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Bone defects are difficult to heal, which conveys a heavy burden to patients' lives and their economy. The total flavonoids of Rhizoma drynariae (TFRD) can promote the osteogenesis of distraction osteogenesis. However, the dose effect is not clear, the treatment period is short, and the quality of bone formation is poor. In our study, we observed the long-term effects and dose effects of TFRD on bone defects, verified the main ingredients of TFRD in combination with network pharmacology for the first time, explored its potential mechanism, and verified these findings. We found that TFRD management for 12 weeks regulated osteogenesis and angiogenesis in rats with 4-mm tibial bone defects through the PI3K/AKT/HIF-1α/VEGF signaling pathway, especially at high doses (135 mg kg

Introduction: Cattail Pollen is a commonly used Chinese medicine for promoting blood circulation and removing blood stasis in infertility patients with endometriosis, but its ingredients and mechanism of action are still unclear. The aims of this study were to explore the potential active ingredients, targets and mechanisms of Cattail Pollen in treating infertility patients with endometriosis based on bioinformatics and molecular docking. Methods: The GSE120103 dataset was downloaded from the Gene Expression Omnibus (GEO) database to screen out differentially expressed genes. Cytoscape software was constructed to construct the protein–protein interaction network and screen for hub proteins, and molecular docking was performed to identify the binding activity of Cattail Pollen active ingredients and infertility genes. Then, DAVID software was used to perform gene ontology (GO) functional analysis and KEGG pathway enrichment analysis on differentially expressed genes. Results: There were 1320 differentially expressed genes in patients with endometriosis. ADCY5, RLN3, and ADCY6 proteins encoded by genes that were upregulated in infertile patients with endometriosis. Eight active ingredients of Cattail Pollen were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform: naringenin ((2R)-5,7-dihydroxy-2-(4-hydroxyphenyl)chroman-4-one), arachidonic acid, isorhamnetin, β-sitosterol, kaempferol, Testosterone palmitate, kaempferol-3-O-α-L-rhamnosyl(1→2)-β-D-glucoside and quercetin. Molecular docking identified that the binding activity of arachidonic acid with ADCY5, RLN3, and ADCY6; and testosterone palmitate with ADCY5 and ADCY6 was strong. GO analysis suggested that differentially expressed genes were involved in multiple biological processes, cellular components, and molecular functions. KEGG enrichment analysis found that differentially expressed genes were enriched in neuroactive ligand–receptor interaction, cytokine–cytokine receptor interaction, chemokine signaling pathway, and Jak-STAT signaling pathway. Conclusions: This study discovered the differentially expressed genes of naturally conceived and infertile patients with endometriosis, and clarified the effective ingredients, targets, and potential signaling pathways of Cattail Pollen in the treatment of infertility patients with endometriosis.

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In China, Yinqiao powder is widely used to prevent and treat COVID-19 patients with Weifen syndrome. In this study, the screening and verification of active ingredients, target selection and DisGeNET scoring, drug-ingredient-gene network construction, protein-protein interaction network construction, molecular docking and surface plasmon resonance (SPR) analysis, gene ontology (GO) functional analysis, gene tissue analysis, and kyoto encyclopedia of genes and genomes (KEGG) pathway analysis were used to explore the active ingredients, targets, and potential mechanisms of Yinqiao powder in the treatment of COVID-19. We also predicted the therapeutic effect of Yinqiao powder using TCM anti-COVID-19 (TCMATCOV). Yinqiao powder has a certain therapeutic effect on COVID-19, with an intervention score of 20.16. Hesperetin, eriodictyol, luteolin, quercetin, and naringenin were the potentially effective active ingredients against COVID-19. The hub-proteins were interleukin-6 (IL-6), mitogen-activated protein kinase 3 (MAPK3), tumor necrosis factor (TNF), and tumor protein P53 (TP53). The potential mechanisms of Yinqiao powder in the treatment of COVID-19 are the TNF signaling pathway, T-cell receptor signaling pathway, Toll-like receptor signaling pathway, and MAPK signaling pathway. This study provides a new perspective for discovering potential drugs and mechanisms of COVID-19.

