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Applications of “Target Fishing” Technique in Pharmacological Research of Traditional Chinese Medicine CHEN Siyi, SHENG Lisong, SUN Rong 2024, 21(12): 1321-1328.  DOI: 10.19803/j.1672-8629.20240700 Abstract ( 250 )   PDF (1661KB) ( 160 )   Objective To review the recent applications of “target fishing” technique in the fields of Traditional Chinese Medicine (TCM) in recent years in order to contribute to overcoming the bottleneck of TCM modernization caused by the complexity of TCM components and the uncertainty of target components. Methods Literature on “target fishing” techniques in the field of TCM in the past 15 years was searched. Research methods involved in the commonly used “target fishing” techniques were summarized. The strengths and weaknesses of these techniques in revealing the action or toxicity targets of TCM components were analyzed. Results “Target fishing” techniques applied in the field of TCM were mostly based on “affinity fishing”, which was often used in conjunction with liquid chromatography, mass spectrometry and other technologies for direct target research of TCM potent or toxic components on the basis of a clear mechanism of affinity fishing and toxicity. It was difficult to apply this technique to small molecules with close conformational relationships or to perform rapid and unbiased protein target identification for complex TCM systems. The interpretation of TCM theories in existing studies remained weak, and there was a lack of in-depth integration with TCM theories in subsequent validation studies or in-depth excavation. Conclusion The “target fishing” technique offers novel insights and methodologies for elucidating the molecular-level mechanisms of TCM action. This study proposes a research strategy for investigating the effects and toxicity of TCM, which should be thoroughly explored within the framework of TCM theories and substantiated from comprehensive system-level perspectives. The“target fishing” technique provides references for integrated evaluation of the “effect-toxicity” of TCM. References | Related Articles | Metrics

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Clinical Characteristics and Treatments of Monkeypox Infections in Patients with HIV/AIDS REN Bingqing, FAN Zibo, ZHANG Yuanyuan, ZHANG Wei, CHEN Zhihai 2024, 21(12): 1329-1336.  DOI: 10.19803/j.1672-8629.20240827 Abstract ( 182 )   PDF (1392KB) ( 131 )   Objective To review the epidemiological features, clinical manifestations, treatments, and prevention strategies of monkeypox infections in patients co-infected with HIV/AIDS in order to enhance the ability of the medical staff to identify and treat such patients. Methods The epidemiological and clinical features of patients with HIV/AIDS co-infection with monkeypox are outlined. The drugs and vaccines currently used are summarized in terms of action mechanisms. Results Since 2022, monkeypox has erupted in multiple countries and regions globally, and HIV-infected individuals are at high risk of monkeypox virus infection. Currently, there are no effective vaccines or specific medications for monkeypox. Some small molecule drugs (tecovirimat, cidofovir and brincidofovi), immunoglobulins (VIG), and vaccines (MVA, MVA-BN) are showing promising antiviral effects in research and clinical trials. Conclusion Cases of monkeypox co-infection with HIV account for a high proportion of global outbreaks. Small molecule antiviral drugs, immunoglobulin, and proactive vaccination can serve as powerful weapons in controlling the outbreak. References | Related Articles | Metrics

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Clinical Characteristics of Patients with Mpox in a Department of Dermatology LIU Jing, YAN Huiwen, ZHAO Xingyun, YUAN Liufeng, ZHAO Tianwei, ZHANG Wei, LUN Wenhui 2024, 21(12): 1337-1342.  DOI: 10.19803/j.1672-8629.20240660 Abstract ( 134 )   PDF (1491KB) ( 101 )   Objective To analyze the clinical characteristics and outcomes of Mpox patients in an outpatient department of dermatology at a hospital in Beijing. Methods A retrospective analysis was conducted of the clinical manifestations of 51 Mpox patients treated between June 1, 2023 and June 15, 2024 in the Department of the Dermatology, Beijing Ditan Hospital. The clinical characteristics were summarized. Results In this study, all the 51 patients with Mpox were males ages 18 to 57, with a median age of 32 years, all of whom had a history of intercourse with men before the onset of the disease, with an incubation period of 1-30 days and a median of 7 days. The most common clinical manifestations were rashes (51/51, 100%) and fever (31/51, 60.78%). The primary rash was papules or pustules with central necrotic crusting. All patients had skin rashes, 24 of whom (24/51, 47.06%) developed rashes that were limited to the genitals and perianal area, 12 (12/51, 23.53%) started with generalized pustules, and 15 (15/51, 29.41%) had rashes that were initially localized before being generalized. 31 cases (31/51, 60.78%) had fever, which did not necessarily follow the rash. There were 32 (32/51,62.75%) HIV-positive patients, 2 (2/51, 3.92%) were in the AIDS stage (CD4+ T lymphocytes < 200 cells·μL-١), and one died. There were 25 cases (25/51, 49.02%) with positive serological tests for syphilis. As symptomatic treatment, 39 patients (39/51, 76.47%) were treated with symptomatic supportive care, including topical and oral anti-infective drugs(such as fusidic acid cream, povidone iodine solution, valaciclovir and cefprozil), 12 patients received no medication, and most of the outcomes were good except for one death. Conclusion Patients during this Mpox epidemic were mostly men who had sex with men, and the clinical manifestations were primarily pustules with central necrotic scabs. Some patients were accompanied by fever, AIDS complicated with Mpox could cause death, and most patients had a good prognosis after symptomatic treatment. References | Related Articles | Metrics

