Effect of Huanshuai Recipe Oral Liquid (缓衰口服液) on Renal Dysfunction Progression in Patients with Atherosclerotic Renal Artery Stenosis

Objective:To investigate the effect of Huanshuai Recipe Oral Liquid(缓衰口服液,HSR) on retarding the progression of renal dysfunction in patients with atherosclerotic renal artery stenosis(ARAS).Methods:A total of 52 ARAS patients with the Chinese medicine(CM) syndrome of qi deficiency and blood stasis,phlegm and dampness retention were recruited and randomly assigned into the treatment group(36 cases) and the control group(16 cases).Both groups received a basic treatment(high-quality low-protein diet,blood pressure control,lipid-lowering,correcting the acidosis,etc.).In addition,the treatment group received 20 mL HSR and the control group received placebo,3 times a day for 6 months.Renal function(serum creatinine,blood urea nitrogen and uric acid) and blood lipids(cholesterol,triglycerides and low density lipoprotein) were examined monthly.The estimated glomerular filtration rate(eGFR) and CM syndrome score were compared between groups.Results:After treatment,compared with the control group,the serum creatinine level,uric acid level and CM syndrome score of the treatment group were significantly decreased(P0.05 or P0.01),and the eGFR in the treatment group were significantly increased(P0.05).Conclusion:HSR can effectively improve the renal function and clinical symptoms of ARAS patients.     

Effect of metabolic syndrome on prognosis and clinical characteristics of revascularization in patients with coronary artery disease

Background People with metabolic syndrome are at higher risk for developing coronary artery disease (CAD). The effect of the metabolic syndrome on outcomes in patients with preexisting CAD has not been well studied. This study was conducted to assess the prevalence, characteristics, in hospital and long term prognosis of CAD with metabolic syndrome and to determine the factors influencing the prognosis of the disease. Methods The DESIRE registry contains data of 3696 patients with CAD between 2001 and 2004. Mean long term followup was (829±373) days. Diagnosis of metabolic syndrome was based on modified International Diabetes Federation (IDF) Worldwide Definition of the Metabolic Syndrome，using body mass index (BMI) instead of waist circumference. Results Of 2596 patients with complete records of height, weight, and so on, 1280 (49.3%) were identified with metabolic syndrome. The patients with metabolic syndrome had higher level of body mass index, systolic blood pressure, diastolic blood pressure, fasting glucose and disordered blood lipid (all P<0.0001), with higher creatinine [(10.5±4.3) mg/L vs (9.9±2.9) mg/L, P<0.0001] and the number of white blood cells [(7.49±2.86)×10(9)/L vs (7.19±2.62) ×10(9)/L, P=0.008) compared with those without metabolic syndrome. The patients with metabolic syndrome showed severer coronary angiographic alterations (left main artery and/or ≥2-vessel) (73.6% vs 69.6%, P=0.031). There were no significant differences of major adverse cardiac and cerebral events (MACCE) or mortality in hospital between the two groups. During followup, the ratio of MACCE in CAD with metabolic syndrome patients increased significantly (11.8% vs 10.0%, P=0.044). Fasting blood glucose (≥1000 mg/L) and triglyceride (TG, ≥1500 mg/L) were responsible for most of the increased risk associated with the metabolic syndrome (adjusted OR 1.465, 95% CI 1.037－1.874, P=0.032; OR 1.378, 95% CI 1.014－1.768, P=0.044). Conclusions The prevalence of metabolic syndrome was very high in CAD patients. The metabolic syndrome confers a higher risk of long term MACCE in patients with CAD, and dysglycaemia and hypertriglycaemia appear to be responsible for most of the associated risk.     

Metabolic syndrome and androgen deprivation therapy in metabolic complications of prostate cancer patients

Background  Incidence of prostate cancer in Chinese males grows significantly in the past decades. Androgen deprivation therapy has been generally employed in the treatment of locally advanced and metastatic prostate cancer for many years, yet only little data was known about the metabolic syndrome in patients receiving hormonal therapy. This study described the prevalence and the changing trends of hormone-related metabolic complications, and analyzed their correlation with different therapies.

