Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Efficacy and safety of Guipi Decoction combined with conventional Western medicine in the treatment of insomnia with deficiency of heart and spleen:a meta-analysis

Objective:To systematically evaluate the efficacy and safety of Guipi Decoction combined with Western medicine in the treatment of insomnia with deficiency of heart and spleen.Methods:English databases(PubMed,Web of Science,The Cochrane Library,EMBASE)and Chinese databases(CNKI,Wanfang database,China Biomedical Literature Service System,VIP database)were searched by computer.Randomized controlled trials of Guipi Decoction on insomnia with deficiency of heart and spleen were searched from the database construction to November 2021.After the first and second authors independently screened the literature,extracted the data and evaluated the risk of bias in the included studies,meta-analysis was performed using RevMan5.3 software.Results:A total of 9 RCTS were included after screening,including 914 patients.Meta-analysis results showed that:Total effective rate[RR=1.22,95%CI(1.16,1.30),P<0.00001],total PSQI score[MD=-3.05,95%CI(-3.96,-2.14),P=0.008],number of night awakening times[[MD=-1.18,95%CI(-1.42,-0.94),P<0.00001],adverse reaction rate[RR=0.32,95%CI(0.21,0.51),P<0.00001]were better than the control group,and the differences were statistically significant.Conclusion:The current evidence shows that,compared with pure using conventional western medicine,belongs to the spleen decoction combined western medicine therapy,cases both deficiency type of insomnia in the total effective rate,reducing the total PSQI score(improve sleep quality,sleep efficiency,sleep disorder,daytime function,etc.),reducing frequency of nighttime awakening,security,have more advantages.However,due to the limitation of the quality and quantity of articles included in the study,more randomized,double-blind,large-sample clinical studies are needed to confirm the above conclusions.

Clinical Observation on the Treatment of Insomnia in Germany with Deficiency of Heart and Spleen by the Ear Bean Therapy

Objective: To observe the effect of insomnia patients with deficiency of heart and spleen in Germany by the therapy of ear points pressing with bean. Methods: A total of 80 cases of insomnia with deficiency of heart and spleen in Germany were divided into the observation group and the control group, with 40 cases in each group. The patients in the control group were treated with oral modified Guipi Decoction(归脾汤), while the patients in the observation group were treated with oral traditional Chinese medicine(TCM) and the therapy of ear points pressing with bean. The efficacy, sleep quality, the TCM syndromes score and the incidence of adverse reactions were compared between the two groups. Results: The effective rate in the observation group was higher than that in the control group, and there was statistical difference between the two group(P<0.05). After treatment, the Pittsburgh sleep quality index scale(PSQI) score, insomnia severity index(ISI) score and the TCM syndromes score in the two groups were decreased sharply(P<0.01), and those scores in the observation group were lower than that in the control group(P<0.05). There was no adverse reaction between the two groups. Conclusion: The therapy of ear points pressing with bean is effective on insomnia in Germany, which is worth further study and promotion.

The Use of Fuzzy Clustering and Correlation to Implement an Heart Disease Diagnosing System in FPGA

In this paper we present a signal processing method capable of detecting cardiopathies in electrocardiograms that was implemented in FPGA. The adopted procedure is based on fuzzy clustering to reduce the amount of data sampling, and a comparison with samples from a previously established database. By using the correlation method on the samples, it is possible to establish an initial indication of a cardiopathy. The reduced number of samples of the clustering process turns the processing simpler and allows its hardware implementation. According to the tests conducted, the method achieves 91% correct diagnoses.

