OBJECTIVETo observe the heart protective effect of exercise preconditioning (EP) in the acute exhaustion exercise (EE) rats, and explore its action mechanism further.METHODSEighty healthy male Sprague-Dawley (SD) rats were divided into control group (C group), EP group, EE group, and EP+EE group randomly, with 20 rats in each group. The rats in EP and EP+EE groups were trained for 3 weeks according to the daily swimming for 60 minutes (swimming 15 minutes, resting 5 minutes, repeating 3 times) with 6 days each week. The rats in EE and EP+EE groups on the last 1 day after 3 weeks, 3% weight heavy weight was carried once for swimming EE. Two hours after the last EE, abdominal aortic blood and heart was harvested, the levels of serum MB isoenzyme of creatine kinase (CK-MB) and calcitonin gene related peptide (CGRP) were determined by enzyme linked immunosorbent assay (ELISA); the ultrastructure of myocardium was observed by optical microscopy; the levels of myocardial malondialdehyde (MDA) and superoxide dismutase (SOD) were determined by ELISA, the mRNA expression of myocardial CGRP was assayed by reverse transcription-polymerase chain reaction (RT-PCR), and the protein expression of myocardial CGRP was assayed by Western Blot.RESULTSCompared with C group, the levels of serum CK-MB and myocardial MDA were significantly increased, serum CGRP content, myocardial SOD activity, and mRNA and protein expressions of myocardial CGRP were significantly decreased in EE group and EP+EE group. Compared with EE group, the levels of serum CK-MB and myocardial MDA in EP+EE group were decreased [CK-MB (U/L): 13.11±0.77 vs. 15.55±0.90, MDA (μmol/L): 389.57±49.60 vs. 709.08±160.49], the level of serum CGRP, and mRNA and protein expressions of myocardium CGRP were increased [serum CGRP (ng/L): 120.41±9.07 vs. 97.97±9.05, CGRP mRNA (2 -ΔΔCT): 0.45±0.09 vs. 0.14±0.02, CGRP protein (gray value): 0.78±0.08 vs. 0.41±0.04, all P < 0.05], the degree of myocardial injury was obviously alleviated. There was no significant difference in the indexes between the EP group and C group.CONCLUSIONSEP has the heart protective effect for the acute EE rats, and the mechanism is closely related to the endogenous protective substance CGRP.

目的:观察运动预适应对某高海拔训练基地参训官兵高强度运动后动态心电图相关指标的影响,探讨运动预适应对作训人员运动性心脏损伤的防护作用及可能的机制.

目的:观察运动预适应(EP)对急性力竭运动诱导的大鼠降钙素基因相关肽(CGRP)表达水平的影响,并进一步探讨其作用机制. 方法:80 只健康成年雄性 SD 大鼠随机分为安静对照组(C组)、单纯运动预适应组(EP 组)、单纯力竭运动组(EE 组)、运动预适应 + 力竭运动组(EP+EE 组),每组 20 只.分别采用光镜、电镜观察心肌组织病理学及超微结构改变;采用酶联免疫吸附试验(ELISA)检测血清降钙素基因相关肽(CGRP)、去甲肾上腺素(NE),左室心肌丙二醛(MDA)、超氧化物歧化酶(SOD)、乳酸(LA)、一氧化氮(NO)含量变化;采用蛋白质免疫印迹试验(Western blot)检测心肌 CGRP 含量变化;应用 Real Time PCR 检测心肌 CGRP mRNA 表达情况;采用 Pearson 分析各项指标之间的相关性.

动脉导管未闭(PDA)是一种较为常见的先天性心脏病(先心病),其发病率约占先心病的5%~11%[1],临床症状取决于PDA的大小,较大PDA患者易患上呼吸道感染及肺炎,可并发心力衰竭和感染性心内膜炎及肺动脉高压等[2].大部分患者可行介入治疗,均能完全治愈,其手术创伤小,患者易恢复,效果等同于外科手术.

Objective To observe the occurrence of exercise-induced cardiac injury in different training intensity and training stages of the new recruits in a training base.Methods 40 new recruits were randomly selected from a training base in the Air Force in 2014, and then divided into general strength training group and intensive training group according to different training intensity after one month of low-intensity military training. The general strength training group received five-kilometer field training once per day besides daily military training, and the intensive training group received five-kilometer field training twice per day besides daily military training. Blood samples were collected at different training stages (before training, 1 week after training and 4 weeks after training) to measure the levels of serum cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB) and creatine kinase (CK).Results All soldiers were male. There was no significant difference in mean age, cTnI level and CK-MB/CK between the two groups (P>0.05). There were no significant differences in cTnI and CK-MB/CK levels between the two training groups (before training, one week after training and four weeks after training) (P>0.05). The levels of cTnI and CK-MB/CK in the intensive training group were higher than those in the general intensity training group after training for one week (P<0.05), but there was no significant difference between the two groups after training for 4 weeks (P>0.05).Conclusion New recruits in this training base did not show signs of exercise-induced heart damage different training stages or training intensity.

