COM挥洒， 等等 ） 。我们相信，随着平衡和步态的物理改善一起有可能是下降的相关风险较低和恐惧。此外，随着疼痛减轻和身体活动的鼓励和引进，通过这种干预措施，我们希望看到在日常体育和社会活动的改进认知挑战性的练习，而抑郁状态的减轻。该研究是初步但它表明了介入可有效解决脆弱的某些方面和由受试者良好接受。干预的持续时间很短，需要后续在稍后的日期来评估的真正价值和利益。一个主要缺点科目参加这项研究是学科的一部分，大的时间承诺。谁有兴趣参与的个体往往无法满足（每周两次为6周）来完成练习，很多付不起路费所需的时间承诺。我们正计划完善的练习，也许减少会议所需的时间。 本研究提供了在临床或家庭环境中使用这种新的可穿戴式传感器虚拟现实基于平衡训练锻炼计划，以改善姿势平衡和步态希望的初步结果。这项研究还探讨了潮流，那些谁获益最多的还是在这些客观的方式最大的改进是郁闷或预虚弱的个体。这可以通过减少跌倒和下降的风险和鼓励的恐惧和提高整体体育锻炼提高他们的整体生活质量。

人类免疫缺陷病毒（HIV）感染的有效的抗逆转录病毒治疗（ART）的执行已导致在活到年龄较大的感染者。1 HIV感染患者的平均年龄是增加2并且可以预测个体的73％被感染艾滋病毒将50岁以上的老年人，到2030年3人感染了艾滋病毒的老化可能有"加速老化"与早于老化的许多疾病，包括脆弱和下降的高风险的预期发生4-8同样，人HIV感染有合并症的发病率较高，包括认知功能减退，外周感觉损伤（ 即神经病变）和疼痛导致身体损伤和高温回落风险。9约有艾滋病病毒感染者的75％，接收至少一个处方药，除了ART包括高跌倒风险（心血管疾病和相关的一些偏方精神药物）。10 HIV感染与神经病，这是非常普遍的老年人与HIV之间相关联。11此外，艾滋病毒可能导致认知衰退，从而影响流动性和下降导致独立的损失和质量差的风险生活12 一些研究表明在HIV患者运动的好处， 例如 ，改进平衡，疼痛的感知，生活满意度感知，减少功能限制，和提高生活质量。13-18然而，传统的运动可能不适合于许多年长的成年人HIV由于跌倒的危险，失去了知觉关节，减少关节的灵活性和整体虚弱的状态。这些功能可能会限制运动性能特别是那些从神经病。19,20 HIV感染的痛苦可以用瘦体重的损失可能在行使涉及到的困难，营养不良有关，广泛疼痛，代谢紊乱和血脂异常，21这些都有助于一个无法参加常规锻炼。15此外，随着脆弱6,7许多练习20％的发病率将不适合年老体弱，年长的成年人。因此，需要几个因素制定和实施锻炼对老年人艾滋病的成年人，包括失去的共同看法补偿过程中予以考虑，以适应练习提高电机的认知能力，控制训练强度，以避免负担过重，最后，运动的个性化他们的强度和时间以考虑物理限制。健身游戏和虚拟现实技术已被评估为与好处，包括视觉和本体资料一致，凸反馈从关节运动，以及在脑马达相关领域的活化老年人22-24电动机控制的训练24-26 </p&gt; 在这项研究中，我们评估的有效性和实时的反馈以及对提高HIV感染的老年人姿势稳定性和日常生活活动的影响下肢的定制基于传感器的互动练习可接受性。运动训练专门针对踝关节和认知和运动部件运动的下肢范围。我们推测，通过与实时视觉关节运动的交互式界面锻炼期间运动训练不仅会提高姿势稳定性，但可以改善脆弱的特征，如果不是脆弱本身。

