Objective To explore the methods of early diagnosis of arteriosclerosis obliterans of lower extremity (ASOLE). Methods The related literatures on ASOLE detection means adopted clinically were reviewed, and their advantages and disadvantages were compared.Results Asymptomatic ASOLE could be discovered by determination of ankle brachial index (ABI) and toe brachial index (TBI), which was a good index for arterial function assessment of lower extremity. Pulse wave velocity (PWV) was more vulnerable and less sensitive than ABI, and therefore more suitable for screening of a large sample. ASI was an index to assess arterial structure and function, and it had a good correlation with PWV. Flow-mediated dilation (FMD) was a measurement evaluating the function of endothelial cell; Pulse wave measurement was simple, sensitive, and its result was reliable. Color Doppler ultrasonography could localizate the lesion and determine the degree of stenosis at the same time. Multiple-slice CT angiography (MSCTA) was more accurate than color Doppler ultrasonography, but its inherent shortcomings, such as nephrotoxicity of contrast agent, was still need to be resolved. 3D-contrast enhancement magnetic resonance angiography (CEMRA) had little nephrotoxicity, but a combination of other imaging methods was necessary. Microcirculation detections required high consistency of the measurement environment, but they were simple, sensitive and noninvasive, and therefore could be used for screening of ASO. Conclusion Publicity and education of highrisk groups, and reasonable selection of all kinds of detection means, are helpful to improve the early diagnosis of ASOLE.
Objective
To investigate and analyze the relationships among glucagon-like peptide-1 (GLP-1) level, chronic inflammation, and atherosclerosis in patients with non-alcoholic fatty liver disease (NAFLD).
Methods
From October 2016 to February 2017, using cross-sectional investigation, the GLP-1 level, chronic inflammation, and atherosclerosis were investigated in 80 subjects (40 NAFLD patients in NAFLD group, and 40 non-fatty liver disease participants in control group) who underwent physical examination at Xi’an Road Community Hospital.
Results
Compared with those in the control group, GLP-1 fasting level in patients with NAFLD [(9.09±1.03) vs. (9.15±1.06) pmol/L, P=0.807] and postprandial plasma GLP-1 [(15.96±3.37) vs. (17.46±4.76) pmol/L, P=0.108] had no changes. The correlations of GLP-1 level with chronic inflammation and insulin resistance (IR) were not significant either. The increased risk of carotid intima-media thickness related cardiovascular disease (CVD) in the NAFLD group was greater than that in the control group, and the difference was statistically significant [22 (55.0%)vs.13 (32.5%), P=0.043]. When the plasma lipoprotein-associated phospholipase A2 level increased, the risk of NAFLD increased [odd ratio (OR)=1.16, 95% confidence interval (CI) (1.02, 1.32), P=0.023]. Plasma ceramide kinase (CERK) in the NAFLD group was lower than that in the control group, and the difference was statistically significant [(12.36±2.45) vs. (18.33±3.71) ng/mL, P<0.001]. When the plasma CERK level of the fasting plasma was elevated, the risk of NAFLD decreased [OR=0.30, 95%CI (0.12, 0.78), P=0.014]. The homeostasis model assessment of insulin resistance (HOMA-IR) in the NAFLD group was higher than that in the control group, and the difference was statistically significant (2.46±2.53 vs. 1.11±0.66, P=0.002). The Matsuda index in the NAFLD group was less than that in the control group, and the difference was statistically significant (5.88±4.09 vs. 10.46±7.90, P=0.002). When HOMA-IR increased, the risk of NAFLD increased [OR=2.75, 95%CI (2.49, 3.12), P=0.036].
Conclusions
Plasma GLP-1 level is not a sensitive indicator of chronic inflammation and IR in patients with NAFLD. Patients with NAFLD are in an increased risk of atherosclerosis and CVD. It suggests that NAFLD might be involved in chronic inflammation and IR. Chronic inflammation can cause IR, and then chronic inflammation and IR can cause NAFLD and subclinical atherosclerosis. In return for this, NAFLD increases chronic inflammation and IR.
