Intima在肾综合征出血热患者输液中的应用

目的研究Intima在肾综合征出血热 (HFRS)患者输液治疗中应用效果。方法将HFRS患者随机分为两组 ,分别用Intima和头皮针进行输液治疗。检测低血压休克期两组患者建立第二组静脉通道所需时间 ,检测两组患者在发热期、少尿期、多尿期输液器乳头细菌污染数 ,统计两组病人液体渗漏例数 ,并将三组观察指标分别进行差异比较。结果Intima组较头皮针组可减少低血压休克抢救建立第二路通道所需时间 ,消除输液器乳头的污染 ,降低液体渗漏率。结论使用Intima可使HFRS患者低血压休克穿刺时间相对缩短 ,消除输液器乳头的污染 。

Intimal pericytes as the second line of immune defence in atherosclerosis

Inflammation plays an essential role in the development of atherosclerosis. The initiation and growth of atherosclerotic plaques is accompanied by recruitment of inflammatory and precursor cells from the bloodstream and their differentiation towards pro-inflammatory phenotypes. This process is orchestrated by the production of a number of pro-inflammatory cytokines and chemokines. Human arterial intima consists of structurally distinct leaflets, with a proteoglycan-rich layer lying immediately below the endothelial lining. Recent studies reveal the important role of stellate pericyte-like cells(intimal pericytes) populating the proteoglycan-rich layer in the development of atherosclerosis. During the pathologic process, intimal pericytes may participate in the recruitment of inflammatory cells by producing signalling molecules and play a role in the antigen presentation. Intimal pericytes are also involved in lipid accumulation and the formation of foam cells. This review focuses on the role of pericytelike cells in the development of atherosclerotic lesions.

Relationship between Waist Circumference and Elevation of Carotid Intima-media Thickness in Newly-diagnosed Diabetic Patients

Objective Waist circumference, as a brief indicator of visceral obesity, is associated with multi-metabolic disorders and cardiovascular diseases. The present study was aimed to find out the relationship between waist circumference and carotid intima media thickness （C-IMT）, as well as the best waist circumference cutoff for identifying C-IMT elevation in Chinese male patients with newly-diagnosed diabetes. Methods Five hundred and seventy-eight patients from Department of Endocrinology and Metabolism in Shanghai Sixth People＇s Hospital affiliated to Shanghai Jiao Tong University were enrolled. Both physical examination （for measurement of waist circumference） and carotid ultrasonography （for measurement of C-IMT） were performed. Results After grouping according to the quartiles of C-IMT, the waist circumference increased across all its quartiles. The waist circumference in 3rd and 4th quartiles （90.7_＋9.8 cm and 90.8＋9.6 cm） was significant higher than in 1st and 2nd quartiles （P〈0.05）. When subjects were divided into 4 groups according to waist circumference, the C-IMT of subjects with waist circumference 90-95 cm was significant higher than that of subjects with waist circumference 85-90 cm and less than 85 cm respectively （P〈0.05）. Both spearman and partial correlation analysis showed that C-IMT was positively correlated with waist circumference （P〈0.01）. C-IMT was found significantly elevated with the increase of waist circumference. Multiple stepwise regression analysis showed that waist circumference was one of the independent risk factors of C-IMT. After an average of 2.23_＋0.85 years follow up, there was a significant elevation of C-IMT in the group with baseline waist circumference over 90 cm P〈0.05）, while no significant difference was detected in the group with baseline waist circumference less than 90 cm （P=0.27）. Logistic regression showed that baseline waist circumference over 90 cm was associated with a relative risk to C-IMT elevation of 1.132 （95% CI 1.043-1.431, P〈0.05）. Conclusion Among newly-diagnosed diabetic male patients, waist circumference over 90 cm not only reflects sub-clinical atherosclerosis in early stage, but also predicts the progression of atherosclerosis.

