Panax Notoginseng Saponins Inhibits Ventricular Remodeling after Myocardial Infarction in Rats Through Regulating ATF3/MAP2K3/p38 MAPK and NF κ B Pathway.

OBJECTIVE: To explore whether Panax notoginseng saponins (PNS) exhibits heart protective effect in myocardial infarction (MI) rats and to identify the potential signaling pathways involved. METHODS: MI rats induced by ligating the left anterior descending (LAD) coronary artery were assigned to sham coronary artery ligation or coronary artery ligation. Totally 36 Sprague-Dawley rats were randomly divided into sham group (distilled water, n=9), MI group (distilled water, n=9), PNS group (PNS, 40 mg/kg daily, n=9) and fosinopril group (FIP, 1.2 mg/kg daily, n=9) according to a random number table. The left ventricular morphology and function were conducted by echocardiography. Histological alterations were evaluated by the stainings of HE and Masson. The serum levels of C reactive protein (CRP), tumor necrosis factor α (TNF-α), growth differentiation factor-15 (GDF-15) and the ratio of metalloproteinase-9 (MMP-9) and tissue inhibitor of MMP-9 (TIMP-1) were determined by ELISA. The levels of activating transcription factor 3 (ATF3), mitogen-activated protein kinase kinase 3 (MAP2K3), p38 mitogen-activated protein kinase (p38 MAPK), phosphorylation of p38 MAPK (p-p38 MAPK), transforming growth factor-ß (TGF-ß1), collagen I, nuclear factor kappa B p65 (NFκB p65), phosphorylation of NFκB p65 (p-NFκB p65), and phosphorylation of inhibitory kappa Bα (p-Iκ Bα) in hearts were measured by Western blot and immunohistochemical staining, respectively. RESULTS: PNS improved cardiac function and fibrosis in MI rats (P<0.05). The serum levels of CRP, TNF-α, GDF-15 and the ratio of MMP9/TIMP1 were reversed by PNS in MI rats. The expressions of TGF-ß1, collagen I, MAP2K3, p38 MAPK, p-p38 MAPK, NFκB p65, p-NFκB p65, and p-IκBα were down-regulated, while ATF3 increased with the treatment of PNS (P<0.05). CONCLUSIONS: PNS may improve cardiac function and fibrosis in MI rats via regulating ATF3/MAP2K3/p38 MAPK and NFκB signaling pathways. These results suggest the potential of PNS in preventing the development of ventricular remodeling in MI rats.

Developing and validating an integrated gross tumor volume (GTV)-TNM stratification system for supplementing unresectable locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy.

PURPOSE: The gross tumor volume (GTV) could be an independent prognostic factor for unresectable locally advanced non-small cell lung cancer (LANSCLC). We aimed to develop and validate a novel integrated GTV-TNM stratification system to supplement LANSCLC sub-staging in patients treated with concurrent chemoradiotherapy (CCRT). METHODS: We performed a retrospective review of 340 patients with unresectable LANSCLC receiving definitive CCRT. All included patients were divided into two randomized cohorts. Then the Kaplan-Meier method and Cox regression were calculated to access the prognostic value of the integrated GTV-TNM stratification system, which was further validated by the area under the receiver operating characteristic curve (AUC) score and F1-score. RESULTS: The optimal outcome-based GTV cut-off values (70 and 180 cm3) of the modeling cohort were used to determine each patient's integrated GTV-TNM stratum in the whole cohort. Our results indicated that a lower integrated GTV-TNM stratum could had better overall survival and progression-free survival (all P < 0.001), which was recognized as an independent prognostic factor. Also, its prognostic value was robust in both the modeling and validation cohorts. Furthermore, the prognostic validity of the integrated GTV-TNM stratification system was validated by significantly improved AUC score (0.636 vs. 0.570, P = 0.027) and F1-score (0.655 vs. 0.615, P < 0.001), compared with TNM stage. CONCLUSIONS: We proposed a novel integrated GTV-TNM stratification system to supplement unresectable LANSCLC sub-staging due to its prognostic value independent of TNM stage and other clinical characteristics, suggesting that it could be considered in individual treatment decision-making process.

Qidong Yixin Oral Liquid for Viral Myocarditis: A Systematic Review and Meta-Analysis.

