Construction and comparative study of ovariectomized mouse model / 中国药理学通报

Aim To compare the effects of different methods on the preparation of ovariectomized mouse models. Methods The bilateral ovaries of mouse were completely removed by desmurgia and diathermocoagulation respectively. The effects of desmurgia and diathermocoagulation methods on ovariectomized mouse models were compared by detecting vaginal smears, organ indexes , biochemical indexes, Micro-CT was used to detect the mor-phological changes in femur tissue, and HE staining was used to observe the pathological changes in femur, uterus, thymus and spleen. Results Compared with the control group, the estrous cycle of mouse was disordered by desmurgia and diathermocoagulation, the indexes of uterus, spleen and thymus were reduced, the levels of BGP, BALP and E

Influence of disinfection methods used in hospitals on monitoring personal dose of external irradiation during COVID-19 / 中国辐射卫生

@#<b>Objective</b> To study whether the disinfection methods for thermoluminescence dosimeters used by major hospitals during the COVID-19 pandemic had an impact on monitoring personal dose of external irradiation, and to screen for the disinfection procedures suitable for use during the pandemic. <b>Methods</b> Hospitals with fever clinics during the epidemic in Shandong Province were selected from March to October 2020, we investigated the disinfection methods as well as the types and frequency of use of disinfection supplies used for thermoluminescence dosimeters during the pandemic in hospitals. Simulations were performed in experimental and control groups. <b>Results</b> The average doses measured by the disc dosimeter with different disinfection methods and the control group were 0.92-0.99 mSv and 0.98 mSv, respectively, and the deviation was ≤ 6%. The average doses measured by the glass tube dosimeter with different disinfection methods and the control group were 0.20-0.22 and 0.21, respectively, and the deviation was ≤ 5%. <b>Conclusion</b> The results showed that the commonly used disinfection methods had no influence on personal dose monitoring, but some disinfection measures were not suitable for dosimeters.

Drilling off the Petrosal Apex and Opening the Upper Wall of Meckel’s Cave Are the Key Elements of Good Outcomes in the Treatment of Trigeminal Neuralgia Secondary to Petrous Apex Meningioma

Objective@#: The surgical management of trigeminal neuralgia (TN) caused by petrous apex meningioma (PAM) is still a challenge because of the lesion’s deep location and the surrounding complex structures. The authors describe the intradural anterior transpetrosal approach (ATPA) and its effect on the treatment of TN secondary to PAM. @*Methods@#: A retrospective analysis of 15 patients with TN secondary to PAM who underwent surgery via the intradural ATPA was conducted. The key techniques, which included drilling off the petrosal apex (PA) and opening the upper wall of Meckel’s cave (MC), are described in detail. @*Results@#: Total removal of the tumor and complete pain relief (Barrow Neurological Institute I) were achieved in all 15 patients without significant morbidity. Five patients developed new facial numbness postoperatively, which disappeared within three months after surgery. The postoperative magnetic resonance imaging showed temporal lobe swelling in three patients, but no clinical symptoms. One patient had cerebrospinal fluid leakage and was managed with bed rest and temporary lumbar drainage. One patient had an intracranial infection and was treated with antibiotics. By the last follow up, no patients had pain relapse or/and tumor recurrence. It is worth noting that the vascular compression at the root of the trigeminal nerve was found in one patient during the operation. @*Conclusion@#: Our experience suggests that drilling off the PA and opening the upper wall of the MC are key elements for a good outcome of the treatment of TN secondary to PAM. The intradural ATPA has the advantages for both tumor resection and pain relief.

