过度训练综合症的预防、诊断和治疗

成功的训练不仅涉及到过负荷,同时必须避免大量过负荷练习与不充分恢复相结合。运动员可经历短期运动成绩下降。这一功能性过量训练在恢复后,可提高运动成绩。当训练和恢复之间平衡被破坏,可发生非功能性的过量训练(NFOR)。区分NFOR和过度训练综合症非常困难(OTS),取决于临床结果和排除诊断。诊断OTS的关键词是"延长性的不良适应",以及生物、神经生化和激素调节上的机制。普遍认为OTS症状比NFOR严重,如疲劳、成绩下降、情绪障碍。尽管目前没有单一的标志物可检测OTS,定期监测运动成绩、生理、生化、免疫和心理上的指标可能是最好的策略:发现不能够应对训练应激的运动员。     

Seasonal coronaviruses and SARS-CoV-2: effects of preexisting immunity during the COVID-19 pandemic

Although the coronavirus disease 2019 (COVID-19) epidemic is still ongoing, vaccination rates are rising slowly and related treatments and drugs are being developed. At the same time, there is increasing evidence of preexisting immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in humans, mainly consisting of preexisting antibodies and immune cells (including T cells and B cells). The presence of these antibodies is mainly due to the seasonal prevalence of four common coronavirus types, especially OC43 and HKU1. The accumulated relevant evidence has suggested that the target of antibodies is mainly the S2 subunit of S protein, followed by evolutionary conservative regions such as the nucleocapsid (N) protein. Additionally, preexisting memory T and B cells are also present in the population. Preexisting antibodies can help the body protect against SARS-CoV-2 infection, reduce the severity of COVID-19, and rapidly increase the immune response post-infection. These multiple effects can directly affect disease progression and even the likelihood of death in certain individuals. Besides the positive effects, preexisting immunity may also have negative consequences, such as antibody-dependent enhancement (ADE) and original antigenic sin (OAS), the prevalence of which needs to be further established. In the future, more research should be focused on evaluating the role of preexisting immunity in COVID-19 outcomes, adopting appropriate policies and strategies for fighting the pandemic, and vaccine development that considers preexisting immunity.