1.Expert Consensus on Clinical Application of Qidong Yixin Oral Liquid
Changkuan FU ; Xiaochang MA ; Mingjun ZHU ; Yue DENG ; Hongxu LIU ; Mingxue ZHANG ; Ying CHEN ; Yan ZHOU ; Ling ZHANG ; Jianhua FU ; Wei YANG ; Yu'er HU ; Ming CHEN ; Yanming XIE ; Yuanyuan LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):147-158
The prescription of Qidong Yixin oral liquid is derived from the experience of national medical master Ren Jixue in treating viral myocarditis (VMC). It has the functions of tonifying Qi, nourishing the heart,calming the mind, and relieving palpitations. It is used to treat VMC and angina pectoris of coronary heart disease caused by deficiency of both Qi and Yin. However,the understanding of its efficacy evidence, advantageous aspects, dosage and administration, and medication safety remains insufficient in clinical practice. Therefore,the development of the Expert Consensus on the Clinical Application of Qidong Yixin Oral Liquid (hereinafter referred to as consensus) was initiated. Consensus strictly followed the process and methods of the expert consensus on the clinical application of Chinese patent medicines of the China Association of Chinese Medicine,successively completing multiple tasks such as the consensus project initiation,determination of clinical problems,evidence search and evaluation,formation of recommendation opinions and consensus suggestions,solicitation of opinions,peer review, submission for review and release, and so on. Consensus formed a total of 10 recommendation opinions and 12 consensus suggestions,clarifying the clinical positioning,efficacy advantages,syndrome differentiation,dosage and administration,combination therapy,timing of medication,adverse reactions,contraindications, and precautions of Qidong Yixin oral liquid,indicating that it has good clinical advantages and safety in the treatment of VMC and angina pectoris of coronary heart disease,providing norms and references for physicians to safely and rationally apply Qidong Yixin oral liquid. Consensus was reviewed and approved for release by the Standardization Office of the China Association of Chinese Medicine on December 23, 2024. Standard number:GSCACM-376-2024.
2.The diagnostic value of high-resolution CT combined with serum TUBA1B and ACSL4 in differentiating benign and malignant solitary pulmonary nodules
Bin LI ; Jiming LIU ; Mingjun WU
Chinese Journal of Radiological Health 2026;35(3):387-393
Objective To explore the clinical value of combining high-resolution CT (HRCT) with serum markers in differentiating malignant solitary pulmonary nodules (SPN). Methods Ninety-two SPN patients admitted to Baoji People’s Hospital between January 2022 and January 2024 were included. According to pathological analysis, they were divided into a benign group (30 cases) and a malignant group (62 cases). The serum levels of TUBA1B and ACSL4 were detected. Diagnostic value was determined using the receiver operating characteristic curve. Kappa test was used for consistency evaluation. Results Significant differences were observed between the benign and malignant groups in HRCT imaging, including the number of cases with spiculation, lobulation, pleural indentation, calcification, and vascular convergence sign (P<0.05). The sensitivity, specificity, and accuracy of HRCT in diagnosing malignant SPN were 74.19%, 86.67%, and 78.26%, respectively. The consistency with clinical diagnosis was moderate, as indicated by a Kappa value of 0.552 (P<0.001). The expression level of TUBA1B in the serum of SPN patients in the malignant group was higher than that in the benign group (P<0.05), while the expression level of ACSL4 was lower than that in the benign group (P<0.05). The areas under the receiver operating characteristic curves of serum TUBA1B and ACSL4 in diagnosing malignant SPN were 0.840 (95%CI = 0.749-0.908) and 0.875 (95%CI = 0.790-0.935), respectively, with sensitivities of 74.19% and 75.81% and specificities of 73.33% and 86.67%, respectively. The sensitivity, specificity, and accuracy of HRCT combined with serum TUBA1B and ACSL4 in diagnosing malignant SPN were 96.77%, 63.33%, and 85.87%, respectively. The consistency with clinical diagnosis was high, as indicated by a Kappa value of 0.721 (P<0.001). The sensitivity and negative predictive value of HRCT combined with serum TUBA1B and ACSL4 in diagnosing malignant SPN were higher than those of individual diagnostic indicators (P<0.05). Conclusion HRCT combined with serum TUBA1B and ACSL4 has high value in the differentiation of benign and malignant SPN.
