Objective To systematically review the influence of Tai Chi exercise on blood pressure in patients with coronary heart disease (CHD). Methods The databases of PubMed, EMbase, Cochrane, CNKI, WanFang Data, VIP and CBM were retrieved for choosing the clinical studies on Tai Chi exercise as a therapeutic measure in CHD patients with treatment course over 1 month. Meanwhile, the bibliographies related to retrieved and published systematic reviews about Tai Chi exercise intervening CHD were retrieved manually. The screen, review and data extract of all literature were carried out independently by 2 researches. The data of complete case information was analyzed by using RevMan5.3 software, and included studies were given evidence review by using online GRADEpro software. Results There were totally 6 studies collected including 4 randomized controlled trials (RCT) and 2 nonrandomized controlled trials (N-RCT) involved 280 patients. There were no reports on severe cardiovascular events and complications. Tai Chi exercise decreased instant blood pressure (BP) after exercise in CHD patients, but had no statistical significance compared with aerobic exercise (SBP: MD=-1, 95%CI:-3.89~1.89, P=0.50;DBP: MD=1, 95%CI:-0.62~2.62, P=0.23). Compared with control group, resting SBP seemed to have descending trend in Tai Chi group after Tai Chi exercise, but difference had no statistical significance (SBP: MD=-3.59, 95%CI:-8.70~1.52, P=0.17). Tai Chi exercise decreased significantly resting DBP in Tai Chi group compared with control group (MD=-5.50, 95%CI:-10.57~-0.43, P=0.03). The peak BP was slightly higher in Tai Chi group than that in control group but the difference had no statistical significance (SBP: MD=0.68, 95%CI:-11.10-12.45, P=0.91;DBP: MD=3, 95%CI:-3.28~9.28, P=0.35). GRADEprp evidence grading showed that evidence grade was low or very low. Conclusion Tai Chi exercise is safe and can reduce BP in CHD patients. Because of limitation of quantity and quality, more studies with higher quality are needed to verify the above conclusion needs.

Background: Tai Chi that originated in China as a martial art is an aerobic exercise with low-to-moderate intensity and may play a role in cardiac rehabilitation. Aim: To systematically review the effect of Tai Chi on cardiorespiratory fitness for coronary disease rehabilitation. Methods: We performed a search for Chinese and English studies in the following databases: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database. The search strategy included terms relating to or describing Tai Chi and coronary disease, and there were no exclusion criteria for other types of diseases or disorders. Further, bibliographies of the related published systematic reviews were also reviewed. The searches, data extraction, and risk of bias (ROB) assessments were conducted by two independent investigators. Differences were resolved by consensus. RevMan 5.3.0 was used to analyze the study results. We used quantitative synthesis if the included studies were sufficiently homogeneous and performed subgroup analyses for studies with different control groups. To minimize bias in our findings, we used GRADEpro to grade the available evidence. Results: Five studies were enrolled-two randomized controlled trials (RCTs) and three nonrandomized controlled trials (N-RCTs)-that included 291 patients. All patients had coronary disease. ROB assessments showed a relatively high selection and detection bias. Meta-analyses showed that compared to other types of low-or moderate-intensity exercise, Tai Chi could significantly improve VO(2)max [MD = 4.71, 95% CI (3.58, 5.84), P < 0.00001], but it seemed less effective at improving VO2max as compared to high-intensity exercise. This difference, however, was not statistically significant [MD = -1.10, 95% CI (-2.46, 0.26), P = 0.11]. The GRADEpro showed a low level of the available evidence. Conclusion: Compared to no exercise or other types of exercise with low-to-moderate intensity, Tai Chi seems a good choice for coronary disease rehabilitation in improving cardiorespiratory fitness. However, owing to the poor methodology quality, more clinical trials with large sample size, strict randomization, and clear description about detection and reporting processes are needed to further verify the evidence.

