Abstract:High-density lipoprotein （HDL） is a complex component containing more than 1000 lipids and many lipoproteins. Therefore, its function is very complicated and is easy to change. Normal HDL can protect cardiovascular function, inhibit atherosclerosis. However, in recent years, it is found that HDL can convert to proinflammatory（Oxidized） HDL and lose the role of protecting cardiovascular function, even impair cardiovascular function in some diseases. Thus, HDL may be a risk factor and a therapeutic target for cardiovascular diseases.

Abstract:Aim To investigate the possible mechanisms by which high-density lipoprotein （HDL） lead to the development of atherosclerosis by analysing the properties changes of HDL from the patients with hypercholesterolemia and its influence on vascular function. Methods 20 patients （male11, female9, aged from 18 to 60 years old） with hypercholesterolemia were selected as hypercholesterolemia group and 20 healthy adults （male12, female8, aged from 18 to 60 years old） were chosen as control group. The plasma concentration of total cholesterol （TC）, triglyceride（TG）, low density lipoprotein cholesterol（LDLC） and high density lipoprotein cholesterol（HDLC） were measured. The inflammatory level of HDL was analyzed. HDL was isolated from the plasma and was incubated with the aortic of C57BL/6 mice to observe the vascular contraction and vasodilation. Results In patients with hypercholesterolemia, the plasma concentration of TC（6.49±0.76 mmol/L vs 4.67±0.34 mmol/L, P<0.05）, TG（3.16±1.85 mmol/L vs 1.27±0.53 mmol/L, P<0.05）, and LDLC（4.52±0.70 mmol/L vs 2.98±0.40 mmol/L, P<0.05） were significantly higher than that in healthy subjects. However, the plasma concentration of HDLC（1.28±0.41 mmol/L vs 1.16±0.23 mmol/L, P>0.05） had no significant difference between hypercholesterolemia group and control group. The inflammatory level of HDL in patients with hypercholesterolemia（RFU:1104.0±182.5 vs 366.2±84.5, P<0.05） was significantly increased compared with the controls. This proinflammatory HDL dramatically inhibited the endothelium-dependent vasodilation. Conclusions HDL in hypercholesterolemia not only turned to inflammatory states and lost its effect on protecting cardiovascular function, but impaired endothelium-dependent vasodilation. Proinflammatory HDL may be one of the key factors in promoting the formation of atherosclerosis.

Abstract:Aim To investigate the effects of calculus bovis cultivated by glucuronidase （CBCG） on high density lipoprotein （HDL） anti-atherosclerotic functions in mice fed with high fat high cholesterol diet. Methods Forty one male 7-8-week-old C57BL/6J mice fed with high fat diet （15.8% fat and 1.25% cholesterol） were randomly divided into three groups: control group （n＝14）, medium-dose （0.75 g/（kg·d）, n＝13） and high-dose （2.25 g/（kg·d）, n＝14） CBCG treated groups. After 12 weeks of treatment, blood was collected from the retroorbital sinus of the C57BL/6J mice without dietary exposure for 12 h. LDL and HDL₃ were separated by sequential ultracentrifugation. HDL functionality assay, Cu²⁺-induced LDL oxidation assay, endothelial cell-monocyte adhesion assay and MTT assay were determined to analyse the functional properties of the HDL particle. Forty male 7-8-week-old apolipoprotein E knockout mice fed with high fat diet （15.8% fat and 1.25% cholesterol） were randomly divided into four groups: control group, low-dose （0.25 g/（kg·d））, medium-dose （0.75 g/（kg·d））, and high-dose CBCG （2.25 g/（kg·d）） treated groups. After 8 weeks of treatment, blood was collected from the retro-orbital sinus of apolipoprotein E knockout mice without dietary exposure for 12 h. Plasma concentrations of IL-6 and TNF-α were determined by ELISA. Plasma levels of malondialdehyde （MDA） and the activity of paraoxonase-1 （PON-1） were determined by spectrophotometric method. The bioactive compounds, namely bilirubin and taurine were determined by ELISA. Plasma concentrations of total cholesterol （TC） and HDLC were determined by enzymatic methods. Non-HDLC was calculated as TC minus HDLC. Results The anti-atherosclerotic actions of CBCG were linked with improving the functional quality of HDL particle in C57BL/6J mice, including reverse cholesterol transport （RCT）-promoting, anti-oxidative （prevention of LDL oxidation）, endothelial protective as well as anti-inflammatory （induce adhesion of monocyte to human umbilical vein endothelial cells） properties. At the end of eight weeks of intragastric administration of CBCG, ELISA revealed that the production of tumor necrosis factor-α and interleukin-6 were significantly suppressed. Spectrophoto-metric measurement showed that plasma levels of MDA were significantly decreased and the activity of PON-1 was significantly improved. CBCG significantly increased the plasma level of bilirubin while the change of taurine level was not obvious. Plasma analysis by enzymatic method showed that CBCG remarkably increased plasma HDLC in mice fed with high fat high cholesterol diet. Conclusions The results reveal that CBCG significantly improve the functional quality of HDL particle in C57BL/6J mice, including RCT-promoting, anti-oxidative, endothelial protective as well as anti-inflammatory properties. The improving function may be linked with the anti-oxidation of CBCG in plasma.

