Reversal of cold induced haemoconcentration

Summary Classically, cold induced plasma volume reduction is explained by an increased diuresis which is generated by an inhibition of antidiuretic hormone release. However, most of the haemoconcentration appears to be reversible during rewarming. This observation weakens the former statement. The aim of this study was to clarify the mechanisms involved in the reversal of the cold induced haemoconcentration. Six young males, resting in a dorsal reclining position, were exposed successively to a thermoneutral environment (30 min), a cold environment (1° C; cold) or thermoneutrality (control) for 120 min, and during a 60-min recovery period in thermoneutral conditions. During cold stress, a reduction of 15% (i.e. 510 ml) of the plasma volume was observed, and osmolality was unchanged. After the 60-min recovery under thermoneutral conditions, plasma volume variation between the Cold and the Control experiments was reduced and reached 3% (i.e. 100 ml). This volume equalled the increased amount of urine production observed during the cold stress experiment. Haemoconcentration cannot be explained by increased urinary water loss (± 100 ml) alone. Therefore a transient shift of plasma water from vascular to interstitial spaces, due to an increase of blood pressure, could be involved in the reduction of plasma volume.     

Thermal responses of men and women during cold-water immersion: influence of exercise intensity

Summary The influence of exercise intensity on thermoregulation was studied in 8 men and 8 women volunteers during three levels of arm-leg exercise (level I: 700 ml oxygen (O₂) · min^–1; level II: 1250 ml O₂ · min^–1; level III: 1700 ml O₂ · min^–1 for 1 h in water at 20 and 28°C (T _w). For the men inT _w 28°C the rectal temperature (T _re) fell 0.79°C (P<0.05) during immersion in both rest and level-I exercise. With level-II exercise a drop inT _re of 0.54° C (P < 0.05) was noted, while at level-III exerciseT _re did not change from the pre-immersion value. AtT _w of 20°C,T _re fell throughout immersion with no significant difference in finalT _re observed between rest and any exercise level. For the women at rest atT _w 28°C,T _re fell 0.80°C (P<0.05) below the pre-immersion value. With the two more intense levels of exercise,T _re did not decrease during immersion. InT _w 20°C, the women maintained higherT _re (P<0.05) during level-II and level-III exercise compared to rest and exercise at level I. The_{T re} responses were related to changes in tissue insulation (I _t) between rest and exercise with the largest reductions inI _t noted between rest and level-I exercise acrossT _w and gender. For men and women of similar percentage body fat, decreases inT _re were greater for the women at rest and level-I exercise inT _w 20°C (P< 0.05). With more intense exercise, the women maintained a higherT _re than the men, especially in the colder water. These findings indicate that exercise is not always effective in offsetting the decrease inI _t and facilitated heat loss in cool or cold water compared to rest. The factors of exercise intensity,T _W, body fat, and gender influence the thermoregulatory responses.     

晕可宁颗粒对急、慢性梅尼埃病模型的影响

目的　探讨晕可宁颗粒的主要药效学 ,为临床提供药效学资料及治疗学基础。方法　采用三氯甲烷破坏豚鼠一侧膜迷路感受器模型 ,探讨受试药对眼震颤、摆头及旋转的影响 ;采用内淋巴囊和内淋巴管阻塞手术复制豚鼠膜迷路实验性膜迷路积水模型 ,研究内耳组织平均中阶面积 (SMA)增加率及形态学的变化。结果　抑眩宁阳性对照组、晕可宁颗粒 (8、16g/kg)模型给药组豚鼠眼球震颤次数减少 ,差异有显著意义 (P <0 .0 5 )。成功复制了不同程度膜迷路积水豚鼠模型 ,表现为前庭膜重度膨出 ,前庭阶缩小 ,膜蜗管增大 ,SMA增加率变大 ,差异有显著意义 (P <0 .0 1) ;晕可宁颗粒灌胃后可减轻豚鼠实验性膜迷路积水的程度 ,差异有显著意义 (P <0 .0 1) ;但与空白对照组比较SMA增加率差异无显著意义 (P >0 .0 5 )。结论　晕可宁颗粒可以减轻内淋巴囊积水程度 ,对梅尼埃病症状有对抗治疗作用。     

Long-term and short-term tolerable work-time in a hot environment: The limit values verification

