Traditional Chinese Medicine Syndromes in Depressive Episodes of Bipolar Disorder Based on Cluster Analysis and Bayesian Network：A Cross-sectional Study / 中医杂志

ObjectiveTo explore the elements， distribution and characteristics of traditional Chinese medicine （TCM） syndromes in depressive episodes of bipolar disorder （BD）. MethodsBasic information， along with the four examination information， the Hamilton Depression Scale and Young Mania Rating Scale scores， were collected from 293 outpatients with BD at Beijing Anding Hospital， Capital Medical University. The four examination information with an occurrence rate greater than 12% were retained. The R language “dist” function was used to calculate the distances between samples using the Euclidean distance method. The hierarchical clustering of the four examination information was performed using the “hclust” function and the squared Euclidean distance method. A team of five researchers was formed to determine the nature and location of the essential elements of TCM syndrome in BD based on the clustering results. The PC algorithm was used to construct a Bayesian network model of the essential elements. The working group combined the essential elements of TCM syndromes in the Bayesian network according to the reference model results， and then extracted common TCM syndromes. The score of each patient based on the essential elements was matched with the common TCM syndromes to determine the syndrome type of each patient. The working group then performs conformity and revision based on this， obtaining the final distribution of TCM syndromes for the patients. ResultsThere were 77 common TCM symptoms in BD with a frequency greater than 12%. The top 15 symptoms with higher frequencies were slippery pulse， mental fatigue and lack of strength， wiry pulse， excessive rumination， preference for solitude， vexation， agitation and irritability， dry mouth， palpitations， profuse dreaming， unwarranted worries， chest oppression， thin white coating， amnesia， frequent sighing， and poor appetite. TCM syndrome elements of BD can be grouped into 11 categories. The nature of disease-related essential elements included fire， qi deficiency， blood deficiency， qi counterflow， yin deficiency， dampness， heat， fire from constraint， and phlegm. The location of disease-related essential elements included heart， liver， spleen， stomach， kidney， bladder channel， and gallbladder. By constructing a Bayesian network model and considering the opinions from the experts， six common syndromes of BD were identified， among which the highest proportion was heart-stomach heat accumulation， accounting for 27.99% （82 cases）， followed by heart-spleen deficiency （55 cases， 18.77%）， non-interaction between the heart and the kidney （49 cases， 16.72%）， liver constraint and blood deficiency （42 cases， 14.33%）， heart qi deficiency （37 cases， 12.63%）， and damp-heat in the liver and gallbladder （28 cases， 9.56%）. ConclusionsThe nature of disease-related elements of BD are predominantly fire and heat， while the location of disease-related essential elements are primarily associated with the heart， liver， and spleen. The most common TCM syndromes are heart-stomach heat accumulation and heart-spleen deficiency.

Bayesian Network Meta-analysis of Therapeutic Effect of Oral Chinese Patent Medicines on Coronary Artery Disease Complicated with Carotid Atherosclerosis / 中国实验方剂学杂志

ObjectiveTo compare the therapeutic effects of oral Chinese medicines （including Chinese patent medicines） on coronary artery disease （CAD） by the Bayesian network Meta-analysis. MethodThe randomized controlled trials of treating CAD with oral Chinese medicines were retrieved from the China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， PubMed， Web of Science， Embase， and Cochrane Library from the inception to December 1， 2022. The Cochrane risk of bias assessment tool was used to evaluate the quality of the included articles. The direct meta-analysis was performed to compare the performance of oral Chinese medicines alone and in combination with Western medicine in the treatment of CAD in terms of intima-media thickness （IMT）， vascular endothelial function， plaque score， hypersensitive C-reactive protein （hs-CRP）， total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， and total response rate. Furthermore， the Bayesian network Meta-analysis was performed to compare the therapeutic effects of different Chinese medicines. ResultA total of 41 articles were included. The direct meta-analysis results showed that Chinese medicines combined with Western medicine outperformed Western medicine alone in recovering all the indicators of CAD. The Bayesian network meta-analysis yielded the following results. In terms of the total response rate， modified Huangqi Guizhi Wuwutang and Sanqi Huayu pills had obvious advantages over other Chinese medicines. In terms of IMT and plaque score， Xiaoban Huazhuo decoction， Yiqi Tongluo formula， Ruangan Jiangzhi capsules， and Guanxin Shutong capsules had obvious advantages over other Chinese medicines. In terms of blood lipid indicators， Shenqi Roumai mixture， Ruangan Jiangzhi capsules， Xiaoban Huazhuo decoction， Qiwei Sanxiong decoction， and Sanqi Huayu pills were superior to other Chinese medicines. The Chinese medicines above mainly had the functions of activating blood， resolving stasis， resolving phlegm， and dredging vessels. ConclusionThe combination of oral Chinese medicines and Western medicine is effective in treating CAD. Clinicians can use the drugs targeting abnormal indicators according to the results of this Bayesian network meta-analysis combined with the actual situation of patients to achieve better therapeutic effects.

