Vascular changes

  • 文章类型: Journal Article
    背景:尽管血管成分在帕金森病的病理生理学中的作用已被广泛接受,并且在帕金森病患者中通常观察到视网膜血管异常,将视网膜血管疾病与患帕金森病风险联系起来的证据是有限的。我们的目的是通过一个全国性的队列研究视网膜血管阻塞与60岁以上人群患帕金森病的风险之间的关系。
    方法:来自14年的韩国国民健康保险服务-高级队列,11,210例视网膜血管阻塞患者和11,210例倾向评分,纳入风险匹配的对照.使用泊松回归估计帕金森病的发病率。Cox比例风险回归模型用于研究视网膜血管阻塞与帕金森病风险之间的关系。
    结果:帕金森氏病的发病率为每100,000人年664.4例(95%置信区间[CI],599.7-736.0)在视网膜血管阻塞队列中。视网膜血管阻塞患者帕金森病的发病率增加(危险比[HR],1.28;95%CI,1.10-1.49)。主要在视网膜动脉阻塞患者中观察到PD风险增加(HR,1.53;95%CI,1.11-2.12),男性患者(HR,1.67;95%CI,1.29-2.17),和诊断后5年(HR,1.46;95%CI,1.10-1.93)。
    结论:我们的研究结果表明,一个共同的病理生理途径,比如脉管系统的变化,可能存在于视网膜血管阻塞和帕金森病之间。视网膜血管闭塞可能是帕金森病未来发展的危险因素之一。该协会的性质值得进一步调查。
    BACKGROUND: Although the role of the vascular component in the pathophysiology of Parkinson\'s disease is widely accepted and retinal vascular abnormalities are commonly observed in Parkinson\'s disease patients, evidence connecting retinal vascular disorders with the risk of developing Parkinson\'s disease is limited. We aimed to investigate the association between retinal vascular occlusion (RVO) and the risk of developing Parkinson\'s disease in people over 60 years using a nationwide cohort.
    METHODS: From the 14-year South Korean National Health Insurance Service-Senior cohort, 11 210 incident RVO patients and 11 210 propensity scores, risk-matched controls were included. The incidence of Parkinson\'s disease was estimated with a Poisson regression. A Cox proportional hazards regression model was used to investigate the associations between RVO and the risk of Parkinson\'s disease.
    RESULTS: The incidence of Parkinson\'s disease was 664.4 cases per 100 000 person-years (95% confidence interval [CI], 599.7-736.0) in the RVO cohort. Individuals with RVO had an increased incidence of Parkinson\'s disease (hazard ratio [HR], 1.28; 95% CI: 1.10-1.49). Increased PD risk was predominantly observed in retinal artery occlusion patients (HR, 1.53; 95% CI: 1.11-2.12), male patients (HR, 1.67; 95% CI: 1.29-2.17), and 5 years after diagnosis (HR, 1.46; 95% CI: 1.10-1.93).
    CONCLUSIONS: Our findings suggest that a common pathophysiological pathway, such as vasculature changes, may exist between RVO and Parkinson\'s disease. RVO may be one of the risk factors associated with future development of Parkinson\'s disease. The nature of this association warrants further investigation.
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  • 文章类型: Editorial
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  • 文章类型: Letter
    背景:糖尿病性视网膜病变(DR)是DM的常见并发症,在发生不可逆损伤之前可能不会引起注意。它的筛查有助于早期发现。虽然,目前还没有研究探讨数字视网膜成像检测糖尿病前期患者血管变化的能力.
    目的:确定糖尿病前期患者RD的患病率和严重程度。
    方法:在2020年1月至2023年4月的糖尿病前期和体重超标患者样本中进行的横断面研究。收集社会人口统计学和临床变量,除了生活习惯。也使用数字视网膜造影进行视网膜造影评价。对于所有变量的分析,采用的显著性水平为5%。用于分析的软件是SPSS版本25.0。
    结果:在所选择的108名患者中,7.1%的患者在检查中出现了指示DR的改变。在糖尿病视网膜病变的参与者中,四个有中等形式(50%),3名参与者为中度形式(37%),只有1名参与者为重度形式(13%).
    结论:我们的研究结果强调了在糖尿病前期患者中采取预防措施和充分控制这些疾病的重要性。为了预防或延缓糖尿病性视网膜病变的进展,因此,降低失明和其他眼部并发症的风险。
    BACKGROUND: Diabetic retinopathy (DR) is a common complication of DM and may go unnoticed until irreversible damage occurs. Its screening can contribute to the early detection. Although, there are no studies which investigate the ability of digital retinography to detect vascular changes in pre-diabetic patients.
