1.Analysis of the evaluation mechanism and methodology of clinical comprehensive evaluation cases of drugs in China
Yuan QIAO ; Fangyi MA ; Yubei HAN ; Mingyue ZHAO ; Minghuan JIANG ; Yu FANG
China Pharmacy 2025;36(2):146-153
OBJECTIVE To sort out the evaluation mechanism and methodology of published cases of comprehensive clinical evaluation of drugs in China, and provide a reference for promoting standardized comprehensive clinical evaluation of drugs and strengthening policy transformation in China. METHODS Clinical comprehensive evaluation cases of drugs published in China from CNKI, Wanfang Data, PubMed and Web of Science were systematically searched, and the retrieval time was from the inception to December 31st, 2023. The summary and analysis were performed from the aspects of theme selection, indicator system construction, evaluation methods, comprehensive decision-making, quality control, etc. RESULTS A total of 143 pieces of literature were ultimately included from 2014 to 2023. The number of publications has shown a rapid upward trend since 2019. The subjects of the evaluation cases were mainly pediatric drugs, Chinese patent medicines, cardiovascular drugs and anti-tumor drugs. The evaluation dimensions were between 3-8, all involving safety and effectiveness dimensions. Most cases adopted rapid evaluation methods based on literature review and expert interviews/questionnaire surveys with less emphasis on real-world research. Most cases did not involve comprehensive decision-making, quality control, or policy transformation. CONCLUSIONS The clinical comprehensive evaluation of drugs in China has made rapid progress under the guidance of national policies. However, there are still issues and challenges such as incomplete evaluation methods and standards, few cases of evaluation results being converted into decision-making, and a lack of quality control mechanisms. It is suggested that standardized evaluation paths and quality control mechanisms should be explored; when the evidence-based basis is insufficient, real-world research should be conducted as much as possible, so as to accelerate the policy transformation of evaluation results.
2.Study progress of novel biomarkers for early prediction of polymyxin-associated acute kidney injury
Ge YANG ; Jun YANG ; Fang LIU ; Yongchuan CHEN ; Hong ZHANG
China Pharmacy 2025;36(2):251-256
Polymyxin is an essential antibiotic for treating multidrug-resistant Gram-negative bacterial infections; however, its significant nephrotoxicity greatly limits its clinical application. To enhance its safety and improve patient outcomes, the study of novel biomarkers for the early prediction of polymyxin-associated acute kidney injury is critically important. Novel biomarkers, such as cystatin C, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, N-acetyl-β-glucosaminidase, β2- microglobulin, have shown obvious advantages in the early prediction of polymyxin-associated acute kidney injury. Compared to traditional biomarkers, these biomarkers can provide sensitive and specific diagnostic information in the early stages of kidney injury, helping to optimize individualized treatment plans and reduce clinical risks. However, the high cost of detection and complex operation still limit their clinical promotion. Future research should focus on optimizing the detection technology of new biomarkers, simplifying the operation process and reducing costs, while conducting multi-center, large-scale randomized controlled trials to systematically evaluate the sensitivity and specificity of various novel biomarkers, in order to promote their application in the field of prediction of renal injury in clinical practice.
3.Analysis of the evaluation mechanism and methodology of clinical comprehensive evaluation cases of drugs in China
Yuan QIAO ; Fangyi MA ; Yubei HAN ; Mingyue ZHAO ; Minghuan JIANG ; Yu FANG
China Pharmacy 2025;36(2):146-153
OBJECTIVE To sort out the evaluation mechanism and methodology of published cases of comprehensive clinical evaluation of drugs in China, and provide a reference for promoting standardized comprehensive clinical evaluation of drugs and strengthening policy transformation in China. METHODS Clinical comprehensive evaluation cases of drugs published in China from CNKI, Wanfang Data, PubMed and Web of Science were systematically searched, and the retrieval time was from the inception to December 31st, 2023. The summary and analysis were performed from the aspects of theme selection, indicator system construction, evaluation methods, comprehensive decision-making, quality control, etc. RESULTS A total of 143 pieces of literature were ultimately included from 2014 to 2023. The number of publications has shown a rapid upward trend since 2019. The subjects of the evaluation cases were mainly pediatric drugs, Chinese patent medicines, cardiovascular drugs and anti-tumor drugs. The evaluation dimensions were between 3-8, all involving safety and effectiveness dimensions. Most cases adopted rapid evaluation methods based on literature review and expert interviews/questionnaire surveys with less emphasis on real-world research. Most cases did not involve comprehensive decision-making, quality control, or policy transformation. CONCLUSIONS The clinical comprehensive evaluation of drugs in China has made rapid progress under the guidance of national policies. However, there are still issues and challenges such as incomplete evaluation methods and standards, few cases of evaluation results being converted into decision-making, and a lack of quality control mechanisms. It is suggested that standardized evaluation paths and quality control mechanisms should be explored; when the evidence-based basis is insufficient, real-world research should be conducted as much as possible, so as to accelerate the policy transformation of evaluation results.
