Problems and thoughts in clinical safety evaluation of traditional Chinese medicine / 中国中药杂志

Amid the modernization and internationalization of traditional Chinese medicine(TCM), the safety of TCM has attracted much attention. At the moment, the government, scientific research teams, and pharmaceutical enterprises have made great efforts to explore methods and techniques for clinical safety evaluation of TCM. Although considerable achievements have been made, there are still many problems, such as the non-standard terms of adverse reactions of TCM, unclear evaluation indicators, unreasonable judgment methods, lack of evaluation models, out-of-date evaluation standards, and unsound reporting systems. Therefore, it is urgent to further deepen the research mode and method of clinical safety evaluation of TCM. Based on the current national requirements for the life-cycle management of drugs, this study focused on the problems in the five dimensions of clinical safety evaluation of TCM, including normative terms, evaluation modes, judgment methods, evaluation standards, and reporting systems, and proposed suggestions on the development of a life-cycle clinical safety evaluation method that conformed to the characteristics of TCM, hoping to provide a reference for future research.

Evaluation methods of clinical efficacy of traditional Chinese medicine / 中国中药杂志

Clinical efficacy is the basis for the development of traditional Chinese medicine(TCM), and the evaluation of clinical efficacy of TCM has always been the focus of attention. The technical and methodological difficulties in the evaluation process often restrict the generation of high-level evidence. Therefore, methodological research should be deepened and innovative practice should be carried out to study the application of scientific research methods in the evaluation of the advantages of TCM. After more than ten years of development, the clinical efficacy evaluation of TCM, on the basis of the initially classic placebo randomized controlled trials, has successively carried out a series of meaningful attempts and explorations in N-of-1 trials, cohort studies, case-control studies, cross-sectional studies, real world studies, narrative medicine studies, systematic evaluation, and other aspects, laying the foundation for the transformation of TCM from "experience" to "evidence". This paper focused on the clinical efficacy evaluation of TCM, summarized the main connotation and development status of efficacy evaluation indicators, standards, and methods, and put forward corresponding countermeasures and suggestions for the problems of indicator selection, standard formulation, and methodology optimization in the research process. It is clear that scientific and objective evaluation of the efficacy of TCM is an urgent problem to be solved at present.

MiR-4484 regulates the expression of integrin α 6 in gastric cancer tissues and its significance / 中华肿瘤杂志

