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Backgrounds Dyslipidemia is a prominent risk factor for cardiovascular diseases and one of the primary independent modifiable factors of diabetes and stroke. Statins can significantly improve the prognosis of dyslipidemia, but its side effects cannot be ignored. Traditional Chinese Medicine (TCM) has been used in clinical practice for more than 2000 years in China and has certain traits in treating dyslipidemia with little side effect. Previous research has shown that Mutual Obstruction of Phlegm and Stasis (MOPS) is the most common dyslipidemia type classified in TCM. However, how to compose diagnostic factors in TCM into diagnostic rules relies heavily on the doctor's experience, falling short in standardization and objectiveness. This is a limit for TCM to play its advantages of treating dyslipidemia with MOPS. Methods In this study, the syndrome diagnosis in TCM was transformed into the prediction and classification problem in artificial intelligence The deep learning method was employed to build the classification prediction models for dyslipidemia. The models were built and trained with a large amount of multi-centered clinical data on MOPS. The optimal model was screened out by evaluating the performance of prediction models through loss, accuracy, precision, recall, confusion matrix, PR and ROC curve (including AUC). Results A total of 20 models were constructed through the deep learning method. All of them performed well in the prediction of dyslipidemia with MOPS. The model-11 is the optimal model. The evaluation indicators of model-11 are as follows: The true positive (TP), false positive (FP), true negative (TN) and false negative (FN) are 51, 15, 129, and 9, respectively. The loss is 0.3241, accuracy is 0.8672, precision is 0.7138, recall is 0.8286, and the AUC is 0.9268. After screening through 89 diagnostic factors of TCM, we identified 36 significant diagnosis factors for dyslipidemia with MOPS. The most outstanding diagnostic factors from the importance were dark purple tongue, slippery pulse and slimy fur, etc. Conclusions This study successfully developed a well-performing classification prediction model for dyslipidemia with MOPS, transforming the syndrome diagnosis problem in TCM into a prediction and classification problem in artificial intelligence. Patients with dyslipidemia of MOPS can be accurately recognized through limited information from patients. We also screened out significant diagnostic factors for composing diagnostic rules of dyslipidemia with MOPS. The study is an avant-garde attempt at introducing the deep-learning method into the research of TCM, which provides a useful reference for the extension of deep learning method to other diseases and the construction of disease diagnosis model in TCM, contributing to the standardization and objectiveness of TCM diagnosis.

Acute myocardial infarction (AMI) has been a preclinical and clinical concern due to high hospitalization rate and mortality. This study was aimed at evaluating the effectiveness and safety of Shexiang Baoxin Pill (SBP) for AMI and exploring the possible mechanism of oxidative stress. Six databases were searched on March 26, 2021. Twenty-four studies were included and accessed by the RoB 2.0 or SYRCLE tool. Compared with routine treatment (RT), SBP showed the effectiveness in the clinical efficacy ( RR = 1.15 , 95% CI [1.06, 1.25]), left ventricular ejection fraction (LVEF) ( SMD = 0.73 , 95% CI [0.62, 0.95]), glutathione (GSH) ( SMD = 2.07 , 95% CI [1.51, 2.64]), superoxide dismutase (SOD) ( SMD = 0.92 , 95% CI [0.58, 1.26]), malondialdehyde (MDA) ( SMD = − 4.23 , 95% CI [-5.80, -2.66]), creatine kinase-myocardial band (CK-MB) ( SMD = − 4.98 , 95% CI [-5.64, -4.33]), cardiac troponin I (cTnI) ( SMD = − 2.17 , 95% CI [-2.57, -1.76]), high-sensitivity C-reactive protein (Hs-CRP) ( SMD = − 1.34 , 95% CI [-1.56, -1.12]), interleukin-6 (IL-6) ( SMD = − 0.99 , 95% CI [-1.26, -0.71]), triglycerides (TG) ( SMD = − 0.52 , 95% CI [-0.83, -0.22]), flow-mediated dilation (FMD) ( SMD = 1.39 , 95% CI [1.06, 1.72]), von Willebrand Factor (vWF) ( SMD = − 1.77 , 95% CI [-2.39, -1.15]), nitric oxide (NO) ( SMD = 0.89 , 95% CI [0.65, 1.13]), and recurrent rate ( RR = 0.30 , 95% CI [0.15, 0.59]). But SBP adjunctive to RT plus PCI had no improvements in almost pooled outcomes except for the Hs-CRP ( SMD = − 1.19 , 95% CI [-1.44, -0.94]) and TG ( SMD = − 0.25 , 95% CI [-0.48, -0.02]). Laboratory findings showed that SBP enhanced the endothelial nitric oxide synthase (eNOS) activity and regulated laboratory indexes especially for homocysteine. In conclusion, SBP has adjunctive effects on AMI via the mechanism of antioxidative stress. The current evidence supports the use of SBP for mild and moderate AMI patients.