随着冠心病(CAD)介入治疗广泛应用于临床,介入治疗虽然可以快速有效地解决病人的病痛,但目前仍存在许多尚待解决的问题,如冠脉介入术后再狭窄、无复流、进行性心功能下降等,这些都是影响病人近期预后和远期心源性死亡及心脏事件的独立危险因素,需要引起足够的重视.中医药通过辨证论治在解决上述问题上发挥重要作用,本文从中医药方面综述了冠心病经皮冠状动脉介入术后心脏康复治疗的研究进展.

Objective To observe the effect of Ruanjian Tongmai decoction on post-PCI patients participating in phase Ⅲ of home-based cardiac rehabilitation (CR). Methods The outpatients following PCI (phase Ⅲ of CR) in our hospital during Jan 2015 to Jan 2016 were recruited to participate in the Randomized Controlled Trial (RCT). The patients were assigned into the control group or Ruanjian Tongmai decoction group (RJTMD). Both groups received home-base CR and western medicines following the guideline; the RJTMD group also received Ruanjian Tongmai decoction. The CQQC and the rate of traditional chinese medicine (TCM) symptoms were evaluated at the baseline and at 8 weeks. Results In total, 62 outpatients following PCI (phase Ⅲ of CR) were enrolled. During the intervention period, 3 were lost to follow-up, 1 took prohibited, and 2 take the initiative to quit. After 8 weeks, 56 participants remained with 28 in the RJTMD group and 28 in the control group. The total effective rate was 78.6% in the RJTMD group, significantly higher than 46.4% in the control group. Changes in scores of CQQC before and after the treatment show that both the RJTMD and the control can improve the patient's quality of life (QOL) from the four dimensions of illness, medical condition, general life and social psychological status; According to the changes in the scores of CQQC between the two groups, the improvement of the physical condition in the RJTMD group was superior to control group (P<0.01), and thus can more effectively improve the QOL of the patients (P<0.01). Conclusion After comprehensive CR, the RJTMD group had better effective rate and QOL than the control group, suggesting that Chinese herbal Ruanjian Tongmai Decoction can help to increase the effect of CR in phase Ⅲ .

Objective To study the effects of Chinese herbal medicine Qixuening on cardiac structure,function and ghrelin expression in rats with myocardial infarction.Methods Male SD rats were randomly divided into sham operation group,model group,Betaloc group,Qixuening low dose group and Qixuening high dose group.The rat model of myocardial infarction was produced by ligation of anterior descending branch of left coronary artery,and the sham operation group was operated by parallel operation without ligation.The rats had intragastric administration for 4 weeks.Then the cardiac structure and function were detected by echocardiography.The pathological changes of myocardium were observed by HE staining.And ghrelin and its receptor GHSR mRNA expression were detected by real time fltorescent quantitative PCR.Results Compared with the sham operation group,the interventricular septum end-stolic thickness got thinner,the left ventricular dimension was increased significantly(P ＜ 0.01),left ventricular ejection fraction and the left ventricular fractional shortening were decreased significantly(P ＜ 0.01)in the model group,Betaloc group,Qixuening low dose group and Qixuening high dose group;and the left ventricular end-systolic dimension in the model group increased significantly(P ＜0.05),cardiac tissue ghrelina and its receptor GHSR mRNA were increased(P ＜ 0.01).Compared with the model group,left ventricular ejection fraction and left ventricular fractional shortening were increased significantly(P ＜ 0.05) in Qixuening high dose group.Ghrelin and its receptor GHSR mRNA expression decreased significantly(P ＜0.05,P ＜0.01),and the pathological damage of myocardial tissue was improved in Betaloc group,Qixuening low dose group and Qixuening high dose group (P ＜ 0.05,P ＜ 0.01).Conclusion Chinese herbal medicine Qixuening can improve the cardiac structure and function,regulate the expression of ghrelin and its receptor GHSR mRNA in rats with myocardial infarction.