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Ancient Chinese Medical Texts and Treatment of 8 Cases of Monkeypox with TCM ZHAO Rui, XIN Xiaoli, XIAO Tingyue, SHI Xiaolin, WANG Yan, TIAN Xia, ZHANG Wei 2024, 21(12): 1343-1349.  DOI: 10.19803/j.1672-8629.20240466 Abstract ( 105 )   PDF (1348KB) ( 187 )   Objective To review ancient Chinese medical literature on monkeypox in terms of the disease name, etiology, pathogenesis, syndrome differentiation and treatments. Methods Literature on monkeypox from ancient Chinese medical texts was reviewed. Analysis was conducted of the clinical data on the etiology pathogenesis, principles and methods of treatment, syndrome differentiation and treatment by stages, pharmacology, and external treatment with TCM related to 8 cases of monkeypox admitted to Shenyang Sixth People's Hospital between June 29, 2023 and February 5, 2024. Results During clinical research on monkeypox using TCM, it was found that the pathological mechanism and clinical manifestations of monkeypox were highly consistent with the category of “epidemic diseases” "variola" in traditional theories of TCM, and that the disease resembled smallpox. The etiology and pathogenesis of monkeypox were believed to be due to external contraction of epidemic toxins prevalent at the time, and with damp-heat accumulations in lungs and spleens. Based on the course of disease, monkeypox was divided into three stages: the initial stage, around 7 days after rash onset, and more than 14 days after rash onset. According to different stages of the disease, treatments involved dispersing wind and clearing heat, relieving the exterior and promoting the eruption of rashes, strengthening the spleen and eliminating dampness, and enhancing the body's resistance to eliminate pathogens. A modified prescription of Shaoyao Guizhi Gancao Tang (Paeoniae Radix, Cassiae Twig, and Glycyrrhizae Radix Decoction) was used in combination with Shenling Baishu San (Poria, Atractylodes, and Coicis Semen Powder) , Sijunzi Tang (Astragalus, Atractylodes, Ginseng, and Poria Decoction) along with Chaige Jieji Tang (Bupleurum, Pueraria, and other herbal decoction) , Bazhen Tang (Eight-Treasure Decoction) combined with Fangfeng Tongsheng San (Saposhnikoviae and other herbal powder). External treatments with TCM such as thunder-fire moxibustion and Chinese herbal decoction soaking were also adopted. Conclusion Based on the disease characteristics of monkeypox at different stages, TCM treatment strategies intended to resolve exterior syndrome and promote eruption, strengthe the spleen to eliminate dampness, and promote the body resistance to eliminate pathogenic factors have been adopted to good clinical effects. References | Related Articles | Metrics

