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RESUMEN Fundamento: la hiperactividad simpática paroxística consiste en episodios autolimitados de hipertensión arterial, taquicardia, taquipnea, hiperhidrosis, disminución del nivel de conciencia, aumento del tono muscular con postura en extensión, hipertermia, sialorrea y midriasis. Con frecuencia se retrasa su reconocimiento lo que incrementa la morbilidad y mortalidad. Objetivo: conocer la importancia de un diagnóstico y tratamiento precoz de la enfermedad para mayor supervivencia del paciente afectado. Presentación del caso: paciente de 33 años de edad, femenina, que desarrolló una hiperactividad simpática paroxística asociada con hidrocefalia obstructiva. Conclusiones: debe sospecharse la enfermedad en pacientes con daño cerebral agudo de diversas causas. El diagnóstico temprano es vital para evitar estudios diagnósticos e intervenciones innecesarias e iniciar un tratamiento rápido y apropiado que modifique la evolución del síndrome.
ABSTRACT Background: paroxysmal sympathetic hyperactivity consists of self-limited episodes of arterial hypertension, tachycardia, tachypnea, hyperhidrosis, decreased level of consciousness, increased muscle tone with extension posture, hyperthermia, sialorrhea and mydriasis. Frequently their recognition is delayed, which increases morbidity and mortality. Objective: to make known the importance of an early diagnosis and treatment of the entity for greater survival of the affected patient. Case report: a 33-years-old female patient who developed a paroxysmal sympathetic hyperactivity associated with obstructive hydrocephalus. Conclusions: the entity should be suspected in patients with acute brain damage of various etiologies. Early diagnosis is vital to avoid unnecessary diagnostic studies and interventions and to initiate a rapid and appropriate treatment that modifies the evolution of the syndrome.
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Objective@#To evaluate the effect of ixeris sonchifolia pretreatment on the expression of hypoxia-inducible factor-1α (HIF-1α) following myocardial injury induced by exhausting exercise in rats.@*Methods@#Fifty-six healthy clean-grade male Wistar rats, weighing 200-220 g, were divided into 3 groups using a random number table method: control group (group C, n=8), exhausting exercise group (group E, n=24) and ixeris sonchifolia pretreatment group (group IS, n=24). In E and IS groups, the model of myocardial injury was established by exhausting swimming.In group IS, the rats were subjected to exhausting swimming after intraperitoneal ixeris sonehifolia 20 ml/kg.In E and IS groups, blood samples were taken from the inferior vena cava at 0, 6 and 24 h after exhaustion (T1-3) for determination of serum cardiac troponin I (cTnI) concentrations by enzyme-linked immunosorbent assay.The animals were sacrificed after anesthesia, and myocardial specimens were obtained for determination of the cell apoptosis index (by TUNEL) and expression of HIF-1α, Bax and Bcl-2 (by immunohistochemistry), and Bax/Bcl-2 ratio was calculated.The area of myocardial injury was observed using HBFP assay.@*Results@#Compared with group C, the area of myocardial injury, concentration of serum cTnl, Bax/Bcl-2 ratio and apoptosis index were significantly increased, and the expression of HIF-1α in myocardial tissues was up-regulated at each time point in E and IS groups (P<0.05). Compared with group E, the area of myocardial injury, concentration of serum cTnl, Bax/Bcl-2 ratio and apoptosis index were significantly decreased, and the expression of HIF-1α in myocardial tissues was down-regulated at each time point in group IS(P<0.05).@*Conclusion@#The mechanism by which ixeris sonchifolia pretreatment mitigates myocardial injury induced by exhausting exercise is related to inhibiting up-regulated expression of HIF-1α in myocardial tissues and reducing cell apoptosis in rats.
