Lesión hepática inducida por Phyllanthus niruri (chancapiedra), un remedio natural para urolitiasis / Liver injury induced by Phyllanthus niruri (chancapiedra), a natural remedy for urolithiasis

Tanto la lesión hepática inducida por drogas (DILI), así como la lesión hepática inducida por hierbas (HILI), son una preocupación creciente en la atención sanitaria contemporánea que plantea importantes desafíos clínicos debido a sus variadas etiologías, presentaciones clínicas y posibles resultados potencialmente mortales. Presentamos el caso de un paciente masculino de 38 años con antecedentes de cálculos renales que consultó por dolor lumbar y hematuria. Al ingreso presentó ictericia, hepatomegalia, dolor a la palpación en fosa ilíaca derecha y no tenía signos de hepatopatía crónica, con pruebas de función hepática anormales, que mostraron un patrón hepatocelular asociado con hiperbilirrubinemia. Se descartó obstrucción biliar, trombosis portal, hepatitis autoinmune y viral, con panel autoinmune negativo. El paciente refirió haber consumido un remedio herbario para los cálculos renales llamado "vino rompe cálculos (chancapiedra)", que se supone contiene Phyllanthus niruri, cinco días antes del inicio de los síntomas. Una biopsia hepática reveló hepatitis aguda con infiltrado inflamatorio mixto. Debido al empeoramiento de las pruebas de función hepática y la sospecha de DILI idiosincrásico, se inició un ensayo terapéutico con corticosteroides, que resultó en una mejoría clínica y del perfil hepático. La gravedad de este caso nos recuerda la necesidad de incrementar el seguimiento por parte de las autoridades reguladoras de medicamentos, implementar campañas educativas para los pacientes e informar a la comunidad sobre productos con alertas activas.

Both drug-induced liver injury (DILI) and herb-induced liver injury (HILI) are a growing concern in contemporary healthcare that poses significant clinical challenges due to their varied etiology, clinical presentations, and potential life-threatening outcomes. We present the case of a 38-year-old male patient with a history of kidney stones who consulted for low back pain and hematuria. On admission he presented with jaundice, hepatomegaly, pain on palpation in the right iliac fossa and no signs of chronic liver disease, with abnormal liver function tests, which showed a hepatocellular pattern associated with hyperbilirubinemia. Biliary obstruction, portal thrombosis, autoimmune and viral hepatitis were ruled out, with negative autoimmune panel. The patient reported consuming an herbal remedy for kidney stones called "stone-breaking wine (chancapiedra)", presumed to contain Phyllanthus niruri, five days before the onset of symptoms. A liver biopsy revealedacute hepatitis with mixed inflammatory infiltrate. Due to worsening liver function tests and suspicion of idiosyncratic DILI, a therapeutic trial with corticosteroids was initiated, which resulted in clinical and liver profile improvement. The severity of this case reminds us of the need to increase follow-up by drug regulatory authorities, implement educational campaigns for patients, and inform the community about products with active alerts.

Evidências clínicas do uso de plantas medicinais e fitoterápicos na cicatrização de feridas cutâneas: uma revisão integrativa / Evidencia clínica sobre el uso de plantas medicinales y medicinas a base de hierbas en la curación de heridas en la piel: una revisión integrativa / Clinical evidence on the use of medicinal plants and herbal medicine in healing skin wounds: an integrative review

Introdução: Plantas medicinais e fitoterápicos são tradicionalmente utilizados na cicatrização de diversos tipos de feridas. Muitas plantas contêm compostos bioativos com propriedades anti-inflamatórias, antimicrobianas e cicatrizantes. Objetivo: Reunir evidências clínicas do uso de plantas medicinais e fitoterápicos na cicatrização de feridas cutâneas. Metodologia: Trata-se de uma revisão integrativa da literatura. Os estudos foram coletados das bases de dados MEDLINE/PubMed e LILACS, utilizando como estratégia de busca os termos ((WoundHealing) ou (Inflammation)) e ((MedicinalPlants) ou (Phytotherapy)) com recorte temporal de 2011 a 2021. Resultados: 15 estudos foram incluídos na revisão. A maioria dos estudos foram do tipo ensaio clínico controlado randomizado. Foi investigada a eficácia de 15 espécies medicinais para o tratamento de feridas agudas e crônicas, sendo as mais recorrentes queimaduras de segundo grau, úlceras crônicas e feridas cirúrgicas. As espécies medicinais que apresentaram melhores resultados foram babosa (Aloevera), centela (Centellaasiatica),beldroega (Portulacaoleraceae), Arnebia euchroma, hipérico (Hypericum perforatum) emil-folhas (Achilleamillefolium), melhorando critérios como eritema, edema, tempodere-epitelização, tempo de cicatrização e a aparência geral da ferida. Conclusões: Plantas medicinais e fitoterápicos apresentam eficácia no processo de cicatrização, sendo, portanto, alternativa terapêutica para o tratamento de feridas cutâneas (AU).

