Systemic evaluation and Meta-analysis of Wenxin Keli in treatment of idiopathic premature beats in randomized controlled trails

Objective:To evaluate the efficacy and safety of Wenxin Keli for premature beats in structurally normal heart systematically.Methods:Eight databases at home and abroad were searched to collect randomized controlled trials of Wenxin Keli for premature beats without cardiac diseases.The included literatures were systematically evaluated with Cochrane Handbook 5.1 evaluation criteria and tools,and Meta analysis was performed with software RevMan5.3.Results:A total of 13 randomized controlled trials with 1278 subjects were included.The exprimental group used Wenxin Keli alone while the control group used antiarrhythmic medicine.The Meta analysis results showed that the total effective rate(RR=1.06,95%CI[0.97,1.16],P=0.23)and clinical symptom effective rate(RR=1.16,95%CI[0.94,1.44],P=0.18)of Wenxin Keli on idiopathic premature beats was not significantly different from western medicine group.The subgroup analysis of total effective rate showed that Wenxin Keli had no significant difference with metoprolol(RR=1.04,95%CI[0.95,1.15],P=0.41),bisoprolol(RR=1.32,95%CI[0.85,2.05],P=0.22)and propanone(RR=1.07,95%CI[0.90,1.26],P=0.44).ECG changes showed that the PR intervals(MD=-12.57,95%CI[-16.15,-8.99],P<0.00001)and QTc intervals(MD=-8.09,95%CI[-15.52,-0.65],P=0.03)in the western medicine group were prolonged significantly more than those of Wenxin Keli.In terms of safety,the incidence of adverse reactions of Wenxin Keli was significantly less than that of western medicine group(RR=0.32,95%CI[0.19,0.54],P<0.0001).Conclusion:The efficacy of Wenxin Keli in the treatment of premature beats with structurally normal heart is accurate,and there are no serious adverse reactions.However,because of the low quality of the included papers,which affected the reliability of the conclusions,high-quality clinical research is needed to further demonstrate.

Efficacy of Metoprolol Succinate Sustained Release Tablets Combined with Wenxin Granules in the Treatment of Coronary Heart Disease Arrhythmia

Objective:To explore the effect of metoprolol succinate sustained-release tablets combined with Wenxin Granules in the treatment of coronary heart disease patients with arrhythmia.Methods:The research objects were 50 patients with arrhythmia who were treated in our hospital from September 2019 to September 2020.According to different treatment methods,they were divided into observation group(Wenxin Granule+metoprolol succinate treatment)and control group(metoprolol succinate treatment),25 cases in each group.The curative effects of the two groups were compared.Results:After treatment,there was no significant difference in rnn50,RMSSD,sdnni and SDANN between the two groups(P>0.05).Compared with the control group,the SDNN in the observation group was higher than that in the control group(P<0.05);Before treatment,there was no significant difference in the above indexes between the two groups(P>0.05);The effective rates of the observation group and the control group were 92.00%and 68.00%respectively,and the curative effect of the observation group was higher than that of the control group(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:In the treatment of patients with coronary heart disease and arrhythmia,Wenxin Granule Combined with metoprolol succinate sustained-release tablets has significant effect,which can effectively improve the dynamic electrocardiogram indexes of patients,improve the clinical efficacy,and has high safety.

Effect of Wenxin granule on Bcl-2/Bax/Caspase apoptosis pathway gene expression in rats with myocardial infarction