Correlation between levels of serum FKN and clinical index in patients with coronary atherosclerotic heart disease

Objective: To investigate the correlation and clinical significance between the serum Fractalkine (FKN) and interleukin-6 (IL-6), C-reactive protein (CRP), BNP, CK, CK-MB, TC, TG, LDL-C, HDL-C levels in patients with coronary atherosclerotic heart disease (CHD). Methods: A total of 95 cases of patients with coronary heart disease were admitted to the Department of Cardiology, the First Affiliated Hospital of Xinjiang Medical University, March 2016 to December 2016, including 52 patients with stable angina pectoris (SAP) and 43 patients with Acute coronary syndrome (ACS), 45 matched healthy subjects were collected. The Serum levels of FKN were detected by ELISA. The correlation and significance of FKN and clinical indexes were analyzed. Results: (1) the levels of serum FKN, IL-6, CRP, BNP, CK, CK-MB, TC, TG, LDL-C in the SAP group and ACS group were significantly higher than those in the control group, HDL-C were significantly decreased. Compared with SAP group, serum FKN level was significantly increased and IL-6, CRP, BNP, CK and CK-MB levels were significantly increased in ACS group, TC, TG, LDL-C, HDL-C levels were not significant difference between SAP group and ACS group. (2) Correlation analyses showed that there was a significant positive correlation between FKN levels and IL-6, CRP, BNP, CK, CK-MB, LDL-C, significant Negative correlation between FKN levels and HDL-C, weakly positive correlation between FKN levels and TC, and no correlation between FKN levels and TG. Conclusions: The serum levels of FKN in patients with CHD are significantly increased, which are closely related to the inflammatory reaction and can be used as biomarker of CHD for early diagnosis and prognosis.

ACUPUNCTURE TREATMENT FOR 100 CASES WITH INSOMNIA OF THE TYPE OF THE HEART AND SPLEEN DEFICIENCY

cases of insomnia of the type of heart and spleen deficiency were treated by acupuncture.Results indicated that 95 cases were cured,accounting for 95%;3 cases were markedly effective,accounting for 3% and the 2 cases were ineffective,accounting for 2%,the total effective rate was 98%.

The Correlation between Free Triiodothyronine, Free Thyroxine and Hypertension in Depression Patients with Hypothyroidism and Its Clinical Guiding Value

Background: Cardiovascular diseases, such as hypertension and coronary heart disease, are often accompanied by thyroid and mental diseases, the harm of which poses great threats to patients’ health. Objective: To explore the correlation between free triiodothyronine (FT3), free thyroxine (FT4) and hypertension in depression patients with hypothyroidism and its clinical guiding value. Methods: A total of 548 patients diagnosed with hypothyroidism in Wuxue First People’s Hospital of Hubei Province from January 2018 to September 2022 were enrolled. According to whether complicated with depression, they were divided into hypothyroidism without depression group (group A) and hypothyroidism with depression group (group B). The gender, age, comorbidities (such as depression, hypertension, diabetes, dyslipidemia, acute myocardial infarction), FT3, FT4, and thyroid stimulating hormone (TSH) levels were recorded. Spearman rank correlation was used to analyze hypertensive patients with hypothyroidism. Multivariate binary Logistic regression was used to analyze the influencing factors of hypertension in patients with hypothyroidism. Results: The TSH level, the number of hypertension, coronary heart disease and hyperlipidemia in group B were statistically significantly higher than those in group A (P 3 level in group B was statistically significantly lower than that in group A (P s = 0.092), coronary heart disease (rs = 0.000), hyperlipidemia (rs = 0.000), diabetes (rs = 0.000), and age (rs = 0.000), and negatively correlated with FT3 (rs = 0.000) (P 3 and FT4 were the influencing factors of hypertension. The risk of hypertension in patients with coronary heart disease and hyperlipidemia significantly increased by 3.425 and 1.761 times (P 3, the risk of hypertension increased (P 4, the risk of hypertension significantly increased (P 3 and FT4 are the influencing factors of hypertension. The lower the FT3 level, the higher the FT4 level, the higher the risk of hypertension. FT3 and FT4 may be potential biomarkers of depression in hypertensive patients. Thyroid function assessment is recommended in patients with hypertension.

