1.The evolution and application progress of non-modified drug target discovery CETSA technology
Guang-yuan LIU ; Ya-hui LI ; Wei ZHANG ; De-zhi KONG
Acta Pharmaceutica Sinica 2024;59(1):25-34
Understanding the research methods for drug protein targets is crucial for the development of new drugs, clinical applications of drugs, drug mechanisms, and the pathogenesis of diseases. Cellular thermal shift assay (CETSA), a target research method without modification, has been widely used since its development. Now, there are various CETSA-based technology combinations, such as mass spectrometry-based cellular thermal shift assay (MS-CETSA), isothermal dose response-cellular thermal shift assay (ITDR-CETSA), amplified luminescent proximity homogeneous assay-cellular thermal shift assay (Alpha-CETSA),
2.Nanomaterial-based Therapeutics for Biofilm-generated Bacterial Infections
Zhuo-Jun HE ; Yu-Ying CHEN ; Yang ZHOU ; Gui-Qin DAI ; De-Liang LIU ; Meng-De LIU ; Jian-Hui GAO ; Ze CHEN ; Jia-Yu DENG ; Guang-Yan LIANG ; Li WEI ; Peng-Fei ZHAO ; Hong-Zhou LU ; Ming-Bin ZHENG
Progress in Biochemistry and Biophysics 2024;51(7):1604-1617
Bacterial biofilms gave rise to persistent infections and multi-organ failure, thereby posing a serious threat to human health. Biofilms were formed by cross-linking of hydrophobic extracellular polymeric substances (EPS), such as proteins, polysaccharides, and eDNA, which were synthesized by bacteria themselves after adhesion and colonization on biological surfaces. They had the characteristics of dense structure, high adhesiveness and low drug permeability, and had been found in many human organs or tissues, such as the brain, heart, liver, spleen, lungs, kidneys, gastrointestinal tract, and skeleton. By releasing pro-inflammatory bacterial metabolites including endotoxins, exotoxins and interleukin, biofilms stimulated the body’s immune system to secrete inflammatory factors. These factors triggered local inflammation and chronic infections. Those were the key reason for the failure of traditional clinical drug therapy for infectious diseases.In order to cope with the increasingly severe drug-resistant infections, it was urgent to develop new therapeutic strategies for bacterial-biofilm eradication and anti-bacterial infections. Based on the nanoscale structure and biocompatible activity, nanobiomaterials had the advantages of specific targeting, intelligent delivery, high drug loading and low toxicity, which could realize efficient intervention and precise treatment of drug-resistant bacterial biofilms. This paper highlighted multiple strategies of biofilms eradication based on nanobiomaterials. For example, nanobiomaterials combined with EPS degrading enzymes could be used for targeted hydrolysis of bacterial biofilms, and effectively increased the drug enrichment within biofilms. By loading quorum sensing inhibitors, nanotechnology was also an effective strategy for eradicating bacterial biofilms and recovering the infectious symptoms. Nanobiomaterials could intervene the bacterial metabolism and break the bacterial survival homeostasis by blocking the uptake of nutrients. Moreover, energy-driven micro-nano robotics had shown excellent performance in active delivery and biofilm eradication. Micro-nano robots could penetrate physiological barriers by exogenous or endogenous driving modes such as by biological or chemical methods, ultrasound, and magnetic field, and deliver drugs to the infection sites accurately. Achieving this using conventional drugs was difficult. Overall, the paper described the biological properties and drug-resistant molecular mechanisms of bacterial biofilms, and highlighted therapeutic strategies from different perspectives by nanobiomaterials, such as dispersing bacterial mature biofilms, blocking quorum sensing, inhibiting bacterial metabolism, and energy driving penetration. In addition, we presented the key challenges still faced by nanobiomaterials in combating bacterial biofilm infections. Firstly, the dense structure of EPS caused biofilms spatial heterogeneity and metabolic heterogeneity, which created exacting requirements for the design, construction and preparation process of nanobiomaterials. Secondly, biofilm disruption carried the risk of spread and infection the pathogenic bacteria, which might lead to other infections. Finally, we emphasized the role of nanobiomaterials in the development trends and translational prospects in biofilm treatment.
