Preliminary studies of acute and sub-chronic toxicity of the aqueous extract of Guibourtia tessmannii(Harms) J.Leonard stem barks (Caesalpiniaceae) in mice and rats

Objective: To investigate the toxicity of aqueous extract of Guibourtia tessmannii(Harms) J. Leonard(G. tessmannii) and evaluate its safety.Methods: NMRI mice were used to determine the acute toxicity of G. tessmannii.Increasing concentrations of the plant extracts were administered intraperitoneally or by force-feeding. General behavior and death were monitored and recorded daily for 7 days.In order to determine the sub-acute toxicity of the extract, several doses were administered by oral gavage daily for 28 days in adult Wistar rats. Different parameters were assessed including body weight, food and water intake, biochemical parameters and several vital organ weights.Results: LD50 of 328.78 mg/kg was obtained by i.p. route and more than 5 000 mg/kg was obtained in acute toxicity by oral route. In sub-acute toxicity, no significant alteration was observed in body weight or vital organs, food and water intake, and biochemical parameters.Conclusions: The results showed that the aqueous extract of G. tessmannii has low toxicity intraperitoneally and no sub-acute toxicity via oral intake.

Use of Chinese herbal medicine to treat AD: advantageous efficacy and stimulation of PKA signaling at crossroad between neural plasticity enhancement and pTau clearance

OBJECTIVE Currently, almost all chemical compounds or biological reagents to reverse or slow down the AD process have failed in clinical trials. An integrative and multi-targeted strategy is increasingly appreciated to effectively combat this devastating disease. Traditional Chinese medicine(TCM) has been widely used for treatment of dementia, and thus the advantages of the potential therapeutic features of TCM treatment and associated mechanisms should be well taken. The Amnesia Remedy Formula(ARF) was invented by one of the most influential Master of TCM SUN Si-miao, who lived for about 100 year old. The aim of this research is to characterize the time course changes of the cognitive behaviors post a ARF, and the mechanism underlying the effects, focusing on PKA-centered signaling for both enhancement of neural plasticity and clearance of the phosphorylated Tau. RESULTS We tested the efficacy of ARF on two animal models of AD, and examine the central role of PKA signaling in the enhancement of neural plasticity via PKA/CREB/BDNF pathway as well as clearance of toxic p Tau via PKA/GSK3β/p Tau pathway. In the scopolamine model, ARF effectively reversed the memory in Morris water maze(MWM) test, with some features superior to anti-AD drug donepezil. In a battery test of MWM, novel object recognition or T maze in 5-month-old senescenceaccelerated mouse prone 8(SAMP8) strain mice, two weeks of administration of ARF showed overall better improvement in memory loss than donepezil, and the effect lasted for at least 1 week after termination of administration of the formula. ARF increased expression of PKA/CREB/BDNF and synaptic proteins PSD95 expression, as well as enhanced Ser9 phosphorylation of GSK3β, thus reduced p Tau in the hippocampus. Blockade of PKA signaling blunted the anti-AD-like effect of ARF, with reversal of CREB/BDNF signaling. Transcriptomic analysis indicated some changes of novel molecules along this pathway may be part of the pathological and therapeutic mechanism, which warrants further investigation. CONCLUSION ARF may display some advantageous features in treating AD with early onset, via multi-targeted manner including enhancement of neural plasticity and reduction in Tau toxicity.

