Myocardial ischemia-reperfusion injury (MIRI) is a key factor affecting the prognosis of myocardial infarction patients. Currently, there remains a lack of specific drugs targeting MIRI, and it is unclear whether Piceatannol-3'-O-β-D-glucopyranoside (PG) improves MIRI through metabolic reprogramming. Therefore, this study takes a clinically oriented approach, using multi-omics technologies to investigate how PG regulates metabolic reprogramming to improve MIRI. The study focuses particularly on PG's regulation of lactate and lactylation. Results indicate that PG enhances LVEF and LVFS, reduces cTnI and CK-MB levels, decreases ROS, lactate, and LDH levels, and increases ATP expression, thereby improving cardiac function. Metabolomics results based on clinical serum samples indicate that PG can reduce lactate and pyruvate levels. The results of research conducted on animal subjects suggest that exogenous lactate supplementation has the capacity to attenuate the cardioprotective effects of PG. PG intervention significantly suppressed the expression of PDK4, MCT1, and ACSL4 proteins while enhancing GPX4 protein expression, inhibiting lipid peroxidation, and improving mitochondrial structure and function. However, the overexpression of PDK4 led to a diminution of the PG-mediated enhancement in MIRI. Overexpression of NDUFS1 K170 lactylation similarly impaired the PG-mediated improvement of MIRI. Therefore, we conclude that PG improves MIRI by inhibiting NDUFS1 K170 lactylation through metabolic reprogramming regulation. The present study provides novel targets and therapeutic agents for MIRI intervention, while also offering fresh insights into the pathogenesis of MIRI.

Introduction: In recent years, ShenSong YangXin capsule (SSYX) has gained widespread application in China as an adjunctive therapy for patients with chronic heart failure combined with atrial fibrillation (CHF-AF). However, its efficacy and safety profile remain subject to debate, and there is a notable lack of relevant systematic reviews and meta-analyses on this topic.Methods: A comprehensive search was conducted across seven databases up to August 25, 2025, identifying eligible randomized controlled trials (RCTs). Meta-analysis, subgroup analysis, and sensitivity analysis were performed using RevMan 5.4 and Stata 15.1. The Risk of Bias 2.0 tool was used to evaluate study quality, and publication bias was assessed with Egger’s test in Stata. Trial sequential analysis and the GRADE framework were utilized to assess the cumulative evidence and certainty of outcomes. The study protocol was prospectively registered with PROSPERO (CRD42023482018).Results: The meta-analysis included 17 RCTs comprising a total of 1756 patients from China. Results indicated that SSYX combined with conventional medication significantly improved clinical efficacy in patients with CHF-AF [RR 1.18 (95% CI 1.11, 1.25), p < 0.00001] and reduced the incidence of major adverse cardiovascular events (MACE) [RR 0.31 (95% CI 0.23, 0.41), p < 0.00001]. Statistically significant improvements were also observed in the following outcomes: B-type natriuretic peptide, N-terminal pro-B-type natriuretic peptide, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, QT dispersion (QTd), ventricular rate, and AF duration. Adverse reactions were reported in 11 trials. According to the GRADE framework, one outcome (MACE) was supported by moderate-certainty evidence, three outcomes (clinical efficacy, QTd, and ventricular rate) were graded as low-certainty, and the remaining six outcomes were assessed as having very low-certainty evidence.Conclusion: The combination therapy incorporating SSYX showed potential benefits compared to conventional treatment alone in patients with CHF-AF. However, the overall certainty of evidence is limited. Therefore, these findings require careful interpretation and further large-scale, rigorously designed RCTs are warranted to provide more robust evidence regarding the efficacy and safety of SSYX.

