Diabetes mellitus is a substantial global health threat due to its high prevalence and its serious complications.The hyperglycemic state causes damage to vascular endothelial cells and disturbance of lipid metabolism,...Diabetes mellitus is a substantial global health threat due to its high prevalence and its serious complications.The hyperglycemic state causes damage to vascular endothelial cells and disturbance of lipid metabolism,thus contributing to the development of vascular disorders,especially atherosclerotic diseases.Aggressive glycemic control combined with vascular intervention is critical to the prevention and treatment of diabetes-associated atherosclerosis.It is suggested that metformin should be combined with hypoglycemic agents with proven vascular benefits for treating type 2 diabetes(T2DM)complicated with atherosclerotic diseases.Clinical studies indicates that the preferred combination is metformin with either glucagon-like peptide-1 receptor agonist or sodium/glucose cotransporter-2 inhibitor,which could offer additional vascular benefits and reduce the risk of atherosclerotic complications.Likewise,combination therapy with metformin and hypolipidemic agents has also shown additive effects on glucose control and lipid-lowering in patients with both diabetes and dyslipidemia,whereas extensive clinical trials using atherosclerotic-associated outcomes are required to support the vascular benefits.Moreover,co-administration of metformin with systemic antioxidant or anti-inflammatory therapy may also provide additional vascular benefits as indicated by several animal studies.For instance,a recent study found that additional supplementation of cholecalciferol and taurine enhanced metformin efficacy in controlling diabetes while reducing the risk of associated atherosclerotic complications.However,these potential benefits remain need validation by the evidence from clinical studies.Despite the limitations,such as heterogeneity across different patient populations,and deficiency in long-term outcomes,such efforts can contribute to finding optimal drug combinations to improve the management of T2DM and reduce its atherosclerotic complications.展开更多
Recent clinical trials have demonstrated a protective effect in using traditional Chinese medicine Tongxinluo(TXL)capsule to treat atherosclerosis.However,clinical evidence of the effects of TXL treatment on coronary ...Recent clinical trials have demonstrated a protective effect in using traditional Chinese medicine Tongxinluo(TXL)capsule to treat atherosclerosis.However,clinical evidence of the effects of TXL treatment on coronary plaque vulnerability is unavailable.In response,we developed this study to investigate the hypothesis that on the basis of statin therapy,treatment with TXL capsule may stabilize coronary lesions in patients with acute coronary syndrome(ACS).The TXL-CAP study was an investigator-initiated,randomized,double-blind clinical trial conducted across 18 medical centers in China.Patients with ACS aging from 18 to 80 years old who had a non-intervened coronary target lesion with a fibrous cap thickness(FCT)<100μm and lipid arc>90°as defined by optical coherence tomography(OCT)were recruited.A total of 220 patients who met the selection criteria but did not meet the exclusion criteria will be finally recruited and randomized to receive treatment with TXL(n=110)or placebo(n=110)for a duration of 12 months.The primary endpoint was the difference in the minimum FCT of the coronary target lesion between TXL and placebo groups at the end of the 12-month follow-up.Secondary endpoints included:(1)changes of the maximum lipid arc and length of the target plaque,and the percentage of lipid,fibrous,and calcified plaques at the end of the12-month period;(2)the incidence of composite cardiovascular events and coronary revascularization within the 12 months;(3)changes in the grade and scores of the angina pectoris as assessed using the Canadian Cardiovascular Society(CCS)grading system and Seattle angina questionnaire(SAQ)score,respectively;and(4)changes in hs-CRP serum levels.The results of the TXLCAP trial will provide additional clinical data for revealing whether TXL capsules stabilizes coronary vulnerable plaques in Chinese ACS patients.展开更多
BACKGROUND Lower limb atherosclerotic occlusive disease(LAOD)is a common complication in diabetic patients,leading to significant symptoms and reduced quality of life.AIM To investigate the efficacy of autologous plat...BACKGROUND Lower limb atherosclerotic occlusive disease(LAOD)is a common complication in diabetic patients,leading to significant symptoms and reduced quality of life.AIM To investigate the efficacy of autologous platelet-rich gel(APRG)as an innovative treatment for LAOD,focusing on clinical outcomes such as symptom relief,flow values,ankle-brachial index(ABI),walking distance,and claudication severity.METHODS This retrospective study involved an analysis of electronic medical records(EMR)from 150 patients diagnosed with LAOD.Participants were assigned to either a treatment group(n=80)or a control group(n=70).Both groups received standard care and underwent dressing changes.In addition,the treatment group was given APRG.Primary outcomes included changes in pain levels,wound healing rates,flow values assessed by plethysmography,ABI measurements,walking distance,and claudication severity.Statistical analyses were conducted to determine the significance of the results.RESULTS The APRG group showed significant improvements after 12 weeks,including a 70%reduction in pain,a 65%increase in wound healing rates,and an average walking distance increase of 150 meters.Flow values improved by 20%,with significant enhancements in ABI measurements(P<0.01).Additionally,patient satisfaction was higher,and 60%of patients reported improved claudication severity,confirming the efficacy of APRG in enhancing clinical outcomes for lower LAOD.CONCLUSION The APRG demonstrates significant efficacy in managing LAOD in diabetic patients,improving key clinical parameters including flow values,ABI,walking distance,and claudication.These findings support the need for further prospective studies to validate long-term efficacy and optimize treatment strategies.展开更多
OBJECTIVE: To investigate the underlying protein molecular mechanisms of "Qi stagnation and blood stasis syndrome"(QS) and "Qi deficiency and blood stasis syndrome"(QD), as two subtypes of coronary...OBJECTIVE: To investigate the underlying protein molecular mechanisms of "Qi stagnation and blood stasis syndrome"(QS) and "Qi deficiency and blood stasis syndrome"(QD), as two subtypes of coronary artery disease(CAD) in Traditional Chinese Medicine(TCM),following percutaneous coronary intervention(PCI).METHODS: In this study, a total of 227 CAD patients with QS and 211 CAD patients with QD were enrolled;all participants underwent PCI. Label-free quantification proteomics were employed to analyze the changes in serum in two subtypes of CAD patients before and 6 months after PCI, aiming to elucidate the intervention mechanism of PCI in treating CAD characterized by two different TCM syndromes.RESULTS: Biochemical analysis revealed significant changes in tumor necrosis factor-α, high density lipoprotein cholesterol, blood stasis clinical symptoms observation, and Gensini levels in both patient groups post-PCI;Proteomic analysis identified 79 and 95 differentially expressed proteins in the QS and QD patient groups, respectively, compared to their control groups.complement C8 alpha chain, complement factor H,apolipoprotein H, apolipoprotein B, plasminogen,carbonic anhydrase 2, and complement factor Ⅰ were altered in both comparison groups. Furthermore,enrichment analysis demonstrated that cell adhesion and connectivity-related processes underwent changes in QS patients post-PCI, whereas lipid metabolism-related pathways, including the peroxisome proliferator-activated receptor signaling pathway and extracellular matrix receptor interaction, underwent changes in the QD group.The protein-protein interaction network analysis further enriched 52 node proteins, including apolipoprotein B,lipoprotein(a), complement C5, apolipoprotein A4,complement C8 alpha chain, complement C8 beta chain,complement C8 gamma chain, apolipoprotein H,apolipoprotein A-Ⅱ, albumin, complement C4-B,apolipoprotein C3, among others. The functional network of these proteins is posited to contribute to the pathophysiology of CAD characterized by TCM syndromes.CONCLUSION: The current quantitative proteomic study has preliminarily identified biomarkers of CAD in different TCM subtypes treated with PCI, potentially laying the groundwork for understanding the protein profiles associated with the treatment of various TCM subtypes of CAD.展开更多
