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Background. This article aims to analyze the research status of integrative complementary medicine (ICM) and features of highly cited papers in the field to provide reference of the future development of ICM. Methods. Publications in the field of ICM from 2009 to 2018 were retrieved from the Web of Science Core Collection. The top 20 countries/territories, institutions, journals, keywords of highly cited and noncited papers, and characteristics of essential science indicator (ESI) papers, as well as open access (OA) and non-OA papers, were analyzed. Results. Mainland China had the largest number of ICM publications. The top 20 journals published a total of 31667 papers in 2009–2018, which represented 92.9% of all publications. Keywords of highly cited and noncited papers point to different research directions. 48 ESI highly cited/hot papers were identified, most of which are related to phytochemistry. Furthermore, the average citation rate (percentage of publications that have been cited one or more times) of OA papers was lower than that of total papers and non-OA papers. Conclusions. China leads in number of publications; however, publication quality in ICM field requires improvement. A few journals accounted for more than half of number of publications and citations, which are important for the development of ICM. Many of the keywords in ICM noncited publications pointed towards broad meaning that poorly reflect the exact research content. Most highly cited ICM studies focused on the identification and evaluation of plant active components. OA may not be an effective approach to increase paper citations in the field of ICM. [ABSTRACT FROM AUTHOR]

Recently, with the development of the social economy, the incidence of infertility has increased year by year. With its complex etiology and diversified syndromes, infertility has become one of the most important diseases that plague the physical and mental health of women of childbearing age worldwide. Endometrial factors as an important part affecting female reproductive capacity, due to which induced repeated abortion and multiple uterine cavity operations occur, can destruct endometrium, failing to provide a normal implantation environment for zygote, thus resulting in infertility. Many patients failed to achieve expected results after receiving conventional treatments such as hormone therapy, assisted reproductive technology (ART), granulocyte colony-stimulating factor (G-CSF) therapy, and cell therapy, then turn to complementary and alternative medicine (CAM) therapies for help. Aiming at clarifying the effectiveness and mechanisms of CAM therapy in the treatment of infertility caused by endometrial factors, our paper systematically searched and studied present related literature on the PubMed, CNKI, and other databases, focusing on the aspects of clinical application and mechanism explorations and highlighting the therapeutic effects of Chinese herbal medicine (CHM), acupuncture, and moxibustion on such diseases. Moreover, this paper also introduces the CAM treatments of traditional Chinese medicine (TCM) retention enema, neuromuscular electrical stimulation (NMES), photobiomodulation therapy, dietary intervention, and other measures for infertility caused by endometrial factors, in order to provide a reference for subsequent basic research and clinical work. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a lifelong reproductive endocrine disease, which is the most common cause of anovular infertility. Modern medicine mainly treats infertile patients with PCOS by improving living habits, ovulation induction therapy, and assisted reproductive technology (ART), but the effect is not satisfied. Complementary alternative medicine (CAM) has conspicuous advantages in the treatment of PCOS infertility due to its good clinical efficacy, wide mechanism of action, and no obvious adverse reactions, but its safety and effectiveness in the treatment of PCOS infertility have not been proved. Based on the existing clinical and experimental studies, this paper looks for the therapeutic effect and the mechanism behind it, and explores the safety and effectiveness of its treatment in PCOS infertility, in order to provide reference for future clinical treatment and experimental research. [ABSTRACT FROM AUTHOR]

Female infertility is a state of fertility disorder caused by multiple reasons. The incidence of infertility for females has significantly increased due to various factors such as social pressure, late marriage, and late childbirth, and its harm includes heavy economic burden, psychological shadow, and even marriage failure. Conventional solutions, such as hormone therapy, in vitro fertilization (IVF), and embryo transfer, have the limitations of unsatisfied obstetric outcomes and serious adverse events. Currently, complementary and alternative medicine (CAM), as a new treatment for infertility, is gradually challenging the dominant position of traditional therapies in the treatment of infertility. CAM claims that it can adjust and harmonize the state of the female body from a holistic approach to achieve a better therapeutic effect and has been increasingly used by infertile women. Meanwhile, some controversial issues also appeared; that is, some randomized controlled trials (RCTs) confirmed that CAM had no obvious effect on infertility, and the mechanism of its effect could not reach a consensus. To clarify CAM effectiveness, safety, and mechanism, this paper systematically reviewed the literature about its treatment of female infertility collected from PubMed and CNKI databases and mainly introduced acupuncture, moxibustion, and oral Chinese herbal medicine. In addition, we also briefly summarized psychological intervention, biosimilar electrical stimulation, homeopathy, hyperbaric oxygen therapy, etc. [ABSTRACT FROM AUTHOR]

As an emerging comprehensive discipline, artificial intelligence (AI) has been widely applied in various fields, including traditional Chinese medicine (TCM), a treasure of the Chinese nation. Realizing the organic combination of AI and TCM can promote the inheritance and development of TCM. The paper summarizes the development and application of AI in auxiliary TCM diagnosis, analyzes the bottleneck of artificial intelligence in the field of auxiliary TCM diagnosis at present, and proposes a possible future direction of its development. [ABSTRACT FROM AUTHOR]

As a reproductive endocrine disease, polycystic ovary syndrome (PCOS) has influenced billions of women during childbearing age worldwide. Owing to its complex etiology and ambiguous pathogenesis, there is still not a specific method to cure it. Clinical treatments, such as hormone therapy and surgical treatment, have side effects. Therefore, it is essential and urgent to seek alternative treatment to solve these problems. The satisfactory efficacy of complementary and alternative medicine (CAM), such as traditional Chinese medicine (TCM), immunotherapy, medicinal foods, vitamin therapy, diet therapy, psychotherapy, spa, and oxygen therapy, in treating PCOS, has aroused an increasing number of medical workers' concern and gradually become the mainstream. This paper reviews the application of CAM in the treatment of PCOS, especially from the perspective of TCM. Meanwhile, the limitations of the literature about CAM in the treatment of PCOS are mentioned and analyzed as well. [ABSTRACT FROM AUTHOR]

