Prescription Compatibility Research Articles

Insights into Q-marker of Shensong Yangxin capsule in treating cardiac arrhythmias based on a linear substitution strategy in quantification of multiple components.

The concept of a Quality marker (Q-marker) has emerged as a crucial tool for ensuring the safety and efficacy of Traditional Chinese Medicine (TCM) formulas. However, significant challenges remained in the identification and practical application of Q-marker, particularly due to the scarcity of reference standards. This study aimed to achieve a multidimensional integration of chemical profiling, target tissue distribution and in vivo high-throughput screening model to effectively identify the Q-marker of Shensong Yangxin Capsule (SSYX) and propose a linear substitution strategy for the quantification of multiple components. First, the chemical constituents of SSYX were detected and systematically characterized using UHPLC/Q-TOF MS. Next, through heart distribution study, high-exposure components in vivo were identified after the oral administration of SSYX. Third, a high-throughput arrhythmia zebrafish model was employed to further screen for key constituents. Finally, potential Q-marker were selected by integrating the aforementioned studies, and a quantification method for the Q-marker was developed using UHPLC-TQ-MS. The results of chemical profiling, heart tissue distribution and anti-arrhythmic activities were integrated into four properties: specificity, traceability from prescription to in vivo, effectiveness and prescription compatibility, which led to the identification of 30 ingredients as potential Q-marker of SSYX. Subsequently, an external standard method (ESM) was developed for these 30 components and applied to the analysis of 10 commercial batches of SSYX. In addition, the feasibility of multi-marker detection via a linear substitution method (LSM) was explored for the first time using SSYX as a case study for method development, based on the stability of linear equations of the compounds in single standard solutions and multi-component mixed standard solutions. The simultaneous quantification of 30 components in SSYX was achieved by employing two linearly stable substances, greatly reducing the amount of standard substances used while maintaining measurability and convenience. A comparison of LSM and ESM revealed no significant difference in the component contents calculated by the two methods, with relative errors within ± 4 %. Our results suggested that 30 ingredients, including six key elements, could be considered as Q-marker of SSYX. Moreover, the LSM strategy offered a novel approach for developing environmentally friendly and convenient methods for the quality control of multi-index components in TCM formulas.

A mathematical multiple-dimensional strategy for Q-markers identification based on “five principles”: Tianshu Capsule for migraine treatment as an example

Ethnopharmacological relevanceQuality control is a critical element for Traditional Chinese medicine (TCM). Due to the varied chemical components, mechanisms of action, and pharmacological functions in TCM, ensuring quality is more challenging compared to chemical drugs. Then, the concept of quality markers (Q-markers) was proposed and ideal Q-markers for TCM prescriptions need to compliant with “five principles”, including pharmacological effectiveness, specificity, transfer and traceability, measurability, and prescription compatibility. Aim of the studyTo establish a mathematical multiple-dimensional “spider-web” strategy and identify the Q-markers of Tianshu capsule (TSC), a Chinese patent medicine for the treatment of migraine, following the “five principles” rules. Materials and methodsQ-marker candidates of TSC were firstly screened according to the HPLC fingerprints. Their contents in 10 batches of TSC and stabilities under high temperature, high humidity and in work solutions were determined quantitatively by HPLC-UV (measurability). Their existences in Gastrodiae Rhizoma, Chuanxiong Rhizoma, TSC, rat plasma and brain samples were investigated using HPLC-Q-TOF/MS (transfer and traceability). Their anti-migraine efficacies were evaluated by network pharmacology and mice hot-plate analgesia test; and their relationships with the property (flavor) of Gastrodiae Rhizoma or Chuanxiong Rhizoma were studied by molecular docking (effectiveness). Their contributions were defined based on their herb source according to the compatibility theories of Da Chuan Xiong Fang (compatibility). Their biosynthetic pathways were studied, and their frequencies detected in different plant families were calculated (specificity). Finally, an eight dimensional “spider-web” mode was developed for 10 components, and the regression area (RA) and the coefficient variation (CV) of each candidate were calculated after data normalization. ResultsTen components including gastrodin, parishin E, chlorogenic acid, ferulic acid, isochlorogenic acid A, senkyunolide I, H, A, Z-ligustilide and levistilide A were selected and evaluated as the Q-marker candidates. The results showed that gastrodin, senkyunolide I, and senkyunolide A had the higher RA and lower CV than other compounds with the established “spider-web” mode, indicating that they could be used as the Q-markers of TSC. ConclusionThe multi-dimensional “spider-web” mode based on “five principles” was firstly applied to identify the Q-markers of TSC, and it can be used as a practical strategy to discover Q-markers of other compounded prescriptions.