OBJECTIVES:To investigate the effect of Shenge powder (SGP) on myocardial fibrosis in rats with heart failure after myocardial infarction and its relation with lysyl oxidase like protein 2 (LOXL2)/transforming growth factor-β1 (TGF-β1)/IL-11 signaling pathway. METHODS:Seventy-two SPF male SD rats were divided into blank control group, model control group, SGP small dose group, SGP large dose group, positive control group, SGP large dose+LOXL2 activator group, with 12 rats in each group. Except for the blank control group, post-myocardial infarction heart failure was induced by coronary constriction. Corresponding treatments were given immediately after successful modeling, once a day for 4 weeks. Left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF) in rats were detected by color Doppler ultrasound imaging. Levels of IL-1β and IL-6 in serum were analyzed by ELISA method. Myocardial collagen volume fraction (CVF) was evaluated by Masson staining. Expressions of collagen Ⅰ and α-smooth muscle actin (α-SMA) in myocardial tissue were detected by immunohistochemical staining. The mRNA expressions of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) in myocardial tissue were detected by qRT-PCR. Expression of LOXL2, TGF-β1, and IL-11 proteins in myocardial tissue were detected by Western blotting. RESULTS:Compared with the blank control group, the LVFS and LVEF of the model control group decreased, the levels of serum IL-6 and IL-1β elevated, and the CVF value, the expressions of collagen Ⅰ and α-SMA in myocardial tissue, MMP-9 and TIMP-1 mRNA, and LOXL2, TGF-β1, IL-11 proteins increased (all P<0.05). Compared with the model control group, the LVFS and LVEF of SGP small dose group, SGP large dose group and positive control group increased, the levels of serum IL-6 and IL-1β decreased, and the CVF value, the expressions of collagen Ⅰ and α-SMA in myocardial tissue, MMP-9 and TIMP-1 mRNA, and LOXL2, TGF-β1, IL-11 proteins decreased (all P<0.05); while LOXL2 activator reversed the improvement effect of high-dose SGP on myocardial fibrosis in heart failure rats after myocardial infarction. CONCLUSIONS:Shenge powder may inhibit myocardial fibrosis in heart failure rats after myocardial infarction by inhibiting the LOXL2/TGF-β1/IL-11 pathway.

Introduction:Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC). Epidemiological studies have found that patients with IBD are more likely to suffer from cardiovascular diseases (CVDs) than the general population. However, so far, no exact causal association has been demonstrated between IBD and CVDs, and more research is needed to clarify this relationship. Material and methods:The two-sample Mendelian randomization (MR) method was used to explore the causal effect of IBD on CVDs. The exposure factor was IBD, including CD and UC. The outcome was CVDs, including chronic heart failure, atrial fibrillation, coronary heart disease, myocardial infarction and hypertension. The single nucleotide polymorphisms (SNPs) are all from the FinnGen genome-wide association study sample database. The CD samples included 210,300 controls and 807 cases, and the UC samples included 215,806 controls and 2701 cases. The samples included are all European samples. SNPs associated with Crohn's disease and ulcerative colitis were extracted from the IEUGWAS database and quality control and screening were carried out. Inverse variance weighted (IVW), MR-Egger, weighted median and other methods were used to study the causal relationship between them and CVDs. Finally, Cochrane's Q test, MR-Egger and the leave-one method were used for sensitivity analysis. Results:In this study, 4 SNPs strongly associated with Crohn's disease and 12 SNPs strongly associated with ulcerative colitis were screened. The IVW method of genetic prediction revealed a positive correlation between Crohn's disease and the risk of chronic heart failure (OR =1.02; 95% CI: 1.00-1.04), and there was a positive correlation between ulcerative colitis and the risk of chronic heart failure (OR = 1.03; 95% CI: 1.00-1.06). IVW, MR-Egger and weighted median showed that Crohn's disease and ulcerative colitis were not associated with the risk of atrial fibrillation, coronary heart disease, myocardial infarction or hypertension. Sensitivity analysis showed that the results are robust. Conclusions:Crohn's disease and ulcerative colitis are associated with an increased risk of chronic heart failure, but they are not associated with the risk of other CVDs.

