Objective To investigate the association between carotid-femoral pulse wave velocity (cfPWV) and composition of the ascending aorta in patients with coronary heart disease (CAD),Methods The study population comprised 60 consecutive CAD patients who underwent coronary artery bypass graft (CABG) surgery in Qilu Hospital of Shandong University.cfPWV vas measured using an automatic device (Complior,Artech,France).A quantitative study was conducted on ascending aorta specimens by histological observation (Masson staining and weigert's resorcin-fuchsin staining) and computer image analysis.Bivariate analyses were performed to study the association between composition of the ascending aortic media and cfPWV.Results cfPWV of the CAD patients was higher (14.2±2.0) m/s than that of the normal subjects.On Masson's-stained specimen slides,disorganization of smooth muscle and focal accumulations of collagen (44.1 ± 3.9)％ were visible alongthe medial aorta of the CAD patients.Weigert's-stained cross sections of the ascending aortic media in CAD patients frequently exhibited focal breakdown or discontinuous segments of elastic fibers(18.4±3.2)％,cfPWV had a positive correlation with relative contents of collagen in the ascending aorta(r=0.68,P＜0.01)and a negative correlation vith relative contents of elastin in the ascending aorta (r=-0.59,P＜0.01),but no relation with relative contents of smooth muscle(r=0.01,P＞0.05).Conclusions The reduced aortic elasticity in CAD patients can be partly ascribed to decreased elastin,increased collagen,and their disorganization.cfPWV can reflect the quantitative changes of collagen and elastin in the ascending aortic media in CAD patients.

Objective To analyze the monitoring data of iodine deficiency disorders in Jiangxi Province and to provide a basis for adjusting iodized salt concentration.Methods Thirty primary schools were selected in 30 counties and 40 pupils' goiters were examined with B ultrasound in every school.At the same time,salt iodine level was tested at their home.Twelve pupils urinary iodine in selected schools,15 pregnant urinary samples,15 lactating women urinary samples in 3 towns around the schools and water samples in the counties with the schools were collected.Results The goiter rate of children aged 8 to 10 was 1.25％ (15/1 200); the median salt iodine was 30.80 mg/kg and the consumption rate of qualified iodized salt was 96.92％ ; the median urinary iodine level of children,pregnant and lactating women was 308.73,206.95 and 206.75 μg/L,respectively.The proportion of urinary iodine level of children above 300 μg/L was 52.25％(186/356),while the proportion of urinary iodine level of pregnant women below 150 μg/L was 34.81％(157/451).The water iodine median was 4.62 μg/L and the per capita daily salt intake was 13.20 g in Jiangxi Province.Conclusions The status of iodine deficiency in Jiangxi has been significantly improved.According to the monitoring results,it's necessary to adjust salt iodization standards appropriately.

Objective To explore the relationship between morphological features of carotid arterial atherosclerosis plaque and various cardiovascular risk factors in the aged.Methods The 321patients who underwent cerebral angiography were classified into two groups:256 patients with carotid arterial atherosclerosis and 65 patients without plaque.The relationships between carotid arterial plaque and cardiovascular risk factors including age,gender,cholesterol(TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C),C-reactive protein(CRP),homocysteine (HCY),hypertension,diabetes,smoking and drinking were analyzed.The relationships between morphological features,including the stenosis degree,surface fairing of plaque,and cardiovascular risk factors were analyzed.After 1 year follow-up,the prospective cardiovascular and cerebrovascular events were analyzed in the two groups.Results Carotid atherosclerosis was connected with cardiovascular risk factors such as TC,LDL-C,uric acid,CRP,hypertension,diabetes,smoking and drinking.Positive correlation was showed between the stenosis degree of carotid artery and age,smoking and diabetes.Closely correlation was showed between surface fairing of carotid arterial plaque and LDL-C,CRP,smoking and diabetes.The stenosis degree of carotid artery only showed positive correlation with cerebrovascular events,but the morphological features of surface fairing of carotid arterial plaque equally showed positive correlations with cerebrovascular events and cardiovascular events.Conclusions The development of carotid arterial atherosclerosis plaque in the aged is closely related to cardiovascular risk factors.Morphological features of carotid arterial plaque may respond the level of general atherosclerosis better than stenosis degree,and it is also in close correlation with cerebrovascular events and cardiovascular events.