Objective: To investigate the relationship between the expression of integrin α 6 (ITGA6), miR-4484 and the pathologic stage of gastric cancer. Methods: Gastric cancer tissues and normal gastric mucosa tissues adjacent to cancer (>5 cm from tumor margin) of 30 patients with primary gastric cancer who underwent direct surgical resection without adjuvant therapy from June to September 2017 in West China Hospital of Sichuan University were selected. Real-time quantitative polymerase chain reaction (PCR) was used to detect the expression levels of miR-4484 and ITGA6, western blot was used to detect the expression level of ITGA6 protein, dual luciferase reporter gene was used to verify the relationship between ITGA6 and miR-4484. Spearman's correlation analysis was used to determine the relationship between miR-4484 and ITGA6 expression levels in gastric cancer tissues. Results: The expression level of ITGΑ6 in gastric cancer (32.30±13.47) was higher than that in matched normal gastric tissues (24.55±10.25, P=0.015), the area under the receiver operating characteristic (ROC) curve was 0.660 and the diagnostic sensitivity and specificity were 43.3% and 96.7%, respectively. The expression level of miR-4484 in gastric cancer (4.11±2.87) was lower than that of matched normal gastric tissues (5.75±2.80, P=0.029), the area under the ROC curve was 0.690 and the diagnostic sensitivity and specificity were 30.0% and 86.7%, respectively. The expression level of miR-4484 was negatively correlated with ITGA6 in gastric cancer tissues (r=-0.621, P<0.001). The expression level of ITGA6 protein in gastric cancer tissues (0.65±0.19) was higher than that in normal adjacent tissues (0.26±0.12, P<0.001). Compared with ITGA6 3'UTR wild-type+ miR-NC group, ITGA6 3'UTR wild-type+ miRNA mimics group had lower luciferase activity (50.69±5.10, 34.00±1.19, P<0.001), while the luciferase activity of ITGA6 3'UTR wild-type+ ASO miR-4484 group was higher than that of ITGA6 3'UTR wild-type+ miR-NC group (82.44±6.37, 50.69±5.10, P<0.001), indicated that ITGA6 was the direct target gene of miR-4484. The expression levels of miR-4484 in T1, T2, T3 and T4 (4a and 4b) gastric cancer tissues were 9.98±2.24, 5.28±2.03, 2.92±2.04 and 4.11±2.87, respectively, with statistical significance (P<0.001). The expression levels of ITGA6 in N0, N1, N2 and N3 gastric cancer tissues were 29.55±8.32, 21.71±3.75, 24.60±8.79 and 40.69±15.83, respectively, with statistical significance (P=0.022). The expression levels of miR-4484 in N0, N1, N2 and N3 gastric cancer tissues were 5.01±3.52, 5.48±2.76, 5.88±1.83 and 2.30±1.56, respectively, with statistical significance (P=0.032). The expression levels of ITGA6 in M0 and M1 gastric cancer tissues were 26.28±7.66 and 52.08±8.12, respectively, with statistical significance (P<0.001). The expression levels of miR-4484 in M0 and M1 gastric cancer tissues were 4.95±2.74 and 1.34±0.80, respectively, with statistical significance (P<0.001). Conclusions: ITGA6 is upregulated in gastric cancer tissues, while miR-4484 is downregulated in the gastric cancer group, and its expression level is related to the clinicopathological features of gastric cancer. ITGA6 is the direct target gene of miR-4484, implicates that miR-4484 may inhibit the invasion and metastasis of gastric cancer by regulating the expression of ITGA6. Both miR-4484 and ITGA6 may be the new prognostic markers and potential therapeutic targets of gastric cancer.

Construction and application of a dynamic adjustment model of medical service price in public hospitals / 中华医院管理杂志

Constructing a scientific, standardized and reasonable dynamic adjustment model of medical service price has important reference value for the dynamic adjustment of medical service price in public hospitals. In view of the current situation at home and abroad, the authors analyzed the influencing factors of such adjustment, and constructed a dynamic adjustment model of medical service price, referring on the resource-based relative value scale theory. This model could calculate the intrinsic price of individual medical services, taking into full account the basic human resource consumption and time consumption, as well as the technical difficulty and risk degree of such services. On such basis, the economic development and price level of individual regions were integrated into the model to calculate the extrinsic price of these services. Taking the debridement(suture) service of a hospital as an example, this model was used for empirical research. It was estimated that the extrinsic price of a debridement(suture)(small) service was 54.82 yuan, that of a debridement(suture)(medium) service was 104.34 yuan, and that of a debridement(suture)(large) was 142.93 yuan. The price gap between the actual price and these estimated prices was 10.18 yuan, -26.34 yuan and -51.93 yuan respectively. This research proved that the model could be helpful to sort out the price ratio relationship and better reflect the technical labor value of medical workers.

Effect of exosome derived from ovarian cancer cell on the differentiation of fibroblast / 中华肿瘤杂志

