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Cardiometabolic disease （CMD） is a clinical syndrome in which there is a causal relationship between metabolic abnormalities and cardiovascular damage. The incidence and mortality rates of CMD remain high despite the use of potent pharmacologic interventions and clinical therapeutic approaches. There is an urgent need for effective evidence-based comprehensive management measures to improve patients' lifespan and quality of life. From the concept of "nourishing through food" proposed in the Huangdi's Internal Classic （Huang Di Nei Jing） to the widespread application of modern dietary patterns such as dietary restriction， plant-based diets， and Jiangnan cuisine， dietary regulation plays a significant role in preventing diseases， early treatment of existing diseases， and recovery. This article systematically reviewed the traditional Chinese medicine （TCM） theory related to dietary patterns， elucidated the cutting-edge evidence and mechanisms of modern dietary patterns like dietary restriction in preventing and treating CMD， and explored the strategy of integrating TCM theory with dietary patterns， aiming to establish a new food-nutrition-medicine approach that combines traditional Chinese and western medicine and provide novel insights and directions for the clinical management of CMD.
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Vascular complications are the primary cause of the high disability and mortality in diabetic patients. Vascular calcification is a pathological basis of diabetic vascular complications and increases the risk of adverse cardiovascular events and the difficulty of revascularization in diabetic patients. It is of great clinical value to explore the measures for prevention and treatment of diabetic vascular calcification with integrated traditional Chinese and Western medicine. This paper explores the intrinsic association of stasis， toxin， and deficiency with diabetic vascular calcification to reveal the pathogenesis of diabetic vascular calcification. Stasis and toxin are causally affected by and combined with each other； deficiency refers to the deficiency of healthy Qi and the loss of Qi and blood. The three elements are associated with the occurrence and development of blood vessel diseases. This paper proposes the evolutional law of stasis， toxin， and deficiency in traditional Chinese medicine （TCM） for diabetic vascular calcification. Specifically， diabetic vascular calcification is rooted in the stasis of meridians and collaterals， develops due to the combination of stasis and toxin， and is aggravated by middle Qi deficiency. Furthermore， this paper proposes the TCM intervention principle of activating blood， removing toxin， tonifying deficiency， and dredging collaterals for the prevention and treatment of diabetic vascular calcification. The aim is to provide a theoretical basis for clinical and translational research on the prevention and treatment of diabetic vascular calcification with integrated Chinese and Western medicine.
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Cardiometabolic disease (CMD), characterized with metabolic disorder triggered cardiovascular events, is a leading cause of death and disability. Metabolic disorders trigger chronic low-grade inflammation, and actually, a new concept of metaflammation has been proposed to define the state of metabolism connected with immunological adaptations. Amongst the continuously increased list of systemic metabolites in regulation of immune system, bile acids (BAs) represent a distinct class of metabolites implicated in the whole process of CMD development because of its multifaceted roles in shaping systemic immunometabolism. BAs can directly modulate the immune system by either boosting or inhibiting inflammatory responses via diverse mechanisms. Moreover, BAs are key determinants in maintaining the dynamic communication between the host and microbiota. Importantly, BAs via targeting Farnesoid X receptor (FXR) and diverse other nuclear receptors play key roles in regulating metabolic homeostasis of lipids, glucose, and amino acids. Moreover, BAs axis per se is susceptible to inflammatory and metabolic intervention, and thereby BAs axis may constitute a reciprocal regulatory loop in metaflammation. We thus propose that BAs axis represents a core coordinator in integrating systemic immunometabolism implicated in the process of CMD. We provide an updated summary and an intensive discussion about how BAs shape both the innate and adaptive immune system, and how BAs axis function as a core coordinator in integrating metabolic disorder to chronic inflammation in conditions of CMD.
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The correlation between vegetarian diets and cardiovascular health is always one of the hotspots. Many scholars have performed so many clinical researches all over the world, providing evidence-based medicine (EBM) reference for clarifying their correlation. In this paper, we raise ideas and expectation on the basis of a Meta-analysis about vegetarian diets and blood pressure (published on JAMA Internal Medicine in Feb 2014) in combination of main clinical research literature in this field in recent 20 years.