Introduction: Medicinal plants and herbal medicines are traditionally used to heal various types of wounds. Many plants contain bioactive compounds with anti-inflammatory, antimicrobial, and wound-healing properties. Objective: Gathering clinical evidence on the use of medicinal plants and herbal medicine in the healing of skin wounds. Methodology:Thisisan integrative review of the literature. The studies were collected from the MEDLINE/PubMed and LILACS data bases, using the terms ((WoundHealing) or (Inflammation)) and ((MedicinalPlants) or (Phytotherapy)) as a search strategy, from 2011 to 2021. Results: Fifteen studies were included in the review. Most of them were of the randomized controlled clinical trial type. The effectiveness of 15 medicinal species was investigated for the treatment of acute and chronic wounds, the most common of which were second-degree burns, chronic ulcers,and surgical wounds. The species with the best results were Aloe vera, Centella asiatica, Portulaca oleraceae, Arnebia euchroma, Hypericum perforatum, and Achillea millefolium, improving criteria such as erythema, edema, re-epithelialization time, healing time, and the general appearance of the wound. Conclusions: Medicinalplants and herbal medicine are effective in the healing process, therefore being a therapeutic alternative for treating skin wounds (AU).

Introducción: Las plantas medicinales y las medicinas a base de hierbas se utilizan tradicionalmente para curar diversos tipos de heridas. Muchas plantas contienen compuestos bioactivos con propiedades antiinflamatorias, antimicrobianas y cicatrizantes. Objetivo: Recopilar evidencia clínica sobre el uso de plantas medicinales y medicinas a base de hierbas en la curación de heridas cutáneas. Metodología: Se trata de una revisión integradora de la literatura. Los estudios fueron obtenidos de las bases de datos MEDLINE/PubMed y LILACS, utilizando como estrategia de búsqueda los términos ((WoundHealing) o (Inflammation)) y ((MedicinalPlants) o (Phytotherapy)) con un marco temporal de 2011 a 2021. Resultados: Se incluyeron 15 estudios en la revisión. La mayoría de los estudios fueron del tipo ensayo clínico controlado aleatorio. Se investigó la eficacia de 15 especies medicinales para el tratamiento de heridas agudas y crónicas, las más comunes fueron quemaduras de segundo grado, úlceras crónicas y heridas quirúrgicas. Las especies medicinales con mejoresr esultados fueron Aloe vera, Centella asiatica, Portulaca oleraceae, Arnebia euchroma, Hypericum perforatum y Achillea millefolium, mejorando criterios como eritema, edema, tiempo de reepitelización, tiempo de cicatrización y aspecto general de la herida. Conclusiones: Plantas medicinales y medicinas a base de hierbas son efectivas en el proceso de cicatrización, siendo portanto un aalternativa terapéutica para el tratamiento de heridas en la piel (AU).

Factores asociados con el consumo de plantas medicinales para la prevención de COVID-19 en población peruana: un estudio transversal / Factors associated with the consumption of medicinal plants for the prevention of COVID-19 in peruvian population: a cross-sectional study

RESUMEN Objetivos . Determinar los factores asociados al consumo de plantas medicinales como prevención de la COVID-19 en la población peruana. Materiales y métodos. Se evaluó población mayor de 18 años, residentes en Perú y sin antecedentes de enfermedad por COVID-19. Los factores asociados al consumo de plantas medicinales se evaluaron mediante un modelo de regresión de Poisson con varianzas robustas. Resultados. De 3231 participantes incluidos, el 84,6% eran jóvenes (18-29 años), el 62,7% eran mujeres y el 59,7% consumía alguna planta medicinal para prevenir la COVID-19. Los factores asociados al consumo de plantas medicinales para prevenir el contagio de COVID-19 fueron residir en la sierra peruana, haber tenido un familiar diagnosticado con COVID-19, haber tenido un familiar fallecido por COVID-19, considerar que su familia se encuentra en mayor riesgo de infección, haber usado medicamentos o dióxido de cloro para prevenir la COVID-19, tener información médica como principal fuente de información sobre la COVID-19, pensar que las plantas medicinales son efectivas para prevenir la enfermedad COVID-19 o no estar informado sobre su eficacia. Conclusión . El 60% de los participantes reportó haber consumido alguna planta medicinal para prevenir la COVID-19. Es importante que las autoridades apliquen estrategias de comunicación sobre lo que implica el consumo de plantas medicinales, priorizando los grupos poblacionales que tienen mayores patrones de consumo.

ABSTRACT Objectives. Determine the factors associated with the consumption of medicinal plants as a preventive measure against COVID-19 in the Peruvian population. Materials and methods. A population over 18 years of age, living in Peru and without a history of COVID-19 disease, was evaluated. The factors associated with the consumption of medicinal plants were evaluated using a Poisson regression model with robust variances. Results. Of the 3231 participants included, 84.6% were young adults (18-29 years old), 62.7% were women, and 59.7% consumed a medicinal plant to prevent COVID-19 infection. The factors associated with the consumption of medicinal plants to prevent COVID-19 infection were residing in the Peruvian highlands, having had a family member diagnosed with COVID-19, having had a family member die from COVID-19, considering their family to be at increased risk of infection, having used medications or chlorine dioxide to prevent COVID-19, having medical information as the main source of information about COVID-19, thinking that medicinal plants are effective in preventing COVID-19 disease, or not being informed about their effectiveness. Conclusion. Sixty percent of the participants reported having consumed a medicinal plant to prevent COVID-19. Authorities must apply communication strategies about the implications of consuming medicinal plants, prioritizing population groups with higher consumption patterns.

