Discussion on acupuncture analgesia from the perspective of acupuncture regulating mind / 中国针灸

To explore the regulating effect of acupuncture on pain based on the three dimensions of pain (pain sensation, pain emotion and pain cognition). The pain sensation is related to the body, the pain emotion is related to the seven emotions, the pain cognition is related to the mind of the five zang, and the three dimensions of pain interact with each other. Through the two ways of "regulating qi to treat mind" and "treating mind to regulate qi ", acupuncture comprehensively acts on pain sensation, pain emotion and pain cognition to achieve comprehensive regulation of pain.

Electroacupuncture Improves Blood-Brain Barrier and Hippocampal Neuroinflammation in SAMP8 Mice by Inhibiting HMGB1/TLR4 and RAGE/NADPH Signaling Pathways / 中国结合医学杂志

OBJECTIVE@#To investigate the molecular mechanisms underlying the beneficial effect of electroacupuncture (EA) in experimental models of Alzheimer's disease (AD) in vivo.@*METHODS@#Senescence-accelerated mouse prone 8 (SAMP8) mice were used as AD models and received EA at Yingxiang (LI 20, bilateral) and Yintang (GV 29) points for 20 days. For certain experiments, SAMP8 mice were injected intravenously with human fibrin (2 mg). The Morris water maze test was used to assess cognitive and memory abilities. The changes of tight junctions of blood-brain barrier (BBB) in mice were observed by transmission electron microscope. The expressions of fibrin, amyloid- β (Aβ), and ionized calcium-binding adapter molecule 1 (IBa-1) in mouse hippocampus (CA1/CA3) were detected by reverse transcription-quantitative polymerase chain reaction (qRT-PCR), Western blot or immunohistochemical staining. The expression of fibrin in mouse plasma was detected by enzyme-linked immunosorbent assay. The expressions of tight junction proteins zonula occludens-1 and claudin-5 in hippocampus were detected by qRT-PCR and immunofluorescence staining. Apoptosis of hippocampal neurons was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining.@*RESULTS@#Fibrin was time-dependently deposited in the hippocampus of SAMP8 mice and this was inhibited by EA treatment (P<0.05 or P<0.01). Furthermore, EA treatment suppressed the accumulation of Aβ in the hippocampus of SAMP8 mice (P<0.01), which was reversed by fibrin injection (P<0.05 or P<0.01). EA improved SAMP8 mice cognitive impairment and BBB permeability (P<0.05 or P<0.01). Moreover, EA decreased reactive oxygen species levels and neuroinflammation in the hippocampus of SAMP8 mice, which was reversed by fibrin injection (P<0.05 or P<0.01). Mechanistically, EA inhibited the promoting effect of fibrin on the high mobility group box protein 1 (HMGB1)/toll-like receptor 4 (TLR4) and receptor for advanced glycation end products (RAGE)/nicotinamide adenine dinucleotide phosphate (NADPH) signaling pathways (P<0.01).@*CONCLUSION@#EA may potentially improve cognitive impairment in AD via inhibition of fibrin/A β deposition and deactivation of the HMGB1/TLR4 and RAGE/NADPH signaling pathways.

Systematic chemical characterization of Xiexin decoctions using high performance liquid chromatography coupled with electrospray ionization mass spectrometry / 中国天然药物

Xiexin decoctions (XXDs) display beneficial anti-inflammatory and anti-diabetic effects, which raises interests on this group of formulae for broad clinical applications. However, there was no report about systematic analysis of XXDs to elucidate the constitution of chemical components, which hampers further investigations on the therapeutic values of XXDs. In this work, crude herbs were extracted and prepared to obtain the XXDs for systemic analysis on their chemical compositions, according to the information described in the ancient Zhang Zhongjing's herbal formulae. LC-MS analysis of five XXDs was carried out to facilitate recognition of the source herbs for compounds in the mixture. A total number of 93 compounds were identified through our methods and their chemical classes encompassed five major groups, including protoberberine alkaloids, flavonoids, stilbenes, anthraquinones and saponins. Our current work provided important information about material basis for pharmacological studies on XXDs and would help shed light on relationships between chemical compositions and therapeutic effects.

