心复康口服液对大鼠力竭性损伤心脏心率变异性的影响

目的 观察心复康口服液对一次性力竭运动后大鼠心率变异性的影响.方法 SD雄性大鼠分为对照组、力竭组、用药组、实验组,每组8只.采用Thomas方法通过力竭性游泳运动建立心脏损伤动物模型.HRV测定包括:总功率(TP)、低频(LF)、高频(HF)以及LF/HF.结果 用药组与对照组各项指标无统计学意义;力竭组与对照组相比:TP显著降低,LF及LF/HF值明显增高,HF降低明显;实验组与力竭组相比:心率明显减慢,TP显著升高,HF明显升高,LF/HF值明显减小,有统计学意义,LF变化不明显,无统计学意义.结论 心复康口服液对一次性力竭运动后大鼠心脏具有保护作用,主要通过减弱心迷走张力的降低而发挥.     

睾酮对钙离子通道和心脏功能的影响

睾酮对人体的全身代谢、心脏的生理和病理均有着重要的影响。较高浓度的睾酮或其慢性作用可以提高T型、L型钙离子通道的密度,较低浓度或急性作用可以阻滞T型、L型钙离子通道,缩短男性Q-Tc 间期,提高对胰岛素的敏感性及改善血脂代谢。睾酮可上调钙调节蛋白、β2受体的表达,在提高细胞内钙离子浓度的情况下,可增加钙瞬变的幅度,减少钙超载。一定浓度的睾酮可以维持血管的一定张力,改善心脏传导或扩张冠脉;减少胰岛素抵抗、代谢综合征的发生,改善心肌缺血、减少心肌细胞凋亡及纤维化,保护心脏,改善心脏收缩舒张效率。     

反复力竭性运动后大鼠血清cTnI和心肌组织形态学的改变

目的: 观察反复力竭性游泳运动后,不同时相大鼠血清心肌肌钙蛋白I（cTnI）与心肌组织形态学的动态改变,以评价过度运动后恢复期是否存在延迟性心肌损伤？方法: 采用经典的Thomas的方法,通过力竭性游泳运动建立运动性心肌损伤实验动物模型。将无训练的87只Wistar雄性大鼠随机分为安静对照组和力竭性运动后即刻组、3 h组、6 h组、12 h组、24 h组、48 h组和96 h组。分别于末次运动结束后即刻、3、6、12、24、48和96 h,采血分离血清检测cTnI,并进行心肌组织的病理学检查。结果: ①与安静对照组比较,力竭性运动后即刻、6 h和48 h大鼠血清cTnI的含量明显增加(P<0.05和P<0.01),其中运动后6 h和48 h分别达高峰,运动后3、12、24 h仍保持在较高水平,运动后96 h基本恢复运动前的水平。②经1周反复力竭性运动,光镜下可见运动后不同时相大鼠心肌细胞均有不同程度的损伤,运动后48 h最严重,96 h有所减轻。结论: 长期过度运动和/或力竭性运动后,心肌组织发生病理性改变,且具有延迟性加重现象,即存在延迟性心肌损伤。     

血清睾酮在老龄大鼠运动中的水平变化及对认知功能的影响

目的探讨血清睾酮在老龄大鼠运动中的水平变化及对认知功能的影响。方法将24只雄性老龄SD大鼠随机平分为0 min组、30 min组和60 min组,每组8只。0 min组不运动,30 min组、60 min组分别每天进行30 min、60 min的跑台训练,为期16 w,训练结束后进行Morris水迷宫实验,测定老年大鼠的认知功能,并检测血清睾酮水平。结果三组逃离潜伏期差异有统计学意义(P<0.05);各组随着天数增加,逃离潜伏期均缩短(P<0.05)。平台持续时间三组之间差异无统计学意义(P=0.995)。平台象限时间百分比60 min组高于0 min组(P<0.05)。穿越平台次数、平台象限路程和血清睾酮水平30 min组、60 min组均高于0 min组(P<0.05)。结论运动可以改善老年大鼠的认知能力和增加血清睾酮水平。     