Abstract:Aim To investigate the effects of IL-4 on ATP-binding cassette transporter A1 （ABCA1） expression and cholesterol efflux in human THP-1 macrophage-derived foam cells. Methods THP-1 macrophage-derived foam cells were treated with different concentrations of IL-4, different time, and liver X receptor α （LXRα） agonist T0901317. Semi quantitative RT-PCR and Western blot were used to detect the expressions of ABCA1, LXRα mRNA and protein respectively. Lipid accumulation in cells was observed by oil red O staining. Intracellular cholesterol efflux was detected by using liquid scintillation counting method. Total cholesterol, free cholesterol and cholesterol ester were determined by high performance liquid chromatography. Results IL-4 significantly decreased the expression of ABCA1 in a concentration- and time-dependent manner, and inhibited cholesterol efflux in the THP-1 macrophage-derived foam cells （P＜0.05）. T0901317 reversed the effect of IL-4 （P＜0.05）. Conclusions IL-4 decreases ABCA1 expression and inhibites cholesterol efflux in THP-1 macrophage-derived foam cells. LXRα activation can reverse the inhibitory effect of IL-4 on ABCA1.

Abstract:Mechanism of the correlation between phospholipid transfer protein （PLTP） activity and diabetes, obesity, and atherosclerosis is related with the participation of PLTP on lipoprotein metabolism. The complex biological roles of PLTP on high density lipoprotein （HDL） metabolism and reverse cholesterol transport （RCT） are spectacular. Does PLTP display the roles on atherosclerosis via affecting HDL and RCT process based on previous literatures and our works on PLTP, we summarized this article to search for answers and clues.

Abstract:High density lipoprotein can be modified in various amid acid sites through myeloperoxidase（MPO）. ox-HDL can damage endothelia cells, lose the ability of reverse cholesterol transport, promote smooth muscle cell proliferation which will decrease HDL anti-atherosclerosis capacity. Therefore the association between HDL specific sites modification and function changes will provide a new method to prevent atherosclerosis.

Abstract:The anti-oxidative and anti-inflammatory activities of high density lipoproteins （HDL） are largely due to the paraoxonase 1 （PON1） located on it. PON1 is mainly synthesized in the liver and secreted into the circulation, using very low density lipoprotein （VLDL） as a vehicle to bind with HDL, and transferred between in the HDL subclasses. PON1 possesses a higher activity through interacting with other protein components in HDL, and plays an important role for HDL structure and its anti-oxidative and anti-inflammatory activities. The change in quantity and activity of PON1 is associated with abnormal structure and the atherogenic “dysfunction” of HDL. In this review we summarize data on the role played by PON1 on HDL structure and function, focusing on the relationship between their binding and interaction and function of HDL.

