GRADE Clinical Study Evidence Evaluation and Expert Consensus on Antihypertensive Chinese Patent Medicines Combined with Western Medicines for Treatment of Hypertension / 中国实验方剂学杂志

ObjectiveTo evaluate the quality of research and evidence related to antihypertensive Chinese patent medicines combined with western medicines for the treatment of hypertension， synthesize and update the evidence， form expert consensus， and provide evidence for clinical decision-making. MethodThe databases of China National Knowledge Infrastructure （CNKI）， WanFang Data Knowledge Service Platform （WanFang）， Vip Chinese Science and Technology Journal Database （VIP）， Chinese Biomedical Literature Service System （Sinomed）， National Library of Medicine （PubMed）， Cochrane Library， Web of Science， and US Clinical Trials Registry were searched for randomized controlled trials of antihypertensive Chinese medicine combined with western medicine for the treatment of hypertension from database construction to July 31， 2022. The quality of the literature was evaluated using the bias risk assessment tool in Cochrane Handbook 6.3. Evidence synthesis of main outcome indicators was performed using R software. The Grading of Recommendations Assessment， Development， and Evaluation profiler （GRADEprofiler） 3.6 was employed to evaluate the quality of evidence. Expert consensus was formed based on the Delphi method after two rounds of voting. Result64 pieces of literature were included， and the results of literature quality evaluation and risk of bias showed that 70.31% （45/64） of the studies indicated some risks， and 29.69% （19/64） indicated high risks. Compared with conventional western medicines， the combination of Chinese patent medicines with western medicines can significantly lower systolic pressure （SBP） and diastolic pressure （DBP）， increase the effective rate of antihypertensive， reduce the incidence of adverse reactions， endothelin-1， and traditional Chinese medicine syndrome scores. Egger's test showed that Songling Xuemaikang capsules reduced SBP and DBP. Tianma Gouteng granules reduced SBP and DBP and increased the effective rate of antihypertensive， and Xinmaitong capsules reduced SBP and increased the effective rate of antihypertensive， without significant publication bias. Songling Xuemaikang capsules increased the effective rate of antihypertensive， and Xinmaitong capsules decreased DBP， with significant publication bias. The results of the GRADE evidence quality evaluation showed that most evidence was at grades B and C. Finally， four strong recommendations and 14 weak recommendations were formed. ConclusionCompared with conventional western medicines for the treatment of hypertension， antihypertensive Chinese patent medicines combined with western medicines have advantages in reducing blood pressure and improving drug use safety， but they are mostly weak recommendations in terms of efficacy， and more high-quality evidence is needed.

Evaluation of GRADE Clinical Research Evidence of Chinese Patent Medicine Combined with Western Medicine in Treatment of Hypertension with Dyslipidemia / 中国实验方剂学杂志

