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Xijiao Dihuang decoction (XDT), a famous formula, was usually used to improve the prognosis of patients with blood-heat and blood-stasis syndrome-related diseases. There were some mutual promotion and mutual assistance herb pairs in XDT. However, the exact functions of these herb pairs in the compatibility of XDT were not elucidated due to the lack of appropriate methodologies. Based on the theory of serum pharmacochemistry, a systematic method was established for the qualitative and quantitative analysis of characteristic components in the extracts and drug-containing plasma samples of XDT and its relational mutual promotion/assistance herb pairs. For qualitative analysis, 85 characteristic components were identified using the liquid chromatography with triple time-of-flight mass/mass spectrometry (LC-Triple QTOF-MS/MS) based on the mass defect filtering, product ion filtering, neutral loss filtering and isotope pattern filtering techniques. For quantitative detection, a relative quantitation assay using an extract ion chromatogram (EIC) of the full scan MS experiment was validated and employed to assess the quantity of the 85 identified compounds in the test samples of single herb, herb pairs and XDT. The results of multivariate statistical analyses indicated that both the assistant and guide herbs could improve the solubilization of active compounds from the sovereign and minister herbs in XDT in vitro, might change the trans-membrane transportation, and regulate metabolism in vivo. The methods used in present study might be also valuable for the investigation of multiple components from other classic TCM formulas for the purpose of compatibility feature study., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The purpose of this research is to summarize the academic expertise of Professor Lu Zhizheng in the treatment of Chronic Atrophic Gastritis, and to explain his clinical reasoning and common prescriptions in the treatment of CAG., Methods: Professor Lu's outpatient cases of CAG from January 2008 to December 2021 were selected, and the PageRank algorithm was applied on the FangNet platform to analyze the usage frequencies of herbs, their four natures and five flavors according to Traditional Chinese Medicine, core herbs, and herb clustering patterns, with the goal of summarizing the distinguishing features of Professor Lu's academic and clinical approach to CAG. A total of 170 patients from 252 consultations were included in this study. The prescriptions involved a total of 239 herbs, which occurred a cumulative 4339 times. The herb natures were mainly warm, neutral, and slightly cold, and the herb flavors were predominantly sweet, bitter, and pungent. The channel tropism of the selected herbs primarily targeted the spleen, stomach, and lung meridians. Herb rank analysis showed that 34 herbs, including Gancao, Taizishen, Banxia, Huanglian, Shengjiang, Baizhu, Yiyiren, Maiya, Cangzhu, and Kuxingren, were the driver herbs used by Professor Lu for the treatment of CAG., Results: Herb-herb co-occurrence/exclusivity analysis revealed 10 sets of frequently used herb pairs; herb cluster analysis yielded 10 herb clusters. These results reflected the emphasis Professor Lu placed on protecting Qi and Yin while clearing damp-heat. Professor Lu Zhizheng utilized dialectics reinforced with flexible thinking in the treatment of CAG, and emphasized that identifying the pathogenesis and addressing the syndrome should be prioritized., Conclusions: The characteristic treatment strategy aimed to replenish Qi and nourish Yin, clear away damp-heat, and treat CAG patients comprehensively under the guidance of established principles.

Ethnopharmacological Relevance: Sargentodoxa cuneata (Sargentodoxa cuneata (Oliv.) Rehder & E.H.Wilson, DXT)-Patrinia villosa(Patrinia villosa (Thunb.) Dufr, BJC) constitutes a commonly employed herb pair in Chinese medicine for colorectal cancer (CRC) treatment. Modern pharmacological investigations have revealed the anticancer activities of both Sargentodoxa cuneata and Patrinia villosa. Nevertheless, comprehensive studies are required to discern the specific antitumor active ingredients and mechanism of action when these two herbs are used in combination., Aim of the Study: Through the integration of network pharmacology, molecular docking techniques, experimental assays, and bioinformatics analysis, our study aims to forecast the active ingredients, potential targets, and molecular mechanisms underlying the therapeutic efficacy of this herb pair against CRC., Materials and Methods: Plant names (1, Sargentodoxa cuneata (Oliv.) Rehder & E.H.Wilson; 2, Patrinia villosa (Thunb.) Dufr.) have been verified through WorldFloraOnline (www.worldFloraonline.org) and MPNs (http://mpns.kew.org). The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) were utilized for screening the active ingredients of the herb pair. The PharmMapper database was employed to predict the target proteins for each active ingredient. CRC-related targets were obtained from the Genecards database, Online Mendelian Inheritance in Man (OMIM) database, Disease Gene Network (DisGeNET) database, and Therapeutic Target Database (TTD). Common targets were identified by intersecting the target proteins of all active ingredients with CRC-related targets. Protein-protein interactions (PPI) for the common target proteins were constructed using the String database and Cytoscape 3.9.1 software. Network topology analysis facilitated the identification of core targets. These core targets were subjected to enrichment analysis of Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) using the Metascape database. Molecular docking was performed using Discovery Studio 2019 to investigate the interactions between the active ingredients and core target proteins. The core targets were validated through bioinformatics analysis using GEPIA, HPA, and the cBioPortal database. Finally, a series of experiments were conducted to further validate the results in vitro., Result: A total of 15 active ingredients and 255 herb targets were identified, resulting in 66 common targets in conjunction with 6113 disease targets. The PPI analysis highlighted AKT1, EGFR, CASP3, SRC, and ESR1 as core targets. KEGG enrichment analysis indicated significant enrichment in the PI3K-AKT signaling pathway, a pathway associated with cancer. Molecular docking experiments confirmed favorable interactions between dihydroguaiaretic acid and the core target proteins (AKT1, EGFR, CASP3, and ESR1). Bioinformatics analysis revealed differential expression of EGFR and CASP3 in normal and CRC tissues. Cellular experiments further verified that dihydroguaiaretic acid induces apoptosis in colorectal cancer cells through the PI3K-AKT signaling pathway., Conclusion: Our network pharmacology study has elucidated that the Sargentodoxa cuneata-Patrinia villosa herb pair exerts the negative regulation of the PI3K/AKT/mTOR signaling pathway, ultimately leading to the induction of apoptosis in colorectal cancer cells. This research has predicted and validated the active ingredients, potential targets, and molecular mechanisms of Sargentodoxa cuneata-Patrinia villosa in the treatment of CRC, providing scientific evidence for the use of traditional Chinese medicine in managing CRC., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Ethnopharmacological Relevance: Complementary treatment with valuable efficacy and less toxic or side effect is in urgent need for colorectal cancer (CRC) therapy. Yiqi Huayu Jiedu Decoction (YHJD) is a polyherbal formulation which has been applied in clinic to treat CRC for a long period of time. Nevertheless, the potential active ingredients and molecular mechanism remains to be further explored., Aim of the Study: To probe the effective compounds of YHJD and its underlying pharmacological effects. Moreover, the influence on liver metastasis of CRC as well as function of natural killer (NK) cells results from YHJD was investigated., Materials and Methods: The active ingredients and target genes of YHJD was examined through TCMSP databases. Compound-compound target network was performed by applying Cytoscape3.9.1 software. The CRC-related disease targets were explored via DisGeNET database. Venn database was used to find the common genes between CRC and YHJD. Protein-protein interaction network was established by STRING database. Biological process and signaling pathways potentially regulated by YHJD were evaluated by DAVID database. Western blot assay was then conducted to further investigate the effect of YHJD on PI3K-AKT signaling. The association between NK cells content and TNM or pathological stages of CRC was studied through TCGA database. The killing efficiency of NK cells was researched by CCK8 experiment. In vivo assay and HE staining were performed to assess the anti-liver metastasis effect of YHJD. The variation of NK cells content was authenticated by applying flow cytometry analysis., Results: We firstly found 176 active ingredients and 268 target genes of YHJD. Compound-compound target network was then established consisted of 455 nodes and 3989 edges. Then 707 disease targets associated with CRC were discovered and 42 common genes between CRC and YHJD were identified. Protein-protein interaction network was further constructed, among which 5 vital genes including TP53, AKT1, TNF, MYC and CCND1 were recognized. GO and KEGG analysis was performed to explore probable biological process and signaling pathways regulated by YHJD. Particularly, the ratio of p-PI3K/PI3K and p-AKT/AKT at protein level representing the activation of PI3K-AKT signaling could be suppressed by YHJD. In addition, bioinformatic analysis detected reduced NK cells content in CRC tissues, which gave rise to more advanced node, metastasis and pathological stages. We next presented that YHJD can improve the killing effect of NK cells on CRC. At meantime, YHJD was capable of suppressing liver metastasis of CRC in vivo as well as promoting the content of NK cells, while the improving effect was partially neutralized by anti-ASGM1., Conclusions: Our research indicates that YHJD can prohibit liver metastasis of CRC in vivo. The therapeutic effectiveness is linked to regulation of multiple targets and effector process, especially PI3K-AKT signaling as well as immune response dominated by NK cells., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Two polysaccharides, named APS2-I and APS3-I, were purified from the water extract of Radix Astragali. The average molecular weight of APS2-I was 1.96 × 10 6 Da and composed of Man, Rha, GlcA, GalA, Glc, Gal, Xyl, and Ara in a molar ratio of 2.3:4.8:1.7:14.0:5.8:11.7:2.8:12.6, while the average molecular weight of APS3-I was 3.91 × 10 6 Da and composed of Rha, GalA, Glc, Gal, and Ara in a molar ratio of 0.8:2.3:0.8:2.3:4.1. Biological evaluation showed APS2-I and APS3-I had significant antioxidant activity and myocardial protection activity. Furthermore, total polysaccharide treatment could significantly enhance hemodynamic parameters and improve cardiac function in rat ischemia and reperfusion isolated heart models. These results provided important information for the clinical application of APS in the field of cardiovascular disease and implied that Astragalus polysaccharides (APS) could be considered as a reference for the quality control of Radix Astragali.

