Image-based computational models have been used for vulnerable plaque progression and rupture predictions,and good results have been reported.However,mechanisms and predictions for plaque erosion are underinvestigated...Image-based computational models have been used for vulnerable plaque progression and rupture predictions,and good results have been reported.However,mechanisms and predictions for plaque erosion are underinvestigated.Patient-specific fluid-structure interaction(FSI)models based on optical coherence tomography(OCT)follow-up data from patients with plaque erosion and who received conservative antithrombotic treatment(using medication,no stenting)to identify risk factors that could be used to predict the treatment outcome.OCT and angiography datawere obtained from10 patientswho received conservative antithrombotic treatment.Five participants had worse outcomes(WOG,stenosis severity≥70%at one-year follow-up),while the other five had better outcomes(BOG,stenosis severity<70%at one-year follow-up).Patient-specific 3D FSI models were constructed to obtain morphological and biomechanical risk factor values(a total of nine risk factors)for comparison and prediction.A logistic regressionmodel was used to identify optimal predictors with the best treatment outcome prediction accuracies.Our results indicated that the combination of wall shear stress(WSS),lipid percent,and thrombus burden was the best group predictor according to the mean area under the curve(AUC)of 0.96(90%confidence interval=(0.85,1.00)).WSS was the best single predictor withmean AUC=0.70(90%confidence interval=(0.20,1.00)).Thrombus burden was the only risk factor showing statistically significant group difference,suggesting its crucial role in the outcomes of conservative anti-thrombotic therapy.This pilot study indicated that integratingmorphological and biomechanical risk factors could improve treatment outcome prediction accuracy in patients with plaque erosion compared to predictions using single predictors.Large-scale patient studies are needed to further validate our findings.展开更多
BACKGROUND Carotid atherosclerosis is a common complication in patients with type 2 diabetes mellitus(T2DM)and is closely associated with an increased risk of cardiovascular events.AIM To identify the key demographic,...BACKGROUND Carotid atherosclerosis is a common complication in patients with type 2 diabetes mellitus(T2DM)and is closely associated with an increased risk of cardiovascular events.AIM To identify the key demographic,clinical,and biochemical factors associated with carotid plaque formation in T2DM patients and evaluate their predictive value.METHODS This retrospective study included 266 T2DM patients(control group,n=158;observation group,n=108)recruited between January 2021 and July 2024.Participants underwent carotid ultrasonography to measure intima-media thickness(IMT)and detect carotid plaques.Comprehensive demographic and biochemical data,including age,body mass index(BMI),fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),serum creatinine(Scr),urinary albumin-to-creatinine ratio(UACR),and serum uric acid(SUA),were collected.Statistical analyses,including Pearson correlation,logistic regression,and receiver operating characteristic(ROC)curve analysis,were performed to identify and evaluate factors associated with carotid plaque formation.RESULTS Significant differences in age,BMI,HbA1c,FPG,Scr,UACR,and SUA were observed between groups(all P<0.05).Pearson correlation analysis showed IMT was positively associated with age,FPG,HbA1c,Scr,UACR,and SUA,and negatively with HDL-C.Multivariate logistic regression identified age(OR=1.050,95%CI:1.015-1.087),FPG(OR=1.096,95%CI:1.006-1.192),HbA1c(OR=1.234,95%CI:1.057-1.445),SBP(OR=1.018,95%CI:1.002-1.034),Scr(OR=1.029,95%CI:1.011-1.046),UACR(OR=1.024,95%CI:1.010-1.037),SUA(OR=1.006,95%CI:1.003-1.009),and HDL-C(OR=0.329,95%CI:0.119-0.917)as independent predictors of IMT(all P<0.05).ROC analysis showed UACR(AUC=0.718)and SUA(AUC=0.651)had predictive value for carotid plaque.CONCLUSION This study highlights the multifactorial nature of carotid atherosclerosis in T2DM,with age,BMI,poor glycemic control,renal dysfunction,and metabolic disturbances identified as key risk factors.The findings underscore the importance of comprehensive risk assessment and targeted interventions to prevent vascular complications in this high-risk population.展开更多
The application of artificial intelligence(AI)in carotid atherosclerotic plaque detection via computed tomography angiography(CTA)has significantly ad-vanced over the past decade.This mini-review consolidates recent i...The application of artificial intelligence(AI)in carotid atherosclerotic plaque detection via computed tomography angiography(CTA)has significantly ad-vanced over the past decade.This mini-review consolidates recent innovations in deep learning architectures,domain adaptation techniques,and automated pl-aque characterization methodologies.Hybrid models,such as residual U-Net-Pyramid Scene Parsing Network,exhibit a remarkable precision of 80.49%in plaque segmentation,outperforming radiologists in diagnostic efficiency by reducing analysis time from minutes to mere seconds.Domain-adaptive fra-meworks,such as Lesion Assessment through Tracklet Evaluation,demonstrate robust performance across heterogeneous imaging datasets,achieving an area under the curve(AUC)greater than 0.88.Furthermore,novel approaches inte-grating U-Net and Efficient-Net architectures,enhanced by Bayesian optimi-zation,have achieved impressive correlation coefficients(0.89)for plaque quanti-fication.AI-powered CTA also enables high-precision three-dimensional vascular segmentation,with a Dice coefficient of 0.9119,and offers superior cardiovascular risk stratification compared to traditional Agatston scoring,yielding AUC values of 0.816 vs 0.729 at a 15-year follow-up.These breakthroughs address key challenges in plaque motion analysis,with systolic retractive motion biomarkers successfully identifying 80%of vulnerable plaques.Looking ahead,future directions focus on enhancing the interpretability of AI models through explainable AI and leveraging federated learning to mitigate data heterogeneity.This mini-review underscores the transformative potential of AI in carotid plaque assessment,offering substantial implic-ations for stroke prevention and personalized cerebrovascular management strategies.展开更多
Carotid artery plaques represent a major contributor to the morbidity and mortality associated with cerebrovascular disease,and their clinical significance is largely determined by the risk linked to plaque vulnerabil...Carotid artery plaques represent a major contributor to the morbidity and mortality associated with cerebrovascular disease,and their clinical significance is largely determined by the risk linked to plaque vulnerability.Therefore,classifying plaque risk constitutes one of themost critical tasks in the clinicalmanagement of this condition.While classification models derived from individual medical centers have been extensively investigated,these singlecenter models often fail to generalize well to multi-center data due to variations in ultrasound images caused by differences in physician expertise and equipment.To address this limitation,a Dual-Classifier Label Correction Networkmodel(DCLCN)is proposed for the classification of carotid plaque ultrasound images acrossmultiplemedical centers.TheDCLCNdesigns amulti-center domain adaptationmodule that leverages a dual-classifier strategy to extract knowledge from both source and target centers,thereby reducing feature discrepancies through a domain adaptation layer.Additionally,to mitigate the impact of image noise,a label modeling and correction module is introduced to generate pseudo-labels for the target centers and iteratively refine them using an end-to-end correction mechanism.Experiments on the carotid plaque dataset collected fromthreemedical centers demonstrate that the DCLCN achieves commendable performance and robustness.展开更多
