Effects of ivabradine on vascular endothelial function in patients with coronary artery disease：a meta-analysis / 中国药房

OBJECTIVE To evaluate the effects of ivabradine on vascular endothelial function in patients with coronary artery disease. METHODS PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang Data， VIP and CBM databases were retrieved to collect randomized controlled trials （RCTs） about ivabradine （intervention group） versus placebo or β-blocker （control group） from the inception to Mar. 20th 2023. The meta-analysis was performed by using RevMan 5.4 software after literature screening， data extraction and quality evaluation. RESULTS A total of 12 RCTs were included， involving 1 206 patients. The results of meta-analysis showed that the levels of flow-mediated dilation （FMD） [MD＝1.71， 95%CI （0.96， 2.46）， P＜0.000 01] and nitric oxide （NO） [MD＝5.80， 95%CI （5.02， 6.59）， P＜0.000 01] in the intervention group were significantly higher than control group， while endothelin-1（ET-1） level was significantly lower than control group [MD＝－7.45， 95%CI （－8.42， －6.47）， P＜0.000 01]. There was no statistical significance in nitroglycerin-mediated dilation （NMD） level between 2 groups [MD＝0.13， 95%CI（－0.74， 1.00）， P＝0.77]. Subgroup analyses based on the different medications and intervention time in the control group showed better improvement in FMD level of patients receiving ivabradine， compared with placebo （P＜0.05）； compared with placebo and β-blocker， the level of NO in patients receiving ivabradine was improved significantly （P＜0.05）， while ET-1 level was decreased significantly （P＜0.05）. Regardless of the duration of the intervention， the levels of FMD， NO， and ET-1 in the intervention group were significantly improved compared to the control group （P＜0.01）， while the difference in NMD was not statistically significant （P＞0.05）. CONCLUSIONS Ivabradine can improve vascular endothelial function in patients with coronary artery disease.

Effect of Guizhi Gegentang on Hemodynamics and Vascular Endothelial Function in Cervical Vertigo / 中国实验方剂学杂志

ObjectiveTo evaluate the therapeutic effect of Guizhi Gegentang on cervical vertigo and its impact on hemodynamics and vascular endothelial function. MethodA total of 144 patients with cervical vertigo treated from April 2019 to June 2022 were included in the study and randomly divided into a control group and an observation group， with 72 patients in each group. During the study， three patients dropped out from the observation group and two patients from the control group. The control group received conventional treatment （oral betahistine mesylate tablets）， while the observation group received conventional treatment combined with Guizhi Gegentang. The clinical efficacy， changes in the frequency and duration of dizziness attacks per month before and after treatment， changes in symptoms and functional evaluation scores of cervical vertigo assessed by the European Scale for Cervical Vertigo （ESCV）， changes in the average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， changes in indicators such as endothelin-1 （ET-1）， neuropeptide Y （NPY）， calcitonin gene-related peptide （CGRP）， changes in the Neck Disability Index （NDI） score， changes in the Functional Assessment of Cancer Therapy-General （FACT-G） score， and adverse reactions were observed and compared between the two groups. ResultThe total effective rate in the observation group was 95.65% （66/69）， significantly higher than 84.29% （59/70） in the control group （χ2=4.957， P<0.05）. Before treatment， there were no significant differences in the frequency and duration of dizziness attacks per month， ESCV scores， average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， levels of ET-1， NPY， CGRP， NDI score， and FACT-G score between the two groups. After treatment， compared with the baseline within each group， there were improvements in the frequency and duration of dizziness attacks per month， ESCV scores， average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， levels of ET-1， NPY， CGRP， NDI score， and FACT-G score in both groups （P<0.05， P<0.01）. Compared with the control group， the observation group showed better improvements in the frequency and duration of dizziness attacks per month， ESCV score， average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， levels of ET-1， NPY， CGRP， NDI score， and FACT-G score （P<0.05， P<0.01）. During the study period， one case of nausea occurred in the control group， and one case of dizziness occurred in the observation group. There was no statistically significant difference in the incidence of adverse reactions between the two groups. ConclusionGuizhi Gegentang can improve the therapeutic effect of cervical vertigo， effectively improve patients' hemodynamics and vascular endothelial function， and enhance their quality of life with few adverse reactions. It is worth applying in clinical practice.

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.

Effect of Jiawei Shenqi Yixin Prescription on Cardiovascular Risk Factors in Patients with Heart Failure with Preserved Ejection Fraction and Insulin Resistance / 中国实验方剂学杂志

