Cardio-cerebral Vascular Diseases Research Articles

Embelin and Its Role in Chronic Diseases.

Embelia ribes Burm of Myrsinaceae family has been widely used as an herb in the traditional medicine of India. Embelin is an active component extracted from the fruits of Embelia ribes. It has a wide spectrum of biological activities and is not toxic at low dose. This review focuses on the physical-chemical properties and bioactivities of Embelin, as well as its effects on chronic diseases such as tumors, autoimmune inflammatory diseases, parasitic infections, microbial infections, diabetes, obesity, and cardio-cerebral vascular diseases. The underlying mechanisms of the effects are also discussed. As a multiple-targeted therapeutic agent, Embelin has the potential to be used widely for the treatment of a variety of chronic diseases, including malignant tumors.

High red blood cell folate is associated with an increased risk of death among adults with diabetes, a 15-year follow-up of a national cohort

Background and aimTo describe the mortality and fatality of diabetes and assess their relationship with the level of red blood cell (RBC) folate. Methods and resultWe analyzed the data of 526 adults with diabetes who participated in the National Health and Nutrition Examination Survey (1991–1994) as the baseline examination, and were followed up through December 31, 2006. Estimates of the hazard ratios (HRs) of selected death causes for individuals with different levels of RBC folate were obtained from Cox proportional hazards regression. A total of 295 deaths were recorded by the end of a 15-year follow-up with a mortality rate of 58.48 per 1000 person year (py). Diabetes was listed as a contributing cause for 136 deaths, accounting for 46.1% of the total deaths with a fatality rate 26.96 per 1000 py. Mortality rate for all-cause in the group with upper quartile of RBC folate was almost twice as high as that among the group with lower quartile, 82.75 vs. 44.10 per 1000 py. After adjusting for covariates, including serum concentration of vitamin B12, cotinine, homocysteine and the history of cardio-cerebral vascular diseases assessed at the baseline, the HRs for dying from any causes were 1.00 (reference), 1.82 (95% CI = 1.25–2.66) and 2.10 (1.37–3.20) among diabetic adults with lower, intermediate, and upper quartiles of RBC folate. ConclusionDiabetes was listed as a contributing cause for less than half of the deaths among adults with diabetes after 15+ years of follow-up; high RBC folate concentration was associated with an elevated risk of death among adults with diabetes.

노인여성들의 복부비만(WHR) 수준과 혈압, 혈중 지질 및 당뇨병 지표의 관계

Elderly population and chronic diseases, such as hypertension, diabetes have been increased rapidly in South Korea. The purpose of this study was to determine the relationships between Waist-Hip Ratio (WHR), blood lipids and diabetes indicators in Korean elderly women. Subjects of this study were Korean elderly women(n=152). They were divided into one of two groups (WHR ≤ .86, NOG, n =41; WHR ≥ .87, OG , n=111). Research variables were blood pressure indicators, such as systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP); blood lipids, such as cardiovascular risk factor (CRF), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C); diabetes indicators, such as glycated hemoglobin (HbA1c), fasting blood glucose (FBG). The results are as follows : BR First, WHR showed low validity for reflecting on blood pressure indicators in Korean elderly women.BR Second, Korean elderly women showed an increase in PP with SBP elevation and DBP decline.BR Third, regardless of abdominal obesity, Korean elderly women mostly belong to a certain range of prediabetes or diabetes.BR Fourth, WHR of Korean elderly women showed a significant explanatory power for diabetes diagnosis indicators, such as HbA1c, FBG.BR In summary, Korean elderly women showed a high probability of onset of cardio-cerebral vascular diseases and peripheral blood vessel diseases. Blood indicators showed more accurate diagnosis of geriatric multiple chronic diseases than blood pressure indicators in elderly women. Abdominal obesity diagnosis index WHR was an useful indicator for the prevention and management of diabetes-related multiple chronic diseases in Korean elderly women.BR

Decision tree analysis of traditional risk factors of carotid atherosclerosis and a cutpoint-based prevention strategy.

