动脉三级淋巴组织与动脉粥样硬化关系的研究进展

学者们对动脉血管的研究常聚焦在血管内膜动脉粥样硬化(As)斑块的形成,而很少关注血管外膜的免疫反应及其对疾病病程的影响。前期研究发现,老龄的ApoE－/－小鼠动脉外膜出现免疫细胞的有序集聚,形成类似淋巴结的异位淋巴组织,称之为动脉三级淋巴组织(ATLO),其形成对内膜As具有明显的调控作用。ATLO的发现及研究为As的研究指明了新的方向,并为其他疾病状况下三级淋巴组织(TLO)的研究提供了很好的范例。因此,阐明TLO的特点及形成机制对As的防治具有重要的意义,并为其在其他疾病中的临床运用提供坚实的基础。     

The hidden aspect of carotid lesions in traffic accidents: A little-known phenomenon

Vascular injuries that occur during traffic accidents are a commonly neglected aspect that can add more detail to the framework of a case. In this study, we analysed a case series of 150 traffic accidents, 39 of which were marked by microscopically identifiable vascular lesions. The purpose was to identify the presence of carotid injuries in individuals who died due to traffic accidents and had nonpenetrating trauma of the neck. We focused on the discrepancies regarding the macroscopical aspect and the histology and demonstrated how histological analysis of the carotids in cases of trauma can reveal injuries that are attributable to the trauma itself. We conducted a histological analysis of the lesions to describe their distribution and type and investigate potential correlations. The study offers insight on how to examine road accidents that involve traumatic injury of the carotid arteries. Indeed the main task of the forensic pathologist in the case of death is to establish the existence of a causal relationship between the micro- or macroscopic alterations observed in the autopsy and the traumatic event that led to the death of the subject. Thus, further morphological elements were provided to the forensic practitioners that may reveal injuries attributable to the trauma itself and should be evaluated in cases of trauma in traffic accidents.     

从血浊理论浅谈动脉粥样硬化的危险因素

血浊作为全新的中医学理念,为心脑血管疾病的防治提供了新的思路与方法,动脉粥样硬化作为心脑血管疾病的病理基础,危险因素广泛,对人们的生命安全威胁极大,故从血浊理论探讨动脉粥样硬化的危险因素,初步阐释血浊与动脉粥样硬化发生、发展的关系。血浊理论是动脉粥样硬化的病理基础,从这一角度为动脉粥样硬化的防治提供了新思路、新方法。     

双黄连对动脉粥样硬化大鼠TLR4/MyD88/NF-κB信号通路表达的影响实验研究

目的探究双黄连对动脉粥样硬化大鼠体内TLR4/MyD88/NF-κB信号通路表达的影响。方法建立动脉粥样硬化大鼠模型,进行双黄连不同剂量的处理后,对大鼠进行相关检测。结果双黄连处理组大鼠血清中的总胆固醇、甘油三酯、高密度脂蛋白和低密度脂蛋白均明显低于模型组,高剂量组效果更明显;将胸主动脉进行HE染色后发现,相比模型组,双黄连处理组均有管腔狭窄的减轻,脂质斑块的减少,泡沫细胞沉积的减少,蓝色颗粒钙化病灶的缩小;免疫组化实验和Western Blot实验检测发现,双黄连处理组大鼠的动脉组织中TLR4、MyD88、NF-κB表达相比模型组发生了明显降低,且高剂量组降低更明显。结论双黄连有利于减轻大鼠动脉粥样硬化的病症,其机理在于降低TLR4、MyD88、NF-κB蛋白的表达水平,且疗效显著。     

