Tetramethylpyrazine and paeoniflorin combination(TMP-PF)alleviates atherosclerosis progress by reducing hyperlipemia and inhibiting plaque angiogenesis via the NR4A1/VEGFR2 pathway

Atherosclerosis remains a great threat to human health worldwide.Previous studies found that tetramethylpyrazine(TMP)and paeonifl orin(PF)combination(TMP-PF)exerts anti-atherosclerotic effects in vitro.However,whether TMP-PF improves atherosclerosis in vivo needs further exploration.The present study aims to assess the anti-atherosclerotic properties of TMP-PF in ApoE^(-/-)mice and explore the related molecule mechanisms.Results showed that TMP and high-dose TMP-PF decreased serum triglyceride and low-density lipoprotein cholesterol levels,suppressed vascular endothelial growth factor receptor 2(VEGFR2)and nuclear receptor subfamily 4 group A member 1(NR4A1)expression in aortic tissues,inhibited plaque angiogenesis,reduced plaque areas,and alleviated atherosclerosis in ApoE^(-/-)mice.Also,TMP-PF exhibited a better modulation effect than TMP or PF alone.However,NR4A1 agonist abolished the anti-atherosclerotic effects of TMP-PF.In conclusion,TMP-PF was first found to alleviate atherosclerosis progression by reducing hyperlipemia and inhibiting plaque angiogenesis via the NR4A1/VEGFR2 pathway,indicating that TMP-PF had a positive effect on reducing hyperlipemia and attenuating atherosclerosis development.

Analysis of a New Toothbrushing Technique through Plaque Removal Success

Background/Aims: Determining the levels of oral health and the quality of dental care are fundamental to building concepts of oral health. This study aims to assess toothbrushing techniques using a technical and physical model, clarifying how children and pre-adults learn to brush their teeth. Materials and Methods: Data were recorded from 23 participants, both male and female of various ages, using a proposed electronic toothbrush equipped with X-Y-Z axes pathways. The data, collected before and after training experiments, were processed with MATLAB to generate plots for the three axes. Results: The study revealed that most parameter values, such as Mean Difference Between Amplitudes (MAV, 6.00), Wilson Amplitude (WAMP, 179.419), and Average Amplitude Coupling (AAC, 1.270), decreased from before to after the experiments. Furthermore, the average overall epoch lengths (AVG) showed a 75% reduction in movement amplitude between the two experiments. Conclusion: Dentist observations indicated which brushing methods were acceptable or not. Analytical values suggest that individuals learn the toothbrushing technique effectively, and medical observations clearly demonstrate the success of the proposed method.

Comparison ofβ-Amyloid Plaque Labeling Methods:Antibody Staining,Gallyas Silver Staining,and Thioflavin-S Staining

Objective To evaluate senile plaque formation and compare the sensitivity of three differentβ-amyloid(Aβ)labeling methods(antibody staining,Gallyas silver staining,and thioflavin-S staining)to detect Aβdeposition.Methods APPswe/PSEN1dE9 transgenic mice(APP/PS1)of different ages were used to examine spatiotemporal changes in Aβplaque deposition.Antibody staining,Gallyas silver staining,and thioflavin-S staining were used to detect Aβplaque deposition in the same brain region of adjacent slices from model mice,and the results were compared.Results With aging,Aβplaques first appeared in the cortex and then the deposition increased throughout the whole brain.Significantly greater plaque deposition was detected by 6E10 antibody than that analyzed with Gallyas silver staining or thioflavin-S staining(P<0.05).Plaque deposition did not show significant difference between the APP/PS1 mice brains assayed with Gallyas silver staining and ones with thioflavin-S staining(P=0.0033).Conclusions The APP/PS1 mouse model of Alzheimer’s disease could mimick the progress of Aβplaques occurred in patients with Alzheimer’s disease.Antibody detection of Aβdeposition may be more sensitive than chemical staining methods.