3.Effect of Heat-Sensitive Moxibustion on Apoptosis of Gastric Mucosal Tissue in Chronic Atrophic Gastritis Model Rats:Based on PI3K/Akt Signaling Pathway
Qi ZHANG ; Yanping ZHOU ; Qide WANG ; Shujuan CHEN ; Yu SUN ; Fang LI ; Hongbin GONG ; Mingjun XIE ; Hui LIU ; Haifeng ZHANG
Journal of Traditional Chinese Medicine 2026;67(15):1650-1658
ObjectiveTo investigate the potential mechanism of heat-sensitive moxibustion on chronic atrophic gastritis (CAG) through the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) signaling pathway. MethodsFifty-eight SD rats were randomly divided into blank group (n=14) and modeling group (n=44). Rats in the blank group were fed routinely, while the rats in the modeling group received drinking water containing 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) at a concentration of 140 μg/ml, combined with irregular fasting and feeding for 12 weeks to establish CAG model. After successful modeling, the rats were randomly divided into model group (n=10), inhibitor group (n=10) and moxibustion group (n=20). After 40 minutes of suspended moxibustion at "Zhongwan" (CV 12) daily, the rats in the moxibustion group were divided into heat-sensitive moxibustion group (n=10) and non-heat-sensitive moxibustion group (n=9) according to the change of tail temperature during moxibustion. The inhibitor group was bound for 40 minutes daily, and then administered with PI3K/Akt signaling pathway inhibitor, rapamycin solution, by gavage at a dose of 1 mg/kg. The model group received intragastric administration of 1 ml/kg normal saline after 40 minutes of restraint stress each day. All interventions were administered once daily for 28 consecutive days, while the blank group received no intervention. After the intervention finished, the body weight of rats in each group was compared. HE staining was used to observe the histopathological changes of gastric mucosa. The apoptosis-positive rate of gastric mucosal cells was detected by TUNEL assay. Immunohistochemistry was performed to determine the protein levels of matric metalloproteinase-7 (MMP7), vascular endothelial growth factor A (VEGFA) and epidermal growth factor receptor (EGFR) in gastric mucosa. The mRNA expression levels of PI3K, Akt and mammalian target of rapamycin (mTOR) in gastric mucosal tissues were detected by qPCR. The protein levels of phosphorylated Akt (p-Akt) and phosphorylated mTOR (p-mTOR) in rat gastric mucosal tissues were measured by Western Blotting. ResultsCompared to the blank group, rats in all other groups exhibited decreased body weight, significantly increased gastric mucosal cell apoptosis-positive rates, elevated protein levels of MMP7, VEGFA and EGFR in gastric mucosa, increased mRNA expression levels of PI3K, Akt and mTOR, and enhanced protein expression levels of p-Akt and p-mTOR (P<0.05 or P<0.01). Histopathological examination revealed thinning of the gastric mucosa, glandular disorganization and atrophy, accompanied by intestinal metaplasia.Compared to the model group, the heat-sensitive moxibustion group, the non-heat-sensitive moxibustion group and the inhibitor group all showed significant improvements in the above-mentioned indicators (P<0.05 or P<0.01). Compared to the heat-sensitive moxibustion group, the non-heat-sensitive moxibustion group and the inhibitor group exhibited increased positive rates of gastric mucosal cell apoptosis; the non-heat-sensitive moxibustion group showed increased protein levels of MMP7, VEGFA and EGFR, as well as mRNA expression levels of PI3K, Akt and mTOR, and protein expressions of p-Akt and p-mTOR; the inhibitor group exhibited elevated protein expression level of EGFR (P<0.05 or P<0.01). Histopathological examination showed that the gastric mucosal glands in the heat-sensitive moxibustion group were arranged more regularly, with an approximately normal structural appearance. ConclusionHeat-sensitive moxibustion can improve the body weight of CAG rats and repair gastric mucosal injury. Its therapeutic effects may be mediated by inhibiting excessive activation of gastric mucosal PI3K/Akt signaling pathway, thereby reducing gastric mucosal cell apoptosis.
