Animal experiments are essential tools in biomedical research, serving as a bridge between basic research and clinical trials. Systematic reviews and meta-analyses (SRs/MAs) of animal experiments are crucial methods for integrating evidence from animal experiment, which can facilitate the translation of findings into clinical research, reduce translational risks, and promote resource integration in basic research. With the continuous development of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology, its application in SRs/MAs of animal experiments has gained increasing attention. This article first outlines the principles and specific applications of the GRADE methodology in SRs/MAs of animal experiments, including qualitative descriptive systematic reviews, meta-analyses, and network meta-analyses. It then deeply analyzes the misuse of the GRADE methodology in practice, including incorrect evidence grading, improper classification of evidence, misapplication in qualitative systematic reviews, inconsistencies between the documentation of the upgrading and downgrading process and results, and inappropriate use for making recommendations. Furthermore, this article comprehensively discusses the factors influencing the grading of evidence certainty in SRs/MAs of animal experiments, including the impact of bias risk, indirectness, inconsistency, imprecision, and publication bias on evidence downgrading, as well as the role of large effect sizes and cross-species consistency in evidence upgrading. Finally, in response to the issues discussed, improvement strategies are proposed, including further research and optimization of the GRADE methodology for SRs/MAs of animal experiments, the development of reporting guidelines tailored to the characteristics of SRs/MAs in animal experiment research, and enhanced professional training for researchers in the GRADE methodology. This article aims to improve the quality of evidence in SRs/MAs of animal experiments, strengthen their reliability in clinical decision-making, and promote the more efficient translation of findings from animal experiment research into clinical practice.

Objective: To explore the changes of mechanosensitive channels Piezos (Piezo 1 and Piezo 2) in neurogenic bladder (NB) of young rats and their effects，so as to provide reference for clinical search of new therapeutic targets. Methods: A total of 30 female young SD rats were divided into 5 groups based on random number table method：sham operation group (sham)，2-week nerve transection group (NB-2W)，6-week nerve transection group (NB-6W)，2-week nerve transection + Piezos inhibitor group (NB-P-2W) and 6-week nerve transection + Piezos inhibitor group (NB-P-6W)，with 6 rats in each group.The NB models were constructed by transecting the L6 and S1 spinal nerves of young rats.The NB-2W and NB-6W groups were not intervened after modeling，while the NB-P-2W and NB-P-6W groups were intraperitoneally injected with Piezos inhibitor GsMTx4 (10 mg/kg) every 2 days after modeling.Bladder cystometry and ultrasound were performed after 2 and 6 weeks of transection.The expressions of Piezos and fibrosis-related indexes (Collagen Ⅰ and α-smooth muscle actin) were detected in bladder tissues. Results: The results of bladder cystometry showed that the basal bladder pressure in NB-2W group was significantly increased，while it was slightly decreased but was still higher in NB-6W group than in the sham group (P<0.05).Basal bladder pressure was lower in NB-P-2W group than in NB-2W group，but was higher than that in the sham group; basal bladder pressure was lower in NB-P-6W group than in NB-6W group，but higher than that in the sham group (P<0.05).Compared with the sham group，the NB-2W and NB-6W groups had firstly increased and then decreased maximum cystometric capacity (MCC) (P<0.05).Compared with NB-2W group，NB-P-2W group had lower bladder leakage point pressure (BLPP)，but higher MCC and bladder compliance (BC) (P<0.05).Compared with NB-6W group，NB-P-6W group had significantly lower BLPP but higher MCC and BC (P<0.05).HE and MASSON staining and ultrasound results showed that，with the extension of nerve transection time，bladder fibrosis gradually worsened，the bladder wall became rough and thickened，calculi were visible inside，and hydronephrosis gradually appeared; the degree of fibrosis in NB-P-2W and NB-P-6W groups was less than that in NB-2W and NB-6W groups，and no hydronephrosis was observed in the upper urinary tract.In addition，Western blotting and immunohistochemical results showed that NB-2W and NB-6W groups had significantly higher relative expression levels of Piezos，Collagen Ⅰ and α-SMA than the sham group (P<0.01)，while NB-P-2W and NB-P-6W groups had lower relative expression levels of Piezos,Collagen Ⅰ and α-SMA than NB-2W and NB-6W groups (P<0.01). Conclusion: The increased expressions of mechanosensitive channels Piezos in NB young rats may be involved in the progression of bladder fibrosis，but its mechanism needs further study.

