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Objective:The hemodynamic parameters of elderly patients with septic shock were measured simultaneously with pulse index continuous cardiac output(PiCCO)and thoracic electrical bioimpedance(TEB)to evaluate the accuracy of TEB and to provide empirical evidence for its clinical use.Methods:A total of 24 elderly patients with septic shock admitted to the intensive care unit of our hospital between July 2021 and December 2021 were retrospectively recruited.TEB and PiCCO hemodynamic monitoring were performed continuously in all patients, and hemodynamic data were collected for statistical analysis.Results:Cardiac output, cardiac index, stroke volume, stroke index and systemic vascular resistance measured by the two methods had no significant difference( P>0.05). The 95% confidence intervals in the Bland-Altman plots for cardiac output, CI, stroke volume, stroke index, and systemic vascular resistance were(-1.18, 1.25), (-0.65, 0.71), (-24.23, 37.00), (-12.93, 19.26)and(397.11, 425.83). In the Bland-Altman plots for cardiac output, cardiac index, stroke volume and systemic vascular resistance, 4.17% of the points(1/24)fell outside of the 95% confidence interval, and in the Bland-Altman plots for stroke index, 8.33% of the points(2/24)fell outside of the 95% confidence interval. Conclusions:TEB and PiCCO have good consistency in evaluating the hemodynamics of elderly patients with septic shock.Therefore, TEB can be recommended for community hospitals and used in elderly patients.
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Exercise rehabilitation is an important method for the prevention and treatment of cardiovascular diseases(CVD). Non-invasive hemodynamic monitoring has the advantage of effectively recording changes in exercise intensity and cardiac function with easy implementation, good compliance, and objective and reliable results.It holds great promise in a wide range of purposes such as helping the formulation of exercise prescriptions and evaluating clinical efficacy for cardiac rehabilitation(CR)in community hospitals.
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Objective:To investigate the effect of enhanced external counterpulsation(EECP)on heart failure with preserved ejection fraction(HFpEF)and hemodynamics in elderly patients.Methods:Clinical data of 66 elderly HFpEF patients admitted to the enhanced external counterpulsation center of our hospital from January 2018 to December 2019 were retrospectively analyzed.The primary assessment parameter was the six-minute walk distance, and the secondary parameters included the Minnesota Living with Heart Failure Questionnaire(MLHFQ). Noninvasive hemodynamic parameters including the cardiac index(CI), stroke volume(SV), isovolumic relaxation period(A2-mitral valve opening, A2-O), pulmonary capillary wedge pressure(PCWP)and total peripheral resistance(TPR)were monitored and mean arterial blood pressure(MAP)was calculated.Results:After EECP treatment, the six-minute walk distance increased(372±87 m vs.341±85 m, P<0.05), the score of MLHFQ decreased(47.0±16.0 vs.50.0±17.0, P<0.05), CI increased(2.8±0.7)L·min -1·m -2vs.(2.6±0.6)L·min -1·m -2( P<0.05), SV, PCWP and A2-O did not show significant change(73.3±16.4 ml vs.71.5±17.1 ml, 10.0±3.3 mmHg vs.11.0±3.6 mmHg, 1 mmHg=0.133 kPa, 98.0±29.5 ms vs.91.0±29.1 ms, P>0.05), TPR decreased(1 719.0±427.0 DS/cm 5vs.1 821.0±508.0 DS/cm 5, P<0.05), and there was no significant change in MAP(96.9±10.7 mmHg vs.98.8±13.1 mmHg, P>0.05), compared with pre-EECP treatment levels.Compared with patients without hypertension, MAP decreased in patients with hypertension(14 cases), when stratified by the initial MAP( P<0.05). Conclusions:For elderly patients with HFpEF, EECP can increase the six-minute walk distance, improve the quality of life and hemodynamic parameters, and is a safe adjuvant treatment.