Objective: To elucidate the main mechanism of Xijiao Dihuang decoction (XJDHT) for the treatment of systemic lupus erythematosus (SLE)., Methods: TCMSP, BATMAN-TCM, ETCM, and TCMID databases and literature search were used to screen the potential active compounds of XJDHT, and TCMSP and SwissProt databases were searched to predict the targets of the compounds. The targets of SLE were obtained from Genegards, OMIM, and DisGeNET databases, and Venn online platform was used to obtain the intersection targets of XJDHT and SLE. Afterwards, the PPI network was constructed by using the STRING database, and the core targets were identified by network topology analysis. GO and KEGG enrichment analyses were performed through R software, and molecular docking of the top three core targets and their corresponding compounds were accomplished by Autodock Vina and Pymol softwares., Results: There were 30 potential active ingredients, 289 potential targets, and 129 intersection targets screened from the above databases. Network topology analysis identified 23 core targets, such as AKT1, TNF, IL6, IL1B, and INS. GO enrichment analysis obtained 2555 terms and mainly clustering on the react to lipopolysaccharide, membrane raft, and ubiquitin-like protein ligase binding. KEGG enrichment analysis obtained 187 signaling pathways, mainly concentrating on the lipid and atherosclerosis, AGE-RAGE signaling pathway in diabetic complications, fluid shear stress, and atherosclerosis. Molecular docking verified that the active compounds of XJDHT have the strong binding activity to the core targets., Conclusion: This study preliminarily uncovers the mechanism of XJDHT acting on SLE through a "multicompound, multitarget, and multipathway" manner. XJDHT may achieve the treatment of SLE by inhibiting the proinflammatory factors, inflammatory signal cvtokines, proliferation, injury, and apoptosis processes. In summary, the present study would provide a promising theoretical basis for further clinical and experimental studies., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2022 Fangzhi Wei et al.)

Objective: To explore the mechanism of action of Bu-Fei-Yi-Shen formula (BFYSF) in treating chronic obstructive pulmonary disease (COPD) based on network pharmacology analysis and molecular docking validation., Methods: First of all, the pharmacologically active ingredients and corresponding targets in BFYSF were mined by the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database, the analysis platform, and literature review. Subsequently, the COPD-related targets (including the pathogenic targets and known therapeutic targets) were identified through the TTD, CTD, DisGeNet, and GeneCards databases. Thereafter, Cytoscape was employed to construct the candidate component-target network of BFYSF in the treatment of COPD. Moreover, the cytoHubba plug-in was utilized to calculate the topological parameters of nodes in the network; then, the core components and core targets of BFYSF in the treatment of COPD were extracted according to the degree value (greater than or equal to the median degree values for all nodes in the network) to construct the core network. Further, the Autodock vina software was adopted for molecular docking study on the core active ingredients and core targets, so as to verify the above-mentioned network pharmacology analysis results. Finally, the Omicshare database was applied in enrichment analysis of the biological functions of core targets and the involved signaling pathways., Results: In the core component-target network of BFYSF in treating COPD, there were 30 active ingredients and 37 core targets. Enrichment analysis suggested that these 37 core targets were mainly involved in the regulation of biological functions, such as response to biological and chemical stimuli, multiple cellular life processes, immunity, and metabolism. Besides, multiple pathways, including IL-17, Toll-like receptor (TLR), TNF, and HIF-1, played certain roles in the effect of BFYSF on treating COPD., Conclusion: BFYSF can treat COPD through the multicomponent, multitarget, and multipathway synergistic network, which provides basic data for intensively exploring the mechanism of action of BFYSF in treating COPD., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Longchuan Wu et al.)

Ethnopharmacological Relevance: Diabetic foot ulcer is one of the most serious complications of diabetes. Effective medical treatment regarding improvement of ulcer healing in patients is essential. Pien Tze Huang (PZH), a valuable Chinese traditional medicine, has been found significant efficacy on the curing of diabetic wound in clinic recently., Aim of the Study: This work was conducted to confirm the efficacy, and compare the therapeutic effect through the oral administration and local delivery route, providing a rationale for the new PZH form development; besides, the mechanisms through which PZH promoted the wound healing was also discussed., Materials and Methods: First, the chemical composition of PZH was characterized by 1 H-NMR and HPLC. The anti-apoptosis effects of PZH on high concentration glucose injured epidermal fibroblast (HFF-1) was investigated in a dose dependent way. Then, the effects of the systematical administration of PZH, and the topical used route on excisional wounds of Streptozotocin (STZ) induced diabetic mice were compared., Results: The results illustrated that PZH decreased the reactive oxygen species (ROS) levels in cells, preventing cell damage/apoptosis through an ROS/Bcl-2/Bax/Caspase-3 pathway. The in vivo study proved that topical use of PZH exceeded the systematical route both in accelerating the wound closure and improving the healing quality. Meanwhile, PZH promoted wound closure through stimulating the secretion of Col-I, decreasing fibroblast apoptosis, and enhancing myo-fibroblast differentiation, in consistent with the mechanism study in vitro., Conclusions: Local used PZH improves wound healing by inhibiting the abnormal HFF-1 apoptosis and senescence. The study held a great promise for development of a topical dosage form of PZH for diabetic wound healing., (Copyright © 2020 Elsevier B.V. All rights reserved.)

To investigate the clinical characteristics and the rule of administration of Ciwujia Injection in patients with cardiovascular disease by correlation analysis and frequency analysis. The information of 5 904 patients who used Ciwujia Injection to treat cardiovascular disease for at least three times in the hospital information system(HIS) of 19 comprehensive tertiary hospitals nationwide. The frequency analysis method was used to analyze the higher frequency variables, and the algorithm of Apriori correlation analysis method was used to analyze the clinical characteristics and medication laws of Ciwujia Injection in treating patients with cardiovascular disease. Among the 5 904 patients, the median age of the patients was 70 years, and the number of patients between 65-75 years old was up to 2 096(35.5%). There were more women than men in terms of diagnosis and treatment, and the women at age of 45-65 and 65-75 years old were more than men. The top three diagnoses by Western medicine were coronary heart disease in 8 104 cases(65.66%), dyslipidemia in 2 515 cases(20.38%), and cardiac function grade Ⅱ-Ⅲ in 581 cases(4.71%), while the largest number of syndromes in traditional Chinese medicine(TCM) at discharge was 1 109(21.37%) in other type, followed by 739 cases(14.24%) of Qi deficiency and blood stasis syndrome, and 698(13.46%) of liver and kidney Yin deficiency syndrome. The most frequently used Western medicine in combined use was Nifedipine in 2 567 cases(7.21%), and most frequently used TCM was Compound Xianzhuli Liquid leachate in 766 cases(3.53%). From the results of pharmacological analysis, the frequency of using Ciwujia Injection + stasi-seliminating agent + calcium channel blocking drugs was highest when using 1 Chinese medicine combined with 1 or 2 Western medicines. In the use of 2 Chinese medicines combined with 1 Western medicine, Ciwujia Injection + heat-clearing agent + stasis-eliminating agent + calcium channel blocker was the most common. This study demonstrated that Ciwujia Injection was more common in middle-aged and elderly patients and more in women than men. Treatment should be based on different cardiovascular disease treatment guidelines to reduce complications caused by underlying diseases, and attention should be paid to the prevention and treatment of cardio-vascular disease risk factors such as hypertension, diabetes and abnormal lipid metabolism. According to the analysis of frequency distribution and association rules, it was concluded that Ciwujia Injection was mainly used in combination with calcium channel blockers and stasis-eliminating agents in the treatment of cardiovascular disease. In the treatment of cardiovascular diseases by Ciwujia Injection in combination with other Chinese and Western medicines, in order to avoid pharmacological changes and avoid affecting the efficacy of the drug, it is necessary to closely observe whether adverse reactions occur and ensure that the medication is safe and effective. This study provides a good reference for the follow-up clinical guidance of Ciwujia Injection.

