Aim: To investigate the effects of the angiotensin II type 1 receptor (AT1) blocker on cerebral ischemia-reperfusion injury in mice with atherosclerosis. Methods: The experiment was done in the Center Laboratory of First Military Medical University from September 2003 to December 2004. Forty apolipoprotein E (apoE) knock out mice were assigned randomly into control group (n=20): They were treated with high cholesterol diet for ten weeks; Telmisartan pretreatment group (n=20): They were given high cholesterol diet for eight weeks, then telmisartan at a dose of 0.3 mg/kg per day mixing with the food for two weeks. After the raising for 10 days, at the same time to establish ischemia reperfusion brain injury models, ischemia for 1 hour and reperfusion for 23 hours. The detection of relative index: Blood pressure (BP) was detected by tail-sleeves methods; The area percentage of infarction was calculated by image analysis system; Death rate of the animals in the two groups; The nerve functional lesion score was as following: 0 points: no nerve functional lesion physical sign; 1 point: the weakening of myodynamia of right-frontier claw; 2 points: bend of body towards left; 3 points: rotatory toward left side; 4 points: without antomatic action; The water containing quantity of brain tissue was detected.The development condition of superoxide anion was observed under the fluorescence microscope. Results: Except the animals dead before the end of the experiment, 5 mice were dead in control group and 4 mice in telmisartan group. Fifteen mice in control group and sixteen mice in telmisartan group were involved in the result analysis. 1 The effect of telmisartan pretreatment on the blood pressure of the animals: Compared with the control group, the effect of telmisartan pretreatment on the blood pressure of the animals before and after ischemia and after reperfusion was insignificant [(101±3), (105±5); (87±6), (88±3); (93±5), (94±6)mm Hg, (P > 0.05)]. 2 The effect of telmisartan pretreatment on the infarct area:Constant white infarct focus appeared after ischemia reperfusion injury. Compared with control group, infarct area decreased in telmisartan pretreatment group, and the difference was significant (P < 0.05). 3 The effect of telmisartan pretreatment on the animal's death rate, nerve functional defect score and the water containing quantity of brain tissues: Compared with control group, the telmisartan pretreatment could decrease the animal's death rate, nerve functional defect score and the water containing quantity of brain tissues [46.67%, 31.13%; 2.75±0.20, 2.00±0.30; (83.29±0.45)%, (80.17±032)%, P < 0.05]. 4 The effect of telmisartan pretreatment on the brain blood stream: After the infarct of mesencephalic arteries, the brain blood stream all decreased to below the 20% of base line value in the focus center of infarct. The brain blood stream in pretreatment group after reperfusion was higher than that in control group (P < 0.05). The brain blood stream in semi-area opaca all deceased to below 50% of the base line value. From 30 minutes post-infarct to post-reperfusion, the brain blood stream in pretreatment group (P < 0.05). 5 The effect of telmisartan pretreatment on the oxygen stress:The development of infarct focus active oxygen increased while the development of active oxygen in telmisartan pretreatment group was insignificant. The activity of recovery corymase II decreased in telmisartan pretreatment group than that of control group [((0.512±0.030),(0.782±0.032) mkat/g, P < 0.05]. Conclusion: The pre-blockade of AT1 receptor can dwindle the infarct area of ischemical reperfusion injury in rats with atheroscherosis, decrease the brain edema and the animal's death rate, imrove nerve loss of function physical sign,and inhibit the development of superoxide anion and the increase of activities of recovery corymase II oxidase in order to reduce the level of brain injury.

BACKGROUND:

several studies have been pointing towards a non-linear relationship between serum 25(OH)D and cardiovascular disease. Next to vitamin D deficiency, also higher levels of 25(OH)D have been reported to be associated with increased cardiovascular risk. We aimed to investigate the nature of the relationship between serum 25(OH)D and measures of arterial stiffness and arteriosclerosis in an elderly population.

DESIGN:

cross-sectional.

SETTING/SUBJECTS:

a subgroup of the B-PROOF study was included to determine associations between serum 25(OH)D and arterial stiffness and atherosclerosis (n = 567, 57% male, age 72.6 ± 5.6 years, mean serum 25(OH)D 54.6 ± 24.1 nmol/l).

METHODS:

carotid intima media thickness (IMT) was assessed using ultrasonography and pulse wave velocity (PWV) was determined with applanation tonometry. Associations were tested using multivariable restricted cubic spline functions and stratified linear regression analysis.