Drugs for the treatment of tumors could result in cardiotoxicity and cardiovascular diseases. We aimed to explore the anticancer properties of Huang yam as well as its cardioprotective properties using network pharmacology and molecular docking technology. The cardiovascular targets of the major chemical components of Huang yam were obtained from the following databases: TCMSP, ETCM, and BATMAN-TCM. The active ingredients of Huang yam were obtained from SwissADME. The cardiovascular targets of antitumor drugs were obtained using GeneCards, OMIM, DrugBank, DisGeNET, and SwissTargetPrediction databases. The drug-disease intersection genes were used to construct a drug-compound-target network using Cytoscape 3.7.1. A protein-protein interaction network was constructed using Cytoscape’s BisoGenet, and the core targets of Huang yam were screened to determine their antitumor properties and identify the cardiovascular targets based on topological parameters. Potential targets were imported into the Metascape platform for GO and KEGG analysis. The results were saved and visualized using R software. The components with higher median values in the network were molecularly docked with the core targets. The network contained 10 compounds, including daucosterol, delusive, dioxin, panthogenin-B, and 124 targets, such as TP53, RPS27A, and UBC. The GO function enrichment analysis showed that there were 478 items in total. KEGG enrichment analysis showed a total of 140 main pathways associated with abnormal transcription of cancer, PI3K-Akt signaling pathway, cell cycle, cancer pathway, ubiquitination-mediated proteolysis, and other pathways. Molecular docking results showed that daucosterol, delusive, dioxin, and panthogenin-B had the highest affinity for TP53, RPS27A, and UBC. The treatment of diseases using traditional Chinese medicine encompasses multiple active ingredients, targets, and pathways. Huang yam has the potential to treat cardiotoxicity caused by antitumor drugs.

A peptic ulcer (PU) is a digestive disorder most commonly found in clinical practice. An oriental herbal formula, Xiao Chai Hu Tang (XCHT), has been used to treat PU for an extended period in China. The effectiveness and safety of XCHT in treating peptic ulcers was evaluated using a systematic review of randomized controlled trials (RCTs). Studies were systematically retrieved from CNKI, Embase, Medline, PubMed, SinoMed, VIP, Wanfang, and Web of Science. The following information was extracted from the relevant RCTs: the clinical efficacy rate, recurrence rate, clinical efficacy of traditional Chinese medicine, and the adverse effects. 13 RCTs, including 1334 patients, were included in this review. The meta-analysis showed that treatment with XCHT was superior to conventional pharmacotherapy (CPT) in improving the clinical efficacy rate (RR: 1.20, 95% confidence intervals (CIs): 1.08–1.34, P = 0.0007 ), poor appetite (RR: 0.30, 95% CI: 0.15–0.61, P = 0.0009 ), abdominal distension (RR: 0.61, 95% CI: 0.39–0.96, P = 0.03 ), vomiting (RR: 0.33, 95% CI: 0.19–0.55, P < 0.0001 ), and stomach pain (RR: 0.36, 95% CI: 0.19–0.68, P = 0.002 ) and reducing adverse events (RR: 0.23, 95% CI: 0.07–0.69, P = 0.009 ). XCHT considerably increased the total clinical efficacy rate (RR: 1.22, 95% CI: 1.15–1.30, P < 0.00001 ) as both monotherapy and adjunctive therapy. The recurrence rate (RR = 0.29; 95% CI: 0.16–0.52, P < 0.0001 ) was remarkably decreased in the XCHT plus CPT group. The meta-analysis did not show a significant beneficial effect of XCHT compared with CPT in reducing the recurrence rate (RR = 0.45; 95% CI: 0.07–3.10, P = 0.42 ) and acid reflux (RR: 0.76, 95% CI: 0.47–1.23, P = 0.26 ). Our findings show that XCHT can treat peptic ulcers as part of an alternative medicine approach.

