Catalpol,an iridoid glucoside isolated from Rehmannia glutinosa,has gained attention due to its potential use in treating cardio-cerebrovascular diseases(CVDs).This extensive review delves into recent studies on catal...Catalpol,an iridoid glucoside isolated from Rehmannia glutinosa,has gained attention due to its potential use in treating cardio-cerebrovascular diseases(CVDs).This extensive review delves into recent studies on catalpol's protective properties in relation to various CVDs,such as atherosclerosis,myocardial ischemia,infarction,cardiac hypertrophy,and heart failure.The review also explores the compound's anti-oxidant,anti-inflammatory,and anti-apoptotic characteristics,emphasizing the role of vital signaling pathways,including PGC-1a/TERT,PI3K/Akt,AMPK,Nrf2/HO-1,estrogen receptor(ER),Nox4/NF-kB,and GRP78/PERK.The article discusses emerging findings on catalpol's ability to alleviate diabetic cardiovascular complications,thrombosis,and other cardiovascular-related conditions.Although clinical studies specifically addressing catalpol's impact on CVDs are scarce,the compound's established safety and well-tolerated nature suggest that it could be a valuable treatment alternative for CVD patients.Further investigation into catalpol and related iridoid derivatives may unveil new opportunities for devising natural and efficacious CVD therapies.展开更多
Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,t...Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.展开更多
Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countrie...Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.展开更多
BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not be...BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.展开更多
BACKGROUND: Carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular disease. Therefore, the c...BACKGROUND: Carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular disease. Therefore, the close relationship of carotid atherosclerotic plaque and ischemic cerebrovascular disease, and ultrasound evaluation of carotid atherosclerotic plaque have become the hot spot in studying ischemic cerebrovascular disease. OBJECTIVE: This study was to detect the degree of carotid atherosclerosis of ischemic cerebrovascular disease patients by ultrasonography, and to analyze the situation of carotid atherosclerosis and its relationship with clinic. DESIGN: Clinical randomized concurrent control experiment. SETTING: Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA. PARTICIPANTS: Totally 60 outpatients and inpatients with ischemic cerebrovascular disease, 42 males and 18 females, admitted to Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA between January 2006 and December 2006 were involved in the patient group. They met the diagnosis criteria of ischemic cerebrovascular disease constituted by the 4th Cerebrovascular Disease Conference in 1996, and were confirmed to suffer from ischemic cerebrovascular disease by skull CT and MRI. Another 20 subjects who received healthy examination concurrently in the same hospital, 12 males and 8 females, were involved in the control group. Informed consents of detected items were obtained from involved subjects. METHODS: The plaque thickness of mid portion, distal end and crotch of common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA) and vertebral artery (VA) of involved subjects, who received health examination was separately detected with color Doppler ultrasonograph (HDI-5000). Then, total integral of plaque was calculated. The intima-media thickness (IMT) was measured with two-dimensional ultrasonography. The inner diameter stenosis degree of subjects who had plaque was measured. Blood flow parameters were recorded, and stenosis degree and plaque area were calculated. Blood flow volume of bilateral carotid artery and VA was separately measured with ultrasound equipment software, and brain blood flow volume was calculated. MAIN OUTCOME MEASURES: Atherosclerotic degree and blood flow volume of patients of two groups. RESULTS: Sixty patients with ischemic cerebrovascular disease and twenty subjects who received health examination participated in the final analysis. ①The IMT thickness, total plaque score, and total plaque area of patient group was significantly superior to that of control group, respectively(t=5.216–10.158,P < 0.05). ② There were significant differences in the stenosis degree of CCA, ICA and VA between patient group and control group (t=6.720–12.816,P < 0.05). ③ The blood flow volume of CCA, ICA, VA and brain of patient group was significantly lower than that of control group, respectively (t=2.872–10.860, P < 0.05). CONCLUSION: Ischemic cerebrovascular disease patients have different degrees of changes in atherosclerosis and arterial blood flow.展开更多
Toll-like receptors(TLRs) are commonly referred to a series of evolutionary conserved receptors which recognize and respond to various microbes and endogenous ligands.Growing evidence has demonstrated that the express...Toll-like receptors(TLRs) are commonly referred to a series of evolutionary conserved receptors which recognize and respond to various microbes and endogenous ligands.Growing evidence has demonstrated that the expression of TLRs in the retina is regulated during retinal ischemic diseases,including ischemia-reperfusion injury,glaucoma,diabetic retinopathy(DR) and retinopathy of prematurity(ROP).TLRs can be expressed in multiple cells in the retina,such as glial cells,retinal pigment epithelium(RPE),as well as photoreceptor cells and endothelium cells.Activation of TLRs in retina could initiate a complex signal transduction cascade,induce the production of inflammatory cytokines and regulate the level of costimulatory molecules,which play prominent roles in the pathogenesis of retinal ischemic diseases.In this review,we summarized current studies about the relationship between TLRs and ischemic retinopathy.A greater understanding of the effect of TLRs on ischemic injuries may contribute to the development of specific TLR targeted therapeutic strategies in these conditions.展开更多
Objective The -455 G/A(HaeIII)polymorphism of β-fibrinogen gene influences levels of plasma fibrinogen. We further investigated whether it influences the risk of ischemic cerebrovascular disease. Methods We accumulat...Objective The -455 G/A(HaeIII)polymorphism of β-fibrinogen gene influences levels of plasma fibrinogen. We further investigated whether it influences the risk of ischemic cerebrovascular disease. Methods We accumulated 134 acute ischemic cerebrovascular disease(ICVD)cases and compared their -455 G/A status with a control group(n = 166). The β-fibrinogen gene -455 G/A polymorphism was analyzed for all subjects by PCR-RFLP with the restrictive enzyme HaeIII. Results Plasma fibrinogen was higher in AA homozygous participants(341 mg/dL)than in partici-pants carrying the G allele: GA(290 mg/dL), GG(298 mg/dL)in the control group. Plasma fibrinogen was also higher in AA homozygous patients(353 mg/dL)than in cases carrying the G allele: GA(287 mg/dL), GG(302 mg/dL)in the ICVD group. However, there was no significant association between β-fibrinogen gene -455 G/A polymorphism and ICVD group. Conclusions Although a small effect cannot be excluded, β-fibrinogen gene -455 G/A polymor-phism is an independent predictor of plasma fibrinogen, but not of ischemic cerebrovascular disease.展开更多