BackgroundReducing the exposure to risk factors for the prevention of cardio-cerebral vascular disease is a crucial issue. Few reports have described practical interventions for preventing cardiovascular disease in different genders and age groups, particularly detailed and specific cutpoint-based prevention strategies.MethodsWe collected the health examination data of 5822 subjects between 20 and 80 years of age. The administration of medical questionnaires and physical examinations and the measurement of blood pressure, fasting plasma glucose (FPG) and blood lipids [total cholesterol (TC), triglycerides (TG), high density lipoprotein–cholesterol (HDL-C), and low density lipoprotein-cholesterol (LDL-C)] were performed by physicians. Carotid ultrasound was performed to examine the carotid intima-media thickness (CIMT), which was defined as carotid atherosclerosis when CIMT ≥0.9 mm. Decision tree analysis was used to screen for the most important risk factors for carotid atherosclerosis and to identify the relevant cutpoints.ResultsIn the study population, the incidence of carotid atherosclerosis was 12.20% (men: 14.10%, women: 9.20%). The statistical analysis showed significant differences in carotid atherosclerosis incidence between different genders (P<0.0001) and age groups (P<0.001). The decision tree analysis showed that in men, the most important traditional risk factors for carotid atherosclerosis were TC (cutpoint [CP]: 6.31 mmol/L) between the ages of 20–40 and FPG (CP: 5.79 mmol/L) between the ages of 41–59. By comparison, LDL-C (CP: 4.27 mmol/L) became the major risk factor when FPG ≤5.79 mmol/L. FPG (CP: 5.52 mmol/L) and TG (CP: 1.51 mmol/L) were the most important traditional risk factors for women between 20–40 and 41–59 years of age, respectively.ConclusionTraditional risk factors and relevant cutpoints were not identical in different genders and age groups. A specific gender and age group-based cutpoint strategy might contribute to preventing cardiovascular disease.

Aspirin resistance and its related factors in patients with stage 3-4 chronic kidney disease

Objective To investigate aspirin resistance (AR) and its related factors in patients with stage 3-4 chronic kidney disease(CKD). Methods The clinical data of 108 patients with stage 3-4 CKD from nephrology department in Beijing Chaoyang Hospital were collected (CKD group); and 110 age and sex-matched subjects with normal renal function served as control group. Anthropometric parameters, blood biochemistry index, ultrasonography and thromboelastograph (TEG) were examined in both groups; and inhibition ratio of arachidonic acid>50% on TEG was defined as AR. Results The incidence of cardio-cerebral vascular disease, the incidence of peripheral vascular disease, ratio of female, the intima-media thickness (IMT) of carotid artery, the levels of high-sensitive C-reactive protein(hsCRP), homocysteine(Hcy), evaluated glomerular filtration rate(eGFR) and maximal thrombelastodegree (MA) on TEG in CKD group were significantly higher than those in control group (all P<0.05), while R value was significantly lower in CKD group. Pearson's correlation analysis revealed that the levels of MA, hsCRP, Hcy, IMT were positively correlated and R value was negatively correlated with eGFR in CKD group. The incidence of AR in CKD group (32.4%) was significantly higher than in control group (20.0%). According to TEG, the patients were divided into AR group (n=35) and aspirin sensitive (AS) group (n=73). The incidence of cardio-cerebral vascular disease, the incidence of peripheral vascular disease, ratio of female, IMT, ratio of diabetes, the levels of hsCRP, Hcy, fasting plasma glucose (FBG), eGFR and MA in AR group were significantly higher than those in AS group (all P<0.05), while R value was significantly lower in AR group. Binary logistic regressive analysis revealed that the ratio of diabete, FBG, eGFR, hsCRP were independent risk factors for AR in patients with stage 3-4 CKD. Conclusions CKD stage 3-4 is associated with increased ratio of platelet activation and atherosclerosis, and this condition is aggravated while eGFR declining. Incidence of AR is 32.4% in this group of CKD patients, the independent risk factors of AR in CKD patients are the ratio of diabetes, FBG, eGFR and hsCRP. Key words: Chronic kidney disease; Aspirin resistance; Risk factors