Background. Despite substantial progress in the treatment of hepatitis C through the use of direct-acting antivirals which have been shown to cure the disease, complementary and alternative medicines (CAM) are popular among patients as a substitute or complement of allopathic medicines. This study aimed to explore the perspectives of patients and CAM practitioners on the use of CAM for the treatment of hepatitis C in Pakistan. Methods. A cross-sectional design was adopted. Participants (CAM practitioners and patients) were recruited from the capital and two provinces: Khyber Pakhtunkhwa and Punjab of Pakistan. A survey using paper-based questionnaires, each specific for patients and CAM practitioners, was conducted to gather information pertaining to demography, disease status, treatment history, and participants' perspectives (about the disease, reasons to switch to CAM, and referring source). Results. A total of 417 respondents (n = 284 patients, n = 133 practitioners) were recruited. Of the total patients, 170 (59.9%) had started CAM during the previous three months. There were 168 (59.2%) of the total patients who had used allopathic treatments for hepatitis C prior to their use of CAM. The confidence in CAM (24.6%), high cost (19%), and unbearable side effects (52.1%) of allopathic medicines were the main reasons to switch to CAM treatment. Majority (49.3%) of the patients were referred to CAM on the recommendations of relatives or care givers (17.3%) whereas only 9.5% were referred by health care professionals. Out of 133 practitioners, 48 (36.1%) were practicing herbal medicines. From practitioners' perspectives, club-moss (Lycopodium clavatum) was the best treatment option for hepatitis C. The majority, 73 (54.9%), of the patients had chosen to use CAM because of the side effects of allopathic medicines. Patients who had previous "good experience" with CAM were the most common referral source (56.4%) for CAM use in hepatitis C. Conclusions. Patients' beliefs in CAM, side effects of allopathic therapy, high cost of allopathic medicines, and referrals from previous CAM users are key factors in the switching of hepatitis C patients to CAM. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the 2nd World Ayurved Congress held in Pune, India on November 9, 2006. It mentions that the workshop was aimed to emphasize the importance of paradigm shift among Ayurvedic scholars. Doctor E. L. Cooper gave a presentation on the global scenario and position of Ayurveda and alternative medicine and the importance of scientific literature. Another session, headed by doctors Cooper and Alexander M. Hankey, involved consultations with researchers concerning their research papers.

The article discusses various papers published within the issue including one about the attitudes towards oriental medicine, another about the utility biomedicine, and reviews on constitutional medicine.

The article offers developments on "Evidence-based Complementary and Alternative Medicine" (eCAM) journal. It states that in volume four of eCAM, it groups the basic science papers together and the clinical analyses together, maintaining the subject but as distinct and separate categories. It also offers information on the policy-structured efforts with the World Health Organization.

While previous reports have established the anti-inflammatory effects of hangeshashinto, the intracellular signal transduction pathways involved have yet to be elucidated. We aim to employ an experimental system using oral cancer cells to assess the impact of hangeshashinto on intracellular signal transduction pathways in response to stimulation by Porphyromonas gingivalis pathogen-associated molecular patterns (PAMP). Hangeshashinto demonstrated the ability to inhibit the production of interleukin (IL)-6 and IL-8 induced by P. gingivalis PAMP. Furthermore, hangeshashinto suppressed the activation of the IL-6 promoter stimulated by PAMP. Hangeshashinto, like Toll-like receptor (TLR) signaling inhibitors (resatorvid and C29) and an immunosuppressant (dexamethasone), exhibited the ability to suppress TLR-mediated activation of the transcription factor nuclear factor-κB (NF-κB) in response to PAMP stimulation. This study suggests that the anti-inflammatory effects of hangeshashinto may be attributed to the inhibition of TLR signal transduction pathways including NF-κB activation, thereby suppressing NF-κB-dependent gene expression. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to bring clarity to the emerging conceptual and methodological literature that focuses on understanding and evaluating complex or 'whole' systems of healthcare. An international working group reviewed literature from interdisciplinary or interprofessional groups describing approaches to the evaluation of complex systems of healthcare. The following four key approaches were identified: a framework from the MRC (UK), whole systems research, whole medical systems research described by NCCAM (USA) and a model from NAFKAM (Norway). Main areas of congruence include acknowledgment of the inherent complexity of many healthcare interventions and the need to find new ways to evaluate these; the need to describe and understand the components of complex interventions in context (as they are actually practiced); the necessity of using mixed methods including randomized clinical trials (RCTs) (explanatory and pragmatic) and qualitative approaches; the perceived benefits of a multidisciplinary team approach to research; and the understanding that methodological developments in this field can be applied to both complementary and alternative medicine (CAM) as well as conventional therapies, in contrast, the approaches differ in the following ways: terminology used, the extent to which the approach attempts to be applicable to both CAM and conventional medical interventions; the prioritization of research questions (in order of what should be done first) especially with respect to how the 'definitive' RCT fits into the process of assessing complex healthcare systems; and the need for a staged approach. There appears to be a growing international understanding of the need for a new perspective on assessing complex healthcare systems. [ABSTRACT FROM AUTHOR]

The present study evaluates the human health risk of metals in locally consumed herbal preparations used to treat diabetes. Atomic absorption spectroscopy (AAS) was used after microwave-assisted digestion to mineralize the samples. Toxic metal assessment was done by adopting mathematical modeling for carcinogenic and noncarcinogenic risks in the exposed population and comparing the raw results with maximum residue limits (MRLs) set by regulatory authorities. Hazard quotient (HQ) values for Fe, Hg, Cu, Pb, and Zn were recorded above 1. Noncarcinogenic health risks remain in 29% of samples for Fe, 67% of samples for Hg, 17% of samples for Cu, 33% of samples for Pb, and 4% of samples for Zn. Hazard index (HI) values in 33% of samples were above 1. Carcinogenic risks for Pb, Cr, Cd, and Ni were higher than the acceptable limit (1 × 10−6). Carcinogenic health risks exist in 54% of samples for Pb, 58% of samples for Cr, 46% of samples for Cd, and 58% of samples for Ni. MRLs for metals were crossed in samples in varying degrees. This is a harrowing account and may put public health safety at risk. Considering these facts, there should be more investigation into toxic metals in other frequently marketed herbal drugs in the antidiabetic and other therapeutic classes. Pre- and postmarket monitoring strategies for the preparations should also be in place to ensure safe consumption. [ABSTRACT FROM AUTHOR]

