Delirium in hospitalized COVID-19 patients: a prospective, multicenter, cohort study.

BACKGROUND: Delirium is a prevalent symptom of acute brain dysfunction caused by Coronavirus disease 2019 (COVID-19). However, the understanding of delirium in COVID-19 patients is currently limited. This study aimed to investigate the prevalence of delirium and its risk factors in hospitalized COVID-19 patients for early identification and management of delirium. METHODS: This cohort study included hospitalized patients with SARS-CoV-2 infection at seven tertiary hospitals from January to February 2023. Delirium was assessed at a single time point using the 3-Minute Diagnostic Assessment for Delirium by trained research assistants. Demographic data, clinical characteristics, in-hospital mortality and other variables were collected from health information system. Multivariate regression analyses were conducted to investigate the risk factors for delirium and the impact of delirium on in-hospital mortality. RESULTS: A total of 4589 COVID-19 patients were included, out of which 651 cases (14.2%) were identified as delirium. In the multivariable analysis, aging (OR 3.58 [95%CI 2.75-4.67], p < 0.001), higher aspartic transaminase/alanine transaminase ratio (OR = 1.11, [95%CI 1.02-1.21], p = 0.018), Mg2+ (OR = 3.04, [95%CI 2.56-3.62], p < 0.001), blood urea nitrogen (OR = 1.01, [95%CI 1.00, 1.02], p = 0.024), and indwelling urethral catheterization (OR = 1.59, [95%CI 1.21, 2.09], p < 0.001) were associated with an increased risk of delirium. After adjusting for age, sex, and CCI, delirium was found to be associated with an increased risk of in-hospital mortality (OR = 2.42, [95%CI 1.59, 3.67], p < 0.001). CONCLUSION: Delirium was a frequent complication among hospitalized COVID-19 patients and was related to unfavorable outcomes. It is crucial to reduce delirium and its long-term effects by addressing the modifiable risk factors.

Application of Chemometric Algorithms in the High-Performance Thin-Layer Chromatography Fingerprint of Traditional Chinese Medicines.

Background: The use of HPTLC fingerprinting for the analysis of traditional Chinese medicines (TCMs) usually involves several image-processing steps. However, these image-processing steps are time consuming. Objective: We describe a new approach that applies artificial neural networks (ANN) directly to raw high-performance thin-layer chromatography HPTLC images. Methods: This approach combines image processing and chemometric modeling and was used to classify TCMs [dried tangerine eel (Chen Pi), green tangerine peel (Qing Pi), immature bitter orange fruit, and bitter orange fruit (Zhi Qiao)]. Images of the plates were processed with Chempattern and chemometric analysis including PCA, PLS-DA, and kNN were carried out all by ChemPattern. Results: The ANN model has an accuracy of 100.00% in all training, validation, and test sets, indicating excellent predictive performance and good generalization ability. The k-nearest neighbors (kNN) and partial least-square discriminant analysis (PLS-DA) models have accuracies of 90.91 and 72.73%, respectively, with the independent test set. The kNN model is also accurate, simple, and can be easily interpreted. Conclusions: HPTLC fingerprinting, combined with advanced image processing and proper chemometric algorithms, is a simple, efficient, and accurate method for the analysis of TCMs. Highlights: HPTLC fingerprints of four TCM crude drugs derived from Citrus spp. were compared by using image analysis algorithms. A new approach that applied ANN directly to raw HPTLC fingerprint images was described. Three image analysis algorithms based on kNN, PLS-DA and ANN are compared in the paper. The ANN model shows excellent predictive performance with high accuracy in test sets.

Quality analysis of commercial samples of Ziziphi spinosae semen (suanzaoren) by means of chromatographic fingerprinting assisted by principal component analysis.

Due to the scarcity of resources of Ziziphi spinosae semen (ZSS), many inferior goods and even adulterants are generally found in medicine markets. To strengthen the quality control, HPLC fingerprint common pattern established in this paper showed three main bioactive compounds in one chromatogram simultaneously. Principal component analysis based on DAD signals could discriminate adulterants and inferiorities. Principal component analysis indicated that all samples could be mainly regrouped into two main clusters according to the first principal component (PC1, redefined as Vicenin II) and the second principal component (PC2, redefined as zizyphusine). PC1 and PC2 could explain 91.42% of the variance. Content of zizyphusine fluctuated more greatly than that of spinosin, and this result was also confirmed by the HPTLC result. Samples with low content of jujubosides and two common adulterants could not be used equivalently with authenticated ones in clinic, while one reference standard extract could substitute the crude drug in pharmaceutical production. Giving special consideration to the well-known bioactive saponins but with low response by end absorption, a fast and cheap HPTLC method for quality control of ZSS was developed and the result obtained was commensurate well with that of HPLC analysis. Samples having similar fingerprints to HPTLC common pattern targeting at saponins could be regarded as authenticated ones. This work provided a faster and cheaper way for quality control of ZSS and laid foundation for establishing a more effective quality control method for ZSS.