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Objective To evaluate the effect of ixeris sonchifolia pretreatment on the expression of hypoxia-inducible factor-1α(HIF-1α)following myocardial injury induced by exhausting exercise in rats.Methods Fifty-six healthy clean-grade male Wistar rats,weighing 200-220 g,were divided into 3 groups using a random number table method: control group(group C,n＝8),exhausting exercise group(group E,n＝24)and ixeris sonchifolia pretreatment group(group IS,n＝24).In E and IS groups,the model of myocardial injury was established by exhausting swimming.In group IS,the rats were subjected to exhaust-ing swimming after intraperitoneal ixeris sonehifolia 20 ml/kg.In E and IS groups,blood samples were taken from the inferior vena cava at 0,6 and 24 h after exhaustion(T1-3)for determination of serum cardiac tro-ponin I(cTnI)concentrations by enzyme-linked immunosorbent assay.The animals were sacrificed after an-esthesia,and myocardial specimens were obtained for determination of the cell apoptosis index(by TUNEL)and expression of HIF-1α,Bax and Bcl-2(by immunohistochemistry),and Bax/Bcl-2 ratio was calculated.The area of myocardial injury was observed using HBFP assay.Results Compared with group C,the area of myocardial injury,concentration of serum cTnl,Bax/Bcl-2 ratio and apoptosis index were significantly in-creased,and the expression of HIF-1α in myocardial tissues was up-regulated at each time point in E and IS groups(P＜0.05).Compared with group E,the area of myocardial injury,concentration of serum cTnl,Bax/Bcl-2 ratio and apoptosis index were significantly decreased,and the expression of HIF-1α in myocardi-al tissues was down-regulated at each time point in group IS(P＜0.05).Conclusion The mechanism by which ixeris sonchifolia pretreatment mitigates myocardial injury induced by exhausting exercise is related to inhibiting up-regulated expression of HIF-1α in myocardial tissues and reducing cell apoptosis in rats.
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BACKGROUND:No uniform standard for constructing the animal model of exercise-induced myocardial ischemia injury results in the incomparability among research results and impedes the development of sport medicine especial y in the cardiovascular field;thereby, it is imperative to reach an agreement in constructing criteria. OBJECTIVE:To explore the method of establishing the rat model of myocardial ischemia induced by running. METHODS:Total y 96 female Sprague-Dawley rats were randomly divided into rest control group, isoprenaline group and 10 exercise groups (1-and 3-time moderate-intensity exercise groups, 1-, 2-and 3-week moderate-intensity exercise groups, 1-and 3-time high-intensity exercise groups, 1-, 2-and 3-week high-intensity exercise groups). After exhaustive exercise, myocardium was col ected for morphological observation by hematoxylin-eosin staining, serum levels of myocardial enzymes and cardiac troponin I were detected, and the expressions of Bcl-2 and Bax were detected by real-time PCR. RESULTS AND CONCLUSION:(1) Hematoxylin-eosin staining showed that the damage degree was more severe with the time of exercise, and the high-intensity exercise groups were more severe than those in the moderate-intensity exercise groups. (2) The activity of serum glutamic-oxaloacetic transaminase and lactic dehydrogenase was significantly increased after 1-week moderate-intensity exhaustive exercise (P<0.05 or P<0.01). From the beginning of the 3-time high-intensity exhaustive exercise, the activity of glutamic-oxaloacetic transaminase and lactic dehydrogenase was significantly increased (P<0.05 or P<0.01). (3) Cardiac troponin I content change trend was basical y the same as glutamic-oxaloacetic transaminase and lactic dehydrogenase changes, but cardiac troponin I content in the moderate-intensity exhaustive exercise groups was significantly higher than that in the rest control group until 2 weeks. The Bcl-2/Bax ratios in al exercise groups were significantly lower than that in the rest control group (P<0.05 or P<0.01);those in the 1-and 3-time high-intensity exercise groups were significantly higher than in the isoprenaline group (P<0.05 or P<0.01);and those in moderate-intensity groups were higher than in the isoprenaline group (P<0.05 or P<0.01). (4) In conclusion, 2-week high-intensity and 3-week moderate-intensity exhaustive exercise can induce myocardial ischemia injury, and pathological analysis, serum levels of myocardial enzymes and cardiac troponin I can be used as the evaluation indexes, while apoptosis regulation genes just as the reference index.