Lean strategy for data mining and continuous improvement of Chinese pharmaceutical process: a case study of sporoderm-removal Ganoderma lucidum spore powder / 中国中药杂志

In the digital transformation of Chinese pharmaceutical industry, how to efficiently govern and analyze industrial data and excavate the valuable information contained therein to guide the production of drug products has always been a research hotspot and application difficulty. Generally, the Chinese pharmaceutical technique is relatively extensive, and the consistency of drug quality needs to be improved. To address this problem, we proposed an optimization method combining advanced calculation tools(e.g., Bayesian network, convolutional neural network, and Pareto multi-objective optimization algorithm) with lean six sigma tools(e.g., Shewhart control chart and process performance index) to dig deeply into historical industrial data and guide the continuous improvement of pharmaceutical processes. Further, we employed this strategy to optimize the manufacturing process of sporoderm-removal Ganoderma lucidum spore powder. After optimization, we preliminarily obtained the possible interval combination of critical parameters to ensure the P_(pk) values of the critical quality properties including moisture, fineness, crude polysaccharide, and total triterpenes of the sporoderm-removal G. lucidum spore powder to be no less than 1.33. The results indicate that the proposed strategy has an industrial application value.

Influencing factors of fall injury risks in manufacturing enterprises based on Bayesian networks / 环境与职业医学

Background Falls are one of the most important types of occupational injuries. The incidence of falls is high in manufacturing workers. However, most of the studies on falls in China focus on primary and secondary school students and the elderly, and there are few studies on falls in the occupational population. Objective To evaluate efficiency of Bayesian network model in predicting fall injury risks in manufacturing enterprise staff, and impacts from work content, work environment, enterprise status, and health management on falls and their mutual relationships, and provide a scientific basis for enterprises to carry out fall-associated injury intervention. Methods Data from the European Survey of Enterprises on New and Emerging Risks (ESENER) were used. The survey provided data on work content, working environment, enterprise status, and health management of enterprises in European countries. The outcome indicator, was fall injury risks reported in enterprises. A total of 23 potential impact factors covering work content, working environment, enterprise status, and health management were screened by least absolute shrinkage and selection operator (LASSO) regression, followed by Bayesian network model for structure learning and parameter learning and area under the curve (AUC) for model fitness evaluation, using R and Netica 5.18. Diagnostic inference analysis was also conducted to identify key influencing factors and key influencing chains of fall injury risks based on the change rate of fall injury risks. Results In 5997 enterprises surveyed, 2573 (42.9%) enterprises reported fall injury risks. Ordered by their coefficient estimates from high to low, the 14 variables (mean-squared error=0.20) selected by LASSO regression were: manual handling, repetitive arm movement, poor posture, using desktop computers, and using robots in the category of work content; abnormal temperature and noise in the category of working environment; company size and employee quality in the category of enterprise status; mental health training, regular risk assessment, availability of psychologists, health and safety procedures, and provision of psychological counseling in the category of health management. The fitting result of Bayesian network model for fall injury risks was good (AUC=0.779). The Bayesian network diagnostic inference identified five key influencing factors, including abnormal temperature (change rate=35.9%), poor posture (change rate=27.3%), noise (change rate=23.4%), manual handling (change rate=18.2%), and repetitive arm movement (change rate=5.1%). The key influencing chain was "manual handling - poor posture - repetitive arm movement - fall injury risks" (combined change rate=16.9%). Conclusion The Bayesian network model has a good predictive performance in predicting the risk of falls in manufacturing enterprises. Manufacturing enterprises need to focus on jobs involving manual handling and repetitive arm movement, identify and improve workers' poor posture and mental health problems, and avoid workers working in harsh temperature or noise environment.

Application of bayesian network in nursing real-world data and implementation of tetrad / 中国实用护理杂志

Objective:It introduced the application of bayesian network in real-world data and the implementation of Tetrad software, so as to provide methodological application reference for medical researchers.Methods:Real-world data for diabetes diagnosis had been taken as an example. UCI machine learning database Pima-Indian-diabetes data set was used as case data, Bayesian network ratiocination was carried out according to the construction order of bayesian network of Tetrad software.Results:When the screening age was over 30 years old, impaired glucose tolerance, abnormal serum insulin two hours after meal, body weight index and family genetic index were large, the probability of diabetes onset from 34.99% to 83.33%.Conclusions:The bayesian network realized by Tetrad software provides a powerful tool for causal inference of real-world data, and promoted the objective and quantitative interpretation of the dependence between variables.

3-State Protein Secondary Structure Prediction based on SCOPe Classes

Abstract Improving the accuracy of protein secondary structure prediction has been an important task in bioinformatics since it is not only the starting point in obtaining tertiary structure in hierarchical modeling but also enhances sequence analysis and sequence-structure threading to help determine structure and function. Herein we present a model based on DSPRED classifier, a hybrid method composed of dynamic Bayesian networks and a support vector machine to predict 3-state secondary structure information of proteins. We used the SCOPe (Structural Classification of Proteins-extended) database to train and test the model. The results show that DSPRED reached a Q3 accuracy rate of 82.36% when trained and tested using proteins from all SCOPe classes. We compared our method with the popular PSIPRED on the SCOPe test datasets and found that our method outperformed PSIPRED.

