Abstract:The lesion site of abdominal aortic aneurysm (AAA) is associated with chronic inflammatory cell infiltration, such as CD4＋ T lymphocytes, macrophages, and B lymphocytes. Activated B lymphocytes produce immunoglobulin, cytokines, and matrix metalloproteinase (MMP), which in turn leads to the activation of macrophages, mast cells (MC), and the complement pathway. These factors cause degradation of collagen and matrix proteins and remodeling of the aortic wall, eventually leading to the occurrence of AAA. The mechanism of B lymphocytes involvement in remodeling of the adventitia in AAA is not clear. This review summarizes the recent research progress on the role of B lymphocytes in the pathogenesis of AAA.

Abstract:Aim To investigate the effect of glycogen synthase kinase 3β(GSK3β)inhibition on the proliferation, migration and adhesion of endothelial progenitor cells(EPC)in atherosclerotic mice. Methods Atherosclerotic mice model were established. Mononuclear cells were isolated and cultured from bone marrow in atherosclerotic mice (atherosclerotic group) and wild type mice (normal control group). EPC in logarithmic phase were transduced with replication defective adenovirus vector expressing catalytically inactive glycogen synthase kinase 3β(GKS3β-KM)(gene transfer group) in atherosclerotic mice. The number and biological functions of EPC, such as proliferation, migration and adhesion were assessed by cells count, MTT assay, modified Boyden's chamber migrationtrial and adhesion test. Results Compared with normal control group, the number of EPC was observably reduced and proliferation, migration and adhesion capacities of EPC were markedly impaired in atherosclerotic mice(P＜0.01,n＝5). Compared with atherosclerotic group, the number (P＜0.01,n＝5)and biological functions of EPC including proliferation (P＜0.01,n＝5), migration (P＜0.01,n＝5) and adhesion were significantly enhanced in gene transfer group (P＜0.01,n＝5). Conclusion GSK3β inhibition could improve impaired proliferation, migration and adhesion capabilities of EPC in atherosclerotic mice.

Abstract:Aim To investigate the possible role of myocardin in the vascular remodeling of vascular smooth muscle cell (VSMC) induced by high cyclic tensile stress. Methods Using FX-5000T in vitro cyclic stretch loading system, the VSMC in vitro were stimulated by cyclic stretch with frequency of 1.25 Hz, loading amplitude of 5% (normal physiological state) and 15% (simulated hypertension state) for 24 hours; Western blot and real time RT-PCR were used to detect the protein expression level and mRNA level of myocardin, atrogin-1, SMA and SM22. The expression level of myocardin and atrogin-1 were measured after the treatment with proteasome inhibitor MG132. The alteration of myocardin, SMA and SM22 was measured after the knockdown of atrogin-1. Results Compared with 5% normal group, 15% cyclic stretch promoted the dedifferentiation of SMCs. Western blot showed that 15% of cyclic stretch decreased the protein le-vels of myocardin, SMA and SM22, and increased the protein expression level of atrogin-1. RT-PCR showed that the mRNA levels of myocardin, SMA and SM22 were down regulated, and the mRNA level of atrogin-1 was up regulated. The results showed that the protein levels of myocardin, SMA and SM22 increased after siRNA down-regulation of atrogin-1. The protein levels of myocardin, SMA and SM22 increased and the protein level of atrogin-1 decreased after treated with 1 μmol/L MG132. Conclusion High cyclic stretch can regulate phenotypic transformation of VSMC by regulating the expression of myocardin, an important transcription co-factor, thus affecting the differentiation and proliferation of VSMC.

