Efficacy and safety of Qili Qiangxin Capsule in the adjuvant treatment of ischemic cardiomyopathy with heart failure: a systematic review and meta-analysis / 数字中医药（英文）

Objective@#To evaluate the efficacy and safety of Qili Qiangxin Capsule (QLQXC) combined with western medicine in patients with ischemic cardiomyopathy (ICM) comorbid with heart failure (HF) for clinical application.@*Methods@#We searched relevant references in Chinese databases including China National Knowledge Infrastructure (CNKI), China Scientific Journal Database (VIP), Wanfang Database, and China Biology Medicine (CBM), as well as English databases including PubMed and Embase, from the foundation of the database to January 8, 2023, without language restrictions. All statistical analyses, including subgroup and sensitivity analyses, were performed using the Review Manager (version 5.4) and Stata (version 15.0).@*Results@#QLQXC combined with western medicine significantly increased the endpoints of overall response rate (ORR) (P< 0.000 01), left ventricular ejection fraction (LVEF) (P< 0.000 01), the score of Minnesota Living with Heart Failure Questionnaire (MLHFQ) (P = 0.000 2), and 6-minute walking distance (6MWD) (P < 0.000 01), decreased left ventricular end-diastolic diameter (LVEDD) (P < 0.000 01), left ventricular end-systolic diameter (LVESD) (P = 0.03), and pro-brain natriuretic peptide (pro-BNP) (P < 0.000 01), and reduced the incidence of rehospitalization (P = 0.000 3) and adverse events (AEs) (P = 0.000 6) compared with those under the conventional western therapy alone. Nonetheless, no significant difference was observed in reducing the mortality between the QLQXC combined with western medicine group and the western medicine group (P = 0.30).@*Conclusion@#The combination therapy of QLQXC with western medicine can potentiate cardiac function and raise the quality of life in patients with ICM comorbid with HF.

Comparative chemical characters of Pseudostellaria heterophylla from geographical origins of China / 中草药·英文版

OBJECTIVE@#Pseudostellaria heterophylla has been paid more attention in recent years, mainly as a medicine food homology plant. The content determination of P. heterophylla is not specified in the Chinese Pharmacopoeia (version 2020). The environmental conditions in different production areas could exert an influence on the quality of P. heterophylla. The purpose of this study is to discriminate P. heterophylla collected from different geographical origins of China.@*METHODS@#In this study, the content of polysaccharide in 28 batches of P. heterophylla was determined using phenol-sulfuric acid. HPLC fingerprints were established under optimised HPLC-PDA methods. Subsequently, the similarity analysis (SA) and the quantification of heterophyllin B were analyzed. The metabolites of P. heterophylla were identified and evaluated using UHPLC-Q Exactive HF orbitrap MS system. Principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), hierarchical cluster analysis (HCA) and orthogonal PLS-DA (OPLS-DA) were performed based on all peak areas.@*RESULTS@#The polysaccharide content in Guizhou and Jiangsu was higher than that of other production areas, which varied significant from different origins. While the content of heterophyllin B in Anhui and Jiangsu was high. The correlation coefficients of HPLC fingerprints for 28 batches samples ranged from 0.877 to 0.990, and the characteristic map can be used to identify and evaluate the quality of P. heterophylla. The samples from Fujian, Guizhou, Jiangsu provinces can be relatively separated using multivariate statistical analysis including PCA, PLS-DA, HCA, OPLS-DA, indicating that their metabolic compositions were significantly different. Ultimately, a total of 15 metabolites which were filtrated by a VIP-value > 1 and a P-value < 0.05 associated with the separation of different origins were identified.@*CONCLUSION@#HPLC fingerprint was established to evaluate the quality and authenticity of P. heterophylla. The present work showed that the difference of geographic distributions had an influence on the internal chemical compositions. A sensitive and rapid untargeted metabolomics approach by UHPLC-Q Exactive HF orbitrap MS was utilized to evaluate P. heterophylla from different origins in China for the first time. Overall, this study provides insights to metabolomics of P. heterophylla and supplies important reference values for the development of functional foods.

Exploration on Syndrome Types and Metabolic Markers of Rat Model with Heart Failure Caused by Transverse Aortic Constriction Based on Theory of Correspondence of Prescription and Syndrome / 中国实验方剂学杂志