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BACKGROUND:It is unclear whether hydrogen-rich water can be used to protect skeletal muscle injury induced by eccentric exercise, as wel as the relative mechanism. OBJECTIVE:To observe the effect of hydrogen-rich water on the mitochondrial oxidative stress and inflammation in rat skeletal muscle after eccentric exercise, and to investigate the relative signaling pathway of hydrogen-rich water. METHODS:Forty Sprague Dawley rats were randomly divided into four groups: control group, eccentric exercise group, eccentric exercise+saline group, and eccentric exercise+hydrogen-rich water group. Rats in three eccentric exercise groups were exercised on a motor-driven rodent treadmil at a speed of 16-18 m/min and a slope of-16° for 90 minutes per day. Rats in the eccentric exercise+hydrogen-rich water group were subjected to intraperitoneal injection of hydrogen-rich water (10 mL/kg) immediately after exercise; and rats in the eccentric exercise+saline group were administrated with normal saline after exercise. Al the interventions lasted for 5 days. RESULTS AND CONCLUSION:Hydrogen-rich water intervention after eccentric exercise could markedly enhance the mitochondrial Sirtuin-3 expression, improve the mitochondrial membrane potential and activity of manganese superoxide dismutase, down-regulate the mitochondrial reactive oxygen species generation and mitochondrial DNA oxidative damage, thus inhibiting inflammatory cytokines expression, such as NLRP3 and interleukin-1β. The results indicated that hydrogen-rich saline could directly scavenge reactive oxygen species. In addition, hydrogen-rich water could improve mitochondrial energy metabolism and antioxidant capacity through up-regulation of Sirtuin-3, which in turn inhibits eccentric exercise-induced mitochondrial oxidative stress and secondary inflammation in the skeletal muscle.
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Physical training induces beneficial adaptations,but long excessive exercise may lead to severe damage to the skeletal muscles,liver,heart,kidneys and immune functions. Over the past few decades,health scholars have been searching for natural components that can prevent or improve the damage induced by hyperkinesis. The mechanisms of organ damage induced by long overtraining include immunosuppression,metabolism disorder,hormone disturbance,oxidative damage, etc. Natural poly-saccharides have interventional effects on these injuries,possibly by improving immunity,regulating metabolism and ameliorating free radical damage.
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Objective To evaluate the effect of ixeris sonchifolia on mitochondrial transcription factor A (mtTFA) expression following myocardial injury induced by exhausting exercise in rats.Methods Forty male Wistar rats,weighing 200-220 g,were randomly divided into 3 groups using a random number table:control group (group C,n =8),exhausting exercise group (group ES,n =16) and ixeris sonchifolia group (group IS,n =16).The model of myocardial injury was established by exhausting swimming.In IS group,the rats were subjected to exhausting swimming after intraperitoneal ixeris sonchifolia 20 g/kg.In ES and IS groups,8 rats were chosen at 6 and 24 h after exhaustion,and blood samples were taken from the inferior vena cava for determination of serum cardiac troponin I (cTnI) concentrations by ELISA.The animals were sacrificed after blood sampling and myocardial specimens were obtained for microscopic examination and for determination of mtTFA expression by Western blot.Results Compared with group C,the concentration of serum cTnI was significantly increased,and the expression of mtTFA in myocardial tissues was down-regulated at 6 and 24 h after exhaustion in ES and IS groups.Compared with group ES,the concentration of serum cTnI was significantly decreased,and the expression of mtTFA in myocardial tissues was up-regulated at 6 and 24 h after exhaustion in group IS.Conclusion Ixeris sonchifolia can reduce exhausting exercise-induced myocardial injury through up-regulating myocardial mtTFA expression in rats.
