冠状动脉粥样硬化性心脏病患者心外膜脂肪组织的生物信息学研究

背景 心血管疾病（CVD）是常见病和多发病,患病率和死亡率呈快速上升趋势。动脉粥样硬化（AS是缺血性CVD的病理基础,研究表明心外膜脂肪组织（EAT）通过分泌外泌体（EXO）和生物活性物质促进AS进展,但其作用机制仍需进一步研究。目的 通过生物信息学方法挖掘冠状动脉粥样硬化性心脏病（CAD）患者EAT中的关键基因,探讨免疫细胞浸润情况,联合CAD患者EXO间差异表达基因（DEGs）推测EAT来源EXO间DEGs并进行验证,从细胞及分子水平上探讨EAT在CAD疾病过程中的作用机制。方法 从基因表达综合数据库（GEO）中下载关于EAT的数据集GSE64554、GSE120774,根据临床信息将EAT的测序数据分为CAD组和健康对照组,使用R语言及相关软件包进行生物信息学分析。首先使用R语言筛选CAD组与健康对照组EAT间DEGs,并进行GO富集分析和KEGG通路富集分析,构建蛋白质-蛋白质相互作用（PPI）网络,评估所选基因的生物学功能及可能参与其调控的转录因子。构建GSE64554数据集中EAT的加权基因共表达网络（WGCNA）,获取同CAD表型相关的基因模块,将所获EAT间DEGs与模...     

急性冠脉综合征患者强化抗栓治疗研究进展

急性冠脉综合征（ACS）是冠心病的严重类型,ACS患者不仅病死率较高,还存在缺血事件（如缺血性卒中、心肌梗死）复发风险。血小板聚集及血栓形成是导致ACS的重要原因。为降低缺血事件的发生风险,临床推荐ACS患者接受阿司匹林联合强效P2Y12抑制剂的双联抗血小板治疗12个月。然而在标准双联抗血小板治疗下,ACS患者残余缺血风险（经抗栓治疗后仍残留的缺血事件发生风险）仍旧较高。因此为进一步降低缺血事件发生风险,临床对强化抗栓方案的研究也逐渐增多。本文通过总结强化抗栓治疗方案的作用机制及其最新研究进展,发现延长双联抗血小板治疗时间、三联抗血小板治疗、双通道抑制（抗血小板联合抗凝治疗）等强化抗栓治疗方案可降低缺血事件发生风险,为进一步指导临床个体化抗栓治疗及明确最佳抗栓策略提供了参考。     

踝肱指数和肱踝动脉脉搏波速度与血管舒张功能联合载脂蛋白B与载脂蛋白A-1比值对中青年冠心病血瘀证的预测价值研究

背景 冠心病属中医“胸痹心痛”范畴,其证候分布以血瘀证最为多见,与老年人相比,中青年血瘀证的发生率更高。本研究在团队前期研究基础上进行拓展,首次运用动脉弹性和血管内皮功能检测联合载脂蛋白比值诊断中青年冠心病血瘀证,旨在为早期发现中青年冠心病血瘀证提供新思路,也可为优化补充冠心病血瘀证的诊断标准提供参考。目的 探讨踝肱指数(ABI)、肱踝动脉脉搏波速度(baPWV)、血管舒张功能(FMD)联合载脂蛋白B与载脂蛋白A-1比值(apoB/apoA-1)与中青年冠心病血瘀证的关系及其预测价值。方法 选取2016年12月至2021年12月于中日友好医院中西医结合心脏内科住院治疗的中青年(<50岁)冠心病患者,并根据《冠心病血瘀证诊断标准》分为血瘀证组和非血瘀证组。收集患者首次冠状动脉造影前的ABI、baPWV、FMD和apoB/apoA-1等临床资料。采用多因素Logistic回归分析构建中青年冠心病患者血瘀证的预测模型,并采用受试者工作特征(ROC)曲线进行预测价值评价。结果 本研究共纳入中青年冠心病患者206例,其中血瘀证组127例,非血瘀证组79例。多因素Logistic回归分析结果...     