Preoperative application of combination of portal venous injection of donor spleen cells and intraperitoneal injection of rapamycin prolongs the survival of cardiac allografts in mice

Objective:To investigate the effects of preoperative portal venous injection of donor spleen cells(PVIDSC) and intraperitoneal injection of rapamycin in the acute rejection of cardiac allograft in mice and the underlying mechanisms. Methods:Homogenous female B6 mice and BALB/c mice were used as recipients and donors of heart transplantation. These mice were randomly divided into different groups and received PVIDSC alone,rapamycin alone,or PVIDSC and rapamycin combined therapy. In addition,the underlying mechanism was studied by measuring a number of cytokines. Results:Preoperative combination of PVIDSC and intraperitoneal injection of rapamycin significantly prolonged the survival of heterotopic cardiac allograft in mice,but had no effects on the survival time of cardiac allografts in mice pre-sensitized by skin grafting. Preoperative combination of PVIDSC and intraperitoneal injection of rapamycin increased the expression of IL-10 and Foxp3 and reduced the expression of INF-γ. Short-term preoperative administration of rapamycin promotes the expression of CD4^+CD25^+Foxp3^+ regulator T cells. However,preoperative using alone of rapamycin,or combination of PVIDSC and rapamycin had no effects on the inhibition of proliferation of memory T cells. Conclusions:Preoperative application of combination of PVIDSC and rapamycin significantly prolonged the survival time of cardiac allografts in mice but not in mice pre-sensitized by skin grafting. This may be explained by the fact that combination of PVIDSC and rapamycin inhibited the cellular immune response and induced the expression of IL-10 from Tr1 cells and CD4^+CD25^+FoxP3^+ regulatory T cells.

Assessing inflammation in Chinese subjects with subtypes of heart failure: an observational study of the Chinese PLA Hospital Heart Failure Registry

Background Inflammation is an important element of the pathophysiological process of heart failure (HF) and is correlated with subtypes of HF. The association between multiple biomarkers of inflammation and HF subtypes in Chinese subjects remains unclear. This study aimed to compare the differences in inflammation biomarkers among Chinese patients with different subtypes of HF who have been identified to date. Methods We included 413 consecutive patients with HF,including 262 with preserved ejection fraction (HFpEF),55 with middle-ranged ejection fraction (HFmrEF) and 96 with reduced ejection fraction (HFrEF). Ten inflammation biomarkers were analyzed and compared according to the HF subtypes. One hundred contemporary non-HF subjects were also recruited as the control group. Moreover,the correlations between the inflammatory biomarkers and left ventricular ejection fraction of the HF subtypes were assessed. Results The mean age of the HF patients was 65.0 ± 12.0 years,65.8% were male. Distinct subtypes of HF demonstrated different inflammation biomarker panels. IL-6,PTX-3,ANGPTL-4 and TNF-α were correlated with HFrEF;IL-1β and PTX-3 were correlated with HFmrEF;and IL-1β and IL-6 were correlated with HFpEF. The multivariable logistic regression showed that IL-1β[relative ratio (RR)= 1.08,95% CI: 1.02–1.15,P = 0.010],IL-6 (RR = 1.03,95% CI: 1.01–1.06,P = 0.016),PTX-3 (RR = 1.31,95% CI: 1.11–1.55,P = 0.001),and ANGPTL-4 (RR = 1.05,95% CI: 1.02–1.07,P < 0.001) were independently associated with HF,while IL-6 (RR = 1.03,95% CI: 1.01–1.04,P = 0.019),PTX-3 (RR = 1.23,95% CI: 1.06–1.43,P = 0.007),and ANGPTL-4 (RR = 1.03,95% CI: 1.01–1.06,P = 0.005) were independently associated with the HF subtype. Conclusions Diverse inflammation biomarkers have multifaceted presentations according to the subtype of HF,which may illustrate the diverse mechanisms of inflammation in Chinese HF patients. IL-6,PTX-3,and ANGPTL-4 were independent inflammation factors associated with HFrEF and HF.