Kounis syndrome(KS)is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome(ACS)and allergic reactions,which can develop in patients with either normal or ...Kounis syndrome(KS)is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome(ACS)and allergic reactions,which can develop in patients with either normal or diseased coronary arteries.[1,2]The condition is typically triggered by various allergens including medications(particularly contrast media),environmental factors,or food exposures,with symptom onset usually occurring within one hour of exposure.展开更多
It is believed that overproduction and deposition of amyloid-β (Aβ) plaques in the hippocampus and cortex region of the brain cause neuronal dysfunction leading to cognitive impairments in Alzheimer’s disease (AD)....It is believed that overproduction and deposition of amyloid-β (Aβ) plaques in the hippocampus and cortex region of the brain cause neuronal dysfunction leading to cognitive impairments in Alzheimer’s disease (AD).Until now,there has been no effective treatment to reduce plaque load from the brain.Recent studies have shown that regular treadmill exercise lowers plaques from the brain of a mouse model of AD.展开更多
BACKGROUND With rising angiography costs and risks,we explored whether a 5-minute femoral ultrasound can predict patients that actually require angiography.AIM To detect associations between atherosclerosis of periphe...BACKGROUND With rising angiography costs and risks,we explored whether a 5-minute femoral ultrasound can predict patients that actually require angiography.AIM To detect associations between atherosclerosis of peripheral arteries and coronary stenosis in patients with coronary heart disease(CHD).METHODS The study included a total of 218 patients(63±10.9 years of age;54%male)with CHD subjected to coronary angiography and routine diagnostic assessment,including ultrasound imaging to assess the extent of peripheral atherosclerotic lesions.Receiver operating characteristic analysis and binomial logistic regression were used to detect the associations.RESULTS We demonstrated for the first time that the presence of atherosclerotic plaque with≥70%stenosis in femoral arteries was associated with significant coronary stenosis,with 93%sensitivity and 90%specificity,and thus can be used as an additional diagnostic marker for coronary stenosis.The data indicated associations between femoral artery atherosclerosis and atherosclerotic lesions of coronary arteries,with a high correlation coefficient r=0.8(P<0.05).The presence of an atherosclerotic plaque in the femoral arteries with≥30% or≥70%stenosis was associated with a 30-or 70-fold higher odds ratio of coronary stenosis,respectively.CONCLUSION For resource-limited clinics,our findings suggest skipping carotids-femoral ultrasound alone may suffice to rule out severe CHD.Ultrasound imaging femoral artery atherosclerosis provides a simplified approach for patient stratification.展开更多
BACKGROUND Inadequately controlled hypertension often leads to an increased cardiovascular death rate in type 2 diabetes mellitus(T2DM).It remains unclear whether systolic blood pressure(SBP)status of hypertension is ...BACKGROUND Inadequately controlled hypertension often leads to an increased cardiovascular death rate in type 2 diabetes mellitus(T2DM).It remains unclear whether systolic blood pressure(SBP)status of hypertension is related to coronary inflammation and plaques in T2DM.AIM To evaluate whether SBP variability(SBPV)and levels of hypertension are related to coronary inflammation and plaques in T2DM patients using coronary computed tomography angiography(CCTA).METHODS This retrospective study involved 881 T2DM patients with CCTA images,including 668 hypertension and 213 normotension patients.Hypertension patients were subgroup based on SBP status:(1)SBPV:Low(<8.96 mmHg)and high(≥8.96 mmHg)groups;and(2)SBP levels:Controlled(<140 mmHg)and uncontrolled(≥140 mmHg)groups.Pericoronary adipose tissue(PCAT)attenuation,high-risk plaques(HRPs)and obstructive stenosis(OS)were evaluated by CCTA.Propensity score matching was utilized to compare these CCTA findings for these groups.The impact of SBPV and SBP levels of hypertension on these CCTA findings in T2DM patients were evaluated by multivariate logistic regression and multivariable linear regression.RESULTS PCAT attenuation of the left anterior descending artery(LAD),any low attenuation plaque(LAP),any spotty calcification(SC),any positive remodeling(PR),and OS had significant differences between the hypertension group and the normotension group,as well as between the high SBPV or uncontrolled SBP group and the low SBPV or controlled SBP group(all P<0.05).Hypertension was independently positively correlated with LADPCAT attenuation(β=1.815,P=0.010),LAP(OR=1.612,P=0.019),SC(OR=1.665,P=0.013),PR(OR=1.549,P=0.033),and OS(OR=1.928,P=0.036)in all T2DM patients.Additionally,high SBPV and uncontrolled SBP were independently positively correlated with LAD-PCAT attenuation(high SBPV:β=1.673,P=0.048;uncontrolled SBP:β=2.370,P=0.004)and PR(high SBPV:OR=1.903,P=0.048;uncontrolled SBP:OR=2.230,P=0.013)in T2DM patients with hypertension.CONCLUSION Inadequately controlled hypertension,including high SBPV and/or uncontrolled SBP levels,may be related to increased coronary artery inflammation,HRPs,and OS in T2DM,leading to increased cardiovascular risk.Achieving both low SBPV and controlled SBP levels simultaneously,especially in individuals with T2DM and hypertension,warrants clinical attention.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
Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames...Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames.Material and methods 16postmortem cases of acute myocardial infarction were studied.The coronary arteries were romoved en block,filled with barium the lumen and ridiographed.Then the arteries wereontinuously insetted and routin HE sections were made.Results 16 cases had plaque ruptures and thrombi.Among the total98 blocks,21 had plaque ruptures on which 20 thrombiccur(95.23%).while the other 777 unrupured blocks had only 2hrombi(0.25%).The difference was significant(p【0.001).Therupture mostly occur on unstable plaques.The ruptured plaqueswith thrombi had different angiographical morphology withunruptured plaques.The former had irregular borders andunraluminal lucencies;while the Iatter had smooth borders and nointraluminal lucencies.Conclusions Plaque ruprure withthrumbus was the major cause of acute myocardial infarction andthe ruptured plaques with thrombus had different angiographicalapperances with unruptured plaques.展开更多
