Efficacy and safety of various doses of hybutimibe monotherapy or in combination with atorvastatin for primary hypercholesterolemia: a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial / 中华心血管病杂志

Objective: To evaluate the efficacy and safety of hybutimibe monotherapy or in combination with atorvastatin in the treatment of primary hypercholesterolemia. Methods: This was a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial of patients with untreated primary hypercholesterolemia from 41 centers in China between August 2015 and April 2019. Patients were randomly assigned, at a ratio of 1∶1∶1∶1∶1∶1, to the atorvastatin 10 mg group (group A), hybutimibe 20 mg group (group B), hybutimibe 20 mg plus atorvastatin 10 mg group (group C), hybutimibe 10 mg group (group D), hybutimibe 10 mg plus atorvastatin 10 mg group (group E), and placebo group (group F). After a dietary run-in period for at least 4 weeks, all patients were administered orally once a day according to their groups. The treatment period was 12 weeks after the first dose of the study drug, and efficacy and safety were evaluated at weeks 2, 4, 8, and 12. After the treatment period, patients voluntarily entered the long-term safety evaluation period and continued the assigned treatment (those in group F were randomly assigned to group B or D), with 40 weeks' observation. The primary endpoint was the percent change in low density lipoprotein cholesterol (LDL-C) from baseline at week 12. Secondary endpoints included the percent changes in high density lipoprotein cholesterol (HDL-C), triglyceride (TG), apolipoprotein B (Apo B) at week 12 and changes of the four above-mentioned lipid indicators at weeks 18, 24, 38, and 52. Safety was evaluated during the whole treatment period. Results: Totally, 727 patients were included in the treatment period with a mean age of (55.0±9.3) years old, including 253 males. No statistical differences were observed among the groups in demographics, comorbidities, and baseline blood lipid levels. At week 12, the percent changes in LDL-C were significantly different among groups A to F (all P<0.01). Compared to atorvastatin alone, hybutimibe combined with atorvastatin could further improve LDL-C, TG, and Apo B (all P<0.05). Furthermore, there was no significant difference in percent changes in LDL-C at week 12 between group C and group E (P=0.991 7). During the long-term evaluation period, there were intergroup statistical differences in changes of LDL-C, TG and Apo B at 18, 24, 38, and 52 weeks from baseline among the statins group (group A), hybutimibe group (groups B, D, and F), and combination group (groups C and E) (all P<0.01), with the best effect observed in the combination group. The incidence of adverse events was 64.2% in the statins group, 61.7% in the hybutimibe group, and 71.0% in the combination group during the long-term evaluation period. No treatment-related serious adverse events or adverse events leading to death occurred during the 52-week study period. Conclusions: Hybutimibe combined with atorvastatin showed confirmatory efficacy in patients with untreated primary hypercholesterolemia, which could further enhance the efficacy on the basis of atorvastatin monotherapy, with a good overall safety profile.

Cross sectional study of familial hypercholesterolemia in dyslipidemia patients receiving lipid-lowering therapy: DYSIS-China subgroup analysis / 中华心血管病杂志

Objectives: To analyze the incidence, blood lipid levels and cardiovascular disease of familial hypercholesterolemia (FH) in dyslipidemia patients receiving lipid-lowing therapy from the DYSIS-China. Methods: Dyslipidemia International Study-China (DYSIS-China) database was re-analyzed according to the criteria of "Chinese guidelines for prevention and treatment of dyslipidemia in adults-2016 version". DYSIS-China database included 25 317 dyslipidemia out-patients who received at least one lipid-lowering drug for at least three months. All the patients were divided into three groups: unlikely HF, possible FH and definite FH according to the Dutch Lipid Clinic Network diagnostic criteria. Age, gender, lipids levels, drug use and complications were compared among the three groups. Factors were compared between Possible FH group and definite FH group in terms of age stratification. Results: A total of 23 973 patients with dyslipidemia were included. The average age was (64.8±9.9) years, 11 757 patients were females (49.0%). The proportion of unlikely FH in the total population was 20 561 (85.7%), possible FH was 3294 (13.7%), and the definite FH was 118(0.5%). Patients in the definite FH group (58.3±8.5 years) was younger than in unlikely HF(65.3±9.8 years) and possible FH(61.8±9.9 years) group. LDL-C ((5.6±1.9) mmol/L) levels were significantly higher in definite FH group than in unlikely HF ((2.5±0.9) mmol/L) and possible FH ((4.3±1.0) mmol/L) group. TC ((7.4±1.8) mmol/L) levels were also significantly higher in definite FH group than in unlikely HF ((4.3±1.0) mmol/L) and possible FH ((6.0±1.0) mmol/L) group. Percent of female sex, sedentary lifestyle and systolic blood pressure value were significantly higher in definite FH group than in other two groups (all P<0.05). Statin use was similar among the 3 groups. Prevalence of ischemic cardiomyopathy (70(59.3%)) was significantly higher in the definite FH group than in unlikely FH group7519 (36.6%) and possible FH group1149 (34.9%). The rate of hypertension (82 (69.5%)) was also significantly higher in the definite FH group than in unlikely FH group (2 063 (62.6%) and in possible FH group (13 928 (67.7%)). The possible FH group had the highest proportion of patients aged 55-64 years (1 146 (34.8%)), and the prevalence of hypertension 358 (76.8%), diabetes 189 (40.6%), ischemic heart disease 186 (39.9%), cerebrovascular disease 149 (32.0%) and heart failure 28 (6.0%) was the highest in patients over 75 years old. The definite FH group had the highest proportion of patients aged 55-64 years (49 (41.52%)), and the prevalence of ischemic heart disease (70 (59.3%)) was the highest in patients aged 45-54 years old group, there was no significant difference in the prevalence of diabetes,hypertension,heart failure,peripheral artery disease and cerebrovascular disease among different age groups. Conclusion: The detection rate of FH in Chinese patients with dyslipidemia is not low, the blood lipid level is poorly controlled, and the risk of cardiovascular disease is high in Chinses FH patients.