Aiming at the trajectory and motion characteristics of weakly constrained non-cooperative targets, a LSTM-based encoder-decoder multi-step trajectory prediction technology (EDMTP) is proposed. The introduction of first-order difference processing reduces the time dependence of the trajectory data, and obtains a trendless trajectory. Constructing an input and output trajectory data pair, transforming the prediction problem into a supervised learning problem, the change of model performance in the multi-step prediction process is studied to realize end-to-end trajectory prediction. Simulation results show that this method can extract more trajectory features from historical trajectory data, and has obvious advantages in multi-step trajectory prediction. Compared with the trajectory prediction algorithms of KFTP and HMMTP, the error growth rate of EDMTP decrease by 2.18% and 3.52% year-on-year, respectively, and achieves better trajectory prediction results.

Objective. To evaluate the clinical effectiveness and safety of acupuncture therapy in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) or functional diarrhea (FD) in adults. Method. Five electronic databases—PubMed, EMBASE, CNKI, VIP, and Wanfang—were searched, respectively, until June 8, 2020. The literature of clinical randomized controlled trials of acupuncture for the treatment of IBS-D or FD in adults were collected. Meta-analysis was conducted by Using Stata 16.0 software, the quality of the included studies was assessed by the RevMan ROB summary and graph, and the results were graded by GRADE. Result. Thirty-one studies with 3234 patients were included. Most of the studies were evaluated as low risk of bias related to selection bias, attrition bias, and reporting bias. Nevertheless, seven studies showed the high risk of bias due to incomplete outcome data. GRADE’s assessments were either moderate certainty or low certainty. Compared with loperamide, acupuncture showed more effectiveness in weekly defecation ( SMD = − 0.29 , 95% CI [-0.49, -0.08]), but no significant improvement in the result of the Bristol stool form ( SMD = − 0.28 , 95% CI [-0.68, 0.12]). In terms of the drop-off rate, although the acupuncture group was higher than the bacillus licheniformis plus beanxit group ( RR = 2.57 , 95% CI [0.24, 27.65]), loperamide group ( RR = 1.11 , 95% CI [0.57, 2.15]), and trimebutine maleate group ( RR = 1.19 , 95% CI [0.31, 4.53]), respectively, it was lower than the dicetel group ( RR = 0.83 , 95% CI [0.56, 1.23]) and affected the overall trend ( RR = 0.93 , 95% CI [0.67, 1.29]). Besides, acupuncture produced more significant effect than dicetel related to the total symptom score ( SMD = − 1.17 , 95% CI [-1.42, -0.93]), IBS quality of life ( SMD = 2.37 , 95% CI [1.94, 2.80]), recurrence rate ( RR = 0.43 , 95% CI [0.28, 0.66]), and IBS Symptom Severity Scale ( SMD = − 0.75 , 95% CI [-1.04, -0.47]). Compared to dicetel ( RR = 1.25 , 95% CI [1.18, 1.32]) and trimebutine maleate ( RR = 1.35 , 95% CI [1.13, 1.61]), acupuncture also showed more effective at total efficiency. The more adverse effect occurred in the acupuncture group when comparing with the dicetel group ( RR = 11.86 , 95% CI [1.58, 89.07]) and loperamide group ( RR = 4.42 , 95% CI [0.57, 33.97]), but most of the adverse reactions were mild hypodermic hemorrhage. Conclusion. Acupuncture treatment can improve the clinical effectiveness of IBS-D or FD, with great safety, but the above conclusions need to be further verified through the higher quality of evidence.

Background and Aim. Antineoplastic drug-induced cardiotoxicity (ADIC) becomes the second leading cause of death for tumor survivors after tumor recurrence and metastasis, and there may be great room for development in the future of traditional Chinese medicine (TCM). However, the theory of anticardiotoxicity of TCM has not yet formed a system. This study aimed to explore the material basis and the rule of TCM against ADIC based on network pharmacology and data mining. Methods. The targets of antineoplastic drugs with cardiotoxicity were obtained from the National Center for Biotechnology Information (NCBI) database, China national knowledge infrastructure (CNKI) database, and Swiss Target Prediction platform. Then, the cardiotoxicity-related targets were derived from the Gene Cards, Disgenet, OMIM, and DrugBank databases, as well as the drug of current clinical guidelines. The targets both in these two sets were regarded as potential targets to alleviate ADIC. Then, candidate compounds and herbs were matched via Traditional Chinese Medicine Systems Pharmacology (TCMSP) platform. Cytoscape3.7.1 was used to set up the target-compound-herb network. Molecular docking between core targets and compounds was performed with AutodockVina1.1.2. The rules of herbs were summarized by analyzing their property, flavor, and channel tropism. Results. Twenty-one potential targets, 332 candidate compounds, and 400 kinds of herbs were obtained. Five core targets including potassium voltage-gated channel subfamily H member 2 (KCNH2), cyclin-dependent kinase 1 (CDK1), matrix metalloproteinase 2 (MMP2), mitogen-activated protein kinase1 (MAPK1), and tumor protein p53 (TP53) and 29 core compounds (beta-sitosterol, quercetin, kaempferol, etc.) were collected. Five core herbs (Yanhusuo, Gouteng, Huangbai, Lianqiao, and Gancao) were identified. Also, the TCM against ADIC were mainly bitter and acrid in taste, warm in property, and distributed to the liver and lung meridians. Conclusion. TCM against ADIC has great potential. Our study provides a new method and ideas for clinical applications of integrated Chinese and western medicine in treating ADIC.