The Relationship of Carotid Plaque, Intima Media Thickness (IMT), Resistivity Index (RI) and Pulsatility Index(PI) in Asian-Indian Patients with Acute Ischemic Stroke with and without Type2 DM

Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subtypes in both diabetic and non-diabetic subjects. Materials and methods: 80 cases of acute ischemic strokes and 40 healthy controls were included in the study. The plaque, IMT, RI and PI were measured by carotid duplex ultrasound. Results: 31 subjects were Type 2 diabetic, 54 hypertensive while 25 were both diabetic and hypertensive. 23 cases (28.75%) had lacunar stroke (LACI), 32 (40%) stroke involving partial anterior circulation(PACI), 10(12.5%) stroke in posterior circulation (PACI) and 15(18.75%) stroke involving total anterior circulation(TACI) respectively. The mean IMT (0.88 ± 0.19mm), RI(0.76 ± 0.05) and PI(1.71 ± 0.19) of patients and mean IMT (0.6±0.09mm), RI (0.61 ± 0.06) and PI (1.53 ± 0.11) of controls were statistically significant (p-0.000). The mean values of IMT, PI and RI were significantly higher in diabetics (IMT-0.90 ± 0.16 VS 0.64 ± 0.11, p-0.013;PI-1.76 ± 0.20 VS 1.49 ± 0.09, P-0.000 and RI-0.76 ± 0.04 VS 0.59 ± 0.06, P-0.000) and similarly the mean values for IMT, PI and RI in hypertensives as compared to controls (IMT-0.88 ± 0.16 vs 0.65 ± 0.10, P-0.006;PI1.69 ± 0.18 vs 1.49 ± 0.09, P-0.000 and RI 0.76 ± 0.04 vs 0.59 ± 0.06, P-0.000). The mean IMT, PI and RI were increased significantly in smokers compared to controls (IMT-0.93 ± 0.20 vs 0.63 ± 0.06, P-0.000;PI-1.82 ± 0.22 vs 1.49 ± 0.09, P-0.000 and RI-0.77 ± 0.04 vs 0.59 ± 0.06, P-0.000). Type 3 plaque accounted for 27 (56.2%) cases and Type 2 plaque 12 (25%) cases. The total number of plaques in patients as compared to controls were significantly more (P-0.0034) and the mean plaque area was 46 mm2 for cases and 20 mm2 for control (P-0.0001). TACI was the most common type of ischemic stroke seen in DM (60%), HTN (66.6%) and smokers (66.7%). Plaques (73.3%), IMT (0.90 ± 0.12), PI(1.72 ± 0.14) and RI (0.76 ± 0.13) were more commonly associated with TACI subtype. On multivariate analysis using ANOVA, the mean PI was highly significant (0.000) in relation to types of plaque. Summary and Conclusions: IMT, RI, PI and plaque type are useful diagnostic parameters for acute ischemic stroke and its subtypes. They can be used as noninvasive tools for predicting and preventing ischemic stroke in smokers as well as subjects with DM and hypertension.

Correlation between Waist Circumference and Carotid Intima-Media Thickness in Women from Shanghai, China

Objective To evaluate whether waist circumference （WC） 〉85 cm is related to asymptomatic preclinical atherosclerosis in women from Shanghai, China. Methods A total of 2365 females aged 〉20 years recruited from 4 communities underwent physical examination and carotid artery scanning. Their carotid intima-media thickness （C-iMT） was measured. Results The C-IMT was significantly higher in overweight or obese women with their BMI 〉25.0 kg/m2 {P〈O.01） and in those with their WC _〉85 cm than in those with their WC 〈85 cm （P〈O.01）. Spearman and partial correlation analysis showed that the C-IMT was significantly correlated with WC which was independent of menopausal status. The C-IMT significantly increased with the increasing WC and reached to a platform in about 85 cm. An increment tendency was found in the subgroup with its WC 〈 85 cm （P〈O.01） while no significant tendency was found in the subgroup with its WC_〉85 cm （P=0.07）. Multiple stepwise regression analysis showed that the WC was an independent risk factor for C-IMT. In logistic regression model, the odd ratio of WC _〉80 cm, _〉80 cm and 〈85 cm and 〉85 cm for evaluating the risk of C-IMT elevation was 2.632, 2.501, and 1.878, respectively. Conclusion WC is significantly correlated with C-IMT in women from Shanghai, China, and WC_〉85 cm may be used in identifying the risk of subclinical carotid atherosclerosis.

