Objective:To study the effect of Shexiang Tongxin Dropping Pill(STDP)on angiogenesis in diabetic cardiomyopathy mice with coronary microcirculation dysfunction(CMD).Methods:According to a random number table,6 of 36 S...Objective:To study the effect of Shexiang Tongxin Dropping Pill(STDP)on angiogenesis in diabetic cardiomyopathy mice with coronary microcirculation dysfunction(CMD).Methods:According to a random number table,6 of 36 SPF male C57BL/6 mice were randomly selected as the control group,and the remaining 30 mice were injected with streptozotocin intraperitoneally to replicate the type 1 diabetes model.Mice successfully copied the diabetes model were randomly divided into the model group,STDP low-dose group[15 mg/(kg·d)],medium-dose group[30 mg/(kg·d)],high-dose group[60 mg/(kg·d)],and nicorandil group[15 mg/(kg·d)],6 in each group.The drug was given by continuous gavage for 12 weeks.The cardiac function of mice in each group was detected at the end of the experiment,and coronary flow reserve(CFR)was detected by chest Doppler technique.Pathological changes of myocardium were observed by hematoxylin-eosin staining,collagen fiber deposition was detected by masson staining,the number of myocardial capillaries was detected by platelet endothelial cell adhesion molecule-1 staining,and the degree of myocardial hypertrophy was detected by wheat germ agglutinin staining.The expression of the vascular endothlial growth factor(VEGF)/endothelial nitric oxide synthase(eNOS)signaling pathway-related proteins in myocardial tissue was detected by Western blot.Results:Compared with the model group,medium-and high-dose STDP significantly increased the left ventricular ejection fraction and left ventricular fraction shortening(P<0.01),obviously repaired the disordered cardiac muscle structure,reduced myocardial fibrosis,reduced myocardial cell area,increased capillary density,and increased CFR level(all P<0.01).Western blot showed that high-dose STDP could significantly increase the expression of VEGF and promote the phosphorylation of vascular endothelial growth factor receptor 2,phosphoinositide 3-kinase,protein kinase B,and eNOS(P<0.05 or P<0.01).Conclusion:STDP has a definite therapeutic effect on diabetic CMD,and its mechanism may be related to promoting angiogenesis through the VEGF/eNOS signaling pathway.展开更多
Objective This study aimed to examine the effects of microcirculatory dysfunction and 654-1intervention after cardiopulmonary resuscitation on myocardial injury.Methods Landrace pigs were divided into a sham operation...Objective This study aimed to examine the effects of microcirculatory dysfunction and 654-1intervention after cardiopulmonary resuscitation on myocardial injury.Methods Landrace pigs were divided into a sham operation group(S group,n=6),ventricular fibrillation control group(VF-C group,n=8)and 654-1 intervention group(VF-I group,n=8).Hemodynamics was recorded at baseline,at recovery of spontaneous circulation(ROSC),and 1 h,2 h,4h and 6 h thereafter.Sidestream dark field(SDF)technology was used to evaluate and monitor the microcirculation flow index,total vessel density,perfusion vessel ratio,De-Backer score,and perfusion vessel density in animal viscera at various time points.Results After administration of 654-1 at 1.5 h post-ROSC,the hemodynamics in the VF-I group,as compared with the VF-C group,was significantly improved.The visceral microcirculation detected by SDF was also significantly improved in the VF-I group.As observed through electron microscopy,significantly less myocardial tissue injury was present in the VF-I group than the VF-C group.Conclusion Administration of 654-1 inhibited excessive inflammatory by improving the state of visceral microcirculation.展开更多
The vascular occlusion test (VOT) is an experiment that simulates the process of distal ischemia-reperfusion of tissue based on the monitoring of tissue oxygen saturation (StO2) to obtain VOT parameters related to StO...The vascular occlusion test (VOT) is an experiment that simulates the process of distal ischemia-reperfusion of tissue based on the monitoring of tissue oxygen saturation (StO2) to obtain VOT parameters related to StO2 changes to evaluate microcirculation function of the measured muscle tissue. VOT has the advantages of real-time, noninvasive and continuous, and is widely used to evaluate the functional status of peripheral microcirculation and the relationship between microcirculation changes and prognosis of patients. In clinical work, doctors mainly focus on hemodynamics of patients, while microcirculation function is often neglected due to the lack of real-time monitoring methods, which may lead to severe poor prognosis of patients, especially patients with critical illness. This paper focuses on the clinical application of vascular occlusion test based on tissue oxygen saturation monitoring.展开更多
