OBJECTIVE: To analyze the acupoint selection patterns and core prescriptions of acupuncture for polycystic ovary syndrome (PCOS) using data mining, and to explore the molecular mechanisms of core acupoints through network acupuncture medicine. METHODS: The randomized controlled trials (RCTs) on acupuncture for PCOS published from January 1, 2004 to July 21, 2024 were retrieved from CNKI, VIP, Wanfang, PubMed, and Web of Science databases. R software (version 4.4.0) was used for acupoint frequency and association rule analysis to identify core acupoint prescriptions. Potential targets were predicted via the STITCH and Swiss Target Prediction databases, and a "core prescription-active compounds-targets- PCOS" network was constructed. Cytoscape 3.7.1 was applied to build protein-protein interaction (PPI) networks of potential targets of core acupoint prescriptions. Key therapeutic targets were subjected to gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses using the DAVID and Microbioinformatics platforms. RESULTS: A total of 176 RCTs were included, covering 208 prescriptions and 89 acupoints. The five most frequently used acupoints were Guanyuan (CV4), Sanyinjiao (SP6), Zigong (EX-CA1), Zusanli (ST36) and Zhongji (CV3). Association rule analysis yielded 13 core acupoint combinations, with Guanyuan (CV4), Sanyinjiao (SP6), Zigong (EX-CA1) and Zusanli (ST36) as the core prescription. Twenty-seven active compounds were involved, with 852 potential therapeutic targets, among which 208 targets overlapped with PCOS-related targets. Network acupuncture medicine analysis suggested that the core prescription may act through targets such as estrogen receptor 1 (ESR1), proto-oncogene tyrosine-protein kinase Src (SRC), signal transducer and activator of transcription 3 (STAT3), peroxisome proliferator-activated receptor gamma (PPARG), and RAC-alpha serine/threonine-protein kinase (AKT1). GO and KEGG analyses indicated that the main pathways included the hypoxia-inducible factor 1 (HIF-1) signaling pathway, phosphatidylinositol 3-kinase-protein kinase B (PI3K-AKT) signaling pathway, and advanced glycation end products-receptor for advanced glycation end products (AGE-RAGE) signaling pathway, involving processes such as signal transduction, receptor complex formation, and cytokine activity. CONCLUSION The core acupoint prescription for PCOS might exert therapeutic effects through multiple targets and pathways, providing a theoretical basis for mechanistic research on acupoint prescriptions.
Humans ; Acupuncture Therapy ; Data Mining ; Acupuncture Points ; Polycystic Ovary Syndrome/metabolism* ; Female ; Protein Interaction Maps ; Randomized Controlled Trials as Topic

Objective:To investigate the relationship between oxygen consumption (VO 2), carbon dioxide production (VCO 2), and Oxygen Consumption/lactate (VO 2/Lac) with risk of death in patients with severe ARDS. Methods:A retrospective cohort study method was used, and the study subjects were hospitalized for >5 days adult patients with severe ARDS in the central intensive care unit of Henan Provincial People's Hospital from 1 March 2020 to 30 June 2023. The following patients were excluded: IC test was not completed on the 4th day of ICU admission, IC test results were unreliable, mechanical ventilation duration had exceeded 48 h at the time of ICU transfer or admission, palliative care patients and pregnant and parturient women. Using indirect calorimetry to determine VO 2 and VCO 2 values on the 4th day of admission, reviewing medical records to obtain general condition, disease information, blood gas analysis (including lactate value), diagnostic and therapeutic measures, and following up deaths by telephone and time of death. The primary outcome measure was death at 90 days, and the secondary outcome measure was death at 28 days, length of stay in ICU, total length of stay, and total hospitalization cost. Cox regression analysis and linear regression analysis were used to investigate the relationship between VO 2, VCO 2, VO 2/Lac and primary and secondary outcome indexes. Results:A total of 216 patients were enrolled, 78 patients (36.1%) died and 138 patients (63.9%) survived at 90 days. After correction for confounders, the results of multifactorial Cox regression analysis suggested that compared with the Q4 group, HR (95% CI) for 90-day risk of death in the VO 2 Q1 and Q2 groups was 3.21 (1.38, 7.49) and 3.24 (1.42, 7.38), and HR (95% CI) for 90-day risk of death in the VCO 2 Q1, Q2 and Q3 groups was 5.88 (2.33, 14.84), 4.26 (1. 60, 11.34) and 3.54 (1.34, 9.35), respectively, and the HR (95% CI) for 90-day risk of death in the VO 2/Lac Q1, Q2 and Q3 groups were 8.72 (3.01, 25.25), 8.43 (2.91, 24.47) and 4.04 (1.34, 12.17) respectively. P-trends were all <0.05, indicating that VO 2, VCO 2 and VO 2/Lac were linearly and negatively associated with the risk of 90-day mortality. In addition, VO 2, VCO 2, and VO 2/Lac were negatively associated with 28-day risk of death and higher VO 2/Lac was negatively associated with length of ICU stay. Conclusions:VO 2, VCO 2 and VO 2/Lac were negatively associated with 90-day mortality risk and 28-day mortality risk in patients with severe ARDS and may be independent risk factors predicting mortality risk of such patients.

