Irisin is a chief myokine released during physical activity and has garnered attention for its potential therapeutic effects on different metabolic and cardiovascular disorders.This review explores the intricate conne...Irisin is a chief myokine released during physical activity and has garnered attention for its potential therapeutic effects on different metabolic and cardiovascular disorders.This review explores the intricate connections between irisin,physical activity,sarcopenia,type 2 diabetes mellitus(T2DM),and cardiovascular complications.Experimental data suggests that through irisin release,physical activity positively influences muscle health,metabolic regulation,and cardiovascular function.In individuals with sarcopenia,characterized by progressive muscle mass and function loss,irisin plays a pivotal role in maintaining muscle integrity and function.Additionally,irisin’s beneficial effects on insulin sensitivity and glucose metabolism suggest its involvement in the pathophysiology of T2DM.The review will examine how irisin may modulate the development of cardiovascular complications,particularly in the context of diabetes and aging.Additionally,it will explore its potential as a therapeutic target for managing sarcopenia,T2DM,and cardiovascular complications,underscoring the importance of physical activity in mitigating these interconnected health challenges.Further research is needed to elucidate the precise mechanisms by which irisin mediates these effects and assess its clinical applicability in preventing and treating metabolic and cardiovascular disorders.展开更多
The aim of this study was to investigate the effects of high-advanced glycation end products （AGEs） diet on diabetic vascular complications. The Streptozocin （STZ）-induced diabetic mice were fed with high-AGEs die...The aim of this study was to investigate the effects of high-advanced glycation end products （AGEs） diet on diabetic vascular complications. The Streptozocin （STZ）-induced diabetic mice were fed with high-AGEs diet. Diabetic characteristics, indicators 3f renal and cardiovascular functions, and pathohistology of pancreas, heart and renal were evaluated. AGEs/RAGE/ROS pathway parameters were determined. During the experiments, the diabetic mice exhibited typical characteristics including weight loss, polydipsia, polyphagia, polyuria, high-blood glucose, and low-serum insulin levels. However, high-AGEs diet effectively aggravated these diabetic sharacteristics. It also increased the 24-h urine protein levels, serum levels of urea nitrogen, creatinine, c-reactive protein （CRP）, low density lipoprotein （LDL）, tumor necrosis factor-a （TNF-a）, and interleukin-6 （IL-6） in the diabetic mice. High-AGEs diet deteriorated the histology of pancreas, heart, and kidneys, and caused structural alterations of endothelial ceils, mesangial cells and podocytes in renal ：ortex. Eventually, high-AGEs diet contributed to the high-AGE levels in serum and kidneys, high-levels of reactive oxygen species ＇,ROS） and low-levels of superoxide dismutase （SOD） in serum, heart, and kidneys. It also upregulated RAGE mRNA and protein expression in heart and kidneys. Our results showed that high-AGEs diet deteriorated vascular complications in the diabetic mice. The activation of AGEs/RAGE/ROS pathway may be involved in the pathogenesis of vascular complications in diabetes.展开更多
More than 200000 hospital admissions happen per year for acute pancreatitis and more than 50000 for chronic pancreatitis in the United States of America.Necrotizing pancreatitis accounts for 20%-30%of the cases.One-qu...More than 200000 hospital admissions happen per year for acute pancreatitis and more than 50000 for chronic pancreatitis in the United States of America.Necrotizing pancreatitis accounts for 20%-30%of the cases.One-quarter of the patients with pancreatitis develop vascular complications,which carries a high mortality.This mini-review will address these complications that can help primary care physicians and hospitalists in managing their patients effectively.展开更多
Chronic pancreatitis is a chronic fibro-inflammatory disorder of the pancreas,resulting in recurrent abdominal pain,diabetes mellitus,and malnutrition.It may lead to various other complications such as pseudocyst form...Chronic pancreatitis is a chronic fibro-inflammatory disorder of the pancreas,resulting in recurrent abdominal pain,diabetes mellitus,and malnutrition.It may lead to various other complications such as pseudocyst formation,benign biliary stricture,gastric outlet obstruction;and vascular complications like venous thrombosis,variceal and pseudoaneurysmal bleed.Development of varices is usually due to chronic venous thrombosis with collateral formation and variceal bleeding can easily be tackled by endoscopic therapy.Pseudoaneurysmal bleed can be catastrophic and requires radiological interventions including digital subtraction angiography followed by endovascular obliteration,or sometimes with a percutaneous or an endoscopic ultrasound-guided approach in technically difficult situations.Procedure-related bleed is usually venous and mostly managed conservatively.Procedure-related arterial bleed,however,may require radiological interventions.展开更多
Cardiovascular complications of patients with type 2 diabetes mellitus(T2DM)threaten the health and life of numerous individuals.Recently,growth factor receptor-binding protein 10(GRB10)was found to play a pivotal rol...Cardiovascular complications of patients with type 2 diabetes mellitus(T2DM)threaten the health and life of numerous individuals.Recently,growth factor receptor-binding protein 10(GRB10)was found to play a pivotal role in vascular complications of T2DM,which participates in the regulation of lipid metabolism of T2DM patients.The genetic variation of GRB10 rs1800504 is closely related to the risk of coronary heart disease in patients with T2DM.The development of GRB10 as a key mediator in the association of lipid metabolism with cardiovascular complications in T2DM is detailed in and may provide new potential concerns for the study of cardiovascular complications in T2DM patients.展开更多