Abstract:Aim To investigate the effect of cytochrome P450 2J2 （CYP2J2） on atherosclerosis by overexpression of CYP2J2 in the cultured human umbilical vein endothelial cell （HUVEC） and human peripheral monocyte-derived foam cell model. Methods Recombinant pLVX-IRES-ZsGreen1-CYP2J2 lentiviral vectors were infected into HUVECs and human peripheral monocyte-derived foam cells. CYP2J2 expressions in cells were detected by reverse transcription polymerase chain reaction （RT-PCR） and Western blot. Cultured HUVECs were divided into control group, vehicle group （pLV group） and CYP2J2 overexpression group （pLV-CYP2J2 group）. Cell proliferation and migration were determined by MTS and Transwell assay. In addition, monocytes were isolated from the peripheral blood of patients with coronary heart disease by Ficoll-Hypaque density gradient centrifugation and plastic adsorptive process. The isolated cells were induced and stimulated by phorbol-12-myristate-13-acetate （PMA） at concentration of 50 nmol/L for 48 h to transfer them into macrophages, then adding oxidized low density lipoprotein （ox-LDL） at a final concentration of 80 mg/L to make the cells transformed into foam cells. Cells were also divided into control group, pLV group and pLV-CYP2J2 group, all of them were collected in 48 h after the virus transfection. Intracellular lipid droplets and total cholesterol were detected by oil red O staining and the total cholesterol assay kit. Results The results of RT-PCR and Western blot demonstrated that CYP2J2 mRNA and protein expression were significantly increased in both HUVECs and foam cells after pLV-CYP2J2 virus infection. Compared with the control group and pLV group, pLV-CYP2J2 infection significantly enhanced the cell proliferation of HUVECs in 24, 48, 72 h, and the cell migration in 48 h, but there was no significant difference in cell proliferation in 12 h. In addition, in human peripheral monocyte-derived foam cell model, pLV-CYP2J2 infection significantly reduced the number of foam cells, oil red lipid droplets and total cholesterol content. Conclusion CYP2J2 can be overexpressed in HUVECs and human peripheral monocyte-derived foam cells, which promotes the proliferation and migration of HUVECs, and reduces the formation of foam cells, so it suggests that CYP2J2 has the function of anti-atherosclerosis.

Abstract:Aim To investigate the role of melatonin in the improvement of blood pressure and mesenteric arterial function induced by aerobic exercise in spontaneously hypertensive rat （SHR）. Methods A total of 72 twelve-week-old male rats were used in the experiments. A group of normotensive WKY rats （n＝18） was used as normal blood pressure control group （WKY group）. 54 SHRs were separated into five groups: SHR sedentary control group （SHR-SED, n＝18）, SHR sedentary with normal saline injection group （SHR-SED＋NS, n＝6）, SHR sedentary with melatonin receptor blocker luzindole （Luz） injection group （SHR-SED＋Luz, n＝6）, SHR aerobic exercise group （SHR-EX, n＝18）, and SHR aerobic exercise with Luz injection group （SHR-EX＋Luz, n＝6）. Luz was injected 1 mg/（kg·d） intraperitoneally. Rats in the aerobic exercise groups were subjected with 8 weeks-treadmill exercise: 0° slope, 18～20 m/min, 60 min each day, 5 days each week. Blood pressure and heart rate （HR） of awake animals were measured by using tail-cuff method before the beginning of the exercise training protocol and at the end of the protocol. Serum melatonin level was examined by ELISA with commercially available kits. The mechanical properties of small mesenteric arteries were studied with vascular ring experiment in vitro. Results （1）After exercise training for 8 weeks, systolic blood pressure （SBP）, diastolic blood pressure, mean arterial pressure and HR were significantly lower in SHR-EX group than those in SHR-SED group. SBP and HR in SHR-EX＋Luz group were greater compared to SHR-EX group. However, there were no significant differences of SBP and HR between SHR-SED group and SHR-SED＋NS group, SHR-SED＋Luz group. （2）The serum melatonin levels in WKY group and SHR-SED group reached peak level at 21∶00～22∶00, and were significantly higher than those at 12∶00～13∶00 and 8∶00～9∶00. However, it reached the peak level at 8∶00～9∶00 in SHR-EX group. In these three time periods of day, serum melatonin concentration in WKY group was always significantly higher than that in SHR-SED group But it was significantly higher at 8∶00～9∶00 in SHR-EX group than those in WKY group and SHR-SED group. （3）Melatonin （10^－6～10^－3 mol/L） caused a concentration-dependent relaxation in small mesenteric arterial beds precontracted by norepinephrine （10^－5 mol/L）, with pIC50 value∶ WKY group>SHR-EX group>SHR-SED group. In the presence of L-nitro-arginine-methyl ester （L-NAME） （eNOS inhibitor）, the pIC50 of the concentration-response curve for melatonin-induced relaxation was lower than that in the absence of L-NAME in both SHR and WKY rats. The relaxation of melatonin was partly blocked by Luz （2×10^－6 mol/L）. Conclusion Aerobic exercise can reduce SBP and HR of SHR, and enhance mesenteric artery vasodilation, in which melatonin plays an important role.

