Background: The availability of essential medicines and medical supplies is crucial for effectively delivering healthcare services. In Zambia, the Logistics Management Information System (LMIS) is a key tool for manag...Background: The availability of essential medicines and medical supplies is crucial for effectively delivering healthcare services. In Zambia, the Logistics Management Information System (LMIS) is a key tool for managing the supply chain of these commodities. This study aimed to evaluate the effectiveness of LMIS in ensuring the availability of essential medicines and medical supplies in public hospitals in the Copperbelt Province of Zambia. Materials and Methods: From February to April 2022, a cross-sectional study was conducted in 12 public hospitals across the Copperbelt Province. Data were collected using structured questionnaires, checklists, and stock control cards. The study assessed LMIS availability, training, and knowledge among pharmacy personnel, as well as data accuracy, product availability, and order fill rates. Descriptive statistics were used to analyse the data. Results: All surveyed hospitals had LMIS implemented and were using eLMIS as the primary LMIS. Only 47% and 48% of pharmacy personnel received training in eLMIS and Essential Medicines Logistics Improvement Program (EMLIP), respectively. Most personnel demonstrated good knowledge of LMIS, with 77.7% able to log in to eLMIS Facility Edition, 76.6% able to locate stock control cards in the system, and 78.7% able to perform transactions. However, data accuracy from physical and electronic records varied from 0% to 60%, and product availability ranged from 50% to 80%. Order fill rates from Zambia Medicines and Medical Supplies Agency (ZAMMSA) were consistently below 30%. Discrepancies were observed between physical stock counts and eLMIS records. Conclusion: This study found that most hospitals in the Copperbelt Province of Zambia have implemented LMIS use. While LMIS implementation is high in the Copperbelt Province of Zambia, challenges such as low training levels, data inaccuracies, low product availability, and order fill rates persist. Addressing these issues requires a comprehensive approach, including capacity building, data quality improvement, supply chain coordination, and investment in infrastructure and human resources. Strengthening LMIS effectiveness is crucial for improving healthcare delivery and patient outcomes in Zambia.展开更多
Addressing the enduring challenge of evaluating traditional Chinese medicines(TCMs),the integrated evidence chain-based effectiveness evaluation of TCMs(Eff-iEC)has emerged.This paper explored its capacity through a d...Addressing the enduring challenge of evaluating traditional Chinese medicines(TCMs),the integrated evidence chain-based effectiveness evaluation of TCMs(Eff-iEC)has emerged.This paper explored its capacity through a demonstration study that evaluated the effectiveness evidence of six commonly used anti-hepatic fibrosis Chinese patent medicines(CPMs),including Biejiajian Pill(BP),Dahuang Zhechong Pill(DZP),Biejia Ruangan Compound(BRC),Fuzheng Huayu Capsule(FHC),Anluo Huaxian Pill(AHP),and Heluo Shugan Capsule(HSC),using both Eff-iEC and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.The recognition of these CPMs within the TCM academic community was also assessed through their inclusion in relevant medical documents.Results showed that the evidence of BRC and FHC received higher assessments in both Eff-iEC and GRADE system,while the assessments for others varied.Analysis of community recognition revealed that Eff-iEC more accurately reflects the clinical value of these CPMs,exhibiting superior evaluative capabilities.By breaking through the conventional pattern of TCMs effectiveness evaluation,Eff-iEC offers a novel epistemology that better aligns with the clinical realities and reasoning of TCMs,providing a coherent methodology for clinical decision-making,new drug evaluations,and health policy formulation.展开更多
Quality marker(Q-Marker)is an innovative concept and model for quality control of Traditional Chinese medicines(TCMs),which will navigate the new direction of quality development of TCMs.Yet,how to characterize the ov...Quality marker(Q-Marker)is an innovative concept and model for quality control of Traditional Chinese medicines(TCMs),which will navigate the new direction of quality development of TCMs.Yet,how to characterize the overall quality attributes of TCMs and their biological effects is still debating.In view of this key scientific issue,this paper proposes a research method based on mass spectrometry imaging(MSI)technology for the discovery and confirmation of TCMs Q-Marker.MSI is powerful in investigating the spatial distribution of molecules in a variety of samples,and visualizing the information obtained from MS.On this basis,combine with the five principles of TCMs Q-Marker validation,i.e.,specificity,transmission and traceability,testability,prescription compatibility,and validity,were applied to confirm the finalized Q-Marker.It will lead the new direction of quality development of TCMs.展开更多
Objective:Irrational medicine consumption practices increase the country's health expenditures and raise public health concerns,challenging sustainable development in multiple ways.The objective of this study is t...Objective:Irrational medicine consumption practices increase the country's health expenditures and raise public health concerns,challenging sustainable development in multiple ways.The objective of this study is to identify the key factors influencing irrational medicine consumption and devise a strategic framework to encourage responsible medicine use.Method:A cross-sectional qualitative descriptive design was used.Study data were collected using semi-structured interviews and analysed using thematic analysis to identify the key factors contributing to irrational medicine consumption.Results:Various factors like cyberchondria coupled with health misinformation,inaccessible healthcare,limited product choices,misleading online pharmacies,and infeasible pharmaceutical regulations act as key drivers of irresponsible medicine consumption.The participants recommended enhancing healthcare access,utilizing technology,promoting health literacy,and updating regulations as strategies to improve responsible medicine use.Against this backdrop,the study proposes a double helix model for responsible consumption of medicines through bilateral efforts from both consumers and the health system.Conclusion:Highlighting the importance of responsible consumption,this paper calls health system actors to action to accelerate the efforts to foster responsible consumption of medicines.展开更多
This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in...This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in quality of life can significantly impact patients’lives.Currently,most treatments are supportive,with no specific treatment options available in Western medicine.Non-Western medicine,often less toxic and easier to administer,has shown promising results when used alongside radiotherapy for cervical cancer.Despite these potential benefits,challenges such as limited evidence and restricted application areas persist.While non-Western medicines may offer potential improvements in chemoradiotherapy outcomes for cervical cancer,further research is necessary to substantiate these benefits.展开更多
The emerging messenger RNA(mRNA)nanomedicines have sprung up for disease treatment.Developing targeted mRNA nanomedicines has become a thrilling research hotspot in recent years,as they can be precisely delivered to s...The emerging messenger RNA(mRNA)nanomedicines have sprung up for disease treatment.Developing targeted mRNA nanomedicines has become a thrilling research hotspot in recent years,as they can be precisely delivered to specific organs or tissues to enhance efficiency and avoid side effects.Herein,we give a comprehensive review on the latest research progress of mRNA nanomedicines with targeting functions.mRNA and its carriers are first described in detail.Then,mechanisms of passive targeting,endogenous targeting,and active targeting are outlined,with a focus on various biological barriers that mRNA may encounter during in vivo delivery.Next,emphasis is placed on summarizing mRNA-based organtargeting strategies.Lastly,the advantages and challenges of mRNA nanomedicines in clinical translation are mentioned.This review is expected to inspire researchers in this field and drive further development of mRNA targeting technology.展开更多
