1.Effect and mechanism of Jichuan decoction on intestinal function in rats model of slow transit constipation
Gui-Bing PEI ; Bo ZHANG ; Zhi-Cheng CHEN ; Hua JIANG
The Chinese Journal of Clinical Pharmacology 2024;40(8):1189-1193
Objective To investigate the effect of Jichuan decoction on defecation in rats with slow transit constipation(STC).Methods A total of 36 SD rats were divided into model group,experimental group and control group.Except the control group,STC rat models were established in the other two groups by gavage of 2%rhein acid suspension.The experimental group was given 170%Jichuan decoction of 10 mL·kg-1 by gavage,while the control group and model group were given with 0.9%NaCl by gavage,once a day for 30 days.Fecal dry-wet weight ratio and colon transport time were observed by fecal weighing and recording of first fecal discharge time;substance P(SP)and vasoactive peptide(VIP)contents in plasma were detected by kit;changes in intestinal flora were detected by real-time fluorescent quantitative polymerase chain reaction(qRT-PCR).Results The dry-wet ratio of feces in control group,model group and experimental group were(44.86±4.40)%,(53.44±3.52)%and(44.28±4.33)%,respectively;the colon transport time were(340.17±34.91),(424.67±37.26)and(377.36±38.87)min,respectively;plasma SP were(79.86±7.56),(60.30±2.41)and(78.84±5.83)pg·mL-1,respectively;plasma VIP were(30.56±2.87),(23.38±6.62)and(28.39±2.37)pg·mL-1,respectively;the numbers of Bifidobacterium were 7.77±0.04,5.19±0.09 and 7.45±0.03,respectively;the numbers of Lactobacillus were 6.40±0.07,4.10±0.05 and 6.36±0.08,respectively.There were statistically significant differences in the above indexes between model group and control group,and between experimental group and model group(P<0.01,P<0.05).Conclusion Jichuan decoction can improve the defecation of rats with slow transit constipation.
2.Discussion on the Pathogenesis of Osteonecrosis of the Femoral Head Under the System of Non-uniform Settlement During Bone Resorption and Multidimensional Composite Bowstring Working in Coordination with the Theory of Liver-Kidney and Muscle-Bone Based on the Concept of Liver and Kidney Sharing the Common Source
Gui-Xin ZHANG ; Feng YANG ; Le ZHANG ; Jie LIU ; Zhi-Jian CHEN ; Lei PENG ; En-Long FU ; Shu-Hua LIU ; Chang-De WANG ; Chun-Zhu GONG
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(1):239-246
From the perspective of the physiological basis of liver and kidney sharing the common source in traditional Chinese medicine(TCM),and by integrating the theory of kidney dominating bone,liver dominating tendon,and meridian sinew of TCM as well as the bone resorption and collapse theory,and non-uniform settlement theory and lower-limb musculoskeletal bowstring structure theory of modern orthopedics,the pathogenesis of osteonecrosis of the femoral head(ONFH)under the system of non-uniform settlement during bone resorption and multidimensional composite bowstring working in coordination with the theory of liver-kidney and muscle-bone was explored.The key to the TCM pathogenesis of ONFH lies in the deficiency of the liver and kidney,and then the imbalance of kidney yin-yang leads to the disruption of the dynamic balance of bone formation and bone resorption mediated by osteoblasts-osteoclasts,which manifests as the elevated level of bone metabolism and the enhancement of focal bone resorption in the femoral head,and then leads to the necrosis and collapse of the femoral head.It is considered that the kidney dominates bone,liver dominates tendon,and the tendon and bone together constitute the muscle-bone-joint dynamic and static system of the hip joint.The appearance of collapse destroys the originally balanced muscle-bone-joint system.Moreover,the failure of liver blood in the nourishment of muscles and tendons further exacerbates the imbalance of the soft tissues around the hip joint,accelerates the collapse of the muscle-bone-joint dynamic and static system,speeds up the process of femoral head collapse,and ultimately results in irreversible outcomes.Based on the above pathogenesis,the systematic integrative treatment of ONFH should be based on the TCM holistic concept,focuses on the focal improvement of internal and external blood circulation of the femoral head by various approaches,so as to rebuild the coordination of joint function.Moreover,attention should be paid to the physical constitution of the patients,and therapy of tonifying the kidney and regulating the liver can be used to restore the balance between osteogenesis and osteoblastogenesis,and to reconstruct the muscle-bone-joint system,so as to effectively delay or even prevent the occurrence of ONFH.