Study on triterpenoic acids distribution in Ganoderma mushrooms by automatic multiple development high performance thin layer chromatographic fingerprint analysis.

Ganoderma--"Lingzhi" in Chinese--is one of the superior Chinese tonic materia medicas in China, Japan, and Korea. Two species, Ganoderma lucidum (Red Lingzhi) and G. sinense (Purple Lingzhi), have been included in the Chinese Pharmacopoeia since its 2000 Edition. However, some other species of Ganoderma are also available in the market. For example, there are five species divided by color called "Penta-colors Lingzhi" that have been advocated as being the most invigorating among the Lingzhi species; but there is no scientific evidence for such a claim. Morphological identification can serve as an effective practice for differentiating the various species, but the inherent quality has to be delineated by chemical analysis. Among the diverse constituents in Lingzhi, triterpenoids are commonly recognized as the major active ingredients. An automatic triple development HPTLC fingerprint analysis was carried out for detecting the distribution consistency of the triterpenoic acids in various Lingzhi samples. The chromatographic conditions were optimized as follows: stationary phase, precoated HPTLC silica gel 60 plate; mobile phase, toluene-ethyl acetate-methanol-formic acid (15 + 15 + 1 + 0.1); and triple-development using automatic multiple development equipment. The chromatograms showed good resolution, and the color images provided more specific HPTLC fingerprints than have been previously published. It was observed that the abundance of triterpenoic acids and consistent fingerprint pattern in Red Lingzhi (fruiting body of G. lucidum) outweighs the other species of Lingzhi.

Perspective of chemical fingerprinting of Chinese herbs.

The holistic system of traditional Chinese medicine (TCM) is an integrity of the ingredients contained in the Chinese herbal medicines, which creates a challenge in establishing quality control standards for raw materials and the standardization of finished herbal drugs because no single component is contributing to the total efficacy. Chromatographic fingerprinting analysis represents a rational approach for the quality assessment of TCM. It utilizes chromatographic techniques, which include CE, GC, HPLC, HPTLC, etc., to construct specific patterns for recognition of multiple compounds in TCMs. Thus, chromatographic fingerprinting analysis of herbal medicines represents a comprehensive qualitative approach for the purpose of species authentication, evaluation of quality, and ensuring the consistency and stability of herbal drugs and their related products. The pragmatic comprehensive chromatographic fingerprinting analysis can disclose the detectable ingredients composition and concentration distribution under quantifiable operational conditions and therefore provide real-time quality information. It may leave a "gray" entity at the primary stage. However, consecutive study will deepen the knowledge and reduce its "gray scale", increase the transparency gradually, thereby strengthening its quality assessment potency.

Chromatographic fingerprinting and metabolomics for quality control of TCM.

Chromatographic fingerprinting technique of traditional Chinese medicine (TCM) has proved to be a comprehensive strategy for assessing the intact quality of herbal medicine. In general, one could use the chromatographic techniques to obtain a relatively complete picture of herbal medicines, which are in common called chromatographic fingerprints of herbal medicines to represent the so-called phytoequivalence. Based on this, the features of chromatographic fingerprints of herbal medicines have been discussed in some detail. The technique based on chromatographic fingerprinting is essentially a kind of high-throughput and integral tools to explore the complexity of herbal medicines. In order to further control the comprehensive quality of TCMs, some new strategies are proposed to trace the chemical changes of chromatographic fingerprints both in product processing and/or after their administration by modern chromatographic techniques and chemometrics. Combined with metabolomics, it seems possible for one to reveal the working mechanism of TCMs and to further control their intrinsic quality. Finally, the intensive study of chromatographic fingerprinting coupled with multivariate analysis tools developed in bioinformatics and chemometrics are emphasized in order to achieve the aim to reveal the working mechanisms of TCMs and to further control and strengthen TCMs' intrinsic quality in a comprehensive manner.