The effects of intensive versus regular therapy on incidence and progress of microalbuminuria in type 2 diabetes were compared. During a follow-up of 3 years, 96 cases of diabetes mellitus were randomized to intensive...The effects of intensive versus regular therapy on incidence and progress of microalbuminuria in type 2 diabetes were compared. During a follow-up of 3 years, 96 cases of diabetes mellitus were randomized to intensive and regular therapy groups. HbA 1c goal was same in the two groups, but the goal of blood pressure (Bp) and lipid was more strict in the intensive therapy group than in the regular therapy group. There was statistically significant difference in the incidence and progression of vascular complications between the two groups. Logistic stepwise-regression analysis (odds ration, OR) showed that there was significant difference in the progression of nephropathy (OR 0.24, 95 % CI 0.12-0.76), retinopathy (OR 0.38, 95 % CI 0.16-0.88), peripheral neuropathy (OR 0.42, 95 % CI 0.22-0.86) and autonomic neuropathy (OR 0.29, 95 % CI 0.12-0.86) between the two groups (P<0.01). It was concluded that intensive blood glucose controlling could retard diabetic vascular complications. Intensive therapy of multiple factors interventions (controlling Bp, regulating blood lipid, improving microcirculation) could decrease various risk factors for diabetic vascular complications.展开更多
Pregnancy requires several changes in the body of the mother to successfully carry and deliver a child.Multiple alterations occur,including changes in cardiovascular system to meet the increased demands of the mother ...Pregnancy requires several changes in the body of the mother to successfully carry and deliver a child.Multiple alterations occur,including changes in cardiovascular system to meet the increased demands of the mother and placenta,the tilting of the hypercoagulable status to a more pro-coagulable state to prevent excessive blood loss post-delivery,and immunologic manipulations to protect the mother and fetus and decreasing the risk of a fatal immunologic response to the allogeneic fetus.These alterations are physiologically normal and expected,but can become pathologic when thresholds are crossed.Pregnancy may cause or exacerbate underlying retinal vascular diseases,a class of disorders compromised predominantly of retinal vein occlusion(RVO),retinal artery occlusion(RAO),central serous retinopathy(CSR),diabetic retinopathy,and hypertensive-related retinopathy,which includes pre-eclampsia,eclampsia,and hemolysis,elevated liver enzymes,and low platelets(HELLP)syndrome.The majority of the literature on retinal changes associated with pregnancy has focused on diabetic retinopathy,while the knowledge regarding the pathogenesis and treatment options of other pregnancy-related vascular diseases remains scarce.Understanding the implications pregnancy has on these rare,but severe,retinal vascular complications can help guide clinical management and potential treatment modalities.This paper aims to serve as a review of the retinal manifestations of diseases outside of diabetic retinopathy.展开更多
The increasing incidence of morbidly adherent placenta （MAP） is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by ...The increasing incidence of morbidly adherent placenta （MAP） is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by performing prophylactic lilac artery balloon occlusion has been reported recently. However, the effectiveness and safety of this technique have not been fully determined. Here we report the case of a 25-year-old woman with placenta increta with preemptive bilateral internal lilac artery balloons who had external lilac artery thrombosis detected by computed tomography angiography （CTA） 72 h post cesarean section. A digital subtraction angiogram （DSA） and intra-arterial thrombolysis were instantly performed followed by supplementary conservative treatments, leading to a desirable resolution, of thrombus without sequela. This is the first report of vascular complications with successful interventional thrombolysis in this setting. Our experience suggests that prophylactic lilac artery balloon occlusion should be used cautiously in cases of MAP and consideration given to minimizing vascular complications given the hypercoagulable state of pregnancy.展开更多
MANTA vascular closure device is an alternative vascular access closure device that is predominantly designed for large bore arteriotomy procedures.Its implementation to reduce morbidity and mortality following percut...MANTA vascular closure device is an alternative vascular access closure device that is predominantly designed for large bore arteriotomy procedures.Its implementation to reduce morbidity and mortality following percutaneous procedures including peripheral veno-arterial(VA)-extracorporeal membrane oxygenation(ECMO)in critically ill patients with various severe clinical conditions such as refractory cardiogenic shock remains to be under scientific discussion.The use of the MANTA vascular closure device leads to a sufficient reduction in a number of post-decannulation complications such as bleeding,vascular complications,inflammatory reactions and major amputation.Furthermore,the technical success of percutaneous decannulation of VA-ECMO with the MANTA vascular closure device appears to be safe and effective.It has been reported that MANTA vascular closure device exerted a strict similarity with other vascular surgical systems in safe profile regardless of the indication for its utilization.Overall,the immobilized patients achieved a favorable recovery outcome with MANTA including safe decannulation and low risk of vascular complications.The authors suggest the use of pulse wave distal Doppler technology for early detection of these clinically relevant complications.In conclusion,MANTA vascular closure device seems to be safe and effective technical approach to provide low-risk vascular assess for a long time for severe sick individuals.展开更多
Objective This review focuses on the role of the large conductance calcium-activated potassium （BKCa） channels in diabetic vascular complications.Data sources Relevant articles published in English or Chinese from 1...Objective This review focuses on the role of the large conductance calcium-activated potassium （BKCa） channels in diabetic vascular complications.Data sources Relevant articles published in English or Chinese from 1981 to present were selected from PubMed.The search terms were ＂BKCa channels＂ and ＂diabetes＂.Important references from selected articles were also retrieved.Study selection Articles regarding the role of BKCa channels in diabetic vascular complications and relevant mechanisms were selected.Results The BKCa channels are abundantly expressed in vascular smooth cells and play an important role in regulation of vascular tone.Multiple studies indicated that the expression and function of BKCa channels are altered by different mechanisms in diabetic vascular diseases such as coronary arterial disease,cerebral arterial disease,and diabetic retinopathy.Conclusion BKCa channels may play an important role in diabetic vascular complications and may be an effective therapeutic target for relieving and reducing the burden of diabetic vascular complications.展开更多