Stored autologous blood transfusion does not increase recurrence of prostate cancer after radical prostatectomy: A preliminary study / 中华男科学杂志

Objective@#To analyze the association of stored autologous blood transfusion (SABT) with tumor recurrence in PCa patients after radical prostatectomy and explore the application of SABT in this surgical procedure.@*METHODS@#Forty-five PCa patients underwent radical prostatectomy in our hospital in recent five years, of whom, 20 received SABT (group A) and the other 25 allogeneic blood transfusion (group B) intraoperatively. After surgery, we followed up the patients regularly for 3－66 months by examination of the levels of total PSA (tPSA) and free PSA (fPSA), digital rectal examination (DRE), and MRI to observe the biochemical recurrence of the tumor. We compared the data obtained between the two groups of patients.@*RESULTS@#In group A, 8 cases were in stages T1a－T1b and 12 in stages T2a－T2c, and in group B, 14 cases were in stages T1a－T1b and 11 in stages T2a－T2c. The volume of transfused blood was 800 ml in group A and 400－1 200 ml in group B. No statistically significant differences were observed between the two groups in the operation time, intraoperative blood loss or postoperative Gleason scores (P > 0.05), nor in the tPSA level or the results of DRE and MRI at 12, 24, 36, 48 and over 48 months (P > 0.05).@*CONCLUSIONS@#SABT is safe for PCa patients undergoing radical prostatectomy and does not increase the tumor recurrence rate after surgery.

Inhibitory Effects of Simvastatin on Oxidized Low-Density Lipoprotein-Induced Endoplasmic Reticulum Stress and Apoptosis in Vascular Endothelial Cells / 中华医学杂志(英文版)

<p><b>Background</b>Oxidized low-density lipoprotein (ox-LDL)-induced oxidative stress and endothelial apoptosis are essential for atherosclerosis. Our previous study has shown that ox-LDL-induced apoptosis is mediated by the protein kinase RNA-like endoplasmic reticulum kinase (PERK)/eukaryotic translation initiation factor 2α-subunit (eIF2α)/CCAAT/enhancer-binding protein homologous protein (CHOP) endoplasmic reticulum (ER) stress pathway in endothelial cells. Statins are cholesterol-lowering drugs that exert pleiotropic effects including suppression of oxidative stress. This study aimed to explore the roles of simvastatin on ox-LDL-induced ER stress and apoptosis in endothelial cells.</p><p><b>Methods</b>Human umbilical vein endothelial cells (HUVECs) were treated with simvastatin (0.1, 0.5, or 2.5 μmol/L) or DEVD-CHO (selective inhibitor of caspase-3, 100 μmol/L) for 1 h before the addition of ox-LDL (100 μg/ml) and then incubated for 24 h, and untreated cells were used as a control group. Apoptosis, expression of PERK, phosphorylation of eIF2α, CHOP mRNA level, and caspase-3 activity were measured. Comparisons among multiple groups were performed with one-way analysis of variance (ANOVA) followed by post hoc pairwise comparisons using Tukey's tests. A value of P < 0.05 was considered statistically significant.</p><p><b>Results</b>Exposure of HUVECs to ox-LDL resulted in a significant increase in apoptosis (31.9% vs. 4.9%, P < 0.05). Simvastatin (0.1, 0.5, and 2.5 μmol/L) led to a suppression of ox-LDL-induced apoptosis (28.0%, 24.7%, and 13.8%, F = 15.039, all P < 0.05, compared with control group). Ox-LDL significantly increased the expression of PERK (499.5%, P < 0.05) and phosphorylation of eIF2α (451.6%, P < 0.05), if both of which in the control groups were considered as 100%. Simvastatin treatment (0.1, 0.5, and 2.5 μmol/L) blunted ox-LDL-induced expression of PERK (407.8%, 339.1%, and 187.5%, F = 10.121, all P < 0.05, compared with control group) and phosphorylation of eIF2α (407.8%, 339.1%, 187.5%, F = 11.430, all P < 0.05, compared with control group). In contrast, DEVD-CHO treatment had no significant effect on ox-LDL-induced expression of PERK (486.4%) and phosphorylation of eIF2α (418.8%). Exposure of HUVECs to ox-LDL also markedly induced caspase-3 activity together with increased CHOP mRNA level; these effects were inhibited by simvastatin treatment.</p><p><b>Conclusions</b>This study suggested that simvastatin could inhibit ox-LDL-induced ER stress and apoptosis in vascular endothelial cells.</p>

