超声造影技术评价颈动脉粥样硬化斑块稳定性的临床研究

目的:探讨超声造影技术评价颈动脉粥样硬化斑块稳定性的临床价值,为动脉粥样硬化诊断准确性提供参考。方法:根据实时超声造影检查的回声图像特点将该院53例(59个斑块)颈动脉粥样硬化斑块患者分为软斑组(24个)、混合斑组(18个)、硬斑组(17个),比较3组的造影增强率、造影增强程度分级,并对各类型斑块的时间-强度进行定量分析。结果:59个斑块中有40个呈现不同程度的增强,增强率为67.80%,其中软斑组、混合斑组、硬斑组超声增强率分别为87.50%、72.22%、35.29%,差异具有统计学意义(P0.05);造影增强程度Ⅰ级和Ⅲ级在三组间差异具有统计学意义(P0.05),其中硬斑组造影增强程度Ⅰ级个数较软斑组和混合斑组多,软斑组造影增强程度Ⅲ级个数较混合斑组和硬斑组多,差异均有统计学意义(P0.05);软斑组达峰时间、平均渡越时间均低于混合斑组和硬斑组,斑块峰值强度高于混合斑组和硬斑组,混合斑组达峰时间、平均渡越时间均低于硬斑组,斑块峰值强度高于硬斑组,差异均具有统计学意义(P0.05)。结论:超声造影技术可无创性地通过造影增强实时反映出颈动脉粥样硬化斑块内的新生血管情况,提供参数成像与定量分析,正确评价斑块的稳定性。     

Behavior of spindles and spindle plaques in the cell cycle and conjugation of Saccharomyces cerevisiae.

The interdependence of spindle plaque with other aspects of cell division and conjugation in Saccharomyces cerevisiae has been investigated. Three forms of the spindle plaque appear sequentially before the formation of the complete, intranuclear spindle. The single plaque is present initially in the mitotic cycle; it becomes transformed into a satellite-bearing single plaque during the latter part of G1. Subsequently, plaque duplication yields the double plaque characteristic of the early phase of budding, which coincides with the period of chromosome replication (S). The eventual separation of these plaques to form a complete spindle, with a single plaque at each pole, is nearly coincident with the completion of S. The form of the plaque differs in two independent cases of G1 arrest: the single plaque is found in a cell in stationary arrest of growth, whereas a cell arrested by mating factors in preparation for conjugation contains a satellite-bearing single plaque. The latter form is retained during zygote formation, where it serves as the initial site of fusion of each prezygotic nuceus with the other. This fusion results in the formation of a single zygotic nucleus with a satellite-bearing single plaque, which is subsequently transformed into a double plaque as the zygote buds. The double plaque is situated adjacent to the site of bud emergence in both vegetative cells and zygotes.     

Molecular mechanisms of plaque instability

PURPOSE OF REVIEW: Coronary artery thrombosis superimposed on a disrupted atherosclerotic plaque initiates abrupt arterial occlusion and is the proximate event responsible for 60-80% cases of acute coronary syndromes. This article provides a concise update on the evolving concepts in the pathophysiology of plaque rupture and thrombosis. RECENT FINDINGS: Over the past several years, the critical role of plaque composition rather than plaque size or stenosis severity, in plaque rupture and thrombosis have been recognized. The necrotic lipid core and plaque inflammation appear to be key factors. Extracellular matrix loss in the fibrous cap, a prelude to rupture, is attributed to matrix degrading enzymes as well as to death of matrix synthesizing smooth muscle cells; inflammation appears to play a critical role in both these processes. Inflammatory cell derived tissue factor is a key contributor to plaque thrombogenicity. Inflammation has also been implicated in plaque neovascularity, intraplaque hemorrhage and plaque expansion. Recent observations have also highlighted the important modulatory role of immune system in atherosclerosis and plaque composition. SUMMARY: Improved understanding of mechanisms causing plaque instability should provide novel insights into prevention of athero-thrombotic cardiovascular events.     

