[Value discovery and resource utilization of by-products in production process of medicinal materials are important ways for poverty alleviation with Chinese herbal medicine industry].

Poverty alleviation by Chinese herbal medicine industry is an important way to implement the major strategic plan of the government and to effectively alleviate poverty and increase income of poor farmers in areas with high resource's endowment of Chinese medicinal materials. Based on the analysis of the existing achievements and problems in poverty alleviation by Chinese herbal medicine industry, this paper proposes that improving the comprehensive benefits of Chinese herbal medicine industry is an important direction for poverty alleviation in the poverty-stricken areas with the high endowment of traditional Chinese medicine resources in the future. Then, based on the concept of resource recycling of traditional Chinese medicinal materials, the feasibility and strategies of utilizing by-products in the production process of Chinese medicinal materials and expanding the ways of poverty alleviation were analyzed and discussed. The aim of all these works was to provide the support for enhancing the comprehensive competitiveness of the industry in poverty-stricken regions, enlarging the poverty alleviation effect of Chinese herbal medicine industry, and consolidating the achievements of poverty alleviation.

Application of high-resolution melting analysis for authenticity testing of valuable Dendrobium commercial products.

BACKGROUND: The accurate identification of botanical origin in commercial products is important to ensure food authenticity and safety for consumers. The Dendrobium species have long been commercialised as functional food supplements and herbal medicines in Asia. Three valuable Dendrobium species, namely Dendrobium officinale, D. huoshanense and D. moniliforme, are often mutually adulterated in trade products in pursuit of higher profit. RESULTS: In this paper, a rapid and reliable semi-quantitative method for identifying the botanical origin of Dendrobium products in terminal markets was developed using high-resolution melting (HRM) analysis with specific primer pairs to target the trnL-F region. The HRM analysis method detected amounts of D. moniliforme adulterants as low as 1% in D. huoshanense or D. officinale products. CONCLUSION: The results have demonstrated that HRM analysis is a fast and effective tool for the differentiation of these Dendrobium species both for their authenticity as well as for the semi-quantitative determination of the purity of their processed products. © 2017 Society of Chemical Industry.

Keeping the doctor in the loop: Ayurvedic pharmaceuticals in Kerala.

Ethnographic inquiry into Ayurvedic commodification in Kerala revealed the prevalence of a distinct regional pharmaceutical market dominated by physician-manufacturers, oriented towards supplying classical medicines to Ayurvedic doctors. This stands in sharp contrast to mainstream Ayurveda that is observed to have undergone biomedicalization and pharmaceuticalization. This paper argues that Kerala's classical-medicine-centric pharmaceutical market constitutes an alternative modernity because it provided Kerala Ayurveda with a different route to modernization impervious to the biomedical regime, as well as endowing it with the institutional power to safeguard its regional identity. Although physician-entrepreneurs are its key architects, it is sustained by value regimes shaped by a unique regional medico-cultural milieu. Even when industrially produced, classical medicines remain embedded within Ayurveda's socio-technical network; unlike proprietary drugs sold as individual product-identities through non-Ayurvedic channels, they travel together as a pharmacopeia, distributed through exclusive doctor-mediated agencies. This clinic-centric distribution format is best conceptualized as an open-source business model as it made low-margin generics viable by packaging them with therapies and services. Besides ensuring better access and affordability, it provided resistance to pharmaceuticalization and intellectual property concentration. By keeping the doctor in the loop, it prevented medicines from degenerating into de-contextualized commodities; the service component of Ayurveda therein preserved went on become the unique selling point in the health-tourism market. The tourism-inspired proliferation of Brand Kerala eventually triggered a paradigm shift in mainstream Ayurveda - shifting focus from 'pharmaceuticals' to 'services' and from 'illness' to 'wellness'. Furthermore, interacting with hybrid Ayurvedas in transnational markets, Kerala Ayurveda co-produces new alterities countervailing the structurally dominant biomedical paradigm.

[Numerical taxonomy of corlor in Phellodendron Cortex].