A Brief Analysis of the Relationship between the Five Internal Organs and the Five Flavors Based on Yin and Yang to Guide the Compatibility of Clinical Prescriptions

A Brief Analysis of the Relationship between the Five Internal Organs and the Five Flavors Based on Yin and Yang to Guide the Compatibility of Clinical Prescriptions

Clinical centralized safety monitoring and evaluation of traditional Chinese medicine formula granules

Traditional Chinese medicine(TCM) formula granules are highly praised for the advanced, convenient, and modern use of Chinese medicinal materials. The safety of TCM formula granules has long been a concern of regulatory authorities and the medical industry. A multi-center, prospective, open, non-interventional, and centralized monitoring was carried out for the patients treated with TCM formula granules in 252 medical institutions from February 5, 2020 to April 19, 2022. All the case data and the incidence of adverse drug reactions/events were recorded. This study evaluated the safety of TCM formula granules, aiming to provide a reference for the clinically use. A total of 20 547 patients were included in this study. Four adverse events were recorded, including 3 adverse drug reactions with an adverse drug reaction rate of 0.015%, all of which occurred in the digestive system. There was no serious adverse event, and no factors related to adverse drug reactions/events were identified. The incidence of adverse drug reactions/events associated with China Resources Sanjiu Medical & Pharmaceutical Co., Ltd. TCM formula granules was rare, which proved their safety in clinical use. A comprehensive data mining and objective analysis was carried out for the medicines with high frequency in TCM formula granules, the commonly used medicine pairs and combinations, and departmental medication. The drug use characteristics, prescription rules, and departmental use of TCM formula granules were summarized, which can shed light on the prescription compatibility and clinical application.

Digeda-4 decoction and its disassembled prescriptions improve dyslipidemia and apoptosis by regulating AMPK/SIRT1 pathway on tyloxapol-induced nonalcoholic fatty liver disease in mice

Ethnopharmacological relevanceNonalcoholic fatty liver disease (NAFLD) is a manifestation of metabolic syndrome in the liver and the leading cause of chronic liver disease worldwide. Digeda-4 decoction (DGD-4) is a commonly prescribed Mongolian herbal drug for treating acute and chronic liver injury and fatty liver. However, the mechanisms underlying the improvement of dislipidemia and liver injury via treatment with DGD-4 remain unclear. Disassembling a prescription is an effective approach to studying the effects and mechanisms underlying Mongolian medicine prescriptions. By disassembling a prescription, it is feasible to discover effective combinations of individual herbs to optimize a given prescription. Accordingly, we disassembled DGD-4 into two groups: the single Lomatogonium rotatum (L.) Fries ex Nym (LR) (DGD-1) and non-LR (DGD-3). Aim of this studyTo study whether DGD-4 and its disassembled prescriptions have protective effects against tyloxapol (TY)-induced NAFLD and to explore the underlying mechanisms of action and compatibility of prescriptions. Material and methodsNAFLD mice were developed by TY induction. Biochemical horizontal analyses, enzyme-linked immunosorbent assay, and liver histological staining were performed to explore the protective effects of DGD-4 and its disassembled prescriptions DGD-3 and DGD-1. Furthermore, we performed immunohistochemical analyses and Western blotting to further explore the expression of target proteins. ResultsDGD-4 and its disassembled prescriptions could inhibit TY-induced dislipidemia and liver injury. In addition, DGD-4 and its disassembled prescriptions increased the levels of p-AMPKα and p-ACC, but decreased the levels of SREBP1c, SCD-1, SREBP-2, and HMGCS1 proteins. The activation of lipid metabolic pathways SIRT1, PGC-1α, and PPARα improved lipid accumulation in the liver. Moreover, DGD-4 could inhibit hepatocyte apoptosis and treat TY-induced liver injury by upregulating the Bcl-2 expression, downregulating the expression of Bax, caspase-3, caspase-8, and the ratio of Bax/Bcl-2, and positively regulating the imbalance of oxidative stress (OxS) markers (such as superoxide dismutase [SOD], catalase [CAT], malondialdehyde [MDA], and myeloperoxidase [MPO]). DGD-1 was superior to DGD-3 in regulating lipid synthesis-related proteins such as SREBP1c, SCD-1, SREBP-2, and HMGCS1. DGD-3 significantly affected the expression of lipid metabolic proteins SIRT1, PGC-1α, PPARα, apoptotic proteins Bcl-2, Bax, caspase-3, caspase-8, and the regulation of Bax/Bcl-2 ratio. However, DGD-1 showed no regulatory effects on Bax and Bcl-2 proteins. ConclusionThis study demonstrates the protective effects of DGD-4 in the TY-induced NAFLD mice through a mechanism involving improvement of dyslipidemia and apoptosis by regulating the AMPK/SIRT1 pathway. Although the Monarch drug DGD-1 reduces lipid accumulation and DGD-3 inhibits apoptosis and protects the liver from injury, DGD-4 can be more effective overall as a therapy when compared to DGD-1 and DGD-3.

