Differential gene sequencing alignment analysis of hyperplastic stenosis in murine arteriovenous fistula / 中华肾脏病杂志

Objective:To establish a mouse model of intra-jugular arteriovenous fistula (AVF) to screen differentially expressed genes in the process of intimal stenosis of AVF for investigating the abnormal expression signaling pathways and the mechanisms.Methods:Forty-six male C57BL/6 mice were randomly divided into AVF group ( n=23) and sham-operated group ( n=23). The AVF group underwent internal jugular arteriovenous fistuloplasty, and the sham-operated group separated the right external jugular vein and common carotid artery and then sutured the incision. The whole-genome sequences of mice with AVF stenosis were determined by transcriptomic reversible chain terminator and synthetic sequencing. The microarray data set was established, and the Benjamini & Hochberg method of gene microarray data analysis was applied to screen the differentially expressed genes. The differentially expressed genes were screened by R-language enrichment analysis. Then, gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) were performed. The subcellular localization of the differentially expressed genes was performed by BUSCA software. The protein network interaction of differentially expressed genes was analyzed by using STRING database and Cytoscape software. Results:In the AVF group, 21 mice were successfully modeled and 2 mice failed. Therefore, there were 21 mice in the AVF group and only 21 mice in the sham-operated group. This mouse internal jugular AVF model was innovated using the continuous-interrupted suture method, which improved the success rate of modeling this model. The differential gene sequencing analysis showed that there were 2 514 differentially expressed genes in the AVF process, including 1 323 up-regulated genes and 1 191 down-regulated genes. GO functional enrichment analysis showed that the differential genes were mainly enriched in metabolic process, activation, redox, mitochondria and so on. KEGG pathway enrichment analysis showed that the differential genes were enriched in metabolism, energy substance synthesis, diabetes, oxidative stress and so on. Statistical analysis of subcellular localization showed that the differences were mainly in mitochondrial proteins (24.24%), cytoplasmic proteins (17.51%), nuclear proteins (13.13%), cell membrane proteins (11.45%), and extracellular proteins (10.77%).Conclusions:Mitochondrial oxidative stress injury may be involved in the pathological damage process of endothelial proliferation stenosis in the AVF.

A new option to prevent fistulas in anterior urethroplasty in patients with kippered urethra: the tunica vaginalis flap

ABSTRACT The objective of this study is describing a technique with the use of a tunica vaginalis flap (TVF) to cover the suture line during anterior urethroplasty in patients with kippered urethra due to chronic indwelling catheterization (CIC). We studied 5 patients (mean age=50.2) with a neurogenic bladder that developed urethral erosion after a long period of CIC. Foley catheter was removed on the 14th postoperative day. One patient developed wound infection and utethrocutaneous fistula, which was conservatively managed and after 12 months of follow-up all the patients didn't report difficulties in intermittent self-catheterization. In conclusion, a urethroplasty with TVF technique may be a viable method for repairing penile urethral erosions, but further studies are required with a bigger sample to confirm our results.

Microscopic analysis of the myocardial bridges and their relationship with atheromatous plaque / Análisis microscópico de los puentes miocárdicos y su relación con la placa ateromatosa

SUMMARY: Most histopathological studies have reported that the segment of the coronary artery below the myocardial bridge does not present atheromatous plaque, while the segment proximal to the myocardial bridge may have it. The aim of this study was to evaluate the microscopic environment of myocardial bridges. This descriptive study was carried out with 60 hearts of individuals who underwent autopsy at the National Institute of Legal Medicine and Forensic Sciences in Bucaramanga-Colombia. For each specimen, the coronary arteries and their branches were dissected, removing the subepicardial adipose tissue to identify the myocardial bridges and obtain histological sections of the compromised arterial branches. The presence of myocardial bridges was observed in 22 hearts (36.7%) with a length of 17.31 + 4.41 mm and a thickness of 904.57 + 312.27 mm. The coronary vessel caliber at the prepontine level was 246.57 + 49.33 mm and was significantly higher than in the pontine (188.92 + 60.55 mm) and postpontin (190.40 + 47 mm) segments (p=0.001 for both values). Atheromatous plaque was observed in the prepontine segment in 12 cases (46.15 %) and in 8 samples (30.76%) at the pontine level, but in this segment, there was slight damage to the vascular endothelium, or phase I level. The thickness of the tunica intima in the cases with atheromatous plaque was 15.68 + 13.39 mm and that of the plaque-free segments was 5.10 + 4.40 mm (p=0.005), and in the pontine segment the overlying periarterial adipose tissue had a thickness of 72.01 + 69.44 mm, which was higher than the other three locations (p=0.005). The morphometry of the perivascular fat pad and the presence of phase I atheromatous plaque are the main contributions of this study to the histology of myocardial bridges.

