Objective To systematically evaluate the efficacy of alendronate on the primary and secondary preventions of osteoporotic fractures in postmenopausal women.Methods Literatures and related references were searched from MEDLINE (from 1966 to April 2011),Embase (from 1966to April 2011),Cochrane Library (the second Issue,2011),CBM disc,CNKI,WANFANG and VIP database by Cochrane systematical evaluation.All related randomized controlled trials were collected,and Meta analysis was performed by RevMan 5.0 soft ware provided by Cochrane collaboration.Results Totally 11 randomized controlled trials were evaluated.Meta-analysis showed that 10 mg oral alendronate daily for secondary prevention could reduce the incidence of spine,hip,wrist and non vertebra fractures (RR 0.57,95％ CI:0.49-0.67),but for the primary prevention,alendronate could not reduce the fracture incidence except for spine fracture (RR=0.55,95％CI:0.38-0.80).Adverse events associated with alendronate were not increased,and the sensitivity analysis results were not changed (RR =0.95,95％ CI:0.83-1.09).Conclusions Alendronate can reduce osteoporotic fractures in postmenopausal women for the secondary prevention,but the effect of alendronate on osteoporotic fractures for the primary prevention needs further study.

OBJECTIVETo investigate the role ofCD4+CD25+ T regulatory (Treg) cells, T helper (Th)17cells and interleukin (IL)-6 in the progression of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) and determine their value as prognostic markers.

METHODSThe Chinese National Knowledge Infrastructure (CNKI), WanFang, Chinese Scientific Journals (VIP), PubMed, Embase and Web of Science databases were searched for English language case-control studies on the relationship between regulatory T lymphocytes and ACLF.The quality of included studies was assessed using the Newcastle-Ottawa scale. The meta-analysis was designed according to the PICOS approach recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. RevMan software, version 5.1, was used to perform the meta-analysis.

RESULTSNine case-cohort studies were selected for inclusion in the metaanalysis.The results of the meta-analyses showed that the level of CD4+CD25+ Treg cells was not significantly different between patients with HBV-related ACLF and patients with chronic hepatitis B (CHB) (mean difference (MD)=0.59, 95% confidence interval (CI)-1.68, 2.85, P=0.61) nor between patients with HBVrelated ACLF and healthy controls (MD=1.12, 95% CI:-1.42, 3.66, P=0.39). Thus, it appears that ACLF patients do not have a higher level of CD4+CD25+ Treg cells than CHB patients or healthy controls. However, the ACLF patients did appear to have a significantly higher level of Th17 cells than both the CHB patients (MD=1.73, 95% CI:0.21, 3.26, P=0.03) and the healthy controls (MD=1.62, 95% CI:(0.52, 2.72, P=0.004). In addition, the ACLF patients also had significantly higher level than both the CHB patients (MD=11.69, 95%CI:1.98, 21.40, P=0.02) and the healthy controls (MD=13.17, 95% CI:1.38, 24.95, P=0.03).

CONCLUSIONCD4+CD25+ Treg cells may be an important protective factor in the progression and prognosis of HBV-related ACLF, while Thl7 cells and IL-6 may be risk factors for further progression and worsened prognosis.

Acute-On-Chronic Liver Failure ; diagnosis ; immunology ; CD8-Positive T-Lymphocytes ; Case-Control Studies ; Disease Progression ; Hepatitis B virus ; Hepatitis B, Chronic ; complications ; Humans ; Interleukin-6 ; immunology ; Prognosis ; T-Lymphocytes, Regulatory ; immunology ; Th17 Cells ; immunology

The hidden risk of acupuncture has become the factor of the high incidence of adverse reaction of acupuncture in clinical practice. The retrospective analysis and the typical cases analysis are especially important for the prevention from the hidden risk of acupuncture. In the paper, the relevant literatures were reviewed, the basic diseases were listed such as diabetes, hypertension and digestive gastric ulcer that were neglected by the physicians, and the adverse reactions induced by the therapeutic history and the body constitutions were analyzed. It was stated in the paper that because of the individual factors of patient, the risks of the atypical clinical accidents of acupuncture were extremely serious and easily neglected by the clinical acupuncture physicians. It is very necessary to remind the clinical acupuncture physicians to understand the basic diseases, basic treatment as well as the peculiarity of body constitution of the patients besides their chief complaints. Moreover, acupuncture should be applied very carefully after identifying the pulse condition and the contraindication so as to ensure the patient's safety and obtain the optimal efficacy.
Accidents ; Acupuncture Therapy ; Contraindications ; Humans ; Retrospective Studies

Fusidic acid is the only fusidane-type antibiotic that has been clinically used. However, biosynthesis of this important molecule in fungi is poorly understood. We have recently elucidated the biosynthesis of fusidane-type antibiotic helvolic acid, which provides us with clues to identify a possible gene cluster for fusidic acid ( cluster). This gene cluster consists of eight genes, among which six are conserved in the helvolic acid gene cluster except and . Introduction of the two genes into the NSAR1 expressing the conserved six genes led to the production of fusidic acid. A stepwise introduction of and revealed that the two genes worked independently without a strict reaction order. Notably, we identified two short-chain dehydrogenase/reductase genes and in the cluster, which showed converse stereoselectivity in 3-ketoreduction. This is the first report on the biosynthesis and heterologous expression of fusidic acid.

Fusidane-type antibiotics, represented by helvolic acid, fusidic acid and cephalosporin P