Trends in cardiovascular and cerebrovascular health scores in the Kailuan population from 2006 to 2011

BACKGROUND The American Heart Association defines cardiovascular health in terms of four behaviors(smoking,diet,physical activity,and body weight)and three factors(plasma glucose,cholesterol,and blood pressure).By this definition,the preva-lence of ideal cardiovascular health behaviors and factors(ICHBF)is negatively correlated with all-cause mortality and risks of cardiovascular and cerebrovas-cular diseases and malignancy.AIM To investigate the changing trends of cardiovascular and cerebrovascular health scores in the Kailuan study population from 2006 to 2011.METHODS The Kailuan population data from three health checkups held in 2006-2007,2008-2009,and 2010-2011 were analyzed,and the constituent ratios of cardiovascular and cerebrovascular health behaviors and factors at ideal,intermediate,and poor levels were calculated by using Huffman and Capewell method.Simultaneously,the cardiovascular and cerebrovascular health behavior and factor scores were calculated.RESULTS From 2006 to 2007,the proportion of people with ideal physical exercise,low salt diet,ideal body mass index,ideal total cholesterol level,no smoking,ideal blood sugar,and ideal blood pressure was 13.12%,9.34%,49.17%,64.20%,49.27%,69.99%,and 20.55%,respectively,in men with a health score of 8.46,and 12.00%,9.13%,61.60%,64.28%,98.19%,78.90%and 36.92%in women,with a score of 10.02.From 2008 to 2009,the proportion was 16.09%,14.04%,51.94%,65.02%,40.18%,66.44%,and 17.04%in men,with a score of 8.18,and 16.860%,17.360%,64.010%,67.433%,98.220%,76.370%,and 42.340%in women,with a score of 10.12.From 2010 to 2011,the proportion was 12.22%,17.65%,49.40%,68.33%,48.17%,64.67%,and 14.68%in males,having a score of 8.21,while in females,the proportion was 11.83%,18.09%,49.40%,67.85%,98.82%,74.52%,and 37.78%,with a score of 9.90.Core Tip:The American Heart Association defines ideal cardiovascular health as the concurrent presence of ideal health parameters(blood glucose,total cholesterol,and blood pressure levels)and ideal health behaviors(weight status,diet,physical activity,and smoking).Our study design was retrospective and based on the Kailuan study.This prospective study was initiated in July 2006 to evaluate the risk factors and interventions for cardiovascular diseases and cerebrovascular diseases in the Kailuan community population,with several articles having been published on such chronic non-communicable diseases.A fixed population was constituted from these 57659 participants,and their cerebrovascular and cardiovascular health parameters and behaviors were surveyed from 2006 to 2011.Furthermore,the distributions of cardiovascular health parameters and behaviors were portrayed,and their health scores were estimated.cholesterol level,no smoking,ideal blood sugar,and ideal blood pressure was 16.09%,14.04%,51.94%,65.02%,40.18%,66.44%,and 17.04%,and it was 16.86%,17.36%,64.01%,67.433%,98.22%,76.37%,and 42.34%for women.From 2010-2011,the proportion of men with ideal physical exercise,low salt diet,ideal body mass index,and ideal total cholesterol level,no smoking,ideal blood sugar,and ideal blood pressure was 12.22%,17.65%,49.40%,68.33%,48.17%,64.67%,and 14.68%,and it was 11.83%,18.09%,49.40%,67.85%,98.82%,74.52%,and 37.78%in women.The prevalence of ideal cardiovascular and cerebrovascular health behaviors and factors of different genders from 2006 to 2011 is shown in Table 1 and Table 2.The prevalence of poor and intermediate cardiovascular and cerebrovascular health behaviors and factors of different genders from 2006 to 2011 was described in our previous research[11].The health scores of men and women in 2006,2008,and 2010 were 8.46 and 10.02,8.18 and 10.12,as well as 8.21 and 9.90,respectively;the distribution of cardiovascular and cerebrovascular health behaviors and factor scores of different genders from 2006 to 2011 are shown in Table 3 and Table 4.The mean±SD of body mass index,blood pressure,fasting blood glucose,and total cholesterol levels of different genders from 2006 to 2011 are shown in Table 5 and Table 6.

A Medicinal and Edible Plant Crocus sativus L.and Its Therapeutic Effects on Cardiovascular and Cerebrovascular Diseases

This paper introduces the biological characteristics,medicinal value,chemical component,and pharmacological effects of Crocus sativus L.,and explores its therapeutic effects on cardiovascular and cerebrovascular diseases such as angina pectoris and coronary heart disease.