颅脑损伤后血清皮质醇变化及MRI改变的临床意义

目的研究颅脑损伤伤后1个月内血清皮质醇变化与伤情严重程度及预后的关系。方法对119例颅脑损伤患者的血清皮质醇按照伤后1、14、28 d进行检测,与30例门诊健康人群对照组比较;伤情严重程度采用GCS评分,预后采用伤后1个月GOS评分,对皮质醇变化与GCS、GOS的关系进行临床相关性研究;部分患者行头颅MRI检查,了解下丘脑-垂体区影像学改变与皮质醇变化之间是否存在联系。结果颅脑损伤后第1天所有患者皮质醇均显著高于对照组(P<0.05),且重型组显著高于轻型组(P<0.05),在伤后1个月的时间窗中,皮质醇异常持续时间越长,预后越差;预后按GOS评分,预后不良组伤后第1、14天的血清皮质醇显著高于对照组(P<0.05)。伤后早期头颅MRI发现下丘脑-垂体区异常改变者皮质醇持续异常。结论颅脑损伤后皮质醇均明显升高,损伤越严重,升高越明显,故可用来判断受伤的严重程度;在预后GOS评分中,预后越差,皮质醇升高持续时间越长,可用来进行预后评估。颅脑损伤患者下丘脑-垂体区影像学改变与皮质醇有一定关联性。     

茶多酚对大鼠心脏乳头肌收缩功能的影响

绿茶提取物茶多酚(TP)具有众多的生物活性，如抑制动脉粥样硬化，减轻心肌缺血再灌注损伤，清除自由基和抗衰老，增强心肌收缩力等作用。本研究探讨TP对正常及糖尿病大鼠离体右心室乳头肌收缩功能的影响，现报道如下。     

冠心病患者空腹血清皮质醇、胰岛素及血糖的变化

报告检测20例冠心病患者及17例正常人的空腹血清皮质醇、胰岛素及血糖的结果.发现前者的此3项指标测值显著高于后者,并对各指标与冠心病的关系进行了讨论.     

老年男性高血压心肌肥厚患者血清总睾酮水平与心脏交感神经分布变化的关系

目的 探讨老年男性高血压心肌肥厚患者血清总睾酮水平与心脏交感神经的分布变化,以及二者间的变化关系.方法 入选老年男性高血压患者共10例,年龄60～90岁,依据心脏超声分为心肌肥厚组和非心肌肥厚组.免疫组化的方法半定量分析酪氨酸羟化酶表达.化学发光免疫分析法检测血清总睾酮和雌二醇水平.采用高压液相法检测心室肌去甲肾上腺素...     

氟对大鼠睾酮及胆固醇含量的影响

给５４只Ｗｉｓｔａｒ雄性大鼠饮水染氟，浓度分别为０．６ｍｇ／Ｌ（对照组）、１００ｍｇ／Ｌ和２００ｍｇ／Ｌ。于染氟后第２，４，６周分批处死，测血清睾酮，睾丸及肝组织胆固醇含量。结果显示，氟可致血清睾酮含量呈降低趋势；肝组织胆固醇含量降低，睾丸胆固醇含量无显著改变、表明氟对生殖系统及肝脏有一定的损伤作用。     

高龄男性糖尿病性肾病患者中血清睾酮的变化及临床意义

目的 探讨高龄男性糖尿病性肾病（DN）患者中血清睾酮水平表达的临床意义。方法 选取2013年1月至2014年6月在沈阳军区总医院干部诊疗科住院的＞75岁的糖尿病（DM）男性患者80例,其中诊断DN者34例,为DN组,其余46例设为非DN组。同时选择同期在沈阳军区总医院干部诊疗科参加体检的＞75岁的非DM老年人20例设为对照组。收集所有研究对象的血清睾酮、胱抑素C、24h微量白蛋白尿及肌酐标本,行双肾超声检查。结果 与对照组相比,高龄男性DM患者的血清睾酮水平降低,差异有统计学意义（P＜0.01）。DN组患者血清睾酮水平进一步低于非DN组[（13.18±3.29） vs （22.07±7.53）nmol/L,P＜0.01],血清胱抑素C水平较非DN组增高[（2.61±0.96） vs （1.09±0.34）mg/L,P＜0.01],且血清睾酮与血清胱抑素C水平呈负相关（r＝-0.658,P＜0.01）。结论 在高龄男性DM患者中,发生DN患者血清睾酮水平低于非DN患者,且与血清胱抑素C水平呈负相关,其指标的检测为早期提供干预策略改善预后提供帮助。     

Changes in serum cortisol levels during community-acquired pneumonia: the influence of dexamethasone