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Clinical Treatment and Medications for Monkeypox with Vulva and Perianal Lesions BAO Lei, LI Jike, TANG Rong, ZHANG Ling, CHENG Deyun, ZHANG Wei, LUO Mei 2024, 21(12): 1350-1356.  DOI: 10.19803/j.1672-8629.20240046 Abstract ( 88 )   PDF (1451KB) ( 167 )   Objective To analyze the clinical characteristics of cases of monkeypox mostly with vulva and perianal lesions and the clinical efficacy of integrated Chinese and Western medicine. Methods The clinical data of 43 patients with vulvar and perianal lesions hospitalized and discharged from Chengdu Public Health Clinical Medical Center between June 29, 2023 and July 31, 2023 was retrospectively analyzed. Results A total of 56 monkeypox patients were admitted in this space of time, 43 of whom had vulvar and perianal lesions, All these patients were males, with a mean age of (31.37 ± 5.47) years (ranging from 19 to 42 years), Among these patients, 35 (81.40%) were MSM, six (13.95%) were bisexual, 16 (37.21%) were infected with HIV, 33 (76.74%) started with perineal and perianal rashes, and 27 had more than 10 herpes. Levels of C reactive protein were significantly elevated [(30.43 ± 25.23) mg·L-1] Their hospital stay averaged (8.98 ± 2.72) days after treatment. The average absorption time of blister fluid was (4.44 ± 1.86) days while complete shedding of the scab skin took (8.95 ± 2.73) days. Nineteen of these cases (44.19%) left scars. A comparison of clinical data between HIV-and non-HIV-infected patients showed that HIV patients had more herpes, higher C-reactive protein levels, lower CD3+ CD4+ T lymphocyte count [(431.40 ± 220.67) vs (719.58 ± 274.04), P<0.01], and a higher proportion of antibiotic use (15/1 vs 18/9, P <0.05). Conclusion Individuals engaging in homosexual or bisexual behavior account for a high proportion among current monkeypox patients, with initial rashes around the perineum and perianal areas. Patients with HIV infections tend to have more severe conditions and recover more slowly than non-HIV infected individuals. For patients presenting with genital or perianal rashes or ulcers, monkeypox screening is recommended. Based on patients' conditions, appropriate medication plans should be formulated. Monkeypox can be effectively treated by combining traditional Chinese and Western medicine. References | Related Articles | Metrics

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Research Progress in Quality Evaluation of Polygonum multiflorum Thunb. Based on Features of Traditional Identification YANG Yanrong, KANG Shuai, LI Yanyi, MA Shuangcheng, WEI Feng, WANG Fang, WANG Qi 2024, 21(12): 1357-1362.  DOI: 10.19803/j.1672-8629.20240343 Abstract ( 95 )   PDF (1454KB) ( 196 )   Objective To clarify the correlation between the characters and microscopic characteristics of Polygonum multiflorum Thunb. and its quality, and establish a method to evaluate the quality. Methods The history and basal traits of Polygonum multiflorum Thunb. were studied based on related literature and books. The correlations between the trait characteristics of “red and white” Polygonum multiflorum Thunb., cloudy pattern, wood center and its quality were explored. Results The authentic basal root of Polygonum multiflorum Thunb. should be Polygonum multifonum Thunb. of the family Polygonaceae. The wood center of Polygonum multiflorum Thunb. referred to the round-shaped central part or the central formation of the layer ring in the cross-section of the herb. There was a correlation between the cloudy pattern and wood center and the quality of Polygonum multiflorum Thunb. Herbs with an obvious cloudy pattern but no wood center had higher contents of effective ingredients while those with a small or no cloud pattern but with a wood center had lower contents. Conclusion The categorization of Polygonum multiflorum Thunb. into “red and white” types remains controversial.Studies are so far insufficient to definitively correlate traits with the quality of Polygonum multiflirum Thunb., so in-depth research is needed in this area. References | Related Articles | Metrics

