Effectiveness and safety of Yufeng Ningxin for the treatment of essential hypertension: A protocol for systematic review and meta-analysis

Background:Essential hypertension is the primary cause of death and disability and it has become a major public health problem globally. Yufeng Ningxin (YFNX) is a commonly used Chinese patent medicine in treating essential hypertension. The objective of this protocol is to evaluate the effectiveness and safety of YFNX for the treatment of essential hypertension.Methods:Randomized controlled trials (RCTs) in relation to the effectiveness and safety of YFNX in the treatment of essential hypertension will be systematically searched and collected from the following databases: PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chinese Scientific Journal Database from the database inception to January 1, 2021. The data screening and extraction will be carried out by 2 different reviewers. The quality of randomized controlled trials will be assessed based on the version 2 of the risk-of-bias tool for randomized trials (RoB 2) in the Cochrane Handbook. The reduction of systolic blood pressure (SBP) and diastolic blood pressure (DBP) will be served as the primary outcome. The secondary outcomes will include average SBP and average DBP during the day and the night measured by 24 hours ambulatory blood pressure monitoring, the clinical effectiveness rate, scores of traditional Chinese medicine syndrome, clinical symptoms, the quality of life and adverse events. Statistical analysis will be conducted with Review Manager 5.3 and STATA 14.0 software.Conclusion:This systematic review will provide strong evidence to assess the effectiveness and safety of YFNX in the treatment of essential hypertension.Trial registration number:INPLASY202110059.     

西地那非通过上调电压依赖性钾通道抗低氧刺激的人肺动脉平滑肌细胞增殖

目的探讨西地那非抗低氧刺激的人肺动脉平滑肌细胞(pulmonary artery smooth muscle cells,PASMCs)增殖的机制与电压依赖性钾通道(voltage-dependent potassium channels,Kv)及环鸟甘酸依赖性蛋白激酶(cGMP-dependent protein kinase,PKG)的关系。方法采用MTT法及细胞免疫荧光法等检测细胞增殖情况;应用膜片钳技术记录低氧刺激PASMCs前后及西地那非或KT-5823干预前后的Kv通道电流,运用Kv1.5抗体透析细胞后的Kv通道电流;应用siRNA干扰技术沉默Kv1.5基因。结果低氧下西地那非组的细胞增殖水平较低氧对照组明显降低;西地那非反转了低氧对细胞K +通道电流,尤其Kv1.5通道电流的降低作用;siRNA组的Kv1.5蛋白表达明显减低,沉默Kv1.5通道基因逆转了西地那非抗低氧刺激的细胞增殖作用;PKG抑制剂KT-5823阻断了西地那非抗低氧刺激的细胞增殖作用,并且反转了西地那非对低氧下的Kv通道电流的上调作用。 结论 西地那非可通过上调Kv通道亚型主要是Kv1.5通道,抑制低氧刺激的人PASMCs增殖,且可能与PKG有关。     

血瘀证患者差异基因表达谱研究

目的：应用寡核苷酸基因芯片技术，研究血瘀证患者差异基因表达谱。 方法：16例血瘀证患者经冠状动脉造影诊断后，分为冠心病血瘀证组和非冠心病血瘀证组，每组8例；并选年龄和性别相匹配的8名健康人为健康对照组。抽取静脉血，分离白细胞，抽提RNA，质控芯片（Test3 芯片）对样本质量进行检测，然后与Affymetrix U133 Plus 2．0芯片进行杂交，通过扫描和软件分析，比较冠心病血瘀证组、非冠心病血瘀证组与健康对照组的基因表达谱，筛选血瘀证相关差异基因，并进一步进行基因本体（Gene Ontology，GO）和通路分析．使用实时荧光定量逆转录聚合酶链反应法对目标基因进行验证。 结果：通过差异基因筛选，与血瘀证相关的差异基因共有48个，其中上调基因26个，下调基因22个；通过GO分析．其中与炎症免疫相关的基因有5个，占10．4％；通路分析结果显示，有意义的10条通路中有5个涉及炎症和免疫反应。经实时荧光定量逆转录聚合酶链反应验证了基因芯片准确可靠。 结论：血瘀证基因表达谱研究显示了炎症和免疫相关基因的比例和显著性优势，说明炎症和免疫反应在一定程度上介导了血瘀证的发生发展。     