Objective:To systematically evaluate the risk prediction model of diabetic foot ulcer (DFU) recurrence, so as to provide theoretical guidance for the prevention of DFU recurrence.Methods:The literature on DFU risk prediction models was systematically searched on the Web of Science, Embase, PubMed, CINAHL, Cochrane Library, China Biology Medicine, CNKI, VIP, WanFang Data, and the citations and references of the included literature were traced back. The search period was from the establishment of the database to March 1, 2024, and the search language was not limited. Two researchers independently conducted literature screening and data extraction, and evaluated the quality of the included studies using the predictive model bias risk assessment tool.Results:A total of 12 articles were included, involving 18 prediction models, with a sample size ranging from 101 to 1 333 cases and a number of outcome events ranging from 29 to 209. The predictive factors with the high number of repeated model reports were ulcer location ( n=9), smoking history ( n=8), gender ( n=6), amputation history ( n=6), glycated hemoglobin ( n=5), and body mass index ( n=5). The area under the receiver operating characteristic curve reported by 18 models ranged from 0.660 to 0.943. Nine articles underwent internal validation, and five articles underwent a combination of internal and external validation. These 18 prediction models had good applicability, but there was a high risk of bias, mainly concentrated in data analysis. Conclusions:Special attention should be paid to male DFU patients with foot ulcers and a history of smoking. The included model has good predictive performance and applicability, which helps medical and nursing staff identify high-risk patients for DFU recurrence early. Extensive and in-depth validation can be conducted on existing models, or prospective studies with multiple centers and large samples can be conducted to reduce bias and continuously optimize the model, thereby serving clinical practice well.

The smoking cessation rate of 1 314 people at high risk of lung cancer in the area of lung cancer screening and early diagnosis and early treatment in Sichuan Province increased from 22.37% at baseline to 41.78% after screening (χ2=227.97, P<0.001), and the smoking amount of persistent smokers decreased from 20 cigarettes per day to 15 cigarettes per day ( t=11.76, P<0.001). Those with positive results in lung cancer screening were more likely to quit smoking or continue to quit smoking. Male, younger age or lower education level would increase the risk of continuous smoking or relapse ( P<0.05).

Objective:To explore the application effect of coaching technique in respiratory function exercise of patients with chronic obstructive pulmonary disease (COPD) in stable stage.Methods:Using the convenient sampling method, a total of 40 COPD patients in stable stage who were treated in Geriatric and Respiratory Departments of 3 provincial hospitals in Hangzhou were selected as the research objects from August 2018 to June 2019. They were given a six-month breathing intervention based on coaching techniques by trained health coaches. COPD Self-Efficacy Scale (CSES) and COPD Assessment Test (CAT) were used to evaluate self-efficacy and quality of life of patients before and after intervention. The awareness and implementation of respiratory function exercise were compared before and after intervention.Results:After6 months of intervention, compared with those before intervention, the score of awareness and implementation of respiratory function exercise of patients increased, and the differences were statistically significant ( P<0.05) . After the intervention, the score of CSES increased and the scores of CAT decreased, and the differences were statistically significant compared with those before the intervention ( P<0.05) . Conclusions:The application of coaching technique in the respiratory function exercise of COPD patients in stable period has a certain effect, which can improve the awareness and implementation of patients with respiratory function exercise and improve their sense of self-efficacy and quality of life.