Impact of COVID-19 on chest CT scan frequency in a general hospital / 中国辐射卫生

@#<b>Objective</b> To explore the effect of coronavirus disease 2019 (COVID-19) on the frequency of chest CT scan. <b>Methods</b> A retrospective study was conducted to extract information on the number of outpatient, emergency, and inpatient visits and patients who had chest CT imaging examination from January 1 to December 31, 2020 and in the same period in 2019 through the hospital’s medical data platform for analysis, and the chi-square test was used to analyze whether the difference in the proportion of patients who had chest CT imaging examination between 2019 and 2020 was statistically significant. <b>Results</b> The proportion of outpatients and emergency patients with chest CT examination was significantly higher in 2020 than in 2019 (2.48% <i>vs</i> 1.47%, <i>χ</i>² = 581.7, <i>P</i> < 0.000). The proportion of inpatients who underwent chest CT examination was significantly higher in 2020 than in 2019 (35.47% <i>vs</i> 28.01%, <i>χ</i>² = 182.0, <i>P</i> < 0.000). <b>Conclusion</b> Under the COVID-19 epidemic, the proportion of chest CT examination in this hospital in 2020 shows a significant upward trend compared with the same period in 2019, which will increase the collective dose due to medical exposure, and the hospital should pay attention to the determination of the legitimacy of chest CT scan.

Effect of respiratory movement on the dose distribution in the TOMO therapy target area / 中国辐射卫生

Objective To explore the effect of respiratory movement on the dose distribution in the TOMO therapy target area. Methods The motion phantom was used to simulate human respiratory movement. The SNC patient analysis software was used to compare the films of the study group with those of the control group, and the effect of respiratory movement on the dose distribution in the TOMO target area was evaluated by the “pass rate” index. Results Visual observation showed that the distribution of film gray in the head-foot direction (i.e., direction of movement) was significantly different with or without respiratory movement. Film analysis showed that the maximum deviation between the width of the target wrapping curve and the treatment plan value was about 2.4 mm at no respiratory movement and about 27.2 mm at respiratory movement; the penumbra width of the target area was 31 mm (head direction) and 28.5 mm (foot direction) at no respiratory movement and 39.7 mm (head direction) and 37 mm (foot direction) at respiratory movement; the “pass rate” of target dose distribution was only 12.3%. Conclusion Respiratory movement has a great impact on the dose distribution in the TOMO target area in the direction of movement. When making clinical treatment plan, the impact of respiratory movement on the dose distribution in the TOMO target area can not be ignored.

Discovery and discussion of 7Be and another full-energy peak in water from 3D water phantom of a proton therapy system / 中国辐射卫生

Objective To discuss 7Be and a 77.2 keV full-energy peak with short half-life found in the water sample from the 3D water phantom of a proton therapy system. Methods We measured the water sample from the 3D water phantom of a proton therapy system according to Determination of Radionuclides in Water by Gamma Spectrometry (GB/T 16140—2018). Results The activity concentration of 7Be in the water sample was 1.30 × 101 Bq·L−1 on December 24, 2018; 4.3 × 101 Bq·L−1 on March 22, 2019; and 1.41 × 101 Bq·L−1 at the time of sampling on December 19, 2018. On December 24, 2018, the net peak area of the 77.2 keV full-energy peak in the sample was 683 ± 45, and the measurement time was 26123.02 s; on March 22, 2019, the net peak area decreased to the background level of 194 ± 49, and the measurement time was 86400.00 s. Conclusion In the 3D water phantom of the proton therapy system, 7Be can be generated from the spallation reaction between high-energy neutrons and oxygen in water. In addition, we find a full-energy peak at 77.2 keV with short half-life. The activity concentration of 7Be in the water sample is lower than the exemption level, but the activity concentration at sampling may not be the maximum activity concentration in the process of quality control. The inductive radionuclide 7Be produced in the 3D water phantom should be identified and properly evaluated in the assessment of occupational radiation hazards of proton therapy system.

Safety and efficacy of transcatheter tricuspid valve replacement with LuX-Valve in patients with severe tricuspid regurgitation / 中华心血管病杂志

