Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Objective To investigate the current status of off-label drug use(OLDU)management in tertiary hospitals of Guizhou province and to provide baseline evidence for developing a unified administration regulation for OLDU in Guizhou province.Methods In line with the relevant policies and regulations,a questionnaire including basic information about the person filling out the form,basic information about the hospitals,and information about OLDU was developed.The questionnaire was sent to 84 tertiary hospitals in Guizhou province through the Wenjuanxing.Results A total of 84 questionnaires were distributed and recovered,with a response rate of 100.00%.Of the 84 hospitals,77 had OLDU,of which 68(88.31%)had established a management system for OLDU.Among the 77 hospitals with OLDU,65(84.42%),42(54.55%),58(75.32%),36(46.75%),15(19.48%),and 21(27.27%)hospitals respectively,required approval from the Committee on Drug Administration and Pharmacotherapy before OLDU,restricted the qualifications of doctors prescribing OLDU,required informed consent from patients or their families before OLDU,recorded the matters and reasons in the medical records of patients treated with OLDU,followed up patients in their files and evaluated the reasonableness of the OLDU,and carried out special reviews for OLDU.Only 30(38.96%)hospitals have set up a catalogue of OLDUs,and 58(75.32%)hospitals have urgent needs to set up a unified provincial catalogue of OLDUs.Conclusion The pharmacy administration level of OLDU in tertiary hospitals of Guizhou province is relatively low,so there is an urgent need to establish a unified OLDU management system and medication catalog.

Objective:To explore the effect of pentraxin 3 (PTX3) on memory improvement and Aβ expression in Alzheimer's disease (AD) model mice.Methods:(1) Ten 5-month-old 5×FAD mice were randomly divided into PTX3 group and model group ( n=5); 5 C57BL/6 wild-type mice at the same age were selected as control group; mice in the PTX3 group and control group were stereotactically injected 4 μL 0.5 g/L PTX3 or same dose of phosphate buffered saline (PBS); Morris water maze test was used to detect the learning and memory abilities, Y maze test was used to detect the short-term memory, and ELISA was used to obsevre the contents of Aβ 40 and Aβ 42 in the brain hemisphere. (2) Twenty-five 3-month-old 5×FAD mice were randomly divided into model group, 2 μg/kg PTX3 group, 4 μg/kg PTX3 group, 8 μg/kg PTX3 group, and 16 μg/kg PTX3 group ( n=5); 5 C57BL/6 wild-type mice at the same age were selected as control group; mice in the PTX3 groups were intranasally injected 2, 4, 8, and 16 μg/kg PTX3, respectively; those in the model group and control group were intranasally injected same dose of PBS; injection was given once every 96 h for a total of 7 times. Morris water maze test was used to detect the learning and memory abilities, Y maze test was used to detect the short-term memory, and ELISA was used to obsevre the contents of Aβ 40 and Aβ 42 in the hippocampus. Results:(1) Compared with the model group, the PTX3 group had significantly shorter platform latency, higher percentage of exploration time and higher percentage of spontaneous alternations ( P<0.05). Compared with those in model group ([63.38±21.42] pg/mL, [29.77±6.11] pg/mL), the concentrations of Aβ 40 and Aβ 42 in the brain tissues of PTX3 group ([15.87±2.11] pg/mL, [16.55±1.95] pg/mL) were statistically lower ( P<0.05). (2) Compared with the model group, the 16 μg/kg PTX3 group had significantly shorter escape latency and higher percentage of exploration time ( P<0.05); compared with the model group, the 2 μg/kg PTX3 group and 16 μg/kg PTX3 group had significantly higher percentage of spontaneous alternations ( P<0.05). The contents of Aβ 40 and Aβ 42 in the hippocampus of 8 μg/kg PTX3 group and 16 μg/kg PTX3 group were statistically lower compared with those in the model group ( P<0.05). Conclusion:PTX3 may attenuate cognitive deficits and decrease Aβ expression in the brain or hippocampus tissues of 5×FAD mice with AD.