The smoking cessation rate of 1 314 people at high risk of lung cancer in the area of lung cancer screening and early diagnosis and early treatment in Sichuan Province increased from 22.37% at baseline to 41.78% after screening (χ2=227.97, P<0.001), and the smoking amount of persistent smokers decreased from 20 cigarettes per day to 15 cigarettes per day ( t=11.76, P<0.001). Those with positive results in lung cancer screening were more likely to quit smoking or continue to quit smoking. Male, younger age or lower education level would increase the risk of continuous smoking or relapse ( P<0.05).

Objective:To investigate the pathological characteristics and the clinical significance of novel coronavirus (2019-nCoV)-infected pneumonia (termed by WHO as coronavirus disease 2019, COVID-19).Methods:Minimally invasive autopsies from lung, heart, kidney, spleen, bone marrow, liver, pancreas, stomach, intestine, thyroid and skin were performed on three patients died of novel coronavirus pneumonia in Chongqing, China. Hematoxylin and eosin staining (HE), transmission electron microcopy, and histochemical staining were performed to investigate the pathological changes of indicated organs or tissues. Immunohistochemical staining was conducted to evaluate the infiltration of immune cells as well as the expression of 2019-nCoV proteins. Real time PCR was carried out to detect the RNA of 2019-nCoV.Results:Various damages were observed in the alveolar structure, with minor serous exudation and fibrin exudation. Hyaline membrane formation was observed in some alveoli. The infiltrated immune cells in alveoli were majorly macrophages and monocytes. Moderate multinucleated giant cells, minimal lymphocytes, eosinophils and neutrophils were also observed. Most of infiltrated lymphocytes were CD4-positive T cells. Significant proliferation of type Ⅱ alveolar epithelia and focal desquamation of alveolar epithelia were also indicated. The blood vessels of alveolar septum were congested, edematous and widened, with modest infiltration of monocytes and lymphocytes. Hyaline thrombi were found in a minority of microvessels. Focal hemorrhage in lung tissue, organization of exudates in some alveolar cavities, and pulmonary interstitial fibrosis were observed. Part of the bronchial epithelia were exfoliated. Coronavirus particles in bronchial mucosal epithelia and type Ⅱ alveolar epithelia were observed under electron microscope. Immunohistochemical staining showed that part of the alveolar epithelia and macrophages were positive for 2019-nCoV antigen. Real time PCR analyses identified positive signals for 2019-nCoV nucleic acid. Decreased numbers of lymphocyte, cell degeneration and necrosis were observed in spleen. Furthermore, degeneration and necrosis of parenchymal cells, formation of hyaline thrombus in small vessels, and pathological changes of chronic diseases were observed in other organs and tissues, while no evidence of coronavirus infection was observed in these organs.Conclusions:The lungs from novel coronavirus pneumonia patients manifest significant pathological lesions, including the alveolar exudative inflammation and interstitial inflammation, alveolar epithelium proliferation and hyaline membrane formation. While the 2019-nCoV is mainly distributed in lung, the infection also involves in the damages of heart, vessels, liver, kidney and other organs. Further studies are warranted to investigate the mechanism underlying pathological changes of this disease.

