Acute mountain sickness (AMS) is a clinical syndrome of multi-system physiological disorder after acute exposure to low pressure and low oxygen at high altitude. Quantitative proteomics can systematically quantify and describe protein composition and dynamic changes. In recent years, quantitative proteomics has been widely used in the prevention, diagnosis, treatment and pathogenesis of many diseases. This review summarizes the progress of quantitative proteomics techniques and its application in the prevention, diagnosis, treatment of AMS and mechanisms of rapidly acclimatizing to plateau, in order to provide a reference for the pathogenesis, early intervention, clinical treatment and proteomic research of AMS.
Humans ; Altitude Sickness/prevention & control* ; Proteomics ; Acute Disease ; Oxygen/metabolism*

This study was performed to evaluate whether increasing hemoglobin before ascent by prophylactic erythropoietin injections prevents acute mountain sickness (AMS). This open-label, randomized, controlled trial involved 39 healthy volunteers with hemoglobin < or =15.5 g/dL who were divided randomly into erythropoietin (n=20) and control (n=19) groups. Epoetin alpha 10,000 IU injections were given weekly for four consecutive weeks. On day 1, and 7 days after the last injection (day 29), oxygen saturation (SaO2), and hemoglobin were measured. The subjects departed Seoul on day 30 and arrived at Annapurna base camp (ABC, 4,130 m) on day 34. AMS was diagnosed when headache and Lake Louise score (LLS) of > or =3 were present. Immediate descent criteria followed US Army recommendations. Two groups differ in hemoglobin levels on day 29 (15.4+/-1.1 vs 14.2+/-1.0 g/dL, P=0.001). At ABC, erythropoietin group had a significantly lower mean LLS, AMS incidence, and number of subjects who met immediate descent criteria. Multiple logistic regression analysis showed that SaO2<87% and control group, but not hemoglobin<15.0 g/dL, independently predicted satisfaction of immediate descent criteria. Erythropoietin-related adverse effects were not observed. In conclusion, erythropoietin may be an effective prophylaxis for AMS.(Clinical Trial Registry Number; NCT 01665781).
Acute Disease ; Adult ; Altitude Sickness/diagnosis/epidemiology/*prevention & control ; Blood Pressure/physiology ; Drug Administration Schedule ; Erythropoietin/*therapeutic use ; Female ; Headache/physiopathology ; Hemoglobins/analysis ; Humans ; Incidence ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Oxygen/blood ; Questionnaires ; Recombinant Proteins/therapeutic use

The incidence of deacclimatization to high altitude syndrome (DAHAS) prevailed up to 80% in highland troops, and 100% in manual workers, and severe DAHAS could significantly affects patients' health, work and life. So it is imperative to develop effective prevention and treatment measures for DAHAS. The present review analyzes effective prophylactic and therapeutic measures against DAHAS, implemented at our hospital.
Acclimatization ; Altitude ; Altitude Sickness ; prevention & control ; therapy ; Humans

OBJECTIVETo explore the effect of prophylaxis on youth's chronic mountain sickness(CMS) who moved to an altitude of above 5 000 meters by long-term oxygen therapy (LTOT).

METHODSNinety-six male youth stationed at 5 070 m, 5 200 m and 5 380 m took oxygen continuously by nasal cannula (LTOT group) every body per day. One year later, epidemiological survey were carried out according to the international CMS diagnostic criteria consist of examining right ventricle end-diastolic dimension (RVED), right ventricular anterior wall (RVAW), right ventricular outflow tract (RVOT), main pulmonary artery (MPA), left ventricular end systolic diameter (LVSD) by ultrasonic diagnostic apparatus, and blood test of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (gamma-GT), creatine kinase (CK), lactate dehydrogenase (LDH), superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), nitric-oxide synthase (NOS) blood oxygen saturation (SaQ2). Then, they were compared with 91 males in the same group stationed at the same altitude (without any interventions, control group).