Objective:To evaluate the immediate effect of Kuanxiong Aerosol(KXA)on perioperative coronary microcirculation in patients with unstable angina(UA)suffering from elective percutaneous coronary intervention(PCI).Method...Objective:To evaluate the immediate effect of Kuanxiong Aerosol(KXA)on perioperative coronary microcirculation in patients with unstable angina(UA)suffering from elective percutaneous coronary intervention(PCI).Methods:From February 2021 to July 2023,UA inpatients who underwent PCI alone in the left anterior descending(LAD)branch were included.Random numbers were generated to divide patients into the trial group and the control group at a ratio of 1:1.The index of coronary microcirculation resistance(IMR)was measured before PCI,and the trial group was given two sprays of KXA,while the control group was not given.IMR was measured again after PCI,cardiac troponin I(cTnI)and creatine kinase isoenzyme-MB(CK-MB)were detected before and 24 h after surgery,and major cardiovascular adverse events(MACEs)were recorded for 30 days.The data statistics and analysis personnel were blinded.Results:Totally 859 patients were screened,and 62 of them were involved into this study.Finally,1 patient in the trial group failed to complete the post-PCI IMR and was excluded,30 patients were included for data analysis,while 31 patients in the control group were enrolled in data analysis.There was no significant difference in baseline data(age,gender,risk factors,previous history,biochemical index,and drug therapy,etc.)between the two groups.In addition,differences in IMR,cTnI and CK-MB were not statistically significant between the two groups before surgery.After PCI,the IMR level of the trial group was significantly lower than that of the control group(19.56±14.37 vs.27.15±15.03,P=0.048).Besides,the incidence of perioperative myocardial injury(PMI)was lower in the trial group,but the difference was not statistically significant(6.67%vs.16.13%,P=0.425).No MACEs were reported in either group.Conclusions:KXA has the potential of improving coronary microvascular dysfunction.This study provides reference for the application of KXA in UA patients undergoing elective PCI.展开更多
Microcirculatory dysfunction(CMD)typically occurs in patients with acute ST-segment elevation myocardial infarction during percutaneous coronary intervention,which is associated with more severe myocardial injury and ...Microcirculatory dysfunction(CMD)typically occurs in patients with acute ST-segment elevation myocardial infarction during percutaneous coronary intervention,which is associated with more severe myocardial injury and a worse prognosis.With the advancement of intracoronary physiology and imaging technology,the prevention and therapeutic interventions of CMD have attracted more attention.However,relevant guidelines or consensus on CMD are lacking in China.The current consensus summarizes the prevention and diagnostic strategies of emergency percutaneous coronary intervention-related CMD and gives suggestions to improve the prognosis of ST-segment elevation myocardial infarction patients based on evidence from recent clinical studies,guidelines,and consensus from international sources.展开更多
基金Supported by the National Natural Science Foundation of China(No.81930113)。
文摘Objective:To study the effect of Shexiang Tongxin Dropping Pill(STDP)on angiogenesis in diabetic cardiomyopathy mice with coronary microcirculation dysfunction(CMD).Methods:According to a random number table,6 of 36 SPF male C57BL/6 mice were randomly selected as the control group,and the remaining 30 mice were injected with streptozotocin intraperitoneally to replicate the type 1 diabetes model.Mice successfully copied the diabetes model were randomly divided into the model group,STDP low-dose group[15 mg/(kg·d)],medium-dose group[30 mg/(kg·d)],high-dose group[60 mg/(kg·d)],and nicorandil group[15 mg/(kg·d)],6 in each group.The drug was given by continuous gavage for 12 weeks.The cardiac function of mice in each group was detected at the end of the experiment,and coronary flow reserve(CFR)was detected by chest Doppler technique.Pathological changes of myocardium were observed by hematoxylin-eosin staining,collagen fiber deposition was detected by masson staining,the number of myocardial capillaries was detected by platelet endothelial cell adhesion molecule-1 staining,and the degree of myocardial hypertrophy was detected by wheat germ agglutinin staining.The expression of the vascular endothlial growth factor(VEGF)/endothelial nitric oxide synthase(eNOS)signaling pathway-related proteins in myocardial tissue was detected by Western blot.Results:Compared with the model group,medium-and high-dose STDP significantly increased the left ventricular ejection fraction and left ventricular fraction shortening(P<0.01),obviously repaired the disordered cardiac muscle structure,reduced myocardial fibrosis,reduced myocardial cell area,increased capillary density,and increased CFR level(all P<0.01).Western blot showed that high-dose STDP could significantly increase the expression of VEGF and promote the phosphorylation of vascular endothelial growth factor receptor 2,phosphoinositide 3-kinase,protein kinase B,and eNOS(P<0.05 or P<0.01).Conclusion:STDP has a definite therapeutic effect on diabetic CMD,and its mechanism may be related to promoting angiogenesis through the VEGF/eNOS signaling pathway.