Objective: This study compares the effects of lithium disilicate glass ceramic onlays and full crowns in restoring cracked teeth that have undergone root canal therapy, providing a reference for the restoration method of cracked teeth that have undergone root canal therapy. Methods: This study was approved by the hospital’s medical ethics committee, and all patients signed the informed consent form. Patients with cracked teeth who underwent root canal treatment in our hospital from January 2022 to January 2023 were enrolled in this study. According to the inclusion and exclusion criteria, 60 patients were screened and enrolled, with a total of 60 affected teeth. The patients were divided into the onlay group and full crown group at a ratio of 2:3 using the random number table method. Lithium disilicate glass ceramic onlays were used to restore the affected teeth in the onlay group (24 cases), and lithium disilicate glass ceramic full crowns were used to restore the affected teeth in the full crown group (36 cases). At 3, 6, and 12 months after the repair, the restoration effect was evaluated and compared with the modified USPH Standard (the aesthetic, functional, and biological aspects of restorations). According to the biological definition of survival, survival analysis was conducted on the affected teeth in both groups. Results: At 3, 6, and 12 months after the repair, 85% of cases in the onlay group achieved grade A, while 80% of cases in the full crown group achieved grade A. There was no statistically significant difference in the restoration effects between the onlay group and the full crown group (P > 0.05). The 12-month survival rate of cracked teeth in the onlay group reached 95.65%, and the 12-month survival rate of cracked teeth in the full crown group reached 94.12%. There was no statistically significant difference in the retention of the affected teeth (P > 0.05). There was no significant effect of age, gender, tooth position, dentition, direction of cracks, the number of marginal ridges associated with cracks, or the type of restoration on the survival status of cracked teeth. (P > 0.05). Conclusion For cracked teeth that have undergone root canal therapy, the short-term effect of lithium disilicate glass ceramic onlays is comparable to that of full crowns, and both have good short-term effects. Onlays are less invasive and are expected to become an alternative restoration method to full crowns.

Objective To study the potential harmful effects of brake-pad sourced particles.Methods Grind the brake pad particles or antimony sulfide particles.Mice were exposed brake pad or antimony sulfide particles by tracheal perfusion for 1 month.We observed pathological changes to the lungs,heart,and liver,and analyzed changes in peripheral blood macrophages and regulatory T cells(Tregs)via flow cytometry.Results After exposure,the deposition of foreign substances in the alveolar wall of mice was seen,with the obvious infiltration of inflammatory cells around blood vessels,which worsened with increasing particle concentration.Pathological changes,such as vascular inflammation and microthrombosis in the heart and hepatocyte swelling in the liver,were observed.Treg cells in peripheral blood decreased and macrophages increased in the antimony sulfide group and low-dose brake pad particles group,while the proportion of M2-type macrophages decreased,in the antimony sulfide group and low-dose brake pad particle group.Conclusions Exposure to brake pad particles and their component antimony sulfide has varying degrees of toxic effects on the lung,heart,and liver of mice and has an impact on the immune system,indicating the potential health hazards of brake-pad-derived air pollution.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

Objective:To document any impact of the timing of rehabilitation interventions on the recovery of motor function among children after a traumatic brain injury (TBI).Methods:Seventy-one children with a TBI were randomly divided into a control group ( n=36) and an observation group ( n=35). All received comprehensive rehabilitation-15 to 30 days after admission for those in the control group and 2 to 14 days after admission for the observation group. It included joint range-of-motion training, multi-sensory stimulation training, low-frequency electrical stimulation, and acupuncture. Before the experiment and 4, 12 and 24 weeks afterward, everyone′s motor functioning, muscle tone, and functional independence were quantified using the Fugl-Meyer Assessment (FMA), the Modified Ashworth Scale (MAS), and the WeeFIM pediatric functional independence measure. Results:Four weeks after the intervention the average FMA and WeeFIM scores of both groups had already increased significantly. At 12 and 24 weeks the average FMA and WeeFIM scores of the observation group were significantly higher than the control group′s averages. Muscle tone was then also significantly better on average. There was no significant difference in the incidence of rehabilitation interruptions between the two groups.Conclusion:Early comprehensive rehabilitation intervention within 2 to 14 days of admission can effectively better the motor functioning and functional independence of pediatric TBI patients.

