黄连解毒汤对高胆固醇兔血液流变学和动脉粥样硬化干预作用

目的:观察黄连解毒汤对肺炎衣原体(Cpn)感染后高胆固醇饮食兔血液流变学和动脉粥样硬化的影响.方法:造模前60只新西兰兔经采血检测Cpn IgG均为阴性.随机选取8只兔作正常组,其余52只以含2.5 g·kg~(-1)胆固醇的饲料喂养并接种Cpn.经检测血清Cpn IgG阳性者随机分为4组:黄连解毒汤高、低剂量(3.34,1.67 g·kg~(-1)·d~(-1))组、阳性药阿奇霉素(20 mg·kg~(-1)·d~(-1))组和模型组(生理盐水),每组11只,灌胃给药6周;Cpn IgG阴性者作高胆固醇组,不予药物干预.治疗结束后采血测定高、中、低全血黏度、血浆黏度和红细胞压积,并计算RBC聚集指数、变形指数和刚性指数;取主动脉弓近左颈总动脉分叉处血管,测定和计算最大血管内膜厚度(MIT)、动脉粥样硬化病变占管周百分比(P_(LCI))、动脉粥样硬化斑块面积指数(Ⅰ_(PA)).结果:高胆固醇组和模型组血液流变学均显著紊乱,主动脉均有典型的动脉粥样硬化病理变化,后者最大MIT(23.65±8.19 vs 12.76±4.06)μm、动脉粥样硬化病变P_(LCI)(41.08±12.51 vs 22.43±9.45)%、动脉粥样硬化斑块Ⅰ_(PA)(9.57±1.82 vs 2.84±0.25)%显著较前者高(均P＜0.01);黄连解毒汤高、低剂量组、阿奇霉素组血液流变学紊乱和动脉粥样硬化病理变化与模型组比较显著改善,其中黄连汤高剂量组MIT(6.45±1.27 vs 23.65±8.19),(P＜0.01),P_(LCI),(22.39±6.74 vs41.08±12.51),(P＜0.05);Ⅰ_(PA)(1.44±0.33 vs 9.57±1.82),(P＜0.01)显著降低.结论:Cpn感染加重高胆固醇饮食兔血液流变学紊乱和动脉粥样硬化损害,黄连解毒汤可减轻Cpn感染所致高胆固醇饮食兔的血液流变学紊乱和动脉粥样硬化损害.     

Reestablishing brain networks in patients without overt hepatic encephalopathy after liver transplantation

Cirrhotic patients without overt hepatic encephalopathy (HE) have associated with widespread neuro-psychological impairment. Liver transplantation can restore metabolic abnormalities but the mechanisms are unclear. We investigate brain functional networks after transplantation using resting-state funtional magnetic resonance imaging (MRI). Twenty-six cirrhotic patients without overt HE completed neuro-psychological assessment before and 6 to 12 months after transplantation, and compared with 35 healthy controls. Five major functional brain networks, default mode (DMN), dorsal attention (DAN), executive control (ECN), salience (SN), and primary networks (PN), were assessed. Nodal efficiency and strength in different functional networks were weighed and their interaction metrics displayed. Granger causal analysis between pretransplantation and posttransplantation was performed. Before transplantation, the intrafunctional connectivity was decreased in DMN, DAN, ECN, and SN. After transplantation, cognitive functions improved with increased functional connectivity. The interaction metrics among large-scale networks in patients became similar to healthy controls. The increase in PN affected the decrease in SN, while the increase in DAN forced a decrease in DMN. There was a bidirectional balance between DMN and SN. Dynamic disruptions and reconstruction in intrinsic large-scale networks are associated with parallel patterns of cognitive information processing deficits and recovery. Remapping of SN, DMN, and DAN is essential for restoring cognition after transplantation.