START RUN, BEFORE SMOKE RUIN – THE EFFECTS OF EXERCISE ON SMOKING CESSATION

The impact of tobacco on health status is boundless. Smoking tobacco is responsible for various diseases including cancer, cardiovascular disease, pulmonary disease, periodontal disease etc. Smoking has been identified as a major risk factor in the development and progression of periodontal disease. Smoking cessation reduces the risk of many diseases. However cravings and withdrawal syndromes have been associated with smoking relapse. Thus exercise plays a significant role in the management of tobacco withdrawal symptoms and cravings that anticipate smoking relapse.

Effect of physical exercise on medical rehabilitation treatment of depression / Efeito de exercícios físicos no tratamento médico para reabilitação da depressão / Efectos de ejercicios físicos en el tratamiento médico para rehabilitación de la depresión

ABSTRACT Introduction: Depression is a common disease worldwide. The main treatment methods currently include medication, psychotherapy, and physical therapy. However, due to limitations in treatment methods, treatment compliance is poor. Participating in various sports is very effective in treating depression. Objective: To verify the influence of sports on the condition of depression and on the effect of its clinical treatment. Methods: The article selected a total of 60 hospitalized patients with depression who were randomly divided into two groups: an experimental group and a control group. The control group took antidepressant drugs for eight weeks, and the experimental group took the drugs with the supplementary practice of sports. The two groups of patients were tested for serum β-endorphin (β-EP) levels before and after treatment, and HAMD scores were performed. Results: The scores and serum β-endorphin (β-EP) levels of the two groups of patients were different, showing that effect of the treatment was better in the experimental group. Conclusion: Physical exercise therapy can mobilize the enthusiasm of patients with depression. This treatment plan increases treatment efficiency and is suitable for long-term clinical promotion and application. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A depressão é uma doença comum em todo o mundo. Os principais métodos de tratamento atuais incluem medicação, psicoterapia e fisioterapia. Contudo, graças às limitações dos métodos de tratamento, a aderência a eles é pequena. Participar de vários esportes é uma maneira eficiente de se tratar a depressão. Objetivo: Verificar a influência de esportes na condição depressiva e seu efeito no tratamento clínico da doença. Método: Selecionou-se 60 pacientes hospitalizados, que foram aleatoriamente divididos em dois grupos: um grupo experimental e um grupo controle. O grupo controle tomou antidepressivos por oito semanas, e o grupo experimental usou os medicamentos somados à prática de esportes. Testou-se os níveis de beta-endorfina (β-EP) dos dois grupos antes e depois do tratamento, e a pontuação na escala HAMD foi avaliada. Resultados: Houve diferença na pontuação e nos níveis de β-EP entre os grupos, indicando que o efeito do tratamento foi melhor no grupo experimental. Conclusão: A terapia com exercício físico é capaz de mobilizar o entusiasmo dos pacientes com depressão. Esse plano de tratamento aumenta a eficiência da terapia e é adequado para promoção e aplicação a longo prazo. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: La depresión es una enfermedad común en todo el mundo. Los principales métodos de tratamiento actuales incluyen medicación, psicoterapia y fisioterapia. Sin embargo, gracias a las limitaciones de los métodos de tratamiento, la adherencia a los mismos es baja. Practicar varios deportes es una forma eficaz de tratar la depresión. Objetivo: Verificar la influencia de los deportes en la condición depresiva y su efecto en el tratamiento clínico de la enfermedad. Método: Se seleccionaron 60 pacientes hospitalizados, que fueron aleatoriamente divididos en dos grupos: un grupo experimental y un grupo control. El grupo control tomó antidepresivos por ocho semanas, y el grupo experimental usó los medicamentos sumados a la práctica de deportes. Se analizaron los niveles de beta-endorfina (β-EP) de ambos grupos antes y después del tratamiento, y se evaluó la puntuación de la escala HAMD. Resultados: Hubo diferencia en la puntuación y en los niveles de β-EP entre los grupos, indicando que el efecto del tratamiento fue mejor en el grupo experimental. Conclusión: La terapia con ejercicio físico es capaz de movilizar el entusiasmo de los pacientes con depresión. Este plan de tratamiento aumenta la eficacia de la terapia y es adecuado para la promoción y aplicación a largo plazo. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Involvement of Opioid Peptides in the Analgesic Effect of Spinal Cord Stimulation in a Rat Model of Neuropathic Pain / 神经科学通报·英文版

