Objective:To discuss the performance of visual score and heart-to-contralateral lung (H/CL) ratio of 99Tc m-pyrophosphate (PYP) SPECT/CT scintigraphy for diagnosing transthyretin-related cardiac amyloidosis (ATTR-CA) by using Meta-analysis. Methods:Relevant studies on 99Tc m-PYP SPECT/CT diagnosis of ATTR-CA published before August 20, 2023 from databases including Pubmed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and China Science and Technology Journal Database (VIP) were retrieved. Articles were screened and indices which reflect the diagnostic efficiency such as sensitivity and specificity were extracted. Forest plots were drawn, and subgroup analysis was performed to analyze the heterogeneity. Results:A total of 160 articles were retrieved, and 11 articles involving 1 802 patients were enrolled, of whom 605 were diagnosed with ATTR-CA. All 11 articles were enrolled when analyzing the diagnostic efficiency of visual score for diagnosing ATTR-CA. After integration, the sensitivity and specificity were 0.95(95% CI: 0.91-0.97) and 0.95(95% CI: 0.90-0.98), respectively. Ten articles (1 611 patients) were enrolled when analyzing the diagnostic efficiency of H/CL ratio for diagnosing ATTR-CA. After integration, the sensitivity and specificity were 0.93(95% CI: 0.82-0.98) and 0.99(95% CI: 0.90-1.00), respectively. Subgroup analysis indicated that lack of uniformity in diagnostic criteria was the primary source of heterogeneity. Conclusion:99Tc m-PYP SPECT/CT scintigraphy exhibits high diagnostic efficiency for ATTR-CA.

In this study, the molecular mechanism of Cinnamomi Cortex-Rehmanniae Radix (CR) in the prevention and treatment of osteoporosis (OP) was investigated by integrating compatibility analysis of compound, bioinformatics and metabolomics. The rat OP models were established, and the Micro-CT indexes and pathological sections were comprehensively evaluated. The results showed that compared with the model group, the indexes such as bone mineral density (BMD) and bone volume/tissue volume (BV/TV) were significantly increased after CR treatment (P < 0.05), and the bone trabeculae were arranged into mesh. The results of UHPLC-Q-TOF/MS mainly involved amino acid metabolism, lipid metabolism and estrogen metabolism pathways. Integrating bioinformatics and metabolomics analysis, it was finally found that: ① cinnamic acid and ethylcinnamate inhibit inflammatory factors such as TNF, IL-1β, and IL-13, thereby preventing and treating OP; ② multiple active ingredients of CR target ESR2, PPARG, and CYP19A1, GABRA1 and other targets, regulate cAMP synthesis, AMPK signaling pathway and lipid metabolism, thereby regulating estrogen levels to prevent and treat OP; ③ oleic acid, arachic acid, etc. act on AR, VDR and other targets, and regulate HIF-1 signaling pathway and AGE-RAGE signaling pathway, thereby regulating osteoblasts and osteoclasts, and affecting calcium and phosphorus absorption to maintain bone homeostasis. This study clarified the molecular mechanism of CR in preventing and treating OP from the perspective of multi-directional regulation of inflammatory factors, estrogen and bone homeostasis, and provided theoretical basis for the clinical application of CR and the development of compound. This experiment complied with the ethical standards of animal experiments and was approved by the Animal Ethics Committee of Shaanxi University of Chinese Medicine (No. SUCMDL20210309002).