桃红四物汤化裁治疗稳定型心绞痛合并心力衰竭临床研究

目的:研究桃红四物汤化裁治疗稳定型心绞痛(SAP)合并心衰患者的临床疗效。方法:选取104例SAP合并慢性心力衰竭(CHF)患者纳入研究,入选患者以简单随机法均分为西药组与桃红组,西药组给予常规单纯西药治疗,桃红组在西药组治疗的基础上加用中药桃红四物汤化裁治疗;治疗6个月后评估两组临床疗效,观察两组患者心功能、血液流变学(血流变)、血清学、血脂指标的变化情况。结果:桃红组总有效49例(94.23%),西药组为40例(76.92%),桃红组总有效率明显高于西药组,差异有统计学意义(P<0.05);两组治疗后血脂指标TC、TG、LDL-C、HDL-C,心功能指标LVEF、LVESV、LVEDV,血流变指标WBV、PV、FIB,血清学指标NT-proBNP、hs-CRP、VEGF、MMP-9均可见改善,同时桃红组均较西药组良好,差异有统计学意义(P<0.05)。结论:桃红四物汤化裁治疗能够提高稳定型心绞痛合并心衰的临床疗效,进一步改善患者的心功能、血液流变学指标,降低患者血脂水平,减轻炎性应激反应,对于延缓心衰进程具有积极作用。     

Phenethyl Isothiocyanate Protects against High Fat/Cholesterol Diet-Induced Obesity and Atherosclerosis in C57BL/6 Mice

This study concerns obesity-related atherosclerosis, hyperlipidemia, and chronic inflammation. We studied the anti-obesity and anti-atherosclerosis effects of phenethyl isothiocyanate (PEITC) and explored their underlying mechanisms. We established an animal model of high fat/cholesterol-induced obesity in C57BL/6 mice fed for 13 weeks. We divided the mice into five groups: control (CON), high fat/cholesterol (HFCD), HFCD with 3 mg/kg/day gallic acid (HFCD + G), and HFCD with PEITC (30 and 75 mg/kg/day; HFCD + P30 and P75). The body weight, total cholesterol, and triglyceride were significantly lower in the HFCD + P75 group than in the HFCD group. Hepatic lipid accumulation and atherosclerotic plaque formation in the aorta were significantly lower in both HFCD + PEITC groups than in the HFCD group, as revealed by hematoxylin and eosin (H&E) staining. To elucidate the mechanism, we identified the expression of genes related to inflammation, reverse cholesterol transport, and lipid accumulation pathway in the liver. The expression levels of peroxisome proliferator activated receptor gamma (PPARγ), liver-X-receptor α (LXR-α), and ATP binding cassette subfamily A member 1 (ABCA1) were increased, while those of scavenger receptor A (SR-A1), cluster of differentiation 36 (CD36), and nuclear factor-kappa B (NF-κB) were decreased in the HFCD + P75 group compared with those in the HFCD group. Moreover, PEITC modulated H3K9 and H3K27 acetylation, H3K4 dimethylation, and H3K27 di-/trimethylation in the HFCD + P75 group. We, therefore, suggest that supplementation with PEITC may be a potential candidate for the treatment and prevention of atherosclerosis and obesity.     

Bupropion Overdose Complicated by Cardiogenic Shock Requiring Vasopressor Support and Lipid Emulsion Therapy

BackgroundBupropion overdose is a commonly encountered presentation in the emergency department (ED). While the majority of cases resolve with supportive care, serious adverse effects, including seizures, cardiogenic shock, and death, can occur. Intravenous lipid emulsion (ILE) therapy has been utilized for a multitude of poisonings with varying levels of success. Although a number of cases suggest the value of ILE therapy in cases of bupropion overdose, more recent data propose that its role may be overstated.Case ReportA young woman presented to the ED with altered mental status complicated by seizure after bupropion overdose. She subsequently developed cardiogenic shock requiring vasopressor support. Bedside echocardiogram revealed a decreased left ventricular ejection fraction (LVEF). She received ILE therapy with significant improvement in both hemodynamic status and LVEF by bedside ultrasound.Why Should an Emergency Physician Be Aware of This?Although the majority of patients presenting with bupropion overdose improve with supportive care, life-threatening sequelae are possible. ILE therapy has shown promise in a variety of different overdose situations, although the evidence in cases of bupropion poisoning has been varied, and it has traditionally been utilized as a last-line rescue modality. Based on hemodynamic parameters and bedside ultrasound, this case suggests that early initiation of ILE therapy should be considered in these cases, as the potential benefits likely outweigh the theoretical risks.     

