Effectiveness and safety of Suhuang Zhike capsule as adjuvant treatment for acute exacerbation of chronic obstructive pulmonary disease: a systematic review and Meta-analysis.

OBJECTIVE: To evaluate the efficacy and safety of Suhuang Zhike capsule in the adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: The database including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Chinese Biomedical Literature Database and Wanfang Data was searched. The retrieval time was from database establishment to May 2021. Randomized controlled trial (RCT) of Suhuang zhike capsule adjuvant treatment for AECOPD was included. The quality of the studies was independently evaluated and cross-checked by two reviewers, and Meta-analysis was performed by using RevMan5.3 software. RESULTS: Thirteen RCT results were included with a total sample number of 1195 cases, including 597 in the experimental group and 598 in the control group. The results showed that Suhuang zhike capsule adjuvant treatment of AECOPD could improve the total clinical effect rate compared with conventional treatment. Suhuang zhike capsule adjuvant treatment could improve forced vital capacity (FVC), forced expiratory volume in one second (FEV), FEV/FVC, peak expiratory flow (PEF) and other pulmonary function indexes; decrease C-reactive protein (CRP), white blood cells, neutrophils and other infectious indicators; besides, the 1-year recurrence rate of the disease was decreased (all 0.05). CONCLUSIONS: Suhuang Zhike capsule can improve the lung function and clinical efficacy of AECOPD, thus increasing the exercise endurance, and reducing the infection and recurrence rate in AECOPD patients.

Classifying Chinese Medicine Constitution Using Multimodal Deep-Learning Model.

OBJECTIVE: To develop a multimodal deep-learning model for classifying Chinese medicine constitution, i.e., the balanced and unbalanced constitutions, based on inspection of tongue and face images, pulse waves from palpation, and health information from a total of 540 subjects. METHODS: This study data consisted of tongue and face images, pulse waves obtained by palpation, and health information, including personal information, life habits, medical history, and current symptoms, from 540 subjects (202 males and 338 females). Convolutional neural networks, recurrent neural networks, and fully connected neural networks were used to extract deep features from the data. Feature fusion and decision fusion models were constructed for the multimodal data. RESULTS: The optimal models for tongue and face images, pulse waves and health information were ResNet18, Gate Recurrent Unit, and entity embedding, respectively. Feature fusion was superior to decision fusion. The multimodal analysis revealed that multimodal data compensated for the loss of information from a single mode, resulting in improved classification performance. CONCLUSIONS: Multimodal data fusion can supplement single model information and improve classification performance. Our research underscores the effectiveness of multimodal deep learning technology to identify body constitution for modernizing and improving the intelligent application of Chinese medicine.

Sensitization characteristics of Juniperus chinensis pollen in Beijing area / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the sensitization characteristics of Juniperus chinensis pollen in patients with allergic rhinitis and/or allergic asthma in Beijing area, and to explore the characteristics of Juniper chinensis pollen sensitized population. Methods: Patients with suspected allergic rhinitis and/or asthma from January 2017 to December 2019 in the outpatient department of Allergy Department of Beijing Shijitan Hospital were selected in this study. Skin prick test (SPT) was performed with Juniper chinensis pollen allergen reagent to compare different age and disease allergen distribution, and to observe the sensitization characteristics of its population. All of the analyses were performed using SAS software version 9.4. Results: A total of 8 380 patients were enrolled in the end. The total positive rate of Juniper chinensis pollen SPT reached 49.92% (4 183/8 380). The positive rate of Juniper chinensis pollen SPT was highest in the 10-14 age group, reaching 60.99% (283/464). Compared with other age groups, there was a statistical difference (χ²=266.77, P<0.01). The SPT positive rate of patients aged less than 10 years increased with the increase of age, while the SPT positive rate of patients aged over 40 years decreased with the increase of age. Single Juniper chinensis pollen was less allergenic, accounting for about 25.05% (1 048/4 183), and the patients' age was (35.21±12.39) years. Regardless of single Juniper chinensis pollen or other pollen allergies, allergic rhinitis was the main disease. Among the patients with SPT positive Juniper chinensis pollen combined with other inhaled pollen allergens, willow pollen accounted for the first (74.99%). The positive rate of Juniper chinensis pollen was the highest in patients with single allergic rhinitis, accounting for 52.05% (3 797/7 295), and the rate in patients with single allergic asthma was the lowest, accounting for 17.49% (53/303), with statistically difference (χ²=138.99, P<0.01). Conclusions: Juniper chinensis pollen is highly sensitized in patients with allergic rhinitis and/or allergic asthma in Beijing . The positive rate of SPT is highest among 10-14 age group, most of which showed strong positive reaction, and allergic rhinitis is more common in Juniper chinensis pollen sensitization diseases.

