Abstract:Coronary heart disease (CHD) is a common complex disease caused by the interaction of multiple genes and environmental factors. In recent years, it has been found that CHD is closely related to epigenetic modification represented by DNA methylation. Epigenetics studies the influence of environment rather than genetic sequence itself on gene expression, which coincides with the overall concept of traditional Chinese medicine (TCM) and the theory of correspondence between nature and man. TCM follows the overall concept, pays attention to the influence of external factors such as environment on the human body, and achieves the internal balance of the body through TCM treatment. In recent years, TCM researchers have made great progress in the research on the DNA methylation connotation of TCM syndromes of CHD and the methylation mechanism of TCM intervention in CHD. The author combed the relevant literature and summarized it in order to provide reference for future research.

Abstract:Cardiovascular disease (CVD) is a collective term for circulatory system diseases. Although CVD has made great progress in clinical research and treatment in recent decades, it is still the main disease with high morbidity and mortality in the world. Inflammation, fibrosis, etc. in CVD process promote the apoptosis of cardiomyocyte (CM), and mature CM lacks the ability to repair and regenerate after injury, which undoubtedly hinders the progress of CVD treatment.In recent years, the discovery of human induced pluripotent stem cell (hiPSC) has promoted the in vitro research of various human diseases, and provided a new direction for exploring the potential molecular mechanism of CVD. CM derived from hiPSC has provided a broad prospect for myocardial repair. In this paper, the role and research status of hiPSC in CVD are reviewed based on the related literatures in recent years.

Abstract:Aim To explore whether cyclin-dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B-AS1) affects high glucose-induced human umbilical vein endothelial cell (HUVEC) injury by targeting miR-98-5p. MethodsHUVECs were divided into control group (cultured in DMEM containing 5 mmol/L glucose), model group (cultured in DMEM containing 33.5 mmol/L glucose), model＋si-NC group, model＋si-CDKN2B-AS1 group, model＋miR-NC group, model＋miR-98-5p mimic group, model＋si-CDKN2B-AS1＋anti-miR-NC group, model＋si-CDKN2B-AS1＋anti-miR-98-5p group. The expressions of CDKN2B-AS1 and miR-98-5p in HUVEC were detected by quantitative real-time polymerase chain reaction; Signal transducer and activator of transcription 3 (STAT3) protein expression was detected by Western blot; Apoptosis was detected by flow cytometry; Superoxide dismutase (SOD), lactate dehydrogenase (LDH), malondialdehyde (MDA) kits were used to detect SOD, LDH, MDA levels. Targeted binding of miR-98-5p to CDKN2B-AS1 and STAT3 was analyzed by dual-luciferase reporter experiment. Results High glucose increased CDKN2B-AS1 and STAT3 expressions, cell apoptosis rate, LDH and MDA levels, and decreased miR-98-5p expression and SOD level in HUVEC (P＜0.05). After silencing CDKN2B-AS1 or overexpressing miR-98-5p, high glucose-induced CDKN2B-AS1 and STAT3 expressions, cell apoptosis rate, LDH and MDA levels decreased, while miR-98-5p expression and SOD level increased in HUVEC (P＜0.05). Dual-luciferase reporter experiment results showed that CDKN2B-AS1 targeted miR-98-5p and miR-98-5p targeted STAT3. Inhibition of miR-98-5p reversed the inhibitory effects of CDKN2B-AS1 silencing on high glucose-induced HUVEC apoptosis, oxidative stress, and STAT3 protein expression. Conclusion Silencing CDKN2B-AS1 suppresses high glucose-induced oxidative stress and apoptosis in HUVEC by regulating the miR-98-5p/STAT3 axis, and CDKN2B-AS1 may serve as a candidate therapeutic target for diabetes-related vascular complications.