ObjectiveTo explore the relationship between five-state personality and Cattell's 16 personality factors. MethodsA total of 913 students recruited from Beijing University of Chinese Medicine from November 2020 to January 2021 were assessed by using the Five-state Personality Test Form and the 16 Personality Factors Questionnaire （16PF）. The five-state personality scores were compared with national norms and gender differences were examined. Additionally， a structural equation model was established and the model fit was assessed using comparative fit index （CFI）， Tucker-Lewis index （TLI）， and root mean square error of approximation （RMSEA）. The five-state personality （Taiyang， Shaoyang， Yin-yang balance， Shaoyin and Taiyin） was used as individual outcome variables while the 16PF factors was employed as predictor variables. Based on standardized parameter estimation results， we explored the relationships between the five-state personality and 16PF. ResultsA total of 913 students were recruited， and 756 valid samples were obtained after excluding unqualified questionnaires. Among these， the scores of Taiyang， Shaoyang and Taiyin in the 756 school students were significantly lower than the national norms， while the scores of Yin-yang balance was significantly higher （P＜0.05 or P＜0.01）. The scores of Taiyang， Shaoyang， Yin-yang balance and Shaoyin were significantly higher than in males compared to females （P＜0.05 or P＜0.01）. Regarding the relationship between the dimensions of five-state personality and 16PF， the model demonstrated a good fit with CFI and TLI values of 0.993 and 0.980， respectively， and an RMSEA value of 0.027. The 16PF factors， including dominance， social boldness， vigilance， rule-consciousness， tension， and emotional stability， positively predicted the Taiyang personality traits， while privateness and apprehension negatively predicted the Taiyang personality traits （P＜0.05 or P＜0.01）. For Shaoyang personality traits， factors such as liveliness， social boldness， dominance， and tension positively predicted them， while rule-consciousness， apprehension， and privateness negatively predicted Shaoyang perso-nality traits （P＜0.05 or P＜0.01）. In the case of Yin-yang balance personality traits， perfectionism， rule-consciousness， emotional stability， and self-reliance positively predicted them， while apprehension negatively predicted Yin-yang balance personality traits （P＜0.05 or P＜0.01）. Regarding Shaoyin personality traits， perfectionism， emotional stability， self-reliance， rule-consciousness， and vigilance positively predicted them， while dominance， social boldness， and liveliness negatively predicted Shaoyin personality traits （P＜0.01）. Apprehension， tension， vigilance， and self-reliance positively predicted Taiyin personality traits， while social boldness， rule-consciousness， and intelligence negatively predicted Taiyin personality traits （P＜0.05 or P＜0.01）. ConclusionThere is a significant correlation between five-state personality test and 16PF with 16PF factors capable of predicting five-state personality factors. The five-state personality demonstrates scientific validity and effectiveness.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies

OBJECTIVE：To study the effect of Cangfu daotan pill （CDP）containing serum on autophagy of ovarian granulosa cells（GCs）of rat. METHODS ：Three-month-old SD rat were divided into normal saline group （normal saline ，ig），FSH injection group（10.71 IU/kg，ih），CDP irrigation high-dose ，medium-dose and low-dse groups [ 0.5，1，2 mg/g（by crude drug ），ig]，with 6 rats in each group. They were given relevant medicine subcutaneously/intragastrically ，once a day ，for consecutive 3 days. After last medication ，blood sample was collected from the abdominal aorta to obtain drug-containing serum. GCs of rat were divided into blank control group ，model group ，FSH group （positive control ）and CDP high-dose ，medium-dose and low-dose groups. The autophagy model was induced by giving testosterone propionate ，except that the blank control group was directly added with 100 μL serum of normal saline group. Then model group was given 100 μL serum of normal saline group，and administration groups were given 100 μL drug-containing serum of corresponding drug group. The contents of estradiol（E2）and progesterone （P）in supernatant of cells were determined by ELISA. Western blot assay was used to detect protein expression of PI 3K，Akt and mTOR in cells. The mRNA expression of PI 3K，Akt，mTOR，Beclin 1，LC3Ⅰ，LC3Ⅱ and p 62 were detected by RT-PCR. RESULTS ： Compared with blank control group ，the content of E 2 in supernatant ，relative mRNA and protein expression of PI 3K，Akt and mTOR were decreased significantly in model group （P＜0.01），while relative mRNA expression of Beclin 1，LC3Ⅰ and LC 3Ⅱ were increased significantly （P＜0.01）. Compared with model group ，the content of E 2 in supernatant were significantly increased in FSH group ，CDP medium-dose and high-dose groups ，while relative mRNA expression of Beclin 1，LC3Ⅰ，LC3Ⅱ and p 62 were decreased significantly （P＜0.05 or P＜0.01）；relative mRNA and protein expression of PI 3K，Akt and mTOR were increased significantly in administration groups （P＜0.05 or P＜0.01）. CONCLUSIONS ：CDP can inhibit autophagy of GCs by activating related protein and mRNA expression of PI 3K/Akt/ mTOR signaling pathway.