3.Research on the regulation of ferroptosis in hepatic stellate cells line LX2 by recombinant cytoglobin
Xun-wei DUAN ; Gui-qing XIAO ; Huai-yu CHEN ; Yong ZHANG ; Wen-lin WU ; Yi GAO ; Yong DIAO
Acta Pharmaceutica Sinica 2024;59(8):2237-2244
Intracellular overexpression of cytoglobin (Cygb) has been shown to reduce extracellular matrix deposition and promote liver fibrosis recovery, but its mechanism is not yet clear. This study constructed and expressed a fusion protein (TAT-Cygb) of cell penetrating peptide TAT and Cygb, to investigate the effect of fusion protein TAT-Cygb on regulating hepatic stellate cells (HSCs) ferroptosis. Cultured human hepatic stellate cells line (LX2) were treated with TAT-Cygb and erastin
4.Accuracy of Contrast-Enhanced Ultrasound Diagnostic Reports for 859 Cases of Pancreatic Space-occupying Lesions
Yang GUI ; Ke LYU ; Hua LIANG ; Xueqi CHEN ; Wanying JIA ; Tianjiao CHEN ; Yuxin JIANG
Medical Journal of Peking Union Medical College Hospital 2024;15(4):825-830
To evaluate the accuracy of contrast-enhanced ultrasound diagnostic reports for pancreatic lesions. In this retrospective study, we included patients who underwent contrast-enhanced ultrasound examination of pancreatic lesions at Peking Union Medical College Hospital from January 2017 to December 2022 and received a confirmed pathological diagnosis. Using pathological diagnosis as the gold standard, the study evaluated the accuracy of contrast-enhanced diagnostic ultrasound. It also analyzed the misdiagnosis of contrast-enhanced ultrasound in diagnosing various pathological types of pancreatic lesions. Of the 859 patients who met inclusion and exclusion criteria, 489 were male(56.9%) and 370 were female(43.1%).Their age ranged from 16 to 85 years, with a median age of 60(53, 66) years. Except for 47 pancreatic space-occupying lesions that were difficult to categorize as either benign or malignant, a total of 812 cases were included in the diagnostic efficacy analysis of benign and malignant lesions. The results suggested that the diagnostic sensitivity and specificity of contrast-enhanced ultrasound for pancreatic malignant lesions were 98.3%(95% CI: 97.1%-99.1%) and 79.0%(95% CI: 70.1%-86.4%), AUC was 0.887(95% CI: 0.863-0.908), positive and negative predictive value were 96.9%(95% CI: 95.6%-97.9%) and 87.4%(95% CI: 79.6%-92.4%), positive and negative likelihood ratio were 4.69(95% CI: 3.24-6.80) and 0.02(95% CI: 0.01-0.04). The diagnostic accuracy rate of contrast-enhanced ultrasound for diagnosing benign and malignant pancreatic lesions was 95.8%. Of the 859 lesions examined, 48 cases were misdiagnosed by contrast-enhanced ultrasound, with a misdiagnosis rate of 5.6%(48/859), including 7 cases(0.8%) of undetermined diagnosis, while the diagnostic accuracy of pancreatic ductal adenocarcinoma was as high as 98.8%. No complications occurred in any of the patients. Contrast-enhanced ultrasound is a safe and effective imaging method for evaluating microvascular perfusion in various pancreatic lesions. It has significant clinical value in diagnosing both benign and malignant pancreatic lesions, particularly in diagnosing pancreatic ductal adenocarcinoma.
5.Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture (version 2024)
Yun HAN ; Feifei JIA ; Qing LU ; Xingling XIAO ; Hua LIN ; Ying YING ; Junqin DING ; Min GUI ; Xiaojing SU ; Yaping CHEN ; Ping ZHANG ; Yun XU ; Tianwen HUANG ; Jiali CHEN ; Yi WANG ; Luo FAN ; Fanghui DONG ; Wenjuan ZHOU ; Wanxia LUO ; Xiaoyan XU ; Chunhua DENG ; Xiaohua CHEN ; Yuliu ZHENG ; Dekun YI ; Lin ZHANG ; Hanli PAN ; Jie CHEN ; Kaipeng ZHUANG ; Yang ZHOU ; Sui WENJIE ; Ning NING ; Songmei WU ; Jinli GUO ; Sanlian HU ; Lunlan LI ; Xiangyan KONG ; Hui YU ; Yifei ZHU ; Xifen YU ; Chen CHEN ; Shuixia LI ; Yuan GAO ; Xiuting LI ; Leling FENG
Chinese Journal of Trauma 2024;40(9):769-780
Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.