Ultrasound Assessraent of Intima-media Thickness and Diameter of Carotid Arteries in Patients Undergoing Hemodialysis or Renal Transplantation

Renal transplant （RT） recipients have a high risk of developing cardiovascular diseases. However, the effects of renal transplantation on the development of arteriosclerosis have been controversial. The carotid intima-media thickness （CIMT） and diameter （CD） are important indicators of vascular remodeling and arteriosclerosis. In this study, 31 patients with hemodialysis （HD）, 31 RT recipients and 84 age- and gender-matched control subjects were enrolled. Their CIMT and CD were measured by ultrasonic radiofrequency tracking, and the linear regression models and Z test were used to identify the progression of arteriosclerosis and the risk factors. Compared with HD group, RT group had significantly lower CIMT and CD. CIMT was found to be associated with age, body weight, resistance index and diastolic velocity, while CD was associated significantly with age, body weight, pulsatility index, end diastolic velocity and diastolic blood pressure （DBP）, respectively. The correlation curves between CIMT and age showed the slopes of curves were decreased successively in control, RT and HD groups, and the curves between CD and age showed the slopes were decreased in order of RT 〉 control 〉 HD groups. It was concluded that CIMT and CD were significantly correlated with age in RT and moderately with age in HD patients. RT could reduce the progress of arteriosclerosis in patients with end-stage renal disease.

Relationship between Carotid Intima-Media Thickness and Diabetes Clinical Risk Factors among Normotensive Type 2 Diabetes Mellitus among Native Black African Population

Background: Type 2 diabetes mellitus is frequently associated with atherosclerosis with changes in the thickness of the intima-media of carotid arteries which causes increased risk of cardiovascular diseases. Cardiovascular disease is a major cause of morbidity and mortality in this group of patients. The carotid artery reflects the degree of atherosclerosis in the various vessels especially coronary arteries. Measurement of the carotid artery thickness with real time, relatively cheap and non-invasive ultrasonography method is used in monitoring atherosclerotic disease progression and response to treatment. This study is aimed at ultrasonographic evaluation of the carotid intima-media thickness (CIMT) in adult Type 2 Diabetic patients compared to non-diabetic healthy controls matched for age, gender and body mass index (BMI). And to also determine its association if any with selected clinical factors among a native Black African population. Methodology: This was a prospective case control study involving 54 adult type 2 diabetics and 54 adult non-diabetic controls. CIMT was measured at 3 segments of the extracranial carotid arteries by a 7.5 - 10 MHz linear transducer of a portable Mindray M5 ultrasound machine. Results: Among the native black African population studied, there was significant difference in CIMT of adult type 2 diabetics compared to healthy non-diabetics adults (p value = 0.012 and 0.001 on the right and left respectively). The mean carotid intima-media thickness in diabetics was 0.81 mm and 0.85 mm, while in non-diabetics it was 0.74 mm and 0.75 mm on the right and left respectively. The presence of diabetes showed independent positive correlation with CIMT (beta: 0.24, p value = 0.004). Age (beta: 0.30, p value = 0.001) and plasma cholesterol level (beta: 0.30, p value = 0.013) also had positive correlation with CIMT. Conclusion: There was statistically significant difference in carotid intima-media thickness between adult type 2 diabetics and age, sex matched non-diabetics. DM showed independent correlation with CIMT.

Clinical and dietary predictors of common carotid artery intima media thickness in a population with type 1 and type 2 diabetes: A cross-sectional study

AIM To determine the clinical and dietary predictors of common carotid artery intima media thickness(CCA IMT) in a cohort of subjects with type 1 and type 2 diabetes. METHODS Participants with type 1(n = 23) and type 2 diabetes(n = 127) had mean and mean maximum CCA IMT measured using B mode ultrasound. Dietary intake was measured using a food frequency questionnaire. Clinical and dietary predictors of mean and mean maximum CCA IMT were determined using linear regression analysis adjusted for potential confounders. RESULTS The main predictors of mean and mean maximum CCA IMT were age and weight. After multivariate adjustment there were no dietary predictors of CCA IMT. However,in subjects that were not prescribed a lipid lowering medication alcohol consumption was positively associated with CCA IMT after multivariate adjustment. No difference existed in CCA IMT between subjects with type 1 or type 2 diabetes once age was adjusted for. CONCLUSION CCA IMT was predominantly predicted by age and weight in these subjects with diabetes. The finding that CCA IMT was not different between people with type 1 and type 2 diabetes warrants further investigation in a larger cohort.