Analysis of characteristics of Chenopodiaceae pollen induced seasonal allergic rhinitis in the Inner Mongolian grassland region of China / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the clinical characteristics of Chenopodiaceae pollen induced seasonal allergic rhinitis (SAR) as well as the distribution and sensitization characteristics of Chenopodiaceae pollen in Inner Mongolia grassland of northern China. Methods: From May 2015 to August 2015, using stratified, cluster and random sampling, a field interviewer-administered survey study and skin prick test (SPT) were conducted in six areas of Inner Mongolia grassland (Xilinhot, Erenhot, Duolun, Tongliao, Jarud, Kailu), and pollen monitoring was carried out in the above six areas from January 1 to December 31 of 2015. The clinical characteristics of Chenopodiaceae pollen induced SAR, distribution and sensitization characteristics of Chenopodiaceae pollen in these regions were observed. SAS software 9.4 was used for data processing. Results: A total of 6 043 subjects completed the study. The prevalence of Chenopodiaceae pollen induced SAR was 13.2% (795/6 043). The highest prevalence was found in the 18-39 age group. Subjects from urban areas showed higher prevalence of SAR than rural areas (61.2% vs 37.9%, P<0.001). There was significant regional difference in the prevalence rate of Chenopodiaceae pollen induced SAR among the above six areas (Xilinhot 21.5%, Erenhot 17.8%, Duolun 8.9%, Tongliao 6.9%, Jarud 15.3%, Kailu 9.7%, P<0.001). The main clinical symptoms of Chenopodiaceae pollen induced SAR were sneezing (96.5%) and nasal itching (92.2%). Eye itching was more obvious among the ocular symptoms (69.1%), while fatigue (32.1%) and drowsiness (31.5%) were more prominent among other related symptoms. Among comorbidities of Chenopodiaceae pollen induced SAR, allergic conjunctivitis accounted for 71.4% (568/795), food allergy accounted for 86.7% (689/795) and asthma accounted for 16.7% (133/795). The peak of Chenopodiaceae pollen spread was in August. The prevalence of Chenopodiaceae pollen induced SAR was positively correlated with the concentration of Chenopodiaceae pollen (R2=0.78, P=0.043). The SPT positive rate of Chenopodiaceae pollen was 21.2% (1 282/6 043), and Xilinhot had the highest rate in six regions (28.0%, 236/842). Conclusions: The prevalence of Chenopodiaceae pollen induced SAR in Inner Mongolia grassland stays at a high level. Sneezing is the most obvious symptom of SAR. The peak of Chenopodiaceae pollen spread is in August and the prevalence of Chenopodiaceae pollen induced SAR is positively correlated with the pollen concentration.

[Study on mechanism of Rhei Radix et Rhizoma-Persicae Semen in treatment of adenomyosis based on network pharmacology].

