This study systematically elucidates the chemical-mechanical synergy mechanism of WC-Co cemented carbide inserts across diverse chemical environments through comprehensive static corrosion characterization and chemical mechanical polishing experiments. The results demonstrate that the corrosion process in WC-Co cemented carbide is driven by galvanic coupling, with material removal behavior highly dependent on the nature of the chemical reagents. In weakly oxidizing H2O2 and moderately strong H3PO4 environments, the surface-formed oxide film lacks protective capability, and the kinetics of material removal are predominantly governed by the corrosion rate of the cobalt-based binder. Upon dissolution of the cobalt-based binder to a critical extent, mechanical stress localizes at exposed WC grains, leading to direct detachment of fine grains and surface embrittlement followed by spalling of coarse grains, enabling surface material removal via the alternating interplay between chemical corrosion and mechanical action. In strongly oxidizing acidic KMnO4 solution, a dense and protective oxide layer forms on the surface, giving rise to a "chemical film formation-mechanical film removal" synergistic mechanism. In contrast, in neutral (Na2SO4, NaCl) and alkaline (KOH) environments, passivation of 1the cobalt phase yields a stable oxide film with negligible chemical reactivity, rendering material removal primarily mechanical through grinding-dominated processes. These findings provide a crucial theoretical foundation for the rational design of specialized polishing slurries and the optimization of polishing processes for high-performance WC-Co cemented carbide inserts.

Objective:This multicenter, double-blind, randomized controlled trial sought to assess the clinical efficacy of Taoren Honghua Jian (THJ) in patients with coronary artery disease (CAD) exhibiting Qi stagnation and blood stasis syndrome, and investigated its effect on NLRP3 inflammasome expression in peripheral blood mononuclear cells (PBMCs). Methods:One hundred and twenty eligible CAD patients from three Shanghai hospitals were randomized to receive either the THJ granule (18.3 g, twice daily) or placebo for four weeks, with a four-week follow-up. Traditional Chinese Medicine Syndrome Score (TCMSS), Seattle Angina Questionnaire (SAQ), and lipid levels were measured before and after treatments. NLRP3 inflammasome components were examined in PBMCs using quantitative PCR, whereas plasma inflammatory cytokines were detected using ELISA. Results:A total of 120 participants participated in the trial. The THJ group showed reduced TCMSS compared to the placebo group (P < 0.01). After four weeks of intervention, the THJ group scored considerably higher on five SAQ aspects compared to the placebo group (P < 0.01). However, lipid levels showed no significance. In PBMCs, THJ lowered mRNA expression of NLRP3 inflammasome components (NLRP3, ASC, caspase-1, IL-1β, IL-18) (P < 0.01). Patients in the THJ group showed significantly lower plasma levels of IL-1β, IL-2, and IL-18 following therapy compared to the placebo group (P < 0.01). Conclusion:THJ reduces angina symptoms and improves quality of life in CAD patients, which suggests that it suppresses NLRP3-related transcriptional activity and hence reduces pro-inflammatory cytokine production. These data suggest that THJ might be an effective adjuvant treatment for inflammation-driven coronary atherosclerosis.

To evaluate the clinical efficacy of Taoren Honghua Jian Granule (THJ) in stable coronary artery disease (SCAD) patients with syndrome of qi stagnation and blood stasis, and to investigate its effect on the expression of NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome in peripheral blood mononuclear cells (PBMCs). In this multicenter, double-blind, randomized controlled trial, 80 eligible SCAD patients from 3 Shanghai hospitals were randomly assigned to receive either the THJ (18.3 g, twice daily, orally) or a matched placebo for 4 weeks 40 in each group, followed by a 4-week follow-up. Chinese medicine (CM) Syndrome Scores and Seattle Angina Questionnaire (SAQ) assessments were conducted pre- and post-intervention. Quantitative PCR was used to analyze mRNA levels of NLRP3 inflammasome components [NLRP3, apoptosis-associated speck-like protein (ASC), caspase-1, interleukin (IL)-1β, and IL-18] in PBMCs, while ELISA was used to detect plasma inflammatory cytokines [IL-10, IL-1β, IL-2, IL-6, IL-8, IL-18, tumor necrosis factor (TNF-α), and high-sensitive C-reactive protein (hs-CRP)]. After 4 weeks of treatment, the overall treatment efficacy was higher in the treatment group than in the placebo group; the CM syndrome scores of the two groups were significantly lower after treatment, and the THJ group was considerably lower than the placebo group (P<0.05, P<0.01). The THJ group had significantly higher scores for 5 SAQ dimensions than the placebo group (P<0.01). Both mRNA expression of NLRP3 inflammasome components (NLRP3, ASC, caspase-1, IL-1β, IL-18) decreased in PBMCs (P<0.01). In addition, plasma levels of IL-2, IL-8, IL-18, and TNF-α significantly decreased in THJ group compared with the placebo group after treatment (P<0.05, P<0.01). THJ alleviates angina symptoms and improves quality of life in SCAD patients, potentially through NLRP3 inflammasome inhibition and subsequent attenuation of pro-inflammatory cytokine release. These findings position THJ as a promising adjunct therapy for inflammation-driven coronary atherosclerosis. (Registration No. ChiCTR1900021772)

