Effect of Scutellariae Radix-Coptidis Rhizoma on Stabilization of Atherosclerotic Vulnerable Plaques via Inhibition of TLR4/MyD88/NF-κB Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo observe the effect of Scutellariae Radix-Coptidis Rhizoma on plaque stability in atherosclerotic （AS） mice and to explore its possible mechanism of action based on the Toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor kappa B （NF-κB） signaling pathway. MethodTen normal C57BL/6J mice were used as the normal group， and the same strain of ApoE knockout （ApoE-/-） mice were fed with a high-fat diet for 12 weeks to construct an atherosclerosis model. Mice were randomly divided into five groups， namely the model group， the atorvastatin group， and the Scutellariae Radix-Coptidis Rhizoma low-， medium-， and high-dose groups， with ten mice in each group. Then normal and model groups were given equal volume of saline gavage， and the low-， medium-， high-dose Scutellariae Radix-Coptidis Rhizoma groups were given 1.95， 3.9， 7.8 g·kg-1 of the drug by gavage for 8 weeks， respectively. The general state of mice was observed. Hematoxylin-eosin staining was utilized to observe the pathology of aortic root plaques and calculate the percentage of plaque area. Masson staining and oil red O staining combined with immunohistochemistry of F4/80 and α-SMA were used to detect the plaque components of aortic root plaques and calculate the plaque vulnerability index. Enzyme-linked immunosorbent assay was adopted to detect the expression levels of serum tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6）. Western blot was applied to detect the protein expression levels of matrix metalloproteinase-2 （MMP-2）， matrix metalloproteinase-9 （MMP-9）， TLR4， MyD88， NF-κB p65， and phosphorylation （p） -NF-κB p65 in the aortic tissues of mice in each group. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） assay was employed to detect the expression levels of MMP-2， MMP-9， TLR4， and MyD88， NF-κB p65 mRNA. ResultCompared with the model group， the general state of the mice in each medication group was improved， and no obvious side effects were observed. Compared with the model group， the percentage of plaque area in the aortic root of AS mice was significantly reduced in the medium- and high-dose Scutellariae Radix-Coptidis Rhizoma groups （P<0.05）. The content of collagen fibers and smooth muscle cells in the plaques of the high-dose Scutellariae Radix-Coptidis Rhizoma group was significantly increased （P<0.01）， and the content of lipids and macrophages was significantly reduced （P<0.05）， the plaque vulnerability index of each dose group of Scutellariae Radix-Coptidis Rhizoma was significantly reduced， with significant reduction of the medium- and high-dose groups （P<0.01）. MMP-2 and MMP-9 protein and mRNA expression levels in aortic tissues were significantly reduced in medium- and high-dose Scutellariae Radix-Coptidis Rhizoma groups （P<0.05）. The serum levels of TNF-α and IL-6 were significantly reduced in AS mice in medium- and high-dose Scutellariae Radix-Coptidis Rhizoma groups （P<0.05）. In the medium- and high-dose Scutellariae Radix-Coptidis Rhizoma groups， the levels of TLR4， MyD88 protein， and mRNA expression in aortic tissues were significantly reduced （P<0.05）， and the level of NF-κB p65 phosphorylation in aortic tissues was significantly reduced （P<0.05）. ConclusionScutellariae Radix-Coptidis Rhizoma may play an anti-inflammatory and stabilizing role by inhibiting the TLR4/MyD88/NF-κB signaling pathway.

Effect of Huatan Tongluo Prescription on Vulnerability of Carotid Atherosclerotic Plaque in Hypertension / 中国实验方剂学杂志

