Variations in Inflammatory Cells and IL-6 in Long-Distance Runners Susceptible to Exercise-Induced Bronchospasm and Previously Treated with Salbutamol

Background: Exercise-Induced Bronchospasm (EIB) is an inflammatory condition characterized by severe airway constriction following the mobilization of inflammatory cells and interleukin-6 (IL-6). When severe, EIB can require the use of pressurized salbutamol to treat athletes. This study investigated the nature of the systemic changes in inflammatory cells and post-exercise IL-6 concentrations after salbutamol treatment in EIB-susceptible distance runners. Materials and Methods: This was an experimental study that enrolled 12 long-distance runners. In Session A, the participants completed a treadmill exercise test, and those who had a maximum expiratory volume per second (FEV1) that was decreased by at least 10% compared to their base value were placed in the EIB-susceptible group (EIB+) (n = 6). Those whose FEV1 did not meet this criterion were placed in the nonresponsive (EIB?) group (n = 6). Before the Session B exercise, athletes in the BIE+ group inhaled two puffs of salbutamol (EIB+ Salb), while their EIB? counterparts received no treatment. Spirometry was performed before and after the exercise using a Spirobank G portable spirometer. Blood samples were taken before, immediately after and 2 hours after the stress test. Results: The mean post-exercise FEV1 values were not significantly different (p > 0.05) between the EIB+ Salb group and the EIB? group. The systemic changes in inflammatory cells and IL-6 concentrations in the EIB+ runners after salbutamol treatment were similar to those observed in their EIB? counterparts. Conclusion: Salbutamol pretreatment improved the systemic immune status of EIB-susceptible athletes.

Dupilumab for Treatment of Food-Dependent, Exercise-Induced Anaphylaxis: Report of One Case

Food-dependent,exercise-induced anaphylaxis(FDEIA)is a potentially life-threatening disorder that often occurs with exercise,and patients typically have eaten a specific food within hours before disease onset.This disease is exceedingly rare,with a prevalence of 0.02%.No well-recognized prevention or treatment strategy has been available for FDEIA except avoiding triggers strictly.Here we report an 11-year-old boy with a history of recurrent anaphylaxis of unknown etiology more than 10 times within two years.As the anaphylactic symptoms had not been controlled after traditional treatments,the patient was given subcutaneous injection of dupilumab seven times within 33 weeks.During dupilumab treatments,the patient was exposed to culprit mushrooms plus exercises at least twice a month but without notable anaphylaxis.Thus,dupilumab may improve the allergic reactions in FDEIA patients.

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.

Exercise-induced irisin in bone and systemic irisin administration reveal new regulatory mechanisms of bone metabolism

Irisin is a polypeptide hormone derived from the proteolytic cleavage of fibronectin-type III domain- containing 5 （FNDC5） protein. Once released to circulation upon exercise or cold exposure, irisin stimulates browning of white adipose tissue （WAT） and uncoupling protein I （UCP1） expression, leading to an increase in total body energy expenditure by augmented UCPl-mediated thermogenesis. It is currently unknown whether irisin is secreted by bone upon exercise or whether it regulates bone metabolism in vivo. In this study, we found that 2 weeks of voluntary wheel-running exercise induced high levels of FNDC5 messenger RNA as well as FNDC5/irisin protein expression in murine bone tissues. Increased immunoreactivity due to exercise-induced FNDC5/irisin expression was detected in different regions of exercised femoral bones, including growth plate, trabecular bone, cortical bone, articular cartilage, and bone-tendon interface. Exercise also increased expression of osteogenic markers in bone and that of UCP1 in WAT, and led to bodyweight loss. Irisin intraperitoneal （IP） administration resulted in increased trabecular and cortical bone thickness and osteoblasts numbers, and concurrently induced UCP1 expression in subcutaneous WAT. Lentiviral FNDC5 IP administration increased cortical bone thickness. In vitro studies in bone cells revealed irisin increases osteoblastogenesis and mineralization, and inhibits receptor activator of nuclear factor-kB ligand （RANKL）- induced osteoclastogenesis. Taken together, our findings show that voluntary exercise increases irisin production in bone, and that an increase in circulating irisin levels enhances osteogenesis in mice.

