超声心动图评价瑞舒伐他汀干预高胆醇血症心室功能早期损伤的效果

目的通过超声心动图评价经过瑞舒伐他汀干预高胆固醇血症后的心室功能效果。方法选取2017年6—12月本院收治的35例高胆固醇血症患者为患者组,选取同期健康体检者35名作为对照组。比较两组由于高胆固醇血症引起的心肌损伤效果,在患者组中,有22例患者经瑞舒伐他汀药物治疗,比较治疗前后心肌功能,评价对心室功能的恢复情况。结果两组经生化指标检验,BMI及各项血脂指标差异均有统计学意义(P<0.05),而血压等指标差异无统计学意义(P>0.05)。两组采用多普勒超声检测二尖瓣流量,比较两组心肌舒张程度,经检验,患者组E/A,即为心脏快速充盈期和心脏缓慢充盈期的比值,对照组比值大于1的为100%,患者组比值大于1的为51.4%,差异有统计学意义(P<0.001),经两组Tei指数Mitr比较,患者组为0.41,高于对照组的0.28,差异有统计学意义(P<0.001)。经治疗后随访6个月指标发现,治疗前与治疗后相比,各生化指标和超声心动图差异均有统计学意义(P<0.05)。结论通过动态心动图证实了在高胆固醇血症患者存在一定程度的心室损害,通过瑞舒伐他汀控制胆固醇水平可以有效改善心肌功能,促进心肌功能恢复。

高胆固醇血症大鼠PAI-1活性的变化

为了解纤溶酶原激活物抑制剂 -1(PAI-1)在高胆固醇大鼠血及肾皮质的表达及其与肾脏损害的关系 ,以高脂饮食 (含4%胆固醇和 1%胆酸钠 )诱发高胆固醇血症大鼠 ,12周后测定血浆及肾皮质 PAI-1活性。结果显示 ,与对照组相比 ,高脂组血浆及肾皮质 PAI-1活性明显升高 ,系膜基质增多 。

怎样正确服用辛伐他汀

我今年76岁，最近做血清检测时发现多项异常：肌酐、尿酸、葡萄糖偏高……不知是否是服用调脂药辛伐他汀引起，如果是，我该如何改服其他药？广西梁读者梁读者：辛伐他汀是目前调节血脂较好的药物，用于控制血液中胆固醇含量、高胆醇血症及预防心血管疾病。根椐您的检验单，有6项指标不太正常，肌酐和尿酸稍高于正常指标，临床上意义不是很大，有可能是您原来肾功能有损害。

哪些人不宜多喝鸡汤

鸡汤素以味道鲜、健身滋补为人们称道,尤其是年老体弱多病者或处于恢复期的病人,常常习惯于用老母鸡炖汤喝,并以此进补。 从营养学角度分析,鸡汤内所含的营养物质是从鸡油、鸡皮、鸡肉和鸡骨里溶解出来的水溶性的小分子蛋白质、脂肪和无机盐等,汤里的鸡油大都属于脂肪酸。

Prevalence of Abnormity of Blood Lipid and Associated Factors in Health Examination Population in Beijing

Objective To investigate the prevalence of abnormity of blood lipid and associated factors in healthy population in Beijing. Methods Totally, 38 462 individuals who received health examination were enrolled in our study. We divided them into eight groups according to their ages. The levels of serum total cholesterol, triglyceride, high density lipoprotein cholesterol, and low density lipoprotein cholesterol were tested, and the relationship of blood lipid abnormity with body mass index (BMI) and fasting blood glucose was analyzed. Results The incidences of hypercholesterolemia, hyperglyceridemia, low high-density lipoprotein cholesterolemia, and hyper low-density lipoprotein cholesterolemia presented increasing trend in this population. The incidence rate of abnormity of blood lipid in health examination population increased with BMI increase. The incidence of abnormity of blood lipid in overweight and obesity population was significantly higher than that in low weight and normal weight populations (P<0.05). Meanwhile, the trend of abnormal blood lipid incidence coincided with that of abnormal fasting blood glucose. Conclusions The prevalence of overweight, obesity, and abnormity of blood lipid in Beijing presents increasing trend. The incidence of abnormity of blood lipid increases with BMI increase, in coincidence with that of fasting blood glucose.