To analyze the clinincal application characteristics of Xiyanping Injection in real world. The data of the patients came from the hospital information systerm(HIS) of 29 tertiary hospitals in China from 2006 to 2016. It included three parts about basic information, Western medicine diagnosis information, and doctor advice information. The exploration was conducted for the characteristics of the patients and disease distribution as well as the therapeutic regimen. Apriori algorithm was adopted to establish the models, and Clementing 12.0 was used for a correlation analysis of the comprehensive therapeutic regimen of Xiyanping Injection. There were 194 873 cases in the study. The male to female ratio was 1.44∶1. The median age was 4 years old. The median daily dosage was 200 mg. 46.68% of the patients were administered with 250-500 mg, and 33.07% were 50-100 mg one day. 47.08% of the patients were administered for 4-7 d, and 32.65% of the patients were 1-3 d. In the doctor advice information, the most frequently types of Western medicine, traditional Chinese medicine were mucilagin, heat-clearing agent. Second generation cephalosporins, third generation cephalosporins, compound penicillin were the most common types of antibiotic. Interferon, nucleoside and nucleotide, human immunoglobulin were the most common types of antiviral drug. The mining association rules results were analyzed, finding the application of Xiyanping Injection in severe infectious diseases. To improve respiratory symptoms, Xiyanping Injection treaments were Budesonide + Ipratropium Bromide + Ambroxol. To severe pulmonary infection, the treaments were Dopamine + Ambroxine. To severe hand, foot and mouth disease, the treatments were Namefen + Mannitol. To pulmonary heart failure, the treatments were Dobutamine + Heparin. Based on the results of the real world HIS, we could provide clinical application the idea, and a reference for further excavation of the applicable diseases of Xiyanping Injection.

To explore the real world clinical application characteristics and the drug combination regularity of Ciwujia Injection, 12 554 cases of patients with Ciwujia Injection were extracted from the information systems of 24 class Ⅲ grade A hospitals in China, and a standardized analysis was carried out. Most of the patients were middle-aged and old-aged, and the main departments were cardiovascular department(22.50%) and neurology department(17.92%). Before 2008, 93.77% of the patients were single overdose users, which reduced to only 2.07% after 2011. The course of treatment was mostly between 8-14 days(32.98%). The top three di-seases diagnosed by Western medicine were hypertension(11.78%), cerebral infarction(9.47%), and coronary heart disease(8.15%), and the most common traditional Chinese medicine syndrome was the deficiency of liver and kidney(18.59%). The most commonly used Western medicine was Acetylsalicylic Acid(51.07%), and the most commonly used traditional Chinese medicine was Danshen Injection(9.67%). The most commonly used Western medicine in combined application was calcium channel blocker(46.88%), and the most commonly used traditional Chinese medicine in combined application was stasis removing agent(93.21%). And the drug combination with the highest support was Isosorbide Mononitrate + Acetylsalicylic Acide, with a high recovery rate after discharge(96.81%). The results showed that Ciwujia Injection had certain regularity. It considered underlying concurrent diseases, anticoagulation and blood circulation, with a wide range of effects in strengthening the body and regulating the mind. The results could expand the understanding of Ciwujia Injection and provide a more detailed real world basis and reference for optimizing therapeutic regimen in clinic.

In this study, the clinical characteristics and drug combination rules of Danshen Chuanxiongqin Injection in the treatment of patients with cerebral infarction were analyzed. The inpatient information of 2 857 patients of cerebral infarction treated with Danshen Chuanxiongqin Injection in HIS database of 20 grade Ⅲ class A hospitals in China was collected, and a model was established by description analysis and Apriori algorithm, in order to explore the clinical characteristics and drug combination rules of Danshen Chuan-xiongqin Injection in the treatment of cerebral infarction. The results showed that among patients of cerebral infarction treated with Danshen Chuanxiongqin Injection, 1 727 patients were older than 65 years old, accounting for 69.61%, and 1 610 were males, accounting for 63.59%. Commonly used drugs included lipid-lowering agents, anticoagulant thrombolytic agents, antiplatelet agents, stimulants of brain metabolism, vasodilators and other Western drugs, as well as traditional Chinese medicines, such as blood-activating agents, heat-clearing agents and expectorant agents. The Western medicine with the highest use frequency in combination with Danshen Chuan-xiongqin Injection was aspirin enteric-coated tablets(1 528 cases, 53.48%). The traditional Chinese medicine with the highest use frequency in combination with Danshen Chuanxiongqin Injection was Xingnaojing Injection, with a total of 378 cases, accounting for 13.23%. Among them, the most commonly used Western drugs combined with Danshen Chuanxiongqin Injection were anticoagulant thrombolytic and antiplatelet drugs, with a usage rate as high as 83.48%. In order to further explore the drug combination rules of Danshen Chuanxiongqin Injection, the association analysis of drug combination in patients of cerebral infarction treated with Danshen Chuanxiongqin Injection was carried out. In clinical combination of two Western drugs, Atorvastatin Calcium Capsules+Cerebral Proteolytic Injection were the most common combination, with a support of 27.10%. In clinical combination with 3 Western drugs, Clopidogrel Bisulfate Tablets+Atorvastatin Calcium Capsules+Cerebral Proteolytic Injection were most commonly used, with a support of 15.90%. The results showed that the patients of cerebral infarction treated with Danshen Chuanxiongqin Injection were mainly elderly males, and often complicated with hypertension, coronary heart disease, diabetes and other basic diseases. The clinical application of Danshen Chuanxiongqin Injection was principally in line with the guidelines. In the treatment of cerebral infarction, it was often combined with Western medicine anticoagulant thrombolysis, antiplatelet drugs, traditional Chinese medicine blood-activating and stasis-dissolving prescription and other drugs with similar pharmacological effects, with an auxiliary therapeutic effect on patients of cerebral infarction complicated with other diseases, and can provide guidance for clinical medication.

Kidney malignant tumor is a type of primary renal cell carcinoma, and mainly refers to renal cancer. The incidence of kidney cancer and the number of hospital cases in China have been increasing. Based on the clinical medicine information of patients in the hospital information system(HIS) database of 37 hospitals in China, the combined medication of patients with kidney malignant tumor were analyzed by Tabu search algorithm, so as to analyze the combined medication of patients with kidney malignant tumor in real world. A total of 7 095 patients with kidney malignant tumor were included, the ratio of males to females was 2.11∶1, and the ratio of male patients increased gradually with age. About 3 933 patients(55.43%) showed a superior effect among those patients. The common therapies of patients with kidney malignant tumor were anti-tumor therapies and symptomatic therapies, including anti-infection, regulation of electrolyte balance, sedation and analgesia, analgesic, regulation of gastrointestinal function. The whole population of patients with kidney malignant tumor were mostly treated with anti-tumor drugs combined with more symptomatic therapies, while the anti-tumor therapies of the superiority population of patients were less combined with other drugs, with less combined medication. The result may be related to the stage of tumor or individual response to the therapeutic regimen. No matter for the whole population or for the superiority population of patients with kidney malignant tumor, the therapies was mainly Western medicines. Based on the pathogenesis of deficiency in origin and excess in superficiality with kidney malignant tumor, Chinese subgroups with formula for clearing heat and removing toxicity, formula for vigorate Qi and replenish the blood, formula for regulate Qi and invigorate the blood, laxative and hemostatic were more commonly used. In the future, further studies shall be conducted for combined therapies for patients of different stages, so as to play the advantages of multi-target, overall regulation, toxicity reduction and efficacy enhancement of traditional Chinese medicine, improve the life quality of patients with kidney malignant tumor, prolong their life time, and improve the survival rate of patients.

From 2001 to 2015, medical data of 16 856 elderly patients aged 65 years and over who used Suxiao Jiuxin Pills in the information system of 37 tertiary A-level hospitals were collected. After standardized analysis, it was found that the average age of 16 856 elderly patients was 72.48 years, and the main admission departments were department of cardiology(19.30%) and geriatric department(9.77%). Generally, 61.96% of the degree of illness is average, and the average hospitalized days were 16.16 days; 47.97% of the patients were diagnosed as coronary heart disease by Western medicine, and 5.86% of the patients were diagnosed as Qi deficiency and blood stasis; The more common combination of Western medicine was isosorbide nitrate(61.15%), Aspirin Enteric Coated Tablets(50.77%) and Gansu(36.88%), the combination of traditional Chinese medicine is Compound Danshen Dropping Pills/Tablets(19.13%), Xuesaitong Capsules/Injection(15.01%), Shexiang Baoxin Pills(12.29%); the commonly used Western medicine is vasodilator(78.39%), Chinese medicine is Huoxue Huayu(82.04%), and the commonly used Western medicine is Aaspirin Enteric Coated Tablets+Isosorbide Nitrate. The author intends to explore the valuable clinical characteristics and the clues of the combined medication scheme, and find that the application of Suxiao Jiuxin Pills basically conforms to the instructions, conforms to the characteristics of the elderly with many common diseases and complicated concurrent diseases; the combination of drugs and the indications-coronary heart disease guidelines are consistent, with certain rules to follow, and expand the recognition of the clinical application of Suxiao Jiuxin Pills, and provide clinical diagnosis and treatment ideas.

