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Quality of Cardiopulmonary Resuscitation in Avalanche Victims with a Single Rescuer: A Prospective, Crossover, Manikin Pilot Study. 单人救援雪崩伤员的心肺复苏质量:一项前瞻性、交叉、人体模型试点研究。
IF 1.6 4区 医学 Q4 BIOPHYSICS Pub Date : 2024-03-01 Epub Date: 2024-02-16 DOI: 10.1089/ham.2023.0058
Shota Tanaka, Koshi Nakagawa, Yosuke Kanagawa, Takashi Katsurahara, Kazuki Kozakai, Ken Tsuhako, Fumitaka Yoshikawa, Soh Gotoh, Kensuke Osanai, Madoka Sono, Hironori Inoue, Shuji Sakanashi, Hiroyuki Takahashi, Hideharu Tanaka

Tanaka, Shota, Koshi Nakagawa, Yosuke Kanagawa, Takashi Katsurahara, Kazuki Kozakai, Ken Tsuhako, Fumitaka Yoshikawa, Soh Gotoh, Kensuke Osanai, Madoka Sono, Hironori Inoue, Shuji Sakanashi, Hiroyuki Takahashi, and Hideharu Tanaka. Quality of cardiopulmonary resuscitation in avalanche victims with a single rescuer: a prospective, crossover, manikin pilot study. High Alt Med Biol. 25:60-67, 2024. Background: Winter outdoor recreational activities such as off-piste skiing have gained popularity and, as a result, the number of avalanche-related deaths has increased. However, the quality of cardiopulmonary resuscitation (CPR) at avalanche sites remains unclear. Our study compared the quality of CPR performed in a simulated avalanche burial on a snowy mountain with that performed indoors. Methods: Ten prehospital health care providers participated in the crossover pilot study. Various methods, including over-the-head CPR (OTH-CPR) and standard CPR, were used to perform avalanche resuscitation, with five rescue breaths, followed by 30 chest compressions and two breaths. The quality CPR was judged by four variables of chest compression and ventilation. Results: The OTH-CPR performed indoors was better in quality: 5.33% [95% confidence interval (CI) -14.2 to 3.5] higher in adequate compression depth (94.3 ± 10.6% on the snow vs. 99.3 ± 1.1% indoors), 3.4% [95% CI -16.1 to 22.9] higher in adequate compression rate (70.4 ± 38.0% vs. 76.1 ± 35.7%), and 2.3% [95% CI -6.4 to 1.72] higher in adequate recoil (96.9 ± 4.8% vs. 99.2 ± 1.6%) than OTH-CPR on the snow. In terms of ventilation quality, OTH-CPR performed indoors had a 50% higher ventilation score [95% CI -73.0 to -27.0] than OTH-CPR on the snow (1.4 ± 4.3% vs. 45.9 ± 32.6%, Cohen's d = -1.81). Conclusions: Chest compression quality was slightly impaired in the avalanche scenarios on the snow than in indoor settings. Asphyxiation is the main cause of avalanche-related deaths; however, low ventilation quality was observed on snow compared with the indoor setting.

