Pharmacokinetics of traditional Chinese medicine(TCM)is a discipline that adopts pharmacokinetic research methods and techniques under the guidance of TCM theories to elucidate the dynamic changes in the absorption,distribution,metabolism and excretion of active ingredients,active sites,single-flavour Chinese medicinal and compounded formulas of TCM in vivo.However,the sources and components of TCM are complex,and the pharmacodynamic substances and mechanisms of action of the majority of TCM are not yet clear,so the pharmacokinetic study of TCM is later than that of chemical medicines,and is far more complex than that of chemical medicines,and its development also confronts with challenges.The pharmacokinetic study of TCM originated in the 1950s and has experienced more than 70 years of development from the initial in vivo study of a single active ingredient,to the pharmacokinetic and pharmacodynamic study of active ingredients,to the pharmacokinetic study of compound and multi-component of Chinese medicine.In recent years,with the help of advanced extraction,separation and analysis technologies,gene-editing animals and cell models,multi-omics technologies,protein purification and structure analysis technologies,and artificial intelligence,etc.,the pharmacokinetics of TCM has been substantially applied in revealing and elucidating the pharmacodynamic substances and mechanisms of action of Chinese medicines,research and development of new drugs of TCM,scientific and technological upgrading of large varieties of Chinese patent medicines,as well as guiding the rational use of medicines in clinics.Pharmacokinetic studies of TCM have made remarkable breakthroughs and significant development in theory,methodology,technology and application.In this paper,the history of the development of pharmacokinetics of TCM and the progress of cutting-edge research was reviewed,with the aim of providing ideas and references for the pharmacokinetics of TCM and related research.

Objective: To explore the feasibility of applying quantitative analysis of the facial skin color to evaluate the severity of motion sickness objectively and to seek objective indicators that can reflect the severity of motion sickness. Methods: Motion sickness was induced in 51 male adult subjects recruited at the Air Force Medical University by Coriolis acceleration stimulation, and facial skin colorimetric values were acquired using a portable spectrophotometer at five time points: before stimulation and at 0 min, 10 min, 20 min and 30 min after the end of stimulation. The Graybiel rating scales were applied to assess the severity of motion sickness in subjects at each time point after stimulation, and the correlation between the magnitude of change in each colorimetric value and the maximum Graybiel's score was analyzed. The ROC curves were used to compare the evaluation performance of colorimetric value indicators which could reflect the severity of motion sickness. Results: Each colorimetric value in the CIE-L^*a^*b^* color system changed significantly after exposure to provocative motion stimuli, and the trend was consistent with the typical sign of pallor in motion sickness. The magnitudes of the increase in the colorimetric value CIE-L^*, the decrease in CIE-a^*, and the increase in CIE-b^* were all significantly and positively correlated with the maximum of Graybiel's scores (r=0.490 0, P=0.000 3; r=0.549 3, P<0.000 1; r=0.540 9, P<0.000 1). Comparing the performance of three colorimetric indicators to assess the severity of motion sickness, CIE-a^* had an area under the ROC curve of 0.875 0, a sensitivity of 85.71%, and a specificity of 87.50%, which was better than CIE-L^* and CIE-b^*. Conclusions: The CIE-L^*a^*b^* colorimeter values can be considered as objective indicators of the severity of motion sickness, among which the colorimetric indicator CIE-a^* has the most diagnostic significance, and the method of quantitative analysis of the facial skin color can provide a new reference for the objective evaluation of the severity of motion sickness.
Adult ; Face ; Feasibility Studies ; Humans ; Male ; Motion Sickness ; Skin Pigmentation

Chronic Disease ; Coronary Occlusion/surgery* ; Humans ; Treatment Outcome ; Ultrasonography, Interventional

This study was designed to investigate the synergistic analgesic effect between choline (Cho) and acetaminophen (Ace). Mice were treated with 0.6% acetic acid solution by intraperitoneal injection to build acetate writhing model. The KM mice were randomly divided into four groups:control group (n=10), Cho group (n=50), Ace group (n=50), combination group (Cho+Ace group, n=40), then the writhing times were counted respectively. OriginPro8.5 was used to calculate ED 50. The isobolographic analysis was used to test the interaction of Cho and Ace. To explore the mechanism, forty KM mice were randomly divided into control group, Cho group, Ace group and Cho + Ace group. Blood was collected for detection of TNF-α, IL-6, PGE₂ and NF-κB content using ELISA kits. The result ED 50 was calculated as followings. ED⁵⁰ of Cho and Ace was 19.47 mg·kg^-1 and 20.56 mg·kg^-1. The concentrations were 2.94 mg·kg^-1 for Cho and 3.15 mg·kg^-1 for Ace in the combination test. The levels of TNF-α, IL-6, PGE₂ and NF-κB in Cho group and Ace group were lower than those in the control group (P< 0.05). Compared to the Cho group and Ace group, the levels of TNF-α, IL-6, PGE₂, NF-κB in Cho + Ace group were reduced further (P< 0.05). The results revealed that Cho and Ace have synergistic analgesic effects, which may associate with inhibition of the NF-κB signaling pathway.