Objectives: To evaluate the safety and efficacy of LuX-Valve on the treatment of severe tricuspid regurgitation (TR). Methods: This is a prospective observational study. From September 2018 to March 2019, 12 patients with severe TR, who were not suitable for surgery, received LuX-Valve implantation in Changhai Hospital. LuX-Valve was implanted under general anesthesia and the guidance of transesophageal echocardiography and X-ray fluoroscopy. Access to the tricuspid valve was achieved via a minimally invasive thoracotomy and transatrial approach. Main endpoints were surgery success and device success. Surgery success was defined as successful implanting the device and withdrawing the delivery system, positioning the valve correctly and stably without severe or life-threatening adverse events. Device success was defined as satisfied valve function (TR severity reduction ≥ 2 grades, tricuspid gradient ≤ 6 mmHg (1 mmHg=0.133 kPa)), absence of malposition, valve failure and reintervention, major adverse events including device related mortality, embolization, conduction system disturbances and new onset shunt across ventricular septum at day 30 post implantation. Results: A total of 12 patients with severe to torrential TR were included in this study. The age was (68.5±6.9) years and 7 were female. All patients had typical right heart failure symptoms. Procedural success was achieved in all cases, there was no intraprocedural mortality or transfer to open surgery. TR significantly improved after LuX-Valve implantation (none/trivial in 8 patients, mild in 3 patients and moderate in 1 patient). The average device time was (9.2±4.2) minutes. Intensive care unit duration was 3.0 (2.0, 4.8) days. One patient died at postoperative day 18 due to non-surgery and device reasons. Transthoracic echocardiography at 30 days after operation showed that TR was significantly reduced (none/trivial in 8 patients, mild in 2 patients and moderate in 1 patient) and device success was achieved in 11 cases. All survived patients experienced a significant improvement in life quality with significantly improvement in New York Heart Association (NYHA) classification (Ⅰ and Ⅱ: 6/11 post operation vs. 0/11 before operation, P=0.012) and there were no device related complications in this patient cohort. Conclusions: LuX-Valve implantation is feasible, safe and effective for the treatment of patients with severe TR.

Histopathological Diagnosis System for Gastritis Using Deep Learning Algorithm / 中国医学科学杂志(英文版)

Objective To develope a deep learning algorithm for pathological classification of chronic gastritis and assess its performance using whole-slide images (WSIs). Methods We retrospectively collected 1,250 gastric biopsy specimens (1,128 gastritis, 122 normal mucosa) from PLA General Hospital. The deep learning algorithm based on DeepLab v3 (ResNet-50) architecture was trained and validated using 1,008 WSIs and 100 WSIs, respectively. The diagnostic performance of the algorithm was tested on an independent test set of 142 WSIs, with the pathologists' consensus diagnosis as the gold standard. Results The receiver operating characteristic (ROC) curves were generated for chronic superficial gastritis (CSuG), chronic active gastritis (CAcG), and chronic atrophic gastritis (CAtG) in the test set, respectively.The areas under the ROC curves (AUCs) of the algorithm for CSuG, CAcG, and CAtG were 0.882, 0.905 and 0.910, respectively. The sensitivity and specificity of the deep learning algorithm for the classification of CSuG, CAcG, and CAtG were 0.790 and 1.000 (accuracy 0.880), 0.985 and 0.829 (accuracy 0.901), 0.952 and 0.992 (accuracy 0.986), respectively. The overall predicted accuracy for three different types of gastritis was 0.867. By flagging the suspicious regions identified by the algorithm in WSI, a more transparent and interpretable diagnosis can be generated. Conclusion The deep learning algorithm achieved high accuracy for chronic gastritis classification using WSIs. By pre-highlighting the different gastritis regions, it might be used as an auxiliary diagnostic tool to improve the work efficiency of pathologists.

Data Mining-Based Macroscopic Exploration of Clinical Medication of Chinese Medicine for Liver Cancer / 中国实验方剂学杂志

Objective:To explore the macroscopic medication rule of Chinese medicine for the treatment of primary liver cancer and provide references for clinical medication. Method:The databases of CNKI，VIP， and Wanfang Data were searched for research articles published from September 1959 to June 2019 with the terms of "Chinese medicine" and "liver cancer". A database was established based on the collected Chinese medicinal prescriptions for the treatment of primary liver cancer. The frequency，clustering， and association rules were analyzed by Excel， etc. Result:In this study，106 effective articles were included，and after the modified prescriptions were removed， 92 effective prescriptions were screened out，involving 281 Chinese herbal medicines used for 1 181 times in total. The top 5 high-frequency drugs were Poria （deficiency-tonifying），Astragali Radix （heat-clearing），Bupleuri Radix （blood-activating and stasis-resolving），Paeoniae Radix Alba （urination-promoting and dampness-draining）， and Codonopsis Radix （Qi-regulating）. The analysis of drug flavor with a frequency higher than 10 showed that most of the drugs were sweet，bitter， and pungent in flavor，cold，warm， and plain in nature，and acted on spleen and liver meridians. Four combinations and 10 herbal pairs were obtained by the cluster analysis of high-frequency drugs and association analysis， respectively. The high-frequency drugs and potential herbal pairs were classified targeting the specific clinical syndromes in different stages of liver cancer. Conclusion:Replenishing Qi， invigorating spleen，clearing heat， removing toxin，activating blood， and resolving stasis were the basic principles for the treatment of primary liver cancer. The combination of those drugs was the main therapeutic strategy. In addition，the resulting 10 potential herbal pairs from high-frequency drugs and cluster analysis could inspire the clinical treatment of primary liver cancer in different clinical stages with various clinical syndromes， which was of reference value for the clinical medication.