Abstract:Aim To investigate the effect of miR-152-3p targeting thioredoxin-interacting protein (TXNIP) on the apoptosis of endothelial progenitor cells (EPC) induced by hydrogen peroxide (H₂O₂). Methods Endothelial progenitor cells were isolated from the peripheral blood of healthy people and identified, a H₂O₂-induced endothelial progenitor cells damage model (500 μmol/L H₂O₂ treated for 8 h) was established and the expression of miR-152-3p in endothelial progenitor cells was detected by RT-qPCR. After overexpression of miR-152-3p or inhibition of TXNIP expression or overexpression of miR-152-3p and TXNIP simultaneously in endothelial progenitor cells, they were treated with 500 μmol/L H₂O₂ for 8 h, the expression level of miR-152-3p, cell apoptosis rate and TXNIP, Bax, Bcl-2, and Caspase-3 protein expression levels were measured; dual luciferase reporter gene experiment was performed to verify the relationship between miR-152-3p and TXNIP. Results Endothelial progenitor cells were successfully isolated from the peripheral blood of healthy people, and the expression level of miR-152-3p in H₂O₂-induced endothelial progenitor cells decreased by 65.0% (P＜0.001). Compared with the control group, the apoptosis rate, Bax and Caspase-3 protein expression levels in the model group increased by 895.1%, 352.0% and 290.3%, and the Bcl-2 expression level decreased by 79.4% (all P＜0.001). Compared with the miR-NC group, the apoptosis rate and the protein expression levels of Bax and Caspase-3 in the miR-152-3p mimic group decreased by 55.7%, 60.9% and 56.8% (P＜0.001), and the protein expression level of Bcl-2 increased by 389.5% (all P＜0.001). Compared with the si-NC group, the apoptosis rate and the protein expression levels of TXNIP, Bax and Caspase-3 in the si-TXNIP group were decreased by about 40.2%, 57.5%, 59.8% and 55.4% (all P＜0.001). Compared with miR-152-3p mimic＋pcDNA group, the apoptosis rate, TXNIP, the protein expression levels of Bax and Caspase-3 increased by 86.8%, 184.8%, 137.7% and 109.2% (P＜0.001), and the protein expression level of Bcl-2 decreased by 69.1% (P＜0.001). The results of dual luciferase reporter gene experiments showed that miR-152-3p was able to target and negatively regulate TXNIP expression. Conclusion MiR-152-3p was under-expressed in H₂O₂-induced endothelial progenitor cells. Overexpression of miR-152-3p can inhibit H₂O₂-induced endothelial progenitor cell apoptosis by targeting the expression of TXNIP.

Abstract:Aim To investigate the effects of naringenin (NAR) on high glucose (HG)-induced rat cardiomyocytes (H9c2) apoptosis and nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) signaling pathway. Methods The cultured H9c2 cells were divided into control group (normal glucose content), HG group (35.5 mmol/L glucose) and HG＋NAR low, medium, high concentration groups (35.5 mmol/L glucose＋6.5,2.5,5.0 μmol/L NAR). The proliferation activity of H9c2 cells was detected by methyl thiazolyl tetrazolium method; Cell apoptosis was detected by flow cytometry; The level of reactive oxygen species (ROS) in cells was detected by fluorescent probe staining with dichloro-dihydro-fluorescein diacetate; The expression levels of Nrf2, heme oxygenase-1 (HO-1), Bax, Caspase-3 and Bcl-2 proteins were detected by Western blot. Results The proliferation activity, the expression levels of Nrf2, HO-1 and Bcl-2 proteins in H9c2 cells treated with HG decreased significantly, while the apoptosis rate, ROS level, Bax and Caspase-3 proteins expression levels increased significantly (P＜0.05). After the H9c2 cells were treated with HG and NAR, the proliferation activity and the expression levels of Nrf2, HO-1 and Bcl-2 proteins in H9c2 cells increased significantly in the NAR low, medium and high concentration groups, while the apoptosis rate, ROS level, Bax and Caspase-3 proteins expression levels decreased significantly (P＜0.05). Conclusion NAR can inhibit H9c2 cell apoptosis induced by HG, and its mechanism may be closely related to activation of Nrf2/ARE signaling pathway.

Abstract:Aim To explore the characteristics of renal function changes in patients with ischemic heart failure (HF) during hospitalization. Methods Patients with ischemic HF hospitalized in the Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University from October 2013 to December 2017 were retrospectively included. Descriptive statistics was used to describe the baseline clinical features of patients. Multivariate Logistic regression model was used to explore the related factors of worsening renal function (WRF) in ischemic HF patients. Results 797 patients with ischemic HF were enrolled in this study, with an average age of (70.5±11.1) years, of whom 68.9% was male. Among them, 22.5% was HF patients with reduced left ventricular ejection fraction (LVEF) and 57.6% was HF patients with retained LVEF. The incidence of WRF was 18.4%. The related factors leading to WRF included high serum creatinine (OR＝1.953, P＜0.001), history of hypertension (OR＝1.859, P＝0.025), low hemoglobin (OR＝0.985, P＝0.002), high fibrinogen (OR＝1.241, P＝0.013), high blood chlorine (OR＝1.042, P＝0.049), high blood uric acid (OR＝1.002, P＝0.039) and using furosemide (OR＝1.773, P＝0.033). Conclusion The incidence of WRF in ischemic HF patients is high, and there are many related factors; Clinically, it is necessary to pay attention to the changes of patients' renal function and control related factors in time, especially low hemoglobin, high fibrinogen, high blood chlorine and high blood uric acid.