This study aimed to comprehensively evaluate non-contrast computed tomography(CT)-based radiomics for predicting early outcomes in patients with severe atherosclerotic renal artery stenosis(ARAS)after percutaneous tra...This study aimed to comprehensively evaluate non-contrast computed tomography(CT)-based radiomics for predicting early outcomes in patients with severe atherosclerotic renal artery stenosis(ARAS)after percutaneous transluminal renal angioplasty(PTRA).A total of 52 patients were retrospectively recruited,and their clinical characteristics and pretreatment CT images were collected.During a median follow-up period of 3.7 mo,18 patients were confirmed to have benefited from the treatment,defined as a 20%improvement from baseline in the estimated glomerular filtration rate.A deep learning network trained via self-supervised learning was used to enhance the imaging phenotype characteristics.Radiomics features,comprising 116 handcrafted features and 78 deep learning features,were extracted from the affected renal and perirenal adipose regions.More features from the latter were correlated with early outcomes,as determined by univariate analysis,and were visually represented in radiomics heatmaps and volcano plots.After using consensus clustering and the least absolute shrinkage and selection operator method for feature selection,five machine learning models were evaluated.Logistic regression yielded the highest leave-one-out cross-validation accuracy of 0.780(95%CI:0.660-0.880)for the renal signature,while the support vector machine achieved 0.865(95%CI:0.769-0.942)for the perirenal adipose signature.SHapley Additive exPlanations was used to visually interpret the prediction mechanism,and a histogram feature and a deep learning feature were identified as the most influential factors for the renal signature and perirenal adipose signature,respectively.Multivariate analysis revealed that both signatures served as independent predictive factors.When combined,they achieved an area under the receiver operating characteristic curve of 0.888(95%CI:0.784-0.992),indicating that the imaging phenotypes from both regions complemented each other.In conclusion,non-contrast CT-based radiomics can be leveraged to predict the early outcomes of PTRA,thereby assisting in identifying patients with ARAS suitable for this treatment,with perirenal adipose tissue providing added predictive value.展开更多
This article explores the foundational research,Chinese medicine theories,and clinical applications of the“heart adjusting acupuncture method”developed by Professor Guanhu Yang to prevent and treat athero-sclerotic ...This article explores the foundational research,Chinese medicine theories,and clinical applications of the“heart adjusting acupuncture method”developed by Professor Guanhu Yang to prevent and treat athero-sclerotic cardiovascular disease(ASCVD).Professor Yang established this method based on experimental studies involving electroacupuncture along the horizontal umbilical line,which demonstrated a reduction in infarct area in the myocardial infarction mice model.This method was formulated using acupoints on the horizontal umbilical line:Daimai(GB 26),Tianshu(ST 25),and Daheng(SP 15).Clinical application has shown that it could effectively improve cardiac function and manage various cardiovascular conditions and proposed a new hypothesis for the treatment of myocardial infarction.Further research is required to determine if electroacupuncture stimulation at the site of myocardial infarction or during transportation can extend the critical treatment window,preserve myocardial tissue,and enhance reperfusion therapy prognosis.Professor Yang advocates that,when combined with active Western medicine treatments,the“heart adjusting acupuncture method”offers an effective measure to prevent and treat ASCVD.展开更多
Intracranial atherosclerotic disease(ICAD)manifests systemic atherosclerosis in the intra-cranial arterial bed.It is the most common risk factor for ischemic stroke in Chinese population,with symptomatic ICAD(sICAD)pa...Intracranial atherosclerotic disease(ICAD)manifests systemic atherosclerosis in the intra-cranial arterial bed.It is the most common risk factor for ischemic stroke in Chinese population,with symptomatic ICAD(sICAD)patients at higher stroke risk.Continuous cerebral hypoperfusion and hemodynamic decompensa-tion caused by arterial stenosis or occlusion are the main pathological mechanisms for stroke recurrence and cog-nitive impairment in sICAD patients.Despite receiving reinforced medical therapy,about 10%of sICAD patients still suffer stroke recurrence.Blood flow reconstruction techniques are not yet established as routine stroke pre-vention for sICAD due to complex perioperative com-plications.Limb remote ischemic conditioning(LRIC)can effectively reduce the incidence of ischemic stroke,and composite cerebrovascular diseases,and improve ce-rebral perfusion,brain metabolism,and cerebrovascular reserve(CVR)in sICAD patients,serving as a novel ther-apeutic strategy.However,the protective mechanisms of LRIC and the optimal treatment regimen for sICAD still require further exploration.Exploring imaging biomark-ers with high sensitivity and specificity for diagnosis is of great significance in evaluating and predicting stroke risk in sICAD patients.展开更多
BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening ...BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening for unstable plaque. The emergence of superb micro-vascular imaging(SMI) offers the possibility of clinically screening for unstable plaque AIM To investigate the value of SMI in predicting ischemic stroke in patients with carotid atherosclerotic plaques.METHODS Patients with carotid atherosclerotic plaques(luminal stenosis of 50%-70%) were enrolled into the present study. All patients received conservative medication.The patient's clinical baseline data, serological data, CEUS and SMI data were analyzed. All patients underwent a 3-year follow-up. The follow-up endpoint was the occurrence of ischemic stroke and patients were divided into stroke group and non-stroke group according to whether the prognosis occurred or not.Subsequently, the difference in clinical data was compared, the correlation of SMI and CEUS was analyzed, and multiple Cox regression and receiver operating characteristic curve were applied to investigate the value of SMI and CEUS in predicting cerebral arterial thrombosis in three years.RESULTS In this study, 43 patients were enrolled in the stroke group and 82 patients were enrolled in the non-stroke group. Cox regression revealed that SMI level(P =0.013) and enhancement intensity(P = 0.032) were the independent factors influencing ischemic stroke. There was a positive correlation between SMI level and enhancement intensity(r = 0.737, P = 0.000). The area under curve of SMI level predicting ischemic stroke was 0.878. The best diagnostic point was ≥ level Ⅱ, and its sensitivity and specificity was 86.05% and 79.27%. The area under curve of enhancement intensity predicting ischemic stroke was 0.890. The best diagnostic point was 9.92 db, and its sensitivity and specificity was 88.37% and89.02%. As the SMI level gradually increased, the incidence of ischemic stroke increased gradually(X^2 = 108.931, P = 0.000).CONCLUSION SMI can be used as a non-invasive method of screening for unstable plaques and may help prevent ischemic stroke.展开更多
Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns...Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns of microstructural damage associated with vascular cognitive impairment in the two diseases. The study recruited 34 patients with moyamoya disease(age 43.9 ± 9.2 years; 20 men and 14 women, 27 patients with cerebrovascular atherosclerotic disease(age: 44.6 ± 7.6 years; 17 men and 10 women), and 31 normal controls(age 43.6 ± 7.3 years; 18 men and 13 women) from Huashan Hospital of Fudan University in China. Cognitive function was assessed using the Mini-Mental State Examination, long-term delayed recall of Auditory Verbal Learning Test, Trail Making Test Part B, and the Symbol Digit Modalities Test. Single-photon emission-computed tomography was used to examine cerebral perfusion. Voxel-based morphometry and tract-based spatial statistics were performed to identify regions of gray matter atrophy and white matter deterioration in patients and normal controls. The results demonstrated that the severity of cognitive impairment was similar between the two diseases in all tested domains. Patients with moyamoya disease and those with cerebrovascular atherosclerotic disease suffered from disturbed supratentorial hemodynamics. Gray matter atrophy in bilateral middle cingulate cortex and parts of the frontal gyrus was prominent in both diseases, but in general, was more severe and more diffuse in those with moyamoya disease. White matter deterioration was significant for both diseases in the genu and body of corpus callosum, in the anterior and superior corona radiation, and in the posterior thalamic radiation, but in moyamoya disease, it was more diffuse and more severe. Vascular cognitive impairment was associated with regional microstructural damage, with a potential link between, gray and white matter damage. Overall, these results provide insight into the pathophysiological nature of vascular cognitive impairment. This study was approved by the Institutional Review Board in Huashan Hospital, China(approval No. 2014-278). This study was registered with ClinicalTrials.gov on December 2, 2014 with the identifier NCT02305407.展开更多
Atherosclerotic cardiovascular disease(ASCVD) is the deadliest disease in the world, with endothelial injury occurring throughout the course of the disease. Therefore, improvement in endothelial function is of essenti...Atherosclerotic cardiovascular disease(ASCVD) is the deadliest disease in the world, with endothelial injury occurring throughout the course of the disease. Therefore, improvement in endothelial function is of essential importance in the prevention of ASCVD. Red yeast rice(RYR), a healthy traditional Chinese food, has a lipid modulation function and also plays a vital role in the improvement of endothelial reactivity and cardiovascular protection; thus, it is significant in the prevention and treatment of ASCVD. This article reviews the molecular mechanisms of RYR and its related products in the improvement of endothelial function in terms of endothelial reactivity, anti-apoptosis of endothelial progenitor cells, oxidative stress alleviation and anti-inflammation.展开更多
Background Klotho proteins （α- and β） are membrane-based circulating proteins that regulate cell metabolism, as well as the lifespan modulating activity of Fibroblast Growth Factors （FGFs）. Recent data has shown...Background Klotho proteins （α- and β） are membrane-based circulating proteins that regulate cell metabolism, as well as the lifespan modulating activity of Fibroblast Growth Factors （FGFs）. Recent data has shown that higher plasma circulating Klotho levels reduce cardio- vascular risk, suggesting Klotho has a protective role in cardiovascular diseases. However, although so far it has been identified in various organs, it is unknown whether cardiomyocytes express Klotho and FGFs, and whether high cardiovascular risk could affect cardiac expres- sion ofKlotho, FGFs and other molecules. Methods We selected 20 patients with an estimated 10-year high atherosclerotic cardiovascular disease and 10 age-matched control subjects with an estimated 10-year low risk undergone cardiac surgery for reasons other than coronary artery by-pass. In myocardial biopsies, we evaluated by immuno-histochemistry whether Klotho and FGFs were expressed in cardiomyo- cytes, and whether higher cardiovascular risk influenced the expression of other molecules involved in endoplasmic reticulum stress, oxida- tive stress, inflammation and fibrosis. Results Only cardiomyocytes of patients with a higher cardiovascular risk showed lower expression of Klotho, but higher expressions of FGFs. Furthermore, higher cardiovascular risk was associated with increased expression of oxidative and endoplasmic reticular stress, inflammation and fibrosis. Conclusions This study showed for the first time that Klotho proteins are ex- pressed in human cardiomyocytes and that cardiac expression of Klotho is down-regulated in higher cardiovascular risk patients, while expression of stress-related molecules were significantly increased.展开更多
Objective To establish the distribution of 10-year atherosclerotic cardiovascular disease （ASCVD） risk among Chinese adults. Methods We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardi...Objective To establish the distribution of 10-year atherosclerotic cardiovascular disease （ASCVD） risk among Chinese adults. Methods We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardiology/ American Heart Association pooled cohort equations （PCEs） to the data obtained from the 2010 China Chronic Disease and Risk Factor Surveillance that involved 61,541 participants （representing 520,158,652 Chinese adults） aged 40-79 years. We also compared the ASCVD risk with the 10-year ischemic cardiovascular disease （ICVD） risk, which was calculated using the simplified scoring tables recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases （Chinese model）. Results Based on the PCEs, the average 10-year ASCVD risk among adults without self-reported stroke or myocardial infraction was 12.5%. Approximately 247 million （47.4%） and 107 million （20.6%） adults had 〉 7.5% and 〉 20% 10-year ASCVD risks, respectively. The 10-year ASCVD risk 〉 20% was higher among men, less educated individuals, smokers, drinkers, and physically inactive individuals than among their counterparts. Overall, 29.0% of adults categorized using the Chinese model were overclassified with the PCEs. Conclusion Our results define the distribution of 10-year ASCVD risk among Chinese adults. The 10-year ASCVD risk predicted by the PCEs was higher than the ICVD risk predicted by the Chinese model.展开更多
Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional a...Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography(CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score(FRS) and the 10-year atherosclerotic cardiovascular disease(ASCVD) risk score. Results Among the 549 participants, 267(48.6%) had no coronary plaques, 201(36.6%) had noncalcified coronary plaques, and 81(14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio(OR) 2.41; 95% confidence interval(CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score(OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment. Conclusion Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.展开更多
Atherosclerotic cardiovascular disease(ASCVD)frequently results in sudden death and poses a serious threat to public health worldwide.The drugs approved for the prevention and treatment of ASCVD are usually used in co...Atherosclerotic cardiovascular disease(ASCVD)frequently results in sudden death and poses a serious threat to public health worldwide.The drugs approved for the prevention and treatment of ASCVD are usually used in combination but are inefficient owing to their side effects and single therapeutic targets.Therefore,the use of natural products in developing drugs for the prevention and treatment of ASCVD has received great scholarly attention.Andrographolide(AG)is a diterpenoid lactone compound extracted from Andrographis paniculata.In addition to its use in conditions such as sore throat,AG can be used to prevent and treat ASCVD.It is different from drugs that are commonly used in the prevention and treatment of ASCVD and can not only treat obesity,diabetes,hyperlipidaemia and ASCVD but also inhibit the pathological process of atherosclerosis(AS)including lipid accumulation,inflammation,oxidative stress and cellular abnormalities by regulating various targets and pathways.However,the pharmacological mechanisms of AG underlying the prevention and treatment of ASCVD have not been corroborated,which may hinder its clinical development and application.Therefore,this review summarizes the physiological and pathological mechanisms underlying the development of ASCVD and the in vivo and in vitro pharmacological effects of AG on the relative risk factors of AS and ASCVD.The findings support the use of the old pharmacological compound(‘old bottle’)as a novel drug(‘novel wine’)for the prevention and treatment of ASCVD.Additionally,this review summarizes studies on the availability as well as pharmaceutical and pharmacokinetic properties of AG,aiming to provide more information regarding the clinical application and further research and development of AG.展开更多
Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomati...Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomatic ischemic stroke who were treated with balloon angioplasty and enterprise stents in Department of Neuro-interventional Radiology, The First Affiliated Hospital of Zhengzhou University from Jan. 2014 to Dec. 2017 were retrospectively enrolled in this study. Diagnostic criteria for complex intracranial atherosclerotic stenosis were as follows: 1) intracranial atherosclerotic stenosis was ≥70% confirmed by digital subtraction angiography(DSA) using the formulas described by the Warfarin Aspirin Symptomatic Intracranial Disease(WASID) method; 2) length of lesion was >10 mm. Basic characteristics of target lesions, technical success rate, perioperative safety, follow-up outcomes were investigated. Results: 20 patients were enrolled in this study, including 15 males and 5 females from 44 to 70 years old with an average age of 57.20 ± 9.25. 20 lesions were treated with 20 enterprise stents. The average preoperative and postoperative residual stenosis was reduced from(77.45 ± 8.44)% to(24.89 ± 16.61)%. The successful rate of operation was 100%. Among the perioperative complications, only 1 case(5%) experienced perforating branch event. The average clinical follow-up period was 13.15 ± 11.33 months(time range: 5–38). There were no ischemic events, no bleeding events and no various causes of death during the follow-up period. 8 lesions(40.0%) underwent DSA follow-up examinations and 12 lesions(60.0%) were checked by CT angiography during the follow-up period. 3 lesions(15.0%) developed ISR without any cerebral ischemia symptoms. Conclusion: This retrospective, single-center study suggests that enterprise stent is effective in the treatment of symptomatic complex intracranial atherosclerotic stenosis with less perioperative complications. Prospective, multicenter, randomized controlled trials are expected.展开更多
This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography....This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography. Fifty patients with carotid atherosclerotic plaques were enrolled and examined with contrast-enhanced ultrasonography. The correlation of contrast agent enhancement of the carotid atherosclerotic plaques and the clinical symptoms was analyzed. The results showed that among the 50 patients, plaques were enhanced in the 23 patients with obvious clinical symptoms. In 27 patients without apparent clinical symptoms, plaques were enhanced sparsely in 15 patients and not enhanced in 12 patients. It was suggested that contrast-enhanced ultrasonography could be used for the examination of the microcirculation in carotid atherosclerotic plaques on real-time basis and serve as a new noninvasive approach for the assessment of stability of carotid atherosclerotic plaques.展开更多
OBJECTIVE: To investigate the efficacy and mechanism of the Qingre Huayu Fang(清热化瘀方) on atherosclerotic vulnerable plaque in apolipoprotein E(Apo E) knockout mice through the ubiquitin proteasome pathway.METHODS:...OBJECTIVE: To investigate the efficacy and mechanism of the Qingre Huayu Fang(清热化瘀方) on atherosclerotic vulnerable plaque in apolipoprotein E(Apo E) knockout mice through the ubiquitin proteasome pathway.METHODS: Sixty 8-week-old C57BL/6J Apo E knockout mice were fed a high-fat for 12 weeks and randomly divided into four treatment groups(n = 15 each): high-fat control, bortezomib(a proteasome inhibitor), bortezomib combined with Qingre Huayu Fang, and Qingre Huayu Fang alone. Aortic sections were examined for plaque development, inflammatory cell infiltration, type Ⅰ/Ⅲ collagen expression and immunohistochemical staining of CD40L, nuclear factor-kappa B(NF-κB)/P65 and ubiquitin.RESULTS: Mice in the high-fat control group had obvious atherosclerosis, with increased aortic plaque area. The degree of atherosclerosis of the atherosclerotic plaque was reduced in all of the treatment groups that received bortezomib and/or Duzhong(Cortex Eucommiae) Qingre Huayu. The expression of NF-?B, CD40L and ubiquitin were all reduced in the group that received combination bortezomib + Qingre Huayu Fang.CONCLUSION: The Qingre Huayu Fang inhibited aortic atherosclerosis in mice through a mechanism that may involve inhibition of the ubiquitin proteasome pathway.展开更多
Objective: To explore the frequency and significance of ApoE gene polymorphisms in Chinese patients with atherosclerotic cerebral infarction (ACI). Methods: Polymerase chain reaction and gene sequencing, single nucleo...Objective: To explore the frequency and significance of ApoE gene polymorphisms in Chinese patients with atherosclerotic cerebral infarction (ACI). Methods: Polymerase chain reaction and gene sequencing, single nucleotide polymorphisms of ApoE gene were used to analyze 33 cases of patients with ACI and 35 controls. Results: The frequencies of ApoE gene single nucleotide polymorphisms 465C/G, 462C/G and 451delC in the ACI group were significantly higher than those in the control group (P<0.05). The prevalence of polymorphism 486G/T in the control group was significantly higher than that in the ACI group ( P = 0.011) . Conclusions: 465C/G,462C/G and 451delC polymorphisms might be associated with ACI.486GT allele might have protective effect on the pathogenesis of ACI.展开更多
The potential of ^99mTc labeled P^1, P^4-di （adenosine-5 ＇ ）-tetraphosphate （Ap4A） for imaging experimental atherosclerotic plaques was evaluated in New Zealand white （NZW） rabbits. To label the ^99mTc to Ap4A,...The potential of ^99mTc labeled P^1, P^4-di （adenosine-5 ＇ ）-tetraphosphate （Ap4A） for imaging experimental atherosclerotic plaques was evaluated in New Zealand white （NZW） rabbits. To label the ^99mTc to Ap4A, stannous tartrate solution was used. ^99mTc-Ap4A was purified on a Sephadex G-25 column. The radiochemistry purities of ^99mTc-Ap4A were 85% to 91%. Biodistribution study revealed ^99mTc-Ap4A cleared from blood rapidly. Thirty min after ^99mTc-Ap4A administrated on NZW atherosclerotic rabbits, lesion to blood （target/blood, T/B） ratio was 3. 17 ±1.27, and lesions to normal （target/non-target, T/NT） ratio was 5.23 ±1.87. Shadows of atherosclerotic plaques were clearly visible on radioautographic film. Aortas with atherosclerotic plaques also could be seen on ex vivo gamma camera images. Atherosclerotic abdominal aortas were clearly visible on in vivo images 15 min to 3 h after ^99mTc-Ap4A administration. ^99mTc-labeled Ap4A can be used for rapid noninvasive detection of experimental atherosclerotic plaque.展开更多
BACKGROUND Coronary artery disease(CAD)is one of the leading causes of death and disease burden in China and worldwide.A practical and reliable prediction scoring system for CAD risk and severity evaluation is urgentl...BACKGROUND Coronary artery disease(CAD)is one of the leading causes of death and disease burden in China and worldwide.A practical and reliable prediction scoring system for CAD risk and severity evaluation is urgently needed for primary prevention.AIM To examine whether the prediction for atherosclerotic cardiovascular disease risk in China(China-PAR)scoring system could be used for this purpose.METHODS A total of 6813 consecutive patients who underwent diagnostic coronary angiography were enrolled.The China-PAR score was calculated for each patient and CAD severity was assessed by the Gensini score(GS).RESULTS Correlation analysis demonstrated a significant relationship between China-PAR and GS(r=0.266,P<0.001).In receiver operating characteristic curve analysis,the cut-off values of China-PAR for predicting the presence and the severity of CAD were 7.55%with a sensitivity of 55.8%and specificity of 71.8%[area under the curve(AUC)=0.693,95%confidence interval:0.681 to 0.706,P<0.001],and 7.45%with a sensitivity of 58.8%and specificity of 67.2%(AUC=0.680,95%confidence interval:0.665 to 0.694,P<0.001),respectively.CONCLUSION The China-PAR scoring system may be useful in predicting the presence and severity of CAD.展开更多
基金Supported by the Natural Science Research Project of Anhui Province,No.2023AH053172National Natural Science Foundation of Anhui Province,No.2408085QH260+1 种基金Projects of Administration of Traditional Chinese Medicine of Anhui Province,No.2024CCCX082National Natural Science Foundation Incubation Program of The Second Hospital of Anhui Medical University,No.2022GMFY08.
