Effects of repetitive transcranial magnetic stimulation on hypothalamic-pituitary-adrenal axis of patients with depression

Objective： To investigate the effects of sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation （SEM-rTMS） and conventional rTMS （C-rTMS） on the activity of hypothalamic-pituitary-adrenal （HPA） axis in patients with depression. Methods： In a double-blind, randomized controlled trial, 164 patients diagnosed with depression were randomized to treatment with SEM-rTMS （n=57）, C-rTMS （n=55） or sham rTMS （n=52） for 30 rain every day for 10 d. Before and after treatment plasma concentrations of adrenocorticotropic hormone （ACTH） and cortisol （CORT） were measured, and the 24-item Hamilton Depression Rating Scale （HAMD-24） was used for assessment. Results： The HAMD-24 scores and plasma ACTH and CORT concentrations of these depressive patients before treatment were significantly different from those of the normal control group （P〈0.05）. The HAMD-24 scores and plasma ACTH and CORT concentrations in the SEM-rTMS group and conventional rTMS group were decreased significantly （P〈0.05）. There was a significant positive correlation between the HAMD-24 scores and plasma ACTH （n=240, r=0.105, P=0.048） and CORT concentrations （n-240, r=0.126, P=0.023） in the patients with depression before and after treatment. Conclusion： The antidepressant effect of rTMS, including SEM-rTMS, may be related to its decreasing HPA axis activity. （This trail was registered. No： ChiCTR-TRC-00000465）     

Impact of vitamin D supplementation on the outcome of tuberculosis treatment: a systematic review and meta-analysis of randomized controlled trials

Background Vitamin D supplementation is believed to be beneficial in the treatment of patients with tuberculosis （TB）,however,results from clinical trials have been inconclusive.Methods We performed a systematic literature search across MEDLINE,EMBASE,the Cochrane Central Register of Controlled Trials,Springer,EBSCO,ProQuest,HighWire Press,and Web of Science,published as of December 2013.We individually inspected citations and extracted data independently.We estimated pooled risk ratios （RR） and 95％ confidence intervals （CI） using random-effect models.We also assessed risk of bias using the Jadad scale and the quality of the evidence using GRADE.We included all randomized controlled trials comparing vitamin D with or without standard TB therapy or placebo.Results A total of five studies were analyzed in our meta analysis covering 841 newly-diagnosed TB cases.Patients receiving vitamin D supplementation had a 39％ reduced risk of sputum smear or culture positive after six weeks of antiTB treatment than those in the control group,although this is not statistically significant （pooled RR 0.61,95％ CI 0.24 to 1.56,P=0.30）.Apart from an increased serum vitamin D level in the supplement group after eight weeks of treatment there was no evidence of any additional adverse effects related to vitamin D.Conclusions The meta analysis results indicate that vitamin D supplementation does not seem to have any beneficial effect in the treatment of TB.Future rigorous randomized controlled trials are needed to explore whether the supplementation of vitamin D could shorten treatment duration and to confirm whether the polymorphisms of vitamin D receptor have any potentially beneficial effect.     

Co-effect of Demand-control-support Model and Effort-reward Imbalance Model on Depression Risk Estimation in Humans： Findings from Henan Province of China

Objective To investigate the co-effect of Demand-control-support （DCS） model and Effort-reward Imbalance （ERI） model on the risk estimation of depression in humans in comparison with the effects when they are used respectively. Methods A total of 3 632 males and 1 706 females from 13 factories and companies in Henan province were recruited in this cross-sectional study. Perceived job stress was evaluated with the Job Content Questionnaire and Effort-Reward Imbalance Questionnaire （Chinese version）. Depressive symptoms were assessed by using the Center for Epidemiological Studies Depression Scale （CES-D）. Results DC （demands/job control ratio） and ERI were shown to be independently associated with depressive symptoms. The outcome of low social support and overcommitment were similar. High DC and low social support （SS）, high ERI and high overcommitment, and high DC and high ERI posed greater risks of depressive symptoms than each of them did alone. ERI model and SS model seem to be effective in estimating the risk of depressive symptoms if they are used respectively. Conclusion The DC had better performance when it was used in combination with low SS. The effect on physical demands was better than on psychological demands. The combination of DCS and ERI models could improve the risk estimate of depressive symptoms in humans.     