Spinal cord stimulation (SCS)-induced analgesia was characterized, and its underlying mechanisms were examined in a spared nerve injury model of neuropathic pain in rats. The analgesic effect of SCS with moderate mechanical hypersensitivity was increased with increasing stimulation intensity between the 20% and 80% motor thresholds. Various frequencies (2, 15, 50, 100, 10000 Hz, and 2/100 Hz dense-dispersed) of SCS were similarly effective. SCS-induced analgesia was maintained without tolerance within 24 h of continuous stimulation. SCS at 2 Hz significantly increased methionine enkephalin content in the cerebrospinal fluid. The analgesic effect of 2 Hz was abolished by μ or κ opioid receptor antagonist. The effect of 100 Hz was prevented by a κ antagonist, and that of 10 kHz was blocked by any of the μ, δ, or κ receptor antagonists, suggesting that the analgesic effect of SCS at different frequencies is mediated by different endorphins and opioid receptors.

Effect of Wenjingtang on Levels of Serum Platelet Activating Factor and β-endorphins in Primary Dysmenorrhea Patients with Cold Stagnation and Blood Stasis Syndrome / 中国实验方剂学杂志

Objective::To explore the effect of Wenjingtang on the levels of serum platelet activating factor (PAF) and β-endorphins in primary dysmenorrhea patients with cold stagnation and blood stasis syndrome. Method::The 120 cases of dysmenorrhea treated at Second Affiliated Hospital, Heilongjiang University of Chinese Medicine from March 2016 to December 2017 were selected as the observation subjects, and divided into control group and observation group according to the random number table method, with 60 cases in each group. The control group was treated with ibuprofen capsules, while the observation group was treated with Wenjingtang and ibuprofen capsules. Dysmenorrhea symptom scores, clinical efficacy, recurrence condition and serum levels of platelet activating factor and β-endorphins were compared before and after treatment. Result::After treatment, the dysmenorrhea symptom scores decreased significantly in both groups, and the scores of patients in observation group were lower than those in control group (P<0.05). After treatment, the total efficiency in observation group was 95%, which was significantly higher than 83.33% in control group (P<0.05). The level of serum PAF decreased significantly in two groups, and the serum PAF in observation group was significantly decreased compared with control group (P<0.05). The level of serum beta-endorphins in observation group was significantly higher than that of control group (P<0.05). After half a year, the recurrence rate of the observation group was 5%, which was significantly lower than 30% of control group (χ2=12.987, P<0.01). Conclusion::Wenjingtang contributes to the reduction of dysmenorrhea symptoms scores in primary dysmenorrhea patients with cold stagnation and blood stasis syndrome, and can improve the clinical efficacy, reduce the serum PAF level and increase the concentration of β-endorphins, reduce the recurrence rate, improve the quality of life of patients, and it is worth promoting.

Extra note of music in anaesthesia

Role of music has been identified since ancient times for alleviating anxiety. Music has been known for its potential to produce a sense of wellbeing and peace. Anaesthesia and surgery are major stress factors for any person. Preoperative anxiety is a usual phenomenon in patients posted for various surgical interventions as well as those admitted to intensive care units (ICU). Literature shows ample evidence regarding neurohormonal disturbances related to stressful situations like preoperative, intraoperative and post-operative periods. Music has been shown to attenuate release of various biochemical molecules leading to relaxing and sedative effects on the brain. Not only patients under regional anaesthesia who are awake have a positive impact, even patients under general anaesthesia have also been shown to benefit from listening to music intraoperatively. Music is a hazard free intervention which can be added to various drug combinations used by anaesthesiologists.