The value of real-time three-dimensional echocardiography in evaluating left ventricular function for different degrees of heart failure

Objective:To explore the value and feasibility of real-time three-dimensional echocardiography(RT-3DE)in evaluating left ventricular function in patients with different degrees of heart failure.Methods:The 60 heart failure patients in the case group were divided into three subgroups according to the New York Heart Association(NYHA)classification:12 cases of cardiac function gradeⅡ,35 cases of cardiac function gradeⅢ,13 cases of cardiac function grade IV,and the other 30 cases of healthy subjects as control group.Compare the left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),and left ventricular 16,12,and 6 segments reaching the minimum systolic volume time standard deviation standardized value(Tmsv SD%),left ventricular 16,12 and 6 segments reaching the minimum systolic volume time standardized values of the maximum difference(Tmsv DIF%),analysis of the correlation between the above left ventricular function-related parameters and cardiac function grading.Results:(1)There were statistically significant differences in LVEDV and LVESV between each group(p<0.001).There was no statistically significant difference in LVEF between the cardiac function gradeⅡgroup and the control group,and between the grade IV group and the gradeⅢgroup(p=0.094 and 0.246).(2)compared with the control group,all parameters related to RT-3DE evaluation of left ventricular synchronization were prolonged in the case group,and the difference was statistically significant(p<0.001).The differences of Tmsv 16-SD%and Tmsv 16-DIF%in each subgroup of the case group were statistically significant(p<0.001).(3)LVEF was negatively correlated with NYHA classification of cardiac function(rs=-0.779,p<0.001),and LVEDV,LVESV,Tmsv 16-SD%,Tmsv 12-SD%,Tmsv 6-SD%,Tmsv 16-DIF%,Tmsv 12-DIF%,Tmsv 6-DIF%were positively correlated with NYHA function classification,showing strong correlation(rs=0.710,0.785,0.885,0.675,0.605,0.885,0.695,0.622,p<0.001),among them,Tmsv 16-SD%and Tmsv 16-Dif%have the highest correlation.Conclusion:RT-3DE can comprehensively evaluate the impairment of cardiac function.The measured parameters of left ventricular function are strongly correlated with cardiac function classification,which has impo-rtant application value for clinical judgment of the severity of heartfailure.

The Prevalence and Short-Term Outcomes of Ventricular Dyssynchrony after Right Ventricular Pacing

Objective: Long-term right ventricular pacing has been associated with an increased risk of heart failure and cardiomyopathy. The pathophysiology of cardiomyopathy associated with right ventricular pacing remains unclear. We aim to evaluate the burden and short-term outcomes of ventricular dyssynchrony after immediate permanent pacemaker implantation. Materials and Methods: This prospective cohort study examined consecutive patients who had permanent pacemaker implantation at Vajira Hospital in 2019. Left ventricular systolic function, specifically left ventricular ejection fraction (LVEF) and echocardiographic ventricular dyssynchrony parameters were assessed. The endpoints included the prevalence of ventricular dyssynchrony, new-onset cardiomyopathy, heart failure, and death. The correlation between QRS complex duration, the burden of ventricular pacing, and echocardiographic ventricular dyssynchrony was measured. Results: Thirty-six consecutive patients underwent pacemaker implantation. The prevalence of mechanical ventricular dyssynchrony was 22.2% using the interventricular conduction delay method, 41.7% using LV pre-ejection period method, and 11.1% using the septal posterior wall motion abnormality method. Electrical ventricular dyssynchrony was 86.1% and new-onset cardiomyopathy was 17.1% after 3 months of permanent pacemaker implantation. The right ventricular pacing of more than 20% was significantly associated with cardiomyopathy (p < 0.022) and heart failure (log-rank, p = 0.049) within 3 months. But heart failure was not associated with mechanical ventricular dyssynchrony parameters (log-rank, p = 0.610;hazard ratio [HR], 1.53;95% confidence interval [CI], 0.29 - 7.96;p = 0.613 for IVMD and log-rank, p = 0.398;HR, 0.04;95% CI, 0.01 - 3316.7 for SPWMD). Conclusion: Mechanical and electrical ventricular dyssynchrony are common findings in right ventricular pacing. High-burden right ventricular pacing after 3 months of permanent pacemaker implantation is often associated with cardiomyopathy and heart failure, but mechanical and electrical ventricular dyssynchrony does not predict a short-term decline in left ventricular systolic function and heart failure.