Objective To investigate theory guidance for preoperative appraisal of advanced stage lower limb arteriosclerosis obliterans and clinical application of arteriae surales. Methods From September 2007 to June 2008, one hundred cases without obviously arteriosclerosis were collected to accepted color Doppler ultrasonography, and parameters of the arteriae surales were observed， such as location, macro-body morphous, caliber, and blood parameters value, meanwhile the caliber and blood parameters value of anterior tibial artery and posterior tibial artery were also measured. Results Detection rate of arteriae surales was 96% (96/100). Arteriae surales located midpiece sequentiae of popliteal fossa, and above flatfish tendinous arch, which in 89 cases were geminous branched from popliteal artery; in the remaining 7 cases, popliteal artery diverged a bole, walked 1-3 cm, then diverged two branches and ingressed gastrocnemius. Diameter and cross section area of arteriae surales were smaller than those of anterior tibial artery and posterior tibial artery (P＜0.05）, but peak flow rate of systolic phase, maximum positive direction flow rate of relaxing period and mean flow rate were not significantly differents between arteriae surales and anterior tibial artery or posterior tibial artery （P＞0.05）. The flow of geminous arteriae surales was 63.1% of anterior tibial artery, and 59.1% of posterior tibial artery. Conclusion Through the ultrasonic study, it is significant for clinical therapy to master the normal anatomy, blood parameters value and flow of arteriae surales.
The way of intravenous drug abuse is to puncture the peripheral blood vessels and inject the drug directly into the blood. Therefore, this method has an impact on the peripheral artery and venous system of the users, and can cause a variety of peripheral vascular diseases, such as phlebitis, deep vein thrombosis, chronic venous insufficiency, phlebangioma, atherosclerosis, acute arterial ischemia, pseudoaneurysm, etc. However, due to the particularity of drug abusers, the vascular complications caused by intravenous drug abuse have not attracted enough attention. This paper reviewed the types and pathogenesis of peripheral vascular diseases caused by intravenous drug abuse, so as to improve the clinical understanding of peripheral vascular diseases caused by intravenous drug abuse, improve the prognosis of patients, reduce occupational exposure of medical staff, and play a certain role in social warning.
ObjectiveTo systematically review the interventional effects of Simiao Yong'an decoction on atherosclerosis animal models.MethodsDatabase including CNKI, WanFang Data, VIP, PubMed, The Cochrane Library, and Web of Science were searched to collect animal experiments on atherosclerosis model intervention by Simiao Yong’an decoction from inception to October 2020. Two reviewers independently screened the literature, extracted data, and used the SYRCLE animal experiment bias risk assessment tool to evaluate risk bias of included studies, and then used RevMan 5.4.1 software for meta-analysis.ResultsA total of 14 animal experiments were included. The results of meta-analysis showed that compared with the blank model group, the Simiao Yong’an decoction group could reduce the aortic plaque area (SMD=?2.04, 95%CI ?3.35 to ?0.74), the ratio of aortic plaque to lumen area (SMD=?1.72, 95%CI ?2.48 to ?0.97), total cholesterol level (SMD=?0.97, 95 %CI ?1.72 to ?0.22), triglyceride level (SMD=?1.21, 95%CI ?1.82 to ?0.60), low-density lipoprotein cholesterol level (SMD=?1.82, 95%CI ?3.12 to ?1.53), tumor necrosis factor-α level (SMD=?3.36, 95%CI ?4.21 to ?2.52), monocyte chemotactic factor-1 level (SMD=?2.98, 95%CI ?4.60 to ?1.35) and C-reactive protein level (SMD=?0.60, 95%CI ?1.08 to ?0.11); however, in the high-density lipoprotein cholesterol level (SMD=0.66, 95%CI ?0.10 to 1.42) and the level of interleukin 1 (SMD=?1.41, 95%CI ?4.11 to 1.30), the differences were not statistically significant.ConclusionsThe existing evidence shows that the intervention of Simiao Yong’an decoction in the atherosclerosis model can reduce the aortic plaque area and the ratio of the aortic plaque to the lumen area, reduce total cholesterol, triglycerides, and low-density lipoprotein cholesterol levels, and reduce tumor necrosis factor-α, monocyte chemotactic factor-1, and C-reactive protein levels. Due to limited quality of included studies, more high quality studies are required to verify the above conclusions.
