Accurate diagnosis of severe coronary stenosis based on resting magnetocardiography: a prospective, single-center, cross-sectional analysis

OBJECTIVE To evalu ate the role of resting magnetocardiography in identifying seve re coronary artery stenosis in patients with suspected coronary artery disease.METHODS A total of 513 patients with angina symptoms were included and divided into two groups based on the extent of coronary artery disease determined by angiography:the non-severe coronary stenusis group(<70% stenosis) and the severe coronary stenosis group(≥70% stenosis).The diagnostic model was constructed using magnetic field map(MFM) parameters,either individually or in combination with clinical indicators.The performance of the models was evaluated using receiver operating characteristic curves,accuracy,sensitivity,specificity,positive predictive value(PPV) and ne gative predictive value(NPV).Calibration plots and decision curve analysis were performed to investigate the clinical utility and performance of the models,respectively.RESULTS In the severe coronary stenosis group,QR_MCTDd,S_MDp,and TT_(MA)C_(50) were significantly higher than those in the non-severe coronary stenosis group(10,46±10.66 vs,5.11±6.07,P <0.001;7.2±8.64 vs.4.68±6.95,P=0.003;0.32±57.29 vs.0.26±57.29,P <0.001).While,QR_MV_(amp),R_(MA),and T_(MA) in the severe coronary stenosis group were lower(0.23±0.16 vs.0.28±0.16,P<0.001;55.06±48.68 vs.59.24±53.01,P<0.001;51.67±39.32 vs. 60.45±51.33,P <0.001).Seven MFM parameters were integrated into the model,resulting in an area under the curve of 0.810(95% CI:0.765-0.855).The sensitivity,specificity,PPV,NPV,and accurecy were 71.7%,80.4%,93.3%,42.8 %,and 73.5%;respectevely.The combined model exhibited an area under the curve of 0.845(95% CI:0.798-0.892).The sensitivity,specificity,PPV,NPV,and accuracy were 84.3%,73.8%,92.6%,54.6%,and 82.1%;respectively.Calibration curves demonstrate d excellent agreement between the nomogram prediction and actual observation.The decision curve analysis showed that the c ombine d model provided greater net benefit compared to the magnetocardingraphy model.CONCLUSIONS The novel quantitative MFM parameters,whether used individually or in combination with clinical indicators,have been shown to effectively pre dict the risk of severe coronary stenosis in patients presenting with angina-like symptoms.Magnetocardiography,an emerging non-invasive diagnostic tool,warrants further exploration for its potential in diagnosing coronary heart disease.

Boswellic acids: a review on its pharmacological properties, molecular mechanism and bioavailability

Boswellic acids is a general term for a series of pentacyclic triterpenoid compounds that are isolated from the oleogin resin of the Boswellia genus and serve as the main active ingredient.It exhibits a wide range of biological activities,such as anti-inflammatory,anti-cancer,antibacterial,antiviral,hepatoprotective,neuroprotective,anti-diabetic,and anti-thrombotic properties.As a result,it has gained significant recognition among practitioners of traditional Chinese and Indian medicine.These biological effects may be associated with multiple molecular targets and signal transduction pathways.However,the poor pharmacokinetic properties of the substance lead to lower bioavailability,which affects its effectiveness.To address this issue,scientists have proposed a number of strategies,such as solid dispersions,phytosome®technologies,and novel drug delivery systems.This article aims to provide a comprehensive overview for boswellic acids on the phytochemistry,molecular mechanisms,potential therapeutic applications,and strategies to improve bioavailability.

Exploration of the efficacy and mechanism of treating head wind disease with the combination change of ginger volatile oil and gingerol by using content-weighted network pharmacology technology