ObjectiveTo observe the effect of Jiawei Shenqi Yixin prescription on cardiovascular risk factors in the patients with heart failure with preserved ejection fraction and insulin resistance. MethodFrom January 2021 to January 2022， a total of 82 patients with heart failure with preserved ejection fraction were enrolled in the ward of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine. The patients were randomly assigned into two groups （ 41 cases） and received the same basic treatment. The observation group was additionally treated with Jiawei Shenqi Yixin prescription for 8 weeks. The clinical efficacy， traditional Chinese medicine （TCM） efficacy， cardiac function indexes ［NT-probrain natriuretic peptide （NT-proBNP） and 6-min walking test （6MWT）］， echocardiographic parameters ［left atrial volume index （LAVI）， left ventricular mass index （LVMI）， peak early diastolic to peak late diastolic mitral flow velocity （E/A） ratio］， insulin resistance-related indexes ［fasting insulin （FINS）， fasting plasma glucose （FPG）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， homeostatic model assessment of insulin resistance （HOMA-IR）， triglyceride-glucose index （TYG）， and triglyceride to high-density lipoprotein cholesterol （TG/HDL-C） ratio］， inflammatory cytokines ［tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， adiponectin （ADP）， and C-reactive protein （CRP）］， vascular endothelial function indicators ［nitric oxide （NO）， endothelial nitric oxide synthase （eNOS）， inducible nitric oxide synthase （iNOS）， and endothelin-1 （ET-1）］， and the safety of treatment were determined. In addition， Pearson correlation analysis was performed to analyze the correlations of insulin resistance， inflammatory cytokines， and vascular endothelial factors with the mitigation of heart failure. ResultIn terms of clinical efficacy， the therapy of the observation group was significantly effective in 26 patients， effective in 12 patients， ineffective in 3 patients， with the total effective rate of 92.68%， the therapy of the control group was significantly effective in 14 patients， effective in 12 patients， and ineffective in 15 patients， with the total effective rate of 63.41%. The clinical total effective rate of the observation group was higher than that of the control group （χ2=11.6， P<0.05）. In terms of TCM efficacy， the therapy of the observation group was significantly effective in 26 patients， effective in 11 patients， and ineffective in 4 patients， with the total effective rate of 90.24%； the therapy of the control group was significantly effective in 9 patients， effective in 13 patients， and ineffective in 19 patients， with the total effective rate of 53.66%. The TCM total effective rate of the observation group was higher than that of the control group （χ2=8.19， P<0.05）. Compared with those before treatment， the levels of NT-proBNP， LAVI， LVMI， FPG， FINS， HOMA-IR， TYG， TG/HDL-C， TNF-α， IL-6， CRP， ET-1， and iNOS in two groups declined after treatment （P<0.05）， while the levels of 6MWT， E/A， ADP， NO， and eNOS elevated （P<0.05）. After treatment， the observation group had lower levels of NT-proBNP， LAVI， LVMI， FPG， FINS， HOMA-IR， TYG， TG/HDL-C， TNF-α， CRP， and ET-1 （P<0.05） and higher levels of 6MWT， E/A， ADP， and NO than the control group （P<0.05）. In addition， the increase in 6MWT after treatment was positively correlated with the increase in NO and the decrease in ET-1. The decrease in LVMI after treatment was positively correlated with the increase in NO and the decrease in FINS. The increase in left ventricular ejection fraction after treatment was positively correlated with the decreases in TNF-α and TYG （P<0.05）. Adverse reactions were observed in neither group. ConclusionJiawei Shenqi Yixin prescription can significantly mitigate the symptoms， reduce inflammation， and improve vascular endothelial function in the patients with heart failure with preserved ejection fraction and insulin resistance， being safe without causing adverse reactions.

Effectiveness of early intervention with levothyroxine sodium in pregnancy complicated with hypothyroidism / 中华内分泌外科杂志

Objective:To investigate the effectiveness of early levothyroxine intervention in pregnancy complicated with hypothyroidism.Methods:A retrospective analysis was performed on 132 pregnant patients with hypothyroidism admitted to the Department of Endocrinology, Anyang People’s Hospital from Nov. 2018 to Sep. 2021. Among them, 68 cases with levothyroxine sodium early intervention were included in the intervention group, and 64 cases without intervention were included in the non-intervention group. The differences in vascular endothelial function indexes, thyroid function indexes, and blood lipid indexes before and after treatment in the intervention group were compared with those in the non-intervention group. The incidence of obstetric complications such as preeclampsia, fetal growth restriction, and adverse pregnancy outcomes of abortion and neonatal asphyxia were compared between the two groups. SPSS 21.0 software was used to process data, measurement data were subjected to t test, and enumeration data were subjected to χ 2 test. Results:After treatment, the endothelium-dependent brachial artery blood flow-mediated vasodilation index (FMD) index, nitric oxide (NO) , and endothelin-1 (ET-1) levels in the intervention group were significantly better than those in the non-intervention group [ (10.37%) ±1.54%) vs (7.25% ± 1.09%) , (60.85 ± 7.03) umol/L vs (39.11 ± 4.31) umol/L, (112.96 ± 13.58) umol/L vs (238.85 ± 26.05) umol/L]. After treatment, the serum thyroid stimulating hormone (TSH) in the intervention group was significantly lower than that in the non-intervention group [ (2.25±0.26) mU/L vs (8.79±1.60) mU/L] ( P<0.001) . After treatment, the levels of total cholesterol (TC) , triacylglycerol (TG) and low-density lipoprotein cholesterol (LDL-C) in the intervention group were significantly lower than those in the non-intervention group [ (3.52±0.91) mmol/L vs (6.51±1.31) mmol/L L, (1.30±0.31) mmol/L vs (1.44±0.36) mmol/L, (2.29±0.31) mmol/L vs (3.32±0.44) mmol/L] ( P<0.001, P=0.036, P<0.001) . The incidence of obstetric complications such as preeclampsia, fetal growth restriction, premature rupture of membranes, and abnormal amniotic fluid volume in the intervention group were significantly lower than those in the non-intervention group (5.88% vs 17.19%, 1.47% vs 9.38%, 10.29% vs. 23.44%, 2.94% vs 12.50%) ( P=0.041, 0.043, 0.043, 0.038) ; the incidence of miscarriage, premature birth, neonatal asphyxia, cesarean section and other adverse pregnancy outcomes in the intervention group were significantly lower than those in the non-intervention group (1.47% vs 9.38%, 4.69% vs 15.36%, 2.94% vs 10.94%, 57.35% vs 75.00%) ( P=0.043, 0.031, 0.038, 0.033) . Conclusion:Early intervention with levothyroxine in pregnancy complicated with hypothyroidism is beneficial to improve thyroid function, reduce blood lipid level, protect vascular endothelial function, reduce related obstetric complications, and reduce the incidence of adverse pregnancy outcomes for mothers and infants.