Objective:To explore the cardioprotective mechanism of Wenxin Granules regulating the expression of apoptosis-related genes in cardiomyocytes.Methods:A rat model of myocardial infarction was established and randomly divided into model group,Wenxin granule low-dose group,Wenxin granule high-dose group,metoprolol group and sham operation group.the left ventricular end systole anterior wall thickness(LVAWs),end systole inner diameter(LVIDs),end systole posterior wall thickness(LVPWs),end-diastolic anterior wall thickness(LVAWd),end-diastolic inner diameter(LVIDd),end-diastolic posterior wall thickness(LVPWd)and left ventricular ejection fraction(LVEF)were detected by echocardiography in each group after 2 weeks of treatment.Hematoxylin eosin(HE)staining was used to observe the changes in the cardiac structure of rats in each group.Real-time PCR(Real-time PCR)was used to detect the relative expression of mammalian B-cell lymphoma-2(BCL-2),BCL-2 related X protein(BAX),Caspase-9(Caspase-9),and Caspase-3(Caspase-3)mRNA.TUNEL staining was used to detect changes in the apoptotic rate of rat cardiomyocytes in each group.Results:Compared with the sham operation group,the LVAWs,LVPWs,LVPWd and LVEF of the model group were significantly reduced(P<0.05,P<0.01),and LVIDs and LVIDd were significantly increased(P<0.05,P<0.01).Severe pathological ischemia injury of heart tissue.The relative expression of BCL-2 mRNA and the ratio of BCL-2/BAX in the model group were significantly reduced(P<0.01),while the relative expression of BAX,Caspase-9 and Caspase-3 mRNA was significantly increased(P<0.01).The apoptosis rate was significantly increased(P<0.01).In the low-dose and high-dose groups of Wenxin Granules and the Metoprolol group,LVAWs,LVPWs,LVPW d,and LVEF of rats in each administration group increased significantly(P<0.05,P<0.01),LVIDs,LVIDd was significantly reduced(P<0.05,P<0.01),the pathological damage of the heart tissue was improved,the expression of BCL-2 mRNA and the ratio of BCL-2/BAX were significantly increased(P<0.05,P<0.01),BAX,The expression of Caspase-9 and Caspase-3 mRNA was significantly reduced(P<0.05,P<0.01),and the apoptotic rate of myocardial cells was significantly reduced(P<0.01).Conclusion:Wenxin granule can play a cardioprotective role by regulating the gene expression of BCL-2/BAX/Caspase apoptosis pathway.

Dissecting the underlying pharmaceutical mechanism of traditional Chinese medicine Wenxin Keli acting on atrial fibrillation through network pharmacology

As a well-known Chinese medicine prescription, Wenxin Keli (WXKL) has been widely used in the treatment of many arrhythmias including atrial fibrillation and has achieved significant clinical effects, but the specific mechanism of its treatment of atrial fibrillation remains unclear. This study used a network pharmacology approach to reveal the potential molecular mechanisms of WXKL in the treatment of atrial fibrillation. It involves oral bioavailability screening of ingredients, drug-likeness evaluation, compound target fishing, H-C-T network and C-T-P network construction and analysis. Through the network pharmacology-based research strategy, the complex system of WXKL was analyzed. It was found that 14 representative compounds of WXKL, 30 protein targets and 12 related signaling pathways help us systematically understand the underlying mechanism of WXKL’s anti-atrial fibrillation effects.

Wenxin granule for cardiac arrhythmia: an overview of systematic reviews

Objectives: Evaluating the quality of systematic reviews/meta-analysis of Wenxin granule in treating cardiac arrhythmia to provide evidence for clinical practice, and analyzing the problems in the research to identify potential research priorities for researchers. Method: The systematic reviews of Wenxin granule in treating cardiac arrhythmia were searched from 8 databases. The methodological quality and evidence quality were assessed by AMSTAR and GRADE respectively. Results: Nineteen eligible systematic reviews with 52,905 participants were included. The overall scores of AMSTAR ranged from 3 to 10 with a mean score of 6.5, the median score was 6. There were 9 (9/19, 47.37%) systematic reviews had the score of 7 or more. 6 of them with appropriate information were assessed the quality of evidence by GRADE. The results showed that the overall quality of evidence was limited (range from “very low” to “low”), no “moderate” or “high” quality of evidence existed. For the outcome reporting, no systematic reviews reported endpoints and limited evidence showed that there is causality between Wenxin granule and adverse effects/events. The outcome matrix showed that there are obvious heterogeneity and incompleteness for the outcome reporting in included systematic reviews, so that some included studies cannot be conducted meta-analysis. Meanwhile, there were studies excluded because of inappropriate outcome measures, such as outcome measures did not meet inclusion criteria, treatment time did not meet inclusion criteria, treatment time was unclear, incomplete data or the data cannot be extracted. Conclusions: Wenxin granule have limited efficacy and safety for treating arrhythmia. In the future, high quality of RCTs and systematic reviews should be conducted. Core outcome set for cardiac arrhythmia is needed to improve outcome reporting and decrease waste.

Translator's Identity in the English Translation of Wenxin Diaolong

In the article Owen’s and Yang Guobin’s English versions of Wenxin Diaolong are compared from the perspective of a translator’s identity.Owen is a translator of A-merican origin while Yang Guobin is of Chinese origin.Their multiple identity as a reader,author,creator and cultural communicator differs much from each other,which produces important influences upon the selection of the strategy of translation.Owen prefers foreignizing translation while Yang favors domesticating translation.The English translation of Wenxin Diaolong provides much value for the research on the translation of Chinese classic literature.