A Histological Study on Subacute Toxicity of "Baikening" in Hy-Line Brown Roosters

[ Objective] A histological study was conducted to investigate the toxicity of ＂Baikening＂ and the toxic effect of ＂Baikening＂ on roosters after longer- term administration at different dose levels. [ Method] Thirty 21-day-old Hy-Line Brown roosters were administered with 0.5 and 1.0 ml of ＂Balkening＂ aqueous extract through drinking water once a day for continuous 14 d. Roosters in control group and experimental groups after drug administration for 14 d and drug with- dmwal for 7 d were euthatfized; livers, kidneys, thymuses, spleens and bursas of Fabricius were collected and weighed for comparative analysis. Various tissues were prepared into paraffin-embedded slices and stained by H. E. , to observe histological changes of various organs under an optical microscope. [ Result ] After drug administration for 14 d, all the roosters in experimental groups survived; there was no visible pathological change in various organs of Hy-Line Brown roosters in each group; organ weights of Fly-Line Brown roosters in various groups showed no significant difference; observation results of tissue slices indicated that there was no pathological change in fine structures, nuclei and cytoplasm of various organs of Hy-Line Brown roosters in different groups ; various blood vessels in different organs also presented no change in blood circulation or other pathological changes. [ Conclusion] ＂Baikening＂ aqueous extract （oral administration） has no toxic and side effect on roosters in the subacute toxicity experiment.

Development of Chinese herbal medicine for sensorineural hearing loss

According to the World Health Organization’s world report on hearing,nearly 2.5 billion people worldwide will suffer from hearing loss by 2050,which may contribute to a severe impact on individual life quality and national economies.Sensorineural hearing loss(SNHL)occurs commonly as a result of noise exposure,aging,and ototoxic drugs,and is pathologically characterized by the impairment of mechanosensory hair cells of the inner ear,which is mainly triggered by reactive oxygen species accumulation,inflammation,and mitochondrial dysfunction.Though recent advances have been made in understanding the ability of cochlear repair and regeneration,there are still no effective therapeutic drugs for SNHL.Chinese herbal medicine which is widely distributed and easily accessible in China has demonstrated a unique curative effect against SNHL with higher safety and lower cost compared with Western medicine.Herein we present trends in research for Chinese herbal medicine for the treatment of SNHL,and elucidate their molecular mechanisms of action,to pave the way for further research and development of novel effective drugs in this field.

A Comprehensive Review on Preclinical Safety and Toxicity of Medicinal Plants

Background:Globally,80%people use plant-derived products for treating or preventing diseases.One prevalent perception about medicinal plants is that they are safe and devoid of adverse effects.However,approximately 1,50,000 plants contain toxic substances.Objective:The present review focuses on medicinal plant extracts/fractions toxicity assessments made in preclin-ical models by oral route.Methods:Detail studies were searched from databases including PubMed and Google Scholar.A manual reference screening of the selected studies was done to identify relevant articles,with no language restriction being imposed at the time of searching.Results:The studies included were performed in rodents,and the test substances were administered orally.Our search revealed 33 widely used plants or products with significant toxicity,and phytochemicals from these plants have been summarized.Through a systematic review,we identified a plethora of medicinal plant extracts reporting safety and toxicity concerns.Conclusion:In the future,preclinical toxicokinetic studies of herbs and the determination of their no-observed-adverse-effect levels are required for a complete safety assessment.Finally,the interaction of herbs with com-monly used/over-the-counter drugs in terms of the latter’s metabolic profile should be undertaken.

Chemical fingerprinting of Su-He-Xiang-Wan and attribution of major characteristic peaks for its quality control by GC-MS

Su-He-Xiang-Wan (SHXW ) 的一条简单、灵巧的煤气的层析团分光计(GCMS ) 指纹被开发，类似分析被进行，并且主要典型山峰的归属为 SHXW 质量控制被识别。GCMS 分析在一台 QP2010 仪器上被执行(Shimadzu，日本) 与 RTX-5MS 的毛状的列装备了。列温度在 50 点被开始 ???????? 控慬獳??? 汰獵瀭畬 ?? ￣′吗？

