Drugs, Chinese Herbal ; therapeutic use ; Humans ; Vascular Diseases ; prevention & control

Blood Vessels ; injuries ; Humans ; Iatrogenic Disease ; prevention & control ; Vascular Diseases ; etiology ; prevention & control

Maintenance of healthy endothelium is essential to vascular homeostasis, and preservation of endothelial cell function is critical for transplant allograft function. Damage of microvascular endothelial cells is now regarded as a characteristic feature of acute vascular rejection and chronic allograft nephropathy, which is an important predictor of graft loss and is often associated with transplant vasculopathy. In this review, we will discuss the role of microvascular endothelium, in renal allograft dysfunction, particularly as it relates to markers of endothelial dysfunction and endothelial repair mechanisms. We also discuss the potential for therapies targeting endothelial dysfunction and transplant graft vasculopathy.
Humans ; Kidney/*blood supply ; *Kidney Transplantation ; Research Support, Non-U.S. Gov't ; Transplantation, Homologous ; Vascular Diseases/*prevention & control/*therapy

Atherosclerosis(AS) is the common pathological basis of many ischemic cardiovascular diseases, and its formation process involves various aspects such as vascular endothelial injury and platelet activation. Vascular endothelial injury is the initiating factor of AS plaque. Monocytes are recruited to differentiate into macrophages at the damaged endothelial cells, which absorb oxidized low-density lipoprotein(ox-LDL) and slowly transform into foam cells. Smooth muscle cells(SMCs) proliferate and migrate continuously. As the only cell producing interstitial collagen fibers in the fibrous cap, SMCs largely determine whether the plaque ruptured or not. The amplifying inflammatory response during the formation of AS recruits platelets to adhere to the damaged area of vascular endothelium and stimulates excessive platelet aggregation. Autophagy activity is associated with vascular lesions and abnormal platelet activation, and excessive autophagy is considered to be a negative factor for plaque stability. Therefore, precise regulation of different types of vascular autophagy and platelet autophagy to treat AS may provide a new therapeutic perspective for the prevention and treatment of atherosclerotic ischemic cardiovascular disease. Currently, treatment strategies for AS still focus on lowering lipid levels with high-intensity statins, which often cause significant side effects. Therefore, the development of safer and more effective drugs and treatment modes is the focus of current research. Traditional Chinese medicine and natural compounds have the potential to treat AS by targeted autophagy, and have been playing an increasingly important role in the prevention and treatment of cardiovascular diseases in China. This paper summarizes the experimental studies on different vascular cell types and platelet autophagy in AS, and sums up the published research results on targeted autophagy of traditional Chinese medicine and natural plant compounds to regulate AS, providing new ideas for further research.
Humans ; Endothelial Cells/metabolism* ; Cardiovascular Diseases ; Medicine, Chinese Traditional ; Atherosclerosis/prevention & control* ; Lipoproteins, LDL/metabolism* ; Endothelium, Vascular ; Plaque, Atherosclerotic ; Autophagy

Plaque disruption and subsequent thrombotic occlusion is the primary mechanism by which atherosclerosis leads to acute coronary syndromes and ischemic stroke. Platelets are the key component of arterial thrombus formation in response to sudden fissuring or rupture of the atheromatous plaque. Low dose aspirin (100~300 mg/day) rapidly inhibits platelets through permanent inactivation of the key platelet enzyme, cyclooxygenase (COX). The efficacy and safety of aspirin have been extensively studied in several populations, ranging from healthy individuals to highrisk patients with acute myocardial infarction or ischemic stroke. It is well established that aspirin reduces the risk of serious vascular events (death, myocardial infarction, and stroke) by approximately 25% in patients with established vascular diseases. However, long-term therapy with aspirin approximately doubles the risk of major extracranial bleeding (mostly gastrointestinal bleeding) and also increases the risk of hemorrhagic stroke. In contrast to the clear benefit of aspirin in secondary prevention, its benefits in primary prevention are less clear. A meta-analysis of primary prevention trials in men demonstrated that aspirin reduces the risk of myocardial infarction by approximately 30% but has no effects on the risk of stroke. By contrast, the Women's Health Study showed that aspirin reduces the risk of stroke by 17% but has no effects on the risk of myocardial infarction. The reasons for this discrepancy remain unclear, requiring additional studies. Taken together, aspirin is recommended for primary prevention in healthy individuals with an annual risk of vascular events >1.5%. In conclusion, aspirin is recommended for secondary prevention in all patients, but its risk-benefit ratio should be carefully considered for primary prevention.
Acute Coronary Syndrome ; Aspirin* ; Atherosclerosis ; Blood Platelets ; Hemorrhage ; Humans ; Male ; Myocardial Infarction ; Primary Prevention ; Prostaglandin-Endoperoxide Synthases ; Rupture ; Secondary Prevention ; Stroke ; Thrombosis ; Vascular Diseases ; Women's Health

OBJECTIVETo investigate the common reasons, prophylaxis and treatment of operation-correlated complications in orthotopic liver transplantation (OLT).

