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In order to judge the future development trend of science and technology, plan ahead and lay out the frontier technology fields and directions, China Association of Chinese Medicine(CACM) has launched consultation projects for collecting "major scienti-fic issues and engineering technology difficulties in traditional Chinese medicine(TCM)" for the industry for three consecutive years since 2019. Up to now, 18 projects have been selected as major issues for research, and some experience and achievements have been made. These projects have been applied in important scientific and technological work such as scientific and technological planning and deployment at all levels of national, local, and scientific research institutions, the selection and cultivation of major national scientific and technological projects, and the construction of innovation bases, giving full play to the role of the think tank advisory committee of CACM. This study reviewed the selection of major issues for the first time, systematically combed its application in the national layout of science and technology, and put forward the existing problems and improvement suggestions, aiming to provide new ideas for further improving the selection of major issues and research direction, providing a theoretical basis and decision support for the national scientific and technological layout in the field of TCM, and promoting scientific and technological innovation to facilitate the high quality development of TCM.
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Medicine, Chinese Traditional , Inventions , China , Drugs, Chinese HerbalABSTRACT
The pathological changes of the heart after myocardial infarction （MI） are complex， involving multiple molecular mechanisms and various cells， such as myocardial cells， endothelial cells， fibroblasts， and macrophages. With multiple targets， Chinese medicine demonstrates ideal cardioprotective effect. However， the complex mechanism of multi-component Chinese medicine formulas has not been elucidated， thus limiting the further application. The high-throughput single-cell RNA sequencing （scRNA-seq） technology offers single-cell transcriptome analysis of hundreds of drugs under different processing conditions in a single experiment and identifies the differences in the response of different cells and cell subtypes to drug treatment. scRNA-seq technology helps us to understand the exact cellular and molecular mechanisms of cardiac remodeling from acute ischemic events to chronic cardiac scarring. The application of scRNA-seq to studying the cardioprotective mechanism of Chinese medicine after MI can boost the development of Chinese medicine， help obtain richer， more accurate and comprehensive information. It can give us a clear insight into the mechanism of Chinese medicine based on complex network. In this study， we summarized the research on cardioprotective mechanism of Chinese medicine and introduced the development of scRNA-seq technology and the application to MI research. Finally， we explored the possible application prospects of scRNA-seq in the research on cardioprotective mechanism of Chinese medicine after MI， hoping to provide ideas for the modernization of Chinese medicine.
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OBJECTIVE@#To evaluate the effectiveness of integrative medicine (IM) on patients with coronary artery disease (CAD) and investigate the prognostic factors of CAD in a real-world setting.@*METHODS@#A total of 1,087 hospitalized patients with CAD from four hospitals in Beijing, China were consecutively selected between August 2011 and February 2012. The patients were assigned to two groups based on the treatment: Chinese medicine (CM) plus conventional treatment, i.e., IM therapy (IM group); or conventional treatment alone (CT group). The endpoint was major adverse cardiac events [MACE; including cardiac death, myocardial infarction (MI), and revascularization].@*RESULTS@#A total of 1,040 patients finished the 2-year follow-up. Of them, 49.4% (514/1,040) received IM therapy. During the 2-year follow-up, the total incidence of MACE was 11.3%. Most of the events involved revascularization (9.3%). Cardiac death/MI occurred in 3.0% of cases. For revascularization, logistic stepwise regression analysis revealed that age ⩾ 65 years [odds ratio (OR), 2.224], MI (OR, 2.561), diabetes mellitus (OR, 1.650), multi-vessel lesions (OR, 2.554), baseline high sensitivity C-reactive protein level ⩾ 3 mg/L (OR, 1.678), and moderate or severe anxiety/depression (OR, 1.849) were negative predictors (P<0.05); while anti-platelet agents (OR, 0.422), β-blockers (OR, 0.626), statins (OR, 0.318), and IM therapy (OR, 0.583) were protective predictors (P<0.05). For cardiac death/MI, age ⩾ 65 years (OR, 6.389) and heart failure (OR, 7.969) were negative predictors (P<0.05), while statin use (OR, 0.323) was a protective predictor (P<0.05) and IM therapy showed a beneficial tendency (OR, 0.587), although the difference was not statistically significant (P=0.218).@*CONCLUSION@#In a real-world setting, for patients with CAD, IM therapy was associated with a decreased incidence of revascularization and showed a potential benefit in reducing the incidence of cardiac death or MI.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Coronary Artery Disease , Drug Therapy , Integrative Medicine , Logistic Models , Medicine, Chinese Traditional , PrognosisABSTRACT