Background:Exploring the efficacy,potential components,and mechanism of the combination of ginger essential oil and gingerols in the treatment of head wind disease based on network pharmacology technology with content weight.Methods:The experimental groups were divided into:0:10,1:4,1:2,1:1,2:1,4:1,10:0.The relative content(Ri)of the chemical constituents of ginger's volatile oil was determined using gas chromatography-mass spectrometry(GC-MS).Additionally,the physicochemical and biological property parameters(LogP,MDCK,PPB,MW)of the components were considered.To assess the quantitative effect of the components,a grading score was performed,and the quantitative effect index(Ki)was calculated.Subsequently,the target effect index(Ti)was calculated by combining the component-target matching score(Fit score).Using these calculations,the target effect score A was determined under the influence of multiple components targeting different targets.Key targets with A≥1000 were identified.To predict the targets related to head wind disease,the Comparative Toxicogenomics Database(https://ctdbase.org/),Gene Cards(https://www.genecards.org/),and Disgenet database(https://www.disgenet.org/)were utilized.The key targets,obtained from different proportions of ginger's volatile oil and gingerol,were intersected with the predicted targets.This facilitated network pharmacological analysis and verification of the efficacy.Results:The content of volatile oil in ginger demonstrated an impact on key targets associated with the volatile oil group.Each specific combination of volatile oil consistently activated distinct pathways,with variations stemming from changes in content.Experimental testing revealed that different combinations of ginger's volatile oil and gingerol effectively alleviated migraine symptoms in rats.Conclusion:Through the application of content-weighted network pharmacology technology and pharmacodynamic verification,it was determined that altering the ratio between ginger's volatile oil and gingerol leads to variations in potential targets and pathways,consequently impacting its efficacy.

Study on the mechanism of SND in the treatment of anxiety disorders based on network pharmacology, molecular docking and experiment validation

Background:Sini decoction(SND)is a classic traditional Chinese medicine(TCM)formulation that can be used to treat anxiety-related disorders,but the active substance and underlying molecular mechanism of its anxiolytic effects are unknown.In this study,network pharmacology,molecular docking research and experimental verification methods were used to preliminarily explore the bioactive compounds and potential target mechanisms of SND anxiolytic.Methods:The active components and corresponding targets of SND were collected by TCMSP.GeneCards,OMIM,PharmGkb,TTD and Drugbank were used to search for the targets of anxiety disorders.The core target of SND in the treatment of anxiety was screened by PPI.R language was used to analyze the intersection targets of SND in the treatment of anxiety disorders by GO and KEGG enrichment analysis.AutoDock Vina was used for molecular docking,and Discovery Studio was used for visual conformation analysis after docking.The anti-anxiety effect and molecular mechanism of SND were studied by in vivo experiment.Results:Based on network pharmacological analysis,we obtained 112 active ingredients and 350 effective targets related to anxiety from SND.In PPI analysis,26 targets such as STAT3,MAPK3,MAPK1,MAPK14,SRC,HSP90AA1,TP53 and PIK3CA were identified as core targets.GO and KEGG analysis showed that the anxiolytic mechanism of SND may be related to the neuroactive ligand-receptor interaction pathway and inflammatory pathway.Molecular docking showed that quercetin,naringenin,licochalcone A had high affinity with JAK2,MAPK14 and MAPK3.Animal experiments have shown that SND reverses the upregulation of GluN2B(NMDAR)and GluA1(AMPAR)proteins,and SND improves anxiety disorders by regulating glutamate transmitter levels,which may be related to neuroactive ligand-receptor interaction pathways,particularly glutamate receptors.Conclusion:This study shows that SND can improve FS-induced behavioral changes in mice and can modulate hippocampal synapse-associated protein defects,partially reversing glutamate receptor expression through the neuroactive ligand-receptor interaction pathway,and further improved anxiety disorders.At the same time,combined with network pharmacology and molecular docking,the key components,core targets and related pathways of SND are discussed,which shows that the active components of SND play an effective role in anxiety through multi-targets and multi-pathways,which provides a reference for the material basis and mechanism of SND.

Exploring the scientific rationality of“Different dosage forms of the same prescription”base on Q-markers of pulvis and pill of Chuanxiong Chatiao Prescription

Objective:To predict and analyze the potential Q-markers of Chuanxiong Chatiao Prescription,and the pharmacokinetic properties of pulvis and pills in vivo were studied,which provided a basis for the rational evaluation of the phenomenon of“Different Dosage Forms of the Same Prescription”.Methods and Material:Q-markers analysis of Chuanxiong Chatiao Prescription based on the“Five Principles”(traceability and transmissibility,specificity,effectiveness,prescription compatibility and testability).The content determination method of Q-markers in Chuanxiong Chatiao Prescription was established by UPLC,and the content difference of Q-markers in the two dosage forms ware determined and compared.The Q-markers in rabbit plasma was determined by LC-MS/MS method,and the pharmacokinetic parameters of Q-markers in pulvis and pills were analyzed.Results:A total of 16 potential Q-markers from the“Five Principles”were used,nine components of tetramethylprazine,ferulic acid,glycyrrhizin,glycyrrhizic acid,luteolin,cimicifugoside,senkyunolideⅠ,isoimperatorin,nodakenin were identified as Q-markers of Chuanxiong Chatiao Presciption.The content of tetramethylprazine and other components in the pulvis form was found to be significantly higher than that in the pills,while the content of senkyunolideⅠwas lower than that in the pills,which may be related to the preparation process of the dosage form and the physicochemical properties of the components.Compared with pulvis,the Tmax and t_(1/2)of ferulic acid and other components in pills were significantly prolonged.To a certain extent,it can explain the classical theory of traditional Chinese medicine“Components in pulvis release quickly and take effect in fast-acting manner,while in pills release slowly and take effect in slow-acting”.Meanwhile,the Cmax and AUC0-t of tetramethylprazine and other components in pills were higher than those in pulvis,which showed unexpected pharmacokinetic characteristics,indicating the complexity of compounding and the importance of dosage form design.Conclusions:A method for the determination of Q-markers content was established by UPLC,which provide reference for the quality control of Chuanxiong Chatiao Prescription.In vivo studies have found the pharmacokinetic parameters indicate the absorption and distribution characteristics of pulvis and pills.However,it is also found that the release behavior of different components not only affected by the dosage form but also closely related to their own physical and chemical properties.

