Generation of traditional Chinese medicine prescription driven by generative artificial intelligence GPT-4 / 中国药房

OBJECTIVE To evaluate the safety and suitability of traditional Chinese medicine prescriptions generated by generative artificial intelligence （AIGC）， and to provide research ideas for empowering the traditional Chinese medicine industry with AIGC. METHODS Using the 2020 edition of Chinese Pharmacopoeia and the 5th edition of Traditional Chinese Medicine as corpus， GPT-4 and the real-time networking model developed based on GPT-4 （referred to as the “networking model”） were used for deep learning. The clinical cases included in the consensus of traditional Chinese medicine experts in recent years were extracted manually to regenerate prescriptions based on diagnosis using the GPT-4 model and networking model； traditional Chinese medicine experts conducted blind evaluation and scoring of GPT-4 generated prescriptions， networking model generated prescriptions， and expert consensus prescriptions. At the same time， Turing testing was used to evaluate whether the GPT-4 model and networking model had the same ability as human intelligence. RESULTS The average score of traditional Chinese medicine prescriptions generated by the GPT-4 model showed no statistically significant difference compared to manual prescriptions （P＞0.05）， while the average score of prescriptions generated by the networking model showed no statistically significant difference compared to traditional Chinese medicine prescriptions generated by the GPT-4 model （P＞0.05）. The proportion of model-generated prescriptions mistakenly judged as manual prescriptions in the Turing test was 51.11%. CONCLUSIONS The traditional Chinese medicine prescriptions generated by the GPT-4 model have reached a certain level of safety and suitability， and the GPT-4 model has passed the Turing test. The introduction of AIGC in the diagnosis and treatment process may provide technical support for the rational use of clinical traditional Chinese medicine.

Construction and application of pharmaceutical service model of traditional Chinese medicine combined outpatient in the first affiliated hospital of Suzhou university / 国际中医中药杂志

This paper introduces the construction and application of "TCM combined outpatient" in the first affiliated hospital of suzhou university. The joint outpatient is set up with senior specialists and clinical pharmacists, and independently developed the traditional Chinese medicine prescription audit system and the pharmaceutical service intelligent platform based on mobile internet technology. The multi-channel doctor- patient-pharmacist exchange platform is set up to assist doctors in drugs selection and patients management with certain achievements.

Regularity of traditional Chinese medicine prescriptions for same treatment for cardiovascular and cerebrovascular diseases / 中国中药杂志

To explore the regularity of traditional Chinese medicine(TCM) prescriptions for cardio-cerebrovascular diseases,the core drug groups with common therapeutic effects on cerebrovascular diseases represented by stroke and cardiovascular diseases represented by coronary artery disease were extracted,and their consistency and difference in the treatment of different diseases were analyzed.A total of 388 Chinese patent medicines were collected for the treatment of cerebrovascular diseases,cardiovascular diseases and cardio-cerebrovascular diseases.The dominant and recessive patterns of Chinese patent medicines in clinical use were found by "frequency analysis","compatibility analysis" and "network analysis" respectively.According to the findings of the three parts,Salviae Miltiorrhizae Radix et Rhizoma,Chuanxiong Rhizoma,Carthami Flos and Astragali Radix have a high frequency of use in the treatment of brain disease,heart disease and both,with frequent combined medication.Data mining confirmed the core drug combinations for the treatment of cerebral and cardiac vascular diseases,so as to reveal the similarities and differences in the drug use of Chinese medicine for these diseases,and provide a basis for the rational use of traditional Chinese medicine in clinical practice.This analysis also defines a new direction for the future development of prescription combinations for different indications of cerebral and cardiac diseases.

Patrones de prescripción de medicamentos para la diabetes mellitus tipo 2 en cinco departamentos de Colombia, en 2014 / Patterns of Medicine Prescriptions for Diabetes Mellitus Type 2 in five Departments of Colombia in 2014 / Padrões de prescrição de medicamento para a Diabetes Mellitus tipo 2 em cinco departamentos da Colômbia em 2014

