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OBJECTIVE@#To explore the relationship between high altitude polycythemia (HAPC) and peptic ulcer bleeding, in order to provide the evidence for the clinical diagnosis and treatment of peptic ulcer disease in Tibet of China.@*METHODS@#A retrospective case-control study was conducted. Patients who hospitalized in the Department of Gastroenterology with the diagnosis of peptic ulcer bleeding from January 1, 2015 to April 30, 2021 in Tibet Autonomous Region People's Hospital were enrolled in the case group, and patients who hospitalized in the Department of Urology without tumor and without the history of peptic ulcer and gastrointestinal bleeding during the same period were selected as the control group. In the study, 1 ∶ 1 case matching was conducted between the two groups according to the gender, age (±2 years), ethnic group (Tibetan, Han), and the residence altitude level (grouped by < 4 000 m or ≥4 000 m), and 393 cases were included in the case group and the control group respectively. All the patients had lived in Tibet with the altitude >2 500 m for more than 1 year, and with age ≥ 18 years. The risk factors of peptic ulcer bleeding (place of residence, smoking, alcohol, the use of NSAIDs/anticoagulants, and combined with chronic diseases, such as HAPC, hypertension, diabetes mellitus, heart disease, hyperlipidemia, cerebrovascular disease, chronic lung disease, joint disease) were analyzed and compared between the two groups.@*RESULTS@#There were 28 (7.1%) patients with HAPC in the case group, and 5 (1.3%) in the control group. The incidence of HAPC in the case group was significantly higher than those in the control group, P < 0.001, and the OR value was 5.953. Multivariate Logistic regression analysis showed that HAPC (OR=5.270, 95%CI: 1.806-15.380), living in cities and towns (OR=2.369, 95%CI: 1.559-3.602), alcohol (OR=3.238, 95%CI: 1.973-5.317) and the use of NSAIDs/anticoagulants (OR=20.584, 95%CI: 2.639-160.545) were the independent risk factors for peptic ulcer bleeding in Tibet. After adjusting for the possible confounding factors, such as living in cities and towns, alcohol, and the use of NSAIDs/anticoagulants, HAPC was associated with an increased risk of peptic ulcer bleeding in Tibet, and the OR value was 5.270.@*CONCLUSION@#HAPC was associated with a significantly increased risk of peptic ulcer bleeding in Tibet. Patients with HAPC and peptic ulcer should be diagnosed and treated actively, in order to avoid gastrointestinal bleeding and other serious complications.
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Adolescent , Humans , Altitude , Case-Control Studies , Peptic Ulcer/epidemiology , Polycythemia/epidemiology , Retrospective Studies , Risk FactorsABSTRACT
【Objective】 To investigate the quality changes of suspended red blood cells (SRBCs) prepared from the blood of Tibetan high Hb population, and explore the availability and safety of blood collected from Tibetan high Hb population. 【Methods】 The voluntary blood donors were grouped according to the Hb concentration at the initial screening: female blood donors from Tibet Autonomous Region (>3 500 m) with Hb≥190 g/L and male blood donors with Hb≥210 g/L were classified as plateau high hemoglobin group. A total of 13 male blood donors from Tibet Autonomous Region were recruited. And the female blood donors (n=13) with Hb(115~165) g/L and male blood donors (n=12) with Hb(120~185) g/L from Chengdu were classified as control group. Whole blood of 200 mL specification was centrifuged to remove the plasma, and MAP additive solution was added to prepare SRBCs, then SRBCs were divided into four aliquots (50 mL/bag and stored at 4℃. Parameters as blood routine, free Hb and hemolysis rate were measured aseptically at day 1, 14, 21, 35 of storage. And 10 mL SRBCs was used to extract membrane proteins for tyrosine phosphorylation detection of band 3 protein. 