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Formulations of traditional Chinese medicine for the prevention and treatment of radiation-induced injury 预防和治疗辐射损伤的中药配方
Pub Date : 2024-07-16 DOI: 10.1097/hm9.0000000000000126
Hong Niu, Ziyan Tang, Qiang Chi, Lina Du, Yiguang Jin
The likelihood of radiation-induced injury (RII) has increased. Currently, the chemical drugs used to prevent and control radiation damage have some drawbacks, such as high toxicity, which can also have other side effects on the body. However, many traditional Chinese medicine (TCM) monomers, single TCM, and compound TCM preparations have shown good therapeutic effects against radiation damage with increased safety and minimal adverse reactions. Therefore, new anti-RII TCMs must be explored and developed. This study reviewed the TCM preparations for the prevention and treatment of RII and their mechanisms of action to provide a better theoretical basis for research on the prevention and treatment of RII. TCM is an efficient, safe, and convenient strategy for the prevention and treatment of RII. Graphical abstract: http://links.lww.com/AHM/A127.
辐射诱发损伤(RII)的可能性增加了。目前,用于预防和控制辐射损伤的化学药物存在一些缺点,如毒性大,还会对人体产生其他副作用。然而,许多中药单体、单味中药和复方中药制剂对辐射损伤有良好的治疗效果,且安全性更高,不良反应极小。因此,必须探索和开发新的抗辐射损伤中药制剂。本研究综述了防治 RII 的中药制剂及其作用机制,为 RII 的防治研究提供更好的理论依据。中药是一种高效、安全、便捷的RII防治策略。图文摘要:http://links.lww.com/AHM/A127。
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引用次数: 0
New Perspective on the Treatment of Rheumatic Arthritis Based on “Strengthening Body Resistance (Fú Zhèng)” in the Theory of Co-inhibitory Receptor-regulated T-Cell Immunity 基于共抑制受体调节 T 细胞免疫理论中 "增强机体抵抗力(Fú Zhèng)"的风湿性关节炎治疗新视角
Pub Date : 2024-07-16 DOI: 10.1097/hm9.0000000000000125
Yifei Xu, Qianqian Liang, Hao Xu
Co-inhibitory receptors serve as crucial regulators of T-cell function, playing a pivotal role in modulating the delicate balance between immune tolerance and autoimmunity. Initially identified in autoimmune disease models, co-inhibitory receptors, including CTLA-4, PD-1, TIM-3, and TIGIT, were found to be integral for immune regulation. Their blockade or absence in these models resulted in the induction or exacerbation of autoimmune diseases. Additionally, scholars have observed that co-inhibitory receptors on lymphocytes hold the potential to influence the prognosis in the context of chronic inflammation. Consequently, the blocking of co-suppressor receptors has emerged as a novel therapeutic approach for inhibiting refractory inflammatory diseases, particularly rheumatoid arthritis. From the standpoint of traditional Chinese medicine (TCM), the treatment of rheumatoid arthritis based on the “strengthening body resistance (Fú Zhèng)” theory can be construed as the regulation of co-suppressor receptors to modulate the body's immune function in combating chronic inflammation. This article provides a succinct overview of the role of co-suppressor receptors in anti-inflammatory processes and explores the research prospects of co-suppressor receptor intervention in the treatment of rheumatoid arthritis. The exploration integrates the “strengthening body resistance (Fú Zhèng)” theory with relevant Chinese medicine formulations. Graphical abstract: http://links.lww.com/AHM/A128.
