Transforming chitosan into N-doped graphitic carbon electrocatalysts.

Chitosan, the only alkaline polysaccharide in nature with rich nitrogen content, is used as the sole precursor to obtain N-doped graphitic carbon-based ORR electrocatalysts. The findings of this work demonstrate that cheap, plentiful and renewable biomasses can be transformed into high value functional carbon materials.

RNA interference of leptin receptor in chicken adipocytes.

In this study, chicken adipocytes were cultured to evaluate RNA interference by the leptin receptor gene. A small interfering RNA of the leptin receptor gene was synthesized, with a suppression rate of 60% being generated (P < 0.01). After the knockdown of the leptin receptor, the expression levels of certain genes decreased significantly; specifically, peroxisome proliferator-activated receptor γ, fatty acid synthase, adipose triglyceride lipase, and lipoprotein lipase. In addition, a significant increase in the expression of the adiponectin gene was documented. These results demonstrate that the leptin receptor gene might contribute to lipid metabolism by influencing the expressions of the peroxisome proliferator-activated receptor γ, fatty acid synthase, adipose triglyceride lipase, lipoprotein lipase, and adiponectin genes.

Response to dietary L-glutamine supplementation in weaned piglets: a serum metabolomic comparison and hepatic metabolic regulation analysis.

A novel metabolomic method based on gas chromatography-mass spectrometry was applied to investigate serum metabolites in response to dietary Gln supplementation in piglets. Sixteen, 21-d-old pigs were weaned and assigned randomly to 2 isonitrogenous diets: 1) Gln diet, which contained 1% L-Gln (as-fed basis), and 2) control diet, which contained L-Ala to make this diet isonitrogenous with the Gln diet. Serum samples were collected to characterize metabolites after a 30-d treatment. in addition, 4 liver samples per treatment were collected to examine enzyme activity and gene expression involved in metabolic regulation. Results indicated that 12 metabolites were altered (P < 0.05) by Gln treatment, including carbohydrates, AA, and fatty acids. A leave-one-out cross validation of random forest analysis indicated that Pro was most important among the 12 metabolites. Thus, these data demonstrate that the control and Gln-supplemented pigs differed (P < 0.05) in terms of metabolism of carbohydrates, Pro, Tyr, and glycerophospholipids. Principal component analysis yielded separate clusters of profiles between the Gln and control groups. Metabolic enzyme activities of Ala aminotransferase and hexokinase increased by 26.8% (P = 0.026) and 26.2% (P = 0.004) in the liver of Gln-supplemented pigs vs. control, respectively, whereas pyruvate kinase (PK) activity decreased by 29.1% (P = 0.001). The gene expression of PK in the liver decreased by 66.1% (P = 0.034) by Gln treatment for 30 d. No differences were observed for the mRNA abundance of mammalian target of rapamycin and PPARγ. On the basis of these data, Gln treatment affected carbohydrate, lipid, and AA metabolism in the whole body of the early weaned piglets. These findings provide insight into specific metabolic pathways and lay the groundwork for the complex metabolic alteration in response to dietary Gln supplementation of pigs.

Topotecan for ovarian cancer.

