Phytochemical profile and biological activities of Bromelia antiacantha extracts / Perfil fitoquímico e atividades biológicas de extratos de Bromelia antiacantha

Reports from popular medicine usually act as a basis for the development of new drugs from natural compounds with therapeutic actions for serious diseases and prevalence such as cancer. Bromelia antiacantha Bertol. is a species of the Bromeliaceae family, considered an unconventional food plant, found in the south and midwest regions of Brazil. Despite the high nutritional content and pharmacological potential of its fruits, few scientific studies report its biological actions. Thus, this study evaluates the phytochemical profile of aqueous and ethanol extracts obtained from B. antiacantha fruits, as well as their possible antioxidant, antitumor, and cytotoxic activities. The aqueous extract exhibited phenolic compounds and flavonoids, while ethanol extracts indicated the presence of flavonoids and coumarin in their composition, regardless of the region of collection. The ethanolic extract demonstrated a more promising antioxidant effect than the aqueous extract and also induced a significant inhibition in the viability of human cervical cancer cells of the SiHa strain. In addition, treatment with both extracts did not alter the viability of non-tumor cells of the immortalized human keratinocyte lineage (HaCaT). These results bring new data about extracts obtained from a native plant, edible and traditionally used in popular medicine, opening new perspectives for its possible therapeutic application.

Relatos da medicina popular costumam atuar como referencial para o desenvolvimento de novos fármacos a partir de moléculas naturais com ações terapêuticas para doenças de alta gravidade e prevalência como o câncer. Bromelia antiacantha Bertol. é uma espécie da família Bromeliaceae, considerada uma planta alimentícia não convencional (PANC), encontrada nas regiões sul e centro-oeste do Brasil. Apesar do alto teor nutritivo e potencial farmacológico de seus frutos, poucos estudos científicos relatam suas ações biológicas. Desta forma, este estudo avalia o perfil fitoquímico de extratos aquoso e etanólico obtidos de frutos de B. antiacantha, bem como a sua possível ação antioxidante, antitumoral e citotóxica. O extrato aquoso apresentou compostos fenólicos e flavonoides, enquanto os extratos etanólicos apontam a presença de flavonóides e cumarina em sua composição, independente da região de coleta. O extrato etanólico demonstrou efeito antioxidante mais promissor do que o extrato aquoso e também induziu uma inibição significativa na viabilidade de células humanas de câncer cervical da linhagem SiHa. Além disso, o tratamento com ambos extratos não alterou a viabilidade de células não tumorais da linhagem de queratinócitos humanos imortalizados (HaCaT). Estes dados trazem novas informações sobre extratos obtidos de uma espécie vegetal nativa, comestível e já utilizada tradicionalmente, mas abrindo novas perspectivas quanto a possíveis aplicações terapêuticas.

Suplementação de vitamina C: o que mostram as revisões sistemáticas Cochrane? / Vitamin C supplementation: what do Cochrane systematic reviews show?

Contextualização: A vitamina C (ácido ascórbico) é, sem dúvida, a mais popular dentre as vitaminas e a vedete de vendas na mídia, sobretudo no inverno, sob o slogan de que previne doenças. Objetivos: O estudo avaliou a efetividade da suplementação de vitamina C para tratamento e prevenção de sintomas e doenças, segundo as revisões sistemáticas da Colaboração Cochrane. Métodos: Trata-se de overview de revisões sistemáticas Cochrane. Procedeu-se à busca na Cochrane Library (2022), sendo utilizado o termo "Ascorbic Acid". O desfecho primário de análise foi a redução da incidência da doença ou a melhora clínica, mediante suplementação de vitamina C. Resultados: A estratégia de busca recuperou 26 revisões sistemáticas Cochrane, sendo oito estudos incluídos, seguindo critérios de inclusão. Foram avaliados 91 ensaios clínicos (n = 54.864 participantes). Condições/doenças fetais, pneumonia, resfriado comum, tétano, doença cardiovascular, asma e broncoconstrição por exercício, retinopatia diabética e Doença de Charcot-Marie-Tooth configuraram objetos de análise. Não foi evidenciada efetividade da vitamina C nas análises dessas condições. Discussão: Não há evidência de efetividade da vitamina C para as doenças analisadas. Embora a maioria dos estudos primários tenha limitações sérias e a evidência seja de baixa qualidade, não é possível recomendar a suplementação da vitamina C para essas condições nesse momento. Conclusão: Não há efetividade, nesse momento, da suplementação da vitamina C para prevenção e tratamento de doenças analisadas pela Cochrane, A evidência é bastante limitada e recomenda-se a realização de novos ensaios clínicos randomizados, utilizando-se o CONSORT (Consolidated Standards of Reporting Trials) Statement.

Monteverdia ilicifolia: um protetor gástrico / Monteverdia ilicifolia: a gastric protector / Monteverdia ilicifolia: protector gástrico

Monteverdia ilicifolia, conhecida popularmente como espinheira-santa, é uma planta da família Celastraceae de relevante ação terapêutica devido às suas propriedades medicinais, principalmente a sua atividade gastroprotetora, possuindo efeitos comprovados sobre acidez e úlceras estomacais. Desta forma o objetivo deste trabalho foi encontrar na literatura evidências para o uso terapêutico da M. ilicifolia, como uma alternativa frente aos fármacos sintéticos disponíveis na indústria farmacêutica voltados para o tratamento de problemas estomacais. Foi utilizado no presente trabalho a base de dados Google acadêmico. Os distúrbios estomacais afetam milhares de pessoas, influenciando de forma negativa na qualidade de vida da população e gerando prejuízos ao sistema de saúde. Os fármacos com atividade sobre a secreção da acidez gástrica são as medicações mais prescritas para essas enfermidades, destacando-se os antagonistas do receptor H2 de histamina e os inibidores da bomba de prótons, amplamente utilizados para o tratamento de úlceras e gastrite. Com o tempo, esses medicamentos passaram a ser indiscriminadamente utilizados, prática que põem em risco a saúde íntegra dos pacientes, mediante aos diversos efeitos adversos que esses medicamentos podem causar. As plantas medicinais têm sido aplicadas na terapia de diversas doenças em toda a história da humanidade. Nesse contexto, a espinheira-santa surge como uma alternativa segura e eficaz para a prevenção e tratamento dessas patologias. Dentre os compostos bioativos que podem desempenhar a atividade gastroprotetora, destacam-se os taninos, triterpenos e flavonóides. Os estudos analisados demonstram que a M. ilicifolia possui relevante ação terapêutica, com potencial para substituir os fármacos usualmente empregados no tratamento de úlceras e gastrite.

