A hypothesis study on a four-period prevention model for high altitude disease.

BACKGROUND: High altitude disease (HAD) can reduce combat effectiveness and damage the health of soldiers at high altitudes. The objective of this hypothesis study is to build a four-period prevention model for high altitude disease that can be applied at high altitudes of over 3000 m. PRESENTATION OF THE HYPOTHESIS: We divided the time at high altitude into nine periods, with three stages from the ascent preparation to the descent to the plain, and applied a continuous dynamic and systematic four-period prevention model across the nine periods. Each period of three stages has its own different measures and targets high altitude health care services for the prevention of high altitude disease. A standard four-period prevention model for high altitude disease was constructed for the high altitude health services at the population level. TESTING THE HYPOTHESIS: Our hypothesized HAD prevention model represents a continuous dynamic and systematic four-period prevention model across the nine periods. This hypothesis can be tested from three aspects. The first one isassessment of soldiers' operating efficacies. The second is comparison of the long-term high altitude population health basic data and development and utilization of big data. The third is descent population health status comparative study and historical retrospective study on prevention. IMPLICATIONS: As we know, it is necessary to protect soldiers' health through the ascent and descent. Through the standard four-period model, we can protect soldiers' health by preventing high altitude diseases, screening the susceptible population, securely tracking their location and maintaining soldiers' health statuses; we also maintain their operational capabilities, eliminate their psychological fears and ease their family troubles.

[Xiaochaihu Tang for treatment of chronic hepatitis B: a systematic review of randomized trials].

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.

[Compound Chinese herbal medicines, Chinese herbal drugs and their active extracts for treatment of chronic hepatitis C: a systematic review and meta-analysis of randomized clinical trials].

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.