【Abstract】ObjectiveTo investigate the effects of CO2 pneumoperitoneum on blood flow of carotid arteries in atherosclerosis rabbits.MethodsFifty Japan white rabbits were randomly divided into control group and three atherosclerosis groups. In atherosclerosis group, the rabbits were randomly subjected to CO2 pneumoperitoneum with an intraabdominal pressure of 0 mm Hg, 10 mm Hg or 15 mm Hg for 2 hours, after the model were created by feeding the rabbits with high fatty diet. The blood flow of the common carotid arteries were measured by electromagnetic blood flowmeter. Artery blood samples were collected for blood gas analysis at 30 minute intervals. ResultsHigher insufflation pressures and longer duration of CO2 pneumoperitoneum were associated with greater increase in blood flow of common carotid arteries. Compared with those in control group and atherosclerosis group with 0 mm Hg CO2 pneumoperitoneum, there were statistically significant increases in blood flow of the common carotid arteries during CO2 pneumoperitoneum in 10 mm Hg and 15 mm Hg pneumoperitoneum group, the changes in 15 mm Hg pneumoperitoneum group were more significant than those in 10 mm Hg pneumoperitoneum group (Plt;0.05). When compared with the blood flow before insufflation, those in 10 mm Hg and 15 mm Hg pneumoperitoneum group also increased significantly during CO2 pneumoperitoneum, even at 30 minute after desufflation (Plt;0.05). However, those in control group and 0 mm Hg pneumoperitoneum group did not change significantly (Pgt;0.05). There were significant decrease in pH and significant increase in PCO2 in both 10 mm Hg and 15 mm Hg groups, when compared with presufflation values or those in control group and 0 mm Hg pneumoperitoneum group(Plt;0.05). The changes in pH and PCO2, however, were no significant at any time point in control group and 0 mm Hg pneumoperitoneum group (Pgt;0.05). HCO3- did not change significantly in either group(Pgt;0.05).ConclusionUnder atherosclerosis conditions, CO2 pneumoperitoneum has an adverse influence on the blood flow of the common carotid arteries which may be associated with increased intrabdominal pressure,absorbed CO2 gas.
The main cause of death in patients with end-stage renal disease (ESRD) is cardiovascular disease, and trimethylamine-N-oxide (TMAO) has been found to be one of the specific risk factors in the pathogenic process in recent years. TMAO is derived from intestinal bacterial metabolism of dietary choline, carnitine and other substances and subsequently catalyzed by flavin monooxygenase enzymes in the liver. The changes of intestinal bacteria in ESRD patients have contributed to the accumulation of gut-derived uremic toxins such as TMAO, indoxyl sulfate and indole-3-acetic acid. While elevated TMAO concentration accelerates atherosclerosis through mechanisms such as inflammation, increased scavenger receptor expression, and inhibition of reverse cholesterol transport. In this review, this research introduces the biological function, metabolic processes of TMAO and mechanisms by which TMAO promotes the progression of cardiovascular disease in ESRD patients and summarizes current interventions that may be used to reverse gut microbiota disturbances, such as activated carbon, fecal microbial transplantation, dietary improvement, probiotic and probiotic introduction. It also focuses on exploring intervention targets to reduce the gut-derived uremic toxin TMAO in order to explore the possibility of more cardiovascular disease treatments for ESRD patients.