Changes of endogenous nociceptin/orphanin FQ (N/OFQ) and C-reactive protein in elderly patients with atrial fibrillation before joint replacement / 天津医药

@#Objective To investigate the serum changes of endogenous nociceptin / orphanin FQ (N / OFQ) and C reactive protein (CRP) before total knee arthroplasty in elderly patients with atrial fibrillation, and to explore its significance. Methods The patients with paroxysmal atrial fibrillation were divided into PAAFⅠ subgroup (≤75 years old, n=32) and PAAFⅡ subgroup (＞75 years old, n=31). At the same time, the patients with persistent atrial fibrillation were divided into PEAFⅠ subgroup (≤75 years old, n=27) and PEAFⅡ subgroup (＞75 years old, n=32). Forty-seven patients with non-AF sinus rhythm were used as control group. The levels of N/OFQ and CRP, left atrial dimension (LAD), ejection fraction of left ventricle (LVEF), fasting triglyceride (TG), low-density lipoprotein (LDL-C) and high-density lipoprotein cholesterol (HDLC) were measured, and the above-mentioned indicators were analyzed. Results The LAD value was higher in PAAF group and PEAF group than that in control group. The LAD value was higher in PEAF group than that in PAAF group, and the LVEF and TG values were lower in PAAF group and PEAF group than those in control group. The values of LVEF, TG, HDL-C and LDL-C were lower in PEAF group than those of PAAF group. The values of HDL-C and LDL-C were higher in PAAF group than those of control group, and the values of HDL-C and LDL-C were lower in PEAF group than those of control group. The levels of N/OFQ and CRP were higher in PAAF group and PEAF group than those in control group, and the levels of N/OFQ and CRP were significantly higher in PEAF group than those in PAAF group (P＜0.05). The level of N/ OFQ was higher in PAAFII subgroup than that in PAAFI subgroup, and the level of N/OFQ was significant higher in PEAF Ⅱ subgroup than that in PEAFⅠ subgroup (P＜0.05). There was no significant difference in CRP level between groups (P > 0.05). Multiple Logistic regression showed that N/OFQ elevation (OR=2.911,95％CI:1.291-6.564) and CRP elevation (OR= 4.636, 95％CI:1.042-20.616) and LAD enlargement (OR=1.369,95％CI:1.000-1.875) were the risk factors of AF. LVEF elevation (OR=0.489,95％CI:0.302-0.792) was the protective factor of AF. The levels of N/OFQ and CRP were positively correlated with LAD and negatively correlated with TG, LDL-C and HDL-C in patients with atrial fibrillation. N/OFQ and CRP levels were positively correlated. The age of AF patients was positively correlated with N/OFQ level, but not with CRP level. LVEF was negatively correlated with N/OFQ level in patients with atrial fibrillation, but no correlation with CRP level. The result of ROC curve analysis showed that the area under the curve of N/OFQ for predicting atrial fibrillation was 0.949 (95％CI：0.917-0.982, P＜0.01), the area under the curve of CRP for predicting atrial fibrillation was 0.855 (95％CI: 0.775- 0.935, P＜0.01), the area under the curve of joint forecasting factor for predicting atrial fibrillation was 0.960 (95％CI: 0.933- 0.987, P＜0.01). Conclusion N/OFQ and CRP are closely related to the occurrence of atrial fibrillation in the elderly, and N/ OFQ is more advantageous in assessing cardiac function before total knee replacement in elderly patients with atrial fibrillation.

Experimental study on the effect of An-pressing and Rou-kneading Huantiao (GB 30) on certain brain nuclei of pleasure circuits in rats with chronic neuralgia / 针灸推拿医学（英文版）

Objective:To explore the central neurobiological mechanisms of pleasure effect on rats with neuralgia treated by tuina manipulations of An-pressing and Rou-kneading Huantiao (GB 30).Methods:A total of 64 male Sprague-Dawley (SD) rats were used in this study.Eighteen rats were randomly selected as a normal group,and the other 46 rats were used to duplicate the chronic constriction injury (CCI) model.Ten rats failed in modeling and 36 rats succeeded.These 36 rats were then randomly divided into a model group and a tuina group,with 18 rats in each group.The rats in the normal group and the model group did not receive any interventions,while those in the tuina group received An-pressing and Rou-kneading Huantiao (GB 30),1 min for each time,once a day,3 weeks in total.Heating tests were evaluated to observe the change of pain-sensitivity score before intervention,1 week after intervention,2 weeks after intervention,and 3 weeks after intervention.After 1 week of intervention,2 weeks of intervention,and 3 weeks of intervention,6 rats were randomly selected from each group respectively for brain extraction.The change of Nissl's body and β-endorphin in the accumbens nucleus as well as amygdaloid nucleus of pleasure circuits,and pro-opiomelanocortin (POMC) in the arcuate nucleus were analyzed by methods of histochemistry and molecular biology.Results:After modeling,the pain-sensitivity scores of the tuina group and the model group were statistically different from the score of the normal group (both P＜0.05).After An-pressing and Rou-kneading Huantiao (GB 30) for one week,the pain-sensitivity score of the tuina group had statistical difference compared with that of the model group (P＜0.05).At each different time point:the amounts of Nissl's body in accumbens nucleus and amygdaloid nucleus of the tuina group were significantly more than those of the model group (all P＜0.01).Besides,the numbers of β-endorphin immunoreactive cells in the accumbens nucleus and amygdaloid nucleus of the rats in the tuina group were significantly higher than those in the model group (all P＜0.01),and so was the expression of POMC in arcuate nucleus (all P＜0.01).Conclusion:An-pressing and Rou-kneading Huantiao (GB 30),where the sciatic nerve is ligated,can reduce pain-sensitivity score and increase pain tolerance value of rats with chronic neuralgia.It can increase the activity of neurons in accumbens nucleus and amygdaloid nucleus of pleasure circuits,which indicates that the analgesia effect of tuina therapy may correlate with pleasure effect,and also reveals a part of neurobiological mechanisms of neuralgia.

