Evaluation of GRADE Clinical Research Evidence of Chinese Patent Medicine Combined with Western Medicine in Treatment of Hypertension with Dyslipidemia / 中国实验方剂学杂志

ObjectiveTo evaluate the effect of antihypertensive and lipid-regulating Chinese patent medicine combined with conventional Western medicine in the treatment of hypertension with dyslipidemia. To carry out the evidence synthesis of clinical research and provide evidence-based evidence support for clinical decision-making. MethodThe databases including China National Knowledge Infrastructure （CNKI），Wanfang Data Knowledge Service Platform （WF），VIP，SinoMed，Embase，PubMed，Web of Science （WOS），and the Cochrane Library were searched for randomized controlled trials （RCT） of all listed Chinese patent medicines in the treatment of hypertension with dyslipidemia from the establishment of the databases to April 15，2023. The literature was screened and extracted，and the risk of bias tool 2.0 （RoB2） was used to assess the quality and risk of bias of the methodology. Revman 5.4.1 software was used to analyze the outcome indicators. Grading of Recommendations Assessment，Development and Evaluation （GRADE） was applied to assess the quality of evidence formed by clinical research data. The inclusion and recommendation of Chinese patent medicines in the National Drug Catalogue for Basic Medical Insurance，Work-related Injury Insurance and Maternity Insurance （2022） and domestic guidelines and consensus were searched to form a bubble chart. ResultA total of 15 studies were included. The evaluation of the methodological quality of each study showed that the risk of bias stemmed from the lack of blinding and allocation concealment，and low sample size. The comprehensive analysis of clinical studies showed that Dengzhan Shengmai capsules combined with rosuvastatin and amlodipine besylate，Yindan Xinnaotong capsules combined with simvastatin and levamlodipine tablets，Xiaoshuan Tongluo capsules combined with nifedipine controlled release tablets and pravastatin sodium tablets，Xinshubao capsules combined with atorvastatin calcium tablets and irbesartan，Wenyading capsules combined with enalapril，and Jiangzhining tablets combined with conventional Western medicines were all superior to conventional Western medicines used in the control group in improving systolic blood pressure （SBP），diastolic blood pressure （DBP），cholesterol （TC），triglyceride （TG），low density lipoprotein cholesterol （LDL-C），and high density lipoprotein cholesterol （HDL-C）. There was no significant difference in the incidence of adverse reactions between the two groups. The GRADE evaluation of the main outcome indicators showed that the evidence quality of SBP and incidence of adverse reactions was graded as B，that of DBP as C，and that of total TC，TG，LDL-C，and HDL-C as D. The evaluation of Chinese patent medicines covered by medical insurance and recommended by guidelines and consensus showed that Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules belonged to class B drugs of medical insurance，and were recommended for 7，6 and 3 times in the guidelines and consensus，respectively. ConclusionCompared with simple medicine treatment，Chinese patent medicine combined with conventional Western medicine has more advantages in improving blood pressure and blood lipid，and shows higher safety. Among them，Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules have stronger clinical applicability and economy. All the trials included in this article adhered to the principle of randomization and reported the outcome measures. However，the quality of evidence in related clinical studies was low. In terms of trial design，large-sample，multi-center，blinded randomized controlled trials based on the consolidated standards of reporting trials （CONSORT） statement are still needed for comprehensive trial designs and reporting，to further improve the GRADE quality evaluation and guideline formulation under the guidance of evidence-based medicine，so as to provide higher quality evidence-based research evidence for clinical decision-making.

Problem Analysis and Standard Establishment of Grade Evaluation Method of Traditional Chinese Medicine Decoction Pieces / 中国实验方剂学杂志

High quality is the premise for the implementation of high quality and good price for decoction pieces， and grade is the most direct manifestation of high quality of decoction pieces. However， there is still a lack of scientific and reasonable methods for evaluating the grade of decoction pieces， and it is urgent to establish a widely recognized and unified standard for the grade of decoction pieces to ensure the quality of the decoction pieces and guarantee the safety and efficacy of clinical use. Based on this， this paper focused on analyzing the problems of the current grade evaluation methods， such as unclear distinction between quality standards and grade standards， unreasonable selection of grade evaluation indicators， and inaccurate application of mathematical statistical methods. Based on the analysis of the grade evaluation of decoction pieces， this paper proposed four criteria for establishing the grade evaluation method of decoction pieces， namely universality， comprehensiveness， reliability and convenience， in order to establish a more reasonable and unified grade standard for decoction pieces and promote the quality improvement of decoction pieces and the development of the industry.