BACKGROUND: Chemotherapeutic agents such as topotecan can be used to treat ovarian cancer. The effects of using topotecan as a therapeutic agent have not been previously been systematically reviewed. OBJECTIVES: To systematically evaluate the effectiveness and safety of topotecan for the treatment of ovarian cancer. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), (Issue 4, 2006); Cochrane Gynaecological Cancer Review Group (CGCRG) Specialised Register (Cochrane Library Issue 4, 2006); MEDLINE (January 1990 to 27 July 2006); EMBASE (January 1990 to 27 July 2006); The European Organization for the Research and Treatment of Cancer (EORTC) database (to 1 August 2006); CBM (Chinese Biomedical Database) (January 1990 to 27 July 2006). SELECTION CRITERIA: Randomised controlled trials (RCTs) which randomized patients with ovarian cancer to single or combined use of topotecan versus interventions without topotecan, or different remedies of topotecan. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted and analysed data. MAIN RESULTS: Six studies including 1323 participants were eligible for this review (Gordon 2004a; Gore 2001a; Gore 2002; Hoskins 1998; Huinink 2004; Placido 2004) All studies, as reported, were identified as being of poor methodological quality. Topotecan had comparable effectiveness to prolong progression-free survival (PFS) compared with pegylated liposomal doxorubicin (PLD), (16.1 weeks versus 17.0 weeks; p = 0.095). Overall survival (OS) time was similar in participants using PLD compared with topotecan (56.7 weeks versus 60 weeks; p = 0.341). Topotecan was more hematologically toxic compared with paclitaxel or PLD, relative risks (RRs) of hematological events: ranged from 1.03 to 14.46 and 1.73 to 27.12 respectively. A 21-day cycle of topotecan was more toxic than a 42-day cycle (RRs of hematological and non-hematological events ranged from 1.03 to 8). Intravenous and oral topotecan had comparable toxicity. Topotecan delayed progression more effectively compared with paclitaxel (23.1 weeks versus 14 weeks, p = 0.0021). Participants were more likely to respond to topotecan on a 21-day cycle as opposed to a 42-day cycle (RR 7.23, 95% CI 0.94 to 55.36). Small tumor diameter, sensitivity to platinum-based chemotherapy was associated with better prognosis. Small sample size, methodological flaws and poor reporting of the included trials made measurement bias of the trials difficult to assess. AUTHORS' CONCLUSIONS: Topotecan appears to have a similar level of effectiveness as paclitaxel and PLD, though with different patterns of side effects. Larger, well-designed RCTs are required in order to define an optimal regime.

Chinese medicinal herbs for influenza.

BACKGROUND: Influenza is an acute respiratory communicable disease which, during epidemics, can cause high morbidity and mortality. Traditional Chinese medicinal herbs, often administered following a particular theory, may be a potential medicine of choice. OBJECTIVES: To assess the effect of Chinese medicinal herbs in preventing and treating influenza, and to estimate the frequency of adverse effects. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2007), which includes the Cochrane Acute Respiratory Infections Review Group specialised register; MEDLINE (January 1966 to January 2007); EMBASE (January 1988 to January 2007); CBM (Chinese Biomedical Database) (January 1980 to January 2007); and the Chinese Cochrane Center's Controlled Trials Register (up to January 2007). We also searched Current Controlled Trials (www.controlled-trials.com) and the National Research Register (http://www.update-software.com/National/) for ongoing trials and reference lists of articles. For more information we telephoned and wrote to researchers in the field, as well as trial authors of studies evaluated in the review SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing traditional Chinese medicinal herbs with placebo, no treatment, or chemical drugs normally used in preventing and treating uncomplicated influenza patients. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed trial quality. MAIN RESULTS: Two studies involving 1012 participants were reviewed. The methodological quality of both studies was 'poor'. Included RCTs separately compared two medicinal herbs with two different antiviral drugs, precluding any pooling of results. 'Ganmao' capsules were found to be more effective than amantadine in decreasing influenza symptoms and speeding recovery in one study, (in which adverse reactions were mentioned in the amantadine group although no data were reported). There were no significant differences between 'E Shu You' and ribavirin in treating influenza, nor in the occurrence of adverse reaction. AUTHORS' CONCLUSIONS: The present evidence is too weak to support or reject the use of Chinese medicinal herbs for preventing and treating influenza. More RCTs with good methodological quality, larger numbers of participants and clear reporting are needed in the future. We recommend that all the clinical trials registered in the Chinese Clinical Trial Register and Chinese journals join in the Joint Statement of Establishing Chinese Clinical Trial Registration and Publishing System.

Effects of soybean isoflavone on growth performance, meat quality, and antioxidation in male broilers.