Through the investigation of Phellodendron Cortex on the market, and 28 batches of samples were collected. By using spectrophotometer the color values of outer surface, inner surface and cross - section of these samples were measured. These measured color data was translated into 3D structure diagram by using the Lab color space tool. The level difference value, the mean value and the threshold value were calculated based the measured color data of these different batches of samples. All 28 groups measured data was analyzed using the methods of Ward linkage and average Euclidean distance. At the same time, we invited Professor Jin Shiyuan, the "Chinese medicine master", to identify, quality-evaluate and grade these 28 batches of Phellodendron Cortex samples base on the traditional experience, then compared the traditional empirical results with the spectrophotometer measurement results. The result showed that, the Phellodendron Cortex could be divided into Phellodendri Amurensis Cortex and Phellodendri Chinensis Cortex by color numerical clustering, and classified according to quality. The classification result has a high degree of consistency with the traditional experience.

[Study on origin and authentication of medicinal materials of Dalbergiae Lignum in crude drug's market].

The study is aimed to distinguish morphological characteristics of Dalbergiae Lignum collected from crude drug's markets and establish a identification methods and the quality standard for Dalbergiae Lignum. The macroscopic and microscopic features of Dalbergiae Lignum from crude drug's market were observed, analyzed and compared according to Hongmu specification issued by the People's Republic of China in 2000, and by the characteristics recorded in domestic monograph of Mucai Shibie (wood identification). The redwood of Dalbergiae Lignum cut into small pieces as medicinal material are dry heart wood of mahogany (trees from Dalbergia sp.), which characteristics of the small pieces as crude drug are different. There are differences in macroscopic and microscopic features about texture of wood and color, odor, taste, transverse section, radial section, tangential section. The results can provide basis for identification, application and improment of the quality standard of Dalbergiae Lignum as medicinal material.

[Research on distribution of patents' holders for Chinese herbal compounds in treating cardiovascular and cerebrovascular based on cluster analysis].

To discuss the distribution of patents' holders for Chinese herbal compounds in treating cardiovascular and cerebrovascular, the patents' holders for Chinese herbal compounds in treating cardiovascular and cerebrovascular were cluster analyzed by means of simple statistics and cluster analysis. Clustering variables were composed of patent applications, patent maintained number, related papers' quantity, etc. Chinese herbal compound patents' holders were divided into four categories according to their different scientific research and patent strength. It is the magic weapon for Chinese herbal compound patents' holders that have scientific research patents' transforming and make coordination of patent protection and scientific innovation.

[Establish research model of post-marketing clinical safety evaluation for Chinese patent medicine].

The safety of Chinese patent medicine has become a focus of social. It is necessary to carry out work on post-marketing clinical safety evaluation for Chinese patent medicine. However, there have no criterions to guide the related research, it is urgent to set up a model and method to guide the practice for related research. According to a series of clinical research, we put forward some views, which contained clear and definite the objective and content of clinical safety evaluation, the work flow should be determined, make a list of items for safety evaluation project, and put forward the three level classification of risk control. We set up a model of post-marketing clinical safety evaluation for Chinese patent medicine. Based this model, the list of items can be used for ranking medicine risks, and then take steps for different risks, aims to lower the app:ds:risksrisk level. At last, the medicine can be managed by five steps in sequence. The five steps are, collect risk signal, risk recognition, risk assessment, risk management, and aftereffect assessment. We hope to provide new ideas for the future research.

Analysis of consumer demand for herbal medicine in the Republic of Armenia.

Herbal medicines nowadays tend to gain more and more popularity among health care providers and drugstore customers, as well. Current study has been an effort to explore the attitudes and customer behavior of drug consumers in Yerevan, Armenia. It is a cross-sectional descriptive study in nature an has no hypothesis set and does not claim to have produced statistically significant generalizable results. However, it is a valuable start point for further investigations with presumably quantitative statistical analysis methods. Some four districts of Yerevan out of twelve were randomly selected with subsequent random selection of proportionately adequate number of drugstores, where the interviewers approached every 4th customer with the request to answer the questionnaire that they had previously developed and tested in three randomly chosen non-target drugstores from one randomly chosen non-target district. Data were collected by filling paper forms followed by entry and processing using SPSS 11.0 for Windows. The results of the study demonstrate that some link exist between customers' appreciation of herbal drugs as safe and effective and their level of education. Another dimension discovered, was that university students appeared to be the most satisfied with the affordability of herbal medicines.