Bayesian Network Meta-analysis of Therapeutic Efficacy and Safety of Chinese Patent Medicine Compound Preparation Combined with Conventional Therapy for Psoriasis Vulgaris / 中国药房

OBJECTIVE：To systematically evaluate the therapeutic efficacy and safety of Chinese patent medicine compound preparation combined with conventional therapy for psoriasis vulgaris ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from CNKI ，Wanfang database ，VIP，CBM，PubMed，the Cochrane Library and Web of Science ， RCTs about Chinese patent medicine compound preparation combined with conventional therapy versus conventional therapy in the treatment of psoriasis vulgaris were collected during the inception to Feb. 2020. After literature retrieval and data extraction ，the quality of the included studies was evaluated with risk bias assessment tool recommended by the Cochrane evaluation manual handbook 5.1. Bayesian network Meta-analysis was perfor med by using Stata 15.0 software，Addis 1.16.6 software and Markov Chain Monte Carlo method. RESULTS ：A total of 41 RCTs were included ，involving 4 122 patients. 5 kinds of interven- tion measures included Compound qingdai capsule ，Xiaoyin SF-010） granule， Keyin pill ，Yujin yinxie tablet and conventional therapy. Results of network Meta-analysis showed that in terms of improving the total effective rate ， compared with conventional therapy ，4 kinds of Chinese patent medicine compound preparations combined with conventional therapy could significantly improve the total effective rate （P＜0.05）；the results of network Meta-analysis were as follows ：Keyin pill combined with conventional therapy ＞Compound qingdai capsule combined with conventional therapy ＞Xiaoyin granule combined with conventional therapy ＞Yujin yinxie tablet combined with conventional therapy ＞conventional therapy. In terms of reducing psoriasis area and severity index （PASI）score after treatment ，compared with conventional therapy ，Keyin pill and Xiaoyin granule combined with conventional therapy could significantly reduce the PASI score （P＜0.05），while Compound qingdai capsule and Yujin yinxie tablet combined with conventional treatment had no significant difference （P＞0.05）；the results of network Meta-analysis showed that Xiaoyin granule combined with conventional therapy ＞Keyin pill combined with conventional therapy ＞ Compound qingdai capsule combined with conventional therapy ＞Yujin yinxie tablet combined with conventional therapy ＞ conventional therapy. In terms of reducing serum inflammatory factor level ，compared with conventional therapy ，Compound qingdai capsule and Xiaoyin granule combined with conventional therapy could significantly reduce the level of IL- 17（P＜0.05）， but Keyin pill and Yujin yinxie tablet combined with conventional therapy had no significant difference （P＞0.05）；the results of network Meta-analysis showed that Xiaoyin granule combined with conventional therapy ＞Compound qingdai capsule combined with conventional therapy ＞Yujin yinxie tablet combined with conventional therapy ＞Keyin pill combined with conventional therapy＞conventional therapy. In terms of safety ，there was no statistical significance in the incidence of ADR between 4 kinds of Chinese patent medicine combined with conventional therapy and conventional therapy （P＞0.05）；the results of network Meta-analysis showed that Compound qingdai capsule combined with conventional therapy ＞Xiaoyin granule combined with conventional therapy ＞Keyin pill combined with conventional therapy ＞conventional therapy ＞Yujin yinxie tablet combined with conventional therapy . CONCLUSIONS ：Compared with conventional therapy ，additional use of 4 kinds of Chinese patent medicine compound preparations can improve the curative effect of psoriasis vulgaris patients with blood heat syndrome ，and Keyin pill is the best ；Xiaoyin granule is the best in reducing the degree of skin lesions and serum inflammatory factors ；additional use of 4 kinds of Chinese patent medicine compound preparations show good safety ，and Compound qingdai capsule is the best.

Bayesian network Meta-analysis of traditional Chinese medicine injections combined with antiviral western medicine in treatment of influenza / 中国中药杂志

To systematically evaluate the efficacy and safety of traditional Chinese medicine injections combined with antiviral wes-tern medicine in the treatment of influenza by Bayesian network Meta-analysis. Four Chinese databases(CNKI, Wanfang, VIP, CBM) and three English databases(PubMed, EMbase, Cochrane Library) were retrieved by computer for randomized controlled trials(RCT) about the comparison between the combined administration of traditional Chinese medicine injections with antiviral western medicine(or with placebo) and the single administration of antiviral western medicine in the treatment of influenza, or the comparison between two different traditional Chinese medicine injections combined with antiviral western medicine in the treatment of influenza. The retrieval time was from the establishment of the databases to July 2020. Two researchers independently screen out the literatures and extracted the data according to the inclusion criteria and exclusion criteria. The included studies were evaluated by the Cochrane 5.1 bias risk assessment tool, and data analysis was conducted by ADDIS 1.16.8 and Stata 14.0. A total of 49 literatures about 5 061 cases were included finally, involving six traditional Chinese medicine injections, namely Reduning Injection, Xiyanping Injection, Tanreqing Injection, Yanhuning Injection, Qingkailing Injection and Shuanghuanglian Injection. The results of network Meta-analysis,(1)in terms of total effective rate, 6 traditional Chinese medicine injections combined with antiviral western medicine was better than antiviral western medicine alone. In terms of probability sorting, Shuanghuanglian Injection combined with antiviral western medicine ranked first.(2)There was no significant statistical difference in adverse reaction rate among all groups, but Reduning Injection ranked first in the probability sorting, due to the least side effects.(3)In terms of antipyretic time, Yanhuning Injection, Xiyanping Injection and Tanreqing Injection combined with antiviral western medicine was better than antiviral western medicine alone and Xiyanping Injection ranked first in the probability sorting.(4)In terms of cough relief time, Qingkailing Injection and Tanreqing Injection combined with antiviral western medicine was better than antiviral western medicine alone and Qingkailing Injection was superior to Yanhuning Injection. Qingkailing Injection combined with antiviral western medicine ranked first in the probability sorting.(5)In terms of the length of hospital stay, Xiyanping Injection, Tanreqing Injection and Reduning Injection combined with antiviral western medicine was superior to antiviral western medicine alone, and Reduning Injection ranked first in the probability sorting due to the shortest hospital stay. Because of the small quantity and low quality of included studies, the results of this study shall be regarded cautiously and comprehensively. In the future, multi-center, large-sample and clinical randomized controlled trials shall be conducted to verify the results.

