Lower body negative pressure protects brain perfusion in aviation gravitational stress induced by push-pull manoeuvre.

KEY POINTS: Rapid alterations of gravitational stress during high-performance aircraft push-pull manoeuvres induce dramatic shifts in volume and pressure within the circulation system, which may result in loss of consciousness due to the rapid and significant reduction in cerebral perfusion. There are still no specific and effective countermeasures so far. We found that lower body negative pressure (LBNP), applied prior to and during -Gz and released at the subsequent transition to +Gz, could effectively counteract gravitational haemodynamic stress induced by a simulated push-pull manoeuvre and improve cerebral diastolic perfusion in human subjects. We developed a LBNP strategy that effectively protects cerebral perfusion at rapid -Gz to +Gz transitions via improving cerebral blood flow and blood pressure during push-pull manoeuvres and highlight the importance of the timing of the intervention. Our findings provide a systemic link of integrated responses between the peripheral and cerebral haemodynamic changes during push-pull manoeuvres. ABSTRACT: The acute negative (-Gz) to positive (+Gz) gravity stress during high-performance aircraft push-pull manoeuvres dramatically reduces transient cerebral perfusion, which may lead to loss of vision or even consciousness. The aim of this study was to explore a specific and effective counteractive strategy. Twenty-three healthy young male volunteers (age 21 ± 1 year) were subjected to tilting-simulated push-pull manoeuvres. Lower body negative pressure (LBNP) of -40 mmHg was applied prior to and during -Gz stress (-0.50 or -0.87 Gz) and released at the subsequent transition to +1.00 Gz stress. Beat-to-beat cerebral and systemic haemodynamics were continuously recorded during the simulated push-pull manoeuvre in LBNP bouts and corresponding control bouts. During the rapid gravitational transition from -Gz to +Gz, the mean cerebral blood flow velocity decreased significantly in control bouts, while it increased in LBNP bouts (control vs. LBNP bouts, -6.6 ± 4.6 vs. 5.1 ± 6.8 cm s-1 for -0.50 Gz, and -7.4 ± 4.8 vs. 3.4 ± 4.6 cm s-1 for -0.87 Gz, P < 0.01), which was attributed mainly to the elevation of diastolic flow. The LBNP bouts showed much smaller reduction of mean arterial blood pressure at the brain level than control bouts (control bouts vs. LBNP bouts, -38 ± 12 vs. -23 ± 10 mmHg for -0.50 to +1.00 Gz, and -62 ± 16 vs. -43 ± 11 mmHg for -0.87 to +1.00 Gz, P < 0.01). LBNP applied at -Gz and released at subsequent +Gz had biphasic counteractive effects against the gravitational responses to the push-pull manoeuvre. These data demonstrate that this LBNP strategy could effectively protect cerebral perfusion with dominant improvement of diastolic flow during push-pull manoeuvres.

[Expression of PTEN in Myocardial Tissue in Coronary Heart Disease].

OBJECTIVE: To observe the expression of phosphatase and tensin homology deleted on chromosome ten (PTEN) in myocardial tissue in patients with coronary heart disease, and explore the relevance between the expression of PTEN and the occurrence and development of coronary heart disease. METHODS: A total of 16 death cases with pathological diagnosis of coronary heart disease were collected as experimental group, and 19 cases without myocardial lesions were selected as control group. The expression of PTEN protein and its mRNA were detected by immunohistochemistry and real-time fluorescence quantitative PCR respectively. The correlation between the expression of PTEN and the pathogenesis of coronary heart disease was analyzed. RESULTS: The expression of PTEN protein in myocardium in cases with coronary heart disease was significantly lower compared with the control group (P < 0.05). There was no statistical difference of the expression of PTEN mRNA between experimental and control group (P > 0.05). CONCLUSION: PTEN may be involved in the occurrence and development of coronary heart disease.

Identification of major metabolites in rat urine and plasma of N(6) -(4-hydroxybenzyl) adenine riboside by LC/MS/MS.

N(6) -(4-hydroxybenzyl) adenine riboside, a novel neuroprotective compound found in Gastrodia elata at trace level, is regarded as a potential drug for the treatment of neural degenerative disease. To understand the metabolism of this compound, the metabolites in rat urine and plasma of N(6) -(4-hydroxybenzyl) adenine riboside were analyzed by HPLC-ESI-MS/MS after oral administration of this compound. Beside the parent compound, six phase I metabolites and four phase II metabolites in urine were detected by scanning all possible metabolites in extracted ion chromatograms mode. By comparing their product ion spectra and retention times with those of parent compound, these metabolites were identified and proved to be mainly formed via hydrolysis or hydroxylation in phase I, N-sulfation or N-glucuronidation in phase II or their combinations. Similarly, the parent compound, one phase I metabolite and two phase II metabolites were also identified in rat plasma. Therefore, the in vivo metabolic pathways of N(6) -(4-hydroxybenzyl) adenine riboside in rat were proposed.

Cuff-Method Thigh Arterial Occlusion Counteracts Cerebral Hypoperfusion Against the Push-Pull Effect in Humans.

Exposure to acute transition from negative (-Gz) to positive (+ Gz) gravity significantly impairs cerebral perfusion in pilots of high-performance aircraft during push-pull maneuver. This push-pull effect may raise the risk for loss of vision or consciousness. The aim of the present study was to explore effective countermeasures against cerebral hypoperfusion induced by the push-pull effect. Twenty healthy young volunteers (male, 21 ± 1 year old) were tested during the simulated push-pull maneuver by tilting. A thigh cuff (TC) pressure of 200 mmHg was applied before and during simulated push-pull maneuver (-0.87 to + 1.00 Gz). Beat-to-beat cerebral and systemic hemodynamics were measured continuously. During rapid -Gz to + Gz transition, mean cerebral blood flow velocity (CBFV) was decreased, but to a lesser extent, in the TC bout compared with the control bout (-3.1 ± 4.9 vs. -7.8 ± 4.4 cm/s, P < 0.001). Similarly, brain-level mean blood pressure showed smaller reduction in the TC bout than in the control bout (-46 ± 12 vs. -61 ± 13 mmHg, P < 0.001). The systolic CBFV was lower but diastolic CBFV was higher in the TC bout. The systemic blood pressure response was blunted in the TC bout, along with similar heart rate increase, smaller decrease, and earlier recovery of total peripheral resistance index than control during the gravitational transition. These data demonstrated that restricting thigh blood flow can effectively mitigate the transient cerebral hypoperfusion induced by rapid shift from -Gz to + Gz, characterized by remarkable improvement of cerebral diastolic flow.

[Preparation of gentiopicroside from the extract of Swertia mussotii Franch by preparative high performance liquid chromatography].

A new method for isolation of gentiopicroside (GPS) from Swertia mussotii Franch with reversed phase preparative high performance liquid chromatography (Pre-HPLC) is described. After 95% ethanol extract was obtained with solvent extraction and macroporous resin separation, a fraction containing GPS was acquired and subjected to Pre-HPLC for isolation of target component. The optimum operation parameters were selected as follows: a C18 column (200 mm x 50 mm, 5 microm), methanol-0.1% acetic water (30:70, v/v) as the mobile phase at flow rate of 75 mL/min, the detection wavelength at 254 nm, and the injection volume of 500 microL at the mass concentration of 225 g/L. The purity of the product was detected by HPLC method. The result showed that the purity of product was above 99%. The effective and rapid method has been successfully applied to the preparation of GPS from Swertia mussotii Franch.