Danhong Injection Research Articles

Comparative efficacy and safety of Chinese patent medicines as an adjunctive therapy for diabetic peripheral neuropathy: systematic review and network meta-analysis of randomized controlled trials

Context Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes mellitus. Chinese patent medicines (CPMs) are widely used in clinical practice to treat DPN. Objective This study aims to summarize the latest evidence on the harms and benefits of CPMs as adjunctive therapy for DPN. Materials and methods We conducted searches for randomized controlled trials (RCTs) evaluating CPMs in conjunction with mecobalamin (Mec) or alpha-lipoic acid (αLA) across eight databases up to July 2024. The surface under the cumulative ranking area (SUCRA) was utilized to assess the clinical efficacy rate (CER), the peroneal motor nerve conduction velocity (pMNCV), the peroneal sensory nerve conduction velocity (pSNCV), the median motor nerve conduction velocity (mMNCV), and the median sensory nerve conduction velocity (mSNCV). Results The search yielded 128 eligible studies with 31 CPMs with Mec and 39 eligible studies with 17 CPMs with αLA. SUCRA rankings indicated that, when combined with Mec, Mailuoning liquid (lMLN) was the most effective regimen for CER, Honghua injection (iHH) for pMNCV, Maixuekang capsule (cMXK) for pSNCV, Dengzhanxixin injection (iDZXX) for mMNCV, and Tongxinluo capsule (cTXL) for mSNCV. Combined with αLA, Danhong injection (iDH) showed the highest efficacy for CER, pSNCV, and mSNCV, while Xueshuantong injection (iXShT) was the most effective for pMNCV and mMNCV. Conclusion This network meta-analysis confirms the efficacy and safety of 37 CPMs combined with Mec or αLA for treating DPN. However, given the potential risk of bias and the very low certainty of the evidence, these recommendations should be adopted with caution.

Assessing the holistic value of Danhong injection for chronic stable angina: a multi-criteria decision analysis in China

IntroductionThis study aimed to assess the holistic value of Danhong injection (DHI) for treating chronic stable angina (CSA) and to identify the therapeutic characteristics of DHI. MethodsThe holistic value of DHI was assessed using a well-established evaluation index system including 34 criteria based on the Multi-criteria decision analysis (MCDA) model. Each criterion was rated by seven experts based on an evidence matrix comprising a literature review on DHI for treating CSA. The overall value of DHI for the treatment of CSA was evaluated by aggregating these performance scores and predetermined weights. Additionally, the contributions of each domain and criterion to the overall value estimate were calculated. Uncertainty was explored using an online retest and intra-rater correlation coefficient (ICC). ResultsWe found that the comprehensive value estimate of DHI for treating CSA was 80.18 points. The domain of “safety and risk management” was the strongest contributor to the final estimated value (30.37), followed by “effectiveness” (23.75). The criteria “size of population affected by disease” (3.79), “risk control of toxic medicinal materials” (4.38), “comparative non-medical costs” (1.14), “clarity of the mechanism of drug action” (0.6), “sustainability of medicinal materials resources” (1.91) and “patient compliance” (4.59) were found to be the most significant contributors to the overall value estimate across the 6 evaluation domains. The initial scores for DHI over the two rounds showed good consistency across panelists (ICC=0.886 [0.858–0.909]). ConclusionCompared with standard treatment alone, DHI was perceived as being at a “good level” intervention.

Development of a new paradigm model for deciphering action mechanism of Danhong injection using a combination of isothermal shift assay and database interrogation

BackgroundIdentification of active components of traditional Chinese Medicine (TCM) and their respective targets is important for understanding the mechanisms underlying TCM efficacy. However, there are still no effective technical methods to achieve this.MethodsHerein, we have established a method for rapidly identifying targets of a specific TCM and interrogating the targets with their corresponding active components based on Isothermal Shift Assay (iTSA) and database interrogation.ResultsWe optimized iTSA workflow and identified 110 targets for Danhong injection (DHI) which is used as an effective remedy for cardiovascular and cerebrovascular diseases. Moreover, we identified the targets of the nine major ingredients found in DHI. Database interrogation found that the potential targets for DHI, in which we verified that ADK as the target for salvianolic acid A and ALDH1B1 as the target for protocatechualdehyde in DHI, respectively.ConclusionOverall, we established a novel paradigm model for the identification of targets and their respective ingredients in DHI, which facilitates the discovery of drug candidates and targets for improving disease management and contributes to revealing the underlying mechanisms of TCM and fostering TCM development and modernization.Graphical

Effect of Danhong injection on pharmacokinetics and pharmacodynamics of rivaroxaban in rats.

Rivaroxaban is often used in combination with DHI to treat thromboembolic disease. Whether the combination causing HDIs is still unknown. The purpose of this study was to evaluate effects of DHI on pharmacokinetics and pharmacodynamics of rivaroxaban in rats and effects on CYP3A2. Plasma concentration of rivaroxaban with or without DHI was determined by HPLC. Pharmacokinetics parameters were calculated. Effect of DHI on pharmacodynamics of rivaroxaban was investigated by APTT, PT, TT, FIB, INR, length of tail thrombosis, vWF, t-PA, PAI-1, IL-1β, TNF-α and histopathological sections. Effect of DHI on CYP3A2 in rats was investigated by probe drug method. Cmax and AUC of rivaroxaban increased significantly in combination group (P < 0.05). APTT, PT, INR and TT increased (P < 0.05), length of tail thrombosis, FIB, vWF, PAI-1, IL-1β and TNF-α of combination group decreased significantly (P < 0.05) compared with rivaroxaban or DHI alone. Histopathologic section of tail thrombus had significant improvement. Cmax and AUC of dapsone increased (P < 0.05) in DHI group. In summary, DHI is an inhibitor of CYP3A2 and could significantly affect pharmacokinetics and pharmacodynamic of rivaroxaban, enhance anticoagulant and antithrombotic efficacy in rats. However, the combination of rivaroxaban and DHI might lead to potential HDIs. The dosage of rivaroxaban should be adjusted in clinical.