Hypertension is one of the most significant public health challenges worldwide. An increasing number of patients prefer to incorporate traditional Chinese medicine into their hypertensive care. The Songling Xuemaikang capsule (SXC), a Chinese herbal formula, is widely used in China for essential hypertension.To assess the efficacy and safety of SXC for essential hypertension.Systematic review and meta-analysis of randomized controlled trials (RCTs).We conducted a systematic literature search of seven databases to identify randomized controlled trials of SXC for hypertension. The outcome measures included blood pressure parameters and patient-reported outcomes. Potential heterogeneity between the studies was resolved by subgroup and sensitivity analyses. The quality of the results was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.A total of 34 trials with 4306 patients were included. The results showed that SXC plus antihypertensive drugs produced a greater effect on reducing systolic blood pressure (SBP) (MD: -7.54 mmHg; 95% CI: -8.92, -6.17; p0.00001), diastolic blood pressure (DBP) (MD: -6.42 mmHg; 95% CI: -7.54, -5.29; p0.00001), 24-hour SBP (MD: -6.88 mmHg; 95% CI: -8.36, -5.39; p0.00001), and 24-hour DBP (MD: -4.31 mmHg; 95% CI: -6.55, -2.07; p = 0.0002) and improving hypertensive symptoms (SMD: -1.09; 95% CI: -1.34, -0.84; p0.00001) than antihypertensive drugs alone. SXC monotherapy was less effective than antihypertensive drugs for 24-hour SBP reduction (MD: 2.07 mmHg; 95% CI: 0.19, 3.96; p = 0.03). No significant difference was observed in the incidence of adverse events between the SXC and control groups.SXC is beneficial for essential hypertension; it can lower BP, improve hypertensive symptoms and is well tolerated.

Ventricular remodeling is the progressive pathologic change of the original substance and morphology of the ventricle caused by various injuries and has attracted increasing attention in the past decade. This study aims to conduct a bibliometric analysis of articles on ventricular remodeling published in the Web of Science Core Collection database from 2012 to 2022 to understand the current research state in the field of ventricular remodeling and provide insights for clinicians and researchers. As a result, a total of 1710 articles on ventricular remodeling were included. Annual publications have been gradually increasing and have remained at a high level over the past 10 years. The United States of America contributed the most publications, followed by China. Circulation was the most mainstream and authoritative journal focusing on ventricular remodeling. Research hotspot analysis suggested that myocardial infarction was the primary risk factor for ventricular remodeling, and emerging risk factor studies have focused on pulmonary hypertension, aortic stenosis, and diabetes. The mechanisms in the pathogenesis of ventricular remodeling were mainly closely associated with inflammation, apoptosis, oxidative stress, and myocardial fibrosis. Intensive investigation of the interactions between different mechanisms might be a future research direction. In terms of treatment, cardiac resynchronization therapy was a hot topic of research. These findings can help researchers grasp the research status of ventricular remodeling and determine future research directions.

By analyzing the development characteristics of sports microblog cultural public opinion under the big data environment and the specific needs of automatic public opinion monitoring, the paper designs a sports microblog cultural public opinion hotspot mining system structure model, and describes the main functions and implementation methods of each layer. The paper first uses tools such as ICTCLAS and AntConc to extract hot words, then describes the standardized data representation, and finally uses the Chameleon clustering algorithm to achieve clustering and topic extraction of hot blog posts. This method will provide information support for timely discovering sensitive information and grasping the hot spots of sports microblog culture and public opinion.