ObjectiveTo observe the difference in the efficacy of three kinds of traditional Chinese medicine （TCM） injections on rat model of heart failure induced by transverse aortic constriction （TAC）， explore the TCM syndrome of the model based on the theory of correspondence of prescription and syndrome， and reveal the biological basis of prescription-syndrome from the perspective of metabolism. MethodRats were treated with TAC for modeling and were divided into Shenmai injection group （6.0 mL·kg-1）， model group， Danhong injection group （6.0 mL·kg-1）， Shenfu injection group （6.0 mL·kg-1） and trimetazidine group （10 mg·kg-1）， and sham operation group was set up as control. After drug intervention for 15 days， echocardiography， serum N-terminal pro-brain natriuretic peptide （NT-proBNP） and myocardial histopathological staining were performed for each group， so as to compare the efficacy to select the effective injection. Colorimetry was used to detect the serum glucolipid metabolism after the intervention of the effective injection， and ultra high performance liquid chromatography-mass spectrometry was used to observe the metabolites and related metabolic pathways in myocardial tissue. ResultCompared with the sham operation group， the left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （FS） in the model group decreased （P<0.01）， while the left ventricular end-diastolic diameter （LVIDd）， left ventricular internal diameter at end-systole （LVIDs） and NT-proBNP level increased （P<0.01）. Compared with model group， LVEF and FS increased （P<0.01）， LVIDd， LVIDs and NT-proBNP level decreased （P<0.05， P<0.01） in Danhong injection group， NT-proBNP level in Shenfu injection group decreased （P<0.05）， LVIDd and NT-proBNP level increased （P<0.05， P<0.01） in Shenmai injection group， in trimetazidine group， LVEF and FS increased （P<0.01）， while LVIDs and NT-proBNP level decreased （P<0.05， P<0.01）. Serum glucose， low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels in Danhong injection group and trimetazidine group were adjusted by callbacks （P<0.01， P<0.05）. There were the callback of 9 myocardial metabolites in Danhong injection group， including glycine， serine and threonine metabolism， glyoxylate and dicarboxylate metabolism， glycerol phospholipid metabolism. There were the callback of 10 myocardial metabolites in trimetazidine group， including glycerol phospholipid metabolism. ConclusionThe efficacy of Danhong injection on heart failure model induced by TAC is significant and superior to Shenfu injection and Shenmai injection， suggesting that the model is closely related to heart-blood stasis. The biological mechanism of Danhong injection interfering with the model involves regulating the metabolic disorder of lipid， glucose， amino acid and butyric acid.

Analysis of Chemical Constituents as Flavonoids and Coumarins in Radix Ardisiae from Different Sources / 中国药房

OBJECTIVE：To identif y and analyze the flavonoids and coumarins in Radix Ardisiae from different sources. METHODS：UPLC-QE-HF-MS/MS was adopted. The determination was performed on Zorbax Eclipse-C 18 column with mobile phase consisted of acetonitrile- 0.1％ formic acid solution （gradient elution ）at the flow rate of 0.3 mL/min. The column temperature was 30 ℃，and the temperature of injector was 4 ℃. The sample size was 2 µL；ESI source was applied in negative and positive scanning ion mode ，the heater temperature was 325 ℃，the sheath gas pressure was 45 arb，the auxiliary gas pressure was 15 arb，the purge gas pressure was 1 arb，the electrospray voltage was 3.5 kV，the capillary temperature was 330 ℃， S-lens RF level was 55％，scan mode was first-order full sca m/z 100-1 500，data-dependent secondary mass spectrometry scanning （dd-MS2，Top N ＝10），the resolution was 70 000 （first mass spectrometry ） ， 17 500 （secondary mass spectrometry），the collision mode was high-energy collision dissociation. Through retrieving foreign and domestic databases as ChemSpider ，mzCloud，mzVault，PubChem，the structure of the compound was identified on the basis of related literatures and reference data ，and the conten ts were compared. RESULTS & CONCLUSIONS：A total of 47 components were separated from Radix Ardisiae of 3 kinds of sources as Ardisia crenata Sims，A. crispa（Thunb.）A. DC. ，A. crenata Sims var . bicolor （Walk）C. Y. Wu et C. Chen. A total of 17 flavonoids were identified ，including 9 flavonols （quercetin 3-O-rhamnoside-7-O-glucoside， myricetin， rutin， mauritanin， kaempferol， quercetin， isorhamnetin， quercetin，mearnsitrin），3 flavan-3-ols [（-）-epigallocatechin，catechin，epigallocatechin gallate ）2 dihydroflavonoids [fustin ， eriodictyol] and 3 other types [ 3-（2，3-dihydro-benzo[1，4]dioxin-6-yl）-7-hydroxy-2-trifluoromethyl-chromen-4-one，methadone， oriciacridone F] ，10 coumarins {bergenin ，（[ 7-hydroxy-4-methyl-2-oxo-2H-chromen-6-yl）oxy]acetic acid ，[7-（carboxymethoxy）- 4-methyl-2-oxo-2hydroxychromo-3-yl]acetic acid ，4，9-dihydroxy-7H-furo[3，2-g]chromen-7-one，6，7-dihydroxy-4-methylcoumarin， esculetin，fraxetin，7，8-dihydroxy-4-methylcoumarin，4-methylumbelliferyl glucuronide ，scoparone}. Results of content analysis showed that in flavonoids and coumarins ，there were 5 common components in Radix Ardisiae from 3 kinds of sources ，i.e. bergenin（peak 2），[7-（carboxymethoxy）-4-methyl-2-oxo-2-hydroxychromo-3-yl] acetic acid （peak 5），methadone（peak 16）， quercetin（peak 18），oriciacridone F （peak 26）；the contents of common components were significantly different. In addition to 5 common components ，there were 22 different chemical components ，which were compounds corresponding to peaks 1，3，4， 6-15，17，19-25 and 27，respectively. Among them ，compounds corresponding to peaks 3，6，8 and 23 were only found in A. crenata Sims var. bicolor（Walk）C. Y. Wu et C. Chen ；compounds corresponding to peaks 12-15，19 were only found in A. crispa （Thunb.）A. DC. UPLC-QE-HF-MS/MS method can efficiently ，accurately and quickly identify the flavonoids and coumarins in Radix Ardisiae from different sources.

