***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To observe the therapeutic effect of Xiaobai Mixture ( XBM ) in treating vitiligo . METHODS Seventy-four patients with vitiligo were r and omly divided into the XBM group treated with XBM and the control group treated with 8-MOP . The therapeutic effect , nail-fold microcirculation , plasma endothelin-1 , serum immunoglobulin were observed and compared . RESULTS The therapeutic effect of XBM was better than that of 8-MOP ( P < 0.05 ) . XBM could also obviously improve the nail-fold microcirculation , elevate the plasma endothelin-1 level and lower the serum IgG ( P < 0.01 ) . CONCLUSION XBM has superiority in treating vitiligo Summary For effective treatment of vitiligo , it is as important to arrest the progression of the disease as it is to induce repigmentation . Recently , oxidative stress has been shown to play an important role in the pathogenesis of vitiligo . Ginkgo biloba extract has been shown to have antioxidant and immunomodulatory properties . In a double‐blind placebo‐controlled trial , we evaluated the efficacy of G. biloba extract in controlling the activity of the disease process in patients with limited and slow‐spreading vitiligo and in inducing repigmentation of vitiliginous areas . Fifty‐two patients were assigned to two treatment groups ( A and B ) in a double‐blind fashion , but only 47 patients could be evaluated , because one patient in group A and four patients in group B withdrew for reasons unrelated to the study . Patients in group A were given G. biloba extract 40 mg three times daily whereas patients in group B received placebo in similar doses . A statistically significant cessation of active progression of depigmentation was noted in patients treated with G. biloba ( P = 0.006 ) . Marked to complete repigmentation was seen in 10 patients in group A , whereas only two patients in group B showed similar repigmentation . The G. biloba extract was well tolerated . G. biloba extract seems to be a simple , safe and fairly effective therapy for arresting the progression of the disease Narrow b and UVB is succeeding psoralen and UVA irradiation as the main treatment of vitiligo vulgaris in several European countries . Vitamin B12 and folic acid deficiency in some vitiligo patients has prompted research ers to investigate the efficacy of these vitamins in the treatment of vitiligo . In the present controlled study we investigated the value of narrow b and UVB phototherapy in the treatment of vitiligo and the possible additive effect of vitamin B12 and folic acid .  Twenty-seven patients with long-term stable vitiligo were included and r and omized in a  " UVB only " ( UVB ) or " UVB combined with vitamin B12 and folic acid " ( UVB+ ) group . Patients were irradiated thrice weekly for one year , whilst repigmentation was carefully monitored . In 92 % ( 25/27 ) of the patients up to 100 % repigmentation was seen . Repigmentation was notable in lesions on the face , neck and throat , lower arm , chest , back and lower legs , whilst repigmentation on the h and s , wrists , feet and ankles proved to be minimal . Maximum repigmentation rates did not differ significantly between the UVB group and the UVB+ group . Our study reconfirms that narrow b and UVB phototherapy is an effective treatment for vitiligo and shows that co-treatment with vitamin B12 and folic acid does not improve the outcome of treatment of vitiligo with narrow b and UVB phototherapy Vitiligo is an idiopathic leukoderma often with a progressive course causing destruction of melanocytes . The best methods for achieving cosmetically acceptable re‐pigmentation of affected skin appear to be both local and systemic PUVA . They may , however , cause serious side effects , which is an argument for conducting research into new , equally effective photo‐chemotherapeutic agents . One of these agents is khellin . We conducted a pilot study in 33 patients to evaluate the effectiveness of local KUVA and systemic PUVA therapy for vitiligo and to compare them in terms of the degree of re‐pigmentation , duration of treatment , number of procedures , total UVA dose and side effects . Local KUVA required longer duration of treatment and higher UVA doses . KUVA‐induced re‐pigmentation depended on the age of the patients ( r = −0.61 , P = 0.001 ) , and better results were achieved with younger individuals [ % re‐pigmentation = 81.76 − ( 1.48 × age in years ) ] . No side effects were observed in cases of local KUVA  treatment . Erythema , itching and gastro‐intestinal disturbances occurred with some patients treated with PUVA . The results demonstrate that local KUVA  may effectively induce re‐pigmentation of vitiligo‐affected skin areas to a degree comparable to that achieved when using systemic PUVA , provided that treatment duration is long enough Vitiligo is a chronic illness of a yet unknown etiology , characterized by an acquired and progressive depigmentation of the skin . There are diverse treatments for this condition around the world , but up to now , none has been completely effective . The objective of this work was to evaluate the application of an antioxidant and mitochondrial stimulating formula , of topic use in leukodermic areas of patients with stable vulgar vitiligo . A clinical , experimental , r and omized , double blind study was carried out in 50 male and 50 female patients with stable vulgar vitiligo . The patients were distributed in five groups as follows : Group 1 ( labelled as VitilVenz AF ) : application of antioxidant and mitochondrial stimulating cream and oral administration of antioxidants and phenylalanine . Group 2 ( labelled as Placebo AF ) : application of a placebo cream and oral administration of antioxidants and phenylalanine . Group 3 ( labelled as without cream AF ) : oral administration of antioxidants and phenylalanine . Group 4 ( labelled as Placebo cream ) : application of a placebo cream . Group 5 ( labelled as VitilVenz ) : application of the antioxidant and mitochondrial stimulating cream . The following were measured in all patients : the clinical area of newly formed pigment every 30 days , during five months ; and the presence of melanocytes