OBJECTIVE: This study aimed to evaluate the efficacy and safety of Qidong Yixin (QY) oral liquid in the treatment of viral myocarditis (VMC). METHODS: We searched seven databases for randomized clinical trials on QY for treating VMC. The retrieval period was from database establishment to December 31, 2019. Cochrane risk of bias tool in the Cochrane Handbook was used to assess the methodological quality. Review Manager (RevMan) 5.3 was used to analyze the results. RESULTS: We included 19 studies comprising 2,608 patients, albeit with low methodological quality. Our meta-analysis revealed that combination therapy with QY and western medicine was more effective than western medicine alone (QY vs other Chinese patent medicines: RR = 1.37, 95% Cl: 1.23∼1.52, P < 0.00001; QY + coenzyme Q10 + routine treatment vs coenzyme Q10 + routine treatment: RR = 1.20, 95% Cl: 1.14∼1.27, P < 0.00001; QY + trimetazidine + acyclovir vs trimetazidine + acyclovir: RR = 1.59, 95% Cl: 1.38∼1.83, P < 0.00001; QY + routine treatment vs routine treatment: RR = 1.09, 95% Cl: 1.03∼1.15, P < 0.003). A study on posttreatment myocardial enzyme levels revealed that QY with western medicine downregulated creatine kinase isoenzyme (CK-MB) (QY + antiviral treatment + routine treatment vs antiviral treatment + routine treatment group: MD = -11.28, 95% CI: -13.33∼-9.22, P < 0.00001; QY + routine treatment vs routine treatment: MD = -4.96, 95% CI: -5.56∼-4.32, P < 0.00001), creatine kinase (CK) (MD = -32.10, 95% CI: -35.63∼-28.57, P < 0.00001), and lactate dehydrogenase (LDH) (QY + antiviral treatment + routine treatment vs antiviral treatment + routine treatment: MD = -48.76 95% CI: -58.18∼-39.33, P < 0.00001; QY + routine treatment vs routine treatment: MD = -23.52, 95% CI: -30.10-16.94, P < 0.00001) rather than western medicine alone, with no evidence of aspartate aminotransferase (AST) downregulation on treatment with QY with western medicine (MD = 2.88, 95% CI: -0.95∼6.71, P < 0.00001) in patients. Two studies reported adverse events, indicating that QY is relatively safe. CONCLUSION: Although QY may have potential advantages in treating VMC, they remain unclear owing to the poor methodological quality of most studies. Larger, multicenter, high-quality randomized controlled trials are required to verify the effectiveness of QY.

[Effect of traditional Chinese medicine in attenuating coronary heart disease and main risk factors by regulating gut micro-biota].

Ischemic heart disease has became the world's most common deadly disease, and coronary heart disease(CHD) is the most common type of ischemic heart disease. The pathological mechanism of CHD has not been fully elucidated. In recent years, scientific studies have found that gut micro-biota are closely related to the occurrence and development of CHD, and CHD could be intervened by regulating gut micro-biota because of the correlation between CHD and intermediate metabolite of gut micro-biota. Current intervention strategies mainly include probiotics supplementation, reduction of TMAO and increase of SCFAs, which can achieve the effect of stabilizing plaques, and controlling blood pressure, blood lipids, blood glucose and obesity. Traditional Chinese medicine(TCM) has the multi-component and multi-target effects, which is correlated to its role in the prevention and treatment of CHD. This paper summarizes the domestic and foreign researches on the effect of TCM in attenuating CHD and its main risk factors by regulating gut micro-biota. The article aims to explore the correlation between gut micro-biota and CHD, and propose three main intervention strategies. Furthermore, the research progress of TCM on CHD, hypertension, dyslipidemia, hyperglycemia and obesity is reviewed by the categories of Chinese medicine monomer and compound, in the hope to provide more theoretical basis for TCM therapy on CHD and guidance for further studies in this field.

[CircRNA as a new field in human disease research].

For the characteristics of high stability， high conservation between species， and tissue specificity， circular RNA(circRNA) has been expected to become a new molecular biomarker for the clinical diagnosis， treatment and prognosis， and the potential target for targeted therapy. Study on the traditional Chinese medicine(TCM) syndrome includes not only the macro indexes collected by using four traditional methods of diagnosis， but also contains some micro information that can not be achieved by using the four traditional diagnosis methods. The questions such as how to deal with the relationship between the holistic concept of TCM and micro research， and how to solve the contradiction between the fuzziness of syndrome description and the accuracy of microscopic research， need to be considered before the micro research in TCM syndrome. circRNA as a new field of understanding human disease， may provide some ideas for the TCM syndrome research due to its characteristics. Overall， it is necessary to pay attention to explore the molecular level with same syndrome in different diseases and reveal the connotation and essence of syndromes by understanding of circRNA.

The prognostic significance of lymphovascular invasion in patients with resectable gastric cancer: a large retrospective study from Southern China.

