Effect of membranous structures of the Kupffer cells on blood clotting

The effect of subcellular fractions of the endothelial Kupffer cells on blood clotting was studied. Cells were obtained from the rabbit liver by magnetic fractionation and the subcellular structures were then isolated from them by differential centrifugation. The inner membranous structures were found to carry thromboplastic activity. No correlation was found between the blood-clotting potential of the intracellular structures of the endothelial cells and the level of their cathepsin C activity.Department of Biological Chemistry, Kazan' Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR A. N. Filatov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 78, No. 7, pp. 9–11, July, 1974.     

伊伐布雷定在慢性射血分数降低心力衰竭易损期的运用及再入院影响因素分析#br#

摘要：目的　探讨伊伐布雷定（Iva）在慢性射血分数降低心力衰竭（HFrEF）易损期的运用及易损期再入院的影响因素。方法　根据是否服用Iva把402例易损期慢性HFrEF患者分为对照组（142例）和观察组（260例）。对照组依据指南给与抗心力衰竭治疗,观察组在对照组的基础上给与Iva。对比2组的疗效、心脏不良事件、心功能指标、炎性因子。采用Logistic回归分析易损期慢性HFrEF患者再入院的影响因素。结果　观察组的疗效明显好于对照组,再住院比例明显低于对照组（P＜0.05）。治疗后与对照组相比,观察组的24 h平均心率减慢,左心室射血分数（LVEF）增高,左心室舒张末期内径（LVEDD）减小,6 min步行距离（6MWD）延长,N末端B型利钠肽原（NT-proBNP）、肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6和超敏C-反应蛋白（hs-CRP）水平均降低（P＜0.05或P＜0.01）。Logistic回归分析结果显示不按时服药、独居是易损期慢性HFrEF患者再入院独立危险因素,而每周复诊1次则是独立保护因素。结论　Iva可提高易损期慢性HFrEF的疗效,降低易损期再入院率和炎性因子水平,同时可改善心功能指标。不按时服药和独居的慢性HFrEF患者在易损期更容易再入院,而每周复诊1次则可降低再入院率。     

射血分数改善型心力衰竭的临床特点及综合管理

左心室射血分数（LVEF）常作为指南对心力衰竭分类的依据。随着心力衰竭诊疗技术的进展,更多心力衰竭患者出现LVEF的改善。2021年多国心力衰竭学会联合报告,对射血分数改善型心力衰竭（HFimpEF）作了统一名称和定义,但目前仍缺乏权威指南讨论HFimpEF的诊疗。故本文将根据现有的研究证据,对HFimpEF的研究进展进行综述,以期讨论HFimpEF的临床特点、诊断与治疗。     

Psychological stress and cardiovascular disease

There is an enormous amount of literature on psychological stress and cardiovascular disease. This report reviews conceptual issues in defining stress and then explores the ramifications of stress in terms of the effects of acute versus long-term stressors on cardiac functioning. Examples of acute stressor studies are discussed in terms of disasters (earthquakes) and in the context of experimental stress physiology studies, which offer a more detailed perspective on underlying physiology. Studies of chronic stressors are discussed in terms of job stress, marital unhappiness, and burden of caregiving. From all of these studies there are extensive data concerning stressors' contributions to diverse pathophysiological changes including sudden death, myocardial infarction, myocardial ischemia, and wall motion abnormalities, as well as to alterations in cardiac regulation as indexed by changes in sympathetic nervous system activity and hemostasis. Although stressors trigger events, it is less clear that stress "causes" the events. There is nonetheless overwhelming evidence both for the deleterious effects of stress on the heart and for the fact that vulnerability and resilience factors play a role in amplifying or dampening those effects. Numerous approaches are available for stress management that can decrease patients' suffering and enhance their quality of life.     

Cardiac function stratification based on echocardiographic or clinical markers of left ventricular filling pressures predicts death and hospitalization better than stratification by ventricular systolic function alone

BACKGROUND: A normal left ventricular ejection fraction (LVEF) often underestimates the poor prognosis associated with diastolic dysfunction. METHODS: We compared overall and hospital-free survival according to echocardiographic diastolic function classification (echo class), clinical probability of diastolic dysfunction (clinical class) and LV grades based on biplane LVEF, in 114 subjects followed-up over a median of 47 months. Diastolic function was classified into normal, impaired relaxation, and severe dysfunction (SDD), using a previously validated 3-staged classification. RESULTS: There were 16 deaths and 42 combined end points of death and hospitalization. Although each classification method globally prognosticated survival (P = 0.001, P =0.046, and P = 0.034 by the echo class, clinical class and LVEF grades, respectively), only echo class correctly distinguished three risk levels. Death was not hierarchically predicted by LVEF whereas severe diastolic dysfunction was associated with a hazard ratio by univariate or a multivariate model (that evaluated the effects of age, gender, and LVEF) of 4.31 (P =0.004) or 3.88 (P = 0.03), respectively. Also, a significant separation was found for the combined end points associated with SDD relative to nonsevere echo classes (P = 0.045). Neither clinical risk staging, nor LV grading showed significant separation of the Kaplan-Meier plots between "high risk" versus others combined, and Normal LV grade versus others combined, respectively. Severe diastolic dysfunction trended strongly as an independent predictor of combined end point with multivariate hazard of 2.29 (95% CI 0.99-5.26 P=0.05). CONCLUSION: Stratification of the severity of diastolic dysfunction using comprehensive echocardiographic parameters of systolic and diastolic function is effective at predicting death and hospital-free survival.     

