Traditional Chinese medicine combined with conventional treatment for the patients after percutaneous coronary intervention: A systematic review and meta-analysis

Purpose: To evaluate the efficacy, quality of care and safety of Traditional Chinese Medicine (TCM) after Percutaneous Coronary Intervention (PCI). using systematic review and meta-analysis of randomized controlled trials.Methods: Relevant studies published between January 1st 2010 and August 20th, 2021, on traditional Chinese medicine (TCM) and conventional treatment (CT) after PCI were sourced from different databases including CNKI, CBM, Web of Science, PubMed, Embase and Cochrane library. The TCM was composed of preparations of chinese eaglewood, peppermint, radix notoginseng, scabrous elephant foot herb, Tongxinluo, Danhong, Naoxintong capsule, Huxin Formula and liquorice root while the CT included aspirin (100 mg/day), clopidogrel (75 mg/day), and statins. PRISMA guidelines were used. Primary outcome was to evaluate the efficacy, quality of care and safety of TCM versus conventional treatment post percutaneous coronary intervention (PCI).Results: 110 randomized controlled trials (RCTs) were retrieved and analyzed. The results from metaanalysis showed an enhanced left ventricular ejection fraction (LVEF) % among patients that received TCM compared to those on CT [mean difference ± sd (MD)=5.17, 95% CI (3.29-7.06), Z = 5.38, (P < 0.001)]. Further, hypersensitive C-reactive protein (HS-CRP) level in TCM group was found to be relatively lower than that of the CT group (CG) [MD=-1.44, 95% CI (-2.87-0.00), Z=1.96, (P=0.05)]. In terms of safety, TCM group relative risk score in fixed-effect model was lower than that of the CG [RR=0.66, 95% CI (0.40, 1.10), Z=1.66,].Conclusion: It can be inferred from the results that TCM has more advantages in terms of clinical efficacy, quality of care and safety compared to conventional therapy. However, the lack of substantial research in deploying TCM for the treatment of CHD demands further exploration and strong evidence prior to clinical application of TCM

Impact of DEM Resolution and Spatial Scale: Analysis of Influence Factors and Parameters on Physically Based Distributed Model

Physically based distributed hydrological models were used to describe small-scale hydrological information in detail. However, the sensitivity of the model to spatially varied parameters and inputs limits the accuracy for application. In this paper, relevant influence factors and sensitive parameters were analyzed to solve this problem. First, a set of digital elevation model (DEM) resolutions and channel thresholds were generated to extract the hydrological influence factors. Second, a numerical relationship between sensitive parameters and influence factors was established to define parameters reasonably. Next, the topographic index (TI) was computed to study the similarity. At last, simulation results were analyzed in two different ways: (1) to observe the change regularity of influence factors and sensitive parameters through the variation of DEM resolutions and channel thresholds and (2) to compare the simulation accuracy of the nested catchment, particularly in the subcatchments and interior grids. Increasing the grid size from 250 m to 1000 m, the TI increased from 9.08 to 11.16 and the Nash-Sutcliffe efficiency (NSE) decreased from 0.77 to 0.75. Utilizing the parameters calculated by the established relationship, the simulation results show the same NSE in the outlet and a better NSE in the simple subcatchment than the calculated interior grids

Localization and interaction of interlayer excitons in MoSe2_2/WSe2_2 heterobilayers

Transition metal dichalcogenide (TMD) heterobilayers provide a versatile platform to explore unique excitonic physics via properties of the constituent TMDs and external stimuli. Interlayer excitons (IXs) can form in TMD heterobilayers as delocalized or localized states. However, the localization of IX in different types of potential traps, the emergence of biexcitons in the high-excitation regime, and the impact of potential traps on biexciton formation have remained elusive. In our work, we observe two types of potential traps in a MoSe$_2$/WSe$_2$ heterobilayer, which result in significantly different emission behavior of IXs at different temperatures. We identify the origin of these traps as localized defect states and the moir{\'e} potential of the TMD heterobilayer. Furthermore, with strong excitation intensity, a superlinear emission behavior indicates the emergence of interlayer biexcitons, whose formation peaks at a specific temperature. Our work elucidates the different excitation and temperature regimes required for the formation of both localized and delocalized IX and biexcitons, and, thus, contributes to a better understanding and application of the rich exciton physics in TMD heterostructures.Comment: 18 pages, 15 figures incl supplemental materia

