时值十一长假，人们的饮食、作息也切换成"过节式"，长途跋涉、舟车劳顿、走亲访友、过度饮酒、暴 饮暴食、熬夜刷剧玩游戏成为常态，原有的生活节奏被打乱，带来的健康风险也不容忽视。 在十一假期期间大快朵颐、熬夜娱乐之余，预防及减轻心脑血管疾病的带来危害也成为国人假日期间所 面临的健康挑战之一。 近几年，心脑血管疾病已经成为危害国人健康的主要"杀手"之一。在心脑血管疾病中，冠心病尤为凶 险，中国国家心血管病中心2023年发布的数据表明，我国冠心病患者已超过1100万，且每年以约2.5% 的速度增长。 冠心病全称冠状动脉粥样硬化性心脏病，根据我国最新统计数据，冠心病在我国的患病率和死亡率呈现 持续上升趋势，在人口老龄化的大形势下，该趋势预计进一步加剧。与此同时，也需要警惕近年来冠心 病发病的年轻化趋势。 "近年来，冠心病发病出现年轻化趋势，这与年轻人不健康的生活方式以及当今社会、环境、心理等多 个因素均密切相关。可以说，冠心病是一个影响国民健康和生命质量的重大公共卫生问题，亟需全社会 和大家的重视和管理。"近日，北京大学第一医院副院长李建平在接受时代周报记者专访时指出。 李建平强调，冠心病年轻化趋势主要源于不健康生活方 ...

Core Insights - Atherosclerosis is increasingly affecting younger adults in their 30s and 40s, not just the elderly, necessitating serious attention to this health issue [1] Group 1: Types of Affected Arteries - The carotid artery, which connects directly to the brain, is prone to plaque buildup, typically starting around age 40, with significant prevalence by age 60 [2] - The coronary arteries are critical as plaque accumulation can lead to coronary heart disease, with most acute myocardial infarctions resulting from ruptured plaques [3] - Peripheral arteries, which supply blood to the lower limbs, can become narrowed or blocked, leading to symptoms like pain and numbness, especially during physical activity [4] - Atherosclerosis in the aorta is more common in men over 40, characterized by reduced elasticity and potential aneurysm formation [5] - Renal artery atherosclerosis can lead to insufficient kidney perfusion, often presenting with fatigue and increased nighttime urination as the disease progresses [6] Group 2: Diagnostic Insights - Carotid artery plaque checks are common due to the superficial location of the carotid artery, making it easier to assess via ultrasound, although any plaque presence is concerning [7] - The stability of plaques is more critical than their size; unstable, soft plaques pose a greater risk of rupture, similar to a thin-skinned dumpling that can easily break [7]

Core Viewpoint - There is a compelling link between gut microbiota and atherosclerosis, a disease characterized by cholesterol and inflammatory cell deposits in arterial walls, leading to potential health issues like stroke and heart attacks [1][5]. Group 1: Research Findings - A study published in Nature identified Imidazole Propionate (ImP), a metabolite produced by gut bacteria, as a driver of atherosclerosis, suggesting new targets for early detection and personalized treatment of cardiovascular diseases [2][10]. - The study highlights the necessity for early intervention in seemingly healthy populations due to rising morbidity and mortality rates associated with cardiovascular diseases [5]. - The research team found a strong correlation between ImP levels and the severity of atherosclerosis in both mouse models and human cohorts [7][10]. Group 2: Mechanism of Action - ImP promotes atherosclerosis through the activation of the imidazoline-1 receptor (I1R) in myeloid cells, indicating a specific signaling pathway that could be targeted for therapeutic purposes [8][10]. - Blocking the ImP-I1R signaling axis can inhibit the development of atherosclerosis induced by either ImP or a high-cholesterol diet, suggesting a potential intervention strategy [8][10]. Group 3: Implications for Treatment - The findings open new avenues for the early diagnosis and personalized treatment of atherosclerosis, emphasizing the importance of understanding gut microbiota's role in cardiovascular health [10].