Resumen Objetivos: Describir los patrones de prescripción de los medicamentos para la diabetes mellitus tipo 2 (DM2) y comorbilidades de pacientes atendidos en cinco instituciones prestadoras de servicios de salud de Colombia. Metodología: Estudio descriptivo transversal, en el cual se revisaron las historias clínicas de 5098 pacientes con DM2, atendidos en centros de atención ambulatoria ubicados en cinco ciudades colombianas entre el 1.º de enero y el 31 de diciembre de 2014. Cada uno de los pacientes con DM2 tenía al menos dos consultas ambulatorias registradas durante el periodo de estudio. La recolección de la información se hizo mediante una encuesta electrónica. Para la categorización de los medicamentos se usaron las guías nacionales e internacionales para el tratamiento de la diabetes. El análisis de los datos fue realizado utilizando el programa IBM SPSS® Statistics versión 21. Resultados: El medicamento de más frecuente prescripción fueron las biguanidas (59 %) y las sulfonilureas (28 %). La prescripción de inhibidores de la dipeptidil peptidasa-4 fue 7 % y la frecuencia de prescripción de agonista del receptor del péptido similar al glucagón tipo 1 (AR GLP-1) fue de 2 %. El medicamento con mayor frecuencia de prescripción como monoterapia fueron las biguanidas (22 %). La combinación más frecuente fue biguanida y las sulfonilureas (21 %), seguida de biguanida e insulina (10 %), y otras combinaciones. El 27 % pacientes con DM2 no recibió ningún tratamiento farmacológico para la diabetes. Con respecto a los medicamentos para comorbilidades, el 52 % de los pacientes utiliza al menos un tipo de antihipertensivo, el 39 % usa al menos un tipo de hipolipemiante y el 35 % utiliza ácido acetilsalicílico. Conclusiones: Las biguanidas fueron el medicamento con mayor frecuencia de prescripción, seguido de las sulfonilureas. Uno de cada cuatro pacientes no tenía registro de prescripción de medicamentos. El uso de ácido acetilsalicílico como prevención del riesgo cardiovascular fue menor al esperado.

Abstract Objetive: to describe the patterns of medicine prescriptions for diabetes mellitus type 2 (dm2) and the comorbidity of patients in five health care institutions in Colombia. Methodology: descriptive cross-sectional study carried out checking the medical records of 5098 patients with dm2 treated at the outpatient service centers in five Colombian cities between January 1 and December 31 of 2014. Each patient with dm2 had a record of at least two outpatient appointments registered during the time of this study. The information was collected through electronic surveys. National and international guides on diabetes treatment were used to categorize the medications. The spss® 21 software was used to analyze the data. Results: the most frequently prescribed medications were biguanides (59%) and sulfonylureas (28%). The prescription of inhibitors for Dipeptidyl peptidase-4 was 7% and the frequency of prescription of glucagon-like peptide-1 receptor agonists (ar glp-1) was 2%. The medication with the highest frequency of prescription as monotherapy were biguanides (22%). The most frequent combination was biguanide and sulfonylureas (21%). The second most frequent combination was biguanide with insulin (10%), and other combinations. 27% of patients with dm2 did not receive any pharmacological treatment for diabetes. Regarding the medicines for comorbidity, 52% of patients use at least one type of antihypertensive drug, 39% use at least one type of hypolipidemic drug and 35% uses acetylsalicylic acid. Conclusions: biguanides were the most frequently prescribed medication, sulfonylureas came after. One in four patients did not have a record of medicine prescription. The prescription of acetylsalicylic acid to prevent cardiovascular risk was lower than expected.

Resumo Objetivo: descrever os padrões de prescrição dos medicamen tos para a Diabetes Mellitus tipo 2 (dm2) e de comorbilidades de pacientes atendidos em cinco instituições de serviço de saú de da Colômbia. Metodologia: estudo descritivo transversal, no qual revisaram-se as histórias clínicas de 5098 pacientes com dm2, atendidos em centros de atendimento ambulatorial localizados em cinco cidades colombianas, entre 1 de janeiro e 31 de dezembro de 2014. Cada paciente com dm2 tinha pelo menos duas consultas ambulatoriais registradas durante o pe ríodo do estudo. A informação coletou-se através de inquérito eletrônico. Para a categorização dos medicamentos, utiliza ram-se os guias nacionais e internacionais para o tratamento da diabete. A análise dos dados realizou-se utilizando o progra ma spss® 21. Resultados: os medicamentos de prescrição mais frequente foram biguanidas (59%) e as sulfoniluréias (28%). A prescrição de inibidores da dipeptidil peptidase IV foi 7% e a frequência de prescrição de agonista do receptor do péptido si milar ao glucagão tipo 1 (ar glp-1) foi de 2%. O medicamento com mais frequência de prescrição como monoterapia foi as biguanidas (22%). A combinação mais frequente foi biguanida e sulfoniluréias (21%). A segunda combinação mais frequente foi biguanida com insulina (10%), e outras combinações. 27% dos pacientes com dm2 não recebeu tratamento farmacológi co nenhum para a diabetes. Respeito dos medicamentos para comorbilidades, 52% dos pacientes utiliza pelo menos um tipo de anti-hipertensivo, 39% utiliza pelo menos um tipo de hi polipemiante e 35% utiliza ácido acetilsalicílico. Conclusões: as biguanidas foram o medicamento com mais frequência de prescrição, e depois as sulfoniluréias. Um de quatro pacientes não rinha registro de prescrição de medicamentos. O uso de ácido acetilsalicílico como prevenção do risco cardiovascular foi menor do que se esperava.