Tanaka, Shota, Koshi Nakagawa, Yosuke Kanagawa, Takashi Katsurahara, Kazuki Kozakai, Ken Tsuhako, Fumitaka Yoshikawa, Soh Gotoh, Kensuke Osanai, Madoka Sono, Hironori Inoue, Shuji Sakanashi, Hiroyuki Takahashi, and Hideharu Tanaka.单人救援雪崩伤员的心肺复苏质量:一项前瞻性、交叉、人体模型试验研究。00:000-000, 2024.背景:越野滑雪等冬季户外娱乐活动越来越受欢迎,因此与雪崩相关的死亡人数也随之增加。然而,雪崩现场心肺复苏(CPR)的质量仍不清楚。我们的研究比较了在雪山模拟雪崩掩埋地和室内进行心肺复苏术的质量。研究方法十名院前医疗服务提供者参加了交叉试验研究。在雪崩急救过程中,采用了各种方法,包括俯卧位心肺复苏术(OTH-CPR)和标准心肺复苏术,先进行五次人工呼吸,然后进行 30 次胸外按压和两次人工呼吸。心肺复苏的质量由胸外按压和通气的四个变量来评判。结果显示在室内进行的 OTH-CPR 质量更高:在足够的按压深度方面高出 5.33% [95% 置信区间 (CI) -14.2 至 3.5](雪地上为 94.3 ± 10.6%,室内为 99.3 ± 1.1%),在按压深度方面高出 3.4% [95% CI -16.1 到 22.9],适当的压缩率(70.4 ± 38.0% 对 76.1 ± 35.7%)比雪地上的 OTH-CPR 高 2.3% [95% CI -6.4 到 1.72],适当的后坐力(96.9 ± 4.8% 对 99.2 ± 1.6%)比室内的 OTH-CPR 高 2.3%[95% CI -6.4 到 1.72]。在通气质量方面,在室内进行的 OTH-CPR 比在雪地上进行的 OTH-CPR 的通气评分高 50%[95%CI-73.0 至 -27.0](1.4 ± 4.3% vs. 45.9 ± 32.6%,Cohen's d =-1.81)。结论:雪地雪崩情况下的胸外按压质量略低于室内环境下的胸外按压质量。窒息是雪崩相关死亡的主要原因;然而,与室内环境相比,雪地上的通气质量较低。
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引用次数: 0
Transient Central Facial Palsy at High Altitude: A Case Report. 高海拔地区一过性中枢性面瘫:病例报告。
IF 1.6 4区 医学 Q4 BIOPHYSICS Pub Date : 2024-03-01 Epub Date: 2021-06-29 DOI: 10.1089/ham.2020.0184
Edem Allado, Bruno Chenuel, Jean-Charles Vauthier, Oriane Hily, Sébastien Richard, Mathias Poussel

Allado, Edem, Bruno Chenuel, Jean-Charles Vauthier, Oriane Hily, Sébastien Richard, and Mathias Poussel. Transient central facial palsy at high altitude: a case report. High Alt Med Biol. 25:100-102, 2024.-High altitude cerebral edema (HACE) is a severe form of acute mountain sickness (AMS). Besides this life-threatening condition, other neurological disorders may develop at high altitude, even if the precise pathophysiological mechanisms generally remain undetermined and are often debated. We report the case of a 34-year-old woman presenting with moderate AMS during an ascent of Mount Kilimanjaro. While descending from the summit, she suddenly experienced focal neurological symptoms of visual blurring, tinnitus, lightheadedness, and the findings of left-sided central facial palsy (flattened nasolabial fold, fall of labial commissure, dysarthria, difficulty in whistling, and facial dysesthesia). These symptoms and signs were confirmed in the field by a physician. Her symptoms regressed spontaneously and completely while continuing to descend. The etiology of this neurological episode at high altitude is discussed. The most probable diagnosis is a transient ischemic attack based on personal and familial vascular history, confirmed unilateral transient central facial palsy and normal results on standard blood work and cerebral magnetic resonance imaging. In this case, migraine should also be considered based on association of headache and transient focal neurological impairment. Overall, special attention should be given to mountaineers presenting with neurological conditions at altitude. Not only HACE should be considered but also the wide spectrum of other neurological conditions that fall outside the usual definition of altitude sickness.

阿拉多(Allado)、埃德姆(Edem)、布鲁诺-切努埃尔(Bruno Chenuel)、让-查尔斯-沃蒂耶(Jean-Charles Vauthier)、奥里安-希利(Oriane Hily)、塞巴斯蒂安-理查德(Sébastien Richard)和马蒂亚斯-普塞尔(Mathias Poussel)。高海拔地区短暂性中枢性面瘫:病例报告。00:000-000, 2020.高海拔脑水肿(HACE)是急性高山病(AMS)的一种严重形式。除了这种危及生命的疾病外,其他神经系统疾病也可能在高海拔地区发生,尽管其确切的病理生理机制一般仍未确定,而且经常引起争议。我们报告了一例 34 岁女性在攀登乞力马扎罗山时出现中度高山反应的病例。在从山顶下山时,她突然出现了视觉模糊、耳鸣、头晕等局灶性神经症状,并出现了左侧中枢性面瘫(鼻唇沟变平、唇突下降、构音障碍、吹口哨困难和面部感觉障碍)。这些症状和体征在现场得到了医生的证实。在继续下降的过程中,她的症状自发地完全消退了。本文讨论了在高海拔地区出现这种神经症状的病因。根据个人和家族血管病史、确诊的单侧短暂性中枢性面瘫以及标准血检和脑磁共振成像的正常结果,最有可能的诊断是短暂性脑缺血发作。在这种情况下,根据头痛和一过性局灶性神经损伤的关联,也应考虑偏头痛。总之,应特别关注在高海拔地区出现神经系统疾病的登山者。不仅应考虑 HACE,还应考虑高原病通常定义之外的其他各种神经系统疾病。
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引用次数: 0
Prevalence and Risk Factors of Hyperuricemia Among Young and Middle-Aged Tibetan Men Living at Ultrahigh Altitudes: A Cross-Sectional Study. 生活在超高海拔地区的藏族中青年男性高尿酸血症的患病率和风险因素:一项横断面研究
IF 1.6 4区 医学 Q4 BIOPHYSICS Pub Date : 2024-03-01 Epub Date: 2024-01-04 DOI: 10.1089/ham.2023.0056
Ben He, Jiayue Feng, Yan Shu, Lichun Yang, Zepin He, Kanxiu Liao, Hui Zhuo, Hui Li

