[an error occurred while processing this directive]

Journal of Chinese Integrative Medicine ›› 2011, Vol. 9 ›› Issue (8): 878-887.doi: 10.3736/jcim20110810

• Original Experimental Research • Previous Articles     Next Articles

Chinese herbal medicine Xiayuxue Decoction inhibits liver angiogenesis in rats with carbon tetrachloride-induced liver fibrosis

Jin-xing Du1,2, Ping Liu1,2,3(), Ming-yu Sun1,2,3, Qing Tao1,2, Li-jun Zhang1,2, Gao-feng Chen1,2, Yi-yang Hu1,2,3, Cheng-hai Liu1,2,3, Lie-ming Xu1,2,3   

  1. 1. Institute of Liver Diseases, Key Laboratory of Liver and Kidney Diseases, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
    2. Shanghai Key Laboratory of Traditional Chinese Clinical Medicine,the Key Research Unit of Liver Diseases,State Administration of Traditionl Chinese Medicine of the Peopled Republic of China for Liver Diseases, Shanghai 201203, China
    3. E-institute of Traditional Chinese Internal Medicine of Shanghai Municipal Education Commission, Shanghai 201203, China
  • Received:2011-04-05 Accepted:2011-04-25 Online:2011-08-20 Published:2011-08-15

Objective: To evaluate the effects of Xiayuxue Decoction, a compound traditional Chinese medicine, on liver angiogenesis in rats with carbon tetrachloride (CCl4)-induced liver fibrosis.
Methods: Liver cirrhosis was induced by intraperitoneal injection of 50% CCl4-olive oil solution at the dose of 1 mL/kg body weight, twice per week for 9 consecutive weeks. After 3- and 6-week injection, 6 rats in the normal group and 6 rats in the model group were randomly sacrificed for dynamic observation. The survival rats of model group were randomly divided into model group (n=15) and Xiayuxue Decoction group (n=11). Six normal rats were used as a normal control. Xiayuxue Decoction was administered orally starting from the 7th week for 3 weeks. At the end of the ninth week, animals were sacrificed and liver tissues were harvested to measure histological changes, activities of matrix metalloproteinase-2 (MMP-2) and MMP-9 and protein expressions of platelet endothelial cell adhesion molecule-1 (CD31), von Willebrand factor (vWF), vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor-2 (VEGFR2), complement decay-accelerating factor (DAF) and α-smooth muscle actin (α-SMA) in the liver tissues.
Results: Compared with the normal group, liver injury, fatty degeneration and collagen deposition were evidently observed in the model group and protein expressions of CD31, vWF, VEGF, VEGFR2, DAF and α-SMA were gradually increased. In addition, the activities of MMP-2 and MMP-9 in liver tissues were enhanced in the model group (P<0.01). Compared with 9-week model group, liver injury, fatty degeneration and collagen deposition were markedly inhibited by Xiayuxue Decoction; protein expressions of CD31, vWF, VEGF, VEGFR2, α-SMA and DAF and activities of MMP-2 and MMP-9 in the liver tissues were decreased in the Xiayuxue Decoction group (P<0.01).
Conclusion: The angiogenesis is evident and aggravating gradually during the progression of liver cirrhosis induced by CCl4. Xiayuxue Decoction inhibits the angiogenesis by decreasing the activities of MMP-2 and MMP-9, inhibiting the activation of hepatic stellate cells, and damaging the new vessel integrality.

Key words: carbon tetrachloride, liver cirrhosis, angiogenesis, drugs,Chinese herbal, rats

Figure 1

Pathological changes of liver tissues A: Photographs of hematoxylin-eosin staining (Light microscopy, ×200); B: Photographs of sirius red staining (Light microscopy, ×100). N: Normal group; 3W: 3-week model group; 6W: 6-week model group; 9W: 9-week model group; X: Xiayuxue Decoction group."