Oral Chinese Herbal Medicine for Depressive Disorder in Patients after Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Objective: To evaluate the effectiveness and safety of oral Chinese herbal medicines(CHMs) on post-percutaneous coronary intervention(PCI) patients with depressive disorder in coronary heart disease(CHD). Methods: A literature search was conducted through databases including PubMed, Cochrane Library, Chinese National Knowledge Infrastructure Databases(CNKI), Chinese Biomedical Literature Database(SinoMed), Chongqing VIP Chinese Science and Technology Periodical Database(VIP) and Wanfang Database up to August 2018. Randomized controlled trials(RCTs) comparing CHMs with placebo or no additional treatments on the basis of standard conventional pharmacological therapies were included. Data extraction, analyses and quality assessment were performed according to the Cochrane standards. RevMan 5.3 software was used to synthesize the results. Results: A total of 16 RCTs enrolling 1,443 participants were included in this systematic review. When compared with antidepressants alone, CHMs showed similar benefits with less side effects [risk ratio=0.54, 95% confidence interval(CI) 0.43 to 0.69, 582 patients]; meanwhile, the combination therapy may have more advantages than antidepressants alone [mean difference(MD)=–1.03, 95%CI –1.81 to –0.25, 267 patients). When identified with placebo, CHMs seem to have more advantages in relieving depressive symptoms(MD=–19.00, 95%CI –20.02 to –17.98, 189 patients). However, when compared with basic treatment of postPCI, CHMs showed different results in two trials. In terms of post-PCI related clinical symptoms, CHMs seem to have more advantages in relieving chest pain and other general clinical symptoms. However, the heterogeneity in this review was generally high, it may be caused by different interventions used in each trial and the low quality of the trials. Conclusions: In total, CHMs showed potentially beneficial effects on depressive symptoms and post-PCI related clinical symptoms. However, because of small sample size and potential bias of most trials, this result should be interpreted with caution. More rigorous trials with larger sample size and higher quality are warranted to give high quality of evidence to support the use of CHMs for CHD complicated with depression.     

Recent clinical trials of acupuncture in the west: Responses from the practitioners

In the West,hundreds of randomized controlled trials（RCTs）have been performed testing acupuncture.They include two types：those that compare acupuncture to other therapies,usual care or no treatment（pragmatic trials）,and those that have placebo controls（efficacy trials）.Acupuncture has generally performed well against other therapies or no treatment,but until recently,the evidence from placebo controlled trials has been considered equivocal or contradictory.A recent series of large RCTs,mostly performed in Germany and also in the US have included both pragmatic and placebo comparisons.The evidence poises a conundrum for the profession of acupuncture.This essay first describes the two types of RCTs used to examine acupuncture and examine the results of two recent large RCTs for chronic low back pain as representative examples of recent large studies.The essay then presents the most common Euro-American acupuncture professions＇ interpretation of these results.Western responses have included：（1）methodological weaknesses; （2）inappropriateness of placebo controls; （3）questions as to whether acupuncture placebo controls are＂inert＂; （4）rejection of evidence-based medicine epistemology; （5）discrepancy between acupuncture performed in RCTs with real world acupuncture; （6）enhanced placebo effects of acupuncture; and（7）needs to re-evaluate acupuncture theory.The authors do not necessarily agree with all of these responses; they are presented in an attempt to foster critical discussion.The paper also looks at recent neuroimaging experiments on acupuncture that may point to some worthwhile new avenues of investigation.Finally,the Euro-American health care policy consequences of these recent RCTs are discussed.     