Objective To analyze the electrocardiogram ( ECG) score changes of the PLA officers and soldiers after a high-intensity exercise in a high altitude training base and its correlation analysis with symptom checklist-90 ( SCL-90) rating scale scores so as to explore the early warning and protective measures of cardiac injury induced by exhausting exercises. Methods The psychological assessment was performed for 77 officers and soldiers in a high altitude training base using SCL-90 rating scale, and the ECG results and the uncomfortable symptoms were recorded before the exercise, immediately after the exercise and 24 h after the exercise. The changes of the ECG scores before and after the exercise and correlation analysis among the scores of the SCL-90 rating scale, the scores of ECG and uncomfortable symptoms were analyzed. The effects of officers and soldiers with different military service times and psychological status on the ECG scores were evaluated. Results The scores of SCL-90 rating scale had no significant correlation with the ECG scores be-fore the exercise, after the exercise immediately and 24 h after the exercise (P>0. 05), but the scores had significant correlation with the scores of the uncomfortable symptoms (P<0. 05). The ECG score immediately after the exercise was significantly higher than those before the exercise and 24 h after the exercise (P<0. 05). The ECG scores of the officers and soldiers with the total average score of the SCL-90 rating scale score being were less than or equal to 1. 44, signifi-cantly higher than that of the officers and soldiers with the total average score of the SCL-90 rating scale score being more than 1. 44 (P<0. 05). There were no significant differences in ECG scores before the exercise, immediately after the ex-ercise and 24 h after the exercise of the PLA officers and soldiers with different military service times (P>0. 05). Con-clusion The high-intensity exercise can influence the ECG changes. The officers and soldiers with higher the scores of SCL-90 rating scale are more prone to developing uncomfortable symptoms, and therefore it is of great significance for the officers and soldiers to make psychological counseling before a high-intensity exercise.

1病例<br>　　患者男性，31岁，主因“间断胸闷、发憋、气短10余年，加重10 d”入院。患者于10余年前活动后胸闷、发憋、气短伴头晕，休息后可缓解。近年症状渐加重，活动耐量减低，步行约20 m即出现上述症状。患者入院10 d前出现发作性右上肢无力，伴言语不清，当地医院行头颅CT示：右侧基底节区腔隙性脑梗死，右侧基底节区脑软化灶。既往“多发性黄色素瘤”史20余年，行手术切除，术后复发，四肢掌指关节、肘关节、踝关节多发皮下肿物。吸烟史多年，20支/日。口服辛伐他汀降脂治疗，疗效欠佳，诊断为“黄色素瘤高脂血症”，为求明确诊断入252医院。心脏超声示：左房扩大，左室肥厚；主动脉瓣钙化伴关闭不全（轻度）；主动脉瓣口狭窄，升主动脉起始处狭窄；主动脉降部狭窄不除外；二尖瓣环钙化伴关闭不全（轻—中度），前叶脱垂不除外；左室舒张功能减低；考虑先天性心脏病，（图1）。颈部血管超声示：双侧颈动脉内膜增厚伴斑块形成；双侧颈内、颈外动脉狭窄（70%~99%）；双侧颈总动脉狭窄（50%~69%）；右锁骨下动脉斑块形成并狭窄；左侧锁骨下动脉狭窄可能性大；双侧椎动脉狭窄（左侧生理性）。心脏冠状动脉成像：前降支近段重度狭窄伴节段性混合型斑块（非钙化斑块为主）；右冠状动脉及旋支近段中度狭窄伴节段性非钙化斑块；前降支中段肌桥（部分包埋型）；升主动脉部缩窄。头颅核磁示：左侧基底节、放射冠、半卵圆中心及额颞枕顶叶多发新鲜腔梗；脑内散在缺血灶、慢性期腔梗；磁共振脑血管（动脉）成像符合颅内动脉硬化。实验室检查：总胆固醇（TC）13.63 mmol/L、低密度脂蛋白胆固醇（LDL-C）9.35 mmol/L、三酰甘油（TG）2.69 mmol/L。