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Digital Characterization of Surface Characteristics of Polygonum multiflorum Thunb. Pieces and Correlations with Chemical Composition Contents YANG Yanrong, SHI Jia, LI Yanyi, WEI Feng, MA Shuangcheng, WANG Fang, WANG Qi 2024, 21(12): 1363-1370.  DOI: 10.19803/j.1672-8629.20240559 Abstract ( 68 )   PDF (2098KB) ( 75 )   Objects To establish a method for evaluating the quality of Polygonum multiflorum Thunb. pieces based on the surface characteristic chromaticity value, that is, the surface color of Polygonum multiflorum Thunb. Methods The surface features of different parts of Polygonum multiflorum Thunb. were collected under a stereo fluorescence microscope, and the chromaticity values of R, G, B, L*, a* and b* were obtained with photo shop cs6 software. The contents of stilbene glucoside, emodin, emodin -8-O-β-D- glucoside, emodin methyl ether and emodin methyl ether -8-O-β-D- glucoside in Polygonum multiflorum Thunb. were determined by UPLC-QQ-MS/MS, and the correlations between the chromaticity value of Polygonum multiflorum Thunb. and the contents of the five components were analyzed via cluster analysis (HCA), one-way ANOVA and Pearson correlation analysis. Results The results of HCA showed that Polygonum multiflorum Thunb. pieces from different habitats were grouped into three categories, which were light yellow-white, yellow-brown and reddish-brown, indicating that the colors of Polygonum multiflorum Thunb. pieces from different habitats varied. The results of one-way ANOVA showed that there were significant differences in the contents of stilbene glycoside and emodin in Polygonum multiflorum Thunb. pieces with different cross sections. Macroscopically, the stilbene glycoside content was higher in Polygonum multiflorum Thunb. pieces with light yellow and white cross sections, emodin content was higher in those with yellow-brown cross sections, and the content of stilbene glycoside and emodin was lower in those with red-brown cross sections. The results of correlation analysis showed that there was also a correlation between the chromaticity value and the related content of Polygonum multiflorum Thunb. The skin chromaticity value A of Polygonum multiflorum Thunb. was negatively correlated with the content of emodin methyl ether. Conclusion The established method is accurate and user-friendly. The quantification of chromaticity values can provide data for empirical identification of Polygonum multiflorum Thunb. It is a compelling interpretation of the traditional identification experience related to Polygonum multiflorum Thunb. and an combination of traditional experience and modern science to reveal the correlations between the cross-section color of decoction pieces and related chemical components of Polygonum multiflorum Thunb. References | Related Articles | Metrics

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Tissue Distribution of Chemical Components Based on Characters of Polygonum multiflorum Thunb. WANG Qi, YANG Yanrong, LI Yanyi, XIE Jingxin, WEI Feng, MA Shuangcheng, WANG Fang, SHI Jia 2024, 21(12): 1371-1376.  DOI: 10.19803/j.1672-8629.20240808 Abstract ( 80 )   PDF (1494KB) ( 67 )   Objective To analyze the differences in tissue accumulation of chemical components in Polygonum multiflorum Thunb. pieces with different characters and characteristics, and to reveal the differences and correlations between characters, chemical components and tissues. Methods The contents of stilbene glucoside, emodin, emodin -8-O-β-D- glucoside, emodin methyl ether and emodin methyl ether -8-O-β-D- glucoside in different tissues of Polygonum multiflorum Thunb were determined with UPLC-QQQ-MS/MS, and the distribution of chemical components in four tissues of Polygonum multiflorum Thunb. with different characteristics was compared while their correlations with different tissues were explored using such statistical methods as ANOVA and Pearson correlation analysis. Results Trans-2,3,5,4'-tetrahydroxydiphenyl ethyl-2-O-β-D- glucoside was obviously accumulated in the cork. The results of one-way ANOVA showed that there were significant differences in the tissue distribution of five main chemical components in Polygonum multiflorum Thunb. The results of correlation analysis showed that the contents of five chemical components in Polygonum multiflorum Thunb. from Gaozhou and Deqing,Guangdong and Qujing, Yunnan were significantly correlated with their parts (P<0.05). There was a positive correlation between the center of Polygonum multiflorum Thunb. from Qujing, Yunnan and emodin -8-O-β-D- glucoside from Yunjin (P <0.05). The cork of Polygonum multiflorum Thunb. from Gaozhou, Guangdong was negatively correlated with emodin -8-O-β-D- glucoside of abnormal vascular bundle (P<0.05), and the central vascular bundles of Polygonum multiflorum Thunb. was positively correlated with stilbene glucoside of abnormal vascular bundle of Polygonum multiflorum Thunb.( P <0.05).The results of one-way ANOVA showed that there were significant differences in the tissue distribution of five main chemical components in Polygonum multiflorum Thunb. The results of correlation analysis showed that the contents of five chemical components in Polygonum multiflorum Thunb. from Gaozhou and Deqing,Guangdong, Qujing Yunnan were significantly correlated with their parts (P<0.05). There was a positive correlation between the central vascular bundles of Polygonum multiflorum Thunb. from Qujing, Yunnan and emodin -8-O-β-D- glucoside from abnormal vascular bundle (P<0.05). The cork of Polygonum multiflorum Thunb. from Gaozhou, Guangdong was negatively correlated with emodin -8-O-β-D- glucoside of Yunjin (P <0.05), and the central vascular bundles of Polygonum multiflorum Thunb. was positively correlated with stilbene glucoside of abnormal vascular bundle(P<0.05). Conclusion The distribution of chemical components in Polygonum multiflorum Thunb. tissues with different characters and characteristics has been characterized, which provides data for quality evaluation of Polygonum multiflorum Thunb. References | Related Articles | Metrics

