Asherman's syndrome(AS) is a common disease that presents endometrial regeneration disorder. However, little is known about its molecular features of this aregenerative endometrium in AS and how to reconstruct the...Asherman's syndrome(AS) is a common disease that presents endometrial regeneration disorder. However, little is known about its molecular features of this aregenerative endometrium in AS and how to reconstruct the functioning endometrium for the patients with AS. Here, we report that ΔNp63 is significantly upregulated in residual epithelial cells of the impaired endometrium in AS; the upregulated-ΔNp63 induces endometrial quiescence and alteration of stemness. Importantly, we demonstrate that engrafting high density of autologous bone marrow mononuclear cells(BMNCs) loaded in collagen scaffold onto the uterine lining of patients with AS downregulates ΔNp63 expression, reverses ΔNp63-induced pathological changes, normalizes the stemness alterations and restores endometrial regeneration. Finally, five patients achieved successful pregnancies and live births. Therefore, we conclude that ΔNp63 is a crucial therapeutic target for AS. This novel treatment significantly improves the outcome for the patients with severe AS.展开更多
Intrauterine adhesion(IUA) is a common cause of uterine infertility and one of the most severe clinical features is endometrial fibrosis namely endometrial scarring for which there are few cures currently. Blocked ang...Intrauterine adhesion(IUA) is a common cause of uterine infertility and one of the most severe clinical features is endometrial fibrosis namely endometrial scarring for which there are few cures currently. Blocked angiogenesis is the main pathological change in the scarred endometrium. The fibroblast growth factor 2(b FGF), a member of FGF family, is usually applied to promote healing of refractory ulcer and contributes to angiogenesis of tissues. In this study, the sustained-release system of b FGF100 μg was administrated around scarred endometrium guiding by ultrasound every 4 weeks in 18 patients(2–4 times). Results showed that after treatment, the menstrual blood volume, endometrial thickness and the scarred endometrial area were improved.Histological study showed blood vessel density increased obviously. Three patients(3/18) achieved pregnancy over 20 gestational weeks. Therefore, administrating the b FGF surrounding scarred endometrium may provide a new therapeutic approach for the patients with endometrial fibrosis.展开更多
Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disease worldwide.The mechanisms involved in NAFLD onset are complicated and multifactorial.Recent literature has indicated that altered intestin...Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disease worldwide.The mechanisms involved in NAFLD onset are complicated and multifactorial.Recent literature has indicated that altered intestinal barrier function is related to the occurrence and progression of liver disease.The intestinal barrier is important for absorbing nutrients and electrolytes and for defending against toxins and antigens in the enteric environment.Major mechanisms by which the intestinal barrier influences the development of NAFLD involve the altered epithelial layer,decreased intracellular junction integrity,and increased intestinal barrier permeability.Increased intestinal permeability leads to luminal dysbiosis and allows the translocation of pathogenic bacteria and metabolites into the liver,inducing inflammation,immune response,and hepatocyte injury in NAFLD.Although research has been directed to NAFLD in recent decades,the pathophysiological changes in NAFLD initiation and progression are still not completely understood,and the therapeutic targets remain limited.A deeper understanding on the correlation between NAFLD pathogenesis and intestinal barrier regulation must be attained.Therefore,in this review,the components of the intestinal barrier and their respective functions and disruptions during the progression of NAFLD are discussed.展开更多
Sulfate, nitrate and ammonium （SNA） are the dominant species in secondary inorganic aerosol, and are considered an important factor in regional haze formation. Size-fractionated aerosol particles for a whole year we...Sulfate, nitrate and ammonium （SNA） are the dominant species in secondary inorganic aerosol, and are considered an important factor in regional haze formation. Size-fractionated aerosol particles for a whole year were collected to study the size distribution of SNA as well as their chemical species in Shanghai. SNA mainly accumulated in fine particles and the highest average ratio of SNA to particulate matter （PM） was observed to be 47% in the fine size fraction （0.49-0.95 ~tm）. Higher sulfur oxidation ratio and nitrogen oxidation ratio values were observed in PM of fine size less than 0.95 ~tm. Ion balance calculations indicated that more secondary sulfate and nitrate would be generated in PM of fine size （0.49-0.95 p.m）. Sulfur K-edge X-ray absorption near-edge structure （XANES） spectra of typical samples were analyzed. Results revealed that sulfur mainly existed as sulfate with a proportion （atomic basis） more than 73% in all size of PM and even higher at 90% in fine particles. Sulfate mainly existed as （NH4）2SO4 and gypsum in PM of Shanghai. Compared to non-haze days, a dramatic increase of （NH4）2SO4 content was found in fine particles on haze days only, which suggested the promoting impact of （NH4）2SO4 on haze formation. According to the result of air mass backward trajectory analysis, more （NH4）2SO4 would be generated during the periods of air mass stagnation. Based on XANES, analysis of sulfate species in size-fractionated aerosol particles can be an effective way to evaluate the impact of sulfate aerosols on regional haze formation.展开更多
Traditional Chinese preserved egg products have exhibited some anti-inflammatory effects,but their mechanisms of action remain unknown.This study aimed to investigate the anti-inflammatory effects of preserved egg whi...Traditional Chinese preserved egg products have exhibited some anti-inflammatory effects,but their mechanisms of action remain unknown.This study aimed to investigate the anti-inflammatory effects of preserved egg white(PEW)treatment on dextran sulfate sodium(DSS)-induced colitis in mice and the underlying mechanisms.The results showed that treatment with PEW in mice with DSS-induced colitis for 14 days effectively improved the clinical signs,inhibited the secretion and gene expression of pro-inflammatory cytokines,and reduced myeloperoxidase(MPO)activity and oxidative stress levels.In addition,western blotting results showed that PEW significantly suppressed DSS-induced phosphorylation levels of nuclear factor-kappa B(NF-κB)p65 and p38 mitogen-activated protein kinase(MAPK)in colon tissues of mice with colitis.PEW also enhanced the production of short-chain fatty acids(SCFAs)and modulated gut microbiota composition in mice with DSS-induced colitis,including increasing the relative abundance of beneficial bacteria Lachnospiraceae,Ruminococcaceae and Muribaculaceae,and reducing the relative abundance of harmful bacteria Proteobacteria.Taken together,our study demonstrated that preserved egg white could alleviate DSS-induced colitis in mice through the reduction of oxidative stress,modulation of inflammatory cytokines,NF-κB,MAPK and gut microbiota composition.展开更多
