This study aims to systematically review and evaluate the quality of clinical research on the treatment of adenomyosis(AM) with traditional Chinese medicine(TCM) in recent ten years, using evidence graphs. Computer searches were conducted on eight Chinese and English databases, commonly used guideline databases, and guideline-related websites, covering the period from January 1, 2014, to October 1, 2024. Two researchers independently screened, extracted information, and evaluated the quality of the evidence. The distribution and quality of the clinical research evidence were presented using both text and charts. A total of 565 articles were included in the study, comprising 523 intervention studies, 23 observational studies, 18 systematic reviews/Meta-analysis, and 1 guideline. The overall publication volume has shown a downward trend in past two years. The sample sizes of the intervention and observational studies primarily focused on 60 to 120 cases. The intervention schemes mainly involved multi-therapy combinations, including 33 classic prescriptions and 25 Chinese patent medicines. Among these, 48 studies related to 17 classic prescriptions and 45 studies related to 10 types of Chinese patent medicines involved TCM syndrome types. Randomized controlled trial(RCT) tended to focus on overall clinical efficacy and the degree of dysmenorrhea as key outcome measures. Methodological quality issues were found in 97 RCTs related to TCM decoctions and 131 RCTs related to Chinese patent medicines, primarily involving unclear explanations of some information. The AMSTAR scores for the 18 systematic reviews/Meta-analysis ranged from 1 to 8 points, with 16 studies suggesting "evidence of potential therapeutic efficacy". The recommended level for the one included guideline was B-level. TCM shows significant advantages in treating AM. Future clinical research should further standardize study designs, reference relevant reporting guidelines, improve the quality of clinical research, generate higher-level evidence-based results, and promote the high-quality development of clinical research on TCM for treating AM.
Humans ; Adenomyosis/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Medicine, Chinese Traditional ; Randomized Controlled Trials as Topic

Purpose: We report the diagnosis and conservative treatment of a patient with dacryocystitis accompanied by a congenital lacrimal sac diverticulum.Case summary: An 11-year-old boy presented with itching and redness in his right eye. His best-corrected visual acuity was 0.8 in the right eye and 1.2 in the left. Physical examination revealed redness, swelling, and tenderness around the right lacrimal sac area. Probing of the nasolacrimal duct showed no obstruction. Additional tests were performed under the diagnosis of acute dacryocystitis. Computed tomography and magnetic resonance imaging suggested inflammation of the soft tissue with abscess formation around the right orbit, with inflammation extending to the lower eyelid. After 7 days of inpatient treatment, the symptoms improved. Dacryocystography performed after the symptoms improved showed a small amount of residual contrast in a space near the lacrimal sac, leading to the diagnosis of a right lacrimal sac diverticulum. Conclusions In patients with dacryocystitis without nasolacrimal duct obstruction, congenital lacrimal diverticulum should be suspected.

Purpose: We report the diagnosis and conservative treatment of a patient with dacryocystitis accompanied by a congenital lacrimal sac diverticulum.Case summary: An 11-year-old boy presented with itching and redness in his right eye. His best-corrected visual acuity was 0.8 in the right eye and 1.2 in the left. Physical examination revealed redness, swelling, and tenderness around the right lacrimal sac area. Probing of the nasolacrimal duct showed no obstruction. Additional tests were performed under the diagnosis of acute dacryocystitis. Computed tomography and magnetic resonance imaging suggested inflammation of the soft tissue with abscess formation around the right orbit, with inflammation extending to the lower eyelid. After 7 days of inpatient treatment, the symptoms improved. Dacryocystography performed after the symptoms improved showed a small amount of residual contrast in a space near the lacrimal sac, leading to the diagnosis of a right lacrimal sac diverticulum. Conclusions In patients with dacryocystitis without nasolacrimal duct obstruction, congenital lacrimal diverticulum should be suspected.

The analysis presented here is based on the blood components of Guanxin Qiwei tablets, the key anti-atherosclerosis pathway of Guanxin Qiwei tablets was screened by network pharmacology, and the anti-atherosclerosis mechanism of Guanxin Qiwei tablets was clarified and verified by cell experiments. HPLC-Q-Exactive-MS/MS technique was used to analyze the components of Guanxin Qiwei tablets into blood, to determine the precise mass charge ratio of the compounds, and to conduct a comprehensive analysis of the components by using secondary mass spectrometry fragments and literature comparison. Finally, a total of 42 components of Guanxin Qiwei tablets into blood were identified. To better understand the interactions, we employed the Swiss Target Prediction database to predict the associated targets. Atherosclerosis (AS) disease targets were searched in disease databases Genecard, OMIM and Disgent, and 181 intersection targets of disease targets and component targets were obtained by Venny 2.1.0 software. Protein interactions were analyzed by String database. The 32 core targets were selected by Cytscape software. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed in DAVID database. It was found that the anti-atherosclerosis pathways of Guanxin Qiwei tablets mainly include lipid metabolism and atherosclerosis and AGE-RAGE signaling pathway in diabetic complications and other signal pathways. The core targets and the core compounds were interlinked, and it was found that cryptotanshinone and tanshinone ⅡA in Guanxin Qiwei tablets were well bound to TNF, PPARγ, AKT1, PTG2 and other targets. The lipid metabolism and atherosclerotic pathway was verified using human hl-7702 hepatocytes. This study preliminarily identified the potential pharmacodynamic components of Guanxin Qiwei tablets in the treatment of AS diseases and predicted their pathways of action, and verified the relationship between regulating lipid metabolism and atherosclerosis of Guanxin Qiwei tablets in vitro, providing a reference for the further study of the pharmacodynamic material basis and mechanism of action of this prescription. This experiment was approved by the Medical Ethics Committee of Inner Mongolia Medical University (No. YKD202401262).