CiteSpace knowledge map of research hotspots and frontiers of Polygalae Radix

In this study, the Web of Science and China National Knowledge Infrastructure(CNKI) were searched comprehensively for the literature about the research on Polygalae Radix. After manual screening, 1 207 Chinese articles and 263 English articles were included in this study. Excel was used to draw the line chart of the annual number of relevant publications. CiteSpace 6.1.R3 was used for the visual analysis of author cooperation, publishing institutions, keyword co-occurrence, keyword clustering, and bursts in the research on Polygalae Radix. The results showed that the number of articles published in Chinese and English increased linearly, which indicated the rising research popularity of Polygalae Radix. WANG J and LIU X were the authors publishing the most articles in Chinese and English, respectively. Shanxi University of Chinese Medicine and Chinese Academy of Medical Sciences were the research institutions with the largest number of Chinese and English publications in this field, respectively. The institutions publishing the relevant articles in English formed a system with the Chinese Academy of Medical Sciences as the core. According to the keywords, the research hotspots of Polygalae Radix included variety selection and breeding, quality standard, extraction and identification of active chemical components, prescription compatibility, processing, clinical medication rules, and pharmacological mechanism. The research frontiers were the molecular mechanisms of Polygalae Radix and its active components in exerting the protective effect on brain nerve, regulating receptor pathways, alleviating anxiety and Alzheimer's disease, as well as data mining and clinical medication summary. This study has reference significance for the topic selection and frontier identification of the future research on Polygalae Radix.

A study of the patterns of prescriptions for heart diseases in The Four Tantras (rGyud bZhi) based on the Tibetan medicinal properties theory

Objective: To reveal the internal and effective rules of prescription compatibility for treating heart diseases in the four tantras. Method: To compare the four kinds of disease in the four tantras. Result: Formulas for the treatment of loong(rlung) disease were mainly formulated sweet, pungent flavors with hot and greasy effects; formulas for the treatment of tripa(mkris-pa) were mainly formulated sweet, pungent and bitter flavors with cold and blunt effects; formulas for the treatment of beygen(bad-kan) were mainly formulated sweet, pungent flavors with hot and dynamic effects; and formulas for the treatment of khrag khrugs nad () were mainly formulated sweet, bitter flavors with cold and blunt effects. Conclusion: It can be seen that the four tantras have a rigorous and regular theory of prescriptions and strong theoretical guidance, which we need to study and learn in depth, and apply in clinical practice in conjunction with the properties of the disease.

Application of network pharmacology in the study of the mechanism of action of traditional chinese medicine in the treatment of COVID-19.