The effects of different arsenic （As） treatments on spatial pattern of radial oxygen loss （ROL）, iron （Fe） plaque formation and As accumulation in rice were investigated using three rice genotypes, planted under...The effects of different arsenic （As） treatments on spatial pattern of radial oxygen loss （ROL）, iron （Fe） plaque formation and As accumulation in rice were investigated using three rice genotypes, planted under greenhouse conditions. Arsenic was applied to soil at 50 and 100 mg/kg, with untreated soil used as a control having an average As concentration of 8.5 mg/kg. It was demonstrated that the ratio of ROL in root tips to that at the root base slightly decreased with increasing As concentration, suggesting that the spatial ROL patterns in these groups may be shifted from the “tight” barrier towards the “partial” barrier form. Furthermore, increasing As concentration led to a increase in Fe plaque formation on root surfaces. In addition, root As concentrations of genotypes in 50 and 100 mg/kg As treatments were significantly higher than that of control treatment （P〈0.05）. Grain As concentration of genotype Nanyangzhan （with lower ROL） was significantly higher （P〈0.05） than that of genotype CNT87059-3 with higher ROL.展开更多
Objective The production of neurotoxic β-amyloid and the formation of hyperphosphorylated tau are thought to be critical steps contributing to the neuropathological mechanisms in Alzheimer’s disease （AD）. However,...Objective The production of neurotoxic β-amyloid and the formation of hyperphosphorylated tau are thought to be critical steps contributing to the neuropathological mechanisms in Alzheimer’s disease （AD）. However, there remains an argument as to their importance in the onset of AD.Recent studies have shown that axonopathy is considered as an early stage of AD. However, the exact relationship between axonopathy and the origin and development of classic neuropathological changes such as senile plaques （SPs） and neurofibrillary tangles （NFTs） is unclear. The present study aimed to investigate this relationship. Methods Postmortem tracing, combined with the immunohistochemical or immunofluo-rescence staining, was used to detect axonopathy and the formation of SPs and NFTs. Results ＂Axonal leakage＂–a novel type of axonopathy, was usually accompanied with the extensive swollen axons and varicosities, and was associated with the origin and development of Aβ plaques and hyperphosphorylated tau in the brains of AD patients. Conclusion Axonopathy, particularly axonal leakage, might be a key event in the initiation of the neuropathological processes in AD.展开更多
AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 pat...AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 patients, Sensation 64 Cardiac, Siemens; Group 2: 200 patients, VCT GE Healthcare, with either Iomeprol 400 or Iodixanol 320, respectively) for suspected coronary artery disease (CAD). CTCA was performed using standard protocols. Image quality (score 0-3), plaque (within the accessible non-calcified component of each non-calcified/mixed plaque) and coronary lumen attenuation were measured. Data were compared on a per-segment/per-plaque basis. Plaques were classified as fibrous vs lipid rich based on different attenuation thresholds. A P < 0.05 was considered significant. RESULTS: In 468 atherosclerotic plaques in Group 1 and 644 in Group 2, average image quality was 2.96 ± 0.19 in Group 1 and 2.93 ± 0.25 in Group 2 (P ≥ 0.05). Coronary lumen attenuation was 367 ± 85 Hounsfield units (HU) in Group 1 and 327 ± 73 HU in Group 2 (P < 0.05); non-calcified plaque attenuation was 48 ± 23 HU in Group 1 and 39 ± 21 HU in Group 2 (P < 0.05). Overall signal to noise ratio was 15.6 ± 4.7 in Group 1 and 21.2 ± 7.7 in Group 2 (P < 0.01). CONCLUSION: Higher intra-vascular attenuation modifies significantly the attenuation of non-calcified coronary plaques. This results in a more difficult characterization between lipid rich vs fibrous type.展开更多
BACKGROUND Discontinued application of statins may be related to adverse cardiovascular events.However,it is unclear whether different statins administration methods have effects on coronary artery plaques.AIM To eval...BACKGROUND Discontinued application of statins may be related to adverse cardiovascular events.However,it is unclear whether different statins administration methods have effects on coronary artery plaques.AIM To evaluate the effects of different statins application methods on plaques in patients with coronary atherosclerosis.METHODS A total of 100 patients diagnosed with atherosclerotic plaque by coronary artery computed tomography were continuously selected and divided into three groups according to different statins administration methods(discontinued application group,n=32;intermittent application group,n=39;sustained application group,n=29).The effects of the different statins application methods on coronary atherosclerotic plaque were assessed.RESULTS The volume change and rate of change of the most severe plaques were significantly reduced in the sustained application group(P≤0.001).The volume change of the most severe plaques correlated positively with low-density lipoprotein(LDL-C)levels only in the sustained application group(R=0.362,P=0.013).There were no changes in plaques or LDL-C levels in the intermittent and discontinued application groups.CONCLUSION Continuous application of statins is effective for controlling plaque progression,whereas discontinued or intermittent administration of statins is not conducive to controlling plaques.Only with continuous statins administration can a reduction in LDL-C levels result in plaque volume shrinkage.展开更多
BACKGROUND Myocardial bridging(MB)is increasingly recognized to stimulate atherogenesis,which may contribute to an acute coronary syndrome.Stenting the coronary segment with MB has been recognized to have an increased...BACKGROUND Myocardial bridging(MB)is increasingly recognized to stimulate atherogenesis,which may contribute to an acute coronary syndrome.Stenting the coronary segment with MB has been recognized to have an increased risk of in-stent restenosis,stent fracture and coronary perforation.The safety and efficacy of stenting the culprit lesion with overlaying MB in ST elevation myocardial infarction(STEMI)as primary reperfusion therapy has not been established.CASE SUMMARY We reported a patient who presented with inferior STEMI with a culprit lesion of an acute thrombotic occlusion in the right coronary artery and thrombolysis and thrombin inhibition in myocardial infarction 0 flow.After the stent placement during primary percutaneous coronary intervention,intravascular ultrasound revealed MB overlying the stented segment where heavy atherosclerotic plaque were present.Likely due to the combination of plaque herniation or prolapse caused by MB,as well as local increased inflammation and thrombogenicity,acute stent thrombosis occurred at this region,which led to acute stent failure.The patient required an emergent repeated cardiac catheterization and placing a second layer of stent to enhance the radial strength and reduce the inter-strut space.CONCLUSION Plaque herniation or prolapse after stenting a MB segment in STEMI is a potential etiology for acute stent failure.展开更多