In silico method for studying property combination of traditional Chinese herbs

Objective:This paper discusses the composition of prescription qualitative,quantitative design principles and methods based on herbal property combination,describing the method application in new prescription design.Method:Qualitative property-combination pattern(PP)calculation was based on bipartite graphing and performing a greedy algorithm which was designed to optimize obtaining a new herbal prescription.Quantitative PP calculation was based on the qualitative computation.To calculate the Euclidean distance for the PP of the new prescription,an optimized algorithm for solving the unknown minimum Euclidean distance was used with,the new weighted proportions.Finally,non-linear optimization software was used to find the minimum Euclidean distance.Results:Using the PP of classic prescription Large Yin-Nourishing Pill,applying quantitative PP calculation a new prescription was created.Mathematical algorithms based on property combinations of traditional Chinese herbs can be applied to identify compatibility and synergies of herbs within prescriptions,especially classic formulas.Conclusion:In silico methods can then be used to create new prescriptions or modify existing ones depending on need.This type of automated approach may increase efficiency in designing new drugs based on Chinese herbs.

Disease-based Toxicology on Safety Assessment Strategy and Application for Herbal and Traditional Medicines

The safety issue on herbal and traditional medicines(H&TM) is one of the most challenging problems and serious concern worldwide. With scientific endeavor and further exploration, we came to realize that there are great differences between H&TM and synthetic drugs in many aspects, such as medical theory, medication experience, compatibility, processing, toxicological characteristics, and safety evaluating requirements. In the current preclinical models for synthetic drugs, the safety assessment results of some conventional deemed 'nontoxic' H&TM were not well consistent with clinical situations, which resulted in major difficulties to understand the mechanisms and guide the safe and rational uses of these H&TM. Thus, based on the traditional Chinese medicine toxicity theory called You Gu Wu Yun, this paper introduces a novel safety assessment strategy for H&TM, named as disease-based toxicology. It aims to cognize the relativity and susceptibility of the toxicity of H&TM, and then to enhance controllability in new drug development and clinical applications. It also provides a theoretical practice for the traditional Chinese medicine toxicity theory and a methodological promotion for the future development of the precision toxicology for H&TM.

方剂有毒药物配伍“增效减毒”的现代研究进展

方剂配伍包含了君臣佐使配伍、七情配伍、药性配伍(四气五味、升降浮沉、性味归经)。古代将一切治疗疾病的药物统称为毒药,按不良反应大小来分;现代则是以对人体不良影响为不良反应。增效即是相须相使,减毒即是相畏相杀。现回顾近年来相关文献,从方剂有毒药物配伍增效减毒内涵、规律和现代科技增效减毒新工艺为3个方面,重点从方剂有毒药物配伍增效减毒规律所包括的君臣佐使法,拆方法,药味、药量变化法,合方法,补脾护胃、顾护中气法、性效相制相成法等探讨方剂有毒药物配伍“增效减毒”的现代研究进展。

中药汤剂治疗乳腺癌患者蒽环类药物化疗心脏毒性的meta分析

目的:用Meta分析(Meta-analysis)对中药汤剂口服治疗乳腺癌患者发生蒽环类药物化疗心脏毒性的情况进行综合分析,以期将中药汤剂作为为临床治疗乳腺癌蒽环类药物心脏毒性的治疗方法。方法:收集已公开发表的有关中药复方口服乳腺癌患者蒽环类药物化疗心脏毒性的临床疗效的临床随机对照试验,分析其选方用药规律,采用RevMan5.2对符合条件的研究进行Meta分析,评价中医药对乳腺癌患者蒽环类药物化疗心脏毒性的临床疗效。结果:符合纳入标准文献共10篇,总样本量648例。中医药+蒽环类药物化疗与单纯蒽环类药物化疗对比,心电图改变的更少,其差异有统计学意义[风险比(odds risk,OR)=0.23,95%可信区间(Confidenceintervals,CI)(0.16,0.34),P <0.00001]。心功能下降更少,其差异有统计学意义[OR=0.18,95%CI(0.09,0.37),P <0.00001]。左心室收缩功能有所改善,其差异有统计学意义[均数差(mean difference,MD)=3.82,95%CI(0.29,7.36),P=0.03 <0.05],心肌酶谱和心肌肌钙蛋白T均有所改善。结论:中医汤剂具有一定的抗乳腺癌患者心肌蒽环类药物损伤的作用。