Figure 2

Protein expression of CD31 in liver tissues A: Photographs of immunofluorescence results (Fluorescence microscopy, ×200); B: Film negatives of Western blot results; C: Grayscale analysis (CD31-to-GAPDH ratio). N: Normal group; 3W: 3-week model group; 6W: 6-week model group; 9W: 9-week model group; X: Xiayuxue Decoction group. The values are represented as x±s. Expressions of CD31 protein in different (N, 9W and X) groups were 0.06±0.01, 0.74±0.03 and 0.08±0.01, respectively. H=6.25, P<0.05. **P<0.01, vs normal group; △△P<0.01, vs 9-week model group. CD31: platelet endothelial cell adhesion molecule-1; GAPDH: glyceraldehyde-3-phosphate dehydrogenase."

Table 1

Scanning density integrals of expressions of CD31, vWF, VEGF, VEGFR2, α-SMA and DAF proteins in liver tissues of rats ($\bar{x}$±s)"

Group n CD31 vWF VEGF VEGFR2 α-SMA DAF
N 2 0.90±0.14 2.25±0.21 7.30±0.14 1.40±0 0±0 0±0
9W 3 11.33±0.21** 7.67±0.12** 15.10±0.26** 13.67±0.21** 7.10±0.20** 14.00±0.12**
X 3 1.33±0.06△△ 3.12±0.35△△ 12.37±0.25 11.20±0.36 1.97±0.15△△ 1.37±0.06△△

Figure 3

Protein expression of vWF in liver tissues A: Photographs of immunofluorescence results (Fluorescence microscopy, ×400); B: Film negatives of Western blot results; C: Grayscale analysis (vWF-to-GAPDH ratio). N: Normal group; 3W: 3-week model group; 6W: 6-week model group; 9W: 9-week model group; X: Xiayuxue Decoction group. The values are represented as x±s. Expressions of vWF protein in different (N, 9W and X) groups were 0.14±0.01, 0.50±0.01 and 0.20±0.02, respectively. **P<0.01, vs normal group;△△P<0.01, vs 9-week model group. vWF: von Willebrand factor; GAPDH: glyceraldehyde-3-phosphate dehydrogenase."

Figure 4

Protein expressions of VEGF, VEGFR2, α-SMA and DAF in liver tissues A: Film negatives of Western blot results; B: Grayscale analysis (ratio to GAPDH). N: Normal group; 3W: 3-week model group; 6W: 6-week model group; 9W: 9-week model group; X: Xiayuxue Decoction group. The values are represented as x±s. Expressions of VEGF protein in different (N, 9W and X) groups were 0.55±0.01, 1.18±0.02 and 0.94±0.03, respectively. Expressions of VEGFR2 protein in different (N, 9W and X) groups were 0.10±0.01, 0.94±0.03 and 0.78±0.03, respectively. Expressions of α-SMA protein in different (N, 9W and X) groups were 0±0, 0.46±0.02 and 0.13±0.01, respectively. Expressions of DAF protein in different (N, 9W and X) groups were 0±0, 0.91±0.01 and 0.09±0.01, respectively. **P<0.01, vs normal group; △△P<0.01, vs 9-week model group. VEGF: vascular endothelial grow factor; VEGFR2: VEGF receptor-2; α-SMA: α-smooth muscle actin; DAF: complement decay-accelerating factor; GAPDH: glyceraldehyde-3-phosphate dehydrogenase."

Figure 5

Activity changes of MMP-2 and MMP-9 in liver tissues A: Film negatives of gelatin zymography; B: Grayscale analysis. N: Normal group; 3W: 3-week model group; 6W: 6-week model group; 9W: 9-week model group; X: Xiayuxue Decoction group. The values of scanning density integrals of activities of MMP-2 and MMP-9 are represented as x±s. Scanning density integrals of activity of MMP-2 in different (N, 9W and X) groups were 0±0, 7.63±0.15 and 0±0, respectively. H=7.62, P<0.05. Scanning density integrals of activity of MMP-9 in different (N, 9W and X) groups were 2.13±0.21, 3.57±0.12 and 2.27±0.25, respectively. **P<0.01, vs normal group; △△P<0.01, vs 9-week model group. MMP: matrix metalloproteinase."

