Lower Limb Arteriosclerosis Obliterans Research Articles

MiR-34a ameliorates arterial blood flow in rats with lower limb arteriosclerosis obliterans via Sirt1 signaling pathway.

In this study, we investigated the impact of microRNA-34a (miR-34a) on lower limb arteriosclerosis obliterans in rats through the Sirtuin 1 (Sirt1) signaling pathway. Thirty-six Sprague-Dawley rats were divided into normal, model, and miR-34a mimics groups. Rats in the normal group were raised normally, while the model group underwent lower limb arteriosclerosis obliterans induction and received saline injections. The miR-34a mimics group also underwent arteriosclerosis obliterans modeling but received miR-34a mimics injections. Immunohistochemistry revealed significantly increased vascular endothelial growth factor (VEGF) expression in both model and miR-34a mimics groups compared to the normal group, with the miR-34a mimics group showing higher levels. Western blotting indicated elevated Sirt1 protein expression in both non-normal groups, with the miR-34a mimics group exhibiting significantly higher levels. Quantitative polymerase chain reaction (qPCR) demonstrated higher levels of miR-34a, VEGF mRNA, and Sirt1 mRNA in the model group compared to the normal group, but significantly lower levels than the miR-34a mimics group. Enzyme-linked immunosorbent assay (ELISA) showed increased VEGF content in the model group compared to the normal group but decreased compared to the miR-34a mimics group. Hemorrheological detection revealed a reduced PU index in both non-normal groups compared to the normal group, with a significant increase in the miR-34a mimics group compared to the model group. Overall, miR-34a upregulation enhanced VEGF expression in rat blood vessels, ameliorating arterial blood flow in lower limb arteriosclerosis obliterans through the Sirt1 signaling pathway.

Diagnostic value of dual-source spiral CT in patients with diabetic lower limb arteriosclerosis obliterans.

Diagnostic value of dual-source spiral CT in patients with diabetic lower limb arteriosclerosis obliterans.

Clinical follow-up study of paclitaxel-coated balloon in the treatment of symptomatic lower extremity arteriosclerosis obliterans

Objective To investigate the clinical effect of paclitaxel coated balloon in the treatment of symptomatic lower extremity arteriosclerosis obliterans. Methods From January 2016 to April 2017, 64 patients with symptomatic lower limb arteriosclerosis obliterans (ASO) of femoral and popliteal artery stenosis admitted to Chongming Branch Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine were selected as the research subjects.According to the principle of randomization, they were divided into two groups, 32 cases in each group.In the drug-coated group, ordinary balloon was pre-expanded, and then paclitaxel drug-coated balloon was used to expand.If there were still retraction and stenosis of diseased vessels, which affected the blood flow of lower limbs, remedial stents were implanted.Bare stent group used a slightly smaller balloon to pre-expand superficial femoral artery and then release the stent.After one year follow-up, the changes of ankle-brachial index (ABI), restenosis rate of target lesion vessels, Rutherford grading changes, clinical drive target vessel revascularization rate, perioperative period, death rate of patients during follow-up period, amputation rate and complication rate were observed. Results There were no amputations or deaths in the whole group during the perioperative period and follow-up.The incidence of complications in the drug-coated group was 3.1% (1/32), significantly lower than that in the bare stent group 18.8% (6/32) (χ2=4.010, P=0.045). Before treatment, the ABI of patients in drug-coated group and bare stent group at 6 months and 12 months after treatment were significantly different (Finter-group=7.028, Pinter-group=0.024, Fintra-group=219.028, Pintra-group=0.000, Finteraction=350.028, Pinteraction=0.000), and ABI of the two groups at 12 months after treatment were (0.73±0.11) and (0.68±0.09), respectively, the difference was statistically significant (t=1.990, P=0.025). Six months after operation, the restenosis rates of target lesions in the two groups were 9.4%(3/32) and 15.6%(5/32), respectively, with no significant difference (χ2=0.571, P=0.450); The restenosis rate of bare stent group was 37.5%(12/32) 12 months after operation, which was significantly higher than that of drug-coated group by 15.6%(5/32) (χ2=3.925, P=0.048). Clinical observation results showed that 12 months after operation, the target-lesion revascularization (TLR) of the drug-coated group was 3.1% (1/32) and that of the bare stent group was 9.4% (3/32), with no significant difference.Rutherford grading was improved in both groups(χ2=1.067, P>0.05). Conclusion Paclitaxel drug-coated balloon is safe and effective in the treatment of symptomatic lower limb arteriosclerosis obliterans, which is worthy of clinical application. Key words: Arterial occlusion of the lower limb; Drug-coated balloon; Paclitaxel; Restenosis; Ankle brachial index