Objective: To study the effects of exosome secreted by ovarian cancer (OC) cell on the differentiation and metastasis of normal fibroblasts (NFs). Methods: NFs were collected from patients who underwent hysteromyoma resection in the Affiliated Hospital of Qingdao University from May to December 2019. Exosome was extracted from the culture supernatant of SKOV3 cells by using ultra-high-speed centrifugation. The NFs were co-cultured with condition medium (CM), exosome of SKOV3 (SKOV3-exo) and control medium. The expression levels of fibroblast activation protein (FAP) and α-smooth muscle actin (α-SMA) were detected by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blot. The metastatic ability of NFs was detected by Transwell array. Results: Under the transmission electron microscope, the extracellular vesicles extracted from the culture supernatant of SKOV3 were 30-100 nm in diameter with cup holder-like bilayer membrane structure, and the protein expression levels of TSG101 and HSP27 in exosomes (1.00±0.05 and 1.12±0.13) were higher than those of ovarian cancer SKOV3 cells (0.22±0.21 and 0.36±0.14, respectively, P<0.05). PKH67 fluorescently labeled exosomes could be taken up by NFs. The expression levels of α-SMA and FAP mRNA in CM group(2.91±0.15 and 3.21±0.33)and SKOV3-exo group (3.50±0.21 and 4.63±0.24, respectively) were higher than that in blank group (1.00±0.06 and 1.00±0.13, P<0.05). The protein expression levels of α-SMA and FAP in CM group and SKOV3-exo group (0.89±0.11 and 1.25±0.09, 0.81±0.09 and 1.20±0.12) were higher than those in the blank group (0.12±0.31 and 0.11±0.19, respectively, P<0.05). The migrated numbers of cells in the CM group and SKOV3-exo group [(215.01±14.80) and (389.72±19.43), respectively] were higher than that in the blank group [(113.73±4.70), P<0.05]. Conclusion: The exosome secreted by SKOV3 cells can be taken up by NFs, which makes it to differentiate into cancer associated fibroblasts (CAFs) and significantly enhances its metastatic ability, indicating that OC cells may promote the transformation of normal ovarian mesenchymal fibroblasts to CAFs through exosome pathways, and then promote the development of ovarian cancer.

Traditional Chinese Medicine Intervention of Ferroptosis Based on Yin-yang Theory： A Review / 中国实验方剂学杂志

Ferroptosis， a new type of iron-dependent programmed cell death， is related to multiple pathways such as glutathione/glutathione peroxidase 4， iron metabolism， lipid metabolism， and iron autophagy， and plays an important part in the occurrence and development of many diseases， such as tumor， cerebral ischemia， and Parkinson's disease. Ferroptosis is a double-edged sword as it can eliminate pathological cells （such as tumor cells） but long-term ferroptosis may cause or aggravate other disorders related to abnormal lipid metabolism and iron metabolism. Regulating the balance between cell proliferation and ferroptosis may be an important target for drug intervention in diseases. The Yin-yang theory is one of the foundational principles of traditional Chinese medicine （TCM）， which is used to explain the physiological functions and pathological changes of human body and to guide the diagnosis and prevention of disease and health care. The balance of cell proliferation and programmed death is essentially the balance of Yin and Yang at the cellular level， which is governed and regulated by the law of balance. TCM intervenes in ferroptosis by promoting ferroptosis of tumor cells （damaging the excess） and inhibiting ferroptosis of other diseases （compensating the deficiency）， which is similar to the treatment principle of adjusting Yin and Yang. On this basis， this article aims to use the Yin-yang theory to clarify the relationship between TCM promoting ferroptosis and inhibiting ferroptosis， which is expected to lay a basis for the modern application of Yin-yang theory and provide new targets for TCM treatment.

Q-marker prediction analysis of Gentiana rigescens Franch. based on HPLC and network pharmacology / 药学学报

Aa a characteristic medicinal plant in China, Gentiana rigescens Franch. has the function of protecting the liver and invigorating the spleen. At present, there are a few studies on the content determination method of characteristic components of G. rigescens, so it is necessary to establish a scientific and effective quality control method; In this study, The high performance liquid chromatography (HPLC) fingerprint of G. rigescens was established, based on literature reviewed and characteristic spectrum identified, the source range of G. rigescens quality marker (Q-marker) was screened. The effectiveness of the ingredients and the corresponding targets and pathways was analyzed through network pharmacology, and drew the diagram of ''component-target-pathway''. Qualitative and quantitative analysis of G. rigescens was performed by HPLC, and screen the main marker components leading to the differences between groups which were determined the Q-marker of G. rigescens; The literature and HPLC had determined that five iridoids were the main source of G. rigescens Q-marker. The network pharmacology (effectiveness) and qualitative and quantitative (detectability) analysis of G. rigescens from different producing areas confirmed that gentiopicroside, swertiamarin, and sweroside can be used as the main landmark components, and there were significant differences in their contents among different producing areas; The analysis of G. rigescens from different producing areas was carried out by network pharmacology and chemical fingerprints, it is confirmed can be used as potential Q-marker to provide sufficient theoretical basis for the quality control of G. rigescens in the later period.

