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1.
Eur J Med Chem ; : 113954, 2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34772527

RESUMO

Modulating the glucose transport in skeletal muscle is a promising strategy for ameliorating glucose homeostasis disorders. However, the complicated mechanisms of glucose transport make it difficult to find compounds therapeutically relevant molecular mechanisms of action, while phenotypic screening is thought to be an alternative approach to mimic the cell state of interest. Here, we report (±)-seneciobipyrrolidine (1a) is first found to enhance glucose uptake in L6 myotubes through phenotype-based screening. Further SAR investigation led to the identfication of compound A27 (EC50 = 2.7 µM). Proteomiic analysis discloses the unique function mechanism of A27 through upregulating the level of the eukaryotic translation initiation factor 4E-binding protein 1 (4E-BP1), subsequently enhancing the Akt and AMPK phosphorylation, thereby promoting the glucose uptake. Chronic oral administration of A27 significantly lowers blood glucose and improves glucose tolerance in db/db mice. This work is new research on seneciobipyrrolidine derivatives, providing a promising avenue for ameliorating glucose homeostasis.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34806347

RESUMO

BACKGROUND: Unintentional weight loss (cachexia) has been associated with poor outcomes in chronic heart failure (CHF). Meteorin-like (Metrnl) is a novel myokine with protective effects on cardiovascular diseases. However, the change of Metrnl concentrations and its role in elderly patients with CHF remains unclear. The aim of this study was to evaluate the association of serum Metrnl with weight loss and outcomes in elderly patients with CHF. METHODS: A total of 931 consecutive elderly patients (aged 60 years and older) with CHF and 135 age-matched and sex-matched control subjects were enrolled. Serum Metrnl concentration was measured by enzyme-linked immunosorbent assay. Body weight was measured at baseline and 12 months. RESULTS: Median of serum Metrnl levels was lower in CHF patients when compared with controls [201.31 (184.95-261.16) pg/mL vs. 168.68 (103.15-197.54) pg/mL, P < 0.001]. Patients with the lowest levels of Metrnl had higher N-terminal pro brain natriuretic peptide (NT-proBNP) levels but lower left ventricular eject fraction (LVEF) and estimated glomerular filtration rate (P < 0.001). Lower serum Metrnl was associated with a higher risk of >5% weight loss from baseline to 12 months [odds ratio = 6.13, 95% confidence interval (CI) = 2.57-14.62 per log decrease; P < 0.001]. Serum Metrnl levels were decreased as LVEF decreased (P < 0.001) and were positively correlated with LVEF (r = 0.267, P < 0.001) but negatively correlated with NT-proBNP levels (r = -0.257, P < 0.001). Cox regression analysis suggested that lower serum Metrnl was associated with higher cardiovascular mortality [hazard ratio (HR) = 6.71, 95% CI = 3.41-13.18 per log decrease; P < 0.001], CHF rehospitalization (HR = 3.07, 95% CI = 1.82-5.17 per log decrease; P < 0.001), and the combined major adverse cardiac event(s) (MACEs) (HR = 5.38, 95% CI = 3.51-8.25 per log decrease; P < 0.001). The Kaplan-Meier survival curves showed that low concentration of Metrnl was a prognostic indicator of MACEs in patients with CHF. CONCLUSIONS: Our study suggests that lower serum Metrnl level is correlated with weight loss and the severity of cardiac dysfunction in elderly patients with CHF.

3.
Int J Mol Sci ; 22(21)2021 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-34768870

RESUMO

Cotton fiber is a seed trichome that protrudes from the outer epidermis of cotton ovule on the day of anthesis (0 day past anthesis, 0 DPA). The initial number and timing of fiber cells are closely related to fiber yield and quality. However, the mechanism underlying fiber initiation is still unclear. Here, we detected and compared the contents and compositions of sphingolipids and sterols in 0 DPA ovules of Xuzhou142 lintless-fuzzless mutants (Xufl) and Xinxiangxiaoji lintless-fuzzless mutants (Xinfl) and upland cotton wild-type Xuzhou142 (XuFL). Nine classes of sphingolipids and sixty-six sphingolipid molecular species were detected in wild-type and mutants. Compared with the wild type, the contents of Sphingosine-1-phosphate (S1P), Sphingosine (Sph), Glucosylceramide (GluCer), and Glycosyl-inositol-phospho-ceramides (GIPC) were decreased in the mutants, while the contents of Ceramide (Cer) were increased. Detail, the contents of two Cer molecular species, d18:1/22:0 and d18:1/24:0, and two Phyto-Cer molecular species, t18:0/22:0 and t18:0/h22:1 were significantly increased, while the contents of all GluCer and GIPC molecular species were decreased. Consistent with this result, the expression levels of seven genes involved in GluCer and GIPC synthesis were decreased in the mutants. Furthermore, exogenous application of a specific inhibitor of GluCer synthase, PDMP (1-phenyl-2-decanoylamino-3-morpholino-1-propanol), in ovule culture system, significantly inhibited the initiation of cotton fiber cells. In addition, five sterols and four sterol esters were detected in wild-type and mutant ovules. Compared with the wild type, the contents of total sterol were not significantly changed. While the contents of stigmasterol and campesterol were significantly increased, the contents of cholesterol were significantly decreased, and the contents of total sterol esters were significantly increased. In particular, the contents of campesterol esters and stigmasterol esters increased significantly in the two mutants. Consistently, the expression levels of some sterol synthase genes and sterol ester synthase genes were also changed in the two mutants. These results suggested that sphingolipids and sterols might have some roles in the initiation of fiber cells. Our results provided a novel insight into the regulatory mechanism of fiber cell initiation.