Role of PERK/eIF2α/CHOP Endoplasmic Reticulum Stress Pathway in Oxidized Low-density Lipoprotein Mediated Induction of Endothelial Apoptosis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>PERK/eIF2α/CHOP is a major signaling pathway mediating endoplasmic reticulum (ER) stress related with atherosclerosis. Oxidized LDL (ox-LDL) also induces endothelial apoptosis and plays a vital role in the initiation and progression of atherosclerosis. The present study was conducted to explore the regulatory effect of ox-LDL on PERK/eIF2α/CHOP signaling pathway in vascular endothelial cells.</p><p><b>METHODS</b>The effects of ox-LDL on PERK and p-eIF2α protein expression of primary human umbilical vein endothelial cells (HUVECs) were investigated by Western blot analysis. PERK gene silencing and selective eIF2α phosphatase inhibitor, salubrinal were used to inhibit the process of ox-LDL induced endothelial cell apoptosis, caspase-3 activity, and CHOP mRNA level.</p><p><b>RESULTS</b>Ox-LDL treatment significantly increased the expression of PERK, PERK-mediated inactivation of eIF2α phosphorylation, and the expression of CHOP, as well as the caspase-3 activity and apoptosis. The effects of ox-LDL were markedly decreased by knocking down PERK with stable transduction of lentiviral shRNA or by selective eIF2α phosphatase inhibitor, salubrinal.</p><p><b>CONCLUSION</b>This study provides the first evidence that ox-LDL induces apoptosis in vascular endothelial cells mediated largely via the PERK/eIF2α/CHOP ER-stress pathway. It adds new insights into the molecular mechanisms underlying the pathogenesis and progression of atherosclerosis.</p>

L-4F Inhibits Oxidized Low-density Lipoprotein-induced Inflammatory Adipokine Secretion via Cyclic AMP/Protein Kinase A-CCAAT/Enhancer Binding Protein β Signaling Pathway in 3T3-L1 Adipocytes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Adipocytes behave like a rich source of pro-inflammatory cytokines including monocyte chemoattractant protein-1 (MCP-1). Oxidized low-density lipoprotein (oxLDL) participates in the local chronic inflammatory response, and high-density lipoprotein could counterbalance the proinflammatory function of oxLDL, but the underlying mechanism is not completely understood. This study aimed to evaluate the effect of apolipoprotein A-I mimetic peptide L-4F on the secretion and expression of MCP-1 in fully differentiated 3T3-L1 adipocytes induced by oxLDL and to elucidate the possible mechanisms.</p><p><b>METHODS</b>Fully differentiated 3T3-L1 adipocytes were incubated in the medium containing various concentration of L-4F (0-50 μg/ml) with oxLDL (50 μg/ml) stimulated, with/without protein kinase A (PKA) inhibitor H-89 (10 μmol/L) preincubated. The concentrations of MCP-1 in the supernatant, the mRNA expression of MCP-1, the levels of CCAAT/enhancer binding protein α (C/EBPα), and CCAAT/enhancer binding protein β (C/EBPβ) were evaluated. The monocyte chemotaxis assay was performed by micropore filter method using a modified Boyden chamber.</p><p><b>RESULTS</b>OxLDL stimulation induced a significant increase of MCP-1 expression and secretion in 3T3-L1 adipocytes, which were inhibited by L-4F preincubation in a dose-dependent manner. PKA inhibitor H-89 markedly reduced the oxLDL-induced MCP-1 expression, but no further decrease was observed when H-89 was used in combination with L-4F (50 μg/ml) (P > 0.05). OxLDL stimulation showed no significant effect on C/EBPα protein level but increased C/EBPβ protein level in a time-dependent manner. H-89 and L-4F both attenuated C/EBPβ protein level in oxLDL-induced 3T3-L1 adipocytes.</p><p><b>CONCLUSIONS</b>OxLDL induces C/EBPβ protein synthesis in a time-dependent manner and enhances MCP-1 secretion and expression in 3T3-L1 adipocytes. L-4F dose-dependently counterbalances the pro-inflammatory effect of oxLDL, and cyclic AMP/PKA-C/EBPβ signaling pathway may participate in it.</p>

