Red blood cell distribution width in elderly hospitalized patients with cardiovascular disease

BACKGROUND Red blood cell distribution width(RDW)is elevated in patients with cardiovascular disease(CVD).AIM To determine RDW values and impact of CV and non-CV coexisting morbidities in elderly patients hospitalized with chronic CVD.METHODS This prospective study included 204 consecutive elderly patients(age 77.5[7.41]years,female 94[46%],left ventricular ejection fraction 53.00%[37.50,55.00])hospitalized with chronic CVD at the Cardiology Department of Larissa University General Hospital(Larissa,Greece)from January 2019 to April 2019.Elderly patients were selected due to the high prevalence of coexisting morbidities in this patient population.Hospitalized patients with acute CVD(acute coronary syndromes,new-onset heart failure[HF],and acute pericarditis/myocarditis),primary isolated valvular heart disease,sepsis,and those with a history of blood transfusions or cancer were excluded.The evaluation of the patients within 24 h from admission included clinical examination,laboratory blood tests,and echocardiography.RESULTS The most common cardiac morbidities were hypertension and coronary artery disease,with acutely decompensated chronic heart failure(ADCHF)and atrial fibrillation(AF)also frequently being present.The most common non-cardiac morbidities were anemia and chronic kidney disease followed by diabetes mellitus,chronic obstructive pulmonary disease,and sleep apnea.RDW was significantly elevated 15.48(2.15);121(59.3%)of patients had RDW>14.5%which represents the upper limit of normal in our institution.Factors associated with RDW in stepwise regression analysis were ADCHF(coefficient:1.406;95%confidence interval[CI]:0.830-1.981;P<0.001),AF(1.192;0.673 to 1.711;P<0.001),and anemia(0.806;0.256 to 1.355;P=0.004).ADCHF was the most significant factor associated with RDW.RDW was on average 1.41 higher for patients with than without ADCHF,1.19 higher for patients with than without AF,and 0.81 higher for patients with than without anemia.When patients were grouped based on the presence or absence of anemia,ADCHF and AF,heart rate was not increased in those with anemia but was significantly increased in those with ADCHF or AF.CONCLUSION RDW was elevated in elderly hospitalized patients with chronic CVD.Factors associated with RDW were anemia and CV factors associated with elevated heart rate(ADCHF,AF),suggesting sympathetic overactivity.

Advances in the relationship between apolipoprotein gene polymorphism and blood lipid and cardiovascular disease

Objective： Dyslipidemia is a leading cause of cardiovascular disease. At present, studies have shown that theincidence of cardiovascular disease in our country increased year by year. According to WHO statistics in 2013, itshowed that about 17 million people worldwide die from coronary heart disease （CHD） every year. Currently, CHDis the first cause of death in western countries and the incidence of CHD also showed a trend of increasing. Inrecent years more experts and scholars at home and abroad found gene polymorphism is closely related tohigh-density lipoprotein cholesterol （HDLC） gene and triglyceride （TG） levels. Apolipoprotein （APO） gene is akind of popular polymorphic proteins, whose genetic polymorphisms is through the impact of lipid metabolism,and then closely related to cerebrovascular diseases. But the results are different in different populations and races,or even the opposite. Methods： This review will summarize the gene polymorphism loci of commonapolipoprotein-ApoA1, ApoA5, Apo B, ApoC3, ApoE, which is associated with lipid levels and cardiovasculardisease. Conclusion： It is important for us to get a further understand and prevent the occurrence and developmentof cardiovascular disease from gene level..

Analysis of Blood Lipids, Blood Glucose, Blood Uric Acid, and Blood Routine Test Results in Retired Employees of a Unit in the Civil Aviation System

Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine results.The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia,hyperuricemia,and other conditions in retired employees.Methods:The examination results of 231 participants were collected and analyzed.The participants were divided into four groups based on age:middle-aged group,young-old group,middle-old group,and old-old group.The blood test results were compared across these groups,and an assessment of atherosclerotic cardiovascular disease(ASCVD)risk levels was completed in conjunction with medical history.Blood test results were also compared by gender.Results:There were no significant statistical differences in blood test results when grouped by age.However,the prevalence of hyperuricemia was higher in males than in females,while the prevalence of hypercholesterolemia was higher in females than in males.The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels.Conclusion:Management of hyperuricemia and hyperlipidemia in retired employees(elderly patients)should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.

