Objective To develop the evidence base for the"Guidelines for the Diagnosis and Treatment of Integrated Traditional Chinese and Western Medicine for Female Menopausal Syndrome"(hereafter referred to as"the guideline"),aiming to provide effective evidence to support the formulation of recommendation statements.Methods Based on Internationally recognized methods and standards for evidence-based guideline development,the PICO(population,intervention,comparison,outcome)framework was used to construct clinical questions.A systematic literature search was conducted across domestic and international databases to identify studies published before 30 July,2022,focusing on the treatment of menopausal syndrome with integrated Chinese and Western medicine.Studies were se-lected based on predefined inclusion and exclusion criteria.Data extraction and synthesis were performed using ReviewManager 5.3software,and the quality of evidence was assessed employing the GRADE(Grading of Recommendations,Assessment,Development and Evaluation)methodology.Results A total of 143322 articles were retrieved,with 92studies ultimately included.These studies encom-passed treatment interventions such as classical formulas,Chinese patent medicines,and distinctive therapies.The evidence from these studies was synthesized and graded,resulting in an overview of evidence pertinent to both foundational and clinical questions.Conclusion The construction process of the evidence body in this guideline is an exploratory practice of evidence-based traditional Chinese medicine.This article reviews the important steps involved,with a view to providing a reference for the development/revision of clinical practice guidelines for traditional Chinese medicine.

Objective To observe the value of multi-task improved nnU-Net model based on enhanced CT for segmenting primary oral cancer and predicting patients'relapse free survival(RFS).Methods Enhanced CT data of 186 cases of primary oral cancer were retrospectively analyzed,and a multi-task improved nnU-Net model was constructed for tumor segmentation and survival prediction tasks.Pre-training of tumor segmentation was completed with nnU-Net as the baseline network,and the accuracy of recognizing and segmenting tumor was improved by enhancing the decoder through the modified skip connection.Then univariable and multivariable regression analyses were used to select clinical features closely associated with RFS.Radiomics and deep learning features were also extracted to construct a survival prediction model,with fine-tuning of the above model.The training set,validation set and test set were divided at a ratio of 7∶2∶1.Dice similarity coefficient(DSC)was used to evaluate the segmentation performance of the modified model,and the consistency index C-index was used to verify the performance of the improved model for predicting RFS.Results DSC of the multi-task improved nnU-Net model(0.78)for segmenting primary oral cancer was superior to that of 3D Inception ResNet(0.65),3D InceptSENet(0.75)and 3D U-Net models(0.69),respectively,its C-index for predicting RFS(0.798)was higher than that of Cox regression model(0.744),ICARE model(0.761),random forest model(0.744),DeepSurv model(0.735),nnU-Net model(0.760)and radiology+nnU-Net model(0.744),respectively.DSC for segmenting primary oral cancer and C-index for predicting RFS of multi-task improved nnU-Net model were both superior to those of simple baseline network(0.653 and 0.649),baseline network+multi-scale convolution fusion(0.755 and 0.752),as well as baseline network combined with clinical features(0.764 and 0.759),radiomics features(0.770 and 0.764)and clinical+radiomics features(0.773 and 0.761),respectively.Conclusion Multi-task improved nnU-Net model could be used to effectively improve the accuracy of tumor segmentation and predicting patients'RFS.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To observe the value of multi-task improved nnU-Net model based on enhanced CT for segmenting primary oral cancer and predicting patients'relapse free survival(RFS).Methods Enhanced CT data of 186 cases of primary oral cancer were retrospectively analyzed,and a multi-task improved nnU-Net model was constructed for tumor segmentation and survival prediction tasks.Pre-training of tumor segmentation was completed with nnU-Net as the baseline network,and the accuracy of recognizing and segmenting tumor was improved by enhancing the decoder through the modified skip connection.Then univariable and multivariable regression analyses were used to select clinical features closely associated with RFS.Radiomics and deep learning features were also extracted to construct a survival prediction model,with fine-tuning of the above model.The training set,validation set and test set were divided at a ratio of 7∶2∶1.Dice similarity coefficient(DSC)was used to evaluate the segmentation performance of the modified model,and the consistency index C-index was used to verify the performance of the improved model for predicting RFS.Results DSC of the multi-task improved nnU-Net model(0.78)for segmenting primary oral cancer was superior to that of 3D Inception ResNet(0.65),3D InceptSENet(0.75)and 3D U-Net models(0.69),respectively,its C-index for predicting RFS(0.798)was higher than that of Cox regression model(0.744),ICARE model(0.761),random forest model(0.744),DeepSurv model(0.735),nnU-Net model(0.760)and radiology+nnU-Net model(0.744),respectively.DSC for segmenting primary oral cancer and C-index for predicting RFS of multi-task improved nnU-Net model were both superior to those of simple baseline network(0.653 and 0.649),baseline network+multi-scale convolution fusion(0.755 and 0.752),as well as baseline network combined with clinical features(0.764 and 0.759),radiomics features(0.770 and 0.764)and clinical+radiomics features(0.773 and 0.761),respectively.Conclusion Multi-task improved nnU-Net model could be used to effectively improve the accuracy of tumor segmentation and predicting patients'RFS.