in the histological study , at the beginning and at the end of treatment . The test of multiple comparison of Turkey-Kramer was used for the analysis of the results . The scheme of treatment that produced the best results was that of the Group 1 , which consisted of the joint application of the antioxidant and mitochondrial stimulating cream and oral administration of antioxidants and phenylalanine ( p < 0.001 ) ; followed by Group 5 that only received the topical treatment with the antioxidant and mitochondrial stimulating cream . The clinical and histological responses of these two groups ( 1 and 5 ) were significantly different to the rest of the groups . We concluded that the melanocytes in these patients could be in a dysfunctional state , product of the formation of free radicals that cause cellular and mitochondrial toxicity ; and that these free radicals are removed by the antioxidant and mitochondrial stimulating elements present in the cream , turning the melanocytes functional and producing melanin in the achromic area of the vitiligo . This effect would be potentiated by the use of oral antioxidants and phenylalanine BACKGROUND The first choice treatment for vitiligo vulgaris is narrow-b and UVB ( NB-UVB ) , but no satisfactory treatment exists . OBJECTIVES To investigate if Polypodium leucotomos , an antioxidative and immunomodulatory plant extract , improves NB-UVB-induced repigmentation . METHODS Fifty patients with vitiligo vulgaris r and omly received 250 mg oral P. leucotomos or placebo three times daily , combined with NB-UVB twice weekly for 25 - 26 weeks . RESULTS Repigmentation was higher in the P. leucotomos group vs. placebo in the head and neck area ( 44 % vs. 27 % , P = 0.06 ) . Small repigmentation increases ( P = n.s . ) were observed for the trunk ( 6 % increased repigmentation ) , extremities ( 4 % ) , and h and s and feet ( 5 % ) in the P. leucotomos group vs. placebo . Patients attending more than 80 % of required NB-UVB sessions showed increased repigmentation in the head and neck area in the P. leucotomos group vs. placebo ( 50 % vs. 19 % , P < 0.002 ) ; no significant differences were seen in the other body areas . Patients with skin types 2 and 3 showed more repigmentation in the head and neck area in the P. leucotomos group vs. placebo ( 47 % vs. 21 % , P = 0.01 ) , and no significant differences were seen in the other body areas . No conclusions could be drawn on skin types 4 and 5 due to low patient numbers . CONCLUSION There is a clear trend towards an increase in repigmentation of vitiligo vulgaris affecting the head and neck area when NB-UVB phototherapy is combined with oral P. leucotomos . This effect may be more pronounced in light skin types Summary The administration of phenylalanine ( Phe ) combined with UVA exposure was found to be effective in vitiligo . Phe is an amino acid which constitutes part of the daily dietary protein , and when orally administered in a dose of 50 mg/kg body weight , it results in an elevated plasma level . Since peak concentrations of Phe in the blood are reached between 30 and 45 min after ingestion , UVA exposure was administered at this time . After 4 months ( 32 treatments ) reasonable repigmentation preferentially occurred in the skin area of subcutaneous fat ( adipose tissue ) . Apart from the repigmentation of hypopigmented macules , vitiligo patients can tolerate more sun than usual , especially at the vitiliginous lesion , and they experience no sunburn as a result of Phe-UVA therapy . Normal skin also tans very well OBJECTIVE To compare the quality of reporting of reports r and omized controlled trials ( RCTs ) published in English and in language s other than English ( LOE ) , and to determine whether there were differences between conventional medicine ( CM ) and complementary and alternative medicine ( CAM ) reports . STUDY DESIGN AND SETTING We examined more than 600 RCTs associated with 125 systematic review s. We extracted characteristics of each RCT using a st and ardized data collection form . We assessed quality using the Jadad scale and the adequacy of allocation concealment . RESULTS There were only minor differences in the quality of reports of RCTs published in English compared with other language s ( median quality score of 3 vs. 2 , P=.10 ) , and the quality of reports of CAM RCTs was similar to the CM reports ( median score of 3 vs. 2 , P=.14 ) . There was no effect of language of publication on quality of reporting for CM trials ( median score of 2 vs. 2 , P=.12 ) . Among CAM trials , however , overall quality scores were higher for reports in English than for reports in other language s ( median score of 3 vs. 2 , P=.04 ) . CONCLUSION The overall quality of reports published in language s other than English is similar to that of English- language reports . Moreover , the overall quality of reporting of RCTs of CAM interventions is as good as that for CM interventions In order to evaluate the efficacy of L-phenylalanine ( L-Phe ) in combination with UVA therapy for vitiligo an open trial ( 149 patients , 18 months ) and a small double-blind trial ( 32 patients , 6 months ) were conducted . Oral L-Phe loading result ed in peak plasma levels of L-Phe after 30 - 60 min and a slight increase in the plasma tyrosine level . Response to  L-Phe plus UVA irradiation  was positive , and various grade s of repigmentation not exceeding 77 % in the open and 60 % in the blind trial were observed . An increased L-Phe dose result ed in increased L-Phe plasma levels but not in improved clinical results . The optimal L-Phe dose appears to be lower than 50 mg/kg/day . Although it is difficult to draw firm conclusions from the present investigation , we think that L-Phe may have a place in the treatment of vitiligo and its role merits further investigation 
    Output:
    
The studies provide weak evidence that photosensitizing plants can be effective in conjunction with phototherapy , and moderate evidence that Ginkgo biloba monotherapy can be useful for vitiligo .
Conclusion Reports investigating the efficacy of NHPs for vitiligo exist , but are of poor method ological quality and contain significant reporting flaws .