Rhabdomyolysis induced by simvastatin-diltiazem interaction in unrecognized hypothyriodism

Simvastatin,a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor,is widely prescribed to patients with hypercholesteremia and its muscular toxicity has been widely reported.The metabolism of simvastatin depends on the enzymic activity of cytochrome P450 3A4 （CYP3A4） and inhibitors of CYP3A4 can result in clinical events by interacting with simvastatin.Diltiazem is a moderate inhibitor of CYP3A4,which is known to increase the serum concentration of simvastatin.Here we report a patient with unrecognized hypothyroidism who had been stable for more than one year on low-dose simvastatin therapy of hypercholesteremia and rhabdomyolysis occurred with the addition of diltiazem.This is one of scanty reports of rhabdomyolysis induced by simvastatindiltiazem drug interaction,especially in hypothyroid patient.This case reminds the clinicians that although diltiazem as a moderate CYP3A4 inhibitor can be used cautiously with small doses of CYP3A4-dependent statius （eg,simvastatin）,these two commonly used drugs should be avoided in hypothyroid patient.

Abdominal Fat Accumulation with Hyperuricemia and Hypercholesterolemia Quail Model Induced by High Fat Diet

Objective To establish abdominal fat accumulation with hyperuricemia and hypercholesterolemia quail model fed with high fat diet. And then to investigate the pathological characteristics of this quail model. Methods Thirty Longcheng quails were randomly divided into two groups： control group and model group （n=15）. The control group quails were fed with normal diet and model group quails were fed with high fat diet for 14 days. After a 12-hour overnight fast, liver and abdominal fat at euthanasia as well as serum were collected. The levels of serum uric acid, total cholesterol, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, triglyceride, free fatty acid （FFA）, and blood glucose were assayed. The activity changes of adenosine deaminase （ADA）, xanthine oxidase （XOD）, lipoprotein lipase （LPL）, hepatic lipase （HL）, and fatty acid synthetase （FAS） were analyzed. Results Compared with control group, the abdominal fat content （0.74±0.63 vs. 1.36±0.65 g, P〈0.05） and abdominal fat index （0.44%±0.30% vs. 0.85%±0.30%, P〈0.01） as well as live lipid index （3.61%±0.65% vs. 11.33%±2.14%, P〈0.01） in model group significantly increased; the levels of serum uric acid （210.61±94,76 vs. 304.25±141.94 /amol/L, P〈0.05）, total cholesterol （4.20±0.51 vs. 20.10±11.25 mmol/L, P〈0.01）, LDL-C （1.16±0.29 vs. 10.78±6.48 mmol/L, P〈0.01）, and FFA （0.39±0.14 vs. 0.55±0.15 mmol/L, P〈0.01） in model group significantly increased; HDL-C （5.85±0.95 vs. 4.14±2.03 mmol/L, P〈0.05） significantly decreased; the levels of triglyceride and blood glucose had no significant changes （P〉0.05）; the activities of ADA （9.71±3.05 vs. 17.19±5.10 U/ml, P〈0.01） and XOD （10.58±6,88 vs. 19.22＋9.44 U/L, P〈0.01） in model group significantly increased; and FAS, LPL, HL had no significant changes （P〉0.05）. Conclusions High fat diet can induce abdominal fat accumulation with hyperuricemia and hypercholesterolemia quail model. The changes of uric acid and lipid metabolic enzyme activities may he the pathological mechanism of abdominal fat accumulation with hyperuricemia and hypercholesterolemia.

The distribution of 10-year cardiovascular risk in Chinese adults： analysis of the China Health Examination Database （CHED） 2008

