摘要 目的:研究射血分数保留的心力衰竭(HFpEF)的证候要素及应证组合类型。方法:采用综合检索方法,检索PubMed、中国知网(CNKI)、维普医学资源数据库(VIP)、万方医学数据库。选用证候要素分析方法对纳入的国内期刊文献中4510例HFpEF病人进行证候分析,揭示HFpEF的证候要素组成规律。结果:HFpEF临床表现可分为12个证候要素,其中,实证8个,虚证4个;共有证候类型16个;证候要素应证组合中单因素证占16.68%,双因素证占45.70%。结论:HFpEF的实性病理因素为血瘀、水饮、痰浊等;虚性病理因素为气虚、阳虚、阴虚等,其中,以血瘀、水饮、气虚在证素中占比较高,且常以气虚+血瘀为多证素的组合。
摘要 目的:基于网络药理学方法预测百合丹参汤(BHDST)治疗心肌缺血再灌注损伤(MIRI)的潜在作用靶点与通路,并通过体外实验进行验证,旨在系统阐明其作用机制。方法:利用TCMSP、GeneCards等数据库筛选BHDST的活性成分及MIRI疾病靶点;通过蛋白相互作用网络分析和分子对接识别核心靶点与成分;采用Langendorff离体心脏灌流系统建立MIRI模型,评估BHDST对心功能指标的影响,并运用实时荧光定量聚合酶链式反应(q-PCR)检测心肌组织中核心靶点mRNA的表达水平。结果:网络药理学分析共筛选出89个活性成分和120个交集靶点。预测槲皮素、木犀草素、丹参酮ⅡA和β-谷甾醇为核心成分,肿瘤坏死因子(TNF)、蛋白激酶B(AKT)1、白介素-6(IL6)、白介素-1β(IL1B)为核心靶点,并富集于TNF、核因子-κB(NF-κB)、白介素-17(IL-17)等炎症通路。分子对接显示,核心成分与核心靶点之间结合良好。体外实验证实,BHDST能显著改善MIRI大鼠的心功能,其机制与抑制TNF-α、IL-6、IL-1β、AKT1 mRNA的过度表达有关。结论:BHDST通过多成分作用于TNF、AKT1、IL6、IL1B等核心靶点,调控炎症反应及相关信号通路,从而缓解MIRI。
摘要 目的:探讨犀角地黄汤加减对瘀热阻窍证急性缺血性脑卒中病人的脑保护作用及机制。方法:1)将60例病人随机分为对照组(常规治疗)与治疗组(常规治疗加服犀角地黄汤加减)。比较两组临床疗效、中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分及血清氧化应激与炎性因子水平。2)通过脑缺血模型小鼠,给予该方主要成分芍药苷干预,检测其神经功能、氧化应激指标及相关通路蛋白表达。结果:1)治疗组临床疗效、中医证候改善及神经功能恢复均优于对照组(P<0.05),病人血清活性氧(ROS)、丙二醛(MDA)、白细胞介素-6(IL-6)水平降低,还原型谷胱甘肽(GSH)、核因子E2相关因子2(NRF2)、谷胱甘肽过氧化物酶4(GPX4)水平升高(P<0.05);2)芍药苷可改善模型小鼠神经功能,减少脑组织细胞凋亡与脂质沉积,并上调NRF2、GPX4、GSH表达。结论:犀角地黄汤加减能改善瘀热阻窍证缺血性脑卒中病人的神经功能与临床症状,其作用机制可能与抗炎、抗氧化及激活NRF2/GPX4/GSH通路有关。
摘要 目的:基于“活性氧(ROS)/缝隙连接重构”通路探究安律胶囊抗心律失常的分子机制。方法:60只Wistar大鼠随机分为6组:空白对照组、模型组、阳性药对照组及安律胶囊高、中、低剂量组。采用股静脉恒速注射乌头碱(0.001%)的方法制备大鼠心律失常模型;造模后灌胃3d,采用流式细胞术检测心肌组织单细胞悬液的ROS水平;蛋白质免疫印迹法(Western Blot)检测心肌组织缝隙连接蛋白40(Cx40)、缝隙连接蛋白43(Cx43)的蛋白表达水平。结果:模型组ROS水平较空白对照组明显升高(P<0.001),Cx40和Cx43表达较空白对照组明显降低(P<0.001);与模型组比较,安律胶囊高剂量组及阳性药组ROS水平明显降低(P<0.01或P<0.001),Cx40和Cx43表达明显升高(P<0.001),且高剂量组与阳性药组之间差异无统计学意义(P>0.05)。中剂量组Cx40、Cx43明显高于模型组(P<0.001),但低剂量组与模型组差异无统计学意义(P>0.05)。相关性分析显示,ROS与Cx40、Cx43均呈明显负相关(r值分别为-0.928,-0.903,均P<0.001),而Cx40与Cx43呈明显正相关(r=0.874,P<0.001)。结论:安律胶囊的抗心律失常作用可能通过抑制ROS/缝隙连接重构通路实现,即通过降低ROS水平,进而改善由ROS介导的Cx40与Cx43蛋白表达。