Effect of Danhong Injection on Articular Cartilage Degeneration in Rabbits with Knee Osteoarthritis

The aim of this research was to investigate the effect of Danhong injection nanoparticle (DIN) plus warm acupuncture (WA) on articular cartilage degeneration in knee osteoarthritis (KOA) rabbits. First, the KOA model and DIN were made. After success, the rabbits were randomly grouped: according to the treatment methods: controls, DIN, WA, and DIN+WA groups, with 10 rabbits in each group. The controls did not receive any treatment, and the other groups received corresponding treatment intervention, respectively. Through treatment, articular cartilage samples were collected. The bone morphology, LequesneMG score, Mankin score were analyzed. The safranin-fast green, toluidine blue, Terminal Deoxynucleotidyl Transferase Mediated dUTP Nick End Labeling (TUNEL), and immunohistochemical staining were observed. The levels of apoptosis-related factors were determined. The results showed that the KOA rabbit model and DIN were successfully constructed. Compared with other groups, the LequesneMG and Mankin scores of DIN+WA group decreased markedly (P &lt; 0.05). Safranin-fast green and toluidine blue staining showed that the number of chondrocytes in DIN+WA group was markedly increased, which was more as against other groups. TUNEL staining revealed that the number of apoptotic chondrocytes was markedly reduced, and the apoptotic index was markedly lower in DIN+WA group as against other three groups (P &lt; 0.05). Compared with other groups, Bax and Caspase-3 were markedly decreased, and Bcl-2 was markedly raised in DIN+WA group (P &lt; 0.05). According to the review, the combined application of DIN and WA can promote the growth of chondrocytes, inhibit the apoptosis of chondrocytes, and effectively improve the degeneration of knee articular cartilage, which has application value.

Comparative effectiveness and safety of four traditional Chinese medicine injections with invigorating blood circulation, equivalent effect of anticoagulation or antiplatelet in acute myocardial infarction: a Bayesian network meta-analysis.

Background: Traditional Chinese medicine injections with invigorating blood circulation (TCMI-IBCs), which have been used as antithrombosis therapies, are widely employed by Chinese clinicians as adjuvant therapy for acute myocardial infarction (AMI). Objective: A Bayesian network meta-analysis was conducted to contrast the effectiveness and safety of four TCMI-IBCs in AMI. Methods: Eight Databases were thoroughly searched before 31 December 2023, for randomized controlled trials (RCTs) focusing on the application of TCMI-IBCs combined with conventional treatments (CT) to treat AMI. All-cause mortality (ACM) was the major endpoint. Secondary outcomes included bleeding events, malignant arrhythmia (MA), recurrent myocardial infarction (RMI), left ventricular ejection fraction (LVEF), and adverse events. Stata17.0 and GeMTC software were employed for Bayesian network meta-analysis. Results: A total of 73 eligible RCTs involving 7,504 patients were enrolled. Puerarin injection (PI), Danhong injection (DI), sodium Tanshinone IIA Sulfonate injection (STSI), and Danshen Chuanxiongqin injection (DCI) combined with CT can significantly reduce the occurrence of ACM and improve LVEF in AMI (P < 0.05), while without significant impact on bleeding events or MA (P > 0.05). STSI + CT would be the optimal treatment strategy in lowering RMI and ACM. DI + CT was the most likely to be the optimal strategy in reducing MA occurrence and improving LVEF. CT was likely the most effective strategy in reducing bleeding events. However, DI + CT exhibited the least favorable safety. Conclusion: TCMI-IBCs + CT had potential benefits in the treatment of AMI. STSI + CT showed the most favorable performance in treating AMI, followed by DI combined with CT. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=384067, identifier CRD42022384067.

Efficacy and safety of Danhong injection for treating myocardial infarction: a systematic review and meta-analysis of randomized controlled trials

Efficacy and safety of Danhong injection for treating myocardial infarction: a systematic review and meta-analysis of randomized controlled trials

Exploring the efficacy and molecular mechanism of Danhong injection comprehensively in the treatment of idiopathic pulmonary fibrosis by combining meta-analysis, network pharmacology, and molecular docking methods.