Objective Traditional medicine(TM)has played a key role in the health care system of East Asian countries,including China,Japan and South Korea.This bibliometric study analyzes the recent research status of these thre...Objective Traditional medicine(TM)has played a key role in the health care system of East Asian countries,including China,Japan and South Korea.This bibliometric study analyzes the recent research status of these three TMs,including traditional Chinese medicine(TCM),traditional Korean medicine(TKM),and Kampo medicine(KM).Methods Research topics of studies published for recent 10 years(2014 to 2023),through a search on MEDLINE via PubMed,was analyzed.Medical Subject Headings were used to distinguish between the three TMs researches.Bibliographic information was analyzed through VOSViewer version.Total 10,151 documents were included:TCM studies(n=9,630);TKM studies(n=256);and KM studies(n=295).Results Comparing the three co-occurrence analysis maps,TCM studies generally overwhelm the quantitative scale of TKM and KM studies.In the trend of the latest research of TCM,not only corona virus disease 2019(COVID-19),but also clinical research topics such as gastrointestinal microbiome and diabetes mellitus have emerged,with in silico research approaches being actively applied.In the case of TKM,obesity and cooperative treatment with Western medicine are gaining attention.In KM,COVID-19 and Scutellaria baicalensis were recent research focuses.Unique features that distinguished from the other two TM research trends included‘gut microbiota’,‘diabetes mellitus’,‘clinical trials’,‘disease models’,and‘quality control’in the TCM map;‘prospective studies’,‘cell line,tumor‘,and‘panax’in the TKM map;and‘aged,80 and over’,‘retrospective studies’,‘glycyrrhiza’,‘panax’,and‘paeonia’in the KM map.Also,some quantitative and qualitative differences were found in author co-operation maps in each TM.Conclusions This analysis revealed that there were clear quantitative and qualitative differences among TCM,TKM,and KM.Although these medicines have a common root,they may have become distinct due to factors such as the size of research funds,cultural differences,and the medical licensing system.展开更多
BACKGROUND Iron deficiency anemia(IDA)is a prevalent nutritional disorder during pregnancy.Clinical studies indicate that incorporating Chinese patent medicines(CPMs)with oral iron(OI)in treating IDA in pregnancy can ...BACKGROUND Iron deficiency anemia(IDA)is a prevalent nutritional disorder during pregnancy.Clinical studies indicate that incorporating Chinese patent medicines(CPMs)with oral iron(OI)in treating IDA in pregnancy can reduce adverse effects and improve clinical outcomes.Nonetheless,the comparative efficacy of different CPMs remains unclear.AIM To assess the safety and effectiveness of different CPMs for treating IDA during pregnancy using network meta-analysis.METHODS We conducted a search for randomized controlled trials(RCTs)that combined CPM and OI for IDA treatment in pregnancy,spanning from 2013 to the present.Data analysis was performed using Rev Man 5.3 and Stata 14.0 on literature that satisfied the quality criteria.RESULTS The analysis included 45 RCTs,encompassing 4422 pregnant patients with IDA.Six CPMs were examined,including Shengxuebao Mixture,Shengxuening Tablets(SXN),Yiqi Weixue CPMs(YQWX),Jianpi Shengxue CPMs(JPSX),Yiqi Buxue Tablets,and Compound Hongyi Buxue Oral Liquid(FFHY).Findings indicated that FFHY+OI significantly improved the clinical effective rate.SXN+OI was most effective in boosting red blood cells counts and hemoglobin levels.YQWX+OI showed superior results in improving serum ferritin,and SXN+OI was most effective in increasing serum iron levels.JPSX+OI was optimal in reducing adverse pregnancy outcomes,while YQBX+OI effectively minimized adverse events.A cluster analysis suggested that SXN+OI could be the potentially optimal therapeutic regimen for IDA in pregnancy.CONCLUSION This study demonstrates that the combination of OI with CPMs offers better outcomes than OI alone.Based on clinical efficacy and other measured outcomes,SXN+OI emerges as the most effective treatment modality for improving the health of pregnant patients with IDA.展开更多
Background: Handling of medicines is a day-to-day activity by patients and many health care providers. However, multiple studies have brought to light inappropriate disposal methods for expired and unused medication (...Background: Handling of medicines is a day-to-day activity by patients and many health care providers. However, multiple studies have brought to light inappropriate disposal methods for expired and unused medication (EUM). Improper disposal of expired and unused medicines is hazardous both to humans and the environment. Objective: This sought to measure patients’ knowledge, attitude, and practices on disposal methods of EUM. Methods: A cross-sectional study was carried out among 384 patients at three outpatient pharmacies at the University Teaching Hospitals (UTHs). The structured questionnaire was used to collect data and STAT version 15.1 was used to analyse the data. Results: 384 respondents participated in this study and, at some point, had EUM. In this study, 356 (92.7%) of the participants reported that they had never heard of a drug take-back system. Most of the participants 285 (74.2%) and 239 (62.2%) kept and donated their unused medicine, respectively. Additionally, 244 (63.5%), 212 (55.2%), and 176 (44.8%) of the participants disposed of expired medicines in the bin or garbage, flushed them in toilets or sinks, or burned them, respectively. Occupation was significantly associated with unsafe disposal of unused medicine [P-value = 0.019]. Conclusion and Relevance: Knowledge of safe disposal methods for EUM was good amongst most participants. However, used unsafe disposal methods. The majority of the participants exhibited positive attitude concerning safe disposal methods. This study highlights the need for drug-take-back program creation in Zambia.展开更多
Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disp...Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disposed of. In Burkina Faso, there are as yet no guidelines for the disposal of unused medicines in households. The aim of this study was to estimate the extent of household possession of unused or expired medicines, and to describe attitudes and disposal practices. Methods: This was a descriptive cross-sectional study covering households in the Ouagadougou commune conducted from June to August 2021. Two-stage stratified sampling was used: selection of Enumeration Zones (EZs) and selection of households, with each EZ comprising several households. Data collection was based on direct interviews using a structured questionnaire. Data were processed using Epi Info software version 7.2.4.0. Results: In total, 417 household residents were surveyed out of the planned 423 households, corresponding to a completion rate of 98.58% compared with the initial sample. Among the respondents, 79.62% had unused and/or expired medicines in their household. A total of 2562 drug packaging units were counted, for a total weight of 121.90 kg. Nearly 75% were aware that improper disposal was a danger to the environment. Some respondents kept their unused medicines at home until they expired (43.41%), and disposed of them mainly by throwing them in the household garbage (75.58%). The majority (79%) were in favor of the government setting up a take-back program for these medicines. Conclusion: The introduction of a take-back program for unused or out-of-date medicines will ensure safer disposal of medicines, and better protection for households and the environment.展开更多
