Developing new drugs from annals of Chinese medicine

Developing new pharmaceuticals requires massive amounts of time,money and efforts.The key step is how to find a safe and effective entity for a disease condition and how to develop it as new drug effectively.Unfortunately,the FDA’s rate of approving new entities has declined dramatically in the last three decades.There is a strong need to review the current strategy and to optimize process in developing new drugs,both to shorten the process and increase the success rate.Chinese medicine has used natural products to treat patients for thousands of years,and Chinese medicine practitioners have chronicled the patients and treatment methods for thousands of years.There is much information that has not yet been used.The success stories of artimisinin and arsentic trioxide are wonderful examples of how the annals of Chinese medicine can provide leads for discovering new drugs.This paper argues that the annals of Chinese medicine are valuable and describes how they can be used in modern drug discovery.The major topics addressed are:(i)why Chinese medicine is a rich resource for finding new drugs;(ii)how to identify a potential valuable record from Chinese medicine annals;(iii)when a potential valuable record is identified from annals,how to proceed;and(iv)both why and how the approach used for chemical drugs should be revised for drugs based on the historical documents related to herbal medicine.In conclusion,we argue here that the annals of Chinese medicine offer not only a rich resource for new drugs,but also several centuries of patient data with regard to safety and efficacy,that in effect represent pilot studies.Acknowledging and using these data can shorten new drug discovery time and improve efficiency of the drug development process,bringing more effective,safe drugs to market much more quickly and cheaply.

Risk factors associated with the progression from mild keloids to severe keloids

Background:Keloids are benign fibrous growths that are caused by excessive tissue build-up.Severe keloids exert more significant effects on patients’quality of life than do mild keloids.We aimed to identify factors associated with the progression from mild keloids to severe keloids,as distinct from those associated with the formation of keloids.Methods:In this retrospective case-control study,251 patients diagnosed with keloids at West China Hospital between November 2018 and April 2021 were grouped according to the severity of lesions(mild[n=162]or severe[n=89]).We collected their basic characteristics,living habits,incomes,comorbidities,and keloid characteristics from Electronic Medical Records in the hospital and the patients’interviews.Conditional multivariable regression was performed to identify the independent risk factors for the progression of keloids.Results:Eighty-nine patients(35.5%)were classified as having severe keloids.We found the distribution of severe keloids varied with sex,age,excessive scrubbing of keloids,family income,the comorbidity of rheumatism,disease duration,characteristics of the location,location in sites of high-stretch tension,the severity and frequency of pain,the severity of pruritus,and infection.Multivariable analysis revealed significant associations between severe keloids and infection(odds ratio[OR],3.55;P=0.005),excessive scrubbing of keloids(OR,8.65;P=0.001),low or middle family income(OR,13.44;P=0.021),comorbidity of rheumatism(OR,18.97;P=0.021),multiple keloids located at multiple sites(OR,3.18;P=0.033),and disease duration>15 years(OR,2.98;P=0.046).Conclusion:Doctors should implement more active and thorough measures to minimize the progression of mild keloids in patients who have any of the following risk factors:infection,excessive scrubbing of keloids,low or middle family income,comorbidity of rheumatism,multiple keloids located at multiple sites,and disease duration>15 years.