***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: Patients with combined hyperlipemia have lipid abnormalities associated with an increased tendency to develop atherosclerosis and thrombosis . This tendency may be accelerated during postpr and ial hyperlipemia . In the present double-blind parallel study , 41 patients with combined hyperlipemia and serum triacylglycerols between 2.0 and 15.0 mmol/L and serum total cholesterol > 5.3 mmol/L at the end of a 3-month dietary run-in period were treated with simvastatin at 20 mg/d for at least 10 weeks ; patients were then r and omized into 2 groups receiving simvastatin+omega-3 fatty acids at 3.36 g/d or placebo ( corn oil ) for an additional 5 weeks . Hemostatic variables that have been associated with increased thrombotic tendency were evaluated with subjects in the fasting state and during postpr and ial hyperlipemia before and after combined treatment . Supplementation of omega-3 fatty acid reduced tissue factor pathway inhibitor antigen ( P<0.05 ) in the fasting state , reduced the degree of postpr and ial hyperlipemia ( P<0.005 ) , and reduced activated factor VII concentration appearing during postpr and ial hyperlipemia . In conclusion , omega-3 fatty acids given in addition to simvastatin to patients with combined hyperlipemia reduced the free tissue factor pathway inhibitor fraction in the fasting state and inhibited the activation of factor VII occurring during postpr and ial lipemia , thus representing a potential beneficial effect on the hemostatic risk profile in this patient group Hypercholesterolemia is combined with enhanced lipid peroxidation , which can promote atherogenesis by inducing endothelial adhesion molecule expression . Statins may protect vascular endothelium in hypercholesterolemia by reducing enhanced plasma levels of low-density lipoprotein and decreasing oxidative stress . Herein , we describe increased circulating levels of soluble intercellular adhesion molecule-1 , vascular cell adhesion molecule-1 , and E-selectin and total 8-iso-prostagl and in F(2 alpha ) ( 8-iso-PGF(2 alpha ) ) concentrations , as indexes of endothelial activation and lipid peroxidation , respectively , in 67 hypercholesterolemic patients compared with 32 normocholesterolemic subjects .  Significant cholesterol reductions were achieved in hypercholesterolemic patients after 6 months under either simvastatin ( 40 mg/d ) or bezafibrate ( 800 mg/d ) treatment , given according to a r and omized double-blind trial . Simvastatin but not bezafibrate simultaneously reduced soluble adhesin and total 8-iso-PGF(2 alpha ) concentrations also . Vitamin E supplementation ( 400 IU/d ) further reduced indexes of endothelial activation and lipid peroxidation in simvastatin-treated patients and significantly reduced the above indexes in bezafibrate-treated patients . Changes in circulating soluble adhesion molecule levels were directly correlated with changes in total 8-iso-PGF(2 alpha ) concentrations in simvastatin-treated patients also receiving vitamin E supplementation . All together , our data demonstrated that hypercholesterolemia was combined with endothelial activation and lipid peroxidation , which were efficaciously counteracted by simvastatin but not bezafibrate treatment . Thus , a different vascular protection can be achieved by different lipid-lowering treatments The objective of the study was to evaluate potential benefits of docosahexaenoic acid ( DHA ) rich fish oil supplementation as an adjunct to statin therapy for hyperlipidaemia . A total of 45 hyperlipidaemic patients on stable statin therapy with persistent elevation of plasma triglycerides ( averaging 2.2 mmol/L ) were r and omised to take 4 g/day ( n = 15 ) or 8 g/day ( n = 15 ) of tuna oil or olive oil ( placebo , n = 15 ) for 6 months . Plasma lipids , blood pressure and arterial compliance were assessed initially and after 3 and 6 months in 40 subjects who completed the trial .  