Interactions of polar lipids with cholesteryl ester multilayers elucidate tear film lipid layer structure

PurposeThe tear film lipid layer (TFLL) covers the tear film, stabilizing it and providing a protective barrier against the environment. The TFLL is divided into polar and non-polar sublayers, but the interplay between lipid classes in these sublayers and the structure-function relationship of the TFLL remains poorly characterized. This study aims to provide insight into TFLL function by elucidating the interactions between polar and non-polar TFLL lipids at the molecular level.MethodsMixed films of polar O-acyl-ω-hydroxy fatty acids (OAHFA) or phospholipids and non-polar cholesteryl esters (CE) were used as a model of the TFLL. The organization of the films was studied by using a combination of Brewster angle and fluorescence microscopy in a Langmuir trough system. In addition, the evaporation resistance of the lipid films was evaluated.ResultsPhospholipids and OAHFAs induced the formation of a stable multilamellar CE film. The formation of this film was driven by the interdigitation of acyl chains between the monolayer of polar lipids and the CE multilayer lamellae. Surprisingly, the multilayer structure was destabilized by both low and high concentrations of polar lipids. In addition, the CE multilayer was no more effective in resisting the evaporation of water than a polar lipid monolayer.ConclusionsFormation of multilamellar films by major tear film lipids suggest that the TFLL may have a similar structure. Moreover, in contrast to the current understanding, polar TFLL lipids may not mainly act by stabilizing the non-polar TFLL sublayer, but through a direct evaporation resistant effect.     

外源性胆绿素对中波紫外线诱导的角质形成细胞光损伤的保护作用和机制

【摘要】 目的 探讨外源性胆绿素对中波紫外线（UVB）照射的HaCaT细胞光损伤的保护作用。方法 将HaCaT细胞分为加入0、0.1、1、10 μmol/L胆绿素并照射UVB的UVB组、0.1 μmol/L UVB组、1 μmol/L UVB组、10 μmol/L UVB组及不做处理的对照组。UVB照射剂量为30 mJ/cm2，照射后继续培养24 h，分别检测细胞活性氧（ROS）水平、超氧化物歧化酶（SOD）活力、丙二醛（MDA）含量，ELISA法检测各组细胞的炎症因子白细胞介素6（IL-6）、IL-8水平。多组间均数比较采用单因素方差分析，组间两两比较采用LSD-t检验。结果 UVB组、0.1 μmol/L UVB 组、1 μmol/L UVB组、10 μmol/L UVB组、对照组细胞ROS水平（3 613.33 ± 206.61、2 958.67 ± 193.87、2 678.33 ± 178.24、2 274.67 ± 118.81、1 905.67 ± 250.25）、SOD活力（24.41 ± 1.78、28.96 ± 2.21、29.75 ± 1.75、30.19 ± 2.29、37.52 ± 2.31）、MDA含量（5.61 ± 0.32、5.46 ± 0.55、4.65 ± 0.22、2.55 ± 0.93、1.31 ± 0.05）、IL-6水平、IL-8水平差异均有统计学意义（F值分别为 34.02、57.36、214.09、29.73、11.40，均P < 0.05），UVB组ROS水平、MDA含量及IL-6、IL-8水平均高于另4组（均P < 0.05），SOD活力均低于另4组（均P < 0.05）。结论 外源性胆绿素减轻UVB引起的HaCaT细胞的氧化损伤、减轻炎症反应和抑制脂质过氧化作用，对细胞光损伤有一定的保护作用。     

Associations of common SNPs in the SORT1, GCKR,LPL, APOA1, CETP,LDLR, APOE genes with lipid trait levels in an Algerian population sample