    OBJECTIVE: Identify the prevalence and severity of RD in patients with pre-diabetes.
    METHODS: Cross-sectionalstudy carried out in a sample of patients with pre-diabetes and weight excess characterized from January 2020 to April 2023. Sociodemographic and clinical variables were collected, in addition to lifestyle habits. Retinographic evaluation was also performed using a Digital Retinography. For the analysis of all variables, the adopted significance level was 5%. The software used for the analysis was SPSS version 25.0.
    RESULTS: Of 108 patients selected 7.1% have alteration in the exam indicating DR. Among the participants with diabetic retinopathy, four had the moderate form (50%), three the moderate form (37%) and only one participant had the severe form (13%).
    CONCLUSIONS: Our findings highlight the importance of preventive measures and adequate control of these conditions in pre-diabetic patients, in order to prevent or delay the progression of diabetic retinopathy and, consequently, reduce the risk of blindness and other ocular complications.
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  • 文章类型: Journal Article
    目的:通过彩色多普勒成像(CDI)评估原发性开角型青光眼(POAG)患者眼眶血管的变化。
    方法:这项横断面研究包括120名受试者-60名POAG患者和60名对照,所有这些人都接受了全面的眼科检查和眼眶CDI。眼动脉(OA),确定了视网膜中央动脉(CRA)和睫状动脉(CA),对于他们每个人来说,我们测量了峰值收缩压速度(PSV),舒张末期速度(EDV)和电阻率指数(RI)。
    结果:与正常对照组相比,POAG患者的OA和CRA的PSV显着降低(分别为P<0.0001,<0.009)。OA中的EDV,CRA和CA显著低于正常对照组(P<0.0001)。OA的RI,POAG患者的CRA和CA明显高于对照组(P<0.0001)。OA的EDV与青光眼病程呈负相关(r=-0.37,P<0.042)。CA的EDV与眼压(IOP)呈显着负相关(r=-0.86,P值0.0001)。CRA的PSV和EDV与眼压呈显著负相关(r=-0.45,r=-0.73,P值分别为0.011和0.0001),CRA的RI与眼压呈显著正相关(r=0.42,P值0.021)。
    结论:CDI是可行的,非侵入性,评估POAG患者眼眶动脉血流动力学变化的安全工具。与对照组相比,POAG患者的眼眶动脉显示出明显较低的流速和增加的电阻率指数,这些变化与青光眼持续时间和眼压相关。
    OBJECTIVE: To assess changes in orbital vessels by Color Doppler Imaging (CDI) in patients with Primary Open Angle Glaucoma (POAG).
    METHODS: This cross-sectional study included 120 subjects - 60 patients with POAG and 60 controls, all of whom underwent full ophthalmological examinations and orbital CDI. The Ophthalmic Artery (OA), Central Retinal Artery (CRA) and Ciliary Arteries (CA) were identified, and for each of them, we measured Peak Systolic Velocity (PSV), End Diastolic velocity (EDV) and Resistivity Index (RI).
    RESULTS: The PSV of the OA and CRA were significantly lower in patients with POAG compared to normal controls (P<0.0001, < 0.009 respectively). The EDV in the OA, CRA and CA were significantly lower than in normal controls (P<0.0001). The RI of the OA, CRA and CA were significantly higher in patients with POAG compared to controls (P<0.0001). The EDV of the OA showed significant negative correlation with duration of glaucoma (r=-0.37, P<0.042). The EDV of the CA showed significant negative correlation with intraocular pressure (IOP) (r=-0.86 and P value 0.0001). The PSV and EDV of the CRA showed significant negative correlation with IOP (r=-0.45, r=-0.73, P values 0.011, and 0.0001 respectively), and the RI of the CRA showed significant positive correlation with IOP (r=0.42 and P value 0.021).
    CONCLUSIONS: CDI is a feasible, noninvasive, safe tool for the assessment of hemodynamic changes in the orbital arteries of POAG patients. The orbital arteries showed significantly lower flow velocities and increased resistivity indices in patients with POAG compared to the control group, and these changes were correlated with glaucoma duration and IOP.