In community-acquired pneumonia (CAP), the cortisol level on admission can be a useful biomarker for prognosis. Serial cortisol measurements during the clinical course of disease and their association with disease outcome have never been reported. Furthermore, the time to recovery of the hypothalamic-pituitary-adrenal axis after a short course of dexamethasone during infection is unclear. We analyzed data from 270 hospitalized patients with CAP. Total serum cortisol was measured on presentation, day 1, 2, 4, and on control visit (day 30). Intensive care unit (ICU) admission and mortality were assessed. Additionally, to study the influence of dexamethasone on the kinetics of the cortisol response, we analyzed serial cortisol values of 43 patients treated with a four-day regimen of dexamethasone 5 mg. During hospital stay, 26/270 patients (9.6%) were admitted to the ICU and 15/270 patients (5.6%) died. Compared to patients with an uneventful recovery, cortisol on presentation was significantly higher in patients with an adverse outcome (360 μg/L, IQR 209-597 vs. 238 μg/L, IQR 151-374) (p:0.01), and also remained significantly higher throughout the course of disease. Dexamethasone treatment resulted in nearly complete suppression of the endogenous cortisol production after the first dose, but cortisol production was fully recovered on control visit. In conclusion, we showed that an adverse outcome of CAP was associated with persisting higher total serum cortisol throughout the course of disease. Delta-cortisol could be another meaningful biomarker in CAP. Next, our data indicate that a four-day dexamethasone regimen during CAP does not lead to prolonged secondary adrenal insufficiency.     

Contrast analysis for the evaluation of the circadian rhythms of plasma cortisol, androstenedione, and testosterone in normal men and the possible influence of meals

To evaluate the circadian rhythms of plasma androstenedione (delta) and testosterone (T), we used continuous blood withdrawal at 30-min intervals for 24 h to obtain integrated concentrations in six normal men. The data were submitted to contrast analysis as well as to a graphical method with smoothing of the variations between samples. As reference, cortisol (F) levels also were measured, since they have a well defined circadian rhythm. Integrated F concentrations had a circadian rhythm, with the highest levels between 0500 and 0900 h, nadir values between 2000 and 300 h, and secretory peaks coincident with lunch and dinner hours, suggesting the influence of food ingestion on secretion. Integrated androstenedione concentrations also had a circadian rhythm, with the highest levels between 0530 and 0930 h and the lowest between 1900 and 0230 h. There also were peaks with lunch and dinner, however, occurring some minutes before the corresponding ones for F. Integrated T concentrations had a circadian rhythm, with the peak values between 0100 and 1130 h and the lowest levels between 0700 and 2100 h. There were no peaks of the T integrated concentrations during the meal periods as found with F and delta. Furthermore, no correlation was found between the integrated concentrations of T and F or delta.     

Divergent responses of serum testosterone and cortisol in athlete men after a marathon race

Physical exercise alters homeostasis, as it requires prompt mobilization of metabolic sources. In this study, we measured serum testosterone (T) and cortisol (C) levels and the muscle-wastage enzymes CK, CKMB and LDH in 20 healthy male athletes (ages 25 to 40 years) in response to a marathon race (42.2 km). Venous blood samples were drawn in 3 different periods: (i) in the morning, 48 h before the competition (control), (ii) at the end of the race (end), and (iii) in the next morning, 20 h after the race (recovery). At the end, T was significantly lower (from 673 to 303 ng/dl) and C higher (from 20.3 to 42.5 microg/dl) as compared to the control period. At recovery, both were virtually identical to control levels. CK, CKMB and LDH were significantly higher at the end of the competition and even higher in the recovering period (except for CKMB), characterizing muscle wastage. CK and LDH disclosed a significant negative correlation with T (-0.412 and -0.546, respectively), whereas CKMB correlated positively with C (0.4521). We conclude that the inverse correlation observed between T and C levels, and the pattern of CK, CKMB and LDH increase, allow us to confirm that a marathon race may cause a marked physical stress, resulting in a distinct hormonal imbalance and severe cellular damage.     