Abstract:Aim To explore the correlation between plasma soluble urokinase-type plasminogen activator receptor （suPAR） level and coronary atherosclerotic plaque stability, coronary lesions severity in patients with coronary heart disease （CHD） and prediction of CHD. Methods 149 enrolled patients were divided into acute coronary syndrome （ACS） group （69 cases）, stable angina pectoris （SAP） group （35 cases） and control group （45 cases） according to the clinical manifestation and angiographic results. Plasma suPAR levels measured by enzyme linked immunosorbent assay （ELISA） were compared among the groups. The correlation between plasma suPAR level and CHD was analyzed. The relationships of plasma suPAR level with coronary lesions count and Gensini score were studied. ROC curve was performed to evaluate the predictive performance of suPAR for CHD and to identify the optimal cut-off value for predicting the presence of CHD. Results The plasma suPAR levels in ACS group and SAP group were higher than that in control group （P<0.05）, and plasma suPAR level was significantly higher in ACS group compared to the SAP group （P<0.05）. Statistically signi cant correlations were observed between plasma suPAR level and the number of diseased vessels （P<0.05） and Gensini score （P<0.05）. Using simple and partial correlation analysis, plasma suPAR level was positively correlated with CHD. In addition, multivariate Logistic regression analysis revealed that suPAR was an independent risk factor of CHD （OR＝3.405, P<0.01）. The ROC curve showed that the optimal cut-off point for suPAR to predict CHD was 1.771 μg/L. The area under the ROC curve was 0.745 （95%CI＝0.661～0.828, P<0.001）. Conclusions Plasma suPAR level was positively correlated with atherosclerotic plaque stability and coronary lesions severity in patients with CHD. suPAR may serve as an independent risk factor of CHD. The cut-off value of suPAR may be one of the indicators to predict CHD.

