Physiological effects of micropauses in isometric handgrip exercise

The physiological response to continuous and intermittent handgrip exercise was evaluated. Three experiments were performed until exhaustion at 25% of maximal voluntary contraction (MVC): experiment 1, continuous handgrip (CH) (n = 8); experiment 2, intermittent handgrip with 10-s rest pause every 3 min (IH) (n = 8); and experiment 3, as IH but with electrical stimulation (ES) of the forearm extensors in the pauses (IHES) (n = 4). Before, during, and after exercise, recordings were made of heart rate (HR), arterial blood pressure (BP), exercising forearm blood flow, and concentrations of potassium [K+] and lactate [La-] in venous blood from both arms. The electromyogram (EMG) of the exercising forearm extensors and perceived exertion were monitored during exercise. Before and up to 24 h after exercise, observations were made of MVC, of force response to electrical stimulation and of the EMG response to a 10-s test contraction (handgrip) at 25% of the initial MVC. Maximal endurance time (tlim) was significantly longer in IH (23.1 min) than in CH (16.2 min). The ES had no significant effect on tlim. During exercise, no significant differences were seen between CH and IH in blood flow, venous [K+] and [La-], or EMG response. The HR and BP increased at the same rate in CH and IH but, because of the longer duration of IH, the levels at exhaustion were higher in this protocol. The subjects reported less subjective fatigue in IH. During recovery, return to normal MVC was slower after CH (24 h) than after IH (4 h).(ABSTRACT TRUNCATED AT 250 WORDS)     

Trace elements and lipid peroxidation in uremic patients on hemodialysis

Trace elements and lipid peroxidation in 26 patients with chronic renal failure treated with hemodialysis and 25 healthy subjects were observed. Both plasma and erythrocyte trace elements and plasma malon dialdehyde (MDA) were examined immediately before and after hemodialysis. Increased levels of plasma Cu, MDA, and erythrocyte Pb, Mn, Zn, and a significantly decreased plasma Se, Zn and erythrocyte Se were found in patients before hemodialysis. After a single hemodialysis, erythrocyte Mn, Cu, Zn, and plasma Cu, Al, and MDA were significantly increased whereas both plasma and erythrocyte Se were lower in patients than in healthy subjects. The level of MDA was not significantly changed during the single hemodialysis. Both plasma and erythrocyte Zn levels and plasma Cu and Al were significantly higher after hemodialysis than before hemodialysis. In conclusion, levels of trace elements are altered by hemodialysis, which may increase patient susceptibility to lipid peroxidation in uremia.     

Essential trace elements in humans

Serum arsenic concentrations of persons suffering from renal failure and undergoing hemodialysis treatment (n=85) and of healthy controls (n=25) were determined by hydride-generation AAS technique after microwave digestion. The results were evaluated by comparing the values of both groups, considering physiological factors and individual data, as well as comorbid conditions of the hemodialysis (HD) patients. Serum arsenic levels were diminished in the patient group compared with controls (mean values 8.5±1.8 ng/mL vs 10.6±1.3 ng/mL). Furthermore, additional diseases within the hemodialysis group, particularly injuries of the central nervous system (CNS), vascular diseases, and cancer, were correlated to occasionally markedly decreased serum arsenic concentrations. It was concluded that arsenic homeostasis is disturbed by HD treatment and certain additional diseases. Desirable arsenic concentrations in the body seem to be reasonable. This consideration results in the conclusion that arsenic could play an essential role in human health. Thus, reference arsenic concentrations in different human tissues and body fluids should be established in order to recognize not only arsenic intoxication, but also arsenic deficiency. Perhaps arsenic deficiency contributes to the increased death risk of HD patients, and therefore, arsenic supplementations for patients with extremely low serum arsenic concentrations should be taken into account.     