Wendan Decoction(温胆汤) for Treatment of Schizophrenia: A Systematic Review of Randomized Controlled Trials

Objective: To assess the beneficial and adverse effects of Wendan Decoction(温胆汤, WDD) for the treatment of schizophrenia. Methods: Five electronic databases were searched until May 2014, including the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Scientist Journal Database, Pub Med, and the Cochrane Central Register of Controlled Trials in the Cochrane Library. The randomized controlled trials(RCTs) testing WDD against placebo, antipsychotic drugs, or WDD combined with antipsychotic drugs against antipsychotic drugs alone were included. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. Results: Thirteen RCTs(involving 1,174 patients) were included and the methodological quality was evaluated as generally low. The pooled results showed that WDD combined with antipsychotic drugs were more effective in clinical comprehensive effect, Positive and Negative Syndrome Scale(PANSS) scores and Brief Psychiatric Rating Scale scores compared with antipsychotic drugs alone. However, WDD had less effectiveness compared with antipsychotics in clinical comprehensive effect; and WDD was not different from antipsychotic drugs for PANSS scores. The side effects were significantly reduced in the intervention group compared with the control group. Conclusions: WDD appears to be effective on improving symptoms in patients with schizophrenia. However, due to poor methodological quality in the majority of the included trials, the potential benefit from WDD needs to be confirmed in rigorous trials and the design and reporting of trials should follow the international standards.     

Is the Chinese Medicinal Formula Guipi Decoction (归脾汤) Effective as An Adjunctive Treatment for Depression? A Meta-Analysis of Randomized Controlled Trials

Objectives: To evaluate the effectiveness and safety of Guipi Decoction(归脾汤, GPD) as an adjunctive in the treatment of depression. Methods: A review of all relevant studies retrieved from a search of the following databases were conducted without any language restriction: Excerpt Medica Database(EMBASE), Pub Med, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure(CNKI), VIP Information, Wanfang Data, and the Chinese Biomedical Literature Database. Papers published until February 2013 were taken into consideration. The analysis was performed using the Cochrane software Revman 5.1. Results: Nine randomized controlled trials involving 620 patients with depression were included in this review. The meta-analysis revealed that compared with antidepressant therapy alone, treatment with a combination of GPD and an antidepressant drug significantly improved the symptoms of depression [weighted mean difference(WMD): –3.09; 95% confidence interval(CI): –4.11 to –2.07] and increased the rates of effectiveness(OR: 4.75; 95% CI: 2.66–8.51) as well as recovery(OR: 1.73; 95% CI: 1.17–2.56). The adverse effects of GPD were not found to be significant in these studies. Conclusions: The findings of this meta-analysis were in keeping with the notion that GPD formulations were effective in the treatment of depression without causing any severe adverse effects. However, currently available evidence was of low quality and therefore inadequate to justify a strong recommendation of using GPD formulations in the management of depression.     

Abstract of Systematic Review of Randomized Controlled Trial of Traditional Chinese Medicine for the Treatment of Depression

In order to investigate the efficacious Chinese medicine for depression, 6 studies according with criteria and 367 randomized patients were included in this review. Compared with western medicine or western medicine plus other therapies or blank control, Chinese medicine can＇t lower the scores of self-rating depression scale （-1.58, 95%CI-3.39- -0.23, p=0.09）; but it is likely to lower the scores of Hamilton depression scale （-0.91, 95%CI-1.97-4）.15, p〈0.00001, 0 was included in the 95% CI）. Although the scores of Hamilton depression scale are possibly lowered, reviewer thinks that more proof is needed to authenticate the above-noted conclusion. The prospect of Chinese medicine for depression is promising; more qualified randomized controlled clinical trials are warranted to assure its efficacy.     