Clinical study of Guben-Tiaoping Decoction in improving the success rate of inhaled corticosteroid stepwise treatment in asthma / 国际中医中药杂志

Objective:To evaluate the effect of combined use of Guben-Tiaoping Decoction on the success rate of stepwise treatment and life quality of asthma patients. Methods:A total of 76 patients with asthma in remission stage who were using ICS were divided into treatment group (38 cases) and control group(38 cases) according to random number table. Both groups were treated with ICS reduction based on the 2017 Gina Protocol. The treatment group was treated with Guben-Tiaoping Decoction for 12 weeks. The number of patients who were able to successfully complete the stepwise treatment after the end of the trial was calculated, the relevant indexes of Asthma Control Test (ACT), TCM Syndrome score, St. George’s respiratory questionnaire (SGRQ) and lung function were collected before and after treatment. Result:After 12 weeks’ treatment, the success rate of stepwise was 89.5% (34/38) in the treatment group and 78.9% (30/38) in the control group ( χ2=14.862, P=0.001). Meanwhile, the ACT score of the treatment group were better than those in the control group (Daytime symptoms t=-3.860, P=0.001, Dyspnea t=-2.007, P=0.40, Night waking t=-2.732, P=0.009, Reliever needed for symptoms t=-2.262, P=0.031, Control situation t=-6.994, P=0.001, Total Score t=-9.562, P=0.001). The score of TCM Syndrome in the treatment group was significantly lower than that of the control group ( P=0.001); PEF in treatment group [(6.92 ± 1.71) L vs. (5.84 ± 1.22) L; t=-2.880, P=0.005] was significantly better than that of the control group. Conclusion:Guben-Tiaoping Decoction is helpful to improve the success rate of ICS stepwise treatment and the life quality of patients.

Association of PLCB1 gene polymorphism with the risk of central precocious puberty in Chinese Han girls / 中国学校卫生

Objective@#To investigate the association between mutation of PLCB1, the downstream gene of KISS1/GPR54 pathway, and the risk of central precocious puberty (CPP) in Chinese Han girls.@*Methods@#Totally 169 pairs of CPP girls on their first visit to hospital and age-matched controls (± 3 months) were recruited. The genotypes of rs6140544, rs11476922, rs3761170 and rs2235613 were determined and the effect of loci variations on CPP was investigated.@*Results@#After adjusting for confounding factors (BMI, maternal age at menarche, maternal age at birth, and time for bed), rs2235613 variation was significantly negative associated with CPP in recessive models(OR=0.46，95%CI=0.24-0.91), and mutation in rs3761170 increased the risk of CPP in dominant models (OR=1.99，95%CI=1.01-3.93).@*Conclusion@#The study suggests that mutation in rs3761170 increases the risk of CPP and rs2235613 variation may have a protective effect on the risk of CPP.

An analysis of risk factors for cardio-cerebrovascular disease in middle-aged and elderly adults / 中华老年医学杂志

Objective:To analyze the risk factors for cardio-cerebrovascular disease(CCVD)in adults aged 45 years and over, so as to provide the basis for formulating intervention and control measures of risk factors and improving the prognosis.Methods:In-service and retired employees of Tianjin First Central Hospital who underwent health examinations from September 2016 to August 2017 were enrolled in this cross-sectional study.A total of 4815 subjects aged 45 years and over were included, and they were divided into the CCVD group(n=947)and the control group(n=3868)according to previous history of myocardial infarction or coronary stent implantation, cerebral hemorrhage and cerebral infarction.Meanwhile, subjects were divided into the 45-59 years old group(n=2123), the 60-74 years old group(n=1434)and the 75-84 years old group(n=1258). Fasting blood glucose(FBG), glycated hemoglobin(HbA1c), blood lipids, blood pressure(BP)and body mass index(BMI)were measured and recorded.Risk factors for CCVD were analyzed by logistic regression analysis.Results:A total of 4 815 valid samples were obtained.There were statistically significant differences in BMI, BP, FBG, HbA1c, triglyceride and high-density lipoprotein cholesterol(HDL-C)between the CCVD group and the control group( P<0.05).60-74 years old( OR=1.67, 95% CI: 1.37-2.02, P<0.01), 75-84 years old( OR=2.95, 95% CI: 2.42-3.61, P<0.01), emaciation( OR=1.44, 95% CI: 1.21-2.26, P<0.05), overweight( OR=1.24, 95% CI: 1.04-1.48, P<0.05)and obesity( OR=1.49, 95% CI: 1.17-1.91, P<0.01)were risk factors for CCVD.The risk of CCVD was higher in diabetes mellitus patients with poor blood glucose control than in subjects without diabetes mellitus( OR=1.74, 95% CI: 1.42-2.14, P<0.01). With the increase of hypertension grade, the risk of coronary heart disease(CHD)was also increased( OR=1.50, 1.78 and 2.96, respectively). Compared with subjects without hypertension, hypertensive patients with target blood pressure control had a higher risk for CHD( OR=1.92, 95% CI: 1.46-2.54, P<0.01). Gender, smoking history, dyslipidemia and fatty liver were not correlated with CCVD in people aged 45 years and above. Conclusions:The prevention and treatment of CCVD should be focused on proper body weight maintenance, BP control, FBG adjustment and comprehensive management of complications in people aged 45 years and above.

