BACKGROUND The prevalence of diabetes and its association with microcirculatory dysfunction presents a significant challenge in contemporary global health.Addressing this nexus is crucial for developing targeted thera...BACKGROUND The prevalence of diabetes and its association with microcirculatory dysfunction presents a significant challenge in contemporary global health.Addressing this nexus is crucial for developing targeted therapeutic interventions.AIM To trace the progression and delineate the current state of interdisciplinary research concerning diabetes and microcirculation.METHODS Employing a bibliometric approach,this study scrutinizes 12886 peer-reviewed publications retrieved from the PubMed and Web of Science databases.The focus is on elucidating the research trajectory and thematic concentrations at the confluence of diabetes and microcirculation.RESULTS Research outputs have surged since 2011,with the United States,China,and the United Kingdom leading in the quantity and quality of publications.This analysis revealed that journals such as Diabetes Care and The New England Journal of Medicine,along with top research institutions,have significantly contributed to advancing the understanding of microvascular processes affected by diabetes.The central themes identified include inflammation,oxidative stress,and endothelial dysfunction,which are critical in mediating the microvascular complications of diabetes.CONCLUSION This bibliometric evaluation reveals an evolving landscape focusing on diabetes and microcirculatory dysfunction.The complexity of diabetic microvascular issues encouraged multidisciplinary research strategies that are imperative for global health outcomes.展开更多
Under the basis of physiological data, a nonlinear and unsteady comprehensive mathematical model of microcirculatory dynamics with distributed parameters is developed. Hemodynamics, interstitium dynamics, lymph dynami...Under the basis of physiological data, a nonlinear and unsteady comprehensive mathematical model of microcirculatory dynamics with distributed parameters is developed. Hemodynamics, interstitium dynamics, lymph dynamics, dynamics of protein transport, oxygen dynamics, dynamics of heat transfer, and myogenic and metabolic regulation procedures are included. The interactions between these factors were comprehensively exhibited. The influences of arteriolar vasomotion and nonlinear viscoelasticity of blood in arteriole are considered. A simplified vessel network consisting of arteriole, open and reserved capillaries, venule, initial lymphatics and arteriole_venule anastomose is adopted as the geometrical model. This kind of comprehensive mathematical model is helpful in analyzing clinical data and developing a “numerical experiment method” in microcirculation research.展开更多
OBJECTIVE:To investigate the protective effects of Shexiang Tongxin dropping pill(麝香通心滴丸,STDP)in a rat model of coronary microcirculatory dysfunction(CMD).METHODS:Sprague-Dawley rats were allocated randomly into...OBJECTIVE:To investigate the protective effects of Shexiang Tongxin dropping pill(麝香通心滴丸,STDP)in a rat model of coronary microcirculatory dysfunction(CMD).METHODS:Sprague-Dawley rats were allocated randomly into four groups:sham,CMD model,STDP,and nicorandil.After 4 weeks of treatment,CMD was induced by injection of sodium laurate(0.2 m L,2 g/L)into the left ventricle while obstructing the ascending aorta.Rats in the sham group underwent an identical surgical procedure but were administered physiological(0.9%)saline(0.2 m L).Twenty-four hours after surgery,blood samples were collected for biochemical analyses and enzyme-linked immunosorbent assays.Heart tissues were removed for histopathology staining;apoptosis and inflammatory cytokines were examined by Western blotting.RESULTS:The STDP group had a lower level of creatine kinase-myocardial band,lactate dehydrogenase,and cardiac troponin-I than that in the CMD model group.Infiltration of inflammatory cells,myocardial ischaemia,and microthrombosis were relieved in the STDP group compared with CMD model group.Levels of endothelin-1,nuclear factor-kappa B,tumour necrosis factor-α,interleukin-6,interleukin-1β,malondialdehyde,B-cell lymphoma(Bcl)-2-associated X protein,and caspase-3 were lower,and levels of nitric oxide,Bcl-2,and superoxide dismutase were higher,in the STDP group in comparison with the CMD model group.CONCLUSION:STDP pretreatment improved the CMD induced by sodium laurate via anti-inflammatory,anti-apoptosis,and anti-oxidant mechanisms.展开更多
BACKGROUND: Since the 1990s, liver grafts from non- heart-beating donor (NHBD) have become an alternative because of the deficiency of grafts from heart-beating-do- nors (HBDs). Warm ischemia injury, however, directly...BACKGROUND: Since the 1990s, liver grafts from non- heart-beating donor (NHBD) have become an alternative because of the deficiency of grafts from heart-beating-do- nors (HBDs). Warm ischemia injury, however, directly influences the grafts' activity and functional recovery after operation. We investigated the microcirculatory change of liver graft at different warm ischemia time (WIT) in rats and determined the maximum limitation of liver graft to warm ischemia. METHODS: According to WIT, 120 rats were divided ran- domly into 5 groups of 0, 15 , 30 , 45 , 60 minutes respec- tively. The microcirculatory changes of their liver grafts were measured including serum level of hyaluronic acid (HA) and ultrastructural changes. After orthotopic liver transplantation (OLT), the recovery of microcirculation of the liver grafts after 24 hours, 48 hours and 3 days was ob- served. RESULTS: Microcirculatory changes and function of the liver grafts became normal after reperfusion when the WIT was less than 30 minutes. In the 45-minute WI group, part of blood sinusoids was full of cytoplasmic blebs stemming from the microvilli of hepatocytes and hemocytes. The se- rum level of HA in each group after 45 minutes of WI re- covered after reperfusion. CONCLUSIONS: The microcirculatory change of rat liver graft is reversible when the WIT is less than 30 minutes: rat liver graft could be safely subject to warm ischemia within30 minutes. The maximal 45 minutes of WI can be tolera- ted by the microcirculatory function of liver graft. After 60 minutes of WI, irreversible disturbance of microcirculation may appear.展开更多
Objective To study the coronary microvascular function in older patients with heart failure with preserved ejection fraction (HFpEF) using an invasive pressure–temperature sensor guidewire. Methods Patients undergoin...Objective To study the coronary microvascular function in older patients with heart failure with preserved ejection fraction (HFpEF) using an invasive pressure–temperature sensor guidewire. Methods Patients undergoing echocardiography and cardiac catheterization examinations for exertional dyspnea and a positive stress test were retrospectively enrolled from January 2014 to November 2017, and were allocated into the control group or HFpEF group. The HFpEF group was secondary divided into two groups according to the age of 65 years. Comparing the clinical features and values obtained in examinations between the three groups, multivariate regression analysis was used to analyze the predictors of left ventricle end diastolic pressure (LVEDP). Results There were 87 patients enrolled in this study. The older HFpEF patients (n = 32) were more likely to be female;and had the most comorbidities, such as diabetes mellitus, atrial fibrillation, and chronic kidney dysfunction (CKD) with a low estimated glomerular filtration rate (eGFR), and had a similar hypertensive prevalence as the adult HFpEF group (n = 24), whose mean LVEDP and index of microcirculatory resistance (IMR) were highest in comparison to the adult HFpEF patients and controls (n = 31). The coronary flow reserve (CFR) in the older HFpEF and adult HFpEF groups was similarly reduced. In the regression analysis, the IMR linearly correlated to LVEDP, and was the only independent predictor of LVEDP. Conclusions An increased IMR and reduced CFR were characteristics of microvascular dysfunction in older HFpEF patients. The IMR independently had a positive linear correlation with LVEDP. Microvascular rarefaction might be a subsequent pathological progression in the development of HFpEF.展开更多