文摘Diabetes mellitus is a substantial global health threat due to its high prevalence and its serious complications.The hyperglycemic state causes damage to vascular endothelial cells and disturbance of lipid metabolism,thus contributing to the development of vascular disorders,especially atherosclerotic diseases.Aggressive glycemic control combined with vascular intervention is critical to the prevention and treatment of diabetes-associated atherosclerosis.It is suggested that metformin should be combined with hypoglycemic agents with proven vascular benefits for treating type 2 diabetes(T2DM)complicated with atherosclerotic diseases.Clinical studies indicates that the preferred combination is metformin with either glucagon-like peptide-1 receptor agonist or sodium/glucose cotransporter-2 inhibitor,which could offer additional vascular benefits and reduce the risk of atherosclerotic complications.Likewise,combination therapy with metformin and hypolipidemic agents has also shown additive effects on glucose control and lipid-lowering in patients with both diabetes and dyslipidemia,whereas extensive clinical trials using atherosclerotic-associated outcomes are required to support the vascular benefits.Moreover,co-administration of metformin with systemic antioxidant or anti-inflammatory therapy may also provide additional vascular benefits as indicated by several animal studies.For instance,a recent study found that additional supplementation of cholecalciferol and taurine enhanced metformin efficacy in controlling diabetes while reducing the risk of associated atherosclerotic complications.However,these potential benefits remain need validation by the evidence from clinical studies.Despite the limitations,such as heterogeneity across different patient populations,and deficiency in long-term outcomes,such efforts can contribute to finding optimal drug combinations to improve the management of T2DM and reduce its atherosclerotic complications.
基金National Key Research and Development Program of China(2017YFC1700502)Ministry of Science and Technology of China。
文摘Recent clinical trials have demonstrated a protective effect in using traditional Chinese medicine Tongxinluo(TXL)capsule to treat atherosclerosis.However,clinical evidence of the effects of TXL treatment on coronary plaque vulnerability is unavailable.In response,we developed this study to investigate the hypothesis that on the basis of statin therapy,treatment with TXL capsule may stabilize coronary lesions in patients with acute coronary syndrome(ACS).The TXL-CAP study was an investigator-initiated,randomized,double-blind clinical trial conducted across 18 medical centers in China.Patients with ACS aging from 18 to 80 years old who had a non-intervened coronary target lesion with a fibrous cap thickness(FCT)<100μm and lipid arc>90°as defined by optical coherence tomography(OCT)were recruited.A total of 220 patients who met the selection criteria but did not meet the exclusion criteria will be finally recruited and randomized to receive treatment with TXL(n=110)or placebo(n=110)for a duration of 12 months.The primary endpoint was the difference in the minimum FCT of the coronary target lesion between TXL and placebo groups at the end of the 12-month follow-up.Secondary endpoints included:(1)changes of the maximum lipid arc and length of the target plaque,and the percentage of lipid,fibrous,and calcified plaques at the end of the12-month period;(2)the incidence of composite cardiovascular events and coronary revascularization within the 12 months;(3)changes in the grade and scores of the angina pectoris as assessed using the Canadian Cardiovascular Society(CCS)grading system and Seattle angina questionnaire(SAQ)score,respectively;and(4)changes in hs-CRP serum levels.The results of the TXLCAP trial will provide additional clinical data for revealing whether TXL capsules stabilizes coronary vulnerable plaques in Chinese ACS patients.
文摘BACKGROUND Lower limb atherosclerotic occlusive disease(LAOD)is a common complication in diabetic patients,leading to significant symptoms and reduced quality of life.AIM To investigate the efficacy of autologous platelet-rich gel(APRG)as an innovative treatment for LAOD,focusing on clinical outcomes such as symptom relief,flow values,ankle-brachial index(ABI),walking distance,and claudication severity.METHODS This retrospective study involved an analysis of electronic medical records(EMR)from 150 patients diagnosed with LAOD.Participants were assigned to either a treatment group(n=80)or a control group(n=70).Both groups received standard care and underwent dressing changes.In addition,the treatment group was given APRG.Primary outcomes included changes in pain levels,wound healing rates,flow values assessed by plethysmography,ABI measurements,walking distance,and claudication severity.Statistical analyses were conducted to determine the significance of the results.RESULTS The APRG group showed significant improvements after 12 weeks,including a 70%reduction in pain,a 65%increase in wound healing rates,and an average walking distance increase of 150 meters.Flow values improved by 20%,with significant enhancements in ABI measurements(P<0.01).Additionally,patient satisfaction was higher,and 60%of patients reported improved claudication severity,confirming the efficacy of APRG in enhancing clinical outcomes for lower LAOD.CONCLUSION The APRG demonstrates significant efficacy in managing LAOD in diabetic patients,improving key clinical parameters including flow values,ABI,walking distance,and claudication.These findings support the need for further prospective studies to validate long-term efficacy and optimize treatment strategies.
基金National Natural Science Foundation of China:Biological Mechanism of Platelet System in the Occurrence and Evolution of Blood Stasis Syndrome (No. 82030124)。
文摘OBJECTIVE: To investigate the underlying protein molecular mechanisms of "Qi stagnation and blood stasis syndrome"(QS) and "Qi deficiency and blood stasis syndrome"(QD), as two subtypes of coronary artery disease(CAD) in Traditional Chinese Medicine(TCM),following percutaneous coronary intervention(PCI).METHODS: In this study, a total of 227 CAD patients with QS and 211 CAD patients with QD were enrolled;all participants underwent PCI. Label-free quantification proteomics were employed to analyze the changes in serum in two subtypes of CAD patients before and 6 months after PCI, aiming to elucidate the intervention mechanism of PCI in treating CAD characterized by two different TCM syndromes.RESULTS: Biochemical analysis revealed significant changes in tumor necrosis factor-α, high density lipoprotein cholesterol, blood stasis clinical symptoms observation, and Gensini levels in both patient groups post-PCI;Proteomic analysis identified 79 and 95 differentially expressed proteins in the QS and QD patient groups, respectively, compared to their control groups.complement C8 alpha chain, complement factor H,apolipoprotein H, apolipoprotein B, plasminogen,carbonic anhydrase 2, and complement factor Ⅰ were altered in both comparison groups. Furthermore,enrichment analysis demonstrated that cell adhesion and connectivity-related processes underwent changes in QS patients post-PCI, whereas lipid metabolism-related pathways, including the peroxisome proliferator-activated receptor signaling pathway and extracellular matrix receptor interaction, underwent changes in the QD group.The protein-protein interaction network analysis further enriched 52 node proteins, including apolipoprotein B,lipoprotein(a), complement C5, apolipoprotein A4,complement C8 alpha chain, complement C8 beta chain,complement C8 gamma chain, apolipoprotein H,apolipoprotein A-Ⅱ, albumin, complement C4-B,apolipoprotein C3, among others. The functional network of these proteins is posited to contribute to the pathophysiology of CAD characterized by TCM syndromes.CONCLUSION: The current quantitative proteomic study has preliminarily identified biomarkers of CAD in different TCM subtypes treated with PCI, potentially laying the groundwork for understanding the protein profiles associated with the treatment of various TCM subtypes of CAD.
基金supported by the National Natural Science Foundation of China,Nos.82022036,82372053,91959130,81971776,62027901,81930053,and 82302296the China Postdoctoral Science Foundation,No.2022M720357.
