Objective To evaluate the efficacy and safety of Qixian Tongluo Formula in the treatment of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome,and to preliminarily explore the molecular mechanism of Qixian Tongluo Formula in improving impaired motor function from the perspective of cross-kingdom regulation of Chinese medicine microRNA(miRNA).Methods A pragmatic randomized controlled trial was conducted with 102 patients in the recovery period of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome in our hospital.Patients were randomly divided into trial group and control group,with 51 cases in each group.The control group received standard Western medicine standard treatment,while the trial group received Qixian Tongluo Formula in addition to the standard treatment,with one dose per day,boiled in water,and taken warm after breakfast and dinner for a course of 2 months.The disability rate was used as the main efficacy indicator,and the incidence of adverse reactions was used as a safety indicator.miRNA from patient serum and Qixian Tongluo decoction were extracted respectively,and high-throughput sequencing was performed.The two sequences were compared to screen out the cross-kingdom gene transfer of Chinese medicine miRNA.Finally,its target genes of miRNA were predicted,and GO function and KEGG pathway enrichment analysis were carried out.Results A total of 67 patients completed the clinical trial,including 36 cases in the trial group and 31 cases in the control group;The disability rate in the trial group(13.9%)was lower than that in the control group(35.5%)(P<0.05);The incidence of adverse reactions was similar between the trial group(7.69%)and the control group(6.06%)(P>0.05);A total of 9530 Qixian Tongluo decoction miRNA sequences were screened,with 150 potentially involved in cross-kingdom gene transfer,including families such as miR-15 and miR-17;According to the target gene prediction of the top 10 miRNAs in cross-kingdom gene transfer of Chinese medicine,345 overlapping target genes were obtained;GO functional enrichment analysis revealed 16 biological processes,7 cellular components,and 2 molecular functions among the top 25 enriched functions,while KEGG pathway analysis mainly focused on the transforming growth factor-βsignaling pathway,neurotrophin signaling pathway,which are closely related to neural repair and functional recovery processes such as glial scar formation and synaptic plasticity after cerebral ischemia.Conclusion Qixian Tongluo Formula can significantly improve the functional independence level of patients with kidney deficiency and blood stasis syndrome in the recovery period of paralysis after cerebral infarction,offering a safe and effective treatment option for these patients;There were a large number of miRNAs in Qixian Tongluo decoction,some of which could cross-kingdom transferred into the human blood circulation,and promote the recovery of motor function in patients with cerebral infarction through multi-target,multi link and multi pathway gene network regulation.This study provides a new idea for subsequent clinical and basic research.

Objective To evaluate the efficacy and safety of Qixian Tongluo Formula in the treatment of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome,and to preliminarily explore the molecular mechanism of Qixian Tongluo Formula in improving impaired motor function from the perspective of cross-kingdom regulation of Chinese medicine microRNA(miRNA).Methods A pragmatic randomized controlled trial was conducted with 102 patients in the recovery period of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome in our hospital.Patients were randomly divided into trial group and control group,with 51 cases in each group.The control group received standard Western medicine standard treatment,while the trial group received Qixian Tongluo Formula in addition to the standard treatment,with one dose per day,boiled in water,and taken warm after breakfast and dinner for a course of 2 months.The disability rate was used as the main efficacy indicator,and the incidence of adverse reactions was used as a safety indicator.miRNA from patient serum and Qixian Tongluo decoction were extracted respectively,and high-throughput sequencing was performed.The two sequences were compared to screen out the cross-kingdom gene transfer of Chinese medicine miRNA.Finally,its target genes of miRNA were predicted,and GO function and KEGG pathway enrichment analysis were carried out.Results A total of 67 patients completed the clinical trial,including 36 cases in the trial group and 31 cases in the control group;The disability rate in the trial group(13.9%)was lower than that in the control group(35.5%)(P<0.05);The incidence of adverse reactions was similar between the trial group(7.69%)and the control group(6.06%)(P>0.05);A total of 9530 Qixian Tongluo decoction miRNA sequences were screened,with 150 potentially involved in cross-kingdom gene transfer,including families such as miR-15 and miR-17;According to the target gene prediction of the top 10 miRNAs in cross-kingdom gene transfer of Chinese medicine,345 overlapping target genes were obtained;GO functional enrichment analysis revealed 16 biological processes,7 cellular components,and 2 molecular functions among the top 25 enriched functions,while KEGG pathway analysis mainly focused on the transforming growth factor-βsignaling pathway,neurotrophin signaling pathway,which are closely related to neural repair and functional recovery processes such as glial scar formation and synaptic plasticity after cerebral ischemia.Conclusion Qixian Tongluo Formula can significantly improve the functional independence level of patients with kidney deficiency and blood stasis syndrome in the recovery period of paralysis after cerebral infarction,offering a safe and effective treatment option for these patients;There were a large number of miRNAs in Qixian Tongluo decoction,some of which could cross-kingdom transferred into the human blood circulation,and promote the recovery of motor function in patients with cerebral infarction through multi-target,multi link and multi pathway gene network regulation.This study provides a new idea for subsequent clinical and basic research.