Methods  In 125 patients treated with castration or maximal androgen blockage for at least 12 months, metabolic indicators were analyzed.

Results  Totally, 13.5% patients in castration group and 30.1% patients in maximal androgen blockage group were diagnosed metabolic syndrome 12 months after the beginning of treatments (χ²=4.739, P=0.029). In castration group, increased triglyceride and decreased high-density lipoprotein-cholesterol were significant at the month 12, increased fasting plasma glucose and blood pressure were significant at the month 4. In maximal androgen blockage group, increased triglyceride and decreased high-density lipoprotein-cholesterol were significant at the month 4, increased fasting plasma glucose and blood pressure were significant at the month 8. Total testosterone and free testosterone in maximal androgen blockage group were significantly lower than castration group at all visits, which were proved to show positive or negative correlations with metabolic indications. Severity of metabolic complications in maximal androgen blockage group was generally more serious than people received castration, with significantly statistical difference or not. Trends of high-density lipoprotein-cholesterol and fasting plasma glucose were significant different between two kinds of therapy (P=0.005, P=0.019, respectively).

Conclusions  Prostate cancer patients receiving androgen deprivation therapy were at high risk of suffering metabolic syndrome. Severity of metabolic complications under different hormonal therapies were not completely consistent, suggested that androgen deprivation therapy may be individualized.

     

Plasma metabolic biomarkers for syndrome of phlegm and blood stasis in hyperlipidemia and atherosclerosis

OBJECTIVE:To explore the plasma metabolite profiles in patients with the syndrome of phlegm and blood stasis in hyperlipidemia and atherosclerosis(As),and to search for the metabolic biomarkers of the syndrome.METHODS:The plasma metabolite profiles of 31 patients with the syndrome of phlegm and blood stasis in hyperlipidemia and As,6 patients with syndromes without phlegm and blood stasis,and 10 healthy subjects were analyzed by gas chromatography-mass spectrometry(GC-MS).Partial least squares-discriminant analyses(PLS-DA) were used to carry out the pattern-recognition analyses of the data.The plasma metabolic biomarkers of patients were obtained by variable importance plot value(VIP value) and Student’s t-test.The structures of biomarkers were defined by the National Institute of Standards andTechnology(NIST) database.RESULTS:PLS-DA score plots of plasma metabolomes did not show overlap between the phlegm-blood stasis syndrome group and syndromes without phlegm and blood stasis group,whereas significant differences in the concentrations in the plasma of 5 metabolites were found(P< 0.05).They were identified as urine,isoleucine,glucuronic acid,palmitic acid and glycerol by searching in NIST database.The concentrations of four metabolites in the plasma of patients with syndrome of phlegm and blood stasis were higher than those with syndromes without phlegm and blood stasis,whereas the glycerol concentration was lower.CONCLUSION:Compared with patients with syndromes without phlegm and blood stasis,five metabolites showed abnormal levels in patients with the syndrome of phlegm and blood stasis.These metabolites could be diagnostic and prognostic biomarkers.     

Study on the relationship between serum high density lipoprotein and Pi-deficiency syndrome in patients with coronary heart disease

Objective:To explore the relationship of Pi(脾)-def iciency syndrome in TCM with the change of serum high density lipoprotein(HDL) in blood lipid metabolic disorder.Methods:Sixty-eight patients with conf irmed coronary heart disease(CHD) were selected for TCM syndrome typing into Pi-defi ciency(PD) group and non-Pi-def iciency(NPD) group.Routine blood lipids and serum lipoprotein electrophoretogram(SLPG) were determined in all patients to analyze the total content of HDL and its relative contents of sub-components HDL1-5,as well as their relation with PD syndrome.Besides,a healthy control group(62 cases) was set up.Results:The level of serum HDL-C was lowered,SLPG abnormality rate increased in the patients with CHD,with total HDL and the relative contents of sub-component HDL1 and HDL3 signifi cantly lower than those in the healthy control group(P<0.01).The total HDL,HDL1 and HDL3 in the PD group were also lower than those in the NPD group(P<0.05,P<0.01).Conclusion:Serum HDL and its sub-components showed a definite relation with TCM PD syndrome type,therefore,further exploring the granular specificity of HDL and its sub-components as well as their influence on reverse cholesterol transport(RCT) may hopefully provide clues for developing RCT regulatory Chinese new drugs and for CHD prevention and treatment.     

