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Introduction: Unstable angina pectoris (UAP) is the common type of coronary heart disease with the risk of developing into acute myocardial infarction (AMI). Currently, there are still numerous patients suffering from recurrent angina after revascularization or conventional medication due to the microvascular lesions, endothelial dysfunction, chronic inflammation, in-stent restenosis, and other factors. As an important part of China's medical and health care system, traditional Chinese medicine (TCM) has rich clinical experience in the treatment of UAP. According to the theory of TCM, Yang deficiency and blood stasis syndrome is a common type of UAP. Wen Xin decoction, as a type of Chinese herbal medicine, has been used in the clinic for years and shown great efficacy in the treatment of UAP with Yang deficiency and blood stasis syndrome. This study aims to evaluate the efficacy and safety of Wen Xin granular in patients with UAP.Methods and Analysis: This is a double-blinded, randomized, placebo-controlled clinical trial. A total of 502 participants will be randomly allocated to the intervention group and the placebo group. Based on conventional medication, the intervention group will be treated with Wen Xin granular and the placebo group will be treated with Wen Xin granular placebo. The primary outcomes are major adverse cardiovascular events (MACE). Assessments will be performed 1 year after the treatment. The secondary outcomes include TCM symptom scale score, Seattle angina questionnaire, and thromboelastography. Assessments will be performed at baseline (before randomization) and 4 and 8 weeks after randomization.Discussion: This trial will provide high-quality data on the benefits and risks of Wen Xin granular in patients with UAP.Trial Registration: ClinicalTrials.gov NCT04661709 . Registered on 30 November 2020. [ABSTRACT FROM AUTHOR]

Background: Coronary heart disease (CHD) has become one of the biggest health problems in the world. Stable angina is a common clinical type of CHD with poor prognosis and high mortality. Although there are various interventions for stable angina, none of them can significantly reduce mortality. Both basic and clinical research have shown that Suxiao Jiuxin Pill (SJP) can relieve the symptoms of angina pectoris and improve the clinical efficacy, but there is a lack of high-quality clinical research to provide research-based evidence. We design a randomized, double-blind, placebo-controlled trial to evaluate the efficacy of SJP for stable angina.Methods/design: This is a prospective, randomized, double-blind, placebo-controlled, and multicenter trial. The trial will enroll 324 participants with chronic stable angina (Qi Stagnation and Blood Stasis syndrome). All participants will have received the conventional therapy of chronic stable angina. Participants will be randomized into two groups, conventional therapy plus SJP group and conventional therapy plus placebo group. Eligible participants will receive either SJP or placebo (five pills administered orally, three times daily) in addition to conventional treatment for 24 weeks. The primary outcomes are the symptom improvement rate of angina from baseline to 4 weeks after inclusion and major adverse cardiovascular events (MACE). The secondary outcomes are angina classification (CCS), improvement of traditional Chinese medicine (TCM) syndromes, Seattle Angina Scale score, the dosage of emergency drugs and the stopping rate, and electrocardiogram (EKG) efficacy. Adverse events will be monitored throughout the trial.Discussion: Integrated traditional Chinese and Western Medicine is commonly used for angina in China. This study will evaluate the clinical effectiveness and safety of SJP for angina. The results of the trial will provide high-level clinical research-based evidence for the application of SJP instable angina.Trial Registration: This study protocol was registered on 14 March 2019. The registration number is ChiCTR1900021876 on the Chinese Clinical Trial Registry. [ABSTRACT FROM AUTHOR]

The yellow pond turtle, Mauremys mutica , is an economically important aquaculture species and is widely cultured in China because of its high value as a food and in traditional Chinese medicine, as well as being a popular pet. However, M. mutica shows poor tolerance to heat stress and frequently experiences mass mortality caused by infectious diseases during late spring and early summer, when high temperatures occur frequently and various pathogens begin to propagate rapidly. In this study, we performed a comparative transcriptome analysis of M. mutica in response to continuous heat stress (3 h, 9 h, 24 h and 48 h) at 32 °C. Compared to the control group (28 °C), a total of 813, 1488, 1856 and 2001 differentially expressed genes (DEGs) were identified in the four heat-stressed groups respectively, indicating that heat stress has a significant influence on gene expression in M. mutica and that the degree of influence gradually increases with heat stress duration. Interestingly, the immunity-associated category for the complement and coagulation cascade pathway was uniquely enriched in the latter three heat stress groups (9 h, 24 h and 48 h) and all DEGs (e.g. C3, C4, C6, C7, C8, C9 and MASP1/2) in this pathway showed down-regulation as the heat stress duration increased, suggesting that immunity continuously decreases with increased heat stress duration. These observations indicate that potential dysfunction of the immune response under heat stress may contribute to the mass mortality of M. mutica during late spring and early summer. This study provides insights into the molecular mechanisms underlying the mass mortality syndrome in M. mutica and is helpful for proposing effective strategies to alleviate the damage caused by heat stress. • The complement and coagulation cascade pathway was uniquely enriched in later three heat stress groups (9 h, 24 h and 48 h). • All DEGs in this pathway showed down-regulation as the heat stress duration increased. • Potential dysfunction of the immune responsemay contribute to the mass mortality of M. mutica during late spring and early summer. [ABSTRACT FROM AUTHOR]