The degree of vessel lumen narrowing is an independent predictor of ischemic stroke. New developments in carotid plaque morphology imaging (MR, CT), may bring new insights to the relationship between carotid atheroscl...The degree of vessel lumen narrowing is an independent predictor of ischemic stroke. New developments in carotid plaque morphology imaging (MR, CT), may bring new insights to the relationship between carotid atherosclerotic disease and stroke risk. Our aim is to review the stroke risk in a symptomatic patient with moderate carotid stenosis by CT imaging and histopathology. A 72-year-old patient with low ABCD2 scores TIA and moderate left internal carotid stenosis (50% by carotid ultrasound), was discharged with an optimized medical therapy. Four months later, he presented an ischemic stroke in the left frontal area. Carotid angiography showed a 60% stenosis in the left-internal carotid artery with a regular surface. CT plaque imaging detected a thin fibrous cap with calcification and an intraplaque hemorrhage (high-risk plaque). These findings were confirmed in the histolopathological study of the atherosclerotic plaque performed after the endarterectomy. After 1 year of follow-up, the patient returned independently to his daily activities. We propose, in this study, the inclusion of noninvasive plaque imaging in the evaluation of acute TIA with moderate carotid stenosis to better select patients with higher risk of stroke recurrence.展开更多
To understand certain mechanisms causing variations between rice cultivars with regard to cadmium uptake and tolerance, pot soil experiments were conducted with two rice cultivars of different genotypes under differen...To understand certain mechanisms causing variations between rice cultivars with regard to cadmium uptake and tolerance, pot soil experiments were conducted with two rice cultivars of different genotypes under different soil Cd levels. The relationships between plant Cd uptake and iron/manganese （Fe/Mn） plaque formation on roots were investigated. The results showed that rice cultivars differed markedly in Cd uptake and tolerance. Under soil Cd treatments, Cd concentrations and accumulations in the cultivar Shanyou 63 （the genotype indica） were significantly higher than those in the cultivar Wuyunjing 7 （the genotype japonica） （P 〈 0.01, or P 〈 0.05）, and Shanyou 63 was more sensitive to Cd toxicity than Wuyunjing 7. The differences between the rice cultivars were the largest at relatively low soil Cd level （i.e., 10 mg/kg）. Fe concentrations in dithionite-citrate-bicarbonate root extracts of Shanyou 63 were generally lower than that of Wuyunjing 7, and the difference was the most significant under the treatment of 10 mg Cd/kg soil. The results indicated that the formation of iron plaque on rice roots could act as a barrier to soil Cd toxicity, and may be a ＂buffer＂ or a ＂reservoir＂ which could reduce Cd uptake into rice roots. And the plaque may contribute, to some extent, to the genotypic differences of rice cultivars in Cd uptake and tolerance.展开更多
AIM: To establish whether virulence factor genes vacA and cagA are present in Helicobacter pylori (H. pylori) retrieved from gastric mucosa and dental plaque in pa-tients with dyspepsia. METHODS: Cumulative dental pla...AIM: To establish whether virulence factor genes vacA and cagA are present in Helicobacter pylori (H. pylori) retrieved from gastric mucosa and dental plaque in pa-tients with dyspepsia. METHODS: Cumulative dental plaque specimens and gastric biopsies were submitted to histological exami-nation, rapid urease test and polymerase chain reac-tion (PCR) assays to detect the presence of cagA and vacA polymorphisms.RESULTS: Detection of H. pylori from dental plaque and gastric biopsy samples was greater by PCR com-pared to histological examination and the rapid ure-ase test. DNA from H. pylori was detected in 96% of gastric mucosa samples and in 72% of dental plaque samples. Sixty-three (89%) of 71 dental plaque sam-ples that were H. pylori-positive also exhibited identical vacA and cagA genotypes in gastric mucosa. The most common genotype was vacAs1bm1 and cagA positive, either in dental plaque or gastric mucosa. These viru-lent H. pylori isolates were involved in the severity of clinical outcome.CONCLUSION: These pathogenic strains were found simultaneously in dental plaque and gastric mucosa, which suggests that gastric infection is correlated with the presence of H. pylori in the mouth.展开更多
Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans. Although H. pylori may be detected in the stomach of approximately half of the world’s population, the me...Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans. Although H. pylori may be detected in the stomach of approximately half of the world’s population, the mechanisms of transmission of the microorganism from individual to individual are not yet clear. Transmission of H. pylori could occur through iatrogenic, fecal-oral, and oral-oral routes, and through food and water. The microorganism may be transmitted orally and has been detected in dental plaque and saliva. However, the role of the oral cavity in the transmission and recurrence of H. pylori infection has been the subject of debate. A large number of studies investigating the role of oral hygiene and periodontal disease in H. pylori infection have varied significantly in terms of their methodology and sample population, resulting in a wide variation in the reported results. Nevertheless, recent studies have not only shown that the microorganism can be detected fairly consistently from the oral cavity but also demonstrated that the chances of recurrence of H. pylori infection is more likely among patients who harbor the organism in the oral cavity. Furthermore, initial results from clinical trials have shown that H. pylori-positive dyspeptic patients may benefit from periodontal therapy. This paper attempts to review the current body of evidence regarding the role of dental plaque, saliva, and periodontal disease in H. pylori infection.展开更多
AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero...AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero-sclerotic plaques in the internal carotid artery were studied.The thickest soft plaque in each patient was examined using contrast-enhanced ultrasound.Time-intensity curves were collected from 5 s to 3 min after contrast injection.The neovascularization within the plaques in the internal carotid artery was evaluated using the ACQ software built into the scanner by 2 of the experienced investigators who were blinded to the clinical history of the patients.RESULTS:Ischemic stroke was present in 7 of 33 patients(21%) with grade Ⅰ plaque,in 14 of 51 pa-tients(28%) with grade Ⅱ plaque,in 26 of 43 patients(61%) with grade Ⅲ plaque,and in 34 of 49 patients(69%) with grade Ⅳ plaque(P < 0.001 comparing grade Ⅳ plaque with grade I plaque and with grade Ⅱ plaque and P = 0.001 comparing grade Ⅲ plaque with grade Ⅰ plaque and with grade Ⅱ plaque).Analysis of the time intensity curves revealed that patients with ischemic stroke had a significantly higher intensity of enhancement(IE) than those without ischemic stroke(P < 0.01).The wash-in time(WT) of plaque was signifi-cantly shorter in stroke patients(P < 0.05).The sensi-tivity and specificity for IE in the plaque were 82% and 80%,respectively,and for WT were 68% and 74%,respectively.There was no significant difference in the peak intensity or time to peak between the 2 groups.CONCLUSION:This study shows that the higher the grade of plaque enhancement,the higher the risk of ischemic stroke.The data suggest that the presence of neovascularization is a marker for unstable plaque.展开更多
基金supported in part by National Sciences Foundation of China grants 11972117a Jiangsu Province Science and Technology Agency under grant number BE2016785+4 种基金support from Natural Science Foundation of China(81827806 and 62135002)support from Natural Science Foundation of China(81722025)Key R&D Project of Heilongjiang Province grant 2022ZX06C07support from the Natural Science Foundation of Shandong Province under grant number ZR2024QA110Shandong Province Medical Health Science and Technology Project(Nos.202425020256,and 202403010254).