Background: Although a number of clinical studies have investigated the effectiveness and safety of auricular therapy for treating hypertension, the overall evidence remains uncertain. Aims: We aimed to evaluate the evidence for the effect of auricular therapy on blood pressure using meta-analysis methodology. Methods: We searched PubMed, Embase, Cochrane Library databases, Clinicalkey, China National Knowledge Infrastructure, China Scientific Journal Database and Wanfang Database and Chinese Biomedicine for trials that compared the effects of auricular therapy to that of sham auricular therapy, antihypertensive drugs, or no intervention on blood pressure. Blood pressure values before and after treatment, magnitude of blood pressure change between baseline and post-intervention, and the efficacy rate, as outcomes, were synthesized by RevMan 5.3. Continuous outcomes were expressed as weighted mean differences, and dichotomous data were expressed as relative risks with 95% confidence intervals. Results: We systematically reviewed 44 randomized controlled trials (involving 5022 patients through June 2018). Auricular acupressure plus antihypertensive drugs might be more effective than antihypertensive drugs alone in both reducing systolic blood pressure value after treatment ( n=464 patients; mean difference, −5.06 mm Hg; 95% confidence interval, –6.76– −3.36, p2=32%), decreasing diastolic blood pressure after treatment ( n=464 patients; mean difference, −5.30 mm Hg; 95% confidence interval, –6.27– −4.33, p2=0%) and the efficacy rate (relative risk, 1.22; 95% confidence interval, 1.17–1.26; p2=0%). Conclusion: Auricular therapy could be provided to patients with hypertension as an adjunct to antihypertensive drugs for lowering blood pressure value and achieving blood pressure targets.

Endothelial dysfunction, induced by oxidative stress, is an essential factor affecting cardiovascular disease. Uncoupling of endothelial nitric oxide synthase (eNOS) leads to a decrease in nitric oxide (NO) production, an increase in reactive oxygen species (ROS) production, NO consumption, and NO synthesis. As a main active ingredient of astragalus, astragaloside IV can reduce the apoptosis of endothelial cells during oxidative stress. This review is aimed at exploring the mechanism of astragaloside IV in improving oxidative stress-mediated endothelial dysfunction relevant to cardiovascular diseases. The findings showed that the astragaloside IV can prevent or reverse the uncoupling of eNOS, increase eNOS and NO, and enhance several activating enzymes to activate the antioxidant system. In-depth validation and quantitative experiments still need to be implemented.

BackgroundAlthough traditional Chinese medicine is safe for the clinical treatment of angiogenesis, the in vivo intervention mechanism is diverse, complex, and largely unknown. Therefore, we aimed to explore the active ingredients of traditional Chinese medicine and their mechanisms for the treatment of angiogenesis.MethodsData on angiogenesis-related targets were collected from the GeneCards, Therapeutic Target Database, Online Mendelian Inheritance in Man, DrugBank, and DisGeNET databases. These were matched to related molecular compounds and ingredients in the traditional Chinese medicine system pharmacology platform. The data were integrated; based on the condition of Degree >1 and relevant literature, a target-compound network as well as compound-medicine and target-compound-medicine networks were constructed using Cytoscape. Molecular docking was used to predict the predominant binding combination of core targets and components.ResultsWe obtained a total of 79 targets for angiogenesis, and 41 targets were matched to 3839 compounds. Then, 110 compounds were selected owing to their high correlation with angiogenesis. Fifty-five combinations in the network were obtained by molecular docking, among which PTGS2-Astragalin (-9.18 kcal/mol), KDR-Astragalin (-7.94 kcal/mol), PTGS2-quercetin (-7.41 kcal/mol), and PTGS2-myricetin (-7.21 kcal/mol) were the top combinations. These results indicated that the selected potential core compounds may have good binding activity with the core targets. Eighty new combinations were obtained from the network, and the top combinations based on affinity were KDR-beta-carotene (-10.13 kcal/mol), MMP9-beta-Sitosterol (-8.04 kcal/mol), MMP9-Astragalin (-7.82 kcal/mol), and MMP9-Diosgenin (-7.51 kcal/mol). The core targets included PTGS2, KDR, VEGFA, and MMP9. The essential components identified were astragalin, kaempferol, myricetin, quercetin, and β-sitosterol. The crucial Chinese medicines identified included Polygoni Cuspidati Rhizoma et Radix, Morus alba Root Bark, and Forsythia Fructus.ConclusionsBy systematically analysing the essential ingredients of traditional Chinese medicine and their targets, it is possible to determine their potential mechanism of action in the treatment of pathological angiogenesis. Our study provides a basis for further research and development of new therapeutics for angiogenesis.