Network pharmacology was rapidly developed based on multidisciplinary holistic analysis of biological systems, which has become a popular tool in traditional Chinese medicine (TCM) research in recent years. Its characteristics of integrity and systematization provide a new approach for the study on complex TCM systems, which has many similarities with the holistic concept of TCM. It has been widely used to explain the mechanism of TCM treatment of diseases, drug repositioning, and interpretation of compatibility of TCM prescriptions, to promote the modernization of TCM. The use of TCM have provided crucial support on prevention and treatment of diseases such as the famous “three medicines and three prescriptions”. Furthermore, TCM has become an important part of the treatment of COVID-19 and is one of the main contents of the “Chinese plan” to fight the epidemic. The current review demonstrated the role of TCM in treating diseases with multiple components, multiple targets, and multiple pathways, interprets the connotation of TCM treatment method selection based on pathogenesis and also discusses the application of network pharmacology in the study of COVID-19 treatment in TCM including single drug and prescription. However, there are still some shortcomings such as the lack of experimental verification and regular upgrading of the TCM pharmacology network. Therefore, we must pay attention to the characteristics of TCM and develop a network pharmacology method suitable for TCM system research when applying network pharmacology to TCM research.

A Real-World Study on Ge Gen Tang in Combination with Herbal Medicines for Relieving Common Cold-Associated Symptoms.

Purpose Real-world evidence refers to patient data derived from the healthcare process. In this study, we used National Health Insurance Research Database (NHIRD) assessments and clinical studies of Ge Gen Tang (GGT, 葛根湯) in patients with common cold to establish a real-world study model of Traditional Chinese Medicine formulae. GGT is widely prescribed for the treatment of common cold in Taiwan, generally in combination with other medicines. The aim of this study was to determine whether a correlation exists between GGT combined with other medicines and an improvement in cold symptoms. We also established a GGT prescription compatibility system by analyzing Taiwan's NHIRD records for GGT prescription patterns in patients with different types of common cold. Materials and Methods We extracted and analyzed records from the NHIRD for the period 2000–2015 to determine the most common clinical applications of GGT. GGT and GGT with Chuan Xiung Cha Tiao San were most commonly prescribed for common cold, as per NHIRD recommendations. Records for adults aged 20–65 years who were prescribed GGT for the treatment of common cold (Diagnosis Code ICD-9-460) were included in this study. We assessed the following indicators of the common cold, before and after treatment with GGT: nasal congestion, cough, runny nose, sneezing, sore throat, hoarseness, stiff shoulder, headache, and general physical condition. Results The cold symptom scores before and after taking the GGT prescriptions significantly differed in the 29 volunteers. The 29 volunteers reported a significantly lower headache severity score after medication than before medication (p < 0.004). Furthermore, patient scores for general physical condition decreased significantly (p < 0.01) after medication.

Investigate the effect of honey on the absorption of seven active ingredients from wu-tou decoction in rats.

Wu-tou decoction has been used as a traditional Chinese medicine prescription for thousands of years. It comprises five herbs, namely Radix Aconiti Preparata, Ephedrae Herba, Astragali Radix, Glycyrrhiza Radix, and Paeoniae Radix Alba. In addition, the original prescription contains honey, but in modern research, the existence of honey is commonly ignored. The aim was to investigate the effect of absorption in rats after oral wu-tou decoction with or without honey. In this research, a rapid and sensitive UPLC-MS/MS method was investigated for the quantitative analysis of ephedrine, pseudoephedrine, paeoniflorin, calycosin-7-glucoside, glycyrrhizic acid, liquiritin, and benzoylmesaconine in rat plasma after single and continuous oral decoctions. The results of the pharmacokinetic parameters showed that Cmax , CL/F, AUC0-t , and AUC0-∞ in the honey group were significantly increased than those in the non-honey group except for ephedrine and pseudoephedrine. The same trend was observed regardless of single or continuous oral administrations. Research studies showed that honey could promote the absorption of some effective components in wu-tou decoction in rats, enhance bioavailability, and provide a theoretical basis for the scientific and rational compatibility of the original prescription.