文摘Image-based computational models have been used for vulnerable plaque progression and rupture predictions,and good results have been reported.However,mechanisms and predictions for plaque erosion are underinvestigated.Patient-specific fluid-structure interaction(FSI)models based on optical coherence tomography(OCT)follow-up data from patients with plaque erosion and who received conservative antithrombotic treatment(using medication,no stenting)to identify risk factors that could be used to predict the treatment outcome.OCT and angiography datawere obtained from10 patientswho received conservative antithrombotic treatment.Five participants had worse outcomes(WOG,stenosis severity≥70%at one-year follow-up),while the other five had better outcomes(BOG,stenosis severity<70%at one-year follow-up).Patient-specific 3D FSI models were constructed to obtain morphological and biomechanical risk factor values(a total of nine risk factors)for comparison and prediction.A logistic regressionmodel was used to identify optimal predictors with the best treatment outcome prediction accuracies.Our results indicated that the combination of wall shear stress(WSS),lipid percent,and thrombus burden was the best group predictor according to the mean area under the curve(AUC)of 0.96(90%confidence interval=(0.85,1.00)).WSS was the best single predictor withmean AUC=0.70(90%confidence interval=(0.20,1.00)).Thrombus burden was the only risk factor showing statistically significant group difference,suggesting its crucial role in the outcomes of conservative anti-thrombotic therapy.This pilot study indicated that integratingmorphological and biomechanical risk factors could improve treatment outcome prediction accuracy in patients with plaque erosion compared to predictions using single predictors.Large-scale patient studies are needed to further validate our findings.
基金Supported by the Zhejiang Traditional Chinese Medicine Science and Technology Plan Project,No.2021ZB133 and No.2017ZB049.
文摘BACKGROUND Carotid atherosclerosis is a common complication in patients with type 2 diabetes mellitus(T2DM)and is closely associated with an increased risk of cardiovascular events.AIM To identify the key demographic,clinical,and biochemical factors associated with carotid plaque formation in T2DM patients and evaluate their predictive value.METHODS This retrospective study included 266 T2DM patients(control group,n=158;observation group,n=108)recruited between January 2021 and July 2024.Participants underwent carotid ultrasonography to measure intima-media thickness(IMT)and detect carotid plaques.Comprehensive demographic and biochemical data,including age,body mass index(BMI),fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),serum creatinine(Scr),urinary albumin-to-creatinine ratio(UACR),and serum uric acid(SUA),were collected.Statistical analyses,including Pearson correlation,logistic regression,and receiver operating characteristic(ROC)curve analysis,were performed to identify and evaluate factors associated with carotid plaque formation.RESULTS Significant differences in age,BMI,HbA1c,FPG,Scr,UACR,and SUA were observed between groups(all P<0.05).Pearson correlation analysis showed IMT was positively associated with age,FPG,HbA1c,Scr,UACR,and SUA,and negatively with HDL-C.Multivariate logistic regression identified age(OR=1.050,95%CI:1.015-1.087),FPG(OR=1.096,95%CI:1.006-1.192),HbA1c(OR=1.234,95%CI:1.057-1.445),SBP(OR=1.018,95%CI:1.002-1.034),Scr(OR=1.029,95%CI:1.011-1.046),UACR(OR=1.024,95%CI:1.010-1.037),SUA(OR=1.006,95%CI:1.003-1.009),and HDL-C(OR=0.329,95%CI:0.119-0.917)as independent predictors of IMT(all P<0.05).ROC analysis showed UACR(AUC=0.718)and SUA(AUC=0.651)had predictive value for carotid plaque.CONCLUSION This study highlights the multifactorial nature of carotid atherosclerosis in T2DM,with age,BMI,poor glycemic control,renal dysfunction,and metabolic disturbances identified as key risk factors.The findings underscore the importance of comprehensive risk assessment and targeted interventions to prevent vascular complications in this high-risk population.
基金Supported by Henan Province International Science and Technology Cooperation Project,2024,No.242102520054.
文摘The application of artificial intelligence(AI)in carotid atherosclerotic plaque detection via computed tomography angiography(CTA)has significantly ad-vanced over the past decade.This mini-review consolidates recent innovations in deep learning architectures,domain adaptation techniques,and automated pl-aque characterization methodologies.Hybrid models,such as residual U-Net-Pyramid Scene Parsing Network,exhibit a remarkable precision of 80.49%in plaque segmentation,outperforming radiologists in diagnostic efficiency by reducing analysis time from minutes to mere seconds.Domain-adaptive fra-meworks,such as Lesion Assessment through Tracklet Evaluation,demonstrate robust performance across heterogeneous imaging datasets,achieving an area under the curve(AUC)greater than 0.88.Furthermore,novel approaches inte-grating U-Net and Efficient-Net architectures,enhanced by Bayesian optimi-zation,have achieved impressive correlation coefficients(0.89)for plaque quanti-fication.AI-powered CTA also enables high-precision three-dimensional vascular segmentation,with a Dice coefficient of 0.9119,and offers superior cardiovascular risk stratification compared to traditional Agatston scoring,yielding AUC values of 0.816 vs 0.729 at a 15-year follow-up.These breakthroughs address key challenges in plaque motion analysis,with systolic retractive motion biomarkers successfully identifying 80%of vulnerable plaques.Looking ahead,future directions focus on enhancing the interpretability of AI models through explainable AI and leveraging federated learning to mitigate data heterogeneity.This mini-review underscores the transformative potential of AI in carotid plaque assessment,offering substantial implic-ations for stroke prevention and personalized cerebrovascular management strategies.
基金supported by Shanghai Technical Service Computing Center of Science and Engineering,Shanghai University.