Determining factors for carotid mean/max intima-media thickness and brachial flow-mediated dilation in healthy young women

Background: Many factors can contribute to atherosclerotic-type vascular changes in older individuals or men. Thus, confining the investigation to young women with no clinical evidence of the condition could enhance understanding of the early stages of cardiovascular disease. The aim of this study was to determine whether carotid mean/max intima-media thickness (IMT) and brachial flow-mediated dilation (FMD) values, which are well-known event-related indices, are associated with laboratory data and the other vascular indices of atherosclerosis in healthy young women. Methods: Carotid mean/max IMT and brachial FMD were measured in young women with no clinical evidence of atherosclerosis (n = 110;mean age, 39 years) who were instructed not to eat, drink or smoke after 9 PM the evening before testing. All participants also underwent laboratory assessment, including simultaneous measurements of arterial stiffness such as augmentation index (AI), cardioankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Results: Mean IMT was signifi-cantly and positively associated with age (p = 0.002), CAVI (p = 0.044), low-density lipoprotein-cholesterol (LDL-C, p = 0.047) and high-sensitive C-reactive protein (hs-CRP, p = 0.002) values but was not related to FMD, AI, baPWV or triglycerides (TG) in the multivariate regression analysis. Similarly, max IMT was positively associated with age (p p = 0.003) and hs-CRP (p = 0.005) values but was not related to FMD, AI, CAVI, baPWV, TG or blood pressure level in the multivariate regression analysis. The association between LDL-C and max IMT was much stronger than that between LDL-C and mean IMT. Brachial FMD was positively associated only with heart rate in the multivariate regression analysis. Conclusions: These results suggest that mean IMT more closely represents the sclerotic aspect of vascular change, whereas max IMT represents the atherotic aspect in healthy young women. Although the relationship between the autonomic nervous system and heart rate is well-known, there may be a complex interaction between the autonomic nervous system and endothelial function.

Relationship between peripheral arterial disease, carotid intima-media thickness and C-reactive protein in elderly diabetic patients

Purpose: To study the association between carotid intima media thickness (CIMT) and high sensitivity CRP (hs-CRP) level as markers for PAD in elderly patients with DM. Subjects: A case-control study on 90 participants aged 60 years and older divided into 60 cases (30 patients with DM alone and 30 patients with DM and comorbidities) and 30 healthy controls. All were assessed by measuring CIMT, ankle brachial index (AB), and markers for cardiovascular disease such as high-sensitivity CRP (hs-CRP), total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), and low density lipoprotein (LDL). Results: hs-CRP levels showed statistically significant difference being highest among patients with DM and comorbidities and lowest among controls (P < 0.001). Also, symptoms of PAD were significantly higher among cases than controls. ABI was able to detect PAD in many asymptomatic patients. Color changes were present in only 43.30% (n = 26) of positive PAD cases while delayed wound healing, claudication pain, rest pain, cold extremities, and trophic changes were present in 23.30% (n = 14), 16.71% (n = 10), 16.71% (n = 10), 45.00% (n = 27), and 21.7% (n = 13). Using logistic regression analysis revealed that DM, CIMT, and hs-CRP were independent predictors for PAD (OR = 4.194, 7.236, 1.003;P value = 0.044, 0.25, 0.031) after adjustment of other coronary risk factors such as sex, smoking, hypertension, TC, and TG. Conclusion: Diabetic elderly have higher prevalence of asymptomatic PAD thannon-diabetics using solely ABI. DM, CIMT, and hs-CRP are independent predictors for the occurrence of PAD. Hs-CRP levels are highest among diabetics with comorbidities.

INTIMA封闭式留置针替代普通输液针进行静脉输液治疗的应用

目的 探讨INTIMA封闭式留置针替代普通输液针进行临床输液治疗的应用效果 ,以利推广使用。方法 5 0例患者为观察组用INTIMA封闭式留置针进行静脉输液 ,70例患者为对照组用普通输液针进行静脉输液治疗 ,对两种输液方法的穿刺次数和液体渗漏等情况进行比较。结果 两组输液方法的穿刺次数经t检验 ,P <0 .0 1,差异有高度显著意义 ;对照组的渗漏率达 6 2 .86 %,观察组的渗漏率为 16 .0 0 %,经卡方检验 ,P <0 .0 1,两组差异有高度显著性意义。结论 以INTIMA封闭式留置针替代普通输液针 ,其操作简便 ,成功率高 ,副作用小 ,减少静脉穿刺次数 ,延长每次静脉穿刺的间隔时间 ,有效提高护理工作效率 ,应在临床上广泛推广应用。