Background Plasma galectin-3, a mediator of fibrogenesis and inflammation, its potential to associate with type 2 diabetes （T2DM） is poorly investigated. Here, we explored its interaction with the serum galectin-3 a...Background Plasma galectin-3, a mediator of fibrogenesis and inflammation, its potential to associate with type 2 diabetes （T2DM） is poorly investigated. Here, we explored its interaction with the serum galectin-3 and vascular complications. Methods We conducted a population-based cross-sectional survey in Zhejiang, China involving 165 men and 119 women （age range, 43-84 years）, investigating the relationship between serum galectin-3 and vascular disease in patients with T2DM. Results Serum galectin-3 was higher in subjects with T2DM than that in control participants （27.4 vs. 17.6 ng/ml, P 〈0.001）. Compared with subjects with galectin-3 values in the lowest quartile, those with values in the highest quartile had an increased likelihood of vascular complications （4th quartile odds ratio （OR） 2.52, 95% confidence interval （CI）, 1.25- 4.07）. Increased risk of micro- or macrovascular complications corrrelated with serum galectin-3 concentration （ORs 11.4 and 8.5, respectively）. An increased number of vascular complications was associated with high serum galectin-3 levels （P 〈0.05）. Patients with serum galectin-3 levels 〉25 ng/ml had an elevated risk of diabetes relative to patients with levels 〈10 ng/ml （OR for any vascular complication 2.64, for heart failure 3.97, for nephropathy 4.09, for peripheral arterial disease （PAD） 4.18; all P 〈0.05）. Complication risk was higher in patients with neurogenic, stroke, or retinopathy complications, but this difference was not significant after risk factor adjustment. Serum galectin-3 levels correlated with diabetes duration, C-reactive protein （CRP） levels, and albuminuria. Conclusion High galectin-3 values were associated with increased odds of developing heart failure, nephropathy, and peripheral arterial disease in patients with T2DM.展开更多
Bisphenol A(BPA)is an endocrine disruptor present in polycarbonate plastics used in food containers and water bottles that resists insulin action and leads to type 2 diabetes mellitus(T2DM).However,there is scant rese...Bisphenol A(BPA)is an endocrine disruptor present in polycarbonate plastics used in food containers and water bottles that resists insulin action and leads to type 2 diabetes mellitus(T2DM).However,there is scant research on the impact of BPA on T2DM-related vascular complications.Fetuin-A(FTA)and osteoprotegerin(OPG)are crucial markers for vascular calcification,which is the primary risk factor for developing vascular complications.This study aims to link external factor BPA levels with the vascular calcification markers FTA and OPG in diabetic subjects with and without vascular complications.Therefore,120 study subjects were included and divided as control(n=30),T2DM with cardiovascular diseases(CVD)(n=30),T2DM with diabetic nephropathy(DN)(n=30),and T2DM without vascular complications(n=30).Serum and urinary FTA,OPG,and BPA levels were measured using an ELISA.FTA(AHSG)and OPG(TNFRSF11B)gene expression were analyzed using qPCR.Both serum(p<0.001)and urinary BPA(p<0.001)were found higher in T2DM with CVD and DN than T2DM without vascular complications and control.Also,T2DM with CVD and DN patients had lower serum and urinary FTA protein levels and increased serum and urinary OPG(p<0.001)levels than T2DM without vascular complications and control.Moreover,FTA(AHSG)gene expression was negatively associated with serum BPA(p<0.001)and urinary BPA(p<0.01).Likewise,OPG(TNFRSF11B)gene expression was positively significant with serum BPA(p<0.001)and urinary BPA(p<0.01)in the study groups.These findings suggest that elevated blood and urinary BPA levels contribute to the severity of vascular complications in T2DM patients through vascular calcification.展开更多
Objective To investigate the distribution of apolipoprotein E (ApoE) genotype among different vascular complications and the variation of allele frequency with age in non insulin dependent diabetes mellitus (NIDDM)...Objective To investigate the distribution of apolipoprotein E (ApoE) genotype among different vascular complications and the variation of allele frequency with age in non insulin dependent diabetes mellitus (NIDDM). Methods 125 NIDDM patients and 50 healthy individuals were selected randomly. Polymerase chain reaction was used to determine their ApoE genotypes. Results The prevalence of ∈3/3 in any vascular complication group was 59.3%, which was significantly lower than 76.0% in controls (P<0.05). The prevalences of ∈3/3, ∈4/3 and ∈4 in coronary heart disease (CHD) group were 51.8%, 33.9% and 20.5%, respectively, which were significantly lower (∈3/3, P<0.01 ) or higher (∈4/3, P<0.01; ∈4, P< 0.05 ) than those in the controls, respectively. The ∈4 frequency was significantly lower in the elderly than in the non elderly group of NIDDM (P<0.05). Conclusion ∈4 increases the risk for vascular complications, especially CHD, and ∈4 may affect the life expectancy of NIDDM patients.展开更多
Objective: To study the changes of endothelin (ET), tumor necrosis factor-α (TNF-α) before and after puerarin treatment in patients with diabetes mellitus vascular complications (DMVC). Methods: Ninety-eight DMVC pa...Objective: To study the changes of endothelin (ET), tumor necrosis factor-α (TNF-α) before and after puerarin treatment in patients with diabetes mellitus vascular complications (DMVC). Methods: Ninety-eight DMVC patients were divided into 2 groups, they were given puerarin (n=68) and normal saline (n=30) respectively, 20 diabetic patients without vascular complications (NDMVC) were taken as control, who were also given puerarin. All the patients were treated on the basis of controlling blood glucose. Plasma ET and serum TNF-α were determined by radioimmunoassay (RIA) before and after treatment. Results: Plasma ET and serum TNF-α in DMVC got higher than that of NDMVC patients (P<0.05), and ET level was correlated with TNF-α (r=0.69, r=0.73, P<0.01). After treatment, the levels of ET and TNF-α were significantly lower than those before treatment of DMVC patients with puerarin (P<0.05). Conclusion: Puerarin could regulate the levels of plasma ET and serum TNF-α of DMVC patients, suggesting that it has the function of regulating endothelial cells.展开更多