Alternative therapies for viral infections caused by SARS-Cov-2 / Terapias alternativas para infecções virais causadas pelo SARS-Cov-2

Abstract Introduction The relevance of the studied topic lies in the complexity of the treatment of infection caused by SARS-CoV-2. Objective To discuss the potential advantages and disadvantages of alternative treatments compared to conventional medical approaches, and to highlight the importance of collaborative communication between patients and healthcare providers in making informed decisions about alternative treatments of the SARS-CoV-2 virus. Methods The research methodology employed literature analysis methods, including bibliographic and bibliosemantic approaches. The study used theoretical, systematic, and statistical methods, including analysis, synthesis, generalization, interpretation, classification, and meta-analysis to explore alternative treatments for SARS-CoV-2 infections, their interrelationships, and statistical trends in incidence. Results The study identifies diverse alternative therapies for treating SARS-CoV-2 infections, highlighting herbal medicine, acupuncture, reflexology, biohacking, homoeopathy, and magnetotherapy. It underscores the potential benefits of herbal remedies like garlic, ginger, chamomile, and honeysuckle, as well as vitamins (C, D, B12) and minerals (zinc, selenium) in managing COVID-19 symptoms. Conclusion While of-fering holistic benefits, these therapies warrant cautious consideration due to limited scientific backing and potential interactions. Cultural understanding, patient-provider dialogue, and informed choices are key in harnessing the potential of alternative medicine along-side conventional approaches for managing COVID-19 challenges.

Resumo Introdução A relevância do tema estudado reside na comple-xidade do tratamento da infeção causada pelo SARS-CoV-2. Objetivo Discutir as potenciais vantagens e desvantagens dos tratamentos alternativos em comparação com as abordagens médicas convencionais e realçar a importância da comunicação colaborativa entre os doentes e os prestadores de cuidados de saúde na tomada de decisões informadas sobre os tratamentos alternativos do vírus SARS-CoV-2. Métodos A metodologia de investigação utilizou métodos de análise da literatura, incluindo abordagens bibliográficas e bibliosemânticas. O estudo utilizou métodos teóricos, sistemáticos e estatísticos, incluindo análise, síntese, generalização, interpretação, classificação e meta-aná-lise para explorar tratamentos alternativos para as infecções por SARS-CoV-2, suas inter-relações e tendências estatísticas da incidência. Resultados O estudo identifica diversas terapias alternativas para o tratamento das infecções por SARS-CoV-2, destacando a fitoterapia, a acupunctura, a reflexologia, o biohacking, a homeopatia e a magnetoterapia. Sublinha os potenciais benefícios dos remédios à base de plantas como o alho, o gengibre, a camomila e a madressilva, bem como das vitaminas (C, D, B12) e dos minerais (zinco, selénio) na gestão dos sintomas da COVID-19. Conclusão Embora ofereçam benefícios holísticos, estas terapias devem ser consideradas com cautela devido ao apoio científico limitado e às potenciais interações. A compreensão cultural, o diálogo paciente-prove-dor e as escolhas informadas são fundamentais para aproveitar o potencial da medicina alternativa juntamente às abordagens convencionais para gerir os desafios da COVID-19.

Anti-cancer Effect and Mechanism of Chinese Herbal Medicine Saponins： A Review / 中国实验方剂学杂志

Cancer， one of the deadliest diseases caused by cells escaping homeostasis， abnormal proliferation， and abnormal differentiation， is fast becoming one of the most burdensome diseases of this century. With decades of human research and cognitive changes in cancer， cancer treatment is also developing rapidly， but there is still a lack of effective treatment and countermeasures. Especially， the search for safe， efficient， and non-toxic drugs has become a long-term goal in the field of cancer. Saponins extracted and separated from traditional Chinese medicine can improve cancer through various pathways and have almost no toxic side effects. Therefore， the research on the anti-cancer effect of saponins is heating up. It is found that saponins play anti-tumor roles by inhibiting proliferation， metastasis， and angiogenesis of cancer cells， promoting apoptosis of cancer cells， inducing autophagy of tumor cells， and regulating miRNA expression and immune functions. Chinese herbal medicine saponins can regulate secretory glycoprotein /β-catenin （Wnt/β-catenin）， adenylate activated protein kinase （AMPK）， nuclear transcription factor-κB （NF-κB）， mitogen-activated protein kinase （MAPK）， phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， Janus kinase/activator of signal transduction and transcription 3 （JAK/ STAT3）， hypoxia-inducible factor-1α （HIF-1α）， Toll-like receptor （TLR）， and other related signaling pathways to get involved in the proliferation， metastasis， angiogenesis， apoptosis， autophagy， and other processes of cancer cells， thus interfering with the progression of cancer. Therefore， the focus of this review is to update the discovery and evaluation of Chinese herbal medicine saponins with anti-cancer properties， clarify their mechanism of action， including the progress of related signaling pathways， and deepen the understanding of the anti-cancer function of Chinese herbal medicine saponins， so as to provide a new perspective and direction for the prevention and treatment of tumors by traditional Chinese medicine and better promote the development and utilization of resources.

