RESUMEN
Psychological stress is associated with a systemic inflammatory response. It is unclear, however, whether psychological stress contributes to vascular inflammation. Here, we examined the effects of unpredictable chronic mild stress (UCMS) on vascular inflammation in rabbits. One hundred rabbits were randomly divided into control and stress groups. UCMS was induced by a set of defined adverse conditions applied in a shuffled order for 4, 8, 12, or 16 weeks, and rabbits were killed 24 h after the end of the UCMS protocol. Expression of different inflammatory molecules was analyzed by real-time polymerase chain reaction, immunohistochemistry, or enzyme-linked immunosorbent assay. UCMS resulted in depression-like behaviors, decreased body weight gain, and hypertension with no significant effects on serum lipids. Aortic mRNA and protein expression for tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP-1), macrophage migration inhibitory factor, and expression of intercellular adhesion molecule-1 (ICAM-1) protein were increased. UCMS increased circulating concentrations of corticosterone, TNF-α, and CRP throughout. Moreover, stress downregulated the expression of endothelial nitric oxide synthase. At 16 weeks of UCMS, macrophage infiltration and lipid accumulation in the subendothelial space were detected in the aorta. In cultured murine vascular smooth muscle cells, treatment with serum from stressed rabbits significantly increased phosphorylation of p38 and c-Jun N-terminal kinase (JNK), and upregulated expression of MCP-1 and ICAM-1 mRNAs, in which the effect was blunted by a TNF-α neutralizing antibody or p38 and JNK inhibitors. Our results indicate that chronic psychological stress induces vascular inflammation via TNF-α and p38/JNK pathways, which may contribute to the development of atherosclerosis.
Asunto(s)
Estrés Psicológico/complicaciones , Estrés Psicológico/patología , Vasculitis/etiología , Vasculitis/patología , Animales , Conducta Animal/fisiología , Western Blotting , Peso Corporal/fisiología , Células Cultivadas , Enfermedad Crónica , Ingestión de Alimentos/fisiología , Hemodinámica/fisiología , Homeostasis/fisiología , Sistema Hipotálamo-Hipofisario/fisiología , Inmunohistoquímica , Metabolismo de los Lípidos/fisiología , Masculino , Ratones , Ratones Endogámicos C57BL , Miocitos del Músculo Liso/fisiología , Ruido/efectos adversos , Periodicidad , Sistema Hipófiso-Suprarrenal/fisiología , Conejos , Reacción en Cadena en Tiempo Real de la Polimerasa , Restricción Física , Estrés Psicológico/psicologíaRESUMEN
In recent years, projects funded by the Division V III of Health Sciences of the National Natural Science Foundation of China (NSFC) increased steadily, which enhanced the process of modernization of Chinese medicine (CM). We analyzed CM projects funded by NSFC during 2003 -2012, which aimed to provide reference to experts in the CM field.
Asunto(s)
Fundaciones , Medicina Tradicional China , ChinaRESUMEN
The applications accepted and approved by general program, young scientist fund and fund for less developed region of national natural science funds in the discipline of Chinese materia medica, NSFC in 2012 have been introduced. The research contents of the funded projects in the popular research areas have been summarized and the problems in the applications have been analyzed to give a reference to the scientists in the field of Chinese materia medica.
Asunto(s)
Organización de la Financiación/organización & administración , Materia Medica/química , Medicina Tradicional China/economía , Disciplinas de las Ciencias Naturales/economía , China , Humanos , Personal de Laboratorio/economía , Disciplinas de las Ciencias Naturales/organización & administración , Recursos HumanosRESUMEN
Diabetic retinopathy (DR) is one of the most common retinal vascular diseases and one of the main causes of blindness worldwide. Early detection and treatment can effectively delay vision decline and even blindness in patients with DR. In recent years, artificial intelligence (AI) models constructed by machine learning and deep learning (DL) algorithms have been widely used in ophthalmology research, especially in diagnosing and treating ophthalmic diseases, particularly DR. Regarding DR, AI has mainly been used in its diagnosis, grading, and lesion recognition and segmentation, and good research and application results have been achieved. This study summarizes the research progress in AI models based on machine learning and DL algorithms for DR diagnosis and discusses some limitations and challenges in AI research.
