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Objective@#To analyze the ultrasound examination and computed tomography angiography (CTA) features of carotid web(CAW), and compare with the pathology after carotid endarterectomy, and then compare diagnostic efficacies of the two methods.@*Methods@#From June 2018 to July 2019, 159 patients underwent carotid endarterectomy(CEA) in Beijing Tian Tan Hospital were collected, ultrasound examination and CTA were performed preoperatively. The presence or absence of CAW and whether there were thrombosis or atherosclerotic plaques associated with it were identified. The location length, thickness, direction in the lumen, echo characteristics of CAW, and complicated with or without thrombosis or atherosclerotic plaques were recorded. The postoperative specimens were observed, and the pathological analysis was performed.@*Results@#Among the 159 cases of CEA, 22 cases were confirmed to have CAW structure by pathology, and HE staining showed extensive intimal fibrohyperplasia and mucoid degeneration, among which 18 cases had plaque formation at the bottom of the carotid web, and 4 cases associated with thrombosis. There were 17 cases of CAW structure diagnosed by ultrasound, 5 cases were misdiagnosed or missed, the sensitivity and specificity of ultrasound in the diagnosis of CAW were 77% (17/22) and 98% (135/137), and the accuracy was 75%. Eleven cases of CAW were diagnosed by preoperative CTA, and 11 cases were misdiagnosed and missed diagnosis, the sensitivity and specificity of CTA in the diagnosis of CAW were 50%(11/22) and 97%(134/137), and the accuracy was 47%.@*Conclusions@#The sensitivity of ultrasound in the diagnosis of CAW is higher than that of CTA, which can better display the structure of CAW and whether it is associated with plaque or thrombosis.
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Objective To explore relationship between the nature of carotid atherosclerotic plaque and the number and function of endothelial progenitor cells in peripheral blood.Methods A prospective study of 80 carotid atherosclerotic plaque patients were selected from June 2016 to March 2017 in Guangdong Second Provincial General Hospital.All patients were examined with Cranial magnetic resonance imaging or X-ray computed tomography,pathological examination,carotid artery color Doppler ultrasonography.Patients were divided into hard plaque group (n =42) and soft plaque group (n =38) according to the nature of carotid atherosclerotic plaque.Forty healthy subjects were selected as controls.Monocytes were obtained from 10 ml of elbow venous blood by density gradient centrifugation.Adherent cells were cultured and identified by confocal laser microscopy.The number,migration,proliferation and adhesion of EPCs in soft plaque group and hard plaque group were evaluated.Results The number of proliferating cells (0.847 ± 0.037),migrating cells(27.697±8.248) and adherent cells (46.184± 7.876) in the normal control group were significantly higher than those in the hard plaque group ((0.647±0.019),(18.643±3.289),(32.165±4.325)) and the soft plaque group ((0.679± 0.023),(23.576± 6.327),(40.587±6.523)) (all P＜ 0.001),while the proliferation,migration and adherent cells in the hard plaque group were lower than those in the soft plaque group (all P＜0.001).Conclusion The nature of carotid atherosclerosis plaque is closely related to the number and function of endothelial progenitor cells in peripheral blood.The number of endothelial progenitor cells in carotid atherosclerosis patients with hard plaque is small,and their proliferation,migration and adhesion ability are impaired.
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Objective To investigate the value of evaluating vertebrobasilar artery atherosclerosis with 3.0 T high-resolution magnetic resonance imaging (HR-MRI) in the progress of posterior circulation transient cerebral ischemia (TIA).Methods From July 2013 to July 2014,30 consecutive patients (outpatients and inpatients) with posterior circulation TIA at the Department of Neurology,the First People's Hospital of Changshu were enrolled respectively.They were all confirmed as the presence of vertebrobasilar atherosclerotic plaques by the head magnetic resonance angiography.The vertebrobasilar artery plaques were examined with 3 T HR-MRI to assess the nature and stability of the plaques.They were randomly divided into either a stable plaque group (n =16) or an unstable plaque group (n =14) according to the results of plaque stability.They were followed up for 24 months.The time and proportion from the first visit to the posterior circulation infarction were recorded and compared between the two groups of patients.Results At the end of follow-up,the time of posterior circulation infarction in the unstable group was significantly shorter than that in the stable group,and the difference was statistically significant (11.5 [7.0,20.0] months vs.24.0[22.5,24.0] months,Z =-2.755,P ＜ 0.05).The ratios of posterior circulation infarction in the stable group and the unstable group were 5/16 and 8/14 respectively.The difference was not statistically significant between the two groups (P ＞ 0.05).Conclusion Evaluating the results of vertebrobasilar artery atherosclerosis plaque with HR-MRI has a certain value for the progression of posterior circulation ischemia disease.
