Single dose of intra-muscular platelet rich plasma reverses the increase in plasma iron levels in exercise-induced muscle damage:A pilot study

Background:Platelet rich plasma(PRP) therapy is widely used in enhancing the recovery of skeletal muscle from injury.However,the impact of intramuscular delivery of PRP on hematologic and biochemical responses has not been fully elucidated in exercise-induced muscle damage.The purpose of this investigation the effects of intramuscular delivery of PRP on hematologic and biochemical responses and recovery strategy muscle damage induced by high intensity muscle exercise(exercise-induced muscle damage,EIMD).Methods:Moderately active male volunteers participated in this study and were assigned to a control group(control,n = 6) and PRP administration group(PRP,n = 6).The subjects performed exercise with a load of 80% one repetition maximum(1RM) maximal voluntary contraction of the elbow flexors until point of exhaustion of the non-dominant arm was reached.The arms were treated with saline or autologous PRP post-24 h EIMD.Venous blood samples were obtained in the morning to establish a baseline value and 1–4 days post-exercise and were analyzed for serum ferritin,iron,iron binding capacity(IBC),creatinine kinase(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),and alanine aminotransferase(ALT).Results:The baseline levels of plasma iron,ferritin,IBC,CK,LDH,AST,and ALT were similar in both the control and PRP groups.However,24-h following exercise a significant increase in these parameters was observed in both groups between 1 and 4 days during the recovery period.Interestingly,PRP administration decreased plasma iron levels compared to the control on the second day post-exercise.Plasma IBC increased in PRP group from Days 2 to 4 post-exercise compared to the control group whilst PRP administration had no effect on plasma ferritin,CK,AST,ALT,or LDH.Conclusion:Acute exhaustive exercise increased muscle damage markers,including plasma iron,IBC,and ferritin levels,indicating muscle damage induced by exercise.PRP administration improves inflammation by reversing the increase in the iron levels post-exercise without displaying any myotoxicity and may have a role to play in the recovery of exercise-induced muscle damage.

Study on Mechanism of Dendrobium officinale Kimura et Migo in Preventing and Treating Exercise-induced Muscle Damage(EIMD)in Rats

[Objectives]This study was conducted to observe the mechanism of Dendrobium officinale Kimura et Migo on gastrocnemius muscle in rats with exercise-induced muscle damage(EIMD).[Methods]The micro-injury model of skeletal muscle was established by treadmill training.Forty two SD rats were randomly divided into a control group,1,12 and 24 h exercise groups,D.officinale 2 ml+1 h exercise group,D.officinale 2 ml+12 h exercise group,and D.officinale 2 ml+24 h exercise group,with 6 rats in each group.Various D.officinale groups were given the drug once in the morning and once in the evening at a dose of 2 ml/time,a week in advance.Except for the quiet group,the samples were collected from the 1,12 and 24 h exercise groups after anesthesia following 1,12 and 24 h of exercise for the last time,respectively,and the D.officinale 2 ml+1 h exercise group,D.officinale 2 ml+12 h exercise group and D.officinale 2 ml+24 h exercise group were also sampled after anesthesia following 1,12 and 24 h of exercise for the last time,respectively.The contents of ATP,CK-MM and CK in rat serum were determined by enzyme-linked immunosorbent assay(ELISA).The histopathological changes of gastrocnemius muscle were observed by HE staining.PCR and Western-blot detection were carried out to analyze the effects of D.officinale on IGF-1 mRNA and protein expression in gastrocnemius muscle.[Results]Compared with the quiet group,the ATP contents in the serum of rats in the 1,12 and 24 h exercise groups significantly decreased(P<0.01),while the CK and CK-MM contents significantly increased(P<0.01).The expression of IGF-1 mRNA and protein in the gastrocnemius muscle tissue significantly increased(P<0.01).Compared with the 1 h exercise group,the ATP content and IGF-1 protein expression in the gastrocnemius muscle tissue of the D.officinale liquid+1 h exercise group significantly increased(P<0.05),while the CK and CK-MM contents significantly decreased(P<0.01).Compared with the 12 h exercise group,the D.officinale liquid+12 h exercise group showed a significant increase in ATP content(P<0.01),significant increases in IGF-1 mRNA and protein expression in the gastrocnemius muscle tissue(P<0.01),and significant decreases in CK and CK-MM contents(P<0.01).Compared with the 24 h exercise group,the ATP content and IGF-1 mRNA and protein expression in the gastrocnemius muscle tissue of the D.officinale liquid+24 h exercise group significantly increased(P<0.01),while the CK and CK-MM contents significantly decreased(P<0.01).From the pathological tissue morphology of the gastrocnemius muscle in rats with EIMD treated with D.officinale,it could be concluded that the gastrocnemius muscle of each exercise group was significantly damaged,and the damage was significantly alleviated after administration of D.officinale liquid.[Conclusions]The effects and mechanism of D.officinale on prevention and treatment of EIMD in rats might be related to the promotion of IGF-1 mRNA and protein expression in injured tissues by reducing ATP energy consumption,CK-MM and CK activity.