To analyzed the actual clinical application of Xingnaojing Injection in treating cerebral infarction in the real world, selected HIS(hospital information system) database of inpatients in 39 hospitals across the country, and conducted descriptive analysis and association rule analysis on the information of 11 674 patients with cerebral infarction using Xingnaojing Injection. The results showed that the average age of the patients was 69.69 years. TCM syndrome of phlegm stasis and collaterals stagnation was the most(37.56%), followed by wind-phlegm obstruction of collaterals(19.01%). Virtual syndrome accounted for 21.06%. Intravenous drip was the most important route of administration(96.50%). Iv infusion single dose of 10-20 mL(52.44%), other off-label doses accounted for a larger proportion(47.56%). Continuous use of the drug within 3 days(55.45%), 15-28 days accounted for 6.96%, >28 days accounted for 0.89%. The top 10 Western drugs used in combination mainly include antihypertensive drugs, acid-suppressing drugs to protect stomach, drugs to improve brain circulation, drugs to protect brain nerves and drugs to fight infection. The top 10 of Chinese patent medicines are mainly activating blood circulation and removing stasis, clearing heat and clearing the surface, etc. According to the analysis of association rules, three types of clinical drug use modes for the combination of Chinese and Western medicine were obtained, mainly including the first type: Xingnaojing Injection+nifedipine(nifedipine, nifedipyridine, Lixinping)+levoflo-xacin+Huayu Tongmai agent. The second category: Xingnaojing Injection+omeprazole+edaravone+Huayu Tongmai agent; The third category: Xingnaojing Injection+ganglioside and ganglioside derivatives+edaravone+Huayu Tongmai agent. The results show that Xingnaojing Injection is not a standard drug in the treatment of cerebral infarction. At the same time, the combined use of drugs is mainly recommended by the guidelines and conventional treatment drugs, reflecting the clinical application of integrated traditional Chinese and Western medicine.

Medicinal herb Bletilla striata as a traditional Chinese herb has been used to treat alimentary canal mucosal damage, ulcers, bruises, and burns for thousands of years. Despite numerous efforts directed at the development of Bletilla striata products, the challenge of preparing Bletilla striata hemostasis dressings while simultaneously maintaining portability and high hemostasis performance has not yet been addressed. Herein, we describe a Bletilla striata polysaccharide (BSP) sponge with hierarchical aligned porous channels formed via directional freeze technology. The microstructure and mechanical property of the BSP sponges could be controlled by modifying the BSP concentration. Notably, in vivo animal studies indicated that BSP sponges show high biocompatibility and degradation and possess excellent hemostasis capability. In addition, BSP sponges showed accelerated wound healing in comparison to commercial dressings. Thus, our study indicates that the constructed BSP sponges could find potential application in dressings for efficient wound healing., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Ethnopharmacological Relevance: The prescription of Shenling Baizhu San (SLBZS) was derived from the Song Dynasty "Taiping Huimin Heji Ju Fang", which was a representative prescription for treating spleen asthenic diarrhea. The prescription comprised of 10 herbs for treating weak spleen and stomach. It describes symptoms like eating less, loose stools, cough, shortness of breath and tired limbs. SLBZS has been reported to be capable of eliminating discomfort when it is administered for treating irritable bowel syndrome and diarrhea. This traditional Chinese medicine (TCM) formula has been widely used for improving gastrointestinal dysfunction and modifying the immune response to inflammation., Aim of the Study: This review is aimed to provide the up-to-date information on the pharmacology and clinical research of SLBZS in the treatment of ulcerative colitis (UC), and to discuss the research findings and possible deficiencies, hoping to better guide the clinical application and scientific research of SLBZS in the treatment of UC., Materials and Methods: Relevant studies from 2004 to 2018 on SLBZS in the treatment of UC mechanism and curative effect were collected from ancient books, pharmacopoeia, reports, thesis via library and Digital databases (PubMed, CNKI, Google Scholar, Web of Science, SciFinder, Springer, Elsevier, etc)., Results: SLBZS could regulate inflammatory factors and intestinal flora, and ERK/p38 MAPK signaling pathway may be one of its targets. In addition, clinical research results show that SLBZS has a good therapeutic effect on UC, and the adverse reactions are small., Conclusion: Although SLBZS has achieved some success in the treatment of UC, there are still some scientific gaps. There is a lack of uniform standards for constructing UC animal models, and some methods of modeling through environmental and dietary interventions are not reproducible, and there is a lack of uniform dosing regimen standards. SLBZS doses follow the tradition and lack toxicological validation. Therefore, more specific toxicological research models are essential. The clinical application of SLBZS requires reassessment and standardization. Although all clinical research reports randomly assigned patients to different groups, most did not describe a detailed method of randomization and no description of the analysis data. In addition, extensive in vitro studies and further in-depth molecular studies are essential for the determination of mechanisms that have been performed in all in vivo experiments on animal models and patients., (Copyright © 2019. Published by Elsevier B.V.)

Xanthii fructus (XF), the fruit of Xanthium sibiricum Patr., is a traditional Chinese materia medica commonly used to treat allergic rhinitis and other rhinitis diseases. To uncover the mechanism of the stir-frying process and its effect on the pharmacokinetic behavior of active compounds in model rats, four active compounds-chlorogenic acid, 4-caffeoylquinic acid, 1,5-O-dicaffeoylquinic acid and apigenin-were selected based on previous spectrum-effect experiments. High performance liquid chromatography tandem triple quadrupole mass spectrometry (UPLC-QqQ-MS) technology, an accurate and feasible method, was applied to measure the concentration of these four compounds in rat plasma. This validated method can accurately measure the concentration of each compound at each sampling point of rat plasma. This validated method shows good linearity, extraction recoveries, matrix effects, intra- and inter-day precision and stabilities. Compared with the XF group, the maximum plasma concentration (C max ) value of 1,5-O-dicaffeoylquinic acid decreased remarkably (p < 0.05) after oral administration of stir-fried Xanthii fructus (SXF) extract, while the other compounds showed no significant difference. The mean residence time value of chlorogenic acid (p < 0.05) and 1,5-O-dicaffeoylquinic acid (p<0.01) after oral administration of SXF extraction demonstrated significant differences compared with the XF group, while the other two compounds showed no statistical difference, indicating that the stir-frying process prolonged the effect time and delayed the removal time of chlorogenic acid and 1,5-O-dicaffeoylquinic acid. The values of the area under the plasma concentration-time curve from zero to the last quantifiable time-point, the area under the plasma concentration-time curve from zero to infinity, the time to maximum concentration and the elimination half-life of four compounds in the SXF group showed no statistically significant difference from the XF group. From this data, we speculated that the stir-frying process can not only keep the absorption of 4-caffeoylquinic acid and apigenin, but also increase the effect time of chlorogenic acid and 1,5-O-dicaffeoylquinic acid, which could be the mechanism underlying the stir-frying process enhancing the effects of XF., (© 2018 John Wiley & Sons, Ltd.)

Xanthii Fructus (XF), a well-known herb in traditional Chinese medicine, has been frequently used for the treatment of allergic rhinitis in the clinic. Its therapeutic metabolic mechanism, however, remains undetermined. In this work, a metabolomics research coupled with metabolic pathway analysis has been employed to screen out the potential mechanism in its effects on allergic rhinitis. Specifically, mouse serum samples containing XF were analyzed based on ultra-high performance liquid chromatography equipped with electrospray ionization quadruple time-of-flight mass spectrometry detection (UHPLC-ESI-Q-TOF-MS) in both positive and negative polarity. In addition, the raw data gained from UHPLC-ESI-Q-TOF-MS were processed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) in order to discover remarkable metabolites. Twenty-seven potential biomarkers in mouse serum were filtered from free databases like HMDB. Interestingly, this study filtered the potential metabolic pathways including glycerophospholipid metabolism and branch-chain amino acid metabolism. We hope that this paper will provide a feasible strategy for revealing the therapeutic mechanism of XF in allergic rhinitis mice model., (© 2018 John Wiley & Sons, Ltd.)