【Results】 The RBCs counts(×1012/L), hematocrit(%) and hemoglobin(g/L) of Tibetan high Hb group and control group were 6.76±0.95 vs 4.65±0.52, 63.3±6.8 vs 43.1±4.4 and 214.4±19.8 vs 143.2±16.9 (P<0.01). The erythrocyte deformability test on the day 1, 14, 21, 35 of storage showed that the deformability of SRBCs prepared from Tibetan high Hb group was significantly lower than that of the control group under shear stress of 3, 5.33, 9.49, 16.87, and 30 Pa, while the hemolysis rate of SRBCs prepared from the Tibetan high Hb group and the control group on the day 1, 14, 21, 35 were 0.050 2±0.040 2 vs 0.022 2±0.011 1, 0.055 4±0.043 vs 0.032 1±0.028 7, 0.061 2±0.025 9 vs 0.034 3±0.031 7 and 0.069 6±0.032 0 vs 0.044 0±0.033 3 (P<0.05). Western blotting showed that the cytoplasmic N-terminal Y21 of band 3 protein of SRBCs prepared from Tibetan high Hb group was highly phosphorylated. 【Conclusion】 The deformability of SRBCs prepared from the Tibetan high Hb group was significantly lower while the hemolysis rate of SRBCs was higher than that of the control group. The hemolysis rate of the SRBCs at the end of storage prepared from the Tibetan high Hb group meets the requirements of the national standard GB18469-2012(<0.8%). The increase of hemolysis rate of SRBCs prepared from the Tibetan high Hb group was closely related to the phosphorylation of band 3 protein.
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Objective: To investigate the effects of salidroside on the structure and function of erythrocyte membrane in rats with high altitude polycythemia (HAPC), and to provide the scientific basis for the mechanism of salidroside preventing and treating HAPC. Methods: A total of 40 Wistar rats were randomly divided into five groups, control group, HAPC model group, salidroside high-dose (200 mg/kg), medium-dose (100 mg/kg), and low-dose (50 mg/kg) groups, four female and four male rats in each group. In addition to the control group, the remaining four groups established the HAPC model. The rats in the control group and model group were ig administered with saline, and rats in salidroside group were treated with different doses of salidroside at the same time. The dosage volume was 10 mL/kg, and once a day for 40 d. After the administration, blood was collected from femoral artery of the rats. Biochemical and enzyme-linked immunoassay were used to determine the lipid fluidity of erythrocyte membrane, total cholesterol content, total phospholipids content, the content of phospholipid components including phosphatidic acid (PA), phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylserine (PS), the activity of Na+, K+-ATPase and Ca2+, Mg2+-ATPase on erythrocyte membrane, and the concentrations of Na+ and Ca2+ in erythrocyte. Results: Salidroside can significantly improve the lipid fluidity, total phospholipids, PA, PC, PE, and PS content of erythrocyte membrane, and improve the activity of Na+, K+-ATPase and Ca2+, Mg2+-ATPase of erythrocyte membrane in HAPC rats. Total cholesterol content on erythrocyte membrane, and the concentrations of sodium and calcium in erythrocyte were significantly reduced. Conclusion: These findings suggested that salidroside can improve the function of erythrocyte membrane and cell metabolic activities by regulating the lipid composition of erythrocyte membrane, thereby alleviating the symptoms associated with high altitude polycythemia.
