Phosphocreatine improves muscle microcirculation during exercise / A fosfocreatinina melhora a microcirculação muscular durante o exercício / La fosfocreatina mejora la microcirculación muscular durante el ejercicio

ABSTRACT Introduction: Phosphate (CP) its biosynthesis begins with the kidney. Glycocianine was synthesized from glycocianine, then methylated in the liver, and finally formed in each tissue. Objective: To study the effects of phosphatic acid in exercise training. Methods: This paper uses 50 pure male mice, 2 month old, weight at 22 ± 3 g, and mice per day, 5 minutes each time. After exercise training, dry dry with a towel and blow it with a hair dryer, and move it to the end of each other. Results: The average time of motion B mouse to give phosphate creatine is significantly longer than the average time of the non-administration of the A group, and the motion time is prolonged to extend 23.20%. Phosphate has improved motor endurance and promotes improvement in muscle microcirculation during exercise. Conclusions: Motion can be used to improve the maximum aerobic capacity of exercise in motion. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A biossíntese Its do fosfato começa no rim. Glicociamina foi sintetizado de glicocianina, e depois transformado em metilato no fígado; finalmente, desenvolve em cada tecido. Objetivo: Estudar os efeitos do ácido fosfato em treinamento de exercícios. Métodos: Este estudo usa 50 camundongos machos puros de dois meses de idade, pesando ± 3g aos 22 meses, e XXX camundongos por dia por cinco minutos cada vez. Após o treino, estes foram secos com uma toalha e secador de cabelo e colocados um do lado do outro. Resultados: O tempo médio de movimento para o grupo B de camundongos produzir fosfato de creatinina é consideravelmente mais longo do que o tempo médio do grupo A, onde não houve administração. O tempo de movimento se prolonga em 23,20%. O fosfato melhora a resistência motora e promove uma melhora na microcirculação durante o exercício. Conclusões: O movimento pode ser usado para melhorar a capacidade aeróbica máxima do exercício em movimento. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: El biosíntesis del fosfato empieza en el riñón. La Glicociamina se sintetizó de Glicocianina, y después se transformó en metilato en el hígado; y finalmente, formó cada tejido. Objetivo: Estudiar los efectos del ácido fosfato en entrenamiento de ejercicios. Métodos: Este estudio utiliza 50 ratones machos puros de 2 meses de edad, pesando ± 3g a los 22 meses, y xxx ratones por día por 5 minutos cada vez. Tras el entrenamiento, se los secó con una toalla y secador de pelo y se los puso lado a lado. Resultados: El tiempo medio de movimiento para el grupo B de ratones producir fosfato de creatina es considerablemente más largo que el tiempo medio del grupo A, donde no hubo administración. El tiempo de movimiento se alarga en 23,20%. El fosfato mejora la resistencia motora y promueve una mejoría en la microcirculación durante el ejercicio. Conclusiones: El movimiento puede usarse para mejorar la capacidad aeróbica máxima del ejercicio en movimiento. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Influence of sodium creatine phosphate on PCI-related myocardial injury in UAP patients / 心血管康复医学杂志

Objective :To explore influence of sodium creatine phosphate (CP) on percutaneous coronary intervention (PCI)-related myocardial injury in patients with unstable angina pectoris (UAP).Methods : A total of 90 UAP pa-tients ,who were supposed to receive selective PCI ,were selected ,randomly and equally divided into routine treat-ment group and CP group (received CP treatment based on routine medication ).Plasma level of cardiac troponin I (cTnI) before and 18h after PCI ,plasma levels of C reactive protein (CRP) and brain natriuretic peptide (BNP) be- fore and 24h after PCI ,LVEDd ,LVESd and LVEF on two weeks after PCI ,and incidence of major adverse cardio-vascular events (MACE) within two weeks after PCI were measured and compared between two groups .Results :Compared with before PCI ,there was significant rise in plasma cTnI level on 18h after PCI ,and significant reduc-tions in plasma CRP and BNP levels on 24h after PCI in two groups ,P＝0-001 all ;compared with routine treatment group after PCI ,there were significant reductions in plasma levels of cTnI [ (1-58 ± 1-59) mg／L vs.(0-07 ± 0-04) mg／L] ,CRP [ (22-02 ± 2-14) ng／L vs .(11-40 ± 1-49) ng／L] and BNP [ (349-20 ± 28-57) ng／L vs .(175-20 ± 28-55) ng／L] in CP group , P＝0-001 all.Compared with routine treatment group ,there were significant reduc-tions in LVEDd [ (54-83 ± 1-23) mm vs.(50-74 ± 0-97) mm] and LVESd [ (45-65 ± 1-64) mm vs .(42-01 ± 1-84) mm] ,and significant rise in LVEF [ (52-41 ± 1-57)% vs.(65-21 ± 3-36)%] in CP group on two weeks af-ter PCI , P＝0-001 all.On two weeks after PCI ,incidence rate of MACE in CP group was significantly lower than that of routine treatment group (4-44% vs.28-89%) , P＝0-021- Conclusion : CP can significantly reduce plasma levels of cTnI ,CRP and BNP after PCI ,reduce PCI-related myocardial injury .