Abstract:Aim To investigate the expression levels of transforming growth factor-β （TGF-β） and periostin in right atrial appendage （RAA） in patients with different types of atrial fibrillation （AF） and its assosiation with atrial fibrosis levels and the recurrence of AF after surgery ablation. Methods A total of 60 patients with valvular heart diseases （VHD） undergoing valve replacement surgery and 10 healthy heart donors were enrolled in this study. Among these patients with valvular heart diseases, 33 patients combined with atrial fibrillation underwent radiofrequency ablation during surgery operation and were followed up for one year. The 60 patients were divided into three groups: sinus rhythm group （SR, n＝20）, paroxysmal atrial fibrillation group （PaAF, n＝15） and persistent atrial fibrillation group （PeAF, n＝25）. 10 healthy heart donors were selected as control group （n＝10）. The protein levels of atrial TGF-β and periostin were measured by Western blot. The degree of atrial fibrosis were evaluated by immunohistochemistry technique. Results The expression of TGF-β as well as periostin was significantly higher in the PeAF group compared to the SR group and control group （both P<0.01）. Periostin level in patients with atrial fibrillation was positively correlated with left atrial diameter （LAD） and pulmonary artery systolic pressure （PASP） （r＝0.53, P<0.01 and r＝0.27, P<0.05 respectively） and was negatively correlated with ejection fraction （EF） （r＝－0.44, P<0.01）. Collagen volume fraction （CVF） and hydroxyproline （Hyp） content in RAAs were both ascended significantly and gradually in the control, SR, PaAF and PeAF groups （P<0.05）, and was significantly correlated with the expression of TGF-β and periostin （P<0.01）. The expression of TGF-β was significantly higher in recurrence group than that in nonrecurrence group after surgery ablation （P＝0.023）. Conclusion Upregulated expression of TGF-β and periostin in RAAs is closely correlated with the degree of atrial fibrosis and recurrence after surgery ablation in patients with AF.

Abstract:Aim To investigate the risk factors of acute kidney injury （AKI） in patients with acute myocardial infarction （AMI）. Methods 728 patients with AMI were divided into two groups: AKI group and non AKI group. Clinical characteristics were compared in the two groups. The independent risk factors of AKI in patients with AMI were analyzed. The effect of emergency percutaneous coronary intervention （PCI） on AKI occurrence was assessed in patients with AMI. Results In 728 AMI patients, AKI was found in 152 patients （20.9%）. Compared with non AKI group, the differences of the eleven indexes of AKI group were statistically significant （P<0.01）, these indexes including: age, history of diabetes, mean arterial pressure, systolic blood pressure, heart rate, cardiac function Killip classification, left ventricular ejection fraction, base estimated glomerular filtration rate （eGFR）, ST-segment elevation myocardial infarction, β-blocker and ACEI/ARB application. Multivariate Logistic regression analysis showed that age, history of diabetes, admission systolic blood pressure, degree of cardiac function, left ventricular ejection fraction, base eGFR, unused ACEI/ARB medication were independent risk factors of AKI occurrence in patients with AMI. In 378 cases of ST-segment elevation myocardial infarction, 256 patients underwent emergency PCI. Statistical analysis showed that the incidence of AKI was significantly higher in patients with non-PCI than that in patients with emergency PCI （39.3% vs 19.5%, P<0.01）. Conclusions AKI is a common complication of AMI, which is related to many factors. Emergency PCI can reduce the incidence of AKI in patients with ST segment elevation myocardial infarction.

Abstract:Aim Thrombelastography for evaluating the antiplatelet efficacy of clopidogrel and ticagrelor in the patients with acute coronary syndrome（ACS） and Type 2 diabetes mellitus undergoing PCI. Methods Eighty-seven patients with ACS and diabetes undergoing PCI were randomized into two groups. The patients of clopidolgrel group（n92） were preoperatively given in loading aspirin 300 mg and clopidogrel 300 mg, followed by 100 mg aspirin and 75 mg clopidogrel per day. The patients of ticagrelor group（n88） were preoperatively given in loading aspirin 300 mg and ticagrelor 180 mg followed by 100 mg aspirin per day and 90 mg ticagrelor twice one day. We investigated platelet reactivity （AA inhibition rate and ADP inhibition rate） by thrombelastography, and observed ischemic of cardiac and bleeding events over 3 months. Results Ticagrelor group had low rate of MA-ADP pathway（%） compared with clopidogrel group（34.94%±11.91% vs 47.16%±14.90%，P<0.001）. For the inhibition rate in AA pathway（%） and inhibition rate in ADP pathway（%）,ticagrelor group was superior to clopidogrel group （68.24%±22.96% vs 48.21%±32.91%，58.16%±23.52% vs 33.34%±26.67%，P<0.001）. Conclusion Ticagrelor had more power to inhibit platelet reactivity compared with clopidolgrel in patients with ACS and diabetes undergoing PCI. Ticagrelor reduced ischaemic events during 3 months, without increasing bleeding events compared with clopidogrel.