Bayesian network Meta-analysis of Chinese medicine injections in treatment of chronic renal insufficiency / 中国中药杂志

In this study, Honghua Injection, Danshen Injection, Shenkang Injection, Shuxuetong Injection, Lulutong Injection, Shenxiong Glucose Injection and Chuanxiong Injection were compared for their clinical efficacy on chronic renal insufficiency by using the method of network Meta-analysis, with Western medicine as the common reference. The randomized controlled trial(RCT) of Hong-hua Injection, Danshen Injection, Shenkang Injection, Shuxuetong Injection, Lulutong Injection, Shenxiong Glucose Injection and Chuanxiong Injection for the treatment of chronic renal insufficiency were obtained by computer-based retrieval. The literature quality was evaluated by using the method in Cochrane Reviewer's Handbook 5.1 after independent screening of the included literature by two reviewers. The RJAGS package and GEMTC package of RevMan 5.3, GEMTC software, R software were used for statistical analysis to compare and sort the different injections in terms of efficacy. A total of 6 197 patients with chronic renal failure were included in 79 RCTs, involving 8 treatment measures. The effective rates of conventional treatment combined with Shenxiong Injection(OR=3.55, 95%CI[1.98, 6.37], P<0.000 1), Honghua Injection(OR=3.77, 95%CI[2.45, 5.81], P<0.000 01), Shuxuetong Injection(OR=6.71, 95%CI[3.30, 13.65], P<0.000 01) and Shenkang Injection(OR=4.14, 95%CI[3.42, 5.03], P<0.000 01) were all better than that in control group, and the effective rate of Honghua Injection combined with conventional treatment(OR=3.89, 95%CI[1.73, 8.74], P=0.001) was better than that in Danshen Injection combined with conventional treatment, all with statistically significant differences. By comprehensive comparison, Shuxuetong Injection, Honghua Injection and Shenkang Injection combined with Western medicine had good clinical effect on the effective rate, serum creatinine reduction and urea nitrogen reduction in patients with chronic renal insufficiency. However, due to the relatively low quality of the included literature, the conclusion has yet to be verified clinically.

Bayesian network-based analysis on the influence of interaction between genes and occupational stress on hypertension in oil workers / 中国职业医学

OBJECTIVE: To analyze the effect of gene-gene and gene-occupational stress interaction on hypertension in oil workers by Bayesian network(BN) analysis. METHODS: A total of 1 233 oil workers from Xinjiang Karamay Oilfield Company were selected as research subjects by the typical sampling method. The blood pressure was measured. The polymerase chain reaction-restriction fragment length polymorphism was used to evaluate the single nucleotide polymorphism(SNP) in α-adductin(ADD1) and β_2-adrenal receptor(β_2-AR) genes. The Effort-Reward Imbalance(ERI) Questionnaire was used to evaluate the ERI model occupational stress of oil workers. BN was used to analyze gene-gene and gene-occupational stress interactions. RESULTS: The detection rate of hypertension and ERI model occupational stress of these oil workers were 25.5%(315/1 233) and 47.4%(585/1 233) respectively. The AA, AG, and GG genotype and the frequency distribution of allele A and G at ADD1 rs17833172 were statistically different in these two groups(all P<0.05). There was no statistical significance in genotypes of GG, GT and TT at Gly460Trp rs4961(P>0.05); but the difference of the frequency of G and T alleles was statistically significant(P<0.05). There was no statistical significance in genotype distribution of AA, AG and GG, and frequency distribution of A and G in β_2-AR-1023 G/A rs2053044 and+252 G/A rs1042717(all P>0.05). After controlling the confounding factors including gender, education level, marital status, smoking, alcohol drinking and body mass index, the occupational stress group had a higher risk of hypertension than the no-occupational stress group(P<0.05, the odds ratio was 1.33, the 95% confidence interval was 1.01-1.74). The directed acyclic graph constructed by BN showed that the rs17833172 and Gly460Trp rs4961 sites of the ADD1 gene was directly associated with hypertension, and the β_2-AR+252 G/A rs1042717 site was indirectly associated with hypertension because of the ADD1 rs17833172 and Gly460Trp rs4961 sites. The interaction between occupational stress and ADD1 and β_2-AR was not associated with hypertension. CONCLUSION: The incidence of hypertension in oil field workers is correlated to occupational stress, and ADD1 gene rs17833172 and Gly460Trp rs4961 polymorphism. The gene-gene interaction between β_2-AR+252 G/A rs1042717 locus and ADD1 Gly460Trp rs4961 and rs17833172 locus is associated with hypertension, while the interaction between the four loci of ADD1 and β_2-AR and occupational stress has no effect on hypertension in the oil workers.