BACKGROUND: The focus of this study was to assess the impact of lymphovascular invasion (LVI) on both the recurrence of cancer and the long-term survival of Chinese patients with resectable gastric cancer (GC). METHODS: A retrospective analysis of the clinicopathological data for 1148 GC patients who had undergone gastrectomy with regional lymphadenectomy was performed. The primary objective was to assess the correlation between LVI and post-surgery outcomes for each patient. This was done by routine H & E staining for LVI on patients' disease-free survival (DFS) and disease-specific survival (DSS). RESULTS: LVI was detected in 404 (35.2%) of the 1148 GC patients. The presence of LVI was significantly correlated with the level of CA19-9, the tumor size, the Lauren classification, tumor differentiation, gastric wall invasive depth, lymph node involvement, distant metastasis and an advanced TNM stage. There was a lower DFS and DSS in the patients with LVI as compared to the patients without LVI. A multivariate analysis also identified LVI as an independent prognostic factor of both DSS and DFS. CONCLUSIONS: The presence of LVI is a risk factor for the recurrence of cancer and an independent indicator of a poor outcome in GC patients following surgery. The LVI status should be taken into consideration when determining the best approach for the treatment of the individual.

[Application of dynamic contrast enhancement MRI and post-processing technique for diagnosis of breast cancer].

BACKGROUND AND OBJECTIVE: Magnetic resonance imaging (MRI), an advanced non-invasive technique, is regarded as one of the potential modalities in the diagnosis of breast cancer. This study was to investigate the application of dynamic contrast enhancement MRI and 3D reconstruction images in diagnosing breast tumors. METHODS: From May 2006 to September 2007, 30 patients with breast diseases were scanned with MRI in Sun Yat-sen University Cancer Center. MR plain scans, dynamic contrast enhancement scans were performed, and 3D reconstruction images were obtained. The normal breast tissue was used as control, and the maximum slope ratio was calculated. RESULTS: Forty-nine lesions were found in 30 patients, with an accuracy rate of 93.3%. CONCLUSION: MRI scan is an effective and specific modality for the diagnosis of breast diseases with high sensitivity and accuracy. Dynamic contrast enhancement MRI, image subtraction, time-signal intensity curve, 3D reconstruction images and the maximum slope ratio are helpful to make the correct diagnosis of breast lesions.

[Three-dimensional white matter tractography based on diffusion-tensor magnetic resonance imaging].

OBJECTIVE: To assess the value of white matter fiber tractography based on magnetic resonance diffusion-tensor imaging (MR-DTI), a new noninvasive technique that helps estimate the structural connectivity of the brain, in understanding the anatomy of the white matter fiber tract. METHODS: Six consecutive volunteers received MR-DTI examination using a GE 1.5T Sign CV/I whole-body MR system and version 2.0 Functool software for image processing. The protocol included T1WI for localization and single-shot echo-planner diffusion tensor imaging of the entire brain in axial, sagittal, and /or coronal sections. RESULTS: White matter fiber tracts imaged by MR-DTI were consistent with known white matter fiber anatomy. The major fiber tracts were well observed in all the cases. The tracts visualized included the corpus callosum, anterior commissure, uncinate fasciculus superior and inferior longitudinal fascicules, inferior occipito-frontal fasciculus, internal capsule and corona radiate. CONCLUSION: A set of detailed white matter fiber anatomy maps of the normal brain is obtained by means of single-shot echo-planner diffusion tensor imaging at high resolution. This technique allows rapid visualization of the white matter tracts in vivo, and provides a new reliable means for studying fiber connectivity in the brain.

[Diffusion tensor imaging of the white matter tracts in preoperative patients with cerebral neoplasm].

OBJECTIVE: To evaluate the quantitative relationship between white matter tract (WMT) variation resulting from cerebral tumors and shifting of the fractional anisotropy (FA) index in magnetic resonance (MR) diffusion tensor imaging (DTI). METHODS: Four female and 8 male patients aged from 21 to 62 years with brain malignancies (2 malignant lymphomas, 2 low-grade astrocytomas, and 8 high-grade cerebral gliomas) underwent conventional contrast-enhanced MR and DTI examinations before operation. Routine T(2)-weighted image, fractional anisotropic (FA) map, color-coded directional map, three-dimensional white matter tractography (WMT), and the FA index of bilateral internal capsule were obtained in every patient. RESULTS: Fiber tractography derived from DTI was consistent with known white matter fiber anatomy. The DTI patterns in WMT altered by the tumor were categorized on the basis of FA1/FA2 ratio as follows: pattern 1, FA1/FA2> or =75% with normal or only slightly decreased FA; pattern 2, 50%< or =FA1/FA2<75% with WMT displacement; pattern 3, 25%< or =FA1/FA2/50% with WMT involvement; pattern 4, FA1/FA2<25% with WMT destruction. CONCLUSIONS: DTI allows for visualization of WMT and benefits surgical planning for patients with intrinsic brain tumor. There is a positive relationship between the bilateral FA ratio (FA1/FA2) variation and WMT alterations resulting from the tumor.