Data Mining and Analysis of the Compatibility Law of Traditional Chinese Medicines Based on FP-Growth Algorithm

The compatibility law of prescriptions is the core link of TCM theory of “theory, method, prescription and medicine,” which is of great significance for guiding clinical practice, new drug development and revealing the scientific connotation of TCM theory, and is also one of the hot spots and difficulties of TCM modernization research. How to efficiently analyze the frequency of drug use, core combination, and association rules between drugs in prescription is a basic core problem in the study of prescription compatibility law. In this paper, a systematic study was made on the compatibility rules of traditional Chinese antiviral classical prescriptions and the mechanism of traditional Chinese medicine molecules. FP-growth algorithm was used to analyze association rules of 961 classical prescriptions collected and to explore the compatibility rules of traditional Chinese antiviral classical prescriptions. In terms of compatibility law of traditional Chinese antiviral prescriptions, this paper studied the compatibility law of traditional Chinese antiviral prescriptions based on the FP-growth algorithm and made exploratory research on the compatibility law information of 961 traditional classical antiviral prescriptions. Firstly, FP tree was constructed based on the classic recipe data set. Then, frequent item set rules were established, and association rules contained in FP tree were extracted. Finally, the frequency and association rules of antiviral TCM prescriptions were analyzed according to dosage forms (decoction, pill, paste, and ingot). The results show that the FP-growth algorithm adopted in this paper has excellent algorithm performance and strong generalization and robustness in the screening and mining of large-scale prescription data sets, which can provide important processing tools and technical methods for the study of the compatibility rule of traditional Chinese medicine prescriptions.

Clinical comprehensive evaluation of Wenxin Granules in treatment of arrhythmia with deficiency of Qi and Yin

This study evaluated the safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine of Wenxin Granules in the treatment of arrhythmia(ventricular premature beat and atrial premature beat) with deficiency of Qi and Yin. The multi-criteria decision analysis(MCDA) model was adopted, and the criterion layer and index layer were weighted by experts. CSC v2.0 was used for clinical comprehensive evaluation. This study embodies the clinical value of Wenxin Granules, promotes its safe, effective and rational use, and provides a basis for national medical decision-making. The multi-source evidence shows that the major adverse reaction of Wenxin Granules is gastrointestinal damage. According to the available studies, Wenxin Granules has controllable risk and thus is rated as grade B in terms of safety. The systematic evaluation of effectiveness shows that compared with antiarrhythmic western medicine, Wenxin Granules demonstrates improved clinical efficacy and electrocardiogram efficacy, which is supported by high-quality evidence, and thus the effectiveness of Wenxin Granules is evaluated as grade A. Economic research shows that Wenxin Granules is more economical than antiarrhythmic western medicine, which is supported by sufficient evidence and clear results, and thus the economy of this preparation is rated as grade B. The indications and contraindications of Wenxin Granules are clear and detailed to different types of arrhythmia, which, together with the precise positioning and prominent clinical innovation and industrial innovation, rates it as grade A in terms of innovation. The suitability of drug storage, prescription circulation, dosage form and course of treatment basically meet the clinical medication needs of doctors and patients, and thus the suitability of Wenxin Granules is evaluated as grade B. Because of the few restrictions and the sustainable resources of medicinal materials, the accessibility of Wenxin Granules is evaluated as grade A. The prescription compatibility focuses on the pathogenesis characteristics of deficiency of Qi and Yin, and there are more than 3 000 cases studied. Therefore, the characteristics of traditional Chinese medicine of Wenxin Granules are evaluated as grade B. Based on the evidence from all the above dimensions, Wenxin Granules has the clinical comprehensive value of class A and prominent characteristics of traditional Chinese medicine. It is suggested to include Wenxin Granules into the policy results related to basic clinical medication management according to the procedure.

The Challenges of Ethical Review in Clinical Research of Traditional Chinese Medicine.

The ethical review of TCM (traditional Chinese medicine) clinical research in China is highly consistent with that of Western medicine, but it lacks the characteristics and culture of TCM. Compared with modern medicine, TCM has its own characteristics, such as the theory of Yin-Yang and the five elements, the treatment of syndrome differentiation, and the compatibility of prescriptions. These characteristics determine the ethical particularity of TCM clinical research. This article discusses the challenges in the ethical review of TCM clinical research, such as scientific design, efficacy evaluation, risk assessment, informed consent, and placebo use. We propose opportunities and difficulties in the ethical review of TCM clinical research and provide some relevant suggestions.