In response to the situation of the African healthcare system,the African Medicines Agency(AMA)was established by the African Union(AU)to regulate access to medicines and support the local manufacture of medications.T...In response to the situation of the African healthcare system,the African Medicines Agency(AMA)was established by the African Union(AU)to regulate access to medicines and support the local manufacture of medications.This study aimed to describe the factors that enabled the establishment of the African Medicines Agency and its successes,challenges,and perceived benefits.We reviewed data sources that explored the progress and challenges of the African Medicines Agency and Medicines Regulation in Africa.The SPIDER framework was used to organise the research focus and to extract the keywords for the literature search.The study data were obtained from PubMed Central,ScienceDirect,and Google Scholar.Out of 249 studies screened,19 were selected for this narrative review.Critical successes observed in the agency's establishment include the appointment of a Special Envoy,the selection of its headquarters,and the signing of its treaty by 37 member states.However,it is hindered by poor political commitment,differences in riskbenefits interpretation and organizational structure,weak legal and regulatory frameworks,inadequate financial mechanisms,and inadequate political and policy leadership in some member states.The value of AMA in achieving optimal health outcomes and its other benefits must be considered despite the challenges being encountered.Therefore,all member states should adopt the best procedures in signing and ratifying the treaty and implementing associated commitments to improve efficiency and accountability in African medicine regulation.展开更多
Cancer immunotherapy has garnered promise in tumor progression, invasion, and metastasis through establishing durable and memorable immunological activity. However, low response rates, adverse side effects, and high c...Cancer immunotherapy has garnered promise in tumor progression, invasion, and metastasis through establishing durable and memorable immunological activity. However, low response rates, adverse side effects, and high costs compromise the additional benefits for patients treated with current chemical and biological agents. Chinese herbal medicines (CHMs) are a potential treasure trove of natural medicines and are gaining momentum in cancer immunomodulation with multi-component, multi-target, and multi-pathway characteristics. The active ingredient extracted from CHMs benefit generalized patients through modulating immune response mechanisms. Additionally, the introduction of nanotechnology has greatly improved the pharmacological qualities of active ingredients through increasing the hydrophilicity, stability, permeability, and targeting characteristics, further enhancing anti-cancer immunity. In this review, we summarize the mechanism of active ingredients for cancer immunomodulation, highlight nano-formulated deliveries of active ingredients for cancer immunotherapy, and provide insights into the future applications in the emerging field of nano-formulated active ingredients of CHMs.展开更多
Microbial resource influences the life activities of medicinal plants from several perspectives.Endophytes,rhizosphere microorganisms,and other environmental microorganisms play essential roles in medicinal plant grow...Microbial resource influences the life activities of medicinal plants from several perspectives.Endophytes,rhizosphere microorganisms,and other environmental microorganisms play essential roles in medicinal plant growth and development,plant yield,and clinical efficacy.The microbiota can influence the biosynthesis of active compounds in medicinal plants by stimulating specific metabolic pathways.They induce host plants to improve their resistance to environmental stresses by accumulating secondary metabolites.Microorganisms can interact with their host plants to produce long-term,targeted selection results and improve their ability to adapt to the environment.Due to the interdependence and interaction between microorganisms and medicinal plants,Chinese herbal medicines(CHMs)quality is closely related to the associated microorganisms.This review summarizes the relationship between medicinal plants and their associated microorganisms,including their species,distribution,life activities,and metabolites.Microorganisms can aid in quality control,improve the efficacy of medicinal plants,and provide markers for identifying the origin and storage time of CHMs.Therefore,a comprehensive understanding of the relationship between microorganisms and medicinal plants will help to control the quality of CHMs from different perspectives.展开更多
In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs t...In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs targeting the receptors,and species variability.Some scientists have focused on natural medicines,especially herbal medicines in traditional Chinese medicine.New drugs with excellent anxiolytic activity are hoped to be found in herbal medicines with anxiolytic effects.This mini-review summarised three Chinese herbal medicines with anxiolytic effects and anxiolytic herbal formulas used in the traditional Chinese medicine clinic.Several key issues that block the development of new anxiolytic drugs are also discussed.We hope to provide some ideas for researching and developing new anxiolytic drugs and studying anxiolytic components in traditional Chinese medicine.展开更多
Accurate analysis of the key substances in traditional Chinese medicines(TCMs)is the prerequisite and foundation for the quality evaluation and pharmacological substance research of TCMs[1].However,the extremely compl...Accurate analysis of the key substances in traditional Chinese medicines(TCMs)is the prerequisite and foundation for the quality evaluation and pharmacological substance research of TCMs[1].However,the extremely complex characteristics of medicinal origins,preparation processes and chemical compositions make it difficult to accurately analyze TCMs in complex multi-scenarios[2].展开更多
Despite the profound cultural and medicinal heritage of traditional African medicines (TAM), their global recognition remains notably limited. This study investigates the factors behind this issue, focusing on cultura...Despite the profound cultural and medicinal heritage of traditional African medicines (TAM), their global recognition remains notably limited. This study investigates the factors behind this issue, focusing on cultural perceptions, scientific validation, regulatory frameworks, and pharmaceutical industry influence. Utilizing a systematic literature review (SLR) to provide a thorough and structured overview, the research addresses these factors with transparency and reproducibility. Key findings reveal that negative cultural perceptions, the dominance of Western medicine, and skepticism towards traditional healers, especially in urban and educated populations, marginalize TAM. Additionally, religious beliefs and historical influences, such as colonialism, further devalue indigenous knowledge systems. The study also highlights a significant lack of scientific research and clinical trials, which challenges the conventional validation of TAM’s efficacy. Moreover, inconsistent international and national regulatory frameworks and the pharmaceutical industry’s dominance impede TAM’s integration into global healthcare systems. To enhance TAM’s credibility and global acceptance, the study advocates for standardized regulatory policies, increased scientific research, and a reevaluation of intellectual property laws. This shift towards a more inclusive and integrative approach in global health systems could bridge the gap between traditional and modern medical practices, promoting a more holistic understanding of health and wellness.展开更多