4.Effect of Heat-Sensitive Moxibustion on Apoptosis of Gastric Mucosal Tissue in Chronic Atrophic Gastritis Model Rats:Based on PI3K/Akt Signaling Pathway
Qi ZHANG ; Yanping ZHOU ; Qide WANG ; Shujuan CHEN ; Yu SUN ; Fang LI ; Hongbin GONG ; Mingjun XIE ; Hui LIU ; Haifeng ZHANG
Journal of Traditional Chinese Medicine 2026;67(15):1650-1658
ObjectiveTo investigate the potential mechanism of heat-sensitive moxibustion on chronic atrophic gastritis (CAG) through the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) signaling pathway. MethodsFifty-eight SD rats were randomly divided into blank group (n=14) and modeling group (n=44). Rats in the blank group were fed routinely, while the rats in the modeling group received drinking water containing 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) at a concentration of 140 μg/ml, combined with irregular fasting and feeding for 12 weeks to establish CAG model. After successful modeling, the rats were randomly divided into model group (n=10), inhibitor group (n=10) and moxibustion group (n=20). After 40 minutes of suspended moxibustion at "Zhongwan" (CV 12) daily, the rats in the moxibustion group were divided into heat-sensitive moxibustion group (n=10) and non-heat-sensitive moxibustion group (n=9) according to the change of tail temperature during moxibustion. The inhibitor group was bound for 40 minutes daily, and then administered with PI3K/Akt signaling pathway inhibitor, rapamycin solution, by gavage at a dose of 1 mg/kg. The model group received intragastric administration of 1 ml/kg normal saline after 40 minutes of restraint stress each day. All interventions were administered once daily for 28 consecutive days, while the blank group received no intervention. After the intervention finished, the body weight of rats in each group was compared. HE staining was used to observe the histopathological changes of gastric mucosa. The apoptosis-positive rate of gastric mucosal cells was detected by TUNEL assay. Immunohistochemistry was performed to determine the protein levels of matric metalloproteinase-7 (MMP7), vascular endothelial growth factor A (VEGFA) and epidermal growth factor receptor (EGFR) in gastric mucosa. The mRNA expression levels of PI3K, Akt and mammalian target of rapamycin (mTOR) in gastric mucosal tissues were detected by qPCR. The protein levels of phosphorylated Akt (p-Akt) and phosphorylated mTOR (p-mTOR) in rat gastric mucosal tissues were measured by Western Blotting. ResultsCompared to the blank group, rats in all other groups exhibited decreased body weight, significantly increased gastric mucosal cell apoptosis-positive rates, elevated protein levels of MMP7, VEGFA and EGFR in gastric mucosa, increased mRNA expression levels of PI3K, Akt and mTOR, and enhanced protein expression levels of p-Akt and p-mTOR (P<0.05 or P<0.01). Histopathological examination revealed thinning of the gastric mucosa, glandular disorganization and atrophy, accompanied by intestinal metaplasia.Compared to the model group, the heat-sensitive moxibustion group, the non-heat-sensitive moxibustion group and the inhibitor group all showed significant improvements in the above-mentioned indicators (P<0.05 or P<0.01). Compared to the heat-sensitive moxibustion group, the non-heat-sensitive moxibustion group and the inhibitor group exhibited increased positive rates of gastric mucosal cell apoptosis; the non-heat-sensitive moxibustion group showed increased protein levels of MMP7, VEGFA and EGFR, as well as mRNA expression levels of PI3K, Akt and mTOR, and protein expressions of p-Akt and p-mTOR; the inhibitor group exhibited elevated protein expression level of EGFR (P<0.05 or P<0.01). Histopathological examination showed that the gastric mucosal glands in the heat-sensitive moxibustion group were arranged more regularly, with an approximately normal structural appearance. ConclusionHeat-sensitive moxibustion can improve the body weight of CAG rats and repair gastric mucosal injury. Its therapeutic effects may be mediated by inhibiting excessive activation of gastric mucosal PI3K/Akt signaling pathway, thereby reducing gastric mucosal cell apoptosis.
