Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients w...Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients with acute coronary syndrome（ACS）. Methods： Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups： 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1（ICAM-1）, chitinase-3-like protein 1（YKL-40） and lipoprotein-associated phospholipase A2（Lp-PLA2）. Results： Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference（P〉0.05）; ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS（P〈0.05）. Conclusion： Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.展开更多
Background XS0601, consisting of active ingredients （Chuangxiongol and paeoniflorin）, has been shown to inhibit arterial neointimal hyperplasia in animal models and in preliminary human studies. The objective of thi...Background XS0601, consisting of active ingredients （Chuangxiongol and paeoniflorin）, has been shown to inhibit arterial neointimal hyperplasia in animal models and in preliminary human studies. The objective of this study was to evaluate the safety and efficacy of XS0601 in preventing restenosis following percutaneous coronary intervention （PCI）. Methods A multi-center, randomized, double-blind, placebo-controlled trial was conducted. A total of 335 patients were randomized into treatment with the oral administration of XS0601, or a placebo for 6 months after successful PCI. Angiographic follow-up was scheduled at 6 months, and clinical follow-ups performed at 1, 3 and 6 months after PCI. The primary end point was angiographic restenosis. The secondary end points were the combined incidence of death, target lesion nonfatal myocardial infarction, repeat angioplasty, and coronary artery bypass graft surgery. Results A total of 308 patients （91.9%） completed the study and 145 cases （47.1%） received angiographic follow-up. The restenosis rates were significantly reduced in the XS0601 group as compared with the placebo group （26.0% vs. 47.2%, P 〈 0.05）, and the minimum lumen diameter （MLD） was greater [（2.08 ± 0.89） mm for XS0601 vs. （1.73 ± 0.94） mm for placebo, P 〈 0.05]. XS0601 also significantly reduced the combined incidence of major adverse cardiac event （10.4% in the XS0601 group vs. 22.7% in the placebo group, P 〈 0.05）. The incidence of recurrent angina at 3 and 6 months after PCI was also significantly reduced in XS0601 group （7.1% and 11.0%） as compared with those in placebo group （19.5% and 42.9%） （P 〈 0.05）. No significant side effects occurred within the 6-month follow-up period in the XS0601 group.Conclusion Administration of XS0601 for 6 months is demonstrated to be safe and effective in reducing restenosis in post-PCI patients.展开更多
Objective: To examine the prognostic value of serum levels of asymmetric dimethylarginine(ADMA)in patients with stable coronary heart disease(CHD) thus explore a potential biomarker of "toxin syndrome" in CH...Objective: To examine the prognostic value of serum levels of asymmetric dimethylarginine(ADMA)in patients with stable coronary heart disease(CHD) thus explore a potential biomarker of "toxin syndrome" in CHD.Methods: In this prospective nested case-control study, 36 of 1,503 Chinese patients with stable CHD experienced at least 1 recurrent cardiovascular event(RCE) during 1-year fol ow-up. Serum levels of ADMA at the start of fol ow-up were compared between these 36 cases and 36 controls which matched to cases in terms of gender, age, history of hypertension, and myocardial infarction. Results: Based on the crude model, subjects in the 2 highest ADMA quartiles showed signi?cantly higher risk of developing RCE than those in the lowest ADMA quartile [odds ratio(OR) 4.09, 95%confidence interval(CI) 1.01 to 16.58; OR 6.76, 95% CI 1.57 to 29.07]. This association was also observed in the case-mix model(OR 5.51, 95% CI 1.23 to 24.61; OR 7.83, 95% CI 1.68 to 36.41) and multivariable model(OR 6.64,95% CI 1.40 to 31.49; OR 13.14, 95% CI 2.28 to 75.71) after adjusting for confounders. The multivariable model which combined ADMA and high-sensitivity C-reactive protein(hs CRP) showed better predictive power with areas under the receiver operator characteristic curves(0.779) than the model of either ADMA(0.694) or hs CRP(0.636). Conclusion:Serum ADMA level may be a potential biomarker of "toxin syndrome" in CHD which shows favorable prognostic value in predicting 1-year RCE in patients with stable CHD. [The registration number is Chi CTR-PRNRC-07000012]展开更多