3.Bioequivalence study of olmesartan medoxomil tablet in Chinese healthy subjects
Na SHAN ; Da-Hai JIANG ; Lin-Lin MIAO ; Zhen-Li REN ; Peng-Bo JIN ; Pei-Qi HAO ; Li AN ; Hong ZHU ; Yong XIN ; Guang-De YANG ; Feng LIU
The Chinese Journal of Clinical Pharmacology 2024;40(20):3033-3037
Objective To study the bioequivalence of test and reference olmesartan tablet in Chinese healthy subjects after single dose under fasting and fed conditions.Methods A single-center,random,open,single-dose,two-preparations,double-period,crossover study was adopted.A total of 48 healthy adult male and female subjects(24 cases of fasting test and 24 cases of fed test)were included in the random crossover administration.Single oral dose 20 mg of test and reference were taken under fasting and postprandial conditions,respectively.Plasma concentration of olmesartan in plasma were determined by liquid chromatography tandem mass spectrometry.The main pharmacokinetic parameters were calculated by Phoenix WinNonlin 8.0 software.Results The main pharmacokinetic parameters of the test and reference preparations of olmesartan tablets in the fasting group were as follows:Cmax were(653.06±133.53)and(617.37±151.16)ng·mL-1,AUC0-t were(4 201.18±1 035.21)and(4 087.38±889.99)ng·mL-1·h,AUC0-∞ were(4 254.30±1 058.90)and(4 135.69±905.29)ng·mL-1·h.The main pharmacokinetic parameters of the test and reference preparations of olmesartan tablets in the postprandial group were as follows:Cmax were(574.78±177.05)and(579.98±107.74)ng·mL-1,AUC0-t were(3 288.37±866.06)and(3 181.51±801.06)ng·mL-1·h,AUC0-∞ were(3 326.11±874.26)and(3 242.01±823.09)ng·mL-1·h.Under fasting and postprandial conditions,the 90%confidence intervals of the main pharmacokinetic parameters of the test and reference preparations are both 80.00%-125.00%.Conclusion Under fasting and postprandial conditions,a single oral dose of test and reference preparations olmesartan tablets in Chinese healthy adult volunteers showed bioequivalence.
4.Temporal trend of the global prevalence rate of tension-type headache in children and adolescents in 1990-2021
Ling-Zi YAO ; De-Nan JIANG ; Jing WU ; Guang-Dian SHEN ; Jin CAO ; Si-Qing CHENG ; Shi-Yi SHAN ; Ze-Yu LUO ; Jia-Li ZHOU ; Pei-Ge SONG
Chinese Journal of Contemporary Pediatrics 2024;26(10):1058-1065
Objective To investigate the prevalence of tension-type headache(TTH)in children and adolescents aged 0-19 years globally in 1990-2021,and to provide a basis for the prevention and treatment of TTH.Methods Based on the Global Burden of Disease Study data,the age-standardized prevalence distribution of TTH and its changing trend were analyzed among the children and adolescents aged 0-19 years,with different sexes,age groups,sociodemographic index(SDI)regions and countries/territories.Results The age-standardized prevalence rate(ASPR)of TTH in children and adolescents aged 0-19 globally in 2021 was 17 339.89/100 000,which was increased by 1.73%since 1990.The ASPR in females was slightly higher than that in males(1990:17 707.65/100 000 vs 16 403.78/100 000;2021:17 946.29/100 000 vs 16 763.09/100 000).The ASPR in adolescence was significantly higher than that in school-aged and preschool periods(1990:27 672.04/100 000 vs 10 134.16/100 000;2021:28 239.04/100 000 vs 10 059.39/100 000).Regions with high SDI exhibited a higher ASPR than the other regions,with significant differences in prevalence rates across different countries.From 1990 to 2021,there was a slight increase in global ASPR,with an average annual percentage change(AAPC)of 0.06%.Females experienced a smaller increase than males based on AAPC(0.04%vs 0.07%).There was reduction in ASPR in preschool and school-aged groups,with an AAPC of-0.02%,while there was a significant increase in ASPR in adolescence,with an AAPC of 0.07%.ASPR decreased in regions with low-middle and low levels of SDI,with an AAPC of-0.02%and-0.04%,respectively,while it increased in regions with middle SDI,with an AAPC of 0.24%.Conclusions There is a consistent increase in the ASPR of TTH in children and adolescents aged 0-19 years globally,with significant differences across sexes,age groups,SDI regions and countries/territories.
