Discussion on the Scientific Connotation of Fortifying Spleen， Resolving Phlegm and Dispelling Stasis in the Treatment of Coronary Heart Disease under the Guidance of Dysfunctional High-Density Lipoprotein / 中医杂志

The key pathogenesis of coronary heart disease （CHD） is spleen deficiency and phlegm stasis， and dysfunctional high-density lipoprotein （dys-HDL） may be the biological basis for the occurrence of CHD due to spleen deficiency and phlegm stasis. Considering the biological properties and effects of high-density lipoprotein （HDL）， it is believed that the structure and components of HDL are abnormal in the state of spleen deficiency which led to dys-HDL； and dys-HDL contributes to the formation of atherosclerotic plaques through two major pathways， namely， mediating the dysfunction of endothelial cells and mediating the foaminess of macrophages and smooth muscle cells， thus triggering the development of CHD. It is also believed that dys-HDL is a microcosmic manifestation and a pathological product of spleen deficiency， and spleen deficiency makes foundation for the production of dys-HDL； dys-HDL is also an important biological basis for the phlegm-stasis interactions in CHD. The method of fortifying spleen， resolving phlegm， and dispelling stasis， is proposed as an important principle in the treatment of CHD by traditional Chinese medicine， which can achieve the therapeutic purpose by affecting the changes in the structure and components of dys-HDL， thus revealing the scientific connotation of this method， and providing ideas for the diagnosis and treatment of CHD by traditional Chinese medicine.

Effects of Shenqi Gualou Xiebai Banxia Decoction （参芪瓜蒌薤白半夏汤） on PPARγ， Bile Acids， and Blood Lipids in Mouse Models of Atherosclerosis / 中医杂志

ObjectiveTo explore the mechanism of Shenqi Gualou Xiebai Banxia Decoction （参芪瓜蒌薤白半夏汤， SGXBD） in the treatment of atherosclerosis. MethodsThirty Apolipoprotein E gene knockout （ApoE-/-） mice were randomly divided into five groups： model group， rosuvastatin group， low-， moderate-， and high-dose SGXBD， with six mice in each group. They were fed a high-fat diet to prepare for atherosclerosis model. Another six C57BL/6J wild-type mice were set as the blank group. After modeling， the low-， moderate-， and high-dose SGXBD groups were gavaged with 6.46， 12.92， and 25.84 g/（kg·d） of SGXBD， respectively. The rosuvastatin group was given 1.55 mg/（kg·d） of rosuvastatin tablets by gavage. The blank group and model group were given 0.5 ml saline by gavage. After four weeks， the total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） in the serum of each group were detected， as well as TC and TG in the liver. The serum bile acid level was detected by enzyme cycling colorimetry. The mRNA and protein expression of peroxisome proliferator-activated receptor γ （PPARγ）， sterol regulatory element-binding protein 2 （SREBP2）， 3-hydroxy-3-methylglutaryl-CoA reductase （HMGCR）， and cholesterol 7α-hydroxylase （CYP7A1） in the liver were detected by real-time RT-PCR and Western blot. ResultsCompared with the blank group， the model group showed significant increases in serum TG， TC， and LDL-C levels， and significant decreases in HDL-C and bile acid levels； the levels of TG and TC in the liver， as well as the expression of SREBP2 and HMGCR proteins and mRNA in the liver significantly increased， while the expression of PPARγ and CYP7A1 proteins and mRNA significantly decreased （all P＜0.01）. Compared with the model group， the rosuvastatin group and high-dose SGXBD group showed significant decreases in serum TG， TC， and LDL-C levels and liver TG and TC levels， and significant increases in bile acid levels； the expression of PPARγ and CYP7A1 proteins and mRNA increased， while the expression of SREBP2 and HMGCR proteins and mRNA decreased； the low-dose SGXBD group showed significant decreases in serum TC and LDL-C levels and liver TC level （P＜0.05 or P＜0.01）. Compared with the rosuvastatin group， the low-dose SGXBD group had a significantly higher liver TC level， while the high-dose SGXBD group had a significantly lower liver TC level， CYP7A1 mRNA level， and PPARγ protein expression level， and a significantly higher SREBP2 protein expression level （P＜0.05 or P＜0.01）. Compared with the low- and moderate-dose groups， the high-dose SGXBD group had significantly lower serum TG and liver TC levels （P＜0.05）. ConclusionSGXBD may improve blood lipid levels and exhibit anti-atherosclerotic effects by regulating the protein level of PPARγ and simultaneously affecting the synthesis of liver cholesterol and the conversion of cholesterol to bile acids.