This study systematically evaluated the efficacy and safety of different Chinese patent medicines combined with conventional western medicine in the treatment of heart failure with preserved ejection fraction(HFpEF) and ranked for the drug selection. Randomized controlled trial(RCT) on Chinese patent medicines in treatment of HFpEF were obtained from the CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, EMbase, Web of Science, and other databases from the inception to October 9, 2022. The included RCT was quantitatively analyzed using gemtc and rjags packages of R software for the network Meta-analysis. 74 RCTs were included, with a total of 7 192 patients enrolled, involving 11 different Chinese patent medicines(Shenfu Injection, Shenmai Injection, Qili Qiangxin Capsules, Shexiang Baoxin Pills, Xuezhikang Capsules, Salvia Miltiorrhiza Polyphenols Injection, Tanshinone Ⅱ_A Sulfonate Injection, Xinmailong Injection, Yangxinshi Tablets, Qishen Yiqi Dripping Pills, and Yixinshu Capsules). The results of network Meta-analysis are shown as followed.(1)In terms of improving clinical effective rate, for injection preparations, Xinmailong Injection + conventional western medicine was recommended. while for oral preparations, Shexiang Baoxin Pills + conventional western medicine, Qishen Yiqi Dripping Pills + conventional western medicine, and Qili Qiangxin Capsules + conventional western medicine were preferred.(2)In terms of improving the mitral ratio of peak early to late diastolic filling velocity(E/A), for injection preparations, Shenmai Injection + Salvia Miltiorrhiza Polyphenols Injection + conventional western medicine, Shenmai Injection + conventional western medicine, Shenfu Injection + conventional western medicine were preferred. While for oral preparations, Yixinshu Capsules + conventional western medicine was preferred.(3)In terms of reducing the ratio of early diastolic mitral inflow to early diastolic mitral annular velocity(E/e'), Shenfu Injection + conventional western medicine could be used as injection preparation, and Qili Qiangxin Capsules + conventional western medicine, Qishen Yiqi Dripping Pills + conventional western medicine for oral preparations.(4)In terms of improving 6-minute walking trail(6MWT), the injection preparations such as Shenmai Injection + conventional western medicine, Xinmailong Injection + conventional western medicine were suitable, while oral preparations like Qishen Yiqi Dripping Pills + conventional western medicine, Qili Qiangxin Capsules + conventional western medicine were recommended.(5)In terms of reducing N-terminal pro B-type natriuretic peptide(NT-proBNP), Qili Qiangxin Capsules + conventional western medicine were preferred.(6)In terms of reducing B-type natriuretic peptide(BNP), Xinmailong Injection + conventional western medicine could be used for injection preparation and Qili Qiangxin Capsules + conventional western medicine can be used for oral preparation. In terms of adverse drug reactions, there was no significant difference between Chinese patent medicine combined with conventional western conventional and traditional western medicine alone. The results showe that Chinese patent medicine combined with conventional western medicine in treating HFpEF is superior to conventional western medicine alone in reducing clinical symptoms, improving cardiac function, and improving exercise tolerance, which also has good drug safety. However, the existing evidence is still limited by the quality and quantity of included studies, so the above conclusion requires further validation through more prospective RCT.