METHODSSix hundred and forty-seven patients who underwent OLT from Apr 1993 to Dec 2004 were enrolled and analyzed retrospectively.

RESULTSThere were totally 39 cases (6.0%, 39/647) of vascular complications including 23 cases (3.6%) of hepatic artery complications, 6 cases (0.9%) of portal vein complications and 10 cases (1.5%) of vena cava complications. All vena cava complications were occurred in the patients of non-cavaplasty. The success rate of stent placement in treatment of hepatic artery stenosis was 2/2; for patients with hepatic artery thrombosis, the success rate of retransplantation was 4/6, that of revasculation and balloon dilation were 3/7 and 2/7 respectively. Stent placement can treat both anastomotic strictures and venae cavae stricture with the cure rate of 3/3 and 10/10 respectively. There were 34 cases of biliary complications, in which 27 cases were in patients with T tube, and 7 cases in without T tube. The incidence of biliary leak and biliary infection was significantly different between these two groups.

CONCLUSIONSThe modified piggyback (cavaplasty) technique could prevent the incidence of venae cavae complications effectively. Stent placement is an effective way to treat vascular stenosis. And retransplantation should be performed in early hepatic artery thrombosis. It is important to protect the blood supply of biliary system, and choledochostomy without T tube is the first choice for biliary reconstruction.

Adolescent ; Adult ; Aged ; Biliary Tract Diseases ; etiology ; prevention & control ; Child ; Child, Preschool ; Hepatic Artery ; Humans ; Infant ; Liver Transplantation ; adverse effects ; methods ; Middle Aged ; Portal Vein ; Postoperative Complications ; etiology ; prevention & control ; Retrospective Studies ; Vascular Diseases ; etiology ; prevention & control

Objective: To investigate the factors influencing the postoperative resolution of varicocele-associated scrotal pain. METHODS: Using the keywords "varicocele", "testicular pain", "scrotal pain", "painful varicocele", "ligation", and "varicocelectomy", we searched the PubMed, Embase, Cochrane Collaboration's Database, CNKI, Wanfang, and VIP Database up to October 2016 for the studies relating to surgical treatment of varicocele-associated scrotal pain. We assessed the quality of the cohort studies included using the Newcastle-Ottawa Scale and that of the randomized controlled trials included with the Cochrane Collaboration's tool. We conducted a meta-analysis using the RevMan software. RESULTS: Finally 14 studies were included in this meta-analysis, of which, 2 involved the history of disease, 8 involved the nature of pain, 2 involved the intensity of pain, 9 involved the grade of varicocele, 3 involved the side of varicocele, 9 involved surgical approaches, 3 involved surgical techniques, and 4 involved postoperative recurrence. The pain resolution rate was significantly higher after subinguinal ligation than after high or inguinal ligation (RR = 0.82, 95% CI: 0.76－0.89, P <0.01; RR = 0.92, 95% CI: 0.86－0.99, P = 0.02), and so was it after microsurgery than after laparoscopic varicocelectomy (RR = 0.77, 95% CI: 0.60－0.99, P = 0.04). CONCLUSIONS Subinguinal varicocelectomy and microsurgery are more effective options than laparoscopic and high or trans-inguinal ligation of the spermatic vein for resolution of varicocele-associated scrotal pain, while the history of disease, the nature and intensity of pain, the grade and side of varicocele, or postoperative recurrence cannot be regarded as the influencing factors.
Adult ; Genital Diseases, Male ; prevention & control ; Humans ; Laparoscopy ; Ligation ; Male ; Microsurgery ; Pain, Postoperative ; prevention & control ; Pain, Procedural ; prevention & control ; Recurrence ; Scrotum ; Testis ; Treatment Outcome ; Varicocele ; surgery ; Vascular Surgical Procedures ; Veins

OBJECTIVETo assess the role of orthotopic liver transplantation (OLT) in the treatment of end-stage liver diseases and to discuss the experience of the operation.

METHODSRetrospective analysis of clinical data of 71 cases of liver transplantation was performed in our hospital from April 1993 to August 2001.