4.
Materials (Basel) ; 14(21)2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34772237

RESUMO

To improve the high brittleness of recycled aggregate concrete containing iron ore tailings (TRAC), the feasibility of adding polypropylene fiber (PPF) to TRAC was studied by performing a compression stress-strain curve test, scanning electron microscope characterization, and a freeze-thaw cycle test. The results indicated that PPF had a beneficial impact on reducing the brittleness of TRAC. With the increase in PPF content, the peak strain increased, the elastic modulus decreased, and the peak stress and energy absorption capacity increased at first and then decreased. Furthermore, the microstructure investigation revealed that the interface friction between the PPF, aggregate, and cement matrix was the main source of energy dissipation. When the load acted on the concrete, the stress was dispersed to the fiber monofilaments, thus effectively enhancing the peak stress and peak strain of concrete and suppressing the generation and development of cracks in the concrete. In terms of freeze-thaw resistance, adding a small amount of PPF could reduce the negative effects of the freeze-thaw process on the cement matrix. On the premise of ensuring strength, the waste utilization should be as high as possible. Therefore, it was suggested that the content of PPF in fiber-reinforced tailings recycled aggregate concrete (TRAC-PP) should be 0.6%.

5.
Chem Sci ; 12(41): 13756-13763, 2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34760160

RESUMO

The indoxyl unit is a common structural motif in alkaloid natural products and bioactive compounds. Here, we report a general method that transforms readily available 2-substituted indoles into 2,2-disubstituted indoxyls via nucleophile coupling with a 2-alkoxyindoxyl intermediate and showcase its utility in short total syntheses of the alkaloids brevianamide A (7 steps) and trigonoliimine C (6 steps). The developed method is operationally simple and demonstrates broad scope in terms of nucleophile identity and indole substitution, tolerating 2-alkyl substituents and free indole N-H groups, elements beyond the scope of most prior approaches. Spirocyclic indoxyl products are also accessible via intramolecular nucleophilic trapping.

6.
World J Clin Cases ; 9(28): 8340-8348, 2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34754843

RESUMO

BACKGROUND: Nickel (Ni) may accumulate in the human body and has biological toxicity and carcinogenicity. Ni has an extensive impact on the health of pregnant women and fetuses during gestation. AIM: To evaluate Ni exposure in pregnant women in Kunming, Yunnan Province, China; to describe the distribution of Ni in the maternal-fetal system and placental barrier function; and to investigate the effect of Ni exposure on fetal health in mothers with pregnancy complications. METHODS: Seventy-two pregnant women were selected using a case-control design. The women were divided into two groups: The control group (no disease; n = 29) and the disease group [gestational diabetes (GDM), hypertensive disorder complicating pregnancy (HDCP), or both; n = 43]. The pregnant women in the disease group were further divided as follows: 14 cases with GDM (GDM group), 13 cases with HDCP (HDCP group) and 16 cases with both GDM and HDCP (disease combination group). Basic information on the pregnant women was collected by questionnaire survey. Maternal blood, placenta blood and cord blood were collected immediately after delivery. The Ni content in paired samples was determined using inductively coupled plasma mass spectrometry. RESULTS: Compared to the control group, age was higher and body mass index was greater in pregnant women in the disease groups (28.14 ± 2.54 vs 28.42 ± 13.89, P < 0.05; 25.90 ± 3.86 vs 31.49 ± 5.30, P < 0.05). The birth weights of newborns in the HDCP group and the control group were significantly different (2.52 ± 0.74 vs 3.18 ± 0.41, P < 0.05). The content of Ni in umbilical cord blood in the entire disease group was higher than that in the control group (0.10 ± 0.16 vs 0.05 ± 0.07, P < 0.05). CONCLUSION: In the maternal-fetal system of women with pregnancy complications, the barrier effect of the placenta against Ni is weakened, thus affecting healthy growth of the fetus in the uterus.

7.
CNS Neurosci Ther ; 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758102

RESUMO

INTRODUCTION: Parkinson's (PD) is a common degenerative disease of the central nervous system. It affects more than 6 million individuals worldwide. The typical clinical manifestations include static tremor, slow movement, and unstable posture. However, the correlation between head tremor and the severity of PD remains unclear. METHODS: In the current study, 18 patients and 18 healthy subjects were recruited to undergo a phonation test. Noldus facereader 7.0 software was used to analyze the range of head trembling between the two groups. RESULTS: The data revealed that patients with PD had significant differences in the x-, y-, and z-axis of head movement with respect to the specific pronunciation syllables compared with the normal group. Moreover, the head movement of the patients with PD was positively correlated with the severity of the disease in the single, double, and multiple syllable tests. In the phonetic test, the head displacement of patients with PD was significantly greater than that of healthy individuals, and the displacement range was positively correlated with the severity of the disease. CONCLUSION: These pieces of evidence suggested that the measurement of head displacement assists the early diagnosis and severity of the disease.

