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Mu K, Liu Y, Liu G, Ran F, Zhou L, Wu Y, Peng L, Shao M, Li C, Zhang Y. A review of hemostatic chemical components and their mechanisms in traditional Chinese medicine and ethnic medicine. JOURNAL OF ETHNOPHARMACOLOGY 2023; 307:116200. [PMID: 36739925 DOI: 10.1016/j.jep.2023.116200] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/01/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Traditional Chinese medicine and ethnic medicine together play an important value in the modern medicine system that is different from that of chemical drugs. Chinese medicine and ethnic medicine with hemostatic effect have unique advantages and development potential in the prevention and treatment of clinical hemorrhagic diseases, reflecting multi-component, multi-target and multi-pathway effects. AIM OF THE STUDY In this paper, the active ingredients related to the hemostatic effect of traditional Chinese medicine and ethnic medicine are taken as the starting point, and the traditional Chinese medicine and ethnic medicine with traditional hemostatic purposes are reviewed, and the existing research progress on the active ingredients and their mechanism of action of these drugs is systematically expounded, aiming to provide theoretical reference for the development of traditional hemostatic drugs, the discovery of hemostatic active ingredients and the research of new hemostatic methods. MATERIALS AND METHODS Hemostatic chinese medicine and ethnic medicine were collected and summarized from the classic books of Materia Medica, public literature database and doctoral or master's thesis repositories. At the same time, we discussed the classification of various types of hemostatic active ingredients of traditional Chinese medicine and ethnic medicine according to the different mechanisms of hemostasis. RESULTS A total of 436 traditional Chinese medicine and ethnic medicine with hemostatic effects have been collected, and their hemostatic active ingredients include alkaloids, quinones, flavonoids, phenylpropanoids, organic acids, amino acids, terpenoids, steroids, phenols, tannins, esters, polysaccharides and herbal extracts, etc. These active ingredients accelerate the formation of hemostasis by improving endogenous and exogenous hemostatic pathways mainly through enhancing vascular wall contraction, increasing platelet aggregation, promoting coagulation system activation and inhibiting fibrinolysis. CONCLUSIONS This article reviews the previous data on various aspects of the hemostatic effect of traditional Chinese medicine and ethnomedicine. Many traditional hemostatic drugs have been discovered and many active ingredients and mechanisms have been reported. However, although there are a large number of drugs with traditional hemostatic effects, there are still few developed and applied. At the same time, the hemostatic components of many drugs still remain in the study of the activity of their total extracts, and the potential link between some drug components achieving hemostatic effects through different mechanisms remains to be elucidated.
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Affiliation(s)
- Kailang Mu
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China
| | - Yuchen Liu
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China.
| | - Gang Liu
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China.
| | - Fei Ran
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China
| | - Lingli Zhou
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China
| | - Yutong Wu
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China
| | - Leqiang Peng
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China
| | - Minghui Shao
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China
| | - Changju Li
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China
| | - Yongping Zhang
- Guizhou University of Traditional Chinese Medicine, 550025, Guizhou, China
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Xenakis A, Ruiz-Soler A, Keshmiri A. Multi-Objective Optimisation of a Novel Bypass Graft with a Spiral Ridge. Bioengineering (Basel) 2023; 10:bioengineering10040489. [PMID: 37106676 PMCID: PMC10136357 DOI: 10.3390/bioengineering10040489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/04/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
The low long-term patency of bypass grafts is a major concern for cardiovascular treatments. Unfavourable haemodynamic conditions in the proximity of distal anastomosis are closely related to thrombus creation and lumen lesions. Modern graft designs address this unfavourable haemodynamic environment with the introduction of a helical component in the flow field, either by means of out-of-plane helicity graft geometry or a spiral ridge. While the latter has been found to lack in performance when compared to the out-of-plane helicity designs, recent findings support the idea that the existing spiral ridge grafts can be further improved in performance through optimising relevant design parameters. In the current study, robust multi-objective optimisation techniques are implemented, covering a wide range of possible designs coupled with proven and well validated computational fluid dynamics (CFD) algorithms. It is shown that the final set of suggested design parameters could significantly improve haemodynamic performance and therefore could be used to enhance the design of spiral ridge bypass grafts.