The Monteverdia ilicifolia, popularly known as espinheira-santa, is a plant of the Celastraceae's family with relevant therapeutic action due to its medicinal properties, mainly its gastroprotective activity, and possesses proven effects on acidity and stomach ulcers. The aim of this work was to find in the literature evidence for the therapeutic use of M. ilicifolia, as an alternative to the synthetic drugs available in the pharmaceutical industry for the treatment of stomach problems. The academic Google database was used in this work. Stomach disorders affect thousands of people, negatively influencing the population's quality of life and causing damage to the health system. The drugs with activity on gastric acid secretion are the most prescribed medications for these diseases, especially histamine H2 receptor antagonists and proton pump inhibitors, widely used for the treatment of ulcers and gastritis. Over time, these drugs began to be used indiscriminately, a practice that jeopardizes the health of patients, due to the various adverse effects that these drugs can cause. Medicinal plants have been applied in the therapy of various diseases throughout human history. In this context, the espinheira-santa emerges as a safe and effective alternative for the prevention and treatment of these pathologies. Among the bioactive compounds that can perform a gastroprotective activity, tannins, triterpenes, and flavonoids stand out. The analyzed studies demonstrate that M. ilicifolia has relevant therapeutic action, with the potential to replace the drugs usually used in the treatment of ulcers and gastritis.

Monteverdia ilicifolia, conocida popularmente como espinheira-santa, es una planta de la familia Celastraceae de relevante acción terapéutica por sus propiedades medicinales, principalmente su actividad gastroprotectora, con efectos probados sobre la acidez y las úlceras estomacales. Así, el objetivo de este trabajo fue encontrar evidencia en la literatura para el uso terapéutico de M. ilicifolia, como alternativa a las drogas sintéticas disponibles en la industria farmacéutica destinadas al tratamiento de problemas estomacales. En este trabajo se utilizó la base de datos académica de Google. Los trastornos estomacales afectan a miles de personas, influyendo negativamente en la calidad de vida de la población y provocando daños en el sistema de salud. Los fármacos con actividad sobre la secreción ácida gástrica son los más prescritos para estas enfermedades, especialmente los antagonistas de los receptores H2 de histamina y los inhibidores de la bomba de protones, muy utilizados para el tratamiento de úlceras y gastritis. Con el tiempo, estos medicamentos comenzaron a utilizarse de forma indiscriminada, práctica que pone en riesgo la salud de los pacientes, debido a los diversos efectos adversos que estos fármacos pueden ocasionar. Las plantas medicinales se han aplicado en la terapia de diversas enfermedades a lo largo de la historia humana. En este contexto, la espinheira-santa surge como una alternativa segura y eficaz para la prevención y el tratamiento de estas patologías. Entre los compuestos bioactivos que pueden realizar actividad gastroprotectora destacan los taninos, los triterpenos y los flavonoides. Los estudios analizados demuestran que M. ilicifolia tiene una acción terapéutica relevante, con potencial para reemplazar los fármacos habitualmente utilizados en el tratamiento de úlceras y gastritis.

Cannabis medicinal: puntos críticos para su uso clínico / Medical cannabis: Critical points for clinical application

El cannabis se ha utilizado desde la antigüedad con fines recreativos y medicinales. Es una fuente muy rica de compuestos químicos, la mayoría denominados fitocannabinoides, que tienen una variedad de efectos fisiológicos, principalmente por su unión a receptores cannabinoides endógenos como el CB1 y CB2, entre otros. El cannabis tiene propiedades terapéuticas potenciales y sus preparaciones se han utilizado como remedios tradicionales para tratar el dolor y la emesis. Los cannabinoides sintéticos se utilizan clínicamente como analgésicos, antiespasmódico, antieméticos y estimulantes del apetito. La toxicidad significativa del cannabis es poco común en los adultos, sin embargo, puede tener múltiples efectos adversos agudos y crónicos. La calidad de la evidencia en este campo se ha visto limitada por la corta duración de los estudios, los reducidos tamaños de las muestras, la falta de grupos de control y la existencia de sesgos en la mayoría de los estudios revisados. En este contexto, son necesarios más estudios de mejor calidad metodológica para apoyar el uso seguro de esta terapia en otras enfermedades. La decisión de incorporar los cannabinoides como terapia en alguna de las condiciones descritas depende de la evidencia, el uso de terapias previas y el tipo de paciente.

Since ancient times cannabis has been used for recreational and medicinal purposes. It is a significant source of chemical compounds, most of them called phytocannabinoids. These compounds have several physiological effects and produce their effects primarily by binding to endogenous cannabinoid receptors such as CB1 and CB2, among others. Cannabis has potential therapeutic properties and its preparations have been used as traditional remedies to treat pain and emesis. Synthetic cannabinoids are used clinically as analgesics, antispastics, antiemetics, and appetite stimulants. Significant cannabis toxicity is rare in adults; however, it can produce countless acute and chronic side effects. The quality of the evidence in this field is limited by the short duration of the trials, poor sample sizes, lack of a control group, and the existence of bias in most of the reviewed studies. Therefore, a larger number of studies with better methodological quality is required to support the safe use of this therapy. The decision to include cannabinoids as a treatment for any of the conditions described will depend on the evidence, the use of previous therapies, and the type of patient.

Foeniculum vulgare (hinojo): alternativa terapéutica femenina / Foeniculum vulgare (fennel): female therapeutic alternative

INTRODUCCIÓN: el Foeniculum vulgare es una planta medicinal de gran importancia por sus propiedades y valor nutricional. Los extractos del hinojo poseen propiedades terapéuticas ante cambios endocrinos, perturbaciones psicológicas, malestares y sintomatología presente en el ciclo vital de la mujer. OBJETIVOS: analizar información sobre las diferentes propiedades y efectos terapéuticos del F. vulgare en las distintas etapas del ciclo vital de la mujer. METODOLOGÍA: se realizó una búsqueda crítica y analítica del tema por medio de lenguaje controlado recopilado del MeSH y DeCs en metabuscadores científicos. RESULTADOS: el desarrollo de esta revisión fue viable debido a la variedad de literatura, estudios y ensayos clínicos internacionales de libre acceso de información relevante al tema. CONCLUSIÓN: esta planta puede ser empleada como tratamiento, prevención y como fuente de nutrientes; y sus extractos tienen un efecto importante en el ciclo vital de la mujer dependiendo se encuentre en menstruación, menopausia o postmenopausia.