Microcirculatory changes and therapeutic effects in 39 non-insulin dependent diabetes mellitus (NIDDM) cases were evaluated. Under the same basic treatment in both groups, the treatment group (21 cases) was treated wi...Microcirculatory changes and therapeutic effects in 39 non-insulin dependent diabetes mellitus (NIDDM) cases were evaluated. Under the same basic treatment in both groups, the treatment group (21 cases) was treated with TCM drugs according to its stages and compared with the control group (18 cases, treated with 654-2). The results showed that the microcirculatory cumulative scores were significantly decreased in both groups (P<0.05), but the decrease in the treatment group was more marked (P<0.05). In the treatment group, 15 cases were cured, 3 markedly effective, 2 effective and 1 ineffective; while in the control group, 13 cases were cured, 1 markedly effective and 4 ineffective. Statistically, there is no significant difference between the 2 groups (P>0.05) in therapeutic effects.展开更多
The dysfunction of coronary microcirculation is an important cause of coronary artery disease(CAD).The index of microcirculatory resistance(IMR)is a quantitative evaluation of coronary microcirculatory function,which ...The dysfunction of coronary microcirculation is an important cause of coronary artery disease(CAD).The index of microcirculatory resistance(IMR)is a quantitative evaluation of coronary microcirculatory function,which provides a significant reference for the prediction,diagnosis,treatment,and prognosis of CAD.IMR also plays a key role in investigating the interaction between epicardial and microcirculatory dysfunctions,and is closely associated with coronary hemodynamic parameters such as flow rate,distal coronary pressure,and aortic pressure,which have been widely applied in computational studies of CAD.However,there is currently a lack of consensus across studies on the normal and pathological ranges of IMR.The relationships between IMR and coronary hemodynamic parameters have not been accurately quantified,which limits the application of IMR in computational CAD studies.In this paper,we discuss the research gaps between IMR and its potential applications in the computational simulation of CAD.Computational simulation based on the combination of IMR and other hemodynamic parameters is a promising technology to improve the diagnosis and guide clinical trials of CAD.展开更多
The evaluation of the microcirculatory bed functional state and the identification of angiospastic disorders with related complications,when the pathological changes are reversible,have an important role in medical pr...The evaluation of the microcirculatory bed functional state and the identification of angiospastic disorders with related complications,when the pathological changes are reversible,have an important role in medical practice.The aim of this study was to evaluate the possibility of using optical noninvasive methods and the cold pressor test to solve this problem.A total of 33 patients with rheumatological diseases and 32 healthy volunteers were included in the study.Laser Doppler flowmetry,tissue reflectance oximetry and pulse oximetry were used as optical noninvasive methods.The parameters were recorded before,immediately after and 20 min after the cold pressor test.Based on the measured parameters,the complex parameters of the microcirculatory bed were calculated.A detailed statistical analysis of the parameter changes for each individual in the two groups displayed diverse microcirculatory bed parameter responses upon cold exposure,with differing recovery of parameters after CPT.New diagnostic criteria were proposed for the identification of angiospastic disorders.According to the proposed criteria,27 people of the volunteers group were confirmed to not display any disorders.In the patient group,however,18 people were observed to have a relatively normal functional state of the microcirculatory bed,while 15 people were observed to have a possible tendency to angiospasm.To highlight the diferences between a relatively normal state and presence of angiospastic disorders,statistical analysis of experimental data was carried out,which revealed significant differences.Further analysis of data with angiospastic disorders identified a relationship between their diagnoses and the results of labo-ratory studies.Thus,the evaluation of combined noninvasive optical diagnostic method use,the cold pressor test and proposed diagnostic criteria showed a positive result.This approach can be used to detect the presence of possible angiospastic disorders and related complications,as well as mi-crocirculatory bed disorders against the background of other diseases.展开更多
The mathematical model described in Part I was solved using “influence line method” combining analytical method and finite element method. Many important aspects of microcirculatory dynamics were analyzed and discus...The mathematical model described in Part I was solved using “influence line method” combining analytical method and finite element method. Many important aspects of microcirculatory dynamics were analyzed and discussed. It show that interstitial fluid pressure changes its sign twice within one arteriolar vasomotion period and it is therefore not important that interstitial fluid pressure is a little higher or lower than atmospheric pressure; arteriolar vasomotion can periodically result in lymph formation and interstitial total pressure plays an important role in this procedure; local regulation of microcirculation can meet metabolic need some extent in the form of dynamic equilibrium. The property of arteriole as a “resistant vessel” and the efficiency of microvascular network as heat exchanger are also shown. These results show that the comprehensive mathematical model developed in Part I is physiologically reasonable.展开更多
AIM： To evaluate the effects of a portocaval shunt on the decrease of excessive portal flow for the prevention of sinusoidal microcirculatory injury in extremely smallfor-size liver transplantation in pigs. METHODS：...AIM： To evaluate the effects of a portocaval shunt on the decrease of excessive portal flow for the prevention of sinusoidal microcirculatory injury in extremely smallfor-size liver transplantation in pigs. METHODS： The right lateral lobe of pigs, i.e. the 25% of the liver, was transplanted orthotopically. The pigs were divided into two groups： graft without portocaval shunt （n = 11） and graft with portocaval shunt （n = 11）. Survival rate, portal flow, hepatic arterial flow, and histological findings were investigated. RESULTS： In the group without portocaval shunt, all pigs except one died of liver dysfunction within 24 h afcer transplantation. In the group with portocaval shunt, eight pigs survived for more than 4 d. The portal flow volumes before and after transplantation in the group without portocaval shunt were 118.2±26.9 mL/min/100 g liver tissue and 270.5±72.9 ml./min/100 g liver tissue, respectively. On the other hand, in the group with portocaval shunt, those volumes were 124.2±27.8 ml./ min/100 g liver tissue and 42.7±32.3 mL/min/100 g liver tissue, respectively （P〈0.01）. As for histological findings in the group without portocaval shunt, destruction of the sinusoidal lining and bleeding in the peri-portal areas were observed afl：er reperfusion, but these findings were not recognized in the group with portocaval shunt. CONCLUSION： These results suggest that excessive portal flow is attributed to post transplant liver dysfunction after extreme small-for-size liver transplantation caused by sinusoidal microcirculatory injury.展开更多