Neuroimaging study of hippocampal subregion involved in post-traumatic stress disorder / 中华行为医学与脑科学杂志

The hippocampus plays an important role in fear learning and memory processing.It is a key brain area in the pathogenesis of post-traumatic stress disorder (PTSD). Neuroimaging studies have confirmed that the hippocampal structure and functional connectivity of patients with PTSD are abnormal, but the changes in hippocampal subregions are still unclear.The results of brain structure studies showed that the cornu ammonis and dentate gyrus atrophy in adult PTSD patients and the symptom of re-experience may be related to pattern separation dysfunction caused by reduced dentate gyrus neurogenesis.Among children diagnosed with PTSD, there is no significant change found in cornu ammonis and dentate gyrus, while atrophy in presubiculum was observed, which could result in fear extinction and deficits in episodic memory.The alteration of hippocampal volume in PTSD may have a gender-specific lateralization phenomenon.The results of brain function studies show that the functional connectivity of hippocampal subregions in PTSD patients is selectively damaged, especially the connectivity with key brain regions in the default mode network is reduced.This article systematically reviews the structural and functional connectivity changes of hippocampal subregions in patients with PTSD from the perspective of neuroimaging, in order to promote the understanding of the pathogenesis of PTSD and identify the therapeutic targets of hippocampal subregions.

Medicinal Textual Research of Tsaoko Fructus / 中国实验方剂学杂志

Tsaoko Fructus is a type of food with the homology of medicine and food，and has a long history of cultivation and application in China. With the deepening of the development and utilization of Tsaoko Fructus，its economic value has appeared obviously，and relevant industries have great potential，with an important role in poverty alleviation in mountainous areas. However，the plants source of Tsaoko Fructus are confused in the process of actual production and resource utilization，and there is a lack of systematic report about the origin of varieties and medicinal history. The paper focused on a textual research for its names，plant sources，changes of the genuine producing areas and traditional efficacy through consulting the herbal works and the analysis of modern literature. The results showed that the medicine of Tsaoko Fructus was first recorded in ancient literatures of the Song dynasty，and there were many aliases and synonyms of the herb， with a great difference between ancient and modern times. In modern records，the medicinal alias names such as Hongcaoguo，Tucaoguo，Caoguoren are similar with the Chinese name of Caoguo，but they are not the same kind of plant and shall be distinguished. In the Ming dynasty，variety and source of the herb was complicated，and it was often recorded as the same class of medicinal materials with Amomi Fructus Rotundus and Alpiniae Katsumadai Semen，until it was listed as a class of medicinal material and distinguished from confounding medicines in the Qing Dynasty. The prescriptions containing Tsaoko Fructus include Caoguoyin，Caoguosan，Caoguowan，Caoguoshushui. Tsaoko Fructus could be used as medicine with peel or only kernel according to different diseases，and mainly processed with water or wine. In addition，there are other processing methods，such as frying，salt-processing， ginger- processing，simmering flour. Ancient literatures have basically the same records on properties，efficacies and indications of Tsaoko Fructus，considering it was warm in nature with the effect in relieving vomiting，eliminating food，intercepting malaria，expelling phlegm. This study provided a theoretical basis for its origin，quality control and resource development and utilization.

