Portal hypertension, one of the vascular diseases, not only has lesions in liver, but also changes in vascular structures and functions of extrahepatic portal system, systemic system and pulmonary drculation. The pabh...Portal hypertension, one of the vascular diseases, not only has lesions in liver, but also changes in vascular structures and functions of extrahepatic portal system, systemic system and pulmonary drculation. The pabhological changes of vasculopathy in portal hypertension include remodeling of arterialized visceral veins, intimal injury of visceral veins and destruction of contractile structure in visceral arterial wall. The mechanisms of vasculopathy in portal hypertension may be attributed to the changes of hemodynamics in portal system, immune response, gene modulation, vasoactive substances, and intrahepatic blood flow resistance. Portal hypertension can cause visceral hyperdynamic circulation, and the development and progression of visceral vasculopathy, while visceral vasculopathy can promote the development and progression of portal hypertension and visceral hyperdynamic circulation in turn. The aforementioned three factors interact in the pathogenesis of hepatic cirrhosisinduced portal hypertension and are involved in hemorrhage due to varicose vein rupture.展开更多
Angiotensin （Ang）-（1-7） is recognized as a new bioactive peptide in renin-angiotensin system （RAS）. Ang-（1-7） is a counter-regulatory mediator of Ang-II which appears to be protective against cardiovascular di...Angiotensin （Ang）-（1-7） is recognized as a new bioactive peptide in renin-angiotensin system （RAS）. Ang-（1-7） is a counter-regulatory mediator of Ang-II which appears to be protective against cardiovascular disease. Recent studies have found that Ang-（1-7） played an important role in reducing smooth muscle cell proliferation and migration, improving endothelial function and regulating lipid metabolism, leading to inhibition of atherosclerotic lesions and increase of plaque stability. Although clinical application of Ang-（1-7） is restricted due to its pharmacokinetic properties, identification of stabilized compounds, including more stable analogues and specific delivery compounds, has enabled clinical application of Ang-（1-7）. In this review, we discussed recent findings concerning the biological role of Ang-（1-7） and related mechanism during atherosclerosis development. In addition, we highlighted the perspective to develop therapeutic strategies using Ang-（1-7） to treat atherosclerosis.展开更多
AIM To investigate the behavior of pulsatile pressure zones(PPZ's) as noted on high resolution esophageal impedance manometry(HREIM), and determine their association with dysphagia.METHODS Retrospective, single ce...AIM To investigate the behavior of pulsatile pressure zones(PPZ's) as noted on high resolution esophageal impedance manometry(HREIM), and determine their association with dysphagia.METHODS Retrospective, single center case control design scr-eening HREIM studies for cases(dysphagia) and controls(no dysphagia). Thoracic radiology studies were reviewed further in cases for(thoracic cardiovascular) thoracic cardiovascular(TCV) structures in esophageal proximity to compare with HREIM findings. Manometric data was collected for number, location, axial length, PPZ pressure and esophageal clearance function(impedance). RESULTS Among 317 screened patients, 56% cases and 64% controls had PPZ's. Fifty cases had an available thoracic radiology comparison. The distribution of PPZ's in these 50 cases and 59 controls was similar(average 1.4 PPZ/patient). Controls(mean 31.2 ± SD 12 years) were a significantly younger population than cases(mean 67.3 ± SD 14.9 years) with P < 0.0001. The upright posture PPZ pressure was higher in controls(15.7 ± 10.0 mm Hg) than cases(10.8 ± 9.7 mm Hg). Although statistically significant(P = 0.005), it was a weak predictor using logistic regression and ROC model(AUC = 0.65). Three dysphagia patients had partial compression from external TCV on radiology(1 aberrant subclavian artery, 2 dilated left atrium). The posture(supine vs upright) with more prominent PPZ's impaired bolus clearance in 9 additional cases by > 20%. CONCLUSION Transmitted TCV pulsations observed in HREIM bear no significant impact on swallowing. However, in older adults with dysphagia, evidence of impaired bolus clearance on impedance should be evaluated for external TCV compression. These associations have never been explored previously in literature, and are novel.展开更多
Objective To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus oxiracetam in treating mild vascular dementia(VD)and seek its underlying mechanism.Methods Ninety-six patients with mild VD were ran...Objective To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus oxiracetam in treating mild vascular dementia(VD)and seek its underlying mechanism.Methods Ninety-six patients with mild VD were randomized into an observation group and a control group,with 47 cases in the observation group and 49 cases in the control group.The control group received oral oxiracetam capsules for treatment,and the observation group was given additional Tuina treatment.Before and after treatment,the mini-mental state examination(MMSE)was adopted to assess the patient’s cognitive function;the activities of daily living(ADL)scale was used to evaluate their ability to conduct daily activities;changes in the serum inflammatory factors and oxidative stress indicators were also detected.Results After treatment,the serum content of malondialdehyde(MDA)decreased in both groups(P<0.05)and was lower in the observation group than in the control group(P<0.05);the serum contents of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)increased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05);the serum contents of interleukin(IL)-1,tumor necrosis factor(TNF)-α,IL-6,and IL-8 declined in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After the intervention,the levels of systolic velocity(Vs)and mean velocity(Vm)of the middle cerebral artery elevated,and the pulsatility index(PI)dropped in patients in the two groups,showing significant intra-group differences(P<0.05);the levels of Vs and Vm in the observation group were higher than those in the control group,and the PI was lower in the observation group than in the control group,showing significant between-group differences(P<0.05).The MMSE and ADL scores increased in both groups after the intervention(P<0.05)and were higher in the observation group than in the control group(P<0.05).Conclusion In the treatment of mild VD,Tuina plus oxiracetam can improve the cerebral blood supply,ADL,and cognitive function;the mechanism may be associated with the reduction of oxidative stress damages and inflammatory reactions.展开更多
基金Supported by the National Natural Science Foundation of China,No. A30170920
文摘Portal hypertension, one of the vascular diseases, not only has lesions in liver, but also changes in vascular structures and functions of extrahepatic portal system, systemic system and pulmonary drculation. The pabhological changes of vasculopathy in portal hypertension include remodeling of arterialized visceral veins, intimal injury of visceral veins and destruction of contractile structure in visceral arterial wall. The mechanisms of vasculopathy in portal hypertension may be attributed to the changes of hemodynamics in portal system, immune response, gene modulation, vasoactive substances, and intrahepatic blood flow resistance. Portal hypertension can cause visceral hyperdynamic circulation, and the development and progression of visceral vasculopathy, while visceral vasculopathy can promote the development and progression of portal hypertension and visceral hyperdynamic circulation in turn. The aforementioned three factors interact in the pathogenesis of hepatic cirrhosisinduced portal hypertension and are involved in hemorrhage due to varicose vein rupture.