Analysis of The Impact of Interventional Nursing on The Therapeutic Effect, Negative Emotions, and Quality of Life of Patients Undergoing Cardiovascular and Cerebrovascular Interventional Therapy

Objective: To explore the impact of interventional nursing on the therapeutic effect, negative emotions, and quality of life of patients undergoing cardiovascular and cerebrovascular interventional therapy. Methods: A total of 106 patients who underwent cardiovascular and cerebrovascular interventional treatment were collected and randomly divided into Group A (control) and Group B (observation), with 53 cases each. Group A received the routine nursing intervention and Group B received the interventional nursing intervention. The clinical efficacy, complications, negative emotions, quality of life, and nursing satisfaction of the two groups of patients were evaluated. Results: The total clinical effective rate of Group B (52/98.12%) was higher than that of Group A (45/84.91%) (χ^(2)= 4.371, P < 0.05). The total incidence of complications in Group B (2/3.78%) was lower than that of Group A (9/16.98%) (χ^(2)= 4.970, P < 0.05). The self-rating anxiety (SAS) score and self-rating depression (SDS) of Group B were lower than those of Group A (P < 0.001). The quality of life of Group B was significantly higher than that of Group A (P < 0.001). The nursing satisfaction of group B (51/96.22%) was higher than that of group A (43/81.13%) (χ^(2)= 6.014, P < 0.05). Conclusion: In the care of patients undergoing cardiovascular and cerebrovascular interventional therapy, interventional nursing intervention effectively improved the patient’s clinical efficacy, reduced the incidence of complications, reduced negative emotions, improved the quality of life, and increased nursing satisfaction.

Relationship of Cardiovascular and Cerebrovascular Diseases to Meteorological Conditions and Forecast Method in Nanjing City

[Objective] The study aimed to discuss the relationship of cardiovascular and cerebrovascular diseases to meteorological conditions and forecast method in Nanjing City. [Method] Based on daily cases of cardiovascular and cerebrovascular diseases from a hospital in Nanjing City as well as daily meteorological data from Nanjing Meteorological Station from January 2003 to July 2008, the monthly and seasonal variations in quantity of patients suffedng from cardiovascular and cerebrovascular diseases in Nanjing City were analyzed firstly, and then the relationship between mete- orological elements and incidence of the diseases was discussed, finally the forecast model for the incidence of the diseases was established using the stepwise regression method. [Result] Cardiovascular and cerebrovascular diseases in Nanjing City happened all the year round, and the inci- dance was high in the seasonal transition phase from autumn to winter. Daily incidence of the diseases in Nanjing City correlated negatively with dai- ly maximum, minimum and average vapor pressure, daily minimum relative humidity and so forth, but their incidence had positive correlations with diumal range of daily temperature, daily maximum, minimum and average pressure. Daily average number of patients suffering from the diseases obviously correlated with daily average temperature, daily maximum vapor pressure and daily average relative humidity. [ Conclusion] The research could provide scientific references for the prevention and forecast of cardiovascular and cerebrovascular diseases in future.

The Cardiovascular and Cerebrovascular Effects on Cognition in Persons with Parkinson’s Disease: A Systematic Review of the Literature

Purpose: The purpose of this systematic review of the literature is to examine the cerebrovascular and cardiovascular effects on cognition in persons with Parkinson’s disease. Relevance: Physical therapy treatment of persons with Parkinson’s disease (PD) has traditionally focused on lessening the impact of disease severity by improving quality of life and functional capacity. Research has shown that quality of life in persons with PD is not only significantly affected by motor symptoms, but also by the presence of defined non-motor symptoms such as cerebrovascular perfusion, cardiovascular dysfunction, and cognitive impairment. This study seeks to determine a causative effect among these non-motor symptoms with the intention to better manage cognitive impairment in persons with PD. Methods: A literature search was conducted utilizing the following databases: Scopus, PubMed, and CINAHL. After evaluating and grading studies using the Downs and Black Checklist, a total of seven studies remained for the final review. Results: Five common domains of cognition emerged throughout the seven studies: executive function, attention, verbal memory and fluency, visual memory, and working memory. Considering the articles reviewed, a relationship between cerebrovascular and cardiovascular deficiency and cognitive impairment in persons with PD was established. Conclusions: Persons with PD and certain cerebrovascular and cardiovascular risk factors, including orthostatic hypotension and systemic hypertension, should be referred to appropriate professionals for comprehensive neuropsychological testing secondary to an increased risk for more severe cognitive deficit.