低容量高强度间歇训练对肥胖或超重人群心血管疾病风险因子影响的Meta分析

目的:通过Meta分析综合定量评价低容量高强度间歇训练对预防肥胖或超重人群心血管疾病的效果,进一步验证低容量高强度间歇训练在肥胖等特殊人群中应用的可行性。方法:在中国知网、PubMed、Web of Science、Cochrane Library和EBSCO-SPORTD运动科学全文数据库检索关于低容量高强度间歇训练相关研究的随机对照试验文献,检索时限为各数据库建库至2024年2月。由2名研究人员对所纳入的研究进行筛选、质量评价和数据提取,采用RevMan 5.4和Stata 17.0软件对结局指标进行Meta分析,包括合并效应量、亚组分析、Leave-One-Out敏感性分析以及发表Egger检验和绘制漏斗图。该方案已在国际系统综述前瞻性注册中心注册(CRD42024534409)。结果:①最终筛选纳入符合要求的13项随机对照试验,共包含349例受试者,纳入文献整体质量较高。②低容量高强度间歇训练干预对心肺适能(SMD=-0.65,95%CI:-0.87至-0.43,P<0.05)、收缩压(SMD=0.38,95%CI:0.11-0.65,P<0.05)、舒张压(SMD=0.42,95%CI:0.15-0.68,P<0.05)和体脂百分比(SMD=0.25,95%CI:0.02-0.49,P<0.05)4项指标具有改善效果。③低容量高强度间歇训练与中等强度持续训练相比在改善超重或肥胖人群心肺适能、收缩压、舒张压、体脂百分比、标准体质量、体质量指数、高密度脂蛋白、低密度脂蛋白和总胆固醇指标方面干预效果相似(P>0.05),但在改善三酰甘油效果方面中等强度持续训练优于低容量高强度间歇训练(SMD=-0.30,95%CI:-0.57至-0.02,P<0.05)。④亚组分析结果进一步显示,低容量高强度间歇训练和中等强度持续训练干预对各项指标的改善效果相似。结论:当前证据表明,低容量高强度间歇训练可以有效提升超重或肥胖人群的心肺适应能力以及促进减脂和血压调控,且改善效果与中等强度持续训练相似。短时间的低容量高强度间歇训练相比于长时间的中等强度持续训练更具有时间效益。建议未来通过更多研究确定适用于超重或肥胖人群最佳的低容量高强度间歇训练运动处方。

Exploring the Relationship between Adiponectin and Blood Pressure in Nigerian Children

Background: Adiponectin possesses essential physiological functions that protect against the onset of cardiovascular and metabolic diseases. Although several studies have discussed the association between adiponectin and Blood Pressure (BP) in adults and older adolescents. To the best of our knowledge, this is the first study to explore the relationship between adiponectin and BP among children in Africa. Significance: This novel discovery is expected to serve as a benchmark for future local studies in examining the role of adiponectin in cardiovascular disorders among Africans. Method: A cross-sectional study was conducted among 86 healthy children aged 4 to 11 years with normal BMI. BP values were measured and percentiles derived from the 2017 revised clinical practice guidelines of the American Academy of Paediatrics. Fasting blood adiponectin values were determined with ELISA, and the level of statistical significance was set at p Result: 86 children were comprised of 42 (48.8%) males and 44 (51.2%) females. The mean age of all subjects was 7.5 ± 2.3 years, while that of fasting adiponectin was 4.8 ± 2.1 ng/dl. There were no significant differences in the age, Body Mass Index, BP and adiponectin concentrations across gender. 69 (80.2%) participants had normal BP while 5 (5.8%) and 12 (14.0%) had elevated BP and stage 1 hypertension. Mean adiponectin values for normal BP, elevated BP and stage 1 hypertension were 5.1 ± 2.1 ng/ml, 3.3 ± 1.2 ng/ml and 4.1 ± 1.9 ng/ml respectively (p-value = 0.039). A significant negative correlation was observed between adiponectin and systolic BP independent of age, sex, and BMI. Although a negative correlation was noted between adiponectin and diastolic blood pressure, this was not statistically significant. Conclusion: Adiponectin correlates negatively with systolic BP in young Nigerian children independent of age, Body Mass Index and gender. More studies are indicated to investigate this relationship in association with vital metabolic factors across different age groups in Africa.

