舒血宁注射液对脑梗塞患者血小板活化状态的影响

目的:观察舒血宁注射液(成分:银杏提取物)对脑梗塞患者血小板活化的影响。方法:将63例脑梗塞患者随机分为两组,其中拜阿司匹灵组(aspirin group)31例,单用拜阿司匹灵治疗,舒血宁注射液+拜阿司匹灵组(Gingko+aspirin group)32例,予拜阿司匹灵联合舒血宁注射液治疗,并设立健康对照组30名,测定两组脑梗塞患者急性期和恢复期及健康对照组的PAC1、CD62P表达率,所测结果进行比较。结果:两组脑梗塞经分别治疗后,舒血宁注射液+拜阿司匹灵组PAC1、CD62P表达率较拜阿司匹灵组降低,差异有统计学意义(P<0.01)。结论:舒血宁注射液联合拜阿司匹灵可更好的抑制血小板活化。     

血小板活化指标及血小板参数在乙肝肝硬化患者中的检测价值研究

目的:研究血小板活化指标及血小板参数在乙肝肝硬化患者中的检测价值。方法:选取2015年11月~2016年8月期间于本院进行诊治的40例乙肝肝硬化患者为观察组,同时期的40名体检结果为健康的人员为对照组,检测与比较两组同龄人员的血小板活化指标及血小板参数,并比较不同分期乙肝肝硬化患者的上述两方面检测结果。结果:观察组的PLT低于对照组,其他血小板参数及血小板活化指标均高于对照组,且不同分期乙肝肝硬化患者的上述两方面检测结果也存在明显差异,P均0.05,比较结果间均有显著性差异。结论:乙肝肝硬化患者的血小板活化指标及血小板参数表达明显异常,且不同肝硬化分期患者的表达水平也存在显著性差异,因此应加强对乙肝肝硬化患者上述指标的监测。     

microRNA调控血小板生成及功能

microRNA（miRNA）是一类长约22nt（19～23nt）在进化上非常保守的非编码RNA,其能够通过降解mRNA或抑制mRNA翻译来调控蛋白表达。研究证实miRNAs在包括胚胎干细胞分化、单核细胞和巨核细胞生成等血细胞形成过程中扮演重要的角色。而由巨核细胞生成的血小板内同样存在miRNAs,并且被证实参与到血小板活化和血小板生理病理状态改变等过程中。对miRNA调控血小板生成及功能的深入研究将有利于早期诊断治疗血液系统相关疾病。     

Flow Cytometric Analysis of Circadian Changes in Platelet Activation Using Anti-Gmp-140 Monoclonal Antibody

The hemostatic activity of blood shows a circadian variation with a higher frequency of acute coronary events in the morning. The thrombotic tendency of blood is influenced by many factors, including platelets. Diurnal changes of in vivo platelet activation were investigated by whole blood flow cytometry in 10 young healthy male volunteers using anti-GMP-140 (anti-α-granule membrane protein 140 kD) monoclonal antibody at 3h intervals from 06:00 to 24:00. We also studied circulating platelet aggregates to investigate whether there exists a similarity between the results of these methods. Results of flow cytometric analysis indicate that there is an increase in platelet activation during the period from 06:00 to 09:00. Platelet activation then decreases gradually during the period from noon to midnight. These changes are accompanied by a similar trend in circulating platelet aggregates. This suggests that GMP-140 expression on platelets is synchronized with or followed by platelet aggregate formation in vivo, and increased platelet activation may predispose individuals to thrombosis at this time.     