Objective Global cardiovascular risk assessment has been incorporated into current Chinese guidelines for the management of hypertension and hypercholesterolemia. The aim of our study is to determine the distribution of 10-year risk for ischemic cardiovascular disease （ICVD） among middle-aged Chinese adults, and to evaluate the usefulness of global risk assessment tools in the primary prevention of ICVD in Chinese population.Methods Simplified prediction tools derived from the USA-PRC Collaborative Study of Cardiovascular Epidemiology cohort were applied to the Chinese Health Examination Database （CHED） 2008. 10-year risk for ICVD was estimated in 461 157 ICVD-free subjects （264 432 male and 196 725 female） aged 35 to 59 years. Results Among the male subjects, 82.4% had a 10-year risk for ICVD of 〈5%, 14.4% of 5% to 12.1% and 3.4 of≥ 12.2%, and in female subjects, 86.7% had a 10-year risk for ICVD of 〈5%, 12.1% of 5% to 12.0% and 1.2% of ≥ 12.1%. All subjects with predicted high level ICVD risk （≥ 12.2% in male or ≥ 12.1% in female） had either remarkably elevated （≥ 160 mmHg） blood pressure, significantly increased （≥ 6.22 mml/L） total serum cholesterol or diabetes.Conclusion Using the currently recommended prediction tools, only very small proportions of middle-aged Chinese men and women who were free of ICVD would be classified into high level risk group. These prediction tools are unlikely to help for the medical intervention decision making in Chinese adult patients with hypertension and/or hypercholesterolemia

Study on the Effects of Reducing Blood Lipid by Flavonoids from Ampelopsis grossedentata on Hyperlipidemia Rats

In order to study the effects of Ampelopsis grossedentata on endogenous cholesterol biosynthesis and the effects of reducing blood lipid in hyperlipidemia rats,extraction of flavonoids from Ampelopsis grossedentata by using ethanol(TFAG),and the effects of TFAG on intracellular cholesterol synthesis were detected by amphotericin B-cell model;SD hyperlipidemia rat model was established by feeding high fat diet.A formulated medicine called Xuezhikang was used as a positive control,and TFAG of different doses were administered to the stomach for 30 d continuously to measure the indexes of heart,liver tissue homogenate and serum;part of the liver was taken for pathological observation.The results showed that TFAG could significantly inhibit the synthesis of cholesterol in cells.TFAG of different doses could significantly reduce the content of TC and TG in serum of hyperlipidemia rats,and increase the content of HDL;TC and TG in heart and liver were also decreased;besides,it could increase the content of SOD,CAT and GSH in the liver of hyperlipidemia rats,and reduce the content of MDA.The results of pathological section showed that TFAG could improve the damage degree of hepatocytes in hyperlipidemia rats,and the effect of high dose group was similar to that of Xuezhikang group.In general,TFAG has good antioxidant and reducing blood lipid effects,and can effectively inhibit liver steatosis.

Response of Hypercholesterolemic Rats to Sesamum indicum Linn Seed Oil Supplemented Diet

Fatty acid composition of Sesamum indicum oil was determined by gas chromatography and the response of hypercholesterolemic rats to diet supplemented with Sesamum indicum seed oil was investigated. Twenty four rats weighing between 120-130 g were randomly assigned into four groups. Group A was fed normal diet, Group B, C and D were fed hypercholesterolemic diet （i.e. 20% fat ＋ 1% cholesterol） for two weeks to establish hypercholesterolemia. Group B were maintained on hyper diet while C and D were fed 5% and 10% benniseed oil supplemented diet for four weeks. Plasma was collected and analyzed for TC （total cholesterol）, HDL-C （high density lipoprotein）, LDL-C （low density lipoprotein） and TG （triglycerides） levels. Linoleic acid （42.44%） and oleic acid （40.60%） were the major unsaturated fatty acid in the oil. Significant increase （P 〈 0.05） was observed in the TC, TG, LDL and LDL/HDL ratio of the hypercholesterolemic rats compared to the normal control. Supplementation with Sesamum indicum seed oil at 5% and 10% levels resulted in significant decrease （P 〈 0.05） in TC, TG, LDL and LDL/HDL ratio, and significant increase in the HDL-C. The high level of unsaturated fatty acid in the oil may in part be responsible for the hypocholesterolemic effect of the oil.