BACKGROUND: Hyperhomocysteinemia, as an important risk factor for ischemic cerebrovascular disease is receiving increasing attention. OBJECTIVE: To analyze whether differences of gender, age, cerebrovascular disease t...BACKGROUND: Hyperhomocysteinemia, as an important risk factor for ischemic cerebrovascular disease is receiving increasing attention. OBJECTIVE: To analyze whether differences of gender, age, cerebrovascular disease typing, and disease conditions exist when ischemic cerebrovascular disease occurs together with hyperhomocysteinemia. DESIGN: A controlled observation. SETTING: Department of Neurology, Tianjin Huanhu Hospital. PARTICIPANTS: A total of 601 acute ischemic cerebrovascular disease inpatients, comprising 386 males and 215 females, aged 33-90 years old, were admitted to the Department of Stroke, Tianjin Huanhu Hospital between August 2005 and April 2007, and were recruited for this study. All included patients consisted of 342 aged patients (≥ 60 years old) and 92 middle-aged and young patients (< 60 years old). Among these patients, 48 suffered from transient cerebral ischemic attack, 138 from lacunar cerebral infarction, 273 from atherosclerotic stroke, 38 from cardiogenic cerebral infarction, 44 from agnogenic ischemic stroke, and 6 from other factor-induced ischemic strokes. All included inpatients corresponded to the diagnosis criteria of acute ischemic cerebrovascular disease, formulated in the 4th National Working Conference of Cerebrovascular Disease, and were confirmed as acute ischemic cerebral infarction by CT and/or MRI examinations. Informed consents of laboratory measurements were obtained from all subjects, and this study was approved by the Hospital’s Ethics Committee. METHODS: Following admission, 2 mL venous blood was collected from each fasting patient on the third morning. Plasma homocysteine level was measured by an enzymatic cycling assay with a CX5 reader (Beckman, USA). Plasma homocysteine levels ≥ 16 μmol/L were defined as hyperhomocysteinemia. Clinical neurological function deficit scoring was also performed for each ischemic stroke patient using Chinese stroke scales. Scores ranged from 0-45 (0-15: mild neurological function deficits, 16-30: moderate neurological deficits, and 31-45: severe neurological deficits). The scores positively correlated with severity of stroke. MAIN OUTCOME MEASURES: Incidence of ischemic cerebrovascular disease patients complicated by hyperhomocysteinemia and the effects of patient age and gender; plasma homocysteine levels of each type of ischemic cerebrovascular disease; and effects of ischemic cerebrovascular disease conditions on plasma homocysteine levels. RESULTS: All 601 inpatients with acute ischemic cerebrovascular disease were included in the final analysis. The detection rate of homocysteine was significantly higher in aged patients than in middle-aged and young patients (χ2 = 5.353 0, P < 0.05). The incidence of hyperhomocysteinemia was significantly higher in male patients than in female patients (χ2 = 9.484 4, P < 0.05). There was no significant difference in the incidence of hyperhomocysteinemia among various types of ischemic cerebrovascular diseases (P > 0.05). No significant difference in incidence of hyperhomocysteinemia existed between mild, moderate, and severe cerebrovascular disease patients (P > 0.05). CONCLUSION: There is a greater chance of ischemic cerebrovascular disease complicated by hyperhomocysteinemia in older, male patients.展开更多
A control study of clinical therapeutic effects of scalp acupuncture was made onforty-four Patients suffering from aphasia caused by acute cerebrovascular diseases,and was observedfor 4 weeks.The results revealed that...A control study of clinical therapeutic effects of scalp acupuncture was made onforty-four Patients suffering from aphasia caused by acute cerebrovascular diseases,and was observedfor 4 weeks.The results revealed that the therapeutic effect in the scalp acupuncture group was betterthan that in the controlgroup.Aphasia was cured more rapidly in the scalpacupuncturegroug than inhe control group.The difference was of significance statistically.展开更多
OBJECTIVE: To assess whether 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene poly-morphism (TT genotype or T allele) is a risk factor for ischemic cerebrovascular disease (ICVD). DATA SOURCES: MEDLINE and PubMe...OBJECTIVE: To assess whether 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene poly-morphism (TT genotype or T allele) is a risk factor for ischemic cerebrovascular disease (ICVD). DATA SOURCES: MEDLINE and PubMed databases from September 1997 to December 2009 were searched for case-control studies that examined MTHFR genotype in human ICVD using "MTHFR, gene, polymorphism, and ischemic cerebrovascular disease" as search key words. STUDY SELECTION: Eighteen associated studies were identified. The methods used to collect relevant information factors were similar between case and control groups, and diagnosis of ischemic cerebrovascular disease was in accordance with Trial of ORG 10172 in Acute Stroke Treatment criteria classification, with some referring to European Stroke Diagnostic Criteria. Quality of all included studies was evaluated, and meta-analysis was conducted using RevMan4.2 software (Cochrane Collaboration, http://www.cochrane-handbook.org) following strict screening. MAIN OUTCOME MEASURES: The correlation between MTHFR gene TT genotype or T allele and ICVD was determined. RESULTS: Eighteen studies involving 4 295 patients with ICVD and 6 169 control subjects were included for this meta-analysis. There was a significant difference in MTHFR gene TT genotype or T allele frequency (χ2 = 15.737, 9.186, P < 0.01) between ICVD cases and controls. In addition, six Chinese Han population studies were specially reviewed by meta-analysis. Results showed no sig-nificant difference between ICVD and control groups with regard to frequency of MTHFR gene TT genotype and T allele (χ2 = 1.076, 2.434, P > 0.05) in the Chinese Han population. CONCLUSION: Results from the present meta-analysis suggested that the MTHFR gene TT genotype or T allele is a risk factor for ICVD. However, the TT genotype or T allele is not a risk factor for ICVD in the Chinese Han population.展开更多
Identified as a treasure of natural herbal products,traditional Chinese medicine(TCM)has attracted extensive attention for their moderate treatment effect and lower side effect.Cardio-cerebrovascular diseases(CCVD)are...Identified as a treasure of natural herbal products,traditional Chinese medicine(TCM)has attracted extensive attention for their moderate treatment effect and lower side effect.Cardio-cerebrovascular diseases(CCVD)are a leading cause of death.TCM is used in China to prevent and treat CCVD.However,the complexity of TCM poses challenges in understanding the mechanisms of herbs at a systems-level,thus hampering the modernization and globalization of TCM.A novel model,termed traditional Chinese medicine systems pharmacology(TCMSP)analysis platform,which relies on the theory of systems pharmacology and integrates absorption,distribution,metabolism,excretion and toxicity(ADME/T)evaluation,target prediction and network/pathway analysis,was proposed to address these problems.Here,we review the development of systems pharmacology,the TCMSP approach and its applications in the investigations of CCVD and compare it with other methods.TCMSP assists in uncovering the mechanisms of action of herbal formulas used in treating CCVD.It can also be applied in ascertaining the different syndrome patterns of coronary artery disease,decoding the multi-scale mechanisms of herbs,and in understanding the mechanisms of herbal synergism.展开更多