Background: Coronary heart disease (CHD) is the most common cardiovascular disease facing human beings. Cardiac remodelling is an important pathological factor for the progression of heart failure (HF) after CHD. At present, Chinese medicine is widely used in the treatment of HF, but there are still some drugs lack of evidencebased and mechanism evidence. Multi-omics techniques can deep explore candidate pathogenic factors and construct gene regulatory networks.This trial is intended to evaluate the effect on Huoxin pill (HXP) in the treatment of HF after programmable communication interface (PCI). Meantime, multi-omics analysis technique will be used to target the fundamental pathological links of cardiac remodelling, so as to study the mechanism of HXP in the treatment of HF after PCI. Methods: This study is a randomized, double-blind, placebo-controlled trial. Sixty patients with HF undergoing PCI are recruited from the First Affiliated Hospital of Henan University of CM. All selected patients will be randomly attributed to receive conventional treatment + HXP or placebo. The packaging, dosage and smell of placebo and heart activating pill were identical. The primary outcome is NYHA cardiac function grade, while the secondary outcomes included Lee's HF score, exercise tolerance test, and quality of life evaluation. Additional indicators include cardiac ultrasound, electrocardiogram, 24-h dynamic electrocardiogram, myocardial injury indicators, and energy metabolism indicators. Discussion: This study may provide a new treatment option for patients with HF after PCI and provide evidence for the treatment of CHD and HF with HXP. Trial registration: 2023-10-08 registered in China Clinical Trial Registry, registration number ChiCTR2300076402.

An evidence map was established to comprehensively sort out the clinical research in the treatment of post-acute myocardial infarction heart failure(P-AMI-HF) with Chinese patent medicines, so as to reveal the distribution of evidence in this field. CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, and EMbase were searched for the randomized controlled trial(RCT), systematic reviews/Meta-analysis, and guidelines/consensus in this field. The evidence was analyzed and displayed in the form of a combination of text, charts, bubble charts, and bar charts, and the quality of RCT, systematic reviews/Meta-analysis, and guidelines/consensus were evaluated by RoB 1.0, AMSTAR2, and AGREE Ⅱ, respectively. A total of 163 RCTs, 4 systematic reviews/Meta-analysis, 1 network Meta-analysis, 2 observational studies, and 5 guidelines/consensus were included. In recent years, the total number of publications in this field has shown an upward trend. There were a variety of Chinese patent medicines in the treatment of P-AMI-HF, among which Shenfu Injection received the most attention. The clinical RCT and systematic reviews/Meta-analysis generally had poor quality, and the RCT mostly had a small size, a single center, and a short cycle. The outcome indicators mainly included cardiac function indicators, myocardial injury markers, total response rate, hemodynamic indicators, and safety indicators, while the characteristic efficacy indicators of TCM received insufficient attention. The development processes of some guidelines/consensus lack standardization, which compromised their authority and rationality. Chinese patent medicines have advantages in the treatment of P-AMI-HF, while there are also problems, which remain to be solved by more high-quality evidence. That is, more large-sample and multi-center clinical studies should be carried out in the future, and the formulation process of relevant systematic reviews/Meta-analysis and guideline/consensus should be standardized and the quality of evidence should be improved. In this way, the effectiveness and safety of Chinese patent medicines in the treatment of P-AMI-HF can be explored.

Background:In China, Shen'ge formula (SGF), a Traditional Chinese Medicine blend crafted from ginseng and gecko, holds a revered place in the treatment of cardiovascular diseases. However, despite its prevalent use, the precise cardioprotective mechanisms of SGF remain largely uncharted. This study aims to fill this gap by delving deeper into SGF's therapeutic potential and underlying action mechanism, thus giving its traditional use a solid scientific grounding. Methods:In this study, rats were subjected to abdominal aortic constriction (AAC) to generate pressure overload. Following AAC, we administered SGF and bisoprolol intragastrically at specified doses for two distinct durations: 8 and 24 weeks. The cardiac function post-treatment was thoroughly analyzed using echocardiography and histological examinations, offering insights into SGF's influence on vital cardiovascular metrics, and signaling pathways central to cardiac health. Results:SGF exhibited promising results, significantly enhanced cardiac functions over both 8 and 24-week periods, evidenced by improved ejection fraction and fractional shortening while moderating left ventricular parameters. Noteworthy was SGF's role in the significant mitigation of myocardial hypertrophy and in fostering the expression of vital proteins essential for heart health by the 24-week mark. This intervention markedly altered the dynamics of the Akt/HIF-1α/p53 pathway, inhibiting detrimental processes while promoting protective mechanisms. Conclusion:Our research casts SGF in a promising light as a cardioprotective agent in heart failure conditions induced by pressure overload in rats. Central to this protective shield is the modulation of the Akt/HIF-1α/p53 pathway, pointing to a therapeutic trajectory that leverages HIF-1α promotion and p53 nuclear transport inhibition.