Efficacy of phosphocreatine pre-administration on XIAP and Smac in ischemic penumbra of rats with focal cerebral ischemia reperfusion injury

Abstract Purpose: To observe the efficacy of phosphocreatine pre-administration (PCr-PA) on X-linked inhibitor of apoptosis protein (XIAP), the second mitochondia-derived activator of caspase (Smac) and apoptosis in the ischemic penumbra of rats with focal cerebral ischemia-reperfusion injury (CIRI). Methods: A total of 60 healthy male Sprague Dawley (SD) rats were randomly divided into three groups (n=20): group A (the sham operation group), group B <intraperitoneally injected with 20 mg/kg (10 mg/ml) of saline before preparing the ischemia-reperfusion (IR) model>, and group C <intraperitoneally injected with 20 mg/kg (10 mg/ml) of PCr immediately before preparing the IR model>. After 24 h for reperfusion, the neurological function was evaluated and the tissue was sampled to detect expression of XIAP, Smac and caspase-3 positive cells in the ischemic penumbra so as to observe the apoptosis. Results: Compared with group B, neurological deficit scores, numbers of apoptotic cells, expression of Smac,caspase-9 and the numbers of Caspase-3 positive cells were decreased while expression of XIAP were increased in the ischemic penumbra of group C. Conclusions: Phosphocreatine pre-administration may elicit neuroprotective effects in the brain by increasing expression of X-linked inhibitor of apoptosis protein, reducing expression of second mitochondia-derived activator of caspase, and inhibiting the apoptosis in the ischemic penumbra.

Therapeutic effect of creatine phosphate sodium combined alprostadil injection on acute-exacerbation CHF and its influence on serum NT-proBNP level / 心血管康复医学杂志

Objective: To explore therapeutic effect of creatine phosphate sodium (CP) injection combined alprostadil injection on acute-exacerbation chronic congestive heart failure (CHF) and its influence on serum level of N terminal pro B-type natriuretic peptide (NT-proBNP). Methods: A total of 120 acute-exacerbation CHF patients treated in our hospital were selected. According to random number table, they were randomly and equally divided into CP group (received CP injection based on routine treatment) and combined treatment group (received alprostadil injection based on CP group), and both groups were treated for two weeks. Cardiac output (CO), stroke volume (SV), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd) and serum NT-proBNP level before and after treatment, total effective rate and incidence rate of adverse reactions were measured and compared between two groups. Results: Compared with before treatment, after two-week treatment, there were significant rise in CO, SV and LVEF, and significant reduction in LVEDd in two groups except CO of CP group (P=0. 001 all); compared with CP group, after two-week treatment, there were significant rise in CO [(4. 9±1. 5) L vs. (5. 6±1. 6) L], SV [(70. 6±7. 5) ml vs. (79. 2±7. 6) ml]and LVEF [(42. 9±7. 6) ％ vs. (49. 3±8. 6) ％], and significant reduction in LVEDd [(58. 4±5. 3) mm vs. (43. 6±5. 5) mm]in combined treatment group, P＜0. 05 or＜0. 01. Compared with before treatment, there was significant reduction in serum NT-proBNP level in two groups on one and two weeks after treatment, and those of after two weeks were significantly lower than those of after one week, P=0. 001 all. Compared with CP group, after one-week and two-week treatment, there was significant reduction in serum NT-proBNP level [after one week: (708. 6±137. 6) ng/L vs. (611. 4±121. 4) ng/L, after two weeks: (573. 9±132. 9) ng/L vs. (359. 1±114. 2) ng/L]in combined treatment group, P=0. 001 all. Total effective rate of combined treatment group was significantly higher than that of CP group (95. 0％ vs. 81. 7％), P=0. 023. There was no significant difference in incidence rate of adverse reactions between two groups, P=0. 675. Conclusion: CP combined alprostadil can significantly improve cardiac function and total effective rate in acute-exacerbation CHF patients, which is worth extending.

Research Progress in Multiple Target Action Mechanisms of Myocardium of Exogenous Phosphocreatine / 医药导报

Phosphocreatine ( PCr), a natural high energy phosphate, plays a pivotal role in maintaining energy homeostasis of the body. Exogenous PCr has been developed as a cardio-protective drug and extensively used in treatment of cardiovascular diseases.PCr has special chemical structure,which confers much bioinformation on it,and becomes a multitarget-directed drug.Since the 21st century,with rapid development of molecular biology,the multiple target action mechanisms of PCr have continually gained elucidation,including energy-related and non-energy-related mechanisms,intracellular and extracellular mechanisms,which are leading to its extensive clinical applications in cardiovascular diseases.Based on author' s research and published literatures,this article reviews the research progress in multiple target action mechanisms of PCr,including energy supply,membrane stabilization, anti-platelet aggregation, electrophysiology, enzyme inhibition and protection of mitochondria, antiapoptotic effect,etc.