Background Diabetes is a major global public health burden.Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines(EMs)which is a challenge especiall...Background Diabetes is a major global public health burden.Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines(EMs)which is a challenge especially in low-and-middle-income countries such as Ethiopia.This study aimed to assess the accessibility of EMs used for diabetes care in central Ethiopia’s public and private medicine outlets with respect to availability and affordability parameters.Methods A cross-sectional study was conducted in 60 selected public and private medicine outlets in central Ethiopia from January to February 2022 using the World Health Organization/Health Action International(WHO/HAI)standard tool to assess access to EMs.We included EMs that lower glucose,blood pressure,and cholesterol as these are all critical for diabetes care.Availability was determined as the percentage of surveyed outlets per sector in which the selected lowest-priced generic(LPG)and originator brand(OB)products were found.The number of days’wages required by the lowest paid government worker(LPGW)to purchase a one month’s supply of medicines was used to measure affordability while median price was determined to assess patient price and price markup difference between public procurement and retail prices.Results Across all facilities,availability of LPG and OB medicines were 34.6%and 2.5%respectively.Only two glucose-lowering(glibenclamide 5 mg and metformin 500 mg)and two blood pressure-lowering medications(nifedipine 20 mg and hydrochlorothiazide 25 mg)surpassed the WHO’s target of 80%availability.The median price based on the least measurable unit of LPG diabetes EMs was 1.6 ETB(0.033 USD)in public and 4.65 ETB(0.095 USD)in pri-vate outlets.The cost of one month’s supply of diabetes EMs was equivalent to 0.3 to 3.1 days wages in public and 1.0 to 11.0 days wages in private outlets,respectively,for a typical LPGW.Thus,58.8%and 84.6%of LPG diabetes EMs included in the price analysis were unaffordable in private and public outlets,respectively.Conclusions There are big gaps in availability and affordability of EMs used for diabetes in central Ethiopia.Policy mak-ers should work to improve access to diabetes EMs.It is recommended to increase government attention to availing affordable EMs for diabetes care including at the primary healthcare levels which are more accessible to the majority of the population.Similar studies are also recommended to be conducted in different parts of Ethiopia.展开更多
Gaps in access to quality essential medicines remain a major impediment to the effective care of children with can-cer in low-and middle-income countries(LMICs).The World Health Organization reports that less than 30%...Gaps in access to quality essential medicines remain a major impediment to the effective care of children with can-cer in low-and middle-income countries(LMICs).The World Health Organization reports that less than 30%of LMICs have consistent availability of childhood cancer medicines,compared to over 95%in high-income countries.Infor-mation provided within this policy brief is drawn from a review of the literature and a mixed-methods study pub-lished in the Lancet Oncology that analyzed determinants of cancer medicine access for children in Kenya,Tanzania,Uganda,and Rwanda.Three key policy options are presented to guide strategic policy direction and critical health system planning for strengthening access to cancer medicines for children:pooled procurement,evidence-based forecasting,and regional harmonization of regulatory processes.Enhancing regional pooled procurement to address fragmented markets and improve medicine supply,investing in health information systems for improved forecasting and planning of childhood cancer medicine needs,and promoting regulatory harmonization to streamline medicine approval and quality assurance across East Africa are recommended.This policy brief is intended for policymakers,clinicians,and health-system planners involved in the procurement,supply chain management,policy and financing of childhood cancer medicines.展开更多
The transformation and implementation of clinical practice guidelines for integrated traditional Chinese medicine(TCM)and Western medicine(WM)is crucial to the adoption of medical science and technological findings an...The transformation and implementation of clinical practice guidelines for integrated traditional Chinese medicine(TCM)and Western medicine(WM)is crucial to the adoption of medical science and technological findings and is an important way for TCM to be made available to the world.First,clinical practice guidelines(CPGs)of TCM and WM integration in recent years was analyzed to clarify the current situation and problems in the existing guidelines according to the following four perspectives:(1)perspective of TCM and WM integration in guidelines,(2)diagnosis Using integrated TCM and WM,(3)integration of TCM and WM treatment,(4)promoting TCM and WM integration.Secondly,the information and quality evaluation of CPGs for integrated Chinese and Western medicine in 2020–2022 were analyzed to explore the degree and methods of integration of Chinese and Western medicine guidelines.And last this study aimed to lay a foundation for the further establishment of Chinese characteristic,repeatable,and calculable clinical practice guidelines of TCM and WM integration.展开更多
Recent trends suggest that Chinese herbal medicine formulas(CHM formulas)are promising treatments for complex diseases.To characterize the precise syndromes,precise diseases and precise targets of the precise targets ...Recent trends suggest that Chinese herbal medicine formulas(CHM formulas)are promising treatments for complex diseases.To characterize the precise syndromes,precise diseases and precise targets of the precise targets between complex diseases and CHM formulas,we developed an artificial intelligence-based quantitative predictive algorithm(DeepTCM).DeepTCM has gone through multilevel model calibration and validation against a comprehensive set of herb and disease data so that it accurately captures the complex cellular signaling,molecular and theoretical levels of traditional Chinese medicine(TCM).As an example,our model simulated the optimal CHM formulas for the treatment of coronary heart disease(CHD)with depression,and through model sensitivity analysis,we calculated the balanced scoring of the formulas.Furthermore,we constructed a biological knowledge graph representing interactions by associating herb-target and gene-disease interactions.Finally,we experimentally confirmed the therapeutic effect and pharmacological mechanism of a novel model-predicted intervention in humans and mice.This novel multiscale model opened up a new avenue to combine“disease syndrome”and“macro micro”system modeling to facilitate translational research in CHM formulas.展开更多
文摘Background: The availability of essential medicines and medical supplies is crucial for effectively delivering healthcare services. In Zambia, the Logistics Management Information System (LMIS) is a key tool for managing the supply chain of these commodities. This study aimed to evaluate the effectiveness of LMIS in ensuring the availability of essential medicines and medical supplies in public hospitals in the Copperbelt Province of Zambia. Materials and Methods: From February to April 2022, a cross-sectional study was conducted in 12 public hospitals across the Copperbelt Province. Data were collected using structured questionnaires, checklists, and stock control cards. The study assessed LMIS availability, training, and knowledge among pharmacy personnel, as well as data accuracy, product availability, and order fill rates. Descriptive statistics were used to analyse the data. Results: All surveyed hospitals had LMIS implemented and were using eLMIS as the primary LMIS. Only 47% and 48% of pharmacy personnel received training in eLMIS and Essential Medicines Logistics Improvement Program (EMLIP), respectively. Most personnel demonstrated good knowledge of LMIS, with 77.7% able to log in to eLMIS Facility Edition, 76.6% able to locate stock control cards in the system, and 78.7% able to perform transactions. However, data accuracy from physical and electronic records varied from 0% to 60%, and product availability ranged from 50% to 80%. Order fill rates from Zambia Medicines and Medical Supplies Agency (ZAMMSA) were consistently below 30%. Discrepancies were observed between physical stock counts and eLMIS records. Conclusion: This study found that most hospitals in the Copperbelt Province of Zambia have implemented LMIS use. While LMIS implementation is high in the Copperbelt Province of Zambia, challenges such as low training levels, data inaccuracies, low product availability, and order fill rates persist. Addressing these issues requires a comprehensive approach, including capacity building, data quality improvement, supply chain coordination, and investment in infrastructure and human resources. Strengthening LMIS effectiveness is crucial for improving healthcare delivery and patient outcomes in Zambia.