Chemical pattern-aided classification to simplify the intricacy of morphological taxonomy of Epimedium species using chromatographic fingerprinting.

Epimedium herb (Yinyanghuo), one of the popular Chinese materia medica, is a multiple species colony of Epimedium genus belonging to Berberidaceae. There are five species of Epimedium that have been officially adopted in Chinese Pharmacopoeia under the same crude drug name 'Yinyanghuo' comprising Epimedium brevicornu, E. koreanum, E. sagittatum, E. pubescens, and E. wushanense. In addition, non-official species like E. acuminatum, E. miryanthum and E. leptorrhizum are also mix-used. Frequently, the morphological taxonomical identification is very difficult during on-site inspection for species authentication in the market. Researchers are often bewildered by the multiple species ambiguity when putting this crude drug in use. Referring to the bioactive constituents that are vital for therapeutic efficacy, the key to clarifying the multiple species confusion should rely on analysis of the bioactive composition. It is well known that medicinal Epimedium herbs contain special C-8 prenylated flavonol glycosides which contribute to various bioactivities and the major four, epimedin A (A), epimedin B (B), epimedin C (C) and icariin (I), are unanimously used as bioactive markers for quality control. In this study, HPLC-DAD fingerprinting was performed for investigating the molecular spectrum of various Epimedium species. It was found that the four major flavonoids constitute the middle part of the chromatographic profiles to form a specific region (named as 'ABCI fingerprint region') being dominant in the HPLC profiles of all medicinal Epimedium species, and the five official species express five different 'ABCI' patterns (different peak: peak ratios). Our study found that the convergent tendency of the 'ABCI region' among multiple species of Epimedium could facilitate differentiation of complex commercial samples based on similar bioactive composition should confer similar bioactivities. Merging the different species that possess the same 'ABCI region' pattern into the same group can create a simpler bioactive-fraction-aided classification array by clustering the commercial samples into three bioactive ingredients-based fingerprint patterns - 'E.b. pattern', 'E.k. pattern' and 'extensive E.w. pattern'. This approach offers the feasibility of characterizing and quality-controlling complex samples in the same genus designated under a single herbal drug entity on the premise of possessing the same bioactive ingredients pattern and supported by long-term traditional usage.

Chromatographic fingerprinting and related chemometric techniques for quality control of traditional Chinese medicines.

Development of chromatographic fingerprint (CF) and related chemometric methods and their applications to quality control of traditional Chinese medicines (TCMs) were discussed. CF is essentially a kind of quality control method for TCMs (or Chinese herbal medicines). Also, it is a quality-relevant-data high-throughput and integral tool to explore chemically the complexity of TCMs. With the help of chemometrics, some difficulties in evaluation and analysis of CFs, such as calculation of information content, peak alignment, pattern analysis, deconvolution of overlapping peaks, etc. could be well solved. To further explore TCMs synergic quality, intensive study of CF coupled with chemometrics will create the possibility to achieve the aim to reveal the working mechanisms of TCMs and to further control and strengthen TCMs' intrinsic quality in a comprehensive manner.

Fingerprinting alterations of secondary metabolites of tangerine peels during growth by HPLC-DAD and chemometric methods.

Tangerine peels are herbal materials of two coupled traditional Chinese medicines, Pericarpium Citri Reticulatae (PCR) and Pericarpium Citri Reticulatae Viride (PCRV). In this paper, high-performance liquid chromatographic fingerprints of tangerine peels during growth were firstly measured for deliberately collected 34 samples from three species (Citrus reticulata 'Chachi', Citrus reticulata 'Dahongpao' and Citrus erythrosa Tanaka). After sixteen characteristic components which have similar change trends in the grown process were screened out with the help of heuristic evolving latent projection (HELP) method, score plots of principal component analysis (PCA) successfully presented the grown footprints of tangerine peels. It implied that July might be the best harvest time for PCRV, November and December were better for PCR. Furthermore, hesperidin, nobiletin and tangeretin were screened as chemical markers by loadings of PCA. The HPLC-HELP-PCA strategy has shown its potential in optimization of harvest time and chemical markers' screening, which will have wide perspective in the analysis of "coupled TCMs".

Study of the destructive effect to inherent quality of Angelicae dahuricae radix (Baizhi) by sulfur-fumigated process using chromatographic fingerprinting analysis.

