The research and development of traditional Chinese medicine (TCM) injections is an important innovation of modernization of TCM, which has great clinical value and irreplaceability in medical enterprise of China. But reports of adverse events of TCM injections gradually increased in recent years and the security problems received much concern with the enlargement of its application range. The reasons include unreliable herb sources and unreasonable utilization, in which the former includes historical reasons and non-unified standard and the latter includes combined use of Chinese and Western medicine, misused dosage and formula not corresponding to syndromes. We should face the problems, and preventive measures should be worked out by pharmaceutical factory, doctors and government. The first one is strictly guarding the pharmaceutical preparation procedures with advanced pharmaceutical technology; the second one is advocating the idea of formula corresponding to syndromes to minimize the occurrence of adverse effects; and the last one is strengthening the postmarketing reevaluation and market supervising management.

Syndrome factors and their combinations based on syndromes are the important links of construction of syndrome differentiation system,in which the theory of prescriptions corresponding to syndromes plays a key role.The basic requirements of good clinical eff icacy are'syndrome factors'seen as the basic connotation of'syndromes'in prescriptions corresponding to syndromes,keeping the compatibility of effect classical prescriptions,emphasizing further detailed formula indication and dynamic evolution,and increasing the conformity of prescription and syndrome.These are also the basis of construction of syndrome differentiation system.Method of evidence-based medicine should be used for reference in clinical research design,and reverse thinking of conjecturing syndrome based on prescription be used for guidance in the constructing process.

Traditional Chinese medicine(TCM)is the most original innovation science. The innovation and development of TCM is based on the precious treatment theory and copious clinic experience of predecessor. Combination of disease and syndrome is the important approach of innovation and development of traditional Chinese medicine.Establish of a perfect evaluation system of clinical effect which has special feature of TCM is the key of innovation and development of traditional Chinese medicine.

By reviewing the research on patient reported outcomes (PRO) and the understanding of the theory of traditional Chinese medicine in coronary heart disease, the author found that the evaluation scale of PRO in coronary heart disease in traditional Chinese medicine should be guided by the theory of traditional Chinese medicine, including the theories of ‘heart-oriented, five internal organs correlation, internal injuries by seven emotions, unity of body and mind, correspondence between human and nature’ and other modern theoretical framework of PRO scale.It was believed that the physical, psychological, independence and social sphere constructed a special PRO efficacy scale of traditional Chinese medicine in coronary heart disease. The field of physiology on the scale was guided by ‘heart-based, five internal organs correlation' theory as the main line, and the scale was divided into various aspects in order to reflect all aspects of uncomfortable self-feeling of patients. Finally, 19 sides such as chest pain, chest tightness, heart palpitations, flank pain, insomnia, soreness and weakness of waist and knees, frequent urination at night, anorexia, weakness, spontaneous perspiration, shortness of breath, individual ability, daily life, positive feelings, negative feelings, personal relations and social support needed, level of social services, social intercourse and economy, healthy and medical care formed the theoretical structure model of the scale,which established the theory foundatio for the further development of PRO scale.

At the premise of ensuring efficacy and minimizing adverse reactions as far as possible, it doesn't achieve to the treatment purpose at the cost of physiological function injury in normal tissue, which is the characteristic of the symptoms and signs targeted theory of the formula corresponding to syndromes in traditional Chinese medicine (TCM). The occurrence of the adverse reactions of Chinese and western drugs is related to formula not corresponding to syndromes to a large extent. It is beneficial to minimizing the occurrence of the adverse reactions when the indication of western drugs is screened in the macroscopic level for patients by using the idea of formula corresponding to syndromes for reference.
Drugs, Chinese Herbal ; adverse effects ; pharmacology ; Humans ; Medicine, Chinese Traditional ; adverse effects

Objective To investigate the clinical effects and influencing factors of the outcomes of early microsurgical treatment in patients with intracerebral hematoma from ruptured intracranial aneurysm. Methods From 2010 to 2016, patients with intracerebral hematoma from ruptured intracranial aneurysm admitted to the Department of Neurosurgery, Xinyu People's Hospital were enrolled retrospectively. The demographic data, Hunt-Hess grade,Glasgow coma scale(GCS)score,imaging data,and procedure-related complications were collected. Glasgow outcome scale (GOS) score was used to evaluate the outcomes. Four to 5 were defined as good outcome and 1 to 3 were defined as poor outcome. The Hunt-Hess gradesⅡ-Ⅲ were used as the low-grade group and the Ⅳ-Ⅴ grades were used as the high-grade group. The survival rate and quality of life of both groups of patients were compared according to the GOS scores. Results A total of 36 patients were enrolled during the study, including 32 with subarachnoid hemorrhage and intracerebral hematoma and 4 with simple intracerebral hematoma. Hunt-Hess grade was grade Ⅱ in 2 cases, Ⅲ in 18 cases, Ⅳ in 14 cases, and Ⅴ in 2 cases. Distribution of responsible aneurysms:18 patients in middle cerebral artery, 9 in anterior communicating artery, 6 in anterior cerebral artery, 3 in posterior communicating artery, including 4 patients with multiple aneurysms. All patients underwent aneurysm clipping+hematoma removal under the general anesthesia within 36 h after onset,24 of them were treated with decompressive craniectomy. One patient died of severe brain swelling after intraoperative reruptureof the aneurysm,1 died of postoperative massive cerebral infarction, and 1 died of severe pulmonary infection and diabetes after giving up further treatment. Thirty-three survivors were followed up for 1 year, 29 had good outcome(80.5％) and 7 had poor outcome (19.5％). There were significant differences in survival rate and quality of life between the low-grade group and the high-grade group (P=0.001). There were significant differences in the Hunt-Hess grade, baseline GCS score, and proportion of patients receiving decompressive craniectomy between the good outcome group and the poor outcome group.Conclusion The Hunt-Hess grade, baseline GCS score, and decompressive craniectomy were the influencing factors of the outcomes in patients with intracerebral hematoma from ruptured intracranial aneurysm. Removal of hematoma and aneurysm clipping should be performed as early as possible,and decompressive craniectomy should be performed if necessary.