基金supported by the Consulting Project Funds of the Chinese Academy of Engineering(No.2023-XZ-88,China)Key Program of National Natural Science Foundation of China(No.82230118,China)Key Program of National Natural Science Foundation of China Regional Union Fund(No.U23A20519,China).
文摘Addressing the enduring challenge of evaluating traditional Chinese medicines(TCMs),the integrated evidence chain-based effectiveness evaluation of TCMs(Eff-iEC)has emerged.This paper explored its capacity through a demonstration study that evaluated the effectiveness evidence of six commonly used anti-hepatic fibrosis Chinese patent medicines(CPMs),including Biejiajian Pill(BP),Dahuang Zhechong Pill(DZP),Biejia Ruangan Compound(BRC),Fuzheng Huayu Capsule(FHC),Anluo Huaxian Pill(AHP),and Heluo Shugan Capsule(HSC),using both Eff-iEC and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.The recognition of these CPMs within the TCM academic community was also assessed through their inclusion in relevant medical documents.Results showed that the evidence of BRC and FHC received higher assessments in both Eff-iEC and GRADE system,while the assessments for others varied.Analysis of community recognition revealed that Eff-iEC more accurately reflects the clinical value of these CPMs,exhibiting superior evaluative capabilities.By breaking through the conventional pattern of TCMs effectiveness evaluation,Eff-iEC offers a novel epistemology that better aligns with the clinical realities and reasoning of TCMs,providing a coherent methodology for clinical decision-making,new drug evaluations,and health policy formulation.
基金sponsored by the National Natural Science Foundation of China(No.82303681&82202950)the Fundamental Research Funds for the Central Universities(No.3332022063)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(No.2021-I2M-1-042)。
文摘Quality marker(Q-Marker)is an innovative concept and model for quality control of Traditional Chinese medicines(TCMs),which will navigate the new direction of quality development of TCMs.Yet,how to characterize the overall quality attributes of TCMs and their biological effects is still debating.In view of this key scientific issue,this paper proposes a research method based on mass spectrometry imaging(MSI)technology for the discovery and confirmation of TCMs Q-Marker.MSI is powerful in investigating the spatial distribution of molecules in a variety of samples,and visualizing the information obtained from MS.On this basis,combine with the five principles of TCMs Q-Marker validation,i.e.,specificity,transmission and traceability,testability,prescription compatibility,and validity,were applied to confirm the finalized Q-Marker.It will lead the new direction of quality development of TCMs.
文摘Objective:Irrational medicine consumption practices increase the country's health expenditures and raise public health concerns,challenging sustainable development in multiple ways.The objective of this study is to identify the key factors influencing irrational medicine consumption and devise a strategic framework to encourage responsible medicine use.Method:A cross-sectional qualitative descriptive design was used.Study data were collected using semi-structured interviews and analysed using thematic analysis to identify the key factors contributing to irrational medicine consumption.Results:Various factors like cyberchondria coupled with health misinformation,inaccessible healthcare,limited product choices,misleading online pharmacies,and infeasible pharmaceutical regulations act as key drivers of irresponsible medicine consumption.The participants recommended enhancing healthcare access,utilizing technology,promoting health literacy,and updating regulations as strategies to improve responsible medicine use.Against this backdrop,the study proposes a double helix model for responsible consumption of medicines through bilateral efforts from both consumers and the health system.Conclusion:Highlighting the importance of responsible consumption,this paper calls health system actors to action to accelerate the efforts to foster responsible consumption of medicines.
文摘This editorial explores the potential integration of non-Western medicine into radiotherapy for cervical cancer.While radiotherapy remains a radical treatment for cervical cancer,its associated toxicity and decline in quality of life can significantly impact patients’lives.Currently,most treatments are supportive,with no specific treatment options available in Western medicine.Non-Western medicine,often less toxic and easier to administer,has shown promising results when used alongside radiotherapy for cervical cancer.Despite these potential benefits,challenges such as limited evidence and restricted application areas persist.While non-Western medicines may offer potential improvements in chemoradiotherapy outcomes for cervical cancer,further research is necessary to substantiate these benefits.
基金supported by the National Key Research and Development Program of China(2022YFA1105304)the National Natural Science Foundation of China(T2225003 and 61927805)+5 种基金the Nanjing Medical Science and Technique Development Foundation(ZKX21019)the Clinical Trials from Nanjing Drum Tower Hospital(2022-LCYJ-ZD-01)the Jiangsu Funding Program for Excellent Postdoctoral Talent(2023ZB032)the Natural Science Foundation of Jiangsu Province(BK20240223)the Project of Institute of Chinese Medicine of Nanjing University(ICM2024011)the Aid Project of Nanjing Drum Tower Hospital Health,Education&Research Foundation.
