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Objective::To discuss the clinical efficacy of Liuwei Dihuangwan combined with Danzi Xiaoyaosan on H-type hypertension with syndrome of Yin deficiency and Yang hyperactivity and its effect on vascular endothelial function and inflammatory factors. Method::One hundred and fifty patients were randomly divided into control group (75 cases) and observation group (75 cases) by random number table.Patients in control group got enalapril maleate and folic acid tablets, 1 tablet/time, 1 time/day, and patients with uncontrollable blood pressure were also given nifedipine sustained-release tablets, 20-30 mg/time, 2 times/days.In addition of the therapy of control group, patients in observation group were also given modified Liuwei Dihuangwan combined with Danzi Xiaoyaosan, 1 dose/day.The course of treatment was 12 weeks.Before and after treatment, systolic blood pressure (SBP), diastolic blood pressure (DBP) and up-to-standard blood pressure were detected.And ambulatory blood pressure, standard deviation of 24-hours systolic blood pressure (24 h SSD), standard deviation of 24-hour diastolic blood pressure 24 h DSD), 24 h mean systolic blood pressure (24 h SBP), 24 h mean diastolic blood pressure (24 h DBP) were recorded.And ankle brachial index (ABI) and brachial artery blood flow mediated diamete (FMD) were discussed, syndrome of Yin deficiency and Yang hyperactivity was scored, and levels of iterleukin-6 (IL-6), IL-10, high-sensitivity C-reactive protein (hsCRP) and homocysteine (Hcy) were detected. Result::The levels of SBP, DBP, 24 h SSD, 24 h DSD, 24 h SBP and 24 h DBP were all lower than those in control group (P<0.01). The achievement rate of accidental blood pressure in observation group was 81.19%, which was higher than 66.98% in control group (χ2=29.81, P<0.01). And levels of ABI, FMD and IL-10 were higher than those in control group (P<0.01), while the score of syndrome of Yin Deficiency and Yang Hyperactivity and the levels of Hcy, leptin, IL-6 and hs-CRP were lower than those in control group (P<0.01). Conclusion::In addition to the therapy of antihypertensive and folic acid, Liuwei Dihuangwan combined with Danzi Xiaoyaosan can be given to control the level of blood pressure and Hcy, relieve the variability of blood pressure, alleviate clinical symptoms, raise the rate of achievement rate of blood pressure, improve the function of vascular endothelium, and regulate inflammatory factors.
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Objective:To observe the relationship between serum homocysteine (Hcy), nitric oxide (NO), high-sensitivity C-reactive protein (hs-CRP) as well as the number and degree of coronary lesions, and the effect of Liu Junzitang combined with Erchentang on Hcy, NO, hs-CRP in patients with coronary heart disease (CHD), so as to explore the protector effect of Liu Junzitang combined with Erchentang on CHD patients. Method:A total of 76 inpatients with phlegm turbidity and internal resistance (CHD) from the Cardiovascular Department of Jiangxi University of Traditional Chinese Medicine（TCM） from November 2016 to April 2019 were selected to analyze the relationship between Hcy, NO, hs-CRP as well as the number and degree of coronary lesions. By lottery, the 76 patients were randomly divided into observation group and control group, with 38 patients in each group. Patients in the control group were given conventional therapy, while patients in the observation group were given Liu Junzitang combined with Erchentang in addition to conventional therapy. The experimental period was 3 months. TCM symptom scores of the two groups before and after administration were evaluated. Hcy, NO, hs-CRP, triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol (TC), apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B), N-terminal B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF) indicators of the two groups were measured before and after administration. Result:The levels of Hcy and hs-CRP were positively correlated with the number and degree of coronary lesions. The level of NO was negatively correlated with the number and degree of coronary lesions. TCM symptom scores were different between the two groups after treatment. Compared with the control group, the TCM symptom score in the observation group was decreased more significantly (P<0.05). The two groups could reduce Hcy, hs-CRP and increase in NO to a certain extent (P<0.05). Compared with the control group, the observation group showed reduction in Hcy, hs-CRP and increase in NO more significantly (P<0.05). After treatment in both groups, TG, LDL, TC, Apo A1, Apo B and HDL were reduced (P<0.05) compared with before treatment. Compared with the control group, the observation group showed decrease in TG, LDL, TC, Apo A1, Apo B and increase in HDL more significantly (P<0.05). Both groups could increase LVEF and decrease NT-proBNP after treatment (P<0.05). Compared with the control group, the observation group increased LVEF and decreased NT-proBNP more significantly (P<0.05). Conclusion:The levels of Hcy and hs-CRP were positively correlated with coronary lesions, while the level of NO was negatively correlated with coronary lesions. Modified Liu Junzitang and Erchentang may be correlated with inhibition of Hcy, hs-CRP and CHD and increase of patient's NO level, thereby reducing the patient's blood lipids, improving the patient's heart function, and improving the patient's clinical symptoms.
