Effects of Danhong Injection () on Peri-Procedural Myocardial Injury and Microcirculatory Resistance in Patients with Unstable Angina Undergoing Elective Percutaneous Coronary Intervention: A Pilot Randomized Study.

OBJECTIVE: To evaluate the effect of Danhong Injection (, DH) on the index of microcirculatory resistance (IMR) and myocardial injury in patients with unstable angina undergoing elective percutaneous coronary intervention (PCI). METHODS: Seventy-eight patients with unstable angina were randomly divided into DH group (39 cases) and the control group (39 cases) during elective PCI. Randomization was performed using a random-number table. The DH group received DH at a dosage of 40 mL (mixed with 250 mL saline, covered by a light-proof bag, intravenous drip) during PCI and daily for 7 consecutive days, while the control group only received the same dosage of saline. Both groups received standardized treatment. The IMR and fractional flow reserve (FFR) were measured at maximal hyperemia before and after PCI. Myocardial markers, including myoglobin, creatine kinase (CK), creatine kinase MB (CK-MB), and coronary troponin T (cTnT) values were measured at baseline and 24 h after PCI. RESULTS: Among the 78 patients enrolled, the baseline and procedural characteristics were similar between the two groups. There was no significant difference in pre-PCI myocardial markers and coronary physiological indexes between the two groups. However, post-PCI CK and CK-MB levels in the DH group were significantly lower than those in the control group (111.97 ± 80.97 vs. 165.47 ± 102.99, P=0.013; 13.08 ± 6.90 vs. 19.75 ± 15.49, P=0.016). Post-PCI myoglobin and cTNT-positive tend to be lower in the DH group than in the control group but did not reach statistical significance (88.07 ± 52.36 vs. 108.13 ± 90.94, P=0.52; 2.56% vs.7.69%, P=0.065). Compared with the control group, the post-IMR levels of the DH group tended to decrease, but there was no statistical difference (20.73 ± 13.15 vs. 26.37 ± 12.31, P=0.05). There were no statistical differences in post-FFR in both groups. The peri-procedural myocardial injury of the DH group was significantly lower than that of the control group (2.56% vs. 15.38%, P=0.025). During the 30-d follow-up period, no major adverse cardiovascular events occurred in either group. CONCLUSION: This study demonstrated benefit of DH in reducing myocardial injury and potential preserving microvascular function in patients with unstable angina undergoing elective PCI.

Effect of Danhong Injection () on Improving Coronary Microcirculation Injury after Percutaneous Coronary Intervention.

OBJECTIVE: To explore the effectiveness of Danhong Injection () on improving microcirculatory injury after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). METHODS: A randomized controlled trial was conducted and 90 patients were enrolled. A random sequence was generated using statistical analysis software. Patients with microcirculatory injuries after PCI were randomly divided into 3 groups for treatment (30 subjects in each group): Danhong Injection group: after PCI, Danghong Injections were given with intravenous administration with 40 mL twice a day for a week; statins intensive group: after PCI, atorvastatin calcium tablets were given oral medication with 80 mg once, and then atorvastatin 40 mg daily for 1 week; the control group: after PCI, atorvastatin calcium tablets were given oral medication with 10-20 mg daily for 1 week. The index of microcirculation resistance (IMR) was used to assess microcirculatory injury during PCI. The IMR of the target vessel was reexamined after 1 week of drug treatment. RESULTS: After one week's drug treatment, IMR was significantly decreased in both statins intensive group and Danhong Injection group compared with the control group (P<0.01), but no difference was found between statins intensive group and Danhong injection group (14.03 ± 2.54 vs. 16.03 ± 5.72 U, P=0.080). CONCLUSIONS: The efficacy of Danhong Injection is non-inferior to statin. Early use of Danhong Injection after PCI can effectively improve coronary microcirculation injury after PCI.