急性脑梗死患者颈动脉斑块内新生血管超声造影评价及其与血脂指标和超敏C反应蛋白水平的关系研究

目的:探讨急性脑梗死患者颈动脉斑块内新生血管超声造影评价及其与血脂指标和超敏C反应蛋白水平的关系。方法:选取2018年6月到2019年6月期间我院收治的ACI患者186例,根据患者的颈动脉内中膜厚度(IMT)数值以及颈动脉斑块内新生血管超声造影情况将其分为无斑块组、稳定斑块组和易损斑块组。对比各组患者的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、美国国立卫生研究院卒中量表(NIHSS)评分、改良的Rankin评分(m RS)、超敏C反应蛋白(hs-CRP)水平。结果:易损斑块组和稳定斑块组患者的TC、LDL-C、TG、hs-CRP水平均明显高于无斑块组(P<0.05),易损斑块组患者的LDL-C、hs-CRP水平均明显高于稳定斑块组(P<0.05),易损斑块组和稳定斑块组患者的NIHSS评分和m RS评分均明显高于无斑块组(P<0.05),易损斑块组患者的NIHSS评分和m RS评分均明显高于稳定斑块组(P<0.05),经Pearson分析显示,LDL-C、hs-CRP、NIHSS评分和m RS评分与斑块分级均呈正相关(P<0.05)。结论:颈动脉斑块内新生血管超声造影技术可有效评估ACI患者的斑块稳定性,ACI患者的斑块分级与脂代谢紊乱、机体的炎症反应以及患者病情严重程度和预后均存在一定的相关性。     

小型猪动脉粥样硬化斑块稳定性模型研究

目前已有的动物模型在研究动脉粥样硬化斑块破裂、破裂的可控性及量化研究方面均不能满足研究的需要.为了建立类似于人类动脉粥样硬化病变的斑块模型,体外研究斑块稳定性,应用传统的高脂高胆固醇膳食诱导建立了小型猪动脉粥样硬化模型,并从血脂水平和斑块病理形态学特征方面加以了证实.该模型中斑块与人类成熟斑块的高度相似性使其成为研究斑块稳定性和斑块破裂的较好模型.从量化比较这一出发点着手,建立了一个体外可控可量化诱导斑块破裂模型,方法简单易行,是一个较好的量化研究斑块破裂和破裂相关因素间关系的实验模型.     

Effects of Iron and Manganese Plaques on Arsenic Uptake by Rice Seedlings (Oryza sativa L.) Grown in Solution Culture Supplied with Arsenate and Arsenite

We have shown previously that phosphorus nutrition and iron plaque on the surface of rice roots influence arsenate uptake and translocation by rice in hydroponic culture. We have now investigated the role of iron (Fe) and manganese (Mn) plaque on arsenate and arsenite uptake and translocation in rice seedlings grown hydroponically. Fe and Mn plaques were clearly visible as reddish or brown coatings on the root surface after 12 h induction, and Fe plaque was much more apparent than Mn plaque. Arsenite or arsenate supply did not decrease plant dry weights significantly. There were significant differences in shoot dry weights but little difference in root dry weights between some plaque treatments. Arsenic (As) concentrations in Fe plaque when arsenate was supplied were significantly higher than those in no plaque (control) and Mn plaque treatments, and much higher than those supplied with arsenite. This showed that Fe plaque on the rice root had higher affinity to arsenate than to arsenite. In Fe plaque treatment, the results indicated that most As was sequestered in roots when arsenite was supplied and most As concentrated in Fe plaque when arsenate was supplied. Most As was accumulated in rice roots in Mn plaque and no plaque treatments for both As species.     

湿地植物根表铁膜研究进展

为了适应渍水环境,许多湿地植物都具有根系泌氧、形成铁膜的能力。因铁膜具有特殊的物理或化学结构,可以通过吸附和共沉淀作用影响元素在土壤中的化学行为和生物有效性,在植物吸收营养元素和重金属中起重要作用。综述了湿地植物根表铁膜的形成、影响因素以及根表铁膜对营养元素和重金属的生态环境效应,从表征技术方面阐述了根表铁膜的作用机制。对今后的研究方向给出如下建议:(1)扩大研究领域;(2)铁膜形成的动态变化过程;(3)铁膜对植物生理形态的影响;(4)利用先进的表征技术以确定铁膜的作用机制。     