Danhong injection, a compound injection of Chinese herbal medicine, has been widely used in idiopathic pulmonary fibrosis (IPF) at present as an adjuvant treatment. However, the clinical efficacy and molecular mechanism of IPF are still unclear. This study will evaluate and explore the clinical efficacy and molecular mechanism of Danhong injection in the treatment of IPF. In meta-analysis, the computer was used to search 8 databases (PubMed, EMbase, CENTRAL, MEDLINE, CBM, CNKI, WanFang, and VIP) to collect the RCTs, and RevMan 5.3 and Stata 14.0 were used for statistical analysis. It has been registered on PROSPERO: CRD42020221096. In network pharmacology, the main chemical components and targets of the chemical components of Danhong injection were obtained in TCMSP and Swiss Target Prediction databases. The main targets of IPF were obtained through Gencards, Disgenet, OMIM, TTD, and DRUGBANK databases. The String platform was used to construct PPI networks. Cytoscape 3.8.2 was used to construct the "Danhong components - IPF targets-pathways" network. The molecular docking verification was conducted by Auto Dock. Twelve RCTs were finally included with a total of 896 patients. The meta-analysis showed that Danhong injection could improve the clinical efficiency ([OR] = 0.25, 95% CI [0.15, 0.41]), lung function, arterial blood gas analysis, inflammatory cytokines, and serum cytokines associated with pulmonary fibrosis of IPF patients, respectively (P < .05). The core active components of Danhong injection on IPF were Luteolin, Quercetin, and Kaempferol, and the core targets were PTGS2, AR, ESR1, PPARG, and RELA. Danhong injection mainly improved IPF through PD-L1 expression and PD-1 checkpoint path in cancer, pathways in cancer, PI3K-Akt signaling pathway, etc. These results provided scientific basis for the clinical use of Danhong injection for the treatment of IPF, and provided a new direction to explore the potential mechanism of action of Danhong injection.

Endotype-driven Co-module mechanisms of danhong injection in the Co-treatment of cardiovascular and cerebrovascular diseases: A modular-based drug and disease integrated analysis

Ethnopharmacological relevanceCardiovascular and cerebrovascular diseases are the leading causes of death worldwide and interact closely with each other. Danhong Injection (DHI) is a widely used preparation for the co-treatment of brain and heart diseases (CTBH). However, the underlying molecular endotype mechanisms of DHI in the CTBH remain unclear. Aim of this studyTo elucidate the underlying endotype mechanisms of DHI in the CTBH. Materials and methodsIn this study, we proposed a modular-based disease and drug-integrated analysis (MDDIA) strategy for elucidating the systematic CTBH mechanisms of DHI using high-throughput transcriptome-wide sequencing datasets of DHI in the treatment of patients with stable angina pectoris (SAP) and cerebral infarction (CI). First, we identified drug-targeted modules of DHI and disease modules of SAP and CI based on the gene co-expression networks of DHI therapy and the protein–protein interaction networks of diseases. Moreover, module proximity-based topological analyses were applied to screen CTBH co-module pairs and driver genes of DHI. At the same time, the representative driver genes were validated via in vitro experiments on hypoxia/reoxygenation-related cardiomyocytes and neuronal cell lines of H9C2 and HT22. ResultsSeven drug-targeted modules of DHI and three disease modules of SAP and CI were identified by co-expression networks. Five modes of modular relationships between the drug and disease modules were distinguished by module proximity-based topological analyses. Moreover, 13 targeted module pairs and 17 driver genes associated with DHI in the CTBH were also screened. Finally, the representative driver genes AKT1, EDN1, and RHO were validated by in vitro experiments. ConclusionsThis study, based on clinical sequencing data and modular topological analyses, integrated diseases and drug targets. The CTBH mechanism of DHI may involve the altered expression of certain driver genes (SRC, STAT3, EDN1, CYP1A1, RHO, RELA) through various enriched pathways, including the Wnt signaling pathway.

Network Meta-analysis of traditional Chinese medicine injections in treatment of chronic pulmonary heart disease

Based on the network Meta-analysis, the efficacy and safety of different traditional Chinese medicine(TCM) injections in the treatment of chronic pulmonary heart disease(CPHD) were systematically evaluated. CNKI, Wanfang, VIP, SinoMed, Web of Science, PubMed, EMbase, and Cochrane Library were searched to collect randomized controlled trial(RCT) of TCM injection in the treatment of CPHD from inception to October 1, 2023. The quality of the included studies was evaluated by the bias risk assessment tool recommended by the Cochrane systematic evaluation manual version 5.3. Stata 17.0 and RevMan 5.4 software were used for statistical analysis of the data. Finally, 103 RCTs were included, involving 9 332 patients and 13 kinds of TCM injections. Network Meta-analysis yielded the following results.(1)In terms of improving the total clinical effective rate, the top three intervention measures in SUCRA ranking are Shuxuetong Injection + conventional western medicine&gt;Ligustrazine Injection + conventional western medicine&gt;Xinmailong Injection + conventional western medicine.(2)In terms of reducing pulmonary artery pressure, the top three intervention measures in SUCRA ranking are Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine&gt;Ligustrazine Injection + conventional western medicine&gt;Shenmai Injection + conventional western medicine.(3)In terms of improving left ventricular ejection fraction(LVEF), the top three intervention measures in SUCRA ranking are Xinmailong Injection + conventional western medicine&gt;Danhong Injection + conventional western medicine&gt;Ginkgo Damo Injection + conventional western medicine.(4) In terms of reducing brain natriuretic peptide(BNP), the top three intervention measures in SUCRA ranking are Xinmailong Injection + conventional wes-tern medicine&gt;Ginkgo Damo Injection + conventional western medicine&gt;Danhong Injection + conventional western medicine.(5) In terms of increasing arterial oxygen partial pressure(PaO_2) and reducing arterial carbon dioxide partial pressure(PaCO_2), the top three intervention measures in SUCRA ranking are Shenxiong Glucose Injection + conventional western medicine&gt;Shenmai Injection + conventional western medicine&gt;Shenfu Injection + conventional western medicine.(6) In terms of improving arterial oxygen saturation(SaO_2), the top three intervention measures in SUCRA ranking are Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine&gt;Xinmailong Injection + conventional western medicine&gt;Shenmai Injection + conventional western medicine.(7) In terms of increasing the percentage of forced expiratory volume in the first second(FEV_1%), the top three intervention measures in SUCRA ranking are Shenfu Injection + conventional western medicine&gt;Tanshinone Sodium Ⅱ_A Sulfonate Injection + conventional western medicine&gt;Shenmai Injection + conventional western medicine.(8) In terms of increasing the proportion of forced expiratory volume to forced vital capacity in the first second(FEV_1/FVC), the top three intervention measures in SUCRA ranking are Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine&gt;Shuxuetong Injection + conventional western medicine&gt;Danhong Injection + conventional western medicine.(9) In terms of safety, neither the experimental group nor the control group experienced any serious adverse drug reactions during the treatment period. In summary, combining TCM injection with conventional western medicine treatment can improve the comprehensive efficacy of treating CPHD, reduce pulmonary artery pressure, and improve cardiopulmonary function and arterial blood gas levels. However, due to the limitations of the quality and quantity of research methodology included, the above conclusions need to be further validated by more well-designed and high-quality RCT.