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Objective To investigate the effect and its mechanism of D-pinitol on advanced glycation end products(AGEs)-induced proliferation and migration in mouse aortic vascular smooth muscle cells (VSMC).Methods VSMCs were isolated from mouse aorta and cultured in vitro.Effects of different concentrations of D-pinitol on proliferation and migration of VSMCs were observed by using the AGEs-induced glycosylation injury model of VSMCs.Cell proliferation and migration were detected by CCK-8 assay and cell scratch,respectively.The protein expression levels of transforming growth factor-β1(TGF-β1),p-smad2,p-smad3 and asporin were determined by Western blot.Results Compared with control group,AGEs group showed the increased protein expression levels of asporin,TGF-β1,p-smad2 and p-smad3 (40.06 ± 4.50 vs.17.47 ± 0.57),(55.25 ± 2.07 vs.14.42± 2.07),(0.97 ± 0.02 vs.0.47 ± 0.02),(0.45±0.01 vs.0.26 ± 0.02),all P＜ 0.01.Compared to AGEs group,D-pinitol group could inhibit the cell proliferation and migration and cause dose-dependent decreases of protein expressions of TGF-β1,p-smad2,p-smad3 and asporin(P ＜ 0.05 or P＜0.01).Conclusions D-pinitol can inhibit AGEs-induced cell proliferation and migration in mouse aortic VSMCs.Asporin may participate in the VSMCs extracellular matrix remodeling via TGF-β/smad pathway.
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Objective To investigate the correlation of glycosylated hemoglobin(HbA1C)levels with carotid atherosclerotic plaque and pulse wave velocity (PWV) in elderly patients with type 2 diabetes mellitus (T2DM).Methods There were 130 cases of elderly patients with T2DM,aged from 60 to 92 years,of whom there were 59 males.All subjects were divided into 3 groups based on the HbA1Clevels:the low level group (HbA1C＜7％,n=49),the middle level group (77％≤HbA1C＜ 8.5 ％,n =58) and the high level group (HbA1C ≥8.5 ％,n=23).Height,body weight,blood pressure,blood glucose,blood lipids,HbA1C and other indexes were collected and compared among groups.In addition,carotid ultrasound and PWV examinations were performed.Results There were significant difference in levels of systolic blood pressure (SBP),fasting blood glucose (FBG),high density lipoprotein cholesterol (HDL-C),carotid intima-media thickness (IMT),plaque score,plaque stability and PWV among groups (all P＜0.05).Correlation analysis showed that IMT levels were correlated with gender (r=0.389),age (r=0.296),FBG (r=0.203),HbA1C(r=0.405) and HDL-C (r =-0.208),all P ＜ 0.05.Carotid artery plaque score correlated with gender (r =0.321),age (r =0.355),HbA1C(r=0.340) and HDL-C (r=-0.249) (all P＜0.01)and there is a correlation between the stability of carotid plaques with body mass index (BMI) (r =-0.286),SBP (r =-0.188),HbA1C(r=-0.368) and HDL-C (r=0.405) (all P＜0.05);PWV was correlated with age (r=0.516),SBP (r=0.521),diastolic blood pressure (r=0.225),FBG (r=0.181),HbA1C(r=0.229),triglyceride (r =-0.253),total cholesterol (r=-0.311) and LDL-C (r=-0.244),all P＜ 0.05.Moreover,there was a correlation between IMT and PWV (r =0.234,P ＜ 0.01).Logistic regression analysis showed that gender,age and HbA1C were independently associated with IMT;gender,age,BMI and HbA1C were independently associated with carotid atherosclerosis plaque score;age,HbA1C and HDL-C were independently associated with the stability of carotid atherosclerotic plaque;age and SBP were independently associated with PWV.Conclusions HbA1C,SBP,HDL-C and BMI are independent risk factors for arteriosclerosis in elderly diabetics.