Power Spectral Analysis of Heart Rate Variability of Driver Fatigue

This investigation was to evaluate the driving fatigue based on power spectral analysis of heart rate variability (HRV) under vertical vibration. Forty healthy male subjects (29.7±3.5 years) were randomly divided into two groups, Group A (28.8±4.3 years) and Group B (30.6±2.7 years). Group A (experiment group) was required to perform the simulated driving and Group B (control group) kept calm for 90 min. The frequency domain indices of HRV such as low frequency (0.04 0.15 Hz, LF), high frequency (0.150.4 Hz, HF), LF/HF together with the indices of hemodynamics such as blood pressure (BP) and heart rate (HR) of the subjects between both groups were calculated and analyzed after the simulated driving. There were significances of the former indices between both groups (P<0.05). All the data collected after experiment of Group A was observed the remarkable linear correlation (P<0.05) and parameters and errors of their linear regression equation were stated (α=0.05, P<0.001) in this paper, respectively. The present study investigated that sympathetic activity of the subjects enhanced after the simulated driving while parasympathetic activities decreased. The sympathovagal balance was also improved. As autonomic function indictors of HRV reflected fatigue level, quantitative evaluation of driving mental fatigue from physiological reaction could be possible.

Relationship between lipidslevelsand right ventricular volume overload in congestive heart failure

BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better outcomes in heart failure, but the mechan-isms underlying the phenomenon are not fully understood. This study was performed to test the hypothesis that reduced intestinal lipid absorption due to venous congestion may lead to low lipid levels.MethodsWe collected data of clinical characteristics, echocardio-graph, and lipid profile in 442 unselected patients with congestive heart failure. Correlations between lipid levels[including total cho-lesterol（TCL）, high-density lipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol（LDL-C）, and triglycerides（TG）]and right ventricle end diastolic diameter （RVEDD）, left ventricle end diastolic diameter （LVEDD）, right atrium diameter （RA）, left atrium diameter （LA）, or left ventricle ejection fraction （LVEF） were analyzed using Pearson correlation and partial correlation. RVEDD, LVEDD, RA, and LA were indexed to the body surface area.ResultsThere was a significantly inverse correlation between TCL le-vels and RVEDD （r=-0.34,P〈0.001） and RA （r=-0.36,P〈0.001）. Other lipids such as LDL-C, HDL-C, and TG had asimilar inverse correlation with RVEDD and RA. All these correlations remained unchanged after adjusting for age, gender, smoking status, physical activity levels, comorbidities, and medication use.ConclusionsLipid levels were inversely correlated to RVEDD in patients with congestive heart failure; however, because this was an observational study, further investigation is needed to verify our results as wellas identify a causal relationship, if any.

APPLICATION OF FRACTAL THEORY IN TRANSIENT CHAOTIC SIGNAL DETECTION

According to the definition of correlation dimension in fractal theory, this paper presented a method to determine and assess noise part in detected transient signal. Such work is essential to decrease the noise part in the detected signal. It is proved that heart period signal (HPS) is one typical sort of transient chaotic signal. Through experiment and simulation, the analysis of chaotic HPS in the detected signal was done. In the end, we deepen the researches on attractor dimension of HPS for persons who are different in age.

The Research of Fractal Characteristics of the Electrocardiogram in a Real Time Mode

The article presents the results of recent investigations into Holter monitoring of ECG, using non-linear analysis methods. This paper discusses one of the modern methods of time series analysis--a method of deterministic chaos theory. It involves the transition from study of the characteristics of the signal to the investigation of metric （and probabilistic） properties of the reconstructed attractor of the signal. It is shown that one of the most precise characteristics of the functional state of biological systems is the dynamical trend of correlation dimension and entropy of the reconstructed attractor. On the basis of this it is suggested that a complex programming apparatus be created for calculating these characteristics on line. A similar programming product is being created now with the support of RFBR. The first results of the working program, its adjustment, and further development, are also considered in the article.

