Cellular mechanosignaling in pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a vasculopathy characterized by sustained elevated pulmonary arterial pressures in which the pulmonary vasculature undergoes significant structural and functional remodeling. To better understand disease mechanisms, in this review article we highlight recent insights into the regulation of pulmonary arterial cells by mechanical cues associated with PAH. Specifically, the mechanobiology of pulmonary arterial endothelial cells (PAECs), smooth muscle cells (PASMCs) and adventitial fibroblasts (PAAFs) has been investigated in vivo, in vitro, and in silico. Increased pulmonary arterial pressure increases vessel wall stress and strain and endothelial fluid shear stress. These mechanical cues promote vasoconstriction and fibrosis that contribute further to hypertension and alter the mechanical milieu and regulation of pulmonary arterial cells.     

慢性下肢静脉曲张性溃疡的病原菌分布及耐药性分析

目的观察绍兴市人民医院血管外科慢性下肢静脉曲张性溃疡（CLU）患者的病原菌分布以及耐药特点,为临床合理用药提供依据。方法对该院血管外科2012年1月至2013年12月的CLU患者,其溃疡面渗出物培养出的病原菌及耐药性进行回顾性分析。结果病原菌分布较广泛,以铜绿假单胞菌和金黄色葡萄球菌为主。金黄色葡萄球菌对青霉素G的耐药率最高,达到97.37%,对红霉素和克林霉素的耐药率分别为60.53%和55.26%,对利奈唑烷和万古霉素全部敏感。铜绿假单胞菌对抗生素的敏感性较好。结论 CLU患者感染的病原菌分布广泛,且易多重感染,临床在采用外科治疗的同时,宜合理使用抗生素,针对不同患者采取个体化、系统化治疗方案,以提高治愈率,降低复发率。     

A case of sparganosis mimicking a varicose vein

Recent advances in radiological and serological techniques have enabled easier preoperative diagnosis of sparganosis. However, due to scarcity of cases, sparganosis has been often regarded as a disease of other etiologic origin unless the parasite is confirmed in the lesion. We experienced a case of sparganosis mimicking a varicose vein in terms of clinical manifestations and radiological findings. Sparganosis should be included among the list of differential diagnosis with the varicose vein.     

医用弹力袜在下肢静脉曲张手术中的应用价值

目的:评价医用弹力袜在下肢静脉曲张手术中的应用价值.方法:在下肢静脉曲张手术中应用医用弹力袜,于同期使用传统弹力绷带治疗的患者进行对比.结果:使用医用弹力袜患者的术后平均住院日、并发症均少于使用传统弹力绷带治疗患者.结论:医用弹力袜在下肢静脉曲张手术中的应用可以有效地缩短住院日,减轻术后不适感,值得在临床推广.     

Venous endothelium reactivity to Angiotensin II: A study in primary endothelial cultures of rat vena cava and portal vein

The role of the vascular endothelium in modulating the arterial system has been widely investigated, but poorly explored at the venous site. In the present work, primary cultures of venous endothelium from rat Vena Cava (VC) and Portal Vein (PV) were established, characterized and analyzed according to their growth pattern and ability to produce nitric oxide (NO) and prostanoids (PGF_{2 α} and PGI₂), at basal state and after stimulation with Angiotensin II (Ang II, 1 μmol/L). Basal NO was detected in all examined cells in culture. Pre-incubation with Ang II increased NO production in cells from VC (but not in PV cultures), through activation of both AT₁ and AT₂ receptors. Both cultures exhibited detectable levels of PGF_{2 α} at resting conditions, which were similarly enhanced by Ang II. Basal PGI₂ levels were higher in PV, but increased after Ang II treatment in VC, with no further effect on PV cells. We conclude that endothelial cells from VC and PV exhibit important properties and react to Ang II, probably influencing the whole circulatory system. This experimental cell model gives support to further studies concerning intracellular pathways of the venous endothelium, analyzed in separate from the vascular smooth muscle wall.     