Modern research progress of traditional Chinese medicine based on integrative pharmacology / 中国中药杂志

Integrative pharmacology (IP) is a discipline that studies the interaction, integration and principle of action of multiple components with the body, emphasizing the integrations of multi-level and multi-link, such as "whole and part", " and ", " process and activity evaluation". After four years of development and practice, the theory and method of IP has received extensive attention and application.In order to better promote the development of IP, this paper systematically reviews the concepts, research contents, research methods and application fields about IP.

Analysis of Herbal Medicine Prescriptions for Patients in An Academic Korean Medical Hospital: A Cross Sectional Study of Electronic Medical Records (2010-2013) / 中国结合医学杂志

<p><b>OBJECTIVE</b>To obtain fundamental information for the standardization of herbal medicine in Korea.</p><p><b>METHODS</b>We analyzed the herbal medicine prescription data of patients at the Pusan National University Korean Medicine Hospital from March 2010 to February 2013. We used the Dongui-Bogam (Dong Yi Bao Jian) to classify prescribed herbal medicines.</p><p><b>RESULTS</b>The study revealed that the most frequently prescribed herbal medicine was 'Liuwei Dihuang Pill (LWDHP, )' which was used for invigorating 'Shen (Kidndy)-yin'. 'LWDHP' was most frequently prescribed to male patients aged 50-59, 60-69, 70-79 and 80-89 years, and 'Xionggui Tiaoxue Decoction (XGTXD, )' was most frequently prescribed to female patients aged 30-39 and 40-49 years. According to the International Classification of Diseases (ICD) codes, 'Diseases of the musculoskeletal system and connective tissue' showed the highest prevalence. 'LWDHP' and 'XGTXD' was the most frequently prescribed in categories 5 and 3, respectively. Based on the percentage of prescriptions for each sex, 'Ziyin Jianghuo Decoction ()' was prescribed to mainly male patients, and 'XGTXD' with 'Guima Geban Decoction ()' were prescribed to mainly female patients.</p><p><b>CONCLUSION</b>This study analysis successfully determined the frequency of a variety of herbal medicines, and many restorative herbal medicines were identified and frequently administered.</p>

Methodology Exploration for Multi-component Chinese Medicine Based on Protein Signal Transduction Network / 世界科学技术-中医药现代化

Multi-component Chinese medicine has been considered an important developmental direction for traditional Chinese medicine (TCM) formula.Nowadays,it is unfit to target a molecule for preventing or curing a disease because it resulted from multiple of factors and resulted in many indications.Thus,the idea focusing on the multiple targets for therapy is increasingly accepted by physicians and scientists.Here,we conceived a new simplified method for screening the active multi-component Chinese medicine based on the complexity of Chinese medicine,the multi-target property of protein signal transduction and the principle of Chinese medicine prescription.Combined with the traditional knowledge on tumor and latest antitumor research results of Chinese medicine and its compounds,the method was concretely illustrated.It helps us to transform the herbal compounds to new complex drugs targeting multiple signaling.