老年冠心病患者血浆HCY、CRP和血脂水平变化及其与冠脉病变程度的关系

目的:探讨冠心病(CHD)患者血浆同型半胱氨酸(HCY)水平与冠脉病变程度及C-反应蛋白(CRP)、血脂水平的关系。方法:检测102例CHD患者和27例正常对照人群的血浆HCY和CRP、甘油三酯(TG)、总胆固醇(TC)和脂蛋白(a)[LP(a)]水平,并进行比较及相关性分析。结果:CHD组血浆HCY以及CRP、TG、TC、LP(a)水平显著高于正常对照组;CHD组血浆HCY水平与CRP、TG、TC、LP(a)无明显相关性(P>0.05),血浆HCY、CRP、TG、TC、LP(a)水平随着冠脉病变支数增加而增高,呈显著正相关。结论:高血浆HCY是CHD的独立危险因素,对CHD的预防和诊断具有一定的临床意义。     

Arteries to the great and second toes based on three-dimensional analysis of 100 cadaveric feet

Summary Three-dimensional arteriography was used to analyse the arterial supply of the great and second toes of 100 cadaveric feet down to the microsurgical level. This information will aid in successful composite tissue transfers of these toes to the hand. The arterial blood supply of the great toe came principally from the first dorsal metatarsal a. (78%) and the first plantar metatarsal a. (22%), and secondarily from the medial tarsal aa. and the three terminal branches of the medial plantar a. For the second toe, the first dorsal metatarsal a. (78%) and the first plantar metatarsal a. (22%) supplied blood from the medial side, and the second dorsal metatarsal a. (78%) and the second plantar metatarsal a. (22%) supplied blood from the lateral side. Seven arterial patterns were found in the interdigital web space. The socalled general pattern was seen in the first web space in 65% of the feet examined. In the second web space it was found in 85%. The first intermetatarsal space sometimes contained a large artery arising directly from the dorsalis pedis or first proximal perforating a. as well as the first dorsal and first plantar metatarsal arteries. In this space, arterial patterns were classified into 4 types and 9 subtypes based on the origins and proximal courses of these arteries. The so-called standard pattern was found in only 19% of the feet, while an arterial pattern with a common proximal trunk on the plantar side for the first dorsal and first plantar metatarsal aa. was found most frequently (46%). In the second intermetatarsal space the second dorsal metatarsal a. was usually located on the dorsum.

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Les artères de l'hallux et du deuxième orteil. Analyse tridimensionnelle de cent pieds de cadavres

Résumé L'artériographie en trois dimensions a été utilisée pour analyser la vascularisation artérielle de l'hallux et du deuxième orteil de cent pieds de cadavres jusqu'au niveau microchirurgical. Ces renseignements aideront au succès des transferts de tissus composites de ces orteils vers la main. La vascularisation artérielle de l'hallux vient principalement de la première artère métatarsienne dorsale (78 %) et de la première artère métatarsienne plantaire (22 %) et secondairement des artères tarsiennes médiales et des trois branches terminales de l'artère plantaire médiale. Pour le deuxième orteil, la première artère métatarsienne dorsale (78 %) et la première artère métatarsienne plantaire (22 %) vascularisent le versant médial, la deuxième artère métatarsienne dorsale (78 %) et la deuxième artère métatarsienne plantaire (22 %) vascularisent le versant latéral. Sept dispositions artérielles ont été trouvées dans la commissure interdigitale. Une disposition dénommée commune a été vue dans la premiere commissure sur 65 % des pieds examinés, dans la deuxième commissure dans 85 % des cas. Le premier espace intermétatarsien contient parfois une volumineuse artère, naissant directement de l'artère dorsale du pied ou de la première artère perforante proximale, mais aussi des premières artères métatarsiennes dorsale ou plantaire. Dans cet espace, les dispositions artérielles sont classées en 4 types et 9 sous-types, basés sur l'origine et le trajet proximal de ces artères. La disposition standard a été trouvée seulement sur 19 % des pieds, alors qu'une disposition comprenant un tronc proximal commun situé sur le versant plantaire, fournissant les premières artères métatarsiennes dorsale et plantaire, a été trouvée plus fréquemment (46 %). Dans le deuxième espace intermétatarsien, la deuxième artère métatarsienne dorsale était habituellement située sur le versant dorsal.

     

Effects of exercise cessation on lipids and lipoproteins in distance runners and power athletes

Summary The purpose of this study was to determine the effects of short-term exercise cessation on lipid and lipoprotein profile and insulin sensitivity in highly trained runners (n=12; mean age 19.9 years) and power athletes (n=12; mean age 24.4 years). Following 14 days of exercise cessation, running time to exhaustion and maximal oxygen uptake decreased by 9.2% and 4.8% (P < 0.05) in the runners, while in the power athletes one repetition maximum squat and bench press did not change (P>0.05). No changes occurred in body composition. Data from a 2-h oral glucose tolerance test revealed an impairment of the glycemic state in all athletes (P<0.05). In contrast, exercise cessation did not significantly (P>0.05) alter plasma levels of cholesterol, triglycerides, and low density (LDL) and high density lipoprotein (HDL). No changes were observed in HDL₂, HDL_2b, and HDL₃ subfractions, LDL diameter, and qualitative LDL pattern (P>0.05). These data thus suggest that despite a decrease in insulin sensitivity, short-term exercise cessation, independent of exercise mode, was insufficient to alter plasma lipid and lipoprotein profiles in well-trained athletes.     

