三种自然刺激对家兔颈动脉体化学感受器活动的影响

在游离灌流的颈动脉体窦神经标本，观察了ＰＯ２降低、ＰＣＯ２增加和ｐＨ降低对化学感受性单位放电的影响。共记录了３２个有自发放电的化学感受性单位对三种自然刺激的反应。所得结果如下：（１）只对ＰＯ２降低有反应的化学感受性单位（对ＰＣＯ２增加及ｐＨ降低均无反应）有１０例（占总数的３１％），对三种自然刺激均有反应的化学感受性单位有９例（占２８％），对ＰＯ２降低和ＰＣＯ２增加有反应的化学感受性单位有９例（占２８％），对ＰＯ２降低和ｐＨ降低两种刺激有反应的化学感受性单位有３例（占９％），另有一例只对ｐＨ降低有反应。（２）不同的自然刺激对化学感受性单位放电频率影响不一致。ＰＯ２降低使放电频率增加最多，其次是ＰＣＯ２增加，作用最弱的是ｐＨ降低。根据以上结果，似可认为，在颈动脉体中存在着不同生理特性的化学感受性单位，它们对ＰＯ２，ＰＣＯ２或ｐＨ有不同的敏感性。

冠心病患者颈动脉粥样硬化程度与血尿酸水平的相关性研究

目的通过对冠心病患者进行血尿酸水平测定和颈动脉超声多普勒检查,探讨颈动脉硬化程度与血尿酸水平之间的相关性。方法选取59例冠心病患者,测定其血尿酸水平,并采用超声多普勒检测颈动脉内膜中层厚度(IMT)及斑块情况,分析二者的关系。结果颈动脉内膜增厚组患者的血清尿酸浓度为(271.3±50.1)μmol/L,明显低于颈动脉斑块形成组的(315.2±48.3)μmol/L(P<0.05);颈动脉狭窄组的血尿酸最低浓度为(347.8±51.2)μmol/L,明显高于颈动脉斑块形成组的(315.2±48.3μmol/L)(P<0.05);颈动脉狭窄组(分轻、中、重共3组)的血尿酸浓度分别为(347.8±51.2)μmol/L,(392.4±49.3)μmol/L和(430.7±48.6)μmol/L,三者之间经比较差异均有统计学意义(P<0.05);冠心病患者颈动脉粥样硬化程度与血尿酸水平存在明显正相关(r=0.4623,P<0.05)。结论冠心病患者颈动脉粥样硬化程度与血尿酸水平间存在正相关,临床诊疗中应该予以重视。

高频超声参数在糖尿病颈动脉粥样化病变程度评估中的应用

目的:分析高频超声参数在糖尿病颈动脉粥样化病变程度评估中的应用效果。方法:选取2021年2月至2022年2月于我院就诊的糖尿病(DM)患者560例,根据冠状动脉造影(CAG)结果分为观察组和对照组,其中观察组为经临床检查确诊DM合并动脉粥样硬化,共390例,对照组为普通DM患者,共170例。将观察组按病变严重程度进行分组,DM合并单支病变为A组,共113例;合并双支病变为B组,共153例;合并双支以上数量病变为C组,共124例。所有患者经高频超声行颈动脉检查,各对比组间超声指标。结果:观察组IMT值、斑块检出例数、溃疡斑块数、斑块厚度、EP、AC、β、PEVβ高于对照组(P<0.05),在合并CHD的患者中,C组IMT值、斑块检出例数、溃疡斑块数、斑块厚度、EP、AC、β、PEVβ最高(P<0.05)。各组不均质回声斑块数量和斑块长度相当(P>0.05)。结论:经高频超声检查,粥样化病变越严重,颈动脉可检出的斑块数和溃疡斑块越多,血管硬化程度越高,斑块厚度越大,对于评估患者病情进展和脑血管事件发生概率有重要意义。

使用不同剂量阿托伐他汀对脑梗死患者颈动脉粥样硬化的影响研究

目的本文就不同剂量阿托伐他汀对脑梗死患者颈动脉粥样化的影响进行分析与探究。方法选择我院自2014年8月至2016年7月期间收治的脑梗死患者30例,其后将本组患者按照入院就诊时间平均分为两组,每组脑梗死患者15例。阿托伐他汀使用剂量为20 mg的患者设为参照组,阿托伐他汀使用剂量为40 mg的患者设为研究组,最后将两组脑梗死患者的治疗效果进行统计和对比。结果经不用剂量治疗后,研究组患者各项生化指标的改善程度较比参照组明显较高,神经功能缺损评分的改善程度也明显好于参照组,组间统计后差异显著。结论对脑梗死患者而言,在使用阿托伐他汀治疗时,要将剂量增大,在一定程度上可以有效改善生化指标,同时其神经功能的恢复速度较快,可进一步实践。

Hepatic steatosis is associated with an increased risk of carotid atherosclerosis