Ischemic heart disease (IHD) is the most common cause of death around the world. Nowadays Platelet counts (PC) and volumetric platelet indices are available routinely in most laboratories and reflect the level of mobi...Ischemic heart disease (IHD) is the most common cause of death around the world. Nowadays Platelet counts (PC) and volumetric platelet indices are available routinely in most laboratories and reflect the level of mobility and production of platelets. It seems that the excessive flexibility and size of the platelets and their local activation have correlation with extent of ischemic heart disease. So our objective is the study of platelet indices in ischemic heart disease. This non-randomized prospective study was performed on 245 patients with ischemic heart disease, who underwent the coronary angiography. The patients were divided into four groups: stable angina, unstable angina, acute myocardial infarction and control group;and then platelet indices, including the platelet counts (PC), the average platelet volume (MPV), the Platelet Distribution Width (PDW) and plateletcrit (PCT) in each group with the extent of coronary disease were compared based on an Syntax Score system and observational methods. The average ages of the patients were 57 years and 65% of them were male and the rest were female. A significant difference is exists between indices in all three groups compared to the control that this difference was related to gender and the type of the coronary artery involvement. However, only in infarction group, PDW in different disease intensities was significantly different. In this study, unlike many of the previous studies no relationship was found between the MPV with the extent of coronary disease.展开更多
<strong>Aims:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""><strong> </strong>To determine the cardiovascular and cerebrovascula...<strong>Aims:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""><strong> </strong>To determine the cardiovascular and cerebrovascular prognosis at 5 years of patients who underwent an ischemic stroke in Senegal. <b>Methods:</b> We performed a descriptive, retrospective and exhaustive study conducted at Principal Hospital of Dakar. We included all patients hospitalized at Principal Hospital of Dakar from 2013 to 201</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">9</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> for an ischemic stroke confirmed by a cerebral CT-Scanner or by magnetic resonance imaging, and who survived the acute phase. <b>Results: </b>Overall, one</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">hundred and seventy-one (171) patients were gathered. Ninety-six (96) male patients account for 56.14% and seventy-five (75) female patients account for 43.86%</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">,</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> with a sex</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ratio of 1.28. Patients’mean age was 66.33 ±</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""></span><span style="white-space:normal;font-size:10pt;font-family:;" "="">13.99 years. Twenty-one (21) young patients (12.35%), aged less than 50 years, presented with an ischemic stroke. Myocardial infarction was found in a female patient (0</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">.</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">6%) 3 months after she experienced an ischemic stroke, nine (9) patients (5.29%) underwent a recurrence of the ischemic stroke with a mean recurrence period of 8 months and extremes rang</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ing</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> from 1 to 24 months. Five (5) patients (2.92%) developed dementia with a score less than 28. A 30 years old patient presented with epilepsy 12 months after the ischemic stroke accounting </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">for </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">0.58%. We registered ninety (90) deaths that occurred in a mean period of 24 months ±</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">9.8 after they presented their ischemic stroke, standing for 52.63% amongst which thirty</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">five (35) accounting for 39% were female patients and fifty</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">five patients (55) representing 61% were male patients. Mortality-related factors included: advanced age, past medical history of heart surgery, known </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">as </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">dys</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">lipidemia, physical inactivity, obesity and recurrent ischemic stroke. <b>Conclusion:</b> Long</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">term prognosis of ischemic stroke remains unclear in Senegal. </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">Therefore</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">,</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> a strategy for primary prevention is highly crucial and </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">it </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">requires the control of risk factors in general and that of high blood pressure in particular.</span>展开更多
Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perf...Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases (83%) with convict vascular stenosis and perfusion abnormalities, and five cases (45%) with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores ≥ 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores < 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.展开更多