Efficacy and Safety of Calcitonin Gene-related Peptide Monoclonal Antibodies in the Preventive Treatment of Migraine：A Bayesian Network Meta-analysis / 中国药房

OBJECTIVE：To systematically evaluate th e efficacy and safety of 4 kinds of calcitonin gene-related peptide （CGRP）monoclonal antibodies in the preventive treatment of migraine ，and to provide evidence-based reference for the clinical treatment of migraine. METHODS ：Retrieved from the Cochrane Library ，PubMed，Embase，CJFD，VIP and Wanfang database ， RCTs about 4 kinds of CGRP monoclonal antibodies （trial Δ 基金项目 ：四川省科技厅重点研发 （重大科技专项 ）项目 group） versus placebo （control group ） in the preventive （No.2019YFS0180） ＊硕士研究生 。研究方向 ：临床药学 、循证药学 。电话：0830- treatment of migraine were collected. After literature screening 3165787。E-mail：lewxinn@outlook.com and data extraction ， the quality evaluation of included # 通信作者：教授，硕士生导师，硕士。研究方向：临床药学、循证 literature was performed by using the bias risk assessment tool 药学。电话：0830-3165787。E-mail：hyl3160131@163.com provided by the Cochrane system evaluator manual 5.1.0. 中国药房 2020年第31卷第18期 China Pharmacy 2020Vol. 31 No. 18 ·2275· Bayesian network Meta-analysis was performed by using GeMTC 0.14.3 software and Stata 16.0 software. RESULTS ：A total of 19 RCTs involving 11 392 patients were included ，involving 10 interventions，such as Erenumab 70，140 mg/month；Fremanezumab 675 mg/3 months，225 mg/month；Galcanezumab 120，240，300 mg/month；Eptinezumab 100 mg/3 months，300 mg/3 months and placebo. Results of Meta-analysis showed that compared with control group ，4 kinds of CGRP monoclonal antibodies significantly reduced the change of mean monthly migraine days （MMD）（P＜0.05）. Among trial groups ，compared with Galcanezumab 300 mg/month [MD ＝－1.30，95％CI（－2.59，－0.05），P＜0.05] and Eptinezumab 100 mg/3 months [MD ＝－1.18， 95％CI（－2.26，－0.03），P＜0.05]，Fremanezumab 225 mg/month could significantly reduce MMD. Network Meta-analysis ranking showed that Fremanezumab 225 mg/month＞Fremanezumab 675 mg/3 months＞Galcanezumab 120 mg/month＞Erenumab 140 mg/month＞Galcanezumab 240 mg/month＞Eptinezumab 300 mg/3 months＞Erenumab 70 mg/month＞Eptinezumab 100 mg/3 months＞Galcanezumab 300 mg/month＞placebo. Compared with control group ，4 kinds of CGRP monoclonal antibodies were significantly increased of the proportion of patients whose mean monthly migraine days reduction ≥50％ compared with baseline （MMD 50）（P＜0.05）. Among trial groups ，compared with Eptinezumab 100 mg/3 months group ，MMD 50 of Fremanezumab 675 mg/3 months group [OR ＝1.51，95％CI（1.02，2.31），P＜0.05]，Fremanezumab 225 mg/month group [OR ＝1.58，95％CI （1.05，2.44），P＜0.05] were increased significantly. Network Meta-analysis ranking showed that Fremanezumab 225 mg/month＞ Fremanezumab 675 mg/3 months＞Erenumab 140 mg/month＞Galcanezumab 120 mg/month＞Eptinezumab 300 mg/3 months＞ Galcanezumab 240 mg/month＞Erenumab 70 mg/month＞Galcanezumab 300 mg/month＞Eptinezumab 100 mg/3 months＞placebo. In terms of safety ，incidence of total adverse events （AE）of trial groups receiving Fremanezumab 675 mg/3 months [OR ＝1.31， 95％CI（1.05，1.64），P＜0.05]，Galcanezumab 240 mg/month [OR ＝1.39，95％CI（1.09，1.74），P＜0.05] were significantly higher than control group. Among trial groups ，compared with Galcanezumab 240 mg/month group ，AE of Erenumab 70 mg/month group [OR ＝0.67，95％CI（0.50，0.93），P＜0.05]，Erenumab 140 mg/month group [OR ＝0.70，95％CI（0.51，0.98），P＜0.05] were decreased significantly. Compared with Fremanezumab 675 mg/3 months group ，AE of Erenumab 70 mg/month group [OR ＝ 0.72，95％CI（0.52，0.98），P＜0.05] were decreased significantly. Network Meta-analysis ranking showed that Galcanezumab 240 mg/month＞ Fremanezumab 675 mg/3 months＞Galcanezumab 120 mg/month＞Galcanezumab 300 mg/month＞Eptinezumab 300 mg/3 months＞Fremanezumab 225 mg/month＞Eptinezumab 100 mg/3 months＞placebo＞Erenumab 140 mg/month＞Erenumab 70 mg/month. CONCLUSIONS ：Four kinds of CGRP monoclonal antibodies are effective in the preventive treatment of migraine ， among which Fremanezumab 225 mg/month is most likely to have the best efficacy and Erenumab 70 mg/month is most likely to have the highest safety.

Research on Bayesian fault diagnosis model of traditional Chinese medicine dry granulation based on failure model and effect analysis (FMEA) / 中国中药杂志

This paper aims to construct a Bayesian(BN) fault diagnosis model of traditional Chinese medicine dry granulation based on the failure model and effect analysis(FMEA), effectively control risk factors and ensure the quality of granules.Firstly, the risk ana-lysis of dry granulation process was carried out with FMEA, and the selected medium and high risk factors were taken as node variables to establish corresponding BN network with causality.According to the mathematical reasoning method of probability theory, the model was accurately inferred and verified by Netica, and the granule nonconformance was used as the evidence for reversed reasoning to determine the most likely cause of the failure that affected the granule quality.The BN fault diagnosis model of traditional Chinese medicine dry gra-nulation was established based on the medium and high risk factors of process, prescription and equipment screened out by FMEA, such as roller pressure, raw material viscosity, clearance between rollers in the paper.The fault diagnosis of traditional Chinese medicine dry granulation process was then carried out according to the model, and the posterior probability of each node under the premise of nonconforming granule quality was obtained.This method could provide strong support for operators to quickly eliminate faults and make decisions, so as to improve the efficiency and accuracy for fault diagnosis and prediction, with innovation in its application.