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Objective To investigate the anti-inflammatory effect of C1q/ tumor necrosis factor (TNF)-related protein 9 (CTRP9) in RAW264.7 mouse macrophage cells treated with oxidized low density lipoprotein (oxLDL),and to explore its mechanism.Methods RAW264.7 mouse macrophage cells were divided into three groups:the control group,the oxLDL group (treated with oxLDl) and the gCTRP9-oxLDL group (pretreated with recombinant globular domain of CTRP9 and stimulated by oxLDL).Foam cells were detected by oil red O staining.Western blot was used to detect the expressions of pro-inflammatory cytokines tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein 1 (MCP-1).In addition,the expression levels of NF-κB p65 in cytoplasm and nucleus proteins extraction were both determined.Results The relative levels of MCP-1 and NF-κB were increased in the oxLDL group as compared with the control group (1.66±0.09 vs.1.03±0.10,0.52±0.11 vs.1.03±0.06,both P＜0.05).The expression levels of TNF-α and MCP-1 were decreased in gCTRP9+oxLDL group as compared with the oxLDL group (both P＜0.05).The expression level of NF κB p65 in nucleus 2 and 8 h after treatment was lower in the gCTRP9+oxLDL group than in the oxLDL group (1.03±0.06 vs.0.17±0.10,0.31±0.03,both P＜0.05).Conclusions oxLDL may induce the expressions of inflammatory cytokines of TNF α and MCP-1 in macrophage ceils.gCTRP9 pretreatment could reduce the oxLDL-induced pro inflammatory effect and nuclear factor κB translocation may be involved in this process,which suggests that gCTRP9 may play a protective role in anti inflammatory and anti-atherosclerosis.
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<p><b>BACKGROUND</b>Ouabain is a mammalian adrenocortical hormone that is involved in the pathogenesis of hypertension by inhibiting Na-K ATPase activity. It also participates in a variety of kinase-mediated signaling pathways associated with Na-K ATPase. Previous studies have shown that ouabain can cause cardiac remodeling independent of elevated blood pressure and that proliferating cell nuclear antigen (PCNA) plays a coordinating role for numerous proteins involved in multiple processes associated with DNA synthesis. Therefore, we hypothesized that ouabain might play a role in the cerebral cortex through signaling pathways independent of hypertension. And PCNA might be involved in this process.</p><p><b>METHODS</b>Male Sprague-Dawley rats were treated with ouabain or with 0.9% nitric sodium as the control group. Systolic blood pressure was recorded weekly. After four weeks of treatment, morphological changes in the cerebral cortex were analyzed using light and transmission electron microscopy. The expression of PCNA in the cerebral cortex was evaluated by immunohistochemistry, real time quantitative PCR, and Western blotting.</p><p><b>RESULTS</b>After 4-week treatment, there was no significant difference in systolic blood pressure compared with the control group, but both structural deterioration and up-regulated expression of PCNA in the brain was induced by ouabain treatment.</p><p><b>CONCLUSIONS</b>These results suggest that ouabain induces alterations in the brain structure, and this effect is independent of blood pressure. PCNA might be involved in the repair process of ouabain-induced brain damage.</p>
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Animals , Male , Rats , Blood Pressure , Hypertension , Drug Therapy , Metabolism , Immunohistochemistry , Ouabain , Therapeutic Uses , Proliferating Cell Nuclear Antigen , Metabolism , Rats, Sprague-Dawley , Real-Time Polymerase Chain Reaction , Sodium-Potassium-Exchanging ATPase , MetabolismABSTRACT
Objective To investigate the efficacy of statin on carotid plaque stability in elderly patients assessed by K trans (the combination of E and F) of dynamic contrast material enhanced (DCE) magnetic resonance (DCE MR) imaging.Methods 37 elderly patients with carotid artery of low echo or mixed echo plaque in carotid artery patches were screened by B type ultrasound.According to the standard of 2011 ESC/EAS guidelines,all patients were divided into two groups:normal level of LDL-C group achieving LDL-C target and high level of LDL C group not achieving target of LDLC.Plaque area and size of lipid-rich necrotic core were measured by 3.0T enhancement magnetic resonance,and K trans was measured by DCE-MR dynamic contrast material enhanced (DCE) magnetic resonance (MR) imaging.and serum hs-C-reactive protein level was detected within 1 week.Results Plaque area,size of lipid-rich necrotic core,ratio of lipoid core over plaque area,K trans and serum level of hs-CRP were less in normal LDL-C level group than in high LDL-C level group [(2.06±0.45) mm2 vs.(3.63±0.62) mm2,(0.52±0.05) mm2 vs.(1.49±0.01) mm2,2 cases (11.8％) vs.14 cases (70.0％),(0.041±0.009) min1 vs.(0.079±0.011) min-1,(1.60±0.27) mmol/L vs.(2.80 ± 0.34),all P＜0.05].Linear regression analysis revealed that there was no significant correlations of K trans with the size of lipid necrotic core (r=0.19,P＞0.05) and hs-CRP (r=0.23,P＞0.05).Conclusions Dynamic contrast material enhanced (DCE) magnetic resonance (MR) imaging is a quantitative method assaying atheromatous plaque components; K trans may be a new indicator to measure the stability of plaques; Statin can stabilize plaques through inhibiting the proliferation of Vasa vasorum in plaque angiogenesis,anti-inflammatory and reducing the size of lipidrich necrotic core.
