Research Advance of Chinese Medicine in Treating Atherosclerosis: Focus on Lipoprotein-Associated Phospholipase A2

As a serious cardiovascular disease, atherosclerosis(AS) causes chronic inflammation and oxidative stress in the body and poses a threat to human health. Lipoprotein-associated phospholipase A2(Lp-PLA2) is a member of the phospholipase A2(PLA2) family, and its elevated levels have been shown to contribute to AS. Lp-PLA2 is closely related to a variety of lipoproteins, and its role in promoting inflammatory responses and oxidative stress in AS is mainly achieved by hydrolyzing oxidized phosphatid...     

Percutaneous balloon aortic valvuloplasty in the treatment of congenital valvu lar aortic stenosis in children

Objective To assess the effect of the balloon valvuloplasty for congenital valvular aortic stenosis (AS) in children.Methods A total of 27 (mean age 6.09 years) children with AS accepted the treatment of percutaneous balloon aortic valvuloplasty (PBAV).The ratios of balloon/valve were 0.95±0.08 for 19 cases of typical AS and 1.00±0.11 for 8 cases of hyp oplastic AS.The patients were evaluated by the gradients across aotic valves i n pre- and post-PBAV and by echocardiogram during the follow-up period.Results Fifteen of 19 （78.9%）cases of typical AS had a better outcome and the gradien t of the remaining 4 cases (26.7%) had increased after follow-up (ΔP>50 mm Hg).Four of 8 (50.0%) cases of hypoplastic AS had satisfactory responses and the gradient of the remaining 3 cases (75.0%) rose.There was no moderate to s evere aortic insufficiency (AI). Conclusion The balloon aortic valvuloplasty provides safe and significant hemodynamic and c linical improvement in pediatric patients.The outcome of PBAV for typical AS is better than for hypoplastic AS.     

Factors affecting the pathogenesis of ankylosing spondylitis

Ankylosing spondylitis (AS) occurs more frequently in young males than in females. The prevalence of AS in Taiwan, according to our previous study, is about 0.3%.1 AS mainly affects the spine, however, it can also result in peripheral arthritis that occurs in the toes, ankles, knees, hip joints and the tendon and ligaments around those joints.2 In addition, the spine of some AS patients may develop kyphoscoliosis due to late diagnosis or failure to cooperate in following the routine medication and exercises prescribed by their doctors.     

Development of a disease-specific health-related quality of life questionnaire for patients with post-stroke spasticity

OBJECTIVE:This study was designed to develop a disease-specific health-related quality of life(HR-QOL) measure for patients with post-stroke spasticity.METHODS:Based on responses from 20 patients with post-stroke spasticity and an extensive literature search,items potentially used to measure these patients’ recovery status were identified and the Apoplexy Spastic-Paralysis Questionnaire(ASPQ) was formed.A sample of 106 patients was then tested twice using the ASPQ,the Self-rating Depression Scale(SDS) and the Stroke-specific Quality of Life(SS-QOL).Clinicians also examined all the patients using the Ashworth Scale(AS).Internal reliability was assessed using Cronbach’s coefficient α,while construct validity was determined using principal component analysis(PCA).Empirical validity was evaluated between patients with depression and those without depression by single factor analysis.Sensitivity was examined by calculating the Spearman correlation coefficient between the changes in scores of the ASPQ,the AS and the SS-QOL.RESULTS:The ASPQ had adequate internal consistency reliability(α=0.874) and sensitivity,with significant correlations between the changes in scores of the AS,the SS-QOL and the ASPQ,with three domains.In a construct validity test,six factors were extracted;the overall variance explained by all factors was 72.6%.For empirical validity,mean values of 19 items and 3 domains were all higher in the depressive patients than in the non-depressive patients.CONCLUSION:The ASPQ is a reliable and valid self-rating scale for measuring the HR-QOL in patients with post-stroke spasticity.     