ObjectiveTo evaluate the effect of antihypertensive and lipid-regulating Chinese patent medicine combined with conventional Western medicine in the treatment of hypertension with dyslipidemia. To carry out the evidence synthesis of clinical research and provide evidence-based evidence support for clinical decision-making. MethodThe databases including China National Knowledge Infrastructure （CNKI），Wanfang Data Knowledge Service Platform （WF），VIP，SinoMed，Embase，PubMed，Web of Science （WOS），and the Cochrane Library were searched for randomized controlled trials （RCT） of all listed Chinese patent medicines in the treatment of hypertension with dyslipidemia from the establishment of the databases to April 15，2023. The literature was screened and extracted，and the risk of bias tool 2.0 （RoB2） was used to assess the quality and risk of bias of the methodology. Revman 5.4.1 software was used to analyze the outcome indicators. Grading of Recommendations Assessment，Development and Evaluation （GRADE） was applied to assess the quality of evidence formed by clinical research data. The inclusion and recommendation of Chinese patent medicines in the National Drug Catalogue for Basic Medical Insurance，Work-related Injury Insurance and Maternity Insurance （2022） and domestic guidelines and consensus were searched to form a bubble chart. ResultA total of 15 studies were included. The evaluation of the methodological quality of each study showed that the risk of bias stemmed from the lack of blinding and allocation concealment，and low sample size. The comprehensive analysis of clinical studies showed that Dengzhan Shengmai capsules combined with rosuvastatin and amlodipine besylate，Yindan Xinnaotong capsules combined with simvastatin and levamlodipine tablets，Xiaoshuan Tongluo capsules combined with nifedipine controlled release tablets and pravastatin sodium tablets，Xinshubao capsules combined with atorvastatin calcium tablets and irbesartan，Wenyading capsules combined with enalapril，and Jiangzhining tablets combined with conventional Western medicines were all superior to conventional Western medicines used in the control group in improving systolic blood pressure （SBP），diastolic blood pressure （DBP），cholesterol （TC），triglyceride （TG），low density lipoprotein cholesterol （LDL-C），and high density lipoprotein cholesterol （HDL-C）. There was no significant difference in the incidence of adverse reactions between the two groups. The GRADE evaluation of the main outcome indicators showed that the evidence quality of SBP and incidence of adverse reactions was graded as B，that of DBP as C，and that of total TC，TG，LDL-C，and HDL-C as D. The evaluation of Chinese patent medicines covered by medical insurance and recommended by guidelines and consensus showed that Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules belonged to class B drugs of medical insurance，and were recommended for 7，6 and 3 times in the guidelines and consensus，respectively. ConclusionCompared with simple medicine treatment，Chinese patent medicine combined with conventional Western medicine has more advantages in improving blood pressure and blood lipid，and shows higher safety. Among them，Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules have stronger clinical applicability and economy. All the trials included in this article adhered to the principle of randomization and reported the outcome measures. However，the quality of evidence in related clinical studies was low. In terms of trial design，large-sample，multi-center，blinded randomized controlled trials based on the consolidated standards of reporting trials （CONSORT） statement are still needed for comprehensive trial designs and reporting，to further improve the GRADE quality evaluation and guideline formulation under the guidance of evidence-based medicine，so as to provide higher quality evidence-based research evidence for clinical decision-making.

Using electroencephalogram for emotion recognition based on filter-bank long short-term memory networks / 生物医学工程学杂志

Emotion plays an important role in people's cognition and communication. By analyzing electroencephalogram (EEG) signals to identify internal emotions and feedback emotional information in an active or passive way, affective brain-computer interactions can effectively promote human-computer interaction. This paper focuses on emotion recognition using EEG. We systematically evaluate the performance of state-of-the-art feature extraction and classification methods with a public-available dataset for emotion analysis using physiological signals (DEAP). The common random split method will lead to high correlation between training and testing samples. Thus, we use block-wise

Effects of transcutaneous electrical acupoint stimulation-assisted anesthesia on pain and rapid recovery in elderly patients undergoing thoracoscopic surgery / 中华老年医学杂志