OBJECTIVE@#To examine the prognostic value of serum levels of asymmetric dimethylarginine (ADMA) in patients with stable coronary heart disease (CHD) thus explore a potential biomarker of "toxin syndrome" in CHD.@*METHODS@#In this prospective nested case-control study, 36 of 1,503 Chinese patients with stable CHD experienced at least 1 recurrent cardiovascular event (RCE) during 1-year follow-up. Serum levels of ADMA at the start of follow-up were compared between these 36 cases and 36 controls which matched to cases in terms of gender, age, history of hypertension, and myocardial infarction.@*RESULTS@#Based on the crude model, subjects in the 2 highest ADMA quartiles showed significantly higher risk of developing RCE than those in the lowest ADMA quartile [odds ratio (OR) 4.09, 95% confidence interval (CI) 1.01 to 16.58; OR 6.76, 95% CI 1.57 to 29.07]. This association was also observed in the case-mix model (OR 5.51, 95% CI 1.23 to 24.61; OR 7.83, 95% CI 1.68 to 36.41) and multivariable model (OR 6.64, 95% CI 1.40 to 31.49: OR 13.14, 95% CI 2.28 to 75.71) after adjusting for confounders. The multivariable model which combined ADMA and high-sensitivity C-reactive protein (hsCRP) showed better predictive power with areas under the receiver operator characteristic curves (0.779) than the model of either ADMA (0.694) or hsCRP (0.636).@*CONCLUSION@#Serum ADMA level may be a potential biomarker of "toxin syndrome" in CHD which shows favorable prognostic value in predicting 1-year RCE in patients with stable CHD. [The registration number is ChiCTR-PRNRC-07000012].
Subject(s)
Humans , Arginine , Blood , Biomarkers , Blood , Coronary Disease , Blood , Odds Ratio , ROC Curve , Recurrence , Risk Factors , SyndromeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the prognosis effect of Chinese herbal medicines (CHMs) for benefiting qi and activating blood circulation adjunctive to conventional treatment in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>A total of 702 patients with ACS who underwent PCI were enrolled and randomly assigned to receive conventional treatment plus CHMs for benefiting qi and activating blood circulation (treatment group, 351 cases) or conventional treatment alone (control group, 351 cases) for 6 months. Six months later, all patients received conventional treatment alone. Follow-ups were scheduled at 6th, 12th, 18th, 24th month after enrollment in April 2008, and the final follow-up visit was during September 2011 and November 2011. The primary endpoint was the composite of cardiac death, nonfatal myocardial infarction or revascularization (PCI or coronary artery bypass grafting); and the secondary endpoint was the composite of re-admission for ACS, congestive heart failure, nonfatal stroke or other thrombus events.</p><p><b>RESULTS</b>A total of 621 (88.59%) patients completed 35.4±3.8 months follow-up, while 80 (11.41%) patients withdrew from the trial (41 in the treatment group and 39 in the control group). The incidence of primary endpoint was 5.7% (20 patients) in the treatment group versus 10.86% (38 patients) in the control group [relative risk (RR): 0.53; 95% confidence interval (CI): 0.30, 0.88; P=0.013; absolute risk reduction (ARR):-0.052, 95% CI: -0.06, 0.01]. The incidence of secondary endpoint was 5.98% (21 patients) in the treatment group versus 10.28% (36 patients) in control group (RR: 0.58, 95% CI: 0.33, 0.97, P=0.037; ARR: -0.043, 95% CI: 0.06, 0.01). Most of the primary and secondary endpoints were occurred in 18 months (84.50% in the treatment group versus 78.10% in the control group).</p><p><b>CONCLUSION</b>CHMs for benefiting qi and activating blood circulation adjunctive to conventional treatment improved clinical outcomes for patients with ACS after PCI in long-term follow-up.</p>
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<p><b>OBJECTIVE</b>To observe the efficacy of Chinese herbs for supplementing qi and activating blood circulation (CHSQABC) on patients with acute coronary syndrome (ACS) and type 2 diabetes mellitus (DM) after successful percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>In this ChiCTR-TRC-00000021, a total of 281 ACS patients complicated with type 2 DM after successful PCI were randomly assigned to the Western medicine treatment group (the control group, treated by routine Western medicine treatment) and the combined treatment group (the treatment group, treated by CHSQABC + routine Western medicine treatment). Patients in the combined treatment group took Xinyue Capsule (2 pills each time, 3 times per day) and Compound Chuanxiong Capsule (2 pills each time, 3 times per day for half a year and 1-year follow-ups). Primary endpoints covered incidence of death, nonfatal myocardial infarction (MI), ischemia-driven revascularization, and secondary endpoints included stroke, heart failure, and rehospitalization for ACS. At the same time scores for blood stasis syndrome (BSS) and the incidence of angina pectoris were evaluated before treatment, at month 1, 3, 6, 9, and 12 after treatment.