To investigate the effects of a synthetic soybean isoflavone (ISF) on growth performance, meat quality, and antioxidation in male broilers, 1,500 birds that were 42 d old were allotted to 5 treatments with 6 replicates per treatment (50 birds per replicate). Birds were fed diets supplemented with 0, 10, 20, 40, or 80 mg of ISF/kg, respectively, for a period of 3 wk ad libitum. The results showed that dietary supplementations with 10 or 20 mg of ISF/kg increased weight gain by 13.6 and 16.2% (P < 0.01) and elevated feed intake by 7.37% (P < 0.05) and 11.2% (P < 0.01), respectively. Addition of 10 mg of ISF/kg decreased feed:gain by 5.5% (P < 0.05). Supplementation with 40 mg of ISF/kg in the diet slightly increased water-holding capacity by 17.24% (P < 0.1), and the addition of 20 or 40 mg/kg of ISF significantly increased the pH value of meat (P < 0.01), although adding 40 or 80 mg of ISF/kg increased the lightness of meat color (P < 0.05). Malondialdehyde production was slightly reduced in plasma of 20 mg of ISF/kg supplemented chickens (P < 0.1) and significantly decreased in breast muscles of 20, 40, or 80 mg of ISF/kg supplemented chickens (P < 0.01). The addition of 40 or 80 mg of ISF/kg significantly increased total antioxidant capability (P < 0.01) and slightly elevated total superoxide dismutase activity (P < 0.1) in plasma of chickens. The dose of 80 mg of ISF/kg slightly improved catalase activity in plasma (P < 0.06). In breast muscle, treatment of birds with 40 or 80 mg of ISF/kg caused an increase of total superoxide dismutase activity by 25.36% (P < 0.05) or 63.93% (P < 0.01). Catalase activity significantly increased by 70.61% by the supplemental ISF at the 40-mg level (P < 0.05). Also, 10, 20, or 40 mg doses of ISF/kg decreased lactic acid production (P < 0.05). The results of this study indicate that dietary ISF could improve growth performance and meat quality by decreasing lipid peroxidation and improving antioxidative status in male broilers.

Medicinal herbs for esophageal cancer.

BACKGROUND: Esophageal cancer is the seventh leading cause of cancer death worldwide. Traditional Chinese medicinal herbs are sometimes used as an adjunct to radiotherapy or chemotherapy for this type of cancer. OBJECTIVES: To assess the efficacy and possible adverse effects of the addition of Chinese medicinal herbs to treatment with radiotherapy or chemotherapy for esophageal cancer. SEARCH STRATEGY: We searched the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Trials Register, The Cochrane Library, MEDLINE, EMBASE, AMED (Allied and Complementary Medicine Database), CBM (Chinese Biomedical Database), China National Knowledge Infrastructure, the Chinese Cochrane Centre Controlled Trials Register and CISCOM (The Research Council for Complementary Medicine) (up to June 2004). Databases of ongoing trials, the internet and reference lists were also searched. SELECTION CRITERIA: Randomised controlled trials comparing the use of radiotherapy or chemotherapy with and without the addition of Chinese medicinal herbs. DATA COLLECTION AND ANALYSIS: At least two review authors extracted data and assessed trial quality. MAIN RESULTS: Two studies were included. The numbers of participants in these two trials were 42 and 80, 122 in total. Both studies were analysed separately because of the differences in interventions used. Although one study reported a positive result, the majority of outcome measurements from the two studies showed no significant benefit with the addition of Chinese herbal medicines to radiotherapy or chemotherapy. There was statistically significant improvement in quality of life with the additional Huachansu injection, however, no statistically significant improvement was found in short-term therapy effects, one-year survival rate or the adverse effect of radiation-induced esophagitis. AUTHORS' CONCLUSIONS: The included studies were of low quality. The results suggest Zhenxiang capsules or Huachansu injection may not improve short-term therapy effects or one-year survival rate when used as adjunct treatment to chemo- or radiotherapy in the treatment of esophageal cancer. The quality of life may be improved by Huachansu injection. The results suggest that more high-quality trials on Huachansu injection and other Chinese herbal medicines are needed in the future.

Yizhi capsule for vascular dementia.