OBJECTIVE: To investigate the relationship between symptom patterns of cold coagulation and blood stasis(CCBS) and microcirculation disturbance. In addition, we determined the efficacy of modified Wenjing decoction(WJ...OBJECTIVE: To investigate the relationship between symptom patterns of cold coagulation and blood stasis(CCBS) and microcirculation disturbance. In addition, we determined the efficacy of modified Wenjing decoction(WJD) for the treatment of CCBS.METHODS: CCBS was induced in rats with an icewater bath treatment. The ovarian function, microvascular and circulatory status of reproductive organs, and function of local microvascular endothelial cells(VECs) and vascular smooth muscle cells(VSMCs) were evaluated.RESULTS: Ovarian dysfunction was observed in the rats with CCBS. It was characterized by the presence of an estrous cycle disorder and a decrease in reproductive hormone levels. Microvascular circulation disorders were associated with an imbalance in vasoconstriction, relaxation substances, nitric oxide, abnormal blood flow in whole blood, and decreased blood flow in the auricle and uterus. VECs were damaged, and VSMCs contracted and proliferated in ovarian and uterine tissues.CONCLUSION: Our findings suggest that the dysfunctional reproductive organs observed in gynecological CCBS may be closely related to the microcirculation disturbance of local tissues, microvascular contraction, and vascular remodeling. Modified WJD can be used to treat CCBS by improving microcirculation in reproductive organs.展开更多
Objective:To investigate color and microvascular blood flow of the tongue in the mini-swine with immune hepatic injury. Methods: Six Chinese mini-swine for experimental use, 3 males and 3 females, were randomly divide...Objective:To investigate color and microvascular blood flow of the tongue in the mini-swine with immune hepatic injury. Methods: Six Chinese mini-swine for experimental use, 3 males and 3 females, were randomly divided into two groups, normal group and model group, 3 swine in each group. The swine in the model group was administrated by injection of 5 mg/kg ConA into the vein of auricular back, once every other day, 3 times each week, for 2 weeks in total. The animal in the control group was administrated with equal volume of saline. At 9 o’clock in the morning of the 15th day of the experiment, each swine was anesthetized with intramuscular injection of 9 ml 2.5% pentobarbital sodium and 3 ml Maleate, and then picture of the tongue was taken, microvascular blood flow on the tongue and the liver was detected with a laser Doppler blood flowmeter; Blood was taken from the precaval vein. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST),total bilirubin (Tbil) and total protein (TP) were determined; Pathological changes of the liver and tongue tissues were investigated by means of HE staining; Serum TNF-α content was detected with ELISA assay. Results: In the mini-swine with immune hepatic injury induced by ConA, the tongue color showed cyanotic color, microvascular perfusion in the liver and the tongue, and partial pressure of oxygen in the tongue tissue significantly decreased; and the microcirculatory perfusion of the tongue was significantly correlated with that of the liver and the HIS color spatial value of the tongue; Serum TNF-α content significantly increased. Conclusion: The mini-swine with immune hepatic injury induced by ConA conforms to pathological characteristics of immune hepatic injury. Formation of the cyanotic tongue is related with microcirculatory disturbance of the tongue, which can indirectly reflect hepatic microcirculatory state in the immune hepatic injury.展开更多
Objective To investigate the effect of ulinastatin(UTI)on hepatic ischemia-reperfusion injury in rats.Methods Totally 24 adult Sprague-Dawley rats were randomly divided into 3 groups:sham-operated control group(SO gro...Objective To investigate the effect of ulinastatin(UTI)on hepatic ischemia-reperfusion injury in rats.Methods Totally 24 adult Sprague-Dawley rats were randomly divided into 3 groups:sham-operated control group(SO group),ischemia-reperfusion group(I/R group)and ulinastatin group(UTI group).Liver in I/R group underwent 1 h of reperfusion after 30 min of ischemia.In UTI group,UTI(2×104 U/kg)was administered to rats 30 min before modeling.The levels of alanine aminotransferase,aspartate aminotransferase and tumor necrosis factor-alpha(TNF-α)in serum were measured and the levels of nitric oxide and malondialdehyde in liver were determined.The histological changes of liver were observed.Results The levels of alanine aminotransferase,aspartate aminotransferase and TNF-α in serum were significantly increased in I/R group compared with those in UTI group(P<0.05).The levels of nitric oxide and malondialdehyde in liver were significantly higher in I/R group than in UTI group(P<0.05).Histological examination of liver indicated that the damages were more severe in I/R group than in UTI group.Conclusion UTI has the ability to inhibit the production of TNF-α and oxyradical,and ameliorate microcirculatory dysfunction in rats with hepatic ischemia-reperfusion injury.展开更多
Pericytes are the main cellular components of tiny arteries and capillaries.Studies have found that pericytes can undergo morphological contraction or relaxation under stimulation by cytokines,thus affecting the contr...Pericytes are the main cellular components of tiny arteries and capillaries.Studies have found that pericytes can undergo morphological contraction or relaxation under stimulation by cytokines,thus affecting the contraction and relaxation of microvessels and playing an essential role in regulating vascular microcirculation.Moreover,due to the characteristics of stem cells,pericytes can differentiate into a variety of inflammatory cell phenotypes,which then affect the immune function.Additionally,pericytes can also participate in angiogenesis and wound healing by interacting with endothelial cells in vascular microcirculation disorders.Here we review the origin,biological phenotype and function of pericytes,and discuss the potential mechanisms of pericytes in vascular microcirculation disorders,especially in pulmonary hypertension,so as to provide a sound basis and direction for the prevention and treatment of vascular microcirculation diseases.展开更多
