Background: Persistent fifth aortic arch (PFAA) is an extremely rare congenital cardiovascular malformation and there is limited data in the literature. The objective of this study is to enhance our understanding and diagnosis of PFAA from echocardiography and computed tomography angiography (CTA) findings, and to evaluate the application of echocardiography in the diagnosis of PFAA.Methods: We retrospectively reviewed five cases of PFAA diagnosed from October 2016 to September 2019 at the Affiliated Children's Hospital of Capital Institute of Pediatrics. We described their diagnosis by echocardiography and CTA findings, and medical history.Results: Five cases of PFAA were identified in the study. Patients aged from 3 to 48 months and weighed from 4 to 12 kg presented different clinical symptoms upon clinical examination. All the patients completed a primary echocardiographic assessment; however, the first two patients were misdiagnosed by echocardiography and was confirmed by supplemental CTA while the other three patients were directly diagnosed by echocardiography. Surgery was necessary for three patients, two of whom accepted and one refused. The other two patients only needed a follow-up assessment, which showed good results. Conclusions:The clinical manifestation of PFAA in our patient population was atypical, and their diagnosis depended on the use of echocardiography. In the case of uncertainty, the final diagnosis was confirmed by CTA. Although the nomenclature and embryonic origin of PFAA remains controversial, the accurate diagnosis of aortic arch abnormalities and associated malformations are imperative for time-sensitive treatments.

Background: Traditional Chinese patent medicine (TCPM) has potential in the treatment of type 2 diabetes mellitus (T2DM). Some studies have reported TCPMs could effectively reduce blood glucose levels in diabetic patients. To enhance glycemic control, relieve uncomfortable symptoms and delay diabetic complications, integrative TCPM and anti-hyperglycemic drugs is essential. Here, we investigated the efficacy and safety of using TCPM according to syndrome differentiation in co-collaboration with antihyperglycemic drugs.Methods: Participants that met the diagnostic criteria of T2DM and traditional Chinese medicine (TCM) syndrome differentiation were included. This is a two-arm multicenter, prospective cohort study.Two hundred and six participants will be included, the cohorts were divided according to the treatment methods they choose. Both groups will propose a healthy lifestyle, the exposure group used TCPMs based on syndrome differentiation, while the control group do not use other therapies. Basic therapy of antihyperglycemic, lipid-lowering and anti-hypertensive treatment accompanied with both groups. The study duration will be 24 weeks, and being followed up for 2 years afterward. Telephone follow-up will be done every two weeks and participant follow-up will be done every four weeks during the intervention period.The primary outcome will be the changes in glycosylated hemoglobin, the secondary outcomes include the changes of blood glucose, blood pressure, blood lipids, body weight, body mass index, waist circumference, hip circumference, incidence of diabetic microvascular and macrovascular complications and improvement in TCM symptoms. T test, Wilcoxon rank sum test, chi-squared test, or Fisher exact test were regarded as the main statistical methods for comparing the outcome variables. Statistical tests will be two-sided, and significance will be assigned at P<0.05.Discussion: The design of the trial coincides with the real-world practice of TCM. We assume that participants with T2DM will be helped by TCPMs. If succeeded, this study will furnish evidence that TCPM in collaboration with anti-hyperglycemic drugs could improve glycolipid metabolism, relieve subjective symptoms and delay the incidence of diabetic complications.

Background: Diabetic retinopathy remains a leading cause of vision loss globally. Here, we investigated the efficacy and safety of Qizhijiangtang capsule (QZJC), a kind of traditional Chinese patent medicine, for patients with NPDR. Methods: This study is a multi-center, randomized, controlled clinical trial. A total of 100 participants will be randomly assigned in a 1:1 ratio to QZJC group or QZJC placebo group. The treatment duration lasts 24 weeks. The primary outcome is the changes in the degree of retinal microaneurysm lesions assessed by fundus photography and fundus fluorescence angiography before and after treatment. The secondary outcomes include the changes in corrected visual acuity, blood glucose, glycosylated hemoglobin, urinary microalbumin excretion rate, the improvement of TCM syndromes and TCM symptoms. Discussion: We postulate that NPDR patients will benefit from QZJC. If successful, this work will provide preliminary evidence that QZJC could delay the progress of DR. Trial registration: Chinese Clinical Trial Registry no. ChiCTR1900023506. The protocol has registered at http://www.chictr.org.cn/showprojen.aspx?proj=39622. Registered 31 May 2019. Template (preprint statement): This manuscript has been preprinted [https://doi.org/10.21203/rs.3.rs-596869/v1].

Background: Diabetic retinopathy is the most frequently occurring complication of diabetes mellitus and remains a leading cause of vision loss globally. Conventional treatments are focused on advanced stage of disease, targeting the early and potentially reversible retinal injury is a promising strategy for delaying non-proliferative diabetic retinopathy (NPDR). Here, we investigated the efficacy and safety of Qizhi Jiangtang capsule (QZJC), a kind of traditional Chinese patent medicine, for patients with NPDR.Methods: This study is a randomized, single-blind, placebo-controlled, multi-center clinical trial. A total of 200 participants will be randomly assigned in a 1:1:1:1 ratio to QZJC plus calcium dobesilate (CaD) group, QZJC placebo plus CaD group, QZJC group or QZJC placebo group. The treatment duration lasts 24 weeks. The primary outcome is the changes in grading of retinal microvascular injury before and after treatment. The secondary outcome will be changes in the vision, glycolipid, blood pressure, urinary albumin excretion rate and improvement of traditional Chinese medicine symptoms. All statistics will be two-sided tests, P < 0.05 is considered statistically significant.Discussion: We postulate that NPDR patients will benefit from QZJC. If successful, this work will provide preliminary evidence that QZJC could delay the progress of DR.Trial registration: Chinese Clinical Trial Registry no. ChiCTR1900023506. Registered 31 May 2019. The Version identifier is 2018121702.