BACKGROUND: Vascular dementia (VD) is a syndrome or diagnosis that has different causes and clinical manifestations relating to several different vascular mechanisms and changes in the brain. Some traditional Chinese herbal medicines were developed for treating VD. DH: Yizhi capsule is one such herbal concoction which is reported to improve clinical symptoms significantly. The efficacy and adverse effects of Yizhi capsule need to be reviewed systematically and assessed critically to inform clinical practice and guide the continued search for new treatment regimens. OBJECTIVES: To assess the effectiveness and possible adverse events of 'Yizhi capsule' in treating vascular dementia. SEARCH STRATEGY: The Cochrane Dementia and Cognitive Improvement Group's Specialised Register was searched on 18 September 2006 using the terms yi-zhi, "yi zhi" and yizhi. This database contains trial references from major health care databases and ongoing trial database and is up to date. In addition the review authors searched a variety of Chinese databases. SELECTION CRITERIA: Randomised, placebo controlled trials in which patients with vascular dementia were treated with 'Yizhi capsule' were included. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We telephoned study authors for missing information as to whether treatment allocation was randomised and other methodological details. MAIN RESULTS: No studies were found that met the inclusion criteria. We identified nine references to trials which included the term 'Yizhi capsule' in the description of the interventions. Two study authors were contacted by telephone and we discovered that the allocation methods they had used were not actually randomised. Four references were describing the same study. Three studies were excluded because 'positive drugs' were used as a control. AUTHORS' CONCLUSIONS: There is no evidence from randomised controlled trials to support or proscribe against the use of 'Yizhi capsule' as a treatment for vascular dementia.

Chinese herbal medicines for hyperthyroidism.

BACKGROUND: Hyperthyroidism is a disease in which excessive amounts of thyroid hormones circulate in the blood. Patients, among other things suffer from tachycardia, warm moist skin and raised body temperature. The treatment of hyperthyroidism includes symptom relief and therapy with antithyroid medications, radioiodine and thyroidectomy. Medicinal herbs are used alone or in combination with antithyroid agents to treat hyperthyroidism in China and some other countries. OBJECTIVES: To assess the effects of Chinese herbal medicines for treating hyperthyroidism. SEARCH STRATEGY: Studies were obtained from computerised searches of MEDLINE, EMBASE, The Cochrane Library, the Chinese Biomedical Database. SELECTION CRITERIA: Randomised controlled trials comparing the effects of Chinese herbal medicines alone with Chinese herbal medicines combined with antithyroid drugs, radioiodine or both. DATA COLLECTION AND ANALYSIS: Three authors interviewed authors of all potentially relevant studies by telephone to verify randomisation procedures. One author entered data into a data extraction form and another author verified the results of this procedure. MAIN RESULTS: Thirteen relevant trials with 1770 participants were included. All of them were of low quality. Fifty-two studies still need to be assessed because the original authors could not be interviewed. None of these trials analysed mortality, health related quality of life, economic outcomes or compliance. Compared to antithyroid drugs alone the results showed that Chinese herbal medicines combined with antithyroid drugs may offer benefits in lowering relapse rates, reducing the incidence of adverse effects, relieving symptoms, improving thyroid antibody status and thyroid function. Two trials investigated Chinese herbal medicine versus radioiodine and reported improvements in anxiety, tachycardia and heat intolerance. However, thyroid function - with the exception of restored thyroid stimulating hormone (TSH) - was not significantly altered. AUTHORS' CONCLUSIONS: The results suggest that traditional Chinese herbal medicines added to other routine treatment have a therapeutic potential for people with hyperthyroidism. However, due to methodological limitations, we could not identify a well-designed trial to provide strong evidence for Chinese traditional herbal medicine in the treatment of hyperthyroidism. Thus, we currently cannot recommend any single preparation or formulation for clinical use.

Bicyclol for chronic hepatitis C.