RESUMEN: La mayoría de los estudios histopatológicos han reportado que el segmento de la arteria coronaria debajo del puente miocárdico no presenta placa ateromatosa, mientras que el segmento proximal al puente miocárdico puede tenerla. El objetivo de este estudio fue evaluar el entorno microscópico de los puentes miocárdico. Este estudio descriptivo se realizó con 60 corazones de individuos a quienes se les práctico autopsia en el Instituto Nacional de Medicina Legal y Ciencias Forenses de Bucaramanga-Colombia. Para cada espécimen se realizó disección de las arterias coronarias y sus ramas, eliminando el tejido adiposo subepicárdico para identificar los puentes miocárdicos y obtener secciones histológicas de las ramas arteriales comprometidas. Se observó presencia de puentes miocárdicos en 22 corazones (36,7 %) con una longitud de 17.31 + 4.41 mm y un espesor de 904.57 + 312.27 mm. El calibre del vaso coronario a nivel prepontino fue 246.57 + 49.33 mm y fue significativamente mayor que en el segmento pontino (188.92 + 60.55 mm) y pospontino (190.40 + 47 mm) (p=0.001 para ambos valores). Se observó placa ateromatosa en el segmento prepontino en 12 casos (46.15 %) y en 8 muestras (30.76%) al nivel pontino, pero en este segmento, correspondieron a fase I, con ligero daño en el endotelio vascular. El espesor de la túnica íntima en los casos con placa ateromatosa fue de 15.68 + 13.39 mm y de los segmentos libres de placa fue 5.10 + 4.40 mm (p=0.005) y en el segmento pontino el tejido adiposo periarterial suprayacente presento un espesor de 72.01 + 69.44 mm, el cual fue mayor a las otras tres ubicaciones (p=0.005). La morfometría de la almohadilla adiposa perivascular y la presencia de placa ateromatosa en fase I son los principales aportes de este estudio a la histología de los puentes miocárdicos.

Different retrieval kits for ultra-long time window OptEase inferior vena cava filter / 中国介入影像与治疗学

Objective: To observe the effect of Cook retrieval group set to retrieve super long time window OptEase inferior vena cava (IVC) filter. Methods: Clinical data of 289 patients who underwent retrieval OptEase recoverable IVC filter were retrospectively analyzed. IVC filters were retrieved in normal time window (the time of filter placement ≤14 days) in 242 cases, including 127 using OptEase retrieval sets (group A) and 115 using Cook retrieval sets (group B).Meanwhile, IVC filters of 47 cases were retrieved in the ultra-long time window (the time of filter placement >28 days), including 22 using OptEase retrieval sets (group C) and 25 using Cook retrieval sets (group D). The filter retrieval success rates, retrieval time and complication rates were compared between group A and B, group C and D. Results: IVC filters were successfully retrieved in group A and B. There was no significant difference of retrieval time nor complication rate between group A and B (both P>0.05). The success rate of filter retrieval in group D was higher than that in group C (P<0.05), while the retrieval time and complication rate of group D were both lower than those in group C (both P<0.05).No serious complication occurred. Conclusion: The retrieval effect of Cook filter retrieval set is good for ultra long-term time window OptEase venous filter.

Study of Morphometry and Elastic Fibre Distribution in Left and Right Coronary Arteries.