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Humans , Cardiovascular System , Diet, Vegetarian , Evidence-Based Medicine , Meta-Analysis as TopicABSTRACT
Objective: To investigate the effects of Chinese herbal drug-containing serum, prepared by administration of Chinese herbal medicine for activating blood (Xiongshao Capsule, XS) or for activating blood and detoxifying (Xiongshao Capsule plus Huanglian Capsule, XSHL) in rats, on cell viability, oxidative damage and apoptosis of human umbilical vein endothelial cells (HUVECs) induced by oxidized low-density lipoprotein (ox-LDL). Methods: Thirty-two rats were randomly divided into 4 groups: control group, positive control group (simvastatin 1.8 mg/kg), activating blood (XS, 0.135 g/kg) group, and activating blood and detoxifying (XS Capsule 0.135 g/kg and Huanglian Capsule 0.135 g/kg, XSHL) group. Corresponding drugs were continuously administered to the rats for 7 days and then drug-containing serum was harvested 1 hour after the last administration. HUVECs isolated from newborn children by collagenase digestion were stimulated by ox-LDL (100 μg/L) and incubated with corresponding drug-containing serum for 24 hours. Untreated HUVECs were also used as a normal control. The morphology and structure of HUVECs were observed by an inverted microscope. Cell viability was measured by methyl thiazolyl tetrazolium method, and cell membrane damage was determined by lactate dehydrogenase (LDH) leakage. Activity of superoxide dismutase (SOD) was examined by spectrophotometry, and content of malondialdehyde (MDA) in the cell lysate was examined by thiobarbituric acid assay. HUVECs were stained with Annexin V-fluorescein isothiocyanate and propidium iodide and analyzed on a flow cytometry to determine apoptosis. Results: Compared with the normal HUVECs, the cell viability and the activity of SOD were significantly decreased while the content of MDA and apoptosis rate were significantly increased after 24-hour ox-LDL stimulation (P<0.01, P<0.05). Simvastatin-, XS-, and XSHL-containing serum significantly promoted the ox-LDL-stimulated HUVEC viability and inhibited early apoptosis (P<0.01, P<0.05), while had no significant effect on LDH leakage. Simvastatin-containing serum and XS-containing serum also showed significant decrease in MDA content and increase in SOD activity, while XSHL-containing serum showed no significant effects. There was no significant difference between the XS-containing serum group and the XSHL-containing serum group. Conclusion: Both sera containing XSHL and XS show protective action against the oxidative damage and apoptosis of HUVECs induced by ox-LDL.
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Objective: To investigate the effects of Radix Ginseng and Radix Notoginseng formula on secretion of vascular endothelial growth factor (VEGF) and expression of vascular endothelial growth factor receptor-2 (VEGFR-2) in human umbilical vein endothelial cells (HUVECs) in vitro. Methods: HUVECs were cultured in vitro. Bovine basic fibroblast growth factor (bFGF) at concentration of 320 U/mL and Radix Ginseng and Radix Notoginseng formula at concentrations of 0.1, 0.2 and 0.4 mg/mL were used to culture with HUVECs. And HUVECs in blank control group were cultured with culture solution only. After 24-hour culture, the content of VEGF in supernatant was detected by enzyme-linked immunosorbent assay and the expression of VEGFR-2 was detected by immunocytochemical staining and Western-blotting. Results: Radix Ginseng and Radix Notoginseng formula at 0.4 mg/mL, the same as bFGF, increased VEGF content in the HUVEC supernatant and the number of VEGFR-2-positive HUVECs. Expression of VEGFR-2 protein in high-dose Radix Ginseng and Radix Notoginseng formula group was up-regulated as compared with the blank control group. Conclusion: Radix Ginseng and Radix Notoginseng formula can promote HUVEC proliferation and secretion of VEGF, as well as the expression of VEGFR-2 protein, which may be one of the mechanisms of Radix Ginseng and Radix Notoginseng formula in promoting angiogenesis.