Cardiac damage in athlete's heart: When the “supernormal” heart fails!

Intense exercise may cause heart remodeling to compensate increases in blood pressure or volume by increasing muscle mass. Cardiac changes do not involve only the left ventricle, but all heart chambers. Physiological cardiac modeling in athletes is associated with normal or enhanced cardiac function, but recent studies have documented decrements in left ventricular function during intense exercise and the release of cardiac markers of necrosis in athlete's blood of uncertain significance. Furthermore, cardiac remodeling may predispose athletes to heart disease and result in electrical remodeling, responsible for arrhythmias. Athlete's heart is a physiological condition and does not require a specific treatment. In some conditions, it is important to differentiate the physiological adaptations from pathological conditions, such as hypertrophic cardiomyopathy, arrhythmogenic dysplasia of the right ventricle, and non-compaction myocardium, for the greater risk of sudden cardiac death of these conditions. Moreover, some drugs and performance-enhancing drugs can cause structural alterations and arrhythmias, therefore, their use should be excluded.

Markers of Heart, Lung and Dorsal Aorta Damage of Mother Rats and Their Neonates Post Therapeutic Treatment with Doxorubicin, Cisplatin and 5-Flurouracil

Aim: Recently, there is an increased average of developing cancers. Though, the chemotherapeutic-treatment is unfavorable during pregnancy due to its harmful effects on developing fetuses, physicians have two ways to minimize these effects either by termination of the pregnancy or minimizing its side effects. The present work aimed to illustrate the susceptibility of cardiac, lung and dorsal aorta function to the widely applicable drugs doxorubicin and cisplatin as well as 5-flurouracil. Materials and Methods: Mother albino rats were arranged into four-groups (control, doxorubicin, cisplatin and 5-flurouracil-treated groups). Each pregnant rat received intraperitoneal administration of 0.2 mg/kg body weight at 10th and 14th day of gestation and sacrificed at parturition (two doses). At parturition, serum of mother rats used to assess troponin I, heat shock protein 70, 8-hydroxydeoxyguanosine, vascular endothelial growth factor and adhesion molecules (ICAM-1 & VCAM-1). Isoenzyme electrophoresis of alkaline and acid phosphatases, glucose-6-phosphate dehydrogenase and lactic dehydrogenase were estimated in serum, myocardium and dorsal aorta of mother rats. The myocardium and lung were processed for histopathological investigations for both mothers and their offspring. Single strand (comet assay) and double strand DNA damage were carried out in heart and dorsal aorta of mother rats. Results: The present finding revealed that there are detected alterations of myocardial markers and lung amino acid metabolism as well as disruption of myocardial isoenzymes. DNA damage of myocardium and dorsal aorta were observed. Conclusions: The authors concluded that the metabolic activity of heart and lung is highly susceptible to doxorubicin and cisplatin treatment compared to 5-flurouracil and the therapeutic doses must be degraded.

