1.Usage and Dosage Analysis and Countermeasures for Development of Compound Preparations of Han Dynasty Famous Classical Formulas
Yan JIN ; Bing LI ; Wei ZHANG ; Huasheng PENG ; Huamin ZHANG ; Huihui LIU ; Lin ZHANG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(7):1-10
In order to provide a reference basis for the development of relevant compound preparations, this article takes a comprehensive analysis of the usage and dosage of famous classical formulas in Han dynasty from various perspectives, and gives corresponding countermeasures on this basis. Through the comprehensive analysis of the classification and statistics of Zhongjing's medication characteristics, decoction methods, administration and dosage, and combining conversion methods of weights and measures by ancient medical practitioners, along with the dosage and administration of the listed Han dynasty famous classical formulas, it was found that the "Jiangxi method" served as a general guideline for administration according to Zhongjing's original text. This method allowed for flexible dosing based on the conversion of the ancient measurements to modern equivalents[13.8 g per Liang(两)], ensuring the safe and effective medication of these formulas. After combing, it is found that although the dosage of single medicine is large in famous classical formulas from Han dynasty, the administration is flexible. The crude drug amount per administration serves as the foundational dose, with the frequency of administration adjusted flexibly according to the condition. This dosing approach becomes the key for the rational development of compound formulations of famous classical formulas. Based on the conclusions of the study, it is recommended that when developing compound formulations of famous classical formulas in Han dynasty, the original administration method and dosage should be respected. The original crude drug amount per administration should be considered as the daily foundational dose, with the frequency of administration described within a range(1 to N times per day, where N is the maximum number of administrations as per the original text). The specific frequency of administration can be adjusted flexibly by clinical practitioners based on the individual condition. This approach should also be adopted in toxicological studies, where the dosage per administration serves as the basis for toxicity research, and the toxicity profile at the maximum administration frequency should be observed, providing guidance on the clinical safety range. Corresponding drug labels should provide information within a range to indicate toxicological risk intervals.
2.Analysis of the efficacy and prognosis of radiotherapy in acute leukemia with extramedullary infiltration
Wenbin LEI ; Hui LIU ; Yan ZHANG ; Yinghao LU ; Yi HUANG ; Ying CHEN ; Rui GAO ; Xiao CHAI ; Yun ZHAN ; Jie XIONG ; Lingyun WANG ; Lei LIU ; Jishi WANG ; Peng ZHAO
Chongqing Medicine 2024;53(4):547-554
Objective To investigate the clinical characteristics,treatment methods,and prognosis of a-cute leukemia patients with extramedullary infiltration.Methods The clinical characteristics and treatment methods of 47 acute leukemia patients with extramedullary infiltration admitted to the Affiliated Hospital of Guizhou Medical University from April 2014 to April 2023 were retrospectively analyzed.Subgroup analysis was performed according to whether there was extramedullary infiltration before transplantation,and whether there was isolated extramedullary recurrence after transplantation.Based on this analysis,the patients were di-vided into the pre-transplantation radiotherapy group and pre-transplantation non-radiotherapy group,the post-transplantation radiotherapy group and post-transplantation non-radiotherapy group.According to the treatment methods of central nervous system leukemia(CNSL),the patients were divided into the intrathecal injection group(n=12)and combination of intrathecal injection and radiotherapy group(n=13).The local remission situation,survival duration,and toxic and side effects of radiotherapy and chemotherapy were com-pared.Results For acute leukemia patients with extramedullary infiltration,the overall survival time(OS)in the radiotherapy group was better than that in the non-radiotherapy group(median OS:706 d vs.151 d,P=0.015).Subgroup analysis showed that the OS of the pre-transplantation radiotherapy group was better than that of the pre-transplantation non-radiotherapy group(median OS:592 d vs.386 d,P=0.035).For CNSL,the combination of intrathecal injection and radiotherapy group had a better OS than the intrathecal injection group(median OS:547 d vs.388 d,P=0.045).The event-free survival time(EFS)of the radiotherapy group was better than that of the non-radiotherapy group(median EFS:175 d vs.50 d,P=0.005).The COX pro-portional-hazards model showed that treatment with or without radiotherapy had a significant impact on the OS of acute leukemia patients with extramedullary infiltration.The risk of death in the pre-transplantation non-radiotherapy group was 2.231 times higher than that in the pre-transplantation radiotherapy group(HR=3.231,95%CI:1.021-10.227,P=0.046).Compared with the non-radiotherapy group,the radiother-apy group had a higher local remission and a lower risk of haematological toxicity,infection,and haemorrhage.Conclusion Radiotherapy can rapidly alleviate the local symptoms of acute leukemia complicated with extr-amedullary infiltration,prolong the survival time of these patients,and reduce the risk of hematologic toxicity,infection,and haemorrhage.