[1] Paternostro C, David E, Novo E, Parola M . Hypoxia, angiogenesis and liver fibrogenesis in the progression of chronic liver diseases[J]. World J Gastroenterol, 2010,16(3):281-288
doi: 10.3748/wjg.v16.i3.281 pmid: 20082471
[2] Mejias M, Garci-Pras E, Tiani C, Miquel R, Bosch J, Fernandez M . Beneficial effects of sorafenib on splanchnic, intrahepatic, and portocollateral circulations in portal hypertensive and cirrhotic rats[J]. Hepatology, 2009,49(4):1245-1256
doi: 10.1002/hep.22758
[3] Llovet JM, Bruix J . Testing molecular therapies in hepatocellular carcinoma: the need for randomized phase Ⅱ trials[J]. J Clin Oncol, 2009,27(6):833-835
doi: 10.1200/JCO.2008.19.1973 pmid: 19139428
[4] Siegel AB, Cohen EI, Ocean A, Lehrer D, Goldenberg A, Knox JJ, Chen H, Clark-Garvey S, Weinberg A, Mandeli J, Christos P, Mazumdar M, Popa E, Brown RS Jr, Rafii S, Schwartz JD . Phase Ⅱ trial evaluating the clinical and biologic effects of bevacizumab in unresectable hepatocellular carcinoma[J]. J Clin Oncol, 2008,26(18):2992-2998
doi: 10.1200/JCO.2007.15.9947
[5] Li HR, Li XR . Feasibility for inhibiting tumor metastasis with Chinese herbal medicines as angiogenesis inhibitors[J]. J Chin Integr Med, 2007,5(4):378-382
李焕荣, 李秀荣 . 中医药抑制肿瘤血管生成抗肿瘤转移的可行性探讨[J]. 中西医结合学报, 2007,5(4):378-382
[6] Mu YP, Liu P, Liu Y, Li FH, Chen GF, Gu HT, Du GL, Wang L, Wang CS . Inhibiting action of Xiayuxue Decoction on hepatic fibrosis at progressive stage in rats and study on the prescription and syndrome[J]. Zhong Yi Za Zhi, 2006,47(3):215-218
慕永平, 刘平, 刘莺, 李风华, 陈高峰, 顾宏图, 都广礼, 王磊, 王春树 . 下瘀血汤对进展期大鼠肝纤维化的抑制作用及其方证探讨[J]. 中医杂志, 2006,47(3):215-218
[7] Du GL, Liu P, Wang L, Wang CS, Long AH, Mu YP . Relationship between traditional medical formulae and syndrome based pharmacological study of Xiayuxue Decoction against porcine serum induced liver fibrosis in rats[J]. Zhongguo Shi Yan Fang Ji Xue Za Zhi, 2007,13(6):30-33
都广礼, 刘平, 王磊, 王春树, 龙爱华, 慕永平 . 下瘀血汤抗猪血清免疫性肝纤维化方证相关的药效学研究[J]. 中国实验方剂学杂志, 2007,13(6):30-33
[8] Nakamura T, Akiyoshi H, Saito I, Sato K . Adenovirus-mediated gene expression in the septal cells of cirrhotic rat livers[J]. J Hepatol, 1999,30(1):101-106
doi: 10.1016/S0168-8278(99)80013-0 pmid: 9927156
[9] Lee TY, Wang GJ, Chiu JH, Lin HC . Long-term administration of Salvia Miltiorrhiza ameliorates carbon tetrachloride-induced hepatic fibrosis in rats[J]. J Pharm Pharmacol, 2003,55(11):1561-1568
doi: 10.1211/0022357022098
[10] Bussolino F, Mantovani A, Persico G . Molecular mechanisms of blood vessel formation[J]. Trends Biochem Sci, 1997,22(7):251-256
doi: 10.1016/S0968-0004(97)01074-8 pmid: 9255066
[11] Risau W . Mechanisms of angiogenesis[J]. Nature, 1997,386(6626):671-674
doi: 10.1038/386671a0
[12] Song ZJ, Wang JY . Angiogenesis and liver fibrosis[J]. Guo Ji Xiao Hua Bing Za Zhi, 2008,28(5):407-409
doi: 10.3969/j.issn.1673-534X.2008.05.018
宋正己, 王吉耀 . 血管新生与肝纤维化[J]. 国际消化病杂志, 2008,28(5):407-409
doi: 10.3969/j.issn.1673-534X.2008.05.018
[13] Nagy P, László V, Schaff Z . Hepatocarcinogenesis in human liver[J]. Magy Onkol, 2006,50(2):107-113
pmid: 16888673
[14] Raskopf E, Vogt A, Sauerbruch T , Schmitz V.siRNA targeting VEGF inhibits hepatocellular carcinoma growth and tumor angiogenesis in vivo[J]. J Hepatol, 2008,49(6):977-984
doi: 10.1016/j.jhep.2008.07.022 pmid: 18845354