RESULTSOne year survival rate of recipients with benign hepatic disease was over 75%. The survival time and life quality of malignant recipients were also improved. Lamivudine monotherapy during the operation period could reduce HBV reinfection rate. The practice of OLT without veno-venous bypass (VVB) was associated with a shorter operating time, less hemorrhape, and thus less blood transfusion during the operation compared with standard technique of OLT with routine use of VVB. The occurrence rate of biliary complications was 5.98% and vascular complication 8.96%.

CONCLUSIONSOLT should become a routine therapeutic choice for end-stage liver diseases. Lamivudine is helpful to reduce HBV reinfection after OLT in HBV-related liver diseases. OLT without VVB is safe and can be performed in the majority of adult patients. The early diagnosis and timely application of interventional radiological technique are important for the treatment of biliary and vascular complications.

Adolescent ; Adult ; Biliary Tract Diseases ; prevention & control ; virology ; Child ; Female ; Follow-Up Studies ; Hepatitis B ; prevention & control ; Humans ; Lamivudine ; therapeutic use ; Liver Diseases ; mortality ; Liver Transplantation ; adverse effects ; methods ; mortality ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; virology ; Retrospective Studies ; Survival Rate ; Vascular Diseases ; prevention & control ; virology

Vascular dementia (VaD) is the second most common cause of dementia in the elderly after Alzheimer's disease. At present, there are only very limited data that might support either the prevention or the treatment of vascular dementia, despite a long history of attempts. Heterogeneity of vascular dementia complicated the study of treatment and its diagnostic paradigm based on Alzheimer's disease made it impossible to identify cases early enough to prevent the development of dementia. A new concept, vascular cognitive impairment (VCI), has been proposed to underscore the impotance of early identification and treatment of vascular dementia. Prevention involves the control of putative vascular risk factors (i.e. hypertension, diabetes, cardiac arrhythmias, smoking, hyperlipidemia) and the promotion of potential protective factors. Primary and secondary prevention of stroke and cardiovascular disease decreases the burden of vascular dementia. Targets for the treatment of vascular dementia include 1) improvement of core symptoms (cognition, executive function, and behavior), 2) improvement of secondary factors affecting cognition (depression, anxiety, agitation), 3) slowing the progression of vascular dementia. Cholinesterase inhibitors used for Alzheimer's disease are also useful in vascular dementia, awaiting to be accepted as the first-line treatment for vascular dementia.
Aged ; Alzheimer Disease ; Anxiety ; Arrhythmias, Cardiac ; Cardiovascular Diseases ; Cholinesterase Inhibitors ; Cognition ; Dementia ; Dementia, Vascular* ; Executive Function ; Humans ; Hypertension ; Population Characteristics ; Risk Factors ; Secondary Prevention ; Smoke ; Smoking ; Stroke

OBJECTIVETo observe the clinical efficacy of Safflower Injection (Al) in treating and preventing the vascular crisis after free flap transplantation.

METHODSSixty patients undergoing free flap transplantation were randomly assigned to the treatment group and control group according to the visiting sequence, thirty in each. Free flap transplantation was performed on all patients, and medication was given 0. 5 h before flap vascular anastomosis, 1-7 days after surgery. Twenty mL Al was intravenously dripped to patients in the treatment group after adding in 250 mL 5% glucose injection, while Dextran-40 was intravenously dripped to patients in the control group. The medication was conducted once per day. The hemorheology and four indices of blood coagulation [prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (FIB)] were compared between the two groups before operation (TO), during operation (T1), 24 h after operation (T2), three days after operation (T3), and seven days after operation (T4). Meanwhile, flaps were observed and adverse reaction recorded. The clinical efficacy and safety were compared.

RESULTSBetter result was obtained in the treatment group when compared their clinical efficacy (86. 67% vs 60. 00%, P<0.05). The whole blood high and low viscosity, plasma viscosity, red blood cell (RBC) volume, RBC aggregation index all decreased, and RBC deformed index increased in the two groups at T4, showing statistical difference when compared with those at T3 (P<0.05, P<0.01). There was no statistical significance in the four indices of blood coagulation when compared with any time point in the same group (P>0.05). There was no statistical significance in hemorheology and the four indices of blood coagulation between the two groups at the same time point (P>0.05). The adverse reaction rate in the treatment group was lower than that in the control group, showing statistical difference (13.33% vs 30.00%, P<0.05).

CONCLUSIONSAI could effectively prevent and treat the vascular crisis after free flap transplantation. It had less adverse reaction and good safety. It was better than Dextran-40. It was a safe and effective drug to prevent the vascular crisis.

Adult ; Carthamus tinctorius ; Female ; Free Tissue Flaps ; adverse effects ; Humans ; Injections ; Male ; Middle Aged ; Phytotherapy ; Skin Transplantation ; adverse effects ; Vascular Diseases ; etiology ; prevention & control ; Young Adult