<table border="0" cellpadding="0" cellspacing="0" width="573">
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			<td height="21" style="height:21px;width:216px;">Handhold</td>
			<td style="width:71px;"></td>
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			<td style="width:167px;">Optional; for very frail patients</td>
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		<tr height="84">
			<td height="84" style="height:84px;width:216px;">2 sensors: LegSys and Pamsys&#160;</td>
			<td style="width:71px;">Biosensics, Cambridge, MA</td>
			<td style="width:119px;"></td>
			<td></td>
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			<td height="21" style="height:21px;width:216px;">Computer screen</td>
			<td style="width:71px;"></td>
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			<td>Placed in front of the subject</td>
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			<td height="21" style="height:21px;width:216px;">Program of exercise protocols</td>
			<td style="width:71px;"></td>
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			<td>These display objects and avatar on the screen</td>
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			<td height="21" style="height:21px;width:216px;">Large clinic examination room</td>
			<td style="width:71px;"></td>
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			<td>Needs to accommodate the activities of subject and trainer</td>
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			<td height="21" style="height:21px;width:216px;">1 older HIV-infected subject</td>
			<td style="width:71px;"></td>
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			<td></td>
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			<td height="21" style="height:21px;width:216px;">1 trainer</td>
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			<td></td>
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</table>

exergaming in older people living with hiv improves balance, mobility and ameliorates some aspects of frailty

大约有120万人在美国生活了艾滋病毒感染。医学的进步增加了预期寿命和这个世代老化。 HIV阳性者有脆弱（〜20％），特点是抑郁症和久坐行为的高发期。运动是健康的，但由于许多HIV阳性者的地位体弱，传统的演习太费力。这项研究的目的是在改善艾滋病毒感染者的脆弱性的某些方面来评价一个新颖的游戏为基础的培训计划（exergame）的有效性和可接受性。十大艾滋病毒感染的老年人在exergame干预的患者。患者进行平衡练习，如重量转移，达到踝关节和越障。实时视频/音频下肢关节运动反馈使用穿戴式传感器，以协助反馈，并鼓励学科准确地执行每个练习任务提供。训练有素的患者TWICEA周45分钟6周。平衡，步态，心理参数和生活质量参数的变化之初，中期和培训计划的结论进行了评估。 10名患者完成了试验及其结果进行分析。平均年龄为57.2±9.2年。参与者显示在大规模摆动的中心显著减少（78.2％，p值= 0.045）与眼睛半串联平衡姿态期间关闭和双任务马达认知评估期间显示在步态速度显著增加（9.3％， p值= 0.048）的增加超过0.1米/秒的步幅速度。在报道疼痛显著降低发生（43.5％，P = 0.041）。在改善平衡性和移动性，同时要求艾滋病病毒感染老年人更加活跃这exergame干预有希望的初步结果。该exergame可以在家里继续，并可能有长期的以及为改善与HIV感染有关的脆弱性的短期利益。