6.Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients (version 2024)
Yao LU ; Yang LI ; Leiying ZHANG ; Hao TANG ; Huidan JING ; Yaoli WANG ; Xiangzhi JIA ; Li BA ; Maohong BIAN ; Dan CAI ; Hui CAI ; Xiaohong CAI ; Zhanshan ZHA ; Bingyu CHEN ; Daqing CHEN ; Feng CHEN ; Guoan CHEN ; Haiming CHEN ; Jing CHEN ; Min CHEN ; Qing CHEN ; Shu CHEN ; Xi CHEN ; Jinfeng CHENG ; Xiaoling CHU ; Hongwang CUI ; Xin CUI ; Zhen DA ; Ying DAI ; Surong DENG ; Weiqun DONG ; Weimin FAN ; Ke FENG ; Danhui FU ; Yongshui FU ; Qi FU ; Xuemei FU ; Jia GAN ; Xinyu GAN ; Wei GAO ; Huaizheng GONG ; Rong GUI ; Geng GUO ; Ning HAN ; Yiwen HAO ; Wubing HE ; Qiang HONG ; Ruiqin HOU ; Wei HOU ; Jie HU ; Peiyang HU ; Xi HU ; Xiaoyu HU ; Guangbin HUANG ; Jie HUANG ; Xiangyan HUANG ; Yuanshuai HUANG ; Shouyong HUN ; Xuebing JIANG ; Ping JIN ; Dong LAI ; Aiping LE ; Hongmei LI ; Bijuan LI ; Cuiying LI ; Daihong LI ; Haihong LI ; He LI ; Hui LI ; Jianping LI ; Ning LI ; Xiying LI ; Xiangmin LI ; Xiaofei LI ; Xiaojuan LI ; Zhiqiang LI ; Zhongjun LI ; Zunyan LI ; Huaqin LIANG ; Xiaohua LIANG ; Dongfa LIAO ; Qun LIAO ; Yan LIAO ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Peixian LIU ; Tiemei LIU ; Xiaoxin LIU ; Zhiwei LIU ; Zhongdi LIU ; Hua LU ; Jianfeng LUAN ; Jianjun LUO ; Qun LUO ; Dingfeng LYU ; Qi LYU ; Xianping LYU ; Aijun MA ; Liqiang MA ; Shuxuan MA ; Xainjun MA ; Xiaogang MA ; Xiaoli MA ; Guoqing MAO ; Shijie MU ; Shaolin NIE ; Shujuan OUYANG ; Xilin OUYANG ; Chunqiu PAN ; Jian PAN ; Xiaohua PAN ; Lei PENG ; Tao PENG ; Baohua QIAN ; Shu QIAO ; Li QIN ; Ying REN ; Zhaoqi REN ; Ruiming RONG ; Changshan SU ; Mingwei SUN ; Wenwu SUN ; Zhenwei SUN ; Haiping TANG ; Xiaofeng TANG ; Changjiu TANG ; Cuihua TAO ; Zhibin TIAN ; Juan WANG ; Baoyan WANG ; Chunyan WANG ; Gefei WANG ; Haiyan WANG ; Hongjie WANG ; Peng WANG ; Pengli WANG ; Qiushi WANG ; Xiaoning WANG ; Xinhua WANG ; Xuefeng WANG ; Yong WANG ; Yongjun WANG ; Yuanjie WANG ; Zhihua WANG ; Shaojun WEI ; Yaming WEI ; Jianbo WEN ; Jun WEN ; Jiang WU ; Jufeng WU ; Aijun XIA ; Fei XIA ; Rong XIA ; Jue XIE ; Yanchao XING ; Yan XIONG ; Feng XU ; Yongzhu XU ; Yongan XU ; Yonghe YAN ; Beizhan YAN ; Jiang YANG ; Jiangcun YANG ; Jun YANG ; Xinwen YANG ; Yongyi YANG ; Chunyan YAO ; Mingliang YE ; Changlin YIN ; Ming YIN ; Wen YIN ; Lianling YU ; Shuhong YU ; Zebo YU ; Yigang YU ; Anyong YU ; Hong YUAN ; Yi YUAN ; Chan ZHANG ; Jinjun ZHANG ; Jun ZHANG ; Kai ZHANG ; Leibing ZHANG ; Quan ZHANG ; Rongjiang ZHANG ; Sanming ZHANG ; Shengji ZHANG ; Shuo ZHANG ; Wei ZHANG ; Weidong ZHANG ; Xi ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Xiaojun ZHANG ; Guoqing ZHAO ; Jianpeng ZHAO ; Shuming ZHAO ; Beibei ZHENG ; Shangen ZHENG ; Huayou ZHOU ; Jicheng ZHOU ; Lihong ZHOU ; Mou ZHOU ; Xiaoyu ZHOU ; Xuelian ZHOU ; Yuan ZHOU ; Zheng ZHOU ; Zuhuang ZHOU ; Haiyan ZHU ; Peiyuan ZHU ; Changju ZHU ; Lili ZHU ; Zhengguo WANG ; Jianxin JIANG ; Deqing WANG ; Jiongcai LAN ; Quanli WANG ; Yang YU ; Lianyang ZHANG ; Aiqing WEN
Chinese Journal of Trauma 2024;40(10):865-881
Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.
