BACKGROUND

Community pharmacists are strategically positioned to dispense Complementary and Alternative Medicine (CAM) products as part of their innate roles in the provision of accurate drug information to patients. This unique position of the pharmacist could be best realized if equipped with good knowledge and skills in regard to CAM products.

This study aimed to assess the readiness of community pharmacists in the provision of CAM productrelated information to patients by assessing the knowledge and determined the attitudes and practices of community pharmacists regarding CAM products in Eastern Visayas, Philippines.

A descriptive mixed-method (qualitative and quantitative) survey design was utilized in this study. Community pharmacists (n=58) in Eastern Visayas, Philippines were the research participants in the study. The survey questionnaire constituted four sections: socio-demographic profile, attitudes, practices, and knowledge of community pharmacists on CAM products. Descriptive statistical analysis was performed using SPSS Version 20.

Results revealed that the majority of respondents are female (87.93%), age range in between 21-30 (62.07%), working full-time (79.31%), and bachelor’s degree holder (98.28%). More than half of the participants (53.45%) did not receive any education or training on CAM products during undergraduate studies. Community pharmacists displayed strong positive attitudes (mean=3.74) and had a moderate frequency of practice on CAM products (mean=3.20). The knowledge test revealed that only a few of the community pharmacists (31.03%) were considered knowledgeable. A significant relationship between years of work experience in community pharmacy and knowledge was found in this study.

Despite having strong attitude and moderate level of practice, community pharmacists in Eastern Visayas showed a low level of knowledge on CAM products. Demand for CAM products by patients encouraged community pharmacists to dispense and provide information. Readiness of community pharmacists in terms of knowledge provision of CAM product-related information to patients were found to be insufficient while a moderate level of practice towards CAM products was reported. Community pharmacists displayed a strong positive attitude towards CAM products. Overall, the community pharmacists are not ready to provide CAM information service in the context of the knowledge, attitude, and practices.

Background: Community pharmacists are strategically positioned to dispense Complementary and Alternative Medicine (CAM) products as part of their innate roles in the provision of accurate drug information to patients. This unique position of the pharmacist could be best realized if equipped with good knowledge and skills in regard to CAM products. Objectives: This study aimed to assess the readiness of community pharmacists in the provision of CAM productrelated information to patients by assessing the knowledge and determined the attitudes and practices of community pharmacists regarding CAM products in Eastern Visayas, Philippines. Methods: A descriptive mixed-method (qualitative and quantitative) survey design was utilized in this study. Community pharmacists (n=58) in Eastern Visayas, Philippines were the research participants in the study. The survey questionnaire constituted four sections: socio-demographic profile, attitudes, practices, and knowledge of community pharmacists on CAM products. Descriptive statistical analysis was performed using SPSS Version 20. Results: Results revealed that the majority of respondents are female (87.93%), age range in between 21-30 (62.07%), working full-time (79.31%), and bachelor’s degree holder (98.28%). More than half of the participants (53.45%) did not receive any education or training on CAM products during undergraduate studies. Community pharmacists displayed strong positive attitudes (mean=3.74) and had a moderate frequency of practice on CAM products (mean=3.20). The knowledge test revealed that only a few of the community pharmacists (31.03%) were considered knowledgeable. A significant relationship between years of work experience in community pharmacy and knowledge was found in this study. Conclusion Despite having strong attitude and moderate level of practice, community pharmacists in Eastern Visayas showed a low level of knowledge on CAM products. Demand for CAM products by patients encouraged community pharmacists to dispense and provide information. Readiness of community pharmacists in terms of knowledge provision of CAM product-related information to patients were found to be insufficient while a moderate level of practice towards CAM products was reported. Community pharmacists displayed a strong positive attitude towards CAM products. Overall, the community pharmacists are not ready to provide CAM information service in the context of the knowledge, attitude, and practices.
Complementary Therapies ; Medicine, Traditional ; Philippines

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.
Humans ; Drugs, Chinese Herbal/pharmacology* ; Liver Diseases/drug therapy* ; Antioxidants ; Polysaccharides/therapeutic use* ; Medicine, Chinese Traditional

