Human Breast Milk Exosomal miRNAs are Influenced by Premature Delivery and Affect Neurodevelopment.

SCOPE: This study investigates the exosomal microRNA (miRNA) profiles of term and preterm breast milk, including the most abundant and differentially expressed (DE) miRNAs, and their impact on neurodevelopment in infants. METHODS AND RESULTS: Mature milk is collected from the mothers of term and preterm infants. Using high-throughput sequencing and subsequent data analysis, exosomal miRNA profiles of term and preterm human breast milk (HBM) are acquired and it is found that the let-7 and miR-148 families are the most abundant miRNAs. Additionally, 23 upregulated and 15 downregulated miRNAs are identified. MiR-3168 is the most upregulated miRNA in preterm HBM exosome, exhibiting targeting activity toward multiple genes involved in the SMAD and MAPK signaling pathways and playing a crucial role in early neurodevelopment. Additionally, the effects of miR-3168 on neurodevelopment is confirmed and it is determined that it is an essential factor in the differentiation of neural stem cells (NSCs). CONCLUSION: This study demonstrates that miRNA expression in breast milk exosomes can be influenced by preterm delivery, thereby potentially impacting neurodevelopment in preterm infants.

Priming methods affected deterioration speed of primed rice seeds by regulating reactive oxygen species accumulation, seed respiration and starch degradation.

Introduction: Seed priming is a pre-sowing seed treatment that is beneficial for rice seed germination and seedling growth, but the reduced seed longevity after seed priming greatly limited its adoption. The deterioration of primed seeds showed large differences among different studies, and the priming method might play an important role in regulating the deterioration speed of primed seeds. However, whether and how the priming method affected the deterioration of primed rice seeds during storage remains unknown. Methods: In this study, two typical seed priming methods, namely hydropriming (HP) and osmopriming (PEG) were compared under artificially accelerated aging conditions, the changes in germination performance, starch metabolism, seed respiration and reactive oxygen species accumulation before and after accelerated aging were determined. Results and discussion: Hydroprimed rice seeds exhibited significantly faster deterioration speed than that of PEG-primed seeds in terms of germination speed and percentage. Meanwhile, α-amylase activity and total soluble sugar content in hydroprimed seeds were reduced by 19.3% and 10.0% respectively after aging, as compared with PEG-primed seeds. Such effects were strongly associated with the increased reactive oxygen generation and lipid peroxidation, as the content of superoxide anion, hydrogen peroxide and malondialdehyde in hydroprimed seeds were 4.4%, 12.3% and 13.7% higher than those in PEG-primed seeds after aging, such effect could be attributed to the increased respiratory metabolism in hydroprimed seeds. In addition, the simultaneous use of N-acetylcysteine with HP and PEG priming greatly inhibited the deterioration of primed rice seeds, suggesting that the ability to scavenge reactive oxygen species may be the key factor affecting the speed of deterioration in primed rice seeds during storage.

Explore the underlying oral efficacy of α-, ß-, γ-Cyclodextrin against the ulcerative colitis using in vitro and in vivo studies assisted by network pharmacology.

The incidence of ulcerative colitis (UC) is rising worldwide. As a refractory and recurrent disease, UC could seriously affect the patients' quality of life. However, current clinical medical treatments for UC are accompanied by various side effects, especially for long-term applications. Here, the underlying efficacy of cyclodextrins (CDs) was studied. As common excipients, CDs endow proven safety for long-term applications. Results of predictive methods derived from network pharmacology prompted the potential anti-inflammatory effects of CDs by oral administration. RAW264.7 cell experiments verified that CDs could inhibit the excessive secretion of TNF-α (ß-CD > α-CD ≈ γ-CD), IL-6, and NO (α-CD > ß-CD ≈ γ-CD) as predicted. In mice with DSS-induced acute UC, oral administration of CDs could effectively mitigate the pathological damage of colon tissue and reduce the level of inflammatory mediators. Moreover, 16S rRNA sequencing displayed that gut microbes disturbed by DSS were significantly regulated by CDs. Conclusively, the study showed the therapeutic application prospects of CDs in UC treatment and indicated the feasibility and advantages of developing 'new' therapeutic activities of 'old' ingredients.Communicated by Ramaswamy H. Sarma.

Simultaneous Application of Red and Blue Light Regulate Carbon and Nitrogen Metabolism, Induces Antioxidant Defense System and Promote Growth in Rice Seedlings under Low Light Stress.