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Identification of Hepatotoxic Components of Polygoni Multiflori Radix Based on Material Basis Combined with Heparg Cell Experiments LI Yanyi, WEN Hairuo, YANG Yanrong, MA Shuangcheng, WANG Qi 2024, 21(12): 1377-1381.  DOI: 10.19803/j.1672-8629.20240427 Abstract ( 82 )   PDF (1666KB) ( 89 )   Objective To explore potential hepatotoxic components based on the differences in cytotoxicity between different batches of Polygoni Multiflori Radix(PM). Methods Ultra-performance liquid chromatography-triple quadrupole mass spectrometry (UPLC-QQQ-MS/MS) was used for quantitative detection of PM while hierarchical cluster analysis was used to classify samples. The half inhibitory concentration (IC50) of HepaRG cells was used as the index to evaluate the toxicity of categorized samples and to reveal the differences between different groups. Orthogonal partial least squares discriminant analysis was used to identify the differences in toxicity between different groups and screen for differential components. Results Twenty-two batches of samples were divided into categories A, B, and C based on common compounds. The IC50 of HepaRG cells indicated that the three groups of samples were significantly different in terms of toxicity, which was the highest in group B, followed by group A and group C. The results of OPLS-DA suggested that the discrimination rate of the models between groups A, B, and C was good, and three potential toxic components with VIP>1 were obtained. Conclusion Different categories of PM samples exhibit differences in toxicity. trans-2, 3, 5, 4'-tetrahydroxystilbene-2-O-β-D-glucoside (THSG), emodin-8-O-β-D-glucoside (EG) and catechin are potential toxic components of PM. References | Related Articles | Metrics

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Advancements in Treating Ischemic Stroke with Chinese Medicine Compounds Formulae LIU Wenjie, GAO Yuanyuan, BAI Xue 2024, 21(12): 1382-1387.  DOI: 10.19803/j.1672-8629.20240654 Abstract ( 98 )   PDF (1427KB) ( 186 )   Objective To examine findings related to the applications of TCM compound formulae in the management of ischemic stroke, and to offer data for subsequent clinical and experimental investigations. Methods By searching China Knowledge Network and PubMed for articles published from the inception to October 20, 2024, TCM compound formulae were summarized and evaluated. Results Clinical investigations indicated that TCM compound formulae, including Buyang Huanwu Tang, Xinglou Chengqi Tang, and Taohong Siwu Tang, exhibited substantial therapeutic efficacy in patients with ischemic stroke. Conclusion TCM compound formulae possess considerable benefits in the management of ischemic stroke. However, investigations are comparatively limited, and there is a lack of clinical studies and large-scale trials. Multi-sample and high-quality clinical studies are lacking. References | Related Articles | Metrics

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Research Progress in Regulation of Wnt/β-Catenin Signaling Pathway by TCM in the Treatment of Ischemic Stroke LIU Sujie, YAN Jiahe, RUAN Jiaxin, WANG Chen, WANG Xiaofan, LIU Shumin, BAI Xue 2024, 21(12): 1388-1392.  DOI: 10.19803/j.1672-8629.20240653 Abstract ( 72 )   PDF (1358KB) ( 113 )   Objective To study the role of the Wnt/β-catenin signaling pathway in acute ischemic stroke (IS), and to summarize the mechanisms by which traditional Chinese medicine formulas and monomers exert therapeutic effects on IS through the Wnt/β-catenin signaling pathway. Methods By searching related literature at home and abroad, traditional Chinese medicine formulas and their monomers currently available were summarized, and future developments were predicted. Results Traditional Chinese medicine could effectively alleviate brain damage caused by IS by targeting the Wnt/β-catenin signaling pathway, including anti-inflammation, antioxidant stress, anti neuronal apoptosis, and promotion of angiogenesis. Conclusion In the treatment of IS, traditional Chinese medicine can exert a good effect through the Wnt/β-catenin signaling pathway. References | Related Articles | Metrics