Objective： To evaluate the effect and safety of Kuanxiong Aerosol （宽胸气雾剂, KA） on patients with angina pectoris. Methods： Block randomization was performed to randomly allocate 750 patients into KA （376 cases...Objective： To evaluate the effect and safety of Kuanxiong Aerosol （宽胸气雾剂, KA） on patients with angina pectoris. Methods： Block randomization was performed to randomly allocate 750 patients into KA （376 cases） and control groups （374 cases）. During an angina attack, the KA group received 3 consecutive sublingual sprays of KA （0.6 mL per spray）. The control group received 1 sublingual nitroglycerin tablet （NT, 0.5 rag/tablet）. Log-rank tests and Kaplan-Meier estimations were used to estimate the angina remission rates at 6 time-points after treatment （1,2, 3, 4, 5, and 〉5 min）. Logistic regression analysis was performed to observe the factors influencing the rate of effective angina remission, and the remission rates and incidences of adverse reactions were compared for different Canadian Cardiovascular Society （CCS） classes of angina. Results： The 5-min remission rates in the KA and control groups were not significantly different （94.41% vs. 90.64%, P〉0.05）. The angina CCS class significantly influenced the rate of remission （95% confidence interval = 0.483-0.740, P〈0.01）. In the CCS subgroup analysis, the 3- and 5-min remission rates for KA and NT were similar in the CCS I and IV subgroups （P〉0.05）, while they were significantly better for KA in the CCS Ⅱ and Ⅲ subgroups （P〈0.05 or P〈0.01）. Furthermore, the inciden0ce of adverse reactions was significantly lower in the KA group than in the control group for the CCS Ⅱ and Ⅲ subgroups （9.29% vs. 26.22%, 10.13% vs. 20.88%, P〈0.05 or P〈0.01）. Conclusions： KA is not inferior to NT in the remission of angina. Furthermore, in CCS Ⅱ and Ⅲ patients, KA is superior to NT, with a lower incidence of adverse reactions. （Registration No. ChiCTR- IPR-15007204）展开更多
Objective To investigate whether Lingbao Huxin Pill(LBHX)protects against acute myocardial infarction(AMI)at the infarct border zone(IBZ)of myocardial tissue by regulating apoptosis and inflammation through the sirtui...Objective To investigate whether Lingbao Huxin Pill(LBHX)protects against acute myocardial infarction(AMI)at the infarct border zone(IBZ)of myocardial tissue by regulating apoptosis and inflammation through the sirtuin 1(SIRT1)-mediated forkhead box protein O1(FOXO1)and nuclear factor-κB(NF-κB)signaling pathways.Methods Six-week-old Wistar rats with normal diet were randomized into the sham,the model,Betaloc(0.9 mg/kg daily),LBHX-L(0.45 mg/kg daily),LBHX-M(0.9 mg/kg daily),LBHX-H(1.8 mg/kg daily),and LBHX+EX527(0.9 mg/kg daily)groups according to the method of random number table,13 in each group.In this study,left anterior descending coronary artery(LADCA)ligation was performed to induce an AMI model in rats.The myocardial infarction area was examined using a 2,3,5-triphenyltetrazolium chloride solution staining assay.A TdT-mediated dUTP nick-end labeling(TUNEL)assay was conducted to assess cardiomyocyte apoptosis in the IBZ.The histopathology of myocardial tissue at the IBZ was assessed with Heidenhain,Masson and hematoxylineosin(HE)staining assays.The expression levels of tumor necrosis factorα(TNF-α),interleukin(IL)-6,IL-1β,and intercellular adhesion molecule-1 were measured using enzyme-linked immunosorbent assays(ELISAs).The mRNA expressions of SIRT1 and FOXO1 were detected by real-time qPCR(RT-qPCR).The protein expressions of SIRT1,FOXO1,SOD2,BAX and NF-κB p65 were detected by Western blot analysis.Results The ligation of the LADCA successfully induced an AMI model.The LBHX pretreatment reduced the infarct size in the AMI rats(P<0.01).The TUNEL assay revealed that LBHX inhibited cardiomyocyte apoptosis at the IBZ.Further,the histological examination showed that the LBHX pretreatment decreased the ischemic area of myocardial tissue(P<0.05),myocardial interstitial collagen deposition(P<0.05)and inflammation at the IBZ.The ELISA results indicated that LBHX decreased the serum levels of inflammatory cytokines in the AMI rats(P<0.05 or P<0.01).Furthermore,Western blot analysis revealed that the LBHX pretreatment upregulated the protein levels of SIRT1,FOXO1 and SOD2(P<0.05)and downregulated NF-κB p65 and BAX expressions(P<0.05).The RT-qPCR results showed that LBHX increased the SIRT1 mRNA and FOXO1 mRNA levels(P<0.05).These protective effects,including inhibiting apoptosis and alleviating inflammation in the IBZ,were partially abolished by EX527,an inhibitor of SIRT1.Conclusion LBHX could protect against AMI by suppressing apoptosis and inflammation in AMI rats and the SIRT1-mediated FOXO1 and NF-κB signaling pathways were involved in the cardioprotection effect of LBHX.展开更多