文摘This study aimed to comprehensively evaluate non-contrast computed tomography(CT)-based radiomics for predicting early outcomes in patients with severe atherosclerotic renal artery stenosis(ARAS)after percutaneous transluminal renal angioplasty(PTRA).A total of 52 patients were retrospectively recruited,and their clinical characteristics and pretreatment CT images were collected.During a median follow-up period of 3.7 mo,18 patients were confirmed to have benefited from the treatment,defined as a 20%improvement from baseline in the estimated glomerular filtration rate.A deep learning network trained via self-supervised learning was used to enhance the imaging phenotype characteristics.Radiomics features,comprising 116 handcrafted features and 78 deep learning features,were extracted from the affected renal and perirenal adipose regions.More features from the latter were correlated with early outcomes,as determined by univariate analysis,and were visually represented in radiomics heatmaps and volcano plots.After using consensus clustering and the least absolute shrinkage and selection operator method for feature selection,five machine learning models were evaluated.Logistic regression yielded the highest leave-one-out cross-validation accuracy of 0.780(95%CI:0.660-0.880)for the renal signature,while the support vector machine achieved 0.865(95%CI:0.769-0.942)for the perirenal adipose signature.SHapley Additive exPlanations was used to visually interpret the prediction mechanism,and a histogram feature and a deep learning feature were identified as the most influential factors for the renal signature and perirenal adipose signature,respectively.Multivariate analysis revealed that both signatures served as independent predictive factors.When combined,they achieved an area under the receiver operating characteristic curve of 0.888(95%CI:0.784-0.992),indicating that the imaging phenotypes from both regions complemented each other.In conclusion,non-contrast CT-based radiomics can be leveraged to predict the early outcomes of PTRA,thereby assisting in identifying patients with ARAS suitable for this treatment,with perirenal adipose tissue providing added predictive value.
基金supported by the Program of Introducing Talents of Discipline to Universities(111 Project)-TCM Prevention and Treatment of Major Chronic Diseases(Tumor-B21028).
文摘This article explores the foundational research,Chinese medicine theories,and clinical applications of the“heart adjusting acupuncture method”developed by Professor Guanhu Yang to prevent and treat athero-sclerotic cardiovascular disease(ASCVD).Professor Yang established this method based on experimental studies involving electroacupuncture along the horizontal umbilical line,which demonstrated a reduction in infarct area in the myocardial infarction mice model.This method was formulated using acupoints on the horizontal umbilical line:Daimai(GB 26),Tianshu(ST 25),and Daheng(SP 15).Clinical application has shown that it could effectively improve cardiac function and manage various cardiovascular conditions and proposed a new hypothesis for the treatment of myocardial infarction.Further research is required to determine if electroacupuncture stimulation at the site of myocardial infarction or during transportation can extend the critical treatment window,preserve myocardial tissue,and enhance reperfusion therapy prognosis.Professor Yang advocates that,when combined with active Western medicine treatments,the“heart adjusting acupuncture method”offers an effective measure to prevent and treat ASCVD.
文摘Intracranial atherosclerotic disease(ICAD)manifests systemic atherosclerosis in the intra-cranial arterial bed.It is the most common risk factor for ischemic stroke in Chinese population,with symptomatic ICAD(sICAD)patients at higher stroke risk.Continuous cerebral hypoperfusion and hemodynamic decompensa-tion caused by arterial stenosis or occlusion are the main pathological mechanisms for stroke recurrence and cog-nitive impairment in sICAD patients.Despite receiving reinforced medical therapy,about 10%of sICAD patients still suffer stroke recurrence.Blood flow reconstruction techniques are not yet established as routine stroke pre-vention for sICAD due to complex perioperative com-plications.Limb remote ischemic conditioning(LRIC)can effectively reduce the incidence of ischemic stroke,and composite cerebrovascular diseases,and improve ce-rebral perfusion,brain metabolism,and cerebrovascular reserve(CVR)in sICAD patients,serving as a novel ther-apeutic strategy.However,the protective mechanisms of LRIC and the optimal treatment regimen for sICAD still require further exploration.Exploring imaging biomark-ers with high sensitivity and specificity for diagnosis is of great significance in evaluating and predicting stroke risk in sICAD patients.
基金Supported by Shanghai Jiading District Health and Family Planning Commission Health Planning Commission Scientific Research Project,No.KYXM,2015-KY-02
文摘BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening for unstable plaque. The emergence of superb micro-vascular imaging(SMI) offers the possibility of clinically screening for unstable plaque AIM To investigate the value of SMI in predicting ischemic stroke in patients with carotid atherosclerotic plaques.METHODS Patients with carotid atherosclerotic plaques(luminal stenosis of 50%-70%) were enrolled into the present study. All patients received conservative medication.The patient's clinical baseline data, serological data, CEUS and SMI data were analyzed. All patients underwent a 3-year follow-up. The follow-up endpoint was the occurrence of ischemic stroke and patients were divided into stroke group and non-stroke group according to whether the prognosis occurred or not.Subsequently, the difference in clinical data was compared, the correlation of SMI and CEUS was analyzed, and multiple Cox regression and receiver operating characteristic curve were applied to investigate the value of SMI and CEUS in predicting cerebral arterial thrombosis in three years.RESULTS In this study, 43 patients were enrolled in the stroke group and 82 patients were enrolled in the non-stroke group. Cox regression revealed that SMI level(P =0.013) and enhancement intensity(P = 0.032) were the independent factors influencing ischemic stroke. There was a positive correlation between SMI level and enhancement intensity(r = 0.737, P = 0.000). The area under curve of SMI level predicting ischemic stroke was 0.878. The best diagnostic point was ≥ level Ⅱ, and its sensitivity and specificity was 86.05% and 79.27%. The area under curve of enhancement intensity predicting ischemic stroke was 0.890. The best diagnostic point was 9.92 db, and its sensitivity and specificity was 88.37% and89.02%. As the SMI level gradually increased, the incidence of ischemic stroke increased gradually(X^2 = 108.931, P = 0.000).CONCLUSION SMI can be used as a non-invasive method of screening for unstable plaques and may help prevent ischemic stroke.
基金supported by the National Natural Science Foundation of China,No.81771237(to YXG)the National Key Basic Research Program of China(973 Program),No.2014CB541604(to YXG)+1 种基金the "Shu Guang" Project of Shanghai Municipal Education Commission and Shanghai Education Development Foundation,China,No.16SG02(to LC)the Scientific Research Project of Huashan Hospital of Fudan University of China,No.2016QD082(to YL)
文摘Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns of microstructural damage associated with vascular cognitive impairment in the two diseases. The study recruited 34 patients with moyamoya disease(age 43.9 ± 9.2 years; 20 men and 14 women, 27 patients with cerebrovascular atherosclerotic disease(age: 44.6 ± 7.6 years; 17 men and 10 women), and 31 normal controls(age 43.6 ± 7.3 years; 18 men and 13 women) from Huashan Hospital of Fudan University in China. Cognitive function was assessed using the Mini-Mental State Examination, long-term delayed recall of Auditory Verbal Learning Test, Trail Making Test Part B, and the Symbol Digit Modalities Test. Single-photon emission-computed tomography was used to examine cerebral perfusion. Voxel-based morphometry and tract-based spatial statistics were performed to identify regions of gray matter atrophy and white matter deterioration in patients and normal controls. The results demonstrated that the severity of cognitive impairment was similar between the two diseases in all tested domains. Patients with moyamoya disease and those with cerebrovascular atherosclerotic disease suffered from disturbed supratentorial hemodynamics. Gray matter atrophy in bilateral middle cingulate cortex and parts of the frontal gyrus was prominent in both diseases, but in general, was more severe and more diffuse in those with moyamoya disease. White matter deterioration was significant for both diseases in the genu and body of corpus callosum, in the anterior and superior corona radiation, and in the posterior thalamic radiation, but in moyamoya disease, it was more diffuse and more severe. Vascular cognitive impairment was associated with regional microstructural damage, with a potential link between, gray and white matter damage. Overall, these results provide insight into the pathophysiological nature of vascular cognitive impairment. This study was approved by the Institutional Review Board in Huashan Hospital, China(approval No. 2014-278). This study was registered with ClinicalTrials.gov on December 2, 2014 with the identifier NCT02305407.