WJD 5^(th) Anniversary Special Issues(2): Type 2 diabetes Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?

Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin.Compared with individuals without diabetes,patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality,and are disproportionately affected by cardiovascular disease.Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension,dyslipidaemia and obesity in these patients.However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors.Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus.Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events.Many of these risk factors could be common history for both di-abetes mellitus and cardiovascular disease,reinforcing the postulate that both disorders come independently from"common soil".The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients.

Implications of discoveries from genome-wide association studies in current cardiovascular practice

Genome-wide association studies(GWAS)have identified several genetic variants associated with coronary heart disease(CHD),and variations in plasma lipoproteins and blood pressure(BP).Loci corresponding to CDKN2A/CDKN2B/ANRIL,MTHFD1L,CELSR2,PSRC1 and SORT1 genes have been associated with CHD,and TMEM57,DOCK7,CELSR2,APOB,ABCG5,HMGCR,TRIB1,FADS2/S3,LDLR,NCAN and TOMM40-APOE with total cholesterol.Similarly,CELSR2-PSRC1-SORT1,PCSK9,APOB,HMGCR,NCAN-CILP2-PBX4,LDLR,TOMM40-APOE,and APOC1-APOE are associated with variations in low-density lipoprotein cholesterol levels.Altogether,forty,forty three and twenty loci have been associated with high-density lipoprotein cholesterol,triglycerides and BP phenotypes,respectively.Some of these identified loci are common for all the traits,some do not map to functional genes,and some are located in genes that encode for proteins not previously known to be involved in the biological pathway of the trait.GWAS have been successful at identifying new and unexpected genetic loci common to diseases and traits,thus rapidly providing key novel insights into disease biology.Since genotype information is fixed,with minimum biological variability,it is useful in early life risk prediction.However,these variants explain only a small proportion of the observed variance of these traits.Therefore,the utility of genetic determinants in assessing risk at later stages of life has limited immediate clinical impact.The future application of genetic screening will be in identifying risk groups early in life to direct targeted preventive measures.

Efficient differentiation of vascular smooth muscle cells from Wharton's Jelly mesenchymal stromal cells using human platelet lysate: A potential cell source for small blood vessel engineering

BACKGROUND The development of fully functional small diameter vascular grafts requires both a properly defined vessel conduit and tissue-specific cellular populations.Mesenchymal stromal cells(MSCs) derived from the Wharton's Jelly(WJ) tissue can be used as a source for obtaining vascular smooth muscle cells(VSMCs),while the human umbilical arteries(h UAs) can serve as a scaffold for blood vessel engineering.AIM To develop VSMCs from WJ-MSCs utilizing umbilical cord blood platelet lysate.METHODS WJ-MSCs were isolated and expanded until passage(P) 4. WJ-MSCs were properly defined according to the criteria of the International Society for Cell and Gene Therapy. Then, these cells were differentiated into VSMCs with the use of platelet lysate from umbilical cord blood in combination with ascorbic acid,followed by evaluation at the gene and protein levels. Specifically, gene expression profile analysis of VSMCs for ACTA2, MYH11, TGLN, MYOCD, SOX9,NANOG homeobox, OCT4 and GAPDH, was performed. In addition,immunofluorescence against ACTA2 and MYH11 in combination with DAPI staining was also performed in VSMCs. HUAs were decellularized and served as scaffolds for possible repopulation by VSMCs. Histological and biochemical analyses were performed in repopulated h UAs.RESULTS WJ-MSCs exhibited fibroblastic morphology, successfully differentiating into"osteocytes", "adipocytes" and "chondrocytes", and were characterized by positive expression(> 90%) of CD90, CD73 and CD105. In addition, WJ-MSCs were successfully differentiated into VSMCs with the proposed differentiation protocol. VSMCs successfully expressed ACTA2, MYH11, MYOCD, TGLN and SOX9. Immunofluorescence results indicated the expression of ACTA2 and MYH11 in VSMCs. In order to determine the functionality of VSMCs, h UAs were isolated and decellularized. Based on histological analysis, decellularized h UAs were free of any cellular or nuclear materials, while their extracellular matrix retained intact. Then, repopulation of decellularized h UAs with VSMCs was performed for 3 wk. Decellularized h UAs were repopulated efficiently by the VSMCs. Biochemical analysis revealed the increase of total hydroyproline and s GAG contents in repopulated h UAs with VSMCs. Specifically, total hydroxyproline and s GAG content after the 1 st, 2 nd and 3 rd wk was 71 ± 10, 74 ± 9 and 86 ± 8 μg hydroxyproline/mg of dry tissue weight and 2 ± 1, 3 ± 1 and 3 ± 1μg s GAG/mg of dry tissue weight, respectively. Statistically significant differences were observed between all study groups(P<0.05).CONCLUSION VSMCs were successfully obtained from WJ-MSCs with the proposed differentiation protocol. Furthermore, h UAs were efficiently repopulated by VSMCs. Differentiated VSMCs from WJ-MSCs could provide an alternative source of cells for vascular tissue engineering.