The present study was aimed to analyze the association rules of Fufang Kushen injection in combination with other modern medications in treating lung cancer based on the electrical medical records in real world clinical situations extracted from hospital information system in Institute of Basic Medical Sciences, China Academy of Chinese Medical Sciences, and provide reference for improving rationality of clinical drug use and exploring the prescription rules as well as subsequent in-depth analysis. The electrical medical records of the hospitalized patients using Fufang Kushen injection for lung cancer were extracted to analyze the frequency distribution characteristics in combined application with western medicine, and Apriori algorithm was used to analyze the specific association rules in combined drug use. A total of 49 597 patients were included in the study. The commonly combined modern medications included 5-HT receptor blockers, antibiotics, chemotherapy drugs, antitumor immune regulating drugs, glucocorticoid drugs and analgesics, which was usually applied in combination with traditional Chinese medications such as those for removing blood stasis, spleen and stomach nourishing drugs, Qi-regulating agent, heat-clearing and detoxifying prescriptions, laxative and Qi invigorating agent in clinical treatment. The results revealed that the distribution characteristics in combined application and association combinations of Fufang Kushen injection had specific rules, consistent with the clinical orientation of this drug in treatment of lung cancer. Such results may provide reference for reasonable application of Fufang Kushen injection in clinical treatment., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

In China, Semen Cassiae is used clinically to improve eyesight, relieve constipation, and to treat headache and dizziness. Prepared Semen Cassiae is obtained by stir-frying raw Semen Cassiae until it turned dark brown, micro dilatancy, and overflow aroma. After processing, the therapeutic effects change-the purgation effect is alleviated and the hepatoprotective effect is enhanced. To explore the changes in chemical compositions of Semen Cassiae after processing and clarify the material basis of the changed therapeutic effects, an ultra-high performance liquid chromatography with quadrupole time-of-flight mass spectrometry coupled with automated data analysis software and statistical strategy was developed. As a result, 53 compounds in raw Semen Cassiae and 43 compounds in prepared Semen Cassiae were found, a total of 55 chemical compounds were identified. Principle component analysis and t-test were processed by Markerview 1.2.1 software. Finally, 39 peaks were found to be the main contributors to the significant difference (p < 0.05) between raw and prepared Semen Cassiae. Compared with raw Semen Cassiae, 19 peaks showed a higher intensity in prepared Semen Cassiae, while the contents of 20 compounds in prepared Semen Cassiae were lower, most of which belonged to naphthopyrones glycosides and anthraquinone glycosides., (© 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

To analyze the clinical application features of Fufang Kushen injection in treating malignant esophageal tumors in the real world by using hospital information system database, and provide reference for clinical application of Fufang Kushen injection. The electronic medical data from 2 550 patients with malignant esophageal tumors using Fufang Kushen injection from 22 large-scale hospitals nationwide were extracted based on the hospital information system (HIS) established by Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences. Then the descriptive analysis based on frequency and rate was conducted for general characteristics, diagnostic characteristics, characteristics of dosage and medication information, characteristics of drug combination, and discharge outcome characteristics. The results showed that the average age of patients treated with Fufang Kushen injection for malignant esophageal tumors was 62.3 years old; more males than females; admitted to hospital mainly in department of cardiology, oncology and digestology first. The total efficiency was 47.15% based on the discharge outcome characteristics; the most common dosage was 10-20 mL for single use; the course of treatment was mainly 4-7 d; and the common drugs in drug combinations included dexamethasone, tropisetron injection, thymosin injection, compound amino acid injection, pantoprazole sodium injection, fluorouracil, et al. The characteristics of the crowd using Fufang Kushen injection to treat the malignant esophageal tumors were clear and in line with the general rule of malignant esophageal tumors; its clinical dosage and scope of treatment for malignant esophageal tumors in the real world were basically consistent with the specification; and the types of clinical drug use combinations were more extensive., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

The present study aimed to analyze the association rules of Fufang Kushen injection in combined medications in the real world based on electrical medical records in hospital information system, and provide reference for its reasonable clinical application. The electrical medical records of the hospitalized patients using Fufang Kushen injection were extracted to analyze the frequency distribution characteristics in combined application with Western medicine, and analyze the specific association rules between these combinations by using Apriori algorithm. A total of 49 597 patients were included in the study, and its common combined medications included 5-HT receptor blockers, hepatic protector, antibiotics, chemotherapeutic drugs, immunomodulatory drugs, glucocorticoids, analgetics and proton pump inhibitors. The results revealed that the distribution characteristics in combined application and association combinations of Fufang Kushen injection had specific rules, consistent with the clinical orientation of this drug in treatment of malignant tumor. Such results may provide reference for reasonable application of Fufang Kushen injection in clinical treatment., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

To analyze the clinical drug use characteristics and medication rules of cervus and cucumis polypeptide injection (CCP injection) for the patients with lumbar vertebra diseases. Based on the electronic medical data of 6 990 patients with CCP injection for lumbar vertebra diseases from 25 first-class hospitals over the whole country from 2004, statistical analysis was conducted for their general information, diagnostic information, orders information, laboratory test information and treatment results. The results showed that the age distribution was highest in patients aged 45 to 64 (3 883, 55.55%); protrusion of lumbar intervertebral disc was most common among lumbar vertebra diseases (5 519, 82.50%); and TCM syndrome mainly included hemostasis. The daily dose was most between 8-12 mL, with a usual treatment course of 1-3 d. Commonly used western medicines in combined drug use included hypertonic dehydrating agent, antibiotics and nutrition nerve medicines, and the commonly used traditional Chinese medicines in combined drug use included the drugs with promoting blood circulation to remove blood stasis, kidney-tonifying and bone-building agents, and formula for clearing heat and removing toxicity, etc. The most commonly used western medicines are methylamine, adenosine, lidocaine injection, mannitol, et al, and the most commonly used Chinese medicines included Jintiange capsules, Qianggu capsules, et al. It is suggested that CCP injection for lumbar vertebrae diseases is mainly used in middle-aged and elderly patients, and is frequently used in combination with kidney-tonifying and bone-building agents, drugs with promoting blood circulation to remove blood stasis, analgesic agents and antibiotics., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

In order to analyze Shenxiong glucose injection in combined use with other medicines for cerebral infarction in real world, the basic information, Chinese and western medicine diagnosis information, doctors'advice information, and laboratory checking information for the patients with Shenxiong glucose injection in treatment of cerebral infarction were extracted from the hospital information system (HIS) of sixteen 3A hospitals. Apriori Algorithm was used to establish models, and Clementine 12.0 was used for correlation analysis. Then complex network was established to analyze the combined drug use and visualize the results. A total of 635 patients were included in the study, among which 599 patients (94.33%) showed superior effect. Shenxiong glucose injection was often used with platelet suppressant drug, neuroprotective agent, lipid regulating agents, free radical scavenger, vitamins and Chinese medicine blood activating and stasis eliminating agent in the treatment of cerebral infarction. In the patients with superior effect, neuroprotective agent and free radical scavengers were also used based on the combined use with Aspirin, hypolipidemic drugs and blood activating and stasis removing agents, highlighting the rain protection strategies. Shenxiong glucose injection in combined use with Chinese and western medicines for cerebral infarction complied with the latest clinical practice guideline on the treatment of cerebral infarction, and the application of neuroprotective agent was propitious to improve the therapeutic effect., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

To analyze the clinical drug use characteristics of Shenxiong glucose injection in the treatment of ischemic cerebrovascular disease. From hospital information system (HIS) of 19 hospitals over China, the basic information of patients with Shenxiong glucose injection for ischemic cerebrovascular disease, traditional Chinese medicine and Western medicine diagnosis information, order information, and laboratory examination information were extracted. Then Apriori algorithm was used to construct the model, and the association analysis was performed by using Clementine 12 to analyze the clinical drug use characteristics of Shenxiong glucose injection in the real world. A total of 411 kinds of Western medicines and 110 kinds of traditional Chinese medicines were included in 784 cases of drug combination. In the drug combination, aspirin had the highest frequency in Western medicine, which was used in 515 cases (65.69%); Ginkgo biloba extract had the highest frequency in Chinese medicine, which was used in 121 cases (15.43%). Atorvastatin+aspirin (association rules of 10.15%) was the most common Western medicine pairs; atorvastatin+clopidogrel+aspirin (association support 5.56%) was the most common triple Western medicine therapy, often combined with antibiotics and blood stasis drugs in use. Results showed that Shenxiong glucose injection was often combined with antiplatelet drugs and blood stasis drugs in the treatment of ischemic cerebrovascular disease clinically, contributing to the enhancement of platelet aggregation and blood stasis. The incompatibility of combined application of drugs shall be noted to ensure the clinical medication safety and efficacy of the combined drug use., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