4.Study progress of novel biomarkers for early prediction of polymyxin-associated acute kidney injury
Ge YANG ; Jun YANG ; Fang LIU ; Yongchuan CHEN ; Hong ZHANG
China Pharmacy 2025;36(2):251-256
Polymyxin is an essential antibiotic for treating multidrug-resistant Gram-negative bacterial infections; however, its significant nephrotoxicity greatly limits its clinical application. To enhance its safety and improve patient outcomes, the study of novel biomarkers for the early prediction of polymyxin-associated acute kidney injury is critically important. Novel biomarkers, such as cystatin C, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, N-acetyl-β-glucosaminidase, β2- microglobulin, have shown obvious advantages in the early prediction of polymyxin-associated acute kidney injury. Compared to traditional biomarkers, these biomarkers can provide sensitive and specific diagnostic information in the early stages of kidney injury, helping to optimize individualized treatment plans and reduce clinical risks. However, the high cost of detection and complex operation still limit their clinical promotion. Future research should focus on optimizing the detection technology of new biomarkers, simplifying the operation process and reducing costs, while conducting multi-center, large-scale randomized controlled trials to systematically evaluate the sensitivity and specificity of various novel biomarkers, in order to promote their application in the field of prediction of renal injury in clinical practice.
5.Effect of Epimedium brevicornu Ethanol Extract on Aging of Castrated Rats by Intervening in Mesenchymal Adipose-derived Stem Cells
Zuyu MENG ; Haiquan LIU ; Shaozi LIN ; Mei WANG ; Yiyao ZHANG ; Fang LIU ; Menghan LI ; Hongling CHEN ; Jiajia QIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):174-181
ObjectiveTo explore the mechanism by which the ethanol extract of Epimedium brevicornu (EEBM) intervenes in mesenchymal adipose-derived stem cells (ADSCs) to delay aging in castrated rats. MethodsForty-five 3-month-old SPF female SD rats were ovariectomized and randomly divided into model group, ADSCs treatment group, and ADSCs groups treated with low, medium, and high concentrations of EEBM (1, 50, 100 μg·L-1), referred to as the AE low, medium, and high concentration groups, with 9 rats in each group. After tail vein injection of 200 μL of the corresponding stem cell suspension, aging-related indicators including cyclin-dependent kinase inhibitor (p21), tumor suppressor gene (p53), interleukin-6 (IL-6), interleukin-8 (IL-8), superoxide dismutase (SOD), malondialdehyde (MDA), B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), cysteine-aspartic acid protease-3 (Caspase-3), and lipofuscin were measured using enzyme-linked immunosorbent assay (ELISA) and Western blot. ResultsCompared with the model group, the IL-6 content in the AE low, medium, and high concentration groups was significantly decreased (P<0.05). Lipofuscin, MDA, and IL-8 levels in the ADSCs treatment group and AE low, medium, and high concentration groups were significantly reduced (P<0.01), while SOD content was significantly increased (P<0.05, P<0.01). Compared with the ADSCs treatment group, lipofuscin and IL-8 levels in the AE low, medium, and high concentration groups were significantly reduced (P<0.05, P<0.01). The MDA content was significantly decreased in the AE medium concentration group (P<0.01). Compared with the model group, protein levels of p21, p53, Bax, and Caspase-3 in the ADSCs treatment group and AE low, medium, and high concentration groups were significantly reduced (P<0.05, P<0.01), while the Bcl-2 protein level was significantly increased (P<0.01). Compared with the ADSCs treatment group, protein levels of p21, p53, Bax, and Caspase-3 in the AE low, medium, and high concentration groups were significantly reduced (P<0.05, P<0.01), and the Bcl-2 protein level in the AE low concentration group was significantly increased (P<0.01). ConclusionThe results of this experiment show that EEBM-treated ADSCs or ADSCs may delay aging in castrated rats by inhibiting cell apoptosis, reducing cell cycle inhibitors and pro-inflammatory factors, enhancing antioxidant capacity, and reducing oxidative reactions. Moreover, EEBM-treated ADSCs demonstrate stronger anti-aging effects than ADSCs alone. This study provides experimental evidence supporting the clinical use of EEBM to intervene in ADSCs and delay aging.