Tilting pad thrust bearings are widely utilized in large rotating machinery such as steam turbines and hydraulic turbines. Defects in their shaft tiles directly impact lubrication characteristics, thereby influencing the overall safety performance of the entire unit. To address this issue, this paper presents a fault diagnosis method for tilting pad thrust bearings using a modified multi-feature fused convolutional neural network (MMFCNN). Initially, an experimental bench for diagnosing faults in tilting pad thrust bearings was developed to collect multi-channel acoustic emission (AE) signals from both normal and faulty pads. Subsequently, the squeeze-and-excitation (SE) module was employed to reallocate the weights of each channel and fuse the features of multi-channel signals. Learning was then conducted on the signal fused with multiple features using the inverse-add module and spanning convolution. Next, a comparative analysis was carried out among the CNN1D, ResNet, and DFCNN models, and the MMFCNN model proposed in this study. The results show that under consistent operating conditions, the MMFCNN model achieves an average fault diagnosis accuracy of 99.58% when utilizing AE signal data from tilting pad thrust bearings in four states as inputs. Furthermore, when different operational conditions are introduced, the MMFCNN model also outperforms other models in terms of accuracy.

Abstract Background Dilated cardiomyopathy (DCM) is a severe condition characterized by cardiac enlargement and declining heart function, often leading to refractory heart failure and life-threatening outcomes. Globally, and particularly in China, a notable challenge arises from the insufficient availability of targeted therapies demonstrating significant efficacy for DCM. Additionally, the application of traditional anti-heart failure drugs in DCM is constrained, as many patients exhibit a propensity for hypotension or show limited improvement in their heart failure symptoms. Kuoxin Formula (KXF), an internally agreed-upon prescription at Longhua Hospital, is supported by clear biological evidence for improving cardiac function and myocardial remodeling. Previous clinical studies have also demonstrated its potential to improve patients' quality of life. This trial aims to further evaluate the safety and efficacy of KXF in treating DCM -related heart failure. Method This prospective, randomized, double-blind, placebo-controlled, multicenter trial recruits 230 patients diagnosed with DCM (Qi-Yin deficiency combined with blood stasis syndrome) from five centers. Participants will be randomly assigned in a 1:1 ratio to either the KXF treatment group or a placebo group. The treatment will span 12 weeks, during which key indicators and adverse events will be monitored. The primary outcome is the proportion of patients whose NT-proBNP decreased by more than 30%. The secondary outcomes include the NYHA functional classification, TCM syndrome scores, echocardiographic parameters, TGF-β, PICP, CITP, galectin-3, ST2 levels, 6MWT, Lee's heart failure score, and MLHFQ score. Discussion: This study will be the first multicentered research conducted in China that utilizes a randomized, double-blind, placebo-controlled design to investigate the use of TCM in the treatment of dilated cardiomyopathy. It seeks to develop new theoretical frameworks and provide solid clinical data to support the integration of TCM and modern medicine in treating heart failure in DCM patients. Trial Registration: China Clinical Trial Registry, ChiCTR2300068937. Registered on March 1, 2023.