Application of FMEA and Bayesian Network in Risk Assessment of Fluidized Bed Granulation of Traditional Chinese Medicine / 中国实验方剂学杂志

Objective:To carry out the risk assessment on the factors in the process of granulation fluidized bed of traditional Chinese medicine(TCM) by using failure model and effect analysis(FMEA) and Bayesian network(BN), in order to effectively control risk factors and improve product quality. Method:The risk analysis of the fluidized bed granulation process was carried out by FMEA and the selected medium risk and high risk factors were taken as the main control points, the corresponding BN was established. The sensitivity analysis was used to screen out the main risk factors affecting particle fluidity, particle size uniformity, solubility and product cleanliness, the occurrence probability of each risk factor was determined by the evidence of unqualified particle quality, finally, taking fluidized bed granulation process of Sanye tablets as an example, the FMEA and BN were combined into the risk assessment process to verify the effectiveness and reliability of the method. Result:Based on the middle and high risk points of fluidized bed process, particle size of raw materials, moisture content and hygroscopicity of raw materials, dosage, concentration and addition amount of binder, cleaning degree and integrity of collection bag, and nozzle position, which were selected by FMEA, a fluidized bed granulation risk network with causality was constructed. Among them, hygroscopicity of raw materials, concentration and addition amount of binder, inlet temperature and atomization pressure were high probability risk factors, and the probability of occurrence were 55%, 63%, 59%and 58%, respectively. According to the Bayesian risk relationship network which controlled Sanye tablets fluidized bed granulation analysis results showed that the P values of inlet temperature, atomization pressure and concentration of binder were 0.003 4, 0.032 6 and 0.041 8, respectively in the regression model of influencing factors and particle size uniformity, indicating that there was a significant correlation between the three factors and the particle quality, which was basically consistent with the conclusion obtained by FMEA-BN method. Conclusion:The combination of FMEA and BN for visualized risk assessment of fluidized bed granulation helps to effectively control the risk factors in the granulation process, reduce product quality risks and provide strong support for the improvement of granulation process of TCM.

Artificial Intelligence Model As Predictor For Dengue Outbreaks

@#Dengue is an increasing threat in Malaysia, particularly in the more densely populated regions of the country. We present an Artificial Intelligence driven model in predicting Aedes outbreak, using predictors of weather variables and vector indices sourced from the Ministry of Health. Analysis and predictions to estimate Aedes populations were conducted, with its results being used to infer the possibility of dengue outbreaks at pre-determined localities around the Klang Valley, Malaysia. A Bayesian Network machine learning technique was employed, with the model being trained using predictor variables such as temperature, rainfall, date of onset and notification, and vector indices such as the Ae. albopictus count, Ae. aegypti count and larval count. The interfaces of the system were developed using the C# language for Server-side configuration and programming, and HTML, CSS and JavaScript for the Client Side programming. The model was then used to predict the population of Aedes at periods of 7, 14, and 30 days. Using the Bayesian Network technique utilising the above predictor variables we proposed a finalised model with predictive accuracy ranging from 79%-84%. This model was developed into a Graphical User Interface, which was purposed to assist and educate the general public of regions at risk of developing dengue outbreak. This remains a valuable case-study on the importance of public data in the context of combating a public health risk via the development of models for predicting outbreaks of dengue which will hopefully spur further sharing of data by all parties in combating public health threats.

Bayesian Network Meta-analysis of Therapeutic Efficacy of Xianling Gubao Capsules Combined with Routine Therapy for Postmenopausal Osteoporosis / 中国药房

OBJECTIVE： To systematically evaluate the difference of therapeutic efficacy of Xianling gubao capsules combined with routine therapy for postmenopausal osteoporosis （PMOP）. METHODS： Retrieved from Cochrane Library， PubMed， Embase， ClinicalTrials， CNKI， VIP， Wanfang database and CBM， clinical randomized controlled trials （RCTs） about Xianling gubao capsules combined with placebo and routine treatment （trial group） versus placebo and routine treatment or Xianling gubao capsules （control group） alone in the treatment of PMOP were collected. After literature screening and data extraction， the quality of included literatures were evaluated with Cochrane system evaluator manual 5.3 recommend bias risk evaluation tool. Bayesian Network Meta-analysis was performed with Stata 14.0 software  and Bayesian Markov Chain Monte Carlo. RESULTS： A total of 16 RCTs were included， involving a total of 1 360 patients and 3 intervention measures as Xianling gubao capsules alone， Xianling gubao capsules combined with routine treatment， routine treatment. Results of Meta-analysis showed that in respect of improving total response rate， compared with routine treatment， Xianling gubao capsules combined with routine treatment [OR＝0.28，95％CI（0.12， 0.64），P＜0.05]could significantly improve total response rate； network Meta-analysis ranking showed that Xianling gubao capsules combined with routine treatment＞Xianling gubao capsules alone＞routine treatment. In terms of increasing bone mineral density （BMD）， compared with routine treatment， Xianling gubao capsules combined with routine treatment [OR＝0.45，95％CI（0.24， 0.84），P＜0.05] and Xianling gubao capsules alone [OR＝0.78， 95％CI（0.32， 0.84），P＜0.05] could significantly improve BMD； network Meta-analysis ranking showed that Xianling gubao capsules combined with routine treatment＞Xianling gubao capsules alone＞routine treatment. In the term of improving serum calcium level， compared with Xianling gubao capsules alone [OR＝4.76，95％CI（2.14， 10.59），P＜0.05] and routine treatment [OR＝0.45， 95％CI（0.21， 0.99），P＜0.05]， Xianling gubao capsules combined with routine treatment could significantly improve serum calcium level； network Meta-analysis ranking showed that Xianling gubao capsules combined with routine treatment＞routine treatment＞Xianling gubao capsules alone. In the term of improving serum phosphorus level， compared with Xianling gubao capsules alone， Xianling gubao capsules combined with routine treatment [OR＝2.85，95％CI（1.81， 4.48），P＜0.05] and routine treatment [OR＝2.93，95％CI（1.76， 4.86），P＜0.05] could significantly improve serum phosphorus level； network Meta-analysis ranking showed that routine treatment＞Xianling gubao capsules combined with routine treatment＞Xianling gubao capsules alone. CONCLUSIONS： Xianling gubao capsules combined with routine treatment can significantly improve therapeutic efficacy of PP patients， increase BMD and serum calcium level after treatment， but routine treatment is the best in improving serum phosphorous level.