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Research Progress on Models of Ischemic Stroke LIU Zhejun, TANG Tian, TAN Tianyang, BAI Xue 2024, 21(12): 1393-1397.  DOI: 10.19803/j.1672-8629.20240637 Abstract ( 74 )   PDF (1476KB) ( 87 )   Objective To find out more about the disease mechanism of ischemic stroke, evaluate the therapeutic efficacy and predict prognosis. Methods The latest progress in clinical models, pharmacological models (including in vivo and in vitro models), and other emerging models related to ischemic stroke research was summarized. Results Clinical models were mostly used for risk prediction, prognosis assessment, and treatment decision support. Pharmacological models played a crucial role in mechanism exploration and drug screening. Emerging computer models and multi-omics models offered new perspectives for personalized treatments and precision medicine. Conclusion Despite significant advancements in ischemic stroke research, these models are still facing challenges related to clinical relevance, model integration, and translational applications. Future research should try to work on the accuracy and generalizability of models, strengthen multidisciplinary collaboration, and promote the translation of basic research into clinical practices in order to improve diagnosis, treatments, and quality of life for patients with ischemic stroke. References | Related Articles | Metrics

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Analysis and Research on the Mechanism of Cerebral Ischemia in China ZHENG Enqi, BAI Xue 2024, 21(12): 1398-1404.  DOI: 10.19803/j.1672-8629.20240595 Abstract ( 75 )   PDF (1923KB) ( 73 )   Objective To explore the developments and research hotspots in the field of cerebral ischemia mechanisms in China over the past two decades in order to provide references for future research. Methods Domestic literature related to cerebral ischemia mechanisms published by China National Knowledge Infrastructure (CNKI) between January 1, 2000 and June 1, 2023 was retrieved while other literature on cerebral ischemia mechanisms related to autophagy and angiogenesis was analyzed. Results A total of 3 346 articles were included. The annual number of publications trended upward. The network diagram of institutional cooperation involved 654 institutions, most of which were traditional Chinese medicine universities or research institutes. Research related to the mechanism of cerebral ischemia revolved around such mechanisms as apoptosis, inflammation, oxidative stress, autophagy and angiogenesis. The targets of study included the blood-brain barrier, hippocampus, mitochondria, and neurons while research methods involved acupuncture and traditional Chinese medicine. Conclusion The research on the mechanism of cerebral ischemia in China has made steady progress in the past 20 years, and most of the research focuses on traditional Chinese medicine. The next step should be clinical and evidence-based analysis of superior traditional Chinese medicine drugs for the treatment of cerebral ischemia, and identify superior prescriptions and classic drugs so as to provide references for research on the treatment of cerebral ischemia by traditional Chinese medicine. References | Related Articles | Metrics

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Research Progress on Traditional Chinese Medicine Compound Formulae against Hemorrhagic Stroke LIU Zhejun, TANG Tian, TAN Tianyang, BAI Xue 2024, 21(12): 1405-1410.  DOI: 10.19803/j.1672-8629.20240636 Abstract ( 87 )   PDF (1368KB) ( 87 )   Objective To explore the research progress in clinical efficacy and mechanisms of action of traditional Chinese medicine compound formulae in the treatment of hemorrhagic stroke in recent years, and to find out more about the potential applications of traditional Chinese medicine compound formulae. Methods Literature related to TCM compound formulae against hemorrhagic stroke that was published from inception to August 2024 was searched for in National Knowledge Infrastructure (CNKI) databases, while related research progress was summarized. Results Clinical studies showed that such TCM compound formulae as Yisui Poxue formula and decoctions for invigorating blood and removing blood stasis could do much to improve the neurological function of patients, reduce cerebral edema, facilitate recovery and improve the quality of life. Studies on the mechanisms suggested that TCM compound formulae could exert such pharmacological effects as protection of neurons, improvement of microcirculation, reduction of inflammatory response, attenuation of oxidative stress, inhibition of apoptosis, pyroptosis and ferroptosis in multi-target and multi-pathway ways. Conclusion With in-depth research, TCM compound formulae are expected to play a greater role in the comprehensive treatment of hemorrhagic stroke and provide patients with more individualized and precise treatment options, but most of the current studies are small-sample observational studies with limited evidence. More high-quality clinical studies are needed in the future to validate the efficacy of TCM compound formulae in the treatment of hemorrhagic stroke. References | Related Articles | Metrics