[Objective]The study aimed to discuss the relationship of cardiovascular and cerebrovascular diseases to meteorological conditions and forecast method in Nanjing City.[Method]Based on daily cases of cardiovascular and...[Objective]The study aimed to discuss the relationship of cardiovascular and cerebrovascular diseases to meteorological conditions and forecast method in Nanjing City.[Method]Based on daily cases of cardiovascular and cerebrovascular diseases from a hospital in Nanjing City as well as daily meteorological data from Nanjing Meteorological Station from January 2003 to July 2008,the monthly and seasonal variations in quantity of patients suffering from cardiovascular and cerebrovascular diseases in Nanjing City were analyzed firstly,and then the relationship between meteorological elements and incidence of the diseases was discussed,finally the forecast model for the incidence of the diseases was established using the stepwise regression method.[Result]Cardiovascular and cerebrovascular diseases in Nanjing City happened all the year round,and the incidence was high in the seasonal transition phase from autumn to winter.Daily incidence of the diseases in Nanjing City correlated negatively with daily maximum,minimum and average vapor pressure,daily minimum relative humidity and so forth,but their incidence had positive correlations with diurnal range of daily temperature,daily maximum,minimum and average pressure.Daily average number of patients suffering from the diseases obviously correlated with daily average temperature,daily maximum vapor pressure and daily average relative humidity.[Conclusion]The research could provide scientific references for the prevention and forecast of cardiovascular and cerebrovascular diseases in future.展开更多
Currently it is not well known whether apolipoprotein E(ApoE) is a genetic susceptibility factor for cerebrovascular diseases in the Chinese Naxi population.The present study detected and sequenced ApoE polymorphisms ...Currently it is not well known whether apolipoprotein E(ApoE) is a genetic susceptibility factor for cerebrovascular diseases in the Chinese Naxi population.The present study detected and sequenced ApoE polymorphisms of 90 patients with cerebrovascular diseases(58 cases of cerebral infarction and 32 cases of intracerebral hemorrhage),and 50 normal people of Naxi nationality from Yunnan province,China.The populations were used to analyze the relationship of ApoE polymorphisms with cerebral infarction and intracerebral hemorrhage.Results showed an association between ApoE gene polymorphism and the onset of cerebral infarction,and a possibility that the ε4 allele is a susceptibility locus for the risk of cerebral infarction.However,there was no evidence of a relationship between the ApoE gene polymorphism and cerebral hemorrhage.展开更多
Dl-3n-butylphthalide is the active component isolated from the seeds of Apium graveolens Linn.A number of pharmacological and clinical studies have proven that dl-3n-butylphthalide is highly potent and multi-targeted ...Dl-3n-butylphthalide is the active component isolated from the seeds of Apium graveolens Linn.A number of pharmacological and clinical studies have proven that dl-3n-butylphthalide is highly potent and multi-targeted with low toxicity and has a long time-window for the treatment of ischemic cerebrovascular disease.The mechanisms underlying dl-3n-butylphthalide include improving mi-tochondrial function and microcirculation,inhibiting apoptosis and reducing oxidative stress.Fur-thermore,dl-3n-butylphthalide may also be promising for the treatment of neurodegenerative dis-eases,such as Alzheimer's disease,vascular dementia and Parkinson's disease.展开更多
Portfolio has been used as an approach to promoting self-learning in the field of education and its effectiveness was reported in school education. The purpose of this study was to assess effectiveness of portfolio as...Portfolio has been used as an approach to promoting self-learning in the field of education and its effectiveness was reported in school education. The purpose of this study was to assess effectiveness of portfolio as a tool for educating patients with ischemic heart diseases as self-management behavior in terms of applicability and efficacy. Subjects of this study were seventeen patients who had myocardial infarction or angina. They were assigned to collect information about their themes chosen from diet, exercise, alcohol intake, smoking cessation, and stress management and gathered in files. Thirty minutes face-to-face educational interviews were conducted by a nurse for once per month over three months. Self-management, self-efficacy, and physiological data were evaluated for baseline and 3 months. Two participants dropped within two months (completion rate is 88.2%). The results showed that portfolio was effective as a self-management education tool on patients who were willing to participate, but did not improve physiological data if they did not continuously implement lifestyle change. Moreover it was dangerous when the patients acquired incorrect information on diseases. For these patients, health education by health professionals is required prior to conducting portfolio. Attributes fit for portfolio were assessed. Effectiveness of portfolio related to high self-efficacy and high self-management, but did not relate to living status, having job, educational background, and health locus of control.展开更多
BACKGROUND The prognosis of cerebrovascular diseases treated with mechanical ventilation during perioperative has not been clearly reported.AIM To analyze mortality and functional disability and to determine predictor...BACKGROUND The prognosis of cerebrovascular diseases treated with mechanical ventilation during perioperative has not been clearly reported.AIM To analyze mortality and functional disability and to determine predictors of unfavorable outcome in the patients with cerebrovascular diseases treated with mechanical ventilation.METHODS A retrospective follow-up study of 111 cerebrovascular disease patients who underwent mechanical ventilation during the perioperative period in the First Hospital of Jilin University from June 2016 to June 2019 was performed.Main measurements were mortality and functional outcome in-hospital and after 3-month follow-up.According to the modified rankin scale(mRS),the functional outcome was divided into three groups:Good recovery(mRS≤3),severe disability(mRS=4 or 5)and death(mRS=6).Univariate analysis was used to compare the differences between three functional outcomes.Multivariate logistic regression analysis was used to for risk factors of mortality and severe disability.RESULTS The average age of 111 patients was 56.46±12.53 years,59(53.15%)were males.The mortality of in-hospital and 3-month follow-up were 36.9% and 45.0%,respectively.Of 71 discharged patients,46.47% were seriously disabled and 12.67% died after three months follow-up.Univariate analysis showed that preoperative glasgow coma scale,operation start time and ventilation reasons had statistically significant differences in different functional outcomes.Multiple logistic regression analysis showed that the cause of ventilation was related to the death and poor prognosis of patients with cerebrovascular diseases.Compared with brainstem compression,the risk of death or severe disability of pulmonary disease,status epilepticus,impaired respiratory center function,and shock were 0.096(95%CI:0.028-0.328),0.026(95%CI:0.004-0.163),0.095(95%CI:0.013-0.709),0.095(95%CI:0.020-0.444),respectively.CONCLUSION The survival rate and prognostic outcomes of patients with cerebrovascular diseases treated with mechanical ventilation during the perioperative period were poor.The reason for mechanical ventilation was a statistically significant predictor for mortality and severe disability.展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos:.82070356 and 81770337)the Key Project of Hunan Provincial Science and Technology Innovation,China(Grant No.:2020SK1013)the Hunan Provincial Natural Science Foundation of China(Grant No.:2021JJ30033).