The efficacy and safety of Shenshao Capsules in combination with conventional western medicine for the treatment of angina pectoris in coronary heart disease were systematically evaluated. Computer search of seven databases, including CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library, was conducted to identify randomized controlled trial(RCT) on Shenshao Capsules for the treatment of angina pectoris in coronary heart disease up to December 2023. According to inclusion and exclusion criteria, articles were screened, and data was extracted. Cochrane bias risk assessment tool 2.0(RoB 2.0) was used to evaluate the quality of the included articles. Meta-analysis was performed by RevMan 5.4 and Stata/SE 15.1 software, and evidence quality was rated by the GRADE system. TSA 0.9.5.10 beta software was used for the trial sequential analysis(TSA). Twelve RCTs, with a total of 1 128 participants(567 in the experimental group and 561 in the control group), were included. Meta-analysis showed that Shenshao Capsules + conventional western medicine significantly improved clinical efficacy(RR=1.20, 95%CI[1.15, 1.26], P&lt;0.000 01) and electrocardiogram efficacy(RR=1.16, 95%CI[1.04, 1.30], P=0.01), reduced the frequency of weekly angina pectoris attacks(MD=-2.85, 95%CI[-5.27,-0.43], P=0.02), daily angina pectoris attacks(MD=-0.30, 95%CI[-0.57,-0.03], P=0.03) and the duration of angina pectoris attacks(RR=-2.28, 95%CI[-3.44,-1.12], P=0.000 1). There was no statistically significant difference in adverse reactions between the two groups(RR=1.33, 95%CI[0.71, 2.51], P=0.37). TSA indicated that the cumulative evidence for clinical efficacy exceeded the traditional boundary but did not exceed the TSA boundary, suggesting a potential false positive result. According to GRADE assessment, except for clinical efficacy, which was rated as low-quality evidence, the remaining outcomes were rated as very low-quality evidence. The results indicate that Shenshao Capsules + conventional western medicine may have certain advantages in improving clinical efficacy and electrocardiographic efficacy, reducing the frequency and duration of angina pectoris attacks. However, due to the limitations of this study, more rigorous and high-quality RCT is needed to validate its efficacy and safety.

目的 探讨桂枝甘草汤治疗心律失常的可能作用机制及配伍意义.方法 30只SD大鼠随机分为桂枝组(桂枝单煎液120mg/ml)、甘草组(甘草单煎液60mg/ml)、桂枝甘草单煎液混合组(桂枝单煎液+甘草单煎液混合180mg/ml)、桂枝甘草汤同煎液组(桂枝和甘草同煎液180mg/ml)、对照组(生理盐水),每组6只.各组每天灌胃相应药物1ml/100g,3天后腔静脉取血制备含药血清.分离豚鼠心室肌细胞,设桂枝血清组、甘草血清组、桂枝甘草单煎液混合血清组、桂枝甘草汤同煎液血清组、对照血清组,每组5个复孔;各组以体积比分别加入10％和15％浓度含药血清,培养24 h后分别检测各组在0、20、30、40、50mV条件下慢激活延迟整流钾电流(IKs)电流密度.HEK293细胞分组及干预方法同心室肌细胞,培养24h后分别检测各组在0、20、30、40、50 mV条件下快激活延迟整流钾电流(IKr)尾电流密度及IKr尾电流动力学参数(包括激活半电压、斜率因子).结果 在10％浓度药物干预下,0、20、30、40、50mV时各组IKs电流密度比较差异均无统计学意义(P＞0.05),20、30、40、50 mV时各组IKr尾电流密度比较差异均无统计学意义(P＞0.05).在15％浓度药物干预下,与对照血清组比较,甘草血清组和桂枝甘草单煎液混合血清组各电压IKs电流密度均降低,桂枝血清组30、40、50 mV时IKs电流密度降低,桂枝甘草汤同煎液血清组50 mV时IKs电流密度降低(P＜0.05);桂枝甘草汤同煎液血清组各电压IKr尾电流密度均降低,桂枝甘草单煎液混合血清组50 mV时IKr尾电流密度降低,甘草血清组0 mV时IKr尾电流密度升高(P＜0.05).在15％浓度药物干预下,与甘草血清组比较,桂枝甘草汤同煎液血清组30 mV时IKs电流密度升高,各电压IKr尾电流密度均降低(P＜0.05);与桂枝血清组比较,桂枝甘草汤同煎液血清组30、40、50 mV时IKr尾电流密度降低(P＜0.05).与对照血清组比较,在10％药物浓度干预下,各组IKr尾电流激活半电压均减小(P＜0.05);在15％药物浓度干预下,各组IKr尾电流激活半电压均减小(P＜0.05),甘草血清组、桂枝血清组斜率因子减小(P＜0.05).结论 桂枝甘草汤可在一定程度上抑制心室肌细胞IKs及HEK293细胞IKr,这可能是其治疗心律失常的作用机制之一,且方中桂枝和甘草配伍具有协同增效的作用.