动脉粥样硬化易损斑块的核医学和磁共振分子影像学研究进展

动脉粥样硬化分子影像学通过使用具有敏感性和特异性影像对比的分子探针针对动脉粥样硬化斑块相关的特定分子进行分子成像.该方法会极大地提高对动脉粥样硬化病变特性的检测水平和增强对该病变特征,尤其对斑块的组成成份的识别能力.斑块的组成成份和斑块的破裂、斑块的易损性以及斑块破裂后导致的结果密切相关.因此了解斑块组成成份的在体无创性检测将对动脉粥样硬化病人的治疗和判断预后产生非常重要的临床应用价值.     

不同程度内质网应激对ApoE-/- 小鼠动脉粥样硬化斑块稳定性的影响

目的:采用Apo E-/-小鼠建立不稳定动脉粥样硬化斑块模型,给予不同剂量衣霉素,观察其对动脉粥样硬化斑块稳定性的影响。方法:取40只6-8周的Apo E-/-小鼠随机分为对照组和手术组。对照组小鼠给予正常饮食;手术组小鼠行右侧颈总动脉套管术(Perivascular carotid collar placement,PCCP),同时给予高脂喂养。9周末分别取对照组和手术组小鼠颈动脉,HE染色观察小鼠颈动脉斑块形成情况。成功造模后,将小鼠随机分为正常对照组、单纯PCCP组、小剂量衣霉素组和大剂量衣霉素组;正常对照组和单纯PCCP组给予生理盐水腹腔注射,小剂量衣霉素组和大剂量衣霉素组分别给予小剂量衣霉素、大剂量衣霉素腹腔注射。2周后,处死小鼠,通过HE染色观察颈动脉斑块形态,油红O染色观察斑块内脂质聚集,抗巨噬细胞免疫组化染色观察斑块内巨噬细胞聚集,Western-blot检内质网应激标志蛋白GRP78和自噬标志蛋白Atg7、P62的表达水平。结果:HE染色结果显示:与单纯PCCP组和大剂量衣霉素组相比,小剂量衣霉素组颈动脉腔内的斑块脂质池减少,斑块结构较为完整且相对稳定;油红O染色结果显示:小剂量衣霉素组斑块内脂质含量显著降低(P0.05 vs单纯PCCP组和大剂量衣霉素组);巨噬细胞免疫组化染色显示:与单纯PCCP组和大剂量衣霉素组相比,小剂量衣霉素组斑块内巨噬细胞的含量显著降低(P0.05);Western-blot结果显示:小剂量衣霉素干预诱导的一定程度的内质网应激可以适度上调自噬(P0.05 vs单纯PCCP组和大剂量衣霉素组)。结论:PCCP手术加高脂饮食可以短期成功建立小鼠不稳定动脉粥样硬化斑块模型,其动脉粥样硬化斑块不稳定性较高,而小剂量衣霉素干预可以使得颈动脉管腔内斑块相对较小,内部脂质池明显较小,纤维帽变厚且结构更完整,斑块结构较稳定;斑块内脂质含量降低;巨噬细胞含量明显降低,且小剂量衣霉素组自噬水平适度上调。因此,小剂量衣霉素干预引起的适度的内质网应激一定程度对动脉粥样硬化斑块起到保护作用。     

卡托普利试验过程中颈动脉斑块与醛固酮含量相关指标变化的相关性研究

目的:研究卡托普利试验过程中血浆醛固酮(PAC)相关指标的变化与颈动脉斑块的相关性。方法:选择在本院住院进行高血压病因筛查并完成了卡托普利试验,且颈动脉彩超资料完整的83例患者为研究对象。以颈动脉彩超诊断结果为分组标准,有颈动脉斑块者为斑块组(57例),无颈动脉斑块者为无斑块组(26例),分析两组患者PAC、血浆肾素活性(PRA)、PAC与PRA的比值(ARR)等指标的变化与颈动脉斑块之间的相关性。结果:颈动脉斑块检出率为68.67%。与无斑块组比较,斑块组患者的年龄更大,载脂蛋白A1(APOA1)水平更低(P均<0.05),卡托普利试验前后斑块组患者的ARR差值更低,PAC及PRA的差值更大(P均<0.05);其中,斑块组PAC及PRA的差值为正;无斑块组此二差值为负,斑块组ARR的差值为负,无斑块组该差值为正。Logistic回归分析表明,在排除了性别等因素之后,仅年龄、卡托普利试验前后PAC差值及ARR差值为颈动脉斑块形成独立的危险因素。结论:在进行高血压病因筛查的住院高血压患者中,颈动脉斑块的检出率较高,卡托普利试验前后PAC的差值及ARR的差值为颈动脉斑块形成独立的危险因素。     