Fatal arrhythmias are the major causes of death after acute myocardial infarction (AMI). This study aimed to assess the association of ventricular remodeling and arrhythmia after myocardial infarction. Twelve rats were divided into model and sham groups (n= 6). The model group animals were submitted to AMI by left anterior descending coronary artery ligation. Sham operated animals wore wires without ligation. Echocardiography was used to assess cardiac structure and function after 8 weeks. Ventricular fibrillation was induced by electrical stimulation in vivo, and partial electrophysiological parameters were detected. In addition, myocardial tissue collagen expression was detected by improved Masson staining and immunohistochemistry. To determine the relationship between cardiac structure/pathology and heart physiological function, multiple linear regression was performed. Compared with sham rats, interventricular septal end diastole and systole (IVSd and IVSs), type III/I collagen ratios, ejection fraction (EF) and ventricular fibrillation threshold (VFT) values were reduced in the model group, while left ventricular diastolic and systolic dimension (LVDd and LVDs), total myocardial collagen, type I and III collagen contents significantly increased. In addition, left and right ventricular effective refractory period to the action potential duration at 90% repolarization level (ERP/APD(90)) ratios decreased significantly. Interestingly, a linear relationship was obtained between cardiac electrophysiological parameters and cardiac structure as well as myocardial tissue fibrosis. These findings indicate that prevention and treatment of ventricular remodeling is very important in reducing arrhythmia after myocardial infarction.

Objective To study the correlation analysis among oxidized low density lipoprotein (ox LDL),control of risk factors and cerebral infarction in patients with essential hypertension (EH). Methods The clinical data of 91 patients with EH were investigated. The changes of serum ox LDL levels were compared between patients with cerebral infarction and non cerebral infarction. The con-trol of risk factors,e.g,blood glucose and blood lipid were analyzed. Then the correlation among ox LDL,multiple risk factors and cerebral infarction in patients with hypertension were analyzed by Logistic regression analysis. Results Compared with the non cer-ebral infarction group,the level of serum ox LDL was significantly increased in the cerebral infarction group (16.78μg/dL±11.41μg/dL vs 35.42μg/dL± 23.11μg/dL,P<0.01). Compared with the no history of diabetes or dyslipidemia group,the non compliance rate of blood glucose,cholesterol and low density lipoprotein test results were significantly increasedin the history group (P<0.05 or P<0.01). The Logistic stepwise regression analysis confirmed that the odds ratios of ox LDL,high density lipoprotein and low density lipoprotein for hypertension complicated with cerebral infarction were 17.491,10.905 and 4.835,respectively (P<0.05 or P<0.01). Conclusion Hypertension complicated with cerebral infarction is closely related to elevated serum ox LDL levels and poor control of risk factors.

Objective:To compare effects on the contents of paeoniflorin and ferulic acid in Bazhen Yimu Decoction (BYD)prepared by machine-boiling method and marmite-boiling method.Method:BYD was decocted by traditional marmite and decocting machine respectively.Then the content of paeoniflorin and ferulic acid in the decoction were determinedby RP-HPLC.Imtakt C18column (250 mm ×4.6 mm,5 μm)was used with acetonitrile:0.3% phosphoric acid (14∶86)as the mobile phase,the flow rate was 1.0 mL/min,and the detection wavelengths of paeoniflorin and ferulic Acid were set at 230 nm and 322 nm with temperature at 25 ℃.Results:The content of paeoniflorin was slightly higher,and that of ferulic acid was similar in the marmite-boiling-decoction than those in the machine-boiling-decoction.Conclusion:The differences was not obvious from the contents of main effective components in the decoctions of BYD prepared by between machine-boiling method and marmite-boiling method.