目的:观察耳穴贴压治疗不稳定型心绞痛(UA)合并睡眠障碍的临床疗效.方法:选取2021年1月—2021年12月河南中医药大学第一附属医院心内科收治的60例UA合并睡眠障碍病人,按照随机数字表法分为对照组和治疗组,每组30例.对照组给予常规治疗,治疗组在治疗UA常规用药基础上加用耳穴贴压方案治疗.比较两组匹兹堡睡眠质量指数(PSQI)、睡眠障碍症状改善疗效、心绞痛疗效积分、中医证候疗效以及不良反应情况.结果:治疗组治疗后PSQI各项评分及总评分均较治疗前明显下降,治疗组治疗后入睡时间、睡眠质量、睡眠障碍、日间功能障碍和总评分低于对照组,差异均有统计学意义(P<0.05或P<0.01).治疗组和对照组睡眠障碍症状改善疗效总有效率分别为86.67％和56.67％,两组比较差异有统计学意义(P<0.05).治疗组治疗后疼痛程度、心绞痛持续时间积分和疗效总分低于对照组(P<0.05或P<0.01);治疗组和对照组中医证候疗效总有效率分别为90.00％和63.33％,两组比较差异有统计学意义(P<0.05).结论:耳穴贴压可以有效改善UA病人的睡眠障碍,改善心绞痛疗效和中医证候积分.

目的:系统评价参附注射液治疗肺源性心脏病(PHD)的有效性与安全性.方法:计算机检索 PubMed、the Cochrane Library、EMbase、中国知网(CNKI)、维普中文期刊(VIP)、万方数据知识服务平台(WanFang)、中国生物医学文献服务数据系统(SinoMed)中英文数据库.收集常规治疗方案联合参附注射液治疗 PHD的随机对照试验(RCT),检索时限为建库至 2022 年 12 月.筛选文献、提取资料和评价纳入研究的偏倚风险后,使用 RevMan 5.3软件进行Meta分析.结果:共纳入 34项RCT,涉及病人 2521例.Meta分析结果显示,与西医常规治疗比较,在西医常规治疗基础上加用参附注射液可提高总有效率[RR=1.24,95%CI(1.20,1.29),P＜0.00001]、左室射血分数[MD=6.68,95%CI(5.75,7.61),P＜0.00001]、6 min步行距离[MD=70.61,95%CI(59.99,81.23),P＜0.00001]、动脉血氧分压[SMD=1.87,95%CI(1.39,2.36),P＜0.00001];降低 N末端脑钠肽前体[SMD=-1.10,95%CI(-1.47,-0.72),P＜0.00001]、右心室内径[MD=-3.51,95%CI(-4.49,-2.52),P＜0.00001]、动脉血二氧化碳分压[MD=-1.32,95%CI(-1.74,-0.89),P＜0.00001].两组不良反应发生率比较差异无统计学意义.结论:现有证据表明,在西医常规治疗基础上加用参附注射液,可进一步提高 PHD病人的临床疗效,且无严重不良反应的发生.

