BACKGROUND:The lactate threshold is a crucial physiological indicator for assessing the aerobic metabolic capacity and training level of endurance athletes,representing the intensity point at which lactate production and clearance reach a dynamic equilibrium within the organism.The traditional lactate threshold training,which is a prolonged and stable-intensity training,aims to enhance the aerobic endurance and lactate clearance efficiency of athletes.In recent years,with the advancement of exercise physiology,double lactate threshold training has emerged as an innovative training modality,drawing extensive attention from both the academic circle and practitioners.Nevertheless,current systematic research on double lactate threshold training remains limited,particularly in aspects such as its physiological mechanisms,optimal implementation plans,and long-term effects.OBJECTIVE:To systematically sort out the development course of double lactate threshold training,deeply analyze its fundamental connotations,objectively assess its application effects,and investigate its physiological action mechanisms,with the expectation of providing scientific basis and guidance for the improvement and optimization of endurance sports training theories and practices.METHODS:With the search terms of"lactate threshold training,double lactate threshold training,lactate training,threshold training,endurance training,Norwegian training method,Norwegian training mode,Norwegian training experience,"a systematic search was conducted in databases,including PubMed,Web of Science,Embase,Medline,Cochrane Library,CNKI,WanFang,and VIP.After screening,8articles met the requirements,involving 8 training cases,and 14 top international athletes,and sports events include 800 m,1 500 m,5 000 m,10 000 m,and cross-country running(9.5 km for men and 4.5 km for women).RESULTS AND CONCLUSION:(1)For the first time,double lactate threshold training was defined as a training strategy aimed at improving aerobic and speed capabilities,involving separate aerobic and anaerobic threshold training sessions within a single training day(aerobic training load intensity requirement of 0.7-2.0 mmol/L,anaerobic training load intensity requirement of 2.0-4.5 mmol/L),with a training frequency of＞2 times per week and a training volume of 120-160 km per week.(2)Double lactate threshold training has positive effects on muscle adaptability and plasticity(dimension and elasticity),increasing aerobic and anaerobic capabilities,and alleviating central neural fatigue and peripheral fatigue.(3)The main mechanisms by which double lactate threshold training yields effects may include hormone secretion,protein synthesis and inhibitory regulation,muscle fiber recruitment and cell swelling,mitochondrial biosynthesis and improvement in the chain of respiratory function,and neurotransmitter regulation.(4)In the practical application of double lactate threshold training,factors such as individualized training plans,load intensity design and monitoring for threshold training days,and applicable sports events should be fully considered.For the systematic improvement of double lactate threshold training,further exploration is still needed in terms of application subjects,training plans,action mechanisms,effect evaluation,and safe application.

BACKGROUND:The lactate threshold is a crucial physiological indicator for assessing the aerobic metabolic capacity and training level of endurance athletes,representing the intensity point at which lactate production and clearance reach a dynamic equilibrium within the organism.The traditional lactate threshold training,which is a prolonged and stable-intensity training,aims to enhance the aerobic endurance and lactate clearance efficiency of athletes.In recent years,with the advancement of exercise physiology,double lactate threshold training has emerged as an innovative training modality,drawing extensive attention from both the academic circle and practitioners.Nevertheless,current systematic research on double lactate threshold training remains limited,particularly in aspects such as its physiological mechanisms,optimal implementation plans,and long-term effects.OBJECTIVE:To systematically sort out the development course of double lactate threshold training,deeply analyze its fundamental connotations,objectively assess its application effects,and investigate its physiological action mechanisms,with the expectation of providing scientific basis and guidance for the improvement and optimization of endurance sports training theories and practices.METHODS:With the search terms of"lactate threshold training,double lactate threshold training,lactate training,threshold training,endurance training,Norwegian training method,Norwegian training mode,Norwegian training experience,"a systematic search was conducted in databases,including PubMed,Web of Science,Embase,Medline,Cochrane Library,CNKI,WanFang,and VIP.After screening,8articles met the requirements,involving 8 training cases,and 14 top international athletes,and sports events include 800 m,1 500 m,5 000 m,10 000 m,and cross-country running(9.5 km for men and 4.5 km for women).RESULTS AND CONCLUSION:(1)For the first time,double lactate threshold training was defined as a training strategy aimed at improving aerobic and speed capabilities,involving separate aerobic and anaerobic threshold training sessions within a single training day(aerobic training load intensity requirement of 0.7-2.0 mmol/L,anaerobic training load intensity requirement of 2.0-4.5 mmol/L),with a training frequency of＞2 times per week and a training volume of 120-160 km per week.(2)Double lactate threshold training has positive effects on muscle adaptability and plasticity(dimension and elasticity),increasing aerobic and anaerobic capabilities,and alleviating central neural fatigue and peripheral fatigue.(3)The main mechanisms by which double lactate threshold training yields effects may include hormone secretion,protein synthesis and inhibitory regulation,muscle fiber recruitment and cell swelling,mitochondrial biosynthesis and improvement in the chain of respiratory function,and neurotransmitter regulation.(4)In the practical application of double lactate threshold training,factors such as individualized training plans,load intensity design and monitoring for threshold training days,and applicable sports events should be fully considered.For the systematic improvement of double lactate threshold training,further exploration is still needed in terms of application subjects,training plans,action mechanisms,effect evaluation,and safe application.