To investigate the safety and efficacy of chitosan ( Anscare,Daxon) in reducing vascular ac cess complications compared to a kind of radial compression device( TR-BAND,Terumo) . Method: We studied 128 patients who had...To investigate the safety and efficacy of chitosan ( Anscare,Daxon) in reducing vascular ac cess complications compared to a kind of radial compression device( TR-BAND,Terumo) . Method: We studied 128 patients who had undergone transradial angiography in our center from December 2009 to April 2010. Among them,64 patients were randomly treated with radial compression device ( TR-BAND,Terumo) when the procedure was over ( CD group) . The other 64 patients were dealt with chitosan ( CS group) . The compression time,the major and minor access site bleeding complications and the errhysis were observed. Results: There were no statistical differences in the baseline clinical characteristics of the patients between two groups. The compression time in CS group was significantly shorter than that of CD group ( P < 0. 001) . There were 12 patients suffering from minor access site bleeding while only 3 patients experienced these minor complications in CS group( 19% vs 4% ,P < 0. 05) . At the same time 20 patients had er- rhysis in CD group and 4 patients in CS group ( 31% vs 6% ,P < 0. 001) . Conclusion: Chitosan,compared to radial compression device ( TR-BAND,Terumo) ,can not only shorten the compression time,but also significantly reduce the rate of minor access site bleeding and puncture-site errhyis.展开更多
Liver transplantation(LT)is the most effective treatment for patients with end-stage liver disease,and maintaining vascular patency of the transplanted liver is one of the crucial prerequisites for surgical success.De...Liver transplantation(LT)is the most effective treatment for patients with end-stage liver disease,and maintaining vascular patency of the transplanted liver is one of the crucial prerequisites for surgical success.Despite hepatic vein complic-ations following LT occurring at a relatively low frequency,ranging between 2%to 11%,delayed diagnosis and treatment may lead to graft dysfunction and even patient mortality.Clinical manifestations of hepatic vein complications are often subtle and nonspecific,posing challenges for early diagnosis.Signs may initially present as mild abnormalities in liver function,delayed recovery of liver function,unexplained ascites,lower limb edema,and perineal edema.Prolonged duration of these complications can lead to hepatic sinusoidal dilatation and eventual liver failure due to prolonged hepatic congestion.Ultrasonography has become the preferred imaging modality for post-liver transplant evaluation due to its convenience and non-invasiveness.Although hepatic vein complications may manifest as disappearance or flattening of the hepatic vein spectrum on routine ultrasound imaging,these findings lack specificity.Contrast-enhanced ultrasound that visualizes the filling of contrast agent in the hepatic veins and dynamically displays blood flow perfusion information in the drainage area can,however,significantly improve diagnostic confidence and provide additional information beyond routine ultrasound examination.展开更多
Diabetes mellitus(DM)is a kind of metabolic disorder characterized by chronic hyperglycemia and glucose intolerance due to absolute or relative lack of insulin,leading to chronic damage of vasculature within various o...Diabetes mellitus(DM)is a kind of metabolic disorder characterized by chronic hyperglycemia and glucose intolerance due to absolute or relative lack of insulin,leading to chronic damage of vasculature within various organ systems.These detrimental e®ects on the vascular networks will result in the development of various diseases associated with microvascular injury.Modern optical imaging techniques provide essential tools for accurate evaluation of the structural and functional changes of blood vessels down to capillaries level,which can o®er valuable insight on understanding the development of DM-associated complications and design of targeted therapy.This review will brie°y introduce the DM-induced structural and functional alterations of vasculature within di®erent organs such as skin,cerebrum and kidneys,as well as how novel optical imaging techniques facilitate the studies focusing on exploration of these pathological changes of vasculature caused by DM both in-vivo and ex-vivo.展开更多
Following Kasai portoenterostomy for biliary atresia(BA),long-term survival in children is associated with chronic liver cirrhosis leading to hepatopulmonary syndrome(HPS)and portopulmonary hypertension(Po PH).This fu...Following Kasai portoenterostomy for biliary atresia(BA),long-term survival in children is associated with chronic liver cirrhosis leading to hepatopulmonary syndrome(HPS)and portopulmonary hypertension(Po PH).This further causes a diverse array of respiratory and circulatory symptoms.The incidence of these complications in children with BA is higher than that seen in other chronic liver diseases.With a faster progression,BA is life-threatening in some severe cases.Moreover,HPS and Po PH may coexist in the same child.Enhancing our understanding of HPS/Po PH,making an early diagnosis,rational selection of medication,and appropriate timing of liver transplantation underscore the need for multidisciplinary collaboration.展开更多
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from im-paired insulin secretion or insulin resistance.Diabetes poses a major global health concern,because of...Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from im-paired insulin secretion or insulin resistance.Diabetes poses a major global health concern,because of its increasing prevalence and substantial morbidity and mortality.This review explores the relationships between altered fatty acid metabolism and microcirculatory impairments in diabetes.Dysregulation of fatty acid metabolism in diabetes leads to changes in fatty acid profiles,abnormal lipid accumulation,and increased oxidative stress.These changes contribute to microvascular dysfunction through mechanisms such as endothelial dysfunction,impaired nitric oxide availability,inflammation,and oxidative damage.Understanding this intricate interplay is essential for identifying novel thera-peutic strategies to alleviate vascular complications in diabetes.By targeting specific pathways involved in fatty acid metabolism and microvascular dysfunction,interventions can be developed to improve patient outcomes.This review is aimed at contributing to future research and the development of effective strategies for preventing and managing dia-betes-associated microcirculatory impairments,to ultimately enhance the quality of life for people living with diabetes.展开更多