共抑制受体是 T 细胞功能的关键调节器,在调节免疫耐受和自身免疫之间的微妙平衡方面发挥着关键作用。包括 CTLA-4、PD-1、TIM-3 和 TIGIT 在内的协同抑制受体最初是在自身免疫疾病模型中被发现的,它们是免疫调节不可或缺的组成部分。在这些模型中,它们的阻断或缺失会导致自身免疫性疾病的诱发或加重。此外,学者们还发现,淋巴细胞上的协同抑制受体有可能影响慢性炎症的预后。因此,阻断共抑制受体已成为抑制难治性炎症疾病(尤其是类风湿性关节炎)的一种新型治疗方法。从传统中医的角度来看,基于 "扶正固本 "理论的类风湿关节炎治疗可理解为通过调节共抑制受体来调节机体的免疫功能,从而对抗慢性炎症。本文简要概述了共抑制受体在抗炎过程中的作用,并探讨了共抑制受体干预治疗类风湿性关节炎的研究前景。该探索将 "扶正固本 "理论与相关中药方剂相结合。图文摘要:http://links.lww.com/AHM/A128。
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引用次数: 0
The Role of Ginseng as an Anti-Asthmatic Agent 人参作为抗哮喘药的作用
Pub Date : 2024-07-15 DOI: 10.1097/hm9.0000000000000123
Kailynn J. Yang, Liana Y.A. Bautista, Danielle G. Iben, Dana H. Tran
Ginseng is one of the most commonly used herbal medicines in Asia owing to its anti-inflammatory, cognitive, and immune effects. Many of these properties can be attributed to the ginsenosides, major pharmacological agents of ginseng. Ginsenosides influence the innate and humoral immune responses, and previous studies have described ginsenosides as potential therapeutic agents for respiratory disorders. Asthma affects over 300 million people worldwide and is underdiagnosed and undertreated, despite the availability of diagnostic tools and therapies. This review summarizes current studies on ginseng as an anti-asthmatic agent in murine models. PubMed, EMBASE, and Cochrane databases were used to conduct a systematic search of published literature until March 29, 2023. Eight full-text articles that examined the association between ginseng and asthma were reviewed. The findings of this study demonstrate that Korean red ginseng, Korean white ginseng, and ginsenosides exert an anti-asthmatic effect, primarily through reduction in mucus cell hypersecretion, inflammatory cell infiltration, Th2 cytokines, and inhibition of inflammatory NFB and COX2 pathways. We suggest that ginseng has a therapeutic potential for the treatment of asthma. As this analysis utilized murine models, the anti-asthmatic effects of ginseng must be further supported by laboratory studies and clinical trials.
人参具有抗炎、认知和免疫作用,是亚洲最常用的草药之一。其中许多特性可归因于人参的主要药理成分--人参皂苷。人参皂苷影响先天性免疫反应和体液免疫反应,先前的研究已将人参皂苷描述为治疗呼吸系统疾病的潜在药物。哮喘影响着全球 3 亿多人,尽管有诊断工具和疗法,但诊断和治疗不足。本综述总结了目前有关人参在小鼠模型中作为抗哮喘药物的研究。 我们使用 PubMed、EMBASE 和 Cochrane 数据库对截至 2023 年 3 月 29 日已发表的文献进行了系统检索。共查阅了八篇研究人参与哮喘关系的全文。 研究结果表明,高丽红参、高丽白参和人参皂苷主要通过减少粘液细胞高分泌、炎症细胞浸润、Th2 细胞因子以及抑制炎症 NFB 和 COX2 通路发挥抗哮喘作用。 我们认为人参具有治疗哮喘的潜力。由于这项分析利用的是小鼠模型,人参的抗哮喘作用必须得到实验室研究和临床试验的进一步支持。
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引用次数: 0
Paeoniae Radix Alba effectively attenuates Polygonum multiflorum Thunb. -induced idiosyncratic liver injury by modulating M2 macrophage polarization 白芍通过调节 M2 巨噬细胞极化,有效减轻何首乌诱导的特发性肝损伤
Pub Date : 2024-05-24 DOI: 10.1097/hm9.0000000000000115
Ye Xiu, Zhixin Wu, Yichong Chen, Wenqing Mu, Xiaomei Zhao, Ming Dong, Yurong Li, Zhaofang Bai, Xiaohe Xiao
Polygonum multiflorum Thunb. (PM) is a commonly used tonic herb known to cause idiosyncratic drug-induced liver injury (IDILI). This study explored the detoxification effects and potential mechanisms of action of Paeoniae Radix Alba (PRA) on PM-induced IDILI. Network pharmacology analysis was utilized to predict the related targets of "PRA-PM-innate immunity.” A non-hepatotoxic lipopolysaccharide (LPS) and PM-induced IDILI model was used to evaluate the detoxification effects of PRA by measuring liver function indicators, pathological examinations, and macrophage-related factors. Bone marrow-derived macrophages (BMDMs) were stimulated with IL-4 to differentiate into M2 macrophages, and the effects of PM and PRA on M2 macrophage polarization were explored. Target screening of "PRA-PM-innate immunity" identified 21 intersecting targets, most of which were closely associated with macrophage polarization. In rat models of IDILI induced by PM, the combined use of PRA significantly reduced the extent of liver damage and the levels of inflammatory factors, while promoting the expression of M2 macrophage-related factors such as IL-4, IL-10, Arg1, and CD206. In vitro, PM dose-dependently inhibited the expression of the Arg1 protein and M2 macrophage-related genes, whereas PRA exhibited the opposite effect. When used in combination, PRA ameliorated the inhibitory effect of PM on M2 macrophage polarization. Our results demonstrate that PRA has a therapeutic effect on PM-induced IDILI; its mechanism may involve alleviating liver injury by promoting M2 macrophage polarization, thus reducing the expression of inflammatory factors.