In Vitro and In Vivo Inhibitory Effect of Gujin Xiaoliu Tang in Non-Small Cell Lung Cancer.

Non-small cell lung cancer (NSCLC) is a serious threat to people's health. This study aims to determine the possible effect of Gujin Xiaoliu Tang (GJXLT) on NSCLC, which is an empirical formula from Professor Dai-Han Zhou. In this study, chromatographic fingerprinting of GJXLT and A549 cell model in vitro and in vivo was established. We cultured A549 cells in vitro and found that GJXLT inhibited A549 cell growth and induced apoptosis. Compared with the control group, the expression of p-STAT3 and VEGF proteins in the GJXLT groups was decreased. Similar findings were also observed in vivo. First, GJXLT inhibited the growth of transplanted tumor and did not reduce the weight of the tumor-bearing mice in comparison with that of the control group. Then, the Ki-67 expression of transplanted tumor in the GJXLT groups was decreased. In addition, the apoptosis rate of transplanted tumor in the GJXLT groups was increased. Overall, our data showed that GJXLT inhibited A549 cell proliferation and induced apoptosis in vivo and in vitro. Furthermore, GJXLT inhibited the growth of lung cancer xenograft in nude mice model with no obvious side effects. The anti-tumor effect of GJXLT might also be related to the inhibition of p-STATS and VEGF expression in the JAK2/STAT3 pathway. Our results demonstrated the potential of GJXLT as a novel treatment for NSCLC.

Effects of green tea catechins with or without caffeine on glycemic control in adults: a meta-analysis of randomized controlled trials.

BACKGROUND: The effect of green tea catechins (GTCs) with or without caffeine on glycemic control is controversial. OBJECTIVE: We aimed to identify and quantify the effects of GTCs or GTC-caffeine mixtures on glucose metabolism in adults. DESIGN: A comprehensive literature search was conducted to identify relevant trials of GTCs with or without caffeine on markers of glycemic control [fasting blood glucose (FBG), fasting blood insulin (FBI), glycated hemoglobin (Hb A1c), and homeostatic model assessment of insulin resistance (HOMA-IR)]. Weighted mean differences were calculated for net changes by using fixed-effects models. Prespecified subgroup analyses were performed to explore the influence of covariates on net changes in FBG and FBI concentrations. RESULTS: Twenty-two eligible randomized controlled trials with 1584 subjects were identified. Pooled analyses showed that FBG (-1.48 mg/dL; 95% CI: -2.57, -0.40 mg/dL) decreased significantly with GTCs with or without caffeine, whereas FBI (0.04 µU/mL; 95% CI: -0.36, 0.45 µU/mL), Hb A1c (-0.04%; 95% CI: -0.15, 0.08%), and HOMA-IR (-0.05; 95% CI: -0.37, 0.26) did not. Subgroup analyses indicated that the glucose-lowering effect was apparent when the duration of follow-up was over a median of 12 wk. Overall, no significant heterogeneity was detected for FBG, FBI, Hb A1c, or HOMA-IR. CONCLUSIONS: The meta-analysis showed that the administration of GTCs with or without caffeine resulted in a significant reduction in FBG. The limited data available on GTCs did not support a positive effect on FBI, Hb A1c, or HOMA-IR. Thus, more large and well-designed trials are needed in the future. This trial was registered at http://www.crd.york.ac.uk/prospero as CRD42012002139.

[Beneficial effects of Tong-xin-luo (herb) on myocardial no-reflow after acute myocardial infarction and reperfusion: experiment of mini-swine model].