Abstract:Aim To investigate the effect of Songling Xuemaikang (SX) on vascular endothelial function and its protective mechanism in rats with cerebral atherosclerosis (CAS). Methods SD rats were divided into 3 groups:control group, CAS group and the SX group. CAS model of hypertension and hyperlipidemia was established in the CAS group and the SX group. Rats in the SX group were treated by Songling Xuemaikang. The blood pressure and blood lipid indexes of each group of rats were detected and compared. Hematoxylin-eosin (HE) staining was used to detect the pathological changes of basilar artery and brain tissue. Serum levels of nitric oxide (NO) and endothelin-1 (ET-1) were measured by enzyme-linked immunosorbent assay. The expression levels of Notch1 and Hes1 protein were detected by Western blot. Results The blood pressure and blood lipid levels of the CAS group were significantly higher than those of the control group (P＜0.05). The blood pressure and blood lipid levels of the SX group were significantly lower than those of the CAS group (P＜0.05). The basilar artery morphology of the control group was normal. In the CAS group, the intima of the rat was damaged, the lipid was deposited in the intima of the artery, and the smooth muscle cells in the middle layer of the artery were disordered. The pathological morphology of the SX group was between the control group and the CAS group. The NO of the CAS group was significantly lower than that of the control group and the ET-1 was significantly higher than the control group (P＜0.05). The NO of the SX group was significantly higher than that of the CAS group and the ET-1 was significantly lower than the CAS group (P＜0.05). In the control group, the brain tissue structure was completed, the cells were normal, the nucleolus was obvious, and the cytoplasm was abundant. In the CAS group, the brain cells of the rats were arranged one time, the nucleoli were not obvious, and the cytoplasm showed empty halos. The morphology and arrangement of the SX group were basically normal, and the nucleolus and cytoplasm were clear. The levels of Notch1 and Hes1 in the CAS group were significantly higher than those in the control group (P＜0.05). The levels of Notch1 and Hes1 in the SX group were significantly lower than those in the CAS group (P＜0.05).Conclusion Songling Xuemaikang has the effect of protecting vascular endothelial cells caused by hypertension and hyperlipidemia and antagonizing brain damage, which may be related to the inhibition of Notch pathway.

Abstract:Aim To investigate the clinical characteristics of acute myocardial infarction (AMI) patients with atrial fibrillation (AF). Methods From January 2014 to December 7,7 AMI inpatients admitted to the Department of Cardiology of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were enrolled. According to the patient's previous history and electrocardiogram diagnosis during hospitalization, the patients were divided into AMI with AF group (78 cases) and AMI without AF group (699 cases). The basic information, cardiovascular risk factors, biochemical indicators, echocardiography, coronary angiography and other data of the two groups were collected for statistical analysis. The differences of clinical characteristics were compared between the two groups. Results The age, smoking history, stroke history, chronic kidney disease history and ventricular arrhythmia incidence in AMI with AF group were significantly higher than those in AMI without AF group (P＜0.05). The hemoglobin, red blood cell count, triglyceride and estimated glomerular filtration rate in AMI with AF group were significantly lower than those in AMI without AF group, while the levels of serum uric acid, urea nitrogen, creatinine, cystatin C, brain natriuretic peptide and high-sensitivity C-reactive protein were significantly higher than those in AMI without AF group (P＜0.05). Echocardiographic results show that compared with AMI without AF group, the left atrium diameter and right atrium diameter increased significantly (P＜0.01), and the left ventricular ejection fraction decreased significantly (P＜0.05), in AMI with AF group. There was no significant difference in the results of coronary angiography between the two groups (P＞0.05). Conclusion The incidences of ventricular arrhythmia and heart failure are high in AMI with AF patients, and are prone to suffer from anemia and chronic kidney disease.

Abstract:Aim To measure and analyze the changes of plasma soluble Sema4D levels during cardiopulmonary bypass(CPB)with ELISA, and analyze possible mechanisms. Methods Recombinant extracellular Sema4D was used as antigen, and antibodies against Sema4D were used to establish ELISA method. Samples from patients during CPB were collected at three time points: before surgery, 10 min after heparinization, and 10 min after neutralization after the surgery.Soluble Sema4D levels in the plasma were measured in these samples with ELISA. Sema4D expression on the surface of T cells and platelets were detected by flow cytometry. Results Sandwich ELISA method was established to detect soluble Sema4D levels in human plasma. Soluble Sema4D levels increased during CPB and remained at high levels until the end of the surgery(P＜0.01). Compared with before surgery, percentage of Sema4D high platelets increased 10 min after heparinization in 75% patients(P＜0.05). There is no significant change of Sema4D expression on the surface of T cells during CPB.Conclusions Platelets activation and release of Sema4D may be one source of the increases of plasma soluble Sema4D during CPB. The change of plasma soluble Sema4D levels may become a prognostic indicator of CPB.