8.
Fitoterapia ; 156: 105086, 2021 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-34798164

RESUMO

Two new isoquinoline alkaloids, cryptowrayines A (1) and B (2), along with one known pavine alkaloid (-)-12-hydroxyeschscholtzidine (3), were isolated from the twigs of Cryptocarya wrayi. The structures of new compounds were elucidated by extensive spectroscopic data analysis and electronic circular dichroism (ECD) calculations. Both compounds 1 and 2 exhibited moderate quinone reductase inducing activity in Hepa 1c1c7 cells.

9.
PLoS One ; 16(11): e0259382, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34739505

RESUMO

Drought stress massively restricts plant growth and the yield of crops. Reducing the deleterious effects of drought is necessary for agricultural industry. The plant-specific NAC (NAM, ATAF1/2 and CUC2) transcription factors (TFs) are widely involved in the regulation of plant development and stress response. One of the NAC TF, JUNGBRUNNEN1 (JUB1), has been reported to involve in drought resistance in Arabidopsis. However, little is known of how the JUB1 gene respond to drought stress in cotton. In the present study, we cloned GhJUB1L1, a homologous gene of JUB1 in upland cotton. GhJUB1L1 is preferentially expressed in stem and leaf and could be induced by drought stress. GhJUB1L1 protein localizes to the cell nucleus, and the transcription activation region of which is located in the C-terminal region. Silencing GhJUB1L1 gene via VIGS () reduced cotton drought tolerance, and retarded secondary cell wall (SCW) development. Additionally, the expression of some drought stress-related genes and SCW synthesis-related genes were altered in the GhJUB1L1 silencing plants. Collectively, our findings indicate that GhJUB1L1 may act as a positive regulator in response to drought stress and SCW development in cotton. Our results enriched the roles of NAC TFs in cotton drought tolerance and laid a foundation for the cultivation of transgenic cotton with higher drought tolerance.

11.
BMC Neurol ; 21(1): 421, 2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34715818

RESUMO

BACKGROUND: Patients with acute large vessel occlusion (LVO) presenting with minor stroke are at risk of early neurological deterioration (END). The present study aimed to evaluate the frequency and potential predictors of END in patients with medical management and LVO presenting with minor stroke. The relationship between SVS length and END was also investigated. METHODS: This was a prospective multicenter study. Consecutive patients were collected with anterior circulation. LVO presented with minor stroke [National Institutes of Health Stroke Scale (NIHSS) ≤ 4] within 24 h following onset. END was defined as a deterioration of NIHSS ≥4 within 24 h, without parenchymal hemorrhage. The length of the susceptibility vessel sign (SVS) was measured using the T2* gradient echo imaging. RESULTS: A total of 134 consecutive patients with anterior circulation LVO presenting with minor stroke were included. A total of 27 (20.15%) patients experienced END following admission. Patients with END exhibited longer SVS and higher baseline glucose levels compared with subjects lacking END (P < 0.05). ROC curve analysis indicated that the optimal cutoff point SVS length for END was SVS ≥ 9.45 mm. Multivariable analysis indicated that longer SVS [adjusted odds ratio (aOR), 2.03; 95% confidence interval (CI), 1.45-2.84; P < 0.001] and higher baseline glucose (aOR,1.02; 95% CI, 1.01-1.03; P = 0.009) levels were associated with increased risk of END. When SVS ≥ 9.45 mm was used in the multivariate logistic regression, SVS ≥ 9.45 mm (aOR, 5.41; 95%CI, 1.00-29.27; P = 0.001) and higher baseline glucose [aOR1.01; 95%CI, 1.00-1.03; P = 0.021] were associated with increased risk of END. CONCLUSIONS: END was frequent in the minor stroke patients with large vessel occlusion, whereas longer SVS and higher baseline glucose were associated with increased risk of END. SVS ≥ 9.45 mm was a powerful independent predictor of END.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Isquemia Encefálica/complicações , Isquemia Encefálica/diagnóstico por imagem , Humanos , Estudos Prospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem
12.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 37(2): 125-134, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-34672149