Evaluation of the smooth muscle cell component and apoptosis in the varicose vein wall

This study was designed to evaluate the role of the smooth muscle cell and the apoptosis in the pathogenesis of the varicose vein. Segments of saphenous vein were obtained from healthy subjects and from those with varicose veins. The vein specimens were subdivided according to subject age (younger or older than 50 years) and according to the varicose vein source (distal or proximal). Morphological, ultrastructural, cell proliferation (anti-PCNA method) and cell death (TUNEL method) analysis were performed. The walls of healthy, control vein specimens acquired a more collagenous and papillomatous appearance with age. A slight increase in the number of TUNEL-positive cells was also observed in specimens from older subjects. The proportion of apoptotic cells was much greater in the varicose veins than in control specimens. Most cellular alterations were seen in proximal varicose segments obtained from young subjects. These specimens showed hypertrophic areas with a high degree of cellularity (both in the media and in the thickened intima). The highest proportion of apoptotic cells and collagenisation were also observed in these areas. The enhanced number of apoptotic cells in varicose veins observed mainly in proximal/young vein specimens could be responsible, at least in part, for the acceleration of the final fibrosclerotic process characteristic of the varicose vein wall.     

Generation of reactive oxygen species by a sufficient, insufficient and varicose vein wall

Despite numerous theories, the etiology and pathogenesis of primary varicose veins remain unclear. The etiology of chronic venous diseases (CVDs) known as chronic venous insufficiency (CVI) is related to leukocyte trapping. Leukocyte trapping involves trapping of white cells in vessel walls followed by their activation and translocation outside the vessel. Release of reactive oxygen species (ROS) from trapped white cells has been documented. Superoxide dismutase (SOD) directly inhibits the generation of free radicals and compounds that are produced during oxidation by ROS, such as malonyldialdehyde (MDA). The aim of this study was to determine the involvement of free radicals in the etiology of venous changes. The following material was used for the study: fragments of sufficient or insufficient venous system and varices from 31 patients diagnosed with chronic venous disease in the 2nd or 3rd degree, according to clinical state, etiology, anatomy and pathophysiology (CEAP), which were qualified for surgical procedure. The levels of oxidative stress markers strongly correlated with lesions observed by USG in insufficient and varicose veins. In both a higher concentration of MDA was observed, which is a sign of lipid peroxidation. Antioxidative mechanisms, SOD activity and total antioxidative power expressed as FRAP were inversely proportional to MDA concentration. In insufficient and varicose veins both FRAP and SOD activities were significantly lower than in normal veins. The severity of clinical changes was inversely dependent on the efficiency of scavenging of ROS, which additionally proves the participation of free radicals in pathogenesis of CVDs.     

Role of fatty infiltration in pathology of malaria

Blood induced P. yoelii nigeriensis infection in Swiss mice has been found to be a very useful model for studying the process of fatty infiltration in both liver and kidney. The fatty infiltration may be due to the involvement of malaria toxins.     

脂质过氧化物酶体增殖物激活受体在心脏生理与病理中的作用

心肌能量代谢状况是其结构与功能的重要决定因素,调节能量代谢是心脏疾病的有效疗法之一.脂质过氧化物酶体增殖物激活受体(PPARs)是一组具有复杂功能的核受体超家族成员,与脂肪形成、糖脂代谢、炎症及肿瘤发生等多种生物过程有关.PPARs可通过调控编码脂肪酸与糖类氧化相关酶的基因转录而调节心肌代谢,在心脏多种疾病病理过程中其表达与活性均有明显变化,因此已被作为心脏病的治疗靶点之一.本文对PPARs在心脏生理与病理中的作用进行简要介绍.     

The determination of the collagen and elastin amount in the human varicose vein by the computer morphometric method

The results of the works dealing with alterations of the connective tissue in varicose vein wall are not ambiguous, so the exact cause of the vein dilatation has still not been established. We were determining the collagen and elastin amounts in human varicose vein wall in comparison with non-dilated long saphenous vein by the light microscopy and computer morphometric method. We have found the lesser amount of collagen in varicose veins than in non-dilated veins, the amounts of the elastin in both the varicose and non-varicose veins were without the statistical significance.