Since the prevalence of nonalcoholic fatty liver disease (NAFLD)has been rising in recent years,more and more attention is be-ing paid to clinical trials of traditional Chinese medicine (TCM)treatment,which is one of the main methods for treating NAFLD.According to the reported clinical trials,consensus needs to be reached on such key points as syndrome selectivity,diagnostic criteria for disease,con-trol of behavior intervention,and establishment of outcome assessment indices.Considering the recent research progress in the world,these issues are reviewed,in order to provide better measures and suggestions for improving the quality of clinical trials of TCM treatment of NAFLD.

OBJECTIVE: To study the effect of Qinggan Huoxue Recipe on alcoholic liver disease(ALD). Methods Effects were observed of Qinggan Huoxue Recipe on the symptoms, physical signs, liver function, blood lipid, markers of liver fibrosis, cytokine and ultrasonogram of ALD patients; the control groups were treated with Xiao Chaihu Decoction or general supportive treatment. RESULTS: The effects of Qinggan Huoxue Recipe were better than that of the other treatments on anorexia, nausea, vomiting, jaundice, ALT, AST and TG; the effects of Qinggan Huoxue Recipe on GGT and VLDL were better than that of the general supportive treatment. Qinggan Huoxue Recipe could decrease the level of cytokines and markers of liver fibrosis, its total effective rate was better than that of Xiao Chaihu Decoction and general supportive treatment. CONCLUSION: Qinggan Huoxue Recipe could prevent and cure ALD markedly, its mechanism might be: resisting lipid peroxidation, stabilizing the membrane of the hepatocytes, rectifying the disturbance of liver lipid metabolism, adjusting the immune function, anti-fibrosis, and promoting the metabolism of ethanol in the liver.

Insulin resistance exists in various chronic liver diseases such as fatty liver disease, liver cirrhosis, hepatitis, etc. Insulin resistance not only participates in the development of chronic liver diseases but also affects the efficacy of drug treatment. Paying more attention to diagnosis and treatment of insulin resistance will enhance the therapeutic effect and improve the prognosis of the patients. Traditional Chinese medicine has displayed its characteristics and advantage in treating insulin resistance. Investigation to chronic liver diseases based on lifestyle interference, exploration of the syndrome mechanism of insulin resistance, and scientific evaluation of the efficacy of Chinese herbal prescriptions will contribute to the research of traditional Chinese medicine in preventing and treating insulin resistance in chronic liver diseases.

Objective To study the effects of the Chinese herbal compound (Erzhiwan, Shixiaosan and combined formula) on cholestasis-induced liver fibrosis rat’s uPA. Methods Bile duct ligation method was used to make the model of cholestasis-induced liver fibrosis. One week after the operation, the rats were randomly divided into five group (model group, UDCA group, Erzhiwan group, Shixiaosan group and hefang group). Each medicine intervention group was given corresponding medicine by intragastric administration. Sham and model group were given sodium chloride with equal dosage. At the end of 4th week, all rats were sacrificed and sampled. General state of health, hepatic function (ALT, AST, ALP, TBil) and pathological histology of hepatic tissue were recorded and measured. Results Compared with the sham group, the level of ALT, AST, ALP, TBil and the degree of liver fibrosis in model group were advanced significantly. Compared with model group, three Chinese herbal compound decreased serum level of ALP, ALT and AST (P