EFFECT OF HERB-MEDICINE-CAKE-SEPARATED MOXIBUSTION ON SERUM LIPOPROTEIN CONTENTS IN HYPERLIPEMIA RABBITS

Objective: To study the effect of medicinal herb-cake-separated moxibustion on serum lipoprotein levels in hyperlipemia rabbits. Methods: A total of 55 New-Zealand rabbits were randomly divided into control group (n=13), model group (n=14), direct moxibustion group (n=14) and medicinal herb-cake-separated moxibustion (indirect moxibustion) group (n=14). Hyperlipemia model was established by feeding the animals with specialized forage (15% vitellus powder, 5% lard, 0.5% cholesterol and common forage) for 6 weeks. Moxibustion was applied to “Juque”(CV 14), “Tianshu”(ST 25), “Fenglong”(ST 40), etc., 4 moxa-cones for every acupoint, once daily and continuously for 40 days. Serum triglyceride (TG) and total cholesterol (TCh) contents were assayed with colorimentric method. Results: Compared with control group, TCh and TG levels of model group increased significantly (P< 0.01). TCh and TG contents of direct moxibustion and indirect moxibustion groups were significantly lower than those of model group (P<0.01). Comparison between two moxibustion groups showed that serum TCh level of indirect moxibustion group was strikingly lower than that of direct moxibustion group (P<0.01). It indicated that both direct and indirect moxibustion could effectively lower hyperlipemia and the therapeutic effect of indirect moxibustion was significantly superior to that of direct moxibustion in lowering serum TCh level. Conclusion: Both direct and indirect moxibustion can regulate lipid metabolism and the therapeutic effect of medicinal herb-cake-separated moxibustion is superior to that of direction moxibustion in hyperlipemia rabbits.

Acupuncture and Related Therapies for Hyperlipidemia:A Network Meta-Analysis

Objective To compare and rank the clinical effects of different acupuncture and related therapies on hyperlipidemia patients.Methods We used network meta-analysis(NMA)to evaluate direct and indirect effects in studies of acupuncture and related therapies for hyperlipidemia.Databases PubMed,EMBASE,Cochrane Library,the China Biology Medicine(CBM),the China National Knowledge Infrastructure(CNKI),Wanfang Data and the Chinese Scientific Journal Database(VIP)were searched to collect randomized controlled trials(RCTs)of acupuncture and related therapies in the treatment of hyperlipidemia.The data were analyzed using Stata 15.0 and WinBUGS 1.4.3 software after two researchers independently screened the literature,extracted the data,and assessed the risk of bias in the included studies.Results We analyzed a total of 36 eligible studies that included 3124 patients,involving 12 types of acupuncture and related therapies and comprehensive therapies.The results of the NMA showed that:for the total cholesterol(TC),acupoint catgut embedding(ACE),simple acupuncture(ACU),acupoint injection(AI),electroacupuncture(EA),western medicine of statins(WM),and combination of acupuncture and related therapies(combined therapies)were all more effective than placebo(P<0.05).For triacylglycerol(TG),ACU,EA,warming acupuncture(WA),WM and combined therapies were better than placebo(P<0.05),while WA was better than Chinese herb(CH)(P<0.05).For low-density lipoprotein cholesterol(LDL-C),combined therapies were more effective than lifestyle modification(LM)(P<0.05).For high-density lipoprotein cholesterol(HDL-C),auricular acupoint stimulation(AAS),ACE,ACU,AI,CH,EA,LM,moxibustion(MOX),WM,combined therapies and placebo were all worse than WA(P<0.05),while WM and combined therapies were better than ACU(P<0.05).Combined ranking results suggest that ACU and combined therapies may be the optimal intervention.Conclusions The efficacy of all kinds of acupuncture-related therapies in patients with hyperlipidemia is better than lifestyle changes.However,for different outcome indicators,all kinds of acupuncture-related therapies have their advantages and disadvantages,and comprehensive ranking results suggest that ACU and combined therapies may be the optimal intervention.

Therapeutic potential of berberine against neurodegenerative diseases

Berberine(BBR) is an organic small molecule isolated from various plants that have been used in traditional Chinese medicine. Isolation of this compound was its induction into modern medicine, and its usefulness became quickly apparent as seen in its ability to combat bacterial diarrhea, type 2 diabetes, hypercholesterolemia, inflammation, heart diseases, and more. However, BBR's effects on neurodegenerative diseases remained relatively unexplored until its ability to stunt Alzheimer's disease(AD) progression was characterized. In this review, we will delve into the multi-faceted defensive capabilities and bio-molecular pathways of BBR against AD, Parkinson's disease(PD), and trauma-induced neurodegeneration. The multiple effects of BBR, some of which enhance neuro-protective factors/pathways and others counteract targets that induce neurodegeneration, suggest that there are many more branches to the diverse capabilities of BBR that have yet to be uncovered. The promising results seen provide a convincing and substantial basis to support further scientific exploration and development of the therapeutic potential of BBR against neurodegenerative diseases.