Lo mejor del Congreso AHA/ACC 2019 / The best of the 2019 AHA/ACC Congress / O melhor do Congresso da AHA/ACC 2019

Resumen: Del 16 al 18 de noviembre de 2019 se celebró en la ciudad de Philadelphia una nueva reunión del congreso anual del American College of Cardiology. Es uno de los eventos más relevantes de la cardiología mundial, y contó en esta oportunidad con la participación de destacados profesionales que presentaron los últimos ensayos clínicos en las sesiones de Late Breaking Science, abordando diferentes aspectos de la especialidad: estrategias innovadoras para reducir el riesgo cardiovascular, resultados de los ensayos de isquemia, controversias en el manejo contemporáneo de la estenosis aórtica, estado del arte del manejo de pacientes con síndromes coronarios agudos, desafíos en insuficiencia cardíaca y nuevas fronteras en la terapia lipídica. A continuación presentamos un resumen de los principales trabajos presentados: - The Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial (DAPA-HF). - The COLchicine Cardiovascular Outcomes Trial (COLCOT). - Global Comparison of a Rivaroxaban-Based Antithrombotic Strategy versus an Antiplatelet-Based Strategy After Transcathether Aortic Replacement to Optimize Clinical Outcomes (GALILEO) Trial: Primary Results. - RECOVERY: Early Surgery versus Conventional Management for Asymptomatic Severe Aortic Stenosis. - International Study of Comparative Health Effectiveness With Medical and Invasive Approaches: Primary Report of Clinical Outcomes (ISCHEMIA).

Summary: A new meeting of the annual congress of the American College of Cardiology, was held from November 16 to 18 last year; located in the city of Philadelphia. As one of the most important events in global cardiology, it was attended by leading professionals who were the last clinical trials in the Late Breaking Science sessions, which addressed different aspects of the specialty: innovative strategies to reduce cardiovascular risk, results of the trials of ischemia, controversies in the contemporary management of aortic stenosis, state of the art of the management of patients with acute coronary syndromes, challenges in heart failure and new frontiers in lipid therapy. We will make a brief summary of the main presented trials: - The Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial (DAPA-HF). - The COLchicine Cardiovascular Outcomes Trial (COLCOT). - Global Comparison of a Rivaroxaban-Based Antithrombotic Strategy versus an Antiplatelet-Based Strategy After Transcathether Aortic Replacement to Optimize Clinical Outcomes (GALILEO) Trial: Primary Results. - RECOVERY: Early Surgery versus Conventional Management for Asymptomatic Severe Aortic Stenosis. - International Study of Comparative Health Effectiveness With Medical and Invasive Approaches: Primary Report of Clinical Outcomes (ISCHEMIA).

Resumo: Uma nova reunião do congresso anual do Colégio Americano de Cardiologia, foi realizada de 16 a 18 de novembro do ano passado; localizado na cidade de Filadélfia. Como um dos eventos mais importantes da cardiologia global, contou com a presença de profissionais líderes que apresentaram os últimos ensaios clínicos nas sessões de Late Breaking Science, que abordaram diferentes aspectos da especialidade: estratégias inovadoras para reduzir o risco cardiovascular, resultados dos ensaios de isquemia, controvérsias no tratamento contemporâneo da estenose aórtica, estado da arte do tratamento de pacientes com síndromes coronárias agudas, desafios na insuficiência cardíaca e novas fronteiras na terapia lipídica. Faremos um breve resumo dos principais trabalhos apresentados: - The Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial (DAPA-HF). - The COLchicine Cardiovascular Outcomes Trial (COLCOT). - Global Comparison of a Rivaroxaban-Based Antithrombotic Strategy versus an Antiplatelet-Based Strategy After Transcathether Aortic Replacement to Optimize Clinical Outcomes (GALILEO) Trial: Primary Results. - RECOVERY: Early Surgery versus Conventional Management for Asymptomatic Severe Aortic Stenosis. - International Study of Comparative Health Effectiveness With Medical and Invasive Approaches: Primary Report of Clinical Outcomes (ISCHEMIA).