Objective： To evaluate the efficacy and safety of Tongxinluo Capsule（通心络胶囊, TXL） for patients with cardiac syndrome X（CSX）. Methods： Randomized controlled trials（RCTs） regarding TXL in the treatment of CS...Objective： To evaluate the efficacy and safety of Tongxinluo Capsule（通心络胶囊, TXL） for patients with cardiac syndrome X（CSX）. Methods： Randomized controlled trials（RCTs） regarding TXL in the treatment of CSX were searched in Chinese Biomedicine Literature Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, Pub Med, EMBASE, Cochrane Central Register of Controlled Trial, websites of the Chinese and International Clinical Trial Registry platform up to June 30, 2015. The intervention was either TXL alone or TXL combined with conventional treatment, while the control intervention was conventional treatment with or without placebo. Data extraction, methodological quality assessment and data analyses were performed according to the Cochrane criteria. The primary outcome was a composite event of death, acute myocardial infarction（AMI）, angina requiring hospitalization, revascularization, and heart failure. The secondary outcome measures were angina symptom improvement, electrocardiograph（ECG） improvement, and serum endothelin-1（ET-1） level. The adverse events were also recorded. RevMan 5.3 software was applied for data analyses. Results： Twelve RCTs（696 patients） were included. Compared with conventional treatment, the addition of TXL to conventional treatment showed some benefits on relieving angina symptoms [risk ratio（RR）： 1.46, 95% confidence interval（CI）（1.25, 1.71）, P〈0.01], and improving ECG [RR： 1.45, 95% CI（1.21, 1.74）, P〈0.01]. The pooled result did not support a benefit of TXL on reducing the incidence of primary outcome [RR： 0.20, 95% CI（0.02, 1.61）, P=0.13]. In addition, TXL decreased serum ET-1 concentration of CSX patients [standardized mean number： –1.63, 95% CI（–2.29, –0.96）, P〈0.01]. No serious adverse events were reported. Conclusions： TXL documents potential benefits on attenuating angina symptoms, improving ECG and decreasing serum ET-1 level for CSX patients. However, more rigorous RCTs with high quality are needed to confirm its efficacy and safety.展开更多
Objective To elucidate the underlying mechanism of Panax notoginseng saponin(PNS)on gastric epithelial cell injury and barrier dysfunction induced by dual antiplatelet(DA).Methods Human gastric mucosal epithelial cell...Objective To elucidate the underlying mechanism of Panax notoginseng saponin(PNS)on gastric epithelial cell injury and barrier dysfunction induced by dual antiplatelet(DA).Methods Human gastric mucosal epithelial cell(GES-1)was cultured and divided into 4 groups:a control,a DA,a PNS+DA and a LY294002+PNS+DA group.GES-1 apoptosis was detected by flow cytometry,cell permeability were detected using Transwell,level of prostaglandins E2(PGE2),6-keto-prostaglandin F1α(6-keto-PGF1α)and vascular endothelial growth factor(VEGF)in supernatant were measured by enzyme linked immunosorbent assay(ELISA),expression of phosphatidylinositide 3-kinase(PI3K),phosphorylated-PI3K(p-PI3K),Akt,phosphorylated-Akt(p-Akt),cyclooxygenase-1(COX-1),cyclooxygenase-2(COX-2),glycogen synthase kinase-3β(GSK-3β)and Ras homolog gene family member A(RhoA)were measured by Western-blot.Results DA induced apoptosis and hyper-permeability in GES-1,reduced supernatant level of PGE2,6-keto-PGF1αand VEGF(P<0.05).Addition of PNS reduced the apoptosis of GES-1 caused by DA,restored the concentration of PGE2,6-keto-PGF1αand VEGF(P<0.05).In addition,PNS attenuated the alteration of COX-1 and COX-2 expression induced by DA,up-regulated p-PI3K/p-Akt,down-regulated RhoA and GSK-3β.LY294002 mitigated the effects of PNS on cell apoptosis,cell permeability,VEGF concentration,and expression of RhoA and GSK-3βsignificantly.Conclusions PNS attenuates the suppression on COX/PG pathway from DA,alleviates DA-induced GES-1 apoptosis and barrier dysfunction through PI3K/Akt/VEGF-GSK-3β-RhoA network pathway.展开更多