[15] Thorat MA, Mehrotra S, Morimiya A, Badve S . COX-2 expression does not correlate with microvessel density in breast cancer[J]. Pathobiology, 2009,76(1):39-44
doi: 10.1159/000178154 pmid: 19188749
[16] Takahara T, Furui K, Funaki J, Nakayama Y, Itoh H, Miyabayashi C, Sato H, Seiki M, Ooshima A, Watanabe A . Increased expression of matrix metalloproteinase-Ⅱ in experimental liver fibrosis in rats[J]. Hepatology, 1995,21(3):787-795
doi: 10.1002/hep.1840210328 pmid: 7875677
[17] Taura K, De Minicis S, Seki E, Hatano E, Iwaisako K, Osterreicher CH, Kodama Y, Miura K, Ikai I, Uemoto S, Brenner DA . Hepatic stellate cells secrete angiopoietin 1 that induces angiogenesis in liver fibrosis[J]. Gastroenterology, 2008,135(5):1729-1738
doi: 10.1053/j.gastro.2008.07.065 pmid: 18823985
[18] Aleffi S, Petrai I, Bertolani C, Parola M, Colombatto S, Novo E, Vizzutti F, Anania FA, Milani S, Rombouts K, Laffi G, Pinzani M, Marra F . Upregulation of proinflammatory and proangiogenic cytokines by leptin in human hepatic stellate cells[J]. Hepatology, 2005,42(6):1339-1348
doi: 10.1002/hep.v42:6
[19] Novo E, Cannito S, Zamara E , Valfrè di Bonzo L, Caliqiuri A, Crananzola C, Compagnone A, Colombatto S, Marra F, Pinzani M, Parola M.Proangiogenic cytokines as hypoxia-dependent factors stimulating migration of human hepatic stellate cells[J]. Am J Pathol, 2007,170(6):1942-1953
doi: 10.2353/ajpath.2007.060887
[20] Ferrara N, Davis-Smyth T . The biology of vascular endothelial growth factor[J]. Endocr Rev, 1997,18(1):4-25
doi: 10.1210/edrv.18.1.0287
[21] Otrock ZK, Makarem JA, Samseddine AI . Vascular endothelial growth factor family of ligands and receptors: review[J]. Blood Cells Mol Dis, 2007,38(3):258-268
doi: 10.1016/j.bcmd.2006.12.003 pmid: 17344076
[22] Plouët J, Moro F, Bertagnolli S, Coldeboeuf N, Mazarguil H, Clamens S, Bayard F . Extracellular cleavage of the vascular endothelial growth factor 189-amino acid form by urokinase is required for its mitogenic effect[J]. J Biol Chem, 1997,272(20):13390-13396
doi: 10.1074/jbc.272.20.13390
[23] Langer DA, Shab VH . Nitric oxide and portal hypertension: interface of vasoreactivity and angiogenesis[J]. J Hepatol, 2006,44(1):209-216
doi: 10.1016/j.jhep.2005.10.004 pmid: 16297493
[24] Grunewald M, Avraham I, Dor Y, Bachar-Lustig E, Itin A, Jung S, Chimenti S, Landsman L, Abramovitch R, Keshet E . VEGF-induced adult neovascularization: recruitment, retention, and role of accessory cells[J]. Cell, 2006,124(1):175-189
doi: 10.1016/j.cell.2006.08.015 pmid: 16413490
[25] Lee JS, Semel D, Iredale J, Shah VH . Sinusoidal remodeling and angiogenesis: a new function for the liver-specific pericyte?[J]. Heptology, 2007,45(3):817-825
doi: 10.1002/hep.21564 pmid: 17326208
[26] Yoshiji H, Kuriyama S, Yoshii J, Ikenaka Y, Noguchi R, Hicklin DJ, Wu Y, Yanase K, Namisaki T, Yamazaki M, Tsujinoue H, Imazu H, Masaki T, Fukui H . Vascular endothelial growth factor and receptor interaction is a prerequisite for murine hepatic fibrogenesis[J]. Gut, 2003,52(9):1347-1354
doi: 10.1136/gut.52.9.1347
[27] Lidington EA, Haskard DO, Mason JC . Induction of decay-accelerating factor by thrombin through a protease-activated receptor 1 and protein kinase C-dependent pathway protects vascular endothelial cells from complement-mediated injury[J]. Blood, 2000,96(8):2784-2792