Analysis on Traditional Chinese Medicine Prescription Patterns in 3609 Patients with Osteoarthritis Based on The Real World / 世界科学技术-中医药现代化

Traditional Chinese medicine (TCM) is widely used as a complementary approach for osteoarthritis treatment.This article is based on the real world.The implicit prescription patterns behind TCM formulae were examined by association rules mining and cluster analysis,so as to explore the Chinese medicinal compatibility patterns or rules in osteoarthritis treatment.This study was based on real-world data from the hospital information system (HIS).Chinese medicinal prescriptions of hospitalized patients with osteoarthritis from June 2012 to June 2016 were collected from the Department of Rheumatism and Immunology,the First Affiliated Hospital of Anhui University of Chinese Medicine.TCM was listed according to the selected medicinal formulae and the added information was organized to establish a database.The frequency and association rules of prescription patterns were analyzed using the SPSS Modeler 14.2 Data Mining System.Cluster analysis of prescription patterns was also analyzed.An initial statistical analysis was carried out to categorize herbs according to their natures,flavors,channel tropisms and functions.Based on categorization,frequencies of occurrence were computed.At the same time,the relationship between TCM and immune and inflammatory markers was analyzed.The results showed that the main prescriptive features from the selected formulae of the mining data were that,(1) warm or cold herbs,sweet or bitter herbs,and with the channel tropism of spleen channel are the most frequently prescribed herbs in 3609 medicinal formulae;(2) herbs with blood-activating and stasis-resolving,restoring vital energy,water-eliminating and damp-removing,heat-clearing and or expelling wind-damp functions are frequently prescribed;(3) association rule analysis extracted three frequently used pairs of herbs,which are Hong Hua & Tao Ren (98.90％),Pu Gong Ying & Bai Hua She She Cao (97.88％),Fu Ling & Ze Xie (92.63％);(4) association rule between TCM and immune-inflammation index showed that the pair of Du Huo and Chen Pi was associated with increased superoxide dismutase (SOD) enzyme.The pair of Mai Ya and Dan Shen was associated with decreased high-sensitivity C-reactive protein (hs-CRP),erythrocyte sedimentation rate (ESR),complement component 3 (C3),complement component 4 (C4),immunoglobulin A (IgA) and immunoglobulin G (IgG).The pair of Mai Ya and Fu Ling was associated with decreased immunoglobulin M (IgM).It was concluded that osteoarthritis was closely related to spleen deficiency.These prescriptions focus on herbs for qi-nourishing and spleen-invigorating,blood-activating and stasis-resolving,spleen-invigorating and dampness-eliminating,heat-clearing and detoxicating which seems to be the key element in the treatment process.Meanwhile,the use of restoring vital energy herbs and spleen-strengthening herbs also forms the basis of prescription patterns.

Relation Extraction of Traditional Chinese Medicine Prescription and Disease Based on Literature Abstracts Data / 世界科学技术-中医药现代化

This paper studied the correlation between traditional Chinese medicine (TCM) prescription and disease based on machine learning.This paper selected TCM literature abstract data in the TCM category of the China National Knowledge Infrastructure (CNKI) database by crawler technology.After data cleaning,lexicon building,word segmentation and other related basic pre-treatment work,it uses natural language processing technique to extract the feature of the web text data,constructs the Support Vector Machine (SVM) classification model,and extracts the relation between TCM prescription and disease.The results showed that among 1073581 abstracts,204780 sentences,which included both TCM prescription and the disease according to dictionaries,were filtered.The SVM classification model whose feature is constructed by constituency parser is in a better accuracy,which achieved 87％.Applying the SVM model in filtered sentences,this study obtained the relation triples between TCM prescription and the disease.It was concluded that by using the method of machine learning to extract relation on abstract data from the CNKI database,the extracted relation triples of TCM prescription and disease will take a positive effect on the research of disease treatment by TCM prescription.

Study on Prescription Regularity of Traditional Chinese Medicine in Treating Cirrhosis Based on Machine Learning / 世界科学技术-中医药现代化

This study was aimed to use machine learning techniques for the prescription regularity of traditional Chinese medicine (TCM) in the treatment of liver diseases in order to provide a reference basis for clinical treatment as well as research and development of new drugs.According to the prescription data of liver disease treatment of the last two years in the hepatology department of a triple-A TCM hospital,the related structure between drugs was firstly found by the complex structure of drugs.And then,association rule,cluster analysis and other unsupervised machine learning methods were used.The prescription regularity of TCM in the treatment of cirrhosis was received through the comparison and analysis.The results showed that there were 589 prescriptions with 257 types of Chinese medicine herbs.The high frequency drug combination included 2 items of 12,3 items of 15,4 items of 14;support ＞ 10％,confidence ＞ 90％ of the association rule include "dried tangerine peel,medicated leaven → largehead atractylodes rhizome," "polyporus umbellatus,dried tangerine peel → largehead atractylodes rhizome" and other 34;through cluster analysis,it showed that Chinese medicine was mainly classified by 5 characteristics.The machine learning result was the same as the constructed complex network.It was concluded that the combination of complex network and machine learning methods in the exploration of prescription regularity of TCM in the treatment of cirrhosis were feasible.It provided clinical treatment of cirrhosis and clues for finding new prescription in the treatment of cirrhosis.