文摘The emerging messenger RNA(mRNA)nanomedicines have sprung up for disease treatment.Developing targeted mRNA nanomedicines has become a thrilling research hotspot in recent years,as they can be precisely delivered to specific organs or tissues to enhance efficiency and avoid side effects.Herein,we give a comprehensive review on the latest research progress of mRNA nanomedicines with targeting functions.mRNA and its carriers are first described in detail.Then,mechanisms of passive targeting,endogenous targeting,and active targeting are outlined,with a focus on various biological barriers that mRNA may encounter during in vivo delivery.Next,emphasis is placed on summarizing mRNA-based organtargeting strategies.Lastly,the advantages and challenges of mRNA nanomedicines in clinical translation are mentioned.This review is expected to inspire researchers in this field and drive further development of mRNA targeting technology.
文摘Objective Traditional medicine(TM)has played a key role in the health care system of East Asian countries,including China,Japan and South Korea.This bibliometric study analyzes the recent research status of these three TMs,including traditional Chinese medicine(TCM),traditional Korean medicine(TKM),and Kampo medicine(KM).Methods Research topics of studies published for recent 10 years(2014 to 2023),through a search on MEDLINE via PubMed,was analyzed.Medical Subject Headings were used to distinguish between the three TMs researches.Bibliographic information was analyzed through VOSViewer version.Total 10,151 documents were included:TCM studies(n=9,630);TKM studies(n=256);and KM studies(n=295).Results Comparing the three co-occurrence analysis maps,TCM studies generally overwhelm the quantitative scale of TKM and KM studies.In the trend of the latest research of TCM,not only corona virus disease 2019(COVID-19),but also clinical research topics such as gastrointestinal microbiome and diabetes mellitus have emerged,with in silico research approaches being actively applied.In the case of TKM,obesity and cooperative treatment with Western medicine are gaining attention.In KM,COVID-19 and Scutellaria baicalensis were recent research focuses.Unique features that distinguished from the other two TM research trends included‘gut microbiota’,‘diabetes mellitus’,‘clinical trials’,‘disease models’,and‘quality control’in the TCM map;‘prospective studies’,‘cell line,tumor‘,and‘panax’in the TKM map;and‘aged,80 and over’,‘retrospective studies’,‘glycyrrhiza’,‘panax’,and‘paeonia’in the KM map.Also,some quantitative and qualitative differences were found in author co-operation maps in each TM.Conclusions This analysis revealed that there were clear quantitative and qualitative differences among TCM,TKM,and KM.Although these medicines have a common root,they may have become distinct due to factors such as the size of research funds,cultural differences,and the medical licensing system.
基金Supported by Shandong Province Traditional Chinese Medicine Science and Technology Project,No.Q-2022126Weifang Municipal Health Commission Traditional Chinese Medicine Scientific Research Project,No.014,2022(Category 3).
文摘BACKGROUND Iron deficiency anemia(IDA)is a prevalent nutritional disorder during pregnancy.Clinical studies indicate that incorporating Chinese patent medicines(CPMs)with oral iron(OI)in treating IDA in pregnancy can reduce adverse effects and improve clinical outcomes.Nonetheless,the comparative efficacy of different CPMs remains unclear.AIM To assess the safety and effectiveness of different CPMs for treating IDA during pregnancy using network meta-analysis.METHODS We conducted a search for randomized controlled trials(RCTs)that combined CPM and OI for IDA treatment in pregnancy,spanning from 2013 to the present.Data analysis was performed using Rev Man 5.3 and Stata 14.0 on literature that satisfied the quality criteria.RESULTS The analysis included 45 RCTs,encompassing 4422 pregnant patients with IDA.Six CPMs were examined,including Shengxuebao Mixture,Shengxuening Tablets(SXN),Yiqi Weixue CPMs(YQWX),Jianpi Shengxue CPMs(JPSX),Yiqi Buxue Tablets,and Compound Hongyi Buxue Oral Liquid(FFHY).Findings indicated that FFHY+OI significantly improved the clinical effective rate.SXN+OI was most effective in boosting red blood cells counts and hemoglobin levels.YQWX+OI showed superior results in improving serum ferritin,and SXN+OI was most effective in increasing serum iron levels.JPSX+OI was optimal in reducing adverse pregnancy outcomes,while YQBX+OI effectively minimized adverse events.A cluster analysis suggested that SXN+OI could be the potentially optimal therapeutic regimen for IDA in pregnancy.CONCLUSION This study demonstrates that the combination of OI with CPMs offers better outcomes than OI alone.Based on clinical efficacy and other measured outcomes,SXN+OI emerges as the most effective treatment modality for improving the health of pregnant patients with IDA.
文摘Background: Handling of medicines is a day-to-day activity by patients and many health care providers. However, multiple studies have brought to light inappropriate disposal methods for expired and unused medication (EUM). Improper disposal of expired and unused medicines is hazardous both to humans and the environment. Objective: This sought to measure patients’ knowledge, attitude, and practices on disposal methods of EUM. Methods: A cross-sectional study was carried out among 384 patients at three outpatient pharmacies at the University Teaching Hospitals (UTHs). The structured questionnaire was used to collect data and STAT version 15.1 was used to analyse the data. Results: 384 respondents participated in this study and, at some point, had EUM. In this study, 356 (92.7%) of the participants reported that they had never heard of a drug take-back system. Most of the participants 285 (74.2%) and 239 (62.2%) kept and donated their unused medicine, respectively. Additionally, 244 (63.5%), 212 (55.2%), and 176 (44.8%) of the participants disposed of expired medicines in the bin or garbage, flushed them in toilets or sinks, or burned them, respectively. Occupation was significantly associated with unsafe disposal of unused medicine [P-value = 0.019]. Conclusion and Relevance: Knowledge of safe disposal methods for EUM was good amongst most participants. However, used unsafe disposal methods. The majority of the participants exhibited positive attitude concerning safe disposal methods. This study highlights the need for drug-take-back program creation in Zambia.
文摘Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disposed of. In Burkina Faso, there are as yet no guidelines for the disposal of unused medicines in households. The aim of this study was to estimate the extent of household possession of unused or expired medicines, and to describe attitudes and disposal practices. Methods: This was a descriptive cross-sectional study covering households in the Ouagadougou commune conducted from June to August 2021. Two-stage stratified sampling was used: selection of Enumeration Zones (EZs) and selection of households, with each EZ comprising several households. Data collection was based on direct interviews using a structured questionnaire. Data were processed using Epi Info software version 7.2.4.0. Results: In total, 417 household residents were surveyed out of the planned 423 households, corresponding to a completion rate of 98.58% compared with the initial sample. Among the respondents, 79.62% had unused and/or expired medicines in their household. A total of 2562 drug packaging units were counted, for a total weight of 121.90 kg. Nearly 75% were aware that improper disposal was a danger to the environment. Some respondents kept their unused medicines at home until they expired (43.41%), and disposed of them mainly by throwing them in the household garbage (75.58%). The majority (79%) were in favor of the government setting up a take-back program for these medicines. Conclusion: The introduction of a take-back program for unused or out-of-date medicines will ensure safer disposal of medicines, and better protection for households and the environment.