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Objective: To observe the effects of Chinese patent medicines with the function of replenishing qi to activate blood (RQAB) plus ischemic postconditioning (IPoC) in protecting myocardium of rats from ischemia-reperfusion (I/R) injury, and to explore the possible mechanisms. Methods: Seventy-five Sprague-Dawley rats were randomly divided into sham-operated group (the suture was penetrated around the left anterior descending coronary artery, but not tied, n=15), I/R group (30 minutes of in situ transient occlusion of the left anterior descending artery, followed by 1 hour of reperfusion, n=15), IPoC group (30 minutes occlusion of the left anterior descending artery, followed by 3 cycles of 10 s of reperfusion/10 s of ischemia before 1-hour reperfusion, n=15), RQAB plus IPoC group (pretreated with 0.162 g/kg Xinyue Capsule and 0.135 g/kg Xiongshao Capsule for 14 days, and treated with IPoC 2 h after the final gavage, n=15), fosinopril sodium plus IPoC group (pretreated with fosinopril sodium, 0.9 mg/kg, n=15). Serum creatine kinase-MB (CK-MB) activity and cardiac troponin T (cTnT) level were detected; myocardial infarction size was measured by nitrotetrazolium blue chloride staining; Toll-like receptor 2 (TLR2) and TLR4 in myocardial tissue were examined by immunohistochemical method; interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) levels in myocardial tissue were examined by enzyme-linked immunosorbant assay. Results: Compared with the I/R group, myocardial enzymes and infarction size were decreased significantly in the IPoC group (P<0.01); expressions of TLR2 and TLR4 and levels of IL-1beta and IL-6 in myocardial tissues were also significantly lower than those in the I/R group (P<0.05). Compared with the fosinopril sodium plus IPoC group, expressions of TLR2 and TLR4 were decreased significantly in the RQAB plus IPoC group (P<0.05, P<0.01). Compared with IPoC, RQAB plus IPoC reduced the infarction size and the release of myocardial enzyme CK-MB (P<0.01), and decreased the expressions of TLR2 and TLR4 and the levels of IL-1beta and IL-6 (P<0.05, P<0.01) in myocardial tissues. Conclusion: Pretreatment with Chinese herbs for nourishing qi and activating blood circulation can enhance the protective effect of IPoC on rat myocardial I/R injury, and its mechanism may be related to inhibition of TLR expression and expressions of the downstream proinflammatory cytokines.
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<p><b>OBJECTIVE</b>To explore effect of extracts from Panax ginseng, P. notoginseng and Ligusticum chuanxiong on human umbilical endothelial cells (HUVECs) replicative senescence.</p><p><b>METHOD</b>HUVECs were induced to aging by generation cultivating to the eighth cells in order to establish a model of endothelial cells replicative senescence. The cultured HUVECs in vitro were divided into 4 groups, the eighth generation cell-senescence untreated group, Vitamin E group, herbal treated high dose and low dose groups. Changes of HUVECs aging were observed by method of SA-beta-gal stained HUVECs and cells cycle were analyzed. Contents of ROS in cells, the levels of anti-superoxide (O2-) and nitric oxide (NO) in cell mediums were examined. Western blot were used to analyse protein expression of NADPH oxidase p47phox, angiotensin type 1 and 2 receptor (AT1R, AT2R).</p><p><b>RESULT</b>Compared with Vitamin E group, the positive cell numbers of beta-gal stained HUVECs were enhanced, cell proliferation was depressed, and the fluorescence intensity of ROS was increased, at the same time, less NO and more O2- in cells were produced in the eighth generation cell-senescence untreated group. Protein expression of p47phox, AT1R and AT2R in cells increased compared with Vit E group. Chinese herbs of high dose and low dose could improve condutions of HUVECs aging. Chinese herbs of high dose and low dose could reduce the positive cell numbers of beta-gal stained HUVEC, increase cell proliferation and decrease fluorescence intensity of ROS in cells, at the same time, cells secreting more NO and less O2-. Protein expression of p47phox, AT1R and AT2R in cells treated with Chinese herbs of high dose and low dose were decreased compared with Vit E group.</p><p><b>CONCLUSION</b>The study indicated that extracts from P. ginseng, P. notoginseng and L. chuanxiong could delay endothelial cell replicative senescence. Herbal extracts downregulate the expression of NAD (P) H oxidase subunit-p47phox by means of ROS, hence decrease O2- production and ultimately delay HUVECs in vitro senescence.</p>
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Humans , Cell Line , Cellular Senescence , Drugs, Chinese Herbal , Pharmacology , Endothelial Cells , Cell Biology , Nitric Oxide , Metabolism , Panax notoginseng , Chemistry , Reactive Oxygen Species , MetabolismABSTRACT