<html>十年长成人艾滋病病毒感染者（年龄:57.2±9.2多年来，BMI:27.0±2.8）行6周（每周两次）培训和圆满完成了各项会议，其结果进行分析.. 与会者半串联平衡姿态呈现在大众（COM）荡荡（78.2％，P = 0.045）的中心显著减少闭眼，对这个群体的子集（ 图3）更困难的位置之一。参与者显示具有增加超过0.1米/秒的步幅速度即达到统计学显着性（ 图4）的双任务马达认知评估（9.3％，p值= 0.048）期间在步态速度显著增加。疼痛问卷也显示在报告疼痛显著减少（43.5％，p值= 0.041），对于生活质量评估的重要指标（ 图5）。 <html> ove_content"FO:保together.within页="1"&gt;表示谁在基线抑郁症（&gt; 16），由CES-D问卷评估那些参与者，报道较慢步速时单任务走的趋势（&lt; 1.3米/秒，R 2 = 0.2911），这组基线较慢步速显示为三角形步态速度较大的改进预与干预后，观察另一个趋势与步态的变化趋势（R 2 = 0.3906）速度到脆弱状态。非体弱患者报告在从基线随访（p值= 0.125）减少平均在其步态速度-0.08米/秒起始和稳态相位中，而病人列为预体弱由于在凹陷基线报道启动和稳态相位，分别干预后相对于基线（p值= 0.143）中的改进在其步态速度平均为0.09和0.082米/秒。 广告/ 54275 / 54275fig1.jpg"/&gt; 图1:主题表演电机认知踝到达任务与沃克的支持对象在屏幕上查看自己（头像）的虚拟表示形式。他的运动响应来自通过在脚踝，大腿和腰部看到的生物传感器提供的在他面前屏幕上的听觉和视觉反馈。个人给予书面同意被拍照。 <img alt="图2" src="/files/ftp_upload/54275/54275fig2.jpg" /> 图2:除执行障碍交叉任务沃克的支持主题看到屏幕和候补委员移动双腿，以避免击中屏幕上显示的虚拟障碍的只是他的下肢。个人给予书面同意被拍照。 <img alt="图3" src="/files/ftp_upload/54275/54275fig3.jpg" /> &gt; 图3:单姿态期间改善群众挥洒中心姿，预处理和后干预的主题演示动作， 也就是说 ，挥洒的减少，表明改善平衡。误差棒表示SEM。 <img alt="图4" src="/files/ftp_upload/54275/54275fig4.jpg" /> 图4:改善跨越速度，预处理和后干预跨越速度以米/秒为单位测量。更快的速度表明了更好的物理性能。误差棒表示SEM。 <img alt="图5" src="/files/ftp_upload/54275/54275fig5.jpg" /> 图5:改善疼痛评估，预处理和后干预这是获得 从自我报告问卷注意到每日疼痛的减少（在0-10的标度）。误差棒表示SEM。 ove_content"FO:保together.within页="1"&gt; <table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always"><tbody><tr><td> 会议 </td><td> 演出活动 </td><td colspan="2"> 时间 </td></tr><tr><td>底线</td><td>平衡和步态练习</td><td colspan="2">总时间20分钟;每次运动（6）和平衡的姿势（6）在持续时间2-3分钟</td></tr><tr><td>第一节</td><td>平衡和踝关节运动范围</td><td colspan="2">总时间25分钟;平衡姿势（4）为2-3分钟，3台的踝到达任务3，每个组是5分钟</td></tr><tr><td>会话2-7 </td><td>学科平衡，脚踝距离和障碍物穿越演习在5％和10％的高度</td><td colspan="2">总时间35分钟;越障，每个高度为5分钟</td></tr><tr><td>中线</td><td>重复基线</td><td colspan="2">总时间20分钟;每次运动（6）和平衡的姿势（6）在持续时间2-3分钟</td></tr><tr><td>会议9-12 </td><td>同2-7会话加上电机认知脚踝范围和跨越障碍时主题15％和20％的高度</td><td colspan="2">总时间为45分钟;对于每个加入的两种高度的附加的10分钟</td></tr><tr><td>跟进</td><td>重复基线</td><td colspan="2">总时间20分钟;每次运动（6）和平衡的姿势（6）在持续时间2-3分钟</td></tr></tbody></table> 表1: 培训和演习。

Watch this Scientific Journal Video about Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty at JoVE.com

Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty

感染艾滋病毒的人往往身体虚弱，抑郁和生活久坐的生活方式为其传统的运动过于繁重。这里，我们目前能够改善在艾滋病病毒感染者脆弱的方面的运动方案。整合认知控制的exergame使用该测量天平，砝码移动和越障生物传感器的发展。

老年人艾滋病感染者健身游戏平衡改善，流动性和可改善虚弱的几个问题

Approximately 1.2 million people in the United States live with HIV infection. Medical advancements have increased the life expectancy and this cohort is ...

exergaming-older-people-living-with-hiv-improves-balance-mobility

Research

JoVE Journal

Medicine

10.1K 次观看.  College of Medicine, University of Arizona. 感染艾滋病毒的人往往身体虚弱，抑郁和生活久坐的生活方式为其传统的运动过于繁重。这里，我们目前能够改善在艾滋病病毒感染者脆弱的方面的运动方案。整合认知控制的exergame使用该测量天平，砝码移动和越障生物传感器的发展。 

视频: Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty

Sequencing of Bacterial Microflora in Peripheral Blood: our Experience with HIV-infected Patients

The healthy gastrointestinal tract is physiologically colonized by a large variety of commensal microbes that influence the development 
	of the humoral and cellular mucosal immune system1,2. 
 Microbiota is shielded from the immune system via a strong mucosal barrier. Infections and antibiotics are known to alter both the normal 
	gastrointestinal tract barrier and the composition of resident bacteria, which may result in possible immune abnormalities3.
HIV causes a breach in the gastrointestinal barrier with progressive failure of mucosal immunity and leakage into the systemic circulation of bacterial bioproducts, such as lipopolysaccharide and 
	bacterial DNA fragments, which contribute to systemic immune activation4-7. Microbial translocation is implicated in HIV/AIDS immunopathogenesis and response to therapy 4,8.
We aimed to characterise the composition of bacteria translocating in peripheral blood of HIV-infected patients. To pursue our aim we set up a PCR reaction for the panbacteric 16S ribosomial gene 
	followed by a sequencing analysis.
Briefly, whole blood from both HIV-infected and healthy subjects is used. Given that healthy individuals present normal intestinal homeostasis no translocation of microflora is expected in 
	these patients. Following whole blood collection by venipuncture and plasma separation, DNA is extracted from plasma and used to perform a broad range PCR reaction for the panbacteric 
	16S ribosomial gene9. Following PCR product purification, cloning and sequencing analyses are performed.

