Objective:To systematically review the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures.Methods:PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Database and VIP Database were systematically searched to collect literature on the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures from inception to June 30, 2024. The languages were limited to Chinese and English. Two researchers screened the literature according to the inclusion and exclusion criteria. Data extraction was performed using the checklist for critical appraisal and data extraction for systematic reviews of prediction modeling studies (CHARMS), encompassing basic study characteristics, model development features, and model performance metrics. The predictors, validation methods, presentation formats, and predictive performance of the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures were evaluated. The prediction model risk-of-bias assessment tool (PROBAST) was employed to assess risk of bias and applicability of the included studies.Results:A total of 11 studies, comprising of 16 prediction models, were included, with a total sample size of 283-1 508 patients and a pulmonary infection incidence rate of 5.4%-16.25%. The independent predictive factors repeatedly included in the models were age, American Society of Anesthesiologists (ASA) scale, preoperative comorbidities, chronic obstructive pulmonary disease (COPD), preoperative albumin level, white blood cell count (WBC), and C-reactive protein (CRP) level. The models were internally validated in 7 studies and externally validated in 3. The models were visualized in the form of a nomogram in 7 studies and a web-based risk calculator in 1. Model prediction performance was analyzed: (1) In terms of the discrimination, 9 studies reported the area under the receiver operating characteristic curve (AUC), with the overall AUC range of 0.664-0.905. (2) In terms of the calibration, 5 studies had Hosmer-Lemeshow test, with the P-values all above 0.05; 2 studies reported the calibration plots, with the slopes close to 1 and the Brier scores of 0.016 and 0.112; 4 studies reported the sensitivity of the models of 73.91%-92.40% and specificity of 57.10%-92.41%. According to PROBAST, all 11 studies exhibited certain risk of bias while maintaining favorable applicability. Conclusions:Age, ASA scale, preoperative comorbidities, COPD, preoperative albumin level, WBC, and CRP level are found to be independent predictive factors repeatedly reported in the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures. The existing models demonstrate a robust overall prediction performance despite certain risks of bias.

Objective:To systematically review the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures.Methods:PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Database and VIP Database were systematically searched to collect literature on the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures from inception to June 30, 2024. The languages were limited to Chinese and English. Two researchers screened the literature according to the inclusion and exclusion criteria. Data extraction was performed using the checklist for critical appraisal and data extraction for systematic reviews of prediction modeling studies (CHARMS), encompassing basic study characteristics, model development features, and model performance metrics. The predictors, validation methods, presentation formats, and predictive performance of the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures were evaluated. The prediction model risk-of-bias assessment tool (PROBAST) was employed to assess risk of bias and applicability of the included studies.Results:A total of 11 studies, comprising of 16 prediction models, were included, with a total sample size of 283-1 508 patients and a pulmonary infection incidence rate of 5.4%-16.25%. The independent predictive factors repeatedly included in the models were age, American Society of Anesthesiologists (ASA) scale, preoperative comorbidities, chronic obstructive pulmonary disease (COPD), preoperative albumin level, white blood cell count (WBC), and C-reactive protein (CRP) level. The models were internally validated in 7 studies and externally validated in 3. The models were visualized in the form of a nomogram in 7 studies and a web-based risk calculator in 1. Model prediction performance was analyzed: (1) In terms of the discrimination, 9 studies reported the area under the receiver operating characteristic curve (AUC), with the overall AUC range of 0.664-0.905. (2) In terms of the calibration, 5 studies had Hosmer-Lemeshow test, with the P-values all above 0.05; 2 studies reported the calibration plots, with the slopes close to 1 and the Brier scores of 0.016 and 0.112; 4 studies reported the sensitivity of the models of 73.91%-92.40% and specificity of 57.10%-92.41%. According to PROBAST, all 11 studies exhibited certain risk of bias while maintaining favorable applicability. Conclusions:Age, ASA scale, preoperative comorbidities, COPD, preoperative albumin level, WBC, and CRP level are found to be independent predictive factors repeatedly reported in the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures. The existing models demonstrate a robust overall prediction performance despite certain risks of bias.