Objective To investigate the efficacy and clinical value of balloon-assisted clipping for the treatment of giant unruptured intracranial aneurysms of internal carotid artery. Methods Patients with giant unruptured intracranial aneurysm of intracranial segment of internal carotid artery treated with balloon-assisted clipping in the Department of Neurosurgery, Xiangya Hospital, Central South University from September 2017 to May 2018 were enrolled retrospectively. The proximal internal carotid artery or the aneurysm neck were temporarily blocked by balloon, and then the aneurysm was clipped in the hybrid operating room. Demographic data, preoperative symptoms, aneurysm characteristics, position of balloon placement, intraoperative angiography, complications, and follow-up results were collected. Results A total of 12 patients with giant (diameter >2 cm) unruptured intracranial aneurysm of intracranial segment of internal carotid artery were enrolled. They were all successfully clipped using balloon-assisted clipping in the hybrid operating room. Among them, 1 was located in the ophthalmic segment, 3 in the supraclinoid segment, 4 in the posterior communicating segment, 2 in the anterior choroidal artery segment, and 2 in the bifurcation of the internal carotid artery. The balloons were placed in the proximal end of internal carotid artery in 9 cases and in the neck of aneurysm in 3 cases. Intraoperative angiography showed that 12 aneurysms were completely occluded; 1 had severe stenosis of parent artery, and 1 had mild stenosis. Postoperative complications included cerebral infarction in 1 case, temporary diabetes insipidus in 1 case (returned to normal 1 week after operation), hemiplegia in 1 case, and epilepsy in 1 case. Glasgow Outcome Scale score at discharge showed 5 in 9 cases, 4 in 2 cases, and 3 in 1 case. The patients were followed up for 2.3 to 12 months after operation (median 7.5 months). Reexamination of CT angiography showed no recurrence of aneurysm. Glasgow Outcome Scale score was 5 in 11 cases and 4 in 1 case. Conclusions The use of balloon-assisted clipping technique in the hybrid operating room for the treatment of giant intracranial segmental aneurysms of the internal carotid artery is safe and effective, and has a good long-term outcome.

ObjectiveTo explore the effect of Tanreqing injection combined with Ceftazide on the clinical efficacy， lung function， and laboratory inflammatory index of patients suffering from phlegm heat obstructing lung syndrome in acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. MethodFrom June 2021 to June 2023， 76 patients diagnosed with phlegm heat obstructing lung syndrome in AECOPD were enrolled in the respiratory and critical medical department of Jieshou Hospital of Traditional Chinese Medicine. They were randomly divided into a control group and an observation group with 38 cases each. The control group used Ceftazidime intravenous drip and other conventional oxygen inhalation and antispasmodic treatment measures of western medicine. The observation group received Tanreqing injection intravenous drip based on the treatment of the control group， with a course of 10 days. The changes of laboratory indicators such as hs-CRP， calcitonin （PCT）， and interleukin-6 （IL-6） before and after treatment were analyzed， and the improvement of forced expiratory volume in the first second （FEV₁）， forced vital capacity （FVC）， one second rate （FEV₁/FVC）， assessment and improvement of the British Medical Research Society’s dyspnea index （mMRC）， self-evaluation test of chronic obstructive pulmonary disease patients （CAT）， and traditional Chinese medicine syndrome score was compared. In addition， the total effective rate between the two groups after treatment was compared. ResultAfter treatment， the hs-CRP， PCT， IL-6， FEV₁， FVC， FEV₁/FVC， mMRC， CAT scores， and traditional Chinese medicine syndrome evaluation of both groups improved （P<0.01）. After treatment， compared with the control group， the observation group showed more significant improvements in hs-CRP， PCT， IL-6， FEV₁， FVC， FEV₁/FVC， mMRC， CAT scores， and traditional Chinese medicine syndrome evaluation， and the difference was statistically significant （P<0.05，P<0.01）. The total clinical effective rate of the control group was 86.84% （33/38）， while that of the observation group was 94.74% （36/38）. The therapeutic effect of the observation group was better than that of the control group （χ²=8.471， P<0.05）. ConclusionTanreqing injection combined with Ceftazidime has obvious efficacy in the treatment of phlegm heat obstructing lung syndrome in AECOPD， which is better than the treatment of Ceftazidime antibiotics alone. It can reduce the risk of acute exacerbation， alleviate clinical symptoms， and delay the decline of lung function.