Effect of ivabradine in the treatment of acute exacerbation of chronic obstructive pulmonary disease with heart failure

Objective: To observe the effectiveness and safety of ivabradine in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and heart failure. Methods:Patients who were admitted to hospital with AECOPD during the period from August 2017 to July 2018. Then those both had heart failure with reduced ejection fraction(HFrEF) and a resting heart rate>70 beats/min were enrolled. A total of 86 cases were screened and completed, which were randomly divided into two groups for treatment. The control group(41 cases) received standard treatments, such as oxygen, anti-infection, anti-spasmodic, hormone, diuretic, ACEI/ARB, recombinant human brain natriuretic peptide (rhBNP), etc. The bisoprolol was given 2.5~5 mg orally once a day to control heart rate, and the test group(45 cases) was further treated with ivabradine 2.5~5 mg orally twice a day on the basis of the control group. The average heart rate, cardiac function, lung function, and 6-minute walking test were compared between the two groups. Results: After treatment, the average heart rate of the test group was lower than the control group, and the heart rate control rate(<70 beats/min%) of the test group was superior to the control group. The level of N-terminal B-type natriuretic peptide(NT-proBNP) in test group was significantly lower than that in control group. The distance of the 6-minute walking test in e test group was significantly longer than that in control group. Conclusion: Ivabradine combined with bisoprolol could help patients with AECOPD and heart failure to further reduce the heart rates, improve heart function and exercise tolerance. Moreover, the therapeutic safety was acceptable during the short term.

Clinical efficacy of Salvia miltiorrhiza in pathological scar treatment:A systematic review and meta-analysis

To systematically assess the clinical efficacy of Salvia miltiorrhiza(SM)in treating pathological scars and provide a reference basis for scar pharmacotherapy,we conducted a comprehensive literature search in both English and Chinese databases from database inception to December 2022.Key search terms included Salvia miltiorhiza,cryptotanshinone,tanshinone IIA,sodium-tanshinol,compound Salvia miltiorrhiza dripping pills,cicatrix,cicatrices,and scar.The inclusion criteria encompassed all clinical randomized controlled studies on the treatment of pathological scars with SM,without regard to blinding or allocation concealment,as well as irrespective of patient nationality,race,or age.Data from the selected literature were subjected to analysis using Rev Man 5.4 software,employing the standard mean difference or weighted mean difference for numerical variables and odds ratios(ORs)for dichotomous variables.Statistical significance was set at P<0.05.Six eligible studies involving a total of 778 patients met the inclusion criteria.The analysis revealed a significant therapeutic efficacy with an OR of 3.83(95%CI:2.65–5.54),indicating a substantially higher therapeutic efficacy rate in SM group compared to the control group.Furthermore,the total effective rate of treatment exhibited an OR of 6.94(95%CI:2.53–19.06),signifying a significantly superior treatment outcome in SM group.Regarding scar scores,no significant improvement was observed in SM group compared to the control group after 3 months of treatment(mean difference[MD]=–0.96,95%CI:–2.29–0.36).However,after 6 months of treatment,the scar score demonstrated a noteworthy improvement in SM group(MD=–1.37,95%CI:–2.44 to–0.30)compared to the control group.In summary,this study affirmed that SM treatment markedly enhanced the therapeutic efficacy and overall treatment efficiency for clinical scar patients,underscoring its positive clinical therapeutic impact on scar patients.

Saikosaponin A induces apoptosis and upregulates autophagy in Huh7 cells

Objective: It is discussed whether saikosaponin A induces apoptosis of human hepatoma Huh7 cells is related to the change of autophagy level.Methods: The effects of different concentrations of SSA on proliferation and apoptosis of Huh7 cells were detected by MTT and flow cytometry, and then constructed recombinant plasmid pEGFP-N1-LC3B and transfected into Huh7 cells. After intervened by SSA culture medium, the autophagy level was observed under confocal microscope. The expression of apoptosis proteins Bax, Bcl-2, PCNA and autophagy-related proteins LC3B, Beclin1, and Apg12-Apg5 were detected by Western Blot. Results: SSA can significantly inhibit the proliferation of Huh7 cells, promote apoptosis, increase the number of autophagy bodies in the cytoplasm, up-regulate the expression of Bax, LC3B-II, Beclin1, Apg12-Apg5 and down-regulate the expression of Bcl-2, PCNA. Conclusion:SSA induced apoptosis of Huh7 cells in vitro and upregulated the autophagy level.

Relationship between serum homocysteine levels and long-term outcomes in patients with ST-segment elevation myocardial infarction

Background:The mortality of cardiovascular disease is constantly rising,and novel biomarkers help us predict residual risk.This study aimed to evaluate the predictive value of serum homocysteine (HCY) levels on prognosis in patients with ST-segment elevation myocardial infarction (STEMI).Methods:The 419 consecutive patients with STEMI,treated at one medical center,from March 2010 to December 2015 were retrospectively investigated.Peripheral blood samples were obtained within 24 h of admission and HCY concentrations were measured using an enzymatic cycling assay.The patients were divided into high HCY level (H-HCY) and low HCY level (L-HCY) groups.Short- and long-term outcomes were compared,as were age-based subgroups (patients aged 60 years and younger vs.those older than 60 years).Statistical analyses were mainly conducted by Student t-test,Chi-squared test,logistic regression,and Cox proportional-hazards regression.Results:The H-HCY group had more males (84.6% vs.75.4%,P=0.018),and a lower prevalence of diabetes (20.2% vs.35.5%,P<0.001),compared with the L-HCY group.During hospitalization,there were seven mortalities in the L-HCY group and 10 in the H-HCY group (3.3% vs.4.8%,P= 0.440).During the median follow-up period of 35.8 (26.9–46.1) months,33 (16.2%) patients in the L-HCY group and 48 (24.2%) in the H-HCY group experienced major adverse cardiovascular and cerebrovascular events (MACCE)(P=0.120).History of hypertension (hazard ratio [HR]:1.881,95% confidence interval [CI]:1.178–3.005,P=0.008) and higher Killip class (HR:1.923,95% CI:1.419–2.607,P<0.001),but not HCY levels (HR:1.007,95% CI:0.987–1.027,P=0.507),were significantly associated with long-term outcomes.However,the subgroup analysis indicated that in older patients,HCY levels were significantly associated with long-term outcomes (HR:1.036,95% CI:1.011–1.062,P=0.005).Conclusion:Serum HCY levels did not independently predict in-hospital or long-term outcomes in patients with STEMI;however,among elderly patients with STEMI,this study revealed a risk profile for late outcomes that incorporated HCY level.