INTRODUCTION: foeniculum vulgare is a medicinal plant of great importance for its properties and nutritional value.Fennel extracts possess therapeutic properties against endocrine changes, psychological disturbances, discomfort and symptomatology present in the vital cycle of women. OBJECTIVES: analyze information on the different properties and therapeutic effects of F. vulgare in the different stages of the life cycle of women. METHODOLOGY: a critical and analytical search of the topic was performed ,by means of controlled language compiled from MeSH and DeCs in scientific meta-search engines. RESULTS: the development of this review was feasible due to the variety of freely available international literature, studies and clinical trials of information relevant to the topic. CONCLUSIÓN: this plant can be used as a treatment, prevention and as a source of nutrients; and its extracts have an important effect on the vital cycle of the woman depending on whether she is in menstruation, menopause or postmenopause.

Mapa de evidências sobre a efetividade clínica da aromaterapia: informe executivo / Evidence map on the clinical effectiveness of aromatherapy: report executive

O mapa apresenta uma visão geral das evidências sobre os efeitos clínicos da Aromaterapia em humanos. A partir de uma ampla busca bibliográfica foram incluídos 73 estudos de revisão sistemática que analisaram o efeito clínico de intervenções com óleos essenciais (49 óleos essenciais), óleos vegetais (06 óleos vegetais graxos), misturas (66 sinergias) e 01 hidrolato, utilizando cinco formas de aplicação: inalação, banho, massagem, ingestão ou tópico. Principais Achados: • Estas formas de aplicação foram associadas a 55 desfechos de saúde distribuídos em 7 grupos: Dor; Indicadores Metabólicos e Fisiológicos; Doenças Não Transmissíveis; Bem-Estar, Vitalidade e Qualidade de Vida; Saúde Mental; Doenças Infectocontagiosas; Saúde Reprodutiva. No total, foram 420 associações entre intervenções e desfechos. • Dentre os grupos de desfechos, o grupo Saúde Mental recebeu 154 associações, seguido pelo grupo Dor (93 associações) e Bem-Estar, Vitalidade e Qualidade de Vida (85 associações). • A maior parte dos estudos reportou efeito positivo para 333 associações. O efeito potencial positivo foi reportado para 50 associações, inconclusivo para 19 associações e sem efeito para 18 associações. Não foram reportados efeitos negativos. • A Lavanda (Lavandula angustifolia) foi o óleo essencial mais analisado, com 116 associações com o óleo puro e outras 89 associações com a lavanda em 49 sinergias com outros essenciais, vegetais e hidrolato. As intervenções com Lavanda demonstraram efeitos relevantes para a Saúde Mental, especialmente transtornos de ansiedade. • O segundo óleo essencial mais pesquisado foi o de Rosa de damasco (Rosa x damascena), com 24 intervenções unitárias (puro) e em sinergias (11). Estas intervenções foram associadas a 10 desfechos de saúde, com destaque para os desfechos de Dor (12 associações). Implicações para prática: Apesar da Aromaterapia trabalhar com produtos naturais, existem técnicas específicas para cada tipo de população que precisam respeitar o modo da intervenção, a diluição, o tempo de uso e a frequência com que se utiliza. A formação profissional adequada é essencial para o uso seguro da Aromaterapia em intervenções terapêuticas. Implicações para pesquisa: Destaca-se que há grande heterogeneidade nos estudos clínicos primários de Aromaterapia, o que dificulta a sistematização da evidência disponível. Recomenda-se, prioritariamente, o fomento em estudos de ensaios clínicos randomizados, principalmente para os óleos essenciais/sinergias. Recomenda-se ampliar este Mapa com novos estudos, em especial com os óleos essenciais dos biomas brasileiros. Implicações para gestão: Espera-se que as associações identificadas possam promover a implementação da Aromaterapia por gestores e profissionais que atuam nos serviços do SUS, especialmente para os desfechos que apresentaram efeito positivo e potencialmente positivo.

This map presents overview evidence of the clinical effects of essential oils in humans. The search was conducted in several databases, and 73 systematic review studies were included. Main Findings: This Map collects evidence for interventions with 49 essential oils, 9 fatty vegetable oils or in 66 mixtures (synergies) and one hydrolate, with applications through inhalation, massage, bath, ingestion, or topical. Each intervention was associated with at least one of 55 health outcomes classified into 8 groups: Pain; Metabolic and Physiological Indicators; Noncommunicable Diseases; Mental Health; Infectious Diseases; Reproductive Health and Other, totaling 420 associations. The effects reported by each study included: positive, potentially positive, no effect, and inconclusive effects. Highlighting that no negative effect was reported. The essential oil most researched was Lavender (Lavandula angustifolia - 116 associations). The Roses essential oil was the second most researched (Rosa damascena - 24 associations). The interventions with Lavender essential oil demonstrated more relevant effects on Mental Health, especially anxiety disorders. Interventions with Rose essential oil the more relevant effects on outcomes related to Women's Health, especially dysmenorrhea and pain in childbirth. This Map found 333 positive effect for different health outcomes. Implications for practice: The therapeutic interventions with Aromatherapy are diverse, where the main focus is on the person, an integral and unique being, with no overlooking health outcomes. Adequate training is of paramount importance for a professional who applies Aromatherapy in health. Although Aromatherapy is a natural product, specific techniques for each type of population need to respect the method of intervention, dilution, time of use, and the frequency with which it is used. Thus, aromatherapy safe practice health will contribute even more to the results already achieved. Implications for research: Noteworthy, that there is heterogeneity in the primary clinical trials of Aromatherapy, which hampered systematizing the available evidence. Recommended, as a priority, the promotion of studies of randomized clinical trials, especially for essential oils/synergies. Besides, expanding this Map is necessary so that new publications are included, especially with essential oils from Brazilian biomes.