Objective To investigate the changes of capacitive arterial compliance(C1) and oscillatory arterial compliance (C2) in elderly patients with the coronary atherosclerosis and the coronary heart disease (CHD)and to study the association between Gensini Score and C1 or C2.MethodsElderly subjects (160 cases) were divided into three groups according to the results of selective coronary angiography: the normal,the coronary atherosclerosis and the CHD group. C1 and C2 were measured using a DO-2020 cardiovascular profiling instrument.The stenosis severity of coronary artery diseases was assessed using a scoring system called Gensini score. Bivariate analyses were performed to study the association between Gensini Score of coronary artery and each of C1 and C2.Results C2 in the coronary atherosclerosis group was significantly lower than that in the normal group, and higher than in CHD group. C1 had no statistically difference among the three groups. Gensini integral in the coronary atherosclerosis versus the CHD groups were ( 5.4+2.6) vs.( 51.3+ 32.1), respectively (t= 10.574, P＜0.01). Gensini Score in the coronary atherosclerosis group had no relation with C1, and was negtively correlated with C2. ConclusionsC2 is decreased in the early stages of the coronary artery atherosclerosis in elderly patients, and may help the identification of early coronary atherosclerosis.

Objective To observe the effect of grape seed proanthocyanidin extract (GSPE) on vascular remodeling in ouabain-induced hypertensive rats.Methods A total of 30 male SpragueDawley rats were randomized into 3 groups:control group (received 0.9％ 1 ml normal saline by intraperitoneal injection and oral gavage in the morning),ouabain treatment group (received 2 mg/kg ouabain by intraperitoneal injection and 0.9 ％ 1 ml normal saline by oral gavage in the morning),and GSPE treatment group (received 2 mg/kg ouabain by intraperitoneal injection and 250 mg Kg 1 d-1 GSPE by oral gavage in the morning).Blood pressure was determined before and 5 weeks after the treatment.The aortas were observed 5 weeks after the treatment.The mRNA and protein levels of nuclear factor-κB (NF-κB p65) and transforming growth factor-β1 (TGF-β1) in rat aorta were detected using real-time PCR and Western blot,respectively.Morphological observations were obtained by Hemotoxylin and Eosin staining and Electron microscope.Results The systolic blood pressure was significantly lower in GSPE treatment group than in ouabain treatment group [(133.6±6.0) mm Hg vs.(146.5±7.9) mm Hg,1 mm Hg=0.133 kPa,P＜0.01].Morphological observation showed that the thickening aortic intimal and structural disorder were found in the ouabain treatment group,and aortic intimal structural integrity were normal in the other two groups.The mRNA and protein levels of NF-κB p65 and TGF-β1 were significantly lower in GSPE treatment group than in the ouabain treatment group (NF-κBp65:2.77±0.58 vs.3.14±0.64,0.73±0.20 vs.0.93±0.21,both P＜0.05; TGF-β1:5.80±0.67 vs.6.09±0.95,0.42±0.14 vs.0.69±0.16,both P＜0.05).Conclusions GSPE may inhibit endogenous ouabain,and delay the process of elevated blood pressure and vascular remodeling by inhibiting NF-κ B p65 and (or) TGF-β3 1 pathways.

Objective To observe the change of profilin-1 during the aging of rats' aorta and the anti-aging effect of grape procyanidins (GPC).Methods Young male Wistar rats (9 weeks) and middle rats (12 months) were randomly divided into GPC treatment and control groups respectively.We quantified arterial aging changes through morphological methods.Thoracic aortas were stained with hematoxylin eosin.Serum levels of 3-nitrotyrosine (3-NT),malondialdehyde (MDA),superoxide dismutase (SOD) and nitric oxide (NO) were tested using enzyme-linked immunosorbent assay (ELISA).Western blotting was performed to measure the protein expression of inducible nitric oxide synthase (iNOS) and profilin-1.Results Compared with the young male Wistar rats group,aging change in the aortic morphology of middle rat group were shown by hematoxylin-eosin staining (HE) staining:media thickness (MT) increased [(98.3±0.5)μm vs.(83.1±1.0)μm,P＜0.05],luminal internal diameter (LD) decreased [(15.5 ±0.2) μm vs.(18.2±0.5,P＜0.05)μm,P＜ 0.05],(MT/LD)％ increased [(6.4±0.1) ％ vs.(4.6±0.1)％,P＜0.05],the protein expressions of profilin-1 and iNOS both increased [profilin-1:(1.58 ± 0.09) vs.(1.29 ± 0.04),iNOS:(1.02±0.12) vs.(0.75±0.02),both P＜0.05],levels of NO and SOD in serum decreased [NO:(6.3±0.2)μmol/L vs.(8.4±0.2) μmol/L,SOD:(172.3±1.6) U/ml vs.(189.1±1.5) U/ml,both P＜0.05],the levels of MDA and 3-NT increased[MDA:(11.3±0.3) μmol/L vs.(9.4 ±0.1) μmol/L,3 NT:(40.2±0.3) nmol/L vs.(35.6±0.5) nmol/L,both P＜0.05)].After treatment with GPC,compared with the control group,MT decreased,LD increased and MT/LD (％)decreased in the middle GPC treatment group.The protein expressions of profilin-1 had no changes before and after treatment with GPC both in young and middle groups.After the GPC treatment in middle group,compared with the middle control group,iNOS expression decreased,serum levels of NO and SOD increased,and the levels of MDA and 3-NT decreased significantly (all P ＜0.05).Conclusions Profilin-1 is related with age-related changes in rat aorta.Profilin-1 participates in vascular aging through iNOS induced oxidative stress.GPC may defer vascular aging by inhibiting vascular oxidative stress.

