Publications by authors named "Yuanyuan Tong"

15 Publications

  • Page 1 of 1

Discovery of a covalent inhibitor of heat shock protein 90 with antitumor activity that blocks the co-chaperone binding via C-terminal modification.

Cell Chem Biol 2021 Apr 26. Epub 2021 Apr 26.

State Key Laboratory of Natural Medicines, and Jiang Su Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing 210009, China; Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China. Electronic address:

Heat shock protein (Hsp90), a critical molecular chaperone that regulates the maturation of a large number of oncogenic client proteins, plays an essential role in the growth of neoplastic cells. Herein, DDO-6600 is identified to covalent modification of Cys598 on Hsp90 from in silico study and is verified by a series of biological assays. We demonstrated that DDO-6600 covalently bound to Cys598 on the Hsp90 C terminus and exhibited antiproliferative activities against multiple tumor cells without inhibiting ATPase activity. Further studies showed that DDO-6600 disrupted the interaction between Hsp90 and Cdc37, which induced the degradation of kinase client proteins in multiple tumor cell lines, promoted apoptosis, and inhibited cell motility. Our findings offer mechanic insights into the covalent modification of Hsp90 and provide an alternative strategy for the development of Hsp90 covalent regulators or chemical probes to explore the therapeutical potential of Hsp90.
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http://dx.doi.org/10.1016/j.chembiol.2021.03.016DOI Listing
April 2021

Contrast media exposure in the perioperative period confers no additional risk of acute kidney injury in infants and young children undergoing cardiac surgery with cardiopulmonary bypass.

Pediatr Nephrol 2021 Feb 7. Epub 2021 Feb 7.

Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.

Background: Recently, there has been an interest in the temporal relationship between contrast exposure (CM) and cardiac surgery suggesting that a "double hit" on the kidney function in close succession increases the risk of acute kidney injury (AKI) after cardiac surgery. However, data from young children is limited. The purpose of this study was to retrospectively evaluate the effects of preoperative CM exposure on postoperative AKI in infant and young children patients and to further analyze the influence of exposure time interval.

Methods: Patients (age ≤ 3 years) who underwent diagnostic imaging within 14 days before on-pump cardiac surgery between 1 May 2017 and 31 May 2018 in Fuwai Hospital, Beijing, were analyzed. Kidney outcome was assessed according to Kidney Disease: Improving Global Outcomes creatinine-based criteria.

Results: One thousand four hundred pediatric patients (192 CM and 1,248 non-CM) were identified. Postoperative AKI occurred in 57 (29.7%) of the 192 patients who were exposed to CM. Following propensity score adjustment, no difference in risk for AKI was observed between the CM and non-CM groups (RR 1.142, 95% CI 0.916-1.424; P = 0.264). Multivariable logistic regression of the CM group indicated that independent predictors of postoperative AKI were lower weight, lower preoperative creatinine level, and longer CPB duration. Time interval between CM exposure and on-pump cardiac surgery was not significantly associated with increased risk of AKI (OR 0.853, 95% CI 0.265~2.747; P = 0.790).

Conclusions: For pediatric patients who are soon to undergo on-pump cardiac procedures, there appears to be no need to hesitate in performing the diagnostic imaging investigations requiring CM, or delay CPB after CM exposure. These patients may benefit from increased diagnostic utility without increasing their risk of postoperative AKI.
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http://dx.doi.org/10.1007/s00467-021-04964-6DOI Listing
February 2021

Signal transducer and transcriptional activation 1 protects against pressure overload-induced cardiac hypertrophy.

FASEB J 2021 01;35(1):e21240

State Key Laboratory of Natural Medicines, Department of Pharmacology, China Pharmaceutical University, Nanjing, China.

