Sonoelastography for Testicular Tumor Identification: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy.

The objective of this review was to summarize the applications of sonoelastography in testicular tumor identification and inquire about their test performances. Two authors independently searched English journal articles and full conference papers from CINAHL, Embase, IEEE Xplore®, PubMed, Scopus, and Web of Science from inception and organized them into a PIRO (patient, index test, reference test, outcome) framework. Eleven studies (n = 11) were eligible for data synthesis, nine of which (n = 9) utilized strain elastography and two (n = 2) employed shear-wave elastography. Meta-analyses were performed on the distinction between neoplasm (tumor) and non-neoplasm (non-tumor) from four study arms and between malignancy and benignity from seven study arms. The pooled sensitivity of classifying malignancy and benignity was 86.0% (95%CI, 79.7% to 90.6%). There was substantial heterogeneity in the classification of neoplasm and non-neoplasm and in the specificity of classifying malignancy and benignity, which could not be addressed by the subgroup analysis of sonoelastography techniques. Heterogeneity might be associated with the high risk of bias and applicability concern, including a wide spectrum of testicular pathologies and verification bias in the reference tests. Key technical obstacles in the index test were manual compression in strain elastography, qualitative observation of non-standardized color codes, and locating the Regions of Interest (ROI), in addition to decisions in feature extractions. Future research may focus on multiparametric sonoelastography using deep learning models and ensemble learning. A decision model on the benefits-risks of surgical exploration (reference test) could also be developed to direct the test-and-treat strategy for testicular tumors.

Traditional Chinese Medicine (TCM) Domain Ontology: Current Status and Rethinking for the Future Development.

The past twenty years have seen the increasingly important role of ontology in traditional Chinese medicine (TCM). However, the development of TCM ontology faces many challenges. Since the epistemologies dramatically differ between TCM and contemporary biomedicine, it is hard to apply the existing top-level ontology mechanically. "Data silos" are widely present in the currently available terminology standards, term sets, and ontologies. The formal representation of ontology needs to be further improved in TCM. Therefore, we propose a unified basic semantic framework of TCM based on in-depth theoretical research on the existing top-level ontology and a re-study of important concepts in TCM. Under such a framework, ontologies in TCM sub-domains should be built collaboratively and be represented formally in a common format. Besides, extensive cooperation should be encouraged by establishing ontology research communities to promote ontology peer review and reuse.

[Exploration of the construction of semantic framework of meridians and acupoints based on top-level ontology].

Based on the top-level ontology and the existing ontology methodology, the related concepts of meridians and acupoints were discriminated, defined and classified; the relationship of core concepts were established, e.g. meridians, acupoints and zangfu. It was attempted to build an ontological semantic framework of meridians and acupoints. Through the investigation on the classification mode of the top-level ontology, it is proposed that the meridians and acupoints, as the unique concepts of traditional Chinese medicine, exist in the form of "emptiness" and belong to "immaterial entity". Meridians refer to the three-dimensional channels in the human body, and acupoints are divided into ontological acupoints and body surface ones. Ontological acupoints are regarded as a three-dimensional structure within the human body, whereas, body surface ones are the optimal sites for acupuncture needle insertion on the body surface, meaning, the zero-dimensional point on the body surface. The main relationships between meridians and acupoints include is-a, exterior-interior, located-in, correspondent-to, mapping, etc. The exploration of the semantic framework of meridians and acupoints is conductive to understanding the connotation of meridians, acupoints and their relationship.

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, PubMed, 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.