The aim of this paper was to screen the active targets of Rhei Radix et Rhizoma and Persicae Semen in the treatment of adenomyosis(AM) by means of network pharmacology, and to investigate their mechanism of action. The effective components of Rhei Radix et Rhizoma and Persicae Semen were screened out by using traditional Chinese medicine systematic pharmacological(TCMSP) database, with oral bioavilability(OB) ≥30% and drug-like(DL) ≥0.18 selected as the thresholds. A network was built between the main components and their corresponding targets. Ninety-five human genes corresponding to the medicine targets were obtained from Uniprot database; 220 genes corresponding to AM were obtained from GeneCards database. A total of 21 intersection genes were screened from disease genes and medicine genes, and the protein-protein interaction network interaction(PPI)analysis was conducted by using STRING tool. Disease-target PPI network was drawn by using Cytoscape software, and component-target-disease network was constructed. Twenty-five nodes and 74 connections were found, and then core networks and targets were screened for Kyoto encyclopedia of genes and genomes(KEGG) pathway enrichment analysis. The animal model of AM was established by feeding tamoxifen citrate mixed droplets to primary mice for verification of the mechanism. Twenty-three signaling pathways were involved in KEGG pathway enrichment. It was found that the therapeutic mechanism of Rhei Radix et Rhizoma and Persicae Semen on AM may involve multiple targets such as inflammation and immunity, proliferation and apoptosis, endocrine and oxidative stress. Among them, the P53 signaling pathway and the apoptotic signaling pathway which mediated the expression of P53 and BAX may be the important ones. Animal experiments proved that the effective components of Rhei Radix et Rhizoma and Persicae Semen can interfere with the P53 signaling pathway and the apoptotic signaling pathway at the junction of endometrial muscle layer, increase the expression of P53 and BAX in muscle layer cells, and promote the apoptosis of cells with abnormal proliferation ability.

Clinical application characteristics of Ciwujia Injection in treatment of 5 904 cases with cardiovascular disease in real world / 中国中药杂志

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.

Analysis of clinical application characteristics of Xiyanping Injection in 194 873 cases in real world / 中国中药杂志

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.

Analysis of clinical application characteristics and drug combination of Ciwujia Injection in 12 554 cases in real world / 中国中药杂志

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.

Study on clinical characteristics of Danshen Chuanxiongqin Injection in treatment of cerebral infarction in real world / 中国中药杂志

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.

Complex network analysis of combination medication of patients with kidney malignant tumor based in real world / 中国中药杂志

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.

Clinical characteristics and combined medication of Suxiao Jiuxin Pills in 16 856 elderly patients in real world study / 中国中药杂志

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.

Clinical application of Xingnaojing Injection in treatment of 11 674 cases of cerebral infarction: a real world study / 中国中药杂志

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.

Exploring Chinese medicine and Western medicine group modules in acute phase of ischemic stroke disease / 中国中药杂志

Under the theoretical guidance of "combination of disease and syndrome， correspondence between syndrome and prescription， and dynamic space-time"， 11 135 acute ischemic stroke patients were collected from hospital information system(HIS) of many 3A grade hospitals of traditional Chinese medicine. Complex network analysis was adopted to obtain the core syndrome elements in different periods of acute ischemic stroke patients， and it was found that the core syndrome elements were blood stasis syndrome， phlegm， endogenous wind， Yin deficiency， Qi deficiency， heat， hyperactivity of liver Yang， liver， and kidney of patients in hospital for the first day， and during 8-14 d in hospitalization， the core syndrome elements were blood stasis， phlegm， Yin deficiency， Qi deficiency， endogenous wind， hyperactivity of liver Yang， liver， and kidney. The data with "improved" and "cured" treatment outcomes were adopted for complex network analysis and correlation analysis to identify the Chinese and Western medicine group modules in patients with different disease conditions in different phases after hospitalization. It was found that the Chinese and Western medicine modules within 14 d after hospitalization mainly included "blood-activating and stasis-dissolving module "consisted by "anti-platelet drug + circulation-improving medicine(or anticoagulant drug and anti-fibrinogen drug， et al) + blood-activating and stasis-dissolving drugs"， as well as "stasis-dissolving and phlegm-reducing module" consisted by "anti-platelet drugs + circulation-improving medicine(or anticoagulant drug and anti-fibrinogen drug， et al) + phlegm refreshing drug". The core Chinese and Western medicine modules in patients with urgent and general conditions within 7 d after hospitalization mainly used "blood-activating and stasis-dissolving module" and "stasis-dissolving and phlegm-reducing module". Three or more Chinese medicine and Western medicines module with more than 1% utilization rate was not found in the patients with critical disease condition in admission. The urgent， general and critically ill patients in admission mainly used "blood-activating and stasis-dissolving module" in 8-14 d. From the real world medical big data research， it was found that the combined use of Chinese and Western medicines were consistent with "combination of disease and syndrome， correspondence between syndrome and prescription， and dynamic space-time" theory， and multiple multidimensional dynamic Chinese medicine and Western medicine group modules of "patient-syndrome-drug-time-effective" at the acute ischemic stroke stage were dug out， forming the method of Chinese and Western medicine combination research based on electrical medical big data.