Plasma triglycerides were reduced 27 % by 8 g/day DHA-rich fish oil ( P < 0.05 ) but not by 4 g/day when compared with the placebo and this reduction was achieved by 3 months and was sustained at 6 months . Even though total cholesterol was already well controlled by the statin treatment ( mean initial level 4.5 mmol/L ) , there was a further dose-dependent reduction with fish oil supplementation ( r = −0.344 , P < 0.05 ) . The extent of total cholesterol reduction correlated ( r = −0.44 ) with the initial total cholesterol levels ( P < 0.005 ) . In the subset with initial plasma cholesterol above 3.8 mmol/L , plasma very low density lipoprotein ( VLDL ) , intermediate-density lipoprotein ( IDL ) and low-density lipoprotein ( LDL ) were isolated and assayed for cholesterol and apolipoprotein B ( apoB ) at the commencement of the trial and at 3 months of intervention . Fish oil tended to lower cholesterol and apoB in VLDL and raise both in LDL . There were no changes in IDL cholesterol , IDL apoB and high-density lipoprotein cholesterol . The results demonstrate that DHA-rich fish oil supplementation ( 2.16 g DHA/day ) can improve plasma lipids in a dose-dependent manner in patients taking statins and these changes were achieved by 3 months . Fish oil in addition to statin therapy may be preferable to drug combinations for the treatment of combined hyperlipidaemia Background The approximately 1100 medical journals now active in China are publishing a rapidly increasing number of research reports , including many studies identified by their authors as r and omized controlled trials . It has been noticed that these reports mostly present positive results , and their quality and authenticity have consequently been called into question . We investigated the adequacy of r and omization  of clinical trials published in recent years in China to determine how many of them met acceptable st and ards for allocating participants to treatment groups . Methods The China National Knowledge Infrastructure electronic data base was search ed for reports of r and omized controlled trials on 20 common diseases published from January 1994 to June 2005 . From this sample , a subset of trials that appeared to have used r and omization methods was selected . Twenty-one investigators trained in the relevant knowledge , communication skills and quality control issues interviewed the original authors of these trials about the participant r and omization methods and related quality -control features of their trials . Results From an initial sample of 37,313 articles identified in the China National Knowledge Infrastructure data base , we found 3137 apparent r and omized controlled trials . Of these , 1452 were studies of conventional medicine ( published in 411 journals ) and 1685 were studies of traditional Chinese medicine ( published in 352 journals ) . Interviews with the authors of 2235 of these reports revealed that only 207 studies adhered to accepted methodology for r and omization and could on those grounds be deemed authentic r and omized controlled trials ( 6.8 % , 95 % confidence interval 5.9–7.7 ) . There was no statistically significant difference in the rate of authenticity between r and omized controlled trials of traditional interventions and those of conventional interventions . R and omized controlled trials conducted at hospitals affiliated to medical universities were more likely to be authentic than trials conducted at level 3 and level 2 hospitals ( relative risk 1.58 , 95 % confidence interval 1.18–2.13 , and relative risk 14.42 , 95 % confidence interval 9.40–22.10 , respectively ) . The likelihood of authenticity was higher in level 3 hospitals than in level 2 hospitals ( relative risk 9.32 , 95 % confidence interval 5.83–14.89 ) . All r and omized controlled trials of pre-market drug clinical trial were authentic by our criteria . Of the trials conducted at university-affiliated hospitals , 56.3 % were authentic ( 95 % confidence interval 32.0–81.0 ) . Conclusion Most reports of r and omized controlled trials published in some Chinese journals lacked an adequate description of r and omization . Similarly , most so called ' r and omized controlled trials ' were not real r and omized controlled trials owing toa lack of adequate underst and ing on the part of the authors of rigorous clinical trial design . All r and omized controlled trials of pre-market drug clinical trial included in this research were authentic . R and omized controlled trials conducted by authors in high level hospitals , especially in hospitals affiliated to medical universities had a higher rate of authenticity . That so many non-r and omized controlled trials were published as r and omized