Effect of creatine phosphate sodium on postoperative cognitive function of patients undergoing off-pump coronary artery bypass grafting / 中华麻醉学杂志

Objective To investigate the effect of creatine phosphate sodium on postoperative cognitive function of the patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods Forty patients of both sexes,aged 52-70 yr,weighing 52-84 kg,of American Society of Anesthesiologists physical status Ⅲ,scheduled for elective OPCABG,were divided into either creatine phosphate sodium group (group CPS) or control group (group C) using a randon number table,with 20 patients in each group.Total intravenous anesthesia was applied during operation to maintain bispectral index value at 40-60 and hemodynamics stable.After induction of anesthesia,creatine phosphate sodium 15 mg/kg (in 100 ml of normal saline) was infused over 30 min via the central vein in group CPS,and the equal volume of normal saline was infused over 30 min instead of creatine phosphate sodium in group C.Postoperative visual analogue scale scores were maintained ≤ 3.Before induction of anesthesia,immediately after the end of operation,and at 24 and 48 h after operation,arterial blood samples were collected for determination of serum C-reactive protein concentrations by immunoturbidimetry.The cognitive function was assessed on day 1 before operation and day 7 after operation,and the development of postoperative cognitive dysfunction was recorded.Results Compared with group C,the concentrations of serum C-reactive protein at 24 and 48 h after operation and incidence of postoperative cognitive dysfunction were significantly decreased in group CPS (P＜0.05).Conclusion Creatine phosphate sodium can improve postoperative cognitive function of the patients undergoing OPCABG.

Effects of phosphocreatine postconditioning on cerebral ischemia-reperfusion injury in rats / 临床麻醉学杂志

Objective To investigate the effects of phosphocreatine postconditioning on cerebral ischemia-reperfusion(IR)injury in rats.Methods Thirty-six SD rats were randomly divided into three groups:groups Sham,IR (treated with normal saline)and PCr.IR was induced by intraluminal middle cerebral artery occlusion (MCAO).All treatments were given intravenously at the begining of reperfusion.Twenty-four hours after the reperfusion, neurological deficit score and magnetic resonance scan were performed.serum concentrations of malonaldehyde and 4-hydroxynonenal,cere-bral infarct volume and destruction of cerebral cortex were estimated.Neuronal apoptosis was further assessed by immunohistochemistry and immunofluorescent staining of caspase-3 and NeuN. Results Compared with group IR,phosphocreatine significantly decreased neurological deficit score, infarct volume,malonaldehyde and 4-hydroxynonenal levels(P < 0.05 ).Cortex structure was more complete,as well as neuronal apoptotic index was smaller in group PCr (P <0.05).Conclusion PCr can reduce cerebral infarct volume,thereby promote neurofunctional recovery.The mechanism of Pcr is related to reduced oxidative stress and inhibitted apopotosis during IR.

Curative Effect of Phosphocreatine Adjuvant Treatment on Neonatal Hypoxic-Ischemic Myocardial Lesion / 中国药师

Objective:To discuss the curative effect of phosphocreatine adjuvant treatment on neonatal hypoxic -ischemic myocardi-al lesion and its influence on serum IL-6 and myocardial enzyme .Methods:Totally 80 cases of newborns with hypoxic-ischemic myo-cardial lesion were divided into the observation group and the control group at random .The two groups were given the routine medical treatment, including maintenance of ventilation , warmth, water-electrolyte and acid-base balance, heart rate, blood pressure, nutrition support and etc, while the newborns in the control group were additionally given 250 mg· kg-1 1,6 diphosphate (FDP), ivgtt bid, for 10 days, while those in the observation group , were additionally given 1.0g phosphocreatine dissolved in 100 ml 0.9% normal saline (NS) on the basis of the treatment of the control group , ivgtt qd, for 10 days.The clinical curative effect and security were observed and the changes of serum IL-6 and myocardial enzyme in the two groups were compared .Results: The levels of LDH, CK, CK-MB and serum IL-6 in the two groups were obviously declined when compared with those before the treatment (P<0.05 or P<0.01), and the declining rate of the observation group was higher than that of the control group (P<0.05).The total clinical efficiency of the ob-servation group was higher than that in the control group after the medical treatment (P<0.05), and no serious untoward effect ap-peared in the two groups during the medical treatment .Conclusion: Phosphocreatine has significant curative effect on neonatal hy-poxic-ischemic myocardial lesion , which can effectively improve myocardial function of newborns and reduce myocardial enzyme and se -rum IL-6 levels.

Effect of creatine phosphate on myocardial injury induced by lung ischemia-reperfusion in rats / 中华麻醉学杂志

Objective To evaluate the effect of creatine phosphate on the myocardial injury induced by lung ischemia-reperfusion (I/R) in rats.Methods Twenty-four male Sprague-Dawley rats,aged 8-10 weeks,weighing 250-350 g,were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S),I/R group,and I/R+creatine phosphate group (group CP).Lung I/R was induced by clamping the left hilum of lung for 0.5 h with a non-invasive microvascular clip followed by mechanical ventilation and 2.0 h of reperfusion.Creatine phosphate 6.6 mg · kg-1 · min-1 were infused intravenously at 30 min before ischemia in group CP,while the equal volume of normal saline was administered in group I/R.At 2.0 h of reperfusion,blood samples were obtained from the right ventricle for determination of the serum concentration of cardiac troponin I (cTnI).Myocardial specimens were obtained from the apex for microscopic examination and for determination of the levels of myocardial superoxide dismutase (SOD),malondialdehyde (MDA),and myeloperoxidase (MPO).Results Compared with group S,the serum cTnI concentrations,MDA content,and MPO activity were significantly increased,and the SOD activity was significantly decreased in I/R and CP groups (P＜0.05).Compared with group I/R,the serum cTnI concentrations,MDA content,and MPO activity were significantly decreased,and the SOD activity was significantly increased in group CP (P＜0.05).Myocardial injury was significantly attenuated in group CP as compared with group I/R.Conclusion Creatine phosphate can attenuate the myocardial injury induced by lung I/R in rats,and the mechanism is related to decrease in damage caused by lipid peroxidation.