Effects of wrist-ankle acupuncture on associated factors in uterus tissue and serum in rats with primary dysmenorrhea / 针灸推拿医学（英文版）

Objective:To observe effects of wrist-ankle acupuncture (WAA) onβ-endorphin (EP), nitric oxide (NO) in uterus tissue and prostaglandin F2α (PGF2α), substance P (SP) in serum of rats with primary dysmenorrhea. Methods:A total of 45 non-pregnant Wistar rats were randomly divided into a control group, a model group and a WAA group, 15 rats in each group. Rats in the model group and the WAA group received continuous abdominal subcutaneous injection of Diethylstilbestrol to establish dysmenorrhea rat models. On the first day after modeling, rats in the WAA group began to receive acupuncture on Point Lower 1 and Point Lower 2, once a day for 10 d. The control group and the model group didn’t receive any treatment. Writhing latencies and frequencies were recorded.β-EP and NO in uterus tissue homogenates and PGF2α, SP in serum were detected. Results:In the model group,β-EP and NO levels were the lowest among the groups, the serum PGF2α level was the highest, and serum SP level was the lowest. These measurements showed significantly difference between the model group and the control group (P<0.05). PGF2α in the WAA group was lower than that in the model group;β-EP, NO and SP levels were higher than those in the model group, with inter-group statistically significant differences (P<0.05). Conclusion: WAA may achieve analgesic effect through decreasing PGF2α, increasingβ-EP, NO and SP to relieve uterine cramps, increase blood flow and promote functional improvement.

Role of μ opioid receptor exon 7 in analgesic efficacy of endomorphin-2 in rats / 中华麻醉学杂志

Objective To evaluate the role of μ opioid receptor exon 7 in the analgesic efficacy of endomorphin-2 in rats.Methods Twenty-four male Sprague-Dawley rats in which IT catheters were successfully implanted,weighing 220-260 g,were randomly divided into 3 groups (n =8 each) using a random number table:normal saline control group (group C),negative siRNA control group (group N-siRNA) andμ opioid receptor exon 7 siRNA group (group E7-siRNA).In C,N-siRNA and E7-siRNA groups,30μl saline solution,negative siRNA plasmid 20 μl + lipofectamine 2000 (10 μl),and μ opioid receptor siRNA plasmid 20μ1 + lipofectamine 2000 (10 μl) were intrathecally injected once a day for 3 consecutive days.The mechanical pain threshold was measured on 4th day (baseline).Endomorphin-2 10 μg was injected intrathecally at 1 h after measurement of the pain threshold.The mechanical pain threshold was measured at 5,20,40 and 60 min after endomorphin-2 injection,and the analgesic efficacy was calculated.Results There was no significant difference in the baseline pain threshold among the three groups.Compared with group C,no significant difference was found in the analgesic efficacy at each time point after endomorphin-2 injection in group N-siRNA,and the analgesic efficacy was significantly decreased at 5 and 20 min after endomorphin-2 injection in group E7-siRNA.Conclusion μ opioid receptor exon 7 is involved in the analgesic efficacy of endomorphin-2 in rats.