Impact of isolated diastolic hypertension on new-onset cardiovascular and cerebro-vascular diseases

To explore the impact of isolated diastolic hypertension (IDH) on new-onset cardio-cerebral vascular diseases (CVD). This cohort study involved 101 510 participants who were employees of the Kailuan Group-a state-run coal mining company, in 2006 and 2007. Among them, 6 780 subjects were diagnosed with IDH, 35 448 subjects were diagnosed with high-normal blood pressure and 19 460 subjects were diagnosed with normal tension. However, none of them had the history of either cardio-cerebral vascular disease or malignant cancer. Cardio-cerebral vascular events including cerebral infarction, cerebral hemorrhage, acute myocardial infarction were recorded every 6 months during the follow-up (47.1 ± 4.8) period. Multivariable Cox proportional hazards regression models were used to analyze the risk factors of first-ever CVD events. 1) There were 675 CVD events occurred during the follow-up period. The incidence rates of CVD events (1.7% vs. 0.9%), cerebral infarction (1.0% vs. 0.6%) and cerebral hemorrhage (0.4% vs. 0.1%) were significantly higher in IDH group than that in the normal tension group (all P < 0.05). 2) After adjustment for other established CVD risk factors, the hazards ratios became 1.67 (95% CI: 1.28-2.17) for total CVD events and 1.59 (95% CI: 1.12-2.27) for cerebral infarction and 2.67 (95% CI: 1.54-4.65) for cerebral hemorrhage in the IDH group. 3). In stratified analysis on age, after adjustment for other established CVD risk factors, the hazards ratio was 2.22 (95% CI: 1.41-3.50) for cerebral infarction in lower 60 years old group, while the it was 7.27 (95% CI: 2.58-20.42) for cerebral hemorrhage in groups older than 60 years of age. IDH was the independent risk factor for the total cardio-cerebral vascular events, on both cerebral infarction and cerebral hemorrhage. The predicted values of IDH for different CVD events were diverse on different age groups.

In vivo angiogenesis screening and mechanism of action of novel tanshinone derivatives produced by one-pot combinatorial modification of natural tanshinone mixture from Salvia miltiorrhiza.

BackgroundNatural products present in low quantity in herb medicines constitute an important source of chemical diversity. However, the isolation of sufficient amounts of these low abundant constituents for structural modification has been a challenge for several decades and subsequently halts research on the utilization of this important source of chemical entities for drug discovery and development. And, pro-angiogenic therapies are being explored as options to treat cardio-cerebral vascular diseases and wound healing recently. The present study investigates the pro-angiogenic potential of tanshinone derivatives produced by one-pot synthesis using zebrafish model.Methodology/Principal FindingsIn order to address the difficulty of chemical modification of low abundant constituents in herb medicines, a novel one-pot combinatorial modification was used to diversify a partially purified tanshinone mixture from Salvia miltiorrhiza. This led to the isolation of ten new imidazole-tanshinones (Compounds 1–10) and one oxazole-tanshinone (Compound 11), the structures of which were characterized by spectroscopic methods in combination with single-crystal X-ray crystallographic analysis. The angiogenesis activities of the new tanshinone derivatives were determined in an experimental model of chemical-induced blood vessels damage in zebrafish. Of all the tested new derivatives, compound 10 exhibited the most potent vascular protective and restorative activity with an EC50 value of 0.026 µM. Moreover, the mechanism underlying the pro-angiogenesis effect of 10 probably involved the VEGF/FGF-Src-MAPK and PI3K-P38 signalling pathways by gene expression analysis and a blocking assay with pathways-specific kinase inhibitors.Conclusions/SignificanceTaken together, our study demonstrated the more distinctive pro-angiogenic properties of 10 than other tanshinones and revealed 10 has potential for development as a pro-angiogenic agent for diseases associated with insufficient angiogenesis. Our results highlighted the great potential of adopting a newly modified one-pot approach to enhance the chemical diversity and biological activities of constituents from natural products regardless of their abundances.