Discussion on clinical problems about bases of new drug of traditional Chinese medicine development / 中国中药杂志

In view of the industry lacking of sufficient analyses on the bases of project establishment about the new drugs of traditional Chinese medicine(TCM) during their applying for the clinical research, from the perspective of clinical evaluation, this paper reviewed and analyzed the present situation and development paths of new drugs of TCM in recent years. Through the analyses of the rationality of formulations, human use experiences and clinical studies, the paper puts forward the countermeasures to solve these difficulties during the technical evaluation of new drugs of TCM in order to improve the new drugs' clinical research.

Prescrição off-label, direito à informação, consentimento informado e processo clinico eletrónico no direito português / Off-label prescription, informed consent and electronical records in Portuguese law / Prescripción off-label, consentimiento informado y processo clínico electrónico en la legislación portuguesa

A prescrição off-label de medicamentos é não só uma prática comum e amplamente aceita, como também incontornável nos sistemas de saúde modernos. Perante a ausência de terapia eficaz, o médico não pode ficar sujeito ao tempo necessário para que todo o processo de aprovação de um determinado uso para um determinado medicamento se desenvolva. No entanto, apesar de se mostrar urgente, ainda não existe uma regulamentação desse tipo de receita médica em Portugal (ou mesmo na Europa). Como uma prerrogativa do médico, a liberdade terapêutica deve garantir o respeito pelo paciente, razão pela qual deve ser plenamente informado. É imperativo que o paciente conheça aquela terapia particular, os seus potenciais riscos e benefícios e as razões que levaram o médico a prescrever off-label. Todas as informações devem, por isso, ser claramente anotadas nos registos clínicos do paciente de modo garantir uma efetiva proteção tanto para o paciente como para o médico. Embora não exista, ainda, consenso quanto à prescrição off-label, em 2014 a Direção Geral de Saúde portuguesa emitiu uma norma que recomenda a obtenção do consentimento informado, sob a forma escrita, para os casos de uso off-label de medicamentos. O problema reside na seguinte questão: como ajustar essa recomendação com a crescente informatização dos registros clínicos e com mecanismos como a Plataforma de Dados de Saúde Português? Na verdade, este é um problema comum. Recentemente, a FDA (Food and Drug Administration, EUA) publicou um projeto que fornece, precisamente, recomendações sobre procedimentos utilizando um consentimento informado eletrónico.

Off-label prescription of a medicine is not only common and a widely accepted practice, but also unavoidable in modern health systems. A practitioner tasked with treating patients in this real world, facing a lack of useful therapy, cannot wait for all the procedure to get a licensed medicine use. However, there is still no regulation of this kind of prescription in Portugal (or Europe). As a physician's prerogative, therapy freedom must guarantee the patient's respect, reason why he/she must be fully informed. It is imperative that the patient knows the particular therapy, its potential risks and benefits and the reasons that led the practitioner to prescribe off-label. Besides all information should be comprehensibly noted in the patient's clinical records to ensure protection for both patient and physician.Although there is no consensus about the form of off-label prescription's informed consent, in 2014, an administrative guideline from DGS (Portuguese Health's Direction) recommends a written form.The problem is: how to adjust this demand with the growing informatization of the clinical records and with mechanisms like the Portuguese Health Data Platform? In fact, this is a common health problem. Recently, FDA (U.S. Food and Drug Administration) published a draft guidance that provides recommendations on procedures using an electronic informed consent

La prescripción off-label de medicamentos no sólo es una práctica común y ampliamente aceptado, asi como es esencial en los sistemas de salud modernos. En ausencia de una terapia eficaz, el médico no puede estar sujeto al tiempo requerido para el proceso de aprobación de un uso específico para un medicamento en particular. Sin embargo, aunque es algo urgente, todavía no hay una regulación de este tipo de prescripción en Portugal (incluso en Europa). Como una prerrogativa del médico, la libertad terapéutica debe garantizar el respeto por el paciente, que debe estar plenamente informado. Es imprescindible que el paciente compre su terapia en particular, los posibles riesgos y beneficios y las razones que llevaron al médico que le recete un medicamento off-label. Por lo tanto, toda la información debe estar claramente indicado en el historia clínica del paciente asegurando una protección eficaz tanto para el paciente como para el médico.Aunque todavía no existe un consenso sobre la prescripción off-label, en el año 2014 la Dirección General de Salud de Portugal emitió una norma que recomienda obtener el consentimiento informado en forma escrita, en los casos de uso off-label de medicamentos.El problema radica en la pregunta: cómo ajustar esta recomendación con la creciente informatización de la historia clínica y mecanismos tales como la Plataforma de Datos de Salud portugués? De hecho, este es un problema común. Recientemente, la FDA (Food and Drug Administration, EE.UU.) publicó un proyecto que ofrece precisamente recomendaciones sobre los procedimientos que utilizan un consentimiento informado electrónico