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Affiliation(s)
- Antonios Xenakis
- School of Engineering, The University of Manchester, Manchester M13 9PL, UK
| | - Andres Ruiz-Soler
- School of Engineering, The University of Manchester, Manchester M13 9PL, UK
| | - Amir Keshmiri
- School of Engineering, The University of Manchester, Manchester M13 9PL, UK
- Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
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Xue Y, Hellmuth R, Shin DH. Formation of Vortices in Idealised Branching Vessels: A CFD Benchmark Study. Cardiovasc Eng Technol 2020; 11:544-559. [PMID: 32666327 DOI: 10.1007/s13239-020-00477-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/30/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE Atherosclerosis preferentially occurs near the junction of branching vessels, where blood recirculation tends to occur (Malek et al. in J Am Med Assoc 282(21):2035-2042, 1999, https://doi.org/10.1001/jama.282.21.2035 ). For decades, CFD has been used to predict flow patterns such as separation and recirculation zones in hemodynamic models, but those predictions have rarely been validated with experimental data. In the context of verification and validation (V&V), we first conduct a CFD benchmark calculation that reproduces the vortex detection experiments of Karino and Goldsmith (1980) with idealised branching blood vessels (Karino and Goldsmith in Trans. Am. Soc. Artif. Internal Organs 26:500-506, 1980). The critical conditions for the formation of recirculation vortices, the so-called critical Reynolds numbers, are the main parameters for comparison with the experimental data to demonstrate the credibility of the CFD workflow. We then characterise the wall shear stresses and develop a surrogate model for the size of formed vortices. METHODS An automated parametric study generating more than 12,000 CFD simulations was performed, sweeping the geometries and flow conditions found in the experiments by Karino and Goldsmith. The flow conditions were restricted to steady-state laminar flow, with a range of inflow Reynolds numbers up to 350, with various flow ratios between the main branch outlet and side branch outlet. The side branch diameter was scaled relative to the main branch diameter, ranging from 1.05/3 to 3/3; and the branching angles ranged in size from [Formula: see text] to [Formula: see text]. Recirculation vortices were detected by the inversion of the velocity vector at certain locations, as well as by the inversion of the wall shear stress (WSS) vector. RESULTS The CFD simulations demonstrated good agreement with the experimental data on the critical Reynolds numbers. The spatial distributions of WSS on each branch were analysed to identify potential regions of disease. Once a vortex is formed, the size of the vortex increases by the square root of the Reynolds number. The CFD data was fitted to a surrogate model that accurately predicts the vortex size without the need to run computationally more expensive CFD simulations. CONCLUSIONS This benchmark study validates the CFD simulation of vortex detection in idealised branching vessels under comprehensive flow conditions. This work also proposes a surrogate model for the size of the vortex, which could reduce the computational requirements in the studies related to branching vessels and complex vascular systems.
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Affiliation(s)
- Yidan Xue
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Parks Road, Oxford, OX1 3PJ, UK.,School of Engineering, The University of Edinburgh, Edinburgh, EH9 3FB, UK
| | - Rudolf Hellmuth
- Vascular Flow Technologies, Unit I/Prospect Business Centre, Dundee, DD2 1TY, UK
| | - Dong-Hyuk Shin
- Department of Aerospace Engineering, Korea Advanced Institute of Science and Technology, Daehak-ro 291, Daejeon, 34141, Republic of Korea.