Investigating the Mechanistic of Danhong Injection in Brain Damage Caused by Cardiac I/R Injury via Bioinformatics, Computer Simulation, and Experimental Validation.

Cardiac ischemia-reperfusion (I/R) injury has negative effects on the brain and can even lead to the occurrence of ischemic stroke. Clinical evidence shows that Danhong injection (DHI) protects the heart and brain following ischemic events. This study investigated the mechanisms and key active compounds underlying the therapeutic effect of DHI against brain damage induced by cardiac I/R injury. The gene expression omnibus database provided GSE66360 and GSE22255 data sets. The R programming language was used to identify the common differentially expressed genes (cDEGs). Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were performed, and protein-protein interaction network was constructed. Active compounds of DHI were collected from the Traditional Chinese Medicine Systems Pharmacology database. Molecular docking and molecular dynamics simulations were performed. The MMPBSA method was used to calculate the binding-free energy. The pkCSM server and DruLiTo software were used for Absorption, Distribution, metabolism, excretion, and toxicity (ADMET) analysis and drug-likeness analysis. Finally, in vitro experiments were conducted to validate the results. A total of 27 cDEGs had been identified. The PPI and enrichment results indicated that TNF-α was considered to be the core target. A total of 80 active compounds were retrieved. The molecular docking results indicated that tanshinone I (TSI), tanshinone IIA (TSIIA), and hydroxyl safflower yellow A (HSYA) were selected as core active compounds. Molecular dynamics verification revealed that the conformations were relatively stable without significant fluctuations. MMPBSA analysis revealed that the binding energies of TSI, TSIIA, and HSYA with TNF-α were -36.01, -21.71, and -14.80 kcal/mol, respectively. LEU57 residue of TNF-α has the highest contribution. TSI and TSIIA passed both the ADMET analysis and drug-likeness screening, whereas HSYA did not. Experimental verification confirmed that DHI and TSIIA reduced the expression of TNF-α, NLRP3, and IL-1β in the injured H9C2 and rat brain microvascular endothelial cells. TNF-α can be considered to be a key target for BD-CI/R. TSIIA in DHI exerts a significant inhibitory effect on the inflammatory damage of BD-CI/R, providing new insights for future drug development.

Network Meta-analysis of different Chinese medicine injections combined with conventional western medicine in treatment of acute heart failure