Design Intervention: An Artistic Strategy (A Strategy) to Minimize Text Fading and Metal Commemorative Plaque Theft in Ghana

The Commemorative Plaque Industry thrives at the hands of the local craftsmen in Ghana. Techniques, methods, tools, and materials used as handed to them by their previous masters have remained the same over the years. As a result, plaques produced had peculiar problems such as text fading, degrading the actual effect of the plaques. Additionally, metals once widely used for making plaques devoid of text fading in the industry seem to have lost their relevance due to metal plaque theft, rust on metal plaques, and the continuous rise in metal prices. This research uses descriptive, experimental, and case studies of the qualitative research method to examine the problems associated with locally produced commemorative plaques. A total of hundred (100) artisans, including metal scrap dealers, and plaque buyers, were selected for the study. Direct observation and face-to-face interviews were conducted with the local craftsmen, art lecturers and students, scrap dealers, and plaque buyers who were purposively sampled for the study. The study revealed that existing materials like ceramic and aluminium could be integrated innovatively to produce commemorative plaques devoid of text fading;a corrosion-resistant text could be made using anodized or coated metals used in smaller quantities to reduce costs while also making them unattractive for theft and lastly, silicone sealant was found to be a viable option for permanently inscribing text on porcelain bases. The results clarify and underline the necessity to grow the local plaque industry in terms of plaque production as another essential basis to assure high-quality plaques with no text fading that will survive for generations to serve their intended purpose.

Isoliquiritigenin regulated ox-LDL through activating the PPAR-γ signaling pathway to stabilize atherosclerosis plaques

Objective:To explore the molecular mechanisms of isoliquiritigenin in stabilizing atherosclerotic plaques by activating PPAR-γsignal pathway to regulate ox-LDL metabolism.Methods:The ApoE-/-mice AS carotid plaque model was prepared by using high fat diet and right perivascular carotid collar placement(PCCP).ApoE-/-mice were randomly divided into the model group and the isoliquiritigenin group after PCCP.C57BL/6J mice were used for the control group.High fat diet continued feeding for 8 weeks after PCCP to establish the AS model.Automatic biochemical analyzer was used to test levels of total cholesterol(TC),triacylglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C).ELISA was used to measure oxidized low-density lipoprotein(ox-LDL)in serum.Hematoxylin-eosin(HE)staining was used to observe the pathological pattern of the carotid artery,and then calculated the carotid parameters.Oil red O staining was used for lipid determination,Masson staining was used to determine collagen content,MOMA-2 andα-SMA immunohistochemical staining were used to determine macrophages and smooth muscle cells,and to calculate the vulnerability index.Western blot was used to detected the expression of PPAR-γ,LXR-α,FABP-4,MMP-2 and MMP-9 in mice arteries.Results:Compared with the normal group,TC、TG、LDL-C、HDL-C and ox-LDL were increased in the model group.Compared with the model group,TC、TG、LDL-C and ox-LDL were reduced,and there was no significant change in HDL-C of the isoliquiritigenin group.Compared with the normal group,intima thickness(IT),intima/media thickness(IT/MT),plaque area(PA),and plaque area/lumen area(PA/LA)of carotid arteries were increased,the content of lipid and MOMA-2 in plaques was increased,collagen andα-SMA content decreased,and the vulnerability index was higher in the model group.The expression of PPAR-γand LXR-αwere reduced and the expression of FABP-4,MMP-2 and MMP-9 were increased in the model group.Compared with the model group,carotid IT,IT/MT,PA,and PA/LA were reduced,the content of lipid and MOMA-2 in plaques was decreased,collagen andα-SMA content were increased,and the vulnerability index was decreased in the isoliquiritigenin group.PPAR-γand LXR-αexpression were increased,FABP-4,MMP-2 and MMP-9 expression were decreased significantly in the isoliquiritigenin group.Conclusion:Isoliquiritigenin can exert anti-AS effects by activating PPAR-γ,up-regulating LXR-α,reducing FABP-4 expression,reducing ox-LDL,reducing the protein expression of MMP-2 and MMP-9,decreasing plaque vulnerability index,and increasing plaque stability.