Empirical Studies of Effects of High Blood Pressure on Medical Costs and Heart Disease: Is the 2017 ACC/AHA Guideline Supported by Enough Evidence?

Background: The American College of Cardiology (ACC), American Heart Association (AHA) and other organizations announced a new hypertension guideline in November 2017. However, previous studies have pointed out that this new guideline might lack sufficient evidence to justify its use. Data and Methods: The effects of blood pressure (BP) on medical costs and on the probability of having heart disease as anamnesis are analyzed. We used a dataset containing 175,123 medical checkups and 6,312,125 receipts from 88,211 individuals obtained from three health insurance societies from April 2013 to March 2016. The dataset was divided into subgroups based on whether the patients had diabetes and took hypertension medications. The power transformation and probit models were used in the study. Results: We observed negative effects of systolic BP (SBP) on medical costs in most subgroups. We could not find evidence that higher SBP made the medical costs and probability of having heart diseases higher. The results raise uncertainty about the reliability of the new guideline, at least for SBP. Conclusion: The results of this study did not support the new 2017 ACC/AHA guideline, at least for SBP. The new guideline must be more carefully reevaluated by additional studies. Limitations: The dataset was observatory, the sample period was only 3 years, and we could not complete a time-series analysis of individuals.

Recent advances in CRISPR-based genome editing technology and its applications in cardiovascular research

The rapid development of genome editing technology has brought major breakthroughs in the fields of life science and medicine. In recent years, the clustered regularly interspaced short palindromic repeats(CRISPR)-based genome editing toolbox has been greatly expanded, not only with emerging CRISPR-associated protein(Cas) nucleases, but also novel applications through combination with diverse effectors. Recently, transposon-associated programmable RNA-guided genome editing systems have been uncovered, adding myriads of potential new tools to the genome editing toolbox. CRISPR-based genome editing technology has also revolutionized cardiovascular research. Here we first summarize the advances involving newly identified Cas orthologs, engineered variants and novel genome editing systems, and then discuss the applications of the CRISPR-Cas systems in precise genome editing, such as base editing and prime editing. We also highlight recent progress in cardiovascular research using CRISPR-based genome editing technologies, including the generation of genetically modified in vitro and animal models of cardiovascular diseases(CVD) as well as the applications in treating different types of CVD. Finally, the current limitations and future prospects of genome editing technologies are discussed.

Blood pressure variability and cerebrovascular disease

Variability is an aspect of blood pressure(BP) relatively unknown and poorly evaluated systematically in clinical practice. Although the introduction of intensive BP measurement methods, such as ambulatory blood pressure monitoring provided evidence of the importance of BP variability in the short-term, more recently, however, emphasis has been placed on the relevance of variability of BP in the medium- and long-term. The adverse cardiovascular consequences of high BP not only depend on absolute BP values, but also on BP variability. Independently of mean BP levels, BP variations in the short- and long-term are associated an increased risk of cardiovascular events and mortality. Also, it has been suggested that modulation of such variability may explain the different level protection exerted by different antihypertensive-drug classes.

