Objective To systematically evaluate the effectiveness and safety of berberine in the treatment of type 2 diabetes. Methods The databases including The Cochrane Library, PubMed (1966 to October 2011), Excerpta Medica Database (EMbase, 1974 to October 2011), Chinese National Knowledge Infrastructure databases (CNKI, 1994 to October 2011), the Chinese Scientific and Technical Journals database (VIP, 1989 to October 2011), and China Doctor Dissertation Full-text Database (CDFD, 1979 to 2011) and China Master Dissertation Full-text Database (CMFD, 1979 to 2011) were searched. The randomized controlled trials (RCTs) on berberine in the treatment of type 2 diabetes were screened according to the inclusive and exclusive criteria. The data were extracted, the quality was assessed, and the systematic review was conducted by using Revman 5.0 software. Results Ten RCTs involving 647 Chinese patients with DM 2 were included, and the quality of each study was generally low. The interventions in the treatment groups were berberine or combined with metformin or glipizide. The control groups included placebo, lifestyle intervention, pioglitazone, rosiglitazone or metformin. Because the experiment and control groups in each included trials were different in drug type and dose, disease duration, and treatment regimens, only the results of all trials were reported rather than performing Meta-analysis. The berberine group was superior to the placebo and lifestyle intervention groups in lowering fasting blood glucose (FBG), but it was not so obviously effective in lowering the postprandial blood glucose (PBG), hemoglobin A1c and BMI and regulating lipid metabolism compared with the placebo, lifestyle intervention, and western hypoglycemic agents. In addition, the berberine treatment had no side effects of hypoglycemia although a few patients complained of gastrointestinal adverse reaction, and there was no significant difference when compared with the placebo and lifestyle intervention groups. Conclusion Berberine is effective in lowering FBG, but not better than metformin, glipizide and rosiglitazone. It is undefined in decreasing PBG, HbA1c, BMI and regulating lipid metabolism, and it will not lead to hypoglycemia except for a few and mild gastrointestinal adverse effects. The current clinical studies on berberine for DM 2 are low in methodology and reporting quality, which has to be further proved by more high-quality clinical trails.
ObjectiveTo summarize the injury characteristics and therapeutic strategy of patients injured in " 8·8” Jiuzhaigou earthquake.MethodsThe clinical data of 48 patients injured in " 8·8” Jiuzhaigou earthquake who were admitted to Mianyang Central Hospital were analyzed retrospectively. There were 25 males and 23 females with an average age of 36 years (range, 5-87 years). The average interval from injury to admission was 30 hours (range, 3-53 hours). The patients from Sichuan province accounted for 45.8% (22 cases), from other province for 52.1% (25 cases), and from abroad for 2.1% (1 case). Patients were primarily hurted by collapsing houses and flying stones. Thirty-seven patients (77.1%) had single injury, mainly involving 36 patients (75.0%) in limbs, and the other 11 patients (22.9%) had multiple injuries. Ten patients (20.8%) had open fractures, including 1 case rated as typeⅠ, 2 as typeⅡ, 3 as type Ⅲa, 2 as type Ⅲb, and 2 as type Ⅲc according to Gustilo classification criteria. The abbreviated injury scale (AIS) score was 2-3 in 37 patients of single injury, and the injury severity score (ISS) was 8-22 (mean, 13.2) in 11 patients of multiple injuries. Sixteen patients (33.3%) were diagnosed as mental disorders by Hamilton rating scale for anxiety (HAMA), including 8 cases had their anxiety scores≥29, 4 cases of 21-28, 3 cases of 14-20, and 1 case of 7-13. Of the 16 patients, 2 showed suicidal tendency.ResultsExcept 2 referrals, 30 patients received operation［28 patients (93.3%) for orthopaedic surgeries］and 16 patients received conservative treatment. The procedures included internal fixation, soft tissue debridement, external fixation, bipolar femoral head replacement, embolization of carotid cavernous sinus arteriovenous fistula, and amputation. Among the 46 patients treated in this hospital, 21 discharged from hospital at 2-12 days (mean, 6.7 days) after admission, the others received further rehabilitation in this hospital or local hospital. No undesirable consequence occurred in 16 patients with mental disorders. Five cases of infection occurred out of hospital were cured after debridement. No dead and nosocomial infection case reported.ConclusionIntensive treatment, specialist management, multidisciplinary team, and early intervention of nosocomial infection and deep venous thrombosis are the key to improve the general level of successful earthquake medical rescue.