Yixin Ningshen Tablet Alleviates Comorbidity of Myocardial Infarction and Depression by Enhancing Myocardial Energy Metabolism and Increasing Availability of Monoamine Neurotransmitter / 中国结合医学杂志

OBJECTIVE@#To investigate the therapeutic effect of Yixin Ningshen Tablet (YXNS) on comorbidity of myocardial infarction (MI) and depression in rats and explore the underlying mechanism.@*METHODS@#The Sprague-Dawley rats were randomly divided into 5 groups with 7 rats in each group according to their weights, including control, model, fluoxetine (FLXT, 10 mg/kg), low-dose YXNS (LYXNS, 100 mg/kg), and high-dose YXNS (HYXNS, 300 mg/kg) groups. All rats were pretreated with corresponding drugs for 12 weeks. The rat model of MI and depression was constructed by ligation of left anterior descending coronary artery and chronic mild stress stimulation. The echocardiography, sucrose preference test, open field test, and forced swim test were performed. Myocardial infarction (MI) area and myocardial apoptosis was also detected. Serum levels of interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF-α), 5-hydroxytryptamine (5-HT), adrenocorticotrophic hormone (ACTH), corticosterone (CORT), and norepinephrine (NE) were determined by enzyme linked immunosorbent assay. The proteins of adenosine 5'-monophosphate -activated protein kinase (AMPK), p-AMPK, peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), and nuclear respiratory factor 1 (NRF1) in heart were detected by Western blot analysis. The expression levels of TNF-α, IL-6, indoleamine 2,3-dioxygenase (IDO1), kynurenine 3-monooxygenase (KMO), and kynureninase (KYNU) in hippocampus were detected by real-time quantitative polymerase chain reaction.@*RESULTS@#Compared with the model group, the cardiac function of rats treated with YXNS improved significantly (P<0.01). Meanwhile, YXNS effectively reduced MI size and cardiomyocytes apoptosis of rats (P<0.01 or P<0.05), promoted AMPK phosphorylation, and increased PGC-1α protein expression (P<0.01 or P<0.05). HYXNS significantly increased locomotor activity of rats, decreased the levels of TNF-α, IL-6 and IL-1β, and increased the serum levels of 5-HT, NE, ACTH, and CORT (all P<0.05). Moreover, HYXNS decreased the mRNA expressions of IDO1, KMO and KYNU (P<0.05).@*CONCLUSIONS@#YXNS can relieve MI by enhancing myocardial energy metabolism. Meanwhile, YXNS can alleviate depression by resisting inflammation and increasing availability of monoamine neurotransmitters. It may be used as a potential drug to treat comorbidity of MI and depression.

Effect of Hawthorn Jiangzhi powder on blood lipids in patients with hyperlipidemia: a pathological analysis of 484 cases / 中国中西医结合急救杂志

Objective To observe the effect of Hawthorn Jiangzhi powder on blood lipids in hyperlipidemia patients.Methods Four hundreds and eighty-four patients with hyperlipidemia were selected from Department of Cardiology in Huanghuai University Affiliated Hospital from January 2011 to June 2016,and they were divided into observation group and control group by random number table,each group 242 cases.The observation group took orally Hawthorn Jiangzhi powder (including ingredients:hawthorn 6 g,salvia miltiorrhiza 18 g,black soybean 16 g,hoelen 6 g,ganoderma lucidum 9 g,kudzuvine root 6 g,Chinese yam 6 g,fructus amomum 9 g,coix seed 16 g,cassia seed 6 g) once 6-9 g powder,twice a day,once in the morning and another in the evening;the control group was given simvastatin,20 mg each day during taking dinner;the therapeutic period lasted 2 months in both groups.The differences in serum lipid and serum inflammatory factor levels were compared before and after treatment in the two groups;the changes of lymphocyte subsets of the two groups were observed and compared with the changes of the subset results of 100 normal healthy subjects aged 35-80 years old in the same period in our hospital,and the total efficiency,the situations of adverse reactions and liver and kidney functions of two groups were observed.Results In the observation group and the control group,before treatment the levels of CD4+,CD8+,CD4+/CD8+ were lower than those of healthy control group,but after treatment the levels of CD4+,CD8+ and CD4+/CD8+ were higher than those before treatment,and the changes of the observation group were more significant than those of the control group(CD4+:0.47±0.11 vs.0.40±0.10,CD8+:0.28 ± 0.10 vs.0.26 ± 0.08,CD4+/CD8+:1.67 ± 0.79 vs.1.53 ± 0.45);After treatment,the levels of hypersensitive C-reactive protein (hs-CRP),interleukin-6 (IL-6),von Willebrand factor (vWF) and homocysteine (Hcy) in the two groups were significantly lower than those before treatment,and the levels of hs-CRP,IL-6 and vWF in the observation group were obviously lower than those in the control group [hs-CRP (mg/L):5.1 ± 1.8 vs.5.8 ± 1.7,IL-6 (ng/L):2.9 ± 1.6 vs.3.7 ± 1.8,vWF:(126.8 ± 12.8)％ vs.(156.5 ± 11.3)％,all P ＜ 0.05].After treatment,Hcy in the observation group was lower than that in the control group,but there was no significant difference between the two groups (μμmol/L:5.2 ± 1.8 vs.5.4 ± 2.6,P ＞ 0.05).In the observation group after treatment at each time point,the levels of total cholesterol (TC),triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) were lower than those before treatment,while the levels of high density lipoprotein cholesterol (HDL-C) and high density lipoprotein cholesterol/total cholesterol (HDL/TC) were higher than those before treatment;after treatment in the control group,the levels of TC,TG and LDL-C were decreased,and the levels of HDL-C and HDL/TC were obviously increased compared with those before treatment;The levels of TC,TG and LDL-C in the observation group after treatment for 2 months were significantly lower than those in the control group [TC (mmol/L):1.26 ± 0.57 vs.2.26 ± 0.56;TG (mmol/L):3.45 ± 0.78 vs.5.45 ± 0.75,LDL-C (mmol/L):2.40±0.65 vs.2.72±0.85;all P ＜ 0.05),and HDL/TC was obviously increased (1.19±0.15 vs.0.62±0.35,P ＜ 0.01).The total therapeutic effective rate of the observation group was significantly higher than that of the control group [90.1％ (218/242) vs.73.4％ (178/242),P ＜ 0.01].Adverse reactions and changes of liver and kidney functions during the period of treatment in the two groups were minimal.Conclusions Hawthorn Jiangzhi powder can effectively reduce the blood lipids and serum inflammation cytokines in patients with hyperlipidemia,improve blood rheological situation,reduce serum levels of inflammatory factors,inhibit the formation and development of atherosclerosis and enhance the immune function obviously in patients with high lipid abnormalities.

The research progress of nurses hierarchical management / 中国实用护理杂志

In order to improve the utilization efficiency of nursing human resources, stable nursing troop and enhance the quality of care, at present, the post management experiences for nurses of domestic and international are adopted by many hospitals and certain results are achieved. Study about nurses stratified management is reviewed, the approach, basis, effects, features and the advantages and disadvantages of hierarchical management experiences for nurses in different countries and regions is summarized and some thinking and prospect in studying is proposed in this article, as well as the follow-up research, to explore a constructive policy of further promoting the development of the level management for nurses.