A group of four efficient mine rescuers at the age of 25-35 years were exposed to a load at a cyclo-ergometer (stage A and B) and a hand ergometer (stage E) in a climate chamber. The total period of work of 120 min was divieded into four work intervals, 30 min each. There were 5-min breaks between the individual intervals. The load at the ergometer was selected in the range of 25-150 W, Tg = 20-40 C, rh = 40-80% and va = 0.2-1.5 m.s-1. The thermal resistance of the working suit was 0.65 clo in the stage A, 1.07 clo in the stage B and 0.81 clo in the stage E. A total of 200 experiments with 50 combinations of the work and climate load were made. Heart rate, oxygen consumption, carbon dioxide production, body temperature, skin temperature, water loss by sweating and perspiration, dry and web bulb air temperature, air velocity and globe temperature were measured during the experiments. The expected production of sweat (SR) and the amount of accumulated heat in the body (Qmax) were calculated for each combination of the work-climate conditions by a computing programme ISO 7933:1989 as well as by our own programme.A good agreement was reached between the measured and predicted SR values, calculated by the ISO programme ( r = 0.871) as well as between the values calculated by the two programmes, respectively ( r = 0.985). The experimental results have shown a good agreement between the predicted and actually measured values of temperature of the body core as an index of short-term tolerable climate load. The values of short-term tolerable time of work calculated at the level of the amount of accumulated heat in the body of 50 W.h.m-2 resulted in the increase of body core temperature by 0.8-1.0 K. The values of heart rate mostly did not exceed 140 min-1, reaching in exceptional (three) cases slightly values above 150 min-1. The authors recommend to limit long-term workheat (climatic) load during a higher metabolic rate ( N > 80 W.m-2 include basal metabolic rate) or acclimatized males and females by the sweat rate SR = 270 g.h-1.m-2, of non-acclimatized persons SR = 206 g.h-1.m-2. The limit for low metabolic rates * M 80 W.m-2) for non-acclimatized and acclimatized persons is proposed for long-term tolerable load SR = 147 g.h-1.m-2. Short-term tolerable load by heat storage within organism for all categories is proposed Qmax= 50 W.h.m-2.     

Méthodes diagnostiques et stratégie thérapeutique des TNE pulmonaires (tumeurs carcinoïdes typiques et atypiques)*<br/>Diagnostic Methods and Treatment Strategies for Neuroendocrine Tumours (Typical and Atypical Carcinoid Tumours)

Typical or atypical bronchial carcinoids are rare tumors. The management of localized forms is essentially based on surgery and their prognosis remains good. The treatment of metastatic forms remains difficult with a low level of evidence. New treatments are emerging (everolimus, Lutatherapy), however, their respective place in the therapeutic algorithm should be clarified. Access to expertise and clinical research via the RENATEN-TENpath network should be promoted.


Résumé
Les carcinoïdes bronchiques typiques ou atypiques sont des tumeurs rares. La prise en charge des formes localisées repose essentiellement sur la chirurgie, et leur pronostic reste bon. Le traitement des formes métastatiques demeure difficile et repose sur un niveau de preuve faible. De nouveaux traitements émergent (évérolimus, lutathérapie), mais leur place respective dans l’algorithme thérapeutique est à préciser. L’accès à l’expertise et à la recherche clinique via les réseaux RENATEN-TENpath doit être favorisé.     

Épidémiologie des tumeurs neuroendocrines intestinales *<br/>Epidemiology of Neuroendrocine Intestinal Tumours

Little is known about the epidemiology of digestive neuroendocrine tumours (NETs). NETs remain a rare cancer, representing 1% of all digestive cancers. In France, incidence rates are estimated to around 1.1/100,000 inhabitants in males and 0.9/100,000 in females. The incidence rates got increased over time, with probably more than 1,000 new cases per year in France. Because of their relatively good prognosis, NETs are the second more prevalent digestive cancer after colorectal cancer. Most digestive NETs are well-differentiated (WDNETs); poorly differentiated neuroendocrine carcinomas (PDNEC) account for less than 20% of the cases in most of the series. Among bowel-NETs, the most frequent anatomical localisations are colorectal and small bowel. Functional NETs are rare (<20%); most of them are carcinoids, insulinomas and gastrinomas. More than half NETs are metastatic at diagnosis, mainly in the liver. Tumour differentiation, histologic grade, anatomic site and stage are the main prognostic factors. WDNETs are slow-growing tumours (relative survival of 55% at 5 years), whereas PDNEC are highly aggressive (relative survival of 4.5% at 5 years).