文摘In response to the situation of the African healthcare system,the African Medicines Agency(AMA)was established by the African Union(AU)to regulate access to medicines and support the local manufacture of medications.This study aimed to describe the factors that enabled the establishment of the African Medicines Agency and its successes,challenges,and perceived benefits.We reviewed data sources that explored the progress and challenges of the African Medicines Agency and Medicines Regulation in Africa.The SPIDER framework was used to organise the research focus and to extract the keywords for the literature search.The study data were obtained from PubMed Central,ScienceDirect,and Google Scholar.Out of 249 studies screened,19 were selected for this narrative review.Critical successes observed in the agency's establishment include the appointment of a Special Envoy,the selection of its headquarters,and the signing of its treaty by 37 member states.However,it is hindered by poor political commitment,differences in riskbenefits interpretation and organizational structure,weak legal and regulatory frameworks,inadequate financial mechanisms,and inadequate political and policy leadership in some member states.The value of AMA in achieving optimal health outcomes and its other benefits must be considered despite the challenges being encountered.Therefore,all member states should adopt the best procedures in signing and ratifying the treaty and implementing associated commitments to improve efficiency and accountability in African medicine regulation.
基金This work is supported by National Key Research and Development Program of China(No.2022YFC3501905)Key project at central government level:The ability establishment of sustainable use for valuable Chinese medicine resources(No.2060302)+2 种基金National Natural Science Foundation of China(NSFC,No.82104076)Science and Technology Commission of Shanghai Municipal(STCSM,No.22S21902400,China)Medicine-Engineering joint foundation of Shanghai Jiao Tong University(No.YG2022QN025 and YG2022QN050,China).
文摘Cancer immunotherapy has garnered promise in tumor progression, invasion, and metastasis through establishing durable and memorable immunological activity. However, low response rates, adverse side effects, and high costs compromise the additional benefits for patients treated with current chemical and biological agents. Chinese herbal medicines (CHMs) are a potential treasure trove of natural medicines and are gaining momentum in cancer immunomodulation with multi-component, multi-target, and multi-pathway characteristics. The active ingredient extracted from CHMs benefit generalized patients through modulating immune response mechanisms. Additionally, the introduction of nanotechnology has greatly improved the pharmacological qualities of active ingredients through increasing the hydrophilicity, stability, permeability, and targeting characteristics, further enhancing anti-cancer immunity. In this review, we summarize the mechanism of active ingredients for cancer immunomodulation, highlight nano-formulated deliveries of active ingredients for cancer immunotherapy, and provide insights into the future applications in the emerging field of nano-formulated active ingredients of CHMs.
基金funded by the National Key Research and Development Program of China(No.2022YFC0867500)the Sanming Project of Medicine in Shenzhen,Guangdong Province,China(No.SZZYSM202111002)+2 种基金the Science and Technology Development Fund,Macao SAR(No.0001/2020/AKP,0061/2019/AGJ,0027/2017/AMJ,and 062/2017/A2)the Jiangmen City Basic and Applied Basic Research Foundation(No.2020[159]-9)the Project of Administration of Traditional Chinese Medicine of Guangdong Province of China(No.20191368).
文摘Microbial resource influences the life activities of medicinal plants from several perspectives.Endophytes,rhizosphere microorganisms,and other environmental microorganisms play essential roles in medicinal plant growth and development,plant yield,and clinical efficacy.The microbiota can influence the biosynthesis of active compounds in medicinal plants by stimulating specific metabolic pathways.They induce host plants to improve their resistance to environmental stresses by accumulating secondary metabolites.Microorganisms can interact with their host plants to produce long-term,targeted selection results and improve their ability to adapt to the environment.Due to the interdependence and interaction between microorganisms and medicinal plants,Chinese herbal medicines(CHMs)quality is closely related to the associated microorganisms.This review summarizes the relationship between medicinal plants and their associated microorganisms,including their species,distribution,life activities,and metabolites.Microorganisms can aid in quality control,improve the efficacy of medicinal plants,and provide markers for identifying the origin and storage time of CHMs.Therefore,a comprehensive understanding of the relationship between microorganisms and medicinal plants will help to control the quality of CHMs from different perspectives.
文摘In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs targeting the receptors,and species variability.Some scientists have focused on natural medicines,especially herbal medicines in traditional Chinese medicine.New drugs with excellent anxiolytic activity are hoped to be found in herbal medicines with anxiolytic effects.This mini-review summarised three Chinese herbal medicines with anxiolytic effects and anxiolytic herbal formulas used in the traditional Chinese medicine clinic.Several key issues that block the development of new anxiolytic drugs are also discussed.We hope to provide some ideas for researching and developing new anxiolytic drugs and studying anxiolytic components in traditional Chinese medicine.
基金supported by the CACMS Innovation Fund(Grant Nos.:CI2021A05206,and CI2021A04504)the National Natural Science Foundation of China(Grant No.:82104380)+1 种基金the Fundamental Research Funds for the Central Public Welfare Research Institutes(Grant No.:ZZ14-YQ-047)the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences(Grant Nos.:CI2023E002,and CI2023C039YGL).
文摘Accurate analysis of the key substances in traditional Chinese medicines(TCMs)is the prerequisite and foundation for the quality evaluation and pharmacological substance research of TCMs[1].However,the extremely complex characteristics of medicinal origins,preparation processes and chemical compositions make it difficult to accurately analyze TCMs in complex multi-scenarios[2].
文摘Despite the profound cultural and medicinal heritage of traditional African medicines (TAM), their global recognition remains notably limited. This study investigates the factors behind this issue, focusing on cultural perceptions, scientific validation, regulatory frameworks, and pharmaceutical industry influence. Utilizing a systematic literature review (SLR) to provide a thorough and structured overview, the research addresses these factors with transparency and reproducibility. Key findings reveal that negative cultural perceptions, the dominance of Western medicine, and skepticism towards traditional healers, especially in urban and educated populations, marginalize TAM. Additionally, religious beliefs and historical influences, such as colonialism, further devalue indigenous knowledge systems. The study also highlights a significant lack of scientific research and clinical trials, which challenges the conventional validation of TAM’s efficacy. Moreover, inconsistent international and national regulatory frameworks and the pharmaceutical industry’s dominance impede TAM’s integration into global healthcare systems. To enhance TAM’s credibility and global acceptance, the study advocates for standardized regulatory policies, increased scientific research, and a reevaluation of intellectual property laws. This shift towards a more inclusive and integrative approach in global health systems could bridge the gap between traditional and modern medical practices, promoting a more holistic understanding of health and wellness.