OBJECTIVE:To observe the clinical efficacy of acupuncture along fascia,meridians,and nerves combined with ultrasound-guided nerve blockage in the treatment of postherpetic neuralgia.METHODS:A total of 61 outpatients w...OBJECTIVE:To observe the clinical efficacy of acupuncture along fascia,meridians,and nerves combined with ultrasound-guided nerve blockage in the treatment of postherpetic neuralgia.METHODS:A total of 61 outpatients with post-chest and back herpes zoster neuralgia were recruited in the Department of Pain at the Xiyuan Hospital,China Academy of Chinese Medical Sciences from May 2019 to June 2021.They were randomly divided into two groups.Thirty-one patients in the control group were treated with ultrasound-guided thoracic paravertebral nerve block(PVB)alone,one patient declined to continue during treatment(n=30),and thirty patients in the observation group received the acupuncture along the fascia,meridians,and nerves combined with ultrasound-guided PVB treatment(n=30).Both control and observation group received treatment weekly for 4 weeks.The medical history data such as age,sex,presence or absence of comorbidities and disease course were analyzed.The visual analog scale(VAS)score was used to assess the pain degree of two groups at T0(before treatment),T1(1-time treatment ended),T2(2 times treatment ended),T3(3 times treatment ended),and T4(4 times treatment ended).The sleep state was examined by Pittsburgh Sleep Quality Index(PSQI)before and after the study.RESULTS:There was no significant difference in general conditions between the control group and the observation group(P>0.05).The VAS score in both control and observation group was decreased in a time-dependent manner after 1-4 weeks of treatment.There were no significant differences in VAS scores between the two groups after 1 or 2 weeks of treatment(P>0.05).After 3 and 4 weeks of treatment,the VAS score was significantly decreased in the observation group compared with that in the control group(P<0.001).In addition,the reduction in VAS score(after treatment-before treatment)between the two groups was statistically significant[D value:-1.53,95%CI(-2.32,0.74),P<0.001].Furthermore,the sleep state of patients in both groups markedly improved and much obvious 展开更多
Analyzing and understanding the effects of ambient pollution on plants is getting more and more attention as a topic of environmental biology.A method based on synchrotron radiation X-ray fluorescence and X-ray absorp...Analyzing and understanding the effects of ambient pollution on plants is getting more and more attention as a topic of environmental biology.A method based on synchrotron radiation X-ray fluorescence and X-ray absorption near edge structure spectroscopy was established to analyze the sulfur concentration and speciation in mature camphor tree leaves （CTLs）,which were sampled from 5 local fields in Shanghai,China.Annual SO2 concentration,SO42-concentration in atmospheric particulate,SO42-and sulfur concentration in soil were also analyzed to explore the relationship between ambient sulfur sources and the sulfur nutrient cycling in CTLs.Total sulfur concentration in mature camphor tree leaves was 766-1704 mg/kg.The mainly detected sulfur states and their corresponding compounds were ＋6 （sulfate,include inorganic sulfate and organic sulfate）,＋5.2 （sulfonate）,＋2.2 （suloxides）,＋0.6 （thiols and thiothers）,＋0.2 （organic sulfides）.Total sulfur concentration was strongly correlated with sulfate proportion with a linear correlation coefficient up to 0.977,which suggested that sulfur accumulated in CTLs as sulfate form.Reduced sulfur compounds （organic sulfides,thiols,thioethers,sulfoxide and sulfonate） assimilation was sufficed to meet the nutrient requirement for growth at a balanced level around 526 mg/kg.The sulfate accumulation mainly caused by atmospheric sulfur pollution such as SO2 and airborne sulfate particulate instead of soil contamination.From urban to suburb place,sulfate in mature CTLs decreased as the atmospheric sulfur pollution reduced,but a dramatic increase presented near the seashore,where the marine sulfate emission and maritime activity pollution were significant.The sulfur concentration and speciation in mature CTLs effectively represented the long-term biological accumulation of atmospheric sulfur pollution in local environment.展开更多
In first aid, traditional information interchange has numerous shortcomings. For example, delayed information and disorganized departmental communication cause patients to miss out on critical rescue time. Information...In first aid, traditional information interchange has numerous shortcomings. For example, delayed information and disorganized departmental communication cause patients to miss out on critical rescue time. Information technology is becoming more and more mature, and as a result, its use across numerous industries is now standard. China is still in the early stages of developing its integration of emergency medical services with modern information technology;despite our progress, there are still numerous obstacles and constraints to overcome. Our goal is to integrate information technology into every aspect of emergency patient care, offering robust assistance for both patient rescue and the efforts of medical personnel. Information may be communicated in a fast, multiple, and effective manner by utilizing modern information technology. This study aims to examine the current state of this field’s development, current issues, and the field’s future course of development.展开更多
With the development of earth observation technologies,the acquired remote sensing images are increasing dramatically,and a new era of big data in remote sensing is coming.How to effectively mine these massive volumes...With the development of earth observation technologies,the acquired remote sensing images are increasing dramatically,and a new era of big data in remote sensing is coming.How to effectively mine these massive volumes of remote sensing data are new challenges.Deep learning provides a new approach for analyzing these remote sensing data.As one of the deep learning models,convolutional neural networks(CNNs)can directly extract features from massive amounts of imagery data and is good at exploiting semantic features of imagery data.CNNs have achieved remarkable success in computer vision.In recent years,quite a few researchers have studied remote sensing image classification using CNNs,and CNNs can be applied to realize rapid,economical and accurate analysis and feature extraction from remote sensing data.This paper aims to provide a survey of the current state-of-the-art application of CNN-based deep learning in remote sensing image classification.We first briefly introduce the principles and characteristics of CNNs.We then survey developments and structural improvements on CNN models that make CNNs more suitable for remote sensing image classification,available datasets for remote sensing image classification,and data augmentation techniques.Then,three typical CNN application cases in remote sensing image classification:scene classification,object detection and object segmentation are presented.We also discuss the problems and challenges of CNN-based remote sensing image classification,and propose corresponding measures and suggestions.We hope that the survey can facilitate the advancement of remote sensing image classification research and help remote-sensing scientists to tackle classification tasks with the state-of-art deep learning algorithms and techniques.展开更多