RESUMO

Objective: The new theory of holistic integrative physiology and medicine, which describes the integrative regulation of respiratory, circulatory and metabolic systems in human body, generates the hypothesis of that breath is the origin of variability of circulatory parameters. We investigated the origin of heart rate variability by analyzing relationship between the breath and heart rate variability (HRV) during sleep. Methods: This retrospective study analyzed 8 normal subjects (NS) and 10 patients of chronic diseases without sleep apnea (CDs-no-SA). After signed the informed consent form, they performed cardiopulmonary exercise testing (CPET) in Fuwai Hospital and monitored polysomnography (PSG) and electrocardiogram (ECG) during sleep since 2014. We dominantly analyzed the correlation between the respiratory cycle during sleep and the heart rate variability cycle of the ECG R-R interval. The HRV cycle included the HR increase from the lowest to the highest and decrease from the highest to the lowest point. The number of HRV (HRV-n), average HRV time and other parameters were calculated. The breath cycle included complete inhalation and subsequent exhalation. The number of breath (B-n), average breath time and other breath parameters were analyzed and calculated. We analyzed each person's relationship between breath and HRV; and the similarities and differences between the NS and CDs-no-SA groups. Independent sample t test was used for statistical analysis, with P<0.05. Results: CPET core parameter such as Peak VO2 (83.8±8.9)% in NS were significantly higher than that (70.1±14.9)% in patients of chronic diseases without sleep apnea (P<0.05), but there was no difference between their AHI (1.7±1.3) in NS and AHI (2.9±1.2) in CDs-no-SA (P>0.05). The B-n and the HRV-n (6581.63±1411.90 vs 6638.38±1459.46), the average B time and the average HRV time (4.19±0.57)s vs (4.16±0.62)s in NS were similar without significant difference (P>0.05). The comparison of the numbers in CDs-no-SA were the number (7354.50±1443.50 vs 7291.20±1399.31) and the average times ((4.20±0.69)s vs (4.23±0.68)s) of B and HRV were similar without significant difference (P>0.05). The ratios of B-n/HRV-n in NS and CDs-no-SA were (0.993±0.027 vs 1.008±0.024) and both were close to 1 and similar without significant difference (P>0.05). The average magnitude of HRV in NS ((5.74±3.21) bpm) was significantly higher than that in CDs-no-SA ((2.88±1.44) bpm) (P<0.05). Conclusion: Regardless of the functional status of NS and CDs-no-SA, there is a similar consistency between B and HRV. The origin of initiating factors of HRV is the respiration.


Assuntos
Síndromes da Apneia do Sono , Doença Crônica , Frequência Cardíaca , Humanos , Estudos Retrospectivos , Sono
13.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 37(2): 135-141, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-34672150

RESUMO

Objective: Based on the hypothesis that respiration causes variability of circulatory indicators proposed by the holistic integrated physiology and medicine theory, the correlation between respiration and heart rate variability during sleep in chronically ill patients with abnormal sleep breathing is analyzed. Methods: Eleven chronically ill patients with abnormal sleep breathing and apnea-hypopnea index (AHI) ≥15 times/hr are recruited. After signing the informed consent, they completed the standardized symptomatic restrictive extreme exercise cardiopulmonary exercise testing (CPET) and sleep breathing monitoring Calculate and analyze the rules of respiratory nasal airflow and ECG RR interval heart rate variability during the oscillatory breathing (OB) phase and the normal steady breathing phase of the patient during sleep, and use the independent sample t test to compare with normal people and no sleep breathing abnormalities in the same period in this laboratory. Of patients with chronic diseases are more similar and different. Results: The peak oxygen uptake and anaerobic threshold (AT) of CPET in chronic patients with abnormal sleep apnea were (70.8±13.6)% Pred and (71.2±6.1)% Pred; 5 cases of CPET had exercise induced oscillatory breathing (EIOB), 6 An example is unstable breathing, which indicates that the overall functional status is lower than normal. In this group of patients with chronic diseases, AHI (28.8±10.0) beats/h, the ratio of the total time of abnormal sleep breathing to the total time of sleep (0.38±0.25); the length of the OB cycle (51.1±14.4)s. The ratio (Bn/HRV-B-n) of the number of breathing cycles in the normal and steady breathing period to the number of heart rate variability cycles in this group of patients with chronic diseases is 1.00±0.04, and the CV (SD of HRV-B-M/x) is (0.33 ±0.11), blood oxygen saturation (SpO2) did not decrease significantly, the average amplitude of heart rate variability (HRV-B-M) of each respiratory cycle rhythm was (2.64±1.59) bpm, although it was lower than normal people (P<0.05) , But it was similar to chronic patients without sleep apnea (P>0.05). In this group of patients with chronic diseases, the ratio of the number of respiratory cycles to the number of heart rate variability cycles (OB-Bn/OB-HRV-B-n) during OB is (1.22±0.18), and the average amplitude of heart rate variability for each respiratory cycle rhythm in OB (OB -HRV-B-M) is (3.56±1.57)bpm and its variability (OB-CV = SD of OB-HRV-B-M/x) is (0.59±0.28), the average amplitude of heart rate variability in each OB cycle rhythm (OB-HRV-OB-M) is (13.75±4.25)bpm, SpO2 decreases significantly during hypoventilation during OB, and the average decrease in SpO2 during OB (OB-SpO2-OB-M) is (4.79±1.39)%. The OB-Bn/OB-HRV-B-n ratio, OB-HRV-OB-M and OB-SpO2-OB-M in the OB period are all significantly higher than the corresponding indicators in the normal stable breathing period Large (P<0.01). Although OB-HRV-B-M has no statistically significant difference compared with HRV-B-M in normal stable breathing period (P>0.05), its variability OB-CV is significantly increased (P<0.01). Conclusion: The heart rate variability of chronic patients with abnormal sleep breathing in the OB phase is greater than that of the normal stable breathing period. When the breathing pattern changes, the heart rate variability also changes significantly. The number of breathing cycles in the stable breathing period is equal to the number of heart rate variability cycles.The ratio is the same as that of normal people and chronically ill patients without sleep apnea, confirming that heart rate variability is respiratory origin; and the reduction of heart rate variability relative to the respiratory cycle during OB is directly caused by hypopnea or apnea at this time, and heart rate variability is also breathing source.