Supplemental material, Online supplementary file 1, for Identification of the Ingredients and Mechanisms of Curcumae Radix for Depression Based on Network Pharmacology and Molecular Docking by Xiaotong Wang, Qiaoru Lin, Meiqing Shen, Haixiong Lin, Junjie Feng, Lulu Peng, Minling Huang, Xiaoxuan Zhan, Ziyin Chen and Tengfei Ma in Natural Product Communications

Supplemental material, Table S1, for Identification of the Ingredients and Mechanisms of Curcumae Radix for Depression Based on Network Pharmacology and Molecular Docking by Xiaotong Wang, Qiaoru Lin, Meiqing Shen, Haixiong Lin, Junjie Feng, Lulu Peng, Minling Huang, Xiaoxuan Zhan, Ziyin Chen and Tengfei Ma in Natural Product Communications

In the past 30 years, dengue has undergone dramatic changes in China every year. This study explores the epidemiological trend of dengue in China during this period to identify high-risk seasons, regions, ages, susceptible populations, and provide information for dengue prevention and control activities. Dengue data from 1990 to 2019 were derived from the Public Health Science Data Center, Web of Science, China National Knowledge Infrastructure, PubMed, and Centers for Disease Control and Prevention of the corresponding province. GraphPad Prism 7 was conducted to generate disease evolution maps, occupational heat maps, and monthly heat maps of dengue cases and deaths in mainland China and Guangdong Province. Excel 2016 was used to create a cyclone map of age and gender distribution. Powerpoint 2016 was performed to create geographic maps. From 1990 to 2019, the annual number of dengue cases showed an increasing trend and reaching a peak in 2014, with 46,864 dengue cases (incidence rate: 3.4582/100,000), mainly contributed by Guangdong Province (45,189 cases, accounting for 96.43%). Dengue pandemics occurred every 4 to 6 years. The prevalence of dengue fever was Autumn, which was generally prevalent from June to December and reached its peak from September to November. The provinces reporting dengue cases each year have expanded from the southeastern coastal region to the southwest, central, northeast, and northwest regions, and the provinces with a high incidence were Guangdong, Guangxi, Yunnan, Fujian, and Zhejiang. People aged 25 to 44 years were more susceptible to dengue virus infection. And most of them were male patients. Dengue mainly occurs in the following groups: students, business service staffs, workers, farmers, retired staffs, housewives, and the unemployed. Four provinces reported deaths from dengue, namely Guangdong Province, Zhejiang Province, Henan Province, and Hunan Province. The dengue fever epidemic occurred every 4 to 6 years, mostly in autumn. The endemic areas were Guangdong, Guangxi, Yunnan, Fujian, and Zhejiang provinces. People aged 25 to 44 years, men, students, business service staffs, workers, farmers, retired staffs, housewives, and the unemployed were more susceptible to dengue fever. These findings help to develop targeted public health prevention and control measures.

Total flavonoids of

Background Alpha lipoic acid (ALA), a type of antioxidant, is used in combination with epalrestat in the treatment of diabetic peripheral neuropathy (DPN). However, whether combined treatment is superior to epalrestat monotherapy is controversial. Methods We conducted a systematic search of PubMed, Cochrane Library and Chinese databases to identify all randomized controlled trials (RCTs) up to October 31, 2017. Data were extracted to evaluate methodological quality and analyzed using Review Manager 5.3.0 software. Results Twelve studies were included. Compared to epalrestat monotherapy, ALA 600 mg/d once a day (qd) combined with epalrestat 50 mg three times a day (tid) augmented the total effectiveness rate (14 days - risk ratio [RR]: 1.40, 95% CI: 1.16-1.69, P=0.0005; 28 days - RR: 1.48, 95% CI: 1.27-1.72, P

Currently, many studies have demonstrated certain beneficial effects of interferon (IFN) combined with matrine (Mat) for chronic hepatitis B (CHB) in China. However, the evidence from these randomized control trials is still controversial. Therefore, the aim of this meta-analysis was to explore the efficacy and safety of Mat combined with IFN for CHB. We performed a systematic search of seven databases to identify all randomized controlled trials that treated CHB with IFN or IFN plus Mat from their start date to September 30, 2015. The clinical efficacy and adverse effects were evaluated. Nine studies involving 1089 participants were included. Compared with IFN monotherapy, IFN 5 MU combined with Mat 150 mg augmented the hepatitis B e-antigen negative conversion rate after 3-month treatment [relative ratio (RR) = 1.41; 95% confidence interval (CI) (1.18, 1.69), p = 0.0002] and after 12-month treatment [RR = 1.96; 95% CI (1.21, 3.19), p = 0.006], hepatitis B virus DNA negative conversion rate after 3-month treatment [RR = 1.37; 95% CI (1.16, 1.62), p = 0.0002] and after 12-month treatment [RR = 1.96; 95% CI (1.21, 3.19), p = 0.006], hepatitis B virus e antibody (anti-HBe) conversion rate after 3-month treatment [RR = 1.47; 95% CI (1.19, 1.81), p = 0.0003], and AST level after 3-week treatment [weighted mean difference = -22; 95% CI (-40.41, -3.59), p = 0.02]. Furthermore, IFN 3 MU 3 months combined with Mat 150 mg after 2-month treatment reduced the risk of leucopenia and thrombocytopenia [RR = 0.55; 95% CI (0.36, 0.85), p = 0.007]. Unfortunately, all of the included trials were not in favor of hepatitis B surface antigen (HBsAg) negative conversion rate or influenza-like symptoms. Combination therapy with IFN plus Mat exhibited better clinical efficacy and fewer adverse effects than did IFN monotherapy in patients with CHB, except in the improvement of HBsAg negative conversion rate and influenza-like symptoms. Given the poor methodological quality of the evidence currently available, future high-quality, three-blinded randomized control trials are necessary to confirm these results. Copyright © 2017 John Wiley & Sons, Ltd.

