1.Safety and efficacy of the early administration of levosimendan in patients with acute non-ST-segment elevation myocardial infarction and elevated NT-proBNP levels: An Early Management Strategy of Acute Heart Failure (EMS-AHF).
Feng XU ; Yuan BIAN ; Guo Qiang ZHANG ; Lu Yao GAO ; Yu Fa LIU ; Tong Xiang LIU ; Gang LI ; Rui Xue SONG ; Li Jun SU ; Yan Ju ZHOU ; Jia Yu CUI ; Xian Liang YAN ; Fang Ming GUO ; Huan Yi ZHANG ; Qing Hui LI ; Min ZHAO ; Li Kun MA ; Bei An YOU ; Ge WANG ; Li KONG ; Jian Liang MA ; Xin Fu ZHOU ; Ze Long CHANG ; Zhen Yu TANG ; Dan Yu YU ; Kai CHENG ; Li XUE ; Xiao LI ; Jiao Jiao PANG ; Jia Li WANG ; Hai Tao ZHANG ; Xue Zhong YU ; Yu Guo CHEN
Chinese Journal of Internal Medicine 2023;62(4):374-383
Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male
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Female
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Humans
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Aged
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Natriuretic Peptide, Brain
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Simendan/therapeutic use*
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Non-ST Elevated Myocardial Infarction
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Heart Failure/drug therapy*
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Peptide Fragments
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Arrhythmias, Cardiac
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Biomarkers
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Prognosis
2.Systematic screening and analysis of bZIP transcription factors in Glycyrrhiza uralensis and their response to ABA stress
Li-wei WU ; Zhi-chao XU ; Qing WANG ; Li-ping NIE ; Ying-xian CUI ; Yu WANG ; Jing-yuan SONG ; Hui YAO
Acta Pharmaceutica Sinica 2022;57(3):818-830
Licorice, one of the most commonly used medicinal materials in China, grows mainly in arid and semi-arid regions and has important economic and ecological values. Basic leucine zipper (bZIP) transcription factors in plants play an important role in regulating biological or abiotic stress responses, growth, and secondary metabolite synthesis. bZIP transcription factors in the published whole genome database of
3.Chloroplast Genomic Analysis of Pyrrosia assimilis
Chu-hong YANG ; Ying-xian CUI ; Li-ping NIE ; Hui YAO ; Yu WANG ; Xia LIU
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(5):123-131
Objective::The complete chloroplast genome of
4.The characteristics of complete chloroplast genome sequence and phylogenetic analysis of Dendrobium moniliforme
Li-wei WU ; Ying-xian CUI ; Li-ping NIE ; Zhi-chao XU ; Yu WANG ; Jing-yuan SONG ; Lian-kui JIAO ; Hui YAO
Acta Pharmaceutica Sinica 2020;55(5):1056-1066
italic>Dendrobium moniliforme is an important source of Dendrobii Caulis and one of the main sources of authentic Fengdou. The complete chloroplast genome of
5.Genome-wide identification of abscisic acid (ABA) receptor pyrabactin resistance 1-like protein (PYL) family members and expression analysis of PYL genes in response to different concentrations of ABA stress in Glycyrrhiza uralensis.
Ying-Xian CUI ; Zhi-Chao XU ; Xin-Lian CHEN ; Li-Ping NIE ; Li-Wei WU ; Yu WANG ; Jing-Yuan SONG ; Hui YAO
Chinese Journal of Natural Medicines (English Ed.) 2020;18(8):606-611
As abscisic acid (ABA) receptor, the pyrabactin resistance 1-like (PYR/PYL) protein (named PYL for simplicity) plays an important part to unveil the signal transduction of ABA and its regulatory mechanisms. Glycyrrhiza uralensis, a drought-tolerant medicinal plant, is a good model for the mechanism analysis of ABA response and active compound biosynthesis. However, knowledge about PYL family in G. uralensis remains largely unknown. Here, 10 PYLs were identified in G. uralensis genome. Characterization analysis indicated that PYLs in G. uralensis (GuPYLs) are relatively conserved. Phylogenetic analysis showed that GuPYL1-3 belongs to subfamily I, GuPYL4-6 and GuPYL10 belong to subfamily II and GuPYL7-9 belongs to subfamily III. In addition, transcriptome data presented various expression levels of GuPYLs under different exogenous ABA stresses. The expression pattern of GuPYLs was verified by Quantitative real-time polymerase chain reaction (qRT-PCR). The study proved that GuPYL4, GuPYL5, GuPYL8 and GuPYL9 genes are significantly up-regulated by ABA stress and the response process is dynamic. This study paves the way for elucidating the regulation mechanism of ABA signal to secondary metabolites and improving the cultivation and quality of G. uralensis using agricultural strategies.