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<p><b>OBJECTIVE</b>To explore the protective effects of Tibetan medicine Zuo-Mu-A Decoction (, ZMAD) on the blood parameters and myocardium of high altitude polycythemia (HAPC) model rats.</p><p><b>METHODS</b>Forty male Wistar rats were randomly divided into 4 groups by a random number table, including the normal, model, Rhodiola rosea L. (RRL) and ZMAD groups (10 in each group). Every group was raised in Lhasa to create a HAPC model except the normal group. After modeling, rats in the RRL and the ZMAD groups were administered intragastrically with RRL (20 mL/kg) and ZMAD (7.5 mL/kg) once a day for 2 months, respectively; for the normal and the model groups, 5 mL of distilled water was administered intragastrically instead of decoction. Then routine blood and hematologic rheology parameters were taken, levels of erythropoietin and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were tested, and ultrastructural change in the left ventricular myocardium was observed using transmission electron microscopy.</p><p><b>RESULTS</b>Compared with the model group, ZMAD significantly reduced the red blood cell count, hemoglobin levels, whole blood viscosity at low/middle shear rates, plasma viscosity, erythrocyte electrophoretic time, erythropoietin and 8-OHdG levels, and also increased the erythrocyte deformation index (P<0.05). There was no difference in all results between the RRL and the ZMAD groups. The cardiac muscle fibers were well-protected, mitochondrial matrix swelled mildly and ultrastructure changes were less prominent in the ZMAD group compared with the model group.</p><p><b>CONCLUSION</b>ZMAD has significant protective effects on the blood parameters against HAPC, and also has the beneficial effect in protecting against myocardial injury.</p>
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Objective To investigate the risk factors for ischemic stroke in patients of Aba Tibetan and Qiang Autonomous Prefecture. Methods From March 2012 to March 2014,314 consecutive patients with ischemic stroke admitted to the Department of Neurology,Aba Tibetan and Qiang Autonomous Prefecture People′s Hospital,Sichuan Province were enrolled respectively. All patients were Tibetans. They were divided into either an observation group (n = 105)or a control group (n = 209)according to whether they had high-altitude polycythemia or not. The observation group was the patients with high-altitude polycythemia complicated with ischemic stroke,and the control group was the patients with ischemic stroke without high-altitude polycythemia. The risk factors for onset of stroke in both groups were compared,and the single factor indices with statistical significance were analyzed by multiple logistic regression analysis. Results There were significant differences in hypercholesteremia,history of heavy smoking,and family history of stroke between the observation group and the control group (χ2 values were 6. 489,8. 107,and 11. 206,respectively;P values were 0. 011,0. 004,and 0. 001,respectively). There were no significantly difference in other stroke risk factors between the 2 groups (all P > 0. 05). Multiple logistic regression analysis showed that hypercholesteremia,history of heavy smoking,and family history of stroke were the independent risk factors for high-altitude polycythemia complicated with ischemic stroke (hypercholester-emia:OR,4 . 799 ,95 % CI 1 . 266 - 3 . 148 ,P = 0 . 028;history of heavy smoking:OR,4 . 539 , 95 % CI 1. 061 -4. 182,P =0. 033;family history of stroke:OR,3. 549,95% CI 1. 279 -5. 377,P =0. 008). Conclusions Hypercholesteremia,history of heavy smoking,and family history of stroke,are the independent risk factors for ischemic stroke. The prevention of stroke in the local area should be targeted at the geograph-ical and population characteristics.
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[ ABSTRACT] AIM:To investigate the expression relevance of transcription factors GATA-1 and GATA-2 in the bone marrow CD71 +cells of a high-altitude polycythemia (HAPC) rat model.METHODS:Male SD rats (n=48) were randomly divided into normal control group and HAPC model group .HAPC model was established at an altitude of 4 300 m in the natural environment and verified by the morphology and quantity of the bone marrow cells and hematologic parameters detection .A relative change in the trend of bone marrow CD 71 +cell numbers was detected by flow cytometry analysis .The expression of GATA-1 and GATA-2 at mRNA and protein levels in the CD 71 +cells was examined by RT-qPCR and West-ern blot .CD71 +cells were cultured under hypoxic condition and transfected with the optimal interference sequence of GA -TA-1shRNA1 for 96 h.The expression of GATA-1 and GATA-2 at mRNA and protein levels was detected by RT-qPCR and Western blot .RESULTS:The establishment of the animal model with HAPC was successful as the bone marrow smears and the hematologic parameters showed compared with the control .The quantity of the bone marrow CD 71 +cells of HAPC rats were significantly increased and the expression of GATA-1 at mRNA and protein levels in the CD 71 +cells were higher than those of the control .The expression of GATA-2 at mRNA and protein levels was similar to that of the control .The correla-tion analysis showed that the expression of GATA-1 was negatively correlated with that of GATA-2 in the control, while no obvious correlation between them was observed in the HAPC rats .The expression of GATA-1 at mRNA and protein levels in HAPC group was lower than that in control group after interfered by GATA-1 shRNA1 for 96 h, but no obvious diversity of GATA-2 expression between the 2 groups was observed .CONCLUSION:GATA-1 and GATA-2 are abnormally expressed and their negative correlation is destroyed in HAPC , which may be one of the pathogenesis of HAPC .
