Effect of respiration on the spectral Doppler wave of the right hepatic vein in right lobe living donor liver transplant recipients.

OBJECTIVE: The purpose of this study was to evaluate the effect of respiration on the spectral Doppler wave of the right hepatic vein (RHV) in right lobe living donor liver transplant (LDLT) recipients. METHODS: A spectral Doppler wave of the RHV was obtained from 23 consecutive right lobe LDLT recipients who had no complications and from 26 healthy subjects during free breathing, breath holding at expiration, and breath holding at inspiration. To assess the RHV flow quantitatively, the venous periodicity index (VPI) was calculated as follows: VPI=(V(F)-V(R))/V(F), where V(F) was the measured peak forward velocity, and V(R) was the measured peak reversed velocity. The mean VPIs of the RHV obtained in the 3 respiratory states were compared by repeated measures analysis of variance. Spectral Doppler waves of the RHV were categorized as triphasic with or without reversed flow, biphasic, or monophasic and were compared among the 3 respiratory states. RESULTS: In both right lobe LDLT recipients and healthy subjects, the mean VPIs of the RHV obtained during breath holding at inspiration were significantly lower than those during free breathing (P<.001) and breath holding at expiration (P<.001). The wave pattern during breath holding at inspiration was monophasic in 7 (30.4%) right lobe LDLT recipients and 3 (11.5%) healthy subjects, whereas the monophasic pattern was not seen during free breathing or breath holding at expiration in any of these subjects. CONCLUSIONS: Breath holding at inspiration significantly reduces the periodicity of RHV flow and can make otherwise pulsatile RHV flow monophasic in right lobe LDLT recipients without postoperative complications as well as in healthy individuals.     

术后病人自控硬膜外镇痛首剂量对循环呼吸的影响

目的观察分析术后病人自控硬膜外镇痛首剂量对循环呼吸的影响.方法选择20例美国麻醉医师体格状况分类Ⅰ～Ⅱ级、在下胸腰段硬膜外阻滞下行全子宫切除术成年病人.手术结束入麻醉恢复室后用惠普监护仪监测收缩压、舒张压、平均压、心率、呼吸次数和血氧饱和度.经硬膜外导管注入镇痛首剂量6 ml,并接镇痛泵持续注药.以注入首剂量前15 min各监测指标平均值为基础值,注入首剂量后30 min内每5 min 1次,30～60 min内每10 min 1次,60～120 min内每15 min 1次记录各监测指标.统计分析各监测指标的变化.结果注入首剂量后,收缩压、舒张压、平均压、心率、呼吸次数和血氧饱和度均有所波动.其中,收缩压、舒张压、平均压有下降趋势,注入首剂量前15 min它们的平均值分别为15.9±2.3、8.5±1.7和11.0±1.9 kPa,注入首剂量后最低值分别为15.1±1.8、7.8±1.7和10.3±1.8 kPa;心率有上升趋势,其由74.5±10.0 次/min升至80.4±12.7 次/min;而呼吸次数和血氧饱和度变化无统计学意义(P＞0.05).且血压和心率变化均未超过10%.结论对一般情况良好的全子宫切除术后病人给予6 ml首剂量镇痛药,临床上对循环呼吸不产生明显影响.     

Effect of food intake on pharmacokinetics of oral artemisinin in healthy Vietnamese subjects.

The influence of food intake on the pharmacokinetics of artemisinin was studied with six healthy Vietnamese male subjects. In a crossover study, artemisinin capsules (500 mg) were administered with and without food after an overnight fast. Plasma samples were obtained up to 24 h after intake of each drug. Measurement of artemisinin concentrations was performed by high-performance liquid chromatography with electrochemical detection. Tolerance was evaluated according to subjective and objective findings, including repeated physical examinations, routine blood investigations, and electrocardiograms. Pharmacokinetics were analyzed with a noncompartmental method and with a one-compartment model. This model had either zero-order or first-order input. No statistically significant differences were found between the results of the two experimental conditions. Specifically, there were no consistent differences in parameters most likely to be affected by food intake, including absorption profile, absorption rate, bioavailability (f) (as reflected in area under the concentration time curve [AUC]), and drug clearance. Some mean +/- standard deviation parameters after food were as follows: maximum concentration of drug in serum (Cmax), 443 +/- 224 microg x liter(-1); time to Cmax, 1.78 +/- 1.2 h; AUC, 2,092 +/- 1,441 ng x ml(-1) x h, apparent clearance/f, 321 +/- 167 liter x h(-1); mean residence time, 4.42 +/- 1.31 h; and time at which half of the terminal value was reached, 0.97 +/- 0.68 h. The total amount of artemisinin excreted in urine was less than 1% of the dose. We conclude that food intake has no major effect on artemisinin pharmacokinetics. In addition, we conclude tentatively that artemisinin is cleared by the liver, that this clearance does not depend on liver blood flow (i.e., that artemisinin is a so-called low-clearance drug), and that absorption of the drug is not affected by food intake.     

