Plasma fibronectin (PFn) was determined serially by both simple radial immunodiffusion (RID) and improved indirect hemoagglutination test (using gelatin-coated sheep RBC) in the serum of 30 patients with severe viral hepatitis (SVH),100 normal subjects,and 30 patients with chronic active hepatitis (CAH).Liver function,serum C3 and immunoglobulin (Ig) were determined simultaneously.Endotoxin was assayed by Limulus lysate test in 21 patients with SVH.The normal value of PFn was 284.31?45.56?g/ml and 1:30.64 (geometrical mean).The PFn level significantly decreased in patients with SVH.Significant correlations were found between PFn levels and the values of total serum bilirubin,prothrombin time,C3 and IgM.Low PFn levels were remarkably associated with the occurrence of endotoxeamia.Serial determinations of PFn in serum can reflect the severity of the illness and prognosis in the patients with SVH.

The key point to define the psychological problem in children is the grasp of degree,also,the key point to educate children is the grasp of degree.Are there some principles to clarify the degree? How to quantify the degree? This paper brought forward the gold zone method of psychological guidance in children and adolescents and defined its quantitive expression as golden section.The gold zone method can grasp the scale set according to the goal,form the proper consumption value,control the interpersonal intimacy,cultivate fine thinking and behavioral pattern,and give appropriate guidance to many basic problems about children's growth.

In 21st century, clinical medicine moves toward a model of individualized health care. The development of the individualized model is based on the research findings of human genomics project including genotype and single nucleotide polymorphisms (SNPs), as well as the new health care model, that is, biological-psychological-social-environmental-spiritual. It reflects the idea of patient-centered care, and corresponds to the traditional practice of Chinese medicine, which addressed the individualized therapy on the basis of symptom pattern differentiation. However, the era of evidence-based medicine affords new meanings of individualized health care and promotes the research on the practice. The practice based on evidence would happen upon the integration of external research evidence, the expertise and experience of practitioners, and the value and preference of patients, so the decision of health care will be conscientious, explicit and judicious. This assay describes the meanings of individualized health care in different medical contexts, the characteristics of individualized practice in Chinese medicine, and proposals for further research in practice.

Cohort study is graded as level II in evidence grading system of evidence-based medicine, secondary to randomized controlled trial. It is one of the important evidence for the evaluation of health care interventions, and it has been applied recently in the evaluation of traditional medicine. The author of the article introduces the basic concept, principle, design, and implementation as well as relevant methodological issues when applied in traditional Chinese medicine.

The quality of clinical trials in traditional Chinese medicine (TCM) was analyzed with respect to their methodology and outcome assessment according to the concepts of evidence-based medicine (EBM). It was suggested that the essential methodological principles of EBM should be applied in clinical trials of TCM, including randomization, control and blindness. The sample size estimation, optimal parameter selection for outcome assessment, compliance and intention-to-treat analysis are all important aspects of randomized controlled trials. To bring the benefits of EBM into clinical trials will improve the quality of research in TCM and also promote international co-operation and communications. It is necessary to establish an assessment system of clinical outcome for TCM on the basis of EBM in order to evaluate the efficacy and safety of TCM objectively and scientifically.

Objective Inaccurate dosing is an important cause of medical malpractice, how to adjust the medication dose to overcome the excessive deviation will be discussed in this paper. Methods Gold zone method was proposed on the basis of the probability theory and mathematical statistics for handling inaccurate dosing problems. Investigation and study in large sample size was carried out on adverse reactions of Cefamandole Nafate for Injection by adopting the method. Results The conclusions from the super large sample size test indicate that there is highly significant difference of total adverse reaction rates between taking values within and outside golden zone of dosage, and the adverse reaction rate of taking values within golden zone is significantly lower than that of outside golden zone. It is noteworthy that when dosage was lower than golden zone,the adverse reaction rate was significantly increased,which is more than 4 times of that within golden zone. Conclusion It is effective measures and simply and easy to apply that taking values within golden zone of dosage reduce adverse drug reactions,probability within golden zone less than 1/4 range of experience that contains the actual demand of the body up to 70%.

A systematic review is based on randomized controlled trials (RCTs), and the reliability of its conclusion is closely related to the quality of original literature. The low quality of existing RCTs in China leads to the failure of conclusive findings in systematic reviews when evaluating the effectiveness of interventions. It is almost universal for systematic reviews to draw the conclusion that "further well-designed multicenter and large-scale RCTs are still required to confirm the beneficial effects of interventions". This paper analyzed the current status of RCTs in China, discussed the influence of including trials of low quality in a systematic review and assessed how a systematic review should be carried out under such circumstances. Furthermore, the methods to evaluate the quality of RCTs were introduced and evaluated. Finally, several strategies were proposed to improve the quality of RCTs in China: foster an honest academic and social environment, enhance the training of doctors on clinical research methodology, promote the implementation of clinical registration systems and strengthen the quality control of clinical research and the medical journals regulations on the quality of submitted papers.

OBJECTIVE:To establish a method for the simultaneous determination of paeoniflorin and ferulic acid in Naoxuesh-uan pill. METHODS:HPLC was performed on the column of Waters SunfireTM C18 with mobile phase of acetonitrile-water-glacial acetic acid(17:82:1,V/V/V)at a flow rate of 1.0 ml/min,detection wavelength was 230 nm,column temperature was 35 ℃,and the volume injection was 20 μl. RESULTS:The linear range was 0.024-0.240 mg/ml for paeoniflorin(r=0.999 9)and 0.009 4-0.141 0 mg/ml(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2%;recoveries were 95.00-97.90%(RSD=0.59%,n=6) and 95.29-98.24%(RSD=0.54%,n=6),respectively. CONCLUSIONS:The method is simple and repro-ducible,and can be used for the quality control of Naoxueshuan pill.

Objectives: To study the correlation between the dynamic expression of aquaporin-4 (AQP-4) around hematoma and the blood-brain barrier permeability after intracerebral hemorrhage in rats. Methods: Forty-two Sprague-Dawley rats were randomly allocated into sham-operation group, and groups of 6 hours, 12 hours, 1, 3, 7 and 14 days (n=6 in each group) after intracerebral hemorrhage. The intracerebral hemorrhage model in rats was established by injecting autologous arterial blood into caudate nucleus. Immunohistochemical method and Evans blue method were used respectively to detect the dynamic changes of AQP-4 around hematoma and the blood-brain barrier permeability in different time periods after intracerebral hemorrhage in rats. Results: (1) The expression of AQP-4 around hematoma increased gradually 12 hours after intracerebral hemorrhage, it increased significantly at day 1 and reached a maximum at day 3. It was slightly higher than normal level at day 7 and almost returned to normal at day 14 (P

Cohort study also named follow up study,has been used in clinical trials of traditional Chinese medicine(TCM),such as prognostic evaluation and therapeutic effect evaluation.Therefore follow up is an important step in a cohort study,and follow up quality will directly affect the statistical analysis and drawing a conclusion.This article introduced the aim,the content,the method and duration of follow up,we also discussed the relevant issues when conducting a follow up and the methods to deel with problems.We hope this article can be helpful to researchers of TCM.