ObjectiveTo evaluate the effect of Huatan Tongluo prescription on the vulnerability of atherosclerotic plaques in the carotid arteries of patients with hypertension of phlegm-stasis combination syndrome. MethodA total of 132 eligible patients were randomly divided into an observation group （66 cases） and a control group （66 cases）. The control group received oral atorvastatin calcium tablets and enteric-coated aspirin tablets， while the observation group received Huatan Tongluo prescription in addition to the treatment received by the control group. The treatment duration was 6 months. A carotid artery ultrasound examination was performed to record the number of plaques， the maximum plaque area， the maximum plaque cross-sectional thickness， and the intima-media thickness （IMT） of the carotid artery. Crouse score， plaque vulnerability score， and phlegm-stasis combination syndrome score were assessed. Blood lipid levels ［total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C）］， inflammatory markers ［neutrophil-to-lymphocyte ratio （NLR）， monocyte-to-lymphocyte ratio （MLR）， interleukin-6 （IL-6）， and high-sensitivity C-reactive protein （hs-CRP）］， vascular endothelial function ［endothelin-1 （ET-1）， von Willebrand factor （vWF）， and nitric oxide （NO）］， and relevant proteins ［pentraxin 3 （PTX3） and galectin-3 （Gal-3）］ levels were measured. Safety evaluation was conducted， and comparisons were made in terms of carotid artery stenosis rate， plaque regression efficacy， and traditional Chinese medicine （TCM） syndrome efficacy. ResultCompared with the results before treatment， both groups showed significant reductions in IMT， plaque number， maximum plaque area， and maximum plaque cross-sectional thickness （P<0.05）. After treatment， the observation group exhibited more significant reductions in the above indicators compared with the control group （P<0.05）. After treatment， Crouse scores， plaque vulnerability scores， and phlegm-stasis combination syndrome scores in both groups were lower than those before treatment （P<0.05）. After treatment， the observation group had lower scores in these indicators than the control group （P<0.05）. In terms of blood lipid levels， both groups showed decreases in TC， TG， and LDL-C levels， and an increase in HDL-C levels after treatment compared to those before treatment （P<0.05）. The observation group exhibited greater improvements in these lipid parameters than the control group （P<0.05）. Inflammatory markers NLR， MLR， IL-6， and hs-CRP significantly decreased in both groups after treatment compared with those before treatment （P<0.05）. The observation group showed more significant reductions in these markers than the control group after treatment （P<0.05）. After treatment， both groups demonstrated decreases in levels of ET-1， vWF， PTX3， and Gal-3， along with an increase in NO levels compared with those before treatment （P<0.05）. The observation group showed more significant improvements in these markers than the control group after treatment （P<0.05）. After treatment， the observation group had a lower carotid artery stenosis rate than the control group （P<0.05）. The plaque regression efficacy rate was 51.72% （30/58） in the observation group， and the total effective rate of TCM syndrome was 84.48% （49/58）， both of which were higher than 18.64% （11/59） and 52.54% （31/59） in the control group （χ²=10.061， 13.799， P<0.05）. No adverse reactions related to the Huatan Tongluo prescription were observed during the treatment period. ConclusionIn addition to statin therapy， Huatan Tongluo prescription can effectively reverse carotid artery atherosclerotic plaques in patients with hypertension and carotid artery stenosis， reduce plaque vulnerability， exhibit lipid-lowering and anti-inflammatory effects， and improve vascular endothelial function. The treatment demonstrates favorable clinical efficacy and safety. Therefore， it is very worthy of clinical promotion and application.

The value of C-reactive protein to high-density lipoprotein cholesterol ratio in predicting the vulnerability of carotid plaque in patients with ischemic stroke / 中风与神经疾病杂志

@#Objective　To explore the predictive value of the ratio of C-reactive protein to high-density lipoprotein cholesterol (CHR) for carotid plaque vulnerability in patients with ischemic stroke.Methods　A retrospectively enrolled 349 patients with acute ischemic stroke in the Department of Neurology of Baoding First Central Hospital from January 2019 to January 2020.All subjects underwent ultrasound examination to evaluate the condition of carotid artery plaques,and based on the ultrasound results,they were divided into no plaque group,stable plaque group,unstable plaque group.The differences in risk factors,blood lipids,and inflammatory indicators in each group were compared.The receiver operating characteristic (ROC) curve was used to estimate the predictive value of each index on the vulnerability of carotid plaque.Results　C-reactive protein and CHR of the unstable plaque group were higher than those of the stable plaque group,and the difference was statistically significant (P<0.05).ROC curve shows that CHR can predict carotid plaque instability more reliably than a single C-reactive protein.Conclusion　CHR has high predictive value for carotid artery vulnerable plaque and can be used as a new circulating biomarker to identify carotid artery plaque vulnerability.