Bayesian Network Meta-analysis of Therapeutic Efficacy and Safety of Different Chinese Patent Medicine Injection for Pro- moting Blood Circulation and Removing Blood Stasis Combined with Routine Treatment after PCI / 中国药房

OBJECTIVE： To systematically evaluate the difference in therapeutic efficacy， safety and cardiac function of Chinese patent medicine injection for promoting blood circulation and removing blood stasis combined with routine treatment after percutaneous coronary intervention （PCI）， and to provide evidence-based reference for clinical drug use. METHODS： Retrieved from Cochrane library， PubMed， Embase， CNKI， Wanfang database and Chinese sci-tech periodicals database， RCTs about different Chinese patent medicine injection for promoting blood circulation and removing blood stasis combined with routine treatment （trial group） versus routine treatment （control group） after PCI were collected. After screening the literature and extracting the data， the quality of the included studies was evaluated by modified Jadad scale. Bayesian network Meta- analysis was performed by using Stata 14.0 software and Markov Chain-Monte Carlo method. RESULTS： A total of 15 RCTs involving 1 364 patients were included， involving Salvia miltiorrhiza injection， Puerarin injection， Yiqi fumai injection， Xuebijing injection， Shenfu injection， Shuxuetong injection， Salvia miltiorrhiza and ligustrazine injection， Rhodiola wallichiana injection， Danhong injection. Results of Meta-analysis showed that in the aspect of improving total response rate of ECG， 8 kinds of intervention measures were involved；compared with control group， 7 kinds of intervention measures could improve the total response rate of ECG of trial group except for Shenfu injection （P＞0.05）； network Meta-analysis ranking showed that S. miltiorrhiza injection＞Puerarin injection＞Shenfu injection＞S. miltiorrhiza and ligustrazine injection＞Shuxuetong injection＞R. wallichiana injection＞ Danhong injection＞routine treatment. In terms of reducing adverse cardiovascular events （MACE） incidence，8 kinds of intervention measures were involved； compared with control group， 7 kinds of intervention measures could reduce the MACE incidence of trial group except for Puerarin injection （P＞0.05）； network Meta-analysis ranking showed that S. miltiorrhiza and ligustrazine injection＞Danhong injection＞Xuebijing injection＞Shuxuetong injection＞S. miltiorrhiza injection＞R. wallichiana injection＞ Puerarin injection＞routine treatment. In terms of improving left ventricular ejection fraction （LVEF） after treatment， 8 kinds of intervention measures were involved； compared with control group， 7 intervention measures could significantly improve LVEF after treatment of trial group except for R. wallichiana injection (P＞0.05）； network Meta-analysis ranking showed that S. miltiorrhiza and ligustrazine injection＞Yiqi fumai injection＞Danhong injection＞Shenfu injection＞S. miltiorrhiza injection＞Shuxuetong injection＞R. wallichiana injection＞routine treatment. CONCLUSIONS： Compared with routine treatment， S. miltiorrhiza injection is the best in improving total response rate of ECG； S. miltiorrhiza and ligustrazine injection is the best in reducing MACE incidence and improving LVEF after treatment.

The survival prediction model of advanced gallbladder cancer based on Bayesian network: a multi-institutional study / 中华外科杂志