MiR-126 promotes endothelial cell apoptosis by targeting PI3K/Akt in rats with lower limb arteriosclerosis obliterans.

To investigate the influence of micro ribonucleic acid (miR)-126 on the rats with lower limb arteriosclerosis obliterans (ASO). Male Sprague- Dawley rats aged 3 months old were randomly divided into Sham operation group (Control group, n=10) and Model group (n=10), and the model of lower limb ASO was established. After modeling, the expression of miR-126 in arteries was detected using quantitative Real Time-Polymerase Chain Reaction (qRT-PCR), and the change in the downstream signaling pathway was examined via Western blotting. The human umbilical vein endothelial cells (HUVECs) were induced by oxidized low-density lipoprotein (Ox-LDL) to establish the model of endothelial injury, followed by detection of miR-126 expression. Then, the Luciferase assay was performed to verify the downstream target gene of miR-126. After being cultured, HUVECs were set as Control group, Ox-LDL induction group, and Ox-LDL + miR-126 inhibitor group, and the expressions of phosphorylated-protein kinase B (p-Akt) and cleaved cysteine-aspartic protease-3 (Caspase-3) were detected in the above groups. After the establishment of the model, the expression level of miR-126 was raised in vessels, but the phosphatidylinositol 3-hydroxy kinase (PI3K)/Akt signals were weakened (p<0.01). Ox-LDL-induced endothelial cell apoptosis promoted the expression of miR-126, and the difference was statistically significant. The bioinformatics analysis results showed that PI3KR2 was a direct target of miR-126, which was also proven via the Luciferase assay. Moreover, the transfection with miR-126 inhibitor into endothelial cells suppressed Ox-LDL-induced cell apoptosis, thereby persistently activating the PI3K/Akt signaling pathway (p<0.01). In rats with lower limb arteriosclerosis obliterans (ASO), miR-126 represses the PI3K/Akt signaling pathway to accelerate endothelial cell apoptosis.

Effect of individual exercise prescription on walking ability of patients with arteriosclerosis obliterans of lower limbs

Objective To explore whether individualized exercise prescription can improve the walking ability of patients with lower extremity arteriosclerosis occlusion (ASO). Methods A total of 64 ASO patients with ankle brachial index (ABI) between 0.6 and 0.9 were randomly divided into the observation group (32 cases) and the control group (32 cases), Patients in the control group received routine nursing intervention, and patients in the observation group received nursing intervention based on individualized exercise prescription, ABI and walking impaired questionnaire (WIQ) scales were measured at admission and 12 weeks after intervention. Results There was no statistically significant difference in ABI values before and after the intervention of the control group (P > 0.05), and ABI values before and after the intervention of the observation group were 0.72 + 0.15 and 0.77 + 0.13 respectively (t=2.254, P 0.05) in the two groups; the walking distance and walking speed after intervention in the observation group were (498.38±77.11) m and (50.44±11.27); the control group was (461.72±64.64) m and (44.02±9.86), and the differences were statistically significant (t=2.06, 2.43, P < 0.05). Conclusions Individualized exercise prescription can improve the degree of ischemia of the affected limb, improve the walking distance and walking speed of the patients, and it is convenient to implement and worthy of clinical promotion. Key words: Individualized exercise prescription; Arteriosclerosis obliterans of lower extremities; Ability of walking