文摘Catalpol,an iridoid glucoside isolated from Rehmannia glutinosa,has gained attention due to its potential use in treating cardio-cerebrovascular diseases(CVDs).This extensive review delves into recent studies on catalpol's protective properties in relation to various CVDs,such as atherosclerosis,myocardial ischemia,infarction,cardiac hypertrophy,and heart failure.The review also explores the compound's anti-oxidant,anti-inflammatory,and anti-apoptotic characteristics,emphasizing the role of vital signaling pathways,including PGC-1a/TERT,PI3K/Akt,AMPK,Nrf2/HO-1,estrogen receptor(ER),Nox4/NF-kB,and GRP78/PERK.The article discusses emerging findings on catalpol's ability to alleviate diabetic cardiovascular complications,thrombosis,and other cardiovascular-related conditions.Although clinical studies specifically addressing catalpol's impact on CVDs are scarce,the compound's established safety and well-tolerated nature suggest that it could be a valuable treatment alternative for CVD patients.Further investigation into catalpol and related iridoid derivatives may unveil new opportunities for devising natural and efficacious CVD therapies.
基金supported by the Youth Fund of Fundamental Research Fund for the Central Universities of Jinan University,No.11622303(to YZ).
文摘Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.
文摘Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.
文摘BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.
文摘BACKGROUND: Carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular disease. Therefore, the close relationship of carotid atherosclerotic plaque and ischemic cerebrovascular disease, and ultrasound evaluation of carotid atherosclerotic plaque have become the hot spot in studying ischemic cerebrovascular disease. OBJECTIVE: This study was to detect the degree of carotid atherosclerosis of ischemic cerebrovascular disease patients by ultrasonography, and to analyze the situation of carotid atherosclerosis and its relationship with clinic. DESIGN: Clinical randomized concurrent control experiment. SETTING: Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA. PARTICIPANTS: Totally 60 outpatients and inpatients with ischemic cerebrovascular disease, 42 males and 18 females, admitted to Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA between January 2006 and December 2006 were involved in the patient group. They met the diagnosis criteria of ischemic cerebrovascular disease constituted by the 4th Cerebrovascular Disease Conference in 1996, and were confirmed to suffer from ischemic cerebrovascular disease by skull CT and MRI. Another 20 subjects who received healthy examination concurrently in the same hospital, 12 males and 8 females, were involved in the control group. Informed consents of detected items were obtained from involved subjects. METHODS: The plaque thickness of mid portion, distal end and crotch of common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA) and vertebral artery (VA) of involved subjects, who received health examination was separately detected with color Doppler ultrasonograph (HDI-5000). Then, total integral of plaque was calculated. The intima-media thickness (IMT) was measured with two-dimensional ultrasonography. The inner diameter stenosis degree of subjects who had plaque was measured. Blood flow parameters were recorded, and stenosis degree and plaque area were calculated. Blood flow volume of bilateral carotid artery and VA was separately measured with ultrasound equipment software, and brain blood flow volume was calculated. MAIN OUTCOME MEASURES: Atherosclerotic degree and blood flow volume of patients of two groups. RESULTS: Sixty patients with ischemic cerebrovascular disease and twenty subjects who received health examination participated in the final analysis. ①The IMT thickness, total plaque score, and total plaque area of patient group was significantly superior to that of control group, respectively(t=5.216–10.158,P < 0.05). ② There were significant differences in the stenosis degree of CCA, ICA and VA between patient group and control group (t=6.720–12.816,P < 0.05). ③ The blood flow volume of CCA, ICA, VA and brain of patient group was significantly lower than that of control group, respectively (t=2.872–10.860, P < 0.05). CONCLUSION: Ischemic cerebrovascular disease patients have different degrees of changes in atherosclerosis and arterial blood flow.
基金Supported by the National Natural Science Foundation of China(No.81271014No.81470655No.81570856)
文摘Toll-like receptors(TLRs) are commonly referred to a series of evolutionary conserved receptors which recognize and respond to various microbes and endogenous ligands.Growing evidence has demonstrated that the expression of TLRs in the retina is regulated during retinal ischemic diseases,including ischemia-reperfusion injury,glaucoma,diabetic retinopathy(DR) and retinopathy of prematurity(ROP).TLRs can be expressed in multiple cells in the retina,such as glial cells,retinal pigment epithelium(RPE),as well as photoreceptor cells and endothelium cells.Activation of TLRs in retina could initiate a complex signal transduction cascade,induce the production of inflammatory cytokines and regulate the level of costimulatory molecules,which play prominent roles in the pathogenesis of retinal ischemic diseases.In this review,we summarized current studies about the relationship between TLRs and ischemic retinopathy.A greater understanding of the effect of TLRs on ischemic injuries may contribute to the development of specific TLR targeted therapeutic strategies in these conditions.
文摘Objective The -455 G/A(HaeIII)polymorphism of β-fibrinogen gene influences levels of plasma fibrinogen. We further investigated whether it influences the risk of ischemic cerebrovascular disease. Methods We accumulated 134 acute ischemic cerebrovascular disease(ICVD)cases and compared their -455 G/A status with a control group(n = 166). The β-fibrinogen gene -455 G/A polymorphism was analyzed for all subjects by PCR-RFLP with the restrictive enzyme HaeIII. Results Plasma fibrinogen was higher in AA homozygous participants(341 mg/dL)than in partici-pants carrying the G allele: GA(290 mg/dL), GG(298 mg/dL)in the control group. Plasma fibrinogen was also higher in AA homozygous patients(353 mg/dL)than in cases carrying the G allele: GA(287 mg/dL), GG(302 mg/dL)in the ICVD group. However, there was no significant association between β-fibrinogen gene -455 G/A polymorphism and ICVD group. Conclusions Although a small effect cannot be excluded, β-fibrinogen gene -455 G/A polymor-phism is an independent predictor of plasma fibrinogen, but not of ischemic cerebrovascular disease.