Background Drynariae Rhizoma (DR) has been widely used in the prevention and treatment of various fractures. However, the specific mechanisms of DR's active ingredients have not been elucidated. The purpose of this study was to explore the synergistic mechanisms of DR for treating fracture. Methods A network pharmacology approach integrating ingredient screening, target exploration, active ingredients-gene target network construction, protein-protein interaction network construction, molecular docking, gene-protein classification, gene ontology (GO) functional analysis, KEGG pathway enrichment analysis, and signaling pathway integration was used. Results This approach identified 17 active ingredients of DR, interacting with 144 common gene targets and 143 protein targets of DR and fracture. NCOA1, GSK3B, TTPA, and MAPK1 were identified as important gene targets. Five most important protein targets were also identified, including MAPK1, SRC, HRAS, RXRA, and NCOA1. Molecular docking found that DR has a good binding potential with common protein targets. GO functional analysis indicated that common genes involve multiple processes, parts and functions in biological process, cellular component, and molecular function, including positive regulation of transcription from RNA polymerase II promoter, signal transduction, cytosol, extracellular exosome, cytoplasm, and protein binding. The KEGG pathway enrichment analysis indicated that common gene targets play a role in repairing fractures in multiple signaling pathways, including MAPK, PI3K/AKT, Ras, and VEGF signaling pathways. MAPK and PI3K/AKT signaling pathways were involved in osteoblast formation, Ras signaling pathway was involved in enhancing mesenchymal stromal cell migration, and VEGF signaling pathway was involved in angiogenesis. Conclusion The study revealed the correlation between DR and fracture and the potential synergistic mechanism of different targets of DR in the treatment of fractures, which provides a reference for the development of new drugs.

Background: Fecal incontinence is a socially and emotionally destructive condition that has a negative impact on personal image, self-confidence, and quality of life. Acupuncture is commonly used to treat chronic conditions, including fecal incontinence. However, no relevant systematic review or meta-analysis has been designed to evaluate the effects of acupuncture on fecal incontinence. Methods: We will identify relevant randomized controlled trials (RCTs) from the Cochrane Library, Medline, Embase, PubMed, Springer, Web of Science, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journals Database, Wanfang database, and clinical trial registration center from their inception to February 28, 2019. The primary outcome measures will be clinical effective rate, functional outcomes, and quality of life. Data that meets the inclusion criteria will be extracted and analyzed using RevMan V.5.3 software. Two reviewers will evaluate the studies using the Cochrane Collaboration risk of bias tool. Publication bias will be assessed by funnel plots, Egger test, and Begg test using the Stata software. Acupoints characteristics will be analyzed by Traditional Chinese Medicine inheritance support system. Results: This study will analyze the clinical effective rate, functional outcomes, quality of life, daily average number of fecal incontinence, and effective prescriptions of acupuncture for patients with fecal incontinence. Conclusion: Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupuncture for patients with fecal incontinence. PROSPERO registration number: PROSPERO CRD42019119680.

