1.Future Development Trends and Considerations for Clinical Research of Traditional Chinese Medicine
Zhihan CHEN ; Dan LIANG ; Lina WAN ; Cheng'en LI ; Cui GUO ; Jianyuan TANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):102-109
The advent of digital times promotes the evolution of clinical research from traditional mode to digital mode. Digital technologies, which are introduced to clinical research of traditional Chinese medicine (TCM), can optimize the research design, improve research quality, and save research funds and time. The digital and remote control of clinical research recruitment and screening, disease diagnosis and treatment, informed consent, indicator measurement, and other processes can be realized by computers, networks, sensors, and other technologies. Artificial intelligence (AI) algorithms, wearable monitoring devices, data management tools, blockchain, and virtual clinical trials (VCTs) are key innovation technologies and research design methods. On this basis, this study summarized relevant literature on key digital technologies and research methods such as AI algorithms, wearable monitoring devices, data management tools, blockchain, and VCT, and the following discoveries were obtained: The future development of clinical research of TCM requires to attach importance to the changes in clinical research brought by digital technologies and to promote the utilization of digital technologies in clinical research of TCM. Digital technologies realize the medical ethical ideas of ''putting people first'', promote the decentralization of clinical research, simplify the participation process of participants, reduce the time and cost of clinical research, improve the efficiency of clinical research of TCM, and enhance the objectivity, authenticity, and stability of clinical research of TCM. Deepening the application of digital technologies in clinical research and realizing the interaction and fusion of various digital technologies are inevitable trends of future development of clinical research of TCM. Under the background of digitization, the digital innovation of clinical research of TCM can accelerate the development of clinical research of TCM and promote the internationalization of TCM.
2.Optimization of Adaptive Design in Clinical Research and Inspiration for Traditional Chinese Medicine Research and Development
Ruiting LYU ; Bingqing LU ; Wenyuan LI ; Jianyuan TANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):110-119
In recent years, adaptive design has gradually emerged in clinical trials, gaining widespread application and expansion. Compared with traditional randomized controlled trials, appropriate adaptive design can save time and resources to some extent, improve the validity of the trial results and strength of the evidence, align better with ethical requirements, and facilitate subsequent drug market research. However, due to the greater flexibility of adaptive design, controlling type Ⅰ error rates and truly enhancing research efficiency are challenging aspects of its application. Therefore, the normative application and optimization of adaptive design in research deserve early focus, including adhering to good adaptive design principles, conducting rigorous pre-design planning, scientifically applying various statistical methods such as Bayesian dynamic models and simulation methods, and utilizing monitoring tools like monitoring committees to ensure the scientific integrity of the research process. Moreover, the flexibility of adaptive design aligns well with the practical realities of traditional Chinese medicine (TCM) clinical practice. The main characteristics of TCM, such as the holistic concept and treatment based on syndrome differentiation, determine that TCM provides a dynamic and personalized treatment plan. In contrast, the traditional fixed development approach of western medicine limits the application of "human experience" in TCM. To address this bottleneck in TCM research and development, the innovative use of adaptive design, a modern scientific theory and methodology with multiplicity and variability, offers a feasible new approach for TCM clinical research and the innovation of Chinese herbal medicine. By learning from successful cases such as the first Food and Drug Administration (FDA)-approved oral botanical drug, Crofelemer, researchers can explore optimal solutions for adaptive design in clinical research protocols and its role in the "three-combination" evaluation system for Chinese herbal medicines, further refine trial design, clarify key trial points, and develop innovative research and development applications that adapt to the clinical positioning of TCM and highlight the characteristics and advantages of TCM, paving the way for the clinical efficacy, pharmacological mechanism exploration, and post-market efficacy evaluation of Chinese herbal compounds.
3.New Strategy of High-quality Development of TCM Industry in Sichuan Driven by TCM Regulatory Science
Hua HUA ; Qingmao FANG ; Qingmiao LI ; Jianyuan TANG ; Shuangcheng MA ; Junning ZHAO
World Science and Technology-Modernization of Traditional Chinese Medicine 2023;25(7):2241-2247
Traditional Chinese medicine(TCM)regulatory science,as an emerging interdisciplinary science,evaluates the safety,effectiveness,quality,and risk-benefit profile of regulated Chinese medicinal products,including Chinese medicinal materials,Chinese medicinal slices,and Chinese patent medicines.It highlights the development of new tools,standards,and methods that align with the unique characteristics of TCM.TCM regulatory science plays a crucial role in establishing a TCM scientific regulatory system that suits the features of TCM,accelerating the transformation of emerging TCM technologies and facilitating innovation in the inheritance and development of TCM.Sichuan,known as the"hometown of TCM therapies and the treasure trove of TCM",has built the first national modernized TCM technology industrial base and one of the first national comprehensive TCM reform demonstration zones.It plays a demonstrative and leading role in the high-quality development of the TCM industry in China.Based on the latest progress in new tools,standards,and methods of TCM regulatory science,this article overviewed its significant role and prospects in enhancing the efficiency of TCM regulation,accelerating the transformation and application of new TCM technologies and products,and promoting the high-quality development of the TCM industry in Sichuan.It is of great significance for ensuring and improving the regulatory capabilities of TCM and driving the healthy development of the TCM industry.
