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.

BACKGROUND: Sodium alginate-poly-lysine can cause foreign body reaction to induce functional inactivation of the microencapsulated islets following transplantation. Can barium chloride solve this problem?OBJECTIVE: To assess the biocompat ibility of purified sodium alginate-barium chloride microcapsules and the bioactivity of the microencapsulated islets of rats.DESIGN: A randomized controlled experiments based on the experimental animals.SETTING: Department of endocrinology in a university hospital.MATERIALS: This experiment was completed in the Laboratory of Endocrinology and Department of Laboratory Animals, First Affiliated Hospital of Nanjing Medical University during July to December 2002. Specific pathogen-free SD and Wistar rats were provided by Center of Animal Experiment, Nanjing Medical University and Animal Experiment Center of Shanghai respectively.METHODS: Purified and non-purified sodium alginate-barium chloride microcapsules were prepared with one-step method using domestically made equipment. The microcapsule was transplanted intraperitoneally into normal SD rats and its biocompatibility was observed 4 weeks later. The bioactivity of the microencapsulated islets was also observed following transplantation in streptozotocin(STZ)-induced diabetic Wistar rat models.MAIN OUTCOME MEASURES: ① The recovery rate of the transplanted empty microcapsule; ② Results of bioactivity assessment of the insulin from the microencapsulated islets; ③ Histological examination.RESULTS: Four weeks after the transplantation, the recovery rate of the transplanted empty microcapsules in the purified group was higher that that in non-purified group( P > 0.05), and the purified microcapsules retained intact and smooth morphology with out causing fibrosis. The islets encapsulated by purified sodium alginate-barium chloride microcapsules showed good insulin-ecreting function in in vitro culture, without significant difference from non-microencaps ulated islets( P > 0. 05) . The islets transplanted via the microcapsules into diabetic Wistar rat models induced by STZ had a survival time over 6 weeks.CONCLUSION: The purified sodium alginate-barium chloride microcapsules have good bioactivity and tissue compatibility, which might provide a solution for the source of donor diabetic islets in the treatment of type Ⅰ diabetes.

Objectives To assess the efficacy and safety of Xiaoyao Powder (Carefree Powder) in the treatment of depression using the method of systematic review of evidence-based medicine.Method Data published before December 2009 were searched from MEDLINE,Cochrane library,CNKI,VIP,CBM.We included randomize-controlled trials (RCT) testing Xiaoyao Powder against placebo or antidepressants,and Xiaoyao Powder combined with antidepressants against antidepressants alone.Two researchers collected data independently.The assessment of methodological quality was based on Cochrane handbook and the materials were analyzed with software RevMan 5.017.The outcome measure index was relative risk or difference of mean value (95% confidence interval).Results Thirty-two RCTs involving 2 253 patients were included.Involved trials published in Chinese were of low quality.In the trials of comparison between Xiaoyao Powder and placebo,only decrease of self-rating depression scale (SDS) score was not significantly different.For general clinical improvement and decrease of Hamilton rating scale for depression (HAMD) and SDS scores,Xiaoyao Powder combined with antidepressants was more effective than antidepressants alone,but the effect of Xiaoyao Powder was equal to antidepressants.No adverse effect was reported in the trials regarding Xiaoyao Powder.Conclusions Xiaoyao Powder appears to be effective for depression.However,the exact effect needs to be confirmed in well-designed large-sampled clinical trials.

Adolescent ; Anemia, Aplastic ; complications ; Female ; Humans ; Lupus Erythematosus, Systemic ; complications

Background: Xiaochaihu Tang was a compound traditional Chinese herbal medicine recorded in ancient Chinese medical book Shanghanlun, and has been widely used for chronic liver diseases especially in Japan. Objective: To assess the beneficial effects and safety of Xiaochaihu Tang, for chronic hepatitis B (CHB). Search strategy: Electronic and manual searches were conducted and the search ended in November 2009. Inclusion criteria: We included randomized clinical trials testing Xiaochaihu Tang against placebo, non-specific treatment, antivirals, or combined with antivirals against antivirals alone. Data extraction and analysis: Selection of trials for inclusion, assessment of methodological quality by Jadad score, data extraction and data syntheses were conducted according to the Cochrane Hepato-Biliary Group methods. Results: Sixteen randomized trials (involving 1 601 CHB patients) with various methodological quality were included. One trial published in English had good quality, while other trials published in Chinese were of poor quality. The pooled results showed that Xiaochaihu Tang combined with antiviral drugs was more effective in serum loss of hepatitis B viral markers and in improving liver function compared with antiviral drugs alone. Xiaochaihu Tang was not different from placebo in terms of viral clearance or improving liver function. However, Xiaochaihu Tang was superior to non-specific treatment in liver function improvement. There were no adverse effects reported in the trials regarding Xiaochaihu Tang, but adverse effects were reported in patients treated by interferon, and severe adverse effects occurred in few cases. Conclusion: Xiaochaihu Tang in this review appears to be effective in improving liver function and clearance of serum hepatitis B viral markers in patients with chronic hepatitis B. However, due to poor methodological quality in the majority of included trials the potential benefits need to be confirmed in rigorous clinical trials following international standards.