[28] Mason JC, Lidington EA, Yarwood H, Lublin DM, Haskard DO . Induction of endothelial cell decay-accelerating factor by vascular endothelial growth factor: a mechanism for cytoprotection against complement-mediated injury during inflammatory angiogenesis[J]. Arthritis Rheum, 2001,44(1):138-150
doi: 10.1002/(ISSN)1529-0131
[29] Mason JC, Yarwood H, Sugars K, Morgan BP, Davies KA, Haskard DO . Induction of decay-accelerating factor by cytokines or the membrane-attack complex protects vascular endothelial cells against complement deposition[J]. Blood, 1999,94(5):1673-1682
[1] Na Wu , Lu Song , Xin-xin Yang, Jiang-lei Wei , Zhen-guo Liu. Effects of Chinese herbal medicine Tianqi Pingchan Granule on G protein-coupled receptor kinase 6 involved in the prevention of levodopa-induced dyskinesia in rats with Parkinson disease. Journal of Chinese Integrative Medicine, 2012, 10(9): 1018-1024.
[2] Lawrence A. Olatunji, Taofeek O. Usman, Joseph O. Adebayo, Victoria A. Olatunji . Effects of aqueous extract of Hibiscus sabdariffa on renal Na+-K+-ATPase and Ca2+-Mg2+-ATPase activities in Wistar rats. Journal of Chinese Integrative Medicine, 2012, 10(9): 1049-1055.
[3] Dhirender Kaushik, Ajay Kumar, Pawan Kaushik, Avatar C. Rana. Anticonvulsant activity of alcoholic extract of bark of Pinus roxburghii Sarg. Journal of Chinese Integrative Medicine, 2012, 10(9): 1056-1060.
[4] Chan Chen, Chang-xun Chen, Xi-min Wu, Rui Wang, Yi-ming Li. Effects of extracts of Radix Scrophulariae on blood pressure in spontaneously hypertensive rats and the underlying mechanisms. Journal of Chinese Integrative Medicine, 2012, 10(9): 1009-1017.
[5] Jian-sheng Li, Ya Li, Su-yun Li, Yuan-yuan Wang, Li Deng, Yan-ge Tian, Su-li Jiang , Ying Wang. Long-term effects of Tiaobu Feishen therapies on systemic and local inflammation responses in rats with stable chronic obstructive pulmonary disease. Journal of Chinese Integrative Medicine, 2012, 10(9): 1039-1048.
[6] Karuna A. Talpate, Uma A. Bhosale, Mandar R. Zambare. Clitorea ternatea, a herb from Indian folklore, improves streptozotocin-induced diabetes and diabetes-induced cognitive decline in rats. Journal of Chinese Integrative Medicine, 2012, 10(8): 939-947.
[7] Samuel Joshua Pragasam, Vachana Murunikara, Evan Prince Sabina, Mahaboobkhan Rasool. Antiperoxidative potential of p-coumaric acid, a common dietary phenol, in adjuvant-induced arthritis in rats. Journal of Chinese Integrative Medicine, 2012, 10(8): 932-938.
[8] Zi-hui Li, Jian Wang, Rong-lin Cai, You-wen Wang, Jian-peng Hu. Establishment and evaluation of a rat model of ulcerative colitis with syndrome of dampness stagnancy due to spleen deficiency. Journal of Chinese Integrative Medicine, 2012, 10(8): 918-924.
[9] Meng Li, Ling Hu, Rong-lin Cai, Zi-jian Wu, Ke-ming Wang. Effects of electro-acupuncture at PC6 and BL15 on nerve electrical activity in spinal dorsal root and norepinephrine and dopamine contents in paraventricular nucleus of hypothalamus in rats with acute myocardial ischemia. Journal of Chinese Integrative Medicine, 2012, 10(8): 874-879.
[10] Hong Wang , Jing-tian Ou , Xin Zhao , Ying Guoz , Hao-ping Mao. Vasodilator effect of oroxylin A on thoracic aorta isolated from rats. Journal of Chinese Integrative Medicine, 2012, 10(8): 880-885.