Our experiment will show how to perform a sequencing analysis of bacterial species translocating in peripheral blood of HIV positive patients.

测序外周血中细菌菌群:我们的经验与艾滋病毒感染者

The healthy gastrointestinal tract is physiologically colonized by a large variety of commensal microbes that influence the development 
	of the humoral ...

科研

医学

Technical Aspects of the Mouse Aortocaval Fistula

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta and inferior vena cava (IVC) are exposed. The proximal infrarenal aorta and the distal aorta are dissected for clamp placement and needle puncture, respectively. Special attention is paid to avoid dissection between the aorta and the IVC. After clamping the aorta, a 25 G needle is used to puncture both walls of the aorta into the IVC. The surrounding connective tissue is used for hemostatic compression. Successful creation of the AVF will show pulsatile arterial blood flow in the IVC. Further confirmation of successful AVF can be achieved by post-operative Doppler ultrasound.

The goal is to produce an arteriovenous fistula that is simple and reproducible. This method does not use sutures or glue adhesive. Therefore the samples can be used with the least amount of foreign materials for analysis.

在的鼠标Aortocaval瘘的技术方面

Technical aspects of creating an arteriovenous fistula in the mouse are discussed. Under general anesthesia, an abdominal incision is made, and the aorta ...

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty

A simple, validated protocol consisting of a battery of tests is available to identify elderly patients with frailty syndrome. This syndrome of decreased reserve and resistance to stressors increases in incidence with increasing age. In the elderly, frailty may pursue a step-wise loss of function from non-frail to pre-frail to frail. We studied frailty in HIV-infected patients and found that ~20% are frail using the Fried phenotype using stringent criteria developed for the elderly1,2. In HIV infection the syndrome occurs at a younger age.
HIV patients were checked for 1) unintentional weight loss; 2) slowness as determined by walking speed; 3) weakness as measured by a grip dynamometer; 4) exhaustion by responses to a depression scale; and 5) low physical activity was determined by assessing kilocalories expended in a week's time. Pre-frailty was present with any two of five criteria and frailty was present if any three of the five criteria were abnormal.
The tests take approximately 10-15 min to complete and they can be performed by medical assistants during routine clinic visits. Test results are scored by referring to standard tables. Understanding which of the five components contribute to frailty in an individual patient can allow the clinician to address relevant underlying problems, many of which are not evident in routine HIV clinic visits.

Frailty syndrome is commonly seen in the aged and reflects multi-system physiological change. However, with reduced functional reserve and resilience frailty is also known to be common in the HIV infected population. This study outlined an easily administered screening test to identify HIV patients with frailty. When significant components of frailty are identified, clinicians will be able to focus on amelioration of the problem and promote reversion to the pre-frail state.

在感染艾滋病毒的个体的测量弱者。体弱患者的识别是第一步改良与弱者拨回

A simple, validated protocol consisting of a battery of tests is available to identify elderly patients with frailty syndrome. This syndrome of decreased ...

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers

Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

We demonstrate: (1) procedures for collection of salivary samples in cognitive impaired older adults by family caregivers in the home setting, (2) procedures for measuring stress activity via salivary cortisol and alpha amylase, and (3) representative profiles. Protocols that allow researchers to study stress-linked processes advance our understanding of biological sensitivity and susceptibility.

Salivary measures have emerged in bio-behavioral research  that are easy-to-collect, minimally invasive, and relatively inexpensive  biologic markers of ...

Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and neurological patients1-4, but also in healthy older adults5,6. The quantitative gait analysis described in this protocol is performed with a recently-introduced photoelectric system (see&#160;Materials table) which has the potential to be used in the clinic because it is portable, easy to set up (no subject preparation is required before a test), and does not require maintenance and sensor calibration. The photoelectric system consists of series of high-density floor-based photoelectric cells with light-emitting and light-receiving diodes that are placed parallel to each other to create a corridor, and are oriented perpendicular to the line of progression7. The system simply detects interruptions in light signal, for instance due to the presence of feet within the recording area. Temporal gait parameters and 1D spatial coordinates of consecutive steps are subsequently calculated to provide common gait parameters such as step length, single limb support and walking velocity8, whose validity against a criterion instrument has recently been demonstrated7,9. The measurement procedures are very straightforward; a single patient can be tested in less than 5 min&#160;and a comprehensive report can be generated in less than 1&#160;min.

