Atherosclerosis: An Integrative East-West Medicine Perspective

Recent understanding of atherosclerosis and coronary heart disease has shifted the focus from lumen stenosis to vulnerable plaque, from lipid deposit to inflammatory reaction, and from vulnerable plaque to vulnerable patient. This has led to a new direction of treatment consisting of intervening the inflammatory reaction, stabilizing the vulnerable plaque, inhibiting thrombosis after plaque rupture, and treating the vulnerable patient instead of treating lumen stenosis. This seems to mirror the traditional Chinese medicine (TCM) focus on prevention and on the vulnerable patient with treatment matched to the pattern dysfunction and dysregulation using the Chinese herbal medicine multitargeted approach. Given the convergence of both the East and the West conceptualization of atherosclerosis, it is hopeful that the integrative East-West approach will facilitate early detection and more effective treatment of the vulnerable patients with coronary heart disease

A Systematic Review of Xuezhikang, an Extract from Red Yeast Rice, for Coronary Heart Disease Complicated by Dyslipidemia

Objective. This systematic review aims to evaluate the benefit and side effect of Xuezhikang for coronary heart disease (CHD) complicated by dyslipidemia. Methods. All randomized clinical trials (RCTs) with Xuezhikang as a treatment for CHD combined with dyslipidemia were considered for inclusion. Data extraction and analyses and quality assessment were conducted according to the Cochrane standards. Results. We included 22 randomized trials. Xuezhikang showed significant benefit on the incidence of all-cause deaths, CHD deaths, myocardial infarction, and revascularization as compared with placebo based on conventional treatment for CHD. It remarkably lowered total cholesterol (TC), triglyceride (TG), and low-density lipoprotein-cholesterol (LDL-C) as compared with the placebo or inositol nicotinate group, which was similar to statins group. Xuezhikang also raised high-density lipoprotein cholesterol (HDL-C) compared to placebo or no intervention, which was similar to Inositol nicotinate and slightly inferior to statins. The incidence of adverse events did not differ between the Xuezhikang and control group. Conclusions. Xuezhikang showed a comprehensive lipid-regulating effect and was safe and effective in reducing cardiovascular events in CHD patients complicated by dyslipidemia. However, more rigorous trials with high quality are needed to give high level of evidence

Domain wall-localized phonons in BiFeO3: spectrum and selection rules

Abstract Ferroelectric domain walls (DWs) are nanoscale topological defects that can be easily tailored to create nanoscale devices. Their excitations, recently discovered to be responsible for GHz DW conductivity, hold promise for faster signal transmission and processing compared to the existing technology. Here we find that DW phonons have unprecedented dispersion going from GHz all the way to THz frequencies, and resulting in a surprisingly broad GHz signature in DW conductivity. Puzzling activation of nominally forbidden DW sliding modes in BiFeO3 is traced back to DW tilting and resulting asymmetry in wall-localized phonons. The obtained phonon spectra and selection rules are used to simulate scanning impedance microscopy, emerging as a powerful probe in nanophononics. The results will guide the experimental discovery of the predicted phonon branches and design of DW-based nanodevices operating in the technologically important frequency range

Neoatherosclerosis after Drug-Eluting Stent Implantation: Roles and Mechanisms

In-stent neoatherosclerosis (NA), characterized by a relatively thin fibrous cap and large volume of yellow-lipid accumulation after drug-eluting stents (DES) implantation, has attracted much attention owing to its close relationship with late complications, such as revascularization and late stent thrombosis (ST). Accumulating evidence has demonstrated that more than one-third of patients with first-generation DES present with NA. Even in the advent of second-generation DES, NA still occurs. It is indicated that endothelial dysfunction induced by DES plays a critical role in neoatherosclerotic development. Upregulation of reactive oxygen species (ROS) induced by DES implantation significantly affects endothelial cells healing and functioning, therefore rendering NA formation. In light of the role of ROS in suppression of endothelial healing, combining antioxidant therapies with stenting technology may facilitate reestablishing a functioning endothelium to improve clinical outcome for patients with stenting

Can Teaching Enthusiasm Partially Predict the Reading Attainment of Low-income Students in Secondary Schools in England?

The poverty achievement gap in early reading is a persistent issue in England and around the world, potentially disadvantaging poor students and their further study. This new study employs student-perceived teaching enthusiasm and reading attitudes to help explain the poverty attainment gap. The sample was 5,242 15-year-old participants in PISA 2018 from 175 secondary schools in England. Path analysis is used to investigate the potential effect of teaching enthusiasm on the reading attainment of low-income students. The findings indicate that family socioeconomic status remains an important predictor of students' reading achievement. Students from economically privileged families tend to rate teaching enthusiasm more highly and express a positive reading attitude, which can partially explain the poverty attainment gap in reading. Therefore, teachers might be able to enhance low-income students’ reading outcomes and close the poverty attainment gap a little through enhanced teaching enthusiasm to cultivate students’ positive reading attitudes

Clinical and Epidemiological Investigation of TCM Syndromes of Patients with Coronary Heart Disease in China

To compare the regional differences in TCM syndromes of patients with coronary heart disease (CHD) between North and South China. A total of 624 patients with a diagnosis of CHD, confirmed by coronary angiography, were included in the comparative analysis to determine the occurrence pattern, characteristics of TCM syndrome distribution, and differences in syndrome combinations and major syndrome types (deficiency or excess) between North and South China. The incidence of CHD tended to be higher in North China (54.6%) compared with that in South China (45.4%). The proportions of patients with a qi-deficiency syndrome (83.7%), turbid phlegm syndrome (68.9%), or blood stasis syndrome (91.5%) were generally higher in the South group, while the proportion of patients with a cold congelation syndrome (7.9%) was identified to be obviously higher in the North group (P < 0.01). Moreover, compared with that in the South group, the overall frequency of syndrome combinations tended to be lower in the North group (P < 0.01); and the most common types of TCM syndrome were excess syndrome (193, 56.6%) and primary deficiency and secondary excess syndrome (244, 86.2%) in the North and South groups, respectively (P < 0.01). A regional difference does exist in the TCM syndromes of patients with CHD between North and South China, indicating that the prevention and treatment of CHD in South China should not only focus on promoting blood circulation and removing blood stasis, but also include supplementing qi and eliminating phleg