Exercise tolerance after anaemia correction with recombinant human erythropoietin in end-stage renal disease

The aim of this study was to evaluate the effect of correction of chronic anaemia on the physical performance and the cardiovascular response to effort in children with end-stage renal disease (ESRD) maintained by haemodialysis. Seven patients (mean age 13.9 years) underwent triangular-type treadmill exercise testing before [haemoglobin (Hb) 6.3±0.9 g/dl] and after (Hb 11.2±1.2 g/dl) anaemia correction with recombinant human erythropoietin (rHuEPO). After treatment, the work-load reached, the peak oxygen uptake and average ventilatory anaerobic threshold (VAT) values were significantly increased (P<0.01,P<0.001,P<0.05 respectively). VAT values, expressed as a percentage of normal values, increased from 55.7±16.6% to 82.4±21%. This improvement correlated well with the increase in Hb (r=0.79). Oxygen pulse also increased significantly, when tested after anacmia correction. In conclusion, these data demonstrate that when the anaemia of children with ESRD is corrected with rHuEPO, there is a clear improvement in acrobic work capacity and effort tolerance.     

Combined evaluation of first pass radionuclide angiography and equilibrium radionuclide ventriculography in the diagnosis of coronary artery disease

Results of 203 patients who underwent first pass radionuclide angiography (FP) and quantitative equilibrium radionuclide ventriculography (qERNV) were stored in a data base system and evaluated statistically. Eighty eight of these patients also underwent exercise equilibrium radionuclide ventriculography (E-qERNV). In patients with coronary artery disease (CAD) without previous myocardial infarction (MI), evaluation of global and regional ejection fraction (gEF, rEF) at rest revealed a poor sensitivity of 64%, the specificity was about 71% (qERNV). FP at rest revealed similar values of sensitivity (69%) and specificity (83%). Additional assessment of stress induced changes of gEF, significantly (P<0.05) improved sensitivity of qERNV in CAD patients without a history of previous MI to 84% (specificity 86%). In patients with one previous MI, however, similar values of sensitivity were found (RFP: 87%, R-qERNV: 84%, E-qERNV: 93%). In patients with several MI's, sensitivity was above 90% at rest and during exercise (R-FP: 96%, R-qERNV: 93%, E-qERNV: 100%).     

运动训练联合基因治疗对肾性高血压大鼠肾功能的影响

目的观察运动训练联合β1肾上腺素能受体基因治疗对肾性高血压大鼠血压、肾功能、肾脏前肾素原mRNA、肾脏β1受体mRNA和蛋白的影响，探讨其改善肾功能的机制。方法两肾一夹法制作肾性高血压模型，基因治疗采用经鼠尾静脉注射阳离子脂质体与β1反义寡核苷酸方法。检测大鼠血压、肾功能变化。半定量RT—PCR测定肾脏β1受体mRNA、前肾素原mRNA水平。Western印迹法测检肾脏β1受体的蛋白水平。结果与模型组比较，运动联合基因治疗可使血压下降并维持4周，血压下降最高达41mmHg；尿蛋白量[（45．82±6．56）比（29．12±5．22）mg／L，P〈0．01】、BUN[（13．10±2．62）比（9．05±1．84）mmol／L，P〈0．05]显著降低（P〈0．01，P〈0．05）；内生肌酐清除率显著升高（P〈0．01）；前肾素原mRNA、β1受体mRNA、蛋白表达水平显著降低（P〈0．05）。结论运动训练联合β1受体反义基因治疗可以明显地降低血压，改善肾功能；且运动训练可以增强基因治疗对β1受体mRNA和蛋白的抑制作用，在转录和翻译水平抑制过度激活的β1受体的表达。     

Evaluation of non-invasive blood pressure measurement by the Finapres method at rest and during dynamic exercise in subjects with cardiovascular insufficiency