Data mining analysis of regularity of formulas containing Salviae Miltiorrhizae Radix et Rhizoma-Carthami Flos medicin pair in Dictionary of Chinese Medicine Prescription / 中国中药杂志

In this study, formulas containing Salviae Miltiorrhizae Radix et Rhizoma-Carthami Flos in the database of Dictionary of Chinese Medicine Prescription (DCMP) were extracted by using traditional Chinese medicine inheritance support system (TCMISS). The drugs pairs and formula composition rules were analyzed with data mining methods, such as association rules, improved mutual information method and complex system entropy clustering. Totally 39 formulas were included in this study and involved 280 Chinese medicines. The top 5 Chinese medicines most frequently used were Danggui (Angelica sinensis), Chuanxiong (Ligusticum chuanxiong), Xiangfu (Cyperi Rhizoma), Baishao(Radix Paeoniae Alba), Taoren(Prunus persica) and Shengdihuang (Radix Rehmanniae Recens). Six core medicinal pairs were obtained through clustering analysis, namely Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Xiangfu (Cyperi Rhizoma)-Honghua (Carthami Flos), Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Baishao (Radix Paeoniae Alba)-Honghua (Carthami Flos), Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Danggui (A. sinensis)-Xiagnfu (Cyperi Rhizoma)-Honghua (Carthami Flos), Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Danggui (A. sinensis)-Baishao (Radix Paeoniae Alba)-Honghua (Carthami Flos), Honghua (Carthami Flos)-Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Baishao (Radix Paeoniae Alba)-Danggui (A. sinensis), Danshen (Salviae Miltiorrhizae Radix et Rhizoma)-Baishao (Radix Paeoniae Alba)-Honghua (Carthami Flos)-Danggui (A. sinensis). The support degree was set at 11 (38.46%), with a confidence coefficient of 80%, and then 38 associated pairs were screened. These results suggested that Salviae Miltiorrhizae Radix et Rhizoma, Carthami Flos is often combined with herbs for activating blood and promoting circulation of qi to treat gynecopathy, stasis blood pain syndrome, stroke and other syndromes.

Protective effect of the traditional Chinese medicine prescription, Jiu Nao Yi Zhi water extract, on human neuroblastoma SH-SY5Y cell line / 中国比较医学杂志

Objective To observe the protective effect of the traditional Chinese medicine prescription, Jiu Nao Yi Zhi water extract, on human neuroblastoma SH-SY5Y cell line, its effect on expression of insulin signal transduction pathway, and to explore the related mechanisms.Methods SH-SY5Y cells cultured in vitro, were divided into control group, Jiu Nao Yi Zhi No.1 prescription group and No.3 prescription group.The doses were 0.0625 mg/mL, 0.125 mg/mL, 0.25 mg/mL, 0.5 mg/mL and 1 mg/mL.The thiazolyl blue ( MTT) metabolic rate of each group was determined.The dose of 0.125 mg/mL was chosen for cell immunofluorescence analysis, and to observe the expression of insulin receptor substrates-1 ( IRS-1 ) , cAMP response element binding protein ( CREB ) , and the factors of insulin signal transduction pathway.Results Compared with the control group, MTT metabolic rates of the Jiu Nao Yi Zhi groups were significantly increased (P<0.05), and the cell morphology was much better in those groups, cell body more plump, well-adherent and neurite extensions were observed.The expressions of IRS-1 and CREB were higher than that in the control group.Conclusions The traditional Chinese medicine prescription Jiu Nao Yi Zhi water extract can protect neurons by promoting nerve cell growth, and improving the expression of IRS-1 and CREB, the factors of insulin signal transduction pathway.