Background: Coronary artery disease also called asischemic heart disease which develops when majorblood vessels that supply blood to heart becomedamaged or diseased. It is also one of the leading causesof death. Morphometry and elastic fibre distribution incoronary arteries may help in using appropriate sizecatheters for diagnostic procedures. Aim andObjectives: To study the morphometry and elastic fibredistribution in left and right coronary artery. Materialand Methods: Segment of left and right coronaryarteries each having length of 0.5 cm were collectedfrom 30 adult human heart specimens fixed in 10%formalin. Outer and inner diameters were measured.Tissues were processed and stained by verhoeff's VanGeison stain. Stained slides were scanned by “IScapture software” under 10 × magnifications. Results:Outer diameter of left coronary artery is 4.225 ±0.6963mm and right coronary artery is 3.827 ±0.6869mm. Inner diameter of left coronary artery is3.338 ± 0.5853 and that of right coronary is 2.869 ±0.6104mm.Conclusion: Diameter, wall thickness,thickness of tunica intima, tunica media is more in leftcoronary artery than the right. Also left coronary arteryshows more number of elastic fibers than right coronaryartery.

Sudden Cardiac Death due to Coronary Fibromuscular Dysplasia: Case Report and Literature Review / 대한법의학회지

Fibromuscular dysplasia (FMD) of the coronary artery is a rare cause of sudden cardiac death; however, its prevalence and fatality may have been overlooked so far. A 47-year-old man complained of pain in his back and shoulder and became unconscious. Despite resuscitation, he died 3 hours after symptom onset. The heart weight was in the normal range; however, all three major coronary arteries showed intimal thickening without atherosclerosis or inflammatory cell infiltration. Fragmentations and duplications of the internal elastic lamina which are histologic features of intimal fibroplasia, a focal-type FMD, were observed. The prevalence of coronary FMD remains unknown, although it may be related to spontaneous coronary artery dissection and sudden death. The histopathologic confirmation of coronary FMD and exclusion of other possible coronary diseases through autopsy are essential to reveal the nature of the disease and therefore apply the information in dealing with legal problems after death.

Correlation of serum uric acid level with acute cerebral infarction and carotid artery lesions in type 2 diabetic patients / 中华全科医师杂志

The clinical data of 103 patients with type 2 diabetes (diabetic group) and 111 diabetic patients with acute cerebral infarction (ACI) admitted from August 2016 to October 2017 were reviewed and 101 health subjects served as normal controls (group NC).The examination results of carotid ultrasound,serum uric acid (SUA) levels and blood biochemistry were compared among three groups.The results show that SUA in diabetic patients with ACI was significantly higher (P ＜ 0.01).The correlation analysis showed that SUA was positively correlated with intimal medial thickness (IMT) of carotid artery,diabetes with ACI (r=0.521 and 0.489,P ＜0.01).Logistic regression analysis showed that SUA was an independent risk factor for diabetes with ACI (OR =1.012,95％ CI:1.007-1.017,P ＜ 0.01).Multiple stepwise regression analysis showed that high SUA and systemic blood pressure (SBP) were independent risk factors of increased IMT.Logistic regression analysis showed that SUA was an independent risk factor for vulnerable carotid plaques (OR =1.052,95％ CI:1.039-1.065,P ＜0.01).

Degradation of a magnesium alloy stent in the rabbit abdominal aorta / 中国组织工程研究

BACKGROUND:Foreign studies have found that the magnesium alloy stent is safe and effective, but there are few studies on the degradation performance of magnesium alloy stents in China.OBJECTIVE:To investigate the degradation of degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta and the effect of degradation process on vascularization.METHODS:Twenty-eight rabbits were enrolled, and the degradable AZ31 magnesium alloy stent was implanted into the rabbit abdominal aorta. Postoperative abdominal aortic X-ray examination and histological observation were done at 30, 60, 90, 120 days after implantation.RESULTS AND CONCLUSION:(1) X-ray examination: 30 days after implantation, the stent expanded completely with structural integrity; 60 days after implantation, the stent deformation, partial stent fracture, and lose of support were found; 90 days after implantation, only a small amount of support rod residues were found, and the majority of the stent was degraded; and 120 days after implantation, there was no support rod residual, and the stent was degraded completely. (2) Histological observation: 60 days after implantation, the number of residual support rods was less than that 30 days after implantation (P< 0.05), the number value at 90 days after implantation was lower than that at 30 and 60 days after implantation (P< 0.05), and the number value at 120 days after implantation was lower than that at 30, 60, 90 days after implantation (P < 0.05), indicating that the number of residual support rods was negatively correlated with post-implantation days. The time for complete stent degradation was 124.8 days. The intimal area at 90 days after implantation was higher than that at 30, 60, 120 days after implantation (P < 0.05), while the lumen area was smaler than that at 30, 60, 120 days after implantation (P < 0.05). There was no significant difference in the intimal area and lumen area at latter three time points after implantation. To conclude, the degradation of the degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta can be completed within 124.8 days, and at 90 days after the stent is implanted, vascular intimal hyperplasia and lumen stenosis are most serious, and then gradualy reduced.