Objective To develop the evidence base for the"Guidelines for the Diagnosis and Treatment of Integrated Traditional Chinese and Western Medicine for Female Menopausal Syndrome"(hereafter referred to as"the guideline"),aiming to provide effective evidence to support the formulation of recommendation statements.Methods Based on Internationally recognized methods and standards for evidence-based guideline development,the PICO(population,intervention,comparison,outcome)framework was used to construct clinical questions.A systematic literature search was conducted across domestic and international databases to identify studies published before 30 July,2022,focusing on the treatment of menopausal syndrome with integrated Chinese and Western medicine.Studies were se-lected based on predefined inclusion and exclusion criteria.Data extraction and synthesis were performed using ReviewManager 5.3software,and the quality of evidence was assessed employing the GRADE(Grading of Recommendations,Assessment,Development and Evaluation)methodology.Results A total of 143322 articles were retrieved,with 92studies ultimately included.These studies encom-passed treatment interventions such as classical formulas,Chinese patent medicines,and distinctive therapies.The evidence from these studies was synthesized and graded,resulting in an overview of evidence pertinent to both foundational and clinical questions.Conclusion The construction process of the evidence body in this guideline is an exploratory practice of evidence-based traditional Chinese medicine.This article reviews the important steps involved,with a view to providing a reference for the development/revision of clinical practice guidelines for traditional Chinese medicine.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To explore the status of knowledge graph-based research into breast cancer micro-environment and to predict future research hotspots.Methods The literature related to breast cancer microenvironment in recent 20 years was retrieved from CNKI and Web of Science Core Collection database and analyzed with CiteSpace and VOSviewer.Results A total of 825 Chinese articles and 16,221 English articles were retrieved.Visual analysis showed that research focus has gradually shifted from cellular research to molecular research and drug innovation.Cancer stem cells,PD-1,PD-L1,immune checkpoint inhibitors,and nanoparticles are the main subjects of interest in research on breast cancer microenvironment,and the United States has the largest number of studies on breast cancer microenvironment,followed by China and Italy.Conclusion Current research mainly focuses on tumor stemness,immunotherapy,and nanodeli-very.Owing to deepening research in this field,the targeting of the breast cancer microenvironment for the prevention of tumor development and metastasis and improvement of tumor prognosis has emerged as a new research direction.

Tumor immune microenvironment has been the focus of tumor research in recent years, and its role in tumor regulation has become prominent and has received increasing attention. The imbalance of the tumor immune microenvironment plays an important role in promoting tumor progression, and the adjustment of its instability plays an important role in controlling tumor progression. The theoretical idea of Traditional Chinese Medicine's "Yipingweiqi" is basically the same as that of modern medicine of controlling tumors by maintaining the balance of the immune microenvironment. This study discusses the aspects of tumor immune microenvironment, its destabilization, relationship to tumor progression, importance in Traditional Chinese Medicine, and regulation by Traditional Chinese Medicine with different treatments. In particular, this work focuses on the role of Traditional Chinese Medicine in maintaining the balance of the tumor immune microenvironment and its potential mechanism by using qi benefit, yang warming, dampness eliminating, and heat clearing under the guidance of the principle of "Yipingweiqi". Results will provide reference for the application of Traditional Chinese Medicine in the diagnosis and treatment of tumors.

Objective To analyze the correlation between emphysema extent measured by high resolution computed tomography (HRCT) and pulmonary function tests, symptom score in patients with chronic obstructive pulmonary disease ( COPD ) , and to study the value of HRCT in the emphysema quantification in the clinical evaluation of COPD patients. Methods 78 patients with stable COPD were recruited to take the HRCT scan , and emphysema extent was qualified by measuring the proportion of low attenuation area in the whole lung (LAA%). Correlations between LAA% and indices of pulmonary function test, bronchial dilation test, mMRC scale, CAT score and six minutes walking distance (6MWD) were assessed. Results LAA% was negatively correlated with FEV1/FVC and DLCO%pred, and the correlation coefficients were -0.759 and -0.589 (P <0.01), respectively. LAA% was positively related to mMRC score (r = 0.342, P < 0.01), and negatively asso-ciated with 6MWD (r = -0.365,P< 0.01). There was no association between LAA% and indices of bronchodila-tion test (⊿FVC, ⊿FVC%, ⊿FEV1, ⊿FEV1%) (P > 0.05). Conclusions The severity of emphysema measured by HRCT is well correlated with the clinical symptoms , pulmonary function tests and exercise capacity in COPD patients. It can be used to diagnose emphysema early and to evaluate the severity of the disease com-prehensively. Thus, the risk factors of COPD can be controlled and the prognosis of the patients can be im-proved.

AIM:To understand the interaction between a195- kilodalton protein,P195, on the surface of Plasmodium falciparum merozoite and human erythrocyte.METHODS:P195 was expressed in eight fragments in E.coli.After being refolded,the expressed proteins were la- belled with12 5 I,and incubated with human erythrocytes.RESULTS:According to binding assay, three fragments of P195:M3,M6,M9were found to have ability to bind to human erythrocyte. M6,which is equal to amino acid( AA) sequence from384 to595,could bind to human erythro- cytes but not to trypsin treated human erythrocytes,and the binding could be eluted by low p H buffer solution. M3( AA 12 3to 30 2 ) and M9( AA 10 78to 12 51) also have the ability to bind to human erythrocytes,but the binding was not affected by trypsin treatment and low p H buffer elu- tion. CONCL USION:The binding site of M6might be a surface protein receptor of human ery- throcytes,while the binding site of M3and M9might be an intracellular componentof human ery- throcyte.