Association of asymmetric dimethylarginine with the pathological process of persistent pulmonary hypertension of the newborn / 中国当代儿科杂志

OBJECTIVES@#To study the change in asymmetric dimethylarginine (ADMA) in the circulation system of full-term infants with persistent pulmonary hypertension of the newborn (PPHN) and its association with treatment response, as well as the possibility of ADMA as a therapeutic target and a marker for treatment response.@*METHODS@#A prospective study was performed. A total of 30 full-term neonates who were diagnosed with PPHN within 3 days after birth were enrolled as the PPHN group, and the neonates without PPHN, matched for gestational age and age, who were treated or observed in the department of neonatology were enrolled as the control group. Serum samples were collected on days 1, 7, and 14 of treatment. The high-performance liquid chromatography-tandem mass spectrometry was used to measure the serum concentrations of L-arginine, ADMA, and its isomer symmetric dimethylarginine (SDMA).@*RESULTS@#For the neonates in the control group, the serum concentrations of ADMA and L-arginine continuously increased and the serum concentration of SDMA continuously decreased within the first 14 days of treatment. On days 1 and 14, there was no significant difference in the serum concentration of ADMA between the control and PPHN groups (P>0.05). On day 7, the PPHN group had a significantly higher serum concentration of ADMA than the control group (P<0.05), while there were no significant differences in serum concentrations of SDMA or L-arginine (P>0.05). Moreover, after 7 days of treatment, the PPHN neonates with a systolic pulmonary arterial pressure (sPAP) of >35 mmHg had a significantly higher serum concentration of ADMA than those with an sPAP of ≤35 mm Hg.@*CONCLUSIONS@#There are continuous increases in the ADMA concentration and the ADMA/SDMA ratio in the circulation system of full-term infants within the first 2 weeks after birth, and this process is accelerated by the pathological process of PPHN, suggesting that ADMA may be involved in the pathologic process of PPHN. A high level of ADMA is associated with the resistance to PPHN treatment, suggesting that inhibition of ADMA might be a potential target of drug intervention to improve the treatment response of PPHN.

Evaluation of diagnostic efficacy of artery elasticity and endothelial function indexes for coronary heart disease with blood stasis syndrome in postmenopausal women by Logistic regression combined with ROC curve model / 中国中药杂志

The present study explored the correlation of coronary heart disease(CHD) with blood stasis syndrome in postmenopausal women with artery elasticity and endothelial function indexes and evaluated the diagnostic efficacy of the prediction model via logistic regression and receiver operating characteristic(ROC) curve model. A retrospective comparison was made between 366 postmenopausal CHD patients from August 1, 2020, to September 30, 2021, in the Department of Cardiology of Integrated Traditional Chinese and Western Medicine of China-Japan Friendship Hospital, who were divided into the blood stasis syndrome group(n=196) and the non-blood stasis syndrome group(n=170). General clinical characteristics of the two groups were compared. Multivariate logistic regression analysis was used to probe the correlation of CHD with blood stasis syndrome in postmenopausal women with brachial-ankle pulse wave velocity(baPWV), ankle-brachial index(ABI), and flow-mediated dilatation(FMD), and the ROC curve was drawn to evaluate the diagnostic efficiency of the prediction model. Multivariate logistic regression analysis showed that the correlation coefficients of CHD with blood stasis syndrome in postmenopausal women with baPWV, ABI, and FMD were 1.123, 0.109, and 0.719, respectively(P=0.004, P=0.005, P<0.001),and the regression equation for predicting probability P was P=1/[1+e~(-(3.131+0.116×baPWV-2.217×ABI-0.330×FMD))]. ROC curve analysis suggested that in the context of baPWV≥19.19 m·s~(-1) or ABI≤1.22 or FMD≤9.7%, it was of great significance to predict the diagnosis of CHD with blood stasis syndrome in postmenopausal women. The AUC of baPWV, ABI, FMD, and prediction probability P was 0.763, 0.607, 0.705, and 0.836, respectively. The AUC of prediction probability P was higher than that of each index alone(P<0.001), and the sensitivity and specificity were 0.888 and 0.647, respectively. The results demonstrate that baPWV, ABI, and FMD are independently correlated with CHD with blood stasis syndrome in postmenopausal women, and show certain independent predictive abilities(P<0.05). The combined evaluation of the three possesses the best diagnostic efficiency.

Protective effects and mechanism of icariin against vascular function in diabetic mice / 中国药科大学学报

@#To explore the effects and molecular mechanism of icariin on the vascular function of mice with type 1 diabetes induced by alloxan, type 1 diabetic mice model was established by intraperitoneal injection with 200 mg/kg alloxan.After oral administration with icariin (60, 120 mg/kg) daily for 2 weeks, blood glucose, body weight, food intake and water intake were detected.To evaluate the impact of icariin on the function of isolated vascular ring contraction and relaxation, thoracic aortas of mice were removed and the Ach-induced vascular ring relaxation, Phe-induced vascular ring contraction, SNP-induced vascular ring relaxation and KCl-induced vascular ring contraction response were detected.To further confirm the mechanism of icariin to improve vascular function, human umbilical vein endothelial cells (HUVECs) were induced by high glucose (HG) in vitro.Western blot was used to detect the effect of icariin on eNOS, p-eNOS, p38 MAPK and p-p38 MAPK expressions in HG-induced human umbilical vein endothelial cells (HUVECs).The results indicated that icariin significantly ameliorated the weight loss and dampened the increase in water intake of the diabetic mice.Meanwhile, icariin had a certain ameliorative effect on blood glucose and food intake without significant difference.The results of isolated thoracic aortas vascular rings contraction and vasodilation function indicated that icariin significantly improved Phe-induced vascular contraction and Ach‐induced vascular relaxation.Meanwhile, icariin had a certain ameliorative effect on KCl-induced vascular contraction response without significant difference.However, no significant change was observed on endothelium‐independent vascular rings relaxation response induced by SNP after treatment with icariin.Results of Western blot showed that icariin inhibited the expression of p-p38 MAPK and induced expression of p-eNOS in the high glucose-induced HUVECs cell model.Therefore, icariin may attenuate alloxan-induced type 1 diabetic mice vascular diastolic function by inhibiting expression of p-p38 MAPK and inducing expression of p-eNOS.