Objective To investigate the combined anti-inflammatory effect of activating blood circulation and detoxifying Chinese medicines in unstable angina(UA)patients.Methods This study was an open-labeled,randomized control...Objective To investigate the combined anti-inflammatory effect of activating blood circulation and detoxifying Chinese medicines in unstable angina(UA)patients.Methods This study was an open-labeled,randomized controlled trial conducted in 5 centers in Beijing.A total of 154 patients were randomized into two groups at a 1:1 ratio by random numbers.Based on the conventional treatment,patients in the activating blood circulation(ABC)group were treated with Guanxin Danshen Droping Pill(冠心丹参滴丸,0.4 g,thrice daily),and patients in the activating blood circulation and detoxifying(ABCD)group were treated with Guanxin Danshen Droping Pill(0.4 g,thrice daily)and Andrographis tablet(0.2 g,thrice daily)for 4 weeks.The primary outcome was the serum level of high sensitive C reaction protein(hs-CRP),and the secondary outcome index included the serum levels of tumor necrosis factorα(TNF-α),interleukin 6(IL-6),soluble CD40 ligand(sCD40L),thrombomodulin(TM),the score of angina pectoris,the score of blood stasis syndrome,and the score of Chinese medicine symptoms,observed at week 0 and week 4.Results A total of 144 patients completed the trial(ABC group,n=70;ABCD group,n=74).There were no significant differences in the clinical baseline characteristics between the two groups.When compared with the ABC group,ABCD group showed better performance in reducing the level of inflammatory factors,especially hs-CRP(P<0.05),IL-6(P<0.01)and TNF-α(P<0.01).In term of clinical symptoms,ABCD group played a better role in improving the scores of angina pectoris and blood stasis syndrome than ABC group(all P<0.05).Conclusions The combination of Guanxin Danshen Dropping Pill and Andrographis tablet exert significant anti-inflammatory effect on UA patients,which is superior to single Guanxin Danshen Dropping Pill.(Registration No.ChiCTR-TRC-13004072)展开更多
基金Supported by National Basic Research Program of China(973 program,No.2015CB554404)
文摘Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients with acute coronary syndrome（ACS）. Methods： Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups： 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1（ICAM-1）, chitinase-3-like protein 1（YKL-40） and lipoprotein-associated phospholipase A2（Lp-PLA2）. Results： Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference（P〉0.05）; ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS（P〈0.05）. Conclusion： Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.
基金THIS STUDY WAS SUPPORTED BY GRANTS FROM NATIONAL TENTH FIVE-YEAR PROJECTS PLAN (NO. 2001BA701A20)
文摘Background XS0601, consisting of active ingredients （Chuangxiongol and paeoniflorin）, has been shown to inhibit arterial neointimal hyperplasia in animal models and in preliminary human studies. The objective of this study was to evaluate the safety and efficacy of XS0601 in preventing restenosis following percutaneous coronary intervention （PCI）. Methods A multi-center, randomized, double-blind, placebo-controlled trial was conducted. A total of 335 patients were randomized into treatment with the oral administration of XS0601, or a placebo for 6 months after successful PCI. Angiographic follow-up was scheduled at 6 months, and clinical follow-ups performed at 1, 3 and 6 months after PCI. The primary end point was angiographic restenosis. The secondary end points were the combined incidence of death, target lesion nonfatal myocardial infarction, repeat angioplasty, and coronary artery bypass graft surgery. Results A total of 308 patients （91.9%） completed the study and 145 cases （47.1%） received angiographic follow-up. The restenosis rates were significantly reduced in the XS0601 group as compared with the placebo group （26.0% vs. 47.2%, P 〈 0.05）, and the minimum lumen diameter （MLD） was greater [（2.08 ± 0.89） mm for XS0601 vs. （1.73 ± 0.94） mm for placebo, P 〈 0.05]. XS0601 also significantly reduced the combined incidence of major adverse cardiac event （10.4% in the XS0601 group vs. 22.7% in the placebo group, P 〈 0.05）. The incidence of recurrent angina at 3 and 6 months after PCI was also significantly reduced in XS0601 group （7.1% and 11.0%） as compared with those in placebo group （19.5% and 42.9%） （P 〈 0.05）. No significant side effects occurred within the 6-month follow-up period in the XS0601 group.Conclusion Administration of XS0601 for 6 months is demonstrated to be safe and effective in reducing restenosis in post-PCI patients.