RESUMEN
OBJECTIVES: Chronic psychological stress is associated with an increased risk of atherosclerosis in humans. Experimental studies using various stress models have yielded controversial results. This study investigated the effects of unpredictable chronic mild stress (UCMS) on atherogenesis in New Zealand white rabbits. METHODS: Rabbits were fed with a cholesterol-enriched (1%) diet for 4 to 16 weeks, with or without concomitant UCMS treatment. Atherosclerosis was assessed in the abdominal aorta by serial sectioning and morphological analysis. Expressions of inflammatory factors were measured with immunohistochemistry and quantitative polymerase chain reaction. Serum nitrate/nitrite levels were determined with Griess assay, and corticosterone and inflammatory markers were determined using enzyme-linked immunosorbent assay. RESULTS: High-cholesterol feeding resulted in hypercholesterolemia and formation of atherosclerotic plaques in the aorta. UCMS exposure significantly increased the plaque size (p = .003) and decreased the plaque stability (decreased the contents of collagen and smooth muscle and increased the amount of macrophage and matrix metalloproteinases). The proatherogenic effects of UCMS were unrelated to changes in serum cholesterol level but accompanied by increased blood pressure (p < .001) and vascular inflammation (up-regulation of tumor necrosis factor α, C-reactive protein, and monocyte chemoattractant protein 1, all p values < .01). Serum concentrations of nitrate/nitrite were lower in UCMS-treated animals (p = .01). Vessels from UCMS-treated animals exhibited augmented phosphorylation of p38 and c-Jun N-terminal kinase and activation of nuclear factor κB. CONCLUSIONS: Chronic psychological stress may contribute to the development of atherosclerosis by enhancing vascular inflammation and decreasing endothelial nitric oxide bioavailability.
Asunto(s)
Aorta Abdominal/patología , Aterosclerosis/etiología , Dieta Aterogénica/efectos adversos , Placa Aterosclerótica/patología , Estrés Psicológico/complicaciones , Animales , Aorta Abdominal/metabolismo , Aterosclerosis/metabolismo , Aterosclerosis/patología , Biomarcadores/sangre , Biomarcadores/metabolismo , Presión Sanguínea/fisiología , Proteína C-Reactiva/metabolismo , Enfermedad Crónica , Corticosterona/metabolismo , Modelos Animales de Enfermedad , Endotelio Vascular/metabolismo , Endotelio Vascular/patología , Ensayo de Inmunoadsorción Enzimática , Inmunohistoquímica , Inflamación/metabolismo , Masculino , Nitratos/sangre , Óxido Nítrico Sintasa de Tipo III/metabolismo , Nitritos/sangre , Placa Aterosclerótica/metabolismo , Reacción en Cadena de la Polimerasa , Conejos , Distribución Aleatoria , Estrés Psicológico/metabolismo , Estrés Psicológico/patología , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
Alzheimer's disease (AD) is affected by genetic factors. Polymorphisms in the glutathione S-transferase omega-1 (Gsto1) gene have been shown by genetic correlation analyses performed in different ethnic populations to be genetic risk factors for AD. Gene expression profile data from BXD recombinant inbred mice were used in combination with genetic and bioinformatic analyses to characterize the mechanisms underlying regulation of Gsto1 variation regulation and to identify network members that may contribute to AD risk or progression. Allele-specific assays confirmed that variation in Gsto1 expression is controlled by cis-expression quantitative trait loci. We found that Gsto1 mRNA levels were related to several central nervous system traits, such as glial acidic fibrillary protein levels in the caudate putamen, cortical gray matter volume, and hippocampus mossy fiber pathway volume. We identified 2168 genes whose expression was highly correlated with that of Gsto1. Some genes were enriched for the most common neurodegenerative diseases. Some Gsto1-related genes identified in this study had previously been identified as susceptibility genes for AD, such as APP, Grin2b, Ide, and Psenen. To evaluate the relationships between Gsto1 and candidate network members, we transfected astrocytes with Gsto1 siRNA and assessed the effect on putative downstream effectors. We confirmed that knockdown of Gsto1 had a significant influence on Pa2g4 expression, suggesting that Pa2g4 may be a downstream effector of Gsto1, and that both genes interact with other genes in a network during AD pathogenesis.