OBJECTIVE Shenfu injection(SFI)is an effective treatment of cardiogenic shock,the pathology of the central link was microcirculation disturbance.However,whether the microcirculation status of the early-and mid-stage o...OBJECTIVE Shenfu injection(SFI)is an effective treatment of cardiogenic shock,the pathology of the central link was microcirculation disturbance.However,whether the microcirculation status of the early-and mid-stage of cardiogenic shock has any difference is unclear.This study aimed to observe the effect of SFI on the microcirculatory disturbance in mesentery for early-and mid-stage of cardiogenic shock rat.METHODS The early-and mid-stage model of cardiogenic shock was established by ligating the ending or root of left anterior descending coronary arteries(LADCA).The rats were randomly divided into 9 groups,ie control group,early-stage model group,mid-stage model group,3 early medicated groups and 3 mid medicated groups(the dosage was 1,3.33,10 mL·kg^(-1) SFI for cardiogenic shock rats of early-and mid-stage,respectively).Parameters in mesenteric microcirculation,such as velocity of RBCs in venules,diameters of venules,the count of leukocyte adhesion and vascular permeability which calculated by FITC-dextran leakage were observed through an GeneandiM2 inverted intravital microscope and high-speed video camera system.RESULTS The cardiogenic shock induced by ligating the LADCA resulted in a number of responses in microcirculation,including a significant increase in the counts of adhesive leukocytes,narrowing of the vascular diameter,decrease in the velocity of RBCs and dextran efflux.All of the above parameters for early-stage cardiogenic shock rats were attenuated by the treatment with SFI,especially the dosage of 10 mL·kg^(-1).While SFI had no apparent time-effect on the vascular diameter and vascular permeability in mesentery for mid-stage cardiogenic shock rats.CONCLUSION The microcirculation status of the early-and mid-stage of cardiogenic shock rats were quite different.The efficacy of early treatment with SFI was more obvious than the mid administration,which could provide experimental and theoretical basis for the patients with cardiogenic shock in an earlier time.展开更多
There have recently appeared many reports dedicated to cerebral hemodynamics disorders in AD. However, certain specific aspects of cerebral blood flow and microcirculation during this disease are not fully understood....There have recently appeared many reports dedicated to cerebral hemodynamics disorders in AD. However, certain specific aspects of cerebral blood flow and microcirculation during this disease are not fully understood. This research focuses on the identification of particular features of cerebral angioarchitectonics and microcirculation at preclinical and clinical AD stages and on the determination of their importance in AD etiology and pathogenesis. 164 patients participated in the research: Test Group—81 patients with different AD stages;Control Group— 83 patients with etiologically different neurodegenerative brain lesions with manifestations of dementia and cognitive impairment but without AD. All patients underwent: assessment of cognitive function (MMSE), severity of dementia (CDR) and AD stages (TDR), laboratory examination, computed tomography (CT), magnetic resonance imaging (MRI), brain scintigraphy (SG), rheoencephalography (REG) and cerebral multigated angiography (MUGA). All Test Group patients, irrespective of their AD stage, had abnormalities of the cerebral microcirculation manifested in dyscirculatory angiopathy of Alzheimer’s type (DAAT), namely: reduction of the capillary bed in the hippocampus and frontal-parietal regions;development of multiple arteriovenous shunts in the same regions;early venous dumping of arterial blood through these shunts with simultaneous filling of arteries and veins;development of abnormally enlarged lateral venous trunks that receive blood from the arterio-venous shunts;anomalous venous congestion at the border of frontal and parietal region;increased loop formation of distal intracranial arterial branches. Control group patients did not have combinations of such changes. These abnormalities are specific for AD and can affect amyloid beta metabolism contributing to its accumulation in the brain tissue and thereby stimulating AD progression.展开更多
Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of th...Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of the methods currently available for its characterization can improve the diagnostic and prognostic accuracy of invasive assessment of the coronary circulation, and help improve clinical decision-making. In this article we summarize the current methods available for a thorough assessment of coronary physiology.展开更多
Objective:Microcirculatory disturbance is pathologically critical to acute pancreatitis(AP),which can be effectively alleviated by traditional Chinese medicine(TCM)formulas that activate blood flow.However,there has b...Objective:Microcirculatory disturbance is pathologically critical to acute pancreatitis(AP),which can be effectively alleviated by traditional Chinese medicine(TCM)formulas that activate blood flow.However,there has been no evidence-based research to date.Therefore,a well-designed systematic review and meta-analysis is necessary to elucidate the therapeutic transformative benefit of improving microcirculation during AP.This study aims to confirm the therapeutic efficacy of TCM formulas and explore the potential mechanisms underlying their effects on AP treatment.Methods:Studies from eight databases including Pubmed,Embase,Web of Science,Cochrane Library,CNKI,CBM,Wanfang,and Chinese VIP,were screened for the eligible randomized controlled trials(RCTs).The APACHEⅡscore and effectiveness rate were set as primary outcomes,while mortality rate,complications,total hospital stays,serum amylase recovery time,the time until the disappearance of abdominal pain,microcirculation indicators,and inflammation indicators were chosen as secondary outcomes.A systematic review and meta-analysis were subsequently conducted.Network pharmacology analysis was performed to analyze potential bioactive components with relevant targets of the core herbs included in the TCM formulas for activating blood flow.Results:A total of 51 RCTs(n=3721)were included.Compared with conventional western medical treatments alone,TCM groups were associated with lower APACHEⅡscore(SMD=1.36,95%CI:2.01 to 0.71,P=0.000)and higher effectiveness rate(RR:1.22,95%CI:1.18 to 1.26,P=0.000).Furthermore,the formulas for activating blood flow demonstrated significant efficacy in improving both microcirculation and inflammation indicators.Additionally,six core Chinese herbal medicines including Rhei Radix et Rhizoma with the highest frequency,Aurantii Fructus Immaturus,Paeoniae Radix Rubra,Bupleuri Radix,Salviae Miltiorrhizae Radix et Rhizoma,and Corydalis Rhizoma were filtered out from the adopted TCM formulas.Finally,166 shared targets between the six herbs and AP were identified.KEGG analysis indicated that lipid and atherosclerosis pathway is highly related to microcirculation.Conclusion:TCM formulas for activating blood flow significantly improve microcirculation and alleviate AP.Further high-quality,well-designed RCTs and deep mechanism exploration are required.展开更多
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from im-paired insulin secretion or insulin resistance.Diabetes poses a major global health concern,because of...Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from im-paired insulin secretion or insulin resistance.Diabetes poses a major global health concern,because of its increasing prevalence and substantial morbidity and mortality.This review explores the relationships between altered fatty acid metabolism and microcirculatory impairments in diabetes.Dysregulation of fatty acid metabolism in diabetes leads to changes in fatty acid profiles,abnormal lipid accumulation,and increased oxidative stress.These changes contribute to microvascular dysfunction through mechanisms such as endothelial dysfunction,impaired nitric oxide availability,inflammation,and oxidative damage.Understanding this intricate interplay is essential for identifying novel thera-peutic strategies to alleviate vascular complications in diabetes.By targeting specific pathways involved in fatty acid metabolism and microvascular dysfunction,interventions can be developed to improve patient outcomes.This review is aimed at contributing to future research and the development of effective strategies for preventing and managing dia-betes-associated microcirculatory impairments,to ultimately enhance the quality of life for people living with diabetes.展开更多
基金Beijing Municipal Natural Science Foundation,China,No.7212068National Natural Science Foundation of China,No.81900747.