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Assessment of boundary conditions for CFD simulation in human carotid artery. Biomech Model Mechanobiol 2018; 17:1581-1597. [PMID: 29982960 DOI: 10.1007/s10237-018-1045-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 06/19/2018] [Indexed: 01/19/2023]
Abstract
Computational fluid dynamics (CFD) is an increasingly used method for investigation of hemodynamic parameters and their alterations under pathological conditions, which are important indicators for diagnosis of cardiovascular disease. In hemodynamic simulation models, the employment of appropriate boundary conditions (BCs) determines the computational accuracy of the CFD simulation in comparison with pressure and velocity measurements. In this study, we have first assessed the influence of inlet boundary conditions on hemodynamic CFD simulations. We selected two typical patients suspected of carotid artery disease, with mild stenosis and severe stenosis. Both patients underwent digital subtraction angiography (DSA), magnetic resonance angiography, and the invasive pressure guide wire measured pressure profile. We have performed computational experiments to (1) study the hemodynamic simulation outcomes of distributions of wall shear stress, pressure, pressure gradient and (2) determine the differences in hemodynamic performances caused by inlet BCs derived from DSA and Womersley analytical solution. Our study has found that the difference is related to the severity of the stenosis; the greater the stenosis, the more the difference ensues. Further, in our study, the two typical subjects with invasively measured pressure profile and thirty subjects with ultrasound Doppler velocimeter (UDV) measurement served as the criteria to evaluate the hemodynamic outcomes of wall shear stress, pressure, pressure gradient and velocity due to different outlet BCs based on the Windkessel model, structured-tree model, and fully developed flow model. According to the pressure profiles, the fully developed model appeared to have more fluctuations compared with the other two models. The Windkessel model had more singularities before convergence. The three outlet BCs models also showed good correlation with the UDV measurement, while the Windkessel model appeared to be slightly better ([Formula: see text]). The structured-tree model was seen to have the best performance in terms of available computational cost and accuracy. The results of our numerical simulation and the good correlation with the computed pressure and velocity with their measurements have highlighted the effectiveness of CFD simulation in patient-specific human carotid artery with suspected stenosis.
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Yu S, Wu S, Zhang Z, Chen Y, Xie Y. Explicit vascular reconstruction based on adjacent vector projection. Bioengineered 2016; 7:365-371. [PMID: 27710433 DOI: 10.1080/21655979.2016.1226667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Blood vascular reconstruction plays an important role in vessel disease diagnosis and prognosis, treatment planning and surgery. Based on adjacent vector projection, a simple and robust explicit algorithm is presented for vascular reconstruction. It generates the base mesh and utilizes the Loop algorithm for perceptual refinement by mesh subdivision. In the end, the reconstructed vascular tree is rendered for volumetric visualization and localization of vascular malformations. Experimental results on the Aneurisk database have validated the capacity of the proposed algorithm in generating smooth surface and natural transition of high tortuosity in real time, while on clinical cases has verified its accuracy on pinning vascular stenosis.
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Affiliation(s)
- Shaode Yu
- a Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen , China.,b Shenzhen Colleges of Advanced Technology, University of Chinese Academy of Sciences , Shenzhen , China
| | - Shibin Wu
- a Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen , China.,b Shenzhen Colleges of Advanced Technology, University of Chinese Academy of Sciences , Shenzhen , China
| | - Zhicheng Zhang
- a Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen , China.,b Shenzhen Colleges of Advanced Technology, University of Chinese Academy of Sciences , Shenzhen , China
| | - Yili Chen
- a Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen , China
| | - Yaoqin Xie
- a Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen , China
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Sousa LC, Castro CF, António CC, Sousa F, Santos R, Castro P, Azevedo E. Computational simulation of carotid stenosis and flow dynamics based on patient ultrasound data - A new tool for risk assessment and surgical planning. Adv Med Sci 2016; 61:32-9. [PMID: 26355739 DOI: 10.1016/j.advms.2015.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 06/09/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE There is nowadays extensive experimental and computational investigation on the pathophysiology of atherosclerosis, searching correlations between its focal nature and local hemodynamic environment. The goal of this work is to present a methodology for patient-specific hemodynamics study of the carotid artery bifurcation based on the use of ultrasound (US) morphological and blood flow velocity patient data. MATERIALS/METHODS Subject-specific studies were performed for two patients, using a developed finite element code. Geometrical models were obtained from the acquisition of longitudinal and sequential cross-sectional ultrasound images and boundary conditions from Doppler velocity measurements at the common carotid artery. RESULTS There was a good agreement between ultrasound imaging data and computational simulated results. For a normal and a stenosed carotid bifurcation the velocity, wall shear stress (WSS) and WSS descriptors analysis illustrated the extremely complex hemodynamic behavior along the cardiac cycle. Different patterns were found, associated with morphology and hemodynamic patient-specific conditions. High values of time-averaged WSS (TAWSS) were found at stenosis site and for both patients TAWSS fields presented low values within areas of high oscillating shear index and relative residence time values, corresponding to recirculation zones. CONCLUSION Simulated hemodynamic parameters were able to capture the disturbed flow conditions in a normal and a stenosed carotid artery bifurcation, which play an important role in the development of local atherosclerotic plaques. Computational simulations based on clinic US might help improving diagnostic and treatment management of carotid atherosclerosis.