Telomeres play an important role in maintaining genomic stability and cell life. Accumulating studies show that telomeres are closely related to human aging, cardiovascular diseases and cerebrovascular diseases. There are a series of researches about telomeres and atherosclerosis across the world, including studies on the relationship between atherosclerosis, cardiovascular diseases, cerebrovascular diseases and telomere length, and on telomere-targeted treatments for cardiovascular and cerebrovascular diseases. Telomeres may be a risk predictor or a new therapeutic target for atherosclerosis and cardiovascular diseases. This article reviews the relationship between telomeres and cardiovascular and cerebrovascular diseases, introduces the research progress of telomere length and cardiovascular diseases, cerebrovascular diseases, and the possible mechanisms of their association, aiming to provide a theoretical basis for exploring new therapeutic targets for atherosclerosis.
ObjectiveTo explore the relationship between plasma homocysteine level and intracranial artery atherosclerosis in patients with cerebral infarction.
MethodsA total of 120 patients with cerebral infarction diagnosed between January and December 2013 were selected.Plasma homocysteine level was analyzed and intracranial artery was detected by DSA.
ResultsIntracranial artery atherosclerosis can be found in most of patients with cerebral infarction.Moreover,Plasma Hcy level of patients with large cerebral artery atherosclerosis was much higher than others (P<0.05).The much higher Plasma Hcy level,the severe intracranial artery atherosclerosis were found in internal carotid artery and cerebral middle artery (P<0.05).
ConclusionIntracranial artery atherosclerosis is common in patients with cerebral infarction.Occurrence of intracranial artery atherosclerosis is positively correlated with plasma homocysteine level.Plasma homocysteine level may be a risk factor of intracranial artery atherosclerosis in patients with cerebral infarction.
Objective To evaluate the relationship between COPD and atherosclerosis, and analyze the risk factors of atherosclerosis among COPD patients. Methods A total of 40 COPD patients and 43 normal subjects were enrolled in the study. Carotid intima-media thickness (IMT) and plaques were detected in both groups. Blood samples were collected to measure the concentration of high sensitive C-reactive protein (hs-CRP) , fibrinogen (Fbg) , total cholesterol (TC) , triglyceride (TG) , high density lipoprotein cholesterol (HDL-C) , low density lipoprotein cholesterol (LDL-C) , while smoking index was recorded. Multiple regression analysis was performed to evaluate the correlative factors of IMT among COPD patients. According to whether luminal stenosis appeared, the COPD patients were allocated into group A ( without luminal stenosis) and group B ( with luminal stenosis) . Age, gender, hs-CRP, Fbg, TC, TG, HDL-C, LDL-C, and smoking index of the two groups were compared respectively. Results Hs-CRP, Fbg, thickness of IMT, plaques detection rate, and smoking index in the COPD group were significantly higher than those in the control group ( Plt;0.05) . TC, HDL-C, LDL-C in the COPD group were significantly lower than those in the control group ( Plt;0. 05) .Multiple regression analysis of IMT correlative factors among COPD patients showed that age, hs-CRP, Fbg, TC, TG, LDL-C, HDL-C, and smoking index were in linear relationship with IMT thickening. Age, hs-CRP, TC, and smoking index were positively correlated with IMT ( Plt;0.05) . Hs-CRP and smoking index in the group A were lower than those in the group B ( Plt;0. 05) .While TC, TG, LDL-C, and HDL-C in the group A were higher than those in the group B ( Plt;0.05) . Conclusions Age, smoking index, hs-CRP, and TC are risk factors for thickening of carotid artery IMT in COPD patients. Furthermore, smoking index, hs-CRP, TC, TG, LDL-C, and HDL-C are related to the severity of IMT thickening. The ultrasound detection of carotid artery IMT can be a valuble tool to screen atherosclerosis in patients with COPD.
