Guanxin Danshen Dripping Pills Improve Quality of Life and Cardiovascular Prognoses of CHD Patients after PCI with Anxiety or Depression (GLAD Study): A Randomized Double-Blind Placebo-Controlled Study / 中国结合医学杂志

OBJECTIVE@#To assess the efficacy and safety of Guanxin Danshen Dripping Pills (GXDS) in the treatment of depression or anxiety in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).@*METHODS@#From September 2017 to June 2019, 200 CHD patients after PCI with depression and anxiety were included and randomly divided into GXDS (100 cases) and placebo control groups (100 cases) by block randomization and a random number table. Patients in the GXDS and control groups were given GXDS and placebo, respectively, 0.4 g each time, 3 times daily for 12 weeks. The primary outcomes were scores of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Scale (GAD-7) and the Seattle Angina Pectoris Scale (SAQ). The secondary outcomes included 12 Health Survey Summary Form (SF-12) scores and the first onset time and incidence of major adverse cardiovascular events (MACEs). Other indices including blood pressure, blood lipids, microcirculation and inflammatory-related indices, etc. were monitored at baseline, week 4, and week 12.@*RESULTS@#In the full analysis set (200 cases), after treatment, the PHQ-9 and GAD-7 scores in the GXDS group were considerably lower than those in the control group (P<0.05). Compared with the baseline, the total PHQ-9 scores of the experimental and control groups decreased by 3.97 and 1.18, respectively. The corrected mean difference between the two groups was -2.78 (95% CI: -3.47, -2.10; P<0.001). The total GAD-7 score in the GXDS group decreased by 3.48% compared with the baseline level, while that of the placebo group decreased by 1.13%. The corrected mean difference between the two groups was -2.35 (95% CI: -2.95, -1.76; P<0.001). The degree of improvement in SAQ score, SF-12 score, endothelin and high-sensitive C-reactive protein levels in the GXDS group were substantially superior than those in the placebo group, and the differences between the two groups were statistically significant (P<0.05). Similar results were obtained in the per protocol population analysis of 177 patients. Three cases of MACES were reported in this study (1 in the GXDS group and 2 in the placebo group), and no serious adverse events occurred.@*CONCLUSIONS@#GXDS can significantly alleviate depression and anxiety, relieve symptoms of angina, and improve quality of life in patients with CHD after PCI. (Registration No. ChiCTR1800014291).

Analysis of Transcriptomes and Differentially Expressed Genes in Leaves and Roots of Tetrastigma hemsleyanum Diels et Gilg / 中国中医药信息杂志

Objective To obtain the transcriptome database and differentially expressed genes of Tetrastigma hemsleyanum Diels et Gilg. by Illumina HiSeq 4000; To provide important molecular information for its molecular biology research. Methods Leaves and roots of Tetrastigma hemsleyanum Diels et Gilg. were chosen as experimental materials to conduct transcriptome sequencing. Then bioinformatics analysis of gene function annotations, metabolic pathways, and microsatellites was performed on the test data. Results 24.13 Gb Clean Data were assembled. Afer assembly steps, 84 433 of T. hemsleyanum Unigene were obtained, and then they were compared in the 7 gene database, and 47 766 annotated information of Unigene was obtained. There were 27 790 annotations in the GO database. The number of differentially expressed genes in the roots, stems and leaves was 4989, of which 3511 were up-regulated and 1478 were down-regulated. The COG database obtained 16 152 homologous sequences of Unigene, which were divided into 25 categories. In the KEGG database, there were 14 511 Unigene obtained the corresponding Ko number, which could be divided into 130 branches of signal metabolism, among which the number of Unigene in the ribosome synthesis pathway was the most, with 1042, and there was only 1 Unigene in the biosynthetic pathway of isoflavones. Conclusion A large number of transcripts of the transcriptome were obtained through splicing, assembling and functional annotation of Tetrastigma hemsleyanum Diels et Gilg., which can provide genomic database resources for molecular biology research of Tetrastigma hemsleyanum Diels et Gilg.

