Objective To assess the diagnostic value of coronary CTA (CCTA) combined myocardial CT perfusion imaging (CTP) in coronary artery disease (CAD) with Meta-analysis.Methods Chinese and English literatures evaluating CCTA combined CTP in diagnosis of CAD in PubMed,Wed of Science,Cochrane Library,China National Knowledge Infrastructure (CNKI) and Wanfang Periodical Database from inception to December 2016 were searched.The extraction was conducted according to the criteria for diagnostic recommended by Cochrane Method Group.The quality of included studies was assessed with quality assessment of diagnostic accuracy studies-2 instrument.The statistical analysis was performed by Meta-disc 1.4 software,the diagnosis efficacy was calculated and the symmetric receiver operating characteristic curves (SROC) was drawn to obtain the area under curve (AUC).Results Five studies involving a total of 611 vessels were included.The pooled sensitivity (SEN),specificity (SPE),diagnostic odds ratio (DOR),positive likelihood ratio (PLR),negative likelihood ratio (NLR) were 0.96 (95％CI [0.92,0.98]),0.91 (95％CI [0.88,0.94],206.14 (95％CI [100,424.94]),9.33 (95％CI [5.57,15.61]),0.06 (95％CI [0.03,0.13]),respectively.The AUC of SROC was 0.977.Conclusion CCTA combined CTP has significant value in diagnosis of CAD.

Objective To study the protective effect of the thin Recipe of Buyanghuanwu on cerebral ischemic injury of rats. Methods Block model in cerebral artery was established through using the suture method of middle cerebral artery. The rats were randomly divided into sham-operation group, model group, Buyanghuanwu group and thin recipe of Buyanghuanyin high, medium and low-dose groups. Buyanghuanwu group and thin recipe of Buyanghuanyin groups were given gavage with relevant medicine, and sham-operation group and model group were given gavage with the same amount of sterile distilled water for continuous 7 days. Matlab software programming was used to analyze data and observe the changes in neurological function, body weight, the area of cerebral infarction and wet/dry weight ratio of brain of the rats. Results Rats with cerebral ischemia suffered large area of infarction, brain edema and neurological dysfunction. The thin recipe of Buyanghuanwu of medium and low dose groups could effectively improve the indexes of model rats compared with the model group, the difference with statistical significance (P<0.05). Conclusion The thin recipe of Buyanghuanwu has protective effect on cerebral ischemia, and the medium dose is the optimal dose.

Objective To investigate the preventive effects of Buyang Huanwu Decoction (BYHWD) and its recipe composition (BYJJF) in focal ischemic brain injury condition in vivo/in vitro. Methods In vivo studies, SD rats were divided into sham-operation group, MCAO group, BYHWD group and BYJJF group based on rat weight, 10 rats in each group. The body weight, infarct area and brain water contents were determined. In vitro studies, H2O2 was used to damage PC12 cells, and the vitro oxidative stress cell model was established. PC12 cells were divided into normal group, blank control group, BYHWD and BYJJF groups with different concentrations (0.1, 0.2, 0.5, 1.0, 2.0, 3.5 mg/mL). MTT method was employed to determine the protective effects of BYHWD and BYJJF on model cells.Results Vivo studies showed that after 7 days of treatment with BYHWD and BYJJF, those determinated quotas were all significantly improved compared with MCAO model rats (P<0.05), and there were no differences between BYHWD and BYJJF (P>0.05).Vtiro studies showed that the protective effects of BYHWD and BYJJF took place 2 hours later, and it was obvious in oxidative stress injury caused by H2O2, with statistical differences with model group (P<0.05). BYHWD and BYJJF could increase cell viability, and there was no difference between the groups with same concentration (P>0.05).Conclusion The research confirmed that BYJJF plays a significant role in improving the cerebral ischemia injury, which is the same performance as BYHWD, and BYJJF can save TCM resources under the precondition of TCM efficacy.