Core Points - The article discusses the development and significance of blood vessels in the human body, highlighting their role in transporting oxygen and nutrients, and the impact of modern lifestyle choices on vascular health [4][6][40] Group 1: Blood Vessel Development and Function - Blood vessels begin to grow from the first month of embryonic development, reaching a total length of approximately 100,000 kilometers in adults, which is enough to circle the Earth's equator two and a half times [2][4] - They serve as the body's highways for transporting essential materials, including oxygen and nutrients, to all tissues and organs [4] Group 2: Impact of Lifestyle on Vascular Health - Aging leads to the natural hardening and aging of blood vessels, which can result in various cardiovascular diseases [6] - Modern lifestyle habits, particularly late-night activities and sedentary behavior, are causing vascular aging to occur earlier in younger populations [8][10] Group 3: Consequences of Poor Lifestyle Choices - Night owls often experience increased blood pressure due to the secretion of adrenaline and noradrenaline, which accelerates heart rate and blood flow [10] - Sedentary habits combined with late-night activities can lead to blood clots due to sluggish blood flow and increased blood viscosity [12][18] Group 4: Health Risks Associated with Vascular Issues - Long-term effects of poor lifestyle choices can lead to the formation of larger blood clots and serious health consequences, including acute embolism [29][35][39] - A significant percentage of global deaths are attributed to thrombotic diseases, surpassing those caused by cancer and infectious diseases [39][40]

Core Insights - The research reveals that metabolic factors, particularly gut health, play a significant role in the development of osteoarthritis, challenging the traditional view that it is primarily caused by local mechanical factors [1][2][3] - The study indicates a notable difference in gut microbiota composition and key metabolites between osteoarthritis patients and healthy individuals, suggesting a potential new direction for treatment [3][4] Group 1: Osteoarthritis Overview - Osteoarthritis is characterized by degeneration of joint cartilage and underlying bone, leading to pain, deformity, and functional impairment, significantly affecting patients' quality of life [2] - As of 2021, approximately 606 million people globally suffer from osteoarthritis, with around 152 million cases in China, reflecting a prevalence rate of 10.8% [2] Group 2: Research Findings - The research team conducted a large-scale study involving 4,080 community residents aged 50 and above, revealing a link between bile acid metabolism and osteoarthritis, influenced by gut microbiota [3][4] - A significant reduction in the abundance of specific gut bacteria (Bacteroides) was observed in osteoarthritis patients, correlating with abnormal bile acid metabolism [4][5] Group 3: Treatment Implications - The study suggests that supplementation with bile acids or GLP-1 analogs can significantly alleviate cartilage degeneration in osteoarthritis models, indicating a potential therapeutic pathway [5] - The findings highlight GLP-1 as a crucial mediator between gut health and joint protection, opening avenues for new treatment strategies [5] Group 4: Broader Implications of Gut Microbiota - Gut microbiota dysbiosis is linked to various diseases, including depression, diabetes, obesity, and cardiovascular diseases, emphasizing the importance of gut health in overall well-being [6][7] - The gut microbiome plays a critical role in immune regulation and systemic inflammation, with imbalances potentially leading to increased risks of autoimmune diseases and infections [7]