基金Supported by Chinese National Program of Key Basic Research(No.2006CB504803)Beijing Committee of Science and Technology(No.D08050703020801)the 12th Five-Year Plan of China(No.2013BAI02B01)
文摘Objective: To examine the prognostic value of serum levels of asymmetric dimethylarginine(ADMA)in patients with stable coronary heart disease(CHD) thus explore a potential biomarker of "toxin syndrome" in CHD.Methods: In this prospective nested case-control study, 36 of 1,503 Chinese patients with stable CHD experienced at least 1 recurrent cardiovascular event(RCE) during 1-year fol ow-up. Serum levels of ADMA at the start of fol ow-up were compared between these 36 cases and 36 controls which matched to cases in terms of gender, age, history of hypertension, and myocardial infarction. Results: Based on the crude model, subjects in the 2 highest ADMA quartiles showed signi?cantly higher risk of developing RCE than those in the lowest ADMA quartile [odds ratio(OR) 4.09, 95%confidence interval(CI) 1.01 to 16.58; OR 6.76, 95% CI 1.57 to 29.07]. This association was also observed in the case-mix model(OR 5.51, 95% CI 1.23 to 24.61; OR 7.83, 95% CI 1.68 to 36.41) and multivariable model(OR 6.64,95% CI 1.40 to 31.49; OR 13.14, 95% CI 2.28 to 75.71) after adjusting for confounders. The multivariable model which combined ADMA and high-sensitivity C-reactive protein(hs CRP) showed better predictive power with areas under the receiver operator characteristic curves(0.779) than the model of either ADMA(0.694) or hs CRP(0.636). Conclusion:Serum ADMA level may be a potential biomarker of "toxin syndrome" in CHD which shows favorable prognostic value in predicting 1-year RCE in patients with stable CHD. [The registration number is Chi CTR-PRNRC-07000012]
基金Supported by the Traditional Chinese Medicine Public Welfare Scientific Research Project,State Administration of Traditional Chinese Medicine of China(No.201007001)
文摘Objective： To evaluate the effect and safety of Kuanxiong Aerosol （宽胸气雾剂, KA） on patients with angina pectoris. Methods： Block randomization was performed to randomly allocate 750 patients into KA （376 cases） and control groups （374 cases）. During an angina attack, the KA group received 3 consecutive sublingual sprays of KA （0.6 mL per spray）. The control group received 1 sublingual nitroglycerin tablet （NT, 0.5 rag/tablet）. Log-rank tests and Kaplan-Meier estimations were used to estimate the angina remission rates at 6 time-points after treatment （1,2, 3, 4, 5, and 〉5 min）. Logistic regression analysis was performed to observe the factors influencing the rate of effective angina remission, and the remission rates and incidences of adverse reactions were compared for different Canadian Cardiovascular Society （CCS） classes of angina. Results： The 5-min remission rates in the KA and control groups were not significantly different （94.41% vs. 90.64%, P〉0.05）. The angina CCS class significantly influenced the rate of remission （95% confidence interval = 0.483-0.740, P〈0.01）. In the CCS subgroup analysis, the 3- and 5-min remission rates for KA and NT were similar in the CCS I and IV subgroups （P〉0.05）, while they were significantly better for KA in the CCS Ⅱ and Ⅲ subgroups （P〈0.05 or P〈0.01）. Furthermore, the inciden0ce of adverse reactions was significantly lower in the KA group than in the control group for the CCS Ⅱ and Ⅲ subgroups （9.29% vs. 26.22%, 10.13% vs. 20.88%, P〈0.05 or P〈0.01）. Conclusions： KA is not inferior to NT in the remission of angina. Furthermore, in CCS Ⅱ and Ⅲ patients, KA is superior to NT, with a lower incidence of adverse reactions. （Registration No. ChiCTR- IPR-15007204）
基金Supported by the National Natural Science Foundation of China(No.81774141 and No.82074418)。