Daily Lifestyle Habits as Risk Factors for Plaque-Induced Gingivitis and Periodontitis Severity and Grading among Samples of Dental Students at King Khalid University

Objective: To assess daily lifestyle habits as risk factors for plaque-induced gingivitis and periodontitis severity and grading among samples of dental students at King Khalid University. Material and Methods: This study included 150 male participants. They were divided according to the levels into three equal groups: levels 5, 6, and 7 (group I), levels 8, 9, 10 (group II) and levels 11, 12, and interns (group III). This study consisted of questions related to age, gender, educational level, father’s education, mother’s education, home ownership, brushing teeth more than or twice a day, in addition to daily lifestyle habits that were daily smoking, daily use of sugary drinks, and daily use of sugary foods. Some clinical parameters of plaque-induced gingivitis and periodontitis and the percentage of radiographic bone loss were recorded. All data were collected and analyzed using Tukey’s test and Chi-square test. A P-value of less than 0.5 (p Results: One hundred fifty male dental students of different levels in the college of dentistry at King Khalid University participated in the study in three groups (I, II, and III). The mean age of group III is more than that of group II and group I, with highly statistically significant differences (p 30%) were more among the participants in group I than the participants in groups III and II. There was an increase in the percentage of affected participants with stages III and IV of clinical attachment loss (CAL), periodontal pocket depth (PPD), radiographic bone loss (%RBL), tooth mobility, as well as glycated hemoglobin (HbA1c) test values (>7%), and the number of cigarettes smoked per day (>10 cigs) in group III more than in group II and I. Conclusion: We conclude that the severity and grading of plaque-induced gingivitis were higher among the participants in group I, while the severity and grading of periodontitis were higher among the participants in group III due to the different impact of their daily lifestyle habits.

Effect of arsenic on spatial pattern of radial oxygen loss and iron plaque formation in rice

The effects of different arsenic （As） treatments on spatial pattern of radial oxygen loss （ROL）, iron （Fe） plaque formation and As accumulation in rice were investigated using three rice genotypes, planted under greenhouse conditions. Arsenic was applied to soil at 50 and 100 mg/kg, with untreated soil used as a control having an average As concentration of 8.5 mg/kg. It was demonstrated that the ratio of ROL in root tips to that at the root base slightly decreased with increasing As concentration, suggesting that the spatial ROL patterns in these groups may be shifted from the “tight” barrier towards the “partial” barrier form. Furthermore, increasing As concentration led to a increase in Fe plaque formation on root surfaces. In addition, root As concentrations of genotypes in 50 and 100 mg/kg As treatments were significantly higher than that of control treatment （P〈0.05）. Grain As concentration of genotype Nanyangzhan （with lower ROL） was significantly higher （P〈0.05） than that of genotype CNT87059-3 with higher ROL.

Angiographical and histopathologic study of atherosclerotic plaques in acute myocardial infarction

Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames.Material and methods 16postmortem cases of acute myocardial infarction were studied.The coronary arteries were romoved en block,filled with barium the lumen and ridiographed.Then the arteries wereontinuously insetted and routin HE sections were made.Results 16 cases had plaque ruptures and thrombi.Among the total98 blocks,21 had plaque ruptures on which 20 thrombiccur(95.23%).while the other 777 unrupured blocks had only 2hrombi(0.25%).The difference was significant(p【0.001).Therupture mostly occur on unstable plaques.The ruptured plaqueswith thrombi had different angiographical morphology withunruptured plaques.The former had irregular borders andunraluminal lucencies;while the Iatter had smooth borders and nointraluminal lucencies.Conclusions Plaque ruprure withthrumbus was the major cause of acute myocardial infarction andthe ruptured plaques with thrombus had different angiographicalapperances with unruptured plaques.