[11] Xin-min Li, Hui Chen, Yan-yan Ren, Yan-li Lu. Effects of Chinese herbal medicine Xifeng Capsule on multidrug resistance-associated protein 1 expression in hippocampus and cortex of rats with lithium-pilocarpine-induced epilepsy. Journal of Chinese Integrative Medicine, 2012, 10(8): 911-917.
[12] C. Mouli Kalla, Vijaya Tartte, Dattatreya Rao Sirpurkar. Effectiveness of flavonoid-rich leaf extract of Acalypha indica in reversing experimental myocardial ischemia: biochemical and histopathological evidence. Journal of Chinese Integrative Medicine, 2012, 10(7): 784-792.
[13] Mei-jiao Mao, Jun-ping Hu, Cong Wang, Yi-yi Zhang, Ping Liu. Effects of Chinese herbal medicine Guanxinkang on expression of PPARγ-LXRα-ABCA1 pathway in ApoE-knockout mice with atherosclerosis. Journal of Chinese Integrative Medicine, 2012, 10(7): 814-820.
[14] Yi-tao Zhao , Xin-guang Zhang , Li Bai , Li-qing Li , Jian-er Yu . Effects of Chinese herbal medicine Pingchuan Formula on airway inflammation, interferon-γ and interleukin-4 in mice with asthma. Journal of Chinese Integrative Medicine, 2012, 10(7): 807-813.
[15] Ling Xu, Qiao-ling Zhou, Jie Han, Dan-ying Zhang, Hui-juan Dong, Zai-long Cai, Chao-qin Yu, Dong-xia Zhai . Effects of Chinese herbal medicine Neiyi Recipe-medicated serum on angiopoiesis of endometriosis in the chick chorioallantoic membrane model. Journal of Chinese Integrative Medicine, 2012, 10(7): 800-806.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Wei-xiong Liang. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 1-4
[2] Zhao-guo Li. Discussion on English translation of commonly used sentences in traditional Chinese medicine: part one. Journal of Chinese Integrative Medicine, 2008, 6(1): 107-110
[3] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[4] Xue-mei Liu, Qi-fu Huang, Yun-ling Zhang, Jin-li Lou, Hong-sheng Liu, Hong Zheng. Effects of Tribulus terrestris L. saponion on apoptosis of cortical neurons induced by hypoxia-reoxygenation in rats. Journal of Chinese Integrative Medicine, 2008, 6(1): 45-50
[5] . Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication (Chinese version, part two). Journal of Chinese Integrative Medicine, 2010, 8(11): 1001-1005
[6] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[7] Hong Liu , Guo-liang Zhang, Li Shen , Zhen Zeng, Bao-luo Zhou, Cheng-hai Liu, Guang Nie . Application and evaluation of a pseudotyped virus assay for screening herbs for anti-H5Nl avian influenza virus. Journal of Chinese Integrative Medicine, 2010, 8(11): 1036-1040
[8] Zhao-guo Li . A discussion of English translation of 1995 and 1997 Chinese National Standards of Traditional Chinese Medical Terminologies for Clinical Diagnosis and Treatment. Journal of Chinese Integrative Medicine, 2010, 8(11): 1090-1096
[9] Rui Jin, Bing Zhang. A complexity analysis of Chinese herbal property theory: the multiple formations of herbal property (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(11): 1198-1205
[10] Hui-min Liu, Xian-bo Wang, Yu-juan Chang, Li-li Gu. Systematic review and meta-analysis of randomized controlled trials of integrative medicine therapy for treatment of chronic severe hepatitis. Journal of Chinese Integrative Medicine, 2012, 10(11): 1211-1228
[an error occurred while processing this directive]