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ntrol group, Xuebijing injection group shortened the abdominal pain and distension relief time in AP patients (WMD = -1.69, 95% CI -1.88--1.50, p less then 0.0001; WMD = -1.48, 95% CI -1.74--1.23, p less then 0.0001), with high heterogeneity (I2 = 84.3%, p = 0.000; I2 = 72.2%, p = 0.000). Serum amylase level was also reduced (WMD = -2.06, 95% CI -2.47--1.64, p less then 0.0001), with significant heterogeneity (I2 = 71.6%, p = 0.000). A total of one SR reported adverse drug reaction (ADR), no ADRs were observed in the control group. Conclusion Although the quality of the evidence is not high, it can still reflect the clinical value of Xuebijing injection as an analgesic and anti-inflammatory traditional Chinese medicine in the treatment of AP/SAP. Therefore, future clinical studies should focus on the long-term efficacy and adverse reactions of drugs. Systematic Review Registration (website), identifier (registration number).Potentially inappropriate prescribing (PIP), including potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs), is a major risk factor for adverse drug reactions (ADRs). Establishing a risk warning model for PIP to screen high-risk patients and implementing targeted interventions would significantly reduce the occurrence of PIP and adverse drug events. Elderly patients with cardiovascular disease hospitalized at the Sichuan Provincial People's Hospital were included in the study. Information about PIP, PIM, and PPO was obtained by reviewing patient prescriptions according to the STOPP/START criteria (2nd edition). Data were divided into a training set and test set at a ratio of 82. Five sampling methods, three feature screening methods, and eighteen machine learning algorithms were used to handle data and establish risk warning models. A 10-fold cross-validation method was employed for internal validation in the training set, and the bootstrap method was used for external validation in the test set. The performances were assessed by area under the receiver operating characteristic curve (AUC), and the risk warning platform was developed based on the best models. The contributions of features were interpreted using SHapley Additive ExPlanation (SHAP). A total of 404 patients were included in the study (318 [78.7%] with PIP; 112 [27.7%] with PIM; and 273 [67.6%] with PPO). After data sampling and feature selection, 15 datasets were obtained and 270 risk warning models were built based on them to predict PIP, PPO, and PIM, respectively. External validation showed that the AUCs of the best model for PIP, PPO, and PIM were 0.8341, 0.7007, and 0.7061, respectively. The results suggested that angina, number of medications, number of diseases, and age were the key factors in the PIP risk warning model. The risk warning platform was established to predict PIP, PIM, and PPO, which has acceptable accuracy, prediction performance, and potential clinical application perspective.Background The incidence of ischemic stroke (IS) is much higher among patients with chronic kidney disease (CKD) compared to the general population. Few studies have evaluated the association between the risk of IS and the use of Chinese herbal medicine (CHM) in patients with CKD. We aimed to investigate the risk of IS among patients with CKD using CHM as add-on therapy. Methods We conducted a retrospective cohort study based on Taiwan's National Health Insurance Research Database to assess 21,641 patients with newly diagnosed CKD between 2003 and 2012. Patients were classified as either the CHM (n = 3,149) or the non-CHM group (n = 3,149) based on whether they used CHM after first diagnosis of CKD. We used the proportional subdistribution hazards model of Fine and Gray to examine the hazard ratio (HR) of IS in propensity-score matched samples at a ratio of 11 for two groups. Results The risk of IS was significantly reduced in the CHM group (adjusted HR [aHR] 0.58, 95% confidence interval [CI] 0.48-0.70) compared with the non-CHM group. Those who used CHM for >180 days had an even lower risk of IS than those in the non-CHM group (aHR 0.51, 95% CI 0.41-0.63). Additionally, frequently prescribed formulae, such as Ji-Sheng-Shen-Qi-Wan, Liu-Wei-Di-Huang-Wan, and Zhen-Wu-Tang were associated with a 30%-50% reduced risk of IS. Conclusion Our results suggest that patients with CKD who used CHM as add-on therapy had a lower hazard of IS than those in the non-CHM group, especially for patients taking CHM for >180 days. Further experimental studies are required to clarify the causal relationship.Descurainia sophia seeds (DS), Astragalus mongholicus (AM), and their formulas are widely used to treat heart failure caused by various cardiac diseases in traditional Chinese medicine practice. However, the molecular mechanism of action of DS and AM has not been completely understood. Herein, we first used mass spectrometry coupled to UPLC to characterize the chemical components of DS and AM decoctions, then applied MS-based quantitative proteomic analysis to profile protein expression in the heart of rats with isoproterenol-induced cardiomyopathy (ISO-iCM) before and after treated with DS alone or combined with AM, astragaloside IV (AS4), calycosin-7-glucoside (C7G), and Astragalus polysaccharides (APS) from AM. We demonstrated for the first time that DS decoction alone could reverse the most of differentially expressed proteins in the heart of the rats with ISO-iCM, including the commonly recognized biomarkers natriuretic peptides (NPPA) of cardiomyopathy and sarcomeric myosin light chain 4 (MYL4), relieving ISO-iCM in rats, but AM did not pronouncedly improve the pharmacological efficiency of DS. Significantly, we revealed that AS4 remarkably promoted the pharmacological potency of DS by complementarily reversing myosin motor MYH6/7, and further downregulating NPPA and MYL4. In contrast, APS reduced the efficiency of DS due to upregulating NPPA and MYL4. These findings not only provide novel insights to better understanding in the combination principle of traditional Chinese medicine but also highlight the power of mass spectrometric proteomics