1.A novel chalcone derivative C13 inhibits the growth of human gastric cancer cells through suppressing ErbB4/PI3K/AKT signaling pathway
Peng TAN ; Yun-feng ZHANG ; Long-yan WANG ; Hui-ming HUANG ; Fei WANG ; Xue-jiao WEI ; Zhu-guo WANG ; Jun LI ; Zhong-dong HU
Acta Pharmaceutica Sinica 2024;59(4):957-964
		                        		
		                        			
		                        			 3ʹ-Hydroxy-4ʹ-methoxy-2-hydroxy-5-bromochalcone (hereinafter referred to as C13) is a novel chalcone derivative obtained in the process of structural modification of DHMMF, the antitumor active compound of 
		                        		
		                        	
2.The antitumor activity and mechanisms of piperlongumine derivative C12 on human non-small cell lung cancer H1299 cells
Hai-tao LONG ; Xue LEI ; Jia-yi CHEN ; Jiao MENG ; Li-hui SHAO ; Zhu-rui LI ; Dan-ping CHEN ; Zhen-chao WANG ; Yue ZHOU ; Cheng-peng LI
Acta Pharmaceutica Sinica 2024;59(10):2773-2781
		                        		
		                        			
		                        			 The compound (
		                        		
		                        	
		                				3.Rapid identification of the chemical compounds in the leaves of Solanum nigrum  L. based on UHPLC-Q Exactive MS and molecular network technology
		                			
		                			Xian-long DONG ; Lin-jiao YANG ; Xue-mei QIN ; Zhen-yu LI
Acta Pharmaceutica Sinica 2023;58(4):1003-1013
		                        		
		                        			
		                        			 The whole herb of 
		                        		
		                        	
4.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
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Natriuretic Peptide, Brain
		                        			;
		                        		
		                        			Simendan/therapeutic use*
		                        			;
		                        		
		                        			Non-ST Elevated Myocardial Infarction
		                        			;
		                        		
		                        			Heart Failure/drug therapy*
		                        			;
		                        		
		                        			Peptide Fragments
		                        			;
		                        		
		                        			Arrhythmias, Cardiac
		                        			;
		                        		
		                        			Biomarkers
		                        			;
		                        		
		                        			Prognosis
		                        			
		                        		
		                        	
5.Pathological features and immune microenvironment in HER-2 intratumoral heterogeneous breast cancers.
Yi Ling YANG ; Yuan Ming SONG ; Hui Qin XUE ; Hui SUN ; Ya Qing LI ; Xiao Long QIAN ; Jiao JIAO ; Kun Peng LI ; Heng ZHANG ; Xiao Jing GUO
Chinese Journal of Oncology 2023;45(2):165-169
		                        		
		                        			
		                        			Objective: To observe the clinical pathology features, and immune microenvironment of HER-2 intratumoral heterogeneity breast cancer. Methods: Thirty cases of HER-2 intratumoral heterogeneous breast cancer were retrospectively analyzed in Tianjin Medical University Cancer Institute and Hospital from November 2017 to June 2020. HER-2 expression was detected by immunohistochemistry and verified by dual color silver-enhanced in-situ hybridization (D-SISH). HER-2 intratumoral positive and negative regions were divided. The pathological characteristics, subtype, and the level of tumor infiltrating lymphocytes (TILs) and the expression of programmed cell death-ligand 1 (PD-L1) were evaluated respectively. Results: The proportion of HER-2 positive cells of the breast cancer ranged from 10% to 90%. The pathological type was mainly invasive non-special typecarcinoma. Six cases presented different pathological types between HER-2 positive and negative regions. The HER-2-positive areas included 2 cases of carcinoma with apocrine differentiation, and the negative areas included 2 cases of invasive micropapillary carcinoma, 1 case of invasive papillary carcinoma, and 1 case of carcinoma with apocrine differentiation. In HER-2 positive regions, 17 cases were Luminal B and 13 cases were HER-2 overexpressed types. There were 22 cases of Luminal B and 8 cases of triple negative tumors in the HER-2 negative areas. The levels of TILs in HER-2 positive and negative areas accounted for 53.3% (16/30) and 26.7% (8/30), respectively, with a statistically significant difference (P=0.035). The positive expression of PD-L1 in HER-2 positive area and HER-2 negative area were 6 cases and 9 cases, respectively. Among 8 cases with HER-2 negative regions containing triple negative components, 4 cases were positive for PD-L1 expression. Conclusions: In the case of HER-2 intratumoral heterogeneity, it is necessary to pay attention to both HER-2 positive and negative regions, and evaluate subtype separately as far as possible. For HER-2 intratumoral heterogeneous breast cancer containing triple negative components, the treatment mode can be optimized by refining the intratumoral expression of PD-L1.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Breast Neoplasms/pathology*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			B7-H1 Antigen/metabolism*
		                        			;
		                        		