Objective To observe the effects of thin recipe ofBuyang Huanwu Decoction on expressions of glutathione (GSH) antioxidant system including GSH, GSH-Px andγ-GCS in the brain of focal cerebral ischemia rats;To study its mechanism of antioxidant effect.Methods Totally 120 SD rats were randomly divided into four groups according to random number table method:sham-operation group, model group,Buyang Huanwu Decoction group and thin recipe ofBuyang Huanwu Decoction group. Except for the sham-operation group, the rest groups established focal cerebral ischemia rat model by middle cerebral arterial occlusion. The treatment groups were given corresponding medicine by gavage, while the sham-operation group and model group were given the same amount of normal saline 2 h after modeling. Each group was detected after cerebral ischemia for 1 day, 3 days, and 7 days respectively. The content of GSH and the activity of GSH-Px were detected. At the same time,γ-GCS mRNA and protein levels were determined by using real time-PCR and Western blot.Results The content of GSH and the activity of GSH-Px at each time point decreased in the model group (P<0.05), compared with the corresponding sham-operation group. But the expression ofγ-GCS mRNA and protein increased, with statistical significance on day 1 (P<0.05). Compared with model group, content of GSH and GSH-Px activity levels increased differently in each treatment group, whileγ-GCS mRNA and protein expression raised, with statistical significance on day 3 (P<0.05).Conclusion The thin recipe ofBuyang Huanwu Decoction plays antioxidant effect by regulating the expression of glutathione antioxidant system GSH, GSH-Px andγ-GCS after cerebral ischemia, which may be one of its therapeutic mechanisms for cerebral ischemia.

Objective To observe the effects of simplified recipe ofBuyang Huanwu Decoction on expression of APJ in the brain of local cerebral ischemia rats;To discuss its mechanism of action. MethodsFocal cerebral ischemia rat models were established by middle cerebral arterial occlusion. The adult rats were randomly divided into sham-operation group, model group,Buyang Huanwu Decoction group and simplified recipe ofBuyang Huanwu Decoction group. Administration groups were given relevant medicine for gavage. The expressions of APJ protein and APJ mRNA at different time points were detected by Western blot and RT-PCR.ResultsCompared with model group and sham-operation group, the expression of APJ protein and APJ mRNA at different time points in Buyang Huanwu Decoction group and simplified recipe ofBuyang Huanwu Decoction group significantly increased (P<0.05). The expression of APJ protein at different time points showed no difference between simplified recipe ofBuyang Huanwu Decoction group andBuyang Huanwu Decoction group;while the expression of APJ mRNA in simplified recipe ofBuyang Huanwu Decoction group was higher than Buyang Huanwu Decoction group (P<0.05).ConclusionSimplified recipe ofBuyang Huanwu Decoction plays a role in neural protection and restoration by promoting the expression of APJ in the brain of focal cerebral ischemia rats.

Aim To evaluate the regulation of thin recipe of Buyang Huanwu decoction on cyclin-dependent kinase 5(Cdk5)expressions in hippocampus tissue of rats after cerebral ischemia.Methods Male SD rats were divided into sham-operation group,MCAO group,Buyang Huanwu decoction group(ig.3.15 g·kg-1)and its thin recipe composition group(ig.2.41 g·kg-1).Each group was then divided into five subgroups based on the time after administration for 1,3,7,14,28 d respectively.Cdk5 protein and mRNA levels in each group were examined by using immunohistochemistry,Western blot and real-time PCR respectively.Results The up-regulation of Cdk5 was observed in model rat hippocampus after cerebral ischemia 1 day,and kept increasing with the aggravation of ischemia injury,the peaked expression was observed after 7～14 d,while the downtrend was observed after 28 days compared with the corresponding sham-operation groups(P<0.01),suggesting that the Cdk5 signal pathway would be activated by cerebral ischemic injury.The expression of Cdk5 in thin recipe of Buyang Huanwu decoction group was significantly lower than that in model group at each time point(P<0.05),and there was also more obvious down-regulation with the extend of intervene time.The regulation effects of thin recipe of Buyang Huanwu decoction was up to the best after 28 days of administration,which indicated the thin recipe was positive to the abnormal expression of Cdk5,and there was no difference between Buyang Huanwu decoction and its thin recipe treated groups(P>0.05).Conclusion The thin recipe of Buyang Huanwu decoction could exert the protective effect by regulating Cdk5 after cerebral ischemia.