基金This work was supported by National Natural Science Foundation of China （NSFC） （No. 81400265 and No. 81270274）, and Peking University People＇s Hospital Research and Development funds （RDB2014-16）.
文摘Angiotensin （Ang）-（1-7） is recognized as a new bioactive peptide in renin-angiotensin system （RAS）. Ang-（1-7） is a counter-regulatory mediator of Ang-II which appears to be protective against cardiovascular disease. Recent studies have found that Ang-（1-7） played an important role in reducing smooth muscle cell proliferation and migration, improving endothelial function and regulating lipid metabolism, leading to inhibition of atherosclerotic lesions and increase of plaque stability. Although clinical application of Ang-（1-7） is restricted due to its pharmacokinetic properties, identification of stabilized compounds, including more stable analogues and specific delivery compounds, has enabled clinical application of Ang-（1-7）. In this review, we discussed recent findings concerning the biological role of Ang-（1-7） and related mechanism during atherosclerosis development. In addition, we highlighted the perspective to develop therapeutic strategies using Ang-（1-7） to treat atherosclerosis.
文摘AIM To investigate the behavior of pulsatile pressure zones(PPZ's) as noted on high resolution esophageal impedance manometry(HREIM), and determine their association with dysphagia.METHODS Retrospective, single center case control design scr-eening HREIM studies for cases(dysphagia) and controls(no dysphagia). Thoracic radiology studies were reviewed further in cases for(thoracic cardiovascular) thoracic cardiovascular(TCV) structures in esophageal proximity to compare with HREIM findings. Manometric data was collected for number, location, axial length, PPZ pressure and esophageal clearance function(impedance). RESULTS Among 317 screened patients, 56% cases and 64% controls had PPZ's. Fifty cases had an available thoracic radiology comparison. The distribution of PPZ's in these 50 cases and 59 controls was similar(average 1.4 PPZ/patient). Controls(mean 31.2 ± SD 12 years) were a significantly younger population than cases(mean 67.3 ± SD 14.9 years) with P < 0.0001. The upright posture PPZ pressure was higher in controls(15.7 ± 10.0 mm Hg) than cases(10.8 ± 9.7 mm Hg). Although statistically significant(P = 0.005), it was a weak predictor using logistic regression and ROC model(AUC = 0.65). Three dysphagia patients had partial compression from external TCV on radiology(1 aberrant subclavian artery, 2 dilated left atrium). The posture(supine vs upright) with more prominent PPZ's impaired bolus clearance in 9 additional cases by > 20%. CONCLUSION Transmitted TCV pulsations observed in HREIM bear no significant impact on swallowing. However, in older adults with dysphagia, evidence of impaired bolus clearance on impedance should be evaluated for external TCV compression. These associations have never been explored previously in literature, and are novel.
文摘Objective To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus oxiracetam in treating mild vascular dementia(VD)and seek its underlying mechanism.Methods Ninety-six patients with mild VD were randomized into an observation group and a control group,with 47 cases in the observation group and 49 cases in the control group.The control group received oral oxiracetam capsules for treatment,and the observation group was given additional Tuina treatment.Before and after treatment,the mini-mental state examination(MMSE)was adopted to assess the patient’s cognitive function;the activities of daily living(ADL)scale was used to evaluate their ability to conduct daily activities;changes in the serum inflammatory factors and oxidative stress indicators were also detected.Results After treatment,the serum content of malondialdehyde(MDA)decreased in both groups(P<0.05)and was lower in the observation group than in the control group(P<0.05);the serum contents of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)increased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05);the serum contents of interleukin(IL)-1,tumor necrosis factor(TNF)-α,IL-6,and IL-8 declined in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After the intervention,the levels of systolic velocity(Vs)and mean velocity(Vm)of the middle cerebral artery elevated,and the pulsatility index(PI)dropped in patients in the two groups,showing significant intra-group differences(P<0.05);the levels of Vs and Vm in the observation group were higher than those in the control group,and the PI was lower in the observation group than in the control group,showing significant between-group differences(P<0.05).The MMSE and ADL scores increased in both groups after the intervention(P<0.05)and were higher in the observation group than in the control group(P<0.05).Conclusion In the treatment of mild VD,Tuina plus oxiracetam can improve the cerebral blood supply,ADL,and cognitive function;the mechanism may be associated with the reduction of oxidative stress damages and inflammatory reactions.