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.

Exercise-induced anaphylaxis with an Ayurvedic drug as cofactor:A case report

BACKGROUND The practice of Indian Ayurvedic medicine is spreading in Western countries and Shilajit is one of the most used drugs, for its antioxidant activities and immunomodulatory effects. Albeit Shilajit has showed a high degree of safety, it can act as cofactor of anaphylaxis, especially in condition at high risk, such as mast cell activation syndrome(MCAS). We reported this case to sensitize practitioners to investigate to the use of complementary and alternative medicine,in case of exercise-induced anaphylaxis(EIAn).CASE SUMMARY A 43-year-old woman, working as a dance teacher, developed urticaria after ingestion of rice, tuna and Shilajit, which did not respond to intramuscular corticosteroids. Subsequently, she developed dyspnoea and hypotension with loss of consciousness that arose 1 h after sexual activity. The patient did not refer personal history of atopy. Specific IgE for main food allergens resulted negative,with total IgE levels of 14 IU/L. Oral provocation test with Shilajit was not perfomed because the patient refused, but we performed prick-by-prick and patch test that resulted negative. Serum tryptase at the time of anaphylaxis was 20.6 μg/L that fell down to of 10.6 μg/L after therapy, but has remained at the high value after two days and during the follow-up. We performed an analysis of the c-KIT gene in peripheral blood, which was negative. We felt the diagnosis consistent with EIAn in a patient with a possible MCAS.CONCLUSION In Western countries the use of drugs from Ayurvedic medicine is more common than in the past. These substances can be cofactors of anaphylaxis in patients with risk factors.

Real-time surface electromyography in Parkinson's disease patients during exercise-induced muscle fatigue

To explore the mechanisms underlying exercise-induced local muscle fatigue in patients with idiopathic Parkinson＇s disease （PD）,we used surface electromyography to record myoelectric signals from the tibialis anterior muscle during isometric contraction-induced fatigue until exhaustion.The results revealed no significant differences between patients with idiopathic PD and healthy controls in maximum voluntary contraction of the tibialis anterior muscle.The basic characteristics of surface electromyography were also similar between the two groups.The duration of isometric contraction at 50% maximum voluntary contraction was shortened in PD patients.In addition,PD patients exhibited a stronger increase in mean square amplitude,but a weaker decrease in median frequency and mean power frequency compared with healthy controls during isometric contraction.The skeletal muscles of PD patients revealed specificity of surface electromyography findings,indicating increased fatigability compared with healthy controls.

EFFICACY OF ANTIHISTAMINE AGENTS ON MODEL FOR EXERCISE-INDUCED ASTHMA IN GUINEA PIGS

Objective To investigate the effects of antihistamine agents, loratadine and ketotifen, on the model of exercise-induced asthma in guinea pigs with lipopolysaccharide （LPS） and metyapone. Methods Nineteen guinea pigs were injected peritoneolly with LPS （ 1mg/kg, i. p. ） and metyapone （ 50mg/kg, i. p. ）. Then they were randomized into 3 groups. The control group （ n = 7） did not take any drug, ketotifen group （ n = 6） administered orally ketotifen （ Img·kg^-1· d^-1 ） and loratadine group （ n = 6） administered orally loratadine （ 2mg·kg^-1·d^-1 ） for 4 days. On thefifth day, lung resistance （RL） and dynamic compliance of respiratory system （Cdyn） of 3 groups were measured before and after exercise challenge. The total number of leukocytes in bronchoalveolar lavage fluid （BALF） from 3 groups was counted and differentiated cell type count was measured. Morphometric examination of the animal lungs was performed. Results In control group, RLincreased and Cdyn decreased significantly after exercise challenge. In ketotifen group and loratadine group with no change. There was a significant increase in the number of neutrophils, macrophages and eosinophils in BALF from control group. The infiltration of neutrophils in the bronchial mucosa was shown in control group in the morphometric study. Conclusion Loratadine and ketotifen can inhibit the exercise-induced bronchoconstriction in guinea pigs pretreated with LPS and metyrapone. Inhibiting the formation of inflammation in airway may be the therapeutic mechanism of these H-I receptor antagonists.