OBJECTIVE: To evaluate the beneficial effects of Tong-xin-luo on myocardial no-reflow after acute myocardial infarction (AMI) and reperfusion. METHODS: Forty mini-swine were randomized into 5 equal groups: control group, low-dose group (pretreated with Tong-xin-luo 0.05 g.kg(-1).d(-1) for 3 days), medium-dose group (pretreated with Tong-xin-luo 0.2 g .kg(-1).d(-1) for 3 days), high-dose group (pretreated with Tong-xin-luo 0.5 g.kg(-1).d(-1) for 3 days), and sham-operation group. The swine in the former four groups were subjected to 3 hours of coronary occlusion followed by 60 minutes of reperfusion. Left ventricle systolic pressure (LVSP), left ventricle end diastolic pressure (LVEDP), rate of maximum pressure change in left ventricle (+/- dp/dt(max)), cardiac output (CO), and heart rate (HR) were measured 5 min before AMI in all groups and 180 min after AMI and 60 min after reperfusion in the groups 1-4. Coronary blood volume (CBV) was recorded 5 min before AMI in all groups and immediately and 60 min after reperfusion in the group 1-4. Myocardial contrast echography (MCE) was used before AMI, 3 h after AMI, and 60 min after reperfusion in the group 1-4 so as to calculate the left ventricle wall area (LVWA), ligation area (LS), and %LA. Sixty minutes after reperfusion thioflavin-S was injected into the left ventricle to dye the reperfusion area, then the descending anterior branch was re-ligated at the original site and Evan's blue was injected into the left ventricle to dye the area outside the reperfusion area blue. The heart was taken out immediately to undergo pathological examination and calculation of LVWA, LS, area of no-reflow (SNR), LA, ANR. necrosis area (NS), and NA. RESULTS: (1) In the control group, systolic and diastolic blood pressures (SBP and DBP), LVSP, +/- dp/dt(max), and CO significantly decreased (P < 0.05 or P < 0.01), while LVEDP significantly increased (P < 0.01) 3 hour after AMI, and then LVSP was significantly recovered while +/- dp/dt(max) further significantly decreased (both P < 0.05) 60 minutes after reperfusion. In the 3 Tongxinluo groups, the changes of LVSP, +/- dp/dt(max), CO and LVEDP were the same as those in the control group 3 hours after AMI, and 60 minutes after reperfusion, +/- dp/dt(max), CO and LVEDP were recovered significantly in the high-dose group to degrees better than those in the control group (all P < 0.05). (2) In the control group, the LS values measured by MCE in vivo and by pathological evaluation were similar (P > 0.05), and the SNR was 78.5% by MCE in vivo and was 82.3% by pathological evaluation with the final NS reaching 98.5% of LS. There was no significant difference in LS by both MCE and pathological evaluation between the Tongxinluo groups and control group, though the values of SNR by both methods in the medium and high-dose groups were 41.1% and 42.4% and 24.1% and 25.0% respectively, all significantly lower than those in the control group and low-dose group (P < 0.05 or P < 0.01) with the values in the high-dose group being significantly lower than those in the median-dose group (P < 0.05 and P < 0.01). The final NS of pathological evaluation was also significantly decreased to 90.2%and 81.2% of LS (P < 0.05). In the control group, CBV was significantly decreased to 45.8% and 50.6% of the baseline value immediately at the beginning of reperfusion and 60 minutes after reperfusion (both P < 0.01). In the high-dose group, CBV was also significantly decreased to 76% and 73.5% of the baseline value immediately at the beginning of reperfusion and 60 minutes after reperfusion (both P < 0.05), however, both significantly higher than those in the control group (both P < 0.01). CONCLUSION: Tongxinluo is effective in preventing myocardial no-reflow, improving left ventricular function and reducing infarct area during AMI and reperfusion.

[The protective effects of Tong-xin-luo on myocardium and microvasculature after reperfusion in acute myocardial infarction].