The lipid-regulating effect and safety of combined statin and bezafibrate therapy in acute coronary syndrome patients complicating with dyslipidemia / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the lipid-regulating effect and safety of combined statin and bezafibrate therapy in acute coronary syndrome(ACS) patients complicating with dyslipedemia.</p><p><b>METHODS</b>One hundred and four hospitalized patients with established ACS and increased serum triglycerides (TG) levels and/or low serum levels of high density lipoprotein cholesterol (HDL-C) were selected. Except for conventional therapy, the patients were randomly divided into 2 groups: control group (n = 52), treated with atorvastatin 20 mg qn or other statin equivalent to 20 mg atorvastatin; treatment group (n = 52), treated with the same dose statin plus bezafibrate 200 mg bid. The serum levels of total cholesterol (TC), TG, low-density lipoprotein cholesterol (LDL-C) and HDL-C were assessed before and after 6 and 12 weeks treatment, side effects and adverse events were recorded.</p><p><b>RESULTS</b>After 6 weeks treatment, the serum levels of TC, TG and LDL-C in two groups were significantly reduced compared to baseline (all P < 0.05), which were further declined after 12 weeks treatment, and the reduction was more significant in treatment group(29.8%, 38.0% and 36.1%, respectively) than in control group(14.7%, 9.8% and 26.7%, respectively) (all P < 0.05). After treatment, the serum levels of HDL-C in the two groups were significantly higher than the baseline levels, especially after 12 weeks treatment (all P < 0.05), and the elevations of HDL-C levels in control group and in treatment group were 19.3% and 24.2%, respectively, but there were no significant difference between the two groups (P > 0.05). After 12 weeks, the rates reaching to target goals of LDL-C, TG, HDL-C, and non-HDL-C levels in the treatment group (69.2%, 88.5%, 92.3%, 46.2% and 65.4%, respectively) were significantly higher than those in the control group (34.6%, 65.4%, 46.2%, 7.7% and 42.3%, respectively, all P < 0.05). No serious side effects were observed in the two groups during the treatment period.</p><p><b>CONCLUSION</b>The combined statin and bezafibrate treatment is safe and could increase the ratios of reaching target lipid levels in ACS patients complicating with increased TG and (or) decreased HDL-C.</p>

Elevated platelet activating factor level in ischemia-related arrhythmia and its electrophysiological effect on myocardium / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The mechanism through which platelet activating factor (PAF) induces cardiac electrical activity and arrhythmia is not well understood and previous studies have suggested a potential involvement of ion channels in its action. The present study was aimed to clarify the role of PAF in fatal arrhythmias following acute myocardia infarction (AMI) and the underlying mechanism.</p><p><b>METHODS</b>(1) Blood PAF levels were measured among 72 AMI patients at the time of diagnosis with AMI and 48 h later, and their electrocardiogram (ECG) was recorded continuously. (2) Ischemia simulation and surface electrocardiogram were conducted in 20 pigs and their PAF levels were measured. (3) PAF perfusion and standard microelectrode recording were performed on guinea pig papillary muscles.</p><p><b>RESULTS</b>In both humans and pigs, elevated PAF levels were detected in AMI and simulated ischemia, respectively, and even higher PAF levels were found when fatal arrhythmias occurred. In guinea pig myocardium, PAF induced a shortening of action potential duration at 90% level of repolarization (APD90)under non-ischemic conditions and a more pronounced shortening under early simulated ischemic conditions.</p><p><b>CONCLUSION</b>AMI and ischemia are associated with increased PAF levels in humans and pigs, which are further raised when fatal arrhythmia follows. The effects of PAF on the myocardium may be mediated by multiple ion channels.</p>

Effect of liver X receptor agonist T0901317 on endothelin-1 induced murine HL-1 cardiomyocytes hypertrophy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the role of liver X receptors (LXRs) on endothelin-1 (ET-1) induced murine HL-1 cardiomyocytes hypertrophy.</p><p><b>METHODS</b>Cultured murine HL-1 cardiomyocytes were divided into four experiment groups: (1) CONTROL GROUP:treated with DMSO; (2) T0901317 group:treated with LXRs agonist T0901317 (1 µmol/L); (3) ET-1 group:treated with ET-1 (1 nmol/L); (4) T0901317 + ET-1 group:treated with T0901317 (1 µmol/L) for 8 hours, then treated with ET-1 (1 nmol/L). Twenty-four hours later, immunofluorescent staining was performed on HL-1 cells, the surface area of HL-1 cells was analyzed with NIH Image J software, and the synthetic rate of protein in HL-1 cells was detected by (3)H-leucine incorporation. The mRNA level of atrial natriuretic peptide (ANP) and β-myosin heavy chain (β-MyHC) was measured by quantitative realtime PCR. The effect of T0901317 on mRNA expression of ANP was also detected after LXRs gene silencing.</p><p><b>RESULTS</b>The surface area of HL-1 cells, mRNA expression of ANP and β-MyHC, and (3)H-leucine incorporation in ET-1 group were 2.00 ± 0.29, 1.98 ± 0.47, 2.13 ± 0.39 and 1.79 ± 0.17, respectively, which were significantly higher than those of control group (1.00 ± 0.26, 1.00 ± 0.21, 1.00 ± 0.31 and 1.00 ± 0.03, respectively, all P < 0.05). Compared with ET-1 group, the surface area of HL-1 cells, mRNA expression of ANP and β-MyHC, and (3)H-leucine incorporation were significantly decreased in T0901317 + ET-1 group (1.24 ± 0.25, 1.19 ± 0.21, 1.48 ± 0.27 and 1.15 ± 0.11, respectively, all P < 0.05). After inhibition of LXRα/β expression in HL-1 cardiomyocytes using the specific siRNAs, the mRNA expression of ANP in T0901317 + ET-1 group was 1.78 ± 0.05, which was similar as that in ET-1 group (1.94 ± 0.17, P > 0.05).</p><p><b>CONCLUSION</b>T0901317, an agonist of LXRs, could inhibit ET-1 induced cardiac hypertrophy in vitro, and LXR ligand-mediated inhibition on ANP mRNA expression by T0901317 is receptor dependent.</p>