Influence of Fuzheng Huayu Tablet (扶正化瘀片) on mental state and social function of patients with post-hepatitis B liver cirrhosis

Objective:To observe the influence of Fuzheng Huayu Tablet(扶正化瘀片,FZHYT)on mental state and social activity of patients with post-hepatitis B liver cirrhosis(LC-HB).Methods:Adopting grouped randomized double-blinded control method,180 LC-HB patients in 3 research centers were distributed to 2 groups,the treated group and the control group,90 in each group.Patients in the treated group were administered with FZHYT;while those in the control group treated with conventional therapy combined with placebo,the course for ail patients were 6 months.Their mental state and social activity were evaluated before treatment,after 3 months’ treatment and at terminal of the 6-month therapeutic course by estimating with Zung self-rating anxiety scale(SAS),self-rating depression scale(SDS)and social deficit screening scale(SDSS). Additionally,the basic demographic materials,liver function,cirrhosis index,hepatic and splenic images,blood coagulation function,etc.in the patients were tested and compared as well.Results:As compared with before treatment,the normal rate of SAS and SDS scores increased and the social deficit rate decreased in the treated group significantly after treatment,showing statistical significance(P<0.05 or P<0.01);while in the control group, change was only shown in the social deficit(P<0.01),inter-group comparisons after treatment showed significant differences in all the three indexes(P<0.05 or P<0.01).Additionally,after treatment,levels of liver function, cirrhosis,blood coagulation function and splenomegaly in the treated group were all improved significantly (P<0.05 or P<0.01),and the improvements were better than those in the control group(P<0.01)in levels of total bilirubin(TBIL),albumin(ALB),typeⅣcollagen(Ⅳ-C),prothrombin time(PT),prothrombin activity(PTA). Conclusion:Most patients of LC-HB have mental disturbance and social activity deficit,which could definitely be improved by intervention with Chinese FZHYT.     

EFFECT OF MASSOTHERAPY ON THE IN V IVO FREE RADICAL METABOLISM IN PATIENTS WITH PROLAPSE OF LUMBAR INTER VERTEBRAL DISC AND CERVICAL SPONDYLOPATHY

The endogenous free radical scavenger superoxide dismutase (SOD) and blood catalase (CAT) in 2 groups of patients with prolapse of lumbar intervertebral disc and cervical spondylopathy were lower than that of the healthy control group, while the -SH reflecting the metabolic disturbance of free radical was higher. After massotherapy, blood SOD and CAT were increased, while lipid peroxide (LPO), -SH in urine were decreased, demon-strating that there are distinct parallel relationships existing in the changes of these enzymes in blood and urine.     

Effect of Tang No.1 granule (糖1号方) in treating patients with impaired glucose tolerance

Objective： To observe the therapeutic effect of Tang No.1 granule （糖1号方, T1G） in treating patients with impaired glucose tolerance （IGT）. Methods： One hundred and forty patients with IGT and with Pi （脾）-Wei （胃） dampness-heat syndrome type were assigned randomly according to their visiting sequence into two equal groups. The control group received only general knowledge about IGT, but to the treated group, based on current knowledge available, T1G was given additionally for 6 months. Changes in related laboratory indexes, including fasting plasma glucose and insulin （FPG and FINS）, plasma glucose 2 h after meal （2hPG）, glycosylated hemoglobin （HbAlc）, serum triglyceride （TG）, low density lipoprotein cholesterol （LDL） and insulin resistance index （HOMA-IR）, were observed. Results： The levels of FPG, 2hPG, HbAlc, FINS, TG and HOMA-IR were significantly decreased after treatment in the treated group, showing a significant difference compared to the control group （P〈0.01）. Among them, HbAlc decreased from 7.08±1.41% to 6.56±1.29% in the treated group, while in the control group, it decreased from 7.02±1.37% to 6.93±1.31%. The level of LDL was also reduced in the treated group after treatment （P〈0.05）. In the treated group, 13 out of 68 patients （19.12%） had their glucose tolerance reversed to normal, while in the control group, only 2/64 （3.1%） got it reverse; a comparison between the two groups in terms of reversion rate showed a significant difference （P〈0.01）. No severe adverse reaction was found in the therapeutic course. Conclusions： T1G has good clinical effect as a treatment intervention for IGT, as it could improve glycometabolism, significantly depress the levels of post-prandial blood sugar and blood lipids, alleviate clinical symptoms of patients, and effectively cut-off and reverse the yielding and development of diabetes mellitus.     