Aplicações terapêuticas do Cymbopogon citratus (capim-limão) na odontologia: uma revisão de literatura integrativa / Therapeutic applications of Cymbopogon citratus (lemon grass) in dentistry: an integrative literature review

Introdução: O Cymbopogon citratus (capim-limão) é uma espécie herbácea pertencente à família Poaceae, que engloba aproximadamente 500 gêneros e 8.000 espécies. Objetivos: Analisar as evidências científicas disponíveis sobre as aplicações terapêuticas de Cymbopogon citratus (capim-limão) na Odontologia durante os últimos dez anos. Métodos: Trata-se de uma revisão integrativa da literatura, que envolveu as seguintes etapas: elaboração da pergunta norteadora, estabelecimento das palavras-chave e dos critérios de inclusão e exclusão de artigos, seleção e análise crítica dos artigos, resultados, discussão e conclusão. Resultados: 8% dos artigos encontrados e analisados nessa revisão de literatura integrativa demonstraram que o Cymbopogon citratus (capim-limão) apresenta potencial terapêutico no que se refere a suas propriedades antimicrobianas, sendo considerado benéfico e promissor na inibição de patógenos colonizadores bacterianos e fúngicos dentários, além de demonstrar baixa citotoxicidade. Conclusão: Apesar da existência de diversas pesquisas in vitro que demonstram eficácia e segurança do uso de diversos compostos de origem natural, nota-se que há poucos protocolos específicos que orientem o profissional cirurgião-dentista para o uso de terapias à base de plantas medicinais e/ou fitoterápicos, como no caso do Cymbopogon citratus (capim-limão). Portanto, são necessários mais estudos para explicar e fundamentar melhor os efeitos do capim-limão na odontologia.

Introduction: Cymbopogon citratus (lemon grass) is an herbaceous species belonging to the Poaceae family, which includes approximately 500 genera and 8,000 species. Objectives: To analyze the available scientific evidence about therapeutic applications of Cymbopogon citratus (lemon grass) in Dentistry over the past ten years. Methods: This is an integrative literature review, which involved the following steps: elaboration of the guiding question, establishment of keywords and criteria for inclusion and exclusion of articles, selection and critical analysis of articles, results, discussion, and conclusion. Results: 8% of the articles found and analyzed in this integrative literature review demonstrated that Cymbopogon citratus (lemon grass) has therapeutic potential because its antimicrobial properties, being considered beneficial and promising in the inhibition of bacterial and fungal dental colonizing pathogens, in addition presents low cytotoxicity. Conclusion: Despite the existence of several in vitro studies that demonstrate the efficacy and safety of natural compounds utilization, there are few specific protocols guiding the dental professional about using based therapies of medicinal and/or phytotherapeutic plants, as in the case of Cymbopogon citratus (lemon grass). Therefore, more studies are necessary to explain and provide a better validation of lemon grass effects in the dentistry practice.

Reconstruction Algorithm-Based Computed Tomography Image Feature for Evaluating the Effect of Internal Administration and Medicated Bath of Liangxue Xiaoyin Decoction on Psoriasis Vulgaris.

Skin computed tomography (CT) image based on improved marching cubes (MC) algorithm was explored to evaluate the therapeutic effect of internal administration of Liangxue Xiaoyin decoction combined with medicated bath in the treatment of psoriasis vulgaris. 712 patients with psoriasis vulgaris blood heat syndrome in hospital were recruited as the research object, which were randomly divided into observation group (TCM oral therapy combined with medicinal bath) and control group (TCM oral therapy), each with 356 cases. Psoriasis area and severity index (PASI), pruritus degree, and clinical treatment effect were compared. The results showed that the reconstruction time of median method was greatly shorter, and the algorithm efficiency was improved by 40.6290%. After treatment, the psoriasis area and severity index (PASI) score of the observation group was 5.61 ± 1.15, ΔPASI = (22.64 ± 2.15). ΔPASI% = 80.14%, which were greatly higher than the control group ((9.41 + 1.56) points, ΔPASI = (18.84 + 1.65) points, ΔPASI% = 66.69%) (P < 0.05). After treatment, the itching degree of the observation group was 3.03 ± 1.01 points, which was lower than that of the control group ((3.71 ± 1.06) points), and the itching degree of the observation group was greater than that of the control group, with substantial difference (P < 0.05). The total effective rate of observation group (88.76%) was higher than that of control group (71.07%) (P < 0.05). Therefore, skin CT image based on the improved MC algorithm can evaluate the therapeutic effect of internal administration of Liangxue Xiaoyin decoction combined with medicated bath in the treatment of psoriasis vulgaris. The internal administration of Liangxue Xiaoyin decoction combined with medicated bath had a good effect on the treatment of psoriasis vulgaris and was of certain clinical application value.

Phytochemistry and Antiviral Properties of Tw o Lotus Species Growing in Egypt / Fitoquímica y propiedades antivirales de dos especies de Lotus que crecen en Egipto

Background:Lotus arabicus L and Lotusglaber Mill. belong to the family Fabaceae, and they grow in the wild in Egypt and have different therapeutic uses in folk medicine. Objectives: This study aimed to evaluate the phytochemical profile, antimicrobial and antiviral properties of the methanolic extracts of two Lotus spp. growing in Egypt, L. arabicus and L. glaber.Material and methods: Gas chromatography-mass spectrometry was used to identify the compounds of the extracts of two Lotus species. An MTT colorimetric assay and the disc diffusion method were performed to investigate the antiviral and antimicrobial activities of two lotus species, respectively. Results: The n-hexane and methanol extracts of L. arabicuscontained high percentages of alkane hydrocarbons, such as 5-methyloctadecane, while L. glaber contained dodecane. The major compounds in the methanol extract of L. arabicuswere hexadecanoic acid methyl ester and dodecanoic acid,2,3-bis(acetyloxy)propyl ester. The major compounds in the methanol extract of L. glaber were palmitic acid and lucenin 2. The indole alkaloid ditaine was found only in L. arabicus. This alkaloid was identified for the first time in the genus Lotus. The antimicrobial properties of the extracts of the two Lotus species showed that the n-hexane extract of both Lotus species may have potential antifungal activity against Candida parapsilosis and Aspergillus flavus. Moreover, the methanolic extracts of both Lotus species have potential antiviral activity against the coxsackie B virus, but only the L. arabicus extract showed activity against the hepatitis A virus. Conclusion:Lotus arabicus might have potential antifungal or antiviral activity greater than L. glaber