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Establishment of Key Performance Indicators for Drug Inspection SONG Fuyu, CAO Yi 2024, 21(12): 1411-1414.  DOI: 10.19803/j.1672-8629.20240777 Abstract ( 201 )   PDF (1287KB) ( 189 )   Objective To establish an identification model and examples of key performance indicators (KPIs) for drug inspection so as to provide references for formulating drug inspection KPIs by drug inspection institutions. Methods The drug regulatory key performance indicators (KPIs) in the Global Benchmarking Tool (GBT) of the World Health Organization (WHO) were studied, the characteristics of KPIs were summarized, the applications of logical models in the identification and formulation of KPIs were outlined. Results An identification model for drug inspection KPIs was established, eight maintenance modules for identification of drug inspection KPIs were proposed, and examples of drug inspection and inspection ability were developed with the model. Conclusion The identification model for drug inspection KPIs provides the methodology and standards for establishment of KPIs, and promotes the improvement of the quality management system (QMS) for drug inspection. References | Related Articles | Metrics

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Construction and Application of Knowledge Base for Toxic Herbal Materials LI Xiaoyang, WANG Yilin, XU Jing, TONG Lin, ZHAI Min, JIANG Wenbo, HE Yanxian, LEI Lei, YOU Yun 2024, 21(12): 1415-1418.  DOI: 10.19803/j.1672-8629.20240705 Abstract ( 129 )   PDF (1283KB) ( 162 )   Objective To establish a knowledge base of toxic traditional Chinese medicine. Methods A knowledge graph storage structure combined with visualization technology was adopted to present the information about the toxin-targeted organs and toxic doses. A visualization platform was built for toxic medicinal materials. Results The knowledge base exclusively related to toxic traditional Chinese medicine constructed by the study summarized the reports about toxic experiments on toxic traditional Chinese medicine, traditional Chinese patent medicines and simple preparations containing toxic traditional Chinese medicine and toxic ingredients, integrated the knowledge of toxic traditional Chinese medicine and kept data more correlated. Conclusion This platform will provide data service support for the applicational research, development, and inheritance of toxic traditional Chinese medicine. References | Related Articles | Metrics

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Medications and Adverse Reaction in Children and Adolescents with Depressive Disorders ZHANG Longying, LOU Lifeng, YOU Qian, WEI Yubing, CAI Yan, LI Bin 2024, 21(12): 1419-1424.  DOI: 10.19803/j.1672-8629.20240664 Abstract ( 188 )   PDF (1421KB) ( 179 )   Objective To examine the real-world clinical medications for pediatric and adolescent patients with depressive disorders, analyze the usage of drugs, and provide references for rational prescriptions. Methods The demographic characteristics, types of drugs used, treatment regimens, and adverse drug reactions among pediatric and adolescent patients with depressive disorders treated at psychological clinic of Fujian Energy General Hospital between 2019 and 2023 were analyzed. Results A total of 2 550 prescriptions for pediatric and adolescent depression patients were collected, involving 14 597 prescriptions for Western medicines and 46 583 drug entries. The majority of patients were aged 16 to 18, who far outnumbered those in groups ages 10 to 12 and 13 to 15. The average age of patients declined over time, with females outnumbering males. The five most commonly prescribed psychiatric medications were sertraline, alprazolam, quetiapine, olanzapine, and aripiprazole. The treatment approach primarily involved polypharmacy (more than 80%), with the most common regimens being antidepressant + antipsychotic (30.81%), and antidepressant + antipsychotic + sedative-hypnotic or anxiolytic (26.69%). Adverse drug reactions included gastrointestinal disorders, metabolic and nutritional disturbances, and psychiatric symptoms. Conclusion Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are the mainstay of treatments for pediatric and adolescent depression in outpatient settings. Sertraline is the most commonly prescribed despite its declining usage. The typical treatment regimen involves a single antidepressant, often combined with benzodiazepine sedative-hypnotics and atypical antipsychotics. References | Related Articles | Metrics