Probiotics’ Preventive Effect on Pediatric Food Allergy：A Meta-analysis of Randomized Controlled Trials

Objective To investigate the preventive effect of probiotics on pediatric food allergy. Methods From MEDLINE bibliographical database, we searched and reviewed all randomized controlled trials on the preventive effects of probiotics on pediatric food allergies up to September 2013 and excluded the studies that do not meet inclusion criteria and extracted the data. Meta-analysis for the results of homogenous studies was performed using RevMan 5.0 and the co-effect was pooled by using fixed-effects model of relative risk （RR） ratios. Results Ten trials published between 2007 and 2012 including 2701 cases were included. Meta-analysis based on included data showed that the preventive effect of prenatal and postnatal probiotic supplementation on food allergies was not significant with the RR=0.88 （95% CI： 0.76-1.03）. Conclusion Present evidences cannot show in unequivocal terms that prenatal and postnatal probiotic supplementation will prevent food allergic diseases.     

Therapeutic Effect and Safety of Ustekinumab for Plaque Psoriasis:A Meta-analysis

Objective To evaluate the efficacy and safety of ustekinumab in the therapy of plaque psoriasis. Methods Literatures published up to November 2013 were collected from Cochrane library, MEDLINE, and PubMed which were related with ustekinumab for plaque psoriasis. The efficacy was estimated using relative risk of Psoriasis Area and Severity Index （PASI） 75 response rate at the week 12 endpoint in clinical trials, and adverse effects were also analyzed. Meta-analysis was carried out by using Review Manager 5.1. Results Six randomized control trials consistent with the inclusion criteria were selected and reviewed. Ustekinumab 45 mg group and 90 mg group could get better therapeutic effect compared with the placebo group （all P〈0.00001）. Furthermore, ustekinumab 90 mg group was more effective than ustekinumab 45 mg group （P=0.01）. Adverse effects in the 6 trials were mentioned including headache, upper respiratory tract infection, nasopharyngtis, infection, serious infection, cardiovascular events, and malignant tumors. There were no statistically significant differences of these adverse effects among three groups （all P〉0.0S）, except that infection rate in ustekinumab 45 mg group was higher than the placebo group （P=0.02）. Conclusions Ustekinumab is an effective and safe therapeutic method for plaque psoriasis. However, further longer time analysis of safety is needed.     

Effects of tacrolimus and cyclosporine treatment on metabolic syndrome and cardiovascular risk factors after renal transplantation: a meta-analysis

Background The therapeutic success of renal transplantation has been largely attributable to the development of effective and balanced immunosuppressive treatment regimens.This study provides a meta-analysis of a series of randomized controlled trials that compared the effects of tacrolimus and cyclosporine on metabolic syndrome （MetS） and cardiovascular risk factors after renal transplantation.Methods We searched various electronic databases and bibliographies,including MEDLINE,the Cochrane Central Register of Controlled Trials,and EMBASE,for relevant studies published prior to October 2012.Results Our meta-analysis included five randomized controlled trials that examined a total of 923 patients.The tacrolimus group and the cyclosporine group exhibited no significant differences in MetS incidence after renal transplantation; risk ratio （RR）：1.06,95％ confidence interval （C/）：0.73-1.55,P=0.76.Cyclosporine treatment was associated with a higher incidence of hyperlipidemia （RR：0.50,95％ CI：0.39-0.64,P ＜0.01）.Although there were no statistically significant differences,cyclosporine treatment was associated with a higher incidence of hypertension （RR：0.91,95％ CI：0.83-1.00,P=0.06） after renal transplantation compared to tacrolimus treatment,and tacrolimus treatment was associated with a higher incidence of diabetes after renal transplantation （RR：1.79,95％ CI：0.98-3.27,P=0.06） compared to cyclosporine treatment.Conclusions Compared to tacrolimus treatment,cyclosporine treatment was associated with a higher incidence of hyperlipidemia.Future large-scale studies are expected to be conducted to further confirm our findings.     

