To study monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome (ARDS) secondary to high altitude pulmonary edema (HAPE),we performed clinic and laboratory studies in 8 patients who prelimi...To study monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome (ARDS) secondary to high altitude pulmonary edema (HAPE),we performed clinic and laboratory studies in 8 patients who preliminarily developed high altitude cerebral edema (HACE) and then ARDS occurred at an altitude of 4 500 m. After an initial emergency treatment on high mountains,all the patients were rapidly transported to a hospital at a lower altitude of 2 808 m. The right cardiac catheterizations were carried out within 5 h after hospitalized. The monitoring hemodynamics and oxygen dynamics were studied via a thermodilution Swan-Gaze catheter. The results showed that before treatments at the beginning of monitoring,there presented a significant pulmonary artery hypertension with a decreased cardiac function,and a lower oxygen metabolism in all the 8 patients. However,after some effective treatments,including mechanical ventilation and using dexamethasone,furosemide,etc,four days later the result of a repeated monitoring showed that their pulmonary artery pressure had been decreased with an improved cardiac function with all the oxygen metabolic indexes increased significantly. Our studies suggested that performing monitoring hemodynamics in patients with ARDS secondary to HAPE will define the clinical therapeutic measures which will benefit the outcome.展开更多
Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria. Methods: This study was conducted using epidemiologic...Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria. Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myo-cardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram (ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude de-acclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated. Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude de-acclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded. Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient’s clinical symptoms and signs.展开更多
The relationship between acute high altitude response (AHAR), cardiac function injury, and high altitude de-adaptation response (HADAR) was assessed. Cardiac function indicators were assessed for 96 men (18 - 35 years...The relationship between acute high altitude response (AHAR), cardiac function injury, and high altitude de-adaptation response (HADAR) was assessed. Cardiac function indicators were assessed for 96 men (18 - 35 years old) deployed into a high altitude (3700 - 4800 m) environment requiring intense physical activity. The subjects were divided into 3 groups based on AHAR at high altitude: severe AHAR (n = 24), mild to moderate AHAR (Group B, n = 47) and non-AHAR (Group C, 25);and based on HADAR: severe HADAR (Group E, n = 19), mild to moderate HADAR (Group F, n = 40) and non-HADAR (Group G, n = 37) after return to lower altitude (1,500 m). Cardiac function indicators were measured after 50 days at high altitude and at 12 h, 15 days, and 30 days after return to lower altitude. Controls were 50 healthy volunteers (Group D, n = 50) at 1500 m. Significant differences were observed in cardiac function indicators among groups A, B, C, and D. AHAR score was positively correlated with HADAR score (r = 0.863, P < 0.001). Significant differ- ences were also observed in cardiac function indicators among groups D, E, F, and G, 12 h and15 days after return to lower altitude. There were no significant differences in cardiac function indicators among the groups, 30 days after return to lower altitude, compared to group D. The results indicated that the severity of HADAR is associated with the severity of AHAR and cardiac injury, and prolonged recovery.展开更多
To evaluate the therapeutic effects of Rong Shuan Jiao Nang （RSJN） on treatment of acute mountain sickness （AMS） and high altitude myocardial ischemic syndrome in workers in Yushu, three groups were studied： grou...To evaluate the therapeutic effects of Rong Shuan Jiao Nang （RSJN） on treatment of acute mountain sickness （AMS） and high altitude myocardial ischemic syndrome in workers in Yushu, three groups were studied： group A （60 patients with AMS, given RSJN）, group B （15 patients with altitude myocardial ischemic syndrome, given RSJN）, and group C （control, without drugs）. All studied subjects were lowland workers who were first time entry to Yushu for work at an altitude of 4 250 m. During the course of treatment, a routing physical examina- tion was performed, AMS Lake Louise Scores were estimated, arterial oxygen saturation （SaO2）, electrocardiography and hemoglobin concentration were measured before and after using RSJN for 10 days. In group A, the effective rate was 68 %, symptomatic improvement in 54 cases （90 %） within 5 days. In group B, the effective rate was 93 %, episodes of angina pectoris stopped in 12 patients within 3 - 7 days, one lasted 8 days. After treatment, the level of SaO2 increased 15.5 %, 21.8 % and 5.6 % in group A, group B and group C, respectively. RSJN tak- en at the start of the arrival at Yushu can decrease AMS scores and facilitate cure. If taken after the illness has begun, RSJN may help lessen symptoms, especially effectively improved angina pectoris of the high altitude myocardial ischemic syndrome. Symptoms usually subside after 3 - 8 days. RSJN should be continually used lbr at least 7 days after ascent.展开更多
Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria.Methods: This study was conducted using epidemiologica...Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria.Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3,011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myocardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram(ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude deacclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated.Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude deacclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded.Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient's clinical symptoms and signs.展开更多
基金"973"National Key Basic Research and Development Program(No.2012CB518202)Project of Qinghai Development of Science and Technology(No.2011-N-150)
文摘To study monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome (ARDS) secondary to high altitude pulmonary edema (HAPE),we performed clinic and laboratory studies in 8 patients who preliminarily developed high altitude cerebral edema (HACE) and then ARDS occurred at an altitude of 4 500 m. After an initial emergency treatment on high mountains,all the patients were rapidly transported to a hospital at a lower altitude of 2 808 m. The right cardiac catheterizations were carried out within 5 h after hospitalized. The monitoring hemodynamics and oxygen dynamics were studied via a thermodilution Swan-Gaze catheter. The results showed that before treatments at the beginning of monitoring,there presented a significant pulmonary artery hypertension with a decreased cardiac function,and a lower oxygen metabolism in all the 8 patients. However,after some effective treatments,including mechanical ventilation and using dexamethasone,furosemide,etc,four days later the result of a repeated monitoring showed that their pulmonary artery pressure had been decreased with an improved cardiac function with all the oxygen metabolic indexes increased significantly. Our studies suggested that performing monitoring hemodynamics in patients with ARDS secondary to HAPE will define the clinical therapeutic measures which will benefit the outcome.