IntroductionDyslipidaemia is a critical factor in the development of atherosclerotic cardiovascular disease. Concerning dyslipidaemia regulation, we advocate for lifestyle interventions such as diet to complement drug treatment. Numerous studies have confirmed that oat β-glucan, a critical component of oats, can help lower cholesterol. However, there is no conclusive evidence for the efficacy of oats and their products in the treatment of dyslipidaemia. As a result, we have developed this protocol to serve as a guide for future research on oat intervention for dyslipidaemias.Methods and analysisWe will conduct a search of eight databases or websites (PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, SinoMed, VIP and Wanfang) to identify studies on oats’ ability to regulate blood lipid levels. Two authors will screen articles independently, extract data based on inclusion and exclusion criteria, and assess the quality and bias of included studies. To assess and quantify heterogeneity, Q and I2 statistics will be used. If there is significant heterogeneity between studies, the source of the heterogeneity will be investigated using subgroup analysis and sensitivity analysis. We will analyse potential publication bias using the Begg funnel plot and Egger’s weighted regression statistics. To assess the quality of evidence for the primary outcomes, the Grades of Recommendations, Assessment, Development and Evaluation method will be used.Ethics and disseminationThis study is based on the existing literature and data in the databases. It is not subject to ethical review. The findings, on the other hand, will be published in a peer-reviewed journal. These findings may aid in the management of dyslipidaemia on a daily basis.PROSPERO registration numberCRD42021226751.

Supplemental Digital Content is available in the text, Introduction: Unstable angina pectoris is an acute exacerbation secondary to coronary artery occlusion. In routine clinical treatment, patients with unstable angina pectoris are prone to recurrence or aggravation of symptoms. Based on the traditional Chinese medicine (TCM) theory, phlegm, and blood stasis are one of the main pathological factors of unstable angina pectoris. The treatment of unstable angina pectoris with phlegm-blood stasis syndrome by Gualou Danshen granules (GLDS) has been the focus of many clinical trials. However, there is no evidence to prove the safety or clinical efficacy of GLDS. Methods and analysis: In this study, we will conduct a 4-week randomized, controlled feasibility study, with participants recruited from Guang’anmen Hospital, Chinese Academy of Traditional Chinese Medicine. Sixty subjects are to be diagnosed as having phlegm-blood stasis syndrome and randomly divided into a treatment group (GLDS) and placebo group in a 1:1 ratio. Result measurements will include therapeutic indicators (Clinical Symptom Rating Scale, Phlegm-Blood Stasis Syndrome Scale, and Seattle Angina Questionnaire) and safety indicators (blood routine, urine routine, electrocardiogram, liver function, and kidney function). The clinical data management system (http://www.tcmcec.net/) will be used to collect and manage data. Quality control will be implemented according to good clinical practice. Discussion: Previous TCM clinical trials have investigated if adding GLDS to standard routine treatment can improve the therapeutic effect in patients with unstable angina pectoris. This study focuses on the safety and efficacy of GLDS on unstable angina pectoris of phlegm-blood stasis type, in order to obtain relevant clinical evidence. Trial registration: This study is approved by the Ethics Committee of Guang’anmen Hospital of the China Academy of Chinese Medical Sciences (no. 2019–187-KY-02) and is registered with chictr.org (registration number ChiCTR2000031780).

To evaluate the safety and clinical efficacy of Yangxue Qingnao (YXQN) granules in the treatment of chronic cerebral circulation insufficiency (CCCI), electronic databases—PubMed, Embase, CNKI, VIP, and Wangfang—were searched for randomized controlled trials (RCTs) published up to January 2019. GRADE and RevMan 5.3.0 were used for grading and analysis, respectively. Fifteen trials involving 1211 CCCI patients were included. Subgroup analysis was performed owing to study heterogeneity. Compared to nimodipine plus routine treatment, YXQN granules plus routine treatment were more effective in increasing basilar artery (BA) blood flow velocity (mean difference (MD) = 3.34, 95% confidence interval (CI) = [2.31, 4.37], P<0.00001), vertebral artery (VA) blood flow velocity (MD = 0.52, 95% CI = [0.27, 0.76], P<0.0001), and internal carotid artery (ICA) blood flow velocity (MD = 7.46, 95% CI = [2.01, 12.90], P=0.007). In improving the clinical efficacy of traditional Chinese medicine (TCM) for symptoms such as headache, dizziness, and insomnia, YXQN granules plus routine treatment were shown to be superior to the following control treatments: nimodipine plus routine treatment (mean difference (M-H) = 4.21, 95% CI = [2.49, 7.12], P<0.00001), flunarizine plus routine treatment (mean difference (M-H) = 3.92, 95% CI = [1.36, 11.29], P=0.01), troxerutin plus routine treatment (mean difference (M-H) = 4.79, 95% CI = [2.20, 10.42], P<0.00001), and routine treatment (mean difference (M-H) = 6.13, 95% CI = [1.48, 25.34], P=0.01). Risk of bias was assessed in 15 trials. One analysis was graded using GRADE and showed poor results. Adverse events were not reported explicitly in all but one trial. Thus, this meta-analysis suggests that YXQN granules may be beneficial for patients with CCCI. However, owing to the poor quality of the clinical trials and small sample sizes, a definite conclusion on the efficacy and safety of YXQN granules cannot be drawn from existing information.