Inhibitory effect of TGF_α-PE40 on neointimal proliferation follow injury to the rabbit common carotid artery

To investigate inhibitory effect of recombinant transforming growth factora-pseudomonas exotoxin fusion protein (TGFInhibitory effect of TGF_α-PE40; TP40) on neointimal proliferation following arterial injury.Methods: Forty-eight male rabbits fed with rich cholesterol diet were randomized into the treatment group(n= 24)and the control group (n=24). The rabbits in the treatment group were treated by local adiministration of TP40 (30 μg) 24 h after arterial injury, and the control group were treated by saline. LM and computer image analysis were used to study the rabbit arterial segments 2, 4 and & weeks after treatment. Results: Irregular thickening of the arterial intima. large amounts of smooth muscle cells within the neointima, and stenosis of the arterial cavity in the control group, and significant inhibition of intimal proliferation and no stenosis of the arterial cavity in the treatment group were observed microscopically. Computer image analysis showed that the neointimal area and the ratio of neointimal/medial area of the treatment group at 2, 4 and 8weeks after treatment were signifantly smaller than those of the control groups (P<0. 01 ). COnclusion: The results suggest that TP40 can significantly inhibit neointimal proliferation following carotid arterial injury.

身体活动水平对2型糖尿病患者颈动脉内膜中层厚度增厚的影响研究

背景心血管疾病是2型糖尿病(T2DM)患者的主要死亡原因,颈动脉内膜中层厚度(CIMT)增厚可预测心血管疾病的发生。中高水平的身体活动(PA)可改善患者的血糖水平并降低心血管疾病的发生率和死亡风险。探讨这一可改变的生活方式与CIMT的关系可能是预防心血管疾病的有效策略。目的分析不同PA水平与T2DM患者CIMT增厚的关系,为患者推荐个性化活动方案提供科学依据。方法本研究为横断面研究,选取2019年1月—2022年2月于江苏省两家三级甲等医院内分泌门诊就诊的3099例T2DM患者为研究对象,采用国际身体活动量表(IPAQ)短问卷评估患者的PA水平,将患者分为轻度及以下PA组、中度PA组和高强度PA组。通过二元Logistic回归分析探讨PA与CIMT增厚的关系,并按照不同肥胖程度和血压、血脂及糖化达标状况进行分层分析。将PA水平作为连续变量绘制限制性立方样条评价PA与CIMT增厚的剂量反应关系。结果与轻度及以下PA患者(n=981)相比,中度(n=1389)和高强度(n=729)PA患者的年龄较小,糖化血红蛋白(HbA_(1c))和低密度脂蛋白胆固醇(LDL-C)水平较高(P<0.05)。二元Logistic回归分析结果显示,中度PA与发生CIMT增厚的风险呈负关联(OR=0.775,95%CI=0.629~0.956,P<0.05),这种关联独立于社会人口学、生活方式及血脂等生化指标。进一步绘制限制性立方样条结果显示,PA与CIMT增厚的风险之间存在非线性关系(P_(非线性)=0.014)。分层分析结果显示,在体质量正常(n=996)和超重(n=1395)的患者中未发现PA与CIMT的关系(P>0.05);而在肥胖患者(n=708)中仅中度PA与CIMT增厚相关(OR=0.614,95%CI=0.382~0.987,P<0.05);血压、血脂及糖化3项指标均不达标(n=324)和仅1项指标达标(n=1416)的患者,中度PA与发生CIMT增厚呈负相关(P<0.05)。结论PA水平与CIMT增厚存在剂量反应关系,中度PA与CIMT增厚呈负相关,尤其是在肥胖、血压、血脂及糖化控制较差的人群中,而高强度PA对CIMT的影响不显著。

All-trans retinoic acid reduces intimal thickening after balloon angioplasty in atherosclerotic rabbits