Assuntos
Síndromes da Apneia do Sono , Doença Crônica , Frequência Cardíaca , Humanos , Polissonografia , Respiração
14.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 37(2): 147-153, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-34672152

RESUMO

Objective: To verify that the cardiopulmonary exercise testing (CPET) performed by clinical subjects is the maximum extreme exercise, we designed The Max test(Max)during clinical CPET. We used Max to verify the accuracy of the quantitative CPET evaluation result, and whether it is feasible and safe to use the specific value of a certain index as the standard for stopping CPET. Methods: Two hundred and sixteen cases from Fuwai Hospital were selected during June 2017 to January 2019,including 41 healthy person(control group) and 175with cardiovascular diseases(patient group),The patients had a CPET peak RER ≤ 1.10, or the peak heart rate and peak blood pressure were basically non-responsive.The Max was first attempted in 60 subjects,and this study is further expanded . When the CPET ended, they had a 5-minute break, then the Max, during which, they cycled with a velocity of ≥ 60 r/min, at a constant intensity equivalent to to 130% of peak work,until exhausted.The difference and percentage difference between the peak heart rate and the peak oxygen uptake were calculated. ①If the percentage difference of heart rate and oxygen uptake are all less than -10%,then the Max is defined as failure,otherwise it is succesful. 2 If the percentage difference is between -10%~10%, then the Max is successful, which proved that the CPET is precise.③If the difference is ≥10%, the Max is successful, which proves that the CPET is non-extreme exercise. Results: Patient group's Peak VO2(L/min,ml/(min·kg)),anaerobic threshold (L/min,ml/(min·kg),%pred),Peak VO2/HR(ml/beat, % pred),Peak RER,Peak SBP,Peak WR,peak heart rate,OUEP (ratio,%pred) were lower than those of the control group(P<0.05).The VE/ VCO2 Slope (ratio,%pred)and Lowest VE/ VCO2(ratio,%pred) were higher in the patient group than in the control group (P<0.05).No adverse events occurred during the CPET and Max in all cases. Among the 216 cases,Max was successful in 198 cases(91.7%).CPET was proved to be maximum extreme exercise for 182 cases,non-maximum extreme exercise for 16 cases,and failed in 18 cases(8.3%).Conclusion: For CPET with a low peak RER and a maximum challenge,the Max can confirm the accuracy of the objective quantitative assessment of CPET. Max is safe and feasible,and that deserved further research and clinical application.


Assuntos
Teste de Esforço , Insuficiência Cardíaca , Limiar Anaeróbio , Exercício Físico , Humanos , Consumo de Oxigênio
15.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 37(2): 154-161, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-34672153

RESUMO

Objective: Cardiopulmonary exercise testing (CPET) was used to investigate the exercise pathophysiology of mitral regurgitation. Methods: 26 patients with moderate and severe mitral regurgitation who completed standardized extreme exercise CPET under strict quality control after signing informed consent since 2016, and 11 normal subjects in the same period as the control group. The core indexes of CPET were analyzed and calculated according to the standard method and compared with normal subjects for intergroup statistical independent sample t-test. At the same time, the patients with heart failure and exercise oscillation breathing (OB) were divided into two subgroups: 11 cases without heart failure, 15 cases with heart failure, 8 cases with non-OB and 18 cases with OB, and their similarities and differences were compared between each subgroup. Results: The core indexes of CPET, such as peak oxygen uptake (85.60 ±9.06)%pred and anaerobic threshold (AT, (87.59 ±15.38)%pred) were normal. The peak oxygen uptake of CPET in patients with mitral regurgitation was (48.15 ±12.11)%pred, peak oxygen pulse was (66.57 ±12.20)%pred, AT was (56.75 ±11.50)%pred, oxygen uptake efficiency plateau was (88.24 ±16.42)%pred , lowest value of carbon dioxide ventilatory efficiency was (125.89 ±27.05)%pred and slope of carbon dioxide ventilatory efficiency was (128.31 ±31.68)%pred. Among them, only oxygen uptake efficiency plateau (OUEP) was normal and low, and the other indexes were significantly abnormal. There were significant differences between the patients and the control group (P<0.01). There was no significant difference between the non-OB group and the OB group, but there was significant difference between the non-OB group and the control group (P<0.05). There was no significant difference between the non-heart failure group and the heart failure group, but there was significant difference between the non-heart failure group and the control group. Conclusion: All the core indexes of cardiopulmonary exercise are significantly abnormal in patients with mitral regurgitation who are significantly lower than those in normal subjects except for the low effectiveness of oxygen ventilation. And with or without heart failure and OB did not affect the cardiopulmonary function.