Geraniol attenuates vascular smooth muscle cell proliferation in rat carotid artery balloon injury model / 天津医药

Objective To evaluate the effects of geraniol(GOH) on neointima hyperplasia in rat carotid artery balloon injury model, and explore the potential molecular mechanisms associated with this effect. Methods Totally 20 male Sprague-Dawley (SD) rats were randomly divided into sham operation group (without balloon injury), control group (with balloon injury), low concentration group (with 50 mg/kg GOH intervention after balloon injury) and high concentration group (with 200 mg/kg GOH intervention after balloon injury). The intima to media (I/M) area ratio of neointima was measured by hematoxylin- eosin (HE) staining. The expression of proliferating cell nuclear antigen (PCNA) was measured by immunohistochemical staining at 14th day after operation. As the marker of oxidative stress, the levels of 8-hydroxy-2’-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) were measured by enzyme linked inmmnosorbent assay (ELISA). Results The I/M ratio, IOD, 8-OHdG and MDA values were increased in control group compared with those of sham group. The I/M ratio, IOD and 8-OHdG values were reduced in low concentration group compared with those of control group. But there was no significant difference in MDA level between low concentration group and control group. The I/M ratio, IOD, 8-OHdG and MDA values were significantly reduced in high concentration group compared with those of control group, which showed a more significant inhibitory effect than that of low concentration group (P<0.05). Conclusion GOH could attenuate balloon iniury induced neointima hyperplasia, which might be related to its effect on inhibiting expression of PCNA and decreasing oxidative stress.

The correlation of TCF7L2 genetic polymorphisms with intimal -medial thickness and stiffness in the hypertension and type 2 diabetic patients / 中国基层医药

Objective To explore the relationship between TCF7L2 genetic polymorphisms with intimal -medial thickness (IMT),carotid arterial stiffness in patients of type 2 diabetes mellitus(T2DM)with hypertension. Methods 872 patients of hypertension and T2DM were enrolled into this study,and they were divided into two groups according to IMT,carotid arterial stiffness and cPWV:the observation group(n =432,IMT >1.0mm,cPWV >12m/s),the control group(n =440,IMT≤1.0mm,cPWV≤12m/s).Meanwhile,400 healthy subjects(normal fasting gluose,blood pressure,without diabetes and hypertension family history)were selected as the healthy group.Typed gene polymorphisms of TCF7L2 by RT -PCR,the body mass index(BMI),waist -hip ratio,systolic blood pressure, diastolic blood pressure,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL -Ch), low -density lipoprotein cholesterol(LDL -Ch),insulin sensitivity index(ISI),glycated hemoglobin A1C(HbA1c) between groups were compared.Calculated each allele and genotype frequencies and implemented Hardy -Weinberg equivalent test.The distributional differences of alleles frequencies between groups were analyzed by χ2 test and geno-type frequencies through dominant model.Results Distributional differences of rs290487 genotype frequencies had statistically significant differences in the observation group vs the control group(χ2 =33.296,P 0.05 ).Conclusion rs290487 involved in the development of T2DM with hypertension,C and T alleles might be the risk factors of increasing the IMT and carotid arterial stiffness levels in patients of T2DMwith hypertension.Logistic regression analysis revealed that the increase of SBP,DBP,TC,TG,LDL-Ch and decrease of HDL -Ch may be the risk factors of hypertension and diabetic patients.Meanwhile,it dedicated that the increase of those biochemical indexes might be the important elements which would lead to the gene variations of C and T alleles.