RESULTS:

the associations between serum 25(OH)D and carotid IMT or PWV were non-linear. Spline functions demonstrated a difference between 25(OH)D deficient and sufficient individuals. In serum 25(OH)D sufficient participants (≥50 nmol/l; n = 287), a positive association with IMT and serum 25(OH)D was present (β 1.24; 95%CI [0.002; 2.473]). PWV levels were slightly lower in vitamin D deficient individuals, but the association with 25(OH)D was not significant.

CONCLUSION:

our study demonstrates that associations of serum 25(OH)D and PWV and IMT in an elderly population are not linear. In particular from serum 25(OH)D levels of 50 nmol/l and up, there is a slight increase of IMT with increasing 25(OH)D levels.

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Ketanserin is a new strong antiserotoninergic drug that, unlike the previous ones, is selective for 5-hydroxytryptamine receptors. This drug has been employed successfully in the treatment of arterial hypertension and of some peripheral vascular diseases. The authors are carrying out a trial on medium term treatment with ketanserin (K) or propranolol (P) in comparison with placebo, to evaluate their effects on blood pressure, haemocoagulative parameters and peripheral circulation. The trial is a double-blind cross-over random trial on subjects with mild or moderate hypertension. Until now 13 patients have ended the study; six of them are suffering from arteriosclerosis obliterans of the lower limbs at 1st or 2nd stage according to Fontaine. Both propranolol and ketanserin significantly reduced the blood pressure, although the decrease in systolic blood pressure was more evident after propranolol. Heart rate diminished significantly only after propranolol administration. The noninvasive, intermittent (every 30 min) monitoring of blood pressure showed a significant 24-hour reduction of blood pressure after administration of propranolol or ketanserin without significant changes of circadian behaviour of the blood pressure. After administration of ketanserin a slight improvement in peripheral circulation was demonstrated, evaluated by using strain-gauge plethysmography. As regards the results obtained for platelet function and other haemocoagulative parameters examined, adenosine diphosphate-induced platelet aggregation, adenosine diphosphate slope, collagen lag period, antithrombin III biological activity, and serum fibrinogen did not show noticeable modifications after treatment, while beta-thromboglobulin levels decreased slightly after ketanserin administration.

BACKGROUND:

Diabetes mellitus (hereafter called diabetes) is considered to accelerate arteriosclerosis leading to coronary heart disease and stroke. Thus, it is important to quantitatively estimate the extent of subclinical arteriosclerosis. A new method called cardio-ankle vascular index (CAVI) is developed to reflect arterial stiffness independently from blood pressure at the time of measurement. Then, we examined if CAVI scores could discriminate the extent of arteriosclerosis between persons with prediabetes (or borderline diabetes) and with diabetes among Japanese urban workers and their families.

METHODS:

Subjects were 9881 men and 12033 women of company employees and their families who participated in cardiovascular disease screening in Japan. Persons having diabetes and prediabetes were defined based on the criteria set by American Diabetes Association. CAVI scores were measured by VaSera VS-1000. We applied the established age-sex specific cutoff points of CAVI scores above which were determined to be abnormally high or advanced level of arteriosclerosis. To examine the association of prediabetes and diabetes with CAVI scores, CAVI scores of screening participants were converted to a binary variable: 1 for less than cutoff points and 2 for equal or greater than cutoff points or abnormally high CAVI scores. Logistic regression method was used to examine the association of prediabetes and diabetes with CAVI scores after adjusting for major cardiovascular disease (CVD) risk factors.

RESULTS:

Prevalence of abnormally high CAVI scores was significantly higher after 40 years of age among persons with diabetes than either among persons with prediabetes or among normal persons in both genders. Significantly elevated odds ratios (ORs) of abnormally high CAVI scores appeared among persons with prediabetes: 1.29 (95 % confidence interval (CI), 1.11-1.48) for men and 1.14 (CI, 1.01-1.28) for women, and among persons with diabetes: 2.41 (CI, 1.97-2.95) for men and 2.52 (CI, 1.94-3.28) for women.

CONCLUSIONS:

The extent of subclinical arteriosclerosis (including arterial stiffness and atherosclerosis) was moderately enhanced among persons with prediabetes and was further advanced among persons with diabetes. Thus, it is important to introduce earlier interventions for changing lifestyle and diet of persons with prediabetes in order to prevent them from developing diabetes and further advancing arteriosclerosis.