Cardiovascular and Cerebrovascular Prognosis at 5 Years of Patients Who Presented with an Ischemic Stroke at Principal Hospital of Dakar

Aims: To determine the cardiovascular and cerebrovascular prognosis at 5 years of patients who underwent an ischemic stroke in Senegal. Methods: We performed a descriptive, retrospective and exhaustive study conducted at Principal Hospital of Dakar. We included all patients hospitalized at Principal Hospital of Dakar from 2013 to 2019 for an ischemic stroke confirmed by a cerebral CT-Scanner or by magnetic resonance imaging, and who survived the acute phase. Results: Overall, one hundred and seventy-one (171) patients were gathered. Ninety-six (96) male patients account for 56.14% and seventy-five (75) female patients account for 43.86%, with a sex ratio of 1.28. Patients’mean age was 66.33 ±13.99 years. Twenty-one (21) young patients (12.35%), aged less than 50 years, presented with an ischemic stroke. Myocardial infarction was found in a female patient (0.6%) 3 months after she experienced an ischemic stroke, nine (9) patients (5.29%) underwent a recurrence of the ischemic stroke with a mean recurrence period of 8 months and extremes ranging from 1 to 24 months. Five (5) patients (2.92%) developed dementia with a score less than 28. A 30 years old patient presented with epilepsy 12 months after the ischemic stroke accounting for 0.58%. We registered ninety (90) deaths that occurred in a mean period of 24 months ± 9.8 after they presented their ischemic stroke, standing for 52.63% amongst which thirty-five (35) accounting for 39% were female patients and fifty-five patients (55) representing 61% were male patients. Mortality-related factors included: advanced age, past medical history of heart surgery, known as dyslipidemia, physical inactivity, obesity and recurrent ischemic stroke. Conclusion: Long-term prognosis of ischemic stroke remains unclear in Senegal. Therefore, a strategy for primary prevention is highly crucial and it requires the control of risk factors in general and that of high blood pressure in particular.

Prediabetes: An overlooked risk factor for major adverse cardiac and cerebrovascular events in atrial fibrillation patients

BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.

Sex and racial disparities in non-alcoholic fatty liver disease-related cardiovascular events: National inpatient sample analysis (2019)

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk factors.However,large-scale cardiovascular sex and race differences are poorly understood.AIM To investigate the relationship between NAFLD and major cardiovascular and cerebrovascular events(MACCE)in subgroups using a nationally representative United States inpatient sample.METHODS We examined National Inpatient Sample(2019)to identify adult hospitalizations with NAFLD by age,sex,and race using ICD-10-CM codes.Clinical and demographic characteristics,comorbidities,and MACCE-related mortality,acute myocardial infarction(AMI),cardiac arrest,and stroke were compared in NAFLD cohorts by sex and race.Multivariable regression analyses were adjusted for sociodemographic characteristics,hospitalization features,and comorbidities.RESULTS We examined 409130 hospitalizations[median 55(IQR 43-66)years]with NFALD.NAFLD was more common in females(1.2%),Hispanics(2%),and Native Americans(1.9%)than whites.Females often reported non-elective admissions,Medicare enrolment,the median age of 55(IQR 42-67),and poor income.Females had higher obesity and uncomplicated diabetes but lower hypertension,hyperlipidemia,and complicated diabetes than males.Hispanics had a median age of 48(IQR 37-60),were Medicaid enrollees,and had non-elective admissions.Hispanics had greater diabetes and obesity rates than whites but lower hypertension and hyperlipidemia.MACCE,all-cause mortality,AMI,cardiac arrest,and stroke were all greater in elderly individuals(P<0.001).MACCE,AMI,and cardiac arrest were more common in men(P<0.001).Native Americans(aOR 1.64)and Asian Pacific Islanders(aOR 1.18)had higher all-cause death risks than whites.CONCLUSION Increasing age and male sex link NAFLD with adverse MACCE outcomes;Native Americans and Asian Pacific Islanders face higher mortality,highlighting a need for tailored interventions and care.