The accuracy and precision of the Finapres in recording rest and exercise blood pressure compared with the intra-arterial (aortic and brachial) and random-zero sphygmomanometer methods was assessed in 84 ischaemic patients in three different studies. Firstly, comparison at rest with the aortic intraarterial pressure in 50 ischaemic patients demonstrated that the Finapres systolic (136.5 ± 21.1 vs. 129.3 ± 19.0 mmHg;p < 0.001) and mean (92.4 ± 13.4 vs. 90.7 ± 11.4 mmHg;p < 0.001) arterial pressures were higher and diastolic pressures lower (70.4 ± 11.5 vs. 71.5 ± 9.8 mmHg;p < 0.001). The reproducibility of the Finapres and invasive method was similar for systolic (4.6% vs. 4.0%), diastolic (2.8% vs. 2.7%) and mean (3.3% vs. 3.0%) blood pressures. Second, in seven subjects studied twice at rest and during 4 min supine bicycle exercise, the exercise increase in blood pressure was greater on the Finapres compared with the brachial intra-arterial pressure (systolic +10.2 ± 6.3 vs. +3.6 ± 9.8 mmHg; diastolic +9.6 ± 11.1 vs. +0.2 ± 2.1 mmHg;p = 0.02 for each); however, at steady-state the peak/trough differences in pressure between the methods were similar. Thirdly, compared under rest conditions, to random zero sphygmomanometer (RZO), the Finapres systolic pressure was higher (6.8 ± 3.5 mmHg) and diastolic pressure lower (–6.0 ± 1.9 mmHg). During upright bicycle exercise, the difference between the Finapres and RZO in systolic blood pressure increased at each level of exercise (+14.3 ± 4.2, +17.9 ± 4.0 and +22.2 ± 4.1 mmHg respectively at each exercise stage:p < 0.01). For RZO, diastolic blood pressure fell as exercise workload increased whereas Finapres diastolic blood pressure increased on exercise (3.1 ± 2.6, 7.0 ± 2.1 and 8.1 ± 2.0 mmHg respectively:p < 0.01). Thus there were systematic differences between the values recorded by the Finapres and proximal blood pressure methods and limited agreement in the rest to exercise increments related to light exercise. Calibration of the Finapres values in terms of the other methods is limited by the variable relationship to these related changes in arterial distensibility.     

参加社会活动和锻炼对冠心病并发抑郁的影响1

目的：研究参加社会活动和锻炼对新兴工业化农村社区冠心病患者并发抑郁的影响。方法：对114例在我院就医、属三角镇户籍常住人口的冠心病（CHD）患者进行Zung量表（SDS量表）检测，同时调查其经济状况、健康习惯、参加社会活动和锻炼情况等。用SPSS13．0版统计软件进行统计分析。结果：抑郁发生率37．7％，女性44．3％（27／61）高于男性30．2％（16／53）。70岁以上者47．6％（30／63）高于70岁以下者25．5％（13／51）。缺少社会活动（几乎不参加社会活动）、缺少锻炼（几乎不锻炼身体）都抑郁发生率高，可能是冠心病并发抑郁的独立预测因素。结论：适度参加社会活动和锻炼对CHD患者并发抑郁可能有预防作用。     

老年人长跑锻炼后血浆白细胞介素—1活性的变化

用刺激C_(57)小鼠胸腺细胞增生后H-TdR参入量的多少来表示IL-1活性的方法,研究长跑锻炼对老年人血浆白细胞介素-1(IL-1)活性的影响。结果表明,长跑锻炼10年以上老年人安静时血浆IL-1活性在14.7～18.7KD、3.8～7.0KD、1.5～2.6KD呈现三个淋巴细胞增生峰,分別为对照组老年人的214％、179％和146％(以对照组为100％)。对这种改变的机制和生理意义进行了讨论。     

Similarities in Skeletal Muscle Strength and Exercise Capacity Between Renal Transplant and Hemodialysis Patients

Exercise intolerance is common in hemodialysis (HD) and renal transplant (RTx) patients. Aim of the study was to assess to what extent exercise capacity and skeletal muscle strength of RTx patients differ from HD patients and healthy controls and to elucidate potential determinants of exercise capacity in RTx patients. Exercise capacity, muscle strength, lean body mass (LBM) and physical activity level (PAL) were measured by cycle-ergometry, isokinetic dynamometry, DEXA and Baecke Questionnaire, respectively, in 35 RTx, 16 HD and 21 controls. VO2peak and muscle strength of the RTx patients were significantly lower compared to controls (p<0.01), but not different compared to HD patients. In RTx patients, strength (p<0.001), PAL (p=0.001) and age (p=0.045) were significant predictors of VO2peak. Muscle strength was related to LBM (p=0.001) and age (p=0.001), whereas gender (p<0.001) and renal function (p=0.01) turned out to be significant predictors of LBM. No effects of corticosteroids were observed. Exercise capacity and muscle strength seem equally reduced in RTx and HD patients compared to controls. In RTx patients, muscle strength and PAL are highly related to exercise capacity. Renal function appears to be a significant predictor of LBM, and through the LBM, of muscle strength and exercise capacity.     

单兵增氧呼吸器对高原移居青年体力负荷时心率的影响

目的:探讨单兵增氧呼吸器对高原移居青年心肺功能及体力作业效率的影响。方法:把进驻海拔3700m20天的24名青年随机分为两组,在佩戴与不佩戴高原单兵增氧呼吸器时分别用EGM-Ⅱ型踏车功量计做坐位踏车运动,初始负荷功率为50W,每3min递增50W,以60rpm连续踏车至200W,3min后终止。用直线回归法计算功率200W时的HR及SaO2,记录运动终止5min后恢复HR。结果:佩戴单兵增氧呼吸器组功率200W时SaO2增高;功率200W时的HR、运动终止5min后恢复HR降低,差别均有显著性(P<0.05)。结论:在高原佩戴单兵增氧呼吸器能明显提高高原移居青年的心肺功能及体力作业效率。