Observation on vulnerable coronary plaques in HIV-infected patients based on coronary CTA / 中国医学影像技术

Objective: To explore whether vulnerable coronary plaques in HIV-infected patients are different with those in non-HIV-infected ones, and to analyze the relative risk factors. Methods: A total of 167 HIV-infected patients (HIV-infected group) and 185 non-HIV-infected patients(non-HIV-infected group) who underwent coronary CTA (CCTA) were collected. Vulnerable plaques were defined as those with two or more high-risk morphological features. The type, location and incidence of vulnerable coronary plaques were analyzed and compared between 2 groups, and the risk factors of vulnerable coronary plaques in HIV-infected patients were analyzed. Results: There was no significant difference of baseline clinical data between the two groups. The most common types of vulnerable coronary plaques in 2 groups were both low attenuation plaques+positive remodeling, most located in the proximal segment of left anterior descending artery (segment 6). The incidence of vulnerable coronary plaques ≥1 coronary segments in HIV-infected patients was higher than that in non-HIV-infected patients (34.73% vs 24.32%,P<0.05). Vulnerable coronary plaques in HIV-infected patients were independently correlated with the duration of antiretroviral therapy (ART) drug (OR=1.29, 95%CI [1.04,1.59], P=0.02). Conclusion: The incidence of vulnerable coronary plaques in HIV-infected patients was higher than that in non-HIV-infected patients. ART drug may be an independent risk factor for coronary plaque vulnerability in HIV-infected patients.

Biomechanical models and numerical studies of atherosclerotic plaque / 生物医学工程学杂志

Atherosclerosis is a complex and multi-factorial pathophysiological process. Researches over the past decades have shown that the development of atherosclerotic vulnerable plaque is closely related to its components, morphology, and stress status. Biomechanical models have been developed by combining with medical imaging, biological experiments, and mechanical analysis, to study and analyze the biomechanical factors related to plaque vulnerability. Numerical simulation could quantify the dynamic changes of the microenvironment within the plaque, providing a method to represent the distribution of cellular and acellular components within the plaque microenvironment and to explore the interaction of lipid deposition, inflammation, angiogenesis, and other processes. Studying the pathological mechanism of plaque development would improve our understanding of cardiovascular disease and assist non-invasive inspection and early diagnosis of vulnerable plaques. The biomechanical models and numerical methods may serve as a theoretical support for designing and optimizing treatment strategies for vulnerable atherosclerosis.

Relationship between platelet endothelial cell adhesion molecule 1 and leiomodin 1 gene polymorphisms and carotid plaque vulnerability / 中国脑血管病杂志

Objective To investigate the relationship between platelet endothelial cell adhesion molecule I (PEC AMI )/leiomodin 1 ( LMOD1 ) gene polymorphism loci and the risk of carotid plaque vulnerability in patients with ischemic stroke. Methods Ischemic stroke patients with carotid plaque admitted to Beijing Tiantan Hospital from May 2014 to October 2017 were enrolled prospectively. The demographic data and relevant clinical information were collected Carotid artery high-resolution magnetic resonance imaging (MRI) was used to distinguish vulnerable and stable plaques. The patients were enrolled in vulnerable plaque group and stable plaque group in turn. Real-time polymerase chain reaction was used. The TaqMan probe was use to conduct genotyping and statistical analysis of the PECAM1 ,LMOD1 gene polymorphism loci rsl 867624 and rs2820315 in the vulnerable plaque group and the stable plaque group. Binary logistic regression analysis was used to investigate the risk factors affecting the vulnerability of carotid atherosclerotic plaques. Results A total of 270 ischemic stroke patients with carotid plaque were enrolled, including 189 with vulnerable plaques and 81 with stable plaques. The polymorphism analysis of the PECAM1 gene locus rsl867624 in the two groups showed that the allele T was a vulnerable plaque risk gene,and its gene frequency in the vulnerable plaque group and the stable plaque group was 87. 3% (330/378) and 79. 6% (129/162;OR, 1.759,95% CI 1.080 -2.864 respectively,P = 0. 022). Analysis of the LM0D1 gene SNP locus rs2820315 showed that allele C was a risk gene for vulnerable plaques,and its gene frequency in the vulnerable plaque group and the stable plaque group was 87.6% (331/378) and 80.9% respectively (13I/I62;0tf, I. 667,95% CI 1. 014 -2. 738, P =0. 042). Logistic regression analysis showed that age (OR, 1.069,95% CI 1.022-1. 118, P = 0.004 ),PECAM1 gene rsl867624 locus T/T genotype (OR, 2.202,95% CI 1. 035 -4. 688 tP =0. 041) ,and LMODl gene rs2820315 locus C/C genotype ( OR,2. 199,95% CI 1. 005 -4. 809 , P =0.048) were the risk factors for the formation of vulnerable plaques. Conclusion The single nucleotide polymorphism locus rsl867624 of PECAM1 gene and single nucleotide polymorphism locus rs2820315 of LMODl gene were associated with carotid plaque vulnerability.