Objective To analyze the clinical effect of brevisapine injection on high sensitivity C-reaction protein level in the treatment of acute myocardial infarction.Methods The patients were randomly divided into treatment group(n=80)and control group(n=80).Both groups were treated with routine midication,but treatment group were given intravenous drip of 100 mg brevisapine once a day.for 14 days.80 paients who came for diagnosis were selected for healthy control group.The selqlm high sensitivity C-reaction protein levels were measured at 2 d,7 d,and 14 d by ELLSA in treatment group,control group and healthy control group.Mortality,heart function status (Killip class),revaseularization and clinical adverse cardic events including postinfartion angina,new arrhythmia,reinfarction and bleeding complication at 4 weeks were observed.Results Treatment group had a significantly high level of hs-CRP compared with healthy subjects[(6.37±1.43)vs.(2.17±1.12)mmol/L,P＜0.01]at the second day.The serum hs-CRP content of treatment group was obviously lower than that of control group(3.21±1.31)and(2.25±0.34)mmol/L vs.(5.87±1.16)、(3.97±1.21)mmol/L,(P＜0.01)]on the 7th,14th days;The revascularization rate of treatment group was obviously higher than that of control group[62.50%(50/80)vs.51.25% (45/80),P ＜0.01];There was no difference between the two groups in mortality(3.75% vs.4.10%,P ＞0.05).No difference was found in the rate of bleeding between the two groups(6.25% vs.7.50%,P ＞0.05);Patients with Killip class＜Ⅱ of treatment group was obviously higher than that of control group (83.75% vs 61.25%,P ＜ 0.05 );Clinical adverse cardic events rates at 4 weeks of treatment group were obviously lower than those of control group (P ＜ 0.01 ).No obvious adverse reactions related to the treatment group were observed.Condusion The serum hs-CRP level is in close relation with acute myocardial infarction,which is the risk factor.It is effective and safe of brevisapine injection in the treatment of acute myocardial infarction.The effects of brevisapine on acute myocardial infarction might be involved in decreasing the level of hs-CRP and inhibiting the vascular inflammatory reaction.

Objective To observe the application value of cardiac troponin I (cTnI),cardiac troponin T (cTnT) and creatine kinase MB (CK MB) for the early diagnosis of acute myocardial infarction (AMI).Methods The same serum sample was measured to detect the indexes of cTnI,cTnT and CK MB levels in 60 patients with AMI and 40 patients with UA.Comparison between AMI and UA was performed and all the indexes were analysed contrastively.Results The sensitivity of cTnI and cTnT was higher than that of CK MB,and their positive rates were 63.3%,46.7% and 18.3% respectively (P0.05) and the specificity of the three indexes were almost the same without significant difference.Conclusion cTnI and cTnT,as specific markers of cardiac damage,are more sensitive and specific in the early diagnosis of AMI.As a convenient,swift and accurate measurement method,cTnI has significant clinical value.