Effect of Qingfei Xiegantang on Chronic Inflammation and Endothelial Function with Metabolic Syndrome / 中国实验方剂学杂志

Objective:To discuss the clinical efficacy of Qingfei Xiegantang on chronic inflammation and endothelial function of people of Taiyin constitution with metabolic syndrome （MS）. Method:Patients （162 cases） were divided into control group （80 cases） and observation group （82 cases）. Both groups got lifestyle intervention and treatment with lipid regulation， blood pressure reduction and hypoglycemia according to MS. Patients in observation group got Qingfei Xiegantang， 1 dose/day. Patients in control group got placebo granules of Qingfei Xiegantang. The treatment lasted for 4 months. Before and after treatment， weight， height， waist （WC）， hip， body mass index （BMI） and waist hip ratio （WHR） were calculated. Levels of triglyceride （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， fasting blood glucose （FBG）， 2-hour postprandial blood glucose （2 hPG）， glycosylated hemoglobin （HbA1c） and fasting insulin （FINS） were measured. Insulin resistance index （HOMA-IR）， insulin sensitivity index （ISI） and islet beta cell function index （HOMA-<italic>β</italic>）， systolic blood pressure （SBD）， diastolic blood pressure （DBP）， tumor necrosis factor-α （TNF-<italic>α</italic>）， interleukin-6 （IL-6）， leptin （LP）， adiponectin （ADP）， nitric oxide （NO）， endothelin-1 （ET-1）， endothelial nitric oxide synthase （eNOS） and inducible nitric oxide synthase （iNOS） were detected and recorded. Then the safety was evaluated. Result:Levels of body mass， BMI， WHR， TG， TC， LDL-C， FBG， 2 hPG， HbA1c， HOMA-IR， SBD， DBP， TNF-<italic>α</italic>， IL-6， LP， ET-1 and iNOS were all lower than those in control group. Levels of HDL-C， InISI， HOMA-<italic>β</italic>， ADP， NO and eNOS were higher than those in control group （<italic>P</italic><0.01）. And score of syndrome differentiation of Taiyin people was lower than that in control group （<italic>P</italic><0.01）. The compliance rate of BMI in observation group was 70.27% （52/74）， which was higher than 53.42% （39/73） in control group （<italic>χ</italic>²=4.421， <italic>P</italic><0.05）. The compliance rate of blood pressure was 95.95% （71/74）， was higher than 84.93% （62/73） in control group （<italic>χ</italic>²=5.171， <italic>P</italic><0.05）. The compliance rate of blood fat was 87.84% （65/74）， which was higher than 72.60% （53/73） （<italic>χ</italic>²=5.386， <italic>P</italic><0.05）. Conclusion:Qingfei Xiegantang can regulate the obesity， blood pressure， blood glucose and blood lipid components of MS， relieve clinical symptoms， improve IR， insulin sensitivity and islet <italic>β</italic> cell function， reduce inflammatory reaction， and increase vascular endothelial function of people of taiyin constitution with metabolic Syndrome.

Salidroside inhibits endothelial-mesenchymal transition by regulating KLF4/eNOS signaling pathway / 中国药理学通报

Aim To investigate the effect and mechanism of salidroside (SAL) on homocysteine (Hcy)-induced endothelial-mesenchymal transition (EndMT) based on the KLF4/eNOS signaling pathway. Methods (1) Salidroside inhibited Hcy-induced EndMT. HUVECs were pretreated with different concentrations of SAL for 2 h, then followed by Hcy (1 mmol · L-l) co-incubation for 48 hours to induce EndMT. The expression levels of VE-cadherin, α-SMA, KLF4 and eNOS were detected by Western blot, scratch repair experiment was used to determin cell migration ability, the level of NO in cells was determined by nitrate reductase method, and the expression and location of KLF4 were observed by immunofluorescence technology. (2) The signal mechanism of SAL inhibiting End-MT through KLF4/eNOS signal was studied. siRNA mediated knockdown of KLF4 in HUVECs, and the protein expression levels of VE-cadherin, α-SMA, KLF4 and eNOS in each group were determined by Western blot. Results Western blotting demonstrated that SAL significantly reversed the Hcy-induced increase in α-SMA and KLF4 expression and decrease in VE-cadherin and eNOS expression. The immunofluorescence analysis suggested that SAL inhibited the translocation of KLF4 from cytoplasm to nucleus. (2) Silencing KLF4 down-regulated the expression of α-SMA and KLF4, and up-regulated the expression of VE-cadherin and eNOS. Compared with the group of SAL + siKLF4, there was no significant difference in the effect of SAL group and siKLF4 group on phenotypic markers. Conclusions Salidroside inhibits EndMT induced by Hcy, which may be related to the regulation of KLF4/eNOS signaling pathway.

