阿托伐他汀联合二甲双胍对老年高血压患者动脉内皮功能的影响

目的研究阿托伐他汀联合二甲双胍治疗对老年高血压患者动脉内皮功能的影响。方法 162例老年高血压患者随机分为对照组、阿托伐他汀组、二甲双胍组和联合治疗组,均给予降压治疗,阿托伐他汀组给予阿托伐他10mg/d,二甲双胍组给予二甲双胍0.25Bid,联合治疗组给予阿托伐他汀10mg/d和二甲双胍0.25Bid。所有研究对象在研究初始均常规测定血压、血液生化、空腹血糖、空腹胰岛素及肱动脉血流介导的血管舒张功能（Flow-mediated dilation,FMD）,治疗90d再次测定上述指标。结果治疗3个月后二甲双胍组、阿托伐他汀组和联合治疗组FMD分别由（5.30±2.09）、（5.29±2.11）和（5.31±2.16）上升至（8.68±2.35）、（11.27±4.91）和（15.17±5.81）（P〈0.05）,组间比较,阿托伐他汀组优于二甲双胍组（P〈0.05）,联合治疗组优于阿托伐他汀组（P〈0.05）。结论阿托伐他汀联合二甲双胍能改善老年高血压患者内皮功能。     

When and How Should We Revascularize Patients With Atherosclerotic Renal Artery Stenosis?

Atherosclerotic renal artery stenosis is the leading cause of secondary hypertension and may lead to resistant (refractory) hypertension, progressive decline in renal function, and cardiac destabilization syndromes (pulmonary edema, recurrent heart failure, or acute coronary syndromes) despite guideline-directed medical therapy. Although randomized controlled trials comparing medical therapy with medical therapy and renal artery stenting have failed to show a benefit for renal artery stenting, according to comparative effectiveness reviews by the Agency for Healthcare Research and Quality, the trials may not have enrolled patients with the most severe atherosclerotic renal artery stenosis, who would be more likely to benefit from renal stenting. Because of limitations of conventional angiography, it is critical that the hemodynamic severity of moderately severe (50% to 70%) atherosclerotic renal artery stenosis lesions be confirmed on hemodynamic measurement. The authors review techniques to optimize patient selection, to minimize procedural complications, and to facilitate durable patency of renal stenting. The authors also review the current American College of Cardiology and American Heart Association guidelines and the Society for Cardiovascular Angiography and Interventions appropriate use criteria as they relate to renal stenting.     

松龄血脉康胶囊改善高血压患者血管顺应性和血管内皮功能的临床研究

目的观察松龄血脉康改善血管顺应性和血管内皮功能的功效。方法选取患者90例,随机分为2组,对照组(45例,常规西药治疗)、治疗组(45例,常规西药治疗+松龄血脉康胶囊),疗程均为12周。结果治疗组C-FPWV较治疗前明显下降(P<0.01),对照组C-FPWV较治疗前也明显下降(P<0.05),两组比较,治疗组C-FPWV下降幅度明显优于对照组(P<0.01)。治疗组与对照组FDM较治疗前明显下降(P<0.01),两组比较,治疗组FDM下降幅度明显优于对照组(P<0.01)。治疗前后血压及症状分级变化,治疗组与对照组治疗前后血压及症状分级较治疗前明显下降(P<0.01)。结论松龄血脉康与降压药联合,可有效改善血管顺应性及内皮功能,较之单用降压药具有明显的临床意义,且可以更好地稳定血压与改善症状。     

The serological response against foot and mouth disease virus elicited by repeated vaccination of dairy cattle

In Israel, cattle are annually vaccinated against foot and mouth disease (FMD). If infections with FMD virus occur in dairy farms it mainly involves heifers and calves, while older dairy cows seldom become infected. We hypothesized that this difference in susceptibility between adult cows and the young heifers and calves is due to stronger and more stable immune response elicited by multiple vaccinations. In order to test this hypothesis, 99 dairy cattle, divided into six groups according to number of prior vaccinations, were annually vaccinated with a trivalent vaccine (A, O and Asia-1) and followed during two consecutive years. In total 988 sera were sampled at 11 time points. Virus neutralization tests (VNT) were performed in order to determine the neutralizing antibody titers (NAT) against the vaccine homologous serotypes: O-4625, O-Manisa, Asia-1-Shamir and the heterologous serotype A-Turkey-20/2006. A similar NAT pattern was observed to all serotypes and therefore statistical analysis was restricted to O-4625 serotype. In the ‘high vaccination’ groups (cows that were vaccinated at least four times before the study), high NAT were found on the beginning of the trial and no or only a mild increase of NAT was observed following further vaccinations. Additionally, in the ‘high vaccination’ groups, the percentage of cows that had a NAT higher than 2.0 (log₁₀) by the end of the 1st year was significantly higher than in the ‘low vaccination’ groups (cows vaccinated only three times or less before the study). We conclude that starting from the 5th vaccination, the NAT increase following vaccination is mild and NAT are persistent, suggesting reduction of the frequency of routine vaccination after multiple vaccinations is possible.     

The selection of naturally stable candidate foot-and-mouth disease virus vaccine strains for East Africa

Foot-and-mouth disease (FMD) is a global burden on the livestock industry. The causative agent, FMD virus (FMDV), is highly infectious and exists in seven distinct serotypes. Vaccination remains the most effective control strategy in endemic regions and current FMD vaccines are made from inactivated preparations of whole virus. The inherent instability of FMDV and the emergence of new strains presents challenges to efficacious vaccine development. Currently, vaccines available in East Africa are comprised of relatively historic strains with unreported stabilities. As an initial step to produce an improved multivalent FMD vaccine we have identified naturally stable East African FMDV strains for each of the A, O, SAT1 and SAT2 serotypes and investigated their potential for protecting ruminants against strains that have recently circulated in East Africa. Interestingly, high diversity in stability between and within serotypes was observed, and in comparison to non-African A serotype viruses reported to date, the East African strains tested in this study are less stable. Candidate vaccine strains were adapted to propagation in BHK-21 cells with minimal capsid changes and used to generate vaccinate sera that effectively neutralised a panel of FMDV strains selected to improve FMD vaccines used in East Africa. This work highlights the importance of combining tools to predict and assess FMDV vaccine stability, with cell culture adaptation and serological tests in the development of FMD vaccines.     

Radioimmunoassay for detection of VP1 specific neutralizing antibodies of foot and mouth disease virus

A solid-phase radioimmunoassay was developed for the detection of antibodies against a specific region of the VP1 protein of the A24 and 01 serotypes of foot and mouth disease virus. The antibody titers from the radioimmunoassay showed a positive correlation with neutralizing antibody titers determined by a mouse protection assay. The specificity of the assay resides in the peptide used as antigen. The assay is rapid, reproducible and does not require the use of whole virions.