基金supported by Clinical Vascular Grant In Chinese Physicians-VG(No.2017-CCA-VG-016)the Basic and Clinical Research Cooperation Project of Capital Medical University(No.16JL42)the Presidential Foundation of Beijing Anzhen Hospital Affiliated with Capital Medical University(No.2016P01)
文摘Atherosclerotic cardiovascular disease(ASCVD) is the deadliest disease in the world, with endothelial injury occurring throughout the course of the disease. Therefore, improvement in endothelial function is of essential importance in the prevention of ASCVD. Red yeast rice(RYR), a healthy traditional Chinese food, has a lipid modulation function and also plays a vital role in the improvement of endothelial reactivity and cardiovascular protection; thus, it is significant in the prevention and treatment of ASCVD. This article reviews the molecular mechanisms of RYR and its related products in the improvement of endothelial function in terms of endothelial reactivity, anti-apoptosis of endothelial progenitor cells, oxidative stress alleviation and anti-inflammation.
文摘Background Klotho proteins （α- and β） are membrane-based circulating proteins that regulate cell metabolism, as well as the lifespan modulating activity of Fibroblast Growth Factors （FGFs）. Recent data has shown that higher plasma circulating Klotho levels reduce cardio- vascular risk, suggesting Klotho has a protective role in cardiovascular diseases. However, although so far it has been identified in various organs, it is unknown whether cardiomyocytes express Klotho and FGFs, and whether high cardiovascular risk could affect cardiac expres- sion ofKlotho, FGFs and other molecules. Methods We selected 20 patients with an estimated 10-year high atherosclerotic cardiovascular disease and 10 age-matched control subjects with an estimated 10-year low risk undergone cardiac surgery for reasons other than coronary artery by-pass. In myocardial biopsies, we evaluated by immuno-histochemistry whether Klotho and FGFs were expressed in cardiomyo- cytes, and whether higher cardiovascular risk influenced the expression of other molecules involved in endoplasmic reticulum stress, oxida- tive stress, inflammation and fibrosis. Results Only cardiomyocytes of patients with a higher cardiovascular risk showed lower expression of Klotho, but higher expressions of FGFs. Furthermore, higher cardiovascular risk was associated with increased expression of oxidative and endoplasmic reticular stress, inflammation and fibrosis. Conclusions This study showed for the first time that Klotho proteins are ex- pressed in human cardiomyocytes and that cardiac expression of Klotho is down-regulated in higher cardiovascular risk patients, while expression of stress-related molecules were significantly increased.
基金funded by the National Health and Family Planning Commission of the People’s Republic of China
文摘Objective To establish the distribution of 10-year atherosclerotic cardiovascular disease （ASCVD） risk among Chinese adults. Methods We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardiology/ American Heart Association pooled cohort equations （PCEs） to the data obtained from the 2010 China Chronic Disease and Risk Factor Surveillance that involved 61,541 participants （representing 520,158,652 Chinese adults） aged 40-79 years. We also compared the ASCVD risk with the 10-year ischemic cardiovascular disease （ICVD） risk, which was calculated using the simplified scoring tables recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases （Chinese model）. Results Based on the PCEs, the average 10-year ASCVD risk among adults without self-reported stroke or myocardial infraction was 12.5%. Approximately 247 million （47.4%） and 107 million （20.6%） adults had 〉 7.5% and 〉 20% 10-year ASCVD risks, respectively. The 10-year ASCVD risk 〉 20% was higher among men, less educated individuals, smokers, drinkers, and physically inactive individuals than among their counterparts. Overall, 29.0% of adults categorized using the Chinese model were overclassified with the PCEs. Conclusion Our results define the distribution of 10-year ASCVD risk among Chinese adults. The 10-year ASCVD risk predicted by the PCEs was higher than the ICVD risk predicted by the Chinese model.
基金supported by the grants from National Key R&D Program of China [2017YFC1310700,2016YFC1305600]the National Natural Science Foundation of China [81622011,81561128019]+2 种基金the Shanghai Municipal Commission of Health and Family Planning [15GWZK0802]the'Gaofeng Gaoyuan Program for Clinical Scientists'from Shanghai Jiao-Tong University School of Medicine [20161301,20161307]Dr.Yu Xu was supported by the'Outstanding Young Talent Program'from Shanghai Municipal Government
文摘Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography(CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score(FRS) and the 10-year atherosclerotic cardiovascular disease(ASCVD) risk score. Results Among the 549 participants, 267(48.6%) had no coronary plaques, 201(36.6%) had noncalcified coronary plaques, and 81(14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio(OR) 2.41; 95% confidence interval(CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score(OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment. Conclusion Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.
基金This research was funded by the National Natural Science Foundation of China(Grant Nos.:81891012 and U19A2010)the National Interdisciplinary Innovation TeamProgram of Traditional Chinese Medicine(Grant No.:ZYYCXTD-D-202209)+1 种基金Chinese Medicine Science and Technology Industry Innovation Team Program of Sichuan Province(Grant No.:2022C001)Chengdu University of Traditional Chinese Medicine“Xinglin Scholars”Discipline Talent Research Promotion Program(Grant No.:XCZX2022010).
文摘Atherosclerotic cardiovascular disease(ASCVD)frequently results in sudden death and poses a serious threat to public health worldwide.The drugs approved for the prevention and treatment of ASCVD are usually used in combination but are inefficient owing to their side effects and single therapeutic targets.Therefore,the use of natural products in developing drugs for the prevention and treatment of ASCVD has received great scholarly attention.Andrographolide(AG)is a diterpenoid lactone compound extracted from Andrographis paniculata.In addition to its use in conditions such as sore throat,AG can be used to prevent and treat ASCVD.It is different from drugs that are commonly used in the prevention and treatment of ASCVD and can not only treat obesity,diabetes,hyperlipidaemia and ASCVD but also inhibit the pathological process of atherosclerosis(AS)including lipid accumulation,inflammation,oxidative stress and cellular abnormalities by regulating various targets and pathways.However,the pharmacological mechanisms of AG underlying the prevention and treatment of ASCVD have not been corroborated,which may hinder its clinical development and application.Therefore,this review summarizes the physiological and pathological mechanisms underlying the development of ASCVD and the in vivo and in vitro pharmacological effects of AG on the relative risk factors of AS and ASCVD.The findings support the use of the old pharmacological compound(‘old bottle’)as a novel drug(‘novel wine’)for the prevention and treatment of ASCVD.Additionally,this review summarizes studies on the availability as well as pharmaceutical and pharmacokinetic properties of AG,aiming to provide more information regarding the clinical application and further research and development of AG.