Exercise-Induced Bronchoconstriction Diagnostics:Impact of a Repeated Exercise Challenge Test

Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatment. The impact of a repeated exercise challenge test (ECT) in a clinical setting is not well established and conducting a repeated ECT with the possibility to adjust the exercise intensity on an individual basis may give more information. The aim of the study was to evaluate the test-retest reliability of an ECT for EIB and its association with exercise intensity. Methods: After examination by a pulmonologist, 20 referred subjects with symptoms strong indications of Exercise-Induced bronchoconstriction performed two consecutive exercise challenge tests on a treadmill. The exercise intensity of the repeated test was adjusted. Forced expiratory volume in 1 second (FEV1) was measured before and 1, 3, 6, 10, and 15 minutes after exercise. EIB was defined as a reduction of ≥ 10% in FEV1. Ventilation and heart rate were measured during exercise. Results: Five subjects tested positive in both tests, and ten subjects tested negative in both tests. Three subjects tested positive in the first test only, while two subjects tested positive in the second test only. The exercise intensity was not significantly different between the two tests for any of the subjects. Conclusion: There were 25% divergences in the diagnostic results of two consecutive exercise challenge tests. The difference in the test results was not explained by a difference in the exercise intensity.

Exercise-induced hypoalgesia in chronic neck pain: A narrative review

Chronic neck pain(CNP)is a worldwide health problem with several risk factors.One of the most widely used treatments for managing this condition is therapeutic exercise,which could generate a response called exerciseinduced hypoalgesia(EIH).There is no consensus on the best exercise modality to induce hypoalgesia.Therefore,this review aims to analyze and synthesize the state-of-the-art about the hypoalgesic effect of exercise in subjects with CNP.We included articles on EIH and CNP in patients older than 18 years,with pain for more than three months,where the EIH response was measured.Articles that studied CNP associated with comorbidities or measured the response to treatments other than exercise were excluded.The studies reviewed reported variable results.Exercise in healthy subjects has been shown to reduce indicators of pain sensitivity;however,in people with chronic pain,the response is variable.Some investigations reported adverse effects with increased pain intensity and decreased pain sensitivity,others found no clinical response,and some even reported EIH with decreased pain and increased sensitivity.EIH is an identifiable,stimulable,and helpful therapeutic response in people with pain.More research is still needed on subjects with CNP to clarify the protocols and therapeutic variables that facilitate the EIH phenomenon.In addition,it is necessary to deepen the knowledge of the intrinsic and extrinsic factors that influence EIH in people with CNP.

Bronchospasm Diagnosis in Motorcycle Taxi Drivers Exposed to Automotive Pollutants in Porto-Novo

Background: In African cities, chronic exposure to pollutants is the most common public health problem faced daily by motorcycle taxi drivers. In Benin, studies conducted on motorcycle drivers, have shown the presence of nitrogen oxides, carbon monoxide, sulfur dioxide, volatile organic compounds and particulate matter in ambient air, which may affect lung function. Aims: This study aims to diagnose potential respiratory problems among 48 motorcycle taxi drivers (47.02 ± 8.75 years) compared to a control group made up of 52 people (46.38 ± 8.81 years) in Porto-Novo, Benin. Methods: A questionnaire, two exploration pulmonary function tests and two 6-minute walk tests were used to identify symptoms and changes in respiratory variables that reveal the existence of bronchospasm. Results: The frequency of respiratory symptoms noted among motorcycle taxi drivers is higher than that recorded among members of the control group. We observed that motorcycle drivers at rest and after physical effort have significantly lower respiratory variables (FVC, FEV1, PEF, FEF25-75, FEF50 and FEF25) (p < 0.05) than those recoded in control group. Conclusion: It can therefore be concluded that, because of the relatively long duration of exposure among motorcycle taxi drivers, the inhalation of automobile pollutants, may cause respiratory problems in this population.