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Objective To investigate the effect of hypertension on the large artery elasticity index (C1),the small artery elasticity index (C2) and the medial structure of the ascending aorta as well as the relationship between artery elasticity and the medial structure of the ascending aorta.Methods Sixty patients with CHD receiving coronary artery bypass graft surgery at our hospital were divided into two groups:30 patients in the hypertension group and 30 patients in the non-hypertension group.C1 and C2 were measured using the CVProfilor DO-2020 system.Sections of tissues taken from the anterior wall of the ascending aorta during the surgery were subjected to Masson's trichrome staining for the detection of vascular smooth muscle and collagen fibers and Weigert's resorcin-fuchsin staining for the detection of elastic fibers.The relative areas of vascular smooth muscle fibers,collagen fibers and elastic fibers of the ascending aorta were measured by a computer image analysis system under the light microscope.The linear correlations of C1 and C2 with the medial structure of the ascending aorta were analyzed.Results C1 in the non hypertension group was higher than that in thehypertensiongroup[11.9±1.8 (ml/mmHg×10) w 13.1±2.5 (ml/mmHg×10),t 2.22,P ＜0.05].In the media of the ascending aorta,the relative content of collagen fibers was higher,while the relative content of elastic fibers was lower in the hypertension group than in the non-hypertension group [(46.0±3.8)％ w (42.2±3.0)％,(17.5±3.5)％ vs.(19.3 2.7)％,respectively,t=4.24 and 2.20,P＜0.01 or 0.05].C1 was positively correlated with the relative content of elastic fibers but negatively correlated with the relative content of collagen fibers in both groups (r=0.52 and 0.39,respectively,P＜0.05 or 0.01).Conclusions The main pathogenic basis of hypertension-induced decline in arterial elasticity in CHD patients is increased collagen fibers and reduced elastic fibers with disorganization of the two types of components.C1 may accurately reflect the effect of hypertension on medial collagen fibers and elastic fibers in the ascending aorta.
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Objective To observe the change of profilin-1 during the aging of rats' aorta and the anti-aging effect of grape procyanidins (GPC).Methods Young male Wistar rats (9 weeks) and middle rats (12 months) were randomly divided into GPC treatment and control groups respectively.We quantified arterial aging changes through morphological methods.Thoracic aortas were stained with hematoxylin eosin.Serum levels of 3-nitrotyrosine (3-NT),malondialdehyde (MDA),superoxide dismutase (SOD) and nitric oxide (NO) were tested using enzyme-linked immunosorbent assay (ELISA).Western blotting was performed to measure the protein expression of inducible nitric oxide synthase (iNOS) and profilin-1.Results Compared with the young male Wistar rats group,aging change in the aortic morphology of middle rat group were shown by hematoxylin-eosin staining (HE) staining:media thickness (MT) increased [(98.3±0.5)μm vs.(83.1±1.0)μm,P＜0.05],luminal internal diameter (LD) decreased [(15.5 ±0.2) μm vs.(18.2±0.5,P＜0.05)μm,P＜ 0.05],(MT/LD)％ increased [(6.4±0.1) ％ vs.(4.6±0.1)％,P＜0.05],the protein expressions of profilin-1 and iNOS both increased [profilin-1:(1.58 ± 0.09) vs.(1.29 ± 0.04),iNOS:(1.02±0.12) vs.(0.75±0.02),both P＜0.05],levels of NO and SOD in serum decreased [NO:(6.3±0.2)μmol/L vs.(8.4±0.2) μmol/L,SOD:(172.3±1.6) U/ml vs.(189.1±1.5) U/ml,both P＜0.05],the levels of MDA and 3-NT increased[MDA:(11.3±0.3) μmol/L vs.(9.4 ±0.1) μmol/L,3 NT:(40.2±0.3) nmol/L vs.(35.6±0.5) nmol/L,both P＜0.05)].After treatment with GPC,compared with the control group,MT decreased,LD increased and MT/LD (％)decreased in the middle GPC treatment group.The protein expressions of profilin-1 had no changes before and after treatment with GPC both in young and middle groups.After the GPC treatment in middle group,compared with the middle control group,iNOS expression decreased,serum levels of NO and SOD increased,and the levels of MDA and 3-NT decreased significantly (all P ＜0.05).Conclusions Profilin-1 is related with age-related changes in rat aorta.Profilin-1 participates in vascular aging through iNOS induced oxidative stress.GPC may defer vascular aging by inhibiting vascular oxidative stress.