Evaluation of high-fluorescence body fluid (HF-BF) parameter as a screening tool of malignancy in body fluids

Introduction: Automated body fluid (BF) analysis is gradually replacing the traditional methods of cell counting in all BFs. This study was done to analyze the high-fluorescence (HF)-BF parameter generated on Sysmex XN-1000 and study its correlation with the presence of malignant cells in the body fluids. A correlation between manual and automated differential counts was also done. Materials and Methods: A total of 1985 samples including 797 ascitic fluids (AF), 532 pleural fluids (PF), and 656 cerebrospinal fluids (CSF) were run on Sysmex XN-1000 in BF mode and cytopathology was available for 924 BFs including 389 AF, 379 PF, and 156 CSF. Both manual and automated methods were used for cell differential and cell morphology. Results: Of the 924 samples with corresponding cytopathology, malignancy was found in 59 samples. The HF-BF%/100 WBCs (24.8 ± 72.5) and HF-BF#/?L (329.86 ± 932.35) for malignant BF samples were found to be significantly higher than the nonmalignant samples (4.41 ± 8.1) and (19.57 ± 61.91), respectively. Receiver–operator-characteristic curve cutoffs for all BF for percentage and absolute HF-BF were 2.85%/100 WBCs and >12/?L. A good correlation was found between the manual and automated WBC differential counts in all fluids except CSF with total count <5/?L. Conclusions: BFs can be reliably analyzed on automated analyzers. HF-BF parameter is helpful in identifying malignant samples but cannot be totally relied upon. If HF-BF%/# are above the lab-generated cutoffs, microscopy should be done. A complete validation study on HF-BF parameter in BF mode is desired to set the standards for the analysis of serious effusions.

Potential Drug-Drug Interactions In Heart Failure Patients

Objective: The aim of the present study was to assess the prevalence, risk rating and the severity of hazardous pDDIs (potential drug-drug interactions) in the prescribed pharmacotherapy in the hospital discharged heart failure (HF) patients, primarily with co-administered drugs with narrow therapeutic index (statins, anticoagulants, antithrombotic drugs). Methods: The prescriptions of chronic heart failure patients for one year (January-December 2014) were analyzed for pDDIs through Lexi-interact® software. DDIs belonging to the categories D (Consider therapy modification) and X (Avoid combination) and/or severity of drug interaction-major, were selected for the study. Results: After reviewing the medical records of 985 patients, 239 patients were selected based on the criteria mentioned above. The average number of prescription drugs at hospital discharge was 7.27 medications (±1.84 SD) per patient. The total number of pDDIs was 1483 or approximately 6.2 (±3.89 SD) pDDIs per patient. With respect to the risk rating, in categories D and X were detected 76 (5.12 %) and 2 (0.13 %) pDDI, respectively. The major pDDIs were 108 (7.28 %). Conclusion: HF patients are at high risk of pDDIs. Screening of prescriptions for pDDIs and monitoring of pharmacotherapy in terms of response and associated adverse drug events will contribute to patient safety.

Lo mejor del Congreso 2018 de la American Heart Association / The best of the 2018 American Heart Association Meeting / O melhor do Congresso 2018 da American Heart Association

Resumen: El Congreso de la American Heart Association 2018 tuvo lugar en la ciudad de Chicago, Illinois, del 10 al 12 de noviembre. Contó con múltiples novedades, se presentaron tres nuevas guías de recomendaciones (abordaje de las bradicardias y trastornos de conducción, actividad física, y tal vez la más esperada, la nueva guía de tratamiento de las dislipemias). Al revisar las recomendaciones de 2013, los expertos norteamericanos introdujeron varios cambios, el más importante de los cuales quizá sea disminuir la trascendencia que se le da al cálculo del riesgo a diez años para volver a enfocarse en la meta de las lipoproteínas de baja densidad (LDL), bajo la premisa de que cuanto más bajo, mejor. Realizaremos un breve resumen de algunos de los principales trabajos científicos presentados durante este evento que, sin duda, tendrán una influencia importante en el futuro próximo de la cardiología mundial. - Reduction of Cardiovascular Events With Icosapent Ethyl-Intervention Trial - REDUCE-IT. - Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease - VITAL. - Angiotensin Receptor-Neprilysin Inhibition in Patients Hospitalized With Acute Decompensated Heart Failure: Primary Results of the PIONEER - HF Randomized Controlled Trial. - Pre-hospital Resuscitation Intra-arrest Cooling Effectiveness Survival Study - the PRINCESS Trial.

Summary: The American Heart Association 2018 Congress was held in the city of Chicago, Illinois, from November 10 to 12. There were many news, three new recommendations guidelines were presented (approach to bradycardia and driving disorders, physical activity, and perhaps the most anticipated, the new treatment guide for dyslipidemia). In reviewing the 2013 recommendations, US experts introduced several changes, the most important of which may be to reduce the significance of the 10-year risk calculation to refocus on the LDL goal, under the premise of that the lower, the better. We will make a brief summary of some of the main scientific papers presented during this event that will undoubtedly have an important influence in the near future of global cardiology. - Reduction of Cardiovascular Events With Icosapent Ethyl-Intervention Trial - REDUCE-IT. - Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease - VITAL. - Angiotensin Receptor-Neprilysin Inhibition in Patients Hospitalized With Acute Decompensated Heart Failure: Primary Results of the PIONEER-HF Randomized Controlled Trial. - Pre-hospital Resuscitation Intra-arrest Cooling Effectiveness Survival Study - the PRINCESS Trial.