The Brazilian market of herbal medicinal products and the impacts of the new legislation on traditional medicines.

ETHNOPHARMACOLOGICAL RELEVANCE: the herbal medicinal products (HMP) market is expanding in the world, an expansion that has not occurred in Brazil when considering the number of licensed products. Despite being a megadiverse country, the number of HMP licensed in Brazil is small, and the number of HMP obtained from native species is even smaller. A new legislation for herbal products licensing, which divides the products into two categories, Herbal Medicine (HM) and Traditional Herbal Product (THP) was launched in Brazil focusing on traditional use, as well as a law regulating the use of biodiversity and traditional knowledge. AIM OF THE STUDY: to evaluate the situation of HMP licensed in Brazil and to make a comparison with the data obtained in 2008 and 2011, discussing the evolution of the licensed products and the possible impacts of the new legislation. MATERIALS AND METHODS: a survey was carried out in the Brazilian Health Regulatory Agency (Anvisa) database to verify the HMP licensed in Brazil in September 2016. The data obtained were compared with two surveys previously published. RESULTS: There are 332 single, and 27 combined HM, totaling 359 HM licensed in Brazil. There is no THP notified in Anvisa's system yet. There are 214 HM classified as nonprescription (OTC), while 145 are sold under prescription, one of them with prescription retention. There are 101 plant species licensed as active in HM in Brazil, 39 of which are native, adapted or cultivated. The most licensed plant species is Mikania glomerata Spreng., with 25 HM licensed. The article includes tables with plant species that have derivatives licensed as simple and combined HM, their therapeutic classification, the native plant species indication and the distribution of the companies by Brazilian regions. CONCLUSIONS: There are few licensed HM in Brazil, and this number has been decreasing in recent years. It is expected that the data obtained, together with the changes promoted in sanitary and environmental rules, will help to develop and regulate HMP chain in Brazil.

POLITICS OF BIOPIRACY: AN ADVENTURE INTO HOODIA/XHOBA PATENTING IN SOUTHERN AFRICA.

BACKGROUND: Africa is being described as the wretched of the earth, despite this, the continent is endowed with natural resources, dynamic ecosystem, and different species of plants and animals, and species derivatives. This paper area of departure is to focus on Hoodia, a plant that is being a source of food, medicine and water for the San and Khoe indigenous peoples before the advent of Europeans into southern Africa. South African Council for Scientific and Industrial Research (CSIR) dubiously patented Hoodia without observing the basic indices of geographical indications (GIs), indigenous knowledge (IK), novelty, access sharing benefit (ASB), prior informed consent (PIC) and sustainability of ecosystem before the rights was sold to Phytopharm pharmaceutical company. MATERIALS AND METHODS: This article adopts neoliberal thesis with emphasis on complex interdependence theory of organic linkages between developing and developed countries. Secondary sources of information taken into account of qualitative and critical discuss content analyses dominate this paper. RESULT: The paper recommends a linkage between developed and developing states based on endowment theory and comparative advantage with the notion of adhering to the Convention on Biological Diversity (CBD) which has three objectives: the conservation of biodiversity; the sustainable utilisation of indigenous biological resources (IBR); and fair and equitable benefit sharing. CONCLUSION: The paper recommends that there is a need to follow CBD and other relevant international regimes that promote equal exchange in exploitation of Africa resources as against the present skewed arrangement that is in favour of multinational corporations (MNCs).

Herbal medicine and treatment of diabetes in Africa: an example from Guinea.

AIM: Use of medicinal plants is widespread in Africa, particularly in Guinea where oral transmission of practices is part of the social ritual. The purpose of this study was to determine the proportion of diabetic patients who use herbal medicine and identify the types of plants in use. Reasons for using herbal medicine and the formulations employed were also noted. METHODS: A questionnaire on use of herbal medicine was proposed to all diabetic patients hospitalized or consulting the Endocrinology Unit of the Conakry University Hospital between April 1 and June 30, 2003. RESULTS: A total of 397 patients responded; 33% declared they used herbal medicine. They proposed many motivations, sometimes in association: belief in its efficacy (74%), easy access to medicinal plants (70%), lower cost (48%), and search for complete cure of diabetes (37%). Hearing about a positive experience had convinced 78% of the users to use herbal medicine. The majority of the users were satisfied (85%). One or more clinical manifestations occurring concomitantly with use of herbs was observed in 23 patients (18%), particularly gastrointestinal disorders (n = 10) and skin problems (n = 8). Two cases of hypoglycaemia were noted. CONCLUSION: Herbal medicine plays an important role in anti-diabetes treatment in Guinea. This type of treatment should be based on scientific evidence but very few studies have been conducted. Conditions of use should be better defined and patients should be informed of potential adverse effects.

