Efficacy and safety of activating blood circulation and removing blood stasis of Traditional Chinese Medicine for managing renal fibrosis in patients with chronic kidney disease: a systematic review and Meta-analysis.

OBJECTIVE: To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine (TCM) for managing renal fibrosis (RF) in patients with chronic kidney disease (CKD). METHODS: We searched randomized controlled trials (RCTs) from eight databases. RESULTS: Sixteen eligible studies with 1,356 participants were included in this study. Compared to treatment with Western Medicine (WM) alone, the combined treatment with activating blood circulation and removing blood stasis in terms of TCM (ARTCM) and WM to manage RF in patients with CKD significantly ameliorated type Ⅳ collagen (CⅣ) (: 2.17, 95% : 3.01 to 1.34), type Ⅲ procollagen (PCⅢ) (: 1.08, 95% : 1.64 to 0.53), laminin (LN) (: 1.28, 95% : 1.65 to 0.90), transforming growth factor ß 1 (TGFß1) (: 0.65, 95% : 1.18 to 0.12), serum creatinine (Scr) (: 1.36, 95% : 1.85 to 0.87), blood urea nitrogen (BUN) (: 1.51, 95% : 2.59 to 0.43), and 24 h urine protein (24hUpro) (: 1.23; 95% : 1.96 to 0.50). The level of hyaluronic acid (HA) was similar in both types of treatment (: 0.74, 95% : 1.91 to 0.44). The subgroup analysis showed that the duration of 8 weeks might affect the concentration of C-Ⅳ, PC-Ⅲ, and LN (<0.05). The effectiveness of the longer duration to C-Ⅳ, PC-Ⅲ, and LN was not certain. However, the result should be interpreted in care. The safety of the treatment using ARTCM and WM could not be evaluated because a few studies had reported adverse effects. The results of the Metaanalysis were not stable enough. There was publication bias for the reports on Scr ( 0.001), C-Ⅳ ( 0.001), PC-Ⅲ ( 0.026), and LN ( 0.030) and no publication bias for the reports on BUN ( 0.293). The quality of evidence varied from low to very low. CONCLUSIONS: The combined treatment using ARTCM and WM to manage RF in patients with CKD has some advantages over treatment with WM alone. Highquality RCTs need to be conducted for the strong support.

Danzhi Jiangtang capsule reduces renal injury in rats with diabetes induced by high fat diet and streptozotocin downregulating toll-like receptor 4-nuclear factor-κB pathway and apoptosis.

OBJECTIVE: To investigate the effect and mechanisms of Danzhi Jiangtang capsule (, DJC) on renal injury in streptozotocin (STZ)-induced diabetes of rats. METHODS: Sprague-Dawley rats were fed with high fat diet for 6 weeks followed by streptozotocin (STZ, 35 mg/kg) injection. These rats were then treated with DJC (270, 540 and 1080 mg/kg) daily for 8 weeks. RESULTS: A combination of high fat diet and STZ significantly increased blood glucose creatinine, urea nitrogen, and urine albumin in rats. Meanwhile, the glomerular and tubular lesions were observed in rats fed with high fat diet and injected with STZ. These biochemical and pathological changes were significantly attenuated by DJC treatments in a dose-dependent manner. Mechanistically, DJC treatments significantly decreased toll-like receptor 4 (TLR4), mitogen-activated protein kinase (MAPK), and nuclear factor-κB (NF-κB) signals in the kidney of rats fed with high fat diet and injected with STZ. Terminal deoxynucleotidyl transferase dUTP nick end labeling staining and caspase-8 levels showed that renal apoptosis was increased in rats fed with high fat diet and injected with STZ, and this was attenuated by DJC treatments. CONCLUSIONS: DJC treatments protect against diabetic kidney disease, and the mechanism may be closely related to downregulation of TLR4/MAPK/NF-κB pathways and apoptosis. This study provides further evidence of using DJC as a potential therapeutic option for diabetic kidney disease.

