Background: The level of circulating p53 is related to inflammation in asymptomatic subjects with cardiovascular risk factors. Whether p53 is associated with the severity of atherosclerosis remains to be determined. Hypothesis: This study examines the relationship of systemic p53 levels with atherosclerotic risk factors and subclinical atherosclerosis. Methods: Circulating levels of p53 and markers of inflammation were measured in 356 subjects with cardiovascular risk factors but who were free from clinical cardiovascular disease. Subclinical atherosclerosis was evaluated by both the mean carotid intima-media thickness (IMT) and the presence of atherosclerotic plaques with the use of B-mode ultrasound in all subjects. Results: p53 levels were positively correlated with age (r = 0.382, P < 0.001), intercellular adhesion molecular-1 (ICAM-1; r = 0.510, P < 0.01), vascular cell adhesion molecular-1 (VCAM-1; r = 0.497, P < 0.01), E-selectin (r = 0.337, P < 0.01), and carotid IMT (r = 0.594, P < 0.01). The association between p53 and IMT remained significant in multiple regression analysis (P < 0.01) when controlling for traditional atherosclerotic risk factors and inflammatory markers. Conclusion: Higher plasma p53 levels were associated with an increase in inflammatory markers, as well as increased carotid IMT. Circulating p53 may be useful in identifying subclinical atherosclerosis in subjects symptomatically free from cardiovascular disease.

Background: Right-to left shunt (RLS) is regarded as a risk factor resulting in migraine, but the relevance between the RLS and migraine remains controversial. This paper aims at investigating the prevalence and RLS grade of patent foramen ovale (PFO) in cases of migraine (including migraine with and without aura) and evaluate the relationship between PFO and migraine. Methods: Synchronous test of contrast transthoracic echocardiography and contrast transcranial Doppler ultrasonography was performed in 251 cases of migraine, which contains 62 cases of migraine with aura (MA) and 189 cases without aura (MO) and 275 healthy adults. Among these cases, 25 cases with migraine and 14 healthy adults were evaluated through transesophageal echocardiography. Results: (1). The prevalence of permanent RLS, total RLS, and large RLS in migraine was 11.16%, 39.04%, and 17.13%, respectively, which was significantly higher than that of the controls ( P = .042, <.001, and.001, respectively). (2). Permanent RLS was detected as 7.93% of the cases in MO, 20.96% in MA, and 6.18% in controls. Total RLS was detected as 35.98% of the cases in MO, 48.38% in MA, and 23.64% in controls. Large RLS was detected as 13.76% of the cases in MO, 27.41% in MA, and 7.27% in controls. Compared with controls, the positive rate of total RLS and large RLS in MO increased ( P = .004 and.022, respectively), the that of permanent RLS, total RLS, and large RLS in MA also increased ( P < .001 for each of the comparisons). The positive rate of permanent RLS and large RLS in MA was remarkably higher than that in MO ( P = .005 and.013, respectively). (3) The presence of large-size PFO (≥2.0 mm) of migraine showed higher than that of the controls ( P = .048). Conclusions: PFO is associated with the migraine (especially with aura), when it is permanent RLS, large RLS, and large-size PFO (≥2.0 mm).

Background To investigate the value of two-dimensional speckle tracking echocardiography (2D-STE) in evaluating cardiac functions in type 2 diabetes mellitus (T2DM) with hyperlipidemia. Methods Sixty T2DM patients with normal left ventricular ejection fraction (LVEF) and poorly-controlled blood glucose were selected. Among these, thirty had hyperlipidemia. Thirty age- and gender-matched healthy individuals were recruited as the normal control group. Longitudinal strain of left ventricular segments, left ventricular global longitudinal strain (LV GLS), left atrial global longitudinal strain (LA GLS), right ventricular global longitudinal strain (RV GLS) and right atrial global longitudinal strain (RA GLS) were measured by 2D-STE. Results (1) Compared with the normal control group, LV GLS in T2DM group and T2DM with hyperlipidemia group decreased (P < 0.05), but there was no significant difference of LV GLS between T2DM group and T2DM with hyperlipidemia group (P > 0.05). Compared with the normal control group and T2DM group, longitudinal strain of middle segment of LV in T2DM with hyperlipidemia group decreased (P < 0.05). (2) There was a significant difference in LA GLS among the three groups. LA GLS of T2DM with hyperlipidemia group was lower compared with the normal control and T2DM group (P < 0.05). (3) Compared with the normal control group, RV GLS in T2DM group and T2DM with hyperlipidemia group was lower (P < 0.05), but there was no significant difference of RV GLS between T2DM group and T2DM with hyperlipidemia group (P > 0.05). RA GLS in T2DM with hyperlipidemia group decreased (P < 0.05) compared to the normal control group and T2DM group. Conclusion Speckle tracking echocardiography can effectively evaluate cardiac dysfunction in patients with T2DM. LA GLS and RA GLS can be used as potential markers of cardiac dysfunction in T2DM with hyperlipidemia, and provide the basis for early clinical diagnosis and treatment.

Objective: To observe the clinical efficacy of common goldenrop decoction combined with ramuli cinnamomi decoction in the treatment of patients with insomnia during the period of the day from 11 PM to 3 AM. Methods: 80 patients with insomnia during the period of the day from 11 PM to 3 AM were randomly divided into control group and intervention group. The control group was treated with 1 mg of estazolam tablets at 9 PM every night; while the intervention group was given common goldenrop decoction combined with ramuli cinnamomi decoction based on the estazolam tablets. After 2 weeks of treatment and after 2 weeks of withdrawal, the improvement in sleep was observed. Results: After 2 weeks of treatment, the efficacy of the intervention group (97.5%) was significantly higher than that of the control group (75.0%). The difference was statistically significant. After 2 weeks of withdrawal, the intervention group still had an effective rate of 87.5%, which was significantly higher than that of the control group (55.0%). Conclusion: common goldenrop decoction combined with ramuli cinnamomi decoction can improve the short-term and long-term sleep quality of patients with insomnia during the period of the day from 11 PM to 3 AM.