Objective To investigate the effects of oral administration of all trans retinoic acid (ATRA) on inhibition of intimal thickening after balloon angioplasty in the rabbit iliac artery atherosclerotic model. Methods Iliac atherosclerosis was induced in 24 rabbits, and balloon angioplasty was performed. At angioplasty, 24 rabbits were randomly divided into four groups (n=6 per group): Group 1: controls not receiving oral ATRA administration; Group 2: receiving oral ATRA (0.6 mg·kg 1 ·d 1 ) administration beginning 1 week prior to angioplasty and continuing for 4 weeks; Group 3: receiving oral ATRA (0.6 mg·kg 1 ·d 1 ) administration beginning immediately after angioplasty and continuing for 4 wk; Group 4: receiving oral ATRA (0.6 mg·kg 1 ·d 1 ) administration beginning 1 wk after angioplasty and continuing for 4 wk. Values of cross sectional area, ratio of intimal/medial area and thickness were determined by a computer based morphometric system, and cell proliferative activity was assessed by 3 H thymidine incorporation.Results Both the cross sectional area and the ratio of intimal/medial area and thickness were significantly reduced by ATRA administration compared with control group (P<0.01). The inhibitory effect is less potent when ATRA is administered 1 week before angioplasty. The ATRA inhibitory effect when administered 1 week after angioplasty is not different significantly form that when administered immediately after angioplasty. The 3H thymidine incorporation was also decreased in ATRA treated rabbits compared with controls (P<0.01). Conclusions Oral ATRA administration can be effective in inhibiting intimal thickening after balloon angioplasty. It is reasonable that ATRA should be administered immediately after angioplasty.

Association between fasting and postprandial triglyceride levels and carotid intima-media thickness in type 2 diabetes patients

OBJECTIVE: To investigate the association of fasting and postpiandial triglyceride with carotid intima-media thickness among type 2 diabetic patients in southeast China. METHODS: A total of 78 type 2 diabetic patients from southeast China were recruited. All the subjects underwent a standardized mixed-meal test (SMMT) and an oral glucose tolerance test. Carotid intima-media thickness (IMT) was measured by color doppler ultrasound examination. RESULTS: Postprandial triglyceride (PTG) after SMMT increased significantly in type 2 diabetic patients. The carotid IMT in patients with postprandial hypertriglyceridemia was significantly greater than that in patients with postprandial normal-triglyceridemia (0.90 mm vs 0.81 mm, P 0.05). CONCLUSION: The results suggest that postprandial hypertriglyceridemia may be an independent risk factor of early atherosclerosis in type 2 diabetes.

Association among plasma interleukin-18 levels, carotid intimamedia thickness and severity of obstructive sleep apnea

Background Epidermic studies have suggested a pathophysiological link between obstructive sleep apnea hypopnea syndrome （OSAHS） and atherosclerosis （AS）; for which carotid intima-media thickness （IMT） has been considered as an early marker. The pathogenesis by which OSAHS can induce AS has not been elucidated. This study was conducted to investigate the association among plasma interleukin-18 （IL-18） levels, carotid IMT and the severity of OSAHS. Methods Based on the apnea hypopnea index （AHI） during sleep monitored by polysomnography, 52 male patients with OSAHS were recruited as the OSAHS group which was further divided into mild OSAHS （n=16）, moderate OSAHS （n=18）, and severe OSAHS （n=18） subgroups. Eighteen healthy subjects were selected as the control group. Of all OSAHS patients, 20 with moderate-to-severe OSAHS underwent continuous positive airway pressure （CPAP） treatment for 90 days. HDL5000 color Doppler ultrasonography was used to measure carotid IMT. Plasma IL-18 levels were measured bv ELISA.Results Compared with the plasma IL-18 levels in the control group （（250.27±76.48） pg/ml）, there was a significant increase in the mild OSAHS subgroup （（352.08±76.32） pg/ml）, the moderate subgroup （（600.17±83.91） pg/ml）, and the severe OSAHS subgroup （（9797.64 ± 109.83） pg/ml） （all P〈0.01）. Moreover, there was a significant difference in plasma IL-18 levels among the three OSAHS subgroups （P〈0.01）. Carotid IMT was significantly greater in the severe OSAHS subgroup than in the mild OSAHS subgroup （P〈0.01）. Before CPAP treatment, plasma IL-18 levels were positively correlated with carotid IMT （r=0.486, P 〈0.001） and with AHI （r=0.865, P〈0.001）. On day 90 of CPAP treatment, plasma IL-18 levels were significantly declined but carotid IMT was not changed significantly. Conclusions In untreated OSAHS patients carotid IMT and plasma IL-18 were positively correlated and were significantly higher than in normal controls; the elevation of plasma IL-18 levels was correlated with the severity of OSAHS. Inflammatory response associated with OSAHS may be related to the development of AS. By improving AHI, miniSaO2, and reducing plasma IL-18 levels, CPAP treatment may slow down or prevent the development of AS in OSAHS patients.

