Objective: Randomized controlled trials (RCTs) of Chinese patent medicines and classic traditional Chinese medicine prescriptions were systematically reviewed from both Chinese and English journals published in 2023. A preliminary summary and evaluation were conducted on the generation and translation of clinical evidence for these treatments. This analysis aims to inform future research on clinical efficacy evaluation and guide the rational application of evidence. Methods: RCTs of Chinese patent medicines and classic traditional Chinese prescriptions published in 2023 were comprehensively retrieved from the Artificial Intelligence Clinical Evidence Database for Chinese Patent Medicine (AICED-CPM), with supplementary searches conducted in China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (SinoMed), Cochrane Library, PubMed, Embase, and Web of Science. The study characteristics and methodological quality of these RCTs were systematically analyzed and evaluated. Results: A total of 1 443 RCTs of Chinese patent medicines were included, comprising 1 399 Chinese articles and 44 English articles. Additionally, 334 RCTs of classic traditional Chinese medicine prescriptions were found, with 331 published in Chinese and 3 in English. 196 567 participants were included, covering 585 types of Chinese patent medicines (487 oral, 61 injectable, and 37 topical) and 179 classic traditional Chinese medicine prescriptions. The involved studies encompassed 22 types of diseases, with research primarily focusing on diseases of the circulatory system, the respiratory system, and the genitourinary system. The sample sizes ranged from 18 to 3 777 participants, and most studies were conducted at a single center. Methodologically, the implementation of allocation concealment and blinding remained insufficiently emphasized. Conclusion Overall, compared with 2022, both the number of RCT publications and their methodological quality have improved in 2023, with heightened attention to research on diseases of the genitourinary system. However, quality control and standardized management in the design and implementation processes still require enhancement to produce more high-quality clinical evidence and accelerate the translation and application of this evidence.

Objective:This study aims to obtain the prevalence and features associated with Violence Against Children (VAC) in China and, thus, formulate a prevention strategy.Methods:The mortality-related data of VAC was sourced from the National Disease Surveillance Points System (DSP) during 2013-2021. We analyzed the DSP data regarding children aged 0-17 years old who died from violence. The hospital cases of VAC was sourced from the National Injury Surveillance System (NISS), 2013-2021. We analyzed the data from NISS with the parameter of "intentional injury" caused by VAC in children aged between 0-17 years. Using robust linear regression, we analyze the time trend in the proportion of violence incidence. To understand the variations in the incidence of different types of violence across genders, we apply the chi-square test and adjusted Pearson residuals.Results:The overall trend of death caused by VAC has declined; it was reduced to 0.14/100 000 in 2021 from 0.33/100 000 in 2013. In 2021, male VAC mortality (0.15/100 000) was higher than females (0.13/100 000). The proportion of VAC cases to all injury cases has declined from 3.34% in 2013 to 2.29% in 2021. Among 9 344 VAC cases supervised by hospitals in 2021, the number of males (7 503 cases) was around 4 times that of females (1 841 cases), and the top three modes of violence were blunt tools (64.77%), falls (7.46%) and sharp instruments (6.18%), and 45 cases of sexual violence included 38 girls and 7 boys.Conclusions:The declining death rate due to VAC may be related to the benign development of Chinese society. Prevention strategies targeting training in parenting skills and problem-solving should be prioritized.

Objective:To investigate the clinicopathological characteristics of gastrointestinal tumors with SWI/SNF complex deficiency and to perform a prognostic analysis of the patients.Methods:Gastrointestinal tumor cases with SWI/SNF complex deficiency expression diagnosed at the Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China from August 2021 to May 2023 were collected. Hematoxylin and eosin (HE) stained slides were reviewed, and immunohistochemical results were analyzed. Clinical and pathological information was recorded, and relevant literature was reviewed.Results:A total of 36 cases of gastrointestinal tumor with loss of SWI/SNF complex expression were identified, including 28 males (77.8%) and 8 females (22.2%). The average age at diagnosis was 70 years (range 48-85 years). Clinical staging showed 3 cases in stage Ⅰ (8.3%), 12 cases in stage Ⅱ (33.3%), 19 cases in stage Ⅲ (52.8%), and 2 cases in stage Ⅳ (5.6%). Complete or partial loss of ARID1A expression was observed in 20 cases (55.6%); complete or partial loss of SMARCA2 expression was observed in 24 cases (66.7%). SMARCA4 exhibited complete loss of expression in 4 cases (11.1%). Eleven cases (30.6%) showed concurrent complete or partial losses of both ARID1A and SMARCA2 expression. Twelve cases (33.3%) had mismatch repair protein deficiency, all of which were characterized by MLH1/PMS2 absence. Mismatch repair protein deficiency was associated with loss of ARID1A expression ( P<0.01). Patients with mismatch repair protein deficiency were also associated with earlier clinical stage and a lower risk of lymph node metastasis compared to the ones with intact mismatch repair proteins ( P<0.05). Conclusions:SWI/SNF complex deficiency in gastrointestinal tumors is associated with dedifferentiation and often accompanied by mismatch repair protein deficiency. Compared to the cases with intact mismatch repair proteins, the cases with defective mismatch repair protein have an earlier clinical stage and a lower risk of lymph node metastasis.