Signal transducers and transcriptional activation 1 (Stat1) is a member of the STATs family, and its role in various biological responses, including cell proliferation, differentiation, migration, apoptosis, and immune regulation has been extensively studied. We aimed to investigate its role in pathological cardiac hypertrophy, which is currently poorly understood. Experiments using H9C2 cardiomyocytes, Stat1, and IfngR cardiomyocyte-specific knockout mice revealed that Stat1 had a protective effect on cardiac hypertrophy. Using transverse aortic constriction (TAC)-induced cardiac hypertrophy in mice, we analyzed the degree of hypertrophy using echocardiography, pathology, and at the molecular level. Mice lacking Stat1 had more pronounced cardiac hypertrophy and fibrosis than wild-type TAC mice. Analysis of the molecular mechanisms suggested that Stat1 downregulated the mRNA levels of hypertrophy and fibrosis markers to inhibit cardiac hypertrophy, and promotes mitochondrial fission through the Ucp2/P-Drp1 pathway, enhancing mitochondrial function, and increasing compensatory myocardial ATP production in the compensatory phase for cardiac hypertrophy inhibition. Overall, this comprehensive analysis revealed that Stat1 inhibits cardiac hypertrophy by downregulating hypertrophic and fibrotic marker genes and enhancing the mitochondrial function to enhance cardiomyocyte function through the Ucp2/P-Drp1 signaling pathway.
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http://dx.doi.org/10.1096/fj.202000325RRRDOI Listing
January 2021

Investigation of myocardial protection during pediatric CPB: Practical experience in 100 Chinese hospitals.

Perfusion 2020 Dec 20:267659120983107. Epub 2020 Dec 20.

State Key Laboratory of Cardiovascular Disease, Department of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Many measures have been proposed for myocardial protection in pediatric congenital heart surgeries, but little data is available for China. This study investigates myocardial protection strategies in pediatric cardiopulmonary bypass (CPB) throughout China. Online questionnaires were delivered to 100 hospitals in 27 provinces. The number of yearly on-pump pediatric cardiovascular surgeries in these hospitals varied greatly. About 91.0% of respondents believe that each surgery should have at least two perfusionists, while only 64.0% of hospitals actually met this requirement. For pediatric patients, crystalloid cardioplegia was more prevalent than blood-based cardioplegia. Histidine-tryptophan-ketoglutarate solution and St. Thomas crystalloid solution were dominant among crystalloid cardioplegia. Del Nido cardioplegia and St. Thomas blood-based cardioplegia ranked the top two in the popularity of blood-based cardioplegia. Dosages varied among different kinds of cardioplegia. In the choice of different cardioplegia, perfusionists mainly focused on myocardial protective effect and cost. Hypothermia of cardioplegia solution was maintained by ice buckets in 3/4 of the hospitals in this survey. In conclusion, the essence of myocardial protection management during pediatric CPB was cardiac arrest induced by cardioplegia under systemic hypothermia. However, there is no uniform standard for the type of cardioplegia, or dosages. Therefore, well-designed multicenter randomized controlled trials are warranted to provide tangible evidence for myocardial protection of cardioplegia in pediatric CPB.
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http://dx.doi.org/10.1177/0267659120983107DOI Listing
December 2020

Outcomes and factors associated with early mortality in pediatric postcardiotomy veno-arterial extracorporeal membrane oxygenation.

Artif Organs 2021 Jan 4;45(1):6-14. Epub 2020 Aug 4.

Department of Cardiopulmonary Bypass, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Mortality and morbidity of children received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support after cardiac surgery remain high despite remarkable advances in medical management and devices. The purpose of this study was to describe outcomes and risk factors of applying VA-ECMO in the surgical pediatric population. We retrospectively analyzed 85 consecutive pediatric patients (aged <18 years) who received postcardiotomy VA-ECMO from January 2010 to December 2018. Median (IQR) age at ECMO implantation in this cohort was 12.7 (6.4, 43.2) months, median weight was 8.5 (6.0, 12.8) kg, mean ECMO duration was 143.2 ± 81.6 hours and mean hospital length of stay was 48.4 ± 32.4 days. Seventy-five patients (88.2%) were indicated for postcardiotomy cardiogenic shock. The successful ECMO weaning rate was 70.6% and in-hospital mortality was 52.9%. The most common diagnosis was transposition of great arteries (n = 18, 21.2%), while acute kidney injury occurred most often (n = 64, 75.3%). Multivariate logistic regression analysis showed that thrombocytopenia, hemolysis, and nosocomial infection were positively correlated with in-hospital mortality. Multivariate Cox proportional hazard regression analysis presented that thrombocytopenia significantly increased the 180-day mortality in patients with successful weaning. Therefore, multiple factors had adverse effects on prognosis. Patient selection and procedures from ECMO implantation to weaning need to be closely monitored and performed in a timely manner to improve outcome.
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http://dx.doi.org/10.1111/aor.13773DOI Listing
January 2021

Effect of two different colloid priming strategies in infants weighing less than 5 kg undergoing on-pump cardiac surgeries.