		                        			Lymphocytes, Tumor-Infiltrating/pathology*
		                        			;
		                        		
		                        			Carcinoma
		                        			;
		                        		
		                        			Tumor Microenvironment
		                        			;
		                        		
		                        			Triple Negative Breast Neoplasms/pathology*
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Biomarkers, Tumor/metabolism*
		                        			
		                        		
		                        	
6.A multicenter epidemiological study of acute bacterial meningitis in children.
Cai Yun WANG ; Hong Mei XU ; Jiao TIAN ; Si Qi HONG ; Gang LIU ; Si Xuan WANG ; Feng GAO ; Jing LIU ; Fu Rong LIU ; Hui YU ; Xia WU ; Bi Quan CHEN ; Fang Fang SHEN ; Guo ZHENG ; Jie YU ; Min SHU ; Lu LIU ; Li Jun DU ; Pei LI ; Zhi Wei XU ; Meng Quan ZHU ; Li Su HUANG ; He Yu HUANG ; Hai Bo LI ; Yuan Yuan HUANG ; Dong WANG ; Fang WU ; Song Ting BAI ; Jing Jing TANG ; Qing Wen SHAN ; Lian Cheng LAN ; Chun Hui ZHU ; Yan XIONG ; Jian Mei TIAN ; Jia Hui WU ; Jian Hua HAO ; Hui Ya ZHAO ; Ai Wei LIN ; Shuang Shuang SONG ; Dao Jiong LIN ; Qiong Hua ZHOU ; Yu Ping GUO ; Jin Zhun WU ; Xiao Qing YANG ; Xin Hua ZHANG ; Ying GUO ; Qing CAO ; Li Juan LUO ; Zhong Bin TAO ; Wen Kai YANG ; Yong Kang ZHOU ; Yuan CHEN ; Li Jie FENG ; Guo Long ZHU ; Yan Hong ZHANG ; Ping XUE ; Xiao Qin LI ; Zheng Zhen TANG ; De Hui ZHANG ; Xue Wen SU ; Zheng Hai QU ; Ying ZHANG ; Shi Yong ZHAO ; Zheng Hong QI ; Lin PANG ; Cai Ying WANG ; Hui Ling DENG ; Xing Lou LIU ; Ying Hu CHEN ; Sainan SHU
Chinese Journal of Pediatrics 2022;60(10):1045-1053
		                        		
		                        			
		                        			Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ2=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Brain Abscess
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Escherichia coli
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hydrocephalus
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Meningitis, Bacterial/epidemiology*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Streptococcus agalactiae
		                        			;
		                        		
		                        			Streptococcus pneumoniae
		                        			;
		                        		
		                        			Subdural Effusion
		                        			;
		                        		
		                        			beta-Lactamases
		                        			
		                        		
		                        	
7.Histone deacetylase 6 promotes skin wound healing by regulating fibroblast migration and differentiation in aged mice.
Yu-Mei QIN ; Ping LI ; Xue-Pan MU ; Zhi-Ming LI ; Chen SUN ; Wen-Long XUE ; Jiao SUN ; Jiao-Jiao BAI ; Yi-Chun ZHU ; Ming-Jie WANG
Acta Physiologica Sinica 2022;74(6):979-992
		                        		
		                        			
		                        			Skin wound healing tends to slow down with aging, which is detrimental to both minor wound recovery in daily life and the recovery after surgery. The aim of current study was to explore the effect of histone deacetylase 6 (HDAC6) on wound healing during aging. Cultured human dermal fibroblasts (HDFs) and mouse full-thickness skin wound model were used to explore the functional changes of replicative senescent dermal fibroblasts and the effect of aging on skin wound healing. Scratch wound healing assay revealed significantly decreased migration speed of senescent HDFs, and BrdU incorporation assay indicated their considerably retardant proliferation. The protein expression levels of collagen and HDAC6 were significantly decreased in both senescent HDFs and skin tissues from aged mice. HDAC6 activity inhibition with highly selective inhibitor tubastatin A (TsA) or HDAC6 knockdown with siRNA decreased the migration speed of HDFs and considerably suppressed fibroblast differentiation induced by transforming growth factor-β1 (TGF-β1), which suggests the involvement of HDAC6 in regulating fundamental physiological activities of dermal fibroblasts. In vivo full-thickness skin wound healing was significantly delayed in young HDAC6 knockout mice when compared with young wild type mice. In addition, the wound healing was significantly slower in aged wild type mice than that in young wild type mice, and became even worse in aged HDAC6 knockout aged mice. Compared to the aged wild type mice, aged HDAC6 knockout mice exhibited delayed angiogenesis, reduced collagen synthesis, and decreased collagen deposition in skin wounds. Together, these results suggest that delayed skin wound healing in aged mice is associated with impaired fibroblast function. Adequate expression and activity of HDAC6 are required for fibroblasts migration and differentiation.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Histone Deacetylase 6
		                        			;
		                        		