This study aims to evaluate the efficacy and safety of Chinese medicine injection in the treatment of acute heart failure. PubMed, Cochrane Library, EMbase, Web of Science, CNKI, VIP, Wanfang, and SinoMed were searched for the randomized controlled trial(RCT) of Chinese medicine injection combined with conventional western medicines in the treatment of acute heart failure with the time interval from the inception to July 10, 2023. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies. Stata 15.1 was used to perform network Meta-analysis. A total of 117 RCTs were included, involving 10 529 patients and 7 Chinese medicine injections: Shenfu Injection, Shenmai Injection, Danhong Injection, Puera-rin Injection, Xinmailong Injection, Shengmai Injection, and Yiqi Fumai Injection. Network Meta-analysis yielded the following results.(1) In terms of improving the total response rate, the surface under the cumulative ranking curve(SUCRA) ranking was Shengmai Injection + conventional western medicine &gt; Danhong Injection + conventional western medicine &gt; Shenmai Injection + conventio-nal western medicine &gt; Shenfu Injection + conventional western medicine &gt; Xinmailong Injection + conventional western medicine &gt; Yiqi Fumai Injection + conventional western medicine &gt; Puerarin Injection + conventional western medicine &gt; conventional western medicine.(2)In terms of reducing brain natriuretic peptide(BNP), the SUCRA ranking was Danhong Injection + conventional western medicine &gt; Xinmailong Injection + conventional western medicine &gt; Yiqi Fumai Injection + conventional western medicine &gt; Shenfu Injection + conventional western medicine &gt; Shenmai Injection + conventional western medicine &gt; Puerarin Injection + conventional wes-tern medicine &gt; Shengmai Injection + conventional western medicine &gt; conventional western medicine.(3)In terms of reducing N-terminal pro-brain natriuretic peptide(NT-proBNP), the SUCRA ranking was Shenmai Injection + conventional western medicine &gt; Yiqi Fumai Injection + conventional western medicine &gt; Xinmailong Injection + conventional western medicine &gt; Shengmai Injection + conventional western medicine &gt; Shenfu Injection + conventional western medicine &gt; Puerarin Injection + conventional western medicine &gt; Danhong Injection + conventional western medicine &gt; conventional western medicine.(4) In terms of improving the left ventricular ejection fraction(LVEF), the SUCRA ranking was Shenmai Injection + conventional western medicine &gt; Xinmailong Injection + conventional western medicine &gt; Shenfu Injection + conventional western medicine &gt; Yiqi Fumai Injection + conventional western medicine &gt; Puerarin Injection + conventional western medicine &gt; Danhong Injection + conventional western medicine &gt; Shengmai Injection + conventional western medicine &gt; conventional western medicine.(5) In terms of decreasing the left ventricular end-diastolic diameter(LVEDD), the SUCRA ranking was Shenmai Injection + conventional western medicine &gt; Shenfu Injection + conventional western medicine=Xinmailong Injection + conventional western medicine &gt; Shengmai Injection + conventional western medicine &gt; Yiqi Fumai Injection + conventional western medicine &gt; conventional western medicine &gt; Puerarin Injection + conventional western medicine.(6) In terms of increasing the 6-min walk trail(6MWT), the SUCRA ranking was Xinmailong Injection + conventional western medicine &gt; Shenfu Injection + conventional western medicine &gt; Shenmai Injection + conventional western medicine &gt; Yiqi Fumai Injection + conventional western medicine &gt; conventional western medicine.(7) In terms of reducing the Minnesota heart failure quality of life scale(MLHFQ) scores, the SUCRA ranking was Xinmailong Injection + conventional western medicine &gt; Shenmai Injection + conventional western medicine &gt; Shenfu Injection + conventional western medicine &gt; conventional western medicine.(8)In terms of safety, the group of Chinese medicine injection combined with conventional western medicine had lower incidence of adverse reactions than the control group. The current evidence shows that combining Chinese medicine injection with conventional western medicine treatment can improve the therapeutic effect on acute heart failure, with high safety. Due to the limited number and quality of included studies, the above conclusions need to be verified by more high-quality studies.

Comparative efficacy of five traditional Chinese medicine injections for treating heart failure with reduced and mildly reduced ejection fraction: Bayesian network meta-analysis

BackgroundMore than half of all heart failure (HF) patients have heart failure with reduced ejection fraction (HFrEF) or mildly reduced ejection fraction (HFmrEF). The combination of traditional Chinese medicine injections (TCMIs) with Western medicine treatment (WMT) has been reported to have better efficacy than using WMT alone. However, the positive effects of TCMIs combined with WMT on HFrEF and HFmrEF require more comprehensive and systematic evidence and warrant further investigation. MethodsThe NMA searched eight databases, including four English and four Chinese, from database creation to November 10, 2022. We used the Cochrane Risk of Bias tool (ROB 2) to assess the selected studies' quality. OpenBUGS and STATA 17.0 were used for network meta-analysis. ResultsThe 101 RCTs were included in the systematic review. Studies have shown that when combined with any of the five TCMIs, WMT was more efficient than WMT alone. Shenmai injection (SMI) + WMT may be the best treatment for clinical effectiveness rate (CER) improvement and b-type natriuretic peptide (BNP) reduction. Huangqi injection (HQI) + WMT was the best treatment for improving left ventricular ejection fraction (LVEF). Danhong injection (DHI) + WMT may be the best treatment for lowering left ventricular end-diastolic dimension (LVEDD). Xinmailong injection (XMLI) + WMT was likely the best treatment for increasing the 6-min walking test (6MWT). In addition, XMLI had the lowest incidence of adverse reactions (3.38%). ConclusionsShenfu injection (SFI), SMI, DHI, XMLI, and HQI combined with WMT have stronger efficiency in treating HFrEF and HFmrEF. However, as all studies were conducted in China, this review is limited by the inevitable selection bias, and further high-quality multicenter randomized controlled trials (RCTs) are required.

Positive Effect of Danhong Assisted by Information Motivation Behavioral-Based Progressive Rehabilitation Nursing on Nutritional Recovery of Patients with Coronary Heart Disease After Percutaneous Coronary Intervention

This study aimed to analyze the influence of Danhong injection, assisted by information-motivation-behavioral skills model-based progressive rehabilitation nursing, on the nutritional status of coronary heart disease patients after percutaneous coronary intervention. A total of 107 coronary heart disease patients were randomly divided into a control group and the research group, comprising 53 and 54 patients, respectively. The control group received routine nursing, while the research group underwent information-motivation-behavioral skills model-based progressive rehabilitation nursing for comparative analysis. We found that the cardiac function and exercise endurance of the research group were improved compared to the control group after nursing, and the hemodynamics was better (P &lt; 0.05). Moreover, although both groups’ average daily energy and protein intakes did not meet the target requirements, the research group exhibited better performance than the control group (P &lt; 0.05). Furthermore, elevated postoperative total protein, hemoglobin, and albumin levels were observed in the research group (P &lt; 0.05). Regarding dietary compliance, the research group exhibited higher compliance and a lower incidence of adverse reactions (P &lt; 0.05). These findings indicated that Danhong injection, assisted by information-motivation-behavioral skills model-based progressive rehabilitation nursing, effectively promotes the nutritional recovery of coronary heart disease patients following percutaneous coronary intervention, thereby enhancing the patient’s health and prognosis.