Prevalence of late-onset hypogonadism among middle-aged and elderly males in China: results from a national survey / 亚洲男科学杂志(英文版)

This study aimed to propose an operational definition of late-onset hypogonadism (LOH) that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China. A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China. Serum total testosterone (TT), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were measured and free testosterone (cFT) was calculated. The Aging Males' Symptoms (AMS) scale was used to evaluate the LOH symptoms. Finally, 5078 men were included in this analysis. The TT levels did not decrease with age (P = 0.59), and had no relationship with AMS symptoms (P = 0.87 for AMS total score, P = 0.74 for ≥ 3 sexual symptoms). The cFT levels decreased significantly with age (P < 0.01) and showed a negative association with the presence of ≥ 3 sexual symptoms (P = 0.03). The overall estimated prevalence of LOH was 7.8% (395/5078) if a cFT level <210 pmol l

Advance on Pharmacological Effect and Clinical Application of Danggui Liuhuang Tang / 中国实验方剂学杂志

Danggui Liuhuang Tang， as one of classical traditional Chinese medicine prescriptions， has been used by major medical experts in clinic since Jin and Yuan dynasties. After review and summarization of relevant literatures on the pharmacological effects and clinical application of Danggui Liuhuang Tang， it was found that Danggui Liuhuang Tang has a wide range of pharmacological activities， and exerts its anti-inflammatory and anti-insulin resistance effects mainly by inhibiting the production of inflammatory factors， such as tumor necrosis factor and interleukin and activating related pathways. In addition， Danggui Liuhuang Tang inhibits the occurrence and development of hepatic fibrosis by attenuating proinflammatory signaling and extracellular matrix accumulation with multiple components， multiple targets， and multiple pathways. Danggui Liuhuang Tang has been widely used in sweat syndromes， with an obvious effect in the treatment of thyroid diseases， diabetes， respiratory tract and other diseases. This paper reviews and summarizes the pharmacological effects and clinical application of Danggui Liuhuang Tang，in an attempt to provide some valuable clues for the subsequent development of Danggui Liuhuang Tang.

Herbal Textual Research on Polygonati Rhizoma and Ethnic Usage / 中国实验方剂学杂志

Polygonati Rhizoma was first recorded in Mingyi Bielu（《名医别录》） as both medicine and food due to its high edible and medicinal values.However，there is no systematic textual research on its use as medicine and food. Polygonati Rhizoma and Polygonati Odorati Rhizoma show similar morphology，so they are often confused.Clematis apiifolia and Polygonatum odoratum are often regarded as the original plants of Polygonati Odorati Rhizoma. By reviewing the related records in Chinese herbal books of the past dynasties，this paper aimed to clarify the relationship between Polygonati Rhizoma，C.apiifolia and P.odoratum，trace the historical evolution of Polygonati Rhizoma as medicine and food from the name，harvesting and processing，property，flavor and meridian tropism，efficacy and indications，edible and medicinal records，and contraindications，and summarize its application in ethnic medicine，in order to inherit and develop the ethnic medicine. The findings demonstrated that the name of Polygonati Rhizoma and its synonyms were derived from its pictogram，function，and place of origin，containing a wealth of myth implication and Taoism thought.Polygonati Rhizoma，C.apiifolia and P.odoratum are three species，different from the conclusions in previous textual research. The seedlings，flowers，seeds，and rhizomes of Polygonati Rhizoma all could be used for edible and medicinal purposes，with its edible records exceeding the medicinal records. There were 22 medical books from the ethnic minority groups such as The Annals of National Medicine in Yunnan，Zhongguo Minzu Yaozhi Yao，and Dictionary of Chinese Ethnic Medicine recording the knowledge and application of 12 species in Polygonatum by 26 ethnic minorities.Due to their different living environments，lifestyles，and cultural customs，ethnic minorities have formed their unique medical cultures.