Construction of Chinese Herbal Medicine Traceability System Based on Influencing Factors of Chinese Herbal Medicine Quality / 中国实验方剂学杂志

As a Chinese saying goes， "good Chinese medicinal material makes good medicine"， the quality of Chinese herbal medicines is related to the development prospect of Chinese medicine industry in China. With the rapid development of new technologies such as traceability methods and monitoring instruments， it is imperative to integrate and innovate traditional Chinese herbal medicines with new-generation information technology in view of the quality problems existing in the current production and circulation of Chinese herbal medicines， and it is of great significance for the construction of traceability system to ensure the quality and safety of Chinese herbal medicines and to promote the industry of Chinese herbal medicines to move towards high-quality development. This paper reviews the development history of the traceability system of Chinese herbal medicines in China， takes the influencing factors of the quality of Chinese herbal medicines as the entry point， and proposes that the construction of the traceability system should satisfy the traceability requirements of the characteristics of Chinese herbal medicines and their traditional medication experience. By analyzing the influencing factors of the quality of Chinese herbal medicines， it is pointed out that focusing on the influencing factors to build a traceability system is of great significance for targeting the problematic links at a later stage and exploring the interrelationship between environmental factors and the quality of Chinese herbal medicines. Based on the previous explorations， the author summarizes the system framework， functional modules and practical applications of the traceability system of Chinese herbal medicines， and looks forward to the development of a traceability system with risk early warning function and expert decision-making function in its functional development. Finally， based on the factors affecting the quality of Chinese herbal medicines， the author puts forward several thoughts on construction of the traceability system， and makes an in-depth analysis and puts forward a solution for the current situation that a unified， standardized and universal traceability system has not yet been built， with a view to providing ideas and references for the construction of traceability system of Chinese herbal medicines.

Development of Chinese herbal medicine for sensorineural hearing loss

According to the World Health Organization's world report on hearing, nearly 2.5 billion people worldwide will suffer from hearing loss by 2050, which may contribute to a severe impact on individual life quality and national economies. Sensorineural hearing loss (SNHL) occurs commonly as a result of noise exposure, aging, and ototoxic drugs, and is pathologically characterized by the impairment of mechanosensory hair cells of the inner ear, which is mainly triggered by reactive oxygen species accumulation, inflammation, and mitochondrial dysfunction. Though recent advances have been made in understanding the ability of cochlear repair and regeneration, there are still no effective therapeutic drugs for SNHL. Chinese herbal medicine which is widely distributed and easily accessible in China has demonstrated a unique curative effect against SNHL with higher safety and lower cost compared with Western medicine. Herein we present trends in research for Chinese herbal medicine for the treatment of SNHL, and elucidate their molecular mechanisms of action, to pave the way for further research and development of novel effective drugs in this field.

Polysaccharides from Chinese herbal medicine: a review on the hepatoprotective and molecular mechanism / 中国天然药物

Polysaccharides, predominantly extracted from traditional Chinese medicinal herbs such as Lycium barbarum, Angelica sinensis, Astragalus membranaceus, Dendrobium officinale, Ganoderma lucidum, and Poria cocos, represent principal bioactive constituents extensively utilized in Chinese medicine. These compounds have demonstrated significant anti-inflammatory capabilities, especially anti-liver injury activities, while exhibiting minimal adverse effects. This review summarized recent studies to elucidate the hepatoprotective efficacy and underlying molecular mechanisms of these herbal polysaccharides. It underscored the role of these polysaccharides in regulating hepatic function, enhancing immunological responses, and improving antioxidant capacities, thus contributing to the attenuation of hepatocyte apoptosis and liver protection. Analyses of molecular pathways in these studies revealed the intricate and indispensable functions of traditional Chinese herbal polysaccharides in liver injury management. Therefore, this review provides a thorough examination of the hepatoprotective attributes and molecular mechanisms of these medicinal polysaccharides, thereby offering valuable insights for the advancement of polysaccharide-based therapeutic research and their potential clinical applications in liver disease treatment.

Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023 edition) / 中草药·英文版

To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.

Clinical Application of Fresh Plantaginis Herba in Acient and Modern Medical Works / 中国实验方剂学杂志

ObjectiveTo explore the clinical application law and provide literature support and development ideas for the modern application of fresh Plantaginis Herba. MethodThe literature about the application of fresh Plantaginis Herba was retrieved from the fifth edition of Chinese medical dictionary， China national knowledge infrastructure （CNKI）， VIP， Wanfang data， and Chinese medical journals and analyzed. ResultFresh Plantaginis Herba appeared frequently in ancient books， with the effects of clearing heat， cooling blood， promoting urination， and relieving stranguria. It was used for the treatment of stranguria， urine retention， bloody urine， sore and carbuncle， epistaxis， red and swelling eye， suppurative inflammation in the throat， and gynecological and pediatric diseases. According to modern medical publications， fresh Plantaginis Herba is mainly used to treated diseases in the kidney， five sense organs， spleen， stomach， lung， liver， gallbladder， and skin and gynecological and pediatric diseases. Specifically， it is mainly used to treat the syndrome of dampness and heat in kidney and skin diseases caused by the accumulation of dampness and heat toxin， with the effects of clearing heat， removing toxin， promoting urination， and relieving stranguria. Since ancient times， there have been reports of using fresh Plantaginis Herbausing for food and health care. ConclusionFresh Plantaginis Herba is widely used in clinical practice and has a high medical value and economic value. However， its modern application lags behind， so it is necessary to promote the development of fresh Plantaginis Herba from the aspects of medicinal material production， storage， transportation， preparation research and development， and clinical application.