5.Gene Analysis of Combined Dual Rare Thalassemia
Cheng-De LI ; Guang-Yu XIAN ; Xiao-Jia HUANG ; Shan CHEN ; Li-Xia LIANG ; Zhi-Fang LIN
Journal of Experimental Hematology 2024;32(5):1479-1484
Objective:To retrospectively analyze the detection and diagnosis process of two cases with double rare thalassemia genotypes,explore the causes of missed diagnosis and misdiagnosis of rare thalassemia,and improve the diagnosis level of rare thalassemia.Methods:Base on the family history,hematological phenotype and hemoglobin electrophoretic analysis results,the common genotypes of α and β-thalassemia were detected by PCR+diversion hybridization.DNA sequencing technology was used for rare α and β protein genes sequencing.Results:Both subjects were combined with double rare thalassemia genotypes,and both rare thalassemia gene combinations were reported for the first time.One of them was αβ complex thalassemia with αα*53_55 del TCC/αα heterozygous merger βIVS Ⅱ2(-T)/βN heterozygous,the other was ααIVS-Ⅱ-55(T→G)in α1/αα4,2-Q double azygous heterozygous α-thalassemia,among whichαα*53_55 del TCC/αα genotype was also reported for the first time.Conclusion:The reported rare gene type αα*53_55 del TCC/αα and two cases of rare gene combinations enriches the spectrum of gene mutations in the Chinese population,and provides richer molecular information for thalassemia diagnosis and eugenics counseling.
6.Expression and Detection Value of 6 Chlamydia Trachomatis Protein Antibodies in Tubal Factor Infertility
Ming-na LIU ; Man-li QI ; Xiao-hong CHEN ; Jin-feng TAN ; Dan ZHANG ; Yu-yan LIU ; Jian-de HAN ; Chun-guang MA
Journal of Sun Yat-sen University(Medical Sciences) 2023;44(1):150-158
ObjectiveTo further study the pathogenic role of different types of Chlamydia trachomatis (CT) proteins in tubal factor infertility, evaluate the clinical detection value of Chlamydia trachomatis protein antibody in predicting tubal factor infertility. MethodsA total of 58 cases of tubal factor infertility (TFI), 41 cases of fertile controls (FC) and 18 cases of infertile controls (IFC) were included. For serum detection, first, CT-IgG ELISA kit was used to detect the expression of CT-IgG in serum of three groups of people; then, 6 kinds of Chlamydia trachomatis proteins were expressed and purified in the early stage to establish the antibody test for these proteins, and ELISA detection method was used to detect the expression of their antibodies in the serum of TFI group, FC group and IFC group, respectively; and finally, the antibody OD value of the 6 kinds of Chlamydia trachomatis proteins in the three groups of subjects were statistically described, and CT-IgG was used as the reference standard to draw the receiver operating characteristic curve (ROC curve) of each CT antibody. The Youden Index determines the cutoff value for each antibody. Taking TFI as the reference class, two disordered multiple classification logistic regression models were established with the FC and IFC groups, respectively; and the reference class was used to explore the value of various antibodies and age in predicting TFI, FC and IFC of Chlamydia trachomatis. The back-off method was used to screen the variables. ResultsThe OD value of CT376 antibody in the TFI group was higher than that in the FC group (0.86 vs. 0.60, P=0.026). The CT376 antibody OD value in the TFI group was higher than that in the IFC group (0.86 vs. 0.64, P=0.026). The CT443 antibody OD value in the IFC group was higher than that in the TFI group (0.59 vs. 0.34, P=0.036) and higher than that in the FC group (0.59 vs. 0.30, P=0.02). The multiple classification logistic regression analysis established between TFI and FC showed that CT-IgG [P<0.001, OR=0.084, 95%CI (0.025, 0.284)], CT376 antibody [P=0.068, OR=0.359, 95%CI (0.120, 1.078)]. CT-IgG is an independent risk factor for tubal infertility, and CT376 antibody cannot be an independent risk factor for tubal infertility. The multiple classification logistic regression analysis established between TFI and IFC showed that among infertile patients, CT-IgG [P<0.05, OR=0.194, 95%CI (0.046, 0.817)], CT376 antibody [P<0.05, OR=0.176, 95%CI (0.038, 0.818)] and CT381 antibody [P<0.05, OR=0.112, 95%CI ( 0.016, 0.796)] were independent risk factors for tubal infertility. ConclusionThe expression of CT376 antibody in tubal infertility patients is higher than that in fertile and infertile controls, suggesting that CT-induced tubal factor infertility may be related to CT376. CT-IgG, and CT376 antibodies are meaningful in predicting CT-induced tubal factor infertility.
