彩色多普勒超声对高血压合并脑梗死颈动脉的临床分析

目的　探讨颈动脉粥样硬化与高血压合并脑梗死的关系。方法　使用百胜 AU4彩色多普勒超声仪 ,对 78例高血压患者 (排除合并脑梗死 )及 82例高血压合并脑梗死患者 ,观察其颈动脉内 -中膜厚度 (IMT)及斑块形成情况。结果　高血压合并脑梗死患者组的颈动脉 IMT、斑块积分、发生率及溃疡斑的检出率显著大于高血压患者 (排除合并脑梗死 ) (P<0 .0 1)。溃疡斑是高血压合并脑梗死患者组的主要栓子来源。结论　彩色多普勒超声可清晰显示颈动脉 IMT情况 ,在高血压合并脑梗死的预防及防治监测上有重要临床意义。     

氯吡格雷稳定易损斑块预防卒中临床观察

目的 探讨氯吡格雷稳定易损斑块预防卒中临床疗效。方法 将60例颈动脉粥样硬化斑块形成的病人随机分成两组,治疗组服用氯吡格雷75mg,1次/d,与服用肠溶阿司匹林75mg,1次/d,作为对照组,服药前后记录斑块面积、颈动脉管腔直径（离颈内外动脉分叉lcm处的测量值、CCAD）、内中膜厚度（IMT）以及斑块性质。结果病人颈动脉粥样硬化斑块面积缩小或消失,CCAD增加、IMT变薄,治疗前后有显著性差异（P〈0.01）,而与对照组相比,亦有显著性差异（P〈0.05）。结论 氯吡格雷稳定易损斑块预防卒中有明显疗效。     

复方罗布麻颗粒联合厄贝沙坦氢氯噻嗪治疗高血压的疗效观察

目的探讨复方罗布麻颗粒联合厄贝沙坦氢氯噻嗪治疗高血压的临床效果。方法选取桐柏县人民医院2016年4月—2017年5月收治的高血压患者162例,随机分成对照组(81例)和治疗组(81例)。对照组口服厄贝沙坦氢氯噻嗪片,1片/次,1次/d。治疗组在对照组基础上口服复方罗布麻颗粒,2袋/次,2次/d。两组患者均经过2个月治疗。观察两组患者临床疗效,同时比较治疗前后两组患者动态血压、心率、动脉脉搏波传导速度(PWV)、颈动脉内膜中层厚度(IMT)和不良反应。结果治疗后,对照组临床有效率86.42%,显著低于治疗组的96.30%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者24 h平均收缩压(ASBP)、24 h平均舒张压(ADBP)和心率均显著下降(P0.05),同时治疗组动态血压和心率改善情况均明显优于对照组患者(P0.05)。治疗后,两组患者PWV和IMT值均显著下降(P0.05),同时治疗后治疗组患者PWV和IMT值明显低于对照组(P0.05)。治疗过程中,对照组不良反应发生率为14.81%,显著高于治疗组的3.70%,两组比较差异具有统计学意义(P0.05)。结论复方罗布麻颗粒联合厄贝沙坦氢氯噻嗪治疗高血压疗效显著,不良反应发生率低,具有一定的临床推广应用价值。     

超声对中青年非酒精性脂肪肝人群颈动脉粥样硬化检测的意义

目的探讨中青年人非酒精性脂肪肝（NAFLD）和颈动脉粥样硬化（CAS）的关系及某些关联的潜在危险因素。方法方法对45岁以下NAFLD人群262例及年龄、性别相匹配的健康人208名的颈总动脉内膜-中层厚度（IMT）、颈动脉斑块的发生率及实验室检查指标进行定量测量分析。结果（1）除个别年龄组因例数少外,NAFLD男、女各年龄组TC、TG值均高于对照组（P〈0．01）,HDL、FPG值某些年龄组差异具有统计学意义（P〈0．05或P〈0．01）。（2）NAFLD组男、女各生化指标异常率均高于对照组（P〈O．01）。（3）NAFLD组男、女各年龄组IMT厚度均值皆明显高于对照组（P〈0．01）,且随年龄增加,IMT增厚越明显。（4）NAFLD组较对照组IMT与斑块异常率明显增高（P〈0．01）。结论45岁以下中青年人NAFLD与cAS的关系密切,结合血脂分析,可达到预防早期动脉粥样硬化发生的目的,为临床适时进行早期干预治疗提供依据。     