Soluble epoxide hydrolase inhibitor t-AUCB ameliorates ox-LDL induced conversion of macrophages into foam cells through activating the PPARγ-ABCA1 pathway / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the effects of soluble epoxide hydrolase inhibitor t-AUCB on foam cell formation and cholesterol efflux in macrophage.</p><p><b>METHODS</b>Mouse macrophages RAW264.7 were cultured and stimulated with ox-LDL (80 µmol/L) in the absence (group A) or presence of t-AUCB (1, 10, 50, 100 µmol/L, group B) or t-AUCB (100 µmol/L) pretreated with PPARγ antagonist GW9662 (5 µmol/L, group C). The foam cell was identified by oil red O staining. The cholesterol efflux rates of (3)H-cholesterol in cells were measured by liquid scintillation counter. mRNA and protein expressions of ABCA1 were detected by real-time PCR or Western blot, respectively.</p><p><b>RESULTS</b>Oil red O staining showed that t-AUCB (100 µmol/L) significantly inhibited foam cell formation which could be significantly reversed by GW9662 (all P < 0.05). t-AUCB dose-dependently increased cholesterol efflux rates in mouse macrophage [(5.91 ± 0.18)% in group A, (7.03 ± 0.33)%, (8.05 ± 0.32)%, (9.04 ± 0.14)%, (10.06 ± 0.85)% in 1, 10, 50, 100 µmol/L t-AUCB groups, all P < 0.05 vs. group A], which could be reversed by pretreatment with GW9662 [(6.33 ± 0.15)% in 100 µmol/L t-AUCB + GW9662 group].t-AUCB also upregulated ABCA1 mRNA and protein expressions in a dose-dependent manner which could be significantly attenuated by pretreatment with GW9662.</p><p><b>CONCLUSION</b>t-AUCB could inhibit foam cell formation by improving cholesterol efflux through activating PPARγ-ABCA1 pathway in macrophage.</p>

Effects of policosanol on serum lipids and heme oxygenase-1 in patients with hyperlipidemia / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the effects of policosanol on serum lipid and heme oxygenase-1 (HO-1) in patients with hyperlipidemia.</p><p><b>METHODS</b>This randomized, open study included 72 patients with hyperlipidemia. The patients were randomly assigned to treatment group (policosanol, 20 mg/d, n = 36) or placebo group (placebo, two tablets/d, n = 36). The levels of serum lipids, hypersensitive C-reactive protein (hs-CRP), HO-1 were assessed before and after 16 weeks treatment. Drug-induced adverse effects and events were recorded during the observation period. The serum HO-1 was measured by ELISA.</p><p><b>RESULTS</b>(1) After 16 weeks, all parameters remained unchanged in the placebo group; the level of TC decreased from (7.01 ± 1.03) mmol/L to (5.66 ± 0.83) mmol/L (-19.4%, P < 0.01), the level of LDL-C decreased from (4.78 ± 0.72) mmol/L to (3.70 ± 0.69) mmol/L (-22.5%, P < 0.01) in the treatment group. TG and HDL-C levels remained unchanged (P > 0.05) while the level of HO-1 significantly decreased from (1.82 ± 1.08) µg/L to (1.45 ± 0.81) µg/L (P < 0.01) and the level of hs-CRP decreased from (3.40 ± 3.64) mg/L to (1.86 ± 2.02) mg/L (P < 0.01) in the treatment group. (2) Safety index was similar between placebo and treatment groups (P > 0.05) and there was no adverse events including allergic reaction, muscle pain in all subjects during the observation period.</p><p><b>CONCLUSION</b>The short-term data obtained from this small hyperlipidemia patient cohort suggest that policosanol is a safe lipid-lowering and anti-inflammatory agent for hyperlipidemia patients.</p>

1,25(OH)(2)D(3) influences endothelial cell proliferation, apoptosis and endothelial nitric oxide synthase expression of aorta in apolipoprotein E-deficient mice / 中华儿科杂志

