Most compounds in blood are blocked from flowing into brain by blood-brain barrier(BBB) to keep central nerve system normal, but this barrier will be open in different diseases with different mechanisms. As these mechanisms are understood more and more clearly, it will do help to protect blood-brain barrier and treat diseases which are correlative to blood-brain barrier. At the same time, it may also be helpful to let drugs entering central nerve system through BBB.

[Objective] Systematic review was carried out in quality analysis of literature of Shuang Huanglian Injection (SHI) for acute respiratoiy infections ( ARI) . [Methods] Database was set up according to the principles of clinical epidemiology and evidence-based medicine and the evaluation scale for ARI. The data was managed by descriptive analysis and uniformity test. [Results] In 49 clinical reports, 42.16% adopted the randomized and controlled method but the quality was not so good; the criteria of inclusion and exclusion was absent or not standardized in most of the reports; blinded method was adopted scarcely; drop-out and missed cases were rarely mentioned while adverse effects were reported usually. [Conclusion] The design of clinical study of SHI for ARI has been improved in recent years but there is still a lot of inadequany.

Objective To assess the effectiveness of the Chinese herbal formula Tongxie Yaofang(TY) or its modified prescriptions in the management of irritable bowl syndrome(IBS).Methods A systematic review was carried out according to the Cochrane standards.A computerized literature search was carried out in main Chinese and English databases including CNKI,CBMdisc,Database of Chinese Doctorate Dissertation,Database of excellent Chinese Master Dissertation,MEDLINE and Cochrane Library.Studies were retrieved when they were randomized controlled trials(RCTs) whose interventions for IBS patients were TY or modified prescriptions of TY with placebos or conventional medicine as controls.Outcome measurement included the alleviation of main symptoms such as abdominal pain,diarrhea frequency,and(or) comprehensive effectiveness and quality of life(QOL).Meta-analysis was performed after evaluating the quality of included studies.Subgroup analysis was done between subgroups of diarrhea-predominant IBS and subtype-regardless IBS,and was also done between diarrhea-predominant IBS treated with TCM syndrome differentiation and that without TCM syndrome differentiation.Funnel plot analysis was used to analyze the publication bias.Results Forty-six studies met the inclusion criteria,and 4155 participants were included in the meta-analysis.The results showed that the effectiveness of TY or modified prescriptions of TY was better than that of conventional medicine or placebos[OR= 5.30,95%CI(4.38,6.41)].Subgroup analysis showed that the OR of TY or modified prescriptions of TY in the diarrhea-predominant groups[OR=5.61,95%CI(4.33,7.25)]was higher than that of subtype-regardless groups[OR=4.95,95%CI(3.74,6.55)],and OR of TY or modified prescriptions of TY in the studies of diarrhea-predominant IBS treated based on TCM syndrome differentiation [OR=6.50,95%CI(3.78,11.20)] was higher than that of the studies without TCM syndrome differentiation[OR=5.37,95%CI(4.01,7.19)],but the difference was insignificant.Funnel plot showed certain publication bias.Conclusion The effectiveness of TY or modified prescriptions of TY for IBS patients is better than that of western medicine and placebo.But their effectiveness for diarrhea-predominant IBS or with TCM syndrome differentiation was not proved to be better than those for other subtypes or without TCM syndrome differentiation.Biases may exist for overall quality of the studies is low;negative results in some high quality studies need further discussion.

Objective To obtain the effective characteristic information for the standardization of diagnosis of traditional Chinese medical(TCM) syndrome in rheumatoid arthritis(RA).Methods Fifty-four items of symptoms and signs in RA patients were input into the computer,and Mahalanobis distance discriminant analysis(DDA) was used for the selection of effective indexes.Results According to the weight value and the result of T test,17 items from 54 had the highest rate of discrimination accuracy,up to 96.5%.Conclusion The results of computerized pattern recognition for the syndrome diagnosis of RA are consistent with the clinical diagnosis,which indicates that computerized pattern recognition can be used for the standardization of syndrome diagnosis of RA.

OBJECTIVE: To test the reliability and validity of Health Scale of Traditional Chinese Medicine (HSTCM) by means of questionnaires. METHODS: A cross-sectional survey was conducted at Liwan Community of Guangzhou, Old People's Home in Guangzhou and Outpatient Department of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine. A total of 652 Chinese individuals (over 18 years old) were assessed with the 88-item version of HSTCM and World Health Organization Quality of Life Measure-Abbreviated Version (WHOQOL-BREF), which were randomly delivered to them. Some socioeconomic characteristics were registered. RESULTS: A test-retest reliability (15-day interval) was found among the 76 persons who completed the questionnaires by themselves. Intra-class correlation coefficient (ICC) was 0.93. Associated 95% confidence interval (CI) was 0.89-0.96. Split-half reliability was 0.79. Inter-investigator reliability (0.93) was also good, and the ICC of HSTCM was 0.90 (95%CI 0.67-0.97). The correlation between HSTCM and WHOQOL-BREF was -0.66. The correlations of HSTCM and questionnaire deliver order, investigator, interview date and interview time were 0.06, -0.12, -0.17 and 0.20 respectively. The correlation between HSTCM and self-rated health (0.46) was greater than that between HSTCM and chronic illness (0.28). Divided by individuals with or without chronic illness, area under the ROC (receiver operator characteristic) curve for HSTCM was 0.67 (95%CI 0.63-0.71). CONCLUSION: It indicates that the HSTCM is conceptually valid with satisfactory psychometric properties and forms a basis for further applications in clinical research of traditional or integrative medicine.