The Functional Role of Garlic and Bioactive Components in Cardiovascular and Cerebrovascular Health: What We Do Know

Cardiovascular disease is a complex and multifactorial disease strongly associated with hypercholesterolemia, hypertension, reduced ?brinolysis, increased blood-clotting time and increased platelet aggregation. Among other confounding factors, oxidative damage is a major factor in cardiovascular and cerebrovascular diseases. The use of garlic in folkloric medicine highlights the potential role in either preventing or delaying cardiovascular disease. Contemporary research reveals how garlic and bioactive components modulate the risk factors of cardiovascular and cerebrovascular diseases thus tending towards validating a measure of folkloric claims concerning the functional efficacy of garlic. This review seeks to elucidate contemporary research attempt towards the validation of the role of garlic and bioactive components, mechanisms of action involved and to define its ultimate role in the prevention and treatment of cardiovascular and cerebrovascular diseases. Some contradictory claims exist possibly due to the use of different experimental protocols/formulations/dosages of garlic. Overwhelming commonality of positive cardiovascular and cerebro-vascular responses reside among research studies thus offering compelling evidence in supports of the bene?cial health effects of garlic and components.

miR-135b: An emerging player in cardio-cerebrovascular diseases

miR-135 is a highly conserved miRNA in mammals and includes miR-135a and miR-135b.Recent studies have shown that miR-135b is a key regulatory factor in cardio-cerebrovascular diseases.It is involved in regulating the pathological process of myocardial infarction,myocardial ischemia/reperfusion injury,cardiac hypertrophy,atrial fibrillation,diabetic cardiomyopathy,atherosclerosis,pulmonary hyperten-sion,cerebral ischemia/reperfusion injury,Parkinson's disease,and Alzheimer's disease.Obviously,miR-135b is an emerging player in cardio-cerebrovascular diseases and is expected to be an important target for the treatment of cardio-cerebrovascular diseases.However,the crucial role of miR-135b in cardio-cerebrovascular diseases and its underlying mechanism of action has not been reviewed.Therefore,in this review,we aimed to comprehensively summarize the role of miR-135b and the signaling pathway mediated by miR-135b in cardio-cerebrovascular diseases.Drugs targeting miR-135b for the treatment of diseases and related patents,highlighting the importance of this target and its utility as a therapeutic target for cardio-cerebrovascular diseases,have been discussed.

Status of Clinical Application of Yufeng Ningxin Preparations and the Meta-Analysis of Its Efficacy and Safety in the Treatment of Cardiovascular and Cerebrovascular Diseases

Objective The objective of this study was to analyze the status of the clinical application of Yufeng Ningxin(YFNX)preparations and systematically evaluate their efficacy and safety in the treatment of cardiovascular and cerebrovascular diseases.Methods Through searching databases of China National Knowledge Infrastructure,Wanfang,SinoMed,VIP,PubMed,Embase,and the Cochrane Library,the literature of clinical research on YFNX preparations in treating malignant tumors of cardiovascular and cerebrovascular diseases from the establishment of the databases to February 2021 was collected.The clinical randomized controlled trials and case-control studies of cardiovascular and cerebrovascular diseases treated with these preparations were analyzed.Two reviewers independently screened literature,extracted data,and assessed the risk of bias in the included studies,and meta analysis was performed by using ReMan 5.3 software to analyze the eficacy and safety of YFNX preparations in the treatment of cardiovascular and cerebrovascular diseases.Results A total of 29 clinical studies were finally included.The dosage forms were dropping plls,tablets,capsules,and granules.The preparations were used for the treatment of coronary heart disease,hypertension,neuropathic headache,etc.This study systematically evaluated the efficacy and safety of YFNX preparations in the treatment of coronary heart disease,hypertension,and nervous headache.A total of 1,162 cases were included in 13 studies,582 cases of the YFNX preparation group and 580 cases of the Western medicine group.The results of meta-analysis showed that the clinical efficacy of YFNX preparations combined with the Western medicine group in the treatment of coronary heart disease and hypertension,improving electrocardiogram and reducing the frequency and duration of angina attacks,was better than that of the simple Western medicine group,and the difference was statistically significant.Conclusion YFNX preparations are effective for coronary heart disease,hypertension,and neuropathic headache,and the adverse reactions are few.

