Adjunctive Effect and Safety of Chinese Herbal Medicine in Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.

Objective: The primary objectives of this systematic review and meta-analysis were to assess the impact of Chinese herbal medicine (CHM) as an adjunctive therapy in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) and to evaluate its safety and efficacy. Methods: Studies were obtained from multiple databases, including PubMed, Web of Science, China National Knowledge Infrastructure Database (CNKI), WanFang Data (WanFang), and Chinese Science and Technology Journal Database (VIP). Randomized controlled trials evaluating the effects of CHM intravenously or orally in patients with CAD undergoing PCI were included. The primary outcome was improvements in major adverse cardiovascular events (MACEs), and the secondary outcomes included differences in echocardiography, serum biomarkers, vascular structures and functions, clinical symptoms, and adverse drug reactions. Data synthesis was conducted using relative risk (RR), weighted mean difference (MD), and 95% confidence intervals (CI). Results: Forty-seven trials, including 12,638 participants, were included in the meta-analyses. CHM significantly reduced MACEs compared with the control group(RR = 0.51, 95% CI= 0.45 to 0.58)). CHM also led to improvements in left ventricular ejection fraction((MD=6.93, 95% CI = 4.03 to 8.03), ventricular end-diastolic dimension(MD=-5.01, 95% CI = -7.0 to -3.03), and cardiac troponin-I levels(MD=-0.37, 95% CI = -0.77 to 0.03]). The anti-inflammatory effects of CHM were observed through downregulation of C-reactive protein(MD=-2.13, 95% CI = -3.1 to -1.05) and high-sensitivity CRP (MD=-1.47, 95% CI= -2.47 to -0.48) when compared with the control groups. CHM also showed a protective effect on renal function and augmented platelet inhibition(7.05, 95% CI=5.91 to 8.19, P < .00001). The blood stasis scores of patients treated with Chinese Medicine were lower in the CHM group (MD=-4.30, 95% CI= -6.53 to -2.07). No significant difference in adverse events was found between the CHM and control groups. Conclusion: The addition of CHM to conventional treatment in patients undergoing PCI for CAD improved primary and secondary endpoint events with no significant adverse drug reactions. These findings suggest that CHM has better clinical efficacy and safety. However, more high-quality studies are needed to validate these results and provide further evidence for the clinical application of CHM in CAD patients undergoing PCI.

WITHDRAWN: The Analgesic Effect of Regional Blocks for Modified Radical Mastectomy: A Network Meta-analysis.

Ahead of Print article withdrawn by publisher.

Spermidine ameliorates the neuronal aging by improving the mitochondrial function in vitro.

Changes in mitochondrial structure and function are the initial factors of cell aging. Spermidine has an antiaging effect, but its effect on neuronal aging and mitochondrial mechanisms is unclear. In this study, mouse neuroblastoma (N2a) cells were treated with d­galactose (d­Gal) to establish cell aging to investigate the antiaging effect and mechanisms of spermidine. Changes in the cell cycle and ß-galactosidase activity were analyzed to evaluate the extent of cell aging. Stabilities of mitochondrial mRNA and mitochondrial membrane potential (MMP) were evaluated in the process of cell aging under different treatments. The mitochondrial function was also evaluated using the Seahorse Metabolic Analysis System combined with ATP production. The unfolded protein response (UPR) of the N2a cells was analyzed under different treatments. Results showed that spermidine pretreatment could delay the cell aging and could maintain the mitochondrial stability during d­Gal treatment. Spermidine increased the proportion of cells in the S phase and maintained the MMP. The oxygen utilization and ATP production in the N2a cells were reduced by d­Gal treatment but were partially rescued by the spermidine pretreatment. Spermidine ameliorated the N2a cell aging by promoting the autophagy and inhibiting the apoptosis except the UPR. These results showed that spermidine could ameliorate the N2a cell aging by maintaining the mitochondrial mRNA transcription, MMP and oxygen utilization during the d­Gal treatment.

Interaction of basolateral amygdala, ventral hippocampus and medial prefrontal cortex regulates the consolidation and extinction of social fear.

BACKGROUND: Following a social defeat, the balanced establishment and extinction of aversive information is a beneficial strategy for individual survival. Abnormal establishment or extinction is implicated in the development of mental disorders. This study investigated the time course of the establishment and extinction of aversive information from acute social defeat and the temporal responsiveness of the basolateral amygdala (BLA), ventral hippocampus (vHIP) and medial prefrontal cortex (mPFC) in this process. METHODS: Mouse models of acute social defeat were established by using the resident-intruder paradigm. To evaluate the engram of social defeat, the intruder mice were placed into the novel context at designated time to test the social behavior. Furthermore, responses of BLA, vHIP and mPFC were investigated by analyzing the expression of immediate early genes, such as zif268, arc, and c-fos. RESULTS: The results showed after an aggressive attack, aversive memory was maintained for approximately 7 days before gradually diminishing. The establishment and maintenance of aversive stimulation were consistently accompanied by BLA activity. By contrast, vHIP and mPFC response was inhibited from this process. Additionally, injecting muscimol (Mus), a GABA receptor agonist, into the BLA alleviated the freezing behavior and social fear and avoidance. Simultaneously, Mus treatment decreased the zif268 and arc expression in BLA, but it increased their expression in vHIP. CONCLUSION: Our data support and extend earlier findings that implicate BLA, vHIP and mPFC in social defeat. The time courses of the establishment and extinction of social defeat are particularly consistent with the contrasting BLA and vHIP responses involved in this process.