To explore the real world clinical medication and combination characteristics of Shenxiong glucose injection. The basic information of patients with Shenxiong glucose injection, traditional Chinese and western medicine diagnosis information, doctor advice information and laboratory test information from the hospital information system(HIS) of 19 tertiary hospitals in China. Apriori algorithm was adopted to establish the models, and Clementine 12.0 was used for correlation analysis to analyze the real world clinical medication and combination characteristics of Shenxiong glucose injection. Among 8 316 patients in the study, 523 kinds of western medicine and 148 kinds of traditional Chinese medicine(TCM) were used. In combined application, the single western medicine with highest use frequency was aspirin(1 908 cases, 22.94%), and single Chinese medicine with highest use frequency was Shuxuetong injection (771 cases, 9.27%); the most common TCM pair was Xianling Gubao capsule+Lugua Duotai injection(rules support degree was 2.55%), and the most common western medicine pair was aspirin+atorvastatin(degree of association rules was 10.15%). They were often used in combination with antibiotics, blood-activating and stasis-dissolving prescription, and adrenal cortical hormone drugs. Shenxiong glucose injection was often used in combination with antiplatelet drugs and blood-activating and stasis-dissolving prescription in clinical application to enhance the effects of anti-platelet aggregation and blood-activating and stasis-dissolving; it was often used in combination with antibiotics to treat cor pulmonale, and incompatibility shall be noticed to ensure efficacy enhancement under the premise of clinical medication safety., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Fufang Kushen injection is used in real world clinical situations to treat different types of malignant tumors. The present study aimed to analyze the association rules of Fufang Kushen injection in combination with other traditional Chinese medicine(TCM) or modern medications in treating malignant tumors based on the electrical medical records extracted from real-world hospital information system. This real world retrospective analysis was based on the clinicians' prescriptions regarding to such treatment by combined TCM and modern medications. Hospital information system data from 22 hospitals, including electrical medical records of 44 588 patients with malignant tumors and Fufang Kushen injection were included in this study, providing useful reference for the development of clinical treatment ideas, and providing reference for clinical rational use of Fufang Kushen injection. High correlation and causal relations were not present in this study, so further exploration and analysis were still needed for the conclusion., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

To explore the effect of Kudiezi injection on renal function in the real world, in order to provide the basis for the clinical medication safety. Patient aged between 18-80 were selected from 18 large hospitals information system (HIS) databases established by clinical research institute for basic traditional Chinese medicine of China academy of Chinese medical sciences. The patients who were treated with Kudiezi injection (24 225 cases) were defined as the exposed group, whereas those who were not treated with Kudiezi injection (14,191 cases) were defined as the non-exposed group. The propensity score method was used to balance the confounding factors. Classic logistic regression, GBM weighted propensity score logistic regression, GBM propensity score weighted logistic regression with covariate and sensitivity analysis were adopted to study the effect of Kudiezi injection on renal function. The results showed no significant difference in the possibility in abnormality in serum creatinine (Scr) (P = 0.940, 0.679, 0.834) and urea nitrogen (BUN) (P = 0, 0.045, 0.164) between both groups. Therefore, the existing data indicated no damage of Kudiezi injection on renal function. Because this study is a retrospective study based on the real world, there may be unknown confounding factors and potential bias. Therefore, further studies shall be conducted to monitor whether Kudiezi injection causes damage on renal function, in order to ensure the clinical medication safety.

Shenfu injection is a common clinical medicine. To explore the common clinical medical combinations with Shenfu injection the real world, 25 704 patients who used Shenfu injection were selected from the hospital information system (HIS) database established by Clinical and Basic Research Institute for Traditional Chinese Medicine of China Academy of Chinese Medical Sciences. The association rules were applied in a correlation analysis on common medical combinations with Shenfu injection in the patients. According to the findings, when Shenfu injection was combined with a single medicine in clinic, the ratio of using Omeprazole, Lidocaine or Furosemide were respectively 22.19%, 20.32%, 19.61%; when Shenfu injection was combined with two medicines, the top three medical combinations were respectively midazolam + omeprazole (11.01%), lidocaine + omeprazole (10.8%) and propofol + midazolam (10.76%); when Shenfu injection was combined with three medicines, the top three medical combinations were respectively propofol + fentany + midazolam (8.83%), remifentanil + propofol + midazolam (8.77% ) and propofol + midazolam + omeprazole (8.77%). According to the further analysis, the combination of Shenfu injection and Propofol + Fentany + Midazolam may reduce the incidence of hypotension and bradycardia during anesthesia, accelerate recovery after anesthesia and relieve the synergistic effect after anesthesia. The combination of Shenfu injection and furosemide may show the synergistic effect in treating the acute left ventricular failure by reducing the returned blood volume and increasing the myocardial contractile force and vitality. The combination of Shenfu injection and Omeprazole may play the synergistic effect in shortening the digestive tract ulcer healing time, reducing the ulcer recurrence and preventing hemorrhagic shock and stress ulcer caused by shock in treating ulcer hemorrhage.

To know the characteristics of Shuxuening injection used on cerebral infarction patients in clinical practice, 6 053 cases of Hospital information system (HIS) data from 20 hospitals were analyzed. Using the basic description method and association rules to analysis the data. By analysis the data we found that the average age of cerebral infarction patients who used Shuxuening injection is 67.96, 83.94% of patients were aged 46-80. The injection is administered intravenously,with most patients receiving a dosage of 15-20 mL per dose for between 1 and 14 days. It is always combined with aspirin (48.508%), cinepazide maleate injection (22.073%), atorvastatin calcium tablets (18.873%) in clinical practice. When it comes to two drug combinations, it always combined with cinepazide maleate injection and aspirin (8.178%), nicergoline capsules and aspirin (7.63%). Therefore, based on existing data, we give the conclusion that for the treatment of cerebral infarction Shuxuening injection is mainly used for older patients, and is often combination with similar pharmacological effects chemical drugs, which is complied with the guidelines. However, the wrong dose is still exist, doctors should realize the hiding risk.

Viral hepatitis is clinical multiple strong infectious disease, to know characteristics of traditional Chinese medicine and western medicine clinical use in patients with viral hepatitis, the research object of this study is 41 180 cases of hospitalized patients with viral hepatitis in hospital information system from 17 grade A hospitals, using frequency statistics and association rules method to analyze the traditional Chinese medicine and western medicine clinical use information, the drug kinds analysis results: western medicine of reduced glutathione tablets use frequency is highest, 14 079 cases (34.61%), traditional Chinese medicine of diammonium glycyrrhizinateuse frequency is highest, 14 058 cases (34.56%); traditional Chinese medicine and western medicine drug combination in diammonium glycyrrhizinate combined with reduced glutathione tabletsuse frequency is highest, 8 607 cases (25.09%). The mechanism of drug classification results :both traditional Chinese medicine and western medicine are the sort of educed enzyme medicine that has the highest percentage of drug use, traditional Chinese medicine 10 983 cases (27.01%), western medicine, 9 595 cases (23.59%); traditional Chinese medicine and western medicine combination in a kind of medicine to clear heat and promote diuresis combined with educed enzyme drug use frequency is highest, 5 621 cases (13.82%). Through the analysis above, combine traditional Chinese and western medicine therapy for the treatment of viral hepatitis should be given priority. Traditional Chinese medicine to clear heat and promote diuresis combined with western medicine of educed enzyme drug is the most commonly appear in clinical two drug combination scheme, traditional Chinese medicine to clear heat and promote diuresis combined with western medicine of educed enzyme drug and nucleustide analogsis the most commonly appear in clinical three drug combination scheme.

Objective: To understand the real world, the use of ultra- treatment Shuxuetong injection on liver and kidney functions are affected., Method: The 18 hospitals of the country's HIS data sources from which to choose to use Shuxuetong injection, between the ages of 18 to 80 years, using Shuxuetong and the first seven days after discontinuation of at least 7 days has once aspartate aminotransferase or alanine aminotransferase, or creatinine or blood urea nitrogen were measured value as a research object, the number of days of medication is based on more than 14 days, divided into treatment group and the normal course of super-group to reach the normal range of physical and chemical indicators 200% of the upper limit is defined as abnormal. Using the propensity score method, balance the known confounding factors, differences in the occurrence of abnormal renal function and compared between the two groups., Result: The treatment group and the normal course of super-group, resulting in alanine aminotransferase, aspartate aminotransferase, creatinine, urea nitrogen equally likely targets abnormal changes, no statistically significant difference., Conclusion: Based on the available data did not find "super treatment using Shuxuetong damage the liver and kidney function" the situation, but the clinical disease lasts insist on the principle can not be arbitrarily extended treatment to prevent long-term medication.