文摘BACKGROUND The prevalence of diabetes and its association with microcirculatory dysfunction presents a significant challenge in contemporary global health.Addressing this nexus is crucial for developing targeted therapeutic interventions.AIM To trace the progression and delineate the current state of interdisciplinary research concerning diabetes and microcirculation.METHODS Employing a bibliometric approach,this study scrutinizes 12886 peer-reviewed publications retrieved from the PubMed and Web of Science databases.The focus is on elucidating the research trajectory and thematic concentrations at the confluence of diabetes and microcirculation.RESULTS Research outputs have surged since 2011,with the United States,China,and the United Kingdom leading in the quantity and quality of publications.This analysis revealed that journals such as Diabetes Care and The New England Journal of Medicine,along with top research institutions,have significantly contributed to advancing the understanding of microvascular processes affected by diabetes.The central themes identified include inflammation,oxidative stress,and endothelial dysfunction,which are critical in mediating the microvascular complications of diabetes.CONCLUSION This bibliometric evaluation reveals an evolving landscape focusing on diabetes and microcirculatory dysfunction.The complexity of diabetic microvascular issues encouraged multidisciplinary research strategies that are imperative for global health outcomes.
基金the Natural Science Foundation of Sichuan Province , P R China
文摘Under the basis of physiological data, a nonlinear and unsteady comprehensive mathematical model of microcirculatory dynamics with distributed parameters is developed. Hemodynamics, interstitium dynamics, lymph dynamics, dynamics of protein transport, oxygen dynamics, dynamics of heat transfer, and myogenic and metabolic regulation procedures are included. The interactions between these factors were comprehensively exhibited. The influences of arteriolar vasomotion and nonlinear viscoelasticity of blood in arteriole are considered. A simplified vessel network consisting of arteriole, open and reserved capillaries, venule, initial lymphatics and arteriole_venule anastomose is adopted as the geometrical model. This kind of comprehensive mathematical model is helpful in analyzing clinical data and developing a “numerical experiment method” in microcirculation research.
基金Supported by Zhejiang Medicine and Technology Plan(No.2018KY827)Zhejiang TCM Science and Technology Plan(No.2018ZB130)-funded Project the Study of the Protective Effects of Shexiang Tongxin dropping pill on Coronary Microcirculatory Dysfunction。
文摘OBJECTIVE:To investigate the protective effects of Shexiang Tongxin dropping pill(麝香通心滴丸,STDP)in a rat model of coronary microcirculatory dysfunction(CMD).METHODS:Sprague-Dawley rats were allocated randomly into four groups:sham,CMD model,STDP,and nicorandil.After 4 weeks of treatment,CMD was induced by injection of sodium laurate(0.2 m L,2 g/L)into the left ventricle while obstructing the ascending aorta.Rats in the sham group underwent an identical surgical procedure but were administered physiological(0.9%)saline(0.2 m L).Twenty-four hours after surgery,blood samples were collected for biochemical analyses and enzyme-linked immunosorbent assays.Heart tissues were removed for histopathology staining;apoptosis and inflammatory cytokines were examined by Western blotting.RESULTS:The STDP group had a lower level of creatine kinase-myocardial band,lactate dehydrogenase,and cardiac troponin-I than that in the CMD model group.Infiltration of inflammatory cells,myocardial ischaemia,and microthrombosis were relieved in the STDP group compared with CMD model group.Levels of endothelin-1,nuclear factor-kappa B,tumour necrosis factor-α,interleukin-6,interleukin-1β,malondialdehyde,B-cell lymphoma(Bcl)-2-associated X protein,and caspase-3 were lower,and levels of nitric oxide,Bcl-2,and superoxide dismutase were higher,in the STDP group in comparison with the CMD model group.CONCLUSION:STDP pretreatment improved the CMD induced by sodium laurate via anti-inflammatory,anti-apoptosis,and anti-oxidant mechanisms.
基金This study was supported by the key clinical project of Minister of Health( No. 97040230 ) and Scientific and Technological Committee of Guang-dong Province, China (No. 99M4902G).
文摘BACKGROUND: Since the 1990s, liver grafts from non- heart-beating donor (NHBD) have become an alternative because of the deficiency of grafts from heart-beating-do- nors (HBDs). Warm ischemia injury, however, directly influences the grafts' activity and functional recovery after operation. We investigated the microcirculatory change of liver graft at different warm ischemia time (WIT) in rats and determined the maximum limitation of liver graft to warm ischemia. METHODS: According to WIT, 120 rats were divided ran- domly into 5 groups of 0, 15 , 30 , 45 , 60 minutes respec- tively. The microcirculatory changes of their liver grafts were measured including serum level of hyaluronic acid (HA) and ultrastructural changes. After orthotopic liver transplantation (OLT), the recovery of microcirculation of the liver grafts after 24 hours, 48 hours and 3 days was ob- served. RESULTS: Microcirculatory changes and function of the liver grafts became normal after reperfusion when the WIT was less than 30 minutes. In the 45-minute WI group, part of blood sinusoids was full of cytoplasmic blebs stemming from the microvilli of hepatocytes and hemocytes. The se- rum level of HA in each group after 45 minutes of WI re- covered after reperfusion. CONCLUSIONS: The microcirculatory change of rat liver graft is reversible when the WIT is less than 30 minutes: rat liver graft could be safely subject to warm ischemia within30 minutes. The maximal 45 minutes of WI can be tolera- ted by the microcirculatory function of liver graft. After 60 minutes of WI, irreversible disturbance of microcirculation may appear.