INTERVENTION:

Prostaglandin for injection (alprostadil) group: 60 mcg of prostaglandin for injection is intravenously administered once a week or more. This therapy is repeated 10 times or more. Ripple injection (alprostadil Injection) group: 10 mcg of ripple injection is administered intravenously once a week or more. This treatment is repeated 10 times or more. Conventional treatment group

CONDITION:

Patients with combined lumbar spinal stenosis and arteriosclerosis obliterans

PRIMARY OUTCOME:

The Japanese Orthopaedic Association (JOA) score

SECONDARY OUTCOME:

Age, sex, affected period, biochemical examination of blood, details of treatment (number and frequency of infusions, concomitant drug therapy, block therapy, and other conservative therapies), SF‐36

, VAS INCLUSION CRITERIA:

The subjects are patients who meet all of the following inclusion criteria and are able to provide informed consent. 1) Male and female patients aged 20 years or older. 2) Patients who are diagnosed with lumbar spinal stenosis based on X‐ray and MRI findings and are undergoing conservative treatment. 3) Patients who are diagnosed with arteriosclerosis obliterans (peripheral arterial disease) Fontaine classification I or II. 4) Patients who understand the objectives of this study and provide informed consent.

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BACKGROUND:

Endoluminal interventions have become one of the main options for the treatment of arteriosclerosis obliterans (ASO).

OBJECTIVE:

To explore the effect of hydration therapy and nursing intervention on the prevention of contrast-induced nephropathy (CIN) after interventional treatment of lower extremity ASO.

METHODS:

A convenience sampling method was used to select 94 patients who received ASO treatment in our hospital from March 2019 to May 2021 as the study subjects. All patients underwent endovascular interventional therapy and were randomly divided into two groups by the random number table method, with odd numbers entering the observation group (n= 47) and even numbers entering the control group (n= 47). The control group received routine nursing intervention, while the observation group underwent hydration therapy and had a corresponding nursing intervention scheme. The clinical efficacy of the two groups and the incidence of contrast-induced nephropathy after interventional therapy were compared, and an evaluation of satisfaction within the two groups was performed via a questionnaire.

RESULTS:

The total effective rate of patients in the observation group was higher after hydration treatment (97.87% vs 87.23%, p< 0.05). The blood urea nitrogen, creatinine, and β2 microglobulin levels in the observation group were significantly lower than those in the control group after the intervention (p< 0.05). Patients in the observation group had higher nursing satisfaction after using preventive measures of hydration therapy combined with nursing interventions (100% vs 89.36%, p< 0.05).

CONCLUSION:

Hydration therapy and nursing intervention can effectively prevent CIN after interventional treatment of lower extremity ASO. After interventional therapy, patients had better clinical outcomes, lower biochemical indexes and improved satisfaction evaluations. The therapy is worthy of clinical promotion and application.

BACKGROUND The aim of this study was to further clarify the effects of valsartan on restenosis in patients with arteriosclerosis obliterans of the lower extremities. MATERIAL AND METHODS Patients with arteriosclerosis obliterans of the lower extremities undergoing continuous stent implantation in the superficial femoral artery were enrolled and randomly divided into an ARB group and a control group. Patients in the ARB group received valsartan orally in a single-blind manner and were followed up for 6 months. An evaluation was performed based on the criteria for clinical efficacies designed by the Committee of Vascular Disease, Chinese Association of Integrative Medicine. The total clinical effective rate was calculated, and ankle brachial index (ABI) of the patients was assessed. The concentrations of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were measured using enzyme-linked immunosorbent assay. The in-stent restenosis of patients was examined by angiography. RESULTS One patient in the control group died due to acute cerebral hemorrhage 4 months after enrollment, and 1 patient was lost to follow-up due to acute myocardial infarction during follow-up 5 months after enrollment. Age, sex, Fontaine stage, and underlying diseases were comparable between the 2 groups. Hs-CRP (3.93±1.43) and IL-6 (11.26±2.29) levels were significant different in the ARB group compared with the control group. The postoperative follow-up showed that ABI was 0.98±0.20 in the ARB group and 0.62±0.48 in the control group. CONCLUSIONS Valsartan inhibited the increase in hs-CRP and IL-6 levels, improved clinical efficacies, increased ABI, and decreased the restenosis rate after the interventional therapy in patients with arteriosclerosis obliterans of the lower extremities.