Simvastatin promotes murine osteoclasts apoptosis through NFATc1 pathway / 南方医科大学学报

OBJECTIVE@#To explore the mechanism by which simvastatin (SIM) regulates osteoclast apoptosis.@*METHODS@#Murine macrophage RAW264.7 cells were divided into 5 groups, namely group A (control group), group B (sRANKL+ M-CSF), group C (SIM+sRANKL+M-CSF), group D (VIVIT peptide+sRANKL+ M-CSF), and group E (SIM+VIVIT peptide+sRANKL+M-CSF). WST-1 assay was used to assess the effects of simvastatin on the proliferation activity of the osteoclasts, and flow cytometry was performed to analyze the effects of SIM and VIVIVIT peptide (a NFATc1 pathway inhibitor) on apoptosis of the osteoclasts. The translocation of NFATc1 into the nucleus was investigated using immunofluorescence assay, and Western blotting was employed to assess the effect of SIM on the phosphorylation of NFATc1 in the nucleus.@*RESULTS@#WST-1 assay showed that SIM (1×10 mol/L) treatment for 24 and 48 h significantly inhibited the proliferation of the osteoclasts (=0.039 and 0.022, respectively). Compared with the control group, the SIM-treated osteoclasts exhibited significantly reduced cell percentage in G0/G1 phase (=0.041) and increased cells in sub-G1 phase (=0.028) with obvious cell apoptosis. DAPI staining and flow cytometry showed that both SIM and VIVIVIT peptide alone significantly promoted osteoclast apoptosis (=0.002 and 0.015, respectively), and their combination produced a similar pro-apoptosis effect (=0.08). Immunofluorescence and Western blotting showed that SIM significantly inhibited the intranuclear translocation of NFATc1 and the phosphorylation of NFATc1 pathway protein (=0.013).@*CONCLUSIONS@#SIM promotes osteoclast apoptosis through NFATc1 signaling pathway.

Effect of a Decoction to Nourish Qi and Invigorate the Spleen on the Activity of Mitochondrial Respiratory Chain Enzyme Complexes in Cardiomyocytes of Rats with Spleen Qi Deficiency Syndrome / 中国医科大学学报

Objective To investigate the effect of a decoction to nourish qi and invigorate the spleen on mitochondrial respiratory chain enzyme complex activity in cardiomyocytes of rats with spleen qi deficiency syndrome. Methods Rats were randomly divided into normal,model,and treatment groups. The model and treatment groups were treated by diet intervention combined with the limit swim method. The general condition and spleen qi deficiency syndrome were assessed on day 15. After the success of the model,the normal and model groups were treated with a con?ventional feeding method combined with normal saline ,and the treatment group was treated by diet intervention combined with a decoction to nour?ish qi and invigorate the spleen for 9 weeks. The activity of two mitochondrial respiratory chain enzyme complexes was observed. Results The ac?tivity of mitochondrial respiratory chain enzyme complexⅡand complexⅣin the model group was significantly lower than the activity in the nor?mal and treatment groups(P<0.05). The activity levels of complexⅡand complexⅣwere significantly different between the model group and the treatment group(P<0.05). Conclusion Spleen qi deficiency can cause decreased activity of mitochondrial respiratory chain enzyme com?plexes in myocardial cells. The decoction to nourish qi and invigorate the spleen can modulate the activity of myocardial mitochondrial respiratory chain enzyme complexesⅡandⅣ.