BACKGROUND: Bicyclol is a novel synthetic 'anti-hepatitis' drug, used in China for chronic hepatitis C. Until now, systematic reviews on bicyclol therapy have not been performed. OBJECTIVES: To study the benefits and harms of bicyclol for patients with chronic hepatitis C. SEARCH STRATEGY: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register (July 2005), the Cochrane Central Register of Controlled Trials in The Cochrane Library (Issue 2, 2005), MEDLINE (1994 to July 2005), EMBASE (1994 to July 2005), Science Citation Index Expanded (1994 to July 2005), The Chinese Biomedical Database (1994 to August 2005), Chinese Journals Full-article Database (1994 to August 2005), VIP Chinese Science and Technique Journals Database (1994 to August 2005), and China National Infrastructure (CNKI) (1994 to August 2005). We also contacted manufacturers and researchers in the field. SELECTION CRITERIA: Randomised clinical trials on bicyclol versus no intervention, placebo, or other interventions in patients with chronic hepatitis C were included, irrespective of blinding, publication status, or language. DATA COLLECTION AND ANALYSIS: The primary outcome measures were total and liver-related mortality and liver-related morbidity (eg, cirrhosis and carcinoma). Secondary outcome measures were viral response and liver histology. MAIN RESULTS: The search identified one randomised clinical trial comparing bicyclol with placebo for 39 patients with chronic hepatitis C. The follow-up was three months. In the trial, there was no evidence that bicyclol was superior to placebo for clearance of HCV RNA (RR 3.80, 95% CI 0.47 to 31.0) and anti-HCV antibodies, but bicyclol was associated with statistically significant decrease in alanine aminotransferase activity at 12-th week after treatment (WMD -69 IU/L, 95% CI -115 to -24). AUTHORS' CONCLUSIONS: Only one randomised clinical trial has examined bicyclol for patients with chronic hepatitis C. This small, short-term trial found no evidence to support or refute its use. Large, randomised, double-blind clinical trials with long-term follow-up are needed to examine the possible benefits and harms associated with bicyclol. Bicyclol can only be recommended for use in randomised trials.

Steroid withdrawal increases risk of acute rejection but reduces infection: a meta-analysis of 1681 cases in renal transplantation.

OBJECTIVE: To evaluate the safety of steroid withdrawal in renal transplantation recipients. METHODS: These following databases were searched: Medline (1966 to September 2005), OVID (1966 to 2004), Embase (1984 to 2004), Cochrane library (issue 4, 2005), Highwire (1849 to September 2005), American Transplant Congress (2005), Chinese Biomedicine database (CBM 1994 to 2005). The safety was measured by the following factors: patient and graft survival, acute rejection, chronic rejection, infection, serum creatinine. We performed meta-analysis by using Revman 4.2.7. RESULTS: Nine randomized clinical trials were identified to have a steroid withdrawal and a steroid continuing group. They included 1681 patients: 845 with steroid withdrawal and 836 with continuing steroid. The risk of acute rejection after steroid withdrawal was two times higher than steroid-continuing group (RR 2.05; 95% confidence interval [CI]: 1.54, 2.72; P < .00001), while the incidence of opportunistic infection and urinary tract infection of steroid withdrawal group were lower than the control group (RR 0.80; 95%CI 0.64, 1.00; P = .05 vs RR 0.74; 95%CI, 0.60, 0.92; P = .004, respectively). The graft and patient survivals, chronic rejection, and serum creatinine were similar to the steroid continuing group. CONCLUSION: Steroid withdrawal can significantly increase the risk of acute rejection episodes, but reduces the incidence of infection to a certain extent. To prophylaxis against serious infection, steroid withdrawal is worth considering using a sufficient immunosuppressive regimen. The key point is to balance the benefit and harm for the individual recipient.

Combination chemotherapy for high-risk gestational trophoblastic tumour.

