RESUMEN
Objective:To investigate the effects of endoplasmic reticulum(ER)stress on the stability of atherosclerotic plaques in mice by examining the action of lipopolysaccharide(LPS)-induced Toll-like receptor 4(TLR4)on the protein expression levels in the ER stress pathway in atherosclerotic plaques of polipoprotein E gene knockout (ApoE -/-) mice. Methods:From October 2015 to February 2016, 24 ApoE -/-mice were randomly divided into the control group, the LPS group and the TAK group after 10 weeks of high-fat feeding(n=8, each group). After 10 weeks of intervention, peripheral blood was extracted by removing the eyeballs for the measurement of total cholesterol(TC), triglycerides(TG)and oxidized low density lipoprotein(ox-LDL). Then mice were sacrificed to obtain carotid and aortic specimens.Immunohistochemistry was used to detect the expression of carotid plaque macrophages(MOMA-2), smooth muscle actin(α-actin), TLR4, interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNFα)and nuclear factor-κ-gene binding(NFκB). Western blotting was used to determine the expression of PKR-like eukaryotic initiation factor 2αkinase(PERK), C/EBP-homologous protein(CHOP)and glucose-regulated protein 78(GRP78). Results:The levels of TC, TG and ox-LDL were elevated in the LPS group, compared with the control and TAK groups[(25.0±2.3) mmol/L vs. (20.2±1.6) mmol/L and (20.8±2.6) mmol/L, (1.3±0.1) mmol/L vs.(1.3±0.1) mmol/L and (1.0±0.1) mmol/L, (17.4±1.3) mmol/L vs.(15.8±1.6) mmol/L and (12.1±1.1) mmol/L, P<0.05]. The comparison of plaque morphology and pathology showed that the LPS group had a wider range of atherosclerotic plaques, more macrophages and fewer vascular smooth muscle cells than the control and TAK groups( P<0.05). The expression of TLR4, IL-1β, IL-6, TNFα, NFκB, PERK, CHOP and GRP78 was higher in the LPS group than in the control and TAK groups( P<0.05). Compared with the control group, the expression of PERK, CHOP and GRP78 was lower in the TAK group( P<0.05). The expression of TLR4, PERK, CHOP and GRP78 was higher in the LPS group. Conclusions:LPS-induced TLR4 can up-regulate the expression of proteins in the ER stress pathway, increase the secretion of inflammatory cytokines downstream of the ER stress pathway, aggravate lipid metabolism disorders and increase the instability of atherosclerotic plaques.
RESUMEN
Objective:To investigate the effects of endoplasmic reticulum(ER)stress on the stability of atherosclerotic plaques in mice by examining the action of lipopolysaccharide(LPS)-induced Toll-like receptor 4(TLR4)on the protein expression levels in the ER stress pathway in atherosclerotic plaques of polipoprotein E gene knockout (ApoE -/-) mice. Methods:From October 2015 to February 2016, 24 ApoE -/-mice were randomly divided into the control group, the LPS group and the TAK group after 10 weeks of high-fat feeding(n=8, each group). After 10 weeks of intervention, peripheral blood was extracted by removing the eyeballs for the measurement of total cholesterol(TC), triglycerides(TG)and oxidized low density lipoprotein(ox-LDL). Then mice were sacrificed to obtain carotid and aortic specimens.Immunohistochemistry was used to detect the expression of carotid plaque macrophages(MOMA-2), smooth muscle actin(α-actin), TLR4, interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNFα)and nuclear factor-κ-gene binding(NFκB). Western blotting was used to determine the expression of PKR-like eukaryotic initiation factor 2αkinase(PERK), C/EBP-homologous protein(CHOP)and glucose-regulated protein 78(GRP78). Results:The levels of TC, TG and ox-LDL were elevated in the LPS group, compared with the control and TAK groups[(25.0±2.3) mmol/L vs. (20.2±1.6) mmol/L and (20.8±2.6) mmol/L, (1.3±0.1) mmol/L vs.(1.3±0.1) mmol/L and (1.0±0.1) mmol/L, (17.4±1.3) mmol/L vs.(15.8±1.6) mmol/L and (12.1±1.1) mmol/L, P<0.05]. The comparison of plaque morphology and pathology showed that the LPS group had a wider range of atherosclerotic plaques, more macrophages and fewer vascular smooth muscle cells than the control and TAK groups( P<0.05). The expression of TLR4, IL-1β, IL-6, TNFα, NFκB, PERK, CHOP and GRP78 was higher in the LPS group than in the control and TAK groups( P<0.05). Compared with the control group, the expression of PERK, CHOP and GRP78 was lower in the TAK group( P<0.05). The expression of TLR4, PERK, CHOP and GRP78 was higher in the LPS group. Conclusions:LPS-induced TLR4 can up-regulate the expression of proteins in the ER stress pathway, increase the secretion of inflammatory cytokines downstream of the ER stress pathway, aggravate lipid metabolism disorders and increase the instability of atherosclerotic plaques.