Discussion on the Prevention and Treatment of COVID-19 Causing Lung Disease and Heart Damage Based on Lei Zhongyi's Theory of Intermingled Phlegm,Blood Stasis and Toxin

Novel coronavirus infection not only damages lung function,but also causes myocardial injury,elevated myocardial enzymes and heart failure,especially for patients with basic heart diseases who develop COVID-19,the first consideration should be the protection of cardiac function.Based on the theory of intermingled phlegm,blood stasis and toxin of heart disease put forward by Master Lei Zhongyi,the dialectical treatment thinking of COVID-19 patients from the concept of damage of phlegm,blood stasis and toxin to the heart were discussed.During the diagnosis,critical stage and recovery period of COVID-19,expectorant and blood-activating agents,heat and detoxification agents can be added to promote lung and asthma,free Bizheng and remove blood stasis,calm the heart and calm the mind,and promote the recovery of cardiopulmonary functions.

Dose-dependent Cardiac Dysfunction and Structural Damage in Rats after Shortwave Radiation

Objective To detect the effects of shortwave radiation on dose-dependent cardiac structure and function in rats after radiation and to elucidate the mechanism of shortwave radiation induced cardiac injury to identify sensitive indicators and prophylactic treatment.Methods One hundred Wistar rats were either exposed to 27 MHz continuous shortwave at a power density of 5,10,and 30 mW/cm^2 for 6 min or undergone sham exposure for the control(the rats had to be placed in the exposure system with the same schedules as the exposed animals,but with an inactive antenna).The Ca^2+,glutamic oxaloacetic transaminase(AST),creatine kinase(CK)and lactate dehydrogenase(LDH)content in the peripheral serum of the rats were detected by an automatic blood biochemical analyser.The electrocardiogram(ECG)of standard lead II was recorded by a multi-channel physiological recording and analysis system.The cardiac structure of rats was observed by light and electron microscopy.Results The results showed that the 5,10,and 30 mW/cm^2 shortwave radiation caused a significant increased in the levels of Ca2+,AST,CK,and LDH in the peripheral serum of rats.The cardiac structure was damaged by radiation and showed a disordered arrangement of myocardial fibres,the cavitation and swelling of myocardial mitochondria.These injuries were most significant 7 d after radiation and were not restored until 28 d after radiation.Conclusion Shortwave radiation of 5,10,and 30 mW/cm^2 can damage rat cardiac function,including damage to the tissue structure and ultrastructure,especially at the level of the myocardial fibres and mitochondria.Shortwave radiation at 5,10,and 30 mW/cm^2 induced damage to rat heart function and structure with a dose-effect relationship,i.e.,the greater the radiation dose was,the more significant the damage was.

THE EXPERIMENTAL RESEARCH ON CARDIOPLEGIC SOLU-TION CONTAINING SELENIUM AND MAGNESIUM AGAINST MYOCARDIAL ISCHEMIA REPERFUSION DAMAGE

The model of this test was set up according to Langendoff isolated heart reperfusion mechanics. The experimental research was designed to observe the protective effects on ischemic andreperfuslon myocardial tissue by using ST. Thomas cardioplegic solution containing selenium andmagnesium. We conclude that using cold crystallold cardioplegic solution containing Se'+, Mg' 4 canobviously reduce ischemic and reperfusion myocardlal injury and bas an advantage of recovering myocardial runctlon after operation by observing the content or lactic dehydrogenase (LDH); creatineI,kasphoklnase CK in the coronary vessel's sinus reflux solutlonl glutatblone peroxldase (GPX); suI,eroxlde dismutase (SOD); maloydladehyde (MDA ) I Se4+ .Mg'+ .Ca'+ and cia-nging or myocardialultrastructure.