急性心理应激下血小板活化参数的变化及其机制探讨

目的:探讨急性心理应激下健康人群血小板活化参数的变化及其与性别、年龄的相关性,并分析其可能的机制。方法:检测54名健康被试者急性心理应激前后的血小板四项变化,包括血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)和大血小板比率(P-LCR)。随后,将被试者分成男、女性组或中、老年组,对其血小板四项结果进行组内及组间比较。结果:急性心理应激可导致健康人群中MPV、PDW和P-LCR的显著增加(P0.05),但年龄分组或性别分组组间均未见显著差异(P0.05)。结论:实验性急性心理应激可导致健康人群血小板活化指标MPV、PDW和P-LCR的显著增加,但与年龄和性别无关。     

高空气球搭载实验对普通鸡冠花抗氧化作用的诱变效应

利用高空气球搭载黄色普通鸡冠花(CelosiaargenteaL.)(yellowflower)种子,进行空间诱变处理。飞行高度为40.112km,飞行时间近4h,回收后播种栽培,采收子一代(SP1)的花序和叶片。采用比色法研究搭载组和对照组花序、叶片水提液对超氧阴离子自由基(O2-.)和羟自由基(·OH)的清除作用,并测定分析了样品的VC,黄酮醇的含量和SOD活力。结果表明,搭载组和对照组花序和叶片水提液均能降低·OH引发的还原型细胞色素C[Cyt·C(Ⅱ)]氧化作用和O2-.对羟胺的氧化作用,而搭载组样品水提取液清除活性氧的能力均比对照组显著提高,这与其自由基清除剂含量和活力的增高有关。这说明高空环境诱变处理对鸡冠花中抗氧化活性物质的合成和抗氧化功能产生了显著效应。     

Exposure to Intermittent High Altitude Induces Different Changes in Adenylyl Cyclase Activity in Hearts of Young and Adult Wistar Rats

Abstract

This study investigates changes of adenylyl cyclase activity in the heart of young and adult Wistar rats exposed to experimental conditions simulating high altitude hypoxia as a model for interpretation of some adaptive changes of adenylyl cyclase observed in human. The exposure of rats to intermittent high altitude (IHA) hypoxia (5000 m) showed significant adaptive changes. The right ventricular weight and the ratio of right/left ventricular weights of adult rats exposed to IHA were significantly increased when compared to appropriate controls; adaptive changes of cardiac adenylyl cyclase being dependent on the age of the animals. The isoprenaline‐stimulated activity was higher in the left than in the right ventricle, and in both ventricles it was higher in young rats than in adult rats. When compared to controls, isoprenaline stimulation was decreased in the right ventricles of adapted young rats and, by contrast, it was increased in the left ventricles of adapted adult rats. This decrease and increase of adenylyl cyclase activity evoked by isoprenaline was paralleled by forskolin‐induced adenylyl cyclase activity in these experimental groups. It seems therefore that the changes in the pattern of total adenylyl cyclase activity observed under IHA hypoxia may at least be partially explained by the changes of beta‐adrenergic receptor susceptibility following IHA hypoxia.     

516例参训官兵高原反应测试分析

目的:探讨在模拟不同海拔高度时,拟赴高原的参训官兵在急进高原时高原反应发生的特点,为高原参训官兵高原病的预防提供理论依据。方法:应用西北特殊环境人工实验舱模拟不同海拔高度,随机对516名平原部队参训官兵进行急进不同海拔高原反应进行测试,动态观察平原环境、急进高原2000 m、3000 m、4500 m海拔高度的自觉症状及部分生理指标(心率、血氧饱和度)的动态变化以及进舱前和出舱后血压值变化情况。结果:(1)516名官兵均完成测试,在海拔2000 m时,53例出现耳闷、耳涨症状,94例出现耳鸣症状,作吞咽动作后在以后的"上升"和"下降"过程中均未出现症状;在海拔4500 m时,39例出现高原反应,其中19例出现头晕症状,20例出现手足麻木,高原反应发生率7.56%。(2)随着海拔高度逐渐升高,受试者心率逐渐加快,从2000 m开始加快明显(p0.05),血氧饱和度逐渐降低,到3000 m开始血氧饱和度下降明显(p0.05)。(3)进舱前和出舱后血压值相比没有统计学差异(p0.05)。结论:参训官兵急进高原后,高原反应主要出现在4500 m海拔高度,高原反应发生率7.56%;高原环境对机体的心率、血氧饱和度的影响随着海拔高度增加而明显,2000 m开始心率明显加快,3000 m开始出现血氧饱和度明显下降,耳部不适症状主要出现在2000 m,但在做吞咽动作后消失。     