Analysis on effectiveness of Xinjikang Granules combined with creatine phosphate sodium for treating children with viral myocarditis / 重庆医学

Objective To investigate the clinical effect of creatinine phosphate sodium combined with Xinjikang Granules in treating children with viral myocarditis ,and provide reference for clinical treatment .Methods 160 children patients with viral myo‐carditis from January 2011 to January 2015 were selected and randomly divided into the control group and the observation group ac‐cording to the digital table method ,80 cases in each group .The control group used the symptomatic treatment of fructose diphos‐phate (FDP) ,vitamin C ,coenzyme Q10 and ribavirin ,while the observation group used creatine phosphate sodium and Xinjikang Granules on the basis of control group .The clinical effects ,ECG improvement ,cardiac enzymes and troponin I levels were compared between the two groups .Results The effective rate in the observation group was 87 .50% ,which was significantly higher than 70 .00% in the control group ,the difference was statistically significant (χ2 =7 .320 ,P=0 .004);the effective rate of ECG improve‐ment in the observation group was 90 .00% ,which was significantly higher than 75 .00% in the control group ,the difference was statistically significant (χ2 = 6 .234 ,P=0 .005);the levels of AST ,CPK ,LDH ,CK‐MB ,HBDH and cTnI after treatment in the two groups were significantly improved compared with before treatment ,the differences were statistically significant (P< 0 .05) ,the levels of AST ,CPK ,LDH ,CK‐MB ,HBDH ,and cTnI after treatment in the observation group were (29 .98 ± 4 .66)U/L ,(184 .41 ± 5 .97)U/L ,(314 .25 ± 9 .84)U/L ,(22 .29 ± 2 .98)U/L ,(268 .37 ± 8 .64)U/L and (0 .13 ± 0 .04)μg/L respectively ,which showed the statistical differences compared with the control group ,[(33 .49 ± 4 .98)U/L、(196 .49 ± 6 .71)U/L、(328 .64 ± 11 .14)U/L、(26 .53 ± 3 .44)U/L、(298 .68 ± 10 .64)U/L、(0 .25 ± 0 .05)μg/L ,P<0 .05] .Conclusion Creatinine phosphate sodium in treating children with viral myocarditis has significant clinical effect ,and is worthy of clinical promotion and application .

Creatina e treinamento resistido: efeito na hidratação e massa corporal magra / Creatine and resistance training: effect on hydration and lean body mass / Creatina y entrenamiento resistido: efecto en la hidratación y masa corporal magra

INTRODUÇÃO: a creatina é um recurso ergogênico cuja suplementação tem sido associada ao aumento da hidratação corporal total e ao aumento da massa muscular dos consumidores. Entretanto, estudiosos questionam se o aumento da massa muscular é um ganho real. OBJETIVO: avaliar o efeito da suplementação de creatina sobre a hidratação e o aumento de massa magra em indivíduos previamente treinados e não treinados, submetidos a um programa de treinamento resistido. MÉTODOS: ensaio clínico não randomizado, constituído por três momentos, M1 - Início da suplementação com 20g/dia de creatina; M2 - 7 dias após iniciada a suplementação e redução da suplementação para 5g/dia; M3 - 28 dias de suplementação. Nos momentos propostos, foram realizadas aferições de peso, estatura e avaliação da composição corporal (massa magra, água corporal total) com a utilização do BYODINAMICS(r) Modelo 310. Para todos os testes estatísticos, foi adotado o nível de significância de 95% (p<0,05). RESULTADOS: participaram desse estudo 14 voluntários adultos do sexo masculino, com idade média de 22,57(±1,45) anos, dos quais sete eram treinados e sete não treinados. Após 28 dias de suplementação, no grupo treinado observou-se um aumento significativo no peso, água corporal total, massa magra e hidratação da massa magra, mas nenhum aumento significativo foi observado no grupo não treinado. Em relação ao ângulo de fase, este aumentou no grupo não treinado e reduziu no grupo treinado. CONCLUSÃO: a suplementação de creatina associada ao treinamento resistido é mais efetiva na hidratação de indivíduos treinados, como também é suficiente para reduzir a diferença significativa do ângulo de fase intergrupos, sugerindo assim, maior hidratação celular em ambos os grupos. Contudo, esse aumento na hidratação não revelou aumento significativo no tecido muscular. .