Apelin-12 improves metabolic and functional recovery of rat heart after global ischemia

This work was designed to explore efficacy of apelin-12 (A-12) as a cardioprotective agent when given before ischemia or at reperfusion using the isolated working heart model. Hearts of male Wistar rats were subjected to 30-min stabilization period followed by 35-min global ischemia and 30-min reperfusion. A short-term infusion of Krebs-Henseleit buffer (KHB) con-taining A-12 (35, 70, 140, 280 or 560 ?M) was ap-plied prior to ischemia (A-12-I) or at onset of reperfusion (A-12-R). KHB infusion was used as control. A-12 infusions induced a dose-dependent increase in recovery of coronary flow, contractile and pump function during reperfu-sion, with the largest augmentation of these indices in the A-12-I group. Both A-12 groups exhibited a significant reduction of LV diastolic pressure rise during reperfusion compared with control. Enhanced functional recovery in the A-12-I group was combined with a decrease in LDH leakage in perfusate on early reperfusion (by 36% vs. control, p < 0.05). Preischemic infusion of 140 ?M A-12 markedly increased myocardial ATP content, enhanced preservation of the total adenine nucleotide pool and improved recovery of the energy charge in reperfused hearts. There was a trend towards increase in myocardial phosphocreatine by the end of re- perfusion in the A-12-I group;however this benefit did not reach statistical significance. At the end of reperfusion, myocardial lactate and lactate/pyruvate ratio were on average 5-fold lower in A-12-I treated hearts compared with control ones and did not differ significantly from the initial values. Therefore, improved cardiac dysfunction after I/R injury and less cell mem-brane damage induced by A-12 are associated with maintaining high energy phosphates, particularly ATP, in reperfused myocardium. Changes in energy metabolism may play a role in mechanisms of cardioprotection afforded by A-12 during I/R stress.

From hypertension to heart failure

Hypertension is an increasing health problem worldwide especially among the elderly.Its therapeutical importance is indicated by the caused organ damages like hypertensive heart disease(HHD) and heart failure with the subsequent higher morbidity and mortality in the population.In HHD ventricular hypertrophy develops as a compensatory mechanism for pressure overload but as the left ventricular compliance decreases,the process can transform into heart failure with firstly preserved and then into reduced ejection fraction(HFp EF,HFr EF).The main characteristics of underlying mechanisms involve cardiomyocyte growth,vessel changes,increased collagen production in all of which several mechanical stress induced neurohumoral agents,signal transduction pathways are involved.According to the new ESC and AHA guidelines five main groups of antihypertensive agents can be applied for decreasing blood pressure and for the prevention of organ damages.Occasionally,patients are not able to tolerate antihypertensive medication because of side effects,drug intolerance or interactions thus it is more difficult to reach the target blood pressure values.Therefore there are several efforts to complete the existing therapeutical possibilities against the development of organ damages like inhibition of Rho/ROCK pathway(e.g.,statins),regulation of ROS formation,influence on mitochondrial biogenesis and enhancing recombinant adenovirus hepatocyte growth factor gene.Hypertension induced oxidative stress causes DNA breaks producing the activation of nuclear poly(ADP-ribose) polymerase-1(PARP) enzyme that leads to energy depletion and unfavorable modulation of different kinase cascades.PARP activation promotes the development of HHD,and its transition to heart failure.Therefore inhibition of PARP-enzyme offers another new therapeutical approach among hypertensive patients.The purpose of this review is to give a comprehensive summary about the most significant mechanisms in HHD and an insight into new potential therapies.

Dynamic Simulation and Hemolysis Evaluation of the Regurgitant Flow over a Tilting-Disc Mechanical Heart Valve in Pulsatile Flow

Regurgitation in the heart diastolic phase represents a critical flow condition associated with many heart valve design considerations. The finite volume method, the Low-Reynolds-Number k-ω turbulent model and sliding mesh model are employed to solve and compare the complex flow field and the torque in each case. The end results expected from a cardiovascular CFD analysis are not limited only to the flowfield investigations. More importantly, it needs an evaluation criterion to judge if the design is acceptable as considered from a broader blood cell damage or activation perspective. In this study, blood cell damage index developed based on stress-time empirical rule and Lagrangian particle tracking is introduced to assess the viscous and turbulence-induced stresses effect to the blood cells.