Cross-country orienteering: interventions for the prevention and control of myopia among children and adolescents / 中国学校卫生

Abstract@#The visual health of children and adolescents in China has become a major issue that is relevant to the nation s present and its future. This article analyzed the value of map reading and searching for specific features during orienteering projects for myopia prevention and control. The findings suggest that orienteering exercises show good regulatory effects on eye muscles, effectively improve concentration, and help to stimulate mental activity and visual system. Targeted exercises, including scanning maps for specific features, is beneficial for myopia prevention and control. It is proposed that, by changing the teaching style of cross-country orienteering, teaching space, and teaching scene, exercises can be tailored to treat and relieve eye strain, as well as to prevent and control myopia, which is essential to promote the visual health of children and adolescents.

Animal model analysis of diabetic lower extremity arterial disease based on clinical symptoms of traditional Chinese and Western medicine / 中国中药杂志

The evaluation standard of LEAD animal model was established according to the understanding of the etiology and pathogenesis of diabetic lower extremity vascular disease based on Chinese and Western medicine. The consistency between the existing LEAD animal model and the clinical characteristics of traditional Chinese and Western medicine was analyzed and evaluated. The advantages and disadvantages of the existing model were compared,the application scope of different models was considered,and the possible improvement methods of the existing model were proposed,so as to provide impetus for the improvement of LEAD animal model.We should reflect more characteristics of traditional Chinese medicine syndromes in the process of model improvement and development,making the LEAD animal model to get closer to clinical features of traditional Chinese and Western medicine.

Analysis of animal models of chronic atrophic gastritis based on characteristics of clinical symptoms of traditional Chinese and Western medicine / 中国中药杂志

Based on the clinical characteristics of chronic atrophic gastritis in traditional Chinese and Western medicine, the domestic and foreign relevant literature reports and animal models of chronic atrophic as well as the clinical diagnostic indicators of traditional Chinese and western medicine, chronic atrophic gastritis evaluation standard was summarized to evaluate and analyze the coincidence degree of clinical symptoms of the existing chronic atrophic gastritis animal models. The statistical results found that modeling methods with a higher coincidence degree with the existing chronic atrophic gastritis animal models are disease and syndrome combination mode-ling, surgical modeling, multifactor comprehensive modeling and MNNG modeling. Although the animal models were reproduced by such methods as etiology, pathogenesis and disease and syndrome combination similar to those of human beings, there is still a big gap with the natural disease state. Further in-depth studies and improvement shall be made in clinical practice in the hope to provide refe-rence for clinical practice and experimental studies of chronic atrophic gastritis.

Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients / 中华医学杂志(英文版)