Levels of Fine Particle Concentrations in Schools and Postexercise Pulmonary Function Disorders in Schoolchildren in Brazzaville

Context: Fine particles (PM2.5 and PM10) can accumulate in classrooms and in schoolyards located near urban roads. PM2.5 and PM10 can initiate, develop and exacerbate exercise-induced bronchospasm (EIB). This study aimed to assess the concentration levels of PM2.5 and PM10 in schools and to determine the rate of sensitivity to EIB among schoolchildren. Methods: A total of 128 students (67 girls and 61 boys) with an average age of 11 participated in this study. An ISAAC II questionnaire on respiratory symptoms was administered. PM2.5 and PM10 were measured. A 6-minute stress test was performed. Spirometry was performed. The ratio (I/O) of the concentrations of PM2.5 and PM10 recorded inside (I) the classrooms to those obtained outside (O) the classrooms was equal to 1 (I/O = 1). Results: The concentrations of PM2.5 and PM10 recorded inside the classrooms and those obtained outside the classrooms were higher than the values recommended by the WHO. 29 students out of 128 were diagnosed as sensitive to EIB [EIB (+)], i.e., a rate of sensitivity to EIB of 22.66%. A drop in postexercise PEF of 17.396% was observed among EIB (+) students. Conclusion: Schoolchildren in schools located near highways are exposed to high levels of PM2.5 and PM10 concentrations. Exposure to PM2.5 and PM10 played an important role in the initiation and exacerbation of exercise-induced bronchospasm in schoolchildren from schools located near highways. Effective programs for improving air quality in schools must be put in place to reduce the effects of particulate pollution on the respiratory health of school children.

High-intensity swimming alleviates nociception and neuroinflammation in a mouse model of chronic postischemia pain by activating the resolvin E1-chemerin receptor 23 axis in the spinal cord

Physical exe rcise effectively alleviates chronic pain associated with complex regional pain syndrome type-Ⅰ.However,the mechanism of exe rcise-induced analgesia has not been clarified.Recent studies have shown that the specialized pro-resolving lipid mediator resolvin E1 promotes relief of pathologic pain by binding to chemerin receptor 23 in the nervous system.However,whether the resolvin E1-chemerin receptor 23 axis is involved in exercise-induced analgesia in complex regional pain syndrome type-Ⅰ has not been demonstrated.In the present study,a mouse model of chronic post-ischemia pain was established to mimic complex regional pain syndrome type-Ⅰ and subjected to an intervention involving swimming at different intensities.Chronic pain was reduced only in mice that engaged in high-intensity swimming.The resolvin E1-chemerin receptor 23 axis was clearly downregulated in the spinal cord of mice with chronic pain,while high-intensity swimming restored expression of resolvin E1 and chemerin receptor 23.Finally,shRNA-mediated silencing of chemerin receptor 23in the spinal cord reve rsed the analgesic effect of high-intensity swimming exercise on chronic post-ischemic pain and the anti-inflammato ry pola rization of microglia in the dorsal horn of the spinal cord.These findings suggest that high-intensity swimming can decrease chronic pain via the endogenous resolvin E1-chemerin receptor 23 axis in the spinal cord.