Ocimum sanctum leaf extracts attenuate human monocytic (THP-1) cell activation

Ethnopharmacological relevance

Ocimum sanctum (OS), commonly known as Holy basil/Tulsi, has been traditionally used to treat cardiovascular diseases (CVD) and manage general cardiac health. The present study is designed to evaluate the antiinflammatory effect of O. sanctum and its phenolic compound and eugenol (EUG) in human monocytic (THP-1) cells and validate its traditional use for treating cardiovascular diseases.

Materials and methods

The phytochemical analysis of alcoholic and water extracts of OS-dry leaves (OSAE and OSWE) was done using LC–QTOF–MS. A phenolic compound, EUG was quantified in both OSAE and OSWE by an LC–MS technique using a mass hunter work station software quantitative analysis system. The effect of both OSAE, OSWE, pure compound EUG and positive control imatinib (IMT) was investigated in THP-1 cells by studying the following markers: lipopolysaccharide (LPS) induced tumor necrosis factor alpha (TNF-α) secretion by ELISA, gene expression of inflammatory markers (TNF-α, IL-6, MIP-1α and MCP-1) by real time PCR and translocation of nuclear factor kappa B (NF-κB) by confocol microscopy. Furthermore, the effect of the extracts, EUG and IMT, was studied on phorbol-12-myristate-13-acetate (PMA) induced monocyte to macrophage differentiation and gene expression of CD14, TLR2 and TLR4.

Results

The LC–MS analysis of OSAE and OSWE revealed the presence of several bioactive compounds including eugenol. Quantitative analysis revealed that OSAE and OSWE had EUG of 12 ng/mg dwt and 19 ng/mg dwt respectively. OSAE, OSWE (1 mg dwt/mL) pure compound EUG (60 µg/mL) and positive control IMT (20 µg/mL) showed marked inhibition on LPS induced TNF-α secretion by THP-1 cells. At the selected concentration, the plant extracts, EUG and IMT inhibited gene expression of cytokines and chemokines (IL-6, TNF-α, MIP-1α, MCP-1) and translocation of NF-κB-p65 to the nuclei. In addition, they showed significant inhibition on PMA induced monocyte to macrophage differentiation and the gene expression of CD14, TLR2 and TLR4 markers.

Conclusion

The result of the present study validated traditional use of Ocimum sanctum for treating cardiovascular disease for the first time by testing antiinflammatory activity of Ocimum sanctum in acute inflammatory model, LPS induced THP-1 cells. The plant extracts showed significant antiinflammatory activity, however, further to be evaluated using chronic inflammatory animal models like diabetic or apolipoprotein E-deficient mice to make it evidence based medicine. The phenolic compound eugenol (60 µg/mL) showed significant antiinflammatory activity. However the amount of eugenol present in 1 mg of OSAE and OSWE (12 ng/mg and 19 ng/mg dwt respectively) used for cell based assays was very low. It suggests that several other metabolites along with eugenol are responsible for the efficacy of the extracts.     

高血压和高脂血症致颈动脉粥样硬化的临床研究

目的 验证并比较高血压和高脂血症致颈动脉粥样硬化(carotid atherosderosis,CAS)作用,评价高血压在CAS发生中的重要意义.方法 2010年12月—2012年12月在仙桃市第一人民医院就诊的正常人群、高脂血症患者和高血压合并高脂血症患者各60例及高血压患者180例(1、2和3级高血压患者各60例)作为研究对象,应用彩色多普勒超声检测所有研究对象的颈动脉内—中膜厚度(intima-media thickness,IMT)和颈动脉粥样斑块的发生率.结果 比较各组IMT值,高脂血症组、高血压合并高脂血症组及高血压组均明显高于正常对照组,差异有统计学意义(P＜0.01);对各组颈动脉粥样斑块发生率进行比较,高脂血症组、高血压合并高脂血症组及高血压组也明显高于正常对照组,差异同样有统计学意义(P＜0.01).高脂血症组的IMT值和颈动脉粥样斑块发生率均高于高血压组,但差异无统计学意义(P＞0.05).1级高血压组的IMT值和颈动脉粥样斑块发生率与正常对照组比较,差异无统计学意义(P＞0.05);2级高血压组的IMT值低于高脂血症组,差异有统计学意义(P＜0.05);颈动脉粥样斑块发生率高于高脂血症组,但差异无统计学意义(P＞0.05);3级高血压组的IMT值和颈动脉粥样斑块发生率均高于高脂血症组,差异有统计学意义(P＜0.05).结论 高血压与高脂血症具有同等重要的致CAS作用,其中3级高血压的致CAS作用强于高胆固醇血症.良好地控制血压(尤其是3级高血压)对于临床减缓CAS进程及减少甚至避免CAS的发生有着比降血脂更加不容忽视的临床意义.     