Effects of Yixin Jiangya Capsules on Insulin Resistance and Tumor Necrosis Factor-a in Cases of Primary Hypertension with Left Ventricular Hypertrophy

To observe the effects of Ftxin Jiangya Capsules （益心降压胶囊capsules for nourishing the heart and lowering blood pressure） on insulin resistance （IR） and tumor necrosis factor-a （TNF-a） in patients with primary hypertension with left ventricular hypertrophy （LVH）. Methods： Totally 93 cases were randomly divided into a control group of 31 cases taking Enalapril and a treatment group of 62 cases taking Enalapril and Irtxin Jiangya Capsules. Results： Fasting serum insulin （FSI） and TNF-a obviously increased and insulin sensitive index （ISI） significantly decreased in both groups before treatment as compared to those of a healthy group. After treatment, FSI, TNF-a and fasting blood glucose （FBG） obviously decreased and ISI remarkably increased in the treatment group, while ISI significantly increased and TNF-a obviously decreased in the control group. The curative effect in the treatment group was remarkably superior to that in the control group. FSI was positively related to TNF-a before treatment in both groups. Conclusion： FSI and TNF-a obviously increase and ISI significantly decreases in patients with primary hypertension with LVH. FSI and TNF-a influencing each other are involved in the generation and development of hypertension. Irtxin Jiangya Capsules can improve IR and decrease TNF-a.     

Efficacy of Modified Qufeng Runmian Powder (加减祛风润面散) on Acne Vulgaris with Syndromes of Dampness and Blood Stasis: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Objective: To evaluate the efficacy and safety of a Chinese medicine(CM) Modified Qufeng Runmian Powder(加减祛风润面散, MQFRMP) for the treatment of acne vulgaris with CM syndromes of dampness and blood stasis. Methods: In this multicenter, randomized, double-blind, placebo-controlled clinical trial, 220 acne vulgaris patients with CM syndrome of dampness and blood stasis were included and randomly assigned using a central area group random design to receive either MQFRMP or the placebo, with 110 cases in each group. MQFRMP or a placebo at 145 g/bag were administered once daily for 4 weeks, respectively. The primary index of efficacy was the effective rate according to the acne severity score(ASS). The secondary indices of efficacy included the changes in the dermatology life quality index(DLQI) score, VISIA scores(spots, pores, brown spots, porphyrins and red areas) and skin assessment(skin p H, sebum amount and hydration) according to a SOFT skin multianalyzer. Results:(1) Follow-up: a total of 204 patients completed the follow-up, with 103 in the treatment group and 101 in the control group.(2) Effective rate: the total effective rate of the treatment group was significantly higher than the control group [83.5%(86/103) vs. 31.7%(32/101), P0.01)] with 95% confidence interval of 39.3%–66.4%.(3) DLQI: DLQI scores were significantly decreased the treatment and control groups(both P0.01), but the treatment group was more obvious than the placebo group(P0.01).(4) VISIA scores: the scores of spots, brown spots and red areas in the treatment group decreased compared with baseline(P0.05). In the control group, the scores of brown spots and pores decreased compared with baseline(P0.05). The improvement was more obvious in the treatment group than in the control group for all items(P0.05).(5) Skin assessment : the p H and sebum score in the both groups decreased drastically compared with the baseline(all P0.01), however, the improvement was more obvious in the treatment group than in the control group(P0.01). The hydration amount in the two groups showed no statistically significant difference compared with the baseline(both P0.05).(6) Safety: two cases of mild drug allergy were observed in the treatment group. Conclusion: MQFRMP was effective and safe for the treatment of acne vulgaris with syndromes of dampness and blood stasis.(No. ChiCTR1900020479).     