Aim To observe the effects of thin recipe of Buyang Huanwu Decoction on angiogenesis and the signal pathway of Nrf2 / HO-1 after cerebral ischemic injury in rats. Methods Totally 120 SD rats were randomly divided into four groups: sham operation group,model group,Buyang Huanwu Decoction group and thin recipe of Buyang Huanwu Decoction group. The focal cerebral ischemia rat model was established by middle cerebral arterial occlusion. Each group was treated with corresponding treatment. Each group was detected after cerebral ischemia for day 1,day 3 and day 7, respectively. Immunohistochemical method was used to detect the plasma levels of factor VIII related antigen( vWF), determination of microvessel density (MVD). The expression of Nrf2,HO-1 gene and pro-tein in brain tissues was detected by Real-Time PCR (RT-PCR) and Western blot. Results ① Compared with sham-operation group, the expression of vWF in the model group was significantly increased on day 3(P< 0. 05). Compared with model group, the expression levels increased differently in each drug group on day 7 (P < 0. 05). ② The expression of Nrf2, HO-1 gene and protein in sham operation group showed a small a-mount of gamma expression. Compared with sham op-eration group at the same time point, the expression of Nrf2 protein was significantly increased on day 3(P <0. 01). Compared with model group at the same time point, the Nrf2mRNA and protein expression was up-regulated in each drug group. The Nrf2mRNA on day 1,the Nrf2 protein on day 1 and day 7 were significant-ly increased( P < 0. 01). Compared with sham opera-tion group at the same time point, the expression of HO-1mRNA and protein in the model group was signif-icantly increased on day 7(P < 0. 05). Compared with model group at the same time point, the HO-1mRNA on day 3, the HO-1 protein on day 3 and day 7 in each drug group were significantly increased (P < 0. 05,P <0. 01). Conclusions The thin recipe of Buyang Hua-nwu Decoction promotes brain angiogenesis after ische-mia. The effect may be related wih the expression of Nrf2 / HO-1 signal pathway.

Objective To evaluate the efficacy and safety of gefitinib combined with concurrent thoracic radiotherapy in the treatment of local - advanced non - small cell lung cancer with sensitive EGFR mutations. Methods From June 2015 to December 2016,fifty-six eligible patients in Chongqing Three Gorges Central Hospital were randomly assigned into two groups by one to one ratio,with 28 cases in each group.A group received treatment of gefitinib combined with concurrent thoracic radiotherapy, and B group adopted concurrent chemoradiotherapy. The toxic effects were recorded and all patients were followed up as defined by the study protocol.Primary study endpoints included:severe toxic effects,objective response rate and disease control rate,progression free survival and overall survival.Results Twenty-six patients in A group completed the study,and the severe toxic effects were as followed:interstitial pneumonia(3/26),radiation esophagitis(4/26),myelosuppression,skin rashes and gastrointestinal disruption. Twenty- eight patients in B group completed the study, and the severe toxicity included: interstitial pneumonia (4/26),radiation esophagitis(3/26),myelosuppression,skin rashes and gastrointestinal disruption.No toxicity higher than gradeⅢdeveloped in both two groups,and there were no statistically significant differences in incidence rates of interstitial pneumonia and radiation esophagitis between the two groups ( all P >0. 05 ). Moreover, there were no statistically significant differences in ORR and DCR between the two groups( ORR:61.5% vs.39.3% ,P=0.102;DCR:84. 6% vs. 71. 4% , P =0. 505 ). A group showed the benefit over B group in PFS ( 12. 45 months vs. 10.35 months,P=0.036).However,OS didn＇t reach and needed further follow-up.Conclusion The modality of gefitinib combined with concurrent thoracic radiotherapy in the treatment of local -advanced non -small cell lung cancer with sensitive EGFR mutations is safe and effective,and it yet needs further follow-up.