4.Remote ischemia conditioning-an endogenous cardioprotective strategy from outside the heart.
Jun XIONG ; Xu LIAO ; Fu-shan XUE ; Yu-jing YUAN ; Qiang WANG ; Jian-hua LIU
Chinese Medical Journal 2011;124(14):2209-2215
OBJECTIVEA general review was made of studies involving: (1) The experimental evidence of remote ischemic preconditioning (RIPC) and relative clinical studies, (2) The experimental and clinical evidences of remote ischemic postconditioning (RIPOC), (3) The potential mechanistic pathways underlying their protective effects.
DATA SOURCESThe data used in this review were mainly from manuscripts listed in PubMed that were published in English from 1986 to 2010. The search terms were "myocardial ischemia reperfusion injury", "ischemia preconditioning", "ischemia postconditioning", "remote preconditioning" and "remote postconditioning".
STUDY SELECTION(1) Clinical and experimental evidence that both RIPC and RIPOC produce preservation of ischemia reperfusion injury (IRI) of myocardium and other organs, (2) Studies related to the potential mechanisms, by which remote ischemic conditioning protects myocardium against IRI.
RESULTSBoth RIPC and RIOPC have been shown to attenuate myocardial IRI in laboratory animals. Also, their cardioprotective effects have appeared in some clinical studies. Except the external, the detailed internal mechanisms of remote ischemic conditioning have been generally described. Through these descriptions better protocols can be developed to provide improved cardioprotective procedures.
CONCLUSIONSRemote ischemic conditioning is an endogenous cardioprotective mechanism from outside the heart that protects against myocardial IRI and represents a general form of inter-organ protection. Remote ischemic conditioning may have an immense impact on clinical practice in the near future.
Humans ; Ischemic Preconditioning, Myocardial ; methods ; Myocardial Reperfusion Injury ; prevention & control
5.Creating A Culture Of Prevention In Occupational Safety And Health Practice: Perceived Body Discomfort In Two Sitting Positions
Sukadarin EH ; Qian FS ; Nawi NSM ; Deros BM ; Zakaria J
Malaysian Journal of Public Health Medicine 2018;18(Special Volume (2)):47-51
Prolonged sitting is one of the factors for back discomfort. Sitting in the same position for long periods of time is worse. This experimental based study was conducted to achieve three objectives. There were to 1) identify whether is there any differences between perceived body discomfort among respondents before and after upright sitting, 2) identify whether is there any differences between perceived body discomfort among respondents before and after slump sitting and 3) compare the level of perceived body discomfort among respondents after two sitting postures. Thirty young and healthy adults were recruited as study respondents. Each respondent was asked to sit in a posture either upright or slump for 30 minutes. Respondents were then rated their body discomfort using Borg CR-10 scale before and after sitting. Another sitting posture was carried out after one day interval. There is a significant difference between perceived body discomfort among respondents before and after upright and slump sitting. Body discomfort of upright sitting was shown significantly greater than slump sitting. Although, slump sitting caused less discomfort than upright, but it proven by previous studies did not provide benefit to occupational safety and health practice in preventing occupational health related disease.
Upright sitting
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slump sitting
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back discomfort
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safety and health
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injury prevention
6.Pharmacological properties and mechanisms of Notoginsenoside R1 in ischemia-reperfusion injury.
Chinese Journal of Traumatology 2023;26(1):20-26
Panax notoginseng is an ancient Chinese medicinal plant that has great clinical value in regulating cardiovascular disease in China. As a single component of panax notoginosides, notoginsenoside R1 (NGR1) belongs to the panaxatriol group. Many reports have demonstrated that NGR1 exerts multiple pharmacological effects in ischemic stroke, myocardial infarction, acute renal injury, and intestinal injury. Here, we outline the available reports on the pharmacological effects of NGR1 in ischemia-reperfusion (I/R) injury. We also discuss the chemistry, composition and molecular mechanism underlying the anti-I/R injury effects of NGR1. NGR1 had significant effects on reducing cerebral infarct size and neurological deficits in cerebral I/R injury, ameliorating the impaired mitochondrial morphology in myocardial I/R injury, decreasing kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin in renal I/R injury and attenuating jejunal mucosal epithelium injury in intestinal I/R injury. The various organ anti-I/R injury effects of NGR1 are mainly through the suppression of oxidative stress, apoptosis, inflammation, endoplasmic reticulum stress and promotion of angiogenesis and neurogenesis. These findings provide a reference basis for future research of NGR1 on I/R injury.
Humans
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Reperfusion Injury/prevention & control*
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Inflammation
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China
;
Apoptosis
7.Myocardial injury after burn at early stage and its treatment.