		                        			Skin
		                        			;
		                        		
		                        			Wound Healing
		                        			;
		                        		
		                        			Cell Movement
		                        			;
		                        		
		                        			Collagen/pharmacology*
		                        			;
		                        		
		                        			Fibroblasts
		                        			;
		                        		
		                        			Mice, Knockout
		                        			;
		                        		
		                        			Cells, Cultured
		                        			
		                        		
		                        	
8.Study on the correlation between maternal iron deficiency anemia and ROP in premature or low birth weight infants
International Eye Science 2022;22(5):853-857
AIM:To explore the correlation between maternal iron deficiency anemia and retinopathy of prematurity(ROP)in premature infants or low birth weight infants so that to provide possible scientific basis for the prevention and control of ROP.
METHODS: This study was a case-control study. The clinical data of 317 premature or low birth weight infants who were diagnosed with ROP and their mothers in our hospital during January 2019 to July 2021 due to ROP screening for the first time(about 30d after birth)were analyzed. The relationship between maternal iron deficiency anemia and ROP and its stages were observed. And the relationship between Hb, blood value characteristics, mean gestational age, gestational weeks, infant birth weight of maternal iron deficiency anemia and ROP stage.
RESULTS: There were 235 mothers(74.1%)with iron deficiency anemia, 82 mothers(25.9%)without iron deficiency. Among them, there were 194 mothers(82.6%)with mild anemia according to anemia classification, 119 cases with stage Ⅰ ROP and 75 cases with stage Ⅱ ROP. There were 39 mothers(16.6%)with moderate anemia, 8 cases with stage Ⅱ ROP, 22 cases with stage Ⅲ ROP and 9 cases with stage Ⅳ ROP. There were 2 mothers(0.9%)of severe anemia, all of whom had stage Ⅳ ROP. No children with stage Ⅴ or threshold ROP and mothers with very severe anemia were found in this study. Compared with mothers with iron deficiency anemia, premature infants or low birth weight infants with normal iron levels were more likely to have stage Ⅰ ROP, but stage Ⅱ ROP was more pronounced in mothers with iron deficiency anemia, and the differences were statistically significant(all P<0.05). Stage Ⅲ and stage Ⅳ ROP was not observed in the mothers with normal serum iron, but was 9.4% and 4.7% in the mothers with iron deficiency anemia, respectively. The differences were statistically significant(P<0.05). Stage Ⅴ and threshold lesions ROP was not observed in preterm or low birth weight infants in mothers with normal serum iron values or iron deficiency anemia. Compared with mothers with normal iron levels, mothers with iron deficiency anemia had significantly lower hemoglobin, hematocrit, mean erythrocyte volume, serum iron and ferritin levels. At the same time, the higher mean gestational age, mean shorter gestational week and mean lower birth weight in the mothers with iron deficiency anemia, and the differences were statistically significant(all P<0.05).
CONCLUSION:Pregnant iron-deficiency anemia is associated with the occurrence and development of ROP in premature or low birth weight infants. The more severe maternal anemia, the higher maybe stage of ROP. Therefore, monitoring and supplementation of iron during pregnancy can effectively prevent and reduce the risk of ROP.
		                        		
		                        		
		                        		
		                        	
9.The effects of robotic-assisted versus laparoscopic-assisted radical right hemicolectomy on short-term outcome and long-term prognosis based on propensity score matching.
Xing Qi ZHANG ; Shou Gen CAO ; Xiao Dong LIU ; Ze Qun LI ; Yu Long TIAN ; Jian Fei XU ; Cheng MENG ; Yi LI ; Xiao Jie TAN ; Shang Long LIU ; Dong GUO ; Xue Long JIAO ; Yu LI ; Dong CHEN ; Liang LYU ; Jian ZHANG ; Hai Tao JIANG ; Zhao Jian NIU ; Yan Bing ZHOU
Chinese Journal of Surgery 2022;60(2):148-153
		                        		