6.Role of Intestinal Microbiota in "Correspondence Between Prescription and Syndrome"
Junxi SHEN ; Leyao FANG ; Zhoujin TAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):267-275
"Correspondence between prescription and syndrome" is the foundation of the objectification of traditional Chinese medicine diagnosis and treatment, and the objectification of traditional Chinese medicine diagnosis is the key to the modernization of traditional Chinese medicine. Combining modern theories and technological means to explore objective indicators or biomarkers of "correspondence between prescription and syndrome" can help clarify quantitative indicators of syndromes. There is a characteristic microbial population in the intestine that is related to syndromes and prescription efficacy. Intestinal microbiota plays an important indicative and discriminative role in determining the formation and evolution of disease patterns and is also an important characterization and pathway of the therapeutic effect of prescriptions. Therefore, intestinal microbiota can serve as an important biological indicator for the objectification of "correspondence between prescription and syndrome", and the research content related to "intestinal microbiota-syndrome" and "intestinal microbiota-prescription" is relatively mature. On this basis, the team proposed a research approach and method of "correspondence among intestinal microbiota, syndrome, and prescription", exploring the biological mechanism of "correspondence between prescription and syndrome" from the perspective of intestinal microbiota. A complete analysis of the "intestinal microbiota-syndrome-prescription" data content of six traditional Chinese medicine diarrhea syndromes was conducted, and the results of intestinal dominant and characteristic microbiota for different syndromes of diarrhea and corresponding formula interventions were obtained. The correlation of key intestinal microbiota and metabolites with the interaction between different syndromes and formula interventions was studied, and the microbiological mechanism of "treating the same disease with different methods" for diarrhea was explored. The research ideas and results provide the possibility for the establishment and application of the theory of "correspondence among intestinal microbiota, syndrome, and prescription" and also provide a research paradigm for other diseases in traditional Chinese medicine. "Correspondence among intestinal microbiota, syndrome, and prescription" is conducive to revealing the micro-mechanisms of the formation and evolution of traditional Chinese medicine syndromes and the efficacy of prescriptions. It establishes an objective diagnosis and treatment system for traditional Chinese medicine syndromes based on intestinal microbiota, providing new methods and ideas for the objective diagnosis and treatment of traditional Chinese medicine syndromes and promoting the modernization and internationalization of traditional Chinese medicine.