Objective:To evaluate the ability of 2015 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria to diagnose gout compared with the widely used 1977 American Rheumatism Association (ARA) criteria and other criteria in clinical practice in Chinese patients,and to compare the sensitivity and specificity of different classification criteria for gout in early and established diseases.Methods:The patients who had ankle arthritis and visited the Department of Rheumatology and Clinical Immunology,Peking University First Hospital between February 2012 and February 2016 were screened.The patients who had been already diagnosed with gout or pyrophosphate deposition disease through arthrocentesis or tissue aspiration and those who had been diagnosed with rheumatoid arthritis,spondyloarthritis,and osteoarthritis were excluded.The patients were diagnosed by two experienced rheumatologists and all of them were followed up for at least one year.Early disease was defined as symptom onset of no more than 2 years;established disease was defined as symptom duration of more than 2 years.The 2015 ACR classification criteria were divided into clinical form with clinical parameters included and complete form with not only clinical parameters but also synovial fluids tests,imaging findings and monosodium urate (MSU) included.The two forms above were short for "clinical form (incorporating clinical parameters)" and "complete form (incorporating imaging and MSU data) " respectively.Results:In this study,284 patients suffering from ankle arthritis were included in the study,219 of them were classified as gout and 65 of them had alternative diagnoses.The sensitivity and specificity of 2015 ACR complete form (incorporating imaging and MSU data) for diagnosing gout were 88.13％ and 95.38％,respectively.The area under the curves (AUC) of 2015 ACR "complete form (incorporating imaging and MSU data)",2015 ACR "clinical form (incorporating clinical parameters) ",2010 Netherlands criteria and 1977 ARA criteria were 0.982,0.983,0.963,and 0.928,respectively.For the 94 early gout patients,the AUC of the above criteria were 0.973,0.968,0.916,and 0.910,respectively.For the established gout patients,the AUC were 0.987,0.991,0.982,and 0.936,respectively.For the patients with disease duration within two years,the odd ratio (OR) for sensitivity of 2015 ACR "complete form (incorporating imaging and MSU data)",2015 ACR "clinical form (incorporating clinical parameters)",2010 Netherlands criteria and 1977 ARA criteria were 1.562 (1.003-2.435),1.500 (1.001-2.346),and 1.812 (1.177-2.791),nevertheless,for the patients with established gout,the OR were 1.702 (1.300-2.229),1.607 (1.224-2.110),and 1.821 (1.396-2.377),respectively.Conclusion:The 2015 ACR/EULAR criteria are more accurate in gout diagnosis compared with the 1977 ARA criteria by elevating the sensitivity and specificity,in respective of the disease duration.The 2015 ACR/EULAR criteria may serve as new diagnostic tools in daily clinical practice in Chinese patients.

BACKGROUNDMetabolic syndrome (MS) is a risk factor for stroke and thromboembolism event. Left atrial or LA appendage (LA/LAA) thrombus is a surrogate of potential stroke. The relationship between MS and atrial thrombus remains unclear. In this study, we sought to investigate the effect of MS on risk stratification of LA/LAA thrombus formation in patients with nonvalvular atrial fibrillation (NVAF).

METHODSThis cross-sectional study enrolled 294 consecutive NVAF patients without prior anticoagulant and lipid-lowering therapies. LA/LAA thrombus was determined by transesophageal echocardiography. Risk assessment of LA/LAA thrombus was performed using the CHADS2 , CHA2DS2 -VASc, MS, CHADS2 -MS, and CHA2DS2 -VASc-MS scores. Logistic regression analyses were performed to determine which factors were significantly related to LA/LAA thrombus. Odds ratio (OR) including 95% confidence interval was also calculated. The predictive powers of different scores for the risk of LA/LAA thrombus were represented by C-statistics and compared by receiver operating characteristic (ROC) analysis.

RESULTSLA/LAA thrombi were identified in 56 patients (19.0%). Logistic analysis showed that MS was the strongest risk factor for LA/LAA thrombus in NVAF patients (OR = 14.698, P < 0.001). ROC curve analyses revealed that the C-statistics of CHADS2 -MS and CHA2DS2 -VASc-MS was significantly higher than those of CHADS2 and CHA2DS2 -VASc scores (CHADS2 -MS vs. CHADS2 , 0.807 vs. 0.726, P = 0.0019). Furthermore, MS was helpful for identifying individuals with a high risk of LA/LAA thrombus in the population with a low risk of stroke (CHADS2 or CHA2DS2 -VASc score = 0).

CONCLUSIONSMS is associated with LA/LAA thrombus risk in patients with NVAF. In addition to the CHADS2 and CHA2DS2 -VASc scores, the CHADS2 -MS and CHA2DS2 -VASc-MS scores provide additional information on stroke risk assessment.

Aged ; Atrial Appendage ; pathology ; Atrial Fibrillation ; complications ; physiopathology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Metabolic Syndrome ; complications ; physiopathology ; Middle Aged ; Multivariate Analysis ; ROC Curve ; Risk Factors ; Thrombosis ; etiology ; physiopathology

OBJECTIVETo analyze the incidence of cytomegalovirus infection and related risk factors after allogeneic hematopoietic cell transplantation and to develop a rational strategy for the preemptive treatment of CMV infection.

