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Ferroptosis is an important form of myocardial cell death in myocardial ischemia-reperfusion injury (MIRI). Naringenin (NAR), as a flavonoid, has a significant advantage in improving MIRI. But the regulatory effect and mechanism of NAR on ferroptosis in MIRI have not been reported. After the rats were given NAR and induced to form myocardial ischemia-reperfusion (MI/R) injury, Tetrazolium chloride (TTC) staining was used to detect the myocardial infarction area of rats, and Hematoxylin-eosin (H&E) staining was used to detect myocardial injury. The markers of tissue inflammation were detected by ELISA. Serum creatine kinase Serum creatin kinase (CPK), Lactate dehydrogenase (LDH), and lipid peroxide (LPO) and oxidative stress related levels were measured. In addition, iron detection kits were used to detect total iron and Fe2+ levels in cardiac tissues, and western blot was used to detect the expression of ferroptosis-related proteins and the expression of nuclear factor-erythroid factor 2-related factor 2 (Nrf2) and glutathione peroxidase 4 (GPX4). At the cellular level, H9C2 cardiomyocytes were induced by hypoxia/reoxygenation (H/R), and ferroptosis inducer Erastin was administered to detect cell viability, ferroptosis-related indicators, oxidative stress related indicators, and expressions of Nrf2 and GPX4, to explore the mechanisms involved. NAR alleviated MI/R-induced pathological damage, inflammation and lipid peroxidation in myocardial tissue of rats. NAR adjusted the NRF2 /System xc – /GPX4 axis and improved ferroptosis. At the cellular level, ferroptosis inducer Erastin reversed the protective effect of NAR on H/R-induced H9C2 cardiomyocytes. In conclusion, NAR can alleviate MIRI by regulating the Nrf2/System xc-/GPX4 axis to inhibit ferroptosis.

Objectives: Although Baduanjin (a traditional Chinese physical activity) has been reported to promote general health, the optimal exercise intensity and kinematic characteristics of this intervention remain poorly understood. This investigation aimed to quantify and compare the exercise intensities of traditional standing Baduanjin (TB) and sitting Baduanjin (SB) using cardiopulmonary exercise testing, to further clarify the sources of the previously observed benefits of this modality. Study design: Observational study. Interventions: Healthy individuals were recruited to perform TB, SB, and cycling (in order) until they reached their ventilatory threshold. Intensity-relevant parameters based on type of exercise and specific time points (exercise start and the end of the 2nd, 4th, 6th, and 8th set of motion) were compared between TB and SB with ventilatory threshold as control. Results: Forty individuals (18 male and 22 female) completed the trial. Significant differences in peak oxygen uptake, metabolic equivalent of task, and Borg scale existed among the three exercise types, indicating a decreasing overall exercise intensity in the order of ventilatory threshold, TB, and SB. All parameters except the respiratory exchange ratio fluctuated significantly across the time points. Conclusions: Both TB and SB resulted in a significantly lower exercise intensity when compared with the ventilatory threshold established through cycling exercise. The benefits of Baduanjin might be explained partly by its appropriate exercise intensity and intermittent intensity pattern. Baduanjin might be a potential alternative to existing schemes for exercise rehabilitation.

IntroductionTakotsubo syndrome (TTS) is a sudden reversible weakening of the left ventricle function induced by severe stress and resembles many features as acute coronary syndrome. Even though many guidelines had been published about TTS, there is no consensus regarding the long-term treatment. Aspirin is one of the most common prescribed medicines at discharge for patients with the intention to reduce thrombus events and improve the overall prognosis. However, existing studies yielded conflicting results concerning its effects. This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management.Methods and analysisAfter searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TTS recurrence, stroke, transient ischaemic attack or myocardial infarction at 30-day and 5-year follow-up will be examined. Risk of bias will be assessed by Newcastle-Ottawa quality assessment scale for observational studies and Cochrane Effective Practice and Organization of Care evaluation tool for interventional studies. Grading of Recommendations Assessment, Development and Evaluations method will be applied to assess the quality of evidence. If available, the effects of aspirin on the above outcomes for patients with TTS will be evaluated using random-effect modelling with relative risk at 95% CIs. Subgroup analysis and sensitivity analysis will also be performed when possible.Ethics and disseminationEthics approval was not required due to the retrospective nature of the study. Results of the review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020212729.

Background：Coronary artery disease (CHD) now accounts for approximately one third of all deaths globally and up to one-quarter of patients may have either continues or recurrent post-PCI chest pain. Yinxing Mihuan oral solution (YMOS) has been proven to bring clinical benefits for patients with CHD and Ginkgo biloba extract can relieve depression in mice. No high-quality randomized controlled trials on YMOS have been published. The aim of this study is to evaluate the efficacy and safety of Yinxing Mihuan oral solution (YMOS) in the treatment of patients with post-percutaneous coronary intervention (PCI) chest pain. This study also aimed to relieve the symptoms of chest pain as a primary outcome, improve the anxiety as a secondary outcome, assess therapeutic effects of YMOS on chest pain, and explore its effects on chest pain caused by psychological disorders after PCI.Methods: 320 patients with symptoms related to heart and a confirmed history of PCI for coronary heart disease (CHD) without the need to undergo selective coronary revascularization plan were recruited in this randomized controlled trial. The included participants were randomly assigned (at a ratio of 1:1) to experimental group and control group; patients in the experimental group received YMOS and standardized medical treatment, while those in control received placebo (10 ml) for three times/day for 12 weeks and standardized medical treatment regimen. The endpoints of the study included Seattle angina questionnaire (SAQ) score, Hamilton anxiety rating scale (HAMA), Hamilton rating scale for depression (HRSD), Canadian Cardiovascular Society (CCS) angina score, New York Heart Association (NYHA) classification, visual analogue scale (VAS), 12-Item short form survey (SF-12), frequency of angina-related symptoms per week, nitroglycerin discontinuation, and reduction rate of HAMA score.Discussion: This clinical trial can provide reliable evidence regarding the efficacy and safety of YMOS for patients with post-PCI chest pain.Trial registration: This research has been registered at the Chinese Clinical Trial Registry (Registration No. ChiCTR2000028760) on January 1, 2020. http://www.chictr.org.cn/showproj.aspx?proj=47528