Cardiac shock wave therapy for coronary heart disease: an updated meta-analysis

Abstract Introduction: The aim of this article is to study the efficacy and safety of cardiac shock wave therapy (CSWT) in the treatment of coronary heart disease (CAD). Methods: A comprehensive search of electronic databases and a manual search of conference papers and abstracts were performed until September 30, 2018. The studies using RevMan 5.3 and STATA 14.0 softwares were reviewed, and meta-analyses were performed on 13 indicators, such as a six-min walking distance test (6MWT), New York Heart Association (NYHA) functional class, Seattle Angina Questionnaire (SAQ) score, angina class (Canadian Cardiology Society [CCS]), etc. Results: A total of 26 articles were included. The total patient population was 855, of which 781 patients were treated with CSWT. Meta-analyses indicated that 6MWT (mean difference [MD] 75.64, 95% confidence interval [CI] 49.03, 102.25, P<0.00001) and NYHA (MD -0.70, 95% CI -0.92) in the CSWT group were comparable to those in the conventional revascularization group (MD -0.70, 95% CI -0.92, -0.49, P<0.00001). SAQ (MD 10.75, 95% CI 6.66, 14.83, P<0.00001), CCS (MD -0.99, 95% CI -1.13, -0.84, P<0.00001), nitrate dosage (MD -1.84, 95% CI -2.77, -1.12, P<0.00001), LVEF (MD 3.77, 95% CI 2.17, 5.37, P<0.00001), and SSS (MD -4.29, 95% CI -5.61, -2.96, P<0.00001), SRS (MD -2.90, 95% CI -4.85, -0.95, P=0.004), and the exercise test (standard mean difference 0.57, 95% CI 0.12, 1.02, P=0.01) all showed significant differences. Conclusion: CSWT may offer beneficial effects to patients with CAD, but more large-scale clinical studies are needed to further verify its therapeutic effect.

Outcomes of chronic total occlusions in coronary arteries according to three therapeutic strategies: a meta-analysis with 6985 patients from 8 published observational studies

Abstract Objective: To perform a systematic review and meta-analysis of studies comparing coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and medical treatment (MT) in patients with chronic total occlusions (CTOs). Methods: We identified eligible observational studies published in the China National Knowledge Infrastructure database, PubMed, Excerpta Medica database, Google Scholar, Cochrane Library, Web of Science, and "Clinical trials" registration from 1999 to October 2018. Main outcome measures were all-cause mortality, cardiac death, major adverse cardiac events (MACEs), and myocardial infarction (MI). Results: There were eight observational studies including 6985 patients. Patients' mean age was 64.4 years. Mean follow-up time was 4.3 years. Comparing with MT (2958 patients), PCI (3157 patients) presented decreased all-cause mortality (odd ratio [OR]: 0.46, 95% confidence interval [CI]: 0.36-0.60; P<0.001), cardiac death (OR: 0.40, 95% CI: 0.31-0.52; P<0.001), MACE (OR: 0.55, 95% CI: 0.43-0.71; P<0.001), and MI (OR: 0.40, 95% CI: 0.26-0.62; P<0.001). Comparing with MT, CABG (613 patients) presented lower all-cause mortality (OR: 0.50, 95% CI: 0.36-0.69; P<0.001) and MACE (OR: 0.50, 95% CI: 0.26-0.96; P=0.04), but not lower MI (OR: 0.23, 95% CI: 0.03-1.54; P=0.13) and cardiac death (OR: 0.83, 95% CI: 0.51-1.35). Comparing with CABG, PCI did not present decreased risk for those outcomes. Conclusions: PCI or CABG was associated with better clinical outcome in patients with CTO than MT. PCI is not better than CABG in decreasing mortality, MI, cardiac death, and MACE in coronary CTO patients.

Deuterated surrogate and UPLC-MS/MS method for simultaneous determination of 22 endocannabinoids in ovariectomized rat plasma / 中国中药杂志

A new method based on ultraperformance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS) was developed for the simultaneous determination of 22 endocannabinoids(eCBs) and relevant compounds in ovariectomized rat plasma. After being extracted by solid-phase column(SPE), the plasma samples were detected by using UPLC-MS/MS. Analysis was carried out with ACQUITY UPLC BEH C₁₈ column. The mobile phase was 0.1% acetic acid solution(A)-acetonitrile and isopropanol(9∶1, B) for the gradient elution. In the positive ion multiple reaction monitoring(MRM) mode, deuterated reagents were taken as standard alternatives to calculate recoveries and simultaneously quantify 22 endocannabinoids. The established method provided a good linearity for the 22 eCBs, and their linearly dependent coefficients were all higher than 0.99. The limits of quantitation(LOQs) ranged from 0.089 6 to 1.965 2 nmol•L-1. Relative recoveries of 5 deuterated surrogates ranged between 11.40% and 129.9%. The repeatability study results showed that RSD was all less than 8.0%. The established method could be used to analyze PGF2a EA, AEA and other endogenous cannabinoids in plasma samples of ovariectomized rats. In summary, this method was proved to boast a high sensitivity, repeatability and practicability, and thus could be used in rat plasma lipid metabolomics study.

Study on effects of sulfur fumigation on chemical constituents of Chrysanthemum morifolium cv. Boju / 中国中药杂志

A comprehensively comparison of the chemical profiles between sun-drying BJ (NBJ) and sulfur-fumigated BJ (SBJ) was conducted by HPLC analysis and the discrepant peaks were identified or tentatively assigned by HPLC-ESI-MSn. A total of 32 chemical components were used for qualitative comparison. Meanwhile, a quantitative comparison of BJwere conducted by HPLC analysis and determining seven compounds from 3 NBJ and 3 SBJ samples dramatic chemical changes were found. After sulfur fumigation, the contents of flavonoids glycosides and phenolic acids were remarkably reduced, but the contents of flavonoids aglycones were significantly increased. Multivariate statistics, including principle component analysis (PCA) and partial least squares discriminate analysis (PLS-DA) were used to investigate the potential damaging effect of sulfur-fumigating process. The PCA score plots showed six samples were clearly classified into the sun-drying and sulfur-fumigating groups. And according to VIP >1, the most important chemical markers were apigenin, luteolin and 3,5-dicaffeoylquninic acid which could be used to distinguish NBJ and SBJ samples. Combining the results of qualitative and quantitative analysis, it showed that the sulfur fumigation has a significant effect on BJ.