Background: Dilated cardiomyopathy (DCM) is a severe heterogeneous cardiomyopathy characterized by cardiac enlargement and declining heart function, often leading to refractory heart failure and life-threatening outcomes, particularly prevalent in China. The challenge lies in the scarcity of targeted therapies with substantial efficacy for DCM. Additionally, traditional anti -heart failure drugs are constrained due to hypotension propensity or limited symptom improvement. Kuoxin Formula (KXF), internally endorsed at Longhua Hospital, demonstrates clear biological evidence for enhancing cardiac function and myocardial remodeling. Previous clinical studies suggest its potential to enhance patients' quality of life. This trial aims to further evaluate KXF's safety and efficacy in managing DCM-related heart failure. Methods: This prospective, randomized, double -blind, placebo-controlled, multicenter trial aims to recruit 230 DCM patients from five centers. Participants will be randomly assigned to either KXF or placebo for 12 weeks, with careful monitoring of key indicators and adverse events. The primary outcome measures the proportion of patients with NT-proBNP reduction exceeding 30%. Secondary outcomes include New York Heart Association functional classification, Traditional Chinese Medicine syndrome scores, 6 -minute walk test, Lee's heart failure score, and Minnesota Heart Failure Quality of Life Scale score. Ventricular remodeling will be assessed using cardiac ultrasound and ELISA. Safety metrics and adverse events will be meticulously recorded. Discussion: This study will be the first multicentered research conducted in China that utilizes a randomized, double -blind, placebocontrolled design to investigate the use of TCM in the treatment of DCM. It seeks to develop new theoretical frameworks and provide solid clinical data to support the integration of TCM and modern medicine in treating heart failure in DCM patients. Trial Registration: China Clinical Trial Registry, ChiCTR2300068937. Registered on March 1, 2023. https://www.chictr.org.cn/bin/ project/edit?pid=190926 .

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To improve the surface integrity of ZA27 alloy, a method of chemical mechanical polishing (CMP) considering the galvanic corrosion at the Zn/Al interface is proposed to treat the surface of ZA27 alloy. Firstly, the electrochemical experiment is carried out to study the influence of the pH, H 2 O 2 concentration, and glycine concentration on corrosion potential between zinc and aluminum. Then the Taguchi method integrated with grey relation analysis and fuzzy inference are used to optimize the CMP parameters of ZA27 alloy. Finally, the prediction model of the MRR and surface roughness Ra is established using the mathematical regression analysis method. The experimental results showed that the minimum zinc-aluminum corrosion potential difference is 14 mV when the pH is 10, H 2 O 2 concentration is 1 wt%, and glycine concentration is 0.4 wt%. The optimum CMP parameter is the polishing pressure of 34 kPa, the polishing plate’s rotational speed of 70 rpm, and the abrasive particle concentration of 15 wt%. After polishing with the optimum CMP parameter, the MRR is 242 nm min −1 , and the surface roughness Ra is 13.91 nm. This study demonstrates that the CMP considering the galvanic corrosion at the Zn/Al interface is an effective method for treating ZA27 alloy surface.

Acute arterial embolism due to tumor embolus is a rare complication in cancer patients, even rarer is lung tumor embolization leading to acute myocardial infarction. We report a patient who had a diagnosis of acute myocardial infarction(AMI)which was brought on by a coronary artery embolism by a metastatic lung cancer tumor. Clinicians need to be aware that tumor embolism can result in AMI. An 80-yeal-old male patient presented with persistent chest pain for 2 h and his electrocardiogram(ECG)showed anterior ST-segment elevation myocardial infarction. Instead of implanting a stent, thrombus aspiration was performed. Pathological examination of coronary artery thrombosis showed that a few sporadic atypical epithelial cells were scattered in the thrombus-like tissue. Combined with immune phenotype and clinical history, metastatic squamous cell carcinoma is more likely. We report a rare case of a patient who was diagnosed of AMI due to a coronary artery embolism by a metastatic mass from lung cancer. Since there is no evidence-based protocol available for the treatment of isolated coronary thrombosis, we used thrombus aspiration to treat thrombosis rather than implanting a stent.

Typical edge defects in the edge region of a new cemented carbide insert without edge preparation include burrs, poor surface quality, micro-breakages, and irregularities along the edge. To address the problems in new cemented carbide inserts without edge preparations, a chemical–mechanical synergistic preparation (CMSP) method for the cemented carbide insert cutting edge was proposed. Firstly, the CMSP device for the insert cutting edge was constructed. Then, the polishing slurry of the CMSP for the insert cutting edge was optimized using the Taguchi method combined with a grey relation analysis and fuzzy inference. Finally, orthogonal experiments, the Taguchi method, and analysis of variance (ANOVA) were used to investigate the effect of the polishing plate’s rotational speed, swing angle, and input frequency of the controller on the edge preparation process, and the parameters were optimized. The results showed that the best parameter combination for the polishing slurry for the cemented carbide inserts was the mass concentration of the abrasive particle of 10 wt%, the mass concentration of the oxidant of 10 wt%, the mass concentration of the dispersant of 2 wt%, and the pH of 8. The CMSP process parameter combination for the linear edge had the polishing plate’s rotational speed of 90 rpm, the swing angle of 6°, and the input frequency of the controller of 5000 Hz. The optimum CMSP process parameter combination for the circular edge had the polishing plate’s rotational speed of 90 rpm, the swing angle of 6°, and the input frequency of the controller of 7000 Hz. The polishing plate’s rotational speed had the most significant impact on the edge preparation process, followed by the swing angle, and the effect of the input frequency of the controller was the smallest. This study demonstrated that CMSP is a potential way to treat the cemented carbide insert cutting edge in a tool enterprise.