何首乌(Polygonum multiflorum Thunb.,PM)是一种常用的滋补药材,已知会导致特异性药物性肝损伤(IDILI)。本研究探讨了白芍(PRA)对PM诱导的特发性药物性肝损伤(IDILI)的解毒作用和潜在作用机制。 研究利用网络药理学分析预测了 "PRA-PM-innate 免疫 "的相关靶点。采用非肝毒性脂多糖(LPS)和PM诱导的IDILI模型,通过测定肝功能指标、病理检查和巨噬细胞相关因子来评估PRA的解毒作用。用IL-4刺激骨髓源性巨噬细胞(BMDMs)分化为M2巨噬细胞,探讨PM和PRA对M2巨噬细胞极化的影响。 PRA-PM-鞘氨醇免疫 "的靶点筛选发现了21个交叉靶点,其中大部分与巨噬细胞极化密切相关。在PM诱导的大鼠IDILI模型中,联合使用PRA能显著降低肝损伤程度和炎症因子水平,同时促进IL-4、IL-10、Arg1和CD206等M2巨噬细胞相关因子的表达。在体外,PM 可剂量依赖性地抑制 Arg1 蛋白和 M2 巨噬细胞相关基因的表达,而 PRA 则表现出相反的效果。当联合使用时,PRA 可改善 PM 对 M2 巨噬细胞极化的抑制作用。 我们的研究结果表明,PRA 对 PM 诱导的 IDILI 有治疗作用;其机制可能是通过促进 M2 巨噬细胞极化来减轻肝损伤,从而减少炎症因子的表达。
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引用次数: 0
Dual effects of Psoraleae Fructus on the liver: hepatoprotection or hepatoxicity? 车前子果实对肝脏的双重作用:肝保护还是肝毒性?
Pub Date : 2024-05-24 DOI: 10.1097/hm9.0000000000000117
Qianhui Tang, Qinwei Yu, Bin Ni, Zhenzhou Jiang, Luyong Zhang
Psoraleae Fructus, the dried mature fruit of the leguminous plant Psoralea corylifolia L., contains flavonoids, coumarins, monoterpene phenols, and benzofurans. It exhibits various pharmacological activities, including immune regulation, antioxidant properties, photosensitivity, and estrogen-like effects, and finds extensive use in the clinical treatment of osteoporosis, vitiligo, and psoriasis. Extensive pharmacological research has demonstrated that Psoraleae Fructus and its components improve liver function and protect hepatocytes in animal and cellular models of liver diseases. Moreover, with the increasing clinical applications of Psoraleae Fructus and its derivatives, as well as the progression in adverse drug reaction surveillance, there is an increase in clinical cases involving these preparations and the enhancement of monitoring for any adverse reactions linked to Psoraleae Fructus and its related compounds. Here, we examined the hepatoprotective effects and hepatotoxicity of the monomer components, extracts, and related preparations of Psoraleae Fructus. We aim to contribute to safety evaluation, facilitate informed clinical application, and foster advancements in Psoraleae Fructus and its derivatives.