strategy combined with conventional pathological approaches for the traditional medicine research.Background Reference to so-called real-world data is more often made in marketing authorization applications for medicines intended to diagnose, prevent or treat rare diseases compared to more common diseases. We provide granularity on the type and aim of any external data on efficacy aspects from both real-world data sources and external trial data as discussed in regulatory submissions of orphan designated medicinal products in the EU. By quantifying the contribution of external data according to various regulatory characteristics, we aimed at identifying specific opportunities for external data in the field of orphan conditions. Methods Information on external data in regulatory documents covering 72 orphan designations was extracted. Our sample comprised public assessment reports for approved, refused, or withdrawn applications concluded from 2019-2021 at the European Medicines Agency. Products with an active orphan designation at the time of submission were scrutinized regarding the role of external dataion Specific opportunities for external data in the setting of marketing authorizations in the field of rare diseases were identified. Ongoing initiatives of fostering systematic data collection are promising steps for a more efficient medicinal product development in the field of rare diseases.Background Osteoporosis (OP) is an age-related bone disease that has emerged as a worldwide public health concern due to its increasing incidence and high disability rate. Tanshinol [D (+) β-3,4-dihydroxyphenyl lactic acid, TS], a water-soluble component extracted from Salvia miltiorrhiza, has proven to be effective in attenuating OP in vitro and in vivo. However, there is insufficient evidence to support its clinical application. Objective This meta-analysis aimed to investigate available OP animal model studies to demonstrate the antiosteoporosis effects of TS in a systematic manner. Methods Electronic searches of related studies were conducted in the following databases EMBASE, PubMed, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese VIP Database, Chinese Biomedical Literature Database, and Wanfang. The retrieval date was January 2022, and there were no time or language restrictions. The CAMARADES 10-item quality checklist was utilized to test the risk of potential bias I = 0.309 to 1.071; p = 0.000, I2 = 12%), Tb.Th (SMD = 0.772; 95% CI = 0.410 to 1.134; p = 0.000, I2 = 32.2%), and S-OCN (SMD = 3.13; 95% CI = 0.617 to 5.65; p = 0.015, I2 = 92.3%), while the Tb.Sp level was markedly decreased in OP models in comparison to the controls (SMD = -0.822; 95% CI = -1.207 to -0.437; p = 0.000, I2 = 0%). Moreover, TS treatment was associated with a significant improvement of the bone biomechanical indicators, including bone maximum load (SMD = 0.912; 95% CI = 0.370 to 1.455; p = 0.001, I2 = 40%) and elasticity load (SMD = 0.821; 95% CI = 0.290 to 1.351; p = 0.002, I 2 = 0%). Conclusion Collectively, our findings suggest that TS can improve BMD, bone microarchitecture, bone biomechanics, and S-OCN expression in rats, implying that it could be used clinically in the future. Systematic Review Registration https//inplasy.com/inplasy-2022-3-0053/, identifier [INPLASY202230053].[This corrects the article DOI 10.3389/fphar.2020.554736.].Background Since the dawn of time, Moroccans have used medicinal plants as a popular remedy to treat a wide range of human and cattle health issues. Nonetheless, very little research has been conducted in the past to record and disseminate indigenous ethnopharmacological knowledge adequately. HDAC inhibitor This study was conducted in the Rif and attempted to identify medicinal plants used by indigenous people to treat cardiovascular problems and the ethnomedicinal knowledge linked with them. Methods The ethnobotanical study was carried out in the Moroccan Rif area over 2 years, from 2016 to 2018. We questioned 520 traditional herbalists and consumers of these herbs in total. The gathered data were examined and contrasted using quantitative ethnobotanical indicators such as family importance value (FIV), the relative frequency of citation (RFC), plant part value (PPV), fidelity level (FL), and informant consensus factor (ICF). Results The findings analysis revealed the presence of 33 plant species classified into 20 families, with the Poaceae dominating (7 species). Regarding disorders treated, the category of cardiac arrhythmias has the greatest ICF (0.98). The study discovered that the leaves were the most often utilized portion of the plants (PPV = 0.353) and that the most frequently used preparation was a decoction (31%). Conclusions The current study's findings revealed the presence of indigenous ethnomedicinal knowledge of medicinal plants in the Moroccan Rif to treat cardiovascular illnesses. Further phytochemical, pharmacological, and toxicological investigations should be conducted to identify novel drugs from these documented medicinal plants.Background The incidence of Type 2 diabetes mellitus (T2DM) combined with non-alcoholic fatty liver disease (NAFLD) has risen over the years. This comorbid condition significantly increases the probability of cirrhosis, liver cancer, and mortality compared to the disease alone. The multi-targeted, holistic treatment efficacy of traditional Chinese medicine (TCM) plays a vital role in the treatment of T2DM and NAFLD. Jiedu Tongluo Tiaogan Formula (JTTF), based on TCM theory, is widely used in clinical treatment, and its effectiveness in lowering glucose, regulating lipids, improving insulin resistance, and its pathways of action have been demonstrated in previous studies. However, the mechanism of this formula has not been investigated from a metabolomics perspective. Moreover, high-quality clinical studies on T2DM combined with NAFLD are lacking. Therefore, we aim to conduct a clinical trial to investigate the clinical efficacy, safety, and possible pathways of JTTF in the treatment of T2DM combined with NAFLD using metabolomics techniques.
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