Chinese Journal of Burns 2008;24(5):369-371
Ischemia/hypoxia is one of the key clinical issues following severe burns, and ischemic/hypoxic damage of tissues and organs is still hard to be prevented or minimized by various fluid resuscitation regimens. To those who suffered severe burns, even though fluid replacement therapy is delivered promptly, ischemic/hypoxic damage of organs is still inevitable. Previously, blood flow in vital organs such as heart was considered not to be reduced because of blood redistribution under the circumstance of stress. The postburn cardiac dysfunction has been mainly attributed to the reduced blood flow returned to the heart due to decreased blood volume caused by increased capillary permeability. Therefore, postburn cardiac dysfunction has been considered to be the result of burn shock. During the past two decades, we have performed serial studies on severe burns, and found that ischemic/hypoxic myocardial damage and functional impairment of myocardium due to activation of renin angiotensin system existing in the heart itself occur immediately after severe burns even before significant reduction in blood volume secondary to an increase of capillary permeability. Such prompt myocardial damage leads to cardiac deficiency, and it is also a precipitating factor for burn shock and ischemic/hypoxic injury of systemic tissues and organs. Therefore, we called it "shock heart" in our reports. The cellular and molecular mechanisms leading to myocardial damage were systematically investigated. Strategies for prevention of early postburn myocardial damage and dysfunction, and a new effective burn shock resuscitation regimen "volume replacement" plus "dynamic support" (cardiac support and myocardial protection) have been proposed based on our previous studies.
Burns
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complications
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metabolism
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Humans
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Hypoxia
;
etiology
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prevention & control
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Myocardial Reperfusion Injury
;
etiology
;
prevention & control
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Myocardium
;
metabolism
8.Advances of perioperative acute kidney injury in elderly patients undergoing non-cardiac surgery.
Journal of Central South University(Medical Sciences) 2023;48(5):760-770
The risk of developing perioperative acute kidney injury (AKI) in elderly patients increases with age. The combined involvement of aging kidneys, coexisting multiple underlying chronic diseases, and increased exposure to potential renal stressors and nephrotoxic drugs or invasive procedures constitute susceptibility factors for AKI in elderly patients. The perioperative AKI in elderly patients undergoing noncardiac surgery has its own specific population characteristics, so it is necessary to further explore the characteristics of AKI in elderly patients in terms of epidemiology, clinical diagnosis, risk factors, and preventive and curative measures to provide meaningful clinical advice to improve prognosis, accelerate recovery, and reduce medical burden in elderly patients. Since AKI has the fastest-growing incidence in older patients and is associated with a worse prognosis, early detection, early diagnosis, and prevention of AKI are important for elderly patients in the perioperative period. Large, multicenter, randomized controlled clinical studies in elderly non-cardiac surgery patients with AKI can be conducted in the future, with the aim of providing the evidence to reduce of the incidence of AKI and to improve the prognosis of patients.
Humans
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Aged
;
Acute Kidney Injury/prevention & control*
;
Kidney
;
Risk Factors
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Prognosis
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Incidence
;
Postoperative Complications/prevention & control*
10.Effects of different modes of intermittent hypobaric hypoxia on ischemia/reperfusion injury in developing rat hearts.
Hao ZHANG ; Chang-Ying YANG ; Ying-Ping WANG ; Xin WANG ; Fang CUI ; Zhao-Nian ZHOU ; Yi ZHANG
Acta Physiologica Sinica 2007;59(5):660-666
The aim of the present study was to explore the effects of two different modes of intermittent hypobaric hypoxia (IHH) on myocardial ischemia/reperfusion injury in developing rat hearts. Postnatal male sprague-Dawley rats (n=72) were divided randomly into 3 groups: intermittent hypoxia at 3 000 m (IHH3000) group, intermittent hypoxia at 5 000 m (IHH5000) group and control group. The isolated hearts were perfused in the Langendorff apparatus, undergoing 30 min of global ischemia and 60 min of reperfusion. Cardiac function, coronary flow and lactate dehydrogenase (LDH) activity were recorded at 5 min before ischemia and 1, 5, 10, 20, 30, 60 min during reperfusion, respectively. The heart weight was measured at the end of the experiment. The results showed that: (1) There was no difference in body weight gaining between IHH3000 and control groups. The gain of body weight in IHH5000 group was much lower than that in IHH3000 and control groups (P<0.01). (2) Compared with that in the control group, the recovery of cardiac function in IHH3000 group was enhanced at 60 min after ischemia/reperfusion, coronary flow was increased, and LDH activity was decreased (P<0.05), meaning a cardioprotective effect occurred. There was no significant difference in heart weight between IHH3000 and control groups. In addition, cardiac function restored better in IHH3000 group after 42 d of hypoxic exposure than that after 28 d of hypoxic exposure (P<0.05). (3) Compared with that in the control group, the recovery of cardiac function in IHH5000 group was lower, coronary flow was decreased, and LDH activity was increased (P<0.05). There was a hypertrophy in the right ventricle in IHH5000 group. All changes indicated definitely that a detrimental effect developed in IHH5000 group. The results suggest that proper IHH can protect developing rat hearts against ischemia/reperfusion injury while this effect could be affected by the modes of intermittent hypoxic exposure.
Animals
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Heart
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Heart Ventricles
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Hypoxia
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Male
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Myocardial Reperfusion Injury
;
prevention & control
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Protective Agents
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Rats
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Rats, Sprague-Dawley
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Reperfusion Injury