INTRODUCTION: creatine is an ergogenic aid which supplementation has been associated to increased hydration and increased muscle mass of consumers. However, researchers have questioned whether the increase in muscle mass is a real gain. OBJECTIVE: to evaluate the effect of creatine supplementation on hydration and increased lean mass in individuals previously trained and untrained, under a resistance training program. METHODS: clinical non-randomized study, consisting of three moments, M1 - start of 20g/day creatine supplementation; M2 - 7 days after the beginning of supplementation and reduction to 5g/day; M3 - 28 days of supplementation. In the proposed moments were made measurements of weight, height and evaluation of body composition (lean mass, total body water) using the BYODINAMICS (r) Model 310. For all statistical tests, we used a significance level of 95% (p<0.05). RESULTS: 14 adult male volunteers with a mean age of 22.57 (±1.45) years, including seven trained and seven untrained individuals, participated in the study. After 28 days of supplementation, the trained group had a significant increase in weight, total body water, lean body mass and hydration of lean mass, but no significant increase was observed in the untrained group. Regarding the phase angle, it increased in the untrained group and decreased in the trained group. CONCLUSION: creatine supplementation combined with resistance training is more effective in hydrating trained individuals and it's also sufficient to reduce the difference of the angle phase intergroup, thus suggesting improved cellular hydration in both groups. However, this increase in hydration revealed no significant increase in muscle tissue. .

INTRODUCCIÓN: la creatina es un recurso ergogénico cuya suplementación ha sido asociada al aumento de la hidratación corporal total y al aumento de la masa muscular de los consumidores. Entretanto, estudiosos cuestionan si el aumento de la masa muscular es un aumento real. OBJETIVO: evaluar el efecto de la suplementación de creatina sobre la hidratación y el aumento de masa magra en individuos previamente entrenados y no entrenados, sometidos a un programa de entrenamiento resistido. MÉTODOS: ensayo clínico no aleatorio, constituido por tres momentos, M1 - Inicio de la suplementación con 20g/día de creatina; M2 - 7 días después de iniciada la suplementación y reducción de la suplementación para 5g/día; M3 - 28 días de suplementación. En los momentos propuestos, fueron realizadas mediciones de peso, estatura y evaluación de la composición corporal (masa magra, agua corporal total) con el uso de BYODINAMICS(r) Modelo 310. Para todos los tests estadísticos, fue adoptado el nivel de significancia de 95% (p<0,05). RESULTADOS: participaron en este estudio 14 voluntarios adultos del sexo masculino, con edad promedio de 22,57(±1,45) años, de los que siete eran entrenados y siete no entrenados. Después de 28 días de suplementación, en el grupo entrenado se observó un aumento significativo en el peso, agua corporal total, masa magra e hidratación de la masa magra, pero ningún aumento significativo fue observado en el grupo no entrenado. En relación al ángulo de fase, aumentó en el grupo no entrenado y se redujo en el grupo entrenado. CONCLUSIÓN: la suplementación de creatina asociada al entrenamiento resistido es más efectiva en la hidratación de individuos entrenados, como también es suficiente para reducir la diferencia significativa del ángulo de fase intergrupos, sugiriendo así mayor hidratación celular en ambos grupos. Sin embargo, ese aumento en la hidratación no reveló aumento significativo en el tejido muscular. .

Influence of phosphocreatine on serum N end B type natriuretic peptide and cardiac function in patients with congestive heart failure / 中国综合临床

Objective To discuss the influence of phosphocreatine on serum N end B type natriuretic peptide(NT-proBNP) and cardiac function in patients with congestive heart failure (CHF).Methods Ninetysix patients with CHF were randomly divided into the control group (n =47) and research group (n =49).The patients of the control group were given conventional therapy for treating CHF while the research group were given phosphocreatine based on treatment of the control group,and the course was 4 weeks.The total effective rate and left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD),left ventricular ejection fraction(LVEF) and NT-proBNP of pretherapy and post-treatment between the two groups were compared.Results There were no statistically significant differences about LVEDD,LVEDD,LVEF and BNP between the two groups (all P＞ 0.05);After treatment,LVEDD in the control group and the observation group patients were (53.5±5.6) mm,(46.4±4.5) mm,LVESD were ((39.9±5.3) mm,(34.6±4.8) mm and NT proBNP were (495.8±42.2) ng/L,(374.4±38.4) ng/L,significantly lower than before treatment ((58.3±6.4) mm,(58.4±6.8) mm;(48.4±6.3) mm,(48.7±6.2) mm;(875.4±64.8) ng/L,869.2 ± ±67.5) ng/L),and LVEF was higher than before treatment significantly (observation group by (35.8±3.2)％ rose to (52.6± 5.2) ％;control group by (36.4± 3.3) ％ rose to (44.5 ± 4.2) ％),and the observation group compared with the control group,the difference was statistically significant(P＜0.05).The total effective rate of research group was evidently higher than that of control group,the difference was statistically significant(93.8％ (45/49) vs.75.0％(36/47);x2=6.836,P=0.037).Conclusion Phosphocreatine can effectively strengthen the heart systolic functionincrease,LVEF,the serum NT-proBNP and enhance the total effective rate of patients with congestive heart failure.

