阿托伐他汀钙联合阿司匹林治疗短暂性脑缺血发作的疗效及对颈动脉粥样硬化斑块和血脂水平的影响研究

目的:探讨阿托伐他汀钙联合阿司匹林对短暂性脑缺血发作的治疗疗效及其对颈动脉粥样硬化斑块和血脂水平的影响。方法:选择我院80例短暂性脑缺血发作患者,按入院顺序随机平均分为两组,研究组40例患者给予阿托伐他汀钙联合阿司匹林治疗,对照组40例患者仅使用阿司匹林治疗。比较两组患者治疗后的治疗有效率,6个月后分别对两组患者颈动脉粥样硬化斑块及血脂水平进行检测。结果:研究组患者治疗总有效率为92.5%,明显高于对照组75%,比较差异具有统计学意义(P0.05);治疗6个月后研究组患者IMT及斑块面积较治疗前明显降低,且降低程度明显高于对照组,比较差异具有统计学意义(P0.05);研究组血清中LDL、TC、TG水平较治疗前显著下降,且下降程度明显高于对照组,同时HDL水平显著上升,而上升程度也明显高于对照组,比较差异具有统计学意义(P0.05)。结论:阿托伐他汀钙联合阿司匹林对短暂性脑缺血发作的治疗疗效显著,可明显减轻或消除颈动脉粥样硬化斑块并明显降低血脂水平,值得推广应用。     

Evaluation of Th17 related cytokines associated with clinical and laboratorial parameters in sickle cell anemia patients with leg ulcers

Leg ulcers (LUs) represent one of the main causes of morbidity in sickle cell anemia (SCA). This manifestation has been related to hemolysis, infections predisposition and inflammation that leads cytokines secretion. In this context, our study aimed to evaluate Th17 related cytokines (IL-6, IL-17A, IL-22 and IL-23) in serum and peripheral mononuclear cells culture supernatants with and without lymphoproliferative stimulation (anti-human CD3 and anti-human CD28). The cytokines levels were also correlated to clinical, hematological and biochemical parameters in SCA patients with and without LUs history (SCALU and SCAWH) as well as in healthy controls. In SCALU patients, high levels of IL-17A were associated with absence of acute chest syndrome (ACS, p = 0.0328). The other clinical parameters analyzed (osteonecrosis, stroke, priapism, splenectomy and blood transfusions history) were not significantly related with other cytokine levels. In SCALU patients was also observed that IL-17A increased levels were associated with high levels of LDH (p = 0.0130), the same association pattern was found for IL-6 (0.0160) and IL-22 (p = 0.0165) in the SCALU group. Interestingly, we did not find statistical correlations with these parameters in SCAWH group. The other hematological parameters (hemoglobin, leucocyte and reticulocyte count) and indirect bilirrubin did not show any correlation with analyzed cytokines in both groups. So, for the first time, we show that IL-17A present in SCALU patients may exert a preventive role in the ACS development. Furthermore, IL-6, IL-17A and IL-22 accompanied the LDH levels only in SCALU patients suggesting to serve as additional markers of hemolysis or to be related with immunity response against extracellular pathogens.     

Arterial stiffness is inversely associated with a better running record in a full course marathon race

[Purpose]

Arterial stiffness is an independent predictor of cardiovascular risk and may contribute to reduced running capacity in humans. This study investigated the relationship between course record and arterial stiffness in marathoners who participated in the Seoul International Marathon in 2012.

[Methods]

A total of 30 amateur marathoners (Males n = 28, Females n = 2, mean age = 51.6 ± 8.3 years) were assessed before and after the marathon race. Brachial-ankle pulse wave velocity (ba-PWV) was assessed by VP-1000 plus (Omron Healthcare Co., Ltd., Kyoto, Japan) before and immediately after the marathon race. Pearson''s correlation coefficient was used to determine the relationship between race record and ba-PWV. In addition, Wilcoxon signed rank test was used to determine the difference in ba-PWV between before and after the race.

