Altitude exposure as a training & iron overload management strategy post leukemia

ObjectivesTo examine iron stores, hemoglobin mass, and performance before, during and after intermittent altitude exposure in a professional male rugby player experiencing iron overload following blood transfusions for treatment for acute myeloid leukemia.DesignLongitudinal, repeated measures, single case-study.MethodsThe player was followed prior to (control), and during (study), an in-season block of altitude training. During the control period two venesections were performed for a total of 750 mL of blood removal. Internal and external training load, match statistics, blood volume, plasma volume, haemoglobin mass, serum ferritin and reticulocyte count were monitored throughout.ResultsDuring the control period serum ferritin declined following the two venesections (∼51%) as did haemoglobin mass (∼2%), reticulocyte count remained stable. During the study period serum ferritin further declined (∼30%), however haemoglobin mass and reticulocyte count increased (∼4% and ∼14% respectively). Internal training load for the control and study period was similar, however external training load was lower in the study period. Match statistics were not favourable for the player during the control period, however they improved during the study period.ConclusionsThis case supports the theory that individuals with elevated iron availability are well placed to achieve increases in haemoglobin mass. Furthermore, although therapeutic venesections may still be required to manage iron overload, the addition of altitude exposure may be a method to assist in reducing total body iron by means of mobilising available (excessive) iron to incorporate into haemoglobin. Altitude exposure did not hinder the players’ performance. Further research is encouraged.     

不同海拔高原官兵亚健康状态的调查研究

目的：调查研究不同海拔高度官兵的亚健康状态。方法抽取4种海拔(1500、3700、5380、5390 m)的高原边防和后勤官兵共344名，进行康奈尔健康量表测评。测评结果建立数据库，用SPSS 17.0进行数据分析，测量相关数据的前后变化。结果数据结果显示不同海拔高度的官兵健康状况随海拔高度的变化存在差异，而高原边防和后勤官兵的整体健康状况差异不大。结论高原官兵要改善亚健康状态，应该从思想教育，心理调整和保障制度等多方面着手，切实保障官兵健康和提高部队战斗力。     

高海拔地区脊柱侧凸患者心肺功能变化

目的评估高寒缺氧环境对脊柱侧凸患者心肺功能的影响。方法回顾分析2006年1月~2012年12月本院收治的高海拔地区特发性脊柱侧凸患者31例,并选取同时期来自平原地区的其他特征(年龄、性别、侧凸角、后凸角)相似特发性脊柱侧凸患者31例作配对研究。收集并分析62例患者术前站立位全脊柱正侧位X线片、术前肺功能和心脏彩超检查结果。结果高海拔地区脊柱侧凸患者心脏彩超结果中每搏输出量(stroke volume,SV)、射血分数(ejection fraction,EF)、左房内径(left atrial internal diameter,LAID)、左室内径(left ventricular internal diameter,LVID)、右房内径(right atrial internal diameter,RAID)以及肺功能检查中肺活量(vital capacity,VC)、肺总量(total lung capacity,TLC)、用力肺活量(forced vital capacity,FVC)、一秒率(FEV1/FVC%)大小与平原地区脊柱侧凸患者检查结果相比差异无统计学意义(P0.05)。而高海拔地区与平原地区脊柱侧凸患者的右室内径(right ventricular internal diameter,RVID)、第一秒用力呼气容积(forced expiratory volume in one second,FEV1)实测值相比,差异具有统计学意义(P0.05)。结论高海拔地区与平原地区脊柱侧凸患者的心肺功能总体上无明显差异,在进行术前评估、准备和围手术期处理上,高海拔地区脊柱侧凸患者与平原地区脊柱侧凸患者相比并无特殊。     

高原红细胞增多症患者骨髓单个核细胞GATA-1和GATA-2的表达研究

目的探讨高原红细胞增多症患者骨髓单个核细胞（MNC）GATA-1、GATA-2 mRNA及蛋白表达的变化及作用。方法采用RT—PCR法检测高原红细胞增多症患者骨髓MNCGATA-1、GATA-2mRNA表达水平，并采用免疫细胞化学方法检测骨髓细胞GATA-1、GATA-2蛋白水平。同时以13例非血液病患者及7名正常人为对照。结果①高原红细胞增多症患者GATA-1和GATA-2 mRNA的相对表达水平分别为1．033±0．146和0．451±0．073，对照组GATA-1和GATA-2相对表达水平分别为0．458±0．076和0．185±0．074，高原红细胞增多症患者明显高于对照组（P〈0．01）。免疫细胞化学检测结果显示高原红细胞增多症患者GATA-1和GATA-2蛋白表达均为阳性，阳性细胞数分别为77．3±33．3和29．4±11．4，阳性细胞积分分别为135．4±75．4和48．4±19．7。20例对照均表达GATA-1蛋白（阳性细胞数为18．1±11．3，阳性细胞积分为24．2±13．4），仅12例表达GATA-2蛋白（阳性细胞数为5．4±3．0，阳性细胞积分为7．3±4．2），高原红细胞增多症患者明显高于对照组（P〈0．01）。②GATA-1、GATA-2 mRNA与蛋白表达水平呈正相关（P〈0．01），高原红细胞增多症患者GATA-1 mRNA和蛋白表达水平与血红蛋白浓度呈正相关（P〈0．01）。③GATA-1和GATA-2蛋白表达分布在细胞质而非细胞核。结论高原红细胞增多症患者骨髓细胞中GATA-1、GATA-2表达升高，进一步影响红系血红蛋白基因表达增强，可能是高原红细胞增多症的重要发病机制之一。     

高原心脏病的临床分期

拉萨（海拔３６５８米）地区高原心脏病（ＨＡＨＤ）５１４例临床资料和６２例尸体解剖心脏病理资料，根据主要临床特点及心脏病理变化，对ＨＡＨＤ的临床分期进行了讨论。认为可依据进入高原后发生心力衰竭的不同时间，将ＨＡＨＤ分为急进期、急性期、亚急性期和慢性期四个临床期。     

Subdural Hematoma Associated with High Altitude

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不同海拔对高原官兵睡眠质量影响的调查

目的研究不同海拔对高原官兵睡眠质量的影响。方法本研究利用匹兹堡睡眠质量指数量表(PSQI),采取整群抽样的方法,对不同海拔的部分守防官兵和后勤保障单位的450人进行睡眠质量检测,单因素方差分析结果。结果不同海拔人群的睡眠质量指数总分存在显著性差异,海拔越高,分数越高,睡眠质量越差(P0.01)。后勤部队的主观睡眠质量较边防部队差。结论高原部队需改善睡眠条件、调整情绪,培养积极的应对方式来提高睡眠质量,达到促进官兵身心健康的目的。