Abstract:Aim To investigate the correlation between miR-25 expression in peripheral blood and apoptotic molecules contents, and 90 d prognosis of patients with acute cerebral infarction. Methods 162 patients with acute cerebral infarction were selected as the acute cerebral infarction group and 150 healthy people as the normal control group. Peripheral blood levels of miR-25 and apoptotic molecules cysteinyl aspartate specific proteinase-3(Caspase-3), B-cell lymphoma-2(bcl-2) were determined in acute cerebral infarction group and normal control group. According to the score of modified Rankin scale (mRS), prognosis of 90 d follow-up was divided into:good prognosis(mRS score≤2 points) and poor prognosis(mRS score ＞2 points). The clinical data of acute cerebral infarction patients with different prognosis were compared and further Logistic regression analysis was performed. ROC curve was used to evaluate the predictive value of miR-25 expression level in peripheral blood of acute cerebral infarction patients for adverse prognosis at 90 days. Results Expression levels of miR-25 and bcl-2 in peripheral blood of acute cerebral infarction group were lower than those in normal control group, levels of Caspase-3 were higher than those in normal control group(P＜0.05). Correlation analysis found that the expression level of miR-25 in peripheral blood of acute cerebral infarction patients was positively correlated with the expression level of bcl-2, negatively correlated with expression level of Caspase-3 (P＜0.05). Patients with acute cerebral infarction were followed up for 90 days, including 119 patients with good prognosis, 43 patients with poor prognosis. The differences in age, onset treatment time and NIHSS score on the day of admission in acute cerebral infarction patients with different prognosis were statistically significant(P＜0.05), while the differences in other clinical data were not statistically significant(P＞0.05). Logistic regression analysis found that:older age, higher NIHSS score on the day of admission, low expression level of miR-25 in peripheral blood were independent risk factors for poor prognosis in patients with acute cerebral infarction on 90 day(P＜0.05). ROC curve found that, cut-off value of miR-25 expression level in peripheral blood predicting the poor prognosis of patients with acute cerebral infarction on the 90 d was 0.635, AUC was 0.699(95%CI 0.609~0.789). The corresponding sensitivity and specificity were 72.09% and 65.55%, respectively.Conclusions Expression level of miR-25 in peripheral blood of patients with acute cerebral infarction decreases, which may be involved in the expression regulation of apoptotic molecules. Low level of miR-25 is a risk factor for poor prognosis and has certain early prediction value.

Abstract:Aim To study the relations of serum γ-glutamyl transferase (γ-GT) level with coronary artery calcification and stenosis in patients with hypertension. Methods 145 patients with hypertension from January 2015 to June 2018 were selected as hypertension group, and 60 cases with normal blood pressure at the same period were set as normotensive group. The serum γ-GT level was compared between the two groups. According to the results of spiral CT coronary angiography and coronary artery calcification score (CACS), patients in hypertension group were divided into mild calcification group, moderate calcification group and severe calcification group; according to the degree of coronary stenosis, patients were divided into severe stenosis group, moderate stenosis group and mild stenosis group. The levels of serum γ-GT were compared in each group. Results The level of serum γ-GT in hypertension group was significantly higher than that in normotensive group (P＜0.05); with the increase of hypertension grade, the level of serum γ-GT increased (P＜0.05). The level of serum γ-GT and CACS score in patients with different degrees of calcification were significantly different (P＜0.05); with the aggravation of calcification, the level of γ-GT increased (P＜0.05). There were significant differences in the level of serum γ-GT and the degree of stenosis in patients with different degrees of coronary artery stenosis (P＜0.05); with the aggravation of the degree of coronary artery stenosis, the level of γ-GT increased (P＜0.05). The level of serum γ-GT was positively correlated with the score of CACS and the degree of coronary artery stenosis (P＜0.05). Serum γ-GT was an independent risk factor for coronary artery stenosis or calcification in patients with hypertension. Conclusion The level of serum γ-GT is significantly increased in patients with hypertension, and and it is significantly related to the degree of coronary artery calcification and stenosis.

Abstract:Aim To analyze the clinical and echocardiographic characteristics of patients with amyloidosis diagnosed by renal biopsy, in order to provide help for the early diagnosis of patients with myocardial amyloidosis. Methods This study included a total of 45 patients with amyloidosis nephropathy diagnosed by renal biopsy. Clinical data (age, gender, blood pressure, etc) and ultrasonic cardiac indicators (interventricular septal thickness, left ventricular end-diastolic diameter, left ventricular ejection fraction, etc) of patients undergoing renal biopsy were collected, and the differences of indicators and prognosis between patients with and without cardiac involvement were compared. ResultsThe interventricular septal thickness and left ventricular posterior wall thickness increased in patients with cardiac involvement compared with the patients without cardiac involvement (P＜0.05). The median survival time was 15 months in patients with cardiac involvement, which was significantly lower than that of patients without cardiac involvement(P＜0.05).Conclusion The echocardiography of patients with amyloidosis diagnosed by renal biopsy indicates that both interventricular septal thickness and left ventricular posterior wall thickness increase, and the interventricular septal thickness is more than 10 mm, which can be used as the early basis to determine whether the patients are complicated with myocardial amyloidosis.

