Effect of ACE2 deletion on vasoconstriction reactivity of aortic segments in mice with tourniquet shock / 中国病理生理杂志

AIM:To observe the effect of angiotensin-converting enzyme 2(ACE2)deletion on vasoconstric-tion reactivity of aortic segments in ACE2 knockout(KO)mice with tourniquet shock(TS).METHODS:The 8-month-old male mice with C57BL/6 background were divided into wild-type(WT)control group,WT-TS group,KO group and KO-TS group,with 10 mice in each group,of which five were used for determination of vascular reactivity,and the other five for the other assays.The hindlimbs of the mice in WT-TS group and KO-TS group were ligated with tourniquet for 2 h and loosened for 4 h.The mice in WT group and KO group were subjected to the same treatment except for tourniquet liga-tion.The vasoconstriction reactivity of the aorta was measured on tensiometer.The morphological damage of the aorta was evaluated by vascular histopathology.Western blot was used to detect the expression of AT1,MAS,ACE and ACE2 pro-teins in aorta.The serum levels of angiotensin(Ang)Ⅱ and Ang-(1-7)were determined by enzyme-linked immunosorbent assay.RESULTS:Compared with WT group,the mice in WT-TS group had lower vascular reactivity to norepinephrine(NE)and obvious vascular lesions.The expression of ACE protein increased significantly(P＜0.01),while the expres-sion of ACE2 decreased(P＜0.05).The expression of AT1 protein in aorta decreased significantly,the expression of MAS protein increased significantly,and the AT1/MAS ratio decreased(P＜0.01).Serum Ang II level increased,serum Ang-(1-7)level decreased,and Ang Ⅱ/Ang-(1-7)ratio increased(P＜0.05).Compared with WT group,vascular reactivity in KO group increased at low concentration of NE(＜10-7 mol/L),and decreased at high concentration(＞10-7 mol/L)without vascular lesion.The expression levels of aortic AT1,MAS and ACE were all elevated(P＜0.05).The serum level of Ang Ⅱ increased(P＜0.05),but the level of Ang-(1-7)had no obvious change.Compared with KO and WT-TS groups,the aortic reactivity in KO-TS group subtracted apparently(P＜0.05),representing its curve shifting to the right obviously.The morphological damage aggravated slightly,and the expression of AT1 and ACE increased slightly in KO-TS group com-pared with WT-TS group(P＜0.05).However,the expression of MAS increased significantly in vascular tissue(P＜0.01).The serum levels of Ang Ⅱ and Ang-(1-7)further increased and decreased,respectively,and the Ang Ⅱ/Ang-(1-7)ratio increased(P＜0.01).CONCLUSION:Deficiency of ACE2 induces severe aortic hyporeactivity to NE during TS,which may be related to the increased imbalance of renin-angiotensin system in ACE2 gene knockout mice.

Procyanidins from hawthorn (Crataegus pinnatifida) alleviate lipid metabolism disorder via inhibiting insulin resistance and oxidative stress, normalizing the gut microbiota structure and intestinal barrier, and further suppressing hepatic inflammation and lipid accumulation.

Recently, lipid metabolism disorder (LMD) has been regarded as a risk factor leading to multiple diseases and affecting human health. Procyanidins have been reported to be a potential therapy for LMD. This study explored the effect and possible mechanism of procyanidins from hawthorn (HPC) in LMD rats fed a high-fat diet. HPC supplementation for 8 weeks significantly relieved lipid accumulation in the serum and liver, and protected the structure of liver in LMD rats. The amelioration of insulin resistance, lipid metabolism related hormones and oxidative stress was also found. Moreover, HPC also regulated the structure of gut microbiota, especially increased the abundances of Akkermansia, Bacteroides and Adlercreutzia, and decreased Lactobacillus, Bifidobacterium, Blautia, Lachnospiraceae and Subdoligranulum. Additionally, HPC enriched genes were involved in the fatty acid biosynthesis, MAPK, and lipopolysaccharide biosynthesis pathways. We found a high LPS level due to the microbiome disorder induced by the high-fat diet, and then western blot results showed that HPC maintained the intestinal barrier and mitigated inflammation and lipid accumulation in the liver via regulating the NF-κB and AMPK pathways, which were related to LMD. This study provided new insights into dietary intervention based on HPC to alleviate LMD via stabilizing the gut-liver axis.