RESULTS(1) The epidemiological survey showed that, SaO2 were increased significantly (P < 0.05) and the prevalence rate of CMS were decreased compared with that of control group (P < 0.05). (2) Echocardiography showed that SOD, NO, NOS were increased (P < 0.05 or 0.01) and LVSD, MPA had no significant difference compared with that of control group (P > 0.05). (3) Biochemical index showed that, SOD, NO, NOS were increased (P < 0.05 or 0.01), MDA, ALT, AST, LDH were decreased (P < 0.05 or 0.01) and gamma-GT, CK had no significant difference compared with that of the control group.

CONCLUSIONAt high altitude, LTOT can reduce lipid peroxidation, improve the important organ injuries caused by hypoxia and protect the mitochondria respiratory function and play an important role on the prevention of chronic mountain sickness.

Adolescent ; Adult ; Altitude Sickness ; blood ; prevention & control ; Humans ; Male ; Oxygen ; administration & dosage ; therapeutic use ; Oxygen Inhalation Therapy ; Young Adult

Acute altitude reaction is a stress response of organism to special altitude environmental factors such as hypoxia, low pressure, cold, dry and strong ultraviolet. As it is the most incident disease in high altitude areas, its prevention remains a problem to be solved. In China, the traditional Chinese (Tibetan) medicines have been recognized as an effective means of preventing and treating acute altitude sicknesses. Some single-recipe or compound traditional Chinese (Tibetan) medicines have been proved to be effective for acute altitude sicknesses. In this article, we will describe traditional Chinese (Tibetan) medicines of different types with efficacy in prevention and treatment of altitude sicknesses.
Acute Disease ; Altitude Sickness ; drug therapy ; prevention & control ; Humans ; Medicine, Chinese Traditional ; Medicine, Tibetan Traditional

OBJECTIVEWhile the technology of the molecular sieve oxygen generation system(MSOGS) onboard was used, pilots could not breathe pure oxygen to eliminate nitrogen during a high altitude flight. There is no report whether it is a threat to altitude decompression sickness(ADS) or not in that condition. This experiment was intended to observe the effects of breathing different oxygen-rich gases of MSOGS on denitrogenation, so that we could make the medical physiological requirements for MSOGS on-board and provide experimental basis for aeromedical supply.

METHODEight healthy males were breathed oxygen-rich gases (60%,70%,80%,90%and 99.6%) in turn for 60 min, and the concentration of nitrogen, oxygen, carbon dioxide and argon at the end of expiration interval in the oxygen mask were continuously measured by a flight mass spectrometer through the oxygen mask. According to the variety of the denitrogenation rate by breathing different oxygen-rich gases, its change law was analyzed.

RESULTSThere were significant differences (P < 0.05) about denitrogenation rate in different oxygen-rich gases due to different oxygen concentration and breathing time. The denitrogenation rate of pure oxygen was higher than that of the others. It was indicated that the concentration of nitrogen in lung would decrease along with the increase in oxygen concentration of oxygen-rich gases, and the nitrogen concentration in the lung almost decreased by 50% or even more if people were breathed 60%-90% oxygen-rich gas longer than 60 s.

CONCLUSIONThe man-made respiration environment of low nitrogen can be provided by breathing oxygen-rich gases, although the denitrogenation velocity of breathing oxygen-rich gases is lower than that of breathing pure oxygen. So it can be used as a measure to eliminate and lower the nitrogen in the body to prevent from ADS.