Objective To explore the effect of blood flow restriction on muscle strength,body compo-sition,circumferences of both lower and upper extremities,and muscle thickness of female freestyle wrestlers during a 4-week freestyle wrestling camp training.Methods Twenty female freestyle wrestlers of Beijing Team with more than 5 years'training were randomly divided into a KAATSU group and a control group.Both groups performed the same wrestling training program,during which the KAATSU group wore blood flow restriction elastic bands.The changes of muscle strength,body composition,limb circumferences,and muscle thickness were compared between the two groups before and after the training.Results After the training,no significant differences were found in both groups in the average body composition(P>0.05).However,after the training,in the KAATSU group,the weight and skele-tal muscle mass increased by 0.57%and 4.10%,respectively,while the amount of fat decreased by 1.48%.Moreover,after the intervention,no significant changes were found in the average circumferenc-es of all limbs except that of the right upper arm,with its increase in the KAATSU group significant-ly greater than the control group.Meanwhile,compared with before training,the thickness of biceps in relaxation as well as quadriceps in relaxation and contraction increased in both groups,with signifi-cant greater increase in the KAATSU group than the control group in relaxation.To be more specific,the thickness of biceps and quadriceps in relaxation increased by 26.59%and 22.36%in the KAAT-SU group after the training(P<0.05 for all).In addition,after the training,the peak torque of the left knee flexion and right knee extension increased in both groups(P<0.05),with the increase in the KAATSU group(6.00%and 8.87%)significantly greater than the control group(5.42%and 0.00%).Moreover,after the training,the maximum strength of squat,bench press,and bench pull in the KAATSU group increased significantly(P<0.05),whose strength of bench press was 70.63 kg,signifi-cantly higher than the control group(51.07 kg),with significantly greater increase than the control group(9.45%vs.0.46%).Conclusion The 4-week freestyle wrestling training with blood flow restric-tion is superior to traditional training in maintaining the ideal body weight,promoting the mass of the major muscles of limbs,the maximum strength of skeletal muscles and related joints during squatting,bench press and bench pull.

Objective To explore the risk factors of aspiration during hospitalization in patients with ischemic stroke (IS) and establish a predictive model. Methods Based on the case-control design, clinical materials of 316 IS patients treated in the Department of Neurology of Suzhou Ninth Hospital Affiliated to Soochow University from March 2022 to October 2023 were retrospectively collected. According to incidence of aspiration during hospitalization, the patients were divided into case group with 89 cases (aspiration occurred during hospitalization) and control group with 227 cases (no aspiration occurred during hospitalization). Univariate and multivariate Logistic regression analyses were performed in both groups to screen out the risk factors of aspiration during hospitalization in IS patients. R software was used to extract 70 % of the data from the two groups as the training set (establishing a Nomogram model), and the remaining 30 % data was used as test set. Value of predictive model was evaluated by area under the curve (AUC) of the receiver operating characteristic (ROC) curve, calibration curve, and decision curve. Results There were significant differences in the terms of age, the National Institutes of Health Stroke Scale (NIHSS) score, number of lesions, homocysteine (Hcy) level, spontaneous cough, and grading of Wada drinking water test between the case group and the control group (P < 0.05). Multivariate Logistic analysis showed that large age (OR=2.201, 95 %CI, 1.254 to 3.865), high NIHSS score (OR=4.816, 95 %CI, 1.652 to 14.041), multiple lesions (OR=2.649, 95 %CI, 1.249 to 5.613), high level of Hcy (OR=1.501, 95 %CI, 1.044 to 2.158), weakened or absent spontaneous cough (OR=3.384, 95 %CI, 1.639 to 6.987), and high grading of Wada drinking water test (OR=2.878, 95 %CI, 1.422 to 5.783) were the risk factors of aspiration during hospitalization in IS patients (P < 0.05). In the training set, the AUC of the Nomogram model for predicting aspiration during hospitalization in IS patients was 0.872 (95 %CI, 0.827 to 0.919), and was 0.859 (95 %CI, 0.807 to 0.904) in the test set. The calibration curve analysis showed that P value was 0.869 in the training set and 0.898 in the test set. The decision curve analysis for both the training set and test set showed that the Nomogram model was of good clinical applicability. Conclusion The risk of aspiration during hospitalization in IS patients is related to large age, high NIHSS score, multiple lesions, high level of Hcy, weakened or absent spontaneous cough, and high grading of Wada drinking water test. The Nomogram predictive model established on these factors can effectively evaluate the risk of aspiration during hospitalization in IS patients.