Many clinical trials and meta-analyses related to acupuncture for osteoporosis (OP) have been published. However, identifying the evidence from these studies still remains a challenge for acupuncturists. We conducted a systematic search of the Chinese Biomedical Medicine (CBM), VIP Database, Wanfang Data, China National Knowledge Infrastructure (CNKI), PubMed, Springer, Cochrane Library, and Embase to identify relevant trials, systematic reviews, and/or meta-analyses up to October 31, 2018. Data were extracted to assess the methodological quality using Veritas plots and to explore potential acupuncture prescriptions using the Traditional Chinese Medicine inheritance support system (TCMISS). In addition, potential mechanisms of core acupoints identified by data mining were summarized based on published studies. A total of 218 clinical trials and ten meta-analyses were included, involving 212 acupuncture prescriptions, 102 acupoints, 13 meridians, three extra meridians, and one Ashi point. The mean Veritas score of publication year, type of study, Assessment of Multiple Systematic Reviews 2, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, heterogeneity, and publication bias were 5.5, 7.2, 6, 5.6, 5.8, and 7.5, respectively. The study of Pan et al. received the highest Veritas score of 8.67 points. The most frequently used meridian was BL. Acupoint combinations BL23 and BL20, BL23 and GV4, and BL23 and ST36 were used frequently. The core acupoints association networks were acupoints BL23, BL20, ST36, GV4, SP6, CV4, and KI3. The potential mechanisms of core acupoints involved upregulated expression of members in OPG/RANKL, Wnt/β-catenin, and MAPK pathways, such as LRP5, β-catenin, Runx2, and OPG. In conclusion, our Veritas plots enable acupuncturists to evaluate key attributes of meta-analysis quality related to acupuncture for primary OP and to improve the quality of evidence-based medicine relating to acupuncture. Data mining analysis revealed an association network of meridians, acupoint combinations, core acupoints, and the underlying mechanisms of acupuncture for primary OP.

Background Curcumae Radix (CR), derived from the dry roots of Curcuma longa L., family Zingiberaceae, is widely used to treat depression. However, the ingredients and mechanisms of CR are still unclear. The purpose of this study was to solve this problem using network pharmacology and molecular docking. Methods The active ingredients of CR were screened through TCMSP, and the depression-related genes were obtained through the Genetic Association, GeneCards, and OMIM databases. Then, DisGeNET score was performed to evaluate the correlation between co-genes and depression. Topological analysis was conducted to screen hub genes and proteins, molecular docking was performed to evaluate the binding ability of the hub protein with active ingredients, and gene ontology (Go) function analysis, gene tissue localization, and KEGG pathway analysis were conducted to explore the function and location of genes, as well as the mechanism of CR for treating depression. Results Eight ingredients of CR were screened based on pharmacokinetic properties, five of which are closely related to depression, including (E)−5-hydroxy-7-(4-hydroxyphenyl)−1-phenyl-1-heptene, (E)−1,7-diphenyl-3-hydroxy-1-hepten-5-one, oxycurcumenol, β-sitosterol, and sitosterol. They interacted with 45 co-genes and co-proteins with a DisGeNET score ≥0.3. AR, NOS2, PTGS2, and TYK2 were pivot genes. EGFR, PTGS2, HSP90AA1, MAPK8, and ESR1 were hub proteins. PTGS2 was found to have good binding potential with oxycurcumenol, (E)−1,7-diphenyl-3-hydroxy-1-hepten-5-one and (E)−5-hydroxy-7-(4-hydroxyphenyl)−1-phenyl-1-heptene. Go functional analysis indicated that co-genes involved complex biological processes, cellular components and molecular functions. PER2, P2RX7, GRM1, TACR1, MAPK8, HCRTR1, EGFR, and TYK2 were highly expressed in the prefrontal cortex. The potential pathways for CR to exert antidepressant effects were calcium, estrogen, PI3K-Akt and ErbB signaling pathways. Conclusions This study revealed the ingredients, effective targets and mechanisms of CR in the treatment of depression, which provides a new perspective for the development of new antidepressants.

Objectives The purpose of this study was to evaluate the performance of human epididymis protein 4 (HE4) and the Risk of Ovarian Malignancy Algorithm (ROMA) in early stage epithelial ovarian cancer (EOC) detection in patients in southern China. Additionally, this study proposes a possible ideal cut-off value for each marker to its own population in South China. Design and methods Serum HE4 and CA125 were measured in 756 patients with pelvic masses (275 malignancies, 53 borderline tumors and 428 benign diseases), and their ROMA values were calculated. Areas under the receiver operator characteristic (ROC) curves (AUC) were assessed for HE4, CA125, ROMA and combinations of these biomarkers. Results Both HE4 and ROMA performed better diagnostically than CA125 alone for early stage EOC, with AUCs ranging from 0.714 for HE4, 0.699 for ROMA, and 0.463 for CA125 in premenopausal subjects, and 0.902 for ROMA, 0.880 for HE4, and 0.256 for CA125 in postmenopausal subjects. Conclusions HE4 and ROMA alone were found to be better than CA125 for detecting borderline tumors and early-stage EOC. The optimal cut-off values (HE4: 70 pmol/l for all; CA125: 60 U/ml for pre- and 35 U/ml for postmenopausal women) could notably improve diagnostic performance in EOC detection in patients in southern China.