Intrauterine adhesion is a major cause of female reproductive disorders.Although we and others uncontrolled pilot studies showed that treatment with autologous bone marrow stem cells made a few patients with severe in...Intrauterine adhesion is a major cause of female reproductive disorders.Although we and others uncontrolled pilot studies showed that treatment with autologous bone marrow stem cells made a few patients with severe intrauterine adhesion obtain live birth,no large sample randomized controlled studies on this therapeutic strategy in such patients have been reported so far.To verify if the therapy of autologous bone marrow stem cells-scaffold is superior to traditional treatment in moderate to severe intrauterine adhesion patients in increasing their ongoing pregnancy rate,we conducted this randomized controlled clinical trial.Totally 195 participants with moderate to severe intrauterine adhesion were screened and 152 of them were randomly assigned in a 1:1 ratio to either group with autologous bone marrow stem cells-scaffold plus Foley balloon catheter or group with only Foley balloon catheter(control group)from February 2016 to January 2020.The per-protocol analysis included 140 participants:72 in bone marrow stem cells-scaffold group and 68 in control group.The ongoing pregnancy occurred in 45/72(62.5%)participants in the bone marrow stem cells-scaffold group which was significantly higher than that in the control group(28/68,41.2%)(RR=1.52,95%CI 1.08–2.12,P=0.012).The situation was similar in live birth rate(bone marrow stem cells-scaffold group 56.9%(41/72)vs.control group 38.2%(26/68),RR=1.49,95%CI 1.04–2.14,P=0.027).Compared with control group,participants in bone marrow stem cells-scaffold group showed more menstrual blood volume in the 3rd and 6th cycles and maximal endometrial thickness in the 6th cycle after hysteroscopic adhesiolysis.The incidence of mild placenta accrete was increased in bone marrow stem cells-scaffold group and no severe adverse effects were observed.In conclusion,transplantation of bone marrow stem cells-scaffold into uterine cavities of the participants with moderate to severe intrauterine adhesion increased their ongoing pregnancy and live birth rates,and this therapy was relati展开更多
Tropical cyclones(TCs) cause catastrophic loss in many coastal areas of the world. TC wind hazard maps can play an important role in disaster management. A good representation of local factors reflecting the effects o...Tropical cyclones(TCs) cause catastrophic loss in many coastal areas of the world. TC wind hazard maps can play an important role in disaster management. A good representation of local factors reflecting the effects of spatially heterogeneous terrain and land cover is critical to evaluation of TC wind hazard. Very few studies, however,provide global wind hazard assessment results that consider detailed local effects. In this study, the wind fields of historical TCs were simulated with parametric models in which the planetary boundary layer models explicitly integrate local effects at 1 km resolution. The topographic effects for eight wind directions were quantified over four types of terrain(ground, escarpment, ridge, and valley),and the surface roughness lengths were estimated from a global land cover map. The missing TC parameters in the best track datasets were reconstructed with local regression models. Finally, an example of a wind hazard map in the form of wind speeds under a 100-year return period and corresponding uncertainties was created based on a statistical analysis of reconstructed historical wind fields over seven of the world's ocean basins.展开更多
The 5-axis NC machining offers the potential of efficient and accuratemachining. However, the present CAM system for 5-axis control is still an unsolved problem due tointerference between tool and surrounding objects....The 5-axis NC machining offers the potential of efficient and accuratemachining. However, the present CAM system for 5-axis control is still an unsolved problem due tointerference between tool and surrounding objects. A new method is presented. There are two steps inthis procedure. First, it detects the interference by calculating the shortest distance between thetool-axis and the surrounding surfaces. Then upon the maximum gouging, the interference-free toolposture for 5-axis NC cylindrical milling free-form surfaces is obtained by adjusting tool. Thevalidity of the proposed method has been confirmed by machining an impeller.展开更多
To editor:Monochorionicity was traditionally considered indicative of monozygosity.However,recent years have witnessed the emergence of several noteworthy instances of monochorionic dizygotic(MCDZ)twins in clinical pr...To editor:Monochorionicity was traditionally considered indicative of monozygosity.However,recent years have witnessed the emergence of several noteworthy instances of monochorionic dizygotic(MCDZ)twins in clinical practice.In 2000,Viëtor et al.1 documented the initial established case of MCDZ twins.Subsequent studies have further documented this unconventional twinning phenomenon.2,3 The recognized complications associated with monochorionic monozygotic pregnancies,including twin-twin transfusion syndrome(TTTS),twin anemia–polycythemia sequence(TAPS),selective intrauterine growth restriction(sIUGR),congenital malformations,and intrauterine fetal death,could also manifest in MCDZ pregnancies.4,5 In this correspondence,we presented an extremely rare case of TTTS in a dizygotic monochorionic diamniotic twin gestation successfully treated with fetoscopic laser photocoagulation.The patients’permission to publish was obtained.展开更多
The place and placeness are believed to be a crucial perspective for comprehending the transformative dynamics of tourist destinations in the context of globalization and the rapid development of the tourism industry....The place and placeness are believed to be a crucial perspective for comprehending the transformative dynamics of tourist destinations in the context of globalization and the rapid development of the tourism industry.As the material carrier of language,linguistic landscape is an intermediary for people to endow emotions and personalities into the place,becoming an effective path for exploring the place-making in a certain area.Mogan Mountain is a famous national tourist resort,which is located in Mogan Mountain Town,Deqing County,Huzhou City,China.This is a good case area for studying the relationship between linguistic landscape and placemaking in tourist destinations.There are two theories that form the theoretical foundation of the study,namely the place and the geosemiotics.Firstly,the results showed the overall style of the linguistic landscape.Multilingual labelling(52.7%),official signs(55.3%),and standardized Chinese characters predominantly shaped the linguistic landscape,with English and other languages being complementary.Secondly,from the perspective of three dimensions of the geosemiotics framework,such as inscription,language preference,and placement position,we conduct a comprehensive semiotic analysis of the linguistic landscape,which encompasses diverse facets such as fonts,materials,shifts in state,text vectors,and symmetrical arrangements.Finally,we explore the influence of linguistic landscapes on the place-making of Mogan Mountain through the dimensions of location,locale,and sense of place.The information on linguistic landscapes indicates the geographical location.These linguistic landscapes play an important role in constructing the language order,nostalgic atmosphere,exotic atmosphere,and elegant and tasteful lifestyle of the public space in Mogan Mountain.Readers of linguistic landscapes,including tourists and residents,generate and identify with the unique sense of place in Mogan Mountain.These linguistic landscapes construct the destination placeness of Mogan Mountain that combines bot展开更多