Objective:To examine the effects of transcutaneous electrical acupoint stimulation(TEAS)on pain and rapid recovery in elderly patients undergoing thoracoscopic surgery.Methods:A total of 60 elderly patients undergoing thoracoscopic surgery were randomly divided into the TEAS group and the control group.Patients in the TEAS group received TEAS in bilateral acupoints of Hegu, Neiguan, Houxi and Zhigou at a frequency of 2/100 Hz for 30 min before anesthesia induction.The electrical stimulation intensity went from weak to strong, and gradually adjusted to the patient's maximum tolerance(10 to 15 mA)continuously for 30 min; TEAS continued during intraoperative anesthesia with a stimulation intensity of 30 mA and a frequency of 2/100 Hz until the end of surgery.Patients in the control group were given electrode pads at the same acupoints without electrical stimulation.Results:Compared with the control group, patients in the TEAS group were associated with significantly decreased doses of Sufentanil[(57.93±5.54)μg vs (44.30±4.03 )μg, t=-10.903, P=0.000)], Remifentanil[(1.56±0.26)μg vs (1.08±0.18)μg, t=-8.3043, P=0.000)], Propofol[(763.23±62.04)mg vs (559.20±46.44) mg, t=-14.420, P=0.000)]and Dexmedetomidine[(545.07±53.36) vs (301.67±43.27) μg, t=-19.405, P=0.000)], reduced frequency of analgesic pump pressing(9.9±2.0 vs 2.9±1.3, t=-10.903, P=0.000), decreased VAS scores 24 h(3.53±1.07 vs 1.90±0.66, t=-7.090, P=0.000)and 48 h(1.37±0.61 vs 0.93±0.37, t=-4.660, P=0.000)postoperatively.Time to regaining consciousness, extubation and detachment were also markedly shortened in the TEAS group.In addition, time to postoperative feeding and time to postoperative ambulation were also reduced.Postoperative hospitalization days( P<0.05)and anesthesia cost( P<0.01)both significantly decreased in the TEAS group compared with those in the control group.Patients in the TEAS group had lower rates of nausea, vomiting, decreased oxygen saturation, dyspnea, dizziness, agitation and lethargy, and increased heart rate and decreased mean arterial pressure after the opening of the pleura(H1)compared with those in the control group(all P<0.05). Bispectral indexes were maintained between 40 and 60 after anesthesia in both groups(all P<0.01). Conclusions:TEAS-assisted anesthesia can effectively alleviate pain in elderly patients undergoing thoracoscopic surgery and promote rapid recovery after operation.

Effect of pretreatment with Rhizoma Alismatis extract on cardiac function and cysteinyl aspartate specific protease-3 in ischemia-reperfusion injury of rats / 中华老年医学杂志

Objective To observe the effect of pretreatment with Rhizoma Alismatis extract on cardiac function and cysteinyl aspartate specific protease-3 (caspase-3)in ischemia-reperfusion injury of rats.Methods Male Sprague-Dawley(SD)rats were randomized into a sham-operated group (S group),an ischemia-reperfusion group(IR group),Rhizoma Alismatis water extract group(S1 group),Rhizoma Alismatis alcohol extract group(S2 group)and Rhizoma Alismatis polysaccharide group(S3 group).At the end of 14-day of intragastric gavages,rats were subjected to 40 min(T1)of LAD(left anterior descending)coronary artery ligation (ischemia)and 120 min (T2)of ligation loosening (reperfusion),called as myocardial ischemia-reperfusion(IR)models.Then,at the end of T1 and T2,the left ventricular end diastolic pressure (LVEDP),left ventricular systolic pressure (LVSP),and maximum rise/fall rate of left intraventricular pressure(± dp/dtmax)were recorded respectively.The level of creatine kinase(CK)and lactate dehydrogenase(LDH)were determined.The area of myocardial infarction and the expression level of caspase-3 protein were tested.Results At end of T2,compared with the index values of IR group as a non-treatment control[LVEDP(6.70 ±0.22)mmHg,LVSP (86.16±15.11)mmHg,+dp/dtmax(997.99±151.03)mmHg,-dp/dtmax(663.71±68.55)mmHg,CK(10.54±2.04)U/L,LDH(296.51±7.00)U/L,the size of myocardial infarction(39.82±11.80)％and expression level of caspase-3(123.42±14.77)],the treatment groups of S1,S2,and S3 showed a lower levels of LVEDP [(5.89 ± 0.47) mmHg,(5.89 ± 0.67) mmHg,(6.07 ±0.51) mmHg],of activity of CK[(8.60± 1.67)U/L(8.90±1.27)U/L,(9.39±0.83) U/L],of LDH[(239.33±30.81) U/L,(223.63 ± 20.26) U/L,(241.19 ± 45.56) U/L],of size of myocardial infarction[(30.39 ± 5.44) ％,(32.18±5.90)％,(33.12±8.16)％],and of expression level of caspase3 protein[(73.44± 15.28),(65.47±12.53),(65.05± 10.45)],(all P＜0.01 or＜0.05);but showed a higher levels of LVSP[(99.24±12.00)mmHg,(97.05±12.45)mmHg,(97.06±7.61) mmHg],and of ±dp/dtmax [(1 137.33±85.70)mmHg,(1 147.24±118.07)mmHg,(1 124.50±141.47)mmHg];[(604.77± 68.37)mmHg,(616.61±46.73)mmHg,(708.76±81.44)mmHg],(all P＜0.01 or＜0.05).Conclusions Pretreatment with Rhizoma Alismatis extract can effectively improve the cardiac function of ischemic repeffusion injury in vivo in rats,and reduce myocardial infarction size and myocardial enzyme release.The mechanism may be related to the down-regulation of apoptotic protein caspase-3 in myocardial tissue.