Effects of Danqidihuang Granules on glucolipid metabolism in insulin-resistant rats

OBJECTIVE:To explore whether the insulin resistance(IR) model could be established through feeding Sprague-Dawley(SD) rats high-sugar and high-fat diets and to further observe the preventive and treatment effects of different doses of Danqidihuang Granules in rats.METHODS:Thirty-two SD rats were divided randomly into control group A(given regular feed),model group B(food high in sugar and fat),intervention group C(food high in sugar and fat as well as regular doses of Danqidihuang Granules),and intervention group D(food high in sugar and fat as well as double doses of Danqidihuang Granules).The interventions were for 8 weeks.Motion,change in color,body weight,and food intake,as well as plasma lipids(including low-density lipoprotein-cholesterol(LDL-C),high-density lipoprotein-cholesterol(HDL-C),total cholesterol(TC) and triglyceride(TG),fasting blood glucose(FBG),fasting insulin(FINs) levels,insulin sensitivity index(ISI),and insulin resistance index(HOMO-IR) were observed.RESULTS:At the end of the second week of the experiment,the appetite and activities of rats in groups B,C and D decreased significantly compared with group A.The fur of the rats in those three groups was curly.After the fourth week,the activities,food intake and color of rats in group B were worse than those in groups C and D,but there were no significant differences in weight(P>0.05).Compared with group A,LDL-C,TC,FBG and HOMO-IR in model group B were increased significantly(P<0.05),whereas the FINs and ISI increased obviously(P<0.05).The levels of LDL-C and TC in group D was decreased obviously compared with those in group C,and HOMO-IR in group D was less than that in group B(P<0.05).CONCLUSION:Danqidihuang Granules helped to prevent and improved the insulin resistance of rats.     

Hawthorn Extract Alleviates Atherosclerosis through Regulating Inflammation and Apoptosis Related Factors: An Experimental Study

Objective: To determine the effects of hawthorn extract on serum lipid levels, pathological changes in aortic atherosclerosis plaque, inflammatory factors, and apoptosis-related protein and mRNA expression in apolipoprotein E gene knockout(ApoE~(-/-)) mice. Methods: Thirty-six ApoE~(-/-) mice were fed with a high-fat diet starting at the age of 8 weeks. Mice were randomly divided into 3 groups by a random number table including model group, hawthorn extract group, and simvastatin group, 12 mice in each group. Twelve 8-week-old C57BL/6 mice were fed a basic diet and served as control. The mice in the control and model groups were administered 0.2 mL saline daily, the mice in the hawthorn extract and simvastatin groups were administered with 50 mg/kg hawthorn extract or 5 mg/kg simvastatin daily for 16 weeks. After 16 weeks, plasma lipids including total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C) were determined by an enzymatic assay. Aortic atherosclerotic lesions were observed by light microscopy, scanning and transmission electron microscopy, respectively. Plasma levels of monocyte chemoattractant protein-1(MCP-1), interleukin-1β(IL-1β), adiponectin(APN), and hypersensitive C-reactive protein(hs-CRP) were measured by enzyme-linked immunosorbent assay(ELISA). Protein and mRNA expressions of Bax and Bcl-2 in the aorta were assessed by Western blotting and quantitative real-time polymerase chain reaction(qR T-PCR), respectively. Results: Compared to the control group, the plasma levels of TC, TG and LDL-C were significantly increased and HDL-C were significantly decreased in the model group(P0.01). Compared to the model group, treatment with hawthorn extract significantly decreased the plasma levels of TC, TG, and LDL-C and increased the plasma level of HDL-C in ApoE~(-/-)mice(P0.01). The levels of MCP-1, IL-1β, and hs-CRP in the model group were significantly increased and APN was significantly decreased compared with the control group(P0.01). Compared to the model group, treatment with hawthorn extract decreased the levels of MCP-1, IL-1β, and hs-CRP and increased the APN level(P0.01). Compared to the control group, the protein and mR NA expression of Bax in the model group were significantly increased and the expression of Bcl-2 was significantly decreased(P0.01). Hawthorn extract also reduced the protein and mR NA expression of Bax and increased the Bcl-2 expression in the aorta(P0.01). Conclusion: Hawthorn extract has anti-atherosclerosis and stabilizing unstable plaque effects. The mechanism may be related to the inflammation and apoptosis signaling pathways.     

