Influence of haemodialysis on early markers of atherosclerosis

Introduction: End-stage renal disease (ESRD) patients treated by haemodialysis (HD) have impaired endothelium-dependent vasodilatation and increased intima-media thickness (IMT) of the carotid artery The aim of the study was to analyse the relationships between parameters of chronic HD treatment and non-invasive assessments of preclinical atherosclerosis (endothelial dysfunction and carotid IMT) in ESRD patients on HD. Methods: Fifty-two (19 females, 33 males) adult patients on chronic maintenance (4.65 ± 3.29 years) HD aged 59.88 ± 15.49 years were investigated. Ultrasonographic studies were performed with a 7.5 MHz high-resolution probe. The common carotid artery IMT was measured. Brachial artery diameter was analysed to the rest. In order to assess flow-mediated dilatation (FMD), hyperaemia was induced by a pneumatic cuff, and an analysis of the diameter was performed 1, 2, 3 and 4 min after cuff deflation. Results: Significant differences were found in the average carotid IMT value between subjects with delivered dialysis dose (Kt/V) ≥1.2 and <1.2 (0.89 ± 0.21 vs 1.04 ± 0.11, P = 0.0045). A correlation between Kt/V and IMT (r = 0.366, P = 0.004) was demonstrated. FMD values of the brachial artery did not correlate with Kt/V. A correlation between low molecular weight heparin per kg of body mass and maximal percent of FMD was demonstrated (r = −0.242, P = 0.049). The maximal percent of brachial FMD was correlated with absolute difference between pre- and postdialysis pulse pressure values (r = −0.265, P = 0.033). In a partial correlation with haemoglobin as control, a variable significant correlation between total erythropoietin dose and maximal carotid IMT (r = −0.262, P = 0.036) was found. In a multiple linear regression model, Kt/V was independently correlated with carotid IMT values (β = −0.227, P = 0.0335). Conclusion: This study has demonstrated the association between HD procedure and early atherosclerosis markers. HD treatment has to be considered as potential modifying factor in atherosclerosis development.     

IMMUNOHISTOCHEMICAL LOCALIZATION OF ENDOTHELIAL ISOFORM (eNOS) IN HUMAN CEREBRAL ARTERIES AND THE AORTA

The common carotid, vertebral, posterior cerebral arteries, and the aorta were studied in the human in terms of its eNOS expression. In around 10 weeks of gestation, the developing intima began to express notable eNOS. In the adult, the positive eNOS sites were in the endothelial cells and the tunica media where the smooth muscles were. In the vessels with athrosclerotic changes, eNOS was down regulated in the endothelial layer and most of the tunica media but was significantly upregulated in the tunica media around the lesion. The protein changes are related to the onset of the athrosclerotic diseases.     

High prevalence of diabetes and impaired fasting glucose in urban Latin America: the CARMELA Study

Aims Cardiovascular risk is increased with glucose metabolism abnormalities. Prevalence data can support public health initiatives required to address this risk. The Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study was designed to estimate the prevalence of Type 2 diabetes, impaired fasting glucose and related risk factors in seven urban Latin American populations. Methods CARMELA was a cross‐sectional, population‐based study of 11 550 adults 25–64 years of age. With a multi‐stage sample design of a probabilistic nature, approximately 1600 subjects were randomly selected in each city. Results Overall, the prevalence of diabetes was 7.0% (95% confidence intervals 6.5–7.6%). The prevalence of individuals with diabetes or impaired fasting glucose increased with increasing age. In the oldest age category, 55–64 years of age, prevalence of diabetes ranged from 9 to 22% and prevalence of impaired fasting glucose ranged from 3 to 6%. Only 16.3% of people with prior diagnosis of diabetes and who were receiving pharmacologic treatment, were in good glycaemic control (fasting glucose < 6.1 mmol/l). The prevalence of diabetes in individuals with abdominal obesity was approximately twofold higher. Participants with hypertension, elevated serum triglycerides and increased common carotid artery intima‐media thickness were also more likely to have diabetes. Conclusions The prevalence of diabetes and impaired fasting glucose is high in seven major Latin American cities; intervention is needed to avoid substantial medical and socio‐economic consequences. CARMELA supports the associations of abdominal obesity, hypertension, elevated serum triglycerides and carotid intima‐media thickness with diabetes.     

丹参注射液对实验性动脉内膜增生的抑制作用

目的：探讨丹参注射液用于预防经皮腔内冠状动脉成形术（ＰＴＣＡ）后再狭窄的可能性。方法：利用Ｆｉｓｈｍａｎ空气干燥法建立了大鼠的动脉损伤模型，观察丹参注射液对动脉损伤后内膜增生的影响。结果：丹参治疗组的动脉最大内膜厚度〔（１８．７３±１．８２）μｍ〕与对照组动脉最大内膜厚度〔（８０．１７±２３．４９）μｍ〕比较明显减薄，具有极显著性差异（Ｐ＜０．０１）。结论：丹参注射液可能具有预防ＰＴＣＡ后动脉再狭窄的作用。     

缝外膜肠线支架减张输精管吻合术

本文报告一种在肉眼下行吻合的缝外膜肠线支架减张输精管吻合新方法.此法与外膜肌层法、全层不锈钢支架法和单纯全层法等对照地进行了动物实验及临床应用研究.自1980年3月以来,在临床上,上四法分别做了30、30、13及13例,术后分别随访到30、28、12及11例;其复精率分别是90%、82.1%、33、3%及27.3%;其复孕率分别是71.4%、60.7%、16.7%及0%.其结果显示,本法较其他肉眼下的输精管吻合法更加简便易行,效果满意.     

