Objective To prospectively study the diagnostic and therapeutic status and prognosis in elderly patients with coronary heart disease(CHD) in national 3rd class-A level hospitals of traditional Chinese medicine(TCM) or integrative western and Chinese medicine(IWCM) in Beijing and Tianjin. The problems and strategies of their in-hospital treatment and secondary prevention of CHD were analyzed combining with follow-up clinical events. Methods Using individualized Information Acquisition Platform of CHD, we collected in-hospital clinical information of CHD patients and then followed up for one year. The diagnostic and therapeutic conditions of elder CHD patients were evaluated based on clinical guidelines. The outcome-related indices were analyzed with one-way ANOVA and muhi-factors analysis. Results The average age of 1864 elderly CHD patients was (72.2±6.8) years, among those 1113 cases were male and 751 cases were female. The major accompanied diseases were hypertension, diabetes, cerebrovascular disease and hyperlipidemia.The standard-reaching rate of blood-lipid level of CHD patients with hyperlipidemia was as follows:TC 74.1%, TG 32. 9%, LDL-C 19. 4%, HDL-C 87. 8%, while it was 64.6% ( systolic pressure)and 84.70% ( diastolic pressure) respectively in CHD with hypertension. As for in-hospital treatment:β-receptor blocker 69.6%, ACEI/ARB 68. 4%, lipid-lowering statina 63. 6%, revascularization 29.1%. During the 12 months of follow-up, cardiogenic death 72 cases (4. 3%, 72/1682), other reasons 5 cases (0. 3%), acute myocardial infarction (AMI) 9 cases (0. 5%), revascularization 15cases (0. 8%). The multi-factors analysis showed that AMI, cardiac dysfunction could increase the incidence rate of endpoint events. Meanwhile, lipid-lowering statins, none of peripheral vessels disease, revaseularization, IWCM treatment, age below 75 years were related with the decreased incidence rate of endpoint events. Conclusions The standard-reaching rates of hlood-lipids (TG,LDL-C) of elderly CHD patients in TCM or IWCM hospitals in Beijing and Tianjin are insufficient,and revascularization should be intensified. There is still certain gap between the usage of ACEI/ARB,β-receptor blocker, lipid-lowering statins and related guidelines, and secondary prevention of CHD must be strengthened. It is the main strategy in preventing cardiovascular events to follow clinical guidelines in medical practice, control multiple risks factors and intervene comprehensively.

The study used questionnaires to investigate clinical TCM master degree students who enrolled in the year of 2011 and 2012 about the implementation effect of training plan before and after standardization of resident training. The results showed that a lot of students in the year 2011 and 2012 were satisfied with their training plan and training mode. However, the ability of clinical skills and academic research improved much higher after standardization of resident training among the students in 2012. The study showed that our education training plan met the training goal and reflected achievements in the cultivation of medical master degree of TCM. The training plan and training mode were higher satisfied for the students in the year 2011 and 2012. The conception of tutor, training target, the relationship between clinical skills and scientific research should be improved in future.

With the development of modern technology and clinical practice,the classic randomized controlled trial nowadays cannot meet the researchers' needs for evidence with more reliable external validity,especially in the field of TCM.Meanwhile,real-world study (RWS) has been attracting more attention and at the forefront of clinical research all over the world for providing evidence in conformity with the real world condition.In this paper,we firstly described the basic concept of RWS,and then found that it was characterized by large representative samples,loose inclusion or exclusion criteria,allocation of interventions according to patients conditions and willingness,long-term follow-up,and clinically relevant endpoints.By analyzing the existing examples of RWS,we noted and discussed the promising future of RWS in TCM clinical research.Finally,we hope this paper will provide some inspiration for TCM researchers.

To evaluate the clinical effects of Shengmai Injection in treating coronary heart disease (CHD) based on correct syndrome differentiation and incorrect syndrome differentiation.

To analyze the relationships among syndrome, therapeutic method and Chinese herbal medicine in patients with coronary artery disease (CAD).

Objective To further study the clinical efficacy and safety of salvianolate injection for the treatment of angina pectoris in coronary heart disease (CHD)with heart-blood stagnation syndrome. Methods A randomized imitative-blind mutli-center clinical trials with positive control and 3 parallel tests was carried out in 480 cases. The patients were divided into three groups: the control group received salviane injection 20 mL (n=120), the treatment group 1 (n=240) and treatment group 2 (n=120) received salvianolate injection in a dosage of 200 mg and 400mg respectively . After 14-daytreatment , the clinical efficacy and safety of salvianolate were observed. Results The total angina pectoris efficacy rates were 88.085 %in treatment group 1, 89.744 %in treatment group 2 and 67.257 %in control group (P

Ventricular remodeling is a crucial pathological process in the prognosis and regression of myocardial infarction. Guided by the theory of “yang transforms into qi， while yin constitutes form" of The Inner Canon of Yellow Emperor （《黄帝内经》）， combined with the pathological characteristics and manifestations of ventricular remodelling， it is believed that insufficient "yang transforms into qi" and excess "yin constitutes form" resulting to heart yang deficiency and turbid pathogen obstruction are the basic pathomechanism of ventricular remodelling after myocardial infarction； insufficient "yin constitutes form" and excess "yang transforms into qi" resulting to inadequate nourishment of the heart meridians and the emergence of various pathological changes are the key pathomechanism of prognosis and regression. Combined with clinical practice， we advocated that harmonizing yin and yang to maintain the dynamic balance of "yang transforms into qi" and "yin constitutes form". We also proposed the use of warming and tonifying to harmonise qi and transform it to help yang transport； resolving phlegm and removing dampness， invigorating blood and resolving toxins to disperse yin accumulation； clearing heat and extinguishing wind， and nourishing yin and channels to improve the prognosis. All these findings and summary could provide ideas on traditional Chinese medicine for prevention and treatment of ventricular remodelling after myocardial infarction.