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Objective: To investigate the effect of the combination of Yindan Xinnao Tong Soft Capsule (YXTSC) and atorvastatin, Clopidogre Tablets on blood lipid, carotid atherosclerosis (CAS) plaque, and the neurological function recovery in the patients of acute cerebral infarction with type 2 diabetes. Methods: One hundred and fifty patients (CAS plaque in them was confirmed by carotid artery color Doppler ultrasound) with acute cerebral infarction and diabetes in Tianjin Hospital during May form 2013 to 2015 were seleted and randomly divided into two groups, 75 cases in each group. On the basis of basic disease treatment for the patients in the two groups, the patients in the control group were given Atorvastatin Tablet of 10 mg/d and Clopidogre Tablets of 75 mg/d, orally once daily. On the basis of the control group treatment, the patients in the treatment group were given YXTSC (0.4 g/capsulae) three capsules once and three times daily. The patients in both groups were given diet control and their blood pressure, blood sugar, and other drug treatments were controlled according to the disease. The blood lipid level was observed before and after the treatment for 12 months in the two groups, the total number of CAS plaque was calculated, the plaque intima media thickness (IMT) was measured, and the nature of the change was determined. The neurological function score, curative effect judgment, and the statistics of the end events between the two groups were carried at the end of the treatment. Results: After the treatment, the serum TC, LDL-C, and TG were reduced, HDL-C of the patients in the two groups increased, while the LDL-C of the patients in the treatment group was lower than that of the patients in the control group significantly (P < 0.05); The IMT of the patients in the two groups was significantly lower than that of patients before the treatment, but the plaque area of the patients in the treatment group was smaller than that of the patients in the control group significantly (P < 0.05); The scores of nervous function of the patients in treatment group were significantly lower than those of the patients in the control group; The curative effect of the treatment group was better than that of the control group (P < 0.01). The incidence of adverse drug reactions in treatment group was lower than that in the control group (P < 0.05). Conclusion: The combination of YXTSC and atorvastatin could effectively treat hyperlipidemia and CAS plaque in cerebral infarction patients associated with type 2 diabetes.
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Objective To observe the efficacy and safety of rosuvastatin in the treatment of hyperlipidemia and carotid atherosclerotic plaque in young ischemic stroke patients.Methods In prospective study,264 young ischemic stroke patients with hyperlipidemia and carotid atherosclerotic plaque were randomly divided into low dose group,middle dose group,high dose group,88 cases in each group.All patients were given rosuvastatin immediately after dinner,in doses of 5mg,10mg,20mg,respectively,for eight months.Then,the changes of hyperlipidemia and carotid atherosclerotic plaque in the three groups were surveyed,and its safety by the observation of clinical symptoms and monitoring of adverse reactions after eight months were assessed.Results Before treatment,the blood fat and carotid atherosclerosis plaque index in the three groups had no statistically significant differences (all P >0.05). After treatment,the total cholesterol,triglycerides,low -density lipoprotein cholesterol of the high dose group were (1.67 ±0.68)mmol/L,(3.23 ±0.53)mmol/L,(1.83 ±0.62)mmol/L,which of the middle dose group were (1.93 ±0.74)mmol/L,(3.73 ±0.23)mmol/L,(2.24 ±0.73)mmol/L,which of the low dose group were (2.16 ± 0.77)mmol/L,(4.06 ±0.93)mmol/L,(2.93 ±0.35)mmol/L.These indicators were decreased than before treat-ment [(2.79 ±0.72)mmol/L,(5.40 ±0.67)mmol/L,(3.64 ±1.03)mmol/L,(2.75 ±0.81)mmol/L,(5.59 ± 0.95)mmol/L,(3.43 ±0.92)mmol/L and (2.83 ±0.53)mmol/L,(5.84 ±0.79)mmol/L,(3.83 ±0.88)mmol/L].The decrease of the high dose group was higher than the middle and low dose group,the difference was statistically significant(F =6.61,P 0.05),and no serious adverse reaction was found.Conclusion The high dose rosuvastatin treatment can reverse the nature of plaque, decrease the thickness of the plaques and lower blood lipid of young ischemic stroke with hyperlipidemia and carotid atherosclerotic plaque,which is better than middle and low dose,and has better security.There is no serious adverse reaction.It is worth for clinical promotion.
