Animals ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Cirrhosis ; therapy ; Phytotherapy

Humans ; Liver Cirrhosis

Animals ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Evidence-Based Medicine ; Hepatitis B, Chronic ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; Medicine, Chinese Traditional ; Phytotherapy

Humans ; Liver Cirrhosis ; physiopathology ; therapy

Fibrosis ; Humans ; Integrative Medicine ; Liver Cirrhosis ; diagnosis

This issue of Journal of Clinical Hepatology focuses on integrated traditional Chinese and Western medicine and has invited the experts who are engaged in the diagnosis and treatment of hepatobiliary & pancreatic diseases using integrated traditional Chinese and Western medicine.With reference to their clinical practice of diagnosis and treatment and related studies,the special topics introduce how to give full play to the advantages of both traditional Chinese and Western medicine to improve patients'benefits and related developmental issues and show the perspectives of the development of integrated traditional Chinese and Western medicine.

The treatment for severe acute respiratory syndrome (SARS) that happened epidemically this spring confirmed again that the integrated traditional Chinese and western medicine had its clinical advantage and vitality, and indicated that this integration could benefit the pathologic understanding and therapeutic strategies for the diseases. Based on the experimental research, western medicine focuses on the histological and structural changes of the diseases. In order to probe the key mechanisms of the disease's occurrence and development, it tries to develop the therapy targeting the mechanism. Materialism is the academic characteristic of western medicine. Based on the differentiation of individual patient and comprehensive analysis of all manifestations, with the academic characteristic of dynamics and dialectics, traditional Chinese medicine (TCM) focuses on the regulation and recovery of the body functions. Theoretically, materialism and dialectics are complementary to each other. Their combination and unity is the key point for the integration of TCM with western medicine in order to improve the clinical effectiveness and TCM development. Therefore, we must adhere to the principles of the evidence-based medicine, strengthen the integrated study on "disease" of western medicine and "syndrome" of TCM, insist on "materialism" and improve the understanding of the mechanism of Chinese herb formula, pay efforts on the clinical study of difficult and common hepatic diseases, in order to develop the integrated traditional and western medicine on liver diseases.

The strategy for treating liver fibrosis in chronic hepatitis patients includes dispelling the etiological factors, inhibiting the inflammatory reaction, decreasing the sedimentation of extracellular matrix, accelerating the degradation of extracellular matrix, improving the microcirculatory and metabolic disturbance, and ameliorating the complicating diseases, etc. Researchers should pay attention to the liver function indexes in chronic liver disease in evaluating the therapeutic effects of anti-fibrosis. Effective etiological treatment should be considered as the first step in treating liver fibrosis in chronic hepatitis patients, and inhibiting the inflammatory reaction is one of the most important tactics for suppressing the development of fibrosis and for decreasing the incidence rate of liver cancer in chronic hepatitis patients. Treatment based on syndrome differentiation, a dynamic therapy aimed at the holistic pathological state, can improve the pathological state of the disease. It is especially important to take the advantages of the integration of traditional Chinese and western medicine in the clinical diagnostic and therapeutic procedure for increasing the therapeutic effect of live fibrosis.

24hr after partial hepatectomy, the isolated remnant liver of rat was perfused to study the effects of several factors on the ability of amino acid intake. The results were as follows: (1). Twenty-four hours after operation the hepatic uptakes of amino acid increased in the hepatectomized groups. The ability of enhanced amino acid uptake by remnant liver depended on hepatic protein synthesis. In a certain range of hepatectomy there was a positive correlation between the amounts of liver which had been cut off and the amounts of amino acid uptake by remnant liver. (2). The addition of insulin alone to the perfusate could stimulate amino acid uptakes by remnant liver and the addition of glucagon alone had no effect. But, when insulin was added to the perfusate in combination with glucagon the hepatic uptake of amino acid was much higher. (3). The extract from regenerating rat liver rather than that from normal adult rat liver may contain certain factor(s) which can stimulate amino acid uptakes by remnant liver.

The authenticity and accuracy of data in clinical trials is extremely important. Any inauthentic data may affect the result of a clinical trial, and cause great loss. In our opinion, inauthentic data includes not only man-made spurious data, but also inaccurate data objectively formed. In this article, the features of inauthentic data are described, how to distinguish inauthentic data is discussed, and the causes of this kind of data are analyzed and concluded, which include: subjective intervention on the result of clinical trials, differentiation of the GCP knowledge level between different investigators, misunderstanding of the protocol, et al. And finally we propose that scientific training to investigators and other involved personnel and quality control during the course of data collection should be strengthened to prevent the occur of inauthentic data in clinical trials.
Clinical Trials as Topic ; standards ; Data Collection ; standards ; Drug Evaluation ; Drug Industry ; Humans ; Quality Control