我国部分冬季项目运动员运动诱发性支气管痉挛流行病学调查

目的:调查我国冬季优势项目运动员运动诱发性支气管痉挛(EIB)发病率,比较发病率在运动项目、性别、运动水平间的人群差异,分析EIB与无EIB运动员的肺通气功能、血液炎症因子的生理差异。方法:招募4个冬奥项目(越野滑雪、短道速滑、单板滑雪、自由式滑雪)的90名运动员(男48、女42;二级61、一级20、健将9),测试日清晨取静脉血,用于炎症因子分析;测试日进行支气管运动激发试验,于试验前即刻、试验后第1、3、5、7、10、15分钟测试肺通气功能指标。结果:90名运动员中检测出33名EIB运动员,平均发病率36.67%;发病率项目间差异为:越野滑雪(43.18%)>短道速滑(38.46%)>单板滑雪(31.25%)>自由式滑雪(23.53%);性别间差异为:女性运动员(42.86%)>男性运动员(31.25%);运动等级间差异为:健将(55.56%)>一级(40%)>二级(32.8%)。肺通气功能指标方面:EIB运动员1秒用力呼气容积(FEV1)和用力呼气容积(FVC)激发试验后第1、3分钟均显著下降(P<0.001),无EIB运动员激发试验后无显著变化;EIB运动员FEV1/FVC比值激发试验后出现下降趋势,而无EIB运动员出现上升趋势。血液指标方面:EIB运动员白细胞计数显著高于无EIB运动员(P=0.028);EIB运动员免疫球蛋白E(IgE)低于无EIB运动员(P=0.07);EIB运动员白细胞介素6(IL-6)显著高于无EIB运动员(P=0.02);EIB运动员克拉氏细胞蛋白16(CC16)显著高于无EIB运动员(P=0.003)。结论:我国冬季项目运动员存在EIB问题,表现为体能类项目发病率高于技巧类项目,女性发病率高于男性,高水平运动员发病率高于普通运动员的特点。同时,EIB运动员的炎症基础水平高于无EIB运动员,气道损伤是其原因之一。

Use of ketamine for severe asthma exacerbation in a pregnant patient with persistent bronchospasm:a case report

Background:Estimated 4%-8%of pregnancies are complicated by asthma.Adequate management in this population is critical to minimize complications.Patients presenting with asthma exacerbation are typically managed with standard bronchodilators and systemic corticosteroids.However,additional agents may be used in patients with refractory asthma exacerbation.Ketamine has been used in refractory bronchospasm,although its efficacy in published literature is heterogeneous.Case Presentation:We present a case of a pregnant patient with severe asthma exacerbation refractory to standard and salvage treatment who achieved termination of bronchospasm with ketamine infusion.Conclusion:After receiving ketamine infusion for several days,the patient had improved air flow and achieved successful extubation,without experiencing rebound bronchospasm.Although this individual clinical case alone cannot change guidelines or directives to use in refractory asthma exacerbations,it offers a possible treatment option to patients and providers in unusually severe cases with extenuating risk factors.

麻醉诱导前静脉注射利多卡因地塞米松预防支气管痉挛的作用

目的:观察在麻醉诱导前静脉注射利多卡因、地塞米松对支气管痉挛的预防作用。方法:选择美国麻醉医师协会分级(ASA)Ⅰ-Ⅱ级、行双腔气管插管的开胸手术患者80例,随机分成对照组(A组)和实验组(B组),B组在诱导前5min静脉给予利多卡因、地塞米松。两组均用异丙酚、芬太尼、力月西、万歌唱松诱导,机械控制呼吸。术中监测气道峰压、血氧饱和度(SPO2)及双肺呼吸音,比较两组结果。结果:B超的气道峰压、呼气相哮鸣音的发生率、SPO2降至96.0%以下的发生率均显著低于A组(P<0.01)结论:诱导前静脉给予利多卡因、地塞米松能有效地预防和改善支气管痉挛的发生,提高患者围术期的安全性。

Effects of electroacupuncture on HPA axis in rats with exercise-induced immunosuppression