Resumo: O Congresso da American Heart Association 2018 foi realizado na cidade de Chicago, Illinois, de 10 a 12 de novembro. Havia muitos novos recursos, três novos guias de recomendações foram apresentados (abordagem para bradicardia e transtornos de direção, atividade física e talvez o mais aguardado, o novo guia de tratamento para dislipidemia). Ao rever as recomendações de 2013, os especialistas norte-americanos introduziram várias mudanças, a mais importante das quais pode ser reduzir a significância do cálculo do risco de 10 anos para reorientar a meta de LDL, sob a premissa de que quanto menor, melhor. Faremos um breve resumo de alguns dos principais trabalhos científicos apresentados durante este evento que, sem dúvida, terão uma influência importante no futuro próximo da cardiologia global. - Reduction of Cardiovascular Events With Icosapent Ethyl-Intervention Trial - REDUCE-IT. - Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease - VITAL. - Angiotensin Receptor-Neprilysin Inhibition in Patients Hospitalized With Acute Decompensated Heart Failure: Primary Results of the PIONEER - HF Randomized Controlled Trial. - Pre-hospital Resuscitation Intra-arrest Cooling Effectiveness Survival Study - the PRINCESS Trial.

A Comparative Study Of Heart Rate Variability In Middle Aged Obese Male And Non Obese Male

Objectives: Obesity is on the rise in our country once viewed as a sign of prosperity it is a contributing factor to diseases. The purpose of this study is to see whether obesity has an effect on the heart rate of the subject by comparing and possibly contrasting the heart rate variability in obese and non-obese males.Materials and methods: Out of 100 participants, 50 healthy male obese (BMI >25kg/m2) individuals and 50 healthy male non-obese individuals (BMI <25kg/m2) of age group 35yrs-55yrs were taken from the general population. The ECG was recorded and HRV were derived from it. Results were compared by using independent ‘t’ test and Pearson’s correlation test was done for BMI and HRV. P < 0.05 was considered as significant.Results: HRV parameters and heart rate between the two groups LF, HF and HFnu, was found to be significantly reduced and LFnu and LF/HF was found to be significantly higher in obese persons. The correlation of BMI with the parameters such as ratio of LF/HF, normalised units of LF and HF revealed a significantly negative relation with HFnu. A positive relationship was also observed between LFnu and LF/HF ratio. However, it was statistically not significant.Conclusion: The middle aged obese males had reduced parasympathetic activity associated with elevated sympathovagal modulation. This altered balance of the autonomic nervous system increases the risk of cardiovascular disorders.

Management protocols for chronic heart failure in India

Heart failure is a common clinical syndrome and a global health priority. The burden of heart failure is increasing at an alarming rate worldwide as well as in India. Heart failure not only increases the risk of mortality, morbidity and worsens the patient’s quality of life, but also puts a huge burden on the overall healthcare system. The management of heart failure has evolved over the years with the advent of new drugs and devices. This document has been developed with an objective to provide standard management guidance and simple heart failure algorithms to aid Indian clinicians in their daily practice. It would also inform the clinicians on the latest evidence in heart failure and provide guidance to recognize and diagnose chronic heart failure early and optimize management.

Avaliação da presença de cocaína e anfetamina em amostras de sangue post mortem e de indivíduos vivos, utilizando técnica de microextração em fase líquida (HF-LPME) / Amphetamine, cocaine and tetrahydrocannabinol evaluation in blood samples of living people and post mortem blood samples using microextraction technique in liquid phase (HF-LPME)

Estima-se atualmente que mais de 5% da população mundial vem fazendo uso recreativo de algum tipo de substância psicoativa, sendo que o direito a esse uso é tema recorrente da sociedade contemporânea. Por apresentar riscos associados à saúde e a segurança das populações, o uso abusivo dessas substâncias tem instigado a toxicologia social na busca de respostas, com as quais se possa caracterizar, analisar e gerenciar esses riscos. Drogas de grande consumo no Brasil são a anfetamina, cocaína e Cannabis sativa. Esta tese desenvolveu uma nova metodologia para detectar e quantificar anfetamina, cocaína e tetrahidrocanabinol em sangue total, com uso de microextração em fase líquida via fibra de polipropileno (HF-LPME), seguida de cromatografia gasosa acoplada a espectrometria de massa (GC-MS). Trata-se de uma técnica que apresenta vantagens sobre as tradicionais, uma vez que demanda quantidades menores de solvente orgânico, diminuindo riscos e custos de processo. Também propôs um estudo com a aplicação dos métodos em 69 amostras de sangue de vivos e de post mortem, as quais foram obtidas por convênio com a superintendência da polícia técnica científica de São Paulo (SPTC/SP). Os métodos desenvolvidos foram validados de acordo com diretrizes internacionais de interesse forense. Como resultado da validação, os métodos desenvolvidos se mostraram precisos e exatos para anfetamina e cocaína. O limite de detecção da cocaína foi de 5 ng . mL-1 e o limite de quantificação de 10 ng . mL-1. Quanto a anfetamina, os limites de detecção e de quantificação foram de 5 ng . mL-1. A técnica de HF-LPME não foi aplicável ao tetraidrocanabinol (Δ9-THC). Como resultado da análise das amostras, 40% delas apresentaram resultados positivos para cocaína. Desses positivos, 35% foram oriundos das matrizes de sangue de vivos e 64% oriundos de sangue post mortem. Nenhuma delas apresentou resultado quantificável para anfetamina