Network Pharmacology Study on the Mechanism of Wutou Decoction in the Treatment of Osteoarthritis / 中国药房

OBECTIVE： To study the mechanism of Wutou decoction in the treatment of osteoarthritis， and to provide a new direction and target for the treatment of osteoarthritis. METHODS： Using oral bioavailability （OB）≥30％， drug like （DL）≥0.18％ as index， active components were screened from Wutou decoction by using TCM systematic pharmacological analysis platform （TCMSP）， such as Aconitum carmichaelii， Ephedra sinica， Astragalus propinquus， Paeonia tactilora， Glycyrrhiza uralensis. Targets of osteoarthritis were obtained by retrieving therapeutic targets database （TTD） and mining thip data from gene expression database （GEO）. Target genes were analyzed by GO and KEGG pathway enrichment analysis were performed by using DAVID database. RESULTS： A total of 30 active components were screened， including quercetin， terpenoids and gardenol； 31 targets related to osteoarthritis were obtained， including β2 adrenergic receptor， arachidonate 5-lipoxygenase and androgen receptor. The biological process of Wutou decoction in treatment of osteoarthritis was mainly related to the IL-1 receptor signal transduction， synergistic activation of peroxidase proliferation activated receptor， signal transduction of tyrosine kinase receptor 2. It mainly regulated tumor necrosis factor signaling pathway， vascular endothelial growth factor signaling pathway， osteoclasts differentiation signaling pathway， nuclear factor κB signaling pathway， Toll-like receptor signaling pathway so as to play a role in the treatment of osteoarthritis. CONCLUSIONS： The study analysis the potential mechanism of Wutou decoction in the treatment of osteoarthritis based on network pharmacology， which can provide reference for further study on the material basis and target of Wutou decoction in the treatment of osteoarthritis.

A new oleanane type triterpenoid from Viburnum taitoense Hayata / 药学学报

The chemical constituents of Viburnum taitoense Hayata were investigated using column chromatography silica gel and Sephadex LH-20, etc. Seven pentacyclic triterpenoids were isolated and their structures were elucidated by spectral data and physicochemical properties as 3β,6β-dihydroxy olean-11,13(18)-dien-28-acid (1), 3β-hydroxy olean-11,13(18)-diene-28-acid (2), 12-ene-olean-28-acid-3β-palmitate (3), 3β-acetylcocodiol (4), corosolic acid (5), uvaol (6) and ursolic acid (7). Among them, compound 1 is a new oleanane type triterpenoid and its absolute configuration was confirmed by single-crystal X-ray diffraction data. Compounds 2-5 were isolated from this genus for the first time. All the compounds were evaluated for their anti-inflammatory activities in vitro, and compound 5 showed significant inhibitory activity against nitric oxide (NO) production in lipopolysaccharide (LPS)-induced RAW264.7 macrophage cells with an IC50 of 25.52 ± 0.56 μmol·L-1 when compared to the positive control, quercetin (IC50 of 25.46 ± 0.62 μmol·L-1).

Regulatory effect of phenylephrine on ProANP and ProBNP expressions in rat cardiomyocytes and their relationship with CaN-NFATc3 and MEK3-p38 MAPK signaling pathways / 医学研究生学报