Whey protein hydrolysate enhances exercise endurance, regulates energy metabolism, and attenuates muscle damage in exercise mice

This study aimed to explore the effects of whey protein concentrate(WPC)and whey protein hydrolysate(WPH)on energy metabolism,muscle injury,and underlying mechanisms in exercise mice by utilizing the swimming 40 min test and exhaustive swimming test,respectively.Results showed that WPH mainly consisted of low molecular weight peptides(359-2266 Da),and 78%of the peptides contained branched chain amino acids.In the swimming 40 min test,WPH possessed better influences than WPC in delaying glycogens consumption,promoting lactate and urea nitrogen elimination,and relieving oxidative stress in mice.Additionally,both WPC and WPH attenuated muscle damage via inhibiting inflammatory response.In the exhaustive swimming test,WPH significantly prolonged swimming time,which was 1.5-and 1.4-fold longer compared with control and WPC groups,respectively.Moreover,WPC and WPH promoted the recovery of muscle damage within 30 min of rest,which might be related to the activation of protein synthesis pathway(mammalian target of rapamycin,mTOR).Notably,compared with WPC,WPH showed better abilities in increasing the contents of glucose and liver glycogen and inhibiting inflammatory pathways,although its swimming time was longer.Taken together,WPH can be an effective ingredient for the prevention and elimination of exercise-induced fatigue.

Rheumatic valvular heart disease treated with traditional Chinese medicine:A case report

BACKGROUND Rheumatic heart disease(RHD)is an autoimmune disease that leads to irreversible valve damage and heart failure.Surgery is an effective treatment;however,it is invasive and carries risks,restricting its broad application.Therefore,it is essential to find alternative nonsurgical treatments for RHD.CASE SUMMARY A 57-year-old woman was assessed with cardiac color Doppler ultrasound,left heart function tests,and tissue Doppler imaging evaluation at Zhongshan Hospital of Fudan University.The results showed mild mitral valve stenosis with mild to moderate mitral and aortic regurgitation,confirming a diagnosis of rheumatic valve disease.After her symptoms became severe,with frequent ventricular tachycardia and supraventricular tachycardia>200 beats per minute,her physicians recommended surgery.During a 10-day preoperative waiting period,the patient asked to be treated with traditional Chinese medicine.After 1 week of this treatment,her symptoms improved significantly,including resolution of the ventricular tachycardia,and the surgery was postponed pending further follow-up.At 3-month follow-up,color Doppler ultrasound showed mild mitral valve stenosis with mild mitral and aortic regurgitation.Therefore,it was determined that no surgical treatment was required.CONCLUSION Traditional Chinese medicine treatment effectively relieves symptoms of RHD,particularly mitral valve stenosis and mitral and aortic regurgitation.

基于毒邪与络病学说探讨免疫炎症在慢性心力衰竭中作用

慢性心力衰竭(以下简称心衰),是各种心脏疾病的终末期阶段,其发病机制与免疫炎症密切相关。免疫细胞激活后,产生大量炎症因子,损伤心肌细胞,导致心肌纤维化、心室重构等病理改变。“毒损心络”是心衰发生、发展的主要病机,贯穿心衰发展的始终,以不同的形式影响心衰的发展及预后。该文通过查阅相关文献,基于毒邪与络病学说,从免疫炎症与心衰的关系及中药防治进行系统梳理,提出心衰早期,以心气虚为主,兼心气阴虚,尚未化毒、入络;心衰中期,心气亏虚为本,痰浊、瘀血、水饮留滞络脉,有化毒、入络趋势;心衰晚期,痰、瘀、水蕴结成毒,损伤心络。中药以复方治疗为主,多具有益气温阳、化瘀利水、解毒通络之功效,通过恢复M1/M2、Th1/Th2及Th17/Treg细胞之间的动态平衡,调节促炎/抗炎因子,从根本上祛除或缓解因毒邪产生的病理状态,减轻炎症,调整心之气血阴阳,达到扶正祛邪、保护心功能的作用,为临床防治心衰提供指导。