It is currently estimated that more than 5% of the world's population has been doing recreational use of some kind of psychoactive substances and the legal right to such use is a recurring theme debated by contemporary society. Due to the risks associated with populations health and safety, the abusive use of these substances has been instigating by social toxicology to search for answers to characterize, analyze and manage these risks. Drugs of great consumption in Brazil are, amphetamine cocaine and marijuana. This thesis proposes to develop a new methodology to detect and quantify psychoactive drugs in whole blood with the use of liquid phase microextraction by polypropylene fiber (HFLPME), followed by gas chromatography coupled to mass spectrometry (GC-MS). It is a technique that presents advantages compared with traditional ones, because of the smaller amounts demands of organic solvent, reducing risks and process costs. It also proposes a study with 69 blood samples taken from living persons and post mortem blood samples, which were obtained by agreement with the Superintendency of São Paulo Scientific Technical Police (SPTC / SP). The methods developed were validated according to international guidelines of forensic interest. As a result of the validation, the methods developed were precise and accurate for amphetamine and cocaine. The limit of cocaine detection was 5 ng . mL-1 and the limit of quantification was 10 ng . mL-1. As for amphetamine, the limits of detection and quantification were 5 ng . mL-1. The HF-LPME technique was not applicable to tetrahydrocannabinol (Δ9-THC). As a result of the sample analysis, 40% of them presented positive results for cocaine. Of these, 35% were from blood samples taken from living persons and 64% from the post mortem blood samples. None of the samples presented quantifiable results for amphetamine

Unsettled Issues and Future Directions for Research on Cardiovascular Diseases in Women

Biological sex (being female or male) significantly influences the course of disease. This simple fact must be considered in all cardiovascular diagnosis and therapy. However, major gaps in knowledge about and awareness of cardiovascular disease in women still impede the implementation of sex-specific strategies. Among the gaps are a lack of understanding of the pathophysiology of women-biased coronary artery disease syndromes (spasms, dissections, Takotsubo syndrome), sex differences in cardiomyopathies and heart failure, a higher prevalence of cardiomyopathies with sarcomeric mutations in men, a higher prevalence of heart failure with preserved ejection fraction in women, and sex-specific disease mechanisms, as well as sex differences in sudden cardiac arrest and long QT syndrome. Basic research strategies must do more to include female-specific aspects of disease such as the genetic imbalance of 2 versus one X chromosome and the effects of sex hormones. Drug therapy in women also needs more attention. Furthermore, pregnancy-associated cardiovascular disease must be considered a potential risk factor in women, including pregnancy-related coronary artery dissection, preeclampsia, and peripartum cardiomyopathy. Finally, the sociocultural dimension of gender should be included in research efforts. The organization of gender medicine must be established as a cross-sectional discipline but also as a centered structure with its own research resources, methods, and questions.

Low cost system to measure active power in electrosurgical units

Abstract Introduction: The real-time measurement of active power delivered to patients during the electrosurgical act is still an engineering challenge. Besides, there is no electrosurgical unit on the market capable of doing it according to the normative requirement. Methods This work presents the design of an electronic structure capable to probe the electrosurgical equipment output electrical signals, using low-costs very common resistors, and High Frequency distortions compensation circuits, and process them to provide an analogue signal proportional to the active power, allowing the knowledge and control of the energy delivered to the biological tissue. The reading circuits and the active power calculation method are presented. The power calculation is performed in two stages. The first one consists of a multiplier circuit that uses the readings voltage and current quantities to determine the instantaneous output power, and the second stage is formed by an integrating circuit which determines the average power value, resulting in a rippled continuous voltage, proportional to the active power delivered to the patient or biological tissue. Results Practical tests of the compensation technical are statistically evaluated by means of linear regressions. Results of 23 tests are summarized in a way to demonstrate de effectiveness of the proposed system. Conclusion Analysis of the results demonstrate the efficiency of the proposed system, whose average error is lower than 5%, and correlating them with the standard IEC 60601-2-2, that regulates the operation of electrosurgery units.

