Background: The conventional therapy for chronic hepatitis C is the combination of interferon-alpha and ribavirin. However, it has some adverse effects and does not response to some patients, and it is also very expensive. Objective: To assess the efficacy and safety of Chinese medicinal herbs for chronic hepatitis C virus infection. Search strategy: Electronic and manual searches were conducted and the search ended in July 2009. Inclusion criteria: We included randomized clinical trials testing Chinese herbal medicine vs placebo, non-specific treatment, antiviral treatment, or Chinese herbal medicine combined with antiviral treatment vs antiviral treatment alone. Data extraction and analysis: Selection of trials for inclusion, assessment of methodological quality, data extraction and data syntheses were conducted according to the protocol of a Cochrane systematic review by the authors. Results: Fifty-one randomized trials (involving 3 678 patients) with various methodological quality were included. The studies published in English had good quality, while studies published in Chinese were of poor quality. The pooled results showed that Chinese herbal medicine alone or in combination with antiviral treatment was generally better than non-specific treatment or antiviral treatment alone, and herbal medicine appeared equal to antiviral treatment regarding comprehensive clinical effect in terms of symptoms, liver function and virological response. Regarding virological response including loss of serum hepatitis C virus (HCV) RNA and anti-HCV antibodies, herbal medicine was better than non-specific treatment, equal to antiviral treatment, and the combination of herbs and antiviral treatment was better than antiviral treatment alone. Similar positive findings were found for liver function improvement. Adverse effects were observed among herbal injections and interferon treatment, and few cases had severe adverse effects. Conclusion: Herbal medicines included in this review have effects in improving symptoms, liver function, and loss of HCV markers in patients with chronic hepatitis C. However, for majority of the included trials were published in Chinese and had low quality, the promising effects from some herbs need to be confirmed in rigorous clinical trials, and the design and reporting of trials should follow international standards. Systematic review registration: http://www.cochrane.org, 380700081611301089.

Objective To study the mechanisms of increasing amyloid [β1-42 (Aβ42) level by presenilin-1 (PS-1) mutation of V97L.Methods Expression level of neprilysin (NEP) in nontransfected, or mock vector, wild type (wt) PS-1 and V97L-PS-1-transfected SH-SY5Y cells were assessed by reverse transcriptional-polymerase chain reaction (RT-PCR) and Western blot.The level of Aβ42 was also assessed by enzyme linked immunosorbent assay (ELISA).Results The mRNA level of NEP was decreased significantly in PS-1 V97L transfected cells (0.650 ± 0.010) compared to that in normal cells (1.090 ± 0.015), wt PS-1 gene (1.040 ± 0.021) and mock (1.080 ± 0.020) stably transfected cell lines (t = 9.236, 10.452, 5.678; all P < 0.01).Although there was a decreased tendency in the protein expression of NEP in PS-Ⅰ V97L transfected cells (1.000 ± 0.126)compared to that in normal cells (1.020 ± 0.110), wt PS-1 gene (1.040 ±0.110), mock (2.130 ±0.130) stably transfected cell lines, nosignificant differences were found.The expression of Aβ42 was increased significantly in PS-1 V97L transfected cells compared to other cell lines (t = 2.109, 3.355, 3.976; all P < 0.01).Conclusions PS-1 V97L mutation can decrease the transcription of NEP, however, in contrast, this mutation also resulted in increased Aβ42.The mechanism needs further analysis.

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Objective To study the degradation of Rhizoma Typhonii polysaccharide with sulfuric acid under the normal and ultrasonic condition. Methods The orthogonal test table L9(34) was used to optimize 4 factors including acid concentration, reaction time, reaction temperature and ultrasonic power, with the yield of the low-molecular-weight polysaccharide as the index. Results The optimal conditions of discomposing Rhizoma Typhonii polysaccharide with sulfuric acid were 10% sulfuric acid, 100 ℃ for 2 h under the normal condition,and the yield of low-molecular-weight polysaccharide was 36.17%. Under the ultrasonic condition, the optimal conditions were 150 W of the ultrasonic power, 5% sulfuric acid, 40 ℃ for 1 h, and the yield was 44.63%. Conclusion The degrading yield of the low-molecular-weight polysaccharide can be increased under ultrasonic condition with sulfuric acid.

Objective To explore the activation of circulating platelet in patients with cerebral infarction(CI) and its correlation with CI.Methods The fibrinogen receptor(FIB-R) and P-selectin were used as molecular marker of circulating platelets, which were analyzed by flow cytometry in 80 healthy persons and 127 CI patients in acute and rehabinating period.Results The FIB-R expression on circulating platelet of CI patients in dangerous period was significantly higher than that in steady period and healthy persons(P0.05).Conclusion The activation of circulating platelet has a close relationship with CI. FIB-R may be a sensitive molecular marker of circulating activated platelet. It will help to evaluate the severe extent of CI and give an anti-platelet treatment as soon as possible to improve the prognosis of CI through monitoring the FIB-R of CI patients successively.

ObjectiveTo observe the effect of early partial body weight support on walking ability for stroke patients with hemiplegia.Methods60 stroke patients were divided into 3 groups, receiving conventional early rehabilitation: group A (20 cases) received conventional rehabilitation for 8 weeks; group B (20 cases) received 2 weeks conventional rehabilitaion and 6 weeks partial body weight support; group C (20 cases) received 5 weeks conventional rehabilitaion and 3 weeks partial body weight support. Fugl-Meyer Assessment(FMA), Barther Index(BI) and Berg Balance Scale(BBS) were used to assess the effect before and after treatment.ResultsThe socres of FMA, BI and BBS improved in walking function after the treatment(P<0.05). Comparing with groups A and C, group B improved more significantly after treatment (P<0.05), and group C was better than group A (P<0.05). ConclusionPartial body weight support can improve walking function of hemiplegic patients at early stage.