Detection of dental plaque and its potential pathogenicity using quantitative light‐induced fluorescence

Quantitative light‐induced fluorescence (QLF) technology can detect some dental plaque as red fluorescence. This in vivo study aimed to identify the microbial characteristics of red fluorescent (RF) dental plaque using 16S rRNA gene sequencing and evaluate the correlations between RF plaque and the clinical symptoms of dental diseases. Paired supragingival plaque samples collected from each 10 subjects and consisted of RF and non‐RF dental plaques as observed by QLF technology using a 405 nm blue light source for excitation. The characteristics of the bacterial communities in the RF and non‐RF plaque samples were compared by sequencing analysis. An increase in microbial diversity was observed in RF plaque compared with the non‐RF plaque. There were significant differences in the community compositions between the 2 types of dental plaque. Periodontopathic bacteria were significantly more abundant in the RF plaque than non‐RF plaque. The fluorescence intensity of RF plaque was significantly related to the proportion of the periodontopathic bacterial community and the presence of gingival inflammation. In conclusion, the plaque red fluorescence is associated with changes in the microbial composition and enrichment of periodontopathic pathogens, which suggests that RF plaque detected by QLF technology could be used as a risk indicator for gingival inflammation.      

Imaging of coronary atherosclerosis and identification of the vulnerable plaque

Identification of the vulnerable plaque responsible for the occurrence of acute coronary syndromes and acute coronary death is a prerequisite for the stabilisation of this vulnerable plaque. Comprehensive coronary atherosclerosis imaging in clinical practice should involve visualisation of the entire coronary artery tree and characterisation of the plaque, including the three-dimensional morphology of the plaque, encroachment of the plaque on the vessel lumen, the major tissue components of the plaque, remodelling of the vessel and presence of inflammation.Obviously, no single diagnostic modality is available that provides such comprehensive imaging and unfortunately no diagnostic tool is available that unequivocally identifies the vulnerable plaque.The objective of this article is to discuss experience with currently available diagnostic modalities for coronary atherosclerosis imaging. In addition, a number of evolving techniques will be briefly discussed.     

宝石能谱CT 冠脉成像在隐匿型冠心病冠状动脉粥样斑块性质判断中的价值

目的:探讨宝石能谱CT冠脉成像在隐匿型冠心病冠状动脉粥样斑块性质判断中的价值,为临床隐匿型冠心病的诊断和治疗提供影像学参考依据。方法:选择2014年6月~2015年6月在我院诊断为心肌缺血且无临床症状的隐匿型冠心病患者共360例,所有入选患者均行宝石能谱CT冠脉成像检查,其中155例有冠状动脉狭窄,且伴有不同性质的粥样斑块。分析冠状动脉不同血管狭窄情况、斑块分型和斑块数目。结果:所有冠脉动脉狭窄均为轻度狭窄和中度狭窄,主要集中在左主干和左前降支,分别占35.48%和37.42%。硬斑块数目最多,占75.43%,其次为混合斑块和软斑块,分别占16.19%和8.38%。冠状动脉4支血管粥样斑块均为硬斑块者最多(29.03%)、硬斑块与软斑块同时存在者占29.03%、硬斑块与软斑块、混合斑块同时存在者占14.84%,未见单纯混合斑块或软斑块的患者。结论:隐匿型冠心病患者冠状动脉狭窄主要为轻、中度狭窄,冠状动脉斑块以硬斑块为主。宝石能谱CT冠脉成像能准确的判断隐匿型冠心病冠状动脉粥样斑块性质,值得临床推广借鉴。     