3.Development and validation of a dynamic prediction tool for post-endo-scopic retrograde cholangiopancreatography early biliary tract infection in patients with choledocholithiasis
Peng LI ; Chao LIANG ; Jia-Feng YAN ; Chun-Hui GAO ; Zhi-Jie MA ; Zhan-Tao XIE ; Ming-Jie SUN
Chinese Journal of Infection Control 2024;23(6):692-699
Objective To develop a prediction tool for post-endoscopic retrograde cholangiopancreatography(ER-CP)early biliary tract infection(PEEBI)in patients with choledocholithiasis,and assist clinical decision-making be-fore ERCP and early personalized intervention after ERCP.Methods An observational bidirectional cohort study was adopted to select inpatients with choledocholithiasis who underwent ERCP in a hospital.Directed acyclic graph(DAGs)and the least absolute shrinkage and selection operator(LASSO)were used to predict PEEBI based on lo-gistic regression,and the models were compared and validated internally and externally.Results From January 1,2020 to September 30,2023,a total of 2 121 patients with choledocholithiasis underwent ERCP were enrolled,of whom 77(3.6%)developed PEEBI,mostly in the first 2 days after surgery(66.2%).The major influencing fac-tors for PEEBI were non-iatrogenic patient-related factors,namely diabetes mellitus(OR=2.43,95%CI:1.14-4.85),bile duct malignancy(OR=3.95,95%CI:1.74-8.31)and duodenal papillary diverticulum(OR=4.39,95%CI:1.86-9.52).Compared with the LASSO model,the DAGs model showed higher ability(3.0%)in com-prehensive discrimination(P=0.007),as well as good differentiation performance(D=0.133,P=0.894)and cal-ibration performance(x2=5.499,P=0.703)in external validation.Conclusion The DAGs model constructed in this study has good predictive performance.With the help of this tool,targeted early preventive measures in clinical practice can be taken to reduce the occurrence of PEEBI.
4.Systematic review and Meta-analysis of Gusongbao preparation in treatment of primary osteoporosis.
Jie-Hang LU ; Zheng-Yan LI ; Guo-Qing DU ; Jun ZHANG ; Yu-Peng WANG ; Jin-Yu SHI ; You-Zhi LIAN ; Fu-Wei PAN ; Zhen-Lin ZHANG ; Hong-Sheng ZHAN
China Journal of Chinese Materia Medica 2023;48(11):3086-3096
This study aims to provide evidence for clinical practice by systematically reviewing the efficacy and safety of Gusongbao preparation in the treatment of primary osteoporosis(POP). The relevant papers were retrieved from four Chinese academic journal databases and four English academic journal databases(from inception to May 31, 2022). The randomized controlled trial(RCT) of Gusongbao preparation in the treatment of POP was included after screening according to the inclusion and exclusion criteria. The quality of articles was evaluated using risk assessment tools, and the extracted data were subjected to Meta-analysis in RevMan 5.3. A total of 657 articles were retrieved, in which 15 articles were included in this study, which involved 16 RCTs. A total of 3 292 patients(1 071 in the observation group and 2 221 in the control group) were included in this study. In the treatment of POP, Gusongbao preparation+conventional treatment was superior to conventional treatment alone in terms of increasing lumbar spine(L2-L4) bone mineral density(MD=0.03, 95%CI[0.02, 0.04], P<0.000 01) and femoral neck bone mineral density, reducing low back pain(MD=-1.69, 95%CI[-2.46,-0.92], P<0.000 1) and improving clinical efficacy(RR=1.36, 95%CI[1.21, 1.53], P<0.000 01). Gusongbao preparation was comparable to similar Chinese patent medicines in terms of improving clinical efficacy(RR=0.95, 95%CI[0.86, 1.04], P=0.23). Gusongbao preparation was inferior to similar Chinese patent medicines in reducing traditional Chinese medicine syndrome scores(MD=1.08, 95%CI[0.44, 1.71], P=0.000 9) and improving Chinese medicine syndrome efficacy(RR=0.89, 95%CI[0.83, 0.95], P=0.000 4). The incidence of adverse reactions of Gusongbao preparation alone or combined with conventio-nal treatment was comparable to that of similar Chinese patent medicines(RR=0.98, 95%CI[0.57, 1.69], P=0.94) or conventio-nal treatment(RR=0.73, 95%CI[0.38, 1.42], P=0.35), and the adverse reactions were mainly gastrointestinal discomforts. According to the available data, Gusongbao preparation combined with conventional treatment is more effective than conventional treatment alone in increasing lumbar spine(L2-L4) bone mineral density and femoral neck bone mineral density, reducing low back pain, and improving clinical efficacy. The adverse reactions of Gusongbao preparation were mainly gastrointestinal discomforts, which were mild.