Introduction. Stachytarpheta jamaicensis (L.) Vahl belongs to the family of Verbenaceae and is commonly known as Gervao, Brazilian tea, verbena cimarrona, rooter comb, or blue porter weed. It is one of the important plants with high medicinal and nutraceutical benefits. S. jamaicensis contains various medicinal properties in traditional and folk medicinal systems, with cures for several diseases. Objective. The objective of this review paper is to collect information concerning the morphology, distribution, traditional usage, phytochemical compositions, biological activities, and safety data of S. jamaicensis. Materials and Methods. The information was obtained from literature search through electronic databases such as PubMed and Google Scholar on S. jamaicensis. Results and Conclusion. The high medicinal properties of this plant, for instance, antimicrobial and antifungal effect as the main activities, but verbascoside as the main active chemical component, make it a valuable source of the medicinal compound. This review paper summarizes all information concerning the morphology, distribution, traditional usage, phytochemical compositions, pharmacological activities, and toxicological studies of S. jamaicensis. [ABSTRACT FROM AUTHOR]

Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE) therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life) and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1) conventional tinnitus treatments and (2) promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs. [ABSTRACT FROM AUTHOR]

Over the past decades, Chinese herbal medicines (CHM) have been extensively and intensively studied through from both clinical and experimental perspectives and CHM have been proved to be effective in the treatment of diabetes mellitus (DM). This study, by searching ancient records and modern research papers, reviewed CHM in terms of their clinical application and principal mechanism in the treatment of DM. We summarized the use of CHM mentioned in 54 famous ancient materia medica monographs and searched papers on the hypoglycemic effect of several representative CHM. Main mechanisms and limitations of CHM and further research direction for DM were discussed. On the basis of the study, we were led to conclude that TCM, as a main form of complementary and alternative medicine (CAM), was well recorded in ancient literatures and has less adverse effects as shown by modern studies. The mechanisms of CHM treatment of DM are complex, multilink, and multitarget, so we should find main hypoglycemic mechanism through doing research on CHM monomer active constituents. Many CHM monomer constituents possess noteworthy hypoglycemic effects. Therefore, developing a novel natural product for DM and its complications is of much significance. It is strongly significant to pay close attention to CHM for treatment of DM and its complications. [ABSTRACT FROM AUTHOR]

Over the past decades, Chinese herbal medicines (CHM) have been extensively and intensively studied through from both clinical and experimental perspectives and CHM have been proved to be effective in the treatment of diabetes mellitus (DM). This study, by searching ancient records and modern research papers, reviewed CHM in terms of their clinical application and principal mechanism in the treatment of DM. We summarized the use of CHM mentioned in 54 famous ancient materia medica monographs and searched papers on the hypoglycemic effect of several representative CHM. Main mechanisms and limitations of CHM and further research direction for DM were discussed. On the basis of the study, we were led to conclude that TCM, as a main form of complementary and alternative medicine (CAM), was well recorded in ancient literatures and has less adverse effects as shown by modern studies. The mechanisms of CHM treatment of DM are complex, multilink, and multitarget, so we should find main hypoglycemic mechanism through doing research on CHM monomer active constituents. Many CHM monomer constituents possess noteworthy hypoglycemic effects. Therefore, developing a novel natural product for DM and its complications is of much significance. It is strongly significant to pay close attention to CHM for treatment of DM and its complications. [ABSTRACT FROM AUTHOR]

Since Bulgarian rose damascena oil is known for its anti-inflammatory, antioxidant, and antimicrobial properties, we investigated its antifungal activity against the species of Candida, which are among the most common opportunistic fungal pathogens. Our disk-diffusion assay revealed that Bulgarian rose damascena oil effectively inhibited the growth of Candida albicans along with various bacteria. The minimum inhibitory and fungicidal concentrations against Candida albicans and Candida glabrata were all 0.25%. Under our experimental conditions, Bulgarian rose damascena oil showed better inhibitory effects on Candida glabrata and Candida albicans than several popular essential oils reported to have antifungal activity other than Origanum vulgare oil. Interestingly, Bulgarian rose damascena oil showed better antifungal activity against Candida species at acidic pH and induced cell death of Candida species in the culture medium, with cell death seen in 25–35% of the cells exposed to 0.05% Bulgarian rose damascena oil. Furthermore, Bulgarian rose damascena oil inhibited the hyphal growth of Candida albicans cultured in the RPMI medium with fetal bovine serum. These findings collectively suggest that Bulgarian rose damascena oil has antifungal activity against Candida species and thus could potentially be developed in novel therapies for vaginitis-causing pathogenic fungi. [ABSTRACT FROM AUTHOR]

Objective. This study was aimed at determining the antioxidant, anti-quorum sensing, and in vitro cytotoxic activities of five wild mushroom extracts. Methods. Wild mushrooms of Auricularia auricula-judae, Termitomyces umkowaani, Trametes elegans, Trametes versicolor, and Microporus xanthopus were collected from Arabuko-Sokoke and Kakamega National Forests, in Kenya. Specimens were identified and extracted using chloroform (CHL), 70% ethanol (Eth), and hot water (HW) solvents. Antioxidant and cytotoxic activities of the extracts were determined using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and Vero cell lines, respectively, while anti-quorum sensing activities were tested against Chromobacterium violaceum. All data were compared using relevant descriptive and inferential statistics at a significance level of p ≤ 0.05. Results. A total of 35 wild mushrooms were collected, identified, and classified into 14 genera. Among screened mycochemicals, fatty acids, flavonoids, polyphenols, and saponins were detected at higher concentrations. The highest free radical scavenging activities of A. auricula-judae, T. umkowaani, T. elegans, and T. versicolor were observed in 70% Eth extract with the percentage values of 76.40 ± 0.12%, 68.40 ± 0.01%, 62.40 ± 0.07%, and 66.40 ± 0.04%, respectively, whereas the HW extract of Microporus xanthopus showed free radical scavenging activity at 65.90 ± 0.02%. None of the extracts, at the tested concentrations (up to 1000 µg/mL), had shown cytotoxic activity against the Vero cell line. The HW extract of T. umkowaani and the 70% Eth extract of T. versicolor showed a statistically significant difference in the inhibitory activity of violacein production against C. violaceum at the concentration of 200 µg/mL. Conclusions. The antioxidant activity of wild mushrooms can help to tackle the diseases caused by free radicals. The anti-quorum sensing potential of wild mushrooms could also provide future alternatives to conventional drug therapies cost-effectively. Further detailed chemistry of the bioactive compounds and their possible mechanisms of action responsible for the observed antioxidant and anti-quorum sensing activities are needed. [ABSTRACT FROM AUTHOR]