Research progress in role of autophagy in diabetic wound healing and traditional Chinese medicine intervention / 中国中药杂志

Diabetic ulcer(DU) is a chronic and refractory ulcer which often occurs in the foot or lower limbs. It is a diabetic complication with high morbidity and mortality. The pathogenesis of DU is complex, and the therapies(such as debridement, flap transplantation, and application of antibiotics) are also complex and have long cycles. DU patients suffer from great economic and psychological pressure while enduring pain. Therefore, it is particularly important to promote rapid wound healing, reduce disability and mortality, protect limb function, and improve the quality of life of DU patients. By reviewing the relevant literatures, we have found that autophagy can remove DU wound pathogens, reduce wound inflammation, and accelerate ulcer wound healing and tissue repair. The main autophagy-related factors microtubule-binding light chain protein 3(LC3), autophagy-specific gene Beclin-1, and ubiquitin-binding protein p62 mediate autophagy. The traditional Chinese medicine(TCM) treatment of DU mitigates clinical symptoms, accelerates ulcer wound healing, reduces ulcer recurrence, and delays further deterioration of DU. Furthermore, under the guidance of syndrome differentiation and treatment and the overall concept, TCM treatment harmonizes yin and yang, ameliorates TCM syndrome, and treats underlying diseases, thereby curing DU from the root. Therefore, this article reviews the role of autophagy and major related factors LC3, Beclin-1, and p62 in the healing of DU wounds and the intervention of TCM, aiming to provide reference for the clinical treatment of DU wounds and subsequent in-depth studies.

Molecular Mechanism of Resveratrol Against NAFLD Based on Network Pharmacology / 中国实验方剂学杂志

ObjectiveTo predict the molecular mechanism of resveratrol against non-alcoholic fatty liver disease （NAFLD） based on network pharmacology and molecular docking and verify the results on the liver cell model induced by PM2.5 exposure. MethodThe targets of resveratrol were screened out from Traditional Chinese Medicine System Pharmacology Database and Analysis Platform （TCMSP）， PubChem， DrugBank， and SwissTargetPrediction， and the potential targets of NAFLD were retrieved from Comparative Toxicogenomics Database （CTD）， DisGeNET， GeneCards， and Online Mendelian Inheritance in Man （OMIM）. Then the common targets were obtained. STRING 11.5 was used to construct the protein-protein interaction （PPI） network of the common targets. Cytoscape 3.8.2 was used to plot the “target-pathway” network， and the core modules and key targets were selected. Metascape was adopted for Gene Ontology （GO） and Kyoto encyclopedia of genes and genomes （KEGG） enrichment analyses of common targets. SYBYL-X 2.0 was used for molecular docking of resveratrol to key targets. Finally，cell apoptosis and the expression of apoptosis-related proteins were detected by flow cytometry and Western blot in the PM2.5-exposed human liver cell line （HepG2）. ResultA total of 115 common targets of resveratrol and NAFLD were obtained. The key targets included tumor necrosis factor （TNF）， B-cell lymphoma-2 （Bcl-2）， and cysteinyl aspartate-specific protease-3（Caspase-3）. As revealed by KEGG enrichment analysis， 174 signaling pathways， represented by the apoptosis and TNF signaling pathways， were obtained. Molecular docking results showed that resveratrol had strong binding activities to Bcl-2 and Caspase-3. Furthermore，the results of flow cytometry and Western blot demonstrated that resveratrol inhibited cell apoptosis of PM2.5-exposed HepG2 cells by regulating the protein expression of Bcl-2 and Caspase-3. ConclusionResveratrol can treat NAFLD in a multi-pathway and multi-target way. It mainly inhibits liver cell apoptosis by affecting the expression of Bcl-2 and Caspase-3， which provides a theoretical basis for the follow-up research on the anti-NAFLD mechanism of resveratrol.