Psoraleae Fructus 是豆科植物 Psoralea corylifolia L. 的干燥成熟果实,含有黄酮类、香豆素、单萜酚和苯并呋喃。它具有多种药理活性,包括免疫调节、抗氧化性、光敏性和雌激素样作用,被广泛用于骨质疏松症、白癜风和牛皮癣的临床治疗。广泛的药理研究表明,在肝脏疾病的动物模型和细胞模型中,车前子及其成分能改善肝功能,保护肝细胞。此外,随着车前子及其衍生物临床应用的不断增加,以及药物不良反应监测工作的不断推进,涉及这些制剂的临床病例也在不断增加,同时也加强了对车前子及其相关化合物不良反应的监测。在此,我们研究了车前子单体成分、提取物和相关制剂的保肝作用和肝毒性。我们的目标是为安全性评估做出贡献,促进知情临床应用,并推动车前子及其衍生物的发展。
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引用次数: 0
Safety evaluation of traditional Chinese medicine: New era, new strategy 传统中药的安全性评价:新时代,新战略
Pub Date : 2024-05-24 DOI: 10.1097/hm9.0000000000000119
Zhao Xu, Zhao-fang Bai, Xiao-yan Zhan, Jia‐bo Wang, Cheng Yung-chi, Xiao-he Xiao
Today, as the use of traditional Chinese medicine (TCM) becomes increasingly widespread globally, TCM is confronted with numerous new safety issues and challenges. In particular, the frequent emergence of safety issues/events such as liver and kidney injury associated with traditionally “non-toxic” TCMs has overturned the traditional understanding of the toxicity and safety of TCM. This has also posed significant challenges to the development and internationalization of TCM. So, how should we understand the situation and problems of TCM safety? How can we scientifically solve the problems in evaluation and risk control of TCM? Our team proposes the following: First, we must keep pace with the times and view the issues of TCM safety in a dialectical manner, without exaggeration or underestimation. Second, we must break through the traditional perception that toxicity only came from the medicine itself, and innovate the theories of TCM toxicity. Third, we must establish precise prevention and control strategies for TCM with different types of toxicity, promoting a shift in the management of TCM safety risks from passive response to scientific and proactive control. On this basis, we have put forward the concept and methodological system of the “New Outlook on TCM Safety”, hoping to provide new theories, strategies, methods, and successful examples for systematically solving the problems in the evaluation and risk control of TCM.
如今,随着传统中药在全球范围内的使用日益广泛,中药也面临着许多新的安全问题和挑战。尤其是传统 "无毒 "中药频繁出现肝肾损伤等安全问题/事件,颠覆了人们对中药毒性和安全性的传统认识。这也给中药的发展和国际化带来了巨大挑战。那么,我们应该如何认识中药安全的现状和问题?如何科学解决中药评价和风险控制中存在的问题?我们团队提出以下几点建议:一是要与时俱进,辩证地看待中药安全问题,不夸大也不低估。二是要突破 "毒性只来自药物本身 "的传统认知,创新中药毒性理论。三是要针对不同毒性类型的中药,建立精准防控策略,推动中药安全风险管理从被动应对向科学防控、主动控制转变。在此基础上,我们提出了 "中药安全新观 "的理念和方法体系,希望为系统解决中药评价和风险控制中的问题提供新的理论、策略、方法和成功范例。
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引用次数: 0
Research progress on the toxicity of Asari Radix et Rhizoma 麻黄毒性的研究进展
Pub Date : 2024-05-24 DOI: 10.1097/hm9.0000000000000114
Xin Li, Ranyun Chen, Shuni Duan, Yijie Li, Huiping Zhou, Runping Liu, Rong Sun
Asari Radix et Rhizoma (ARR), also known as Xixin, has been broadly used as a traditional herbal medicine in East Asia and is an important component of classic prescriptions, including mahuang fuzi xixin decoction. It was initially classified as a “top grade” herb in ancient Chinese Pharmacopeia, Shennong’s Materia Medica. Volatile oils, lignans, fatty acids, flavonoids, and nitrogen-containing compounds are the main ARR components. Previous pharmacological studies have shown that ARR exerts beneficial effects in humans for treating headaches, toothaches, and several inflammatory diseases by dispelling wind and cold, alleviating pain, and eliminating phlegm. However, “the dosage of ARR should not exceed one coin (approximately 3.75 grams)”, as stated in Shizhen Li’s Compendium of Materia, emphasized the considerable ARR toxicity and significantly constrained its clinical application. This review aimed to consolidate recent advancements in the understanding of the toxic ARR components. Additionally, we provide an overview of the hepatotoxicity, genotoxicity, neurotoxicity, and pulmonary toxicity of ARR and discuss the underlying molecular mechanisms. This study reviews the limitations of current studies and enhances our understanding of the toxic effects of ARR from the perspective of its toxic components and mechanisms, thereby providing a theoretical basis for the rational clinical practice of ARR-based medications.