Abstract:Aim To explore the relationship of serum zinc, copper, copper/zinc ratio and coronary artery calcification (CAC) in patients with chronic kidney disease. Methods Using the cross-sectional analysis method, 274 patients with chronic kidney disease were studied. According to the coronary artery calcification scores, the patients were divided into calcified group and non-calcified group, and the clinical data and laboratory indicators of the two groups were compared. Spearman correlation analysis was used to analyze CAC related factors, binary Logistic regression was used to analyze CAC risk factors, and ROC curve was used to explore the predictive value of zinc, copper, and copper/zinc ratio on CAC. Results The serum zinc level of calcified group ((77.09±15.84) μmol/L) was lower than that of non-calcified group ((88.21±11.55) μmol/L). Serum copper ((13.99±3.76) μmol/L) and copper/zinc ratio (0.19±0.08) were higher in calcified group than those of non-calcified group ((12.10±3.99) μmol/L, (0.14±0.05)). Spearman correlation analysis showed that serum zinc level (r＝－0.387, P＜0.001) was negatively correlated with coronary artery calcification scores (CACS). Serum copper(r＝0.356, P＜0.001) and copper/zinc ratio (r＝0.477, P＜0.001) were positively correlated with CACS. Binary Logistic regression analysis showed age (OR＝1.085, P＜0.001), serum copper (OR＝1.114,P＜0.001) and copper/zinc ratio (OR＝1.143, P＜0.001) were risk factors for CAC. And serum zinc (OR＝0.948, P＜0.001) was protective factor for CAC. ROC curve analysis showed that the AUC of zinc, copper, and copper/zinc ratio were 0.1,0.0,0.716 in predicting CAC (P＜0.001). Conclusion Patients with chronic kidney disease with high age, high levels of copper and copper/zinc ratio, and low zinc have higher risk of CAC, and the copper/zinc ratio has better predictive value for the occurrence of CAC.

Abstract:Aim To investigate the relationship between left atrial thrombosis and peripheral blood neutrophil to lymphocyte ratio (NLR) in patients with non-valvular atrial fibrillation (NVAF). Methods 207 NVAF patients diagnosed and treated in our hospital from March 2016 to August 2020 were selected and divided into low NLR group and high NLR group according to the level of peripheral blood NLR. The clinical data of the two groups were compared. The correlation between NLR and clinical indicators and left atrial thrombosis were analyzed. The influencing factors of left atrial thrombosis and their predictive value were analyzed. Results Compared with the low NLR group, the CHADS2 score, CHA2DS2-VASc score, NLR, D-dimer (D-D), serum uric acid (SUA), brain natriuretic peptide (BNP), C-reactive protein (CRP), left atrial dimension (LAD) and ratio of peak mitral early diastolic velocity (E) to peak mitral annular early diastolic velocity (Em) (E/Em) were significantly increased, and left atrial ejection fraction (LAEF) was significantly decreased in the high NLR group (P＜0.05). NLR was significantly positively correlated with CHADS2 score, CHA2DS2-VASc score, D-D, SUA, BNP, CRP, LAD, and E/Em, and significantly negatively correlated with LAEF (P＜0.000 1). CHADS2 score, CHA2DS2-VASc score, NLR, D-D, SUA, BNP, CRP, LAD, and E/Em all had a significant positive correlation with the occurrence of left atrial thrombus (P＝0.000), while LAEF had a significant negative correlation with the occurrence of left atrial thrombus (P＝0.000). CHADS2 score, CHA2DS2-VASc score, NLR, D-D and LAD were the risk factors for left atrial thrombosis (P＜0.05). With the optimal cutoff value of 1.85, the area under the ROC curve of NLR in the prediction of left atrial thrombosis in NVAF was 0.806 (95%CI:0.746～0.865), the sensitivity was 74.82% (95%CI:0.668～0.818), and the specificity was 67.65% (95%CI:0.552～0.785). Conclusion Elevated level of NLR significantly increases the risk of left atrial thrombosis in patients with NVAF. As an independent risk factor for left atrial thrombosis in patients with NVAF, NLR has certain predictive value for left atrial thrombus.