Purpose: We report the diagnosis and conservative treatment of a patient with dacryocystitis accompanied by a congenital lacrimal sac diverticulum.Case summary: An 11-year-old boy presented with itching and redness in his right eye. His best-corrected visual acuity was 0.8 in the right eye and 1.2 in the left. Physical examination revealed redness, swelling, and tenderness around the right lacrimal sac area. Probing of the nasolacrimal duct showed no obstruction. Additional tests were performed under the diagnosis of acute dacryocystitis. Computed tomography and magnetic resonance imaging suggested inflammation of the soft tissue with abscess formation around the right orbit, with inflammation extending to the lower eyelid. After 7 days of inpatient treatment, the symptoms improved. Dacryocystography performed after the symptoms improved showed a small amount of residual contrast in a space near the lacrimal sac, leading to the diagnosis of a right lacrimal sac diverticulum. Conclusions In patients with dacryocystitis without nasolacrimal duct obstruction, congenital lacrimal diverticulum should be suspected.

A scoping review was performed to systematically search and summarize the clinical research in the treatment of dysmenorrhea with oral Chinese patent medicines. The oral Chinese patent medicines for treating dysmenorrhea in three major drug lists, guidelines, and textbooks were screened, and the relevant clinical trials were retrieved from eight Chinese and English databases. The key information of the included trials was extracted and visually analyzed. A total of 50 Chinese patent medicines were included, among which oral Chinese patent medicines for the dysmenorrhea patients with the syndrome of Qi stagnation and blood stasis accounted for the highest proportion, and the average daily cost varied greatly among Chinese patent medicines. A total of 150 articles were included, involving 22 Chinese patent medicines, among which Guizhi Fuling Capsules/Pills, Sanjie Zhentong Capsules, and Dan'e Fukang Soft Extract were the most frequently studied. These articles mainly reported randomized controlled trial(RCT), which mainly focused on the comparison of the intervention effect between Chinese patent medicines combined with western medicine and western medicine alone, and the sample size was generally 51-100 cases. The high-frequency outcome indicators belonged to nine domains such as effective rate, adverse reactions, and laboratory examinations. This study showed that oral Chinese patent medicines had advantages in the treatment of dysmenorrhea, and the annual number of related clinical trials showed an overall growing trend. However, there were still problems such as insufficient safety information and vague description of traditional Chinese medicine(TCM) syndromes types in the instructions of Chinese patent medicines. The available clinical research had shortcomings such as uneven distribution of Chinese patent medicines, limited research scale, poor methodological rigor, and insufficient standardization of outcome indicators. In the future, it is necessary to deepen the development of high-quality clinical research and improve the contents of the instructions to ensure the effectiveness and safety of the clinical application of oral Chinese patent medicines in the treatment of dysmenorrhea.
Dysmenorrhea/drug therapy* ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Female ; Administration, Oral ; Nonprescription Drugs/administration & dosage*

Objective To analyze the risk factors for catheter-related thrombosis(CRT)in the upper arm infusion port(UAP)and to construct a machine-learning prediction model.Methods A total of 6028 patients,who received UAP implantation at Shanghai Renji Hospital of China from February 2014 to February 2023,were enrolled in this study.The patients were divided into training set(n=4 219)and validation set(n=1 809).Six machine-learning prediction models,including Least Absolute Shrinkage and Selection Operator(LASSO)regression,random forest,decision tree,neural network,XGBoost and logistic,were constructed,and the model having best performance was selected as the optimal model.SHapely Additive exPlanations(SHAP)analysis was used to explain the neural network model,and DALEXtra package was used to explain the continuous variables.Results The neural network model was chosen as the final model.The variables,in order of the degree of importance from high to low,included sex,the diameter of catheter,catheter tip confirmation method,the length of catheter,inpatient or outpatient status,history of central venous catheter implantation,the length of subcutaneous tunnel,age,body mass index(BMI),primary tip displacement,and left or right venous approach.The learning curve,i.e.the area under curve(AUC)of the receiver operating characteristic(ROC)curve,for the training set was＞0.6,and the Delong testing and Bootstrap Methods Test showed that the neural network model performed well(P＜0.05).The Kolmogorov-Smirnov plot(KS plot)value was 0.313 5,indicating that the model had the good ability of discrimination.The clinical impact curve(CIC)assessment revealed that the model had good clinical value.Conclusion The machine-learning prediction model of upper arm infusion port with CRT has been successfully constructed.For minimizing the risk of CRT,it is recommended to prioritize the use of 5 F diameter catheters,adopt left-sided venous approach and positioning the tip of the catheter based on anatomical measurements,besides,the catheter length should be not shorter than 36.56 cm,and the subcutaneous tunnel length should not be less than 5 cm.The basic features associated with higher CRT risk include age of 50-65 years,BMI being between 18.69 kg/m2 and 20.81 kg/m2 or between 23.68 kg/m2 and 23.94 kg/m2 and male.