4.Application of Self-assembled Nano-strategies of Traditional Chinese Medicine in Tumor Therapy: A Review
Ju HUANG ; Yu ZHU ; Hang XIAO ; Songtao LI ; Jingwen LIU ; Qiao ZHENG ; Xiangrui MENG ; Jianyuan TANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(24):185-193
Chinese medicine self-assembly nano-strategies(CSAN) is to utilize the self-assembly property of Chinese medicine components, so that the Chinese medicine components can self-assemble to form structurally stable nano-preparations through non-covalent interactions. The formation of Chinese medicine self-assembly nano-preparations is often a synergistic result of a variety of non-covalent interactions, and many Chinese medicine monomers are susceptible to self-assembly due to their structural characteristics, and the phenomenon of self-assembly of Chinese medicine is also common in the decoction of single or compound Chinese medicine, which has attracted the attention of researchers. It is found that CSAN can improve the solubility and bioavailability of active components in Chinese medicine, which is of positive significance for the development and application of insoluble components of Chinese medicine. The self-assembly phenomenon of Chinese medicine decoction is closely related to the therapeutic efficacy, and the study of self-assembly phenomenon of Chinese medicine will bring a new perspective for the explanation of the mechanism of Chinese medicine decoction. At the same time, traditional Chinese medicine(TCM) has unique advantages in the field of anti-tumor. The application of CSAN in the field of oncology can not only exert the anti-tumor effect of the active components of Chinese medicine directly, but also act as a natural nano-carrier to carry chemotherapy drugs for combination chemotherapy, improve the targeting of drugs, enhance the anti-tumor efficacy, and reduce the side effects of chemotherapy, which has excellent anti-tumor potential. The preparation method of Chinese medicine self-assembly nano-preparations is simple, low cost, and has better safety than traditional nano-preparations, which is conducive to the promotion of the clinical transformation of nano-preparations, and also helps to provide new strategies and perspectives for promoting the modernization of TCM. Therefore, based on a large number of researches in this field in recent years, this paper reviewed the formation mechanism, different assembly forms, formation conditions and stability of Chinese medicine self-assembly nano-preparations by searching databases such as China national knowledge infrastructure(CNKI), PubMed, WanFang data and VIP, and summarized the application of CSAN in different tumor therapies, providing a reference for further research on CSAN.
5.Effect of Ursolic Acid on Proliferation and Apoptosis of Colorectal Cancer Cells Based on Akt/FoxO Signaling Pathway
Qiao ZHENG ; Nianzhi CHEN ; Gang ZHANG ; Ziyi ZHAO ; Jianyuan TANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(17):109-115
ObjectiveTo investigate the effects and molecular mechanism of ursolic acid on the proliferation and apoptosis of colorectal cancer cells. MethodThe proliferation inhibition rate of human colorectal cancer RKO cells treated with different concentrations of ursolic acid (0, 5, 10, 15, 20, 25, 30 μmol·L-1) was detected by cell counting kit-8 (CCK-8), and the half maximal inhibitory concentration (IC50) at 24 h and 48 h was calculated. According to the IC50 of RKO cells treated with ursolic acid for 24 h, two concentrations were selected for subsequent experiments. The colony formation assay was used to detect the proliferation ability of the cells and flow cytometry was used to detect the apoptosis rate and cell cycle arrest after treatment of RKO cells with ursolic acid. After treatment of RKO cells with ursolic acid for 24 hours, the expression of B-cell lymphoma 2 (Bcl-2)-associated X protein (Bax) in RKO cells, Bcl-2 in Raji cells, PMA responsive gene in T lymphocyte (Noxa), cyclin-dependent kinase inhibitor 1A (p21), cyclin-dependent kinase inhibitor 1B (p27), cyclin-dependent kinase 4 (CDK4), protein kinase B (Akt), phosphorylated Akt (p-Akt), forkhead transcription factor O3a (FoxO3a), and phosphorylated FoxO3a (p-FoxO3a) was determined by Western blot. ResultCompared with the blank group, the ursolic acid groups could inhibit the viability of RKO cells (P<0.05, P<0.01), and the colony formation rates of RKO cells in the ursolic acid groups were reduced (P<0.05, P<0.01) in a concentration-dependent manner. The cells in the ursolic acid group (20 μmol·L-1) experienced cell cycle arrest, which increased in the early stage of synthesis, ie, the G0/G1 phase (P<0.05) as compared with the results in the blank group. Compared with the blank group, the ursolic acid groups (15 and 20 μmol·L-1) showed increased protein expression of p21 and p27, decreased expression of CDK4 protein (P<0.05, P<0.01), and increased apoptosis rate, and the ursolic acid group (20 μmol·L-1) showed increased protein expression of Bax and Noxa and decreased expression of Bcl-2 (P<0.05, P<0.01). In terms of mechanism, compared with the blank group, the ursolic acid group (20 μmol·L-1) down-regulated the expression of p-Akt protein and up-regulated the expression of p-FoxO3a (P<0.05, P<0.01), and there was no significant change in the total protein of Akt and FoxO3a. ConclusionUrsolic acid can effectively inhibit the proliferation of colorectal cancer RKO cells and promote cell apoptosis, which may be related to the Akt/FoxO pathway.