坐式八段锦联合运动康复治疗对急性冠脉综合征PCI术后患者运动耐力、血清心肌损伤标志物和生活质量的影响

摘要 目的：探讨坐式八段锦联合运动康复治疗对急性冠脉综合征（ACS）经皮冠状动脉介入治疗术（PCI）后患者运动耐力、血清心肌损伤标志物和生活质量的影响。方法：根据随机数字表法,将我院2020年4月~2021年5月期间收治的ACS行PCI术的患者（n=120）分为对照组（运动康复治疗,n=60）和研究组（坐式八段锦联合运动康复治疗,n=60）。对比两组心功能指标[左心室舒张末期内径（LVEDD）、左心室射血分数（LVEF）、氨基末端B型脑利钠肽前体（NT-proBNP）、左心室舒张末期容积（LVEDV）]、心肌损伤标志物[肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白I（cTnI）]、运动耐力指标[无氧阈（AT）、最大摄氧量（VO_2max ）、运动持续时间（ED）]和生活质量[西雅图心绞痛量表（SAQ）评分：躯体活动受限程度（PL）、心绞痛稳定情况（AS）、疾病认知程度（DS）、心绞痛发作状况（AF）和治疗满意程度（TS）],并纪录两组不良心血管事件发生情况。结果：研究组的心血管不良事件发生率低于对照组（P<0.05）。研究组治疗3个月后LVEF高于对照组,LVEDD、LVEDV、NT-proBNP低于对照组（P<0.05）。研究组治疗3个月后CK-MB、cTnI低于对照组（P<0.05）。研究组治疗3个月后AT、VO_2max 、ED高于对照组（P<0.05）。研究组治疗3个月后PL、AS、DS、AF、TS评分高于对照组（P<0.05）。结论：坐式八段锦联合运动康复治疗可促进ACS患者PCI术后心功能改善,减轻心肌损伤,进而提高运动耐力和生活质量。     

Alterations in Norepinephrine and Dopamine Content in Selected Brain Areas of Guinea Pigs Adapted to Simulated High Altitude

Abstract: The alterations in brain content of norepinephrine (NE) and dopamine (DA) were studied in guinea pigs adapted to simulated high altitude (hypobaric hypoxia) equivalent to 5500 meters. The animals were adapted for 46 days over a period of 82 days to a pressure of 375 mm Hg. The animals were then killed and the following brain parts dissected: cerebellum, neocortex, caudate head/basal forebrain, diencephalons/rhinencephalon, and brain stem. NE and DA content were analyzed by high pressure liquid chromatography with electrochemical detection by a technique described. Results showed a significant increase of NE and DA in neocortex; a significant increase of DA but not NE in caudate/basal forebrain, and a significant decrease of NE and not DA in diencephalons/rhinencephalon.     

Effect of Acute Exposure to Moderate Altitude on Muscle Power: Hypobaric Hypoxia vs. Normobaric Hypoxia

When ascending to a higher altitude, changes in air density and oxygen levels affect the way in which explosive actions are executed. This study was designed to compare the effects of acute exposure to real or simulated moderate hypoxia on the dynamics of the force-velocity relationship observed in bench press exercise. Twenty-eight combat sports athletes were assigned to two groups and assessed on two separate occasions: G1 (n = 17) in conditions of normoxia (N1) and hypobaric hypoxia (HH) and G2 (n = 11) in conditions of normoxia (N2) and normobaric hypoxia (NH). Individual and complete force-velocity relationships in bench press were determined on each assessment day. For each exercise repetition, we obtained the mean and peak velocity and power shown by the athletes. Maximum power (P_max) was recorded as the highest P_mean obtained across the complete force-velocity curve. Our findings indicate a significantly higher absolute load linked to P_max (∼3%) and maximal strength (1RM) (∼6%) in G1 attributable to the climb to altitude (P<0.05). We also observed a stimulating effect of natural hypoxia on P_mean and P_peak in the middle-high part of the curve (≥60 kg; P<0.01) and a 7.8% mean increase in barbell displacement velocity (P<0.001). No changes in any of the variables examined were observed in G2. According to these data, we can state that acute exposure to natural moderate altitude as opposed to simulated normobaric hypoxia leads to gains in 1RM, movement velocity and power during the execution of a force-velocity curve in bench press.     