摘要 目的:基于单核细胞趋化蛋白-1(MCP-1)/CC趋化因子受体2(CCR2)通路探讨电针(EA)对心肌缺血再灌注损伤(MIRI)大鼠心肌炎症损伤的影响。方法:将建模成功的54只MIRI大鼠分为MIRI组、EA组(双侧“内关”EA干预)、EA+MCP-1组(每日腹腔注射5 ng的MCP-1蛋白+双侧“内关”EA干预),每组18只,另选择18只大鼠作为Sham组。超声心动图检测MIRI大鼠心功能;酶联免疫吸附法(ELISA)检测MIRI大鼠血清中肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、心肌肌钙蛋白I(cTnI)水平;氯化三苯甲基四氮唑(TTC)染色检测MIRI大鼠心肌梗死面积;苏木素-伊红(HE)染色检测MIRI大鼠心肌组织病理形态;脱氧核糖核苷酸末端转移酶介导的缺口末端标记(TUNEL)染色检测MIRI大鼠心肌组织细胞凋亡;蛋白质免疫印迹法(Western Blot)检测MIRI大鼠心肌组织中MCP-1、CCR2蛋白表达。结果:Sham组心肌细胞排列有序;MIRI组心肌细胞减少,排列紊乱和肿胀,肌原纤维收缩,有大量炎性细胞浸润;EA组心肌组织病理损伤减轻,炎性细胞浸润和肌纤维断裂减少;EA+MCP-1组心肌组织病理损伤进一步加重,炎性细胞浸润和肌纤维断裂进一步增加。MIRI组左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、心肌梗死面积比值、凋亡率、TNF-α、IL-6、CK-MB、LDH、cTnI、MCP-1、CCR2高于Sham组,左心室短轴缩短分数(FS)、左室射血分数(LVEF)低于Sham组(P<0.05);EA组LVESD、LVEDD、心肌梗死面积比值、凋亡率、TNF-α、IL-6、CK-MB、LDH、cTnI、MCP-1、CCR2低于MIRI组,FS、LVEF高于MIRI组(P<0.05);EA+MCP-1组LVESD、LVEDD、心肌梗死面积比值、凋亡率、TNF-α、IL-6、CK-MB、LDH、cTnI、MCP-1、CCR2高于EA组,FS、LVEF低于EA组(P<0.05)。结论:EA通过抑制MCP-1/CCR2通路减轻MIRI大鼠心肌炎症损伤。
摘要 目的:探究猪牙皂皂苷调控内质网应激(ERS)对缺血性脑卒中(CIS)大鼠的作用机制。方法:将40只Wistar大鼠随机分为假手术组、模型组、猪牙皂皂苷组、ERS抑制剂4-苯基丁酸(4-PBA)组,每组10只。除假手术组外,其余各组采用Longa线栓法复制大鼠CIS动物模型。猪牙皂皂苷组和4-PBA组分别腹腔注射6.5 mg/kg猪牙皂皂苷和30 mg/kg 4-PBA,其他组注射等剂量生理盐水,每日1次,持续7 d。术后24 h采用Zea-Longa评分法进行神经功能缺陷评分;氯化三苯基四氮唑(TTC)染色法比较脑组织梗死面积;苏木素-伊红(HE)染色法观察脑组织病理学变化;生化法检测脑组织丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平;末端脱氧核苷酸转移酶dUTP缺口末端标记法(TUNEL)染色法检测脑组织凋亡水平;蛋白质免疫印迹法(Western Blot)检测脑组织内蛋白激酶R样内质网激酶(PERK)途径蛋白水平。结果:与假手术组比较,模型组大鼠神经功能缺损评分及脑梗死面积增大(P<0.05),脑组织MDA、细胞凋亡率、葡萄糖调节蛋白78(GRP78)、转录激活子4(ATF4)、CCAAT/增强子结合蛋白同源蛋白(CHOP)及磷酸化PERK(p-PERK)/PERK蛋白表达水平升高,SOD、GSH-Px水平降低(P<0.05);与模型组比较,猪牙皂皂苷组和4-PBA组大鼠神经功能缺损评分及脑梗死面积减小(P<0.05),脑组织中MDA、细胞凋亡率、GRP78、ATF4、CHOP及p-PERK/PERK蛋白表达水平降低,SOD、GSH-Px水平升高(P<0.05)。结论:猪牙皂皂苷对CIS大鼠脑损伤具有保护作用,其作用机制可能与调控PERK通路改善内质网应激相关。
Research Progress on the Pathogenesis of Atrial Functional Mitral Regurgitation FENG Yanqing, SI Xincheng, MIAO Pengfei Corresponding Author MIAO Pengfei, E-mail: 759952069@qq.com Keywords atrial f
Research Progress on Transcranial Direct Current Stimulation in the Rehabilitation of Lower Limb Dysfunction after Stroke YE Songling 1 , LIAN Tao 2 Corresponding Author LIAN Tao, E-mail: taolian10
摘要 目的:探讨养心活血方治疗气虚血瘀型稳定型心绞痛伴焦虑抑郁的疗效。方法:共纳入178例符合要求的病人进行随机、单盲对照试验,对照组接受西药及养心活血方安慰剂治疗,治疗组接受西药及养心活血方治疗。干预12周后评估心功能、心绞痛症状、患者健康问卷-9项(PHQ-9)评分、广泛性焦虑障碍量表-7项(GAD-7)评分、中医证候、安全性指标等。结果:与对照组比较,治疗组治疗后心功能及焦虑、抑郁症状、中医证候均明显改善,且无明显不良反应。结论:养心活血方在气虚血瘀型稳定型心绞痛伴焦虑抑郁病人的治疗中具有更好的疗效,且临床安全性较好。