Postoperative complications of patients with varicose vein of lower limbs treated with foam sclerotherapy and endovenous laser / 中华普通外科杂志

Objective To Compare postoperative complications between patients with varicose veins of the lower limbs treated with foam sclerotherapy or endovenous laser.Method From 2011 to 2015,simple varicosis of great saphenous vein patients (grade C3-6) in 2 542 cases,3 468 limbs were divided into 2 groups.Combined with high ligation of great saphenous vein plus stripping,foam sclerotherapy group (1 355 cases) underwent calf foam sclerotherapy (1％ polidocanol),endovenous laser group (1 187 cases) underwent endovenous laser therapy.All postoperative patients were treated with stretch socks for 3 months.Postoperative pain (calf),deep vein thrombosis,pulmonary embolism,superficial thrombophlebitis,saphenous nerve injury,ecchymoma,migraine,allergic dermatitis,pigmentation in 2 groups were compared.Result During the follow-up,28 cases in foam sclerotherapy group had saphenous nerve injury (2％),1 071 (79.1％) cases had subcutaneous ecchymosis,613 cases (51.6％) in endovenous laser group had saphenous nerve injury,979 cases (82.5％) had subcutaneous ecchymosis,8 cases (1.0％) had skin burns (x2 =824.660,4.786,9.161,P ＜ 0.05).Endovenous laser group (23.8％) was significantly better than that of foam sclerotherapy group (30.8％) in pigmentation (x2 =15.243,P ＜0.05).Conclusion Treatment of varicose veins of the lower leg with foam sclerotherapy has less postoperative complications compared with endovenous laser.

Effect of thrombus aspiration on myocardial reperfusion during mergency percutaneous coronary intervention / 中国综合临床

Objective To evaluate the effects of thrombus aspiration on postoperative clinical prognosis of acute ST-segment elevation myocardial infarction (STEMI) patients with emergency percutaneous coronary intervention(PCI).Methods From September 2009 to January 2012,a total of 239 patients with STEMI undergoing emergency PCI (thrombus aspiration + PCI (n =118) and PCI (n =121)) were enrolled in this study.The angiographic and clinical results were retrospectively analyzed and compared between the two groups of patients.Results There were significant differences between the thrombns aspiration group and the PCI group on instant blood flow TIMI3 grade (106 (89.8％) vs.96 (79.3％) ; x2 =5.026,P ＜ 0.05),ST-segment depression rate at two hours after surgery (101 (85.6％) vs.90 (75.2％) ; x2 =5.500,P ＜ 0.05),ejection fraction within one week after surgery (68 (57.6％) vs.52 (43.0％) ; x2 =5.130,P ＜ 0.05),incidence of reinfarction during hospitalization (0 (0) vs.5 (4.1％) ; x2 =4.980,P ＜ 0.05).There were no significant statistical difference between the two groups on the average length of stay ((10.05 ± 5.40) d vs.(10.40 ± 5.03) d; t =-0.525,P ＞ 0.05),incidence of ventricular fibrillation during surgery (4 (3.4％) vs.3 (2.5 ％ ; x2 =0.174,P ＞ 0.05),heart failure during hospitalization (15 (12.7％) vs.18 (14.9％) ; x2 =0.235,P ＞0.05),Malignant arrhythmias (12 (10.2％) vs.15 (12.4％) ; x2 =0.296,P ＞ 0.05),and mortality rate (2 (1.7％) vs.5(4.1％);x2 =1.248,P ＞0.05).Conclusion Application of thrombus aspiration,which is a safe and effective way,may improve the clinical outcomes in acute ST-segment elevation myocardial infarction patients with emergency PCI.