Bushen Qiangji Granule(补肾强脊颗粒)Medicated Serum Inhibits Osteogenic Differentiation of Fibroblasts in Ankylosing Spondylitis by Inhibiting the BMP/Smads Signal Pathway in vitro

Objective: To explore the mechanism of Bushen Qiangji Granule(补肾强脊颗粒, BSQJ) in restraining the osteogenic differentiation of ankylosing spondylitis(AS) fibroblasts. Methods: Hip joint capsules were obtained from AS patients(n=10) receiving total hip replacement and healthy hip joint capsules from patients with hip fracture(n=10) receiving surgery as a control. Finite fibroblast lines were established from these tissue samples to observe the effect of BSQJ on suppressing osteogenic differentiation of fibroblasts. The expression of osteogenic marker gene corebinding factor a1(Cbfa1) and Smad family proteins were examined by Western blot and real-time quantitative polymerase chain reaction(q PCR). Results: The m RNA expression level of Cbfa1 was significantly higher in AS fibroblasts than that in normal fibroblasts and the expression of p Smad1, p Smad5, Smad4 and Cbfa1 in AS fibroblasts was also higher, demonstrating the activation of the BMP/Smads signal pathway in AS fibroblasts. BSQJ-medicated serum not only restrained the m RNA and protein expression levels of Cbfa1 and inhibited protein expression level of Smad4 but also decreased the expression quantities of p Smad1 and p Smad5. Conclusions: BSQJ can inhibit osteogenic differentiation of AS fibroblasts in vitro by suppressing the activation of the BMP/Smads signal pathway. This may be the important molecular mechanism of BSQJ in regulating AS ossification.     

Eosinophilic gastroenteritis: Pathogenesis,diagnosis, and treatment

Eosinophilic gastroenteritis (EGE) is a gastrointestinal disorder of unclear etiology that is characterized by eosinophilic infiltration of the stomach and small intestine, and consists of mucosal, muscular, and serosal subtypes. Eosinophilic infiltration of the gastrointestinal tract is a fundamental histopathological characteristic of EGE and is driven by several T-helper type 2 (Th2)-dependent cytokines and induced by food allergy. Due to the lack of a diagnostic gold standard, EGE has a high...     

A clinicopathological study of Alport syndrome and detection of type IV collagen chains in Alport patients

OBJECTIVE To summarize the clinical and pathological findings of Alport syndrome (AS), detect the distribution of type IV collagen within basement membrane of patients with AS and evaluate the diagnostic value of indirect immunofluorescence (iIF) study of type IV collagen in AS.

METHODS Fourteen patients belonging to 12 families were collected from January 1990 to June 1996. The clinical examinations include biochemical examination, audiometry and ocular examination. IIF technique was used to detect the location of chains of type IV collagen in 6 renal and 5 skin specimens from 8 Alport patients.

RESULTS Among fourteen patients, 11 were male and 3 female (mean age 29.4 years). Microscopic hematuria was found in 13 patients, and recurrent gross hematuria in 7. All had proteinuria. Three patients presented nephrotic syndrome. Slowly progressive renal failure occurred in 10 of 11 males (11-39 years) and 1 female (40 years). Sensorineural deafness was observed in 9 patients particularly high frequency sound. Anterior lenticonus were presented in 2. Five families transmitted as X-linked dominant (XD) trait and 3 autosomal dominant, 3 autosomal recessive inheritance. In 7 renal biopsies, the findings by light microscopy mostly revealed focal and segmental sclerosis glomerulonephritis (4/7). The results of IF were negative in 4. Ultrastructural studies showed variable thickening, thinning of glomerular basement membrane (GBM) in 7 specimens with lamellation and basket wearing of GBM in 1. Using the iIF technique, the alpha 3, 4, 5 (IV) chains were observed to be absent within both GBM and EBM of 4 male XD-AS patients. Six patients were treated with hemodialysis, 2/6 with transplantation.

CONCLUSIONS Alport syndrome (AS) is a heterogeneous hereditary disease characterized by progressive hematuric nephritis with or without sensorineural hearing loss and ocular defects. Ultrastructural alterations of GBM are helpful to the diagnosis of AS. IIF study suggests that type IV collagen in basement membrane of AS was abnormal and iIF study of type IV collagen chains distribution is useful for confirming the diagnosis of AS.

     

Progress of research in treatment of hyperlipidemia by monomer or compound recipe of Chinese herbal medicine

Hyperlipidemia （HLP） is the No.1 risk factor for patients with atherosclerosis （AS） and is directly related to the occurrence of coronary artery disease （CAD） and cerebrovascular disease. Therefore, prevention and treatment of AS is of great importance and of practical significance in controlling the incidence and mortality of CAD. With its peculiar syndrome-dependent therapy, traditional Chinese medicine （TCM） has accumulated abundant practical experiences in this field and good clinical effects have been achieved. Chinese herbal medicine, with its particularly unique advantages and high potentials yet to be tapped, displays its huge strength in HLP prevention and treatment. The progress of studies concerning prevention and treatment of HLP by Chinese herbal medicines, in the form of monomers or compound recipes, is reviewed in this paper.     