Effect of moxibustion on Nrf2/HO-1 signaling pathway in rats with diminished ovarian reserve / 中国针灸

OBJECTIVE@#To observe the effect of moxibustion on Nrf2/HO-1 signaling pathway in rats with diminished ovarian reserve (DOR), and to explore the protective mechanism of moxibustion on ovarian reserve function.@*METHODS@#Forty SD rats were randomly divided into a blank group, a model group, a moxibustion group and a hormone group, 10 rats in each group. The rats in the model group, moxibustion group and hormone group were treated with intragastric administration of tripterysium glycosides turbid liquid to prepare DOR model. The rats in the blank group were treated with intragastric administration of sodium chloride solution with the same volume, once a day for 14 days. The rats in the hormone group were treated with hormone sequential therapy for 14 days from the day of modeling; the rats in the moxibustion group were treated with moxibustion at bilateral "Shenshu" (BL 23) or "Guanyuan" (CV 4) and "Zhongwan" (CV 12) from the day of modeling, and the two groups acupoints were alternated every other day, 10 min each time, for 14 consecutive days. The estrus cycle was observed every day by vaginal exfoliated cell smear, and the estrus cycle disorder rate in each group was calculated. After the intervention, the HE staining was used to observe the histological morphology of ovaries; ELISA was used to detect the contents of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E@*RESULTS@#Compared with the blank group, the rate of estrus cycle disorder in the model group was increased (@*CONCLUSION@#Moxibustion could reduce the rate of estrus cycle disorder, improve the level of serum sex hormones and antioxidant stress in DOR rats, and the mechanism may be related to the regulation of Nrf2/HO-1 signaling pathway.

Mechanism of Sleep Deprivation and Cognitive Impairment and Research Progress of Traditional Chinese Medicine Intervention / 中国实验方剂学杂志

Adequate sleep is an important factor to ensure the healthy functioning of the body. A type of chronic sleep diseases characterized by insufficient sleep can be collectively referred to as sleep deprivation （SD）， which is divided into primary and secondary sources in terms of sources. As one of the most frequent types of diseases in recent years， SD has received more and more attention and attention from the whole society. SD can have a wide-ranging and far-reaching impact on cognitive behavior， such as decreased wakefulness， decreased alertness， and inattention， decreased sensory perception， decreased learning and memory capabilities， et al， involving the impact on multiple system functions of the human body， and It is closely related to the occurrence of many diseases， and may cause serious troubles to the normal life of patients and even their relatives and friends. The cognitive impairment caused by SD has been fully verified in clinical tests and various animal behavior experiments， mainly involving pathological damage such as changes in synaptic plasticity， enhanced endoplasmic reticulum stress， circadian rhythm disorders， and energy metabolism imbalance. Western medicine treatments for SD mostly have negative factors such as high side effect and strong addiction. However， Chinese medicine intervention focuses on the overall concept， has long-lasting effectiveness， significant effects， and mild side effects. It has also been widely recognized clinically for improving the complications of sleep disorders. This article reviews the current status and classification of SD research， its pathological mechanisms that lead to cognitive impairment and its molecular-level exploration directions and results. In recent 5 years， the therapeutic effect and experience of traditional Chinese medicine intervention therapy such as compound Chinese medicine， acupuncture and moxibustion as well as auxiliary therapy such as exercise and five sounds， in order to further summarize and clarify the interaction mechanism between SD and cognitive behavior， and provide a theoretical basis for the study of the pathological mechanism of SD disease and future clinical treatment.

[Influence of early bolting on anatomical structure and coumarins of Peucedanum praeruptorum].

To explore the effects of early bolting on the quality of Peucedanum praeruptorum, the anatomical structures of P. praeruptorum root between bolting and no-bolting were investigated by paraffin section method, and contents of praeruptorin A, praeruptorin B, praeruptorin E, bergapten were determined by HPLC, then the differences and inter-relations were studied by comparative analysis method. The results showed that there existed great influences of early bolting on the root anatomical structures and coumarins content of P. praeruptorum.(1)The area of pericyclic parenchyma tissue and secondary phloem in P. praeruptorum without bolting are large, and have higher content of coumarins.(2) The areas of secondary phloem in bolting P. praeruptorum are large, and have lot of vessels and wood fiber, and the content of coumarins is low.(3)There are significant different of coumarins contents in P. praeruptorum with and without bolting, in their main root(MR),outside the vascular cambium(PP), inside the vascular cambium(PX), and the leaf(LF) parts, and the total content of coumarins was PP>MR>LF>PX. Accordingly, the root anatomical structure and active component of P. praeruptorum were changed after early bolting, which have an important influence on the quality of Peucedani Radix.