Chinese expert consensus on the non-invasive imaging examination pathways of stable coronary artery disease

1 Introduction Early detection and diagnosis of stable coronary artery disease （SCAD） is essential for proactive secondary prevention of myocardial infarction （MI）, control of disease progress, and reduction of mortality. Clinical decision-making in modem medicine is increasingly dependent on cardiovascular imaging techniques. 2012 ACCF/AHA/ACP/AATS/ PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease has been issued by American Heart Association （AHA）. European Society of Cardiology （ESC） has issued 2013 ESC guidelines on the management of stable coronary artery disease.

Predictors of adherence to home-based cardiac rehabilitation program among coronary artery disease outpatients in China

Background Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors for adherence, which is very much unknown in China, would be valuable for effective rehabilitation. This study aims to determine the adherence to home-based CR programs in Chinese coronary artery disease patients and determine predictors of adherence. Methods The current study included 1033 outpatients with coronary heart disease in the First Medical Center of Chinese PLA General Hospital in Beijing from July 2015 to June 2017. Participants were given an exercise prescription and took part in home-based exercise training lasting for 3–24 months. A questionnaire was used to evaluate the completion of the CR program, understanding of the program, motivation of the patients, and family/peer support. Results Two thirds of the patients adhered well to the home-based CR program. Elder patients (≥ 65-year-old) adhere to the program better, while men adhered better than women. Patients who used to exercise (B = 6.756, P < 0.001), understood the program (B = 0.078, P = 0.002), with stronger motivation to participate (B = 0.376, P < 0.001), and received better family support (B = 0.487, P < 0.001) also adhere better to the program. Conclusions Understanding the program, self-motivation of patients, and family support help to keep patients engaged in a home-based CR program. Improvement of family support by educating both patients and families may be helpful in improving adherence to home-based CR programs.

Simulation on release of heavy metals Cd and Pb in sediments

The re-release process and the release rate of heavy metals,cadmium and plumbum,which are rich in sediments of a certain water area,were investigated using a combined experimental and numerical method.Results show that the release law of Cd and Pb in sediments is divided into two stages:rapid release and dynamic equilibrium,which is in great agreement with the pseudo second-order kinetic equation with a correlation coefficient R2 above 0.99.As the flow velocity accelerates,the release rate of heavy metals increases.The analysis results indicate that the water quality in the area can exceed the surface water Class V standard less than 3 h,and all but one of the relative deviations between the simulation value and the field survey result are within±10%.

Armarium facilitating angina management post myocardial infarction concomitant with coronavirus disease 2019

The outbreak and spread of coronavirus disease 2019(COVID-19)are not only a disaster of people’s life and health over the world,[1–3]but also the challenge for medical practitioner in clinical management.Owing to many diagnostic instruments are not suitable or convenient to use any more in contagious ward considering the risk of cross infections,such as traditional stethoscope or electrocardiogram(ECG).In this scenarios,wireless and digital equipment are optimal choices for epidemic management in order to exert rapid diagnosis and disease evaluation.Herein,we reported a case of the patient suffering both COVID-19 and myocardial infarction,for which the tele-ECG and wireless stethoscope facilitated the accurate diagnosis and instant management.