CAI Ying 1 , XU Miao 1 , YANG Dongmei 1 , GOU Hualiang 1 , XU Mengxia 2 1. Dazhou Central Hospital, Dazhou 635000, Sichuan, China; 2. Dazhou Vocational College of Traditional Chinese Medicine Corr
Relationship between Prothrombin Activity and Myocardial Microcirculation Status and Prognosis in Patients with Heart Failure after STEMI LIU Lihui, HE Jiangbo, YANG Zhannan Corresponding Author YA
The Influence of Thumbtack Needle and Auricular Acupressure with Cowherb Seed on Blood Lipid Levels and Sleep Quality in Patients with Coronary Heart Disease and Insomnia XIANG Yiming 1,2,3 , XIE W
The Influence of Abdominal Meridian Cupping Combined with a Dampness-eliminating and Turbidity-reducing Formula on Glucose and Lipid Metabolism and High-risk Factors of Cardiovascular and Cerebrovas
The Impact of Meridian-guided Pulmonary Function Training on Functional Recovery in Patients with Hemiplegia Secondary to Cerebral Infarction DONG Xiaoke, ZHANG Qiang, WANG Qiu, JIN Zichen, PANG Ha
The Predictive Value of Serum CLEC-2 and PON-1 for Hemorrhagic Transformation after Intravenous Thrombolysis in Patients with Acute Ischemic Stroke CHU Jun, WANG Xinyu, DAI Ke Corresponding Author
The Predictive Value of Serum Gas6 and PSGL-1 for Stroke Associated Pneumonia in Patients with Acute Cerebral Infarction XIA Jing 1 , LIU Lihua 1 , JIANG Lai 1 , JIN Yue 1 , HAN Yujia 1 , GAO Hongx
Therapeutic Effect of Warm Acupuncture Combined with Repetitive Transcranial Magnetic Stimulation in the Treatment of Elderly Patients with Post-stroke Depression DING Shanshan, JIAO Daiyan, DENG H
Effects of Tirofiban on Platelet Activation Markers CD62p and PAC-1 in Acute Cerebral Infarction LEI Xia, LIU Jie, SU Guohua Cangzhou People's Hospital, Cangzhou 061000, Hebei, China Correspondin
Establishment of Random Forest Model for Predicting Cognitive Impairment after Stroke LIU Chao, HUO Huiyong, LIU Tiantian, LI Juntao Corresponding Author LI Juntao, E-mail: 1690832804@qq.com Keywor