Antihypertensive Effect of Tianmu Jiangya Powder on SHR Rats and Its Mechanism / 中国实验方剂学杂志

Objective::To investigate the antihypertensive effect of Tianmu Jiangya powder and its related antihypertensive mechanism by using SHR rats as a model, and protein expressions provide an experimental basis for the clinical application of Tianmu Jiangya powder in the treatment of hypertension. Method::Sixty male SHR rats were randomly divided into six groups according to body weight after one week of adaptive feeding: model group, valsartan group (12 mg·kg-1), captopril group (9 mg·kg-1), hydrochlorothiazide group (6 mg·kg-1), Tianmu Jiangya powder low and high-dose group (0.36, 1.44 g·kg-1), WKY rats were used as the normal group, and the intragastric administration lasted for 16 weeks. Softron BP-2010A intelligent non-invasive blood pressure meter was used to measure the systolic blood pressure (SBP)and heart rate (HR) of rat tail arteries. Adobe Photoshop CS5 software was used to analyze the left auricle and claw fixed selected areas to evaluate the effect on blood stasis syndrome. Vevo 2100 small animal ultrasound imaging system detects left ventricular ejection fraction (LVEF), left ventricular shortening (FS), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular end-systole dimension (LVIDs), left ventricular end-diastole dimension (LVIDd), interventricular septum end-systolic depth (IVSs), and interventricular septum end-diastolic depth (IVSd). Then the rats were sacrificed and the materials were taken (blood, heart, aorta, liver, kidney, tibia), and the weight of heart, liver, kidney and tibia length were measured and recorded. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of the heart and thoracic aorta. Separation of serum and plasma, and determination of nitric oxide (NO) in serum by nitrate reductase method. Radioimmunoassay was used to detect plasma adrenaline/3 methoxyadrenaline (MN), urea (UREA), and uric acid (UA) contents. The expression of nitric oxide synthase(iNOS) and vascular endothelial growth factor(VEGF) protein in thoracic aorta of each group was detected and analyzed by immunohistochemical method. Result::Compared with normal group, the SBP and HR of the rats in model group were significantly increased (P<0.05). The r value of the claw was significantly reduced and the g value was significantly increased at 8 and 16 weeks (P<0.05). LVEF and FS significantly decreased, LVESV, LVIDs, IVSd increased significantly (P<0.05). Heart weight, heart weight /tibia length, liver weight and liver weight /tibia length, plasma of MN, UREA, and UA contents significantly increased, and promoted the expression of iNOS and VEGF proteins in the aortic (P<0.05). Compared with the model group, the Tianmu Jiangya powder administration group could continuously reduce SBP in SHR rats, maintain HR stability (P<0.05), significantly increase the claw of r value, lower the claw of g value(P<0.05). LVEF, FS significantly increased, LVEDV, LVESV, LVIDd and LVIDs significantly decreased (P<0.05), significantly increased serum NO content, decreased liver weight, liver weight/tibia length, plasma MN, UREA, UA content (P<0.05), and down-regulated the expression of iNOS and VEGF protein in the aorta(P<0.05). Conclusion::Tianmu Jiangya powder has a certain antihypertensive effect, and its mechanism may be mainly related to protecting heart function, improving vascular endothelial function, reducing catecholamines and sedative analgesia.

Clinical Efficacy of Liuwei Dihuangwan Combined with Danzi Xiaoyaosan on H-type Hypertension with Syndrome of Yin Deficiency and Yang Hyperactivity / 中国实验方剂学杂志

Objective::To discuss the clinical efficacy of Liuwei Dihuangwan combined with Danzi Xiaoyaosan on H-type hypertension with syndrome of Yin deficiency and Yang hyperactivity and its effect on vascular endothelial function and inflammatory factors. Method::One hundred and fifty patients were randomly divided into control group (75 cases) and observation group (75 cases) by random number table.Patients in control group got enalapril maleate and folic acid tablets, 1 tablet/time, 1 time/day, and patients with uncontrollable blood pressure were also given nifedipine sustained-release tablets, 20-30 mg/time, 2 times/days.In addition of the therapy of control group, patients in observation group were also given modified Liuwei Dihuangwan combined with Danzi Xiaoyaosan, 1 dose/day.The course of treatment was 12 weeks.Before and after treatment, systolic blood pressure (SBP), diastolic blood pressure (DBP) and up-to-standard blood pressure were detected.And ambulatory blood pressure, standard deviation of 24-hours systolic blood pressure (24 h SSD), standard deviation of 24-hour diastolic blood pressure 24 h DSD), 24 h mean systolic blood pressure (24 h SBP), 24 h mean diastolic blood pressure (24 h DBP) were recorded.And ankle brachial index (ABI) and brachial artery blood flow mediated diamete (FMD) were discussed, syndrome of Yin deficiency and Yang hyperactivity was scored, and levels of iterleukin-6 (IL-6), IL-10, high-sensitivity C-reactive protein (hsCRP) and homocysteine (Hcy) were detected. Result::The levels of SBP, DBP, 24 h SSD, 24 h DSD, 24 h SBP and 24 h DBP were all lower than those in control group (P<0.01). The achievement rate of accidental blood pressure in observation group was 81.19%, which was higher than 66.98% in control group (χ2=29.81, P<0.01). And levels of ABI, FMD and IL-10 were higher than those in control group (P<0.01), while the score of syndrome of Yin Deficiency and Yang Hyperactivity and the levels of Hcy, leptin, IL-6 and hs-CRP were lower than those in control group (P<0.01). Conclusion::In addition to the therapy of antihypertensive and folic acid, Liuwei Dihuangwan combined with Danzi Xiaoyaosan can be given to control the level of blood pressure and Hcy, relieve the variability of blood pressure, alleviate clinical symptoms, raise the rate of achievement rate of blood pressure, improve the function of vascular endothelium, and regulate inflammatory factors.