Present Situation Analysis and Thinking on Quality Control Mode of Chinese Materia Medica / 中国实验方剂学杂志

The quality of Chinese materia medica is the premise to ensure its safety and effectiveness in clinical application， and the standardization of Chinese materia medica quality is the most important to realize the sustainable development of traditional Chinese medicine （TCM）. At present， the quality control system of Chinese materia medica has been transformed from a single chemical evaluation to the overall quality control guided by clinical efficacy. However， some quality control items of decoction pieces are still lacking or imperfect in the drug standard of prescription， which makes it difficult to guarantee the effectiveness and safety of Chinese materia medica in clinical application. Based on this， the quality control models and innovative ideas of Chinese materia medica were analyzed and discussed from the perspectives of chemical analysis， biological evaluation and clinical application in this paper. Aiming at the existing problems and actual needs in the control system of Chinese materia medica， this paper proposed the improvement strategies in accordance with the characteristics of TCM， in order to provide theoretical basis for the related research on quality control of Chinese materia medica.

Present Situation Analysis and Thinking on Quality Control Mode of Chinese Materia Medica / 中国实验方剂学杂志

The quality of Chinese materia medica is the premise to ensure its safety and effectiveness in clinical application， and the standardization of Chinese materia medica quality is the most important to realize the sustainable development of traditional Chinese medicine （TCM）. At present， the quality control system of Chinese materia medica has been transformed from a single chemical evaluation to the overall quality control guided by clinical efficacy. However， some quality control items of decoction pieces are still lacking or imperfect in the drug standard of prescription， which makes it difficult to guarantee the effectiveness and safety of Chinese materia medica in clinical application. Based on this， the quality control models and innovative ideas of Chinese materia medica were analyzed and discussed from the perspectives of chemical analysis， biological evaluation and clinical application in this paper. Aiming at the existing problems and actual needs in the control system of Chinese materia medica， this paper proposed the improvement strategies in accordance with the characteristics of TCM， in order to provide theoretical basis for the related research on quality control of Chinese materia medica.

Grade Evaluation of Salviae Miltiorrhizae Radix et Rhizoma Decoction Pieces Based on Relative Quality Constant / 中国实验方剂学杂志

Objective:To establish the grade evaluation standard of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces combining traditional character evaluation and modern intrinsic quality analysis. Method:The appearance character parameters （thickness and weight） and contents of internal index components （tanshinones and salvianolic acid B） of 18 batches of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces were determined， and the relative quality constant was calculated. The maximum value of the percentage quality constants of the tested samples was assumed to be 100%， the value ≥80% was classified as the first-class， ≥50% and <80% as the second-class， <50% as the third-class. Result:The relative quality constants of 18 batches of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces ranged from 349 to 884. According to the percentage quality constant， 18 batches of samples were successfully divided into three grades. The relative quality constant of the first-class product was ≥707， including samples ds5， ds8 and ds14， accounting for about 17% of the total number of samples. The relative quality constant of the second-class product was ≥442 and <707， accounting for about 61% of the total number of samples. the other samples were of the third-class， and their relative quality constants were all <442. Conclusion:The method of relative quality constant overcomes the one-sidedness of the single method in the grade evaluation of Salviae Miltiorrhizae Radix et Rhizoma decoction pieces， and the evaluation results can objectively， reasonably and scientifically classify the grade of the decoction pieces， which can provide reference for the establishment of the grade standard of other decoction pieces.