Objective To evaluate the risk of bias and reporting quality in randomized controlled trials(RCTs)of the Chinese medicine injection for acute cerebral infarction in the last five years.Methods RCTs literature on Chinese medicine injection in the treatment of acute cerebral infarction was systematically searched in CNKI,Wanfang Data,VIP,China Biology Medicine Database(CBM),PubMed,Embase and Cochrane Library from April 20,2018 to April 20,2023.The risk of bias and reporting quality of included RCTs were evaluated using the Cochrane Risk of Bias Tool(ROB 1.0)and CONSORT-CHM Formulas 2017,respectively.Results A total of 4 301 articles were retrieved,and 408 RCTs were included according to inclusion and exclusion criteria.The ROB evaluation results showed that the the majority of studies were rated as having an unclear risk of bias due to the lack of reporting on allocation concealment,blind method,trial registration information,and funding sources.The evaluation results of CONSORT-CHM Formulas 2017 showed that the number of reported papers of 17 items was greater than or equal to 50%,and the number of reported papers of 25 items was less than 10%,and most of the RCTs did not show the characteristics of TCM syndrome differentiation and treatment.Conclusion The quality of Chinese medicine injection in the treatment of acute cerebral infarction RCTs is generally low.It is recommended that researchers refer to the methodology design of RCTs and international reporting standards,improve the trial design,standardize the trial report,and highlight the characteristics of TCM syndrome differentiation and treatment.

The irrational use of Chinese patent medicines （CPM） is becoming more and more prominent， which makes the demand for clinical practice guidelines of CPM gradually increase. In order to make domestic scholars understand the latest developments and existing problems of the CPM guidelines， and promote its development， this paper introduced the concept of CPM guidelines， summarized the characteristics of the two development modes， namely “taking CPM as the key” and “taking disease/syndrome as the key”， and analyzed the current methodological status of developing and reporting CPM guidelines. Based on the existed problems， three suggestions have been put forward to optimize the quality of CPM guidelines， which were clarifying the target users and scope of CPM guidelines， establishing an open and transparent mechanism of the personnel involvement and process steps， and formulating implementable and operable recommendations for the use of CPM.

Electroencephalogram (EEG) is characterized by high temporal resolution, and various EEG analysis methods have developed rapidly in recent years. The EEG microstate analysis method can be used to study the changes of the brain in the millisecond scale, and can also present the distribution of EEG signals in the topological level, thus reflecting the discontinuous and nonlinear characteristics of the whole brain. After more than 30 years of enrichment and improvement, EEG microstate analysis has penetrated into many research fields related to brain science. In this paper, the basic principles of EEG microstate analysis methods are summarized, and the changes of characteristic parameters of microstates, the relationship between microstates and brain functional networks as well as the main advances in the application of microstate feature extraction and classification in brain diseases and brain cognition are systematically described, hoping to provide some references for researchers in this field.
Electroencephalography ; Brain ; Cognition

Hepatitis B virus （HBV） has the characteristics of wide transmission， a high chronic infection rate， and a low cure rate， and improving the cure rate of HBV may help to improve the long－term prognosis of patients. Heat shock protein 90 （Hsp90） is a chaperone protein widely present in organisms. In recent years， more and more studies have shown that Hsp90 is associated with HBV infection and plays an important role in HBV replication. It can not only interact with specific proteins of the virus to promote its replication， but also interact with the host’s own proteins to perform its function. This article reviews the role of Hsp90 in HBV replication in recent studies， so as to provide new theoretical guidance and directions for the development of new anti－HBV drugs targeting Hsp90 and the prevention and treatment of HBV infection in the future.