The aim of this study is to optimize the performance conditions used for maximum anti-inflammatory activity and to clarify in vitroanti-inflammatory properties of fermented C. tricuspidata fruit. Based on the single-factor experiment and Box–Behnken design, the optimized fermentation conditions of C. tricuspidata fruit for maximum anti-inflammatory activity were 3.8 d fermentation period, 8.4% (v/w) inoculation concentration, and 29.2°C fermentation temperature. Under optimal conditions, anti-inflammatory activity-based nitric oxide of fermented C. tricuspidata fruit reached 93.9%. Moreover, this study provides a theoretical basis and experimental data containing β-hexosaminidase and reactive oxygen species for the medical use and industrialization of C. tricuspidata fruit fermentation. Interestingly, the results of GC-MS analysis confirmed that fermented C. tricuspidata fruits detect volatile components different from unfermented C. tricuspidata fruits. We suggested that this volatile component may have been involved in the anti-inflammatory reaction, but scientific verification of this is needed later. Therefore, an in-depth study of volatile components detected from fermented C. tricuspidata fruits will need to be conducted later. [ABSTRACT FROM AUTHOR]

From drawing to sculpture, poetry to journaling, and dance to music and song, the arts can have a major impact on patients' spiritual well-being and health. The arts empower patients to fulfill the basic human drive to create and give patients a sense of possibility. Through creative expression, patients regain a feeling of wholeness, individually and as part of the larger world. Although spiritual caregivers have made occasional use of the arts, it would be better for the arts to be seen as a pillar of spiritual care provision. This paper provides a model for arts-based spiritual care (chaplaincy) in oncology/hematology and elsewhere. We discuss how to match the art form intervention to the individual patient and give examples of many kinds of uniquely spiritual arts-based interventions. In life, there are occasional "caseuras," or ruptures. Using a theoretical foundation drawn from theologian Michael Fishbane, our model of arts-based spiritual care bridges the experience of the caesura to a renewed sense of meaning, or spiritual reorientation, that can be discovered within the reality of illness. Additionally, the ambiguity and playfulness inherent to creative expression strengthen the patient's flexibility and resilience. [ABSTRACT FROM AUTHOR]

Background. Evidence rankings do not consider equally internal (IV), external (EV), and model validity (MV) for clinical studies including complementary and alternative medicine/integrative health care (CAM/IHC) research.This paper describe this model and offers an EV assessment tool (EVAT©) forweighing studies according to EVandMVin addition to IV. Methods. An abbreviated systematic review methodology was employed to search, assemble, and evaluate the literature that has been published on EV/MV criteria. Standard databases were searched for keywords relating to EV, MV, and bias-scoring from inception to Jan 2013. Tools identified and concepts described were pooled to assemble a robust tool for evaluating these quality criteria. Results. This study assembled a streamlined, objective tool to incorporate for the evaluation of quality of EV/MV research that is more sensitive to CAM/IHC research. Conclusion. Improved reporting on EV can help produce and provide information that will help guide policy makers, public health researchers, and other scientists in their selection, development, and improvement in their research-tested intervention. Overall, clinical studies with high EV have the potential to provide the most useful information about "real-world" consequences of health interventions. It is hoped that this novel tool which considers IV, EV, and MV on equal footing will better guide clinical decision making. [ABSTRACT FROM AUTHOR]

Digital interventions are becoming an increasingly popular method of delivering healthcare as they enable and promote patient self management. This paper provides a methodological guide to the processes involved in developing effective digital interventions, detailing how to plan and develop such interventions to avoid common pitfalls. It demonstrates the need for mixed qualitative and quantitative methods in order to develop digital interventions which are effective, feasible, and acceptable to users and stakeholders. [ABSTRACT FROM AUTHOR]

Many Americans, not completely satisfied with traditional western medicine, have turned to alternative and complementary medicine which explains the increasing popularity of the herbal products and the Chinese herbal medicine. The lack of government regulations and the increasing advertisements by the manufactures have created an impression to the common public that the natural herbal remedies are inherently safer and cheaper than conventional medicine. The skyrocketing rise of healthcare cost and the adverse reaction and side effects incurred from the prescribed drugs have both reinforced such an impression. Herbs in the USA and in many European countries have been prepared as capsules, tablets, teas, lozenges, juice extracts, tincture, and ointments. Most of the herbs are administered as a single herb in the USA and Europe. However, the traditional Chinese herbal medicine contains multiple active ingredients from various herbs and is prepared as concoctions by simmering them for hours to produce pharma-therapeutic properties useful for the treatment of a particular disease. Those prepared concoctions are taken gingerly with specific treatment purposes. In the USA and some European counties, herbs are distributed and labeled as dietary supplements and are taken by many individuals for a long period of time creating some medical and dental complex problems among them, especially in terms of anesthesia-surgery complications. This paper provides insight into basic differences in how herbs are prepared before administration to the patients in China versus a single unprepared herb sold in the USA and Europe. Also addressed are the interdisciplinary issues with health professionals, the proper regulations for better quality control of imported herbs, and the proper warning on the labels of the herbs. [ABSTRACT FROM AUTHOR]