The Influence of Intensive Blood Pressure Reduction on Neurological Function, Inflammatory Response and Prognosis in Patients with Acute Ischemic Stroke YANG Cheng, DONG Jingjing, XU Hui Correspon
Predictive Value of Susceptibility Weighted Imaging Combined with Serum Fibrinogen for Cognitive Impairment After Ischemic Stroke ZOU Pan, LIU Kan, GE Zijing Corresponding Author GE Zijing, E-mail:
The Relationship Between E-selectin Gene Polymorphism and Early Hematoma Expansion in Patients with Hypertensive Intracerebral Hemorrhage GUAN Haibo, SHOU Jixin, HE Yun, GAO Haidong, JIA Chuanyu C
Risk Factor Screening and Interaction Analysis for Carotid Atherosclerosis in Adults ZOU Disha 1 , CHEN Dingyuan 2 , YU Ping 2 , YU Jian 2 , YU Zhiqi 3 Corresponding Author YU Zhiqi, E-mail: 2857349
Exploring Imaging Characteristics of Intracranial Atherosclerotic Stenosis and Precision Interventional Treatment Strategies Using AI Analysis WANG Xilong 1 , HE Feng 2 , CHENG Wenjuan 3 1. Yibin
Discussion on the Pathogenesis, Syndrome Differentiation and Treatment of Myocardial Remodeling in Dilated Cardiomyopathy Based on the "Spleen Governing Muscles" Theory LIU Zhan, GUO Ming, CHEN Yif
Treating Heart Failure with Preserved Ejection Fraction Based on the Theory of "Yang Deficiency with Three Lackings, Controlled by the Spleen" ZHANG Bowen, LIU Yunlong, ZHANG Ludan, SONG Zhijie, LY
Diagnosis and Treatment of No Reflow Phenomenon after Percutaneous Coronary Intervention Based on the Theory of "Host Guest Interaction-Network Disease" HUANG Guanming 1 , CHEN Longxia 2 , WANG Jin
Professor Liu Hongxu's Experience in Treating Cardiovascular Diseases with Insect Medicines to "Break Blood Circulation and Remove Blood Stasis" ZHANG Heyi 1,2 , LIU Zihao 1 , LIU Hongxu 1 , LIAN Y
He Huaiyang's Experience in Diagnosing and Treating Recurrent Angina Pectoris after PCI for Coronary Heart Disease Based on the Principle of "Mutual Causation between Reception and Transformation"
Professor WU Wei's Experience in Diagnosing and Treating Elderly Isolated Systolic Hypertension Based on "Heart-spleen-related with Concurrent Phlegm-stasis Resolution" Theory ZENG Yinxiang 1,2 , X