Background: Chronic hepatitis C is one of the major causes of end-stage liver disease with a high incidence rate, amounting to a grave and serious problem of public health. Currently, interferon-based (with or without ribavirin) antiviral therapy has limited use due to its stringent indications, possible contraindications and side effects. Traditional Chinese medicine (TCM) may have advantages in the prevention and treatment of chronic hepatitis C and it is of significant value to discover the advantages. Through this research, a safe and effective treatment protocol of TCM or integrated TCM and Western medicine for chronic hepatitis C can be formed. To this end, during China's Eleventh Five-Year Plan, special research projects on acquired immune deficiency syndrome (AIDS), viral hepatitis and the other major infectious diseases were established. Our studies on chronic hepatitis C constitute one of the major special research topics. Methods and design: Clinical information of patients with chronic hepatitis C will be first collected in a large, multicenter epidemiological survey. Positive symptoms will be analyzed by rapid cluster analysis, principal constituent analysis and factor analysis, and syndrome types will be diagnosed based on expert advice. Concurrently, a large, multicenter, randomized, parallel-group prospective study will be launched based on evidence-based medical principles to evaluate the effects and safety of the treatment protocol for chronic hepatitis C. The evaluated indexes will include the normalization rate of liver function, virological improvement and quality of life improvement for the short-term efficacy and the incidence of liver cirrhosis and (or) primary liver cancer and mortality for the long-term efficacy. Discussion: This study will investigate the TCM syndrome differentiation norms and the syndrome distribution rules of chronic hepatitis C and evaluate the efficacy and safety of a treatment protocol for chronic hepatitis C based on TCM theory or combined treatment of TCM and Western medicine. The study results will be helpful to developing a TCM treatment program for chronic hepatitis C. Trial registration: The research program was registered in the Chinese Clinical Trial Registry in English and Chinese in January 2010. Registration number: ChiCTR-TRC-10000770.

Objective To sum up main syndrome differentiation points of liver depression and spleen asthenia syndrome of chronic hepatitis B(CHB).Methods Logistic regression and discriminant analysis were used for analysis of symptoms,tongue and pulse of liver depression and spleen asthenia syndrome,liver depression syndrome and spleen asthenia syndrome.Results The symptoms selected by logistic regression of liver depression and spleen asthenia syndrome were:abdominal distention or pain,lassitude,poor appetite,loose stool,hypochondriac pain or discomfort and tense pulse;while that selected by discriminant analysis were:abdominal distention or pain,lassitude,loose stool and yellowish fur.Conclusion Main syndrome differentiation points of liver depression and spleen asthenia syndrome of CHB include hypochondriac pain or discomfort,abdominal distention or pain,lassitude,poor appetite and loose stool.Logistic regression and discriminant analysis are feasible for analysis of main diagnosis points of liver depression and spleen asthenia syndrome of CHB.

Objective To observe the clinical efficacy of auricular point sticking with magnetic bead in treating insomnia in hepatocirrhosis patients. Method Ninety patients with hepatocirrhosis complicated with insomnia were randomized into a treatment group and a control group, 45 in each group. The treatment group was intervened by auricular point sticking with magnetic bead, while the control group was by auricular point sticking with medical adhesive tape. After successive 2-week treatments, the Insomnia Severity Index (ISI) and the Evaluation Criteria of Therapeutic Efficacy for Mental Disorders were observed for evaluating the treatment result. Result The ISI was significantly improved in the treatment group after intervention (P<0.05), and the improvement was significantly different from that in the control group (P<0.05). The total effective rate was 86.7% in the treatment group versus 60.0% in the control group, and the difference was statistically significant (P<0.01). Conclusion Auricular point sticking with magnetic bead is easy-to-operate and can produce a satisfactory efficacy in treating insomnia of hepatocirrhosis patients.

Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver dysfunction and has complex pathogenesis and progression. With in-depth studies in recent years, the theory of “two hits” has gradually been replaced by the theory of “multiple hits”. The theory of “multiple hits” including the neuroendocrine immune inflammatory network suggests that various factors participate in the progression of NAFLD, such as insulin resistance, adipose tissue dysfunction, mitochondrial dysfunction, endoplasmic reticulum stress, inflammatory activation, fatty acids, gut microbiota, iron overload, dietary factors, genetic factors, and epigenetic factors. With reference to the research advances in recent years, this article reviews the pathogenesis of NAFLD from the aspects of genetic and epigenetic factors, gut microbiota, intrahepatic immune cells, and aquaporin.