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Objective To investigate the effects of Inula Britannica on myocardial caspase-3 and cytochrome c ( cyt c) following overtraining-induced acute myocardial injury in rats.Methods Forty-eight male Wistar rats weighing 200-220 g were randomly divided into 3 groups:group control (group C,n =8) ; group exhausting swim (group E,n =24) and group Inula Britannica (group IB,n =16).The animal model of overtraining-indnced acute myocardial injury was developed by exhausting swim.The animals were forced to swim until they were exhausted.The animals sank to the bottom and no righting reflex or escape response was elicited when they were taken out of water in groups E and IB.In group IB oral Inula Britannica 25 ml/kg was given 24 h and immediately before overtraining.Blood samples were taken from inferior vena cava immediately and at 6,24 h after overtraining in group E and at 6,24 h after overtraining in group IB for determination of serum cardiac troponin I (cTnI) concentration (by ELISA).The animals were sacrificed after blood sampling and myocardial specimens were obtained for microscopic examination and determination of caspase-3 and cyt c expression (by immuno-histochemistry).Results Overtraining significantly increased serum cTnI concentration and up-regulated myocardial caspase-3 and cyt c expression in group E as compared with group C.Oral Inula Britannica significantly attenuated overtraining-induced increase in serum cTnI concentration and myocardial caspase-3 and cyt c expression in group IB as compared with group E.Conclusion Inula Britannica can reduce overtraining-induced acute myocardial injury by down-regulating caspase-3 and cyt c expression.
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Objective To evaluate the effect of anisodamine on expression of Toll-like receptor 4 (TLR4) in the kidneys of exhausted rats.Methods Forty-eight male SD rats weighing 200-220 g were randomly divided into 3 groups:control group (group Ⅰ ) (.n =8) ; exhaustion group (group Ⅱ ) ( n =24) and anisodamine group (gronp Ⅲ) (n =16).In groups Ⅱ and Ⅲ exhaustion was induced by exhausting swimming and defined by (1) the animal sank to the bottom and stayed for＞ 10 s during swimming,(2) uncoordinated swimming,and (3) the animal lost escape/righting reflex when placed on the table In group Ⅲ intraperitoneal anisodamine 10 mg/kg was administered at 20 min before swimming.The animals were sacrificed immediately (T1 ),6 h (T2 ) and 24 h (T3 ) after exhaustion respectively.Their kidneys were obtained for detection of apoptosis and determination of TLR4 protein (by immuno-histochemical staining) and mRNA (by RT-PCR).Results Exhaustion significantly increased the number of apoptotic cells and up-regulated TLR4 protein and mRNA expression in group Ⅱ as compared with group Ⅰ,and anisodamine significantly attenuated the exhaustion-induced increase in the number of apoptotic cells and up-regulation of TLR4 protein and mRNA expression in group Ⅲ as compared with group Ⅱ.Conclusion Anisodamine can decrease apoptosis in renal cells in exhausted rats bydown-regulating TLR4 expression.
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ObjectiveTo investigate effects of anisodamine on myocardial caspase-1 and interleukin-18 expression following overtraining-induced acute myocardial injury in rats.Methods Forty-eight male Wistar rats weighing 200-220 g were randomly divided into 3 groups:group control (group C,n =8) ; group exhausting swim (group ES,n =24) and group anisodamine (group AD,n =16).The animal model of overtraining-induced acute myocardial injury was developed by exhausting swim The animals were forced to swim until they were exhausted.The animals sank to the bottom and no righting reflex or escape response was elicited when they were taken out of water in groups ES and AD.In group AD anisodamine 10 mg/kg was given intraperitoneally 20 min before overtraining.Blood samples were taken from inferior vena cava immediately (T1) and at 6 and 24 h after overtraining (T2,T3 ) in group ES and at T2,T3 in group AD for determination of serum cardiac troponin 1 (cTnI) concentration (by ELISA).The animals were sacrificed after blood sampling and myocardial specimens were obtained for microscopic examination and determination of caspase-1 and interleukin-18 expression (by immuno-histochemistry).ResultsOvertraining significantly increased serum cTnI concentration and up-regulated myocardial caspase-1 and interleukin-18 expression in group ES as compared with group C.Anisodamine significantly attenuated overtraining-induced increase in serum cTnI concentration and myocardial caspase-1 and interleukin-18 expression in group AD as compared with group ES.ConclusionAnisodamine can reduce overtraining-induced acute myocardial injury by down-regulating caspase-1 and interleukin-18 expression.