As the search for effective treatments for COVID-19 continues, the high mortality rate among critically ill patients in Intensive Care Units (ICU) presents a profound challenge. This study explores the potential benefits of traditional Chinese medicine (TCM) as a supplementary treatment for severe COVID-19. A total of 110 critically ill COVID-19 patients at the Intensive Care Unit (ICU) of Vulcan Hill Hospital between Feb., 2020, and April, 2020 (Wuhan, China) participated in this observational study. All patients received standard supportive care protocols, with a subset of 81 also receiving TCM as an adjunct treatment. Clinical characteristics during the treatment period and the clinical outcome of each patient were closely monitored and analysed. Our findings indicated that the TCM group exhibited a significantly lower mortality rate compared with the non-TCM group (16 of 81 vs 24 of 29; 0.3 vs 2.3 person/month). In the adjusted Cox proportional hazards models, TCM treatment was associated with improved survival odds (P < 0.001). Furthermore, the analysis also revealed that TCM treatment could partially mitigate inflammatory responses, as evidenced by the reduced levels of proinflammatory cytokines, and contribute to the recovery of multiple organic functions, thereby potentially increasing the survival rate of critically ill COVID-19 patients.
Humans ; COVID-19 ; Medicine, Chinese Traditional ; SARS-CoV-2 ; Critical Illness ; Treatment Outcome

Humans ; Medicine, Chinese Traditional ; Bone Density ; Drugs, Chinese Herbal ; China

Cancer is one of the deadliest diseases affecting the health of human beings. With limited therapeutic options available, complementary and alternative medicine has been widely adopted in cancer management and is increasingly becoming accepted by both patients and healthcare workers alike. Chinese medicine characterized by its unique diagnostic and treatment system is the most widely applied complementary and alternative medicine. It emphasizes symptoms and ZHENG (syndrome)-based treatment combined with contemporary disease diagnosis and further stratifies patients into individualized medicine subgroups. As a representative cancer with the highest degree of malignancy, pancreatic cancer is traditionally classified into the "amassment and accumulation". Emerging perspectives define the core pathogenesis of pancreatic cancer as "dampness-heat" and the respective treatment "clearing heat and resolving dampness" has been demonstrated to prolong survival in pancreatic cancer patients, as has been observed in many other cancers. This clinical advantage encourages an exploration of the essence of dampness-heat ZHENG (DHZ) in cancer and investigation into underlying mechanisms of action of herbal formulations against dampness-heat. However, at present, there is a lack of understanding of the molecular characteristics of DHZ in cancer and no standardized and widely accepted animal model to study this core syndrome in vivo. The shortage of animal models limits the ability to uncover the antitumor mechanisms of herbal medicines and to assess the safety profile of the natural products derived from them. This review summarizes the current research on DHZ in cancer in terms of the clinical aspects, molecular landscape, and animal models. This study aims to provide comprehensive insight that can be used for the establishment of a future standardized ZHENG-based cancer animal model.
Animals ; Humans ; Medicine, Chinese Traditional ; Hot Temperature ; Pancreatic Neoplasms/therapy* ; Models, Animal ; Syndrome

OBJECTIVE: To assess the outcomes after acupoint application in patients with pharyngeal pain in a real-world settings, and analyze the characteristics of effective population and prescription characteristics of acupoint application. METHODS: Based on CHUNBO platform, patients with pharyngeal pain who were candidates for acupoint application on the basis of physician-evaluation, were enrolled in a nationwide, prospective, 69-week multicenter observational study from August 2020 to February 2022. Propensity score matching (PSM) was used to match the confounding factors and the association rules were used to analyze the characteristics of effective population and prescription characteristics of acupoint application. Outcome assessments included the disappearance rate of pharyngeal pain (within 3, 7, and 14 days), disappearance time of pharyngeal pain, as well as adverse events. RESULTS: Of 7,699 enrolled participants, 6,693 (86.9%) received acupoint application and 1,450 (21.7%) with non-acupoint application. After PSM, there were 1,004 patients each in the application group (AG) and non-application group (NAG). The disappearance rate of pharyngeal pain in the AG at 3, 7, and 14 days were all higher than those in the NAG (P<0.05). The disappearance time of pharyngeal pain in the AG were shorter than that in the NAG (logrank P<0.001, hazard ratio=1.51, 95% confidence interval: 1.41-1.63). The median age of effective cases was 4 years, mainly 3-6 years old (40.21%). The disappearance rate of pharyngeal pain in the application group with tonsil diseases was 2.19 times higher than that in the NAG (P<0.05). The commonly used acupoints for the effective cases were Tiantu (RN 22), Shenque (RN 8) and Dazhui (DU 14). The commonly used herbs for the effective cases were Natrii sulfas, Radix et Rhizoma Rhei, and Herba Ephedrae. Among them, Natrii sulfas was applied to RN 8 most frequently (support 84.39%). A total of 1,324 (17.2%) patients experienced AEs, and mainly occurred in the AG, with significant difference in the incidence of AEs between goups (P<0.05). All AEs reported were the first grade, and the average regression days of AEs was 2.8 days. CONCLUSIONS Acupoint application in patients with pharyngeal pain resulted in improved effective rate and shortened duration, especially children aged 3-6 years old, and those with tonsil diseases. Acupoint of RN 22, RN 8 and DU 14, Natrii sulfas, Radix et Rhizoma Rhei, and Herba Ephedrae were the most commonly used herbs in the treatment of pharyngeal pain.
Child ; Humans ; Child, Preschool ; Acupuncture Points ; Medicine, Chinese Traditional/methods* ; Prospective Studies ; Pain