Lipotoxicity is a pivotal factor that initiates and exacerbates liver injury and is involved in the development of metabolic-associated fatty liver disease(MAFLD).However,there are few reported lipotoxicity inhibitors...Lipotoxicity is a pivotal factor that initiates and exacerbates liver injury and is involved in the development of metabolic-associated fatty liver disease(MAFLD).However,there are few reported lipotoxicity inhibitors.Here,we identified a natural anti-lipotoxicity candidate,HN-001,from the marine fungus Aspergillus sp.C1.HN-001 dose-and time-dependently reversed palmitic acid(PA)-induced hepatocyte death.This protection was associated with IRE-1a-mediated XBP-1 splicing inhibition,which resulted in suppression of XBP-1s nuclear translocation and transcriptional regulation.Knockdown of XBP-1s attenuated lipotoxicity,but no additional ameliorative effect of HN-001 on lipotoxicity was observed in XBP-1s knockdown hepatocytes.Notably,the ER stress and lipotoxicity amelioration was associated with PLA2.Both HN-001 and the PLA2 inhibitor MAFP inhibited PLA2 activity,reduced lysophosphatidylcholine(LPC)level,subsequently ameliorated lipotoxicity.In contrast,overexpression of PLA2 caused exacerbation of lipotoxicity and weakened the anti-lipotoxic effects of HN-001.Additionally,HN-001 treatment suppressed the downstream pro-apoptotic JNK pathway.In vivo,chronic administration of HN-001(i.p.)in mice alleviated all manifestations of MAFLD,including hepatic steatosis,liver injury,inflammation,and fibrogenesis.These effects were correlated with PLA2/IRE-1a/XBP-1s axis and JNK signaling suppression.These data indicate that HN-001 has therapeutic potential for MAFLD because it suppresses lipotoxicity,and provide a natural structural basis for developing anti-MAFLD candidates.展开更多
Background: Hepatitis B is an infectious disease, which is a main way of vertical transmission of infectious HBV between mother and infant. Hepatitis B virus infection is always a hot topic of social concern, especial...Background: Hepatitis B is an infectious disease, which is a main way of vertical transmission of infectious HBV between mother and infant. Hepatitis B virus infection is always a hot topic of social concern, especially in China. The paper studies hepatitis B virus in maternal blood, breast milk, saliva of hepatitis B virus infection model (HBV-M) in Hefei city, Anhui province, PRC. HBV-DNA load and related data in Hefei city are used for risk assessment of the transmission of hepatitis B virus to provide evidence for evidence-based medicine and scientific guidance of infant feeding patterns. Methods: On the principle of informed consent, inpatient hepatitis B maternal blood 695, breast milk, saliva 614,169 copies were used as the object of analysis, using the ELISA method for the detection of HBV-M, using real-time fluorescence quantitative PCR detection of HBV-DNA load. We analyze HBsAg in saliva, milk, the positive rate of HBV-DNA and HBV-M in serum, saliva, milk, and explore the positive rate of HBV-DNA and serum HBV-DNA load correlation. Results: At the age of 18 - 44 years old perinatal women, HBV-DNA positive rates of maternal serum, breast milk, saliva were 157 cases in A group HBsAg, HBeAg positive: 99.36%, 88.06%, 96.77%;in 312 cases in group B, HBeAb HBsAg, HBcAb positive: 17.63%, 2.93%, 54.67%;69 cases in C group HBsAg, HBcAb positive: 63.77%, 27.27%, 28.57%;D group of 71 patients with simple HBcAb positive: 12.68%, 3.13%, 0%;E group and 86 cases in control group HBVM: 1.16%, 0%, 0%. According to the serum and milk testing of Group A and Group B, HBV-DNA chi-square is χ2 = 237.45, P;there is a significant difference in serum and saliva;HBV-DNA chi-square χ2 = 289.49, P < 0.01, the difference has statistical significance. Conclusion: 1) HBV-DNA load high maternal blood, breast milk, saliva are potentially persistent hepatitis B virus infection risk, especially infectious blood. 2) Of maternal milk, saliva and blood HBV-DNA HBV-DNA load were positively correlated (r = 0.96;P ing, breast milk and saliv展开更多
Background.Hundreds of coronavirus disease 2019(COVID-19)clinical practice guidelines(CPGs)and expert consensus statements have been developed and published since the outbreak of the epidemic.However,these CPGs are of...Background.Hundreds of coronavirus disease 2019(COVID-19)clinical practice guidelines(CPGs)and expert consensus statements have been developed and published since the outbreak of the epidemic.However,these CPGs are of widely variable quality.So,this review is aimed at systematically evaluating the methodological and reporting qualities of COVID-19 CPGs,exploring factors that may influence their quality,and analyzing the change of recommendations in CPGs with evidence published.Methods.We searched five electronic databases and five websites from 1 January to 31 December 2020 to retrieve all COVID-19 CPGs.The assessment of the methodological and reporting qualities of CPGs was performed using the AGREE II instrument and RIGHT checklist.Recommendations and evidence used to make recommendations in the CPGs regarding some treatments for COVID-19(remdesivir,glucocorticoids,hydroxychloroquine/chloroquine,interferon,and lopinavir-ritonavir)were also systematically assessed.And the statistical inference was performed to identify factors associated with the quality of CPGs.Results.We included a total of 92 COVID-19 CPGs developed by 19 countries.Overall,the RIGHT checklist reporting rate of COVID-19 CPGs was 33.0%,and the AGREE II domain score was 30.4%.The overall methodological and reporting qualities of COVID-19 CPGs gradually improved during the year 2020.Factors associated with high methodological and reporting qualities included the evidence-based development process,management of conflicts of interest,and use of established rating systems to assess the quality of evidence and strength of recommendations.The recommendations of only seven(7.6%)CPGs were informed by a systematic review of evidence,and these seven CPGs have relatively high methodological and reporting qualities,in which six of them fully meet the Institute of Medicine(IOM)criteria of guidelines.Besides,a rapid advice CPG developed by the World Health Organization(WHO)of the seven CPGs got the highest overall scores in methodological(72.8%)and reporting 展开更多
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences (XDA01030505)Key research and development program of Jiangsu province (BE2016612), Jiangsu Biobank of Clinical Resources (BM2015004)+1 种基金the Key Laboratory for Maternal-Fetal Medicine from the Health Department of Jiangsu Province, China (XK201102)Project of Nanjing clinical medicine center and the National Natural Science Foundation of China (81401223)
文摘Asherman's syndrome(AS) is a common disease that presents endometrial regeneration disorder. However, little is known about its molecular features of this aregenerative endometrium in AS and how to reconstruct the functioning endometrium for the patients with AS. Here, we report that ΔNp63 is significantly upregulated in residual epithelial cells of the impaired endometrium in AS; the upregulated-ΔNp63 induces endometrial quiescence and alteration of stemness. Importantly, we demonstrate that engrafting high density of autologous bone marrow mononuclear cells(BMNCs) loaded in collagen scaffold onto the uterine lining of patients with AS downregulates ΔNp63 expression, reverses ΔNp63-induced pathological changes, normalizes the stemness alterations and restores endometrial regeneration. Finally, five patients achieved successful pregnancies and live births. Therefore, we conclude that ΔNp63 is a crucial therapeutic target for AS. This novel treatment significantly improves the outcome for the patients with severe AS.