Efficacy and mechanism of electroacupuncture on insulin resistant polycystic ovary syndrome / 中国针灸

OBJECTIVE@#To explore the therapeutic effect and partial mechanism of electroacupuncture (EA) for patients with insulin resistance (IR) polycystic ovary syndrome (PCOS).@*METHODS@#Seventy patients with IR-PCOS were randomly divided into an EA group (36 cases, 5 cases dropped off) and a medication group (34 cases, 4 cases dropped off). The patients in the medication group were treated with oral administration of metformin hydrochloride, 500 mg each time, twice a day. The patients in the EA group were treated with EA (continuous wave, 2 Hz of frequency) at Zusanli (ST 36), Zhongwan (CV 12), Qihai (CV 6), Yishu (EX-B 3), Shenshu (BL 23), Pishu (BL 20), Ciliao (BL 32) for 30 min, three times a week. One menstrual cycle or 4 weeks were taken as a course of treatment, and 3 continuous courses were given. The follow-up was 3 months. The lipid metabolism indexes of triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL), homeostasis model assessment-insulin resistance index (HOMA-IR) and testosterone (T) in serum were compared before and after treatment, and the clinical effects of the two groups were evaluated during the follow-up.@*RESULTS@#The total effective rate was 67.7% (21/31) in the EA group and 60.0% (18/30) in the medication group, with no significant difference between the two groups (>0.05). After treatment, the levels of serum T, HOMA-IR, LDL, TG and TC were decreased significantly in the two groups (<0.01, <0.05), and HDL was increased significantly (<0.01); the levels of TC in the EA group after treatment was lower than that in the medication group (<0.05).@*CONCLUSION@#EA may adjust some dyslipidemia in patients to correct IR and improve endocrine disorder of PCOS, which had superior/similar effects to metformin.

Virtual screen of effective AChE inhibitory constituents from Glycyrrhizae Radix et Rhizoma based on pharmacophore and molecular docking / 中国中药杂志

This research is to predict anti-Alzheimer's disease active constituents on the target of acetylcholinesterase(AChE) from Glycyrrhizae Radix et Rhizoma with the help of pharmacophore and molecular docking. AChE ligand-based pharmacophore model was set up and the molecular library of the constituents from Glycyrrhizae Radix et Rhizoma were established by collecting literature. Then the constituents from Glycyrrhizae Radix et Rhizoma were screen for the potential AChE inhibitory potency in silico through matching with the best pharmacophore model. The flexible docking was used to evaluate the interactions between compounds screened from pharmacophore model and AChE protein(PDB ID:4 EY7). The interactions were expressed including but not limited to CDOCKER interaction energy, hydrogen bonds and non-bonding interactions. The molecular library of Glycyrrhizae Radix et Rhizoma contains 44 chemical constituents. As for the pharmacophore model, six kinds of potential AChE inhibitory constituents from Glycyrrhizae Radix et Rhizoma were considered to be the promising compounds according to the results of searching 3 D database of pharmacophore model. The molecular docking was possessed and the interaction patterns were given to show the detail interactions. The compounds screening from the pharmacophore model were consistent with the existing studies to some degree, indicating that the virtual screen protocols of AChE inhibitory constituents from Glycyrrhizae Radix et Rhizoma based on pharmacophore and molecular docking was reliable.