The after-harvesting sun-dried process of Angelicae dahuricae radix (Chinese name: Baizhi) was previously the traditional treatment for commodity. Over recent decades the natural drying process for some fleshy roots or rhizomes of Chinese materia medica has been replaced by sulfur-fumigation for curtailing the drying duration and pest control. We used high performance liquid chromatography (HPLC) and high performance thin-layer chromatography (HPTLC) fingerprinting analysis to investigate the potential damaging effect of the sulfur-fumigating process. The experimental conditions were as follows. HPTLC analysis was carried out on pre-coated silica-gel 60 plate, twice development was performed with two solvent systems (mobile phase) A, chloroform-ethyl acetate (10:1) and B, hexane-chloroform-ether (4:1:2); the fluorescent images were observed under UV 365 nm. HPLC was preceeded on Zorbax SB-C(18) column; the linear gradient elution was conducted with mobile phase prepared from methanol-0.5% acetic acid; column temperature was at 25 degrees C; the detection wavelength was 250 nm. We found serious degradation of the majority of coumarins in sulfur-fumigated Baizhi. The destructive effect was manifested by the defaced chromatographic profile and verified by imitating the sulfur dioxide reaction with the constituents in Baizhi in the laboratory. It is suggested that sulfur-fumigation process is an unacceptable approach for processing herbal drugs.

Species differentiation and quality assessment of Radix Paeoniae Rubra (Chi-shao) by means of high-performance liquid chromatographic fingerprint.

There are two species under the monograph of Radix Paeoniae Rubrae ("Chi-shao" in Chinese) in Chinese Pharmacopoeia 2005 edition-Paeonia lactiflora Pallas and Paeonia veitchii Lynch. Due to different species and growing conditions, there are significant chemical differences between the two species, which may result in the improper clinical usage under the same name. Chemical pattern expressed by high performance liquid chromatographic (HPLC) fingerprint analysis can play an important role in species differentiation and quality control of Radix Paeoniae Rubra. In the present work, HPLC fingerprints of two kinds of Radix Paeoniae Rubra have been established and analysed with chemometric methods including similarity evaluation and principal component analysis. Both of the fingerprint common patterns of the two species comprise 13 characteristic peaks, nine of which were common peaks of the two species. However, significant differences between the roots of P. veitchii and P. lactiflora exist not only in the content of certain constituents, especially phenolic acids but also in peak-to-peak ratios expressed by the fingerprint patterns. According to the recent pharmacological studies on polyphenolic constituents, root originating from P. veitchii may possess better efficacy and quality than that from P. lactiflora. Our research reveals that further pharmacological investigation is very necessary to determine whether the two species should be embodied under the same monograph in Chinese Pharmacopoeia.

Understanding the traditional aspect of Chinese medicine in order to achieve meaningful quality control of Chinese materia medica.

Although sophisticated and technologically advanced, current quality control methods for Chinese medicines (syn. Chinese materia medica or CMM) lack comprehensiveness and practicability. They are more suited for analyzing single-chemical drugs or specific, known chemical components that have already been isolated. While these methods can fully satisfy the modern scientific requirements for identity, purity and quality in the assessment of chemical drugs, they are not suitable for handling the complex chemical nature of traditional CMM whose multifunctional components along with their inherent holistic activities are frequently unknown and thus are not adequately analyzed by these methods. In order to assess properly and meaningfully the identity and quality of complex CMM (also known as Chinese herbs and Chinese herbal medicines), additional measures that can retain the traditional aspect of CMM need to be included. This requires a basic understanding of traditional Chinese medicine (TCM).

Evaluation of traditional Chinese herbal medicine: Chaihu (Bupleuri Radix) by both high-performance liquid chromatographic and high-performance thin-layer chromatographic fingerprint and chemometric analysis.