The effects of the levels of serum beta-endorphin and substance P on mechanical ventilated patients with midazolam combined with fentanyl / 中国医师进修杂志

Objective To evaluate the effects ofbeta-endorphin (β-EP) and substance P (SP)with sedative and analgesic drugs on mechanical ventilated patients. Methods Twenty-eight mechanical ventilated patients were randomly divided into two groups: midazolam group (M group, 14 cases) and midazolam combined with fentanyl group (M + F group, 14 cases). Eight healthy persons were as control group (C group). The sedative target was VAS≤3 scores and Ramsay 2-4 scores. The levels of serum β -EP and SP were tested before sedation and 12, 24 h after sedation in mechanical ventilated patients and at 8 Am in C group. The sedation levels were evaluated and the hemodynamie and respiratory parameters were recorded before sedation and 1, 12, 24 h after sedation in mechanical ventilated patients. The oxygenation index was measured before sedation and 1,12, 24 h after sedation. Results The levels of serum β -EP and SP in M and M+F group were significantly higher than those in C group(P< 0.05). After sedation, the level of SP in M+F group [(101.42 ± 12.46) ng/L]was significantly lower than that in M group [(132.72 ± 23.82) ng/L] (P < 0.05). Compared with before sedation, there were significant differences in heart rate, VAS and Ramsay scores between M group and M+F group (P< 0.05). Compared with M group, pressure airway and respiratory rate at 12, 24 h and total after sedation were lower in M+F group (P <0.05). The amount of serum SP in mechanical ventilated patients. Fentanyl improves the ventilator synehron and reduces the dose of midazolam.

Effect of endomorphin on colonic electromyography activity in endomorphin cathartic colon rats / 中华老年医学杂志

Objective To determine the effect of endomorphin (EM) on colonic electromyography activity and investigate the pathogenesis of slow transit constipation (STC). Methods An experimental rat model of slow transit constipation was constructed by contract laxatives mixed with the feed. The changes of colonic electromyography and reaction to endomorphin 1 and endomorphin 2 were examined. Results Compared with the control group, the frequency and amplitude of slow wave in cathartic colon rats were decreased significantly. Endomorphin 1 and endomorphin 2 significantly decreased the amplitudes of slow wave, but did not change the frequencies of slow wave. The effect of endomorphin 1 was more pronounced than that of endomorphin 2, which could be reversed by the morphine antagonist Naloxone in concentration-dependent manner. Endomorphin could not block the stimulating effect of acetylcholine. Conclusions Endomorphin can influence the colonic electromyography activity and intestine motility of cathartic colon rats, and may be involved in the pathologic mechanism of slow transit constipation.

Comparison of allodynic effect induced by intrathecal administration of nociceptin between two mouse strains / 中华麻醉学杂志

Objective To compare the allodynic effect of intrathecal nociceptin between Swiss albino and C57 BL mice. Methods The allodynic effect was evaluated by allodynic scores by light touching using paintbrush. The allodynic effect of intrathecal nociceptin was observed over 50 min after injection in two mouse strains in a double blind manner. Results The allodynia induced by nociceptin lasted for 50 min in Swiss albino and no dose-response relationship was observed from dose 5 fmol- 50 pmol per mouse. In C57 BL mice, allodynic effect lasted for 30 min and showed a bell-shaped dose-response curve from dose 10 frnol-1 nmol per mouse. Conclusion These results demonstrate that the allodynic eflect of intrathecal nociceptin is different between strains.

Detection of Serum Beta endorphin and its Clinical Significance in Patients with Psoriasis / 中华皮肤科杂志

In order to study the possible role of beta endorphin (? EP) in the pathogenesis of psoriasis, serum ? EP was detected by radioimmunoassay in 51 patients with psoriasis and 32 healthy controls. The results showed that serum ? EP level was markedly increased in patients with psoriasis in comparison with healthy controls. The serum ? EP level was reduced when the skin lesions of the patients were cleared after treatment, however, it was still higher than in healthy controls. Although there was a tendency towards an increase of ? EP in patients with precipitating factors in comparison with those without precipitating factors, their levels were not significantly different. There was a negative correlation between the intensity of pruritus and ? EP levels. It is suggested that ? EP involves in the pathogenisis of psoriasis. Its production and release were controlled by the central nervous system and also affected by the inflammation of skin lesions. There might be a causality between ? EP levels and inflammatory reaction of skin lesions.