BACKGROUND: Gestational trophoblastic disease (GTD) includes gestational trophoblastic tumour and hydatidiform mole. Many women of reproductive age are affected by this disease although its incidence differs by geographical location. A number of chemotherapy regimens are used for treating the disease, such as methotrexate, actinomycin D and cyclophosphamide (MAC), methotrexate, actinomycin D, cyclophosphamide, doxorubicin, melphalan, hydroxyurea and vincristine (CHAMOC), etoposide, methotrexate and actinomycin (EMA) plus cyclophosphamide and vincristine (CO) (EMA-CO), etoposide, methotrexate and actinomycin (EMA) plus etoposide and cisplatin(EP) (EMA-EP). The efficacy of these drugs has not been systematically reviewed. OBJECTIVES: To determine the efficacy and safety of combination chemotherapy in treating high-risk GTT. SEARCH STRATEGY: Electronic searches of MEDLINE, EMB, Cochrane Central Register of Controlled Trials (CENTRAL) and CBM were carried out. Four journals were handsearched and other searching methods were used for identifying more studies. SELECTION CRITERIA: The review included randomized controlled trials (RCTs) or quasi-RCTs of combination chemotherapy for treating high-risk GTT. Patients with placental-site trophoblastic tumour (PSTT), who had received chemotherapy in the previous two weeks, or patients with chemotherapy intolerance were excluded. DATA COLLECTION AND ANALYSIS: Two investigators independently collected data using a data extraction form. Meta-analysis was not performed and the review was conducted as a narrative review. MAIN RESULTS: One study with 42 participants was included in this review. It indicated that a MAC regimen was better than a CHAMOCA regimen for high-risk GTT because of lower toxicity. The quality of the study was unclear. AUTHORS' CONCLUSIONS: The methodological limitations of the included study prevent any firm conclusions about the best combination chemotherapy regimen for high-risk GTT. High quality studies are required.

Chinese herbal medicine for the treatment of pre-eclampsia.

BACKGROUND: Pre-eclampsia is a common disorder of pregnancy with uncertain etiology. In Chinese herbal medicines, a number of herbs are used for treating pre-eclampsia. Traditional Chinese medicine considers that, when a woman is pregnant, most of the blood of the mother is directed to the placenta to provide the baby with the required nutrition; other maternal organs may in consequence be vulnerable to damage. These organs include the liver, the spleen, and the kidneys. The general effects of Chinese herbal medicines that can protect these organs may be valuable in pre-eclampsia by encouraging vasodilatation, increasing blood flow, and decreasing platelet aggregation. The use of Chinese herbal medicine is often based on the individual and presence of traditional Chinese medicine symptoms. OBJECTIVES: To assess the effect of Chinese herbal medicine for treating pre-eclampsia and compare it with that of placebo, no treatment or Western medicine. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Groups Trial Register (31 March 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2005), MEDLINE (1969 to December 2004), EMBASE (1984 to March 2004) and CBM (1978 to February 2005) and we handsearched several main journals published in China. SELECTION CRITERIA: Randomized controlled trials in which Chinese herbal medicine was used for treating pre-eclampsia. DATA COLLECTION AND ANALYSIS: One review author assessed trials for inclusion. The trials were also assessed by a second review author if there was any doubt about whether or not to include the trial. Analysis was not performed as there were no trials included in this review. MAIN RESULTS: No trials were suitable for inclusion in this review. AUTHORS' CONCLUSIONS: The effect of Chinese herbal medicine for treating pre-eclampsia remains unclear. There are currently no randomized controlled trials to address the efficacy and safety of Chinese herbal medicine for the treatment of pre-eclampsia. Well conducted randomized controlled trials are required.

Chinese medicinal herbs for measles.

BACKGROUND: Measles is an infectious disease caused by Morbillivirus. Chinese physicians believe that medicinal herbs are effective in alleviating symptoms and preventing complications. Chinese herbal medicines are dispensed according to the particular symptoms. OBJECTIVES: To assess the effectiveness and possible adverse events of Chinese medicinal herbs in treating measles. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) (The Cochrane Library Issue 4, 2005); MEDLINE (1966 to June 2005); EMBASE (1980 to June 2005); the Chinese Biomedical Database (1976 to June 2005); VIP Information (1989 to June 2005); China National Knowledge Infrastructure (CNKI) (1994 to June 2005); and the metaRegister of Controlled Trials was searched for ongoing trials. SELECTION CRITERIA: Randomised controlled trials (RCTs) in which patients with measles without complications were treated with Chinese medicinal herbs were included. DATA COLLECTION AND ANALYSIS: The primary outcome measure was death from any cause. The secondary outcome measure was improvement of overall symptoms. The tertiary outcome measure was fever clearance time. MAIN RESULTS: We identified 28 trials which claimed to use random allocation. Nineteen study authors were contacted by telephone and we discovered that the allocation methods they had used were not actually randomised. Three studies were excluded because the patients experienced complications. We were unable to contact the remaining six authors. These require further assessment and have been allocated to the 'Studies awaiting assessment' section. AUTHORS' CONCLUSIONS: Two authors independently assessed trial quality and extracted data. We interviewed by telephone the study authors for missing information regarding random allocation of the study process. Some trials allocated the participants according to the sequence they were admitted to the trials, that is to say, by using a pseudo-random allocation method. None of the trials concealed the allocation or blinding method. We hope future randomised controlled trials (RCTs) in this field will be conducted.