Helicobacter pylori in dental plaque and stomach of patients from Northern Brazil

AIM: To establish whether virulence factor genes vacA and cagA are present in Helicobacter pylori (H. pylori) retrieved from gastric mucosa and dental plaque in pa-tients with dyspepsia. METHODS: Cumulative dental plaque specimens and gastric biopsies were submitted to histological exami-nation, rapid urease test and polymerase chain reac-tion (PCR) assays to detect the presence of cagA and vacA polymorphisms.RESULTS: Detection of H. pylori from dental plaque and gastric biopsy samples was greater by PCR com-pared to histological examination and the rapid ure-ase test. DNA from H. pylori was detected in 96% of gastric mucosa samples and in 72% of dental plaque samples. Sixty-three (89%) of 71 dental plaque sam-ples that were H. pylori-positive also exhibited identical vacA and cagA genotypes in gastric mucosa. The most common genotype was vacAs1bm1 and cagA positive, either in dental plaque or gastric mucosa. These viru-lent H. pylori isolates were involved in the severity of clinical outcome.CONCLUSION: These pathogenic strains were found simultaneously in dental plaque and gastric mucosa, which suggests that gastric infection is correlated with the presence of H. pylori in the mouth.

Role of dental plaque,saliva and periodontal disease in Helicobacter pylori infection

Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans. Although H. pylori may be detected in the stomach of approximately half of the world&#x02019;s population, the mechanisms of transmission of the microorganism from individual to individual are not yet clear. Transmission of H. pylori could occur through iatrogenic, fecal-oral, and oral-oral routes, and through food and water. The microorganism may be transmitted orally and has been detected in dental plaque and saliva. However, the role of the oral cavity in the transmission and recurrence of H. pylori infection has been the subject of debate. A large number of studies investigating the role of oral hygiene and periodontal disease in H. pylori infection have varied significantly in terms of their methodology and sample population, resulting in a wide variation in the reported results. Nevertheless, recent studies have not only shown that the microorganism can be detected fairly consistently from the oral cavity but also demonstrated that the chances of recurrence of H. pylori infection is more likely among patients who harbor the organism in the oral cavity. Furthermore, initial results from clinical trials have shown that H. pylori-positive dyspeptic patients may benefit from periodontal therapy. This paper attempts to review the current body of evidence regarding the role of dental plaque, saliva, and periodontal disease in H. pylori infection.

Assessment of neovascularization within carotid plaques in patients with ischemic stroke

AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero-sclerotic plaques in the internal carotid artery were studied.The thickest soft plaque in each patient was examined using contrast-enhanced ultrasound.Time-intensity curves were collected from 5 s to 3 min after contrast injection.The neovascularization within the plaques in the internal carotid artery was evaluated using the ACQ software built into the scanner by 2 of the experienced investigators who were blinded to the clinical history of the patients.RESULTS:Ischemic stroke was present in 7 of 33 patients(21%) with grade Ⅰ plaque,in 14 of 51 pa-tients(28%) with grade Ⅱ plaque,in 26 of 43 patients(61%) with grade Ⅲ plaque,and in 34 of 49 patients(69%) with grade Ⅳ plaque(P < 0.001 comparing grade Ⅳ plaque with grade I plaque and with grade Ⅱ plaque and P = 0.001 comparing grade Ⅲ plaque with grade Ⅰ plaque and with grade Ⅱ plaque).Analysis of the time intensity curves revealed that patients with ischemic stroke had a significantly higher intensity of enhancement(IE) than those without ischemic stroke(P < 0.01).The wash-in time(WT) of plaque was signifi-cantly shorter in stroke patients(P < 0.05).The sensi-tivity and specificity for IE in the plaque were 82% and 80%,respectively,and for WT were 68% and 74%,respectively.There was no significant difference in the peak intensity or time to peak between the 2 groups.CONCLUSION:This study shows that the higher the grade of plaque enhancement,the higher the risk of ischemic stroke.The data suggest that the presence of neovascularization is a marker for unstable plaque.