文摘Carotid artery plaques represent a major contributor to the morbidity and mortality associated with cerebrovascular disease,and their clinical significance is largely determined by the risk linked to plaque vulnerability.Therefore,classifying plaque risk constitutes one of themost critical tasks in the clinicalmanagement of this condition.While classification models derived from individual medical centers have been extensively investigated,these singlecenter models often fail to generalize well to multi-center data due to variations in ultrasound images caused by differences in physician expertise and equipment.To address this limitation,a Dual-Classifier Label Correction Networkmodel(DCLCN)is proposed for the classification of carotid plaque ultrasound images acrossmultiplemedical centers.TheDCLCNdesigns amulti-center domain adaptationmodule that leverages a dual-classifier strategy to extract knowledge from both source and target centers,thereby reducing feature discrepancies through a domain adaptation layer.Additionally,to mitigate the impact of image noise,a label modeling and correction module is introduced to generate pseudo-labels for the target centers and iteratively refine them using an end-to-end correction mechanism.Experiments on the carotid plaque dataset collected fromthreemedical centers demonstrate that the DCLCN achieves commendable performance and robustness.
基金supported by the National Key Research and Development Program of China(No.2022YFB380-7300)the National Natural Science Foundation of China(No.12471455)+2 种基金the Clinical Cohort Construction Program of Peking University Third Hospital(BYSYDL2022005)the Key Clinical Projects of Peking University Third Hospital(BYSYZD2023006)the Innovation&Transfer Fund of Peking University Third Hospital(BYSYZHKC2023-109).
文摘Kounis syndrome(KS)is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome(ACS)and allergic reactions,which can develop in patients with either normal or diseased coronary arteries.[1,2]The condition is typically triggered by various allergens including medications(particularly contrast media),environmental factors,or food exposures,with symptom onset usually occurring within one hour of exposure.
基金supported by merit awards (1I01BX005002 and I01BX005613) from US Department of Veterans Affairsa grant (AT10980) from NIH (to KP)。
文摘It is believed that overproduction and deposition of amyloid-β (Aβ) plaques in the hippocampus and cortex region of the brain cause neuronal dysfunction leading to cognitive impairments in Alzheimer’s disease (AD).Until now,there has been no effective treatment to reduce plaque load from the brain.Recent studies have shown that regular treadmill exercise lowers plaques from the brain of a mouse model of AD.
文摘BACKGROUND With rising angiography costs and risks,we explored whether a 5-minute femoral ultrasound can predict patients that actually require angiography.AIM To detect associations between atherosclerosis of peripheral arteries and coronary stenosis in patients with coronary heart disease(CHD).METHODS The study included a total of 218 patients(63±10.9 years of age;54%male)with CHD subjected to coronary angiography and routine diagnostic assessment,including ultrasound imaging to assess the extent of peripheral atherosclerotic lesions.Receiver operating characteristic analysis and binomial logistic regression were used to detect the associations.RESULTS We demonstrated for the first time that the presence of atherosclerotic plaque with≥70%stenosis in femoral arteries was associated with significant coronary stenosis,with 93%sensitivity and 90%specificity,and thus can be used as an additional diagnostic marker for coronary stenosis.The data indicated associations between femoral artery atherosclerosis and atherosclerotic lesions of coronary arteries,with a high correlation coefficient r=0.8(P<0.05).The presence of an atherosclerotic plaque in the femoral arteries with≥30% or≥70%stenosis was associated with a 30-or 70-fold higher odds ratio of coronary stenosis,respectively.CONCLUSION For resource-limited clinics,our findings suggest skipping carotids-femoral ultrasound alone may suffice to rule out severe CHD.Ultrasound imaging femoral artery atherosclerosis provides a simplified approach for patient stratification.
基金Supported by Natural Science Foundation of Hubei Province,No.2023AFB848.
文摘BACKGROUND Inadequately controlled hypertension often leads to an increased cardiovascular death rate in type 2 diabetes mellitus(T2DM).It remains unclear whether systolic blood pressure(SBP)status of hypertension is related to coronary inflammation and plaques in T2DM.AIM To evaluate whether SBP variability(SBPV)and levels of hypertension are related to coronary inflammation and plaques in T2DM patients using coronary computed tomography angiography(CCTA).METHODS This retrospective study involved 881 T2DM patients with CCTA images,including 668 hypertension and 213 normotension patients.Hypertension patients were subgroup based on SBP status:(1)SBPV:Low(<8.96 mmHg)and high(≥8.96 mmHg)groups;and(2)SBP levels:Controlled(<140 mmHg)and uncontrolled(≥140 mmHg)groups.Pericoronary adipose tissue(PCAT)attenuation,high-risk plaques(HRPs)and obstructive stenosis(OS)were evaluated by CCTA.Propensity score matching was utilized to compare these CCTA findings for these groups.The impact of SBPV and SBP levels of hypertension on these CCTA findings in T2DM patients were evaluated by multivariate logistic regression and multivariable linear regression.RESULTS PCAT attenuation of the left anterior descending artery(LAD),any low attenuation plaque(LAP),any spotty calcification(SC),any positive remodeling(PR),and OS had significant differences between the hypertension group and the normotension group,as well as between the high SBPV or uncontrolled SBP group and the low SBPV or controlled SBP group(all P<0.05).Hypertension was independently positively correlated with LADPCAT attenuation(β=1.815,P=0.010),LAP(OR=1.612,P=0.019),SC(OR=1.665,P=0.013),PR(OR=1.549,P=0.033),and OS(OR=1.928,P=0.036)in all T2DM patients.Additionally,high SBPV and uncontrolled SBP were independently positively correlated with LAD-PCAT attenuation(high SBPV:β=1.673,P=0.048;uncontrolled SBP:β=2.370,P=0.004)and PR(high SBPV:OR=1.903,P=0.048;uncontrolled SBP:OR=2.230,P=0.013)in T2DM patients with hypertension.CONCLUSION Inadequately controlled hypertension,including high SBPV and/or uncontrolled SBP levels,may be related to increased coronary artery inflammation,HRPs,and OS in T2DM,leading to increased cardiovascular risk.Achieving both low SBPV and controlled SBP levels simultaneously,especially in individuals with T2DM and hypertension,warrants clinical attention.
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Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames.Material and methods 16postmortem cases of acute myocardial infarction were studied.The coronary arteries were romoved en block,filled with barium the lumen and ridiographed.Then the arteries wereontinuously insetted and routin HE sections were made.Results 16 cases had plaque ruptures and thrombi.Among the total98 blocks,21 had plaque ruptures on which 20 thrombiccur(95.23%).while the other 777 unrupured blocks had only 2hrombi(0.25%).The difference was significant(p【0.001).Therupture mostly occur on unstable plaques.The ruptured plaqueswith thrombi had different angiographical morphology withunruptured plaques.The former had irregular borders andunraluminal lucencies;while the Iatter had smooth borders and nointraluminal lucencies.Conclusions Plaque ruprure withthrumbus was the major cause of acute myocardial infarction andthe ruptured plaques with thrombus had different angiographicalapperances with unruptured plaques.