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Objective To investigate changes of coagulation function in patients with high altitude polycythemia (HAPC) .Meth‐ods Activated partial thromboplastin time (APTT) ,prothrombin time (PT) ,thrombin time (TT) and fibrinogen (Fbg) were de‐tected and compared between 69 patients with HAPC and 60 healthy subjects (controls) .Results Fbg ,APTT and TT levels in pa‐tients with HAPC were higher than controls (P0 .05) .Dynamic obser‐vation indicated that comprehensive therapy could these recover coagulation function .Conclusion Hemorrhage and coagulation process in patients with HAPC could be very complicated ,including physiological adaptation and the process of physiology evolving into pathology .
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High altitude polycythemia (HAPC) had become one of the main common chronic diseases, which had seriously threatened the health of Plateau people. In the Tibetan medicine classic bookSi-Bu Yi-Dian, there were recordings on HAPC treatment methods and medications, which had the unique advantages of identified therapeutic effect with little side effect. This article analyzed Tibetan medicine in the prevention and treatment of HAPC from aspects such as etiology and pathogenesis, clinical treatment advantages and modern innovation study. Questions were also raised on lacking of standardization on HAPC clinical effectiveness, as well as Tibetan medicine compound material basis and action mechanisms were unclear. It was proposed that based on the inheritance of Tibetan medicine theoretical basis and clinical therapeutic effect, the Tibetan medicine original thinking should be combined with modern science and technology, in order to strengthen the analysis of ancient literature collection in HAPC treatment and data mining in medication experiences. The clinical treatment standards and medication plan should be standardized. Methods of systems biology, such as metabolomics, can be used in the further study of the scientific connotation of HAPC treatment by Tibetan medicine.
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The article was aimed to study the influence of low pressure and hypoxia on rat metabolism and evaluate the intervention effect of San-Guo-Tang-San (SGTS) on high altitude polycythemia (HAPC) rats. A total of 25 rats were divided into the plain control group, high altitude model group, Hong-Jing-Tian capsule (Nuo-Di-Kang cap-sule) group, high-dose SGTS group and low-dose SGTS group, with 5 rats in each group. After one week adaptation, rats in the model group and the medication groups were put into the hyperbaric chamber for 40 days (22 h/d) to simulate high altitude environment of 5 000 m. In the end of 40th day, the hemorheology and the dry/wet weight ratio of lung of rats were measured. And plasma samples were derivatized with ECF prior to GC-MS instrumental analysis. Principal component analysis (PCA) was used to find potential biomarkers, and evaluate the intervention effects of SGTS. The results showed that the low pressure and hypoxia changed the hemorheology and dry/wet weight ratio of lung of rats markedly. Metabolomics studies showed that the high altitude model group, high-dose SGTS group, low-dose SGTS group, and Hong-Jing-Tian capsule group can be obviously differentiated. Main markers such as 9-hexylheptadecane, glycine, N-methyl-N-methoxycarbonyl-ethyl ester, 2,4-Di-tert-butylphenol, were found to be the endogenous substances of SGTS which intervening the HAPC rats. It was concluded that SGTS can intervene low pressure and hypoxia induced HAPC.
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Objective To evaluate the efficacy and safety of oxygen inhalation combined with oral administration of soy isoflavones on people who migrated from plains to high altitude area suffering from polycythemia. Methods Eighty young men, who migrated to the area of altitude of 3500~5300m for more than ten months, and their hemoglobin (HGB) level was verified in the range of 190g/L≤HGB 0.05). Multiple linear regression analysis revealed that the affecting factors of HGB that the change in HGB values was significantly associated with test grouping. In addition, there were no obvious side effects and changes in BP, ECG, chest X-ray, liver and kidney functions before and after soy isoflavones intake. Conclusion In high-altitude area, oxygen and oral administration of soy isoflavones are safe and more effective measure in the early prevention of high altitude polycythemia.