Diagnostic value of lung ultrasound B-line score in acute heart failure / 中华危重病急救医学

Objective To investigate the value of bedside lung ultrasound B-line score in the diagnosis of acute heart failure (AHF). Methods A retrospectively analysis was conducted. The adult patients presenting with acute dyspnea in intensive care unit (ICU) of Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2016 to June 2017 were enrolled. An 8-zone lung ultrasound was performed and plasma B-type natriuretic peptide (BNP) level was tested in all patients. AHF was determined as the final diagnosis by two experienced ICU doctors according to the diagnostic criteria of AHF. Patients were divided into two groups: AHF group and non-AHF group. The levels of BNP and B-line score were compared between the two groups, and the diagnostic value of BNP and B-line score in AHF was evaluated. Results Fifty-six patients were included in this study, with 32 of men and 24 of women,and with an average age of 77.3±8.8. Thirty-six patients were diagnosed as AHF. The level of BNP and lung ultrasound B-line score in AHF group were higher than those in non-AHF group [BNP (ng/L): 1 640.4±1 078.4 vs. 236.9±124.9,B line score: 12.8±5.3 vs. 5.4±1.8, both 1 < 0.01]. There was a strong correlation between elevated BNP levels and an increased B-lines score (R2 = 0.712, 1 = 0.000). The receiver operating characteristic curve (ROC) showed that when the cut-off of lung ultrasound B-line score was 8.5, AHF could be discriminated from dyspnea caused by other diseases (sensitivity was 77.8%, specificity was 95%, positive likelihood ratio was 15.56, negative likelihood ratio was 0.23).The area under the ROC curve (AUC) of lung ultrasound B-line score was 0.917 [95% confidence interval (95%CI) =0.847-0.987, 1 = 0.000], slightly lower than that of plasma BNP [0.979 (95%CI = 0.951-1.008)]. Conclusion Lung ultrasound B-line score was highly specific, but moderately sensitive for identifying patients with AHF.

Clinical characteristics of Yinhua Miyanling Pian users based on real world study / 中国中药杂志

Clinical characteristics of Yinhua Miyanling Pian user group were analyzed based on real world hospital information system (HIS)database. The information was collected from the HIS in sixteen hospitals of grade Ⅲ-A. Normalizing the data and descriptive analysis was performed. Among the 5 312 cases, female patients(63.67%) were more than male patients (36.33%). The median age was 49 years old. The age of 18-65 accounted for 74.52%.The patient was admitted to the hospital's department of obstetrics and gynecology(28.71%) and urology(28.43%). The median single dose is 2 g, accounted for 49.55%. The median daily dose is 6 g. 88.80% of patients were treated for less than 7 d. The median hospitalization were 12 d, most were 7-14 d accounted for 41.70%. Most hospitalization expenses payment by medicare, accounted for 80.22%. The median hospitalization expenses was 12 211.47 RMB. Most patients with benign tumor(27.36%) and malignant tumor(15.56%), next is the obstruction of urinary tract(15.49%) and urinary calculi(10.52%). The most common syndromes were damp heat syndrome(32.46%), liver and kidney deficiency syndrome(15.33%) and splenasthenic fluid-retention syndrome(15.01%). Clinical use is combined with antibiotics, as well as traditional Chinese medicine heat clearing agents, tonic drugs and so on. Finally, 44.22% were cured and 51.05% were better. Most of the drug users were adults, and mostly were female. Most with the tumor, urinary tract obstruction or stones. TCM syndrome is mainly characterized by dampness and heat, deficiency of liver and kidney, and dampness of spleen. In clinical practice, it was mainly combined with Western medicines, and Chinese medicines were also a-vailable. And most are combined with antibiotics.The medication basically conforms to the drug instruction. Based on the results of the real world HIS，Yinhua Miyanling Pian could provide theidea and reference for regulating the medication in adolescent patients.