文摘Objective To study the coronary microvascular function in older patients with heart failure with preserved ejection fraction (HFpEF) using an invasive pressure–temperature sensor guidewire. Methods Patients undergoing echocardiography and cardiac catheterization examinations for exertional dyspnea and a positive stress test were retrospectively enrolled from January 2014 to November 2017, and were allocated into the control group or HFpEF group. The HFpEF group was secondary divided into two groups according to the age of 65 years. Comparing the clinical features and values obtained in examinations between the three groups, multivariate regression analysis was used to analyze the predictors of left ventricle end diastolic pressure (LVEDP). Results There were 87 patients enrolled in this study. The older HFpEF patients (n = 32) were more likely to be female;and had the most comorbidities, such as diabetes mellitus, atrial fibrillation, and chronic kidney dysfunction (CKD) with a low estimated glomerular filtration rate (eGFR), and had a similar hypertensive prevalence as the adult HFpEF group (n = 24), whose mean LVEDP and index of microcirculatory resistance (IMR) were highest in comparison to the adult HFpEF patients and controls (n = 31). The coronary flow reserve (CFR) in the older HFpEF and adult HFpEF groups was similarly reduced. In the regression analysis, the IMR linearly correlated to LVEDP, and was the only independent predictor of LVEDP. Conclusions An increased IMR and reduced CFR were characteristics of microvascular dysfunction in older HFpEF patients. The IMR independently had a positive linear correlation with LVEDP. Microvascular rarefaction might be a subsequent pathological progression in the development of HFpEF.
文摘Microcirculatory changes and therapeutic effects in 39 non-insulin dependent diabetes mellitus (NIDDM) cases were evaluated. Under the same basic treatment in both groups, the treatment group (21 cases) was treated with TCM drugs according to its stages and compared with the control group (18 cases, treated with 654-2). The results showed that the microcirculatory cumulative scores were significantly decreased in both groups (P<0.05), but the decrease in the treatment group was more marked (P<0.05). In the treatment group, 15 cases were cured, 3 markedly effective, 2 effective and 1 ineffective; while in the control group, 13 cases were cured, 1 markedly effective and 4 ineffective. Statistically, there is no significant difference between the 2 groups (P>0.05) in therapeutic effects.
基金supported by the Natural Science Foundation of China(Nos.61527811 and 61701435)the Key Research and Development Program of Zhejiang Province(No.2020C03016)+1 种基金the Zhejiang Provincial Natural Science Foundation of China(No.LY17H180003)the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission(No.2020RC094),China。
文摘The dysfunction of coronary microcirculation is an important cause of coronary artery disease(CAD).The index of microcirculatory resistance(IMR)is a quantitative evaluation of coronary microcirculatory function,which provides a significant reference for the prediction,diagnosis,treatment,and prognosis of CAD.IMR also plays a key role in investigating the interaction between epicardial and microcirculatory dysfunctions,and is closely associated with coronary hemodynamic parameters such as flow rate,distal coronary pressure,and aortic pressure,which have been widely applied in computational studies of CAD.However,there is currently a lack of consensus across studies on the normal and pathological ranges of IMR.The relationships between IMR and coronary hemodynamic parameters have not been accurately quantified,which limits the application of IMR in computational CAD studies.In this paper,we discuss the research gaps between IMR and its potential applications in the computational simulation of CAD.Computational simulation based on the combination of IMR and other hemodynamic parameters is a promising technology to improve the diagnosis and guide clinical trials of CAD.
文摘The evaluation of the microcirculatory bed functional state and the identification of angiospastic disorders with related complications,when the pathological changes are reversible,have an important role in medical practice.The aim of this study was to evaluate the possibility of using optical noninvasive methods and the cold pressor test to solve this problem.A total of 33 patients with rheumatological diseases and 32 healthy volunteers were included in the study.Laser Doppler flowmetry,tissue reflectance oximetry and pulse oximetry were used as optical noninvasive methods.The parameters were recorded before,immediately after and 20 min after the cold pressor test.Based on the measured parameters,the complex parameters of the microcirculatory bed were calculated.A detailed statistical analysis of the parameter changes for each individual in the two groups displayed diverse microcirculatory bed parameter responses upon cold exposure,with differing recovery of parameters after CPT.New diagnostic criteria were proposed for the identification of angiospastic disorders.According to the proposed criteria,27 people of the volunteers group were confirmed to not display any disorders.In the patient group,however,18 people were observed to have a relatively normal functional state of the microcirculatory bed,while 15 people were observed to have a possible tendency to angiospasm.To highlight the diferences between a relatively normal state and presence of angiospastic disorders,statistical analysis of experimental data was carried out,which revealed significant differences.Further analysis of data with angiospastic disorders identified a relationship between their diagnoses and the results of labo-ratory studies.Thus,the evaluation of combined noninvasive optical diagnostic method use,the cold pressor test and proposed diagnostic criteria showed a positive result.This approach can be used to detect the presence of possible angiospastic disorders and related complications,as well as mi-crocirculatory bed disorders against the background of other diseases.
文摘The mathematical model described in Part I was solved using “influence line method” combining analytical method and finite element method. Many important aspects of microcirculatory dynamics were analyzed and discussed. It show that interstitial fluid pressure changes its sign twice within one arteriolar vasomotion period and it is therefore not important that interstitial fluid pressure is a little higher or lower than atmospheric pressure; arteriolar vasomotion can periodically result in lymph formation and interstitial total pressure plays an important role in this procedure; local regulation of microcirculation can meet metabolic need some extent in the form of dynamic equilibrium. The property of arteriole as a “resistant vessel” and the efficiency of microvascular network as heat exchanger are also shown. These results show that the comprehensive mathematical model developed in Part I is physiologically reasonable.
基金Supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan, the Ministry of Welfare of Japan, and by a grant from Graduate School of Medicine, Tohoku University
文摘AIM： To evaluate the effects of a portocaval shunt on the decrease of excessive portal flow for the prevention of sinusoidal microcirculatory injury in extremely smallfor-size liver transplantation in pigs. METHODS： The right lateral lobe of pigs, i.e. the 25% of the liver, was transplanted orthotopically. The pigs were divided into two groups： graft without portocaval shunt （n = 11） and graft with portocaval shunt （n = 11）. Survival rate, portal flow, hepatic arterial flow, and histological findings were investigated. RESULTS： In the group without portocaval shunt, all pigs except one died of liver dysfunction within 24 h afcer transplantation. In the group with portocaval shunt, eight pigs survived for more than 4 d. The portal flow volumes before and after transplantation in the group without portocaval shunt were 118.2±26.9 mL/min/100 g liver tissue and 270.5±72.9 ml./min/100 g liver tissue, respectively. On the other hand, in the group with portocaval shunt, those volumes were 124.2±27.8 ml./ min/100 g liver tissue and 42.7±32.3 mL/min/100 g liver tissue, respectively （P〈0.01）. As for histological findings in the group without portocaval shunt, destruction of the sinusoidal lining and bleeding in the peri-portal areas were observed afl：er reperfusion, but these findings were not recognized in the group with portocaval shunt. CONCLUSION： These results suggest that excessive portal flow is attributed to post transplant liver dysfunction after extreme small-for-size liver transplantation caused by sinusoidal microcirculatory injury.
