Optimized new Shengmai powder inhibits myocardial fibrosis in heart failure by regulating the rat sarcoma/rapidly accelerated fibrosarcoma/mitogen-activated protein kinase kinase/extracellular regulated protein kinases signaling pathway.

OBJECTIVE: Exploring the effect of Optimized New Shengmai powder (, ONSMP) on myocardial fibrosis in heart failure (HF) based on rat sarcoma (RAS)/rapidly accelerated fibrosarcoma (RAF)/mitogen-activated protein kinase kinase (MEK)/extracellular regulated protein kinases (ERK) signaling pathway. METHODS: Randomized 70 Sprague-Dawley rats into sham (n = 10) and operation (n = 60) groups, then established the HF rat by ligating the left anterior descending branch of the coronary artery. We randomly divided the operation group rats into the model, ONSMP [including low (L), medium (M), and high (H) dose], and enalapril groups. After the 4-week drug intervention, echocardiography examines the cardiac function and calculates the ratios of the whole/left heart to the rat's body weight. Finally, we observed the degree of myocardial fibrosis by pathological sections, determined myocardium collagen (COL) I and COL Ⅲ content by enzyme-linked immunosorbent assay, detected the mRNA levels of COL I, COL Ⅲ, α-smooth muscle actin (α-SMA), and c-Fos proto-oncogene (c-Fos) by universal real-time, and detected the protein expression of p-RAS, p-RAF, p-MEK1/2, p-ERK1/2, p-ETS-like-1 transcription factor (p-ELK1), p-c-Fos, α-SMA, COL I, and COL Ⅲ by Western blot. RESULTS: ONSMP can effectively improve HF rat's cardiac function, decrease cardiac organ coefficient, COL volume fraction, and COL I/Ⅲ content, down-regulate the mRNA of COL I/Ⅲ, α-SMA and c-Fos, and the protein of p-RAS, p-RAF, p-MEK1/ 2, p-ERK1/2, p-ELK1, c-Fos, COL Ⅰ/Ⅲ, and α-SMA. CONCLUSIONS: ONSMP can effectively reduce myocardial fibrosis in HF rats, and the mechanism may be related to the inhibition of the RAS/RAF/MEK/ERK signaling pathway.

Biomarkers in heart failure: the past, current and future.

Despite the enhanced knowledge of the pathophysiology of heart failure (HF), it still remains a serious syndrome with substantial morbidity, mortality, and frequent hospitalizations. These are due to the current improvements in other cardiovascular diseases (like myocardial infarction), the aging population, and growing prevalence of comorbidities. Biomarker-guided management has brought a new dimension in prognostication, diagnosis, and therapy options. Following the recommendation of natriuretic peptides (B-type natriuretic peptide and N-terminal-proBNP), many other biomarkers have been thoroughly studied to reflect different pathophysiological processes (such as fibrosis, inflammation, myocardial injury, and remodeling) in HF and some of them (like cardiac troponins, soluble suppression of tumorigenesis-2, and galectin 3) have subsequently been recommended to aid in the diagnosis and prognostication in HF. Consequently, multi-marker approach has also been approved owing to the varied nature of HF syndrome. In this review, we discussed the guidelines available for HF biomarkers, procedures for evaluating novel markers, and the utilities of both emerging and established biomarkers for risk stratification, diagnosis, and management of HF in the clinics. We later looked at how the rapidly emerging field-OMICs, can help transform HF biomarkers discoveries and establishment.

Effects of supplementing qi and activating blood circulation on platelet inhibition rate and platelet membrane glycoprotein in elderly patients with unstable angina pectoris undergoing percutaneous coronary intervention / 中华老年医学杂志

Objective To investigate the effects of supplementing qi and activating blood circulation method(YQHX) on platelet inhibition rate and platelet membrane glycoprotein in elderly patients with unstable angina pectoris undergoing percutaneous coronary intervention(PCI).Methods Totally 177 elderly patients with unstable angina(qi deficiency and blood stasis syndrome) pectoris were randomized into two groups:90 cases in the treatment group and 87 cases in the control group.Both groups received conventional western medicinal treatment,for 14 days but YQHX was added to the treatment group.Platelet inhibition rate and platelet membrane glycoprotein were measured before and 14 days after treatment.Results After 14 days of treatment,the platelet inhibition rates induced by arachidonic acid (AA) and adenosine diphosphate (ADP) were significantly increased in the treatment group in comparison to pre-treatment and to control group respectively(P＜0.01).The prevalence of aspirin and clopidogrel resistance were lower in the treatment group than in the control group(8.9％ vs.21.8％,11.1％ vs.25.3％,both P＜0.05).After 14 days of treatment,the expression rates of CD62p,CD63 and PAC-1 were significantly lower in the treatment group than in pre-treatment and control group respectively (P＜0.01).Conclusions YQHX might effectively inhibit the platelet function and reduce the prevalence of aspirin and clopidogrel resistance in elderly patients with unstable angina pectoris undergoing the percutaneous coronary intervention.