Artif Organs 2020 Jan 7;44(1):58-66. Epub 2019 Oct 7.

State Key Laboratory of Cardiovascular Disease, Department of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Our aim was to explore the effect of two different priming strategies (artificial colloid only vs. artificial colloid combined with human serum albumin) on the prognosis of children weighing less than 5 kg undergoing on-pump congenital heart disease (CHD) surgery. A total of 65 children weighing less than 5 kg who underwent on-pump CHD surgery in our hospital from September 2016 to December 2017 were enrolled in this study. The children were randomly divided into two groups: artificial colloid priming group (AC group, n = 33) and artificial colloid combined albumin priming group (ACA group, n = 32). The primary clinical endpoint was the peri-CPB colloid osmotic pressure (COP). Secondary clinical endpoints included perioperative blood product and hemostatic drug consumption, postoperative renal function, coagulation function, postoperative renal function, and postoperative recovery parameters. COP values were not significant in the priming system as well as peri-CPB time points between the two groups (P > .05). Platelet consumption in the AC group was significantly lower than that in the ACA group (P < .05). There were no significant differences in the use of other blood products and hemostatic drugs as well as perioperative coagulation parameters between the two groups (P > .05). Postoperative length of stay in the AC group was significantly lower than that in the ACA group (P < .05). There were no significant differences in mortality, postoperative mechanical ventilation time, ICU time, and perioperative adverse events (including postoperative AKI) occurrences between the two groups (P > .05). In the on-pump cardiac surgeries of patients weighing less than 5 kg, total colloidal priming would not affect peri-CPB COP values, postoperative coagulation function, and blood products consumption. Total artificial colloidal priming strategy is feasible in low-weight patients.
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http://dx.doi.org/10.1111/aor.13561DOI Listing
January 2020

Perioperative blood product transfusion of two different perfusion strategies on pediatric patients undergoing aortic arch surgery.

Artif Organs 2020 Jan 5;44(1):40-49. Epub 2019 Aug 5.

State Key Laboratory of Cardiovascular Disease, Department of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Simple regional cerebral perfusion (SRCP) or cerebro-myocardial perfusion (CMP) is selectively used in one-stage complex aortic arch malformation repair. This analysis was performed to investigate the effect of CMP and SRCP on perioperative blood product consumption, and to evaluate whether these two strategies have different effects on the clinical outcomes. A retrospective analysis of 284 children with complicated aortic malformation from January 2010 to June 2018 was performed. The overall cohort was divided into SRCP group (n = 202) and CMP group (n = 82). A comprehensive comparison of perioperative blood product consumption-related indexes was performed. Cardiopulmonary bypass time, cardiac arrest time, cooling, and rewarming time in the CMP group were significantly shorter than those in the SRCP group (P < .05). Chest tube time was 3.82 ± 1.33 days in the SRCP group compared to 3.42 ± 0.97 days in the CMP group (P = .005). Moreover, intraoperative platelet (PLT) transfusion volume (mL/kg) and rate (%) were significantly lower in the CMP group (P < .001). Multivariate regression analysis found that intraoperative PLT transfusion was significantly negatively correlated with CMP management [OR = 0.237 (0.110-0.507), P < .001] and CPB time was independently associated with delayed chest tube removal (>3 days) [OR = 1.010 (1.001-1.020), P = .031]. In-hospital mortality and early postoperative adverse events were not significantly different between the two groups. In children with on-pump complex aortic arch surgeries, CMP is more preferable than SRCP in blood protection. However, overall prognosis was not remarkably different between these two perfusion groups. They are both safe and feasible.
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http://dx.doi.org/10.1111/aor.13539DOI Listing
January 2020

Perioperative Outcomes of Using Different Temperature Management Strategies on Pediatric Patients Undergoing Aortic Arch Surgery: A Single-Center, 8-Year Study.

Front Pediatr 2018 27;6:356. Epub 2018 Nov 27.

Department of Cardiopulmonary Bypass, Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital, Beijing, China.