Background@#A patient’s infectivity is determined by the presence of the virus in different body fluids, secretions, and excreta. The persistence and clearance of viral RNA from different specimens of patients with 2019 novel coronavirus disease (COVID-19) remain unclear. This study analyzed the clearance time and factors influencing 2019 novel coronavirus (2019-nCoV) RNA in different samples from patients with COVID-19, providing further evidence to improve the management of patients during convalescence.@*Methods@#The clinical data and laboratory test results of convalescent patients with COVID-19 who were admitted to from January 20, 2020 to February 10, 2020 were collected retrospectively. The reverse transcription polymerase chain reaction (RT-PCR) results for patients’ oropharyngeal swab, stool, urine, and serum samples were collected and analyzed. Convalescent patients refer to recovered non-febrile patients without respiratory symptoms who had two successive (minimum 24 h sampling interval) negative RT-PCR results for viral RNA from oropharyngeal swabs. The effects of cluster of differentiation 4 (CD4)+ T lymphocytes, inflammatory indicators, and glucocorticoid treatment on viral nucleic acid clearance were analyzed.@*Results@#In the 292 confirmed cases, 66 patients recovered after treatment and were included in our study. In total, 28 (42.4%) women and 38 men (57.6%) with a median age of 44.0 (34.0–62.0) years were analyzed. After in-hospital treatment, patients’ inflammatory indicators decreased with improved clinical condition. The median time from the onset of symptoms to first negative RT-PCR results for oropharyngeal swabs in convalescent patients was 9.5 (6.0–11.0) days. By February 10, 2020, 11 convalescent patients (16.7%) still tested positive for viral RNA from stool specimens and the other 55 patients’ stool specimens were negative for 2019-nCoV following a median duration of 11.0 (9.0–16.0) days after symptom onset. Among these 55 patients, 43 had a longer duration until stool specimens were negative for viral RNA than for throat swabs, with a median delay of 2.0 (1.0–4.0) days. Results for only four (6.9%) urine samples were positive for viral nucleic acid out of 58 cases; viral RNA was still present in three patients’ urine specimens after throat swabs were negative. Using a multiple linear regression model (F=2.669, P=0.044, and adjusted R2=0.122), the analysis showed that the CD4+ T lymphocyte count may help predict the duration of viral RNA detection in patients’ stools (t=-2.699, P=0.010). The duration of viral RNA detection from oropharyngeal swabs and fecal samples in the glucocorticoid treatment group was longer than that in the non-glucocorticoid treatment group (15 days vs 8.0 days, respectively; t=2.550, P=0.013) and the duration of viral RNA detection in fecal samples in the glucocorticoid treatment group was longer than that in the non-glucocorticoid treatment group (20 days vs 11 days, respectively; t=4.631, P <0.001). There was no statistically significant difference in inflammatory indicators between patients with positive fecal viral RNA test results and those with negative results (P >0.05).@*Conclusions@#In brief, as the clearance of viral RNA in patients’ stools was delayed compared to that in oropharyngeal swabs, it is important to identify viral RNA in feces during convalescence. Because of the delayed clearance of viral RNA in the glucocorticoid treatment group, glucocorticoids are not recommended in the treatment of COVID-19, especially for mild disease. The duration of RNA detection may relate to host cell immunity.

Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients / 中华医学杂志(英文版)

BACKGROUND@#A patient's infectivity is determined by the presence of the virus in different body fluids, secretions, and excreta. The persistence and clearance of viral RNA from different specimens of patients with 2019 novel coronavirus disease (COVID-19) remain unclear. This study analyzed the clearance time and factors influencing 2019 novel coronavirus (2019-nCoV) RNA in different samples from patients with COVID-19, providing further evidence to improve the management of patients during convalescence.@*METHODS@#The clinical data and laboratory test results of convalescent patients with COVID-19 who were admitted to from January 20, 2020 to February 10, 2020 were collected retrospectively. The reverse transcription polymerase chain reaction (RT-PCR) results for patients' oropharyngeal swab, stool, urine, and serum samples were collected and analyzed. Convalescent patients refer to recovered non-febrile patients without respiratory symptoms who had two successive (minimum 24 h sampling interval) negative RT-PCR results for viral RNA from oropharyngeal swabs. The effects of cluster of differentiation 4 (CD4)+ T lymphocytes, inflammatory indicators, and glucocorticoid treatment on viral nucleic acid clearance were analyzed.@*RESULTS@#In the 292 confirmed cases, 66 patients recovered after treatment and were included in our study. In total, 28 (42.4%) women and 38 men (57.6%) with a median age of 44.0 (34.0-62.0) years were analyzed. After in-hospital treatment, patients' inflammatory indicators decreased with improved clinical condition. The median time from the onset of symptoms to first negative RT-PCR results for oropharyngeal swabs in convalescent patients was 9.5 (6.0-11.0) days. By February 10, 2020, 11 convalescent patients (16.7%) still tested positive for viral RNA from stool specimens and the other 55 patients' stool specimens were negative for 2019-nCoV following a median duration of 11.0 (9.0-16.0) days after symptom onset. Among these 55 patients, 43 had a longer duration until stool specimens were negative for viral RNA than for throat swabs, with a median delay of 2.0 (1.0-4.0) days. Results for only four (6.9%) urine samples were positive for viral nucleic acid out of 58 cases; viral RNA was still present in three patients' urine specimens after throat swabs were negative. Using a multiple linear regression model (F = 2.669, P = 0.044, and adjusted R = 0.122), the analysis showed that the CD4+ T lymphocyte count may help predict the duration of viral RNA detection in patients' stools (t = -2.699, P = 0.010). The duration of viral RNA detection from oropharyngeal swabs and fecal samples in the glucocorticoid treatment group was longer than that in the non-glucocorticoid treatment group (15 days vs. 8.0 days, respectively; t = 2.550, P = 0.013) and the duration of viral RNA detection in fecal samples in the glucocorticoid treatment group was longer than that in the non-glucocorticoid treatment group (20 days vs. 11 days, respectively; t = 4.631, P  0.05).@*CONCLUSIONS@#In brief, as the clearance of viral RNA in patients' stools was delayed compared to that in oropharyngeal swabs, it is important to identify viral RNA in feces during convalescence. Because of the delayed clearance of viral RNA in the glucocorticoid treatment group, glucocorticoids are not recommended in the treatment of COVID-19, especially for mild disease. The duration of RNA detection may relate to host cell immunity.