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Acquired hepatocerebral degeneration (AHD) and hepatolenticular degeneration can have similar clinical presentations, but when a chronic liver disease and atypical motor findings coexist, the distinction between AHD and hepatic encephalopathy (HE) can be even more complicated. We describe three cases of AHD (two having HE) with different neuroimaging findings, distinct hepatic diseases and similar motor presentations, all presenting chronic arterial hypertension and weight loss before the disease manifestations. The diagnosis and physiopathology are commented upon and compared with previous reports. In conclusion, there are many correlations among HE, hepatolenticular degeneration and AHD, but the overlapping of AHD and HE could be more common depending on the clinical knowledge and diagnostic criteria adopted for each condition. Since AHD is not considered a priority that affects the liver transplant list, the prognosis in AHD patients remains poor, and flow interruption in portosystemic shunts must always be taken into account.
A degeneração hepatocerebral adquirida (AHD) e a degeneração hepatolenticular podem ter apresentações clínicas semelhantes, mas quando uma doença hepática crônica e achados motores atípicos coexistem, a distinção entre AHD e encefalopatia hepática (HE) pode ser ainda mais complicada. Descrevemos três casos de AHD (dois tendo HE) com diferentes achados em neuroimagem, doenças hepáticas distintas e apresentações motoras semelhantes, todos com hipertensão arterial e perda de peso antes das manifestações motoras. O diagnóstico e a fisiopatologia são comentados e comparados com relatos prévios. Concluímos que existem muitas correlações entre HE, degeneração hepatolenticular e AHD, mas a sobreposição de HE e AHD pode ser mais comum dependendo do conhecimento clínico e da acurácia dos critérios diagnósticos adotados para cada enfermidade. Como a AHD não é considerada prioridade na lista de transplante hepático, o prognóstico dos pacientes com AHD permanece ruim, e a interrupção do fluxo nos shunts portossistêmicos deve ser sempre considerada.
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Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Encefalopatia Hepática/diagnóstico , Hepatite Autoimune/diagnóstico , Degeneração Hepatolenticular/diagnóstico , Cirrose Hepática/diagnóstico , Antidiscinéticos/uso terapêutico , Diagnóstico Diferencial , Progressão da Doença , Haloperidol/uso terapêutico , Encefalopatia Hepática/tratamento farmacológico , Encefalopatia Hepática/fisiopatologia , Hepatite Autoimune/fisiopatologia , Degeneração Hepatolenticular/tratamento farmacológico , Degeneração Hepatolenticular/fisiopatologia , Cirrose Hepática/fisiopatologia , Imageamento por Ressonância Magnética , Prognóstico , Índice de Gravidade de DoençaRESUMO
Objective To investigate the effects of intra-articular hyaluronan(HA)injection on the expression of cartilage oligomeric matrix protein(COMP)in synovium of strenuous running rats,and investigate the possibility of predicting the effectiveness of HA based on COMP in synovium.Methods 36 healthy male Wistar rats were randomly divided into control group,strenuous running group and strenuous running group and HA injection group.Strenuous running group and HA injection group were intra- articularly injected with HA once a week for 5 consecutive weeks.The histological changes of synovium of knee joint was examined by H.E.staining and immunohistochemical expression of COMP in three groups after 6 weeks' strenuous running.Results Synovial inflammation was less severe in strenuous running and HA injection group than strenuous running group(t =7.15,P ＜0.01).The immunohistochemical expression of COMP in rats'synovium of knee joint in strenuous running and HA injection group was significantly lower than that in rats'synovium in strenuous running group(t = 6.30,P ＜ 0.01).Conclusions Intra- articular HA injection suppressed synovitis,and the expression of COMP in synovium could be used to predict the effectiveness of HA.