OBJECTIVE： To systematically evaluate therapeutic efficacy of modified Cangfu daotan decoction （MCDD） combined with chemical medicine versus chemical medicine alone in the treatment of polycystic ovarian syndrome （PCOS）， and to provide evidence-based reference for clinical decision. METHODS： Retrieved from PubMed， Embase， Cochrane Library， CJFD， Wanfang database， VIP and CBM， randomized controlled trials （RCTs） about MCDD combined with chemical medicine [ethynestradiol cycloprogesterone （Diane-35）， clomiphene， metformin] （trial group） versus chemical medicine alone （control group） in the treatment of PCOS were collected. After data extraction and quality evaluation with Cochrane 5.1.0 bias risk evaluation tool and Jadad scale， Meta-analysis was conducted for total response rate， serum hormone level （FSH， LH， LH/FSH， testosterone）， BMI， ovulation rate and physical signs （hirsutism， acne） by using Stata 14.0 software. Trial sequential analysis（TSA）was conducted by using TSA 0.9 software. RESULTS： A total of 20 RCTs were included， involving 1 484 patients. Results of Meta analysis showed that total response rate [RR＝1.13，95％CI （1.02，1.24），P＜0.05]， serum hormone level {FSH [WMD＝－0.59，95％CI（－0.98，－0.20），P＜0.05]，LH [WMD＝－0.95，95％CI（－1.41， －0.52），P＜0.05]，LH/FSH [WMD＝－1.04，95％CI（－1.78，－0.33），P＜0.05]，testosterone [WMD＝－0.93，95％CI（－1.38，－0.28），P＜0.05]}， BMI [SMD＝－1.01，95％CI  （－1.76，－0.27），P＜0.05]， ovulation rate [RR＝1.17，95％CI（1.02，1.34），P＜0.05] and physical signs {hirsutism [WMD＝－0.48，95％CI（－0.86， －0.10），P＜0.05]， acne [WMD＝－1.16，95％CI（－1.56，－0.75），P＜0.05]} of trial group were all better than those of control group， with statistical significance. TSA showed that there are reliable evidences for MCDD combined with chemical medicine in the treatment of PCOS. CONCLUSIONS： Versus chemical medicine alone in the treatment of PCOS， MCDD combined with chemical medicine can improve total response rate and ovulation rate， reduce serum hormone levels， BMI and physical signs.