He, Ben, Jiayue Feng, Yan Shu, Lichun Yang, Zepin He, Kanxiu Liao, Hui Zhuo, and Hui Li. Prevalence and risk factors of hyperuricemia among young and middle-aged Tibetan men living at ultrahigh altitudes: a cross-sectional study. High Alt Med Biol. 25:42-48, 2024. Background: Few studies have examined the prevalence or risk factors of hyperuricemia among populations living at ultrahigh altitudes. Here we examined the prevalence of hyperuricemia and factors associated with it among young and middle-aged Tibetan men living at ultrahigh altitudes. Methods: This cross-sectional study analyzed 672 Tibetan men 18-60 years old living on the Qinghai-Tibet Plateau (mean altitude 4,014 m) within the county of Litang in the Ganzi Tibetan autonomous prefecture of Sichuan Province, China. Demographic and clinical data were collected from self-administered questionnaires, physical examinations and laboratory tests. Participants whose blood uric acid (UA) contained >420 μmol/l were classified as having hyperuricemia. Results: Of the 672 men analyzed, 332 (49.4%) had hyperuricemia. Multivariate logistic regression showed risk of hyperuricemia to correlate positively with body mass index (per 1 U increase: odds ratio [OR] 1.172, 95% confidence interval [CI] 1.1066-1.243), triglycerides (OR 1.408, 95% CI 1.084-1.828), red blood cell count (OR 1.376, 95% CI 1.009-1.875), and creatinine level (per 1 U increase: OR 1.051, 95% CI 1.033-1.070). Conversely, risk of hyperuricemia correlated negatively with the presence of diabetes mellitus (OR 0.412, 95% CI 0.175-0.968). Subgroup analyses showed that prevalence of hyperuricemia was significantly higher among those with polycythemia than among those without it, and that UA levels correlated positively with hematocrit and hemoglobin levels. Conclusions: Hyperuricemia is an important public health problem among Tibetan men living at ultrahigh altitudes in Ganzi autonomous prefecture. The region urgently requires appropriate prevention and management efforts.

何奔、冯嘉悦、舒艳、杨丽春、何泽平、廖康秀、卓慧、李慧。生活在超高海拔地区的藏族中青年男性高尿酸血症的患病率和风险因素:一项横断面研究。24:000-000, 2024.背景:很少有研究调查生活在超高海拔地区的人群中高尿酸血症的患病率或风险因素。在此,我们研究了生活在超高海拔地区的藏族中青年男性的高尿酸血症患病率及其相关因素。研究方法这项横断面研究分析了居住在中国四川省甘孜藏族自治州理塘县境内青藏高原(平均海拔 4014 米)的 672 名 18-60 岁藏族男性。研究人员通过自填问卷、体格检查和实验室检测收集人口统计学和临床数据。血尿酸(UA)含量大于 420 μmol/l 的参与者被列为高尿酸血症患者。结果:在分析的 672 名男性中,有 332 人(49.4%)患有高尿酸血症。多变量逻辑回归显示,高尿酸血症的风险与体重指数呈正相关(每增加 1 U:几率比 [OR] 1.172,95% 置信区间 [CI] 1.1066-1.243)、甘油三酯(OR 1.408,95% CI 1.084-1.828)、红细胞计数(OR 1.376,95% CI 1.009-1.875)和肌酐水平(每增加 1 U:OR 1.051,95% CI 1.033-1.070)呈正相关。相反,高尿酸血症的风险与是否患有糖尿病呈负相关(OR 0.412,95% CI 0.175-0.968)。亚组分析表明,多血细胞症患者的高尿酸血症发病率明显高于非多血细胞症患者,而且尿酸水平与血细胞比容和血红蛋白水平呈正相关。结论是高尿酸血症是甘孜藏族自治州生活在超高海拔地区藏族男性的一个重要公共卫生问题。该地区迫切需要开展适当的预防和管理工作。
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引用次数: 0
Letter to the Editor: Central Serous Chorioretinopathy at High Altitude: A Multifactorial Perspective. 致编辑的信:高海拔地区的中心性浆液性脉络膜视网膜病变:多因素视角。
IF 1.6 4区 医学 Q4 BIOPHYSICS Pub Date : 2024-03-01 Epub Date: 2023-11-02 DOI: 10.1089/ham.2023.0085
Vipin Rana, Meenu Dangi, S Bandopadhyay, Vijay K Sharma
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引用次数: 0
Menopause and High Altitude: A Scoping Review-UIAA Medical Commission Recommendations. 更年期和高海拔:范围审查UIAA医学委员会的建议。
IF 1.6 4区 医学 Q4 BIOPHYSICS Pub Date : 2024-03-01 Epub Date: 2023-11-06 DOI: 10.1089/ham.2023.0039
Kastė Mateikaitė-Pipirienė, Dominique Jean, Peter Paal, Lenka Horakova, Susi Kriemler, Alison J Rosier, Marija Andjelkovic, Beth A Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, Linda E Keyes