Application of Relative Quality Constant in Grade Evaluation of Codonopsis Radix Slices / 中国实验方剂学杂志

Objective:To establish the grade evaluation method for Codonopsis Radix slices based relative quality constants， in order to provide scientific theoretical basis for grading of Codonopsis Radix slices. Method:Through literature and market research，the main production areas of Codonopsis Radix slices were determined，and 67 batches of Ludangshen slices（52 batches） and Baitiaodang slices （15 batches） were collected. The appearance traits （average quality and average thickness of Codonopsis Radix slices） were observed and measured. According to Chinese Pharmacopoeia （2015 edition）， the extract and the content of Codonopsis pilosula polysaccharide was determined by phenol-sulphoacid method. Then the relative quality constant was calculated，and the results of grade evaluation were evaluated through systematic cluster analysis and correlation analysis. Result:Relative quality constants of 67 batches of Codonopsis Radix slices were between 0.32-2.97. If these samples were divided into three grades：the first-grade relative quality constants were greater than or equal to 2.08，the second grade was greater than or equal to 0.89 but less than 2.08，while the third grade was less than 0.89. The results of systematic cluster analysis showed that 67 batches of Codonopsis Radix slices were clustered into 3 categories，and the results were basically consistent with the classification. The correlation analysis showed a positive correlation between the content of the extracts and the polysaccharide content （P<0.05）. Conclusion:This method links the extrinsic characteristics to the intrinsic quality，and objectively grade Codonopsis Radix slices， so as to provide a basis for its grade standards.

Systematic review and sequential analysis of Xuebijing Injection in treatment of systemic inflammatory response syndrome / 中国中药杂志

To systematically review the efficacy of Xuebijing Injection combined with western medicine in the treatment of systemic inflammatory response syndrome(SIRS). In this study, CBM, CNKI, Wanfang, VIP, PubMed and EMbase databases were retrieved for clinical randomized controlled trials on the effect of Xuebijing Injection combined with western medicine in the treatment of SIRS from the establishment of the database to July 31, 2020. After screening, Meta-analysis was conducted by RevMan 5.3 software, trial sequential analysis was conducted by TSA 0.9.5.10 beta software, and the evidence quality level was evaluated by GRADEprofiler 3.6.1 software. Meta-analysis showed that Xuebijing Injection combined with western medicine could reduce white blood cell count(MD=-2.32, 95%CI[-2.44,-2.21], P<0.000 01), C-reactive protein count(MD=-22.70, 95%CI[-29.61,-15.79], P<0.000 01), APACHE Ⅱ score(MD=-2.15, 95%CI[-2.43,-1.87], P<0.000 01), tumor necrosis factor alpha count(SMD=-1.23, 95%CI[-1.48,-0.99], P<0.000 01) and interleukin-6 count(SMD=-0.92, 95%CI[-1.15,-0.69], P<0.000 01), improve treatment efficiency(RR=1.39, 95%CI[1.23, 1.56], P<0.000 01), reduce incidence of multiple organ dysfunction(RR=0.47, 95%CI[0.35, 0.64], P<0.000 01) and mortality(RR=0.22, 95%CI[0.13, 0.37], P<0.000 01), which were better than western medicine treatment alone. Trial sequential analysis showed that in terms of reducing the incidence of multiple organ dysfunction and C-reactive protein count, the cumulative Z value passed through the traditional threshold, TSA threshold and expected information value, and reached the required number of cases. GRADE evaluation showed that the level of evidence was low or very low. According to the findings, Xuebijing Injection combined with western medicine is effective in treating SIRS. However, as the low quality of the included studies may affect the reliability of the conclusion, more high-quality studies shall be included for further verification in the future, so as to provide better suggestions for clinical medication.

Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis / 中西医结合学报

BACKGROUND@#Acupuncture therapy has shown promise for effectively relieving preoperative anxiety. Nevertheless, previous findings from randomized controlled trials (RCTs) are inconsistent and must be examined in detail.@*OBJECTIVE@#This study systematically evaluates the efficacy and safety of acupuncture therapy for preoperative anxiety as well as the quality of evidence supporting this application.@*SEARCH STRATEGY@#The China National Knowledge Infrastructure Database, Wanfang Data Journal Database, Chinese Biomedical Literature Database, Chongqing VIP, Embase, PubMed and Cochrane Library Databases were queried from their inception to 19, February 2020, using keywords such as "acupuncture therapy," "preoperative" and "anxioty." Manual searches expanded the search breadth and included conference abstracts and other reference lists.@*INCLUSION CRITERIA@#RCTs were included in the current study if they contained a comparison between a group of anxiety patients that received acupuncture therapy and a control group that received sham acupuncture.@*DATA EXTRACTION AND ANALYSIS@#Literature was reviewed, and various articles were selected using the NoteExpress 3.2.0 software. Two researchers independently screened and extracted data and evaluated the risk of bias in the included studies. The RevMan 5.3 software was used for data aggregation and the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) assessment was used to evaluate the quality of the study outcomes.@*RESULTS@#Twelve studies were included in the review, containing a total of 916 patients. Meta-analysis showed that, compared with the control group, patients who received acupuncture therapy had reduced State-Trait Anxiety Inventory Scale (STAI-S) score (mean difference [MD] = -9.07, 95% confidence interval [CI] [-13.19 to -4.96], P < 0.0001) and Visual Analogue Scale (VAS) score (MD = -1.37, 95% CI [-2.29 to -0.45], P = 0.003). However, for the Hamilton Anxiety Scale (HAMA) score, there was no difference between the two groups (MD = -3.98, 95% CI [-12.89 to 4.92], P = 0.38). Further, the GRADE assessment demonstrated that the STAI-S was of moderate quality, the VAS of low quality and the HAMA of very low quality.@*CONCLUSION@#Acupuncture therapy may be able to decrease anxiety in preoperative patients, but the results need to be further verified due to the small sample sizes and the low quality of evidence to date.

Systematic evaluation and trail sequential analysis of efficacy and safety of Yangxue Qingnao Granules in treatment of essential hypertension and its accompanying symptoms / 中国中药杂志

To systematically evaluate the efficacy and safety of Yangxue Qingnao Granules combined with conventional Western medicine in the treatment of essential hypertension and its accompanying symptoms. PubMed, EMbase, Cochrane Library, VIP, CNKI, Wanfang, and China biomedical database(CBD) were searched to screen out from the establishment of the database to April 2020 about the clinical randomized controlled trials of Yangxue Qingnao Granules combined with conventional Western medicine in the treatment of essential hypertension and accompanying symptoms. The articles were selected according to the inclusion and exclusion criteria. RevMan 5.3 software was used for Meta-analysis. TSA 0.9.5.10 Beta software was used for sequential analysis, and GRADE 3.6 was used for evidence quality evaluation. A total of 4 532 patients were included in 34 randomized controlled trials. Meta-analysis results showed that: Yangxue Qingnao Granules combined with conventional anti-hypertensive agents reduced systolic blood pressure(MD=-10.56, 95%CI[-13.63,-7.50], P<0.000 01) and diastolic blood pressure(MD=-8.21, 95%CI[-10.84,-5.59], P<0.000 01), improved total effective rate(RR=1.21, 95%CI[1.14, 1.29], P<0.000 01), improved patients dizziness(RR=1.29, 95%CI[1.21, 1.37], P<0.000 01), insomnia(RR=1.66, 95%CI[1.44, 1.91], P<0.000 01), headache(RR=1.32, 95%CI[1.21, 1.43], P<0.000 01), chest distress(RR=1.26, 95%CI[1.12, 1.42], P=0.000 1), memory loss(RR=1.24, 95%CI[1.10, 1.40], P=0.000 4), palpitation(RR=1.28, 95%CI[1.17, 1.41], P<0.000 01), and improved traditional Chinese medicine symptom scores(MD=-4.24, 95%CI[-5.25,-3.23], P<0.000 01) and headache symptom improvement scores(MD=-2.02, 95%CI[-2.51,-1.53], P<0.000 01) as compared with Western medicine group alone. Subgroup analysis results showed that Yang-xue Qingnao Granules combined with ACEI drug had more obvious effects in lowering systolic blood pressure and diastolic blood pressure. There was no statistically significant difference in the incidence of adverse reactions, and no abnormal liver and kidney function was observed in each study. Trial sequential analysis showed that the total effective rate was cumulative across the traditional and TSA thresholds, further confirming its clinical efficacy. The evidence level was mostly low or extremely low in GRADE evaluation. The clinical application of Yangxue Qingnao Granules combined with conventional Western medicine in the treatment of essential hypertension and its accompanying symptoms is clear and safe, so it is recommended for clinical application.