Application of four-track teaching mode (LBL, CBL, PBL and mind map) in the pediatric teaching of integrated traditional Chinese and Western Medicine / 中华医学教育探索杂志

Objective:To explore the application effect of four-track teaching mode (LBL: lecture-based learning; CBL: case-based learning; PBL: problem-based learning) in pediatric teaching of integrated traditional Chinese and Western Medicine.Methods:175 integrated traditional Chinese and Western medical students in seven-year program were divided into experimental group and control group. The experimental group was taught by four-track teaching mode, while students in the control group. Were applied with traditional teaching method ("LBL+CBL").Results:Students in the experimental group highly rated the four-track teaching mode and were better than those in the control group in the following aspects: satisfaction with teaching methods, interest in learning, the ability of creative thinking, the thinking ability of clinical diagnosis and treatment, and memorization ( P<0.05). And students' mid-term, final and comprehensive scores in the experimental group were significantly higher than those in the control group ( P<0.05). Conclusion:Compared with traditional teaching methods, the four-track teaching mode can improve the quality of pediatric teaching of integrated traditional Chinese and Western medical students, which should be further integrated and perfected in the teaching practice.

Research progress and application strategy on network pharmacology in Chinese materia medica / 中草药

Chinese materia medica (CMM) is a complex system with multiple components, multiple targets and multiple pathways. CMM and its compound prescription for the treatment of diseases follow the thought of holistic view. As an important part in systems biology, network pharmacology is a new subject to reveal the role of traditional Chinese medicine in regulating the organism network at the system level, its characteristics of integrality, systematicness and emphasis on drug interactions are consistent with the basic features of traditional Chinese medicine. It has built a bridge for the study of the relationship between traditional Chinese medicine and modern pharmacology. The paper summarizes the present application status and existing problem of network pharmacology in the field of traditional Chinese medicine, and systematically describes the research thinking, key technology and application method and strategy of network pharmacology. It is the purpose to provide the guidance and reference for the reveal of the modern scientific connotation of traditional Chinese medicine with the network pharmacology.

Clinical Efficacy and 5-HT，VIP Levels of Hegan Granule in Treating Non-erosive Reflux Disease of Liver Depression and Spleen Deficiency / 中国实验方剂学杂志

Objective: To observe the clinical efficacy of Hegan granule in the treatment of non-erosive reflux disease with liver stagnation and spleen deficiency syndrome and its effect on quality of life, 5-hydroxytryptamine (5-HT) and vasoactive intestinal peptide (VIP) level. Method: Patients with non-erosive reflux disease of liver stagnation and spleen deficiency were randomly divided into treatment group (32 cases) and control group (33 cases). The treatment group was orally given Hegan granules after meal, 10 g/bag, 1 bag/time, 2 times/day. The control group was orally given with omeprazole enteric-coated tablets twice daily, 20 mg/grain. Both groups were treated for 8 weeks. The total scores of traditional Chinese medicine (TCM) symptoms, SF-36 health scale scores, 5-HT and VIP levels were observed before and after treatment. Result: The medical efficacy of the two groups was 87.5%and 81.8%in the treatment group and the control group, respectively. The treatment group was superior to control group (PPPPConclusion: Hegan granule has a good clinical efficacy in treating patients with non-erosive reflux disease and liver stagnation and spleen deficiency. It can significantly alleviate the symptoms of TCM, improve the quality of life of patients, and reduce the sensitivity of esophageal viscera.

Effects of Scalp Acupuncture Combined with Cognitive Training on Cognitive Impairment after Traumatic Brain Injury / 中国康复理论与实践

Objective:To investigate the clinical effects of scalp acupuncture combined with cognitive therapy on cognitive impairment after traumatic brain injury. Methods:From June, 2016 to October, 2017, 60 patients with cognitive impairment after traumatic brain injury were randomly divided into scalp acupuncture group (n = 20), cognitive training group (n = 20) and combined group (n = 20), who accepted their own therapies for 40 times. They were assessed with Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and modified Barthel Index (MBI) before and after treatment. Results:All the groups improved in the scores of MMSE, MoCA and MBI after treatment (F > 21.923, P < 0.001), which were the best in the combined group (F > 3.423, P < 0.05). Conclusion:Combination of scalp acupuncture and cognitive training is more effective on cognitive impairment after traumatic brain injury.