基金supported by The Strategic Priority Research Program of the Chinese Academy of Sciences (XDA01030505)Jiangsu Provincial Key Medical Center (YXZXB2016004)+3 种基金Key Research and Development Program of Jiangsu Province (BE2016612)National Natural Science Foundation of China (81771526)Excellent Youth Natural Science Foundation of Jiangsu Province (BK20170051)Six Talent Peaks Projects in Jiangsu Province (WSW-074)
文摘Intrauterine adhesion(IUA) is a common cause of uterine infertility and one of the most severe clinical features is endometrial fibrosis namely endometrial scarring for which there are few cures currently. Blocked angiogenesis is the main pathological change in the scarred endometrium. The fibroblast growth factor 2(b FGF), a member of FGF family, is usually applied to promote healing of refractory ulcer and contributes to angiogenesis of tissues. In this study, the sustained-release system of b FGF100 μg was administrated around scarred endometrium guiding by ultrasound every 4 weeks in 18 patients(2–4 times). Results showed that after treatment, the menstrual blood volume, endometrial thickness and the scarred endometrial area were improved.Histological study showed blood vessel density increased obviously. Three patients(3/18) achieved pregnancy over 20 gestational weeks. Therefore, administrating the b FGF surrounding scarred endometrium may provide a new therapeutic approach for the patients with endometrial fibrosis.
基金supported by the National Natural Science Foundation of China (81900508)the Natural Science Foundation of Jiangsu Province (BK20190172)Livelihood Science and Technology Foundation of Suzhou (SKY2021038).
文摘Nonalcoholic fatty liver disease(NAFLD)is the most common chronic liver disease worldwide.The mechanisms involved in NAFLD onset are complicated and multifactorial.Recent literature has indicated that altered intestinal barrier function is related to the occurrence and progression of liver disease.The intestinal barrier is important for absorbing nutrients and electrolytes and for defending against toxins and antigens in the enteric environment.Major mechanisms by which the intestinal barrier influences the development of NAFLD involve the altered epithelial layer,decreased intracellular junction integrity,and increased intestinal barrier permeability.Increased intestinal permeability leads to luminal dysbiosis and allows the translocation of pathogenic bacteria and metabolites into the liver,inducing inflammation,immune response,and hepatocyte injury in NAFLD.Although research has been directed to NAFLD in recent decades,the pathophysiological changes in NAFLD initiation and progression are still not completely understood,and the therapeutic targets remain limited.A deeper understanding on the correlation between NAFLD pathogenesis and intestinal barrier regulation must be attained.Therefore,in this review,the components of the intestinal barrier and their respective functions and disruptions during the progression of NAFLD are discussed.
基金supported by the National Natural Science Foundation of China(No.11079049)the National Natural Science Foundation for Young Scholars(No.11005141,11005144,11105171,11305242)+1 种基金the Key Program of Basic Research of Shanghai Science and Technology Commission Foundation(No.10JC1417200)the Major Project of Knowledge Innovation Programof Chinese Academy of Sciences(No.KJCX3.SYW.N3)
文摘Sulfate, nitrate and ammonium （SNA） are the dominant species in secondary inorganic aerosol, and are considered an important factor in regional haze formation. Size-fractionated aerosol particles for a whole year were collected to study the size distribution of SNA as well as their chemical species in Shanghai. SNA mainly accumulated in fine particles and the highest average ratio of SNA to particulate matter （PM） was observed to be 47% in the fine size fraction （0.49-0.95 ~tm）. Higher sulfur oxidation ratio and nitrogen oxidation ratio values were observed in PM of fine size less than 0.95 ~tm. Ion balance calculations indicated that more secondary sulfate and nitrate would be generated in PM of fine size （0.49-0.95 p.m）. Sulfur K-edge X-ray absorption near-edge structure （XANES） spectra of typical samples were analyzed. Results revealed that sulfur mainly existed as sulfate with a proportion （atomic basis） more than 73% in all size of PM and even higher at 90% in fine particles. Sulfate mainly existed as （NH4）2SO4 and gypsum in PM of Shanghai. Compared to non-haze days, a dramatic increase of （NH4）2SO4 content was found in fine particles on haze days only, which suggested the promoting impact of （NH4）2SO4 on haze formation. According to the result of air mass backward trajectory analysis, more （NH4）2SO4 would be generated during the periods of air mass stagnation. Based on XANES, analysis of sulfate species in size-fractionated aerosol particles can be an effective way to evaluate the impact of sulfate aerosols on regional haze formation.
基金financially supported by the Chinese National Natural Science Funds (31772043)the Fundamental Research Funds for the Central Universities (2662018JC021)
文摘Traditional Chinese preserved egg products have exhibited some anti-inflammatory effects,but their mechanisms of action remain unknown.This study aimed to investigate the anti-inflammatory effects of preserved egg white(PEW)treatment on dextran sulfate sodium(DSS)-induced colitis in mice and the underlying mechanisms.The results showed that treatment with PEW in mice with DSS-induced colitis for 14 days effectively improved the clinical signs,inhibited the secretion and gene expression of pro-inflammatory cytokines,and reduced myeloperoxidase(MPO)activity and oxidative stress levels.In addition,western blotting results showed that PEW significantly suppressed DSS-induced phosphorylation levels of nuclear factor-kappa B(NF-κB)p65 and p38 mitogen-activated protein kinase(MAPK)in colon tissues of mice with colitis.PEW also enhanced the production of short-chain fatty acids(SCFAs)and modulated gut microbiota composition in mice with DSS-induced colitis,including increasing the relative abundance of beneficial bacteria Lachnospiraceae,Ruminococcaceae and Muribaculaceae,and reducing the relative abundance of harmful bacteria Proteobacteria.Taken together,our study demonstrated that preserved egg white could alleviate DSS-induced colitis in mice through the reduction of oxidative stress,modulation of inflammatory cytokines,NF-κB,MAPK and gut microbiota composition.