Objective: To evaluate the clinical performance of HPV genotyping with cytology for detecting cervical precancer among women attending co-testing. Methods: A total of 2 883 females who participated in cervical cancer screening program were recruited from Erdos in 2016. All the participants were tested by cytology and HPV genotyping. In 2017, women with abnormal cytology results or HPV positive were followed up. Pathological cervical intraepithelial neoplasia (CIN) 2+ was the study end-point. Clinical performance indexes were calculated, including sensitivity, specificity, positive predictive value, negative predictive value, referral rate and missed cases. Results: INNO-LiPA resulted in a detection rate of 18.87%(544/2 883) for the 14-type high risk HPV. HPV16 was the most common infectious genotype (4.06%), followed by HPV52 (3.61%), HPV51 (2.50%), HPV58 (1.98%), and HPV18 (1.56%). With more HPV genotypes added into the group, sensitivity increased and the specificity decreased. Addition of HPV16, 58, 33, 39, 52, 18, 31 for detection lead to the maximun value of area under the curve (AUC)=0.913 (95%CI: 0.882-0.944). Compared with traditional screening method by cytology, cotesting decreased the number of missed diagnosis. Meanwhile, the fifth method (co-testing: triage of women with HPV16/18+ , cytological minor abnormalities and HPV58, 33, 39, 52, 31+ or cytological high grade abnormalities) did not increase referral rate (8.99% vs. 8.71%, P=0.525), with five cases of missed diagnosis (sensitivity of 92.1% and specificity of 93.2%). Conclusions Co-testing with triage of women with HPV16/18+ , cytological minor abnormalities and HPV58, 33, 39, 52, 31+ or cytological high grade abnormalities would provide better clinical performance. In co-testing, triage of HPV16/18 was used in women with normal cytology; triage of HPV58, 33, 39, 52 and 31 was used in women with low-grade abnormal cytology; referral colposcopy was used in women with high-grade abnormal cytology, which would provide better clinical performance.

Objective Bone defect repair remains a challenge in regenerative medicine, which has triggered a research upsurge on improving the bone repairing effect using heterogeneous bone combined with growth factors.The aim of this study was to evaluate local bone formation following surgical implantation of coralline hydroxyapatite (CHA), a heterogeneous bone, in combination with the concentrated growth factor (CGF).Methods This randomized prospective study included 24 New Zealand rabbits, which were equally divided into a CHA/CGF+CHA, a CHA/CGF+autograft and a CHA+autograft group.A defect 10 mm in diameter was made in the parietal bone of each animal and filled with CHA/CGF, CHA or autograft.At 6 and12 weeks after the operation, we observed the bone formation by micro-CT and histological examination.Results The bone volume (BV) was significantly higher in the CHA/CGF+CHA than in the CHA+autograft group both at 6 weeks ([39.00±7.61] vs [32.12±6.55] mm3, P<0.05) and at 12 weeks after the operation ([49.75±2.36] vs [39.45±7.02] mm3, P<0.05), and so was the bone mineral density (BMD) ([308.30±29.82] vs [256.85±151.25] mg/mL, P<0.05;[389.00±31.87] vs [302.53±127.05] mg/mL, P<0.05).Histological examination showed that the new bone was distributed throughout the CHA scaffold in the CGF/CHA group at 6 weeks, and the new bone was observed only in the periphery region of the CHA scaffold in the CHA group.The bone defects in the CGF/CHA group were fully repaired at 12 weeks, while those in the CHA group were partly repaired with bone and fibrous tissue in the central region of the defects.Conclusion Combination of CHA with CGF could effectively enhance bone healing.CHA/CGF compound artificial bone is an ideal substitute in bone transplantation.

Objective To evaluate the accuracy of magnifying endoscopy with narrow-band imaging (ME-NBI) for detecting early esophageal cancer invasion depth. Methods We searched Embase, Pubmed, Web of Science, Cochrane Library, CBM, CNKI, Wanfang and VIP databases from inception to Feb.2016. Domestic articles related to the accuracy of ME-NBI detecting the early esophageal cancer invasion depth were collected comprehensively. The quality of the papers was evaluated by quality assessment of diagnostic accuracy studies (QUADAS). Data analysis was conducted by Stata 12.0 software. Results Seven group data from six studies including 319 patients with 366 lesions met the inclusion criteria. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, SROC area under the curve and DOR were 93.8 % (95 % CI: 0.886~0.967), 75.2 % (95 % CI: 0.658~0.827), 3.779 (95 % CI: 2.685 ~ 5.318), 0.083 (95 % CI: 0.044~0.155), 0.80 (95 % CI: 0.770~0.840) and 45.658 (95 % CI:21.006~99.240). Conclusions The results suggest that ME-NBI may be an effective tool for detecting invasion depth of early esophageal cancer, which plays an important role in clinical selection of surgical approach and treatment.