Clinical study on surgical treatment of lower extremity chronic ischemia caused by arteriosclerosis obliterans of lower extremity-analysis of 4 602 cases

Objective The incidence of chronic lower limb ischemia caused by arteriosclerotic obliteration of lower extremities is increasing recent years and there is a high risk of amputation and mortality. This study was to find out the changes in a single center for 16 years. Methods A retrospective analysis of the data of patients in single-center vascular surgery in the past 16 years was carried out. The patients with chronic lower limb ischemia caused by lower limb arteriosclerosis obliterans were screened out, and the data of operation information, amputation, length of stay and hospitalization expenses during hospitalization were collected. Results A total of 4 602 patients were included, of whom 57.39% were diabetic. It was found that the number of patients admitted, the number of endovascular treatment, the average cost of hospitalization increased year by year, and the average length of hospitalization decreased year by year. The amputation rate decreased from 8.12% (from 2002 to 2007) to 0.92% (from 2008 to 2017) (P<0.01). The average days of hospitalization decreased from 28.20 days (from 2002 to 2007) to 11.65 days (from 2008 to 2017) (P<0.01). The average hospitalization cost rose from 54 466.94 yuan (from 2002 to 2007) to 73 685.22 yuan (from 2008-2017) (P<0.01). There was no significant difference in amputation rate, hospitalization days and hospitalization costs between diabetic group and non-diabetic group. In diabetic subgroup, amputation rate decreased from 8.83% (between 2002 and 2007) to 1.05% (between 2008 and 2017) (P<0.01). The average hospitalization days decreased from 30.12 days (between 2002 and 2007) to 12.60 days (between 2008 and 2017) (P<0.01). The average cost of hospitalization rose from 58 530.94 yuan (between 2002 and 2007) to 74 433.75 yuan (between 2008 and 2017) (P<0.01). Conclusions From 2002 to 2017, the number of patients with chronic lower limb ischemia increased gradually, and so as the number of endovascular treatment. While the amputation rate and average hospitalization time decreased, and the average hospitalization cost increased. The same trend was observed in the diabetic subgroup. The significant decrease in amputation rate may be related to the development of endovascular therapy and angiogenesis therapy. Key words: Arteriosclerosis obliterans/CO; Lower extremity/BS; Ischemia/ET; Diabetes mellitus; Amputation

Effects of warming needle moxibustion in patients with lower limbs arteriosclerosis obliterans of blood stasis type

Objective To explore the clinical effects of warming needle moxibustion on lower limbs arteriosclerosis obliterans of blood stasis type. Methods From September 2015 to September 2017, we selected 60 patients from the First Affiliated Hospital and the Second Affiliated Hospital, Heilongjiang University of Chinese Medicine. All of the patients were divided into control group and intervention group with the randomized control method, 30 cases in each group. Patients of control group were treated with Huo Xue Tong Mai Yin decoction. Patients of intervention group accepted warming needle moxibustion and Huo Xue Tong Mai Yin decoction. We compared the clinical effects, diameter and blood flow parameters of lower extremity artery, the expression of nitric oxide (NO) and endothelin (ET) between two groups before and after treatment. Results Clinlcal symptoms of patients between two groups all relieved in different degrees. For example, pain eased; the temperature of lower limb got warm again; the dull-red and pale colour weakened; the number of walk and qi-blood increased; the improvements of the symptoms in intervention group were better than those in control group with significant differences (P<0.05) . The improvements of diameter and blood flow parameters of lower extremity artery in intervention group were significantly better than those in control group (P<0.05) . After treatment, the expression of NO and ET of intervention group was (39.30±3.10) ng/L and (28.14±3.10) μmol/L respectively better than those of control group with significant differences (t=3.277, 2.716; P<0.05) . Conclusions Warming needle moxibustion has a remarkable clinical effect on lower limbs arteriosclerosis obliterans of blood stasis type. It is worth to be generalized. Key words: Nitric oxide; Arteriosclerosis obliterans of lower limbs; Blood stasis type; Warming needle moxibustion; Vascular endothelial cells

