Qi-Shen-Yi-Qi Dripping Pills for the Secondary Prevention of Myocardial Infarction: A Randomised Clinical Trial

Background. Several types of drugs have been recommended for the secondary prevention of myocardial infarction (MI). However, these conventional strategies have several limitations, such as low adherence, high cost, and side effects during long time use. Novel approaches to this problem are still needed. This trial aimed to test the effectiveness and safety of Qi-Shen-Yi-Qi Dripping Pills (QSYQ), a multi-ingredient Chinese patent medicine, for the secondary prevention of MI. Methods and Findings. A total of 3505 eligible patients were randomly assigned to QSYQ group (1746 patients) or aspirin group (1759). Patients took their treatments for 12 months. The final follow-up visit took place 6 months after the end of the trial drugs. The 12-month and 18-month estimated incidences of the primary outcome were 2.98% and 3.67%, respectively, in the QSYQ group. The figures were 2.96% and 3.81% in the aspirin group. No significant difference was identified between the groups. Conclusions. This trial did not show significant difference of primary and secondary outcomes between aspirin and QSYQ in patients who have had an MI. Though inconclusive, the result suggests that QSYQ has similar effects to aspirin in the secondary prevention of MI

Wenxin-Keli Regulates the Calcium/Calmodulin-Dependent Protein Kinase II Signal Transduction Pathway and Inhibits Cardiac Arrhythmia in Rats with Myocardial Infarction

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 the α- and β-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

Anticancer Therapy-Induced Atrial Fibrillation: Electrophysiology and Related Mechanisms

Some well-established immunotherapy, radiotherapy, postoperation, anticancer drugs such as anthracyclines, antimetabolites, human epidermal growth factor receptor 2 blockers, tyrosine kinase inhibitors, alkylating agents, checkpoint inhibitors, and angiogenesis inhibitors, are significantly linked to cardiotoxicity. Cardiotoxicity is a common complication of several cancer treatments. Some studies observed complications of cardiac arrhythmia associated with the treatment of cancer, including atrial fibrillation (AF), supraventricular arrhythmias, and cardiac repolarization abnormalities. AF increases the risk of cardiovascular morbidity and mortality; it is associated with an almost doubled risk of mortality and a nearly 5-fold increase in the risk of stroke. The occurrence of AF is also usually researched in patients with advanced cancer and those undergoing active cancer treatments. During cancer treatments, the incidence rate of AF affects the prognosis of tumor treatment and challenges the treatment strategy. The present article is mainly focused on the cardiotoxicity of cancer treatments. In our review, we discuss these anticancer therapies and how they induce AF and consequently provide information on the precaution of AF during cancer treatment

Meta-Analysis of Risk Stratification of SCN5A With Brugada Syndrome: Is SCN5A Always a Marker of Low Risk?

Background:SCN5A with Brugada syndrome (BrS) is not commonly considered as an independent risk marker for subsequent cardiac events. However, the risk of SCN5A combined with other clinical characteristics has not been fully investigated.Objectives: The aim of this study is to investigate and evaluate risk stratification and related risk factors of SCN5A in BrS.Methods: The databases of PubMed, EMBASE, Cochrane Library, MEDLINE, Chinese National Knowledge Infrastructure (CNKI) and Wanfang Data were searched for related studies published from January 2002 to May 2018 followed by meta-analysis. The BrS patients who underwent SCN5A gene tests were included. The prognosis and risk stratification of SCN5A combined with symptoms and asymptoms diagnosis in BrS, electrophysiology study (EPS) were then investigated and evaluated. Outcomes were defined as ventricular tachycardia/fibrillation (VT/VF), sudden cardiac death (SCD).Results: Eleven suitable studies involving 1892 BrS patients who underwent SCN5A gene tests were identified. SCN5A (+) was not considered to be a significant predictor of future cardiac events (95% CI: 0.89–2.11; P = 0.15; I2 = 0%). However, SCN5A (+) patients with symptoms at diagnosis revealed a higher prevalence of future VT/VF, SCD compared to SCN5A (–) patients with symptoms at diagnosis. (95% CI: 1.06–3.70; P = 0.03 I2 = 0%) Among asymptomatic patients, the risk did not significantly differ between SCN5A (+) patients and SCN5A (–) patients. (95% CI: 0.51–4.72; P = 0.45 I2 = 0 %). In an investigation involving patients in EPS (–) BrS electrocardiogram (ECG), the risk of SCN5A (+) is higher than that of SCN5A (–) (P < 0.001).Conclusions: In BrS patients with symptoms at diagnosis or EPS (–), the meta-analysis suggests that SCN5A (+) are at a higher risk of arrhythmic events than SCN5A (–)

Huangqi Injection (a Traditional Chinese Patent Medicine) for Chronic Heart Failure: A Systematic Review