Discrimination of Different Species in Swertia Using FTIR Combined with Chemometrics / 中国实验方剂学杂志

Objective:To realize the rapid and accurate discrimination of Swertia plants by Fourier transform infrared spectroscopy (FTIR) and chemometrics. Method:The original infrared spectra data from different parts (roots,stems,leaves) of all of the 543 samples of S. davidii,S. mileensis,S. punicea,S. angustifolia and S. cincta were collected and preprocessed by multiplicative scatter correction (MSC),standard normal variate (SNV),Savitzky-Golay filter (SG),first derivative (1D),second derivative (2D),third derivative (3D). Then,the spectral ranges of 4 000-3 700,2 799-1 800 cm-1 and 682-653 cm-1 were deleted before PLS-DA and SVM analysis. Result:The samples of the five species could not be distinguished with similar averaged infrared spectra in the same part. The characteristic peaks of different parts in the same species were different, and the sequence of complexity was leaves > stems > roots. The five species of Swertia could accurately be identified by PLS-DA and SVM models established by spectra data in roots, stems and leaves. MSC+SG+2D showed the best preprocessing effect,and the prediction accuracies of all models were 100%. The values of R2Y in PLS-DA of all of the parts were more than 0.8, and the RMSEP was less than RMSECV,indicating that the model was stable and more effective. Furthermore,the value of Q2 exceeded 0.6, and the accuracy of prediction set reached 100%, indicating a high classification accuracy. It showed that PLS-DA models had a strong prediction ability. The c values in SVM model of roots,stems and leaves were 22.627 4,2 and 1.414 2,respectively,which were all within the normal ranges. The accuracy of prediction set was 100%, suggesting a high accuracy. Conclusion:FTIR combined with PLS-DA and SVM could accurately distinguish different species from Swertia, and the model has a good prediction effect and provides certain reference for the identification of other plants.

Low Calf Circumference Predicts Nutritional Risks in Hospitalized Patients Aged More Than 80 Years / 生物医学与环境科学（英文）

OBJECTIVE@#The aim of this study was to determine whether low calf circumference (CC) could predict nutritional risk and the cutoff values of CC for predicting nutritional risk in hospitalized patients aged ⪖ 80 years.@*METHODS@#A total of 1,234 consecutive patients aged ⪖ 80 years were enrolled in this study. On admission, demographic data, CC, and laboratory parameters were obtained. Patients with Nutritional Risk Screening 2002 (NRS-2002) total score ⪖ 3 were considered as having nutritional risk.@*RESULTS@#CC values were significantly lower in patients with nutritional risk compared to those in patients without nutritional risk [27.00 (24.50-31.00) vs. 31.00 (29.00-33.50], P < 0.001]. CC was negatively correlated with age and nutritional risk scores. Logistic regression analysis of nutritional risk revealed that body mass index, albumin level, hemoglobin level, cerebral infarction, neoplasms, and CC (OR, 0.897; 95% confidence interval, 0.856-0.941; P < 0.001) were independent impact factors of nutritional risk. Nutritional risk scores increased with a decrease in CC. In men, the best CC cutoff value for predicting nutritional risk according to the NRS-2002 was 29.75 cm. In women, the cutoff value was 28.25 cm.@*CONCLUSION@#CC is a simple, noninvasive, and valid anthropometric measure to predict nutritional risk for hospitalized patients aged ⪖ 80 years.

Research progress in chemical constituents in plants of Polygonatum and their pharmacological effects / 中国中药杂志

Polygonatum plants are perennial plants of Liliaceae. There are about 60 species reported at home and abroad,32 species in China,mainly distributed in the north temperate zone. Their main chemical components are steroidal saponins,polysaccharides,flavonoids,alkaloids,etc. They have anti-aging,anti-tumor,immunomodulation,antibacterial,antiviral,hypoglycemic and blood lipid effects. With the development of health industry,Polygonati Rhizome used as medicine and food has attracted great attention in recent years,and has become a research hotspot. However,the material basis of its efficacy is unclear and the product quality is uneven,which seriously limited the rapid upgrading of the industry. This review summarizes Polygonatum plants system classification,the chemical composition and pharmacological activity to provide theoretical basis for the development and utilization of Polygonatum plants.