Survey on frequency of medical X-ray diagnosis in Shandong province / 中华放射医学与防护杂志

Objective To analyze the distribution characteristics and influencing factors of X-ray diagnostic imaging in Shandong province,and to estimate the application frequency of X-ray diagnostic imaging in the province,and provide data support for X-ray equipment.Methods A random sampliug method was used to extract 32 medical institutions as respondents from 10 prefecture-level cities in Shandong province.The basic information of medical institutions and the age,sex,examination and procedure of the subjects were analyzed.The distribution of the X-ray application was analyzed and estimated by using a multiple linear regression model.Results Totally 14 694 085 subjects were surveyed,and the proportion of male and female in the sample was not completely uniform.A total of 2 099 155 X-ray diagnostic information was collected in 2016,and the frequency of conventional radiography was the highest,accounting for 59.49％.The next was CT examination,accounting for 28.34％.The frequency of the two examinations showed an increasing trend with the age of subjects.For the total frequency of conventional diagnostic radiography and CT examination,the tertiary hospitals accounted for the highest proportion of the total,up to 52.13％,while the secondary hospitals accounted for the relatively low proportion of 30.09％,and the primary hospitals the lowest with 17.77％.The chest radiography had the highest proportion in conventional radiography accounting for 32.79％ of the total frequency of X-ray diagnostic imaging,and the head procedure had the highest proportion in CT examination,accounting for 10.07％ of the total frequency of X-ray diagnostic imaging.The fluoroscopy,mammography and dental radiography were mainly concentrated in the tertiary hospitals,and the primary hospitals had mainly radiography.Multiple linear regression models showed that the frequency of application of conventional X-ray diagnostic imaging (including radiography,fluoroscopy,dental radiography and mammography) was positively correlated with equipment quantity,number of outpatient and emergency patients,and tertiary hospitals (t=4.334,3.615,2.339,P＜ 0.05).CT examination was positively correlated with equipment quantity and the number of inpatient (t =2.167,2.595,P＜0.05).The frequency of conventional X-ray diagnostic imaging and CT examination in Shandong province were estimated about 491.17 examinations per 1 000 population and 258.17 examinations per 1 000 population respectively.Conclusions The frequency of X-ray exposure in Shandong province increased significantly compared with that during the " 9th Five-Year Plan" period.All relevant departments should take effective measures to strengthen medical radiation protection and reduce radiation risk.