"Screening of Ingredients Assembling of Chinese Medicine ""BZL"" Prescription and Its Effect on Experimental Fatty Liver Rats" / 世界科学技术-中医药现代化

This study was aimed to explore five Chinese medicine components or ingredients from Qu-Shi Hua-Y u Decoction (QSHYD) with uniform design method and screen ingredients assembling of Chinese medicine BZL pre-scription in order to verify its therapeutic effect on experimental fatty liver rats. High-fat diet was used in the estab-lishment of fatty liver rat models. Five effective ingredients (i.e., chlorogenic acid, geniposide, curcumin, polydatin and polysaccharide of Atractylodes macrocephala Koidz) of QSHYD were used as study subjects. Uniform design was applied in the grouping design. The intragastric administration was given for four weeks. The screening index was the content of liver triglyceride (TG). The ingredients assembling of Chinese medicine BZL prescription was screened through uniform design and regression analysis. The same fatty liver animal model was used in the comparison be-tween QSHYD and rosiglitazone. The TG content in liver tissues of rats and serum ALT activity were detected. The pathological changes of liver tissues were observed (HE stain and oil red O stain) with Ridit analysis to verify its therapeutic effect. The results showed that through screening, the regression equation was Y = 15.083X1 + 5.321X2- 5.186X3 - 16.157X4 + 9.35X5 + 17.667X3X4 - 8.422X1X2 - 6.617X3X5 + 16.571 (X1: chlorogenic acid, X2:polydatin, X3: polysaccharide of Atractylodes macrocephala Koidz, X4: geniposide, X5: curcumin). According to this equation, the best TG reducing effect occurred when the chlorogenic acid (X1), polysaccharide of Atractylodes macrocephala Koidz (X3), and geniposide (X4) were the maximum dosage. It showed that the best combination in inhibiting TG content in liver tissues was X3, X4 and X1 (i.e. BLZ prescription). Among fatty liver rat mod-els induced with same high-fat diet, the screened Chinese medicine ingredient BZL prescription can obviously reduce its TG content in liver tissues and serum ALT activity ( P < 0 . 01 ) . It obviously improved the fatty degen-eration of rat's liver. It was concluded that ingredients assembling of Chinese medicine BZL prescription screened through uniform design can obviously prevent and treat fat deposition and injury of the liver among rat models induced by high-fat diet .

O paciente idoso sob o aspecto da utilização de antimicrobianos: repercussão ao sistema público de saúde brasileiro (SUS) / Elderly patients from the aspect of use of antimicrobial: repercussion in the Brazilian Public Health System (SUS)

Os idosos constituem a parcela da população que mais vem aumentando em todo o mundo. No Brasil, o envelhecimento populacional tem ocorrido de forma rápida e acentuada. Os pacientes acima de 60 anos chegam a somar 50% dos multiusuários do SUS, representando um grande consumo de medicamentos de modo a ser o destinatário de uma fração significativa dos recursos empregados. Contudo, destacam-se os antimicrobianos como os medicamentos prescritos com maior frequência a essa população.

The elderly constitute the population that is increasing most in the world. In Brazil, the aging of the population has been happening fast and accentuated. The patients who are over 60 years of age correspond to 50% of the government medical care (SUS) clients, which represents a high consumption of medication which means a significant percentage of resources used. However, the antimicrobials seem to represent as the most prescribed medications to this population.

Estudo das prescrições de antibacterianos para pacientes idosos realizado no Hospital Universitário da Universidade Federal de Juiz de Fora (HU/UFJF) / Study of antibacterial prescriptions for elderly patients held at the University Hospital from Federal University of Juiz de Fora (HU/UFJF)

Os idosos constituem a parcela da população que mais cresce em todo o mundo. No Brasil, o envelhecimento populacional tem ocorrido de forma rápida e acentuada. Os pacientes acima de 60 anos chegam a somar 50% dos multiusuários do SUS. Com o objetivo de descrever e analisar os antibacterianos prescritos a pacientes idosos no âmbito hospitalar, foi realizado um estudo descritivo retrospectivo e transversal. Em um universo de 1.148 prescrições, 360 (31,36%) foram destinadas a pacientes idosos e 129 (11,24%) continham ao menos um antibacteriano, totalizando 188 antibacterianos prescritos a idosos (5,70% do total de medicamentos). As prescrições para pacientes idosos tiveram uma grande representatividade no HU/UFJF sendo os antibacterianos uma importante parcela dos medicamentos prescritos a esses pacientes.