<p><b>OBJECTIVE</b>To study possible influences of 1,25(OH)(2)D(3) on endothelial cell proliferation, apoptosis and endothelial nitric oxide synthase (eNOS) expression of aorta in apolipoprotein E-deficient (apoE(-/-)) mice and to explore the relationship between vitamin D and atherosclerosis.</p><p><b>METHOD</b>Endothelial cell of aorta in apoE(-/-) mice were isolated and cultured, and the influence of 1,25(OH)(2)D(3) on endothelial cell proliferation were observed by MTT, apoptosis of cells were quantitated by terminal deoxynucleotidyl transferase mediated dUTP nick end labelling, Bcl-2 mRNA, fas mRNA and eNOS mRNA was detected by reverse transcription-polymerase chain reaction.</p><p><b>RESULT</b>Endothelial cell proliferation rate of aorta did not significantly change in the two control groups (0.162 ± 0.031 vs. 0.158 ± 0.006, P > 0.05). Compared with control groups, 1,25(OH)(2)D(3) stimulated endothelial cell proliferation of aorta (P < 0.05), but endothelial cell proliferation rate did not significantly change in different 1,25(OH)(2)D(3) concentration groups [1,25(OH)(2)D(3) concentration: 10(-4)mol/L, 10(-5) mol/L, 10(-6) mol/L, 10(-7) mol/L, 10(-8) mol/L, endothelial cell proliferation rate: 0.189 ± 0.013 vs. 0.285 ± 0.011 vs. 0.296 ± 0.026 vs. 0.284 ± 0.017 vs. 0.233 ± 0.010, P > 0.05]. 1,25(OH)(2)D(3) research concentration as chosen as 10(-6) mol/L. In 1,25(OH)(2)D(3) 10(-6) mol/L group, the expression of Bcl-2, eNOS mRNA was significantly increased (0.78 ± 0.16 vs. 0.46 ± 0.21 vs. 0.42 ± 0.17, 0.56 ± 0.16 vs. 0.39 ± 0.13 vs. 0.35 ± 0.11, 0.46 ± 0.2 vs. 10.42 ± 0.17 vs. 0.78 ± 0.16, 0.79 ± 0.21 vs. 0.81 ± 0.20 vs. 0.43 ± 0.12), apoptotic index, Fas mRNA was significantly decreased (15.14 ± 3.19 vs. 18.94 ± 4.22 vs. 19.27 ± 4.58, 0.43 ± 0.12 vs.0.79 ± 0.21 vs. 0.81 ± 0.20)(P < 0.05). The quantity of eNOS gene expression was inversely associated with apoptosis index and Fas mRNA, was positively associated with Bcl-2 mRNA (r = -0.676, -0.758, 0.762, P < 0.01).</p><p><b>CONCLUSION</b>1,25(OH)(2)D(3) stimulated endothelial cell proliferation, inhibited apoptosis and increased eNOS expression of aorta in apoE(-/-) mice. These results may deepen understanding of the pathogenesis of atherosclerosis.</p>

Association between adipocyte fatty acid binding proteins/adiponectin and coronary artery stenosis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the relationship between serum and monocyte-derived-macrophages secreted adipocyte fatty acid binding protein (A-FABP), adiponectin (or A-FABP/adiponectin ratio) and coronary artery disease.</p><p><b>METHODS</b>Three hundred and forty subjects underwent coronary angiography (CAG) were classified into CAD group (n = 211) and non-CAD group (n = 129) according to the CAG results. The severity of coronary artery stenosis was assessed by the numbers of involved coronary artery branches and the sum of the Gensini scores. Fasting venous blood was collected from all subjects and peripheral monocytes were isolated from 20 subjects (10 selected from each group with age-, gender-, and BMI-matched). Peripheral blood monocytes were obtained and stimulated into macrophages with PMA, cell culture supernatant was collected. The concentration of serum/supernatant A-FABP and adiponectin levels were assayed by enzyme-linked immunosorbent assays.</p><p><b>RESULTS</b>(1) A-FABP levels tended to be higher in CAD patients compared to non-CAD subjects [18.3(13.2, 22.8) µg/L vs. 16.4(13.5, 20.4) µg/L, P = 0.088]. The concentration of adiponectin in CAD group was significantly lower than those in non-CAD group [13.9 (9.8, 17.1) mg/L vs. 19.7 (14.5, 27.6) mg/L, P < 0.05]. (2) The A-FABP levels increased and the adiponectin levels decreased as the number of stenotic vessels increased. Gensini scores were positively correlated with serum A-FABP (r = 0.120, P = 0.043) and inversely correlated with adiponectin (r = -0.405, P = 0.007). (3) The difference in A-FABP/adiponectin ratio was more prominent between subjects with CAD and subjects without CAD [(1.51 ± 0.79) µg/mg vs. (0.89 ± 0.30) µg/mg, P < 0.01] and there was a stronger positive correlation of Gensini score to A-FABP/adiponectin ratio(r = 0.531, P = 0.000). (4) Monocyte-derived-macrophages from patients with CAD had higher A-FABP/adiponectin ratio than that in patients without CAD [(0.51 ± 0.19) µg/mg vs. (0.36 ± 0.11) µg/mg, P < 0.05].</p><p><b>CONCLUSIONS</b>Increased levels of serum A-FABP and reduced levels of adiponectin in CAD patients serves as a novel biomarker for the severity of the coronary stenosis. A-FABP/adiponectin ratio is superior to A-FABP or adiponectin alone on predicting CAD risks.</p>

Statin reduced triglyceride level via activating peroxisome proliferator activated receptor α and upregulating apolipoprotein A5 in hypertriglyceridemic rats / 中华心血管病杂志

