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OBJECTIVE To provide a detailed report and interpretation of the method and results for determining the weights of the technical indicators from the “multi-dimensional and multi-criteria comprehensive evaluation index system （first edition）” stated in Guideline for Multi-dimensional and Multi-criteria Comprehensive Evaluation of Chinese Patent Medicine. METHODS Normalization calculations were performed on the comprehensive weight values calculated by the analytic hierarchy process and expert weighting method to obtain the objective weights of the indicators. RESULTS The weight results of the six primary dimensions in the current comprehensive evaluation indicator system of Chinese patent medicine showed effectiveness dimension＞ safety dimension＞standard dimension＞application dimension＞scientific dimension＞economic dimension， with weight values of 0.281 0， 0.268 5， 0.195 8， 0.107 3， 0.096 1 and 0.051 3 respectively， consistent with the results of most researches currently. CONCLUSIONS The process of weight determination in this indicator system is scientifically reasonable， with clear methods and clear interpretations， and is worthy of further optimization and widespread application.
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The weight coefficients of appearance traits, extract yield of standard decoction, and total content of honokiol and magnolol were determined by analytic hierarchy process(AHP), criteria importance though intercrieria correlation(CRITIC), and AHP-CRITIC weighting method, and the comprehensive scores were calculated. The effects of ginger juice dosage, moistening time, proces-sing temperature, and processing time on the quality of Magnoliae Officinalis Cortex(MOC) were investigated, and Box-Behnken design was employed to optimize the process parameters. To reveal the processing mechanism, MOC, ginger juice-processed Magnoliae Officinalis Cortex(GMOC), and water-processed Magnoliae Officinalis Cortex(WMOC) were compared. The results showed that the weight coefficients of the appearance traits, extract yield of standard decoction, and total content of honokiol and magnolol determined by AHP-CRITIC weighting method were 0.134, 0.287, and 0.579, respectively. The optimal processing parameters of GMOC were ginger juice dosage of 8%, moistening time of 120 min, and processing at 100 ℃ for 7 min. The content of syringoside and magnolflorine in MOC decreased after processing, and the content of honokiol and magnolol followed the trend of GMOC>MOC>WMOC, which suggested that the change in clinical efficacy of MOC after processing was associated with the changes of chemical composition. The optimized processing technology is stable and feasible and provides references for the modern production and processing of MOC.
Subject(s)
Zingiber officinale , Magnolia/chemistry , Drugs, Chinese Herbal/chemistry , Biphenyl Compounds/chemistry , Lignans/chemistryABSTRACT
Objective:To investigate the treatment efficacy of adjuvant anti-VEGF/VEGFR targeted therapy in patients with non-metastatic (cM 0) non-clear cell renal cell carcinoma and tumor thrombus (nccRCC-VTT). Methods:This retrospective study enrolled 26 patients who underwent radical nephrectomy combined with inferior vena cava tumor thrombectomy at Peking University Third Hospital from January 2014 to July 2021. Patients were divided into adjuvant therapy group (10 cases) and control group (16 cases)based on the use of postoperative targeted therapy. The distribution of baseline clinical characteristics in the adjuvant therapy group and the control group were as follows: gender (6 males and 4 females in the adjuvant therapy group, 12 males and 4 females in the control group, P=0.66), age (56.2±18.5 years old in the adjuvant therapy group; 54.6±14.5 years old in the control group; P=0.80), BMI(24.0±3.5 in the adjuvant therapy group; 24.3±3.3 in the control group; P=0.80), presence of clinical symptoms (8 cases in the adjuvant therapy group; 15 cases in the control group; P=0.54), tumor laterality(6 cases on the left and 4 cases on the right in the adjuvant therapy group; 6 cases on the left and 10 cases on the right in the control group; P=0.42), location of tumor thrombus (2 cases with renal vein tumor