Mateikaitė-Pipirienė, Kastė, Dominique Jean, Peter Paal, Lenka Horakova, Susi Kriemler, Alison J. Rosier, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, and Linda E. Keyes for the UIAA MedCom writing group on Women's Health in the Mountains. Menopause and high altitude: A scoping review-UIAA Medical Commission Recommendations. High Alt Med Biol. 25:1-8, 2024. Background: Older people are an important fraction of mountain travelers and climbers, many of them postmenopausal women. The aim of this work was to review health issues that older and postmenopausal women may experience at high altitude, including susceptibility to high-altitude illness. Methods: We performed a scoping review for the UIAA Medical Commission series on Women's Health in the mountains. We searched PubMed and Cochrane libraries and performed an additional manual search. The primary search focused on articles assessing lowland women sojourning at high altitude. Results: We screened 7,165 potential articles. The search revealed three relevant articles, and the manual search another seven articles and one abstract. Seven assessed menopausal low-altitude residents during a high-altitude sojourn or performing hypoxic tests. Four assessed high-altitude residents. We summarize the results of these 11 studies. Conclusions: Data are limited on the effects of high altitude on postmenopausal women. The effects of short-term, high-altitude exposure on menopause symptoms are unknown. Menopause has minimal effect on the physiological responses to hypoxia in physically fit women and does not increase the risk of acute mountain sickness. Postmenopausal women have an increased risk of urinary tract infections, which may be exacerbated during mountain travel. More research is needed on the physiology and performance of older women at high altitude.

马泰凯特-皮皮里恩、卡斯特、多米尼克·让、彼得·帕尔、伦卡·霍拉科娃、苏西·克里姆勒、艾莉森·J·罗西尔、玛丽亚·安德耶尔科维奇、贝丝·A·贝德尔曼、米娅·德斯汀、杰奎琳·皮克勒·赫夫蒂、大卫·希莱布兰特和琳达·E·凯斯为UIAA MedCom山区妇女健康写作小组撰写。更年期和高海拔:UIAA医学委员会建议的范围审查。High Alt-Med Biol 00:000-0002023。背景:老年人是登山者和登山者的重要组成部分,其中许多是绝经后的女性。这项工作的目的是审查老年妇女和绝经后妇女在高海拔地区可能遇到的健康问题,包括对高海拔疾病的易感性。方法:我们对UIAA医学委员会关于山区妇女健康的系列进行了范围审查。我们搜索了PubMed和Cochrane图书馆,并进行了额外的手动搜索。主要搜索集中在评估在高海拔地区逗留的低地妇女的文章上。结果:我们筛选了7165篇潜在文章。搜索发现了三篇相关文章,手册搜索了另外七篇文章和一篇摘要。其中7人评估了在高海拔逗留期间或进行低氧测试的更年期低海拔居民。四名高海拔居民接受了评估。我们总结了这11项研究的结果。结论:关于高海拔对绝经后妇女影响的数据有限。短期高海拔暴露对更年期症状的影响尚不清楚。更年期对身体健康的女性对缺氧的生理反应影响很小,不会增加患急性山病的风险。绝经后妇女患尿路感染的风险增加,在山区旅行时可能会加剧这种风险。需要对高海拔地区老年妇女的生理和表现进行更多的研究。
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引用次数: 0
Acknowledgment of Reviewers 2023. 鸣谢 2023 年审稿人。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1089/ham.2023.29031.ack
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引用次数: 0
Sex Differences in Mountain Bike Accidents in Austria from 2006 to 2018: A Retrospective Analysis. 2006 年至 2018 年奥地利山地自行车事故的性别差异:回顾性分析
IF 1.6 4区 医学 Q4 BIOPHYSICS Pub Date : 2024-03-01 Epub Date: 2023-12-11 DOI: 10.1089/ham.2023.0086
Simon Woyke, Anja Hütter, Christopher Rugg, Willi Tröger, Bernd Wallner, Mathias Ströhle, Peter Paal