Reversal of selenium and zinc deficiencies in chronic hemodialysis patients by intravenous sodium selenite and zinc gluconate supplementation

In six chronic dialyzed uremic patients, an intravenous sodium selenite (Se 50 μg during 5 wk and then 100 μg) and zinc gluconate (Zn 5 mg) supplementation was performed during 20 wk at each dialysis session three times weekly. Before supplementation, plasma Se and Zn, plasma and erythrocytes (RBC) antioxidant metalloenzymes glutathione peroxidase (GPX), and superoxide dismutase (SOD) were significantly decreased, whereas lipid peroxidation (as thiobarbituric acid reactants TBARs) was increased. To obtain a significative change in plasma selenium, we had to use an Se dose of 100 μg/dialysis session. Then, treatment-increased plasma Se (from 0.58 ±0.09 to 0.89±0.16 μmol/L) led to a repletion of RBC-GPX (from 29.6±6 to 43±5.8 U/g Hb) and increased plasma GPX levels (from 62±13 to 151±43 U/L). Plasma Zn and RBC-SOD did not vary significantly. The change of TBARs was not observed between wk 1 and 4. They decreased significantly between wk 4 (4.80±0.21μmol/L) and wk 20 (4.16±0.26 μmol/L). We noted a low correlation between TBARs and plasma GPX. A strong correlation was observed between Se and plasma GPX. The reversal of Se deficiencies should reduce oxidative damage observed in these patients.     

不同血液净化方法对维持性血液透析尿毒症动脉粥样硬化患者血清microRNA-144和microRNA-155水平的影响及其临床意义

摘要 目的：探讨不同血液净化方法对维持性血液透析（MHD）尿毒症动脉粥样硬化患者血清microRNA-144和microRNA-155水平的影响及其临床意义。方法：选取2019年6月~2020年6月川北医学院附属医院收治的98例MHD尿毒症动脉粥样硬化患者为研究组,另选取98例同期本院体检健康的志愿者为健康对照组,比较两组血清microRNA-144和microRNA-155、血清炎症因子[白细胞介素-6（IL-6）、单核细胞趋化蛋白-1（MCP-1）、超敏C反应蛋白（hs-CRP）]水平。采用Pearson分析法分析血清microRNA-144、microRNA-155水平与MHD尿毒症动脉粥样硬化患者内膜中层厚度（IMT）值、斑块面积及血清炎症因子的相关性。采用多因素Logistic回归分析MHD尿毒症动脉粥样硬化患者IMT增厚的影响因素。将研究组按随机数字表法分为血液透析滤过组和血液灌流组,各49例。血液透析滤过组给予血液透析滤过联合血液透析治疗,血液灌流组给予血液灌流联合血液透析治疗。比较两组血清microRNA-144和microRNA-155、血清炎症因子水平、IMT值和斑块面积。结果：研究组血清microRNA-144、microRNA-155、IL-6、MCP-1、hs-CRP水平明显高于健康对照组（P<0.05）;Pearson相关性结果显示,血清microRNA-144、microRNA-155均与MHD尿毒症动脉粥样硬化患者IMT值、斑块面积及IL-6、MCP-1、hs-CRP均呈正相关（P<0.05）;多因素Logistic回归分析结果显示,血清microRNA-144、microRNA-155、IL-6、MCP-1、hs-CRP水平均是导致MHD尿毒症动脉粥样硬化患者IMT增厚的危险因素（P<0.05）。治疗后,血液灌流组血清microRNA-144和microRNA-155水平均明显低于血液透析滤过组（P<0.05）,IL-6、MCP-1、hs-CRP水平均明显低于血液透析滤过组（P<0.05）,IMT值和斑块面积均明显低于血液透析滤过组（P<0.05）。结论：血清microRNA-144、microRNA-155水平与IMT值、斑块面积及IL-6、MCP-1、hs-CRP水平呈正相关,均是MHD尿毒症动脉粥样硬化患者IMT增厚的危险因素。血液灌流联合血液透析治疗可减轻机体炎症反应,延缓动脉粥样硬化进程,可能与下调患者血清microRNA-144、microRNA-155水平有关。     

