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).

The pathogenesis of mental stress-induced myocardial ischemia: a review / 中华老年医学杂志

At present, diagnostic standards and treatment guidelines for mental stress-induced myocardial ischemia have not been established.Clinical symptoms are often seen in patients, but clinical evidence of myocardial ischemia is lacking.With increasing research closely related to mental stress-induced ischemia and adverse cardiovascular outcomes, more and more attention has been paid to coronary microcirculation in stenosis or coronary microvasospasm.With mental stress as a starting point, this article analyzes the incidence and characteristics of mental stress-induced myocardial ischemia and reviews its pathological mechanisms from the perspectives of myocardial inflammatory reaction, vasoconstriction, endothelial dysfunction, sympathetic nerve conduction and genetic factors.

Development of Traditional Chinese Medicine in Iraq / 国际中医中药杂志

Iraq is a multi-ethnic, multi-religious federal country located in southwest Asia and northeast of the Arabian Peninsula. Medical insurance is based on the primary health care model, supplemented by private medical care. Traditional medicine in Iraq is dominated by Islamic medicine. With the support of the Chinese government, the first Traditional Chinese Medicine (TCM) center was established in 2000. However, due to safety issues, the management of the center had problems such as insufficient staff, limited medical experience, and non-persistentsupport. At present, TCM has not been included in the Iraqi medical insurance system, which has affected the people’s medical choice and hindered the development of TCM. It is recommended to strengthen the construction of existing TCM centers, improve the accessibility of TCM education, and strengthen the cooperation and exchanges of traditional medicine between the two countries to promote the spread and development of TCM in Iraq.

Analysis on associated risk factors and syndrome types in diabetes mellitus type 2 patients complicated with non-alcoholic fatty liver / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the risk factors and the main TCM syndrome types associated with the diabetes mellitus type 2 (DM2) patients complicated with non-alcoholic fatty liver (FL).</p><p><b>METHODS</b>Adopted controlled trial method, the age, stature, body weight, and body mass index (BMI) of 180 DM2 patients were compared with those complicated with or without FL. And some related laboratory indexes, including the age, stature, body weight, BMI, fasting blood glucose (FBG), C-peptide (CP), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), high and low density lipoprotein cholesterol (HDL-C and LDL-C), and 2 h post-prandial CP (2 h CP), were compared as well. Moreover, patients' TCM syndrome types were classified.</p><p><b>RESULTS</b>No significant differences were found between DM2 patients complicated with or without FL in aspects of FBG, HbA1c, TC, LDL-C and age, stature (P > 0.05), but significant difference did show between them in aspects of CP (4.09 +/- 2.40 microg/L vs 2.47 +/- 1.74 microg/L), 2h CP (6.38 +/- 5.46 microg/L vs 4.35 +/- 2.92 microg/L), TG (2.81 +/- 2.33 mmol/L vs 1.93 +/- 1.92 mmol/L), HDL-C (1.07 +/- 0.06 mmol/L vs 1.19 +/- 0.32 mmol/L) as well as in body weight (73.4 +/- 11.7 kg vs 61.4 +/- 10.1 kg) and BMI (26.0 +/- 3.67 vs 22.8 +/- 3.23), respectively (P < 0.05 or P < 0.01). Moreover, phlegm-dampness type was more liable to appear in DM2 patients complicated FL.</p><p><b>CONCLUSIONS</b>Obesity, insulin resistance and lipid metabolism disorder are the chief risk factors in DM2 patients complicated with FL and phlegm-dampness is the chief pathogenesis.</p>