时间空间相关成像联合5D Heart智能导航技术用于正常胎儿心脏超声筛查

目的评估时间空间相关成像(STIC)联合5DHeart智能导航技术在正常胎儿心脏超声筛查中的应用价值。方法由医师甲采用常规二维超声和STIC联合5DHeart智能导航技术对114胎正常胎儿进行心脏超声筛查,记录2种检查方法采集图像所用时间,并对相同的9个切面进行评分;1周后,医师甲再次、医师乙首次对STIC联合5DHeart智能导航技术的图像质量进行评分。比较2种检查方法对各切面显示合格率,分析同一医师和不同医师间图像质量评分的一致性。结果2胎因胎动明显无法确定智能导航点位置而被排除。胎儿心脏容积图像和常规二维超声图像的采集时间分别为(94.76±35.21)s和(595.88±139.29)s,差异有统计学意义(P<0.001)。STIC联合5DHeart智能导航技术与常规二维超声对胎儿四腔心、五腔心、右心室流出道、三血管气管、主动脉弓、动脉导管弓切面的显示合格率差异无统计学意义(P均>0.05);STIC联合5DHeart智能导航技术对胃泡水平腹部横切面、左心室流出道切面的显示合格率低于常规二维超声检查(P均<0.05)。不同医师间(除三血管气管和主动脉弓切面)及同一医师不同时间(除主动脉弓切面)对容积数据进行分析后各切面的评分一致性好(Kappa均>0.75)。结论STIC联合5DHeart智能导航技术可缩短检查时间;9个胎儿心脏切面图像质量能够满足胎儿心脏超声筛查需要,用于正常胎儿心脏超声筛查的可行性和可重复性均好。

Plasma brain natriuretic peptide, platelet parameters, and cardiopulmonary function in chronic obstructive pulmonary disease

BACKGROUND Chronic obstructive pulmonary disease(COPD)is a chronic respiratory disease with worldwide occurrence and high disability and mortality rate.It occurs mostly in the elderly population with pulmonary heart disease,type II respiratory failure,and other serious complications.AIM To investigate the correlation of plasma brain natriuretic peptide(BNP)and platelet parameters with cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease.METHODS From June 2016 to June 2019,52 patients with COPD-pulmonary heart disease(pulmonary heart disease group),30 patients with COPD(COPD group),and 30 healthy individuals(control group)in our hospital were enrolled in the study.The pulmonary heart disease group was further divided into subgroups according to cardiac function classification and pulmonary artery pressure.Plasma BNP and platelet parameters were estimated and compared among each group and subgroup.The correlation of plasma BNP and platelet parameters with cardiac function classification and pulmonary artery pressure was then analyzed.RESULTS In the pulmonary heart disease group,the COPD group,and the control group,the levels of plasma BNP,platelet distribution width(PDW),and mean platelet volume(MPV)showed a decreasing trend(P<0.05),while an increasing trend was found in platelet count(PLT)and plateletcrit(PCT)levels among the three groups(P<0.05).In the pulmonary hypertension mild,moderate,and severe subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was observed in PLT levels(P<0.05);however,PCT levels showed no significant difference among the three subgroups(P>0.05).In the cardiac function grade I,II,III,and IV subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was noted in PLT and PCT levels among the four subgroups(P<0.05).Correlation analysis showed that the levels of plasma BNP,PDW,and MPV in patients with pulmonary heart disease were positively correlated with their pulmonary artery pressure(P<0.05),while PLT was negatively correlated with their pulmonary artery pressure(P<0.05).Moreover,plasma BNP,PDW,and MPV levels were positively correlated with cardiac function grade(P<0.05)of these patients,while PLT and PCT levels were negatively correlated with their cardiac function grade(P<0.05).CONCLUSION Plasma BNP and PLT parameters are significantly correlated with the cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease,indicating that these parameters have high clinical relevance in reflecting the health condition of these patients and for guiding their treatment.

