Wei Yang

The incidence of mild cognitive impairment (MCI) and diabetes mellitus (DM) is increasing year by year. Clinical findings show that Banxia Xiexin Decoction

Parenterally administered Shuxuening is a commonly used Chinese medicine. There is a need to understand the characteristics of adverse drug reactions (ADRs) to it. 9 601 ADR cases reports were collected from the national adverse drug reaction monitoring center reported between January, 2005 and December, 2012. These included 326 serious ADR cases, accounting for 3.93% of the total. It was found that ADR reports increased annually from 2005, reaching a peak in the third quarter of 2009. The number of ADR cases reports were greatest in the third quarter of each year. ADRs in patients aged 60-74, accounted for 3 348 (34.87%) of all cases. 9 391(97.81%) cases were administered by intravenous infusion. In 8 431 cases, the dosage was in accordance with instructions. 61.61% ADR cases occurred on first administration. The ten most frequent symptoms were, rashes, itching, dizziness, palpitations, chills, allergic reactions, shortness of breath, nausea, phlebitis and vomiting. Systemic damage mainly affected the skin and its accessories damage, or the nervous system damage. Through the use of proportional reporting ratio (PRR) and Bayesian confidence propagation neural network (BCPNN) and propensity score applying generalized boosted models (GBM) to control for 17 confounding factors, analysis of the 10 kinds of ADRs found that for the ADR signals of dizziness, palpitations, phlebitis, and vomiting, BCPNN found that dizziness and phlebitis were early warning signals. This research found that in the 60-89 age group, higher dosages of parenterally administered Shuxuening gave rise to more phlebitis. This study provides important information for parenterally administered Shuxuening research, and guidance for its risk management.

To assess if adverse drug reactions (ADR)s to parenterally administered Dengzhan Xixin are allergic in origin. Hospital information system (HIS) data from 20 hospitals in China were used to carry out a nested case control design study. Included were patients who received dexamethasone for suspected allergic reactions after receiving parenterally administered Dengzhan Xixin. These were compared with non-allergic reaction people. Single factor logistic regression and multiple factor logistic regression were used to analyze data. Condition on admission, allergic history, dosage, disease status and drug combinations were taken into account in cases of suspected allergic reactions. After analysis we found that the condition on admission had a significant effect, P = 0.008 3, OR value = 5.642 on suspected cases of allergic reactions. Using vitamin B6 injection or ambroxol at the same time as parenterally administered Dengzhan Xixin were significant, P = 0.000 2 and 0.016 7, OR value = 9.545 and 3.194, risk factors in this group. Based on this current research, condition on admission as well as the concomitant use of vitamin B6 or ambroxol may be the risk factors in suspected cases of allergic reactions. However, further research for verification is required. This study can provide guidance for safe clinical practice in using parenterally administered. It can also provide a new method for the pharmcovigilance of parenterally administered Dengzhan Xixin.

The safety of parenterally administered Chinese medicine has caught the attention of clinicians, patients and drug administration departments. However, there are few studies that have assessed liver function damage from these medications. This study retrospectively analyzed hospital information system (HIS) data, from 20 nationwide general hospitals, of patients who were treated with parenterally administered Shuxuening. Patients that were given doses of 21-50 mL, which is above the recommended dose, acted as the observation group. Those receiving the recommended dose of < 20 mL were the control group. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured before and after parenteral administration of Shuxuening, changes after treatment were outcomes. Also recorded were: age, costs, length of hospitalization and the patients' condition on admission. Propensity score method was used to balance 71 confounding variables such as gender, age, mortality, and costs. The influence of dosage of ALT and AST can then be known. Analysis of the impact of parenterally administered Shuxuening on ALT, before logistic regression based on adjusted propensity score, then the P value is 0.007. However, after logistic regression based on adjusted propensity score method the P value became 0. 254. Hence, no differences were found between the two groups; using parenterally administered Shuxuening at the higher dose of 21 to 50 mL had no significant effects on ALT compared with the normal dose. Similarly analysis of AST changes before and after logistic regression based on adjusted propensity score method, P value changes from 0.192 to 0.568. There were no differences between the two groups using parenterally administered Shuxuening; a dosage of 21 to 50 mL each time had no significant effects on AST. Nevertheless, this study is a retrospective analysis, whilst known confounding factors have been taken into account there may be unknown ones to include inanalysis. Logistic regression based on adjusted propensity score method can control known confounding factors very well. This research serves as an aid to the safe clinical use of parenterally administered Shuxuening.