thrombus and 8 cases with inferior vena cava tumor thrombus in the adjuvant therapy group; 2 cases with renal vein tumor thrombus and 14 cases with inferior vena cava tumor thrombus in the control group; P=0.67), ASA classification (2 cases in ASA class 1 and 8 cases in ASA class 2 in the adjuvant therapy group; 2 cases in ASA class 1 and 14 cases in ASA class 2 in the control group; P=0.63), surgical approach (7 minimally invasive surgeries and 3 open surgeries in the adjuvant therapy group; 9 minimally invasive surgeries and 7 open surgeries in the control group; P=0.68), conversion to open surgery (2 cases in the adjuvant therapy group; 2 cases in the control group; P=0.63), operation time [287.5(222.2, 456.0) minutes in the adjuvant therapy group; 344.0(287.8, 482.5) minutes in the control group; P=0.34), blood loss [400.0(250.0, 600.0)ml in the adjuvant therapy group; 575.0(175.0, 800.0)ml in the control group; P=0.63), Clavien-Dindo classification of postoperative complications (8 cases with no postoperative complications, 2 cases with level 1-2 complications, and 0 cases with level ≥3 complications in the adjuvant therapy group; 10 cases with no postoperative complications, 4 cases with level 1-2 complications, and 2 cases with level ≥3 complications in the control group; P=0.68), postoperative hospital stay (8.5 [5.5, 11.5] days in the adjuvant therapy group; 7.5 [6.0, 13.0] days in the control group; P=1.00), maximum tumor diameter[ (9.2±2.7)cm in the adjuvant therapy group; (8.9±3.3)cm in the control group; P=0.81], sarcomatoid differentiation (0 cases in the adjuvant therapy group; 1 case in the control group; P=1.00), perinephric fat invasion (2 cases in the adjuvant therapy group; 7 cases in the control group; P=0.40), tumor necrosis (6 cases in the adjuvant therapy group; 5 cases in the control group; P=0.23), pathological subtype (1 case of PRCC type 1, 6 cases of PRCC type 2, and 3 cases of TFE3 rearrangement RCC in the adjuvant therapy group; 2 cases of PRCC type 1, 10 cases of PRCC type 2, and 1 case each of oncocytic PRCC, TFE3 rearrangement RCC, FH-deficient RCC, and unclassified RCC in the control group; P=0.72), WHO/ISUP nuclear grade (10 cases of grades 3-4 in the adjuvant therapy group; 4 cases of grades 1-2 and 12 cases of grades 3-4 in the control group; P=0.14), invasion of tumor thrombus into the vessel wall (5 cases in the adjuvant therapy group; 5 cases in the control group; P=0.43), T stage (1 case of T 3a, 3 cases of T 3b, 5 cases of T 3c, and 1 case of T 4 in the adjuvant therapy group; 1 case of T 3a, 4 cases of T 3b, 10 cases of T 3c, and 1 case of T 4 in the control group; P=1.00), and positive lymph nodes metastasis(3 cases in the adjuvant therapy group; 0 cases in the control group; P<0.05). The recommended doses for sunitinib, axitinib, and pazopanib are 50mg qd, 5mg q12h, and 800mg qd, respectively. The primary endpoint of this study was disease-free survival (DFS), and the secondary endpoint was overall survival (OS). Statistical analyses were performed using R v4.2.2. Confounding factors were adjusted using propensity score weighting. Results:The median follow-up time for DFS was 29 months in the adjuvant therapy group and not reached in the control group, while median follow-up time for OS was 28 and 26 months, respectively. In the univariate Cox regression analysis, there were no statistically significant difference in the impact of all baseline characteristics and exposure factors on DFS and OS between the two groups. In survival analysis, there were no significant difference between DFS and OS curves of patients in the adjuvant therapy group and the control group (DFS, P=0.62; OS, P=0.74). The median DFS of patients in the adjuvant therapy group and the control group were 17 and 19 months, respectively, while the median OS was 43 and 27 months. After adjusting for confounding factors, the median DFS of patients in the adjuvant therapy group and the control group were 26 and 12 months, respectively, and the median OS remained 43 and 27 months, with no significant difference (DFS, P=0.81; OS, P=0.40). Conclusion:There is currently a lack of definitive evidence for survival benefit from adjuvant anti-VEGF/VEGFR targeted therapy in patients with cM0 nccRCC-VTT after surgery.