Antecedentes:Lotus arabicus L y Lotus glaber Mill. pertenecen a la familia de las fabáceas y crecen en estado silvestre en Egipto y tienen diferentes usos terapéuticos en la medicina popular. Objetivos: El objetivo de este estudio es evaluar el perfil fitoquímico y las propiedades antimicrobianas de los extractos metanólicos de dos especies de Lotus que crecen en Egipto, L. arabicus y L. glaber. Material y métodos: Se utilizó la cromatografía de gases-espectrometría de masas para identificar los compuestos de los extractos de las dos especies de Lotus. Se realizó un ensayo colorimétrico MTT y el método de difusión en disco para investigar las actividades antiviral y antimicrobiana de las dos especies de Lotus, respectivamente. Resultados: Los extractos de n-hexano y metanol de L. arabicus contenían altos porcentajes de hidrocarburos alcanos, como el 5-metiloctadecano, mientras que L. glaber contenía dodecano. Los principales compuestos del extracto de metanol de L. arabicus eran el éster metílico del ácido hexadecanoico y el éster dodecanoico, 2,3-bis(acetiloxi)propilo. Los principales compuestos del extracto de metanol de L. glaber fueron el ácido palmítico y la lucenina 2. El alcaloide indólico ditaína sólo se encontró en L. arabicus. Este alcaloide fue identificado por primera vez en el género Lotus. Las propiedades antimicrobianas de los extractos de las dos especies de Lotus mostraron que el extracto n-hexano de ambas especies de Lotus puede tener una potencial actividad antifúngica contra Candidaparapsilosis y Aspergillus flavus. Además, los extractos metanólicos de ambas especies de Lotustienen una potencial actividad antiviral contra el virus coxsackie B, pero sólo el extracto de L. arabicus mostró actividad contra el virus de la hepatitis A. Conclusión: L. arabicus puede tener una potencial actividad antifúngica o antiviral mayor que L. glaber

Consumo y buenas prácticas de preparación de medicamentos homeopáticos en un servicio farmacéutico comunitario / Consumption and good practices in the preparation of homeopathic medicines in a community pharmacy service

La Homeopatía es una modalidad terapéutica que se practica desde el siglo XIX, siendo reconocida por la Organización Mundial de la Salud. En Cuba, con el desarrollo de la Medicina Natural y Tradicional (MNT), el uso de la Homeopatía se ha extendido y se ha incrementado el consumo de sus medicamentos. Objetivo: Caracterizar el consumo y el cumplimiento de las Buenas Prácticas de Preparación de medicamentos homeopáticos. Métodos: Se realizó un estudio descriptivo transversal del tipo consumo, en la Farmacia Homeopática Provincial de Santiago de Cuba. Resultados: El 94,03% del total de las ventas, fue mediante recetas médicas, entre los 12 medicamentos homeopáticos más prescriptos estuvieron la Drossera, Sambucus y Belladona. La especialidad con más prescripciones fue la de Pediatría con el 53,32%, recibiéndose recetas de 12 Instituciones de salud de la provincia. Dentro de los errores detectados en las recetas sin calidad predominó en el 87,35% la omisión de las potencias y errores en la nomenclatura del medicamento. En la valoración del cumplimiento de las normas de Buenas Prácticas de Preparación se obtuvo la puntuación de 83 puntos de 100, clasificándose el cumplimiento en dicho servicio con la categoría de Bien. La dispensación de los medicamentos homeopáticos resultó ser adecuada en el 100 % de los casos. Conclusión: Se comprobó el amplio uso de esta terapéutica en el territorio. Se detectaron deficiencias en la calidad de las recetas médicas. La dispensación constituyó un factor de impacto positivo en los pacientes(AU)

Homeopathy is a therapeutic modality that has been practiced since the 19th century, been recognized by the World Health Organization. In Cuba, with the development of Natural and Traditional Medicine (NTM), the use of Homeopathy has spread and the consumption of its medicines has increased. Objective: To characterize the consumption and compliance with the Good Practices for the Preparation of homeopathic medicines. Methods: A cross-sectional descriptive study of the consumption type was carried out in the Provincial Homeopathic Pharmacy of Santiago de Cuba. Results: 94.03% of total sales were through medical prescriptions, among the 12 most prescribed homeopathic medicines were Drossera, Sambucus and Belladonna. The specialty with the most prescriptions was Pediatrics with 53.32%, with prescriptions received from 12 health institutions in the province. Among the errors detected in the prescriptions without quality, 87.35% were due to omission of potencies and errors in the nomenclature of the drug. In the evaluation of compliance with the standards of Good Preparation Practices, a score of 83 points out of 100 was obtained, classifying compliance in this service with the category of Good. The dispensing of homeopathic medicines was adequate in 100 % of the cases. Conclusion: The wide use of this therapy in the territory was verified. Deficiencies were detected in the quality of medical prescriptions. Dispensing was a factor of positive impact on patients(AU)

Cnidoscolus aconitifolius: therapeutic use and phytochemical properties. Literature review / Cnidoscolus aconitifolius: usos terapéuticos y propiedades fitoquímicas. Revisión de la literatura

Abstract Introduction: Medicinal plants have been traditionally used to cure or alleviate infectious and non-infectious diseases. They are widely accepted due to their low cost and low toxicity indexes. These plants are frequently used in cases involving skin irritation, superficial wounds, insect bites, and snake bites. Objective: To compile available evidence on the main therapeutic uses and phytochemical components of Cnidoscolus aconitifolius (popularly known as chaya), a plant that grows in tropical regions of Mexico and Central America. Materials and methods: A literature review of studies on C. aconitifolius published until 2017 was conducted in the BIREME, PubMed/Medline, Elsevier and SciELO databases. Descriptors "Cnidoscolus" and "aconitifolius" were used for the literature search, and no language restrictions were applied. Results: 82 articles were retrieved after completing the initial search. Once the studies were filtered by title (descriptors in the title) and duplicates were removed, 18 articles were reviewed. Based on the information found, it was possible to confirm that this plant has multiple health benefits. Conclusions: The traditional therapeutic use of Cnidoscolus aconitifolius is backed by scientific evidence. Therefore, further research aimed at identifying new phytochemical properties of this plant should be conducted to establish alternative therapies for treating different conditions.

Resumen Introducción. El uso tradicional de plantas medicinales para tratar diferentes enfermedades, ya sean infecciosas o no, es ampliamente aceptado debido a su bajo costo y sus bajos índices de toxicidad. Estas plantas son frecuentemente usadas en casos que involucran irritaciones de la piel, heridas superficiales, picaduras de insectos y mordeduras de víboras. Objetivo. Recopilar la información disponible sobre los principales usos terapéuticos y los componentes fitoquímicos de Cnidoscolus aconitifolius, una planta conocida popularmente como chaya y que crece en regiones tropicales de México y Centroamérica. Materiales y métodos. Se realizó una revisión de la literatura sobre C. aconitifolius publicada hasta 2017 en las bases de datos BIREME, PubMed/Medline, Elsevier y SciELO. Para la búsqueda se emplearon los descriptores "Cnidoscolus" y "aconitifolius", y no se aplicaron filtros de idioma. Resultados. Se identificaron 82 artículos luego de completar la búsqueda inicial. Después de filtrar los estudios por título (presencia de descriptores de búsqueda en el título) y remover duplicados, se incluyeron 18 artículos en la revisión. De acuerdo a la información encontrada, fue posible confirmar que esta planta ofrece diversos beneficios para la salud. Conclusiones. El uso terapéutico tradicional de la chaya está sustentado por evidencia científica, por lo que se sugiere realizar más investigaciones centradas en la identificación de nuevas propiedades fitoquímicas de esta planta y, así, establecer alternativas terapéuticas para distintas afecciones.