Intervention of Chinese Herbal Medicine Formulas on Oxidative Stress of Chronic Obstructive Pulmonary Disease： A Review / 中国实验方剂学杂志

Chronic obstructive pulmonary disease （COPD） is a common disease in clinical practice. It is associated with obvious exposure to toxic particles or gases and has become the leading cause of death and disability worldwide. The pathogenesis of COPD is complex， and the oxidative stress involved in COPD plays a crucial role in the pathological process of the disease. Patients with COPD usually have high levels of oxidative stress in the lungs， which will affect the whole body for a long time， causing a variety of complications and accelerating the development of the disease. On the one hand， oxidative stress can directly damage the airway and lung tissue. On the other hand， it also drives other pathological mechanisms to jointly promote the development of disease， such as participating in inflammatory reactions and protease/anti-protease imbalance， promoting mucus secretion， accelerating cellular senescence， causing autoimmunity， and involving in genetic regulatory pathways. At present， western medicine treatment is mostly based on conventional drug treatment， and antioxidant-targeted oxidative stress is adopted， but there are still some challenges in efficacy and safety. Traditional Chinese medicine has a long history of preventing and treating COPD. In particular， Chinese herbal medicine formulas have great potential to interfere with the oxidative stress of COPD. Whether it is the modified classical traditional Chinese medicine or the new formulation developed by modern doctors， the research results reflect the multi-target and multi-channel advantages of traditional Chinese medicine treatment， and their efficacy and safety are gradually verified. This paper reviewed the literature in recent years， starting with the basic and clinical research on the intervention of traditional Chinese herbal medicine formulas on oxidative stress of COPD， so as to provide further ideas for related research on the prevention and treatment of oxidative stress of COPD by traditional Chinese medicine.

Phytotherapy: knowledge, experience and prescription in oral healthcare. A cross-sectional survey of dental practitioners / Conhecimento, experiência e prescrição de fitoterapia em saúde bucal: Um levantamento transversal com dentistas clínicos

ABSTRACT Herbal medicine is widely used as an integrative complementary treatment for common chronic diseases, yet potential risks include adverse effects and coprescription Aim This exploratory survey assessed Brazilian dentists' knowledge, attitudes, and practices regarding phytotherapy Material and Method This study used a consecutive sample of registered dentists who were active in clinical practice and attending advanced training for complex oral rehabilitation at a leading dental school in Latin America. Participants responded to a semi-structured 38-item instrument designed to collect data on sociodemographic, professional and health variables, and on their knowledge, use, prescription and opinions of phytotherapy. Quantitative data were analyzed with descriptive and inferential statistics. Qualitative data were described and analyzed with a thematic approach Results A total 53 dentists responded the survey (88.3% response rate). Six dentists reported formal education in phytotherapy and 33 had informal knowledge. Twenty-one dentists (39.6%) reported using herbal medicine, and 17 (32.1%) prescribed phytotherapy to their patients, mostly traditional medicinal plants. A logistic regression model showed that post-graduate degree and personal use of phytotherapy were associated with phytotherapy prescription. Opinions on how to improve the rational use of phytotherapy included the need for research evidence, specific academic education, and knowledge dissemination to clinicians. As a clinical recommendation, it was proposed that questions on herbal medicine should be asked during the dental patient's anamnesis Conclusions Dentists with post-graduate degrees and personal use of phytotherapy prescribe herbal medicines for their patients in real-world clinics, regardless of formal education on the subject. Qualitative findings indicate the need to implement scientific initiatives.

RESUMO A fitoterapia é amplamente utilizada como um tratamento integrativo e complementar para doenças crônicas comuns, mas os riscos potenciais incluem efeitos adversos e co-prescrição Objetivo Esta pesquisa exploratória avaliou o conhecimento, as atitudes e as práticas de cirurgiões-dentistas brasileiros sobre fitoterapia Materiais e Método Uma amostra consecutiva foi composta por dentistas com registro profissional, que eram ativos em prática clínica e frequentavam treinamento avançado para reabilitação oral complexa em uma das principais escolas de odontologia da América Latina. Os participantes responderam a um instrumento semiestruturado de 38 itens para coletar dados sobre variáveis sociodemográficas, profissionais e de saúde, bem como conhecimento, uso, prescrição e opiniões sobre fitoterapia. Os dados quantitativos foram analisados com estatística descritiva e inferencial. Os dados qualitativos foram descritos e analisados com abordagem temática Resultados Um total de 53 dentistas respondeu à pesquisa (taxa de resposta de 88,3%). Seis cirurgiões-dentistas relataram formação em fitoterapia e 33 possuíam conhecimento informal. Vinte e um dentistas (39,6%) relataram o uso de fitoterápicos e 17 (32,1%) prescreveram fitoterapia para seus pacientes, principalmente plantas medicinais tradicionais. Um modelo de regressão logística mostrou que pós-graduação e uso pessoal de fitoterapia estiveram associados à prescrição de fitoterapia. As opiniões para melhorar o uso racional da fitoterapia incluíram a necessidade de evidências de pesquisa, formação acadêmica específica e disseminação do conhecimento para os clínicos. Como recomendação clínica, foram propostas questões sobre fitoterapia para a anamnese odontológica do paciente Conclusões Cirurgiões-dentistas com pós-graduação e uso pessoal de fitoterapia prescrevem mais medicamentos fitoterápicos para seus pacientes em clínicas do mundo real, independentemente da educação formal sobre o assunto. Os resultados qualitativos indicam a necessidade de iniciativas de implementação científica.