Objective To develop and validate a nomogram model that integrates systemic inflammatory markers to predict the likelihood of pelvic lymph node metastasis(PLNM)in prostate cancer patients prior to surgery.Methods This study retrospectively analyzed the clinical data and preoperative inflammatory markers—including neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),and monocyte-to-lymphocyte ratio(MLR)—of patients diagnosed with prostate cancer.Univariate and multi-variate logistic regression analyses were conducted to identify markers that were significantly associated with PLNM.Based on the results of the multivariate analysis,a nomogram was developed and its predictive accuracy was assessed using receiver operating characteristic curves(ROC)and calibration plots.Results Among the 334 enrolled patients with prostate cancer,107 were identified with PLNM.Univariate analysis revealed statistically significant differences in free prostate-specific antigen(fPSA),Gleason score,NLR,PLR,MLR,and SII between the PLNM and non-pelvic lymph node metastasis(NPLNM)groups(P<0.05).Multivariate analysis confirmed that fPSA,Gleason score,and SII were independent predictors of PLNM(P<0.05).A nomogram incorporating these predic-tors exhibited strong discriminative ability,with an area under the ROC curve(AUC)of 0.79(95%CI:0.73～0.84).Calibration analysis further demonstrated good consistency between the predicted and observed probabilities of PLNM.Conclusions This study successfully developed a nomogram model based on systemic inflammatory markers for preoperative prediction of pelvic lymph node metastasis in prostate cancer.Owing to its user-friendly design and high predictive accuracy,this tool may serve as a valuable complementary method to conventional imaging techniques,thereby supporting personalized treatment decision-making.

Objective To develop and validate a nomogram model that integrates systemic inflammatory markers to predict the likelihood of pelvic lymph node metastasis(PLNM)in prostate cancer patients prior to surgery.Methods This study retrospectively analyzed the clinical data and preoperative inflammatory markers—including neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),and monocyte-to-lymphocyte ratio(MLR)—of patients diagnosed with prostate cancer.Univariate and multi-variate logistic regression analyses were conducted to identify markers that were significantly associated with PLNM.Based on the results of the multivariate analysis,a nomogram was developed and its predictive accuracy was assessed using receiver operating characteristic curves(ROC)and calibration plots.Results Among the 334 enrolled patients with prostate cancer,107 were identified with PLNM.Univariate analysis revealed statistically significant differences in free prostate-specific antigen(fPSA),Gleason score,NLR,PLR,MLR,and SII between the PLNM and non-pelvic lymph node metastasis(NPLNM)groups(P<0.05).Multivariate analysis confirmed that fPSA,Gleason score,and SII were independent predictors of PLNM(P<0.05).A nomogram incorporating these predic-tors exhibited strong discriminative ability,with an area under the ROC curve(AUC)of 0.79(95%CI:0.73～0.84).Calibration analysis further demonstrated good consistency between the predicted and observed probabilities of PLNM.Conclusions This study successfully developed a nomogram model based on systemic inflammatory markers for preoperative prediction of pelvic lymph node metastasis in prostate cancer.Owing to its user-friendly design and high predictive accuracy,this tool may serve as a valuable complementary method to conventional imaging techniques,thereby supporting personalized treatment decision-making.