Woyke, Simon, Anja Hütter, Christopher Rugg, Willi Tröger, Bernd Wallner, Mathias Ströhle, and Peter Paal. Sex differences in mountain bike accidents in Austria from 2006 to 2018: a retrospective analysis. High Alt Med Biol. 25:89-93, 2024. Introduction: Mountain biking is becoming increasingly popular, and mountain bike (MTB) accidents are on the rise. The aim of this study was to assess sex differences in mountain biking accidents in the Austrian Alps. Methods: This retrospective study includes all MTB accidents in Austria from 2006 to 2018. Data were collected by Alpine Police officers and recorded in a national digital registry. Results: The accidents involved 5,095 mountain bikers (81% men and 19% women). The number of MTB accidents rose markedly from 208 in 2006 to 725 in 2018. Men wore a helmet more often than did women (95% vs. 92%; p = 0.001). The most common injury category was "wound/bleeding" for both sexes (men 40% and women 41%). Women were more frequently transported by helicopter or terrestrially (p > 0.001). Conclusion: In the Austrian Alps, the number of MTB accidents more than tripled between 2006 and 2018. Women were involved in only one fifth of all accidents. Sex differences in MTB accidents include (1) women wearing helmets less often, (2) women being less frequently injured, (3) women suffering fewer serious injuries, and (4) women being more frequently transported by helicopter or terrestrially, while men more often did not require transportation.

Woyke, Simon, Anja Hütter, Christopher Rugg, Willi Tröger, Bernd Wallner, Mathias Ströhle, and Peter Paal.2006年至2018年奥地利山地自行车事故的性别差异:回顾性分析。High Alt Med Biol 00:000-000, 2023.导言:山地自行车越来越受欢迎,山地自行车(MTB)事故也呈上升趋势。本研究旨在评估奥地利阿尔卑斯山山地自行车事故的性别差异。研究方法这项回顾性研究包括 2006 年至 2018 年奥地利发生的所有山地自行车事故。数据由阿尔卑斯警官收集,并记录在国家数字登记册中。研究结果事故涉及 5095 名山地车骑行者(81% 为男性,19% 为女性)。山地车事故数量从 2006 年的 208 起明显上升至 2018 年的 725 起。男性比女性更经常佩戴头盔(95% 对 92%;P = 0.001)。男女最常见的受伤类别都是 "伤口/出血"(男性占 40%,女性占 41%)。女性更常被直升机或地面运送(P > 0.001)。结论在奥地利阿尔卑斯山,2006 年至 2018 年间山地车事故数量增加了两倍多。女性仅占所有事故的五分之一。山地车事故中的性别差异包括:(1)女性戴头盔的频率较低;(2)女性受伤的频率较低;(3)女性受重伤的频率较低;(4)女性更多地被直升机或地面运输,而男性更多不需要运输。
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引用次数: 0
Chronic Intermittent Hypobaric Hypoxia Reduces Hypothalamic N-Methyl-d-Aspartate Receptor Activity and Sympathetic Outflow in Spontaneously Hypertensive Rats. 慢性间歇性低压缺氧降低自发性高血压大鼠下丘脑 N-甲基-d-天冬氨酸受体活性和交感神经外流
IF 1.6 4区 医学 Q4 BIOPHYSICS Pub Date : 2024-03-01 Epub Date: 2024-01-19 DOI: 10.1089/ham.2023.0098
Xinqi Guo, Hongyu Ma, Ziye Cui, Qiyue Zhao, Ying Zhang, Lu Jia, Liping Zhang, Hui Guo, Xiangjian Zhang, Yi Zhang, Yue Guan, Huijie Ma