Efficacy and Safety of Jianpi Jieyu Decoction for Patients with Mild-to-Moderate Depression of Xin(Heart)-Pi(Spleen)Deficiency Syndrome:A Multi-centre Randomized Controlled Study

Objective:To evaluate the efficacy and safety of Jianpi Jieyu Decoction(JJD)for treating patients with mild-to-moderate depression of Xin(Heart)-Pi(Spleen)deficiency(XPD)syndrome.Methods:In this multi-center,randomized,controlled study,140 patients with mild-to-moderate depression of XPD syndrome were included from Xiyuan Hospital of China Academy of Chinese Medical Sciences and Botou Hospital of Traditional Chinese Medicine from December 2017 to December 2019.They were randomly divided into JJD group and paroxetine group by using a random number table,with 70 cases in each group.The patients in the JJD group were given JJD one dose per day(twice daily at morning and evening,100 m L each time),and the patients in the paroxetine group were given paroxetine(10 mg/d in week 1;20 mg/d in weeks 2-6),both orally administration for a total of 6 weeks.The primary outcome was the change of 17-item Hamilton Depression Rating Scale(HAMD-17)score at week 6 from baseline.The secondary outcomes included the Hamilton Anxiety Scale(HAMA)score,Traditional Chinese Medicine Symptom Scale(TCMSS),and Clinlcal Global Impression(CGI)scores at the 2nd,4th,and 6th weekends of treatment,HAMD-17 response(defined as a reduction in score of>50%)and HAMD-17 remission(defined as a score of 7)at the end of the 6th week of treatment.Adverse events(AEs)were also recorded.Results:From baseline to week 6,the HAMD-17 scores decreased 10.2±4.0 and 9.1±4.9 points in the JJD and paroxetine groups,respectively(P=0.689).The HAMD-17 response occurred in 60%of patients in the JJD group and in 50%of those in the paroxetine group(P=0.292);HAMD-17 remission occurred in 45.7%and 30%of patients,respectively(P=0.128).The differences of CGI scores at the 6th week were not statistically significant(P>0.05).There were significant differences in HAMD-17 scores between the two groups at 2nd and 4th week(P=0.001 and P=0.014).The HAMA scores declined 8.1±3.0 and 6.9±4.3 points from baseline to week 6 in the JJD and paroxetine groups,respectively(P=0.905 between groups).At 4th week of treatment,there was a significant difference in HAMA between the two groups(P=0.037).TCMSS decreased 11.4±5.1,and 10.1±6.8 points in the JJD and paroxetine groups,respectively(P=0.080 between groups).At the 6th week,the incidence of AEs in the JJD group was significantly lower than that in the paroxetine group(7.14%vs.22.86%,P<0.05).Conclusion:Compared with paroxetine,JJD was associated with a significantly lower incidence of AEs in patients with mild-tomoderate depression of XPD syndrome,with no difference in efficacy at 6 weeks.(Trial registration No.Chi CTR2000040922).

Automatic Extraction of Medical Latent Variables from ECG Signals Utilizing a Mutual Information-Based Technique and Capsular Neural Networks for Arrhythmia Detection

From a medical perspective,the 12 leads of the heart in an electrocardiogram(ECG)signal have functional dependencies with each other.Therefore,all these leads report different aspects of an arrhythmia.Their differences lie in the level of highlighting and displaying information about that arrhythmia.For example,although all leads show traces of atrial excitation,this function is more evident in lead II than in any other lead.In this article,a new model was proposed using ECG functional and structural dependencies between heart leads.In the prescreening stage,the ECG signals are segmented from the QRS point so that further analyzes can be performed on these segments in a more detailed manner.The mutual information indices were used to assess the relationship between leads.In order to calculate mutual information,the correlation between the 12 ECG leads has been calculated.The output of this step is a matrix containing all mutual information.Furthermore,to calculate the structural information of ECG signals,a capsule neural network was implemented to aid physicians in the automatic classification of cardiac arrhythmias.The architecture of this capsule neural network has been modified to perform the classification task.In the experimental results section,the proposed model was used to classify arrhythmias in ECG signals from the Chapman dataset.Numerical evaluations showed that this model has a precision of 97.02%,recall of 96.13%,F1-score of 96.57%and accuracy of 97.38%,indicating acceptable performance compared to other state-of-the-art methods.The proposed method shows an average accuracy of 2%superiority over similar works.