Several biological activities of pomegranate have been widely described in the literature, but the anti-inflammatory effect in the gastrointestinal tract has not been reviewed till now. The aim of the present paper is to summarize the evidence for or against the efficacy of pomegranate for coping with inflammatory conditions of the gastro-intestinal tract. The paper has been organized in three parts: (1) the first one is devoted to the modifications of pomegranate active compounds in the gastro-intestinal tract; (2) the second one considering the literature regarding the anti-inflammatory effect of pomegranate at gastric level; (3) the third part considers the anti-inflammatory effect of pomegranate in the gut. In vivo studies performed on the whole fruit or juice, peel, and flowers demonstrate antiulcer effect in a variety of animal models. Ellagic acid was the main responsible for this effect, although other individual ellagitannins could contribute to the biological activity of the mixture. Different preparations of pomegranate, including extracts from peels, flowers, seeds, and juice, show a significant anti-inflammatory activity in the gut. No clinical studies have been found, thus suggesting that future clinical studies are necessary to clarify the beneficial effects of pomegranate in the gastrointestinal tract. [ABSTRACT FROM AUTHOR]

Physical exercises and relaxation have been found to be beneficial for depression. However, there is little evidence on the use of Qigong, a mind-body practice integrating gentle exercise and relaxation, in the management of depression. The aim of this paper is to evaluate the effects of Qigong on depression. The paper examined clinical trials measuring the effect of Qigong on depression within six large-scale medical research databases (PubMed, Medline, ProQuest, Science Direct, EMBASE, and Psyclnfo) till October 2011. Key words "Qigong," "depression," and "mood" were used. Ten studies were identified as original randomized controlled trial (RCT) studies investigating the effect of Qigong on depression as primary (n = 2) or secondary outcome (n = 8). Four studies reported positive results of the Qigong treatment on depression; two reported that Qigong effect on depression was as effective as physical exercise. One study reported that Qigong was comparable to a conventional rehabilitation program, but the remaining three studies found no benefits of Qigong on depression. While the evidence suggests the potential effects of Qigong in the treatment of depression, the review of the literature shows inconclusive results. Further research using rigorous study designs is necessary to investigate the effectiveness of Qigong in depression. [ABSTRACT FROM AUTHOR]

Complementary and Alternative Medicines (CAM) are used by an extensive number of patients in the UK and elsewhere. In order to understand this pattern of behavior, it is helpful to examine the characteristics of people who use CAM. This narrative review collates and evaluates the evidence concerning the demographic characteristics and health status factors associated with CAM use in community-based non-clinical populations. A systematic literature search of computerized databases was conducted, and published research papers which present evidence concerning associations between CAM use and demographic and health characteristics are discussed and evaluated. The evidence suggests that people who use CAM tend to be female, of middle age and have more education. In terms of their health, CAM users tend to have more than one medical condition, but might not be more likely than non-users to have specific conditions such as cancer or to rate their own general health as poor. The multivariate studies that have been conducted suggest that both demographic and health characteristics contribute independently to CAM use. In conclusion, demographic characteristics and factors related to an individual's health status are associated with CAM use. Future research is needed to address methodological limitations in existing studies. [ABSTRACT FROM PUBLISHER]

As more clinical acupuncture trials for pain are published, it becomes increasingly difficult to compare and evaluate the merits and shortcomings of such studies. A major contributory factor to this centers on the description of and the assumptions made about, the control intervention used. In considering an acupuncture control, it is important to evaluate its physiological activity and thus far, this has not been done. A variety of different and sometimes very novel controls have been tried and used in the research setting and the inevitable consequence of this is confusion, particularly when attempting to interpret the results of trials. Researchers and other interested parties such as patients, primary care practitioners, funding agencies etc., searching for evidence in the literature are likely to be misled or confused by such variability. There is therefore a need to define and standardize many of these terms, to clarify reporting and to convey the correct information in a way that it is not misleading. This paper details the background and need for this and is primarily intended to assist those who intend to publish primary and secondary acupuncture research. However, standardization of reporting will be of benefit to anybody who will need to examine the literature for evidence. This article proposes and recommends a nomenclature when reporting future acupuncture clinical research. This nomenclature arose through discussion at a meeting convened by the World Health Organisation (Western Pacific Regional Office) and will be incorporated into their policy document later this year. [ABSTRACT FROM AUTHOR]

Higher utilization of complementary and alternative medicine (CAM), both in cross-sections and over time, is commonly related to better socioeconomic status and to increased dissatisfaction with conventional medicine and its values. Little is known about health differences between users and nonusers of CAM. The objective of the paper is to explore the difference in health measured by the SF-36 instrument between users and non-users of CAM. and to estimate the relative importance of the SF-36 health domains scales to the likelihood of consulting CAM providers. Interviews were used to collect information from a sample of 2000 persons in 1993 and 2500 persons in 20(X), representing the Israeli Jewish urban population aged 45-75 in those years. Bivariate and logistic regression analyses were used to explore the above associations. The results show that while users of CAM enjoy higher socioeconomic status and younger age, they tend to report worse health than non-users on the eight SF-36 health domains scales in both years. However, controlling for personal characteristics, lower scores on the bodily pain, role-emotional and vitality scales are related to greater likelihood of CAM use in 2000. In 1993, no scale had a significant adjusted association with the use of CAM. The conclusions are that CAM users tend to report worse health. With CAM becoming a mainstream, though somewhat luxurious, medical practice, pain and affective-emotional distress are the main drivers of CAM use. [ABSTRACT FROM AUTHOR]

Stroke is currently the second largest contributor to disability-adjusted life years (DALYs) in developing countries, and it is the third largest contributor to DALYs in developed countries. It requires a large number of resources from the health care system every year, which places a great burden on society, families, and individuals. The treatment of traditional Chinese medicine exercise therapy (TCMET) during stroke recovery has become a hot topic of current research due to its few adverse events and high efficiency. This article sorts out the latest progress of TCMET on the recovery of stroke through the review method and explores its role and mechanism based on existing clinical and experimental studies. TCMET treatment of stroke recovery mainly includes Tai Chi, Baduanjin, Daoyin, Yi Jin Jing, five-fowl play, and six-character tips, which can effectively improve motor function, balance and coordination ability, cognitive dysfunction, nerve function, depression or emotional state, daily living ability, and so on after stroke. The mechanisms of stroke treated by TCMET are discussed, and deficiencies in the literature are discussed and analyzed. It is hoped that some guiding suggestions will be provided for future clinical treatment and experimental studies. [ABSTRACT FROM AUTHOR]

The author reflects on the issue of providing linkages and revealing the interdependence of basic science and clinical analyses. He mentions an analysis being made which illustrates the benefit of complementary and alternative medicine (CAM) approaches to clinical problems. He asserts that sufficient support and proper examination of all parameters that surround the efficacy of the clinical trials are needed.