Correlation of serum cholesteryl ester fatty acid composition with susceptibility to atherosclerosis in different species.

Fatty acid composition of serum cholesteryl esters (CEs) in Chinese and 9 species of laboratory animals was analysed. Polyunsaturated fatty acids (PUFAs) were the predominant fatty acids in CEs. A close correlation between PUFAs to saturated fatty acids ratio (P/S) in CEs and susceptibility to atherosclerosis (AS) was observed in different species. Animals with high P/S such as mice (13.0), tree shrews (9.0) and rats (9.0) were AS-resistant, and those with low P/S such as rabbits (2.9) were susceptible to AS. The P/S value in men (4.9) was between those of the above two kinds of animals, and similar to those of pigs (4.2) and monkeys (3.7). Marked physiological significance of the rich PUFAs in CEs may be expected. As the main constituent of low density lipoprotein (LDL), CEs may provide PUFAs for cells efficiently via LDL receptor. It is assumed that PUFAs in CEs may play an important role in the metabolism of cholesterol and the development of AS by regulating LDL receptor activity, platelet function and prostaglandin metabolism.

     

The Effectof the Lyso PC-induced Endothelial Cell Conditioned Medi-um on Proliferating Cell Nuclear Antigen Expression of the Calf Tho-racic Aorta Smooth Muscle Cell

Proliferation of aorta smooth muscle cells(ASMCs) and move towards aortas intima layer isthe fundamental pathological change in atheroscle-rosis(AS) .Plasma low density lipoprotein(LDL)and especially the increased density of oxidized(Ox- LDL can speed up the formation of AS[1] . Inthe process of oxidation of LDL,phos-phatidylcholine (PC) is changed into Lysophos-phatidylcholine (Lyso PC) and constitutes the mainphosphatide ingredient of Ox- LDL[2 ] . Owing tothe real expression of a…     

Dr. Feng Xinghua’s Experience in Treating Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a rheumatic disease mainly involving the axial joints, characterized by sacro-iliilis and rigid spine. Dr. Feng Xinghua from Guang’anmen Hospital affiliated to China Academy of Chinese Medical Sciences has been engaged in t…     

Non-alcoholic fatty liver disease:Epidemiology,pathophysiology and an update on the therapeutic approaches

Non-alcoholic fatty liver disease(NAFLD)denotes a spectrum of fatty liver disease in individuals without significant alcohol consumption.NAFLD is set to be the most common etiology of serious liver diseases in numerous nations when accompanied by obesity and type 2 diabetes.It is further histologically categorized into the non-alcoholic fatty liver(NAFL;steatosis without hepatocellular injury)and non-alcoholic steatohepatitis(NASH)which is characterized by the coexistence of hepatic steatosis and inflammation and is accompanied by hepatocyte injury(ballooning),either with or without fibrosis.NAFL is considered the benign and reversible stage arising from the excessive accumulation of triglycerides in hepatocytes.However,NASH is a more progressive stage of NAFLD,due to the increased risks of evolving more serious diseases such as cirrhosis,hepatocellular carcinoma.This concept,however,has been lately challenged by a hypothesis of multiple parallel hits of NAFLD,in which steatosis and NASH are separate entities rather than two points of the NAFLD spectrum,not only from a set of histological patterns but also from a pathophysiological perspective.The current review highlights the epidemiology and pathophysiology of NAFLD,and its progression towards steatohepatitis,with special focus on the novel imminent therapeutic approaches targeting the molecular aspects and the pathogenic pathways involved in the development,and progression of NAFLD.     