Experimental study of chitosan inhibiting vascular intimal hyperplasia of rabbit arteriovenous fistula / 中华肾脏病杂志

Objective To investigate the effete of chitosan on rabbit carotid artery internal jugular vein fistula intimal hyperplasia and its regulation on TLR4/NF-κB signaling.Methods A total of 28 New Zealand white rabbits were randomly divided into the control group(n=4),the model group(n=12) and the chitosan group(n=12).Model group and chitosan group rabbits were established respectively carotid artery internal jugular vein fistula models.After AVF surgery,chitosan was smeared on venous blood vessels and anastomosis.After 4,6 and 8 weeks,the rabbits were separately sacrificed and the AVF venous vascular tissues were taken.The pathological changes of AVF venous vascular tissue in each group were observed.The changes of α-SMA were detected by immunohistochemistry method.The mRNA expressions of PCNA and TLR4 in the tissues were measured by Real-time PCR.At the same time,the protein expressions of PCNA,TLR4,MyD88 and NF-κB were detected by Western blotting.The experimental data were processed by two-factor analysis of variance in statistics.Results (1) After 4 weeks,vascular intimal was thicked in mdel group.In intimal hyperplasia,α-SMA was staining,and then proliferation of vascular smooth muscle cell was significant.As time increasing,more intimal hyperplasia shown obviously,the expression of α-SMA significantly increased.Compared with model group,chitosan group significantly reduced the degree of intimal hyperplasia,the level of α-SMA was significantly decreased,vascular smooth muscle cell proliferation was also extraordinarily decreased.(2) Compared with control group,the expression levels of PCNA,TLR4,MyD88 and NF-κB increased with time.The indices of Chitosan group were markedly higher than control group,but significantly lower than model groups.Conclusion Chitosan can inhibit the proliferation of rabbit VSMCs.The mechanism may be concerned in down regulating TLR4-mediated signaling pathway,reducing the possibility of intimal hyperplasia of rabbit AVF venous blood vessels.

Relationship Between 1h, 2h Post-load Blood Glucose Elevation and Carotid Intima-media Thickness in Healthy Population / 中国循环杂志

Objective: To observe the relationship between 1h, 2h post-load plasma glucose (PG) elevation and carotid intima-media thickness (CIMT) in healthy population. Methods: The healthy subjects from normal physical examinations in our hospital from 2013-09 to 2015-05 were selected and oral glucose tolerance test (OGTT) was conducted in them, plasma levels of fasting glucose (FPG), 1hPG and 2hPG were monitored. Finally, 482 subjects with normal fasting glucose, without diabetes were enrolled and divided into 4 groups:①Normal glucose tolerance (NGT) group,n=201,②1hHPG group, the subjects with 1h post-load high and 2h post-load normal glucose,n=83,③2hHPG group, the subjects with 1h post-load normal and 2h post-load high glucose,n=101 and④1hHPG/2hHPG group,n=97. The gender, age, BMI, blood pressure and lipid levels in all subjects were recorded, CIMT was evaluated by Doppler ultrasound; the relationship between 1hHPG, 2hHPG and CIMT were analyzed. Results:①The gender, age, BMI, systemic blood pressure (SBP), DBP and the levels of TC, TG, LDL-C were similar among 4 groups,P>0.05.②For CIMT at both side, both bifurcations and both internal carotid arteries, 1hHPG/2hHPG group was higher than those in 1hHPG group and 2hHPG group; 1hHPG group was higher than 2hHPG group; CIMT in above 3 groups were all higher than NGT group, allP Conclusion: Abnormal 1hHPG and 2hHPG were related to increased CIMT.