Aberrant Resting-State Functional Connectivity in the Default Mode Network in Pediatric Bipolar Disorder Patients with and without Psychotic Symptoms / 神经科学通报·英文版

Mood disorders/psychosis have been associated with dysfunctions in the default mode network (DMN). However, the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder (PBD) remain unclear. The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients. Twenty-nine psychotic and 26 non-psychotic PBD patients, as well as 19 age- and sex-matched healthy controls underwent a resting-state functional MRI scan and the data were analyzed by independent component analysis. The DMN component from the fMRI data was extracted for each participant. Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements. The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex, bilateral caudate nucleus, bilateral angular gyri, and left middle temporal gyrus, while non-psychotic PBD was not, suggesting further impairment with the development of psychosis. In summary, we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group. These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.

Hip survival rate in the patients with avascular necrosis of femoral head after transtrochanteric rotational osteotomy: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#The clinical outcome of transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH) remains controversial, and the promising clinical results of several Japanese studies could not be reproduced in American and European studies. Trying to solve controversies on TRO for ONFH rising from apparently conflicting studies, a meta-analysis was conducted to assess the 5- and 10-year hip survival rates (with conversion to artificial joint replacement and radiographic failure as endpoints) after TRO.@*METHODS@#All eligible studies were searched in seven comprehensive databases including PubMed, Web of Science, Embase, Cochrane Library, VIP Database, China Knowledge Resource Integrated Database, and Wan Fang Database prior to June 2019. The outcomes evaluated were 5- and 10-year hip survival rates after TRO. The odds ratio and risk difference for the non-comparative binary data with the 95% confidence intervals (CIs) were calculated for each outcome. The included studies were assessed for methodologic bias and potential reasons for heterogeneity were explored.@*RESULTS@#Nineteen studies of TRO for ONFH were eligible for this meta-analysis according to inclusion criteria. Based on the previous report, two calculation methods (Methods 1 and 2) were adopted in this meta-analysis. Furthermore, we performed a sub-group analysis of the 5- and 10-year hip survival rates (Method 1) after TRO for ONFH: Asian sub-population and non-Asian sub-population. Taking conversion to artificial joint replacement as the endpoint, 5- and 10-year hip survival rates (Method 1) after TRO for ONFH in the Asian population were 0.86 (95% CI = 0.82-0.89) and 0.72 (95% CI = 0.65-0.78), respectively, and 5- and 10-year hip survival rates after TRO for ONFH in the non-Asian population were 0.55 (95% CI = 0.43-0.67) and 0.42 (95% CI = 0.28-0.55), respectively. The 5- and 10-year hip survival rates (Method 2) after TRO for ONFH were 0.90 (95% CI = 0.79-0.95) and 0.89 (95% CI = 0.81-0.94), respectively. Taking radiographic failure as the endpoint, 5- and 10-year hip survival rates after TRO for ONFH were 0.70 (95% CI = 0.64-0.76) and 0.53 (95% CI = 0.46-0.61), respectively.@*CONCLUSIONS@#The 5- and 10-year hip survival rates after TRO for ONFH were satisfactory in the Asian population, and were acceptable in the non-Asian population despite high early failure rates.

Analysis of the incidence and mortality trend of breast cancer in Chinese women from 2005 to 2013 / 中华疾病控制杂志