Effects of Hedan Tablet(荷丹片)on Lipid Profile,Proprotein Convertase Subtilisin/Kexin Type 9 and High-Density Lipoprotein Subfractions in Patients with Hyperlipidemia:A Primary Study

Objective: To investigate the effects of Hedan Tablet(荷丹片) on serum lipid profile, proprotein convertase subtilisin/kexin type 9(PSCK9) and high-density lipoprotein(HDL) subfractions in patients with hyperlipidemia. Methods: Thirty-seven patients with hyperlipidemia were randomized to treatment with Hedan Tablet 4.38 g/day as Hedan group(18 cases) or placebo(19 cases) as control group for 8 weeks. The lipid profile, PCSK9 and HDL subfractions were determined at day 0 and week 8 in both groups respectively. Results: Hedan treatment for 8 weeks mildly decreased serum low-density lipoprotein cholesterol(LDL-C) levels, while no changes were found in total cholesterol(TC), triglycerides(TG) and PCSK9 concentrations. Furthermore, Hedan treatment increased the concentration of large high-density lipoprotein cholesterol(HDL-C) and the percentage of large HDL subfraction, while decreased the concentration of small HDL-C and the percentage of small HDL subfraction without changing serum HDL-C levels in patients with hyperlipidemia. Conclusion: Hedan treatment of 4.38 g per day for 8 weeks could confer a favorable effects on serum LDL-C concentration as well as HDL subfractions.     

The effects of Chinese Yam-Epimedium mixture on respiratory function and quality of life in patients with chronic obstructive pulmonary disease

OBJECTIVE:To examine the clinical effects of a mixture of Chinese Yam and Epimedium in patients with stable moderate or severe chronic obstructive pulmonary disease(COPD).METHODS:Forty-nine patients with COPD were randomly allocated to a group whose usual treatment was supplemented with oral Chinese Yam-Epimedium mixture,or a control group given placebo.For each patient,body mass index,airflow obstruction,dyspnea,and exercise capacity were measured and converted into the BODE index before treatment and at one and three months after initiation of treatment.Participants also completed the St George’s Respiratory Questionnaire(SGRQ) at the same intervals.RESULTS:After one month,improvements were seen in the BODE index and SGRQ of participants taking Chinese Yam-Epimedium mixture compared to controls.There were statistically significant differences in the SGRQ:three of its components and the total SGRQ scores were significantly decreased(P<0.05),respiratory symptom scores had improved(P<0.01),and the dyspnea component of the BODE index had significantly decreased(P<0.05).Similar improvements were observed after three months of treatment,but exercise tolerance had also improved:the six-minute walking distance had significantly increased(P<0.05) in the treatment group when compared with controls.CONCLUSION:Chinese Yam-Epimedium mixture can significantly improve dyspnea,exercise capacity,and the quality of life of patients with stable moderate or severe COPD.     