We investigated the acupoint selection regulations and workable core acupoint combinations in cancer-related anorexia (CA) treatment. The Apriori algorithm, complemented by the FP-growth algorithm, was used to mine association rules based on retrieved randomized control trials (RCTs) and clinical control trials (CCTs). We searched the following databases for acupuncture treatment regimens for CA: PubMed, Embase, Cochrane Central, Web of Science, WanFang Data, VIP, China Journal Full-Text Database (CNKI), and SinoMed (CBM). We extracted acupoints prescriptions from the 27 enrolled RCTs and CCTs for analysis. There have been 38 acupoints refined from 27 prescriptions. The pinnacle three regularly chosen acupoints were Zusanli (ST36), Zhongwan (RN12), and Sanyinjiao (SP6). We investigated 10 association rules, and the consequences confirmed that {RN4} ≥ {RN12}, {PC6} ≥ {ST36}, {RN12, SP6} ≥ {RN4}, {HT7} ≥ {RN12}, and {DU20} ≥ {RN12} had been the most frequent associated rules in the adoption literature. Zusanli (ST36), Sanyinjiao (SP6), Guanyuan (RN4), Zhongwan (RN12), Neiguan (PC6), Shenmen (HT7), and Baihui (DU20) would be regarded as acupuncture prescriptions in the treatment of CA. [ABSTRACT FROM AUTHOR]

Background. Recurrent implantation failure (RIF), a clinical disorder characterized by failure to achieve pregnancy after repeated (≥3) embryo transfer, is a challenge for reproductive demands worldwide. In our preliminary work, the Zhuyun formula (ZYF) with auricular acupressure, a complementary and alternative medicine (CAM) with a small sample size for RIF, can improve the clinical pregnancy rate (41.2% vs. 26.7%, treatment group vs. control group, p < 0.05). Based on the toxicological and pregnancy-related pharmacological analysis of ZYF for RIF, the T-cell receptor signaling pathway might be involved in the pharmacological activity. This study aimed at evaluating the efficacy and safety of the CAM therapy according to pregnancy outcomes and maternal and child health and investigating the changes of T-helper (Th) cells in the peripheral blood of unexplained RIF women. Materials and Methods. We conducted a prospective, two-arms, randomized, nonblinded study. All eligible women were randomly assigned to the treatment group (TG) and the control group (CG) according to a computer-generated randomization list in sealed opaque envelopes. Blood samples were collected from the two groups, and serum Th1, Th2, and Treg were detected by flow cytometry. The cytokines were detected by an enzyme-linked immunosorbent assay (ELISA). The TG was administrated with ZYF and auricular acupressure for three months before ovarian stimulation, while the control group was on a waiting list for the same period. The primary outcome was CPR. The second outcomes were the serum levels of immune parameters. For the safety evaluation, the perinatal outcomes of maternal and child were obtained by follow-up. Post-hoc sensitivity analyses were performed to assess the effect of missing data. Results. One hundred and twenty-three women were randomized into the TG (n = 62) and CG (n = 61). The CPR was increased significantly in the TG (45.2%) than CG (26.2%) (p = 0.029). Twenty blood samples were collected, and the Th2/Th1 and Treg expression level was significantly higher in the TG than in the CG. IL-2, IL-10, and Foxp3 were higher significantly in the TG than in the CG. The maternal and child perinatal outcomes were not significantly different between the two groups. Conclusions. The ZYF with auricular acupressure was effective and safe in improving the pregnancy outcomes of RIF. It might be related to balancing the level of cytokines related to the immune tolerance of the maternal-fetal interface to protect the embryo from the maternal immune system. Clinical Trial Registration: Clinical Trial Registry; date: 14/Dec/2013; no. NCT03078205. [ABSTRACT FROM AUTHOR]

P2Y1 receptor (P2Y1R), which belongs to G protein-coupled receptors (GPCRs), is an important target in ADP-induced platelet aggregation. The crystal structure of P2Y1R has been solved recently, which revealed orthosteric and allosteric ligand-binding sites with the details of ligand-protein binding modes. And it suggests that P2Y1R antagonists, which recognize two distinct sites, could potentially provide an efficacious and safe antithrombotic profile. In present paper, 2D similarity search, pharmacophore based screening, and molecular docking were used to explore the potential natural P2Y1R antagonists. 2D similarity search was used to classify orthosteric and allosteric antagonists of P2Y1R. Based on the result, pharmacophore models were constructed and validated by the test set. Optimal models were selected to discover potential P2Y1R antagonists of orthosteric and allosteric sites from Traditional Chinese Medicine (TCM). And the hits were filtered by Lipinski’s rule. Then molecular docking was used to refine the results of pharmacophore based screening and analyze the binding mode of the hits and P2Y1R. Finally, two orthosteric and one allosteric potential compounds were obtained, which might be used in future P2Y1R antagonists design. This work provides a reliable guide for discovering natural P2Y1R antagonists acting on two distinct sites from TCM. [ABSTRACT FROM AUTHOR]

Objective. This overview is to evaluate the current evidence from systematic reviews (SRs) of Danhong injection (DHI) for ischemic stroke (IS). Methods. SRs of randomized controlled trials (RCTs) concerning DHI and IS were searched in six databases without language restrictions until September 2015. Assessment of multiple systematic reviews (AMSTAR) was used to evaluate the methodological quality of all included SRs. Result. A total of 8 articles were included. After the administration of DHI, clinical efficiency and neurological deficits score have marked advantages over those of the control group. However, the overall poor quality of meta-analysis and original studies affected the reliability of the results. Evaluation of methodological quality found that no one paper meets the requirements of all 11 items. The main flaws of the methodology quality included the following: not providing “a priori” design and reasonable objectives, duplicate study selection not given enough attention, performing an incomprehensive literature search, not paying attention to publication bias and other bias reports, characteristics of included studies not provided in detail, and ignoring clinical heterogeneity when performing meta-analyses. Conclusion. The current published SRs suggest DHI appears to be a safe and effective way for IS treatment in general. However, it lacks a high quality systematic evaluation and analysis. The quality of SRs should be improved. Further large sample-size and well-designed RCTs are needed. [ABSTRACT FROM AUTHOR]