</p><p><b>RESULTS</b>The incidence of ischemia-driven revascularization was obviously less in the treatment group than in the control group (P < 0.05). No patient had nonfatal MI in the treatment group, while 5 patients in the control group had it. The incidence of non-fatal MI showed an obvious lowering tendency in the treatment group, but with no statistical difference when compared with that in the control group (P > 0.05). Four patients readmitted to hospital in the treatment group, while 12 patients readmitted. There existed obvious tendency in the treatment group, but with no statistical difference when compared with that in the control group (P > 0.05). The incidence of angina was significantly lower in the treatment group at month 6, 9, and 12 than that at month 1 , but it was lower in the control group at 9 months (P < 0.05). The incidence of angina was 15. 4% in the treatment group, obviously lower than that in the control group (26.2%, P < 0.05). Compared with before treatment, scores for BSS were obviously lowered in the treatment group at 1, 3, 6, 9, and 12 months of treatment and in the control group at 3, 6, 9, and 12 months of treatment (P < 0.05). It was obviously lower in the treatment group than in the control group at 3, 6, 9, and 12 months of treatment (P < 0.01).</p><p><b>CONCLUSION</b>Administration of CHSQABC combined routine Western medicine treatment could reduce the event of revascularization and post-PCI recurrent angina, and improve scores for BSS of ACS patients complicated with DM after PCI.</p>
Subject(s)
Humans , Acute Coronary Syndrome , General Surgery , Therapeutics , Angina Pectoris , Combined Modality Therapy , Diabetes Mellitus, Type 2 , Therapeutics , Drugs, Chinese Herbal , Pharmacology , Incidence , Medicine, Chinese Traditional , Myocardial Infarction , Percutaneous Coronary Intervention , QiABSTRACT
<p><b>OBJECTIVE</b>To analyze the correlation of Chinese medicine syndrome evolvement and cardiovascular: events in patients with stable coronary heart disease (CHD).</p><p><b>METHODS</b>This prospective cohort study investigated and: collected the clinical information of patients with stable CHD and observed the syndrome type at the baseline and 6-month at follow-up, as well as the cardiovascular events during the 6-month and 12-month follow-up. The patients were divided into the event group and the non-event group. The interaction and the impact of syndrome evolvement on cardiovascular events were examined through multifactor dimensionality reduction (MDR) analysis and the results were verified by Chi-square test.</p><p><b>RESULTS</b>Totally 1,333 of 1,503 stable CHD patients enrolled met the inclusion criteria: of MDR analysis. Among them, 959 (71.9%) cases were males and 374 (28.1%) cases were females. Thirty seven cases had cardiovascular events during 6 to 12 months after the study began. The results of the MDR analysis and verification using Chi-square test showed that the development of cardiovascular events was positively correlated with interaction between blood stasis and toxic syndrome at the baseline, blood stasis at the baseline and qi deficiency at the 6-month follow-up, toxic syndrome at the baseline and qi deficiency at the 6-month follow-up, toxic syndrome at the base line and blood stasis at the 6-month follow-up, qi deficiency and blood stasis at the 6-month follow-up (P<0.05 for all).</p><p><b>CONCLUSIONS</b>Blood stasis, toxic syndrome and qi deficiency are important factors of stable CHD. There: are positive correlation between cardiovascular events and syndrome evolution from blood stasis to qi deficiency, from toxic syndrome to qi deficiency and from toxic syndrome to blood stasis, indicating the pathogenesis of toxin consuming qi, toxin leading to blood-stasis in stable CHD patients prone to recurrent cardiovascular events.</p>
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Aged , Female , Humans , Male , Middle Aged , Cardiovascular Diseases , Coronary Angiography , Coronary Disease , Medicine, Chinese Traditional , Multifactor Dimensionality Reduction , SyndromeABSTRACT
The diagnostic criteria of blood stasis syndrome (BBS) established by the Specialty Committee of Activating Blood Circulation and Removing Stasis, Chinese Association of Integrative Medicine 1986 has been widely used in clinical practice of Chinese medicine. But coronary heart disease (CHD) of BBS has its own features. By using clinical epidemiological methods, establishing the diagnostic criteria for CHD patients of BBS is of great significance in furthering its studies, exerting the advantages of Chinese medicine in preventing and treating CHD, and elevating the clinical efficacy.