Objective: to judge the possible peripheral vascular complications of patients in the process of treatment and complete nursing intervention. Methods: the patients in the control group received routine nursing, and th...Objective: to judge the possible peripheral vascular complications of patients in the process of treatment and complete nursing intervention. Methods: the patients in the control group received routine nursing, and the patients in the observation group received complication nursing. Results: the complications, nursing satisfaction and quality of life in the observation group were better than those in the observation group (P < 0.05). Conclusion: based on the diagnosis and treatment of patients with femoral artery intervention, with the help of complication nursing, the complications of patients can be reduced, and then the satisfaction and quality of life can be improved.展开更多
文摘Irisin is a chief myokine released during physical activity and has garnered attention for its potential therapeutic effects on different metabolic and cardiovascular disorders.This review explores the intricate connections between irisin,physical activity,sarcopenia,type 2 diabetes mellitus(T2DM),and cardiovascular complications.Experimental data suggests that through irisin release,physical activity positively influences muscle health,metabolic regulation,and cardiovascular function.In individuals with sarcopenia,characterized by progressive muscle mass and function loss,irisin plays a pivotal role in maintaining muscle integrity and function.Additionally,irisin’s beneficial effects on insulin sensitivity and glucose metabolism suggest its involvement in the pathophysiology of T2DM.The review will examine how irisin may modulate the development of cardiovascular complications,particularly in the context of diabetes and aging.Additionally,it will explore its potential as a therapeutic target for managing sarcopenia,T2DM,and cardiovascular complications,underscoring the importance of physical activity in mitigating these interconnected health challenges.Further research is needed to elucidate the precise mechanisms by which irisin mediates these effects and assess its clinical applicability in preventing and treating metabolic and cardiovascular disorders.
基金supported by National Nature Science Foundation of China(No.81073111)the Priority Academic Program Development of Jiangsu Higher Education Institutions(No.nzyzyxjp1006)Jiangsu Province graduate student scientific research innovation plan project(No.CXZZ13_0622)
文摘The aim of this study was to investigate the effects of high-advanced glycation end products （AGEs） diet on diabetic vascular complications. The Streptozocin （STZ）-induced diabetic mice were fed with high-AGEs diet. Diabetic characteristics, indicators 3f renal and cardiovascular functions, and pathohistology of pancreas, heart and renal were evaluated. AGEs/RAGE/ROS pathway parameters were determined. During the experiments, the diabetic mice exhibited typical characteristics including weight loss, polydipsia, polyphagia, polyuria, high-blood glucose, and low-serum insulin levels. However, high-AGEs diet effectively aggravated these diabetic sharacteristics. It also increased the 24-h urine protein levels, serum levels of urea nitrogen, creatinine, c-reactive protein （CRP）, low density lipoprotein （LDL）, tumor necrosis factor-a （TNF-a）, and interleukin-6 （IL-6） in the diabetic mice. High-AGEs diet deteriorated the histology of pancreas, heart, and kidneys, and caused structural alterations of endothelial ceils, mesangial cells and podocytes in renal ：ortex. Eventually, high-AGEs diet contributed to the high-AGE levels in serum and kidneys, high-levels of reactive oxygen species ＇,ROS） and low-levels of superoxide dismutase （SOD） in serum, heart, and kidneys. It also upregulated RAGE mRNA and protein expression in heart and kidneys. Our results showed that high-AGEs diet deteriorated vascular complications in the diabetic mice. The activation of AGEs/RAGE/ROS pathway may be involved in the pathogenesis of vascular complications in diabetes.
文摘More than 200000 hospital admissions happen per year for acute pancreatitis and more than 50000 for chronic pancreatitis in the United States of America.Necrotizing pancreatitis accounts for 20%-30%of the cases.One-quarter of the patients with pancreatitis develop vascular complications,which carries a high mortality.This mini-review will address these complications that can help primary care physicians and hospitalists in managing their patients effectively.
文摘Chronic pancreatitis is a chronic fibro-inflammatory disorder of the pancreas,resulting in recurrent abdominal pain,diabetes mellitus,and malnutrition.It may lead to various other complications such as pseudocyst formation,benign biliary stricture,gastric outlet obstruction;and vascular complications like venous thrombosis,variceal and pseudoaneurysmal bleed.Development of varices is usually due to chronic venous thrombosis with collateral formation and variceal bleeding can easily be tackled by endoscopic therapy.Pseudoaneurysmal bleed can be catastrophic and requires radiological interventions including digital subtraction angiography followed by endovascular obliteration,or sometimes with a percutaneous or an endoscopic ultrasound-guided approach in technically difficult situations.Procedure-related bleed is usually venous and mostly managed conservatively.Procedure-related arterial bleed,however,may require radiological interventions.
文摘Cardiovascular complications of patients with type 2 diabetes mellitus(T2DM)threaten the health and life of numerous individuals.Recently,growth factor receptor-binding protein 10(GRB10)was found to play a pivotal role in vascular complications of T2DM,which participates in the regulation of lipid metabolism of T2DM patients.The genetic variation of GRB10 rs1800504 is closely related to the risk of coronary heart disease in patients with T2DM.The development of GRB10 as a key mediator in the association of lipid metabolism with cardiovascular complications in T2DM is detailed in and may provide new potential concerns for the study of cardiovascular complications in T2DM patients.
