OBJECTIVE: To establish an arterial remodeling model of rats and to investigate the expression and role of Hippo signaling pathway in this model. METHODS: In the model group (n=40), the left common carotid artery was removed through the median incision of the neck. The 6-0 non-absorbable line was used to ligate the carotid artery near the proximal end as far as possible, completely blocking the blood flow. The common carotid artery of rats in control group (n=20) was not ligated using the operative line. After 14 days, the animals were sacrificed and the common carotid arteries were separated through the original surgical pathway and the arteries from the ligature to the distal end were collected. Arterial morphology and fibrosis were observed by HE and MASSON staining. Immunohistochemical staining was used to detect the expressions of anti-α smooth muscle actin (α-MSA) and proliferating cell nuclear antigen (PCNA) in the carotid artery. Western blot was used to detect the expressions of yes associated protein (YAP), transcriptional coactivator with PDZ-binding motif (TAZ), TEAD1, Bcl-2-like protein 4 (Bax), and B-cell lymphoma-2 (Bcl-2). RESULTS: Compared with the control group, the HE staining showed that the vascular remodeling was obvious, the ratio of the neointima/middle membrane was increased significantly, and the MASSON staining indicated that the fibrosis was significantly increased in model group. The immunohistochemical staining suggested that the expressions of α-SMA and PCNA were increased significantly; Western blot suggested that the expressions of YAP, TAZ, TEAD1, and Bcl-2 were increased in carotid artery of the model group. While the expression of Bax and the ratio of Bax/Bcl-2 were decreased. CONCLUSION A rat model of arterial remodeling mediated by carotid artery ligation was established successfully in this study. Hippo signaling pathway was proved to be activated in the arterial remodeling model induced by carotid artery ligation in rats, and might regulate the change of Bax/Bcl-2 ratio related to proliferation and apoptosis, and subsequently involved in the proliferation of smooth muscle cells to promote vascular remodeling.
Animals ; Carotid Arteries ; metabolism ; Carotid Artery, Common ; Cell Proliferation ; Myocytes, Smooth Muscle ; Protein-Serine-Threonine Kinases ; metabolism ; Rats ; Signal Transduction ; Vascular Remodeling ; physiology

OBJECTIVE: To determine the feasibility of ultrasound to measure blood flow on patients with chest compression cardiopulmonary resuscitation (CPR), and to find out a real-time, noninvasive hemodynamic evaluation method. METHODS: A prospective study was conducted. All adult patients undergoing CPR admitted to Department of Emergency and intensive care unit (ICU) of Zhengzhou People's Hospital from May 2016 to November 2018 were enrolled. The blood flow over the right carotid arteries during chest compressions was recorded with a bedside ultrasound machine. The peak systolic flow velocity (PSV) and end diastolic flow velocity (EDV) of carotid artery were recorded at 1 minute after the start of CPR and 1 minute before the end of CPR. The mean compression frequency during the whole recovery period was recorded, the rate of compression reaching the standard was evaluated by ultrasound (the rate of compression 100-120 times/min was defined as up to standard), and the interruption time of compression was calculated retrospectively according to the ultrasound image data recorded during CPR. RESULTS: Thirty-nine patients were enrolled, and 21 patients were successfully rescued, with a successful rate of 53.8%, the time of restoration of spontaneous circulation (ROSC) was (10.9±5.3) minutes. The time from CPR to retrieve an ultrasound image was 1.1-4.9 minutes, with an average of (2.5±1.2) minutes. Satisfactory ultra-sonographic images were obtained in 28 patients during the whole course of chest compression. The acquisition rate was 71.8% (28/39). In the process of compression, if the frequency of compression was less than 100 times/min or the velocity of carotid artery dropped (PSV < 30 cm/s), the chest compressors should be reminded and corrected in time. The PSV at 1 minute after CPR start of 28 patients with satisfactory ultrasound images was (62.9±18.5) cm/s, and the EDV was (13.9±3.5) cm/s, the PSV at 1 minute before the end of CPR was (55.4±18.4) cm/s, and the EDV was (12.9±3.7) cm/s. There was no significant difference in above parameters between the two time points (both P > 0.05), suggesting that satisfactory resuscitation effect was achieved in the whole process of CPR. The compression frequency of 28 patients was 100-149 times/min with an average of (117±47) times/min. The rate of compression with standard was 85.7% (24/28), and the total interruption time of compression accounted for 4.4% of all compression time (25.9 minutes/587.2 minutes). CONCLUSIONS Ultrasound measurement of common carotid artery blood flow during CPR has the advantage of real-time and non-invasive, and it is feasible in clinical work.
Adult ; Blood Flow Velocity/physiology* ; Cardiopulmonary Resuscitation/methods* ; Carotid Artery, Common/physiology* ; Feasibility Studies ; Humans ; Pressure ; Prospective Studies ; Retrospective Studies ; Ultrasonography, Doppler

INTRODUCTIONWe studied the effect of head rotation on the relative position of the right common carotid artery (CCA) and the right internal jugular vein (IJV) in patients with laryngeal mask airway (LMA) insertion to evaluate the accuracy of anatomical landmarks for right IJV cannulation.