To address the challenges associated with nonlinearity, non-stationarity, susceptibility to redundant noise interference, and the difficulty in extracting fault feature signals from rolling bearing signals, this study introduces a novel combined approach. The proposed method utilizes the variational mode decomposition (VMD) and K-singular value decomposition (K-SVD) algorithms to effectively denoise and enhance the collected rolling bearing signals. Initially, the VMD method is employed to separate the overall noise into intrinsic mode functions (IMFs), reducing the noise content within each IMF. To optimize the mode component, K, and the penalty factor, α, in VMD, an improved arithmetic optimization algorithm (IAOA) is employed. This ensures the selection of optimal parameters and the decomposition of the signal into a set of IMFs, forming the original dictionary. Subsequently, the signals are decomposed into multiple IMFs using VMD, and an original dictionary is constructed based on these IMFs. K-SVD is then applied to the original dictionary to further reduce the noise in each IMF, resulting in a denoised and enhanced signal. To validate the efficacy of the proposed method, rolling bearing signals collected from Case Western Reserve University (CWRU) and thrust bearing test rigs were utilized. The experimental results demonstrate the feasibility and effectiveness of the proposed approach in denoising and enhancing the rolling bearing signals.

Although doxorubicin (DOX) is an efficient chemotherapeutic drug for human tumors, severe cardiotoxicity restricts its clinical use. Cinnamaldehyde (CA), a bioactive component isolated from Cinnamonum cassia, possesses potent anti-oxidative and anti-apoptotic potentials. The major aim of this study was to evaluate the protective role of CA against DOX-induced cardiotoxicity. To this end, cardiomyocyte injury models were developed using DOX-treated H9c2 cells and DOX-treated rats, respectively. Herein, we found that CA treatment increased cardiomyocyte viability and attenuated DOX-induced cardiomyocyte death in vitro. CA further protected rats against DOX-induced cardiotoxicity, as indicated by elevated creatine kinase (CK) and lactate dehydrogenase (LDH) levels, myocardium injury, and myocardial fibrosis. CA alleviated DOX-induced myocardial oxidative stress by regulating reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione (GSH) levels. Mechanistically, CA markedly accelerated nuclear translocation of nuclear erythroid factor 2-related factor 2 (Nrf2) and increased heme oxygenase-1 (HO-1) expression. Consequently, CA decreased DOX-induced cardiomyocyte ferroptosis, while Erastin (a ferroptosis agonist) treatment destroyed the effect of CA on increasing cardiomyocyte viability. Taken together, the current results demonstrate that CA alleviates DOX-induced cardiotoxicity, providing a promising opportunity to increase the clinical application of DOX.

目的:研究调心方治疗冠心病伴焦虑/抑郁患者临床疗效及对血清5-羟色胺(5-HT)、p-血小板球蛋白(β-TG)及髓过氧化物酶(MPO)水平的影响.方法:将66例诊断为冠心病伴焦虑/抑郁状态患者,随机分为调心方组和黛力新组,每组33例.在冠心病常规西药治疗的基础上,黛力新组同时予西药黛力新治疗,调心方组予中药调心方治疗.连续服药治疗8周,观察治疗前后各组患者临床疗效、患者健康问卷(PHQ-9)量表、广泛性焦虑(GAD-7)量表、西雅图心痛(SAQ)量表、心率变异性分析、血清5-HT、β-TG及MPO水平变化两组患者不良反应发生率.结果:两组患者基线各项指标差异均无统计学意义,两组具有可比性.治疗8周后,调心方组的中医证候疗效总有效率87.88％(29/33),优于黛力新组的63.64％(21/33)(Z=-2.653,P＜0.05).与本组治疗前比较,治疗4、8周时,两组患者PHQ-9量表、GAD-7量表积分均明显下降(P＜0.05),治疗后两组间差异无统计学意义.与本组治疗前比较,治疗4、8周时,两组患者SAQ量表各维度积分均明显升高(P＜0.05);与黛力新组比较,治疗后调心方组患者的躯体活动受限程度及心绞痛稳定状态两个维度积分明显升高(P＜0.05).与本组治疗前比较,治疗后两组患者血清5-HT水平均明显升高,血清β-TG、MPO水平明显降低(P＜0.05);与黛力新组比较,两组间差异无统计学意义.与本组治疗前比较,调心方组心率变异性时域指标R-R间期的总体标准差(SDNN)及R-R间期平均值标准差(SDANN)明显升高(P＜0.05);与黛力新组比较,治疗后调心方组时域指标SDNN、SDANN明显升高(P＜0.05).试验期间药物不良反应发生率调心方组明显低于黛力新组(P＜0.05).所有患者研究过程中无临床不良事件发生.结论:中药调心方能改善冠心病伴焦虑/抑郁患者临床症状,升高血清5-HT水平,降低血清β-TG、MPO水平,药物不良反应少且安全性高,具有较高临床价值,值得推广.