Objective To summarize and evaluate the available evidence from randomized controlled clinical tri-als( RCTs)of baduanjin exercise for patients with coronary heart disease( CHD). Methods Databases were searched up to June 2015 with the terms baduanjin,ba duan jin,eight section brocades,cardiac,heart,coronary,myocardial,in the title,abstract,or key words. No language restrictions were imposed. The quality and validity of RCTs were evalua-ted using the Jadad Scale. Results Three RCTs met the inclusion criteria. These studies examined the effectiveness of baduanjin exercise for patients with CHD and demonstrated limited favorable effects of improving the quality of life and easing the angina. Conclusions The existing evidence suggests that baduanjin exercise is hopeful to benefit the pa-tients with CHD as a kind of rehabilitation programs. More researches are needed to prove the effectiveness of baduan-jin for CHD.

Objective:To investigate the TCM syndrome and treatment evolving rules and medicating charac-ters for heart failure (stage C) induced by coronary atherosclerotic heart disease (CHD for short) in clinic. Methods:The medical records of 151 CHD patients' with heart failure from January 2010 to December 2013 in Dongzhimen Hospital of Beijing University of Chinese Medicine were gathered by information collection table. The evolution rules of TCM syndromes and the medication by Qi-supplementing and blood-activating medicine as well as western medicine for CHD patients with heart failure (stage C) were reviewed and analyzed. Results:The TCM syndrome of heart failure (stage C) induced by CHD mainly was qi deficiency and blood stasis syndrome and its development had certain correlation with the combination of western medicine (P=0.012). Conclusion:Qi deficiency and blood stasis are the basic pathological factors for the development of heart failure (stage C) induced by CHD. The conventional treatment by western medicine with the combination of qi-supplementing and blood-activating medicine can post-pone the development of heart failure in a certain degree, which indicates that the early application of supplementing Qi and activating blood circulation method has positive meaning for the treatment of heart failure (stage B) due to CHD in clinic.

Objective To study the reference value of neuron specific enolase (NSE)for the diagnosis of cerebral infarction and the differentiation of traditional Chinese medicine (TCM)syndrome in hypertensive patients.Methods Clinical data of 174 cases of pa-tients with essential hypertension were col ected.The serum concentration of NSE was detected by Enzyme linked immunosorbent assay (ELISA).The clinical value,the Optimal Operating Point (OOP)and discriminatory power of NSE to diagnose cerebral infarc-tion were determined by using the Receiver Operating Characteristic (ROC)curves in hypertensive patients.Then the correlation be-tween NSE and TCM syndromes were analyzed.Results Compared with non infarction group,the serum concentration of NSE was increased significantly in hypertension complicated with cerebral infarction group (4.49μg/L± 1.23μg/L vs 3.20μg/L± 2.01μg/L, P<0.01).The area under the curve was 0.785 with a certain accuracy (P<0.01).The OOP of NSE was determined and interpreted at 4.27μg/L,corresponding to 67.6% sensitivity and 81.8% specificity.Compared with non phlegm syndrome group,the serum con-centration of NSE was increased significantly in phlegm syndrome group (4.48μg/L± 1.31μg/L vs 3.23μg/L± 2.00μg/L,P<0.01). Correlation analysis showed that there was a positive correlation between NSE and phlegm syndrome (r= 0.385,P<0.01).Con-clusion NSE has some reference value for the diagnosis of cerebral infarction and the differentiation of phlegm syndrome in hyper-tensive patients.