Objective:To introduce the clinical application of three-dimensional(3D) printed titanium alloy prosthesis in the reconstruction of mandibular defects.Methods:Three patients with extensive mandibular defects, who were either ineligible for or refused autologous bone transplantation were selected from the Oral and Maxillofacial-Head and Neck Oncology Department at School & Hospital of Stomatology, Wuhan University between April 2019 and December 2021. Preoperative oral and maxillofacial CT scanning was performed, followed by a virtual surgical plan and the design and manufacture of titanium mandibular prosthesis as well as the surgery guide-plate. Repair of mandibular defects using 3D printed titanium mandibular prosthesis. Follow-up after surgery to evaluate the patient’s functional and cosmetic recovery.Results:The study included three male patients aged 27, 10 years and 8 months, and 74 years, respectively. Two cases involved recurrent mandibular tumors postoperatively, and one case involved mandibular defects following gingival tumor surgery that affected the patient’s facial appearance and eating. All surgeries were successfully completed, with postoperative outpatient follow-ups at 36, 32, and 6 months, respectively. Follow-up indicated that the facial contours were basically symmetrical, the degree of mouth opening was normal, and the occlusion on the healthy side was essentially normal. No exposure, loosening, or fracturing of the prostheses was observed.Conclusion:3D printed titanium mandibular prosthesis can effectively restore the facial contour and mandibular function of patients.

Objective:To introduce the clinical application of three-dimensional(3D) printed titanium alloy prosthesis in the reconstruction of mandibular defects.Methods:Three patients with extensive mandibular defects, who were either ineligible for or refused autologous bone transplantation were selected from the Oral and Maxillofacial-Head and Neck Oncology Department at School & Hospital of Stomatology, Wuhan University between April 2019 and December 2021. Preoperative oral and maxillofacial CT scanning was performed, followed by a virtual surgical plan and the design and manufacture of titanium mandibular prosthesis as well as the surgery guide-plate. Repair of mandibular defects using 3D printed titanium mandibular prosthesis. Follow-up after surgery to evaluate the patient’s functional and cosmetic recovery.Results:The study included three male patients aged 27, 10 years and 8 months, and 74 years, respectively. Two cases involved recurrent mandibular tumors postoperatively, and one case involved mandibular defects following gingival tumor surgery that affected the patient’s facial appearance and eating. All surgeries were successfully completed, with postoperative outpatient follow-ups at 36, 32, and 6 months, respectively. Follow-up indicated that the facial contours were basically symmetrical, the degree of mouth opening was normal, and the occlusion on the healthy side was essentially normal. No exposure, loosening, or fracturing of the prostheses was observed.Conclusion:3D printed titanium mandibular prosthesis can effectively restore the facial contour and mandibular function of patients.

Objective: This study aimed to assess the degree of interest in robot-assisted spine surgery (RASS) among residents and to investigate the learning curve for beginners performing robotic surgery. Methods: We conducted a survey to assess awareness and interest in RASS among young neurosurgery residents. Subsequently, we offered a hands-on training program using a dummy to educate one resident. After completing the program, the trained resident performed spinal fusion surgery with robotic assistance under the supervision of a mentor. The clinical outcomes and learning curve associated with robotic surgery were then analyzed. Results: Neurosurgical residents had limited opportunities to participate in spinal surgery during their training. Despite this, there was a significant interest in the emerging field of robotic surgery. A trained resident performed RASS under the supervision of a senior surgeon. A total of 166 screw insertions were attempted in 28 patients, with 2 screws failing due to skiving. According to the Gertzbein-Robbins classification, 85.54% of the screws were rated as grade A, 11.58% as grade B, 0.6% as grade C, and 1.2% as grade D. The clinical acceptance rate was approximately 96.99%, which is comparable to the results reported by senior experts and time per screw statistically significantly decreased as experience was gained. Conclusion RASS can be performed with high accuracy within a relatively short timeframe, if residents receive adequate training.