Objective Studies are rarely reported on the relationship of the sympathetic pathway mediated by alpha 1-AR with the expression of the natriuretic peptide and regulation of its activity. Our research aimed to observe the effect of phenylephrine (PE) on the expression of natriuretic peptides and explore the mechanism of phenylephrine acting on the expressions of the atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) as well as their relationships with Calcineurin (CaN)-NFATc3 and MEK3-P38 MAPK signaling pathways.Methods Neonatal rat cardiomyocytes were isolated and cultured in vitro for 72 hours, and then divided into five groups: control, PE, prazosine (Praz)+PE, calcineurin inhibitor cyclosporine (CsA) pretreatment+PE, and P38 MAPK inhibitor SB203580 pretreatment+PE, and treated with respective agents. The proliferation of the cardiomyocytes was determined by trypan blue counting and MTT assay, their viability detected by colorimetry, the protein expressions of ProANP, ProBNP, Calcineurin A and p-P38 MAPK measured by Western blot, and the contents of the NFATc3 (T cell activating transcription factor 3) and MEK3 (MAP2K3, mitogen-activated protein kinase family) examined by ELISA.Results After treatment, the cardiomyocytes in the Praz+PE group were sparsely arranged, with nuclear pyknosis and no regular beating, those in the CsA+PE group exhibited poikilocarynosis, with bright margins and cord-like fibers, and those in the SB203580+PE group, the cytoplasm was lightly stained, with slight fragmentation and lots of dead cells. The A value was increased in the PE group (0.78±0.09) as compared with the control, but decreased in the Praz+PE, CsA+PE and SB203580+PE groups (0.31±0.09, 0.47±0.12 and 0.42±0.14) (P<0.05), significantly lower in the Praz+PE, CsA+PE and SB203580+PE than in the PE group (P<0.05), but higher in the CsA+PE and SB203580+PE than in the Praz+PE group (P<0.05). The expressions of the ProANP and ProBNP proteins in the cardiomyocytes were remarkably upregulated in the PE group as compared with those in the control (P<0.01) but suppressed in the other three groups (P<0.05), significantly lower in the Praz+PE, CsA+PE and SB203580+PE than in the PE group (P<0.05), but higher in the CsA+PE and SB203580+PE than in the Praz+PE group (P<0.05). The expressions of the CaN and p-P38 proteins in the cardiomyocytes were elevated in the PE group as compared with those in the control (P<0.05) but reduced in the other three groups (P<0.05), significantly lower in the Praz+PE, CsA+PE and SB203580+PE than in the PE group (P<0.05), while that of CaN markedly higher in the CsA+PE and SB203580+PE than in the Praz+PE group (P<0.05) and that of p-P38 higher in the CsA+PE than in the Praz+PE group (P<0.05). The expressions of the NFATc3 and MEK3 in the cardiomyocytes were increased in the PE group as compared with those in the control (P<0.05) but decreased in the other three groups (P<0.05), significantly lower in the Praz+PE, CsA+PE and SB203580+PE than in the PE group (P<0.05), but higher in the CsA+PE and SB203580+PE than in the Praz+PE group (P<0.05).Conclusion Phenylephrine can activate the ANP and BNP sympathetic signaling pathways, and CaN-NFATc3 and MEK3-P38 related signaling pathways may be involved in α1-adrenergic receptor-mediated endocrine hormone (ANP/BNP) expressions in isolated cardiomyocytes.

Network pharmacology study on Drynariae Rhizoma in treatment of osteoarthritis / 中草药

Objective: To investigate the potential molecular mechanism of Drynariae Rhizoma in the treatment of osteoarthritis based on network pharmacology and bioinformatics. Methods: The potential active constituents and targets of Drynariae Rhizoma were screened and predicted through the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP). Using TTD and four other osteoarthritis related disease databases, combining the topological analysis, the specific target of Drynariae Rhizoma in the treatment of osteoarthritis was filtered. And the further possible molecular mechanism of Drynariae Rhizoma was analyzed through ClueGo method. Results: Seventy-one corresponding compounds of Drynariae Rhizoma were retrieved from TCMSP. According to the values of oral bioavailability (OB) and drug likeness (DL), 18 possible bioactive components were screened out, and 92 potential targets were obtained by using the related target prediction technique. A total of 168 known targets closely related to the development of osteoarthritis were retrieved from the disease-related databases. A total of 99 key genes were screened out through network topological analysis. The ClueGo analysis showed that the action mode of Drynariae Rhizoma in treating osteoarthritis was mainly working on 31 signaling pathways related to cell cycle, inflammation, infection and cancer etc. Conclusion: Drynariae Rhizoma has the characteristics of multisystem, multiple targets, and multicomponent in the treatment of osteoarthritis. Through analysis, the possible mechanism includes not only directly acting on proliferation, apoptosis, differentiation of cells related to bone reconstruction and regulation of the balance of bone metabolism, but also affecting and interfering the bone and cartilage microenvironment through regulating immunity, inflammation, and other systems, which is consistent with the current mechanism of osteoarthritis treatment.