Curative efficacy of sodium phosphocreatine combined with aminophylline in the treatment of postpartum hypertensive heart failure / 中国基层医药

Objective To investigate the curative efficacy of sodium phosphocreatine combined with amin-ophylline in the treatment of postpartum hypertensive heart failure.Methods 80 patients with postpartum hyperten-sive heart failure were randomly divided into the control group and the observation group equally by random number table method,40 cases in each group.The control group was given conventional treatment,such as oxygen inhalation, diuresis by furosemide,strengthening heart by cedilanid,vascular dilation by nitroglycerin,keeping water -electrolyte balance and so on.Besides that,the observation group was given sodium phosphocreatine in combination with amin-ophylline.Then,the curative efficacy,changes of blood pressure,indices of cardiac function and adverse reactions were compared.Results The total effective rate of the observation group was 95.0%,which was higher than 80.0% of the control group(χ2 =4.1 1 ,P <0.05).After treatment,SBP,DBP,LVEDD,LVESD,LVEF in the control group and the observation group were (1 25.7 ±6.5)mmHg vs (1 20.1 ±7.2)mmHg(t =3.651 ),(88.4 ±8.9)mmHg vs (81 .4 ± 9.0)mmHg(t =3.498),(64.0 ±6.8)mm vs (61 .3 ±6.2)mm(t =2.268),(53.7 ±6.3)mm vs (51 .0 ±5.6)mm (t =2.461 ),(38.6 ±9.0)% vs (42.5 ±8.7)%(t =2.476),respectively.In comparison with the control group, SBP[(1 25.7 ±6.5)mmHg vs.(1 20.1 ±7.2)mmHg],DBP[(88.4 ±8.9)mmHg vs.(81 .4 ±9.0)mmHg], LVEDD[(64.0 ±6.8)mm vs.(60.7 ±6.2)mm],LVESD[(53.2 ±5.3)mm vs.(50.2 ±5.6)mm]were signifi-cantly reduced and LVEF[(38.6 ±9.0)% vs.(42.5 ±8.7)%]was significantly increased in the observation group (t =3.651 ,3.498,2.268,2.461 ,2.476,all P <0.05).During the treatment,there was no severe adverse reaction. Conclusion Sodium phosphocreatine combined with aminophylline is effective for postpartum hypertensive heart fail-ure,which can significantly increase curative efficacy,decrease blood pressure and improve cardiac function with less adverse reactions.

Role of the phosphocreatine system on energetic homeostasis in skeletal and cardiac muscles / Papel do sistema da fosfocreatina na homeostase energética das musculaturas esquelética e cardíaca

Adenosine triphosphate is the present energy currency in the body, and is used in various cellular and indispensable processes for the maintenance of cell homeostasis. The regeneration mechanisms of adenosine triphosphate, from the product of its hydrolysis – adenosine diphosphate – are therefore necessary. Phosphocreatine is known as its quickest form of regeneration, by means of the enzyme creatine kinase. Thus, the primary function of this system is to act as a temporal energy buffer. Nevertheless, over the years, several other functions were attributed to phosphocreatine. This occurs as various isoforms of creatine kinase isoforms have been identified with a distinct subcellular location and functionally coupled with the sites that generate and use energy, in the mitochondria and cytosol, respectively. The present study discussed the central and complex role that the phosphocreatine system performs in energy homeostasis in muscle cells, as well as its alterations in pathological conditions.

A adenosina trifosfato é a moeda corrente de energia no organismo, sendo utilizada em diversos processos celulares e indispensável para a manutenção da homeostase celular. Mecanismos de regeneração da adenosina trifosfato, a partir de seu produto de hidrólise – a adenosina difosfato – são, dessa forma, necessários. A fosfocreatina é conhecidamente sua fonte mais rápida de regeneração, por meio da enzima creatina quinase. Assim, a principal função desse sistema é atuar como um tampão temporal de energia. Entretanto, ao longo dos anos, diversas outras funções foram atribuídas à fosfocreatina. Isso ocorreu à medida que foram identificadas diversas isoformas da creatina quinase com localização subcelular distinta e acopladas de forma funcional aos sítios geradores e utilizadores de energia, na mitocôndria e citosol, respectivamente. O presente trabalho discutiu o papel central e complexo que o sistema da fosfocreatina desempenha na homeostase energética nas células musculares, bem como suas alterações em quadros patológicos.

Effect of creatine phosphate sodium on myocardial protection and calcium-sensitive receptor expression after high-level spinal cord injury / 中华创伤杂志

Objective To investigate the effect of creatine phosphate sodium on myocardial protection and calcium-sensitive receptor (CaSR) expression following high-level spinal cord injury.Methods Thirty healthy male SD rats weighing 250-300 g were assigned to sham operation,12-hour injury,24-hour injury,12-hour injury followed by a single intraperitoneal injection of creatine phosphate sodium,and 24-hour injury followed by a single intraperitoneal injection of creatine phosphate sodium according to the random number table,with 6 rats in each group.High-level spinal cord injury was induced at C7 segment by dropping a 10 g weight falling freely along the hollow glass tube from a 5 cm height.Level of blood troponin Ⅰ (cTnⅠ) was measured.Myocardial tissues were collected to study ultrastructure of myocardial cells under transmission electron microscope and CaSR expression using fluorescence quantitative PCR and Western blotting.Results cTnⅠ level was (0.031 ±0.002) U/L and (0.026 ± 0.001) U/L in 12-and 24-hour injury groups,but it was reduced to (0.023 ± 0.002) U/L and (0.018 ± 0.006) U/L at the same time point in treatment groups (P ＜ 0.05).Whereas either in injnry or treatment groups,cTnⅠ level was higher than (0.004 ± 0.002) U/L in sham operation group (P ＜ 0.05).CaSR mRNA level was (0.991 ±0.146) × 10-3 and (1.245 ±0.204) × 10-3 in 12-and 24-hour injury gronp and decreased to (0.880 ± 0.096) × 10-3 and (0.782 ± 0.138) × 10 3 at the same time point in treatment groups (P ＜ 0.05),but all were higher than (0.437 ± 0.065) × 10-3 in sham operation group (P ＜ 0.05).CaSR protein expressed in 12-and 24-hour injury group was (0.627 ±0.066) × 10 3 and (0.809 ±0.154) ×10 3 and lowered to (0.505 ±0.176) × 10-3 and (0.524 ±0.138) × 10-3 at the same time point in treatment groups,but all were higher than (0.331 ± 0.102) × 10-3 in sham operation group (P ＜ 0.05).Transmission electron microscopy demonstrated normal myocardial ultrastructure in sham operation group but impairment in injury groups,but the impairment was significantly improved in treatment groups.Conclusion Creatine phosphate sodium can decrease cTnⅠ level,attenuate the damage to myocardial ultrastructure and down-regulate CaSR after high-level spinal cord injury.