Impaired verbal memory is a significant predictor of early cerebral‐cardiovascular death, an 18‐year follow‐up of a national cohort

The mortality pattern of individuals with impaired verbal memory (IVM) has not yet been well described. We sought to describe the risk of all-causes, as well as specific causes of death associated with IVM. We used the data of 4151 nationally representative adults ≥60 years old who participated in the third National Health and Nutrition Examination Survey, 1988-1994, and completed one non-contextual (i.e., word list memory) and one contextual delayed-recall tests (i.e., short story recall). The participants were passively followed up through 31 December 2006. We determined the hazard ratio of death from all-causes and specific cause through Cox proportional hazard regression. Severe and moderate IVM were present in 268 (6.5%) and 495 (11.9%) participants at baseline survey, and 2550 deaths occurred by the end of 18-year follow-up (median = 12 years). The medians of survival time adjusted for all-causes death were 6.17 (95% CI: 5.50, 6.92), 9.50 (8.92, 10.25), and 13.17 (12.75, 13.58) years, respectively for the individuals with severe, moderate, and no IVM. Severe IVM was significantly associated with death from cardio-cerebral vascular diseases [hazard ratio = 1.70, 95% CI = (1.36-2.12)], stroke [2.60 (1.69-3.99)], and Alzheimer's disease [3.50 (1.40-8.76)]. The shortened survival time of the participants with IVM was mainly driven by the deaths of cerebral-cardiovascular diseases, which accounted for almost half of all deaths. The predictability of memory scores to early cerebral-cardiovascular deaths demonstrated that central challenge among individuals with cognitive impairment was cardiovascular diseases management.

Resistance to acetylsalicylic acid in patients with type 2 diabetes mellitus is associated with lipid disorders and history of current smoking

BackgroundDiabetes mellitus (DM) is an important risk factor for stroke. Acetylsalicylic acid (ASA) is the most frequently used medication for prevention of cardio-cerebral vascular diseases. However, some patients experience ischaemic vascular events despite the use of ASA. This phenomenon is known as “aspirin resistance” (AR). The aim of this study was to assess the prevalence of AR in diabetic patients and search for factors associated with it.Materials and methodsThe examined group consisted of 96 subjects with diagnosed type 2 DM. Platelet function test was performed by the method of whole blood impedance aggregometry.ResultsAmong examined subjects, 51 patients (53.1 %) were sensitive to ASA action (ASA responders) and 45 patients (46.9 %) were resistant to ASA action (ASA non-responders). No association was found between platelet aggregation and gender, age, dose of ASA, known duration of diabetes, BMI, heart rate, mean systolic and diastolic blood pressure, and risk factors except for current smoking (p = 0.030). ASA non-responders were treated shorter with ASA than ASA responders (p = 0.010). The mean total cholesterol (p = 0.020), LDL concentration (p = 0.005), HCT (p = 0.010), WBC (p = 0.030), and PLT (p = 0.050) were significantly higher in ASA non-responders. No association was found between AR and results of other laboratory tests and medications. Multiple logistic regression analysis revealed factors associated with AR: current smoking and LDL concentration higher than 3.5 mmol/l.ConclusionsResults of our study did not confirm the association between poor glycaemic control in the diabetic patients and AR. Resistance to ASA in diabetic patients is associated with lipid disorders and history of current smoking.