Clinical Efficacy of Modified Jingui Shenqitang in Treatment of Renal Hypertension with Spleen-kidney Yang Deficiency Syndrome / 中国实验方剂学杂志

Objective::To explore the efficacy of modified Jingui Shenqitang in the treatment of renal hypertension with spleen-kidney yang deficiency syndrome and its effect on blood lipids, renal function and vascular endothelial function. Method::Totally 110 patients were randomly divided into control group and observation group by random number table method, with 55 cases in each group. Control group was given levamlodipine (2.5-5 mg every time, once/day) and enalapril maleate (10 mg every time, once/day), and observation group was given modified Jingui Shenqitang in addition to the therapy of control group (1 dose/day). They were treated for 12 weeks. Blood pressure monitoring was performed, the systolic blood pressure (SBD) and diastolic blood pressure (DBP) were compared before and after treatment, and the blood pressure compliance was calculated. The 24 h urinary protein quantification (24 hUpr), serum creatinine (SCr), albumin (ALB) and urea nitrogen (BUN) were detected before and after treatment, the glomerular filtration rate (eGFR) was calculated, and the triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HLD-C) and low-density lipoprotein( LDL-C) were detected before and after treatment. The spleen-kidney Yang deficiency syndromes were scored before and after treatment. The levels of nitric oxide (NO), plasma endothelin (ET) and angiotensin Ⅱ (Ang Ⅱ) were detected before and after treatment. Result::The blood pressure efficacy in observation group was better than that in control group (Z=1.905, P<0.05). The efficacy of traditional Chinese medicine(TCM) syndromes in observation group was better than that in control group (Z=2.416, P<0.01). The compliance rate of causal blood pressure in observation group was higher than that in control group (88.89% vs 71.25%) (χ2=7.861, P<0.01). SBP and DBP in observation group were lower than those in control group (P<0.05). TC and LDL-C in observation group were lower than those in control group (P<0.01). The 24 hUpr, BUN and SCr in observation group were lower than those in control group (P<0.05), while the eGFR was higher than that in control group (P<0.05). The levels of ET-1 and Ang Ⅱ in observation group were lower than those in control group (P<0.05), whereas the NO level was higher than that in control group (P<0.01). Conclusion::In addition to the routine intervention with western medicine, modified Jingui Shenqitang for patients with spleen-kidney Yang deficiency syndrome can further control blood pressure level, improve blood pressure compliance rate, regulate lipid metabolism, protect kidney function, and regulate vascular endothelial function, with a better clinical efficacy than pure western medicine.

Effect of Modified Yuquanwan Combined with Taohong Siwutang on Major Cardiovascular Risk Factors of Patients with Type 2 Diabetes / 中国实验方剂学杂志

Objective:To observe the efficacy of modified Yuquanwan combined with Taohong Siwutang on major cardiovascular risk factors of type 2 diabetes and its effect on inflammatory factors and endothelial function. Method:One hundred and sixty patients were randomly divided into control group (80 cases) and observation group (80 cases) by random number table. The control group was given Tianqi Jiangtang capsule 5 tablets/time,3 times/day. Bothgroups were taken orally. aspirin enteric-coated tablets, 0.1 g/time,1 time/day, insulin for injection or oral antidiabetic, simvastatin tablets, 20 mg/time, 1 time/day, and irbesartan tablets, 150 mg/time, 1 time/day.patients in observation group were added with modified Yuquanwan combined with Taohong Siwutang for 24 weeks, 1 dose/day, and a 48-week follow-up visit were paid. Blood glucose, lipid, blood pressure, fasting plasma glucose (FPG), blood sugar 2 h after meal (2 h PG), glycosylated hemoglobin (HbA1c), systolic (SBP) and diastolic pressure (DBP) were detected for every 8 weeks, and at the 8th, 16th, and 24th week after treatment, up-to-standard HbA1c, LDL-C, SBP, DBP and all of those indexes were recorded, and levels of blood glucose, lipids and blood pressure were compared at different time points. During the treatment and within the 72-week follow-up, cardiovascular events, stroke events, peripheral vascular events and microvascular complications were recorded. And levels of tumor necrosis factor-α (TNF-α), homocysteine (Hcy), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), endothelin (ET-1) and nitric oxide (NO) were detected, and at the 8th, 16th and 24th week after treatment, body mass index (BMI) was recorded. Result:At the 24th week after treatment, the compliance rate of HbA1c in observation group was 81.16%（56/69）, which was higher than 64.71%（44/68） in control group (χ2=4.701, P<0.05), and the compliance rate of SBP was 94.2%（65/69）, which was higher than 82.36%（56/68） in control group (χ2=4.662, P<0.05). At the 16th week and 24th week after treatment, the compliance rate of LDL-C were 79.71%（55/69） and 88.41%（61/69）, which were higher than 63.24%（43/68） and 70.59%（48/68） in control group (χ2=4.5642, χ2=5.108, P<0.05). At the 16th week, the comprehensive compliance rate (blood glucose, blood pressure, blood lipid) in observation group was 59.42%（41/49）, which was higher than 41.18% （28/68） in control group (χ2=4.559, P<0.05). At the 24th week, the comprehensive compliance rate in observation group was 69.57% （48/69）, which was higher than 51.47% （36/68） in control group (χ2=4.695, P<0.05). At the 16th week, the compliance rate of BMI was 60.87% （42/69）, which was higher than 39.71% （27/68）in control group (χ2=6.136, P<0.05). At the 24th week, the compliance rate of BMI was 72.46% （50/69）, which was higher than 52.94% （36/68） in control group (χ2=5.585, P<0.05). At the 16th week after treatment, levels of 2 h PG and HbA1cin observation group were lower than those in control group (P<0.05). At the 24th week after treatment, levels of FPG, 2 hPG, HbA1c, SBP and DBP were lower than those in control group (P<0.05). Levels of TNF-α, Hcy, IL-6, hs-CRP and ET-1 were lower than those in control group (P<0.01), while level of NO was higher than that in control group (P<0.01). During 72 weeks of observation period, the rate of adverse vascular events in observation group was 13.04%(9/69), which was lower than 30.88%(21/68) in control group (χ2=5.957, P<0.05). Conclusion:In addition to the conventional western medicine therapy, modified Yuquanwan combined with Taohong Siwutang can further control the main cardiovascular risk factors of patients with T2DM, improve the endothelial function of T2DM patients, inhibit the expression of pro-inflammatory factors, and reduce the incidence of adverse vascular events.