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  • 文章类型: Journal Article
    门静脉高压(PHT)是肝硬化的主要病因。门体侧支血管的形成和内脏血管舒张有助于高动力循环的发展,这反过来又加重了PHT并增加了并发症的风险。为了研究PHT中肠系膜小动脉的变化,结扎胆总管建立肝硬化大鼠模型。4周后,肝硬化大鼠患有严重的PHT和内脏高动力循环,以门静脉压力(PP)增加为特征,心输出量(CO),心脏指数(CI),肠系膜上动脉(SMA)血流。肝硬化大鼠的肠系膜小动脉表现出明显的血管舒张,血管重塑,和收缩不足。基于这些发现进行RNA测序。共检测到1637个差异表达基因(DEGs),889个上调基因和748个下调基因。与血管变化相关的信号通路被丰富,包括血管内皮生长因子(VEGF),磷脂酰肌醇-3-激酶-AKT(PI3K-AKT),活化B细胞的核因子κ轻链增强子(NF-κB)信号通路,在其他人中。此外,根据蛋白质-蛋白质相互作用(PPI)网络中的程度节点筛选前十大hub基因。功能富集分析表明,hub基因参与细胞周期调控,有丝分裂,和细胞对氧化应激和一氧化氮(NO)的反应。此外,用于改善PHT的有希望的候选药物,如白藜芦醇,是基于集线器基因预测的。一起来看,我们的研究强调了肝硬化PHT大鼠肠系膜小动脉的显着变化。转录组分析揭示了内脏高动力循环中血管变化的潜在分子机制。
    Portal hypertension (PHT) is a major cause of liver cirrhosis. The formation of portosystemic collateral vessels and splanchnic vasodilation contribute to the development of hyperdynamic circulation, which in turn aggravates PHT and increases the risk of complications. To investigate the changes in mesenteric arterioles in PHT, cirrhotic rat models were established by ligating the common bile ducts. After 4 weeks, the cirrhotic rats suffered from severe PHT and splanchnic hyperdynamic circulation, characterized by increased portal pressure (PP), cardiac output (CO), cardiac index (CI), and superior mesenteric artery (SMA) flow. Mesenteric arterioles in cirrhotic rats displayed remarkable vasodilation, vascular remodeling, and hypocontractility. RNA sequencing was performed based on these findings. A total of 1,637 differentially expressed genes (DEGs) were detected, with 889 up-regulated and 748 down-regulated genes. Signaling pathways related to vascular changes were enriched, including the vascular endothelial growth factor (VEGF), phosphatidylinositol-3-kinase-AKT (PI3K-AKT), and nuclear factor kappa light chain enhancer of activated B cells (NF-κB) signaling pathway, among others. Moreover, the top ten hub genes were screened according to the degree nodes in the protein-protein interaction (PPI) network. Functional enrichment analyses indicated that the hub genes were involved in cell cycle regulation, mitosis, and cellular response to oxidative stress and nitric oxide (NO). In addition, promising candidate drugs for ameliorating PHT, such as resveratrol, were predicted based on hub genes. Taken together, our study highlighted remarkable changes in the mesenteric arterioles of cirrhotic rats with PHT. Transcriptome analyses revealed the potential molecular mechanisms of vascular changes in splanchnic hyperdynamic circulation.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    人类对了解医学科学各个方面的好奇心使人类解开了关于人类生存生理学的最深层秘密,在这个过程中,已经达到了一个世纪前只能想象的里程碑。最近的突破性突破帮助世界各地的科学家和医生更新疾病的科学基础,从而进一步提高治疗效果。根据最近的研究,科学家发现肠道菌群与疾病的发病机理之间存在联系,包括心血管疾病.肠道微生物群的典型栖息地的任何变化都已显示出导致各种代谢和心脏疾病的高潮。因此,肠道微生物群可以被认为影响疾病的发展过程。生活在肠道中的细菌物种的组成和功能的任何变化都可能对身体产生有益和有害的影响。肠道菌群通过多种机制实现这一作用。各种代谢物的产生,如TMAO(三甲胺N-氧化物),增加各种细菌抗原的可接受性,在各种代谢途径如胆汁酸途径中,酶作用的破坏可能导致代谢和心血管疾病的发展。即使它们可能不是疾病发病的唯一病因,它们很可能是导致病情恶化的一个因素。研究表明,它们在动脉粥样硬化斑块形成和血压升高等心血管疾病的进展中积极发挥作用。本文的重点是建立各种心血管疾病与肠道微生物群之间的关系。这可能对临床医生有益,卫生保健提供者,和科学家在治疗心脏病患者的同时开发新的治疗算法。
    Relentless human curiosity to understand the basis of every aspect of medical science has led humanity to unlock the deepest secrets about the physiology of human existence and, in the process, has reached milestones that a century ago could only be imagined. Recent ground-breaking breakthroughs have helped scientists and physicians all over the world to update the scientific basis of diseases and hence further improve treatment outcomes. According to recent studies, scientists have found a link between intestinal flora and the pathogenesis of diseases, including cardiovascular diseases. Any change in the typical habitat of gut microbiota has been shown to result in the