基金This project was supported by grants from Science and Re-search Founction of the Ministry of Health ( No.96- 2 - 10 2 )and Hubei Provincial Natural SciencesFoundation ( No.96J0 77)
文摘The effects of intensive versus regular therapy on incidence and progress of microalbuminuria in type 2 diabetes were compared. During a follow-up of 3 years, 96 cases of diabetes mellitus were randomized to intensive and regular therapy groups. HbA 1c goal was same in the two groups, but the goal of blood pressure (Bp) and lipid was more strict in the intensive therapy group than in the regular therapy group. There was statistically significant difference in the incidence and progression of vascular complications between the two groups. Logistic stepwise-regression analysis (odds ration, OR) showed that there was significant difference in the progression of nephropathy (OR 0.24, 95 % CI 0.12-0.76), retinopathy (OR 0.38, 95 % CI 0.16-0.88), peripheral neuropathy (OR 0.42, 95 % CI 0.22-0.86) and autonomic neuropathy (OR 0.29, 95 % CI 0.12-0.86) between the two groups (P<0.01). It was concluded that intensive blood glucose controlling could retard diabetic vascular complications. Intensive therapy of multiple factors interventions (controlling Bp, regulating blood lipid, improving microcirculation) could decrease various risk factors for diabetic vascular complications.
文摘Pregnancy requires several changes in the body of the mother to successfully carry and deliver a child.Multiple alterations occur,including changes in cardiovascular system to meet the increased demands of the mother and placenta,the tilting of the hypercoagulable status to a more pro-coagulable state to prevent excessive blood loss post-delivery,and immunologic manipulations to protect the mother and fetus and decreasing the risk of a fatal immunologic response to the allogeneic fetus.These alterations are physiologically normal and expected,but can become pathologic when thresholds are crossed.Pregnancy may cause or exacerbate underlying retinal vascular diseases,a class of disorders compromised predominantly of retinal vein occlusion(RVO),retinal artery occlusion(RAO),central serous retinopathy(CSR),diabetic retinopathy,and hypertensive-related retinopathy,which includes pre-eclampsia,eclampsia,and hemolysis,elevated liver enzymes,and low platelets(HELLP)syndrome.The majority of the literature on retinal changes associated with pregnancy has focused on diabetic retinopathy,while the knowledge regarding the pathogenesis and treatment options of other pregnancy-related vascular diseases remains scarce.Understanding the implications pregnancy has on these rare,but severe,retinal vascular complications can help guide clinical management and potential treatment modalities.This paper aims to serve as a review of the retinal manifestations of diseases outside of diabetic retinopathy.
基金Project supported by the Natural Science Foundation of Science and Technology Commission of Shanghai Municipality(No.16ZR1420000),China
文摘The increasing incidence of morbidly adherent placenta （MAP） is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by performing prophylactic lilac artery balloon occlusion has been reported recently. However, the effectiveness and safety of this technique have not been fully determined. Here we report the case of a 25-year-old woman with placenta increta with preemptive bilateral internal lilac artery balloons who had external lilac artery thrombosis detected by computed tomography angiography （CTA） 72 h post cesarean section. A digital subtraction angiogram （DSA） and intra-arterial thrombolysis were instantly performed followed by supplementary conservative treatments, leading to a desirable resolution, of thrombus without sequela. This is the first report of vascular complications with successful interventional thrombolysis in this setting. Our experience suggests that prophylactic lilac artery balloon occlusion should be used cautiously in cases of MAP and consideration given to minimizing vascular complications given the hypercoagulable state of pregnancy.
文摘MANTA vascular closure device is an alternative vascular access closure device that is predominantly designed for large bore arteriotomy procedures.Its implementation to reduce morbidity and mortality following percutaneous procedures including peripheral veno-arterial(VA)-extracorporeal membrane oxygenation(ECMO)in critically ill patients with various severe clinical conditions such as refractory cardiogenic shock remains to be under scientific discussion.The use of the MANTA vascular closure device leads to a sufficient reduction in a number of post-decannulation complications such as bleeding,vascular complications,inflammatory reactions and major amputation.Furthermore,the technical success of percutaneous decannulation of VA-ECMO with the MANTA vascular closure device appears to be safe and effective.It has been reported that MANTA vascular closure device exerted a strict similarity with other vascular surgical systems in safe profile regardless of the indication for its utilization.Overall,the immobilized patients achieved a favorable recovery outcome with MANTA including safe decannulation and low risk of vascular complications.The authors suggest the use of pulse wave distal Doppler technology for early detection of these clinically relevant complications.In conclusion,MANTA vascular closure device seems to be safe and effective technical approach to provide low-risk vascular assess for a long time for severe sick individuals.
基金This study was supported in part by grants from the National Natural Science Foundation of China （No. 81070157 and No. 81370303）, Natural Science Foundation of Jiangsu Province （No. BK2011179）, Medical Key Personnel of Jiangsu Province （RC 2011034） and Top Qualified Personnel in Six Fields of Jiangsu Province （006） to Dr. Wang Ruxing.
文摘Objective This review focuses on the role of the large conductance calcium-activated potassium （BKCa） channels in diabetic vascular complications.Data sources Relevant articles published in English or Chinese from 1981 to present were selected from PubMed.The search terms were ＂BKCa channels＂ and ＂diabetes＂.Important references from selected articles were also retrieved.Study selection Articles regarding the role of BKCa channels in diabetic vascular complications and relevant mechanisms were selected.Results The BKCa channels are abundantly expressed in vascular smooth cells and play an important role in regulation of vascular tone.Multiple studies indicated that the expression and function of BKCa channels are altered by different mechanisms in diabetic vascular diseases such as coronary arterial disease,cerebral arterial disease,and diabetic retinopathy.Conclusion BKCa channels may play an important role in diabetic vascular complications and may be an effective therapeutic target for relieving and reducing the burden of diabetic vascular complications.