The Effect of Exercise on Platelet Aggregability and Lipid Peroxidation

The effects of single bicycle ergometric exercises of a moderate or high intensity on platelet ADP-dependent aggregation, content of malonic dialdehyde (MDA), and activity of catalase were studied in young men with relatively high working capacities. Platelet aggregability either increased or decreased in response to the exercise. Hyperaggregation was recorded in about two-thirds of the subjects and hypoaggregation, in one-third. Changes in the aggregation parameters correlated with their basal values at rest. Muscular activity raised the aggregability of platelets when it was initially low and lowered it when it was initially high. An increased intensity of exercise made these correlations stronger. The exercise-caused changes in the MDA content in platelets also correlated with its basal level. A low MDA content at rest increased, and an initially high MDA content decreased. The response of hypoaggregation was associated with moderate and strong correlations between the basal content of MDA and catalase activity in platelets and the exercise-induced changes in the MDA content and platelet aggregability. It was concluded that a high basal level of MDA in platelets is a factor decreasing platelet aggregability during muscular activity.     

Comparison of pulmonary vascular response to endogenous nitric oxide inhibition in sheep and pigs living at 2,300 m

To compare the role of nitric oxide in an adaptive process to chronic hypoxia, we examined the effects of endogenous nitric oxide synthase inhibition on pulmonary vascular tone in conscious sheep and pigs living at high altitude. Unanesthetized male sheep (n=6) and pigs (n=5), born and residing in the highlands of Qinghai Province, China (2,300–3,000 m a.s.l.) were studied at that altitude. Pulmonary artery pressure (P_pa), pulmonary artery wedge pressure (P_cwp), and cardiac output (CO) were measured. Pulmonary vascular resistance (PVR) was calculated as (P_pa—P_cwp)/CO. Using a climatic chamber, hemodynamic measurements during exposures to atmospheric pressures corresponding to altitudes of 0, 2,300, and 4,500 m a.s.l. were performed with and without NO inhibition, using N^w-nitro-l-argine (NLA; 20 mg kg^–1), a potent stereospecific competitive inhibitor of nitric oxide synthase. P_pa and PVR at baseline (2,300 m) and during hypoxic exposure (4,500 m) were significantly higher in pigs than in sheep. After NLA administration, P_pa increased and CO decreased in both animals, resulting in significantly increased PVR at baseline and during hypoxic exposure. However, there were no significant differences in the percent increase in basal or hypoxic PVR after NLA administration between sheep and pigs. We conclude that augmented endogenous NO production could contribute to the regulation of pulmonary vascular tone at high altitude in sheep and pigs. However, it is unlikely that NO is responsible for the different pulmonary vascular tones between sheep and pigs at basal condition at moderately high altitude.Communicated by G. Heldmaier     

八段锦联合肺功能康复训练对慢性阻塞性肺病稳定期患者肺功能、运动耐力及生活质量的影响

摘要 目的：观察肺功能康复训练联合八段锦对慢性阻塞性肺病（COPD）稳定期患者运动耐力、肺功能及生活质量的影响。方法：选取80例COPD稳定期患者,纳入病例时间：2018年1月~2020年7月,采用随机数字表法分为观察组（肺功能康复训练联合八段锦,40例）、对照组（肺功能康复训练,40例）,干预6个月。对比两组干预前、干预6个月后的肺功能[用力肺活量（FVC）、1秒用力呼气容积（FEV₁）]、运动耐力[6 min步行距离（6MWD）]及生活质量[世界卫生组织生存质量量表简表（WHOQOL-BREF）评分]、症状评分[改良英国医学研究学会呼吸困难量表（mMRC）评分、慢阻肺综合评估测试（CAT）评分]。结果：两组干预6个月后FVC、6MWD、FEV₁均较干预前升高,且观察组高于对照组（P<0.05）。两组干预6个月后WHOQOL-BREF各维度评分较干预前升高,且观察组高于对照组（P<0.05）。干预6个月后, 两组mMRC评分、CAT评分较干预前下降,且观察组低于对照组（P<0.05）。结论：肺功能康复训练联合八段锦干预COPD稳定期患者,可缓解其临床症状,提高肺部适应性,进而改善患者运动耐力及生活质量。     