		                        			
		                        			Objective: To compare the short-term and long-term outcomes between robotic-assisted and laparoscopic-assisted radical right hemicolectomy in patients with adenocarcinoma of the right colon. Methods: Retrospective review of a prospectively collected database identified 288 right colon cancer patients who underwent either robotic-assisted (n=57) or laparoscopic-assisted right hemicolectomy (n=231) between October 2014 and October 2020 at Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University. There were 161 males and 127 females, aging (60.3±12.8) years (range: 17 to 86 years). After propensity score matching as 1∶4 between robotic-assisted and laparoscopic-assisted right hemicolectomy, there were 56 cases in robotic group and 176 cases in laparoscipic group. Perioperative outcomes and overall survival were compared between the two groups using t test, Wilcoxon rank sum test, χ2 test, Fisher exact test, Kaplan-Meier method and Log-rank test, respectively. Results: The total operative time was similar between the robotic and laparoscopic group ((206.9±60.7) minutes vs. (219.9±56.3) minutes, t=-1.477, P=0.141). Intraoperative bleeding was less in the robotic group (50 (20) ml vs. 50 (50) ml, Z=-4.591, P<0.01), while the number of lymph nodes retrieved was significantly higher (36.0±10.0 vs. 29.0±10.1, t=4.491, P<0.01). Patients in robotic group experienced significantly shorter hospital stay, shorter time to first flatus, and defecation (t: -2.888, -2.946, -2.328, all P<0.05). Moreover, the overall peri-operative complication rate was similar between robotic and laparoscopic group (17.9% vs. 22.7%, χ²=0.596,P=0.465). The 3-year overall survival were 92.9% and 87.9% respectively and the 3-year disease-free survival rates were 83.1% and 82.6% with no statistical significance between the robotic and laparoscopic group (P>0.05). Conclusions: Compared to laparoscopic-assisted right hemicolectomy, robot-assisted right hemicolectomy could improve some short-term clinical outcomes. The two procedures are both achieving comparable survival.
		                        		
		                        		
		                        		
		                        			Colectomy
		                        			;
		                        		
		                        			Colonic Neoplasms/surgery*
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Laparoscopy
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Propensity Score
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Robotic Surgical Procedures
		                        			;
		                        		
		                        			Treatment Outcome
		                        			
		                        		
		                        	
10.Naoxintong Capsule for Secondary Prevention of Ischemic Stroke: A Multicenter, Randomized, and Placebo-Controlled Trial.
Xiao-Fei YU ; Xu-Ying ZHU ; Can-Xing YUAN ; Dan-Hong WU ; Yu-Wu ZHAO ; Jia-Jun YANG ; Chang-de WANG ; Wei-Wen WU ; Xue-Yuan LIU ; Zhen-Guo LIU ; Zhi-Yu NIE ; Ben-Qiang DENG ; Huan BAO ; Long-Xuan LI ; Chun-Yan WANG ; Hong-Zhi ZHANG ; Jing-Si ZHANG ; Ji-Han HUANG ; Fan GONG ; Ming-Zhe WANG ; Yong-Mei GUO ; Yan SUN ; Ding-Fang CAI
Chinese journal of integrative medicine 2022;28(12):1063-1071
		                        		
		                        			OBJECTIVE:
		                        			To examine whether the combination of Naoxintong Capsule with standard care could further reduce the recurrence of ischemic stroke without increasing the risk of severe bleeding.
		                        		
		                        			METHODS:
		                        			A total of 23 Chinese medical centers participated in this trial. Adult patients with a history of ischemic stroke were randomly assigned in a 1:1 ratio using a block design to receive either Naoxintong Capsule (1.2 g orally, twice a day) or placebo in addition to standard care. The primary endpoint was recurrence of ischemic stroke within 2 years. Secondary outcomes included myocardial infarction, death due to recurrent ischemic stroke, and all-cause mortality. The safety of drugs was monitored. Results were analyzed using the intention-to-treat principle.
		                        		
		                        			RESULTS:
		                        			A total of 2,200 patients were enrolled from March 2015 to March 2016, of whom 143 and 158 in the Naoxintong and placebo groups were lost to follow-up, respectively. Compared with the placebo group, the recurrence rate of ischemic stroke within 2 years was significantly lower in the Naoxintong group [6.5% vs. 9.5%, hazard ratio (HR): 0.665, 95% confidence interval (CI): 0.492-0.899, P=0.008]. The two groups showed no significant differences in the secondary outcomes and safety, including rates of severe hemorrhage, cerebral hemorrhage and subarachnoid hemorrhage (P>0.05).
		                        		
		                        			CONCLUSION
		                        			The combination of Naoxintong Capsule with standard care reduced the 2-year stroke recurrence rate in patients with ischemic stroke without increasing the risk of severe hemorrhage in high-risk patients. (Trial registration No. NCT02334969).
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Secondary Prevention/methods*
		                        			;
		                        		
		                        			Ischemic Stroke
		                        			;
		                        		
		                        			Stroke/prevention & control*
		                        			;
		                        		
		                        			Cerebral Hemorrhage/complications*
		                        			;
		                        		
		                        			Double-Blind Method
		                        			;
		                        		
		                        			Platelet Aggregation Inhibitors
		                        			
		                        		
		                        	
            
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