运动、昼夜节律和呼吸对心率变异性的影响(英文)

目的探索运动、昼夜节律和呼吸对心率变异性的影响。方法2000-01/2000-02从第三军医大学西南医院门诊收集34名自愿受试者,于清晨5h和下午5h、运动前后分别记录心动周期信号,并测量和分析。用相继各心动周期的标准差(SDNN)作为心率变异性的一个指标。结果10名受试者清晨5h和下午5h心率变异性指标SDNN的均值分别为30ms和29ms,而清晨5h和下午5h两组心动周期数据汇成一组时的SDNN增大至262ms;34名受试者运动前SDNN的均值为18ms,运动后的SDNN的均值为10ms,受试者运动前后心率变异性的差异非常显著(t=6.049,P<0.01);呼吸周期I内的心动周期最大差值与呼吸周期J内的心动周期最大差值之间的差异不显著(t=0.024,P>0.05)。结论长时程(24h)心率变异性指标SDNN的正常值(141±39)ms的基础之一是心动周期的昼夜差;运动是影响心率变异性的重要因素;呼吸对心率变异性有一定的影响,但其大小次于心动周期的昼夜差对心率变异性的影响。     

呼吸与骨盆外肌群收缩对凯格尔运动效果的影响

目的 研究不同呼吸和骨盆外肌群收缩对凯格尔运动训练盆底肌效果的影响。方法 2021年10月至2022年2月,健康女性20例依次行单纯凯格尔运动,并分别在呼气、吸气时,及骨盆外肌群(腹横肌、髋内收肌群、髋外旋肌群)不同强度收缩时行凯格尔运动,超声测量膀胱底上移最大距离。结果 与单纯凯格尔运动相比,呼气时或腹横肌收缩时行凯格尔运动,膀胱底上移距离更大(P <0.05)。结论 呼气结合凯格尔运动和腹横肌收缩结合凯格尔运动,对盆底肌的锻炼效果更优。     

Effect of a high-fat diet on food intake and hypothalamic neuropeptide gene expression in streptozotocin diabetes.

Insulin-deficient diabetic rats are markedly hyperphagic when fed a high-carbohydrate (HC) diet, but normophagic when fed a high-fat (HF) diet. When maintained on a HC diet, diabetic rats also exhibit increased gene expression of the orexigenic peptide neuropeptide Y (NPY) in the hypothalamic arcuate nucleus, and reduced expression of the anorectic peptide corticotropin-releasing hormone (CRH) in the paraventricular nucleus, and these changes are hypothesized to contribute to diabetic hyperphagia. In this experiment we assessed whether the normophagia displayed by HF-fed diabetic rats is associated with the opposite profile of NPY and CRH expression. Our results show that relative to diabetic rats on the HC diet, the diabetic rats on the HF diet exhibited significantly reduced caloric intake (-40%), NPY expression in the arcuate nucleus (-27%), and elevated CRH expression in the paraventricular nucleus (+37%). Insulin and corticosterone, which are known to affect hypothalamic NPY and CRH expression, were not different between these two groups, making it unlikely that they can account for the differences in either feeding behavior or hypothalamic peptide expression. There was a small but significant increase in plasma leptin levels in the diabetic animals maintained on the HF, and large differences in parameters associated with elevated fat oxidation. These observations support the hypothesis that the normalization of food intake observed in diabetic rats consuming a HF diet may in part be mediated by reductions in NPY expression and elevations in CRH expression.     

Effect of food intake on left and right ventricular systolic tissue Doppler measurements

Systolic tissue Doppler measurements (s′) have been used to measure the velocity in myocardial motion and are a valuable tool for evaluating the systolic function of the left and right ventricles. Digestion of food is known to significantly alter hemodynamics and may therefore affect s′. The effect of food intake on s′ parameters has not yet been studied. We assessed whether s′ is affected by food intake. Nineteen healthy subjects aged 26·2 ± 4·2 years were investigated. s′ was measured with pulsed tissue Doppler imaging in the right and left ventricles before the subjects ate a standardized meal and also 30 and 110 min after the meal. Three measurements were taken in each projection, and a mean value was calculated for each. s′ increased significantly (P<0·05) from fasting to 30 min after food intake in every measured site except in the left inferolateral wall (P = 0·15, NS). Several, but not all, variables returned to base value 110 min after food intake. This study shows that food intake affects the tissue Doppler variables used to evaluate systolic heart function. Further studies are needed in older healthy subjects and older subjects with various cardiovascular diseases.     