Association rules analysis of Fufang Kushen injection in combination with traditional Chinese medicine or modern medications in treating malignant tumor: real-world retrospective study / 中国中药杂志

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.

Real world analysis to explore clinical features of Shenxiong glucose injection combined with other medications / 中国中药杂志

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.

Drug combination characteristics of Shenxiong glucose injection in treating ischemic cerebrovascular disease in real world / 中国中药杂志

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.

Real World Analysis of Law of Solar Terms During A Year and Time During A Day in Mortality of Patients with Viral Hepatitis / 世界科学技术-中医药现代化

This study was aimed to explore the death rule of viral hepatitis patient according to the 24-calendar cycle and time.Information of 40 681 inpatients diagnosed as viral hepatitis from 20 triple-A hospitals in China were collected from December 2003 to August 2011.The death rule of viral hepatitis patient according to the 24-calendar cycle and time was analyzed.It is the first time to put traditional Chinese medicine (TCM) concept of time into survival ending.Its mechanism was explained from the aspects of both TCM and modern medicine.It provided a reference method to combine TCM theory and clinical practice.The results showed that among 40 681 patients,36 547 patients had treatment ending.Among them,386 patients were dead,with the total death rate of 1.06％;308 patients were diagnosed as viral hepatitis B,which was about 79.79％ of the whole dead patients.The proportion of the death time is focused on the Great Heat and the Cold Dew,which is about 6.67％ and 6.4％,respectively.And the percentage of death in the winter is lowest,which is about 3％.The highest percentage of death in one day is Shen-Shi (from 3 pm to 5 pm,23.82％) and You-Shi (from 5 pm to 7 pm,21.78％).It was concluded that the death rule of viral hepatitis patient was at the highest percentage in summer and autumn;that of the spring was the second;and that of the winter was the lowest.In one day,the highest percentage of death lies in Jin-Shi (from 3 pm to 7 pm).

Analysis on Traditional Chinese Medicine Syndrome and Solar Term of Cervus and Cucumis Polypeptide Injection among Fracture Patients in the Real World / 世界科学技术-中医药现代化

This paper was aimed to understand the clinical features of traditional Chinese medicine (TCM) through the analysis of relevant information among fracture patients treated by the Cervus and Cucumis Polypeptide Injection (CCPI).The study was conducted among fracture patients treated by CCPI in the hospital information systems (HIS) among 26 national triple-A hospitals from 2003 to 2014.The general information,TCM syndrome and solar term of morbidity were analyzed.The results showed that the number of patients from 45-64 years old were the most,accounting for 39.84％.Among them,the number of male patients from 18-44 years old was the most,accounting for 43.38％;the number of female patients from 45-64 year old was the most,accounting for 44.33％.The main TCM syndrome of admission and discharge was qi stagnation and blood stasis,which accounted for 60.53％ and 53.08％,respectively.Beginning of Summer (7th solar term) and Rain Water (2nd solar term) were solar terms with the most patients,which accounted for 5.26％ and 5.24％,respectively.It was concluded that the majority of fractures patients treated with CCPI were the elderly.The syndrome of qi stagnation and blood stasis was the most.The hospital admission of most patients was at the Beginning of Summer and Rain Water.It provided theoretical basis to pay attention on TCM syndrome differentiation in the treatment of clinical fractures.The treatment should be adapted to the characteristics of the disease itself,the change of solar terms,and dialectical medication.