RESUMEN
AIM: To examine whether danshensu could protect vascular endothelia in a rat model of hyperhomocysteinemia. METHODS: The model was established by feeding rats with a methionine-rich diet (1 g·kg⻹·d⻹) for 3 months. Immediately following the discontinuation of methionine-rich diet, rats were treated with danshensu (67.5 mg·kg⻹·d⻹, po) or saline for 3 additional months. One group of rats receiving vitamin mixture (folic acid, vitamin B12 and vitamin B6) was included as a positive control. One group of rats not exposed to methionine-rich diet was also included as a blank control. The expression of tumor necrosis factor-alpha (TNF-alpha) and intercellular adhesion molecule-1 (ICAM-1) protein in the descending aorta was examined using immunohistochemistry and Western blot. Homocysteine and blood concentration of endothelin and nitric oxide (NO) was also examined. RESULTS: Methionine-rich diet resulted in accumulation of "foam cells", up-regulated expression of TNF-alpha and ICAM-1 in the descending aorta, and significantly increased serum homocysteine. Plasma endothelin concentration was significantly increased; NO was decreased. Danshensu treatment, either simultaneous to methionine-rich diet or afterwards, attenuated the above mentioned changes. CONCLUSION: Chronic treatment with danshensu could prevent/attenuate the formation of atherosclerosis. Potential mechanisms include inhibited expression of representative proinflammatory cytokines and adhesion molecules in arterial endothelia. Changes in homocysteine and circulating molecules that control vascular contraction/relaxation via endothelial cells (eg, endothelin and NO) were also implicated.
Asunto(s)
Fármacos Cardiovasculares/farmacología , Endotelio Vascular/efectos de los fármacos , Hiperhomocisteinemia/tratamiento farmacológico , Lactatos/farmacología , Animales , Aorta Torácica/metabolismo , Aterosclerosis/metabolismo , Aterosclerosis/prevención & control , Fármacos Cardiovasculares/uso terapéutico , Dieta , Modelos Animales de Enfermedad , Endotelinas/sangre , Endotelio Vascular/metabolismo , Femenino , Hiperhomocisteinemia/metabolismo , Hiperhomocisteinemia/patología , Molécula 1 de Adhesión Intercelular/sangre , Lactatos/uso terapéutico , Masculino , Metionina , Óxido Nítrico/sangre , Ratas , Ratas Wistar , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
Nurses' work-related fatigue has been recognized as a threat to nurse health and patient safety. The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan, China, and to analyze its influencing factors on fatigue. A multi-center, descriptive, cross-sectional design with a convenience sample was used. The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3, 2020 to March 10, 2020 in Wuhan of China. A total of 2667 samples from 2768 contacted participants completed the investgation, with a response rate of 96.35%. Social-demographic questionnaire, work-related questionnaire, Fatigue Scale-14, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Chinese Perceived Stress Scale were used to conduct online survey. The descriptive statistic of nurses' social-demographic characteristics was conducted, and the related variables of work, anxiety, depression, perceived stress and fatigue were analyzed by t-tests, nonparametric test and Pearson's correlation analysis. The significant factors which resulted in nurses' fatigue were further analyzed by multiple linear regression analysis. The median score for the first-line nurses' fatigue in Wuhan was 4 (2, 8). The median score of physical and mental fatigue of them was 3 (1, 6) and 1 (0, 3) respectively. According to the scoring criteria, 35.06% nurses (n=935) of all participants were in the fatigue status, their median score of fatigue was 10 (8, 11), and the median score of physical and mental fatigue of them was 7 (5, 8) and 3 (2, 4) respectively. Multiple linear regression analysis revealed the participants in the risk groups of anxiety, depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses' fatigue, the frequency of exercise and nurses' fatigue had a statistically significant negative correlation, and average daily working hours had a significantly positive correlation with nurses' fatigue, and the frequency of weekly night shift had a low positive correlation with nurses' fatigue (P<0.01). There was a moderate level of fatigue among the first-line nurses fighting against COVID-19 pandemic in Wuhan, China. Government and health authorities need to formulate and take effective intervention strategies according to the relevant risk factors, and undertake preventive measures aimed at reducing health hazards due to increased work-related fatigue among first-line nurses, and to enhance their health status and provide a safe occupational environment worldwide. Promoting both medical and nursing safety while combating with the pandemic currently is warranted.
Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/enfermería , Fatiga/etiología , Enfermeras y Enfermeros , Enfermedades Profesionales/etiología , Estrés Laboral/etiología , Pandemias , Neumonía Viral/enfermería , Adulto , COVID-19 , China/epidemiología , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Fatiga/epidemiología , Fatiga/psicología , Femenino , Humanos , Modelos Lineales , Masculino , Fatiga Mental/epidemiología , Fatiga Mental/etiología , Fatiga Mental/psicología , Persona de Mediana Edad , Enfermeras y Enfermeros/psicología , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/psicología , Estrés Laboral/epidemiología , Estrés Laboral/psicología , Neumonía Viral/epidemiología , Prevalencia , Factores de Riesgo , SARS-CoV-2 , Encuestas y Cuestionarios , Centros de Atención Terciaria , Carga de Trabajo/psicología , Adulto JovenRESUMEN
BACKGROUND AND PURPOSE: Non-small cell lung cancer (NSCLC) accounts for approximately 80-85% of all lung cancers, especially in patients 70 years old or more. In this study, we investigated the efficacy and safety of involved-field radiotherapy (IFRT) for patients 70 years old or more with early stage NSCLC. PATIENTS AND METHODS: We conducted a multicenter prospective study in elderly patients with NSCLC treated with intensity-modulated radiotherapy (IMRT). From January 1999 to December 2001, 80 patients with medically inoperable or refused surgery early stage (I/II) NSCLC were eligible for toxicity and treatment response analysis. IMRT plans were designed to deliver 66.6 Gy to involved-field that included only the primary tumor and clinically enlarged lymph nodes using six equidistant coplanar 6-MV beams. Elective nodal failure (ENF) was defined as a recurrence in an initially uninvolved lymph node in the absence of local failure. RESULTS: The objective response rate of all patients was 88.6% with a median overall survival (OS) time of 38 months and the 1-, 2- and 5-year OS rates and local progression-free survival (LPFS) rates were 65.8%, 55.7%, 25.3% and 84.8%, 59.5%, 34.2%, respectively. The medians OS time for patients with gross tumor volume (GTV) >100.8 cm3 and GTV < or =100.8 cm3 were 13 and 50 months, respectively (p=0.0001). Only 29 patients (36.7%) with ENF were identified, with a median time to treatment failure of 55 months (range, 49-61 months) after treatment. There were no treatment-related deaths or grade 4 toxicity. Grade 3 toxicities were esophagitis (1.3%), radiation pneumonitis (3.8%) and hematological effects (2.5%). CONCLUSIONS: This study indicated that IFRT using IMRT did not cause a significant amount of failure in lymph node regions not included in the tumor volume and improved outcomes in elderly patients. Therefore, IFRT is an acceptable technique in the treatment of elderly inoperable NSCLC.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Neoplasias Pulmonares/radioterapia , Radioterapia de Intensidad Modulada/métodos , Anciano , Carcinoma de Pulmón de Células no Pequeñas/patología , Progresión de la Enfermedad , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Dosificación Radioterapéutica , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
BACKGROUND: Radiation induced lung toxicity (RILT) is the main adverse effect in the radiation therapy of lung cancer. However, the optimal management of RILT has not been defined. In this paper, we investigated the effects of rhubarb extract on RILT, pulmonary function (PF), transforming growth factor-beta-1 (TGF-beta1), and interleukin-6 (IL-6) in lung cancer patients treated with radiotherapy. PATIENTS AND METHODS: We conducted a randomized, double-blind, placebo-controlled trial. Eighty consecutive patients were randomly enrolled into two groups: trial group and control group. The trial group received three-dimensional conformal radiation therapy (3D-CRT) plus rhubarb (at a dose of 20 mg kg(-1) once a day) for 6 weeks. The control group received 3D-CRT plus a placebo containing starch for 6 weeks. Plasma TGF-beta1 and serum IL-6 were measured in all patients before, every 2 weeks during, and at 6 weeks after the completion of the treatment. RILT and PF were evaluated at 6 weeks and 6 months after the end of the treatment, respectively. The differences of TGF-beta1, IL-6, RILT, and PF between the two groups were analysed. RESULTS: The incidence of RILT in the trial group was significantly lower than that in the control group at 6 weeks and 6 months after treatment (32.4% versus 56.7% at week 6, and 27.0% versus 52.8% at month 6, both P<0.05). The plasma TGF-beta1 levels in the trial group were significantly lower than that in the control group during and after the treatment (P<0.05 or 0.01, respectively). The serum IL-6 levels in the trial group were significantly lower than that in the control group during the treatment (all P<0.01). The forced vital capacity (FVC), forced expiratory volume at 1s (FEV1) at 6 weeks and the diffusion capacity for carbon monoxide (DLCO) at 6 months in the trial group were significantly improved compared to the control group (P<0.05 or 0.01, respectively). CONCLUSIONS: The rhubarb extract significantly attenuated RILT and improved PF, probably by decreasing the level of TGF-beta1 and IL-6. These results may be of value for the prophylaxis of RILT, but the exact mechanisms underlying these prophylactic effects remain to be further explored.