As a serious cardiovascular disease, atherosclerosis (AS) causes chronic inflammation and oxidative stress in the body and poses a threat to human health. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a member of the phospholipase A2 (PLA2) family, and its elevated levels have been shown to contribute to AS. Lp-PLA2 is closely related to a variety of lipoproteins, and its role in promoting inflammatory responses and oxidative stress in AS is mainly achieved by hydrolyzing oxidized phosphatidylcholine (oxPC) to produce lysophosphatidylcholine (lysoPC). Moreover, macrophage apoptosis within plaque is promoted by localized Lp-PLA2 which also promotes plaque instability. This paper reviews those researches of Chinese medicine in treating AS via reducing Lp-PLA2 levels to guide future experimental studies and clinical applications related to AS.
Humans ; 1-Alkyl-2-acetylglycerophosphocholine Esterase ; Medicine, Chinese Traditional ; Atherosclerosis/drug therapy* ; Lipoproteins ; Plaque, Atherosclerotic ; Biomarkers

Chinese medicine (CM) diagnosis intellectualization is one of the hotspots in the research of CM modernization. The traditional CM intelligent diagnosis models transform the CM diagnosis issues into classification issues, however, it is difficult to solve the problems such as excessive or similar categories. With the development of natural language processing techniques, text generation technique has become increasingly mature. In this study, we aimed to establish the CM diagnosis generation model by transforming the CM diagnosis issues into text generation issues. The semantic context characteristic learning capacity was enhanced referring to Bidirectional Long Short-Term Memory (BILSTM) with Transformer as the backbone network. Meanwhile, the CM diagnosis generation model Knowledge Graph Enhanced Transformer (KGET) was established by introducing the knowledge in medical field to enhance the inferential capability. The KGET model was established based on 566 CM case texts, and was compared with the classic text generation models including Long Short-Term Memory sequence-to-sequence (LSTM-seq2seq), Bidirectional and Auto-Regression Transformer (BART), and Chinese Pre-trained Unbalanced Transformer (CPT), so as to analyze the model manifestations. Finally, the ablation experiments were performed to explore the influence of the optimized part on the KGET model. The results of Bilingual Evaluation Understudy (BLEU), Recall-Oriented Understudy for Gisting Evaluation 1 (ROUGE1), ROUGE2 and Edit distance of KGET model were 45.85, 73.93, 54.59 and 7.12, respectively in this study. Compared with LSTM-seq2seq, BART and CPT models, the KGET model was higher in BLEU, ROUGE1 and ROUGE2 by 6.00-17.09, 1.65-9.39 and 0.51-17.62, respectively, and lower in Edit distance by 0.47-3.21. The ablation experiment results revealed that introduction of BILSTM model and prior knowledge could significantly increase the model performance. Additionally, the manual assessment indicated that the CM diagnosis results of the KGET model used in this study were highly consistent with the practical diagnosis results. In conclusion, text generation technology can be effectively applied to CM diagnostic modeling. It can effectively avoid the problem of poor diagnostic performance caused by excessive and similar categories in traditional CM diagnostic classification models. CM diagnostic text generation technology has broad application prospects in the future.
Humans ; Medicine, Chinese Traditional ; Pattern Recognition, Automated ; Asian People ; Language ; Learning

Toxic epidermal necrolysis (TEN) is a rare, life-threatening dermatological emergency characterized by extensive epidermal necrosis and detachment, along with significant mucous membrane erosions and systemic symptoms. While conventional medications such as sulfonamides and anticonvulsants are known triggers, recent reports suggest that herbal medications can also induce TEN. This case report highlights the development of TEN in a patient with invasive cervical cancer following the use of an herbal supplement.

A 48-year-old Filipino woman with newly diagnosed invasive cervical cancer developed TEN after taking an herbal supplement containing 23 botanical extracts. Despite discontinuing the supplement, her condition rapidly worsened, with vesicles and bullae progressing to epidermal detachment over 90% of her body surface area. A histopathological examination confirmed the diagnosis of TEN. The patient was treated with systemic corticosteroids and supportive care, achieving full recovery within 14 days.

This case underscores the potential risks associated with herbal medications, particularly in vulnerable patients such as those with cancer. Although conventional pharmaceuticals are the primary culprits for TEN, this report highlights the need for greater awareness of herbal medicine-induced adverse drug reactions. Underreporting of such events, due to lack of awareness among patients and healthcare providers, further complicates the issue. This case emphasizes the need for strengthened regulatory policies and enhanced education to safeguard public health amidst the increasing use of herbal remedies worldwide.