Guo, Xinqi, Hongyu Ma, Ziye Cui, Qiyue Zhao, Ying Zhang, Lu Jia, Liping Zhang, Hui Guo, Xiangjian Zhang, Yi Zhang, Yue Guan, and Huijie Ma. Chronic intermittent hypobaric hypoxia reduces hypothalamic N-Methyl-d-Aspartate Receptor activity and sympathetic outflow in spontaneously hypertensive rats. High Alt Med Biol. 25:77-88, 2024. Objective: This study aims to determine the role of hypothalamic renin-angiotensin system (RAS) in the antihypertensive effect of chronic intermittent hypobaric hypoxia (CIHH). Methods: Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHRs) received 35 days of hypobaric hypoxia simulating an altitude of 4,000 m, 5 h/day. The levels of RAS, blood pressure, and N-methyl-d-aspartate receptor (NMDAR) activities of hypothalamic paraventricular nucleus (PVN) presympathetic neurons from each group of rats were determined. Results: The systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure (MAP) of SHRs significantly decreased from the third week of CIHH treatment. This blood pressure reduction effect could be maintained for at least 2 weeks after stopping the CIHH treatment. CIHH treatment also attenuated the decrease in MAP and renal sympathetic nerve activity induced by hexamethonium administration in SHRs, but not in WKY rats. Furthermore, CIHH reversed the increase in serum angiotensin (Ang)II concentration and the expression of PVN angiotensin-converting enzyme (ACE) and AngII type 1 (AT1) receptors, as well as the decrease in serum Ang1-7 concentration and the expression of PVN ACE2 and Mas receptors in SHRs. In addition, the administration of CIHH resulted in a reduction in the frequency of miniature excitatory postsynaptic currents and amplitude of NMDAR current in PVN presympathetic neurons of SHRs, which means that CIHH decreased the pre- and postsynaptic NMDAR activity of PVN presympathetic neurons in SHRs. However, pretreatment with A779 (a Mas receptor blocker) or AngII abrogated the above effects. Meanwhile, Ang1-7 pretreatment mimicked the CIHH effect on pre- and postsynaptic NMDAR activity of presympathetic neurons in SHRs. Conclusions: Our data indicate that CIHH reduces pre- and postsynaptic NMDAR activity of PVN presympathetic neurons, sympathetic outflow, and blood pressure by decreasing the activity of the ACE/AngII/AT1 axis and increasing the activity of ACE2/Ang1-7/Mas axis in the hypothalamus in hypertension.

郭欣琦、马宏宇、崔子晔、赵启悦、张颖、贾璐、张丽萍、郭慧、张湘健、张毅、关悦、马慧杰。慢性间歇性低压缺氧降低自发性高血压大鼠下丘脑N-甲基-d-天冬氨酸受体活性和交感神经外流00:000-000, 2024.目的:本研究旨在确定下丘脑肾素-血管紧张素系统(RAS)在慢性间歇性低压缺氧(CIHH)降压作用中的作用。研究方法Wistar-Kyoto(WKY)大鼠和自发性高血压大鼠(SHR)接受 35 天模拟海拔 4,000 米的低压缺氧,每天 5 小时。测定了各组大鼠的 RAS 水平、血压和下丘脑室旁核(PVN)交感神经前神经元的 N-甲基-d-天冬氨酸受体(NMDAR)活性。结果自 CIHH 治疗第三周起,SHR 的收缩压、舒张压和平均动脉血压(MAP)均显著下降。这种降压效果在停止 CIHH 治疗后可维持至少 2 周。CIHH 治疗还可减轻六甲氧氨嘧啶给药引起的 SHR 大鼠 MAP 和肾交感神经活性的降低,但对 WKY 大鼠没有影响。此外,CIHH 还逆转了 SHR 大鼠血清血管紧张素(Ang)II 浓度的升高、PVN 血管紧张素转换酶(ACE)和 AngII 1 型(AT1)受体的表达,以及血清 Ang1-7 浓度的降低和 PVN ACE2 和 Mas 受体的表达。此外,CIHH 还导致 SHR PVN 交感神经节前神经元的微型兴奋性突触后电流频率和 NMDAR 电流幅度降低,这说明 CIHH 降低了 SHR PVN 交感神经节前神经元突触前和突触后 NMDAR 的活性。然而,使用 A779(一种 Mas 受体阻断剂)或 AngII 预处理可减轻上述影响。同时,Ang1-7 预处理模拟了 CIHH 对 SHR 交感神经前元和突触后元 NMDAR 活性的影响。结论:我们的数据表明,CIHH 通过降低高血压患者下丘脑中 ACE/AngII/AT1 轴的活性和提高 ACE2/Ang1-7/Mas 轴的活性,降低了 PVN 交感神经前突触前后 NMDAR 的活性、交感神经外流和血压。
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引用次数: 0
The Effect of High-Altitude Hypoxia on Neuropsychiatric Functions. 高原低氧对神经精神功能的影响。
IF 1.6 4区 医学 Q4 BIOPHYSICS Pub Date : 2024-03-01 Epub Date: 2023-10-10 DOI: 10.1089/ham.2022.0136
Bo Liu, Minlan Yuan, Mei Yang, Hongru Zhu, Wei Zhang