Background Femoral neck fracture is a common type of hip fracture, which has a high morbidity and mortality. Surgical treatment is the first choice. However, the functional rehabilitation after operation has not been paid enough attention. In addition, the quality of exercise is difficult to quantify, and the rehabilitation is lack of standards. Therefore, the intelligent rehabilitation assistant system which could record exercise details, might be used to evaluate the quality and adherence to the prescribed exercise to this fragile group of patients has great relevance, so as to provide new ideas for postoperative rehabilitation of hip fracture. Methods This is an opening, prospective, double-dummy RCT. Fifty femoral neck fractures patients, older than 65 years and are about to hospitalize for HA, will be invited to study. The sample will be divided into monitoring group and control group randomly at a 1:1 ratio. The prescribed exercises need to be done continuously for 2 weeks. The monitoring group needs additional use intelligent rehabilitation assistant system. Each subject will receive a total of 4 follow-up visits at the designated time (2 weeks, 4 weeks, 12 weeks, and 24 weeks). The following factors will be talked as dependent variables:Each subject will receive a total of 4 follow-up visits at the designated time, and the findings will be analyzed statistically considering a 5% significance level (P Discussion Exercise under monitor may improve patients compliance and exercise quality, and accelerate the rehabilitation process. This protocol reported in accordance with the CONSORT 2010 checklist and SPIRIT 2013 Checklist. Trial registration The trial is registered at Chinese Clinical Trials Registry (ChiCTR2000033213, May 24, 2020).

Introduction In China, acupuncture has been used to treat mental health disorders for thousands of years. Although previous studies support the benefits of acupuncture for people with schizophrenia, the selection of appropriate acupoints remains challenging. In this study, we discovered potential acupoints to treat schizophrenia. Methods The frequency and combination of acupoints in schizophrenia treatment were analyzed using the Traditional Chinese Medicine Inheritance Support System. Clinical trials including acupuncture prescriptions completed before February 29, 2020, were included, and their quality was evaluated using the CONSORT and STRICTA statements. Results In total, 49 clinical trials with 51 acupuncture prescriptions were included. GV 20, PC 6, GV 29, ST 36, SP 6, LI 4, LR 3, ST 40, HT 7, EX-HN 1, GV 24, and GV 26 were the most frequently used acupoints. The Governor vessel was the most commonly used meridian. Acupoint combinations of GV 20 and GV 29, GV 20 and LI 4, GV 20 and PC 6, and GV 20 and ST 36 were frequently used. Overall, 30 acupoint combinations achieved confidence levels of 60–100%, with 11 showing >80% confidence. GV 24 to > GV 20, LI 4, and GV 29 to > GV 20 showed the highest confidence. Conclusions Our results provide a reference for the selection and combination of acupoints for clinical schizophrenia treatment and indicate that complete adherence to the CONSORT and STRICTA statements must be ensured while designing clinical trials of acupuncture for schizophrenia treatment.

Background Insomnia is a common sleep disorder characterized by chronically disturbed sleep or loss of sleep, and even cognitive dysfunction. Acupoint catgut embedding is widely used to treat sleep disorders. However, there is no systematic review and data mining of the effectiveness and potential acupoints prescription of acupoint catgut embedding for insomnia. Methods Randomized controlled trials (RCTs) from the Web of Science, PubMed, Cochrane Library, Springer, Wanfang database, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journals Database, and 2 clinical trial registration center will be included. The search time will be established from each database to December 30, 2019. The outcome measures will be Pittsburgh sleep quality index (PSQI), clinical effective rate, International Unified Sleep Efficiency Value (IUSEV) and adverse events. Data from RCTs that meets the inclusion criteria will be analyzed through RevMan V.5.3 software. Risk of bias and publication bias will be analyzed to identify the quality of the included studies. Besides, Traditional Chinese Medicine inheritance support system (TCMISS) will be used to analyze the potential acupoints prescriptions. Results This study will clarify PSQI, IUSEV, clinical effective rate, adverse events, and potential acupoint prescriptions of acupoint catgut embedding for patients with insomnia. Conclusion Our study will provide evidence of acupoint catgut embedding for insomnia, which may be beneficial to practitioners in the field of non-pharmacological interventions.PROSPERO registration number: CRD42019144636.

