清热祛浊胶囊对痰湿郁热型2型糖尿病患者血管内皮功能的影响

目的:探究清热祛浊胶囊对痰湿郁热型2型糖尿病(Type 2 Diabetic Nephropathy,T2DN)患者血管内皮功能的保护作用。方法:将初诊的痰湿郁热型2型糖尿病患者60例随机分为对照组和清热祛浊胶囊组,每组各30例。两组患者均根据个体情况给予糖尿病饮食处方控制、健康教育及个体化运动指导等基础治疗,在此基础上,对照组给予二甲双胍肠溶片治疗,清热祛浊胶囊组在对照组治疗基础上联合清热祛浊胶囊治疗,两组均连续治疗12周。观察两组患者治疗12周后体质量指数(Body Mass Index,BMI)、血糖、糖化血红蛋白(Hemoglobin,HbA1c)、胰岛素抵抗指数(HOMA-IR)、血脂、内皮素-1(Endothelin-1,ET-1)、一氧化氮(Nitric Oxide,NO)水平变化情况,超声测定内皮依赖性血管舒张功能(FMD),评价两组患者中医证候积分。结果:治疗12周后,两组患者治疗后的中医证候积分有下降趋势,糖脂代谢、体质量指数、胰岛素抵抗均有所改善,血管内皮功能ET-1水平均有下降趋势,而NO、FMD则有所上升,以清热祛浊胶囊组的变化程度更为明显。结论:清热祛浊胶囊利于减轻痰湿郁热型2型糖尿病患者的临床症状,改善糖脂代谢、胰岛素分泌,起到血管内皮保护作用。     

No between-pen transmission of foot-and-mouth disease virus in vaccinated pigs

Many studies have shown transmission of foot-and-mouth disease virus (FMDV) within groups of pigs, even when vaccinated, but only limited information is available on transmission between pens. Three new experiments were carried out in two replicates, which consisted of infectious pigs housed in a central pen surrounded by four separate pens. First, all pigs were non-vaccinated and pens were separated by a walkway of 40–70 cm. Second, all pigs were non-vaccinated again but pens were adjacent. Third, this was repeated with all pigs vaccinated.     

Vitamin D replacement ameliorates serum lipoprotein functions,adipokine profile and subclinical atherosclerosis in pre-menopausal women

Background and aims

Low vitamin D (vitD) has been linked to increased cardiovascular (CV) risk, but the effects of vitD supplementation are not clarified. We evaluated the impact of vitD normalization on HDL cholesterol efflux capacity (CEC), which inversely correlates with CV risk, the proatherogenic serum cholesterol loading capacity (CLC), adipokine profile and subclinical atherosclerosis.

Improvement of endothelial function and insulin sensitivity with vitamin C in patients with coronary spastic angina: possible role of reactive oxygen species

OBJECTIVES

This study was designed to examine the effect of antioxidant supplementation on the endothelial function and insulin sensitivity in patients with coronary spastic angina (CSA).

BACKGROUND

Insulin resistance may play a key role in coronary heart disease, and there is a possible link between acetylcholine-induced coronary vasoconstriction and hyperinsulinemia in patients with CSA. Endothelial dysfunction is present in the systemic arteries in CSA patients, and reactive oxygen species may cause inactivation of nitric oxide in these patients.

METHODS

We measured flow-mediated dilation of the brachial artery using ultrasound technique in 22 patients with CSA and 20 control subjects. We also evaluated glucose tolerance using a 75-g oral glucose tolerance test and insulin sensitivity using steady-state plasma glucose (SSPG) methods in the same patients.

RESULTS

The incidence of impaired glucose tolerance was higher in the CSA group than in the control group. Vitamin C infusion augmented flow-mediated dilation and decreased SSPG levels in the CSA group (from 3.27 ± 0.77% to 7.00 ± 0.59% [p < 0.001 by analysis of variance (ANOVA)] and from 177.3 ± 13.3 to 143.1 ± 14.9 mg/dl [p = 0.047 by ANOVA], respectively) but not in the control group (from 6.47 ± 0.66% to 6.80 ± 0.60% and from 119.8 ± 11.7 mg/dl to 118.1 ± 11.3 mg/dl, respectively). The steady-state plasma insulin levels were not affected by vitamin C infusion in either group.

CONCLUSIONS

Vitamin C improves both endothelial function and insulin sensitivity in patients with CSA. Thus, reactive oxygen species and/or decreased nitric oxide bioactivity may play an important role in the genesis of both endothelial dysfunction and insulin resistance in patients with CSA.     

The role of tissue factor pathway inhibitor in atherosclerosis and arterial thrombosis

Tissue factor pathway inhibitor (TFPI) is the main inhibitor of tissue factor (TF)-mediated coagulation. In atherosclerotic plaques TFPI co-localizes with TF, where it is believed to play an important role in attenuating TF activity. Findings in animal models such as TFPI knockout models and gene transfer models are consistent on the role of TFPI in arterial thrombosis as they reveal an active role for TFPI in attenuating arterial thrombus formation. In addition, ample experimental evidence exists indicating that TFPI has inhibitory effects on both smooth muscle cell migration and proliferation, both which are recognized as important pathological features in atherosclerosis development. Nonetheless, the clinical relevance of these antithrombotic and atheroprotective effects remains unclear. Paradoxically, the majority of clinical studies find increased instead of decreased TFPI antigen and activity levels in atherothrombotic disease, particularly in atherosclerosis and coronary artery disease (CAD). Increased TFPI levels in cardiovascular disease might result from complex interactions with established cardiovascular risk factors, such as hypercholesterolemia, diabetes and smoking. Moreover, it is postulated that increased TFPI levels reflect either the amount of endothelial perturbation and platelet activation, or a compensatory mechanism for the increased procoagulant state observed in cardiovascular disease. In all, the prognostic value of plasma TFPI in cardiovascular disease remains to be established. The current review focuses on TFPI in clinical studies of asymptomatic and symptomatic atherosclerosis, coronary artery disease and ischemic stroke, and discusses potential atheroprotective actions of TFPI.     

阿托伐他汀对冠脉介入术后内皮功能不全的干预研究

目的：探讨冠脉介入治疗（PCI）对冠脉血管内皮功能的影响及阿托伐他汀的干预作用。方法：采用超声测定肱动脉血流介导的血管舒张功能（FMD）及硝酸甘油介导的血管舒张功能（NMD）。共入选了80例冠心病患者,测量PCI术前的FMD、NMD;根据PCI术前的药物治疗分为实验组及对照组,比较两组术前及术后30d的FMD、NMD,同时进行临床事件随访。结果：①接受PCI治疗引起FMD的降低（P〈0．05）,NMD在PCI治疗前后无明显变化;②实验组术后30天与术前比较FMD无明显改变,而对照组术后30天与术前比较FMD明显下降,NMD在两组之间及治疗前后无统计学差别③主要心脏不良事件（MACE）随访显示实验组较对照组PCI术后30d再发心绞痛事件发生率降低,但无统计学差异。结论：PCI治疗加重内皮功能障碍,阿托伐他汀的干预可防止PCI术后内皮功能的恶化。