Characteristics and Prognosis in Patients of Acute Coronary Syndrome Combining Anemia After Percutaneous Coronary Intervention / 中国循环杂志

Objective: To investigate the impact of anemia on prognosis for acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). Methods: A total of 220 ACS patients with successful PCI were studied. According to WHO standard, anemia was deifned by HB<130 g/L in male, HB<120 g/L in female, the patients were divided into 2 groups: Anemia group,n=56 and Non-anemia group, n=164, clinical condition was followed-up for 1 year to record the incidence of major adverse cardiac events ( MACE); based on MACE incidence, the patients were divided into another 2 groups: MACE group,n=61, Non-MACE group,n=159, clinical condition with relevant risk factors were analyzed and compared between 2 groups. Results: The patients’ mean age was at (62.39 ± 10.17) years, the ratio of anemia was 26.8% (56/220). Compared with Non-anemia group, the patients in Anemia group had more female gender and 3-vessel disease, higher Gensini score and MACE incidence; while decreased eGFR, lower levels of TC, TG and lower ratios of hypertension and smoking, allP<0.05. Compared with Non-MACE group, the patients in MACE group had the elder age, higher occurrence rates of anemia, diabetes, left ventricular dysfunction (LVEF<50%) and decreased eGFR, allP<0.05-0.001. Logistic analysis indicated that anemia (OR=2.507, 95% CI 1.012-6.208,P=0.047) was the independent risk factors for MACE occurrence in ACS patients at 1 year after PCI. Conclusion: ACS patients combining anemia had the higher incidence of MACE, anemia was the independent risk factor for poor prognosis in ACS patients after PCI.

Acupuncture combined with Western medicine for angina of coronary artery disease: a systematic review / 中国针灸

The effectiveness and safety of acupuncture combined with western medicine for angina of coronary artery disease are evaluated. Databases including Pubmed, Embase, Cochrane Library, CBMDisk,. CNKI, Wanfang, Chinese Clinical Trial Registry, etc. are searched with search time from beginning of the database establishment to January of 2014. As a result, totally 15 articles of acupuncture for angina of coronary artery disease that met the inclusive criteria were collected, involving 11 researches and 1 232 patients. The results of Meta-analysis indicate that based on regular western medicine, additional use of acupuncture could further improve symptoms of angina, increase efficacy of electrocardiogram (ECG) and reduce the dosage of nitroglycerin, in the meanwhile the hemorheology could be ameliorated, and the contents of C reactive protein (CRP), malondialdehyde (MDA), lipid peroxide (LPO), endothelin (ET) could be reduced, while the contents of superoxide dismutase (SOD) and nitric oxide (NO) could be increased; besides, the occurrence rate of cardiovascular event could be reduced without causing obvious adverse events. Except for certain outcomes (including dynamic ECG and blood viscosity) those have no statistical significance between treatment group and control group, the differences of remaining outcomes are: statistically significant. It is believed that acupuncture combined with regular treatment of western medicine are effective treatment plan for angina of coronary artery disease, which are superior to regular treatment of western medicine, but the results of this systematic review be taken with caution, and more clinical trials with high quality are looking forward to be included into Meta-analysis to increase the level of evidence.

Research Progress on Animal Modeling Methods and Model Evaluation of Spleen-yang Deficiency / 世界科学技术-中医药现代化

The paper was aimed to review the modeling methods of spleen-yang deficiency, which can be classified into imitating traditional Chinese medicine (TCM) etiology methods and modern medicine methods. At present, methods of modeling were not generally accepted and the main presented problems were as follows. Modern medicine methods did not conformed to the rules of TCM etiology and pathogenesis. The evaluation of yang deficiency models was not accurate. Some modeling methods can lead to other diseases at the same time. The names of spleen deficiency model were not unified. It was difficult to distinguish the modeling methods of spleen-yang deficiency and spleen-qi deficiency, and etc. Model evaluation of spleen-yang deficiency was various. However, the domestic standard evaluation system had not been formed. The main model evaluation problems were as follows. Macro symptoms of the model lacked of objective and quantitative evaluation. It lacked of evaluation indexes of pulse and tongue with TCM characteristics. The disproof of prescription selection was not unified. Similar syndromes had not been ruled out. The microscopic indexes were fragmented, and etc. This paper reviewed on animal modeling methods of spleen-yang deficiency.