Expression of heparanase and angiogenesis in human carotid atherosclerotic plaques / 中国脑血管病杂志

Objective To investigate the expression characteristics of heparinase (Hpa) and angiogenesis in human carotid atherosclerotic plaques. Methods Fifty-five consecutive patients with atherosclerotic stenosis in internal carotid artery system treated with carotid endarterectomy (atherosclerosis group) at the Department of Neurosurgery,Fuxing Hospital,Capital Medical University from December 2014 to December 2017 were enrolled retrospectively. They were confirmed by imaging methods,such as vascular ultrasound, CT angiography and/or DSA. According to the atherosclerotic histopathological classification method of American Heart Association, the well-defined advanced atherosclerotic plaques (types IV- VI) were screened as carotid atherosclerotic plaque specimens (ra =73). According to the morphological classification criteria,73carotid atherosclerotic plaque specimens were divided into vulnerable plaques (n =42) and metastatic plaques (n =31). Autopsy was performed at the Department of Pathology, Peking University Medical School at the same time,and 15 patients without atherosclerotic lesions were identified as non-atherosclerotic group (15 normal arterial specimens). Immunohistochemistry and immunofluorescence staining were used to analyze the expression characteristics of Hpa and neovascularization in carotid atherosclerotic plaque. Results (1) There was no Hpa expression in normal arterial tissue; in the carotid atherosclerotic plaque,the positive expression rate of Hpa was 64.4% (47/73). (2) Compared with the metastatic plaques, the positive expression rate of Hpa in the vulnerable plaques increased (92. 9% [39/42] vs. 25. 8% [8/ 31] ,x∗= 34.968,P<0.01). (3) The expression of neovascularization was positive in carotid atherosclerotic plaques. Compared with the metastatic plaques,the positive expression rate of neovascularization in the vulnerable plaques was higher (95. 2% [40/42] vs. 22. 6% [7/31] # =41. 060,P <0. 01). (4) In carotid atherosclerotic plaques, Hpa and neovascularization expression was mainly located in the fibrous cap and shoulders of the plaques. Conclusions Hpa has a certain role in the progression of advanced atherosclerotic lesions. Hpa and angiogenesis expression in carotid atherosclerotic plaques has a co-regionality.

Effects of Atorvastatin Combined with CORM- 3 on Inflammation and Oxidative Stress Indexes in Atherosclerotic Vulnerable Plaque Model Rats / 中国药房

OBJECTIVE： To study the effects of atorvastatin combined with carbon monoxide releasing molecule 3 （CORM-3） on inflammation and oxidative stress indexes in atherosclerotic （AS） vulnerable plaque model rats. METHODS： The rats were randomly divided into control group （normal saline， i.g.）， model group （normal saline， i.g.）， statin group （atorvastatin 2 mg/kg，  i.g.）， and statin+CORM-3 group （atorvastatin 2 mg/kg， i.g.+CORM-3 10 mg/kg， i.p.）， with 8 rats in each group. Control group was fed with basal diet， and the right common carotid artery was exposed to surgery without injury and was treated with normal saline instead of drug； other three groups were fed with high-fat diet+right common carotid artery injury+heteroprotein injection to induce AS vulnerable plaque model， for 10 weeks； and then they were given relevant medicine for intervention， once a day， for consecutive 2 weeks. 24 h after last medication， abdominal artery blood was collected； the concentration of LDL-C and HDL-C were determined by fully automatic biochemical analyzer. The levels of hs-CRP， IL-10， MCP-1 and MMP-9 in plasma were detected by ELISA； plasma levels of MDA and oxidized low density lipoprotein （ox-LDL） were determined by chemical colorimetry； the protein expression of heme oxygenase-1 （HO-1） was determined by Western blot. The pathological changes of right common carotid artery were observed under light microscope. RESULTS： Compared with control group， the levels of LDL-C， hs-CRP， MCP-1， MMP-9， MDA and ox-LDL， and protein expression of HO-1 were increased significantly （P＜0.05）， while the levels of HDL-C and IL-10 were decreased significantly in model group （P＜0.05）； the right common carotid artery formed obvious AS plaques. Compared with model group， the levels of LDL-C， hs-CRP， MCP-1， MMP-9， MDA and ox-LDL were decreased significantly in statin group and statin+CORM-3 group in model group （P＜0.05）， while the levels of HDL-C， IL-10 and the protein expression of HO-1 were increased significantly （P＜0.05）. Except for LDL-C and HDL-C， the improvement of other indexes in statin+CORM-3 group was more significant than statin group （P＜0.05）； pathological changes of right common carotid artery in statin group were not obvious， but the pathological changes of rats in statin+CORM-3 group were significantly alleviated and plaque structure also tended to be more stable. CONCLUSIONS： Atorvastatin combined with CORM-3 is better than atorvastatin alone in improving inflammation and oxidative stress indexes of AS vulnerable plaque model rats， and can promote the stability of AS vulnerable plaques.