Aspirin,Platelet Aggregation,and the Circadian Variation of Acute Thrombotic Events

The onset of several acute cardiovascular diseases occurs in a circadian pattern, with a peak incidence in the hours soon after awakening. This finding, coupled with laboratory data that confirm a surge in platelet activation during the early morning hours, suggests that acute changes in platelet aggregability may be an important trigger of thrombosis. Therefore, the efficacy of antiplatelet agents, such as aspirin, in reducing risks of vascular occlusion may result, at least in part, from a blunting of these short-term changes in platelet aggregability. In this review, clinical and laboratory evidence describing these cyclical changes is discussed, as is current evidence of the effects of aspirin on platelet function and the circadian variation of acute thrombosis.     

Aspirin, Platelet Aggregation, and the Circadian Variation of Acute Thrombotic Events

The onset of several acute cardiovascular diseases occurs in a circadian pattern, with a peak incidence in the hours soon after awakening. This finding, coupled with laboratory data that confirm a surge in platelet activation during the early morning hours, suggests that acute changes in platelet aggregability may be an important trigger of thrombosis. Therefore, the efficacy of antiplatelet agents, such as aspirin, in reducing risks of vascular occlusion may result, at least in part, from a blunting of these short-term changes in platelet aggregability. In this review, clinical and laboratory evidence describing these cyclical changes is discussed, as is current evidence of the effects of aspirin on platelet function and the circadian variation of acute thrombosis.     

Effects of Acute Exposure to Moderate Altitude on Vascular Function,Metabolism and Systemic Inflammation

Background

Travel to mountain areas is popular. However, the effects of acute exposure to moderate altitude on the cardiovascular system and metabolism are largely unknown.

Objectives

To investigate the effects of acute exposure to moderate altitude on vascular function, metabolism and systemic inflammation.

Methods

In 51 healthy male subjects with a mean (SD) age of 26.9 (9.3) years, oxygen saturation, blood pressure, heart rate, arterial stiffness, lipid profiles, low density lipoprotein (LDL) particle size, insulin resistance (HOMA-index), highly-sensitive C-reactive protein and pro-inflammatory cytokines were measured at 490 m (Zurich) and during two days at 2590 m, (Davos Jakobshorn, Switzerland) in randomized order. The largest differences in outcomes between the two altitudes are reported.

Results

Mean (SD) oxygen saturation was significantly lower at 2590 m, 91.0 (2.0)%, compared to 490 m, 96.0 (1.0)%, p<0.001. Mean blood pressure (mean difference +4.8 mmHg, p<0.001) and heart rate (mean difference +3.3 bpm, p<0.001) were significantly higher at 2590 m, compared to 490 m, but this was not associated with increased arterial stiffness. At 2590 m, lipid profiles improved (median difference triglycerides −0.14 mmol/l, p = 0.012, HDL +0.08 mmol/l, p<0.001, total cholesterol/HDL-ratio −0.25, p = 0.001), LDL particle size increased (median difference +0.45 nm, p = 0.048) and hsCRP decreased (median difference −0.18 mg/l, p = 0.024) compared to 490 m. No significant change in pro-inflammatory cytokines or insulin resistance was observed upon ascent to 2590 m.