Strategy for Targeting Medical Diagnosis of Cerebral Ischemia Regions by Linking Gsk-3β Antibody and RVG29 to Magnetosomes

Background: In our previous studies, we have identified Gsk-3β as a crucial target molecule in response to Danhong injection for cerebral ischemia intervention. Furthermore, it can serve as a molecular imaging probe for medical diagnosis. Bacterial magnetic particles (BMPs), synthesized by magnetotactic bacteria, are regarded as excellent natural nanocarriers. Methods: In this study, we utilized biological modification and chemical crosslinking techniques to produce a multifunctional BMP known as "RVG29-BMP-FA-Gsk-3β-Ab", which exhibits both magnetic properties and brain-targeting capabilities. Then, a combination of analytical techniques was used to characterize the properties of the multifunctional BMPs. Finally, we evaluated the cell targeting ability of the RVG29-BMP-FA-Gsk-3β-Ab. Results: The multifunctional BMPs were observed to possess uniform size and shape using TEM analysis, with a particle size of 70.1±7.33 nm. Zeta potential analysis revealed that the nanoparticles exhibited a regular and non-aggregative distribution of particle sizes. Relative fluorescence intensity results demonstrated that the complex of 1mg of RVG29-BMP-FA-Gsk- 3β-Ab could bind to FITC-RVG29 polypeptide at a concentration of 2189.5 nM. Cell viability analysis indicated its high biocompatibility and minimal cytotoxicity. The RVG29-BMP-FAGsk- 3β-Ab was observed to possess active targeting towards neuronal cells and fluorescence imaging capabilities in vitro, as evidenced by fluorescence imaging assays. The complex of RVG29-BMP-FA-Gsk-3β-Ab exhibited favourable properties for early diagnosis and efficacy evaluation of traditional Chinese medicine in treating cerebral ischemia. Conclusion: This study establishes a fundamental basis for the prospective implementation of multimodal imaging in traditional Chinese medicine for cerebral ischemia.

Network Meta-analysis of efficacy and safety of different traditional Chinese medicine injections in treating post-acute myocardial infarction heart failure

This study aims to systematically review the efficacy and safety of different traditional Chinese medicine injections combined with conventional treatment for patients with post-acute myocardial infarction heart failure. The relevant randomized controlled trial(RCT) was retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library with the time interval from inception to May 13, 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network Meta-analysis was then performed in RevMan 5.3 and Stata 15.1. A total of 68 RCTs involving 11 traditional Chinese medicine injections and 5 995 patients were included. The results were explained based on the surface under the cumulative ranking curve(SUCRA).(1) In terms of reducing major adverse cardiovascular event(MACE), the therapies followed the trend of Xinmailong Injection+conventional treatment(83.8%) &gt; Yiqi Fumai Injection+conventional treatment(57.1%) &gt; Xuebijing Injection+conventional treatment(56.6%) &gt; Shenmai Injection+conventional treatment(53.1%) &gt; Shenfu Injection+conventional treatment(45.3%) &gt; conventional treatment(4.0%).(2) In terms of increasing left ventricular ejection fraction(LVEF), the therapies followed the trend of Yiqi Fumai Injection+conventional treatment(84.0%) &gt; Shenmai Injection+conventional treatment(69.6%) &gt; Shenfu Injection+conventional treatment(62.7%) &gt; Xinmailong Injection+conventional treatment(61.6%) &gt; Shuxuening Injection+conventional treatment(54.8%) &gt; Shenqi Fuzheng Injection+conventional treatment(46.7%) &gt; Shengmai Injection+conventional treatment(45.9%) &gt; Breviscapine Injection+conventional treatment(39.9%) &gt; Danhong Injection+conventional treatment(38.8%) &gt; Huangqi Injection+conventional treatment(38.7%) &gt; conventional treatment(7.3%).(3) In terms of reducing B-type natriuretic peptide(BNP), the therapies followed the trend of Xinmailong Injection+conventional treatment(98.6%) &gt; Shenmai Injection+conventional treatment(57.7%) &gt; Shenfu Injection+conventional treatment(52.5%) &gt; Shengmai Injection+conventional treatment(30.1%) &gt; conventional treatment(11.0%).(4) In terms of reducing cardiac troponin Ⅰ(cTnⅠ), the therapies followed the trend of Shenmai Injection+conventional treatment(92.3%) &gt; Yiqi Fumai Injection+conventional treatment(61.5%) &gt; Shenfu Injection+conventional treatment(51.2%) &gt; Shengmai Injection+conventional treatment(48.1%) &gt; Xinmailong Injection+conventional treatment(26.6%) &gt; conventional treatment(20.3%).(5) In terms of reducing high-sensitivity C-reactive protein(hs-CRP), the therapies followed the trend of Shenmai Injection+conventional treatment(79.9%) &gt; Xinmailong Injection+conventional treatment(68.1%) &gt; Shenfu Injection+conventional treatment(63.1%) &gt; Xuebijing Injection+conventional treatment(56.7%) &gt; Shengmai Injection+conventional treatment(51.1%) &gt; Shenqi Fuzheng Injection+conventional treatment(42.8%) &gt; Huangqi Injection+conventional treatment(34.7%) &gt; conventional treatment(3.5%).(6) A total of 22 RCTs reported the occurrence of adverse reactions, mainly involving the damage of the circulatory system, digestive system, and coagulation function. The current evidence suggested that Xinmailong Injection+conventional treatment may have the best therapeutic effect in reducing MACE and BNP; Yiqi Fumai Injection+conventional treatment may be the best in increasing LVEF; Shenmai Injection+conventional treatment may be the best in reducing cTnI and hs-CRP. The safety needs further quantitative research and analysis. However, more high-quality RCT is required to validate the above conclusions due to limitations in the quality and quantity of the included studies.