METHODSWe simulated needle insertion to the right IJV on sonograms via the central landmark approach and an approach using the external jugular vein, in patients with LMA insertion (n = 50) or endotracheal intubation (E-tube, n = 50). Overlap index and successful simulation rates were measured according to the different degrees of head rotation.

RESULTSThe overlap index between the right CCA and the right IJV increased with greater degrees of head rotation. It was significantly greater in the LMA insertion group than in the E-tube group in the following head rotation positions: neutral, 15° and 45°. The success rate of the simulation was lower in the LMA insertion group than in the E-tube group. In the LMA insertion group, the success rate of the simulation was highest (62%) with the central landmark approach and in the 15° head rotation position.

CONCLUSIONIn the LMA insertion group, the overlap index increased incrementally with greater head rotation degrees (from neutral to 45°). The central landmark approach and 15° head rotation position appear to be the optimal puncture site and degree of head rotation for right IJV cannulation in patients with LMA insertion.

Adult ; Anesthesia, General ; methods ; Carotid Artery, Common ; anatomy & histology ; diagnostic imaging ; Catheterization, Central Venous ; methods ; Computer Simulation ; Female ; Head ; diagnostic imaging ; physiology ; Humans ; Jugular Veins ; anatomy & histology ; diagnostic imaging ; Laryngeal Masks ; Male ; Middle Aged ; Needles ; Patient Positioning ; methods ; Prospective Studies ; Punctures ; Rotation ; Ultrasonography

The present study was designed to test the hypothesis that a medium-term simulated microgravity can induce region-specific remodeling in large elastic arteries with their innermost smooth muscle (SM) layers being most profoundly affected. The second purpose was to examine whether these changes can be prevented by a simulated intermittent artificial gravity (IAG). The third purpose was to elucidate whether vascular local renin-angiotensin system (L-RAS) plays an important role in the regional vascular remodeling and its prevention by the gravity-based countermeasure. This study consisted of two interconnected series of in-vivo and ex-vivo experiments. In the in-vivo experiments, the tail-suspended, hindlimb unloaded rat model was used to simulate microgravity-induced cardiovascular deconditioning for 28 days (SUS group); and during the simulation period, another group was subjected to daily 1-hour dorso-ventral (-G(x)) gravitation provided by restoring to normal standing posture (S + D group). The activity of vascular L-RAS was evaluated by examining the gene and protein expression of angiotensinogen (Ao) and angiotensin II receptor type 1 (AT1R) in the arterial wall tissue. The results showed that SUS induced an increase in the media thickness of the common carotid artery due to hypertrophy of the four SM layers and a decrease in the total cross-sectional area of the nine SM layers of the abdominal aorta without significant change in its media thickness. And for both arteries, the most prominent changes were in the innermost SM layers. Immunohistochemistry and in situ hybridization revealed that SUS induced an up- and down-regulation of Ao and AT1R expression in the vessel wall of common carotid artery and abdominal aorta, respectively, which was further confirmed by Western blot analysis and real time PCR analysis. Daily 1-hour restoring to normal standing posture over 28 days fully prevented these remodeling and L-RAS changes in the large elastic arteries that might occur due to SUS alone. In the ex-vivo experiments, to elucidate the important role of transmural pressure in vascular regional remodeling and differential regulation of L-RAS activity, we established an organ culture system in which rat common carotid artery, held at in-vivo length, can be perfused and pressurized at varied flow and pressure for 7 days. In arteries perfused at a flow rate of 7.9 mL/min and pressurized at 150 mmHg, but not at 0 or 80 mmHg, for 3 days led to an augmentation of c-fibronectin (c-FN) expression, which was also more markedly expressed in the innermost SM layers, and an increase in Ang II production detected in the perfusion fluid. However, the enhanced c-FN expression and increased Ang II production that might occur due to a sustained high perfusion pressure alone were fully prevented by daily restoration to 0 or 80 mmHg for a short duration. These findings from in-vivo and ex-vivo experiments have provided evidence supporting our hypothesis that redistribution of transmural pressures might be the primary factor that initiates region-specific remodeling of arteries during microgravity and the mechanism of IAG is associated with an intermittent restoration of the transmural pressures to their normal distribution. And they also provide support to the hypothesis that L-RAS plays an important role in vascular adaptation to microgravity and its prevention by the IAG countermeasure.
Angiotensinogen ; genetics ; metabolism ; Animals ; Aorta, Abdominal ; pathology ; physiopathology ; Carotid Artery, Common ; pathology ; physiopathology ; Hindlimb Suspension ; Male ; Muscle, Smooth, Vascular ; metabolism ; pathology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptor, Angiotensin, Type 1 ; genetics ; metabolism ; Renin-Angiotensin System ; physiology ; Weightlessness Simulation

OBJECTIVETo evaluate wave intensity (WI) on left ventricular (LV) performance in the different hypertensive remolding hearts.