Effect and mechanism of Imatinib mesilate on intimal hyperplasia of rabbit carotid artery after ballon injury / 天津医药

Objective To investigate the effect and mechanism of Imatinib mesilate (Imatinib) on intimal hyperplasia of rabbit carotid arteries after balloon injury. Methods Thirty adult Newzealand rabbits were randomly divided into three groups:group A, B and C. Their right carotid arteries were injuried then administered with 0, 25 or 50 mg/kg of Imatinib dai?ly for 14 consecutive days when the rabbits were sacrificed. The carotid arteries were harvested and sectioned for HE-stain?ing and immunohistochemisty staining. Real-Time PCR was used to examine transcription levels of PDGF-B and PDGFR-βmRNA. The plasma level of PDGF-BB was assayed by ELISA. Results Arterial intimal hyperplasia and stenosis following balloon injury were seen in three groups. Thickness and area of neointima, ratio of thickness of intima to media, ratio of area of intima to media and mRNA level of PDGF-β are all higher in group A than those in group B than those in group C (P<0.01). By contrast, the mRNA transcription level of PDGFR-β increased significantly in group C than that in group A (1.236±0.356 vs 0.708±0.372;t=2.91;P<0.01). Plasma level of PDGF-BB increased in all three groups after balloon injury than that in the baseline (P<0.01). The transcription level of PDGF-BB is higher in group A than that in group B and in group C (ng/L:23.464±3.542, 19.504±2.454, 16.588±1.207, F=17.322, P<0.05). There was no difference between group B and C. There was positive correlation between mRNA transcription level of PDGF-B and plasma level of PDGF-BB ( r=0.806, P<0.01). Conclusion Vascular injury can cause intimal hyperplasia and increased PDGF-B mRNA transcription. Imatinib mesilate could inhibit the intimal hyperplasia through down regulating PDGF-B mRNA transcription.

Influence of long-term exercise training on carotid intima-media thickness in patients with mild-moderate hypertension / 心血管康复医学杂志

Objective: To observe influence of long-term exercise training on carotid intima-media thickness (IMT) in patients with mild-moderate hypertension. Methods: A total of 92 patients with essential mild-moderate hypertension were randomly divided into routine treatment group (n=46) and exercise group (n=46, received exercise training based on routine treatment) according to number table. All patients were followed up for one year, and the blood pressure, carotid artery diameter and carotid IMT were measured, compared and analyzed in two groups before and after treatment. Results: There was no significant difference in systolic and diastolic blood pressure before treatment between two groups (P＞0.05). Compared with baseline value, there were significant decrease in systolic blood pressure [(176.66±l1.78)mmHg vs. (130.89±13.01)mmHg], diastolic blood pressure [(101.43±6.41)mmHg vs. (81.71±8.45)mmHg], carotid artery diameter [(6.62±0.97)mm vs. (6.22±1.01)mm] and carotid IMT [(0.98±0.12)mm vs. (0.84±0.11)mm] in exercise group after one-year training (P<0.05 all), and they were all significantly lower than those of routine treatment group (P<0.05 all ). Conclusion: Long-term exercise training can effectively control blood pressure, decrease carotid artery diameter and carotid intima-media thickness.

Influence of exercise training on carotid intima-media thickness in patients with mild-to-moderate hy-pertension / 心血管康复医学杂志

Objective:To observe the influence of long-term exercise training on carotid intima-media thickness (IMT)in patients with mild-to-moderate hypertension.Methods:A total of 92 patients with mild-to-moderate es-sential hypertension (EH)were randomly and equally divided into exercise group and routine treatment group.Exer-cise group received exercise training based on routine treatment.All patients were followed up one year.Influence of long-term exercise training on carotid artery diameter and carotid IMT was observed in EH patients.Results:Af-ter one year,there were significant reductions in systolic blood pressure (SBP),diastolic blood pressure (DBP),ca-rotid artery diameter and carotid IMT in both groups,P<0.05 all;compared with routine treatment group,there were significant reductions in SBP [(145.72±11.31)mmHg vs.(130.89±13.01)mmHg],DBP [(88.49±7.32) mmHg vs.(81.71±8.45)mmHg],carotid artery diameter [(6.34±1.23)mm vs.(6.22±1.01)mm]and carotid IMT [(0.89±0.21)mm vs.(0.84±0.11)mm]in exercise group after treatment,P<0.05 all.Conclusion:Long-term exercise training can effectively reverse early arteriosclerosis lesion of carotid wall and effectively control blood pressure.