Undertake analysis of the pragmatic use of Shuxuening injection, in order to understand the drug's characteristics and risks. This will provide the basis for a deeper understanding for risk management. Twenty general hospitals using Shuxuening injections were selected nationwide. Data analysis of their hospital information systems (HIS), comprising 48 445 inpatients of which 13 936 had received Shuxuening injections, took place. Analysis of patient demographics, drug use, drug combinations and patient deaths was carried out. More than 79% of patients were over 45 years old. Clinical use of the injection was for the treatment of cerebral infarction (equivalent to the Chinese medicine category of zhongfeng), coronary heart disease (equivalent to the Chinese medicine category of xiongbi), diabetes and hypertension. However, only 37.66% of Western medicine diagnoses are in accordance with recommendations and only 49.09% of Chinese medicine diagnoses follow the guidelines. The injection is administered intravenously, with most patients receiving a dosage of 15-20 mL per dose for between 3 and 7 days. It is always combined with aspirin in clinical practice. Shuxuening injection is primarily used for older patients. Several clinical risk factors have been identified including administering the wrong dose for inappropriate conditions and failure to follow guidelines. Appropriate risk management is required to protect patients.

Traditional Chinese medicine (TCM) injection's safety problems has been paid attention for the country and people, TCM injection's labels described the adverse reactions always shows "unclear" or blank, especially the adverse drug reactions(ADR) rates hardly reported. To save the problem, large-scale safety surveillance of TCM injection research is very important. The article introduces the research aim, research type, simple size, outcomes and ethic problem during make the plan. It is a multi-center, large sample size, registry research program about TCM injections safety monitoring. The aim is to get the ADR's rate of TCM injections. According to the "three rules" , each of the TCM injection will be observed for 30 000 cases which are inpatients. The research adopt to using the barcode system and hospital information system(HIS) & laboratory information management system(LIS) to make sure enroll all patients. Case report file (CRF) is used for record patient's information which contained 3 types(A, B, C) tables. Most of people just need to fill table A, and the patient need to fill table B when they have ADR. The outcome of the research is severe ADR. Abide by the international ethical principle to keep the patient's right.

To know the truth how does Dengzhanxixin injection be used in clinical practice, and to regulate clinical use, and to direct the prospective study design. Twenty comprehensive hospital information system (HIS) data are collected. Cleaning up the database, then analysis the patients' information which the patients have used Dengzhanxixin injection. Using the basic description method and association rules to analysis the data. By analysis the Dengzhanxixin data come from HIS database we found that the most patient's age are elder than 45, it was used to treat ischemic stroke, coronary heart disease, diabetes and hypertension. It is always used in the form of intravenous injection, and are always used in 30-40 mL dosage in clinical practice, and it is always used for 14 days for one time. The patients are usually used in old people. And the injection's using in clinical are mostly complied with the instructions. The patients who had been used Dengzhanxixin injection usually have diabetes and hypertension.

There are many kinds of Chinese traditional patent medicine used in clinical practice and many adverse events have been reported by clinical professionals. Chinese patent medicine's safety problems are the most concerned by patients and physicians. At present, many researchers have studied re-evaluation methods about post marketing Chinese medicine safety inside and outside China. However, it is rare that using data from hospital information system (HIS) to re-evaluating post marketing Chinese traditional patent medicine safety problems. HIS database in real world is a good resource with rich information to research medicine safety. This study planed to analyze HIS data selected from ten top general hospitals in Beijing, formed a large HIS database in real world with a capacity of 1 000 000 cases in total after a series of data cleaning and integrating procedures. This study could be a new project that using information to evaluate traditional Chinese medicine safety based on HIS database. A clear protocol has been completed as for the first step for the whole study. The protocol is as follows. First of all, separate each of the Chinese traditional patent medicines existing in the total HIS database as a single database. Secondly, select some related laboratory tests indexes as the safety evaluating outcomes, such as routine blood, routine urine, feces routine, conventional coagulation, liver function, kidney function and other tests. Thirdly, use the data mining method to analyze those selected safety outcomes which had abnormal change before and after using Chinese patent medicines. Finally, judge the relationship between those abnormal changing and Chinese patent medicine. We hope this method could imply useful information to Chinese medicine researchers interested in safety evaluation of traditional Chinese medicine.