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Objective To quantitatively analyze the risk indicators of re-introduction of imported malaria in China and their weighting coefficients, so as to investigate the difference in the contribution of risk indicators included in the current risk assessment framework for re-introduction of imported malaria in China to the risk assessment of re-introduction of imported malaria. Methods Publications pertaining to the risk assessment framework for re-introduction of imported malaria in China that reported the risk indicators and their weighting coefficients were retrieved in PubMed, Web of Science, CNKI, Wanfang Data, and VIP with terms of “malaria”, “re-introduction/re-transmission/re-establishment”, “risk assessment/risk evaluation/risk prediction” from the inception of the database through 3 August 2023, and literature search was performed in Google Scholar to ensure the comprehensiveness of the retrieval. Basic characteristics of included studies were extracted using pre-designed information extraction forms by two investigators, and data pertaining to risk indicators of re-introduction of imported malaria were cross-checked by these two investigators. The risk indicators included in the risk assessment framework for re-introduction of imported malaria in China and their weighting coefficients were visualized with the Nightingale’s rose diagrams using the software R 4.2.1, and the importance of risk indictors was evaluated with the frequency of risk indicators included in the risk assessment framework and the ranking of weighting coefficients of risk indicators. In addition, the capability of risk indicators screened by different weighting methods was compared by calculating the ratio of the maximum to the minimum of the weighting coefficients of the risk indicators screened by different weighting methods. Results A total of 2 138 publications were retrieved, and following removal of duplications and screening, a total of 8 publications were included in the final analysis. In these 8 studies, 8 risk assessment frameworks for re-introduction of imported malaria in China and 52 risk indicators of re-introduction of imported malaria were reported, in which number of imported malaria cases (n = 8) and species of malaria vectors were more frequently included in the risk assessment frameworks (n = 8), followed by species of imported malaria parasites (n = 6) and population density of local malaria vectors (n = 6), and species of local malaria vectors (n = 6), number of imported malaria cases (n = 5) and species of imported malaria parasites had the three highest weighting coefficients (n = 4). The weighting methods included expert scoring method, combination of expert scoring method and analytic hierarchy process, and combination of expert scoring method and entropy weight method in these 8 studies, and the ratios of the maximum to the minimum of the weighting coefficients of the risk indicators screened by the expert scoring method were 1.143 to 2.241, while the ratios of the maximum to the minimum of the weighting coefficients of the risk indicators screened by combination of the expert scoring method and analytic hierarchy process were 34.970 to 162.000. Conclusions Number of imported malaria cases, species of imported malaria parasites, species of local malaria vectors and population density of local malaria vectors are core indicators in the current risk assessment framework for re-introduction of imported malaria in China. Combination of the expert scoring method and analytic hierarchy process is superior to the expert scoring method alone for weighting the risk indicators.
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Background Few studies have investigated the association between air pollution and arterial stiffness in Chinese population, and the findings are inconsistent. The problem of multicollinearity exists when modeling multiple air pollutants simultaneously. Objective To investigate potential association between air quality index (AQI) and population brachial-ankle pulse wave velocity (baPWV) in Beijing. Methods This study retrieved medical examination data of 2971 participants from the Beijing Health Management Cohort, who were under 60 years old and not yet retired, from January 1, 2015 to December 31, 2019. The most recent medical examination data available were utilized for this analysis. AQI data from 35 air pollution monitoring sites in Beijing and meteorological data (including atmospheric pressure, air temperature, wind speed, and relative humidity) from 16 meteorological monitoring stations from January 1, 2014 to December 31, 2019 were collected. An average AQI exposure level for 365 d before the date of physical examination for each participant was computed using inverse distance weighting. Multiple linear regression analysis was employed to investigate the relationship between AQI and baPWV in Beijing, after adjusting for confounding variables including age, gender, body mass index, mean arterial pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting blood glucose, atmospheric pressure, temperature, wind speed, relative humidity, medication history of diabetes, medication history of hypertension, cardiovascular disease, education, smoking status, drinking status, and physical activity intensity. Subgroup analysis was performed by age, sex, presence of diabetes, and presence of hypertension. Results AQI demonstrated an overall decreasing trend during the study period and was lower in the northern regions and higher in the southern regions of Beijing. After adjusting the confounding variables, each 10 unit increase in AQI was associated with 6.18 (95%CI: 1.25, 11.10) cm·s−1 increase in baPWV in all participants, 8.05 (95%CI: 2.32, 13.79) cm·s−1 increase in the participants <50 years, 15.82 (95%CI: 8.33, 23.31) cm·s−1 increase in the female group, 10.10 (95%CI: 4.66, 15.55) cm·s−1 increase in the participants without diabetes, and 9.41 (95%CI: 4.21, 14.62) cm·s−1 increase in the participants without hypertension. However, there was no statistically significant association observed between AQI and baPWV in the age group ≥50 years, the male group, the diabetic group, and the hypertensive group (P>0.05). Conclusion An increase in long-term AQI levels is associated with an elevation in the degree of arterial stiffness. Individuals under 50 years old, females, without hypertension or diabetes are susceptible populations to arterial stiffness when being exposed to air pollution. Improving air quality may contribute to prevent arterial stiffness.