文摘Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria. Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myo-cardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram (ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude de-acclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated. Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude de-acclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded. Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient’s clinical symptoms and signs.
文摘The relationship between acute high altitude response (AHAR), cardiac function injury, and high altitude de-adaptation response (HADAR) was assessed. Cardiac function indicators were assessed for 96 men (18 - 35 years old) deployed into a high altitude (3700 - 4800 m) environment requiring intense physical activity. The subjects were divided into 3 groups based on AHAR at high altitude: severe AHAR (n = 24), mild to moderate AHAR (Group B, n = 47) and non-AHAR (Group C, 25);and based on HADAR: severe HADAR (Group E, n = 19), mild to moderate HADAR (Group F, n = 40) and non-HADAR (Group G, n = 37) after return to lower altitude (1,500 m). Cardiac function indicators were measured after 50 days at high altitude and at 12 h, 15 days, and 30 days after return to lower altitude. Controls were 50 healthy volunteers (Group D, n = 50) at 1500 m. Significant differences were observed in cardiac function indicators among groups A, B, C, and D. AHAR score was positively correlated with HADAR score (r = 0.863, P < 0.001). Significant differ- ences were also observed in cardiac function indicators among groups D, E, F, and G, 12 h and15 days after return to lower altitude. There were no significant differences in cardiac function indicators among the groups, 30 days after return to lower altitude, compared to group D. The results indicated that the severity of HADAR is associated with the severity of AHAR and cardiac injury, and prolonged recovery.
基金"973"National Key Basic Research and Development Program(No.2012CB518202)Project of Qinghai Development of Science and Technology(No.2011-N-150)
文摘To evaluate the therapeutic effects of Rong Shuan Jiao Nang （RSJN） on treatment of acute mountain sickness （AMS） and high altitude myocardial ischemic syndrome in workers in Yushu, three groups were studied： group A （60 patients with AMS, given RSJN）, group B （15 patients with altitude myocardial ischemic syndrome, given RSJN）, and group C （control, without drugs）. All studied subjects were lowland workers who were first time entry to Yushu for work at an altitude of 4 250 m. During the course of treatment, a routing physical examina- tion was performed, AMS Lake Louise Scores were estimated, arterial oxygen saturation （SaO2）, electrocardiography and hemoglobin concentration were measured before and after using RSJN for 10 days. In group A, the effective rate was 68 %, symptomatic improvement in 54 cases （90 %） within 5 days. In group B, the effective rate was 93 %, episodes of angina pectoris stopped in 12 patients within 3 - 7 days, one lasted 8 days. After treatment, the level of SaO2 increased 15.5 %, 21.8 % and 5.6 % in group A, group B and group C, respectively. RSJN tak- en at the start of the arrival at Yushu can decrease AMS scores and facilitate cure. If taken after the illness has begun, RSJN may help lessen symptoms, especially effectively improved angina pectoris of the high altitude myocardial ischemic syndrome. Symptoms usually subside after 3 - 8 days. RSJN should be continually used lbr at least 7 days after ascent.
基金supported by the National Key Technology Research and Development Program of China (2009BAI85B03)Health Subject of Chinese PLA (2013BJZ032)
文摘Objective: The objective of this study was to investigate the diagnostic methods of high altitude de-acclimatization syndrome and to formulate diagnostic criteria.Methods: This study was conducted using epidemiological surveys and a multi-center randomized controlled clinical trial. A total of 3,011 subjects were studied, and the following indices were collected after their return to low altitude areas from the plateau: general health status, blood, urine and stool samples, myocardial enzyme levels, liver and kidney function, nerve function, sex hormone levels, microalbuminuria, electrocardiogram(ECG), echocardiography, pulmonary function, and hemorheological markers. These data were compared to those of randomized healthy subjects in the same age range who lived at the same altitude to determine the characteristics of high altitude deacclimatization syndrome. Based on these characteristics, diagnostic criteria for high altitude de-acclimatization syndrome were formulated.Results: This study demonstrated that the incidence of high altitude de-acclimatization syndrome was 84.36%. Sixty percent of the cases were mild, 30% were medium, and 10% were severe. The incidence was higher among those who returned to a place of lower altitude, resided at a high altitude for a longer period of time, or engaged in heavy labor while at high altitude. Patients with high altitude de-acclimatization syndrome manifested hematological abnormalities and abnormal ventricular function, notably a right ventricular diastolic function, which recovered to baseline function after one to five years. Exposure to long-term hypoxia often caused obvious changes in cardiac morphology, i.e., left and right ventricular hypertrophy, particularly within the right ventricle. In addition, patients with high altitude de-acclimatization syndrome often presented with low blood pressure, low pulse pressure, and microalbuminuria. A few patients presented with occult blood in their feces. The diagnosis of high altitude deacclimatization syndrome can be made if a patient who recently returns to the plain from the plateau complains of dizziness, weakness, sleepiness, chest tightness, edema, memory loss, and other symptoms and signs that do not alleviate under short-term rehabilitation or symptomatic treatment, and if organic diseases of the heart, lung, kidney, and other organs have been excluded.Conclusion: The diagnosis of high altitude de-acclimatization syndrome should be made after a comprehensive analysis of the patient's clinical symptoms and signs.