《文心雕龙》英译的外显化策略分析

本文基于自建汉英平行语料库,对《文心雕龙》宇文所安译本和施友忠译本的外显化特征进行定量和定性相结合的研究。通过提取威氏拼音和词汇、句法层面的参数发现:两个英译本总体呈现外显化特征,主要体现在译文的语言及诗学形式、词句意义和文化语境等方面,背后的非文本原因可归于翻译意图、文化立场和意识形态等因素。两位译者的外显化翻译使译文指涉更加明确,语境更加清晰,意义更易理解,原著的文论思想、美学精神和文化内涵得到充分阐释。外显化翻译在信息补偿、话语建构和文论互动方面具有一定价值,表明其作为中国古代文论的指导性翻译策略具有可能性和可行性。

《文心雕龙》英译中的读者意识——以宇文所安英译本为例

读者不是译文的消极消费者,而是译文意义的能动建构者。读者意识是译者以读者视角观照翻译、使翻译行为围绕读者中心逐步向前推进的心理机制。宇文所安的读者意识体现在内容导向、沟通途径、主流诗学和读者接受四个方面,表现为材料选择的贴近意识、思想交流的贴心意识、表达习惯的贴合意识、服务读者的体贴意识。得益于读者意识,宇文所安充分履行了译者的职责,妥善处理了译者、作者和读者的三方关系,促进了《文心雕龙》在英语世界的接受与传播。中国文论要走向世界,译者的翻译能力是前提与基础,而读者意识是确保译者翻译能力得到充分展示的思想保证。读者意识有助于译文走进读者的心灵世界,有利于译文在译入语文化语境的进一步传播。

刘勰古典主义思想的跨语际之辨

国内外学者对刘勰古典主义者这一身份标签的界定莫衷一是。为此,将刘勰古典主义者文化身份问题置于海外汉学视域下加以整体观照,通过中西文论的双向阐释,对刘勰古典主义思想中的“文用之辨”“古今之辨”和“奇正之辨”深入剖析,辨驳海外汉学视域中有关“刘勰是不彻底的古典主义者”“刘勰的古典主义是一种文学退化历史观”以及“刘勰对待《楚辞》的态度偏离儒家正统文学观”等观点。在中西文论的互通与互识之中,解构刘勰古典主义者的文化身份,为系统识解刘勰古典主义思想的内在机理、促进中西文论的生成性比较与对话提供借鉴。

黄侃在北京大学如何讲授《文心雕龙》——对《黄侃〈文心雕龙札记〉考原》一文论证前提的思考

《黄侃〈文心雕龙札记〉考原》一文以范文澜《文心雕龙讲疏》对黄侃《文心雕龙札记》的征引为前提,判断黄侃在北大“词章学”课堂讲授《文心雕龙》的篇目内容以及授课讲义的编撰情况。由于这一前提并不可靠,故所得结论亦难令人信服。其实,范文澜撰写《讲疏》时已拥有黄侃讲授《文心雕龙》的全部讲义,而“词章学”课程的教学内容以文章作法为主,并非无所不包。黄侃在北大讲授《文心雕龙》有前后期之分,前期主要是在“词章学”课堂讲授创作论部分的篇目,后期则在“中国文学概论”课堂重点讲授总论部分的篇目,至于文体论几篇,通常作为讲授创作论和总论时的例证,贯穿于前后期,用以配合串讲。

《文心雕龙》格式塔意象翻译研究——以施友忠英译本为例

《文心雕龙》格式塔意象在构建和传达文学理论方面发挥着重要作用,它们来源于作者认知世界中的意义载体或心理映射,与英文格式塔意象存在着巨大差异。如何再造译文格式塔意象是译者无法推卸的责任。施友忠分别采用等效移用、变异增益、融通新创的翻译策略建构译文格式塔意象,而支撑这些翻译策略的是译者认知、读者认知和混合认知三种翻译路径。三种翻译路径作为文论逻辑建构的网络节点,充当了认知开关的按钮,激发了读者关于意象的语义联想,疏通了读者关于文论思想的解读通道,拓展了译文可理解和接受的空间,也为《文心雕龙》在异域文化语境的传播与接受打下了坚实的基础。

“以兵为喻”与《文心雕龙》批评话语的生成

在中国古代文艺理论批评史上,“以兵为喻”是一种独特的言说方式与批评范式。军事理论与文艺理论间的相似性、相通性,奠定了文艺理论批评“以兵为喻”的学理基础。古代思想家、理论家文武兼修、道器并进的知识结构,为文艺理论批评“以兵为喻”提供了丰富的话语资源。《文心雕龙》作为中国古代文艺理论象喻批评的典范之作,在“以兵为喻”范式的运用上,无论是取譬的广度、阐释的深度,抑或使用的频率,均达到了前所未有的水平。举凡兵形、兵势、兵器,以及阵法、士气等军事元素,皆被刘勰援以论文。“以兵为喻”由此成为中国古代文艺理论话语生成的重要路径。