The purpose of this study is to determine the effect of light quality on growth, carbon and nitrogen metabolism, and antioxidant defense system of rice seedlings. Six light conditions were employed, including white (W), red (R), blue (B), combined LED of R and B at 3:1 (R3B1), combined LED of R and B at 1:1 (R1B1), as well as combined LED of R and B at 1:3 (R1B3). Combined application of red light and blue light could promote the growth of rice seedling leaves and roots under low light stress to varying degrees, increase the photosynthetic area by increasing the leaf area, improve the root characteristics by increasing the root volume, and increase the dry matter accumulation of rice seedlings. In addition, the combination of red light and blue light could increase carbon and nitrogen metabolites in rice seedling leaves, regulate the expression of genes related to carbon and nitrogen metabolism and enzyme activity, and enhance the antioxidant enzyme activity of rice seedlings. These results indicate that red light and blue light directly have synergistic effects which can regulate the carbon and nitrogen metabolism of rice seedlings, promote the morphogenesis of rice seedlings under low light stress, and promote growth, which has never been reported in previous studies. This study is a new discovery in the application of light quality in crop production and provides new avenues to enhance crop stress resistance. However, further study is needed to explore the physio-biochemical and molecular mechanisms of light quality in crop production.

Influence of cryopreservation methods of ex vivo rat and pig skin on the results of in vitro permeation test.

In vitro permeation test (IVPT) is a frequently used method for in vitro assessment of topical preparations and transdermal drug delivery systems. However, the storage of ex vivo skin for IVPT remains a challenge. Here, two cryopreservation media were chosen to preserve rat and pig skin at -20 °C and -80 °C for further IVPT, namely, 10 % DMSO and 10 % GLY. The skin viability test confirmed that the skin protective capacity of 10 % DMSO and 10 % GLY was almost equal. The results of skin viability and IVPT showed that the skin viability and permeability of rat skin in 10 %DMSO or 10 % GLY were maintained for at least 7 and 30 days at -20 °C and -80 °C compared to fresh skin, respectively; in contrast, those of porcine skin were just maintained for <7 days at -20 °C and -80 °C. These results indicated that ex vivo skin for IVPT preserved at -80 °C in 10 % DMSO or 10 % GLY was optimal. Furthermore, skin permeability was independent of skin barrier integrity. Our study provides reference conditions for preserving IVPT skin, and skin viability can be a potential indicator of IVPT skin.

Growth changes of tomato seedlings responding to sodium salt of α-naphthalene acetic acid and potassium salt of fulvic acid.

In present study, sodium salt of α-naphthalene acetic acid (NA), potassium salt of fulvic acid (KF) and their combinations were applied to the growth substrates of tomato seedlings (Solanum lycopersicum L.) under chilling stress. The changes in aboveground biomass, root attributes, pigment contents, chlorophyll fluorescence, photosynthesis, osmotic regulation substances, and antioxidant enzymes activity of the tomato seedlings in response to NA and KF were investigated. The application of NA, KF and their combination could promote the growth of plant height and stem diameter of tomato seedlings under chilling stress to varying degrees, and improve root characteristics by increasing root volume, root length and root activity, and increase dry matter accumulation. In addition, the combined use of NA and KF improved the seedling leaf chlorophyll content, qP, Fv/Fm, ΦPSII , Pn and increased the activity of antioxidant enzymes in the tomato plants. The above results suggested a synergistic effect between NA and KF to stimulate the seedlings growth and to enhance the ROS scavenging ability of tomato, which has never been reported in previous research before. However, further researches are needed to explore the physiological and molecular mechanism underlying the synergistic effect between NA and KF.

Cutting time & height improve carbon and energy use efficiency of the forage-food dual-purpose ratoon rice cropping.