Relationship Between Plasma suPAR Level and Acute Coronary Syndrome With its Influencing Factors / 中国循环杂志

Objective: To explore the relationship between plasma level of soluble urokinase plasminogen activator receptor (suPAR) and the severity of acute coronary syndrome (ACS) with its influence factors. Methods: A total of 321 consecutive patients with chest pain admitted in our hospital from 2015-03 to 2016-09 were studied. According to clinical presentation, laboratory test and coronary angiography (CAG), the patients were divided into 2 groups: ACS group, n=228 and Control group, the patients with normal coronary artery, n=93. Plasma levels of suPAR and high sensitive C reaction protein (hs-CRP) were measured by ELISA and compared between 2 groups. Results: The levels of plasma suPAR in ACS patients were significantly higher than those in the control group (OR= 0.104, 95％ CI: 0.048-0.223, P<0.01). In ACS group, the plasma suPAR level gradually increased with the increase of Gensini score, The sensitivity and specificity of the levels of suPAR were determined by ROC curve. The values of ACS were predicted to be 1.8 μg / L, the sensitivity was 0.732 and the specificity was 0.710. Multiple linear regression analysis showed that smoking, Gensini score and uric acid were the main factors affecting plasma suPAR levels. Conclusion: Elevated plasma suPAR level has been related to the severity of coronary stenosis in ACS patients, such relationship is superior to hs-CRP; suPAR might be worked as a new biomarker for predicting coronary stenosis and risk stratification in ACS patients.

Relationship Between Plasma suPAR Level and Acute Coronary Syndrome With its Influencing Factors / 中国循环杂志

Objective: To explore the relationship between plasma level of soluble urokinase plasminogen activator receptor (suPAR) and the severity of acute coronary syndrome (ACS) with its influence factors. Methods: A total of 321 consecutive patients with chest pain admitted in our hospital from 2015-03 to 2016-09 were studied. According to clinical presentation, laboratory test and coronary angiography (CAG), the patients were divided into 2 groups: ACS group, n=228 and Control group, the patients with normal coronary artery, n=93. Plasma levels of suPAR and high sensitive C reaction protein (hs-CRP) were measured by ELISA and compared between 2 groups. Results: The levels of plasma suPAR in ACS patients were significantly higher than those in the control group (OR= 0.104, 95％ CI: 0.048-0.223, P<0.01). In ACS group, the plasma suPAR level gradually increased with the increase of Gensini score, The sensitivity and specificity of the levels of suPAR were determined by ROC curve. The values of ACS were predicted to be 1.8 μg / L, the sensitivity was 0.732 and the specificity was 0.710. Multiple linear regression analysis showed that smoking, Gensini score and uric acid were the main factors affecting plasma suPAR levels. Conclusion: Elevated plasma suPAR level has been related to the severity of coronary stenosis in ACS patients, such relationship is superior to hs-CRP; suPAR might be worked as a new biomarker for predicting coronary stenosis and risk stratification in ACS patients.

Effects of xinfuli granule on cardiomyocyte apoptosis in rats with dilated heart failure induced by adriamycin / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effects of Xinfuli Granule (XG) on cardiomyocyte apoptosis in rats with adriamycin-induced dilated cardiomyopathy (DCM).</p><p><b>METHODS</b>Seventy-two male SD rats were randomly divided into 6 groups, i.e., the normal control group, the model group, the irbesartan group, the low dose XG group, the medium dose XG group, and the high dose XG group. The DCM heart failure rat model was established using peritoneal injection of ADR. Equal volume of normal saline was injected to those in the normal control group, once per week for 6 consecutive weeks. The medication was started from the 5th week by gastrogavage. XG was dispensed into 0.5 g/mL suspension with distilled water. The XG was administered at the daily dose of 0.675 g/kg, 1.350 g/kg, and 2.700 g/kg to those in the low dose XG group, the medium dose XG group, and the high dose XG group, respectively. Irbesartan was administered to rats in the irbesartan group at the daily dose of 50 mg/kg. Equal volume of normal saline was administered to those in the normal control group and the model group by gastrogavage, once in the morning for 4 consecutive weeks. Myocardial apoptosis was measured by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), and the expressions of the Bcl-2 and Bax protein of cardiomyocytes were measured by immunohistochemical assay.</p><p><b>RESULTS</b>Compared with the normal control group, the cardiomyocyte apoptosis rate and Bax expression level obviously increased, but the expression of Bcl-2 and the Bcl-2/Bax ratio decreased significantly in the model group (P < 0.05). Compared with the model group, the expression of Bax and the Bcl-2/Bax ratio increased significantly in the high dose XG group and the irbesartan group (P < 0.01). The Bax expression level obviously decreased in all groups except the normal control group (P < 0.01).</p><p><b>CONCLUSIONS</b>XG could obviously attenuate cardiomyocyte apoptosis in the adriamycin-induced DCM rats, and reverse the occurrence and development of heart reconstruction. The underlying mechanism might be related to regulating and controlling the expressions of Bax and Bcl-2.</p>

Ultrasound-guided percutaneous tube drainage combined with directly-viewed debridement with cholangioscopy: a mini-invasive strategy for peripancreatic necrotizing infection / 中华外科杂志