METHODSThe clinical data of 398 patients undergoing allogeneic hematopoietic cell transplantation from December 2011 to December 2014 were analyzed retrospectively by using a Kaplan Meier analysis and Logistics model.

RESULTSOut of 398 patients 233 developed post-transplant CMV infection (58.5%). Univariate analysis showed that HLA mismatch, ATG administration, acute graft versus host disease (aGVHD), using prednisone ≥ 1 mg/kg body weight or equivalent were associated with increase of CMV infection. Multivariate analysis showed that HLA mismatch (HR = 2.765, P = 0.000), ATG administration (HR = 3.866, P = 0.000), using prednisone ≥ 1 mg/kg body weight or equivalent (HR = 4.767, P = 0.000) also were associated with increase of CMV infection.

CONCLUSIONHLA mismatch, ATG administration, using prednisone ≥ 1 mg/kg are risk factors for CMV reaction.

Cytomegalovirus Infections ; diagnosis ; epidemiology ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Incidence ; Kaplan-Meier Estimate ; Logistic Models ; Multivariate Analysis ; Prednisone ; administration & dosage ; Retrospective Studies ; Risk Factors

OBJECTIVE: To determine the normal reference values of 33 elements, Ag, Al, As, Au, B, Ba, Be, Ca, Cd, Co, Cr, Cs, Cu, Fe, Ga, Hg, Li, Mg, Mn, Mo, Ni, Pb, Rb, Sb, Se, Sr, Th, Ti, Tl, U, V, Zn and Zr, in the blood and urine samples from the general population in Sanmen County of Zhejiang province, a typical coastal area of eastern China. METHODS: The 33 elements in 272 blood and 300 urine samples were determined by inductively coupled plasma-mass spectrometry (ICP-MS). The normality test of data was conducted using SPSS 17.0 Statistics. The data was compared with other reports. RESULTS: The normal reference values of the 33 elements in the blood and urine samples from the general population in Sanmen County were obtained, which of some elements were found to be similar with other reports, such as Co, Cu, Mn and Sr, while As, Cd, Hg and Pb were generally found to be higher than those previously reported. There was a wide variation between the reports from different countries in blood Ba. CONCLUSION The normal reference values of the 33 elements in the blood and urine samples from the general population in Sanmen County are established, and successfully applied to two poisoning cases.
Blood Chemical Analysis ; China ; Elements ; Environmental Monitoring ; Humans ; Urinalysis

OBJECTIVE: To establish the electricity plate digestion and inductively coupled plasma-mass spectrometry (ICP-MS) method for determination of 33 inorganic elements in human hair. METHODS: Lithium (6Li), Germanium (72Ge), Yttrium (89Y), Indium (115In), and Terbium (159Tb) were used as internal standards. The electric heating board digestion in a mixture of nitric acid and hydrogen peroxide was used as the pre-treatment of the hair. Thirty-three inorganic elements in human hair were analyzed by ICP-MS method. RESULTS: The detection limit of ICP-MS was 0.0001 microg/g(Th)-10.9 microg/g (Ca) and the limit of quantitation was 0.0005 microg/g (Th)-25 microg/g (Ca). The recovery rate of this method was 86%-113%. The RSD for the intra-day and inter-day were less than 9.2%. The method was not statistically different from microwave digestion method. CONCLUSION This method is highly efficient and accurate. It can be used for analysis of 33 inorganic elements in human hair.
Electricity ; Hair/chemistry* ; Humans ; Limit of Detection ; Mass Spectrometry/methods* ; Microwaves ; Reference Standards ; Sensitivity and Specificity ; Trace Elements/analysis*

Objective To study the prevalence and distribution of mental disorders among registered and non-registered residents in Shenzhen. Methods An epidemiological survey on mental disorders were carried out in Shenzhen by stratified multi-stage randomized sampling method; 7134 respondents were assessed through face-to-face interview, using the WHO standardized version on World Mental Health (WMH) Survey Initiative of the Composite International Diagnostic Interview (CIDI3.1). Results (1)The weighting prevalence of mental disorders was 21.87%. The prevalence of non-registered residents was significantly higher than that of the registered residents (22.34% vs. 19.99% ; OR= 1.15,95%CI: 1.03-1.29; P<0.05) and the prevalence of females was significantly higher than that of males (22.68% vs. 19.67%; OR=1.20,95%CI: 1.07-1.34; P<0.05). The weighting prevalence of mood disorders, anxiety disorders and psychoses were 9.62%, 14.45% and 1.40%, respectively. (2) The weighting twelve-month incidence of mental disorders was 13.42%. The incidence of non-registered residents was significantly higher than that of the registered residents (13.80% vs. 11.90%; OR=1.19, 95%CI: 1.03-1.36; P<0.05). (3)The co-morbidity rate between mental disorders was 35.76%. (4)The prevalence and severity of mental disorders were associated with sex, household situation of registration, marital status, education, economic condition and occupation status. Conclusion Mental disorders have become common diseases and serious public health problem in Shenzhen, with non-registered residents and females deserve more attention.