Effects of Mimosa caesalpiniifolia pre-formulation on the intestinal barrier during sodium dextran sulfate-induced colitis in Wistar rats / Efectos de la preformulación de Mimosa caesalpiniifolia sobre la barrera intestinal durante la colitis inducida por sulfato de dextrano sódico en ratas Wistar

Introduction. Anti-inflammatories, immunosuppressants, and immunobiological are commonly used in the treatment of inflammatory bowel disease. However, some patients do not present an adequate response or lose effective response during the treatment. A recent study found a potential anti-inflammatory effect of the hydroalcoholic extract of Mimosa caesalpiniifolia on trinitrobenzene sulfonic acid-induced colitis in Wistar rats. Objective. To evaluate the effects of M. caesalpiniifolia pre-formulation on the intestinal barrier using dextran sulfate sodium-induced colitis model. Materials and methods. Leaf extracts were prepared in 70% ethanol and dried with a Buchi B19 Mini-spray dryer using 20% Aerosil® solution. Thirty-two male Wistar rats were randomized into four groups: basal control, untreated colitis, pre-formulation control (125 mg/kg/day), and colitis treated with pre-formulation (125 mg/kg/day). Clinical activity index was recorded daily and all rats were euthanized on the ninth day. Colon fragments were fixed and processed for histological and ultrastructural analyses. Stool samples were collected and processed for analysis of the short-chain fatty acid. Results. Treatment with the pre-formulation decreased the clinical activity (bloody diarrhea), inflammatory infiltrate, and the ulcers. Pre-formulation did not repair the epithelial barrier and there were no significant differences in the goblet cells index. There was a significant difference in butyrate levels in the rats treated with the pre-formulation. Conclusions. The pre-formulation minimized the clinical symptoms of colitis and intestinal inflammation, but did not minimize damage to the intestinal barrier.

Introducción. Los antiinflamatorios, inmunosupresores e inmunobiológicos se utilizan comúnmente para tratar la enfermedad intestinal inflamatoria. Sin embargo, algunos pacientes no presentan una respuesta adecuada o pierden respuesta efectiva durante el tratamiento. En un estudio reciente, se encontró un potencial efecto antiinflamatorio del extracto hidroalcohólico de Mimosa caesalpiniifolia en la colitis inducida por el ácido trinitrobenceno sulfónico utilizando ratas Wistar. Objetivo. Evaluar los efectos de la preformulación de M. caesalpiniifolia sobre la barrera intestinal durante la colitis inducida por sulfato de dextrano sódico. Materiales y métodos. Los extractos de hojas se prepararon con una solución que contenía 70 % de etanol y se secaron con un secador por aspersión Mini B19 de Buchi usando una solución con 20 % de Aerosil®. Treinta y dos ratas Wistar macho se aleatorizaron en cuatro grupos: control basal, colitis sin tratar, control con preformulación (125 mg/kg/ día) y colitis tratada con preformulación (125 mg/kg/día). El índice de actividad clínica se registró diariamente y todas las ratas se sacrificaron el noveno día. Los fragmentos de colon se fijaron y se procesaron para análisis histológicos y ultraestructurales. Se recolectaron muestras de heces y se procesaron para el análisis de ácidos grasos de cadena corta. Resultados. El tratamiento con la preformulación disminuyó la actividad clínica (diarrea sanguinolenta), el infiltrado inflamatorio y las úlceras. La preformulación no reparó la barrera epitelial y no hubo diferencias significativas en el índice de células caliciformes. Se obtuvo una diferencia significativa en los niveles de butirato en las ratas tratadas con la preformulación. Conclusiones: La preformulación minimizó los síntomas clínicos de colitis e inflamación intestinal pero no minimizó el daño a la barrera intestinal.

Consumption of medicinal plants and herbal medicines by children and adolescents with chronic conditions: a survey in a tertiary-care outpatient clinic / Utilização de plantas medicinais e derivados por crianças e adolescentes com condições crônicas: levantamento em um serviço pediátrico terciário

Objectives: Medicinal plants and herbal medicines are widely used worldwide. However, patients with chronic health conditions or their caregivers do not often disclose these practices to their healthcare providers, leading to potentially severe interactions with current treatments, especially in children. We aimed to describe the prevalence of the use of medicinal plants and herbal medicines by children and adolescents with chronic health conditions and whether their physicians were informed about it. Methods: We conducted a cross-sectional electronic survey on parents and caregivers of children and adolescents with chronic health conditions seen at a university, tertiary-care pediatric outpatient clinic. The common names of the plants cited by respondents were reviewed and Latin names of the species were provided whenever possible. Results: From 20,213 text messages sent in May and June 2021, 521 valid responses were obtained. The prevalence of the use of medicinal plants and herbal medicines was 34.6%, most without a medical prescription (self-medication), and few physicians (4.0%) were aware of it. The five most used species were: Mentha spicata L. (mint), Foeniculum vulgare Mill. (fennel), "cidreira" (a common name possibly corresponding to Cymbopogon citratus (DC.) Stapf, Melissa officinalis L. or Lippia alba (Mill.) N.E. Br. ex Britton & Wilson, P.), Matricaria chamomilla L. (German chamomile), and Plectranthus barbatus Andrews (boldo). Conclusions: The prevalence of the use of medicinal plants and herbal medicines by children and adolescents with chronic health conditions in a tertiary-care outpatient clinic was 34.6%, and only a few physicians were aware of it (AU).