Therapeutic effects on ovulation and reproduction promotion with acupuncture and clomiphene in polycystic ovary syndrome / 中国针灸

<p><b>OBJECTIVE</b>To compare the difference in the therapeutic effects on ovulation disorder in polycystic ovary syndrome (PCOS) between the combined therapy of electroacupuncture and clomiphene and the single medication of clomiphene and to explore the effect mechanism.</p><p><b>METHODS</b>A total of 80 patients of PCOS were randomized into an acupuncture plus medication group (40 cases) and a medication group (40 cases). In the medication group, since the 5th day of menstruation or medicine-withdrawal bleeding, clomiphene was prescribed for oral administration, continuously for 5 days. In the acupuncture plus medication group, the medication was the same as the medication group. Additionally, 30 min electroacupuncture (continuous wave, 2 Hz) was applied to Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Dahe (KI 12), Sanyinjiao (SP 6), Zhongji (CV 3), Diji (SP 8), Shenshu (BL 23), Sanjiaoshu (BL 22) and Ciliao (BL 32), etc. The treatment started on the 5th day of menstruation or medicine-withdrawal bleeding, once every two days, 3 times a week. One cycle of menstruation or 1 month was taken as one course. The treatment cycles were 3 months in the two groups. The level of estradiol (E) and progesterone (P) in the serum, the endometrial thickness and morphology, ovulation rate and clinical pregnancy rate, as well as the clinical therapeutic effects were compared after treatment in the two groups.</p><p><b>RESULTS</b>Two cases were dropped out because the herbal medicine was taken simultaneously in the acupuncture plus medication group. In the medication group, the medication was discontinued in 3 cases due to gastrointestinal adverse reactions. The total effective rate was 86.8% (33/38) in the acupuncture plus medication group, better than 64.9% (24/37) in the medication group (<0.05). The ovulation rate in the acupuncture plus medication group was higher than that in the medication group [(86.8%, 33/38) vs (64.9% 24/37), <0.05]. The pregnancy rate in the acupuncture plus medication group was higher than the medication group in tendency, without significant difference [21.1% (8/38) vs 16.2% (6/37), >0.05]. After treatment, the results of endometrial thickness and morphology (A-type rate) in the acupuncture plus medication group were better than those in the medication group (<0.01, <0.05). After treatment, regarding the levels of E and P in the serum in the window period of implantation, the results in the acupuncture plus medication group were higher remarkably than those in the medication group (both <0.01).</p><p><b>CONCLUSION</b>The combined intervention of electroacupuncture and clomiphene achieves the definite effects of ovulation and pregnancy promotion in PCOS. It remarkably increases the levels of E and P in the serum, the endometrial thickness and A-type rate. The therapeutic effects of the combined intervention are remarkably better than those of the simple application of clomiphene. This combined intervention is safe and tolerable for the adverse reactions. The effect mechanisms may be related to the improvements of estrogen, progestin and endometrial receptivity.</p>

Fumigation treatment of Four Yellow Qing Ling Water with artificial tears for dry eyes / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To observe the clinical efficacy of fumigation treatment of traditional Chinese medicine(Four Yellow Qing Ling Water) for dry eye, and to provide the reference for clinical treatment of dry eye. · METHODS: Totally 82 patients (164 eyes) were randomly divided into two groups from June 2016 to December 2016 in Ophthalmology Department of our hospital. The patients in control group were given artificial tears;the patients in the observation group were given artificial tears and fumigation treatment of traditional Chinese(Four Yellow Qing Ling Water) once a day. After treatment for 14d, the SchirmerⅠtest (SⅠt), break-up time (BUT), cornea fluorescein staining (FL) and clinical efficacy of two groups were compared. ·RESULTS:The efficiency rate of observation group was significantly better than the control group (87. 8% vs 70.7%,P<0.5). The SⅠt and BUT in the observation group were significantly higher than those in the control group (8.43 ± 2.51mm/5min vs 6.38 ± 2.52mm/5min, P<0.05;8.60±2.47s vs 6.35±2.29s, P<0.05); the FL in the observation group (0.84 ± 0.75 vs 1.26 ± 0.84, P<0.05) significantly lower than those in the control group. ·CONCLUSION: The fumigation treatment of traditional Chinese medicine (Four Yellow Qing Ling Water) combined with artificial tears for dry eyes can improve the clinical symptoms of dry eye syndrome.