Assuntos
Insuficiência da Valva Mitral , Exercício Físico , Teste de Esforço , Humanos , Consumo de Oxigênio , Relatório de Pesquisa
16.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 37(2): 177-188, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-34672156

RESUMO

Objective: To observe and study the resting radial artery pulse wave and changes after a single individualized exercise in patients with long-term chronic diseases. Methods: We selected 16 patients with chronic disease (disease duration ≥5 years) who have been clearly diagnosed as hypertension and/or diabetes and/or hyperlipemia, and first completed the symptom-restricted limit cardiopulmonary exercise testing (CPET). Then a single individualized exercise with Δ50% power as the exercise intensity was completed within one week after CPET. We measured and recorded 50s pulse wave data before exercise and 10 min, 20 min, 30 min after exercise, then obtained each pulse wave characteristic point: starting point (B), main wave peak point (P1), trough of a repulse point (PL), crest of a repulse point (P2), and end point (E). The raw data of the abscissa (time T) and ordinate (amplitude Y) corresponding to each point were derived from the instrument. We treated the end point E of the previous pulse wave as the start point B of the next wave, returned TB to zero, and got the main observation indicators: YB, YP1, YPL, YP2 and TP1, TPL, TP2, TE, and calculated out ΔYP1, ΔYPL, ΔYP2, TE-TPL, (TE-TPL)/TPL, pulse rate, S1, S2 ,ΔYP2-ΔYPL and TP2-TPL as secondary observation indicators. Then calculated the occurrence rate of dicrotic wave with obvious crest. Finally we analyzed individually the 50 s pulse wave data of each patient before and after exercise, and then averaged all the data for overall analysis. Results: ①16 patients with long-term chronic diseases (males 14, females 2), ages (53.7±12.6, 28~80) years old, height (171.7±6.6, 155~183) cm, body weight (80.0±13.5, 54~98) kg. 2YB (91.5±10.8, 71.1~108.6), YP1 (203.6±24.7, 162.7~236.3), YPL (127.1±6.2, 118.2~140.3), YP2 (125.9±6.2, 115.7~137.7), TP1 ( 137.2±22.3, 103.0~197.1), TPL (368.7±29.5, 316.3~434.0), TP2 (422.7±32.8, 376.9~494.7), TE (883.4±95.0, 672.2~1003.3), ΔYP1 (112.1±33.8, 60.3~ 157.5), ΔYPL (35.5±14.2, 17.5~66.2), ΔYP2 (34.4±13.3, 20.0~62.9), TE-TPL (514.6±85.4, 341.4~621.9), (TE-TPL)/TPL (1.4±0.2, 1.0~1.7), pulse rate (68.8±8.4, 59.8~89.3), S1 (0.9±0.3, 0.4~1.4), S2 (0.0±0.0, -0.1~0.0), ΔYP2-ΔYPL (-1.2±2.6,- 6.5 ~ 2.5), TP2-TPL (54.0 ± 10.8, 33.6 ~ 81.1). ③10min after exercise, YB, YPL, YP2, TPL, TE decreased, YP1 increased. ΔYPL, TE-TPL, (TE-TPL)/TPL decreased, and ΔYP1, pulse rate, S1, ΔYP2-ΔYPL, TP2 -TPL increased (all P<0.05). The change trend of pulse wave at 20min and 30min after exercise was consistent with that at 10min after exercise, but most indicators gradually recovered to the resting level before exercise from 10 min. ④The appearance rate of dicrotic wave with obvious crest in 16 patients with long-term chronic disease at rest was 28.6%, and the appearance rate of 10 min (65.7%), 20 min (77.1%), 30 min (73.7%) after exercise was significantly increased (all P< 0.01). In 6 patients, the incidence of dicrotic waves with obvious peaks after exercise was significantly increased, and it could continue until 30 minutes. In 3 patients, the incidence increased significantly 10 minutes after exercise, and began to decrease at 20 minutes. In 1 patient, the rate of appearance only started to increase 20 minutes after exercise. In 2 patients, the incidence increased 10 minutes after exercise and then decreased. In 1 patient, the rate of occurrence increased briefly 20 minutes after exercise and then decreased. The incidence of 1 patient dropped after exercise and began to rise at 20 minutes. In 2 cases, the incidence rate did not increase after exercise, and it increased slightly after 30 minutes. Conclusion: In patients with long-term chronic diseases, the radial artery pulse wave is short and the dicrotic wave is not obvious or even disappears. After a single precise power exercise, the main wave increases, the position of the dicrotic wave decreases, and the amplitude increases. The specific response should be analyzed individually.


Assuntos
Teste de Esforço , Exercício Físico , Idoso de 80 Anos ou mais , Pressão Sanguínea , Doença Crônica , Feminino , Frequência Cardíaca , Humanos , Masculino
17.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 37(2): 208-218, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-34672160