Cognitive level of disease risk factors and clinical identification in high risk population of arteriosclerosis obliterans of lower limbs

Objective To assess the cognitive level of disease risk factors and clinical identification in high risk population of arteriosclerosis obliterans (ASO) of lower limbs. Methods By purpose sampling survey, a total of 330 patients in high risk of ASO from a ClassⅢ grade A hospital in Chongqing were investigated using a self-designed semi-structured questionnaire from May to June 2015 to assess the cognitive level of disease risk factors and clinical identification in high risk population of ASO. A database was set up in EpiData, and analyzed by SPSS 16.0 statistic software, including descriptive analysis, non-parametric test, Spearman correlation analysis. Results Among all respondents, 70.1% of them have never heard of lower limbs ASO. More than 80.0% of respondents did not know the risk factors, while more than 92.0% of them did not know its clinical manifestations, only 15.5% of them had received medical examination for diagnosing ASO. There were statistically significant differences in cognitive scores among respondents with different education background, residence and income (P<0.01) . Conclusions The cognitive level of disease risk factors and clinical identification in high risk population of ASO of lower limbs is obviously insufficient, especially those who are with lower education, lower income, and who live in small towns or villages. It is suggested that professional medical staff should strengthen the health education for people with ASO high-risk factors. Key words: Arteriosclerosis obliterans; Risk factors; Population surveillance; Health education

Effects of puerarin on blood lipids and inflammatory factors in rats with lower limb arteriosclerosis obliterans

Abstract This study investigated the effects of puerarin (PUE) on blood lipid and inflammatory factor levels in rats with lower limb arteriosclerosis obliterans (ASO). Sixty rats were randomly divided into control, model, simvastatin, low-PUE, middle-PUE and high-dose PUE group. The animals in later 5 groups were with lower limb ASO, and the later 4 groups were given 1 mg/kg simvastatin and 5, 10 and 20 mg/kg PUE, respectively. The blood lipid and inflammatory factor levels were determined. Results showed that, the serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) level in model group were significantly increased (P 0.05). PUE can obviously decrease the blood lipid and inflammatory factor levels in rats with lower limb ASO.

Isobaric tags for relative and absolute quantification-based quantitative proteomic analysis for identification of potential serum biomarkers for lower limb arteriosclerosis obliterans

Objective Using a proteomic approach we aimed to determine potential serum biomarkers for diagnosis and managememt of lower limb arteriosclerosis obliterans (LASO).Methods Serum samples were collected from 23 patients with LASO and 23 healthy volunteer subjects.Isobaric tags for relative and absolute quantitation (iTRAQ)-tagging combined with two-dimensional liquid chromatographytandem masss pectrometry (2D LC-MS/MS) analysis was used to identification of differentially expressed proteins between LASO patients and healthy subjects.Candidates were validated in independent cohorts of LASO patients and healthy subjects by Westerm blotting.Results Using a proteomic approach,we identified 20 serum proteins are differentially expressed in LASO patients as compared with that in healthy subjects,of which 12 proteins increased more than two-fold,while 8 proteins decreased more than two-fold among the LASO patients.Western blotting test verified that Olfactomedin-1 (OLFM1) was up-regulated in LASO group as compared with the control group (2.05 ±0.66 vs 0.96 ±0.18,P ＜0.01).Conclusion Using an iTRAQ MS approach,we identification of differentially expressed proteins between LASO patients and healthy subjects,which might serve as potential candidates for diagnostic or therapeutic measures. Key words: Lower limb arteriosclerosis obliterans ; Proteomic ; Serum ; Biomarkers

Interventional treatment for diabetes complicated with lower limb arteriosclerosis obliterans