With the wide application of clinical guidelines and standardization of Chinese medicine (CM), guidelines of CM and/or integrative medicine (IM) were also emerging. By the guideline evaluation instruments such as the Appraisal of Guidelines Research and Evaluation (AGREE) Instrument and Conference on Guideline Standardization (COGS), a preliminary assessment of 11 clinical guidelines for CM and/or IM published before October 2008 was performed. Methodological description of evidence collection or synthesization was absent in most clinical guidelines, and evidence-grading criteria were listed in only one of the eleven guidelines. Inadequate standardization of guideline development, single professional background of guideline developers, and lack of high-grade evidence were the current problems. It was suggested that guideline development group should include individuals from multiple relevant professional fields. Stress should be laid on evidence collection and recommendation grading. Guideline developers should follow the rigorous development methodology of evidence-based guidelines, and the methods for evaluating evidence and grading recommendations should be set up according to the characteristics of medical literature of CM. In addition, more attention should be paid to appraise the quality of clinical practice guidelines of CM and IM.
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To investigate the genotype distributions of PLA1/PLA2 polymorphism in Chinese Han population from Beijing and Hebei Province and to study the correlation between the platelet membrane glycoprotein IIIa polymorphism and coronary heart disease (CHD) or CHD with blood-stasis syndrome.
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Objective To investigate the indications and methods of retaining only portal vein for the hilar cholangiocarcinoma radical resection to improve the therapeutic efficacy. Methods Six patients with hilar cholangiocarcinoma underwent left hepatectomy and extrahepatic bile duct excision. Tumor invaded hepatic artery was resected and fight hepatic duct-jejunum anastomosis was made during July 2006 to December 2007. Results There was no mortality. Bile leakage developed in one case and was cured by drainage. No liver failure developed postoperatively. All 6 cases were followed up for 10 - 23 months, and all were still alive. Conclusions Retaining only portal vein for the treatment of hilar cholangiocarcinoma radical resection under definite indications is safe.
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Objective To prospectively study the diagnostic and therapeutic status and prognosis in elderly patients with coronary heart disease(CHD) in national 3rd class-A level hospitals of traditional Chinese medicine(TCM) or integrative western and Chinese medicine(IWCM) in Beijing and Tianjin. The problems and strategies of their in-hospital treatment and secondary prevention of CHD were analyzed combining with follow-up clinical events. Methods Using individualized Information Acquisition Platform of CHD, we collected in-hospital clinical information of CHD patients and then followed up for one year. The diagnostic and therapeutic conditions of elder CHD patients were evaluated based on clinical guidelines. The outcome-related indices were analyzed with one-way ANOVA and muhi-factors analysis. Results The average age of 1864 elderly CHD patients was (72.2±6.8) years, among those 1113 cases were male and 751 cases were female. The major accompanied diseases were hypertension, diabetes, cerebrovascular disease and hyperlipidemia.The standard-reaching rate of blood-lipid level of CHD patients with hyperlipidemia was as follows:TC 74.1%, TG 32. 9%, LDL-C 19. 4%, HDL-C 87. 8%, while it was 64.6% ( systolic pressure)and 84.70% ( diastolic pressure) respectively in CHD with hypertension. As for in-hospital treatment:β-receptor blocker 69.6%, ACEI/ARB 68. 4%, lipid-lowering statina 63. 6%, revascularization 29.1%. During the 12 months of follow-up, cardiogenic death 72 cases (4. 3%, 72/1682), other reasons 5 cases (0. 3%), acute myocardial infarction (AMI) 9 cases (0. 5%), revascularization 15cases (0. 8%). The multi-factors analysis showed that AMI, cardiac dysfunction could increase the incidence rate of endpoint events. Meanwhile, lipid-lowering statins, none of peripheral vessels disease, revaseularization, IWCM treatment, age below 75 years were related with the decreased incidence rate of endpoint events. Conclusions The standard-reaching rates of hlood-lipids (TG,LDL-C) of elderly CHD patients in TCM or IWCM hospitals in Beijing and Tianjin are insufficient,and revascularization should be intensified. There is still certain gap between the usage of ACEI/ARB,β-receptor blocker, lipid-lowering statins and related guidelines, and secondary prevention of CHD must be strengthened. It is the main strategy in preventing cardiovascular events to follow clinical guidelines in medical practice, control multiple risks factors and intervene comprehensively.