[Results]

There was no significant change in the ba-PWV of marathoners before and after the race (1271.1 ± 185 vs. 1268.8 ± 200 cm/s, P=0.579). Both the full course record (Pearson''s correlation coefficient = 0.416, P = 0.022) and the record of half line (Pearson''s correlation coefficient = 0.482, P = 0.007) were positively related with the difference in ba-PWV, suggesting that reduced arterial stiffness is associated with a better running record in the marathon.

[Conclusion]

These results may suggest that good vascular function contributes to a better running record in the marathon race.     

脑梗死患者血浆纤维蛋白原水平与颈动脉粥样硬化的关系

目的：探讨脑梗死患者血浆纤维蛋白原（Human Fibrinogen,Fro）水平的改变与颈动脉粥样硬化（CAS）的关系。方法：选取2009年5月-2012年6月入住解放军八一医院神经内科脑梗死患者508例。采用彩色多普勒超声检测脑梗死患者颈内动脉颅外段（／ntemalcarotidartery,ICA）、总动脉（common carotid artery,CCA）、颈总动脉分叉处内一中膜厚度（Intima—medial Thickness,IMT）。评定标准：颈动脉IMT〉0．9toni或（和）颈动脉斑决定义为CAS。24h内将患者空腹静脉血送检,记录测定后的生化指标及№水平,记录吸烟史、糖尿痛、高血压病等病史,采用Logistic回归分析测定的相关危险因素对颈动脉粥样硬化的作用强度。结果：按FIB水平分组（FIB≤3g／L组、FIB〉3g／L组）,Logistic回归分析显示FIB〉3g／L组的危险度为2．04,年龄、FIB水平、高血压病史及吸烟史对CAS有影响,差异有统计学意义（P〈0．05）,其中FIB与CAS的相关性最强。结论：FIB水平与脑梗死患者CAS的发展密切相关,其作用可能强于其他的传统危险因素。     

血清同型半胱氨酸、脂联素、高敏C反应蛋白水平与颈动脉内膜中层厚度在老年2型糖尿病合并脑梗死患者中的意义

目的：观察血清同型半胱氨酸（Hcy）、脂联素（APN）、高敏C反应蛋白（hs．CRP）水平与颈动脉内膜中层厚度（1MT）在老年2型糖尿病合并脑梗死患者中的意义。方法：选择2008年5月至2012年5月在我院就诊的2型糖尿病患者218例,按照是否合并脑梗死分为糖尿病伴脑梗死组（105例）和单纯糖尿病组（113例）。选择同期健康体检者30例为健康对照组。观察三组血清Hcy、APN、hs—CRP和IMT的水平变化。结果：糖尿病伴脑梗死组和单纯糖尿病组的血清Hcy、hs—CRP和IMT的水平均较正常对照组明显提高（P〈0．01）,糖尿病伴脑梗死组以上指标显著高于单纯糖尿病组（P〈0．01）;而糖尿病伴脑梗死组和单纯糖尿病组的血清APN的水平较正常对照组明显降低（P〈0．01）,糖尿病伴脑梗死组血清APN的水平较单纯糖尿病组显著降低（P〈0．01）。血清Hcy和hs—CRP水平随着1MT的严重程度增加而升高（P〈0．01）,而APN水平随着IMT严重程度升高而降低（P〈0．01）。结论：糖尿病伴脑梗死的患者大血管病变较单纯糖尿病患者更为严重,颈动脉IMT与Hcy和hs—cRP呈正相关,而与APN呈负相关。     

