How do I use it?
I tried to put it all on "auto use" but it does nothing?
-I already enabled it in the game rule.

If you put all item in "auto use", then items are used as soon as you get them.
But, you can get item when

1. every 100 combo
2. every 50 worst

You can see a yellow ball moving to item list box in these timing.

I'm now adding new features to PPDMulti, so these spec will be changed.

I have seen an Item in the item box(bottom right) being used already, but still, no effect.