Chinese herbal medicine combined with nucleotide analogues for compensated HBV-related cirrhosis: a systematic review of randomized controlled trials

Objective:To systematically evaluate the effectiveness and safety of Chinese herbal medicine (CHM) plus nucleotide analogues (NAs) for treating compensated HBV-related cirrhosis,the early stage of cirrhosis.Methods:PubMed,Cochrane library,China Network Knowledge Infrastructure Database (CNKI),Chinese Scientific Journals Database (VIP),Wan Fang Database and Sino-Med Database were searched.Randomized controlled trials (RCTs) and quasi-RCTs comparing NAs and NAs plus CHM therapy on patients with compensated HBV-related cirrhosis were included.Two reviewers independently extracted information and assessed the methodological quality of the trials.Different CHM herbal formulas used in the trials were considered.Primary metaanalysis was conducted when there were at least two trials comparing the same CHM formula.Results:Forty-five trials comprising 3497 participants were included.The quality of most of the trials was moderate or low.Twenty-six herbal formulations were identified.A meta analysis was conducted for compound Biejia Ruangan (FFBJ),Dahuang Zhechong (DHZC),and Fuzheng Huayu (FZHY).The results of the subgroup analysis showed a beneficial effect of FFBJ plus entecavir (ETV),and DHZC plus adefovir dipivoxil (ADV) on hyaluronic acid (HA);FFBJ plus ADV on laminin (LN);and FZHY plus ADV on HA,LN,and precollagen type Ⅲ (PC-Ⅲ).The results from other studies suggested significant benefits of CHM plus NAs compared with NAs alone,except those on albumin (ALB).None of the trials evaluated the quality of life or reported severe adverse events.Conclusions:A positive effect was found for FFBJ plus ETV,DHZC plus ADV,and FZHY plus ADV on HA;FZHY plus ADV and FFBJ plus ADV on LN;and FZHY plus ADV on PCⅢ compared with the effects of NAs used alone.

GABAergic Interneurons are Required for Generation of Slow CA1 Oscillation in Rat Hippocampus

Neuronal oscillations are fundamental to hip- pocampal function. It has been shown that GABAergic interneurons make an important contribution to hippocampal oscillations, but the underlying mechanism is not well understood. Here, using whole-cell recording in the complete hippocampal formation isolated from rats at postnatal days 14-18, we showed that GABAA receptormediated activity enhanced the generation of slow CA1 oscillations. In vitro, slow oscillations （0.5-1.5 Hz） were generated in CA1 neurons, and they consisted primarily of excitatory rather than inhibitory membrane-potential changes. These oscillations were greatly reduced by blocking GABAA receptor-mediated activity with bicuculline and were enhanced by increasing such activity with midazolam, suggesting that interneurons are required for oscillation generation. Consistently, CA1 fast-spiking interneurons were found to generate action potentials usually preceding those in CA1 pyramidal cells. These findings indicate a GABAA receptor-based mechanism for the generation of the slow CA1 oscillation in the hippocampus.