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 investigate the effect of two different injection durations and four local pressing durations on the incidence of subcutaneous hemorrhage after low molecular weight heparin, and find a optimum injection duration and pressing time to reduce the incidence of subcutaneous hemorrhage associated with subcutaneous low molecular weight heparin. Methods 80 patients, who were deep venous thrombosis (DVT), pulmonary embolism (PE), and undergone inferior vena cava filter (IVCF) after the operation and received low molecular weight heparin (LWMH) for eight times were selected. The injection time and pressing duration after the injection were randomized into 30 s and 2 min, 30 s and 6 min, 30 s and 10 min, 30s and 14 min, 10s and 2 min, 10s and 6 min, 10 s and 10 min, 10 s and 14 min respectively. The incidence of subcutaneous hemorrhage were measured after 12 h. Single and multiple factor logistic regression analysis were used to analyze the data. Results The injection time and pressing duration after the injection were randomized into 30 s and 2 min, 30 s and 6 min, 30 s and 10 min, 30 s and 14 min, 10 s and 2 min, 10 s and 6 min, 10 s and 10 min, 10 s and 14 min respectively. The results of the incidence rate of subcutaneous hemorrhage were 46.25% (37/80), 22.50% (18/80), 23.75% (19/80), 25.00% (20/80), 71.25% (57/80), 43.75% (35/80), 50.00% (40/80), 50.00% (40/80) respectively. By the single factor test, the results showed that pressing duration and injection duration are associated with the incidence of subcutaneous hemorrhage after low molecular weight heparin. With regard to the incidence of subcutaneous hemorrhage, there was significantly difference between 2 min group and the other 3 groups (P<0.01), while other adjacent groups had no significant differences (P>0.05). By multiple factors logistic regression analysis, it was revealed that pressing duration and injection duration were significant factors (P<0.01), but the interaction term of pressing duration and injection duration had no significant. It was also revealed that the effect of injection duration was better than pressing duration (|b'(injection duration)|=|-1.8890|>|b'(pres ing duration)|=|-1.0729|). Compared with inject 10 s, there was a significantly lower incidence of bruising in inject 30 s. There was a significantly lower incidence of bruising in the longer pressing duration (b<0). By multiple factors logistic regression analysis, it was also revealed that pressing duration and injection duration were significant factors regardless of the interaction term of pressing duration and injection duration (P<0.01). The effect of injection duration was better than pressing duration (|b'(injection duration)|>|b'(pres ing duration)|). Compared with inject 10 s, there was a significantly lower incidence of bruising in inject 30 s (b<0). there was significantly difference between 2min group and the other 3 groups (P<0.01), while other adjacent groups had no significant differences. Compared with others, there was a significantly high incidence of bruising in pressing 2min and the pressing duration for at least 6 min. Conclusions It is suggested that inject 30 s with pressing for 6 min can effectively reduce the incidence of subcutaneous hemorrhage resulted from subcutaneous injection of LMWH.

AIM: To explore the treatment of subclinical hepatic encephalopathy(SHE) by traditional Chinese medicine. METHODS: Sixty patients with SHE were randomized into two groups: treatment group with 30 cases treated by Qingkai Granule and control group with another 30 cases treated by lactulose.They were all treated for two weeks.The evoked potentials(Eps) were measured,moreover,number connection test(NCT) and digit symbol test(DST) were conducted. RESULTS: In treatment group,the period for NCT was shorter and the DST also improved apparently;peak latency(PL) and interpeak latency(IPL) of SEP and AEPs were shorter to different degrees,with significant differences among groups. CONCLUSION: Qingkai Granule acts to effectively increase the learning,memory and space cognitive capacities in patients,and improves the nerve electrophysiology in patients.

OBJECTIVE: A method based on dubious condition of information entropy was introduced and applied to discuss a complexity problem in the analysis of correlation between traditional Chinese medicine (TCM) syndrome and season. METHODS: Eight hundred and seventy one cases of chronic virus hepatitis B (hepatitis B) with TCM clinical data were analyzed by information entropy method. RESULTS: It was found that hepatitis B with Yin deficiency of liver and kidney happened more often in summer than in other seasons. CONCLUSION: It is inferred that the difference of seasons may influence the variation of TCM syndromes.