胡黄连苷Ⅱ调节HMGB1/RAGE信号通路对冠心病大鼠内皮细胞损伤的影响

目的:初步探讨胡黄连苷Ⅱ(P-Ⅱ)调节高迁移率族蛋白B1(HMGB1)/晚期糖基化终末产物受体(RAGE)信号通路对冠心病(CHD)大鼠内皮细胞损伤的影响。方法:SPF级SD大鼠随机分为control组、CHD组、P-Ⅱ低、中、高剂量组、P-Ⅱ高剂量+DEX组(P-Ⅱ高剂量+HMGB1/RAGE信号通路激活剂DEX),除control组外,采用高脂饮食联合腹腔注射垂体后叶素法建立CHD大鼠模型,灌胃或腹腔注射相应药物,1次/d,连续4周。生化分析仪分析大鼠血脂水平;ELISA检测血清血管内皮损伤标志物一氧化氮(NO)、内皮素(ET)-1、血管紧张素Ⅱ(AngⅡ)及血清和冠状动脉组织TNF-α、IL-1β、IL-6炎症因子水平;试剂盒检测大鼠冠状动脉组织活性氧(ROS)、谷胱甘肽过氧化物酶(GSH-Px)水平;HE染色观察大鼠冠状动脉组织病理损伤;TUNEL染色观察血管内皮细胞凋亡;Western blot检测冠状动脉组织中血管内皮生长因子(VEGF)、HMGB1、RAGE蛋白表达。结果:相较于control组,CHD组大鼠TC、TG、LDL-C、ET-1、AngⅡ、TNF-α、IL-1β、IL-6、ROS、内皮细胞凋亡率及HMGB1、RAGE表达显著升高,HDL-C、NO、GSH-Px及VEGF表达显著降低(P<0.05);相较于CHD组,P-Ⅱ低、中、高剂量组TC、TG、LDL-C、ET-1、AngⅡ、TNF-α、IL-1β、IL-6、ROS、内皮细胞凋亡率及HMGB1、RAGE表达显著降低,HDL-C、NO、GSH-Px及VEGF表达显著升高(P<0.05);HMGB1/RAGE信号通路激活剂DEX可减弱P-Ⅱ对CHD大鼠内皮细胞损伤的保护作用。结论:P-Ⅱ能有效减轻CHD大鼠内皮细胞损伤,其作用机制可能与抑制HMGB1/RAGE通路激活有关。

心电向量图诊断高血压早期心脏靶器官损害的临床应用及影响因素

目的探讨心电向量图(vectorcardiogram,VCG)对高血压心脏电活动异常的诊断价值,并分析早期心脏靶器官损害的影响因素。方法选取昆明市中医医院心血管病科2022年1月至2023年2月的高血压病住院患者80例,经超声心动图(ultrasound cardiogram,UCG)排外心脏结构异常。比较心电图(electrocardiogram,ECG)与VCG对异常心室除极与复极指标的检出情况。按心电向量检查结果将80例病例分为正常组(n=40)与异常组(n=40),比较2组早期心脏损害的相关影响因素指标,将差异有统计学意义的因素做二元Logistic回归分析,筛选出早期心脏损害的独立影响因素。结果VCG检出异常心室复极指标较ECG有优势(P<0.05),二者对异常除极指标的检出差异无统计学意义(P>0.05)。正常组与异常组比较,在年龄、规律服药、家族史、糖尿病、24 h平均收缩压(24 h average systolic blood pressure,24 h SBP)、白昼平均收缩压(daytime average systolic blood pressure,DSBP)、夜间平均收缩压(night average systolic blood pressure,NSBP)、血压负荷值、清晨血压、脉压差等指标上,差异有统计学意义(P<0.05)。二元Logistic回归分析显示,年龄[OR(95%CI)=0.891,0.998]、夜间平均收缩压[OR(95%CI)=1.018,2.10]、家族史[OR(95%CI)=0.029,0.499]、糖尿病[OR(95%CI)=0.042,0.916]是高血压早期心脏损害的独立影响因素。结论VCG为高血压早期心脏靶器官损害的有效检测手段。