Background::Joint dislocations significantly impact public health. However, a comprehensive study on the incidence, distribution, and risk factors for joint dislocations in China is lacking. We conducted the China National Joint Dislocation Study, which is a part of the China National Fracture Study conducted to obtain the national incidence and risk factors for traumatic fractures, and to investigate the incidence and risk factors for joint dislocations.Methods::For this national retrospective epidemiological study, 512,187 participants were recruited using stratified random sampling and probability-proportional-to-size method from January 19 to May 16, 2015. Participants who sustained joint dislocations of the trunk, arms, or legs (skull, sternum, and ribs being excluded) in 2014 were personally interviewed to obtain data on age, educational background, ethnic origin, occupation, geographic region, and urbanization degree. The joint-dislocation incidence was calculated based on age, sex, body site, and demographic factors. The risk factors for different groups were examined using multiple logistic regression.Results::One hundred and nineteen participants sustained 121 joint dislocations in 2014. The population-weighted incidence rate of joint dislocations of the trunk, arms, or legs was 0.22 (95% confidence interval [CI]: 0.16, 0.27) per 1000 population in 2014 (men, 0.27 [0.20, 0.34]; women, 0.16 [0.10, 0.23]). For all ages, previous dislocation history (male: OR 42.33, 95% confidence interval [CI]: 12.03–148.90; female: OR 54.43, 95% CI: 17.37–170.50) and alcohol consumption (male: OR 3.50, 95% CI: 1.49–8.22; female: OR 2.65, 95% CI: 1.08–6.50) were risk factors for joint dislocation. Sleeping less than 7 h/day was a risk factor for men. Compared with children, women aged ≥15 years (female 15–64 years: OR 0.16, 95% CI: 0.04–0.61; female ≥65 years: OR 0.06, 95% CI: 0.01–0.41) were less likely to sustain joint dislocations. Women with more than three children were at higher dislocation risk than women without children (OR 6.92, 95% CI: 1.18–40.78).Conclusions::The up-to-date data on joint dislocation incidence, distribution, and risk factors can be used as a reference for national healthcare, prevention, and management in China. Specific strategies for decreasing alcohol consumption and encouraging adequate sleeping hours should be developed to prevent or reduce dislocation incidents.Trial Registration::Chinese Clinical Trial Registry, ChiCTR-EPR-15005878.

Objective:To explore the clinical application and long-term safety of hydroxychloroquine sulfate (HCQ) in the treatment of rheumatic diseases.Methods:A multi-center cross-sectional study was conducted between August 2017 and August 2018 in a random sample of eleven medical institutions of rheumatology and immunology in China. Patients who took HCQ for more than 3 months were enrolled into this study. The cumulative dose and long-term side effects of HCQ were recorded. The changes of laboratory indexes before and after treatment with HCQ were analyzed. Categorical variables were presented with counts and proportions, and evaluated by Chi-square test. Continuous parametric data were presented as Mean±standard deviation, and evaluated by Student's t test or Mann-Whitney U test. P-values less than 0.05 were considered statistically significant. Results:A total of 886 patients with rheumatic diseases were enrolled into this study, including 505 cases with systemic lupus erythematosus (57.0%), 210 cases with rheumatoid arthritis (23.7%), 80 cases with Sj?gren's syndrome (9.0%), 57 cases with undifferentiated connective tissue disease (6.4%), 12 cases of systemic vasculitis (1.4%), 10 cases of mixed connective tissue disease (1.1%), 7 cases of myositis (0.8%) and 5 cases with systemic sclerosis (0.6%). The most common long-term side effects of HCQ was skin or mucous lesions (12.4%) and vision problems (8.0%). Other adverse reactions included problems of digestive system (3.0%), nervous system (2.1%), musculoskeletal system (1.1%) and cardiovascular system (0.9%). 140 cases (15.8%) had stopped taking HCQ during the treatment. More than half of them decided to stop taking medicine by themselves. Fifty-four patients (6.1%) stopped using HCQ due to side effects while 24 of them took it again, and another 12 patients (1.4%) stopped the drug due to remission of illness. Patients were divided into three groups according to the cumulative dose of HCQ: less than 500 g, 500-1 000 g and more than 1 000 g respectively. There was significant difference in the incidence of long-term side effects among the three groups ( χ2=6.382, P=0.041). The last group (more than 1 000 g) suffered the highest incidence of long-term adverse reactions (37.1%). No severe adverse drug reactions were observed in this study. Conclusion:Hydroxychloroquine is widely used in the treatment of rheumatic diseases. The incidence of long-term side effects is 20.4%, is 6.1% lead to drug withdrawal, which are especially related to the cumulative doses. It should be adjusted properly according to the clinical application.