Introduction Stable angina pectoris has a high prevalence and causes serious harm. Revascularization therapy can relieve angina pectoris to some extent, but it is not widely accepted in China due to the cost and secondary events. The Chinese proprietary medicine Danlou tablet has been widely used to treat angina pectoris, but previous trials had inadequate methodologies. In this study, we aim to conduct a randomized controlled trial to evaluate its efficacy and safety on stable angina. Methods and analysis This study is a WeChat-based randomized, double-blind, and placebo-controlled clinical trial in China. Eligible participants are adults (aged 30-75 years) with CT-confirmed stable angina and traditional Chinese medicine-diagnosed intermingled phlegm and blood stasis syndrome. A total of 76 participants will be randomly allocated in a 1:1 ratio to the oral Danlou tablet group (1.5 mg a time, 3 times daily for 28 days) or the placebo group. Patients are permitted concomitant use of routine medications during these 28 days. The primary outcome is angina frequency per week. The secondary outcomes include angina severity, angina duration, traditional Chinese medicine efficacy, the withdrawal rate of emergency medications, blood lipids, and electrocardiograph efficacy. The WeChat app will be used to remind patients to take their medicines and fill out the forms. All data will be recorded in case report forms and analyzed by Statistical Analysis System software. Ethics and dissemination This study has been approved by the Ethics Committee of Guang'anmen Hospital, China Academy of Chinese Medical Sciences in Beijing, China (No. 2019-225-KY). Trial registration number ClinicalTrials.gov, ID: ChiCTR1900028068.

Background Research on coronary heart disease (CHD) remains one of the major concerns in the medical and health fields in recent decades, yet data on the circumstances of CHD are unsatisfying. We aimed to evaluate the situations and trends of the most cited articles in CHD via bibliometric approaches. Methods and results The Web of Science database was used to identify the 100 most cited articles concerning CHD. General and bibliometric information was collected and analyzed. The total citations ranged from 7829 to 1157. Clinical trial was the largest proportion in article type while risk factor was the most preferred study content. The New England Journal of Medicine published the most T100 articles ( n =31), followed by Lancet ( n =21), Circulation ( n =19) and JAMA ( n =12). The USA and UK were the leading countries in the field of CHD, and contributed enormously in combating CHD. Conclusions This study presented a detailed analysis of the 100 most cited articles focused on CHD in recent decades, which provides insights into the circumstances and trends in preventing and treating CHD.

Qi stagnation and blood stasis syndrome (QS&BSS) is one of the common Zhengs in traditional Chinese medicine (TCM), which manifests as various symptoms and signs, such as distending pain or a tingling sensation in a fixed position. In recent years, a number of clinical trials have focused on the effectiveness and safety of XFZYC in patients with a QS&BSS subtype disease, such as coronary heart disease, hyperlipidaemia, ischaemic cerebrovascular disease, gastritis, dysmenorrhoea, or arthritis, in terms of the outcomes of relevant diseases. However, there is lack of evidence of the effects of XFZYC in patients with QS&BSS with different diseases, focusing on the outcomes of Zhengs. A randomised, controlled, pilot and feasibility trial will be employed in this study, using a 7-week study period. Participants will be recruited from Guang’anmen Hospital, Huguosi TCM Hospital, Wangjing Hospital in China. One hundred and twenty participants will be randomised to a treatment group (Xue-Fu-Zhu-Yu Capsule (XFZYC)) and placebo group in a 1:1 ratio. Participants included in the study must be diagnosed with Qi stagnation and blood stasis syndrome criteria. The outcome measurements will include the traditional Chinese medicine patient-reported outcome (PRO) scale for QS&BSS, the single symptom and sign scale of QS&BSS, and the pain scale of QS&BSS. The clinical data management system ( http://www.tcmcec.net /) will be used to collect and manage the data. Quality control will be used, according to Good Clinical Practice (GCP). Previous studies were expected to evaluate whether the addition of XFZYC to standard routine treatment would enhance the treatment effectiveness and improve the biomedical parameters pertaining to relevant disease. However, this trial is focused on the outcome of Zhengs, and we chose a range of outcome measurements to assess the improvement of relevant symptoms and signs. This trial is the first study designed to define and optimise the outcome measurements of Zhengs of XFZYC in the treatment of patients with QS&BSS. ClinicalTrials.gov, NCT03091634 . Registered on 12 August 2018. Release date 6 May 2017.