Effect of short term intensive multitherapy on carotid intima-media thickness in patients with newly diagnosed type 2 diabetes mellitus

Background Controlling plasma glucose levels, blood pressure and lipid levels is proven to reduce the risk of vascular complications in patients with type 2 diabetes mellitus. This has prompted intensive multitherapy targeted at several macrovascular risk factors. Carotid intima-media thickness （cIMT） is a reliable measure of early atherosclerosis. We sought to determine whether a 6-month intensive mutiltherapy program resulted in better goal attainment than usual care and its effect on the development of cIMT among patients with newly diagnosed type 2 diabetes mellitus. Methods The study randomly assigned 220 patients with newly diagnosed type 2 diabetes mellitus to intensive or traditional therapy groups. The clinical parameters, such as fasting plasma glucose, total cholesterol, triglyceride, blood pressure, body weight and insulin were assessed at the baseline and after the 6-month therapy, cIMT of the patients was also obtained. Results The average levels of fasting plasma glucose, hemoglobin Alc, total cholesterol （TC） and low-density lipoprotein cholesterol （LDL-C） in the intensive group were significantly lower than those in the control group at the end of 6-month treatment. By 6 months, a higher proportion of patients in the intensive therapy group than in the control group attained goals for fasting plasma glucose （FPG）, TC, LDL-C and hemoglobin Alc. With intensive multherapy the level of carotid intima-media thickness in the intensive therapy group was lower than that in the control group （（0.88±0.26） mm vs （0.96±0.22） mm, P 〈0.01）. Conclusions The evidence from this clinical trial demonstrates that intensive glucose, lipid and blood pressure control in patients with newly diagnosed type 2 diabetes is associated with diabetic macrovascular benefits. Intensive multitherapy allows more patients to achieve aims of control and may reduce macrovascular complications and delay disease progression.

Association between Carotid Intima-media Thickness and Aldehyde Dehydrogenase 2 Glu504Lys Polymorphism in Chinese Han with Essential Hypertension

Background： Aldehyde dehydrogenase 2 （ALDH2） is involved in the pathophysiological processes of cardiovascular diseases. Recent studies showed that mutant ALDH2 could increase oxidative stress and is a susceptible factor for hypertension. In addition, wild-type ALDH2 could improve the endothelial functions, therefore reducing the risk of developing atherosclerosis. The aim of the present study was to explore the frequency of the Glu504Lys polymorphism of the ALDH2 gene and its relation to carotid intima-media thickness （CIMT） in a group of patients with essential hypertension （EH） and to investigate the association between the Glu504Lys polymorphism and CIMT in Chinese Han patients with EH. Methods： In this study, 410 Chinese Han patients with EH who received physical examinations at the People＇s Hospital of Sichuan Province （China） were selected. DNA microarray chip was used for the genotyping of the Glu504Lys polymorphism of the ALDH2 gene. The differences in CIMT among patients with different Glu504Lys ALDH2 genotypes were analyzed. Results： The mean CIMT of the patients carrying AA/AG and GG genotypes was 1.02 ± 0.31 mm and 0.78 ±0.28 mm, respectively. One-way ANOVA showed that the CIMT of the patients carrying the AA/AG genotype was significantly higher than in the ones carrying the GG genotype （P 〈 0.001）. Multivariate logistic regression showed that the Glu504Lys AA/AG genotype of the ALDH2 gene was one of the major factors influencing the CIMT in patients with EH （odds ratio = 3.73 l, 95% confidence interval = 1.589-8.124, P = 0.001）. Conclusions： The Glu504Lys polymorphism of the ALDH2 gene is associated with the CIMT of Chinese Han patients with EH in Sichuan, China.