Anthropometric parameter-based assessment for cardiovascular disease predisposition among young Indians

AIM:To assess the predisposition for cardiovascular diseases among young Asian Indians by anthropometric data analysis.METHODS:One hundred and thirty males and 329 females aged between 15 and 26 years,attending health care check-ups at VIT University,were included in this study.Their body mass index,systolic and diastolic blood pressure,waist circumference,waist-to-hip ratio,pulse rate and pressure,along with mean arterial pressure,were measured and the data analyzed as per World Health Organization guidelines.RESULTS:Based on the analysis,54% of the male population was found to be predisposed to cardiovascular disease.Of these,approximately 40% were at highest possible risk,with greater than threshold values of body mass index,waist circumference and waist-to-hip ratio.Females were found to have lower risk.Both genders showed significant correlation(P < 0.0001) between body mass index and waist circumference.Waist-to-hip ratio correlated significantly only in males with the former index whereas it correlated significantly with waist circumference in both genders.Receiver operating curve analysis,when performed,showed optimal sensitivity and specificity for body mass index and waist circumference.CONCLUSION:The above results indicate that seeds of cardiovascular disease may have been sown at a young age in Asian Indian populations.Interventional measures are advised to prevent accelerated atherosclerosis leading to premature cardiovascular disease.

Assessment of Lipid Profile and Atherogenic Indexes of Hepatitis B Virus Carriers amongst Volunteer Blood Donors in Nigeria

Introduction: Infectious agents such as hepatitis B virus can constitute major public health problems as ii affects the liver resulting into inflammatory conditions. This study was designed to assess plasma lipid profile and atherogenic indexes of hepatitis B virus carriers among voluntary blood donors in North Central, North East and South-South regions of Nigeria. Materials & Methods: A total of 183 blood samples were collected from subjects in North Central consisting of 137 males and 46 females;176 blood samples from the North East consisting of 129 males and 47 females and 173 blood samples from subjects in South-South region consisting of 123 males and 50 females. The mean ages of the subjects were 34.89 ± 9.19 years, 39.81 ± 9.60 years and 39.92 ± 9.27 years for North Central, North East and South-South regions respectively. The specimens were tested for hepatitis B surface antigen using enzyme-linked immunosorbent assay. All specimens were analyzed for total cholesterol, HDL-C, LDL-C and triglycerides with standard biochemical procedures. The atherogenic indexes were computed using established ratios. The data was analyzed statistically and p-value Results: The mean values of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and triglycerides did not vary significantly (p > 0.05) between the hepatitis B positive carriers and hepatitis B negative subjects across the geo-political zones studied although in some of the parameters the values were on the high normal range between the male and female subjects. The AIP and CRR-1 and CRR-11 of the blood donors in the zones in both the HBsAg positive and negative subjects were within the reference range. The atherogenic coefficient value of >3.0 was obtained for some HBsAg negative and positive subjects in some of the zones. Conclusion: The findings thus indicate that asymptomatic HBV infection may be associated with low risk of dyslipidaemia in the population.

Vascular dysfunctions and platelet activations by arsenic: two major contributing factors to cardiovascular disease

Arsenic in drinking water is a worldwide health problem that is associated with cardiovascular disease, but the cause is currently unknown. In order to examine whether arsenic affects vasomotor tone in blood vessels, we investigated the effect of arsenic on agonist-induced vasorelaxation and vasoconstriction using the isolated rat aortic rings in in vitro organ bath system. Treatment with inorganic arsenite (AsⅢ) inhibited acetylcholine-induced relaxation of aortic rings by inhibiting production of nitric oxide in endothelium.

Obesity and High Blood Pressure among Professional Long-Distance Drivers in Yaoundé, Cameroon: Cross-Sectional Study

Background: Drivers play a very important role in the transportation of people, goods and services in Cameroon. The data on obesity and hypertension amongst these professionals is insufficient. The study aimed to determine the prevalence and risk factors of obesity and high blood pressure (HBP) among professional bus drivers in Yaoundé. Methods: This was an analytic cross-sectional study among long-distance bus drivers stationed in Yaoundé between march and April 2018. The data collected focused on driving history, eating habits, driver’s lifestyle, and anthropometric measurements. The analysis was completed using SPSS 21 software;STATA 13;SPAD 5.5 and Excel. Results: Of the 309 drivers, 27.18% and 17.80% were obese and hypertensive, respectively. The risk of developing HBP and obesity was higher among drivers with ≥20 years of driving experience. The risk of obesity was 3.99 (95% CI = 1.65 - 9.64);14.57 (95% CI = 3.65 - 58.16) and 15.23 (95% CI = 3.30 - 70.40) times higher in drivers with 10 - 14, 15 - 19 and 20 years of experience respectively. The risk of HBP was 3.64 (95% CI = 1.22 - 10.85);5.08 (95% CI = 1.18 - 21.92) and 9.42 (95% CI = 1.87 - 47.44) times higher in drivers with 10 - 14;15 - 19 years and 20 years of service, respectively. The more involved the drivers were in sporting activities, the less likely they are to be obese (RR = 0.46;95% CI = 0.24 - 0.88);the risk of HBP was 1.96 (95% CI = 1.05 - 3.67) times higher among drivers who were unable to make trips of at least 10 minutes. And the risk of HBP was less when drivers did not snack while traveling (RR = 0.43;95% CI = 0.21 - 0.90) than when they did. When a driver ate at least 3 meals a day, the risk of being obese was 5.75 (95% CI = 3.15 - 10.48) times higher. The risk of HBP was 4.04 (95% CI = 2.20 - 7.41) times higher in obese drivers than in those with a normal body mass index. Conclusion: Obesity and HBP are common conditions amongst the population of bus drivers. They are particularly exposed due to their socio-professional characteristics, their eating habits, and their lifestyle. These observations call for nutritional and sports education campaigns among bus drivers.