Systematic evaluation and trial sequential analysis of Tianma Gouteng Granules combined with anti-hypertensive drugs in treatment of essential hypertension / 中国中药杂志

To systematically evaluate the efficacy and safety of Tianma Gouteng Granules combined with conventional anti-hypertensive drugs in the treatment of essential hypertension. The clinical randomized controlled trials(RCTs) on the treatment of essential hypertension with Tianma Gouteng Granules combined with conventional anti-hypertensive drugs were searched in PubMed, EMbase, Cochrane Library, VIP, CNKI, Wanfang, SinoMed since the establishment of the databases to April 2020 based on inclusion and exclusion criteria, and Meta-analysis was conducted by using RevMan 5.3 software. A total of 15 RCTs were included, involving a total of 1 508 patients. Meta-analysis results showed that Tianma Gouteng Granules combined with conventional Western medicine were supe-rior to the control group in reducing systolic blood pressure(MD=-10.24, 95%CI[-13.54,-6.95], P<0.000 01), diastolic blood pressure(MD=-5.33, 95%CI[-7.21,-3.45], P<0.000 01), improving the clinical efficacy of patients(RR=1.22, 95%CI[1.15, 1.28], P<0.000 01) and curative effect of traditional Chinese medicine syndrome(RR=1.26, 95%CI[1.02, 1.57], P=0.04), increasing nitric oxide content(MD=9.59, 95%CI[7.23, 11.96], P<0.000 01), reducing endothelin-1(MD=-10.74, 95%CI[-15.74,-5.75], P<0.000 1), tumor necrosis factor(MD=-0.28, 95%CI[-0.36,-0.19], P<0.000 01), and interleukin-6(MD=-39.71, 95%CI[-43.40,-36.03], P<0.000 01). There was no statistically significant difference between the test group and the control group in the incidence of adverse reactions. No liver and kidney dysfunction occurred. The results of the subgroup analysis showed that the effect of Tianma Gouteng Granules combined with ARB drugs was more obvious in reducing the systolic and diastolic pressure. Trial sequential analysis showed that the studies accumulatively included for clinical efficacy crossed the traditional threshold and the TSA threshold, further affirming its clinical efficacy. The clinical application of Tianma Gouteng Granules combined with conventional Western medicine in the treatment of primary hypertension and accompanying symptoms has clear efficacy and certain safety, so it is recommended for clinical application.

Evaluation of Astragali Radix quality grade based on appearance characteristics and internal ingredients / 中国中药杂志

This study is to provide the basis of establishing a quality evaluation system, based on the differences in appearance and internal components of Astragali Radix from different sources. The diameter of 18 batches of Astragali Radix, the content of alcohol(water) extract and 7 kinds of flavonoids were determined. The peak area ratio of flavonoid aglycon to aglycone was calculated. PCA and CA were carried out by synthesizing various indexes. The results of PCA and CA showed that Astragali Radix was obviously clustered into three types. Alcohol extract, formononetin/formosan glycosides,(pilose isoflavones+astragalus flavonoid A)/pilose isoflavone glucoside are the most significant differences in the variable importance projection index(VIP) of Astragali Radix. Combining the diameter, alcohol(water) extract, flavonoid aglycon to aglycone peak area ratio can provide an analysis method for the establishment of the grade evaluation system of Astragali Radix.

Research on grade evaluation method of Paeoniae Radix Rubra based on correlation of "biological activity-quality marker" / 中草药

Objective: A logistic regression model for grade evaluation of Paeoniae Radix Rubra medicinal slices was constructed based on the quality control idea of traditional Chinese medicines that "ingredients reflect activity and activity expresses effect". Methods: Q-marker content of paeoniflorin was tested by ultra-high performance liquid chromatography (UPLC). Anticoagulation valence, inhibition rate of hydroxyl radical and DPPH clearance rate were used as evaluation indexes of biological activity. Correlations between paeoniflorin content in different batches and bioactivity indexes were analyzed by the logistic algorithm. Finally, a "principal component analysis-Logistic regression" model for grade evaluation of Paeoniae Radix Rubra was constructed. Results: According to grade evaluation results, the grade probability of different batches of Paeoniae Radix Rubra was higher than 95%. Among 16 batches of Paeoniae Radix Rubra, 15 batches were evaluated excellent, good and moderate (five for each), and one batch was evaluated poor. Conclusion: A new grade evaluation method for Paeoniae Radix Rubra medicinal slices is constructed preliminarily. It is applicable to quality evaluation of Paeoniae Radix Rubra medicinal slices.