Rac1 regulates the release of Weibel-Palade Bodies in human aortic endothelial cells

Background The release of Weibel-Palade Bodies (WPB) is a form of endothelial cell activation. But the signal transduction pathway leading to WPB release is not yet defined. We hypothesized that small G-protein racl and reactive oxygen species (ROS) mediate the ligand induced release of WeibeI-Palade Bodies. Methods We tested this hypothesis by using wild-type and mutant adenoviral racl expression vectors, and by manipulating the production and destruction of superoxide and hydrogen peroxide in human aortic endothelial cells (HAEC). Results Thrombin (1.0 Unit, 30min) induced the increase of WPB release by 3. 7-fold in HAEC, and that H2O2 (0. 1mmol/L, 30 min) induced by 4. 5-fold. These results correlated with thrombin-stimulated activation of rac-GTP binding activity by 3. 5-fold, and increase of ROS production by 3. 4-fold. The dominant negative adenoviral rac-N17 gene transfer dramatically inhibited the release of WPB by 64.2% (control) and 77.3% (thrombin-stimulation), and decreased ROS production by 65.5% (control) and 83.6% (thrombin-stimulation) compared with non-infected cells, respectively. Anti-oxidants, catalase and N-acetyl-cysteine significantly decreased the release of WPB by 34% and 79% in control cells, and further decreased by 63.6% and 46.7% in rac-N17 transferred cells compared with non-infected cells. We also confirmed that racl was located upstream of ROS in the WPB release pathway. Conclusions Small G-protein racl medicates ligand-induced release of WeibeI-Palade Bodies in human aortic endothelial cells, and the signal pathway of WPB release is a racl-dependent ROS regulating mechanism.     

Benign symmetric lipomatosis of the knees

Benign symmetric lipomatosis(BSL)is a rare disease characterized by the presence of multiple,symmetric and nonencapsulated fat masses in the face,neck and other areas.It is commonly seen in middle-aged Caucasian Mediterranean males,while its etiology is still not clear.The majority of the patients with BSL have a history of alcohol abuse and hepatopathy.BSL of the limbs is very rare.This article reports a unique case of a 60-year-old Chinese woman with involvement of the knees confirmed by the results of magnetic resonance imaging(MRI)and histopathology,which was not described previously in published literatures.     

Acute myocardial infarction: myocardial salvage assessment

Primary coronary revascularization by means of percutaneous coronary intervention(PCI)is a highly effective treatment of acute myocardial infarction re-establishing coronary perfusion and stopping the ongoing necrosis in the dependent myocardium.Single-photon emission computed tomography(SPECT)is the most widely used modality assessing myocardial salvage as the difference between the acute perfusion defect before intervention and the remaining scar size measured in a second scan several days after the event.SPECT allows quantification of area at risk(AAR)and final infarct size(FIS)by tracer injection prior to revascularization and after 1 month,respectively.SPECT provides the most validated measure of myocardial salvage and has been utilized in multiple randomizedclinical trials.However,SPECT is logistically challenging,expensive,and includes radiation exposure.More recently,a large number of studies have suggested that cardiac magnetic resonance(CMR)can determine salvage in a single examination by combining measures of myocardial oedema in the AAR exposed to ischaemia reperfusion with FIS quantification by late gadolinium enhancement.     

Asymmetric Crying Facies with Multiple Congenital Malformations: a Case Report

ASYMMETRIC crying facies (ACF) is characterized by facial asymmetry only when crying. It may present as an exclusive symptom, or be con-comitant with other congenital malformations and even some fatal birth defects. Clinically, ACF is fea-tured by drooping of the intact corner of the mouth during crying, while the face appears symmetric at rest. The facial nerve function is symmetric, as determined by frowning, forehead wrinkling, eye closure, and nasolabial fold depth. When ACF alone is present, the cause is often compression of the mandibular branch of the facial nerve that is prob-ably due to birth trauma or abnormal fetal posturein utero. ACF with other congenital anomalies is usually caused by hypoplasia of the depressor anguli oris muscle (DAOM) on one side of the mouth. We described a 26-month-old girl with ACF and multiple congenital malformations in this report and reviewed the relevant literature regarding the occurrence, coexisting anomalies, probable etiologies, and surgical intervention.     

The relationship between gap junctional remodeling and human atrial fibrillation

Atrial fibrillation (AF) is currently the most common cardiac tachyarrhythmia in clinical practice. AF has a tendency to become more persistent over time. Progression of an underlying disease is one explanation. Another possible explanation is electrical, structural, and gap junctional remodeling of the atrium by repetitive induction of AF.1 The expression level and distribution of it have close relation with the conduction velocity of electrical activation in the atrium. The aim of the present study was to investigate the alternations of the expression and distribution of (connexin 40, Cx 40) and (connexin 43, Cx 43) in the right atrial appendages of the patients with AF by laser confocal scanning microscopy and Western blot technique.