The clinical analysis of the efficacy of creatine phosphate sodium therapy in children with primary myocarditis / 中国医师进修杂志

Objective To analyze the characteristics of primary myocarditis,and investigate the clinical efficacy of creatine phosphate sodium therapy in children with primary myocarditis.Methods A retrospective analysis of 56 cases of primary myocarditis in children,divided into control group and treatment group by random digits table method,each group 28 cases.Two groups of patients received conventional treatment,the treatment group was added the use of creatine phosphate sodium,after 14 d of continuous treatment,the clinical efficacy,myocardial enzymes (creatine kinase,creatine kinase-MB,lactate dehydrogenase),troponin and ECG in both groups were observed.Results After treatment,the total effective rate in treatment group was significantly higher than that in control group [89.3％(25/28) vs.53.6％ (15/28)] (x2 =4.094,P ＜0.05).The myocardial enzymes after treatment in both groups significantly improved compared with before treatment (P ＜ 0.05),the improvement in treatment group was better than that in control group,the difference was statistically significant (P ＜ 0.05).The negative conversion ratio of troponin in treatment group was significantly higher than that in control group (16/18 vs.9/17)(x2 =6.052,P ＜ 0.05).The total effective rate of ECG in treatment group was significantly higher than that in control group (x2 =3.896,P ＜ 0.05).Conclusions Creatine phosphate sodium for the treatment of children with primary myocarditis has better clinical efficacy,physiological indicators of myocardial enzymes,such as troponin significantly improve,with some clinical significance.

Effect of Phosphocreatine on Angiotensin II Induced Proliferation and Collagen Synthesis of Cardiac Fibroblasts in Neonatal Rats With its Mechanism / 中国循环杂志

Objective: To investigate the effect of phosphocreatine (PCr) on angiotensin II (Ang II) induced proliferation and collagen synthesis of cardiac ifbroblasts in neonatal rats with its mechanism. Methods: The cardiac ifbroblasts (CF) from neonatal rats were cultured in vitro and were divided into 4 groups.①Control group, the CF was cultured in non-serum DMEM,②Ang II group, the CF was cultured with Ang II at (1×10-6) mol/L,③PCr treated group, the CF was cultured with PCr at 10 mmol/L, and④Ang II+PCr group. The CF cell cycle percentage was detected by lfow cytometric assay, myocardial collagen content was observed by VG staining and protein expression of phosphorylated extracellular signal-regulated kinase (pERK1/2) was detected by immuneohistochemistry. Results: ① Compared with Control group, the CF in Ang II group showed increased percentage of S phase and decreased percentage of G0/G1 and G2/M phases, increased collagen content and pERK1/2 protein expression, all P0.05. ③ Compared with Control group, Ang II + PCr group had elevated pERK1/2 protein expression, P0.05.④Compared with Ang II group, the CF in Ang II + PCr group had increased percentage of G0/G1 and G2/M phases, decreased percentage of S phase, decreased collagen content and pERK1/2 protein expression, all P Conclusion: PCr may partially inhibit Ang II induced CF proliferation and collagen synthesis which might be related to the inhibition of excessively activated ERK1/2. Therefore, PCr could improve Ang II induced myocardial ifbrosis in neonatal rats.

Effects of Creatine Phosphate Sodium on Plasma Cardiotrophin-1 and N Terminal Probrain Natriuretic in Elderly Hypertensive Patients with Heart Failure / 天津医药

Objective To investigate the effect of hosphocreatine therapy on the plasma cardiotrophin-1(CT-1) and N terminal probrain natriuretic (NT-proBNP) in elderly hypertensive patients with heart failure. Methods A total of 76 hy-pertensive patients with heart failure, aged 65 or over, were randomly divided into treatment group and control group (n=38 for each group). The control group received routine anti-heart failure treatment. The treatment group received conventional therapy plus creatine phosphate sodium for 2 weeks. The plasma levels of CT-1 and NT-proBNP were determined in two groups. The plasma CT-1 level was measured by a double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The plasma level of NT-proBNP was tested by Rui Pu fluorescent dry quantitative analyzer. Results The plasma levels of CT-1 and NT-proBNP were significantly lower after treatment in two groups (P＜0.01). The plasma levels of CT-1 and NT-proBNP were significantly decreased in treatment group than those in control group (P＜0.05). The total effective rate was 89.47%in treatment group, which was significantly higher than that of control group (71.05%, P＜0.05). Symptoms of heart failure improved in one week (21 cases in treatment group/9 cases in control group) and in two weeks (13 cases in treatment group/18 cases in control group). Conclusion The conventional therapy plus creatine phosphate sodium can decrease the plasma CT-1 and NT-proBNP levels in elderly hypertensive patients with heart failure, which improves symptoms of heart failure in a shorter period of time.