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Objective • To study the relationship between homocysteine (HCY) in plasma and carotid atherosclerosis in the elderly patients and its clinical significance. Methods • The intima-media thickness (IMT) of the common carotid arteries and the sclerotic lesions at the carotid arteries bulbs were evaluated by color Doppler ultrasonography in 99 elderly in-patients (65 years old or above). Fasting venous blood was drew from the patients for the determination of plasma HCY and other indexes. According to the plasma HCY concentration, the patients were divided into two groups, i.e., control group (HCY<15 μmol/L) and high HCY group (HCY ≥ 15 μmol/L). General clinical data, carotid plaque number, plaque thickness, plaque stability and carotid IMT were investigated in the two group of patients. Results • The numbers (P=0.015), stability (P=0.013) and thickness (P=0.001) of carotid plaques between the two groups were significantly different. After balancing the effects of age by the partial correlation analysis, plasma HCY concentration was positively correlated with the number (partial correlation coefficient=0.133, P=0.049), instability (partial correlation coefficient=0.046, P=0.023) and thickness (partial correlation coefficient=0.119, P=0.024) of carotid plaques. Nevertheless, the difference in the IMT of carotid arteries between the two groups was not significant (P=0.057). Conclusion • Plasma HCY concentration is correlated with the number, stability and thickness of carotid plaques.
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Objeetive To investigate the clinical significance of combined detection of lipoprotein associated serum phospholipase A2 (Lp-PLa2),homocysteine (Hcy) and cystatin C (CysC) in the diagnosis of hypertensive disorders complicating pregnancy (HDCP).Methods From January 2013 to May 2016 in Changan Hospital,selected 113 cases of pregnancy induced hypertension patients as the observation group,and were divided into three group A,B and C (group A:55 cases of HDCP patients,group B:32 cases of mild preeclampsia and group C for patients with severe preeclampsia 26 cases).At the same period,selected 50 cases of normal college pregnancy as control group,serum Lp-PLa2 (enzyme-linked immunosorbent assay),Hcy (cyclophorase method) and CysC (particle enhanced turbidimetric method),the test results were analyzed and compared.Results Serum Lp-PLa2,Hcy and CysC test results in the control group,the observation group A,observation group B and observation group C increased significantly,in the observation group C increased most obviously.Compared with the control group,the serum levels of Lp-PLa2,Hcy and CysC in the observation group were significantly higher,the difference was statistically significant (F=8.102,7.231 and 6.926,all P＜0.05).Pearson correlation analysis showed that there was a positive correlation between serum Lp-PLa2,Hcy and CysC and blood pressure (r=0.71,0.69,0.63,all P＜0.05).The abnormal rate of serum Lp-PLa2,Hcy and CysC for three joint detection was higher than that of single detection,and the difference was statistically significant (x2 =6.725,P＜0.001).The abnormal rate of serum Lp-PLa2,Hcy and Cys single test results increased with the exacerbation of HDCP,and the difference was statistically significant (x2=9.351,P＜0.000).Conclusion Serum Lp-PLa2,Hey,CysC and pregnancy would be closely related to the occurrence and development of hypertension syndrome,so combined detection of HDCP can improve the detection rate of abnormal results,and it has important clinical significance for early diagnosis and prognosis of HDCP.