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Risk Signal Mining of Adverse Events Related to Levothyroxine Sodium Tablets Based on FAERS CHEN Chongze, ZHOU Tianyu, SUN Siman, GUO Shushu, JIN Hongtao 2024, 21(12): 1425-1431.  DOI: 10.19803/j.1672-8629.20240036 Abstract ( 387 )   PDF (1426KB) ( 161 )   Objective To analyze the adverse drug events (ADE) caused by levothyroxine sodium tablets to provide a reference for rational and safe clinical use. Methods The U. S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) was searched to retrieve the ADE data on the primarily suspected drug collected from the first quarter of 2015 to the second quarter of 2023. The reporting odds ratio (ROR)、proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCNPP) and multi-item gamma poisson shrinker (MGPS) methods were used to screen for effective signals of ADEs of drugs. Results A total of 271 356 ADEs related to levothyroxine tablets as the primary suspect were reported. Most of the people involved were women (198 219, 73.05%) and the patients ranged from 18 to 85 in age (62.46%). A total of 5 991 adverse events of levothyroxine sodium tablets were mined, 3 371 signals were obtained after excluding non-drug adverse event signals, and 20 organ systems were found to be involved. Fatigue (22 511 items), nausea (17 591 items), diarrhea (16 400 items), headache (15 043 items) and dyspnea (12 866 items)were the top five ADEs reported.Analysis showed that neonatal gangrene (ROR=267.57, IC025=4.66), bronchiolithiasis (ROR=187.30, IC025=267.57), homophonic association (ROR=107.03, IC025=267.57), increased trans-triiodothyronine (ROR=89.19, IC025=4.42), and decreased free thyroxine indexes (ROR=80.27, IC025=4.38）were the top five ADEs in terms of intensities of signals. Based on secondary screening, the top three PTs related to the neonatal risk signal intensity were neonatal gangrene, neonatal intestinal dilation, and neonatal thyrotoxicosis. The top three PTs regarding the stone risk signal intensity were bronchial stones, cerebral stones, and staghorn stones. A total of 146 signals that were not recorded in the instructions were found, which were mostly manifested in various examinations, gastrointestinal system diseases, infections and invasive diseases, nervous system diseases, benign and malignant tumors of unknown nature. Conclusion Levothyroxine sodium tablets can potentially cause such ADRs as calculuses, infections and secondary tumors in patients with hypothyroidism. Clinical multidisciplinary follow-up is recommended for patients taking levothyroxine sodium tablets. References | Related Articles | Metrics

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Research Progress in Mechanisms of Rhubarb Anthraquinone Based on Hepatic Lipid Regulation and Hepatotoxicity LIU Ying, SONG Xuyu, SUN Rong 2024, 21(12): 1432-1440.  DOI: 10.19803/j.1672-8629.20240693 Abstract ( 87 )   PDF (1638KB) ( 116 )   Objective To review the efficacy and toxicity material basis of rhubarb, especially the regulation of liver lipids by rhubarb anthraquinones, and the mechanisms of hepatotoxicity in order to facilitate the treatment of liver lipid metabolism disorders. Methods Literature published over the past 10 years (as of September 5, 2024) was retrieved from such databases as CNKI, PubMed, Web of Science, Wiley and Google scholar. Studies related to the regulation of liver lipids and hepatotoxicity induced by rhubarb anthraquinones were analyzed, and the mechanisms of action were summarized. Results The main anthraquinone compounds in rhubarb that regulated liver lipids included emodin, chrysophanol, aloe-emodin, and physcion. The mechanisms of action involved reducing the expressions of extracellular matrix (ECM)-related proteins such as type I collagen and a-smooth muscle actin (α-SMA) inhibiting liver fibrosis, reducing malondialdehyde (MDA) and reactive oxygen species (ROS) levels, and mitigating hepatic oxidative stress. Additionally, these anthraquinone compounds could reduce the expressions of inflammatory mediators, including interleukin-1α (IL-1α)and tumor necrosis factor-α(TNF-α) while alleviating liver inflammation. Meanwhile, the hepatotoxicity of anthraquinones was primarily linked to changes in mitochondrial membrane potential, disruption of oxidative phosphorylation, increased intracellular ROS, induction of oxidative stress, and abnormalities in bilirubin metabolism. Conclusion Rhubarb anthraquinones can regulate liver lipid metabolism and induce hepatotoxicity via multi-component, multi-target, and multi-pathway actions. More research is needed to determine the range of safe dosage, minimize risks, and optimize clinical applications for the treatment of liver lipid metabolism disorders. References | Related Articles | Metrics