文摘Objective To investigate whether Lingbao Huxin Pill(LBHX)protects against acute myocardial infarction(AMI)at the infarct border zone(IBZ)of myocardial tissue by regulating apoptosis and inflammation through the sirtuin 1(SIRT1)-mediated forkhead box protein O1(FOXO1)and nuclear factor-κB(NF-κB)signaling pathways.Methods Six-week-old Wistar rats with normal diet were randomized into the sham,the model,Betaloc(0.9 mg/kg daily),LBHX-L(0.45 mg/kg daily),LBHX-M(0.9 mg/kg daily),LBHX-H(1.8 mg/kg daily),and LBHX+EX527(0.9 mg/kg daily)groups according to the method of random number table,13 in each group.In this study,left anterior descending coronary artery(LADCA)ligation was performed to induce an AMI model in rats.The myocardial infarction area was examined using a 2,3,5-triphenyltetrazolium chloride solution staining assay.A TdT-mediated dUTP nick-end labeling(TUNEL)assay was conducted to assess cardiomyocyte apoptosis in the IBZ.The histopathology of myocardial tissue at the IBZ was assessed with Heidenhain,Masson and hematoxylineosin(HE)staining assays.The expression levels of tumor necrosis factorα(TNF-α),interleukin(IL)-6,IL-1β,and intercellular adhesion molecule-1 were measured using enzyme-linked immunosorbent assays(ELISAs).The mRNA expressions of SIRT1 and FOXO1 were detected by real-time qPCR(RT-qPCR).The protein expressions of SIRT1,FOXO1,SOD2,BAX and NF-κB p65 were detected by Western blot analysis.Results The ligation of the LADCA successfully induced an AMI model.The LBHX pretreatment reduced the infarct size in the AMI rats(P<0.01).The TUNEL assay revealed that LBHX inhibited cardiomyocyte apoptosis at the IBZ.Further,the histological examination showed that the LBHX pretreatment decreased the ischemic area of myocardial tissue(P<0.05),myocardial interstitial collagen deposition(P<0.05)and inflammation at the IBZ.The ELISA results indicated that LBHX decreased the serum levels of inflammatory cytokines in the AMI rats(P<0.05 or P<0.01).Furthermore,Western blot analysis revealed that the LBHX pretreatment upregulated the protein levels of SIRT1,FOXO1 and SOD2(P<0.05)and downregulated NF-κB p65 and BAX expressions(P<0.05).The RT-qPCR results showed that LBHX increased the SIRT1 mRNA and FOXO1 mRNA levels(P<0.05).These protective effects,including inhibiting apoptosis and alleviating inflammation in the IBZ,were partially abolished by EX527,an inhibitor of SIRT1.Conclusion LBHX could protect against AMI by suppressing apoptosis and inflammation in AMI rats and the SIRT1-mediated FOXO1 and NF-κB signaling pathways were involved in the cardioprotection effect of LBHX.
基金Supported by the National Science and Technology Support Plan of China(No.2013BAI02B01)
文摘Objective： To evaluate the efficacy and safety of Tongxinluo Capsule（通心络胶囊, TXL） for patients with cardiac syndrome X（CSX）. Methods： Randomized controlled trials（RCTs） regarding TXL in the treatment of CSX were searched in Chinese Biomedicine Literature Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, Pub Med, EMBASE, Cochrane Central Register of Controlled Trial, websites of the Chinese and International Clinical Trial Registry platform up to June 30, 2015. The intervention was either TXL alone or TXL combined with conventional treatment, while the control intervention was conventional treatment with or without placebo. Data extraction, methodological quality assessment and data analyses were performed according to the Cochrane criteria. The primary outcome was a composite event of death, acute myocardial infarction（AMI）, angina requiring hospitalization, revascularization, and heart failure. The secondary outcome measures were angina symptom improvement, electrocardiograph（ECG） improvement, and serum endothelin-1（ET-1） level. The adverse events were also recorded. RevMan 5.3 software was applied for data analyses. Results： Twelve RCTs（696 patients） were included. Compared with conventional treatment, the addition of TXL to conventional treatment showed some benefits on relieving angina symptoms [risk ratio（RR）： 1.46, 95% confidence interval（CI）（1.25, 1.71）, P〈0.01], and improving ECG [RR： 1.45, 95% CI（1.21, 1.74）, P〈0.01]. The pooled result did not support a benefit of TXL on reducing the incidence of primary outcome [RR： 0.20, 95% CI（0.02, 1.61）, P=0.13]. In addition, TXL decreased serum ET-1 concentration of CSX patients [standardized mean number： –1.63, 95% CI（–2.29, –0.96）, P〈0.01]. No serious adverse events were reported. Conclusions： TXL documents potential benefits on attenuating angina symptoms, improving ECG and decreasing serum ET-1 level for CSX patients. However, more rigorous RCTs with high quality are needed to confirm its efficacy and safety.