Humans ; Thyroidectomy ; ethics ; legislation & jurisprudence

Objective To investigate the effect of glycated albumin on recurrent cerebral infarction in elderly patients with diabetes mellitus. Methods All of 252 elderly acute cerebral infarction patients with diabetes mellitus were chosen from clinics. They were divided into 2 groups: A group ( glycated albumin <19.0% , 117 patients) and B group ( glycated albumin ≥ 19.0%, 135 patients). The clinical characteristics and the recurrent rate of cerebral infarction were compared between two groups. Results The levels of glycated albumin, fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol and triglycerides in B group were significantly higher than those in A group:(21.00 ± 4.93)%vs. (16.75±1.72)%, (9.84 ± 2.89) mmol/L vs. (5.36 ± 1.00) mmol/L, (5.44 ± 1.30) mmol/L vs. (4.57 ± 1.00) mmol/L, (3.13±0.81) mmol/L vs. (2.58 ± 0.74) mmol/L, (2.34 ± 1.61) mmol/L vs. (1.74 ± 1.47) mmol/L, P<0.01 or<0.05. The recurrent rate of cerebral infarction in B group was significantly higher than that in A group: 53.3%(72/135) vs.36.7%(43/117), χ2 = 6.946, P = 0.008. Logistic regression analysis showed that the increase of glycated albumin was the independent risk factor of recurrent cerebral infarction in elderly patients with diabetes mellitus (P=0.048). Conclusions The recurrent rate of cerebral infarction is increased in elderly diabetes patients with high glycated albumin. The increase of glycated albumin is the independent risk factor of recurrent cerebral infarction.

Objective Discussing the clinical features, early diagnosis and therapeutic methods of aortic dissection (AD). Methods We analyzed and concluded the clinical datum of 33 AD patients in our hospital. Results The rate of male to female was 5.6 to 1 among all patients, average age 60, hypertension accounted for 81.8 percent. There were 26 patients (78.8 percent) suffered an acute pain, of who 22 patients got a pain in anterior chest.There were 22 of 26 patients diagnosed AD through echocardiography, 20 and 11 patients confirmed AD by MRI or CT respectively among all 33 patients. 13 patients had abnormal ECG, 10 ST-T segment changed, 12 left ventricular hypertrophy or hyper-voltage. Hypertension patients were treated through a infusion of nitroglycerin or nitroprusside by intervenous drop or by vein pump firstly to decend systolic blood pressure to the level of 100~120 mmHg and heart rate to 60~70 bpm,combining with the use of beta blocker, calcium antagonist and rennin- angiotensin inhibitor. 27 patients’ pain alleviated gradually even disappeared after controling their blood pressure, whose state of illness became to stable. 2 persons did the operation of aortic replacement in emergency. 6 persons died for aortic dissection broken in one week or one month. Conclusions The clinical manifestations of AD are complex, and the rate of false or leak diagnosis is high. Radiology studies including echocardiography, MRI or CT may be very important to enhance the ability of diagnosing AD early and to guide the treatment. Taking medical treatment is primary in emergency. Operating the replacement of aorta is an effective measure to treat AD.

Acetaminophen ; therapeutic use ; Child ; Fever ; drug therapy ; Humans ; Ibuprofen ; therapeutic use ; Neonatology

Fatty liver disease is caused by abnormal accumulation of lipids within hepatocytes. According to traditional Chinese medicine (TCM) theory, lipids belong to the category of essence obtained from cereals and the normal distribution of essence relies on the function of spleen yang. When spleen yang is injured, the normal distribution of essence (lipids) will be affected, leading to formation of phlegm retention in the liver. That is the TCM pathogenesis of fatty liver disease. Hence the treatment of fatty liver disease should be concentrated on warming yang to activate qi. With such a treatment, the normal distribution of essence will be restored, essence will be distributed, and phlegm will be dissipated.

It is one of the key problems for the development of Chinese medicine to standardize the diagnosis of syndromes. The authors mainly discuss the ideas and methods of the study of standardization of syndrome diagnosis by retrospective analysis, also put forward the following suggestions: (1) the main ideas of this study should be based on the comparison of the diseases and their relevant syndromes and the predictive diagnosis of syndromes by the effects of herbal prescription treatment; (2) they are important ways to carry out multicenter, large sample and perspective clinical trials on the basis of the investigation and study of literature, consultation of experts and retrospective case review, and following the principles of clinical epidemiology, and to use the methods of evidence-based medicine to do systemic evaluation on the criteria of syndrome diagnosis; (3) they are important sectors of the study of standardization of syndrome diagnosis to enhance the objective studies on the four diagnostic methods of traditional Chinese medicine, and to do the functional studies under the conduction of systems biology; (4) Both data excavation technology and computer intelligence are the important technique supporting this study.