BACKGROUND: A noninvasive, safe, and economic imaging technique is required to identify epileptogenic lesions in the brain. PURPOSE: Our aim was to perform a meta-analysis evaluating the accuracy of arterial spin-labeling in localizing the epileptic focus in the brain and the changes in the blood perfusion in these regions.DATA SOURCES: Our sources were the PubMed and EMBASE data bases. STUDY SELECTION:English language studies that assessed the diagnostic accuracy of arterial spin-labeling for detecting the epileptogenic zone up to July 2019 were included. DATA ANALYSIS:The symptomatogenic foci of seizures in the brain were determined and used as the references. The relevant studies were evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The outcomes were evaluated using the pooled sensitivity, pooled specificity, pooled accuracy, diagnostic odds ratio, area under the summary receiver operating characteristic curve, and likelihood ratio.DATA SYNTHESIS: Six studies that included 174 patients qualified for this meta-analysis. The pooled sensitivity, pooled specificity, and area under the summary receiver operating characteristic curve were 0.74 (95% CI, 0.65-0.82), 0.35 (95% CI, 0.03-0.90), and 0.73 (95% CI, 0.69-0.76), respectively. The accuracy of arterial spin-labeling for localizing the epileptic focus was 0.88 (accuracy in arterial spin-labeling/all perfusion changes in arterial spin-labeling) in cases of a positive arterial spin-labeling result. The epileptogenic zone exhibited hyperperfusion or hypoperfusion. LIMITATIONS:Only a few studies were enrolled due to the strict inclusion criteria.CONCLUSIONS: Arterial spin-labeling can be used for assessing, monitoring, and reviewing, postoperatively, patients with epilepsy. Blood perfusion changes in the brain may be closely related to the seizure time and pattern.ABBREVIATIONS: ASL ¼ arterial spin-labeling; QUADAS-2 ¼ Quality Assessment of Diagnostic Accuracy Studies-2; SOZ ¼ seizure onset zone E pilepsy is the most common chronic neurologic disease, characterized by the occurrence of repeat seizures. Several diseases, including brain tumors, hypoxia-related brain diseases, and cerebral cortical dysplasia, can cause epilepsy. Electroencephalography, which identifies the epileptic discharges in the brain, was the earliest method applied for the diagnosis and localization of epileptic disorders. 1,2 The development of imaging technology in recent years has

Background: Jiedu Huoxue decoction (JDHXD) can be effectively alleviated chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) patients’ pelvic pain, lower urinary tract symptoms, and other discomforts. But its mechanism of action involving multi-component, multi-target and multi-pathway is unclear. Objectives: Integrated strategy of network pharmacological prediction, molecular docking, and experimental validation elucidate potential mechanism of JDHXD in treating CP/CPPS.Study design and methods: Two traditional Chinese medicine systems pharmacology databases and three disease related databases were applied to identify the herbs active components and the putative targets of CP/CPPS. Using the Cytoscape to constructed and analysis the herbs-compounds-targets network. Subsequently, the protein-protein interaction (PPI) was investigated by STRING database. Using DAVID databases to perform Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. The binding of core active compounds with hub targets were assessed by molecular docking. Furthermore, in vivo efficacy of JDHXD was validated in CP/CPPS rat model. The key signal pathway of network pharmacological prediction would be validated by animal experiment.Result: In total, 149 active compounds of 10 Chinese herbals and 909 potential CP/CPPS-related targets were identified. Network pharmacology revealed 161 common targets between 136 potential active compounds and CP/CPPS. After topology analysis, 5 core active compounds and 18 hub targets have been screened. PPI analysis obtained 18 hub targets. Based on enrichment analysis of 161 targets, we obtained GO function 277 items and KEGG pathway 114 items. Molecular docking verification shown that the top 5 hub targets were well binding with 5 core active compounds. Animal experiment shown that JDHXD had protective effect on CP/CPPS. JDHXD can significantly down-regulated the key gene expression (JNK, ERK1/2 and P38) and inhibit phosphorylation of ERK1/2，JNK and P38 in the MAPK signaling pathway.Conclusions: This study demonstrated potential mechanism of JDHXD in treating CP/CPPS. Network pharmacological, molecular docking and experimental verification revealed its multi-component, multi-target and multi-pathway treatment characteristics. The reliability and effectiveness of those method are very helpful to explore the material basis and mechanism of traditional Chinese medicine.

Background: Venous leg ulcers (VLUs) are the most common ulcer on the lower extremity, with 4% of patients over the age of 65 suffering from VLUs worldwide. As a recurrent, chronic, disabling disease, VLUs are associated with prolonged disability, substantial socioeconomic impact, and significant psychosocial morbidity. At present, Skin grating is one of the most effective treatments for non-healing ulcers. However, there are still no new studies based on the latest research and new research methods to evaluate and compare the effect of different types of skin grafts for treating venous leg ulcers. Therefore, a Bayesian network meta-analysis (NMA) will be conducted to systematically assess skin grafting efficacy for VLUs. Methods: We will include randomized controlled trials (RCTs) involving patients with VLUs treated by skin grafts. Electronic databases and clinical trials registries will be searched from their inception until June 2021, without language or publication restrictions on status. The search strategy mainly includes Medical Subject Headings (MeSH) and free-text terms. Two review authors will independently perform data extraction and assessment of study quality. And We will use Bayesian NMA to evaluate all available evidence in STATA 14.0 and WinBUGS software. Results: This protocol will use Bayesian NMA to assess the effectiveness of different types of skin grafting for treating venous leg ulcers. Conclusion: This study aims to synthesize the available evidence from RCTs in a network meta-analysis to summarize the best research available and provide consistency among treatment protocols given to patients, resulting in improved efficacy and the quality of care and reduced cost.

Background Attention provides the foundation for cognitions, which was shown to be affected by microwave (MW) radiation. With the ubiquitous of microwaves, public concerns regarding the impact of MW radiation on attention has hence been increased. Our study aims to investigate the potential effect and mechanism of acute microwave exposure on attention. Results We identified obvious impairment of attention in mice by the five-choice serial reaction time (5-CSRT) task. Proteomic analysis of the cerebrospinal fluid (CSF) revealed neuroinflammation and microglial activation potentially due to acute MW exposure. Moreover, biochemical analysis further confirmed microglial activation in the prefrontal cortex (PFC) of mice subjected to acute MW exposure. Finally, minocycline, a commercially available anti-inflammatory compound, attenuated neuroinflammation, inhibited the upregulation of N-methyl-D-aspartic acid receptor (NMDAR) including NR2A and NR2B, and also accelerated the attentional recovery after MW exposure. Conclusions We believe that microglial activation and NMDAR upregulation likely contribute to inattention induced by acute MW exposure, and we found that minocycline may be effective in preventing such process.