The neurotoxin β-amyloid (Aβ) is the main hallmark of Alzheimer′s disease (AD). Recent evidence suggests that, in common sporadic or late-onset forms of AD, elevated brain Aβ levels are caused by impaired clearance rather than overproduction. The cell surface receptor′s low-density lipoprotein receptor-related protein-1 (LRP1) has been reported to not only play a role in Aβ endocytosis, but also exist in the blood-brain barrier system, peripheral blood, liver, kidney and other tissues and organs, and transport Aβ to the cerebrospinal fluid or blood system by passing through the blood-brain barrier or the blood-cerebrospinal fluid barrier effectively, and finally clear it out of the body through peripheral tissues and organs. In this review, the role of LRP1 in the peripheral transport and clearance of Aβ is described, and it may be a safe and effective way to reduce Aβ in the brain and even improve cognitive dysfunction.

Objective:To explore the causes and preventive measures of early complications after free gracilis muscle transfer in reconstruction of brachial plexus injury, and to improve the postoperative function of the transferred gracilis muscle.Methods:Patients were recruited from August, 2005 to December, 2016. All 111 patients of brachial plexus injury underwent reconstructive surgery using 122 free gracilis flaps. Early postoperative complications, including recipient site, donor site and systemic complications, were closely observed and recorded. Outcome measurements included incidence and timing of flap compromise, type of flap compromise, causes of vascular occlusion and salvage rate. The postoperative strength of gracilis was evaluated according to the BMRC score. The data were statistically analyzed. The difference was statistically significant if P<0.05. Results:The survival rate of 122 free gracilis transfers was 98.4% (120/122). Early complications occurred in 32 cases (including 2 complications in 6 patients) : 27 cases with recipient site complications (84.4%), 4 with donor site complications and 7 with systemic complications. Among the 32 cases of complications, 17 flap compromises caused by vascular obstruction and 15 of them were salvaged completely after exploration. Flap crisis was the main issue that affected the postoperative function of gracilis muscle, and 58.8% (10/17) of patients with vascular crisis showed muscle strength above M 3 after surgery. The main causes of vascular crisis were venous tortuosity and venous thrombosis, which had nothing to do with operation time and intraoperative blood loss. Conclusion:Flap crisis is the main factor affecting the postoperative function of gracilis. The rate of flap salvage can be tremendously increased by early detection, re-exploration and effective management of the flap crisis.

Objective To analyze the status of supply and the affected factors of the home care of the elderly in community of Shenzhen.Methods The investigation was carried out in 78 community health ser-vice centers and 216 elderly from 6 communities using self-designed questionnaire.Results 84% of the el-derly had the demand of home care, 38.1% of them had even received home care services.In 32 demand items of home care, the top 6 were in turn the blood pressure monitoring, the blood sugar monitoring, the health consults, the caregivers guidance, the psychological care, medication instruction.48 of 78 commu-nity health service center provided door-to-door services, 44% of them(home care service center)provided more than 10 projects, 67% of the center provided more than 5 projects, 17% of them provided 2 projects, 30 community health service center did not provide door-to-door service.The main reasons that influenced home care delivery in community were the shortage of nursing staff of home medical care, the risk factors, the medical environment, and the limited health care facilities.Conclusions The elderly has large de-mand to the home care service, home care which the community health center provided is lagging and in short supply.It is imperative to increase the number of community nurses, improve the community home care profession standard and promote stable development of home care.

Objective To investigate the correlation of the vascular endothelial growth factor (VEGF) gene variations in the promoter region with the sporadic Alzheimer' s disease (SAD) in Chinese Han population for better understanding the mechanism of SAD. MethodsThe polymorphisms of 279 SAD Chinese Han patients from Northern China were analyzed by comparing with those from 317 healthy individuals using the method of polymeraee chain reaction-restriction fragment length polymorphism ( PCR-RFLP) or direct sequencing.The commercial statistics package SPSS 11.5 was used to compare the distribution of the allele and the genotype, and to analyze their correlations with SAD. ResultsThree polymorphism sites were found for the VEGF promoters in the Chinese Han sample group including -2578C/A,- 2549I/D and- 1154G/A.- 2549I/D and- 2578C/A exhibiting strong linkage disequilibrium. Individuals with the A allele at position -2578 had an insertion of 18 nucleotides at -2459I/D, whereas CC homozygotes did not contain th es were found between the SAD patients and the controls in the 3 VEGF polymorphisms. After adjusting the data for gender, age and the ApoE ε4 allele using Logistic regression, the - 1154G/G genotype of the VEGF promoter might increase the risk of SAD in Chinese Han population.Among the subgroup without the ApoE ε4 allele, -2549D/-1154G haplotype might increase the risk for SAD (OR = 1.325, 95％ CI 1.023--1.716, P=0.033). ConclusionsThree polymorphism sites ( -2578C/A, -254911D, and -1154G/A) are found in the VEGF promoter regions in Chinese Han population. The-1154G/G genotype of the VEGF promote appears to increase the risk of SAD in Chinese Han population.In the absence of ApoE ε4, the -2549D/-1154G haplotype of the VEGF promoter appears to affect the risk for SAD.