With the widespread application of regional low-flow perfusion (RLFP), development of surgical techniques, and shortened circulatory arrest time, deep hypothermia is indispensable for organ protection. Clinicians have begun to increase the temperature to reduce hypothermia-related adverse outcomes. The aim of this study was to evaluate the safety and efficacy of elevated temperatures during aortic arch surgery with lower body circulatory arrest (LBCA) combined with RLFP. We retrospectively analyzed data from 207 consecutive pediatric patients who underwent aortic arch repair with LBCA & RLFP between January 2010 and July 2017 and evaluated different hypothermia management strategies. The overall cohort was divided into three groups: deep hypothermia (DH, 20.0-25.0°C), moderate hypothermia (MoH, 25.1-30.0°C) and mild hypothermia (MH, 30.1-34.0°C). The percentage of AKI-1 occurrences was significantly increased in the MH group (51.52%) compared to those in the DH (25.40%) and MoH (37.84%) groups ( = 0.036); prolonged hospital stay occurrences were decreased with elevated temperature (DH 47.62%, MoH 28.83%, MH 18.18%, = 0.006). Neurological complications, peritoneal dialysis, hepatic dysfunction, 30-day hospital mortality, delay extubation occurrences were no significant among the groups. Logistic analysis showed that the MH group was negatively associated with post-op AKI-1 compared with the DH group [ = 0.329 (0.137-0.788), = 0.013], no differences were found between the MoH and the MH group. Compared to other groups, the intubation time ( = 0.006) and postoperative hospital stay ( = 0.009) were significantly decreased in the MH group. Multivariate logistic analysis showed hypothermia levels were not significant with prolonged hospital stay. This retrospective analysis demonstrated that for pediatric patients undergoing surgeries with RLFP & LBCA, three different gradient temperature management strategies are available: deep, moderate, and mild hypothermia. Utilizing mild or moderate hypothermia is safe and feasible. Although the number of AKI-1 occurrences in the MH group was significantly increased compared to those in the other groups, further analysis showed no significance in the MoH and MH group, mild hypothermia management is as safe as others when used appropriately.
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http://dx.doi.org/10.3389/fped.2018.00356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277883PMC
November 2018

Concomitant type I IFN and M-CSF signaling reprograms monocyte differentiation and drives pro-tumoral arginase production.

EBioMedicine 2019 Jan 7;39:132-144. Epub 2018 Dec 7.

State Key Laboratory of Pharmaceutical Biotechnology and MOE Key Laboratory of Model Animals for Disease Study, Model Animal Research Center of Nanjing University, Nanjing 210061, China. Electronic address:

Background: Type I IFN-based therapies against solid malignancies have yielded only limited success. How IFN affects tumor-associated macrophage (TAM) compartment to impact the therapeutic outcomes are not well understood.

Methods: The effect of an IFN-inducer poly(I:C) on tumor-infiltrating monocytes and TAMs were analyzed using a transplantable mouse tumor model (LLC). In vitro culture systems were utilized to study the direct actions by poly(I:C)-IFN on differentiating monocytes.

Results: We found that poly(I:C)-induced IFN targets Ly6C monocytes and impedes their transition into TAMs. Such an effect involves miR-155-mediated suppression of M-CSF receptor expression, contributing to restricting tumor growth. Remarkably, further analyses of gene expression profile of IFN-treated differentiating monocytes reveal a strong induction of Arg1 (encoding arginase-1) in addition to other classical IFN targets. Mechanistically, the unexpected Arg1 arm of IFN action is mediated by a prolonged STAT3 signaling in monocytes, in conjunction with elevated macrophage colony-stimulating factor (M-CSF) signaling. Functionally, induction of ARG1 limited the therapeutic effect of IFN, as inhibition of arginase activity could strongly synergize with poly(I:C) to enhance CD8 T cell responses to thwart tumor growth in mice.

Conclusions: Taken together, we have uncovered two functionally opposing actions by IFN on the TAM compartment. Our work provides significant new insights on IFN-mediated immunoregulation that may have implications in cancer therapies.
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http://dx.doi.org/10.1016/j.ebiom.2018.11.062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354658PMC
January 2019

Rapamycin-sensitive mTORC1 signaling is involved in physiological primordial follicle activation in mouse ovary.