Discussion on the mechanism of Xiaoyao Wan in the treatment of depression and anxiety based on network pharmacology

In order to clarify the targets of Xiaoyao Wan in the treatment of depression and anxiety,the pharmacological database of traditional Chinese medicine system and the analysis platform(TCMSP)were used to search the chemical components and potential targets of Xiaoyao Wan.The databases of Malacards and Genecards were used to mine the targets related to depression and anxiety.With the help of Cytoscape3.2.1 software,the“Xiaoyao Wan-targets-diseases”network is constructed.The PPI network is constructed through String database.Common targets are enriched by cluster Profiler software package in R language.161 active components of Xiaoyao Wan were screened,and 247 targets related to Xiaoyao Wan were predicted(excluding repetitive targets).The related targets of depression and anxiety were 379,337 respectively.Through the intersection of Venny diagram,24 targets of Xiaoyao Wan,depression and anxiety were obtained.24 key targets were screened out by constructing the interaction network of Xiaoyao Wan,depression and anxiety.Pathway enrichment analysis showed that Xiaoyao Wan mainly acts on key targets involves D(2)dopamine receptor(DRD2),Interleukin-6(IL6),5-hydroxytryptamine receptor 2A(HTR2A),Interleukin-1 beta(IL1B),5-hydroxytryptamine receptor 3A(HTR3A),Sodium-dependent dopamine transporter(SLC6A3),D(1A)dopamine receptor(DRD1),Interleukin-10(IL10),Sodium-dependent noradrenaline transporterin(SLC6A2)and other key targets in the treatment of depression and anxiety,and participates in important pathway processes such as Serotonergic synapse,Dopaminergic synapse,Neuroactive ligand-receptor interaction and regulation of neurotransmitter levels.It is speculated that Xiaoyao Wan plays a role in the treatment of depression and anxiety by affecting neurotransmitters 5-HT and DA,participating in hypothalamic-pituitary-adrenal(HPA)and interfering in the process of inflammation.

HRV changes before and after radiofrequency ablation in patients with different origin of right ventricular outflow tract ventricular premature contraction

Objective:To observe the HRV changes before and after the radiofrequency current catheter ablationventricular premature beats originated from different site of right ventricular outflow tract.Methods:A total of 102 patients with frequent RVOT-VPC admitted to our hospital were accepted radiofrequency current catheter ablation (RF). According to the origin of RVOT-VPC, it was divided into 2 groups, one is from ventricular septum, and the other one is from free wall, and in each group, male and female are observed separately.Results:(1) HRV before RF ablation: 1) rMSSD in the female patients with RVOT-VPC from free wall was significantly lower than those from septum;2) frequency domain index (W, LF) were higher than normal range, and in male patients, LF/HF<1 were found, but in female patients, LF/HF>1. (2) HRV after RF ablation: 1) Significant changes were found in female patients with RVOT-VPC from septum, rMSSD, PNN50, HF and LF decreased;2) In female patients with RVOT-VPC from free wall, rMSSD decreased;3) In male patients, there were no significant HRV changes found before and after RF ablation. (3) Heart rate changes: 1) In female patients with RVOT-VPC from septum, heart rate decreased significantly ((76.47±9.47) bpm vs (69.29±14.59) bpm)2) No significant changes were found in male patients.Conclusion:In patients with RVOT-PVC sympathetic and vagus excitability increased, and after catheter ablation, in female patients with RVOT-PVC originated from septum, the HRV index relating to sympathetic and vagus excitability significantly decreased.

Numerical research on slamming characteristics of aircraft landing on water

In order to investigate the impact characteristic of an aircraft landing on water,a computational fluid dynamics(CFD)simulation is conducted to explore the slamming characteristics of the NACA TN 2929 A model.The flow around the model is solved by using Reynolds-averaged Navier-Stokes equations with the shear stress transport(SST)k—ωturbulence model,based on finite volume method(FVM).The free surface is captured by using the volume of fluid(VOF)method,and the aircraft impact process is realized with help of overset mesh technology.Then,the effects of horizontal and vertical velocities and initial pitch angle on the slamming load,attitude change,impact pressure and flow field evolution are investigated.The results reveal that the horizontal velocity has a considerable influence on whether the aircraft’s horizontal tail hits the water,and further affects the maximum vertical load as well as the maximum pitch angle throughout the impact process.The vertical velocity determines the slamming load before the horizontal tail strikes the water,while the horizontal velocity has a significant effect on the load after the horizontal tail hits the water.A smaller initial pitch angle results in not only a heavier slamming load but also a more dramatic change of the posture after the aircraft impacts the water.The impact pressure of the aircraft is maximized at the junction of the approaching surface of the fuselage and the free surface.In some cases,the pressure is also concentrated on the undersurface of the horizontal tail.