Objective To observe the clinical value of detecting serum interleukin-6 ( IL-6 ) for the diagnosis and syndrome differentiation of ischemic stroke in patients with hypertension. Methods The concentrations of serum IL-6 in 189 cases of patients with essential hypertension were detected. The differ-ences in IL-6 concentration were compared between the hypertension group complicated with ischemic stroke and the hypertension group without ischemic stroke. The clinical value of serum IL-6 for the diagno-sis of ischemic stroke was determined by using the receiver operating characteristic ( ROC) curves. Then the differences in Traditional Chinese Medicine ( TCM) syndromes under different levels of concentrations of IL-6 were analyzed, and based on the analysis, the correlation between IL-6 and TCM syndromes were further explored. Results Compared with the hypertension group without ischemic stroke, the concentra-tion of serum IL-6 [Median (25th percentile, 75th percentile)] was significantly higher in the hyperten-sion group complicated with ischemic stroke [21. 47 (5. 52, 45. 44) vs 2. 92 (1. 68, 4. 67) pg/mL, P<0. 01]. The area under ROC curves in the diagnosis of ischemic stroke in patients with hypertension by means of serum IL-6 was 0. 784 (P<0. 01). The optimal cut-off point of IL-6 was 10. 10 pg / mL, with a corresponding sensitivityof 72. 1% and specificity of 88. 4%. Compared with the low IL-6 concentration group, the probability of occurrence of phlegm syndrome increased and the probability of occurrence of defi-ciency syndrome decreased in the high IL-6 concentration group (P<0. 01). Furthermore the correlation analysis showed that there was a positive correlation between IL-6 and phlegm syndrome (r=0. 404, P<0. 01). Conclusion Serum IL-6 has some reference value in the diagnosis of ischemic stroke and can as-sist TCM in the differentiation of phlegm syndrome in patients with hypertension.

ObjectiveTo investigate the laws of distribution and combination of traditional Chinese medicine (TCM) syndromes of patients with diastolic heart failure (DHF); To research the relevance between TCM syndromes and DHF.Methods A four diagnostic information survey was conducted among 124 DHF patients in order to analyze their basic information and information about TCM four diagnostic methods. Statistical analysis method was used to determine the syndrome types of the DHF patients and the features of syndrome combination.ResultsMost DHF patients were in their sixties or seventies, the number of female patients was larger than that of male patients, and their heart function was in II or III grade. Qi deficiency, phlegm turbidity, Qi stagnation, blood stasis, water stagnation, Yang deficiency and Yin deficiency were the common syndromes. Two-card combination and three-card combination were more common, mainly with Qi deficiency, phlegm turbidity or blood stasis as the main patterns of manifestation. Conclusion This research could provide a clinical basis for the establishment of the standard for the TCM syndromes DHF.

Objective. To explore the mechanism of cardioprotective effects of Chinese medicine, Yiqi Huoxue recipe, in rats with myocardial infarction-(MI-) induced heart failure. Methods. Male Sprague-Dawley rats underwent left anterior descending artery (LAD) ligation or sham operation. The surviving MI rats were divided randomly into three groups: MI (5 mL/kg/d NS by gavage), MI + Metoprolol Tartrate (MT) (12mg/kg/d MT by gavage), andMI + Yiqi Huoxue (5 mL/kg recipe by gavage). And the sham operation rats were given 5 mL/kg/d normal saline. Treatments were given on the day following surgery for 4 weeks. Then rats were detected for heart structure and function by transthoracic echocardiography. Apoptosis in heart tissues was detected by TUNEL staining. To determine whether the endoplasmic reticulum (ER) stress response pathway is included in the cardioprotective function of the recipe, ER stress related proteins such as GRP78 and caspase-12 were examined. Results. Yiqi Huoxue recipe attenuated heart function injury, reversed histopathological damage, alleviated myocardial apoptosis and inhibited ER stress in MI rats. Conclusion. All the results suggest that Yiqi Huoxue recipe improves the injured heart function maybe through inhibition of ER stress response pathway, which is a promising target in therapy for heart failure.