The efficacy of jade moxibustion in knee osteoarthritis.

INTRODUCTION: This study aims to compare clinical effect between Jade moxibustion and traditional moxibustion, and to determine the clinical effect of Jade moxibustion on knee osteoarthritis (KOA). METHODS/DESIGN: This is a 2-parallel-group, randomized controlled trial. A total of 148 subjects with KOA (Kellgren-Lawrence grade II or III) will be recruited and randomized to receive Jade moxibustion treatment or a traditional moxibustion treatment in a 1:1 ratio. Jade moxibustion group: The affected knee of the subjects will be covered with jade kneepad. Traditional moxibustion group: Chosen the ST35, ST34, EX-LE4, SP10 and Ashi points at the affected knee. The subjects will receive treatment three times a week, altogether 12 times in 4 weeks. The main outcomes are WOMAC knee pain score, knee function score and SF-36 quality of life questionnaire changes at the 4th week. Secondary outcomes include WOMAC knee pain score and knee function score, overall clinical efficacy evaluation, medication, safety evaluation at the 2nd, 12th, and 24th week, and cytokines related to osteoarthritis in serum. DISCUSSION: This randomized controlled trial used traditional moxibustion as a control group to provide rigorous evidence for the clinical efficacy and safety of Jade moxibustion in treatment of KOA. TRIAL REGISTRATION: ISRCTN registry, No 21174552. Registered on 28 February 2020.

Traditional Chinese medicine insights of newly-diagnosed and young hypertension and clinical practice of Tianma Gouteng Decoction for hypertension treatment / 中国中药杂志

Hypertension is a global major public health problem. Early intervention and timely blocking are necessary for newly-diagnosed hypertensive and young hypertensive patients. Tianma Gouteng Decoction recorded in Zabing Zhengzhi Xinyi written by HU Guangci has the major functions in treating excess syndrome and wind-Yang disturbance syndrome with effects in calming liver-wind, clearing heat and activating blood, and nourishing liver and kidney. As we known, Tianma Gouteng Decoction is a classical formula for treating hypertension. However, due to the limitation of historical conditions, some problems impede Tianma Gouteng Decoction from being handed down successfully, such as uncertain diagnosis, uncertain antihypertensive efficacy and treatment-course. In this case, we ask whether Tianma Gouteng Decoction can be used as antihypertensive therapy and the exactly decrease of systolic and diastolic blood pressure, and wonder the half-life of Tianma Gouteng Decoction and the relationship with Western medicine. Therefore, defined prescription and syndrome, efficacy, treatment-course are important in clinical practice. According to the findings, ① previously, we thought that hypertension was a liver-Yang hyperactivity and liver-wind stirring syndrome, and the liver-based therapy theory was effective. However, based on our study, long-term treatment with Western medicine could block disease progression, control the increased blood pressure and change the pathogenesis and syndrome of traditional Chinese medicine. Therefore, the frequency of liver-Yang hyperactivity syndrome "fire syndrome" decreased sharply, and the main syndrome was fluid-retention syndrome and deficiency syndrome. The etiology and pathogenesis of hypertension was prone to deficiency syndrome accompanied with excess syndrome. Therefore, it was necessary to intervene hypertension in "liver-wind" and "liver-Yang" excess syndrome stage, and the early intervention and treatment are important. ② The newly-diagnosed hypertensive and young hypertensive patients usually had no Western medicine intervention. Thus, the etiology and pathogenesis of hypertension were free from Western medicine, which maintained the initial stage of hypertension in line with the liver-Yang hyperactivity syndrome. ③ The pathological mechanisms of newly-diagnosed and young hypertension were mainly increase in sympathetic activity, active renin-angiotensin-aldosterone system, change in morphology of vascular smooth muscle cells and endothelial cell dysfunction. ④ According to the syndrome of Tianma Gouteng Decoction, in modern medicine, Tianma Gouteng Decoction was widely used to treat the early-stage hypertension and the early-intervention of hypertension without Western medicine, particularly newly-diagnosed, young hypertension, Ⅲ hypertension, hypertensive crisis and hypertensive emergency. Tianma Gouteng Decoction can treat such symptoms as headache, dizziness, fullness of head, slurring of speech; facial flushing, conjunctival congestion and blurred vision; dysphoria, anxiety, palpitation, insomnia, mental disorder and hot flushes; dry-mouth with bitter taste and sweeting; myasthenia of limbs and lassitude in loin and legs; brown urine with burning sensation during urination; a solid or liquid stool consistency; red tongue, slippery and rapid pulse, wiry and rapid pulse over to Cunkou. ⑤ After treatment with Tianma Gouteng Decoction for three to six months, the blood pressure was decreased, and the symptoms were improved with reduction or even discontinuance of Western medicine. ⑥ According to recent studies, Caul is Polygoni Multiflori of Tianma Gouteng Decoction induced certain hepatotoxicity and increased the risk of long-term treatment. However, with the regular monitoring of biomedical index, long-term treatment with Caulis Polygoni Multiflori(3-10 g·d~(-1) for 3 to 6 months) didn't show hepatic dysfunction. ⑦ The pharmacological activity of Tianma Gouteng Decoction coincided with the pathology and disease mechanism of newly-diagnosed and young hypertension. Therefore, Tianma Gouteng Decoction was the specific recipe for newly-diagnosed and young hypertension. Therefore, further studies of efficacy, safety and molecular mechanism of Tianma Gouteng Decoction may make a medical breakthrough for hypertension treatment.