Previous studies have suggested that treatment plans for segmental bone defects (SBDs) are affected by the bone defect sizes. If the selected treatment was not the most appropriate, it would not contribute to bone healing, but increase complications. The induced membrane technique (IM) and distraction osteogenesis (DO) have been proved to be effective in treating SBDs. However, the differences between the two in therapeutic effects on SBDs with different sizes are still unclear. Thus, we aimed to observe the effects of IM and DO on different sizes of SBDs and to further determine what method is more appropriate for what defect size. Rat models of 4-, 6-and 8-mm mid-diaphyseal defects using IM and DO techniques were established. X-rays, micro-CT, histological and immunohistochemical examinations were performed to assess bone repair. Faster bone formation rate, shorter treatment duration, higher expressions of OPN and OCN and higher parameters of bone properties including bone mineral density (BMD), bone volume/total tissue volume (BV/TV), mineral apposition rate (MAR) and mineral surface/bone surface (MS/BS) were found in 4-mm SBDs treated with DO than in those with IM treatment. However, the results were reversed and IM outperformed DO in bone repair capacity for 8-mm SBDs, while no significant difference emerges in the case of 6-mm SBDs. This study suggests that the therapeutic effects of IM and DO may be subjected to sizes of bone defects and the best treatment size of defects is different between the two. For small-sized SBDs, DO may be more suitable and efficient than IM, but IM has advantages over DO for over-sized SBDs, while DO and IM show similar bone repair capability in moderate-sized SBDs, which would offer a new insight into how to choose DO and IM for SBDs in clinical practice and provide references for further clinical research.

Rationale: Multiple diaphyseal sclerosis (MDS), known as Ribbing disease, is a rare congenital bone disease resulting from autosomal recessive inheritance. The case study involved a 22-year-old female patient who had been diagnosed with chronic sclerosing osteomyelitis due to lack of knowledge about MDS. Previous studies reported rarely on this condition. Patient concerns: A 22-year-old female with MDS was analyzed. Diagnoses: MDS is characterized radiographically by a fusiform widening of the diaphyseal portion of the long bones, which is caused by a thickening of the cortex with obstruction of the medullary cavity. The pathologies are observed utilizing diagnostic imagery and are often difficult to identify. Intervention: The patient was following a suggested regimen of oral celecoxib capsules at 200 mg/day for 6 days. Outcomes: The patient's diagnosis was revised to the rare condition of Ribbing disease by reviewing the clinical history and distinctive radiography images and because the symptoms were alleviated by celecoxib capsule. We also present a review of the literature on the diagnosis and differential diagnosis of MDS based on clinical and imaging features. Lessons: MDS is rare and may often be initially misdiagnosed as another type of sclerosing bone dysplasia, thus, it is important to be aware of the existence of MDS. Once MDS is suspected, differential diagnosis should be performed to exclude other sclerosing bone dysplasias, taking into account clinical history, distinctive radiographic appearance, distribution, and laboratory and histopathologic findings. Laboratory evaluation and pathologic findings are nonspecific but assist in excluding other diagnoses. More evidence is needed to illustrate the effectiveness of medical or surgical treatments for patients with MDS.

Supplemental Digital Content is available in the text, Background: Although many patients try to seek acupuncture to improve in vitro fertilization (IVF) outcomes, evidence regarding its efficacy and acupoints characters are lacking. The aim of this protocol is to evaluate the effectiveness and safety, as well as the acupoints characteristics of acupuncture in the treatment of female undergoing IVF, by conducting a systematic review and data mining. Methods: The following 6 databases will be searched from their inception to April 30, 2018: PubMed, Chinese National Knowledge Infrastructure, Wanfang, VIP database, Embase, and Cochrane Library. The randomized controlled trials (RCTs) or case–control studies of acupuncture that assess clinical effects and side effects in female undergoing IVF are included. The primary outcome measures will be number of oocytes retrieved, fertilization rate, oocyte cleavage rate, high-quality embryos rate, ovarian hyperstimulation syndrome (OHHS) incidence rate, clinical pregnancy rate (CPR), biochemical pregnancy rate (BPR), implantation rate, and cycle cancellation rate. Two reviewers will independently undertake data extraction and quality assessments. Data will be synthesized by RevMan V.5.3 software. Acupoints characteristics will be excavated using Traditional Chinese Medicine inheritance support system (TCMISS). Reporting bias will be assessed by Funnel plots, Begg test, and Egger test. Results: This review will assess the clinical efficacy and safety, as well as the acupoints characteristics of acupuncture on IVF. Conclusion: These findings will summarize the current evidence of acupuncture on IVF outcomes and may provide guidance for clinicians and infertile women to select acupuncture for IVF.