Figure S1. Study flow chart. (PDF 203 kb)

Standard protocol items: recommendation for interventional trials (SPIRIT) 2013 checklist: Recommended items to address in a clinical trial protocol and related documents. (PDF 171 kb)

Table S1. TCM syndrome diagnostic scale of QS&BSS. Table S2. Chinese Medicine PRO Scale in Patients of Qi-stagnation and blood-stasis Syndrome. Table S3. Single Symptom and Sign Scale of QS&BSS. Table S4. Pain Scale of QS&BSS (PDF 360 kb)

Wenxin-Keli (WXKL) is a Chinese herbal compound reported to be of benefit in the treatment of cardiac arrhythmia, cardiac inflammation, and heart failure. Amiodarone is a noncompetitive inhibitor of theα- andβ-adrenergic receptors and prevents calcium influx in the slow-response cells of the sinoatrial and atrioventricular nodes. Overexpression of Ca2+/calmodulin-dependent protein kinase II (CaMKII) in transgenic mice results in heart failure and arrhythmias. We hypothesised that administration of WXKL and amiodarone can reduce the incidence of arrhythmias by regulating CaMKII signal transduction. A total of 100 healthy Sprague Dawley rats were used in the study. The rats were randomly divided into four groups (a sham group, a myocardial infarction (MI) group, a WXKL-treated group, and an amiodarone-treated group). A myocardial infarction model was established in these rats by ligating the left anterior descending coronary artery for 4 weeks. Western blotting was used to assess CaMKII, p-CaMKII (Thr-286), PLB, p-PLB (Thr-17), RYR2, and FK binding protein 12.6 (FKBP12.6) levels. The Ca2+content in the sarcoplasmic reticulum (SR) and the calcium transient amplitude were studied by confocal imaging using the fluorescent indicator Fura-4. In conclusion, WXKL may inhibit heart failure and cardiac arrhythmias by regulating the CaMKII signal transduction pathway similar to amiodarone.

The objective of this study was to systematically evaluate the effects of Traditional Chinese Medicine (TCM) therapy including acupuncture, tu'ina, oral herbal medicine, herbal bathing, and collateral-channels conduct therapy for treating children with cerebral palsy (CP).We included randomized controlled trials (RCTs) on TCM for children with CP. We searched the China National Knowledge Infrastructure, Database for Chinese Technical Periodicals, Chinese Biomedical Literature Database, databases of Chinese biomedical journals/Chinese Medical Current Contents, Wan Fang Data, PubMed, MEDLINE, Embase, and the Cochrane Library until the end of July 2009, and searched the reference list of retrieved papers. Data were extracted by 1 author and checked for validation by another author, and data were analyzed using RevMan 4.3.2. Only one meta-analysis was performed due to the heterogeneity among the trials.Thirty-five (35) RCTs involving 3286 children with CP using TCM therapy and conventional therapy (CT) including physical, occupational, and speech therapy, hyperbaric oxygen, cranial nerves nutrition agents, or any combination of above were included. The methodological quality was generally low in terms of allocation concealment, blinding, and intention-to-treat analysis. Meta-analysis showed acupuncture combine with CT improved activities of daily living (mean difference: 6.38, 95% confidence interval 5.15-7.61; p0.00001, n = 160) compared with CT alone. Acupuncture plus tu'ina, or plus herbal medicine and CT showed significant beneficial effects on comprehensive function in terms of both physical and mental aspects, independence, and verbal function compared with CT alone. The combination of radix Astragali injection with CT showed significant benefit on gross motor function and social behavior adaptation comparing with CT. There are six trials reported adverse events that were not associated with acupuncture, tu'ina, and/or herbal medicine.Acupuncture with or without CT or other conventional therapy, tu'ina, herbal medicine, and collateral channels conduct treatment combined with CT may have benefit in children with CP. However, due to insufficient evidence, further rigorous trials are warranted.