Multimodal integrated strategy for the discovery and identification of quality markers in traditional Chinese medicine / 药物分析学报

With the modernization and internationalization of traditional Chinese medicine(TCM),the requirement for quality control has increased.The quality marker(Q-marker)is an important standard in this field and has been implemented with remarkable success in recent years.However,the establishment of Q-markers remains fragmented and the process lacks systematicity,resulting in inconsistent quality control and insufficient correlation with clinical efficacy and safety of TCM.This review introduces four multi-modal integrated approaches that contribute to the discovery of more comprehensive and accurate Q-markers,thus aiding in the establishment of new quality control patterns based on the characteristics and principles of TCM.These include the whole-process quality control strategy,chemical-activity-based screening method,efficacy,safety,and consistent combination strategy,and TCM theory-guided approach.Furthermore,methodologies and representative examples of these strategies are described,and important future directions and questions in this field are also proposed.

Risk factors and prognoses analysis of new-onset atrial fibrillation in patients with acute myocardial infarction / 中华内科杂志

Objective To explore the risk factors and prognoses of new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI).Methods A total of 468 patients with AMI were admitted into Beijing Anzhen Hospital for emergency pereutaneous coronary intervention (PCI).According to the NOAF occurred during hospitalization,the patients were divided into two groups:the NOAF (n=37) group and the non-NOAF (n=431) group.Parameters including general clinical conditions,coronary lesions,echocardiography,biochemical markers,C-reactive protein (CRP),N-terminal pro-brain natriuretic peptide (NT-pro-BNP),and myocardial markers were collected.In-hospital mortality and incidence of in-hospital main adverse cardiovascular and cerebrovascular events (MACCE) were compared between the two groups.Logistic multivariate regression analyses were performed for the association between the risk factors and NOAF.Results The incidence of NOAF was 7.9％ in AMI patients undergoing emergency PCI.There were no significant differences in door-to-balloon time,weight,platelet counts,baseline serum creatinine (SCr),postoperative SCr,triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,uric acid,glycosylated hemoglobin A1c,preoperative medication,number of lesions,thrombus aspiration,location of myocardial infarction,and history of hypertension,diabetes,peripheral vascular disease and old myocardial infarction between the two groups.The percentage of women was in the NOAF group (32.4％ vs.16.7％,P＜0.05) and subjects in this group were significantly elder than those in the non-NOAF groups [(66±10) years vs.(571±11) years,P＜0.001].Moreover,the levels of no-reflow rate (40.5％ vs.12.6％,P＜0.001),CRP [25.2 (15.43,29.97)mg/L vs.5.21 (2.33,16.98) mg/L,P＜0.001],white blood cell counts [(11.19±3.44)× 109 vs.(9.91 ±3.23)× 109,p=0.022],NT-pro-BNP [(652.6± 108.8) ng/L vs.(258.3±105.9) ng/L,P＜0.001],and troponin I (TnI) [20.41(1.78,87.89) μg/L vs.7.72(1.29,36.39) μg/L,P=0.006] were significantly higher in the NOAF group than in the non-NOAF group,while left ventricular ejection fraction [(47.70± 7.34)％ vs.(53.35 ± 8.05)％,P＜0.001],and hemoglobin [137.0(125.5,146.0) g/L vs.144.0(133.0,156.0) g/L,P=0.042] were significantly lower in the NOAF group than the non-NOAF group.Patients in the NOAF group had significantly longer hospital stay than those in the non-NOAF group [(8.7± 5.6) d vs.(6.0± 2.3) d,P=0.007].The in-hospital mortality (8.1％ vs 1.4％ P=0.004) and the incidence of in-hospital MACCE (37.8％ vs.7.7％,P＜0.001) in the NOAF group were significantly higher than those in the non-NOAF group.Logistic multivariate regression analyses showed that age (HR 1.083,95％CI 1.028-1.141,P=0.003),CRP (HR 1.116,95％CI 1.049-1.187,P=0.001),NT-pro-BNP (HR 1.463,95％CI 1.001-4.064,P=0.001) and no-reflow (HR 4.388,95％CI 1.006-19.144,P=0.049) were independent predictors of NOAF after AMI.Conclusions Age,elevated levels of CRP,NT-pro-BNP,and the absence of no-reflow are risk factors for incident NOAF in patients with AMI in hospital.