Objective:To establish and evaluate a nomogram for long-term survival of patients with intrahepatic cholangiocarcinoma (ICC) after radical resection.Methods:The data of ICC patients who underwent radical resection for the first time at Zhongshan Hospital, Fudan University from January 2014 to December 2017 were retrospectively analyzed. Of 167 patients who were enrolled, there were 104 males and 63 females, with the age of (60.3±10.9) years. Tumor tissues were collected for immunohistochemical staining and interpretation. Univariate Cox regression, LASSO regression and multivariate Cox regression were used to analyze influencing factors of postoperative long-term survival after ICC. R software was used to construct a nomogram in predicting ICC prognosis.Results:Cox regression analysis showed that TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression to be independent risk factors associated with poor long-term survival after radical resection. The prognostic nomogram model of ICC was constructed based on these factors. The C-index was 0.821. The nomogram model consistency index had a high degree of prognostic differentiation. The 45° diagonal of the 3-year postoperative calibration curve which represented the actual survival fitted well with the segmented line which represented the predicted survival of the nomogram. The area under the receiver operating characteristic curve of the nomogram model was higher than that of AJCC TNM staging (0.894 vs. 0.803, z=4.10, P<0.001). The nomogram model was more effective in predicting postoperative survival of ICC patients than the TNM staging. Conclusion:TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression were independent risk factors for postoperative survival of ICC. The nomogram model could better evaluate long-term prognosis of ICC patients after radical resection than the traditional TNM staging system.

The use of whole exome sequencing (WES) for the detection of disease-causing variants of genetic diseases and for non-invasive prenatal screening (NIPS) of fetal aneuploidies are two major clinical applications of next generation sequencing (NGS). This article has summarized the official documents developed and updated by the American College of Medical Genetics and Genomics (ACMG) on governing WES and NIPS. These include the development of expert consensus policies and position statements on an ongoing basis to guide clinical application of NGS technology and variant analysis, establish evidence-based practical resources, as well as standards and guidelines to govern diagnosis and screening. These ACMG documents are valuable references to Chinese geneticists, but direct adoption of these standards and guidelines may not be practical due to the differences in disease-associated variant frequencies in Chinese population, socioeconomic status, and medical practice between the two countries. It is hoped that this review could facilitate the development of NGS and NIPS standards and guidelines that are consistent with international standards and concordant with medical genetics practice in China to provide high-quality, efficient and safe clinical services for patients and their families with genetic diseases.
China ; Consensus ; Female ; Genomics ; High-Throughput Nucleotide Sequencing ; Humans ; Pregnancy ; Technology ; United States

