Research progress of magnetic resonance imaging on the correlation between coronary plaque properties and pericoronal fat

Because of the small size of coronary plaque and its continuous beating with the heart,the assessment of the nature of coronary atherosclerotic plaques by magnetic resonance imaging remains a challenge in current research.Recent studies have shown that changes in the pericoronary fat environment are closely related to the nature of coronary atherosclerotic plaques.At present,the new multi-modal magnetic resonance technology can quantitatively assess the changes of pericorral fat environment,which is expected to effectively evaluate the properties of coronary artery plaque.Therefore,it is of greater clinical importance to study pericoronary fat.Advances in the biological significance of pericoronary fat,comparative imaging for pericoronary fat assessment and clinical applications of its imaging will be reviewed.

M3 Muscarinic Acetylcholine Receptor Antagonist Darifenacin Protects against Pulmonary Fibrosis through ERK/NF-κB/miR-21 Pathway

Idiopathic pulmonary fibrosis is an untreatable lethal lung disease, which is related to the aberrant proliferation of fibroblasts. M3 muscarinic acetylcholine receptor (M3-mAChR) activation exerts proliferative effect on various kinds of cells. However, whether M3-mAChR inhibition has a protective effect on pulmonary fibrosis remains unexplored. A rat model of pulmonary fibrosis was established by intratracheal instillation of bleomycin. Darifenacin was used to block M3-mAChR. Histological changes were observed using Masson’s Trichrome and hematoxylin and eosin (HE) staining. Hydroxyproline was measured by Hydroxyproline detection kit. Transforming growth factor β1 (TGF-β1) and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA). In vitro, pulmonary fibroblasts were isolated from lungs of neonatal rat. After treatment, the cell viability, Hydroxyproline level was measured by MTT and Hydroxyproline detection kit respectively. The expression level of extracellular signal-regulated kinase (ERK), nuclear factor kappa-B (N-NF-κB), and microRNA-21 (miR-21) was detected by western blot or quantitative real-time PCR (qRT-PCR). Darifenacin relieved the fibrotic effects provoked by bleomycin. The expression level of hydroxyproline, TGF-β1 and TNF-α level was all downregulated after darifenacin treatment. In lung fibroblasts, darifenacin decreased cell viability and hydroxyproline level induced by bleomycin. Besides, phosphorylation-ERK and nuclear N-NF-κB protein level was downregulated, as well as miR-21 level. M3-mAChR antagonist darifenacin attenuates bleomycin-induced pulmonary fibrosis in rats, which may relate to the ERK/NF-κB/miRNA-21 signaling pathway.

Effect of Epalrestat combined with Huoxue Huayu preparation on early diabetic retinopathy and its effect on serum oxidative stress and inflammatory factors

Objective:To investigate the effect of Epalrestat combined with Huoxue Huayu preparation on early diabetic retinopathy and its effect on serum oxidative stress and inflammatory factors.Methods:132 patients with early diabetic retinopathy from June 2017 to July 2019 in our hospital were randomly divided into the control group(66 cases)and the observation group(66 cases);The control group was treated with epalrestat,and the observation group was treated with epalrestat combined with ginkgo damo injection;The treatment effect,blood rheology indexes,serum oxidative stress indexes and inflammatory factor indexes of the two groups were compared.Results:The treatment efficiency of the observation group(96.96%)was significantly higher than that of the control group(84.84%)(P<0.05).After 3 months of treatment,the high-cut whole blood viscosity(3.62±0.45 mPa/s),low-cut whole blood viscosity(1.54±0.26 mPa/s),erythrocyte sedimentation rate(15.63±2.97 mm/s)of the observation group compared with the control group(4.57±0.52 mPa/s,2.91±0.30 mPa/s,22.36±3.38 mm/s)were significantly lower(P<0.05).After 3 months of treatment,the SOD(93.41±10.17 nmol/mL)and TAC(20.57±3.76 u/mL)of the observation group compared with the control group(82.26±9.45 nmol/mL,18.26±3.63 u/mL)were significantly higher(P<0.05),and the MDA of the observation group(9.22±1.98 u/mL)was significantly lower than that of the control group(12.13±1.06 u/mL)(P<0.05).After 3 months of treatment,the CRP(9.74±1.12 mg/L),IL-2(70.37±12.13 ng/L),TNF-a(11.36±2.08 ng/L)of the observation group compared with the control group(15.28±1.73 mg/L L,82.46±10.58 ng/L,16.28±2.43 ng/L)were significantly lower(P<0.05).Conclusion:Epalrestat combined with Huoxue Huayu preparation is more effective in the treatment of early diabetic retinopathy,and can significantly improve the blood rheology indexes,serum oxidative stress indexes and inflammatory factor indexes of patients.