This protocol is used to evaluate spatial and temporal gait variables of neurological/orthopedic patients and older persons by means of a recently-introduced floor-based photocell system.

时空步态参数的患者和老年人的临床评估

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and ...

The Rabbit Blood-shunt Model for the Study of Acute and Late Sequelae of Subarachnoid Hemorrhage: Technical Aspects

Early brain injury and delayed cerebral vasospasm both contribute to unfavorable outcomes after subarachnoid hemorrhage (SAH). Reproducible and controllable animal models that simulate both conditions are presently uncommon. Therefore, new models are needed in order to mimic human pathophysiological conditions resulting from SAH.
This report describes the technical nuances of a rabbit blood-shunt SAH model that enables control of intracerebral pressure (ICP). An extracorporeal shunt is placed between the arterial system and the subarachnoid space, which enables examiner-independent SAH in a closed cranium. Step-by-step procedural instructions and necessary equipment are described, as well as technical considerations to produce the model with minimal mortality and morbidity. Important details required for successful surgical creation of this robust, simple and consistent ICP-controlled SAH rabbit model are described.

The experimental intracranial pressure-controlled blood shunt subarachnoid hemorrhage (SAH) model in the rabbit combines the standard procedures &#8212; subclavian artery cannulation and transcutaneous cisterna magna puncture, which enables close mimicking of human pathophysiological conditions after SAH. We present step-by-step instructions and discuss key surgical points for successful experimental SAH creation.

蛛网膜下腔出血急性和后遗症的研究兔血分流型号:技术问题

Early brain injury and delayed cerebral vasospasm both contribute to unfavorable outcomes after subarachnoid hemorrhage (SAH). Reproducible and ...

Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets

Pulmonary arterial hypertension (PAH) is a disease affecting distal pulmonary arteries (PA). These arteries are deformed, leading to right ventricular failure. Current treatments are limited. Physiologically, pulsatile blood flow is detrimental to the vasculature. In response to sustained pulsatile stress, vessels release nitric oxide (NO) to induce vasodilation for self-protection. Based on this observation, this study developed a protocol to assess whether an artificial pulmonary pulsatile blood flow could induce an NO-dependent decrease in pulmonary artery pressure. One group of piglets was exposed to chronic hypoxia for 3 weeks and compared to a control group of piglets. Once a week, the piglets underwent echocardiography to assess PAH severity. At the end of hypoxia exposure, the piglets were subjected to a pulsatile protocol using a pulsatile catheter. After being anesthetized and prepared for surgery, the jugular vein of the piglet was isolated and the catheter was introduced through the right atrium, the right ventricle and the pulmonary artery, under radioscopic control. Pulmonary artery pressure (PAP) was measured before (T0), immediately after (T1) and 30 min after (T2) the pulsatile protocol. It was demonstrated that this pulsatile protocol is a safe and efficient method of inducing a significant reduction in mean PAP via an NO-dependent mechanism. These data open up new avenues for the clinical management of PAH.

Pulmonary hypertension is associated with a significant reduction in pulmonary artery pulsatility, contractility and elasticity, contributing to an increase in pulmonary artery pressure and pulmonary resistance. Using a hypoxic piglet model, this study demonstrated that improving pulmonary artery plasticity using a newly developed pulsatile catheter improves hypoxic pulmonary hypertension.

增加肺动脉脉动流改善缺氧性肺动脉高压的仔猪

Pulmonary arterial hypertension (PAH) is a disease affecting distal pulmonary arteries (PA). These arteries are deformed, leading to right ventricular ...

Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis

Hip weakness is a common symptom affecting walking ability in people with multiple sclerosis (MS). It is known that resistance strength training (RST) can improve strength in individuals with MS, however; it remains unclear the duration of RST that is needed to make strength gains and how to adapt hip strengthening exercises for individuals of varying strength using only resistance bands. This paper describes the methodology to set up and implement an adapted resistance strength training program, using resistance bands, for individuals with MS. Directions for pre- and post-strength tests to evaluate efficacy of the strength-training program are included. Safety features and detailed instructions outline the weekly program content and progression. Current evidence is presented showing that significant strength gains can be made within 8 weeks of starting a RST program. Evidence is also presented showing that resistance strength training can be successfully adapted for individuals with MS of varying strength with little equipment.

Hip weakness is a common symptom affecting walking ability in people with multiple sclerosis. Isolated muscle strengthening is a useful method to target specific weaknesses. This protocol describes a progressive resistance-training program using exercise bands to increase hip muscle strength.

改编阻力训练提高力量在八周内的个人与多发性硬化症

Hip weakness is a common symptom affecting walking ability in people with multiple sclerosis (MS). It is known that resistance strength training (RST) can ...

TRUE Gene Silencing: Screening of a Heptamer-type Small Guide RNA Library for Potential Cancer Therapeutic Agents

TRUE gene silencing (termed after tRNase ZL-utilizing efficacious gene silencing) is one of the RNA-directed gene silencing technologies, which utilizes an artificial small guide RNA (sgRNA) to guide tRNA 3&#8242; processing endoribonuclease, tRNase ZL, to recognize a target RNA. sgRNAs can be taken up by cells without any transfection reagents and can downregulate their target RNA levels and/or induce apoptosis in human cancer cells. We have screened an sgRNA library containing 156 heptamer-type sgRNAs for the effect on viability of human myeloma and leukemia cells, and found that 20 of them can efficiently induce apoptosis in at least one of the cancer cell lines. Here we present a protocol for screening of a heptamer-type sgRNA library for potential therapeutic drugs against blood cancers. The protocol includes how to construct the sgRNA library, how to assess the effect of each sgRNA on cell viability, and how to further evaluate the effective sgRNAs by flow cytometry. Around 2,000 hits would be expected to be obtained by screening the full-scale sgRNA library composed of 16,384 heptamers.

Here we present a protocol for screening of a heptamer-type sgRNA library for potential therapeutic drugs against blood cancers.

TRUE基因沉默:一个七聚物型小导RNA库的筛选潜在的癌症治疗药

TRUE gene silencing (termed after tRNase ZL-utilizing efficacious gene silencing) is one of the RNA-directed gene silencing technologies, which utilizes ...

Depletion of Mouse Cells from Human Tumor Xenografts Significantly Improves Downstream Analysis of Target Cells

The use of in vitro cell line models for cancer research has been a useful tool. However, it has been shown that these models fail to reliably mimic patient tumors in different assays1. Human tumor xenografts represent the gold standard with respect to tumor biology, drug discovery, and metastasis research 2-4. Tumor xenografts can be derived from different types of material like tumor cell lines, tumor tissue from primary patient tumors4 or serially transplanted tumors. When propagated in vivo, xenografted tissue is infiltrated and vascularized by cells of mouse origin. Multiple factors such as the tumor entity, the origin of xenografted material, growth rate and region of transplantation influence the composition and the amount of mouse cells present in tumor xenografts. However, even when these factors are kept constant, the degree of mouse cell contamination is highly variable.
Contaminating mouse cells significantly impair downstream analyses of human tumor xenografts. As mouse fibroblasts show high plating efficacies and proliferation rates, they tend to overgrow cultures of human tumor cells, especially slowly proliferating subpopulations. Mouse cell derived DNA, mRNA, and protein components can bias downstream gene expression analysis, next-generation sequencing, as well as proteome analysis 5. To overcome these limitations, we have developed a fast and easy method to isolate untouched human tumor cells from xenografted tumor tissue. This procedure is based on the comprehensive depletion of cells of mouse origin by combining automated tissue dissociation with the benchtop tissue dissociator and magnetic cell sorting. Here, we demonstrate that human target cells can be can be obtained with purities higher than 96% within less than 20 min independent of the tumor type.

Human tumor xenografts are vascularized and infiltrated by cells of mouse origin during the growth phase in vivo. To circumvent the bias caused by these contaminating cells during downstream analysis, we developed a method allowing for comprehensive depletion of all mouse cells by magnetic cell sorting.

从人类肿瘤异种移植的小鼠细胞的消耗显着改善靶细胞下游分析

The use of in vitro cell line models for cancer research has been a useful tool. However, it has been shown that these models fail to reliably mimic ...