Core Viewpoint - The article discusses the development of a novel targeted drug delivery system, ALD@EM, based on traditional Chinese medicine components, specifically targeting atherosclerosis, which is a major pathological factor leading to ischemic heart disease [2][7]. Group 1: Atherosclerosis Overview - Atherosclerosis is a chronic inflammatory disease significantly impacting major cardiovascular events such as ischemic heart disease and stroke [3]. - The pathophysiological mechanisms of atherosclerosis involve endothelial injury, lipid accumulation, and a self-perpetuating cycle of inflammation, leading to plaque formation and progression [3]. Group 2: Current Treatments and Limitations - Statins are the first-line treatment for atherosclerosis, primarily working by inhibiting cholesterol synthesis and lowering plasma low-density lipoprotein cholesterol (LDL-C) levels [3]. - However, statins have potential risks, including increased diabetes risk and contraindications in patients with renal impairment, along with varying drug tolerability across different ethnic groups [3]. - Emerging anti-inflammatory therapies, such as the monoclonal antibody Canakinumab targeting IL-1β, have shown effectiveness in reducing cardiovascular event risks without affecting LDL-C levels, but serious infection risks limit their clinical application [3][4]. Group 3: Novel Drug Development - The research team extracted an active monomer, decursin, from the root of the traditional Chinese herb Angelica sinensis, which interacts with protein kinase Cδ (PKCδ) to inhibit lipid accumulation and inflammation in macrophages, showing low cytotoxicity in vitro and minimal side effects in vivo [4][5]. - To address the short half-life of decursin, the team developed the ALD@EM targeted cascade drug delivery system, which uses antibodies to ICAM-1 and VCAM-1 for targeting atherosclerotic plaques, embedding LDL particles, and utilizing apoptotic endothelial cell membranes to enhance macrophage uptake and release of decursin [5][6]. - The ALD@EM delivery system significantly increased the accumulation of decursin within arterial plaques and markedly reduced lipid deposition and plaque inflammation [5][6]. Group 4: Conclusion - This research successfully combines the active components of traditional Chinese medicine with cutting-edge nanobiotechnology, creating a novel targeted delivery system that overcomes application bottlenecks of natural components and utilizes the pathophysiological characteristics of the disease for precise drug delivery, offering a new strategy for targeted atherosclerosis treatment [7].

Core Viewpoint - The study reveals that exosomes derived from macrophage-derived foam cells in atherosclerotic plaques exacerbate ischemic white matter injury and vascular cognitive impairment by transmitting metabolic defects to microglia [2][5][10]. Group 1: Research Findings - Atherosclerosis (AS) is identified as an independent risk factor for vascular cognitive impairment (VCI), with unclear mechanisms [2]. - The research team discovered that exosomes in the circulation of AS patients worsen ischemic white matter injury and VCI [5]. - Foam cells produce exosomes that target microglia in the central nervous system, transmitting oxidative stress imbalance and metabolic defects through the miR-101-3p-Nrf2-Slc2a1 signaling axis [5][7]. Group 2: Potential Therapeutic Targets - The study confirms that inhibiting miR-101-3p or activating Nrf2 can counteract the effects of atherosclerotic exosomes and improve vascular cognitive impairment [6][7]. - The findings suggest a long-distance connection between peripheral macrophages and microglia, providing new insights and potential therapeutic targets for atherosclerosis-induced vascular cognitive impairment [3][10].

Core Insights - The research conducted by Professor Qin Chuan's team at Huazhong University of Science and Technology reveals the pathogenic mechanism by which atherosclerosis exacerbates white matter injury and cognitive dysfunction, providing new perspectives for the prevention and treatment of vascular cognitive impairment in atherosclerotic populations [1][4] Group 1: Research Findings - The study highlights the increasing prevalence of vascular dementia, which is the second most common type of dementia after Alzheimer's disease, particularly as the global population ages [1] - Atherosclerosis is linked to vascular dementia, but the underlying pathological mechanisms connecting atherosclerosis to white matter injury and cognitive dysfunction have not been clearly defined, posing significant challenges for prevention and treatment [1] - The research utilized various techniques, including public databases, atherosclerosis patient cohorts, single-cell sequencing, and multi-omics analysis, to discover the heterogeneity of circulating exosomes in atherosclerosis [1] Group 2: Mechanisms and Implications - The identified exosomes can transmit oxidative stress and metabolic defects to microglial cells in the central nervous system, thereby exacerbating ischemic white matter injury and cognitive dysfunction, revealing a novel pathophysiological mechanism [1] - The study provides potential targets for risk warning and comorbidity treatment in patients with atherosclerosis-related vascular cognitive impairment [4] - Assessing the levels of peripheral blood exosomal miR-101-3p in atherosclerosis patients may predict the progression of atherosclerotic plaques and the risk of vascular cognitive impairment [4] - Targeting Nrf2 with clinical drug interventions may offer a new therapeutic approach for treating atherosclerosis combined with vascular cognitive impairment [4]