The elderly people represent the percentage of the population with the highest level of growth worldwide. In Brazil, the aging of the population has been happening fast and accentuated. The patients who are over 60 years of age correspond to 50% of the government medical care (SUS). Aiming to describe and analyze the anti-bacterium prescribed to elderly patients in hospitals, we performed a retrospective descriptive study and transverse. In a total of 1.148 prescription, 360 (31.36%) were prescribed to elderly patients whereas 129 (11.4%) had at least one anti-bacterium prescribed to those patients subtotaling 188 anti-bacteria prescribed to elderly patients (5.7% of the total medication). The prescriptions for elderly patients had a large representation in the HU / UFJF anti-bacterials being a significant portion of prescription drugs to those patients.

Dilemas éticos nn las relaciones entre la indusria farmacéutica y los profesioonales de la salud / Ethnic dilemmas in the relationships between the pharmaceutical industry and health personnel

El siguiente documento expone reflexiones acerca de las tensiones que se presentan en la relación entre los médicos y la industria farmacéutica, generadas en los intereses y obligaciones inherentes a cada uno de ellos, los cuales son fuente importante de dilemas éticos en tres dimensiones: la prescripción de medicamentos, la educación médica y la investigación. Fundamentado el texto en la revisión de diferentes fuentes, posiciones y reflexiones de los autores, se parte de la premisa de que es posible y necesaria una relación ética entre la industria farmacéutica y los profesionales de la salud, la cual implica un continuo análisis de los riesgos y beneficios que esta genera, proponiendo a la autorregulación como alternativa de acción más constructiva.

This article puts forward the tensions occurring between physicians and the pharmaceutical industry and arising from their respective inherent interests and obligations as an important source of three-dimensional ethical dilemmas: the prescription of medicines, medical education, and research. The text being well grounded in the review of the authors' different sources, and personal stands and reflections, it starts from the premise that a good ethical relationship between the pharmaceutical industry and health professionals is both possible and necessary. This implies an endless analysis of its deriving risks and benefits, by proposing self-regulation as the most constructive choice action.

Neste documento são expostas reflexões acerca das tensões produzidas na relação entre os médicos e a indústria farmacêutica, devido aos interesses e obrigações de cada sector. Estes interesses originam dilemas éticos muito importantes em três campos: formulação de medicamentos, educação médica e pesquisa. Depois de revisar fontes, posições e reflexões de diversos autores, chegamos a inferir que é possível e necessária uma relação ética entre a indústria farmacêutica e os profissionais da saúde, baseada na analise contínua dos riscos e benefícios gerados, e propomos a auto-regulação como uma alternativa de ação mais construtiva.

Survey and Analysis of Chinese Traditional Medicine Prescriptions in 2006 in Our Hospital / 中国药房

OBJECTIVE:To investigate the writing quality of Chinese traditional medicine prescriptions and the medication status in our hospital to promote standard prescription writing and rational administration.METHODS:A total of 11 018 Chinese traditional medicine prescriptions were randomly sampled from outpatient dispensary of traditional Chinese medicine in our hospital in 2006 to find out the non-standard and irrational prescriptions with age and sex,clinical diagnosis,dosage form,specification,usage,and the consumption sum of drugs as main indexes.RESULTS:Of the total Chinese traditional medicine prescriptions,27.85%(3 068)were non-standard in writing,of which,0.47% were without items of age and sex,5.59% without clinical diagnosis,2.72% without dosage form,1.39% without usage,23.64% were unclear in specification and dosage;the prescriptions in which only one drug was prescribed accounted for 90.86%;30.51% were prescriptions for special group;and 5.92% had a prescription consumption sum of no less than 200 yuan(≥200 yuan).CONCLUSION:The quality of Chinese traditional medicine prescriptions in our hospital remains to be further improved.

Review of the Traditional Chinese Medicine Prescriptions in Our Hospital in 2006 / 中国药房

OBJECTIVE:To improve the writing quality prescriptions of traditional Chinese medicines and to facilitate the standardization of traditional Chinese medicine prescriptions.METHODS:A total of 15 000 prescriptions were sampled in our hospital in 2006 for an analysis of the problems in accordance with the related standards specified in Chinese Pharmacopoeia(CP,2005 edition)and the new "Prescription management method".RESULTS:The problems manifested as nonstandard in drug name and footnotes,or overdosage and so on.CONCLUSION:We should strengthen the management of the traditional Chinese drugs and improve our pharmaceutical care.