Chinese medicinal herbs for influenza.

BACKGROUND: Influenza is an acute respiratory communicable disease which can cause high morbidity and mortality in an epidemic. Traditional Chinese medicinal herbs following a particular theory may be a potential medicine of choice. OBJECTIVES: The objective of this review was to assess the therapeutic effect and adverse reaction of Traditional Chinese medicinal herbs in treating uncomplicated influenza. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2004); MEDLINE (January 1966 to October 2004); EMBASE (January 1988 to October 2004); CBM (Chinese Biomedical Database) (January 1980 to December 2003); and the Chinese Cochrane Center's Controlled Trials Register (up to December 2003). We also searched Current Controlled Trials (www.controlled-trials.com) and the National Research Register (http://www.update-software.com/National/) for ongoing trials and reference lists of articles. We wrote to researchers in the field, or authors of studies evaluated in the review for more information. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing traditional Chinese medicinal herbs with placebo, or various other Chinese medicinal herbs, or with other current regimes normally used in care or comparing drugs with herbal preparations to simple drugs in treating defined uncomplicated influenza patients. DATA COLLECTION AND ANALYSIS: At least two reviewers extracted data and assessed trial quality. MAIN RESULTS: Eleven studies with the number of participants ranged from 52 to 479. In total 2,088 participants were included in the review. As the interventions of the included studies were different from each other and most of the studies were of low quality, we did not perform a summary meta-analysis. Some of the studies showed positive results favouring Traditional Chinese medicinal herb treatment compared to antiviral or antipyretic-analgesic drugs or the combination of them. Only three studies mentioned adverse reactions but no detailed data were acquired in the included studies. Eleven studies with the number of participants ranged from 52 to 479, 2,088 in total were included. As the interventions of the included studies were different from each other and most of the studies were of low quality, we failed to perform a summary meta-analysis. Some of the studies showed positive results favouring Traditional Chinese medicinal herb treatment compared to antiviral or antipyretic-analgesic drugs or the combination of them. Only three studies mentioned adverse reactions but no detailed data was acquired in the included studies. AUTHORS' CONCLUSIONS: The small number of included studies and participants, as well as the low quality of most studies, made the evidence far from conclusive for clinical decision making, although traditional Chinese medicinal herbs as a whole seem to be comparatively or more effective compared to different chemical drugs. A certain herbal preparation could not be recommended for there was not enough evidence. More high quality randomised controlled trials (RCTs) with similar interventions are required to strengthen the evidence for the efficacy and safety of certain herbal preparation.

Effectiveness of live-attenuated Japanese encephalitis vaccine (SA14-14-2): a case-control study.

BACKGROUND: Japanese encephalitis is a major cause of death and disability throughout Asia, including the Indian subcontinent. Although an effective vaccine for Japanese encephalitis is available, hundreds of millions of susceptible individuals remain unimmunised because of the vaccine's cost. In 1988, an inexpensive live-attenuated vaccine (SA14-14-2) was licensed in China. We have measured the effectiveness of this vaccine. METHODS: In a case-control study in rural Sichuan Province, China, the 56 cases consisted of children admitted to hospital with acute Japanese encephalitis, and were confirmed serologically. 1299 village-matched and age-matched controls were identified, and vaccination histories obtained from pre-existing written records. FINDINGS: The effectiveness of one dose was 80% (95% Cl 44 to 93%); that of two doses was 97.5% (86 to 99.6%). Controlling for multiple potential confounders did not alter these results. INTERPRETATION: We conclude that a regimen of two doses of live-attenuated Japanese encephalitis vaccine, administered 1 year apart, is effective in the prevention of clinically important disease. Subsequent study is needed to assure the safety of this vaccine.