Detection of an anti-angina therapeutic module in the effective population treated by a multi-target drug Danhong injection: a randomized trial.

It's a challenge for detecting the therapeutic targets of a polypharmacological drug from variations in the responsed networks in the differentiated populations with complex diseases, as stable coronary heart disease. Here, in an adaptive, 31-center, randomized, double-blind trial involving 920 patients with moderate symptomatic stable angina treated by 14-day Danhong injection(DHI), a kind of polypharmacological drug with high quality control, or placebo (0.9% saline), with 76-day following-up, we firstly confirmed that DHI could increase the proportion of patients with clinically significant changes on angina-frequency assessed by Seattle Angina Questionnaire (ΔSAQ-AF ≥ 20) (12.78% at Day 30, 95% confidence interval [CI] 5.86-19.71%, P = 0.0003, 13.82% at Day 60, 95% CI 6.82-20.82%, P = 0.0001 and 8.95% at Day 90, 95% CI 2.06-15.85%, P = 0.01). We also found that there were no significant differences in new-onset major vascular events (P = 0.8502) and serious adverse events (P = 0.9105) between DHI and placebo. After performing the RNA sequencing in 62 selected patients, we developed a systemic modular approach to identify differentially expressed modules (DEMs) of DHI with the Zsummary value less than 0 compared with the control group, calculated by weighted gene co-expression network analysis (WGCNA), and sketched out the basic framework on a modular map with 25 functional modules targeted by DHI. Furthermore, the effective therapeutic module (ETM), defined as the highest correlation value with the phenotype alteration (ΔSAQ-AF, the change in SAQ-AF at Day 30 from baseline) calculated by WGCNA, was identified in the population with the best effect (ΔSAQ-AF ≥ 40), which is related to anticoagulation and regulation of cholesterol metabolism. We assessed the modular flexibility of this ETM using the global topological D value based on Euclidean distance, which is correlated with phenotype alteration (r2: 0.8204, P = 0.019) by linear regression. Our study identified the anti-angina therapeutic module in the effective population treated by the multi-target drug. Modular methods facilitate the discovery of network pharmacological mechanisms and the advancement of precision medicine. (ClinicalTrials.gov identifier: NCT01681316).

[Network Meta-analysis of Chinese patent medicine in treatment of unstable angina pectoris].

Network Meta-analysis was used to compare the efficacy and safety of Chinese patent medicines in the treatment of unstable angina pectoris. PubMed, Cochrane Library, CNKI, Wanfang, VIP and other databases were retrieved by computers from the establishment of the databases to June 2020. Randomized controlled trials(RCTs) of Chinese patent medicines for the treatment of unstable angina pectoris were collected. Two investigators independently screened out the literatures, and extracted data according to the inclusion and exclusion criteria. The quality of the included RCTs was evaluated according to the bias risk assessment tool recommended by the Cochrane System Reviewer Manual, and the Stata 13.0 software was used for data analysis and mapping. Through screening, 28 eligible studies were finally included, with the sample size of 2 885 cases, involving 8 Chinese patent medicines. The results of the network Meta-analysis showed that in terms of total effective rate for angina symptom improvement, the order was as follows: Shenshao Capsules > Naoxintong Capsules > Ginkgo Ketone Ester Dripping Pills > Compound Danshen Dripping Pills > Ginkgo Leaf Tablets > Shexiang Baoxin Pills > Tongxinluo Capsules > Yindan Xinnaotong Soft Capsules; in terms of total effective rate for ECG curative effect, the order was as follows: Ginkgo Ketone Ester Dripping Pills>Compound Danshen Dripping Pills > Tongxinluo Capsules > Shenshao Capsules > Shexiang Baoxin Pills > Yindan Xinnaotong Soft Capsules; in terms of hypersensitivity-C-reactive protein curative effect, the order was as follows: Tongxinluo Capsules > Shenshao Capsules > Ginkgo Leaf Tablets>Compound Danshen Dropping Pills> Shexiang Baoxin Pills > Naoxintong Capsules > Yindan Xinnaotong Soft Capsules > Ginkgo Ketone Ester Dropping Pills. Chinese patent medicine combined with conventional therapy can improve the clinical efficacy of unstable angina pectoris. Due to the differences in the quantity and quality of the included studies, the order results of Chinese patent medicines need to be further verified.

[Chinese Herbs Prevented and Treated Radiographic Contrast Nephropathy after Percutaneous Coronary Intervention: an Analysis of Mechanism].

Now percutaneous coronary intervention (PCI) is an important treatment way for diag- nosing and treating coronary atherosclerotic heart disease (abbreviated as coronary heart disease). But use of contrast medium during intervention will result in acute renal failure. Hydration is a main measure to prevent radiographic contrast nephropathy at present. Chinese herbs play certain roles in preventing and treating radiographic contrast nephropathy. Theories of Chinese medicine hold blood stasis and toxin factor are main pathogeneses in radiographic contrast nephropathy. Therefore, blood promoting, stasis removing, and detoxification therapy is a main treatment method for preventing and treating radiographic contrast nephropathy.

[Analysis of therapeutic effect of acupuncture at neiguan (PC 6) and zusanli (ST 36) on acute renal colic].

OBJECTIVE: To observe the efficacy differences among acupuncture at Neiguan (PC 6) and Zusanli (ST 36), dolantin and scopolamine in treatment of acute renal colic, and to verify the clinical effect of acupuncture at Neiguan (PC 6) and Zusanli (ST 36). METHODS: Two hundred and forty patients were randomly divided into an acupuncture group, a scopolamine group and a dolantin group, 80 cases in each group. The acupuncture group was treated by acupuncture at unilateral or bilateral Neiguan (PC 6) and Zusanli (ST 36). The scopolamine group was treated by intramuscular injection of scopolamine combined with intravenous drip of scopolamine, and the dolantin group was treated by intramuscular injection of dolantin. The clinical therapeutic effects were observed 30 min after drug administration or acupuncture, and the onset time of effect and adverse reactions were compared among the groups. RESULTS: The total effective rate of 95.0% (76/80) in the acupuncture group had a similar therapeutic effect to 92.5% (74/80) in dolantin group (P>0.05), which were both superior to 76.3% (61/80) in scopolamine group (both P<0.05). The onset time of (13.24 +/- 2.12) min in the acupuncture group was significant earlier than (23.11 +/- 6.22) min in scopolamine group and (22.17 +/- 3.15) min in dolantin group (both P<0.05), and compared with the other two groups, the adverse reactions in the acupuncture group were significant decreased (both P<0.05). CONCLUSION: Acupuncture at Neiguan (PC 6) and Zusanli (ST 36) has a good analgesic effect with a low incidence of adverse reactions, which is superior to that of dolantin and scopolamine.