Chaihu (Bupleuri Radix), roots of Bupleurum chinense and B. scorzonerifolium, is an authentic Chinese Materia Medica in the Chinese Pharmacopoeia. Some other species such as the roots of B. falcatum, B.bicaule and B. marginatum var. stenophyllum similar to Chaihu can also be occasionally found in local raw herb markets. The quality of 33 lots of authenticated Chaihu samples vs. 31 lots of commercial samples was evaluated by both high-performance liquid chromatography-evaporative light scattering detector (HPLC-ELSD) and high-performance thin-layer chromatography (HPTLC) analyses of its principal bioactive components (saikosaponins). The pre-treated data acquired from both HPLC fingerprints and HPTLC fluorescent images were processed by chemometrics for similarity and pattern recognition, including Artificial Neural Networks (ANNs), k-nearest neighbor (k-NN) and an expert's panel. It was apparent that k-NN classifier exhibited good performance with sufficient flexibility for processing HPTLC fingerprint images which were otherwise not easily dealt with by other algorithms due to the shift of R(f) values and varying hue/saturation of the band colours between different TLC plates. These two chromatographic fingerprint methods can be considered complementary measure of quality control. The roots of Chaihu from different species of the genus Bupleurum could readily be distinguished from each other so that commercial samples can easily be classified. Chaihu collected from several major herbal distribution centers was found to belong to B. chinense with great variation in the content of its major saikosaponins.

[Study of HPLC-DAD fingerprint on complex traditional Chinese medicine proprietary preparation-Baoji pills].

OBJECTIVE: Based on 'Back-tracking' method, identification and quality evaluation of complex traditional Chinese medicine (TCM) preparation of Baoji pills (BJP) were carried out by HPLC fingerprint analysis. METHOD: HPLC-DAD fingerprint of BJP was conducted with Zorbax SB-C18 column and non-linear elution with the mobile phase consisted of acetonitrile-0.5% glacial acetic acid at column temperature 30 degrees C and detective wavelengths of 250 nm and 283 nm. From the established chromatographic pattern of BJP, track backward to the corresponding crude herbal drugs in the formula, attribution ofmost peaks in the BJP fingerprint can be disclosed. RESULT: The BJP HPLC fingerprint consisted of 44 peaks among which 35 peaks were assigned by parallel comparison with the fingerprint of the 10 corresponding crude drugs in the formula such as pueraria, pummelo peel, and magnolia bark, etc. and 22 peaks we reidentified by comparison with the chemical reference substances. CONCLUSION: The established HPLC fingerprint represents the whole character of BJP, which enhanced the specialty for control and assessment of the product quality. It exemplified much more effective for quality control than selecting any marker for qualitative or quantitative testing target. And the Back-tracking' experimental method extended the study mentality for complex formula TCM products chromatographic fingerprinting analysis.

[HPLC fingerprinting of radix paeoniae alba].

To establish a sensitive and specific HPLC method for quality control of Radix Paeoniae Alba, HPLC method was applied for quality assessment of Radix Paeoniae Alba. HPLC analysis was performed on a Symmetry C18 column (250 mm x 4. 6 mm ID, 5 microm, Waters, USA). The mobile phase consisted of acetonitrile (solvent A) and water containing 0.1% (v/v) phosphoric acid (solvent B) at a constant flow rate of 0.8 mL x min(-1). An increasing linear gradient (v/v) of solvent A was used (t/min, % A): (0,10), (5,10), (25,15), (45, 22), (46, 65), (50, 80) and (60, 80). The column temperature was set at 25 degrees C. The chromatograms were monitored at 230 nm and the on-line UV spectra were recorded in the range of 190 - 400 nm. The HPLC chromatographic fingerprinting of Radix Paeoniae Alba, showing 11 characteristic peaks, was established from 28 lots of Radix Paeoniae Alba. The areas of main chromatographic peaks were found to complied with the following rule: paeoniflorin > 1, 2, 3, 4, 6-penta-O-galloyl-glucos > albiflorin > methyl gallate > other compounds. The chromatographic fingerprinting of Radix Paeoniae Alba with high specificity can be used to control its quality and assure lot-to-lot consistency.

Quality control and discrimination of pericarpium citri reticulatae and pericarpium citri reticulatae viride based on high-performance liquid chromatographic fingerprints and multivariate statistical analysis.

High-performance liquid chromatographic (HPLC) fingerprints of pericarpium citri reticulatae (PCR) and pericarpium citri reticulatae viride (PCRV) were firstly measured for deliberately collected 39 authentic samples and 21 commercial samples. Both correlation coefficients of similarity for chromatograms and absolute peak areas of characteristic compounds were calculated for quantitative expression of the HPLC fingerprints. After principal component analysis (PCA) successfully distinguished the 'mixed peels' samples from authentic samples, partial least squares-linear discrimination analysis (PLS-LDA) was then effectively applied to class separation between authentic PCR and PCRV. Furthermore, the unequivocally determined compounds, hesperidin, nobiletin and tangeretin, were screened out by loadings plots of PCA and PLS-LDA. The results indicated that they could be used as chemical markers for discrimination among different groups of samples. The proposed method shows an efficient strategy for quality control of PCR and PCRV, which cannot only distinguish the 'mixed peels' but also discriminate authentic PCR and PCRV. This method has potential perspective for quality control of traditional Chinese medicine (TCM).