基于数据挖掘和网络药理学探讨治疗抑郁症的中药复方专利用药规律及机制

目的基于数据挖掘、网络药理学方法,分析探讨治疗抑郁症的中药复方专利用药规律以及核心药物的分子作用机制。方法通过中国专利公布公告网检索获得治疗抑郁症的中药复方,提取中药名称、药味、药性、归经等信息,借助Microsoft Excel 2016、SPSS Modeler 18.0、Cytoscape 3.9.1、中医传承计算平台V3.5软件,对中药进行用药频次、性味归经、关联规则分析,并筛选出核心药物。在数据挖掘基础上,借助中药系统药理数据库与分析平台(TCMSP)获取核心药物的活性成分并预测其作用靶点;通过DisGeNET、GeneCards数据库收集抑郁症靶点,并利用EVenn在线平台获得核心药物治疗抑郁症的潜在靶点;通过STRING 11.5数据库分析蛋白-蛋白相互作用(PPI)及关键靶点网络;借助Cytoscape 3.9.1软件构建核心药物-成分-潜在靶点-通路网络;利用R软件包org.Hs.eg.db(version 3.1.0)和ClusterProfiler(version 3.14.3)对潜在靶点进行基因本体(GO)和京都基因与基因组百科全书(KEGG)富集分析。结果①本研究共收集303首中药复方、涉及中药663味,其中使用频次≥30次的中药有26味,共出现1469次,占总频次的39.93%。②本研究涉及的663味中药的药性以温、寒、平为主,药味以甘、苦、辛为主,归经以肝、心、脾、肺、肾、胃为主。③关联规则显示,中药复方治疗抑郁症常用药物组合有15组,涉及中药有当归、柴胡、甘草、郁金、白芍、茯苓等。④网络药理学分析结果显示,中药复方核心药物当归、柴胡、甘草、郁金、酸枣仁、白芍、茯苓的主要活性成分可能是植物甾醇、茯苓酸D、胡萝卜苷、芍药吉酮和当药黄素,这些成分可能作用于非受体酪氨酸蛋白激酶(SRC)、V-Rel网状内皮增生病毒癌基因同源物A(RELA)、蛋白激酶B(AKT)1等关键靶点,并通过调控白介素-17(IL^(-1)7)、C型凝集素受体(CLRs)、肿瘤坏死因子(TNF)、磷脂酰肌醇3激酶(PI3K)/AKT等多条信号通路发挥作用。结论治疗抑郁症的中药复方专利主要涉及疏肝药、理气药、补血药,核心药物有当归、柴胡、甘草、郁金、酸枣仁、白芍、茯苓;其作用机制可能主要与免疫系统信号通路以及神经炎症相关。

PDCA循环在提高中药饮片处方合格率的应用分析

目的研究使用PDCA循环提升中药饮片处方合格率的效果。方法回顾性对2017年10~12月连续3个月中药饮片处方进行点评,根据点评结果,找出影响因素进行干预,进入PDCA循环。结果经过两个阶段的持续改进,门诊中药饮片处方合格率分别为82.79%(循环前)、93.03%(第一阶段循环后)和98.26%(第二阶段循环后)。门诊中药饮片处方不合格的问题类型构成比较循环前明显改善(P<0.05)。结论PDCA循环在提升中药饮片处方合格率方面效果显著。