Forage-food dual-purpose ratoon rice cropping (FFRR) is used to balance forage demands with ratoon rice grain yields, that is whole plant (stem and sheath, panicles) cuttings in the main season are used as forage, and rice in the regeneration season is used as food. In this study, the local ratoon rice production system as the control, we were carried out the field experiment of cultivation practices (cutting time and cutting height), and investigated the system productivity, economic benefits, carbon footprints and energy use efficiency. The energy use efficiency, energy productivity and energy profitability increased with cutting time delay, and cutting height decreased. Significant differences of these index were observed among the treatments for cutting time and cutting height (p < 0.05). Carbon efficiency and carbon sustainability index was increase with cutting time delay, and there was significant difference among the treatment of cutting time in 2018 (p < 0.05), the minimum carbon footprint of FFRR was 78.6 kgCO2 t-1 averagely at the cutting time of 30 days after the flowering stage. In 2018, the maximum net income of FFRR was 30,577 CNY hm-2 at a cutting time of 30 days after the flowering stage while the stubble height was 10 cm, and dependent on the forage yield of the main crop; in 2019, the maximum net income of FFRR was 27,326 CNY hm-2 at a cutting time of 10 days after the flowering stage while the stubble height was 10 cm, and dependent on the grain yield of the ratoon crop. Therefore, the optimal cultivation practice of the FFRR (cutting at 30 days after the flowering stage and with a stubble height of 10 cm) showed higher carbon and energy use efficiency, economic benefits of the FFRR were fluctuated with the price of forage of the main crop and rice grain of the ratoon crop.

Study on the preparation of EGCG-γ-Cyclodextrin inclusion complex and its drug-excipient combined therapeutic effects on the treatment of DSS-induced acute ulcerative colitis in mice.

In this study, γ-cyclodextrins (γ-CD) and epigallocatechin-3-gallate (EGCG) were designed to form an inclusion complex (EGCG-γ-IC) for ulcerative colitis (UC) treatment. The drug-excipient combined therapeutic potential of γ-CD and EGCG was verified, when stability and compliance were also achieved. EGCG-γ-IC effectively inhibited the secretions of NO, TNF-α, and IL-6 and the intracellular ROS in RAW264.7 cells. The effectiveness of EGCG-γ-IC in treating DSS-induced acute UC in mice was observed including improving the histological conditions of the colon, reducing the levels of IL-1ß, IL-6, and TNF-α in serum, and restoring MPO, GSH, and sIgA levels in intestinal tissues. Moreover, EGCG-γ-IC had a more prominent effect on regulating bacterial dysbiosis caused by DSS than EGCG and γ-CD alone. Therefore, EGCG-γ-IC designed here displayed UC treating capacity with safety in the long-term application and promised an industrial production potential due to its excellent storage stability.

Measurement of nitrogen content in rice plant using near infrared spectroscopy combined with different PLS algorithms.

Nitrogen plays an important role in rice growth, and determination of nitrogen content in rice plants is of great significance in assessing plant nutritional status and allowing precision cultivation. Traditional chemical methods for determining nitrogen content have the disadvantages of destructive sampling and lengthy analysis times. Here, the feasibility of rapid nitrogen content analysis by near-infrared (NIR) spectroscopy of rice plants was studied. Spectral data from 447 rice samples at several growth stages were used to establish a predictive model. Different spectral preprocessing methods and characteristic selection methods were compared, such as interval partial least-squares (iPLS), synergy interval partial least-squares (SiPLS), and moving-window partial least-squares (mwPLS). The SiPLS method exhibited better performance than mwPLS or iPLS. Specifically, the combination of four subintervals (7, 26, 27, and 28), with characteristic bands at 5299-4451 cm-1 and 10445-10423 cm-1, resulted in the best model. The optimal SiPLS model had a correlation coefficient of 0.9533 and a root mean square error of prediction (RMSEP) of 0.1952 on the prediction set. Compared to using the full spectra, using SiPLS reduced the number of characteristics by 87 % in the model, and RMSEP was reduced from 0.2284 to 0.1952. The results demonstrate that NIR spectroscopy combined with the SiPLS algorithm can be applied to quickly determine nitrogen content in rice plants. This study provides a technical framework to guide future precision agriculture efforts with respect to nitrogen application.

Research on the impact of the socio-educational environment on the academic performance of college students: the mediating role of study motivation.

Background: Enhancing the academic performance (AP) of college students can contribute to the overall scientific literacy among this population, thereby fostering societal progress. Objective: The study investigates the correlation between college students' AP and the socio-educational environment (SEE, including family, roommates, and teachers), study motivation (SM, including self-efficacy and study behaviors). Based on the research findings, recommendations are offered to students, educators, and school administrators. Settings: Utilizing a stratified sampling approach, data was collected by selecting a sample of 330 first-year computer science students from a specific local university in Hebei Province, China. Methods: Data will be collected through a hierarchical sampling method. Using correlation analysis, difference analysis, and structural equation modeling (SEM) as data analysis methods. The data passed reliability and validity analysis (Cronbach's Alpha = 0.88, KMO = 0.88, χ2/df = 1.49RMSEA = 0.04). Results: The independent sample T-test results showed that female students had higher academic performance than male students (p < 0.001), and there was no significant difference in academic performance between students from single parent or orphan families and students from normal families (p = 0.14), from non urban areas and from urban areas (p = 0.67). The results of the mediating effect analysis indicate that SM exerts complete mediation in the association between SEE and AP, with a mediating effect value of 0.18. Conclusion: The educational disparity between urban and rural areas in China is gradually narrowing. Support policies for students from impoverished families in higher education institutions are showing initial effectiveness. The conducive learning environment and educational atmosphere for students can indirectly influence their psychological state, thus impacting their academic performance during their university years.

Multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation: A case report and review of the literature.

Patients with multiple myeloma (MM) rarely present with central nervous system (CNS) involvement as a manifestation of extramedullary disease (EMD), a condition that is associated with poor prognosis. CNS relapse without evidence of systemic involvement is even rarer, and there is no standardized treatment because there are only few case reports. We present a 47-year-old female who was diagnosed with nonsecretory multiple myeloma (NSMM) 9 years previously. She had a complete remission after receiving aggressive therapies, including high-dose chemotherapy and autologous stem cell transplantation (ASCT). However, after 7 years of progression-free survival, she had CNS relapse without evidence of systemic involvement. We switched to a salvage regimen consisting of high-dose methotrexate with lenalidomide. She achieved rapid clinical improvement, with a reduction in cerebrospinal fluid plasmacytosis of more than 80%, and no notable side effects. Our description of this unique case of a patient with MM and isolated CNS relapse after ASCT provides a reference for physicians to provide more appropriate management of these patients. We also reviewed previously reported cases and summarized the outcomes of isolated CNS relapse after ASCT, and discuss the pathogenesis and possible treatment strategies for MM with isolated CNS relapse.

The emerging roles of HDACs and their therapeutic implications in cancer.

Deregulation of protein post-translational modifications is intensively involved in the etiology of diseases, including degenerative diseases, inflammatory injuries, and cancers. Acetylation is one of the most common post-translational modifications of proteins, and the acetylation levels are controlled by two mutually antagonistic enzyme families, histone acetyl transferases (HATs) and histone deacetylases (HDACs). HATs loosen the chromatin structure by neutralizing the positive charge of lysine residues of histones; whereas HDACs deacetylate certain histones, thus inhibiting gene transcription. Compared with HATs, HDACs have been more intensively studied, particularly regarding their clinical significance. HDACs extensively participate in the regulation of proliferation, migration, angiogenesis, immune escape, and therapeutic resistance of cancer cells, thus emerging as critical targets for clinical cancer therapy. Compared to HATs, inhibitors of HDAC have been clinically used for cancer treatment. Here, we enumerate and integratethe mechanisms of HDAC family members in tumorigenesis and cancer progression, and address the new and exciting therapeutic implications of single or combined HDAC inhibitor (HDACi) treatment.

Simultaneous Detection of Pathogens and Tumors in Patients With Suspected Infections by Next-Generation Sequencing.

Background: Differential diagnosis of patients with suspected infections is particularly difficult, but necessary for prompt diagnosis and rational use of antibiotics. A substantial proportion of these patients have non-infectious diseases that include malignant tumors. This study aimed to explore the clinical value of metagenomic next-generation sequencing (mNGS) for tumor detection in patients with suspected infections. Methods: A multicenter, prospective case study involving patients diagnosed with suspected infections was conducted in four hospitals in Shanghai, China between July 2019 and January 2020. Based upon mNGS technologies and chromosomal copy number variation (CNV) analysis on abundant human genome, a new procedure named Onco-mNGS was established to simultaneously detect pathogens and malignant tumors in all of the collected samples from patients. Results: Of 140 patients screened by Onco-mNGS testing, 115 patients were diagnosed with infections; 17 had obvious abnormal CNV signals indicating malignant tumors that were confirmed clinically. The positive percent agreement and negative percent agreement of mNGS testing compared to clinical diagnosis was 53.0% (61/115) and 60% (15/25), vs. 20.9% (24/115) and 96.0% (24/25), respectively, for conventional microbiological testing (both P <0.01). Klebsiella pneumoniae (14.8%, 9/61) was the most common pathogen detected by mNGS, followed by Escherichia coli (11.5%, 7/61) and viruses (11.5%, 7/61). The chromosomal abnormalities of the 17 cases included genome-wide variations and local variations of a certain chromosome. Five of 17 patients had a final confirmed with malignant tumors, including three lung adenocarcinomas and two hematological tumors; one patient was highly suspected to have lymphoma; and 11 patients had a prior history of malignant tumor. Conclusion: This preliminary study demonstrates the feasibility and clinical value of using Onco-mNGS to simultaneously search for potential pathogens and malignant tumors in patients with suspected infections.