The important herbal pair for the treatment of COVID-19 and its possible mechanisms

BackgroundCoronavirus Disease 2019 (COVID-19) is an unprecedented disaster for people around the world. Many studies have shown that traditional Chinese medicine (TCM) are effective in treating COVID-19. However, it is difficult to find the most effective combination herbal pair among numerous herbs, as well as identifying its potential mechanisms. Herbal pair is the main form of a combination of TCM herbs, which is widely used for the treatment of diseases. It can also help us to better understand the compatibility of TCM prescriptions, thus improving the curative effects. The purpose of this article is to explore the compatibility of TCM prescriptions and identify the most important herbal pair for the treatment of COVID-19, and then analyze the active components and potential mechanisms of this herbal pair.MethodsWe first systematically sorted the TCM prescriptions recommended by the leading experts for treating COVID-19, and the specific herbs contained in these prescriptions across different stages of the disease. Next, the association rule approach was employed to examine the distribution and compatibility among these TCM prescriptions, and then identify the most important herbal pair. On this basis, we further investigated the active ingredients and potential targets in the selected herbal pair by a network pharmacology approach, and analyzed the potential mechanisms against COVID-19. Finally, the main active compounds in the herbal pair were selected for molecular docking with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) 3CLpro and angiotensin converting enzyme II (ACE2) for further verification.ResultWe obtained 32 association rules for the herbal combinations in the selection of TCM treatment for COVID-19. The results showed that the combination of Amygdalus Communis Vas (ACV) and Ephedra sinica Stapf (ESS) had the highest confidence degree and lift value, as well as high support degree, which can be used in almost all the stages of COVID-19, so ACV and ESS (AE) were selected as the most important herbal pair. There were 26 active ingredients and 44 potential targets, which might be related to the herbal pair of AE against COVID-19. The main active ingredients of AE against COVID-19 were quercetin, kaempferol, luteolin, while the potential targets were Interleukin 6 (IL-6), Mitogen-activated Protein Kinase 1 (MAPK)1, MAPK8, Interleukin-1β (IL-1β), and Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) p65 subunit (RELA). The protein-protein interaction (PPI) cluster demonstrated that IL-6 was the seed in the cluster, which plays an important role in connecting other nodes in the PPI network. The potential pathways mainly involved tumor necrosis factor (TNF), Toll-like receptor (TLR), hypoxia-inducible factor-1 (HIF-1), and nucleotide-binding oligomerization domain (NOD)-like receptor (NLRs). The molecular docking results showed that the main active ingredients of AE have good affinity with SARS-COV-2 3CLpro and ACE2, which are consistent with the above analysis.ConclusionsThere were 32 association rules in the TCM prescriptions recommended by experts for COVID-19. The combination of ACV and EAS was the most important herbal pair for the treatment of COVID-19. AE might have therapeutic effects against COVID-19 by affecting the inflammatory and immune responses, cell apoptosis, hypoxia damage and other pathological processes through multiple components, targets and pathways.

Exploring the Mechanism of Lingzhu San in Treating Febrile Seizures by Using Network Pharmacology.

Lingzhu San (LZS) is a traditional Chinese medicine (TCM) prescription that can be effective in treating febrile seizures (FS) and there are few research works conducted on its mechanisms. In order to better guide the clinical use of LZS, we used the research ideas and methods of network pharmacology to find the potential core compounds, targets and pathways of LZS in the complex TCM system for the treatment of FS, and predict the mechanism. Databases such as BATMAN, TCMSP, TCMID, and SWISS TARGET are used to mine the active compounds and targets of LZS, and the target information of FS is obtained through GENECARDS and OMIM. Using Venny2.1.0 and Cytoscape software, the potential core compounds and targets of FS were obtained. The R language and ClusterProfiler software package are adopted to enrich and analyze the KEGG and GO pathways of the core targets and the biological processes and potential mechanisms of the core targets are also revealed. 187 active compounds and 2113 target proteins of LZS were collected. And 38 potential core compounds, 35 core targets and 775 metabolic and functional pathways were screened, which were involved in mediating FS. Finally, the role of the core compounds, targets and pivotal pathways of LZS in regulating FS in the pathogenesis and the therapeutic mechanism of FS were discussed and clarified. In this paper, the multi-compounds, multi-targets and multi-pathways mechanism of LZS in the treatment of FS were preliminarily screened through the analysis of network pharmacology data, which are consistent with the principle of multi-compounds' compatibility with TCM prescriptions and a unified treatment of diseases from multiple aspects, and it provides a new way for TCM to treat complex diseases caused by multiple factors.