运动对循环系统的影响

本文从运动对心血管系统形态及功能影响的角度,介绍了运动形式、类型、强度及一些相关因素对心脏、血管及心脏内分泌系统的影响。目的在于说明锻炼效果与合理运动之间的关系,帮助大家了解进行运动时所需要注意的事项。     

Relation of dietary restraint scores to activation of reward-related brain regions in response to food intake, anticipated intake, and food pictures

Prospective studies indicate that individuals with elevated dietary restraint scores are at increased risk for future bulimic symptom onset, suggesting that these individuals may show hyper-responsivity of reward regions to food and food cues. Thus, we used functional magnetic resonance imaging (fMRI) to examine the relation of dietary restraint scores to activation of reward-related brain regions in response to receipt and anticipated receipt of chocolate milkshake and exposure to pictures of appetizing foods in 39 female adolescents (mean age=15.5 ± 0.94). Dietary restraint scores were positively correlated with activation in the right orbitofrontal cortex (OFC) and bilateral dorsolateral prefrontal cortex (DLPFC) in response to milkshake receipt. However, dietary restraint scores did not correlate with activation in response to anticipated milkshake receipt or exposure to food pictures. Results indicate that individuals who report high dietary restraint have a hyper-responsivity in reward-related brain regions when food intake is occurring, which may increase risk for overeating and binge eating.     

Effects of hydralazine, nitroglycerin, and food on estimated hepatic blood flow

Several recent studies have shown that hydralazine and nitroglycerin may increase the apparent oral bioavailability of high-clearance drugs. It has been postulated that the mechanism responsible may be a vasodilator-induced transient increase in hepatic blood flow with an associated reduction in first-pass metabolism. To test this hypothesis, we examined the effect of hydralazine (25 mg) and sublingual nitroglycerin (2 doses of 0.6 mg separated by 30 minutes) on indocyanine green (ICG) blood clearance (ClB). Forty minutes after the start of nitroglycerin therapy, ICG ClB fell from a baseline of 648 +/- 98 to 607 +/- 151 ml/min, and was further decreased to 578 +/- 98 ml/min 80 minutes after dosing. Hydralazine induced no consistent effect on ICG ClB. ICG ClB was 744 +/- 376, 721 +/- 218, and 763 +/- 195 ml/min at baseline, 40 minutes, and 80 minutes after dosing. As a positive control, ICG ClB was assessed after a high-protein meal. After this meal, ICG ClB increased from 656 +/- 107 to 811 +/- 141 and 801 +/- 132 ml/min at 40 and 80 minutes after dosing. These data suggest that one or more mechanism(s) other than changes in hepatic blood flow are involved in the vasodilator-induced increase in the apparent oral bioavailability of high-clearance drugs.     

Difference of hepatic circulation between alcoholic and non-alcoholic hepatic cirrhosis

Comparisons were made of hepatic circulation between alcoholic and non-alcoholic cirrhosis. The wedged hepatic venous pressure and per cent intrahepatic shunt measured by the method of continuous infusion of D-galactose-1-14C were similarly markedly increased. On the other hand, the wedged hepatic venography showed the main portal trunk and extrahepatic collaterals, namely, the tendency of reverse or stagnant portal flow, more frequently in alcoholic cirrhosis than in non-alcoholic cirrhosis. The nodules shown by slow low-pressure hepatic sinusoidography were larger in non-alcoholic cirrhosis than in alcoholic cirrhosis.     

Gastrointestinal regulation of food intake

Despite substantial fluctuations in daily food intake, animals maintain a remarkably stable body weight, because overall caloric ingestion and expenditure are exquisitely matched over long periods of time, through the process of energy homeostasis. The brain receives hormonal, neural, and metabolic signals pertaining to body-energy status and, in response to these inputs, coordinates adaptive alterations of energy intake and expenditure. To regulate food consumption, the brain must modulate appetite, and the core of appetite regulation lies in the gut-brain axis. This Review summarizes current knowledge regarding the neuroendocrine regulation of food intake by the gastrointestinal system, focusing on gastric distention, intestinal and pancreatic satiation peptides, and the orexigenic gastric hormone ghrelin. We highlight mechanisms governing nutrient sensing and peptide secretion by enteroendocrine cells, including novel taste-like pathways. The increasingly nuanced understanding of the mechanisms mediating gut-peptide regulation and action provides promising targets for new strategies to combat obesity and diabetes.