临床中药师干预对中药处方规范性的影响

目的:探讨临床中药师干预对中药处方规范性的影响。方法:随机抽取2020年1—12月北京方庄社区卫生服务中心中医科开具的中药处方1 200张作为对照组,2021年1—12月中药处方1 200张作为研究组。对照组采用常规管理模式,研究组采用临床药师干预模式。比较两组不合理处方发生情况,分析不合理处方类型。结果:两组不合理处方占比前三的原因为超量用药、诊断不规范、脚注缺失,其中研究组超量用药、诊断不规范、脚注缺失以及重复用药发生率低于对照组,差异有统计学意义(P<0.001);两组用药禁忌、书写不规范发生率比较,差异无统计学意义(P>0.05)。结论:临床中药师干预能够促进中药处方规范性提高,减少不合理处方。

PDCA循环法在中药饮片处方质量中的应用

目的:探讨PDCA循环法在中药饮片处方质量改进中的应用,促进中药饮片的合理使用。方法:首先对中药饮片处方不合理现状和造成处方不合理的原因进行分析,然后按照PDCA循环法的四个阶段,即制定计划和目标、执行、检查、处理,对中药饮片处方进行持续质量改进,比较PDCA循环法运用前后中药饮片处方合格率的情况和不合理处方类型变化情况。结果:中药饮片处方的合格率由改进前低于90%提高到97%,不合理处方类型问题逐渐变得单一,不规范处方的数量明显减少。结论:PDCA循环法对中药饮片处方质量有明显的提高,促进了中药饮片的合理使用。

基于HL7 CDA的中草药处方文档规范构建

目的:参照HL7 CDA文档规范的表示方法,对中医处方中中草药处方的数据进行建模,并建立中草药处方的CDA文档规范,使其能够完整地表示中草药处方的信息。方法:通过研究中医电子病历处方信息特征及组成结构,将中医电子处方信息抽象提取相应的信息元素,参照HL7 CDA模板构建中草药处方文档规范,使其能够充分表达中草药处方信息的概念与属性。结果:通过将中草药处方数据元素与CDA模板进行映射来完成中草药处方的数据表达具有可行性,为中医处方信息规范化研究提供了新的指导方法。

归脾汤治疗消化性溃疡中远志的应用与思考

归脾汤是临床治疗消化性溃疡的常用方剂,但部分患者使用后容易出现消化道不适症状。远志作为其重要的组成药物,对胃酸具有双重调节作用,既可抑制胃酸分泌,又可抑制胃肠运动导致胃酸增多,从而引起胃肠道不适。通过梳理文献,从远志的药理作用研究、归脾汤在消化性溃疡中的应用情况、归脾汤中远志的作用分析等方面,聚焦单味药和复方探讨归脾汤治疗消化性溃疡中远志的作用,并从剂量、炮制、配伍角度梳理归脾汤中使用远志的注意事项,建议远志用蜜炮制,用量控制在3~10 g为宜,并与甘草、石菖蒲、厚朴按比例配伍使用,且不宜长期使用。

中药饮片处方的临床不合理用药情况分析

目的分析中药处方的临床不合理应用情况,并进行中药处方点评,以探讨中药处方点评对中药饮片使用合理性的影响。方法将开展中药处方点评前(2019年1~12月)的650张处方作为对照组,开展中药处方点评后(2020年1~12月)的710张处方作为研究组。对照组未开展中药处方点评,研究组开展中药处方点评。比较两组不合理处方发生情况及医患纠纷发生情况。结果研究组的不规范处方、不适宜处方、大处方发生率分别为21.97%、30.42%、0.99%,均明显低于对照组的73.69%、69.08%、5.08%,差异有统计学意义(P<0.05)。研究组医患纠纷发生率为1.27%(9/710),低于对照组的6.77%(44/650),差异有统计学意义(P<0.05)。结论中药饮片临床应用存在较多不合理用药情况,通过中药处方点评可有效的促进中药饮片的合理应用水平,并能监测中药饮片的用药质量,加强中药饮片处方的监管,从而保障患者的用药安全,改善医患关系。

