Influence of Rivaroxaban on Vascular Endothelial Function and p38MAPK/NF-κB Pathway in Rats with Lower Extremity Arteriosclerosis Obliterans / 中国药师

Objective:To explore the influence of rivaroxaban on vascular endothelial function and p38MAPK/NF-κB pathway in the rats with arteriosclerosis obliterans. Methods:The rats were divided into the sham operation group,the model group,rivaroxaban low dose group,rivaroxaban medium dose group and rivaroxaban high dose group. The contents of nitric oxide (NO) and endothelin (ET-1) in serum were detected, the number of endothelial cells in serum was studied, and the expression level of p38MAPK, p-p38MAPK and NF-κB were measured. Results:Compared with that of the model group, the number of endothelial cells in venous blood of rivaroxaban groups decreased. The content of NO in serum of rivaroxaban groups was significantly higher than that of the model group,and the content of ET-1 was significantly lower than that of the model group(P<0.05). The expression level of p-p38MAPK in arterial vessels of rivaroxaban groups was significantly lower than that of the model group,and the expression level of NF-κB was sig-nificantly higher than that of the model group(P<0.05),and the effects were all in a dose-dependent manner. Conclusion:Rivarox-aban can improve vascular endothelial function in the rats with arteriosclerosis obliterans,and the effects may be achieved by modula-ting the p38MAPK / NF-κB pathway.

Technique of minor- caliber and long balloon in treatment of lower limb peripheral arterial disease on diabetic patients / 中国基层医药

Objective To investigate the effect of percutaneous transluminal angioplasty(PTA) by minor-caliber and long balloon on diabetic patients with below-knee artery. Methods 16 consecutive DM patients(21 limbs)were treated with PTA by minor-caliber and long balloon and followed 7 months(1 ～22 months). The success rate,complication,clinical effects and the changes of ABI were investigated and analyzed. Results The technical success rate is 90.5% (19/21) ,no serious complication occurred. The clinical symptoms of all patients improved after successful PTA. The median ABI marginally increased from the baseline value of (0.31 ±0. 15) to (0.57 ±0.23) after intervention,the difference is significant (P ＜ 0.05). Post-operative pain in patients with rest pain disappeared 9 (60.0%), relieved 4 (26.7%), reduce 2 (13.3 %). Ulcer healing in patients with foot gangrene 4 (66.7 %), Ulcer area was significantly reduced 1 (16.7%), high amputation 1 (16.7%). Postoperative follow-up, two limbs reoperation because of increased symptoms. Conclusion The treatment of percutaneous transluminal angioplasty by minorcaliber and long balloon was effective on diabetic patients with below-knee arterial disease.