RESUMO

Objective: Under the guidance of the new theory of holistic integrated physiology and medicine, the effect of individualized accurate exercise program on the overall functional state was studied according to cardiopulmonary exercise testing (CPET). Methods: Li xx, female, 31 years old, has a fast heart rate since childhood (90~100 bpm), usually feel cold, especially in autumn and winter, and general health good. CPET was performed after signing the informed consent form at Fuwai Hospital in September 2019. Peak oxygen uptake, anaerobic threshold (AT), and peak cardiac output were (69~72)% pred, respectively, and the oxygen uptake ventilation efficiency and carbon dioxide exhaust ventilation efficiency were basically normal (96~100)% pred. The resting heart rate was fast, the blood pressure was low, the blood pressure response was weak during exercise, and the heart rate was mainly increased. The holistic integrated physiology medical theory pointed out that she was in weak health and heart weakness was the main manifestation. CPET was used to guide individualized precise exercise intensity titration, combine continuous beat-by-beat blood pressure, ECG, pulse and blood glucose dynamic monitoring to formulate an holisticplan of individualized quantitative exercise .Reexamine CPET after 8 weeks' strengthening management. Results: After 8 weeks of intensive holistic management, the limbs were warm and the cold symptoms disappeared. Re-examination of CPET peak oxygen uptake, AT and peak cardiac output were (90~98)% pred, which increased by (30~36)% respectively, and the holistic weak functional status was significantly improved; basically normal oxygen uptake ventilation efficiency and carbon dioxide exhaust ventilation efficiency also increased by (10~37)% respectively; resting heart rate and blood pressure basically returned to normal, and blood pressure and heart rate response during exercise were normal. Continuous ambulatory blood glucose monitoring indicated that the average blood glucose level decreased slightly and became more stable. Repeated measurement results of continuous ECG and beat-to-beat blood pressure also indicated a decrease in heart rate and an increase in blood pressure during rest, exercise and during sleep, and radial pulse wave. The amplitude of the dicrotic wave increases and becomes more pronounced. Conclusion: The new theoretical system to guide CPET to formulate an holistic plan for individualized precision exercise can safely and effectively enhance myocardial contractility, increase stroke volume, increase blood pressure, lower heart rate, stabilize and slightly lower blood glucose, and improve holistic functional status.


Assuntos
Teste de Esforço , Consumo de Oxigênio , Adulto , Glicemia , Automonitorização da Glicemia , Criança , Feminino , Estado Funcional , Humanos
18.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 37(2): 219-224, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-34672161

RESUMO

Objective: Observe the increased anatomical dead space of the mask, summarize the law of exercise induced oscillatory breathing (EIOB) in the results of CPET's new 9 figure, and analyze its incidence and age groups that are prone to oscillatory breathing. Methods: After signed the informed consent form by guardian, 501 children from pre-school to middle-school, aged 3~14 year, performed Harbor-UCLA standard protocol CPET with strict quality control in the CPET laboratory of Liaocheng Children's Hospital since 2014. CPET data was interpreted second by second from the breath by breath collection, averaged by 10s and then display by 9 plots. We analyzed the trends, pattern, incidence and age difference for EIOB and gas leakage. Results: The incidence of EIOB was the highest in the 3 to 6-year-old group, which was 42%. The 7 to 10-year-old group was 29.4% and the 11- to 14-year-old group was 29.9%. The three groups were tested by chi-square (x2=7.512), and the difference was statistically significant (P<0.05). 14 out of 508 children had air leakage during CPET, the incidence rate was 2.7%. Conclusion: The phenomenon of oscillatory breathing (OB) in children may be caused by the increased anatomical dead space of the mask, and it is not caused by disease. To improve the quality of CPET and to reduce clinical misdiagnosis, it is recommended to use a mouthpiece to decrease the dead space rather than the musk.


Assuntos
Teste de Esforço , Respiração , Adolescente , Grupo com Ancestrais do Continente Asiático , Criança , Pré-Escolar , China/epidemiologia , Erros de Diagnóstico , Humanos
19.
Artigo em Chinês | MEDLINE | ID: mdl-34672456

RESUMO

Objective: The fetus has no actual respiration, and the newborn begins to breathe after birth. We assume that the first breath dominantly generated by hypoxia. In this study, the changes and lowest limit of blood oxygen partial pressureof umbilical artery (PuaO2) after chemoreceptor were analyzed to explore the mechanism of neonatal spontaneous breathing. Methods: With signed consent form by all fetal parents before birth, 14 newborns successfully completed the umbilical artery or vein catheterization and drawn blood according to the heartbeat. All blood samples analyzed by blood gas analyzer,calculated and analyzed the similarities and differences between umbilical vein(Puv) and umbilical artery(Pua). Results: Although we completed 14 newborns, there were only 9 cases of umbilical artery samples and 8 cases of umbilical vein samples were collected. Only 3 cases collected both Pua and Puv blood samples at the same time (see serial paper II). PuaO2 in gradually decreased with time (heartbeat frequency), until Pua contracted after spontaneous breathing produced about 8~10 heartbeats, and then could not get enough blood samples. Only 3 newborns were able to take blood samples after spontaneous breathing for 8~10 heartbeats, and their PuaO2 were jumped to 186.0, 137.0 and 93.8 mmHg respectively. The mean value of PuaO2 was (25.94±6.79, 18.04~37.51)mmHg, the highest value was (29.11±6.46, 23.00~45.90)mmHg, and the lowest value was (21.34±5.54, 14.00~33.60)mmHg. Although PuvO2 decreased gradually with time (heartbeat) too, most of them also showed the tendency of alternately rising and falling with the regularity of mother's respiration. The mean value of PuvO2 was (53.35±21.35, 32.56~100.73)mmHg, the highest value was (90.38±48.44, 43.40~153.00)mmHg, and the lowest value was (36.96±14.90, 24.80~73.80)mmHg. Although there were large individual differences, the mean, highest and lowest values of PuvO2 were significantly higher than those of PuaO2 (P<0.05); although PuvCO2 slightly lower than PuaCO2, it was no significant difference (P>0.05). Conclusion: PuaO2 decreases gradually with time before spontaneous breathing after the delivered fetus as a newborn, and it induces the first inhalation to start spontaneous breathing when it reaches the threshold of triggering breathing.