基金Supported by Natural Science Foundation-funded Project Based on the Theory of"Cold Leads to Blood Vessel Collection and Blood Stasis",to Discuss the Characteristics of Microvascular Endothelial Function Changes in the Syndrome of Cold Coagulation and Blood Stasis,and the Influence of TCM(No.81373514)。
文摘OBJECTIVE: To investigate the relationship between symptom patterns of cold coagulation and blood stasis(CCBS) and microcirculation disturbance. In addition, we determined the efficacy of modified Wenjing decoction(WJD) for the treatment of CCBS.METHODS: CCBS was induced in rats with an icewater bath treatment. The ovarian function, microvascular and circulatory status of reproductive organs, and function of local microvascular endothelial cells(VECs) and vascular smooth muscle cells(VSMCs) were evaluated.RESULTS: Ovarian dysfunction was observed in the rats with CCBS. It was characterized by the presence of an estrous cycle disorder and a decrease in reproductive hormone levels. Microvascular circulation disorders were associated with an imbalance in vasoconstriction, relaxation substances, nitric oxide, abnormal blood flow in whole blood, and decreased blood flow in the auricle and uterus. VECs were damaged, and VSMCs contracted and proliferated in ovarian and uterine tissues.CONCLUSION: Our findings suggest that the dysfunctional reproductive organs observed in gynecological CCBS may be closely related to the microcirculation disturbance of local tissues, microvascular contraction, and vascular remodeling. Modified WJD can be used to treat CCBS by improving microcirculation in reproductive organs.
基金supported by a grant from Beijing Municipal Personnel and Organization Ministry (No.20071D0501800247)Natural Science Grant of Capital Medical University (No.2006ZR01)
文摘Objective:To investigate color and microvascular blood flow of the tongue in the mini-swine with immune hepatic injury. Methods: Six Chinese mini-swine for experimental use, 3 males and 3 females, were randomly divided into two groups, normal group and model group, 3 swine in each group. The swine in the model group was administrated by injection of 5 mg/kg ConA into the vein of auricular back, once every other day, 3 times each week, for 2 weeks in total. The animal in the control group was administrated with equal volume of saline. At 9 o’clock in the morning of the 15th day of the experiment, each swine was anesthetized with intramuscular injection of 9 ml 2.5% pentobarbital sodium and 3 ml Maleate, and then picture of the tongue was taken, microvascular blood flow on the tongue and the liver was detected with a laser Doppler blood flowmeter; Blood was taken from the precaval vein. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST),total bilirubin (Tbil) and total protein (TP) were determined; Pathological changes of the liver and tongue tissues were investigated by means of HE staining; Serum TNF-α content was detected with ELISA assay. Results: In the mini-swine with immune hepatic injury induced by ConA, the tongue color showed cyanotic color, microvascular perfusion in the liver and the tongue, and partial pressure of oxygen in the tongue tissue significantly decreased; and the microcirculatory perfusion of the tongue was significantly correlated with that of the liver and the HIS color spatial value of the tongue; Serum TNF-α content significantly increased. Conclusion: The mini-swine with immune hepatic injury induced by ConA conforms to pathological characteristics of immune hepatic injury. Formation of the cyanotic tongue is related with microcirculatory disturbance of the tongue, which can indirectly reflect hepatic microcirculatory state in the immune hepatic injury.
文摘Objective To investigate the effect of ulinastatin(UTI)on hepatic ischemia-reperfusion injury in rats.Methods Totally 24 adult Sprague-Dawley rats were randomly divided into 3 groups:sham-operated control group(SO group),ischemia-reperfusion group(I/R group)and ulinastatin group(UTI group).Liver in I/R group underwent 1 h of reperfusion after 30 min of ischemia.In UTI group,UTI(2×104 U/kg)was administered to rats 30 min before modeling.The levels of alanine aminotransferase,aspartate aminotransferase and tumor necrosis factor-alpha(TNF-α)in serum were measured and the levels of nitric oxide and malondialdehyde in liver were determined.The histological changes of liver were observed.Results The levels of alanine aminotransferase,aspartate aminotransferase and TNF-α in serum were significantly increased in I/R group compared with those in UTI group(P<0.05).The levels of nitric oxide and malondialdehyde in liver were significantly higher in I/R group than in UTI group(P<0.05).Histological examination of liver indicated that the damages were more severe in I/R group than in UTI group.Conclusion UTI has the ability to inhibit the production of TNF-α and oxyradical,and ameliorate microcirculatory dysfunction in rats with hepatic ischemia-reperfusion injury.
基金Program of Fundamental Research Funds for the Central Universities,Grant/Award Number:22120220562Program of Natural Science Foundation of Shanghai,Grant/Award Number:201409004100 and 21ZR1453800+1 种基金Three Year Action Plan to Promote Clinical Skills and Clinical Innovation in Municipal Hospitals,Grant/Award Number:SHDC2020CR6016-002 and SHDC2020CR4021Program of Shanghai Pulmonary Hospital,Grant/Award Number:fkzr2320 and FKLY20005。
文摘Pericytes are the main cellular components of tiny arteries and capillaries.Studies have found that pericytes can undergo morphological contraction or relaxation under stimulation by cytokines,thus affecting the contraction and relaxation of microvessels and playing an essential role in regulating vascular microcirculation.Moreover,due to the characteristics of stem cells,pericytes can differentiate into a variety of inflammatory cell phenotypes,which then affect the immune function.Additionally,pericytes can also participate in angiogenesis and wound healing by interacting with endothelial cells in vascular microcirculation disorders.Here we review the origin,biological phenotype and function of pericytes,and discuss the potential mechanisms of pericytes in vascular microcirculation disorders,especially in pulmonary hypertension,so as to provide a sound basis and direction for the prevention and treatment of vascular microcirculation diseases.