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Objective To analyze the protein expression changes of retina in diabetic mice using isobaric tags for relative and absolute quantitation (iTRAQ) approach and to study proteins of apoptosis.Methods 8 diabetic mice were chosen as the diabetic model group (DM group),8diabetic mice as the normal control group.The animals were housed in wire-bottomed cages and received normal pellet chow and tap water in a constant environment.After 10 weeks,all mice were killed,and their retina were dissected.After hematoxylin and eosin(H&E) staining,the sections of retina were examined using light microscopy.The changes of protein expression in retina were studied using iTRAQ approach.Expression of apoptosis associated proteins was analyzed using ingenuity pathway analysis (IPA).Results Compared with control group,mice retina in DM group developed looser structures,tissue edema and obvious telangiectasia under light microscopy.Using iTRAQ approach,a total of 348 differential proteins were identified.Among those proteins,16 proteins were related with apoptosis,including Ataxin-10,Protein NDRG1,mucin-4,Aquaporin-1 and annexin A4,etc.There were 8 apoptosis-related proteins in retina with up-regulation,and the other 8 proteins with down-regulation in the DM group.The relationship between these proteins were analyzed and charted by IPA.Conclusions Apoptosis may be involved in the development of diabetic retinopathy.The identification of the apoptosis-related proteins will be helpful for the further study.
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Objective To study the proteins related to aging in aortic of old rats for laying the foundation of further study of aging mechanism.Methods The rat model of aging was built,and all model rats were divided into 4 groups:the adult group(9 weeks),the old group(12 months)of WistarKyoto (WKY) rats,and the age-matched spontaneously hypertensive rats (SHR).Blood pressure of 4 groups was observed.Morphological change of aorta was observed by HE staining.Differential proteins were identified by isobaric tags for relative and absolute quantitation,(iTRAQ)-coupled liquid chromatography and tandem mass spectrometry technology.Part of differential proteins was subsequently detected by real time PCR and Western blot.Results The mean SBP of the old group SHR was higher than WKY of 97.1％ (t=39.00,P＜0.05),and the adult group of SHR was also higher than WKY of 5.4％(t=3.64,P＜0.05).Compared with the adult group,aging change in the aortic morphology of old SHR and WKY were shown in HE staining,and the change in SHR rats was more marked.7 proteins related to aging were identified by Mass spectrum analysis,and they were Profilin-1,Prelamin A,HSP70,creatine kinase-M,Fibulin-5,eIF5A and Prohibitin.Part of differential proteins was subsequently confirmed by real time PCR and Western blot.Prelamin-A was up-regulated in the old group of WKY and SHR (0.15±0.01 vs.0.45±0.04,0.34±0.02 vs.0.78±0.06) (t=12.67,12.06,all P＜0.01),Prohibitin was down-regulated in the old group of WKY and SHR(1.34±0.05 vs.1.01± 0.06,1.24±0.05 vs.0.88±0.08) (t=7.41,7.09,all P＜0.01).Profilin-1 was up-regulated in the old group of WKY and SHR (9.12±0.4 vs.20.76±0.8,16.84±0.5 vs.55.16±0.9) (t=22.55,64.46,both P＜0.01),and Profilin-1 expression in the old group of SHR was higher thanWKY (55.16±0.90 vs.20.76±0.8,t=49.49,P＜0.01).Conclusions Differential proteins of the old rat aorta are identified through the comparative proteomics method.These differential proteins will provide new targets for the prevention and control of vascular aging.