Model for Intravital Microscopic Evaluation of the Effects of Arterial Occlusion-caused Ischemia in Bone

An in vivo model has been developed for chronic observation of the effects of ischemia on cortical bone remodeling and perfused vascularity. Diaphragm occluders were implanted around the right common iliac artery of four rabbits and inflated to produce 10 h of ischemia to the limb. Microcirculation was monitored with intravital microscopy of injected fluorescent microspheres and FITC-Dextran 70 through a bone window, the tibial bone chamber implant (BCI). Bone resorption and apposition in the BCI were indicated with mineralization dyes. Between 2 and 12 h following release of the occluder, secondary ischemia/no-reflow and other evidence of reperfusion injury were observed. Vessel damage was suggested by abnormally high leakage of FITC-D70 from the few vessels perfused during secondary ischemia. In the weeks following occluder release perfused vasculature increased beyond pre-occlusion levels. Net bone resorption reached a maximum when vascularity passed normal levels. In order to further validate the arterial occlusion model for osteonecrosis, techniques for (1) confirming bone death and (2) detecting increased leukocyte adherence to endothelial cells were added. The dead cell stain Ethidium homodimer-1 was used to tag dead osteocytes immediately after occlusion and produced a measure designated osteonecrosis index. To detect leukocytes adhering to vessel walls, carboxyfluorescein diacetate, succinimidyl ester was injected at occluder release. An increase in the number of adherent leukocytes was detected. © 1999 Biomedical Engineering Society. PAC99: 8764Rr, 8717-d, 8719Tt     

Apolipoprotein E polymorphism is not associated with lipid levels and coronary artery disease in Greek patients with familial hypercholesterolaemia

Abstract Familial hypercholesterolaemia is a genetic disorder characterised by high low-density lipoprotein (LDL) cholesterol concentrations, which frequently gives rise to premature coronary artery disease (CAD). The clinical expression of familial hypercholesterolaemia is highly variable even in patients carrying the same LDL receptor gene mutation. This variability may be due to environmental and other genetic factors. Apolipoprotein E (Apo-E) has been extensively studied for its effects on the phenotype of familial hypercholesterolaemia. In this study we examined the influence of Apo-E genotype on lipid parameters and the incidence of CAD in 93 Greek patients with familial hypercholesterolaemia. Apo-E E2, E3 and E4 allele frequencies were 0.06, 0.86 and 0.09 respectively. The levels of total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, apolipoproteins A and B and lipoprotein α did not differ significantly among carriers and non-carriers of the E4 allele. The prevalence of CAD and hypertension did not differ either. Our results suggest that the E4 allele is not associated with lipid levels or with the prevalence of CAD among familial hypercholesterolaemia patients of the Greek population. *The two authors were equally involved in the work     

Relationship of polymorphisms in the renin-angiotensin system and in E-selectin of patients with early severe coronary heart disease

 Previous association studies between angiotensin-converting enzyme (ACE) and angiotensinogen (AGT) polymorphisms and several cardiovascular diseases have reported variable results. Therefore we examined the association of the DNA variants of ACE and AGT with early, severe coronary heart disease (CHD). In addition, we compared the genotypes of both polymorphisms and the recently discovered polymorphism in the E-selectin gene in both patients and an unselected population. This study included 113 patients with severe CHD (50 years old or less) and up to 197 control subjects. The frequencies of the ACE I/D variants were 48% I and 52% D in the controls and 46% I and 54% D in the patients. The frequencies of the AGT-M235T polymorphism were 60.8% M and 39.2% T in controls and 49.1% M and 50.9% T in the patients. The frequencies of the S128R polymorphism of the E-selectin were 91.3% S and 8.7% R in controls and 84.5% S and 15.5% R in the patients. In our studies the DD genotype of ACE was not associated with early severe CHD. We found a correlation between the M235T molecular variant of AGT and the S128R variant of E-selectin to early severe CHD. Received: 15 February 1996 / Accepted: 2 October 1996