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.

Heart failure (HF) is a worldwide health issue, and the application of Chinese medicine could provide new methods for the treatment of HF. Currently, there is no good medicine for diastolic heart failure (DHF) at present; therefore, we hope our study can confirm the effectiveness of Shen'ge formula (SGF) in the treatment of DHF and provide new strategies for patients with HF. To analyze the potential effect of SGF against HF, especially against DHF, we consult and summarize our previous researches on SGF. Our previous clinical studies demonstrated that SGF combined with conventional western medicine was able to improve ventricular contractility, heart function and reduce serum brain natriuretic peptide (BNP)/NT-proBNP levels of patients. The quality of life and clinical symptoms in HF patients were significantly improved after intervention. And basic researches also manifested that SGF was capable of preserving heart function, improving symptoms, and reducing cardiac hypertrophy and fibrosis in rats. Mechanisms involved in SGF ameliorating heart function probably were through downregulating AT1R, NADPH oxidase 2, 4, inhibiting TGF-β/smads pathway and RhoA/ROCK1 pathway. And SGF reducing serum metabolites accumulation was feasibly by up-regulating heart mRNA expressions of COX2, ATP6 and ATP8. In all, SGF exhibits many advantages in HF treatment according to the results of our previous researches, which indicates that SGF could be the potential beneficial strategy in DHF.

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 研究参蛤散对压力负荷型心力衰竭大鼠心脏的保护作用及机制.方法 采用腹主动脉缩窄术诱导大鼠压力负荷性心力衰竭.术后大鼠灌胃参蛤散[1.89g/(kg·d)]和比索洛尔[1 mg/(kg·d)],持续8周和12周.观察参蛤散和比索洛尔对大鼠心脏超声、血流动力学、病理形态以及凋亡相关分子的影响.结果 与模型组相比,参蛤散组射血分数和缩短分数升高(P＜0.01),左室舒张末期压(LVEDP)、左室压力最大上升/下 降速率(±dP/dtMax)和左室后壁(LVPW)降低(P＜0.05).参蛤散减少了心肌细胞凋亡,改善心肌肥厚,增加PECAM-1表达.与模型组相比,参蛤散能够下调p53、Bax、Caspase-3、β-MHC和NF-κB的mRNA表达.结论 参蛤散可改善压力负荷型心力衰竭大鼠的心功能,作用机制可能与抑制细胞凋亡、心肌肥厚和炎症等相关.

Introduction: Diastolic heart failure (DHF) is an important pathological type of heart failure, that involves multiple organ dysfunction and multiple complications. The prevalence of DHF is high, and effective treatments are lacking. Chinese herbs are an alternative therapy for DHF. Shen'ge formula (SGF) is a classical formula from which patients can benefit, but convincing evidence of its efficacy is lacking. Therefore, we designed this randomized controlled trial protocol. Methods/design: This randomized, double-blind, placebo-controlled clinical trial will evaluate the efficacy and safety of SGF in the treatment of DHF. A total of 130 patients with DHF will be enrolled in the trial and treated with SGF granules or placebo for 12 weeks and followed up for 12 weeks. The primary outcome measurement will be to changes in plasma N-terminal brain natriuretic peptide precursor before versus after treatment, while the second primary outcome measurement will be changes in heart function before versus after treatment and the 12-week follow-up period. It will also include echocardiography, a cardiopulmonary exercise test, cardiac function grading, traditional Chinese medicine syndrome score, and the Minnesota Heart Failure Quality of Life Scale. Adverse events will be evaluated throughout the trial. Discussion: The results of this trial will demonstrate whether SGF could alleviate symptoms, improve cardiac function, reduce readmission rates, and improve quality of life of patients with DHF.