Background. Traditional Chinese medicine decoction (TCMD) is an oral liquid made by decocting crude medicinal compounds with water. It has complex compositions and diverse odor and taste, most of which have an unacceptable level of bitterness which seriously affects patients' medication compliance. To solve this problem, a variety of taste-masking pathways and different types of taste-masking excipients were combined, using the application of coffee-mate to mask the bitterness of coffee as an existing example. Three composite taste-masking adjuvants were developed to improve the taste of TCMD, referred to as the Chinese Medicine Decoction-Mate (CMD-M). However, whether CMD-M has a good taste-masking effect and whether it affects the chemical compositions and pharmacological effects of the medicine remain unclear. Method. The commonly used pediatric medicine Qingre Huazhi Decoction (QRHZD) and the personalized decoctions used in clinical practices were used as the masking research carriers. The taste-masking effect of CMD-M on QRHZD was evaluated by both healthy volunteers and an electronic tongue, and the personalized decoctions were evaluated by clinical subjects. The changes of chemical components of QRHZD before and after taste-masking were evaluated by HPLC. The changes in anti-inflammatory effects were evaluated by establishing mice as an acute inflammatory model. Results. The taste-masking effect evaluation results showed that the bitterness of QRHZD was significantly reduced after adding CMD-M. There was no significant difference in the relative peak areas change rate and total peak areas ratio of common peaks of QRHZD before and after taste-masking (P > 0.05), shown by HPLC analysis. The inhibitory rates of QRHZD on ear swelling in mice before and after taste-masking also showed no significant difference (P > 0.05). Conclusions. CMD-M can effectively mask the bitterness of decoctions while bringing no significant difference overall in chemical compositions and pharmacological effects before and after QRHZD masking. [ABSTRACT FROM AUTHOR]

Background and Objective. Several treatments are used to attain good control of symptoms and to reduce asthmatic exacerbations. The survey was designed to compare different systems of treatments for asthma and to explore the most preferred treatment in terms of efficacy, side effects, long-term use, and satisfaction. Materials and Methods. The cross-sectional survey was conducted; primary data were collected from asthmatic patients in different hospitals and clinics of allopathic, homeopathic, and herbal practitioners in Karachi, Pakistan. The study duration was from January 2020 to December 2020. Asthmatic patients aged over 13 years were selected for the study. A written informed consent was taken from the patients before the interview. Collected data were analyzed by the Statistical Package of Social Sciences (SPSS) 22. Result. Among 255 asthmatic patients; 51.4% (n = 131) were male and 48.6% (n = 124) were female. For control of acute attacks of asthma 88.2% (p = 0.0001) of patients significantly preferred allopathic treatment while 6.3% (p = 0.008) used homeopathic treatment and 5.5% chose herbal treatment. For maintenance of asthma, 78.8% (p = 0.0001) patients used allopathic treatment while 12.4% (p = 0.0001) homeopathic and 8.8% (p = 0.0001) patients used herbal treatment. About 63.4% (p = 0.0001) of the asthmatic patients used short-acting β-2 agonists for managing acute asthmatic episodes while long-acting β-2 agonists (p = 0.0001) and inhaled corticosteroids (p = 0.0001) were found to be the preferred medicines for maintenance therapy. Effectiveness of treatment (p = 0.004) and cost effectiveness (p = 0.0001) significantly act as contributing factors for the selection of the treatment. The majority of the patients were satisfied with their chosen treatments for control of asthmatic symptoms. Conclusion. Most asthmatic patients preferred allopathic treatment for the management of acute episodes and control of asthmatic symptoms. It was found that the major factors for selecting a specific treatment include effectiveness, cost, and minimal side effects. [ABSTRACT FROM AUTHOR]

Background. The application of virtual reality (VR) in clinical settings is growing rapidly, with encouraging results. As VR has been introduced into complementary and alternative medicine (CAM), a systematic review must be undertaken to understand its current status. Aim. This review aims to evaluate and summarize the current applications of VR in CAM, as well as to explore potential directions for future research and development. Methods. After a brief description of VR technology, we discuss the past 20 years of clinical VR applications in the medical field. Then, we discuss the theoretical basis of the combination of VR technology and CAM, the research thus far, and practical factors regarding usability, etc., from the following three main aspects: clinical application, teaching, and scientific research. Finally, we summarize and propose hypotheses on the application of VR in CAM and its limitations. Results. Our review of the theoretical underpinnings and research findings to date leads to the prediction that VR and CAM will have a significant impact on future research and practice. Conclusion. Although there is still much research needed to advance the science in this area, we strongly believe that VR applications will become indispensable tools in the toolbox of CAM researchers and practitioners and will only grow in relevance and popularity in the era of digital health. [ABSTRACT FROM AUTHOR]

Background. Cancer patients are among the main consumers of traditional, complementary, integrative, and alternative medicine (TCIM) such as natural products (herbals, integrators, etc.) and mind and body practices (yoga, acupuncture, etc.). Methods. A questionnaire on TCIM was submitted to 415 Italian cancer patients. The questionnaire consisted of three sections: (i) biographical and clinical information; (ii) use of natural substances; and (iii) use of mind-body practices. Results. 406 patients completed the questionnaire. The prevalence of TCIM use was 72.3%. Of them, 75.6% started to use TCIM after a tumor diagnosis. The main reasons for using TCIM were to mitigate side effects (65.0%), to regain physical and mental balance (35.9%), to relieve pain (18.3%), and to improve the efficacy of cancer therapy (16.0%). 44.7% of patients taking natural products used them during conventional therapies (chemotherapy, radiotherapy, etc.), and in 67.5% of cases without consulting a doctor. As a consequence, only about 50% of patients taking natural substances used these compounds appropriately, and the most common errors were related with the purpose of reducing the side effects of the therapy (52.3%) and for boosting immune system (32.1%). Conclusions. There is an impelling need to provide patients with scientifically validated information to raise awareness about the benefits and risks of using TCIM. [ABSTRACT FROM AUTHOR]