Myocardial Protective Effect of Gas Signal Molecule Hydrogen Sulfide on Cardiovascular Disease

Cardiovascular diseases increase continually in the worldwide scale,and its specific pathogenesis has not been completely clear.The gas signal molecule hydrogen sulfide(H2S)is a new type of neuroactive substance,which plays many biological roles in many systems such as cardiovascular system.In recent years,a lot of research has confirmed H2S has myocardial protective effect on cardiovascular diseases such as atherosclerosis,ischemia-reperfusion injury,hypertension and heart failure.This paper reviews the research status of myocardial protective effect of H2S on cardiovascular diseases.

Protocol to study the effects of AMPK-mTOR/PINK-Parkin dual signaling pathways on the formation of coronary heart disease showing blood stasis symptom pattern based on traditional Chinese medicine theory of“heart governing blood and vessels”

In this study,we aim to combine gene transfection techniques with the modeling methods previously employed by the research group to deeply investigate the corresponding theories of traditional Chinese medicine regarding“myocardial energy metabolism”and“aortic thrombosis”.Our goal is to elucidate the biological mechanism underlying the occurrence and development of coronary heart disease with blood stasis syndrome from the perspectives of“heart and vessels”and“Qi(in traditional Chinese medicine,it refers to the most fundamental and subtle substances that constitute the human body and maintain life activities.At the same time,it also has the meaning of physiological function.In terms of traditional Chinese medicine,Qi and different words are used together to express different meanings)and blood”.The research content is divided into four modules as follows:1.establishment of an animal model of coronary heart disease with blood stasis syndrome through fibrinogen overexpression.2.Investigation of the mitochondrial quality control system in coronary heart disease with blood stasis syndrome under fibrinogen overexpression.3.Study of platelet autophagy in coronary heart disease with blood stasis syndrome under fibrinogen overexpression.4.Examination of the relationship between the AMPK-mTOR pathway and metabolism in platelet autophagy of coronary heart disease with blood stasis syndrome under fibrinogen overexpression.Ninety-six Sprague Dawley rats will be randomly assigned to the following groups:control group,model group,fibrinogen group and adeno-associated virus group.All rats will undergo a 14-week model construction process,and modern molecular biology methods will be employed to evaluate the model and examine relevant research indicators.The obtained data will be analyzed according to a predefined statistical analysis plan.