基金supported by National Natural Science Foundation(2010CB530603)Science and Technology Development Plan of Lianyungang City(ZD1508)+1 种基金Natural Science Foundation of Jiangxi Province(20151BAB215037)Science and Technology Program of Health Department of Jiangxi Province(2015A039)
文摘OBJECTIVE Shenfu injection(SFI)is an effective treatment of cardiogenic shock,the pathology of the central link was microcirculation disturbance.However,whether the microcirculation status of the early-and mid-stage of cardiogenic shock has any difference is unclear.This study aimed to observe the effect of SFI on the microcirculatory disturbance in mesentery for early-and mid-stage of cardiogenic shock rat.METHODS The early-and mid-stage model of cardiogenic shock was established by ligating the ending or root of left anterior descending coronary arteries(LADCA).The rats were randomly divided into 9 groups,ie control group,early-stage model group,mid-stage model group,3 early medicated groups and 3 mid medicated groups(the dosage was 1,3.33,10 mL·kg^(-1) SFI for cardiogenic shock rats of early-and mid-stage,respectively).Parameters in mesenteric microcirculation,such as velocity of RBCs in venules,diameters of venules,the count of leukocyte adhesion and vascular permeability which calculated by FITC-dextran leakage were observed through an GeneandiM2 inverted intravital microscope and high-speed video camera system.RESULTS The cardiogenic shock induced by ligating the LADCA resulted in a number of responses in microcirculation,including a significant increase in the counts of adhesive leukocytes,narrowing of the vascular diameter,decrease in the velocity of RBCs and dextran efflux.All of the above parameters for early-stage cardiogenic shock rats were attenuated by the treatment with SFI,especially the dosage of 10 mL·kg^(-1).While SFI had no apparent time-effect on the vascular diameter and vascular permeability in mesentery for mid-stage cardiogenic shock rats.CONCLUSION The microcirculation status of the early-and mid-stage of cardiogenic shock rats were quite different.The efficacy of early treatment with SFI was more obvious than the mid administration,which could provide experimental and theoretical basis for the patients with cardiogenic shock in an earlier time.
文摘There have recently appeared many reports dedicated to cerebral hemodynamics disorders in AD. However, certain specific aspects of cerebral blood flow and microcirculation during this disease are not fully understood. This research focuses on the identification of particular features of cerebral angioarchitectonics and microcirculation at preclinical and clinical AD stages and on the determination of their importance in AD etiology and pathogenesis. 164 patients participated in the research: Test Group—81 patients with different AD stages;Control Group— 83 patients with etiologically different neurodegenerative brain lesions with manifestations of dementia and cognitive impairment but without AD. All patients underwent: assessment of cognitive function (MMSE), severity of dementia (CDR) and AD stages (TDR), laboratory examination, computed tomography (CT), magnetic resonance imaging (MRI), brain scintigraphy (SG), rheoencephalography (REG) and cerebral multigated angiography (MUGA). All Test Group patients, irrespective of their AD stage, had abnormalities of the cerebral microcirculation manifested in dyscirculatory angiopathy of Alzheimer’s type (DAAT), namely: reduction of the capillary bed in the hippocampus and frontal-parietal regions;development of multiple arteriovenous shunts in the same regions;early venous dumping of arterial blood through these shunts with simultaneous filling of arteries and veins;development of abnormally enlarged lateral venous trunks that receive blood from the arterio-venous shunts;anomalous venous congestion at the border of frontal and parietal region;increased loop formation of distal intracranial arterial branches. Control group patients did not have combinations of such changes. These abnormalities are specific for AD and can affect amyloid beta metabolism contributing to its accumulation in the brain tissue and thereby stimulating AD progression.
文摘Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of the methods currently available for its characterization can improve the diagnostic and prognostic accuracy of invasive assessment of the coronary circulation, and help improve clinical decision-making. In this article we summarize the current methods available for a thorough assessment of coronary physiology.
基金supported by National Natural Science Foundation of China(No.82274321 to Q.X.,No.82374256 to D.D.,No.82104598 to C.H.)the Sichuan Provincial Natural Science Foundation(No.2022NSFSC0641 to Q.X.)。
文摘Objective:Microcirculatory disturbance is pathologically critical to acute pancreatitis(AP),which can be effectively alleviated by traditional Chinese medicine(TCM)formulas that activate blood flow.However,there has been no evidence-based research to date.Therefore,a well-designed systematic review and meta-analysis is necessary to elucidate the therapeutic transformative benefit of improving microcirculation during AP.This study aims to confirm the therapeutic efficacy of TCM formulas and explore the potential mechanisms underlying their effects on AP treatment.Methods:Studies from eight databases including Pubmed,Embase,Web of Science,Cochrane Library,CNKI,CBM,Wanfang,and Chinese VIP,were screened for the eligible randomized controlled trials(RCTs).The APACHEⅡscore and effectiveness rate were set as primary outcomes,while mortality rate,complications,total hospital stays,serum amylase recovery time,the time until the disappearance of abdominal pain,microcirculation indicators,and inflammation indicators were chosen as secondary outcomes.A systematic review and meta-analysis were subsequently conducted.Network pharmacology analysis was performed to analyze potential bioactive components with relevant targets of the core herbs included in the TCM formulas for activating blood flow.Results:A total of 51 RCTs(n=3721)were included.Compared with conventional western medical treatments alone,TCM groups were associated with lower APACHEⅡscore(SMD=1.36,95%CI:2.01 to 0.71,P=0.000)and higher effectiveness rate(RR:1.22,95%CI:1.18 to 1.26,P=0.000).Furthermore,the formulas for activating blood flow demonstrated significant efficacy in improving both microcirculation and inflammation indicators.Additionally,six core Chinese herbal medicines including Rhei Radix et Rhizoma with the highest frequency,Aurantii Fructus Immaturus,Paeoniae Radix Rubra,Bupleuri Radix,Salviae Miltiorrhizae Radix et Rhizoma,and Corydalis Rhizoma were filtered out from the adopted TCM formulas.Finally,166 shared targets between the six herbs and AP were identified.KEGG analysis indicated that lipid and atherosclerosis pathway is highly related to microcirculation.Conclusion:TCM formulas for activating blood flow significantly improve microcirculation and alleviate AP.Further high-quality,well-designed RCTs and deep mechanism exploration are required.
基金This study was funded by grants from National Natural Science Foundation of China(No.81901853)to FYAdditional support was supported by Specially Funded scientific research project of the Fourth Affiliated Hospital of Harbin Medical University(No.HYDSYTB202126)to DWY.
文摘Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from im-paired insulin secretion or insulin resistance.Diabetes poses a major global health concern,because of its increasing prevalence and substantial morbidity and mortality.This review explores the relationships between altered fatty acid metabolism and microcirculatory impairments in diabetes.Dysregulation of fatty acid metabolism in diabetes leads to changes in fatty acid profiles,abnormal lipid accumulation,and increased oxidative stress.These changes contribute to microvascular dysfunction through mechanisms such as endothelial dysfunction,impaired nitric oxide availability,inflammation,and oxidative damage.Understanding this intricate interplay is essential for identifying novel thera-peutic strategies to alleviate vascular complications in diabetes.By targeting specific pathways involved in fatty acid metabolism and microvascular dysfunction,interventions can be developed to improve patient outcomes.This review is aimed at contributing to future research and the development of effective strategies for preventing and managing dia-betes-associated microcirculatory impairments,to ultimately enhance the quality of life for people living with diabetes.