颈内动脉支架置入术对颈动脉狭窄患者认知功能影响的研究

目的：研究颈动脉狭窄对认知功能的影响,探讨颈动脉支架置入术（CAS）患者术后不同时期认知功能的变化及其可能的机制。方法：选取2010年1月至2012年12月我院神经内科收住的急性脑梗死（前循环）患者75例,按颈内动脉狭窄程度,分成无狭窄组,轻度狭窄组（狭窄程度〈30％）,中度狭窄组（30-69％）和治疗组（70．99％）,前三组给予药物治疗,治疗组同时给予颈内动脉支架置入术,应用蒙特利尔认知评估量表（MoCA）、简易精神状态检查表（MMSE）、搭火柴测验（stickTest）,对患者进行认知功能评估,比较术前、术后不同时期认知功能的变化,同时利用SPECT／CT对治疗组20例患者术后局部脑血流改善状况进行评价。结果：治疗组和对照组在术前比较MoCA总分、MMSE评分、StickTest评分,发现治疗组评分低于对照组,且随着颈动脉狭窄程度的加重,认知功能受损越明显;治疗组在术后1周与术前比较,评分反而降低,差异有统计学意义;术后3个月、术后6个月与术前比较,评分均有所提高,差异有统计学意义;通过SPECT／CT对治疗组术前感兴趣区血流量与同侧小脑平均脑血流量比较,术后再与同侧小脑比较,结果显示术后脑灌注明显改善。结论：颈动脉狭窄与血管性认知功能障碍有关,而且认知功能障碍的程度与颈动脉狭窄程度呈正相关,颈内动脉支架置入术可最终改善认知功能,尤其表现在视空间／执行能力,延迟回忆能力,注意力等方面。     

高血压前期患者颈动脉血管弹性超声参数与左室舒张功能的关系研究

摘要 目的：研究高血压前期患者颈动脉血管弹性超声参数与左室舒张功能的关系。方法：选取2019年12月-2020年12月因血压异常于河北北方学院附属第一医院接受诊断与治疗的161例患者,根据血压水平分为高血压前期组（82例）与高血压组（79例）;另选取同期于我院体检的80例健康志愿者作为对照组。收集三组临床资料,检测生化指标与血压;通过超声诊断仪中超声射频信号血管内中膜定量分析（QIMT）与动脉僵硬度定量分析（QAS）软件测量颈动脉血管弹性超声参数[颈动脉内中膜厚度（IMT）、顺应性系数（CC）、扩张性系数（DC）、血管弹性指数（α、β）、脉搏波传导速度（PWV）];超声心动图检查左室功能指标[左室射血分数（LVEF）、左室质量指数（LVMI）、舒张早期血流速度峰值（E）/舒张晚期血流速度峰值（A）、等容舒张时间（IVRT）、舒张期减速时间（DT）];采用Pearson相关性法分析颈动脉血管弹性超声参数与心室指标的相关性。结果：三组收缩压与舒张压水平存在统计学意义（P＜0.05）。高血压前期组与高血压组IMT、α、β、PWV高于对照组,DC、CC低于对照组（P＜0.05）,且高血压前期组IMT、α、β、PWV低于高血压组,DC、CC高于高血压组（P＜0.05）。高血压前期与高血压组E/A低于对照组,IVRT、DT高于对照组（P＜0.05）,且高血压前期组E/A高于高血压组,IVRT、DT低于高血压组（P＜0.05）。经Peason相关性分析显示,IMT、α、β、PWV与E/A呈负相关,与IVRT、DT呈正相关（P＜0.05）;DC、CC与E/A呈正相关,与IVRT、DT呈负相关（P＜0.05）。结论：高血压前期患者颈动脉血管弹性功能下降,且伴有左室舒张功能受损,颈动脉血管弹性超声参数与左室舒张功能密切相关。     

The association of oxidative stress with arterial compliance and vascular resistance in a bi-ethnic population: the SABPA study