7.Difference of lipid-lowering efficacy of "Xinjianqu" before and after fermentation and its mechanism based on LKB1-AMPK pathway and 16S rDNA sequencing technology.
De-Hua LI ; Rui-Sheng WANG ; Zhen-Ling ZHANG ; Jian-Guang ZHU ; Meng-Mei SUN ; Jia QIAO
China Journal of Chinese Materia Medica 2023;48(8):2146-2159
On the basis of establishing the prescription of Xinjianqu and clarifying the increase of the lipid-lowering active ingredients of Xinjianqu by fermentation, this paper further compared the differences in the lipid-lowering effects of Xinjianqu before and after fermentation, and studied the mechanism of Xinjianqu in the treatment of hyperlipidemia. Seventy SD rats were randomly divided into seven groups, including normal group, model group, positive drug simvastatin group(0.02 g·kg~(-1)), and low-dose and high-dose Xinjianqu groups before and after fermentation(1.6 g·kg~(-1) and 8 g·kg~(-1)), with ten rats in each group. Rats in each group were given high-fat diet continuously for six weeks to establish the model of hyperlipidemia(HLP). After successful modeling, the rats were given high-fat diet and gavaged by the corresponding drugs for six weeks, once a day, to compare the effects of Xinjianqu on the body mass, liver coefficient, and small intestine propulsion rate of rats with HLP before and after fermentation. The effects of Xinjianqu before and after fermentation on total cholesterol(TC), triacylglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), alanine aminotransferase(ALT), aspartate aminotransferase(AST), blood urea nitrogen(BUN), creatinine(Cr), motilin(MTL), gastrin(GAS), and the Na~+-K~+-ATPase levels were determined by enzyme-linked immunosorbent assay(ELISA). The effects of Xinjianqu on liver morphology of rats with HLP were investigated by hematoxylin-eosin(HE) staining and oil red O fat staining. The effects of Xinjianqu on the protein expression of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK), phosphorylated AMPK(p-AMPK), liver kinase B1(LKB1), and 3-hydroxy-3-methylglutarate monoacyl coenzyme A reductase(HMGCR) in liver tissues were investigated by immunohistochemistry. The effects of Xinjianqu on the regulation of intestinal flora structure of rats with HLP were studied based on 16S rDNA high-throughput sequencing technology. The results showed that compared with those in the normal group, rats in the model group had significantly higher body mass and liver coefficient(P<0.01), significantly lower small intestine propulsion rate(P<0.01), significantly higher serum levels of TC, TG, LDL-C, ALT, AST, BUN, Cr, and AQP2(P<0.01), and significantly lower serum levels of HDL-C, MTL, GAS, Na~+-K~+-ATP levels(P<0.01). The protein expression of AMPK, p-AMPK, and LKB1 in the livers of rats in the model group was significantly decreased(P<0.01), and that of HMGCR was significantly increased(P<0.01). In addition, the observed_otus, Shannon, and Chao1 indices were significantly decreased(P<0.05 or P<0.01) in rat fecal flora in the model group. Besides, in the model group, the relative abundance of Firmicutes was reduced, while that of Verrucomicrobia and Proteobacteria was increased, and the relative abundance of beneficial genera such as Ligilactobacillus and Lachnospiraceae_NK4A136_group was reduced. Compared with the model group, all Xinjianqu groups regulated the body mass, liver coefficient, and small intestine index of rats with HLP(P<0.05 or P<0.01), reduced the serum levels of TC, TG, LDL-C, ALT, AST, BUN, Cr, and AQP2, increased the serum levels of HDL-C, MTL, GAS, and Na~+-K~+-ATP, improved the liver morphology, and increased the protein expression gray value of AMPK, p-AMPK, and LKB1 in the liver of rats with HLP and decreased that of LKB1. Xinjianqu groups could regulate the intestinal flora structure of rats with HLP, increased observed_otus, Shannon, Chao1 indices, and increased the relative abundance of Firmicutes, Ligilactobacillus(genus), Lachnospiraceae_NK4A136_group(genus). Besides, the high-dose Xinjianqu-fermented group had significant effects on body mass, liver coefficient, small intestine propulsion rate, and serum index levels of rats with HLP(P<0.01), and the effects were better than those of Xinjianqu groups before fermentation. The above results show that Xinjianqu can improve the blood lipid level, liver and kidney function, and gastrointestinal motility of rats with HLP, and the improvement effect of Xinjianqu on hyperlipidemia is significantly enhanced by fermentation. The mechanism may be related to AMPK, p-AMPK, LKB1, and HMGCR protein in the LKB1-AMPK pathway and the regulation of intestinal flora structure.