<p><b>OBJECTIVE</b>to explore the potential role of apolipoprotein A5 (apoA5) on the hypertriglyceridemia (HTG)-lowering effects of statin.</p><p><b>METHODS</b>twenty-four Sprague-Dawley rats were randomized into 3 groups: (1) control group (n = 8), with no special treatment; (2) HTG group (n = 8), treated with 10% fructose water for 6 weeks; (3) statin group (n = 8), treated with 10% fructose water for 2 weeks and cotreated with atorvastatin 10 mg×kg(-1)×d(-1) for another 4 weeks. Body weight, fasting plasma lipids and the hepatic expressions of apoA5 and peroxisome proliferator activated receptor (PPAR)α were determined. In separate in vitro experiments, we tested the effects of atorvastatin on TG and the expressions of apoA5 and PPARα in HepG2 cells.</p><p><b>RESULTS</b>(1) at 6 weeks, plasma TG was higher in rats in HTG group than in controls, which was significantly reduced in statin group (both P < 0.05). (2) Rat hepatic apoA5 expression in HTG group was significantly lower than in control group and was significantly higher in statin group than in HTG group (both P < 0.05). (3) Similarly, rat PPARα mRNA expression in HTG group was lower than in control group and was higher in statin group than in HTG group (both P < 0.05). (4) Statin significantly upregulated the expressions of apoA5 and PPARα and decreased TG in HepG2 cells. The above effects induced by statin was blocked in the presence of PPARα inhibitor.</p><p><b>CONCLUSIONS</b>upregulation of apoA5 expression contributes to TG lowering effect of statin via PPARα signaling pathway.</p>

Increased serum apolipoprotein A5 in patients with acute coronary syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the relationship between serum apolipoprotein A5 (ApoA5) and lipid profile or high sensitive C-reactive protein (hs-CRP) in patients with acute coronary syndrome (ACS).</p><p><b>METHODS</b>Serum apoA5 and hs-CRP levels were measured by ELISA and immunoturbidimetry in control subjects (n = 232), patients with stable angina (SA, n = 127), unstable angina (UA, n = 116) and acute myocardial infarction (AMI, n = 112). Triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were also measured.</p><p><b>RESULTS</b>Compared with controls [(108.7 +/- 23.2) microg/L] and SA patients [(78.3 +/- 20.2) microg/L], serum ApoA5 level was significantly increased in UA [(340.6 +/- 63.5) microg/L] and AMI patients [(373.2 +/- 73.8) microg/L] (all P < 0.05). ApoA5 was positively correlated with TG (r = 0.63 and 0.67, respectively, all P < 0.05) and hs-CRP (r = 0.57 and 0.55, respectively, all P < 0.05) in UA and AMI patients but there were no significant correlations between ApoA5 and TC, HDL-C and LDL-C in ACS patients (all P > 0.05).</p><p><b>CONCLUSION</b>Increased serum apoA5 level and the positive correlation between ApoA5 and serum TG and hs-CRP in ACS patients might reflect increased inflammation responses in ACS patients.</p>

Effects of atorvastatin, alone and in combination with probucol on endothelial function in patients with acute coronary syndrome / 中华心血管病杂志

<p><b>OBJECTIVES</b>To evaluate the effects of combined atorvastatin and probucol use on endothelial function in patients with acute coronary syndrome (ACS).</p><p><b>METHODS</b>Thirty patients with ACS were randomized to receive atorvastatin (20 mg/d) and probucol (500 mg/d, combination group, n = 15) or atorvastatin (20 mg/d) alone (atorvastatin group) within 24 h after admission for 4 weeks. Endothelium-dependent flow-mediated dilatation (FMD) and endothelium-independent sublingual nitroglycerin-mediated dilatation (NMD) as well as the levels of lipids and C-reactive protein were assessed at baseline, 1 week and 4 weeks after therapy.</p><p><b>RESULTS</b>Compared to baseline, the levels of total cholesterol, LDL-C and C-reactive protein were significantly reduced after 1 week and 4 weeks in both groups, FMD equally increased after 1 week in both groups (atorvastatin group: 3.75% +/- 0.78% vs. 1.09% +/- 0.44%, combination group: 3.67% +/- 0.36% vs. 1.24% +/- 0.37%, P < 0.01). Post 4 weeks therapy, FMD increase was significantly higher in combination group (3.67% +/- 0.36% at 1 week vs. 6.85% +/- 0.64% at 4 weeks, P < 0.01) than that in atorvastatin group (3.75% +/- 0.78% vs. 3.80% +/- 0.31%, P = 0.954). NMD also equally and increased over 4 weeks in two groups (P < 0.01 vs. baseline). There was no correlation between the change in FMD/NMD and the changes in lipids or C-reactive protein levels.</p><p><b>CONCLUSIONS</b>The combined atorvastatin and probucol therapy early after ACS is superior to atorvastatin alone on improving endothelial function.</p>