益气养阴活血中药对急性心肌梗死患者血运重建后心室壁运动的影响

目的 观察益气养阴活血中药对急性心肌梗死（AMI）患者血运重建后心室壁运动和收缩功能的影响。     

苓桂气化方对射血分数保留性心力衰竭模型大鼠心脏功能及糖脂代谢的影响

[目的] 观察苓桂气化方（LGQH）对射血分数保留性心力衰竭（HFpEF）模型大鼠的心脏功能及血糖、血脂相关指标的影响。[方法] 采用高脂高糖饮食诱导加低剂量链脲佐菌素（STZ）建立复合HFpEF心力衰竭大鼠模型,随机分为HFpEF模型组、诺欣妥组、苓桂气化方低剂量、高剂量组,以及自发性高血压大鼠（SHR）正常对照组、Wistar kyoto（WKY）空白对照组,各给药组灌胃相应药物,HFpEF模型组及两个对照组灌胃等量生理盐水,连续8周。超声心动图检测大鼠心脏超声功能指标包括舒张早期二尖瓣血流速度（E）、二尖瓣心房收缩期最大血流（A）等;酶联免疫吸附（ELISA）法测定大鼠空腹胰岛素（FINS）、C肽（C-P）、心钠素（ANP）、B型脑尿钠肽（BNP）等的含量;取大鼠心脏组织做大体病理和病理切片检测。[结果] 与HFpEF组比较,诺欣妥和苓桂气化方低、高剂量组均对E、E/A比值有一定的改善作用（P<0.05或P<0.01）,苓桂气化方组可使大鼠ANP、BNP含量不同程度的减低（P<0.05或P<0.01）,而诺欣妥组仅BNP含量较前降低（P<0.01）,诺欣妥和苓桂气化方低、高剂量组可不同程度降低FINS、C-P及LEP含量（P<0.05或P<0.01）,苓桂气化方低、高剂量组还可降低GSP及GLU水平（P<0.05或P<0.01）;苓桂气化方低、高剂量组大鼠血脂指标TC及LDL-CHO水平均较前降低（P<0.05或P<0.01）;诺欣妥和苓桂气化方低、高剂量组均对大鼠hs-CRP指标有明显的改善作用（P<0.01）。[结论] 苓桂气化方具有改善大鼠心脏舒张功能,抑制心房结构性重构,同时具有降低炎性因子、改善糖脂代谢及内皮功能的作用。     

从心肌组织无复流现象谈中医治疗急性心肌梗死的可能优势

急性心肌梗死(AMI)相关动脉的血运重建,开创了AMI现代治疗的新纪元,减少了AMI患者住院并发症和死亡率,改善了预后,但AMI仍是冠心病主要的死亡原因,相关冠状动脉血运重建后一年内心血管病事件的发生率仍在18%左右。相关冠状动脉局部病变的介入治疗为目前成熟并普遍推广应用的技术,但对介入治疗后的心肌组织无复流现象,尽管近年来进行机械、药物干预的许多尝试,仍无理想的干预对策,原因在于AMI作为一种应激损伤引起的机体病变的复杂性,包括内皮功能障碍、高凝状态、氧化应激、微血栓形成等,使心肌组织无法得到理想灌注,心肌细胞不能恢复正常的代谢状态。传统中医药包括益气、活血、解毒等的单味或复方中药,可作用于AMI后应激损伤的多个病理环节,如抑制氧化应激损伤、抗血小板聚集、改善微循环和内皮细胞功能等。应用现代科学技术,从复杂成分和效应关系,复杂效应和患者预后关系等方面进行系统研究,对提高现代中医药防治AMI的疗效将有十分重要的意义。     

Effect of Chinese herbal medicine for activating blood circulation and detoxifying on expression of inflammatory reaction and tissue damage related factors in experimental carotid artery thrombosis rats