Grade Evaluation of Polygoni Multiflori Caulis Based on Quality Constant Method / 中国实验方剂学杂志

Objective::To establish a scientific and reasonable grade evaluation standard for Polygoni Multiflori Caulis. Method::The quality constant method was used to conduct a grade evaluation study on Polygoni Multiflori Caulis. A total of 16 batches of samples were collected from Chinese herbal slices enterprises and medicinal materials markets. By measuring its appearance traits (average quality and average thickness of the decoction pieces) and the intrinsic quality indicators (content of 2, 3, 5, 4′-tetrahydroxystilbene-2-O-β-D-glucoside), then its quality constant and percentage quality constant were calculated comprehensively, finally, the grades of Polygoni Multiflori Caulis were classified by quality constant method. Result::The quality constant of 16 batches of the decoction pieces was 0.054-0.417, and the percentage quality constant was 12.98-100.00.If these samples were divided into three grades, the quality constant shall be ≥0.334 for the first-grade decoction pieces, the quality constant shall be <0.334 and ≥0.209 for the second-grade decoction pieces, while for the third-grade decoction pieces, the quality constant shall be <0.209. Conclusion::The grade evaluation method based on quality constant can overcome the shortcomings of traditional evaluation method for decoction pieces, and can realize scientific, objective and simple classification of Polygoni Multiflori Caulis. This study enriches the research data of modern grade evaluation of Polygoni Multiflori Caulis, and provides reference for grade evaluation and market circulation of other decoction pieces.

Meta-analysis and trial sequential analysis of Qingjin Huatan Decoction for treating community-acquired pneumonia in elderly / 中国中药杂志

To systematically evaluate the clinical efficacy and safety of modified Qingjin Huatan Decoction in the treatment of community-acquired pneumonia in the elderly, and provide evidence-based reference for the clinical application of this prescription. Randomized controlled trials of Qingjin Huatan Decoction in the treatment of community-acquired pneumonia in the elderly were collected by searching PubMed, EMbase, Cochrane Library, CNKI, China Biomedical Literature database, VIP database and WanFang database. Outcome indicators included clinical effective rate, inflammation index, symptom improvement time, chest radiograph improvement time, hospitalization time and adverse reactions. RevMan 5.3 and Stata/IC 15.1 software were used for Meta-analysis; TSA 0.9.5.10 Beta software was used for trial sequential analysis, and GRADE profiler 3.6 was used for grade evidence quality evaluation. Thirteen studies were included finally, including 1 058 patients, 536 patients in the experimental group and 522 patients in the control group.Meta-analysis showed that, the clinical effective rate of the experimental group was significantly higher than that of the control group(RR=1.16, 95%CI[1.10, 1.21], P<0.000 01); fever time(MD=-1.32, 95%CI[-1.93,-0.71], P<0.000 1), cough time(MD=-1.95, 95%CI[-2.69,-1.21), P<0.000 01), time to rale disappearance(MD=-1.55, 95%CI[-2.37,-0.73], P=0.000 2), time to chest radiograph improvement(MD=-1.72, 95%CI[-2.98,-0.46], P=0.007), and hospitalization time(MD=-3.16, 95%CI[-4.58,-1.74], P<0.000 01) in the experimental group were significantly shorter than those in the control group. The improvement in CRP(WMD=-3.44,95%CI[-4.50,-2.38],P<0.001), WBC(WMD=-2.04,95%CI[-3.31,-0.78],P<0.01), IL-6(WMD=-4.27,95%CI[-4.62,-3.92],P<0.001), and TNF-α(WMD=-0.47,95%CI[-0.55,-0.39], P<0.001) of the experimental group was significantly better than that of the control group. There was no significant difference in PCT improvement between the two groups(WMD=-0.63, 95%CI[-1.65, 0.40], P=0.23). No serious adverse reactions occurred in both groups. Sequential analysis of the trial showed that in the studies with cumulative inclusion of clinical effective rate, the data passed the traditional threshold and TSA threshold, further confirming its clinical efficacy. GRADE evaluation showed that the evidence level was low to extremely low. Western medicine treatment combined with Qingjin Huatan Decoction may improve clinical efficiency in the treatment of community-acquired pneumonia in the elderly, improve clinical symptoms faster, reduce CRP, WBC and other inflammatory indicators, and shorten hospital stay. The level of evidence obtained in this study is low, which needs to be further verified by high-quality multi-center, randomized controlled trials.