文摘Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomatic ischemic stroke who were treated with balloon angioplasty and enterprise stents in Department of Neuro-interventional Radiology, The First Affiliated Hospital of Zhengzhou University from Jan. 2014 to Dec. 2017 were retrospectively enrolled in this study. Diagnostic criteria for complex intracranial atherosclerotic stenosis were as follows: 1) intracranial atherosclerotic stenosis was ≥70% confirmed by digital subtraction angiography(DSA) using the formulas described by the Warfarin Aspirin Symptomatic Intracranial Disease(WASID) method; 2) length of lesion was >10 mm. Basic characteristics of target lesions, technical success rate, perioperative safety, follow-up outcomes were investigated. Results: 20 patients were enrolled in this study, including 15 males and 5 females from 44 to 70 years old with an average age of 57.20 ± 9.25. 20 lesions were treated with 20 enterprise stents. The average preoperative and postoperative residual stenosis was reduced from(77.45 ± 8.44)% to(24.89 ± 16.61)%. The successful rate of operation was 100%. Among the perioperative complications, only 1 case(5%) experienced perforating branch event. The average clinical follow-up period was 13.15 ± 11.33 months(time range: 5–38). There were no ischemic events, no bleeding events and no various causes of death during the follow-up period. 8 lesions(40.0%) underwent DSA follow-up examinations and 12 lesions(60.0%) were checked by CT angiography during the follow-up period. 3 lesions(15.0%) developed ISR without any cerebral ischemia symptoms. Conclusion: This retrospective, single-center study suggests that enterprise stent is effective in the treatment of symptomatic complex intracranial atherosclerotic stenosis with less perioperative complications. Prospective, multicenter, randomized controlled trials are expected.
文摘This study was aimed to evaluate the relationship between carotid atherosclerotic plaque stability and the clinical symptoms in patients with carotid atherosclerotic plaques by using contrast-enhanced ultrasonography. Fifty patients with carotid atherosclerotic plaques were enrolled and examined with contrast-enhanced ultrasonography. The correlation of contrast agent enhancement of the carotid atherosclerotic plaques and the clinical symptoms was analyzed. The results showed that among the 50 patients, plaques were enhanced in the 23 patients with obvious clinical symptoms. In 27 patients without apparent clinical symptoms, plaques were enhanced sparsely in 15 patients and not enhanced in 12 patients. It was suggested that contrast-enhanced ultrasonography could be used for the examination of the microcirculation in carotid atherosclerotic plaques on real-time basis and serve as a new noninvasive approach for the assessment of stability of carotid atherosclerotic plaques.
基金Supported by Guizhou Basic Research Project (Study on the Effect of Eucommia ulmoides Extract through Nuclear Factor NF-κB Molecular Pathway to Interfere with Atherosclerosis, Qian Heke Foundation[2019]No.1190)National Natural Science Foundation Regional Fund Project (the Role of Eucommia Ulmoides Extract in the Mechanism of Atherosclerosis Through the Ubiquitin Protease Pathway,81173420, 81760071)。
文摘OBJECTIVE: To investigate the efficacy and mechanism of the Qingre Huayu Fang(清热化瘀方) on atherosclerotic vulnerable plaque in apolipoprotein E(Apo E) knockout mice through the ubiquitin proteasome pathway.METHODS: Sixty 8-week-old C57BL/6J Apo E knockout mice were fed a high-fat for 12 weeks and randomly divided into four treatment groups(n = 15 each): high-fat control, bortezomib(a proteasome inhibitor), bortezomib combined with Qingre Huayu Fang, and Qingre Huayu Fang alone. Aortic sections were examined for plaque development, inflammatory cell infiltration, type Ⅰ/Ⅲ collagen expression and immunohistochemical staining of CD40L, nuclear factor-kappa B(NF-κB)/P65 and ubiquitin.RESULTS: Mice in the high-fat control group had obvious atherosclerosis, with increased aortic plaque area. The degree of atherosclerosis of the atherosclerotic plaque was reduced in all of the treatment groups that received bortezomib and/or Duzhong(Cortex Eucommiae) Qingre Huayu. The expression of NF-?B, CD40L and ubiquitin were all reduced in the group that received combination bortezomib + Qingre Huayu Fang.CONCLUSION: The Qingre Huayu Fang inhibited aortic atherosclerosis in mice through a mechanism that may involve inhibition of the ubiquitin proteasome pathway.
文摘Objective: To explore the frequency and significance of ApoE gene polymorphisms in Chinese patients with atherosclerotic cerebral infarction (ACI). Methods: Polymerase chain reaction and gene sequencing, single nucleotide polymorphisms of ApoE gene were used to analyze 33 cases of patients with ACI and 35 controls. Results: The frequencies of ApoE gene single nucleotide polymorphisms 465C/G, 462C/G and 451delC in the ACI group were significantly higher than those in the control group (P<0.05). The prevalence of polymorphism 486G/T in the control group was significantly higher than that in the ACI group ( P = 0.011) . Conclusions: 465C/G,462C/G and 451delC polymorphisms might be associated with ACI.486GT allele might have protective effect on the pathogenesis of ACI.
文摘The potential of ^99mTc labeled P^1, P^4-di （adenosine-5 ＇ ）-tetraphosphate （Ap4A） for imaging experimental atherosclerotic plaques was evaluated in New Zealand white （NZW） rabbits. To label the ^99mTc to Ap4A, stannous tartrate solution was used. ^99mTc-Ap4A was purified on a Sephadex G-25 column. The radiochemistry purities of ^99mTc-Ap4A were 85% to 91%. Biodistribution study revealed ^99mTc-Ap4A cleared from blood rapidly. Thirty min after ^99mTc-Ap4A administrated on NZW atherosclerotic rabbits, lesion to blood （target/blood, T/B） ratio was 3. 17 ±1.27, and lesions to normal （target/non-target, T/NT） ratio was 5.23 ±1.87. Shadows of atherosclerotic plaques were clearly visible on radioautographic film. Aortas with atherosclerotic plaques also could be seen on ex vivo gamma camera images. Atherosclerotic abdominal aortas were clearly visible on in vivo images 15 min to 3 h after ^99mTc-Ap4A administration. ^99mTc-labeled Ap4A can be used for rapid noninvasive detection of experimental atherosclerotic plaque.
文摘BACKGROUND Coronary artery disease(CAD)is one of the leading causes of death and disease burden in China and worldwide.A practical and reliable prediction scoring system for CAD risk and severity evaluation is urgently needed for primary prevention.AIM To examine whether the prediction for atherosclerotic cardiovascular disease risk in China(China-PAR)scoring system could be used for this purpose.METHODS A total of 6813 consecutive patients who underwent diagnostic coronary angiography were enrolled.The China-PAR score was calculated for each patient and CAD severity was assessed by the Gensini score(GS).RESULTS Correlation analysis demonstrated a significant relationship between China-PAR and GS(r=0.266,P<0.001).In receiver operating characteristic curve analysis,the cut-off values of China-PAR for predicting the presence and the severity of CAD were 7.55%with a sensitivity of 55.8%and specificity of 71.8%[area under the curve(AUC)=0.693,95%confidence interval:0.681 to 0.706,P<0.001],and 7.45%with a sensitivity of 58.8%and specificity of 67.2%(AUC=0.680,95%confidence interval:0.665 to 0.694,P<0.001),respectively.CONCLUSION The China-PAR scoring system may be useful in predicting the presence and severity of CAD.