To assess whether the Shuxuening injection influences liver function, this paper analyzes the hospital information system (HIS) data from 20 national hospitals. The patients were divided two groups: patients (5 353 cases) using Shuxuening injection acted as the exposed group, then the patients (4 863 cases) not using Shuxuening injection acted as the unexposed group. Take the abnormal changes of alanine aminotransferase and aspartate aminotransferase indexes as the result. Control confounding factors by stratification analysis, classic logistic regression analysis, before logistic regression based on propensity score weighting method and logistic regression based on generalized boosted models (GBM) of propensity score weighted combination of covariate adjustment. Then, the study analyzes the effects of Shuxuening injection on liver function by observing the changes of the indexes. Analysis of the impact of parenterally administered Shuxuening on ALT shows that, before logistic regression based on propensity score, then the regression is -0.232 (P value is 0.017). However, after logistic regression based on propensity score method the regression became -0.150 (P value is 0.370). Whereas, analysis of the impact of parenterally administered Shuxuening on AST shows that, before logistic regression based on propensity score, then the regression is -0.034 (P value is 0.767). However, after logistic regression based on propensity score method the regression became -0.091(P value is 0.538). Thus, propensity score method can control a large number of confounding factors, making the results more close to the clinic. Hence, based on existing electronic medical data, this study didn't find that parenterally administered Shuexuening influences ALT and AST.

The study was to research the clinical characteristics of Shenmai injection treating tumor based on hospital information system, including the characteristics of the age, the sex, the dosage, the course of the treatment and the combination drugs. The data of tumor patients injected with Shenmai injection was analyzed. The information was collected from the hospital information system (HIS) in twenty hospitals of grade III-A. The method of frequencies and association rules was used in this reaearch. The patients over 45 years old were up to 3 338, about 79.36% of the whole. The ratio of male and female was 1.73: 1. The hospitalization day between 15 and 28 was most. The complications of the hypertension and coronary heart disease happened most. The support was 5.939% and 5.099% respectively. Fifty-five patients had the traditional Chinese medicine (TCM) syndrome of Qi-Yin deficiency, about 14.78% of the whole. There were 8 491 patients treated with the single dose of 81 to 100 mL, about 48.70% of the whole. The main combination drugs were dexamethasone, tropisetron and maxolon. The confidence was 44.63%, 31.22% and 20.53% respectively. The information from HIS showed that tumor patients used Shenmai injection were most quinquagenarian with smooth condition. The dose of the Shenmai injection sometimes was higher than that of the drug use instructions in clinical. Shenmai injection was most often combined with glucocorticoid, antemetic and nutritional support medicine when treating tumor in clinical.

The safety of drugs has been the important issue that has caught the mutual attention of clinicians and patients. Kidney is one of the important organs in drug metabolism. The study is based on hospital information system (HIS) data from 20 nationwide general hospitals, indicated by Scr and BUN. Generalized boosted models (GBM) based on propensity score method were used to balance confounding factors. The study contrasts changes on renal function between used Shuxuening injection patients and the unused to explore whether Shuxuening injection affects renal function in clinical. The results showed that Shuxuening injection is likely to affect Scr in logistic regression (P value is 0.035); after the logistic regression based on propensity score method (P value became 0.513, 0.590), no differences were found between the two groups; before and after the logistic regression based on propensity score method (P value was less than 0.05), Shuxuening injection possibly affects BUN. Nevertheless, this study is a retrospective analysis. Logistic regression based on propensity score method can control the known confounding factors very well, while there may be the unknown ones. Therefore, the further exploration is required to monitor whether Shuxuening injection affects really BUN, which will provide clinical guidance for Shuxuening injection safe application.

Objective: To understand the real world Shuxuetong injection suspicious allergic factors., Method: National 18 hospitals of the hospital information system using Shuxuetong data, using design methods retrospective nested case-control, and contrast using Shuxuetong after the occurrence of allergic reactions in patients with non-allergic patients differences in age, gender, admission illness, allergies, etc., Result: Based on available data, indicate suspicious allergies affect Shuxuetong factors may be hospitalized illness, solvent, single dose, concomitant medications., Conclusion: When using Shuxuetong for critically ill patients should use caution and pay attention to solvents, dose, combination therapy of choice clinically. Conclusions of this study need further study to be verified.

To evaluate the efficacy of Yupingfeng droppill and western medicine in treatment of allergic rhinitis, 76 patients from Beijing Shijitan hospital during April 2011 to May 2012 were selected and randomly divided into the treatment group (n = 44) and control group (n = 32). The treatment group was treated with Yupingfeng droppill and cetirizine tablets, the control group was treated with cetirizine tablets, the effect of the two groups was observed after 28 days, after treatment, the symptoms and inferior turbinate volume contrast of the two groups were better than before. The obvious effective rate and total effective rate were 84.09%, 95.45% and 46.87%, 56.25% in the treatment group and and control group. The differences in the obvious effective rate and total effective rate were statistically significant between two groups (P < 0.05), Yupingfeng droppill has the curative effect on allergic rhinitis, which is better than simple oral cetirizine tablets.

Objective: To study the inhibitory effect of wogonin on the growth and proliferation of breast cancer cells MDA-MB-23, and observe its effect on the adhesion, migration and invasion of MDA-MB-23 cells, in order to further study its molecular mechanism., Method: MTT assay was used to detect the effect of wogonin on MDA-MB-23 cell growth. Ki-67 assay was adopted to test the effect of wogonin on cell proliferation. Scratch test, adherence test and invasion chamber assay were taken to detect the effect on the migration and invasion abilities of MDA-MB-231 cells. Proliferation and metastasis-related proteins and relevant signaling pathways were detected by Western blotting., Result: Wogonin could remarkably inhibit the growth and proliferation of MDA-MB-231 cells, significantly inhibit migration, adhesion and invasion abilities of breast cancer cells at a low concentration, and effectively inhibit the expression of Survivin, Bcl-2, ICAM-1, MMP-2, MMP-9 proteins of MDA-MB-231 cells., Conclusion: Wogonin could notably inhibit growth and proliferation of breast cancer cells, and inhibit migration, adhesion and invasion of MDA-MB-231 cells. Its invasive and adhesive effects on MDA-MB-231 cells may be related to the decrease in ICAM-1, MMP-2, MMP-9 expressions.

Objective: To assess whether the dosage of Shenmai injection influences renal function., Method: Analysis of hospital information system (HIS) data from 18 national hospitals using Shenmai injections. Patients were aged between 18 to 80 years old. Blood analysis of creatinine and serum urea nitrogen was undertaken 7 days before and after exceeding the maximum recommended dose of 100 mL of Shenmai injection. Propensity score method was used to compare the differences between the two groups of renal function scores., Result: The differences in abnormal changes in creatinine and serum urea nitrogen levels between the groups before and after exceeding the recommended dose was not statistically significant, but abnormal changes were detected., Conclusion: Based on the available data we did not find that exceeding the recommended dose of Shenmai injection had a significantly deleterious effect on renal function. However, caution should be applied in its clinical use.

Objective: To estimate treatment effects of Shuxuetong injection on abnormal changes on ALT index, that is, to explore whether the Shuxuetong injection harms liver function in clinical settings and to provide clinical guidance for its safe application., Method: Clinical information of traditional Chinese medicine (TCM) injections is gathered from hospital information system (HIS) of eighteen general hospitals. This is a retrospective cohort study, using abnormal changes in ALT index as an outcome. A large number of confounding biases are taken into account through the generalized boosted models (GBM) and multiple logistic regression model (MLRM) to estimate the treatment effects of Shuxuetong injections on abnormal changes in ALT index and to explore possible influencing factors., Result: The advantages and process of application of GBM has been demonstrated with examples which eliminate the biases from most confounding variables between groups. This serves to modify the estimation of treatment effects of Shuxuetong injection on ALT index making the results more reliable., Conclusion: Based on large scale clinical observational data from HIS database, significant effects of Shuxuetong injection on abnormal changes in ALT have not been found.

Objective: To estimate real world treatment effects of parenterally administered Shuxuetong on abnormal changes in blood urea nitrogen (BUN) index, inorder to to explore whether parenterally administered Shuxuetong affects kidney function and to provide clinical guidance for its safe application., Method: Analyze hospital information system (HIS) data and laboratory information management system (LIS) data from 18 nationawide general hospitals in China. A retrospective cohort study with two cohorts of patients, assessing abnormal changes of BUN index as an outcome, confounding factors are balanced through use of generalized boosted models (GBM) and multiple logistic regression based on adjusted propensity score to estimate treatment effects of parenterally administered Shuxuetong on abnormal changes of BUN index and to explore possible influencing factors., Result: Logistic regression based on adjusted propensity score results showed that there was a statistically significant difference (P < 0.05), in abnormal BUN in rates between the two groups. However, the GBM propensity score method showed that abnormal BUN rates were not statistically significantly different between the two groups., Conclusions: Based on large sample clinical observational data from HIS and LIS database, significant effects of parenterally administered Shuxuetong on abnormal changes of BUN have not been found. The generalized boosted models (GBM) method is more suitable for retrospective non-randomized observational data. These results should be confirmed through largescale prospective randomized controlled trials.