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To evaluate the clinical effects of Shengmai Injection in treating coronary heart disease (CHD) based on correct syndrome differentiation and incorrect syndrome differentiation.
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OBJECTIVE: To investigate the differential gene expression profiles in patients with blood stasis syndrome by oligonucleotide microarray technique. METHODS: Sixteen patients with blood stasis syndrome were divided into patients with coronary heart disease (CAD) (n=8) and non-CAD patients (n=8) by using coronary angiography. The sex- and age-matched eight healthy persons were enrolled as control group. Venous bloods were collected for extracting RNA. Test-3 chip was first employed to examine the quality of samples. Then the samples were hybridized with Affymetrix U133 Plus 2.0 array to compare the gene expression profiles among the three groups. Gene-array scanner and gene chip operating software were applied to screen hybridization signals and analyze gene expression respectively. Based on the comparison of the three groups of samples, the differential genes related with blood stasis syndrome were analyzed by Gene Ontology (GO) and pathway, and confirmed by real-time reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Forty-eight differential genes were found being associated with blood stasis syndrome, including 26 up-regulated genes and 22 down-regulated genes. Five of the forty-eight genes (10.4%) were related to inflammatory reaction and immune response through the GO analysis. In the pathway analysis, five of ten significant pathways were referred to inflammation and immune response. The results of real-time RT-PCR proved the accuracy of the gene chip. CONCLUSION: Inflammatory- and immune-related genes have a remarkable predominance in blood stasis syndrome gene expression profiles, which may explain the function of inflammation and immune response in the occurrence and development of blood stasis syndrome.
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According to the basic theory of traditional Chinese medicine (TCM), the pathogenetic factors such as platelet activation, adhesion, congregation and thrombosis fall into the category of blood stasis, while the pathological changes such as tissue necrosis, oxidative stress injury and inflammation, etc, are far beyond the etiological category of blood stasis. The toxin or the combination and transformation of toxin and blood stasis of TCM are involved in the pathogenesis of thrombotic cerebro-cardiovascular diseases. It is significant to recognize and stress the combination and transformation of toxin and stasis in pathogenicity so as to enrich TCM etiology and improve TCM clinical efficacy in the treatment of cerebro-cardiovascular and thrombotic diseases.
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To investigate the effects of Xuefu Zhuyu Oral Liquid, a compound traditional Chinese herbal medicine for resolving stagnation, on hemorheology in the patients with blood-stasis syndrome due to coronary disease and their relationship with human platelet antigen-3 (HPA-3) polymorphism of membrane glycoprotein IIb (GPIIb).