Discussion on Relevance and Studies of Prescription Compatibility in Chinese Medicine.

With Chinese medicine (CM) gaining popularity in recent years, researchers and clinicians have put in much interest and effort into the makings and effects of it, especially after the recent announcement of World Health Orgnitation's incorporation of CM into mainstream medical compendium. Individual herb has complex properties, coming from its pharmacological properties and the Chinese medical principles of organ-directed, taste and dynamic orientational behaviours. The use of individual herb in CM is rare, where various herbs/ingredients are mostly found in a prescribed formula. To fully reveal the effects of CM is a great challenge. The complexity of various herbs in combined effect, the absorption and utility rate by the body, uniqueness of individual physique, sub-types of pathological behaviors and time-line progression of the healing process add on to the complication of understanding the full effect of CM. Various theories such as pathophysiology guidance, pharmacokinetic-pharmacodynamic compatibility method, and Global Systems Biology for Integrative Genomics, Proteomics and Metabolomics, which interactively provide a wider scope, more details, with the consideration of development timeline, may shed more light to revealing the full picture of the effects of compatibility prescription.

Adherence to ASCO for Prophylaxis of Acute Chemotherapy- Induced Nausea and Vomiting in Iran.

Introduction:Chemotherapy-induced nausea and vomiting (CINV) is one of the scariest chemotherapy-induced adverse effects. We evaluated the adherence to the 2017 American Society of Clinical Oncology (ASCO), the latest guideline recommendations, for the management of acute CINV at our institute. Methods:During a 6-months cross-sectional study on outpatient’s cancer patients, we collected data from the prescription documents during temporary hospitalization and compared the results with ASCO guideline recommendations. Results:The most prescribed prophylactic regimens for the management of CINV were combination of aprepitant, granisetron, and dexamethasone and metoclopramide (51.8%). Regarding prescription compatibility in our center with ASCO guideline recommnedations, selection of different regimens for prophylaxis of acute CINV in our institute was compliant in 0 %, 22%, 4%, and 40% of high, moderate, low, and minimal emetogenic potential of chemotherapy regimen groupss, respectively. Conclusion:Although our hospital is a referral and university-affiliated center, adherence to the ASCO guideline recommendations for prophylaxis of CINV was poor.

Prescription compatibility connotation and action mechanism of Siwu Decoction in treating primary dysmenorrhea

The aim of this paper was to study the prescription compatibility connotation in the treatment of primary dysmenorrhea(PD) and verify the mechanism as predicted by network pharmacology of Siwu Decoction(SWD). Mice PD model was constructed by using estradiol benzoate-oxytocin. PD mice were randomly divided into 8 groups, namely normal group, model group, positive group, complete formula group, Rehmanniae Radix Praeparata-free group, Paeoniae Radix Alba-free group, volatile oil-free group, Chuan-xiong Rhizoma and Angelicae Sinensis Radix-free group. Latent time, writhing times, inhibition rate, prostaglandin F_2_α(PGF_2_α) and prostaglandin E_2(PGE_2) levels in serum, endothelin-1, Ca~(2+), expression levels of prostaglandin synthase 2 G/H(PTGS2), estrogen receptor(ESR1), glucocorticoid receptor gene(NR3 C1) mRNA and protein expression levels in the uterus homogenate and pathological changes of uterine tissue were index to explore the prescription compatibility connotation and verify the mechanism of SWD in the treatment of PD. Compared with the extraction liquid of the whole recipe, the effect of Rehmanniae Radix Praeparata-free group and Paeoniae Radix Alba-free group with volatile oil were slightly lower, the effect of essential oil-free group was significantly lower, and the effect of Chuanxiong Rhizoma and Angelicae Sinensis Radix-free group was worse than that of the whole recipe. The relative expression levels of PTGS2 protein and mRNA were significantly reduced by the SWD. The relative expressions of protein and mRNA of ESR1, NR3 C1 were significantly increased. SWD treats PD by regulating the expression of key proteins PTGS2, ESR1 and NR3 C1.Its main medicinal herbs were Angelicae Sinensis Radix and Chuanxiong Rhizoma. Active components were mainly in volatile oil, but Paeo-niae Radix Alba and Rehmanniae Radix Praeparata also had some contributions.