culmination of various metabolic and cardiac diseases. Therefore, gut microbiota can be credited for influencing the course of the development of a disease. Any change in the composition and function of bacterial species living in the gut can result in both beneficial and harmful effects on the body. Gut microbiota achieves this role by numerous mechanisms. Generations of various metabolites like TMAO (trimethylamine N-oxide), increased receptibility of various bacterial antigens, and disruption of the enzyme action in various metabolic pathways like the bile acids pathway may result in the development of metabolic as well as cardiovascular diseases. Even if they may not be the only etiological factor in the pathogenesis of a disease, they may very well serve as a contributing factor in worsening the outcome of the condition. Studies have shown that they actively play a role in the progression of cardiovascular diseases like atherosclerotic plaque formation and rising blood pressure. The focus of this review article is to establish a relation between various cardiovascular diseases and gut microbiota. This could prove beneficial for clinicians, health care providers, and scientists to develop novel therapeutic algorithms while treating cardiac patients.
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  • 文章类型: Journal Article
    迄今为止,许多研究证明,COVID-19增加了血栓形成和凝血病的发生率,但这种疾病结局背后的确切机制尚不清楚.本文对COVID-19发病过程中肺栓塞患者血栓形成的病理生理学及锌、铜在此过程中的作用进行综述。由于锌和铜的抗炎和抗氧化特性,补充锌和铜可能对COVID-19患者有益。另一方面,生物体中过量的这些微量元素可能是有害的,这就是为什么首先应该标记这些微量营养素的水平。我们还建议进一步研究在COVID-19血栓形成过程中锌和铜的诊断和治疗选择,以发挥其在患者护理中的潜力,特别强调他们的不平衡的剂量和持续时间。
    To date, many studies have proved that COVID-19 increases the incidence of thrombus formation and coagulopathies but the exact mechanism behind such a disease outcome is not well known. In this review we collect the information and discuss the pathophysiology of thrombus formation in patients with pulmonary embolism in the course of COVID-19 disease and the role of zinc and copper in the process. Supplementation of zinc and copper may be beneficial for COVID-19 patients due to its anti-inflammatory and anti-oxidative properties. On the other hand, excess of those microelements in the organism may be harmful, that is why marking the level of those micronutrients should be done at first. We also propose further investigation of diagnostic and therapeutic options of zinc and copper in course of COVID-19 thrombus formation to their potential in patient care, with particular emphasis on the dosage and the duration of their misbalance.
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  • 文章类型: Journal Article
    UNASSIGNED:糖尿病患者的视锥细胞由于代谢和血管变化而处于危险之中。通过在高倍率下成像视网膜血管建模,我们减少了它对圆锥分布测量的影响。视网膜血管图像和视网膜厚度测量提供了有关视锥微环境的信息。
    UNASSIGNED:我们比较了10名糖尿病受试者(28-78岁)的视锥数据与我们公布的36名年轻和10名老年对照的规范。所有受试者均同意并以印第安纳大学机构审查委员会批准的方式进行测试。遵守赫尔辛基宣言。使用自定义自适应光学扫描激光检眼镜(AOSLO)对视锥和视网膜微循环进行成像。我们计算了中央凹和颞叶视网膜蒙太奇的视锥细胞,使用4个在0.9-7度内的非连续样品,这些样品被选择为视锥细胞的最佳可见性和最少的病理学。数据用两个参数指数模型拟合:ln(视锥密度)=a*微米偏心率+b。将这些结果与来自SDOCT的视网膜厚度测量结果进行比较。
    UASSIGNED:糖尿病视锥图的变化比对照组更大,包括斑块,或者异常明亮和黑暗的锥体,中央和更外围。模型参数和黄斑中心14度内的总视锥细胞在糖尿病患者中有所不同。总视锥分为两组:5例与正常情况相似。2名年轻糖尿病受试者和3名老年受试者中的2名低于正常值,低,但不超出信心限制。糖尿病患者视网膜血管均有不同程度的重塑:微动脉瘤;毛细血管增厚,变薄,或弯曲;和血管伸长,包括毛细管环,缠结,和抵押品。然而,SD-OCT显示,在任何象限中,没有糖尿病受试者的总视网膜厚度超出对照组的置信区间。
    未经证实:AOSLO图像指出了所有糖尿病患者眼中广泛的视网膜血管重塑,但SDOCT显示视网膜厚度没有增加.在所有糖尿病患者中都发现了锥体反射率的变化,但只有一些锥体密度明显低。这些结果与神经的早期变化一致,胶质,或视网膜的血管成分,由于渗出而没有明显的视网膜增厚。
    UNASSIGNED: Cones in diabetic patients are at risk due to metabolic and vascular changes. By imaging retinal vessel modeling at high magnification, we reduced its impact on cone distribution measurements. The retinal vessel images and retinal thickness measurements provided information about cone microenvironment.