Research on grade prediction of Persicae Semen based on binary Logistic regression analysis / 中草药

Objective: A Logistic model for quality evaluation of Persicae Semen slices was constructed and its feasibility was verified in this study based on the thoughts on quality control of Chinese materia medica “Components reflect activity and activity points to efficacy”. Methods: Content of amygdalin, thrombin time (TT), ABTS clearance rate, DPPH inhibition rate, and hydroxyl radical scavenging ability in vitro were analyzed by a binary Logistic algorithm. Besides, a grade prediction model for Persicae Semen was established and verified. Results: A total of 18 batches of Persicae Semen were divided into four grades: excellent (represented by Neimeng Persicae Semen), good (represented by Gansu Persicae Semen), medium (represented by Liang Persicae Semen), and poor (represented by Shaanxi Persicae Semen) according to the probability formula of the Logisitc model. All batches of Persicae Semen slices were classified accurately, manifested by the high value of fitting probability (P > 98%). Conclusion: The classification standard based on the Logistic algorithm involving quality control component-in vitro titer is applicable to Persicae Semen slices on the market. Classification results are accurate and reliable.

Grade evaluation of Carthamus tinctorius based on correlation of “biological activity-quality marker” / 中草药

Objective: To establish a Logistic model for quality assessment of Carthamus tinctorius based on content determination and bioactivity. Methods: A method to determinate hydroxy safflor yellow A by using ultra-high performance liquid chromatography (UPLC) was proposed. The activity of anticoagulant was reflected by thrombin time (TT) and the anti-oxidant activity was expressed by scavenging ability of hydroxyl radical and DPPH radical. Later, a Logistic model grade evaluation of C. tinctorius was constructed based on correlation analysis between content and biological activity Logistic.Results: The constructed Logistic model had outstanding stability and high prediction accuracy of grades and it divides 19 batches of C. tinctorius into four grades. Conclusion: The Logistic model based on content determination and biological activity is applicable to assess quality of C. tinctorius slices and provides some reference for quality control.

Grade Standard of Ginseng Radix et Rhizoma / 中国实验方剂学杂志

Objective:Through the analysis of the characteristics and main chemical components of Ginseng Radix et Rhizoma,the correlation between the characteristics and components of Ginseng Radix et Rhizoma was explored,and a new evaluation standard of Ginseng Radix et Rhizoma grade was established to provide a more comprehensive and scientific basis for the quality evaluation of Ginseng Radix et Rhizoma. Method:The appearance characteristics of 48 batches of Ginseng Radix et Rhizoma samples were quantitatively measured. The contents of 9 kinds of Ginseng Radix et Rhizoma were determined. The results of correlation analysis,principal component analysis and cluster analysis were used to classify ginseng medicinal materials according to the analysis results,and the grade evaluation criteria were constructed. Result:First-class ginseng medicinal materials:diameter of main root>1.72 cm,length of reed head>2.61 cm,weight of single branch>14.15 g,content of ginsenoside Rb1>0.612 1%,content of ginsenoside Re>0.385 8%,content of ginsenoside Rg1>0.320 8%,no scar,impurities,moth,mildew. Second-class ginseng medicinal materials:the diameter of main root is 1.55-1.72 cm,the length of reed head is 1.74-2.61 cm,the weight of single branch is 10.24-14.15 g,the content of ginsenoside Rb1 is 0.496 8%-0.612 1%,the content of ginsenoside Re is 0.323 3%-0.385 8%,the content of ginsenoside Rg1 is 0.263 6%-0.320 8%,and there are no scars,impurities,worms and mildew. Third-class ginseng medicinal materials:main root diameter 1.29-1.55 cm,reed head length 1.34-1.74 cm,single branch weight 6.90-10.24 g,ginsenoside Rb1 content 0.389 5%-0.496 8%,ginsenoside Re content 0.235 2%-0.323 3%,ginsenoside Rg1 content 0.217 1%-0.263 6%,no impurities,worms,mildew. Fourth-class ginseng medicinal materials:diameter of main root11Conclusion:The appearance indexes of ginseng medicinal materials were divided according to the standards of taproot diameter,reed head length and single ginseng weight,and the content of ginsenoside Rg1,Re,Rb1 was used as the internal quality evaluation index. Ginseng commercial specifications were divided into four grades,which integrated the appearance and internal indicators,and had more scientific and comprehensive characteristics,which could be used as the basis for the classification of Ginseng Radix et Rhizoma medicinal materials.