Elevated plasma apolipoprotein AV in acute coronary syndrome is positively correlated with triglyceride and C-reactive protein / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Increased triglyceride (TG) occurs in patients with acute coronary syndrome (ACS), and apolipoprotein AV (apoAV) has been shown to lower TG levels. In the present study, we investigated plasma apoAV level and its relationship with TG and C-reactive protein (CRP) in ACS patients.</p><p><b>METHODS</b>A total of 459 subjects were recruited and categorized into control group (n = 116), stable angina (SA) group (n = 115), unstable angina group (n = 116) and acute myocardial infarction group (n = 112). Plasma apoAV level was measured by a sandwich ELISA assay.</p><p><b>RESULTS</b>Compared with controls ((100.27 +/- 22.44) ng/ml), plasma apoAV was decreased in SA patients ((76.54 +/- 16.91) ng/ml) but increased in patients with unstable angina ((330.89 +/- 66.48) ng/ml, P < 0.05) or acute myocardial infarction ((368.66 +/- 60.53) ng/ml, P < 0.05). Inverse correlations between apoAV and TG were observed in the control or stable angina groups (r = -0.573 or -0.603, respectively, P < 0.001), whereas positive correlations were observed in the patients with unstable angina or acute myocardial infarction (r = 0.696 or 0.690, respectively, P < 0.001). Furthermore, a positive relationship between apoAV and CRP was observed in the ACS patients but not in the non-ACS subjects.</p><p><b>CONCLUSION</b>The plasma apoAV concentration is increased and positively correlates with TG and CRP in ACS patients.</p>

Expression and purification of human apolipoprotein M / 中南大学学报(医学版)

OBJECTIVE@#To express and purify the extra cellular full-length human apolipoprotein M(ApoM).@*METHODS@#The ApoM gene fragment was amplified from the human liver cDNA library by PCR. The resulting product was cloned into pGEXT vector and sequenced. Then the confirmed canstatin cDNA was cloned into plasmid E.coli JM109 and then transformed into E.coli DL21(DE3) where it was induced to express protein by IPTG.@*RESULTS@#The ApoM gene was cloned by PCR and a 560 bp DNA fragment was shown on the agarose electrophoresis. The cloned gene was sequenced and demonstrated to have the same sequence as that of human ApoM gene in GenBank. Then ApoM cDNA gene fragment was induced by IPTG, and a 24 kD recombinant ApoM protein was tested on SDS-PAGE.@*CONCLUSION@#Human ApoM gene is successfully cloned and its recombinant proteins are expressed.

Clinical significance of rapid increase of heart rate at onset of treadmill exercise test / 中南大学学报(医学版)

OBJECTIVE@#To analyze the correlation between rapid increase of heart rate at onset of electrocardiogram treadmill exercise test and coronary artery lesion.@*METHODS@#We selected 245 patients who underwent electrocardiogram treadmill exercise and coronary angiography. The patients were divided into a coronary heart disease (CHD) group and a non-CHD group according to the Results of coronary angiography. The patients of the CHD group were divided into a single-vessel disease group, a double-vessel disease group, and a triplet-vessel disease group. The increased heart rate during the first minute (DeltaHR 1minute) of treadmill exercise test and the extent of coronary artery lesion were analyzed.@*RESULTS@#DeltaHR 1minute in the CHD group was significantly higher than that in the non-CHD group(P<0.01). DeltaHR 1minute had an increasing trend with the severity of coronary artery lesion. DeltaHR 1minute was positively correlated to the depression of ST segment and the severity of coronary artery lesion(r=0.252,0.470, P<0.01).@*CONCLUSION@#Patients with CHD have an increased DeltaHR 1minute. DeltaHR 1minute can be one of the indexes to estimate the extent of myocardial ischemia and coronary artery lesion.

Effect of valsartan on postprandial plasma inflammatory factors in patients with essential hypertension / 中南大学学报(医学版)

OBJECTIVE@#To explore the effect of valsartan on the concentrations of plasma inflammatory factors after a high-fat meal in patients with essential hypertension in very short time.@*METHODS@#Fifty hypertensive patients and 25 healthy controls were studied. Patients randomly accepted lacidipine 4 mg/d (lacidipine group) or valsartan 80 mg/d (valsartan group) for 1 week. The concentrations of plasma lipid profiles, high-sensitivity C-reactive protein (hsCRP) and soluble P-selectin were measured in fasting state and at 4 h after a single high-fat meal in all subjects at baseline and in patients after 1 week.@*RESULTS@#The concentrations of postprandial plasma hsCRP and soluble P-selectin significantly increased after a high-fat meal in patients (P < 0.05), as compared with those at fasting levels, but not in the controls. The postprandial plasma triglyceride concentrations significantly increased in the healthy controls (P < 0.05), but were lower than those in hypertensive patients (P < 0.01). Postprandial change in plasma concentration of triglyceride was significantly correlated with those of log (hsCRP) (r = 0.344)and soluble P-selectin (r = 0.432), respectively (n = 75, both P < 0.01). Lipids profiles did not change significantly after 1 week. There was no significant difference between the fasting and postprandial plasma concentrations of either hsCRP or soluble P-selectin in valsartan group, while the postprandial increments of inflammatory factors were still significant in the lacidipine group.@*CONCLUSION@#High-fat meal can induce postprandial inflammation response in patients with essential hypertension. Valsartan effectively attenuates this postprandial inflammation response within a very short time.