目的 观察红参水煎液干预斑马鱼血管生长的作用,为红参的临床应用提供依据.方法 建立斑马鱼正常血管生长模型,加入不同浓度的红参水煎液,观察对斑马鱼肠下静脉情况.采用血管内皮生长因子酪氨酸酶抑制剂Ⅱ(VRI)建立斑马鱼血管损伤模型,采用不同浓度红参水煎液干预,观察斑马鱼脊背节间血管情况.结果 红参水煎液各浓度组平均交叉数与空白对照组比较差异均无统计学意义(P>0.05);红参水煎液3μg/mL组、30μg/mL组、100μg/mL组出芽数多于空白对照组(P<0.01);红参水煎液10μg/mL组血管直径较空白对照组明显增加(P<0.05).在斑马鱼血管损伤模型中,与空白对照组比较,VRI组及红参水煎液各浓度组完整血管个数明显减少(P<0.01),缺陷血管明显增多(P<0.01);与VRI组比较,红参水煎液1μg/mL组完整血管数增多(P<0.05),红参水煎液3μg/mL组、10μg/mL组、30μg/mL组、100μg/mL组完整血管明显增多(P<0.01),红参水煎液10μg/mL组、100μg/mL组缺陷血管数明显减少(P<0.01).结论 红参水煎液有一定促进斑马鱼血管生长的作用,并能够抑制VRI诱导的血管损伤.

周端教授认为,高血压病病位在头窍,与肝、肾、心、脾四脏密切相关,阴虚是其病理核心,贯穿疾病始终.高血压病总属阴虚阳亢,虚者多而实者少,可分为初期、中期、晚期,在高血压病初期、中期应用膏方较为适宜.周老师运用膏方调治高血压病时,注重辨证与辨病、辨体质相结合,注重情志调节.在开具膏方时,重视滋补肝肾、调气活血,以平肝熄风治其标,更注重补肝肾之阴治其本,常用熟地黄、黄精、枸杞子、山萸肉等补肾填精,滋水涵木,以阴制阳;重视脾胃功能,将培元顾胃法作为膏方治疗高血压病的重要治则,以白术、茯苓、薏苡仁、六神曲、山药等培元健脾;善加活血之品,治疗"血瘀"之标实之证;根据患者气之升降,酌加陈皮、香附、川楝子、枳壳等使其顺"苍天之气",使各脏"阴密阳固".

目的 观察人参皂苷Rb3对过氧化氢(H2 O2)诱导的心肌细胞损伤模型中缺氧诱导因子1α(HIF-1α)、血管内皮生长因子(VEGF)的调节作用,并探讨其作用机制.方法 采用心肌细胞株H9c2细胞,人参皂苷Rb3(25μmol/L)预处理24 h后,加入H2 O2(400μmol/L)分别诱导1 h和2 h,并使用磷酯酰激醇3-激酶(PI3K)抑制剂LY294002(LY294),通过荧光定量逆转录-聚合酶链式反应法测定细胞中HIF-1α、VEGF的mRNA表达水平.结果 与空白对照组相比,H2 O2增强了HIF-1α和VEGF的mRNA表达(P<0.01);与H2 O2组相比,人参皂苷Rb3可提高HIF-1α、VEGF的mRNA水平(P<0.01);与H2 O2+Rb3组相比,LY294降低了H2 O2作用2 h后HIF-1α的mRNA表达水平(P<0.01).结论 人参皂苷Rb3可以促进H2 O2诱导的心肌细胞损伤模型中HIF-1α和VEGF的mRNA表达,且前者可能与PI3K/蛋白激酶B(Akt)信号通路有关.