Abstract:Aim To explore the value of intravascular ultrasound (IVUS) and quantitative coronary angiography (QCA) in the interventional therapy of borderline coronary lesions. Methods 60 patients with borderline coronary lesions(coronary artery stenosis between 40％～70％ confirmed by coronary angiography (CAG)) were enrolled. They were divided into QCA group(n=30, received QCA examination after CAG) and IVUS group (n=30, received IVUS detection after CAG). QCA and IVUS quantitative analysis were used to measure difference in reference vessel diameter, minimal lumen diameter, minimal lumen area, stenotic rates of diameter and area between two groups, and qualitative analysis was used to detect coronary plaques imaging morphology with IVUS. Finally, all the patients were followed up for 12 months. Incidence rate of major adverse cardiovascular events (MACE) during admission and follow-up were compared between two groups. Results Compared with QCA group, the ratio of lumen diameter stenosis ((57.80％±8.18％) vs (51.73%±7.91%)) and area stenosis ((67.01％±10.41％) vs (57.07%±10.71%)) were increased, while the ratio of minimum lumen area ((3.90±0.79) mm² vs (4.14±0.60) mm²) was decreased in IVUS group (P＜0.05). Meanwhile there was no MACE during admission in two groups, but the incidence rate of MACE was significantly lower in IVUS group than that in QCA group since one month after follow-up started(P＜0.05). Conclusion Compared with QCA, IVUS can detect more severe stenosis rate of angiographical borderline lesions, more effectively detect “unstable” lesions, guide percutaneous coronary intervention of borderline lesion, reduce the occurrence of cardiovascular events, and improve the prognosis.

Abstract:Aim To investigate the correlation between platelet crit (PCT) and global registry of acute coronary events (GRACE) score in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and its predictive value for severe lesions. Methods The clinical data of 193 patients with NSTEMI in Wuhan Yaxin General Hospital from January 2019 to January 2020 were analyzed retrospectively. According to the results of coronary angiography, the patients who involved three coronary arteries and/or left main artery were severe lesion group (96 cases), and the rest were non-severe lesion group (97 cases). Spearman correlation analysis was used to observe the correlation between PCT and GRACE score, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of PCT for severe lesions of NSTEMI. Results PCT in severe lesion group was significantly higher than that in non-severe lesion group ((0.32%±0.05%) vs (0.24%±0.04%), P＜0.001), and platelet count (PC) was significantly lower than that in non-severe lesion group ((180.46±19.46)×10⁹/L vs (212.54±30.17)×10⁹/L, P＜0.001). Spearman correlation analysis showed that no matter the non-severe lesion group or the severe lesion group, PCT was positively correlated with GRACE score (r＝0.288, P＝0.004; r＝0.777, P＜0.001), while PC was negatively correlated with GRACE score (r＝－0.846, P＜0.001; r＝－0.822, P＜0.001). For the area under curve of ROC, PCT was the largest (0.858), followed by PC (0.802). The critical value of PCT was 0.275, the sensitivity was 81.3%, and the specificity was 84.5% in the diagnosis of NSTEMI severe lesions. Conclusion PCT is positively correlated with GRACE score, and it has a better predictive value for NSTEMI severe lesions.

Abstract:Aim To retrospectively investigate the relationship between the severity and long-term prognosis of coronary heart disease(CHD) and chronic renal failure (CRF). Methods 776 patients with CHD undergoing coronary artery stent implantation were selected. All patients were divided into two groups with or without CRF according to their basic kidney function level, among which 535 cases were in the CRF group and 241 cases were in the CRF-free group. Clinical characteristics, coronary artery lesions and 1-year incidence of major adverse cardiovascular events (MACE) were compared between the two groups. Results Compared with the control group, the degree of coronary artery stenosis in the CRF group was significantly worse, with more coronary artery number of lesions (P＜0.001) and higher proportion of coronary artery three-vessel lesions (P＜0.001) and higher gensini scores (P＜0.001). The 1-year MACE incidence was higher in the CDK group than in the control group (P=0.014). Multivariate Cox regression analysis showed that CRF was a risk factor for 1-year MACE occurrence. Conclusion CHD patients with CRF have more severe coronary artery stenosis, and CRF is an important index to predict the prognosis of CHD.