Mol Reprod Dev 2013 Dec;80(12):1018-34

In mammals, resting female oocytes reside in primordial ovarian follicles. An individual primordial follicle may stay quiescent for a protracted period of time before initiating follicular growth, which is also termed “activation.” Female reproductive capacity is sustained by the gradual, streamlined activation of the entire population of primordial follicles, but this process also results in reproductive senescence in older animals. Based on the recent findings that genetically triggered, excessive mammalian target of rapamycin complex 1 (mTORC1) activation in mouse oocytes leads to accelerated primordial follicle activation, we examined the necessity of mTORC1 signaling in physiological primordial follicle activation. We found that induction of oocyte mTORC1 activity is associated with early follicular growth in neonatal mouse ovaries. Pharmacological inhibition of mTORC1 activity in vivo by rapamycin treatment leads to a marked, but partial, suppression of primordial follicle activation. The suppressive effect of rapamycin on primordial follicle activation was reproduced in cultured ovaries. While rapamycin did not apparently affect several plausible cellular targets in neonatal mouse ovaries, such as mTORC2, AKT, or cyclin-dependent kinase (CDK) inhibitor p27-KIP1, its inhibitory effect on Cyclin A2 gene expression implies that mTORC1 signaling in oocytes may engage a Cyclin A/CDK regulatory network that promotes primordial follicle activation. The current work strengthens the concept that mTORC1-dependent events in the oocytes of primordial follicles may represent potential targets for intervention in humans to slow the depletion of the ovarian reserve.
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http://dx.doi.org/10.1002/mrd.22267DOI Listing
December 2013

Review of controlled clinical trials on acupuncture versus sham acupuncture in Germany.

J Tradit Chin Med 2013 Jun;33(3):403-7

Institute of Medical Informatics, China Academy of Chinese Medical Sciences, Beijing 100700, China.

Objective: To examine German controlled clinical trials on the therapeutic effects of acupuncture vs sham acupuncture, and to find whether there are problems with the conclusion that sham acupuncture has no significant deviation from acupuncture.

Methods: We focused on literature from the last ten years (2002-2011) included in PubMed about controlled clinical trials on acupuncture vs sham acupuncture carried out in Germany. The methods applied in sham acupuncture are summarized, and the difference between the acupuncture and sham groups were analyzed. We measured effects based on the following criteria: acupuncture is effective and superior to sham, acupuncture is effective but similar to sham, both of them have uncertainty regarding treatment effect, or no significant effect. Finally, we reviewed the hypotheses of different scholars on sham acupuncture and analyzed their results.

Results: Four types of controlled clinical trials including sham acupuncture on non-Traditional Chinese Medicine acupoints, minimal acupuncture on non-acupoints, placebo needle and sham laser acupuncture had varying results in the 57 articles analyzed. Some showed that acupuncture had a better effect than sham, while some suggest acupuncture and sham had similar effects. In all studies using sham acupuncture on non-therapeutic points, sham electrodes, and sham electro-acupuncture, the therapeutic effect was better than sham. Of the trials, 37 demonstrated that acupuncture had a better effect than sham acupuncture. Only nine trials found no significant difference between acupuncture and sham. Two controlled trials for the same condition (neck pain) conducted by two different German research institutes used the same control method, but reached contradictory conclusions.

Conclusion: We found problems in conclusions based on results of controlled clinical trials of sham acupuncture in Germany. Therefore, there is still not enough evidence to support the statements that "acupuncture and sham acupuncture have no difference in treatment effect" and "acupuncture is just a placebo effect." The control methods of sham acupuncture used in Germany may not be standardized and may not be suitable for acupuncture clinical trial research. We suggest that research on the methodology of sham acupuncture should be given priority in the design of acupuncture trials in the future.
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http://dx.doi.org/10.1016/s0254-6272(13)60187-9DOI Listing
June 2013

Content analysis of systematic reviews on effectiveness of traditional Chinese medicine.

J Tradit Chin Med 2013 Apr;33(2):156-63

Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, CACMS, Beijing 100700, China.

Objective: To evaluate evidence for the efficacy of Traditional Chinese Medicine (TCM) in systematic reviews.