Despite exciting achievements with some malignancies, immunotherapy for hypoimmunogenic cancers, especially glioblastoma (GBM), remains a formidable clinical challenge. Poor immunogenicity and deficient immune infiltrates are two major limitations to an effective cancer-specific immune response. Herein, we propose that an injectable signal-amplifying nanocomposite/hydrogel system consisting of granulocyte-macrophage colony-stimulating factor and imiquimod-loaded antigen-capturing nanoparticles can simultaneously amplify the chemotactic signal of antigen-presenting cells and the "danger" signal of GBM. We demonstrated the feasibility of this strategy in two scenarios of GBM. In the first scenario, we showed that this simultaneous amplification system, in conjunction with local chemotherapy, enhanced both the immunogenicity and immune infiltrates in a recurrent GBM model; thus, ultimately making a cold GBM hot and suppressing postoperative relapse. Encouraged by excellent efficacy, we further exploited this signal-amplifying system to improve the efficiency of vaccine lysate in the treatment of refractory multiple GBM, a disease with limited clinical treatment options. In general, this biomaterial-based immune signal amplification system represents a unique approach to restore GBM-specific immunity and may provide a beneficial preliminary treatment for other clinically refractory malignancies.

Objective:Based on network pharmacology and molecular docking to explore the targets and mechanism of Xiaoyong Sanjie Formula treating Non-Puerperal Mastitis (NPM).Methods:By retrieving the active components and the corresponding target information of each component in Xiaoyong Sanjie Formula with Pharmacology Database and Analysis Platform of Chinese Medicine System (TCMSP), and NPM-related genes in database like GeneCard, OMIM, PharmGkb, TTD, and DrugBank, the data of the core targets of Xiaoyong Sanjie Formula and disease-related genes was compared to obtain intersecting genes, and the STRING database was used to analyze the protein interaction network and find the core genes. With the help of Cytoscape 3.8.0, the active ingredient-target-pathway regulation network diagram of Xiaoyong Sanjie Formula for the treatment of NPM was established. The R language pack was used to enrich the targets with GO function and KEGG pathway enrichment, and the potential targets and mechanism of Xiaoyong Sanjie Formula in the treatment of NPM were explored. Finally, molecular docking verification was carried out to analyze the effecacy of key components and potential core targets of Xiaoyong Sanjie Formula.Results:Network pharmacological analysis showed that there were 47 active component and 1 692 NPM-related potential targets in Xiaoyong Sanjie Formula, and 235 core targets of NPM in the treatment of Xiaoyong Sanjie Formula. The key components of Xiaoyong Sanjie Formula in the treatment of NPM include Quercetin, Naringenin, Kaempferol, Diosgenin, Luteolin, etc., with the core targets of intercellular adhesion molecule-1 (ICAM-1), vascular endothelial growth factor (VEGFA), tumor necrosis factor (TNF), interleukin-6 (IL-6), Epidermal growth factor receptor (EGFR), interleukin-1β (IL-1B), chemokine-8 (CXCL8), chemokine-2 (CCL2), etc. GO enrichment obtained 1 492 biological process entries. The KEGG pathway is enriched to obtain 105 pathways, including the TNF signaling pathway, the PI3K-Akt signaling pathway, the NF-kappa B signaling pathway, and the JAK-STAT signaling pathway, IL-17 signaling pathway, C-type lectin receptor signaling pathway, etc. The final molecular docking verified that the key active ingredients of Xiaoyong Sanjie Formula could bind with the potential core targets closely.Conclusion:Xiaoyong Sanjie Formula can treat NPM with multi-component, multi-target characteristics,which plays a role of treating NPM through signaling pathways such as immuno-inflammatory response, the metabolism of the medicine, cellular adaptive stress response, and vascular function regulation.

This article reported 2 cases primary renal Ewing sarcoma (PRES)/primitive neuroectodermal tumor (PNET). By reviewing literature, renal PRES/PNET has a high degree of malignancy, and early symptoms are not typical. It needs to be combined with clinical manifestations, imaging examinations and pathological examination results. At present, surgical treatment is the main treatment, combined with radiotherapy and chemotherapy or targeted treatment might help.