6.Molecular structure and phylogenetic analyses of the complete chloroplast genomes of three original species of Pyrrosiae Folium.
Chu-Hong YANG ; Xia LIU ; Ying-Xian CUI ; Li-Ping NIE ; Yu-Lin LIN ; Xue-Ping WEI ; Yu WANG ; Hui YAO
Chinese Journal of Natural Medicines (English Ed.) 2020;18(8):573-581
Pyrrosia petiolosa, Pyrrosia lingua and Pyrrosia sheareri are recorded as original plants of Pyrrosiae Folium (PF) and commonly used as Chinese herbal medicines. Due to the similar morphological features of PF and its adulterants, common DNA barcodes cannot accurately distinguish PF species. Knowledge of the chloroplast (cp) genome is widely used in species identification, molecular marker and phylogenetic analyses. Herein, we determined the complete cp genomes of three original species of PF via high-throughput sequencing technologies. The three cp genomes exhibited a typical quadripartite structure with sizes ranging from 158 165 to 163 026 bp. The cp genomes of P. petiolosa and P. lingua encoded 130 genes, whilst that of P. sheareri encoded 131 genes. The complete cp genomes were compared, and five highly divergent regions of petA-psbJ, matK-rps16, ndhC-trnM, psbM-petN and psaC-ndhE were screened as potential DNA barcodes for identification of Pyrrosia genus species. The phylogenetic tree we obtained indicated that P. petiolosa and P. lingua are clustered in a single clade and, thus, share a close relationship. This study provides invaluable information for further studies on the species identification, taxonomy and phylogeny of Pyrrosia genus species.
7.Research progress on chemical composition and pharmacological effects of Periplocae Cortex and predictive analysis on Q-marker.
Xue YANG ; Meng-Yu LI ; Chang-Yang YAN ; Zhi-Jun XIAO ; Wei-Qi JIANG ; Xiao-Yu WANG ; Xi-Xi CUI ; Wen-Xian LI ; Ke-Nan YAO ; Chuan-Xin LIU
China Journal of Chinese Materia Medica 2020;45(12):2772-2783
Periplocae Cortex is a traditional Chinese medicine in China, which is mainly produced in northeast China, north China, northwest China, southwest China. In recent years, the increasing in-depth research resulted in the discovery of anti-tumor and cardiac pharmacological activities of Periplocae Cortex, which has broad application prospects. On the basis of summarizing chemical components and pharmacological effects, combined with the theoretical system of Q-marker, the quality control components of Periplocae Cortex were predicted from the aspects of the correlation between chemical composition and traditional medicinal properties, traditional efficacy, and new clinical use, plasma composition, measurable composition, storage time by analyzing literature. Among the components, periplocoside, periplocin, periplogenin, 4-methoxy salicylaldehyde showed significant activity, which provides a scientific basis for quality evaluation of Periplocae Cortex.
Biomarkers
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China
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Drugs, Chinese Herbal
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analysis
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Medicine, Chinese Traditional
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Quality Control
8.Differentiation Diagnosis and Treatment of Functional Constipation of Children Based on Theory of Qi Ascending and Descending
Fan GUO ; Xia CUI ; Nan YAO ; Lu-Sha YAN ; Hong-Xian ZHANG ; Qian-Qian ZHOU
Chinese Journal of Information on Traditional Chinese Medicine 2018;25(11):115-118
The main pathogenesis of functional constipation in children is the disturbance of large intestine conduction function, so the treatment of lubricating bowel and purging stool, dispersing food and abducting stagnation, nourishing blood and enriching yin is used in clinic. According to the characteristics of the physiopathologic of children, based on the clinical practice, this article believed that the occurrence of this disease was closely related to the ascending the clear of the spleen, the descending turbidity of the stomach, the dispersion of the lung and the catharsis of the liver. The root of pathogenesis is disturbance in ascending and descending of the functional activities of qi, so it is effective to treat the disease with the theory of qi ascending and descending.