Effect of Simiao Yongan Tang on Permeability of Vasa Vasorum of Atherosclerotic Plaque / 中国实验方剂学杂志

Objective:To observe the effect of Simiao Yongan Tang on the pathologic morphology of atherosclerosis (AS) vulnerable plaque and the permeability of vasa vasorum (VV), and to explore its intervention mechanism with VV as the target. Method:Healthy male ApoE-/- mice were randomly divided into model group, Simiao Yongan Tang group(11.7 mg·kg-1·d-1)and simvastatin group(2.6 mg·kg-1·d-1). High-fat diet supplemented with 1.1% L-methionine was given to induce the animal model, while C57BL/6 mice were used as the control group. The model was evaluated after 8 weeks of feeding. After successful modeling, continued drug intervention was given for 8 weeks, and the pathological changes of the mouse aorta were observed by oil red O staining. The expression levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) proteins in the outer membrane of aortic root plaques were observed by immunohistochemical staining. Result:The results of oil red O staining showed that as compared with the control group, the plaque area of the aortic wall was significantly increased in the model group (PPPPPPConclusion:Simiao Yongan Tang can reduce the area of mouse aortic plaque, reduce the VV permeability of the outer plaque by regulating the expression of MMP-9 and TIMP-1, and stabilize the vulnerable plaque.

Diagnostic value of serum alpha2-heremans-schmid glycoprotein combined with tumor necrosis factor-α and interleukin-1β in detecting carotid vulnerable plaque in patients with acute cerebral infarction / 实用医学杂志

Objective To investigate the role of the combination of alpha2-heremans-schmid glycoprotein (AHSG) , tumor necrosis factor-α (TNF-α) , and interleukin-1 β (IL-1β) in detecting carotid vulnerable plaque in patients with acute cerebral infarction (ACI). Methods A total of 136 ACI patients were enrolled. According to the carotid ultrasound results, patients were assigned into the stable plaque group (n = 57) and vulnerable plaque group (n = 79). And their clinical data were collected. Logistic regression analyses were performed to identify independent risk factors of carotid vulnerable plaque in ACI patients. Receiver operating characteristic (ROC) was used to explore the diagnostic efficacy of AHSG, TNF-α, IL-1β and their combination in detecting carotid vulnerable plaque. Results (1) AHSG level of vulnerable plaque group was significantly lower than that of stable plaque group (P < 0.05) , while the levels of TNF-α and IL-1β of vulnerable plaque group were higher than those of stable plaque group. (2) Multivariate logistic regression analyses revealed that hypertension (OR = 1.257, 95％CI: 1.017～ 1.554) , type 2 diabetes (OR=1.474, 95％ CI: 1.048 ～2.074) , AHSG (OR= 0.510, 95％ CI:0.287 ～0.920) , TNF-α (OR = 1.020, 95％CI: 1.006 ～1.029) and IL-1β (OR= 1.484, 95％CI: 1.067 ～2.062) were independent risk factors of carotid vulnerable plaque. (3) ROC curves revealed that the area under the curve (AUC) of AHSG combined with TNF-α and IL-1β detecting carotid vulnerable plaque was 0.903 (95％CI: 0.840～0.947) , with sensitivity of 89.87％ and specificity of 75.44％, which was significantly superior to that of three individual biomarker (P < 0.05). Conclusions AHSG, TNF-α and IL-1β are independent risk factors of carotid vulnerable plaque in ACI patients, and their combination has the highest predictive efficacy which is of high clinical significance.