Influence of fluvastatin on carotid intima-media thickness and pulse pressure in patients with hypertension / 心血管康复医学杂志

Objective: To analyze influence of fluvastatin on carotid intima-media thickness (IMT) and pulse pressure (PP) in patients with essential hypertension (EH). Methods: A total of 62 EH patients were enrolled and randomly divided into fluvastatin group (n=32, received fluvastatin therapy based on routine antihypertensive therapy) and routine treatment group (n=30, received routine antihypertensive therapy). Course of treatment was one year for all patients. Levels of blood lipids, PP and carotid IMT were compared between two groups before, six and 12 months after treatment. Results: Compared with before treatment, there were significant decrease in levels of all blood lipids, PP [(66.9±7.3) mmHg vs. (53.1±6.2) mmHg] and IMT [(0.97±0.42) mm vs. (0.76±0.29) mm] in fluvastatin group after treatment six and 12 months, and significantly improved more than those of routine treatment group, P0.05）. Conclusion: Fluvastatin can improve carotid intima-media thickness and pulse pressure in patients with hypertension and is worth extending in clinic.

Subintimal angioplasty true lumen re-entry technology in the treatment of lower limb atherosclerosis obliterans / 国际外科学杂志

Subintimal angioplasty had been widely used in the intervention of lower extremity arterial obliterans disease in recent years.True lumen re-entry is the key to subintimal angioplasty.This comprehensive exposition of the true lumen re-entry can improve the chances of ultrasound and subintimal arterial flossing with antegraderetrograde intervention and catheter systems and other emerging technologies in the application of subintimal angioplasty,and various types of technology advantages and disadvantages.

Blockade of oxidative stress and Ras-MEK1/2-ERK1/2 pathway is involved in fasudil attenuating balloon injury-induced neointima hyperplasia / 中华老年医学杂志

Objective To evaluate the effects of fasudil on neointima hyperplasia in rat carotid artery balloon-injury model,and explore the potential molecular mechanisms of this effect.Methods Totally 30 male Sprague-Dawley (SD) rats were randomly divided into sham operation group,balloon injury group,2.5 ml/kg fasudil intervention group,5 ml/kg fasudil intervention group,10 ml/kg fasudil intervention group.The intima-to media(I/M) area ratio of neointima was calculated at 14th day after operation; the protein expression of proliferating cell nuclear antigen(PCNA) was measured by immunohistochemical and the integrated optical density (IA) was calculated.As the marker of oxidative stress,the levels of 8-hydroxy-2'-dcoxyguanosine (8OHdG) and malondialdehyde (MDA) were measured by enzyme-linked immunosorbent assay (ELISA).The expressions of phosphorylated and non phosphorylated Ras,mitogen activated protein kinase kinase (MEK1/2) and extracellular signal regulated kinase (ERK1/2) were measured by Western blot.Results The I/M ratios were (0.22 ± 0.01) in sham operation group,(2.71 ± 0.23) in balloon injury group,( 1.72 ±0.24)in 2.5 ml/kg fasudil intervention group,(1.23±0.11)in 5 ml/kg fasudil intervention group,(0.85±0.12)in 10 ml/kg fasudil intervention group.As compared with sham operation group,I/M area ratio was increased in balloon injury group,and three fasudil intervention group inhibited neointima hyperplasia in a dose-dependent manner (all P＜0.01).The IA indexes were(15.11 ±1.42),(53.42±2.30),(45.25±1.62),(22.55±0.88) and(19.61±0.79) in the above five groups,respectively,showing the fasudil inhibited PCNA expression (all P＜0.01).Fasudil also inhibited the levels of 8-OHdG and MDA in a dose-dependent manner [8OHdG:(54.34±4.50)μg/kg,(106.81 ± 6.67)μg/kg,(94.21 ± 3.34) μg/kg,(65.58 ± 5.13) μg/kg,(51.32 ± 2.34) μg/kg; MDA:(19.94 ± 0.65 ) μmol/kg,( 58.83 ± 2.81 ) μmol/kg,(48.94 ± 1.35 ) μmol/kg,(40.62 ± 3.24 )μmol/kg,( 36.85 ± 0.91)μmol/kg (all P＜0.01)].Compared with balloon injury group,the relative expressions of Ras in three fasudil intervention group were 0.49±0.12,0.39±0.13,0.20±0.23 vs.0.62±0.10(P＜0.05 or,P＜0.01); MEK1/2 0.35±0.14,0.29±0.09,0.11±0.12 vs.0.56±0.1(P＜0.05 or,P＜0.01); ERK1/2 0.48±0.15,0.32±0.08,0.12±0.09 vs.0.64±0.13(P＜0.05 or,P＜0.01).The activations of ERK1/2,MEK1/2 and Ras were strongly suppressed in fasudil treated samples on day 14 after balloon injury.Conclusions Blockade of oxidative stress and Ras MEK1/2 ERK1/2 pathway is involved in the fasudil attenuating of balloon injury-induced neointima hyperplasia