文摘Background Plasma galectin-3, a mediator of fibrogenesis and inflammation, its potential to associate with type 2 diabetes （T2DM） is poorly investigated. Here, we explored its interaction with the serum galectin-3 and vascular complications. Methods We conducted a population-based cross-sectional survey in Zhejiang, China involving 165 men and 119 women （age range, 43-84 years）, investigating the relationship between serum galectin-3 and vascular disease in patients with T2DM. Results Serum galectin-3 was higher in subjects with T2DM than that in control participants （27.4 vs. 17.6 ng/ml, P 〈0.001）. Compared with subjects with galectin-3 values in the lowest quartile, those with values in the highest quartile had an increased likelihood of vascular complications （4th quartile odds ratio （OR） 2.52, 95% confidence interval （CI）, 1.25- 4.07）. Increased risk of micro- or macrovascular complications corrrelated with serum galectin-3 concentration （ORs 11.4 and 8.5, respectively）. An increased number of vascular complications was associated with high serum galectin-3 levels （P 〈0.05）. Patients with serum galectin-3 levels 〉25 ng/ml had an elevated risk of diabetes relative to patients with levels 〈10 ng/ml （OR for any vascular complication 2.64, for heart failure 3.97, for nephropathy 4.09, for peripheral arterial disease （PAD） 4.18; all P 〈0.05）. Complication risk was higher in patients with neurogenic, stroke, or retinopathy complications, but this difference was not significant after risk factor adjustment. Serum galectin-3 levels correlated with diabetes duration, C-reactive protein （CRP） levels, and albuminuria. Conclusion High galectin-3 values were associated with increased odds of developing heart failure, nephropathy, and peripheral arterial disease in patients with T2DM.
文摘Bisphenol A(BPA)is an endocrine disruptor present in polycarbonate plastics used in food containers and water bottles that resists insulin action and leads to type 2 diabetes mellitus(T2DM).However,there is scant research on the impact of BPA on T2DM-related vascular complications.Fetuin-A(FTA)and osteoprotegerin(OPG)are crucial markers for vascular calcification,which is the primary risk factor for developing vascular complications.This study aims to link external factor BPA levels with the vascular calcification markers FTA and OPG in diabetic subjects with and without vascular complications.Therefore,120 study subjects were included and divided as control(n=30),T2DM with cardiovascular diseases(CVD)(n=30),T2DM with diabetic nephropathy(DN)(n=30),and T2DM without vascular complications(n=30).Serum and urinary FTA,OPG,and BPA levels were measured using an ELISA.FTA(AHSG)and OPG(TNFRSF11B)gene expression were analyzed using qPCR.Both serum(p<0.001)and urinary BPA(p<0.001)were found higher in T2DM with CVD and DN than T2DM without vascular complications and control.Also,T2DM with CVD and DN patients had lower serum and urinary FTA protein levels and increased serum and urinary OPG(p<0.001)levels than T2DM without vascular complications and control.Moreover,FTA(AHSG)gene expression was negatively associated with serum BPA(p<0.001)and urinary BPA(p<0.01).Likewise,OPG(TNFRSF11B)gene expression was positively significant with serum BPA(p<0.001)and urinary BPA(p<0.01)in the study groups.These findings suggest that elevated blood and urinary BPA levels contribute to the severity of vascular complications in T2DM patients through vascular calcification.
文摘Objective To investigate the distribution of apolipoprotein E (ApoE) genotype among different vascular complications and the variation of allele frequency with age in non insulin dependent diabetes mellitus (NIDDM). Methods 125 NIDDM patients and 50 healthy individuals were selected randomly. Polymerase chain reaction was used to determine their ApoE genotypes. Results The prevalence of ∈3/3 in any vascular complication group was 59.3%, which was significantly lower than 76.0% in controls (P<0.05). The prevalences of ∈3/3, ∈4/3 and ∈4 in coronary heart disease (CHD) group were 51.8%, 33.9% and 20.5%, respectively, which were significantly lower (∈3/3, P<0.01 ) or higher (∈4/3, P<0.01; ∈4, P< 0.05 ) than those in the controls, respectively. The ∈4 frequency was significantly lower in the elderly than in the non elderly group of NIDDM (P<0.05). Conclusion ∈4 increases the risk for vascular complications, especially CHD, and ∈4 may affect the life expectancy of NIDDM patients.
文摘Objective: To study the changes of endothelin (ET), tumor necrosis factor-α (TNF-α) before and after puerarin treatment in patients with diabetes mellitus vascular complications (DMVC). Methods: Ninety-eight DMVC patients were divided into 2 groups, they were given puerarin (n=68) and normal saline (n=30) respectively, 20 diabetic patients without vascular complications (NDMVC) were taken as control, who were also given puerarin. All the patients were treated on the basis of controlling blood glucose. Plasma ET and serum TNF-α were determined by radioimmunoassay (RIA) before and after treatment. Results: Plasma ET and serum TNF-α in DMVC got higher than that of NDMVC patients (P<0.05), and ET level was correlated with TNF-α (r=0.69, r=0.73, P<0.01). After treatment, the levels of ET and TNF-α were significantly lower than those before treatment of DMVC patients with puerarin (P<0.05). Conclusion: Puerarin could regulate the levels of plasma ET and serum TNF-α of DMVC patients, suggesting that it has the function of regulating endothelial cells.