Abstract:Aim To investigate the different serum levels of tumor necrosis factor-alpha（TNF-α） and transforming grouth factor-beta（TGF-β） between atrial fibrilliation and other control groups, and its chemotatic effects on cardiac fubroblast. Methods Serum concentrations of TNF-α and TGF-β were measured by enzyme-linked immune-absorbent assay（ELISA）Cardiac fibroblast were isolated from the venticles of 1～3 days Sprague-Dawley neonatal rats and passaged three to four generation, the transwell chamber assay were used to test the different chemotatic effects of the cardiac fibroblasts with the different concentration （1 μg/L, 10 μg/L, 50 μg/L） of TNF-α and TGF-β. Results Compared with control group, the serum of TNF-α and TGF-β in other groups were obviously increased. The group of persistent atrial fibrillation （per-Af） was the highest, the serum of TNF-α and TGF-β in non-Af atrial arrhythmia（AA） was higher than paroxysmal Af（per-Af）, the control group was the least. In different concentration （1 μg/L,10 μg/L, 50 μg/L） of TNF-α and TGF-β chemotaxis induced, the number of cells that migrated through the polycarbonate membrane were different, 50 μg/L group were significantly increased compared with other concentrations, the number of migrated cell in 10 μg/L group was higher than 1 μg/L group. The multiple Logistic regression analysis showed that the migrated cells in the lower surface were related to the concentration of TNF-α and TGF-β. Conclusions The different concentration of TNF-α and TGF-β among each group show that the occurrence of atrial fibrillation is associated with the potential inflammatory state. TNF-α and TGF-β have chemotaxis effect on cardiac fibroblast,its level is correlated with chemotatic movement. The chemotaxis of the serum with atrial fibrillation patients is partly mediated by TNF-α and TGF-β and it plays an important role in atrial fibrosis. The concentration of TNF-α and TGF-β can be used to reflect indirectly the presence, severity, extent of the myocardial damage.

Abstract:Aim To explore the clinical effects of high dose rosuvastatain on inflammatory factors of angina patients treated with percutaneous coronary intervention（PCI）. Methods The study was carried out with 150 angina patients receiving PCI during February 2013 to October 2014. The patients were divided into five groups by preoperative rosuvastatain dose, namely low dose group（LD, 5 mg/d）, moderate-low dose group（MLD, 10 mg/d）, moderate dose group（MD, 15 mg/d）, moderate-high dose group（MHD, 20 mg/d）, and high dose group（HD, 25 mg/d）. Each group consisted of 30 patients. All patients were treated with 5 mg/d rosuvastatain after PCI. The preoperative and postoperative （24 h） interleukin 6（IL-6）, interleukin 10（IL-10）, interferon γ（IFN-γ）, and tumor necrosis factor α（TNF-α） were tested. Results The IL-6, IFN-γ and TNF-α levels in group LD were significantly higher during postoperative period than preoperative period（P<0.05） IL-6 and IFN-γ levels in group MLD were significantly greater during postoperative period than preoperative period（P<0.05） IL-6, IFN-γ and TNF-α levels in group MD, MHD, and HD during postoperative period had no significant difference compared with that in preoperative period（P>0.05）, but IL-10 level was significantly greater during postoperative period than preoperative period（P<0.05）. The 15 mg/d rosuvastatain dose could effectively reduce inflammatory factor levels and increase anti-inflammatory factor levels, and further increases in the rosuvastatain dose had no significant influences on inflammatory factor levels. Conclusions Relatively higher dose of rosuvastatain （15 mg/d） during preoperative period could reduce inflammatory factor levels and increase anti-inflammatory factor levels.