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Objective To explore the feasibility of 7.0T MR scanner in mouse aorta atherosclerosis models.Visualising the TN-C in atherosclerotic plaque by immunohistochemistry and its correlation with CD68 to provide experimental basis for the feasibility of TN-C in targeted MRI.Methods ApoE-/- mice and wild type C57 mice were fed on high fat diet to establish aorta atherosclerosis model (n=10),the aorta were observed by MRI after 14 weeks.The aorta specimens were taken to stain with HE to observe the pathological changes.The plaque was stained with oil red O,anti-TNC and TN-C antibody respectively to observe the fat,CD68 and TN-C in plaque.Results 7.0 MRI showed the aortic wall of the experimental group was thicker,high signal on T1 WI and PDWI,and low signal on T2 WI after 14 weeks.The histopathlogic examination showed the intima was obviously thicker,and the lumen was ir-regulary narrow.Both of CD68 and TN-C were highly expressed in plaque,and the distribution of TN-C correlated with CD68.In the control group,no case showed hyper-signal in the vessel wall of aorta or narrow lumen by MRI,and the histopathlogy showed no for-mation of atherosclerotic plaque in the aorta.Conclusion Aorta atherosclerotic plaque can be established through high fat diet on ApoE-/- mouse,and 7.0 MR can successfully detect it.TN-C is high expressed in AS plaque and the expression is correlated with CD68,which may suggest that they may collaborate in the development of AS.Detecting TN-C could be useful for the further study of atherosclerotic plaque.
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ABSTRACT:Objective To analyze the correlation between plasma nitric oxide (NO)level and atherosclerotic lesion in high cholesterol-fed (HCD ) rabbits.Methods Twenty male Japanese white rabbits were divided randomly into two groups,which were fed with normal diet (control group,n =10)or HCD (experimental group, n =10 )for 1 6 weeks.At the end of the experiment,plasma lipid and NO levels were measured.The gross atherosclerotic lesions in each group were detected by Sudan IV staining while intimal lesion area was measured by hematoxylin/eosin (HE)and elastica van gieson (EVG).Moreover,the macrophages (MΦ)and smooth muscle cells (SMC)were detected by immunohistochemical staining.The correlation analysis was made to reveal the relationship between atherosclerotic lesions and plasma NO level.Results Compared with those in control group, the total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C)and NO levels all increased significantly in experimental group.Atherosclerotic lesions appeared on the vascular wall in the latter group.The area of atherosclerotic lesions and MΦ in the plaque had a positive association with plasma NO level. Conclusion There is a relationship between plasma NO level and the size of HCD-induced atherosclerotic lesions in rabbits.Meanwhile,the MΦ positive area in the atherosclerotic plaque is also associated with plasma NO level in cholesterol-fed rabbits,suggesting that plasma NO level may be associated with the occurrence and progress of early atherosclerosis.
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Objective To explore the effect of carotid atherosclerotic plaque ( CAP) on severity and recurrence of patients with cerebral infarction ( CI ) .Methods The prospective cohort study was utilized in this research. Existence and type of CAP were detected by Doppler ultrasound, and patients were divided into plaque group and without plaque group.The patients was evaluated by NIHSS on admission and 7 d, 14 d after admission, and patients were followed up for 1 year.The condition of CI recurrence was be observed.Results According to the Doppler ultrasound, patients were divided into plaque group ( 173 cases, 70.3%) and without plaque group ( 73 cases, 29.7%) .Compared with without plaque group, age, NIHSS score and incidences of hypertension, diabetes, hyperlipidemia, hyperfibrinogenemia were significantly increased (P<0.05 -0.01).In the patients who were conducted follow-up, cerebral infarction recurrence was in 39 cases (24.84%) in plaque group, recurrence time was 10.12 month.The recurrence time was 11.82 month in patient with non-vulnerable plaque, it was 10.62 month in patient with mixed plaque, and it was 9.13 month in patient with vulnerable plaque.Cerebral infarct recurrence was in 7 cases (10.45%) in without plaque group, recurrence time was 11.56 month.The recurrence rate in plaque group was significant increased than that in without plaque, however, the recurrence time for without plaque group was longer than that for plaque group ( all P<0.05 ) .The recurrence rate and recurrence time in patient with vulnerable plaque was significantly earlier than that in patient with non-vulnerable plaque (P=0.034).Conclusion The CAP in patients with acute CI can exacerbate the disease, and increase recurrence rate.It is especially in patients with vulnerable plaque.