Asari Radix et Rhizoma(ARR),又名西新,在东亚被广泛用作传统草药,是麻黄附子西新煎等经典处方的重要组成部分。中国古代药典《神农本草经》最初将其列为 "上品 "药材。挥发油、木脂素、脂肪酸、黄酮类和含氮化合物是 ARR 的主要成分。以往的药理研究表明,ARR 具有祛风散寒、止痛化痰的功效,可用于治疗头痛、牙痛和多种炎症。然而,《李时珍本草纲目》中记载的 "阿胶用量不可过一钱(约 3.75 克)",强调了阿胶的毒性较大,极大地限制了其临床应用。本综述旨在总结近年来在了解 ARR 毒性成分方面取得的进展。此外,我们还概述了 ARR 的肝毒性、遗传毒性、神经毒性和肺毒性,并讨论了其潜在的分子机制。本研究回顾了当前研究的局限性,从毒性成分和机制的角度加深了我们对 ARR 毒性作用的理解,从而为基于 ARR 的药物的合理临床实践提供了理论依据。
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引用次数: 0
Guidelines for safe use of Polygoni Multiflori Radix 何首乌安全使用指南
Pub Date : 2024-05-21 DOI: 10.1097/hm9.0000000000000113
Xiaohe Xiao, Jiabo Wang, Haibo Song, Dongsheng Ouyang, Zhengsheng Zou, Ruilin Wang, Tingting He, Jing Jing, Yuming Guo, Zhaofang Bai, Xiaoyan Zhan, Ming Niu, Zhijie Ma, Chunyu Li
Polygoni Multiflori Radix is a Chinese medicine widely used in clinical treatment and preventive healthcare. However, recently there have been frequent reports of liver injury caused by Polygoni Multiflori Radix and its related preparations, and some patients have serious adverse outcomes, attracting wide attention worldwide. The risk of liver damage caused by preparations containing Polygoni Multiflori Radix or Polygoni Multiflori Caulis has been repeatedly reported by the Chinese Food and Drug Administration. Fortunately, substantial progress has recently been made in revealing the basic properties, main causes, material basis, and molecular mechanism of Polygoni Multiflori Radix-related liver injury. The basic characteristics and biomarkers of susceptible people have been identified, indicating that Polygoni Multiflori Radix has the risk of inducing liver injury only in a few specific populations and is safe for most populations. This study provides a scientific basis for a correct and objective understanding of liver injury caused by Polygoni Multiflori Radix, and a reasonable formulation of safe medication measures for Polygoni Multiflori Radix and related preparations. The China Association of Chinese Medicine organized experts in relevant fields across the country to draft and formulate the “Guidelines for Safe Use of Polygoni Multiflori Radix,” with the aim of helping the public and relevant institutions at home and abroad to scientifically understand, evaluate, and avoid the risk of liver injury; guide the rational use; protect the health rights and interests of consumers; and promote the healthy and sustainable development of Polygoni Multiflori Radix and related preparations. These guidelines were issued by the China Association of Chinese Medicine (No.T/CACM 1328-2019).