Humans
;
Bone Density
;
Low Back Pain
;
Medicine, Chinese Traditional
;
Osteoporosis/drug therapy*
5.Progress in research of prophylactic therapy in contacts of rifampicin-resistant tuberculosis patients.
Zhan WANG ; Wen Jin WANG ; Xiao Yan DING ; Peng LU ; Li Mei ZHU ; Qiao LIU ; Wei LU
Chinese Journal of Epidemiology 2023;44(3):470-476
Tuberculosis (TB) prophylactic therapy for latent infection, which can reduce the risk for the development of active TB, is an important measure in TB control. China recommends prophylactic therapy for latent tuberculosis infection (LTBI) in some key populations to reduce the risk for TB. Contacts of patients with multi-drug and rifampicin-resistant TB (MDR/RR-TB) are at high risk for the infection with drug-resistant pathogen, however, no unified prophylactic therapy regimen has been recommended for LTBI due to exposure to MDR/RR-TB patients. This paper summarizes the current MDR/RR-TB prophylactic therapy regimen and its protection effect based on the results of the retrieval of literature, guidelines, expert consensus and technical specifications to provide reference for the prevention and control of LTBI.
Humans
;
Rifampin/therapeutic use*
;
Tuberculosis, Multidrug-Resistant/prevention & control*
;
Tuberculosis/drug therapy*
;
Latent Tuberculosis/chemically induced*
;
China
;
Antitubercular Agents/therapeutic use*
6.Application and thinking of acupuncture therapy in comprehensive management of hypertension.
Yi-Zhan WANG ; Hong-Wei LIU ; Yan GUO ; Bin LI ; Shao-Song WANG ; Xin WANG ; Lin-Peng WANG ; Yuan-Bo FU
Chinese Acupuncture & Moxibustion 2023;43(2):213-216
The theory of disease prevention with traditional Chinese medicine is introduced into the prevention of chronic diseases such as hypertension. In order to fully implement the advantages of acupuncture, the three-level prevention strategy is strengthened on the whole-process intervention with acupuncture for hypertension, including prevention before disease onset, starting intervention at the early phase, and prevention disease from exacerbating. Moreover, the comprehensive management scheme, multidisciplinary coordination and participation mechanism are investigated in the field of traditional Chinese medicine for preventive treatment of hypertension.
Humans
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Acupuncture Therapy
;
Medicine, Chinese Traditional
;
Acupuncture
;
Chronic Disease
;
Hypertension
7.Chemical constituents in Dolomiaea plants and their pharmacological activities: a review.
Yan-Hui LYU ; Wei CHEN ; Yan-Ping WEI ; Xin-Tong WEI ; Jie WANG ; Qian-Qian DING ; Zhan-Hong LI ; Ji-Xiang HE ; Xian-Peng ZU
China Journal of Chinese Materia Medica 2023;48(6):1463-1482
Dolomiaea plants are perennial herbs in the Asteraceae family with a long medicinal history. They are rich in chemical constituents, mainly including sesquiterpenes, phenylpropanoids, triterpenes, and steroids. The extracts and chemical constituents of Dolomiaea plants have various pharmacological effects, such as anti-inflammatory, antibacterial, antitumor, anti-gastric ulcer, hepatoprotective and choleretic effects. However, there are few reports on Dolomiaea plants. This study systematically reviewed the research progress on the chemical constituents and pharmacological effects of Dolomiaea plants to provide references for the further development and research of Dolomiaea plants.
Plant Extracts/pharmacology*
;
Asteraceae
;
Triterpenes
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Sesquiterpenes/pharmacology*
;
Anti-Inflammatory Agents
;
Phytochemicals/pharmacology*
8.Advances in the research of HIV-1 envelope glycoprotein gp120 inhibitors
Ming-hui XIE ; Zhao WANG ; Yan-ying SUN ; Xiang-yi JIANG ; Peng ZHAN ; Xin-yong LIU ; Dong-wei KANG
Acta Pharmaceutica Sinica 2023;58(3):616-628
From the process of human immunodeficiency virus-1 (HIV-1) invading cells, the combination of gp120 and CD4 is the first step for HIV-1 to invade cells. Interfering with this process can prevent HIV from recognizing target cells and inhibit virus replication. Therefore, HIV-1 gp120 is an important part of the HIV-1 life cycle. Fostesavir, a phosphatate prodrug derived from the gp120 inhibitor BMS-626529 modified by the prodrug strategy, was approved for the treatment of adult patients with multidrug resistant HIV-1 infection by the US FDA and the European Medicines Agency in 2020 and 2021, respectively. In this review, we focus on the research progress of small molecule inhibitors targeting the interaction of gp120-CD4 from the perspective of medicinal chemistry, in order to provide reference for the subsequent research of gp120 inhibitors.
9.Dead heart of pith-decayed Scutellariae Radix: a study based on multi-omics.