9.Prevalence and risk factors of healthcare-associated infection in a tertiary first-class hospital in 2012-2015
Xiao-Yan LIU ; Cui-Yao XIAN ; Fa-Xia WANG ; Wei-Hong ZHOU ; Xiang-Lian LIU
Chinese Journal of Infection Control 2017;16(11):1026-1029
Objective To understand the prevalence and risk factors of healthcare-associated infection(HAD,and provide evidence for prevention and control of HAI.Methods A cross-sectional survey was adopted,bedside survey and medical record reviewing method was combined to investigate and analyze the prevalence of HAI in a tertiary first-class hospital in 2012-2015.Results A total of 4 725 hospitalized patients were surveyed,the prevalence rates in 2012-2015 were 6.00%,4.77%,3.93%,and 3.05% respectively,difference was significant(P<0.05);antimicrobial usage rates were 30.56%,33.82%,32.84%,and 34.48% respectively,difference was not significant (P>0.05);the main infection site was lower respiratory tract (43.00 %),followed by surgical site (16.43 %);the risk factors for HAI were age ≥65 years,chronic systemic diseases(diabetes,cirrhosis,chronic renal failure,chronic lung disease),immunodeficiency(white blood cell<1.5 × 109/L),coma,tracheotomy,and mechanical ventilation.Conclusion Survey on HAI prevalence can promote continuous improvement of HAI management,surveillance on surgical site infection and risk factors of HAI should be strengthened.
10.The synergistic effect of FGF-21 and insulin on regulating glucose metabolism and its mechanism.
Dan YU ; Cui-Yu SUN ; Guo-Peng SUN ; Gui-Ping REN ; Xian-Long YE ; Sheng-Long ZHU ; Wen-Fei WANG ; Peng-Fei XU ; Shu-Jie LI ; Qiang WU ; Ze-Shan NIU ; Tian SUN ; Ming-Yao LIU ; De-Shan LI
Acta Pharmaceutica Sinica 2014;49(7):977-984
Previous studies proposed that the synergistic effect of fibroblast growth factor-21 (FGF-21) and insulin may be due to the improvement of insulin sensitivity by FGF-21. However, there is no experimental evidence to support this. This study was designed to elucidate the mechanism of synergistic effect of FGF-21 and insulin in the regulation of glucose metabolism. The synergistic effect of FGF-21 and insulin on regulating glucose metabolism was demonstrated by investigating the glucose absorption rate by insulin resistance HepG2 cell model and the blood glucose chances in type 2 diabetic db/db mice after treatments with different concentrations of FGF-21 or/and insulin; The synergistic metabolism was revealed through detecting GLUT1 and GLUT4 transcription levels in the liver by real-time PCR method. The experimental results showed that FGF-21 and insulin have a synergistic effect on the regulation of glucose metabolism. The results of real-time PCR showed that the effective dose of FGF-21 could up-regulate the transcription level of GLUT1 in a dose-dependent manner, but had no effect on the transcription level of GLUT4. Insulin (4 u) alone could up-regulate the transcription level of GLUT4, yet had no effect on that of GLUT1. Ineffective dose 0.1 mg kg(-1) FGF-21 alone could not change the transcription level of GLUT1 or GLUT4. However, when the ineffective dose 0.1 mg x kg(-1) FGF-21 was used in combination with insulin (4 u) significantly increased the transcription levels of both GLUT1 and GLUT4, the transcription level of GLUT1 was similar to that treated with 5 time concentration of FGF-21 alone; the transcription level of GLUT4 is higher than that treated with insulin (4 u) alone. In summary, in the presence of FGF-21, insulin increases the sensitivity of FGF-21 through enhancing GLUT1 transcription. Vice versa, FGF-21 increases the sensitivity of insulin by stimulating GLUT4 transcription in the presence of insulin. FGF-21 and insulin exert a synergistic effect on glucose metabolism through mutual sensitization.
Animals
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Blood Glucose
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Diabetes Mellitus, Experimental
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metabolism
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Drug Synergism
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Fibroblast Growth Factors
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pharmacology
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Glucose
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metabolism
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Glucose Transporter Type 1
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metabolism
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Glucose Transporter Type 4
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metabolism
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Hep G2 Cells
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Humans
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Insulin
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pharmacology
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Insulin Resistance
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Liver
;
metabolism
;
Mice

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