Value of superb micro-vascular imaging in predicting ischemic stroke in patients with carotid atherosclerotic plaques

BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening for unstable plaque. The emergence of superb micro-vascular imaging(SMI) offers the possibility of clinically screening for unstable plaque AIM To investigate the value of SMI in predicting ischemic stroke in patients with carotid atherosclerotic plaques.METHODS Patients with carotid atherosclerotic plaques(luminal stenosis of 50%-70%) were enrolled into the present study. All patients received conservative medication.The patient's clinical baseline data, serological data, CEUS and SMI data were analyzed. All patients underwent a 3-year follow-up. The follow-up endpoint was the occurrence of ischemic stroke and patients were divided into stroke group and non-stroke group according to whether the prognosis occurred or not.Subsequently, the difference in clinical data was compared, the correlation of SMI and CEUS was analyzed, and multiple Cox regression and receiver operating characteristic curve were applied to investigate the value of SMI and CEUS in predicting cerebral arterial thrombosis in three years.RESULTS In this study, 43 patients were enrolled in the stroke group and 82 patients were enrolled in the non-stroke group. Cox regression revealed that SMI level(P =0.013) and enhancement intensity(P = 0.032) were the independent factors influencing ischemic stroke. There was a positive correlation between SMI level and enhancement intensity(r = 0.737, P = 0.000). The area under curve of SMI level predicting ischemic stroke was 0.878. The best diagnostic point was ≥ level Ⅱ, and its sensitivity and specificity was 86.05% and 79.27%. The area under curve of enhancement intensity predicting ischemic stroke was 0.890. The best diagnostic point was 9.92 db, and its sensitivity and specificity was 88.37% and89.02%. As the SMI level gradually increased, the incidence of ischemic stroke increased gradually(X^2 = 108.931, P = 0.000).CONCLUSION SMI can be used as a non-invasive method of screening for unstable plaques and may help prevent ischemic stroke.

Contrast-enhanced ultrasound imaging of the vasa vasorum of carotid artery plaque

The vasa vasorum of carotid artery plaque is a novel marker of accurately evaluating the vulnerability of carotid artery plaque, which was associated with symptomatic cerebrovascular and cardiovascular disease. The presence of ultrasound contrast agents in carotid artery plaque represents the presence of the vasa vasorum in carotid artery plaque because the ultrasoundcontrast agents are strict intravascular tracers. Therefore, contrast-enhanced ultrasound(CEUS) is a novel and safe imaging modality for evaluating the vasa vasorum in carotid artery plaque. However, there are some issues that needs to be assessed to embody fully the clinical utility of the vasa vasorum in carotid artery plaque with CEUS.

Progress in atherosclerotic plaque imaging

Cardiovascular diseases are the primary cause of mortality in the industrialized world,and arterial obstruction, triggered by rupture-prone atherosclerotic plaques,lead to myocardial infarction and cerebral stroke.Vulnerable plaques do not necessarily occur with flow-limiting stenosis,thus conventional luminographic assessment of the pathology fails to identify unstable lesions.In this review we discuss the currently available imaging modalities used to investigate morphological features and biological characteristics of the atherosclerotic plaque. The different imaging modalities such as ultrasound, magnetic resonance imaging,computed tomography, nuclear imaging and their intravascular applications are illustrated,highlighting their specific diagnostic potential.Clinically available and upcoming methodologies are also reviewed along with the related challenges in their clinical translation,concerning the specific invasiveness, accuracy and cost-effectiveness of these methods.