Effect of remote post-ischemic conditioning on the prognosis of elderly patients with acute cerebral infarction / 中华老年医学杂志

Objective To observe the effect of remote post-ischemic conditioning(RPIOC)on the cerebral blood flow,neural function and prognosis of patients with acute cerebral infarction and the risk factors for short-term prognosis.Methods 133 patients with acute cerebral infarction in the Second Hospital of Beijing from January 2016 to December 2017 were selected,and randomly divided into the RIPOC group(66 cases,with RPIOC)and the control group(67 cases,without RIPOC).In the first day after hospital,patients in the RIPOC group were given RIPOC,which was tightening the left aim with a tonometer bandage for 5 minutes per time and 2 times a day at an interval of 5 minutes.All patients were provided routine treatment.All patients' cerebral blood flow,neural function and survival data were recorded.Recovery was assessed by modified Rankin Scale(mRS)180 d after stroke.Logistic regression was used to evaluate the risk factors for prognosis.Results Of the 133 patients enrolled,there were 67 males.The mean age was (73.1 ± 10.1)year.Basic clinical characteristics,neural function and cerebral blood flow were similar between groups(P＞0.05).After 10 d treatment,cerebral blood flow and neural function was significantly increased (P＜0.05)in the RIPOC group.After 180 d follow up,the RIPOC group had significantly higher rate of adverse cerebrovascular events(P＜0.05).Logistic regression analyses demonstrated that advanced age(P =0.003),hypertension(P =0.03)and high NIHSS score(P =0.005)were all risk factors for prognosis.Conclusions RIPOC can enhance the cerebral blood flow,activities of daily living,limb function and prognosis.However,it does not reduce the risk of mortality.Advanced age,hypertension and high NIHSS score are risk factors for short-term prognosis.

Development and Evaluation of GS-SF for Gastric Stuffiness (Wei PI) Patients Based on Item Response Theory, Computerized Adaptive Testing, and Data Simiuation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To develop and evaluate the short version of patient reported outcomes (PROs) questionnaire for gastric stuffiness (Wei Pi) patients with modern test theory and technologies, hoping to provide testing tools for related clinical practice and scientific researches with higher quality and less administrative and response burdens.</p><p><b>METHODS</b>Using descriptive study design, clinical data were collected with sociological questionnaire and previous developed full items version of PROs instrument for gastric stuffiness (Wei Pi) patients via field and online surveys between Sep 2011 and Mar 2012. The statistical analysis group identified the termination parameters firstly, and then selected items with discrimination, fitting residual, item information curve (IIC) , item characteristic curve (ICC), and the rank of computerized adaptive testing (CAT) select proportion, etc. After assumption evaluation of item response theory (IRT), IIC, ICC, difficulty coefficient distribution, items-response relation and thresholds, etc. were used for psychometric evaluation of instrument.</p><p><b>RESULTS</b>A total of 331 patients [Ages: 31.99 +/- 10.29 yrs; Male: 186 (56.3%)] were enrolled in statistical analysis. The test termination criterion was Max SE = 0.2 or Max items number =16. After items selection, a 15-item short version of instrument, which contains symptoms facet (8 items) and impact facet (7 items) was generated. With good unidimensionality, local independence, and monotonicity, the IC and ICC in IRT analysis showed good working capability of the questionnaire. The difficulty coefficient distribution and items-response relation were also rational, as well as response thresholds.</p><p><b>CONCLUSIONS</b>The short version of PROs instrument for adult gastric stuffiness (Wei Pi) patients was successfully developed and assessed. The instrument with good methodological and reporting quality could be used in clinical and scientific evaluating their symptoms and impact.</p>

Identification of prototype foamy virus Bel1 nuclear localization signal and its corresponding importins / 病毒学报

Bel1, a transactivator of prototype foamy virus (PFV), plays pivotal roles in the replication of PFV. Previous studies have shown that Bel1 bears a nuclear localization signal (NLS), but its amino acid sequence remains unclear and the corresponding importins have not been identified. In this report, we inserted various fragments of Bel1 into an EGFP-GST fusion protein and investigated their subcellular localization by fluorescence microscopy. We found that the 215PRQKRPR221 fragment could direct nuclear localization, which accords with the consensus sequence K(K/R)X(K/R) of monopartite NLS. Point mutation experiments revealed that K218, R219, and R221 are essential for the nuclear localization of Bel1. The results of the GST-pulldown showed that the Bel1 fragment with residues 215-223, which bears the NLS, interacts with KPNA1, KPNA6, and KPNA7. This result suggests that KPNA1, KPNA6, and KPNA7 maybe involved in Bel1 nuclear translocation.