Effect of Danhong injection on heart failure in rats evaluated by metabolomics.

Heart failure (HF) is characterized by reduced ventricular filling or ejection function due to organic or non-organic cardiovascular diseases. Danhong injection (DHI) is a medicinal material used clinically to treat HF for many years in China. Although prior research has shown that Danhong injection can improve cardiac function and structure, the biological mechanism has yet to be determined. Serum metabolic analysis was conducted via ultra-high-performance liquid chromatography-quadrupole time-of-flight/mass spectrometry (UHPLC-QE/MS) to explore underlying protective mechanisms of DHI in the transverse aortic constriction (TAC)-induced heart failure. Multivariate statistical techniques were used in the research, such as unsupervised principal component analysis (PCA) and orthogonal projection to latent structures discriminant analysis (OPLS-DA). MetaboAnalyst and Kyoto Encyclopedia of Genes and Genomes (KEGG) were employed to pinpoint pertinent metabolic pathways. After DHI treatment, cardiac morphology and function as well as the metabolism in model rats were improved. We identified 17 differential metabolites and six metabolic pathways. Two biomarkers, PC(18:3(6Z,9Z,12Z)/24:0) and L-Phenylalanine, were identified for the first time as strong indicators for the significant effect of DHI. This study revealed that DHI could regulate potential biomarkers and correlated metabolic pathway, which highlighted therapeutic potential of DHI in managing HF.

Quercetin inhibits mesothelial-mesenchymal transition and alleviates postoperative peritoneal adhesions by blocking the TGF-β1/PI3K/AKT pathway

Ethnopharmacological relevanceCarthami flos is a dried flower of the Asteraceae plant Carthamus tinctorius (L.). Danhong injection, composed of Carthami flos and Danshen can prevent the formation of postoperative peritoneal adhesions. Quercetin (QUE), an active compound of Carthami flos, has also been proved to prevent postoperative abdominal and uterine cavity adhesions. However, whether QUE is the key component in Carthami flos and the mechanism in preventing postoperative peritoneal adhesions has not been studied. Aim of the studyTo predict whether QUE is the key molecule in Carthami flos and explore the effect and mechanism of QUE in preventing postoperative peritoneal adhesions. Materials and methodsDrug composition and target analysis was used to predict the key component in Carthami flos. The method of cecum-sidewall abrasion was used to establish adhesion models, and the antiadhesion effect of QUE was evaluated with the adhesion scoring system. Network pharmacology was used to predict the targets and potential mechanism of QUE in preventing adhesion. The mechanism was further verified by immunofluorescence, Western blot, wound healing experiment, and molecular docking. ResultsQuercetin was predicted to be the key to preventing postoperative peritoneal adhesions in Carthami flos. Animal experiments revealed that QUE effectively ameliorated adhesions and reduced the expression of mesothelial-mesenchymal transition (MMT) related markers and TGF-β1. Moreover, the TGF-β1/PI3K/AKT pathway was predicted via protein-protein interaction and Kyoto encyclopedia of Genes and Genomes enrichment analysis to play a crucial part in preventing adhesion by QUE. Furthermore, in vitro experiments and molecular docking demonstrated that QUE could block the TGF-β1/PI3K/AKT pathway through forming a stable combination with TβR-II, thereby inhibiting MMT and ameliorating peritoneal adhesion. ConclusionsQUE can not only reduce postoperative TGF-β1 but also block the TGF-β1/PI3K/AKT pathway to inhibit MMT of mesothelial cells, and finally alleviate postoperative peritoneal adhesions. These findings may provide insights towards development of a safe and effective anti-adhesive drug for prevention of postoperative peritoneal adhesions.

Danhong Injection Up-regulates miR-125b in Endothelial Exosomes and Attenuates Apoptosis in Post-Infarction Myocardium.