文摘OBJECTIVE:To observe the clinical efficacy of acupuncture along fascia,meridians,and nerves combined with ultrasound-guided nerve blockage in the treatment of postherpetic neuralgia.METHODS:A total of 61 outpatients with post-chest and back herpes zoster neuralgia were recruited in the Department of Pain at the Xiyuan Hospital,China Academy of Chinese Medical Sciences from May 2019 to June 2021.They were randomly divided into two groups.Thirty-one patients in the control group were treated with ultrasound-guided thoracic paravertebral nerve block(PVB)alone,one patient declined to continue during treatment(n=30),and thirty patients in the observation group received the acupuncture along the fascia,meridians,and nerves combined with ultrasound-guided PVB treatment(n=30).Both control and observation group received treatment weekly for 4 weeks.The medical history data such as age,sex,presence or absence of comorbidities and disease course were analyzed.The visual analog scale(VAS)score was used to assess the pain degree of two groups at T0(before treatment),T1(1-time treatment ended),T2(2 times treatment ended),T3(3 times treatment ended),and T4(4 times treatment ended).The sleep state was examined by Pittsburgh Sleep Quality Index(PSQI)before and after the study.RESULTS:There was no significant difference in general conditions between the control group and the observation group(P>0.05).The VAS score in both control and observation group was decreased in a time-dependent manner after 1-4 weeks of treatment.There were no significant differences in VAS scores between the two groups after 1 or 2 weeks of treatment(P>0.05).After 3 and 4 weeks of treatment,the VAS score was significantly decreased in the observation group compared with that in the control group(P<0.001).In addition,the reduction in VAS score(after treatment-before treatment)between the two groups was statistically significant[D value:-1.53,95%CI(-2.32,0.74),P<0.001].Furthermore,the sleep state of patients in both groups markedly improved and much obvious
基金supported by the National Natural Science Foundation of China(No.11079049,11005141,10775150)the Major Project of Knowledge Innovation Program of Chinese Academy of Sciences(No.KJCX3.SYW.N3)
文摘Analyzing and understanding the effects of ambient pollution on plants is getting more and more attention as a topic of environmental biology.A method based on synchrotron radiation X-ray fluorescence and X-ray absorption near edge structure spectroscopy was established to analyze the sulfur concentration and speciation in mature camphor tree leaves （CTLs）,which were sampled from 5 local fields in Shanghai,China.Annual SO2 concentration,SO42-concentration in atmospheric particulate,SO42-and sulfur concentration in soil were also analyzed to explore the relationship between ambient sulfur sources and the sulfur nutrient cycling in CTLs.Total sulfur concentration in mature camphor tree leaves was 766-1704 mg/kg.The mainly detected sulfur states and their corresponding compounds were ＋6 （sulfate,include inorganic sulfate and organic sulfate）,＋5.2 （sulfonate）,＋2.2 （suloxides）,＋0.6 （thiols and thiothers）,＋0.2 （organic sulfides）.Total sulfur concentration was strongly correlated with sulfate proportion with a linear correlation coefficient up to 0.977,which suggested that sulfur accumulated in CTLs as sulfate form.Reduced sulfur compounds （organic sulfides,thiols,thioethers,sulfoxide and sulfonate） assimilation was sufficed to meet the nutrient requirement for growth at a balanced level around 526 mg/kg.The sulfate accumulation mainly caused by atmospheric sulfur pollution such as SO2 and airborne sulfate particulate instead of soil contamination.From urban to suburb place,sulfate in mature CTLs decreased as the atmospheric sulfur pollution reduced,but a dramatic increase presented near the seashore,where the marine sulfate emission and maritime activity pollution were significant.The sulfur concentration and speciation in mature CTLs effectively represented the long-term biological accumulation of atmospheric sulfur pollution in local environment.
文摘In first aid, traditional information interchange has numerous shortcomings. For example, delayed information and disorganized departmental communication cause patients to miss out on critical rescue time. Information technology is becoming more and more mature, and as a result, its use across numerous industries is now standard. China is still in the early stages of developing its integration of emergency medical services with modern information technology;despite our progress, there are still numerous obstacles and constraints to overcome. Our goal is to integrate information technology into every aspect of emergency patient care, offering robust assistance for both patient rescue and the efforts of medical personnel. Information may be communicated in a fast, multiple, and effective manner by utilizing modern information technology. This study aims to examine the current state of this field’s development, current issues, and the field’s future course of development.
基金This research was jointly funded by the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDA23100103)the 13th Five-year Informatization Plan of Chinese Academy of Sciences(No.XXH13505-07)State Key Laboratory of Resources and Environmental Information System(O88RA20CYA).
文摘With the development of earth observation technologies,the acquired remote sensing images are increasing dramatically,and a new era of big data in remote sensing is coming.How to effectively mine these massive volumes of remote sensing data are new challenges.Deep learning provides a new approach for analyzing these remote sensing data.As one of the deep learning models,convolutional neural networks(CNNs)can directly extract features from massive amounts of imagery data and is good at exploiting semantic features of imagery data.CNNs have achieved remarkable success in computer vision.In recent years,quite a few researchers have studied remote sensing image classification using CNNs,and CNNs can be applied to realize rapid,economical and accurate analysis and feature extraction from remote sensing data.This paper aims to provide a survey of the current state-of-the-art application of CNN-based deep learning in remote sensing image classification.We first briefly introduce the principles and characteristics of CNNs.We then survey developments and structural improvements on CNN models that make CNNs more suitable for remote sensing image classification,available datasets for remote sensing image classification,and data augmentation techniques.Then,three typical CNN application cases in remote sensing image classification:scene classification,object detection and object segmentation are presented.We also discuss the problems and challenges of CNN-based remote sensing image classification,and propose corresponding measures and suggestions.We hope that the survey can facilitate the advancement of remote sensing image classification research and help remote-sensing scientists to tackle classification tasks with the state-of-art deep learning algorithms and techniques.