7.Longitudinal intussusception versus end-to-side vasoepididymostomy:Comparison of their recanalization rates
Lu-Gang ZHAO ; Hong CHEN ; Gui-Hua LIU ; Cong FANG ; Xiao-Yan LIANG ; Jing ZHANG
National Journal of Andrology 2024;30(11):1002-1008
Objective:To compare the recanalization rate of 2-suture longitudinal intussusception vasoepididymostomy(LIVE)with that of4-suture end-to-side vasoepididymostomy(ESVE).Methods:This retrospective case-control study included 127 cases of obstructive azoospermia(OA)treated by LIVE(n=87)or ESVE(n=40)in our Center of Reproductive Medicine from October 2013 to July 2024.We analyzed the clinical data and compared the age,testis volume,level of serum follicle-stimulating hormone(FSH),operation time and postoperative recanalization rate between the two groups.Results:Spermatozoa were observed in 90(70.9%)of the 127 cases after surgery.There were no statistical differences in age,testis volume and FSH between the two groups of patients(all P>0.05),and nor were there any serious surgical complications.The operation time was significantly longer in the ESVE than in the LIVE group(22.0[20.0-25.8]vs 17.0[15.0-23.0]min,P<0.05),while the postoperative recanalization rate remarkably higher in the former than in the latter group(85.0%vs 64.4%,P<0.05).Vasoepididymostomy was performed at the caput epididymis in 11 cases,with a higher recanalization rate in the ESVE than in the LIVE group(50.0%[1/2]vs 33.3%[3/9]).Conclusion:ESVE achieved a higher postoperative recanalization rate than LIVE in the treatment of OA,but its advanta-ges need further investigation.
8.Establishment of HPLC fingerprints and content determination of seven constituents for Tanacetum tatsienense
Rui LI ; Wen-Li CHEN ; Dian-Dian KANG ; Jie-Yu SUN ; Ze-Yuan SUN ; Rui GU ; Gui-Hua JIANG
Chinese Traditional Patent Medicine 2024;46(6):1794-1799
AIM To establish the HPLC fingerprints for Tanacetum tatsienense(Bureau & Franchet)K.Bremer & Humphries and to determine the contents of chlorogenic acid,quercetin-3-O-glucoside,luteolin-7-O-glucoside,luteolin-7-O-glucuronide,apigenin-7-O-glucuronide,luteolin and apigenin.METHODS The analysis was performed on a 35 ℃ thermostatic Agilent ZORBAX Extend C18 column(4.6 mm×250 mm,0.5 μm),with the mobile phase comprising of 0.5%phosphoric acid-acetonitrile flowing at 1.0 mL/min,and the detection wavelength was set at 350 nm.Subsequently,principal component analysis,partial least squares discriminant analysis and cluster analysis were carried out.RESULTS There were twelve common peaks in the fingerprints for fourteen batches of samples with the similarities of 0.761-0.975.Seven constituents showed good linear relationships within their own ranges(R2≥0.999 1),whose average recoveries were 84.00%-105.11%with the RSDs of 1.28%-2.86%.Various batches of samples were clustered into three types,and seven differential constituents were observable,containing peaks 4(luteolin-7-O-glucoside),12(apigenin),9(apigenin-7-O-glucuronide),8,11(luteolin),5(luteolin-7-O-glucuronide)and 2.CONCLUSION This precise,stable,specific and reproducible method can be used for the quality control of T.tatsienense.