Relationship between arterial atheromatous plaque morphology and platelet-associated miR-126 and miR-223 expressions

Objective:To study the expression of miR-126 and miR-223 in platelet of rabbit arterial plaque models,and explore its correlation with plaque morphology.Methods:Rabbit arterial plaque models were established,peripheral blood of models and control animals was collected.Plaque morphologies were divided into typeⅠ.typeⅡand typeⅢbased on angiography plaque morphology and Ambrose method.Platelet isolation kit was applied to isolate and purify peripheral blood platelets,CD45 immunomagnetic beads were used to remove the residual white blood cells.The miRNAs of platelets was extracted by miRNA Isolation Kit,and expressions of miR-126 and miR-223 of the platelets samples were detected by Real-time PCR.The correlation between plaque morphology and platelet-associated miR-126 and miR-223 expressions were analyzed.Expressions of target gene VCAM-1 and P2Y12 receptors of miR-126 and miR-223 in the atherosclerosis plaque of rabbit model were detected by Western blot.Results:Relative expression levels of miR-126 and miR-223 in the model group were 0.27±0.10 and 0.71±0.14,respectively.Plaque morphology was divided into typesⅠ,ⅡandⅢ;and miR-126 and miR-223 expression levels were detected in each type.Expression levels of miR-126 in each type were 0.42±0.07,0.17±0.11 and 0.22±0.15,respectively;and expression levels of miR-223 in each type are 0.68±0.02,0.57±0.06 and 0.88±0.10.respectively.Relative to the control group,miR-126 and miR-223 known target genes in VCAM-1 and P2Y12receptors increased platelets in rabbit atherosclerotic plaque models(P<0.05).Conclusions:Relative to normal control animals,miR-126 and miR-223 platelets were reduced in the rabbit atherosclerotic plaque model group(P<0.05).In the typeⅡplaque morphology group,miR-126 was greatly reduced;and there is no significant correlation between miR-223 and plaque morphology.

Effect of microbial mediated iron plaque reduction on arsenic mobility in paddy soil

The potential of microbial mediated iron plaque reduction, and associated arsenic （As） mobility were examined by iron reducing bacteria enriched from As contaminated paddy soil. To our knowledge, this is the first time to report the impact of microbial iron plaque reduction on As mobility. Iron reduction occurred during the inoculation of iron reducing enrichment culture in the treatments with iron plaque and ferrihydrite as the electron acceptors, respectively. The Fe（II） concentration with the treatment of anthraquinone-2, 6-disulfonic acid （AQDS） and iron reducing bacteria increased much faster than the control. Arsenic released from iron plaque with the iron reduction, and a significant correlation between Fe（II） and total As in culture was observed. However, compared with control, the increasing rate of As was inhibited by iron reducing bacteria especially in the presence of AQDS. In addition, the concentrations of As（III） and As（V） in abiotic treatments were higher than those in the biotic treatments at day 30. These results indicated that both microbial and chemical reductions of iron plaque caused As release from iron plaque to aqueous phase, however, microbial iron reduction induced the formation of more crystalline iron minerals, leading to As sequestration. In addition, the presence of AQDS in solution can accelerate the iron reduction, the As release from iron plaque and subsequently the As retention in the crystalline iron mineral. Thus, our results suggested that it is possible to remediate As contaminated soils by utilizing iron reducing bacteria and AQDS.

Correlation between Enhanced Intensity of Atherosclerotic Plaque at Contrast-enhanced Ultrasonography and Density of Histological Neovascularization

Summary： The feasibility of contrast-enhanced ultrasonography in the assessment of atherosclerotic plaque neovascularization and its relation to histological findings were investigated. Abdominal aortic atherosclerotic plaque model was induced in 25 New Zealand white rabbits by a combination of high cholesterol-rich diet and balloon aortic denudation. Standard and contrast-enhanced ultrasonography was performed at the 16th week of the model induction period. The plaques were classified as echogenic plaques or echolucent plaques according to their echogenicity at standard ultrasonography. The maxi- mum thickness of plaque was measured in the longitudinal section. Time intensity curve was used to quantify the enhanced intensity of the plaque. Animals were euthanized and abdominal aortas were har- vested for histological staining of CD31 to evaluate the neovascularization density of atherosclerotic plaque. The results showed that the echolucent plaques had higher enhanced intensity during con- trast-enhanced ultrasonography and higher neovascularization density at CD31 staining than the echo- genic plaques. The enhanced intensity of atherosclerotic plaque and its ratio to lumen were well corre- lated with histological neovascularization density （r=0.75, P〈0.001; r=0.68, P〈0.001, respectively）. However, the maximum thickness of plaque was not correlated with neovascularization density （r=0.235, P=0.081）. These findings demonstrated that the enhanced intensity in the plaque and ratio of enhanced intensity to that in the lumen of abdominal aorta may be more accurate in the evaluation of plaque neovascularization than maximum thickness. Our study indicates that contrast-enhanced ultra- sonography provides us a reliable method for the evaluation of plaque neovascularization.