Are Hodgkin and non‐Hodgkin patients at a greater risk of atherosclerosis? A follow‐up of 3 years

BILORA F., PIETROGRANDE F., CAMPAGNOLO E., ROSSATO A., POLATO G., POMERRI F. & MUZZIO P.C. (2010) European Journal of Cancer Care 19 , 417–419
Are Hodgkin and non‐Hodgkin patients at a greater risk of atherosclerosis? A follow‐up of 3 years Aims and background are to ascertain whether Hodgkin and non‐Hodgkin patients are more affected by atherosclerotic process. We studied 96 patients during a period of 3 years (2003–2007). Patients were assessed in the first year soon after receiving radiotherapy and chemotherapy and then reassessed in the third year. All the cases underwent echo‐colour Doppler of the carotid axis, and the intima‐media thickness (IMT) was measured. When the two time points were compared, the IMT was greater in the arterial district examined at the first assessment; while at the second there was a reduction in the IMT, so patients seemed to improve with time. Flow‐mediated dilatation did not improve. Hodgkin and non‐Hodgkin patients experience an increase in IMT during treatment, but afterwards they return in their precedent condition. They seem to have a persistently reduced flow‐mediated dilatation. Lymphoma therapy probably predisposes patients to early atherosclerosis, and it would be worth trying to reverse this tendency by administering antioxidant therapy.     

缓释厄贝沙坦涂层支架置入对内膜增生的影响

目的:探讨缓释厄贝沙坦涂层支架置入对内膜增生的影响。方法:建立冠状动脉支架置入的广西种的微型猪动物模型,分别置入普通裸支架和缓释厄贝沙坦涂层支架。于支架置入后3、7、28、90和180d截取支架段血管连同邻近的近端正常血管段,通过病理组织学分析和聚合酶链反应技术检测支架局部内膜增生情况。结果:正常血管段表达PCNAmRNA在各个时间段差异没有显著性。普通支架置入后3d局部血管壁PCNAmRNA的表达明显增高,并在术后7d达到高峰。术后90dPCNAmRNA的表达呈现下降的趋势,但仍显著高于正常血管段,并且差异一直持续到术后180d。术后第3天药物支架段PCNAmRNA的表达明显增高,并在术后7d达到高峰。术后7d药物支架段PCNAmRNA的表达已显著低于普通支架段,并且差异一直持续到术后90d。术后90～180d药物支架段内膜加中膜面积明显小于普通支架段。结论:缓释厄贝沙坦涂层支架置入可在一定程度上减少支架置入后内膜的增生反应。     

代谢综合征患者静息心率与颈动脉内膜中层厚度的关系

目的探讨代谢综合征（MS）患者静息心率（RHR）与颈动脉内膜-中层厚度（IMT）的关系。方法对96例MS患者进行调查，每位患者均测RHR、血压、空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C），颈动脉超声检测IMT，按RHR频率分RHR1组：RHR〈70次／min，RHR2组：70-80次／min，RHR3组：RHR〉80次／min。结果代谢综合征患者RHR与IMT呈显著正相关（r=0．432P〈0．01）；且RHR与FPG、TG呈正相关（FPGr=0．24，TGr=0．24，P〈0．05）。结论MS患者RHR与IMT有明显相关性。     

桡动脉中膜内膜厚度比值在监测慢性肾脏病5期患者血管钙化中的意义

目的本研究探讨桡动脉内膜中膜厚度（IMT）、内膜厚度（IT）、中膜厚度（MT）以及中膜内膜厚度比值（MITR）与慢性肾脏病5期（CKD5期）患者桡动脉钙化的关系。方法40例CKD5期患者为试验组,于行首次动静脉内瘘术时取桡动脉的修剪为试验组标本;38例单纯性外伤性脾破裂患者为对照组,取其脾小梁动脉为对照组标本。用钙盐特异性染色法（von Kossa法）对动脉进行钙化染色;应用计算机病理图像分析系统（IPP6．0）对组织切片进行半定量化图像分析;采用SPSS19．0统计分析软件进行数据处理。结果试验组40例患者有12例（30％）有明显钙盐染色阳性,位于中膜的平滑肌细胞层,而对照组无明显钙盐染色。试验组MITR与钙盐染色程度呈正相关,试验组IT与钙盐染色程度呈负相关。试验组MT、IMT与钙盐染色程度无统计学相关性。结论MITR可以作为慢性肾脏病患者中型动脉钙化的早期标志,而IMT不能准确反应动脉的钙化程度。     

家兔阴道黏膜刺激实验及注意事项

目的对某公司妇科消毒产品进行阴道黏膜刺激反应试验。方法以家兔阴道注入2 ml/只受试液,受试液为中药洗剂,同时设立对照组,观察对阴道的刺激反应,按《消毒技术规范》进行实验,然后取完整阴道用10%甲醛固定,24 h后分别取前中后3段脱水,石蜡包埋,常规制片,阅片按相关标准进行评分。结果操作和受试物以及对照用生理盐水的选取对试验结果影响较大。结论阴道黏膜刺激性试验影响因素多,有必要加强对实验细节的规范。