Jin-Xiu QIAN ; Ya-Peng WANG ; Huai-Zhu LI ; Yan-Meng LIU ; Yi-Han WANG ; Li-Ping KANG ; Tie-Gui NAN ; Jin-Fu TANG ; Zhi-Lai ZHAN
China Journal of Chinese Materia Medica 2023;48(17):4634-4646
Dead heart is an important trait of pith-decayed Scutellariae Radix. The purpose of this study was to clarify the scientific connotation of the dead heart using multi-omics. Metabolomics and transcriptomics combined with multivariate statistical analysis such as principal component analysis(PCA) and partial least squares discriminant analysis(PLS-DA) were used to systematically compare the differences in chemical composition and gene expression among phloem, outer xylem and near-dead xylem of pith-decayed Scutella-riae Radix. The results revealed significant differences in the contents of flavonoid glycosides and aglycones among the three parts. Compared with phloem and outer xylem, near-dead xylem had markedly lowered content of flavonoid glycosides(including baicalin, norwogonin-7-O-β-D-glucuronide, oroxylin A-7-O-β-D-glucuronide, and wogonoside) while markedly increased content of aglycones(including 3,5,7,2',6'-pentahydroxy dihydroflavone, baicalin, wogonin, and oroxylin A). The differentially expressed genes were mainly concentrated in KEGG pathways such as phenylpropanoid metabolism, flavonoid biosynthesis, ABC transporter, and plant MAPK signal transduction pathway. This study systematically elucidated the material basis of the dead heart of pith-decayed Scutellariae Radix with multiple growing years. Specifically, the content of flavonoid aglycones was significantly increased in the near-dead xylem, and the gene expression of metabolic pathways such as flavonoid glycoside hydrolysis, interxylary cork development and programmed apoptosis was significantly up-regulated. This study provided a theoretical basis for guiding the high-quality production of pith-decayed Scutellariae Radix.
Drugs, Chinese Herbal/chemistry*
;
Scutellaria baicalensis/chemistry*
;
Glucuronides
;
Multiomics
;
Flavonoids/chemistry*
10.Epidemiological study of incidence of systematic lupus erythematosus in Yinzhou, Ningbo, 2016-2021.
Xue Feng LAI ; Zhi Ke LIU ; Peng SHEN ; Ye Xiang SUN ; Huai Chu LU ; Si Yan ZHAN ; Hong Bo LIN
Chinese Journal of Epidemiology 2023;44(7):1080-1085
Objective: To characterize the incidence density of systematic lupus erythematosus (SLE) in Yinzhou District of Ningbo from 2016 to 2021, and compare the age and gender specific differences. Methods: A retrospective cohort study was conducted based on the related data from 2015 to 2021 collected from the Health Information Platform of Yinzhou. Suspected SLE cases in local residents were identified by fuzzy matching of International Classification of Diseases 10th edition code "M32" or Chinese text "lupus". The classification criteria from Systemic Lupus International Collaboration Clinics-2012 and The European League Against Rheumatism/American College of Rheumatology-2019 were used for case verification. SLE cases were identified with specific algorithm based on verification results, and new cases were identified with 1 year as the washout period. The incidence density and 95%CI were estimated by Poisson distribution. Results: From 2016 to 2021, a total of 1 551 921 permanent residents were registered in Yinzhou, in whom 51.52% were women. The M(Q1,Q3) age at enrollment was 40.38 (27.54, 53.54) years. The M(Q1,Q3) of follow-up person-years was 3.83 (0.41, 5.83) years. There were 451 new SLE cases, in which 352 were women (78.05%). The 6-year incidence density was 8.14/100 000 person-years (95%CI: 7.41/100 000 person-years-8.93/100 000 person-years) for the total population, 3.68/100 000 person-years (95%CI: 2.99/100 000 person-years-4.48/100 000 person-years) for men and 12.37/100 000 person-years (95%CI: 11.11/100 000 person-years- 13.73/100 000 person-years) for women. The incidence density in men appeared a small peak at 20-29 years old, and began to increase with age from 40 years old. The incidence density in women was highest in age group 20-29 years (16.57/100 000 person-years) and remained to be high until 30-79 years old. The incidence density of SLE in Yinzhou show no significant temporal trend from 2016 to 2021 (men: P=0.848; women: P=1.000). Conclusions: The incidence density of SLE in Yinzhou from 2016 to 2021 was similar to those of other areas in China. SLE has a high incidence in women, especially in the young and elderly, suggesting that more attention should be paid to the diagnosis and treatment of SLE in women.
Adult
;
Aged
;
Female
;
Humans
;
Male
;
Middle Aged
;
Young Adult
;
Asian People
;
Incidence
;
Lupus Erythematosus, Systemic/diagnosis*
;
Retrospective Studies
;
China/epidemiology*

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