A loss of arterial elasticity increases the risk for cardiovascular events. Oxidative injury to the vessel wall may be one of the underlying mechanisms influencing arterial elasticity. We compared markers of oxidative stress, antioxidant capacity, inflammation, windkessel compliance (Cwk), and total peripheral resistance (TPR) in black and white South Africans. Associations of arterial compliance and vascular resistance (as indicated by TPR) with oxidative stress, antioxidant capacity and inflammatory markers were also investigated. We included 146 black and 181 white men and women. Measurements from the Finometer device were used to calculate Cwk and TPR while thiobarbituric acids reactive substances (TBARS), glutathione peroxidase (GPx), C-reactive protein (CRP), and interleukin-6 (IL-6) were analyzed in serum or urine samples. Black participants had higher TPR, TBARS, GPx, CRP, and IL-6 levels (all p?≤?0.018) and lower Cwk (both p?≤?0.013) compared to white participants. Multiple regression analyses revealed independent associations of Cwk (β?=??0.27, p?=?0.015) and TPR (β?=?0.18, p?=?0.018) with TBARS in black participants, while Cwk (β?=??0.10; p?=?0.019) and TPR (β?=?0.13, p?=?0.047) were independently associated with GPx in white participants. Decreased arterial compliance and increased vascular resistance associated with increased oxidative damage independent of hypertensive status in black participants. These results suggest that oxidative stress plays a role in early vascular changes in a black population prone to the development of cardiovascular disease.     

Genetic mosaic analysis of decapentaplegic and wingless gene function in the Drosophila leg

 Genetically mosaic flies were constructed which lack a functional decapentaplegic (dpp) or wingless (wg) gene in portions of their leg epidermis, and the leg cuticle was examined for defects. Although dpp has previously been shown to be transcribed both ventrally and dorsally, virtually the only dpp-null clones that affect leg anatomy are those which reside dorsally. Conversely, wg-null clones only cause leg defects when they reside ventrally – a result that was expected, given that wg is only expressed ventrally. Both findings are consistent with models of leg development in which the future tip of the leg is specified by an interaction between dpp and wg at the center of the leg disc. Null clones can cause mirror-image cuticular duplications confined to individual leg segments. Double-ventral, mirror-image patterns are observed with dpp-null clones, and double-dorsal patterns with wg-null clones. Clones that are doubly mutant (null for both dpp and wg) manifest reduced frequencies for both types of duplications. Duplications can include cells from surrounding non-mutant territory. Such nonautonomy implies that both dpp and wg are involved in positional signaling, not merely in the maintenance of cellular identities. However, neither gene product appears to function as a morphogen for the entire leg disc, since the effects of each gene’s null clones are restricted to a discrete part of the circumference. Interestingly, the circumferential domains where dpp and wg are needed are complementary to one another. Received: 25 March 1996 / Accepted: 13 June 1996     

Age- and gender-related development of stretch shortening cycle during a sub-maximal hopping task

The aim of this study was to analyse the effects of age and gender (and their interaction) on a stretch shortening cycle solicited during a hopping task. For this aim, 147 girls and 148 boys aged 11 to 20 years, who were enrolled in middle school or secondary school with no experience in sport activity, or training less than three times per week, performed 3×5 hops in place. Leg-stiffness, jump-height and reactive-strength indices were assessed using an accelerometer (Myotest). The participants were selected in order to form five age groups: 11 12, 13-14, 15-16, 17-18 and 19-20 years. Regression analysis between force and centre of mass displacement revealed spring-mass behaviour for all groups (r²=.73-.89), meaning that beginning at the age of 11 years, children are able to perform complex inter-muscular coordination of the lower limbs, revealing efficient neural control early in childhood. Leg stiffness increased from 24.7 ± 10.6 kN · m⁻¹ at 11-12 years to 44.1 ± 14 kN · m⁻¹ in boys, with a small increase until 16 years (+17%) and a large increase between 17 and 20 years (+32.7%). In girls, leg stiffness increased from 26.6 ± 9 kN · m⁻¹ at 11-12 years to 39.4 ± 10.9 kN · m⁻¹ at 19-20 years, with a curious decrease in leg stiffness at 17-18 years, probably due to an increase in the percentage of fat at this age (25%). While no gender effect was found, the reactive-strength index revealed that, from 15-16 years onward, boys were better able to produce high levels of force in a shorter time than girls. The age of 15-16 years is a threshold of maturity and gender differentiation, where the boys investigated are more efficient in the stretch shortening cycle.