Abstract:Aim To analyze characteristics of the coronary atherosclerotic plaques in patients with acute coronary syndrome（ACS） and stable angina（SA） through the virtual histology-intravascular ultrasound, and study the correlation between the coronary atherosclerotic plaques and serum Galectin-3. Methods 257 patients with coronary heart disease（SA group（n85）, ACS group（n172），the control group（n120） were examined and diagnosed as CHD by coronary angiography and patients with CHD will be examined by intravascular ultrasound further to record the gray-scale and virtual histology image data, test the serum Galectin-3 level and hypersensitive C-reactive protein level, analyze the correlation between these results and the coronary atherosclerotic plaques characteristics. Results There were no obvious diversity in general information among three groups. The results of VH-IVUS show: the vascular remodeling index, the proportion of necrotic core and plaque eccentricity index in ACS group were higher in the SA group. The diversity was statistically significant（P<0.05）. Galectin-3 in ACS group is higher obviously than Galectin-3 in the SA group and control group, the diversity was statistically significant（P<0.05）. There was a positive correlation between Galectin-3 and the proportion of necrotic core plaque remodeling index and plaque eccentricity index in ACS group（r0.632，P0.017；r0.640，P0.020；r0.615，P0.021）. Conclusion （1） Coronary atherosclerotic plaques in ACS are mostly made of necrotic core, partial plaques. Coronary atherosclerotic plaques in SA are mostly made of fibrous tissue or fibro-fatty tissue. （2） There was a obviously positive correlation between Galectin-3 and the proportion of necrotic core, plaque remodeling index and plaque eccentricity index in ACS group.

Abstract:Aim To observe the efficacy of atorvastatin combined with ezetimibe in patients with acute coronary syndrome. Methods 306 patients with acute coronary syndrome were randomly divided into atorvastatin routine-doze group （n98, atorvastatin 20 mg/d）, atorvastatin double-doze group （n103, atorvastatin 40 mg/d） and co-administration group （n105, atorvastatin 20 mg/d+ezetimibe 10 mg/d）. Levels of total cholesterol（TC）, triglyceride（TG） and low density lipoprotein-cholesterol（LDLC） were detected before and after 24-week therapy. The adverse reactions and cardiovascular events were also observed during the treatment. Results Compared with baseline, the levels of TC, TG and LDLC were reduced after 24 weeks in the three groups, and the TC,TG,LDLC levels in co-administration group were more significantly reduced than atorvastatin routine-doze group and atorvastatin double-doze group（TC: 2.51±0.51 mmol/L vs 3.22±0.53 mmol/L and 3.10±0.63 mmol/L, P<0.05TG: 1.12±0.30 mmol/L vs 1.67±0.39 mmol/L and 1.53±0.27 mmol/L, P<0.05 LDLC: 1.58±0.27 mmol/L vs 2.11±0.33 mmol/L and 2.01±0.31 mmol/L, P<0.05） The LDLC target rate in co-administration group was significantly higher than those in atorvastatin routine-doze group and atorvastatin double-doze group（69.5% vs 43.9% and 48.5%, P<0.05）. The incidence of adverse reactions in co-administration group was lower than that in atorvastatin double-doze group （P<0.05）. The incidence of cardiovascular events （recurrence of angina pectoris and acute myocardial infarction） in co-administration group was lower than those in other two groups （P<0.05）. Conclusions The combined atorvastatin and ezetimibe therapy after ACS had a good security, and was superior to atorvastatin alone on improving lipid levels and reducing the incidence of cardiovascular events.