何首乌是一种广泛应用于临床治疗和预防保健的中药。然而,近来有关何首乌及其相关制剂导致肝损伤的报道屡见报端,部分患者出现了严重的不良后果,引起了世界各国的广泛关注。含有何首乌或何首乌的制剂引起肝损伤的风险已多次被中国食品药品监督管理局通报。所幸的是,近年来在揭示何首乌相关肝损伤的基本性质、主要原因、物质基础和分子机制方面取得了实质性进展。目前已确定易感人群的基本特征和生物标志物,表明何首乌仅对少数特定人群有诱发肝损伤的风险,对大多数人群是安全的。该研究为正确客观认识何首乌引起的肝损伤,合理制定何首乌及相关制剂的安全用药措施提供了科学依据。中国中药协会组织全国相关领域专家起草制定了《何首乌安全用药指导原则》,旨在帮助公众和国内外相关机构科学认识、评估和规避肝损伤风险,指导合理用药,保护消费者健康权益,促进何首乌及相关制剂的健康可持续发展。本指南由中国中药协会发布(编号:T/CACM 1328-2019)。
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引用次数: 0
The Correlation between Chemical Ingredients and Acute Toxicity of Psoraleae Fructus and Two Classic Prescriptions 车前子和两种经典药方的化学成分与急性毒性的相关性
Pub Date : 2024-05-20 DOI: 10.1097/hm9.0000000000000112
Zhuo Shi, Jin-chao Pan, Cheng Zhang, Jia-lu Cui, Xiang-jun Wu, Fang-yang Li, Mao-xing Li, Cheng-rong Xiao, Zengchun Ma, Yuguang Wang, Yue Gao
To compare the acute toxicity and chemical ingredients of Psoraleae Fructus (PF) with those of two classic prescriptions, Ershen Wan (ESW) and Sishen Wan (SSW). Based on classical toxicological methods, body weight, food and water consumption, lethal conditions, and toxic reactions were recorded after administering single oral doses of PF, ESW, and SSW. The 50% lethal dose (LD50) values of PF and ESW and the maximum tolerance dose (MTD) of SSW were determined. In addition, PF, ESW, and SSW constituents were detected using ultra-high-performance liquid chromatography/mass spectrometry (UPLC-MS), and the spectrum-toxicity correlation was analyzed. The LD50 of PF and ESW were 53.9 g/kg/d (46.2–63.0 g/kg/d, 95% CL) and 68.3 g/kg/d (59.0–78.9 g/kg/d, 95% CL), which were respectively about 40 times and 50 times of the human daily dosage. The MTD of SSW was 41.0 g/kg/d, indicating the highest safety. The chemical ingredients and toxicity correlation analyses inferred that compatibility reduced the contents of 13 potential hepatotoxin compounds in PF. The classic compatibility of ESW and SSW effectively attenuated the hepatotoxicity of PF, which was related to the reduced content of potentially toxic substances, particularly coumarins. This study explored the principles of attenuating the toxicity of classic prescriptions to provide a reference for the rational clinical use of PF.
目的:比较车前子(Psoraleae Fructus,PF)与二神丸(Ershen Wan,ESW)和四神丸(Sishen Wan,SSW)两种经典方剂的急性毒性和化学成分。 根据经典毒理学方法,记录了单次口服 PF、ESW 和 SSW 后的体重、食物和水消耗量、致死条件和毒性反应。测定了 PF 和 ESW 的 50% 致死剂量 (LD50) 值以及 SSW 的最大耐受剂量 (MTD)。此外,还使用超高效液相色谱/质谱法(UPLC-MS)检测了 PF、ESW 和 SSW 的成分,并分析了光谱与毒性的相关性。 PF和ESW的半数致死剂量分别为53.9克/千克/天(46.2-63.0克/千克/天,95%CL)和68.3克/千克/天(59.0-78.9克/千克/天,95%CL),分别约为人体日剂量的40倍和50倍。SSW 的 MTD 为 41.0 克/千克/天,安全性最高。化学成分和毒性相关性分析表明,相容性降低了 PF 中 13 种潜在肝毒素化合物的含量。 ESW 和 SSW 的经典兼容性有效地减轻了 PF 的肝毒性,这与潜在毒性物质,尤其是香豆素的含量降低有关。本研究探讨了经典处方的毒性减弱原理,为临床合理使用 PF 提供了参考。
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引用次数: 0
Regulation and application of Chinese herbs in the US—Misuse is the main cause of toxic incidents 美国对中草药的监管和应用--误用是造成中毒事件的主要原因
Pub Date : 2024-05-14 DOI: 10.1097/hm9.0000000000000110
Willow JH Liu
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引用次数: 0
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Acupuncture and herbal medicine
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