Objective To explore correlation between cerebral microbleeds(CMBs)and cognitive dysfunction in patients with cerebral small vessel disease.Methods A total of 80 patients with cerebral small vessel disease admitted to Department of Encephalopathy in Nanjing University of Chinese Medicine Affiliated Lianyungang Hospital from January 2020 to December 2022 were selected as research objects.They were divided into CMBs positive group(50 cases)and CMBs negative group(30 cases)based on the presence or absence of CMBs in the cerebral hemisphere.General clinical data of two groups were compared.Cognitive function was assessed by using Montreal cognitive assessment scale(MoCA).Results Age and incidence rate of hypertension in CMBs positive group were significantly higher than those in CMBs negative group(P<0.05).Total score of MoCA,scores of visuospatial and executive function,abstract thinking and delayed recall in CMBs positive group were significantly lower than those in CMBs negative group(P<0.05).Conclusion CMBs are closely related to the potential mechanism,clinical diagnosis and degree assessment of cognitive dysfunction in patients with cerebral small vessel disease.

Subretinal fibrosis(SRF),the end pathological stage of neovascular age-related macular degeneration(nAMD),can cause severe and irreversible vision loss in patients.In recent years,the high clinical incidence of SRF and the severe visual impairment it causes have led to a rapid development of SRF-related research.In order to systematically understand the clinical progress of SRF,recent studies on SRF secondary to nAMD were reviewed in this article.

Objective To observe the value of ovarian-adnexal reporting and data system ultrasound 2022 version(O-RADS US v2022)and it combined with risk of malignancy index 4(RMI4)for differential diagnosis of benign and malignant adnexal tumors.Methods Data of 126 patients with adnexal tumors confirmed by surgical pathology were retrospectively analyzed.O-RADS US v2022 was used to classify:1-3 as benign lesion and 4-5 as malignant lesion.RMI4 classification took 450 as the critical value.And classification was performed based on the two combination.Taking pathological results as gold standard,receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of O-RADS US v2022 and RMI4 alone or combination for the differential diagnosis of benign and malignant adnexal tumors.Results Among 126 cases,94 were benign and 32 were malignant tumors.The sensitivity,specificity,accuracy and area under the curve(AUC)of O-RADS US v2022 were 78.13％,80.85％,80.16％and 0.795,respectively.The diagnostic results of RMI4 were 71.88％,84.04％,80.95％and 0.780,respectively.The specificity and accuracy of the combination of the two(93.62％,92.06％)were higher than those of O-RADS US v2022(x2=7.322,5.967,P=0.007,0.015)or RMI4(x2=4.625,5.331,P=0.032,0.021),while no significant difference in sensitivity and AUC(87.50％,0.906)was found with O-RADS US v2022 or RMI4(all P＞0.05).Conclusion O-RADS US v2022 could effectively differentiate benign and malignant adnexal tumors,and combined with RMI4 could improve the diagnostic specificity and accuracy.

BACKGROUND:Bone transport has been used for a variety of reasons in bone defects with good clinical results.However,various complications have also attracted the attention of practitioners and the avoidance of non-healing of the docking point has become a common concern for doctors and patients. OBJECTIVE:To explore effective methods of avoiding non-healing of the docking point in the treatment of tibial bone defects by bone transport so as to shorten the treatment period and reduce the pain of patients. METHODS:The clinical data of 21 patients with unilateral tibial bone defect admitted to the No.910 Hospital of Joint Logistics Support Force of Chinese PLA from January 2018 to January 2021 were retrospectively analyzed,including 16 males and 5 females,aged(32.8±10.3)years,with an average bone defect length of 10.2 cm.All 21 patients received bone transport surgery,during which the bone defect area was filled with bone cement to reduce the adverse factors affecting the healing of the docking point.The Association for the Study and Application of the Methods of Ilizarov,healing index and incidence of adverse reactions were evaluated during postoperative follow-up. RESULTS AND CONCLUSION:The 21 patients were followed up for 15 to 24 months after surgery,and the extended area was all well mineralized and had no malformations,and no refractures occurred during treatment.Among them,one patient had foot drop,which could not be completely corrected after surgical release of the Achilles tendon and wearing foot and ankle orthotics.19 patients had different degrees of needle tract infection,and no deep infection occurred after timely needle tract nursing.The healing rate of the docking point was 100%;the healing index was 36-45 d/cm and the average was 38 d/cm.The Association for the Study and Application of the Methods of Ilizarov showed that bone healing was excellent in 17 cases(81%)and poor in 4 cases(19%).The results of limb function were excellent in 18 cases(86%)and good in 3 cases(14%).These findings show that bone cement segmental filling during bone transport is an effective method to solve the non-healing of the docking point,shorten the patient's treatment period and reduce the patient's pain.