5.Application value of soluble C5b-9 in the diagnosis of delayed graft function after kidney transplantation
Lihong SHANG ; Zhihua WANG ; Wenyan ZHANG ; Jiaoxia LIANG ; Mingjun WANG ; Ning LI ; Shaohua SHI ; Linru ZHU
Organ Transplantation 2026;17(5):757-764
Objective To explore the diagnostic value of soluble C5b-9 (sC5b-9) for delayed graft function (DGF) following kidney transplantation. Methods Clinical data of 49 kidney transplant recipients who underwent sC5b-9 detection at the Second People’s Hospital of Shanxi Province between January 2024 and December 2025 were retrospectively analyzed. Recipients were divided into the DGF group (n=25) and the non-DGF group (n=24) according to the occurrence of DGF. Baseline characteristics and serum sC5b-9 levels were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of sC5b-9 for DGF. A restricted cubic spline model was adopted to investigate the association between sC5b-9 and DGF. Results Among the 49 recipients, DGF occurred in 25 patients. Compared with the non-DGF group, the DGF group presented a higher proportion of male patients, a higher incidence of adverse transplant outcomes, and elevated final serum creatinine levels (all P<0.05). Within 30 days after transplantation, sC5b-9 concentrations were significantly higher in the DGF group than those in the non-DGF group (P<0.001). ROC analysis revealed that the area under the curve (AUC) of sC5b-9 for diagnosing DGF was 0.81, with a 95% confidence interval (CI) of 0.68-0.92, and the optimal cutoff value was 265.7 ng/mL. Recipients with elevated sC5b-9 (≥265.7 ng/mL) had a significantly higher incidence of DGF than those with low sC5b-9 levels (<265.7 ng/mL) (P<0.001). Recipients with adverse outcomes exhibited significantly higher sC5b-9 levels than those without adverse outcomes (P<0.001), and the AUC of sC5b-9 for identifying adverse outcomes was 0.82 (95%CI 0.63-0.95). A significant nonlinear correlation was observed between sC5b-9 and final serum creatinine (P<0.001). Conclusions Elevated sC5b-9 is correlated with the development of DGF after kidney transplantation and exhibits favorable diagnostic performance. It may serve as a potential biomarker for predicting early allograft dysfunction and adverse outcomes in kidney transplant recipients.