Pseudoexfoliation syndrome and cardiovascular diseases

Pseudoexfoliation(PEX) syndrome is a well-recognized late-onset disease caused by a generalized fibrillopathy. It is linked to a broad spectrum of ocular complications including glaucoma and perioperative problems during cataract surgery. Apart from the long-known intraocular manifestations, PEX deposits have been found in a variety of extraocular locations and they appear to represent a systemic process associated with increased cardiovascular and cerebrovascular morbidity. However, as published results are inconsistent, the clinical significance of the extraocular PEX deposits remains controversial. Identification of PEX deposits in the heart and the vessel wall, epidemiologic studies, as well as, similarities in pathogenetic mechanisms have led to the hypothesis of a possible relation between fibrillar material and cardiovascular disease. Recent studies suggest that PEX syndrome is frequently linked to impaired heart and blood vessels function. Systemic and ocular blood flow changes, altered parasympathetic vascular control and baroreflex sensitivity, increased vascular resistance and decreased blood flow velocity, arterial endothelial dysfunction, high levels of plasma homocysteine and arterial hypertension have all been demonstrated in PEX subjects. Common features in the pathogenesis of both atherosclerosis and PEX, like oxidative stress and inflammation and a possible higher frequency of abdominal aorta aneurysm in PEX patients, could imply that these grey-white deposits and cardiovascular disorders are related or reflect different manifestations of the same process.

Systems pharmacology for traditional Chinese medicine with application to cardio-cerebrovascular diseases

Identified as a treasure of natural herbal products,traditional Chinese medicine(TCM)has attracted extensive attention for their moderate treatment effect and lower side effect.Cardio-cerebrovascular diseases(CCVD)are a leading cause of death.TCM is used in China to prevent and treat CCVD.However,the complexity of TCM poses challenges in understanding the mechanisms of herbs at a systems-level,thus hampering the modernization and globalization of TCM.A novel model,termed traditional Chinese medicine systems pharmacology(TCMSP)analysis platform,which relies on the theory of systems pharmacology and integrates absorption,distribution,metabolism,excretion and toxicity(ADME/T)evaluation,target prediction and network/pathway analysis,was proposed to address these problems.Here,we review the development of systems pharmacology,the TCMSP approach and its applications in the investigations of CCVD and compare it with other methods.TCMSP assists in uncovering the mechanisms of action of herbal formulas used in treating CCVD.It can also be applied in ascertaining the different syndrome patterns of coronary artery disease,decoding the multi-scale mechanisms of herbs,and in understanding the mechanisms of herbal synergism.

Ginsenoside Rb_(1) in cardiovascular and cerebrovascular diseases:A review of therapeutic potentials and molecular mechanisms

Cardiovascular and cerebrovascular diseases(CCVDs), which are circulatory system diseases caused by heart defects and vascular diseases, are the major noncommunicable diseases affecting global public health. With the improvement of economic level and the change of human lifestyle, the prevalence of CCVDs continues to increase. Ginseng(Panax ginseng C. A. Mey.) was widely used in traditional diseases due to its supposed tonic properties. Ginsenoside Rb_(1) (G-Rb_(1) ) is the most abundant active ingredient with multiple pharmacological effects extracted from ginseng, which has been shown to have potential benefits on the cardiovascular system through a variety of mechanisms, including anti-oxidation, antiinflammatory, regulation of vasodilation, reduction of platelet adhesion, influence of calcium ion channels, improvement of lipid distribution, involving in glucose metabolism and controlling blood sugar.This review reviewed the protective effects of G-Rb_(1) on CCVDs and its potential mechanisms, such as atherosclerosis(AS), hypertension, coronary heart disease(CHD), ischemic stroke(IS) and periocular microvascular retinopathy. Finally, we reviewed and reported the results of in vivo and in vitro experiments using G-Rb_(1) to improve CCVDs, highlighted its efficacy, safety, and limitations.

Mg alloy cardio-/cerebrovascular scaffolds: Developments and prospects

Vascular scaffolds are one of the important application fields of biodegradable Mg alloys, and related research has been carried out for more than 20 years. In recent years, the application expansion of Mg alloy vascular scaffolds has brought new challenges to the research of related fields. This review focuses on the relevant advances in the field of Mg alloys for both cardio-/cerebrovascular scaffolds. The frequently investigated alloy series for vascular scaffolds were reviewed. The bottleneck of processing of Mg alloy minitubes was elucidated.The idea of functionalized surface modification was also pointed out in this review, and the authors put forward guidelines based on research experience in terms of scaffold structural design and degradation behavior evaluation. Finally, suggestions for further research directions of Mg alloy vascular scaffolds were provided.