Effects of five-year intensive multifactorial intervention on the serum amyloid A and macroangiopathy in patients with short-duration type 2 diabetes mellitus

Background A five-year follow-up study of intensive multifactorial intervention was undertaken to assess the changes of circulating serum amyloid A （SAA） levels and the incidence of atherosclerosis （AS） in patients with short-duration type 2 diabetes mellitus （T2DM） without macroangiopathy, and whether intensive multifactorial intervention could prevent or at least postpone the occurence of macroangiopathy. Methods Among 150 patients with short-duration T2DM, 75 were assigned to receive conventional outpatient treatment （conventional group） and the others underwent intensive multifactorial integrated therapy targeting hyperglycemia, hypertension, dyslipidemia and received aspirin simultaneously （intensive group）. Results Plasma SAA levels were higher in diabetic patients than those in healthy control subjects, and decreased obviously after intensive multifactorial intervention. The levels of SAA were positively correlated with body mass index （BMI）, waist hip ratio （WHR）, triglyceride （TG）, high sensitive C-reactive protein （hs-CRP） and common carotid intima-media thickness （CC-IMT）. The standard-reaching rates of glycemia, blood pressure and lipidemia were significantly higher in intensive group than those of conventional group. The incidence of macroangiopathy decreased by 58.96% in intensive group compared with conventional group. Conclusions Intensive multifactorial intervention may significantly reduce the SAA levels and prevent the occurrence of AS in short-duration patients with T2DM. SAA might be one of the risk factors of T2DM combined with AS.     

Protective effects of Radix Astragalus on vascular endothelial Cells of patients with Binswanger’s disease

Objective: To compare the effects of Radix Astragalus (RA) on vascular endothelial cells in Binswanger’s disease (BD) patients with Radix Salviae miltiorrhizae (RSM).Methods: There were 37 patients with BD in the treated group and 37 healthy subjects in the control group. Thirty-seven patients were further randomly subdivided into two groups: RA group (19 patients) and RSM group (18 patients). Circulating endothelial cells (CEC) and the levels of endothelin-1 (ET-1), nitric oxide (NO) and malondialdehyde (MDA) in the blood of internal jugular vein which were examined before and after treatments.Results: When compared with those of the control group, CEC counts, ET-1 and MDA levels in plasma increased significantly, meanwhile serum NO concentration decreased significantly in the treated group. When compared with those of pretreatment, CEC counts, ET-1 and MDA decreased significantly and serum NO concentration increased significantly after treatment in RA group. There were no significant changes of these indices in RSM group after treatment.Conclusions: There are damage and dysfunction of vascular endothelial cells in patients with BD. RA injection is an effective drug to protect vascular endothelial cells of BD patients.     

Tiaobu Xinshen Recipe (调补心肾方) Improved Mild Cognitive Impairment of Alzheimer's Disease Patients with Xin (Heart) and Shen (Kidney) Deficiency

Objective: To observe the intervention effects of Tiaobu Xinshen Recipe(调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer's disease(MCI-AD). Methods: Totally 88 MCI-AD patients with syndrome of Xin(Heart) and Shen(Kidney) deficiency were assigned to the experimental group(47 cases, treated with TXR) and the control group(41 cases, treated with donepezil hydrochloride) using a random number table. Final recruited qualified patients were 44 cases in the experimental group and 39 cases in the control group. The therapeutic course was 12 weeks. Neuropsychological scales [mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA)], and Chinese medicine(CM) dementia syndromes scales were performed in all patients, and results were compared between groups or intra-group before and after treatment. Results: MMSE and Mo CA scores of the two groups were increased after treatment compared with those before treatment(P0.05). But there was no statistical difference in MMSE or MOCA scores after treatment between the two groups(P0.05). CM dementia syndrome score was significantly decreased after treatment in the experimental group compared with the control group(P0.01). Visual spatial and executive function scores and delayed recall scores of the two groups were increased compared with those before treatment(P0.01). Conclusion: TXR could effectively improve cognitive impairment of MCI-AD patients with syndrome of Xin and Shen deficiency.     