6.Mechanism of Shengxian Yixin Granule (升陷益心颗粒) in the Treatment of Heart Failure with Preserved Ejection Fraction Based on Macrophage-Mediated Inflammatory Response
Zhengwei DONG ; Rui YU ; Qiaozhi LI ; Huan ZHAO ; Jingjing WEI ; Genhao FAN ; Xinlu WANG ; He WANG ; Yongxia WANG ; Mingjun ZHU
Journal of Traditional Chinese Medicine 2026;67(19):2086-2094
ObjectiveTo investigate the effect and mechanism of Shengxian Yixin Granule (升陷益心颗粒, SYG) in treating heart failure with preserved ejection fraction (HFpEF). MethodsExperiment 1: Forty male C57BL/6 mice were randomly divided into control group, model group, low-dose [25 mg/(kg·d)], medium-dose [50 mg/(kg·d)], and high-dose [(75 mg/(kg·d)] SYG groups, with 8 mice per group. Except for the control group, HFpEF was induced by a high-fat diet combined with Nω-nitro-L-arginine methyl ester in drinking water for 16 weeks. After 10 weeks of modeling, treatment groups received corresponding doses of SYG by gavage, while the control group and model group received equal volume of normal saline, for 6 weeks. After 6 weeks of administration, the body weight, blood pressure including systolic blood pressure (SBP) and diastolic blood pressure (DBP), and heart weight-to-tibia length ratio (HW/TL) were recorded. Echocardiography was used to evaluate left ventricular ejection fraction (LVEF) and the ratio of early to late diastolic transmitral flow velocity (E/A). Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) levels were measured by ELISA. The expression level of brain natriuretic peptide (BNP) in heart tissue was detected by qRT-PCR. Blood lipid levels, including low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC), were determined by a biochemical analyzer. Splenic proportions of M1 macrophages, M2 macrophages, T helper 17 (Th17) cells, and regulatory T (Treg) cells were analyzed by flow cytometry. Experiment 2: RAW 264.7 cells were stimulated with lipopolysaccharide (LPS) to establish an M1 macrophage polarization model, and then treated with SYG-containing serum for 24 h. The cells were divided into four groups, including blank serum group, high-dose SYG-containing serum group, LPS group, and LPS plus high-dose SYG-containing serum group. Combined with asignal transducer and activator of transcription 3 (Stat3) inhibitor for 24 h, the cells were divided into a lipopolysaccharide group, a high-dose SYG-containing serum group, an inhibitor group, and high-dose SYG-containing serum plus inhibitor group. The expression levels of inducible nitric oxide synthase (iNOS) and interleukin-1β (IL-1β) in each group were detected by qRT-PCR. The protein levels of iNOS, IL-1β, Stat3, and phosphorylated Stat3 (p-Stat3) were detected by Western Blotting. ResultsExperiment 1: Compared to the control group, the model group showed significantly decreased E/A ratio, and increased cardiac BNP expression, plasma NT-proBNP,HW/TL ratio, body weight, TC, LDL-C, SBP, and DBP, as well as shortened exhaustion distance and exhaustion time (P<0.05 or P<0.01). Compared to the model group, the E/A ratio increased in the low-, medium-, and high-dose SYG groups; cardiac BNP expression decreased in the low- and high-dose groups, and plasma NT-proBNP levels decreased in the high-dose group; the HW/TL ratio and body weight decreased, while exhaustion distance and exhaustion time increased in the medium- and high-dose groups; TG levels decreased in the low- and medium-dose groups, and LDL-C levels decreased in the medium- and high-dose groups; SBP and DBP decreased in the low-, medium-, and high-dose groups (P<0.05 or P<0.01). Compared to the low-dose SYG group, body weight decreased, and both exhaustion distance and exhaustion time increased in the medium- and high-dose groups (P<0.05 or P<0.01). Compared to the medium-dose SYG group, the exhaustion time increased in the high-dose SYG group (P<0.01). Experiment 2: In the LPS‑induced M1 macrophage polarization model, compared to the blank serum group, the LPS group showed significantly increased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.01). Compared to the LPS group, the high‑dose SYG-containing serum plus LPS group showed significantly decreased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.05 or P<0.01). Compared to the LPS group, the inhibitor group also showed significantly reduced these parameters (P<0.05 or P<0.01). ConclusionSYG can improve cardiac function, ventricular remodeling, exercise capacity, and lipid metabolism in HFpEF mice, while inhibiting inflammatory responses. Its mechanism may be related to the regulation of the Stat3 signaling pathway and inhibition of M1 macrophage polarization.