Supplemental Digital Content is available in the text, Background: Functional dyspepsia (FD) is a gastrointestinal disorder affecting people in the globe. Spleen-deficiency syndrome is one of its basic syndromes. Zhizhu Kuanzhong capsule was the most frequent Chinese herbal formula used in the spleen-deficiency researches. We aim to assess the effectiveness and safety of Zhizhu Kuanzhong capsule on FD. Methods: A systematic literature search for randomized controlled trials (RCTs) from their inception until December 31, 2017 will be conducted using 7 databases: PubMed, Cochrane Library, Embase, VIP Database, Chinese National Knowledge Infrastructure, Wanfang Data, and Chinese BioMedical Database. Inclusion the trials of Zhizhu Kuanzhong capsule which evaluate motilin level, clinical syndrome, and side effect in people with FD. The primary outcome measures will be motilin level, clinical syndrome integral, and clinical total effective rate. Data extraction and risk of bias assessments will be performed by 2 reviewers independently. Methodological and reporting quality of included studies will be assessed by the consolidated standards of reporting trials for Chinese herbal medicine formulas. All statistical analyses will be conducted using RevMan V.5.3 software. Funnel plots, Begg's test, and Egger's test will be developed to evaluate reporting bias. Results: This review will assess the effect of Zhizhu Kuanzhong capsule on clinical total effective rate, symptom remission rate, plasma motilin level, and safety of FD in patients. Conclusion: The conclusion of our study will provide updated evidence to judge whether Zhizhu Kuanzhong capsule is an effective intervention for patients with FD.

Objective. To understand the bacterial profile and antibiotic resistance patterns in diabetic foot infection (DFI) in different Wagner’s grades, IDSA/IWGDF grades, and different ulcer types in Guangzhou, in order to provide more detailed suggestion to the clinician about the empirical antibiotic choice. Methods. 207 bacteria were collected from 117 DFIs in Sun Yat-sen Memorial Hospital from Jan.1, 2010, to Dec.31, 2015. The clinical data and microbial information were analyzed. Results. The proportion of Gram-negative bacteria (GNB) was higher than Gram-positive bacteria (GPB) (54.1% versus 45.9%), in which Enterobacteriaceae (73.2%) and Staphylococcus (65.2%) were predominant, respectively. With an increasing of Wagner’s grades and IDSA/IWGDF grades, the proportion of GNB bacterial infection, especially Pseudomonas, was increased. Neuro-ischemic ulcer (N-IFU) was more susceptible to GNB infection. Furthermore, with the aggravation of the wound and infection, the antibiotic resistance rates were obviously increased. GPB isolated in ischemic foot ulcer (IFU) showed more resistance than the N-IFU, while GNB isolates were on the opposite. Conclusions. Different bacterial profiles and antibiotic sensitivity were found in different DFU grades and types. Clinician should try to stay updated in antibiotic resistance pattern of common pathogens in their area. This paper provided them the detailed information in this region.

Currently, many studies have demonstrated certain beneficial effects of interferon (IFN) combined with matrine (Mat) for chronic hepatitis B (CHB) in China. However, the evidence from these randomized control trials is still controversial. Therefore, the aim of this meta-analysis was to explore the efficacy and safety of Mat combined with IFN for CHB. We performed a systematic search of seven databases to identify all randomized controlled trials that treated CHB with IFN or IFN plus Mat from their start date to September 30, 2015. The clinical efficacy and adverse effects were evaluated. Nine studies involving 1089 participants were included. Compared with IFN monotherapy, IFN 5 MU combined with Mat 150 mg augmented the hepatitis B e-antigen negative conversion rate after 3-month treatment [relative ratio (RR) = 1.41; 95% confidence interval (CI) (1.18, 1.69), p = 0.0002] and after 12-month treatment [RR = 1.96; 95% CI (1.21, 3.19), p = 0.006], hepatitis B virus DNA negative conversion rate after 3-month treatment [RR = 1.37; 95% CI (1.16, 1.62), p = 0.0002] and after 12-month treatment [RR = 1.96; 95% CI (1.21, 3.19), p = 0.006], hepatitis B virus e antibody (anti-HBe) conversion rate after 3-month treatment [RR = 1.47; 95% CI (1.19, 1.81), p = 0.0003], and AST level after 3-week treatment [weighted mean difference = -22; 95% CI (-40.41, -3.59), p = 0.02]. Furthermore, IFN 3 MU 3 months combined with Mat 150 mg after 2-month treatment reduced the risk of leucopenia and thrombocytopenia [RR = 0.55; 95% CI (0.36, 0.85), p = 0.007]. Unfortunately, all of the included trials were not in favor of hepatitis B surface antigen (HBsAg) negative conversion rate or influenza-like symptoms. Combination therapy with IFN plus Mat exhibited better clinical efficacy and fewer adverse effects than did IFN monotherapy in patients with CHB, except in the improvement of HBsAg negative conversion rate and influenza-like symptoms. Given the poor methodological quality of the evidence currently available, future high-quality, three-blinded randomized control trials are necessary to confirm these results. Copyright © 2017 John WileySons, Ltd.