基金This work was supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(XDA16040302,XDA01030505)the National Natural Science Foundation of China(81971336)+1 种基金Jiangsu Provincial Key Medical Center(YXZXB2016004)Jiangsu Provincial Obstetrics and Gynecology Innovation Center(CXZX202229)。
文摘Intrauterine adhesion is a major cause of female reproductive disorders.Although we and others uncontrolled pilot studies showed that treatment with autologous bone marrow stem cells made a few patients with severe intrauterine adhesion obtain live birth,no large sample randomized controlled studies on this therapeutic strategy in such patients have been reported so far.To verify if the therapy of autologous bone marrow stem cells-scaffold is superior to traditional treatment in moderate to severe intrauterine adhesion patients in increasing their ongoing pregnancy rate,we conducted this randomized controlled clinical trial.Totally 195 participants with moderate to severe intrauterine adhesion were screened and 152 of them were randomly assigned in a 1:1 ratio to either group with autologous bone marrow stem cells-scaffold plus Foley balloon catheter or group with only Foley balloon catheter(control group)from February 2016 to January 2020.The per-protocol analysis included 140 participants:72 in bone marrow stem cells-scaffold group and 68 in control group.The ongoing pregnancy occurred in 45/72(62.5%)participants in the bone marrow stem cells-scaffold group which was significantly higher than that in the control group(28/68,41.2%)(RR=1.52,95%CI 1.08–2.12,P=0.012).The situation was similar in live birth rate(bone marrow stem cells-scaffold group 56.9%(41/72)vs.control group 38.2%(26/68),RR=1.49,95%CI 1.04–2.14,P=0.027).Compared with control group,participants in bone marrow stem cells-scaffold group showed more menstrual blood volume in the 3rd and 6th cycles and maximal endometrial thickness in the 6th cycle after hysteroscopic adhesiolysis.The incidence of mild placenta accrete was increased in bone marrow stem cells-scaffold group and no severe adverse effects were observed.In conclusion,transplantation of bone marrow stem cells-scaffold into uterine cavities of the participants with moderate to severe intrauterine adhesion increased their ongoing pregnancy and live birth rates,and this therapy was relati
基金supported by the National Key Research and Development Program of China(No.2017YFA0604903)
文摘Tropical cyclones(TCs) cause catastrophic loss in many coastal areas of the world. TC wind hazard maps can play an important role in disaster management. A good representation of local factors reflecting the effects of spatially heterogeneous terrain and land cover is critical to evaluation of TC wind hazard. Very few studies, however,provide global wind hazard assessment results that consider detailed local effects. In this study, the wind fields of historical TCs were simulated with parametric models in which the planetary boundary layer models explicitly integrate local effects at 1 km resolution. The topographic effects for eight wind directions were quantified over four types of terrain(ground, escarpment, ridge, and valley),and the surface roughness lengths were estimated from a global land cover map. The missing TC parameters in the best track datasets were reconstructed with local regression models. Finally, an example of a wind hazard map in the form of wind speeds under a 100-year return period and corresponding uncertainties was created based on a statistical analysis of reconstructed historical wind fields over seven of the world's ocean basins.
文摘The 5-axis NC machining offers the potential of efficient and accuratemachining. However, the present CAM system for 5-axis control is still an unsolved problem due tointerference between tool and surrounding objects. A new method is presented. There are two steps inthis procedure. First, it detects the interference by calculating the shortest distance between thetool-axis and the surrounding surfaces. Then upon the maximum gouging, the interference-free toolposture for 5-axis NC cylindrical milling free-form surfaces is obtained by adjusting tool. Thevalidity of the proposed method has been confirmed by machining an impeller.
基金Six Talent Peaks Project in Jiangsu Province(WSN-141)Nanjing Youth Medical Innovation Personnel Training Project(QRX17014).
文摘To editor:Monochorionicity was traditionally considered indicative of monozygosity.However,recent years have witnessed the emergence of several noteworthy instances of monochorionic dizygotic(MCDZ)twins in clinical practice.In 2000,Viëtor et al.1 documented the initial established case of MCDZ twins.Subsequent studies have further documented this unconventional twinning phenomenon.2,3 The recognized complications associated with monochorionic monozygotic pregnancies,including twin-twin transfusion syndrome(TTTS),twin anemia–polycythemia sequence(TAPS),selective intrauterine growth restriction(sIUGR),congenital malformations,and intrauterine fetal death,could also manifest in MCDZ pregnancies.4,5 In this correspondence,we presented an extremely rare case of TTTS in a dizygotic monochorionic diamniotic twin gestation successfully treated with fetoscopic laser photocoagulation.The patients’permission to publish was obtained.
基金the National Natural Science Foundation of China (Grant No. 41971171)The National Social Science Foundation of China (Grant No. 21BYY098) for funding support
文摘The place and placeness are believed to be a crucial perspective for comprehending the transformative dynamics of tourist destinations in the context of globalization and the rapid development of the tourism industry.As the material carrier of language,linguistic landscape is an intermediary for people to endow emotions and personalities into the place,becoming an effective path for exploring the place-making in a certain area.Mogan Mountain is a famous national tourist resort,which is located in Mogan Mountain Town,Deqing County,Huzhou City,China.This is a good case area for studying the relationship between linguistic landscape and placemaking in tourist destinations.There are two theories that form the theoretical foundation of the study,namely the place and the geosemiotics.Firstly,the results showed the overall style of the linguistic landscape.Multilingual labelling(52.7%),official signs(55.3%),and standardized Chinese characters predominantly shaped the linguistic landscape,with English and other languages being complementary.Secondly,from the perspective of three dimensions of the geosemiotics framework,such as inscription,language preference,and placement position,we conduct a comprehensive semiotic analysis of the linguistic landscape,which encompasses diverse facets such as fonts,materials,shifts in state,text vectors,and symmetrical arrangements.Finally,we explore the influence of linguistic landscapes on the place-making of Mogan Mountain through the dimensions of location,locale,and sense of place.The information on linguistic landscapes indicates the geographical location.These linguistic landscapes play an important role in constructing the language order,nostalgic atmosphere,exotic atmosphere,and elegant and tasteful lifestyle of the public space in Mogan Mountain.Readers of linguistic landscapes,including tourists and residents,generate and identify with the unique sense of place in Mogan Mountain.These linguistic landscapes construct the destination placeness of Mogan Mountain that combines bot
基金This study was supported by National Natural Science Foundation of China(82260674 to Yong Rao,82160653 to Ling Huang)Fundamental Research Funds for Hainan University(KYQD(ZR)-21114 to Yong Rao,KYQD(ZR)-21089 to Ling Huang,China)+2 种基金Hainan Provincial Natural Science Foundation of China(822MS054 to Yong Rao)Natural Science Foundation of Guangdong Province(2021A1515010488 to Yong Rao,China)Central Public-interest Scientific Institution Basal Research Fund for CATAS-ITBB(1630052022016,1630052019011,China).