Objective To investigate the epidemiological features and trends of adult carpal fractures at The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the adult patients with carpal fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender and fracture type were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 1,181 carpal fractures were collected,accounting for 5.99％ (1,181/19,712) of the hand fractures and 1.10％ (1,181/107,648) of the total fractures in the same period.They involved 967 males and 214 females,with a male/female ratio of 4.52∶ 1.The high-risk age group was from 21 to 30 years (33.28％);the high-risk type was scaphoid fracture (72.99％).In group A of 453 cases,the male/female ratio was 6.68∶1,the median age 29 years and the high-risk type scaphoid fracture (83.89％).In group B of 728 cases,the male/female ratio was 3.70∶ 1,the median age 34 years and the high-risk type also scaphoid fracture (66.21％).Group B had a significantly lower male/female ratio,a significantly lower proportion of scaphoid fractures and a significantly older median age than group A (P ＜ 0.05).Conclusions In the 10 years at our institute,adult carpal fractures accounted for 5.99％ of the hand fractures and 1.10％ of the total fractures in the same period.They mostly occurred in males and during the age from 21 to 30 years.Of all the carpal bones,the scaphoid was the most often fractured.The latter 5 years witnessed significantly increased median age,proportion of females and proportion of scaphoid fractures compared with the former 5 years.

Objective To investigate the epidemiological features and trends of supracondylar humeral fractures from 2003 to 2012 at The Third Affiliated Hospital to Hebei Medical University.Methods The data of the patients with supracondylar humeral fracture who had been treated between 2003 and 2012 at our hospital were collected through the PACS system and case reports checking system.The data between 2003 and 2007 were classified as group A and those between 2008 and 2012 as group B.The data concerning gender,age and fracture type were statistically analyzed and compared between the 2 groups.Results Atotalof3,111 supracondylar humeral fractures were treated,accounting for54.4％ (3,111/5,723) of the distal humeral fractures,34.8％ (3,111/8,932) of the elbow fractures and 2.5％ (3,111/126,479) of the total fractures.They were 2,018 males (64.9％) and 1,093 females (35.1％).The age range from 1 to 10 years obtained the highest constitute ratio for both genders,77.0％ (1,554/2,018) for males and 78.2％ (854/1,093) for females.The extension type and flexion type had 2,693 (86.6％) and 418 (13.4％) cases,respectively,and their male to female ratios were 2.0:1 and 1.2:1 respectively,all showing significant differences (P ＜ 0.001).There were 1,902 cases in group A and 1,209 cases in group B,accounting for 60.0％ (1,902/3,168) and 47.3％ (1,209/2,555) of the distal humeral fractures,41.4％ (1,902/4,199) and 27.9％ (1,209/4,333) of the elbow fractures,and 2.9％ (1,902/65,267) and 2.0％ (1,209/61,212) of the total fractures,respectively,all showing significant differences between groups (P ＜ 0.001).The male to female ratio was 1.9:1 for group A and 1.8:1 for group B,showing an insignificant difference (P ＞ 0.05).The age range from 1 to 10 years had a constitute ratio of 75.0％ (1,426/1,902) for group A and that of 81.2％ (982/1,209) for group B,showing a significant difference (P ＜ 0.001).The proportion of extension type was 85.4％ (1,624/1,902) for group A and 88.4％ (1,069/1,209) for group B,showing a significant difference (P ＜ 0.05).Conclusions The current investigation has revealed the epidemiological features and trends of supracondylar humeral fractures which had been treated between 2003 and 2012.They were mostly seen in children from 1 to 10 years old.The extension type predominated.Compared with the first 5 years,the proportion of age range from 1 to 10 years and the extension type increased in the latter 5 years.