Asunto(s)
Interleucina-6/sangre , Neoplasias Pulmonares/radioterapia , Fitoterapia/métodos , Preparaciones de Plantas/uso terapéutico , Traumatismos por Radiación/tratamiento farmacológico , Rheum , Factor de Crecimiento Transformador beta/sangre , Biomarcadores de Tumor/sangre , Cromatografía Líquida de Alta Presión , Relación Dosis-Respuesta en la Radiación , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/sangre , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Traumatismos por Radiación/sangre , Traumatismos por Radiación/etiología , Radioterapia Conformacional/efectos adversos , Factor de Crecimiento Transformador beta/efectos de los fármacos , Resultado del TratamientoRESUMEN
Idiopathic thrombocytopenic purpura (ITP) is an organ-specific autoimmune disease characterized by the production of antiplatelet antibodies secreted by B cells resulting in enhanced destruction of platelets by macrophages. B cells have been demonstrated to play a critical role in the genesis of ITP. Recently identified B cells activating factor of the TNF ligand family (BAFF) is essential in their physiology which can promote B cells development, survival, proliferation and maturation, then the secretion of more antibodies. In the pathological conditions of ITP, there is an overproduction of BAFF. Therefore, we propose that BAFF plays, at least in part, an important role in the pathogenesis of ITP and offers the opportunity to improve our therapeutic approach.
Asunto(s)
Factor Activador de Células B/fisiología , Linfocitos B/fisiología , Púrpura Trombocitopénica Idiopática/genética , Factor Activador de Células B/genética , Linfocitos B/citología , Linfocitos B/patología , Supervivencia Celular , Humanos , Transducción de SeñalRESUMEN
Atherosclerosis is an inflammatory disease characterized by a large amount of hyperproliferation and poorly differentiated or undifferentiated smooth muscle cells in atherosclerotic plaque. Cancer cells differ from normal cells in many aspects, including hyperproliferation and loss of differentiation. So the research on tumor may shed light on the treatment of atherosclerosis. Given that Kruppel-like factor 4 (KLF4) has an important function in tumor development and progression, it may be associated with the formation and development of atherosclerosis. Recently, KLF4 expression has been documented in vascular endothelial cells. KLF4, which is normally not expressed in differentiated SMC in vivo, was rapidly up-regulated in response to vascular injury. In addition, KLF4 is a critical regulator in macrophage activation. Endothelial dysfunction, macrophage activation and VSMC phenotype switching are critical component elements in development of atherosclerosis. Herein we hypothesize that KLF4 is an important regulator in different phase of atherosclerosis and may be a novel target of prevention and cure of atherosclerosis. Further investigation is needed to approach the concrete signaling pathways about KLF4.
Asunto(s)
Aterosclerosis/terapia , Regulación de la Expresión Génica , Factores de Transcripción de Tipo Kruppel/fisiología , Animales , Aterosclerosis/metabolismo , Proliferación Celular , Citocinas/metabolismo , Progresión de la Enfermedad , Humanos , Inflamación , Factor 4 Similar a Kruppel , Factores de Transcripción de Tipo Kruppel/metabolismo , Macrófagos/metabolismo , Modelos Biológicos , Modelos Teóricos , Neoplasias/patología , Neoplasias/terapia , Transducción de SeñalRESUMEN
Hormone replacement therapy (HRT) can ameliorate lipid metabolism after menopause, but it is not suitable for long-term use because of serious side effects. Herba Epimedii is a widely used herbal medicine in many Asian countries, it potentially treats menopausal syndrome and its complications with few side effects and good curative effects. The study aimed to evaluate the effects of Herba Epimedii water extract on blood lipid and sex hormone levels. Ninety subjects were randomly divided into two groups: a trial group which received Herba Epimedii water extract and a control group which was administered an equal amount of water placebo. At the baseline and after 6 months of medication, serum estradiol (E(2)), progesterone (P), testosterone (T), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) concentrations were measured. The results indicated that Herba Epimedii water extract decreased the TC and TG levels (p < 0.01). Furthermore, Herba Epimedii water extract significantly increased the serum level of E(2) (p < 0.01) compared with the pre-treatment level. In conclusion, Herba Epimedii water extract produces its beneficial actions in postmenopausal women.
