Kudiezi (KDZ) injection is commonly used in traditional Chinese medicine as treatment for cerebral infarction and angina pectoris. The present study investigated the therapeutic effects of KDZ injection on myocardial injury induced by acute cerebral ischemia and the possibly protective mechanisms. Rats were divided into three groups: sham, 6h-ischemia, and KDZ treatment (KDZ). The neurological deficits were determined by the Garcia score. The cerebral infarct volume was measured by 2,3,5-triphenyltetrazolium chloride (TTC) staining, and brain water content was also evaluated. Serum creatinine kinase (CK), lactate dehydrogenase (LDH), and creatine kinase-myocardial band (CK-MB) activity, myocardial tissue malondialdehyde (MDA) levels, L-Glutathione (GSH) levels, and superoxide dismutase (SOD) activity as well as mitochondrial cytochrome c oxidase (COX) activity were determined. Mitochondrial COX I and COX III mRNA expressions of myocardial tissues were measured by RT-PCR. Impaired neurological function and brain edema were observed in the 6h-ischemia group. TTC staining showed that the 6h-ischemia group had larger infarct zones than the sham group. Myocardial ischemic changes (widened myocardial cell gap, cracks, and obvious edema) were detected in the 6h-ischemia group compared with the sham group, with elevated serum CK-MB activity and CK and LDH levels. Electrocardiography showed lower medium frequency (MF) and high frequency (HF) in the 6h-ischemia group compared with the sham group. In myocardial tissue, COX activity was elevated in the 6h-ischemia compared with the sham group, while SOD, GSH, and MDA levels, and COX I and COX III mRNA expressions remained unchanged. KDZ injection decreased neurological impairment, brain edema, gaps between cells, and infarct size. Compared with the 6h-ischemia group, it reduced serum CK-MB activity and CK and LDH levels, and MDA levels in myocardial tissue. KDZ significantly increased GSH levels, SOD activity, and mitochondria COX activity and the expression of COX I and COX III mRNA in myocardial tissue compared with the sham group. KDZ injection had a protective effect against cerebral ischemia in rats. KDZ injection could also alleviate myocardial injury after acute cerebral ischemia in rats. The possible mechanisms involve the regulation of the oxidative stress/antioxidant capacity after cerebral ischemia.

Purpose: Cognitive impairment (CI) is one of the most significant post-stroke complications. The Montreal Cognitive Assessment (MoCA) is widely applied to the early screening of post-stroke CI (PSCI), and has good sensitivity and specificity, but needs a long time to administer. Clinicians and researchers need shorter, more effective cognitive testing tools. The purpose of this study was to detect the sensitivity and specificity of two different short-form versions of the MoCA (SF-MoCA) for screening of PSCI in a Chinese population. Methods: A total of 2,989 stroke participants were included from 14 hospitals in northern and southern China between June 2011 and September 2013. The sensitivity and specificity of the two SF-MoCA versions were compared. Results: Using an MoCA score < 26 as the critical value, the National Institute of Neurological Disease and Stroke–Canadian Stroke Network SF-MoCA showed sensitivity of 91% and specificity of 63% (PPV 71%, BPV 87%) with scores ≤ 10 points. The sensitivity and specificity of the Bocti SF-MoCA were 92% and 69% (PPV 75%, BPV 89%) with scores ≤ 7, respectively. The area under the curve was 0.885 (95% CI 0.873– 0.897) and 0.912 (95% CI 0.902– 0.922), respectively. Conclusion: The Bocti SF-MoCA can be used as a briefer and more effective screening tool for PSCI in Chinese.

Geniposide, as a pharmacologically bioactive component, is derived from a classic and common Chinese herb, Gardenia jasminoides Ellis. Geniposide has been shown to be effective for treating I/R injury in recent studies. Current effectively pharmaceutical treatments are scarce, and treatment based on geniposide may become a novel option. As far as we know, this research is the initial systematic evaluation of the protective effects of geniposide in I/R injury. This study is engrossed in evaluating the mechanism of action of geniposide in I/R injury through a preclinical systematic review with meta-analysis and network pharmacology. We built a systematic review which provided a view of effect and mechanism of geniposide for I/R injury. Based on seven databases, an open-ended search from their inception to August 31st, 2022, was conducted. Animal studies on the effects of geniposide in I/R injury were considered. The data was analyzed using Review Manager 5.3, and bias was assessed using the CAMARADES 10-item scale. 13 articles including 279 animals were selected finally. And network pharmacology was joined to elucidate the mechanism. According to the meta-analysis, in I/R injury, geniposide can attenuate cardiomyocytes viability and the size of MI, decrease the volume of cerebral infraction and neurological score, decrease serum ALT and AST activity, and downregulated serum Cr and BUN. The review found that geniposide protects against I/R injury by inhibiting apoptosis, oxidation, inflammation and improvement of autophagy and mitochondrial respiration, which is consistent with the results of the network pharmacology screening. This preclinical systematic review including meta-analysis and network pharmacology, which was the first one summarizing the relationship between geniposide and ischemia diseases, shows a novel therapy for I/R injury and appears an enticing implication of geniposide in I/R injury, and further research is looked forward. Given the restricted quantity of included researches and the unclear risk of bias of the studies, we should interpret the results with caution.

Objective: The efficacy of traditional Chinese medicine (TCM) treatments for Western medicine (WM) diseases relies heavily on the proper classification of patients into TCM syndrome types. We develop a data-driven method for solving the classification problem, where syndrome types are identified and quantified based on patterns detected in unlabeled symptom survey data. Method: Latent class analysis (LCA) has been applied in WM research to solve a similar problem, i.e., to identify subtypes of a patient population in the absence of a gold standard. A widely known weakness of LCA is that it makes an unrealistically strong independence assumption. We relax the assumption by first detecting symptom co-occurrence patterns from survey data and use those patterns instead of the symptoms as features for LCA. Results: The result of the investigation is a six-step method: Data collection, symptom co-occurrence pattern discovery, pattern interpretation, syndrome identification, syndrome type identification, and syndrome type classification. A software package called Lantern is developed to support the application of the method. The method is illustrated using a data set on Vascular Mild Cognitive Impairment (VMCI). Conclusions: A data-driven method for TCM syndrome identification and classification is presented. The method can be used to answer the following questions about a Western medicine disease: What TCM syndrome types are there among the patients with the disease? What is the prevalence of each syndrome type? What are the statistical characteristics of each syndrome type in terms of occurrence of symptoms? How can we determine the syndrome type(s) of a patient?