Altitude ; Altitude Sickness ; prevention & control ; Carbon Dioxide ; Decompression Sickness ; prevention & control ; Humans ; Male ; Nitrogen ; Oxygen ; therapeutic use ; Respiration

The aim of this study was to investigate the effect of integripetal rhodiola herb on pulmonary arterial remodeling and expression of vascular endothelial growth factor (VEGF) in high altitude pulmonary hypertension in rats. Fifty healthy male Wistar rats were divided into five groups randomly: Plain control group (LC group), 10-day plateau group (H(10) group), 30-day plateau group (H(30) group), 10-day rhodiola-treated plateau group (R(10) group), and 30-day rhodiola-treated plateau group (R(30) group). Each group included 10 rats. The rats in LC group were kept in Chengdu (500 meters above sea level), and rats in H and R groups were kept in Lhasa (3 700 meters above sea level). The rats in R group were daily treated with integripetal rhodiola herb extract (24%, 10 mL/kg) intragastrically for 10 d or 30 d, while rats in LC and H groups were treated with the same volume of saline. Mean pulmonary arterial pressure (mPAP) was detected via a catheter in the pulmonary artery by pressure waveform monitoring. The ratio value of right ventricle weight to left ventricle plus septum weight [RV/(LV + S)] was measured. The microstructure of pulmonary arterioles was examined by electron microscopy. The expression of VEGF in the lung was investigated using immunohistochemistry. The results showed that mPAP and [RV/(LV + S)] in H(10) group and H(30) group were higher than those in LC group (P < 0.05); but there was no significant difference between H(10) group and R(10) group (P < 0.05); and mPAP and [RV/(LV + S)] in H(30) group were lower than those in H(30) group (P < 0.05). Electron microscopy showed that compared to LC group, arteriolar endothelial cells were arranged in a columnar or palisading form, protruding into the lumen, accompanied with luminal stenosis, irregular internal elastic membrane, and proliferation of vascular smooth muscle cells in H groups, which was more obvious in H(30) group than in H(10) group; while these pathological changes were attenuated in the R groups compared to H groups. The levels of VEGF protein in H groups were also higher than those in LC group (P < 0.05); while the expression of VEGF in R(30) group was lower than that in H(30) group. In summary, the results show that the integripetal rhodiola herb can attenuate high altitude-induced pulmonary arterial remodeling in rats, and the inhibition of VEGF protein expression by rhodiola may be one of the mechanisms.
Altitude ; Altitude Sickness ; prevention & control ; Animals ; Arterioles ; metabolism ; pathology ; Drugs, Chinese Herbal ; pharmacology ; Hypertension, Pulmonary ; metabolism ; pathology ; physiopathology ; Male ; Pulmonary Artery ; metabolism ; pathology ; RNA, Messenger ; metabolism ; Rats ; Rats, Wistar ; Rhodiola ; Vascular Endothelial Growth Factor A ; metabolism

Acclimatization ; physiology ; Altitude ; Altitude Sickness ; prevention & control ; Humans ; Hypoxia ; physiopathology ; Male ; Military Personnel ; Mountaineering ; physiology ; Oxygen Consumption ; physiology ; Physical Fitness ; physiology ; Young Adult

OBJECTIVETo explore the effects of different doses of P-8 in increasing the Hypoxia tolerance of mice and the mechanisms involved.

METHODSThe health mice were placed into the oxygen deficit bottles and measured the survival time in the condition of hypoxia. The male mice were put into the ladder cage, then placed them into the hypobaric champer to determine the survival time of mice with decompression hypoxia (min). We observed the activity changes of the mice's organization carbonic anhydrase II (CAII). By using the drug in prophylaxis, we investigated the effects of carbonic anhydrase target-based inhibitors P-8 for improving the hypoxia tolerance.