AIM: Although an association between hepatic steatosis and vascular risk factors has been described, direct relationships between fatty liver and atherosclerosis have not yet been investigated. The aim of the present study has been to investigate those relationships. METHODS: The Study of Health in Pomerania examined a random population sample aged between 20 and 79 years. A study population of 4 222 subjects without hepatitis B and C infections and without liver cirrhosis was available for the present analysis. Hepatic steatosis was defined sonographically and intima-media thickness (IMT) as well as plaque prevalence were estimated by carotid ultrasound. RESULTS: The prevalence rate of hepatic steatosis was 29.9%. Among subjects aged ≥45 years, an association between hepatic steatosis and IMT of the carotid arteries was found in bivariate analysis, but not after adjustment for atherosclerotic risk factors. Individuals with fatty liver had more often carotid plaques than persons without fatty liver (plaque prevalence rate 76.8% vs 66.6%; P<0.001). This association persisted after adjustment for confounding factors and was predominantly present in subjects with no to mild alcohol consumption. CONCLUSION: There is an independent association between hepatic steatosis and carotid atherosclerotic plaques. Metabolic changes due to nonalcoholic fatty liver disease may explain this relationship.

INSULIN RESISTANCE AND CAROTID ATHEROSCLEROSIS IN 221 PATIENTS WITH POTENTIAL HYPERGLYCEMIA

Objective To investigate the relationship between insulin resistance and carotid atherosclerosis in patients with potential hyperglycemia. Methods A total of 221 patients were recruited among those with potential hyperglycemia. All participants underwent physical examination, medical history interview, and 75 g oral glucose tolerance test. Venous blood was sampled for measurement of insulin and cholesterol levels. The intima-media thickness (IMT) in bilateral common carotid arteries was observed by B-mode ultrasound. Insulin resistance index was calculated by homeostasis model assessment (HOMA-IR). Subjects were stratified in quintiles according to HOMA-IR values. Risk factors and atherosclerotic parameters were analyzed. Results With HOMA-IR value increase, incidence of impaired glucose tolerance, diabetes mellitus, hypertension, and coronary artery disease increased, the levels of triglyceride (TG), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose, 2 hour plasma glucose, and fasting insulin increased as well, while the level of high density lipoprotein cholesterol (HDL-C) decreased. Meanwhile, all atherosclerotic parameters increased. Multivariate regression analysis showed that TG, total cholesterol, HDL-C, LDL-C levels, and ln(HOMA-IR) were related to IMT, hence were risk factors for IMT increase. Conclusion Insulin resistance is implicated in atherogenesis.

Fatty liver,carotid disease and gallstones:A study of age-related associations

AIM: To evaluate carotid intima-media thickening (IMT) and plaques, gallstone disease (GD) and fatty liver (FL) as a function of age. METHODS: In 449 subjects, FL and carotid disease were assessed ultrasonographically. In a subgroup of 65/449 patients with non-alcoholic fatty liver disease (NAFLD), carotid disease, GD and associated factors were determined. RESULTS: FL of unspecified etiology was more common in younger and GD in older individuals. FL subjects had an increased prevalence of IMT and a decreased prevalence of plaques and manifested carotid disease earlier. Plaques were more common in subjects with GD. Age was an independent predictor of carotid disease outcome and FL was a protective factor for plaques. In NAFLD, there was an inverse correlation between body weight and age and the latter independently predicted carotid findings. CONCLUSION: Cardiovascular risk in patients with FL and NAFLD needs to be assessed as a function of age and body weight.

Effect of intraarterial chemotherapy on vascular endothelial growth factor expression and microvessel density in carcinoma of the cervix

Objective: To clarify the effect of intraarterial chemotherapy on vascular endothelial growth factor (VEGF) expres- sion and microvessel density (MVD) count in carcinoma of the cervix. Methods: Before intraarterial chemotherapy and after 2–3 weeks of therapy, the expression of VEGF and MVD count in 36 carcinoma tissues of locally advanced cervical cancer were determined by CD34. Results: Before intraarterial chemotherapy and after 2–3 weeks, the expression of VEGF were 75% (27/36) and 30.6% (11/36) respectively, and MVD were reduced obviously (P<0.001). Conclusion:?The intraarterial chemotherapy can reduce the expression of VEGF and MVD, and adjust malignancy of cervical cancer, and cut down the postoperative metastasis.

Analysis of the Curative Effect of Preoperative Intra-Arterial Infusion Chemoembolization on Stage IB2-IIB Uterine Cervix Cancer