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Humans , Coronary Disease , Diagnosis , Diagnosis, Differential , Medicine, Chinese Traditional , Methods , Reference Standards , Reference StandardsABSTRACT
<p><b>OBJECTIVE</b>To seek the key platelet functional proteins (PFPs) for the occurrence of blood-stasis pattern (BP) in patients with coronary heart disease (CHD).</p><p><b>METHODS</b>Peripheral blood platelet protein of 22 patients and 24 healthy person (for control) were extracted respectively in 4 batches for carrying 4 times of the test out. Differential PFPs in samples were screened out by two-dimensional fluorescence difference gel electrophoresis, and identified with matrix-assisted laser desorption/ionization-time of flight mass spectrometry; then the identified proteins were further authenticated by Western-blotting.</p><p><b>RESULTS</b>Thirteen differential PFPs were screened out, and among them the 7 identified by spectrometry were: isoform 1 of integrin alpha- II b, isoform 2 of integrin alpha- II b, actin-cytoplasmic 1, actin-cytoplasmic 2, cDNA FLJ52842, cDNA FLJ55253, and cDNA FLJ43573 fis. Among them isoform 2 of integrin alpha- II b (CD41) and actin-cytoplasmic 2 (Acting) were authenticated successfully.</p><p><b>CONCLUSION</b>CD41 and acting are the possible marker proteins, and the other PFPs might play crucial roles in the occurrence and development of BSS in CHD.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Blood Platelets , Case-Control Studies , Coronary Disease , Blood , Diagnosis , Electrophoresis, Gel, Two-Dimensional , Medicine, Chinese Traditional , Platelet Membrane Glycoproteins , Spectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationABSTRACT
<p><b>OBJECTIVE</b>To systematically evaluate the therapeutic efficacy of Shengmai Injection (SMI) on the fatality rate of patients with acute myocardial infarction (AMI).</p><p><b>METHODS</b>Literature associated with randomized controlled trials (RCT) or quasi-RCT of SMI in treating patients with AMI were retrieved by computerized searching from Cochrane Central Register of Controlled Trials (Issue 3, 2007), PubMed (1980 - 2007), EMBASE (1979 -2007.4) , OVID (1979 - 2007.4), Chinese Biological Medicine Database (1979 - 2007.4), CNKI (1980 -2007.4), VIP (1989 - 2007.4) and those in Chinese Conference Treatises in cardiovascular diseases were hand searched (update to Dec 2006). Quality of them was evaluated with the method recommended in Cochrane Reviewer's Handbook 4.2.6, and statistical analysis was performed using the Cochrane Collaboration's Rev Man 4.2.9 software.</p><p><b>RESULTS</b>Four RCT (conducted in China), involving 376 AMI patients meeting the inclusion criteria were identified. All the included RCT were graded as C. The results of meta-analyses indicated that the fatality rate in the SMI treated group was cut down [RR: 0.18, 95% CI (0.04, 0.77)], but the decreasing trend become insignificant when SMI was used in combination with vasoactive agents [RR: 0.67,95% CI (0.29, 1.51)].</p><p><b>CONCLUSIONS</b>According to the present evidence, the fatality rate can be decreased by combined use of SMI with the conventional therapy of modern medicine. However, it is necessary to do further research on whether SMI is suitable for combined use with vasoactive agent, the opportunity and method of doing that way. As the evidence obtained is not strong enough due to the rather poor quality of current studies enclosed, further studies with high-quality, large-scale trials are required for identification.</p>
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Humans , Drugs, Chinese Herbal , Injections , Myocardial Infarction , Drug Therapy , Mortality , Randomized Controlled Trials as TopicABSTRACT
<p><b>OBJECTIVE</b>To explore the characteristics of Chinese medicinal treatment on 302 chronic heart failure (CHF) patients of coronary heart disease and diabetes.</p><p><b>METHOD</b>Data of CHF patients of coronary heart disease and diabetes hospitalized in 9 hospitals of Beijing and Tianjin from Jan. 2003 to Sep. 2006 were collected and their clinical syndromes, condition of treatment (both western and Chinese medicine) were investigated and analyzed using the data system of Chinese medicine clinical research for coronary heart disease.</p><p><b>RESULT</b>In the 302 patients, the intravenous perfusion were mainly injections of puerarin, Salvia mitrorrhiza, sanchi total saponin and fleabane. The Chinese medicinal treatment applied was mainly the methods of supplementing Qi, activating blood circulation, dissolving phlegm. In the apozem, hoelen is the highest frequency in all drugs and the frequency in order is hoelen, glycyrrhizae, Salvia mitrorrhiza, astragali, Rhizoma Pinelliae, etc.</p><p><b>CONCLUSION</b>The patients of these 9 hospitals were mainly treated by integrative medicine and the Chinese medicinal treatment applied was mainly the methods of supplementing Qi, activating blood circulation, dissolving phlegm.</p>