Perfil de riesgo cardiovascular en adultos jóvenes asintomáticos con grosor íntima media carotídeo elevado / Cardiovascular risk factors among young subjects with high carotid intima media thickness

Background: Cardiovascular risk factor (RF) assessment is essential to prevent and predict cardiovascular disease. The presence of RF at early ages, are determinant for the presence of atherosclerosis later in life. Aim: To determine the RF profile of young subjects with high carotid intima media thickness (CIMT). Material and Methods: We studied 689 subjects (50 percent women, mean age 36±6 years) from Santiago, Chile. We determined body mass index (BMI), waist circumference, blood pressure, fasting serum lipids, blood glucose and C-reactive protein. CIMT was assessed by ultrasound using an automatic border recognition software. Results: Body mass index, waist circumference, blood pressure and serum lipids were significantly higher among subjects located in the higher CIMT quartile. Also, subjects in the higher quartile of CIMT had a higher prevalence of three or more RF compared with the lower quartile (p = 0.01). Finally, individuals with three or more RF showed three times more risk of being in the higher CIMT quartile, than subjects with no RF (odds ratio = 3.1, p < 0.01). Conclusions: There is a negative influence of cardiovascular RF on CIMT among young subjects.

Correlation of peripheral blood CD34+ cell level with cerebrovascular disease risk factors in patients with cerebral infarction / 中华老年医学杂志

Objective To observe the change of peripheral blood CD34+ cell level in patients with acute cerebral infarction, and explore its relationships with cerebrovascular risk factors,neurological function and carotid artery intima-media thickness (IMT). Methods The 45 patients with acute cerebral infarction (onset within 72 h) (infarction group) and 27 patients with cerebr ovascular risk factors but without cerebral infarction (high-risk group) were chosen for the study. The cerebrovascular disease risk factors including history of alcohol abuse, smoking, coronary heart disease, hypertension, diabetes, abnormal levels of serum triglycerides, total cholesterol,low-density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were recorded in all subjects. The peripheral blood CD34+ cell levels were measured by flow cytometry.The correlations of peripheral blood CD34+ cell level with cerebrovascular disease risk factors were analyzed. The neurological function and carotid artery IMT were recorded in infarction group, and the correlations of peripheral blood CD34+ cell level with neurological function and carotid artery IMT were analyzed. Results (1) The peripheral blood CD34+ cell level was significantly negatively correlated with coronary heart disease, hypertension, diabetes and LDL-C level (r =- 0. 749,-0. 717, - 0. 688, - 0. 764, all P＜0. 01) ; (2) Multiple linear regression analysis showed that peripheral blood CD34+ cell level was an independent relative factor of acute cerebral infarction (P＜0.05); (3) The peripheral blood CD34+ cell level was lower in infarction group than in high-risk group, and was significantly negatively correlated with neurological deficit score (r=-0. 721, P＜0.01) and carotid artery IMT (r= -0. 695, P＜0. 01). Conclusions Peripheral blood CD34+ cell level could be an independent relative factor of acute cerebral infarction; The peripheral blood CD34+ cell level is significantly negatively correlated with neurological function and carotid artery IMT in patients with acute cerebral infarction; And it can be used as cytological marker which reflect early vascular endothelial function in patients with ischemic stroke.