Objective@#To investigate the clinical value of Bayesian network in predicting survival of patients with advanced gallbladder cancer(GBC)who underwent curative intent surgery.@*Methods@#The clinical data of patients with advanced GBC who underwent curative intent surgery in 9 institutions from January 2010 to December 2015 were analyzed retrospectively.A median survival time model based on a tree augmented naïve Bayes algorithm was established by Bayesia Lab software.The survival time, number of metastatic lymph nodes(NMLN), T stage, pathological grade, margin, jaundice, liver invasion, age, sex and tumor morphology were included in this model.Confusion matrix, the receiver operating characteristic curve and area under the curve were used to evaluate the accuracy of the model.A priori statistical analysis of these 10 variables and a posterior analysis(survival time as the target variable, the remaining factors as the attribute variables)was performed.The importance rankings of each variable was calculated with the polymorphic Birnbaum importance calculation based on the posterior analysis results.The survival probability forecast table was constructed based on the top 4 prognosis factors. The survival curve was drawn by the Kaplan-Meier method, and differences in survival curves were compared using the Log-rank test.@*Results@#A total of 316 patients were enrolled, including 109 males and 207 females.The ratio of male to female was 1.0∶1.9, the age was (62.0±10.8)years.There was 298 cases(94.3%) R0 resection and 18 cases(5.7%) R1 resection.T staging: 287 cases(90.8%) T3 and 29 cases(9.2%) T4.The median survival time(MST) was 23.77 months, and the 1, 3, 5-year survival rates were 67.4%, 40.8%, 32.0%, respectively.For the Bayesian model, the number of correctly predicted cases was 121(≤23.77 months) and 115(>23.77 months) respectively, leading to a 74.86% accuracy of this model.The prior probability of survival time was 0.503 2(≤23.77 months) and 0.496 8(>23.77 months), the importance ranking showed that NMLN(0.366 6), margin(0.350 1), T stage(0.319 2) and pathological grade(0.258 9) were the top 4 prognosis factors influencing the postoperative MST.These four factors were taken as observation variables to get the probability of patients in different survival periods.Basing on these results, a survival prediction score system including NMLN, margin, T stage and pathological grade was designed, the median survival time(month) of 4-9 points were 66.8, 42.4, 26.0, 9.0, 7.5 and 2.3, respectively, there was a statistically significant difference in the different points(P<0.01).@*Conclusions@#The survival prediction model of GBC based on Bayesian network has high accuracy.NMLN, margin, T staging and pathological grade are the top 4 risk factors affecting the survival of patients with advanced GBC who underwent curative resection.The survival prediction score system based on these four factors could be used to predict the survival and to guide the decision making of patients with advanced GBC.

Bayesian Network Meta-analysis of Somatostatin and Protease Inhibitors for the Prevention of Post-ERCP Pancreatitis and Hyperamylase / 中国药房

OBJECTIVE:To evaluate the clinical efficacy of somatostatin and protease inhibitors in the prevention of post-ERCP pancreatitis(PEP)and hyperamylasemia(PEHA). METHODS:Retrieved from databases as Cochrane Library, PubMed,Embase,RCTs about therapeutic efficacy of somatostatin and protease inhibitors in the prevention of PEP were included. EndNote X8 software was used to eliminate duplicate documents,and the quality of included studies was evaluated according to Cochrane System Evaluator Manual version 5.3.3. Bayesian network Meta-analysis was conducted by MCMC method with R 3.4.3 software Gemtc 0.8 program package. Risk of bias was evaluated by using Rev Man 5.3 software,and risk of publication was evaluated by using Stata 14.0 software draws funnel map. RESULTS:A total of 33 RCTs were included,involving 10 576 patients,somatostatin,gabexate,ulinastatin,nafamostat. Network Meta-analysis showed that in the prevention of PEP,the order of curative effect was as follows:somatostatin(intravenous bolus)>nafamostat>ulinastatin>somatostatin(high-dose intravenous drip)>gabexate,somatostatin(low-dose intravenous drip)was ineffective. In the prevention of PEHA,the order of probability being somatostatin(high-dose intravenous drip)>somatostatin(intravenous bolus)>ulinastatin. Only nafamostat was effective in preventing PEP in high-risk patients. CONCLUSIONS:Compared with somatostatin(low-dose intravenous drip)and gabexate,somatostatin(intravenous bolus)and somatostatin(high-dose intravenous drip),ulinastatin,nafamostat can more effectively prevent PEP. Nafamostat cannot prevent PEHA,but can prevent PEP in high risk patients.

Incidence difference of cutaneous complications in different targeted drugs for treating malignant melanoma:a network Meta-analysis / 重庆医学

Objective To adopt the network meta analysis method to compare the incidence difference of cutaneous squamous-cell carcinoma(SCC)and rash in 5 kinds of targeted drugs regimen for treating malignant melanoma.Methods PubMed and Cochrane Library databases were retrieved by computer.The retrieval range was from their establishment to November 2015.The network meta analysis pooled the evidences of direct and indirect comparison for evaluating the pooled odds ratio(OR)and cumulative probability of cutaneous complications occurrence difference in 5 kinds of targeted drugs regimen for treating malignant melanoma.Results Six randomized controlled trials(RCTs)conforming to the inclusion criteria were included.The meta analysis results revealed that compared with Dabrafenib+Trametinib,the cutaneous SCC occurrence rate of Vemurafenib was higher(OR=9.20,95％CI=1.26-52.53),while the rash occurrence rate of Vemurafenib+Cobimetinib was higher(OR=6.81,95％CI=1.01-41.87).The surface under the cumulative ranking curves(SUCRA)value showed that adopting Trametinib had the lowest occurrence rate for SCC,and adopting Dabrafenib+Trametinib had the lowest occurrence rate of rash.Conclusion Dabrafenib+Trametinibis generate the lowest complication incidence rate of malignant melanoma.

Using the Tabu-search-algorithm-based Bayesian network to analyze the risk factors of coronary heart diseases / 中华流行病学杂志

Under the available data gathered from a coronary study questionnaires with 10 792 cases,this article constructs a Bayesian network model based on the tabu search algorithm and calculates the conditional probability of each node,using the Maximum-likelihood.Pros and cons of the Bayesian network model are evaluated to compare against the logistic regression model in the analysis of coronary factors.Applicability of this network model in clinical study is also investigated.Results show that Bayesian network model can reveal the complex correlations among influencing factors on the coronary and the relationship with coronary heart diseases.Bayesian network model seems promising and more practical than the logistic regression model in analyzing the influencing factors of coronary heart disease.