Asunto(s)
Estrógenos/sangre , Metabolismo de los Lípidos/efectos de los fármacos , Extractos Vegetales/farmacología , Posmenopausia , Adulto , Anciano , Método Doble Ciego , Femenino , Humanos , Persona de Mediana Edad , Placebos , Extractos Vegetales/efectos adversos , Progesterona/sangre , Testosterona/sangre , AguaRESUMEN
Unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI) is associated with an increased risk of cardiac death and an efficacious drug with few side effects is necessary. The study aimed to evaluate the effects of Bulbus allii macrostemi (B. macrostemi) on UA/NSTEMI patients as well as to elucidate possible mechanisms. 79 patients were randomly divided into two groups: the trial group received B. macrostemi plus baseline therapy, the control group was given placebo plus baseline therapy. The trial lasted 8 weeks. The evaluation involved main clinical symptoms, changes of electrocardiogram and biochemical examination. After treatment, the trial group showed more significant improvement on clinical manifestation. The plasma oxidized low-density lipoprotein (ox-LDL) level decreased significantly in the trial group (p < 0.01); the plasminogen activator inhibitor-1 (PAI-1) level decreased in both groups and it decreased more significantly in the trial group (p < 0.01). In contrast, the activity of plasminogen (PLG) increased in both groups and the change was more marked in the trial group (p < 0.01). The results suggested that B. macrostemi combined with baseline therapy could improve clinical symptoms of UA/NSTEMI patients by decreasing the ox-LDL and PAI-1 levels and enhancing the activity of PLG.
Asunto(s)
Angina Inestable/tratamiento farmacológico , Lipoproteínas LDL/metabolismo , Infarto del Miocardio/tratamiento farmacológico , Cebollas/química , Fitoterapia , Plasminógeno/metabolismo , Anciano , Femenino , Humanos , Lipoproteínas LDL/sangre , Masculino , Medicina Tradicional China , Persona de Mediana Edad , Inhibidor 1 de Activador Plasminogénico/sangre , Inhibidor 1 de Activador Plasminogénico/metabolismo , Resultado del TratamientoRESUMEN
OBJECTIVES: To investigate the effects of the Traditional Chinese Medicine (TCM) Quyu Xiaoban capsules (QYXB) on clinical outcomes and platelet activation and aggregation in patients with unstable angina pectoris (UAP) and phlegm and blood stasis syndrome. DESIGN: Ninety (90) UAP patients were randomly divided into two groups: the control group received a loading dose of 300 mg aspirin and a maintenance dose of 100 mg of aspirin plus baseline therapy for 4 weeks, and the trial group received the same doses of aspirin and baseline therapy plus QYXB for 4 weeks. The severity of anginal attacks, alterations of TCM symptoms and signs, and electrocardiographic (ECG) changes were observed in all patients before and after treatment. Plasma platelet aggregation (PAG) rate and P-selectin level were measured in all patients at baseline and at the end of the fourth week. RESULTS: After treatment for 4 weeks, both group of patients showed improvement in the severity of angina pectoris and TCM symptoms and signs, and there was a significant difference of the total effective rate in clinical improvement between the two groups, whereas no difference of the total effective rate in ECG improvement between the two groups was found. Compared with the baseline level, PAG rate in both groups decreased significantly at the end of the fourth week (63.74 +/- 11.18% versus 55.69 +/- 10.40 % in the control group, and 63.83 +/- 12.70% versus 50.04 +/- 8.91% in the trial group). Similar changes of P-selectin levels were observed in both groups (9.40 +/- 1.25 ng/mL versus 8.90 +/- 1.34 ng/mL in the control group and 9.56 +/- 1.16 ng/mL versus 7.80 +/- 0.98 ng/mL in the trial group). However, both PAG rate and P-selectin level decreased to a greater extent in the trial group than in the control group after treatment, and the difference between treatment was significant (both p<0.05). Nevertheless, these biochemical changes were too small to explain fully the beneficial clinical outcomes achieved by QYXB capsules. CONCLUSIONS: On the background of baseline and aspirin therapy, QYXB capsules significantly attenuated anginal attacks and improved TCM symptoms and signs in patients with UAP, and the exact mechanisms underlying these therapeutic effects remain to be explored.