Post-Stroke Cognitive Disorders and Associated Factors in French Speaking West Africa, Benin Case

Introduction: Cognitive disorders frequency arising after a cardio-cerebral vascular disease (stroke) is currently on the rise due to the ageing population and the increase in the number of survivors after stroke occurrence. Objective: Determining post-stroke cognitive decline and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study which was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. The study involved 100 patients who have known stroke for at least the past 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. The cognitive decline (CD) was estimated by using a modified and adapted MMSE to suit our cultural era. Results: All patients were aged 58.9 years ± 13.6 years. Sex-ratio was 1.4. Cognitive decline frequency was 20%. Post-stroke cognitive decline frequency per sex was 11.6% and 8.4% respectively for females and males. Ischemia stroke patients had a higher cognitive decline (22.5%). 58.3% had severe CD. Moreover the CD frequency increased with time, from 16.7% in a year to 50% in 3 years. Total MMSE varied from 6 to 23 with 21 as median. From the unvaried analysis, the presence of sphincter disorders (1.26 [0.35-4.59], p = 0.004), consciousness disorders (15.67 [1.46-168], p = 0.04), and convulsion disorders (3.77 [1.01 -14.00], p = 0.003) was associated with cognitive decline. From multi-varied analysis, the sole presence of convulsive attacks (11.5 [1.79-73.58], p = 0.01) was individually associated with post-stroke cognitive decline. Conclusion: This study reveals the importance of CD after stroke. The occurrence of convulsions at stroke acute stage is a prognostic factor of CD medium or long-term occurrence. The overall coverage improvement depends on the integration of these data in stroke reach-out programs.

Advance in studies on chemical constitutions, pharmacological mechanism and pharmacokinetic profile of Dalbergiae Odoriferae Lignum

Dalbergiae Odoriferae Lignum is a traditional Chinese medicine (TCM) commonly used for promoting blood circulation, relieving pain and removing blood stasis. Volatile oil and flavonoid compounds are two main chemical constituents of Dalbergiae Odoriferae Lignum. Modern pharmacological studies show that Dalbergiae Odoriferae Lignum has many effects, such as relaxing blood, increasing blood flow of coronary, anti-oxidation, anti-inflammation and antitumor. Dalbergiae Odoriferae Lignum, as a characteristic TCM with the potential of further development, is generally compatible with other TCMs to treat cardio-cerebral vascular diseases. This article summarizes studies on chemical composition, pharmacological action, pharmacokinetic procfile in vivo and TCM compatibility in recent years, in order to provide references for further studies.

The relationship between self-rated health and objective health status: a population-based study.

BackgroundSelf-rated health (SRH), a subjective assessment of health status, is extensively used in the public health field. However, whether SRH can reflect the objective health status is still debatable. We aim to reveal the relationship between SRH and objective health status in the general population.MethodsWe assessed the relationship between SRH and objective health status by examining the prevalence of diseases, laboratory parameters, and some health-related factors in different SRH groups. Data were collected from 18,000 residents randomly sampled from the general population in five cities of China (3,600 in each city). SRH was assessed by a single-item health measure with five options: “very good,” “good,” “fair,” “bad,” and “very bad.” The differences in prevalence of diseases, laboratory parameters, and health-related factors between the “healthy” (very good plus good), “relatively healthy” (fair), and “unhealthy” (bad plus very bad) groups were examined. The odds ratios (ORs) referenced by the healthy group were calculated using logistic regression analysis.ResultsThe prevalence of all diseases was associated with poorer SRH. The tendency was more prominent in cardio-cerebral vascular diseases, visual impairment, and mental illnesses with larger ORs. Residents with abnormalities in laboratory parameters tended to have poorer SRH, with ORs ranging from 1.62 (for triglyceride) to 3.48 (for hemoglobin among men) in a comparison of the unhealthy and healthy groups. Most of the health-related factors regarded as risks were associated with poorer SRH. Among them, life and work pressure, poor spiritual status, and poor quality of interpersonal relationships were the most significant factors.ConclusionsSRH is consistent with objective health status and can serve as a global measure of health status in the general population.