The role of tumor size, ultrasonographic findings, and serum tumor markers in predicting the likelihood of malignant testicular histology / 亚洲男科学杂志(英文版)

The clinical predictive factors for malignant testicular histology remain unclear because of the low prevalence. Therefore, the aim of this study was to investigate predictors of malignant histology for testicular masses and decide more testis-sparing surgeries before surgery. This retrospective study enrolled 325 consecutive testicular mass patients who underwent radical orchiectomy (310/325) or testicular preserving surgery (15/325) from January 2001 to June 2016. The clinicopathological factors, including tumor diameter, cryptorchidism history, ultrasound findings, serum alpha-fetoprotein, and human chorionic gonadotropin (HCG) levels, were collected retrospectively for statistical analysis. A predictive nomogram was also generated to evaluate the quantitative probability. Among all patients, 247 (76.0%) were diagnosed with a malignant testicular tumor and 78 (24.0%) with benign histology. Larger tumor diameter (per cm increased, hazard ratio [HR] = 1.284, P = 0.036), lower ultrasound echo (HR = 3.191, P = 0.001), higher ultrasound blood flow (HR = 3.320, P < 0.001), and abnormal blood HCG (HR = 10.550, P < 0.001) were significant predictive factors for malignant disease in all testicular mass patients. The nomogram generated was well calibrated for all predictions of malignant probability, and the accuracy of the model nomogram measured by Harrell's C statistic (C-index) was 0.92. According to our data, the proportion of patients who underwent radical orchiectomy for benign tumors (24.0%) was much larger than generally believed (10.0%). Our results indicated that the diameter, ultrasonic echo, ultrasonic blood flow, and serum HCG levels could predict the malignancy in testicular mass patients.

Prevention and Treatment Effect of Traditional Chinese Medicine for Stroke Based on Regulating Gut Microbiome / 中国实验方剂学杂志

The gut microbiome is a unique ecosystem, known as the "forgotten organ" of the human body, and the "second genome" of human. Gut microbiome imbalance is associated with many central nervous system diseases such as Parkinson's disease, Alzheimer's disease, schizophrenia and disseminated sclerosis. Stroke is characterized by high morbidity, recurrence, mortality, and disability. Gut microbiome plays a key role in the occurrence and development of stroke, which can further affect the onset of stroke by affecting the body's absorption, metabolism, blood pressure, blood sugar, blood lipids and atherosclerotic plaque. In Chinese medicine, it is believed that the spleen and stomach qi and blood flow loss, the Yin and yang imbalance, the body's physiological dysfunction, metaplasia "wind, fire, phlegm, deficiency, silt" and other pathological products, can cause the occurrence of stroke. The spleen and stomach are mainly involved for decomposing food, transporting and transforming nutrients from foodstuff, and the gut microbiome affect the digestion and absorption of the diet. The function of gut microbiome in modern research is related to the dysfunction of the spleen and stomach in Chinese medicine. Therefore, adjusting the homeostasis of the gut microbiome can be used as a potential intervention target to prevent and treat ischemic stroke. Traditional Chinese medicine(TCM) intervention has already achieved good results in stroke, and whether it is related to the regulation effect of gut microbiome is worthy of further research in the future. At the same time, the research progress of active ingredients in TCM (berberine, baicalin, resveratrol, et al), single TCM prescriptions (Salviae Miltiorrhizae Radix Et Rhizoma, Rhodiolae Crenulatae Radix Et Rhizoma, et al) and compound TCM prescriptions (Buyang Huanwu Tang, Naoxintong capsule, Buzhong Yiqi Tang) in prevention and treatment of cerebral ischemia were reviewed in this study, providing new ways and ideas for the prevention of ischemic stroke and development of new therapies.

Analysis and Significance of Autophagy in Liver Cancer Cells Induced by Traditional Chinese Medicine / 中国实验方剂学杂志