@# Objective To Analyze the change trend of the incidence and mortality of breast cancer in Chinese women from 2005 to 2013 in the Chinese Cancer Registry Annual Report in order to provide references for the implement of the prophylaxis and treatment of breast cancer. Methods Extracted all the records of the incidence and mortality of breast cancer in Chinese women from 2005 to 2013, applied the Joinpoint regression model to analyze the change trend of the incidence and mortality of breast cancer in Chinese women. Results The incidence levels of breast cancer among urban women in China was higher than that in rural from 2005 to 2013, the change trend of urban incidence was stable(t=-0.2, P=0.828), the rural incidence showed an increasing trend(t=7.8, P<0.001). The peaks of urban and rural incidence were in the age group of 50- and the age group of 45- respectively.The mortality of breast cancer among urban women in China was higher than that in rural from 2005 to 2013, the change trend of urban mortality was stable(t=0.8, P=0.458), and the rising trend of rural mortality was obvious(t=3.3, P=0.014). The mortality of urban women began to rise after the age of 30, accelerating to rise after the age of 75, the mortality of rural women began to rise after the age of 30, the change tended to be stable at the age of 55-69, and began to rise after the age of 70 again. Conclusions The incidence and mortality of breast cancer among urban women in China were all higher than that in rural from 2005 to 2013, the rising trend of the incidence and mortality of breast cancer among rural women was obvious, so the prophylaxis and treatment measures of breast cancer should be actively formulated and perfected.

Meta-analysis of brain functional images under N-back and DMTS paradigm in human working memory / 中华行为医学与脑科学杂志

Objective To study the similarities and differences in brain activation under N-back and DMTS paradigms of working memory. Methods Through searching of BrainMap function database by the combination keywords,a total of 122 articles with 122 experiments ( N-back: 67 experiments,937 sub-jects,900 foci;Delayed Matched to Sample: 55 experiments,806 subjects,872 foci). Maps were analyzed using the FDR PN (P<0. 0001) method based coordinates of the Montreal Neurological Institute ( MNI) space. Results In the combine of the N-back and DMTS paradigms,these regions were activated including the bilateral inferior parietal lobe (Left: -36,-52,44; Right: 38,-52,48) and insula(Left:-34,22,0;Right:34,24,2),the superior frontal gyrus (2,16,50) and inferior frontal gyrus (-44,8,30) of the left brain,and the middle frontal ( 46,36,24) and sub-gyral ( 30,4,56) of the right brain. The N-back paradigm was similar to the above results,whereas the DMTS paradigm only activated the precentral gyrus (-50,8, 34) of the left brain and the right insula ( 34,24,4) . Conclusion The neural circuit of working memory is the frontal-parietal networks. N-back paradigm with the brain activation consists to the neural circuit of work-ing memory. However,DMTS paradigm activates less brain regions and is inconsistent to the neurons of work-ing memory.

Correlation of serum androgen levels with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou / 中华男科学杂志

<p><b>Objective</b>To investigate the relationship of the levels of serum androgens with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou.</p><p><b>METHODS</b>Using the stratified cluster sampling method, we conducted a questionnaire investigation and physical examinations among 437 men in Zunyi City. We divided the subjects into a middle-aged (40－64 ［53.20 ± 7.41］ years, n = 269) and an elderly group (=≥65 ［70.63 ± 4.66］ years, n = 168) and collected fasting elbow venous blood samples from them for measuring the levels of total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), total cholesterol (TCH), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), calculated free testosterone (cFT), free testosterone index (FTI), and testosterone secretion index (TSI).</p><p><b>RESULTS</b>Compared with the elderly group, the middle-aged males showed significantly lower SHBG, LH, HDL and LDL, and higher cFT, FTI, TSI, TG and TCH (all P < 0.05). TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, while cFT was positively correlated with TCH, and so was FTI with TG, TCH with LDL, and TSI with TCH, HDL and LDL (all P < 0.05), but LH was negatively correlated with TG, TCH and LDL (all P < 0.05). Multivariate linear regression analysis showed that TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, and so was LH with TCH, HDL and LDL (all P < 0.05).</p><p><b>CONCLUSIONS</b>In the middle-aged and elderly men in Zunyi, low concentrations of TT, SHBG and LH were associated with the increased risk of high-TCH and -LDL dyslipidemia, low concentrations of TT and SHBG with that of high-TG dyslipidemia, while high concentrations of TT, SHBG and LH with that of low-HDL dyslipidemia.</p>