Association between moderately oxidized low-density lipoprotein and high-density lipoprotein particle subclass distribution in hemodialyzed and post-renal transplant patients

Disturbances in the metabolism of lipoprotein profiles and oxidative stress in hemodialyzed （HD） and post-renal transplant （Tx） patients are proatherogenic, but elevated concentrations of plasma high-density lipoprotein （HDL） reduce the risk of cardiovascular disease. We investigated the concentrations of lipid, lipoprotein, HDL particle, oxidized low-density lipoprotein （ox-LDL） and anti-ox-LDL, and paraoxonase-1 （PON-1） activity in HD （n=33） and Tx （n=71） patients who were non-smokers without active inflammatory disease, liver disease, diabetes, or malignancy. HD patients had moderate hypertriglyceridemia, normocholesterolemia, low HDL-C, apolipoprotein A-I （apoA-I） and HDL particle concentrations as well as PON-1 activity, and increased ox-LDL and anti-ox-LDL levels. Tx patients had hypertriglyceridemia, hypercholesterolemia, moderately decreased HDL-C and HDL particle concentrations and PON-1 activity, and moderately increased ox-LDL and anti-ox-LDL levels as compared to the reference, but ox-LDL and anti-ox-LDL levels and PON-1 activity were more disturbed in HD patients. However, in both patient groups, lipid and lipoprotein ratios （total cholesterol （TC）/HDL-C, LDL-C/HDL-C, triglyceride （TG）/HDL-C, HDL-C/non-HDL-C, apoA-I/apoB, HDL-C/apoA-I, TG/HDL） were atherogenic. The Spearman＇s rank coefficient test showed that the concentration of ox-LDL correlated positively with HDL particle level （R=0.363, P=0.004）, and negatively with TC （R=-0.306, P=0.012）, LDL-C （R=-0.283, P=0.020）, and non-HDL-C （R=-0.263, P=0.030） levels in Tx patients. Multiple stepwise forward regression analysis in Tx patients demonstrated that ox-LDL concentration, as an independent variable, was associated significantly positively with HDL particle level. The results indicated that ox-LDL and de- creased PON-1 activity in Tx patients may give rise to more mildly-oxidized HDLs, which are less stable, easily undergo metabolic remodeling, generate a greater number of smaller pre-13-HDL particles, and thus accelerate reverse cholesterol transport, which may be beneficial for Tx patients. Further studies are necessary to confirm this.

Pitavastatin calcium improves endothelial function and delays the progress of atherosclerosis in patients with hypercholesterolemia

Background： Statins have proven efficacy in inhibiting the onset and progress of atherosclerosis. The effectiveness of pitavastatin in reversing carotid atherosclerosis associated with hypercholesterolemia （HC） is un-known. Objectives： To explore the simultaneous effects of pitavastatin calcium on brachial arterial flow-mediated vasodilatation （FMD）, carotid intima-media thickness （IMT）, and arterial stiffness （β）, three surrogate markers of ath-erosclerosis were studied in HC patients. Methods：A randomized, double-blind trial was performed with 40 HC sub-jects who fulfil ed the inclusion/exclusion criteria. Patients were given pitavastatin calcium 1 mg/d （Group 1） or 2 mg/d （Group 2） for 8 weeks. There were 20 patients in each group, and 30 gender-and age-matched healthy subjects as controls were recruited. FMD of the brachial artery, carotid IMT, and arterial stiffness indicated byβwere measured at baseline and at 8 weeks after starting pitavastatin calcium therapy using ultrasound techniques. Biochemical tests were also made on al subjects. Results： At baseline, higher total cholesterol （TC） and low-density lipoprotein cho-lesterol （LDL-C）, reduced FMD, and increasedβand IMT were observed in HC patients （P0.05）. Significant negative interactions between TC/LDL and FMD （P〈0.05–0.001）, positive interactions between TC and IMT （P=0.003） and between TC/LDL and β （P〈0.001–0.000） were found. Conclusions： Treatment with pitavastatin calcium exerted fa-vorable effects on endothelial function and arterial stiffness. It also improved carotid atherosclerosis in patients with HC.