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RESUMEN La crisis del COVID-19, sus implicaciones socio jurídicas, se abordan mediante su incidencia en los derechos humanos, consecuencia del Estado de emergencia dictado en Colombia en el año 2020, para el resguardo del derecho a la salud, pero generando a su vez una situación de conflictos entre diversos tipos de derechos. El trabajo constituye una reflexión sustentada en una investigación bibliográfica mediante la indagación documental sobre decisiones del poder ejecutivo y de la corte constitucional que ejercen su control, referentes a la regulación jurídica de la pandemia del COVID-19 en Colombia, además de la normativa constitucional y legal y la doctrina referida a la temática. El objetivo es demostrar como la hermenéutica constitucional, mediante los principios de proporcionalidad, ponderación y el contenido esencial, es capaz de fomentar una mayor cultura de los derechos humanos, debido a que estos lineamientos interpretativos pueden ser comprendidos por la ciudadanía mediante una labor que abarque la educación, con el concurso no solo de abogados sino también de maestros, sociólogos, ONG, entre otros.
ABSTRACT The COVID-19 crisis, its socio-legal implications, are addressed through its impact on human rights, as a consequence of the State of Emergency issued in Colombia in 2020, to protect the right to health, but generating in turn a situation of conflicts between different types of rights. The work constitutes a reflection based on a bibliographical investigation through documentary research on decisions of the executive power and the constitutional court that exercise their control, referring to the legal regulation of the COVID-19 pandemic in Colombia, in addition to the constitutional regulations and legal and the doctrine referred to the subject. The objective is to demonstrate how constitutional hermeneutics, through the principles of proportionality, weighting and essential content, is capable of promoting a greater culture of human rights, because these interpretative guidelines can be understood by citizens through work that encompasses education, with the participation not only of lawyers but also of teachers, sociologists, NGO, among others.
RESUMО A crise da COVID-19 e suas implicações sócio-legais são abordadas através de seu impacto nos direitos humanos, conseqüência do Estado de Emergência ditado na Colômbia no ano 2020, para salvaguardar o direito à saúde, mas ao mesmo tempo gerando uma situação de conflito entre diferentes tipos de direitos. O trabalho constitui uma reflexão baseada em uma pesquisa bibliográfica através de pesquisa documental sobre decisões do poder executivo e do tribunal constitucional que exercem seu controle, referindo-se à regulamentação legal da pandemia da COVID-19 na Colômbia, além da regulamentação constitucional e legal e da doutrina sobre o assunto. O objetivo é demonstrar como a hermenêutica constitucional, através dos princípios de proporcionalidade, ponderação e conteúdo essencial, é capaz de promover uma maior cultura de direitos humanos, visto que estas diretrizes interpretativas podem ser compreendidas pelos cidadãos através da educação, com a ajuda não só de advogados, mas também de professores, sociólogos, ONGs, entre outros.
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Background The association between serum nickel (Ni) and oral cancer incidence is unclear and most of the previous studies were observational studies that did not control for confounding factors between groups. Objective To assess the correlation of serum Ni with oral cancer incidence based on propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Methods A cohort of 456 newly diagnosed oral cancer patients was recruited from the First Hospital of Fujian Medical University during November 2011 to May 2019, and residents ordered their health check-up in hospitals or local community health centers over the same period were selected as a control group, which included a total of 1410 participants. Serum Ni was evaluated by inductively coupled plasma mass spectrometry. Case-control pairs were selected using a 1:1 PSM (caliper value of 0.02), and the study subjects in the case group and control group were weighted for subsequent analysis by IPTW. The general characteristics of the study subjects were tested for equilibrium before and after matching by chi-square test and standardized mean difference (SMD). This was followed by exploring the potential nonlinear dose-response relationship between serum Ni and oral cancer using restricted cubic splines as well as analyzing the association between serum Ni and oral cancer incidence by conditional logistic regression and weighted logistic regression. Results After controlling for between-group covariates by PSM and IPTW, the dose-response curves demonstrated that the risk of developing oral cancer tended to decline and then increase with the increasing serum Ni level. The outcome of the analysis using PSM demonstrated that as compared to the control group, the risk of developing oral cancer in the 0.09-16.80 μg·L−1 serum Ni group was negatively correlated with serum Ni level (OR=0.36, 95%CI: 0.24-0.54), whereas the risk of developing oral cancer in the >16.80 μg·L−1 serum Ni group was positively correlated with serum Ni level (OR=5.43, 95%CI: 2.76-10.68). After applying IPTW, a negative association was found between the risk of oral cancer and serum Ni concentration within a serum Ni window ranging from 0.09 to 20.55 μg·L−1 (OR=0.39, 95%CI: 0.29-0.52), while a positive association with an OR and 95%CI of 5.54 (3.62-8.49) for the Ni concentration > 20.55 μg·L−1. Conclusion In this study, a J-shaped relationship between serum Ni concentration and the risk of developing oral cancer is found, which shows that high serum Ni concentration (>20.55 μg·L−1) may be a risk factor for oral cancer.