AF-HF001-induced positive inotropic and electrocardiac effect in normal isolated rat hearts / 中国药科大学学报

@#In this study, normal isolated rat heart model was adopted to investigate the inotropic and electrocardiac effect of AF-HF001 with Lanfendorff technique on the left ventricular systolic pressure(LVSP), left ventricular end diastolic pressure(LVEDP), peak rate of rise of left ventricular pressure(+dp/dtmax)and peak rate of fall of left ventricular pressure(-dp/dtmax). The results indicated that AF-HF001 could significantly enhance LVSP, LVEDP and ±dp/dtmax in a dose-dependent manner and exerted a positive inotropic effect on normal isolated rat hearts. This study also analyzed the electrocardiac effect of AF-HF001 with the electrodes located on tip of heart, ventricular free wall and aortic root. The results exhibited that AF-HF001 did not change PR, QRS, QT or HR at various concentrations, which means that AF-HF001 could safely increase cardiac contractility. This research lays a good foundation for the further study on AF-HF001 and research on structure-activity relationship of its analogs.

Spectral Heart Rate Variability During Late Gestation In Moderately Anaemic Pregnancy.

Abstracts: Backround: Third trimester of pregnancy is associated with profound adaptive autonomic cardiovascular changes. Anaemia in pregnancy, which is a common problem in India, is known to put pregnant female at higher cardiovascular risk. The aim of this study is to measure & compare the cardiovascular autonomic balance in normal pregnancy i.e. control group (Hb ≥ 11.0 g/dl) & pregnancy with moderate anaemia i.e. case group (Hb = 7.0 to 9.9 g/dl). Methodology: Spectral HRV was measured in supine position using digital polyrite and kubios HRV analysis software. Parameters LF(for sympathetic and parasympathetic modulation) , HF(for vagal modulation) in absolute power (ms 2 ) and normalised units (n.u.) and LF/HF ratio for sympathovagal balance were measured and analysed using SPSS 16.0 software. Results: A significantly high LF power(p<0.001) ,low HF power(p<0.001) and high LF/HF ratio (p<0.001) were observed during late gestation period in moderately anaemic pregnant females compared with healthy pregnant females. Conclusion: Third trimester of pregnancy with moderate anaemia has an elevated sympathetic activity and reduced parasympathetic activity characterised by compensatory rise in cardiac output mainly because of rise in stroke volume. Spectral HRV is a better test to diagnose above change than mere measuring heart rate and blood pressure.

LCZ696 is effective in treating patients with heart failure:based on PARADIGM-HF data / 天津医药

Heart failure (HF) is a complex clinical syndrome, which is caused by cardiac structural abnormalities and dysfunction. It can lead to ventricular filling and impaired ejection capacity with high incidence and mortality . The constant activation of the rennin-angiotensin-aldosterone system (RAAS) plays an important role in the development of heart failure. Angiotensin angiotensin converting enzyme inhibitor (ACEI), angiotensin angiotensin receptor antagonist (ARB) and aldoste?rone receptor antagonist (MRA) had been confirmed to be with good therapeutic effects therefore played important roles in heart failure treatment strategy shown by large scale clinical trials. The first PARADIM-HF data published by European So?ciety of Cardiology in annual meeting on August 30, 2014 showed that LCZ696 can reduce cardiovascular mortality risk of HF patient by 20%when combining with beta blockers and MRA . It also reduced the number of hospitalizations of patients with chronic heart failure (CHF) by 21%. LCZ696, using its unique dual phase mode verified that the regulation of neuroen?docrine is the modern concept for the treatment of heart failure. LCZ696 lead to innovation and shed new light in traditional drug treatment for heart failure.

Autonomic Dysfunction in Major Depressive Disorder.

Background: Cardiovascular (CV) morbidity is a major problem in patients suffering from depression as greater CV mortality is found in cardiac patients with depression. Objective: To assess cardiac autonomic nerve activity by power spectral analysis of heart rate variability in patients with Major Depressive disorder. Methods: This case control study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka during 2011. Sixty patients of both sexes with Major Depressive disorder (MDD) aged 20-50 years were enrolled. The patients were selected from the Department of Psychiatry in Bangabandhu Sheik Mujib Medical University (BSMMU). Thirty drug naive MDD patients and thirty medicated MDD patients were compared with 30 healthy control and also between them. The HRV parameters were recorded by 4 active channels, RMS Polyrite-D. For statistical analysis independent sample t-test test was used. Results: LF norm and LF/HF were significantly higher and Total power, HF power, HF norm were significantly lower in both drug naive and medicated MDD patients in comparison with those of healthy control. Conclusion: Autonomic nerve dysfunction involved both the drug naive and medicated MDD patients which was associated with higher sympathetic activity and reduced vagal modulation of the heart and sympathovagal imbalance. Antidepressent drug treatment did not have any effect on autonomic dysfunction.