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ABSTRACT:Objective To verify whether rosuvastatin can inhibit homocysteine (Hcy)‐induced rat aortic vascular smooth muscle cell (VSMC ) phenotype transformation and its potential mechanism .Methods The primary culture and identification of rat VSMCs were conducted , using VSMCs in passage4‐7 for the following experiments .The VSMCs were divided into 4 groups:control group ,Hcy (100μmol/L) group ,Hcy+ rosuvastatin group ,and Hcy+ rapamycin group .MTT was used to investigate the proliferation of VSMCs .Transwell chambers and wound healing were employed to test the migration ability of VSMCs . ICC was used to detect the VSMCs'morphology .Western blotting was used to investigate the expressions of SM‐actin ,SM‐MHC ,calponin ,OPN ,and p‐P70S6K1 in VSMCs of each group .Results Compared with those in control group , the proliferation and migration ability of VSMCs were significantly increased in Hcy modulation group (P< 0 .01) .The expressions of SM‐MCH and calponin increased but those of OPN and p‐P70S6K1 decreased in Hcy group compared with control group (P<0 .01) .The expression of SM‐actin did not significantly differ between the groups .Compared with those in Hcy modulation group , the proliferation and migration ability of VSMCs were significantly decreased in rosuvastatin and rapamycin groups ( P<0 .01) .The expressions of SM‐MCH and calponin increased while OPN and p‐P70S6K1 expressions decreased in rosuvastatin and rapamycin groups compared with Hcy group ( P< 0 .01 ) . Conclusion Hcy can induce the dedifferentiation of VSMCs ,and rosuvastatin can inhibit this effect of Hcy .Its potential mechanism may be realized via the mTOR/P70S6K1 signal pathway .
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Objective To investigate the relationship of hypersensitive C reactive protein with carotid atherosclerosis and serum calcium and phosphorus in elderly patients with type 2 diabetes mellitus plus hypertension and increased homocysteine . Methods A total of 105 subjects were enrolled .Carotid intima-media thickness(CIMT) was determined by doppler ultrasound .All the participants were divided into three groups :control group (n=30 ,CIMT0.05).The levels of lipoproteins (LP) and HbA1 c were significantly higher in common carotid sclerosis group and common carotid plaque group than in the control group (P<0.05).The TC was higher in common carotid plaque group than in the control group[(4.32 ± 1.10) vs (3.69 ± 0.67)mmol/L , P<0.05].Pearson correlation analysis showed than CIM T was positively associated with hsC‐RP and Hcy (r=0.560 ,0.452 ,P<0.01). Logistic regression analysis showed that CIMT is independently associated with hsC‐RP and Hcy(OR=1.501 ,1.523 ,P<0.01). Conclusion The levels of serum hsC‐RP and Hcy were not only independent risk factors for carotid artery atherosclerosis but also related to the stability of atherosclerosis plaque in the patients with type 2 diabetes mellitus with hypertension .
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Objective To investigate the serum homocysteine (HCY)levels of patients with various liver diseases,and discuss the clinical value of combined detection of HCY and other liver function indicators in liver disease diagnosis.Methods Se-lected 123 cases of inpatients with different liver diseases (79 cases of male,44 cases of female),including 39 cases of chronic active hepatitis,52 cases of cirrhosis and 32 cases of primary hepatic cancer from Department of Gastroenterology,and 90 ca-ses of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospi-tal.Detected serum HCY and some indicators of liver function (TBIL,ALT,GGT and TBA)in different liver disease groups and normal control group with Roche MODUALR automatic biochemical analyzer,and did statistic analysis.Results The serum HCY levels of chronic active hepatitis,liver cirrhosis and primary hepatic cancer were 16.25± 3.98μmol/L,20.89± 4.26μmol/L and 22.92 ± 6.08μmol/L respectively,and significantly higher than those in normal control group (8.16 ± 4.03μmol/L,t=5.352~9.021,P<0.01).The serum HCY levels of liver cirrhosis and primary hepatic cancer group were higher than that of chronic active hepatitis group (P<0.05).Serum levels of HCY were obviously lower after treatment than that before treatment (P<0.05)for three groups of liver diseases.The positive rate of HCY was higher than those of other liver function indicators (P<0.05).Conclusion Serum homocysteine may be as one of the most important indexes of liver damage,and the combined detection of other liver function indicators may have important clinical value for liver disease diagnosis,differential diagnosis,treatment and prognosis.