Liu, Bo, Minlan Yuan, Mei Yang, Hongru Zhu, and Wei Zhang. The effect of high-altitude hypoxia on neuropsychiatric functions. High Alt Med Biol. 25:26-41, 2024. Background: In recent years, there has been a growing popularity in engaging in activities at high altitudes, such as hiking and work. However, these high-altitude environments pose risks of hypoxia, which can lead to various acute or chronic cerebral diseases. These conditions include common neurological diseases such as acute mountain sickness (AMS), high-altitude cerebral edema, and altitude-related cerebrovascular diseases, as well as psychiatric disorders such as anxiety, depression, and psychosis. However, reviews of altitude-related neuropsychiatric conditions and their potential mechanisms are rare. Methods: We conducted searches on PubMed and Google Scholar, exploring existing literature encompassing preclinical and clinical studies. Our aim was to summarize the prevalent neuropsychiatric diseases induced by altitude hypoxia, the potential pathophysiological mechanisms, as well as the available pharmacological and nonpharmacological strategies for prevention and intervention. Results: The development of altitude-related cerebral diseases may arise from various pathogenic processes, including neurovascular alterations associated with hypoxia, cytotoxic responses, activation of reactive oxygen species, and dysregulation of the expression of hypoxia inducible factor-1 and nuclear factor erythroid 2-related factor 2. Furthermore, the interplay between hypoxia-induced neurological and psychiatric changes is believed to play a role in the progression of brain damage. Conclusions: While there is some evidence pointing to pathophysiological changes in hypoxia-induced brain damage, the precise mechanisms responsible for neuropsychiatric alterations remain elusive. Currently, the range of prevention and intervention strategies available is primarily focused on addressing AMS, with a preference for prevention rather than treatment.

刘、Bo、袁敏兰、杨梅、朱鸿儒、张伟。高海拔缺氧对神经精神功能的影响。High Alt-Med Biol 00:000-0002023。背景:近年来,从事高海拔活动越来越受欢迎,如徒步旅行和工作。然而,这些高海拔环境会带来缺氧的风险,从而导致各种急性或慢性脑疾病。这些疾病包括常见的神经系统疾病,如急性山地病(AMS)、高原脑水肿和高原相关的脑血管疾病,以及焦虑、抑郁和精神病等精神疾病。然而,对海拔高度相关的神经精神状况及其潜在机制的综述很少。方法:我们在PubMed和Google Scholar上进行搜索,探索包括临床前和临床研究在内的现有文献。我们的目的是总结高原缺氧诱导的常见神经精神疾病、潜在的病理生理机制,以及可用于预防和干预的药理学和非药理学策略。结果:高原相关脑疾病的发展可能由各种致病过程引起,包括与缺氧相关的神经血管改变、细胞毒性反应、活性氧的激活以及缺氧诱导因子-1和核因子红系2相关因子2的表达失调。此外,缺氧诱导的神经和精神变化之间的相互作用被认为在脑损伤的进展中发挥了作用。结论:虽然有一些证据表明缺氧诱导的脑损伤发生了病理生理变化,但导致神经精神改变的确切机制仍然难以捉摸。目前,可用的一系列预防和干预策略主要集中在解决AMS问题上,倾向于预防而非治疗。
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引用次数: 0
Acknowledgment of Reviewers 2023. 鸣谢 2023 年审稿人。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2024-02-01 DOI: 10.1089/gyn.2023.29009.ack
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High altitude medicine & biology
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