Objective To analyze cardiovascular risk factors in senile patients with acute myocardial infarction(AMI).Methods Fifty-six elderly patients with AMI aged ≥65 years were enrolled as elderly group in our hospital from January 2014 to December 2015,and 76 elderly patients with AMI aged＜65 years during the same period were selected as a non-elderly group.Cardiovascular disease-related factors were analyzed in elderly patients with AMI.Results The proportions of complicated diabetes mellitus,hypertension,and dyslipidemia were higher in 56 elderly patient[29 cases (51.8％),41 cases(73.2％)and 37 cases(66.1％)]than in 76 non-elderly patients[12 cases,(15.8 ％),23 cases(30.3％)and 17 cases(22.4％),respectively,x2 =9.652,8.744,11.489;P=0.002,0.003,0.001].The proportion of male elderly group and non-elderly group were higher than those of female patients.The prevalence of cardiovascular disease was 87.5 ％ (14/16)in female elderly patients,which was 53.2％ (17/32)in female non-elderly patients(x2 =5.510,P =0.019).The incidence of a typical chest pain,heart failure and disturbance of consciousness after AMI attack was 26.8 ％ (15/56),64.3 ％ (36/56) and 23.3 ％ (13/56) in elderly group,respectively,which were higher than those in non-elderly group[39.5 ％ (3/76),31.6 ％ (24/76),5.26 ％ (4/76);x2 =3.965,9.075,5.365;P =0.047,0.003,0.021].Conclusions Acute myocardial infarction in elderly patients often coexists with hyperlipidemia,diabetes,high blood pressure and other risk factors.There is often no significant incentive before the onset of AMI in elderly patients.Its main clinical symptoms conclude atypical chest pain,heart failure and consciousness.

This article deals with the influence of shear stress on endothelial NO synthesis, and the role of caveolae in shear stress-induced eNOS activation. Human umbilical vascular endothelial cells (HUVEC) were cultured and exposed to different levels of laminal shear stress and Filipin, the perfused cultures were collected, and NO(2-)/NO(3-) was detected using nitrate reduction method. The structure of caveolae was observed through transmission electron microscopy (TEM). The level of NO(2-)-/NO(3-) was found to increase with the elevation of shear stress level (P < 0.01). It was the highest at 1.5 N/m2. After treatment with Filipin, the level of NO produced by HUVEC decreased significantly (P < 0.01), but after recovery and shear without Filipin, the level of NO synthesis bounded back (P < 0.01). It was then concluded that shear stress can induce endothelial NO synthesis and caveolae plays a key role in shear stress-induced eNOS activation.
Caveolae ; physiology ; Cells, Cultured ; Endothelium, Vascular ; cytology ; Filipin ; pharmacology ; Humans ; Nitric Oxide Synthase Type III ; metabolism ; Shear Strength ; Umbilical Veins ; cytology

Objective To investigate the efficacy and safety of Irbesartan Hydrochlorothiazide combined with Metoprolol as initial therapy in the treatment of heart failure in the elderly.Methods A total of 128 elderly patients with heart failure admitted into our hospital from September 2017 to August 2018 were randomly divided into Group A(n=64)and Group B(n=64).Group A was treated with oral Irbesartan Hydrochlorothiazide tablets.Group B was treated with sustained-release oral Metoprolol tablets in addition to what was given in Group A.Therapeutic effects were compared between the groups.Results Compared with Group A,the effectiveness rate of group B was significantly improved(93.8％ vs.81.3％,x2 =4.571,P=0.033).There was no significant difference in brain natriuretic peptide (BNP),interleukin (IL)-12,left ventricular ejection fraction (LVEF),left ventricular end-systolic diameter(LVESD),or left ventricular end-diastolic diameter(LVEDD)between the two groups before treatment (P＞0.05).Compared with Group B,BNP,IL-12,LVEF,LVESD and LVEDD had significantly better profiles in Group A after treatment (P ＜ 0.05).The time-domain measurements of heart rate variability such as sequential five-minute R-R interval means(SDANN),standard deviation of the N-N interval(SDNN),percent of differences between adjacent RR intervals ＞50ms(PNN50)and root mean square of the successive differences(RMSSD)were higher in Group B than in Group A after treatment.No serious adverse reactions were observed in either group,and there was no significant difference in the incidence of adverse reactions between the two groups(4.7％ vs.7.8 ％,x2 =0.533,P =0.465).Conclusions Irbesartan Hydrochlorothiazide combined with Metoprolol as initial therapy has good clinical effects in treating elderly heart failure.It can not only improve the clinical symptoms of patients,but also ensure clinical medication safety.