Advance in studies on anti-inflammatory and immunoregulatory monomers of Tripterygium wilfordii / 中国中药杂志

Tripterygium wilfordii has complex chemical components. To study and summarize the advance in studies on the anti-inflammatory and immunoregulatory activities and toxicology of known monomers of T. wilfordii, the pertinent literatures related to the studies on the pharmacology, toxicology and pharmacokinetics of T. wilfordii over past 30 years were searched. According to the findings, more than ten anti-inflammatory and immunoregulatory monomers were found in T. wilfordii. The pharmacology and toxicology of wilforidine, triptolidenol, triptonide, demethylzeylasteral shall be further studied.

Meta-analysis of the efficacy of combined therapy vitamin D with calcium in nutritional rickets / 国际儿科学杂志

Objective To assess the efficacy of combined vitamin D with calcium and vitamin D or cal-cium alone in rickets of vitamin D deficiency by meta-analysis method. Methods Searches were made in Cochrance Library , Pubmed, Web of science, Scirus, CNKI, Chinese Biological Medical Literature Database, (CBM),Wangfang from the establishment of the data base till March 2013. All randomized controlled trials about combined with vitamin D and calcium in rickets of vitamin D deficiency were eligible. Serum 25-( OH) ritamin D,phosphate ,ALP,calcium,PTH,phosphate,albumin ,radiographic score were chosen as evaluation in-dex to evaluate the weighted mean diffreence ( WMD) and 95% confidence interval ( CI) for continuous data. RevMan 5. 0. 2 software was used to make meta-analysis. Results 437 literatures were reviewed. Three eligible trials were used for meta-analysis. Meta-analysis showed that:(1)the increase of Serum 25-(OH)vitamin D:Combined therapy group and vitamin D group (MD= -7. 88,95%CI:-12. 24~ -3. 52);Combined therapy group and calcium group (MD= -18. 32,95%CI:-22. 61~ -14. 04). (2)the increase of serum phosphate:Combined therapy group and vitamin D group ( MD= -0. 64 ( 95%CI:-0. 86 ~ -0. 42 );Combined therapy group and calcium group MD= -0. 16 ( 95%CI:-0. 84 ~0. 51 ) . ( 3 ) the decrease of Serum ALP:Combined therapy group and vitamin D group (MD= 109. 99,95%CI:20. 40 ~199. 58);Combined therapy group and calcium group (MD=59. 89,95%CI:10. 09~109. 59 ). (4)the increase of serum calcium :Combined therapy group and vitamin D group (MD= -0. 71,95%CI:-0. 91,-0. 52);the decrease of Radiographic score:Com-bined therapy group and vitamin D group( MD=0. 68,95%CI:0. 42~ 0. 95). Except that the increase of serum phosphate between combined therapy group and calcium group had no significant difference,the rest had signifi-cant difference. Conclusion The long term efficacy in combined therapy group is much effective than vitamin D group or calcium group.

A randomized, single-center study of equivalence of 2 intraocular lenses used in cataract surgery.

PURPOSE: To compare the outcomes of 2 intraocular lenses (IOLs) for the treatment of age-related cataracts. DESIGN: Prospective, randomized trial. PARTICIPANTS: Patients with age-related cataracts were recruited and randomized to receive phacoemulsification and implantation of either the AcrySof SA60AT lens (Alcon, Inc, Fort Worth, TX) or the low-cost Tecsoft Flex lens (Fred Hollows Foundation, Tilganga, Nepal). A total of 300 patients were available for description and analysis (148 in the AcrySof group and 152 in the Tecsoft group). METHODS: Patients underwent phacoemulsification and implantation of the AcrySof SA60AT lens or the Tecsoft Flex lens. They were followed up and examined at baseline, 1 week, 1 month, 6 months, and 12 months after cataract surgery. MAIN OUTCOME MEASURES: Uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BDVA), incidence of posterior capsule opacification (PCO), Visual Function Index questionnaire results, and safety of the implanted IOLs. RESULTS: No significant difference (P>0.05) was found in UDVA and BDVA after surgery between the 2 groups. The equivalence test of the 95% confidence intervals showed that both lenses had an equal improvement of UDVA and BDVA as well as similar rates of PCO after cataract surgery. There was no significant difference between the 2 groups with regard to visual functioning or the incidence of adverse surgical events during (P>0.05) or after (P>0.05) the surgery. CONCLUSIONS: The Tecsoft Flex IOL is a low-cost suitable alternative that is similar to the AcrySof IOL in terms of safety and visual outcomes.