Objective To observe the effects of grape seed proanthocyanidin extract (GSPE)combined with atorvastatin on carotid atherosclerosis of the elderly. Methods Consecutivly 122 patient aged( 73.2 ±12.8) years with hypercholesterolemia and diagnosed as asymptomatic carotid artery plaques were randomly assigned to single atorvastatin(20 mg/d) treatment group (n=63) and combination treatment (atorvastatin 10 mg/d plus GSPE 400 mg/d) group (n=59).Serum total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) and high-sensitive C-reactive protein (hs-CRP) levels were detected before treatment and 3,6,12 months after treatment.Mean maximum carotid intima-media thickness (CIMT),plaque score and stability were also assessed by carotid ultrasound. Results After 3 months of treatment,serum levels of TC,TG and LDL-C in both groups were lower than before treatment (all P＜0.01),but no difference was found between the two groups (P＞0.05).HDL-C levels was enhanced by 20.2％ in combination treatment group after 3 months of treatment (P＜0.05),there was difference after 6 months treatment between two groups (P＜0.05).Serum hs-CRP concentrations were decreased by 1.7 mg/L and 3.6 mg/L,3.8 mg/L and 6.3 mg/L,5.9 mg/L and 8.3 mg/L after 3,6 and 12 months treatment as compared with pretreatment,respectively in the two groups (P＜0.05 or P＜0.01).There was difference in hs-CRP levels between groups after 6 and 1.2months of treatment (P＜0.05 or P＜0.01).There were MMCIMT reduction by 1.3％ and 2.0％ (P＞0.05),3.4％ and 5.3％(P＞0.05 and P＜0.05 ),5.1％ and 8.6％ after 3,6 and 12 months of treatment(P＜0.05 and P＜0.01) in the two groups,with distinct difference after 12 month treatment (P＜ 0.01 ).The plaque scores were declined by 6.8 ％ and 13.1％ ( both P ＞ 0.05 ),14.5 ％ and 28.0％ (P＞0.05 and P＜0.05),19.2％ and 45.0％(P＜0.05 and P＜0.01)after 3,6 and 12 months of treatment while significant difference was found between the two groups after 12 months treatment (P＜0.05).Unstable plaque and the total number of plaque was dropped by 8 and 14 in single group,19 and 28 in combination group,respectively,after 12 months of treatment. Conclusions GSPE combined with atorvastatin may inhibit the development of carotid intima-media thickness,reduce carotid plaque and promote stabilization of carotid plaque.

Objective To study the proteins related to aging in aortic of old rats for laying the foundation of further study of aging mechanism.Methods The rat model of aging was built,and all model rats were divided into 4 groups:the adult group(9 weeks),the old group(12 months)of WistarKyoto (WKY) rats,and the age-matched spontaneously hypertensive rats (SHR).Blood pressure of 4 groups was observed.Morphological change of aorta was observed by HE staining.Differential proteins were identified by isobaric tags for relative and absolute quantitation,(iTRAQ)-coupled liquid chromatography and tandem mass spectrometry technology.Part of differential proteins was subsequently detected by real time PCR and Western blot.Results The mean SBP of the old group SHR was higher than WKY of 97.1％ (t=39.00,P＜0.05),and the adult group of SHR was also higher than WKY of 5.4％(t=3.64,P＜0.05).Compared with the adult group,aging change in the aortic morphology of old SHR and WKY were shown in HE staining,and the change in SHR rats was more marked.7 proteins related to aging were identified by Mass spectrum analysis,and they were Profilin-1,Prelamin A,HSP70,creatine kinase-M,Fibulin-5,eIF5A and Prohibitin.Part of differential proteins was subsequently confirmed by real time PCR and Western blot.Prelamin-A was up-regulated in the old group of WKY and SHR (0.15±0.01 vs.0.45±0.04,0.34±0.02 vs.0.78±0.06) (t=12.67,12.06,all P＜0.01),Prohibitin was down-regulated in the old group of WKY and SHR(1.34±0.05 vs.1.01± 0.06,1.24±0.05 vs.0.88±0.08) (t=7.41,7.09,all P＜0.01).Profilin-1 was up-regulated in the old group of WKY and SHR (9.12±0.4 vs.20.76±0.8,16.84±0.5 vs.55.16±0.9) (t=22.55,64.46,both P＜0.01),and Profilin-1 expression in the old group of SHR was higher thanWKY (55.16±0.90 vs.20.76±0.8,t=49.49,P＜0.01).Conclusions Differential proteins of the old rat aorta are identified through the comparative proteomics method.These differential proteins will provide new targets for the prevention and control of vascular aging.