Objetivos: Plantas medicinais e seus derivados são amplamente utilizados no mundo todo. Entretanto, pacientes com condições crônicas de saúde ou seus cuidadores frequentemente não informam essas práticas para seus profissionais de saúde, levando a interações potencialmente graves com os demais tratamentos, especialmente em crianças. Nós objetivamos descrever a prevalência do uso de plantas medicinais e derivados por crianças e adolescentes com condições crônicas de saúde, e se seus médicos foram informados sobre isto. Métodos: Levantamento eletrônico transversal junto a pais e cuidadores de crianças e adolescentes com condições crônicas de saúde atendidos em um serviço ambulatorial pediátrico universitário terciário. Os nomes comuns das plantas citadas pelos participantes foram revisados e os nomes latinos das espécies foram identificados, sempre que possível. Resultados: De 20.213 mensagens de texto enviadas em maio e junho de 2021, 521 respostas válidas foram obtidas. A prevalência de utilização de plantas medicinais e derivados foi de 34,6%, sendo a maioria sem prescrição médica (automedicação), e poucos médicos (4,0%) estavam cientes disto. As cinco plantas mais comumente utilizadas foram: Mentha spicata L. (hortelã), Foeniculum vulgare Mill. (funcho), "cidreira" (possivelmente correspondendo a Cymbopogon citratus (DC.) Stapf, Melissa officinalis L. ou Lippia alba (Mill.) N.E. Br. ex Britton & Wilson, P.), Matricaria chamomilla L. (camomila) e Plectranthus barbatus Andrews (boldo nacional). Conclusões: A prevalência de uso de plantas medicinais e derivados por crianças e adolescentes com condições crônicas de saúde em um serviço ambulatorial pediátrico terciário foi de 34,6%, com grande potencial para interações, e somente poucos médicos estavam cientes disto

Toxicity Reduction Measures of Herbal Medicines Causing Liver Injury and Role of Herbal Medicines in Preventing and Treating Liver Injury / 中国实验方剂学杂志

Chinese herbal medicines play a great role in disease prevention and treatment， while some may cause adverse effects on the human body after of long-term application. Liver injury， one of such adverse effects， is an important check item in the development of new Chinese medicines for clinical application and has become a major reason for the withdrawal of many listed drugs from the market. With the rising concern about the safety of Chinese herbal medicines， studies about liver injury caused by herbal medicines are increasing. Most of the studies focus on liver injury caused by Chinese herbal medicines or their ingredients. To improve the safety of Chinese herbal medicines， this paper summarizes the material basis and mechanisms of several Chinese herbal medicines that cause liver injury and the measures to reduce liver injury. These measures include reducing the dose and course of administration， changing the route of administration， and altering the dosage form， compatibility， and processing. In addition， this paper introduces the biological effects and mechanisms of single Chinese herbal medicines， Chinese medicine prescriptions， and active components in the prevention and treatment of liver injury. Furthermore， this paper proposes the safe dose and efficacy-toxicity boundary of Chinese herbal medicines that may cause liver injury by referring to the modern research on toxicity reduction， clarifies the mechanisms of toxicity reduction measures， and determines the material basis of liver injury induced by Chinese herbal medicines， which will ensure the safe application of herbal medicines in clinical practice. Finally， this paper suggests that efforts should be made to strengthen the clinical research on the prevention and treatment of liver injury and elucidate the scientific connotation of the prevention and treatment of liver injury by Chinese herbal medicines by using modern science and technology， aiming to provide a scientific basis for the clinical prevention and treatment of liver injury.

Four Properties of Chinese Herbal Medicine： A Review / 中国实验方剂学杂志

The four properties of Chinese herbal medicine have a history of several thousand years and are one of the important theoretical guides for the clinical application of Chinese herbal medicine. However， there have been few reviews of research methods and techniques for the four properties of Chinese herbal medicine in recent years. Therefore， this article summarized the advances and techniques for the four properties of Chinese herbal medicine by screening relevant literature on the four properties of Chinese herbal medicine and clarifying the characteristics， advantages， and applicable objects of each technique， in order to provide references for in-depth research on the four properties in the future. Chinese databases such as China national knowledge infrastructure （CNKI）， Wanfang data， and VIP， as well as international databases including PubMed， Cochrane Library， and EMbase were searched for relevant literature on the four properties of Chinese herbal medicine. The advances， research objects， and research techniques involved in the literature were extracted， classified， and summarized. Currently， the research techniques for the four properties of Chinese herbal medicine mainly include six categories， i.e.， literature data research， network pharmacology， biothermodynamics， cell biology， proteomics， and metabolomics. The research hierarchy can be divided into micro-level， small-level， medium-level， and macro-level. The research objects used in each experimental study are different， mainly single Chinese herbal medicine， Chinese herbal monomers， targets， microbial communities， cells， mice， and rats. Different research techniques explain the four properties of Chinese herbal medicine from different dimensions， which overall indicate the material basis of the four properties of Chinese herbal medicine. In future research， the interpretation of the four properties of Chinese herbal medicine can be first located at the research hierarchy， then corresponding research techniques can be selected according to the research hierarchy， and research indicators can be determined to obtain research conclusions. This can help researchers of traditional Chinese medicine effectively carry out research design and perform related experiments on the four properties of Chinese herbal medicine.