Aiming at defects such as small pits and scratches on the surface caused by the aggregation of alumina particles during the chemical mechanical polishing (CMP) process of the cemented carbide inserts, the effect of the dispersant types, pH and dispersant concentration on the dispersion stability of the alumina suspension is investigated. It is found that sodium dodecyl sulfate (SDS) is the best dispersant of the six different dispersants, and the suspension has good dispersion stability when the pH value is 11 and the SDS concentration is 3 wt%. Furthermore, based on the DLVO theory, SDS is verified to improve suspension stability at the micro-scale. Finally, the insert CMP experiments are carried out using the polishing slurry with SDS and without dispersant. CMP experiments show that using the polishing slurry with SDS to polish the insert can achieve a better material removal rate (MRR) and lower surface roughness.

目的 观察参蛤散对H9c2心肌细胞增殖的影响,为参蛤散后续研究提供依据.方法 采用H9c2心肌细胞株,制备参蛤散冻干粉进行干预,在24 h、48 h、72 h各时间点,用细胞计数试剂盒-8(CCK-8)法检测细胞吸光度值(OD值),细胞划痕实验检测细胞迁移率.结果 24 h参蛤散0.03 mg/mL、0.10 mg/mL、0.30 mg/mL、1.00 mg/mL组OD值高于对照组(P<0.05);48 h参蛤散各浓度组OD值均高于对照组(P<0.05);72 h参蛤散0.01 mg/mL组OD值高于对照组(P<0.05),其余组与对照组比较差异均无统计学意义(P>0.05).24 h参蛤散0.10 mg/mL、0.30 mg/mL、1.00 mg/mL组细胞迁移率大于对照组(P<0.05);48 h参蛤散0.01 mg/mL、0.10 mg/mL、0.30 mg/mL组细胞迁移率大于对照组(P<0.05);72 h参蛤散0.01 mg/mL、0.30 mg/mL组细胞迁移率大于对照组(P<0.05).结论 参蛤散可以促进H9c2心肌细胞增殖.

Doxorubicin, sold under the brand name Adriamycin among others, is an important drug for cancer therapy; however, its use is limited by its cardiotoxicity. Ginsenoside Rg2 is extracted from Panax ginseng C.A.Mey., Araliaceae, which is believed to have cardioprotective properties. However, to date, there have been no reports on whether ginsenoside Rg2 could protect cardiomyocytes against doxorubicin. In this study, we investigated the action and the underlying mechanisms of cardioprotection of ginsenoside Rg2 upon doxorubicin treatment. Cell counting kit-8 was used to determine cell viability; in addition, terminal deoxynucleotidyl transferase–mediated dUTP nick-end labeling staining was used to detect apoptotic cells. Western blotting was used to investigate the relevant pathways. LY294002, a phosphatidylinositol 3-kinase inhibitor, was also used in this study. Ginsenoside Rg2 significantly ( p < 0.01) neutralized cardiomyocyte apoptosis induced by doxorubicin in a dose-dependent manner, but this effect was blocked by LY294002. Furthermore, ginsenoside Rg2 upregulated protein kinase B phosphorylation through the phosphatidylinositol 3-kinase/protein kinase B pathway and inhibited p53 expression. These results suggest that ginsenoside Rg2 could attenuate doxorubicin-induced cardiomyocyte apoptosis via the phosphatidylinositol 3-kinase/protein kinase B pathway. Graphical abstract