The clinical significance and costs of herbs and food supplements used by complementary and alternative medicine for the treatment of cardiovascular diseases and hypertension.

Complementary and alternative medicine (CAM) is widely used by people in the United States and other countries for the treatment of health conditions that include hypertension (HTN), cardiovascular disease (CVD), heart failure, hyperlipidemia and other condtions. The visits to CAM practitioners result in significant out-of-pocket expenses, as CAM is not covered by health insurance in the majority of cases. The reasons for this are that the products used are not closely regulated by governmental regulatory agencies and lack scientific evidence about their effectiveness and safety. The people regard these products as being 'natural' and, consequently, safe. However, there is evidence that these products can be contaminated and adulterated with other substances and could cause harm to the persons who take them. The responsibility falls on the health professionals, who should become familiar with the various CAM products, inquire their patients whether they taking any of these products and advise them accordingly. This review is based on a recent statement issued by the American Medical for the use of CAM for the treatment of HTN. For its preparation, a Medline search of the English language literature was performed between 2010 and 2014 restricted in the use of CAM for CVD and HTN, and from the 88 abstracts reviewed, 23 pertinent papers were selected. These papers together with collateral literature will be discussed in this review regarding CAM and CAM products on their effectiveness and safety for the treatment of CVD and HTN.

Are herbal remedies and dietary supplements safe and effective for breast cancer patients?

There remains limited scientific evidence on the efficacy and safety of 'natural' therapies such as herbal remedies and dietary supplements. Nevertheless, breast cancer patients are particularly prone to purchasing such products because of the perception that 'natural' products are less toxic than conventional prescribed medicines. However, the potential for interactions of supplements with current medications, the potential for adverse effects from consumption at high levels, and the lack of disclosure of such treatments by the patient to their doctor are serious public health issues. Robust clinical trials are required to prove the efficacy and lack of adverse effects of such preparations, and communication between patients and doctors must be improved and doctors made more aware that their patients may be seeking advice and treatment from sources outside conventional medicine.

Health food store recommendations: implications for breast cancer patients.

BACKGROUND: Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer. METHODS: Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired about product safety, potential drug interactions, costs and efficacy. They also enquired about employee training related to the products. RESULTS: Thirty-four stores were examined. A total of 33 different products were recommended, none of which are supported by sufficient evidence of efficacy. The average cost of the products they recommended was 58.09 dollars (CAD) (minimum 5.28 dollars, median 32.99 dollars, maximum 600 dollars) per month. Twenty-three employees (68%) did not ask whether the patient took prescription medications. Fifteen employees (44%) recommended visiting a healthcare professional (naturopaths (9), physicians (5), nutritionists (1). Three employees (8.8%) discussed potential adverse effects of the products. Eight employees (23.5%) discussed the potential for drug interactions. Two employees (5.9%) suggested a possible cure with the products and one employee (2.9%) suggested discontinuing Tamoxifen. Four employees (11.8%) recommended lifestyle changes and three employees (8.8%) recommended books for further reading on the products. CONCLUSION: This study draws attention to the heterogeneity of advice provided by natural health food stores to individuals seeking treatments for breast cancer, and the safety and cost implications of some of the products recommended. Physicians should enquire carefully about the use of natural health food products by patients with breast cancer. Regulators need to consider regulations to protect vulnerable patients from incurring significant costs in their purchasing of natural health food products lacking evidence of benefit and of questionable safety.

Are herbal medicines effective?

Herbal medicine is again popular and its widespread use demands that we assess its effectiveness objectively. The evidence in this area has grown considerably in recent years, not least due to the endeavors of the Cochrane Collaboration. They show amongst other things that it is possible to evaluate herbal medicines in much the same way as conventional drugs. By far the biggest hindrance to research into herbal medicine is the lack of funds available for this line of scientific investigation. In view of the present popularity of herbal medicine it seems necessary to overcome obstacles to rigorous research and establish which herbal medicines do more good than harm for which conditions.