To investigate the involvement of endothelial cells (ECs)-derived exosomes in the anti-apoptotic effect of Danhong Injection (DHI) and the mechanism of DHI-induced exosomal protection against postinfarction myocardial apoptosis. A mouse permanent myocardial infarction (MI) model was established, followed by a 14-day daily treatment with DHI, DHI plus GW4869 (an exosomal inhibitor), or saline. Phosphate-buffered saline (PBS)-induced ECs-derived exosomes were isolated, analyzed by miRNA microarray and validated by droplet digital polymerase chain reaction (ddPCR). The exosomes induced by DHI (DHI-exo), PBS (PBS-exo), or DHI+GW4869 (GW-exo) were isolated and injected into the peri-infarct zone following MI. The protective effects of DHI and DHI-exo on MI hearts were measured by echocardiography, Masson's trichrome staining, and TUNEL apoptosis assay. The Western blotting and quantitative reverse transcription PCR (qRT-PCR) were used to evaluate the expression levels of miR-125b/p53-mediated pathway components, including miR-125b, p53, Bak, Bax, and caspase-3 activities. DHI significantly improved cardiac function and reduced infarct size in MI mice (P<0.01), which was abolished by the GW4869 intervention. DHI promoted the exosomal secretion in ECs (P<0.01). According to the results of exosomal miRNA microarray assay, 30 differentially expressed miRNAs in the DHI-exo were identified (28 up-regulated miRNAs and 2 down-regulated miRNAs). Among them, DHI significantly elevated miR-125b level in DHI-exo and DHI-treated ECs, a recognized apoptotic inhibitor impeding p53 signaling (P<0.05). Remarkably, treatment with DHI and DHI-exo attenuated apoptosis, elevated miR-125b expression level, inhibited capsase-3 activity, and down-regulated the expression levels of proapoptotic effectors (p53, Bak, and Bax) in post-MI hearts, whereas these effects were blocked by GW4869 (P<0.05 or P<0.01). DHI and DHI-induced exosomes inhibited apoptosis, promoted the miR-125b expression level, and regulated the p53 apoptotic pathway in post-infarction myocardium.

Network Meta-analysis of Chinese medicine injections for activating blood and resolving stasis in adjuvant treatment of acute ischemic stroke

Network Meta-analysis was employed to compare the efficacy of Chinese medicine injections for activating blood and resolving stasis combined with conventional western medicine in the treatment of acute ischemic stroke and the effects on platelet aggregation rate, fibrinogen(FIB), and hypersensitive C-reactive protein(hs-CRP), with a view to providing evidence-based medicine reference for clinical medication. CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Cochrane Library, and EMbase were searched for randomized controlled trial(RCT) on the treatment of acute ischemic stroke with Salvia Miltiorrhiza Ligustrazine Injection, Danhong Injection, Shuxuetong Injection, Xueshuantong Injection, Shuxuening Injection, Safflower Yellow Pigment Injection, and Ginkgo Diterpene Lactone Meglumine Injection combined with conventional western medicine. The retrieval time was from database inception to March 18, 2023. The articles were extracted by two researchers and their quality was evaluated. R 4.2.2 was used for network Meta-analysis. A total of 87 RCTs involving 8 580 patients were included. Network Meta-analysis showed that, in terms of reducing National Institutes of Health stroke scale(NIHSS) scores, the surface under the cumulative ranking curve(SUCRA) showed the order of Xueshuantong Injection + conventional western medicine(88.7%) &gt; Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(73.7%) &gt; Shuxuetong Injection + conventional western medicine(69.7%) &gt; Shuxuening Injection + conventional western medicine(51.8%) &gt; Danhong Injection + conventional western medicine(43.7%) &gt; Safflower Yellow Pigment Injection + conventional western medicine(36.8%) &gt; Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(35.3%) &gt; conventional western medicine(1.7%). In terms of improving clinical total effective rate, SUCRA showed the order of Danhong Injection + conventional western medicine(63.0%) &gt; Shuxuening Injection + conventional western medicine(59.0%) &gt; Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(58.9%) &gt; Safflower Yellow Pigment Injection + conventional western medicine(57.1%) &gt; Xueshuantong Injection + conventional western medicine(56.8%) &gt; Shuxuetong Injection + conventional western medicine(54.6%) &gt; Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(50.5%) &gt; conventional western medicine(0.03%). In terms of improving Barthel index, SUCRA showed the order of Danhong Injection + conventional western medicine(84.7%) &gt; Shuxuetong Injection + conventional western medicine(72.4%) &gt; Safflower Yellow Pigment Injection + conventional western medicine(61.6%) &gt; Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(44.6%) &gt; Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(43.2%) &gt; Shuxuening Injection + conventional western medicine(42.2%) &gt; conventional western medicine(1.4%). In terms of reducing platelet aggregation rate, SUCRA showed the order of Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(82.4%) &gt; Shuxuetong Injection + conventional western medicine(81.6%) &gt; Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(40.7%) &gt; Danhong Injection + conventional western medicine(37.3%) &gt; conventional western medicine(8.0%). In terms of reducing FIB, SUCRA showed the order of Danhong Injection + conventional western medicine(81.0%) &gt; Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(71.9%) &gt; Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(70.0%) &gt; Shuxuetong Injection + conventional western medicine(46.7%) &gt; Xueshuantong Injection + conventional western medicine(22.6%) &gt; conventional western medicine(8.7%). In terms of reducing hs-CRP, SUCRA showed the order of Shuxuening Injection + conventional western medicine(89.9%) &gt; Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(78.8%) &gt; Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(52.4%) &gt; Danhong Injection + conventional western medicine(47.6%) &gt; Xueshuantong Injection + conventional western medicine(43.5%) &gt; Shuxuetong Injection + conventional Western medicine(35.6%) &gt; conventional western medicine(2.3%). The results indicated that Xueshuantong Injection + conventional western medicine, Danhong Injection + conventional western medicine, and Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine ranked the top three. Xueshuantong Injection + conventional western medicine had the best effect on reducing NIHSS scores. Danhong Injection + conventional western medicine showed the best performance of improving clinical total effective rate, improving Barthel index, and reducing FIB in the blood. Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine had the best effect on reducing platelet aggregation rate in the blood. Shuxuening Injection + conventional western medicine had the best effect on reducing hs-CRP. However, more high-quality RCTs are needed for verification in the future to provide more reliable evidence-based medical reference.