文摘BACKGROUND: Hyperhomocysteinemia, as an important risk factor for ischemic cerebrovascular disease is receiving increasing attention. OBJECTIVE: To analyze whether differences of gender, age, cerebrovascular disease typing, and disease conditions exist when ischemic cerebrovascular disease occurs together with hyperhomocysteinemia. DESIGN: A controlled observation. SETTING: Department of Neurology, Tianjin Huanhu Hospital. PARTICIPANTS: A total of 601 acute ischemic cerebrovascular disease inpatients, comprising 386 males and 215 females, aged 33-90 years old, were admitted to the Department of Stroke, Tianjin Huanhu Hospital between August 2005 and April 2007, and were recruited for this study. All included patients consisted of 342 aged patients (≥ 60 years old) and 92 middle-aged and young patients (< 60 years old). Among these patients, 48 suffered from transient cerebral ischemic attack, 138 from lacunar cerebral infarction, 273 from atherosclerotic stroke, 38 from cardiogenic cerebral infarction, 44 from agnogenic ischemic stroke, and 6 from other factor-induced ischemic strokes. All included inpatients corresponded to the diagnosis criteria of acute ischemic cerebrovascular disease, formulated in the 4th National Working Conference of Cerebrovascular Disease, and were confirmed as acute ischemic cerebral infarction by CT and/or MRI examinations. Informed consents of laboratory measurements were obtained from all subjects, and this study was approved by the Hospital’s Ethics Committee. METHODS: Following admission, 2 mL venous blood was collected from each fasting patient on the third morning. Plasma homocysteine level was measured by an enzymatic cycling assay with a CX5 reader (Beckman, USA). Plasma homocysteine levels ≥ 16 μmol/L were defined as hyperhomocysteinemia. Clinical neurological function deficit scoring was also performed for each ischemic stroke patient using Chinese stroke scales. Scores ranged from 0-45 (0-15: mild neurological function deficits, 16-30: moderate neurological deficits, and 31-45: severe neurological deficits). The scores positively correlated with severity of stroke. MAIN OUTCOME MEASURES: Incidence of ischemic cerebrovascular disease patients complicated by hyperhomocysteinemia and the effects of patient age and gender; plasma homocysteine levels of each type of ischemic cerebrovascular disease; and effects of ischemic cerebrovascular disease conditions on plasma homocysteine levels. RESULTS: All 601 inpatients with acute ischemic cerebrovascular disease were included in the final analysis. The detection rate of homocysteine was significantly higher in aged patients than in middle-aged and young patients (χ2 = 5.353 0, P < 0.05). The incidence of hyperhomocysteinemia was significantly higher in male patients than in female patients (χ2 = 9.484 4, P < 0.05). There was no significant difference in the incidence of hyperhomocysteinemia among various types of ischemic cerebrovascular diseases (P > 0.05). No significant difference in incidence of hyperhomocysteinemia existed between mild, moderate, and severe cerebrovascular disease patients (P > 0.05). CONCLUSION: There is a greater chance of ischemic cerebrovascular disease complicated by hyperhomocysteinemia in older, male patients.
文摘A control study of clinical therapeutic effects of scalp acupuncture was made onforty-four Patients suffering from aphasia caused by acute cerebrovascular diseases,and was observedfor 4 weeks.The results revealed that the therapeutic effect in the scalp acupuncture group was betterthan that in the controlgroup.Aphasia was cured more rapidly in the scalpacupuncturegroug than inhe control group.The difference was of significance statistically.
文摘OBJECTIVE: To assess whether 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene poly-morphism (TT genotype or T allele) is a risk factor for ischemic cerebrovascular disease (ICVD). DATA SOURCES: MEDLINE and PubMed databases from September 1997 to December 2009 were searched for case-control studies that examined MTHFR genotype in human ICVD using "MTHFR, gene, polymorphism, and ischemic cerebrovascular disease" as search key words. STUDY SELECTION: Eighteen associated studies were identified. The methods used to collect relevant information factors were similar between case and control groups, and diagnosis of ischemic cerebrovascular disease was in accordance with Trial of ORG 10172 in Acute Stroke Treatment criteria classification, with some referring to European Stroke Diagnostic Criteria. Quality of all included studies was evaluated, and meta-analysis was conducted using RevMan4.2 software (Cochrane Collaboration, http://www.cochrane-handbook.org) following strict screening. MAIN OUTCOME MEASURES: The correlation between MTHFR gene TT genotype or T allele and ICVD was determined. RESULTS: Eighteen studies involving 4 295 patients with ICVD and 6 169 control subjects were included for this meta-analysis. There was a significant difference in MTHFR gene TT genotype or T allele frequency (χ2 = 15.737, 9.186, P < 0.01) between ICVD cases and controls. In addition, six Chinese Han population studies were specially reviewed by meta-analysis. Results showed no sig-nificant difference between ICVD and control groups with regard to frequency of MTHFR gene TT genotype and T allele (χ2 = 1.076, 2.434, P > 0.05) in the Chinese Han population. CONCLUSION: Results from the present meta-analysis suggested that the MTHFR gene TT genotype or T allele is a risk factor for ICVD. However, the TT genotype or T allele is not a risk factor for ICVD in the Chinese Han population.
基金grants from Northwest A&F University(grant number No.:201003)National Natural Science Foundation of China(#31170796 and#81373892)+1 种基金the“973”program(#2013CB531800)The China Academy of Chinese Medical Sciences provided partial support(#ZZ0608).