9.Analysis of the Current Situation of Basic Research on Acupuncture and Moxibustion and Strategy for Its Development
Xiao-Rong TANG ; Si-Yun CHEN ; Wei-Hua YUAN ; Jian SUN ; Ai-Jun LIU ; Li-Ming LU ; Chun-Zhi TANG ; Neng-Gui XU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(10):2727-2733
In recent years,the development of acupuncture and moxibustion(shortened as acup-moxibustion)has flourished.With the verification of clinical efficacy of acup-moxibustion,its basic research has gradually drawn the attention of the practitioners accordingly.But how to scientifically perform the basic research of acup-moxibustion and to serve the clinic effectively has become a major problem for the contemporary Chinese medicine practitioners.By analyzing the characteristics of acup-moxibustion-related research projects funded by the National Natural Science Foundation of China,this paper outlined the current status of domestic research of acup-moxibustion,and proposed four suggestions after analyzing the problems and weaknesses of acup-moxibustion basic research in China:①the clinical evidence-based system in the current acup-moxibustion should be further constructed and the basic research should be focused on the area of advantages;② the key problems of acup-moxibustion basic research should be clarified,and the proportion of original researches should be increased;③ the integration of production,teaching and research of acup-moxibustion should be enhanced to adapt to the era of big science;④ the funding system and its polity and structure needed to be reformed.This study will help to increase the discipline ranking of acup-moxibustion,enhance its high-quality development,and promote its internationalization.
10.Study on after-effect of electroacupuncture with different time intervals on corticospinal excitability in primary motor cortex.
Meng-Meng XIE ; Zi-Zhen CHEN ; Wei-Li CHENG ; Jian-Peng HUANG ; Neng-Gui XU ; Jian-Hua LIU
Chinese Acupuncture & Moxibustion 2023;43(11):1239-1245
OBJECTIVES:
To compare the effects of electroacupuncture (EA) with different time intervals on corticospinal excitability of the primary motor cortex (M1) and the upper limb motor function in healthy subjects and observe the after-effect rule of acupuncture.
METHODS:
Self-comparison before and after intervention design was adopted. Fifteen healthy subjects were included and all of them received three stages of trial observation, namely EA0 group (received one session of EA), EA6h group (received two sessions of EA within 1 day, with an interval of 6 h) and EA48h group (received two sessions of EA within 3 days, with an interval of 48 h). The washout period among stages was 1 week. In each group, the needles were inserted perpendicularly at Hegu (LI 4) on the left side, 23 mm in depth and at a non-acupoint, 0.5 cm nearby to the left side of Hegu (LI 4), separately. Han's acupoint nerve stimulator (HANS-200A) was attached to these two needles, with continuous wave and the frequency of 2 Hz. The stimulation intensity was exerted higher than the exercise threshold (local muscle twitching was visible, and pain was tolerable by healthy subjects, 1-2 mA ). The needles were retained for 30 min. Using the single pulse mode of transcranial magnetic stimulation (TMS) technique, before the first session of EA (T0) and at the moment (T1), in 2 h (T2) and 24 h (T3) after the end of the last session of EA, on the left first dorsal interosseous muscle, the amplitude, latency (LAT), resting motor threshold (rMT) of motor evoked potentials (MEPs) and the completion time of grooved pegboard test (GPT) were detected. Besides, in the EA6h group, TMS was adopted to detect the excitability of M1 (amplitude, LAT and rMT of MEPs) before the last session of EA (T0*).
RESULTS:
The amplitude of MEPs at T1 and T2 in the EA0 group, at T0* in the EA6h group and at T1, T2 and T3 in the EA48h group was higher when compared with the value at T0 in each group separately (P<0.001). At T1, the amplitude of MEPs in the EA0 group and the EA48h group was higher than that in the EA6h group (P<0.001, P<0.01); at T2, it was higher in the EA0 group when compared with that in the EA6h group (P<0.01); at T3, the amplitude in the EA0 group and the EA6h group was lower than that of the EA48h group (P<0.001). The LAT at T1 was shorter than that at T0 in the three groups (P<0.05), and the changes were not obvious at the rest time points compared with that at T0 (P > 0.05). The GPT completion time of healthy subjects in the EA0 group and the EA48h group at T1, T2 and T3 was reduced in comparison with that at T0 (P<0.001). The completion time at T3 was shorter than that at T0 in the EA6h group (P<0.05); at T2, it was reduced in the EA48h group when compared with that of the EA6h group (P<0.05). There were no significant differences in rMT among the three groups and within each group (P>0.05).
CONCLUSIONS
Under physiological conditions, EA has obvious after-effect on corticospinal excitability and upper limb motor function. The short-term interval protocol (6 h) blocks the after-effect of EA to a certain extent, while the long-term interval protocol (48 h) prolongs the after-effect of EA.
Humans
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Electroacupuncture
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Motor Cortex/physiology*
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Transcranial Magnetic Stimulation/methods*
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Upper Extremity
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Exercise
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Muscle, Skeletal/physiology*

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