Correlation Between Serum Inflammatory Biomarkers and Carotid Plaque Stability in Hypertensive Postmenopausal Women / 中国循环杂志

Objectives: To investigate the relationships between the stability of carotid plaque and serum Lp-PLA2, A-FABP levels in hypertensive postmenopausal women. Methods: 195 postmenopausal women with hypertension were selected and divided into non-plaque group, stable plaque group and unstable plaque group according to the results of carotid intima-media thickness (IMT) and plaque types derived from color doppler ultrasonography. In addition, 40 healthy postmenopausal women were recruited as normal control group. The serum Lp-PLA2 and A-FABP levels of all subjects were measured. Lp-PLA2 and A-FABP levels were compared among four groups by One-Way ANOVA. Spearman correlation analysis and multiple logistic regression analysis were also performed. Results: Plaque group included 123 subjects (unstable plaque group: 29 cases; stable plaque group: 94 cases), and non-plaque group included 72 subjects. The average serum A-FABP level was significantly higher in unstable plaque group [(172.60±33.70) ng/L] than in non-plaque group[(133.04±29.49) ng/L], P<0.05. Serum Lp-PLA2 level was similar between the four groups, P>0.05. Serum A-FABP level was positively correlated with the carotid plaque (r=0.3446, P=0.0049);serum Lp-PLA2 level was not correlated with the carotid plaque (r=0.2058, P=0.0996). Multiple logistic regression analysis showed that high A-FABP level was associated with stable plaque in hypertensive postmenopausal women (P=0.040, OR=1.017, 95%CI: 1.001~1.033), which was also associated with unstable plaque in this population (P=0.003, OR=1.031, 95%CI: 1.010~1.052). Conclusions: The level of A-FABP is a determinant responsible for the occurrence and stability of carotid plaque among hypertensive postmenopausal women. There was no correlation between Lp-PLA2 level and the stability of carotid plaque in this patient cohort.

Study on correlationship between fasting blood glucose level and coronary arterial vulnerable plaque in civil airline pilots / 重庆医学

Objective To investigate the relationship between fasting blood glucose(FBG) with coronary arterial vulnerable plaque in civil airline pilots and its risk factors.Methods One hundred and twenty civil airline pilots with coronary heart disease were divided into the vulnerable plaque group and non-vulnerable plaque group based on the virtual histology intravascular ultrasound(VH-IVUS) results.Then the clinical data were collected.Logistic regression analysis was used to analyze the risk factors of vulnerable plaque.Results The FBG level in the vulnerable plaque group was much higher(P＜0.05);FBG,high-sensitivity C-reactive protein and low density lipoprotein were the risk factors for vulnerable plaque;FBG was positively correlated with the plaque necrosis core constituent ratio(r=0.44,P＜0.05).The area under curve of ROC curve efficiency for diagnosing vulnerable plaque was 0.72(95％CI:0.66-0.81),at FBG cut-off value of 6.39,the sensitivity was 71.35％ and specificity was 76.15％.Conclusion The FBG level is an independent risk factor of coronary arterial vulnerable plaque,which can assist in the identification of vulnerable plaque in civil airline pilots.

Clinical outcomes of the vulnerable plaque sealing with drug-eluting stents for the treatment of intermedi-ate coronary stenosis / 实用医学杂志

Objective To evaluate the one-year clinical outcomes in patients with the vulnerable plaque sealing with drug-eluting stents for the treatment of intermediate coronary stenosis. Methods 327 patients with an-giographically intermediate lesions(diameter stenosis 50%~70%)with the vulnerable plaque which were detected by 64 slice coronary CT were prospectively enrolled. Patients were divided into medical therapy group (n = 160) and sirolimus-eluting stent group group(n=160). The incidences of one-year major adverse cardiovascular events (MACE)was evaluated(cardiac death,myocardial infarction ,revascularization). Results The MACE tended to be lower in the sirolimus-eluting stent group than medical therapy group(3.13%vs. 10%,log-rankχ2=6.62,P=0.01). The incident of cardiac death and myocardial infarction were lower in the sirolimus-eluting stent group than medical therapy group(1.25%vs. 5.63%,log-rankχ2=4.61,P=0.03). Conclusion The treatment of the siroli-mus-eluting stent can reduce MACE for the paitents with the vulnerable plaque of intermediate coronary stenosis than medical therapy only.