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Objective To investigate the relationship between carotid atherosclerotic plaque and multiple risk factors of angiocardiopathy,and to evaluate the injuries caused by different risk factors to subclinical target organ to control the general risk factors of angiocardiopathy.Methods Four hundred and twenty six outpatients and impatients,treated in our hospital from May 2007 to May 2009 with the results of color ultrasonic examination,were divided into carotid atherosclerotic plaque group(284 cases) and no carotid atherosclerotic plaque group( 142 cases).The clinical information including their age,body mass index,smoking condition,past medical history such as hypertension,diabetes mellitus and hyperlipoidemia were recorded,and the levels of total cholesterol(T C),high density lipoprotein cholesterol( HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride (TG),lipoprotein ( a ) ( LP (a) ),apolipoprotein A - 1 ( Apo A 1 ),apolipoprotein B ( Apo B ),highsensitivity C-reactive protein( hs-CRP),homocysteine ( HCY),microalbuminuria( MAU ) and uricacid(UA) were determined by lab tests.The independent variable and univariable data were processed and analyzed statistically to find out the risk factors of carotid atherosclerotic plaque.Results Age and drinking were significantly correlated with the carotid intima-media wall thickening(IMT) (P ＜ 0.001 ).Overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,age,increased MAU and HCY could independently predict carotid atherosclerosis and plaque formation ( x2 =71.35,38.45,t =3.26,x2 =37.23,t =118.51,6.723 and 3.17respectively,Ps ＜ 0.05 ).The aggregated number of the risk factors was correlated to IMT and carotid atherosclerotic plaque ( P =0.0001 ).Conclusion Age,drinking,overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,MAU and HCY are risk factors of carotid atherosclerosis and plaque formation,and the contribution of each factor can multiply and overlap,more risk factors means greater risk.
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Objective To investigate the role of Shenqihuang steady plaque caps (SQH) and simvastatin on stabilization of atherosclerosis plaque in rabbits whit atherosclerosis (AS). Methods Forty-five rabbits were randomly divided into five groups: normal food group (A), instability plaque group (B), SQH group (C), simvastatin group (D), SQH add simvastatin group. A group was fed with common feeds, and B, C, D, E groups were given high cholesterol feeds. An atherosclerotic rabbit model was established by feeding high cholesterol diet supplemented for 12 weeks in B, C, D, E groups. Then C, D, E groups received corresponding drugs. At the end of 24~(th) week, the drug were injected into the aortic segments rich in plaque. Two weeks later, the concentration in serum of lipids, vascular cellular adhesion molecule-1 (VCAM-1), intercellular cellular adhesion molecule-1 (ICAM-1) and high sensitivity C reaction protein (hs-CRP), and area of plaque, the thickness of endomembrane, ttmica media, fibrous cap were detected. Results Compared with B group, the concentration of VCAM-1, ICAM-1, hs-CRP and area of plaque, the thickness of endomembrane, tunica media in C, D and E groups were lower significantly, the thickness of fibrous cap was thicker significantly (P
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Objective:Atherosclerosis of the carotid artery is the main cause and risk factor of ischemic cerebral infarction.We aim to evaluate the relation between acute ischemic cerebral infarction and the carotid atherosclerosis plaque.Methods: The distribution,shape,number and echoic features of the carotid atherosclerosis plaques confirmed by MRI diffusion-weighted imaging(DWI) were analyzed by color Doppler ultrasonography in 90 patients with acute ischemic cerebral infarction(Group A) and 82 controls(Group B).Results: The positive rate of acute cerebral ischemic infarction was significantly higher in Group A(76.7%) than in Group B(32.9%,P
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Objective To explore the incidence of the carotid artery atherosclerotic plaque in patients with cerebral infarction(CI).Methods 138 CI patients on their carotid artery were examed with color doppler ultrasonography.The incidence,stability and location of the carotid artery atherosclerotic plaque in CI patients were observed and compared with those of the normal controls.Results 120 cases(87.7%) of the 138 CI patients were turned out 175 atherosclerotic plaques.36 cases of the 140 normal controls were turned out to be with atherosclerotic plaque(25.7%).There was significant difference between the two groups(P
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Objective To investigate the effects of Xuezhikang (XZK) on carotid atherosclerosis plaque and blood lipids in patients with transient ischemic attack (TIA). Methods 65 patients with TIA were randomly divided into two groups: XZK group and control group.XZK group received XZK and Aspirin for 6 months, while the control group received Aspirin only. The intima-midia thickness (IMT) of carotid artery,the area of carotid atherosclerosis plaque, and levels of blood lipids, oxidized low density lipoprotein cholesterol (ox-LDL) and serum nitric oxide (NO) were measured before and after treatment.Incidence rate of cerebrovascular event in the two groups were compared in 6 months. Results After 6 months of treatment, the total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and ox-LDL concentrations decreased significantly in XZK group, however high density lipoprotein (HDL) and NO levels increased markedly (all P0.05).Conclusion It is shown that XZK not only effectively adjusts blood lipids, inhibits peroxide of lipids and protects vascular endothelial, but also regresses the atherosclerosis and stabilizes the plaque.