Résumé
Les données disponibles concernant l’incidence et les facteurs pronostiques des tumeurs neuroendocrines (TNE) digestives sont souvent fragmentaires. Les TNE digestives sont rares et représentent environ 1 % des cancers digestifs. En France, l’incidence des TNE digestives malignes est estimée à 1,1/100 000 chez l’homme et à 0,9/100 000 chez la femme. L’incidence augmente au cours du temps. Du fait de leur longue survie, les TNE constituent, après le cancer colorectal, le cancer digestif dont la prévalence est la plus élevée. La plupart des TNE sont bien diffé- renciées, les carcinomes neuroendocrines peu différenciés représentent moins de 20 % des TNE digestives. Parmi les TNE bien différenciées intestinales, les localisations les plus fréquentes sont l’intestin grêle et le colorectal. Plus de la moitié des TNE sont diagnostiquées au stade métastatique, principalement au niveau hépatique. Le degré de différenciation, le grade histologique, la localisation du primitif et le stade sont les principaux facteurs pronostiques. Les taux de survie relative à cinq ans étaient de 4,5 % pour les tumeurs peu différenciées versus plus de 55 % pour les TNE bien différenciées.     

Glucocorticoids enhance and suppress heart rate and behaviour in time dependent manner in greylag geese (Anser anser)

Stress responses involve autonomic, endocrine and behavioural changes. Each of these responses has been studied thoroughly in avian species, but hardly in an integrative way, in free-living birds. This is necessary to reveal the temporal dynamics of the stress response. Towards that goal, we recorded heart rate (HR) and behaviour in free-ranging male greylag geese (Anser anser) simultaneously over 2 h. The geese were subjected to (a) unmanipulated control condition, (b) capture, handling and injection of ACTH, and (c) capture, handling and injection of a saline solution (SHAM). Fecal samples for the non-invasive determination of immuno-reactive glucocorticoid metabolite (BM) concentrations were collected for 7 h thereafter. The SHAM control caused a significant BM increase, a transient increase in HR, an initial increase of preening behaviour and a delay in feeding. ACTH treatment, relative to SHAM, produced significantly higher BM concentrations, and activation of “displacement behaviours” such as wing flapping, body shaking and preening. Also, feeding activity as well as resting was postponed and/or lower for a longer period of time after ACTH than after SHAM. ACTH injection had a greater effect than SHAM injection on HR increase in the first hour, but particularly on HR decline in the second hour following the injection. Hence, glucocorticoids had time- and dose-dependent stimulatory and suppressive effects on cardiovascular activity and behaviour. HR dynamics after ACTH actually matched with behavioural dynamics: both were first enhanced and later suppressed, which is in alignment with adaptive stress management involving the fight-flight response and recovery from stress, respectively.     

缩短腹腔镜子宫切除术患者术后卧床时间

目的缩短腹腔镜子宫切除术患者术后卧床时间。方法成立品管圈小组,运用质量管理工具对腹腔镜子宫切除术患者从手术结束至首次下床活动时间进行把握和解析,并制定针对性措施加以改进。结果腹腔镜子宫切除 术患者术后卧床时间从13.02小时缩短至6.12小时。结论开展品管圈活动缩短了腹腔镜子宫切除术患者术后卧床时间,降低了平均住院日,提高了住院患者满意度,在患者受益的同时实现了医疗资源的优化配置,值得推广     

镇眩汤对梅尼埃病大鼠血管加压素的影响

目的探讨中药复方镇眩汤治疗梅尼埃病的机制。方法采用阻塞前庭导水管的方法复制梅尼埃病模型,观察大鼠用药前后听觉诱发电位听阈的变化及大鼠血浆中血管加压素的含量。结果与假手术组比较,模型组大鼠听觉诱发电位听阈和血浆血管加压素水平显著升高;与模型组比较,镇眩汤高、中剂量组大鼠听阈和血管加压管水平显著降低(P<0.05)。结论镇眩汤治疗梅尼埃病的机制与其调节血浆血管加压素有关。