文摘To investigate the safety and efficacy of chitosan ( Anscare,Daxon) in reducing vascular ac cess complications compared to a kind of radial compression device( TR-BAND,Terumo) . Method: We studied 128 patients who had undergone transradial angiography in our center from December 2009 to April 2010. Among them,64 patients were randomly treated with radial compression device ( TR-BAND,Terumo) when the procedure was over ( CD group) . The other 64 patients were dealt with chitosan ( CS group) . The compression time,the major and minor access site bleeding complications and the errhysis were observed. Results: There were no statistical differences in the baseline clinical characteristics of the patients between two groups. The compression time in CS group was significantly shorter than that of CD group ( P < 0. 001) . There were 12 patients suffering from minor access site bleeding while only 3 patients experienced these minor complications in CS group( 19% vs 4% ,P < 0. 05) . At the same time 20 patients had er- rhysis in CD group and 4 patients in CS group ( 31% vs 6% ,P < 0. 001) . Conclusion: Chitosan,compared to radial compression device ( TR-BAND,Terumo) ,can not only shorten the compression time,but also significantly reduce the rate of minor access site bleeding and puncture-site errhyis.
基金Supported by The Shenzhen Science and Technology Research and Development Fund,No.JCYJ20220530163011026 and No.JCYJ20210324131809027Shenzhen Medical Key Discipline Project,No.G2021008 and No.G2022008.
文摘Liver transplantation(LT)is the most effective treatment for patients with end-stage liver disease,and maintaining vascular patency of the transplanted liver is one of the crucial prerequisites for surgical success.Despite hepatic vein complic-ations following LT occurring at a relatively low frequency,ranging between 2%to 11%,delayed diagnosis and treatment may lead to graft dysfunction and even patient mortality.Clinical manifestations of hepatic vein complications are often subtle and nonspecific,posing challenges for early diagnosis.Signs may initially present as mild abnormalities in liver function,delayed recovery of liver function,unexplained ascites,lower limb edema,and perineal edema.Prolonged duration of these complications can lead to hepatic sinusoidal dilatation and eventual liver failure due to prolonged hepatic congestion.Ultrasonography has become the preferred imaging modality for post-liver transplant evaluation due to its convenience and non-invasiveness.Although hepatic vein complications may manifest as disappearance or flattening of the hepatic vein spectrum on routine ultrasound imaging,these findings lack specificity.Contrast-enhanced ultrasound that visualizes the filling of contrast agent in the hepatic veins and dynamically displays blood flow perfusion information in the drainage area can,however,significantly improve diagnostic confidence and provide additional information beyond routine ultrasound examination.
基金the National Key Research and Development Program of China(Grant No.2017YFA0700501)the National Natu-ral Science Foundation of China(Grant Nos.61860206009,81870934,62105113 and 81961138015)+1 种基金China Postdoctoral Science Foundation Funded Project(Nos.BX20200138,BX20190131,2021M691145 and 2019M662633)the Innovation Fund of WNLO.
文摘Diabetes mellitus(DM)is a kind of metabolic disorder characterized by chronic hyperglycemia and glucose intolerance due to absolute or relative lack of insulin,leading to chronic damage of vasculature within various organ systems.These detrimental e®ects on the vascular networks will result in the development of various diseases associated with microvascular injury.Modern optical imaging techniques provide essential tools for accurate evaluation of the structural and functional changes of blood vessels down to capillaries level,which can o®er valuable insight on understanding the development of DM-associated complications and design of targeted therapy.This review will brie°y introduce the DM-induced structural and functional alterations of vasculature within di®erent organs such as skin,cerebrum and kidneys,as well as how novel optical imaging techniques facilitate the studies focusing on exploration of these pathological changes of vasculature caused by DM both in-vivo and ex-vivo.
文摘Following Kasai portoenterostomy for biliary atresia(BA),long-term survival in children is associated with chronic liver cirrhosis leading to hepatopulmonary syndrome(HPS)and portopulmonary hypertension(Po PH).This further causes a diverse array of respiratory and circulatory symptoms.The incidence of these complications in children with BA is higher than that seen in other chronic liver diseases.With a faster progression,BA is life-threatening in some severe cases.Moreover,HPS and Po PH may coexist in the same child.Enhancing our understanding of HPS/Po PH,making an early diagnosis,rational selection of medication,and appropriate timing of liver transplantation underscore the need for multidisciplinary collaboration.
基金This study was funded by grants from National Natural Science Foundation of China(No.81901853)to FYAdditional support was supported by Specially Funded scientific research project of the Fourth Affiliated Hospital of Harbin Medical University(No.HYDSYTB202126)to DWY.
文摘Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from im-paired insulin secretion or insulin resistance.Diabetes poses a major global health concern,because of its increasing prevalence and substantial morbidity and mortality.This review explores the relationships between altered fatty acid metabolism and microcirculatory impairments in diabetes.Dysregulation of fatty acid metabolism in diabetes leads to changes in fatty acid profiles,abnormal lipid accumulation,and increased oxidative stress.These changes contribute to microvascular dysfunction through mechanisms such as endothelial dysfunction,impaired nitric oxide availability,inflammation,and oxidative damage.Understanding this intricate interplay is essential for identifying novel thera-peutic strategies to alleviate vascular complications in diabetes.By targeting specific pathways involved in fatty acid metabolism and microvascular dysfunction,interventions can be developed to improve patient outcomes.This review is aimed at contributing to future research and the development of effective strategies for preventing and managing dia-betes-associated microcirculatory impairments,to ultimately enhance the quality of life for people living with diabetes.
文摘Objective: to judge the possible peripheral vascular complications of patients in the process of treatment and complete nursing intervention. Methods: the patients in the control group received routine nursing, and the patients in the observation group received complication nursing. Results: the complications, nursing satisfaction and quality of life in the observation group were better than those in the observation group (P < 0.05). Conclusion: based on the diagnosis and treatment of patients with femoral artery intervention, with the help of complication nursing, the complications of patients can be reduced, and then the satisfaction and quality of life can be improved.