OBJECTIVE： To systematically evaluate the efficacy of Compound xuanju capsules combined with chemical medicine versus chemical medicine alone in the treatment of polycystic ovarian syndrome （PCOS）， in order to provide evidence-based medicine guidelines for clinical medication. METHODS： Retrieved from PubMed， Embase， Cochrane library， CBM， VIP， CJFD and Wanfang database from database establishment to Apr. 5， 2019， randomized controlled trials （RCTs） about therapeutic efficacy （total response rate， ovulation rate， pregnancy rate， FSH level， LH level， testosterone level， degree of endometrial thickening） of Compound xuanju capsules combined with chemical medicine （trial group） versus chemical medicine alone （control group） in the treatment of PCOS were collected. After data extraction and quality evaluation of included studies with modified Jadad scale， Meta-analysis was conducted by using STATA 14.0 software. Trial sequential analysis （TSA） was conducted by using TSA 0.9 software. RESULTS： A total of 15 RCTs were included， involving 1 259 patients. The results of Meta-analysis showed that the total response rate [RR＝1.27，95％CI（1.13，1.44），P＜0.001]， ovulation rate [RR＝1.18，95％CI（1.03，1.37），P＜0.001]， pregnancy rate [RR＝1.34，95％CI（1.11，1.61），P＜0.001]， serum hormone level {FSH [SMD＝－0.66，95％CI （－0.51，  －0.82），P＜0.001]， 95％CI（－1.76，－1.41），P＜0.001]， LH [SMD＝－1.24，95％CI（－1.39， －1.08），P＜0.001]， testosterone [SMD＝－1.59，95％CI（－1.76，－1.41），P＜0.001]} and endometrial thickness [SMD＝1.20，95％CI（1.04，1.37），P＜0.001] of the trial group were better than those of the control group， with statistical significance. The results of TSA were reliable. CONCLUSIONS： In the treatment of PCOS， Compound xuanju capsules combined with chemical medicine is better than chemical medicine alone in improving total response rate， pregnancy rate， ovulation rate and endometrial thickness， and reducing serum hormone levels.

Objective To explore the clinical phenotype of 22q11.2 deletion syndrome with imperforate anus. Methods The clinical diagnosis and treatment of one case of 22q11.2 deletion syndrome complicated with anal atresia were retrospectively analyzed. Gene and phenotype of this disease were analyzed, and the related literature was reviewed. Results An elder male test tube infant of twins, born to a G2P2 mother were found to have special facial features, cleft palate, congenital heart disease, and imperforate anus after birth. A genome-wide microarray scan revealed 22q11.2 deletion syndrome. In related literatures, 22q11.2 deletion syndrome could be affected by TBX1 gene, histone modification, Ranbp1 gene, and even microRNA; while imperforate anus were influenced by multiple elements such as genetic, maternal, and environmental factors and multiple embryonic developments related genes could be involved in its pathogenesis. Conclusions Congenital imperforate anus and 22q11.2 deletion syndrome are mostly sporadic cases in epidemiology and are incidental accidents in development. Whether there is a common interaction factor between them needs to be further studied and defined.

Objective To discuss pathogens findings in children with severe pneumonia.Methods Bacteria was detected by using sputum culture and blood culture in sterile culture media.Viruses and atypical pathogenic antibodies were detected by using indirect immunofluorescence.Influenza A (H1N1) virus RNA were tested using RT-PCR.According to the results of bacterial culture and drug sensitive test,we can guide the use of antibiotics,and individualize treatment was carried out,including anti-inflammatory,organ function support.Results Bacteria was found in 69 children by using sputum culture.Gram negative bacteria accounted for 57.47％.Gram positive bacteria accounted for 42.53％.Escherichia coli(14.94％),Haemophilus influenzae (20.96％) and klebsiella pneumoniae(13.79％) were the main strains of Gram negative bacteria,Staphylococcus aureus (21.84％)and Streptococcus pneumonia(16.1％)were the main strains of Gram positive bacteria.Bacteria was found in 7 (8.00％) children by using blood culture.Virus were identified in 11 out of 123 patients,including 2 cases of respiratory syncytial virus antibody positive,2 cases of adenovirus antibodies positive,4 cases of influenza B virus antibody positive,2 cases of parainfluenza virus antibody positive and influenza A(H1N1) virus from only one case,Mycoplasma pneumonia agents were identified in 8 patients.Eighty-nine children (72.36％) complicated with sepsis,85 children (69.11％) with respiratory failure,48 children (39.02％) with gastrointestinal dysfunction,32 children (26.02％) with heart failure,18 children(14.63％) with septic shock,13 cases (10.57％) with toxic encephalopathy,5 children (4.07％) with disseminated intravascular coagulation.Among them,17 children (13.82％) complicated with multiple organ dysfunction syndrome.In the 123 children with severe pneumonia,46 cases (37.4％) were cured,73 cases (59.35％) improved,and 4 cases died (3.25％) with critical multiple organ dysfunction syndrome.Conclusion The detection rate of pathogen is high in this study.We should pay more attention to individualize therapy for complication,so that the cure rate could be increased.