Objective: To understand the clinical circumstances for the use of parenterally administered Shenfu in the treatment of coronary heart disease, in order to provide a reference guide for its clinical use., Method: Information was extracted and summarized on the treatment of coronary heart disease patients, who received parenterally administered Shenfu, from 20 nationwide general hospitals HIS data. Descriptive statistical methods were used to analyze the usage and dosage. Correlation analysis was adopted to analyze information including drug combinations, and outcomes were compared with other combinations., Result: Real world HIS data showed that the drug delivery method for parenterally administered Shenfu was intravenous infusion. Treatment courses were from 3 to7 days, at a dosage of 60 mL. The drug combination was mostly with chemical drugs. The most common combinations were Shenfu plus clopidogrel, aspirin and isosorbide dinitrate., Conclusion: Parenterally administered Shenfu is a common drug used in the treatment of coronary heart disease. Most of the usage was in accordance with instructions. The chemical combination drugs were mainly clopidogrel, aspirin and isosorbide dinitrate.

Objective: Undertake analysis of the pragmatic use of Shuxuening injection, in order to understand the drug's characteristics and risks. This will provide the basis for a deeper understanding for risk management., Method: Twenty general hospitals using Shuxuening injections were selected nationwide. Data analysis of their hospital information systems (HIS), comprising 48 445 inpatients of which 13 936 had received Shuxuening injections, took place. Analysis of patient demographics, drug use, drug combinations and patient deaths was carried out., Result: More than 79% of patients were over 45 years old. Clinical use of the injection was for the treatment of cerebral infarction (equivalent to the Chinese medicine category of zhongfeng), coronary heart disease (equivalent to the Chinese medicine category of xiongbi), diabetes and hypertension. However, only 37.66% of Western medicine diagnoses are in accordance with recommendations and only 49.09% of Chinese medicine diagnoses follow the guidelines. The injection is administered intravenously, with most patients receiving a dosage of 15-20 mL per dose for between 3 and 7 days. It is always combined with aspirin in clinical practice., Conclusion: Shuxuening injection is primarily used for older patients. Several clinical risk factors have been identified including administering the wrong dose for inappropriate conditions and failure to follow guidelines. Appropriate risk management is required to protect patients.

Cerebral infarction is one of the indications for parenterally administered Dengzhan Xixin. This study aims to analyze treatment outcomes in patients with cerebral infarction of parenterally administered Dengzhan Xixin, in the real world. Data from 20 national hospitals' hospital injection system (HIS) databases were collected. 1 008 cases of parenterally administered Dengzhan Xixin for the treatment of cerebral infarction were compared with 1 504 cases who did not receive Dengzhan Xixin who acted as the control group. Outcome was defined by mortality or survival following cerebral infarction. It was found that, before controlling for confounding factors, parenterally administered Dengzhan Xixin did not have a significant effect on mortality, P = 0.098 3. Stratified analysis taking into account, age, gender, condition on admission,dosage, and length of treatment found that parenterally administered Dengzhan Xixin had significant effects on cerebral infarction mortality when dosage and length of treatment course were stratification factors; P values were 0.029 3 and 0.030 9 respectively. When applying classic logistic regression to the analysis there was no difference between the observation group and control group, P = 0.106. Generalized boosted models (GBM) and propensity score (PS) weighted Logistic regression, was then applied to balance 72 variables such as age and gender, this found that there were significant differences between the observation and control groups, P < 0.001. This study concludes that parenterally administered Dengzhan Xixin can reduce the mortality of cerebral infarction patients based on existing data. However,there are many known and unknown confounders in retrospectively analysis, and the propensity score can only control for known confounding factors. Therefore, these findings should be considered as a reference for treating cerebral infarction.

Hospital information system (HIS) data from 18 hospitals was analyzed. 107 723 cases were divided into two groups, those that received Shuxuetong and those that did not. Patients, 18 to 80 years old, suffering from cerebral infarction, whose treatment outcome was clear were selected. Resulting in 7 520 cases in the treatment group and 3 353 who did not receive parenterally administered Shuxuetong. Using propensity score, confounding factors were balanced between the two groups, three logistic regression methods were used to compare the groups following treatment for cerebral infarction. The three methods of comparison indicated that the use of Shuxuetong significantly increased cure rates compared to the control group. Therefore, based on existing data, for the treatment of cerebral infarction, the outcomes are more effective when combination therapy including Shuxuetong is used.

In order to understand the treatment of coronary heart disease with parenterally administered Shenmai and the efficacy of combination therapies, the study selected 18 hospitals for analysis. Data from each hospital's hospital injection system (HIS) was collected. Data of in-patients receiving parenterally administered Shenmai for a diagnosis of coronary heart disease was analyzed using; the Apriori algorithm to model use, Clementine 12.0 linkage analysis to find correlations between various drugs, and chi-square test for commonly used combination therapies to ascertain the cure rate. In 5 583 patients with coronary heart disease, it was found that Shenmai was commonly used with isosorbide mononitrate, aspirin, clopidogrel hydrogen and common combinations of combination therapy, and that the cure rate was better in these combinations than for other treatment regimes. When Shenmai is used with combination therapies for coronary heart disease, treatment guidelines should be complied with. In clinical application, the types of concomitant medications and their interactions, should be observed so as to prevent of adverse reactions.

Objective: Hospital information system data of cerebral infaction patients who received parenterally administered Shuxuetong was analyzed. This provided frequency data regarding patients' conditions and related information in order to provide a clinical reference guide., Method: In this study, HIS data from 18 hospitals was analyzed. Patients receiving parenterally administered Shuxuetong for the treatment of cerebral infarction were included. Information on age, gender, costsand route of administration were collated., Result: The average age of patients was 66 years old. Days of hospitalization ranged from 15 to 28 days. The majority of patients were classified as having phlegm and blood stasis syndrome, which is inaccordance with the indications for this drug. The most commonly used drugs used in combination with parenterally administered Shuxuetong were: aspirin, insulin and heparin., Conclusion: Patients with cerebral infarction crowd using parenterally administered Shuxuetong were a mostly elderly population, with an average age of 66. Although generally use was in accordance with indications, dosage, and route of administration, there were however some discrepancies. Therefore, doctors need to pay close attention to guidelines and closely observe patients when using parenterally administered Shuxuetong and to consider both the clinical benefits and risks.

The safety of parenterally administered Chinese medicine has caught the attention of clinicians, patients and drug administration departments. However, there are few studies that have assessed liver function damage from these medications. This study retrospectively analyzed hospital information system (HIS) data, from 20 nationwide general hospitals, of patients who were treated with parenterally administered Shuxuening. Patients that were given doses of 21-50 mL, which is above the recommended dose, acted as the observation group. Those receiving the recommended dose of < 20 mL were the control group. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured before and after parenteral administration of Shuxuening, changes after treatment were outcomes. Also recorded were: age, costs, length of hospitalization and the patients' condition on admission. Propensity score method was used to balance 71 confounding variables such as gender, age, mortality, and costs. The influence of dosage of ALT and AST can then be known. Analysis of the impact of parenterally administered Shuxuening on ALT, before logistic regression based on adjusted propensity score, then the P value is 0.007. However, after logistic regression based on adjusted propensity score method the P value became 0. 254. Hence, no differences were found between the two groups; using parenterally administered Shuxuening at the higher dose of 21 to 50 mL had no significant effects on ALT compared with the normal dose. Similarly analysis of AST changes before and after logistic regression based on adjusted propensity score method, P value changes from 0.192 to 0.568. There were no differences between the two groups using parenterally administered Shuxuening; a dosage of 21 to 50 mL each time had no significant effects on AST. Nevertheless, this study is a retrospective analysis, whilst known confounding factors have been taken into account there may be unknown ones to include inanalysis. Logistic regression based on adjusted propensity score method can control known confounding factors very well. This research serves as an aid to the safe clinical use of parenterally administered Shuxuening.

To assess if adverse drug reactions (ADR)s to parenterally administered Dengzhan Xixin are allergic in origin. Hospital information system (HIS) data from 20 hospitals in China were used to carry out a nested case control design study. Included were patients who received dexamethasone for suspected allergic reactions after receiving parenterally administered Dengzhan Xixin. These were compared with non-allergic reaction people. Single factor logistic regression and multiple factor logistic regression were used to analyze data. Condition on admission, allergic history, dosage, disease status and drug combinations were taken into account in cases of suspected allergic reactions. After analysis we found that the condition on admission had a significant effect, P = 0.008 3, OR value = 5.642 on suspected cases of allergic reactions. Using vitamin B6 injection or ambroxol at the same time as parenterally administered Dengzhan Xixin were significant, P = 0.000 2 and 0.016 7, OR value = 9.545 and 3.194, risk factors in this group. Based on this current research, condition on admission as well as the concomitant use of vitamin B6 or ambroxol may be the risk factors in suspected cases of allergic reactions. However, further research for verification is required. This study can provide guidance for safe clinical practice in using parenterally administered. It can also provide a new method for the pharmcovigilance of parenterally administered Dengzhan Xixin.