Abstract:Aim To explore the clinical value of prospective ECG-gating low-dose coronary angiography (CCTA) based on iterative reconstruction algorithm (IRA) in the evaluation of mural coronary artery lumen. Methods From January 2015 to January 8,0 patients with myocardial bridge (MB) of left anterior descending coronary artery diagnosed by CCTA and treated in Panzhihua Central Hospital were selected as research objects. Invasive coronary angiography was as the gold standard. According to the degree of MB lesion, the patients were divided into three groups:non-systolic compression group (32 cases), mild systolic compression group (56 cases) and severe systolic compression group (72 cases). The mural coronary artery-contrast opacification difference (MCA-COD), transluminal attenuation gradient (TAG), standardized TAG and MB length were measured and compared in the three groups. The clinical value of standardized TAG, MCA-COD and MB length in the diagnosis of systolic compression MB was evaluated by receiver operating characteristic curve (ROC). Results With the increase of the degree of systolic compression, the TAG and standardized TAG decreased gradually, and the MCA-COD and MB length increased gradually; The difference between the severe systolic compression group and the mild systolic compression group, the non-systolic compression group was statistically significant (P＜0.001). MCA-COD had higher diagnostic sensitivity and specificity than standardized TAG and MB length in detecting whether MB was accompanied with systolic compression, and the combined detection of the three had higher diagnostic value in predicting severe systolic compression. In the mild systolic compression group, the sensitivity of the combined detection was 83.12%, the specificity was 80.00%, and the area under ROC curve was 0.816 (95%CI 0.768~0.864); In the severe systolic compression group, the sensitivity of the combined detection was 90.62%, the specificity was 87.50%, and the area under ROC curve was 0.844 (95%CI 0.799~0.890). The combined detection of the three was more valuable than the single detection of each index. Conclusion MCA-COD, standardized TAG and MB length as prospective ECG-gating low-dose CCTA indexes based on IRA have important diagnostic value for evaluating MB with systolic compression.

Abstract:Klotho is an important endogenous pluripotent protein involved in pathophysiological processes such as aging and calcium/phosphorus metabolism, which is closely correlated with cardiovascular diseases. Recent clinical studies have found that low levels of Klotho expression are associated with more cardiovascular risk factors and predict cardiovascular risk; Basic studies have also shown that Klotho plays a pivotal role in maintaining vascular homeostasis and heart function. Klotho can promote nitric oxide (NO) production, reduce the expression of inflammatory factors and adhesion molecules, mediate the biological effects of anti-oxidation, anti-apoptosis, and anti-aging, alleviate atherosclerosis and vascular calcification, and inhibit cardiac hypertrophy and fibrosis. Klotho may serve as a new interventional target and provide new insights for the prevention and treatment of cardiovascular diseases. This review aims to summarize the association of Klotho with cardiovascular diseases and its underlying biological mechanisms.

Abstract:Monocytes are important mediators of the innate immunity and play crucial roles in various inflammatory diseases, including vascular inflammation and atherosclerosis (As). Hyperlipidemia can accelerate cardiovascular disease progression, especially As. Under hyperlipidemia, circulating monocytes can take up lipids, become foamy monocytes and change phenotypes, which may contribute to development of As. For a long time, the response of monocytes and their different subtypes to hyperlipidemia and the effect on As have been the focus of research. This paper discusses the characteristics of monocyte subtypes in human and mice, the effects of hyperlipidemia on monocytes, and the effects of monocytes on As, and focuses on the research progress of monocytes affecting As process through lipid phagocytosis, foam cell formation, patrolling and migration into plaques.

Abstract:Chronic inflammation plays an important role in the development of atherosclerosis (As). Immune response related mechanisms are involved in the process of arterial inflammatory disease. Regulatory T cell (T regulatory cells,Treg) is a T lymphocyte subset with unique immunomodulatory function. A great deal of evidence shows that the quantitative changes and dysfunction of Treg are closely related to the pathogenesis of As. This paper briefly describes and summarizes the mechanism of Treg in the development of As, and introduces the latest research progress of Treg as a new drug therapeutic target in the prevention and treatment of As, in order to provide new ideas for the prevention and treatment of atherosclerotic diseases.