Methods: Chinese (TCM Periodical Literature Database, Chinese Biological Medicine database, Chinese Medical Current Contents, China Hospital Knowledge Database journal fulltext database, Virtual Machining and Inspection System, and Wanfang) and English (Cochrane Database of Systematic Reviews, PubMed and Embase) databases were searched.

Results: Three thousand, nine hundred and fifty-five articles were initially identified, 606 of which met the inclusion criteria, including 251 in English (83 from the Cochrane Database) and 355 in Chinese. The number of articles published each year increased between 1989 and 2009, Cardiocerebrovascular disease was the most studied target disease. Intervention measures included TCM preparations (177 articles), acupuncture (133 articles) and combinations of TCM and Western Medicine (38 articles). Control measures included positive medical (177 articles), basic treatment (100 articles), placebo (219 articles), and blank and mutual (107 articles). All articles included at least one reference; the greatest number was 268. Six of 10 articles with high quality references demonstrated curative effectsagainst target diseases including upper respiratory tract infection, dementia and depression. Interventions that were not recommended were tripterygium for rheumatoid arthritis and TCM syndrome differentiation for pediatric nocturia. In 10.4% of the studies, the authors concluded that the intervention had a curative effect. The assessors agreed with the authors' conclusions in 88.32% of cases, but rejected 8.94% (54 articles).

Conclusion: 1) Training in systematic review methods, including topic selection, study design, methods and technology, should be improved. 2) Upper respiratory tract infection, dementia and depression may become the predominant diseases treated by TCM, and the corresponding interventions could be developed into practical applications. 3) Use of non-recommended interventions should be controlled, and there should be more research on side effects.
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http://dx.doi.org/10.1016/s0254-6272(13)60118-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7148763PMC
April 2013

[Safety research in Chinese medicines based on application of data mining].

Zhongguo Zhong Yao Za Zhi 2011 Nov;36(21):3047-50

China Academy of Chinese Medical Sciences, Institute of Information on Traditional Chinese Medicine, Beijing 100700, China.

The current status of the application of data mining in Chinese medicine (TCM) safety research are analyzed in this paper, and the future development trend are discussed, which include: to establish ADR (adverse drug reaction) signal detection and automatic warning system based on traditional Chinese medicine (TCM) adverse reaction database, to explore the characteristics and influencing factors of TCM safety problems, to devise appropriate new algorithm, and to develop TCM adverse reaction literature mining.
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November 2011

[Retrospective study on Xiaohe tablet-related liver damage and discussion on risk control].

Zhongguo Zhong Yao Za Zhi 2010 Aug;35(16):2199-203

National Center for Drug Reevaluation, State Food and Drug Administration, Beijing 100045, China.

To investigate the clinical characteristics and risk factors of liver damage cases related to Xiaohe tablet so as to propose risk control measures. We search literatures on cases and group cases reports of Xiaohe tablet-related liver damage published domestically from 1978 to 2009, and then conduct a statistical analysis on the data. The 194 reports (9 cases reports and 185 group cases) of Xiaohe tablet-related liver damage are involved, the main clinical manifestations are gastrointestinal symptoms, skin stained yellow, icteric sclera, abnormal hepatic function and even hepatic failure. Most liver damage cases are reversible and can be cured by timely treatment after stopping use of this drug. There is a certain correlation between Xiaohe tablet and liver damage. Therefore, the following measures may be effective for risk control of Xiaohe tablet: to use drug under the guidance of physician, according to the recommended dose and indications in drug specification; to closely monitor liver function during the clinical treatment; to strengthen safety-related basic study.
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August 2010

[Retrospective study of adverse reactions of Niuhuang Jiedu tablet (pill) and risk control based on literature analysis].

Zhongguo Zhong Yao Za Zhi 2010 May;35(10):1342-5

Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China.

In this retrospective study, 56 cases of adverse reactions caused by Niuhuang Jiedu tablet (pill) were statistically analyzed in respects of genders, ages, routes of administration, clinical manifestations, etc. We pinpointed that the main factors related to safety problems of Niuhuang Jiedu tablet (pill) are irrational drug use and drug quality, and put forward suggestions for strengthening the surveillance and administration of Niuhuang Jiedu tablet (pill) and improving clinical rational use.
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http://dx.doi.org/10.4268/cjcmm20101027DOI Listing
May 2010