Asunto(s)
Angina Inestable/tratamiento farmacológico , Aspirina/uso terapéutico , Medicamentos Herbarios Chinos/uso terapéutico , Fitoterapia , Inhibidores de Agregación Plaquetaria/uso terapéutico , Agregación Plaquetaria , Adulto , Angina Inestable/prevención & control , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Quimioterapia Combinada , Electrocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Selectina-P/sangre , Agregación Plaquetaria/efectos de los fármacos , Resultado del TratamientoRESUMEN
OBJECTIVES: To investigate the effects of the Traditional Chinese Medicine (TCM) Quyu Xiaoban capsules (QYXB) on clinical outcomes and platelet activation and aggregation in patients with unstable angina pectoris (UAP) and phlegm and blood stasis syndrome. DESIGN: Ninety patients with UAP were randomly divided into two groups: a control group that received a loading dose of 300 mg aspirin and a maintenance dose of 100 mg of aspirin plus baseline therapy for 4 weeks, and a trial group that received the same doses of aspirin and baseline therapy plus QYXB for 4 weeks. The severity of anginal attacks, alterations of TCM symptoms and signs, and electrocardiographic (ECG) changes were assessed in all patients before and after treatment. The plasma platelet aggregation (PAG) rate and P-selectin level were measured in all patients at baseline and at the end of the fourth week of treatment. RESULTS: After treatment for 4 weeks, both group of patients showed improvement in the severity of angina pectoris and TCM symptoms and signs, but there was a significant difference in the two groups' rates of clinical improvement, whereas the rate of ECG improvement of the two groups showed no difference. As compared with the baseline value, the PAG rate in both groups decreased significantly at the end of the fourth week (63.74 +/- 11.18% vs. 55.69 +/- 10.40% in the control group, and 63.83 +/- 12.70% vs. 50.04 +/- 8.91% in the trial group). Similar changes in P-selectin levels were observed in the two groups (9.40 +/- 1.25 ng/mL vs. 8.90 +/- 1.34 ng/mL in the control group, and 9.56 +/- 1.16 ng/mL vs. 7.80 +/- 0.98 ng/mL in the trial group). However, both the PAG rate and P-selectin level decreased to a greater extent in the trial group than in the control group after treatment, and the difference between the two groups was significant (both p < 0.05). Nevertheless, these biochemical changes were too small to fully explain the beneficial clinical outcomes achieved with QYXB capsules. CONCLUSIONS: In comparison with both the respective baseline values and with aspirin therapy, QYXB capsules significantly attenuated anginal attacks and improved TCM symptoms and signs in patients with UAP. The exact mechanisms underlying these therapeutic effects remain to be explored.
Asunto(s)
Angina Inestable/tratamiento farmacológico , Aspirina/uso terapéutico , Medicamentos Herbarios Chinos/uso terapéutico , Fitoterapia , Inhibidores de Agregación Plaquetaria/uso terapéutico , Agregación Plaquetaria/efectos de los fármacos , Angina Inestable/prevención & control , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Quimioterapia Combinada , Electrocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Selectina-P/sangre , Resultado del TratamientoRESUMEN
Rhubarb has been used to decrease plasma cholesterol levels and reduce vascular endothelial cellular damage in recent years. However, it is not known whether reported lipid-lowering effects are associated with the improvement of endothelial function. This work aimed to elucidate the therapeutic effects of rhubarb on serum lipids and brachial artery endothelial function, as well as to investigate the relationship between them. One hundred and three patients with atherosclerosis were randomly divided into two groups: patients in the control and the trial group received a placebo and rhubarb, respectively, in addition to the 6 month baseline therapy. Serum lipids and brachial artery endothelial functions were measured in all patients before and after treatment. A total of 83 patients completed the 6-month follow-up protocol. Serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the trial group decreased significantly and LDL-C was significantly lower than that in the control group. Flow-mediated dilation (FMD) in the trial group was significantly higher after treatment in comparison to the baseline and to the control group. Improvement in FMD correlated with the decreased magnitude of TC and LDL-C levels. The results obtained appeared to confirm that rhubarb significantly improves endothelial function mainly due to lipid-lowering effects in patients with atherosclerosis.