Objective To explore the effects of ischemia and ischemia reperfusion on the proliferation,apoptosis,migration ability,inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) expression of endothelial progenitor cells (EPCs).Methods Collection of peripheral blood from volunteers and culture of endothelial progenitor cells in vitro.The cells were divided into three groups:control group,hypoxia group and hypoxia reoxygenation group.Methyl thiazolyl tetrazolium (MTT) assay was used to detect cell proliferation.Transwell chamber method was used to detect cell migration.Cell apoptosis was detected by flow cytometry.Western blot was used to detect iNOS and eNOS expressions.Results A confocal microscope was used to observe the basic adherence of the cells to the wall for about 3 days,and the area became larger.After 7 d of single nucleus cell culture,the growth of colony-like pattern was more than that of spindle.The cell counts of the three groups in the microscope were (1.83 ± 0.92),(5.07± 0.84),(2.11 ± 0.74).Compared with the control group (0.24 ± 0.04),the hypoxia group (0.62± 0.06) could promote EPCs proliferation,and the difference was statistically significant (t =12.142,P ＜ 0.05);While there was no significant difference between the hypoxia reoxygenation group (0.39 ± 0.06) and the control group (P ＞ 0.05).The number of cell migration in the hypoxia group (18.28 ± 2.05) and hypoxic complex oxygen group (14.08 ± 2.11) was not statistically significant compared with the control group (15.14 ± 1.25) (P ＞ 0.05).The apoptosis rate in hypoxia group (34.57 ±0.42)％ and hypoxia reoxygenation group (41.08 ± 0.44)％ was significantly higher than that in control group (24.83 ± 0.38) ％ (x2 =13.427,15.084,P ＜ 0.05).The apoptosis rate of hypoxia reoxygenation group was significantly higher than that of hypoxia group (x2 =9.657,P ＜ 0.05).The expression of iNOS in hypoxia group and hypoxia reoxygenation group was significantly higher than that in control group,and the difference was statistically significant (P ＜ 0.05).Conclusions Ischemia could promote the proliferation of EPCs,and increase the expression of iNOS,but the expression of EPCs was down-regulated after reperfusion.

Objective To explore the effect of different types of helicobacter pylori(Hp)on carotid atherosclerosis(CAS)and the efficacy of rosuvastatin.Methods Totally 346 subjects were examined in the physical examination center of our hospital from February 2020 to June 2022.According to the results of 14C urea breath test and Hp antibody typing,they were divided into 102 cases of type Ⅰ Hp infection group,79 cases of type Ⅱ Hp infection group and 165 cases of Hp negative group,inflammatory factors,blood lipids and carotid artery ultrasound were also examined.All subjects with carotid atherosclerosis were instructed to treat with rosuvastatin 10mg/d,and the level of low density lipoprotein cholesterol(LDL-C)was rechecked after 4 weeks.Results There were significant differences in high sensitivity C-reactive protein(hs-CRP),IL-6 and tumor necrosis factor-α(TNF-α)between the three groups(P<0.05).Compared with Hp negative group,cholesterol(TC)and LDL-C in type Ⅰ and type Ⅱ Hp infection groups were significantly increased,while high density lipoprotein cholesterol(HDL-C)in type Ⅰ Hp infection group was significantly decreased;compared with type Ⅱ Hp infection group,LDL-C in type Ⅰ Hp infection group was significantly increased,and HDL-C was significantly decreased(P<0.05).The detection rate of stable plaque and unstable plaque in Hp positive subjects was significantly higher than that in Hp negative subjects(P<0.05);the detection rate of stable plaque and unstable plaque in type Ⅰ Hp infected subjects was significantly higher than that in type Ⅱ Hp infected subjects(P<0.05);after adjusting for age,hypertension,diabetes and other risk factors,it was still an independent risk factor of carotid atherosclerotic plaque vulnerability.After 4 weeks,the LDL-C level of CAS subjects in the three groups before and after treatment was significantly different(P<0.05).Compared with the type Ⅰ Hp group,the LDL-C level of CAS subjects in the Hp-negative group was significantly lower(P<0.05).Conclusion Hp infection,especially type Ⅰ Hp infection,is related to dyslipidemia,stimulation of inflammatory reaction and instability of carotid plaque,affecting the efficacy of lipid-lowering drugs.

Objective To investigate the role of triggering receptor expressed on myeloid cells-1(TREM-1)in ath-erosclerosis induced by chronic intermittent hypoxia(CIH).Methods ApoE-/-mice were randomly divided into blank group,model group and experimental group.The mice in the model group and the experimental group were kept in a hypoxic environment and fed with a high-fat diet.After 4 weeks of high-fat feeding,mice in the experi-mental group were intraperitoneally injected with TREM-1 inhibitor LR12(5 mg/kg)for 8 weeks.After 12 weeks of feeding,the level of serum total cholesterol(TC),low density lipoprotein(LDL),triglyceride(TG),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and interleukin-10(IL-10)were detected.Histological analysis of aortic TREM-1 expression,plaque area and macrophage level were examined.Results Compared with blank group,the expression of TREM-1 in the aorta of the model group significantly increased(P＜0.05).Com-pared with model group,the aortic plaque,the level of lipids in serum(TC,LDL,TG)and inflammatory factors(TNF-α,IL-1β,IL-10),aortic plaque,the expression of TREM-1 and infiltrating macrophages in aortic plaque of the experimental group were all significantly reduced(P＜0.05).Conclusions TREM-1 is involved in the develop-ment of CIH-induced AS.Inhibition of TREM-1 can alleviate CIH-induced AS and its mechanism is related to the inhibition of macrophage activation.