Evaluation of Carotid Plaque Neovascularization in Patients with Diabetes Mellitus by Contrast-enhanced Ultrasonography

This study investigated the relationship between carotid plaque neovascularization and diabetes mellitus（DM） by using contrast-enhanced ultrasonography. Contrast-enhanced ultrasonography was performed in 104 patients with carotid plaque thicker than 2.0 mm. There were 36 patients with DM and 68 patients without DM. The enhanced intensity in the plaque and the ratio of enhanced intensity in the plaque to that in the lumen of the carotid artery in patients with DM were significantly greater than those in patients without DM. Our study demonstrated that the enhanced intensity in patients with DM is greater than that their counterparts without DM, suggesting that carotid plaque in DM patients may have more neovessels and may be more vulnerable.

Relationship between Levels of Serum C-Reactive Protein,Leucocyte Count and Carotid Plaque in Patients with Ischemic Stroke

In order to study the relationship between serum C-reactive protein (CRP) levels, leukocyte count and carotid plaque in patients with ischemic stroke, carotid duplex examination was performed by high-definition imaging (HDI) 5000 triplex system. Serum CRP was measured by nephelometry within 72 h after index ischemic stroke. A lesion was considered a plaque in the presence of a maximum intimal-medial wall thickness (IMT) 1.2 mm. Results of carotid ultrasonography were divided into two groups: M1, normal (IMT <1.2 mm) and M2, abnormal (IMT ≥1.2 mm). The results showed that the mean age of M2 was significantly older than that of M1 (69.7±10.4 versus 62.5±9.6, P =0.001). The patients with hypertension and diabetes mellitus (78 %, 35 % respectively)in M2 were significantly more than those (52 %, 18 % respectively) in M1 ( P <0.01, P <0.05). There were 32 (65 % ) patients with elevated CRP levels in M2, but 33 (46 %) patients with elevated CRP levels in M1, with the difference being significant between the two groups ( P <0.05). The levels of serum glucose and leukocyte count (8.1±5.5, 10.3±4.0, respectively) in abnormal CRP group were significantly higher than that of normal CRP group (6.4±2.8, 8.7±3.4) ( P <0.05, P <0.05); elevated CRP levels was found in 42 (62 %) patients with territory infarction and 23 (43 %) patients with lacunar infarction respectively, with the difference being significant between these two groups ( P <0.05). It was concluded that the elevation of CRP levels was an significant clinical index for carotid plaque in patients with acute cerebral infarction.

Noninvasive diagnosis of vulnerable coronary plaque

Myocardial infarction and sudden cardiac death are frequently the first manifestation of coronary artery disease.For this reason,screening of asymptomatic coronary atherosclerosis has become an attractive field of research in cardiovascular medicine.Necropsy studies have described histopathological changes associated with the development of acute coronary events.In this regard,thin-cap fibroatheroma has been identified as the main vulnerable coronary plaque feature.Hence,many imaging techniques,such as coronary computed tomography,cardiac magnetic resonance or positron emission tomography,have tried to detect noninvasively these histomorphological characteristics with different approaches.In this article,we review the role of these diagnostic tools in the detection of vulnerable coronary plaque with particular interest in their advantages and limitations as well as the clinical implications of the derived findings.