Benthic macrofaunal communities in intermittent estuaries during a drought: Comparisons with permanently open estuaries

Drought conditions have prevailed in many areas of NSW since 2002. On the mid-north coast, below-average rainfall resulted in reduced riverine flows and the extended closure of intermittent estuaries within the Solitary Islands Marine Park. Patterns of structure of benthic infaunal communities were evaluated at the height of the drought to determine if they differed between closed, intermittent estuaries and permanently open estuaries within the region. Replicate van Veen grab samples were taken in the upper, mid- and lower reaches of six intermittent and three permanently open estuaries and sieved to retain the macrofauna. A range of physico-chemical measures was also taken at each sampling time. Multivariate analyses of assemblage data revealed a significant difference between the structure of the two estuary types and also among estuaries within each type. Differences between estuary types were attributable to small differences in the abundance of a number of taxa but also to the absence of the amphipod Urohaustorius metungi from most of the intermittent estuaries. In contrast, these small amphipods dominated communities in the lower reaches of the permanently open estuaries. Physico-chemical variables were highly variable among estuaries and were not strongly correlated with assemblage patterns. Correlations with catchment size were the strongest and, as most of the intermittent estuaries in the region are smaller than the permanently open estuaries, this confounds the interpretation of assemblage patterns in this preliminary study. In order to differentiate between the effects of catchment size and entrance status, the same estuaries need to be resurveyed during periods when at least some of the intermittent estuaries are open.     

丹参多酚酸盐对维持性血液透析患者残余肾功能与钙磷代谢的影响

目的:探讨丹参多酚酸盐对维持性血液透析患者残余肾功能与钙磷代谢的影响。方法:2014年1月-2019年5月选择在本院肾内科就诊的终末期肾病患者72例,根据随机数字表法分为观察组与对照组各36例。所有患者都给予维持性血液透析治疗,在此基础上观察组给予丹参多酚酸盐治疗,持续3个月,记录残余肾功能与钙磷代谢变化情况。结果:治疗后观察组的总有效率为97.2%,高于对照组的83.3%(P<0.05)。两组治疗后的24 h尿量、肾小球滤过率(glomerular filtration rate,GFR)、血清转化生长因子β1(Transforming growth factorβ1,TGF-β1)和白介素-6(Interleukin-6,IL-6)低于治疗前,观察组也低于对照组(P<0.05)。两组治疗后的血钙值高于治疗前,观察组也高于对照组;两组治疗后的血磷值低于治疗前,观察组也低于对照组(P<0.05)。结论:丹参多酚酸盐在维持性血液透析患者中的应用有利于残余肾功能的恢复,调节钙磷代谢平衡,抑制炎症因子的表达,从而提高治疗效果。     

糖尿病肾病与非糖尿病肾病维持性血液透析患者血钙、血磷及甲状旁腺激素水平的分析

目的：探讨糖尿病肾病（diabtic nephropgthy,DN）与非糖尿病肾病（non-DN）维持性血液透析患者（maintenance hemodialysis,MHD）血钙、血磷、甲状旁腺激素（intact parathyroid hormone,iPTH）水平的差异;分析其血钙、血磷、iPTH和糖化血红蛋白（glycosylated hemoglobin,HbA1c）水平的相关性。方法：选择沈阳军区总医院血液透析中心收治的148例MHD患者,分为糖尿病组（58例）和非糖尿病组（90例）,比较两组间血钙、血磷、甲状旁腺激素水平的差异,并分析其血钙、血磷、iPTH、HbA1c水平的相关性。结果：糖尿病组iPTH、血磷水平均明显低于非糖尿病组（P〈0.05）,两组血钙水平比较无明显差异。在非DN组中,iPTH与血钙水平呈显著负相关（r=-0.320,P=0.036）,iPTH与血磷水平呈明显正相关（r=0.426,P=0.005）。在DN组中,iPTH与血钙、血磷无显著相关性,而iPTH与HbA1C水平呈显著负相关（r=-0.732,P=0.007）。结论：糖尿病肾病血液透析患者的iPTH水平和血磷水平明显低于非糖尿病肾病血液透析患者,HbA1c可能抑制iPTH的分泌。     