Prevalence of polymyxin-induced nephrotoxicity and its predictors in critically ill adult patients:A meta-analysis

BACKGROUND Polymyxin-induced nephrotoxicity is a major safety concern in clinical practice due to long-term adverse outcomes and high mortality.AIM To conducted a systematic review and meta-analysis of the prevalence and potential predictors of polymyxin-induced nephrotoxicity in adult intensive care unit(ICU)patients.METHODS PubMed,EMBASE,the Cochrane Library and Reference Citation Analysis database were searched for relevant studies from inception through May 30,2022.The pooled prevalence of polymyxin-induced nephrotoxicity and pooled risk ratios of associated factors were analysed using a random-effects or fixed-effects model by Stata SE ver.12.1.Additionally,subgroup analyses and meta-regression were conducted to assess heterogeneity.RESULTS A total of 89 studies involving 12234 critically ill adult patients were included in the meta-analysis.The overall pooled incidence of polymyxin-induced nephrotoxicity was 34.8%.The pooled prevalence of colistin-induced nephrotoxicity was not higher than that of polymyxin B(PMB)-induced nephrotoxicity.The subgroup analyses showed that nephrotoxicity was significantly associated with dosing interval,nephrotoxicity criteria,age,publication year,study quality and sample size,which were confirmed in the univariable meta-regression analysis.Nephrotoxicity was significantly increased when the total daily dose was divided into 2 doses but not 3 or 4 doses.Furthermore,older age,the presence of sepsis or septic shock,hypoalbuminemia,and concomitant vancomycin or vasopressor use were independent risk factors for polymyxin-induced nephrotoxicity,while an elevated baseline glomerular filtration rate was a protective factor against colistin-induced nephrotoxicity.CONCLUSION Our findings indicated that the incidence of polymyxin-induced nephrotoxicity among ICU patients was high.It emphasizes the importance of additional efforts to manage ICU patients receiving polymyxins to decrease the risk of adverse outcomes.

Study of the AQP4 expression in traumatic brain edema and multimodal MRI imaging

The aquaporin-4(AQP4)is a highly selective membrane protein.It is important for the body to maintain the water balance between internal and external environment of cells,the studies have found that the abnormal expression of AQP4 is related to the occurrence of many diseases.The cerebral edema is the most common and serious complication of brain trauma,and its pathogenesis is closely related to AQP4.The development of multimodal magnetic resonance imaging(M-MRI)could been provided imaging basis for accurate diagnosis of traumatic brain edema.In recent years,the correlation between AQP4 and M-MRI has become a hotspot of research.This paper reviews the research progress on the correlation between AQP4 expression in traumatic cerebral edema and M-MRI.

Effect and mechanism of dexmedetomidine on ischemic arrhythmia

Objective:To explore the antiarrhythmic effect and mechanism of dexmedetomidine,a myocardialα2 receptor agonist in vitro.Methods:Fifty Wistar rats were randomly divided into five groups(n=10):sham operation group(Ctl),arrhythmia model group(Model),arrhythmia+dexmedetomidine group(Dex),arrhythmia+yohimbine+dexmedetomidine group(Yoh+Dex),arrhythmia+yohimbine group(Yoh).The Ctl group just thread left anterior descending coronary artery without ligation.Model group recorded 10 minutes of normal ECG,ligated the left anterior descending coronary artery,and continued to record the ECG for 2 hours.Dex group,Yoh+Dex group and Yoh group were ligated left anterior descending coronary artery after administration.Use BL-420E system to record ECG;Curtis and Walker arrhythmia scores were used to analyze the severity of arrhythmia;perform survival analysis according to the life span of each group of rats;after 21 days of modeling,measure the area of myocardial infarction by TTC staining.The pH value of extracellular fluid was decreased to simulate myocardial ischemia.Patch clamp technique was used to detect the action potential duration of myocardial cells.Results:Compared with the Ctl group,the arrhythmia score and myocardial infarction area in the Model group was increased(P<0.05),the mortality and myocardial infarction area were alsosignificantly reduced(P<0.05).Compared with Model group and Yoh group,the arrhythmia score of Dex group was significantly lower(P<0.001),the mortality and myocardial infarction area were significantly lower(P<0.05);Dexmedetomidine shortened QTc interval(P<0.01),APD50 and APD90(P<0.05).The α_(2) receptor blocker Yohimbine inhibited the effect of dexmedetomidine.Conclusion:Dexmedetomidine affects the action potential repolarization process by stimulating myocardial α_(2) receptors,and prevents ischemia-induced ventricular arrhythmia.