基金Projects(41201493,31300815)supported by the National Natural Science Foundation of China
文摘The effects of different arsenic （As） treatments on spatial pattern of radial oxygen loss （ROL）, iron （Fe） plaque formation and As accumulation in rice were investigated using three rice genotypes, planted under greenhouse conditions. Arsenic was applied to soil at 50 and 100 mg/kg, with untreated soil used as a control having an average As concentration of 8.5 mg/kg. It was demonstrated that the ratio of ROL in root tips to that at the root base slightly decreased with increasing As concentration, suggesting that the spatial ROL patterns in these groups may be shifted from the “tight” barrier towards the “partial” barrier form. Furthermore, increasing As concentration led to a increase in Fe plaque formation on root surfaces. In addition, root As concentrations of genotypes in 50 and 100 mg/kg As treatments were significantly higher than that of control treatment （P〈0.05）. Grain As concentration of genotype Nanyangzhan （with lower ROL） was significantly higher （P〈0.05） than that of genotype CNT87059-3 with higher ROL.
基金supported by an"Excellent Project"of the China Ministry of Human Resources for Return Overseas Chinese Scholarshippartly by the Research Foundation for"Key Laboratory of Neu-roscience and Neuroengineering"of South-Central University for Nationalities(No.XJS09001)the National Natural Science Foundation of China(No.31070961)
文摘Objective The production of neurotoxic β-amyloid and the formation of hyperphosphorylated tau are thought to be critical steps contributing to the neuropathological mechanisms in Alzheimer’s disease （AD）. However, there remains an argument as to their importance in the onset of AD.Recent studies have shown that axonopathy is considered as an early stage of AD. However, the exact relationship between axonopathy and the origin and development of classic neuropathological changes such as senile plaques （SPs） and neurofibrillary tangles （NFTs） is unclear. The present study aimed to investigate this relationship. Methods Postmortem tracing, combined with the immunohistochemical or immunofluo-rescence staining, was used to detect axonopathy and the formation of SPs and NFTs. Results ＂Axonal leakage＂–a novel type of axonopathy, was usually accompanied with the extensive swollen axons and varicosities, and was associated with the origin and development of Aβ plaques and hyperphosphorylated tau in the brains of AD patients. Conclusion Axonopathy, particularly axonal leakage, might be a key event in the initiation of the neuropathological processes in AD.
基金Supported by An unrestricted grant from GE Healthcare
文摘AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 patients, Sensation 64 Cardiac, Siemens; Group 2: 200 patients, VCT GE Healthcare, with either Iomeprol 400 or Iodixanol 320, respectively) for suspected coronary artery disease (CAD). CTCA was performed using standard protocols. Image quality (score 0-3), plaque (within the accessible non-calcified component of each non-calcified/mixed plaque) and coronary lumen attenuation were measured. Data were compared on a per-segment/per-plaque basis. Plaques were classified as fibrous vs lipid rich based on different attenuation thresholds. A P < 0.05 was considered significant. RESULTS: In 468 atherosclerotic plaques in Group 1 and 644 in Group 2, average image quality was 2.96 ± 0.19 in Group 1 and 2.93 ± 0.25 in Group 2 (P ≥ 0.05). Coronary lumen attenuation was 367 ± 85 Hounsfield units (HU) in Group 1 and 327 ± 73 HU in Group 2 (P < 0.05); non-calcified plaque attenuation was 48 ± 23 HU in Group 1 and 39 ± 21 HU in Group 2 (P < 0.05). Overall signal to noise ratio was 15.6 ± 4.7 in Group 1 and 21.2 ± 7.7 in Group 2 (P < 0.01). CONCLUSION: Higher intra-vascular attenuation modifies significantly the attenuation of non-calcified coronary plaques. This results in a more difficult characterization between lipid rich vs fibrous type.
文摘BACKGROUND Discontinued application of statins may be related to adverse cardiovascular events.However,it is unclear whether different statins administration methods have effects on coronary artery plaques.AIM To evaluate the effects of different statins application methods on plaques in patients with coronary atherosclerosis.METHODS A total of 100 patients diagnosed with atherosclerotic plaque by coronary artery computed tomography were continuously selected and divided into three groups according to different statins administration methods(discontinued application group,n=32;intermittent application group,n=39;sustained application group,n=29).The effects of the different statins application methods on coronary atherosclerotic plaque were assessed.RESULTS The volume change and rate of change of the most severe plaques were significantly reduced in the sustained application group(P≤0.001).The volume change of the most severe plaques correlated positively with low-density lipoprotein(LDL-C)levels only in the sustained application group(R=0.362,P=0.013).There were no changes in plaques or LDL-C levels in the intermittent and discontinued application groups.CONCLUSION Continuous application of statins is effective for controlling plaque progression,whereas discontinued or intermittent administration of statins is not conducive to controlling plaques.Only with continuous statins administration can a reduction in LDL-C levels result in plaque volume shrinkage.
文摘BACKGROUND Myocardial bridging(MB)is increasingly recognized to stimulate atherogenesis,which may contribute to an acute coronary syndrome.Stenting the coronary segment with MB has been recognized to have an increased risk of in-stent restenosis,stent fracture and coronary perforation.The safety and efficacy of stenting the culprit lesion with overlaying MB in ST elevation myocardial infarction(STEMI)as primary reperfusion therapy has not been established.CASE SUMMARY We reported a patient who presented with inferior STEMI with a culprit lesion of an acute thrombotic occlusion in the right coronary artery and thrombolysis and thrombin inhibition in myocardial infarction 0 flow.After the stent placement during primary percutaneous coronary intervention,intravascular ultrasound revealed MB overlying the stented segment where heavy atherosclerotic plaque were present.Likely due to the combination of plaque herniation or prolapse caused by MB,as well as local increased inflammation and thrombogenicity,acute stent thrombosis occurred at this region,which led to acute stent failure.The patient required an emergent repeated cardiac catheterization and placing a second layer of stent to enhance the radial strength and reduce the inter-strut space.CONCLUSION Plaque herniation or prolapse after stenting a MB segment in STEMI is a potential etiology for acute stent failure.