血府逐瘀汤合温胆汤加减联合西药治疗高血压颈动脉硬化的临床观察

目的:观察血府逐瘀汤合温胆汤加减联合西药治疗高血压颈动脉硬化的效果。方法:选取2017年6月至2018年6月聊城市中医院收治的高血压颈动脉硬化患者92例作为研究对象,按照随机数字表法随机分为对照组与观察组,每组46例。对照组患者给予左旋氨氯地平+阿托伐他汀口服,观察组在对照组基础上加用血府逐瘀汤合温胆汤加减口服。观察患者血压、血脂控制情况,测定颈动脉内膜中层厚度(IMT)、斑块面积、血管皮内皮功能、血清蛋白酶分子水平。结果:与对照组比较,观察组治疗后的血压SBP、DBP及血脂TG、TC、LDL-C等指标更低(P<0.05);颈动脉粥样硬化斑块IMT厚度、斑块面积明显缩小(P<0.05),血管内皮功能指标ET-1、AngⅡ、TXB2水平明显降低,NO水平明显升高(P<0.05);血清CatK、MMP-9水平明显降低(P<0.05);观察组不良反应发生率8.70%明显低于对照组不良反应发生率21.74%(P<0.05)。结论:血府逐瘀汤合温胆汤加减联合西药更利于控制高血压颈动脉硬化患者的血压,调节脂质代谢,改善血管内皮功能,降低血清蛋白酶分子的含量,用药安全。     

艳山姜挥发油通过调控巨噬细胞CD36和ABCA1表达抑制泡沫细胞的形成

目的:观察艳山姜挥发油对氧化低密度脂蛋白(ox-LDL)诱导巨噬细胞转化为泡沫细胞的抑制作用,并探索其机制。方法:使用佛波酯(PMA,100μg·L^-1)诱导人白血病单核细胞(THP-1)24 h后形成巨噬细胞,实验分为4组,分别为空白组(无血清RPMI 1640),模型组(80 mg·L^-1ox-LDL),艳山姜挥发油低剂量组(80 mg·L^-1ox-LDL+4μg·L^-1艳山姜挥发油),艳山姜挥发油高剂量组(80 g·L^-1ox-LDL+20μg·L^-1艳山姜挥发油)。噻唑蓝(MTT)比色法检测艳山姜挥发油对巨噬细胞的活性的影响,蛋白免疫印迹法(Western blot)检测巨噬细胞中白细胞分化抗原36(CD36)和三磷酸腺苷结合盒转运体A1(ABCA1)的表达,酶联免疫吸附测定(ELISA)检测巨噬细胞内胆固醇酯含量,油红O染色法检测巨噬细胞中脂质小滴的含量。结果:艳山姜挥发油对巨噬细胞无毒性。与空白组比较,模型组的巨噬细胞内脂滴和胆固醇酯的含量显著增加(P<0.01),CD36蛋白表达显著上升(P<0.01),ABCA1蛋白表达无显著变化;与模型组比较,艳山姜挥发油显著抑制巨噬细胞中脂滴和胆固醇酯的含量(P<0.01),下调CD36的蛋白表达(P<0.01),上调ABCA1蛋白的表达(P<0.01),艳山姜挥发油可抑制巨噬细胞向泡沫细胞的转化。结论:艳山姜挥发油对ox-LDL诱导的巨噬细胞向泡沫细胞的形成具有抑制作用,该药理作用与艳山姜挥发油下调巨噬细胞CD36和上调ABCA1蛋白的表达有关。     

How accurate is atherosclerosis imaging by coronary computed tomography angiography?

Invasive coronary plaque imaging such as intravascular ultrasound and optical coherence tomography has been widely used to observe culprit or non-culprit coronary atherosclerosis, as well as optimize stent sizing, apposition and deployment. Coronary computed tomographic angiography (CTA) is non-invasively available to assess coronary artery disease (CAD) and has become an appropriate strategy to evaluate patients with suspected CAD. Given recent technologies, semi-automated plaque software is available to identify coronary plaque stenosis, volume and characteristics and potentially allows to be used for the assessment of more details of plaque information, progression and future risk as a surrogate tool of the invasive imaging modalities. This review article aims to focus on various evidence in coronary plaque imaging by coronary CTA and describes how accurate coronary CTA can classify coronary atherosclerosis.