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Objective:To investigate the association of metabolic syndrome(MS) with cardiovascular disease(CVD) mortality and all-cause mortality in peritoneal dialysis patients.Methods:A retrospective analysis was performed on patients who underwent peritoneal dialysis from January 1, 2013 to July 31, 2021 in the Shaoxing People′s Hospital. Patients were divided into MS group and non-MS group. The differences in baseline biochemical variables, comorbidities, and clinical outcomes between the two groups were compared. Kaplan-Meier method was used to obtain survival curves, the Cox regression model was used to evaluate the influence of MS for survival rates, and the inverse probability of treatment weighting(IPTW) was used to eliminate influence of the confounders in the groups.Results:A total of 494 peritoneal dialysis patients were enrolled in this study, which were divided into MS group( n=266) and non-MS group( n=228). The total median follow-up time was(31±22) months. At baseline, the standard mean difference( SMD) in smoking history, drinking history, CVD history, prevalence of chronic glomerulonephritis, left ventricular ejection fraction, B-type natriuretic peptides, hemoglobin, blood calcium, hypersensitive C-reactive-protein, intact parathyroid hormone, ultrafiltration and 4 h dialysate/plasma creatinine in the two groups were greater than 0.1. Their SMD decreased to under 0.1 after IPTW, showing a good balance between the two groups. The analysis of the survival curve of Kaplan Meier showed that the cumulative survival rate and cumulative CVD survival rate in MS group were significantly lower than those in non-MS group before and after IPTW( P<0.05). After IPTW was used to eliminate the effect of confounders, multivariate Cox regression analysis still displayed that MS was an independent risk factor for all-cause mortality( HR=1.824, 95% CI 1.121-2.968, P=0.015) and CVD mortality( HR=2.470, 95% CI 1.324-4.609, P=0.004)in peritoneal dialysis patients. Conclusion:The prevalence of metabolic syndrome is high in peritoneal dialysis patients. MS is an independent risk factor for all-cause mortality and CVD mortality in peritoneal dialysis patients.
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OBJECTIVE To study the quality grade stand ard of the premature Forsythia suspensa . METHODS A total of 138 batches of premature F. suspensa were collected from the main producing areas of F. suspensa in China. According to 2020 edition of Chinese Pharmacopoeia ，the contents of impurities ，moisture，ethanol-soluble extract ，volatile oil ，forsythin and forsythoside A in the premature F. suspense were determined ，and the qualified samples were screened. AHP-PCA mixed weighting method was used to give comprehensive weight to the indicators （except for the limit of impurity ）. The comprehensive score of the samples was calculated. The suggestions on the quality grade division of premature F. suspensa were put forward according to cluster analysis of K-mean value. RESULTS & CONCLUSIONS The contents of impurities ，moisture，ethanol-soluble extract ，volatile oil ，forsythin and forsythoside A in the premature F. suspense were 0-7.80％，1.60％-8.18％，13.13％-61.60％，0.21％-3.47％，0.02％-2.15％ and 0.79％-14.04％，respectively；average contents of them were 1.24％，4.97％，34.88％，2.01％，0.42％，6.86％，respectively. Totally 47 batches of 138 batches were qualified in all indexes. It is suggested that the quality grade of the premature F. suspense can be divided into three grades ：in first grade of F. suspense ，the contents of volatile oil ，forsythin，forsythoside A ， ethanol-soluble extract and moisture were ≥2.40％，≥0.59％，≥8.34％，≥38.66％ and ≤4.99％，respectively；in second grade of F. suspense ，the contents of above indicators were ≥2.26％，≥0.41％，≥7.47％，≥32.58％ and ≤5.33％，respectively；in third grade of F. suspense ，the contents of above indicators were ≥2.15％，≥0.32％，≥4.60％，≥31.52％ and≤7.23％，respectively.
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OBJECTIVE To identify and evaluate the risk factors in the operation process of the vaccine supply chain ，clarify the importance of each process risk in the overall risk of the vaccine supply chain ，and provide reference for stakeholders in the vaccine supply chain to formulate risk management and control strategies. METHODS In the supply chain operation reference model，the risk factors existing in the operation of vaccine supply chain were identified ，and the vaccine supply chain risk evaluation index system was constructed. The best-worst method and entropy weight method were used to determine the subjective and objective weight of the index ，and the Lagrange multiplier method was used to solve the optimal combination weight value of the index. RESULTS & CONCLUSIONS A vaccine supply chain risk evaluation index system with 18 indexes was established. Only 67％ of the indexes reflected 85％ of the vaccine supply chain risk information. The construction of the system was reasonable. The results showed that the risk weight of production process was 0.607，which accounts for the highest weight in the overall risk of vaccine supply chain ，followed by procurement （0.234），distribution（0.102），planning（0.053）and return （0.004） process risk . When managing and controlling risks ，enterprises should attach great importance to the risk factors in vaccine production；at the same time ，enterprises should also focus on other risks such as unqualified materials for products ，mixed use of materials and so on.