7.Mechanism of Shengxian Yixin Granule (升陷益心颗粒) in the Treatment of Heart Failure with Preserved Ejection Fraction Based on Macrophage-Mediated Inflammatory Response
Zhengwei DONG ; Rui YU ; Qiaozhi LI ; Huan ZHAO ; Jingjing WEI ; Genhao FAN ; Xinlu WANG ; He WANG ; Yongxia WANG ; Mingjun ZHU
Journal of Traditional Chinese Medicine 2026;67(19):2086-2094
ObjectiveTo investigate the effect and mechanism of Shengxian Yixin Granule (升陷益心颗粒, SYG) in treating heart failure with preserved ejection fraction (HFpEF). MethodsExperiment 1: Forty male C57BL/6 mice were randomly divided into control group, model group, low-dose [25 mg/(kg·d)], medium-dose [50 mg/(kg·d)], and high-dose [(75 mg/(kg·d)] SYG groups, with 8 mice per group. Except for the control group, HFpEF was induced by a high-fat diet combined with Nω-nitro-L-arginine methyl ester in drinking water for 16 weeks. After 10 weeks of modeling, treatment groups received corresponding doses of SYG by gavage, while the control group and model group received equal volume of normal saline, for 6 weeks. After 6 weeks of administration, the body weight, blood pressure including systolic blood pressure (SBP) and diastolic blood pressure (DBP), and heart weight-to-tibia length ratio (HW/TL) were recorded. Echocardiography was used to evaluate left ventricular ejection fraction (LVEF) and the ratio of early to late diastolic transmitral flow velocity (E/A). Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) levels were measured by ELISA. The expression level of brain natriuretic peptide (BNP) in heart tissue was detected by qRT-PCR. Blood lipid levels, including low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC), were determined by a biochemical analyzer. Splenic proportions of M1 macrophages, M2 macrophages, T helper 17 (Th17) cells, and regulatory T (Treg) cells were analyzed by flow cytometry. Experiment 2: RAW 264.7 cells were stimulated with lipopolysaccharide (LPS) to establish an M1 macrophage polarization model, and then treated with SYG-containing serum for 24 h. The cells were divided into four groups, including blank serum group, high-dose SYG-containing serum group, LPS group, and LPS plus high-dose SYG-containing serum group. Combined with asignal transducer and activator of transcription 3 (Stat3) inhibitor for 24 h, the cells were divided into a lipopolysaccharide group, a high-dose SYG-containing serum group, an inhibitor group, and high-dose SYG-containing serum plus inhibitor group. The expression levels of inducible nitric oxide synthase (iNOS) and interleukin-1β (IL-1β) in each group were detected by qRT-PCR. The protein levels of iNOS, IL-1β, Stat3, and phosphorylated Stat3 (p-Stat3) were detected by Western Blotting. ResultsExperiment 1: Compared to the control group, the model group showed significantly decreased E/A ratio, and increased cardiac BNP expression, plasma NT-proBNP,HW/TL ratio, body weight, TC, LDL-C, SBP, and DBP, as well as shortened exhaustion distance and exhaustion time (P<0.05 or P<0.01). Compared to the model group, the E/A ratio increased in the low-, medium-, and high-dose SYG groups; cardiac BNP expression decreased in the low- and high-dose groups, and plasma NT-proBNP levels decreased in the high-dose group; the HW/TL ratio and body weight decreased, while exhaustion distance and exhaustion time increased in the medium- and high-dose groups; TG levels decreased in the low- and medium-dose groups, and LDL-C levels decreased in the medium- and high-dose groups; SBP and DBP decreased in the low-, medium-, and high-dose groups (P<0.05 or P<0.01). Compared to the low-dose SYG group, body weight decreased, and both exhaustion distance and exhaustion time increased in the medium- and high-dose groups (P<0.05 or P<0.01). Compared to the medium-dose SYG group, the exhaustion time increased in the high-dose SYG group (P<0.01). Experiment 2: In the LPS‑induced M1 macrophage polarization model, compared to the blank serum group, the LPS group showed significantly increased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.01). Compared to the LPS group, the high‑dose SYG-containing serum plus LPS group showed significantly decreased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.05 or P<0.01). Compared to the LPS group, the inhibitor group also showed significantly reduced these parameters (P<0.05 or P<0.01). ConclusionSYG can improve cardiac function, ventricular remodeling, exercise capacity, and lipid metabolism in HFpEF mice, while inhibiting inflammatory responses. Its mechanism may be related to the regulation of the Stat3 signaling pathway and inhibition of M1 macrophage polarization.