文摘Identified as a treasure of natural herbal products,traditional Chinese medicine(TCM)has attracted extensive attention for their moderate treatment effect and lower side effect.Cardio-cerebrovascular diseases(CCVD)are a leading cause of death.TCM is used in China to prevent and treat CCVD.However,the complexity of TCM poses challenges in understanding the mechanisms of herbs at a systems-level,thus hampering the modernization and globalization of TCM.A novel model,termed traditional Chinese medicine systems pharmacology(TCMSP)analysis platform,which relies on the theory of systems pharmacology and integrates absorption,distribution,metabolism,excretion and toxicity(ADME/T)evaluation,target prediction and network/pathway analysis,was proposed to address these problems.Here,we review the development of systems pharmacology,the TCMSP approach and its applications in the investigations of CCVD and compare it with other methods.TCMSP assists in uncovering the mechanisms of action of herbal formulas used in treating CCVD.It can also be applied in ascertaining the different syndrome patterns of coronary artery disease,decoding the multi-scale mechanisms of herbs,and in understanding the mechanisms of herbal synergism.
文摘Ischemic heart disease (IHD) is the most common cause of death around the world. Nowadays Platelet counts (PC) and volumetric platelet indices are available routinely in most laboratories and reflect the level of mobility and production of platelets. It seems that the excessive flexibility and size of the platelets and their local activation have correlation with extent of ischemic heart disease. So our objective is the study of platelet indices in ischemic heart disease. This non-randomized prospective study was performed on 245 patients with ischemic heart disease, who underwent the coronary angiography. The patients were divided into four groups: stable angina, unstable angina, acute myocardial infarction and control group;and then platelet indices, including the platelet counts (PC), the average platelet volume (MPV), the Platelet Distribution Width (PDW) and plateletcrit (PCT) in each group with the extent of coronary disease were compared based on an Syntax Score system and observational methods. The average ages of the patients were 57 years and 65% of them were male and the rest were female. A significant difference is exists between indices in all three groups compared to the control that this difference was related to gender and the type of the coronary artery involvement. However, only in infarction group, PDW in different disease intensities was significantly different. In this study, unlike many of the previous studies no relationship was found between the MPV with the extent of coronary disease.
文摘<strong>Aims:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""><strong> </strong>To determine the cardiovascular and cerebrovascular prognosis at 5 years of patients who underwent an ischemic stroke in Senegal. <b>Methods:</b> We performed a descriptive, retrospective and exhaustive study conducted at Principal Hospital of Dakar. We included all patients hospitalized at Principal Hospital of Dakar from 2013 to 201</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">9</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> for an ischemic stroke confirmed by a cerebral CT-Scanner or by magnetic resonance imaging, and who survived the acute phase. <b>Results: </b>Overall, one</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">hundred and seventy-one (171) patients were gathered. Ninety-six (96) male patients account for 56.14% and seventy-five (75) female patients account for 43.86%</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">,</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> with a sex</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ratio of 1.28. Patients’mean age was 66.33 ±</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""></span><span style="white-space:normal;font-size:10pt;font-family:;" "="">13.99 years. Twenty-one (21) young patients (12.35%), aged less than 50 years, presented with an ischemic stroke. Myocardial infarction was found in a female patient (0</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">.</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">6%) 3 months after she experienced an ischemic stroke, nine (9) patients (5.29%) underwent a recurrence of the ischemic stroke with a mean recurrence period of 8 months and extremes rang</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ing</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> from 1 to 24 months. Five (5) patients (2.92%) developed dementia with a score less than 28. A 30 years old patient presented with epilepsy 12 months after the ischemic stroke accounting </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">for </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">0.58%. We registered ninety (90) deaths that occurred in a mean period of 24 months ±</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">9.8 after they presented their ischemic stroke, standing for 52.63% amongst which thirty</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">five (35) accounting for 39% were female patients and fifty</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">five patients (55) representing 61% were male patients. Mortality-related factors included: advanced age, past medical history of heart surgery, known </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">as </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">dys</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">lipidemia, physical inactivity, obesity and recurrent ischemic stroke. <b>Conclusion:</b> Long</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">-</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">term prognosis of ischemic stroke remains unclear in Senegal. </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">Therefore</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">,</span><span style="white-space:normal;font-size:10pt;font-family:;" "=""> a strategy for primary prevention is highly crucial and </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">it </span><span style="white-space:normal;font-size:10pt;font-family:;" "="">requires the control of risk factors in general and that of high blood pressure in particular.</span>
基金supported by the Youth Fund of the First Clinical College of Liaoning Medical University, No. 2010C20
文摘Thirty-four patients with cerebral infarction and 18 patients with transient ischemic attack were examined by multi-slice spiral CT scan, CT perfusion imaging, and CT angiography within 6 hours after onset. By CT perfusion imaging, 29 cases in the cerebral infarction group and 10 cases in the transient ischemic attack group presented with abnormal blood flow perfusion, which corresponded to the clinical symptoms. By CT angiography, various degrees of vascular stenosis could be detected in 41 patients, including 33 in the cerebral infarction group and eight in the transient ischemic attack group. The incidence of intracranial artery stenosis was higher than that of extracranial artery stenosis. The intracranial artery stenosis was located predominantly in the middle cerebral artery and carotid artery siphon, while the extracranial artery stenosis occurred mainly in the bifurcation of the common carotid artery and the opening of the vertebral artery. There were 34 cases (83%) with convict vascular stenosis and perfusion abnormalities, and five cases (45%) with perfusion abnormalities but without convict vascular stenosis. The incidence of cerebral infarction in patients with National Institutes of Health Stroke Scale scores ≥ 5 points during onset was significantly higher than that in patients with National Institutes of Health Stroke Scale scores < 5 points. These experimental findings indicate that the combined application of various CT imaging methods allows early diagnosis of acute ischemic cerebrovascular disease, which can comprehensively analyze the pathogenesis and severity of acute ischemic cerebrovascular disease at the morphological and functional levels.