METHODS105 hypertensive and 98 control subjects were underwent noninvasive evaluation of carotid arterial wave intensity, LV structure and function.

RESULTS(1) There were increasing trends in the levels of blood pressure, LV end-diastolic diameter and LV mass index in the control, normal geometry group, concentric remodeling group, concentric and eccentric hypertrophy group. LV ejection fraction increased in the concentric hypertrophy group and decreased in the eccentric hypertrophy group in which mid-wall fractional shortening showed a decreasing trend. LV diastolic filling pressure presented increased progression accompanied by LV remodeling (P < 0.05). (2) Transient acceleration wave intensity (W1) in hypertensive subjects were higher than that in the control (P < 0.05). Transient deceleration wave intensity (W2) was lower than that in the control (P < 0.05). (3) W1 in the concentric hypertrophy group was higher and lower in the eccentric hypertrophy, compared with that in the control group, normal geometry group and concentric remodeling group (P < 0.05). W2 was lower in concentric hypertrophy group and eccentric hypertrophy group than that in the control, normal geometry group and concentric remodeling group (P < 0.05).

CONCLUSIONWI is a noninvasively obtained, clinically useful parameter for evaluation of LV performance.

Aged ; Blood Flow Velocity ; physiology ; Carotid Artery, Common ; physiopathology ; Case-Control Studies ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Pulsatile Flow ; physiology ; Ventricular Function, Left ; physiology ; Ventricular Remodeling

OBJECTIVE: To investigate the relationship between microalbuminuria and endothelial-dependent relaxing function and atherosclerosis of common carotid artery (CCA) in aged patients with essential hypertension (EH). METHODS: Sixty-four aged EH patients were recruited. According to the albumin excretion rate (AER) in the urine measured by immunoturbidimetry, patients were divided into 2 groups: normoalbuminuria group (NAU group) and microalbuminuria group (MAU group). Thirty aged persons without EH were served as the control group. The endothelium-dependent relaxing function of blood vessels, intima-media thickness (IMT) and the plaque of CCA were measured by color Doppler ultrasound. RESULTS: The flow-mediated dilation in the MAU group [(4.98+/-1.35)%] and that in the NAU group [(6.31+/-1.14)%] were significantly lower than that in the control group [(9.09+/-1.83)%, P<0.05, respectively], especially lower in the MAU group. The IMT of CCA in the MAU group [(0.97+/-0.19)mm] and that in the NAU group [(0.86+/-0.10)mm] were significantly thicker than that in the control group [(0.78+/-0.13)mm] (P<0.05, respectively), especially thicker in the MAU group. The analysis of multiple stepwise regression showed that the microalbuminuria was successively related to EDF, the IMT of CCA, the plaque index of CCA, systolic blood pressure, etc. CONCLUSION EDF is impaired, and there is the atherosclerosis of CCA in aged patients with EH. Microalbuminuria correlates with the decrease of endothelium-dependent relaxing function and the IMT of CCA in aged patients with EH.
Aged ; Aged, 80 and over ; Albuminuria ; etiology ; Arteriosclerosis ; complications ; diagnostic imaging ; Carotid Artery, Common ; diagnostic imaging ; Endothelial Cells ; physiology ; Female ; Humans ; Hypertension ; complications ; urine ; Male ; Middle Aged ; Ultrasonography

In order to investigate the mechanism of mechanical stress-mediated arterial remodeling, we studied the pressure-induced expression of immediate-early response gene product c-Jun in common carotid arteries in rats. The common carotid arteries were perfused with both high pressure (160 mmHg) and normal pressure (80 mmHg) for 0.5, 1, 3 and 6 hours. Expression of immediate-early response gene product c-Jun in the arteries was examined by immunohistochemistry and computer image processing. c-Jun was weakly expressed at 1 h, then increased at 3 h and 6 h after exposure of the arteries to normal pressure. Positive immunohistochemical product of c-Jun appeared in the arteries at 0.5 h after the onset of high pressure, then it increased markedly till 6 h. There was significant difference between the two groups. These results indicate that expression of c-Jun of the arteries can be induced by pressure, which may play an important role in mechanical stress-mediated arterial remodeling.
Animals ; Biomechanical Phenomena ; Carotid Artery, Common ; cytology ; metabolism ; physiology ; Genes, Immediate-Early ; Male ; Muscle, Smooth, Vascular ; cytology ; metabolism ; Pressure ; Proto-Oncogene Proteins c-jun ; biosynthesis ; genetics ; Rats ; Rats, Sprague-Dawley ; Stress, Mechanical