RESULTS(1) In improving the endurance of mice in the condition of hypoxia, the survival time of 6.25 mg/(kg x d) and more doses of P-8 groups were (27.38 +/- 4.63, 29.53 +/- 4.43, 29.67 +/- 7.28, 31.55 +/- 6.34, 32.45 +/- 6.65, 36.81 +/- 7.24 and 35.41 +/- 4.20) min, compared with the control group (22.90 +/- 3.19) min , the survival time significantly prolonged (P < 0.05, P < 0.01); compared to the same dose of acetazolamide groups (24.54 +/- 3.17, 22.70 +/- 3.04, 22.67 +/- 2.99, 23.93 +/- 0.96, 27.87 +/- 5.06, 30.79 +/- 5.12 and 35.14 +/- 6.46) min, the survival time significantly prolonged; P-8 groups and Acetazolamide's minimum effective dose were 6.25 and 100 mg/(kg x d), the potency of P-8 is 16 times Acetazolamide. (2) In improving the endurance of mice in the condition of hypoxia, the survival time of middle and high doses of P-8 groups [(24.82 +/- -3.92, 28.27 +/- 5.89) min] were significantly longer than those in control group [(21.96 2.51) min, P < 0.05]; compared with the acetazolamide (23.11 +/- 3.71) min, the survival time of high dose of P-8 group was significantly prolonged. (3) Compared with the normal control group, P-8 [(25 mg/(kg x d), 50 mg/(kg x d), 100 mg/(kg x d), 200 mg/(kg x d)] dose groups inhibited the activity of carbonic anhydrase II (CAII) in the renal (P < 0.05, P < 0.01); P-8 [100 mg/(kg x d) and 200 mg/(kg x d)] dose group significantly inhibited the activity of carbonic anhydrase II (CA II) in the brain (P < 0.05).

CONCLUSIONP-8 treatment improved the endurance of mice in the condition of hypoxia and worked better than Acetazolamide. The mechanism may be related to the inhibition of carbonic anhydrase organization.

Adaptation, Physiological ; physiology ; Altitude Sickness ; prevention & control ; Animals ; Carbonic Anhydrase Inhibitors ; pharmacology ; therapeutic use ; Hypoxia ; physiopathology ; Male ; Mice

OBJECTIVETo study on the protective effects of new compound codonopsis tablets against acute mountain sickness (AMS).

METHODSForty-five male plain resident soldiers stayed at 1400 m altitude for 3 months were randomly divided into two groups, control (15 men) and treatment group (30 men). Single blind trial was used in this study. The subjects in the two groups took placebo and new compound codonopsis tablets respectively for 5 days before climbing to high mountain, and continued to take for another 10 days until the 3rd day after arriving at 5200 m altitude. On the 1st , 3rd, and 5th day after they arrived at 5200 m altitude, the score and the degree of AMS symptoms of soldiers were followed up and recorded according to State Military Standard GJB1098-91--"Principles of diagnosis and treatment of benign form of acute mountain sickness", heart rate (beats/min) and arterial oxygen saturation (%) were detenrmined. On the 6th day after they arrived at high altitude, forced vital capacity(FVC), forced expired volume in one second(FEV1.0), FEV1% (FEV1.0/FVC), FEF25%-75%, peak expiratory flow (PEF) and maximal voluntary ventilation (MVV) were detected, total frequency of hands cross movement and memory of order numbers test were measured.

RESULTSComparison with control, AMS symptoms of treatment group reduced on the 1st, 3rd, and 5th day after arriving at 5200 m high altitude (P < 0.01). The degree of AMS symptoms of treatment group was significantly different from that of control. The proportion of slight symptoms in treatment group was high, and that of relative serious symptoms in control was high. Compared with control, FVC, FEV1.0, FEF25%-75%, PEF and MVV of treatment group increased (P < 0.05, P < 0.01), and Ttis, Ctis of treatment group increased (P < 0.05, P < 0.01), Atime decreased markedly (P < 0.05), there was no statistically significant difference in Etis and Sum between the two groups.

CONCLUSIONNew compound codonopsis tablets could decrease the incidence of AMS, mitigate the symptoms of AMS, and improve breathing function and fingers movement function. New compound codonopsis tablets have an obvious effect on prevention and treatment of acute mountain sickness.

Acute Disease ; Adolescent ; Altitude Sickness ; prevention & control ; Codonopsis ; chemistry ; Drug Compounding ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Phytotherapy ; Tablets ; Young Adult