新冠病毒轻型感染对献血者血液学指标及捐献单采血小板适宜性的影响

目的:通过对新冠病毒Omicron变异株轻型感染献血者血液学指标的变化分析,探讨新冠病毒轻型感染对成人血液学指标的影响,进而评估其对捐献单采血小板适宜性的影响。方法:以2022年12月-2023年1月期间出现新冠病毒轻型感染症状、连续捐献单采血小板3次的72例献血者(其中阳性组42例,疑似感染组30例)和2022年10月-11月期间未接种新冠疫苗、未感染新冠病毒、连续捐献3次单采血小板的42例献血者(对照组)为研究对象,通过重复测量方差分析法回顾性比较阳性组和疑似感染组出现症状前(Time1)后(Time2和Time3)及对照组连续3次(Time1、Time2、Time3)的血常规变化,并采用贝叶斯判别法建立近期是否感染新冠病毒的判别方程式。结果:阳性组和疑似感染组组内测量次数的简单效应显著(F_(阳性组)=6.98,P<0.001,偏η^(2)=0.79;F_(疑似感染组)=4.31,P<0.001,偏η^(2)=0.70);阳性组、疑似感染组Time2与Time1、Time3血常规指标相比较,RBC、HCT、HGB降低,PLT与PCT明显升高(P<0.05),阳性组、疑似感染组Time3的RDW-CV、RDW-SD与Time1、Time2相比均明显升高(P<0.001)。对照组组内测量次数简单效应不显著(F=0.96,P=0.55,偏η^(2)=0.34);组内3次血常规指标差异无统计学意义(P>0.05)。建立“近期是否感染新冠病毒”的判别方程式,方程特征值是0.22,典型相关性为0.43(χ^(2)=27.81,P<0.001),分析正确率为72.9%。结论:新冠病毒轻型感染献血者血液学指标中RBC、HCT、HGB、PLT、PCT、RDW-CV和RDW-SD呈动态变化,近期是否感染新冠病毒的判别方程式有较高的准确率。

血清血尿酸及甲状腺激素与2型糖尿病患者发生动脉粥样硬化性心血管疾病的关系

目的探究血清血尿酸(SUA)及甲状腺激素水平与2型糖尿病(T2DM)患者发生动脉粥样硬化性心血管疾病(ASCVD)的关系,并构建发生风险预测模型。方法回顾性选取2020年5月至2023年5月丽水市人民医院内分泌科诊治的326例T2DM患者,根据是否发生ASCVD,将其分为发生组(n=152)与未发生组(n=174)。收集所有研究对象临床资料以血清SUA及甲状腺激素(TT3、TT4、FT3、FT4、TSH)水平。采用单因素logistic回归、多因素logistic回归分析T2DM患者发生ASCVD的危险因素,依据危险因素构建T2DM患者发生ASCVD的风险列线图预测模型。结果两组对象年龄、空腹血糖、糖尿病病程、三酰甘油、SUA、TSH水平比较,差异有统计学意义(P<0.05),除此外,两组其他资料比较差异无统计学意义(P>0.05)。二元logistics回归结果显示,年龄大、糖尿病病程长、三酰甘油高、SUA水平高、TSH水平高为T2DM患者发生ASCVD的独立危险因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,年龄、糖尿病病程、三酰甘油、SUA、TSH及列线图预测模型的ROC曲线下面积(AUC)分别为0.711、0.702、0.668、0.755、0.965、0.987,可知,均对T2DM患者发生ASCVD有较好的预测价值。当取cut-off时,各自敏感度分别为0.638、0.539、0.638、0.730、0.941、0.960,特异度分别为0.690、0.799、0.644、0.661、0.943、0.954。Bootstrap法(B=1000)对列线图预测模型进行内部验证显示,Bias-corrected预测曲线与Ideal线基本重合,C-index为0.975,该模型预测能力较好。决策曲线显示,该模型的阈值概率范围为0.01~0.98,其净收益率>0。结论血清SUA及甲状腺激素水平是预测T2DM患者发生ASCVD的重要指标,构建的风险列线图预测模型具有较好的预测性能和临床应用价值。

基于“三因四证”调整免疫炎症状态的中医药治疗心血管疾病研究述评

动脉粥样硬化是心血管疾病发生发展的重要病理基础,物质代谢异常和免疫炎症反应是其发生发展的重要原因,由此导致的免疫炎症状态贯穿其病理始终。本文以“病”(心力衰竭)为切入点,结合心脉相关理论,总结气、血、水“三因”病机与免疫炎症状态的相关性。心气、心血、心水异常可出现在心力衰竭的不同阶段,持续的免疫炎症状态贯穿心力衰竭始终。同时,岭南地区常年湿热的气候环境因素及人群气虚、阳虚和湿热体质与免疫炎症状态发生密切相关,“积湿生热”及“湿自热生”的湿热相互转化机制使得岭南地区心血管疾病的病机以气虚痰浊夹瘀多见。在此基础上,痰、瘀、湿、热等伏匿机体的多种病理产物在疾病发展过程中累积,久酿而成内生伏毒,由此总结性归纳将痰、瘀、湿、毒“四证”与免疫炎症状态紧密联系。本文用“病—证—治”关联视角探讨中医药防治心血管疾病,融合治未病思想,从理论到应用,从基础到临床,以期为进一步制定和实施中医药诊疗方案提供理论指导。