Power Spectral Analysis of Heart Rate Variability in Female Rheumatoid Arthritis Patients.

Background: Association of increased cardiovascular morbidity and higher sympathetic activity in patients with Rheumatoid arthritis (RA) has been recognized. Heart rate variability (HRV) is a useful measure to assess sympatho-vagal balance. Objective: To assess autonomic nerve function status in patients with Rheumatoid Arthritis (RA) by HRV analysis. Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from January to December 2010. Sixty female RA patients aged 18-50 years were included in the study group. They were enrolled from the Out Patient Department of Rheumatology Wing of the Department of Medicine, BSMMU, Dhaka. For comparison age matched thirty apparently healthy females were also studied as control. The HRV parameters were recorded by a Polyrite machine. For statistical analysis independent sample t test was used. Results: Mean resting pulse rate, diastolic blood pressure and mean systolic blood pressure were higher in rheumatoid arthritis patients in comparison to those of healthy control. Mean values of LF power, LF norm and LF/ HF were significantly higher (p<0.001) & TP and HF power, HF norm were significantly lower (p<0.001) in RA patients in comparison to those of healthy control. Conclusion: This study may conclude that sympathetic activity was higher with lower parasympathetic activity along with shifting of sympathovagal balance towards sympathetic predominance in patients with rheumatoid arthritis.

The Toxicity and Anti-cancer Activity of the Hexane Layer of Melia azedarach L. var. japonica Makino's Bark Extract

In this study, the 4-week oral toxicity and anti-cancer activity of the hexane layer of Melia azedarach L. var. japonica Makino's bark extract were investigated. We carried out a hollow fiber (HF) assay and 28-day repeated toxicity study to confirm the anti-cancer effect and safety of the hexane layer. The HF assay was carried out using an A549 human adenocarcinoma cell via intraperitoneal (IP) site with or without cisplatin. In the result, the 200 mg/kg b.w of hexane layer with 4 mg/kg b.w of cisplatin treated group, showed the highest cytotoxicity aginst A549 carcinoma cells. For the 28-day repeated toxicity study, 6 groups of 10 male and female mice were given by gavage 200, 100, or 50 mg/kg b.w hexane layer with or without 4 mg/kg b.w of cisplatin against body weight, and were then sacrificed for blood and tissue sampling. The subacute oral toxicity study in mice with doses of 200, 100, and 50 mg/kg b.w hexane layer showed no significant changes in body weight gain and general behavior. The cisplatin-treated group significantly decreased in body weight compared to the control group but regained weight with 100 and 200 mg/kg b.w of hexane layer. The biochemical analysis showed significant increase in several parameters (ALT, total billirubin, AST, creatinine, and BUN) in cisplatin-treated groups. However, in the group given a co-treatment of hexane layer (200 mg/kg b.w), levels of these parameters decreased. In hematological analysis, cisplatin induced the reduction of WBCs and neutrophils but co-treatment with hexane layer (100 and 200 mg/kg b.w) improved these toxicities caused by cisplatin. The histological profile of the livers showed eosinophilic cell foci in central vein and portal triad in cisplatin treated mice. These results show that hexane layer might have an anti-cancer activity and could improve the toxicity of cisplatin.

Power Spectral Analysis of Heart Rate Variability in Hypertensive Male.

Background: Essential hypertension is associated with altered cardiovascular autonomic nerve function. Heart Rate Variability (HRV) analysis is an important tool for quantitative measurement of autonomic nerve activity. Objective: To assess the cardiac autonomic nerve function status in essential hypertension by analyzing power spectral measures of heart rate variability. Methods: This cross sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University between July 2008 and June 2009. Sixty male hypertensive patients with age range 40-60 years (group B) were enrolled from the Out Patient Department of Cardiology,BSMMU, Dhaka. Thirty age and sex matched apparently healthy normotensive subjects (group A) were studied as control, Hypertensive patients were further divided into group B1 consisting of 30 untreated patients on their 1st day of diagnosis and group B2 consisting of 30 patients under antihypertensive therapy. Power Spectral measures of Heart Rate Variability (HRV) such as total power, low frequency (LF) and high frequency power(HF) LH/HF ratio were assessed by a digital Polygraph. For statistical analysis , Independent sample t-test, One-way ANOVA test and Pearson’s correlation coefficient test were done as applicable. Results: Mean TP,LF,HF and HF norm was significantly (p<0.001) lower and LF/HF ratio and LF norm were significantly (p<0.001) higher in both untreated and treated hypertensive patients compared to those of normotensive subjects. Again, significant differences of LF norm and HF norm and LF/HF ratio were found between the two hypertensive groups. The LF/HF ratio and LF norm were positively and HF norm was negatively correlated with SBP and DBP in both the hypertensive groups. However, all these findings were more marked in untreated hypertensive patients than those of treated group. Conclusion: Sympathovagal balance in hypertensive patients is towards higher sympathetic and lower vagal modulation and effective treatment of the patients can return the balance towards normal.