Chinese Patent Medicine Tongxinluo Capsule for Hypertension: A Systematic Review of Randomised Controlled Trials

Background. This study was intended to evaluate the efficacy and safety of Tongxinluo capsule for hypertension. Search Strategy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, The PubMed, EMBASE, Chinese Bio-Medical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database, and Wan-fang Data started from the first of database to October 28, 2013. No language restriction was applied. We included randomized clinical trials testing Tongxinluo capsule against western medicine, Tongxinluo capsule versus placebo, and Tongxinluo capsule combined with western medicine versus western medicine. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. Results. 25 trials with 1958 participants were included. The methodological quality of the included trials was evaluated as generally low. The blood pressure (BP) lowering effect of Tongxinluo capsule plus western medicine was significantly higher than that of western medicine (systolic blood pressure (SBP): −3.87, −5.32 to −2.41, P<0.00001; and diastolic blood pressure (DBP): −2.72, −4.19 to −1.24, P=0.0003). The BP also decreased significantly from baseline with Tongxinluo capsule than placebo (SBP: −9.40, −10.90 to −7.90, P<0.00001; and DBP: −11.80, −12.40 to −11.20, P<0.00001) or western medicine (SBP: −3.90, −4.93 to −2.87, P<0.00001; and DBP: −3.70, −3.83 to −3.57, P<0.00001). 12 trials reported adverse events without details. Conclusions. There is some but weak evidence about the effectiveness of TXL in treating patients with hypertension

Effect of glycerol on the separation of nucleosomes and bent DNA in low ionic strength polyacrylamide gel electrophoresis

This paper seeks to understand extreme public transit riders in Beijing using both traditional household surveys and emerging new data sources such as Smart Card Data (SCD). We focus on four types of extreme transit behaviors: public transit riders who (1) travel significantly earlier than average riders (‘early birds’); (2) ride in unusual late hours (‘night owls’); (3) commute in excessively long distance (‘tireless itinerants’); and (4) make significantly more trips per day (‘recurring itinerants’). SCD are used to identify the spatiotemporal patterns of these four extreme transit behaviors. In addition, household surveys are employed to supplement the socioeconomic background and tentatively profile extreme travelers. While the research findings are useful to guide urban governance and planning in Beijing, our methodology and procedures can be extended to understand travel patterns elsewhere

Endovascular management of spontaneous axillary artery aneurysm: a case report and review of the literature

INTRODUCTION: Spontaneous atraumatic true axillary artery aneurysm is a relatively unusual disorder. Although most cases are asymptomatic, complications of axillary artery aneurysms may result in acute vascular insufficiency and neurological deficits. Prompt treatment, therefore, should be employed in the management of this condition. To date, the standard treatment for peripheral aneurysms is still surgical resection with end-to-end anastomosis. However, aneurysmectomy and interposition grafting with autologous or artificial vessels are more invasive and time-consuming. The ideal treatment for axillary artery aneurysm should be relatively noninvasive, safe and free of significant complications, cost-effective, cosmetically acceptable, and incur less absence from usual daily activities. Endovascular stent grafts have also been successfully used to treat these aneurysms. Management of select aneurysms using stent grafts has become more prevalent with the developing endoluminal technology. CASE PRESENTATION: We report a case of a spontaneous atraumatic axillary artery aneurysm where the patient was a 48-year-old ethnic Han Chinese woman with a gradually enlarging left axillary pulsatile mass. She was treated with endovascular stent grafts. The postoperative course of the patient was uneventful during the six-month follow-up. CONCLUSIONS: We show that there are significant early advantages with the endovascular management technique versus the conventional operation in the management of axillary artery aneurysm

Traditional Chinese Medicine Syndromes for Essential Hypertension: A Literature Analysis of 13,272 Patients

Background. To simplify traditional Chinese medicine syndrome differentiation and allow researchers to master syndrome differentiation for hypertension, this paper retrospectively studied the literature and analyzed syndrome elements corresponding to hypertension syndromes. Methods. Six databases including PubMed, EMBASE, Chinese Bio-Medical Literature Database, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wan-fang Data were searched from 1/January/2003 to 30/October/2013. We included all clinical literature testing hypertension syndromes and retrospectively studied the hypertension literature published from 2003 to 2013. Descriptive statistics calculated frequencies and percentages. Results. 13,272 patients with essential hypertension were included. Clinical features of hypertension could be attributed to 11 kinds of syndrome factors. Among them, seven syndrome factors were excess, while four syndrome factors were deficient. Syndrome targets were mainly in the liver and related to the kidney and spleen. There were 33 combination syndromes. Frequency of single-factor syndromes was 31.77% and frequency of two-factor syndromes was 62.26%. Conclusions. Excess syndrome factors of hypertension patients include yang hyperactivity, blood stasis, phlegm turbidity, internal dampness, and internal fire. Deficient syndrome factors of hypertension patients are yin deficiency and yang deficiency. Yin deficiency with yang hyperactivity, phlegm-dampness retention, and deficiency of both yin and yang were the three most common syndromes in clinical combination