OBJECTIVETo investigate the short-term and long-termtherapeutic efficacy of preoperative intra-arterial infusion chemo-embolization on stage IB_2-IIB uterine cervix cancer (UCC).METHODS A total of 143 patients with Stage IB_2-IIB UCCwere divided into a clinical trial group and a control group.Thepatients in the clinical trial group(n=86)were treated with acombined therapy,i.e.,preoperative intra-arterial infusion chemo-embolization,surgical therapy and postoperative radiotherapy,and those in the control group (n=57) were given surgical therapyand post-operative radiotherapy.The adverse effects,changes inlocal lesion and pathological examinations of the cancer,and thestate during the surgery were observed after the intra-arterialinfusion chemo-embolization.The survival rate and recurrencerate between the two groups were compared.RESULTS The total effective rate of the intra-arterial infusionchemo-embolization on Stage IB_2-IIB UCC was 93.02%.Thetreatment could reduce tumor size,bring about retro-conversionsof the clinical stage of the tumors and pathological grade of thecancer cells,and decrease the quantity of intra-operative bloodloss as well as the operating time.It could significantly improvethe 5-year survival rate (P<0.05),and reduce the 2 and 5-yeartumor recurrence rates (P<0.05).Moreover,its side effects werelittle.CONCLUSION Preoperative intra-arterial infusion chemo-embolization can create conditions for radical operation,lower thepostoperative recurrence rate,and improve the prognosis in thepatients with UCC.It is an effective therapy in treating UCC.

Coronary atherosclerosis burden is not advanced in patients with β-thalassemia despite premature extracardiac atherosclerosis： a coronary artery calcium score and carotid intima-media thickness study

Background Thalassemic patients demonstrate an increased rate of extracardiae vascular complications and increased carotid wall intima-media thickness （cIMT）, but very low prevalence of coronary artery disease （CAD）. We investigated the atheroma burden by assessing the coronary artery calcium （CAC） and elMT in these patients. Methods We examined 37 patients with β-thalassemia and 150 healthy control volunteers with multi-detector computer tomography （CT） and ultrasonography to determine CAC score and cIMT, respectively. Results Propensity score matching （C-statistic： 0.88; 95% CI： 0.83-0.93） resulted in 27 pairs of patients; severe CAC was observed in 2 （7.4%） and 0 of β-thalassemia patients and healthy volunteers respectively （P = 0.5）. Median calcium score was 0 （0-0） in β-thalassemia patients and 0 （0-4） in healthy volunteers （P = 0.8）. Median intima-media thickness was higher in β-thalassemia patients compared to control group [0.45 （0.06-0.65） vs. 0.062 （0.054-0.086）; P = 0.04]. Conclusions Patients with β-thalassemia in comparison with healthy control subjects exhibit similar CAC score and increased cIMT. Our findings indicate a disparate rate of progression of atherosclerosis between coronary and extracardiac arteries in these patients lending support to the epidemiological evidence.

Percutaneous transluminal stenting in patients with carotid artery stenosis

Objective To assess the efficacy and safety of percutaneous transluminal stenting for patients with carotid artery stenosis.Methods Selective percutaneous transluminal stenting was performed for patients with symptomatic carotid artery stenosis(luminal narrowing ≥ 70%).Success rates and complications associated with the procedures were observed.During six months of follow-up,both recurrent symptom and restenosis rates were recorded.Results There were 17 bifurcating lesions among 27 stenoses in 26 patients,of whom 18 had concomitant coronary artery diseases.The acute procedural success rate was 96.3%(26/27),and the degree of stenosis was reduced from 88.6% ± 8.9%(range 70 - 100)to 0.4% ± 2.0%(range 0 - 10).Six patients developed severe bradycardia and hypotension,and 3 experienced transient loss of consciousness during balloon dilatation.During hospitalization,2 patients experienced loss of consciousness and convulsion,respectively,due to hyperperfusion,and both recovered 12 hours later.There were 2 minor stroke cases (7.4%)but no cases of major stroke or death.At the 6-month follow-up,there were no cases of TIA or new onset of stroke.There was no restenosis detected in 16 cases using angiography and in 10 cases using MRI in 6 to 16 months of follow-up.Conclusions Percutaneous transluminal stenting for patients with carotid artery stenosis has a high procedural success rate with few and acceptable complications.Few patients suffered from recurrent symptoms or showed restenosis in long-term follow-up.

Effects of linagliptin on inflammatory factors and arteriosclerosis in patients with newly diagnosed type 2 diabetes mellitus

In the present study,we aimed to investigate the effects of linagliptin on inflammatory factors and carotid intima-media thickness(CIMT)in newly diagnosed type 2 diabetes mellitus(T2 DM)patients with carotid atherosclerotic disease(CAD).A total of 326 patients with newly diagnosed T2 DM complicated with CAD were randomly divided into two groups.There were 163 patients in the control group,who were treated with metformin monotherapy.There were 163 patients in the experimental group,who were treated with metformin in combination with linagliptin.The CIMT before and after treatment was measured by color Doppler ultrasound,and the contents of IL-6 and IL-1βbefore and after treatment were detected by ELISA.The levels of inflammatory factors and CIMT before and after treatment were compared between the two groups,and the correlation between IL-6,IL-1βand CIMT was studied.After 24 weeks of treatment,the levels of inflammatory factors and CIMT in the experimental group were significantly lower compared with the control group(P<0.01),and the serum levels of IL-6 and IL-1βwere positively correlated with CIMT.In the present study,we concluded that linagliptin could improve the levels of inflammatory factors and CIMT in newly diagnosed T2 DM patients with CAD,and IL-6 and IL-1βmight participate in the occurrence and development of CAD by influencing CIMT.