Rats
;
Animals
;
AMP-Activated Protein Kinases/metabolism*
;
Rats, Sprague-Dawley
;
Cholesterol, LDL
;
Fermentation
;
Aquaporin 2/metabolism*
;
Lipid Metabolism
;
Liver
;
Lipids
;
Hyperlipidemias/genetics*
;
Adenosine Triphosphate/pharmacology*
;
Diet, High-Fat/adverse effects*
8.Percutaneous kyphoplasty assisted by three dimensional printing percutaneous guide plate for the treatment of osteoporotic vertebral compression fractures.
Jiang-Long LIAO ; Li DENG ; De-Guang LI ; Hao-Min SUN ; Jian LI ; Yan SU ; Bo JIANG ; Lyu-Yu LI
China Journal of Orthopaedics and Traumatology 2023;36(5):445-449
OBJECTIVE:
To verify the safety of three dimensional printing percutaneous guide plate assisted percutaneous kyphoplasty(PKP) in the treatment of osteoporotic vertebral compression fractures(OVCFs).
METHODS:
The clinical data of 60 patients with OVCFs treated by PKP from November 2020 to August 2021 were retrospectively analyzed. There were 24 males and 36 females, aged from 72 to 86 years old with an average of (76.5±7.9) years. Routine percutaneous kyphoplasty was performed in 30 cases (conventional group) and three dimensional printing percutaneous guide plate assisted PKP was performed in 30 cases (guide plate group). Intraoperative pedicle puncture time (puncture needle to posterior vertebral body edge) and number of fluoroscopy, total operation time, total number of fluoroscopy, amount of bone cement injection, and complication (spinal canal leakage of bone cement) were observed. The visual analogue scale (VAS) and the anterior edge compression rate of the injured vertebra were compared before operation and 3 days after operation between two groups.
RESULTS:
All 60 patients were successfully operated without complication of spinal canal leakage of bone cement. In the guide plate group, the pedicle puncture time was(10.23±3.15) min and the number of fluoroscopy was(4.77±1.07) times, the total operation time was (33.83±4.21) min, the total number of fluoroscopy was(12.27±2.61) times;and in the conventional group, the pedicle puncture time was (22.83±3.09) min and the number of fluoroscopy was (10.93±1.62) times, the total operation time was(44.33±3.57) min, the total number of fluoroscopy was(19.20±2.67) times. There were statistically significant differences in the pedicle puncture time, intraoperative number of fluoroscopy, the total operation time, and the total number of fluoroscopy between the two groups(P<0.05). There was no significant difference in amount of bone cement injection between the two groups(P>0.05). There were no significant differences in VAS and the anterior edge compression rate of the injured vertebra at 3 days after operation between two groups(P>0.05).
CONCLUSION
Three dimensional printing percutaneous guide plate assisted percutaneous kyphoplasty is safe and reliable, which can reduce the number of fluoroscopy, shorten the operation time, and decrease the radiation exposure of patients and medical staff, and conforms to the concept of precise orthopaedic management.
Male
;
Female
;
Humans
;
Aged
;
Aged, 80 and over
;
Kyphoplasty/methods*
;
Fractures, Compression/surgery*
;
Spinal Fractures/surgery*
;
Bone Cements
;
Retrospective Studies
;
Treatment Outcome
;
Osteoporotic Fractures/surgery*
9.Transcutaneous Electrical Acupoint Stimulation Combined with Warm Acupuncture for Breast Cancer Related Upper Limb Lymphedema: A Retrospective Cohort Study.