AIM:To investigate the regulatory effects of phosphatylinositol 3-kinase/protein kinase B (PI3K/PKB) signaling pathway on the expression of osteopontin ( OPN) in transforming growth factor-β1 ( TGF-β1 )-induced hu-man hepatic stellate cells .METHODS:Human hepatic stellate cell line LX-2 was cultured in DMEM and stimulated by TGF-β1 at the final concentration of 2.5, 5, 10 and 20 μg/L for 24 h or at final concentration of 10 μg/L for 12 h, 24 h and 48 h.LX-2 cells were pretreated with wortmannin , a specific inhibitor of PI3K/PKB signaling pathway , at final con-centration of 0.1 μmol/L for 1 h, followed by incubation with TGF-β1 at final concentration of 10μg/L for 24 h.The cells were collected.The expression of OPN was detected by real-time PCR and Western blotting .RESULTS: In LX-2 cells, the expression of OPN was apparently elevated when incubated with TGF-β1 .With the increase in TGF-β1 concentration or the extension of incubation hours , the expression of OPN was increased gradually in a dose-and time-dependent manner with certain limits.LX-2 cells pretreated with wortmannin and incubated with TGF-β1 had a significant decrease in the OPN expression as compared with control group (P<0.01).CONCLUSION:The expression of OPN in TGF-β1-induced LX-2 cells is regulated by the PI3K/PKB signaling pathway.

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.

Abundant experience has been accumulated when it comes to the traditional Chinese medicine (TCM) prevention and treatment of chronic hepatitis B (CHB). However, there still exist some deficiencies such as insufficient randomized controlled trials (RCTs) and lack of attention to objective indices for therapeutic evaluation. Therefore, future clinical prevention and treatment should be tied closely to the research progress in the immune pathogenesis of CHB and give full play to the characteristics and advantages of TCM in modulating the functional status (including immunity) of human body. Moreover, clinical and translational research on the TCM regulation of immune response in CHB should be carried out to further improve clinical therapeutic effect. In addition, biochemistry, virology, and pathology should be applied actively in place of outcomes while paying attention to the symptoms of patients in an effort to improve the objectivity of therapeutic evaluation when summarizing clinical practice experience. Furthermore, RCTs should be employed as much as possible to enhance global recognition of the therapeutic effect of TCM treatment. And there is no doubt that bringing the advantages of integrated traditional Chinese and Western medicine therapy into full play will benefit a huge number of patients.

OBJECTIVE To share surgical experience of ossicular chain malformations with CO2 laser.METHODS A retrospective analysis was performed.9 patients with clinical diagnosis of ossicular malformations underwent ossicular reconstruction with CO2 laser-assisted from May 2010 to Mar 2016,the results were evaluated by comparing preoperative and postoperative audiometric outcomes and the rate of postoperative complications.RESULTS 8 cases with complex lesion combining incus and stapes were found intraoperatively,the deformity located on stapes was showed in one case.The mean postoperative air conduction (AC) value was (26.53 ± 12.28) dB,the mean postoperative air-bone gap (ABG) was (9.44 ± 9.62) dB,the postoperative AC and ABG value improved considerably comparing with the preoperative value in all the patients,the difference was statistically significant.CONCLUTION CO2 laser is a suitable and effective adjunct in surgery for ossicular malformations such as otosclerosis.The use of the laser improves hearing results and operation efficiency and is not likely to increase side-effects to patients.

Nonalcoholic fatty liver disease has become the most important chronic liver disease in China and the leading cause of abnormal liver biochemical parameters in physical examination. Mitophagy can degrade the mitochondria with impaired function and misfolded protein in the liver to regulate cell death and help to maintain stable lipid metabolism in the liver. The binding of adiponectin secreted by adipose tissue to adiponectin receptor 2 can increase the secretion of autophagy agonists in Kupffer cells, induce hepatocyte mitophagy, promote lipid metabolism, and thus reduce liver inflammation, which provides new thoughts for the research and development of drugs with a marked clinical effect and a clear mechanism of action in the treatment of nonalcoholic fatty liver disease.

OBJECTIVETo analyze the chemical compositions and their contents in non-alkaloids fraction from Radix Sophorae Tonkinensis.

METHODThe non-alkaloids from Radix Sophorae Tonkinensis were analyzed by gas chromatography/mass spectrometry after trimethylsilyl derivatization. The chemical compositions were identified by comparison of the authentic sample and NIST database; the contents of 19 identified components were determined by linear regression equation.

RESULT19 compounds constituting 34.72% of the non-alkaloids were identified. The major components were saccharides (5 compounds constituting 22.62%), organic acid (9 compounds constituting 11.81%), and others (5 compounds constituting 0.29%).

CONCLUSIONThe GC-MS is a simple, rapid and sensitive method to investigate the complex primary metabolites in plants.