Neutrophil-to-lymphocyte ratio and incident end-stage renal disease in Chinese patients with chronic kidney disease: results from the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE)

Abstract Background Chronic kidney disease (CKD) leads to end-stage renal failure and cardiovascular events. An attribute to these progressions is abnormalities in inflammation, which can be evaluated using the neutrophil-to-lymphocyte ratio (NLR). We aimed to investigate the association of NLR with the progression of end stage of renal disease (ESRD), cardiovascular disease (CVD) and all-cause mortality in Chinese patients with stages 1–4 CKD. Methods Patients with stages 1–4 CKD (18–74 years of age) were recruited at 39 centers in 28 cities across 22 provinces in China since 2011. A total of 938 patients with complete NLR and other relevant clinical variables were included in the current analysis. Cox regression analysis was used to estimate the association between NLR and the outcomes including ESRD, CVD events or all-cause mortality. Results Baseline NLR was related to age, hypertension, serum triglycerides, total serum cholesterol, CVD history, urine albumin to creatinine ratio (ACR), chronic kidney disease-mineral and bone disorder (CKD-MBD), hyperlipidemia rate, diabetes, and estimated glomerular filtration rate (eGFR). The study duration was 4.55 years (IQR 3.52–5.28). Cox regression analysis revealed an association of NLR and the risk of ESRD only in patients with stage 4 CKD. We did not observe any significant associations between abnormal NLR and the risk of either CVD or all-cause mortality in CKD patients in general and CKD patients grouped according to the disease stages in particular. Conclusion Our results suggest that NLR is associated with the risk of ESRD in Chinese patients with stage 4 CKD. NLR can be used in risk assessment for ESRD among patients with advanced CKD; this application is appealing considering NLR being a routine test. Trial registration ClinicalTrials.gov Identifier NCT03041987. Registered January 1, 2012. (retrospectively registered) ( https://www.clinicaltrials.gov/ct2/show/NCT03041987?term=Chinese+Cohort+Study+of+Chronic+Kidney+Disease+%28C-STRIDE%29&rank=1 )https://deepblue.lib.umich.edu/bitstream/2027.42/148285/1/12967_2019_Article_1808.pd

The Ventral Intermediate Nucleus Differently Modulates Subtype-Related Networks in Parkinson’s Disease

Background: Posture instability gait difficulty-dominant (PIGD) and tremor-dominant (TD) are two subtypes of Parkinson’s disease (PD). The thalamus is involved in the neural circuits of both subtypes. However, which subregion of the thalamus has an influence on the PD subtypes remains unclear.Objective: To explore the core subregion of the thalamus showing a significant influence on the PD subtypes and its directional interaction between the PD subtypes.Methods: A total of 79 PD patients (43 TD and 36 PIGD) and 31 normal controls (NC) were enrolled, and the gray matter volume and perfusion characteristics in the thalamus were compared between the three groups. The subregion of the thalamus with significantly different perfusion and volume among three groups was used as the seed of a Granger causality analysis (GCA) to compare the causal connectivity between different subtypes.Results: Perfusion with an increased gradient among the three groups (TD > PIGD > NC) in the bilateral ventral intermediate nucleus (Vim) was observed, which was positively correlated with the clinical tremor scores. The GCA revealed that TD patients had enhanced causal connectivity from the bilateral Vim to the bilateral paracentral gyrus, M1 and the cerebellum compared with the NC group, while the PIGD subtype revealed an increased causal connectivity from the bilateral Vim to the bilateral premotor cortex (preM) and putamen. Additionally, there were positive correlations between the tremor scores and a causal connectivity from the Vim to the cerebellum. The connectivity from the right Vim to the right preM and the right putamen was positively correlated with the PIGD scores.Conclusion: This multilevel analysis showed that the Vim had a significant influence on the PD subtypes and that it differentially mediated the TD and PIGD-related causal connectivity pattern in PD