OSAHS风险对患者静脉麻醉术后认知功能障碍的影响

目的:探讨OSAHS风险与静脉麻醉手术患者术后发生认知功能障碍的关系。方法:采用No SAS评分对55例静脉麻醉手术患者进行OSAHS风险评估,并将其分为对照组23例(NoSAS 8分)和OSAHS组32例(No SAS≥8分),以蒙特利尔认知评估量表(MoCA)对两组患者在术前和术后第一天进行认知功能评估,计算每位患者手术前后Mo CA评分的差值△Mo CA(术前MoCA-术后MoCA),比较两组患者手术前后的MoCA评分及△MoCA。结果:OSAHS组术前MoCA评分(25.83±1.80)明显低于对照组术前MoCA评分(28.05±1.31)(P0.05)。OSAHS组术后MoCA评分(25.13±1.64)较术前无明显变化(P0.05),对照组术后Mo CA评分(26.73±1.17)明显低于术前(P0.05)。OSAHS组△MoCA(0.39±1.03)明显低于对照组(1.32±1.08),主要表现为视空间与执行功能[(0.09±0.29) vs.(0.30±0.32)]、注意力[(0.09±0.60) vs.(0.47±0.70)]和延时回忆力[(0.17±0.39) vs.(0.47±0.51)]两方面(P0.05)。结论:OSAHS高风险患者静脉麻醉术后认知功能障碍的程度较OSAHS低风险人群显著降低。     

高通量血液透析治疗慢性肾衰竭尿毒症的疗效及对尿毒症毒素、免疫球蛋白及肺功能指标的影响

目的:探讨高通量血液透析(HFHD)治疗慢性肾衰竭尿毒症的疗效及对尿毒症毒素、免疫球蛋白及肺功能指标的影响。方法:选取90例于2012年1月-2017年3月期间在喀什地区第一人民医院治疗的慢性肾衰竭尿毒症患者,依据随机数字表法将其分为对照组(n=45)和观察组(n=45),对照组给予血液透析滤过(HDF)治疗,观察组给予HFHD治疗,两组均透析治疗1个月。对比两组患者透析前后症状缓解情况及尿毒症毒素、免疫球蛋白及肺功能指标水平,记录两组相关并发症的发生情况。结果:透析治疗结束后观察组患者缓解率为91.11%(41/45),高于对照组的73.33%(33/45)(P0.05)。两组患者透析后血磷(P~-)、血钾(K~+)、甲状旁腺激素(PTH)、β2-微球蛋白(β2-MG)水平明显低于透析前,血钙(Ca~(2+))水平明显高于透析前(P0.05);观察组透析后K~+、Ca~(2+)、P~-等尿毒症毒素水平与对照组比较差异无统计学意义(P0.05),观察组透析后PTH、β2-MG水平明显低于对照组(P0.05)。透析后,两组患者的免疫球蛋白Ig M、Ig A、Ig G水平均较透析前上升,且观察组高于对照组(P0.05)。透析后,两组患者残气量(RV)均低于治疗前,最大肺活量(FVC)、肺活量(VC)、肺总量(TLC)均高于治疗前,且观察组RV低于对照组,FVC、VC、TLC均高于对照组(P0.05)。观察组并发症发生率为8.89%(4/45),低于对照组的24.44%(11/45)(P0.05)。结论:HFHD治疗慢性肾衰竭尿毒症能够安全有效地清除尿毒症毒素,缓解患者的临床症状,且能够提高患者的免疫功能和肺功能。