Chronic heart failure (CHF) is a global public health problem. Therefore, novel and effective drugs that show few side-effects are needed. Early literature studies indicated that Huangqi injection is one of the most commonly used traditional Chinese patent medicines for CHF in China. As a large number of clinical studies has been carried out and published, it is essential to evaluate the effectiveness and safety of Huangqi injection. Therefore, we carried out this systematic review under the support of the framework of the Joint Sino-Italian Laboratory (JoSIL).To evaluate the efficacy and safety of Huangqi injection for CHF according to the available scientific knowledge.An extensive search including PubMed, EMBASE, CBM, the Cochrane Library and Chinese literature databases was performed up to July 2008. Clinical trials regarding Huangqi injection for the treatment of CHF were searched for, irrespective of languages. The quality of each trial was assessed according to the Cochrane Reviewers' Handbook 5.0, and RevMan 5.0 provided by the Cochrane Collaboration and STATA 9.2 were used for data analysis.After selection of 1,205 articles, 62 RCTs and quasi-RCTs conducted in China and published in Chinese journals were included in the review. The methodological quality of the trials was low. In most trials inclusion and exclusion criteria were not specified. Furthermore, only one study evaluated the outcomes for drug efficacy after an adequate period of time. For these reasons and because of the different baseline characteristics we did not conduct a meta-analysis.Although available studies are not adequate to draw a conclusion on the efficacy and safety of Huangqi injection (a traditional Chinese patent medicine), we hope that our work could provide useful experience on further studies on Huangqi injections. The overall level of TCM clinical research needs to be improved so that the efficacy of TCM can be evaluated by the international community and possibly some TCM can enter into the international market

Synthesis, electrochemistry and application of 2D and 3D graphene-composite materials

Although graphene materials process excellent chemical and physical properties, their practical application is hindered by large-scale production through efficient and environmentally-friendly methods. We developed green approaches for the preparation of graphene materials, and found suitable strategies to assemble them into 2D and 3D macroscopic materials with different functionalities. The application of the self-assembled graphene materials in the field of electrochemistry was also investigated in order to address the current energy and health issues. Specifically, we first fabricated noble nanoparticle modified graphene film and graphene paper for glucose biosensors and direct liquid fuel cells. Carbon nanotubes or metal oxides nanoparticles were then incorporated into the free-standing graphene papers for supercapacitor application. At last, we prepared 3D graphene hydrogels under mild conditions and explored their application for electrochemical energy storage.DOCTOR OF PHILOSOPHY (SCBE

Acupuncture-related adverse events: a systematic review of the Chinese literature

OBJECTIVE: To systematically review the Chinese-language literature on acupuncture-related adverse events. METHODS: We searched three Chinese databases (the Chinese Biomedical Literature Database, 1980-2009; the Chinese Journal Full-Text Database, 1980-2009; and the Weipu Journal Database, 1989-2009) to identify Chinese-language articles about the safety of traditional needle acupuncture. Case reports, case series, surveys and other observational studies were included if they reported factual data, but review articles, translations and clinical trials were excluded. FINDINGS: The inclusion criteria were met by 115 articles (98 case reports and 17 case series) that in total reported on 479 cases of adverse events after acupuncture. Fourteen patients died. Acupuncture-related adverse events were classified into three categories: traumatic, infectious and "other". The most frequent adverse events were pneumothorax, fainting, subarachnoid haemorrhage and infection, while the most serious ones were cardiovascular injuries, subarachnoid haemorrhage, pneumothorax and recurrent cerebral haemorrhage. CONCLUSION: Many acupuncture-related adverse events, most of them owing to improper technique, have been described in the published Chinese literature. Efforts should be made to find effective ways of monitoring and minimizing the risks related to acupuncture

High-performance asymmetric supercapacitor based on graphene hydrogel and nanostructured MnO2

We have successfully fabricated an asymmetric supercapacitor with high energy and power densities using graphene hydrogel (GH) with 3D interconnected pores as the negative electrode and vertically aligned MnO2 nanoplates on nickel foam (MnO2-NF) as the positive electrode in a neutral aqueous Na2SO4 electrolyte. Because of the desirable porous structure, high specific capacitance and rate capability of GH and MnO2-NF, complementary potential window of the two electrodes, and the elimination of polymer binders and conducting additives, the asymmetric supercapacitor can be cycled reversibly in a wide potential window of 0–2.0 V and exhibits an energy density of 23.2 Wh kg–1 with a power density of 1.0 kW kg–1. Energy density of the asymmetric supercapacitor is significantly improved in comparison with those of symmetric supercapacitors based on GH (5.5 Wh kg–1) and MnO2-NF (6.7 Wh kg–1). Even at a high power density of 10.0 kW kg–1, the asymmetric supercapacitor can deliver a high energy density of 14.9 Wh kg–1. The asymmetric supercapacitor also presents stable cycling performance with 83.4% capacitance retention after 5000 cycles

Growth of copper nanocubes on graphene paper as free-standing electrodes for direct hydrazine fuel cells

We have developed a new type of flexible electrodes based on Cu nanocube-decorated free-standing graphene paper (GP) using a facile electrodeposition method. The Cu nanocubes–graphene paper (Cu–GP) hybrid electrode processes remarkable electrocatalytic activity with an onset potential of −0.10 V toward hydrazine oxidation in alkaline solutions and can serve as the catalyst layer for direct hydrazine fuel cells. One interesting finding is that a copper hydroxide/oxide layer in situ formed on Cu nanocube surfaces plays an important role in enhancing the electrocatalytic activity and durability of the electrocatalyst. A totally irreversible and diffusion-controlled oxidation of hydrazine occurs on the electrocatalyst, eventually leading to environmentally friendly products such as nitrogen and water