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OBJECTIVE：To management recheck and sorting weight for finished intravenous solutions in PIVAS ，to provide reference for reducing dispensing error and improving the safety and quality of intravenous infusion therapy. METHODS ：The weight analysis method was used to determine the weight of main drug and solvent in the finished intravenous solutions and infusion bottle . The weight maintenance information was added in PIVAS information management system ，and the marked weight of finished intravenous solutions was calculated for the verification of finished intravenous solutions. Average daily check quantity of finished product ，checking time ，average checking time of finished products per bag ，detection rate of dispensing error ，external error and timeliness of finished infusion batch were compared before （Mar.-May，2019，n＝83 006）and after （Jun.-Aug.，2019， n＝83 173）management. The effects of weighting recheck management were evaluated. RESULTS ：Compared with before the implementation of weighting recheck management ，there were no significant differences in the average daily check quantity of finished products ，the detection rate of dispensing errors caused by wrong labeling of liquid ，or the times of delayed drug delivery batches after the implementation of weighting recheck management （P＞0.05）. The checking time of finished products ，average checking time of finished products per bag ，the number of bags added or subtracted error ，detection rate of dose dispensing error ， total error detection rate prolonged or increased significantly （P＜0.05），and the number of external error was decreased significantly（P＜0.05）. CONCLUSIONS ：The weighting recheck management improves the accuracy and safety of PIVAS preparation，effectively improves error detection rate ，reduces the occurrence of external error ，but prolongs the time of checking ， which are urgent to be solved by information and automation means.
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OBJECTIVE：To provide refere nce f or the quality control and evaluation of rice-wine processed Coptidis Rhizoma decoction piece. METHODS ：Taking 17 batches of rice-wine processed Coptidis Rhizoma decoction piece from different manufacturers as samples ，HPLC method was adopted to determine the contents of 4 kinds of alkaloids as epiberberine ，coptisine， palmatine and berberine. The compound weights of epiberberine ，berberine，palmatine and berberine were calculated by the subjective and objective combination weighting method （AHP combined with variation coefficient ）. Then the quality evaluation method was used to evaluate the quality of decoction pieces combined with the appearance of decoction pieces and the contents of 4 alkaloids. The percent mass constant was calculated and the grade of rice-wine processed Coptidis Rhizoma decoction piece was classified. RESULTS ：According to the results of content determination of 4 kinds of alkaloids ，among 17 batches of samples ，a total of 13 batches of samples met the requirements of 2015 edition of Chinese Pharmacopoeia （part Ⅳ）. Mass constants of 13 batches of qualified samples were 10.03-26.96，and the percent mass constants were 37.20％-100％. If the percent mass constant ≥ 80％ of the sample was listed as the first-class product ，the sample with the percent mass constant between 50％-＜80％ was classified as the second-class product ，and the rest was listed as the third-class product ，therefore the quality constant of first-class product was ≥21.57，that of second-class product was 13.48-＜21.57，and that of third-class product was ＜13.48. According to the grading standard ，3 batches of 13 batches of qualified samples are classified as first-class products ，6 batches are classified as second-class products ，4 batches are classified as third-class products. CONCLUSIONS ：The established subjective and objective combination weighting method and quality constant method can more scientifically and reasonably classify rice-wine processed Coptidis Rhizoma decoction piece.