<p><b>OBJECTIVE</b>To establish "an integrative therapy" of drainage and debridement on peripancreatic necrotizing infection (PPNI) with minimally invasive technique, and to detect its clinical effects.</p><p><b>METHODS</b>There were 17 patients who accepted ultrasound-guided percutaneous tube drainage combined with directly-viewed debridement with cholangioscopy from March 2006 to January 2008. Percutaneous puncture and catheter (6 - 8 F) drainage were adopted on the patients suffering from PPNI with B-us guidance, then the drainage sinus was expanded progressively from 8 F to 24 F in diameter with Cook fascia dilator by degrees, and the 22 F or 24 F tube was easily placed into the interior of PPNI instead of the prior catheter. So a better drainage effect was achieved. One week later, the necrotizing tissue of PPNI could be observed and debrided with choledochoscope under a directly-viewed way through the enlarged new sinus. Thus, with the continuous tube drainage and repeated debridement, the focus was absorbed and covered gradually.</p><p><b>RESULTS</b>Seventeen cases accepted the mini-invasive therapy, 15 cases were saved finally with cure rate of 88.2%, and 2 cases conversion to laparotomy because of some technical reasons. The mean healing time was 73 days, and the mean hospitalization time was 57 days. Bleeding was occurred in 2 cases localized in sinus and the inside of PPNI, digestive tract fistula was detected in 2 cases, and these patients with the complications were cured under nonoperative management. All the patients were still alive with following-up, neither remains nor recurrence of the PPNI was found in our group.</p><p><b>CONCLUSIONS</b>Ultrasound-guided percutaneous tube drainage combined with directly-viewed debridement with cholangioscopy, as a mini-invasive therapy, could complete the goal-directed therapy of PPNI, meanwhile, realize the modern surgery ideal of damage control.</p>

Retrospective analysis on 116 cases of bradyarrhythmia treated with TCM based syndrome differentiation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To retrospective analyze the short- and long-term therapeutic effect of TCM treatment based on syndrome differentiation on bradyarrhythmia.</p><p><b>METHODS</b>Data of 116 patients with bradyarrhythmia treated by TCM based on syndrome differentiation from 1995 to 2005 were collected. The changes of clinical symptoms and their outcomes as well as the 24h-dynamic cardiogram were evaluated. And a 1-5 years follow-up study was conducted to survey the heart rhythm, heart rate, drugs applied and artificial cardiac pacemaker (ACP) installation in the patients.</p><p><b>RESULTS</b>After 3 months' treatment, the total effective rate was 91.4%. During the 1-5 years of follow-up, except 6 patients received ACP installation, all the others were alive in stable condition, and no obvious side effect was found.</p><p><b>CONCLUSION</b>TCM treatment based on syndrome differentiation has reliable and stable therapeutic effects on bradyarrhythmia.</p>

Clinical study on compatibility and dismantlement of Xuefu Zhuyu decoction / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the regularity of traditional Chinese compound prescription by observing the clinical effect of the compatibility and dismantlement of Xuefu Zhuyu decoction on blood stasis and stagnation of qi syndrome of angina.</p><p><b>METHOD</b>123 outpatients were randomly divided into Xuefu Zhuyu group(XF), Jingzhi Xuefu Zhuyu group(JZ), Yaodui group(YD) and placebo group and treated.</p><p><b>RESULT</b>The array of angina effect and blood stasis and qi stagnation of syndrome effect was XF group, JZ group, YD group, placebo group( P < 0.01). The levels of blood viscosity, platelet adhesiveness, RED transfigure were significantly different before and after treatment in XF group (P < 0.05). The levels of blood viscosity, platelet adhesiveness were significant different before and after treatment in JZ group ( P < 0.05). The levels of blood plasma viscosity, platelet adhesiveness were significantly different before and after treatment in YD group ( P < 0.05). The levels of platelet adhesiveness, RED transfigure were significantly different before and after treatment in placebo group (P < 0.05). There are no difference among levels of blood lipoprotein and ET of four groups ( P > 0.05). Significant difference was found among four groups in increase of NO and t-PA and decrease of IL-6 (P < 0.05).</p><p><b>CONCLUSION</b>The clinical effect and indexes amelioration are correlated to the combination of prescription and the corresponding degree of prescription to syndrome. There are same material foundation in the series of Xuefu Zhuyu dismantle decoction, but the function degree and targets are different with the change of herbs. The method of conjugating disease and syndromes, and prescription to syndromes are a practical pattern to expound the relationship between disease and syndrome.</p>