Objective To observe modulatory effects of electroacupuncture （EA） on hypothalamus-pituitary adrenal （HPA） axis, thymus-exponent （TE）, γ-IFN and interleukin-2 （IL-2） in rats with exercise-induced immunosuppression. Methods Forty-three SD rats were randomly, by using digits, divided into three groups： group A, B and C. Group A （n=10） was taken as a control group. Rats in group B （n=17） accepted intense swimming exercise for 150 min each time, 6 times each week for 8 weeks. Rats in group C （n=16） accepted EA intervention following each swimming since the second week of swimming exercise with the same duration and times as those in group B. The indices reflecting functional states of the HPA axis such as hypothalamic corticotropin releasing hormone （CRH）, plasma adrenocorticotropic hormone （ACTH）, corticosterone （CORT） etc. and changes in TE, serum γ-IFN, and IL-2 were determined. Results （1） Compared with group A, the values of ACTH and CORT in group B significantly increased （P〈0.01, P〈0.05）, but no significant differences were found in group C （both P〉0.05） though they were somewhat elevated. Compared with group A, CRH values increased by 85.14% in group B and decreased by 64.09% in group C, respectively, but both differences were without statistical significance （both P〉0.05）. Serum IL-2, γ-IFN and TE values in group B were significantly lower than those in group A（P〈0.05, P〈0.01 ）, among which γ-IFN decreased by 32.19%. The values of IL-2, γ-IFN and TE in group C tended to reduce but without significance, compared with group A. （2） Compared with group B, ACTH value in group C was very significantly lowered than that in group B （P〈0.01）, and CRH value was lower while CORT value was higher than those in group B but without significance （both P〉0.05）. The values of TE and γ-IFN in group C were significantly higher than those in group B （P〈0.01, P〈0.05）. Conclusion （1） Long-term of intense exercise induces accentuation of functions of the HPA axis and sustained high level of CORT, resulting in neuroendocrine disturbance and inhibition of immune functions. （2） EA provides favorable modulation on long-term of intense exercise-induced lowering of immune function and on the HPA axis.

注射用头孢呋辛钠致支气管痉挛一例分析并文献复习

目的提高临床医师对注射用头孢呋辛钠致支气管痉挛发病机制与诊治措施的认识,为临床处理提供参考。方法结合注射用头孢呋辛钠的药理特点、不良反应和支气管痉挛诊治的相关文献报道,对1例因注射用头孢呋辛钠致支气管痉挛的临床资料和成功救治经验进行回顾性分析。结果注射用头孢呋辛钠致支气管痉挛系过敏原(头孢呋辛钠)引起的支气管反应性增高所致。治疗措施主要是迅速脱离过敏原、应用抗过敏和舒张支气管药物。结论注射用头孢呋辛钠的不良反应不容忽视,应用时要密切观察,以确保临床用药安全。

胃食管反流胃底折叠术中支气管痉挛的处理

目的探讨胃食管反流病(GERD)胃底折叠术中支气管痉挛的发生与处理措施。方法总结GERD胃底折叠术中发生支气管痉挛的34例资料。结果 34例中剖腹手术6例,腹腔镜手术28例。支气管痉挛有8例在气管插管后即刻发生,10例在气管插管后1～10min手术开始前发生,14例在术中不同时间不明原因发生,1例在术后气管拔管送回监护病房后发生,1例气管插管后的顽固支气管痉挛未行手术。处理措施均为静注糖皮质激素和氨茶碱,吸入七氟醚,呼吸机正压通气。以上措施无效者加用肾上腺素。结论 GERD胃底折叠术患者多有支气管痉挛的呼吸道症状,为麻醉的危险因素之一,麻醉医师应高度重视,妥善处理。

Advances of studies on relieving of exercise-induced fatigue by transcutaneous electrical acupoint stimulation

The occurrence of exercise-induced fatigue can be delayed and exercise endurance can be strengthened by removing lactic acid, decreasing serum creatine kinase, elevating hemoglobin, maintaining blood glucose, eliminating free radical, regulating amino acid metabolism and retaining heart rate with transcutaneous electrical acupoint stimulation （TEAS）. Problems in the above researching field are generalized in this paper. For instance, the point selection is relatively simple; the selection of wave band, frequency and duration during the application of TEAS apparatus are not unified; and observation indices mainly remained in the aspect of biochemistry. It also prospects the future directions of TEAS relieving exercise-induced fatigue including selecting acupuncture point by differentiation of symptoms and signs, setting uniform standards for TEAS, and studying the mechanisms of TEAS relieving exercise-induced fatigue by testing gonadal axis, adrenal axis, gene and protein .