High-performance thin-layer chromatographic fingerprints of isoflavonoids for distinguishing between Radix Puerariae Lobate and Radix Puerariae Thomsonii.

The roots of Pueraria lobata (Wild.) Ohwi and Pueraria thomsonii Benth have been officially recorded in all editions of Chinese Pharmacopoeia under the same monograph 'Gegen' (Radix Puerariae, RP). However, in its 2005 edition, the two species were separated into both individual monographs, namely 'Gegen' (Radix Puerariae Lobatae, RPL) and 'Fenge' (Radix Puerariae Thomsonii, RPT), respectively, due to their obvious content discrepancy of puerarin, the major active constituent. In present paper, the fingerprint of high-performance thin-layer chromatography (HPTLC) combining digital scanning profiling was developed to identify and distinguish the both species in detail. The unique properties of the HPTLC fingerprints were validated by analyzing ten batches of Pueraria lobata and P. thomsonii samples, respectively. The common pattern of the HPTLC images of the roots of Pueraria spp. and the respective different ratios of the chemical distribution can directly discern the two species. The corresponding digital scanning profiles provided an easy way for quantifiable comparison among the samples. Obvious difference in ingredient content and HPTLC patterns of the two species questioned their bio-equivalence and explained that recording both species separately in the current edition of Chinese Pharmacopoeia (2005 edition) is reasonable due to not only the content of major constituent, puerarin, but also the peak-to-peak distribution in the fingerprint and integration value of the total components. Furthermore, the HPTLC fingerprint is also suitable for rapid and simple authentication and comparison of the subtle difference among samples with identical plant resource but different geographic locations.

Modified secured principal component regression for detection of unexpected chromatographic features in herbal fingerprints.

Secured principal component regression is modified for the qualitative analysis of chromatographic fingerprint data sets of herbal samples with residual concentrations. After chromatographic shift-correction and autoscaling are performed on the data, this modified secured principal component regression (msPCR) can detect unexpected chromatographic features in various herbal fingerprints. The successful application of msPCR to two real herbal medicines of Erigeron breviscapus from different geographical origins and Ginkgo biloba from various sources or vendors demonstrates that the proposed method can detect reasonably unexpected features differing from the regulars or not being modeled. From a chemical point of view, the causes have also been explained to corroborate the results. Moreover, it presents a viable approach for the qualitative evaluation of diverse herbal objects with a regular class of chromatographic fingerprints.

Chromatographic fingerprint analysis--a rational approach for quality assessment of traditional Chinese herbal medicine.

Traditional Chinese Herbal Medicine (TCHM) contain multiple botanicals, each of which contains many compounds that may be relevant to the medicine's putative activity. Therefore, analytical techniques that look at a suite of compounds, including their respective ratios, provide a more rational approach to the authentication and quality assessment of TCHM. In this paper we present several examples of applying chromatographic fingerprint analysis for determining the identity, stability, and consistency of TCHM as well as the identification of adulterants as follows: (1) species authentication of various species of ginseng (Panax ginseng, Panax quinquefolium, Panax noto-ginseng) and stability of ginseng preparations using high performance thin-layer chromatography (HPTLC) fingerprint analysis; (2) batch-to-batch consistency of extracts of Total Glycosides of Peony (TGP), to be used as a raw material and in finished products (TGP powdered extract products), using high performance liquid chromatography (HPLC) fingerprint analysis with a pattern recognition software interface (CASE); (3) documenting the representative HPLC fingerprints of Immature Fruits of Terminalia chebula (IFTC) through the assessment of raw material, in-process assay of the extracts, and the analysis of the finished product (tablets); (4) HPLC fingerprint study demonstrating the consistent quality of total flavonoids of commercial extracts of ginkgo (Ginkgo biloba) leaves (EGb) along with detection of adulterations. The experimental conditions as well as general comments on the application of chromatographic fingerprint analysis are discussed.