A hospital-based study on the use of alternative medicine in patients with chronic liver and gastrointestinal diseases.

To determine the extent to which Taiwanese patients use alternative medicine, we interviewed 500 consecutive patients with chronic liver and gastrointestinal disorders at an outpatient-service. Forty-two patients were excluded due to incomplete data. The percentages of patients with chronic liver (102/269, 37.9%) and gastrointestinal (74/189, 39.2%) diseases using alternative medicine were not significantly different (p = 0.70). The patients who used alternative medicine were not statistically different in gender (p = 0.37), age (p = 0.59), education level (p = 0.83), family income (p = 0.90), or occupation (p = 0.72). Only 36% (64/176) of patients informed their doctors of their use of alternative medicine. The kinds of alternative medicine used by the 176 patients included: Chinese/herbal medicine, 169 (96%); acupuncture, 31 (18%); nutritional supplements, 22 (13%); chiropractic, 17 (10%); scratching, 14 (8%); Qigong, 13 (7%); cupping, 13 (7%); and incense ash, 3 (2%). Sixty-six percent (111/169) of patients used Chinese/herbal medicine in addition to Western allopathic medicine. Only 11% (19/169) of them believed that Chinese/herbal medicine had side effects. Our study indicates the use of alternative medicine occurs across all demographic groups in one-third of patients with chronic liver and gastrointestinal diseases at a major general hospital in Taipei. We suggest that the doctors question all patients for history of alternative therapy use.

Traditional knowledge for promotion of socioeconomic inclusion of local communities.

This paper discusses the key role played by public research institutes for promoting socioeconomic inclusion of local communities based on traditional knowledge and traditional medicine. Nongovernmental organizations and cooperatives have had an important role in raising financial resources, being involved with advocacy of local communities and advancing legislation changes. But strict best manufacturing practices regulations imposed by the Brazilian National Health Surveillance Agency on the requirements for approval and commercialization of drugs based on herbal medicine products call for the involvement of strong public research institutes capable of supporting community-based pharmacies. Thus, public research institutes are pivotal as they can conduct scientific research studies to evidence the efficacy of herbal medicine products and help building the capacity of local communities to comply with current regulations.

Value chains of herbal medicines--research needs and key challenges in the context of ethnopharmacology.

BACKGROUND: Value chain analyses are commonly used to understand socioeconomic and power relationships in the production chain from the initial starting material to a final (generally high value) product. These analyses help in terms of understanding economic processes but also have been used in the context of socioeconomic and socioecological research. AIMS OF THE STUDY: However, there is a gap in the ethnopharmacological literature in terms of understanding what relevance a critical analysis of value chains of herbal medicines could have. Here we provide a research framework for achieving such an analysis. METHODS: An extensive review of the literature available on value chains and their analysis was conducted, based both on a systematic online search of the relevant literature and a hand search of bibliographies and discussions with experts in value chain analysis RESULTS: While the concept of value chains is commonly used in the relevant industries, very few studies investigate the value chains of herbal medicines and products derived from them. The studies identified mostly look at socio-ecological aspects, especially in the context of sustainable resource use. We suggest an analytical framework which can help in understanding value chains in the context of ethnopharmacology and can serve as a basis for addressing questions related to value chains and their relevance in ethnopharmacology. CONCLUSIONS: We identified a crucial gap in current ethnopharmacological and medicinal plant research which impacts on a wide-range of factors relevant for a sustainable, socio-culturally equitable and safe supply of herbal medicines.

Collaboration with traditional health practitioners in the provision of skin care for all in Africa.

The Task force for Skin Care for All: Community Dermatology seeks to meet WHO objectives, to draw attention to the role of Traditional Health Practitioners and to develop integrated skin care. In many African countries patients will first use traditional medicine to treat skin diseases. Many traditional practices are beneficial but some are harmful. The Task Force recommends education of traditional and modern health practitioners to improve collaboration, safety and efficacy. Thereby, it aims to improve skin care and to reinforce the best practices.