The skill of robotic hand-eye coordination not only helps robots to deal with real time environment, but also affects the fundamental framework of robotic cognition. A number of approaches have been developed in the literature for construction of the robotic hand-eye coordination. However, several important features within infant developmental procedure have not been introduced into such approaches. This paper proposes a new method for robotic hand-eye coordination by imitating the developmental progress of human infants. The work employs a brain-like neural network system inspired by infant brain structure to learn hand-eye coordination, and adopts a developmental mechanism from psychology to drive the robot. The entire learning procedure is driven by developmental constraint: The robot starts to act under fully constrained conditions, when the robot learning system becomes stable, a new constraint is assigned to the robot. After that, the robot needs to act with this new condition again. When all the contained conditions have been overcome, the robot is able to obtain hand-eye coordination ability. The work is supported by experimental evaluation, which shows that the new approach is able to drive the robot to learn autonomously, and make the robot also exhibit developmental progress similar to human infants.

Supplemental Digital Content is available in the text, Background: Diabetic peripheral neuropathy (DPN) is a common long-term complication of diabetes mellitus, affecting patients in the world. Epalrestat combined with α-lipoic acid (ALA) is the most frequent combine therapy used in the DPN researches. We aim to assess the effectiveness and safety of epalrestat combined with ALA in patients with DPN, compare with epalrestat alone. Methods: We will search Cochrane Library, PubMed, Wanfang Data, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journals Database, and Chinese Biomedical Database from inception until October 31th, 2017. Inclusion the randomized controlled trials and clinical control trials of combine therapy which evaluate clinical efficacy and side effect in people with DPN. Data extraction and risk of bias assessments will be independently conducted by 2 reviewers. The primary outcome measures will be total effective rate, motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV), Toronto clinical scoring system (TCSS), and total symptom score (TSS). All statistical analyses will be performed using RevMan V.5.3 software. Results: This review will evaluate the total effective rate, nerve conduction velocity, TCSS, TSS, and safety of ALA combined with epalrestat for patients with DPN, compare with epalrestat alone. Conclusion: Our study will provide evidence to assess whether epalrestat combined with ALA is an optional treatment for patients with DPN.

Robotic hand-eye coordination plays an important role in dealing with real time environment; and the learning procedure of this skill affects the fundamental framework of robotic cognition. Theories from developmental psychology have motivated the appearance of cognitive developmental robotics; however, several important features within infant developmental procedure have not been introduced into researches on developmental robotics. This paper proposes a new approach to robotic hand-eye coordination by imitating the developmental progress of human infant. The work employs a brain-like neural network system to learn hand-eye coordination. The learning procedure is driven by developmental constraints, the robot starts to learn under fully constrained conditions, when the system becomes saturated, a new constraint is assigned to the robot; the robot needs to learn this new conditions again, until the all contained conditions have been overcome. The work is supported by experimental evaluation, which shows that the new approach is able to drive the robot to own the hand-eye coordination ability autonomously, and the robot also behaves similar developmental progress with human infants'.

Robotic hand-eye coordination plays an important role in dealing with real time environment; and the learning procedure of this skill affects the fundamental framework of robotic cognition. This paper introduces a novel developmental approach to hand-eye coordination in an autonomous robotic system. Existing work employs neural network models to map visual perception to hand. In the approach, a computational structure and a cross-modal link mechanism are applied to simulate brain cortices; and a movement pattern inspired by infant behaviors is designed to help robot learn to build its hand-eye coordination. This work is supported by experimental evaluation, which shows that the learning algorithm provides a fast and incremental learning of behavioral competence.