年龄越大越容易发生动脉粥样硬化，但这并不意味着斑块只是老年人的"专利"，如今三四十岁的青 壮年的患病率也在增高，因此需要我们认真对待。 人体的循环系统很复杂，有各种各样的血管，心内科专家就来揭秘5种更容易形成动脉粥样硬化和 堵塞的血管。 颈动脉 颈动脉直接连通大脑，位于颈前部和气管两侧，重要性不言而喻。颈动脉呈现独特的"Y"字型结 构，因而在分叉处很容易发生堵塞，临床上粥样硬化斑块也常堆积在颈动脉。一般来说，人到40岁左 右，颈动脉处便开始显现或大或小的斑块了；到60岁左右，颈动脉斑块基本就成常态了，只不过轻重不 一，需要具体情况具体对待。 冠状动脉 值得一提的是，我们平时听得最多的检查莫过于"颈动脉斑块"检查。这主要是因为颈动脉非常表 浅，超声检查比较容易探及和评估，更多是出于"方便"考量，实际上任何位置出现斑块都是不利的。 另外，很多人会将斑块的大小视为最危险的因素，其实最可怕的不是斑块大小，而是斑块的不稳 定，也就是"柔软"的易损斑块。这就好比馅大皮薄的饺子很容易煮破，一旦破损非常麻烦，因此要认真 对待。本组文/汪芳（北京医院） 当斑块积聚在冠状动脉时，就会导致冠心病等，情况还是比较严重的。绝大多数急性 ...

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]