C-reactive protein and non-valvula atrial fibrillation combining with thrombosis / 中华内科杂志

ObjectiveTo investigate the alteration of plasma C-reactive protein (CRP) count in patients with non-valvula atrial fibrillation combining thrombosis.MethodsA total of 154 patients with non-valvula atrial fibrillation were divided into thrombus group (n = 46) and non-thrombus group (n = 108)in accordance with transesophageal echocardiography (TEE) results.The concentration of CRP by scattering turbidimetry, D-dimer by immunoturbidmetry, left atrium diameter (LAd), fraction shortening (FS) and left ventricular ejection fraction (LVEF) by TEE or echocardiography were detected.Logistic multi-factors regression analysis was performed.ResultsThere were significant differences in CRP [(5.77 ± 6.37)mg/L vs (1.73 ±2.39)mg/L,P =0.003], LAd [(59.86 ± 10.70) mm vs (47.97 ± 13.19)mm,P ＜0.001]and LVEF[(58.75 ±8.28)％vs (64.10 ±6.75)％, P ＜0.001]between thrombus group and nonthrombus group.The results of logistic regression analysis found CRP ≥ 1.33 mg/L(OR 2.856, 95％ CI 1.235-6.600,P =0.014) and LAd≥54.5 mm(OR 4.236, 95％ CI 1.877-9.562,P =0.001) were independent risk factors of patients with non-valvula atrial fibrillation combining with thrombosis.ConclusionsCRP and LAd are independent risk factors for patients with non-valvula atrial fibrillation combining with thrombosis.Inflammation may involve with the formation of thrombosis.

Visualization of serotonin 1A receptor trafficking in neuron-like PC12 cells / 基础医学与临床

Objective To explore the mechanisms of trafficking and signaling of serotonin 1A receptor(5-HT_(1A))and its spatiotemporal distribution in living cells.Methods The mouse 5-HT_(1A) gene amplified by RT-PCR was recombined into pEGFP-N1 vector and the EGFP coding sequence was located in-frame at the C-terminal end of the 5-HT_(1A) receptor.The 5-HT_(1A)-EGFP was transfected into neuron-like PC12 cells as well as HEK293.The transfected cells were visualized using confocal microscopy,the mobility of 5-HT_(1A)-EGFP was monitored by live measurements and fluorescence recovery after photobleaching.Results The 5-HT_(1A) gene was identitical with the published gene sequence NM_008308.4 and a 5-HT_(1A)-EGFP fusion construct was created.After stable transfection of the plasimd into a PC12 cell line and analysis with a confocal laser scanning microscopy,the EGFP-tagged 5-HT_(1A) was predominantly associated with the plasma membrane,but some intracellular vesicles in the perinuclear region also contained the fusion protein.The predominant localization of 5-HT_(1A)-EGFP at the plasma membrane was confirmed in transiently transfected HEK293 cells.Bleached fluorescence was partialy recovered in 100 seconds,indicating that the 5-HT_(1A)-EGFP was mobiled on the membrane.Conclusion Spatiotemporal distribution and mobility of 5-HT_(1A) tagged with EGFP can be monitored in the 5-HT_(1A)-EGFP stable PC12 cell line,which could be an excellent neuron-like experimental cell model for research of 5-HT_(1A) trafficking and signaling.

Revascularization of coronary artery disease in patients with left ventricular ejection fraction ≤40 % / 中国综合临床

Objective To investigate the effect of PCI/CABG for the patients with coronary artery disease(CAD) with LVEF≤40%. Methods 196 CAD patients with LVEF≤40% were divided into PCI (n = 106) and CABG group (n=90). The clinical factors, revaseularization, medication, and in-hospital and follow-up malignant cardiological events(MACCE) were retrospectively compared,and the survival curve were drew by COX regression.Results Survival rate of the PCI group and CABG group in 30-day (96% vs. 94% ), 1-year(95 % vs. 92% ), and 2-year(93% vs. 87% )were similar. There was no MACCE within 30 days in the two groups(92% vs. 92% ) and 1-year survival rate without MACCE was similar in the two groups(86% vs. 88% ). CABG group had higher 2- year survival rate without MACCE than PCI group (83%vs. 72% ). But the COX survival curves of the two group were not signifi-cantly different (P=0. 662). Conclusion The patients with LVEF ≤ 40% undergoing PCI have short-term and long-term survival rate similar to those accepting CABG.