Objective：To observe the pharmaceutical effect of Chinese drugs for activating blood circulation （Xiongshao Capsule,XSC,芎芍胶囊）and for activating blood circulation and detoxification（Xiongshao Capsule and Huanglian Capsule,XSHLC,黄连胶囊）in terms of the indices of thrombosis,inflammatory reaction and tissue damage related factors in experimental carotid artery thrombosis rats.Methods：Fifty Wistar rats were randomly divided into the sham operation group,the model group,the Simvastatin group（SG）,the activating blood circulation（ABC）group,and the activating blood circulation and detoxifying（ABCD）group,with 10 rats in each group.Simvastatin（1.8 mg/kg）,XSC（0.135 g/kg）and XSHLC（0.135 g/kg）were administered to Simvastatin,ABC and ABCD group by gastrogavage,and an equal volume of normal saline was given to the sham operation group and the model group.After 2 weeks of successive medication,the rats in the model and all drug therapy groups were made into experimental carotid artery thrombosis model.The serum levels of matrix metalloproteinases（MMP-9）,tissue inhibitors to metalloproteinase（TIMP-1）,granule membrane protein-140（GMP-140）,tissue-type plasminogen activator（t-PA）,high-sensitivity C-reactive protein（hs-CRP） and interleukin-6（IL-6）were detected with enzyme-linked immunoassay 24 h later.Results：Compared with the model group,the levels of serum GMP-140,hs-CRP,IL-6 and MMP-9 were significantly decreased,and the level of t-PA was significantly increased in the ABC and ABCD group（P〈0.05）,while the level of serum hs-CRP in ABCD group decreased significantly compared with that in the ABC group（P〈0.05）.Conclusions：Chinese drugs both for activating blood circulation and for activating blood circulation and detoxifying have good effects on regulating indices of thrombosis,inflammatory reaction and tissue damage in experimental carotid artery thrombosis rats.The effect of activating blood circulation and detoxifying drugs on regulating the level of serum hs-CRP is superior to that of activating blood circulation drug alone.     

冠心病稳定期血瘀证与冠状动脉病变特点的相关性

目的:探讨冠心病稳定期血瘀证及其兼证与冠状动脉造影Gensini评分的关系。方法:选取131例经冠状动脉造影证实的冠心病患者,记录其稳定期中医证候与血瘀证计分,并根据患者冠状动脉造影特点进行Gensini评分,分析其血瘀证及其兼证、血瘀证计分与其冠状动脉病变特点和Gensini评分之间的关系。结果:冠心病稳定期患者以血瘀证、痰浊证、气虚证最为多见,分别占64.9%(85/131)、63.4%(83/131)、64.9%(85/131)。血瘀证患者冠状动脉病变长度与Gensini评分的数值均高于非血瘀证者(P<0.05,P<0.01)。在血瘀证兼证中,血瘀兼痰浊患者的冠状动脉病变长度与Gensini评分的数值均高于非血瘀证者(P<0.05);血瘀证计分>9分的患者,其冠状动脉病变长度长于血瘀证计分≤9分的患者(P<0.05);冠心病稳定期患者血瘀证计分与Gensini评分无明显相关性(Pearson相关系数为0.104,P=0.241)。结论:血瘀证是冠心病稳定期患者的常见证候,血瘀证计分反映了患者血瘀证严重程度,稳定期患者的血瘀证计分与冠心病患者发病时冠状动脉病变严重程度没有相关性。     

Identification of the metabolites of baicalein in human plasma

The metabolites of baicalein in human plasma were investigated after taking baicalein, which is one of the main bioactive flavones in Scutellaria baicalensis Georgi. Five metabolites (M1–M5) together with the parent drug baicalein (P) were detected and identified by the HPLC-diode-array detector (DAD) and LC-MS/MS methods. Among them, 7-methoxybaicalein 6-O-glucuronide (M5) is a new metabolite. Based on the results, the proposed metabolic pathway of baicalein in humans was inferred.     

运用Markov模型评价益气活血中药干预不稳定性心绞痛远期疗效的探索

目的基于Markov模型评价益气活血中药联合西医常规干预不稳定性心绞痛（unstable angina, UA）支架术后气虚血瘀证患者的远期疗效。方法根据益气活血中药联合西医常规干预、西医常规干预UA支架术后患者的预后和转归建立Markov模型。通过40个Markov周期的状态转移概率和人均累积获得质量调整生命年（quality-adjusted life years, QALYs）的比较,评价益气活血中药联合西医常规干预的疗效优势。结果经过Markov模型20年的预测,益气活血中药联合西医常规干预组血运重建、非致命性心肌梗死、非致命性中风、全因死亡的累积转移概率分别为56.65%、6.53%、5.16%、31.66%,人均累积QALYs为12.95;西医常规干预组相应的累积转移概率分别为55.31%、6.87%、5.25%、32.57%,人均累积QALYs为12.84。与西医常规干预比较,益气活血中药联合西医常规干预的人均增量QALYs为0.11。结论基于Markov模型的预测结果,益气活血中药联合西医常规干预UA支架术后患者的疗效优于西医常规干预,说明益气活血中药可以改善UA支架术后气虚血瘀患者的远期疗效。