The effect of catheter based renal synthetic denervation on renin-angiotensin-aldosterone system in patients with resistant hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>to explore the effect of catheter based renal synthetic denervation on renin-angiotensin-aldosterone system (RAAS) and blood pressure reduction in patients with resistant hypertension. and assess the validity and security of the treatment.</p><p><b>METHODS</b>Ten patients with resistant hypertension from June 2011 to December 2011 were retrospectively reviewed, and then all of 10 patients screened for eligibility were allocated to renal denervation. Primary endpoints were changes of office blood pressure at 1 week, 1, 3 and 6 months after procedure. We assessed the effectiveness of renal sympathetic denervation with heart rate (HR), renin activity (PRA), angiotensin II (AngII), aldosterone (Ald), and creatinine (Cr) before and 2 weeks after procedure.</p><p><b>RESULTS</b>Office blood pressure after catheter-based renal denervation decreased by 22.8/9.1 mm Hg (1 mm Hg = 0.133 kPa), 34.8/14.7 mm Hg, 42.6/20.7 mm Hg, 43.2/21.6 mm Hg, at 1 week, 1, 3 and 6 months, respectively (P < 0.001). Meanwhile, the level of PRA, AngII, Ald decreased by (1.11 ± 0.89) ng×ml(-1)×h(-1) (P = 0.003), (17.06 ± 13.82) ng/L (P = 0.004), (404.5 ± 285.8) ng/L (P = 0.002), respectively; and heart rate decreased by 5.1 bpm (P = 0.002). However, the Cr level and eGFR did not change significantly (P > 0.05).</p><p><b>CONCLUSION</b>Catheter-based renal sympathetic denervation can reduce the level of renin activity, angiotensin II and aldosterone, and causes substantial and sustained blood-pressure reduction.</p>

Observation on hybrid bioartificial liver support systems in treating chronic severe hepatitis: a study of 60 cases / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the clinical efficacy of three kinds of hybrid bioartificial liver support systems (HBLSS) in treating chronic severe hepatitis.</p><p><b>METHODS</b>A bioartificial liver support system (BAL), comprising porcine hepatocytes and fiber tube style bioreactor, was constructed. Then three kinds of HBLSS were constructed: Molecular absorbent recirculating system (MARS) plus BAL; slow plasma exchange (SPE) plus continuous hemodiafiltration (CHDF) and BAL; and SPE plus hemoperfusion (HP) and BAL. One hundred-twenty patients in middle or late stages of chronic severe hepatitis were enrolled in this study. They were randomly divided into 6 groups: H1 group was treated with BAL+MARS, H2 with BAL+SPE+CHDF and H3 with BAL+SPE+HP (as treatment groups); C1 group was treated with MARS, C2 with SPE+CHDF and C3 with SPE+HP (as control groups). The changes in the clinical symptoms, in the hepatic encephalopathy stages, and in the serum total bilirubin (TBIL), the serum albumin (ALB), the prothrombin activities (PTA), endotoxin, ammonia, creatinine and a-fetal protein (AFP) were all observed before the treatment, right after it and 72 hours later. The improving and curing rates and the rates of side effect occurrences in each group were observed.</p><p><b>RESULTS</b>In all 6 groups, the patients' clinical symptoms ameliorated; their TBIL, endotoxin and ammonia levels decreased (P<0.05), and their PTA and AFP levels lowered significantly (P<0.05). But in the H1, H2 and H3 groups they were more distinctive than in the control groups. In H1 and H2 groups creatinine and ammonia levels were decreased more significantly than in the H3 group (P<0.05). The improving and curing rates of each group were 65 % (13/20), 60% (12/20), 45% (9/20), 45% (9/20), 40% (8/20) and 20% (4/20) respectively. No serious side effects were observed during the treatment.</p><p><b>CONCLUSION</b>In treating middle and late stage chronic severe hepatitis, the measures used in H1, H2 and H3 are better than those in C1, C2 and C3. Furthermore, H1 and H2 treatments can ameliorate hepatic and renal functions, prevent the development of multiple organ dysfunction syndrome, and are better than those used in H3.</p>