Effect of oral vitamin C ingestion on the vascular endothelial function and oxidative stress marker exposed to after transient heat-not-burn tobacco smoking / 体力科学

Heat-not-burn (HNB) tobacco smoking has spread throughout the market. While it is suggested that HNB tobacco smoking reduces the vascular endothelial function and is associated with a high risk of developing cardiovascular disease. The antioxidant of vitamin C may attenuate the unfavorable effects of HNB tobacco smoking. In the present study, we examined the effect of oral vitamin C ingestion on the flow-mediated dilation (FMD) at the brachial artery and oxidative stress markers in patients before and after transient HNB tobacco smoking. Twelve healthy adult males underwent high-resolution ultrasonography of the brachial artery and evaluations of reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP) before and after a single session of HNB smoking. FMD was used to examine the endothelial function and the oxidative stress and antioxidant status were determined by using a FRES4 analyzer. In this randomized, crossover, controlled trial, measurements were performed on 2 different days 20 min after the oral administration of 1000 mg of ascorbic acid (VC trial) or a placebo (P trial). Although the FMD values decreased after a single HNB smoking session in both trials, the VC trial showed significantly higher values than the P trial at 60 and 120 min after smoking. Whereas the FMD values 120 min after smoking in the P trial were lower compared to the Pre values, there was no difference in the VC trial. These results suggested that the ingestion of vitamin C might suppress the decrease in the endothelial function caused by a single HNB smoking.

Effects of aerobic exercise combined with Levocarnitine on improving endothelial function and antioxidation in patients with stable angina pectoris of coronary heart disease / 中国综合临床

Objective To investigate the effect of aerobic exercise combined with Levocarnitine in treating stable angina pectoris ( SAP ) and its effect on vascular endothelial function and serum levels of superoxide dismutase ( SOD ), total antioxidant capacity ( TAC ), glutathione peroxidase ( GSH-px ), malondialdehyde (MDA),and lipid peroxide( LPO) . Methods One hundred and fifty patients with SAP were selected in Affiliated Hospital of Yan′an University from september 2017 to september 2018 and randomly divided into control group and observation group( 75 cases in each group) . Both groups received routine intervention according to the guidelines. The control group was given with intravenous drip of left carnitine(3 g／time and once a day). On basis of the control group,the observation group was treated with regular aerobic exercise therapy. After 8 weeks＇ treatment for two groups,attack frequency degree of angina pectoris,score of life quality of Seattle angina scale(SAQ),and clinical effect were compared between the two groups. And the vascular endothelial function ( plasma endothelin ( ET ) 1, nitric oxide ( NO )), flow mediated vasodilation(FMD) of brachial artery and antioxidant effect(serum levels of SOD,TAC,GSH-px, MDA and LPO) were detected. Results After 8 weeks＇treatment,frequency of angina pectoris and episode of duration of angina pectoris in the observation group were less(( 4. 19± 0. 56) vs. ( 6. 22 ± 0. 89) time, (4. 31±0. 50) vs. (5. 25±0. 71) min),while life quality indexes SAQ score was higher,than those in the control group,and the difference was statistically significant (( 18. 44 ± 2. 30) vs. ( 12. 49 ± 1. 82) score, (56. 31±6. 62) vs. (48. 05± 5. 88) score,(14. 46 ± 1. 99) vs. ( 9. 22 ± 1. 10) score,( 21. 41 ± 2. 95)) vs. (18. 09±2. 26) score,(16. 14±2. 17) vs. (12. 05±1. 82) score,(all P＜0. 01)). The total clinical effective rate of the observation group ( 92%( 69 ／ 75)) was higher than that of the control group ( 80%( 60 ／75)),the difference was statistically significant (χ2＝4. 485,P＝0. 034). After 8 weeks′ treatment,level of ET-1,FMD of brachial artery,MDA,and LPO were lower than those in the control group(( 65. 38± 7. 91) ng／L vs. (77. 12±8. 56) ng／L,( 9. 44± 1. 34)% vs. ( 12. 55± 1. 81)%,(2. 81± 0. 43) μmol／L vs. ( 3. 90 ±0. 50) μmol／L,(3. 14±0. 44) μmol／L vs. (4. 40± 0. 63) μmol／L),while NO,SOD,TAC,GSH-px were higher than control group(( 67. 51 ± 7. 79) μmol／L vs. ( 52. 17± 6. 08) μmol／L,( 85. 25± 9. 67) U／L vs. (76. 01±8. 33) U／L,(12. 79±1. 80) kU／L vs. (9. 64±11. 05) kU／L,(117. 65±15. 03) U／L vs. (111. 76 ±14. 19) U／L),and the difference was statistically significant (all P＜0. 01). Conclusion Aerobic exercise combined with Levocarnitine in treating SAP can reduce the attack of angina pectoris, improve the life treatment of patients,and improve the clinical effect,which may be related to the improvement of endothelial function and antioxidant effect.

Influence of repetition exercise requiring less work than continuous exercise on the vascular endothelial function / 体力科学

High-intensity interval exercise leads to greater improvements in the vascular endothelial function than continuous exercise at moderate intensity. However, few studies have been performed on the effects of repetition exercise consisting of high-intensity exercise followed by complete rest on the arterial function. Therefore, the purpose of this study was to investigate the effects of repetition exercise on the vascular endothelial function determined by flow-mediated vasodilation (FMD). Eleven healthy male subjects completed two exercise sessions on a cycle ergometer in a counterbalanced order. The exercise sessions were 20 min cycling at 50% maximal work rate (Wmax) (continuous exercise, CE) and 20 × 20-sec intervals at 100%Wmax interspersed with 40-sec intervals at complete rest (repetition exercise, RE). Before and after each protocol, the brachial systolic and diastolic blood pressure were measured in the supine position. Relative FMD was assessed at rest and 30 and 60 min after each exercise regimen, and then the normalized FMD (nFMD) was calculated from the peak shear rate. The FMD significantly increased 30 min after RE (8.2 ± 1.5% to 11.5 ± 3.1%, p<0.01) and non-significantly increased 30 min after CE (7.5 ± 1.6% to 8.1 ± 2.1%, n.s.) before returning to baseline at 60 min after both exercise regimens. The FMD value at 30 min after RE was significantly greater than that at 30 min after CE (p<0.01). The nFMD (a.u.) significantly increased 30 min after RE (1.38 ± 0.64 to 2.00 ± 0.94, p<0.05) and non-significantly increased 30 min after CE (1.20 ± 0.54 to 1.49 ± 0.57, n.s.) before returning to baseline at 60 min after both exercise regimens. These results suggest that repetition exercise may lead to an acute improvement in the vascular endothelial function.