At present,intranasal delivery has entered clinical trial stage.In recent years,how to imroving the efficiency of intranasal delivery has been extensively investigated.This article briefly reviews some factors that impact the targeting of intranasal delivery and the drug concentration in the central nervous system.

Objective To evaluate the efficacy and safety ofGuipi Decoction vs. antidepressants for depression. Methods Articles about the randomized controlled trials (RCTs) ofGuipi Decoction for depression were searched in the databases of CNKI, VIP, Wanfang Data, CMB, Embase, PubMed, and Cochrane Library. Two researchers independently screened the articles, extracted the data, and evaluated the methodological quality. Meta-analyses were performed by using RevMan 5.2 software.Results A total of 9 RCTs articles involving 893 cases were included. Meta-analysis results suggested that as compared with antidepressants only,Guipi Decoction together with antidepressants was associated with a significantly greater reduction in HAMD scores (MD=-4.63, 95%CI [-5.95, -3.32];P<0.001). There was no significant difference in HAMD scores betweenGuipi Decoction used alone and antidepressants (MD=-0.30, 95%CI [-4.22, 3.62];P=0.88). As compared with antidepressants,Guipi Decoction together with antidepressants increased in the rates of total effective events (RR=1.26, 95%CI [1.14, 1.38];P<0.001). No serious adverse reactions were reported. Meta-analysis results suggested that the incidence of adverse reactions of Guipi Decoction(RR=0.48, 95%CI [0.40, 0.58];P<0.001) andGuipi Decoction together with antidepressants (RR=0.51, 95%CI [0.30, 0.85];P=0.010) were lower than that of antidepressants alone.Conclusion The present evidence suggests thatGuipi Decoction is effective and relatively safe for patients with depression. However, because the quality of included research was low, more large-scale RCTs with multicenter and high quality are needed for further verification.

Evaluation Studies as Topic ; Humans ; Medicine, Chinese Traditional ; Publishing ; standards ; Quality Control ; Randomized Controlled Trials as Topic ; standards

Objective To investigate the risk factors for early neurological deterioration (END) in patients with acute middle cerebral artery infarction.Methods From January 2009 to December 2012,81 patients with acute middle cerebral artery infarction completed cerebral angiography admitted to the Department of Neurology,Nanjing General Hospital of Nanjing Military Command were enrolled retrospectively.END was defined as that the National Institutes of Health Stroke Scale (NIHSS) score increased ≥2 or the motor score increased ≥ 1 with in 72 h after admission compared with the baseline score on admission.All the patients were divided into either an END group (26 cases) or a non-END group (55 cases) according to whether the occurrence of END.Univariate factor analysis was used to analyze the differences of the clinical data between the two groups.The grade standard of collateral circulation was assessment with the collateral circulation assessment system of the American Society of Interventional and Therapeutic Neuroradiology/Sociey of Interventional Radiology.Multivariable Logistic regression analysis was used to analyze the risk factors for END after acute middle cerebral artery infarction.Results Compared with the patients in the non-END group,the proportions of age 60 years (65.4％ [17/26] vs.36.4％ [20/55];x2 =5.992,P =0.014),high-sensitivity C-reactive protein level ≥4.0 mg/L (76.9％ [20/26] vs.45.5％ [25/55];x2 =7.080,P =0.008) and diabetes (38.5％ [10/26] vs.16.4％ [9/55],x2 =4.802,P =0.028) in the END group were increased significantly,while the collateral circulation grade was decreased significantly (Z =-3.253,P ＜ 0.01).Multivariable Logistic regression analysis showed that the age ≥60 years (OR,3.412,95 ％ CI 1.075-10.824;P =0.037),high-sensitivity C-reactive protein level ≥ 4.0 mg/L (OR,3.812,95％ CI 1.141-12.740;P =0.030),and collateral circulation grade (OR,2.165,95％ CI 1.241-5.514;P =0.009) were the independent risk factor for END in acute middle cerebral artery infarction.Conclusion The decreased collateral circulation level,age ≥ 60 years and high-sensitivity C-reactive protein≥4.0 mg/L were the independent risk factors for occurring END in acute middle cerebral artery infarction.

Objective To investigate the awareness of osteoporosis and its influential factors in middle-aged and older people. Methods By using self-designed questionnaire, 354 middle-aged and old people were investigated as to their awarness of osteoporosis in Chajiao street community in Guangzhou. Among them, 58 people were measured the bone density in the calcaneal bone by Ultrasound. Results The average score of the questionnaire was 9.46 ± 5.13, and the accuracy was 39.4%. In the diagnosis and treatment, the accuracy was just 17.8%. The diet (the accuracy in 54%) and sport (the accuracy in 50.3%) were good. The statistical analyses showed the linear relationship between the T value of bone density and the age (P = 0.021), between the T value and the score (P = 0.047). Wilcoxon rank sum test found that the T value between female and male was significantly different (Z = -3.749, P < 0.000). With multiple linear regression analysis, the T value had a linear correlation with the score (F = 4.224, P = 0.045) positively. Conclusions Currently, the awareness of osteoporosis in the middle-aged and old people was inadequate. To better prevent osteoporosis, the propogation of knowledge and guidance provided by clinicians in osteoporosis should be improved necessarily and emergently.