The Effect of Naloxone on the Reversal of Hypovolemic Shock in Rats / 대한마취과학회지

The effects of morphine in bringing sleep and an end to pain have been known from the beginning of recorded history. But the existence of endogenous opiates(endorphin) has been demonstrated only in the last decade. Endorphin bind to opiate receptors and exhibit potent opiate-like activity. In the corticotroph cells of the anterior lobe of pitultary, ACTH and beta-endorphin are synthesized simultaneously. There is a hypothalamic releasing factor which causes the secretion both beta-endorphin and ACTH, but ACTH and beta-endorphine are also released simultaneously by stress. Endorphins adversely affect the circulatory status and these effects are reversed by the intravenous injection of the narcotic antagonist, naloxone. The author studied Dirksen's hypothesis that endorphins may be involved in the pathophysiology of hemorrhagic shock. In this experiment, the author divided in the pathophysiology of hemorrhagic shock. In this experiment, the author divided laboratory animals into 3 groups and administered normal saline, salicylate or hyprocortisone, respectively. l. normal saline pretreated group. ll. salicylate pretreated group. lll. hydrocortisone pretreated group. Each group was then divided into 4 subgroups and treated as follows: 1) hypovolemic shock + normal saline. 2) hypovolemic shock + naloxone. 3) hypovolemic shock + hydrocortisone. 4) hypovolemic shock + PGE1. The following results were obtained: 1) MAP was significantly increased after naloxone and PGE1 adminitration in the normal saline pretreated group. 2) MAP was not changed in the salicylate pretreated group. 3) MAP was significantly increased after naloxone and PGE1 administration in the hydrocortisone pretreated group. 4) Pulse pressure was significantly increased after anloxone, hydrocortisone and PGE1 administration in the normal saline and hydrocortisone pretreated groups. From the above experiment, it may be inferred that endorphins and prostaglandin may play a role in the pathophysiology of hypovolemic shock.

Plasma immunoreactive Beta-endorphin in response to oral glucose tolerance test in children with simple obesity / 中国病理生理杂志

We studied the immunoreactive Beta-endorphin (ir-?-Ep) plasma levels inresponse to an oral glucose tolerance test in 7 children with simple obesity and 7 childrenof normal weight. It was shown that the levels of ir-?-Ep and insulin were significantlyhigher in the obese children as compared to controls during oral glucose tolerance test,which reached a peak at 60 minutes. The result supports the concept of a possible linkbetween Beta-endorphin and glucose homeostasis.

The effects of intravenous administration of naloxone on the biphasic fever induced by endotoxin and on the normal body temperature in rabbits / 中国病理生理杂志

With 28 of new zealand rabbits, following observations were carried out: effects of intravnnous admiaistration of naloxone, an antagonist of opiate receptor, (1) on the biphasie fever induced by endotoxin; (2) on the body temperature of the normal rabbits. The results obtained indicated: the biphasic fever, which was induced by endotoxin at a dose of 5?g/kg was not changed significantly by the pretreatment of naloxone. However, the body temperature of normal rabbit was decreased to-0.46℃ following the administration of naloxone. The authors suggest that the endogenous opioid peptides are not necessary in the pathogenesis of the endotoxin biphasic fever. However, they play probably some role in the maintaining of physiological body temperature of the rabbit.

The Effect of Plasma ?-EP on Hemorrhagic Shock in Rats during Acute Hypoxia / 第三军医大学学报

40 rats were divided into 2 groups. At sea level and simulated high altitude of 4000m respectively, nalozone and saline are injected to observe the effect of nalozone on LVSP, LVDP, dp/dtmax, HR and survival time in hemorrhaged rats.blood plasma ?-EP is measured before and after bleeding to study the relation between ?-EP and hemorrhagic shock.Results: the circulatory parameters on hemorrhagic shock change more significantly at high altitude than at sea level; naloxone make these parameters recover and the survival time prolong both at sea level and high altitude; blood plasma ?-EP increases after bleeding, especially at high altitude-Suggestions; at high altitude hemorrbagic shock may be induced easilier.and symptomy is severer, development occurs rapider, and mortality higher is higher; change of ?-EP is related to the patholgical process of hemorhagic shock and the effect of ?-EP on cardiac contractility may be one of causes affecting bemorrbagic shock; naloxone has a role to antagonize hemorrhage shock at high altitude;