6.Guidance for the clinical evaluation of traditional Chinese medicine-induced liver injuryIssued by China Food and Drug Administration.
Xiaohe XIAO ; Jianyuan TANG ; Yimin MAO ; Xiuhui LI ; Jiabo WANG ; Chenghai LIU ; Kewei SUN ; Yong'an YE ; Zhengsheng ZOU ; Cheng PENG ; Ling YANG ; Yuming GUO ; Zhaofang BAI ; Tingting HE ; Jing JING ; Fengyi LI ; Na AN
Acta Pharmaceutica Sinica B 2019;9(3):648-658
7.Developmental and Regulatory History of Food and Drug Administration
World Science and Technology-Modernization of Traditional Chinese Medicine 2017;19(6):924-930
TThe USA Food and Drug Administration (FDA) has an over 100-year history and is the most authority drug administration.During its past records,the most important thing for FDA is facing law enforcement challenges.However,FDA insists on improving legislation and finding the perfect mode of regulation.This paper introduced the history evolution,regulatory course,present office structure of FDA,Center for Drug Evaluation and Research (CDER),and Center for Biologics Evaluation and Research (CBER).The frustration and experience for FDA is well discussed.The legislation system is interpreted through historical events.To learn the developmental and regulatory history of USA food and drug administration is important to our drug administration for practicing the mission of protecting and promoting public health.
8.Premarketing Clinical Evaluation of Drug-induced Liver Injury
Na AN ; Jianyuan TANG ; Ruyi HE
World Science and Technology-Modernization of Traditional Chinese Medicine 2017;19(6):931-935
The liver injury caused by drug and / or its metabolites is one of the most common reasons for drugs to be withdrawn or disapproved.Premarketing clinical evaluation of drug-induced liver injury (DILI) is extremely important to drug evaluation.Signals of DILI and Hyman's Law (Hy's Law),clinical evaluation and lessons of DILI were discussed to help developing new drugs.
9.Analysis of FDA's Review for NDA208542-Rociletinib
World Science and Technology-Modernization of Traditional Chinese Medicine 2017;19(7):1083-1088
Lung cancer is the highest mortality rate of malignancies in the world.Among them,non-small cell lung cancer (NSCLC) accounts for 85%.Epidermal growth factor receptor (EGFR) gene is one of the most common driving genes in NSCLC.The EGFR tyrosine kinase inhibitors (EGFR-TKIs) bring a breakthrough in the treatment for patients with EGFR gene-sensitive mutations.However,the drug resistance problem of EGFR-TKIs has been increasingly highlighted.So a drug for the patients accompanied by EGFR T790M positive mutation and along with progression in or after treatment with EGFR-TKI NSCLC is clinically urgent needed.Rociletinib is designed to address this unmet clinical need.While considering the non-superior effectiveness to the similar drugs in the market and the high risk of safety (hyperglycemia,QT prolongation and sudden death) of Rociletinib,the dosage was not accepted by the Food and Drug Administration (FDA).And Rociletinib did not make it to the market eventually.This paper discussed lessons learned from this case under review perspective for reference and inspiration.
10.Clinical Research Guidelines for the Treatment of Stable Angina with New Uyghur Medicine (Draft)
Aibai SILAFU ; Maimaiti MAINISHA ; Pingshan WANG ; Lei ZHANG ; Gongshu LI ; Binglin LIU ; Jinfeng LI ; Jianyuan TANG ; Zhijian LI ; Abuduaini ABUDUJILILI
Chinese Journal of Information on Traditional Chinese Medicine 2015;(2):133-136
Uyghur medicine has not yet had the clinical research guidelines consistent with Uyghur medicine theory for its new medicine. In this research, retrospective multi-center study on medical records of Uyghur medicine diagnosis and treatment program of stable angina was conducted. Data about demography, diagnostics, therapeutics, efficacy evaluation, and nursing were collated and analyzed. Uyghur medicine syndrome diagnosis indicators and their contribution to stable angina were identified, and Uyghur medicine syndrome differentiation criteria were established. Uyghur medicine established its primary and secondary disease syndrome and its symptoms quantization table entries for the syndrome elements of Uyghur medicine syndrome differentiation criteria. Then combined with symptoms of angina and ECG changes, nitroglycerin stop and decrement rate, evaluation criteria for the efficacy of disease symptom combination were established. On this basis, in accordance with the technical requirements of the national new medicine evaluation, the study developed clinical research guidelines for the treatment of stable angina with new Uyghur medicine.

Result Analysis
Print
Save
E-mail