基于“浊毒-线粒体自噬”探讨慢性肾脏病心脏损害

心脏损害是慢性肾脏病进展过程中常见并发症之一,大量研究表明线粒体自噬能干预慢性肾脏病心脏损害的病程。线粒体自噬是当今医学调控慢性肾脏病心脏损害重要靶点及研究课题。慢性肾脏病患者体内毒素代谢异常,同时心肾两脏富含线粒体,慢性肾脏病后期尿毒症毒素内积,线粒体凋亡及受损线粒体释放出的大量有害物质的过程与中医浊毒内生相似。通过从慢性肾脏病、线粒体自噬与浊毒的关系,慢性肾脏病并发心脏损害的浊毒理论,浊毒、线粒体自噬与心脏损害的联系,浊毒-线粒体自噬-慢性肾脏病并发心脏损害的形成,中医药祛浊毒理论干预线粒体自噬治疗慢性肾脏病心脏损害来论述。

皮肌炎重叠系统性硬化症心脏损害1例并临床探讨

皮肌炎以对称性近端肌无力为特征,常同时累及其他器官,多伴有血清肌酶升高及肌电图异常,合并心血管病变为其死亡危险因素之一,但临床上明显的心脏受累较为罕见,也可能是合并心脏受累的情况尚未得到重视。系统性硬化症具有复杂的发病机制和多样性的临床表现,在疾病表现上具有广泛异质性,临床表现主要以雷诺现象,皮肤受累如指端硬化、弥漫性皮肤改变,肠道动力障碍,以及心、肺、肾等脏器受损。皮肌炎重叠系统性硬化症在临床上常见,心脏损害为其重要的死亡原因之一,本文通过回顾潍坊市中医院1例皮肌炎重叠系统性硬化症导致心肌损害患者的病例资料,通过分析其临床特点,治疗转归等,并检索万方数据、知识平台PubMed、中国知网等国内外权威数据库搜索相关文献,分析、归纳其特点,从而加强临床医师对疾病的认知,提高警惕,通过早期检查、诊断以及综合治疗改善患者预后。

心中风浅析

[目的]梳理古籍文献中“心中风”的内涵、病机以及治疗,以期为临床病毒性心肌炎、癫痫等难治性疾病的治疗提供理论参佐。[方法]基于第5版《中华医典》数据库,查阅古籍文献中关于“心中风”的论述,分别从“心之义”“中之音”“风之义”三个角度辨析“心中风”的具体内涵,并概括其临床症状、病机和治疗,以期更好地指导临床。[结果]中医学之“心”乃五脏六腑之大主,不仅具有主血脉之功,尚具主藏神之能,同时部分古代医家常以“心”来代指中焦脾胃。中医学之“风”则有外风与内风之别,内风多因情志而生。故笔者基于古今文献相关论述,简要阐析“心中风”之不同内涵,其中包括血肉之心中风、神明之心中风以及其他心中风。血肉之心中风和其他心中风多由外风所致,神明之心中风可因外风或内风引起。血肉之心中风治疗以祛风药为主,佐以益气养血之药;神明之心中风则以安神药为主。[结论]血肉之心中风、神明之心中风及其他心中风分别与现代医学之病毒性心肌炎、神经系统疾病、胃肠疾病甚为相似,或可依据古籍文献为此三类疾病的临证组方提供理论依据。

蒽环类药物心脏毒副作用机制及中医药治疗研究进展

蒽环类药物是恶性肿瘤常用的化疗药物之一,但蒽环类药物引起的心脏毒性已成为恶性肿瘤治疗的最严重并发症之一,从而限制了蒽环类化疗药物的临床应用。中医药在恶性肿瘤的治疗过程中起着重要作用。中药可以预防、治疗以及减少因蒽环类药物治疗所造成的心脏毒性。在保护心肌方面,中药能够降低心肌缺血再灌注损伤、拮抗氧化应激、改善心肌重塑、调节细胞凋亡,进一步拓展了中医药治疗的应用前景。本文就近年来蒽环类药物引起心脏毒性的作用机制的研究新进展和因其治疗引起的心脏毒性方面的研究进行综述。