BACKGROUNDOuabain is a mammalian adrenocortical hormone that is involved in the pathogenesis of hypertension by inhibiting Na-K ATPase activity. It also participates in a variety of kinase-mediated signaling pathways associated with Na-K ATPase. Previous studies have shown that ouabain can cause cardiac remodeling independent of elevated blood pressure and that proliferating cell nuclear antigen (PCNA) plays a coordinating role for numerous proteins involved in multiple processes associated with DNA synthesis. Therefore, we hypothesized that ouabain might play a role in the cerebral cortex through signaling pathways independent of hypertension. And PCNA might be involved in this process.

METHODSMale Sprague-Dawley rats were treated with ouabain or with 0.9% nitric sodium as the control group. Systolic blood pressure was recorded weekly. After four weeks of treatment, morphological changes in the cerebral cortex were analyzed using light and transmission electron microscopy. The expression of PCNA in the cerebral cortex was evaluated by immunohistochemistry, real time quantitative PCR, and Western blotting.

RESULTSAfter 4-week treatment, there was no significant difference in systolic blood pressure compared with the control group, but both structural deterioration and up-regulated expression of PCNA in the brain was induced by ouabain treatment.

CONCLUSIONSThese results suggest that ouabain induces alterations in the brain structure, and this effect is independent of blood pressure. PCNA might be involved in the repair process of ouabain-induced brain damage.

Animals ; Blood Pressure ; drug effects ; Hypertension ; drug therapy ; metabolism ; Immunohistochemistry ; Male ; Ouabain ; therapeutic use ; Proliferating Cell Nuclear Antigen ; metabolism ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Sodium-Potassium-Exchanging ATPase ; metabolism

Objective To compare the effect of palliative mitral valve surgeries and medication therapies for secondary non-ischemic mitral regurgitation. Methods The clinical data of patients with non-ischemic functional mitral regurgitation treated in our hospital between 2009 and 2019 were retrospectively analyzed. Patients with a left ventricular ejection fraction (LVEF)＜40% underwent a dobutamine stress test, and a positive result was determined when the LVEF improved by more than 15% compared to the baseline value. Positive patients were divided into a surgery group and a medication group. The surgery group underwent surgical mitral valve repair or replacement, while the medication group received simple medication treatment. Follow-up on survival and cardiac function status through outpatient or telephone visits every six months after surgery, and patients underwent cardiac ultrasound examination one year after surgery. The main research endpoint was a composite endpoint of all-cause death, heart failure readmission, and heart transplantation, and the differences in cardiac function and cardiac ultrasound parameters between the two groups were compared. Results Ultimately 41 patients were collected, including 28 males and 13 females with an average age of 55.5±11.1 years. Twenty-five patients were in the surgery group and sixteen patients in the medication group. The median follow-up time was 16 months, ranging 1-96 months. The occurrence of all-cause death in the surgery group was lower than that in the medication group (HR=0.124, 95%CI 0.024-0.641, P=0.034). The difference between the two groups was not statistically significant in the composite endpoint (HR=0.499, 95%CI 0.523-1.631, P=0.229). The New York Heart Association (NYHA) grade of the surgery group was better (NYHA Ⅰ-Ⅱ accounted for 68.0% in the surgury group and 18.8% in the medication group, P<0.01) as well as the grade of mitral valve regurgitation (87.5% of the patients in the medication group had moderate or above regurgitation at follow-up, while all the patients in the surgery group had moderate below regurgitation, P<0.01). There was no statistical difference in preoperative and follow-up changes in echocardiograph parameters between the two groups (P＞0.05). Conclusion For non-ischemic functional mitral regurgitation, if the cardiac systolic function is well reserved, mitral valve surgery can improve survival and quality of life compare to simple medication therapy.