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Background: Diabetic retinopathy is the commonest complication that occurs from the very beginning in patients with diabetes mellitus (DM). DM itself leads to increased homocysteine (Hcy) level. It is postulated that hyperhomocysteinaemia causes retinal vascular damage as Hcy is an established vasculotoxic agent and auto-oxidation of Hcy leads to oxidative stress, endothelial dysfunction, platelet activation and thrombus formation. Objective: The aim of the study was to evaluate the serum Hcy in newly diagnosed type 2 diabetic subjects with diabetic retinopathy. Materials and method: A case control study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of January 2006 to December 2007. Total 85 newly diagnosed type 2 diabetic subjects were included in this study, 40 were case having retinopathy and 45 were age and sex matched control without retinopathy. Serum Hcy was measured and compared between case and control. Results: Serum Hcy level in cases was significantly higher (p<0.05) compared to that of control (15.11±5.49 μmol/L vs. 12.59±4.01 μmol/L). Odds ratio was also determined for hyperhomocysteinemia (OR=2.23; CI 0.9-5.45). Conclusion: Hyperhomocysteinaemia is associated with diabetic retinopathy in newly diagnosed type 2 diabetes.
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@#ObjectiveTo study the relevant pathogenic factors, Thromboxane B2 (TXB2), oxidized low density lipoprotein (OxLDL), lipoprotein(a) (Lp(a)), and homocysteine (Hcy), in patients with cerebral infarction and the correlation among them. Methods205 patients and 40 health persons (the control) were measured with the plasma TXB2, 6-keto-prostaglandin F1α (PGF1α) and TXB2/6-keto-PGF1α (T/6-K), OxLDL, Lp(a), Hcy within 24 h. Results and ConclusionThe levels of plasma TXB2, T/6-K，OxLDL, Lp(a), and Hcy significantly increased compared with the controls (P<0.01). OxLDL was correlated with Lp(a); TXB2 was correlated with T/6-K and Hcy; T/6-K was correlated with OxLDL, Lp（a）.
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@#ObjectiveTo study the relationship between the homocysteine (Hcy) level and stroke. Methods57 cases, including cerebral haemorrhage (CH, 21 cases) and cerebral infarction (CI, 36 cases) , and 28 healthy cases as control group were selected to measure their level of Hcy, VitB12 , folic acid and creatinine(Cr). At the same time, the clinical neurological disfunction scale(CNDS) of all patients was evaluated and the hematom volume (HV) of the CH group was assayed. ResultsThe Hcy level of both CI and CH group was significantly higher than that of the control group(P<0.05 or P<0.01). No significant difference was found between CI and CH group on Hcy level. The Hcy level showed a very strong or strong reverse association with folic acid level in the CI and CH group (r=-0.442,P=0.007 or r=-0.531,P=0.013), but no significant correlation with VitB12 level. No correlation was found between Hcy level and CNDS in both the CI and CH group, either no correlation between Hcy level and HV in the CH group. ConclusionThere is a close relationship between hyperhomocysteine and stroke. Hcy level is reversely associated with folic acid level but not correlated with VitB12 level.
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Objective To explore the relationship between gene mutation and different syndromes of TCM in the early stage of diabetic nephropathy(DN).Methods Sixty-three patients with diabetic nephropathy in the early stage were observed.The methylene tetrahydrofolate reductase(MTHFR)C676T polymorphism was determined by polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP)assay.The levels of homocysteine(Hcy),acidum folicum,fasting glucose,postprandial glucose,glycosylated hemoglobin(HbA1C),urinary albumin excretion rate(UAER),and blood lipid were measured respectively,and the TCM syndromes were recorded.Results Of the 63 patients,19 were genotype CC,17 were genotype TT,and 27 were genotype CT.The genotypic frequency of TT was 27.00%,that of CT was 42.85%,and that of CC was 30.15%.The T allele frequency was 48.41% and C allele frequency 51.59%.The MTHFR C676T mutation was related with plasma Hcy level(P