RESUMEN
Objective ToMeasureofleftventricularregionalsystolicfunctioninpatientswithcirrhosisby2DGSTItechnology.To exploretheclinicalvalueofleftventricularsystolicfunctionindifferentChildGPughgradedlivercirrhosispatientsanditscorrelation withthedegreeoflivercirrhosis.Methods Toselecting60casesoflivercirrhosispatientsincirrhosisgroup.AccordingtotheChildGPugh classification,thepatientsinA,BandCgradesweredividedintoA,BandCgroups.Toselecting30outpatientswithphysicalexaminations, whoseageandgendermatchedwithcirrhosispatientsatthesameperiodasnormal/controlgroup.Measuredtheconventionalindexes, andanalysedtwoGdimensionaldynamicimagesoftwoGchamber,threeGchamber,fourGchamberviewofapical.Thedifferencesinstrain indexandrelatedparametersbetweenthecirrhosisgroupsandthenormalcontrolgroupwerecompared.Results (1)Betweenliver cirrhosisgroupandcontrolgroup,therewerestatisticaldifferencesinheartrate,interventricularseptumthicknessandleftventricular enddiastolicvolume(P＜0.05).leftventricularejectionfraction wassignificantlylowerintheChildCgroupthanintheChild A groupandtheChildBgroup(P＜0.05),andwassignificantlyhigherintheChildBgroupthanthecontrolgroup(P＜0.05).Withthe increaseofChildGPughscoreinlivercirrhosisgroup,interventricularseptumthickness,leftatrialanteroposteriordiameter,leftventricular enddiastolicdiameterandleftventricularenddiastolicvolumeweregraduallyincreasing.Therewerestatisticallysignificantdifferences betweensomegroups(P＜0.05);(2)Longitudinalsystolicpeakstrainofeachsegmentofleftventricularwallwasgenerallylowerin thelivercirrhosisgroupthanthecontrolgroup,andthestrainin bothgroupsshowedincreasingtrendfromthebasaltotheapical segments.There werestatisticallysignificantdifferences between partialsegment(P＜0.05);(3)WiththeincreaseofChildGPugh scoreincirrhosisgroup,longitudinalsystolicpeakstrainofthe leftventricularwallgraduallydecreased.ChildCgroupcomparedwithothergroups,theleftventricularlongitudinalstrainaverage valuedifferencewasstatisticallysignificant(P＜0.05).Therewerestatisticallysignificantdifferencesinpartialsegmentbetweenthe othergroups(P＜0.05).Conclusion (1)2DGSTItechnologycanbesensitiveandreliabletodetectsubGclinicalmyocardialregional systolicdysfunctioninpatientswithcirrhosis;(2)LeftventricularsystolicfunctionisnegativelycorrelatedwithChildGPughgradein patientswithlivercirrhosis.
RESUMEN
Objective To inves1tigate the needs and influencing factors of patients with cerebrovascular disease and their caregivers in rural areas.Methods An online questionnaire designed by World Stroke Organization for stroke patients and their caregivers was used,and modified appropriately according to China's national conditions.A questionnaire survey about general situation,and needs for psychological support,stroke-related knowledge,diagnosis and nursing,social support,and functional recovery in inpatients with cerebrovascular disease and their caregivers in rural areas was performed.Results A total of 514 patients with stroke and their caregivers (n =514) completed the questionnaires.93.0％ of the patients had the needs for mental support,followed by clinical diagnosis and nursing (84.8％),stroke knowledge (74.7％),social support and functional recovery (53.5％);95.1％ of the caregivers had the needs for mental support,followed by stroke knowledge (89.9％),clinical diagnosis and nursing (84.0％),social support,and functional recovery (66.3％).The degree of need for stroke knowledge,social support,and functional recovery in caregivers was higher than that in the patients (all P ＜ 0.05).Multiple linear regression analysis showed that age,gender,degree of education,the National Institutes of Health Stroke Scale score,and the time from the first stroke onset were the influencing factors of needs for patients with cerebrovascular disease and their caregiver.Conclusions Many needs have not been met in patients with cerebrovascular disease and their caregivers,especially the psychological demand.The regional and individual services should be provided according to the different demands in patients with cerebrovascular disease and their caregivers,enhance the awareness of the prevention and treatment of stroke,and continuously improve the construction of rural health service system.