Predictive validity of BODE index for anxious and depressive symptoms in patients with chronic obstructive pulmonary disease

Background Anxiety and depression are two of the commonest and most modifiable comorbidities of chronic obstructive pulmonary disease （COPD） and have an independent effect on health and prognosis. FEV1% has been shown to be a poor predictor of anxiety and depression. The body mass index, degree of airflow obstruction, dyspnea, and exercise capacity （BODE） index is a multidimensional assessment system which may predict health outcome in COPD patients. The purpose of this study was to investigate the predictive validity of the BODE index for anxious and depressive symptoms in COPD patients. Methods This was a multicenter prospective cross-sectional study in 256 patients with stable COPD. Anxious and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale （HADS）. The relationships between anxiety, depression and potential predictors （including the BODE index） were analyzed by a binary Logistic regression model. Results Subjects who were anxious and depressive waJked a shorter sJx-mJnute waJkJng distance （6MWD~, had more dyspnea, a higher BODE index, and lower health-related quality of life （P 〈0.01）. Anxiety and depression score was significantly correlated with BODE index, respectively （r=0.335, P 〈0.001 ; r=0.306, P 〈0.001）. The prevalence of anxiety and depression increased with BODE stage increasing （P 〈0.05）. On the basis of binary Logistic regression, the BODE index was a good and independent predictor of anxiety and depression because it comprised dyspnea and 6MWD, which were shown to be the main determinants. Conclusions The predictive validity of the BODE index for anxiety and depression was demonstrated. We propose that the BODE index should be included in assessment of COPD severity.     

穴位埋线治疗过敏性鼻炎：一项系统综述

Objective： To assess the effectiveness and the possible adverse effects of catgut implantation at acupoints for allergic rhinitis （AR）. Methods： This systematic review was carried out in accordance with the Cochrane Handbook version 5.1.0 and the Preferred Reporting Items for Systematic Reviews and Meta- Analyses statement. Extensive literature searches were conducted in PubMed, Excerpta Medical Databases, the Cochrane Library, the China National Infrastructure, Wanfang Chinese Digital Periodical and Conference Database, and the Weipu Chinese Science and Technique Journals Database. The Chinese Clinical Trial Registry Center was also searched for ongoing trials up to September 2012. Randomized controlled trials （RCTs） or quasi-RCTs were included. Risk of bias assessment was performed using the Cochrane tool for assessing risk of bias. Results： Five RCTs with 285 participants were found from 49 relevant studies, but there was just one RCT which met the inclusion criteria for this review. The study showed that treatment of catgut implantation at acupoints could lead to a better alleviation of the signs and symptoms of AR than the crude herb moxibustion. No adverse events were reported in this study. Conclusions： Because of the methodological shortcoming and the risk of bias of the included trial catgut implantation was proved with only limited evidence for the treatment of AR. Robust RCTs with high quality and larger sample size in this field are hoped to be carried out in the future.     

Meta-analysis on integrative medicine for the treatment of malignant ascites: a comparative study

OBJECTIVE: To compare the efficacy of integrated Chinese and Western Medicine with that of only Western Medicine for the treatment of malignant ascites.METHODS: All randomized controlled trials(January 2004 to March 2013) from the China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, and Wanfang Database were searched with keywords. Meta-analysis was conducted by combining the odds ratios of the individual studies. Review Manager 5.0 was used for the analysis.RESULTS: One thousand one hundred and fifty-six patients from 19 randomized controlled trails were included. Of them, 630 patients were treated with integrated Chinese and Western Medicine(the integrative group), and 526 patients were treated with Western Medicine alone(the control group). The Meta-analysis showed that the total effective rate was 78.73% in the integrated group, and 59.13% in the control group. The effective percentage was sig-nificantly higher in the integrative group than that of the control group [OR = 2.85, 95% CI(2.16,3.74),P < 0.01].CONCLUSION: The short-term curative effect in the integrative group was better than that in the control group. Integrative medicine may be beneficial for malignant ascites.     