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Objective To observe the effects of phlorizin on aorta of diabetes db/db mice and to explore its mechanism.Methods Sixteen diabetes db/db mice were randomized into two groups:untreated diabetic group (DM group) and diabetic group treated by phlorizin(DMT group) with eight db/m mice as normal control group(CC group).Phlorizin (20 mg/kg) was given in normal saline solution intragastrically to the mice of the DMT group for 10 weeks.Mice of the other two groups were given the same amount of saline solution intragastrically for 10 weeks.Animals were weighed weekly.At 10th weekend,all mice were fasted overnight and then sacrificed.Fasting blood was collected,and aortas were dissected.The blood samples were analyzed for fasting blood glucose (FBG),triglycerides (TG),total cholesterol (TC),Serum advanced glycation end products(AGEs)and malondialdehyde (MDA).Aortic tissue were examined microscopically.Results At 10th weekend,the weight (57.53±3.40)g and serum concentration of FBG(31.21±2.16) mmol/L,TG (0.39±0.12) mmol/L,TC(3.15±0.30)mmol/L,AGEs (0.28±0.04) AU/mg and MDA (15.18± 1.60)mol/L in DM group were increased than those in CC group (P＜0.01),and the weight(54.24± 1.28)g,FBG(29.17±1.41) mmol/L,TG(0.26±0.06) mmol/L,TC(2.71±0.26) mmol/L,AGEs (0.24±0.03) AU/mg and MDA(13.46±1.28)mol/L were lowered significantly in DMT group than those in DM group (P＜0.05 or P＜0.01).The severity of aorta damage in DMT group was less than that in DM group.Conclusions Phlorizin can protect the db/db mice from diabetic macrovascular complications,which may be attributed to its decreasing of blood glucose,TG,TC,and AGEs levels,and its antioxidant potential.
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Objective To observe the effect of grape seed proanthocyanidin extract (GSPE) on vascular remodeling in ouabain-induced hypertensive rats.Methods A total of 30 male SpragueDawley rats were randomized into 3 groups:control group (received 0.9％ 1 ml normal saline by intraperitoneal injection and oral gavage in the morning),ouabain treatment group (received 2 mg/kg ouabain by intraperitoneal injection and 0.9 ％ 1 ml normal saline by oral gavage in the morning),and GSPE treatment group (received 2 mg/kg ouabain by intraperitoneal injection and 250 mg Kg 1 d-1 GSPE by oral gavage in the morning).Blood pressure was determined before and 5 weeks after the treatment.The aortas were observed 5 weeks after the treatment.The mRNA and protein levels of nuclear factor-κB (NF-κB p65) and transforming growth factor-β1 (TGF-β1) in rat aorta were detected using real-time PCR and Western blot,respectively.Morphological observations were obtained by Hemotoxylin and Eosin staining and Electron microscope.Results The systolic blood pressure was significantly lower in GSPE treatment group than in ouabain treatment group [(133.6±6.0) mm Hg vs.(146.5±7.9) mm Hg,1 mm Hg=0.133 kPa,P＜0.01].Morphological observation showed that the thickening aortic intimal and structural disorder were found in the ouabain treatment group,and aortic intimal structural integrity were normal in the other two groups.The mRNA and protein levels of NF-κB p65 and TGF-β1 were significantly lower in GSPE treatment group than in the ouabain treatment group (NF-κBp65:2.77±0.58 vs.3.14±0.64,0.73±0.20 vs.0.93±0.21,both P＜0.05; TGF-β1:5.80±0.67 vs.6.09±0.95,0.42±0.14 vs.0.69±0.16,both P＜0.05).Conclusions GSPE may inhibit endogenous ouabain,and delay the process of elevated blood pressure and vascular remodeling by inhibiting NF-κ B p65 and (or) TGF-β3 1 pathways.