OBJECTIVE: To evaluate the protective effects of Tongxinluo on myocardium and microvasculature after reperfusion in patients with acute myocardial infarction. METHODS: The research was performed on the patients with AMI whose initial ECG showed ST segment elevation and the patients received PCI or thrombolysis immediately after onset. These patients were classified randomly into two groups: control group in which the patients were given routine drug treatment (52 cases) and treatment group in which the patients were given routine drug plus Tongxinluo capsule (60 cases). We observed the abnormal movement of the ventricle wall in 2DE, and the change in LVEDV or LVEF on the 1st day, 7th day, 13th day, 3rd month, and 6th month after onset, which were compared with the result of DISA and SPECT for myocardial image. At the same time we also examined the blood NO and MDA levels on the 1st day, the 7th day and 13th day. RESULTS: (1) The recover rate for the abnormal movement of the ventricle segments in the treatment group were 11.86%, 18.12% and 18.79% respectively, which were higher than that of the control group (4.13%, 8.27% and 11.11% respectively) on the 1st week, the 2nd week, and the 1st month. At the 6th month the total recover rate for the abnormal movement of the ventricle segments of Tongxinluo group was 70.03%, which was significantly higher than that of the control group (51.68%). The WMSI was also decreased more than that of the control group. (2) The LVEDV in Tongxinluo group increased by 9.42% one week after onset, which was close to that of the control group (9.59%). There was no significant change (9.40% and 9.42% respectively) after two weeks and one month in Tongxinluo group, whereas it was increased continuously in the control group (11.84% and 12.33%). LVEDV in Tongxinluo group was decrease obviously after three and six months (3.62% and 5.07% respectively), which was close to the original level, whereas the result of the control group remained on a higher level (13.70% and 11.72% respectively). (3) LVEF of the Tongxinluo group was 53.32% before treatment, which was comparable with that of the control group (P = 0.45). There was no significant difference between the two groups after treatment for 1 week, 2 week and 1 month (P = 0.11, P = 0.13, P = 0.18, respectively). LVEF for the two groups was 58.27% and 53.40% respectively after three months and there was a statistical significance (P < 0.01). LVEF for the two groups was 58.33% and 53.82% respectively after 6 months and the difference remained statistically significant (P < 0.05). (4) The 2DE WMSI for the Tongxinluo group was 1.7552 after 12 hours to 24 hours of the CVR and there was no significant difference compared with that of the control group (WMSI = 1.5380, P = 0.6945). After 6 months, the WMSI decreased to 1.3767 in the Tongxinluo group, which was statistically different from that of the control group (WMSI = 1.5380, P < 0.01). The myocardium acquire isotope score index of the Tongxinluo group was 0.6075 at 6 months, which was significantly different from that of the control group (0.8781). (5) Ultrasonic humerus artery examination in static status showed that there was no significant difference on the diameter of blood vessel and the speed of blood stream between Tongxinluo group and control group with. The diameter of the blood vessel after artery pressure in Tongxinluo group was expanded, which was significantly different from that in the static status (P < 0.001) and that in control group (P < 0.001). The diameter of blood vessel after administration of nitroglycerin in both groups was expanded, which was significantly different from that in the static status (P < 0.001 and P < 0.05). However, Tongxinluo group was expand more obviously than that of the control group (P < 0.05). (6) The MDA level of the Tongxinluo group was decreased (all P < 0.05) and the NO level was increased (all P < 0.05) gradually from the 1st week to the 4th week; however, the MDA level of the control group was not decreased until the 4th week (P < 0.05), and the NO level of the control group was increased evidently at the 2nd week (P < 0.05). CONCLUSIONS: (1) After reperfusion in AMI patients, administration of routine drug combined with Tongxinluo is more effective than routine drug alone in the reduction of infarction size. (2) In Tongxinluo group, the recover time and the total recover rate of the abnormal movement of the ventricle segments were higher than the control group, and the WMSI were significantly decreased than the control group. (3) The improvement degree and the recover time on LVEDV in Tongxinluo group was superior to control group. (4) The improvement of LVEF in time and in degree was superior to control group. (5) The blood concentration of the MDA was decreased significantly in Tongxinluo group, while the NO level was increased significantly, and the time was superior to control group significantly.