Study on medication regularity of chronic atrophic gastritis in Beijing-Tianjin-Hebei region based on latent structure model

To explore the etiology, pathogenesis, distribution of syndromes and the rule of medication of chronic atrophic gastritis(CAG) in Beijing-Tianjin-Hebei region based on the latent structure model. Chronic atrophic gastritis of 279 cases in Beijing-Tianjin-Hebei region were extracted from the established database of spleen and stomach diseases of famous veteran Chinese medicine experts. The latent structure models of symptoms and drugs of chronic atrophic gastritis were constructed by using Lantern 3.1.2 software, and the latent structure models were interpreted. SAS 10.0 software was used to mine association rules of drugs and symptoms. The constitutional characteristics of patients with chronic atrophic gastritis in Beijing-Tianjin-Hebei region were "turbid toxin and damaging Yin". The common syndromes were turbid toxin, deficiency of stomach Yin, stagnation of liver and stomach, stagnation of liver and stomach Qi, obstruction of stomach collaterals and blood stasis, and weakness of spleen and stomach. Common medicines are Lobeliae Chinensis Herba, Scutellariae Barbatae Herba, Amomi Fructus Rotundus, Amomi Fructus, Poria, Isatidis Radix, Artemisiae Scopariae Herba, Scorpio, Coptidis Rhizoma, Lilii Bulbus, Linderae Radix, Phragmitis Rhizoma, Ophiopogonis Radix, Pogostemonis Herba, Eupatorii Herba, Magnoliae Officinalis Cortex, Aurantii Fructus Immaturus. Common prescriptions are Baihe Wuyao Powder, Danggui Shaoyao Powder, Xiaoyao Pills, Xiangsu Powder, Dachengqi Decoction, Zuojin Pills, Qingzhong Decoction, Zhishi Daozhi Pills, etc. The application of latent structure model and correlation analysis in the empirical study of famous and veteran Chinese medicine experts is in line with the research direction of modern Chinese medicine "traditional Chinese medicine + X". The conclusions obtained effectively tap the experience of famous and veteran TCM experts, and provide a data and visual clinical reference and prescription compatibility for young TCM physicians in the treatment of chronic atrophic gastritis based on syndrome differentiation.

Screening the Best Compatibility of Selaginella moellendorffii Prescription on Hyperuricemia and Gouty Arthritis and Its Mechanism.

Objectives The Selaginella moellendorffii prescription (SMP) consists of S. moellendorffii Herba (SM), Smilacis glabrae Rhizoma (SGR), and Plantaginis Semen (PS). It has been commonly used to treat hyperuricemia and acute gouty arthritis as a hospital preparation. This study was aimed at investigating the best compatibility ratio of SMP on hyperuricemia and gouty arthritis and getting better insight of the possible mechanism. Methods. In vitro, anti-inflammatory activity of SMP was evaluated by lipopolysaccharide (LPS) induced RAW264.7 cells. The release of nitric oxide (NO) was screened by Griess assay, and NF-κB p65 and NLRP3 proteins expression was examined by immunofluorescence assay. Then, the levels of creatinine (Cr), blood urea nitrogen (BUN), and uric acid (UA) were detected in mice induced by potassium oxonate, and the paw oedema, inflammatory mediators, and histological examination were analyzed in rats induced by monosodium urate (MSU). HPLC method was employed to investigate the chemical profile of this preparation. Results. In vitro, SMP-3 (the ratio of SMP:SGR:PS was 3:1:1) exhibited the most potent anti-NO production activity without obvious toxicity. This anti-inflammatory effect was associated with suppression of NF-κB p65 nuclear translocation and NLRP3 protein expression. In animal experiments, the levels of BUN and Cr in SMP-3 group were lower than other extract groups, and the level of UA was also remarkably decreased by SMP-3 in hyperuricemic mice (P<0.01). Besides, SMP-3 extract was able to prevent the paw edema, reduce gouty joint inflammatory features, and decrease the levels IL-1β, PGE-2, IL-8, and NO in gouty arthritis rats. Furthermore, 6-C-β-D-xylopyranosyl-8-C-β-D-glucopyranosyl, apigenin, and astilbin were identified from SMP-3 extract. Conclusions In summary, SMP-3 may be a potential therapeutic agent for the prevention of hyperuricemic and gout.