7.Analysis of factors influencing macular edema in patients with diabetes cataract after surgery
Ming LI ; Fang XU ; Zhijuan XU
International Eye Science 2025;25(1):140-143
AIM: To explore the risk factors of macular edema in patients with diabetes cataract after surgery, and provide reference for postoperative prevention and treatment.METHODS: A total of 55 diabetes cataract patients(55 eyes)with macular edema after phacoemulsification surgery at the ophthalmology department of Jiaozhou Central Hospital of Qingdao from January 2022 to January 2024 were selected as edema group. In addition, 59 patients(59 eyes)with diabetes cataract who received the same surgical treatment but did not develop macular edema were treated as control group, and the relationship between interferon-induced protein-10(IP-10), macrophage chemotactic protein-1(MCP-1), vascular endothelial growth factor(VEGF)and postoperative macular edema was analyzed.RESULTS:Age, diabetes course, best corrected visual acuity(BCVA), glycated hemoglobin(HbA1c), creatinine, levels of IP-10, MCP-1 and VEGF in aqueous humor in the edema group were higher than those in the control group(all P<0.05). The risk factors for postoperative macular edema in patients with diabetes cataract were prolonged duration of diabetes, BCVA, increased HbA1c, increased creatinine and IP-10 in aqueous fluid, increased MCP-1 and increased VEGF(all P<0.05).CONCLUSION:Macular edema after surgical treatment in diabetes cataract patients is associated with prolonged duration of diabetes, BCVA, HbA1c, creatinine, IP-10, MCP-1, and VEGF, and clinical interventions should be given in advance.
8.Mechanism of Yantiao Prescription in Treating Lipopolysaccharide-induced Acute Lung Injury Based on Arachidonic Acid Metabolic Pathways
Pengcheng LI ; Tianyang CHEN ; Rong FANG ; Anna ZHANG ; Sijia WU ; Wei LIU ; Qian WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):101-110
ObjectiveTo clarify the anti-inflammatory and lung-protective effects of Yantiao prescription on lipopolysaccharide (LPS)-induced acute lung injury (ALI), and to explore the impact of Yantiao prescription on the metabolic pathways of arachidonic acid (AA) in vivo. MethodsThirty male C57BL/6J mice were randomly divided into the following groups based on body weight: normal group, model group, dexamethasone group (2 mg·kg-1), low-dose Yantiao prescription group (18 g·kg-1), and high-dose Yantiao prescription group (36 g·kg-1), with 6 mice in each group. The ALI mouse model was established by intraperitoneal injection of LPS. The treatment groups received oral gavage once a day for 7 consecutive days, and serum and lung tissue were collected at the end of the experiment. The content of pro-inflammatory cytokines tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in serum was detected by enzyme-linked immunosorbent assay (ELISA). Hematoxylin-eosin (HE) staining was used to assess lung tissue pathology. The wet/dry weight ratio (W/D) and myeloperoxidase (MPO) activity in lung tissue were measured. The content of AA metabolites in serum and lung tissue was measured by liquid chromatography triple quadrupole-mass spectrometry (LC-MS/MS). ResultsCompared with the conditions in the normal group, the content of serum pro-inflammatory cytokines TNF-α, IL-1β, and IL-6 in the model group was significantly increased (P<0.01). The alveolar structure in mice was severely damaged, with markedly thickened alveolar walls and extensive inflammatory cell infiltration. The W/D ratio and MPO activity in lung tissue were significantly increased (P<0.01). The content of AA metabolites, including prostaglandin D2 (PGD2), prostaglandin E2 (PGE2), 11(S)-hydroxy-eicosatetraenoic acid [11(S)-HETE], and 5-hydroxy-eicosatetraenoic acid (5-HETE) in serum and lung tissue was significantly increased (P<0.05), while the content of 11,12-epoxyeicosatrienoic acid (11,12-EET) and 14,15-epoxyeicosatrienoic acid (14,15-EET) in serum was significantly decreased (P<0.01). Compared with the results in the model group, the content of serum pro-inflammatory cytokines TNF-α, IL-1β, and IL-6 in the dexamethasone group, low-dose Yantiao prescription group, and high-dose Yantiao prescription group was significantly reduced (P<0.05). Mild thickening of alveolar walls, scattered inflammatory cell infiltration, and relatively intact tissue structure with improved alveolar architecture were observed. The W/D ratio and MPO activity in lung tissue were significantly reduced (P<0.01). The content of AA metabolites PGD2, PGE2, 11(S)-HETE, and 5-HETE in serum from the dexamethasone group was significantly decreased (P<0.05), while the content of 14,15-EET in serum significantly increased (P<0.01), and the content of 5-HETE in lung tissue significantly decreased (P<0.01). In the low-dose and high-dose Yantiao prescription groups, the content of AA metabolites PGD2, PGE2, 11(S)-HETE, and 5-HETE in serum and lung tissue was significantly decreased (P<0.05), while the content of 11,12-EET in both serum and lung tissue was significantly increased (P<0.05). ConclusionYantiao prescription has significant protective effects against LPS-induced ALI, which are related to its regulation of AA metabolic pathways in vivo.