Effects of epimedium total flavonoids on bone mineral density and bone metabolism-related indices in primary osteoporosis / 中国组织工程研究

BACKGROUND: Previous animal experiments have shown that epimedium total flavonoids can exhibit preventive effects on estrogen-related bone loss, but few data are available in clinical research.OBJECTIVE: To investigate the effects of pimedium total flavonoids on bone mineral density (BMD) inprimary osteoporosis.DESIGN, TIME AND SETTING: A randomized, double-blinded, positively controlled clinical observation was performed at the Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between June 2005 and September 2007.PARTICIPANTS: A total of 64 patients with primary osteoporosis consisting of 11 males and 53 females were included in this study. METHODS: All patients were randomly and evenly assigned into a treatment group and a control group. The treatment group was orally administered epimedium total flavonoids, 0.45 g once, three times daily, for a total of 6 months. Simultaneously, the control group was orally administered Gushukang, 10 g once, twice daily, for a total of 6 months. MAIN OUTCOME MEASURES: BMD in the sites of lumbar vertebrae (L1-4), neck of femur, Wards triangle, greater trochanter, and left hip was measured, and simultaneously serum levels of calcium, phosphorus, and alkaline phosphatase (ALP) were detected pdor to and after treatment in each group.RESULTS: All 64 patients with primary osteoporosis were included In the final analysis, The BMD in the lumbar vertebrae (L1-4) was significantly higher in the treatment group than in the control group (P<0.05) and there was no significant difference In BMD in other sites between the two groups (P>0.05). Compared with pdor to drug application, BMD in the treatment group did not present obvious change after epimedium total flavonoids application, while in the control group, BMD in the sites of lumbar vertebrae (L1-4), neck of femur, Wards triangle, and greater trochanter was significantly decreased (P<0.01-0.05). After drug application, serum level of calcium was significantly increased in each group, compared with prior to drug application (P<0.05), and no significant difference existed between the treatment and control groups (P>0.05). Tn the treatment group, serum levels of phosphorus and ALP did not alter significantly compared with prior to epimedium total flavonoids application (P>0.05).CONCLUSION: Epimedium total flavonoids exhibit effective effects on the maintenance of BMD in primary osteoporosis.

Clinical Study on 48 Cases of Progressive Cerebral Infarction Controlled by Aspirin Failure to be Treated with Low Molecular Weight Heparin plus Traditional Chinese Medicine / 国际中医中药杂志

Objective To observe the clinical effects and safety of preventing progressive cerebral infafction failure to be controlled by Aspirin with the low-molecular-weight heparin combined with traditional Chinese medicine.Methods All cases diagnosed by CT SCan to be progressive cerebral infarction were randomly recruited into a control group and a treatment group,with 48 cases in each group.The treatment group was treated with low molecular heparin of 4000u/times,twice/day for 7 days MS and then was administrated with warfarin and Daqinjiao decoction.The control group was treated with aspmn of 200mg/day for 7 days and 150mg/day for the rest.Neurological deficit SCOre and efficacy evaluation was assayed 30 days before and after the treatment.Results Clinical results showed that the therapeutic effects oftlle treatment group Was much better than the control group(P＜0.05).Besides the incidence of serious bleeding complications were mcreasmg.Conclusion Low molecular heparin combined with traditional Chinese medicine is effective and safe to treat the patients of progresmve cerebral infaretion whose disease failed to be controlled bv Aspirin.