Study advance of depressive animal models and its application in traditional Chinese medicines / 中国中药杂志

Depression is a kind of mental disease with main symptoms of low mood and lack of pleasure, which seriously endangers human health. An appropriate depressive animal model is of great significance for the study of depression and new antidepressant drugs, while the suitable selection and matching of experimental animals, modeling methods and evaluation indexes are critical to eva-luate the scientificity and effectiveness of the depressive animal model. The study advance of depressive animal models in the aspects of experimental animal selection, modeling principle and method, characteristics, evaluation indexes and their application in traditional Chinese medicine are summarized through the systematic review of relevant literatures in PubMed, CNKI and other databases. The depressive animal modeling methods utilized in recent studies include stress, glucocorticoid induction, reserpine induction, lipopolysaccharide induction, surgical modeling, gene knockout, joint application modeling methods. Stress method is better to simulate the depressive symptoms of clinical patients, whereas there are some deficiencies, such as long modeling time and large cost. The depressive animal models induced by glucocorticoid, reserpine and lipopolysaccharide have the advantages of short modeling time and good controllability, but with a poor reliability. The pathogenesis of surgical modeling is highly matched with that of clinical depressive patients, whereas it has the defect of long postoperative recovery period. Gene knockout models can be used to study the precise role of specific genes in depression. However, its applicability may be restricted in studies on depression. The joint application modeling method can improve its reliability and accuracy, and attracts more and more attention. This paper provides a reference for the selection of animal models in future studies of pathological mechanism of depression, and screening and evaluation of antidepressant drugs.

Study on anti-inflammatory active components and mechanism of Corydalis Bungeanae Herba / 中国中药杂志

Corydalis Bungeanae Herba is often used to treat a variety of inflammatory diseases in traditional Chinese medicine. In order to determine its chemical material basis, the components of Corydalis Bungeanae Herba were isolated by automated purification system. Flavonoids and alkaloids were prepared, and all such components were identified by mass spectrometry. The effects of the components on the production of inflammatory mediators and pharmacological mechanisms in the lipopolysaccharide(LPS)-induced RAW264.7 cell inflammation model were examined. Mouse macrophages(RAW264.7) were first treated with LPS. The relationship between cell viability and LPS concentration was observed. Then, the effects of flavonoids components and alkaloid components with different administration concentrations on cell viability were detected to determine the maximum administration concentration. Secondly, 2.5, 5, 10 and 20 μg·mL~(-1) flavonoids components and alkaloid components were added respectively to observe the effects and mechanism of different concentrations of flavonoids components and alkaloid components on LPS-induced inflammation of RAW264.7 macrophages. Griess reagent assay was used to detect NO content in cell supernatant. The inflammatory cytokines(TNF-α, IL-1β and IL-6) in cell supernatant were determined by ELISA method. Western blot method was used to detect the intracellular nuclear factor(NF-κB) IκBα phosphorylation(p-IκBα), p65 phosphorylation(p-p65) and protein expression of TLR4, TLR2. The results showed that the alkaloid components inhibited the production of NO, TNF-α, IL-1β and IL-6 in a dose-dependent mannerin the concentration range of 2.5-20 μg·mL~(-1). In inflammation upstream pathways, the inhibitory effect of the alkaloid components on the TLR2 expression level was weaker than that of TLR4. In inflammation downstream, alkaloid components significantly inhibited phosphorylation of IκBα and p65 in a dose-dependent manner. These data suggested that the alkaloid components were the material basis components of Corydalis Bungeanae Herba, and its anti-inflammatory mechanism might be related to inhibiting the transmission of inflammatory signals in TLRs/NF-κB signaling pathways dominated by TLR4, interfering with the activation of inflammatory genes and inhibiting their over expression, and down-regulating the secretion level of inflammatory factors.

Study on therapeutic effect of Chaiyin Particles on combining disease with syndrome of human coronavirus pneumonia with pestilence attacking lung syndrome based on regulation of immune function / 中国中药杂志

According to the classification of traditional Chinese medicine syndromes of coronavirus disease 2019 by the national competent authority, this study determined that human coronavirus 229 E(HCoV-229 E) was infected in a mouse model of cold and dampness syndrome, so as to build the human coronavirus pneumonia with pestilence attacking lung syndrome model. The model can simulate the traditional Chinese medicine treatment of common disease syndromes in Coronavirus Disease 2019 Diagnosis and Treatment Program(the sixth edition for trial). Specific steps were as follows. ABALB/c mouse model of cold and dampness syndrome was established, based on which, HCoV-229 E virus was infected; then the experiment was divided into normal control group, infection control group, cold-dampness control group, cold-dampness infection group(the model group), high-dose Chaiyin Particles group(8.8 g·kg~(-1)·d~(-1)), and low-dose Chaiyin Particles group(4.4 g·kg~(-1)·d~(-1)). On the day of infection, Chaiyin Particles was given for three consecutive days. Lung tissues were collected the day after the last dose, and the lung index and inhibition rate were calculated. The nucleic acid of lung tissue was extracted, and the HCoV-229 E virus load was detected by Real-time fluorescent quantitative RT-PCR. Blood leukocytes were separated, and the percentage of T and B lymphocytes was detected by flow cytometry. Lung tissue protein was extracted, and IL-6, IL-10, TNF-α and IFN-γ contents were detected by ELISA. High and low-dose Chaiyin Particles significantly reduced the lung index(P<0.01) of mice of human coronavirus pneumonia with pestilence attacking the lung syndrome, and the inhibition rates were 61.02% and 55.45%, respectively. Compared with the model control group, high and low-dose Chaiyin Particles significantly increased cross blood CD4~+ T lymphocytes, CD8~+T lymphocytes and total B lymphocyte percentage(P<0.05, P<0.01), and reduced IL-10, TNF-α and IFN-γ levels in lungs(P<0.01). In vitro results showed that TC_(50), TC_0, IC_(50) and TI of Chaiyin Particles were 4.46 mg·mL~(-1), 3.13 mg·mL~(-1), 1.12 mg·mL~(-1) and 4. The control group of in vitro culture cells had no HCoV-229 E virus nucleic acid expression. The expression of HCoV-229 E virus nucleic acid in the virus control group was 1.48×10~7 copies/mL, and Chaiyin Particles significantly reduced HCoV-229 E expression at doses of 3.13 and 1.56 mg·mL~(-1), and the expression of HCoV-229 E nucleic acid was 9.47×10~5 and 9.47×10~6 copies/mL, respectively. Chaiyin Particles has a better effect on the mouse model with human coronavirus pneumonia with pestilence attacking the lung syndrome, and could play a role by enhancing immunity, and reducing inflammatory factor expression.