Direct evidence showing the effect of root surface iron plaque on arsenite and arsenate uptake into rice (Oryza sativa) roots

The present study aimed to investigate the effects of root surface iron plaque on the uptake kinetics of arsenite and arsenate by excised roots of rice (Oryza sativa) seedlings. The results demonstrated that the presence of iron plaque enhanced arsenite and decreased arsenate uptake. Arsenite and arsenate uptake kinetics were adequately fitted by the Michaelis-Menten function in the absence of plaque, but produced poor fits to this function in the presence of plaque. Phosphate in the uptake solution did not have a significant effect on arsenite uptake irrespective of the presence of iron plaque; however phosphate had a significant effect on arsenate uptake. Without iron plaque, phosphate inhibited arsenate uptake. The presence of iron plaque diminished the effect of phosphate on arsenate uptake, possibly through a combined effect of arsenate desorption from iron plaque.     

Double-layer plaque assay for quantification of enteroviruses

We describe here a double-layer plaque assay for the quantification of enteroviruses, combining a monolayer plaque assay and a suspended-cell plaque assay. The double-layer assay provides significantly greater counts than other methods of virus quantification of both suspensions of pure culture viruses and naturally occurring viruses. The counts obtained by this method are approximately one order of magnitude greater than those obtained with the more commonly used method, the monolayer plaque assay. We conclude that the methods available for quantifying viruses rank in efficiency as follows: double-layer plaque assay >or=suspended-cell plaque assay > counting cytopathogenic virus adsorbed to cellulose nitrate membrane filters >or= most probable number of cytopathogenic units > monolayer plaque assay. Moreover, the double-layer plaque assay allows the use of two different cell lines in the two layers. Using the human colonic carcinoma cell line CaCo2 facilitates the recovery of a greater number and diversity of naturally occurring enteroviruses in water than the monolayer agar method. In addition, the pretreatment of cells with 5-iodo-2'-deoxyuridine (IDU) prior to the quantification of enteroviruses by the double-layer plaque assay provides significantly higher recoveries than the use of IDU does with the other methods of quantification.     

Effect of calcification on the mechanical stability of plaque based on a three-dimensional carotid bifurcation model

Background

This study characterizes the distribution and components of plaque structure by presenting a three-dimensional blood-vessel modelling with the aim of determining mechanical properties due to the effect of lipid core and calcification within a plaque. Numerical simulation has been used to answer how cap thickness and calcium distribution in lipids influence the biomechanical stress on the plaque.

Method

Modelling atherosclerotic plaque based on structural analysis confirms the rationale for plaque mechanical examination and the feasibility of our simulation model. Meaningful validation of predictions from modelled atherosclerotic plaque model typically requires examination of bona fide atherosclerotic lesions. To analyze a more accurate plaque rupture, fluid-structure interaction is applied to three-dimensional blood-vessel carotid bifurcation modelling. A patient-specific pressure variation is applied onto the plaque to influence its vulnerability.

Results

Modelling of the human atherosclerotic artery with varying degrees of lipid core elasticity, fibrous cap thickness and calcification gap, which is defined as the distance between the fibrous cap and calcification agglomerate, form the basis of our rupture analysis. Finite element analysis shows that the calcification gap should be conservatively smaller than its threshold to maintain plaque stability. The results add new mechanistic insights and methodologically sound data to investigate plaque rupture mechanics.

Conclusion

Structural analysis using a three-dimensional calcified model represents a more realistic simulation of late-stage atherosclerotic plaque. We also demonstrate that increases of calcium content that is coupled with a decrease in lipid core volume can stabilize plaque structurally.     

Plaque Assay for Pneumonia Virus of Mice

A plaque assay for the quantitation of pneumonia virus of mice is described. To obtain reproducible plaque formation, proteolytic enzymes had to be incorporated in the overlay medium. The plaque morphology observed in the presence of pancreatin and chymotrypsin was superior to that seen with trypsin. Although the plaque assay was found to be slightly less sensitive than the TCID(50) determination described by Harter and Choppin, it enables cloning of the virus by plaque selection and permits further study of pneumonia virus of mice.     