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Objective To observe the effects of grape seed proanthocyanidin extract (GSPE)combined with atorvastatin on carotid atherosclerosis of the elderly. Methods Consecutivly 122 patient aged( 73.2 ±12.8) years with hypercholesterolemia and diagnosed as asymptomatic carotid artery plaques were randomly assigned to single atorvastatin(20 mg/d) treatment group (n=63) and combination treatment (atorvastatin 10 mg/d plus GSPE 400 mg/d) group (n=59).Serum total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) and high-sensitive C-reactive protein (hs-CRP) levels were detected before treatment and 3,6,12 months after treatment.Mean maximum carotid intima-media thickness (CIMT),plaque score and stability were also assessed by carotid ultrasound. Results After 3 months of treatment,serum levels of TC,TG and LDL-C in both groups were lower than before treatment (all P＜0.01),but no difference was found between the two groups (P＞0.05).HDL-C levels was enhanced by 20.2％ in combination treatment group after 3 months of treatment (P＜0.05),there was difference after 6 months treatment between two groups (P＜0.05).Serum hs-CRP concentrations were decreased by 1.7 mg/L and 3.6 mg/L,3.8 mg/L and 6.3 mg/L,5.9 mg/L and 8.3 mg/L after 3,6 and 12 months treatment as compared with pretreatment,respectively in the two groups (P＜0.05 or P＜0.01).There was difference in hs-CRP levels between groups after 6 and 1.2months of treatment (P＜0.05 or P＜0.01).There were MMCIMT reduction by 1.3％ and 2.0％ (P＞0.05),3.4％ and 5.3％(P＞0.05 and P＜0.05 ),5.1％ and 8.6％ after 3,6 and 12 months of treatment(P＜0.05 and P＜0.01) in the two groups,with distinct difference after 12 month treatment (P＜ 0.01 ).The plaque scores were declined by 6.8 ％ and 13.1％ ( both P ＞ 0.05 ),14.5 ％ and 28.0％ (P＞0.05 and P＜0.05),19.2％ and 45.0％(P＜0.05 and P＜0.01)after 3,6 and 12 months of treatment while significant difference was found between the two groups after 12 months treatment (P＜0.05).Unstable plaque and the total number of plaque was dropped by 8 and 14 in single group,19 and 28 in combination group,respectively,after 12 months of treatment. Conclusions GSPE combined with atorvastatin may inhibit the development of carotid intima-media thickness,reduce carotid plaque and promote stabilization of carotid plaque.
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Objective To investigate the association between carotid-femoral pulse wave velocity (cfPWV) and composition of the ascending aorta in patients with coronary heart disease (CAD),Methods The study population comprised 60 consecutive CAD patients who underwent coronary artery bypass graft (CABG) surgery in Qilu Hospital of Shandong University.cfPWV vas measured using an automatic device (Complior,Artech,France).A quantitative study was conducted on ascending aorta specimens by histological observation (Masson staining and weigert's resorcin-fuchsin staining) and computer image analysis.Bivariate analyses were performed to study the association between composition of the ascending aortic media and cfPWV.Results cfPWV of the CAD patients was higher (14.2±2.0) m/s than that of the normal subjects.On Masson's-stained specimen slides,disorganization of smooth muscle and focal accumulations of collagen (44.1 ± 3.9)％ were visible alongthe medial aorta of the CAD patients.Weigert's-stained cross sections of the ascending aortic media in CAD patients frequently exhibited focal breakdown or discontinuous segments of elastic fibers(18.4±3.2)％,cfPWV had a positive correlation with relative contents of collagen in the ascending aorta(r=0.68,P＜0.01)and a negative correlation vith relative contents of elastin in the ascending aorta (r=-0.59,P＜0.01),but no relation with relative contents of smooth muscle(r=0.01,P＞0.05).Conclusions The reduced aortic elasticity in CAD patients can be partly ascribed to decreased elastin,increased collagen,and their disorganization.cfPWV can reflect the quantitative changes of collagen and elastin in the ascending aortic media in CAD patients.