Objective To study the correlation between interleukin 6 (IL 6),cardiovascular and cerebrovascular infarction events, and traditional Chinese medicine (TCM)syndrome in patients with hypertension.Methods Clinical data of 226 patients with essential hypertension were collected.The serum concentration of IL 6 was detected by ELISA.Then the correlation between IL 6,infarction events and TCM syndromes were analyzed.Results The analysis showed that cardiovascular and cerebrovascular infarction events was positively correlated with the serum concentration of IL 6 (P<0.01).Compared with non phlegm syndrome group,the serum concentration of IL 6 was increased significantly in phlegm syndrome group (P<0.01).Furthermore,there was a positive correla-tion between IL 6 and phlegm syndrome (P<0.01).Conclusion IL 6 had some reference value to evaluate the risk of the cardio-vascular and cerebrovascular events and to assist TCM differentiation of phlegm syndrome in patients with hypertension.

目的：在近50年中，对于急性心肌梗死的治疗，我们经历了心脏冠状动脉非再灌注治疗和再灌注治疗的时代，也正面临着进入以心肌细胞为中心的诊治心肌缺血时代。

Vascular remodeling occurs in atherosclerosis, hypertension, and restenosis after percutaneous coronary intervention. Adventitial remodeling may be a potential therapeutic target. Yiqihuoxuejiedu formula uses therapeutic principles from Chinese medicine to supplement Qi, activate blood circulation, and resolve toxin and it has been shown to inhibit vascular stenosis. To investigate effects and mechanisms of the formula on inhibiting vascular remodeling, especially adventitial remodeling, rats with a balloon injury to their common carotid artery were used and were treated for 7 or 28 days after injury. The adventitial area and α -SMA expression increased at 7 days after injury, which indicated activation and proliferation of adventitial fibroblasts. Yiqihuoxuejiedu formula reduced the adventitial areas at 7 days, attenuated the neointima and vessel wall area, stenosis percent, and α -SMA expression in the neointima, and reduced collagen content and type I/III collagen ratio in the adventitia at 28 days. Yiqihuoxuejiedu formula had more positive effects than Captopril in reducing intimal proliferation and diminishing stenosis, although Captopril lowered neointimal α -SMA expression and reduced the collagen content at 28 days. Yiqihuoxuejiedu formula has inhibitory effects on positive and negative remodeling by reducing adventitial and neointimal proliferation, reducing content, and elevating adventitial compliance.

目的:研究碎裂QRS波(FQRS)在急性冠状动脉综合征(ACS)中的作用.方法:入选我院84例确诊为ACS的住院患者,分为ST抬高性心肌梗死(STEMI)组及非ST抬高性ACS(NSTE-ACS)组.观察FQRS波有无.冠状动脉造影结果行Gensini系统评分.超声心动图检查左室收缩及舒张末期内径,计算左室射血分数.测定心肌钙蛋白和肌酸激酶同工酶(CK-MB).结果:FQRS波与Gensini积分和CK-MB相关；FQRS波在STEMI组阳性率高于NSTE-ACS组(91.4％∶75.5％,P-0.051)；FQRS波在ACS中的阳性率为82.14％.结论:FQRS波可以作为ACS的诊断指标.

To investigated the involvement of pulmonary function impairment in ulcerative colitis (UC), to explore a scientific basis for the Chinese medicine (CM) theory of exterior-interior correlation between Lung (Fei) and Large intestine (Dachang).

目的 探讨急性心肌梗死患者心电图ST改变的导联与冠状动脉罪犯血管的关系.方法 对93例急性心肌梗死患者心电图ST段改变与选择性冠状动脉造影结果进行对比分析.结果 心电图V1～V4ST抬高伴Ⅱ、Ⅲ、aVF ST段下移的罪犯血管主要为左前降支(LAD),少数前壁心肌梗死伴下壁ST段抬高;Ⅱ、Ⅲ、aVF ST抬高伴V1～V4ST段下移的主要罪犯血管为右冠状动脉(RCA),少部分为左回旋支(LCX),极少部分为LAD;胸前导联T高尖与ST抬高导联不一致可排除LAD;高侧壁Ⅰ、AVL ST段抬高多数罪犯血管为LCX.结论 心电图ST改变的导联对急性心肌梗死罪犯血管能进行初步预测.