9.Gualou Xiebai Banxiatang in Treatment of Cardiovascular Diseases: A Review
Yalong KANG ; Bo NING ; Juanjuan TAN ; Hongfei QI ; Yan SHI ; Fang GUAN ; Haifang WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):256-267
Cardiovascular diseases (CVD),a group of common diseases in clinical practice,are witnessing a steady rise in both incidence and mortality rates,posing a challenge to public health. Gualou Xiebai Banxiatang,originating from Synopsis of the Golden Chamber (《金匮要略》),was initially used to treat severe cases of chest impediment. The formula consists of Trichosanthis Fructus,Allii Macrostemonis Bulbus,Pinelliae Rhizoma,and Baijiu. It has a wide range of clinical applications,with therapeutic effects including moving Qi to relieve depression,activating Yang to dissipate mass,and expelling phlegm to alleviate chest congestion. In recent years,clinical research has confirmed that Gualou Xiebai Banxiatang,with or without modification,used alone or in combination with Western medicine,has definite effects in the treatment of CVD such as hyperlipidemia,coronary atherosclerotic heart disease,hypertension,heart failure,and arrhythmia. It can alleviate disease symptoms and reduce the risk of re-hospitalization. Basic research indicates that the mechanisms of Gualou Xiebai Banxiatang include improving endothelial functions,exhibiting anti-inflammatory properties,countering oxidative stress,preventing apoptosis,inhibiting ventricular remodeling,regulating mitochondrial functions,improving hemorheology,and modulating autophagy and neurotransmitters. This article reviews relevant articles in recent years with focuses on the compatibility,clinical application,and mechanism of Gualou Xiebai Banxiatang. This review is expected to provide a theoretical basis for the mechanism research and clinical application of this formula in treating CVD and to offer ideas and reference for in-depth research.
10.Active Components of Salviae Miltiorrhizae Radix et Rhizoma and Its Compound in Treatment of Nervous System Diseases: A Review
Weining SONG ; Shuxiang ZHANG ; Fang LU ; Zhize WANG ; Ruyang CHENG ; Shumin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):303-313
Nervous system diseases, also known as neuropathies, encompass a wide range of conditions, primarily including Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease, and other neurodegenerative disorders, as well as depression, subarachnoid hemorrhage, cerebral ischemia-reperfusion injury, vascular dementia, and other neurological diseases. These diseases pose serious threats to the health and lives of patients, bringing heavy burdens to society and families. The pathogenesis of nervous system diseases is highly complex, involving mechanisms such as neuroinflammation, oxidative stress, apoptosis, endoplasmic reticulum stress, mitochondrial dysfunction, brain-derived neurotrophic factor deficiency, reduced cholinergic activity, axonal injury, and demyelination. In recent years, the incidence and mortality of nervous system diseases have been rising annually. Currently, western medicine primarily focuses on symptomatic treatment, often accompanied by many adverse reactions, including lethargy, excessive sedation, dizziness, headaches, tachycardia, liver function damage, metabolic disorders, and incomplete recovery after surgery. As a traditional Chinese medicine, Salviae Miltiorrhizae Radix et Rhizoma has effects such as promoting blood circulation, removing blood stasis, cooling the blood, clearing the heart, nourishing the blood, and calming the nerves. It can play a role in the treatment and protection against nervous system diseases through multiple targets, pathways, and mechanisms. Studies have found that the water-soluble phenolic acids and fat-soluble diterpenoid quinones in Salviae Miltiorrhizae Radix et Rhizoma are the main active ingredients for the treatment of nervous system diseases. This paper summarized the effects of the active components and compounds of Salviae Miltiorrhizae Radix et Rhizoma on nervous system diseases over the past ten years, aiming to provide a theoretical basis and research ideas for the development and application of active components and compounds of Salviae Miltiorrhizae Radix et Rhizoma in nervous system diseases.

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