Expert Survey on Application of Traditional Chinese Medicine in Different Clinical Classifications of Coronary Heart Disease / 世界科学技术-中医药现代化

This study was aimed to take an expert survey on the application of traditional Chinese medicine (TCM) in different clinical classifications of coronary heart disease (CHD) in order to master its medication characteristics and principles . Delphi method was applied in different clinical classifications of CHD , which contain angina pectoris, acute myocardial infarction, heart failure, arrhythmia, after percutaneous coronary inter-vention ( PCI ) and after coronary artery bypass graft ( CABG ) . Two rounds of nationwide expert survey were giv-en on the commonly-used TCM decoction , oral administration of TCM patent drugs and TCM intravenous preparations in CHD treatment . The results showed that TCM medications in the treatment of angina pectoris contain Xuefu Zhuyu decoction, Gualou Xiebai Banxia decoction, Tongxinluo capsules, Compound Danshen dripping pills, Shexiang Baoxin pill, Danshen injection, Danhong injection, and etc. And commonly used TCM medications for the treatment of acute myocardial infarction include Xue fu Zhuyu decoction , Gualou Xiebai Banxia decoction, Compound Danshen dripping pills, Shexiang Baoxin pill, Suxiao Jiuxin pills, Shengmai injec-tion , She nmai injection and so on . Heart failure of CHD was treated by Zhenwu decoction , Qili Qiangxin cap-sule, Qishen Yiqi dripping pills, Shenfu injection, Shengmai injection, Shenmai injection and so on. TCM treatments of arrhythmia of CHD usually include Zhigancao decoction , Tianwang Buxin boluses , Wenxin gran-ules, Shensong Yangxin capsule, Shengmai injection, Shenmai injection and so on. The commonly used TCM medications after PCI contain Xuefu Zhuyu decoction, Tongxinluo capsules, Compound Danshen dripping pills, Shengmai injection and Danshen injection and so on. Commonly used TCM medications after CABG include Xuefu Zhuyu decoction, Buyang Huanwu decoction, Tongxinluo capsules, Shexiang Baoxin pill, Compound Dan-shen dripping pills, Shengmai injection and Danhong injection and so on. It was concluded that different clini-cal classifications of CHD had characteristics and commonness in the application of TCM . Findings based on expert consensus through the survey provide certain reference values in the clinical syndrome differentiation of CHD .

Clinical epidemiology survey of the traditional Chinese medicine etiology and syndrome differentiation of coronary artery disease: study protocol of a multicenter trial / 中西医结合学报

BACKGROUD: Coronary artery disease (CAD), a common disease with high incidence and mortality rate, has seriously threatened the health and life of the public. Traditional Chinese medicine (TCM) has an important role in the prevention and treatment of this disease. Through clinical epidemiological survey, a deeper understanding of TCM etiology and syndrome characteristics in CAD would further improve clinical efficacy in the treatment of this disease.

Application of Delphi method in traditional Chinese medicine clinical research / 中西医结合学报

In recent years, Delphi method has been widely applied in traditional Chinese medicine (TCM) clinical research. This article analyzed the present application situation of Delphi method in TCM clinical research, and discussed some problems presented in the choice of evaluation method, classification of observation indexes and selection of survey items. On the basis of present application of Delphi method, the author analyzed the method on questionnaire making, selection of experts, evaluation of observation indexes and selection of survey items. Furthermore, the author summarized the steps of application of Delphi method in TCM clinical research.

Literature study on the relation between seasons and traditional Chinese medicine syndromes distribution of coronary artery disease / 国际中医中药杂志

ObjectiveOn the basis of the analysis for the related literatures,to study the relation between seasons and traditional Chinese medicine(TCM)syndromes distribution of coronary artery disease (CAD) preliminarily.MethodsBy the reviewed analysis for the related literatures and the summary for different seasons,to study the relation between seasons and TCM syndromes distribution of CAD.Results In summer and autumn season,the most commonly seen TCM syndromes are blood stasis in heart,heart-Qi deficiency,and phlegm blocking heart vessel.While,in winter and spring season are blood stasis in heart,phlegm blocking heart vessel,and Qi-yin deficiency.The syndrome of blood stasis in heart is common in four seasons of whole year.There is more heart-Qi deficiency syndrome in summer and autumn season.The proportion of phlegm blocking heart vessel syndrome is higher in winter and spring season.Cold accumulated in heart pulse syndrome also can be often found in summer and autumn season.ConclusionAs the preliminary study on the relation between seasons and TCM syndromes distribution,the results can provide some experience for the treatment of CAD,but more accurate conclusions need to be supported by large samples of clinical investigation through four seasons.