Based on the natures and flavors of herbal medicinals recorded in Shen Nong's Classic of the Materia Medica （《神农本草经》）； Miscellaneous Records of Famous Physicians （《名医别录》）， this study analyzed the characte-ristics of the natures， flavors and combination of medicinals of the two-herb compound formulas in Treatise on Cold Damage and Miscellaneous Diseases （《伤寒杂病论》）.Finally， 31 compound formulas were included， and it was found that the nature and flavor of the herbs in these two-herb compound formulas are closely related to the functions of the compound formulas， such as the common pairing of the acrid and the sweet herbs to warm yang and transform qi， the acrid and the bitter herbs in pairs to regulate and harmonize cold and heat， the sweet and the bitter in pairs to remove dampness and clear heat， the acrid and the acrid in pairs to arrest vomiting and direct qi downward， and the sour and the sweet in pairs to slow the urgent and relieve pain. Regardless of the deficiency or excess nature of the disease， the corresponding two-herb compound formulas often aim to reinforce healthy qi while eliminating pathogenic factors， with some formulas showcasing a unique correspondence between the disease pattern and the symptoms addressed.

ObjectiveTo observe the effects of Qingxin Jieyu granules （QXJYG） on FeCl₃-induced carotid artery thrombosis in rats and on the expression of thrombosis-related proteins tissue factor （TF） and tissue factor pathway inhibitor （TFPI） as well as the protein kinase B （Akt）/nuclear factor-κB （NF-κB） signaling pathway in EA.hy926 cells exposed to tumor necrosis factor-α （TNF-α）， thus preliminarily exploring the mechanism of QXJYG in inhibiting thrombosis. MethodsThirty-six SD rats were randomized into normal control， model， positive control （aspirin， 9 mg·kg^-1）， and low-， medium-， and high-dose （0.99， 1.98， 3.96 g·kg^-1， respectively） QXJYG groups （n=6）. The rats in the drug treatment groups were administrated with corresponding drugs， and those in the normal control group and model group were given an equal volume of distilled water. After 14 consecutive days of prophylactic gavage， the rat model of common carotid artery thrombosis was established with 45% FeCl₃ solution， and the blood vessels were collected and the wet weight of thrombus was weighed by an electronic balance （precision of 1/10 000）. The thrombosis in the common carotid artery of each group of rats was observed by hematoxylin-eosin staining. The plasma levels of von Willebrand factor （vWF）， platelet endothelial cell adhesion molecule-1 （PECAM-1）， tissue-type plasminogen activator （t-PA）， and plasminogen activator inhibitor-1 （PAI-1） were determined by enzyme-linked immunosorbent assay. An endothelial cell injury model was established by treating EA.hy926 human umbilical vein endothelial cells with TNF-α. The cell counting kit-8 method was used to screen the intervention concentrations of QXJYG. Western blot was employed to determine the protein levels of TF， TFPI， Akt， p-Akt， NF-κB p65， and p-NF-κB p65 in each group of cells. ResultsThe animal experiment showed that compared with the normal control group， the model group showed an increase in carotid artery thrombus weight （P<0.05）， with unclear vascular structure and extensive thrombosis in the lumen. In addition， the plasma levels of vWF， PECAM-1， and PAI-1 were elevated， while the t-PA level became lowered （P<0.05） in the model group. Compared with the model group， the aspirin and QXJYG groups showed reductions in the weight of FeCl₃-induced carotid artery thrombi （P<0.05） and thrombosis in the lumen， declines in plasma levels of PECAM-1 and PAI-1， and an elevation in the t-PA level （P<0.05）. Moreover， the QXJYG groups showed reductions in the plasma level of vWF （P<0.05）， which， however， had no significant difference between the aspirin group and the model group. The cell experiments indicated that 31.25， 62.5， 125， 250， 500 mg·L^-1 QXJYG had no effect on the viability of EA.hy926 cells. Therefore， 250， 500 mg·L^-1 QXJYG were selected as the intervention concentrations for subsequent experiments. Western blotting results showed that compared with the control group， the TNF-α stimulation downregulated the expression of TFPI （P<0.05）， upregulated the expression of TF， and increased the ratios of p-Akt/Akt and p-NF-κB p65/NF-κB p65 （P<0.05） in EA.hy926 cells. Compared with the model group， the intervention with QXJYG upregulated the expression of TFPI （P<0.05）， inhibited the expression of TF， and decreased the ratios of p-Akt/Akt and p-NF-κB p65/NF-κB p65 （P<0.05）. ConclusionQXJYG has the effect of inhibiting thrombosis and regulating the expression of TF and TFPI in endothelial cells exposed to TNF-α by suppressing the abnormal activation of the Akt/NF-κB signaling pathway.