8.Regulation of Signaling Pathways Related to Myocardial Infarction by Traditional Chinese Medicine: A Review
Wenjun WU ; Chidao ZHANG ; Jingjing WEI ; Xue LI ; Bin LI ; Xinlu WANG ; Mingjun ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):321-330
The pathological changes of myocardial infarction (MI) are mainly characterized by progressive myocardial ischemic necrosis, decline in cardiac diastolic function, thinning of the ventricular wall, and enlargement of the ventricles. The clinical manifestations include myocardial ischemia, heart failure, arrhythmia, shock, and even sudden cardiac death, rendering MI one of the most perilous cardiovascular diseases. Currently, the clinical treatment for MI primarily involves interventional procedures and drug therapy. However, due to their significant side effects and high complication rates associated with these treatments, they fail to ensure a satisfactory quality of life and long-term prognosis for patients. On the other hand, traditional Chinese medicine has demonstrated remarkable potential in improving patient prognosis while reducing side effects. Research has elucidated that various signaling pathways such as nuclear transcription factor-κB (NF-κB), adenosine 5̒-monophosphate-activated protein kinase (AMPK), transforming growth factor-β (TGF-β)/Smads, mitogen-activated protein kinase (MAPK), Wnt/β-catenin (β-catenin), and phosphatidylinositol 3-kinase (PI3K)/protein kinase B(Akt) play crucial roles in regulating the occurrence and development of MI. Effectively modulating these signaling pathways through its therapeutic interventions, traditional Chinese medicine can enhance MI management by inhibiting apoptosis, providing anti-inflammatory properties, alleviating oxidative stress levels, and resisting myocardial ischemia. Due to its notable efficacy and favorable safety, it has become an area of focus in clinical practice.
9.Effect of Modified Zhigancao Granules (炙甘草汤加味颗粒) on Early Recurrence Following Radiofrequency Ablation in Patients with Atrial Fibrillation of Qi-Yin Deficiency Syndrome:A Randomized,Double-Blind,Placebo-Controlled Trial
Yucai HU ; Boyong QIU ; Jingjing WEI ; Bin LI ; Zuoying XING ; Huixia PENG ; Mingjun ZHU ; Yongxia WANG
Journal of Traditional Chinese Medicine 2025;66(23):2460-2466
ObjectiveTo evaluate the clinical effectiveness and safety of Modified Zhigancao Granules (炙甘草汤加味颗粒) for preventing the early recurrence following radiofrequency ablation in patients with atrial fibrillation (AF) of qi-yin deficiency syndrome. MethodsA multi-center, randomized, double-blind, placebo-controlled trial was designed. A total of 116 patients with atrial fibrillation of qi-yin deficiency syndrome who underwent radiofrequency ablation for the first time were enrolled from 3 centers, and they were randomly divided into a treatment group (59 cases) and a control group (57 cases). Both groups received basic western medicine treatment after surgery. In addition, the treatment group was given oral Modified Zhigancao Granules, while the control group was given oral placebo granules. The dosage for both groups was 20 g each time, twice a day, with continuous treatment for 12 weeks. The recurrence of atrial fibrillation in both groups was recorded at 24 hours, 4 weeks, 8 weeks, and 12 weeks after surgery. The serum levels of B-type natriuretic peptide (BNP), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor-α (TNF-α) were detected before treatment and 12 weeks after treatment in both groups. The scores of Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) Questionnaire (including scores of the daily life dimension, symptom dimension, treatment worry dimension, treatment satisfaction dimension, and total score) and traditional Chinese medicine (TCM) syndrome scores were compared before treatment and at 4 weeks, 8 weeks, and 12 weeks between groups. Safety indicators such as blood routine, urine routine, liver function, and renal function were monitored before and after treatment. ResultsNine of the treatment group and seven of the control group dropped out. Finally, 50 patients in each group were included in the statistical analysis. At 24 hours, 4 weeks, 8 weeks, and 12 weeks after surgery, the recurrence rates of AF in the treatment group were 2.0% (1/50), 2.0% (1/50), 4.0% (2/50), and 