如乐之和:《文心雕龙》的“以乐舞为喻”批评范式

在中国古代文学批评史上,注重节奏、崇尚和谐是一脉相承、一以贯之的审美追求,它往往通过“以乐舞为喻”的象喻批评范式来呈现。华夏民族诗乐舞合一的艺术传统,是“以乐舞为喻”批评范式的学理依据。春秋以讫魏晋礼乐崩坏所带来的诗乐舞分殊,则为“以乐舞为喻”批评范式提供了必要的逻辑前提。《文心雕龙》作为古代文学理论象喻批评的典范之作,对于“以乐舞为喻”批评范式的运用达到了前所未有的水平。刘勰取譬乐舞以论文,打破了艺术门类之间固有的藩篱,实现了不同知识域的经验互通与话语共享,大大拓展了文学批评的言说空间。

文化主体性与生成式人工智能的价值导向干预

生成式人工智能通过对海量互联网数据的深度学习来生产信息,不可避免地带有数据提供主体所在时空的文化观念,因此,其生成的内容具有时空上的局限性和动态演化的特征。以大型语言模型ChatGPT和文心一言为比较研究对象,通过对真实的种族争议案例进行内容生成测试实验,从文化主体性角度探讨基于不同时空语料的生成式人工智能平台的价值观差异。结果表明,基于中文训练的文心一言语言模型并未展示出与ChatGPT明显区分的当代中国公众所持有的文化主体意识。该现象与自21世纪初开始积累的中文互联网语料的文化主体性时间演化特征相关。据此提出,通过对语言模型语料库进行时间轴加权或复制训练以调整“时空折叠”,能够对生成式人工智能平台的价值观导向进行干预。

应用大语言模型解答儿童哮喘问题的效果研究

目的评估大语言模型解答儿童哮喘问题的表现,全面了解其提供儿童健康相关信息的质量,并识别其局限以促进模型的改进。方法制订出60个儿童哮喘相关的常见问题,分别向2种在国内向公众开放使用的文心一言、智谱清言大语言模型提问。由3名儿科哮喘专业医师采用盲法评估大语言模型的回答质量。结果在准确性、理解力、可靠性和逻辑性维度方面,文心一言得分较高;在安全性维度方面,智谱清言的得分较高。对比5个不同的维度的得分发现,大语言模型在理解力、可靠性、逻辑性方面得分较高,而在准确性与安全性方面相对不足。结论大语言模型在儿童哮喘患者教育中的应用能够为儿童哮喘患者及其家长提供有益的参考。然而,当前大语言模型技术在准确性、安全性等方面仍存在一定的局限性,需要进一步改进和优化。

The Efficacy and Safety of Wenxin Keli in Patients with Frequent Premature Ventricular Contractions： A Randomized, Double-blind, Placebo-controlled, Parallel-group, Multicenter Trial

Background：Premature ventricular contractions （PVCs） are common in the general population,and frequent PVCs may result in the poor quality of life or even the damage of cardiac function.We examined the efficacy and safety of a traditional Chinese medicine Wenxin Keli for the treatment of frequent PVCs among a relatively large Chinese cohort.Methods：We performed a randomized,double-blind,placebo-controlled,parallel-group,multicenter trial.A total of 1200 eligible participants were randomly assigned in a ratio of 1：1 to receive Wenxin Keli or the placebo for 4 weeks.The primary and secondary endpoint was the change of PVC numbers and PVC-related symptoms after a 4-week treatment compared with baseline,respectively.In addition,vital signs,laboratory values,and electrocardiographic parameters were assessed in a safety analysis.Results：At the initial evaluation,no significant differences in the baseline characteristics were observed between the Wenxin Keli group and the placebo group.A smaller number of PVCs was observed after the 4-week treatment than at baseline,in both the Wenxin Keli group （5686 ± 5940 vs.15,138 ± 7597 beats/d,P ＜ 0.001） and the placebo group （10,592 ± 8009 vs.14,529 ± 5929 beats/d,P ＜ 0.001）;moreover,the Wenxin Keli group demonstrated a significantly greater reduction in the frequency of PVCs than the placebo group （P ＜ 0.001）.In a full analysis set,patients in the Wenxin Keli group exhibited significantly higher total effective responses in the reduction of PVCs compared to those in the placebo group （83.8％ vs.43.5％,P ＜ 0.001）.The per-protocol analysis yielded similar results （83.0％ vs.39.3％,P ＜ 0.001）.Treatment with Wenxin Keli also demonstrated superior performance compared to the placebo with respect to PVC-related symptoms.No severe adverse effects attributable to Wenxin Keli were reported.Conclusions：Wenxin Keli treatment effectively reduced the overall number of PVCs and alleviated PVC-related symptoms in patients without structural heart diseases and had no severe side effects.