Oxygen metabolism,oxidative stress and acid-base physiology of dental plaque biofilms

Dental plaque is a natural biofilm which has been a focus of attention for many years because of its known roles in caries and periodontal diseases. Acid production by plaque bacteria leads to the erosion of tooth mineral in caries, and the cariogenicity of plaque is related to population levels of acid-tolerant organisms such as mutants streptococci. However, the biofilm character of plaque allows for survival of a diverse flora, including less acid-tolerant organisms, some of which can produce ammonia from arginine or urea to counter acidification. Plaque is often considered to be relatively anaerobic. However, evidence is presented here that both supragingival and subgingival plaque have active oxygen metabolism and that plaque bacteria, including anaerobes, have developed defenses against oxidative stress. Even in subgingival plaque associated with periodontitis, measured residual oxygen levels are sufficient to allow for oxygen metabolism by organisms considered to be extremely anaerobic such asTreponema denticola, which metabolizes oxygen by means of NADH oxidases and produces the protective enzymes superoxide dismutase and NADH peroxidase. The finding that plaque bacteria produce a variety of protective enzymes is a good indicator that oxidative stress is a part of their everyday life. The biofilm character of plaque allows for population diversity and coexistence of aerobes, anaerobes and microaerophiles. Overall, agents that affect oxidative metabolism offer possibilities for reducing the pathogenic activities of plaque.     

急性缺血性脑卒中患者血浆Lp-PLA2 的表达及与斑块稳定性及神经功 能缺损的关系

目的：探讨急性缺血性脑卒中患者血浆脂蛋白相关磷脂酶（Lp-PLA2）的表达及与斑块稳定性及神经功能缺损的关系。方法： 按照颈动脉彩超结果将2014 年5 月-2015 年1 月我院收治的80 例急性缺血性脑卒中患者分为斑块稳定组（25 例）、斑块不稳定 组（39 例）和无斑块组（16 例）,并于同期随机抽取120 例健康体检者为对照组。采用散射比浊法测定各组血浆Lp-PLA2,同时采 用美国国立卫生研究所中风量表（NIHSS 评分）对三组的神经功能缺损情况进行评估。结果：斑块稳定组、斑块不稳定组以及无斑 块组血浆Lp-PLA2 高于对照组,斑块稳定组、斑块不稳定组高于无斑块组,斑块不稳定组高于斑块稳定组,差异均有统计学意义 （P<0.05）,患者血浆Lp-PLA2水平与动脉粥样硬化斑块的稳定性呈正相关性（rs=0.638,P<0.05）。神经功能缺损中型组、重型组血 浆Lp-PLA2 高于轻型组,重型组高于中型组,差异有统计学意义（P<0.05）,患者血浆Lp-PLA2 水平与神经功能缺损程度呈正相关 性（rs=0.715,P<0.05）。结论：血浆Lp-PLA2 可作为预测急性缺血性脑卒中患者颈动脉硬化斑块稳定性以及评估患者神经功能缺 损程度的重要指标。     

Design and optimizing a novel ocular plaque brachytherapy with dual-core of 103Pd and 106Ru

In recent decades, eye plaques of brachytherapy have been extensively used as primary treatment as well as a complementary treatment for ocular cancer. The purpose of this study is the development of the eye plaque brachytherapy throughout a new design of eye plaque by combining the COMS plaque and the CCB BEBIG plaque loaded by IRA1-¹⁰³Pd and ¹⁰⁶Ru, respectively. A new dual-core plaque with a diameter of 20 mm was designed in the way that the BEBIG plaque with a diameter of 20 mm loaded by ¹⁰⁶Ru plate is attached to the COMS plaque with a diameter of 20 mm loaded by 24 of IRA1-¹⁰³Pd seeds. Dose calculations for the new plaque were performed by using the MCNP5 code. Dose calculations of dual-core plaque including ¹⁰³Pd seeds (gamma) and ¹⁰⁶Ru plate (beta) were separately done for the sake of MCNP constraints in gamma and beta particle transfer simultaneously. The new dual-core plaque delivers a much higher dose rate to the tumor compared with every single plaque, while the dose rate reached to healthy tissues is slightly higher than each plaque separately. Of course, this is acceptable because the treatment time reduces and subsequently the error in radiation therapy reduces.