Review conclusion According to the "Quality Management Standards for Drug Clinical Trials" promulgated and implemented by the State Drug Administration of the People's Republic of China in 2003, the drug clinical trial ethical review work guiding

Background Numerous meta-analyses have been conducted on music and pain, but no studies have investigated music and cardiac procedural pain. Objective To assess the effects of music intervention on pain in cardiac procedures in the published randomized controlled trials. Methods This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All the included randomized controlled studies were published between 1999 and 2016. Studies were obtained from electronic databases or by hand-searching of related journals and reference lists. The main outcome was pain intensity, and the secondary outcomes were vital signs such as heart rate, respiration rate, systolic blood pressure, and diastolic blood pressure. Risk of bias of the included studies was evaluated according to the Cochrane Collaboration guidelines. Results Analysis of 14 studies indicated that music interventions had statistically significant effects on decreasing pain scales (mean deviation [MD] = –1.84), heart rate (MD = –2.62), respiration rate (MD = –2.57), systolic blood pressure (MD = –5.11), and diastolic blood pressure (MD = 0.44). The subgroup analysis method was used in all five outcomes. Conclusions Considering all the possible benefits, music intervention may provide an effective complement for the relief of cardiac procedural pain.

Doxorubicin, sold under the brand name Adriamycin among others, is an important drug for cancer therapy; however, its use is limited by its cardiotoxicity. Ginsenoside Rg2 is extracted from Panax ginseng C.A.Mey., Araliaceae, which is believed to have cardioprotective properties. However, to date, there have been no reports on whether ginsenoside Rg2 could protect cardiomyocytes against doxorubicin. In this study, we investigated the action and the underlying mechanisms of cardioprotection of ginsenoside Rg2 upon doxorubicin treatment. Cell counting kit-8 was used to determine cell viability; in addition, terminal deoxynucleotidyl transferase–mediated dUTP nick-end labeling staining was used to detect apoptotic cells. Western blotting was used to investigate the relevant pathways. LY294002, a phosphatidylinositol 3-kinase inhibitor, was also used in this study. Ginsenoside Rg2 significantly (p < 0.01) neutralized cardiomyocyte apoptosis induced by doxorubicin in a dose-dependent manner, but this effect was blocked by LY294002. Furthermore, ginsenoside Rg2 upregulated protein kinase B phosphorylation through the phosphatidylinositol 3-kinase/protein kinase B pathway and inhibited p53 expression. These results suggest that ginsenoside Rg2 could attenuate doxorubicin-induced cardiomyocyte apoptosis via the phosphatidylinositol 3-kinase/protein kinase B pathway. Graphical abstract

Background Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by diastolic dysfunction. Despite the increasing incidence of HFpEF, there is no available therapy that reduces the mortality rate of HFpEF. Zhigancao Tang has been used traditionally for the treatment of cardiovascular diseases in China. The use of traditional Chinese medicine (TCM) is associated with improvements in clinical syndromes and quality of life of patients. A randomized clinical trial should be conducted to provide clear evidence regarding the efficacy and safety of Zhigancao Tang granules for the treatment of HFpEF. Methods A randomized, double-blinded, placebo-controlled clinical trial was proposed. A total of 122 patients with HFpEF will be randomly assigned to receive Zhigancao Tang granules or placebo for 12 weeks. The primary outcome measure is cardiac function. The secondary outcomes include measurement of the integral TCM syndrome score, echocardiography, 6-min walk test, N-terminal-pro hormone B-type natriuretic peptide level, atrial natriuretic peptide level, Minnesota Living with Heart Failure scale, and Lee’s scale. The outcome measures will be evaluated at baseline, 4 weeks, and 12 weeks. Adverse events will be evaluated from baseline till the 12-week follow-up period. Discussion The results of this trial will demonstrate whether Zhigancao Tang granules are effective and safe for treating HFpEF. Trial registration ClinicalTrials.gov NCT04317339. Registered on 23 March 2020.

The PPARγ-LXRα-ABCA1 pathway is involved in lipid regulation and inflammation activities. Over-expression of the genes has complicated effects on atherosclerosis in ApoE-knockout mice with high-cholesterol diet. GXK decoction has anti-inflammatory and anti-matrix metalloproteinase activities by regulating PPARγ, LXRα and ABCA1 interactions in the ApoE-knockout mice.