文摘Lipotoxicity is a pivotal factor that initiates and exacerbates liver injury and is involved in the development of metabolic-associated fatty liver disease(MAFLD).However,there are few reported lipotoxicity inhibitors.Here,we identified a natural anti-lipotoxicity candidate,HN-001,from the marine fungus Aspergillus sp.C1.HN-001 dose-and time-dependently reversed palmitic acid(PA)-induced hepatocyte death.This protection was associated with IRE-1a-mediated XBP-1 splicing inhibition,which resulted in suppression of XBP-1s nuclear translocation and transcriptional regulation.Knockdown of XBP-1s attenuated lipotoxicity,but no additional ameliorative effect of HN-001 on lipotoxicity was observed in XBP-1s knockdown hepatocytes.Notably,the ER stress and lipotoxicity amelioration was associated with PLA2.Both HN-001 and the PLA2 inhibitor MAFP inhibited PLA2 activity,reduced lysophosphatidylcholine(LPC)level,subsequently ameliorated lipotoxicity.In contrast,overexpression of PLA2 caused exacerbation of lipotoxicity and weakened the anti-lipotoxic effects of HN-001.Additionally,HN-001 treatment suppressed the downstream pro-apoptotic JNK pathway.In vivo,chronic administration of HN-001(i.p.)in mice alleviated all manifestations of MAFLD,including hepatic steatosis,liver injury,inflammation,and fibrogenesis.These effects were correlated with PLA2/IRE-1a/XBP-1s axis and JNK signaling suppression.These data indicate that HN-001 has therapeutic potential for MAFLD because it suppresses lipotoxicity,and provide a natural structural basis for developing anti-MAFLD candidates.
文摘Background: Hepatitis B is an infectious disease, which is a main way of vertical transmission of infectious HBV between mother and infant. Hepatitis B virus infection is always a hot topic of social concern, especially in China. The paper studies hepatitis B virus in maternal blood, breast milk, saliva of hepatitis B virus infection model (HBV-M) in Hefei city, Anhui province, PRC. HBV-DNA load and related data in Hefei city are used for risk assessment of the transmission of hepatitis B virus to provide evidence for evidence-based medicine and scientific guidance of infant feeding patterns. Methods: On the principle of informed consent, inpatient hepatitis B maternal blood 695, breast milk, saliva 614,169 copies were used as the object of analysis, using the ELISA method for the detection of HBV-M, using real-time fluorescence quantitative PCR detection of HBV-DNA load. We analyze HBsAg in saliva, milk, the positive rate of HBV-DNA and HBV-M in serum, saliva, milk, and explore the positive rate of HBV-DNA and serum HBV-DNA load correlation. Results: At the age of 18 - 44 years old perinatal women, HBV-DNA positive rates of maternal serum, breast milk, saliva were 157 cases in A group HBsAg, HBeAg positive: 99.36%, 88.06%, 96.77%;in 312 cases in group B, HBeAb HBsAg, HBcAb positive: 17.63%, 2.93%, 54.67%;69 cases in C group HBsAg, HBcAb positive: 63.77%, 27.27%, 28.57%;D group of 71 patients with simple HBcAb positive: 12.68%, 3.13%, 0%;E group and 86 cases in control group HBVM: 1.16%, 0%, 0%. According to the serum and milk testing of Group A and Group B, HBV-DNA chi-square is χ2 = 237.45, P;there is a significant difference in serum and saliva;HBV-DNA chi-square χ2 = 289.49, P < 0.01, the difference has statistical significance. Conclusion: 1) HBV-DNA load high maternal blood, breast milk, saliva are potentially persistent hepatitis B virus infection risk, especially infectious blood. 2) Of maternal milk, saliva and blood HBV-DNA HBV-DNA load were positively correlated (r = 0.96;P ing, breast milk and saliv
文摘Background.Hundreds of coronavirus disease 2019(COVID-19)clinical practice guidelines(CPGs)and expert consensus statements have been developed and published since the outbreak of the epidemic.However,these CPGs are of widely variable quality.So,this review is aimed at systematically evaluating the methodological and reporting qualities of COVID-19 CPGs,exploring factors that may influence their quality,and analyzing the change of recommendations in CPGs with evidence published.Methods.We searched five electronic databases and five websites from 1 January to 31 December 2020 to retrieve all COVID-19 CPGs.The assessment of the methodological and reporting qualities of CPGs was performed using the AGREE II instrument and RIGHT checklist.Recommendations and evidence used to make recommendations in the CPGs regarding some treatments for COVID-19(remdesivir,glucocorticoids,hydroxychloroquine/chloroquine,interferon,and lopinavir-ritonavir)were also systematically assessed.And the statistical inference was performed to identify factors associated with the quality of CPGs.Results.We included a total of 92 COVID-19 CPGs developed by 19 countries.Overall,the RIGHT checklist reporting rate of COVID-19 CPGs was 33.0%,and the AGREE II domain score was 30.4%.The overall methodological and reporting qualities of COVID-19 CPGs gradually improved during the year 2020.Factors associated with high methodological and reporting qualities included the evidence-based development process,management of conflicts of interest,and use of established rating systems to assess the quality of evidence and strength of recommendations.The recommendations of only seven(7.6%)CPGs were informed by a systematic review of evidence,and these seven CPGs have relatively high methodological and reporting qualities,in which six of them fully meet the Institute of Medicine(IOM)criteria of guidelines.Besides,a rapid advice CPG developed by the World Health Organization(WHO)of the seven CPGs got the highest overall scores in methodological(72.8%)and reporting