Objective To explore the efficacy of interventional treatment for diabetes complicated with lower limb arteriosclerosis obliterans.Methods 46 patients with diabetes complicated with lower limb arteriosclerosis obliterans were selected as study objects.All the patients were checked with CTA before the operation,then were treated interventionally,and were checked with DSA during the operation.The efficacies of different Fontatine types were compared after the treatment.The hemorrheology before the treatment was compared with that after the treatment.Results The efficacy was 100.0％ in Fontatine Ⅰ and Ⅱ,69.2％ in Fontatine Ⅲ,and 53.8％ in Fontatine Ⅳ.The efficacies of Fontatine Ⅰ and Ⅱ were significantly higher than that of Fontatine Ⅲ (x 2=4.062,P=0.044) and Fontatine Ⅳ (x 2＝6.769,P=0.009).Femoral artery systolic peak velocity was (76.53 ± 18.96) cm/s before the treatment and (68.18 ± 14.79) cm/s after the treatment,mean flow velocity (48.59 ± 12.26) cm/s and (44.10 ± 13.27) cm/s,blood flow (840.80 ± 51.13) ml/min and (796.21 ± 48.16) ml/min,pulsatility index (4.16 ± 0.59) and (4.83 ± 0.86),and flow index (0.63 ± 0.09) and (0.81 ± 0.20),with statistical differences (P ＜ 0.05).Conclusions Interventional treatment for Fontatine Ⅰ and Ⅱ diabetes complicated with lower limb arteriosclerosis obliterans has better efficacy than that for Fontatine Ⅲ and Ⅳ and can effectively improve the patient's hemorrheology. Key words: Diabetes; Lower limb arteriosclerosis obliterans; Intervention; Efficacy; Hemorrheology

Randomised comparison of G-CSF-mobilized peripheral blood mononuclear cells versus bone marrow-mononuclear cells for the treatment of patients with lower limb arteriosclerosis obliterans

Previous studies have suggested that the lower limb arteriosclerosis obliterans (LASO) could be improved by autologous transplantation of either bone marrow mononuclear cells (BM-MNC) or G-CSF-mobilized peripheral blood mononuclear cells (M-PBMNC). However, the number of patients observed was very limited, and little information is available regarding comparison. The present randomised trial was designed to assess which is the better option. One hundred fifty patients with LASO were randomised to either group A (76 cases implanted with M-PBMNC) or group B (74 cases implanted with BM-MNC), and followed up for 12 weeks. Primary outcomes were safety and efficacy of treatment, based on ankle-brachial index (ABI) and rest pain, and analysis was per protocol. Significant improvement of the main clinical index was observed in both groups after transplantation. No transplantation-related complication was observed in either group. Comparative analysis revealed that at 12 weeks after cell implantation, improvement of ABI (difference 0.06 +/- 0.01; p < 0.0001), skin temperature (difference 0.55 +/- 0.25; p = 0.028), and rest pain (difference -0.57 +/- -0.15;p < 0.0001) was significantly better in groupA patients than group B patients. However, there was no significant difference between two groups for pain-free walking distance, transcutaneous oxygen pressure, ulcers, and rate of lower limb amputation. Autologous transplantation of either M-PBMNC or BM-MNC significantly promotes improvement of limb ischaemia in patients with LASO. Comparative analysis indicated that M-PBMNC should be more practical in comparison with BM-MNC in the treatment of LASO.

Arteriosclerosis Obliterans of the Lower Limbs as a Model of Peripheral Vascular Disease with Hypertension

In patients with arteriosclerosis obliterans of the lower limbs, hypertension is often characterized by a disproportionate increase in systolic pressure whereas diastolic blood pressure remains normal or even low. This hemodynamic pattern is associated with a reduction in systemic and forearm arterial compliance, whereas cardiac output and peripheral vascular resistance remains within the normal range in the absence of complications. The reduced arterial compliance is influenced not only by structural modifications of the arterial wall but also by changes in vasomotor tone. Whereas increased sodium intake and beta-blockade by propranolol reduce arterial compliance, nitrate derivatives increase arterial compliance with a resulting selective decrease in systolic pressure.

閉塞性下肢動脈硬化症に対するＧｏｒｅ‐Ｔｅｘグラフト・バイパスと再手術の成績

閉塞性下肢動脈硬化症に対するＧｏｒｅ‐Ｔｅｘグラフト・バイパスと再手術の成績