Genome-wide association studies have identified many lipid-associated loci primarily in European and Asian populations. In view of the differences between ethnic groups in terms of the frequency and impact of these variants, our objective was to evaluate the relationships between eight lipid-associated variants (considered individually and in combination) and fasting serum triglyceride, total cholesterol, HDL- and LDL-cholesterol levels in an Algerian population sample (ISOR study, n = 751). Three SNPs (in SORT1, CETP and GCKR) were individually associated with lipid level variations. Moreover, the risk allele scores for total cholesterol, triglyceride and LDL-C levels (encompassing between three and six SNPs) were associated with their corresponding lipid traits. Our study is the first to show that some of the lipid-associated loci in European populations are associated with lipid traits in Algerians. Although our results will have to be confirmed in other North African populations, this study contributes to a better understanding of genetic susceptibility to lipid traits in Algeria.     

The role of immune mechanisms in alcoholic and nonalcoholic steatohepatitis: a 2015 update

So far, innate immune mechanisms have been recognized as the main responsible for the evolution of both alcoholic steatohepatitis (ASH) and nonalcoholic steatohepatitis (NASH). However, increasing evidence points toward the possible role of adaptive immune responses, as an additional factor in promoting hepatic inflammation in steatohepatitis. In this article, we discuss recent data involving circulating antibodies and lymphocyte-mediated responses in sustaining the progression of ASH and NASH to fibrosis, as well as the possible mechanisms implicated in favoring the onset of adaptive immunity in the setting of steatohepatitis.     

血清血管紧张素转换酶的水平在阻塞性睡眠呼吸暂停低通气综合征患者中的变化研究

目的检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中血清血管紧张素转换酶(ACE)水平的变化及其临床意义。方法设置OSAHS组(n=40)和健康对照组(n=40),测定并比较患者的血压、血脂和血清ACE水平在两组间的差异;分析ACE水平与患者病情变化、血压、血脂的相关性。结果 OSAHS患者在体重、BMI指数、颈围、腰围、AHI、收缩压、舒张压、TC、LDL-C和血清ACE方面高于健康人(P体重=0.002,P颈围=0.024,P腰围=0.038,PBMI=0.019,PAHI=0.001,P收缩压=0.001,P舒张压=0.001,PTC=0.017,PLDL-C=0.010,PACE=0.039),在LSa O2上低于健康人(PLSa O2=0.001)。OSAHS患者的收缩压、TC、ACE在轻中度和中重度之间均存在统计学差异(P收缩压=0.018、0.043,PTC=0.045、0.034,PACE=0.030、0.001),相关性分析显示,OSAHS患者中血清ACE与收缩压和TC均呈正相关(r=0.35,P=0.017;r=0.28,P=0.044)。结论 OSAHS患者血清ACE能反映患者病情的变化,并与血压和血脂具有一定相关性。     

Arterial Thickness and Immunometabolism: The Mediating role of Chronic Exercise

Metabolic alterations and cardiovascular diseases, such as atherosclerosis, are associated with lifestyle modifications, particularly the increase of physical inactivity and poor eating habits, which contribute to one of the main causes of death in modern times. Cardiovascular diseases are positively correlated with several illnesses, such as obesity, hypertension and dyslipidemia, and these disorders are known to contribute to changes in immune cells, cytokines and metabolism. Atherosclerosis is a chronic inflammatory disease characterized by the formation of lipid plaques and fibrous tissue (atheroma) in the artery walls and this process is related to the oxidation of LDL-c (low density lipoprotein) and the formation of a particle, termed LDLox, which can generate toxic injury to the vessel wall. In this atherogenic process there is an inflammatory response generated by the injury in the vascular endothelium, which in itself is able to express and secrete a variety of molecules, such as myeloid colony-stimulating factors (M-CSF), monocyte chemotactic protein-1 (MCP-1) and tumor necrosis factor alpha (TNF-α), that act as activators of the immune system. Therefore, the main purpose of this review is to highlight the immuno-metabolic alterations involving the thickening and stiffness of arteries observed in atherosclerosis, and how chronic exercise can act as an anti-inflammatory and anti-atherogenic approach.