Effect of &lt;i&gt;Vaccinium dunalianum&lt;/i&gt; Glycoside on Platelet Aggregation in Animals

1-O-(p-hydroxyphenyl)-6-O-caffeoyl-β-D-glucoside (PPCG) was isolated in extraordinary high yield from the dried buds of Vaccinium dunalianum. The present study was aimed to investigate the effect of PPCG on platelet aggregation in animals. In in vitro tests, PPCG showed an inhibitory effect on ADP/PAF-induced platelet aggregation. PPCG significantly prolonged the mice bleeding and clotting time. PPCG (100 and 200 mg/kg) dose dependently reduced mortality of ADP-induced acute pulmonary thromboembolism mice to 80% and 70%, respectively, a high dose (200 mg/kg) of that can reduce serum TC and TG levels of the experimental hyperlipidemia animals, but cannot lower blood viscosity. The observations provide a scientific basis for traditional use of this plant for the treatment of articular rheumatism. Furthermore, these results also suggested that PPCG had anti-thromboembolic effects and good prospects for drug development of cardio-cerebral vascular diseases.

Association between Interleukin-1 Gene Single Nucleotide Polymorphisms and Ischemic Stroke Classified by TOAST Criteria in the Han Population of Northern China

Increasing evidence suggests that IL-1β (C-511T) and IL-1α (C-889T) genes polymorphisms are associated with the susceptibility to cardiocerebral vascular disease. In this paper, we investigated the relationships between these polymorphisms and the risk of ischemic stroke (IS) classified by TOAST criteria in the north Chinese Han population. 440 cases of IS and 486 age- and gender-matched controls of Chinese Han population were enrolled. Association study showed that the TT genotype and T allele of IL-1α-889 C/T were significantly associated with IS of a large artery atherosclerosis (LAA) (TT: OR = 2.01, 95% CI = 1.34–3.0, and P < 0.001; T: OR = 1.44, 95% CI = 1.18–1.78, and P = 0.001). However, there was no significant difference in the distribution of IL-1α-889 C/T genotypes and allele frequencies between the two subgroups (small-artery occlusion (SVD) and cardioembolism (CE)) of IS and control groups. No significant association was also found between the IL-1β-511 TT genotype and T allele (TT: OR = 0.79, 95% CI = 0.56–1.11, and P = 0.175; T: OR = 0.83, 95% CI = 0.68–1.01, and P = 0.066) and IS as well as subgroups of CE and SVD. Our results implicated that IL-1α-889 C/T gene polymorphism might be associated with the susceptibility to IS, especially to IS with LAA, in a north Chinese Han population.

Preservation of residual renal function by not removing water in new hemodialysis patients: a randomized, controlled study

To investigate the effect of no water removal (NWR) on preservation of residual renal function (RRF) in new hemodialysis (HD) patients. Fifty-six patients with a daily urine volume ≥ 1,000 mL were included. Patients were randomized to different fluid management groups of NWR or water removal (WR) for 6 months. If predialysis BP was >150/90 mmHg, patients could take antihypertensive drugs. The primary endpoints included death, cardio-cerebral vascular disease, refractory hypertension, and edema or an auxiliary examination indicating obvious fluid retention. The secondary endpoint was oliguria. A daily urine volume, 24-h urine creatinine clearance, the defined daily dose (DDD) index of antihypertensive drugs, erythropoietin resistance index, cardiothoracic ratio, and left ventricular mass index (LVMI) were recorded. Eight patients in the NWR group reached the primary endpoints. Nine patients in the WR group reached the secondary endpoint. At the end of the study, patients in the NWR group had more increased systemic blood pressure (9.0 ± 8.3 vs. -2.4 ± 2.0 mmHg, p < 0.001), DDD index (1.2 ± 1.02 vs. -0.9 ± 0.51, p < 0.001), daily urine volume (164 ± 351 vs. -726 ± 342 mL, p < 0.001), cardiothoracic ratio (0.02 ± 0.04 vs. -0.03 ± 0.03, p < 0.001), LVMI (9.6 ± 17.0 vs. -12.0 ± 21.4 g/m(2), p < 0.001), and less decreased urine creatinine clearance (-1.0 ± 0.4 vs. -2.0 ± 1.0, p < 0.001), compared with those patients in the WR group. Preservation of RRF by NWR is warranted in new HD patients, but is not appropriate for all patients.