基金Supported by the"Meteorology and Health"Subject of Shanghai Science and Technology Committee(QXJK201214)
文摘[Objective]The study aimed to discuss the relationship of cardiovascular and cerebrovascular diseases to meteorological conditions and forecast method in Nanjing City.[Method]Based on daily cases of cardiovascular and cerebrovascular diseases from a hospital in Nanjing City as well as daily meteorological data from Nanjing Meteorological Station from January 2003 to July 2008,the monthly and seasonal variations in quantity of patients suffering from cardiovascular and cerebrovascular diseases in Nanjing City were analyzed firstly,and then the relationship between meteorological elements and incidence of the diseases was discussed,finally the forecast model for the incidence of the diseases was established using the stepwise regression method.[Result]Cardiovascular and cerebrovascular diseases in Nanjing City happened all the year round,and the incidence was high in the seasonal transition phase from autumn to winter.Daily incidence of the diseases in Nanjing City correlated negatively with daily maximum,minimum and average vapor pressure,daily minimum relative humidity and so forth,but their incidence had positive correlations with diurnal range of daily temperature,daily maximum,minimum and average pressure.Daily average number of patients suffering from the diseases obviously correlated with daily average temperature,daily maximum vapor pressure and daily average relative humidity.[Conclusion]The research could provide scientific references for the prevention and forecast of cardiovascular and cerebrovascular diseases in future.
基金the Scientific Research Foundation of Yunnan Provincial Science and Technology Department, Kunming Medical College, No. 2008CD010
文摘Currently it is not well known whether apolipoprotein E(ApoE) is a genetic susceptibility factor for cerebrovascular diseases in the Chinese Naxi population.The present study detected and sequenced ApoE polymorphisms of 90 patients with cerebrovascular diseases(58 cases of cerebral infarction and 32 cases of intracerebral hemorrhage),and 50 normal people of Naxi nationality from Yunnan province,China.The populations were used to analyze the relationship of ApoE polymorphisms with cerebral infarction and intracerebral hemorrhage.Results showed an association between ApoE gene polymorphism and the onset of cerebral infarction,and a possibility that the ε4 allele is a susceptibility locus for the risk of cerebral infarction.However,there was no evidence of a relationship between the ApoE gene polymorphism and cerebral hemorrhage.
基金the Undergraduate Creative Program of Central South University,No. 081053358the Education Expenditure of Hunan Provincial Finance Department,No. 2010163the Key Frontier Research Project of Central South University (from 2010 to 2011)
文摘Dl-3n-butylphthalide is the active component isolated from the seeds of Apium graveolens Linn.A number of pharmacological and clinical studies have proven that dl-3n-butylphthalide is highly potent and multi-targeted with low toxicity and has a long time-window for the treatment of ischemic cerebrovascular disease.The mechanisms underlying dl-3n-butylphthalide include improving mi-tochondrial function and microcirculation,inhibiting apoptosis and reducing oxidative stress.Fur-thermore,dl-3n-butylphthalide may also be promising for the treatment of neurodegenerative dis-eases,such as Alzheimer's disease,vascular dementia and Parkinson's disease.
文摘Portfolio has been used as an approach to promoting self-learning in the field of education and its effectiveness was reported in school education. The purpose of this study was to assess effectiveness of portfolio as a tool for educating patients with ischemic heart diseases as self-management behavior in terms of applicability and efficacy. Subjects of this study were seventeen patients who had myocardial infarction or angina. They were assigned to collect information about their themes chosen from diet, exercise, alcohol intake, smoking cessation, and stress management and gathered in files. Thirty minutes face-to-face educational interviews were conducted by a nurse for once per month over three months. Self-management, self-efficacy, and physiological data were evaluated for baseline and 3 months. Two participants dropped within two months (completion rate is 88.2%). The results showed that portfolio was effective as a self-management education tool on patients who were willing to participate, but did not improve physiological data if they did not continuously implement lifestyle change. Moreover it was dangerous when the patients acquired incorrect information on diseases. For these patients, health education by health professionals is required prior to conducting portfolio. Attributes fit for portfolio were assessed. Effectiveness of portfolio related to high self-efficacy and high self-management, but did not relate to living status, having job, educational background, and health locus of control.
文摘BACKGROUND The prognosis of cerebrovascular diseases treated with mechanical ventilation during perioperative has not been clearly reported.AIM To analyze mortality and functional disability and to determine predictors of unfavorable outcome in the patients with cerebrovascular diseases treated with mechanical ventilation.METHODS A retrospective follow-up study of 111 cerebrovascular disease patients who underwent mechanical ventilation during the perioperative period in the First Hospital of Jilin University from June 2016 to June 2019 was performed.Main measurements were mortality and functional outcome in-hospital and after 3-month follow-up.According to the modified rankin scale(mRS),the functional outcome was divided into three groups:Good recovery(mRS≤3),severe disability(mRS=4 or 5)and death(mRS=6).Univariate analysis was used to compare the differences between three functional outcomes.Multivariate logistic regression analysis was used to for risk factors of mortality and severe disability.RESULTS The average age of 111 patients was 56.46±12.53 years,59(53.15%)were males.The mortality of in-hospital and 3-month follow-up were 36.9% and 45.0%,respectively.Of 71 discharged patients,46.47% were seriously disabled and 12.67% died after three months follow-up.Univariate analysis showed that preoperative glasgow coma scale,operation start time and ventilation reasons had statistically significant differences in different functional outcomes.Multiple logistic regression analysis showed that the cause of ventilation was related to the death and poor prognosis of patients with cerebrovascular diseases.Compared with brainstem compression,the risk of death or severe disability of pulmonary disease,status epilepticus,impaired respiratory center function,and shock were 0.096(95%CI:0.028-0.328),0.026(95%CI:0.004-0.163),0.095(95%CI:0.013-0.709),0.095(95%CI:0.020-0.444),respectively.CONCLUSION The survival rate and prognostic outcomes of patients with cerebrovascular diseases treated with mechanical ventilation during the perioperative period were poor.The reason for mechanical ventilation was a statistically significant predictor for mortality and severe disability.