Appendiceal inflammatory myofibroblastic tumor: a rare postoperative finding

Inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue neoplasm of unknown etiology. It mimics, clinically and radiologically, malignant tumors. Histologically, this tumor is composed of differentiated myofibroblastic spindle cells accompanied by an inflammatory infiltrate, with numerous plasma cells and/or lymphocytes. Initially described in the lung, numerous extrapulmonary sites of this tumor have been found but appendiceal IMT is rare, especially in adult women. In this study, we aimed to examine the literature as well as to describe a case of a 42-year-old woman that we operated on that presented as an appendiceal mass that obstructed the lumen of the appendix and caused acute appendicitis. Upon histopathological examination, the lesion was identified as an IMT. Awareness of this type of tumor in the differential diagnosis of appendiceal masses, avoids overtreatment, and highlights the need of long-term follow-up regarding the tendency for local recurrence and small risk of distant metastasis.     

脉搏波速度技术对原发性高血压患者颈动脉弹性功能的初步探讨

目的：评价脉搏波速度（ PWV）这一技术的稳定性和可重复性,研究颈动脉弹性和血压之间的相关性。方法收集高血压72例,男31例,女41例,年龄17～85（62．76±12．17）岁。依据血压水平将入组的高血压患者分为三个亚组（1、2、3级组）。同时纳入26例非高血压受检者作为对照组,男10例,女16例,年龄41～76（59．65±8．12）岁。两位医生分别测得颈动脉内中膜厚度（ IMT）、颈动脉PWV数值收缩期开始[ PWV（ BS）]、收缩期结束[ PWV（ ES）],评价IMT、BS、ES数值的可重复性,同时比较定量参数（ IMT、BS、ES）在组间（高血压组和对照组）及组内（高血压三个亚组）的差异性。结果①IMT、BS、ES数值的可重复性高。②对照组与高血压组之间比较,三个变量（ IMT、BS、ES）均存在组间统计学差异。高血压组组内（三个亚组间）比较：IMT,2级组与3级组无统计学意义;BS,1级组与2级组之间、2级组与3级组无统计学意义;ES,三个亚组间均有统计学意义（ P＜0．05）。结论 PWV技术可重复性高,相对IMT,PWV能更敏感显示血管弹性和血压之间的相关性。     

The role of low-grade inflammation in the polycystic ovary syndrome

PCOS is not only the most frequent cause of oligomenorrhea in young women, but also a metabolic disorder characterized by insulin resistance, glucose intolerance, dyslipidemia, and obesity, especially the visceral phenotype. PCOS represents a broad spectrum of endocrine and metabolic alterations which change with age and with increasing adiposity. In fact, during adolescence and youth the predominant clinical manifestations of PCOS are menstrual abnormalities, hirsutism and acne, whereas in peri-menopausal and post-menopausal periods metabolic disorders and an increased risk for cardiovascular diseases prevail. The pathogenetic links between PCOS and metabolic or cardiovascular complications are still debated. However, recent evidence has been focused on a condition of low-grade chronic inflammation as a potential cause of the long-term consequence of the syndrome.     

Associations of intra-renal arterial resistance index with chronic kidney disease and carotid intima-media thickness in type 2 diabetes mellitus

Renal dysfunction can be evaluated by increased intra-renal arterial resistance index (RI). We evaluated 113 Chinese men with type 2 diabetes on their RI. Results suggest that RI is associated with chronic kidney disease and subclinical arteriosclerosis. RI may help monitoring the deterioration of intra-renal hemodynamics.