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Pesquisas recentes demonstram a relação direta da leptina na regulação do balanço energético e como um dos fatores envolvidos em transtornos alimentares. Com ação no sistema nervoso central, a leptina interfere na ingestão alimentar, no metabolismo da glicose, no peso corporal, na produção de hormônios sexuais e na atividade física. As pesquisas realizadas tanto em seres humanos como em animais demonstram que a queda nos níveis de leptina está relacionada aos sintomas apresentados na anorexia nervosa: a baixa ingestão alimentar, a perda excessiva de peso corporal, a amenorréia e a hiperatividade. Assim, o grau de hipoleptinemia não é apenas uma forte indicação de baixa reserva de tecido adiposo, mas também de severa desordem, sendo que os níveis de leptina podem ser utilizados para avaliar melhor a gravidade da doença. Pesquisas estão sendo realizadas com o objetivo de discutir a possibilidade de utilização da leptina como coadjuvante no tratamento de pacientes com anorexia nervosa para a diminuição da hiperatividade. Acredita-se que o tratamento com leptina associado à medicação e à psicoterapia, poderia ser benéfico em pacientes anoréxicas extremamente ativas, deixando-as mais suscetíveis ao tratamento adicional. Uma realimentação suficiente, a medicação, a psicoterapia e um ambiente acolhedor durante o tratamento com leptina devem ser assegurados. Assim, este artigo tem como objetivo discorrer sobre a leptina e aspectos relacionados à anorexia, e discutir como esta informação pode ser importante na avaliação clínica de pacientes com este transtorno alimentar.
Recent studies have demonstrated a direct relationship between leptin and the regulation of energy balance, and as a factor involved in eating disorders. Acting on the central nervous system, leptin affects food intake, glucose metabolism, body weight, the production of sexual hormones, and physical activity. Studies with humans and animals indicate that low leptin levels are related to symptoms of anorexia nervosa: low food intake, excessive loss of body weight, amenorrhea and hyperactivity. Thus, the degree of hypoleptinemia is not only a strong indication of low reserves of adipose tissue, but also of a severe disorder, and leptin levels can be used to better evaluate the seriousness of the disease. Research has aimed to study the use of leptin in the treatment of patients with AN, and positive results have been obtained in the reduction of hyperactivity. It is possible that leptin treatment associated with medication and psychotherapy can be beneficial for extremely active anorexia nervosa patients, making them more susceptible to further treatment. Adequate food intake, medication, psychotherapy, and a comfortable environment during leptin treatment should be ensured. Thus, this article aims to describe leptin and aspects related to anorexia, and discuss how this information can be important in the clinical evaluation of patients with this eating disorder.
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Anorexia Nervosa/tratamento farmacológico , Hipercinese/tratamento farmacológico , Leptina/uso terapêuticoRESUMO
Objective To study the influence of interim overload exercise on health and it's biochemical mechanism.Methods 45 Wistar rats were randomly divided to three groups(n=15):no exercises group(control,C),normal exercise group(NE,the rats ran in the animal running machines at 15 m?min-1for 5 d in one week,exercise time was 30 min?2,and rested for 10 min after ran for 30 min),overload exercise group(OE,the rats exercised 2 bouts,2 d in consecutive in one week,exercise time was 100 min?2,and they rested for 10 min after ran for 100 min).After training for 8 weeks,the rats in three groups were sacrificed and 15 biochemical indexes in blood of rats were determined.Results Compared with C and NE groups,CK,LDH,and ALT increased obviously(P
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【Objective】To observe the effect of liguistrazine(Liz)on cerebral and serum monoamine neurotransmitter contents in spontaneous hypertension rats (SHR).【Methods】Twenty-four SHR rats were randomized into model group,hightdose Liz group(40 mg?kg-1?d-1),low-dose Liz group(20 mg?kg-1?d-1),and votalin group(4 mg?kg-1?d-1).The rats received gastric gavage of corresponding drugs according to the experimental design for 14 days.After treatment,the serum and hippocampal contents of dopamine,5-hydroxytryptamine and norepinephrine(NE)were detected with high performance liquid chromatography(HPLC).【Results】 High-and low-dose Liz markedly decreased cerebral NE content,increased serum and cerebral DA and 5-HT contents(P