controlled trials reflected the fact that peer review needs to be improved and a good practice guide for peer review including how to identify the authenticity of the study urgently needs to be developed Thirty elderly ( mean + /- SEM : 73.8 + /- 2.1 y ) nondiabetic , moderately obese ( body mass index = 28.3 + /- 0.6 kg/m2 ) patients with stable effort angina underwent an oral-glucose-tolerance test and a euglycemic hyperinsulinemic glucose clamp before and after vitamin E supplementation ( 900 mg/d for 4 mo ) . The study was of a r and omized , placebo-controlled , double-blind , and crossover design . Anthropometric indexes were stable throughout the study . Despite similar fasting and 2-h plasma glucose concentrations , vitamin E administration ( compared with placebo ) lowered fasting ( 88 + /- 14 and 68 + /- 9 pmol/L , P < 0.02 ) and 2-h ( 348 + /- 43 and 263 + /- 28 pmol/L , P < 0.05 ) plasma insulin concentrations , plasma triglyceride concentrations ( 1.34 + /- 0.06 and 1.07 + /- 0.03 mmol/L , P < 0.05 ) , and the ratio of plasma LDL to HDL cholesterol ( 7.64 + /- 0.31 and 5.52 + /- 0.38 , P < 0.02 ) . Vitamin E administration was associated with higher nonoxidative glucose metabolism ( 18.1 + /- 0.5 and 10.6 + /- 0.7 mumol.kg lean body mass-1.min-1 , P < 0.03 ) than was placebo administration during the euglycemic glucose clamp . We conclude that chronic intake of pharmacological doses of vitamin E might be useful in the therapy of elderly insulin-resistant patients with coronary heart disease BACKGROUND Supplementation with vitamin E may antagonize vitamin K in healthy adults , but it is unclear whether intake of vitamin E decreases the risk of venous thromboembolism ( VTE ) . METHODS AND RESULTS The Women 's Health Study r and omized 39,876 women > or = 45 years of age to receive 600 IU of natural source vitamin E or placebo on alternate days . Before r and omization , 26,779 participants gave blood sample s , which were used to determine factor V Leiden , G20210A prothrombin , and 677C > T MTHFR polymorphisms . Documented VTE ( including deep vein thrombosis or pulmonary embolism ) and unprovoked VTE ( no recent surgery , trauma , or cancer diagnosis ) were prospect ively evaluated , secondary end points of the trial . During a median follow-up period of 10.2 years , VTE occurred in 482 women : 213 in the vitamin E group and 269 in the placebo group , a significant 21 % hazard reduction ( relative hazard , 0.79 ; 95 % CI , 0.66 to 0.94 ; P=0.010 ) . For unprovoked VTE , the hazard reduction was 27 % ( relative hazard , 0.73 ; 95 % CI , 0.57 to 0.94 ; P=0.016 ) . In subgroup analyses , the 3 % of participants who reported VTE before r and omization had a 44 % hazard reduction ( relative hazard , 0.56 ; 95 % CI , 0.31 to 1.00 ; P=0.048 ) , whereas women without prior VTE had an 18 % hazard reduction ( relative hazard 0.82 ; 95 % CI , 0.68 to 0.99 ; P=0.040 ) . Women with either factor V Leiden or the prothrombin mutation had a 49 % hazard reduction associated with vitamin E treatment ( relative hazard , 0.51 ; 95 % CI , 0.30 to 0.87 ; P=0.014 ) . CONCLUSIONS These data suggest that supplementation with vitamin E may reduce the  risk of VTE in women , and those with a prior history or genetic predisposition may particularly benefit BACKGROUND Aged Garlic Extract ( AGE ) reduces multiple cardiovascular risk factors , including blood pressure , cholesterol , platelet aggregation and adhesion , while stimulating nitric oxide generation in endothelial cells . However , no study has evaluated the ability of AGE to inhibit vascular calcification , a marker of plaque formation in human coronary arteries . O 
    Output:
    
With only a few small studies available per supplement , evidence was insufficient for all predefined gradable clinical efficacy and harms outcomes , such as mortality and serious adverse events .
Incremental benefits were noted for triglyceridemia with omega-3 fatty acid added to statins ; and there was an improvement in levels of high-density lipoprotein cholesterol with garlic supplementation when people also consumed nitrates Conclusions Evidence of low-strength indicates benefits of omega-3 fatty acids ( plus statin , or calcium channel blockers and antiplatelets ) and garlic ( plus nitrates or warfarin ) on triglycerides and HDL-C , respectively .