基金The first author received financial support from the Graduate Programs of Addis Ababa University to conduct the researchThe last author was a research fellow at the Rollins School of Public Health as part of the COALESCE program,which is a project funded by the Fogarty International Center of the National Institutes of Health under Award Number D43 TW011404 during the authorship of this article.
文摘Background Diabetes is a major global public health burden.Effective diabetes management is highly dependent on the availability of affordable and quality-assured essential medicines(EMs)which is a challenge especially in low-and-middle-income countries such as Ethiopia.This study aimed to assess the accessibility of EMs used for diabetes care in central Ethiopia’s public and private medicine outlets with respect to availability and affordability parameters.Methods A cross-sectional study was conducted in 60 selected public and private medicine outlets in central Ethiopia from January to February 2022 using the World Health Organization/Health Action International(WHO/HAI)standard tool to assess access to EMs.We included EMs that lower glucose,blood pressure,and cholesterol as these are all critical for diabetes care.Availability was determined as the percentage of surveyed outlets per sector in which the selected lowest-priced generic(LPG)and originator brand(OB)products were found.The number of days’wages required by the lowest paid government worker(LPGW)to purchase a one month’s supply of medicines was used to measure affordability while median price was determined to assess patient price and price markup difference between public procurement and retail prices.Results Across all facilities,availability of LPG and OB medicines were 34.6%and 2.5%respectively.Only two glucose-lowering(glibenclamide 5 mg and metformin 500 mg)and two blood pressure-lowering medications(nifedipine 20 mg and hydrochlorothiazide 25 mg)surpassed the WHO’s target of 80%availability.The median price based on the least measurable unit of LPG diabetes EMs was 1.6 ETB(0.033 USD)in public and 4.65 ETB(0.095 USD)in pri-vate outlets.The cost of one month’s supply of diabetes EMs was equivalent to 0.3 to 3.1 days wages in public and 1.0 to 11.0 days wages in private outlets,respectively,for a typical LPGW.Thus,58.8%and 84.6%of LPG diabetes EMs included in the price analysis were unaffordable in private and public outlets,respectively.Conclusions There are big gaps in availability and affordability of EMs used for diabetes in central Ethiopia.Policy mak-ers should work to improve access to diabetes EMs.It is recommended to increase government attention to availing affordable EMs for diabetes care including at the primary healthcare levels which are more accessible to the majority of the population.Similar studies are also recommended to be conducted in different parts of Ethiopia.
基金This policy brief was generously funded through the American Childhood Cancer Organization,the Canadian Institutes for Health Research,and the Hospital for Sick Children.
文摘Gaps in access to quality essential medicines remain a major impediment to the effective care of children with can-cer in low-and middle-income countries(LMICs).The World Health Organization reports that less than 30%of LMICs have consistent availability of childhood cancer medicines,compared to over 95%in high-income countries.Infor-mation provided within this policy brief is drawn from a review of the literature and a mixed-methods study pub-lished in the Lancet Oncology that analyzed determinants of cancer medicine access for children in Kenya,Tanzania,Uganda,and Rwanda.Three key policy options are presented to guide strategic policy direction and critical health system planning for strengthening access to cancer medicines for children:pooled procurement,evidence-based forecasting,and regional harmonization of regulatory processes.Enhancing regional pooled procurement to address fragmented markets and improve medicine supply,investing in health information systems for improved forecasting and planning of childhood cancer medicine needs,and promoting regulatory harmonization to streamline medicine approval and quality assurance across East Africa are recommended.This policy brief is intended for policymakers,clinicians,and health-system planners involved in the procurement,supply chain management,policy and financing of childhood cancer medicines.
基金Supported by the National Administration of Traditional Chinese Medicine to Enhance the Evidence-Based Ability of Traditional Chinese Medicine Encephalopathy and Platform Construction(No.2019XZZX-NB003)National Natural Science Foundation of China(No.82174230)Fundamental Research Funds for the Central Universities(No.2042022kf1213)。
文摘The transformation and implementation of clinical practice guidelines for integrated traditional Chinese medicine(TCM)and Western medicine(WM)is crucial to the adoption of medical science and technological findings and is an important way for TCM to be made available to the world.First,clinical practice guidelines(CPGs)of TCM and WM integration in recent years was analyzed to clarify the current situation and problems in the existing guidelines according to the following four perspectives:(1)perspective of TCM and WM integration in guidelines,(2)diagnosis Using integrated TCM and WM,(3)integration of TCM and WM treatment,(4)promoting TCM and WM integration.Secondly,the information and quality evaluation of CPGs for integrated Chinese and Western medicine in 2020–2022 were analyzed to explore the degree and methods of integration of Chinese and Western medicine guidelines.And last this study aimed to lay a foundation for the further establishment of Chinese characteristic,repeatable,and calculable clinical practice guidelines of TCM and WM integration.
基金supported by the National Natural Science Foundation of China(Grant No.:82174246)the National Key R&D Program of China(Grant No.:2019YFC1708701)the Postdoctoral Innovation Talent Support Program(Grant No.:BX20220329).
文摘Recent trends suggest that Chinese herbal medicine formulas(CHM formulas)are promising treatments for complex diseases.To characterize the precise syndromes,precise diseases and precise targets of the precise targets between complex diseases and CHM formulas,we developed an artificial intelligence-based quantitative predictive algorithm(DeepTCM).DeepTCM has gone through multilevel model calibration and validation against a comprehensive set of herb and disease data so that it accurately captures the complex cellular signaling,molecular and theoretical levels of traditional Chinese medicine(TCM).As an example,our model simulated the optimal CHM formulas for the treatment of coronary heart disease(CHD)with depression,and through model sensitivity analysis,we calculated the balanced scoring of the formulas.Furthermore,we constructed a biological knowledge graph representing interactions by associating herb-target and gene-disease interactions.Finally,we experimentally confirmed the therapeutic effect and pharmacological mechanism of a novel model-predicted intervention in humans and mice.This novel multiscale model opened up a new avenue to combine“disease syndrome”and“macro micro”system modeling to facilitate translational research in CHM formulas.