文摘Objective This study aimed to examine the effects of microcirculatory dysfunction and 654-1intervention after cardiopulmonary resuscitation on myocardial injury.Methods Landrace pigs were divided into a sham operation group(S group,n=6),ventricular fibrillation control group(VF-C group,n=8)and 654-1 intervention group(VF-I group,n=8).Hemodynamics was recorded at baseline,at recovery of spontaneous circulation(ROSC),and 1 h,2 h,4h and 6 h thereafter.Sidestream dark field(SDF)technology was used to evaluate and monitor the microcirculation flow index,total vessel density,perfusion vessel ratio,De-Backer score,and perfusion vessel density in animal viscera at various time points.Results After administration of 654-1 at 1.5 h post-ROSC,the hemodynamics in the VF-I group,as compared with the VF-C group,was significantly improved.The visceral microcirculation detected by SDF was also significantly improved in the VF-I group.As observed through electron microscopy,significantly less myocardial tissue injury was present in the VF-I group than the VF-C group.Conclusion Administration of 654-1 inhibited excessive inflammatory by improving the state of visceral microcirculation.
基金Sichuan provincial health department(2018SHD1-10)
文摘The vascular occlusion test (VOT) is an experiment that simulates the process of distal ischemia-reperfusion of tissue based on the monitoring of tissue oxygen saturation (StO2) to obtain VOT parameters related to StO2 changes to evaluate microcirculation function of the measured muscle tissue. VOT has the advantages of real-time, noninvasive and continuous, and is widely used to evaluate the functional status of peripheral microcirculation and the relationship between microcirculation changes and prognosis of patients. In clinical work, doctors mainly focus on hemodynamics of patients, while microcirculation function is often neglected due to the lack of real-time monitoring methods, which may lead to severe poor prognosis of patients, especially patients with critical illness. This paper focuses on the clinical application of vascular occlusion test based on tissue oxygen saturation monitoring.
基金Supported by Capital's Funds for Health Improvement and Research(No.2022-1-2231)Beijing Science and Technology Program(No.Z221100007422127)Beijing Municipal Hospital Administration Green Seedling Talent Project(No.QML20231003)。
文摘Objective:To evaluate the immediate effect of Kuanxiong Aerosol(KXA)on perioperative coronary microcirculation in patients with unstable angina(UA)suffering from elective percutaneous coronary intervention(PCI).Methods:From February 2021 to July 2023,UA inpatients who underwent PCI alone in the left anterior descending(LAD)branch were included.Random numbers were generated to divide patients into the trial group and the control group at a ratio of 1:1.The index of coronary microcirculation resistance(IMR)was measured before PCI,and the trial group was given two sprays of KXA,while the control group was not given.IMR was measured again after PCI,cardiac troponin I(cTnI)and creatine kinase isoenzyme-MB(CK-MB)were detected before and 24 h after surgery,and major cardiovascular adverse events(MACEs)were recorded for 30 days.The data statistics and analysis personnel were blinded.Results:Totally 859 patients were screened,and 62 of them were involved into this study.Finally,1 patient in the trial group failed to complete the post-PCI IMR and was excluded,30 patients were included for data analysis,while 31 patients in the control group were enrolled in data analysis.There was no significant difference in baseline data(age,gender,risk factors,previous history,biochemical index,and drug therapy,etc.)between the two groups.In addition,differences in IMR,cTnI and CK-MB were not statistically significant between the two groups before surgery.After PCI,the IMR level of the trial group was significantly lower than that of the control group(19.56±14.37 vs.27.15±15.03,P=0.048).Besides,the incidence of perioperative myocardial injury(PMI)was lower in the trial group,but the difference was not statistically significant(6.67%vs.16.13%,P=0.425).No MACEs were reported in either group.Conclusions:KXA has the potential of improving coronary microvascular dysfunction.This study provides reference for the application of KXA in UA patients undergoing elective PCI.
基金supported by the National Key Research and Development Projects(2022YFC3602400)the National Natural Science Foundation of China(92249301 and U22A6008).
文摘Microcirculatory dysfunction(CMD)typically occurs in patients with acute ST-segment elevation myocardial infarction during percutaneous coronary intervention,which is associated with more severe myocardial injury and a worse prognosis.With the advancement of intracoronary physiology and imaging technology,the prevention and therapeutic interventions of CMD have attracted more attention.However,relevant guidelines or consensus on CMD are lacking in China.The current consensus summarizes the prevention and diagnostic strategies of emergency percutaneous coronary intervention-related CMD and gives suggestions to improve the prognosis of ST-segment elevation myocardial infarction patients based on evidence from recent clinical studies,guidelines,and consensus from international sources.