脉血康胶囊(肠溶片)治疗心脑血管疾病临床应用专家共识

脉血康胶囊(肠溶片)治疗心脑血管疾病具有良好的临床疗效及安全性。在临床医生问卷调查和脉血康胶囊(肠溶片)研究文献系统回顾的基础上,采用国际临床医学专家共识研制方法,基于现有最佳证据,充分结合专家经验,遵循“循证为主,共识为辅,经验为鉴”的原则,国内26位中西医临床、药学、方法学等多学科专家共同研制该共识,旨在进一步提高临床医生对该药的认识,更好地指导其临床合理用药。共识采用国际公认的证据分级推荐标准即评估、发展和评价建议的分级(Grading of Recommendations Assessment,Development and Evaluation,GRADE分级),如果证据充分则形成“推荐意见”,采用GRADE网格计票规则;如果证据不充分,则形成“共识建议”,采用多数计票规则。共识对脉血康胶囊(肠溶片)用于心脑血管疾病的适应证、用法用量、疗程、禁忌证、合并用药进行了推荐或建议,并完善了安全性信息,为其临床的合理使用提供参考。

应重视心脑血管疾病的外科干预

心脑血管疾病是全球居民死亡的主要原因之一,动脉粥样硬化是其主要病理学改变,常同时累及心血管和脑血管,需神经外科和心血管外科同时手术干预。缺血性心脑血管疾病患者是采取颈动脉内膜切除术联合冠状动脉旁路移植术同期手术还是分期手术(颈动脉内膜切除术后冠状动脉旁路移植术和冠状动脉旁路移植术后颈动脉内膜切除术)尚未形成一致性意见。随着对心脑血管疾病研究的深入、手术技术的改进和血管内介入技术的发展,为外科手术同时干预提供了理论基础和技术支持。

心脑血管疾病的“脑心同治”

动脉粥样硬化是脑血管病和心血管病共同的病理生理学机制,二者为同源性疾病,可共病,这也是“脑心同治”的病理生理学基础。近年随着药物治疗和手术技术改进,“脑心同治”得以实现并提高临床疗效。本文综述“脑心同治”策略,以为心脑血管疾病的治疗提供理论基础和临床指导。

估算的脉搏波传导速度的变化对心脑血管事件的影响

[目的]研究估算的脉搏波传导速度(ePWV)的变化对心脑血管事件的影响。[方法]以参加开滦集团2006—2007年度健康体检并且参加了2010—2011年度健康体检的61714例员工为研究对象,按观察期基线及观察期末的ePWV值将观察对象分为四组:持续正常组、正常-增高组、增高-正常组及持续增高组,采用Cox回归模型分析不同的ePWV变化情况对心脑血管事件的影响。[结果]平均随访时间为(8.52±1.59)年,随访结束共发生心脑血管事件3715例(6.02%),持续正常组、正常-增高组、增高-正常组、持续增高组发病密度分别为3.81、10.80、13.54、15.85/千人年。Cox回归模型分析显示,校正各种混杂因素后,与持续正常组相比,正常-增高组、增高-正常组、持续增高组发生心脑血管事件的风险显著增加,HR(95%CI)分别为2.68(2.44~2.95)、3.14(2.67~3.69)、4.03(3.71~4.38)。[结论]维持ePWV持续正常能有效减少心脑血管事件。

HIV/AIDS肺脾气虚证相关心脑血管疾病风险因素探析

目的通过检测血脂四项、血管内皮损伤因子、炎症相关因子,并结合前期的基因芯片结果,初步探讨人类免疫缺陷病毒(HIV)/艾滋病(AIDS)肺脾气虚证相关心脑血管疾病风险因素及机制,为中医药早期干预心脑血管疾病提供依据。方法2020年9月—2020年11月选取河南省某地区确诊的20例HIV/AIDS肺脾气虚证患者作为研究对象,同地区20例HIV抗体阴性作为健康对照组。检测CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)计数,并计算CD_(4)^(+)/CD_(8)^(+)比值;检测血脂四项甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);检测氧化低密度脂蛋白(Ox-LDL)、载脂蛋白A-I(ApoAⅠ)、载脂蛋白A-Ⅱ(ApoAⅡ)、载脂蛋白B(ApoB)、锌-α2-糖蛋白1(AZGP1)、可溶性血栓调节蛋白(sTM)、血管性血友病因子(vWF)、脂联素、瘦素(LEP)、超敏C反应蛋白(Hs-CRP)、单核细胞趋化因子1(MCP-1)、肿瘤坏死因子α(TNF-α)。结果HIV/AIDS肺脾气虚证患者与健康对照组比较CD_(4)^(+)降低,CD_(4)^(+)/CD_(8)^(+)比值倒置,TC降低,sTM、AZGP1、Ox-LDL、Hs-CRP升高。结论HIV/AIDS肺脾气虚证患者存在炎性反应、血脂异常的表现,罹患心脑血管疾病风险增加。为中医药早期干预心脑血管疾病的发生提供新思路。