我院儿科门诊0~12周岁儿童毒性中药处方的回顾性分析

目的 分析我院儿科门诊2022年0~12周岁儿童毒性中药处方的使用情况及特点。方法 回顾性分析2022年我院儿科门诊0~12周岁儿童毒性中药处方的临床资料,并对患儿的年龄、性别、疾病、中药处方、剂量等数据进行统计分析。结果 调查获得处方共计816张,包含12种毒性中药成分。依照《中国药典(2020年版)》中对于毒性中药的描述,有毒中药为炒苍耳子、制草乌以及制川乌,小毒中药为燀苦杏仁、川楝子、蛇床子、艾叶、胆南星、法半夏、细辛、重楼以及蒺藜。这12味毒性药物中大部分为辛、苦药,主要归肺、肝、肾经。在我院儿科门诊816例0~12周岁患儿中,男518例,占比63.48%;女298例,占比36.52%。其中学龄前期(3~6岁)患儿使用含毒性中药处方占比最高,婴儿期患儿占比最低,4岁儿童毒性中药使用率居于第一位。含有毒性中药的处方大部分主治呼吸系统疾病,排名第1位的主要证型为风邪外袭证。在开具的含毒性中药处方中,排名前4位的中药分别是燀苦杏仁、法半夏、炒苍耳子以及细辛。部分药物(总计89例)存在超剂量使用情况,占比10.91%,其中法半夏占比最高。结论 目前,儿科门诊开具的中药处方中含有毒性中药属于普遍现象,但仍需要严格监督其合理使用,应尽量避免在用药过程中出现超药典剂量用药的情况。

PDCA循环法在中药饮片处方管理中的应用

目的探讨PDCA循环法在中药饮片处方管理中的应用效果。方法在医院2018年1月至2018年12月采取PDCA循环法管理中药饮片处方,期间随机选取120张中药饮片处方作为研究组样本;在医院2017年1月至2017年12月采取常规管理方法管理中药饮片处方,期间随机选取120张中药饮片处方作为对照组样本;就2组中药饮片处方合格率、不合格处方存在问题情况进行对比分析。结果研究组的中药饮片处方合格率为95%,对照组处方合格率为78%,研究组较对照组处方合格率明显提高,不合格处方明显减少,处方存在的问题也逐渐趋于单一化。结论PDCA循环法在中药饮片处方质量管理中的应用效果确切,可提高中药饮片处方合格率,从而提高中药饮片处方质量。

Analysis of Herbal Medicine Prescriptions for Patients in An Academic Korean Medical Hospital:A Cross Sectional Study of Electronic Medical Records(2010–2013)

Objective： To obtain fundamental information for the standardization of herbal medicine in Korea. Methods： We analyzed the herbal medicine prescription data of patients at the Pusan National University Korean Medicine Hospital from March 2010 to February 2013. We used the Dongui-Bogam （Dong Yi Bao Jian） to classify prescribed herbal medicines. Results： The study revealed that the most frequently prescribed herbal medicine was ‘Liuwei Dihuang Pill （LWDHP, 六味地黄丸）＇ which was used for invigorating ‘Shen （Kidndy）-yin＇. ‘LWDHP＇ was most frequently prescribed to male patients aged 50-59, 60-69, 70-79 and 80-89 years, and ‘Xionggui Tiaoxue Decoction （XGTXD, 芎归调血饮）＇ was most frequently prescribed to female patients aged 30-39 and 40-49 years. According to the International Classification of Diseases （ICD） codes,‘Diseases of the musculoskeletal system and connective tissue＇ showed the highest prevalence. ‘LWDHP＇ and ＇XGTXD＇ was the most frequently prescribed in categories 5 and 3, respectively. Based on the percentage of prescriptions for each sex, ‘Ziyin Jianghuo Decoction （滋阴降火汤）＇ was prescribed to mainly male patients, and ‘XGTXD＇ with ‘Guima Geban Decoction （桂麻各半汤）＇ were prescribed to mainly female patients. Conclusion： This study analysis successfully determined the frequency of a variety of herbal medicines, and many restorative herbal medicines were identified and frequently administered.