Efficacy of externally applied Chinese herbal drugs in treating psoriasis: A systematic review

Objective:To assess the efficacy and safety of external application of Chinese herbal drugs(exCHD) in the treatment of psoriasis.Methods:Literature regarding randomized clinical trials(RCTs) of psoriasis treatments with ex-CHD,either alone or combined with Western medicine(WM) or physiotherapy,controlled by untreated,placebo or WM treatment were found in electronic databases,including PubMed/MEDLINE, EMBASE,Cochrane Library,Cochrane Central Register of Controlled Trials,China Biology Medicine Disc(CBM), Chinese National Knowledge Infrastructure(CNKI),Wanfang database and VIP database from their inception through July 2011.Study selection,data extraction,quality assessment,and data analyses were conducted according to the Cochrane standards.Results:A total of 10 randomized trials(involving 1,435 patients) were included.Because both test and control drugs used in the RCTs were different from each other,the effects can only be described singly and calculated.Regarding the total effective rate for the treatment of psoriasis,exCHD in combination with ultraviolet radiation b(UVB) or narrow band ultraviolet radiation b(NB-UVB),which was reported in 6 trials,was superior to UVB alone.One study reported that ex-CHD and externally applied WM had equivalent effects.In another study,ex-CHD showed better results than placebo.However,another two comparisons of ex-CHD and WM(all in combining with oral WM) showed uncertain outcomes.Nine trials reported adverse reactions.Of these,7 RCTs included statistical analysis.The results showed that the sideeffects that occurred in ex-CHD combined with UVB were less severe than those caused by UVB alone,but the incidence was roughly the same as WM.Conclusion:The evidence supporting the efficacy of ex-CHD with respect to treating psoriasis is quite limited and must be strengthened by high-quality studies.     

脑源性神经营养因子Val66Met功能基因多态性与环境因素对抗抑郁剂临床疗效的影响

Objective To explore the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism,environmental factor and their interactions on antidepressant treatment.Methods 340 patients of major depressive disorder (MDD) who met the diagnosis criteria of MDD ( DSM-Ⅳ Axis Ⅰ) were recruited.280 patients of them were finished 12 weeks antidepressant treatment.The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS) before and after 12 weeks antidepressant treatment.Childhood Trauma Questionnaire,28-item Short Form (CTQ-SF) and Life Events Scale (LES) were used to evaluate childhood adverse and life stress before onset.Genotyping of BDNF Val66Met polymorphism was detected by Illumina GoldenGate assays.Results Male patients proportion were significantly higher in non-remitters than remitters (P =0.008 ).After adjusting by gender, the frequencies of genotype and allele for the BDNF Val66Met polymorphism were no significant difference between remitters (AA: AG: GG = 28: 79: 40, A:G = 135:159 ) and non-remitters (AA: AG: GG = 29:81:23 ,A: G = 139:127 ) (P ＞0.05 ).There was no significant difference of CTQ scores and LES scores between the two groups (P＞0.05 ).The regression analysis showed that social intercourse problem and age were the risk factor for the severity of depression.The gender, HDRS baseline scores and mental disorder family history were associated with the efficacy of 12 weeks antidepressant.However,there was no significantly relationship between the interaction of BDNF Val66Met polymorphism and environment with the antidepressant treatment.Conclusion The older men with the mental disorder family history, severe depression symptom would be less-response to antidepressant treatment.However, BDNF Val66Met polymorphism, childhood trauma, life events stress and the interaction of BDNF Val66Met polymorphism and environment have no significantly effect on the 12 weeks antidepressant treatment.     