Effect of Xiongshao Capsule（芎芍胶囊）on the Function of Vascular Endothelium of Patients with Cervical Atherosclerosis

Objective: To study the effect of Xiongshao Capsule (芎芍胶囊, XSC), a TCM herb that can promote blood circulation to remove blood stasis, on the endothelial dependent relaxation function, serum nitric oxide (NO), and plasma endothelin-1 (ET-1) of the patients with cervical atherosclerosis. Methods: Forty patients were randomly divided into two groups: XSC group and Probucol group (western medicine control).In addition, 20 healthy people were set as a normal control group. Plasma ET-1, serum NO, the internal diameter of basal brachial artery, endothelial dependent flow mediated dilation (FMD) and non-endothelial dependent nitroglycerin induced dilation (NID) to the trial group before and after therapy and to the healthy control group were determined respectively. Results: Compared to the healthy control group, FMD of patients with atherosclerosis was damaged obviously, the serum NO level decreased, plasma ET-1 increased (P＜0.01), NID also decreased (P＜0.05), the internal diameter of basal brachial artery has no obvious difference (P＞0.05). After the patients with atherosclerosis were treated with Xiongshao Capsule for 12 weeks,FMD increased evidently, plasma ET-1 decreased, serum NO and the ratio of NO/ET-1 increased, compared with the level before therapy and Probucol group, the difference was significant (P＜0.05, P＜0.01), NIDdidn′t change obviously (P＞0.05). Conclusion: XSC could regulate vascular activity factor and improve the function of endothelial dependent vascular dilation of patients with atherosclerosis.     

Variation of serum monocyte chemoattractant protein-1 in patients with diabetes and metabolic syndrome

This study investigated the variation of serum monocyte chemoattractant protein-1(MCP-1) in patients with both diabetes mellitus(DM) and metabolic syndrome(MS).Based on the International Diabetes Federation(IDF) diagnostic criteria,93 patients enrolled in this study were divided into four groups:normal control(NC),simple DM,simple MS,and DM plus MS(DM-MS) groups.The main measures included height,weight,waist circumference(WC),hip circumference,blood pressure,fasting blood glucose,insulin resistance index(HOMA-IR),serum triglyceride(TG),HDL-ch,LDL-ch,and MCP-1.The results showed that the serum levels of MCP-1 in the DM-MS group were significantly increased as compared with those in the DM and MS groups(P<0.05),and the increase in the MCP-1 level in the DM group was much higher than in the MS group(P<0.05).The DM-MS group had the highest HOMA-IR levels,followed by MS,DM and NC groups(P<0.05).Correlation tests showed that the association of MCP-1 with age,HDL-ch,or LDL-ch was insignificant,whereas that of MCP-1 with body mass index(BMI),waist hip rate(WHR),WC,systolic blood pressure(SBP),diastolic blood pressure(DBP),TG,and HOMA-IR was significantly positive.It was concluded that circulating MCP-1 was substantially increased in patients with both DM and MS as compared with that in the patients with DM or MS alone,and the central obese state may contribute to a more vicious proinflammatory condition and insulin resistance in patients with diabetes.     

Rosiglitazone could improve clinical outcomes after coronary stent implantation in nondiabetic patients with metabolic syndrome

Background Recent studies have shown that thiazolidinediones （TZDs） could reduce in-stent restenosis and improve clinical outcomes in patients with type 2 diabetes after coronary stent implantation. It remains unclear whether nondiabetic patients with metabolic syndrome after stenting could also benefit from the treatment with TZDs. Methods Three hundred and sixty patients with metabolic syndrome who underwent coronary stent implantation were randomly assigned to a rosiglitazone group （n= 180） or a control group （n= 180）. Patients in the rosiglitazone treatment group were treated with rosiglitazone 1 day before coronary stenting （4 mg once daily） and treatment was continued until the 9 months follow-up; while in the control group, patients were treated with placebo 1 day before the procedure and until the 9 months follow-up. Adverse events were death, myocardial infarction and urgent target vessel revascularization within 9 months after coronary stenting. Results One hundred and fifty two patients in the rosiglitazone group and 145 patients in the control group survived during the follow-up. Baseline characteristics among patients in the two groups were well balanced. There was no significant difference in target vessels or the procedure of stent implantation. Compared with the control group, treatment with rosiglitazone was associated with a lower rate of death, myocardial infarction and urgent target vessel revascularization （7.2% vs 14.5%, P=0.044）. Conclusion Rosiglitazone could reduce the risk of the adverse cardiovascular event and improve clinical outcomes in nondiabetic patients with metabolic syndrome after coronary stent implantation.