Effect of acupoint injection of bone marrow mesenchymal stem cells on expression of vascular cell adhesion molecule-1 and very late antigen-4 in myocardial infarction model rats / 中国组织工程研究

BACKGROUND:Now, the bone marrow mesenchymal stem cel homing is thought to be mediated by adhesion molecules and chemokines, and this process involves bone marrow endothelial cel s, hematopoietic stem cel s, bone marrow microenvironment and its secreted or expressed molecules, in which, adhesion molecules may play an important role. OBJECTIVE:To explore the migrating and chemotactic mechanism of bone marrow mesenchymal stem cel s via acupoint injection into myocardial cel s by determining the expression of vascular cel adhesion molecule-1 and very late antigen-4. METHODS:Bone marrow mesenchymal stem cel s were cultured using adherent method, and the passage 3 cel s were used as seed cel s at a density of 1×1010/L. Sixty Sprague-Dawley rats were randomly divided into sham group, model group, myocardial injection group, and acupoint injection group, 15 rats in each group. The left coronary arteries of rats were ligated for establishing a model of myocardial infarction. At 72 hours after myocardial infarction, 0.3 mL bone mesenchymal stem cel s were transplanted into the Xinyu, Zhiyang, Tanzhong acupoints, respectively, in the acupoint injection group;while in the myocardial injection group, secondary thoracotomy was done, and 1.2 mL bone marrow mesenchymal stem cel s were equably transplanted into six sites in the feeding area of the left anterior descending artery and the surrounding myocardium. At 4 weeks after myocardial infarction, a multi-channel polygraph was adopted for detection of hemodynamic parameters, and the levels of serum vascular cel adhesion molecule-1 and very late antigen-4 were measured by ELISA. RESULTS AND CONCLUSION:The heart function of rats in the myocardial injection and acupoint injection groups were improved, and compared with the model group, the levels of serum vascular cel adhesion molecule-1 and very late antigen-4 were significantly higher in the myocardial injection and acupoint injection groups. However, there was no significant difference between the myocardial injection and acupoint injection groups. These findings suggest that vascular cel adhesion molecule-1 and very late antigen-4 may be one of the chemotactic mechanisms of bone mesenchymal stem cel s transplanted in myocardial infarction model rats by acupoint injection.

Effect of acupoint injection of bone marrow mesenchymal stem cells on hemodynamics of rat model with acute myocardial infarction / 中国中西医结合急救杂志

Objective To explore the effect of acupoint injection of bone marrow mesenchymal stem cells (BMSCs)on hemodynamics of rat model with acute myocardial infarction(AMI). Methods Sixty Sprague-Dawley (SD)rats were randomly divided into sham group,model group,myocardium injection BMSCs group and acupoint injection BMSCs group(each n=15). The left anterior descending coronary artery(LAD)was ligated to establish a rat model of AMI. After the rat model was successfully established for 72 hours,0.2 ml BMSCs(1×1010/L)were transplanted by a micro-quantity syringe at 6 points in equal amount in the LAD blood-supply area and its periphery in the myocardial injection group,while in the acupoint injection group,0.3 ml BMSCs(1×1010/L)was transplanted at each of the following acupoints:Xinshu,Zhiyang and Tanzhong. Four weeks after AMI,polyethylene tubing was inserted into the right carotid artery to measure the hemodynamics,at the same time animals were sacrificed,and the heart was take out to calculate the heart mass index(HMI)and left ventricular mass index(LVMI). Results One, 3,5 and 4 rats were respectively dead in the sham group,model group,myocardium injection group,and acupoint injection group during the experimental period. Compared with the sham group,the left ventricular systolic pressure (LVSP,mm Hg,1 mm Hg=0.133 kPa),the maximum rate of increase of left ventricular pressure(+dp/dt max, mm Hg/s), the maximum rate of decrease of left ventricular pressure(-dp/dt max,mm Hg/s), the maximum logarithmic change rate of left ventricular pressure〔(dp/dt)?P-1max,s-1〕,HMI(mg/g),LVMI were significantly decreased,and left ventricular end-diastolic pressure(LVEDP,mm Hg),heart rate(HR,bpm)were obviously increased in model group(all P<0.05). Compared with the model group,the LVSP,+dp/dt max,-dp/dt max, (dp/dt)?P-1max, HMI,LVMI were significantly increased in myocardial injection group and acupoint injection group〔LVSP:130.38±14.96,124.36±14.36 vs. 114.36±12.71,+dp/dt max:4707.52±394.36,4597.14±411.05 vs. 3791.43±327.29,-dp/dt max:4075.11±317.89,3938.05±373.76 vs. 3116.32±275.04,(dp/dt)?P-1max:215.26±21.29,197.39±18.96 vs. 155.93±25.14〕,and the LVEDP and HR were significantly decreased(LVEDP:5.15±2.39,5.64±1.96 vs. 10.58±2.49,HR:400.50±42.58,395.55±44.62 vs. 414.51±35.75,all P<0.05). There were no significant differences in above indexes between myocardium injection group and acupoint injection group. Conclusion Acupoint injection of BMSCs can improve the heart function of rat model with AMI.