Effects of Shengmai injection on platelet parameters and CD4+CD25+T cells in patients with chronic lymphocytic leukemia / 中国生化药物杂志

Objective To study the effect of Shengmai injection on the platelet parameters and CD4+CD25+cells in peripheral blood of patients with chronic lymphocytic leukemia,and to explore the optimal regimen for patients with chronic lymphocytic leukemia.Methods One hundred and twenty patients with chronic lymphocytic leukemia were enrolled in this study from January 2012 to December 2014.(D1),vincristine 4mg(d1),prednisone 60 mg/d(d1-5)were given to the CHOP regimen in the control group: cyclophosphamide 600 mg/m2(d1),doxorubicin 25 mg/m2(d12)28d a course of treatment,a total of 4 courses,the observation group of patients in the control group of patients treated on the basis of Shengmai injection,compared the two groups of patients with chemotherapy,platelet parameters and serum CD4+CD25+T cells and Th17 cells.Results After treatment,the PLT,MPV and PDW of the observation group were(215.4± 31.7),(9.5±2.5)and(16.9±2.4),respectively,which were significantly higher than those of the control group.The CD4+CD25+T cells in the observation group were(1.5±0.8)The total effective rate of the control group was 35.0％,the total effective rate was 35.0％,and the total effective rate of the control group was 35.0％.There were significant difference between the control group and the control group(P<0.05),The difference was statistically significant.Conclusion Shengmai injection combined with CHOP regimen in chronic lymphocytic leukemia patients can improve immune function,promote platelet growth,improve platelet clinical parameters,and help improve the efficiency of chemotherapy,compared with CHOP alone Program treatment is better,worthy of clinical application.

Effect of ketamine on sensory processing of thalamocortical circuits in rats / 中华麻醉学杂志

Objective To investigate the effect of ketamine injected into the ventral posteromedial nucleus (VPM) of the thalamus on sensory processing of thalamocortical circuits in rats.Methods Twenty-four SpragueDawley rats in which the neurophysiological model was successfully established,aged 2 months,weighing 280-350g,were randomly divided into 4 groups (n=6 each):control group (group C),specific inhibitor of NMDA receptors AP-5 group (group A) and two different concentrations of ketamine groups (K1 and K2 groups).Normal saline 1 μl,AP-5 5 μg/μl and ketamine 12.5 and 25.0 μg/μl were injected into the VPM in A,AP-5,K1 and K2groups,respectively.Somatosensory-evoked potentials (SEPs) in the primary somatosensory cortex (S1) of the rat was recoded at 4 time periods:300 s before administration-immediately after administration (baseline,T0),immediately after administration-300 s after administration (T1),300-600 s after administration (T2),600-900 s after administration (T3).Results Compared with the baseline value at T0,there was no significant difference in the peak amplitude of SEPs at T1-3 in group C (P ＞ 0.05),and the peak amplitude of SEPs was significantly decreased at T1-3 in A,K1 and K2 groups (P ＜ 0.05).Compared with group C,the peak amplitude of SEPs was significantly decreased at T1-3 in A,K1 and K2 groups (P ＜ 0.05).Compared with group A,the peak amplitude of SEPs was significantly increased at T3 in group K1 (P ＜ 0.05).There was no significant difference in the peak amplitude of SEPs between A and K2 groups,K1 and K2 groups (P ＞ 0.05).Conclusion Ketamine results in damage to the integrity of sensory processing of thalamocortical circuits and reduction of incoming sensory information,and the mechanism may be related to blockade of NMDA receptors in VPM of the thalamus.