基金Supported by the National Natural Science Foundation of China(No.81273933 and 81102722)the Eleven Five-Year Plan of National Science and Technology Support Project(No.2006BAI04A01-2)the Jilin Province Major Science and Technology Achievement Transforming Project(No.11ZDZH005)。
文摘Objective To elucidate the underlying mechanism of Panax notoginseng saponin(PNS)on gastric epithelial cell injury and barrier dysfunction induced by dual antiplatelet(DA).Methods Human gastric mucosal epithelial cell(GES-1)was cultured and divided into 4 groups:a control,a DA,a PNS+DA and a LY294002+PNS+DA group.GES-1 apoptosis was detected by flow cytometry,cell permeability were detected using Transwell,level of prostaglandins E2(PGE2),6-keto-prostaglandin F1α(6-keto-PGF1α)and vascular endothelial growth factor(VEGF)in supernatant were measured by enzyme linked immunosorbent assay(ELISA),expression of phosphatidylinositide 3-kinase(PI3K),phosphorylated-PI3K(p-PI3K),Akt,phosphorylated-Akt(p-Akt),cyclooxygenase-1(COX-1),cyclooxygenase-2(COX-2),glycogen synthase kinase-3β(GSK-3β)and Ras homolog gene family member A(RhoA)were measured by Western-blot.Results DA induced apoptosis and hyper-permeability in GES-1,reduced supernatant level of PGE2,6-keto-PGF1αand VEGF(P<0.05).Addition of PNS reduced the apoptosis of GES-1 caused by DA,restored the concentration of PGE2,6-keto-PGF1αand VEGF(P<0.05).In addition,PNS attenuated the alteration of COX-1 and COX-2 expression induced by DA,up-regulated p-PI3K/p-Akt,down-regulated RhoA and GSK-3β.LY294002 mitigated the effects of PNS on cell apoptosis,cell permeability,VEGF concentration,and expression of RhoA and GSK-3βsignificantly.Conclusions PNS attenuates the suppression on COX/PG pathway from DA,alleviates DA-induced GES-1 apoptosis and barrier dysfunction through PI3K/Akt/VEGF-GSK-3β-RhoA network pathway.
基金Supported by the National Natural Science Foundation of China(No.81573818 and No.81774141)。
文摘Objective To investigate the combined anti-inflammatory effect of activating blood circulation and detoxifying Chinese medicines in unstable angina(UA)patients.Methods This study was an open-labeled,randomized controlled trial conducted in 5 centers in Beijing.A total of 154 patients were randomized into two groups at a 1:1 ratio by random numbers.Based on the conventional treatment,patients in the activating blood circulation(ABC)group were treated with Guanxin Danshen Droping Pill(冠心丹参滴丸,0.4 g,thrice daily),and patients in the activating blood circulation and detoxifying(ABCD)group were treated with Guanxin Danshen Droping Pill(0.4 g,thrice daily)and Andrographis tablet(0.2 g,thrice daily)for 4 weeks.The primary outcome was the serum level of high sensitive C reaction protein(hs-CRP),and the secondary outcome index included the serum levels of tumor necrosis factorα(TNF-α),interleukin 6(IL-6),soluble CD40 ligand(sCD40L),thrombomodulin(TM),the score of angina pectoris,the score of blood stasis syndrome,and the score of Chinese medicine symptoms,observed at week 0 and week 4.Results A total of 144 patients completed the trial(ABC group,n=70;ABCD group,n=74).There were no significant differences in the clinical baseline characteristics between the two groups.When compared with the ABC group,ABCD group showed better performance in reducing the level of inflammatory factors,especially hs-CRP(P<0.05),IL-6(P<0.01)and TNF-α(P<0.01).In term of clinical symptoms,ABCD group played a better role in improving the scores of angina pectoris and blood stasis syndrome than ABC group(all P<0.05).Conclusions The combination of Guanxin Danshen Dropping Pill and Andrographis tablet exert significant anti-inflammatory effect on UA patients,which is superior to single Guanxin Danshen Dropping Pill.(Registration No.ChiCTR-TRC-13004072)