Adolescent ; Female ; Humans ; Premenstrual Syndrome ; etiology ; physiopathology ; therapy

Objective To investigate the differences of clinical symptoms,risk factors,plasma D?dimer level and severity of acute pulmonary embolism( APE) between females and males. Methods Clinical data of 153 cases APE patients were analyzed retrospectively. Symptoms,risk factors,electrocardiogram( ECG) findings, plasma D?dimer level and risk classification were analyzed between females and males. Results The proportion of palpitation in females was significantly higher than that in males ( 29. 3%( 24/82 ) vs. 8. 5%( 6/71 ) ,χ2=10. 46,P<0. 01) . The proportion of chest pain in females was significantly lower than that in males ( 4. 9%( 4/82) vs. 25. 4%( 18/71) ,χ2=12. 96,P<0. 01) . The proportion of patients who had three or more symptoms was significantly higher in females than that in males ( 32. 9%( 27/82 ) vs. 7. 0%( 5/71 ) ,χ2 = 15. 41, P<0. 01). D?dimer mean level in females was significantly higher than that in males(334. 00(620. 00) μg/L vs. 528. 00( 812. 75) μg/L,Z=-2. 447,P<0. 05) . The proportion of low risk patients in females was lower than that in males ( 31. 7%( 26/82 ) vs. 53. 3%( 38/71 ) ,χ2 = 7. 44, P<0. 01 ) , while the proportion of the intermediate?high?risk patients was higher ( 34. 1% ( 28/82 ) vs. 14. 1 ( 10/71 )%,χ2 = 8. 20, P<0. 01) . Conclusion The symptoms was more variable in females with the main symptom of palptation. The level of plasma D?dimer is higher in females than that in males. The prognosis of females may be severe than that of males.

Objective To describe the real experience of nurses from different grade hospitals during further study in the three-level hospital.And to provide the basis to make plans,improve the effect of fustther study and ensure the realization of further study aim.Methods In-depth interviews were canied out with 28 nurses by using Hidegerian phenomenological method.The acquired data were reorganized,analyzed and extracted themes.Results Different grade hospital nurses had different psychological experience such as aims,willingness,effects,obtainment and stress.Condusions Further study should be based on subjective willingness and definite goals.Hospitals should strictly select nursing teachers,give differential treatment in education,fully understand the pressure source and provide corresponding measures to reduce stress of nurses.

Objective To investigate the expressions of lung cancer related genes and miRNA in peripheral blood of the residents surrounding the extremely high radon hot springs in Ruoergai County,Sichuan Province. Methods Peripheral blood samples were collected from the local residents.Expressions of lung cancer related genes (p53,k-ras) and miRNA (let-7a,miR-34a/b) were detected by real-time PCR and the protein expressions of p53 and k-ras were detected by Western blot.Results The expressions of p53 and k-ras mRNA of the residents in high radon area were 0.97 and 1.33 times of the control respectively (t =0.13,-1.12,P ＞0.05),and the p53 and k-ras protein levels were 0.70 and 1.23 times of the control respectively (t =0.72,0.46,P ＞ 0.05).The let-7a of the residents in high radon area was lower (t =1.63,P ＞ 0.05 ) while the miR-34a and miR-34b were significantly higher than those of the controls (t =- 3.20,- 3.32,P ＜ 0.05).Conclusions Based on the expressions of p53 and k-ras gene and miRNA,it can be concluded that the residents surrounding the high radon hot springs received radiation damage.

Objective To learn the control status of iodine deficiency disorders in Baoji City of Shaanxi Province.Methods From 2009 to 2011,according to the National Iodized Salt Monitoring Program,the iodized salt was monitored,and thyroid was examined in 12 counties(areas) of Baoji City.According to rural and urban area stratification,60 children aged 8 to 10 were selected in each county(district),and their urine samples were collected for determination of iodine content.In 2011,per capita daily salt intake was surveyed by the three weighing method at children's home whose urine was collected.Chencang Area,Fufeng County and Taibai County,representatives of Baoji City different geomorphic features were selected for investigation of water iodine,and urinary iodine of pregnant and lactating women,and 15 people were selected in each county (district).Results From 2009-2011,in the 12 counties(areas) in Baoji City,the coverage rate of iodized salt was all 100.00％(3468/3468); the qualified rate of iodized salt and the consumption rate of qualified iodized salt were all ＞ 99.00％.Children's goiter rate was 3.41％(87/2548),3.06％(77/2520) and 3.33％(84/2520),and they were all less than that of the national standard (＜ 5％).Medians of urinary iodine of 8-10 years old children were 368.20,293.80 and 332.50 μg/L,respectively,and the ratios of urine iodine ≥300 μg/L were accounted for 66.42％ (797/1200),48.05％(692/1440) and 56.67％(816/1440),respectively.Median urinary iodine of pregnant women was 301.81 μg/L and lactating women was 329.79 μg/L.A total of 1116 households were investigated,the median of per capita daily salt intake was 8.9 g.Eighteen water samples were collected,range of water iodine value were 0.60-10.25 μg/L.Conclusions Iodine nutrition in general population of Baoji City is exceeded the optimum level,and the current iodized salt concentration has some down space,but fully consideration should be taken on iodine needs in different iodine deficiency areas and among different groups of people.