Thrombosis is considered to be closely related to several diseases such as atherosclerosis, ischemic heart disease and stroke, as well as rheumatoid arthritis, hyperuricemia, and various inflammatory conditions. More and more studies have been focused on understanding the mechanism of molecular and cellular basis of thrombus formation as well as preventing thrombosis for the treatment of thrombotic diseases. In reality, there is considerable interest in the role of natural products and their bioactive components in the prevention and treatment of thrombosis related disorders. This paper briefly describes the mechanisms of thrombus formation on three aspects, including coagulation system, platelet activation, and aggregation, and change of blood flow conditions. Furthermore, the natural products for antithrombosis by anticoagulation, antiplatelet aggregation, and fibrinolysis were summarized, respectively. [ABSTRACT FROM AUTHOR]

We examined the National Health Interview Survey (NHIS) 2012 to explore how US adult consumers of CAM differ by gender in terms of their sociodemographic characteristics, current health conditions, and perceived benefits of CAM. All individuals who completed the adults core interviews (N = 34,525) were included. CAM use, major sociodemographic variables, perceived benefits of using CAM, and top ten reported health conditions for which CAM was used were selected and analyzed by Stata. Findings revealed that 29.6% (n = 10,181) reported having used at least one form of CAM in the previous 12 months. Compared to male CAM users, female CAM users were more likely to have a bachelor degree, to be divorced/separated or widowed, and less likely to earn $75,000 or more. Back pain/problem was the most common problem reported by both male and female CAM users (32.2% and 22.6%, resp.). A higher proportion of female CAM users reported using CAM for perceived benefits such as general wellness or general disease prevention. This paper provides foundation information regarding gender differences in CAM use and is a platform for further in-depth examination into how and why males and females differ in their reasons for CAM use. [ABSTRACT FROM AUTHOR]

This paper reviews the reported pharmacological properties of protocatechuic acid (PCA, 3,4-dihydroxy benzoic acid), a type of phenolic acid found in many food plants such as olives and white grapes. PCA is a major metabolite of anthocyanin. The pharmacological actions of PCA have been shown to include strong in vitro and in vivo antioxidant activity. In in vivo experiments using rats and mice, PCA has been shown to exert anti-inflammatory as well as antihyperglycemic and antiapoptotic activities. Furthermore, PCA has been shown to inhibit chemical carcinogenesis and exert proapoptotic and antiproliferative effects in different cancerous tissues. Moreover, in vitro studies have shown PCA to have antimicrobial activities and also to exert synergistic interaction with some antibiotics against resistant pathogens. This review aims to comprehensively summarize the pharmacological properties of PCA reported to date with an emphasis on its biological properties and mechanisms of action which could be therapeutically useful in a clinical setting. [ABSTRACT FROM AUTHOR]

This paper reviews the reported pharmacological properties of protocatechuic acid (PCA, 3,4-dihydroxy benzoic acid), a type of phenolic acid found in many food plants such as olives and white grapes. PCA is a major metabolite of anthocyanin. The pharmacological actions of PCA have been shown to include strong in vitro and in vivo antioxidant activity. In in vivo experiments using rats and mice, PCA has been shown to exert anti-inflammatory as well as antihyperglycemic and antiapoptotic activities. Furthermore, PCA has been shown to inhibit chemical carcinogenesis and exert proapoptotic and antiproliferative effects in different cancerous tissues. Moreover, in vitro studies have shown PCA to have antimicrobial activities and also to exert synergistic interaction with some antibiotics against resistant pathogens. This review aims to comprehensively summarize the pharmacological properties of PCA reported to date with an emphasis on its biological properties and mechanisms of action which could be therapeutically useful in a clinical setting. [ABSTRACT FROM AUTHOR]

We examined the National Health Interview Survey (NHIS) 2012 to explore how US adult consumers of CAM differ by gender in terms of their sociodemographic characteristics, current health conditions, and perceived benefits of CAM. All individuals who completed the adults core interviews (M = 34,525) were included. CAM use, major sociodemographic variables, perceived benefits of using CAM, and top ten reported health conditions for which CAM was used were selected and analyzed by Stata. Findings revealed that 29.6% (n = 10,181) reported having used at least one form of CAM in the previous 12 months. Compared to male CAM users, female CAM users were more likely to have a bachelor degree, to be divorced/separated or widowed, and less likely to earn $75,000 or more. Back pain/problem was the most common problem reported by both male and female CAM users (32.2% and 22.6%, resp.). A higher proportion of female CAM users reported using CAM for perceived benefits such as general wellness or general disease prevention. This paper provides foundation information regarding gender differences in CAM use and is a platform for further in-depth examination into how and why males and females differ in their reasons for CAM use. [ABSTRACT FROM AUTHOR]

Anthraquinones are a class of aromatic compounds with a 9,10-dioxoanthracene core. So far, 79 naturally occurring anthraquinones have been identified which include emodin, physcion, cascarin, catenarin, and rhein. A large body of literature has demonstrated that the naturally occurring anthraquinones possess a broad spectrum of bioactivities, such as cathartic, anticancer, antiinflammatory, antimicrobial, diuretic, vasorelaxing, and phytoestrogen activities, suggesting their possible clinical application in many diseases. Despite the advances that have been made in understanding the chemistry and biology of the anthraquinones in recent years, research into their mechanisms of action and therapeutic potential in autoimmune disorders is still at an early stage. In this paper, we briefly introduce the etiology of autoimmune diabetes, an autoimmune disorder that affects as many as 10 million worldwide, and the role of chemotaxis in autoimmune diabetes. We then outline the chemical structure and biological properties of the naturally occurring anthraquinones and their derivatives with an emphasis on recent findings about their immune regulation. We discuss the structure and activity relationship, mode of action, and therapeutic potential of the anthraquinones in autoimmune diabetes, including a new strategy for the use of the anthraquinones in autoimmune diabetes. [ABSTRACT FROM AUTHOR]