Abstract:Aim To investigate the clinical effect of dabigatran etexilate versus warfarin double anticoagulation scheme in antithrombotic therapy for elderly patients with atrial fibrillation (AF) and coronary heart disease (CHD). Methods 198 elderly patients with AF complicated with CHD treated in our hospital from August 2018 to December 2019 were selected as the research objects. Using random number table method, the patients were divided into observation group and control group with 99 cases in each group. The observation group was treated with dabigatran etexilate, while the control group was treated with warfarin combined with antiplatelet drugs (aspirin). Follow-up for one year, the curative effect of antithrombotic therapy was compared between the two groups. The prothrombin time (PT), international normalized ratio (INR), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (Fib), D-dimer (D-D), platelet count (PLT) and C-reactive protein (CRP) were compared between the two groups before treatment and 1,6 and 12 months after treatment. The thrombotic event, bleeding event and adverse drug reaction were observed and recorded in the two groups. Results After 1,6 and 12 months of treatment, the PLT, CRP and D-D levels showed a gradual and obvious downward trend in the observation group and the control group (F＝42.7,8.4,4.582, all P＜0.001). Compared with before treatment, PT, INR, TT, APTT and Fib were significantly improved in the two groups (F＝356.1,5.9,2.6,5.7,5.623, all P＜0.001). Serum uric acid levels in both groups decreased significantly (F＝105.515, P＜0.001), and the degree of decrease in the observation group was more significant than that in the control group (F＝145.854, P＜0.001). After treatment, the incidence of bleeding in the observation group was 5.05%, which was significantly lower than 21.21% in the control group (χ²＝11.335, P＝0.001). Conclusion The effect of dabigatran etexilate in antithrombotic therapy of elderly patients with AF and CHD is similar to that of warfarin double anticoagulation scheme, but the incidence of bleeding event is lower and the safety is higher, so it can be used as an ideal choice for clinical antithrombotic therapy of elderly patients with AF and CHD.

Abstract:Sacubitril/valsartan is the first angiotensin receptor neprilysin inhibitor that simultaneously inhibits neprilysin and blocks angiotensin receptor. “Guidelines for the Diagnosis and Treatment of Heart Failure in China 2018” made a class Ⅰ recommendation for sacubitril/valsartan that surpassed European and American guidelines. 2021 US Food And Drug Administration approves sacubitril/valsartan for the treatment of heart failure patients with normal ejection fraction. Numerous studies have shown beneficial effects of sacubitril/valsartan in patients with heart failure, myocardial infarction, arrhythmia, hypertension, chronic kidney disease and diabetes. This article reviews the application progress of sacubitril/valsartan in the treatment of cardiovascular disease and related diseases.

Abstract:Dysregulation of glucose and lipid metabolism is associated with a long-term chronic low-grade inflammatory reaction, and the dysregulation of intestinal flora may be one of the main reasons for the occurrence and development of this disease and the systemic chronic inflammatory reaction. Probiotics can improve oxidative stress and inflammation levels by regulating the intestinal microenvironment and correcting imbalances in blood glucose and lipid homeostasis. As a non-drug hypoglycemic and lipid lowering method, the application of probiotics aims to provide a new vision for improving metabolic diseases and arouse more thoughts on the research, development and utilization of probiotics.

Abstract:Hypertrophic cardiomyopathy is a common autosomal dominant genetic disease with an incidence of about 0.2% to 0.5% in the population. It is characterized by unexplained asymmetric hypertrophy of the left ventricle and interventricular septum. The clinical symptoms include fatigue, dyspnea, chest pain, syncope, etc. At present, western medicine treatment methods for hypertrophic cardiomyopathy mainly include drug treatment, interventional treatment, etc.Traditional Chinese medicine has also accumulated effective experience in the treatment of this disease. This article will focus on the current status and progress of traditional Chinese and western medicine treatment of hypertrophic cardiomyopathy, in order to provide a certain reference for the clinical treatment of hypertrophic cardiomyopathy.

Abstract:Aortic valve stenosis is one of the most common valve diseases in clinic, which can lead to increased risk of heart failure and death, and its incidence may double in the next 20 years as the population ages. At present, the preferred treatment for patients with symptomatic severe aortic stenosis is surgery or transcatheter aortic valve replacement. However, the optimal timing of surgery for patients with asymptomatic severe aortic stenosis is still controversial. The vigilant waiting strategy is safe and secure. It is feasible, but the risk of sudden death is almost 5% per year. Studies have found that plasma natriuretic peptide levels are related to the severity of aortic valve stenosis, the development of symptoms, and prognosis, which can help monitor disease progression and determine which patients will benefit most from early treatment intervention, thereby reducing long-term adverse events risks. This article outlines the role of natriuretic peptides in the diagnosis, clinical management, risk stratification, and potential therapeutic significance of aortic stenosis.

Abstract:Cardiovascular diseases are the leading cause of human death. Among them, vascular stenosis diseases account for a high proportion of cardiovascular diseases, which seriously endanger people's physical and mental health. Stent intervention is currently the most commonly used method for the treatment of vascular stenosis, but the proportion of restenosis after percutaneous intervention of coronary, carotid and peripheral arteries is very high, which seriously affects the prognosis of interventional patients. Therefore, a stable animal model can provide a tool for research and resolution of restenosis after percutaneous intervention. This article summarizes the method of creating ballon injury animal model and its application, in order to provide basis for the prevention and treatment of cardiovascular diseases.