Aberrantly Activated APOBEC3B Is Associated With Mutant p53-Driven Refractory/Relapsed Diffuse Large B-Cell Lymphoma.

Tumor protein 53 (TP53) mutation predicts an unfavorable prognosis in diffuse large B-cell lymphoma (DLBCL), but the molecular basis for this association remains unclear. In several malignancies, the cytidine deaminase apolipoprotein B mRNA editing enzyme catalytic subunit 3B (APOBEC3B) has been reported to be associated with the TP53 G/C-to-A/T mutation. Here, we show that the frequency of this mutation was significantly higher in relapsed/refractory (R/R) than in non-R/R DLBCL, which was positively associated with the APOBEC3B expression level. APOBEC3B overexpression induced the TP53 G/C-to-A/T mutation in vitro, resulting in a phenotype similar to that of DLBCL specimens. Additionally, APOBEC3B-induced p53 mutants promoted the growth of DLBCL cells and enhanced drug resistance. These results suggest that APOBEC3B is a critical factor in mutant p53-driven R/R DLBCL and is therefore a potential therapeutic target.

Enhancement in Seed Priming-Induced Starch Degradation of Rice Seed Under Chilling Stress via GA-Mediated α-Amylase Expression.

Chilling stress is the major abiotic stress that severely limited the seedling establishment of direct-seeded rice in temperate and sub-tropical rice production regions. While seed priming is an efficient pre-sowing seed treatment in enhancing crop establishment under abiotic stress. Our previous research has identified two seed priming treatments, selenium priming (Se) and salicylic priming (SA) that effectively improved the seed germination and seedling growth of rice under chilling stress. To further explore how seed priming enhance the starch degradation of rice seeds under chilling stress, the present study evaluated the effects of Se and SA priming on germination and seedling growth, α-amylase activity, total soluble sugar content, hormone content and associated gene relative expression under chilling stress. The results showed that both Se and SA priming significantly increased the seed germination and seedling growth attributes, and enhanced the starch degradation ability by increasing α-amylase activity and total soluble sugar content under chilling stress. Meanwhile, seed priming increased the transcription level of OsRamy1A, OsRamy3B that regulated by GA, and increased the transcription level of OsRamy3E that regulated by sugar signals. Furthermore, seed priming significantly improved the GA3 contents in rice seeds by up-regulating the expression of OsGA3ox1 and OsGA20ox1, and decreased the ABA content and the expression of OsNCED1, indicating that the improved starch degradation ability in primed rice seeds under chilling stress might be attributed to the increased GA3 and decreased ABA levels in primed rice seeds, which induced the expression of GA-mediated α-amylase. However, studies to explore how seed priming mediate hormonal metabolism and the expression of OsRamy3E are desperately needed.

Successful treatment of a pure red-cell aplasia patient with γδT cells and clonal TCR gene rearrangement: A case report.

Pure red-cell aplasia (PRCA) is a syndrome associated with reduced erythroid precursors. This report presents the case of an elderly PRCA patient with significantly proliferated γδT cells and clonal T-cell receptor (TCR) gene rearrangement. The cause of this patient's PRCA was confirmed to be an autoimmune disorder rather than malignancy on the basis of flow cytometry, TCR gene rearrangement, and positron emission tomography/computed tomography (PET/CT) findings. Moreover, the γδT cell group identified in this case was captured for the first time under the microscope; this CD4+/CD8- (extremely high CD4/CD8 ratio) population is rare in PRCA patients. Our patient with a monoclonal and polyclonal hybrid of TCR gene rearrangement was sensitive to cyclosporin A (CsA), despite previous reports suggesting that patients with TCR clonal rearrangement may respond poorly to this drug. Overall, this case presents valuable clinical findings for the future diagnosis and management of PRCA caused by autoimmune conditions and further research on γδT cells' autoimmune pathophysiology and gene rearrangement.

Treatment of Central Nervous System Relapse in Acute Promyelocytic Leukemia by Venetoclax: A Case Report.