Effect of ketogenic diet on vascular endothelial function in children with intractable epilepsy / 中华实用儿科临床杂志

Objective@#To study the effect of ketogenic diet (KD) on vascular endothelial function in children with intractable epilepsy.@*Methods@#Clinical informations of 14 children with intractable epilepsy in Fujian Medical University Affiliated Union Hospital from May 2014 to March 2018 were collected.Their blood index values were tested and retested before and after 3 months of KD treatment, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low density lipoprotein (LDL), nitric oxide (NO), endothelin-1 (ET-1), and von Willebrand factor (vWF). These data were statistically analyzed by using repeated measurement analysis of variance.@*Results@#(1)Changes in blood lipid levels: the levels of TG and TC increased slightly [(1.08±0.14) mmol/L, (5.19±0.64) mmol/L vs.(0.97±0.10) mmol/L, (4.57±0.29) mmol/L]and the level of HDL decreased slightly [(1.19±0.08) mmol/L vs.(1.31±0.08) mmol/L]after 3 months of KD treatment, but the differences were not statistically significant in the above indexes (all P>0.05). The level of LDL before KD was significantly lower than that after 3 months of KD [(2.93±0.25) mmol/L vs.(3.73±0.40) mmol/L ], and the difference was statistically signi-ficant(P=0.034). (2)Assessment of vascular endothelial function: compared with before KD, all the levels of NO [(60.84±5.29) μmol/L vs.(66.45±5.39) μmol/L ], ET-1 [(1.24±0.30) ng/L vs.(2.13±0.78)ng/L] and vWF [(150.53±12.97) μg/L vs.(137.57±13.10) μg/L]had no statistically significant changes after 3 months of KD(all P>0.05).@*Conclusions@#KD treatment lasting 3 months in children with intractable epilepsy can raise the level of LDL, but can′t change the vascular endothelial function.

Effect of ketogenic diet on vascular endothelial function in children with intractable epilepsy / 中华实用儿科临床杂志

Objective To study the effect of ketogenic diet(KD)on vascular endothelial function in children with intractable epilepsy. Methods Clinical informations of 14 children with intractable epilepsy in Fujian Medical University Affiliated Union Hospital from May 2014 to March 2018 were collected. Their blood index values were tested and retested before and after 3 months of KD treatment,including triglycerides( TG),total cholesterol( TC),high－density lipoprotein( HDL),low density lipoprotein( LDL),nitric oxide( NO),endothelin －1( ET －1),and von Willebrand factor(vWF). These data were statistically analyzed by using repeated measurement analysis of variance. Results (1)Changes in blood lipid levels:the levels of TG and TC increased slightly[(1. 08 ± 0. 14)mmol/L, (5. 19 ± 0. 64)mmol/L νs.(0. 97 ± 0. 10)mmol/L,(4. 57 ± 0. 29)mmol/L]and the level of HDL decreased slightly [(1. 19 ± 0. 08)mmol/L νs.(1. 31 ± 0. 08)mmol/L]after 3 months of KD treatment,but the differences were not sta﹣tistically significant in the above indexes(all P＞0. 05). The level of LDL before KD was significantly lower than that after 3 months of KD[(2. 93 ± 0. 25)mmol/L νs.(3. 73 ± 0. 40)mmol/L ],and the difference was statistically signi﹣ficant(P﹦0. 034).(2)Assessment of vascular endothelial function:compared with before KD,all the levels of NO [(60. 84 ± 5. 29)μmol/L νs.(66. 45 ± 5. 39)μmol/L ],ET－1[(1. 24 ± 0. 30)ng/L νs.(2. 13 ± 0. 78)ng/L]and vWF[(150. 53 ± 12. 97)μg/L νs.(137. 57 ± 13. 10)μg/L]had no statistically significant changes after 3 months of KD(all P＞0. 05). Conclusions KD treatment lasting 3 months in children with intractable epilepsy can raise the level of LDL,but can′t change the vascular endothelial function.

Effect of vitamin C ingestion on the vascular endothelial function exposed to transient passive smoking / 体力科学

As well as active smoking, passive smoking is associated with a high risk of developing cardiovascular disease. The antioxidant vitamin C may inhibit the unfavorable effects of passive smoking. In this study, we investigated the effects of vitamin C ingestion on changes in the flow-mediated dilatation (FMD) at the brachial artery in patients exposed to transient passive smoking. The study participants included seven healthy adult males who were examined by high-resolution ultrasonography of the brachial artery before and after 15-minute of passive smoking. FMD was used to examine the endothelial function. Randomized crossover controlled trial, measurements were performed on two different days 120-minute after the oral administration of 1000mg of ascorbic acid (VC trial) or a placebo (P trial). Although the FMD values decreased after passive smoking in both trials, the FMD values of the VC trial were higher than those of the P trial, with significant differences between the trials observed immediately and 30-minute after passive smoking. The results of this study suggested that the ingestion of vitamin C may suppress the decrease in the vascular endothelial function caused by transient passive smoking.