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Background and purpose:Recent researches have shown that Secreted Protien Acidic and Rich in Cysteine (SPARC) was closely related to tumor genesis, tumor progression and tumor metastasis. SPARC was highly expressed in malignant melanoma, glioma, meningioma, bladder cancer, lung cancer and prostate cancer, etc. In this study we investigated SPARC expression in hepatocellar carcinoma (HCC) and its signifi cance. Methods:RT-PCR was used to detect SPARC mRNA expression in cancer tissue samples and their adjacent liver tissue samples from 62 patients with hepatocellar carcinoma and 30 normal liver tissue samples, respectively. And the differential protein expression of SPARC between these groups was analyzed by immunohistochemistry (IHC). Results:SPARC mRNA was highly expressed in HCC(14.0?3.6) and in the adjacent liver tissue (6.8?1.8); compared with low expression of 2.7?0.9 in normal liver tissue, there were signifi cant differences among the three groups (p=0.000). SPARC positively stained was found in 54 of 62 patients with HCC and 4 of 30 normal liver tissue, there was significant difference between these two groups (P=0.000). SPARC immunohistochemical score was 21.5?4.8 in the carcinoma group; 11.3?3.6 in paracarcinoma group and 5.7?1.8 in the normal group, there were also significant differences among the three groups (P=0.000). The expression of SPARC protein was significantly upregulated with the progress of Enmondson pathological classification. There was obviously differences between Ⅰvs Ⅱ(P=0.029), and Ⅱ vs Ⅲ Ⅳ(P=0.008). There was more SPARC expression in the patients with metastasis of HCC (26/27, 96.3%) than that without metastasis(23/35, 65.7%)(P=0.004). Conclusion:SPARC mRNA expression and its protein were related to HCC histological differentiation and metastatic lymph node; SPARC is helpful to clinical evaluation of HCC.
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Objective:To observe the additional effects of Xin Qing-ning Tablets,a representative herb with the effect of activating blood circulation and detoxication(ABCD) consisting of rhubarb extractives,on the serum in ammatory markers and blood lipids in stable coronary heart disease(CHD) patients receiving standardized statins treatment.Methods:Thirty stable CHD patients were randomized to three groups(10 in each group):the control group treated with standardized statins;the ABC and ABCD group,treated with Dan Qi Tablets or Xin Qing-ning Tablets respectively in addition to standardized statins treatment.After one month treatment,the concentrations of high-sensitivity C reaction protein(hs-CRP),Tumor necrosis factor-?(TNF-?) in serum,blood lipid and blood-stasis syndrome score(BSSS) of CHD patients before and after treatment were determined.Results:The ABCD group showed superior e ects in reducing the concentration of hs-CRP in serum[a di erence of(6.83?4.99)mg/L]as compared with the control group(1.90?2.15)mg/L and the ABC group(1.49?1.48)mg/L(P
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<p><b>OBJECTIVE</b>To observe the angiogenesis promoting effects of clinical common used Chinese herbal medicines (CHM) for activating blood circulation to remove stasis on chick embryo chorio-allantoic membrane (CAM).</p><p><b>METHODS</b>Chicken CAM model was established and mice blood serum containing different kinds of medicines, including Radix Peaoniae rubra, Radix Angelicae sinensis, Flos Carthami, Rhizoma Chuanxiong, Radix Salviae miltiorrhizae, Astragalus membranaceus, and their complex prescriptions, Danggui Buxue Decoction, Xuefu Zhuyu Decoction, Xiongshao Capsule, was applied on it respectively to observe the condition of angiogenesis 72 hrs after incubation. Besides, the normal saline group, blank serum group, blank group and basic fibroblast growth factor (bFGF) group were set up for control.</p><p><b>RESULTS</b>All the CHM applied and bFGF had the CAM angiogenetic promoting effect, among them, Radix Salviae Miltiorrhizae and the three complex prescriptions showed better effects than the three negative control groups in capillary formation and count, with the efficacy similar to that of bFGF. The effect of complex prescriptions was superior to that of single herb except Radix Salviae miltiorrhizae.</p><p><b>CONCLUSION</b>Radix Salviae miltiorrhizae, Danggui Buxue Decoction, Xuefu Zhuyu Decoction and Xiongshao Capsule have good angiogenesis promoting effect on CAM. This study elucidated, from a certain aspect, the mechanism of action of CHM on ischemic diseases, and unfolded the scientific evidence of applying complex prescription.</p>
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Animals , Chick Embryo , Mice , Angiogenesis Inducing Agents , Pharmacology , Chorioallantoic Membrane , Chorion , Drugs, Chinese Herbal , Pharmacology , Neovascularization, Physiologic , Random Allocation , Salvia miltiorrhizaABSTRACT
0.05),but enhanced 6-keto-PGF_(1?) synthesis at concentrations of 1,0.5,0.1 and 0.01 ?mol?L~(-1)(P