文摘The degree of vessel lumen narrowing is an independent predictor of ischemic stroke. New developments in carotid plaque morphology imaging (MR, CT), may bring new insights to the relationship between carotid atherosclerotic disease and stroke risk. Our aim is to review the stroke risk in a symptomatic patient with moderate carotid stenosis by CT imaging and histopathology. A 72-year-old patient with low ABCD2 scores TIA and moderate left internal carotid stenosis (50% by carotid ultrasound), was discharged with an optimized medical therapy. Four months later, he presented an ischemic stroke in the left frontal area. Carotid angiography showed a 60% stenosis in the left-internal carotid artery with a regular surface. CT plaque imaging detected a thin fibrous cap with calcification and an intraplaque hemorrhage (high-risk plaque). These findings were confirmed in the histolopathological study of the atherosclerotic plaque performed after the endarterectomy. After 1 year of follow-up, the patient returned independently to his daily activities. We propose, in this study, the inclusion of noninvasive plaque imaging in the evaluation of acute TIA with moderate carotid stenosis to better select patients with higher risk of stroke recurrence.
基金supported by the Natural Science Foundation of Jiangsu Province (No. BK2008144)the Postgraduate Research and Innovation Project of the Universities in Jiangsu Province (No. CX08S-018Z)the Research Grants Council of Hong Kong (No. HK-BU2181/03M)
文摘To understand certain mechanisms causing variations between rice cultivars with regard to cadmium uptake and tolerance, pot soil experiments were conducted with two rice cultivars of different genotypes under different soil Cd levels. The relationships between plant Cd uptake and iron/manganese （Fe/Mn） plaque formation on roots were investigated. The results showed that rice cultivars differed markedly in Cd uptake and tolerance. Under soil Cd treatments, Cd concentrations and accumulations in the cultivar Shanyou 63 （the genotype indica） were significantly higher than those in the cultivar Wuyunjing 7 （the genotype japonica） （P 〈 0.01, or P 〈 0.05）, and Shanyou 63 was more sensitive to Cd toxicity than Wuyunjing 7. The differences between the rice cultivars were the largest at relatively low soil Cd level （i.e., 10 mg/kg）. Fe concentrations in dithionite-citrate-bicarbonate root extracts of Shanyou 63 were generally lower than that of Wuyunjing 7, and the difference was the most significant under the treatment of 10 mg Cd/kg soil. The results indicated that the formation of iron plaque on rice roots could act as a barrier to soil Cd toxicity, and may be a ＂buffer＂ or a ＂reservoir＂ which could reduce Cd uptake into rice roots. And the plaque may contribute, to some extent, to the genotypic differences of rice cultivars in Cd uptake and tolerance.
基金Supported by Coordenao de Aperfeioamento de Pessoal de Nível Superior and Federal University of Pará
文摘AIM: To establish whether virulence factor genes vacA and cagA are present in Helicobacter pylori (H. pylori) retrieved from gastric mucosa and dental plaque in pa-tients with dyspepsia. METHODS: Cumulative dental plaque specimens and gastric biopsies were submitted to histological exami-nation, rapid urease test and polymerase chain reac-tion (PCR) assays to detect the presence of cagA and vacA polymorphisms.RESULTS: Detection of H. pylori from dental plaque and gastric biopsy samples was greater by PCR com-pared to histological examination and the rapid ure-ase test. DNA from H. pylori was detected in 96% of gastric mucosa samples and in 72% of dental plaque samples. Sixty-three (89%) of 71 dental plaque sam-ples that were H. pylori-positive also exhibited identical vacA and cagA genotypes in gastric mucosa. The most common genotype was vacAs1bm1 and cagA positive, either in dental plaque or gastric mucosa. These viru-lent H. pylori isolates were involved in the severity of clinical outcome.CONCLUSION: These pathogenic strains were found simultaneously in dental plaque and gastric mucosa, which suggests that gastric infection is correlated with the presence of H. pylori in the mouth.
文摘Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans. Although H. pylori may be detected in the stomach of approximately half of the world’s population, the mechanisms of transmission of the microorganism from individual to individual are not yet clear. Transmission of H. pylori could occur through iatrogenic, fecal-oral, and oral-oral routes, and through food and water. The microorganism may be transmitted orally and has been detected in dental plaque and saliva. However, the role of the oral cavity in the transmission and recurrence of H. pylori infection has been the subject of debate. A large number of studies investigating the role of oral hygiene and periodontal disease in H. pylori infection have varied significantly in terms of their methodology and sample population, resulting in a wide variation in the reported results. Nevertheless, recent studies have not only shown that the microorganism can be detected fairly consistently from the oral cavity but also demonstrated that the chances of recurrence of H. pylori infection is more likely among patients who harbor the organism in the oral cavity. Furthermore, initial results from clinical trials have shown that H. pylori-positive dyspeptic patients may benefit from periodontal therapy. This paper attempts to review the current body of evidence regarding the role of dental plaque, saliva, and periodontal disease in H. pylori infection.
基金Supported by The Science and Technology Department of Zhejiang Province,No.2008C33012Zhejiang Nature Science Foundation,No.Y2080718
文摘AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero-sclerotic plaques in the internal carotid artery were studied.The thickest soft plaque in each patient was examined using contrast-enhanced ultrasound.Time-intensity curves were collected from 5 s to 3 min after contrast injection.The neovascularization within the plaques in the internal carotid artery was evaluated using the ACQ software built into the scanner by 2 of the experienced investigators who were blinded to the clinical history of the patients.RESULTS:Ischemic stroke was present in 7 of 33 patients(21%) with grade Ⅰ plaque,in 14 of 51 pa-tients(28%) with grade Ⅱ plaque,in 26 of 43 patients(61%) with grade Ⅲ plaque,and in 34 of 49 patients(69%) with grade Ⅳ plaque(P < 0.001 comparing grade Ⅳ plaque with grade I plaque and with grade Ⅱ plaque and P = 0.001 comparing grade Ⅲ plaque with grade Ⅰ plaque and with grade Ⅱ plaque).Analysis of the time intensity curves revealed that patients with ischemic stroke had a significantly higher intensity of enhancement(IE) than those without ischemic stroke(P < 0.01).The wash-in time(WT) of plaque was signifi-cantly shorter in stroke patients(P < 0.05).The sensi-tivity and specificity for IE in the plaque were 82% and 80%,respectively,and for WT were 68% and 74%,respectively.There was no significant difference in the peak intensity or time to peak between the 2 groups.CONCLUSION:This study shows that the higher the grade of plaque enhancement,the higher the risk of ischemic stroke.The data suggest that the presence of neovascularization is a marker for unstable plaque.