Summary of 32 patients with cardiac syndrome X treated by TCM therapy of regulating qi relieving chest stuffiness and promoting blood circulation

Objective： To evaluate the clinical effect of Liqi Kuanxiong Huoxue method （宽胸活血,LKH, traditional Chinese medicine, TCM therapeutic method for regulating qi, relieving chest stuffiness and promoting blood circulation） in treating patients with cardiac syndrome X （CSX）. Methods： The prospective, non-randomized controlled study was conducted on 51 selected patients with CSX, who were non-randomly assigned to 2 groups, the treated group treated with LKH in addition to the conventional treatment （32 patients）, and the control group treated with conventional treatment （19 patients） like nitrate, diltiazem hydrochloride, etc. The treatment course was 14 days. The changes of such symptoms as angina pectoris, TCM syndrome and indexes of treadmill exercise test before and after treatment were observed. Results： After treatment, such symptoms as chest pain and stuffy feeling and palpitation in the treated group were improved more than those in the control group （P〈0.05）; the total effective rate on angina pectoris and TCM syndrome in the treated group was better than that in the control group （P〈0.05）. The treadmill exercise test showed that the maximal metabolic equivalent （Max MET）, the time of angina onset and ST segment depression by 0.1 mV were obviously improved after treatment in both groups, but the improvement in the treated group was better than that in the control group respectively （P〈0.05）. Conclusion： The LKH method could reduce the frequency of angina attacks and improve the clinical condition of patients with CSX.     

Oligosaccharide and Creatine Supplementation on Glucose and Urea Nitrogen in Blood and Serum Creatine Kinase in Basketball Athletes

Summary： The effects of oligosaccharide and creatine （Cr） supplementation on glucose, lactic acid and urea nitrogen levels in blood and activity of serum creatine kinase （CK） were explored. Twenty CUBA male athletes were divided into 4 groups： group A （supplementation of Cr alone）, group B （supplementation of oligosaccharide）, group C （supplementation of oligosaccharide and Cr） and group D （placebo control group）. By using orthogonal L4 table （2a ）, the experiment was performed. There were factors including oligosaccharide （carbohydrate, CHO）, Cr and their correlation. Each factor had two levels： supplementation and no-supplementation. The results showed that the supplementation of CliO or Cr alone, combined supplementation of CHO and Cr could significantly reduce the glucose, urea nitrogen levels in blood and serum CK activity after competition in the athletes. Moreover, the effects of combined supplementation of CHO and Cr were more satisfactory. It was concluded that supplementation of CliO and Cr could promote the recovery of physical performance and athletic abilities after athletics in basketball athletes.     

Tai chi for management of type 2 diabetes mellitus: A systematic review

Objective:Tai chi has been recommended for treating type 2 diabetes mellitus.The purpose of this systematic review was to evaluate evidence from controlled clinical trials testing the effectiveness of tai chi in treating type 2 diabetes mellitus.Methods:Systematic searches were conducted on 14 electronic databases without restrictions on either population characteristics or language of publication.The outcome measures considered for inclusion were changes in fasting blood glucose（FBG）,glycosylated haemoglobin A_1c(HbA_1c) and quality of life（QOL）.Results:Eight randomised clinical trials（RCTs） and two controlled clinical trials（CCTs） met all inclusion criteria.Three RCTs from 1 trial compared the effects of tai chi with sham exercise and failed to show effectiveness of tai chi on FBG,HbA_1c,or QOL.The other 3 RCTs tested the effects of tai chi compared with other types of exercise on FBG.The meta-analysis failed to show an FBG-lowering effect of tai chi[n=118,weighted mean difference（WMD）:-0.14 mmol/L,95%CI:-0.86 to 0.58,P=0.70].Four studies （2 RCTs and 2 CCT） compared tai chi with no treatment or self-management programme and failed to report significant differences between the experimental and control groups except for QOL from 1 RCT and 1 CCT. Conclusion:The existing evidence does not suggest that tai chi is an effective therapy for type 2 diabetes. Currently,there are few high-quality trials on which to make definitive judgements.