美托洛尔联合稳心颗粒治疗心房颤动患者导管消融术后房性心动过速的价值

目的 探讨美托洛尔联合稳心颗粒对心房颤动(AF)患者导管消融术后房性心动过速(AT)的治疗价值。方法 选取2018年5月至2022年1月在苏北人民医院心血管内科诊断为AF并成功行导管消融术的患者253例,采用掷币法随机分为稳心颗粒组(56例)、美托洛尔组(79例)、联合组(79例)、对照组(39例)。比较4组患者治疗AT次数、最长AT心搏次数、平均心率及不良反应等情况。结果 对照组术后1年平均心率、AT阵数、AT最长心搏次数及Ⅰ、Ⅱ、Ⅲ类房性过早搏动次数均高于基线,差异有统计学意义(P<0.01)。稳心颗粒组、美托洛尔组、联合组术后1年平均心率、AT阵数、AT最长心搏次数及Ⅰ、Ⅱ、Ⅲ类房性过早搏动次数均低于基线,差异有统计学意义(P<0.01);联合组术后1年平均心率、AT阵数、AT最长心搏次数及Ⅰ、Ⅱ、Ⅲ类房性过早搏动次数均低于稳心颗粒组和美托洛尔组,差异有统计学意义(P<0.05);稳心颗粒组、美托洛尔组、联合组不良反应总发生率比较无显著差异(7.1%vs 13.9%vs 8.9%,P=0.301)。结论 美托洛尔联合稳心颗粒可用于治疗AF患者导管消融术后AT,可有效降低平均心率,减少AT发生次数、房性过早搏动次数、减少AT最长心搏次数,可能减少术后AF复发,安全性较高。

稳心颗粒联合胺碘酮治疗心力衰竭并发室性心律失常有效性及安全性的Meta分析

目的:系统评价稳心颗粒结合胺碘酮治疗心力衰竭并发室性心律失常的疗效与安全性。方法:计算机检索中国知网(CNKI)、维普网(VIP)、万方、中国生物医学文献数据库(CBM)、PubMed、Web of Science和the Cochrane Library等数据库,检索有关稳心颗粒联合胺碘酮治疗心力衰竭并发室性心律失常的随机对照试验(RCT)。由2名研究者分别对文献进行筛选、提取数据和评价纳入研究的偏倚风险后,采取RevMan 5.3及R语言统计软件进行Meta分析。结果:共纳入18项研究,涉及1 527例病人。Meta分析结果显示,稳心颗粒联合胺碘酮治疗心力衰竭并发室性心律失常,在提高临床总有效率[RR=1.19,95%CI(1.14,1.25),P<0.000 1]、减少室性期前收缩次数[SMD=-2.42,95%CI(-4.66,-0.18),P=0.03]、稳定心率[SMD=-1.66,95%CI(-1.94,-1.37),P<0.000 1]、增加左室射血分数[SMD=1.57,95%CI(0.54,2.61),P=0.003]均优于单独使用胺碘酮,且不良反应发生率低于单独使用胺碘酮[RR=0.59,95%CI(0.43,0.80),P=0.000 8]。结论:现有证据表明,稳心颗粒联合胺碘酮在治疗心力衰竭并发室性心律失常,能够明显提高临床疗效、LVEF,且不良反应更少,安全性较好。

Expert Consensus on Wenxin Granule for Treatment of Cardiac Arrhythmias

INTRODUCTIONAntiarrhythmic drugs remain a critically important component of the approach to therapy of cardiac arrhythmias. Over the past 20 years, despite their antiarrhythmic efficacy in many pathological settings, Class Ⅰ and Ⅲ antiarrhythmic drugs have been shown to be associated with the development of proarrhythmias and an increase in the likelihood of causing higher mortality by inducing torsade de pointes ventricular tachycardia and other serious adverse reactions. Consequently, the development of safe and effective antiarrhythmic regimens remains a primary focus of contemporary cardiovascular research.

文心图书馆阅读活动研究

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