Conclusions

Short-term stay at moderate altitude is associated with increased blood pressure and heart rate likely due to augmented sympathetic activity. Exposure to moderate altitude improves the lipid profile and systemic inflammation, but seems to have no significant effect on glucose metabolism.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01130948","term_id":"NCT01130948"}}NCT01130948     

噪声和高温对机体健康影响的复合效应

当今社会随着经济和科技的发展,多种有害职业因素往往共同存在于同一岗位。复合因素对机体健康影响的相互作用包括四种情况:协同作用、相加作用、拮抗作用和无关作用。噪声和高温作为有害的职业因素常存在于同一岗位,那么噪声复合高温对机体健康会产生怎样的影响,这两种环境因素是否存在复合效应?文献报道不一。噪声和高温联合对听觉系统、心血管系统、神经系统的影响可能表现为协同、相加、拮抗和无关作用,对呼吸系统的影响表现为拮抗作用,目前,研究结果不一致主要原因是实验条件和暴露方法的不一致。我们认为将来的研究热点集中在噪声和高温联合产生复合效应的条件及剂量反应关系研究、机制及防治措施研究,噪声和高温联合对其他系统如消化、免疫系统是否存在复合效应也值得深入研究。     

八段锦联合心脏运动康复对急性心肌梗死急诊PCI术后患者心功能、运动耐力和生活质量的影响

摘要 目的：观察八段锦联合心脏运动康复对急性心肌梗死（AMI）急诊经皮冠状动脉介入术（PCI）后患者心功能、运动耐力和生活质量的影响。方法：选择2019年6月~2021年6月期间我院收治的AMI急诊PCI术后患者100例,根据随机数字表法分为对照组（心脏运动康复干预,50例）和观察组（八段锦联合心脏运动康复干预,50例）,观察两组患者心功能、运动耐力及生活质量改善情况,对比两组心脏不良事件发生率。结果：干预后,两组左心室射血分数（LVEF）较干预前升高,且观察组高于对照组（P<0.05）。干预后,两组左室舒张末期内径（LVDD）、左室收缩末期内径（LVDS）、B型脑利钠肽（BNP）较干预前下降,且观察组低于对照组（P<0.05）。干预后,两组运动持续时间（ED）、峰值摄氧量（VO₂peak）及无氧阈值（AT）较干预前升高,且观察组高于对照组（P<0.05）。干预后,两组健康调查简表（SF-36）各维度评分较干预前升高,且观察组高于对照组（P<0.05）。观察组的心脏不良事件发生率低于对照组（P<0.05）。结论：八段锦联合心脏运动康复用于AMI急诊PCI患者的术后干预中,可促进心功能恢复,改善患者的运动耐力及生活质量,同时还可降低心脏不良事件发生率。     

Features and incidence of thromboembolic disease: A comparative study between high and low altitude dwellers in Saudi Arabia

To estimate and compare the incidence of thromboembolic disease among patients who are clinically suspected for VTE among high and low altitude dwellers in Saudi Arabia. A prospective study conducted over two years (2011–2013) conducted in two different geographical areas in Saudi Arabia; Abha City and Riyadh City. Patients clinically suspected with deep vein thrombosis and pulmonary embolism was recruited to the study. A detailed social, medical and laboratory investigations were taken from all patients including lifestyle, occupation and smoking. A total of 234 patients participated in the study. There were 146 (62.4%) females and 88 (37.6%) males. Mean age was 51.7 years. A 56.8% incidence of DVT was seen among high altitude dwellers compared to 13.0% among low altitude dwellers. Also, a 12.6% incidence of PE was documented among high altitude dwellers, compared to 4.1% of the low altitude dwellers. VTE was significantly more among high altitude dwellers (81.9%) compared to low altitude dwellers (21.9%). Mean WBC count was significantly higher among the high altitude dwellers (10.8 ± 9.7 vs. 8.2 ± 3.4, p = 0.043). Mean platelet count was significantly higher among the high altitude dwellers compared to the low altitude dwellers (327.4 ± 162.4 vs. 212.0 ± 158.9, p = 0.005). The likelihood of developing VTE is greater among people who resided at moderate to high altitude for prolonged periods of time. The changes in the factors for coagulation including platelet counts may not reflect the true status of hypercoagulability especially if patients have stayed longer in high altitudes because of physiological adaptation to the environment.