10.0% (5/50), respectively; while those in the control group were 2.0% (1/50), 26.0% (13/50), 28.0% (14/50), and 34.0% (17/50), respectively. Compared with the control group at the same time points, the early recurrence rates of AF in the treatment group were significantly lower at 4 weeks, 8 weeks, and 12 weeks after surgery (P<0.01). Compared with the baseline within group, BNP, hs-CRP, IL-6, and TNF-α in the treatment group all decreased after 12 weeks of treatment (P<0.05); the difference in hs-CRP levels (before vs. after treatment) in the treatment group was higher than that in the control group (P<0.01). Compared with the baseline within group, both groups showed decreases in the total score of AFEQT Questionnaire, scores of the daily life dimension, treatment worry dimension, symptom dimension, and TCM syndrome scores at 4 weeks, 8 weeks, and 12 weeks after treatment. Meanwhile, the score of the treatment satisfaction dimension of AFEQT increased in both groups (P<0.01), and the improvements in all the above scores in the treatment group were superior to those in the control group at all time points (P<0.05 or P<0.01). All safety indicators of patients in both groups were within the normal range before treatment and at 12 weeks after treatment, and no adverse reactions or adverse events occurred in either group. ConclusionModified Zhigancao Granules can reduce the early recurrence rate following radiofrequency ablation in AF patients with qi-yin deficiency syndrome, improve clinical symptoms and quality of life, suppress inflammatory response, and show good safety.
10.Endovascular therapy for early neurological deterioration in patients with minor stroke due to anterior circulation large vessel occlusion: comparison with medical treatment
Zhonglun CHEN ; Zhaokun LI ; Mingjun PU ; Shanshan ZHANG ; Xianwen ZHANG ; Xiaochen GONG ; Yufeng TANG
International Journal of Cerebrovascular Diseases 2025;33(7):508-514
Objective:To investigate the efficacy and safety of endovascular therapy (EVT) for early neurological deterioration (END) in patients with minor stroke due to acute anterior circulation large vessel occlusion.Methods:Consecutive patients with mild stroke due to acute anterior circulation large vessel occlusion admitted to Mianyang Central Hospital from October 2015 to October 2023 were included retrospectively. Minor stroke was defined as a baseline National Institutes of Health Stroke Scale (NIHSS) score <6. END was defined as an increase of ≥4 in NIHSS score compared to baseline within 12 hours of onset. According to whether EVT was performed or not, they were divided into EVT group and standard medical treatment (SMT) group. At 90 days after onset, the modified Rankin Scale was used to evaluate the outcome. 0-1 was defined as excellent outcome (primary outcome measure) and 0-2 was defined as good outcome (secondary outcome measure). The safety endpoints included symptomatic intracranial hemorrhage (sICH) within 72 hours after EVT and all-cause mortality within 90 days. Multivariate logistic regression analysis was used to determine the correlation between EVT and clinical outcome. Results:A total of 164 patients with minor stroke due to acute anterior circulation large vessel occlusion were included. Eighty-four patients (51.2%) developed END, of which 52 (61.9%) underwent EVT and 32 (38.1%) received SMT; 60 patients (71.4%) had excellent outcome, and 64 (76.2%) had good outcome. There was no significant difference in demographic and baseline clinical data between the EVT group and the SMT group. The excellent outcome rate of the EVT group at 90 days after onset showed a trend higher than that of SMT group (78.8% vs. 59.4%; χ2=3.680, P=0.055), but there was no significant difference in the good outcome rate and safety endpoints between the two groups. Multivariate logistic regression analysis showed that after adjusting for confounding factors, EVT was significantly and independently associated with excellent outcome at 90 days (odds ratio 4.955, 95% confidence interval 1.331-22.284; P=0.024). Conclusion:For patients with minor stroke due to anterior circulation large vessel occlusion who experience END, EVT may improve their functional outcome without increasing the risk of sICH and mortality.

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