Traditional Chinese medicine(TCM) and its components play a role in the field of anti-hepatocarcinoma. The definition of its mechanism of action in autophagy contributes to the development of TCM in the field of anti-hepatocarcinoma. In this paper, we summarized reports on the autophagy of liver cancer cells induced by TCM and its active ingredients, including those on promoting apoptosis and cycle inhibition induced by autophagy and inhibiting autophagy to block tumor cell cycle, but with a lack of systematic summarization. In this paper, according to different effect of TCM on autophagy induced by hepatocarcinoma, the TCM and its components were inductively analyzed in four aspects:inducing killing autophagy, inhibiting protective autophagy, inducing protective autophagy in liver cancer, and inducing unclear autophagy. According to the findings, TCMs and components that cause killing autophagy can inhibit the occurrence of autophagy, arrest cell cycle, induce cell senescence or promote apoptosis. TCMs and components that inhibit protective autophagy can inhibit protective autophagy and hepatoma cell proliferation. TCMs and components that induce protective autophagy have a significant anti-hepatocarcinoma effect, shall be considered to be combined with autophagy inhibitors to enhance the lethality of drugs on liver cancer cells, and become a new way for such drugs to treat liver cancer. TCMs and components with an unclear inductive effect shall be first identified for their type of autophagy, then combined with autophagy agonists or blockers according to the type of autophagy to enhance their anti-liver cancer effect, and provide a new clinical therapeutic approach for liver cancer. In the aspect of autophagy, this study not only reveals the molecular mechanism of anti-hepatocarcinoma of TCM, but also makes it a new way to study anti-hepatocarcinoma by TCM.

Mechanism of External Treatment with Traditional Chinese Medicine Based on“Neurological-Endocrine-Immune Network” / 中国实验方剂学杂志

With a clear efficacy in external treatment of diseases, traditional Chinese medicine(TCM) has been widely applied in surgery, in acute, pediatric, gynecological, internal medicine and other departments. Its advantages include easy use, direct access to lesions, and prevent of the first-pass effect of the liver. However, its mechanism of action is still unclear, which impacts its clinical promotion. This article makes analysis and summary on the clinical application of TCM in external treatment of diseases, the characteristics of commonly used TCM in treatment of diseases, and the relationship of the common externally treated diseases and the "neurological-endocrine-immune network". The findings showed that TCM for external treatment were widely used, with exact curative effects; the pathogenesis of commonly used TCM for externally treating diseases is closely related to the "neuro-endocrine-immune network". Moreover, the modern pharmacological effects of TCM for externally treating diseases were found to be 100%related to the "neuro-endocrine-immune network". According to the analysis of the relationship between the common diseases externally treated with TCM and the "neuro-endocrine-immune network", the pathogenesis of the treatment with TCM is closely related to the "neuro-endocrine-immune network". Therefore, we believe that the "neuro-endocrine-immune network" system is probably one of the main mechanisms of action of TCMs for externally treating diseases. The verification of this mechanism requires the joint efforts of various departments in conducting clinical or experimental verification in the future, so as to provide a reference for clarifying the mechanism of TCM for external use, and basis for the promotion and application of TCM for external use.

Analysis of Animal Model with Clinical Disease Characteristics of Uterine Dysplasia / 中国实验方剂学杂志

Uterine dysplasia or naive uterus mainly refers to a pathological state in which the uterus volume is significantly smaller than normal after adolescence. It is a common gynecological disease, which is caused by low levels of hormones during development process. The main symptoms are delayed menstruation, scanty menstruation, dysmenorrhea and even amenorrhea, and often manifested as infertility after marriage. The article summarizes existing animal models of uterine dysplasia based on clinical symptom characteristics of uterine dysplasia according to clinical diagnostic standard of traditional Chinese medicine (TCM) and western medicine. According to etiology and pathogenesis of uterine dysplasia and diagnostic criteria of TCM and Western medicine, advantages and disadvantages and coincidence of animal models with characteristics of uterine dysplasia and clinical symptoms of uterine dysplasia were proposed. The corresponding animal model evaluation index system and existing uterine dysplasia animal models were proposed to improve ideas and methods. At present, there are not many methods for establishing uterus dysplasia models. The existing models of uterine dysplasia are pathological models based on western medicine indexes. The existing models reflect clinical situations of uterine dysplasia in some aspects, but there is no evaluation index system of uterine dysplasia model and animal model reflecting cause of TCM. Based on existing single-factor animal models, a composite animal model with clinical conditions and similar typical symptoms of human uterine dysplasia is established, which is more consistent with characteristics of clinical symptoms. At same time, it is focus of future researches to improve evaluation index system of uterine animal models and establish a combination model of dysplasia of uterus with TCM syndromes.