Objective: To investigate the effect of C-phycocyanin (C-PC) on the epithelial-mesenchymal transition (EMT) of cervical cancer Caski cells induced by transforming growth factor beta1 (TGF-β1). Methods: According to different treatment methods, Caski cells were divided into three groups: 10 ng/ml TGF-β1 treatment group, 10 ng/ml TGF-β1+300 μg/ml C-PC co-treatment group and control group (untreated). After 24 h of treatment, the morphological changes of Caski cells were observed, and the effects of TGF-β1 and C-PC on the migration and invasion of Caski cells were detected by Scratch test and Transwell test, respectively. Western blotting was used to detect the effect of C-PC on the expression of epithelial phenotypic marker protein E-cadherin and stromal phenotypic marker protein N-cadherin in TGF-β1-induced Caski cells, and qPCR was used to detect the mRNA expressions of EMT related factors Snail, Zeb1 and Twist. Results: Caski cells in the TGF-β1 treatment group lost the characteristics of the original epithelial phenotype, while the cells in the TGF-β1+C-PC co-treatment group maintained the characteristics of normal epithelial phenotype; the migration rate ([60.0±1.4]% vs [33.5±2.2]%, [40.0±2.8]%, both P<0.05) and the number of invasive transmembrane cells ([108.2±6.2] vs [25.2±3.1], [39.8±5.4], both P<0.01]) of Caski cells in the TGF- β1 treatment group were significantly higher than those in the co-treatment group and the control group. Compared with the control group, the expression of E-cadherin in Caski cells treated with TGF-β1 decreased significantly (P<0.05), while the mRNA expressions of Twist, Snail and Zeb1 increased significantly (all P<0.05); However, co-treatment with C-PC reversed above changes (P<0.05 or P<0.01), and significantly decreased the protein expression level of N-cadherin (P< 0.05). Conclusion: C-PC treatment can inhibit the invasion and metastasis ability of Caski cells induced by TGF-β1 and further affects the EMT process. The mechanism may be related to the decrease of mRNAexpressions of Twist, Snail and Zeb1 by C-PC treatment. ·

Objective:To understand the status quo of patient safety cultural cognition among nurses in a senior friendly hospital, and analyze the influencing factors of their patient safety cultural cognition, in order to provide a basis for formulating nursing safety management measures.Methods:Totally 360 clinical in-service nurses from 26 nursing units in a senior friendly hospital were investigated with the Hospital Survey on Patient Safety Culture (HSOPSC) and the Nurse Psychological Contract Scale. Single factor analysis, correlation analysis and multiple linear regression analysis were used to analyze the influencing factors of their patient safety cultural cognition.Results:The total score of nurses' patient safety cultural cognition was (173.74±16.04) , which was positively correlated with the total score of psychological contract and the scores of its various dimensions ( P<0.01) . Multiple linear regression analysis showed that the hospital's team responsibility and development responsibility were the influencing factors for the scores of nurses' patient safety cultural cognition. Conclusions:Generally, nurses have a good understanding of patient safety culture. There is still much room for improvement in the hospital responsibilities of the nurses' psychological contract, especially the hospital's team responsibility and development responsibility. Managers should improve the level of nurses' psychological contract by supporting team behavior in hospital management and providing guarantees for development, so as to further enhance the nurses' patient safety cultural cognition, and enabling nurses to form positive awareness and behaviors of patient safety.

Objective: To evaluate the safety and feasibility of Da Vinci robot in the treatment of thyroid cancer with hyperthyroidism via bilateral axillo-breast approach (BABA). Methods: The clinical data of 21 patients with thyroid cancer complicated with hyperthyroidism who received thyroidectomy + central lymph node dissection and(or)neck lymph node dissection using the Da Vinci through axillo-bilateral-breast approach in the thyroid and breast surgery of the 960th Hospital of the PLA Joint Logistics Support Force, from February 2014 to February 2019 were analyzed retrospectively. The clinical data of 21 patients were used as observation group, including 5 males and 16 females, aged (46.03±3.08) years. At the same period, 19 patients with the thyroid cancer complicated with hyperthyroidism who underwent traditional open surgery were selected as the control group, including 5 males and 14 females, aged (47.06±2.03) years. The t test, rank sum test, and χ² test were used to compare the operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain (VAS), cosmetic outcome satisfaction, and related surgical complications between the two groups. Results: All the patients of the two groups completed the operation successfully. The operation time of the observation group was longer than that of the control group [(191.12±3.17) vs (145.37±6.37) min, P<0.05]; The postoperative pain degree score of the observation group was lower than that of the control group [(3.40±1.12) points vs (5.10±1.19) points, P<0.05]. The cosmetic effect score of the observation group was better than that of the control group [(9.10±3.03) points vs (5.05±1.02) points, P<0.05]. There were no significant differences in the amount of intraoperative blood loss, mean postoperative drainage, postoperative hospital stay, central lymph node metastasis and complication rate between the two groups (P>0.05). There was no significant difference in Tg level and recurrence rate between the two groups (P>0.05). Conclusion Da Vinci robotic assisted treatment for thyroid cancer with hyperthyroidism is safe and feasible, which with good cosmetic and privacy protection effects.