Measurement of health-related quality of life in coronary heart disease: a review / 中西医结合学报

This paper introduces the development and application of health-related quality of life (HRQOL) scales in research on coronary heart disease (CHD). Currently, the scales for CHD patients have been more systematically developed and widely used in foreign countries, while domestically in China, they are developed successfully but problematically; research in this field has started later and the scales introduced are limited and not suitable for the entire range of domestic CHD patients. Thus, this paper introduces 26 HRQOL scales in research on CHD, including five generic scales, ten disease-specific scales from abroad and eleven scales originating from China. With the deficiency of HRQOL scales, especially that in traditional Chinese medicine and specific scales, this paper analyzes and summarizes the problems existing in development of scales. The authors also provide solutions in order to help the development and application of scales in further studies.

Effects of bone marrow mesenchymal stem cell transplantation on collagen remodeling in rabbits following acute myocardial infarction / 中国组织工程研究

BACKGROUND: Stem cell transplantation can significantly improve heart function foUowing myocardial infarction. This is correlated with the differentiation of stem cells into cardiomyocytes and promotion effect on angiogenesis. Paracrine and ventricular reconstruction inhibition (especially extracallular collagen reconstruction) have important effects on improving heart function.OBJECTIVE: To investigate the effects of bone marrow mesenchymal stem cell (BMSC) transplantation on coUagen remodeling after acute myocardial infarction in rabbits.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Laboratory of Acupuncture and Electrophysiology of Liaoning University of Traditional Chinese Medicine from June to August 2007.MATERIALS: A total of 57 healthy Japanese rabbits were purchased from Experimental Animal Center, Uaoning University of Traditional Chinese Medicine.METHODS: BMSCs were acquired from the bone marrow of two rabbits, and marked with BrdU before transplantation. Ten rabbits served as a normal group. Forty-five rabbits were used to establish the left ventricular infarct by ligation of the left coronary artery. Thirty success models of myocardial infarction were randomly divided into 3 groups (n=10)" model, saline and call transplantation groups. Following 7 days of myocardial infarction, rabbit models in the cell transplantation group were injected in the ear vein with 1 mL of BMSCs (2x106 cells). Rabbits in the saline group were infused with 1 mL of saline. The culture was performed for 5 weeks.MAIN OUTCOME MEASURES: Fibrous structure of myocardial stroma was observed, and collagen volume fraction was measured by Masson Trichrome staining. The ratio of type Ⅰ and Ⅲ collagen was determined by immunohistochemistry.RESULTS: BrdU-positive BMSCs could be seen in the cell transplantation group. After myocardial infarction, a few collagen fibers was confluent in or surrounding the infarct area, arranged orderly in the cell transplantation group. Collagen fiber plaque-shaped confluence was significant, and arranged disorderly in the model and saline groups. At 5 weeks following myocardial infarction, compared with the normal group, collagen volume fraction was significantly decreased in and surrounding the infarct region (P < 0.05), and the ratio of type Ⅰ and Ⅲ collagen was increased significantly in the model group (P < 0.05).Compared with the model group, collagen volume fraction and the ratio of type Ⅰ and Ⅲ collagen were significantly decreased (P< 0.05).CONCLUSION: BMSCs could survive in infarct heart. BMSCs transplantation could reduce collage volume and improve collage ratio and had beneficial effects on collage remodeling processes after acute myocardial infarction.