Advances in the treatment of diabetic ulcers by Chinese herbal extracts / 药学实践杂志

Skin ulcers are the most prevalent consequence of diabetes mellitus, and people with diabetic ulcers have a substantially greater death risk than those who do not have ulcers. Herbal medications have gained wide concern in recent years due to their multi-component, multi-target, and multi-pathway synergistic therapeutic effects. Clinical trials have demonstrated the safety and efficacy of herbal treatments in diabetic refractory ulcers. To systematically evaluate the healing effect of herbs on diabetic wounds, a literature search was conducted, the mechanism of action of 15 herbal extracts in promoting diabetic wound healing were reviewed, and the classification based on traditional Chinese medicine theory was discussed, which could provide a reference for the precise treatment and exploitation of herbal medicines for diabetic ulcers.

Advances in Phytochemistry and Modern Pharmacology of Saposhnikovia Divaricata (Turcz.) Schischk / 中国结合医学杂志

Saposhnikovia divaricata (Turcz.) Schischk (S. divaricata, Fangfeng) is a herb in the Apiaceae family, and its root has been used since the Western Han Dynasty (202 B.C.). Chromones and coumarins are the pharmacologically active substances in S. divaricata. Modern phytochemical and pharmacological studies have demonstrated their antipyretic, analgesic, anti-inflammatory, antioxidant, anti-tumor, and anticoagulant activities. Technological and analytical strategy theory advancements have yielded novel results; however, most investigations have been limited to the main active substances-chromones and coumarins. Hence, we reviewed studies related to the chemical composition and pharmacological activity of S. divaricata, analyzed the developing trends and challenges, and proposed that research should focus on components' synergistic effects. We also suggested that, the structure-effect relationship should be prioritized in advanced research.

Efficacy of Chinese Herbal Medicines on Pregnancy Outcomes in Patients with Endometriosis in Long-Term Management: A Multicenter Retrospective Cohort Study / 中国结合医学杂志

OBJECTIVE@#To analyze the factors related to pregnancy of endometriosis and whether Chinese herbal medicines (CHMs) can improve pregnancy outcomes in patients with endometriosis in long-term management.@*METHODS@#This multicenter cohort study retrospectively analyzed the clinical data of endometriosis patients with fertility needs from January 2019 to November 2019. A total of 252 patients with endometriosis from 5 level-III Grade A hospitals in Beijing were included in this study. Univariate and multivariate logistic regression analysis were performed for the relevant factors. The propensity score matching (PSM) function of SPSS software was used to match the CHMs group with the non-CHMs group. The pregnancy rate and live birth rate were analyzed.@*RESULTS@#The results of univariate analysis showed that age, disease course, presence of infertility, presence of adenomyosis, time after surgery or use of gonadotropin-releasing hormone agonist (GnRH-a), use of CHMs and follow-up time were influencing factors of pregnancy in endometriosis patients (P<0.05). The results of multivariate analysis showed that age, presence of adenomyosis, time after surgery or use of GnRH-a, use of CHMs and follow-up time were independent factors affecting pregnancy in endometriosis patients, among which, age ⩾35 years old, presence of adenomyosis and follow-up time >6 months were independent risk factors (OR=0.445, 0.348, 0.140, respectively, P<0.05), time after surgery or use of GnRH-a ⩽6 months and use of CHMs were independent protective factors (OR=3.839, 3.842, respectively, P<0.05). After PSM, 99 pairs of two groups were matched successfully. The pregnancy rate of the CHMs group was higher than that of the non-CHMs group [55.56% (55/99) vs. 36.36% (36/99), P<0.05]. The live birth rate of the CHMs group was higher than that of the non-CHMs group [49.49% (49/99) vs. 35.35% (35/99), P<0.05].@*CONCLUSION@#CHMs can effectively improve clinical pregnancy rate and live birth rate of patients with endometriosis in the chronic disease management.

Historical investigation on paradigm of "species standardization" of Chinese herbal medicine / 中国中药杂志

The paradigm can be summarized as the same methodological principles followed by the members of the learning community who received common education, training, and edification in the common social and historical stage, and had common academic views, concepts, and terms. The "species standardization" paradigm of botanical drugs in China has experienced the period of non-standardization of names(the end of the Warring States period), the period of multi-dimensional textual research paradigm of traditional materia medica(from the end of the Warring States period to 1930s), and periods of modern plant taxonomy system research paradigm(from 1930s to the present). The multi-dimensional textual research paradigm of traditional materia medica is characterized by the textual research of species in different regions and years based on the classification of the natural attributes and the habit of correspondence between names and materials, from the multi-dimensional investigation of the name, appearance, color, smell, texture, growth environment, efficacy, and morphological characteristics of medicinal materials, to find the correspondence between names and materials. The purpose of the progress in traditional species standardization is practicality for humans, and there is a lack of systematic research on the classification and naming principles in line with its laws from the plant itself, resulting in inaccurate research results. The research paradigm of modern plant taxonomy is herbal research. The characteristics of this paradigm are using plant taxonomy knowledge to conduct textual research to confirm the species of the drug and calibrate the scientific name by the double name method, based on the plant morphology, harvest season, origin distribution, ecological habits, names, drug efficacy, and other data in the lite-rature of previous dynasties. This paradigm combines the knowledge of traditional materia medica and modern plant taxonomy, and the results of species research are accurate.