OBJECTIVES: To evaluate the response to cardiac resynchronization therapy (CRT) and the correlation between CRT and pulmonary artery hemodynamic parameters. METHODS: The patients with chronic heart failure indicator for CRT were enrolled. The left ventricular end-systolic volume (LVESV) was measured by echocardiography and New York Heart Association (NYHA) classification was evaluated between one week before and six months after CRT. Mean pulmonary artery pressure (mPAP), pulmonary artery systolic pressure (PASP) and pulmonary vascular resistance (PVR) were measured by right heart catheterization. Left ventricular reverse remodeling (LVRR) is defined as a decrease of 15% or more in LVESV at the 6th month after CRT; Clinical response is defined as a decrease of NYHA classification at or above grade 1 at the 6th month after CRT. Pulmonary hypertension (PH) was defined as mPAP≥25 mmHg. According to the response, patients were divided into 3 groups: group A (LVRR+clinical response), group B (no LVRR+clinical response) and group C (no LVRR+no clinical response). The changes of NYHA classification, echocardiographic and pulmonary hemodynamic parameters were observed in the 3 groups. The Kaplan-Meier survival curve was used to analyze the differences in all-cause mortality, combined end-point events of death or re-hospitalization due to heart failure among different groups. RESULTS: A total of 45 patients with CRT implantation [aged (63.27±9.55) years, 36 males] were included. The average follow-up period was (33.76±11.50) months. Thirty-one patients (68.89%) were in group A, 9 of whom with PH. Eight patients (17.78%) were in group B, 7 of whom with PH. Six patients were in group C, all with PH. Cardiac function including NYHA classification, echocardiographic and pulmonary hemodynamic parameters had been significantly improved in group A after CRT implantation (<0.05). In group B, NYHA classification and pulmonary hemodynamic parameters were decreased significantly (<0.05), but echocardiographic parameters did not change obviously (>0.05). There were no significant changes in NYHA classification, echocardiographic and pulmonary hemodynamic parameters in group C (>0.05). Compared with group C, group A and group B had lower all-cause mortality (=0.005) and lower incidence of composite endpoint events (=0.001). CONCLUSIONS Patients with LVRR and clinical response after CRT have a good prognosis. Patients with clinical response but without LVRR have a better prognosis than those without clinical response and LVRR, which may be related to the decrease of pulmonary hemodynamic parameters such as mPAP and TPG.
Aged ; Cardiac Resynchronization Therapy ; Heart Failure ; therapy ; Hemodynamics ; Humans ; Male ; Middle Aged ; Pulmonary Artery ; Treatment Outcome ; Ventricular Remodeling

Objective To evaluate the clinical efficacy of super-selective prostatic arterial embolization(PAE) for the treatment of benign prostatic hyperplasia(BPH).Methods From February 2012to March 2015,a total of 17 patients with BPH who failed in medical treatment,or unwilling to accept surgery were selected for PAE as the study group.The mean age was 73 years (range 61-84 years) and the mean prostatic volume was 64.6 ml (ranging 50-85 ml).The study group underwent super selective arterial embolization.The internal iliac artery angiography was performed and the main blood vessel of prostate was showed.The femoral artery was punctured under local anesthesia and X-ray monitoring,a F4-5 Cobra catheter was inserted,and then the Embosphere microspheres were implanted.A total of 40 patients who underwent transurethral resection of the prostate(TURP) were selected as the control group.The mean age was 70 years (ranging 59-87 years).The mean prostatic volume was 68.7 ml(ranging 55-90 ml).All cases were followed up for 1 year.The changes of prostatic volume (PV),international prostate symptom score(IPSS),quality of life (QOL),pre-and post-treatment peak urinary flow (Qmax) were evaluated.Results For the 17 patients who underwent PAE,the PV decreased from (64.6 ± 10.2) ml to(42.0 ± 7.5) ml,the IPSS decreased from 23.9 ±4.9 to 13.1 ±3.5,QOL decreased from 4.1 ±0.7 to 2.1 ±0.7,and Q increased from (9.5 ± 3.7) ml/s to(21.8 ± 4.2) ml/s,which were statistically significant (P ＜ 0.05) compared with the pre-treatment parameters.The post-operative parameters of the control group were also significantly improved compared with the preoperative parameters (P ＜ 0.05).Conclusions PAE is safe and effective in treating BPH,especially for those failing in medical treatment,or unwilling to accept surgery.

Objective To review the clinical diagnosis and treatment of acute focal renal infarction. Methods Three cases of focal renal infarction were reported and the literature was reviewed.The patients aged from 45 to 63 years with mean age of 54. Two cases had low back pain, 1 case with abdominal pain. Based on clinical history, B-ultrasonography and CT scan, focal renal infarction was diagnosed in 3 patients. There were 2 cases on left kidney and 1 case right. All cases were applied digital subtraction angiography (DSA) and thrombolytic anticoagulant therapy. Results Two cases received DSA and thrombolytic therapy. The other one case received pethidine 50 mg, progesterone 20 mg treatment, the salvia infusion and low molecular heparin 6000 U anticoagulant therapy. All patients had symtoms relieved after 1 d. A week later CT scan, 3 cases of renal infarction were apparently disappeared. Serum creatinine and urea nitrogen were normal. Three patients were followed, mean follow-up time was 1. 5 (0. 5-2) years. Conclusions The diagnosis of acute focal renal infarction mainly depends on B-ultrasound and CT. Early diagnosis and treatment is important for achieving recovery of the compromised renal function. Renal infarction should be suspected in the presence of abdominal pain of sudden onset.