The severity of carotid intima-media thickness (IMT) is an independent predictor of atherosclerosis which causes transient cerebral ischemia, stroke, and coronary events such as myocardial infarction. The IMT consists of intima thickness (IT) and media thickness (MT). However, the Individual clinical significance of IT and MT has not been well studied. We devised a method of measuring IT, MT, and IMT using B-mode ultrasound image processing technique for the diagnosis of atherosclerosis. To inspect the clinical significance of IT, MT, and IMT, one hundred forty-four consecutive patients (mean age; 57 years old, 72 males) were underwent common carotid artery scanning using high-resolution ultrasound. Results showed that, the IT (p<0.05), MT (p<0.05) as well as IMT (p<0.01) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hypertension showed significantly thicker IT (p<0.01), MT (p<0.001), and IMT (p<0.001). However, only IT was thicker in patients with smoking (p<0.01). The IT (r=0.374, p=0.001), MT (r=0.433, p=0.000), and IMT (r=0.479, p=0.000) showed positive correlation with age. The coefficients of determination (r(2)) were estimated to be 92.4% for IMT and MT, 49.1% for IMT and IT, and 27.4% for IT and MT. This result suggests that the intima layer of the carotid artery has a different physiology with the media layer.
Atherosclerosis ; Carotid Arteries ; Carotid Artery, Common ; Carotid Intima-Media Thickness ; Diagnosis ; Humans ; Hypertension ; Ischemic Attack, Transient ; Middle Aged ; Myocardial Infarction ; Physiology ; Smoke ; Smoking ; Stroke ; Ultrasonography

The aim of the present study was to investigate the effect of ERK on 17beta-estradiol (E(2)) inhibition of vascular smooth muscle cell (VSMC) proliferation in rats after vascular injury. Common carotid artery balloon-injury (Inj) model was established in ovariectomized rats (OVX). Female SD rats were randomly divided into 4 groups: OVX, E(2)+OVX, OVX+Inj, and E(2)+OVX+Inj groups. The thickness of the vessels, the plasma content of NO, and the expression of ERK, phosphorylated ERK as well as eNOS protein were measured. The results showed that compared with OVX, the vessel wall was significantly thickened and the plasma content of NO was significantly decreased in OVX+Inj group. E(2) significantly decreased the vessel thickness but increased the plasma NO content after balloon injury. E(2) inhibited the expression of ERK, phosphorylated ERK and induced the eNOS expression. There is a positive correlation between plasma NO content and eNOS protein expression, while there is a negative correlation between plasma NO content and the thickness of vessel. The plasma NO content and the expression of ERK protein were negatively correlated. These results suggest that E(2) increases the vascular eNOS protein expression and NO release, leading to the inhibition of VSMC proliferation after balloon injury by inhibiting the ERK and phosphorylated ERK protein expression.
Animals ; Carotid Artery, Common ; pathology ; Catheterization ; adverse effects ; Cell Proliferation ; drug effects ; Estradiol ; pharmacology ; Extracellular Signal-Regulated MAP Kinases ; physiology ; Female ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; cytology ; drug effects ; physiology ; Nitric Oxide ; blood ; Nitric Oxide Synthase Type III ; metabolism ; Ovariectomy ; Phosphorylation ; Rats

To investigate the role and mechanism of mechanical stress on arterial remodeling, a new model of common carotid artery exposed to stress in vivo was established in rat, in which the change of pressure is the only influencing factor. The effect of high pressure on the morphology and expression of alpha-actin and proliferating cell nuclear antigen (PCNA) of vascular smooth muscle cells (VSMCs) in the artery was assessed. The arteries were perfused by both high pressure (160 mmHg) and normal pressure (80 mmHg) for 6 hours. The changes of morphology, expression of alpha-actin and PCNA in VSMCs were studied by histology and immunohistochemistry. The results showed that the new model could be controlled well in pressure and frequency. The euchromatin was increased and PCNA-positive particles were observed in the nuclei of VSMCs, but the expression of alpha-actin was decreased when the arteries were exposed to the high pressure. The new model has been successfully established, which provides a new tool for studying the effect of mechanical stress on arterial remodeling. In this experiment, VSMCs underwent a transformation from contractile phenotype into synthetic phenotype and tended to proliferate in response to the high pressure.
Actins ; biosynthesis ; Animals ; Carotid Artery, Common ; cytology ; physiology ; Chemotherapy, Cancer, Regional Perfusion ; Male ; Muscle, Smooth, Vascular ; cytology ; Pressure ; Proliferating Cell Nuclear Antigen ; biosynthesis ; Rats ; Rats, Sprague-Dawley