Chao LU ; Guang-Liang LI ; De-Hou DENG ; Wen-Long BAO ; Yan WANG ; Ai-Qin ZHANG
Chinese journal of integrative medicine 2023;29(6):534-539
OBJECTIVE:
To observe the clinical efficacy of transcutaneous electrical acupoint stimulation (TEAS) combined with warm acupuncture in treating breast cancer associated with upper limb lymphedema (BCRL).
METHODS:
This was a retrospective cohort study using a paired control design. Fifty-two BCRL patients were assigned to the control group (27 cases) and the treatment group (25 cases). The patients in the control group were treated with lymphedema comprehensive detumescence treatment (CDT) for 4 weeks, including systematic therapy composed of manual lymphatic drainage, compression bandage, skincare, and functional exercise. The patients in the treatment group were treated with TEAS combined with warm acupuncture based on the control group methods. Each treatment lasted for 30 min and was applied twice a week for 4 weeks. The arm circumference (AC) of different positions of the affected limb and the degree of swelling of the affected limb were evaluated before the first treatment and after the last treatment. The clinical efficacy was evaluated according to the degree of edema before and after treatment. All adverse events during treatment were recorded.
RESULTS:
The patients' AC and the swelling feeling of the affected limb in the treatment group and the control group were both reduced compared with those before treatment. Compared with the control group, AC of the wrist joint transverse stria, the midpoint between the wrist joint transverse stria and the elbow joint transverse stria in the treatment group were significantly reduced (P<0.05). The decrease in AC diameter at the midpoint between the elbow joint transverse stria and the axillary transverse stria was the most significant (P<0.01). The swelling degree of the affected limbs in the treatment group was significantly lower than before treatment, and was significantly lower compared with the control group after treatment (P<0.01). The total effective rate was 72% in the treatment group, significantly higher than that in the control group (55.56%, P<0.05). No serious adverse events occured in either group.
CONCLUSIONS
TEAS combined with warm acupuncture can effectively reduce AC and swelling feeling of the affected limb in patients with BCRL. The effect is better than that of CDT therapy alone. (Registration No. ChiCTR2200062075).
Humans
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Female
;
Breast Neoplasms/therapy*
;
Acupuncture Points
;
Retrospective Studies
;
Lymphedema/complications*
;
Acupuncture Therapy/adverse effects*
;
Upper Extremity
;
Treatment Outcome
10.Reference values for carotid artery intima-media thickness among community adult dwellers in Shenzhen City.
Yu Xin XIE ; De Liang LYU ; Ke PENG ; Hong Wei XIE ; Yong JIANG ; Xin Bo ZHONG ; Xi Lin WEN ; Zi Wei FU ; Gui Li ZHOU ; Zhi Guang ZHAO ; Yi Chong LI
Chinese Journal of Preventive Medicine 2023;57(7):1011-1017
Objective: To establish reference values for carotid intima-media thickness (CIMT) of adult dwellers in Shenzhen City. Methods: The study was conducted based on the Shenzhen heart failure epidemiological survey from 2021 to 2022. In this survey, residents aged 18 years and above in Shenzhen were selected by using a multi-stage stratified random sampling method. General information, cardiovascular disease (CVD) related behavior and carotid ultrasound examination and etc. were collected from the participants. People with CVD factors, a history of atherosclerotic cardiovascular disease, carotid plaque or having no carotid ultrasound examination results were excluded. The parameter regression model based on fractional polynomial was used to establish the reference values of CIMT by age and sex. Results: A total of 2 163 healthy individuals were enrolled in the final analysis, including 576 males (26.6%) and 1 587 females (73.4%). The fractional polynomial regression of the CIMT mean and standard deviation was obtained. For men, the regression was meanCIMT=0.324 7+0.006 9×age and SDCIMT=0.076 9+0.001 2×age. For women, the regression was meanCIMT=0.354 9+0.005 4×age and SDCIMT=0.041 6+0.002 0×age. Conclusion: The age and sex reference values for CIMT of adult people in Shenzhen established in this study could provide the latest reference standards for early screening of subclinical CVD.
Male
;
Humans
;
Adult
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Female
;
Carotid Intima-Media Thickness
;
Cardiovascular Diseases
;
Reference Values
;
Carotid Arteries/diagnostic imaging*
;
Ultrasonography, Carotid Arteries
;
Risk Factors
;
Carotid Artery Diseases

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