Asunto(s)
Aterosclerosis/tratamiento farmacológico , Arteria Braquial/fisiopatología , Medicamentos Herbarios Chinos/uso terapéutico , Endotelio Vascular/fisiopatología , Rheum , Anciano , Aterosclerosis/sangre , Aterosclerosis/fisiopatología , Arteria Braquial/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Medicamentos Herbarios Chinos/efectos adversos , Medicamentos Herbarios Chinos/farmacología , Endotelio Vascular/efectos de los fármacos , Femenino , Humanos , Lípidos/sangre , Masculino , Persona de Mediana Edad , Fitoterapia/métodos , Vasodilatación/efectos de los fármacosRESUMEN
OBJECTIVE: To evaluate the therapeutic effects of Quyu Xiaoban Capsule (QYXBC) on endothelial dependent vascular relaxation (EDVR) function in patients with atherosclerosis (AS) with ultrasonic technique. METHODS: Tested were the endothelial function and blood lipids of 42 patients with AS in the treated group and 30 healthy volunteers in the control group. And re-examination of these parameters was carried out on the AS patients after they had been treated with QYXBC for 10 months. RESULTS: Before treatment, the reactive hyperemia induced changes in artery diameter in the treated group was significantly lower than that in the control group (P < 0.01), while insignificant difference was found between the two groups in response to nitroglycerin. In the treated group after treatment, with D%-R improved significantly (P < 0.01), total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) decreased by 16.3%, 5.6%, 10.2% respectively and high-density lipoprotein cholesterol (HDL-C) increased by 7.5%. EDVR was correlated negatively with the serum TC, LDL-C concentrations and the baseline brachial diameter (D(0)) (r = -0.41, -0.66, -0.59, respectively, all P < 0.01), but correlated positively with HDL-C (r = 0.62, P < 0.05). The ameliorative extent of EDVR was correlated positively to the decreased magnitude of TC and LDL-C concentrations (r = 0.67, 0.59, both P < 0.01). CONCLUSION: QYXBC can lower the level of blood lipids and improve significantly EDVR function.
Asunto(s)
Enfermedades de las Arterias Carótidas/tratamiento farmacológico , Medicamentos Herbarios Chinos/administración & dosificación , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/fisiología , Fitoterapia , Adulto , Anciano , Arteria Braquial/fisiología , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Medicamentos Herbarios Chinos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ultrasonografía , Vasodilatación/efectos de los fármacosRESUMEN
OBJECTIVE: To investigate the effect of Quyu Xiaoban Capsule (QYXB) on the regressive treatment of atherosclerosis (AS) with acoustic densitometry (AD) technique. METHODS: Eighty patients with AS were randomly divided into two groups, trial group was treated with QYXB and conventional medicine, and control group was treated with conventional medicine alone. Normal arterial wall and different types of atherosclerotic plaques were detected with AD technique before treatment and 10 months later. RESULTS: The corrected averages in intimal echo intensity (AIIc%) were elevated in both groups but without significant difference, AIIc% of fatty plaques were increased in both groups and the value after treatment was significantly higher than that of pre-treatment in the trial group (68.12 +/- 5.54 vs 61.43 +/- 5.37, P < 0.05). The increment rate of AIIc% in trial group was significantly higher than that in control group (10.9 +/- 5.1% vs 2.5 +/- 5.5%, P < 0.05). CONCLUSION: QYXB can stabilize the atherosclerotic plaque by increasing its acoustic density. Acoustic densitometry technique can differentiate the different histological plaques and monitor the histological changes of plaques during treatment.
Asunto(s)
Arterias/diagnóstico por imagen , Estenosis Carotídea/diagnóstico por imagen , Estenosis Carotídea/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Adulto , Anciano , Arterias/efectos de los fármacos , Aterosclerosis/diagnóstico por imagen , Aterosclerosis/tratamiento farmacológico , Cápsulas , Densitometría , Medicamentos Herbarios Chinos/farmacología , Femenino , Arteria Femoral/efectos de los fármacos , Arteria Femoral/ultraestructura , Humanos , Masculino , Medicina Tradicional China , Persona de Mediana Edad , UltrasonografíaRESUMEN
OBJECTIVE: To study the effect of Quyu Xiaoban capsule (QXC) on regression and stabilization of atherosclerotic plaque with high-frequency ultrasound technique. METHODS: Eighty patients with atherosclerosis (AS) were randomly divided into the treated group and the control group, level of blood lipids was measured, and intima-media thickness (IMT) and corrected value of image average echo intensity (AIIc%) were determined by ultrasound technique at the beginning of experiment and after being treated for six months. RESULTS: The levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were significantly decreased in the treated group after treatment (68.12 +/- 5.54 vs 61.43 +/- 5.37, P<0.05). The AIIc% of fatty atherosclerotic plaque was significantly increased after treatment (68.12 +/- 5.54 vs 61.43 +/- 5.37), and the change rate of AIIc% in the treated group was significantly different to that in the control group (10.9 +/- 5.1% vs 2.5 +/- 5.5%, P < 0.05). CONCLUSION: QXC can significantly lower the blood lipids level, delay the progress and enhance the stability of atherosclerotic plaque.