目的 观察益气养阴方联合阿胶治疗气阴两虚型慢性心力衰竭的临床疗效.方法 选取2016年7月—2018年6月上海中医药大学附属龙华医院心病科收治的气阴两虚型慢性心力衰竭病人105例,随机分为对照组、治疗A组和治疗B组,每组35例.对照组予常规西药抗心力衰竭治疗,治疗A组在对照组基础上加用益气养阴方,治疗B组在治疗A组基础上加阿胶,3组均治疗8周.观察两组治疗前后中医证候积分、6 min步行距离、心脏射血分数(EF)、每搏输出量(SV)变化.结果 治疗后,3组中医证候积分、6 min步行距离、EF、SV均较治疗前改善(P<0.01);与对照组比较,治疗A组和治疗B组中医证候积分、6 min步行距离、EF、SV改善均更明显(P<0.01);与治疗A组比较,治疗B组中医证候积分、6 min步行距离改善更明显(P<0.05).结论 益气养阴方可以改善慢性心力衰竭病人中医证候积分、6 min步行距离、EF、SV,联合阿胶可进一步增强其疗效.

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias and can lead to heart failure (HF), stroke, pulmonary embolism (PE), and other complications, seriously affecting people’s quality of life and health. Western medicine is limited in the treatment of AF, while Traditional Chinese Medicine (TCM) has unique advantages, such as less side effects, low toxicity, long effect duration, and high compliance. The prescription of HTDJ is a common prescription for the treatment of atrial fibrillation in Longhua Hospital, Shanghai University of Traditional Chinese Medicine. It has been used for many years and has a large number of clinically effective cases. It has a good clinical application prospect, but there is a lack of effective evaluation of its clinical efficacy. This study adopts a randomized double-blind, single-simulated, placebo-controlled research method. Participants were randomly assigned in a 1:1 ratio through a centrally controlled, computer-generated, simple randomization schedule. Participants would take the medicine for 1 month, and the curative effect would be evaluated. Subsequently, the participants would not take TCM and only receive western medicine treatment. They would be followed up for another 8 weeks, and a clinical evaluation would be conducted. The secondary outcomes include echocardiography, Hamilton Anxiety Scale, Hamilton Depression Scale, rate of increase and decrease of anti-arrhythmia western medicine, the MOS 36-item short-form health survey, N-terminal-pro hormone B-type natriuretic peptide level, and integral TCM syndrome score. Adverse events will be monitored throughout the trial. Cases are from outpatient and inpatient with atrial fibrillation in the Cardiology Department of Longhua Hospital. Evaluations will be conducted at baseline and at weeks 4 and 12 after randomization. In this study, the efficacy and safety of HTDJ plus western medicine in the treatment of atrial fibrillation (qi deficiency and phlegm opacities) will be evaluated, so as to provide medical evidence of short-term and medium-term clinical efficacy for the treatment of atrial fibrillation with integrated traditional and western medicine and lay a foundation for further clinical development and application. ClinicalTrials.gov ChiCTR2000030517 . Registered on March 5, 2020, with the Chinese Clinical Trial Registry

BackgroundHeart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by diastolic dysfunction. Despite the increasing incidence of HFpEF, there is no available therapy that reduces the mortality rate of HFpEF. Zhigancao Tang has been used traditionally for the treatment of cardiovascular diseases in China. The use of traditional Chinese medicine (TCM) is associated with improvements in clinical syndromes and quality of life of patients. A randomized clinical trial should be conducted to provide clear evidence regarding the efficacy and safety of Zhigancao Tang granules for the treatment of HFpEF.MethodsA randomized, double-blinded, placebo-controlled clinical trial was proposed. A total of 122 patients with HFpEF will be randomly assigned to receive Zhigancao Tang granules or placebo for 12weeks. The primary outcome measure is cardiac function. The secondary outcomes include measurement of the integral TCM syndrome score, echocardiography, 6-min walk test, N-terminal-pro hormone B-type natriuretic peptide level, atrial natriuretic peptide level, Minnesota Living with Heart Failure scale, and Lee's scale. The outcome measures will be evaluated at baseline, 4weeks, and 12weeks. Adverse events will be evaluated from baseline till the 12-week follow-up period.DiscussionThe results of this trial will demonstrate whether Zhigancao Tang granules are effective and safe for treating HFpEF.Trial registrationClinicalTrials.gov NCT04317339. Registered on 23 March 2020.