Abstract:Aim Dyslipidemia is a key risk factor for atherosclerosis, which is strongly related to coronary artery disease （CAD）. The aim of the present study was to investigate the effects of Hedan on serum lipid profile, proprotein convertase subtilisin/Kexin 9 （PSCK9） and high density lipoprotein （HDL） subfractions in patients with hyperlipidemia. Methods Thirty-seven patients with hyperlipidemia were randomized to treatment with Hedan tablet 4.38 g/day as Hedan group （n＝18） and placebo （n＝19） as control group for 8 weeks. The lipid profile, PCSK9 and HDL subfractions were determined at day 0 and week 8 in both groups respectively. Results Hedan treatment for 8 weeks mildly decreased serum low density lipoprotein cholesterol （LDLC） levels, while no changes were found in total cholesterol （TC）, triglyceride （TG） and PCSK9 concentrations. Furthermore, Hedan treatment increased the concentration of large high density lipoprotein cholesterol （HDLC） and the percentage of large HDL subfraction, while decreased the concentration of small HDLC and the percentage of small HDL subfraction without changing serum HDLC levels in patients with hyperlipidemia. Conclusion The results suggested that Hedan treatment of 4.38 g/d for 8 weeks could confer a favorable effect on serum LDLC concentration as well as HDL subfractions.

Abstract:Aim To explore the association between long, middle, recent-term high-sensitivity C-reactive protein （hs-CRP） and peripheral arterial sclerosis in middle-aged and old population. Methods Prospective cohort study method was used in our study. A total of 101510 persons who had took part in the 2006 to 2007 kailuan healthy examination were stratified randomly, and 5440 persons with sufficient information for questionnaire and blood biochemical test were recruited. The healthy examinations were taken during 2006-2007, 2008-2009 and 2010-2011, respectively. Brachial-ankle pulse wave velocity （baPWV） was measured during 2010-2011. The participants who were missed the data of hs-CRP or baPWV and who had baPWV extreme value data during the healthy examination, were excluded. 3948 participants were included for final analysis. The characteristic of the observation population was described according to the data of the three times healthy examination. Multivariate linear regression was used to analyze the relationship between hs-CRP and baPWV. Further more, in order to increase the stability of hs-CRP, the mean value of the three times of hs-CRP was used to analysis. Results Multivariate linear regression analysis showed that hs-CRP was positively correlated with baPWV. Among the long, middle, recent-term hs-CRP and mean hs-CRP, the association between mean hs-CRP and baPWV was the strongest, and the long-term hs-CRP was the weakest. The correlation between hs-CRP and baPWV gradually increased with time. The standard regression coefficients （Beta values ） were 0.16, 0.17, 0.21 and 0.22 respectively between long, middle, recent-term hs-CRP, mean hs-CRP and baPWV. After adjusted for the other covariates, the standard regression coefficients were 0.02, 0.04, 0.05 and 0.06, respectively. Conclusion The correlation between hs-CRP and baPWV is positive, and the correlation between recent-term hs-CRP and baPWV is better than long-term hs-CRP, but the strongest correlation is the mean hs-CRP that is repeatedly tested in three different times.

Abstract:Myocardial fibros is closely related to heart failure, arrhythmias, sudden cardiac death. Prevention and reversal of cardiac fibrosis is one of the key points in clinical research. Pathogenesis of myocardial fibrosis is not fully understood. Currently, it is believed that the development of myocardial fibrosis has close links with inflammatory cells, and autophagy as an important factor in the regulation of inflammatory cell function influences the outcome of myocardial fibrosis. This review elaborates the latest progress of research of inflammatory cells and autophagy of inflammatory cells in myocardial fibrosis.

Abstract:Atherosclerosis is an inflammatory disease caused by lipid. Monocytes and their descendant macrophages play an important role in the occurrence and development of atherosclerosis. Macrophages become foam cells after lipid-laden, and foam cells form the lipid stripes and plaques of atherosclerosis. Over the past several years, the understanding of how monocytes accumulate in the growing lesion, differentiate, ingest lipids, and their roles in atherosclerosis has advanced substantially. Monocyte/macrophage's phenotype and functional complexity suggests that it is likely to become a new target for the treatment of atherosclerosis. Monocyte/macrophage's behavior changes in the process of atherosclerosis are reviewed in this article.