Clinical outcomes of the vulnerable plaque sealing with drug-eluting stents for the treatment of intermedi-ate coronary stenosis / 实用医学杂志

Objective To evaluate the one-year clinical outcomes in patients with the vulnerable plaque sealing with drug-eluting stents for the treatment of intermediate coronary stenosis. Methods 327 patients with an-giographically intermediate lesions(diameter stenosis 50%~70%)with the vulnerable plaque which were detected by 64 slice coronary CT were prospectively enrolled. Patients were divided into medical therapy group (n = 160) and sirolimus-eluting stent group group(n=160). The incidences of one-year major adverse cardiovascular events (MACE)was evaluated(cardiac death,myocardial infarction ,revascularization). Results The MACE tended to be lower in the sirolimus-eluting stent group than medical therapy group(3.13%vs. 10%,log-rankχ2=6.62,P=0.01). The incident of cardiac death and myocardial infarction were lower in the sirolimus-eluting stent group than medical therapy group(1.25%vs. 5.63%,log-rankχ2=4.61,P=0.03). Conclusion The treatment of the siroli-mus-eluting stent can reduce MACE for the paitents with the vulnerable plaque of intermediate coronary stenosis than medical therapy only.

Advances in research on comprehensive indexes for assessing vulnerable atherosclerotic plaque / 西安交通大学学报(医学版)

Atherosclerosis is the most common type of arteriosclerosis.Vulnerable plaque is prone to rupture. Coronary vulnerable plaque rupture can lead to the occurrence of acute coronary syndrome (ACS ).This paper summarizes non-invasive detection and invasive detection of vulnerable plaque,as well as research on serological indexes of vulnerable plaque.It may provide a comprehensive basis for detecting vulnerable plaque.

Early warning model for vulnerable plaque biomarker / 实用医学杂志

Objective To analyse the risk factors of vulnerable plaque biomarker and to construct an early warning system. Methods Ninety patients with suspected acute coronary syndrome (ACS) hospitalized during December 2012 and December 2013 were selected. The coronary artery lesions were divided into type I, II and III plaque groups by the morphology of atherosclerotic plaque. Serum SAA, PLGF, sCD40L and Npt were measured. The results of SAA, PLGF, sCD40L and Npt were compared. Logistic regression model was fitted to explore the main influencing factors of the vulnerable plaque. Results SAA, PLGF, sCD40L, and Npt were main influencing factors of the vulnerable plaques, and the ORs were 1.61, 1.88, 1.96 and 1.79 respectively. Conclusion The detection of SAA, PLGF, sCD40L and Npt biochemical markers in patients with chest pain is important for predicting the vulnerable plaque and guiding clinical treatment.

Biomechanical mechanism and quantitative assessment indices for vulnerable carotid plaques / 医用生物力学

The rupture of carotid atherosclerotic plaques and thrombosis are the main risk factor for ischemic stroke. The risk of carotid plaque rupture is closely related with the local biomechanical situation, morphology, components and biological activity of the carotid plaques. In this article, the research progress on methodology for studying carotid stenosis biomechanics, the risk of vulnerable plaque rupture in carotid stenosis and decision-making in clinical treatment, the animal modeling and experiment on vulnerable carotid plaques, and the components and biological activities of carotid plaques was summarized, the existing problems were analyzed, and the in-depth prospective about the biomechanical mechanism and quantitative assessment indices for vulnerable carotid plaques was also proposed, expecting to provide necessary theoretical guidance for feasible decision-making on the treatment of carotid stenosis.