    UNASSIGNED: We compared cone data in 10 diabetic subjects (28-78 yr) to our published norms from 36 younger and 10 older controls. All subjects were consented and tested in a manner approved by the Indiana University Institutional Review Board, which adhered to the Declaration of Helsinki. Custom adaptive optics scanning laser ophthalmoscopy (AOSLO) was used to image cones and retinal microcirculation. We counted cones in a montage of foveal and temporal retina, using four non-contiguous samples within 0.9-7 deg that were selected for best visibility of cones and least pathology. The data were fit with a two parameter exponential model: ln(cone density) = a * microns eccentricity + b. These results were compared to retinal thickness measurements from SDOCT.
    UNASSIGNED: Diabetic cone maps were more variable than in controls and included patches, or unusually bright and dark cones, centrally and more peripherally. Model parameters and total cones within the central 14 deg of the macula differed across diabetic patients. Total cones fell into two groups: similar to normal for 5 vs. less than normal for 2 of 2 younger diabetic subjects and 3 older subjects, low but not outside the confidence limits. Diabetic subjects had all retinal vascular remodeling to varying degrees: microaneurysms; capillary thickening, thinning, or bends; and vessel elongation including capillary loops, tangles, and collaterals. Yet SD-OCT showed that no diabetic subject had a Total Retinal Thickness in any quadrant that fell outside the confidence limits for controls.
    UNASSIGNED: AOSLO images pinpointed widespread retinal vascular remodeling in all diabetic eyes, but the SDOCT showed no increased retinal thickness. Cone reflectivity changes were found in all diabetic patients, but significantly low cone density in only some. These results are consistent with early changes to neural, glial, or vascular components of the retinal without significant retinal thickening due to exudation.
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  • 文章类型: Journal Article
    皮质扩散抑郁或CSD是一种电生理现象,影响大脑生理学的各种观点,如离子平衡,神经递质水平,和大脑中的血液流动。这种现象对脑功能的影响更大,并导致人类许多疾病的病理贡献,如先兆偏头痛,中风,和创伤性脑损伤。各种因素,如营养,压力,睡眠,年龄,酒精,炎症和氧化应激使病情恶化并影响CSD易感性。离子失衡和神经递质改变等潜在机制是相互关联的,可能会使CSD的病情恶化。因此,纠正这些主要罪犯可能会改善CSD的繁琐影响,从而在与CSD相关的疾病中提供益处。这篇综述整理了大多数使人们容易患上CSD疾病的触发因素及其潜在机制。
    Cortical spreading depression or CSD is an electrophysiological phenomenon affecting various perspectives of brain physiology such as ionic balance, neurotransmitter level, and blood flow in the brain. This phenomenon has greater impact on the brain function and results in the pathological contribution of many diseases in humans such as migraine with aura, stroke, and traumatic brain injury. Various factors such as nutrition, stress, sleep, age, alcohol, inflammation and oxidative stress worsen the condition and affect CSD susceptibility. The underlying mechanisms such as ionic imbalance and neurotransmitters\' alteration are interconnected and may worsen the condition of CSD. Thus, correction of these main culprits might ameliorate the cumbersome effect of CSD, thereby providing benefits in diseases associated with CSD. This review collates most of the triggering factors that makes one prone to the CSD condition along with its underlying mechanisms.
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