Evaluation of equine laminar vein function: harvesting, dissection and the use of functional methods to distinguish between veins and arteries

INTRODUCTION: Pharmacological evaluation of the unique equine laminar microvasculature is crucial to understanding its role in health and in diseases such as laminitis. However, separating the distinctive characteristics of arterial versus venous components of this complex vascular network has previously proved to be extremely difficult. Encased in a hard hoof capsule, isolation of individual blood vessels presents a considerable challenge. Exacerbating this difficulty, the laminar venous network is adapted to sustain high intravascular pressures and consequently has thickened walls, making the normally straightforward visual distinction between arteries and veins problematic. Here we describe a novel harvesting and dissection method coupled with a functional analysis procedure that facilitates distinction of arteries and veins. METHODS: Laminar tissue was recovered from the hoof of euthanized, clinically normal horses by dissection at the coronary band and stored in cold Krebs-Henseleit physiological salt solution prior to further dissection in the laboratory to remove 2 mm segments of vessels 100-500 microm in diameter. Active length tension measurements were made to evaluate optimal conditions for experimentation, and based on the differences in contractility and appearance, an experimental protocol was set up to allow a) initial distinction between arteries and veins and b) in vitro pharmacological evaluation. RESULTS: Active length tension studies clearly revealed the presence of two populations of vessels distinguished by either a large or a lower maximal contraction that subsequent histological evaluation confirmed to be arteries and veins respectively. Functional distinction using relative contractility to 60 mM potassium salt solution then demonstrated equine laminar veins to have increased sensitivity to the agonist endothelin 1 (ET-1) compared to arteries. DISCUSSION: In vitro evaluation of laminar vessels is possible despite anatomical obstacles. Furthermore, a clear distinction can be made between laminar veins and arteries using functional characteristics providing vessels of a similar size range are selected. Utilising these novel procedures, investigators can unambiguously analyse the pharmacological characteristics of equine laminar veins and arteries to decipher the physiological mechanisms responsible for the control of laminar blood flow.     

基于基础疗法的芪苈强心胶囊综合用药对慢性充血性心力衰竭患者HR、LVEF、LVEDD水平的影响

目的:研究基于基础疗法的芪苈强心胶囊综合用药对慢性充血性心力衰竭患者心率(HR)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)水平的影响。方法:选取2016年1月至2018年1月山东省滨州市人民医院收治的慢性充血性心力衰竭患者94例,按照随机数字表法平均分为对照组和观察组,每组47例。对照组予以常规治疗,观察组则在常规治疗的基础上予以芪苈强心胶囊治疗。分别比较2组临床疗效,治疗前后HR、LVEF、LVEDD水平,治疗前后VEGF、NO水平以及血浆AngⅡ、ET、BNP水平。结果:观察组总有效率为91. 49%(43/47),高于对照组的72. 34%(34/47),差异有统计学意义(P 0. 05)。治疗后观察组HR、LVEDD水平分别为(76. 43±6. 52)次/min、(46. 12±4. 08) mm,低于对照组的(88. 61±7. 33)次/min、(50. 13±4. 33) mm,而LVEF水平为(42. 30±7. 01)%,高于对照组的(36. 72±6. 11)%,差异均有统计学意义(均P 0. 05)。治疗后观察组VEGF、NO水平分别为(522. 58±127. 57) ng/L、(43. 49±7. 01)μmol/L,高于对照组的(441. 38±113. 52) ng/L、(34. 85±6. 88)μmol/L,差异均有统计学意义(均P 0. 05)。治疗后观察组血浆AngⅡ、ET、BNP水平分别为(135. 42±24. 48) pg/m L、(53. 68±22. 82) ng/L、(287. 96±62. 02)μg/L,低于对照组的(161. 33±23. 66) pg/m L、(84. 68±27. 48) ng/L、(372. 02±64. 86)μg/L,差异均有统计学意义(均P 0. 05)。结论:基于基础疗法的芪苈强心胶囊综合用药治疗慢性充血性心力衰竭疗效明显,有利于促进患者心功能恢复,同时有效改善血管内皮功能。     

正常妊娠和妊高征孕妇血浆内皮素血栓素前列环素心钠素含量测定及意义

目的　了解妊娠期妇女血浆内皮素 (ET)、血栓素 (TXA2 )、前列环素 (PGI2 )、心钠素 (ANP)含量变化 ,探讨其与妊高征的关系。方法　采用放免法 ,在妊娠早、中、晚期及产后序贯测定血浆ET、TXA2 、PGI2 和ANP含量。正常妊娠142例 ,妊高征 36例 ,与非妊娠妇女 30例对照。结果　正常妊娠中期ET明显下降 (P <0 0 5 ) ,TXA2 、PGI2 、ANP含量与对照组无明显差异。妊娠晚期四项参数含量显著高于对照组 (P <0 0 1)。ET/ANP和TXA2 /PGI2 比值无显著变化。妊高征中期ET、TXA2 明显高于正常妊娠组 (P <0 0 1,P<0 0 5 )。ET/ANP ,TXA2 /PGI2 比值明显增高。妊高征妊娠晚期 ,除PGI2 外 ,其它三项参数及ET/ANP ,TXA2 /PGI2 比值均高于正常妊娠组 (P <0 0 1,P <0 0 5 )。结论　ET ,TXA2 含量及ET/ANP ,TXA2 /PGI2 比值升高与妊高征发病密切相关 ,比值增高幅度与病情严重程度成正比。