A Clinical Study On The Prescription Of Clearing Away Heat, Removing Phlegm And Promoting Blood Circulation By Inhibiting Cell Apoptosis And Stabilizing Vulnerable Carotid Plaques

Background:Atherosclerosis(AS)is the critical pathological basis of many cardiovascular diseases.Plaque rupture and Secondary thrombus were significantly associated with cardiovascular diseases.Many researches found that Vulnerable plaque is one of the main factors of acute severe such diseases like acute cerebral infarction and Acute coronary syndrome.The incidence and mortality of cardiovascular and cerebrovascular diseases has been rising gradually in recent years,and that is a trend of younger.detecting and stabilizing the Vulnerable plaque has drawn attentions in recent researches.In the pathological mechanism research of vulnerable plaques,In 1999,beyond the knowledge of AS,Ross proposed an idea that ASwas a kind of inflammatory diseases based on the Endothelial injury theory,.Lots of evidence also suggests that the inflammation and inflammatory factor of the vulnerable plaques have close relation with plaque rupture,but the mechanism and pathway is yet to be further research.In addition,researches found that smooth muscle cells and macrophages in plaque undergo apoptosis and necrosis,especially apoptosis take participate in the formation of vulnerable plaques.We have studied that Qingre Huoxue Formula is able to stabilize vulnerable plaques by inhibiting the inflammatory factor,but its mechanism pathways remain to be further discussion.This experiment aims to observe Qingre Huoxue Formula how to effect the expression of ubiquitin and apoptosis in severe carotid stenosis plaque,revealing the potential mechanism of plaque stabilization.Objective:1.To Explore Qingre Huoxue formulas stabilizng vulnerable plaques in the patients with severity carotid stenosis through the ubiquitin-proteasome pathway.2.To Explore Qingre Huoxue formulas stabilizng vulnerable plaques in the patients with severity carotid stenosis through inhibiting apoptosis.Methods:We classified 60patients with severity carotid stenosis into the treatment group and control group randomly which come from china-japan friendship hospital cardiovascular internal medicine and cardiovascular surgery syndrome.The treatment group were given Qingre Huoxue formulas and western medicine,the control group were given simple western medicine.the course of treatment was 16 weeks,all of the patients were accepted endarterectomy.the carotid artery intima to dehydration,paraffin embedding treatment made paraffin section,.immunohistochemical method detecting the expression of ubiquitin,immunofluorescence method(TUNEL)detecting apoptosis,and comparing the difference between two groups.Results;1.Compare with the control group,the treatment group can significantly reduct the expression of ubiquitin E3 ligase,Qingre Huoxue formulas upstream regulatory factors of stablilize plaques may be related to ubiquitin-proteasome pathway.2.Comparing with the control group,showed that Qingre Huoxue formulas significantly inhibit apoptosis of severe carotid atherosclerotic plaques.it may be one of the mechanisms of stabilizing vulnerable plaques.Conclusion:Qingre Huoxue formulas is possible to reach the role of stability of carotid vulnerable plaques through the ubiquitin-proteasome pathway,and the ways to inhibit apoptosis.