Similarities and differences between Ginkgo biloba and Panax notoginseng in treatment of ischemic cerebrovascular disease / 中国中药杂志

Ginkgo biloba and Panax notoginseng are both herb medicines for cerebrovascular disease, and play an active role in treating ischemic cerebrovascular disease(ICVD). Their mechanisms of action include antioxidant stress, nerve protection, vascular protection. According to the comparative study of literatures, G. biloba has a certain protective effect from the early stage of free radical formation throughout the whole process of causing cell inflammation and apoptosis in antioxidant stress; while P. notoginseng has mainly anti-inflammatory, anti-apoptosis effects. In the nerve protection and repair of nerve damage caused by glutamate, both could promote neurogenesis, repair damaged axons and protect nerve cells. In addition, G. biloba could also relieve neurotoxicity caused by glutamate damage, while P. notoginseng have a unique effect in repairing blood-brain barrier(BBB) and blood vessel regeneration. In clinic, they are used as auxiliary drugs in combination with thrombolytic therapy, and play curative effects in alleviating inflammation, eliminating edema, improving the cure rate and the prognosis. For cerebral diseases caused by chronic cerebral hypoperfusion, G. biloba could reduce inflammation and improve cognition. In addition, G. biloba could protect neurocyte by adjusting the secretion of dopamine in vivo, and has a certain effect on antidepressant diseases, which however needs further studies.

Mechanism of Xuanfei Baidu Tang in treatment of COVID-19 based on network pharmacology / 中国中药杂志

The study aimed to investigate the multi-constituent, multi-target mechanism of Xuanfei Baidu Tang(XFBD) in the treatment of coronavirus disease 2019(COVID-19), through exploring the main ingredients and effective targets of XFBD, as well as analyzing the correlation between XFBD targets and COVID-19. The compounds of each herb in XFBD were collected from TCM-PTD, ETCM, TCMSP and SymMap database. Next, the information of meridian tropisms was collected from Chinese Pharmacopoeia(2015 edition), and the target information of the major constituents of XFBD were obtained from TCM-PTD, ETCM, TCMSP and TargetNet database. Subsequently, the target network model and the major modules were generated by Cytoscape, and the functional enrichment analysis of XFBD targets were completed by DAVID and STRING. As a result, ten of the 13 herbs in XFBD belonged to the lung meridian, and 326 of the 1 224 putative XFBD targets were associated with the disease target of COVID-19, among which 109 targets were enriched in the disease pathways of viral infection and lung injury. The main biological pathways regulated by the key XFBD targets included viral infection, energy metabolism, immunity and inflammation, parasites and bacterial infections. In conclusion, the therapeutic mechanism of XFBD in COVID-19 showed a multi-herb, multi-constituent, multi-target pattern, with lung as the chief targeted organ. By regulating a series of biological pathways closely related to the occurrence and development of diseases, XFBD plays a role in balancing immunity, eliminating inflammation, regulating hepatic and biliary metabolism and recovering energy metabolism balance.

Clinical application of Xingnaojing Injection in treatment of 11 674 cases of cerebral infarction: a real world study / 中国中药杂志

To analyzed the actual clinical application of Xingnaojing Injection in treating cerebral infarction in the real world, selected HIS(hospital information system) database of inpatients in 39 hospitals across the country, and conducted descriptive analysis and association rule analysis on the information of 11 674 patients with cerebral infarction using Xingnaojing Injection. The results showed that the average age of the patients was 69.69 years. TCM syndrome of phlegm stasis and collaterals stagnation was the most(37.56%), followed by wind-phlegm obstruction of collaterals(19.01%). Virtual syndrome accounted for 21.06%. Intravenous drip was the most important route of administration(96.50%). Iv infusion single dose of 10-20 mL(52.44%), other off-label doses accounted for a larger proportion(47.56%). Continuous use of the drug within 3 days(55.45%), 15-28 days accounted for 6.96%, >28 days accounted for 0.89%. The top 10 Western drugs used in combination mainly include antihypertensive drugs, acid-suppressing drugs to protect stomach, drugs to improve brain circulation, drugs to protect brain nerves and drugs to fight infection. The top 10 of Chinese patent medicines are mainly activating blood circulation and removing stasis, clearing heat and clearing the surface, etc. According to the analysis of association rules, three types of clinical drug use modes for the combination of Chinese and Western medicine were obtained, mainly including the first type: Xingnaojing Injection+nifedipine(nifedipine, nifedipyridine, Lixinping)+levoflo-xacin+Huayu Tongmai agent. The second category: Xingnaojing Injection+omeprazole+edaravone+Huayu Tongmai agent; The third category: Xingnaojing Injection+ganglioside and ganglioside derivatives+edaravone+Huayu Tongmai agent. The results show that Xingnaojing Injection is not a standard drug in the treatment of cerebral infarction. At the same time, the combined use of drugs is mainly recommended by the guidelines and conventional treatment drugs, reflecting the clinical application of integrated traditional Chinese and Western medicine.

Arsenic-Containing Qinghuang Powder () is an Alternative Treatment for Elderly Acute Myeloid Leukemia Patients Refusing Low-Intensity Chemotherapy / 中国结合医学杂志

OBJECTIVE@#To analyze the overall survival (OS) of elderly acute myeloid leukemia (AML) patients treated with oral arsenic-containing Qinghuang Powder (, QHP) or low-intensity chemotherapy (LIC).@*METHODS@#Forty-two elderly AML patients treated with intravenous or subcutaneous LIC (1 month for each course, at least 3 courses) or oral QHP (3 months for each course, at least 2 courses) were retrospectively analyzed from January 2015 to December 2017. The main endpoints of analysis were OS and 1-, 2-, 3-year OS rates of patients, respectively. And the adverse reactions induding bone marrow suppression, digestive tract discomfort and myocardia injury were observed.@*RESULTS@#Out of 42 elderly AML patients, 22 received LIC treatment and 20 received QHP treatment, according to patients' preference. There was no significant difference on OS between LIC and QHP patients (13.0 months vs. 13.5 months, >0.05). There was no significant difference on OS rates between LIC and QHP groups at 1 year (59.1% vs. 70.0%), 2 years (13.6% vs. 15%), and 3 years (4.6% vs. 5.0%, all >0.05). Furthermore, there was no significant difference of OS on prognosis stratification of performance status > 2 (12 months vs. 12 months), age> 75 year-old (12.0 months vs. 12.5 months), hematopoietic stem cell transplant comorbidity index >2 (12 months vs. 13 months), poor cytogenetics (12 months vs. 8 months), and diagnosis of secondary AML (10 months vs. 14 months) between LIC and QHP patients (>0.05).@*CONCLUSION@#QHP may be an alternative treatment for elderly AML patients refusing LIC therapy.