Assuntos
Dióxido de Carbono , Artérias Umbilicais , China , Humanos , Recém-Nascido , Oxigênio , Pressão Parcial
20.
Artigo em Chinês | MEDLINE | ID: mdl-34672458

RESUMO

Objective: To observe and study the resting radial artery pulse wave and the pulse wave changes after a single individualized exercise in young healthy normal subjects. Methods: We selected 16 young healthy graduate students, advanced training doctors, and visiting scholars from Fuwai Hospital without any disease diagnosis and low daily exercise. They first completed the symptom-restricted limit cardiopulmonary exercise testing (CPET). A single individualized exercise with Δ50% power as the exercise intensity was completed within one week after CPET. We measured and recorded 50 s pulse wave data before exercise and 10 min, 20 min, 30min after exercise, let the instrument automatically fix the point and then manually recheck to obtain each pulse wave characteristic point: starting point (B), main wave peak point (P1), trough of a repulse point (PL), crest of a repulse point (P2), and end point (E), and the raw data of the abscissa (time T) and ordinate (amplitude Y) corresponding to each point were derived from the instrument. We treated the end point E of the previous pulse wave as the start point B of the next wave, returned TB to zero, and got the main observation indicators: YB, YP1, YPL, YP2 and TP1, TPL, TP2, TE, and calculated out ΔYP1 (YP1-YB), ΔYPL (YPL-YB), ΔYP2 (YP2-YB), TE-TPL, (TE-TPL)/TPL, pulse rate, S1 (the slope of main wave ascending branch), S2 (the slope of dicrotic ascending branch), ΔYP2-ΔYPL and TP2-TPL as secondary observation indicators; defined the dicrotic wave with obvious crest as YP2>YPL, and calculated the occurrence rate of dicrotic wave with obvious crest (number of waveforms with YP2>YPL in 50 s /total number of waveforms×100%). We analyzed individually the 50 s pulse wave data of each subject before and after exercise, and then averaged all the data for overall analysis. Results: ①16 healthy young subjects (males 10, females 6), age (30.6±6.4, 24~48) years old; height (170.4±8.2, 160~188) cm; body mass (63.9±12.8, 43~87) kg. ②YB (87.2±5.8, 78.1~95.9), YP1 (223.5±15.8, 192.7~242.3), YPL (122.8±7.8, 110.0~133.8), YP2 (131.4±4.9, 116.7~137.5), TP1 (126.2±42.2, 94.2~280.0), TPL (360.2±44.8, 311.5~507.3), TP2 (432.4±50.8, 376.2~589.0), TE (899.7±86.9, 728.3~1042.0). ΔYP1 (136.3±19.9, 96.8~ 158.6), ΔYPL (35.7±10.7, 16.0~55.7), ΔYP2 (44.3±8.1, 22.5~56.5), TE-TPL (539.5±79.3, 405.9~691.3), (TE-TPL)/TPL (1.5±0.3, 0.8~2.0), pulse rate (67.3±6.6, 57.6~82.4), S1 (1.1±0.2, 0.6~1.4), S2 (0.1±0.1, 0.0~0.2), ΔYP2-ΔYPL (8.6±6.1, 0.9 ~19.8), TP2-TPL (72.3±19.9, 38.3~108.4). ③10 min after exercise, YPL (97.0±13.2 vs 122.8±7.8), YP2 (109.6±12.8 vs 131.4±4.9), ΔYPL (6.6±9.8 vs 35.7±10.7), ΔYP2 (19.3±11.2 vs 44.3±8.1), TE (667.8±123.1 vs 899.7±86.9), TE-TPL (330.2±128.4 vs 539.5±79.3), (TE-TPL)/TPL (1.0±0.4 vs 1.5±0.3) decreased, while the pulse rate (92.2± 14.0 vs 67.3±6.6), ΔYP2-ΔYPL (12.7±9.7 vs 8.6±6.1), TP2-TPL (98.0±38.1 vs 72.3±19.9) increased (all P<0.05). The trend of pulse wave changes at 20 min and 30 min after exercise was consistent with that at 10 min after exercise, but from 20 min, most of the indicators gradually recovered to the resting level before exercise. ④The incidence of dicrotic waves with obvious peaks in 16 young healthy persons at rest was 94.5%, and increased at 10 min (96.3%), 20 min (98.5%), and 30 min (99.8%) after exercise (all P<0.01). Among them, the incidence of dicrotic waves with obvious peaks before and after exercise was maintained at about 100% in 10 subjects. The appearance rate of 2 cases had reached 100% before exercise, but it decreased at 10 minutes after exercise, and then continued to increase, at 30 minutes recovered to 100%. Three subjects had a low resting rate and started to increase after exercise. In 1 case, the rate was low only 20 minutes after exercise, considering the influence of human factors. Conclusion: The influence of exercise on the pulse wave of normal people is mainly reflected in the dicrotic wave. On the whole, after a single precise power exercise, the position of the dicrotic wave is reduced, the amplitude is deepened, and the appearance rate of the dicrotic wave with obvious crest is generally increased, and this change can be maintained for at least 30 minutes. From an individual point of view, the response trend of each subject is different.


Assuntos
Teste de Esforço , Exercício Físico , Artérias , Feminino , Voluntários Saudáveis , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade
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