Effects of Shenmai Injection on serum concentration and pharmacokinetics of digoxin in dogs with heart failure / 中西医结合学报

To explore the effects of Shenmai Injection (SMI), a compound traditional Chinese herbal medicine, on pharmacokinetics and serum concentration of digoxin when applied together with digoxin.

Effect of Endothelins on Restenosis after Percutaneous Coronary Intervention (review) / 中国康复理论与实践

@# A general situation on research about the endothelins (ET) such as its synthesis, secretion and the mitogenic activity on vascular smooth muscle cells (VSMC), and its effect on restenosis after percutaneous coronary intervention (PCI) was reviewed by the authors.

Myocardial infarction secondary prevention study (MISPS) / 老年心脏病学杂志（英文版）

Background Traditional Chinese medicine (TCM), especially herbal medicine, has been widely used in China and now is also being increasingly used in other countries for the treatment of cardiovascular diseases. Although many studies have demonstrated that certain Chinese herbal products are effective and safe for the treatment of cardiovascular diseases, most of these lack sufficient quality. Therefore, large randomized clinical trials and further scientific research to determine its safety, effectiveness are necessary.QiShen YiQi Dripping Pills (QSYQDP) is a herbal preparation clinically used in the treatment and prevention of coronary artery disease. Preliminary observations have shown its safety and effectiveness. Methods/Design This randomized, controlled trial will recruit 3600 patients with a history of myocardial infarction. Patients will be randomized into two groups by a Centr-Randomized System. One group receives QSYQDP, the other group receive aspirin. This trial protocol will describe eligibility criteria, detailed information on the treatment definition, blinding, endpoints, statistical methods, sample size determination, data management, legal aspects, and the current status of the trial. Discussion This trial is one of the first randomized, controlled clinical trial to evaluate the efficacy and safety of traditional Chinese herbal medicine in the treatment and secondary prevention of coronary artery disease. The results of this study should help to define the role of TCM in modern medical care, as well as to provide the management strategy for CAD patients in China and other countries.

A systematic review for Qili Qiangxin Capsule for chronic heart failure / 中成药

AIM: To evaluate the clinical efficacy and safety of Qili Qiangxin Capsule(Radix Astragali,Radix Aconiti lateralis praeparata,Radix et Rhizoma Salviae miltiorrhizae,Radix et Rhizoma Ginseng,Semen Lepidii,Semen Descurainiae,Flos Carthami,Pericarpium Citri reticulatae,Rhizoma Alismatis,Cortex Periplocae,Rhizoma Polygonati odorati,Ramulus Cinnamomi) with chronic heart failure(CHF).METHODS: Seven randomized controlled trials were reviewed.RESULTS: The meta-analysis indicated that the treatment group of Qili Qiangxin Capsule could decrease the cardiac functional grading of NYHA with 1.21 of the relative risk,and 95% confidence interval(CI) from 1.08 to 1.36;increase 6 minute walking distance with the weighted mean difference(WMD) was 37.39,and 95% confidence interval was from 22.58 to 52.20;raise left ventricular ejection fraction(WMD = 3.97[2.09,5.85]),decrease the left ventricular end-diastolic diameter(WMD = 2.81[1.41,4.22]),lower the level of B-type natriuretic peptide(WMD = 118.00[4.44,231.56]) and N-terminal pro-brain natriuretic peptide(WMD = 476.90[371.26,582.54]) in blood plasma and drop the score of Minnesota living with heart failure questionnaire(WMD =8.00[3.48,12.52]),but Qili Qiangxin Capsule for reduction in left ventricular end-diastolic volume,left ventricular end-systolic volume,heart rate and blood pressure also need to be confirmed.Besides,individual ca-ses occurred adverse reactions like dry cough,epigastric discomfort,gastric distention.However,It could be tolerated and hadn't significant statistical difference with comparison to control group.CONCLUSION: Qili Qiangxin Capsule is effective and safe for the patients of chronic heart failure in improving the heart function and living quality.

Multi-center clinical study of Rhadiola Extract Injection on the treatment of stable angina pectoris of coronary heart disease with cariac blood stasis syndrome / 中成药

AIM: To evaluate the therapeutic effect and safety of Rhadiola Extract Injection for treatment of stable angina pectoris of coronary heart disease with cariac blood stasis syndrome. METHODS: Arandomized,double-blind,positive drug parallel controlled,multi-center clinical trial was adopted.414 patients with stable angna pectoris of coronary heart disease with cariac blood stasis syndrome were randomly chosen and divided into two groups: test group(n=308 cases) and control group(n=106 cases).The test group was treated with Rhadiola Extract Injection and the control group received Xiangdan Injection.Treatment course of each group was 10 days.(RESULTS:) The therapeutic effect and changes of electrocardiogram in the test group were better than that of the control group(P0.05).The test group had no obvious side-effects. CONCLUSION: Rhadiola Extract Injection is safe and effective in treating stable angina pectoris of coronary heart disease with cariac blood stasis syndrome.