342 CLINICAL ANALYSIS OF OBSTRUCTIVE SLEEP APNEA-HYPOPNEA SYNDROME-RELATED HYPERTENSIVE PATIENTS

Objective: To analyze the clinical characteristics, distribution and complications of obstructive sleep apnea-hypopnea syndrome (OSAHS)-related hypertensive patients. Methods: Retrospective study was performed in 1976 hypertensive patients at department of hypertension in People‘s Hospital of Xinjiang Uygur Autonomous Region from Jan 2004 to March 2010, which were divided into four groups according to the findings of polysomnography (PSG): hypertension without OSAS (group 1, n=386), hypertension with mild OSAHS (group 2, n=581), hypertension with moderate OSAHS (group 3, n=458) and hypertension with severe OSAHS (group 4, n=551). Results: Compared with group 4, patients in other groups had lower values of waist circumference[(95.1±9.5), (98.5±9.3), (100.1±8.7) vs.(103.5±9.8)cm], body mass index[(26.8±3.0), (27.6±3.2),(28.8±3.4) vs.(29.3±3.4)kg/m2],systolic blood pressure[(143.1±18.3), (142.6±18.0), (142.9±17.7) vs. (145.8±18.6) mmHg] and diastolic blood pressure[(94.7±12.5), (93.7±11.4), (94.1±11.6) vs.(96.9±12.9)mmHg] (P<0.05). The detection rate of sleep apnea-related hypertension patients in male was higher than in female among 1976 subjects [83.3% (1239/1487) vs.71.8% (351/489), χ2=31.139, P<0.01)].The detection of inpatients with hypertension aged between 60 and 70 years was the highest (94.7% in male, 94.7% in female).The prevalence of the young, middle-aged and elderly in these subjects was 39.8%, 46.3% and 13.8%, respectively. Of all sleep apnea-related hypertensive patients, 92.4% was the overweight and obesity. Compared with group IV, the detection of coronary heart disease, cerebral disease and adipose hepatica in other groups was lower (P<0.008). Conclusions: High occurrence of sleep apnea-related hypertension is found in male and obesity. The peak age of high occurrence was 60∼70 years. Severe sleep apnea-related hypertension is susceptible to combine with cardio-cerebral vascular diseases and clinicians should pay more attention to it.

HPLC–MS/MS Analysis of a Traditional Chinese Medical Formulation of Bu-Yang-Huan-Wu-Tang and Its Pharmacokinetics after Oral Administration to Rats

Bu-yang-huan-wu-tang (BYHWT) is one of the most popular formulated traditional Chinese medicine prescriptions, and is widely for prevention of ischemic cardio-cerebral vascular diseases and stroke-induced disability. A specific high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) has been developed and validated for simultaneous quantification of the nine main bioactive components, i.e., astragaloside I, astragaloside II, astragaloside IV, formononetin, ononin, calycosin, calycosin-7-O-β-d-glucoside, ligustilide and paeoniflorin in rat plasma after oral administration of BYHWT extract. This method was applied to investigate the pharmacokinetics in conscious and freely moving rats. No significant matrix effects were observed. The overall analytical procedure was rapid and reproducible, which makes it suitable for quantitative analysis of a large number of samples. Among them, three astragalosides and four isoflavones in A. membranaceus, ligustilide in Radix Angelicae Sinensis and Rhizoma Ligustici Chuanxiong and paeoniflorin in Radix Paeoniae Rubra were identified. This developed method was then successfully applied to pharmacokinetic studies of the nine bioactive constituents after oral administration of BYHWT extracts in rats. The pharmacokinetic data demonstrated that astragaloside I, astragaloside II, astragaloside IV and ligustilide presented the phenomenon of double peaks. The other herbal ingredients of formononetin, ononin, calycosin, calycosin-7-O-β-d-glucoside and paeoniflorin appeared together in a single and plateau absorption phase. These phenomenona suggest that these components may have multiple absorption sites, regulation of enterohepatic circulation or the gastric emptying rate, or there is ingredient-ingredient interaction. These pharmacokinetic results provide a constructive contribution to better understand the absorption mechanism of BYHWT and to support additional clinical evaluation.