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Objective To explore the relationship between morphological features of carotid arterial atherosclerosis plaque and various cardiovascular risk factors in the aged.Methods The 321patients who underwent cerebral angiography were classified into two groups:256 patients with carotid arterial atherosclerosis and 65 patients without plaque.The relationships between carotid arterial plaque and cardiovascular risk factors including age,gender,cholesterol(TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C),C-reactive protein(CRP),homocysteine (HCY),hypertension,diabetes,smoking and drinking were analyzed.The relationships between morphological features,including the stenosis degree,surface fairing of plaque,and cardiovascular risk factors were analyzed.After 1 year follow-up,the prospective cardiovascular and cerebrovascular events were analyzed in the two groups.Results Carotid atherosclerosis was connected with cardiovascular risk factors such as TC,LDL-C,uric acid,CRP,hypertension,diabetes,smoking and drinking.Positive correlation was showed between the stenosis degree of carotid artery and age,smoking and diabetes.Closely correlation was showed between surface fairing of carotid arterial plaque and LDL-C,CRP,smoking and diabetes.The stenosis degree of carotid artery only showed positive correlation with cerebrovascular events,but the morphological features of surface fairing of carotid arterial plaque equally showed positive correlations with cerebrovascular events and cardiovascular events.Conclusions The development of carotid arterial atherosclerosis plaque in the aged is closely related to cardiovascular risk factors.Morphological features of carotid arterial plaque may respond the level of general atherosclerosis better than stenosis degree,and it is also in close correlation with cerebrovascular events and cardiovascular events.
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ObjectiveTo investigate the effects of grape seed proanthocyanidin extracts (GSPE) on advanced glycation end product receptor (RAGE),NF-Κb and connective tissue growth factor (CTGF) in the myoeardium of diabetic rats.MethodsTotal 30 streptozotocin (STZ) induced diabetic rats were randomly divided into 2 groups:diabetic group (DM1,n-15) and GSPE (250 mg/ kg,i.g) treated diabetic group (DM2,n= 15).Another two control groups:normal rats(C1,n= 10)and normal rats treated with GSPE (250 mg/kg,i.g) (C2 group,n= 10) were also observed.After 24 weeks,blood was collected to measure fasting plasma glucose (FBG) and RAGE.The protein expression of NF-Κb was determined in myocardial tissue by immunohistochemical staining and Western blot.The protein expressions of RAGE and CTGF were measured by Western blot.Results The levels of FBG and RAGE were significantly higher in diabetic rats than in control rats (P＜0.05).After GSPE treatment,RAGE level significantly reduced (P＜0.05),but FBG had no change in diabetic rats.The protein expressions of RAGE,NF-Κb and CTGF in the myocardial tissue of diabetic rats had marked increase compared with control rats (P＜ 0.05),however,their levels significantly reduced after GSPE treatment (P＜0.05).ConclusionsGSPE may protect diabetic rats against cardiomyopathy,possibly by decreasing the protein expressions of RAGE,NF-Κb and CTGF.
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Objective To investigate the changes of capacitive arterial compliance(C1) and oscillatory arterial compliance (C2) in elderly patients with the coronary atherosclerosis and the coronary heart disease (CHD)and to study the association between Gensini Score and C1 or C2.MethodsElderly subjects (160 cases) were divided into three groups according to the results of selective coronary angiography: the normal,the coronary atherosclerosis and the CHD group. C1 and C2 were measured using a DO-2020 cardiovascular profiling instrument.The stenosis severity of coronary artery diseases was assessed using a scoring system called Gensini score. Bivariate analyses were performed to study the association between Gensini Score of coronary artery and each of C1 and C2.Results C2 in the coronary atherosclerosis group was significantly lower than that in the normal group, and higher than in CHD group. C1 had no statistically difference among the three groups. Gensini integral in the coronary atherosclerosis versus the CHD groups were ( 5.4+2.6) vs.( 51.3+ 32.1), respectively (t= 10.574, P＜0.01). Gensini Score in the coronary atherosclerosis group had no relation with C1, and was negtively correlated with C2. ConclusionsC2 is decreased in the early stages of the coronary artery atherosclerosis in elderly patients, and may help the identification of early coronary atherosclerosis.