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OBJECTIVE：To optimize the extraction technology of Senecio scandens ，and to provide reference for the further development and utilization of the medicinal material. METHODS ：The method of reflux extraction with 80 ℃ water bath was used to extract S. scandens . HPLC method was adopted to determine the contents of chlorogenic acid and hyperoside. The determination was performed on Diamonsil C 18 with mobile phase consisted of 0.2％ glacial acetic acid water solution-methanol （82∶18，V/V）at the flow rate of 1.0 mL/min；the column temperature was set at 35 ℃；the detection wavelength was 327 nm，and the sample size was 5 μL. UV-Vis spectrophotometry was used to determine the contents of total flavonoids（by rutin ）and total alkaloids （by matrine）and the detection wavelengths were set at 509 nm and 208 nm，respectively. Based on single factor tests ，using ethanol volume fraction （A，％），solvent folds （B，mL/g），extraction time （C，h），extraction times （D，times）as factors ，using the contents of chlorogenic acid ，hyperoside，total flavonoids and total alkaloids as indexes ，and t he weight coefficients of above indicator components were calculated based on information entropy weighting method so as to calculate their comprehensive scores ， then L 9（34）orthogonal design was used to further optimize the extraction technology. The validation tests were also performed. RESULTS：The optimal extraction technology of S. scandens included that 8-fold 50％ ethanol，extracting for 3 times，lasting for 1.5 h each time. Results of 3 times of validation tests showed that RSDs of the contents of chlorogenic acid ，hyperoside，total flavonoids and total alkaloids were all lower than 1.5％（n＝3）. CONCLUSIONS ：The optimized technology is reproducible ， stable and feasible ，and can be used for the extraction of S. scandens .
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Background: Paucity of studies in world literature and lack of any Indian study assessing the frequency, prevalence and severity of minor physical anomalies (MPAs) in children with mental retardation (MR) as well as their importance for prediction and timely recognition of mental insufficiency, if any.Methods: A cross-sectional observational study involving 273 mentally retarded children aged 5-18 years was conducted over a period of one year and were compared with their age and sex matched controls. Waldrop and Halverson (1971) physical anomaly scale was used to assess those MPAs.Results: In the study group, higher percentage (79.85% vs. 40.29%) of children had MPAs with a predominance of multiple MPAs in comparison to healthy children (40.29% and 0%, respectively). Higher average frequency of MPAs per child was noted in the study group (1.42) than control group (0.40). Mean Waldrop weighting score was significantly higher among mentally retarded children than their controls (3.7'0.8 versus 0.8'0.2, P<0.0001). Authors noticed a gradual and significant decrease in Waldrop score with increase in intelligence quotient (IQ) [F=175.72, P<0.001]. A significant strong negative correlation between Waldrop score and IQ level (r=-0.89, P<0.001) was also observed. Out of eighteen variables of Waldrop score, seven were found as significant in binary logistic regression model for MR. Our model can explain 37.6% to 50.1% variability of the MR.Conclusions: MPAs are more prevalent in mentally retarded children than healthy children.' A clear-cut demarcation between these two groups is possible by the frequency of anomalies and the increased strength of their expression (i.e. their weighting scores).
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Objective: To optimize the extraction of total flavonoids from leaves of Psidium guajava. Methods: L9(34) orthogonal test was used to screen the optimal extraction technology of total flavonoids from leaves of P. guajava with ethanol concentration, solid-liquid ratio, extraction time, and extraction times as factors. The weight coefficient of the four evaluation indicators, including the yield of total flavonoids, hyperoside, quercetin-3-O-β-D-pyranarabinoside, and quercetin-3-O-α-L-furanarabinoside was calculated by information entropy weighting so as to calculate comprehensive score. We obtained the optimal technology by orthogonal analysis based on the comprehensive score. Results: The optimal extraction technology was that using 8-fold 70% ethanol water to extract 2 h for three times. The mean comprehensive score of the three batches was 0.142 1 and the RSD was 2.37%. Conclusion: The optimal extraction technology of total flavonoids from leaves of P. guajava was stable and feasible with high yield.
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OBJECTIVE： To optimize the water extraction technology of Bupi yangshen granules， and to provide basis for the follow-up research and development of it. METHODS： The contents of astragaloside Ⅳ and salvianolic acid B in water extract of Bupi yangshen granules， were determined by HPLC-ELSD and HPLC-DAD. Using the comprehensive score of contents of astragaloside Ⅳ and salvianolic acid B and extract yield as index， weight coefficient of indicators were determined by AHP， CRITIC and AHP-CRITIC mixed weighting method. L9（34） orthogonal test was used to optimize decoction time， water volume and decoction times in water extraction technology of Bupi yangshen granules. Validation test was also performed. RESULTS： The weight coefficient determined by AHP-CRITIC mixed weighting method was the most reasonable. The optimal extraction technology was decocting twice， adding 12-fold water， 1 h each time. The results of 3 times of validation test showed that the average contents of astragaloside Ⅳ and salvianolic acid B were 8.79， 609.50 mg （total amount of 121 g medicinal herbs extracted from whole prescription）， respectively. The average extract yield was 31.24％. Average comprehensive score was 96.59（RSD＝1.01％，n＝3）. CONCLUSIONS： The optimized water extraction technology is reproducible， stable and feasible. It can provide a scientific basis for the follow-up development and industrial production of Bupi yangshen granules.