Grade Standard of Glycyrrhizae Radix et Rhizoma / 中国实验方剂学杂志

Objective:To explore the correlation between the characters and chemical constituents of Glycyrrhizae Radix et Rhizoma through the analysis of characters and main chemical constituents of Glycyrrhizae Radix et Rhizoma,and establish the grade evaluation criteria of Glycyrrhizae Radix et Rhizoma, so as to provide reference for the quality evaluation and quality control of Glycyrrhizae Radix et Rhizoma. Method:Correlation analysis,principal component analysis and cluster analysis were carried out for appearance and intrinsic indexes of Glycyrrhizae Radix et Rhizoma. Result:Class Ⅰ of Glycyrrhizae Radix et Rhizoma:the diameter of big end was more than 1.60 cm,middle circumference was more than 3.76 cm,inner core chromaticity b* was more than13.88,outer skin chromaticity a* was more than 37.61,glycyrrhizin content was more than 1.13%,with no worm,rot and impurity. Class Ⅱ of Glycyrrhizae Radix et Rhizoma:the diameter of big end was 1.39-1.60 cm,the middle circumference was 3.09-3.76 cm,the inner core chromaticity b* was 10.22-13.88,the skin chromaticity a* was 35.57-37.61,glycyrrhizin content was 0.69%-1.13%,with no worm,rot and impurity. Class Ⅲ of Glycyrrhizae Radix et Rhizoma:the diameter of the big end was 1.08-1.39 cm,the middle circumference was 2.41-3.09 cm,the inner core chromaticity b* was 5.16-10.22,the skin chromaticity a* was 29.19-35.57,glycyrrhizin content was 0.55%-0.69%,with no worm and rot. Substandard Glycyrrhizae Radix et Rhizoma:the diameter of the big end was lower than 1.08 cm,the central circumference was lower than 2.41 cm,the inner core color b* was lower than 5.16,the outer skin color a* was lower than 29.19, and glycyrrhizin content was lower than 0.55%. Conclusion:The grade evaluation standards established in this paper include appearance and intrinsic indexes, with scientific,comprehensive and practical characteristics. It can be used for the grade evaluation of Glycyrrhizae Radix et Rhizoma medicinal materials.

Grades evaluation of Phellodendri chinensis cortex pieces based on quality constant / 中国中药杂志

Quality constant is a comprehensive grades evaluation method for traditional Chinese medicine decoction pieces, which is better but based on traditional way. In this paper, a new grading mode for Phellodendri chinensis pieces was established based on quality constant evaluation method. The results showed that the range of relative quality constant for 15 batches of different samples was from 0.41 to 0.96. As customary, if these samples were divided into three grades: the relative quality constant shall be ≥0.77 for first grade; <0.77 but ≥0.48 for the second grade; and ＜0.48 for the third grade. This research indicated that the quality constant mode can be used to effectively grade the P. chinensis pieces in a scientific, reasonable, objective and specific way. Simultaneously, it provided a beneficial reference for grading cortex herbal pieces or medicines.

Survey of the standardization of medical records writing by physicians / 中华医院管理杂志

Objective To study the standardization of medical records writing by residents in hospitals. Methods With both quantitative and qualitative analysis, medical records made by residents were sampled in groups to study their standardization. Results Recognition rate of such medical records was 82. 55%, and the excellence rate was 24. 50% in the grade evaluation. For senior residents, their rate of writing excellence falls below those of junior ones; whether the evaluators have medical background bears no significant difference for grade evaluation of medical records writing, yet a significant difference was found with the recognition rate. Conclusion Writing of medical records by residents is found with incompliance now and then, and the recognition rate ought to be improved.