Tracking the nematicity in cuprate superconductors: a resistivity study under uniaxial pressure

Overshadowing the superconducting dome in hole-doped cuprates, the pseudogap state is still one of the mysteries that no consensus can be achieved. It has been suggested that the rotational symmetry is broken in this state and may result in a nematic phase transition, whose temperature seems to coincide with the onset temperature of the pseudogap state $T^*$ around optimal doping level, raising the question whether the pseudogap results from the establishment of the nematic order. Here we report results of resistivity measurements under uniaxial pressure on several hole-doped cuprates, where the normalized slope of the elastoresistivity $\zeta$ can be obtained as illustrated in iron-based superconductors. The temperature dependence of $\zeta$ along particular lattice axis exhibits kink feature at $T_{k}$ and shows Curie-Weiss-like behavior above it, which may suggest a spontaneous nematic transition. While $T_{k}$ seems to be the same as $T^*$ around the optimal doping and in the overdoped region, they become very different in underdoped La$_{2-x}$Sr$_{x}$CuO$_4$. Our results suggest that the nematic order, if indeed existing, is an electronic phase within the pseudogap state.Comment: 6 pages, 4 figure

Clinical Study Simple and Robust Analysis of Cefuroxime in Human Plasma by LC-MS/MS: Application to a Bioequivalence Study

A simple, robust LC-MS/MS assay for quantifying cefuroxime in human plasma was developed. Cefuroxime and tazobactam, as internal standard (IS), were extracted from human plasma by methanol to precipitate protein. Separation was achieved on a Zorbax SB-Aq (4.6 × 250 mm, 5 m) column under isocratic conditions. The calibration curve was linear in the concentration range of 0.0525-21.0 g/mL ( = 0.9998). The accuracy was higher than 90.92%, while the intra-and interday precision were less than 6.26%. The extraction procedure provides recovery ranged from 89.44% to 92.32%, for both analyte and IS. Finally, the method was successfully applied to a bioequivalence study of a single 500 mg dose of cefuroxime axetil in 22 healthy Chinese male subjects under fasting condition. Bioequivalence was determined by calculating 90% Cls for the ratios of max , AUC 0− , and AUC 0−∞ values for the test and reference products, using logarithmic transformed data. The 90% Cls for the ratios of max (91.4%∼104.2%), AUC 0− (97.4%∼110.9%), and AUC 0−∞ (97.6%∼111.1%) values were within the predetermined range. It was concluded that the two formulations (test for capsule, reference for tablet) analyzed were bioequivalent in terms of rate and extent of absorption and the method met the principle of quick and easy clinical analysis

Chinese Herbal Medicine Qi Ju Di Huang Wan for the Treatment of Essential Hypertension: A Systematic Review of Randomized Controlled Trials

Background. Chinese herbs are potentially effective for hypertension. Qi Ju Di Huang Wan (QJDHW) is a commonly used Chinese herbal medicine as a monotherapy or in combination with other antihypertensive agents for the treatment of essential hypertension (EH). However, there is no critically appraised evidence such as systematic reviews or meta-analyses on the effectiveness and safety of QJDHW for EH. Methods and Findings. CENTRAL, PubMed, CBM, CNKI, VIP, and online clinical trial registry websites were searched for published and unpublished randomized controlled trials (RCTs) of QJDHW for essential hypertension up to January 2013 with no language restrictions. A total of 10 randomized trials involving 1024 patients were included. Meta-analysis showed that QJDHW combined with antihypertensive drugs was more effective in lowering blood pressure and improving TCM syndrome for the treatment of essential hypertension than antihypertensive drugs used alone. No trials reported severe adverse events related to QJDHW. Conclusions. Our review suggests that QJDHW combined with antihypertensive drugs might be an effective treatment for lowering blood pressure and improving symptoms in patients with essential hypertension. However, the finding should be interpreted with caution because of the poor methodological quality of included trials. There is an urgent need for well-designed, long-term studies to assess the effectiveness of QJDHW in the treatment of essential hypertension