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Diseases such as diabetes and hypertension can lead to change the shape of the retinal blood vessels. Segmentation of fundus images is a key step in the process of quantitative analysis of the disease, which is instructive in the analysis and diagnosis of clinical diseases. In this paper, a method for the segmentation of retinal image vessels based on fully convolutional network (FCN) with depthwise separable convolution and channel weighting is presented. Firstly, CLAHE and Gamma correction of the green channel of the fundus image are used to enhance the contrast. Then, in order to adapt to network training, the enhanced image is divided into patches to expand the data. Finally, the depthwise separable convolution instead of the standard convolution method is used to increase the network width. Meanwhile, the channel weighting module is introduced to explicitly model the relationship between the characteristic channels in order to improve the distinguishability of the features. The combination of them is applied to the FCN and the results of expert manual identification are used to supervise the experiment on the DRIVE database. The results show that the segmentation accuracy of the proposed method in DRIVE database reached 0.963 0 and AUC reached 0.983 1. The segmentation accuracy in STARE database reached 0.962 0 and AUC achieved 0.983 0. To some extent, the proposed method has better feature resolution and better segmentation performance.
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Objective To estimate the absorbed dose and effective dose to the examined adult patients during digital tomosynthesis and to provide reference data for radiation dosimetry.Methods The phantom experiments were grouped according to the examined site(main beam scanned site),and the data displayed in real time during digital tomosynthesis are used as conditions for the phantom experiments.The effective doses to the examined patients were estimated on the basis of phantom scanning and tissue-absorbed dose calculation.Results During digital tomosynthesis,the effective doses to the examined patients of various groups were 0.524 mSv for head,0.736 mSv for cervical spine,2.719 mSv for thoracic vertebra,1.810 mSv for chest,1.240 mSv for lumbar spine,2.317 mSv for abdomen and 2.316 mSv for pelvis,respectively.Conclusions During digital tomography,the highest value of effective doses was estimated to be 2.719 mSv in thoracic vertebra group,followed by abdominal group 2.317 mSv and pelvic group 2.316 mS,with the lowest 0.524 mSv in head group.The main factors influencing the effective dose include tube voltage,total mAs,irradiation field size,main beam irradiation range,and the number of tissues or organs in scanned range.
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Near-infrared spectroscopy ( NIR ) is widely used in the area of food quantitative and qualitative analysis.Variable selection technique is a critical step of the spectrum modeling with the development of chemometrics.In this study, a novel variable selection strategy, automatic weighting variable combination population analysis (AWVCPA), was proposed.Firstly, binary matrix sampling (BMS) strategy that gives each variable the same chance to be selected and generates different variable combinations, was used to produce a population of subsets to construct a population of sub-models.Then, the variable frequency ( Fre) and partial least squares regression ( Reg) , which were two kinds of information vector ( IVs) were weighted to obtain the value of the contribution of each spectral variables, the influence of two IVs of Rre and Reg was considered to each spectral variable.Finally, it used the exponentially decreasing function ( EDF) to remove the low contribution wavelengths so as to select the characteristic variable.In the case of near infrared spectrum of beer and corn, the prediction model based on partial least squares ( PLS ) was established.Compared with other variable selection methods, the research showed that AWVCPA was the best variable selection strategy in the same situation.It had 72.7% improvement compared AWVCPA-PLS with PLS and the predicted root mean square error (RMSEP) decreased from 0.5348 to 0.1457 on beer dataset.It had 64.7% improvement compared AWVCPA-PLS with PLS and the RMSEP decreased from 0.0702 to 0.0248 on corn dataset.
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Objective In observational studies or non-randomized design,the researchers' ability to make causal inferences from data was hampered by confounding factors.This study used this method to analyze a group of observational medical data in order to instruct relevant medical personnel to carry out their own causal inference studies.Methods At present,the four main types of propensity scoring methods:matching,stratification,inverse probability weighting and covariate adjustment have been widely used in the study of causal inference.Propensity score method can theoretically eliminate the bias of the observable confounding factors,so that the treatments variables are close to the result of random assignment design,thus,it is estimated that the treatment factor has a causal effect on the outcome.Results Considering the advantages of the inverse probability weighting method over other methods,this paper summarizes the applicable conditions for the estimate of causal effect,particularly illustrates the use of a modern nonparametric statistical technology--Generalized Boosted Models (GBM) and its advantages and disadvantages.Conclusion When there is a lot of different types of confounding factors,and uncertain functional forms for their associations with treatment selection in linear,non-linear or interaction effect,and other issues,GBM propensity score weighting method can overcome the obstacles in the process of accurately estimating propensity score.