Effects of pretreatment with different doses of phosphocreatine on hepatic ischemia-reperfusion injury in rats / 中华麻醉学杂志

Objective To evaluate the effects of pretreatment with different doses of phosphocreatine on hepatic ischemia-repeffusion (I/R) injury in rats.Methods.Thirty male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 5 groups (n =6 each):sham operation group (group S),hepatic I/R group (group I/R),and pretreatment with different doses of phosphocreatine groups (groups P1-3).Hepatic I/R was induced by 90 min occlusion of the hepatic artery and portal vein entering the middle and left lobes of the liver followed by 4 h reperfusion in anesthetized rats.Phosphocreatine 50,150 and 450 mg/kg were injected via the tail vein at 60 min before ischemia in groups P1-3,respectively.In groups S and I/R,the equal volume of normal saline was given instead.Blood samples were taken from the abdominal aorta at 4 h of reperfusion for determination of plasma alanine aminotransferase (ALT),aspartate aminotransferase (AST),TNF-α and IL-1β concentrations.The rats were then sacrificed and the livers were removed for determination of myeloperoxidase (MPO) activity (by ELISA),intercellular adhesion molecule-1 (ICAM-1) expression (by immunohistochemistry),and cell apoptosis (by TUNEL) and for microscopic examination (by electron microscopy).Results The MPO activity in liver tissues,plasma ALT and AST activities,TNF-α and IL-1β concentrations and the number of apoptotic cells were significantly higher in groups I/R and P1-3 than in group S,while lower in groups P1-3 than in group I/R (P ＜ 0.05).The parameters mentioned above were decreasedin turn in groups P1-3 (P ＜ 0.05).Conclusion Phosphocreatine pretreatment can attenuate the hepatic I/R injury in rats in a dose-dependent manner and inhibition of the inflammatory responses is involved in the mechanism.

Effects of exogenous phosphocreatine on brain energy metabolism of rats after cardiopulmonary resuscitation / 中华急诊医学杂志

Objective To study the effects of exogenous phosphocreatine (CP) on brain injury after cardiopulmonary resuscitation (CPR) in rats.Methods A total of 160 male adult SD rats were randomly ( random number) divided into 4 groups:sham-operation control group ( group A),CPR group ( group B),low-dose CP group ( group C),high-dose CP group ( group D),and each group was further divided into 5 subgroups (n =8) as per study at different intervals,0.5,3,6,12 and 24 h after restoration of spontaneous circulation (ROSC) in groups B,C and D or after tracheotomy in group A.Cardiac arrest (CA) was induced by using asphyxia to establish CPR model in group B,C and D.The CP0.5 g/kg used in group C or CP 1.0 g/kg used in group D was injected into femoral vein at beginning of ROSC.Rats in each subgroup were sacrificed and the tissues of frontal lobe of brain of rats were taken at different intervals.The levels of adenosine triphosphate (ATP),adenosine diphosphate (ADP) and adenosine monophosphate (AMP) in cerebral cortex were measured by high performance liquid chromatography (HPLC),and values of total adenine nucleotides ( TAN ) and energy charge ( EC ) were detected.The activities of Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase in cerebral cortex were assayed by spectrophotometric method. The pathological changes of cerebral cortex were observed under optical microscope.The experimental data were processed with analysis of variance by using SPSS 16.0 package. Results Compared with group A,the levels of ATP,TAN,EC,Na + -K + -ATPase,Ca2+ -Mg2+ -ATPase were lower ( P ＜ 0.05 or P ＜ 0.01 ) at each interval in groups B and C,and at intervals of 0.5,3,6,12 h in group D,and the levels of AMP were higher (P ＜ 0.01 ) at each interval in group B and at intervals of 0.5 h and 3 h in groups C and D.Compared with group B,the levels of ATP,TAN,EC,Na + -K + -ATPase,Ca2 + -Mg2+ -ATPase were higher ( P ＜ 0.05 or P ＜ 0.01 ),and the levels of AMP were lower ( P ＜ 0.05 or P ＜ 0.01 ) at intervals of 6,12 and 24 h in groups C and D.Compared with group C,the levels of ATP at interval of 24 h and TAN,Na +- K + -ATPase,Ca2 + -Mg2 + -ATPase at intervals of 6,12 and 24 h were higher in group D ( P ＜ 0.05 or P ＜ 0.01 ).There were severe pathological changes in cerebral cortex in group B,and mild changes in groups C and D. Conclusions There was obvious energy metabolism disorder after CPR in rats.Treatment with exogenous CP could increase the levels of ATP and activities of ATPase,alleviate pathological changes,especially in high-dose,and mitigate injury in cerebral cortex after CPR in rats.