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Samuelson R, Nair P, Snyder K, Frakes D, Preul MC, Nakaji P, Spetzler RF. Fluid dynamic characterization of a novel branching anastomosis design. Int Biomech 2015. [DOI: 10.1080/23335432.2015.1057228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Sousa LC, Castro CF, António CC, Santos AMF, Dos Santos RM, Castro PMAC, Azevedo E, Tavares JMRS. Toward hemodynamic diagnosis of carotid artery stenosis based on ultrasound image data and computational modeling. Med Biol Eng Comput 2014; 52:971-983. [PMID: 25249277 DOI: 10.1007/s11517-014-1197-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 09/17/2014] [Indexed: 11/29/2022]
Abstract
The ability of using non-expensive ultrasound (US) image data together with computer fluid simulation to access various severities of carotid stenosis was inquired in this study. Subject-specific hemodynamic conditions were simulated using a developed finite element solver. Individual structured meshing of the common carotid artery (CCA) bifurcation was built from segmented longitudinal and cross-sectional US images; imposed boundary velocities were based on Doppler US measurements. Simulated hemodynamic parameters such as velocities, wall shear stress (WSS) and derived descriptors were able to predict disturbed flow conditions which play an important role in the development of local atherosclerotic plaques. Hemodynamic features from six individual CCA bifurcations were analyzed. High values of time-averaged WSS (TAWSS) were found at stenosis site. Low values of TAWSS were found at the bulb and at the carotid internal and external branches depending on the particular features of each patient. High oscillating shear index and relative residence time values assigned highly disturbed flows at the same artery surface regions that correlate only moderately with low TAWSS results. Based on clinic US examinations, results provide estimates of flow changes and forces at the carotid artery wall toward the link between hemodynamic behavior and stenosis pathophysiology.
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Affiliation(s)
- Luísa C Sousa
- Faculdade de Engenharia, Instituto de Engenharia Mecânica (IDMEC-Polo FEUP), Universidade do Porto, Rua Dr. Roberto Frias, s/n, 4200-465, Porto, Portugal.
| | - Catarina F Castro
- Faculdade de Engenharia, Instituto de Engenharia Mecânica (IDMEC-Polo FEUP), Universidade do Porto, Rua Dr. Roberto Frias, s/n, 4200-465, Porto, Portugal
| | - Carlos C António
- Faculdade de Engenharia, Instituto de Engenharia Mecânica (IDMEC-Polo FEUP), Universidade do Porto, Rua Dr. Roberto Frias, s/n, 4200-465, Porto, Portugal
| | - André Miguel F Santos
- Faculdade de Engenharia, Instituto de Engenharia Mecânica e Gestão Industrial, Universidade do Porto, Rua Dr. Roberto Frias, s/n, 4200-465, Porto, Portugal
| | - Rosa Maria Dos Santos
- Departamento de Neurologia, Faculdade de Medicina, Hospital São João, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Pedro Miguel A C Castro
- Departamento de Neurologia, Faculdade de Medicina, Hospital São João, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Elsa Azevedo
- Departamento de Neurologia, Faculdade de Medicina, Hospital São João, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - João Manuel R S Tavares
- Faculdade de Engenharia, Instituto de Engenharia Mecânica e Gestão Industrial, Universidade do Porto, Rua Dr. Roberto Frias, s/n, 4200-465, Porto, Portugal
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Sousa LC, Castro CF, António CC, Santos A, Santos R, Castro P, Azevedo E, Tavares JMR. Haemodynamic conditions of patient-specific carotid bifurcation based on ultrasound imaging. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING-IMAGING AND VISUALIZATION 2014. [DOI: 10.1080/21681163.2013.875486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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