Current progress of research on pharmacologic actions of salvianolic acid B

As one of the main water-soluble composites of Radix Salviae, salvianolic acid B is a phenolic acid ingredient of the Chinese drug, which is rich content in the herb and has strong pharmaceutical activity. It is used to treat cardiocerebral vascular diseases, antagonize hepatic/renal fibrosis, prevent cancer, and promote stem cell proliferation and differentiation. In the researches of its acting mechanisms, rather deepened studies have been carried out for its application on cardiocerebral vascular diseases, but that for others are rather fewer.

Molecular mechanism of elicitor-induced tanshinone accumulation in Salvia miltiorrhiza hairy root cultures

To develop an optimal bioprocess for the production of tanshinone which is mainly used for the treatment of cardiocerebral vascular disease, the tanshinone biosynthetic pathway regulation must be better understood. In this paper, expression of tanshinone biosynthetic pathway related genes as well as tanshinone accumulation in Salvia miltiorrhiza hairy root cultures were investigated, in response to biotic and abiotic elicitors, respectively. Our results showed tanshinone accumulation in S. miltiorrhiza hairy roots was highly regulated by the coordination of the expression of several genes involved in tanshinone biosynthesis pathway. Our results showed a positive correlation between gene expression and tanshinone accumulation, suggesting that tanshinone accumulation may be the result of the coexpression up-regulation of several genes involved in tanshinone biosynthesis under the treatment of various elicitors. Meantime, SmHMGR, SmDXS2, SmFPPS, SmGGPPS and SmCPS were identified as the potential key enzymes in the pathway for targeted metabolic engineering to increase accumulation of tanshinone in S. miltiorrhiza hairy roots. This is the first report integrating comprehensively the transcript and metabolite biosynthesis of tanshinone in S. miltiorrhiza hairy roots.

Impact of seasons on emergency visit in patients with cardio-cerebro-vascular diseases in Jiangmen district

Objective To investigate the impact of seasons on emergency visit in patients with cardio-cerebral vascular diseases in Jiangmen district. Methods The information of the patients with cardio-cerebral vascular diseases visited in the emergency department of Jiangmen Central Hospital during the 5-year period from July 2006 to June 2010, were collected. And the data of the. patients were retrospectively examined and analyzed. Results 13685 patients with cardio-cerebral vascular diseases were enrolled in the study with average 7.5 cases per day, the most frequent period is from November to February (8.1-9.0 visits/d) and the least frequent one is from May to August(6.4～6.7visits/d); the patients with coronary heart disease visited peaked in December and bottomed in May, which was obviously higher in winter than in summer; Hypertensive had a similar seasons rhythm with coronary heart disease ,which peaked in January and bottomed in June; Patients with Cerebral Infarction visited peaked in July and bottomed in December, which was much higher in summer than in winter; Patients with Cerebral Hemorrhage visited most in January. There was no season rhythm in cerebral hemorrhage and cardiac arrhythmic. Conclusion A rule of season rhythm was observed in emergency visit in patients with cardio-cerebral vascular disease in Jiangmmen district. Key words: Cardio-cerebral vascular diseases; Emergency; Season rhythm