Obesity does not influence the correlation between exercise capacity and serum NT-proBNP levels in chronic heart failure

Recent studies have shown that obesity is an independent predictor of lower N-terminal pro-BNP (NT-proBNP) levels and raised concerns about the validity of this biomarker in obese subjects. We evaluated the influence of obesity (body mass index>or=30 kg/m(2)) on the correlation between exercise capacity and serum NT-proBNP levels in 100 chronic heart failure (CHF) patients referred for cardiopulmonary exercise testing. Circulating NT-proBNP levels correlated well with lean body mass-adjusted peak oxygen consumption (VO(2)) in the entire cohort (R=-0.72, p<0.001) and in the obese (R=-0.71, p<0.001) and non-obese (R=-0.72, p<0.001) subgroups. There was no significant difference between the correlation coefficients of the two subgroups (p=0.934). In conclusion NT-proBNP levels predict exercise capacity in CHF patients irrespective of the presence of obesity.     

Prolactin,testosterone and cortisol as possible markers of changes in cardiovascular function associated with urbanization

People living in large informal settlements in South Africa showed a significant increase in cardio/cerebrovascular disease. This study was undertaken to compare the cardiovascular and endocrine parameters of urbanized and rural black female and males. The hormone levels such as prolactin, cortisol and testosterone may also change with urbanization and could make a contribution to the high rate of hypertension. For this study, 1202 black subjects were selected from 37 randomly selected rural and urbanized settlements. Resting blood pressure was recorded with a Finapres apparatus. Cardiac output, stroke volume, heart rate, total peripheral vascular resistance and compliance had been obtained with the Fast Modelflow software program. An acute laboratory stressor (hand dynamometer exercise) was applied to challenge the cardiovascular system and the measurements were repeated. Blood sampling was done and hormone levels were determined by biochemical analyses. For females, significant lower levels of cortisol were found in the urban strata in comparison with the rural strata. The testosterone levels were significantly lower and the prolactin levels significantly higher for females in the informal settlements compared with the rural strata. It is noticeable that most cardiovascular parameters showed the highest changes with the application of the stressor in the informal settlement strata and the lowest in people living on farms for both male and female. The prolactin levels in males are significantly higher in the informal settlement stratum. Subjects living in informal settlements showed a noticeable endocrine pattern of ongoing stress that can be associated with changes in the cardiovascular parameters with urbanization. This can partly explain the reported high rate of cardio/cerbrovascular disease in black South Africans living in informal settlements.     

Changes in serum cortisol with age in critically ill patients

BACKGROUND: Mortality in the intensive care unit (ICU) rises with age, a high basal serum cortisol and a small response to adrenocorticotropin (ACTH) stimulation. Even slight impairment of the adrenal response during severe illness can be lethal. OBJECTIVES: To determine if age is associated with changes in basal or stimulated serum cortisol in critically ill patients. METHODS: We studied 2 groups of surgical ICU patients with hypotension despite > or = 6 h of catecholamine therapy. Group 1 comprised 7 patients aged <30 (mean 22.9 +/- 3.7) years, and group 2 comprised 8 patients aged >60 (mean 75.8 +/- 10.3) years (p < 0.001). We compared baseline serum cortisol levels and the serum cortisol response 30 and 60 min after stimulation with low-dose (1 microg) and 2 h later standard-dose (250 microg) ACTH. We also determined the incidence of adrenal insufficiency in each group using standard criteria and compared selected clinical variables. RESULTS: There was no significant difference in the mean serum cortisol at baseline although it tended to be higher in older patients. Group 2 patients had a significantly smaller response to the low-dose test at 30 min (p = 0.002), and to the standard-dose test at both 30 (p = 0.02) and 60 min (p = 0.04). There was no significant difference in the incidence of adrenal insufficiency between the 2 groups: 1/7 or 14.3% in group 1 vs. 1/8 or 12.5% in group 2 (p = 1.0). There was no significant difference between the 2 groups in the mean acute physiology score, blood pressure, serum albumin, dopamine, or dobutamine dose (p > 0.05). Creatinine clearance was significantly lower in group 2 (p > 0.001) and endogenous ACTH significantly higher (p = 0.04). Significantly more patients in group 1 (5/7, 72%) than group 2 (1/8, 12.5%) had a diagnosis of trauma on admission (p = 0.04). Seven of the eight patients (88%) in group 2 vs. 1/7 (14%) of patients in group 1 died in the ICU, but this difference was not statistically significant (p = 0.18). CONCLUSION: In this small exploratory study, baseline serum cortisol tended to be higher in older patients and older patients had a significantly smaller response to ACTH stimulation on both low-dose and standard-dose tests. In view of the high death rate in the older ICU patients, the findings in this study need to be confirmed in a larger study. The mechanism and clinical significance of these findings remain to be determined but may be related to deterioration in renal function with age.