F-18 Fluoride Positron Emission Tomography-Computed Tomography for Detecting Atherosclerotic Plaques

A large number of major cardiovascular events occur in patients due to minimal or some lumen narrowing of the coronary artery. Recent biological studies have shown that the biological composition or vulnerability of the plaque is more critical for plaque rupture compared to the degree of stenosis. To overcome the limitations of anatomical images, molecular imaging techniques have been suggested as promising imaging tools in various fields. F-18 fluorodeoxyglucose (FDG), which is widely used in the field of oncology, is an example of molecular probes used in atherosclerotic plaque evaluation. FDG is a marker of plaque macrophage glucose utilization and inflammation, which is a prominent characteristic of vulnerable plaque. Recently, F-18 fluoride has been used to visualize vulnerable plaque in clinical studies. F-18 fluoride accumulates in regions of active microcalcification, which is normally observed during the early stages of plaque formation. More studies are warranted on the accumulation of F-18 fluoride and plaque formation/vulnerability; however, due to high specific accumulation, low background activity, and easy accessibility, F-18 fluoride is emerging as a promising non-invasive imaging probe to detect vulnerable plaque.

Association between tumor necrosis factor superfamily member 4 gene polymorphism and risk of asymptomatic carotid vulnerable plaque in a Chinese population / 中华流行病学杂志

Objective Vulnerable plaque of carotid artery is one of the risk factors of atherosclerotic cerebral infarction.Detection and treatment of vulnerable atherosclerotic plaque of carotid artery before symptoms of cerebral infarction is an effective way to prevent atherosclerotic cerebral infarction.Tumor necrosis factor superfamily member 4 (TNFSF4) plays a key role in the process of atherosclerosis,a common risk factor for both myocardial and cerebral infarctions.Studies have indicated that the single nucleotide polymorphism (SNP) rs3850641 in TNFSF4 is associated with higher risk of myocardial infarction and SNP rs3861950 in TNFSF4 is associated with higher risk of atherosclerosis cerebral infarction (ACI),but little is known about the association between TNFSF4 variations and vulnerable plaque of carotid artery.Methods A case-control study involving 510 patients with asymptomatic vulnerable plaque of carotid artery and 485 age and sex matched healthy subjects without vulnerable plaque of carotid artery was conducted in Hunan province.Asymptomatic vulnerable plaque of carotid artery means vulnerable plaque of carotid artery without cerebral infarction.Two SNPs of TNFSF4,rs3850641 and rs3861950,were genotyped by the TaqMan SNP genotyping method,and verified partly by Genomic DNA Sequencing.Results The results revealed a significant allelic association between rs3861950 and asymptomatic vulnerable plaque of carotid artery in case group (x2=9.13,P=0.003;OR=1.41,95％ CI:1.12-1.76).Compared with control subjects,the difference in genotype was significant in case group (x2=25.28,P＜ 0.000 1).However,there was no significant association between rs3850641 and asymptomatic vulnerable plaque of carotid artery(OR=1.16,95％CI:0.92-1.46;x2＝ 1.47,P=0.225).Conclusion TNFSF4 gene polymorphism rs3861950 was associated with the risk of vulnerable plaques of carotid artery in a Chinese population,which might be middle phenotype indicating higher risk of cerebral infarction.

Intermittent Cold Stress Reducing the Collagen Content of Atherosclerotic Plaque in Experimental ApoE-/-Mice / 中国循环杂志

Objective: To investigate the influence of intermittent cold stress on collagen content of atherosclerotic plaque in experimental ApoE-/-mice. Methods: A total of 20 male ApoE-/-mice at 8 weeks of age were divided into 2 groups:Experimental group, the mice had intermittent cold exposure at (4 ± 1)°C from 8am to 12noon and Control group, the mice were living at (24 ± 2) °C. All animals were treated for 12 weeks, n=10 in each group. The collagen content of atherosclerotic plaque at the aortic root in ApoE-/-mice was observed by Masson staining, the protein expressions of aortic MMP-2, MMP-9 and TIMP-1 were examined by Western blot analysis. Results: Compared with Control group, the Experimental group presented the lower collagen content of atherosclerotic plaque at the aortic root, higher protein expressions of MMP-2, MMP-9 and lower protein expression of TIMI 1. Conclusion: Intermittent cold stress may disturb the balance of MMP/TIMP and decrease collagen content of atherosclerotic plaque to form vulnerable plaque in experimental ApoE-/-mice which may cause acute coronary syndrome.