Extramedullary relapse of acute promyelocytic leukemia is a rare phenomenon and is associated with a poor prognosis, with the central nervous system being the most common site of relapse. The current treatments are still limited. Venetoclax, a selective inhibitor of BCL2, is a small molecule that can cross the blood-brain barrier and shows a potential efficacy in the treatment of chronic lymphocytic leukemia with central nervous system involvement. Although venetoclax has also been used in the treatment of acute myeloid leukemia in recent years, there are no reports of its use in the treatment of central nervous system relapse in acute promyelocytic leukemia. Here, we report a case of central nervous system relapse in acute promyelocytic leukemia that achieved complete remission after oral treatment with venetoclax. The presence of venetoclax in the patient's CSF was confirmed by testing CSF and plasma by mass spectrometry. The concentration of venetoclax in CSF was approximately 1/300 of that in plasma trough concentration. The treatment experience in this case demonstrates the potential ability of venetoclax to treat of central nervous system relapse/involvement in acute promyelocytic leukemia, thus providing a new treatment option for this kind of patient.

Respiratory Aspergillus Colonization Was Associated With Relapse of Acute Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Analysis of Data From A Retrospective Cohort Study.

Background: Patients with chronic obstructive pulmonary disease (COPD) are more susceptible to Aspergillus colonization or infection. Several studies have demonstrated that invasive pulmonary Aspergillosis (IPA) and Aspergillus hypersensitivity (AH) have a detrimental effect on COPD. However, it remains to be clarified whether Aspergillus colonization is associated with acute exacerbation of COPD (AECOPD). This study aimed to explore the impact of Aspergillus colonization in the lower respiratory tract on AECOPD. Method: Patients with Aspergillus colonization were identified from a retrospective cohort of hospitalized AECOPD from 2011 to 2016 in eight centers in Shanghai, China. The demographic information, conditions of the stable stage, clinical characteristics during hospitalization, and 1-year follow-up information after discharge were collected and compared to participants without fungi colonization. Result: Twenty-six hospitalized AECOPD patients with Aspergillus colonization and 72 controls were included in the final analysis after excluding patients with other fungi isolation and matching. The rates of recurrence of acute exacerbation within 90 days and 180 days after discharge in the patients with Aspergillus colonization were both significantly higher than that in the fungi negative patients (90 days: 19.2 vs. 4.2%, p = 0.029; 180 days: 23.1 vs. 4.2%, p = 0.010), and the all-cause mortality within 1 year was also higher (11.5 vs. 0.0%, p = 0.017). Multivariate logistic regression analysis showed that Aspergillus colonization was an independent risk factor for the recurrence of acute exacerbation within 90 days and 180 days (90 days: OR = 8.661, 95% CI: 1.496-50.159, p = 0.016; 180 days: OR =10.723, 95% CI: 1.936-59.394, p = 0.007). Conclusion: Aspergillus colonization may predict poor prognosis of AECOPD while leading to an increased risk of recurrent AECOPD in a short period.

Comparative efficacy and safety of traditional Chinese patent medicine for NAFLD in childhood or adolescence: A protocol for a Bayesian network meta analysis.

BACKGROUND: Nonalcoholic fatty liver disease is a common reason for chronic liver disease in children and adults. The increasing incidence of the disease has become one of the most critical public health problems in the 21st century, closely related to genetic and environmental factors. So far, apart from changing lifestyle and diet, modern medicine still lacks effective treatment measures. Chinese patent medicine has the advantages of apparent curative effect, overall regulation and fewer side effects. However, there is a lack of research on the simultaneous comparison of various Chinese patent medicines. Therefore, we used a reticular meta-analysis to indirectly compare the efficacy and safety of different oral Chinese patent medicines through standard reference. METHOD: We will conduct a comprehensive and systematic search of Chinese and English databases from the beginning to December 2020. All randomized controlled trials (RCTs) of oral Chinese patent medicine for NAFLD in children will be searched. The 2 researchers then independently filter the retrieved literature, extract the data according to the data extraction table and assess the risk of bias. We will perform a pair of meta-analyses and a Bayesian network meta-analysis. STATA and Win BUGS software will be used for data analysis. RESULTS: This study will thoroughly compare and analyze the differences in the efficacy of all kinds of TCPM in NAFLD treatment in childhood or adolescence. CONCLUSION: This study will provide reference and evidence support for clinical drug selection optimization. ETHICS AND DISSEMINATION: This study does not require ethical approval. INPLASY REGISTRATION NUMBER: 2020120068.