Background and purpose:Previous studies demonstrated that intraplaque haemorrhage increased the contents of cholesterol and oxidants in atherosclerotic plaques. The present study was aimed to test the hypothesis that enhanced expression of haem oxygenase-1 (HO-1) may stabilize vulnerable plaques. Experimental approach: Intravascular ultrasound (IVUS) was performed to identify three similar abdominal aortic plaques in each of 58 fat-fed New Zealand rabbits after aortic balloon injury. With the guidance of IVUS, 50 mL autologous erythrocytes (RBC) or normal saline (NS) were injected from adventitia into two of the pre-selected plaques, respectively, whereas the third plaque served as a blank control. All rabbits were randomly divided into two groups, receiving intraperitoneal injection of haemin and saline respectively. Key results: Compared with NS or control plaques, RBC plaques had more macrophage infiltration and lipid content, thinner plaque fibrous cap, and higher expression of inflammatory factors and incidence of plaque rupture. RBC plaques in the haemin group had about a 50% lower incidence of plaque rupture than those in the control group. Conclusions and implications:Haem oxygenase-1 may eliminate haem or other oxidants, exert unexpected anti-oxidative and anti-inflammatory effects and serve as a promising approach to the direct inhibition of erythrocyte-induced plaque instability.British Journal of Pharmacology (2010) 160, 1484-1495; doi:10.1111/j.1476-5381.2010.00799.x Keywords: atherosclerosis; erythrocyte; vulnerable plaque; haem oxygenase-1; intraplaque hemorrhage Abbreviations: EEMA, external elastic membrane area; GAPDH, glyceraldehyde 3-phosphate dehydrogenase; HDL, highdensity lipoprotein; HO-1, haem oxygenase-1; IVUS, intravascular ultrasound; LA, lumen area; LDL, lowdensity lipoprotein; MCP-1, monocyte chemoattractant protein-1; MDA, malondialdehyde; MMP, matrix metalloproteinase; NF-kB, nuclear transcription factor kB; NS, normal saline; PB, plaque burden; PBS, phosphate buffered saline; RBC, erythrocyte; SDS-PAGE, sodium dodecyl sulphate-polyacrylamide gel electrophoresis; SOD, superoxide dismutase; TC, total cholesterol; TG, triglycerides; TIMP-1, tissue inhibitor of metalloproteinase 1; VCAM-1, vascular cell adhesion molecule-1 IntroductionPathological studies have demonstrated that vulnerable plaques induced by intraplaque hemorrhage are frequently associated with increased density of microvessels (Burke et al., 1999;Kockx et al., 2003) and presence of erythrocyte membranes within the necrotic core (Kolodgie et al., 2003). The number of vasa vasorum was increased twofold and fourfold in vulnerable and ruptured plaques, respectively, as compared with stable plaques. The cholesterol content of the erythrocyte membrane was also found to contribute to the progression of atherosclerosis (Torkhovskaia et al., 1983;Miwa et al., 2003). Lipid contents derived from erythrocytes were associated with large necrotic cores of atherosclerotic plaques with intraplaque hemorrhage (Kolodgie et al., 200...
Objective. To explore the application effect of medical care integration combined with family intervention under the evidence-based nursing mode on child patients with severe hand-foot-mouth disease (HFMD) and its influence on intestinal function. Methods. 120 child patients with severe HFMD admitted to Qilu Children’s Hospital of Shandong University from January 2019 to January 2020 were selected as the research object and randomly divided into group A and group B, with 60 cases each. Conventional nursing was performed on patients in group B, and medical care integration combined with family intervention under the evidence-based nursing mode was performed on patients in group A. Patients were assessed after the intervention using the hospital-made treatment adherence scale, PedsQLTM 4.0 (Pediatric Quality of Life Inventory Version 4.0) scale, and the faces pain scale-revised (FPS-R). The levels of gastrointestinal function indicators such as serum endotoxin (ET), diamine oxidase (DAO), and d-lactic acid (D-LA) were measured before and after the intervention, and recovery such as time to clear fever and time to relief of oral pain were recorded in both groups. Results. Children in group A had significantly higher compliance in diet, behaviour, exercise, and medication than group B ( P < 0.05 ); the time to clear fever, time to relief of oral pain, time to healing of oral ulcers, time to relief of skin herpes, time to hospitalization, and time to eating were shorter in group A than those in group B ( P < 0.001 ); all scores on the PedsQLTM 4.0 scale were higher in group A than those in group B after the intervention ( P < 0.001 ); ET, DAO, and D-LA levels decreased in both groups after the intervention, with group A having lower levels than group B ( P < 0.001 ), in addition, group A had lower eating pain scores after the intervention ( P < 0.05 ). Conclusion. Medical care integration combined with family intervention under the evidence-based nursing mode can effectively improve the treatment compliance of child patients with severe HFMD, accelerate their recovery progress, ensure a better prognostic quality of life and gastrointestinal tract function, and reduce the eating pain, indicating that such comprehensive nursing intervention mode should be promoted in practice.
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